PMID- 6479992 TI - Paternity index and attribution of paternity. AB - If blood typing and similar tests do not exclude a putative father in a paternity case, his probability of paternity can be assessed with the formulae of Essen Moller[1938]. Gurtler[1956] uses an alternative route, viz. the paternity index, to reach identical end results. Majumder and Nei [1983] claim that the methods are not powerful enough. This opinion can always be defended, but may have been enhanced by their inadequate computer model. They also contend that current methods may more often than not lead to false attributions of paternity. This is outright erroneous. PMID- 6479993 TI - On the positive identification of paternity. AB - Valentin's criticism of Majumder and Nei's [1983] paper is apparently based on his misunderstanding of the latter authors' attitude and approach to paternity test problems. PMID- 6479994 TI - On the positive identification of paternity. AB - It is attempted to meet some of the critical points raised by Valentin [1984] in a comment on a recent paper by Majumder and Nei [1983] which discussed the efficiency of the statistical methods for positive identification of fathers in paternity cases. PMID- 6479995 TI - A pair of siblings with diastrophic dysplasia and E trisomy mosaicism. AB - A mixture of clinical signs seen in diastrophic dysplasia as well as in trisomy 18 was found in two siblings with an E trisomy mosaicism. The E trisomy mosaicism was present in blood and skin during the first years of life, but disappeared later on. PMID- 6479996 TI - Polymorphism of red cell S-formylglutathione hydrolase in a Finnish population. AB - Red cell hemolysates from a Finnish population sample (n = 242) were fractionated by isoelectric focusing on polyacrylamide gel, and S-formylglutathione hydrolase (EC 3.1.2.12) was located by activity staining. Polymorphism, which is probably genetically determined, was found. The samples from most persons studied gave one major enzyme band, whereas for 6 persons three enzyme bands were found. The enzyme is a dimer, and the polymorphism observed appears to result from two alleles, FGH1 and FGH2 at an autosomal locus. The frequency found for FGH1 was 0.988. PMID- 6479997 TI - Commingling in the distributions of fat-related measures in Punjabi families. AB - The distribution of anthropometric measurements related to fatness levels is examined to determine if skewness alone accounts for the nonnormality of such measures. A mixture of two normal distributions or a single skewed distribution fit the data significantly better than a single normal in all cases. For maximum hip width, knee diameter, and weight, two skewed distributions give a better fit than one skewed distribution, rejecting the null hypothesis of a single distribution even when skewness is considered. There is evidence for three skewed component distributions for biceps skinfold. Abdomen circumference, upper arm circumference, triceps skinfold, and calf skinfold are best approximated by a one component log-normal distribution. Children and parents show slightly different patterns in skewness and kurtosis when considered separately, but differences between them do not account for the commingling found in the combined distributions. PMID- 6479998 TI - Genetic polymorphisms in the Kuwaiti Arabs. AB - Blood samples were collected from 162 Kuwaiti Arabs. These samples were typed for the ABO, MNSs, Rh, Kell and Duffy blood group systems, serum protein haptoglobins, the red cell isoenzymes acid phosphatase, phosphoglucomutase (locus 1), adenylate kinase, 6-phosphogluconate dehydrogenase, and the lactate and malate dehydrogenase variants. Comparisons were made with serological findings for other Arab populations in the Arabian peninsula. PMID- 6479999 TI - Genetic relationship between Indian tribes and Australian Aboriginals. AB - Using gene frequency data of ten blood group and protein loci (A1A2BO, MNSs, Rh, P, Lu, Fy, Hp, Tf, Hb beta and Gm) the genetic relationships of three tribes, namely, the Toda, Irula, Kurumba in south India and one tribe, namely, the Veddah in Sri Lanka with the Aboriginals in Malay, New Guinea and Australia were studied by genetic distance analysis. The tribes in south India and Sri Lanka are genetically closer to one another than to the Aboriginals in southeast Asia and Oceania. Despite their morphological similarity there is no genetic evidence to suggest that the Indian tribes and Australian Aboriginals are biologically related. PMID- 6480000 TI - A surveillance system for metabolic disorders in Japan. AB - Statistical procedures based on a Poisson hypothesis for surveying serial occurrences of incidence were developed. Three methods, the z-test, the cusum technique and the sequential test were applied in a study of a nationwide screening system on newborns for hereditary metabolic disorders in Japan. It was found that the statistical tests well detected human errors involved in data processing. PMID- 6480001 TI - Serum cholinesterase activity in population samples from Iraq. AB - Serum cholinesterase activity has been determined from normal subjects in a sample of the Iraqi population. The enzyme activity was distributed over a comparatively wide range. There was a highly significant difference between males and females with respect to the enzyme level, although the values were relatively higher than those reported elsewhere. The enzyme activity showed no relationship with age and blood group in both sexes. PMID- 6480002 TI - Absence of genetic polymorphism of human plasma fibronectin studied by immunoelectrophoresis. AB - Plasma fibronectin from 500 blood donors was studied by immunoelectrophoresis. No variants were found. Plasma fibronectin does not appear to be electrophoretically polymorphic in humans. PMID- 6480003 TI - Aspartame: succession of false alarms. PMID- 6480004 TI - Inherent limitations of the yellow card system for the detection of unsuspected adverse drug reactions. AB - The number of cases of an adverse reaction which could be seen by individual doctors was investigated taking realistic values for the frequency of drug prescribing and a range of frequencies of adverse drug reactions. The results indicated that, for almost all drugs, general practitioners (GPs) will seldom see other than single cases of an adverse reaction. It is argued that doctors will be unlikely to recognize an adverse reaction from a single case (unless it presented with some striking clinical features) so that potential new adverse reactions will rarely be reported by GPs under the Yellow Card scheme. A similar analysis for hospital doctors indicated that clinicians working in some specialties, may have a greater chance of seeing more than one case of an adverse reaction. A review of the identification of several important adverse reactions revealed that all the reports from British doctors were submitted by clinicians with hospital appointments. This study suggests that the major part of the operation of the Yellow Card system will contribute little to the identification of adverse reactions and that its organization and activities need to be reassessed. A modified system designed to encourage reporting by hospital clinicians could be of greater value. PMID- 6480005 TI - Glutathione and caffeine antagonize the sperm-immobilizing effect of a vaginal contraceptive. AB - The concentration-dependent inhibition of Neosampoon, a vaginal contraceptive, on ejaculated human sperm motility was studied with a transmembrane migration method. Caffeine (5mM), glutathione (5mM) and glutathione (15mM) all reactivated the motility of Neosampoon-immobilized sperm. Caffeine (5mM) was more potent than glutathione in antagonizing Neosampoon; there was no difference between the potency of 5mM- and 15mM-glutathione. Human sperm motility could be a model for studying the interaction of membrane-active drugs, including the protective effect of glutathione against membrane-disrupting agents. PMID- 6480006 TI - Temporal stability of blood lead concentrations in adults exposed only to environmental lead. AB - The temporal stability of blood lead concentrations of 21 healthy adults (14 men and 7 women) exposed only to environmental lead was assessed by analysis of 253 blood specimens collected serially over periods from 7 to 11 months. Improved analytical sensitivity allowed detection of small (less than 1.0 microgram/100 ml) changes in blood lead concentrations and both within- and between-run analytical errors were minimized by a strict internal quality control protocol. The women had lower blood lead concentrations (mean 8.5, range 7.4-10.8 micrograms/100 ml) than did the men (mean 12.2, range 8.6-15.8 micrograms/100 ml). These are within the expected ranges for non-occupationally exposed persons. Blood lead concentrations in the serial specimens from both men and women changed very little over the study period, with standard deviations of less than 0.5 micrograms/100 ml for the majority of individual mean concentrations: for all except two subjects the standard deviations were less than 0.8 micrograms/100 ml. Two subjects showed significant changes in blood lead concentrations during the study (standard deviations of mean greater than 1.0 micrograms/100 ml). A temporary increase in oral lead intake was identified for one of these subjects. In the absence of substantial changes in lead exposure blood lead levels in adults are remarkably stable and for their environmental monitoring a single blood lead concentration is an excellent biological indicator. PMID- 6480008 TI - Proceedings of a symposium on distalgesic; safety and efficacy. London, 1984. PMID- 6480007 TI - Acute renal failure after intoxication with Cortinarius mushrooms. AB - Four previously healthy young adults developed the clinically recognised features of Cortinarius poisoning 3-4 days after intoxication. Two patients treated with haemoperfusion and haemodialysis 5 days after ingestion of the mushrooms regained normal kidney function. Two patients treated late with single haemoperfusion or dialysis had irreversible renal failure. The clinical results and our experimental studies on the toxic principle of the mushrooms indicate that early treatment with HP and HD may be important in order to avoid the development of irreversible renal failure. PMID- 6480009 TI - Measurement of dextropropoxyphene and nordextropropoxyphene in biological fluids. AB - Detection, identification and measurement of dextropropoxyphene and its principal plasma metabolite, nordextropropoxyphene, can be important in the diagnosis of acute poisoning. A combination of thin-layer chromatography (TLC) and gas-liquid chromatography (GLC) of solvent or solid-phase extracts of urine or gastric contents usually serves to detect these and many other compounds, and an homogeneous enzyme immunoassay (EMIT-DAU) is also available for dextropropoxyphene. Measurement of dextropropoxyphene by GLC is complicated by the instability of this compound under certain conditions. However, a relatively polar stationary phase such as Carbowax 20M together with nitrogen-selective detection can give adequate sensitivity and selectivity for the measurement of the plasma concentrations attained after overdosage. High-performance liquid chromatography (HPLC) has not been widely applied in the assay of dextropropoxyphene and nordextropropoxyphene since these compounds have no pronounced ultraviolet absorption or fluorescence spectra. However, electrochemical oxidation detection can be used with a silica column/non-aqueous ionic eluent system. This gives good selectivity and sensitivity, and can facilitate the measurement of both compounds in plasma specimens after single oral dosage. PMID- 6480010 TI - International regulatory status of dextropropoxyphene compounds. PMID- 6480011 TI - Self-poisoning with dextropropoxyphene and dextropropoxyphene compounds: the USA experience. AB - This survey continues and expands earlier studies (Finkle et al., 1976a, b). A total of 27 medical examiner or coroner offices across the USA and Canada were visited. The combined jurisdictional population of these 27 sites is 64.8 million people: 56.5 million people in the USA (27% of the US population) and 8.3 million in Canada (Ontario). Since 1969 through mid-1983, a total of 4412 cases provided information sufficient for inclusion in this study. In each of the cases the presence of propoxyphene, and often its major metabolite, in the blood or tissues of the deceased was confirmed by toxicological analysis at the survey site. The following is a summary of the survey findings: The incidence of propoxyphene associated deaths reached a peak in 1977, then declined by 22.2% from 1977 to 1978 and by 33.3% from 1978 to 1979, and by a further 10-18% since then. This continuing decline has occurred despite increased interest in propoxyphene misuse and the existence of improved analytical methods for the detection of propoxyphene and its metabolites. The decline is greater than can be accounted for by the decline in propoxyphene prescribing. The most common manner of death was suicide, accounting for about 45% of the cases; it can be safely assumed that the suicides were under-reported. A large majority of the suicides involving propoxyphene were multiple-drug intoxications, including alcohol. Propoxyphene alone was noted in about one-sixth of the suicides. These findings confirm those of the earlier studies, i.e., that a high proportion of the deaths associated with propoxyphene are suicides, and, in most cases, the deceased were victims of multiple-drug toxicity. More than 90% of cases involved persons between the ages of 20 and 40 years. There were very few instances of paediatric, adolescent or older adult deaths associated with propoxyphene. There is no evidence to support the view that the deceased were part of the street drug-abuse population. A history of heroin abuse appeared in less than 5% of the cases. Even fewer people had been known to have abused propoxyphene before their deaths, but 18% of the population had been known to 'self-medicate', using multiple drugs without appropriate medical supervision. The distribution of males to females approximated that of the US population.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6480012 TI - Deaths from paracetamol and dextropropoxyphene (Distalgesic) poisoning in England and Wales in 1979. AB - Paracetamol and dextropropoxyphene were implicated on clinical and analytical grounds in 237 poison deaths in England and Wales in 1979. In addition to paracetamol, dextropropoxyphene and ethanol, other agents were detected in 61 of these cases (26%). Analytical evidence suggests that very substantial overdoses of paracetamol and dextropropoxyphene were ingested in the majority of cases; their mean plasma concentrations in those ingesting no other agents were 252 and 8.64 mg/l respectively. Significant quantities of ethanol were ingested in 133 of 237 cases (56%). The mean ethanol concentration in those in whom quantitative estimations of paracetamol, dextropropoxyphene and ethanol were undertaken and who had not ingested other drugs, was 1588 mg/l. There was no analytical support for the diagnosis of paracetamol and dextropropoxyphene poisoning in 74 of 305 cases (24%) of H.M. Coroners' returns to the Office of Population, Censuses and Surveys for the period 1 January-31 December 1979. In addition, dextropropoxyphene was detected analytically in six cases classified as being due to paracetamol alone. PMID- 6480013 TI - Fatal self-poisoning in the UK and the paracetamol/dextropropoxyphene combination. AB - Coroners' files have been examined to ascertain the numbers of deaths involving self-poisoning with analgesic drugs with specific reference to the paracetamol/dextropropoxyphene combination. The period of study was 1976-1980. This report concentrates on cases in England, although reference is made to similar deaths occurring in Scotland and Northern Ireland. Data have been collected extensively on a wide range of issues concerning fatal self-poisonings mainly by visiting coroners' offices in England to make direct investigation of records. The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated. The number of cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated. Involvement of people aged 30 years and below comprises 32% of all cases. 'Gesture' overdoses comprise an estimated 14% of all cases in England. An analysis of fatalities from cases where quantities in post-mortem blood of dextropropoxyphene less than 1 microgram/ml and paracetamol less than 50 micrograms/ml are found and of cases where death occurs within 2 h of ingestion of the overdose has been carried out. The results are inconclusive. In most cases alcohol and/or other drugs are found to be involved. Critical inspection of coroners' files shows relatively few of these cases where the combination product is ingested on its own. There is wide variability in the data available in coroners' files. In many cases data of value to this research are not recorded. Medical history and quantitative levels of drugs suspected (particularly dextropropoxyphene) are particular examples of factors which may not be recorded. Office of Population, Censuses and Surveys (OPCS) mortality data are based on certified causes of death. Because of the underestimate of the involvement of this combination product and the under reporting of other drug and/or alcohol ingestion with the combination, care must be exercised in quoting or drawing conclusions from OPCS statistics. PMID- 6480014 TI - Dextropropoxyphene deaths: coroner's report. AB - Dextropropoxyphene has been increasingly prescribed as an analgesic in the UK, chiefly in the form of Distalgesic (dextropropoxyphene hydrochloride 32.5 mg and paracetamol 325 mg per tablet). After reports of sudden deaths from the misuse of this combination, prescribing is declining. Distalgesic remains the most common cause of fatal drug overdose in the West Midlands, UK. The 1983 Birmingham inquests are compared with those from the year 1976 to 1979. In comparison with other drug fatalities, death characteristically occurs rapidly, as little as 1 h after ingestion and usually before hospital treatment can be initiated. Toxicity is increased by alcohol which is also extensively abused. The fatal dose may be as small as 15 tablets or possibly less. Many victims are young and some never intended to take their life. Convulsions and respiratory failure precede death. The elderly and respiratory cripples may be more vulnerable to accidental death. Evidence suggests a liability to dependence or even addiction with dextropropoxyphene. PMID- 6480015 TI - Pharmacokinetics of propoxyphene. PMID- 6480016 TI - Pharmacokinetics of dextropropoxyphene and nordextropropoxyphene in elderly hospital patients after single and multiple doses of distalgesic. Preliminary analysis of results. AB - The plasma elimination half-life of dextropropoxyphene and its metabolite nordextropropoxyphene was investigated in seven elderly hospital patients after the administration of both single and multiple doses of Distalgesic. The mean elimination half-life of dextropropoxyphene after multiple dosing was 35.7 h (range 24.0-50.6 h) and the mean half-life of nordextropropoxyphene was 53.3 h (range 25.1-76.3 h). The half-lives of both dextropropoxyphene and nordextropropoxyphene are much longer than those reported by other investigators in younger subjects. PMID- 6480017 TI - Severe acute drug overdose treated in ICU. PMID- 6480018 TI - Haemodynamic, electrocardiographic and cardiometabolic changes after overdose of propoxyphene. An experimental study in pentobarbitone-anaesthetized pigs. PMID- 6480019 TI - Epidemiology of analgesic overdose in England and Wales. AB - The number of deaths from acute poisoning in England and Wales has remained constant at approximately 4000 per annum for the last 10 years despite major changes in the agents responsible. Deaths due to carbon monoxide and barbiturate and non-barbiturate hypnotics have fallen, while those due to psychotropic and analgesic drugs have risen. The number of hospital admissions in England and Wales due to analgesics taken in overdose has risen from 15 940 in 1968 to 24 930 in 1980, with aspirin and paracetamol being the preparations most commonly ingested. Currently, the mortality from salicylate intoxication is falling while that due to paracetamol is rising. In 1980, the Office of Population Censuses and Surveys recorded 790 deaths from analgesic poisoning, of which 181 were due to salicylates and 152 to paracetamol alone. A further 269 deaths were attributed to paracetamol and dextropropoxyphene, and an additional 132 deaths were thought to be due to paracetamol in combination with other drugs. An important factor in the changing mortality from salicylate and paracetamol poisoning is the trend observed in the sales and usage of these agents. Since 1979, the number of analgesic tablets containing aspirin sold in the UK (except Northern Ireland), excluding hospital use, has fallen by 326 X 10(6), while sales of those containing paracetamol have increased by 395 X 10(6) tablets. PMID- 6480020 TI - Clinical features and management of Distalgesic overdose. PMID- 6480021 TI - Dextropropoxyphene poisoning: problems with interpretation of analytical data. AB - Difficulties in the estimation and interpretation of dextropropoxyphene and norpropoxyphene analyses have added to the controversy concerning the toxicity of these compounds. Poor performance in external proficiency assessment trials reflects the unsatisfactory state of many dextropropoxyphene and norpropoxyphene analyses in general use. There is substantial overlap between blood concentrations of dextropropoxyphene and norpropoxyphene encountered in chronic therapeutic dose and those associated with acute toxicity. As dextropropoxyphene and norpropoxyphene are often taken in overdose with other drugs, their blood concentrations must be interpreted in the context of careful identification and quantitation of such agents. The present availability of accurate methods for measurement of parent drug and metabolite should now make anecdotal reports unsupported by analytical data entirely superfluous. PMID- 6480022 TI - 3AE8: monoclonal antibody defining inflammatory macrophages in three species. AB - A mouse monoclonal antibody (MAb 3AE8) of the IgG1 isotype was prepared against rabbit splenocytes and was found by indirect immunofluorescence and direct binding assays to react, in the rabbit, primarily with oil-induced peritoneal exudate macrophages (PEM phi). This MAb did not bind to rabbit T cells, B cells, polymorphonuclear leukocytes, or resident alveolar or peritoneal M phi but it did bind to a subpopulation of rabbit splenocytes with surface characteristics of null cells. The antibody also recognized mouse and rat PEM phi as well as the murine M phi cell lines P388D1 and IC-21. Consistent with findings in the rabbit, it did not bind to M phi obtained from the peritoneal cavities of rats or mice. The addition of MAb 3AE8 to mouse PEM phi caused a marked enhancement in the phagocytic uptake of erythrocyte target cells sensitized with a mouse antierythrocyte antiserum. PMID- 6480023 TI - Specific bovine monoclonal antibody produced by a re-fused mouse/calf hybridoma. AB - Hybridomas made by fusing NSO (subline NSI Ag 4-1) mouse myeloma cells with lymph node cells from a calf immunized with sheep red blood cells failed to maintain antibody secretion in culture. However, when two of these hybridomas were selected in 8-azaguanine and then re-fused with immunized calf lymph node cells, several lines were obtained that secreted bovine Ig. One cloned line, producing bovine IgG1 (strongly lytic in the presence of rabbit complement and presumed to be an anti-Forssman) was maintained in culture for five months. Cytogenetic studies confirmed that the mouse/calf hybridomas lost bovine chromosomes as they proliferated, but that re-fusion increased the bovine complement from a mean of 5 (2 n) to 11 (2 n) bovine chromosomes per cell. It is proposed that the selected hybridoma lines may be suitable fusion partners for the production of further monoclonal bovine antibodies. PMID- 6480024 TI - Production and characterization of monoclonal antibody to gentamicin. AB - Splenocytes from BALB/c mice immunized with a gentamicin-hemocyanin conjugate were fused with X63-Ag8.653 murine myeloma cells to produce hybridomas that secreted monoclonal antibody to gentamicin. Sixteen positive clones were obtained. The monoclonal antibody chosen for a gentamicin immunoassay has been characterized with respect to class, subclass, type of light chain, electrophoretic homogeneity, and binding affinity. Gentamicin monoclonal antibody purified from mouse ascites fluid was analyzed by immunoelectrophoresis, double immunodiffusion, enzyme-linked immunosorbent assay (ELISA), and polyacrylamide gel electrophoresis (PAGE). The results show that the antibody is an IgG2a (kappa). Two bands were detected when the purified antibody was electrophoresed on polyacrylamide gels: a major band and a less mobile minor component (5.6% of the major band). Both were IgG2a (kappa). The major band contained antibody which bound 2.1 moles of the substrate-labeled gentamicin derivative, beta-galactosyl umbelliferone sisomicin, per mole of IgG, whereas one mole of the minor band bound only 0.095 moles of the substrate-labeled conjugate. The antibody has an affinity constant of 1.22 X 10(10) M-1. PMID- 6480025 TI - Production of human monoclonal antibody in mouse ascites. AB - Human B-cell hybridomas were grown in nude mouse ascites. The growth of cells in ascites requires prior subcutaneous (SC) adaptation, but the amount of antibody harvested is 100-fold that produced in in vitro culture. The relative merits of in vitro versus in vivo production of human monoclonal antibodies are discussed. PMID- 6480026 TI - [Antimycotic chemotherapy in weakened resistance]. AB - Antifungal chemotherapy in weakened resistance is restricted to the following three substances: amphotericin B, 5-fluorocytosine and the azo dyes. The paper only discusses the therapy of indigenous iatrogenic fungal infections due to mycelial fungi (molds) and yeasts. The pathogenesis must be investigated in every case, since a healthy individual does not contract such a fungal infection. Prophylaxis would be more important than treatment of such complications. At the end of the paper, the therapy is summarized in a table. It is clearly seen from the table that the optimal modern therapy of systemic mycoses is a combination of 5-fluorocytosine in a normal dosage and amphotericin B at reduced dosage. PMID- 6480027 TI - [Granulocyte transfusion as a part of compensation for a biological defect]. AB - As compared to the widespread application of erythrocyte- and platelet transfusion, granulocyte substitution is still not without difficulties. In spite of the introduction of automated separation systems, the procurement of adequate numbers of granulocytes is not easy, mainly for numerical-technical reasons. Also, the need for an effective organizational background and a close functional connection of transfusion medicine and oncology are not appropriately observed. Whereas the results of studies investigating the prophylactic value of granulocyte transfusions remained negative, mainly due to an inadequate granulocyte dosage, the importance of earlier trials, demonstrating the therapeutic efficacy remains without objection, as subsequent studies also suffer from the transfusion of cells too low for clinical requirements. Granulocyte substitution is only one aspect of the biological defect compensation in the immunocompromised host. In spite of a reduced frequency of applications and the introduction of newer therapeutic developments, granulocyte transfusion, if sufficient cell numbers are applied, may well play a valuable role within the concept of biological defect compensation for the control of septicemia. PMID- 6480028 TI - [Anaerobic bacterial meningitis with multiple brain abscesses]. AB - The improvement of bacteriological techniques for isolation and identification of anaerobes has led to an increased interest in anaerobic infections. However, anaerobes have only rarely been found in cases of purulent meningitis, representing less than 1 percent of all isolated pathogens. We observed anaerobic meningitis in a patient suffering from multiple lung abscesses from which anaerobic bacteria spread to the brain, causing formation of anaerobic brain abscesses and consecutive meningitis. Microbiological examinations for anaerobes should be performed in those cases of meningitis in which purulent infections of other organs with known or suspected anaerobic etiology are present or in which a traumatic lesion of the subarachnoid space has preceded the development of meningitis. PMID- 6480029 TI - Gene and haplotype frequencies of the fourth component of complement (C4) in type 1 diabetics and normal controls. AB - C4 gene and haplotype frequencies were calculated from phenotype data of 380 unrelated Caucasian patients with insulin dependent (type 1) diabetes mellitus and were compared with analogous frequencies of 382 unrelated healthy Caucasian individuals. In diabetics, a significantly increased frequency of the rare allele C4B 3 (p less than 10(-7] and of the silent alleles C4A Q0 (p less than 10(-7] and B Q0 (p less than 0.002) was observed. Accordingly, insulin dependent diabetes is associated with partial C4 deficiency, which may contribute to the pathogenesis of the disease. PMID- 6480030 TI - Antigenicity of proteins from cultured synovial fibroblasts. AB - We were able to characterize about 25 antigenic proteins of cultured synovial fibroblasts with apparent molecular weights of 15-230 kd by SDS-electrophoresis and immunoblotting using guinea pig antiserum. Some of these proteins were bovine serum-derived, adsorbed onto fibroblasts from culture medium. Both rheumatoid and normal sera contained natural antibodies reacting with synovial fibroblast as well as bovine serum antigens when studied with immunoblotting. The amounts of antibodies were quantitated with enzyme immunoassay, measuring IgG and IgA class antibodies against plasma membrane preparations of rheumatoid and normal synovial fibroblasts. No rheumatoid arthritis-related changes were detected in synovial fibroblast protein antigens or antibodies against them in rheumatoid patient specimens. PMID- 6480031 TI - Some particularities of human skin and the skin of nonhuman primates. PMID- 6480032 TI - [Dysmetabolic cutaneous microangiopathies. Histochemical and histoimmunological characteristics]. PMID- 6480033 TI - [Ultrastructural changes in cutaneous capillaries in diabetes and porphyria cutanea tarda]. PMID- 6480034 TI - [Cutaneous arteriosclerotic microangiopathy]. PMID- 6480035 TI - [Cutaneous glucose in healthy and diabetic subjects]. PMID- 6480036 TI - [Ballistometric study on diabetic skin]. PMID- 6480037 TI - [Telethermography with a cryostimulation technic in the study of microcirculation in diabetic patients]. PMID- 6480038 TI - [Study of cutaneous diabetic microangiopathy in a group of dermopathies correlated with diabetic disease]. PMID- 6480039 TI - [Occurrence of cutaneous diabetic microangiopathies in various dermopathies statistically associated with diabetes]. PMID- 6480040 TI - [The problem of the relation between Kaposi's disease and diabetes: a case/control study]. PMID- 6480041 TI - [Skin changes in diabetes]. PMID- 6480042 TI - Radioimmunoassay of estradiol-17B in buffaloes peripartum. PMID- 6480043 TI - Report on loss of certain properties of cobra venom components after their exposure to synchrotron radiation. PMID- 6480044 TI - Effect of aspirin containing silastic implants placed adjacent to epididymis on fertility of rats. PMID- 6480045 TI - Histochemical localization and properties of acid phosphatase in testis of a passerine bird, red-vented bulbul Pycnonotus cafer Linnaeus. PMID- 6480046 TI - Nitroso derivatives of harman and norharman--their formation, characterization and mutagenicity. PMID- 6480047 TI - Effect of carbon tetrachloride induced toxicity on 125(I)-insulin receptor interaction and U-14(C)glucose/U-14(C)galactose homeostasis in isolated rat hepatocytes. PMID- 6480048 TI - A general microsensitive assay method for transaminases. PMID- 6480049 TI - Inhibitory actions of retinoic acid and butylated hydroxyanisole on cervical carcinogenesis induced by 3-methylcholanthrene in mouse. PMID- 6480050 TI - Susceptibility of various cell culture systems to sheep pox virus strains. PMID- 6480051 TI - A new method for sequential extraction of oxytocin and antidiuretic hormone for radioimmunoassay. PMID- 6480052 TI - Catabolism of benzoate and salicylate by Aspergillus japonicus. PMID- 6480053 TI - Antihemolytic action of surface active drugs. PMID- 6480054 TI - Maintenance of late replication of X-chromosomes in hyperdiploid cells of the barking deer Muntiacus muntjak. PMID- 6480055 TI - X-linked sterility and lethality--a working hypothesis to explain abnormal sexual development. PMID- 6480056 TI - Influence of hyperthermia on the effectiveness of UV-radiation for induction of reproductive death of cultured mammalian cells. PMID- 6480057 TI - Hyperthermic modification of drug effectiveness for reproductive death of cultured mammalian cells. PMID- 6480058 TI - Intermingling of efferent fibres in right vagus and sympathetic nerves supplying the sino-auricular node and adjacent tissues of cat as evident from a study of vagal tachycardia. PMID- 6480059 TI - Utilization of cheap carbohydrate sources for production of calcium gluconate by Penicillium funiculosum mutant MN238. PMID- 6480060 TI - Effect of ibuprofen and naproxen on implantation and pregnancy in rat. PMID- 6480061 TI - Cyproheptadine: a non-specific competitor of steroid hormone receptors. PMID- 6480062 TI - Multiple drug resistance in Salmonellae. PMID- 6480063 TI - Influence of age and sex on the skin diseases prevalent amongst school children in Surat District, (Gujarat). PMID- 6480064 TI - A genetic study of lactose digestion in Pakistani families. PMID- 6480065 TI - Serum total cholesterol in children and young adults between 5 to 19 years of age. PMID- 6480066 TI - Urban malaria in Maharashtra. PMID- 6480067 TI - The rheumatological disease process. Inflammation, immunology, and non-steroidal anti-inflammatory drugs. Proceedings of an international symposium. London, England, April 28-29, 1983. PMID- 6480068 TI - Non-steroidal anti-inflammatory drugs in rheumatoid arthritis. Effects on clinical parameters and cellular immunity. AB - Fourteen patients with classical or definite rheumatoid arthritis were studied for the effect of piroxicam treatment on clinical parameters and cellular immunity. The treatment caused reduced disease activity as assayed by an augmented grip strength, reduced total stiffness, reduced duration of morning stiffness and reduced Ritchies articular index. No effect of the treatment was observed on the percentages of T8 and T4 positive cells nor on the natural killer (NK) cell activity in the peripheral blood mononuclear cells. In contrast, the treatment led to a reduction in the total amount of rheumatoid factor. Since rheumatoid factor is mainly produced locally in the inflamed synovial membranes, our results suggest an effect of piroxicam on the immune system locally but not in the peripheral blood. PMID- 6480069 TI - Effect of piroxicam on structure and function of joint cartilage. AB - In vitro experiments were performed on isolated articular chondrocytes under the influence of piroxicam. It was demonstrated that this non-steroidal anti inflammatory agent affected neither cell proliferation nor the incorporation of 35SO4 into matrix macromolecules. Dogs were treated with piroxicam for 8 weeks. Morphological studies were performed on the tissues of the knee joints. Macroscopic and light microscopic investigations revealed no structural differences between the tissues (synovial membrane and articular cartilage) of control and treated dogs. Even at the ultrastructural level no alterations in the cartilage were observed. The capacity of chondrocytes to incorporate 35SO4 under in vitro conditions was identical in control and experimental animals. It is concluded that piroxicam has no adverse effect on chondrocytes under in vitro conditions or on articular cartilage structure in the in vivo model. PMID- 6480070 TI - Current understanding of rheumatoid arthritis. AB - A full understanding of rheumatoid arthritis depends on the appreciation of clinical, radiological, immunological, genetic, biochemical, and structural mechanisms. Rheumatoid arthritis is characterized by the destruction of tissue structures such as articular cartilage and bone, but may also involve tendonous tissue, artery walls, cardial structures, and sclera of the eye. Structural analysis of tissue obtained by biopsy and operation in rheumatoid arthritis patients reveals a complicated mosaic of different components, which are together responsible for the clinical symptoms and destructive nature of the disease. PMID- 6480071 TI - The immunological basis of inflammatory diseases. AB - Most immunologically-mediated diseases are inflammatory in nature, as assessed by cellular infiltrates at the lesion site. Recent immunohistological studies using monoclonal antibodies on tissue sections and synovial or cerebrospinal fluid reveal that B- and T-lymphocytes (predominantly T) participate in this reaction, together with monocytes and macrophages. The etiopathogenesis of inflammatory diseases of immunological origin can be discussed at two levels. (1) Lesions may be secondary to the cytopathic effect of antibodies, either by direct cytolysis or by opsonization, antigenic modulation, or blockage of functionally-relevant molecules. Immune complexes formed in the circulation or locally at the lesion site may intervene. Direct cellular mechanisms are probably involved, as suggested by evidence in hepatitis (indirect) and in juvenile insulin-dependent diabetes (direct). K-cells may act by antibody-dependent cytotoxicity, particularly in autoimmune diabetes and thyroiditis where lymphocyte-dependent antibodies are demonstrated. Unfortunately, the absence of adequate markers does not permit adequate detection of K-cells in inflammatory reaction sites. (2) Etiological factors are multiple in a given disease and even in a single patient. Deficiency of suppressor T-cells, assessed using monoclonal anti T-cell antibodies, represents a major predisposing factor, although suppressor cell deficit may be restricted to some antigens (EBV) in certain patients. The deficiency of interleukin-2 production in lupus and rheumatoid arthritis is intriguing but the mechanism and its relationship to disease etiology are unknown. Other immunological factors include intrinsic B-cell hyperactivity, anti T-cell auto-antibodies, and complement deficiencies, whereas non-immunological factors such as viruses, drugs or sex hormones are important but ill defined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480072 TI - Lymphocyte sub-populations and NSAIDs. Methodological aspects. AB - Activated lymphocytes can be enumerated as the less dense lymphocyte population (LDL) on a Ficoll density gradient column. The numbers of LDL are higher in rheumatoid arthritis (RA) but fall with successful second-line therapy; they correlate with active synovitis rather than with extra-articular disease. A cytospin technique has been developed which uses fewer cells than conventional suspension techniques and which allows further characterization of LDL using monoclonal antibodies. This confirms that these cells are relatively T-depleted but enriched in IA bearing cells, which may relate to homing patterns to the RA synovium. Using this technique, RA patients with active synovitis were shown to have more LDL and IA bearing cells, as were the active disease controls, including patients with other autoimmune disease (vasculitis) and with non-immune disease (sepsis). There were no differences between the ratios of T-suppressor to T-helper cells within these patient groups. PMID- 6480073 TI - Glomerular filtration rate in term and preterm infants in the first three weeks of life. PMID- 6480074 TI - Adolescent growth--self-appraisal and personality correlates. PMID- 6480075 TI - The role of the health-worker in an integrated child health programme in slums. PMID- 6480076 TI - Anemia in children. PMID- 6480077 TI - Effect of fetal age in cephalofacial measurements. PMID- 6480078 TI - Lipids and lipoprotein values in normal children. PMID- 6480079 TI - Infant feeding and rearing practices in a rural community of Western Orissa. PMID- 6480080 TI - Role of blood groups in etiopathogenesis and prevention of rheumatic fever. PMID- 6480081 TI - Serum lipid status in neonates. PMID- 6480082 TI - Kocher Debre Semelaigne syndrome. PMID- 6480083 TI - Pyridoxine in tetanus neonatorum. PMID- 6480084 TI - Congenital solitary cyst of neonatal liver. PMID- 6480085 TI - Intravenous antibiotics--what dilutions are required? PMID- 6480086 TI - Immunisation in children--a study of temporal trend in a defined area. PMID- 6480087 TI - Maternal determinants of birth weight: a multivariate analysis. PMID- 6480088 TI - Effect of hyperpyrexia on urinary antidiuretic hormone. PMID- 6480089 TI - Study of selenium in Indian childhood cirrhosis (ICC). PMID- 6480090 TI - Screening for aminoacid disorders in mental retardation. PMID- 6480091 TI - A study of serum sialic acid levels. PMID- 6480092 TI - Neonatal congenital malformations in Calcutta. PMID- 6480093 TI - Prevalence of asymptomatic urinary tract infections. PMID- 6480094 TI - Noonan syndrome. PMID- 6480095 TI - Complete duplication of stomach. PMID- 6480096 TI - Incidence of Indian childhood cirrhosis. PMID- 6480097 TI - Pediatric education at the cross-road. PMID- 6480098 TI - [Behavior of oxypolygelatine (Gelifundol) in patients with dialysis-dependent kidney failure]. AB - Colloidal solutions are used with increasing frequency as plasma replacement, in addition to thrombosis prophylaxis, for treating disturbances of the microcirculation and hemodilution as well as for cases of decreases in blood pressure during hemodialysis and hemofiltration treatments. The effects of the dextran, hydroxyethyl amylum and gelatine preparations available very greatly, for example with regard to expander effect, half life, elimination etc. Gelatine solutions have a particularly short intravascular retention and therefore appeared to us to be especially suitable for treating decreases in blood pressure and states of shock during hemodialysis and hemofiltration. We examined the behaviour of 5,5% oxypolygelatine (OPG) in 11 patients during dialysis treatment (6 patients with a residual diuresis smaller than 500 ml/24 h, 5 patients with a residual diuresis larger than 500 ml/24 h). Before each of the 12 treatments 250 ml OPG was administered to all patients. 48 hours later 86-93% of the infused OPG had been eliminated. Despite repeated doses no remarkable OPG cumulation was registered. PMID- 6480099 TI - [Behavior of free amino acids in severely burned patients (II: In the urine). Clinical studies]. AB - Urinary amino acids were measured in 10 severely burned patients weekly during 4 weeks after burning. For control the same measurements have been made in 12 multiple injured patients during the first two weeks after the accident. In burned patients the renal loss of free amino acids was up to 3 g/24 h +/- 1 in the first week, together with a high excreation of sodium (450 mmol/24 h +/- 73) in the first week. Urinary output of ornithin (highest value in the 2nd week: 1093 +/- 525% of normal) and lysin (highest value in the 2nd week: 1093 +/- 525% of normal) and Lysin (highest value in the 1st week: 654 +/- 166% of normal) was increased and caused an augmented loss of cystin (645 +/- 133% of normal in the first week) and 742 +/- 64% of normal in the second week. In the first and second week after burning the excretion of valin was up to 12 times the normal. Methionine-excretion staid high (5 times the normal) during all 4 weeks. The mean rate of 3-methylhistidine output in urine (80 +/- 38 mg/24 h) was elevated from the second until fourth week, suggesting muscle protein breakdown. In the control group urinary excretion of glutamin and asparagin (1st week: 608 +/- 97% of normal), threonin (2nd week: 693 +/- 240% of normal), serin (2nd week: 517 +/- 232% of normal) and histidin (1st week: 358 +/- 115% of normal) was high. Only urinary citrullin, isoleucin, prolin and taurin were not elevated in both groups during all 4 weeks. PMID- 6480100 TI - Bacteriology of experimental gingivitis in children. AB - Children are more resistant to gingivitis than are adults. To determine possible differences in their periodontal floras, an experimental gingivitis study, identical in design to one reported earlier with young adults, was conducted with four 4- to 6-year-old children. The incidence of sites that developed gingival index scores of 2 in children was less than one-third of the incidence observed in adults. The composition of the flora of each child was statistically significantly different from that of any other child or adult. The floras of the children as a group were statistically significantly different from those of the adults. Children had 3-fold greater proportions of Leptotrichia species, 2.5-fold greater proportions of Capnocytophaga species, 2.3-fold greater proportions of Selenomonas species, 2-fold greater proportions of bacterial species that require formate and fumarate, and 1.5-fold greater proportions of Bacteroides species. Adults had greater proportions of Fusobacterium, Eubacterium, and Lactobacillus species. Fusobacterium nucleatum, Actinomyces WVa 963, Selenomonas D04, and Treponema socranskii were predominant species that correlated with increasing gingival index scores in both children and adults. PMID- 6480101 TI - Genetically manipulated virulence of Yersinia enterocolitica. AB - Mobilizable virulence plasmids of Yersinia enterocolitica of serotypes O:3 and O:9 were constructed by cointegration of a mobilizable vector into the virulence plasmids. The obtained cointegrates were mobilized into plasmidless Y. enterocolitica strains of serotypes O:3, O:5, O:8, and O:9. The transfer experiments revealed the existence of two different subgroups of plasmid associated traits. (i) Animal virulence functions (mouse lethality and conjuctivitis provocation) were only transferable to plasmid-cured derivatives of virulent parent strains (serotypes O:3, O:8, and O:9), but they were not transferable to Y. enterocolitica antigen reference strains (serotypes O:3 and O:8) or to a plasmidless clinical isolate of serotype O:5. A further striking result was that a serotype O:8 strain regained the mouse lethality trait after receipt of a plasmid from a strain not lethal to mice. These results demonstrate that plasmid-mediated animal virulence functions are not uniformly expressed within Y. enterocolitica. (ii) The second subgroup of plasmid-mediated traits (calcium dependency, surface agglutinogens, HEp-2 cell adherence, and protein release) were transferable to all Y. enterocolitica recipient strains tested (serotypes O:3, O:5, O:8, and O:9 of different origin). For the first time HEp-2 cell adherence and temperature-induced release of five major protein species are described as transferable traits. PMID- 6480102 TI - Purification and some properties of Aeromonas hydrophila hemolysin. AB - A hemolysin produced by a strain of Aeromonas hydrophila isolated from a patient with diarrhea was purified by acid precipitation and quarternary aminoethyl Sephadex chromatography. The molecular weight of the hemolysin was estimated at 50,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and at 48,000 by Sephadex G-100 gel filtration. In polyacrylamide gel electrophoresis at pH 4.0 and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the hemolysin migrated as a single band, whereas electrophoresis at pH 9.4 and thin-layer isoelectric focusing demonstrated multiple bands. The results may indicate charge isomers of the hemolysin. The purified hemolysin had a hemolytic activity of 134 hemolytic units per microgram of protein on rabbit erythrocytes. It caused fluid accumulation in infant mouse intestines and rabbit ligated ileal loops. Purified hemolysin also elicited cytotoxicity to Vero cells and lethal toxicity to mice. All these biological activities were lost on heating for 5 min at 56 degrees C. These findings support the notion that A. hydrophila hemolysin is a cytotoxic enterotoxin. PMID- 6480103 TI - Stage-specific variations in lectin binding to Leishmania donovani. AB - Visceral leishmaniasis is caused by the dimorphic protozoan Leishmania donovani, which exists as an aflagellar amastigote within mammalian mononuclear phagocytes and as a flagellated extracellular promastigote in its sandfly vector. We have identified four plant lectins that bind to the L. donovani surface, and through these we have documented stage-specific differences in exposed surface carbohydrates. Concanavalin A bound to both promastigotes and amastigotes; binding was inhibited by mannose or alpha-methyl-mannoside, implying a mannose containing residue on the surface of both parasite stages. Ricinus communis agglutinin, which binds to galactose-containing residues, also bound to both stages and was inhibited by lactose, implying a galactose-containing glycoconjugate on the parasite surface. Two other lectins, wheat germ agglutinin (WGA) and peanut agglutinin (PNA), exhibited stage specificity in their binding characteristics. Amastigotes bound WGA but not PNA. During the process of conversion from the amastigote to the promastigote stage, the WGA-binding glycoconjugate was lost, and a PNA-binding residue was newly displayed. WGA binding was inhibited by N-acetyl-D-glucosamine and was not altered by neuraminidase treatment, suggesting the presence of an exposed N-acetyl-D glucosamine moiety on the amastigote surface. The PNA binding site is known to accommodate the oligosaccharide beta-D-galactose-(1----3)-N-acetyl-D galactosamine; in our system, PNA may have identified an internal rather than a terminal galactose on the promastigote surface. Localized binding of WGA and PNA to the surface of intermediate phases of the parasite suggested inhomogeneous and changing surface characteristics during conversion from amastigote to promastigote stages. This evolution of L. donovani surface glycoconjugates may be important in the adaptation of the organism to its divergent mammalian host and arthropod vector environments. PMID- 6480104 TI - Genetic control of resistance to Mycobacterium intracellulare infection in mice. AB - The susceptibilities of various strains of mice to a highly pathogenic strain of Mycobacterium intracellulare, the Mino strain, were determined by intravenous injection of 5 X 10(6) bacteria. CFU were counted on days 1 and 21 of infection. Among 10 strains of mice, C57BL/6, C57BL/10, BALB/c, B10.BR, B10.A, and B10.D2 were susceptible, whereas DBA/2, A/J, CBA, and C3H/He were resistant. In the susceptible mouse strains, the number of bacteria increased during 21 days of infection, whereas no bacterial growth was observed in the resistant strains. Susceptible mice showed weak but positive delayed-type hypersensitivity to M. intracellulare purified protein derivative 20 days after injection of bacteria. Resistant mice developed no delayed-type hypersensitivity. Histological examination showed severe granulomatous lesions in livers or spleens of the susceptible mice after M. intracellulare injection. Analysis of F1 hybrids of susceptible and resistant strains and of F2 and backcross mice showed that the resistance to M. intracellulare seems to be controlled genetically by a single dominant gene. The pattern of distribution of resistance to M. intracellulare among the mouse strains was consistent with that of natural resistance to Mycobacterium bovis to BCG. Thus, resistance to M. intracellulare infection may be regulated by a gene linked to the Bcg gene on chromosome 1. PMID- 6480105 TI - Enhancement of Vibrio parahaemolyticus virulence by lysed erythrocyte factor and iron. AB - The effect of lysed blood on the virulence of Vibrio parahaemolyticus for mice was investigated. A factor present in lysed erythrocytes was found to greatly reduce the 50% lethal dose of V. parahaemolyticus for mice. Similar effects were observed with ferric ammonium citrate and manganous sulfate. V. parahaemolyticus grown in brain heart infusion containing lysed erythrocyte factor appeared to produce a lethal toxin which was either inapparent or absent when the organism was grown in brain heart infusion alone. PMID- 6480106 TI - Outer membrane proteins from rough strains of four Brucella species. AB - Outer membrane proteins from 15 rough strains of Brucella abortus, B. ovis, B. canis, and B. melitensis were extracted with a dipolar detergent, and outer membrane proteins from selected strains were purified by anion exchange chromatography and gel filtration (Verstreate et al., Infect. Immun. 35:979-989, 1982). Outer membrane proteins produced two types of profiles on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. One type, demonstrated by B. abortus, B. ovis, and B. canis strains, contained the three predominant protein groups present in smooth B. abortus strains (Verstreate et al., Infect. Immun. 35:979 989, 1982): groups 1, 2 (porin [Douglas et al., Infect. Immun. 44:16-21]), and 3. B. melitensis strains demonstrated the second profile type, in which there was an additional band between groups 1 and 2. The relative proportion of porin was considerably lower in B. ovis, B. canis, and B. melitensis than in B. abortus. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis profiles could be used to distinguish B. abortus and B. melitensis from each other and from B. canis and B. ovis. The amino acid compositions of groups 2 and 3 from rough strains of B. abortus, B. canis, and B. melitensis were similar to those of corresponding proteins from smooth B. abortus strains. Zwittergent-soluble fractions from most rough strains contained antigen [b], which cross-reacted with group 2 from smooth B. abortus strains, and antigens [c] and [d], which cross-reacted with group 3 from smooth B. abortus strains. Antigen [a], shared by groups 2 and 3 (D. R. Verstreate and A. J. Winter, Infect. Immun. 46:182-187, 1984), was detected in most rough strains. None of these antigens were related to either rough or smooth lipopolysaccharide. PMID- 6480107 TI - Lactose transport in Streptococcus mutans: isolation and characterization of factor IIIlac, a specific protein component of the phosphoenolpyruvate-lactose phosphotransferase system. AB - The transport of lactose in Streptococcus mutans is mediated via an inducible phosphoenolpyruvate-lactose phosphotransferase system. This system requires for catalytic activity a membrane fraction (enzyme II), two general proteins called enzyme I and HPr, and a soluble specific protein termed factor IIIlac. This protein factor was purified from S. mutans ATCC 27352 by chromatographies on DEAE cellulose, hydroxylapatite, Ultrogel AcA 34, and phosphocellulose. The purified protein migrated as a single band with a molecular weight of 10,000 on polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate and urea. The molecular weight calculated from the amino acid composition was 10,541. Gel filtration of the native protein gave a molecular weight of 41,500. Its isoelectric point was ca. 4.70. A specific antiserum was prepared against purified factor IIIlac. Immunodiffusion experiments revealed that only cellular extracts from lactose-grown cells contained factor IIIlac. A cross-reaction was observed with all of the S. mutans strains tested as well as with Streptococcus sanguis 10556, Streptococcus lactis 11454, and Staphylococcus aureus 6538. No precipitin band was observed with extracts of Streptococcus salivarius, Streptococcus faecalis, Lactobacillus casei, and Bacillus subtilis. PMID- 6480108 TI - Experimental Lyme disease in rabbits: spirochetes found in erythema migrans and blood. AB - In attempts to produce experimental Lyme disease, 33 rabbits were inoculated with Lyme spirochetes by tick feeding or from tick organ homogenates or cultures. Two rabbits developed erythema chronicum migrans at the site of inoculation, in one instance 2 days after injection of a tick organ homogenate and in the other instance, 17 days after feeding of infected Ixodes dammini ticks. Spirochetes were seen in skin biopsy specimens of the second lesion with Warthin-Starry and immunoperoxidase stains. Spirochetes were also recovered from blood cultures of two additional rabbits 2 weeks post-inoculation. These findings are characteristic of early Lyme disease in humans and give additional support for the spirochetal etiology of Lyme disease. PMID- 6480109 TI - Cell surface proteins of oral streptococci. AB - Whole cells of representative strains of oral streptococci (Streptococcus sanguis, S. mitis, and S. salivarius) were radiolabeled by the lactoperoxidase method of radioiodination. The labeled polypeptides obtained by extraction of whole cells with boiling sodium dodecyl sulfate were analyzed by polyacrylamide gel electrophoresis and autoradiography. Of the total radioactivity, ca. 70% was released by treating whole cells with trypsin, suggesting that the labeling was confined to proteins located on the cell surface. Most S. sanguis strains studied gave a characteristic banding pattern consisting of a high-molecular-weight (120,000 [120K] to 63K) group of six proteins. Three low-molecular-weight (12K, 16K, and 18K) proteins were also detected in many strains. PMID- 6480110 TI - Association of fibril structure formation with cell surface properties of Yersinia enterocolitica. AB - Electron microscopic examination of virulence plasmid-bearing cells of Yersinia enterocolitica revealed the formation of a fibril structure when grown at 37 degrees C but not at 22 degrees C. Plasmidless cells did not exhibit any surface matrix. The formation of this surface component was associated with increased cell surface charge and hydrophobicity, formation of long chains of cells, and autoagglutination. This structure is distinct from the rigid appendages (fimbriae) which are elaborated by certain Yersinia strains. PMID- 6480111 TI - Spontaneous and egg antigen-induced syntheses of immunoglobulin and antibody by spleen cells and hepatic granulomas of mice infected with Schistosoma japonicum. AB - In the absence of egg antigen (SEA), spleen cells from C57BL/6 mice infected for 22 weeks with Schistosoma japonicum were spontaneously induced in vitro to synthesize total immunoglobulin and antibody to SEA. Hepatic granulomas from mice infected for 12 weeks, but not for 22 weeks, also showed spontaneous syntheses of total immunoglobulin and antibody to SEA, but these syntheses were not enhanced upon the addition of SEA. Total immunoglobulin production was enhanced when SEA was added to spleen cells from mice infected for 4 to 7 weeks but not at any other time point. PMID- 6480112 TI - Production of monoclonal antibodies that recognize specific and cross-reactive antigens of Bacteroides gingivalis. AB - Four monoclonal antibodies directed against Bacteroides gingivalis were established by hybridoma technology. Their reactivity against B. gingivalis, Bacteroides intermedius, and Bacteroides melaninogenicus was detected by the enzyme-linked immunosorbent assay. Three monoclonal antibodies specifically reacted with B. gingivalis. One recognized antigens that were cross-reactive between B. gingivalis and B. intermedius. These monoclonal antibodies provide new tools for antigenic analysis of B. gingivalis. PMID- 6480113 TI - Lack of cross-reactivity of antibodies to ribosomal preparations from Streptococcus mutans with human heart and kidney antigens. AB - Previous studies have suggested that sera from animals immunized with whole Streptococcus mutans cells may cross-react with human and monkey heart sarcolemmal tissues. In the present study, sera and saliva from rats and rabbits immunized peripherally with ribosomal preparations from S. mutans 6715 (serotype g) or GS-5 (serotype c) were examined for their ability to react with normal human heart sarcolemmal and kidney glomerular tissues by using enzyme-linked immunosorbent and immunofluorescence assays. The results showed that antibodies to serotype g and c ribosomal preparations do not react with either the human heart or renal antigens. Sera from mice immunized with human heart tissue and from a patient with a high anti-streptolysin O titer reacted strongly with human heart sarcolemmal and kidney glomerular tissues. These data indicated that ribosomal preparations from S. mutans lack the putative human heart cross reactive determinant and suggest that the use of an S. mutans ribosomal vaccine against dental caries may not be pathogenic to human heart or renal tissues. PMID- 6480114 TI - Atrophic rhinitis in swine: correlation of Pasteurella multocida pathogenicity with membrane protein and lipopolysaccharide patterns. AB - Cell envelope proteins and lipopolysaccharides (LPS) of Pasteurella multocida strains associated with atrophic rhinitis in swine were compared by using sodium dodecyl sulfate gel electrophoresis. Among 34 strains, three different types of cell envelope protein patterns, named I (16 strains), II (3 strains), and III (15 strains), could be distinguished. These differences were based on the electrophoretic mobility of the major protein, designated as protein H. Comparison of cell envelope protein type and pathogenicity of the strain, the latter property predicted by the guinea pig skin test, revealed that all type I strains, 6 of 15 type III strains, and none of the type II strains were pathogenic. Although pathogenicity has been correlated with extracellular toxin activity, no protein could be detected in either the cell envelopes or in the extracellular fluid that absolutely correlated with pathogenic strains. Electrophoretic analysis of the LPS revealed that all strains possessed low molecular-weight LPS, which is inconsistent with the presence of a classical O antigen. The method allowed the detection of at least six types of LPS, which often coincided with a certain cell envelope protein type and with the presence or absence of the pathogenic character of the strain. These results strongly suggest that the sampled swine carry a limited number of P. multocida clones, in each of which the patterns of cell envelope proteins and LPS, as well as the presence or absence of the ability to produce extracellular toxin, are well conserved. Therefore, the possibility is discussed that sodium dodecyl sulfate gel electrophoresis of cell envelope proteins and LPS may be used for the prediction of the pathogenic character of part of the strains. Finally, the typing of strains based on cell envelope protein patterns might contribute to the development of vaccines containing outer membrane proteins as protective antigens. PMID- 6480115 TI - Adoptive transfer of immune enhancement of experimental ulcerative colitis. AB - Previous experiments with the carrageenan model for ulcerative colitis have shown that the inflammatory response in guinea pigs can be enhanced by immunization with and subsequent feeding of Bacteroides vulgatus to experimental animals. The present studies showed that only certain strains of B. vulgatus are capable of provoking immune enhancement of ulcerative colitis. Animals were fed carrageenan and various strains of viable B. vulgatus after immunization with a strain of B. vulgatus isolated from a guinea pig with experimentally induced colitis. Histological comparison of immune and nonimmune groups revealed that immune animals which received B. vulgatus from a patient with inflammatory bowel disease had a significantly (P less than 0.025) greater number of histopathological lesions at 21 days than did nonimmune animals. Immune animals receiving B. vulgatus isolated from a clinically normal source did not show any significant difference in disease status when compared to nonimmune animals. Additional experiments showed that adoptive transfer of spleen cells from animals immunized with B. vulgatus to nonimmune recipient animals is effective in transferring the immune enhancement demonstrated in actively immunized animals. Animals which received immune spleen cells with concurrent feeding of B. vulgatus showed a significant (P less than 0.005) increase in inflammation over control groups, in the absence of high titers of circulating antibody. These experiments indicate that B. vulgatus strain-specific factors are important to immune enhancement of experimental disease and also suggest an involvement of the cell-mediated immune system in this model. PMID- 6480116 TI - Interaction of Legionella micdadei with human monocytes. AB - We have recently shown that Legionella micdadei is ingested, but not killed, by human neutrophils. Herein we investigate the role of human monocytes in defense against this organism. Serum and monocytes from normal donors having no detectable antibody to L. micdadei were used. Egg-passaged L. micdadei organisms multiplied inside these monocytes with a peak growth of 2 log units within 12 h. No growth occurred when monocytes were omitted or when sonicated monocytes were used. Electron microscopy 18 h after infection revealed these organisms to be intracellular in normal-appearing phagosomes. When the input multiplicity of L. micdadei was greater than 1 CFU per monocyte, no intracellular growth occurred. When egg-passaged Legionella pneumophila organisms were used, intracellular organisms were found in phagosomes studded with ribosomes at the same time period. Peak intracellular growth of L. pneumophilia occurred by 48 h. L. micdadei activated the complement system and was opsonized by C3. However the use of complement-depleted (heat-inactivated) serum as the opsonic source had no effect on the bacterium's ingestion or growth in the monocyte. Thus, L. micdadei multiples in human monocytes. This entry and growth is independent of antibody or complement. The intracellular locations of L. micdadei and L. pneumophila differ, suggesting different mechanisms for the survival of these two organisms in the monocyte. PMID- 6480117 TI - Complement (C5)-derived chemotactic activity accounts for accumulation of polymorphonuclear leukocytes in cerebrospinal fluid of rabbits with pneumococcal meningitis. AB - Experiments were performed to identify the chemoattractant for polymorphonuclear leukocytes that appears in the cerebrospinal fluid of rabbits with experimental pneumococcal meningitis. Meningitis was induced in anesthetized New Zealand white rabbits by injecting 10(4) cells of stationary-phase Streptococcus pneumoniae type III intracisternally. Before bacteria were injected, cerebrospinal fluid contained neither polymorphonuclear leukocytes nor chemotactic activity. Significant chemotactic activity for rabbit polymorphonuclear leukocytes was detected 12 h after inoculation with bacteria and was maximal after 18 to 20 h. Chemotactic activity appeared in cerebrospinal fluid while concentrations of pneumococci and total protein were increasing but before there was any accumulation of polymorphonuclear leukocytes. The chemotactic activity in cerebrospinal fluid was heat stable (56 degrees C for 30 min), eluted from Sephadex G-75 with a profile identical to that of the chemotactic activity in zymosan-activated rabbit serum, and was inhibited by treatment with antibodies to native human C5. In addition, preincubation of polymorphonuclear leukocytes with partially purified rabbit C5a selectively inhibited their subsequent chemotactic responses to cerebrospinal fluid. These data indicate that complement (C5) derived chemotactic activity appears in cerebrospinal fluid during the course of experimental pneumococcal meningitis in rabbits and suggest that this activity accounts for the accumulation of polymorphonuclear leukocytes observed in this infection. PMID- 6480118 TI - Blastomyces dermatitidis chemotactic factor: kinetics of production and biological characterization evaluated by a modified neutrophil chemotaxis assay. AB - Chemotactic activity for human polymorphonuclear neutrophils (PMNs) was detectable in culture filtrates (CFs) of Blastomyces dermatitidis and may have influenced the pathogenesis of blastomycosis. Production of this chemotaxin depended upon culture age and medium; peak levels were achieved after incubation for 17 days or more in minimal essential medium. This factor was also chemotactic for human monocytes. CF was temperature stable even after treatment at 100 degrees C for 60 min. The activity was stable under alkaline conditions but was destroyed below pH 7. Dialyzed, chemotactically active CF contained approximately 60 micrograms of carbohydrate per ml; total protein was estimated to be less than 0.8 micrograms/ml. Preincubation of PMNs with CF or N-formyl-L-methionyl-L-leucyl L-phenylalanine deactivated their chemotactic response to each agent, whereas the chemotactic response to zymosan-activated serum was not affected. In addition, deactivation with N-formyl-L-methionyl-L-leucyl-L-phenylalanine reduced the response to CF. Pretreatment of CF with PMNs decreased chemotactic activity, which may reflect binding of the chemotaxin molecules to PMN receptors. A modified chemotaxis assay was developed in which commercial, disposable multiwell plates are used. This method was rapid, efficient, and inexpensive and permitted the assay of larger numbers of samples than was previously feasible with conventional chemotaxis methods. PMID- 6480119 TI - Fatal intoxication by 1,2-dichloroethane--a case report. AB - This is a case report of acute fatal intoxication after accidental exposure to 1,2-dichloroethane in a 51-year-old man. Clinical manifestations, blood chemistry, and autopsy findings are described. High levels of lactate and ammonia in blood had been observed before the elevation of glutamic transaminases, lactic dehydrogenase, and creatine phosphokinase. Ornithine carbamyl transferase and glutamic oxaloacetic transaminase of mitochondrial origin (m-GOT) were remarkably high. PMID- 6480120 TI - Occupational lead exposure. Effects on saccadic eye movements. AB - Quantitative measures of saccadic eye movements were examined in 52 lead exposed autobody shop workers and 52 age matched controls with no history of occupational lead exposure. Three characteristics of saccadic eye movements were studied: 1) saccade accuracy; 2) number of overshoots; and 3) maximum velocity. The results indicated that workers exposed to inorganic lead showed a decrease in saccade accuracy and an increase in overshoots compared with controls. Saccade maximum velocity was lower in lead exposed workers than in controls but the difference was just short of statistical significance. Correlations between measures of saccadic eye movements and indicators of lead absorption--blood lead (Pb-B) and zinc protoporphyrin (ZPP) levels--were analyzed in the lead exposed workers. Saccade accuracy was negatively correlated with both Pb-B and ZPP levels. The number of overshoots was not correlated with either Pb-B or ZPP levels. Saccade maximum velocity was not correlated with Pb-B, however, there was a significant negative correlation with ZPP. Age effects observed in the control group were disrupted in lead exposed workers. In addition, saccadic eye movements in younger workers (below 30 years old) were more affected by exposure to inorganic lead than were saccadic eye movements in older workers (50 years and older). It is proposed that these findings are consistent with a relatively rapid buildup of metabolically active lead burden observed in the study group. The data suggest that quantitative assessment of eye movements may be an important tool for studying subclinical central nervous system (CNS) dysfunction due to inorganic lead exposure. PMID- 6480121 TI - Causes of death in Minamata disease: analysis of death certificates. AB - The causes of death in Minamata disease were analyzed and compared with those of control subjects. Of the 1422 Minamata disease patients in the Kumamoto Prefecture, 378 had died by the end of 1980. Of these 378, the first death occurred in 1954 with a peak incidence in 1956 when Minamata disease was officially reported for the first time. The number of deaths increased rapidly after 1972 with a second peak in 1976. The male:female ratio was 1.8:1 and the mean age-at-death was 67.2 years (SD = +/- 18.65). The mean age-at-death was younger in the cases of the initial outbreak than in those recently. There were, on the average, 2.8 causes of death per person. Of these cases, 157 (41.5%) had Minamata disease indicated on the death certificate, though 64 (16.9%) had Minamata disease coded as the underlying cause. Minamata disease and the noninflammatory diseases of the central nervous system (CNS) were the main underlying causes of death between 1954 and 1969, while, in the multiple cause data, pneumonia and non-ischemic heart disease were the most prevalent. Cerebrovascular diseases (18.0%) were the main underlying causes of death followed by malignant neoplasms (14.7%), cardiovascular diseases (14.1%) and Minamata disease (14.1%) in 1970 or later, while cardiovascular diseases (18.6%), Minamata disease (14.5%), cerebrovascular diseases (10.4%) and malignant neoplasms (7.1%) were the major multiple causes of death. As compared with the control, the proportions of deaths due to noninflammatory diseases of CNS and pneumonia were higher in the initial outbreak. Although the difference in the causes of death was less apparent recently, malignant neoplasms and hypertensive diseases tended to be lower. These results suggest that there is a need for a long-term follow-up of Minamata disease patients. The data also show the potential value of multiple causes of death coding in analyses of mortality. PMID- 6480122 TI - Primary liver cancer and exposure to solvents. AB - A case-referent study was done on the possible association between primary liver cancer (ICD 155.0) and occupational exposures. In all, 374 cases were reported to the Finnish Cancer Registry in 1979 and 1980. After the exclusion of wrong diagnoses, nonrespondents and cases for whom the primary site was uncertain, 126 cases (64 men and 62 women) remained. Each case was matched for sex, age (+/- 5 years), vital status and geographical district with two cases of coronary infarction selected from hospital records without any knowledge of occupational history. Nonrespondence (38%) reduced the number to 175 referents (82 men and 92 women). A questionnaire on former employment and tasks was mailed to living subjects (6 + 6) and to the next of kin of deceased patients. An industrial hygienist then evaluated the exposure history blindly and, whenever necessary, contacted the workplace or the next of kin for more details. Only exposures commencing 10 years or more before diagnosis were considered. Altogether six female cases but no referent had been exposed to solvents. One had been exposed to chlorinated solvents in dry cleaning and two others had used both carbon tetrachloride and aromatic and aliphatic solvents. Three cases had been exposed to mixtures of aliphatic and aromatic solvents, but not chlorinated hydrocarbons. By contrast, the men did not differ with regard to exposure to solvents. Two cases and five referents were classified as having been exposed to solvent mixtures. The present results are hypothesis generating only, and the excess solvent exposure found for women must be confirmed in other studies before any conclusions can be drawn. PMID- 6480123 TI - Behaviour of plasma and urinary aluminium levels in occupationally exposed subjects. AB - Aluminium in urine (AlU) and in plasma (AlP) was determined in seven subjects occupationally exposed to environmental concentrations of aluminium below or equal to the TWA (5 mg/m3). The AlU levels in these workers were markedly higher than those found in the control group. The levels of the indicator were definitely higher at the end of the shift than at the beginning of the same working day; also, the AlU levels were higher on Friday morning than on Monday morning. After an interruption in work of two weeks, the values of the indicator underwent a marked reduction and were then only slightly higher than those of the control group. Occupational exposure to fumes produced higher AlU levels than exposure to dusts, and in the subjects exposed to fumes the AlU levels were clearly influenced by the degree of exposure. The levels of aluminium in plasma in the exposed workers on the other hand, hardly differed from the levels found in the control group. These data appear to indicate that, whereas AlU allows daily and weekly exposure to be evaluated, AlP cannot be used as an indicator of occupational exposure, at least in the case of brief exposures to environmental concentrations below or equal to the TWA. PMID- 6480124 TI - Spontaneous abortions among female industrial workers. AB - Previous descriptive epidemiologic studies have indicated that women working in some industrial settings might experience more spontaneous abortions than the average woman. This study, based on reproductive and work histories obtained by interviews, describes the abortion experience of 4121 women while working in the following industrial productive sectors: textiles, electromechanics, light bulbs, pharmaceuticals, plastics and rubber, thread and wool. Abortion rates experienced (no. of pregnancies spontaneously terminated before the 28th week of gestation per 100 pregnancies) are compared with abortion rates experienced by the same women in previous work settings or in pregnancies when they were home makers. The overall abortion rate is 10.8%. The abortion rate of pregnancies while the woman held her present industrial job was 11.5%. The abortion rate for previous pregnancies was 10.4% while working as a homemaker, and 9.6% while working in other types of work. The only two productive sectors that seem associated with a higher abortion risk are the production of pharmaceuticals and the production of plastics and rubber. The increased risk for abortion in this last sector was observed in all three factories included in the study, and is more evident in the second and third birth orders and in women over 25. The findings are discussed and compared with those of previous studies. PMID- 6480125 TI - Adjustment of the oral temperature rhythm to a fixed watchkeeping system on board ship. AB - Oral temperature data were collected from 12 members of the crew of an oil tanker at sea. Most of the personnel examined were engaged on watchkeeping duties on a '4 on, 8 off' fixed-hours system; the remainder included 3 "day-workers". The study commenced after the subjects had been following their particular work schedules continuously for several weeks, thus providing good opportunity for adaptation to them. Observations were made at 4-hourly intervals during waking hours, over a period ranging from 8 to 13 days in individual cases. The form of the mean curves produced by averaging the readings over all days indicated that a reasonable degree of adjustment of the temperature rhythm to the different sleep/wake routines imposed by the work system had occurred. Estimates of rhythm phase and amplitude obtained by "single cosinor" time series analyses of the sequential data supported this impression. However, further investigations are needed to substantiate these findings, and also to determine how long it takes for the rhythm adjustment process to reach completion in inexperienced workers. PMID- 6480126 TI - Risk factors of coronary heart disease among personnel in a bus company. AB - A cohort of all the men employed in a bus company was undertaken to elucidate possible adverse health effects of diesel exhaust exposure. The results showed that the most heavily exposed group (bus garage workers) had a fourfold increase in risk of dying from cardiovascular disease, even after correction for smoking, and allowing for at least 10 years of exposure and 15 years or more of induction latency time. The findings are in accordance with the hypothesis of a possible connection between exposure to carbon monoxide and cardiovascular disease. PMID- 6480127 TI - Effects of acute exposure of toluene and methyl ethyl ketone on psychomotor performance. AB - Organic solvents are used frequently in industry and workers are often exposed to various combinations of these chemicals. Several are CNS depressants, and the purpose of this experiment was to assess the behavioral effects of 4-hour inhalation exposures to two solvents, toluene and methyl ethyl ketone (MEK) alone and combined. Ethanol at 0.08% blood levels was used as a positive control. A total of 144 paid volunteers were randomly assigned to one of eight treatment combinations in a series of four two-group between subjects studies. Testing was carried out in an exposure chamber, and participants were tested before, during, and after the treatment or control condition on three performance tasks. The tasks measured alertness and psychomotor function and produced a total of 28 measures on each individual over the approximate 8 h of testing. Results indicated that toluene at 100 ppm produced a small but significant impairment on one measure of a visual-vigilance task by lowering the percentage of correct hits. MEK at 200 ppm produced no interpretable significant effects on any of these measures. Additivity was not evident when individuals were exposed to MEK (100 ppm) and toluene (50 ppm) in combination, as no significant performance differences were noted. Ethanol, at 0.08%, affected both the visual-vigilance and a choice-reaction time task at statistically significant levels on two measures, confirming the sensitivity of these two tasks to CNS depressants. PMID- 6480128 TI - Anesthetic considerations in the surgery of atherosclerotic cerebral vascular disease. PMID- 6480129 TI - Monitoring of evoked responses during carotid endarterectomy and extracranial intracranial anastomosis. PMID- 6480130 TI - Selective shunting on the basis of carotid clamping under regional anesthesia. PMID- 6480131 TI - Protection of the brain during carotid endarterectomy. IV. Shunt almost never. PMID- 6480132 TI - Postoperative complications following carotid endarterectomy and their management. PMID- 6480133 TI - A perspective on carotid endarterectomy. PMID- 6480134 TI - Atherosclerotic cerebrovascular disease: significance. PMID- 6480135 TI - Evaluation of patients for surgery. I. Neurological considerations. PMID- 6480136 TI - Coexisting medical problems: assessment and management for surgery. PMID- 6480137 TI - Chairman's report to the WHO-IUIS Nomenclature Committee. Kyoto, August 25, 1983. PMID- 6480138 TI - Humoral autoimmune response to rat male accessory glands. Effect of castration on the humoral response. AB - The ability to induce antibodies to rat male accessory glands in male and female rats was demonstrated, but a higher response with wider specificity was revealed in female animals. In order to investigate whether this different response may be influenced by sexual hormones we castrated male and female rats at 4 or 30 days after birth. After that we studied the course and specificity of their humoral response to male accessory glands comparing them with that of sham-operated, sex matched, littermate controls. Orchidectomy in male or oophorectomy in female rats changed neither the course nor specificity of humoral immune response. We conclude, therefore, that hormonal factors do not play any important role in the experimental model under study. PMID- 6480139 TI - Regulation of eosinophilia in rats infected with Nippostrongylus brasiliensis. I. Eosinophil chemotactic factor produced spontaneously by mesenteric lymph node cells of infected rats. AB - The possible mechanism of eosinophilia was studied in rats undergoing primary infection with Nippostrongylus brasiliensis (Nb). In vivo studies showed that the kinetics of intestinal tissue eosinophilia was not directly related to those of the intestinal worm burden. Furthermore, Nb worm extract has no or only very weak in vitro eosinophil chemotactic activity, suggesting that parasite-derived eosinophil chemotactic factor (ECF) is, if at all, not a major regulator for intestinal tissue eosinophilia in this Nb rat system. On the other hand, when mesenteric lymph node (MLN) cells obtained various days after infection were cultured, potent ECF activity was detected in the cell-free supernatant from the cultures of MLN cells 15-20 days after infection, at which time marked intestinal tissue eosinophilia was observed in vivo. Production of ECF by MLN cells from Nb infected rats seems to be spontaneous, since these cultures were performed without adding worm antigen. ECF-producing activity of day-20 MLN cells was suppressed by adding various metabolic inhibitors such as cycloheximide, mitomycin C, or puromycin. After Sephadex G-75 gel filtration, ECF activity produced by day-20 MLN cells was associated with two different molecules. PMID- 6480140 TI - Levels of seminal free L(-) carnitine in fertile and infertile men. AB - Data about the levels of free L-carnitine, an epididymal marker in human semen, are contradictory and unclear, particularly in their relationship to fertility. This can perhaps be explained by the absence of any studies of seminal L carnitine in a large group of fertile men, and by the lack of consideration of factors influencing its secretion. In this study, free L-carnitine was determined using a spectrophotometric method in deproteinized semen samples from fertile (n = 162) and infertile men without azoospermia (n = 303). Our results can be summarized as follows: Infertile men were found to have significantly lower (P less than 0.001) seminal carnitine levels (755 +/- SD 499 nmoles) compared with fertile men (1010 +/- 570). Percentiles have been calculated for fertile men, and 'normal' values proposed (10th percentile = 390 and 90th percentile = 1830 nmoles). Distribution of the levels of L-carnitine were asymmetric in fertile as well as in infertile men (median: 922 nmoles vs 645). In both groups, a significant increase in carnitine levels was observed with increasing length of abstinence, and a decrease in the ratio of carnitine/days of abstinence. Methodological, physiological and pathological factors which may explain these results are discussed. PMID- 6480141 TI - The role of citrate in determining the activity of calcium ions in human semen. AB - The concentrations of calcium and citrate in 52 samples of human semen obtained from 10 donors were 11.07 +/- 0.41 (mean +/- SEM) and 27.2 +/- 1.62 mM, respectively, and were strongly correlated (r = + 0.79). The pH of the semen was 7.65 +/- 0.069. All 3 parameters varied significantly between the donors (P less than 0.001 in each case), but the activity of calcium ions measured with a calcium electrode was 0.24 +/- 0.022 mM (n = 45) and did not vary significantly between donors. The expected activity of calcium ions was calculated on the hypothesis that the chelation of calcium by citrate could explain the discrepancy between the concentration and the activity of the ion. The result was 0.57 +/- 0.043 mM (n = 52). It was concluded that chelation by citrate could be the most important factor in determining the low activity of Ca++ in semen. PMID- 6480142 TI - The temporal response of rat testes to hCG stimulation during sexual maturation. AB - Serum testosterone responses to a single sc injection of hCG (25 IU/100 g body weight) were monitored for 5 days in rats throughout sexual maturation (22-70 days). Two hours after hCG injection serum testosterone levels rose in 22, 37 and 53 day-old animals and remained elevated for 2 days, returning to control levels on day 3. This response differed markedly from the biphasic secretion of testosterone reported for adult animals. In 70 day-old animals the serum testosterone response approached that seen in adult animals. Testosterone levels were elevated 2 h after hCG injection (25.4 +/- 2.5 ng/ml) and declined significantly at 12 and 24 h to 17.1 +/- 1.0 and 16.1 +/- 3.4 ng/ml, respectively. Testosterone levels tended to increase again on days 2 and 3 (19.9 +/- 2.8 and 21.1 +/- 3.5 ng/ml, respectively) but the increase was not statistically significant. This response differed markedly to the biphasic secretion of testosterone reported for adult animals. In vitro patterns of basal and hCG-stimulated testosterone secretion by decapsulated testes following a single hCG injection also changed during sexual maturation. In 22 day-old animals the testes exhibited refractoriness to in vitro hCG stimulation at 12 h, but testes from 37 day old rats were refractory from 2 to 24 h. In vitro testosterone responses of testes from 53 and 70 day-old rats were similar to that reported for adult rats with a period of refractoriness from 12 h to 2 days. This study demonstrates that during sexual maturation in the rat alterations occur in the temporal patterns of testosterone secretion in vivo and in vitro following hCG stimulation. PMID- 6480143 TI - Synthesis and secretion of proteins in vitro by isolated epithelial strips from the proximal and distal vas deferens of the rat. AB - Epithelial strips of rat vas deferens were isolated by a new technique and used to study differences in protein synthesis and secretion between morphologically defined segments of the vas deferens. The isolated strips were viable as judged by linear oxygen uptake over the incubation period and by preservation of structure. Epithelium from the proximal vas deferens incorporated more labelled amino acids into cytosolic (P less than 0.02) and incubation medium (P less than 0.01) proteins than did epithelium from distal vas deferens; this incorporation was inhibited by cycloheximide. Although some of the incubation medium proteins arose by leakage from damaged cells, specific protein secretion was indicated by differences in SDS-PAGE autoradiogram banding patterns and by differences in glycosylation between proteins in the incubation medium and those in the cytosol. Thus, the former contained more label from [14C]galactose incorporation than did cytosolic proteins (proximal: P less than 0.05; distal: P less than 0.005). PMID- 6480144 TI - Multielement proton-induced X-ray emission analysis of Bangladeshi tobacco. AB - The concentration of 12 different elements in cigarette tobacco of different brands, commercially made in Bangladesh, was determined using the proton particle induced x-ray emission (proton PIXE) method. In all the present experiments, proton beams of 2.0 MeV (on the target in air) and about 30 nA current were used for characteristic x-ray excitation. The concentration of the elements (K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn, Br, Rb and Sr) was determined by comparison with a calibration obtained from the NBS orchard leaf standard, SRM 1571. The results have been compared with available data on some foreign brands of tobacco and the probable reasons for the difference in the contents of some of the elements found in the Bangladeshi brands are discussed. PMID- 6480145 TI - Radiohalodestannylation: synthesis of 125I-labeled 17 alpha-E-iodovinylestradiol. AB - 17 alpha-E-Iodovinylestradiol and its iodine-125-labeled analog were prepared by halodestannylation. The synthesis of the unlabeled compound was achieved from estrone in two steps with an overall yield of 30%. The tributylstannylvinylestradiol intermediate reacted with sodium [125I]iodide (specific activity = 2200 Ci/mmol) in the presence of hydrogen peroxide and acetic acid to give the 17 alpha-E-[125I]iodovinylestradiol in 40-60% yield after isolation by reversed phase column chromatography. The radiochemical purity was greater than 98% and no other u.v. active components could be detected by HPLC. The ease of preparation and isolation of this radioligand suggests that radiohalodestannylation may be the method of choice for this and structurally similar compounds. PMID- 6480146 TI - The assay of 228Ra in biological material. AB - Some aspects of possible interference in the assay of 228Ra in biological samples were investigated. 228Ra is determined, after coprecipitation with BaSO4, by counting its daughter 228Ac carried on LaF3, due corrections being made for Ba and La recoveries. Tracer studies with 133Ba, 45Ca, 89Sr, 91Y and 234Th, under assay conditions, showed that (i) the small amount (5 mg) of Ba carrier is recovered nearly quantitatively after complete separation from large amounts of Ca (30-480 mg) which if precipitated with Ba would distort the results by falsely high Ba recoveries, (ii) fall-out Sr and Y, as well as natural Th, would not interfere in the assay and (iii) LaF3, in the amounts involved in the assay, produces negligible self-absorption but would enhance the 228Ac activity by as much as about 18% due to scattering. PMID- 6480147 TI - Biodistribution of 6-[211At]astato-2-methyl-1,4-naphthoquinol bis(diphosphate salt) and 211At- in mice with a transplanted rectal adenocarcinoma. AB - 6-[211At]astato-MNDP is currently being investigated as a potential high LET endoradiotherapeutic drug. Biodistribution and whole-body radiation retention studies have been carried out with 6-[211At]astato-MNDP and 211At- in a murine rectal tumour model; results indicate that the 211At-C bond in the compound is metabolically stable for at least 6 h. The Mean Biological Concentration of 6 [211At]astato-MNDP in tumour tissue ranged from 170-253% over an initial 12 h period; this was higher than that observed for the [211At]astatide anion. Conversely, the uptake of compound into radiobiologically critical organs was significantly lower. PMID- 6480148 TI - Radiation absorbed dose estimates at the cellular level for some electron emitting radionuclides for radioimmunotherapy. AB - Calculation of the radiation dose at the cellular level is given for several radionuclides that appear promising for radioimmunotherapy using the radiation dose distribution from a point source. The radionuclides have half-lives in the 1 3 day range and have electron ranges up to several hundred micrometers. The investigation emphasizes the physical considerations in radionuclide choice for the radiolabeling of monoclonal antibodies or antibody fragments. PMID- 6480149 TI - Perturbed gamma-gamma angular correlation studies of 111In bound to double and single stranded DNA. AB - Using 111In as a probe, the dynamics of double and single stranded DNA have been studied by performing time-differential gamma-gamma angular correlation measurements on the 173-247 keV transitions in 111Cd. Binding of indium to DNA was investigated by analysis of sedimentation profiles, thermal transition spectrophotometry and electrochromatography. Rotational correlation times tau c greater than or equal to 400 ns and tau c = 27 +/- 7 ns were obtained respectively for double stranded (native) and single stranded (denatured) DNA. The corresponding quadrupole interaction frequencies were omega 0 = 711 +/- 15 Mrad/s and omega 0 = 151 +/- 13 Mrad/s. PMID- 6480150 TI - Free fatty acids in irradiated hake fillets. PMID- 6480151 TI - Dry weight and exudate production in irradiated tuna loins. PMID- 6480152 TI - Schistosoma japonicum and colorectal cancer: an epidemiological study in the People's Republic of China. AB - Prevalence of infestation with Schistosoma japonicum was highly correlated with mortality from colorectal cancer in 89 communes in four counties of Jiangsu province, China (rank correlation coefficient = 0.68) in 1973-75, and with incidence of colorectal cancer in 24 communes of Haining county, Zhejiang province in 1977-79. No similar correlations were seen with lung cancer. The presence or absence of a past history of schistosomiasis was ascertained from 154 patients with cancer of the rectum, 98 patients with cancer of the colon and two sets of individually matched control patients. One set consisted of patients with non-gastrointestinal cancer and the other of near neighbours of the colorectal cancer patients. In patients with a history of schistosomiasis, relative risk of rectal cancer was 8.3 (95% confidence interval 3.1 to 22.6) when other cancer patients were used as controls and 4.5 (95% confidence interval 1.7 to 12.1) with neighbourhood controls. Relative risk of colon cancer was not significantly increased (1.20 with 95% confidence interval 0.48 to 3.18 in a matched triplet analysis) in association with schistosomiasis. PMID- 6480153 TI - Hyperprolactinemia is an indicator of progressive disease and poor prognosis in advanced breast cancer. AB - In a long-term follow-up study, prolactin levels were measured in 149 patients with advanced metastatic breast cancer. Control groups included 221 patients with primary operable breast cancer and 150 women with benign breast disease. Hyperprolactinemia (greater than 1,000 mIU/I; HYPRL) occurs in 44% of patients with metastatic breast cancer in the course of the disease (p less than 0.001 compared to patients with non-metastatic disease). HYPRL is associated with progressive breast cancer in 88% of cases. In patients experiencing several episodes of disease remission and relapse, incidence of HYPRL increases with each relapse. Prolactin blood levels return to normal if hyperprolactinemic patients experience remission after chemotherapy. Patients expressing HYPRL have a shorter survival time after mastectomy when compared to patients who never developed HYPRL (154/89 months, p = 0.01). It is concluded that HYPRL is of prognostic significance and a reliable indicator of progressive disease in advanced metastatic breast cancer. PMID- 6480154 TI - A case-control study on lip cancer risk factors in Ragusa (Sicily). AB - Incidence rates of lip cancer in males in Ragusa (Sicily) are amongst the highest in Europe [age-standardized rate (world) for 1980-82: 7.5 per 100,000]. A case control study was conducted on 53 male cases and 106 controls matched for sex, age (+/- 2 1/2 years), residence and hospital from which cases had been drawn. Individual interviews were carried out for the evaluation of ethnic, environmental, pathologic and occupational risk factors. Lip cancer was significantly associated with: fair, brown, or red hair (relative odds = 2.3), blue eyes (r.o. = 5.3), fair skin (r.o. = 8.0), sensitivity to sunburns (r.o. = 4.1), working outdoors (r.o. = 4.9), coexistence of non-specific lesions of exposed body parts (r.o. = 12,2), low socioeconomic status (r.o. = 15.8), farming (r.o. = 2.6) and working in greenhouses (r.o. = 12.0). Recall of recurrent Herpes labialis was not significantly associated; also association with tobacco smoking was not significant after adjustment for socioeconomic status. Risk increased exponentially with the number of ethnic characteristics of northern European populations. PMID- 6480155 TI - Susceptibility of skin fibroblasts from individuals genetically predisposed to cancer, to transformation by the tumour promoter 12-O-tetradecanoylphorbol-13 acetate. AB - Skin fibroblasts from patients with hereditary retinoblastoma (RB) and familial polyposis coli (FPC) were chosen for study since their predisposition to the tumour may be due to an inherited "initiation" event which is present in every cell. Thus, it might be predicted that skin fibroblasts from these patients would exhibit increased susceptibility to in vitro transformation by tumour promoters alone. In the case of skin fibroblasts from RB patients, transformation as assessed by the ability of the cells to grow in semi-solid medium and their migration in collagen gels did not occur. However, experiments involving skin fibroblasts from FPC patients showed certain of these cells to grow in semi-solid medium following treatment with the tumour promoter 12-O-tetradecanoylphorbol-13 acetate (TPA) alone, although the pattern of migration of the parent cell population in collagen gels was unchanged and they were non-tumorigenic in nude mice. The clones which grew in semi-solid medium, although stable with regard to anchor-age-independent growth, were also unaltered in terms of their migration pattern in collagen gels and their tumorigenicity in nude mice, and were considered not to be completely transformed. Parallel cytogenetic analysis showed that, during the course of these transformation studies, TPA significantly increased not only tetraploidy but also the chromosome aberration frequency. Several quadriradial figures were noted. PMID- 6480156 TI - Primary liver cancer and oesophageal basal cell hyperplasia in rats caused by Fusarium moniliforme. AB - Fusarium moniliforme Sheldon is one of the most prevalent fungi associated with maize throughout the world. A correlation has been found between the incidence of F. moniliforme in home-grown maize and the human oesophageal cancer rate in Transkei, southern Africa. Culture material on maize of F. moniliforme strain MRC 826, isolated from maize in a high-risk area for oesophageal cancer in Transkei, was either freeze-dried or oven-dried and fed to groups of 20 inbred male BD IX rats on a life-long basis. At a dietary level of 8%, both types of culture material were hepatotoxic and caused 100% mortality. Hepatic lesions in rats that died were characterized by cirrhosis, nodular hyperplasia and bile-duct proliferation. At a dietary level of 4% for 286 days followed by 2% for the remainder of the experiment, both types of culture material were hepatocarcinogenic and caused hepatocellular carcinoma in 80% and ductular carcinoma of the liver in 63% of the rats surviving more than 450 days. Only one of 30 such rats did not have a primary hepatic carcinoma. No hepatocellular or ductular carcinomas occurred in the controls. Hepatocellular carcinomas in the experimental rats invariably developed in severely cirrhotic livers showing nodular hyperplasia. Adenofibrosis also developed concurrently with hepatocellular carcinoma. A higher incidence of basal cell hyperplasia occurred in the oesophageal epithelia of rats fed freeze-dried than in those fed oven dried material. The chemical nature of the hepatotoxic and hepatocarcinogenic mycotoxin(s) produced by F. moniliforme is unknown. PMID- 6480157 TI - Biologic and biochemical differences between in vitro and in vivo passaged Friend erythroleukemia cells. II. Changes in cell surface glycoproteins associated with a highly malignant phenotype. AB - Friend erythroleukemia cells (FLC), serially passaged in vitro or by intraperitoneal injection in DBA/2 mice, exhibit markedly different tumorigenicity and capacity to metastasize. We have attempted to determine whether the differences in tumorigenicity between these two lines of FLC were correlated with any biochemical changes in their cell membranes. Although consistent modifications of FLC membrane gangliosides were detected after FLC multiplied in the peritoneum, the pattern of FLC gangliosides was not a stable characteristic and did not correlate with tumorigenicity. In contrast, analysis of FLC membrane glycoproteins by cell surface labelling techniques (i.e., galactose-oxidase-borohydride techniques and polyacrylamide gel electrophoresis fluorography) or by metabolic labelling of glycoproteins with 3H-galactose, revealed consistent differences in the high MW region of the gels between parental in vitro passaged FLC (either 745 or 3Cl-8 cells) and clones derived from in vivo passaged cells. No significant differences in the membrane proteins were detected between in vitro and in vivo passaged FLC when lactoperoxidase catalyzed iodination and polyacrylamide gel electrophoresis-autoradiography were used. It is seen that repeated in vivo passages of FLC resulted in the appearance of different patterns of membrane glycoproteins and that these changes appeared to be associated consistently with the capacity of these cells to grow as tumor ascites and to metastasize to the liver and spleen. PMID- 6480158 TI - Inhibition of experimentally-induced murine metastases by recombinant alpha interferon: correlation between the modulatory effect of interferon treatment on natural killer cell activity and inhibition of metastases. AB - The effect of a human recombinant hybrid alpha interferon (referred to as rHuIFN alphaA/D) on pulmonary metastases induced by intravenous injection of B16 F10 melanoma cells in C57BL/6 mice was examined; rHuIFN-alphaA/D has been previously shown to have anti-viral, anti-proliferative and immunomodulatory activities in murine cells. Pretreatment of mice with 4 daily intraperitoneal injections of rHuIFN-alphaA/D resulted in a marked decrease in the number of pulmonary metastases. This inhibition was dose-dependent but was not seen when mice were similarly treated with rHuIFN-alphaA, a human recombinant alpha interferon subtype which is inactive on murine cells. Treatment of mice with rHuIFN-alphaA/D following B16 F10 injection resulted in no significant inhibition of pulmonary metastases. Mice given a similar treatment regimen of rHuIFN-alphaA/D had elevated natural killer (NK) cell activity as measured by in vitro cytotoxicity against YAC-I or in vivo pulmonary clearance of B16 F10 cells. Pretreatment of mice with 10 daily injections of rHuIFN-alphaA/D resulted in decreased NK activity and less inhibition of metastases. Therefore, in this model system, rHuIFN-alphaA/D inhibits metastases when given in the appropriate treatment schedule. Furthermore, the data are consistent with the hypothesis that rHuIFN alphaA/D-induced inhibition is a consequence of the immunomodulation of NK cells, which prevent the establishment of pulmonary metastases. PMID- 6480159 TI - Relationship of a novel extracellular matrix glycoprotein to cell detachment in highly metastatic B16 melanoma: modulating effect of bromodeoxyuridine. AB - Growth of highly invasive B16 melanoma BL6 cells with bromodeoxyuridine (BUdR) decreases in vitro cell detachment and modulates extrapulmonary growth in vivo. We now show: (1) The presence of an 80 kd glycoprotein in the Triton-insoluble matrix of control BL6 cells but not in the corresponding fractions from BUdR treated BL6 cells and poorly metastatic F1r cells. (2) The matrix fractions from the two last mentioned cells reveal Triton-insoluble glycoproteins of about 55-58 kd. (3) Mild trypsin treatment of intact cells before matrix preparation leads to the preferential disappearance of the 80 kd component from control BL6 matrix, suggesting its extracellular localization. (4) Prevention of Triton-mediated BL6 matrix detachment by zinc chloride pretreatment, and analysis of different BL6 clones with significant metastatic behavior, also revealed the presence of 80-90 kd matrix-associated glycoproteins in control but not in corresponding BUdR-grown cultures. Since BUdR decreases cell detachment, extrapulmonary metastasis and the levels of the 80-90 kd Triton-insoluble glycoprotein species in metastatic B16 melanoma, and this matrix component is also decreased in poorly metastatic F1r cells, we propose an involvement of this glycoconjugate in tumor cell detachment and metastatic behavior. PMID- 6480160 TI - Carotid sinus syncope. PMID- 6480161 TI - Assessment of right heart hemodynamics by contrast echocardiography. AB - We studied inferior vena cava contrast echocardiography after upper extremity injection in 70 subjects; 59 were patients and 11 were controls. Inferior vena cava contrast was seen in 35 patients and in 1 control. "A-wave synchronous pattern" of contrast appearance was observed in 13 patients and 1 normal subject. The pattern did not depend upon the height of right atrial a-wave pressure or the right ventricular (RV) end-diastolic pressure, but was related to the respiratory cycle. A "random pattern" of contrast appearance was seen in 3 patients with cardiac arrhythmia and normal right heart hemodynamics. One patient with ventricular premature beats showed both "a-wave synchronous" and "random" patterns. A "v-wave synchronous pattern" was found in 20 patients, of which 17 had tricuspid regurgitation. Persistence of inferior vena cava contrast correlated with the height of right atrial v-wave (r = 0.87, p less than 0.001) and the severity of tricuspid regurgitation estimated from RV cineangiography. The differences of RV systolic pressure and echocardiographic right ventricular dimension between the study patients with and without tricuspid regurgitation did not reach statistical significance. We conclude: the echocardiographic RV dimension and the degree of RV hypertension are not predictors for the presence of tricuspid regurgitation and its severity; inferior vena cava contrast echocardiography may be used to estimate the severity of tricuspid regurgitation. PMID- 6480162 TI - Detection of myocardial infarction extension or reattack by serum myoglobin radioimmunoassay. AB - We evaluated serum myoglobin levels in patients with acute myocardial infarction and investigated their diagnostic significance on episodic reattack on the course of acute infarction. Myoglobin was measured by radioimmunoassay, and the upper limit of normal was 50 ng/ml. Raised myoglobin levels were present in 52 of 53 patients (98%) with documented acute myocardial infarction admitted within 12 hr and in 16 of 20 patients (80%) admitted between 12 and 24 hr after the onset. Maximal values occurred 11.1 +/- 5.0 (mean +/- SD) hr and returned to the normal ranges 1.6 +/- 1.1 days after the onset. Because of its early normalization and high sensitivity to new necrosis, myoglobin might be a useful biochemical marker for diagnosis of infarct extension or reattack. Forty-seven episodic reelevations were classified into three groups (definite, probable and possible) according to the rating system indicating reattack of myocardial infarction. The incidence of definite and probable reattack or extension was 21%, and possible 19%. Reelevation of serum myoglobin occurred on an average of 5.0 days after the initial attack, within the first 3 days in 53% and on the second day in 31%. These results might suggest that an unexpectedly large cohort of myocardial infarction shows reattack in its early days of initial suffering. PMID- 6480163 TI - Acute effects of doxorubicin (adriamycin) on left ventricular function in dogs. AB - Although chronic doxorubicin (adriamycin) cardiotoxicity often is attributed to repeated episodes of acute myocardial injury, the acute effects of doxorubicin on in vivo left ventricular performance have not been studied in a carefully controlled setting. Accordingly, we recorded high-fidelity left ventricular pressures and segmental dimensions before and after either intravenous or intracoronary doxorubicin in twelve open-chest dogs. Propranolol was administered to prevent reflex sympathetic stimulation, and heart rate was held constant by atrial pacing. Intravenous doxorubicin (1.5 mg/kg) (n = 6) caused significant decreases in all measured indices of myocardial contractility, in association with a large decrease in left ventricular systolic pressure (125 +/- 28 and 81 +/ 23 mm Hg before and 5 min after doxorubicin, respectively, P less than 0.01). Intracoronary doxorubicin (0.075 to 0.3 mg/kg) (n = 6) caused similar decreases in percent segment shortening (from 19 +/- 7 to 16 +/- 8, P less than 0.05), mean normalized shortening rate (from 0.87 +/- 0.34 to 0.71 +/- 0.37 segment lengths/sec, P less than 0.05), and peak positive left ventricular dP/dt (by 10 +/- 11%, P less than 0.07), although left ventricular systolic pressure was only modestly decreased (126 +/- 20 and 113 +/- 17 mm Hg before and after doxorubicin, respectively, P less than 0.01). Intracoronary doxorubicin also slowed the rate of left ventricular relaxation, as evidenced by an increase in the time constant for isovolumic pressure fall from 32.0 +/- 9.0 to 36.9 +/- 7.5 msec, and significantly altered the relationship between left ventricular pressure and dimension at end-diastole. PMID- 6480164 TI - Cardiac damage after blunt chest trauma, diagnosed using CK-MB enzyme and electrocardiogram. AB - In the present study, 78 patients with a blunt thorax trauma were examined. Fifty four percent of the patients had been injured in traffic. Creatinine kinase (CK) and its isoenzymes (MM, MB and BB), ASAT, ALAT, ECG and thorax X-ray were taken. In 24% of the patients examined, the activity of serum MB isoenzyme was greater than or equal to 6% of the total activity of CK, and in 40% no MB activity was observed. Pathological ECG changes were detected in 89% in the MB greater than or equal to 6% group and in 32% in the MB = 0% group. ECG changes cannot be regarded as specific indicators of cardiac contusion. Arrhythmias, conduction defects, ST segment and T wave changes, and a pathologically long QTc interval were present significantly more often (P less than 0.01) in the MB greater than or equal to 6% group than in the MB = 0% group. Roentgenologically, pulmonary contusion, cardiac dilatation and venous congestion-pulmonary edema were diagnosed more frequently in the MB greater than or equal to 6% group (P less than 0.01) than in the MB = 0% group. Eleven of the patients died. A forensic autopsy was performed on these patients, and a macroscopic heart injury was detected in five of them. Serum MB activity had been found in all these five. PMID- 6480165 TI - Abnormal pulmonary artery branching in tetralogy of Fallot with "absent" pulmonary valve. AB - Microangiographic postmortem study in a case of tetralogy of Fallot with so called absent pulmonary valve disclosed an abnormal branching pattern of the intrapulmonary arteries, but failed to detect any compression of intrapulmonary bronchi as a consequence of the distorted segmental arteries. The case also featured the absence of the ductus arteriosus, which should be considered a basic associated anomaly in the development of this malformative complex. PMID- 6480166 TI - Cardiac arrhythmia and hip fracture. AB - In 2 patients cardiac rhythm disturbances clearly caused falls and hip fractures. This prompted us to study patients with hip fractures to determine if any combination of clinical and laboratory findings identified those with fractures due to arrhythmia. PMID- 6480167 TI - On sudden death. PMID- 6480168 TI - Computerized boundary identification in two-dimensional echocardiography: wishful thinking or a reality? PMID- 6480169 TI - Preventing change through current substance use intervention: a role analysis. PMID- 6480170 TI - Alcohol and marijuana use in adolescents' daily lives: a random sample of experiences. AB - High school students filled out reports on their experiences at random times during their daily lives, including 48 occasions when they were using alcohol or marijuana. Alcohol use was reported primarily in the context of Friday and Saturday night social gatherings and was associated with a happy and gregarious subjective state. Marijuana use was reported across a wider range of situations and was associated with an average state that differed much less from ordinary experience. PMID- 6480171 TI - Paraprofessional versus professional drug counselors: the progress of clients in treatment. AB - The progress in treatment of 302 methadone maintenance and drug-free outpatient clients was examined as a function of the background of their 82 counselors. Counselors were either ex-addict paraprofessionals (EXAs), non-ex-addict paraprofessionals (NEAs), or degreed professional counselors (PROs). Client progress was assessed in five areas: drug use, criminality, educational activities, employment, and life quality. In the first four areas, status at treatment entry contrasted with that at two subsequent measurement points: the first interview and a 4-month follow-up. In no area of evaluation were outcomes substantially more favorable for clients of one counselor group over another. It was concluded that the three counselor groups were equally effective. PMID- 6480172 TI - An analysis of alcohol portrayal on prime-time television. AB - A content and functional analysis of alcohol use was conducted on the 15 most popular prime-time television programs in late 1979. These shows were videotaped and then rated by two independent observers. Interrater agreement, averaged over all code categories, was 91%. Results indicated that alcohol use and verbalizations about alcohol are frequent occurrences on prime-time television. Antecedent conditions to alcohol ingestion were identified. However, no consistent behavioral consequences of alcohol use were observed. PMID- 6480173 TI - Alcohol and drug use in the elderly visited at home. AB - During a 3 year prospective study, 223 new patients aged 65 and over were seen at their own residences. This setting enabled a detailed record to be made of current medication and alcohol use. The average consumption was 2.9 different drugs daily per patient, but one-third of the patients took 4 or more different preparations. One patient in 10 showed a severe alcohol-related problem. These findings were in a group with an average age of 77, not overtly physically ill, referred for a psychiatric opinion. PMID- 6480174 TI - Evaluation of a substance abuse prevention program for junior high school students. AB - Seventh-grade students in the experimental school received two primary prevention strategies. One strategy, Effective Classroom Management, was an unstructured affective approach provided by the students' classroom teachers. The other strategy was Drug Education, a mini-course taught directly to students by a specialist. The seventh-grade students from another school served as a comparison group. Both process and outcome evaluation data were collected. Results indicated positive program effects for females on drug knowledge, cigarette smoking, and perceptions of their peers' attitudes toward and use of drugs. No effects attributable to the intervention were found for males. The discussion is in terms of problems inherent in unstructured affective strategies and the need for further research on drug education. PMID- 6480175 TI - Human smoking patterns and smoke deliveries. AB - This study, based on a sample (N = 517) of adult medical patients at a southeastern medical center who were current users of cigarettes, reports the interrelationships among the puff characteristics of cigarette smoking behavior and smoke deliveries of tar and nicotine. Average puff duration, average puff volume, and the number of puffs were found to be significantly positively correlated with daily tar and nicotine intake. Intervals between puffs and total time smoking were not correlated with nicotine and tar intake. It was concluded that "how" a person smokes affects "how much" this person is exposed to tar and nicotine. PMID- 6480176 TI - An ecological analysis of the interrelationships among drug abuse and other indices of social pathology. AB - In a study of the interrelationships among 12 separate indices of social pathology, including drug abuse, in which census tracts were the units of analysis, moderate to high intercorrelations among all indices were observed. A subsequent components-types factor analysis revealed only a single eigenvalue greater than unity, suggesting that the interrelationships among the several indices may be most parsimoniously explained in terms of a single underlying construct-generalized social pathology. Exact factor scores on this construct were computed for each tract, and those may be viewed as estimates of the degree of social upheaval present. PMID- 6480177 TI - Glue sniffing: a pilot study of the cognitive effects of long-term use. AB - A psychological test battery briefly assessing memory, intelligence, and attention was administered to 10 delinquent solvent inhalers and 10 matched controls. The solvent abuse group showed significant impairment in tests of memory, nonverbal intelligence, and attention and concentration. The implications for future research are discussed. PMID- 6480178 TI - An examination of the drug abuse scale of the Millon Clinical Multiaxial Inventory. AB - The Millon Clinical Multiaxial Inventory, which includes a drug abuse scale, was administered to a group of known drug abusers several times during the course of treatment. The scoring characteristics of the drug abusers in this sample were found to be consistent with those of drug abusers used in the MCMI standardization sample. Group scores obtained in the present sample on the MCMI drug abuse scale at intake and after 1 and 3 months of treatment show considerable consistency. The results suggest that this drug abuse scale may be measuring relatively enduring characteristics, uninfluenced by treatment, at least in the short term. PMID- 6480179 TI - Drug use intervention and individual/group adaptation: facilitation of coping in potential worlds of adaptation. AB - A schema is presented designed to help intervention agents and agencies plan and carry out programs which focus on helping individuals, groups, and systems to better "cope"/"adapt" in a variety of selected worlds of adaptation. PMID- 6480180 TI - An experiential model for drug use intervention. AB - A schema is presented designed to help intervention agents and agencies plan and carry out programs which focus upon a broad but selected range of human (individual and systemic) experiences. PMID- 6480181 TI - The value of computerized tomography in fractures of the pelvic ring. AB - Thirty four fractures of the pelvic ring were examined by computerized tomography and the findings compared with those obtained with conventional radiography. CT scanning enabled precise delineation of the fracture sites in the posterior ring. A new classification is proposed which defines five patterns of fracture of the posterior ring. Computerized tomography is a valuable aid in planning operation in these injuries. PMID- 6480182 TI - [Automatic retroversion of the femur neck during fasciculated nailing of pertrochanteric fractures by the Ender method]. AB - The shape of the standard Ender nail may result in malunion in external rotation in intertrochanteric fractures treated with this device. The nail is curved in one plane, and is usually introduced into the femur without making allowance for the bowing of the diaphysis and the anteversion present in the neck. We have measured radiographically the anteversion of the femoral neck in three groups of patients after operation using Ender nails, and also assessed the anteversion of the unoperated hip for comparison. In Group I normal Ender nails were used. The operated hip showed an average of 12 degrees of retroversion compared with the opposite side. In Group II the nails were bent anteriorly at their upper end, but an average retroversion of 14 degrees was produced compared with the other hip. In Group III the nails were bent to produce anterior bowing as well as proximal anteversion. The group showed retroversion of only 1 degree compared with the normal side. We therefore recommend that Ender nails be bent in this manner in order to reduce rotatory malunion when used for intertrochanteric fractures of the neck of the femur. PMID- 6480183 TI - Juxta-acetabular mucoid cyst in a patient with osteoarthritis of the hip secondary to dysplasia. AB - A marginal acetabular notch associated with a soft tissue mucoid cyst was observed in a 54 year old woman suffering from osteo-arthritis of the left hip with bilateral hip dysplasia. This condition is compared with observations made in patients suffering from osteo-arthritis of the knee with similar findings on the medial tibial condyle. The role of enthesopathic factors in the pathogenesis of such changes is postulated. PMID- 6480184 TI - The surgical reconstruction of fractures and fracture dislocations of the thoraco lumbar spine. AB - Sixty patients have undergone surgical reconstruction of the injured thoraco lumbar spine during the period 1968 to 1978 at the Spinal Unit of the National Murayama Hospital. The aim of treatment of any fracture, dislocation, or fracture dislocation of the spine is to render it stable and painfree. This is best achieved by reduction and stabilisation of the involved segment of the spinal column. Where the posterior ligaments and intervertebral disc are ruptured healing of these structures with return to normal stability cannot be anticipated. In order to obtain permanent stability at the affected vertebral level we elect to perform anterior intervertebral fusion. PMID- 6480185 TI - Scoliosis associated with congenital brain-stem abnormalities. A report of eight cases. AB - Eight children of five families, seven boys and one girl, suffering from scoliosis associated with absence of lateral eye movement and horizontal nystagmus have been studied. The absence of lateral vision was noticed soon after birth, while the scoliosis appeared after the beginning of walking. A review of the relevant bibliography is presented, with a summary of the 18 cases of this interesting syndrome so far described. The pathogenesis of idiopathic scoliosis is considered in the light of the information obtained from the study of these patients. PMID- 6480186 TI - The significance of motor-point tenderness in patients with lumbar intervertebral disc protrusions. AB - The relationship between tender motor-points and physical signs was investigated in 48 patients with low back pain caused by intervertebral disc protrusions. There were 42 controls with no history of back pain. Motor-point tenderness was quantified on a four-point scale. All patients (except one) showed a variable degree of tenderness in the motor-points related to the relevant myotomes as determined by clinical examination. The greater the tenderness, the longer was the period of disability. The degree of tenderness seemed to have a prognostic value related to recovery from pain and the length of disability as judged by absence from work. PMID- 6480187 TI - Intravenous anaesthesia in the upper limb: a review of 225 cases. AB - The technique of intravenous regional anaesthesia for the upper limb is described and its use in 225 patients is reported. The method can be used for elective or emergency surgery on the hand or upper limb and has been found to be safe, simple and effective. PMID- 6480188 TI - The open palm technique for Dupuytren's contracture. AB - The results of subtotal palmar fasciectomy employing an open palm technique have been reviewed. Full correction of the metacarpophalangeal flexion deformity was achieved in the majority of 120 hands which were followed up for between one and nine years after operation, but the results from associated digital dissection were less satisfactory. Leaving the transverse distal palmar wound open lessens many of the hazards inherent in a palmar dissection, and the approach is therefore relatively safe for the less experienced surgeon. Efficient supervision of the hand after surgery is of paramount importance and may influence the outcome as significantly as the operation itself. PMID- 6480189 TI - Replacement of the patello-femoral joint with the total condylar knee arthroplasty. AB - We have studied 241 total condylar knee arthroplasties with replacement of the articular surface of the patella in 206 patients. The average age was 65 years. The technique of replacement of the patellofemoral joint emphasises realignment of the quadriceps mechanism, minimal excision of the patella to preserve subchondral bone, preservation of soft tissue attachments including the infrapatellar fat pad, and closure of the quadriceps without tension. The results of replacement have been good to excellent in 95 per cent of patients followed for two years or more. There were no subluxations, dislocations or fractures. Loosening was noted in one case associated with anterior knee pain. Discomfort was also noted with eccentric placement of the prosthesis where bone was left uncovered. We consider that routine replacement of the patello-femoral joint is advisable with total condylar knee arthroplasty. PMID- 6480190 TI - Hallux sesamoid bones. Anatomical observations with special reference to osteoarthritis and hallux valgus. AB - The normal characteristics of the hallux sesamoid bones were studied in 200 toes (100 dissections and 100 radiographs from patients with hallux valgus), and pathological changes were recorded. Normally each sesamoid articulated with a separate groove on the plantar surface of the first metatarsal head. A bony ridge on the head separated these grooves. Bipartite sesamoids were found in 4% of the toes. Osteoarthritic changes manifested by deformity, irregularity, lipping, cysts in the sesamoids and in the heads of the first metatarsal, and erosions in the articular surfaces were present in 32% of the dissected toes. Fusion of the sesamoids was found in 6%. Ankylosis between the sesamoids and the head of the metatarsal was observed in 4%. In the toes affected by hallux valgus the sesamoids, together with the plantar pad and the tendon of the flexor hallucis brevis, were displaced laterally to a variable degree. In severe deformities the lateral sesamoid was dislocated lateral to the first metatarsal head and the medial sesamoid occupied the groove originally corresponding to the lateral sesamoid, while the metatarsal ridge separating the two sesamoids tended to disappear. Osteoarthritis of the metatarsophalangeal joint frequently accompanied hallux valgus. PMID- 6480191 TI - [A rare cause of traumatic hip blockage in a child]. AB - A seven year old boy presented with locking of the left hip after a minor fall. An arthrogram demonstrated a bucket handle tear of the acetabular labrum, and this was confirmed at arthrotomy. The mechanism, management and prognosis of this injury is discussed. PMID- 6480192 TI - Natural resistance of mice pretreated with 5-(3,3'-dimethyl-1-triazeno)-imidazole 4-carboxamide (DTIC) + cyclophosphamide (Cy) against virus-induced lymphoma cells. AB - Virus-induced leukemia was inoculated into histocompatible or allogeneic hosts pretreated with 5-(3,3'-dimethyl-1-triazeno)-imidazole-4-carboxamide (DTIC) + Cyclophosphamide (Cy), which abrogate endogenous cell proliferation and T dependent graft responses, but not selected "natural resistance" (NR) activities. Marked impairment of lymphoma cell growth occurred mainly in the spleen of allogeneic mice with respect to that of histocompatible controls. Tumor inhibition was still present when lymphoma challenge was performed on day + 3 after Cy administration. Parallel studies on "natural killer" (NK) activity in vitro or in vivo showed that complete abrogation of the NK function was detectable on day + 3 or + 6 after Cy treatment. It was concluded that in vivo inhibition of lymphoma growth in mice pretreated with DTIC + Cy could be a drug resistant NR at least in part distinguishable from the NK function. PMID- 6480193 TI - Inhibition of polymorphonuclear leucocyte motility by benoxaprofen related to activation of cellular oxidative metabolism. AB - Incubation of human blood polymorphonuclear leucocytes (PMNL) with benoxaprofen at concentrations of greater than 1 X 10(-5)M caused inhibition of random and leucoattractant-induced migration of these cells in vitro. The drug at the same concentrations and in the absence of an added stimulant caused increased PMNL oxidative metabolism measured by chemiluminescence, hexose-monophosphate shunt activity and myeloperoxidase release. Furthermore benoxaprofen also induced PMNL auto-oxidation detected by cellular auto-iodination. Co-incubation of PMNL with the anti-oxidants ascorbate or levamisole prevented benoxaprofen-mediated inhibition of PMNL migration and cellular auto-oxidation. The drug per se was not an oxidising agent and its inhibitory effects on PMNL motility were dependent upon intact cellular oxidative metabolism. The inhibitory effects of benoxaprofen on PMNL migration in vitro are caused by the proxidant activity of the drug. PMID- 6480194 TI - Mechanisms of estrogen-induced myelotoxicity: evidence of thymic regulation. AB - Mice exposed to pharmacological levels of steroidal and nonsteroidal estrogens including alpha-dienestrol, 17 beta-estradiol, and diethylstilbestrol demonstrate bone marrow hypocellularity, and decreased numbers of pluipotent hemopoietic stem cells. Hormones with little estrogenic activity including testosterone and progesterone failed to induce myelotoxicity as did nonestrogenic metabolites of DES. Myelotoxicity associated with estrogen exposure is regulated by a complex bimodal mechanism. One of these mechanisms is mediated through the thymus since surgical thymectomy abolished the ability of estrogens to suppress CFU proliferation. Furthermore, supernatants of thymic epithelial cells cultured in the presence of estradiol were capable of inhibiting CFU-GM colony formation. Specific myelotoxic events can also be disassociated chemically by testing weakly estrogenic compounds such as zearalanol which shows different sensitivity on cytoxic and antiproliferative events. Myelotoxicity is not mediated indirectly through the ovary or adrenal gland. That the initial events in estrogen-induced myelotoxicity may be mediated through a receptor mechanism was suggested by the ability of antiestrogens to induce antagonism when administered prior to estradiol and the presence of estrogen binding components in lymphoreticular tissues including the thymus and bone marrow. These studies suggest that reduced CFU kinetics observed following estrogen exposure is, in part, due to alterations in regulatory factors produced by thymic epithelial cells in response to a specific estrogen stimulus. Estrogens may also influence bone marrow functions through non-thymic mechanisms at higher dose levels. PMID- 6480195 TI - The effect of 3-methylcholanthrene on mouse natural killer cells in vitro. AB - The effect of the chemical carcinogen 3-methylcholanthrene (3-MCA) on mouse natural killer (NK) cells was tested in vitro applying kinetic analysis of the NK tumor cell interaction. 3-MCA inhibited the lytic activity of spleen cells against YAC-1 target cells in a dose-dependent manner. Maximal inhibition, of Vmax was about 60% and a parallell decrease in KM values was observed. Inhibition was observed after 30 min preincubation of effector cells while pre-incubation of target cells had no effect. Inclusion of Indomethacin in the assay to exclude the possibility that prostaglandins induced by 3-MCA were the mediators of NK suppression had no effect. 3-MCA inhibited basal and interferon-activated NK lysis to about the same extent, while Vmax and KM values of effector cells pretreated with 3-MCA and assayed in the presence of interferon was close to control values. In a single cell assay for NK activity it was found that 3-MCA interfered with the lytic step of NK mediated lysis without affecting target binding. These data are in accordance with an earlier observation that a single injection of 3-MCA transiently inhibited mouse NK cells in vivo and evidence is presented that 3-MCA inhibits the lytic activity of a subpopulation of NK cells. The effects of 3-MCA were reversed by interferon. PMID- 6480196 TI - Differential inhibition of lymphocyte function by 2-chloroadenosine. AB - The effects of 2-chloroadenosine, a poorly metabolized adenosine analogue, on some human lymphocyte functions were studied. Mixed lymphocyte responses were strongly inhibited by very low concentrations of 2-chloroadenosine. The mitogen induced proliferation of human lymphocytes was also generally suppressed by 2 chloroadenosine in a dose dependent manner. Blastogenesis induced by Con A and PWM was severely inhibited by low doses of 2-chloroadenosine while its inhibition of that induced by PHA was less marked. Natural killer cell activity was inhibited only about 55% by high concentrations of 2-chloroadenosine. These results suggested that many subsets of human lymphocytes are controlled by adenosine receptor. PMID- 6480197 TI - Heightened cholinergic responsiveness in IgE-producing rabbits. AB - Atopic humans express an array of autonomic nervous system abnormalities. An animal model of IgE-mediated allergy was herein employed to determine if the induction of an IgE antibody response would affect autonomic responsiveness. Rabbits were immunized so as to selectively produce IgE antibodies, and their pupillary miotic and mydriatic responses to cholinergic and alpha adrenergic stimuli, respectively, were determined. IgE-producing rabbits exhibited hyperresponsiveness to cholinergic but not alpha adrenergic stimulation, a pattern resembling that seen in nonasthmatic atopic humans. Repeated sublethal anaphylactic episodes induced in three IgE-producing rabbits did not affect the pattern of autonomic responsiveness when compared to controls challenged with saline, despite clear evidence of increased plasma histamine levels immediately after antigen challenges in the IgE group. This study indicates that elicitation of an IgE antibody response is associated with the concomitant development of cholinergic hyper-responsiveness. PMID- 6480198 TI - Acting mechanisms of Lentinan in human--I. Augmentation of DNA synthesis and immunoglobulin production of peripheral mononuclear cells. AB - The immunopotentiating activity and acting mechanisms of Lentinan were investigated in the human system, resulting in clarification of the following characteristics. (a) Augmentation of DNA synthesis of peripheral mononuclear cells (PMNC) occurred both in vitro and in vivo by adding or injecting Lentinan, for which the coexistence of T cells, B cells and adherent cells (mainly monocytes) was essential. (b) No additional mitogenic effect of Lentinan was observed when PMNC were incubated with both Lentinan and other mitogens. (c) In vitro production of immunoglobulin by PMNC induced with pokeweed mitogen was enhanced through the inhibition of suppressor T cell activity by Lentinan. PMID- 6480199 TI - Endurance training, VO2 max, and OBLA: a longitudinal study of two different age groups. AB - This study examined the effect of a 20-week training program of two groups: six middle-aged men (37 +/- 4 yrs) (GIT) and six young male subjects (20 +/- 1 yrs) (GIIT). The training program consisted of bicycle ergometer exercise, 1 h/day, 3.5 days/week at a work load corresponding to 80%-85% of HR max. Before (S0) and at the end of the training program (S20), measurements of VO2 max, maximal work load (MWL), net efficiency, onset of blood lactate accumulation, absolute (OBLAW), and relative to MWL (OBLA %) were made on GIT and GIIT groups and on a third group (21 +/- 2 yrs) (GIIC), used as a control. Muscle fiber composition of m. vastus lateralis was studied after training for GIT and before and after the training period for GIIT and GIIC. VO2 max (ml X kg-1 X min-1), which was initially similar in GIT and GIIT (49 ml X kg-1 X min-1), increased significantly by 8% in GIT and by 19% in GIIT. OBLAW increased significantly to the same level in the two groups (38% and 42%, respectively). OBLA % increased significantly (20%) in GIT only. In the groups studied (GIIT), no change was observed for muscle fiber composition. % ST fiber type did not correlate to OBLAW or OBLA % S0 values nor to OBLAW and OBLA % changes during training. This leads to the conclusion that age and the initial physical fitness were the two major factors affecting the outcome of this endurance training program upon the two groups. Further research is needed to establish which of these two factors is the most influential. PMID- 6480201 TI - Caffeine: use and abuse in sports. AB - The urinary caffeine content was compared between a control group and 775 cyclists checked for doping during the 1982 season. The data for sportsmen demonstrate that the (mis)use of caffeine is more pronounced in both professional and amateur classes than in the younger categories (debutant and junior). Caffeine was also monitored during a 60-h period in the urine of several coffee drinkers. Based on all results, a "maximum level of caffeine" of 15 micrograms X ml-1 in urine for sporting competitions is proposed. PMID- 6480200 TI - Effects of concentric and eccentric exercise on protein catabolism in man. AB - To test the effects of different modes of exercise on indices of protein catabolism, eight adult males on a meat-free diet performed single 60-min bouts of concentric and eccentric cycle ergometer exercise in two 7-day periods. Although the absolute intensities for the two exercise bouts were similar, VO2 averaged 70% and 40% of VO2 max for the concentric and eccentric exercise, respectively. Mean heart rate during the eccentric exercise was 26% lower (P less than 0.001) than during concentric exercise, and only for the latter was post exercise lactate significantly elevated. The excretion of 3-methylhistidine, creatinine, and urea in 24 h urine samples was constant over the 2 weeks in which exercise was performed. Compared to pre-exercise values, the concentrations of 3 methylhistidine, creatinine, and urea were unchanged in serum samples obtained immediately after and for up to 48 h following eccentric exercise. However, serum urea concentration was elevated by 18% and 21% (P less than 0.05) in samples obtained immediately and 1 h after concentric exercise only. Despite the fact that the eccentric exercise was associated with delayed muscle soreness, these results reveal that neither concentric nor eccentric cycling exercise at moderate intensity had a major influence on indices of protein catabolism. PMID- 6480202 TI - Effects of physical activity and diet on lipemic risk factors for atherosclerosis in women. AB - Serum lipoproteins were studied in active and sedentary young women. The groups were matched for age, body weight, and blood pressure. A quantitative and qualitative evaluation of the diet was performed. In spite of a higher intake of saturated fat and cholesterol, serum concentrations of triglyceride, total cholesterol, and low-density lipoprotein cholesterol in the active group were not significantly different from the controls. Nevertheless, high-density lipoprotein cholesterol (HDL-C) levels were significantly higher in the active subjects even after covariance adjustment for nutrient intake; therefore, the HDL-C increase seems to depend on physical activity "per se" rather than on differences in diet. PMID- 6480203 TI - Characteristics of the spino-bulbo-spinal reflex with evoked EMGs in human subjects. AB - Training in sports medicine and rehabilitation medicine requires the establishment of conditioned reflexes. Reinforcement of a conditioned reflex is more effective when it is part of a set of two or three reflexes. The late spinal reflexes appearing after conditioning were resolved into a stretch reflex and a spino-bulbo-spinal (SBS) reflex. H and M waves on the tibialis anterior muscle induced by tibial nerve stimulation were determined from the escape potential of the triceps sural muscle contraction. The tibial nerve and peroneal nerve were stimulated bilaterally, and H and M waves from the triceps sural muscle and tibialis anterior muscle were recorded bilaterally. The complete separation method of the late response and the time course of the stretch reflex and SBS reflex that composed the late response are described in this paper. PMID- 6480204 TI - Histochemical and metabolic changes in lower leg muscles in exercise-induced pain. AB - Intramuscular pressure, fiber type distribution, relative cross-sectional area of slow-twitch muscle fibers, muscle lactate, and water content were studied in eight patients with medial tibial syndrome and in eight patients with chronic anterior compartment syndrome. The variables were determined before and after standardized exercise that provoked lower leg pain. In patients with medial tibial syndrome, the intramuscular pressures in the deep posterior compartment were not elevated before or 10 min after exercise. In patients with chronic anterior compartment syndrome, there was a significant post-exercise increase from 9 +/- 9 to 48 +/- 35 mmHg (P less than 0.01) in the anterior tibial compartment. The patients with medial tibial syndrome and chronic anterior compartment syndrome had a predominance of slow-twitch fibers in the deep posterior (69% and 77%, respectively) as well as in the anterior tibial (69% and 80%, respectively) compartments. The slow-twitch muscle fibers covered less cross sectional area than could be expected from the fiber composition. Muscle lactate concentration did not increase after exercise in any of the patient groups in contrast to the healthy controls in whom there was an increase (P less than 0.05). The lactate change ratio (post-exercise/pre-exercise) correlated negatively to the percentage of slow-twitch muscle fibers (P less than 0.05) in the patients but not in the healthy controls. Muscle water content increased for both patient groups in the anterior tibial but not in the deep posterior compartment. The findings indicate that the chronic anterior compartment syndrome is related to changes on the muscle fiber level and to a subsequently changed anaerobic metabolism and fluid infiltration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480205 TI - Changes in HDL composition in female subjects following a 100-km run. AB - In 12 female subjects participating in a 100-km run, the concentrations of cholesterol and triglycerides as well as those of HDL components (total cholesterol, cholesteryl ester, unesterified cholesterol, phosphatidyl choline, apolipoprotein A-I, and apolipoprotein A-II) were measured before and after the run. The concentrations of HDL unesterified cholesterol, HDL phosphatidyl choline, and HDL apolipoprotein A-I of the participants of the 100-km run were higher than the corresponding values of a control group of female company employees, whereas there was no difference in triglycerides, total cholesterol. HDL cholesterol, and HDL apolipoprotein A-II. Values of triglycerides and total cholesterol ascertained after the run were clearly decreased when compared to pre exercise values (by 70% and 10%, respectively). Also, total protein content of the serum was marginally reduced after the run. Considering the reduction in protein level. HDL cholesterol and HDL apolipoprotein A-I values were raised after the run (P less than 0.01, P less than 0.05, respectively) while HDL phosphatidyl choline values decreased irrespective of the reduction in total protein (P less than 0.01). The quotients HDL cholesterol / total cholesterol as well as HDL cholesterol / HDL phosphatidyl choline were clearly higher after the run than before (P less than 0.01). The HDL apolipoprotein A-II level did not change post-exercise. These results indicate a change in the structure of HDL following a 100-km run in female athletes. PMID- 6480206 TI - Muscle strength and flexibility in different positions of soccer players. AB - One-hundred eighty soccer players were tested for muscle strength in knee extension and knee flexion and for flexibility in the lower extremity. The strength measurements were done with a Cybex II isokinetic device (Lumex, Bay Shore, New York). The range of motion (ROM) was measured according to a method described by Ekstrand et al. (1982). The players were divided into groups according to their player position: goalkeepers, defenders, midfielders, and forwards. The results showed a significantly higher knee extensor torque in goalkeepers and defenders than in forwards (P less than 0.05). The knee flexion/knee extension ratio (H/Q ratio) was significantly higher for forwards compared to goalkeepers (P less than 0.001) and defenders (P less than 0.01). The goalkeepers were significantly more flexible than the other players in hip flexion (P less than 0.001), knee flexion (P less than 0.01), and ankle dorsiflexion (P less than 0.001). PMID- 6480207 TI - Government intervention in American dermatology. PMID- 6480208 TI - Dermatofibrosarcoma protuberans. AB - In view of the important clinicopathologic, evolutional, and ultrastructural characteristics of dermatofibrosarcoma Protuberans, a review was made of 30 patients seen during the last 25 years in Colombia's Instituto Nacional de Cancerologia. The incidence is low, accounting for 0.06% of all malignant tumors and 1.17% of all soft-parts sarcomas. The series comprises 19 women and 11 men, with the highest incidence found between ages of 30 and 50 years, although the study includes two children, ages 8 and 13. The chest was the most common site. Forty percent of the lesions were multinodular, and 23.3% showed ulceration. Histologic appearance is characterized in all cases by fusiform cells arranged like spokes around an empty hub. The fibroblastic origin was ascertained by electron-microscopic studies. The treatment used was broad surgical excision, removing tissue down to the aponeurosis to avoid recurrence. PMID- 6480209 TI - Larva currens and systemic disease. AB - Of 26 patients infested with Strongyloides stercoralis 10 (38.5%) were asymptomatic without systemic or cutaneous signs. Nine patients (34.6%) presented with systemic complaints only and seven patients (26.9%) had systemic and cutaneous manifestations. Further observations of the skin lesions on four of those with systemic and cutaneous manifestations revealed linear urticarial bands, extending to several centimeters within 1 hour and persisting up to many days, waiting and waning. Blood examination showed eosinophilia in all patients. These findings confirm the concept that larva currens even alone should be considered a cutaneous sign of systemic disease. PMID- 6480210 TI - Chromomycosis spontaneously healed. PMID- 6480211 TI - Tertiary peptide bond containing-oligo(Leu)s. Conformational studies in solution of oligo (L-leucine)s with L-proline residue and glycyl-N-(2, 4-dimethoxybenzyl) L-leucine sequence. AB - In order to elucidate the role of tertiary peptide bonds in the conformational development and solubility improvement of peptides, the conformational properties of oligo(Leu)s with the Pro residue and the Gly-(Dmob)Leu sequence were investigated in solution using i.r. absorption, CD, and molar rotation measurements. The i.r. absorption spectroscopy indicated that the peptides soluble in inert solvents such as CCl4 and toluene had a predominantly beta-sheet structure in these solvents. The conformations of the peptides in CCl4 and toluene were essentially the same as those in a solid state, whereas in THF and in MeOH, the peptides examined were efficiently subjected to solvation, and a randomly coiled structure was predominant. In order to confirm the randomly coiled structure, measurements have been made of the molar rotations of the peptides in a variety of strong proton acceptor and donor solvents. CD measurements are also carried out in MeOH. Through the investigations, it was shown that the protection of peptide bonds and the insertion of the Pro residue had the same effect on conformational and solubilizing behaviors and induced onset of an unordered structure and easy solvation of the peptides in medium and high polarity-solvents. PMID- 6480212 TI - Residue contacts in protein structures and implications for protein folding. AB - The preferential association of amino acid side groups with specific side chain atoms are examined in 44 known protein structures. The resulting association potentials among residue side groups are used to detect structural homology in proteins displaying little or no homology in their primary sequences. Suggestions are also made regarding the nature of the protein folding process. They are based on statistical observations that delineate the extent of short and long range interactions and that display side group bias in association with other side chain atoms on their N-terminal side. PMID- 6480213 TI - Nuclear magnetic resonance analyses of side chain conformations of histidine and aromatic amino acid derivatives. Solvent and pH dependence. AB - Stereoselectively beta-deuterated species were synthesized of Ac-His-NHMe, Ac-His OEt, Ac-His-OH and H-His-NHMe, which are useful as models of histidine residues in peptides. From the spectral comparison of 1H n.m.r., the beta-proton resonances of the normal species were unambiguously assigned. In (C2H3)2SO, C2(2)H5O2H, C2H3O2H, and C5(2)H5N solution and in aqueous solution, the lower field and higher-field components of beta-proton resonances of the four histidine derivatives are assigned to the pro-R and pro-S protons, respectively. The alternative assignments apply for Ac-His-NHMe, Ac-His-OEt and Ac-His-OH in non polar solvents such as C2HCl3. Vicinal coupling constants 3J alpha beta S and 3J alpha beta R were obtained for calculating the fractional populations of rotamers about the C alpha-C beta bond. The rotamer populations depend little on the ionization states of the alpha-amino and carboxyl groups or the imidazole ring. The rotamer populations depend significantly on the solvent polarity, similar to those of Phe, Tyr and Trp derivatives. For the two beta-proton resonances of His, Phe, Tyr, and Trp derivatives in a variety of solvents, linear relationships are found between the differences in chemical shifts and the differences in vicinal coupling constants. PMID- 6480214 TI - Structure and conformation of linear peptides. I. Structure of L-tyrosyl-L tyrosine. AB - L-tyrosyl-L-tyrosine crystallizes as a dihydrate in the orthorhombic system, space group C222(1), with a = 12.105(2), b = 12.789(2), c = 24.492(3) A, Z = 8. The structure was solved by direct methods and refined to a final R-value of 0.059 for 1740 observed reflections. The molecule exists as a zwitterion, the peptide unit is trans planar, and the backbone torsion angles correspond to an extended conformation, with psi 1 = 149.4 degrees, phi 2 = -161.2 degrees, psi 2 = 158.3 degrees. The values of the side-chain torsion angles (chi 1, chi 2) are ( 58.8 degrees, -63.1 degrees) for the first tyrosine and (-171.7 degrees, -116.5 degrees) for the second. The planes of the aromatic rings are nearly parallel (dihedral angle of 6.1 degrees), and their centers are separated by 10.9 A. The carboxyl plane forms a dihedral angle of 23.8 degrees with the plane of the peptide bond. PMID- 6480215 TI - Ontogeny of the bovine neurohypophyseal hormone precursors. Foetal neurohormones and neurophysins. AB - Neurohypophyseal hormones are fragments of precursor proteins that include specific neurophysins and are processed during axonal transport. Neurohormones and neurophysins purified from 7-9 month old bovine foetuses have been characterized by amino acid analysis and partial amino acid sequences. Oxytocin and arginine vasopressin, on one hand, and VLDV-neurophysin and MSEL-neurophysin, on the other, are identical to products previously characterized in the adult. Whereas oxytocin and vasopressin genes seem to be expressed at the same rates in the adult, as judged by the amounts of their peptide products in neurohypophysis, in the late foetus the vasopressin gene appears to be roughly three times more active than the oxytocin gene. PMID- 6480216 TI - Isolation of large peptides derived by cyanogen bromide cleavage of thermolysin using fast protein liquid chromatography (FPLC). AB - The recently introduced fast protein liquid chromatography (FPLC) system of Pharmacia (Uppsala, Sweden) was employed to isolate rather large peptides derived from thermolysin by selective chemical fragmentation at methionine in positions 120 and 205 of the polypeptide chain of 316 amino acid residues. Thermolysin was cleaved under conditions of limited fragmentation in order to produce, besides fragments 1-120, 121-205 and 206-316, the overlapping fragments 1-205 and 121 316. These polypeptides were separated employing prepacked Mono Q or Mono S columns (quaternary ammonium and sulfonic acid support, respectively). The columns were equilibrated with acetate-7 M urea buffer, pH 5.0 or 6.0, and eluted with a gradient of sodium chloride or acetate. Separations were achieved in 10-20 min and were carried out also at a semi-preparative level (1-3 mg per run). All five protein fragments were isolated in homogeneous form, as judged by amino acid analysis and electrophoresis. Considering that protein fragmentation with cyanogen bromide is the most commonly used procedure to achieve selective chemical fragmentation of a polypeptide chain, these results indicate that FPLC with ionic exchangers can be usefully employed to isolate rather large protein fragments especially suitable for automatic sequence analysis with the sequenator. PMID- 6480217 TI - Syntheses of tetra- and pentapeptides from skin extracts of Phyllomedusa rhodei (tryptophyllins). AB - Syntheses by solution methods of tryptophyllins -4 and -5 (TPH-4 and TPH-5), tetra- and pentapeptides isolated from the skin extracts of the South American frog Phyllomedusa rhodei, are reported. The incorporation of the Pro2-Pro3 sequence into pentapeptides and the use of flash chromatography for purification of intermediates and target compounds are discussed. Preliminary biological results seem to indicate a growth-promoting activity for this peptide family. PMID- 6480218 TI - Dynamics of amino acid residues in globular proteins. AB - The dynamic differential equation model developed and tested for bovine pancreatic trypsin inhibitor and tuna ferrocytochrome c in Ponnuswamy, P.K. & Bhaskaran, R. (Int. J. Peptide Protein Res. 24, 168-179, 1984) is extended for 17 more protein crystals in this work. Average displacements are computed for 20 amino acid residues observed in 19 proteins. Detailed information on the dynamic behaviour of the individual proteins and individual residues is presented. The effect of atomic packing on the fluctuations of the amino acid residues in alpha chymotrypsin is illustrated. A number of general points on the dynamic characteristics of globular protein molecules are presented. PMID- 6480219 TI - Resolution of human mercapt- and nonmercaptalbumin by high-performance liquid chromatography. AB - Gel-exclusion high-performance liquid chromatographic (HPLC) analysis of human serum albumin (HSA) on PGP 2000 column (0.10 M sodium phosphate buffer, 0.30 M NaCl, pH 6.86) showed at least two peaks, the principal component corresponding to human mercaptalbumin (HMA) and the second one to human nonmercaptalbumin (HNA). Mechanism for the separation of HMA and HNA might be due to weak resin-HSA interaction. HPLC analysis of bovine plasma albumin (BPA) showed a single peak on PGP 2000 column. The elution volume of HSA was larger than that of BPA, resulting in a clear resolution of HSA and BPA. PMID- 6480220 TI - 'Contact glass for use with high power lasers--geometrical and optical aspects', by P. Roussel and F. Fankhauser (1). AB - Roussel and Fankhauser have proposed contact glasses with a collecting front surface centred on the bundle focus for use with high power lasers. We demonstrate here that the main contribution to the gain in energy density within the focus spot must be attributed to the front surface of the glass. This is at variance with the explanation given by Roussel and Fankhauser, namely that the energy gain is due to the difference in refractive index between the glass and the aqueous humour. PMID- 6480221 TI - Retinal phototrauma during intra-ocular lens-implantation. AB - The use of the operating microscope has become almost a necessity in the surgery of the anterior segment of the eye. However the coaxial light of the operating microscope is potentially hazardous for the retina, especially during intra ocular lens implantation. The risk of producing a photic retinopathy increases if the duration of the surgical procedure is prolonged once the pseudophakos is in the eye and if high levels of illumination are used. We encountered our first case in a patient, whose intervention was filmed and where thus an increased illumination was needed. This complication is however also found in cases where no extra illumination was needed. As the clinical signs are usually very mild, the retinal lesions related to over-exposure to light are easily overlooked. PMID- 6480222 TI - The effect of concentrated antibiotics on the rabbit's corneal epithelium. AB - The effect of concentrated antibiotics on the healing rate of epithelial erosions in rabbit was measured by serial standardized photography. Histological studies were also performed. Our results suggest that Kanamycin 30 mg/ml (p less than 0.001), Penicillin 100,000 units/ml (p less than 0.001) and Vancomycin 31 mg/ml (p less than 0.01) administered six times a day retard the epithelial wound healing compared with control animals which received isotonic NaCl. PMID- 6480223 TI - Effect of topical anaesthesia on corneal epithelial fragility. AB - The effect of topical anaesthetics on human corneal integrity was assessed by measurement of the alterations they cause in corneal damage threshold. The anaesthetics investigated were 1.0% Amethocaine HCl, assessed immediately after instillation and after delays of 20 min and 60 min, and 0.5% Amethocaine HCl and 0.4% Benoxinate HCl, assessed 20 min after instillation. At 20 min after instillation of 1.0% Amethocaine HCl, the corneal damage threshold was significantly decreased. At other times for this anaesthetic, and for 0.5% Amethocaine HCl and 0.4% Benoxinate HCl, the corneal damage threshold was unaltered. PMID- 6480224 TI - Monitoring demyelination in multiple sclerosis with multi-flash campimetry. AB - Multi-flash campimetry is a computer-implemented psychophysical technique that allows a rapid and extensive assessment of visual flicker sensitivity. Multi flash field maps generated from the data typically reveal the presence of 'islands' of degraded temporal resolution in multiple sclerosis (MS) patients, but not in normal control observers. These distinct 'islands' presumably reflect the influence of demyelination as well as a variety of other possible transient factors, such as edema and inflammation of the optic nerve. The question addressed in the present study concerned a means of distinguishing among such influences. The strategy employed was to test MS patients more than once over a period of several months. Under the assumption that there is little or no significant remyelination in the central nervous system, it was argued that 'islands' that remain present over time should be those that principally reflect demyelination. Transient changes that appear in the fields of MS patients probably reflect the influence of other mediating factors. Examples of multi flash field maps are presented to illustrate this point and to serve as an initial assessment of the reliability of the technique. It is concluded that multi-flash campimetry may prove to be an effective aid in documenting the degree of progressive visual involvement in MS, and provide a means of monitoring the clinical course of demyelination in the visual system. PMID- 6480225 TI - Can macrophages cause obstruction to aqueous outflow in rabbits? AB - We describe a technique by which large numbers of peritoneal macrophages can be harvested without harming the experimental animal. The macrophages can be reintroduced into the same animal avoiding possible immune reactions associated with injection of foreign cells or other antigenic materials. In an attempt to obstruct aqueous outflow rabbit peritoneal macrophages engorged with mineral oil were injected intracamerally in the same rabbit's eye. The number of cells per single injection varied from 4.0 X 10(4) to 1.4 X 10(6) in eight rabbits. In three animals daily injections of 1 X 10(6) cells were performed. Using the Perkins applanation tonometer daily and hourly, no pressure elevation could be detected. PMID- 6480226 TI - Scanning electron microscopy of vascular casts of the human scleral lamina cribrosa. AB - Vascular casts of the human lamina cribrosa region were studied in three autopsy specimens utilizing scanning electron microscopy (S.E.M.) in own modified technique. The lamina cribrosa is supplied from two major sources, the short posterior ciliary artery within the sclera and the distal optic nerve sheath pial vasculature. Recurrent choroidal arteries supplied a small number of centripetal branches to the lamina cribrosa. The central retinal artery did not give off centrifugal branches as it coursed through the lamina. The findings in these three human cases in three-dimensional visualization support other recent studies using serial histologic sectioning techniques. The photomicrographs are presented as a first successful images in S.E.M. for additional appreciation of the topographic morphology of radial arterioles. PMID- 6480227 TI - Effects of anesthesia on the spontaneous activity of the microvasculature. AB - The effects of pentobarbital, alpha-chloralose, alphaxalone-alphadolone, diethyl ether and chloralose-urethane anesthesia on microvascular vasomotion were studied in the hamster skin fold window preparation. All these agents paralyzed vasomotion in the arterioles causing an initial vasodilation, where diameters were above the control-unanesthetized mean values (UMD) for a period of 5-60 min and returned to UMD, and lower, after periods up to 90 min depending on the type of anesthetic. During chloralose-urethane anesthesia vasodilation lasted until the end of observation (90 min). The responses were quantitatively different as a function of vessel type, being more pronounced in the smaller terminal arterioles. Vasomotion did not recover at the end of anesthesia, when the animals awoke, and the vessels tended to remain inert for periods up to 10-20 min, at which time the activity was reestablished with the same control fundamental frequency. Small veins and venules did not exhibit vasomotion and showed various reactions that were characteristic for each anesthetic and vessel type, where vasodilation was the prevalent feature during pentobarbital anesthesia while diethyl ether had the opposite effect. Venular microvessels recovered control diameters 10-20 min after awakening. PMID- 6480228 TI - Effect of intracoronary adenosine upon regional blood flow, microvascular blood volume and hematocrit in canine myocardium. AB - Microvascular blood volume and red cell volume fraction (hematocrit) and their relation to increased coronary blood flow were investigated in the dog heart. In response to intracoronary adenosine infusion into the anterior descending branch (LAD) of the left coronary artery, myocardial blood flow increased markedly in the perfusion zone compared with a region of the left ventricular free wall as supplied with blood from the circumflex branch (Cx) of the left coronary artery. Raising the LAD blood flow by 800% significantly reduced microvascular blood volume in the dilated vascular bed compared with the undilated vascular bed of the Cx. Control microvascular hematocrit averaged 29 +/- 2%. Hematocrit was not only low at control flow but decreased with increased blood flow, average 20 +/- 2%. The volume of red cells contained within microvessels decreased significantly in the adenosine-dilated vascular bed whereas the volume of plasma remained unchanged compared with the control vascular bed. The present data favor the view that such alterations in microvascular blood volume and red cell volume fraction may be due to reduction of the density of red blood cell perfused capillaries and unchanged density of plasma perfused capillaries. PMID- 6480229 TI - Postinflammatory oedema in two patients with contact dermatitis. Effect of benzo pyrones. AB - Two female patients with oedema of the arms and legs due to contact dermatitis complicated with recurrent infections were examined. The concentrations of plasma proteins of different molecular weight in the oedema fluid (collected from suction blisters) were highly increased. Albumin outflux as measured with radiolabelled albumin from the vessels of oedematous skin was markedly decreased corresponding to a decreased lymphatic function. Treatment with benzo-pyrones for 6 months did reduce the protein concentrations of the oedema fluid, but the clinical response was disappointing. PMID- 6480230 TI - Problems in pediatric otorhinolaryngic pathology. V. Diseases of the larynx and trachea. AB - The autopsy and surgical pathologic diagnosis of lesions of the laryngotrachea of young persons can be difficult. The clinical and histopathologic features that aid differential diagnosis are discussed. PMID- 6480231 TI - Altered auditory brainstem evoked responses in the ferret model for Reye's syndrome. AB - The effects of influenza B, aspirin and hyperammonemia on the functional integrity of the cochlea were examined using the ferret model for Reye's syndrome. Auditory brainstem evoked responses (ABR) were recorded from treated ferrets and compared to those recorded from controls. Delayed latencies of all waves, as well as increased I-IV Interwave latencies were observed in recordings from treated ferrets. Importantly, the latencies of Wave I, nerve generator potential from the eighth nerve, and Wave IV, response potential from the brainstem nuclei, increased on Days 3 and 5 of the study. However, recorded ABR from treated ferrets on Day 10 showed that while the latencies of Wave IV were approximate to those of controls, Wave I remained delayed. These results suggest that systemic effects of influenza B, aspirin and hyperammonemia may lead acutely to both peripheral and central auditory dysfunction, and that the functional integrity of the central auditory system may recover more quickly than that of the peripheral system. Furthermore, these results suggest that such effects may lead to acute transient hearing impairment in patients with Reye's syndrome. PMID- 6480232 TI - Radiographic features of the ear-related developmental anomalies in patients with mandibulofacial dysostosis. AB - Among the conditions that arise from disturbances in development of the first two branchial arches, the symmetric syndrome of mandibulofacial dysostosis and the asymmetric anomalies of the hemicraniofacial microsomia represent a characteristic pattern of craniofacial malformation distinct from other first and second arch syndromes. Since the usual embryonic aberration in both of these anomalies involves the first and second branchial arch derivatives, malformations of the external and middle ear are common. The external auditory canal is absent in the vast majority of the cases. Incudomallear deformities are usually present. In this paper, radiographic analysis of the ear-related developmental anomalies of 17 patients with mandibulofacial dysostosis is described. PMID- 6480233 TI - Beneficial effect of pneumococcal vaccination on otitis media in children over two years old. AB - The effect of immunization with a 14-valent pneumococcal vaccine (Pneumovax) was studied in a double-blind trial in which 405 children between the ages of 6 months and 5 years were matched in vaccine/control pairs according to age and history of otitis media. The fact that all the children attended day-care centres ensured that both vaccinees and controls were similarly exposed to upper respiratory tract pathogens. The total incidence of acute otitis media was reduced during a 2-year follow-up period by 24% (P less than 0.05) among those vaccinated between the ages of 2 and 5. For recurrent episodes a decrease by 40% was noted. Protective efficacy was demonstrable during the first post vaccinational year, but not when more than 1 year had lapsed after the vaccination. These findings suggest that, while the vaccine had not effect on children under 2 years old, it may be a useful aid in preventing recurrent attacks of otitis media in children between 2 and 5 years of age. PMID- 6480234 TI - Sudden deafness in children. AB - The authors present a report of 38 cases of sudden deafness (SD), observed in the Bambino Gesu Hospital in Rome. Twenty-six cases were due to infective causes, such as mumps, meningitis, measles, varicella or to physical trauma. The other 12 cases were defined as idiopathic (ISD) on the basis of their anamnestic and clinical findings. The etiological, prognostic and therapeutic aspects are discussed. PMID- 6480235 TI - Speech development in young institutionalized retarded children under an early intervention procedure. AB - The author describes the speech development in 43 young institutionalized retarded children under a therapeutic-rehabilitative procedure which lasted two years. Retarded children not following the special rehabilitation program and normally developing children from the same institution were used as control groups. The development of speech in the rehabilitation group was significantly better than that of the retarded group, but not as good as that of the control group of normally developing children. PMID- 6480236 TI - Laryngeal atresia: a detailed histologic study. AB - Laryngeal atresia is a rare, life-threatening anomaly. A case is reported with histological analysis of the deformity. Although there are different theories of glottic development, all authors agree that the primitive glottis is occluded at one time by an epithelial plug. Laryngeal atresia is felt to represent a lack of recanalization of the embryonic larynx. Laryngeal embryology is reviewed and the various types of laryngeal atresia are compared to the stages of laryngeal development. PMID- 6480237 TI - Epidermolysis bullosa letalis in the larynx causing acute respiratory failure: a case presentation and review of the literature. AB - The case history is presented of a 29-month-old boy with the characteristic skin lesions of epidermolysis bullosa letalis, requiring steroid therapy. After an episode of gastrointestinal haemorrhage, probably caused by the steroids, the child experienced progressive stridor and respiratory failure and died 10 days later. The postmortem findings in the larynx were of marked mucosal inflammation and cystic swelling of the serumucinous glands producing severe narrowing of the supraglottic airway. The laryngeal cysts were thus entirely different in nature to the cutaneous bullae. PMID- 6480238 TI - Muco-epidermoid tumour of the bronchus. AB - A 7-year-old boy with recurrent pneumonia of the right lower lobe is described. At bronchoscopy a small tumour almost totally obliterating the right lower lobe was detected. Surgical treatment was undertaken. Histopathologic studies showed findings consistent with those of a muco-epidermoid tumour. The case emphasizes bronchoscopy as an important investigation in children with recurrent pneumonia. It also shows the importance of performing the bronchoscopy during a prolonged course of antibiotic prophylaxis in order to ensure a minimum of infected mucus within the bronchi. This report is completed with a short review of the literature on muco-epidermoid tumours of the bronchus in children. Their favourable prognosis and very low malignant potential is underlined. PMID- 6480239 TI - Disseminated gonorrhoea from a pharyngeal infection in a prepubertal child. AB - A young boy with disseminated gonorrhoea from the pharynx is presented. The clinical setting in which this may be seen is also discussed. PMID- 6480240 TI - Bilateral tension pneumothorax during pediatric bronchoscopy (high-frequency jet injection ventilation). AB - Bilateral tension pneumothorax complicating high-frequency jet injection ventilation during rigid open bronchoscopy for foreign body removal in a 3-year old child is reported. Subcutaneous emphysema, bradycardia and low voltage of the QRS complex were the presenting symptoms. Disparition of heart dullness by percussion was the most suggestive clinical sign while auscultation of the breath sounds was not conclusive. It is stressed that tension pneumothorax is a potential life-threatening complication of high-frequency injection ventilation and should be promptly considered in any case of persistent cardiac deterioration during pediatric bronchoscopy. PMID- 6480241 TI - Wildervanck syndrome--the external appearance and radiologic findings. AB - Wildervanck syndrome is a combination of congenital anomalies characterized by deafness, Klippel-Feil deformity, and an unusual ocular motility disturbance called Duane retraction syndrome. This syndrome is seen infrequently in the general population and may not be recognized since the external appearance of the ears may be normal, and the unusual form of strabismus may not be obvious to the non-ophthalmologist. Patients with the full extent of this triad have a unique appearance. CT examination in these patients delineates the cervical anomalies as well as the inner ear deformity. PMID- 6480242 TI - Is there right hemisphere dysfunction in major depression? AB - A line-bisection test was applied in order to detect the presence of right hemisphere dysfunction in patients with Major Affective Disorder (Nonpsychotic Major Depression). Depressive patients and control subjects did not differ in perception of the midpoint of the line. Both groups differed in dispersion to the mean value with the depressive patients showing less precision. These data are not supportive of the notion of a right hemisphere dysfunction in the depressive disorder. PMID- 6480243 TI - Cognitive asymmetries after wakings from REM and NONREM sleep in right-handed females. AB - Eleven right-handed females were awakened from REM and NONREM sleep and tested on three tests designed to measure functions attributed to the left hemisphere and on three tests designed to measure right hemisphere function. A significant shift in cognitive profile was found in the direction of right hemisphere dominance after waking from REM sleep, and left hemisphere dominance after waking from NONREM sleep. Comparison of the cognitive shifts in females to that observed in males revealed a significant interaction of gender and awakening condition. Females showed a larger increase in right hemisphere performance following awakening from REM sleep relative to NONREM sleep, and a smaller increase in left hemisphere performance following awakening from NONREM sleep relative to REM sleep. The reverse trend was found for males. PMID- 6480244 TI - Effects of lateralized brain damage on factor scales of the MMPI. AB - The present study examined the effects of lateralized brain damage on factoral scales of the Minnesota Multiphasic Personality Inventory (MMPI). Twenty subjects (ten with left hemisphere brain damage, ten with right hemisphere brain damage) closely matched on age, education, race and sex variables were administered the MMPI. t-tests on four factorial scales of the MMPI were computed between groups. None of the factor scale comparisons were statistically significant. Theoretical implications are discussed. PMID- 6480245 TI - The profile elevation scale and the impairment scale: two new summary scales for the Luria-Nebraska Neuropsychological Battery. AB - Two new clinical summary scales have been developed for the Luria-Nebraska Neuropsychological Battery. The scales were constructed in a derivation/ crossvalidation design with a sample of 459 mixed brain impaired patients and 135 non-brain impaired persons. Preliminary evidence suggests that the Profile Elevation scale and the Impairment scale are psychometrically viable, produce additional information to what is offered by the current clinical summary scales, and deserve further investigation. Interpretations are suggested for the two new scales and supported by two neurosurgical case examples. The scales are also expected to offer the possibility of quick screening devices. PMID- 6480246 TI - Differentiation of alcoholic from brain-damaged patients by the Psychiatric Organic (P-O) special scale of the MMPI. AB - The value of the Psychiatric-Organic (P-O) special scale of the MMPI for the separation of the alcoholic from brain-damaged patients was investigated. A sample of 55 males containing 30 brain-damaged patients and 25 alcoholic patients, was administered the MMPI. Statistical analysis yielded significant difference. Clinical implications of the results are discussed. PMID- 6480247 TI - Conditioning in the unattended left ear. AB - Two experiments demonstrated that a conditioned emotional response can both be established and arouse responses without awareness in a dichotic paradigm. Right handed male subjects performed a complex verbal task presented to the right ear, while patterns of musical notes were presented to the left ear. For experimental subjects, one of the patterns was always followed by an aversive noise in the left ear; the noises were presented at random times to control subjects. In Study 1, latency of skin potential response to the noise decreased among experimental subjects relative to control subjects, indicating that the critical tone pattern was acting as a CS. Subject awareness was determined through both recall and recognition procedures, and only unaware subjects were used. Study 2 demonstrated the effect more powerfully by showing conditioned responses among experimental subjects on interpolated CS-alone trials and a lack of reportable awareness among all subjects. PMID- 6480248 TI - A new approach to endogenous event-related potentials in man: relation between EEG and P300-wave. AB - The family of late positive waves which occur at latencies of 250 to 500 msec (P300) has been the most widely studied endogenous event related potential of the brain. We performed experiments with human subjects by applying repetitive acoustical tone bursts; every third or fourth signal was omitted. The endogenous potential related to the omitted stimulation was first averaged. The averaged record was then transformed to frequency domain with Fourier analysis in order to obtain the frequency characteristics. We observed frequency selectivities between 1-2.5 Hz, 3-8 Hz and between 8-13 Hz. After this procedure, single epochs of prestimulus EEG and endogenous potentials were pass-band filtered in the above frequency ranges. The comparison of filtered prestimulus EEG and of single endogenous responses gave the following results: In delta and theta frequency ranges the EEG prior to omitted stimulation showed in most of the trials a phase reordering; the P300-wave seems to be a continuation of the ordered and stationary pre-EEG. In some cases the P300-wave depicts an amplitude-enhancement against the delta and theta components of the pre-EEG. Alpha-enhancement and alpha-blocking also make important contributions to the organization of the endogenous event-related potentials. PMID- 6480249 TI - Evidence for deficit in interhemispheric transfer of information in dyslexic boys. AB - Visual thresholds for identification of briefly flashed, lateralized letters were obtained for dyslexics and normal readers, age 11-15 years. Subjects were also tested for ability to localize tactile stimuli on the fingers and transfer information intermanually, a task failed by callosal agenesis patients (Dennis, 1976). Dyslexics differed significantly from normals on both tasks. Half the dyslexics demonstrated high threshold asymmetry across hemifields and many tactile localization errors, a pattern suggesting an "interhemispheric transfer deficit" as a cause of reading failure. Despite equally severe initial handicaps, dyslexics showing low, symmetric thresholds and few tactile errors, showed more reading improvement than did the others. PMID- 6480250 TI - Asymmetric cognitive function in anorexia nervosa. AB - Three anorexics, one at normal weight, were examined, with a neuropsychological battery including the Halstead-Reitan tests. Their data were contrasted with that of 24 psychiatric controls matched for age, sex and IQ. Individually and as a group the anorexics showed above average verbal/academic scores and impaired spatial skills, whereas visual-motor and problem solving skills were equivalent to controls. Somatosensory recognition was impaired bilaterally in all three patients, and motor skills were low in the two emaciated patients. Other sensory tests and intermanual comparisons of sensory and motor skills were not impaired relative to controls. The findings suggest that a spatial reasoning deficit may be a predisposing or maintaining factor in this disorder. High verbal skills, in contrast, may reflect substantial left hemisphere contributions to the anorexic's cognitive style. PMID- 6480251 TI - Lateral asymmetry of H-reflex recovery curves in cat: evidence for a spinal motor asymmetry. AB - Recovery curve of the Hoffmann reflex from the left and right sides was studied in lightly anesthetized cats before and after spinalization. According to the differences in the H-reflex recovery curves from the left and right lateral gastrocnemiussoleus nerves, three populations of intact animals were found: right dominant with higher recovery curve on the right side (31.8%), left dominant with higher recovery curve on the left side (36.4%), and ambilateral with no dominance (31.8%). After spinalization the dominance remained the same in the two first groups and dominance appeared in 5 out of the 7 cats of the last group. These results provide evidence for a bilateral asymmetry of alpha motoneuron excitability in cats, which can be used as a model to study the possible mechanisms of spinal motor asymmetry. PMID- 6480252 TI - The Stroop color-word test: indicator of dementia severity. AB - The Stroop color-word test was used to examine patterns of cognitive decline in Alzheimer-type dementia (ATD) and non-Alzheimer dementia. Slowing on color naming and word reading was observed, and was greater in moderate than in mild dementia subjects. However, error scores were unrelated to dementia type and severity. The Stroop interference effect, measured with reaction time, was high in individuals with mild ATD and mild non-Alzheimer dementia. In contrast, the more severely impaired ATD subjects showed less Stroop interference effect than mildly impaired subjects when the reaction time was adjusted for color naming performance. These findings are attributed to variation in speed-accuracy tradeoff for the patient groups due to differences in information processing deficits, linguistic impairment, and attitudes to errors. This study demonstrates the importance of partialling out underlying deficits for the understanding of complex cognitive processes in dementia. PMID- 6480253 TI - Period analysis of the EEG in early putative Alzheimer's disease. AB - The EEG of patients with presumptive diagnoses of mild-to-moderate dementia of the Alzheimer type (DAT) and still residing in the community was examined using period analytic techniques. DAT patients were found to have significantly slower major and intermediate period EEG activity as compared to controls. Furthermore, one DAT patient, whose clinical EEG was read as normal, had period analytic EEG descriptors that were greater than one standard deviation below the mean of the control group. Results suggest that EEG activity, as quantified by period analysis, can be detected very early in the course of DAT. PMID- 6480254 TI - Biodistribution of lipophilic 99mTc complexes of cyclam derivatives. AB - Several n-alkyl-cyclam derivatives were synthesized which form stable single component cationic chelates with 99mTc. These results suggest that the cyclam moiety in these derivatives complexes 99mTc in the same manner as the underivatized macrocycle. Biodistribution studies in mice show that all of these chelates are cleared from circulation by both the kidneys and liver. The ratio and rates of clearance by these organ systems is related to lipid solubility. None of the lypophilic-cationic-99mTc agents show any significant myocardial uptake. Also, these chelates show no significant ability to penetrate the blood brain-barrier. PMID- 6480255 TI - A simple synthesis of 18F-labelled 5-fluorouracil using acetylhypofluorite. AB - 18F-labelled 5-fluorouracil was synthesized by reacting labelled acetylhypofluorite in situ with uracil. Evaporation in the presence of triethylamine yielded 18F-5-fluorouracil in an overall radiochemical yield of about 20-30%. The solution was purified by passing it through a Sep-Pak column. PMID- 6480256 TI - Radioiodinated prolactin as a potential mammary tumor localizing agent. AB - The feasibility of using radioiodinated prolactin for early detection of solid mammary tumors was studied in the rat. Radioiodinated prolactin was first injected into tumored and control rats in order to define the localization of the labeled hormone in their target organs, then it was injected into extracorporeal blood-loop of tumored and healthy rats, in order to study its clearance in those animals. At 15 min post injection, 75-82% of the labeled hormone was recovered, of which 4-5% were counted in the tumor. Deiodination was apparent only 30 min after injection. As much as high deposition of the labeled hormone was not achieved in the hormone-dependent tumor lines investigated, some of the pitfalls that may be encountered are documented. The clearance of the labeled prolactin as determined by the blood-loop technique is 3.3 min in the R3230 tumor, and 6.4 min in the 13762 mammary tumor. The healthy rats had a blood clearance of 4.6 min. PMID- 6480257 TI - The labelling of magnetically responsive particles with 99mTc and 32P. AB - Carbonyl iron and magnetically responsive iron oxide particles have been labelled with 99mTc and 32P. The biodistribution of these particles could be controlled by an external magnetic field. PMID- 6480258 TI - Dithiocarbamato complexes of technetium: relationship between structure and hepatobiliary excretion. AB - A series of dithiocarbamato complexes of 99mTc have been prepared and their potential as radiopharmaceuticals investigated in mice. The complexes ranged from non-polar and colloidal to polar and completely soluble. The non-polar complexes were rapidly extracted by the liver and then only slowly excreted while the polar complexes were cleared more slowly from the blood with concurrent rapid hepatobiliary excretion. PMID- 6480259 TI - Electrophilic iodination of aromatic rings. PMID- 6480260 TI - In vivo and in vitro characteristics of the N-methyl derivative of [125I]3 quinuclidinyl 4-iodobenzilate. PMID- 6480261 TI - Thyroid dysfunction following mantle radiotherapy for Hodgkin's disease. PMID- 6480262 TI - Radioimmunoimaging with 99mTc monoclonal antibodies: clinical studies. PMID- 6480263 TI - Study of the distribution of tumor affinity metal compounds and alkaline metal compounds in the tumor tissues by macroautoradiography. PMID- 6480264 TI - Influence of diazepam on thyroid function tests in normal Nigerians. PMID- 6480265 TI - Total body water determinations with HTO on obese patients. PMID- 6480266 TI - Total body water in rats. PMID- 6480267 TI - The effect of cyclophosphamide on immunological control mechanisms. AB - Cyclophosphamide (CY) given three days before immunization with a range of antigens increases the intensity of cell-mediated immune responses. CY given around the time of immunization also reverses immunological tolerance, blocks antigenic competition and modifies desensitization. The effect on antibody production is not so predictable. However, it may increase the IgE response without affecting IgG1 or IgG2 response to the same antigen and may abolish immunological memory. The action of CY is on rapidly-turning-over cell populations. Lymphocytes are maximally at risk 48 hours before they transform into large pyroninophilic cells, that is just before the S phase of cell division. CY has a preferential effect on both T- and B- suppressor cells. The application of these findings to experimental cancer models is discussed. These findings are not restricted to CY, as a wide range of cytotoxic drugs with different actions at the cellular level may have similar profound effects on the regulation of the immune response. PMID- 6480269 TI - Considerations on the dynamics of adipose cells in relation to ponderal variations: morphoquantitative aspects. AB - The sizes and numbers of subcutaneous adipose-tissue fat cells were determined in obese patients, some of whom had undergone severe weight reduction induced by a jejuno-ileal bypass operation, and others a moderate thinning by a reducing diet, for comparison with those in normals. The size-class distribution of the fat cells suggests a morphoquantitative, dynamic interpretation of the two known forms of obesity, one being of moderate degree and called hypertrophic, the other more severe and called hyperplastic. The hypertrophic obese condition is characterized by a bimodal size-distribution curve of the adipocytes, similar to the curve in normal individuals. In both the normal and the hypertrophic obese, ponderal variations displace this curve forwards or backwards without altering its shape. By contrast, the hyperplastic obese shows a flat size-distribution curve without discernible modes. The smallest size-class of fat cells are the most sensitive to weight-reduction process and hypotrophize so much that they can no longer be recognized as adipocytes in histological sections; thus the size distribution curve for hyperplastic obese individuals losing weight changes in shape from uniform to bimodal. The relationship which expresses the mean fat cell diameter as a function simultaneously of the initial weight and of ponderal variation was also studied, and tested by multiple regression analysis. PMID- 6480268 TI - Effect of indomethacin on collagen biosynthesis by rabbit articular chondrocytes in monolayer cultures. AB - The influence of indomethacin on collagen biosynthesis in rabbit articular chondrocyte monolayer cultures was studied. Two applications within the space of three days of therapeutic doses (10(-5) or 10(-6)M), as well as repeated applications four days running of lower doses (10(-8) or 10(-10)M), increased the biosynthesis of both collagen and non-collagen proteins. Two applications of higher doses (10(-3) or 10(-4M) decreased DNA synthesis and inhibited both collagen and non-collagen protein biosynthesis. These results might well be considered in connection with the adverse reactions observed in some patients with long-term use of indomethacin. PMID- 6480270 TI - An animal model for aseptic necrosis after intramuscular injections. AB - Ten drugs or vaccines commonly given to patients by intramuscular injection were injected into the femoral artery of normal young anaesthetized pigs, in order to establish an animal model for macroscopically identifiable aseptic tissue necrosis (Nicolau syndrome). Despite the wide range of constituents and chemical groupings in the drugs which had caused Nicolau syndrome in patients, when injected into the pigs a typical pattern of reactions could be observed for many of them, as follows: the leg contracted rapidly, the skin area supplied by this artery initially became pale and then bluish-red with an irregular reticular appearance before finally tissue necrosis developed. These reactions are comparable to the symptoms of Nicolau syndrome in man. However, no reactions were seen when drugs or vaccines which have not been known to cause aseptic necrosis in man, e.g. tetanus toxoid, influenza vaccine or triamcinolon, were injected i.a. PMID- 6480271 TI - Scanning electron microscopic and electron microprobe X-ray analysis of cortical bone of fluoride-treated rabbits. AB - Sodium fluoride was administered to rabbits through the intragastric route at the rate of 10 mg/kg every day for a period of 8 months. Cortical bone from the diphyseal region of the femur was studied morphologically with a scanning electron microscope, and significant structural changes in collagen fiber were observed in the fluoride-treated animals as compared to normal bone. Similar bone samples were assessed physically for their CaK alpha/PK alpha ratio by electron microprobe x-ray analysis, and chemically for their calcium and phosphorus content. The bone from the rabbits to which sodium fluoride had been administered showed a higher Ca/P ratio than that from untreated control animals by both of the methods of assessment. Possible explanations for the increased Ca/P ratio in relation to the observed structural changes are discussed. PMID- 6480272 TI - Hormonal control of fracture healing in a dog with chorea. AB - An experimental fracture in a dog with chorea was found to heal faster, and with a larger callus, than normal. Serum levels of parathormone (PTH), calcitonin (CT) and vitamin D metabolities were determined during callus formation. Serum concentrations of vitamin D metabolites were lower from the beginning while serum CT levels were higher compared to normal dogs. A massive increase in serum levels of 24,25-dihydroxyvitamin D was noted during the healing period. These results and observations suggest the existence of some disturbances in the secretion of hormones regulating calcium metabolism during bone repair where a nervous system lesion exists. PMID- 6480273 TI - Histological and microradiographical study of Crouzon's disease. AB - A histological and microradiographical study of thin undecalcified sections from the cranial vault of three different cases of Crouzon's disease has been performed. The fundamentally abnormal aspects of the bone tissues observed in this disease consist of a premature closing of the sutures, an external membranous bone apposition and an internal selective bone resorption leading to the production of the crests already visible in the clinical radiographs. A thickening of these crests by secondary bone apposition has been observed. The bone fragment removed in a fourth case during a second surgical treatment, when studied by the same technique, showed apparently normal bone. PMID- 6480274 TI - Controversies in glaucoma. PMID- 6480275 TI - Early trabeculectomy in the treatment of chronic open-angle glaucoma in relation to histological changes. PMID- 6480276 TI - Combined procedures for cataract and glaucoma. PMID- 6480277 TI - Management of glaucoma in the aphakic eye. PMID- 6480278 TI - Glaucoma and the intraocular lens patient. PMID- 6480279 TI - Clinical aspects of argon laser trabeculoplasty. PMID- 6480280 TI - Laser trabeculoplasty: technique, indications, results, and complications. PMID- 6480281 TI - Applicability of biosuppressin as an urease-inhibitor. AB - Prevention of the formation of struvite and carbonate-apatite calculi, which rapidly increase in size and tend to recur, is of prime importance. One of the urease inhibitors, hydroxycarbamide, was studied in vitro. The results are favourable and justify further studies aimed at the local application of the inhibitor. PMID- 6480282 TI - Spontaneous production of a pyeloduodenal fistula. PMID- 6480283 TI - Malignant Leydig-cell tumour of testis. AB - A rare case of a malignant Leydig-cell tumour of the testis in a 26-year-old patient, with radical orchiectomy from an inguinal incision is described. Although the results of AFP, HCG, biochemical, X-ray, lymphographic and scintigraphic examinations were negative, the first metastases into the lungs appeared one year after the operation. Combined cytostatic treatment, polychemotherapy and X-ray therapy proved ineffective. The patient died of multiple metastases 28 months after the surgical intervention. PMID- 6480284 TI - Reliability of detection of leucocyturia by means of the dip-stick Cytur-Test. AB - Urine from 72 children was tested for leukocyturia simultaneously by means of the Cytur-Test and microscopically in a counting chamber. Total agreement of both methods in detection of leukocyturia was noted in 69 cases (96%). Bacteriuria had no influence on the results of the Cytur-Test. It is concluded that the Cytur Test is a sensitive and specific means for detection of leukocyturia, being especially suitable in the ambulatory practice. PMID- 6480285 TI - Impaired renal tubular reabsorption of magnesium (TRMg) in Ca-containing kidney stone formers. AB - Calculations of TRMg% were performed in 69 kidney stone formers. In patients with impaired TRMg significant increment in urinary Ca excretion and urinary Ca/Mg ratio was found. A life-long Mg supplementation is suggested in order to prevent Mg deficiency, stone recurrency and renal insufficiency. PMID- 6480286 TI - The tumor-cell-releasing machine. AB - We describe the construction of a machine for the injection of 10- to 100 microliter volumes of viable cells in suspension. The cells are maintained in a tissue culture environment and can be injected according to a preprogrammed schedule. Preliminary results show that the tumor incidence and metastasis pattern of TA3Ha cells injected intravenously into mice are the same if the cells are injected in a single dose, or administered in 20 fractions during 3 h. PMID- 6480287 TI - Platelet-aggregating activities of metastasizing tumor cells. II. Variety of the aggregation mechanisms. AB - The mechanisms by which B16, 3LL and MH134 tumor cells induce platelet aggregation were studied. The B16 and 3LL tumors, which have high or moderate procoagulant activities, aggregated platelets only in the presence of Ca2+ and plasma factors. MH134, which had much lower procoagulant activity, aggregated platelets even in the absence of these factors. The induction of aggregation by B16 and 3LL could be prevented by thrombin inhibitors but not by the ADP scavenger, suggesting that thrombin, generated by procoagulant activities of tumor cells themselves, might play a major role in initiating aggregation. MH134 induced aggregation was not affected by any of the inhibitors, indicating that the mechanisms by which MH134 initiate platelet aggregation are independent of both thrombin and ADP. PMID- 6480288 TI - Comparison of invasiveness and non-invasiveness of two epithelial cell lines in vitro. AB - Two epithelial cell lines of urological origin have been compared for their invasiveness in an in vitro three-dimensional culture system, using embryonic chick cardiac muscle as host tissue. Cells from the Nara bladder tumor line (NBT II), an invasive tumor in the rat, invaded and progressively occupied the cardiac muscle which degenerated. Cells from a dog kidney line (MDCK), which are of low tumorigenicity in nude mice, failed to invade into the cardiac muscle in vitro. MDCK cells formed a structurally polarized epithelium around the heart tissue. MDCK is the first established epithelial cell line that has been found to grow in this invasion assay culture system and yet did not invade the heart fragment. PMID- 6480289 TI - Effects of antimetastatic dimethyltriazenes in mice bearing Lewis lung carcinoma lines with different metastatic potential. AB - The effects of 5-(3,3-dimethyl-1-triazeno)-imidazole-4-carboxamide (DTIC) and its benzenoid analog p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt (DM-COOK) have been examined in mice bearing two Lewis lung carcinoma lines with different potential to spontaneously metastasize to the lungs. DTIC similarly depresses the growth of intramuscular and pulmonary tumor nodules, and also reduces the development of spontaneous lung metastases for both tumor lines. DM-COOK causes effects similar to those of DTIC on the tumor line with low metastatic potential; on the contrary, although it is highly active in inhibiting lung metastasis formation for the line with high metastatic potential, it is ineffective or marginally cytotoxic on intramuscular or on pulmonary tumor nodules, respectively. These data indicate, at least for the dimethyltriazene DM-COOK, a dissociation between sensitivity to cytotoxic and antimetastatic effects, and that tumor cell populations with a higher potential to spontaneously metastasize have a greater sensitivity to selective antimetastatic effects, concomitant with a reduced cytotoxic response to the effects of this drug. PMID- 6480290 TI - Effects of dimethyltriazenes on in vitro Lewis lung carcinoma tumor lines with different metastatic capacity. AB - The effects of a selective antimetastatic agent: the aryldimethyltriazene derivative 1-p-(3,3-dimethyl-1-triazeno)benzoic acid potassium salt (DM-COOK) have been examined on two in vitro tumor cell lines derived from lung metastases of Lewis lung carcinoma. These stabilized in vitro tumor cell lines named C108 and BC215 have been reported to differ in their metastatic potential evaluated as lung colony forming ability and as the number of spontaneous metastases produced after intramuscular implant of tumor cells. The cytotoxic effect of DM-COOK in vitro was also compared with the one demonstrated by the structure-related compound 4-(3,3-dimethyl-1-triazeno)imidazole-5- carboxamide (DTIC) on the same variant lines. Survival curves show a different chemosensitivity of the two in vitro lines to the DM-COOK treatment, whereas no differences were detected between C108 and BC215 after exposure to DTIC. Moreover, DM-COOK and DTIC exhibit different trends of cell killing, implying different mechanisms of action for the two drugs. Results are discussed in view of the selective in vitro action of the aryldimethyltriazene derivative DM-COOK on cells which express a high metastatic potential. PMID- 6480291 TI - Behavioral recovery in albino rats with glutamate-damaged retinas. AB - Adult, male, albino rats were trained to discriminate between two patterned stimuli in a T-maze. Performance on this task was assessed following intravitreal injection of 1 mumol glutamate. Discrimination performance declined to nearly random levels by 1 day postinjection and remained significantly depressed for 2 weeks. However, by 2 months after injection, there was evidence of behavioral recovery to preinjection levels despite significant loss of inner retinal neurons. Task-related experience immediately following or 2 months after injection proved both necessary and facilitative for recovery. PMID- 6480293 TI - Measurement of retinal permeability to sodium fluorescein in vitro. AB - Fluorescein permeabilities of isolated dog retinal pigment epithelium (RPE) choroid and sensory retina were measured individually. Retina to choroid (outward) permeability of sodium fluorescein was significantly larger than choroid to retina (inward) permeability at RPE-choroid under both open- and short circuit conditions. Outward permeability was decreased by the addition of 10(-3) M KCN and of 10(-4) M probeneside but was not affected by 10(-6) M ouabain. These drugs decreased transepithelial potential and short-circuit current. No directional difference of fluorescein permeability for sensory retina was found. Active transport of fluorescein across RPE from retina to choroid is suggested. Fluorescein permeability of sensory retina was larger than inward but less than outward permeability of RPE-choroid. The result indicates that the sensory retina acts as a diffusion barrier for sodium fluorescein. PMID- 6480292 TI - RPE destruction causes choriocapillary atrophy. AB - The authors have obtained evidence that destruction of the retinal pigment epithelium (RPE) causes choriocapillaris (CC) atrophy. The observations led us to hypothesize that the RPE modulates CC structure and function. Rabbits received injections of sodium iodate, which selectively destroyed the RPE. The authors killed the rabbits at various times after iodate and examined the RPE and CC by fluorescein angiography, fundus photography, and light and electron microscopy. Fluorescein angiography and fundus photography revealed a pattern of retinopathy similar to that described by other investigators, eg, blood-retinal barrier breakdown and the patchy nature of the RPE/CC degeneration. One week after injection of iodate, the RPE transformed into a mixture of flattened, depigmented cells and plump, highly pigmented ones lying along Bruch's membrane. The CC appeared normal by light microscopy, but electron microscopy revealed changes indicating CC atrophy: degenerating endothelial cells (EC), EC that appeared normal but had reduced numbers of fenestrae, and pericapillary basal laminae that looped away from the endothelium, as if the latter had shrunk. One month after iodate, patches of Bruch's membrane were devoid of RPE, which was replaced by scar tissue. The CC was markedly atrophic over these patches, having reduced numbers of profiles and smaller lumina in those which remained. The CC appeared normal over areas where RPE remained. Eleven weeks after iodate, the light microscopic picture parallelled that seen 1 month after injection, but the patchy RPE degeneration was more extensive. By electron microscopy, the CC profiles over areas devoid of RPE showed severe atrophy. Degenerating EC were more numerous. EC adjacent to areas of RPE loss had few or no fenestrae. Here, capillaries were encased in dense, collagenous, connective tissue, unlike the CC of normal rabbits. These changes were not seen where the RPE still covered Bruch's membrane. These observations suggest that RPE modulates CC structure and function. The authors propose that a diffusible vascular modulating factor produced by RPE cells does this. PMID- 6480294 TI - Changes in chick corneal lipids during development. AB - Chick corneas from days 9 through 18 of embryonic development were analyzed for phospholipid and glycolipid content, and for phospholipid and ganglioside classes using chromatographic techniques. Little change in phospholipid headgroup classes was detected during this time span, with the exception of a steady increase in the content of phosphatidylserine from 12 to 18% of the total. Changes in glycolipid content also were observed, with a maximum in the sphingolipid/phospholipid ratio at day 14. This increase was correlated with the appearance of highly sialylated gangliosides at days 14 and 15; these ganglioside species then declined in abundance until they were no longer detectable at day 18. These results indicate that gangliosides with high sialic acid content undergo stage-specific developmental cycles in the chick cornea. Furthermore, the data suggest that phosphatidylserine content may be a sensitive biochemical measure of corneal innervation. PMID- 6480295 TI - A simple geometrical method of measuring anterior chamber dimensions. AB - Equations are described to derive the true anterior chamber dimensions of an eye from a photograph of its optical section. If the surface of the eye is assumed to be spherical, the three-dimensional coordinates of rays emanating from the anterior chamber to a camera can be transformed to two-dimensional coordinates on a plane, which contains rays both inside and outside of the "eye." The actual dimensions of the anterior chamber then were computed on the basis of the ray tracing over the entire corneal surface. The accuracy of the equations was checked using scales prepared from photographs of curvilinear grids inside an artificial anterior chamber. The advantages of this method are that the true anterior chamber dimensions can be measured in an eye of any corneal curvature and with any type of slit-lamp camera. It appears sufficiently accurate and convenient to be used for clinical and animal studies. PMID- 6480296 TI - Polymorphonuclear neutrophils delay corneal epithelial wound healing in vitro. AB - Using an in vitro system for measuring epithelial wound healing, we studied the effect of polymorphonuclear neutrophils (PMNs) and PMN lysate on rat corneal epithelial wound healing. After 22 hr of organ culture, epithelial defects that were originally 3 mm in diameter (7.06 mm2) measured 0.41 mm2 (range, 0.17-0.72 mm2) in control rat corneas, 2.11 mm2 (range, 0.81-3.91 mm2) in corneas incubated in medium containing 5 X 10(6) PMN/ml, and 2.49 mm2 (range, 2.21-2.76 mm2) in corneas incubated with lysate obtained from an equivalent number of PMNs. Scanning and transmission electron microscopy showed similar morphology in the three groups. PMNs selectively adhered to the leading edge of the wound in corneas incubated with PMNs. These data indicate that PMNs and PMN lysate significantly slow corneal epithelial wound healing in vitro. PMID- 6480297 TI - An improved method for restraining rabbits for examination of the eye. AB - Rabbits are strapped to a specially shaped platform with their legs dangling over the sides. This system of restraint allows freer access to the eyes for examination than other methods and prevents the animal from injuring itself by kicking. The animals appear to be quite relaxed and show no signs of harm on release. PMID- 6480298 TI - Herpetic keratitis in inbred mice. AB - The corneas of four inbred strains of mice (BALB/c, DBA/2, C3H and C57BL/6) were inoculated with the RE strain of herpes simplex virus, type 1. The corneas were examined at frequent intervals and graded on a scale of 0 (clear cornea) to +5 (severe necrotizing stromal keratitis). At 3 weeks postinfection, the mean corneal scores were: DBA/2, 4.0; BALB/c, 2.2; C3H, 0.7; and C57BL/6, 0.15. The differences between the scores are statistically significant (P less than 0.05), except for the C3H and C57BL/6 strains. The order of severity of corneal disease in these mice corresponds to the order of susceptibility to systemic infection found in these same inbred strains. Additional studies of herpetic keratitis in inbred mice should prove helpful in understanding the genetic and immunologic basis of herpetic stromal keratitis. PMID- 6480299 TI - Outflow facility in acute experimental ciliochoroidal detachment. AB - Total outflow facility was measured by constant pressure perfusion in six cynomolgus monkey eyes with ciliochoroidal detachment and in fellow eyes following sham operation. Outflow facility in eyes with ciliochoroidal detachment was 0.22 +/- 0.04 microliter/min-1/mmHg-1 (P less than 0.05). Since the spontaneous intraocular pressure following acute ciliochoroidal detachment was lower than the normal episcleral venous pressure, it is concluded that the increase in outflow facility in eyes with ciliochoroidal detachment actually may be a measure of the rate of fluid flow across the sclera out of the suprachoroidal space. PMID- 6480300 TI - Calibration of saccades in infants. AB - Prism induced shift of fixation was measured in 12 cooperative patients utilizing electro-oculography. These recordings were compared with a voluntary shift in fixation of the same eye. No differences were noted when comparing voluntary movements with prism induced movements. Trial of the prism induced eye movement for calibration in a group of 10 infants has shown it can be used successfully. PMID- 6480301 TI - "Pulsatile" abdominal mass. PMID- 6480302 TI - Hydrostatic pulmonary edema. An analysis of lung density changes by computed tomography. AB - The computed tomographic (CT) appearance of pulmonary edema induced by elevated left atrial (LA) pressure was examined. Dogs, in the prone position, were scanned during suspended ventilation at functional residual capacity. A surgically implanted LA balloon was inflated to elevate LA pressure for 30 to 140 minutes to a mean pressure of 29.8 mm Hg. Lung water, measured gravimetrically, averaged 14.7 ml/kg body weight compared with 5.7 ml/kg in nonedema control dogs. Lung density in dogs with edema was 69.5% higher than base-line density, while in the control group final lung density was only 4% higher than base line. Analysis of regional density indicated that there were greater increases in density in more central and dependent (ventral) zones of the lung and relatively smaller increases in nondependent (dorsal) peripheral zones. These results are in contrast to the previously reported pattern of density change seen with oleic acid injury in which density increases were primarily in peripheral zones of the lung. PMID- 6480303 TI - Measuring lung volumes from chest films using equations derived from computed tomography. AB - Computed tomographic scans show true cross-sectional area of a segment of the chest. Measurement of the cross-sectional area of the lung at several adjacent levels permits calculation of a geometrically defined volume. CT scans from 26 cases were used to derive equations to predict regional volume from measurements which can be obtained from plain PA and lateral chest films. Separate equations were derived for slices above and below the top of the diaphragm. The best correlation between linear dimensions and true volume was obtained with equations that used lung width and antero-posterior (AP) diameter of each scan, maximum AP lung diameter, and relative scan level (apex to base). These equations predicted the volumes of individual slices above the diaphragm with a correlation coefficient (r) of 0.99 on the right, 0.97 on the left. Below top of the diaphragm, r was 0.91 on the right, 0.92 on the left. Total lung volume was predicted with an r of 0.98 (s.e. 4.8%) on the right and 0.97 (s.e. 5.3%) on the left. Using total chest width instead of AP diameter of each slice reduced r to 0.96 for the volume of either lung. This method compares favorably with previous regression or geometric approximation methods for total lung volume and also makes it possible to obtain estimates of portions of lung volume from chest films. PMID- 6480304 TI - Architecture of the myocardium in computed tomography. AB - To determine whether current concepts of myocardial organization were in fact the result of artifacts introduced by the dissection technique, a method comprising air injection of the coronary arteries (which gently separated the myocardial fibers) and computerized tomography was devised. Viewing the tomographs cinematographically confirmed the concept that the heart is formed by a double looping of myocardial fiber bands was correct. Examination of abnormal hearts, eg, one with Duchenne muscular dystrophy, shows that pathologic tissue disarrangements could also be identified. PMID- 6480305 TI - A phantom for testing ECG-gated computed tomography of the heart. AB - A mechanical phantom has been built to evaluate electrocardiographically gated computed tomography of the heart. The phantom simulates the heart in terms of cyclic changes in chamber dimensions and wall thickness. Rate and excursion are variable, and the cavity of the chamber can be filled with liquid contrast media of different degrees of radio-opacity. Preliminary experiments with a prototypic gating system are described. PMID- 6480306 TI - Microvasculature architecture of small liver metastases in man. A correlation between microfil vascular preparations and histologic sections. AB - The hepatic artery and the portal vein of 12 human cadaver livers with metastases of various sizes and origins were injected with Microfil. The microvascular appearances of the metastases were studied in order to receive an explanation to findings at angiography and contrast enhanced computed tomography. Histologic examinations were also performed of Microfil-injected specimens. PMID- 6480307 TI - Dynamic CT of liver cirrhosis. AB - Time-density curves of the liver and spleen from dynamic CT-scans, performed on ten patients with liver cirrhosis and 15 patients with fatty liver were compared with 41 normal cases. After the intravenous bolus injection of urographic contrast medium (18.5 g I), six scans per minute for 2 minutes and single scans at 3, 4, and 5 minutes were executed. In patients with fatty liver the curves of the liver and spleen did not differ from those in the normal patients. In liver cirrhosis the peak contrast enhancement of both liver and spleen was lower and delayed and the washout phases slower. The results indicate that the patterns of the time-density curves of the liver and spleen may contain diagnostic information in liver cirrhosis. PMID- 6480308 TI - Computed tomography in the detection of abdominal metastases from malignant melanoma. AB - Malignant melanoma is an unpredictable and often virulent cutaneous malignancy. Although computed tomography is the most sensitive method for detection of intrathoracic metastases, its value in the assessment of abdominal spread has not been fully defined. We evaluated the sites of CT-identified metastases in 70 patients with pathologically confirmed malignant melanoma. Results were correlated with Clark's level, Breslow thickness, site of the primary, and clinicopathologic stage. CT detected enlarged abdominal or pelvic lymph nodes in 75% of patients with Clark's level 5 lesions but only in 24% and 33% of those with level 3 and 4, respectively. Patients with deep primary lesions of the lower extremities had a high frequency of pelvic node metastases. Liver and splenic metastases were detected in up to 25% of patients with level 4 or 5 melanoma. Adrenal and subcutaneous metastases were frequently discovered as were unsuspected nodules at the lung bases. PMID- 6480310 TI - The Iowa wrestling study: lessons for physicians. PMID- 6480309 TI - Neuronal effects of water-soluble contrast agents. AB - The in vitro rat hippocampus slice preparation has been utilized to examine the direct neurotoxicity of water-soluble contrast agents. Intraneuronal recordings were obtained from pyramidal cells in the CA1 field of rat hippocampus slices. Synaptic activity was evoked by Schaffer's collateral stimulation. The effects of Na-diatrizoate and metrizamide were studied. Test solutions were 300 to 345 mOsm and had iodine concentrations of 22.5 to 30 mg I/ml which are probably near clinical concentrations. The two effects of the contrast agents are apparent within 10 minutes and reversible within 30 to 45 minutes. The first is an epileptogenic property reflected by repetitive action potentials arising from an early prolonged depolarization. The second effect is a depression of electrical activity characterized by hyperpolarization of the resting membrane potential. Na diatrizoate predominantly produced the first effect. Metrizamide principally produced the second effect. These results indicate that contrast agent seizure activity is not due to hyperosmolarity but a more direct chemical effect. The depression, however, may be related to a hyperosmolar effect. The differences between the dominant effects of the ionic vs. nonionic agents observed in these experiments seem to correlate with clinical experience and may indicate the etiology of central nervous system neurotoxicity of these drugs. PMID- 6480311 TI - Common and preventable: pill esophagitis. PMID- 6480312 TI - Classification of Vibrio bacteriophages. AB - 85 Vibrio phages, 84 of them tailed and 1 filamentous, were surveyed. The tailed phages belonged to six basic morphotypes and to the Myoviridae, Siphoviridae, or Podoviridae families. 63 phages were classified into 18 species. The filamentous phage is a member of the Inovirus genus of the Inoviridae family. Vibrio phages are very heterogenous and include some morphologically interesting viruses. Several Vibrio phages closely resemble phages of other gram-negative bacteria, possibly indicating phylogenetic relationships between their hosts. PMID- 6480313 TI - Should tomato spotted wilt virus be considered as a possible member of the family Bunyaviridae? AB - From a comparison of published data on the properties of tomato spotted wilt virus and viruses in the family Bunyaviridae, it is concluded that tomato spotted wilt virus should be considered as a possible member of the family. PMID- 6480314 TI - Examination of the mode of action of ribavirin against tobacco mosaic virus. AB - Ribavirin inhibited a specific step of tobacco mosaic virus (TMV) replication. Time-courses of sensitivity of TMV multiplication in asynchronous and synchronous infections demonstrated that ribavirin inhibited an early function that occurs prior to the period of viral RNA and protein synthesis. In the synchronous infection, ribavirin inhibited the synthesis of both single-stranded genomic RNA and double-stranded replicative form RNA when treatment began during the first 4 h, but there was no inhibition when treatment began at 12 h or later, even though most RNA synthesis occurred after 12 h. Viral protein synthesis also was inhibited when treatment began during the first 4 h and not when treatment began later. Unlike the mechanisms proposed against animal viruses, ribavirin appears to inhibit TMV replication by preventing an early function that is necessary to initiate viral RNA synthesis. PMID- 6480315 TI - Retrograde electrical pacing and its influence on the migrating motor complex of the canine jejunum. PMID- 6480316 TI - A comparison of plasma and saliva levels of carbamazepine and phenytoin as monotherapy. PMID- 6480317 TI - Management of a widowmaker. PMID- 6480318 TI - Metabolic changes in small bowel ischaemia. PMID- 6480319 TI - Diagnosis and management of gastric polyps: study of fifteen cases with review of the literature. PMID- 6480320 TI - Epidural morphine for post-operative analgesia: experience with ten cases. PMID- 6480321 TI - Portuguese type amyloidosis in an Irish patient. PMID- 6480322 TI - Bilateral stress fractures of the fused lower fibular epiphysis. PMID- 6480323 TI - Neurogenic claudication (spinal stenosis). PMID- 6480324 TI - An unrecognised zoonosis?: Leptospirosis hardjo in man in the Republic of Ireland. PMID- 6480325 TI - Traumatic diaphragmatic rupture--an occult injury. PMID- 6480326 TI - The use of hospital facilities in general practice: a survey. PMID- 6480327 TI - Infective endocarditis. PMID- 6480328 TI - Farming and industrial accidents in the midlands during 1981--a pilot study. PMID- 6480329 TI - Unexpected delivery outside hospital. PMID- 6480330 TI - Hallucinations--an unusual adverse reaction to chlorambucil. PMID- 6480331 TI - Symptomatic, nonstenotic carotid bifurcation atherosclerosis. PMID- 6480332 TI - Consultation rates in a group of West Cork general practitioners. PMID- 6480333 TI - A review of the factors affecting consultations in general practice. PMID- 6480334 TI - A cotton dust study unmasked. PMID- 6480335 TI - In defense of the dignity of being human. PMID- 6480336 TI - Bone marrow metastases--26 years' experience. PMID- 6480337 TI - Acupuncture practice in Hawaii. PMID- 6480338 TI - Anatomy of a dermatology practice--a year's experience on Kauai. PMID- 6480339 TI - The utility of shave biopsy in office practice. PMID- 6480340 TI - [Current status of dermatology research]. PMID- 6480341 TI - [Mucinosis follicularis. Histologic and electron microscopy studies]. AB - We studied a case of idiopathic mucinosis follicularis which persisted for 7 months. Histologically, the strong pathological changes began within the sebaceous glands and secondarily occurred in other parts of the pilosebaceous unit. We could demonstrate by electron microscopy that all the follicular cells in this process were undifferentiated sebaceous cells. Therefore, we think that the pathogenesis of mucinosis follicularis originates from a disturbance in the differentiation process of sebaceous cells. PMID- 6480342 TI - [Cutis hyperelastica circumscripta. A case report with a morphologic study]. AB - This is a report on a 20-year-old female patient with localized cutis hyperelastica. Light and electron microscopy revealed an increase of elastic fibers compared to collagen tissue. PMID- 6480343 TI - [Necrobiosis lipoidica in a patient with bronze diabetes]. AB - A case of necrobiosis lipoidica in a patient with idiopathic hemochromatosis and diabetes mellitus is presented. Histologic examination revealed excessive amounts of iron pigment in macrophages in the corium of the necrobiotic skin. There were no iron deposits in the normal skin. PMID- 6480344 TI - [Malignant blue nevus in Ota's nevus]. AB - A 21-year-old Caucasian woman with congenital nevus of Ota developed a subcutaneous tumor below the lacrimal sack within the area of discoloration. The tumor, located subcutaneously, has been present for 4 years. Histologically, parts of the tumor showed neuroid structures as well as those like cellular blue nevus. In one part, however, malignant transformation features could be found. PMID- 6480345 TI - [Morphologic knowledge of polyneuropathy in progressive scleroderma]. AB - The occurrence of polyneuropathy in connection with systemic sclerosis is extremely rare. Proliferative changes leading to mechanical compression of the nerves have been ascribed to an etiological involvement. In the case reported here, polyneuropathy could be verified morphologically (nervebiopsy). The elevated IgG in the cerebrospinal fluid suggests inflammatory changes of the nerves to be the cause of polyneuropathy. PMID- 6480346 TI - [Cutaneous leiomyosarcoma]. AB - Primary cutaneous leiomyosarcomas are rare mesenchymal skin tumors with relatively good prognosis and low risk of metastasis if there is no subcutaneous involvement. A 48-year-old patient with a primary cutaneous leiomyosarcoma of ten years duration is described. Therapy and differential diagnosis are discussed. PMID- 6480347 TI - [Penetration of benzoyl peroxide in the skin]. AB - Benzoyl peroxide preparations have proven to be effective agents in the treatment of acne. In comparison to the numerous clinical communications, very few reports exist concerning the pharmacokinetics of benzoyl peroxide. The benzoyl peroxide content of abraded horny layers and its metabolite benzoic acid were investigated by high-pressure liquid chromatography after application (1-2 min) of emulsion containing benzoyl peroxide. It was found that benzoyl peroxide penetrates the stratum corneum very quickly where it is rapidly degraded to benzoic acid. No benzoyl peroxide depot in the stratum corneum could be demonstrated. PMID- 6480348 TI - [Cheilitis granulomatosa (Melkersson-Rosenthal syndrome): treatment with clofazimine]. AB - A pilot study with the anti-leprosy agent clofazimine was conducted on seven patients with cheilitis granulomatosa or complete Melkersson-Rosenthal syndrome. Beneficial effects were observed in all patients, dependent on the degree of the clinical expression of the disease: the variable attacks of lip swelling, characteristic for the edematous phase of this disease, were suppressed promptly and completely in all patients. Persistent residual swelling of the lips, caused by cellular inflammatory infiltrates, which was present in four patients prior to therapy, responded much less rapidly and--in three out of four--only incompletely. After drug withdrawal, four patients remained free of symptoms for periods ranging from 5 to 45 months; the remaining three patients relapsed after intervals of 3-18 months. The mode of action clofazimine takes in cheilitis granulomatosa is not understood at the present time but is likely to be linked to the phagocytosis-stimulating effect of this drug on macrophages. PMID- 6480349 TI - [Congenital onychodysplasia: Iso-Kikuchi syndrome]. AB - We report the first German case of Iso-Kikuchi syndrome, which is characterized by a congenital onychodysplasia commonly involving the index fingers, but not infrequently also the neighbouring fingers, and typical bony alterations of the corresponding terminal phalanges. This is also the first report of associated great toe anomalies. PMID- 6480350 TI - Health impact of radioactive debris from the satellite Cosmos 954. AB - This paper describes a program of laboratory and field studies undertaken to assess the health impact of radioactive debris from the re-entry of the Soviety nuclear-powered satellite, Cosmos 954, on 24 January 1978. It was estimated that about one-quarter of the reactor core descended over Canada's Northwest Territories in the form of submillimetre particles. The other three-quarters apparently remained as fine dust in the upper atmosphere. Each particle contained megabecquerel quantities of the fission products 95Zr, 95Nb, 103Ru, 106Ru, 141Ce and 144Ce, as well as traces of other fission and activation products. Laboratory tests indicated that these radionuclides would not dissolve significantly in drinking water supplies or in dilute acids. Contamination of air, drinking water, soil and food supplies was not detected. The dose equivalent to the GI tract for an individual who might have inhaled or ingested a particle could have been as high as 140 mSv. PMID- 6480351 TI - The assessment of unwanted radiation around diathermy RF capacitive applicators. AB - The electromagnetic field intensities in the vicinity of apparatus which generate RF fields are influenced by a multiplicity of variables which are tied to the conditions of their use. The setting up of proper ambient surveillance requires the predisposition of operational protocols which take variable factors into account, permitting the individualization of major risk situations, and assuring the repeatability and comparability of the results. To that end, in relation to a diathermy apparatus operating at 27.12 MHz (a source of excess radiation in confined environments), the variation of the levels of E-field intensities as a function of the configuration of phantom-electrodes are determined experimentally. Finally a theoretical relation is determined, which, in accord with the experimental data, permits the generalization of the results obtained for a multiplicity of real situations. PMID- 6480352 TI - Radon-222 in the gastrointestinal tract: a proposed modification of the ICRP Publication 30 model. AB - The New England states have a long involved history of radon in individual well water supplies. As a result of these previous findings on the abundance of radon, coupled with its potential health impact, the New England Radiological Health Committee (NERHC) formulated a technical working group in 1980 which was charged with evaluating the possibility of developing uniform concentration guidelines for radon in individual domestic water supplies. This working group determined that the current ICRP Publication 30 metabolic model for the gastrointestinal (GI) tract was inadequate to address the empirically observed rates of 222Rn removal from the body. A modification to the ICRP Publication 30 GI tract model is proposed which attempts to resolve these differences. Calculations are presented, using both the original and modified ICRP Publication 30 models, which indicate that individual potable water supplies containing 222Rn concentrations as high as 400,000 pCi/l. do not significantly increase the probability of stomach or intestinal cancer, as defined by the BEIR III risk estimates. Since this paper deals exclusively with the GI tract, no attempt is made to address the lung burden imposed by the contribution of radon released into the household air by aeration at the tap or other fixtures. Only when the contribution of the radon water source term to both the respiratory and ingestion pathways is evaluated as a whole can any meaningful standard for 222Rn in individual domestic water supplies be established. PMID- 6480353 TI - Probability for human intake of an atom randomly released into ground, rivers, oceans and air. AB - Numerical estimates are developed for the probability of an atom randomly released in the top ground layers, in a river, or in the oceans to be ingested orally by a human, and for an atom emitted from an industrial source to be inhaled by a human. Estimates are obtained for both probability per year and for eventual probability. Results vary considerably for different elements, but typical values for total probabilities are: ground, 3 X 10(-3); oceans, 3 X 10( 4); rivers, 1.7 X 10(-4); and air, 5 X 10(-6). Probabilities per year are typically 1 X 10(-7) for releases into the ground and 5 X 10(-8) for releases into the oceans. These results indicate that for material with very long-lasting toxicity, it is important to include the pathways from the ground and from the oceans. PMID- 6480354 TI - Predicting the apparent half-life for 3H rainout in United States, 1972-1980. PMID- 6480355 TI - Radiocontamination in medical centers from diagnostic nuclear medicine procedures. PMID- 6480356 TI - An estimate of the somatically effective dose from diagnostic radiology in the Netherlands during 1976-1980. PMID- 6480357 TI - The activities and total number of transformations in organs following the ingestion of radionuclides. PMID- 6480358 TI - The effects of sera from Ra dial painters on the mitogenic responses of normal human lymphocytes. AB - Sera from former Ra workers were incubated with normal human lymphocytes and the effects produced in stimulation assays with specific mitogens were compared with those observed with incubation using normal human sera. The sera from the Ra workers with high residual body burdens (greater than 0.1 muCi 226Ra) inhibited normal control lymphocytes stimulated with Con A and PHA when compared with control homologous sera. Although a significant suppression was not obtained between high- and low-body-burden groups a trend was indicated. Sera from the highest body-burden worker (0.58 muCi) was inhibitory to all normal lymphocyte populations tested regardless of the mitogen stimulant employed. PMID- 6480359 TI - Two decades of health physics at INMAS. PMID- 6480360 TI - Utility of excretion data for estimation of 147Pm body burdens of dial painters. PMID- 6480361 TI - A case of Hb J-Camaguey or alpha 2141(HC3)Arg----Gly beta 2 in a Chinese family. PMID- 6480362 TI - Hemoglobin Kariya or alpha 240(C5)Lys----Glu beta 2 in a Caucasian family from South Carolina. PMID- 6480363 TI - Hemoglobin Presbyterian [beta 108(G10) Asn----Lys] found in Japan. PMID- 6480364 TI - Hb Beograd-beta zero thalassemia in a Turkish family from Yugoslavia. PMID- 6480365 TI - Citrate agar electrophoresis of Lemur hemoglobins: relationship to DPG binding. PMID- 6480366 TI - Micronuclei and chromosome aberrations found in bone marrow cells and lymphocytes from thorotrast patients and atomic bomb survivors. PMID- 6480367 TI - Defect in lung perfusion and ventilation scanning of patients with permanent transvenous implantable pacemaker. PMID- 6480368 TI - Influence of Ureaplasma urealyticum and Mycoplasma hominis on the human spermatozoal motility. PMID- 6480369 TI - Function of trace metal in experimental fulminant hepatic failure--special reference to variation in zinc content in liver. PMID- 6480370 TI - Effect of electrical stimulation on healthy skeletal muscles. PMID- 6480371 TI - Isolation of Ureaplasma urealyticum and Mycoplasma hominis from patients with genitourinary tract infection. PMID- 6480372 TI - High performance gel-chromatography as a parameter for the progress of hepatic failure in dogs. PMID- 6480373 TI - Recent knowledge on the cleft hand: it's pathologic pattern and scope. PMID- 6480374 TI - A salivary gland lymphoma involving contralateral parotid gland and submaxillary gland with a review of the literature. PMID- 6480375 TI - A statistical evaluation on the age and sex distribution of basal serum gastrin and gastric acid secretion in subjects with or without peptic ulcer disease. PMID- 6480376 TI - The serum pregnancy associated alpha 2-glycoprotein level in patients with IgA nephropathy. PMID- 6480377 TI - Histochemical and ultrastructural studies on experimental gastritis in mice. PMID- 6480378 TI - Application of computer system to analysis of muscle morphology: statistical analysis of spatial pattern of muscle fibers. PMID- 6480379 TI - A case of cystinuria with nephrotic syndrome. PMID- 6480380 TI - Evaluation of estrogen dependency of human breast cancers. II. Clinical evaluation of tamoxifen in advanced primary and recurrent breast cancer. PMID- 6480381 TI - Xeromammography: a study of 59 cancers and 204 non-cancerous lesions of the breast. PMID- 6480382 TI - Membrane potential changes in polymorphonuclear leukocytes of patients with chronic granulomatous disease. PMID- 6480383 TI - Surgical treatment for periampullary carcinoma: a study of 129 patients. PMID- 6480384 TI - VIPergic innervation of the gall bladder in health and disease. PMID- 6480385 TI - A rare type of polydactylous thumb and its surgery. PMID- 6480386 TI - Review of a case with a rare heterotopic redundant limb. PMID- 6480387 TI - Recent trend of surgery for thumb polydactyly--plastic operation using the removed thumb as fillet pedicle. PMID- 6480388 TI - Ultrastructural aspect in the immotile cilia syndrome. PMID- 6480389 TI - A case report of postradiation sarcoma. PMID- 6480390 TI - The microanalysis of rat brain noradrenaline and dopamine by high performance liquid chromatography. PMID- 6480392 TI - Firefly luciferase assay for adenosine triphosphate in cultured cells. PMID- 6480391 TI - Detection of low molecular weight urokinase in plasma of patient with acute pancreatitis followed by disseminated intravascular coagulation. PMID- 6480393 TI - Fluorometric measurement of neuraminidase activity of influenza viruses. PMID- 6480394 TI - The structure of the middle ear epithelium of the rat and the effect of Eustachian tube obstruction. AB - The middle ear cavity of the rat is lined with ciliated and squamous epithelium. The arrangement of the ciliated cells, interspersed with secretory cells, in distinct tracts and their continuity with the ciliated epithelium of the Eustachian tube, suggests the existence of a mucociliary transport system for cleaning the middle ear cleft. The secretory cells produce either neutral or sulphated glycoproteins, dependent on their location. In addition to these secretions, the epithelium of the lower part of the Eustachian tube is bathed with secretory products of seromucous glands. Also in the areas with squamous epithelium, numerous small secretory cells, the character of which is only identifiable with the electronmicroscope, are present. It is concluded that the middle ear lining can be considered as a locally modified respiratory epithelium. Blockade of the mucociliary transport system, supposedly a crucial aetiological factor in secretory otitis media, by obstruction of the Eustachian tube, induces pathogenic behaviour of microorganisms normally present in the middle ear. This results in either a transient or a longstanding infective middle ear disease, associated with a large variety of changes of the mucosa, especially with respect to the secretory activity. The data obtained indicate that the increased secretory activity encountered in secretory otitis media cannot be attributed to the isolated effect of tubal occlusion, but rather to an infective process. PMID- 6480395 TI - The use of colloidal gold complexes in an ultrastructural study of lectin-binding sites and matrix deposition of normal human primary breast epithelium on collagen gels. AB - Colloidal gold probes were used to study the distribution of peanut agglutinin binding sites and the deposition of extracellular fibronectin and type IV collagen in cultured human breast cells grown on type I collagen gels. Qualitative analysis was performed at the ultrastructural level and appraised in relation to the possible role of peanut agglutinin, fibronectin and type IV collagen as functional markers for distinguishing cell types using this methodology. Peanut agglutinin bound to the surface of cuboidal epithelial cells but not on basal, putative myoepithelial cells in the cell islands, suggesting that it may be a useful functional marker. The binding on the epithelial cells was markedly increased by pre-treatment of the cells with neuraminidase. No correlation was seen between the amount of binding and either the surface topography or cellular ultrastructure. Fibronectin and type IV collagen were demonstrated on the fibrillar network left on the collagen gels after removal of the cell sheet. Any cells still adhering to the gel surface showed no evidence of gold probe binding on their upper surfaces. Examination of the under surfaces of the cell sheet showed gold probe binding equivalent to that found on the gels under the cells. However, it was not proven conclusively which cells produce the fibronectin and type IV collagen. PMID- 6480396 TI - Simultaneous high resolution localization of Ag-NOR proteins and nucleoproteins in interphasic and mitotic nuclei. AB - Silver stainable proteins of the Nucleolar Organizer Regions (Ag-NOR proteins) of human breast cancer tissues have been localized at the electron microscopical level with a new method which combines a simple and reproducible one step Ag-NOR staining method combined with an acetylation procedure. This new method allows the fine identification of nucleolar components, particularly those which are stained by silver. In order to determine the cytochemical nature of the components associated with Ag-NOR proteins, the EDTA regressive preferential staining procedure for ribonucleoproteins has been applied to sections. By this means the precise localization of the Ag-NOR proteins was studied simultaneously with that of ribonucleoprotein within interphasic nucleoli and mitotic chromosomes. In interphasic nucleoli, stainable Ag-NOR proteins were localized in fibrillar centres and part of the dense fibrillar component. No silver deposits were seen on perichromatin or interchromatin fibrils and granules. In metaphasic nuclei, Ag-NOR proteins were only found on roundish fibrillar ribonucleoprotein structures, which could correspond to secondary constrictions. No silver deposits were seen on the well defined ribonucleoprotein sheet surrounding the chromosomes. In telophasic nuclei, Ag-NOR proteins were seen on the central part of roundish ribonucleoprotein fibrillar structures integrated in decondensing chromosomes. These structures have been interpreted as the nucleolar organizer regions around which rRNA synthesis resumes. In interphasic and mitotic nuclei, Ag-NOR proteins were never found within condensed chromatin but always in association with ribonucleoprotein components. The new method proposed here appears to be a useful tool for the simultaneous study of the localization of ribonucleoprotein and Ag-NOR proteins during the cell cycle. PMID- 6480397 TI - A quantitative histochemical technique for the study of vascularization in tissue sections using horseradish peroxidase. PMID- 6480398 TI - Histochemical localization of monoamine oxidase in whole-body, freeze-dried sections of mice. AB - Monoamine oxidase was investigated histochemically in tissues of the mouse by incubating freeze-dried, whole-body sections with tryptamine, serotonin, tyramine, beta-phenylethylamine, or benzylamine as substrate and Nitroblue tetrazolium as the final electron acceptor. The most intense staining with tryptamine was exhibited by intestinal epithelium and adrenal cortex; moderate staining was noted in the epithelium of the nose, bronchi, oesophagus, and upper stomach and in preputial gland, pancreas, nerve, spinal cord and brain. Weak staining was seen in the lung, spleen, liver and kidney. The distribution of the formazan deposition was similar, but much less intense, when serotonin and tyramine were used as the substrates. Only very weak staining was observed when beta-phenylethylamine was the substrate; no staining was seen with benzylamine. Monoamine oxidase activities with tryptamine were greatly inhibited by pretreatment with clorgyline (10 microM), while deprenyl (10 microM) slightly inhibited activities in all tissues except liver. This staining technique should be useful in further studies on the identification of the multiple forms of monoamine oxidase in tissues of the mouse. Nicotine and nitrosonornicotine were not substrates in any of the tissues; consequently, this enzyme system does not appear to produce the proximal carcinogen from this nitrosamine. PMID- 6480399 TI - Immunocytochemistry of lysosomal hydrolases and their precursor forms in normal and mutant human cells. AB - The acid hydrolases alpha-glucosidase, beta-galactosidase, N-acetyl-beta-D hexosaminidase, beta-glucocerebrosidase and cathepsin D were studied immunocytochemically in normal and mutant human cells using monoclonal and affinity-purified polyclonal antibodies. For light microscopy, Rhodamine or Fluorescein-labelled conjugates were used, and for electron microscopy protein A gold conjugates were employed. With the double labelling procedure, it was found that in normal fibroblasts every lysosome contained all the enzymes studied. The method described also enabled us to demonstrate the presence or absence of mutant enzyme protein in fibroblasts derived from patients with a genetic lysosomal enzyme deficiency. Immunoreactive acid hydrolases or their precursor forms were found in the rough endoplasmic reticulum, the cisternae of the Golgi complex, Golgi associated vesicles and lysosomes. This is in agreement with the present concept that the Golgi complex plays an essential role in the processing and targeting of lysosomal enzymes. PMID- 6480400 TI - The inhibitory effect of actinomycin D and cycloheximide on the increase in activity of glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase in experimentally induced diseased skeletal muscles. AB - The myotoxic effect of the subcutaneous administration of N,N1-dimethyl-p phenylenediamine (DPPD) in rats was enhanced by the simultaneous administration of hyaluronidase. The resulting myopathy was associated with an early and dramatic increase in activity of glucose-6-phosphate dehydrogenase and 6 phosphogluconate dehydrogenase. Administration of actinomycin D or cycloheximide prior to the combined DPPD and hyaluronidase treatment prevented the increase in activity of both pentose phosphate pathway enzymes, indicating that the increase in activity requires RNA synthesis and protein synthesis. The possibility that the increase in activity of both NADPH-regenerating enzymes results from the modification by effectors of existing less active forms of these enzymes leading to more highly active forms was refuted. PMID- 6480401 TI - Implementing the NACNE report. PMID- 6480402 TI - Next please: a review of dietetic out-patient attendance. AB - During a 12-month period all new out-patients referred for dietetic advice to the Mid-Ulster Hospital, Magherafelt were carefully monitored with respect to age, sex, weight, reason for referral and source of referral. Their degree of interest and compliance with their diet as measured by their follow-up rate was recorded. Weight-reduction patients provided the bulk of new referrals, and the main source of patients generally was the hospital out-patient department. Diabetic and weight-reduction patients showed similar trends in follow-up rates with 46 per cent and 42 per cent of the total referrals respectively being classified as 'regular' attenders. Weight loss in weight-reduction patients who returned for reviews was encouraging, being on average 5.0 kg per patient. Drop-out rates for all patients were high. PMID- 6480403 TI - Parents' attitudes towards school meals for primary school children in 1981. AB - Parents' opinions on the school meals system were obtained for 6468 English and 1977 Scottish parents in 1981, a year after new legislation for the school meals system was introduced in the UK. Uptake of school meals was 54.5 per cent and 29.6 per cent in the English and Scottish areas respectively. This was lower than at any time in the 1970s. Subscribers to the system were mainly from poorer sectors of the community and were less critical of it. The high price for school meals was the main factor in England that explained whether a child would take a midday meal at school. The nutritional advantages and disadvantages of school meals were recognized as more important characteristics of the system than provision for the child of a safe place to stay, an opportunity for social interaction or a reduction in the mother's time spent travelling. Poor families in wealthier communities, more than elsewhere, may be reluctant to claim free school meals because the demand for the service in the wealthy areas is lower than in the poorer areas and an individual child may be more easily identified by their classmates as receiving free lunches. The readiness of parents to take the child out of the scheme if he or she dislikes the meals may result in catering planners in schools being more prone to make easily available convenience foods which are attractive to children instead of less popular but healthier food. PMID- 6480404 TI - Influence of multi-holed shakers on salting on food. AB - In a study of 2241 Australian adults consuming main meals at a cafeteria, single and multi-holed (5, 9, 13) salt shakers were weighed before and after use. For all hole numbers, salt use increased linearly with an increase in hole area to a maximum value of 1.1-1.2 g which was the same irrespective of hole number. For a given hole area multi-holed shakers decreased salt use compared with single-holed shakers suggesting that multi-holed shakers are easier for consumers to control. However the greatest restriction in salt use (0.37 g per meal) is obtained by use of a single-holed shaker of 3 mm2 hole area. PMID- 6480405 TI - Contributions of foods to sodium in the Australian food supply. AB - The sodium contributions of various foods in the Australian supply have been calculated by applying recent local food composition data to food availability data and to typical notional Australian diets. Sodium available for consumption from the food supply was 3.00 g per capita per day. Of foods which are salted during processing, the three heaviest contributors of sodium were bread (23 per cent of total available sodium), processed meat and fish (14 per cent), and margarine (8 per cent). Other important contributors were breakfast cereals, biscuits, cheese, butter, potato crisps, dried soups and cakes (including pastries, pies and puddings). Foods identified by health authorities as 'highly salted' and thus prime targets for reduced consumption, provided 33 per cent of total available sodium, less than the 50 per cent contributed by other foods salted during processing. Take-away foods per se did not contribute more sodium than processed foods generally. PMID- 6480406 TI - Salting of take-away foods at point of purchase. AB - Sodium and potassium levels were determined in ten types of fried take-away foods and sandwiches purchased from retail outlets with and without the addition of salt by the food handler. In virtually all foods the major source of sodium was that added during manufacture of the food ingredients rather than that added by the food preparer. PMID- 6480407 TI - Epidemiology for nutritionists: 5. Some statistical aspects. AB - This paper discusses sample sizes, organisation of data, descriptive statistics, transformation of data, tests of significance, and confidence intervals. PMID- 6480408 TI - Nutrition education for children aged 7-11 years--a practical approach. PMID- 6480409 TI - The preparation and use of guar bread in diet therapy. AB - Guar bread rolls were prepared in the hospital diet kitchen from a recipe developed in the Food Science Department of Queen Elizabeth College, using a bread mix to which was added 30 g of guar gum (French, 1982). Four bread rolls per day provided 15 g guar. The dose can be varied as required. The method was satisfactory for home baking providing a regular supply of guar in small quantities can be made available. PMID- 6480410 TI - The debate about dietary fat in coronary heart disease is highly controversial. PMID- 6480411 TI - Ultrastructural localization of secretin in endocrine cells of the dog duodenum by the immunogold technique. Comparison with ultrastructurally characterized S cells of various mammals. AB - Secretin has been localized by the immunogold technique in endocrine cells of the dog duodenum--previously described as "K cells"--characterized by secretory granules with double structure consisting of a secretin-containing osmiophilic core surrounded by an argyrophil halo. Granules resembling those of dog secretin cells were also found in some ultrastructurally characterized S cells of the cat, pig, rat and rabbit duodenum, thus confirming in these species the identification of S cells with secretin cells. Conversely, the cells previously described as "S cells" in the dog lacked secretin immunoreactivity. PMID- 6480412 TI - Histochemically demonstrable catecholamines in sympathetic ganglia and carotid body of spontaneously hypertensive and normotensive rats. AB - The catecholamine content and morphology of the superior cervical and the hypogastric ganglion and the carotid body were studied in Spontaneously Hypertensive Rats (SHR) before (at the age of 6 weeks) and after (at the age of 20 weeks) becoming hypertensive, with Wistar Kyoto (WKY) rats as controls. The study was performed by formaldehyde-induced fluorescence method combined with quantitative microfluorimetry of catecholamines. At the age of 6 weeks the only significant difference observed between the rat strains was a greater number of small intensely fluorescent (SIF) cells in the superior cervical ganglion of SHR. At the age of 20 weeks the fluorescence intensity was higher in the principal neurons of the superior cervical ganglion and in glomus cells of the carotid body of SHR compared to WKY. The volumes of superior cervical ganglion and carotid body were larger in 20-week-old SHR compared to WKY. In the hypogastric ganglion differences were not found between SHR and WKY rats. The present results show differences in the superior cervical ganglion and in the carotid body of adult SHR compared to controls. These differences develop during the time period when the SHR become hypertensive, and might be functionally significant in the regulation or maintenance of the increased blood pressure in SHR rats. PMID- 6480413 TI - Chromosomes for molecular hybridization. Assignment of repetitive and single copy genes using a rapid filter-fixation method. AB - Specific recombinant DNA sequences (5S rRNA, B1, albumin) were assigned to flow sorted chromosomes of the Chinese hamster cell line CHV79. For this purpose, a rapid protocol was developed using filterbound chromosomal DNA and probing with various nucleic acids, that allows sequence identification in chromosomes. A flow histogram and a flow karyogram of the CHV79 cell line were established by flow analysis in order to calculate the amount of DNA per CHV79 cell and their chromosomes. Subsequently, metaphase chromosomes or chromosomal groups were fractionated by electronic sorting and a defined number of chromosomes was directly bound to nitrocellulose filters for sequence homology analysis by a dot blot hybridization procedure. This procedure not only allows the assigning of specific DNA sequences to particular chromosomes, it is also applicable to studies of changes in karyotypes, for example translocations of given sequences. PMID- 6480414 TI - Effects of glycoprotein and basement membrane synthesis inhibitors on the growth of cultured renal collecting duct epithelium. AB - The biochemical and morphological extent of glycoprotein synthesis inhibition of cellular and extracellular proteins was studied on cultured renal collecting duct (CD) epithelium. We found that tunicamycin (4 micrograms/ml) inhibits the glycosylation of a 150,000 d glycoprotein (gpCDI). A 85,000 d glycoprotein (gpCDII) was not affected. The inhibition by tunicamycin demonstrates that gpCDI has characteristics of a N-glycan, whereas gpCDII seems to be an O-glycan. 6 diazo-5-oxo-norleucine (4 X 10(-5) M) which was used as glutamine analogue, did not show a comparable inhibitory effect as seen with tunicamycin. The lack of effect of norleucine demonstrates that glutamine is not the locus of glycosylation in both proteins. However, because of the tunicamycin inhibition it points to asparagine as the site of glycosylation in the gpCDI. Long term cultures of the tissue up to 15 days in the presence of tunicamycin and norleucine and of substances usually used as basement membrane inhibitors, such as hydroxy-D-proline (1 mM), L-azetidine-2-carboxylic acid (1 mM) and o- and p nitrophenyl-xylopyranoside 1 mM), revealed that it is possible to eliminate completely the fibroblasts beneath the cultured epithelium and within the degenerating corematerial. Experiments with hydroxy-D-proline showed the most striking effect. Experiments with L-azetidine-2-carboxylic acid and nitrophenyl xylopyranoside resulted in the elimination of fibroblasts and dedifferentiation of the collecting duct epithelium. PMID- 6480415 TI - The use of ultrathin cryosections for localisation of influenza virus antigens in infected vero cell cultures. AB - The localisation of influenza virus antigens in infected Vero cell monolayer cultures by post embedding immunoelectron microscopy requires both good resolution and the retention of antigenicity in the tissue sections. Ultrathin cryosections are superior to ultrathin resin sections for this purpose. The colloidal gold probe was used in conjunction with specific antibody preparations to localise three viral proteins. Antibody raised against haemagglutinin glycoproteins labelled the host cell membrane and the virus fringe without contamination of the host cell nucleus, whereas antibody raised against viral nuclear protein labelled throughout the host cell cytoplasm and nucleus. Matrix protein was localised within the nucleus and was associated with the host cell membrane of the infected cell. The appearance of all these proteins was maximal 24 h post infection. PMID- 6480416 TI - The biochemical and ultrastructural studies on the effects of trimethyltin on regional brain lipid profiles and lipid peroxidation. PMID- 6480417 TI - Personal dosimeter for ozone using the ozonolysis of trans-stilbene. PMID- 6480418 TI - Effects of single exposure to toluene on operant behavior and brain toluene levels in rats. PMID- 6480419 TI - Alteration in carbohydrate metabolism of freshwater prawn, Macrobrachium lamarrei after dichlorvos exposure. PMID- 6480420 TI - Reduction of grinder vibration by balancing. PMID- 6480421 TI - Noise levels in a hospital. PMID- 6480422 TI - Studies on the inhibition of erythrocyte and hepatic delta-aminolevulinic acid dehydratase activities and its restoration in mice exposed to lead. PMID- 6480423 TI - Effect of time intervals of selenium administration after injection of mercuric chloride on toxicity and renal concentration of mercury in mice. PMID- 6480424 TI - A long-term survey of environmental, blood and urine mercury levels and clinical findings in workers manufacturing mercury relays. PMID- 6480425 TI - [Clinical aspects and pathology of chondromatous tumors of the larynx]. AB - Two cases of chondroma of the larynx are presented: After the first laryngofissure and excision both tumours recurred so that several operations became necessary. A transformation from chondroma to chondrosarcoma was observed based on repeated histological examinations. In the first patient pulmonary metastases and a recurrence at the tracheostomy appeared 11 years after presentation and 41/2 years after laryngectomy. In the other female patient no obvious signs of the neoplasm are present 9 years after presentation, and 4 months after the last operation for recurrence, but the prognosis remains undetermined. 101 cases of chondrosarcoma from the literature plus our 2 observations are listed and compared with 130 chondrosarcomas of the skeleton. Contrary to previous opinions, we conclude that chondrosarcoma of the larynx behaves in the same malignant manner as those of the skeleton. Some develop metastases quickly, others only after years and after at least one operation for recurrence. We could demonstrate that a detailed histological examination allows the prognosis to be assessed. Additional risk factors were also investigated. These two cases enable a better and more reliable judgement to be made of the prospective biological behaviour of chondromatous tumours of the larynx and at an earlier period of time of the process. PMID- 6480426 TI - [Experiences with the Blom-Singer prosthesis following Blom-Singer puncture and following functionally disordered neoglottis phonatria]. AB - The Blom-Singer puncture is a new operative technique which can help to make the laryngectomized patient speak again even years after laryngectomy. 34 patients were treated with a modified procedure. 5 patients with a good voice gave up despite intensive medical and speech therapy. Painstaking postoperative treatment is needed to make the Blom-Singer puncture successful. Patients who had a Blom Singer prosthesis fitted after a neoglottis procedure spoke after only brief instruction without speech therapy being necessary. PMID- 6480427 TI - [Glottoplasty--a new method of surgical voice rehabilitation]. AB - A simple operative technique is presented which restores speech without any later risk of aspiration in a one-stage operation performed together with the laryngectomy. 4 types can be distinguished depending on the extent of the resection and the amount of reconstruction necessary. The surgical technique is described. Resection of the tumour is not restricted. Our results on 85 patients are presented. Attention is drawn to mistakes and dangers. PMID- 6480428 TI - [Significance, necessity, indications and practical implementation of complex voice treatments within the scope of an inpatient treatment procedure (voice health cure)]. AB - The decisive advantages of inpatient therapy for voice disorders are described. The purpose of these complex and intensive health resorts for voice disorders is to change the tuning of the voice, and to alter the behaviour of the individuals using a deficient voice sound, ie. it is a holistic voice therapy. The concept of treatment covers a large spectrum of voice disturbances including paralyses and organic disorders. The results of therapy were satisfactory particularly with professional voice users. PMID- 6480429 TI - [Development of laryngoscopy]. AB - The development of laryngoscopy is described and the inventions of Kirstein, Killian, Seiffert, Kleinsasser and Weerda are mentioned. The development of microlaryngeal surgery and the anaesthesic techniques are also described. PMID- 6480430 TI - [Operative tasks with regard to the cranial base for ENT medical care. II]. PMID- 6480431 TI - [Clinical aspects of sudden deafness]. AB - Sudden deafness is a disease of multifactorial genesis. The cause remains as ever unknown. In addition to the vascular theory, the possibility of a perilymphatic fistula due to rupture of the oval or the round window membranes has gained more significance. Therefore the treatment of sudden deafness should begin as soon as possible. We treat such patients with infusions of Dextran 40. BVK and Complamin in increasing amounts, in addition to stella-ganglion block. It is not justifiable, for legal reasons to withhold treatment, and therapy should begin immediately. PMID- 6480432 TI - [Clinical study on the use of urografin in the treatment of sudden deafness. Necessary preliminary study, results and review]. AB - We treated 33 patients with a sudden hearing loss with Natrium - Meglumine diatrizoat (Urografin) when all other standard therapy had failed. Detailed investigations were carried out, and thorough measures were taken against anaphylactic reactions before and during the intravenous administration of Urografin. In 10 cases (30%) an improvement of hearing of at least 20 dB was observed with restitution of almost normal hearing in some cases. The treatment was most successful in those cases where an excessive hearing loss (more than 40 dB) occurred for the first time. Since the drug is only intended for diagnostic use, further use as a therapeutic agent will require legal endorsement. PMID- 6480433 TI - [Spontaneous remission in sudden deafness]. AB - In a group of 63 patients (average age 50.5 years) with a sudden hearing loss the result was an improvement in 89% of cases, and a complete remission without any treatment in 68%. For the whole group the average hearing improvement was 25.6 dB (based on an analysis of single frequencies at 0.5, 1, 2 and 5 kHz). Patients with minor hearing difficulty had the same rate of improvement as those with medium and severe loss of hearing, but a greater number of complete remissions. The rate of spontaneous remission decreased with age. 89% of 28 patients younger than 50 years showed an improvement in 96% of cases and a complete remission in 89%. The occurrence of tinnitus or previous damage to the affected inner-ear have no influence on the prognosis of spontaneous remissions in hearing loss. The comparison of different published methods used in the treatment of sudden hearing loss shows almost the same hearing improvement, and this does not differ essentially from the improvement due to spontaneous remissions. PMID- 6480434 TI - [Evaluation of individual prognosis in sudden deafness]. AB - Based on a recently published paper, we attempted to assess the individual prognosis for patients suffering from sudden deafness. We selected several factors of importance in the prognosis: Positive-Factors: no deafness, no vestibular dysfunction, therapy began within 4 days, and not more than one vascular risk factor. Negative-Factors: deafness, objective vestibular dysfunction, therapy began later than 21 days and more than one vascular risk factor. Every patient was examined and given a positive or negative score between +4 and -4. According to these results a good prognosis (in 70%) can be expected for patients with at least one positive factor, whereas poor prognosis was found (in 75%) of patients without a positive-factor. PMID- 6480435 TI - Pattern reversal evoked potentials in infantile spasms. AB - Visual evoked potentials in response to sinusoidal gratings of various spatial frequencies, alternating in contrast at 8 Hz were recorded from infants affected by an idiopathic form of infantile spasms (West syndrome). In two infants in whom the spasms began at 3 and 5 months of age, respectively, the VEP's were found to be depressed in amplitude at and around a spatial frequency of 3 and 5 c/deg, respectively. This midfrequency depression, which has never been reported in the literature for normal infants, suggests that infantile spasms in idiopathic patients may interfere at least temporarily with the development of visual function. PMID- 6480436 TI - Handwriting posture, visuomotor integration, and lateralized reaction-time parameters. AB - On a simple manual reaction-time (RT) task to lateralized visual signals, right handers and left-handers with the noninverted handwriting posture (RN and LN subjects, respectively) were faster and more consistent when the signal and response hand were homolateral as compared to heterolateral, but left-handers with the inverted handwriting posture (LI subjects) were not. For LI subjects, there was no speed difference for homolateral and heterolateral hand-signal combinations, and there was a clear and significant heterolateral superiority for response consistency. In agreement with suggestions of others, we believe that the anomalous response pattern of LI subjects is likely to be due to a disorder of visuomotor integration and cannot be attributed to reliance on uncrossed motor pathways. PMID- 6480437 TI - Normal and impaired development of children's gait. AB - The development of bipedal locomotion was studied electrophysiologically in 50 children, ages varying between 6 months and 7 years. The typical features of the immature gait were: A co-activation of antagonistic leg muscles during the stance phase. With the development of free walking the activity pattern gradually became more reciprocally organized. Up to an age of 4 years, large solitary biphasic potentials in gastrocnemius with segmental latency after the muscle was stretched as the forefoot reached the ground. A reduced magnitude of gastrocnemius-EMG at the early stages of stepping. While the magnitude of tibialis anterior EMG did not change substantially with the maturation of gait, the final magnitude of gastrocnemius activity was established around 4-5 years. In the early stages of gait development, preprogrammed leg muscle EMG in form of the co-activation, and segmental stretch reflex activity appear separately. It is conjectured that during the course of maturation, the integration of the stretch-reflex activity into the preprogrammed leg muscle EMG corresponds to an increase of gastrocnemius activity with optimal adaptation to the environment. The locomotor pattern of older children with cerebral palsy showed a striking similarity to the early stages of gait development in healthy children. PMID- 6480438 TI - Microcomputers in medicine: cardiorespiratory assessment. PMID- 6480439 TI - Parathyroid carcinoma with massive parathyroid hormone production and severe mitral incompetence: report of a case with review of the literature. PMID- 6480440 TI - Hydatid disease (echinococcosis) of the lung in a community hospital: report of a case. PMID- 6480441 TI - Kirner's deformity of the little finger: report of a case. PMID- 6480442 TI - Measurements of glutathione and other thiols in cells and tissues: a simplified procedure based on the HPLC separation of monobromobimane derivatives of thiols. AB - Although there is intense interest in the role of thiols in controlling the efficiency of radiosensitizers, and in developing thiols (or pro-drugs liberating thiols) as radioprotectors, there is little information regarding the concentration of specific thiols in cells, tumors and normal tissues. Details are presented of a modified procedure using the thiol binding agent monobromobimane with separation using paired-ion reverse phase high performance liquid chromatography (HPLC). This method has been extended to include measurements of the radiosensitizer misonidazole and its desmethylated metabolite Ro 05-9963 in tissues. PMID- 6480443 TI - Measurement of glutathione-protein mixed disulfides. AB - We have undertaken the development of a sensitive and highly specific assay for the presence of mixed disulfides between protein thiol groups and endogenous thiols. Previous investigations on the concentrations of glutathione (GSH), glutathione disulfide (GSSG) and protein glutathione mixed disulfides (ProSSG) have been of limited usefulness because of the poor specificity of the assays used. Our assay for these forms of glutathione is based on high performance liquid chromatography (HPLC) and is an extension of an earlier method. After perchloric acid precipitation, the protein sample is washed with an organic solvent to fully denature the protein. Treatment with 25 mM dithiothreitol (DTT) in 50 mM N-morpholinopropane sulfonic acid buffer, pH 8.0, reduces disulfides on the protein, and free thiols resulting from this procedure are analyzed by HPLC. We have found up to a 10-fold increase in GSH released from fetal bovine serum (FBS) protein when the protein precipitate is washed with ethanol rather than ether, as earlier suggested. Similar effects have been observed with an as yet unidentified thiol which elutes in our chromatography system with a retention volume similar to cysteine. Future experiments concerning this unidentified thiol are in progress. PMID- 6480444 TI - HPLC assay for 2-(3-aminopropylamino)ethanethiol (WR-1065) in plasma. AB - A high pressure liquid chromatography (HPLC) plasma assay for WR-1065 is described which is both precise (coefficient of variation less than 5%) and accurate (% average deviation less than or equal to 6.1) throughout the concentration range from 1 to 500 micrograms/mL of plasma. The analyte is separated by HPLC and detected with a thiol specific electrochemical transducer cell. The detector response is linear over the ranges 1 to 10 micrograms/mL (R2 = 0.995), 10 to 100 micrograms/mL (R2 = 0.995), and 100 to 500 micrograms/mL (R2 = 0.974). The absolute retention times for WR-1065 and WR-1729 are 9 and 12 minutes, respectively. The assay uses 100 microL of plasma and requires a total chromatography cycle time of 40 minutes. The method has been found suitable for the determination of WR-1065 in plasma from a beagle dog after i.v. administration of S-2-(3-aminopropylamino)ethyl phosphorothioate (WR-2721). PMID- 6480445 TI - Pulse radiolysis studies of WR-1065. AB - WR-1065, the dephosphorylated sulfhydryl form of WR-2721 has been suggested as the metabolite responsible for the radioprotective abilities of the latter and as being active during the radiation chemical stage of damage production. Hence this study was performed to determine some of the radiation chemical parameters of the compound. Pulse radiolysis techniques, developed for use with SH compounds, were employed in the current work: Three systems were used to attempt to measure the rate constant for reaction of OH. radicals with WR-1065; (a) Competition with phenylalanine, in which the decrease in the amount of RSSR- caused by the addition of phenylalanine is monitored; this failed because of the absence of an absorbance attributable to RSSR-. (b) Competition with 2,2'-Azinobis-(3 ethylbenzthiazoline-6-sulfonate) (ABTS), monitoring the decrease in OH. induced ABTS absorbance caused by WR-1065 addition. This was unsuccessful due to reaction of RS. with ABTS. (c) Competition with CNS-, observing the decrease in (CNS)-2 caused by WR-1065 addition indicates that the second order rate constant for reaction of OH. with WR-1065 is 9.2 +/- 0.3 X 10(9) M-1 s-1. To investigate the ability of WR-1065 to react with DNA radicals the yield of ABTS radicals was monitored in a situation where DNA scavenges 50% of the OH. radicals in the presence of ABTS (20%) and WR-1065 (30%). DNA radicals were shown not to react with ABTS but WR-1065 radicals do, the absence of additional ABTS absorbing species indicates that DNA radicals do not react with WR-1065 under the experimental conditions used. An attempt was made to investigate the possibility that WR-1065 is concentrated close to DNA macromolecules in solution: The rate constant for reaction Br2- with WR-1065 was measured in the presence and in the absence of excess DNA (with which Br2- was not observed to react). The observed rates of reaction were independent of the presence of DNA indicating that the latter does not affect the availability of WR-1065 for reaction with Br2- radical. Reaction of WR-1065 with Br2- was used as a probe for determining the pK of the SH group. The rate of reaction increases from 1.8 X 10(8) M-1 s-1 at pH 6.3 to 1.6 X 10(9) M-1 s-1 at pH 8.4, the mid-point of the increase indicates a pK of 7.3. PMID- 6480446 TI - The effect of the drug lonidamine on Chinese hamster ovary cells in vitro and on experimental tumors. AB - Hypoxic cells in solid tumors are known to be resistant to radiation, and may also be resistant to some anti-cancer drugs. Biochemical properties of hypoxic cells, such as their dependence on anaerobic glycolysis leading to production of lactate and low pH might have potential for inhibition by drugs with selective activity against hypoxic cells. Such drugs might improve the Therapeutic Index when used with radiation or some conventional anti-cancer drugs. Preliminary studies have shown that the combination of hypoxia and low pH (pH 6.5-6.0) was cytotoxic to Chinese Hamster Ovary (CHO) cells incubated in vitro for up to 6 hours, although neither factor alone reduced plating efficiency. Lonidamine, an inhibitor of mitochondrially-bound hexokinase and lactate transport, was cytotoxic to CHO cells at low pH, but had no effect at physiological pH under aerobic or hypoxic conditions. Lonidamine has also been tested for in vivo effects against three murine tumors: the KHT fibrosarcoma, 16/C mammary carcinoma and the Lewis Lung Tumor. The drug was tested either alone, or with radiation or Adriamycin to kill aerobic cells, and/or with glucose and insulin to lower intra tumor pH. No major therapeutic effects have been demonstrated. PMID- 6480447 TI - Chemosensitization: do thiols matter? AB - It is well known that endogenous sulfhydryls are radioprotective in mammalian cells. Their comparable role in chemotherapeutic drug toxicity has been known for almost as long but less well defined. Thiol depletion as a mechanism responsible for enhanced cytotoxicity of melphalan was assayed by pretreatment of cells in vitro with misonidazole and buthionine sulfoximine (BSO). Hypoxic cell sensitizers, such as MISO, deplete endogenous thiols by metabolic activation under hypoxic conditions to thiol reactive intermediates, whereas BSO specifically inhibits a key enzyme in the synthesis of glutathione. For a given level of thiol reduction, sensitization to melphalan was far greater by preincubation with MISO than it was for BSO. This indicated that thiol reduction itself was not the sole factor involved in chemosensitization by MISO. As evidence that the method of thiol depletion predisposes to the expression of biological damage, it was shown that cells preincubated with MISO were appreciably more vulnerable to oxidative stress than those exposed to BSO. BSO was shown to totally inhibit the repair of damage from a preincubation treatment with MISO, demonstrating that recovery is dependent upon thiol regeneration. Thiol depletion "per se" is a good qualitative but not necessarily a quantitative indicator of chemosensitization--the biological and biochemical function of the thiol depleting agents used influences further drug interactions. The results of the study with these two agents suggest that thiols may play a potentially more critical role in the repair rather than the initiation of drug-induced damage. PMID- 6480448 TI - Mechanism of melphalan crosslink enhancement by misonidazole pretreatment. AB - Sensitization of Chinese hamster ovary cells to melphalan (L-PAM) toxicity by prior treatment with misonidazole (MISO, 5 mM, 2 hr, hypoxic conditions, 37 degrees C) is associated with increased levels of DNA crosslinks believed to be the critical lesion for bifunctional alkylating agent toxicity. Enhanced L-PAM crosslinking of DNA could occur by a variety of mechanisms in MISO-pretreated cells including: (1) increased transport or binding of L-PAM, (2) decreased repair of L-PAM monoadducts which would allow more time for their conversion to crosslinks, (3) decreased crosslink repair (unhooking of one arm), or (4) chemical modification of the DNA structure, presumably by bound MISO derivatives, such that crosslink formation is facilitated. Previous studies have eliminated mechanisms (1) and (3). Mechanism (4) was investigated by following MISO pretreatments of whole cells with L-PAM treatments of the isolated DNA from these cells. This was accomplished by using a modification of the alkaline elution assay for DNA crosslink measurement in which a 1 hr treatment with L-PAM (0-12 micrograms/ml) was inserted between the cell lysis steps and DNA elution procedure. Treatment of bare DNA with L-PAM modeled very well the crosslinking behavior in whole cells although it was somewhat more efficient (more crosslinks at a given L-PAM dose). In the presence of double stranded DNA and absence of repair systems during and after the L-PAM exposure, it was determined that MISO pretreatments did not increase the crosslinking efficiency of L-PAM (mechanism [4] above). Inhibition of repair of L-PAM monoadducts (mechanism [2] above) still remains as a possible means for crosslink enhancement by MISO-pretreatment. PMID- 6480449 TI - Survival in subpopulations of cells derived from solid KHT sarcomas by centrifugal elutriation following treatment with CCNU and MISO. AB - Misonidazole (MISO) has been shown to enhance the cytotoxicity of 1-(2 chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) in a number of different animal tumor systems. We have investigated the response to therapy of the various subpopulations of cells comprising the KHT sarcoma, to determine whether chemopotentiation occurred as a preferential enhancement of killing in one subpopulation of cells. Twenty-four hr after drug treatment, cells dissociated from solid tumors were separated into homogeneous populations based on cell size by the technique of centrifugal elutriation. By this method the majority of the non-neoplastic cells could be removed and the tumor cells separated into fractions containing 90 to 95% G1 cells, 70 to 75% S cells and 70 to 80% G2M cells. Clonogenic cell survival was measured for each elutriated fraction. In vivo treatment with 0.5 mg/g MISO produced no measurable cell-kill across the cell cycle. Those cells in late G1 and S phase 24 hr after treatment were most sensitive to CCNU alone. The enhancement of CCNU cytotoxicity by MISO occurred primarily in the early G1 and S fractions. These data suggest that chemopotentiation does not occur equally in all tumor cell subpopulations and that some specificity of enhanced cell killing exists. PMID- 6480450 TI - The effect in the KHT sarcoma of CCNU and MISO on cell cycle progression evaluated by flow-cytometry. AB - Previous studies using the KHT sarcoma have shown that misonidazole (MISO) enhances the cytotoxicity of 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU) by as much as a factor of 2.0. In the present study flow cytometry was used to monitor the changing DNA distributions of cells dissociated from solid tumors at successive times following treatment with CCNU, applied either alone or in combination with 0.5 mg/g MISO. The proportion of cells in late S and the G2M phases of the cell cycle increased gradually after CCNU treatment. MISO did not significantly change this block in cell progression, which persisted for at least 48 hr after treatment in all cases. CCNU shows marked carbamoylating activity, which has been associated with inhibition of RNA processing and with the degree of chemopotentiation achieved with MISO. Consequently, to evaluate whether MISO chemopotentiation was influencing the RNA distributions in tumors, RNA histograms were generated using acridine orange to differentially stain cellular DNA and RNA. By 24 hr after treatment, CCNU clearly altered the distribution of RNA, but no significant differences could be detected between results obtained from drug and drug plus sensitizer treated groups. These studies demonstrate the effect of CCNU on cell cycle progression in vivo. The addition of MISO did not result in further perturbation of the total tumor population, suggesting that cell cycle redistribution does not play a major role in chemopotentiation by MISO. PMID- 6480452 TI - Potentiation of cyclophosphamide cytotoxicity in vivo: a study with misonidazole and fifteen other 1-substituted 2-nitroimidazoles. AB - It has recently been reported that compounds more lipophilic than misonidazole are better potentiators of CCNU tumor cytotoxicity in vivo. There is now a need to extend these studies to include other tumors and cytotoxic drugs. In the present study we have shown that misonidazole (MISO) can potentiate cyclophosphamide cytotoxicity in the Lewis lung carcinoma but not in the B16 melanoma. Further studies in the Lewis lung carcinoma, using 15 1-substituted 2 nitroimidazoles possessing a range of octanol:water partition coefficient (P) (from 0.18- greater than 100) have shown that potentiation increases with increasing lipophilicity. The most efficient compounds at administered dose levels of 1.0 and 2.0 mumol/g were Ro-07-1902, benznidazole (Ro-07-1051) and RSU 1050 which possess octanol:water partition coefficients in the range of 2.5-10. However, on the basis of an equitoxic administered dose (1/2LD50/2d), little difference in potentiation is seen over the range of P studied. PMID- 6480451 TI - Enhanced tumor responses through therapies combining CCNU, MISO and radiation. AB - Studies were performed to determine whether the radiation sensitizer misonidazole (MISO) could enhance the tumor control probability in a treatment strategy combining radiation and the nitrosourea 1-(2-chloroethyl)-3-cyclohexyl-1 nitrosourea (CCNU). In initial experiments KHT sarcoma-bearing mice were injected with 1.0 mg/g of MISO simultaneously with a 20 mg/kg dose of CCNU 30-40 min prior to irradiation (1500 rad). These timings were chosen to maximize the effectiveness of MISO both as a chemopotentiator and radiosensitizer. With this treatment protocol approximately 60% of the mice were found to be tumor-free 100 days post treatment. By comparison all 2 agent combinations led to 0% cures. To evaluate the relative importance of chemopotentiation versus radiosensitization in the 3 agent protocol, tumors were treated with MISO plus one anti-tumor agent (either radiation of CCNU) and then at times ranging from 0 to 24 hr later exposed to the other agent. When the time between treatments was 0 to 6 hr, a 60 to 80% tumor control rate was achieved for both MISO plus radiation followed by CCNU and MISO plus CCNU followed by radiation. However if the time interval was increased to 18 or 24 hr, the cure rate in the former treatment regimen dropped to 10% while that of the latter remained high at 40%. These results were not due to the radiation-CCNU sequence but rather reflected the ability of the sensitizer to act as a chemopotentiator when CCNU is given 0 to 6 hr after the MISO radiation combination. This was not the case when the MISO-radiation combination was administered 18 or 24 hr prior to CCNU. The data therefore indicate that 1) improved tumor responses may be achieved when MISO is added to a radiation chemotherapy combination and 2) MISO may be more effective in such a protocol when utilized as a chemopotentiator. PMID- 6480453 TI - DNA damage produced by combined hyperglycemia and hyperthermia in two mouse fibrosarcoma tumors in vivo. AB - In this study we used alkaline elution to examine DNA damage produced in two murine fibrosarcomas after hyperthermia (42 degrees C), with or without preinduced hyperglycemia. The work was stimulated by a recent report that pretreatment of mice with glucose prior to hyperthermia decreased the growth rate in a similar fibrosarcoma tumor. The intercellular tumor pH dropped from its resting value of 7.1 to a value of 6.6 at 1.5 hr after a single injection of glucose. While treatment with either glucose alone or heat alone produced very little detectable damage, the combination of these two agents resulted in marked degradation of tumor DNA isolated immediately after treatment. DNA degradation was accompanied by a simultaneous decrease in cell viability; thus, direct cell killing and subsequent nuclease or lysosomal enzyme activity are probably involved. We also tested whether hyperglycemia combined with hyperthermia influenced the DNA-DNA crosslinking induced by subsequent cyclophosphamide (Cy) treatment. Because of the extensive degradation caused by the pretreatment alone under the conditions used in these initial experiments, we were not able to quantitate with validity the amount of Cy-induced crosslinking. However, damage in viable cells may presumably interact with the subsequent Cy treatment to produce further selective cell killing in the tumor. PMID- 6480454 TI - Modification of radiation and dihydroxyanthraquinone-induced cell lethality by cysteamine and N-ethylmaleimide. AB - The effect of alteration of sulfhydryl levels on the cell lethality induced by ionizing radiation and dihydroxyanthraquinone (DHAQ) was investigated in cultured Chinese hamster V79 cells. DHAQ produces a potentiation of radiation-induced cell lethality, both by increasing the slope and decreasing the shoulder of the survival curve. It has been suggested that DHAQ functions through the production of free radicals which then produce DNA strand breaks and crosslinks, resulting in cytotoxicity. If this mode of action predominates, then one would expect to be able to change the degree of cell kill by modifying conditions such that free radical processes were altered. This was accomplished by the addition of N ethylmaleimide (NEM) or Cysteamine (CYS) to the culture medium during treatment with DHAQ. It was observed that the combination of DHAQ and NEM did not produce more cytotoxicity than would be expected from an additive interaction. Likewise, CYS did not reduce the cytotoxicity induced by DHAQ. When cells were treated with DHAQ and radiation plus either NEM or CYS, the resultant survival was consistent with an additive interaction between the potentiation of DHAQ for radiation induced cell kill and the extra effect of NEM or CYS. These results indicate that alterations of sulfhydryl levels do not produce changes in the cytotoxicity induced by DHAQ, nor in the enhancement by DHAQ of radiation-induced lethality. More investigation is required before definite conclusions can be reached as to the mechanisms of action by which DHAQ, alone or in combination with ionizing radiation, induces mammalian cell lethality. PMID- 6480455 TI - Misonidazole with dexamethasone rescue: an escalating dose toxicity study. AB - Neurotoxicity induced by misonidazole (MISO) and desmethylmisonidazole (DMM) has become the dose limiting factor in clinical work. In 1981, we reported a preliminary study suggestive that Dexamethasone (DEXA) does have a protective effect against peripheral neuropathies (PN) resulting from toxicity of misonidazole. Furthermore, in that study we have observed that DEXA did not alter the plasma pharmacokinetics of misonidazole. We are presently investigating the use of DEXA (2 mg t.i.d. during treatment), with escalating doses of MISO in an attempt to modify its neurotoxicity. To date, 16 patients have been registered to receive total doses of MISO ranging from 13.5 to 17.5 gm/M2 given in 9 equally divided doses over 3 weeks. DEXA, 2 mg t.i.d. is given 3 days prior to the first dose and continues for the duration of therapy. All patients receive palliative radiation. No toxicity was seen at the total dose of 13.5 gm/M2. One grade I PN occurred in the first four patients receiving 15.5 gm/M2. Six additional patients were entered at this dose level and no further incidence of PN was observed. Patients are being entered at the next step of 17.5 gm/M2. PMID- 6480456 TI - Clinical trials with cyclophosphamide and misonidazole combination for maintaining treatment after radiation therapy of lung carcinoma. AB - Fifteen patients with inoperable non oat cell lung carcinoma, who had already been treated with telecobalt therapy in the mediastinum-hilar region, were treated with continuing therapy with misonidazole (MISO) and cyclophosphamide (Cy). MISO was administered in single doses of 1000 mg/m2 and 500 mg/m2, orally. Cy was administered in single doses of 500 mg/m2 and 250 mg/m2, i.v. This treatment was given every 4 weeks. All patients (15/15) suffered from hyporexia, nausea and vomiting within 48 hours from administration; furthermore, 2 patients had hemoragic cystitis, 2 had peripheral neurotoxicity, 3 had fever, and 2 had serious nervous depression. Leukopenia occurred in all patients immediately after drug administration, although it was not present in any patient by the time of the next administration. This clinical trial was concluded in December 1981. The follow-up at 18 months shows 7/15 cases of relapse (3 patients dead and 1 patient alive with recurrence, 2 patients dead and 1 patient alive with metastasis without recurrence). Eight of 15 patients are alive with progression of disease from 8 to 18 months. PMID- 6480457 TI - A phase I study of the combination of benznidazole and CCNU in man. AB - The 2-nitroimidazole benznidazole (BENZO) has previously been shown to be an effective potentiator of the cytotoxicity of CCNU in mice, at levels which are achievable in man. This enhancement is greater than that for normal tissues, resulting in a therapeutic gain. In this study BENZO has been given to 46 patients in oral doses of 4 mg/kg to 30 mg/kg, and drug concentrations measured in plasma, urine, tumor and normal brain by HPLC. The mean plasma t 1/2 was 12.8 +/- 0.5 h and plasma peak concentration and AUC0-infinity were linearly related to dose over the whole range. Approximately 60% of the drug was bound to plasma proteins and 6% excreted unchanged in urine. Mean tumor/plasma ratios of 88% (range 54 to 122%) for 11 gliomas and 72% (range 46 to 103%) for 6 superficially accessible non-brain tumors were obtained while that for normal brain was 69% (range 53 to 75%). Doses of more than 17 mg/kg BENZO produce changes in the plasma pharmacokinetics of CCNU (130 mg/m2 p.o.), increasing the half life of active hydroxylated metabolites. In addition, CCNU parent compound is present. This is not seen when CCNU is given alone. Such changes may result in improved response rates as it is possible to achieve in man, plasma and tumor levels of BENZO, which in the mouse model produce effective enhancement of the response to CCNU. No evidence was seen that BENZO enhanced wither the acute gastrointestinal toxicity or the hematological toxicity of CCNU over the dose range studied. PMID- 6480458 TI - A phase I study of the hypoxic cell radiosensitizer Ro-03-8799. AB - The 2-nitroimidazole hypoxic cell radiosensitizer Ro-03-8799 has been suggested to have possible advantages over misonidazole with regard both to radiosensitization and toxicity on the basis of reported experimental work. The present work reports a Phase I escalating dose toxicity study of the drug. This has shown severe acute central neurotoxicity at high dose levels (greater than 1 g/m2). Initial results of a multiple-dose toxicity study indicate that 1 g/m2 is likely to be the maximum dose which may be given repeatedly. The plasma and tumor pharmacokinetics of the drug have been measured. The mean t 1/2 for 9 patients was 5.8 +/- 1.5 hr. Peak plasma concentration is linearly related to dose and at 1 g/m2 is 12.1 +/- 2.3 micrograms/ml (n = 6). Human tumor drug concentrations have been measured after single doses of 1 g/m2 given to 8 patients with a variety of tumors. Peak tumor concentrations of drug of 11.7-81.6 micrograms/g were found. Because of acute, dose-limiting toxicity related to individual doses it may not be possible to achieve, in human tumors, concentrations of drug that offer significant advantage over misonidazole in terms of radiosensitizing efficiency. No evidence of chronic cumulative toxicity was observed at the doses employed. PMID- 6480459 TI - The clinical testing of Ro 03-8799--pharmacokinetics, toxicology, tissue and tumor concentrations. AB - Ro 03-8799, a lipophilic nitroimidazole with a basic side chain, has now been administered intravenously to 69 patients. The elimination half-life in plasma was 5.1 hr and the plasma concentration at 30 min was 14.8 micrograms/ml standardized to a dose of 1 g per square meter of surface area. Immediate symptoms of malaise, heat, sweating and disorientation limit the amount of the drug which may be given on any one occasion. However, a dose of 750 mg per square meter of surface area may be given combined with daily radiotherapy. Our data suggest that when given with a 20 fraction course of radiotherapy, sensitization of hypoxic cells may be achieved equal to a 10-fold increase in the dose of misonidazole above that presently permitted. PMID- 6480460 TI - A phase I clinical study of Nimorazole as a hypoxic radiosensitizer. AB - Nimorazole, a 5-Nitromidazole compound has been shown in animal studies to have similar radiosensitizing properties to misonidazole at clinically acceptable dose levels. The drug is well absorbed in humans after oral administration with peak plasma levels occurring around 90 min after ingestion (range 35-135 min) and a plasma half life between 2 and 4.8 hours. Total doses of Nimorazole up to 60 grams given in daily doses with conventional radiation therapy have demonstrated a significant lack of side effects, in particular no demonstrable neurotoxicity. PMID- 6480461 TI - Phase I study of intravenous bromodeoxyuridine used concomitantly with radiation therapy in patients with primary malignant brain tumors. AB - We report here the results of a Phase I study conducted to determine the toxicity and serum levels that could be tolerated by patients receiving i.v. bromodeoxyuridine (BUdR) concomitantly with radiation therapy. Because of severe thrombocytopenia and leukopenia that was produced in three patients treated by a 96 hour infusion of BUdR at a dose of 1.5 g/m2/24 hours, the dose was reduced to 0.8 g/m2/24 hours in these patients and the remaining 9 patients in the study group. Even at this dosage, myelotoxicity was observed. BUdR levels were measured by an isocratic high performance liquid chromatographic (HPLC) method developed for this study. Results of in vitro studies conducted by others suggest that serum levels produced in our patients by administration of doses of 0.6 to 0.8 g/m2/24 hours should be adequate to achieve a therapeutic effect. PMID- 6480463 TI - The right to inspect a veterinary practice. PMID- 6480462 TI - Chemical modifiers of cancer treatment. AB - It is clear that the investigators involved in chemical modification have reached an historical turning point in radiobiology. Studies in the 1960s concentrated on physical and chemical radiobiology, studying dose response relationships and initial chemical reactions. More recently, the area of biochemical radiobiology has been entered and studies of cellular modification of the initial events and cellular repair mechanisms have been initiated. The future would appear to belong to biochemical modulation. The ability to increase or decrease the various cellular components through enzyme blocking or stimulation gives much greater power to our abilities to chemically modify radiation and cytotoxic agents in the future. We are thus come from the winding country lane of sensitizer development to the complex city expressway of chemical modification. Non-nitro-compounds and pyrimidine analogs have entered the field, and cellular biochemistry has assumed a major role in our future progress. Although misonidazole has overall been a clinical failure, the investment in its laboratory and clinical study has opened up a whole new field of chemical modification based on sound biochemical principles. PMID- 6480464 TI - Paraovarian-omental bands as a cause of small intestinal obstruction in cows. AB - Small intestinal obstruction caused by a fibrous band extending from the free edge of the greater omentum to the ovary or the tip of uterine horn was found in 4 cows. The band and distended small intestine were palpable per rectum in each cow. In 3 cows, severance of the fibrous band relieved the small intestinal obstruction and the cows recovered without complication. In the fourth cow, the compromised portion of intestine ruptured during manipulation and the animal was euthanatized. PMID- 6480465 TI - Isolation of toxigenic strains of Pasteurella multocida from lungs of pneumonic swine. AB - Lungs from 113 pneumonic pigs were examined for Pasteurella multocida. The lungs were smeared directly onto blood agar and homogenized in brain-heart infusion broth and then inoculated intraperitoneally in mice. Pasteurella multocida isolates were typed for serotypes A (by hyaluronidase inhibition of capsule) and D (by acriflavine autoagglutination). Strains were tested for toxin production by intradermal injection of 0.2 ml of filtered 24-hour culture supernatants into guinea pigs. Most lungs (70.8%) yielded isolations. Most isolants (87.5%) were type A and 12.5% were type D. Of the type D strains, 80% were toxigenic. Of the type A isolants, 18.2% were toxigenic. PMID- 6480466 TI - A modified method for complete bovine fetotomy. AB - A modification of the "Utrecht technique" for complete bovine fetotomy was developed. In cranial presentation, the first step is decapitation, then oblique indirect section through the neck and thorax to remove 1 forelimb with a small part of the thoracic wall. This is followed by thoracic and abdominal evisceration. The final step is direct oblique section of the fetal pelvis or, alternatively, deep detruncation followed by bisection of the pelvis. In caudal presentation, the first step is removal of a hindlimb, then abdominal and thoracic evisceration, followed by thoracic detruncation and oblique section for removal of 1 forelimb and most of the remaining thorax. The neck and remaining forelimb are removed together to complete the procedure. PMID- 6480467 TI - Feeding trials with vomitoxin (deoxynivalenol)-contaminated wheat: effects on swine, poultry, and dairy cattle. AB - Nutritional and toxicologic feeding trials with 3 species of farm animals demonstrated that decreased feed consumption and reduced weight gains in pigs are the main effects of ingestion of a diet with low vomitoxin (deoxynivalenol; DON) content, eg, 2 mg of DON/kg of feed, ie, 2 ppm. The feeding trials indicated that swine can ingest up to 2 mg of DON/kg of feed without serious adverse effects. Poultry can tolerate at least 5 mg of DON/kg feed. In fact, at concentrations up to 5 mg of DON/kg feed, some beneficial effects on poultry were observed. In dairy cattle, feed consumption decreased slightly when a wheat-oats diet containing 6 mg of DON/kg was fed at the rate of 1% of body weight/day, with hay offered ad libitum. In surveys of Canadian grains carried out during the past 3 years, the DON content (maximum of 8.5 mg/kg) in eastern Canadian wheats probably was not high enough to account for reports of feed refusal, vomiting, and reproductive problems in livestock operations. This conclusion is based partly on the fact that even at the highest concentrations of DON found in wheat, formulated diets comprise, at maximum, about 70% to 80% wheat. Consequently, the actual DON content of diets fed to farm animals would be much lower. PMID- 6480468 TI - Dirofilariasis with arteriosclerosis in a horse. AB - Arteriosclerosis caused by Dirofilaria immitis adult parasites was diagnosed in a 20-month-old Quarter horse stallion that died from cantharidin toxicosis. Microscopically, the pulmonary vascular changes were typical of those described as "proliferative endarteritis" in D immitis-infected dogs. PMID- 6480469 TI - Vaginal perforation after coitus in three mares. AB - Three cases of vaginal perforation after coitus are discussed. The most consistent clinical sign is a small amount of blood escaping from the vulvar lips immediately after breeding. Secondary infection and posttraumatic swelling may cause abdominal pain due to rectal impaction. Treatment with high levels of an appropriate antibiotic is important to reduce the risk of a severe infectious peritonitis. The use of artificial insemination or a breeding roll to prevent full intromission is recommended. PMID- 6480471 TI - Complications associated with the use of the cuffless endotracheal tube in the horse. AB - Complications following the use of the cuffless large animal endotracheal tube during general anesthesia in 2 horses are reported. One horse developed laryngeal edema during recovery. The edema was treated successfully with dexamethasone, but severe laryngeal trauma was confirmed 24 hours later at necropsy. The second horse had a swollen tongue and had difficulty eating for 3 days after anesthesia. The condition resolved without treatment. this report is a reminder of the potential damage which can occur from endotracheal intubation. PMID- 6480470 TI - Chondrosarcoma in the radius of a horse. AB - An aged Thoroughbred stallion was examined because of progressive lameness, carpal swelling, and weight loss. Radiography revealed a destructive lesion in the caudomedial, distal portion of the radius. Chondrosarcoma was diagnosed by tumor-core biopsy. Gross and histologic evaluation of the neoplasm after necropsy revealed a locally invasive chondrosarcoma at the distal end of the radius that infiltrated the radiocarpal joint capsule and invaded the carpal bones. The malignant nature of this tumor was evident by its invasiveness and histologic features of cell pleomorphism and presence of mitotic figures. PMID- 6480472 TI - Hypoplastic left ventricular syndrome in a foal. AB - A necropsy diagnosis of hypoplastic left ventricular syndrome was made in a day old foal. The cardiac abnormalities included mitral and aortic valve atresia, patent ductus arteriosus, and a secundum atrial septal defect. The left ventricle was hypoplastic and nonfunctional. The brief survival of the foal was a consequence of left-to-right shunting through the atrial septal defect and right to-left shunting through the patent ductus. The information is presented to demonstrate the existence of the syndrome as a congenital defect in the horse and to clarify the necropsy findings for the practitioner to diagnose if seen. PMID- 6480473 TI - Surgical management of proximal articular fracture of the patella in a horse. AB - A patellar fracture was identified radiographically in the right stifle of a mature Tennessee Walking Horse stallion. The horse was markedly lame (grade IV/V) on the right hindlimb. Due to the articular nature and small size of the fragment, surgical removal via arthrotomy was selected. A dorsomedial approach to the femoropatellar joint was used. The horse recovered well and has returned to training as a show horse by 8 months following surgery. PMID- 6480474 TI - Ventral approach for stabilization of atlantoaxial subluxation secondary to odontoid fracture in a foal. AB - Atlantoaxial subluxation secondary to odontoid fracture in a 30-day-old foal was corrected by alignment of the atlantoaxial joint and stabilization with 2 ventrally placed dynamic compression plates. At 90 days after surgery, healing of the fracture, with adequate alignment of the atlantoaxial joint, was confirmed radiographically. The foal was only slightly tetraparetic at that time. At 1 year after surgery, the gait was normal. It was concluded that the technique has advantages over the use of Steinmann's pins or external coaptation for stabilization. The ventral approach allows decompression, anatomic alignment, and immediate stabilization of the subluxation. Potential complications of the ventral approach include laryngeal paralysis. PMID- 6480475 TI - Campylobacter jejuni abortion in a heifer. AB - Campylobacter jejuni was isolated from the lung and stomach contents of an aborted bovine fetus. The bacterial isolate was classified according to morphologic, biochemical, and thermotolerance characteristics as well as sensitivity to antibiotics and biochemical agents. Serotyping was specific for C jejuni and excluded this isolate from the more common bovine causes of campylobacteriosis, C fetus subsp venerealis or C fetus subsp fetus. This report stresses the need for careful speciation of all Campylobacter isolates from aborted fetuses, especially in conditions where routine vaccination has not reduced abortion rates in the herd. Campylobacter jejuni is much more prevalent in causing human infections than is C fetus subsp venerealis or C fetus subsp fetus. Therefore, from a public health standpoint identification is important. PMID- 6480476 TI - Adenocarcinoma of the jejunum in two cows. AB - Two cows from separate farms were examined for gastrointestinal disturbances. The first animal had an acute gastrointestinal disturbance with colic and the second animal had chronic weight loss and anemia. Both cows had jejunal adenocarcinoma with metastasis. They were euthanized and necropsied. Adenocarcinomas of each cow were similar histologically. Adenocarcinoma of the intestine is a rare disorder of cattle, but may present as either an acute or chronic gastrointestinal disturbance. PMID- 6480477 TI - Granulomatous colitis associated with small strongyle larvae in a horse. AB - Horses presented with chronic weight loss are difficult to manage clinically. A diagnosis of granulomatous colitis due to mucosal stages of cyathostomes (small strongyles) should be considered in those cases exhibiting weight loss, intermittent diarrhea, hypoalbuminemia, increased serum globulins, and low fecal egg counts. Treatment can be attempted with larva-cidal doses of fenbendazole or ivermectin. Clinical and necropsy findings in one such case are presented. PMID- 6480478 TI - Congenital phalangeal hypoplasia in Equidae. AB - Three cases of unilateral congenital phalangeal hypoplasia are described in 2 horses and 1 mule. Radiographic lesions include severe hypoplasia of the 3rd phalanx, and associated hypoplasia of the 2nd phalanx in 2 cases, and hypoplasia or aplasia of the navicular bone in 2 cases. All animals could ambulate but were lame. Two cases had palpable laxity at the level of the coronary band. Documented etiology was not determined for the dysgenesis, but possibilities include inherited transmission or an environmental teratogen. PMID- 6480479 TI - Pleural effusion as a sequela to aelurostrongylosis in a cat. AB - A two-year-old domestic cat was admitted with dyspnea and coughing. Unilateral pleural effusion with characteristics of an eosinophilic exudate was demonstrated. A direct fecal smear was positive for Aelurostrongylus abstrussus larvae. Treatment with levamisole and fenbendazole was curative. Aelurostrongylosis should be suspected in any cat with dyspnea, coughing, or pleural effusion. PMID- 6480480 TI - Comparative therapeutics of canine and human rheumatoid arthritis. AB - For a variety of reasons--both medical and medicolegal--a more aggressive approach is taken in canine than in human rheumatoid arthritis. While cytotoxic agents are probably the drugs of choice in the dog, they are normally the last resort of the rheumatologist. On the other hand, the nonsteroidal anti inflammatory drugs, which are the cornerstone of treatment in man, are of questionable safety--if not absolutely contraindicated--in the dog. Canine rheumatoid arthritis is an uncommon diagnosis, and it is not the intent of this discussion to encourage either the use of cytotoxic drugs or the experimentation with unproven agents in dogs with vaguely defined forms of arthritis. PMID- 6480481 TI - What is your diagnosis? Intervertebral disk herniation. PMID- 6480482 TI - Long-term aging behavior of ultraviolet-absorbing intraocular lenses. AB - The chemical composition and molecular weight distribution of typical materials used for fabrication of intraocular lenses have been determined by high performance liquid chromatography and on-line electronic and FT-IR spectroscopic analysis. The leaching rate of unreacted monomers was determined by Soxhlet extraction techniques. These analytical methods were then utilized to monitor chemical changes in one type of intraocular lens subjected to accelerated aging conditions. PMID- 6480483 TI - Preliminary study of hydrophilic hydrogel intraocular lens implants in cats. AB - Soft hydrophilic intraocular lenses (IOLs) made of an aminopolyamide (Duragel) and a hydroxyethylmethylmethacrylate (HEMA) hydrogel polymer were implanted in cats and followed for six weeks. During surgery, a 45-second purposeful contact between the lens surface and the corneal endothelium was made. During the course of the experiment, all implanted eyes maintained clear IOLs and manifested a continuing mild iritis. Scanning electron microscopy of the corneas revealed numerous microvilli but no damage to cell membranes. Scanning electron microscopy of the aminopolyamide IOLs revealed fibroblast growth on the surface. No fibroblast growth was noted on the surface of the HEMA IOLs. These experiments suggest that soft hydrogel IOLs may be better than conventional hydrophobic acrylic IOLs in minimizing endothelial contact damage. However, the observation of corneal microvilli may indicate a mild adverse reaction to the hydrogels, possibly from impurities. Fibroblast growth on the aminopolyamide may also be due to an ocular inflammatory response to the material or impurities. Hydrogel IOLs may be of interest because of their semirigid physical properties and greater safety on contacting the endothelium. However, considerable attention must be given to polymer composition and polymer purification. PMID- 6480484 TI - Shearing posterior chamber intraocular lenses: five-year postoperative results. AB - Long-term follow-up data for 424 patients with an IOLAB Shearing J-loop posterior chamber intraocular lens are presented. One hundred sixty-eight patients were given a complete ophthalmologic exam at five years (59 to 69 months) after surgery. Charts of the remaining 256 patients were reviewed for the most recent visit data. Ten surgeons contributed patients to this follow-up study. Results indicate that 91.5% of the patients in the five-year exam group obtained a visual acuity of 20/40 or better at one year after surgery and 89.3% obtained this visual acuity at five years after surgery, thus showing only a decrease of two percentage points over time. If patients with preoperative pathology or macular degeneration are excluded, the percentage of patients seeing 20/40 or better at five years is 94.0%. Few of the complications observed at five years are implant related; macular degeneration is the primary condition causing vision worse than 20/40. No macular edema and few corneal problems were observed at five years. Endothelial cell counts were obtained for 53 of the 168 patients examined at five years and averaged 1,947 cells/mm2. The rate of lens dislocation is low, and no clinical evidence of degradation or failure of the polypropylene haptics was noted. PMID- 6480485 TI - A comparative study of the 91Z and other anterior chamber intraocular lenses. AB - A retrospective study of 113 91Z anterior chamber intraocular lenses (IOLs) used with intracapsular cataract extraction (ICCE) was performed. The study compared operative complications, visual acuity at three and six or more months, and complications of the 91Z with other types of anterior chamber IOLs. The 91Z had a low incidence of operative complications, good short-term visual acuities, and few short-term complications. It had a high incidence of late, severe, inflammatory/hemorrhagic complications including uveitis-glaucoma-hyphema plus vitreous hemorrhage (UGH+ syndrome), cystoid macular edema, and iris chafing/bleeding. These complications necessitated removal of five lenses (4.5%). An additional 16 patients (14.2%) are under treatment for these late complications. This IOL was often difficult to remove without traumatizing the eye. I have not experienced these late complications with the other types of anterior chamber IOLs reported here; their long-term visual acuities were good and they were stable. None of them has been explanted. PMID- 6480486 TI - Subcapsular phacoemulsification and aspiration. AB - To protect the corneal endothelium from ultrasound damage, we performed phacoemulsification under the anterior capsule on 26 eyes of 21 patients between January 7, 1980, and September 1, 1980. Patients were followed for at least three years. In 20 eyes, various intraocular lenses were implanted. The average corneal endothelial cell loss in all eyes was 12.0 +/- 7.4% (M.S.D.), range 1.3% to 36.2%. In six eyes without intraocular lens implantation, the average cell loss was 6.9 +/- 3.0% (M.S.D.), range 1.3% to 10.0%. The best postoperative visual acuity was 20/40 or better in all patients. Intraoperative and postoperative complications occurred in 11 eyes (42.3%), including three (11.5%) posterior capsule ruptures. All complications were managed satisfactorily. PMID- 6480487 TI - Initial clinical results with YAG laser capsulectomy with a monomode, Q-switched unit (LASAG). AB - We present initial clinical experience for posterior capsulectomy with a monomode, Q-switched YAG laser (LASAG). Results indicate 100% capsulectomy success with less than 100% visual improvement. Complications were minimal and usually transient. Implant nicking was reduced by using low energy levels and precise focusing, and by the surgeon's increased facility with experience. PMID- 6480488 TI - Automated perimetry--Part I. PMID- 6480489 TI - The double-closed-loop posterior chamber lens. PMID- 6480490 TI - Amvisc and Healon. PMID- 6480491 TI - A method of continuing education. PMID- 6480492 TI - Peripheral iridotomy. PMID- 6480493 TI - Use of the Faulkner lens after vitreous loss. PMID- 6480494 TI - Manual dexterity evaluation of surgical and subsurgical residency programs. PMID- 6480495 TI - Causes and management of intraoperative shallowing of the anterior chamber. PMID- 6480496 TI - Anterior capsulotomy with ultrasound cystotome. AB - An ultrasound-powered cystotome that uses the phacofragmentation unit is described. The cystotome is a fragmentor needle bent and fashioned in the configuration of the usual aqueous cystotome tip. Ultrasound is transmitted to the distal end of the tip and causes it to act like an extremely sharp instrument that cuts the anterior capsule uniformly. PMID- 6480498 TI - Forceps for implantation of posterior chamber loop haptic lenses. PMID- 6480497 TI - Lens capsule retractor for in-the-bag placement of posterior chamber lenses. PMID- 6480499 TI - A forceps for implanting J-loop lenses. PMID- 6480500 TI - Intraocular lens insertion forceps. PMID- 6480501 TI - A microcomputer system for measuring and analyzing corneal endothelium. AB - A microcomputer system was developed for the Department of Ophthalmology, Vanderbilt University School of Medicine. It is being used as a measurement and analysis tool for corneal endothelial and epithelial research programs, as well as objective measurement of clinical visual field tests. PMID- 6480502 TI - Phosalacine, a new herbicidal antibiotic containing phosphinothricin. Fermentation, isolation, biological activity and mechanism of action. AB - Phosalacine, a new herbicidal antibiotic containing phosphinothricin was isolated from the culture filtrate of a soil isolate Kitasatosporia phosalacinea KA-338. It was a water soluble, amphoteric compound obtained as an amorphous powder (C14H28N3O6P, MW 365). The antibiotic exhibited antimicrobial activity against Gram-positive and Gram-negative bacteria and some fungi on a minimal medium and the activity was reversed by L-glutamine. It also showed herbicidal activity against alfalfa. It is suggested that phosalacine was decomposed to provide phosphinothricin after its incorporation into microbial or plant cells, and exhibited the antimicrobial and herbicidal activities by inhibiting glutamine synthetase with phosphinothricin although phosalacine itself hardly inhibited the enzyme. PMID- 6480503 TI - Structure-activity relationships of saframycins. AB - In vitro antitumor activities of 13 saframycins, including the potent antitumor component, saframycin A, were determined with the highly sensitive established cell line of L1210 mouse leukemia to investigate structure-activity relationships. Saframycins which lack the alpha-cyanoamine group or the alpha carbinolamine group exhibited much lower cytotoxic activity than saframycin A. The modification of active saframycins either at the C-14 position on the basic skeleton or at the C-25 position on the side chain with bulky substituents resulted in a decrease in cytotoxic activity. These structure-activity relationships corroborated the proposed major mechanism of action for the antitumor activity of saframycin A and supported our proposed model for the saframycin A-DNA adduct. PMID- 6480504 TI - Comparative analysis of hexaene antibiotics. AB - A study of nine hexaene antibiotics resulted in their assignment to three subgroups on the basis of their bioactivities. Separation of individual components of the nine antibiotic complexes was accomplished by thin-layer chromatography. Similarities and differences among members of the subgroups were established by thin-layer chromatography, spectrophotometry and high performance liquid chromatography. Two antibiotics (endomycin and hexafungin) were found to be similar. PMID- 6480505 TI - Structure-activity relationships in 1,2,3-triazol-1-yl derivatives of clavulanic acid. AB - The synthesis of a series of analogues of clavulanic acid, possessing a substituted 1,2,3-triazole ring in place of the exocyclic hydroxyl group, is described. Quantitative structure-activity relationships in this series are discussed. PMID- 6480506 TI - New anthracycline derivatives from betaclamycin A. PMID- 6480507 TI - Precursor directed biosynthesis of paulomycins A and B. The effects of valine, isoleucine, isobutyric acid and 2-methylbutyric acid. PMID- 6480508 TI - Synergistic activity in vitro of the new cephalosporin antibiotic HR 810 with gentamicin and amikacin against multiresistant pathogens. PMID- 6480509 TI - The structure of phosalacine, a new herbicidal antibiotic containing phosphinothricin. PMID- 6480510 TI - Physiological properties of the electrically stimulated auditory nerve. I. Compound action potential recordings. AB - The electrically evoked compound action potential (CAP) of the auditory nerve exhibits two peaks, termed N0, at 350 microseconds latency, and N1, at 550 microseconds latency. At low stimulus intensities the CAP consists solely of the long latency N1 peak. As the stimulus strength is increased the higher threshold N0 appears. At high stimulus intensities N1 disappears and only the N0 component of the CAP remains. It is postulated that N1 represents action potentials propagated from the dendritic processes of the auditory neurons and that N0 represents action potentials initiated on the axons of these cells. The N1 peak exhibits anomalous refractory behavior which can be identified in the electrically evoked auditory brainstem response (EABR). That behavior may be useful diagnostically in assessing the extent of dendrite degeneration in cochlear implant candidates and users. PMID- 6480511 TI - Physiological properties of the electrically stimulated auditory nerve. II. Single fiber recordings. AB - Single fiber recordings from the electrically stimulated auditory nerve yield post-stimulus time (PST) histograms demonstrating several response patterns. With pulsatile stimulation of the cochlea, the PST histogram for most fibers at threshold consists of a long-latency (500-800 microseconds), broad response peak with significant latency variability. At increased stimulus intensities, the response pattern changes to a short-latency (300-500 microseconds), high synchrony peak. In preparations where stimulation is applied directly to the axons of the auditory nerve, the response pattern consists solely of a short latency, high-synchrony peak. It is postulated that threshold excitation of normal auditory neurons occurs on the dendritic processes. At higher stimulus intensities, the site of excitation appears to shift to the axonal region of the cells. Two additional response patterns to electrical stimulation which are attributed to synaptic excitation of the auditory neurons via the hair cells are described. PMID- 6480512 TI - Frequency threshold curves and simultaneous masking functions in single fibres of the guinea pig auditory nerve. AB - Tuning curves for simultaneous masking were measured electrophysiologically, in single fibres of the guinea pig auditory nerve. The masking paradigm used was an analogy of that used in the determination of psychophysical tuning curves in man. The resulting tuning curves ran nearly parallel to the corresponding neural frequency threshold curve, over all except the high-frequency portion of the tuning curve. There, the masking functions had a shallower slope than the excitatory frequency threshold curve. The frequency at which the slope became shallower had a close and consistent dependence on fibre characteristic frequency, reaching a value of 1.2 times fibre characteristic frequency in high frequency fibres. Analysis of firing rates during the threshold determination gave information about the mechanism of the masking, and the results were supported by theoretical analysis. The results give information useful for the interpretation of psychophysical tuning curves, determined by simultaneous masking, in man. PMID- 6480513 TI - Representation of voice pitch in discharge patterns of auditory-nerve fibers. AB - Responses of populations of auditory-nerve fibers were measured for synthesized consonant-vowel stimuli. This paper explores the encoding of fundamental frequency (pitch) in these responses. Post-stimulus time (PST) histograms were computed from 25 ms segments of the spike trains. Discrete Fourier transforms with a 40 Hz resolution were computed from the histograms. Two representations of pitch are considered. The first representation is based on the pitch-related temporal properties of the speech signal. Histograms for individual units can show envelope modulations directly related to the pitch period. These modulations reflect the responses of these fibers to a number of stimulus harmonics near fiber CF. Responses of fibers near formant frequencies are dominated by a single large harmonic component, and thus show small or no pitch-related enveloped modulations. Envelope modulations are reduced in the presence of background noise. The second representation uses both temporal properties of auditory-nerve responses and cochlear place to encode the pitch-related harmonic structure of speech. As a measure of the response of the population of fibers to each harmonic of 40 Hz the magnitude of the component of the Fourier transform at that frequency was averaged across all fibers whose characteristic frequencies were within one-fourth octave of that harmonic. We call this measure the average localized synchronized rate (ALSR). The ALSR provides a good representation of stimulus spectrum, even in the presence of background noise. From the harmonic structure of the ALSR, we are able to extract the stimulus pitch frequency. The relationship of these two representations to pitch perception in both acoustic and electrical stimulation (via cochlear implants) is discussed. PMID- 6480514 TI - Some electrical circuit properties of the organ of Corti. II. Analysis including reactive elements. AB - The simplified network model of the organ of Corti-hair cell complex that was studied in previous publications (Dallos, P. (1983): In: Hearing - Physiological Bases and Biophysics, pp. 32-37, editors: R. Klinke and R. Hartmann; Dallos, P. (1983): Hearing Res. 12, 89-119) is extended to include the capacitive reactances of hair cell 12, 89-119) is extended to include the capacitive reactances of hair cell membranes. With the assumption that the circuit is parametrically excited by resistance changes of the apical hair cell membrane, intracellular responses for outer (eO) and inner (eI) hair cells and the organ of Corti potential (eOC) are computed for the linear case. In order that frequency-dependent effects be primarily determined by the network properties of the system, the eO/eOC and eI/eOC ratios are considered. The amplitude and phase dependence of these computed functions is compared to corresponding experimental results from the third turn of the guinea pig's cochlea. The eO/eOC function is predicted to be a simple low-pass filter whose cutoff frequency (1250 Hz) is determined by the parallel resistance-capacitance circuit of the cell's baso-lateral membrane. This circuit prediction is in excellent agreement with the data. The eI/eOC function is again derived as a low-pass filter. The cutoff frequency is obtained as 472 Hz, which corresponds to an RC membrane time constant of 0.34 ms. Experimental data are widely divergent from this predicted pattern. In order to bring the theoretical and experimental results in agreement, two steps are necessary. First, a differentiation (i.e., multiplication by j omega) needs to be included in the input to inner hair cells to account for their velocity dependence [4,10]. Second, an underdamped complex pole, located above the cell's best frequency must be introduced. The velocity dependence and the resonance represented by the underdamped pole-pair indicate that the electrical response pattern of inner hair cells is more complex than that of outer hair cells. PMID- 6480515 TI - Compound action potentials and single unit responses to a 1 kHz haversine in the cat. AB - The single-cycle 1 kHz haversine (one cycle of a 1 kHz sine wave beginning at -90 degrees) is a low-frequency impulsive stimulus which has been little use, but which has significant potential applications both as a clinical and a research tool. The auditory nerve compound action potential (CAP) and single unit discharge patterns evoked by a single-cycle 1 kHz haversine stimulus were studied in anesthetized cats. The haversine CAP waveform consisted of two or three short latency peaks with peak to peak intervals of about 1.0 ms. Latencies of the CAP peaks decreased with increased stimulus intensity and were also strongly dependent on stimulus polarity. Typically, CAP peak latencies changed by about 0.5 ms with stimulus polarity reversal. Single unit responses were classified by the peak latency pattern of their haversine post-stimulus time histograms (PSTHs). Low CF units had low thresholds and PSTHs resembling their click responses. High CF units had high thresholds and PSTHs comprised of one or two short latency peaks whose latencies were polarity-sensitive. Some units in an intermediate CF range (approximately 1.5-3.0 kHz) had PSTHs which were a transitional form between the high and low CF types of response. The unit discharge patterns strongly suggested a low frequency origin for the haversine CAP at all intensities. PMID- 6480516 TI - The effects of furosemide on the endocochlear potential and auditory-nerve fiber tuning curves in cats. AB - Furosemide was injected intravenously in anesthetized cats while the endocochlear potential (EP) and tuning curves from fibers of the auditory nerve were simultaneously monitored in the same ear. The characteristic frequencies (CF's) of the fibers studied ranged from 0.25 to 28 kHz. Furosemide administration produced reversible, dose-related decreases in the EP which were accompanied by threshold elevations and alterations in the tuning curves of auditory nerve fibers. There was approximately 1 dB of threshold elevation for every millivolt decrease in the EP. For fibers with CF's above 3 kHz, threshold elevation at CF (in the tip of the tuning curve) was three times that in the tail of the tuning curve. Threshold elevation in the tip was always accompanied by threshold elevation in the tuning curve tail. Threshold elevation was dependent upon the CF of the fiber, with higher CF fibers showing larger threshold shifts than lower CF fibers. Threshold elevation was accompanied by a systematic shift in the CF of the fiber. Fibers with CF above 1 kHz exhibited downward shifts in CF, while those with CF less than 1 kHz generally exhibited upward shifts in CF. PMID- 6480517 TI - Guinea pig cochlear hair cell density; its relation to frequency discrimination. AB - The density of guinea pig cochlear hair cells fluctuates within a narrow range in a regular and species-specific manner. Two density maxima may be identified within the range. This pattern of density changes resembles the curve of frequency discrimination thresholds reported for guinea pigs in the literature. PMID- 6480518 TI - Frequency-following responses in the cat. AB - The frequency-following response was studied in five cats aged 1 week to 3 years. Animals studied had either monaural or binaural hearing. Responses were recorded differentially from vertex and circumaural electrodes to tonebursts at octave intervals from 0.5 to 4 kHz. Thresholds and dynamics of the responses with and without white-noise masking were investigated. Evidence was found to support the view that the cochlear microphonic makes a major contribution to the frequency following response, while the double frequency-following response to the 0.5 kHz stimulus is neural. PMID- 6480519 TI - Studies on hair cells in isolated coils from the guinea pig cochlea. AB - A technique has been developed for the dissection and maintenance of coils of guinea pig cochlea in tissue culture medium in a microscope chamber where the organ of Corti is viewed with interference contrast optics. The state of the sensory cells can be judged by observing signs of degeneration such as loss of birefringence in the cell cytoplasm, appearance of the nucleus, swelling of mitochondria and cell body, and clumping of sensory hairs. A fibre of quartz glass, 1-1.5 micron diameter, was used to probe the mechanical properties of the sensory hair bundles of outer and inner hair cells. The stereocilia were found to be laterally connected so that force applied at one point also caused movement of stereocilia at some distance from the probe. Interconnecting material was seen in the electron microscope to be present close to the tips of the stereocilia. When displaced, the stereocilia pivot at their base as stiff rods and snap back when released due to elastic properties. When overstrained, the lateral connections break and the stereocilia may fracture at the base. PMID- 6480520 TI - Stiffness of sensory-cell hair bundles in the isolated guinea pig cochlea. AB - Stiffness of hair bundles on cochlear hair cells was measured in turns 2, 3 and 4 of isolated preparations of the guinea-pig organ of Corti maintained in tissue culture medium. Defined as the force required to produce a linear 1.0 micron deflection of the hair-bundle tip, stiffness is greater for deflection in the excitatory than in the inhibitory direction. The excitatory-to-inhibitory ratio for inner hair cells (IHC) is significantly lower than the ratio for outer hair cells (OHC). Hair-bundle stiffness decreases radially from the first to third rows of OHC. Over the measurement range of 9.0-18.0 mm from the stapes hair bundle stiffness decreases much more for OHC (88-97%) than for IHC (50%). Although an increase in hair-bundle length with distance from the stapes accounts for some of the observed stiffness decrease, the major decrease is due to an increase in compliance of the sensory-hair attachment to the hair-cell surface. PMID- 6480521 TI - Analysis of the frequency following response in the cat. AB - The generators of the frequency following response (FFR) were characterized for three frequency ranges by studying changes in FFR response after lesioning the nuclei within the central brainstem auditory pathway. Responses to low frequency (200-500 Hz) stimulation demonstrated changes in the complexity of the FFR waveform in both time and frequency domains following lesions in the brainstem auditory pathway. The results indicate that the complexity of the low frequency FFR is due to activity from multiple sites within the auditory pathway. The intermediate frequency (700-1500 Hz) responses showed unpredictable amplitude changes following similar lesions and no conclusion could be drawn about the generators of the FFR in this frequency range. The responses to high frequency (3 8 Hz) stimulation showed no reduction in amplitude following serial lesioning. These results, combined with other experimental evidence presented, indicate that the high frequency FFR response originates from the cochlear microphonic. Different electrode configurations were used to evaluate the low frequency FFR. In contrast to multiple generator sources recorded with the standard vertex mastoid electrode configuration, we were able to record a response contributed primarily by the inferior colliculi with a less peripherally sensitive electrode configuration (vertex-linked-pinnae) at low intensity stimulation. The fact that auditory brainstem nuclei contribute to the FFR in varying amounts depending on the electrode configuration may explain some of the conflicting characterizations of this response in the literature. Despite this difficulty, the FFR neural generators were identified and characterized in the low frequency range using our most sensitive electrode configuration (vertex-mastoid) and in the high frequency range where the single generator is the cochlear microphonic. PMID- 6480522 TI - Responses elicited from medial superior olivary neurons by stimuli associated with binaural masking and unmasking. AB - The responses of binaural neurons of the medial superior olive were measured as a function of interaural temporal differences for tones and as a function of signal to-noise ratio under homophasic and antiphasic masking conditions. The degree of neural response synchrony to the frequency of the signal was related to the degree of behavioral detectability of the signal in the homophasic, but not the antiphasic masking condition. For the antiphasic condition, a decrease in discharge rate resulted from the addition of the signal to the noise, similar to the decrease which occurred when interaural temporal differences were introduced in the tonal stimuli. The results are compatible with a model in which interaural temporal-difference information arriving over monaural afferents in the form of synchronized impulses is mapped into a place code by a neural coincidence detection device. Several differences were noted between the responses to tones found in the present experiment and those reported by others. These differences were attributed mainly to differences among the experimental procedures in use among the various reporting laboratories. PMID- 6480523 TI - Water permeability of the endolymph-perilymph barrier in the guinea pig cochlea. AB - The diffusional water permeability of the endolymph-perilymph barrier was determined in guinea pigs by perfusing the perilymphatic space with tritiated water and measuring the uptake of tritiated water into the endolymph. Assuming that the volume flow across the endolymph-perilymph barrier is negligible for short periods of perfusion, the water permeability of the barrier is approximately 130 times greater than its permeability to K+ in normal guinea pigs. PMID- 6480524 TI - Furosemide selectively reduces one component in rate-level functions from auditory-nerve fibers. AB - Furosemide, an ototoxic diuretic, was administered intravenously while rate- and phase-level functions of auditory nerve fibers were measured in the cat. Normal level functions can demonstrate two components distinguished by an abrupt shift in the phase of the response as the sound level is increased. Furosemide, administered at doses that decrease the endocochlear potential, selectively reduces the discharge rate in response to tones at sound levels below that of the abrupt phase shift. PMID- 6480525 TI - The microstructure of quiet and masked thresholds. AB - Factors leading to the microstructure of the audiogram (a constant pattern of threshold maxima and minima as a function of frequency) are shown to influence masked thresholds, changing the shape of masking functions when both constant and variable tonal maskers are used. Simultaneous masking with broadband noise gradually reduces the difference between threshold maxima and minima until no further differences can be seen when masked thresholds are above 40-50 dB SPL. Nonsimultaneous masking with broadband noise reveals a changed microstructure when thresholds are elevated above 30-40 dB SPL. Thus in both simultaneous and nonsimultaneous masking the rate of threshold growth with increasing masker level is different for tones from threshold minima than for tones from threshold maxima. These psychophysical measures are related to measures of evoked cochlear emissions and the results are discussed in terms of the implications for understanding the cochlear mechanisms responsible for the microstructure and for the interpretation of psychophysical measures with low level stimuli. PMID- 6480526 TI - The reconnection of auditory posterior root fibers in the red-eared turtle, Chrysemys scripta elegans. AB - The auditory portion of the eighth nerve, the posterior root, was transected in Chrysemys scripta elegans. Two groups of animals were allowed to survive; one for 22 days and the second for 64 days. Each group was then reoperated to inject HRP into the cochlear duct and allowed to survive for an additional three days - for a total survival time of 25 days and 67 days. The 67 day survivors had HRP reaction product in the eighth nerve and the primary auditory nuclei, while the 25-day survivors did not. Degeneration byproduct was present in the same structures in the 25-day survivors while little was in the 67-day survivors. These results indicate as reconnection of the eighth nerve fibers to the acoustic tubercle. PMID- 6480527 TI - Influence of reduced litter size and daily litter separation on fertility of sows at 2 to 5 weeks postpartum. AB - Two experiments were conducted to determine the influence of various lactational treatments on the incidence of estrus and subsequent fertility of sows. Experiment 1 consisted of 60 crossbred (Yorkshire X Duroc) sows assigned to one of four treatment groups. Litter size was reduced (RLS) to two to four nursing pigs/sow at 2 (n = 16), 3 (n = 15) or 4 (n = 15) wk of lactation for 5 d before final weaning or litters were weaned from control sows (n = 14) at 5 wk of age. Reduced litter size resulted in 19 of 43 (44%) sows detected in estrus on the day of weaning. More (P less than .05) RLS sows were in estrus 0 to 3 d after weaning than control sows. Fertility traits (number of corpora lutea, eggs recovered, egg recovery rate, eggs fertilized, fertilization rate, cleaved eggs and cleavage rate) were similar among treatment groups at 4 to 6 d postestrus. Experiment 2 consisted of 59 crossbred (Yorkshire X Duroc) sows assigned to one of four treatment groups. Litters were separated from their dams for 6 (n = 20) or 12 (n = 10) h/d between 2 and 4 wk or litters were weaned at 2 (n = 13) and 4 (n = 15) wk of age. Lactational estrus was detected in 13 of 20 (65%) sows and 5 of 10 (50%) sows that were separated from their litters for 6 or 12 h/d, respectively. Lactational estrus (LE, n = 18) in sows was observed 4 to 8 d after initial separation, while sows remaining anestrus during lactation (LA, n = 12) were in estrus 2 to 7 d postweaning. Average intervals from separation or weaning to estrus for LE and LA sows and for sows whose litters were weaned at 2 or 4 wk were 5.9, 4.4, 4.4 and 4.2 d, respectively, and were longer (P less than .05) for LE sows. Fertility traits were similar among treatment groups. These studies demonstrate that lactations of 2 to 5 wk and lactational treatments of sows, including either litter reduction before weaning or daily separation of sows from their litters, resulted in similar postweaning or post-treatment intervals to estrus and similar fecundity regardless of treatment or lactation length. While 50% of the sows responded to treatments, reasons for the lack of response in the remaining sows is not explained, but it appears that body weight and backfat of sows at weaning, and feed intake during lactation were unrelated to the success of the treatments imposed. PMID- 6480528 TI - The effects of sexual stimulation on the sexual performance of Hereford bulls. AB - In the present study, 12 Hereford bulls approximately 22.5 mo of age were individually introduced to a restrained nonestrous stimulus female for 15 to 30 min under four treatment conditions: (1) without prior sexual stimulation and visually isolated from male conspecifics (control), (2) being watched by another male during matings, (3) after observing the copulatory activities of another male and (4) after being restrained in close proximity to a female. During sexual performance tests, an observer recorded the times at which the bulls exhibited ejaculations, mounts without ejaculation, mount attempts, mount intentions, head throws and Flehmen responses. The observer also recorded the percentage of time spent in proximity to the stimulus female and objectively rated the bulls for overall sexual performance and mating efficiency. Relative to the control treatment, the greatest improvement in sexual performance was noted when the bulls had observed the copulatory activities of conspecifics. Sexual performance was improved, albeit to a lesser degree, by being watched by another male and by restraint in the presence of the stimulus female. The advantages of sexual stimulation should be considered when breeding farm animals and when evaluating the sexual performance of males to be used in a breeding program. PMID- 6480529 TI - Fostering lambs by odor transfer: the substitution experiment. AB - Lamb-specific odor is used by ewes to discriminate between their own and alien offspring. The objective of the present study was to investigate the feasibility of transferring own-lamb odor to alien young to facilitate fostering. Shortly after birth, cloth stockinettes (body suits) were placed on the offspring of 37 multiparous ewes. At 48 to 72 h after parturition, a lamb from each ewe was replaced by an alien lamb. In 31 cases the odor-impregnated stockinette of the ewe's own lamb was placed on the alien lamb; in the remaining six cases the alien lamb retained its own stockinette (control condition). Lamb acceptance tests were conducted every 12 h for 2 d after fostering and once daily for the following 2 d. Twenty-six of the 31 experimental ewes (84%) adopted alien lambs using the odor-transfer technique. All of the control lambs were rejected. Of the 26 ewes that adopted foster young, 10 (38%) showed immediate acceptance and 22 (85%) were exhibiting acceptance behaviors by 36 h after fostering. There were no significant differences in the fostering success of ewes bearing single lambs and those with twins. The presence of own-lamb odor rather than the absence of alien lamb odor appears to be the salient cue for lamb acceptance. Lamb-specific odor transfer represents a relatively inexpensive and rapid technique to achieve maternal acceptance of alien lambs by postpartum ewes. PMID- 6480530 TI - Nutrient intake and efficiency of calf production by two-breed cross cows. AB - Individual consumption of total digestible nutrients (TDN) was measured on 105 two-breed cross cows (Hereford X Angus reciprocal crosses, HA; Simmental X Angus, SA; Simmental X Hereford, SH; Brown Swiss X Angus, BA; Brown Swiss X Hereford BH; Jersey X Angus, JA and Jersey X Hereford, JH) and their three-breed cross calves managed in drylot. Cows were 4 to 6 yr of age and mated to Charolais or Limousin bulls. Cows remained in the drylot for a period of approximately 1 yr (from weaning one year to weaning the next year). Ad libitum consumption of corn silage was allowed for about 4 h each day and fixed amounts of grain and protein supplement were fed as needed. Calf creep feed was provided during the latter portion of lactation. Compared with the average weight of HA cows (454 kg), SA cows were 7% heavier, SH, BA and BH cows were similar, while JH and JA cows were 15 and 22% lighter in weight, respectively. Total intake of TDN by cow and calf for the 365-d drylot period was greatest for the SA group (2,309 kg), exceeding that of the HA group by 11.2%. The JA group consumed 7.2% less than HA, while other groups were similar to HA in TDN intake. Daily intake of TDN for the 365-d period, expressed as a percentage of cow weight and cow weight .75, was highest for the smaller J crosses. The ratio of 365-d TDN intake to 205-d calf weight, a measure of weaning efficiency, averaged 10.0 kg/kg for JH, BH and SH, 10.5 kg/kg for HA and BA and 10.9 kg/kg for JA and SA. When TDN intake was adjusted for cow weight change, crossbred cow group was not a significant source of variation for kg TDN/205-d calf weight. PMID- 6480531 TI - Effects of feeding pattern and dietary regimen on growth and adipose tissue cellularity in polygenic obese mice. AB - The effect of varying feed intake and feeding pattern during the early postweaning period on growth, body composition and adipose tissue cellularity was studied in polygenic obese and control normal mice. Male mice were assigned to the following dietary treatments at 4.5 wk of age: stock diet fed ad libitum(AL), four palatable foods cafeteria-fed(CF), stock diet fed every 2 h by automatic feeders adjusted for maximum intake(MI), fed same procedure as MI but restricted to produce 70% of the gain of mice fed ad libitum(RE), and stock diet fed one meal/d the same amount fed RE mice(PM). Mice were killed after 5 wk on treatment. Cafeteria-fed control mice were heavier (P less than .05) than RE control mice, but they were not different (P greater than .05) from AL, MI and PM control mice, while CF obese mice were heavier and RE obese mice were smaller than AL, MI and PM obese mice (P less than .05). Cafeteria-fed mice were fatter than mice from all other treatments in both the obese and control lines. Maximum intake, PM and RE mice were fatter than AL mice but this effect was only significant in the obese line. Alterations in feeding pattern can affect body composition even though body weight may not show a correlated response. Cafeteria-fed obese mice had larger fat pads and more small (less than 40 micron) and large (greater than 110 micron) adipocytes than other obese mice. Results indicate that the difference in the development of obesity on cafeteria diet was due primarily to genetic effects while the increase in percentage fat after restriction on MI, PM and RE treatments was due mainly to the acute change of feeding pattern. PMID- 6480532 TI - Composition of growth in mice with a major gene for rapid postweaning gain. AB - Previous research from this laboratory identified the existence of a major gene for rapid growth in mice. This trait is expressed as rapid postweaning growth and is inherited as a single recessive gene, designated hg. The hg/hg males and females had greater (P less than .05) body weights at 49-d of age as compared with their Hg/-counterparts; 45.6 +/- .64 and 34.0 +/- .64 vs 33.2 +/- .23 and 27.3 +/- .15 g, respectively. Twenty-four male littermate pairs (hg/hg and Hg/-) were euthanized at 49 d of age for determination of carcass composition. Percentage body water was not affected by genotype (hg/hg, 66.7 +/- .5; Hg/-, 67.8 +/- .3). However, there was a decrease (P less than .05) in percentage body protein (20.2 +/- .1 vs 20.8 +/- .1) and body ash (3.4 +/- .01 vs 3.7 +/- .01) in hg/hg males as compared with Hg/- males, while percentage lipid was significantly increased in hg/hg males (8.7 +/- .5 vs 6.7 +/- .3). When carcass weights were adjusted for differences in dry weight, only body protein was significantly affected by genotype, being greater for hg/hg males (8.54 +/- .19 vs 7.70 +/- .19 g). All other components of body composition were not affected by genotype. The regression coefficient for the covariate of dry weight was significantly different from zero for all carcass components. However, there was no significant difference in the regression coefficient between Hg/- and hg/hg males for each component.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480533 TI - Sex differences in plasma cortisol and growth in the bovine. AB - Tame, pubescent beef calves (six bulls; six heifers) were used to examine the relationship between sex, increase in body weight (BW) and plasma cortisol (C). In bulls (B), plasma testosterone (T) was also examined. The two groups were fed a concentrate to 1.5% BW and Coastal bermudagrass hay ad libitum. From 7 to 12 mo of age, at 28-d intervals, the animals were weighed and jugular vein blood was collected every 15 min for 6 h. Onset of puberty was determined weekly by measuring scrotal circumference in B and assaying for plasma progesterone in the heifers (H). Acceptable growth occurred in both B (.83 kg/d) and H (.67 kg/d). These growth rates were different (P less than .02). Plasma C concentrations were significantly different between the sexes over the time span examined. Whereas C remained between 1.6 and 1.8 ng/ml between 7 and 12 mo of age in B, C rose from 2.9 to 6.0 ng/ml in H. The experiment means for B and H were 2.8 +/- .3 (mean +/- SE) and 5.7 +/- .4 (P less than .01). There were significant correlations between plasma C and age or weight in H, but not in B. Mean plasma T in B was greatest at 9 and 10 mo of age (1.4 and 1.3 ng/ml) and lowest at 7 and 12 mo of age (.76 and .74 ng/ml). Plasma T was not correlated with plasma C or age. The lower plasma C concentrations in B compared with H is commensurate with the greater growth that occurred in B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480534 TI - Bovine muscle glycogen as affected by fasting and refeeding. AB - Twelve bulls about 12 mo of age were used to study the effects of dietary stress and realimentation on muscle glycogen depletion and repletion over time. Needle biopsy techniques were used to obtain longissimus muscle samples 11 d before fasting, at the end of fasting, and 3, 7, 10 and 14 d postfasting. Fasting reduced (P less than .05) muscle glycogen from 77 to 50 mumol glycogen-glucose/g. Depressed muscle glycogen content persisted through d 3 while animals were reestablishing normal feed consumption. A glycogen repletion rate of 3 mumol glycogen-glucose X g-1 X d-1 was observed from d 3 to 7. PMID- 6480535 TI - Effects of long-term consumption of sewage solids on blood, milk and tissue elemental composition of breeding ewes. AB - Fine-wool ewes received for 2 yr a complete pelleted basal diet (11% protein) or the basal diet fortified with 3.5% cottonseed meal (CSM; 12% protein) or gamma irradiated (1 megarad) dried solids (SS; 12% protein) from primary (undigested) sewage (Las Cruces, New Mexico, municipal sewage). Five ewes fed each diet were sampled to determine Ag, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb and Zn in blood, milk and tissues. Tissues and blood were sampled at slaughter 40 d after weaning of lambs. Mean whole blood mineral concentrations were similar (P less than .05) among treatments 3 d postpartum; however, at 42 d after lambing (mean +/- SE) both basal- (54 +/- 2 micrograms/ml) and sewage-fed (54 +/- 2 micrograms/ml) ewes had elevated (P less than .05) blood Ca compared with ewes fed CSM (46 +/- 2 micrograms/ml). No biologically important differences were detected in the concentrations of elements in milk. Ewes fed SS had lower (P less than .05) blood Fe than animals in the other groups. Sewage-fed ewes also had higher (P less than .05) liver Fe (1,092 +/- 100 micrograms/g) than basal-fed ewes (626 +/- 100 micrograms/g); whereas Fe in CSM-fed ewes (873 +/- 100 micrograms/g) was similar to both. Basal-fed animals had 1.1- to 1.3 times more (P less than .05) liver Mg and two- to threefold higher liver Na than CSM or SS. Livers from SS-fed ewes had higher concentrations (P less than .05) of Cd (1.5- to 1.6-times) and Pb (1.4- to 1.9-times) than livers from CSM- or basal-fed ewes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480536 TI - Effects of dietary sewage solids on feedlot performance, carcass characteristics, serum constituents and tissue elements of growing lambs. AB - Twenty fine-wool wether lambs were allotted randomly at weaning to be fed a conventional diet (CD) formulated for growing lambs, or the same basal mixture plus dried gamma-irradiated solids from primary sewage sludge (SS) incorporated as 7% of the dry matter. Feedlot performance and chemical elements in whole blood were monitored during 90 d, after which lambs were slaughtered and carcass data were collected. Concentrations of Ag, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb and Zn were measured in livers, kidneys, bones, spleens and muscles. Sewage solids in the diet did not affect performance appreciably, although dressing percentages from lambs fed SS were 4% lower than CD-fed animals (P less than .05). Rib eye areas, fat thicknesses, quality and yield grades were similar (P greater than .05). Element concentrations in whole blood at weaning, after 56 d of the feeding trial and at slaughter did not differ (P greater than .05) between dietary groups. Serum chemistry determinations showed no biologically meaningful patterns related to diets. Lambs fed SS had higher (P less than .05) concentrations of Cu in livers (51.1 vs 34.3 +/- 3.8 micrograms/g, mean +/- SE) and Pb in kidneys (4.0 vs 2.2 +/- .3 micrograms/g) and lower (P less than .05) Mg in kidneys (.69 vs .72 +/- .01 mg/g). None of the elements in spleen and muscle tissue differed (P greater than .05) between diet groups. Lambs fed SS had elevated (P less than .05) bone Co, Cu, Fe, K and Na compared with those of CD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480537 TI - Testicular development, epididymal sperm reserves and seminal quality in two-year old Hereford and Angus bulls: effects of two levels of dietary energy. AB - The effect of high (HED) and medium energy diets (MED), fed to Hereford (H) and Angus (A) bulls from 6 through 24 mo of age, on scrotal circumference (SC), paired testes weight (PTW), epididymal sperm reserves (ESR) and seminal traits were examined. Over 3 yr, 120 bulls were involved. Angus exceeded H for both SC and PTW. Hereford bulls in yr 2 had smaller SC than in yr 1 or 3 but the response for A was consistent. Year affected PTW. In yr 2 Hereford bulls fed HED had 75% fewer ESR than MED-H bulls (9.3 vs 37.2 X 10(9]. Comparably treated A bulls had similar ESR numbers (29.2 vs 33.4 X 10(9]. In yr 3, epididymal sperm reserves of HED-H were depressed by 35% compared with MED-H (23.1 vs 35.7 X 10(9], whereas HED-A had 14% fewer ESR than did MED-A bulls (28.6 vs 33.1 X 10(9]. It was not obvious why H bulls were more susceptible to the effects of HED. Seminal quality of HED bulls was inferior to that of MED bulls, particularly with respect to progressive motility and the incidence of sperm in which a crater defect of the head was present at 2 yr of age. In yr 2 all seminal traits were severely depressed in 2-yr-old HED-H. Feeding HED to young H and A bulls reduced their reproductive potential. PMID- 6480538 TI - Relationship between LH and testicular development in progesterone-implanted prepubertal ram lambs. AB - The relationship between systemic luteinizing hormone (LH) and testicular development was investigated in Finn and Suffolk ram lambs treated at 2 wk of age with sc progesterone implants for 0, 4, 8 or 12 wk. Serial samples of blood (30 min intervals for 3 h) were collected from five rams X breed-1 X treatment-1 at 6, 8, 10, 12, 14, 18 and 22 wk of age plus 1 and 2 wk after implant removal. Scrotal circumference was measured at 10, 14, 18 and 22 wk of age. A testicular biopsy was obtained at 14, 18 and 22 wk for microscopic evaluation of testicular development and spermatogenesis. Pulsatile LH releases occurred 60 to 180 min apart in control lambs between 6 and 22 wk of age; LH secretion was not affected by age except for a decrease (P less than .01) in mean LH at 22 wk. Transient increases in testosterone were found subsequent to LH pulses. Systemic testosterone increased (P less than .01) progressively with age, was higher (P less than .05) in Finn than in Suffolk rams at 18 and 22 wk and was correlated positively (P less than .01) within breeds with seminiferous tubule diameter at 14 wk and with scrotal circumference at 10 and 14 wk. Tubule diameter was larger (P less than .01) but testes size and weight were smaller (P less than .01) in Finn than in Suffolk rams. Progesterone implants decreased (P less than .01) LH secretion at 4, 6, 8, 10 and 12, but not at 14 wk of age; decreased systemic testosterone between 4 and 14 wk; decreased (P less than .01) seminiferous tubule diameter at 14 wk, which was related inversely to duration of progesterone treatment; and delayed puberty from 18 to 22 or more wk in rams implanted from 2 to 10 or 14 wk of age. Both control and treated rams with elongated spermatids at 18 vs 22 or more wk had increased LH secretion, higher systemic testosterone and larger tubule diameter and testes size at a younger age. These results suggest that rate of sexual maturation in ram lambs is related to level of postnatal LH stimulation and to the prepubertal age when increased LH stimulation occurs. PMID- 6480539 TI - Characteristics of bovine spermatozoa after migration through a bovine serum albumin gradient. AB - Experiments were conducted to determine the efficiency with which viable, morphologically normal bovine spermatozoa could be isolated using a discontinuous bovine serum albumin (BSA) gradient. In the first experiment, extended semen was layered on top of a BSA gradient (4% BSA over 10% BSA) contained in a 500-ml separatory funnel. When comparing 1, 3, 5, 7, 14 or 21 X 10(9) spermatozoa applied to the gradient, the percentage of spermatozoa recovered from the lower third of the 10% BSA ranged from 2.9 to 18.5%. The greatest recovery was achieved when 1 X 10(9) sperm cells were applied. Increasing the number of spermatozoa applied to the gradient increased the percentage of spermatozoa remaining in the upper portions of the gradient. Motility of spermatozoa immediately after collection from the 10% BSA layer of the gradient was greater than 90%, regardless of the number of spermatozoa applied. In a second experiment with freeze-thawed separated or unseparated spermatozoa, post-thaw motility (greater than 60%) and acrosomal integrity (greater than 85%) of separated spermatozoa (4 or 10% BSA layer) was greater (P less than .05) than that of unseparated spermatozoa (38 and 66%, respectively). The discontinuous gradient excluded decapitated spermatozoa and spermatozoa with mid-piece and principal piece abnormalities from entering the lower layers. Sperm cells with head abnormalities were not separated. These data indicate that a population of spermatozoa with a high frequency of viable, motile, morphologically-normal bovine spermatozoa can be isolated using a discontinuous BSA gradient. PMID- 6480540 TI - Laboratory methods for flucytosine (5-fluorocytosine). Report of a Working Group of the British Society for Mycopathology. PMID- 6480541 TI - Effect of gestational age and birth weight on tobramycin kinetics in newborn infants. AB - The effects of gestational age and birth weight on tobramycin kinetics were studied in 26 newborn infants with presumed or proven bacterial sepsis during the first week of postnatal age. The infants received tobramycin, 2.5 mg/kg intravenously every 12 h. Group A consisted of nine patients 28 to 30 weeks of gestational age; group B had 11 patients greater than 30 to less than or equal to 34 weeks of gestational age; and group C had six patients greater than 34 to less than or equal to 40 weeks of gestational age. Steady-state peak serum concentrations of tobramycin averaged 6.5, 7.2 and 7.1 mg/l in groups A, B and C; the corresponding trough concentration averaged 2.0, 2.3 and 1.3 mg/l. The frequency of tobramycin trough serum concentration above 2 mg/l was 44% in group A, 45% in group B and 0% in group C. Total body clearance of tobramycin averaged 1.04, 1.13 and 1.28 ml/min/kg; apparent volume of distribution averaged 0.84, 0.81 and 0.61 l/kg; and elimination half-life averaged 9.3, 8.9 and 5.6 h in groups A, B and C. Group M consisted of seven infants with 1.0-1.25 kg birth weight; group N had six infants 1.26-1.50 kg birth weight; group O had seven infants 1.51-2.0 kg birth weight; and group P had six infants 2.1-3.5 kg birth weight. Steady-state peak serum concentration of tobramycin averaged 5.7, 7.3, 7.8 and 7.1 mg/l; and the trough serum concentration averaged 2.2, 2.4, 1.9 and 1.3 mg/l in groups M, N, O and P.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480542 TI - Pharmacokinetics of apalcillin in intensive-care patients: study of penetration into the respiratory tract. AB - A pharmacokinetic study of apalcillin was performed in 12 patients in an intensive-care unit. All received a single dose of 30 mg/kg in a 30 min infusion followed by 90 mg/kg/day for four days; six patients (group A) were treated by intermittent administration for two days (30 mg/kg in 30 min infusion, three times daily), followed by continuous infusion for the next two days; six other patients (group B) first received continuous infusion followed by intermittent infusion. Serial serum specimens were collected after the first infusion and on the third and fifth days of treatment. Bronchial secretions were taken simultaneously via an endotracheal tube or the tracheostomy cannula, in order to study the penetration of the drug into the respiratory tract. Assays were performed by a microbiological method. A mean serum peak value of 87.1 +/- 6.13 mg/l 5 min after the end of the first injection was followed by a slow decrease in serum levels and a residual value of 6.29 +/- 3.21 mg/l (8h). Intermittent administration resulted in a mean serum peak of 79.56 +/- 12.35 mg/l whereas after continuous infusion, a steady state of about 30 mg/l was obtained. No significant difference was found between pharmacokinetic parameters for the two groups. In bronchial secretions, a mean peak value of 5.8 mg/l was attained by the second hour. Decreased levels in bronchial secretions measured after three or five days treatment were possibly related to a decrease in inflammation. PMID- 6480543 TI - Erythromycin compared with a combination of ampicillin plus flucloxacillin for the treatment of community acquired pneumonia in adults. AB - Erythromycin was compared with a combination of ampicillin plus flucloxacillin for treating adults admitted to hospital with community acquired pneumonia. A satisfactory clinical response to a seven day course of antibiotics was observed in 29 of 36 patients (81%) in the erythromycin group and 35 of 39 patients (90%) treated with ampicillin plus flucloxacillin, as judged by a fall in temperature, improvement in the general condition, diminution of respiratory symptoms and radiographic improvement. Streptococcus pneumoniae was the causative organism most commonly detected and a satisfactory outcome of treatment of diagnosed pneumococcal pneumonia cases was observed in 16 of 18 patients (89%) treated with erythromycin compared with 20 of 22 patients (91%) treated with ampicillin plus flucloxacillin. These results indicate that erythromycin has similar clinical efficacy to ampicillin plus flucloxacillin, given as a seven day course, for the treatment of community acquired pneumonia in adults. PMID- 6480544 TI - Reasons to leave shiftwork and psychological and psychosomatic complaints of former shiftworkers. PMID- 6480545 TI - Electrodermal activity to auditory stimuli in autistic, retarded, and normal children. AB - Electrodermal activity to auditory stimuli was compared in 20 autistic children and their matched retarded and normal controls (N = 80). The autistic children were virtually indistinguishable in individual features of electrodermal activity from controls when both chronological and mental age comparisons were accounted for. When patterns of activity were considered globally, both autistic and retarded children could be distinguished from one another and from normal controls. However, in some respects autistic and same-aged normal children were alike--both showed sensitization to 70-dB tones and both had a higher incidence of children with larger left- than right-hand responses, interpreted as evidence of focused attention under left hemisphere control. PMID- 6480546 TI - Hyperlexia in infantile autism. AB - Twenty boys meeting the current DSM III criteria for infantile autism at the time of diagnosis were found to be hyperlexic in childhood and have been followed up for 7-17 years. The most striking feature of the group was the compulsion to decode written material without comprehension of its meaning, and this constituted a behavioral phenotype for this population. On word recognition tests such as the WRAT, they scored significantly higher than would be predicted on the basis of intelligence but demonstrated severe reading retardation on tests of reading comprehension such as the Gates-McGinitie. Major differences in intelligence were detected, ranging from severe mental retardation to very superior intelligence. Major differences in verbal and nonverbal abilities were also noted. Many were found to have unusually good memory, both visual and auditory, and the majority possessed an excellent stored vocabulary that could be used with written words despite the poverty of their expressive language. It is suggested that the presence of hyperlexia may identify a subgroup of autistic children. PMID- 6480547 TI - The effects of a sensory extinction procedure on stereotypic sounds of two autistic children. AB - A reversal design was used to investigate the effects of a sensory extinction procedure on stereotypic sounds produced by two autistic children. White noise programmed through earphones was used to mask auditory stimuli resulting from aberrant vocalizations (termed "slurring," "snorts," and "arias") and from clapping hands and dropping objects. This sensory extinction procedure substantially reduced the stereotypic vocalizations but had little practical effect on the clapping and object-dropping responses. The discussion addresses some of the limitations and potential uses of sensory extinction procedures. PMID- 6480548 TI - Language intervention: a pragmatic approach. AB - The approach to language intervention described in this paper provides a means of teaching pragmatically appropriate and effective uses of language in conversational contexts while simultaneously teaching the production and comprehension of specific linguistic forms. The approach, developed in work with seriously language-disabled young children, consists of a series of communication games. These games, which focus and intensify certain characteristics of conversational situations, teach vocabulary, syntax, and articulation as devices for serving the same pragmatic functions these devices serve in ordinary conversation. The games integrate the advantages of the traditional language lessons and those of incidental teaching. Spontaneous speech data collected before and after a 4-month interval from trained and contrast-group children suggest the positive impact of the intervention on the language performance of children with no or moderate cognitive delays, but the results do not suggest a similar impact on children with severe cognitive delays. The results suggest that the intervention merits further application and evaluation, with particular attention to the control of cognitive level. PMID- 6480549 TI - Conversational skills for autistic adolescents: teaching assertiveness in naturalistic game settings. AB - A naturalistic social skills training program was used to teach assertive responses to three autistic adolescents. Training and assessment of positive and negative assertions occurred in the context of two game situations-a card game and a ball game. Training consisted of modeling and behavioral rehearsal prior to each game, with tokens delivered contingent on assertive responses. Evaluation of training effects was accomplished in a multiple baseline across response classes. The results demonstrated the effectiveness of the procedure in generating high levels of positive and negative assertions that maintained across a 4.5-month follow-up interval. This in vivo procedure for teaching social behaviors permits the concurrent acquisition of assertive responses and leisure behaviors, two skills that are of special importance in improving the quality of autistic youth's experiences with their peers. PMID- 6480550 TI - Suppression of pica by overcorrection and physical restraint: a comparative analysis. AB - Overcorrection and physical restraint procedures have been shown to be effective in controlling certain classes of maladaptive behavior in mentally retarded persons. In the present study, an alternating treatments design was used to measure the differential effects of overcorrection and physical restraint procedures in the treatment of pica. Changes in collateral behaviors were also monitored. Each occurrence of pica was followed by either an overcorrection procedure or a physical restraint procedure. Although both procedures reduced the occurrence of pica and had a similar effect on the occurrence of collateral behaviors, physical restraint was clinically more effective in terms of immediate response reduction. PMID- 6480551 TI - Diagnostic checklist Form E2: a reply to Parks. PMID- 6480552 TI - Conrad's "The Idiots": case examples of autism? PMID- 6480554 TI - Differential gene expression during aerobic germination of Mucor racemosus sporangiospores. AB - Evidence is provided suggesting that several modes of differential gene expression operate concomitantly during the first 60 min of germination of Mucor racemosus sporangiospores under air. Protein synthesis was initiated immediately upon exposure of the spores to nutrient medium and accelerated exponentially throughout the period of observation. All translation during the first 30 min of germination occurred using only preformed stable mRNAs as a template. Analysis of the protein products synthesized in vivo was performed by L-[35S]methionine labeling, one- and two-dimensional polyacrylamide gel electrophoresis, and autoradiography. The population of proteins accumulated during spore formation and present at the time of harvest differed significantly from those proteins synthesized during spore germination. Autoradiographs displayed several proteins synthesized during the former but not the latter morphogenetic process. Conversely, other proteins were synthesized during the first 30 min of germination but not during spore formation, even though the mRNA specifying these proteins must have been synthesized and stored in the dormant spore. A posttranscriptional regulatory mechanism that directs selective translation thus appears to exist in the developing spore. In addition, autoradiographs showed that many proteins, although made throughout the intervals examined, displayed significant changes in their relative rates of synthesis. One gene product exemplified a possible case of post-translational modification during the first hour of sporangiospore germination. PMID- 6480553 TI - Physiological function of hydrogen metabolism during growth of sulfidogenic bacteria on organic substrates. AB - Desulfovibrio vulgaris Madison and Thermodesulfobacterium commune contained functionally distinct hydrogenase activities, one which exchanged 3H2 into 3H2O and was inhibited by carbon monoxide and a second activity which produced H2 in the presence of CO. Cell suspensions of D. vulgaris used either lactate, pyruvate, or CO as the electron donor for H2 production in the absence of sulfate. Both sulfidogenic species produced and consumed hydrogen as a trace gas during growth on lactate or pyruvate as electron donors and on thiosulfate or sulfate as electron acceptors. Higher initial levels of hydrogen were detected during growth on lactate-sulfate than on pyruvate-sulfate. D. vulgaris but not T. commune also produced and then consumed CO during growth on organic electron donors and sulfate or thiosulfate. High partial pressures of exogenous H2 inhibited growth and substrate consumption when D. vulgaris was cultured on pyruvate alone but not when it was metabolizing pyruvate plus sulfate or lactate plus sulfate. The data are discussed in relation to supporting two different models for the physiological function of H2 metabolism during growth of sulfidogenic bacteria on organic electron donors plus sulfate. A trace H2 transformation model is proposed for control of redox processes during growth on either pyruvate or lactate plus sulfate, and an obligate H2 cycling model is proposed for chemiosmotic energy coupling during growth on CO plus sulfate. PMID- 6480555 TI - Protein on the cell surface of the moderately halophilic phototrophic bacterium Rhodospirillum salexigens. AB - A cell surface protein (Mr 68,000) of the moderately but obligately halophilic phototrophic bacterium Rhodospirillum salexigens was identified by two independent methods: first, by labeling the cell surface with radioactive iodine and lactoperoxidase, and second, by washing cells in 30% sucrose to remove proteins attached to the cell surface by ionic bonds. The identified protein very likely represents the outermost layer of the cell envelope of R. salexigens as observed by electron microscopy. The protein was isolated. Its isoelectric point was determined to be 4.4; the excess of acidic over basic amino acids was found to be 18.3 mol%; and its average hydrophobicity was 2.26 kJ per residue. PMID- 6480556 TI - Purification and biochemical characterization of pyruvate oxidase from Lactobacillus plantarum. AB - Pyruvate oxidase (EC 1.2.3.3) was isolated and characterized from Lactobacillus plantarum. The enzyme catalyzes the oxidative decarboxylation of pyruvate in the presence of phosphate and oxygen, yielding acetyl phosphate, carbon dioxide, and hydrogen peroxide. This pyruvate oxidase is a flavoprotein, with the relatively tightly bound cofactors flavin adenine dinucleotide, thiamine pyrophosphate, and a divalent metal ion, with Mn2+ being the most effective. The enzyme is only slightly inhibited by EDTA, implying that the enzyme-bound metal ion is poorly accessible to EDTA. Only under relatively drastic conditions, such as acid ammonium sulfate precipitation, could a colorless and entirely inactive apoenzyme be obtained. A partial reactivation of the enzyme was only possible by the combined addition of flavin adenine dinucleotide, thiamine pyrophosphate, and MnSO4. The enzyme has a molecular weight of ca. 260,000 and consists of four subunits with apparently identical molecular weights of 68,000. For catalytic activity the optimum pH is 5.7, and the optimum temperature is 30 degrees C. The Km values for pyruvate, phosphate, and arsenate are 0.4, 2.3, and 1.2 mM, respectively. The substrate specificity revealed that the enzyme reacts also with certain aldehydes and that phosphate can be replaced by arsenate. In addition to oxygen, several artificial compounds can function as electron acceptors. PMID- 6480557 TI - Specificity and mechanism of ferrioxamine-mediated iron transport in Streptomyces pilosus. AB - Although the ferrioxamines are an important and well-characterized class of siderophores produced by several species of Nocardia, Streptomyces, Micromonospora, Arthrobacter, Chromobacterium, and Pseudomonas, no studies of the mechanism of ferrioxamine-mediated iron uptake have been performed for an organism which produces the siderophore. This is the first report of metal transport in Streptomyces pilosus mediated by the native ferrioxamines B, D1, D2, and E. 55Fe accumulation in these ferrioxamines was dependent on metabolic energy and was a saturable process with increasing complex concentration. The apparent Km for [55Fe]ferrioxamine B uptake was approximately 0.2 microM. Both chromic desferriferrioxamine B and [67Ga]desferriFerrioxamine B were transported at rates similar to those of the 55Fe complexes: this implies that no decomplexation or reduction of the metal ion is required for transport, since the chromic complexes are kinetically inert and the gallium complexes have no stable divalent state as a possible reduction product. In addition, isomers of inert chromic desferriferrioxamine B complexes were used to probe the stereospecificity of the ferrioxamine uptake system. The chromic complexes were separated into three fractions by cationic exchange chromatography and assigned as two cis and a (mixture of) trans geometrical isomer(s) by their visible spectra. [55Fe]ferrioxamine B uptake was equally inhibited by each isomer, suggesting that no differentiation between cis and trans geometrical isomers occurs. In the presence of chromic desferriferrioxamine B isomers, the uptake rates for 55Fe labeled ferrioxamines E, D1, and D2 were even more strongly reduced than was that for [55Fe]ferrioxamine B itself. From these results we conclude that all the ferrioxamines tested are transported into the cells by the same uptake system. PMID- 6480558 TI - Iron transport in Streptomyces pilosus mediated by ferrichrome siderophores, rhodotorulic acid, and enantio-rhodotorulic acid. AB - Streptomyces pilosus is one of several microbes which produce ferrioxamine siderophores. In the accompanying paper (G. Muller and K. Raymond, J. Bacteriol. 160:304-312), the mechanism of iron uptake mediated by the endogenous ferrioxamines B, D1, D2, and E was examined. Here we report iron transport behavior in S. pilosus as mediated by the exogenous siderophores ferrichrome, ferrichrysin, rhodotorulic acid (RA), and synthetic enantio-RA. In each case iron acquisition depended on metabolic energy and had uptake rates comparable to that of [55Fe]ferrioxamine B. However, the synthetic ferric enantio-RA (which has the same preferred chirality at the metal center as ferrichrome) was twice as effective in supplying iron as was the natural ferric RA complex, suggesting that stereospecific recognition at the metal center is involved in the transport process. Iron uptake mediated by ferrichrome and ferric enantio-RA was strongly inhibited by kinetically inert chromic complexes of desferrioxamine B. These inhibition experiments indicate that iron from these exogenous siderophores is transported by the same uptake system as ferrioxamine B. Since the ligands have no structural similarity to ferrioxamine B except for the presence of three hydoxamate groups, we conclude that only the hydroxamate iron center and its direct surroundings are important for recognition and uptake. This hypothesis is supported by the fact that ferrichrome A and ferrirubin, which are both substituted at the hydroxamate carbonyl groups, were not (or were poorly) effective in supplying iron to S. pilosus. PMID- 6480560 TI - Division of temperature-sensitive Streptococcus faecium mutants after return to the permissive temperature. AB - The regrowth of 27 temperature-sensitive division mutants of Streptococcus faecium ATCC 9790 was examined after various periods of incubation at the nonpermissive temperature. Several of the mutants blocked at various stages of septum formation or of daughter-cell separation divided in a partially or completely synchronous way after a short incubation at the nonpermissive temperature. All four lytic mutants blocked early in the cell division cycle divided at a normal rate after a brief lag. PMID- 6480559 TI - Methanogenic cleavage of acetate by lysates of Methanosarcina barkeri. AB - Cell lysates of acetate-grown Methanosarcina barkeri 227 were found to cleave acetate to CH4 and CO2. The aceticlastic reaction was identified by using radioactive methyl-labeled acetate. Cell lysates decarboxylated acetate in a nitrogen atmosphere, conserving the methyl group in methane. The rate of methanogenesis from acetate in the cell lysates was comparable to that observed with whole cells. Aceticlastic activity was found in the particulate fraction seperate from methylcoenzyme M methylreductase activity, which occurs in the soluble fraction. Pronase treatment eliminated methylcoenzyme M methylreductase activity in lysates and stimulated aceticlastic activity, indicating the aceticlastic activity was not derived from unbroken cells, which are unaffected by proteolytic treatment. PMID- 6480561 TI - Monoclonal antibodies to Rhizobium meliloti and surface mutants insensitive to them. AB - Monoclonal antibodies were produced to the surface of the symbiotic nitrogen fixing bacterium Rhizobium meliloti. Bacterial lysis in the presence of complement or cycles of agglutination and growth were used to select mutants no longer recognized by the antibodies. The mutants were used to produce new antibodies with different specificities. Several mutants had altered sensitivity to one or more bacteriophages. R. meliloti strains from different sources had distinct patterns of sensitivity to monoclonal antibodies and phages, which together can be used for discriminative typing. PMID- 6480562 TI - Physiological role of pyruvate oxidase in the aerobic metabolism of Lactobacillus plantarum. AB - Under aerobic growth conditions Lactobacillus plantarum produced acetic acid in addition to lactic acid. It was found that lactic acid was predominantly produced at first, and then when the carbohydrate was nearly exhausted, lactic acid was metabolized further to acetic acid. The most likely enzyme involved in the aerobic metabolism of L. plantarum is pyruvate oxidase. Its activity is enhanced in the presence of oxygen and is reduced in the presence of glucose. The specific activity of pyruvate oxidase is highest at the beginning of the stationary-growth phase, where a strong increase in acetic acid production was also observed. PMID- 6480563 TI - Vitamin requirements of three spiroplasmas. AB - A chemically defined medium (CC-494M) was used to study the vitamin requirements of three spiroplasmas representing three distinct serogroups: flower spiroplasmas [Spiroplasma floricola and FS (SR-3)] and honeybee spiroplasma [HBS (AS-576)]. Nicotinic acid and riboflavin were essential to spiroplasma growth. Nicotinamide could substitute for nicotinic acid. Populations of S. floricola, FS (SR-3), and HBS (AS-576) reached 3.2 X 10(9), 1.96 X 10(10), and 6.1 X 10(9) CFU/ml, respectively, when nicotinic acid (0.036 mg/liter) and riboflavin (0.014 mg/liter) were supplied. PMID- 6480564 TI - Levels of cyclic-2,3-diphosphoglycerate in Methanobacterium thermoautotrophicum during phosphate limitation. AB - Batch-grown Methanobacterium thermoautotrophicum cells grew nonexponentially in the absence of exogenous Pi until intracellular cyclic-2,3-diphosphoglycerate (cyclic DPG) had fallen below 2 mumol/g (dry weight), the limit of detection. Growth resumed immediately upon transfer to medium containing Pi Cyclic DPG levels were also below detection in Pi-limited chemostat cultures operating at a dilution rate of 0.173 h-1 (4-h doubling time), with reservoir Pi concentrations below 200 microM. At this dilution rate, the Pi concentration in the culture was 4 microM. An H2-limited steady state was achieved with 400 microM Pi in the inflowing medium (67 microM in the culture). The cyclic DPG content of these cells was 72 to 74 mumol/g, about one-third the amount in batch-grown cells. The specific growth rate accelerated immediately to 0.36 h-1 (1.9-h doubling time) under washout conditions at high dilution rate. The cellular content of cyclic DPG declined over a 2-h period, and then increased rapidly as the Pi level in the medium approached 200 microM. Expansion of the cyclic DPG pool coincided with a marked increase in Pi assimilation. These results indicated that M. thermoautotrophicum accumulated cyclic DPG only when Pi and H2 were readily available. PMID- 6480565 TI - Psychiatric disorders among relatives of surgical controls. AB - The risks of various psychiatric illnesses among the first-degree relatives of 160 surgical control patients were estimated. Morbidity risks were calculated separately for males and females because of previous findings showing significant sex differences for certain diagnoses. The findings, based on ICD-9 criteria, demonstrate a significantly higher risk of depression, neurosis, and organic brain syndrome in females than in males. The risk of alcoholism was significantly higher in males. PMID- 6480566 TI - Cerebral asymmetry in subtypes of schizophrenia. AB - CT scans of 26 nonparanoid and 10 paranoid right-handed male schizophrenics were examined. Multiple measurements were made of each region of the brain and a standard error of measurement with a confidence level of p less than .01 was used to define significant asymmetry. Three aspects of cerebral asymmetry, i.e., local hemispheric width, local hemispheric protrusion, and regional hemispheric size, were examined. Paranoid and nonparanoid patients were similar in their patterns of frontal asymmetries. However, a substantial proportion of nonparanoid schizophrenics had wider, longer, and larger right parieto-occipital lobes compared to paranoid patients. PMID- 6480567 TI - Biorhythms revisited: rhythm and blues? AB - In a previous study, no significant relationship was seen between date of psychiatric admission or psychiatric emergency room visit and various phases or critical days in the biorhythm cycle. The present study evaluated these relationships for date of admission of 313 patients--192 with major depression, 88 with bipolar disorder, and 33 with schizophrenia or other diagnoses. No significant relationship to critical days or any combination of critical/noncritical days was found. Two further analyses failed to reveal any significant relationship between admission date and ascendant versus recuperative phases or any combination of cycle and phase. No differences were seen between affectively ill and other patients on any measures evaluated. PMID- 6480568 TI - A comparison of the cortisol suppression index and the dexamethasone suppression test. AB - The cortisol suppression index (CSI) (the ratio of pre- to postdexamethasone serum cortisol concentrations) was compared to the dexamethasone suppression test (DST) in endogenously depressed DST suppressors (N = 20) and nonsuppressors (N = 21) and in normal controls (N = 23). The 8 a.m. CSI detected 17.1% and 31.7% of endogenous depressives at the 4.0 and 6.0 thresholds; for the 4 p.m. CSI, rates were 48.8% and 65.9%. The 4 p.m. CSI produced 17.4% and 39.1% false positives in normal controls at the two thresholds, whereas the false positive rate for the DST was 4.3%. These data suggest that the CSI is not as specific as the standard DST for the detection of endogenous depression. PMID- 6480569 TI - Dynamics of the cortisol suppression index in depression. AB - The cortisol suppression index (CSI), a ratio of predexamethasone to postdexamethasone plasma cortisol levels, has been suggested as an alternate approach to the use of the DST in the diagnosis of depression. Forty-eight psychiatric inpatients were prospectively studied to compare the utility of the CSI to results obtained using Carroll's fixed values at 4 p.m. and 11 p.m. Eighty eight percent (22/25) of depressed patients had an 8 a.m. CSI below 7.0; 73% (16/22) had a 4 p.m. CSI less than 2.5. This compared to a 76% detection rate using Carroll's criteria for nonsuppression. In this study the CSI provided a sensitive and specific interpretation of the dexamethasone suppression test in depression. PMID- 6480570 TI - Cortisol suppression index: a further evaluation. AB - The cortisol suppression index (CSI) is the ratio of pre- to postdexamethasone plasma cortisol concentrations. The 8 a.m. CSI was previously found to identify 66% of a sample of psychiatric inpatients with major depression. In the present study, a 4 p.m. CSI identified 71% of psychiatric inpatients with major depression, in contrast to 53% when using DST criteria alone. This finding adds further validation to the CSI. Further studies of the utility of the CSI are suggested to help improve the detection of major depression. PMID- 6480571 TI - Treatment-resistant depression in an elderly patient with pancreatic carcinoma: case report. AB - A case is reported of a recurrent and treatment-resistant depression with a positive DST in an individual in whom adenocarcinoma of the pancreas was eventually diagnosed. Following excision of the tumor, there was increased therapeutic response to antidepressants and normalization of the DST. PMID- 6480572 TI - Treatment of attention deficit and borderline personality disorders with psychostimulants: case report. AB - A case is reported of a young woman with attention deficit disorder and concomitant borderline personality disorder who was successfully treated with methylphenidate. The overlapping criteria for these disorders are discussed and recommendations for treatment with psychostimulants are suggested. PMID- 6480573 TI - Lithium in a patient with renal failure on hemodialysis. PMID- 6480574 TI - Use of desipramine in the medically ill. AB - The use of desipramine in treating major depressive disorder in the hospitalized medically ill patient is described. Desipramine has a low incidence of anticholinergic side effects, causes little orthostatic hypotension, and has a quinidine-like effect on cardiac arrhythmias. Desipramine should be used with caution in patients with risk of heart block and bundle branch block. Guidelines for administration of desipramine in the medically ill are discussed, and drug interactions with medications commonly used in this population are reviewed. Finally, the importance of providing psychotherapy along with desipramine treatment in treating the medically ill depressed patient is emphasized. PMID- 6480575 TI - Ultrastructure of C4b-binding protein fragments formed by limited proteolysis using chymotrypsin. AB - C4b-binding protein is a regulator of the classical pathway of the complement system, acting as a cofactor to the serine protease factor I in the degradation of C4b. Its molecular weight is approximately 570,000 and it is composed of multiple, disulfide-linked 70-kDa subunits. Visualized by electron microscopy (Dahlback, B., Smith, C. A., and Muller-Eberhard, H. J. (1983) Proc. Natl. Acad. Sci. U. S. A. 80, 3641-3645), it has an unusual spider-like structure with multiple thin (30 A), elongated (330 A) tentacles. The number of tentacles was estimated to be seven. Limited proteolysis by chymotrypsin produces fragments of approximately 50- and 160-kDa, the latter composed of multiple, disulfide-linked, 25-kDa polypeptides. We now have isolated the undenatured C4b-binding protein fragments formed by treatment of the protein with chymotrypsin and have visualized them by electron microscopy. The 160-kDa fragment comprises the central portion of the C4b-binding protein, which appears as a ringlike structure with an inner diameter of 13 A and an outer diameter of 60 A and having attached an approximately 40-A long piece of each tentacle. The liberated 50-kDa fragment constitutes the major part (290-A long) of the tentacles. Chymotrypsin digestion of C4b-binding protein was also monitored as a function of time by polyacrylamide gel electrophoresis and the number of subunits cleaved was found to be seven, supporting our previous ultrastructural data which suggested that C4b-binding protein contains seven identical tentacle-like subunits. PMID- 6480576 TI - In situ biochemical studies of intestinal alkaline phosphatase in normal and phosphate-depleted rats by microdensitometry. AB - A quantitative microdensitometric study has been designed to characterize in situ intestinal brush border-bound alkaline phosphatase of rat duodenal villosities. Intestinal slices were incubated with beta-glycerophosphate as substrate. Free phosphate liberated was precipitated in presence of a lead reagent as lead sulfide. The precipitate was quantified in situ by scanning and integrating microdensitometry. Kinetic parameters of the reaction were determined at 37 degrees C, pH 8.8, in the middle part of the villosities. Apparent Michaelis constant (Km) for beta-glycerophosphate was found to be 8.16 +/- 0.56 mM (mean +/ S.E.). Maximal enzyme activation was obtained at pH 8.5. Maximal inhibition of enzyme activity was observed in the presence of L-phenylalanine (30 mM) or theophylline (5 mM). Along the villosity axis, enzyme activity rose from the crypt up to the midportion of the villosity and finally decreased at the tip region. In phosphate-depleted rats, enzyme activity was increased in all portions of the villosity, with conservation of the same activity gradient. In this situation, kinetic analysis showed a marked decrease of Km, i.e. 4.56 +/- 0.39 mM (mean +/- S.E.) as compared to normal rats. PMID- 6480577 TI - Identification of the alpha subunit half-cystine specifically labeled by an affinity reagent for the acetylcholine receptor binding site. AB - Nicotinic acetylcholine receptors contain a readily reducible disulfide bond at the periphery of the acetylcholine binding site. Following reduction of this disulfide, the binding site is susceptible to affinity labeling by electrophilic reagents with quaternary ammonium moieties. We reduced purified receptor from Torpedo californica electric tissue and affinity alkylated it with 4-(N maleimido)benzyltri[3H]methylammonium iodide. The label was incorporated solely into the alpha subunit of the receptor. Isolated, labeled alpha subunit was cleaved with CNBr, and the fragments were separated by reverse-phase high performance liquid chromatography. A uniquely labeled CNBr fragment was isolated, and its partial sequence was determined by automated Edman degradation. This CNBr fragment was cleaved at tryptophan residues, the subfragments were separated, and the labeled subfragments were partially sequenced. From our protein sequence information, we identify the labeled CNBr fragment as residues 179 to 207 of the sequence of alpha predicted from the cDNA sequence (Noda, M., Takahashi, H., Tanabe, T., Toyosato, M., Furutani, Y., Hirose, T., Asai, M., Inayama, S., Miyata, T., and Numa, S. (1982) Nature (Lond.) 299, 793-797). From the cycle of the Edman degradation in which radioactive residues are released, we conclude that Cys 192 and, possibly in addition, Cys 193 are the residues specifically labeled by 4-(N-maleimido)benzyltri[3H]methylammonium iodide. They are, therefore, close to the acetylcholine binding site. PMID- 6480578 TI - The determination of molecular weight of proteins by gel permeation chromatography in organic solvents. AB - Very amphiphilic proteins with a high tendency to self-aggregate may exist in an aggregated form even in the presence of detergents or denaturants. In order to mitigate the tendency towards self-association, it is necessary to eliminate the amphiphilicity of these proteins. In order to achieve this end, proteins were modified covalently, first by dinitrophenylation followed by permethylation, which rendered the proteins tested soluble in nonpolar organic solvents, such as chloroform/methanol (4/1, v/v). The permethylated 2,4-dinitrophenyl-proteins were then chromatographed using Sepharose CL-6B in chloroform/methanol (4/1, v/v). For ten commonly used molecular weight marker proteins, a single symmetrical peak was obtained in the elution profile of the modified proteins, indicating that these products are monodisperse with respect to molecular size. The one exception was gamma globulin which has two polypeptide chains, and thus the elution profile showed two symmetrical peaks. The KD value was found to be a linear function of the logarithm of the molecular weight of the parent protein. From the calibration line generated from the molecular weight marker proteins, the technique was applied to five highly amphiphilic proteins: bacteriorrhodopsin, uricase, insecticyanin, apolipoprotein B of plasma low density lipoproteins, and band 3 of human erythrocyte membrane, for which the following apparent molecular weights were obtained: 25,000, 31,000, 23,400, 19,000, and 85,000, respectively. These values match the molecular weights obtained from the amino acid sequence in those cases in which the sequence is known. Thus, permethylation in conjunction with organic media disrupts the major driving forces for tertiary and quarternary structure formation in aqueous media, namely, the hydrophobic effect, salt bridges, and hydrogen bonding with the solvent. PMID- 6480579 TI - The molecular weights of UDP-glucuronyltransferase determined with radiation inactivation analysis. A molecular model of bilirubin UDP-glucuronyltransferase. AB - The molecular masses of the UDP-glucuronyltransferases were determined by means of radiation-inactivation analysis of sodium dodecyl sulfate-treated lyophilized rat liver microsomal preparations using a calibrated 60Co source. Bilirubin glucuronidation with formation of bilirubin monoglucuronide is catalyzed by a 41,500-Da enzyme; conversion of bilirubin mono- to diglucuronide is catalyzed by a 175,000-Da enzyme. The glucuronidation of estrone and testosterone is mediated by enzymes with molecular masses of 73,500 and 142,000 Da, respectively, and the glucuronidation of p-nitrophenol and phenolphthalein is mediated by enzymes with molecular masses of 109,000 and 159,000 Da, respectively. Our results show that UDP-glucuronyltransferase consists of a heterogenous group of enzymes with strikingly different molecular masses. Our data furthermore suggest that these enzymes may be oligomers composed of one to four subunits with similar molecular masses. Based on these findings, a molecular model of bilirubin UDP glucuronyltransferase is proposed, consisting of four subunits. For bilirubin diglucuronide formation, the complete tetrameric enzyme is required, whereas formation of monoglucuronide can be mediated by a single subunit. The monomeric monoglucuronide-forming enzyme is resistant to sodium dodecyl sulfate, treatment whereas the tetrameric diglucuronide-forming enzyme is labile, but once inactivated, the diglucuronide-forming enzyme can be reconstituted by decreasing the sodium dodecyl sulfate concentration by means of dialysis. PMID- 6480581 TI - Interaction of microtubule-associated proteins with actin filaments. Studies using the fluorescence-photobleaching recovery technique. AB - The interaction of microtubule-associated proteins with actin filaments has been investigated by measuring the diffusion coefficient of either the filament or the microtubule-associated proteins. Experiments were performed using the technique of fluorescence photobleaching recovery with actin labeled with iodoacetamidotetramethyl rhodamine or microtubule-associated proteins labeled with iodoacetamidofluorescein. Actin filaments composed of pure rhodamine-labeled actin are not immobilized under a variety of conditions (Tait, J. F., and Frieden, C. (1982c) Biochemistry 21, 6046-6053). We find that addition of microtubule-associated proteins to rhodamine-labeled actin in a ratio as low as 1:1000 can cause immobilization, presumably cross-linking actin into a network of nondiffusible filaments. Immobilization occurs after polymerization is complete, suggesting either a length redistribution of actin filaments, a redistribution of the cross-links between filaments, or the slow addition of actin filaments to other filaments via the microtubule-associated protein. Experiments using fluorescein-labeled microtubule-associated proteins show that these proteins are bound to actin filaments as they are formed and that binding depended on actin concentration, indicating that there are a number of binding sites on the actin filaments. However, while the actin filaments become completely immobilized, the microtubule-associated proteins become only partially immobilized suggesting at least two different classes of binding affinities. The large peptide obtained from trypsin-treated fluorescein-labeled microtubule-associated proteins is not able to immobilize actin filaments since it does not bind to the filaments. PMID- 6480580 TI - On the molecular basis of transition mutations. Frequency of forming 2 aminopurine-cytosine base mispairs in the G X C----A X T mutational pathway by T4 DNA polymerase in vitro. AB - An in vitro model system including wild-type T4 DNA polymerase, the mutagenic nucleotide analogue 2-aminopurine deoxyribonucleoside triphosphate, and poly[d(A,C)] X oligo(dT) poly(dC) X oligo(dG) template-primers is used to measure the frequency of 2-aminopurine X cytosine base mispairs formed in the G X C----A X T mutational pathway. Incorporation and turnover of the analogue into DNA is dependent on the presence of cytosine on the template strand and is reduced significantly in the presence of dGTP. 2-Aminopurine X cytosine mispairs are observed to occur at a 2-3 order of magnitude greater frequency than adenine X cytosine mispairs. The frequency of inserting 2-aminopurine deoxyribonucleoside monophosphate in place of dGMP opposite template cytosine sites is about 3-6% when either strong or weak base-stacking partners are present on the primer strand. However, enzymatic proofreading of the mispair strongly depends on base stacking partners. Greater than 85% of misinserted 2-aminopurine deoxynucleotides are excised whenever the mispairs are formed next to 5'-primer thymine sites. A 5 fold reduction in proofreading frequency occurs when the mispair is formed with 2 aminopurine deoxynucleoside monophosphate stacked adjacent to a 5'-primer guanine. The frequency of 2-aminopurine X cytosine base mispair formation in the G X C----A X T pathway is similar to that found previously in the A X T----G X C pathway (Watanabe, S. M., and Goodman, M.F. (1981) Proc. Natl. Acad. Sci. U.S.A. 78, 2864-2868). We propose a criterion for base selection by DNA polymerase to account for the unexpected similarity in base mispairing rates in the two transition pathways. PMID- 6480582 TI - Role of supernatant protein factor and anionic phospholipid in squalene uptake and conversion by microsomes. AB - Supernatant protein factor (SPF), a cytosolic protein (Mr = 47,000) stimulates microsomal squalene epoxidase activity 4- to 10-fold in the presence of anionic phospholipid such as phosphatidylglycerol (PG) (Saat, Y., and Bloch, K. (1976) J. Biol. Chem. 251, 5155-5160). This effect has been ascribed to substrate translocation from inactive to active pools within the membrane of the endoplasmic reticulum (Friedlander, E. J., Caras, I. W., Lin, L. F. H., and Bloch, K. (1980) J. Biol. Chem. 255, 8042-8045). Here we show that SPF and PG also stimulate squalene uptake per se by microsomes as well as stimulate squalene epoxidase. Microsomes preloaded with substrate in the presence of SPF and PG show full epoxidase activity. They do not require further addition of these factors during enzyme assay. Addition of SPF and PG to assay mixtures containing microsomes preloaded with substrate in the presence of SPF and PG did not further increase epoxidase activity. We also show that PG tightly binds to microsomes. This binding of PG is essential for the response of microsomal epoxidase to SPF. Solubilized microsomal enzymes have been reconstituted and show high epoxidase activity. In this system, SPF and PG do not stimulate the conversion of squalene into products. PMID- 6480583 TI - Properties of the specific binding site for arginine vasopressin in rat hippocampal synaptic membranes. AB - In a previous paper (Pearlmutter, A. F., Constantini, M. G., and Loeser, B. (1983) Peptides 4, 335-341), we have shown that saturable, high-affinity binding sites for [3H]arginine vasopressin (AVP) are located in rat brain membrane preparations. Binding was dependent upon the presence of Ni2+ and could be dissociated by EDTA. In the hippocampus, [3H]AVP binding could be localized to synaptic membranes. In this paper, we characterize in more depth the specificity of [3H]AVP binding to a crude hippocampal synaptic preparation and the metabolism of [3H]AVP in our synaptic preparation. By means of HPLC analysis we demonstrate that the radioactive material specifically bound to hippocampal synaptic membranes is intact [3H]AVP. The ability of analogues of AVP to displace the high affinity, specific binding of [3H]AVP parallels closely the potency of these analogues to inhibit the extinction of avoidance behavior. In the presence of membrane and Ni2+, [3H]AVP has a half-life of 7 h. In the absence of Ni2+, the half-life of [3H]AVP is 1.2 h. Fractionation by high-pressure liquid chromatography of the supernatant from the incubation media not containing Ni2+ yields three peaks of radioactivity. Analysis of the biological activity of the [3H]AVP peak and the two non-AVP peaks which represent breakdown products show the following: (a) the [3H]AVP peak (52%) and peak III (8%) bind to fresh membranes and (b) peak II (40%) has no binding activity. Although Ni2+, Co2+, benzamidine, and phenanthroline can prevent [3H]AVP degradation, only Ni2+ and, to a much lesser extent, Co2+, can potentiate specific [3H]AVP binding. The results show that AVP-specific binding has properties which parallel its biological activity in behavioral assays; that, ultimately, proteolysis by membrane-bound peptidases inactivates AVP; and that Ni2+ acts both by preventing AVP breakdown and by potentiating specific binding. PMID- 6480584 TI - 19-kDa tumor antigen coded by early region E1b of adenovirus 2 is required for efficient synthesis and for protection of viral DNA. AB - The adenovirus E1b region (mp 4.5-11.2) codes for two major tumor antigens of 53 and 19 kDa. The lp+ locus maps within the 19-kDa tumor antigen-coding region and has been shown to play an essential role in cell transformation. We have investigated the role of the 19-kDa tumor antigen during productive virus growth using a specific Ad2 mutant (dl250) lacking most of the 19-kDa tumor antigen coding region. Mutant dl250 grows more slowly and yields about 100-fold less progeny virus than Ad2 wt in human KB cells. In cells infected with mutant dl250, viral DNA is present at only about one-half the level of that of Ad2 wt. The defect in DNA accumulation appears to be both at the level of DNA synthesis and stability of newly synthesized DNA. In mutant-infected cells, newly replicated viral as well as cellular DNA are extensively degraded during late stages of viral infection. We have mapped a class of Ad12 (highly oncogenic group A) mutants (cyt) that are nononcogenic in newborn hamsters and induce DNA degradation to the 19-kDa tumor antigen-coding region by intertypic complementation analysis. These results strongly suggest that the 19-kDa tumor antigen plays an essential role in efficient viral DNA synthesis and protection of newly replicated viral DNA against cellular nucleases in addition to its role in cell transformation and tumorigenesis. PMID- 6480585 TI - The mechanism of soluble peptidoglycan hydrolysis by an autolytic muramidase. A processive exodisaccharidase. AB - The action of purified N-acetylmuramoylhydrolase (muramidase, EC 3.2.1.17) of Streptococcus faecium ATCC 9790 on linear, uncross-linked, soluble, peptidoglycan chains produced by the same organism in the presence of benzylpenicillin was characterized as a processive exodisaccharidase. Specific labels, one [( 14C]Gal) added to the nonreducing ends of chains, and the other (3H from [3H]NaBH4) incorporated into the reducing ends of the chains, were used to establish that an enzyme molecule binds at the nonreducing terminus and sequentially hydrolyzes the glycosidic bonds, releasing disaccharide-peptide units. An enzyme molecule remains bond to a chain, and is not released at a detectable rate, until hydrolysis of that chain is complete. Reaction rates increased with the length of the polymer chain to give a maximum of 91 bonds cleaved/min/enzyme molecule for hydrolysis of a continuous polymeric substrate. The relationship between hydrolytic rate and glycan chain length is consistent with hydrolysis of bonds within the chain followed by slow release of enzyme from the distal, reducing terminus. This mechanism was experimentally confirmed by analysis of product formation during hydrolysis with stoichiometric mixtures of enzyme and soluble peptidoglycan chains. Kinetic analyses showed an apparent Km of 0.17 microM for the enzyme, independent of substrate polymer length. The dissociation constant for the initial enzyme-substrate complex was calculated to be 1.5 nM. Kinetic analyses are consistent with one catalytic site per enzyme molecule. The Kcat/Km value of 9 X 10(6) M-1 S-1 is near the limit imposed by diffusion for the initial hydrolytic events when long chains are hydrolyzed. The kinetic and physical properties of this muramidase are highly consistent with its location outside of the cellular permeability barrier and its ability to remain with and hydrolyze appropriate bonds in the cell wall in such an environment. PMID- 6480586 TI - Immobilization-dependent fluorescence of colchicine. AB - Colchicine fluoresces when bound to tubulin but not in water, dioxane, or benzene. The basis of the fluorescence has now been investigated. Colchicine fluoresces in higher alcohols and shows a blue shift as a function of chain length. Glycerol produces a higher fluorescence efficiency and a further blue shift. Plots of 1/fluorescence versus T/eta yield straight lines for both alcohols and glycerol/water mixtures. Fluorescence in glycerol/dimethyl sulfoxide mixtures, in which the dielectric constant remains unchanged, varies as a function of solvent viscosity. Even highly nonpolar solvents such as dioxane require a threshold viscosity for fluorescence to occur. When solvent polarity was decreased at constant viscosity, there was also an enhancement of colchicine fluorescence, but this effect appeared to be smaller than that obtained with increasing viscosity. Immobilization by covalent attachment of desacetylcolchicine to thyroglobulin, serum albumin, or lysozyme also promotes fluorescence from the drug. By contrast, the highly rigid analogue of colchicine, imerubine, fluoresces in water and is unaffected by viscosity changes. We concluded that a major contribution to colchicine fluorescence stems from immobilization of colchicine in the site and that this response to immobilization depends, in part, on the partially flexible nature of the drug. Since certain other flexible molecules such as auramine O, reduced flavines, and diarylalkanes also require increased viscosity or binding to macromolecules to fluoresce at room temperature, we propose that immobilization-enhanced fluorescence may be more common than heretofore believed. PMID- 6480587 TI - Actin polymerization. The effect of brevin on filament size and rate of polymerization. AB - Fluorescent probes covalently bound to actin or to the actin binding protein, brevin, have been utilized to provide information about actin filaments formed in the presence of brevin as well as about the effect of brevin on the rate of polymerization. At actin to brevin ratios of 10:1 to 100:1, the observed diffusion coefficients of filaments, as measured by fluorescence photobleaching recovery using rhodamine-labeled actin or fluorescein-labeled brevin, are similar to those calculated from theoretical considerations for rigid rods. At lower brevin concentrations, the observed diffusion coefficients for actin filaments are lower than predicted, indicating that the filament structure is closer to that observed in the absence of brevin where filaments are immobilized due to interactions between them. The fluorescein-labeled brevin was found to be about as effective in influencing actin polymerization as unlabeled brevin. Using pyrene-labeled actin, we show that brevin binds 2 mol of monomeric actin. We conclude that at sufficiently high brevin concentration there is one brevin molecule per actin filament. From measurements of the initial rate of polymerization at 5.9 microM actin in the presence of brevin, we calculate both the apparent elongation rate constant and dissociation rate constant from one end (presumably the slow-growing end) of the actin filament. The former is highly dependent on Mg2+ concentration while the latter is not. PMID- 6480588 TI - Characterization of skeletal muscle calsequestrin by 1H NMR spectroscopy. AB - Calsequestrin (Mr = 44,000) is a calcium-binding (KD congruent to 1 mM, congruent to 50 sites/molecule) protein found in the lumen of the sarcoplasmic reticulum of skeletal muscle. The 1H NMR spectrum of calsequestrin in the calcium-free form is presented and is characteristic of a protein largely in the random coil configuration. A number of peaks in the aromatic region have been assigned based on their chemical shifts and sensitivity to pH. The interaction of this protein with Ca2+ and K+ was studied by 1H NMR. Potassium ion binding to calsequestrin caused broadening and concomitant loss of intensity in both the aromatic and aliphatic regions of the spectrum. Calcium ion binding caused similar effects but at much lower metal ion concentrations. It was found that the binding of Ca2+ to calsequestrin was cooperative (Hill coefficient n = 2.9 +/- 0.2) with a dissociation constant of 0.25 +/- 0.06 mM in the absence of K+. In contrast, K+ showed binding to a single class of independent sites (KD = 0.20 +/- 0.04 M). Calcium binding was also studied by circular dichroism at protein concentrations similar to the NMR experiments. The binding profile and cooperativity (n = 2.0 +/ 0.1, KD = 0.19 +/- 0.04 mM) were in agreement with the 1H NMR results. Circular dichroism studies performed at low protein concentrations to reduce the possible effect of calcium binding on the concentration of free calcium gave similar values of n = 2.42 +/- 0.14 and KD = 0.21 +/- 0.005 mM. This cooperativity was also observed in the presence of 100 mM KCl although the affinity for calcium has been significantly reduced (n = 1.65 +/- 0.09, KD = 0.87 +/- 0.036 mM). In view of the large number of calcium binding sites in calsequestrin, these small Hill coefficients show that calcium binding to calsequestrin is only mildly cooperative. PMID- 6480589 TI - Reactions of 1-N6-ethenoadenosine nucleotides with myosin subfragment 1 and acto subfragment 1 of skeletal and smooth muscle. AB - The fluorescent nucleotides epsilon ADP and epsilon ATP were used to study the binding and hydrolysis mechanisms of subfragment 1 (S-1) and acto-subfragment 1 from striated and smooth muscle. The quenching of the enhanced fluorescence emission of bound nucleotide by acrylamide analyzed either by the Stern-Volmer method or by fluorescence lifetime measurements showed the presence of two bound nucleotide states for 1-N6-ethenoadenosine triphosphate (epsilon ATP), 1-N6 ethenoadenosine diphosphate (epsilon ADP), and epsilon ADP-vanadate complexes with S-1. The equilibrium constant relating the two bound nucleotide states was close to unity. Transient kinetic studies showed two first-order transitions with rate constants of approximately 500 and 100 s-1 for both epsilon ATP and epsilon ADP and striated muscle S-1 and 300 and 30 s-1, respectively, for smooth muscle S 1. The hydrolysis of [gamma-32P] epsilon ATP yielded a transient phase of small amplitude (less than 0.2 mol/site) with a rate constant of 5-10 s-1. Consequently, the hydrolysis of the substrate is a step in the mechanism which is distinct from the two conformational changes induced by the binding of epsilon ATP. An essentially symmetric reaction mechanism is proposed in which two structural changes accompany substrate binding and the reversal of these steps occurs in product release. epsilon ATP dissociates acto-S-1 as effectively as ATP. For smooth muscle acto-S-1, dissociation proceeds in two steps, each accompanied by enhancement of fluorescence emission. A symmetric reaction scheme is proposed for the acto-S-1 epsilon ATPase cycle. The very similar kinetic properties of the reactions of epsilon ATP and ATP with S-1 and acto-S-1 suggest that two ATP intermediate states also occur in the ATPase reaction mechanism. PMID- 6480590 TI - The role of dissimilar subunits of NAD-specific isocitrate dehydrogenase from pig heart. Evaluation using affinity labeling. AB - NAD-specific isocitrate dehydrogenase from pig heart is composed of three dissimilar subunits present in the native enzyme as 2 alpha:1 beta: 1 gamma, with a tetramer being the smallest form of complete enzyme. The role of these subunits has been explored using affinity labeling. Specifically labeled subunits are separated and then recombined with unmodified subunits to form dimers. Recombination of beta or gamma subunits modified by the isocitrate analogues, 3 bromo-2-ketoglutarate and 3,4-didehydro-2-ketoglutarate, with unmodified alpha subunit led to the same activity in the dimer as when unmodified beta or gamma was combined with alpha. Contrastingly, modification of alpha with these isocitrate analogues led to loss in activity either alone or when recombined with beta or gamma. Hence, the isocitrate site on alpha is required for catalytic activity but the isocitrate sites on beta or gamma are not necessary for the activity of the functional dimer. Reaction of isolated subunits with 3-bromo-2 ketoglutarate shows that alpha and the alpha beta dimer are modified at about the same rate as holoenzyme, suggestive of similarity of the isocitrate site in native enzyme and in isolated active entities containing alpha subunit; in contrast, beta and gamma subunits react more slowly. Modification by the 2',3' dialdehyde derivative of the allosteric effector, ADP, led to loss of activity in reconstituted dimers, independent of which subunit was modified. Reaction of isolated subunits with the dialdehyde derivative of ADP is slow compared to the initial reaction with native enzyme, indicating differences in the effects of ADP on intact enzyme and subunits. The ADP sites on all subunits may thus be important in intersubunit interactions, which in turn modulate catalytic activity. PMID- 6480591 TI - Hepatic microsomal glucuronidation of bilirubin in unilamellar liposomal membranes. Implications for intracellular transport of lipophilic substrates. AB - It has been assumed that following hepatic uptake, bilirubin is bound exclusively to cytosolic proteins prior to conjugation by microsomal UDP-glucuronyl transferase. Since bilirubin partitions into lipid rather than the aqueous phase at neutral pH, we postulated that bilirubin reaches the sites of glucuronidation by rapid diffusion within membranes. To examine this hypothesis, [14C]bilirubin was incorporated into the membrane bilayer of small unilamellar liposomes of egg phosphatidylcholine. Radiochemical assay of this membrane-bound substrate in a physiologic concentration, using native rat liver microsomes, demonstrated immediate formation of bilirubin glucuronides at a more rapid initial velocity than for bilirubin bound to the high-affinity sites of purified cytosolic binding proteins, i.e. glutathione S-transferases (p less than 0.025) or native liver cytosol (p less than 0.05). Kinetic analysis suggested that the mechanisms of substrate transfer from liposomal membranes and from purified glutathione S transferases to microsomal UDP-glucuronyltransferase were similar. The exchange of 3H- and 14C-labeled bilirubin substrate between binding proteins and liposomal membranes was then investigated using Sepharose 4B chromatography. As the concentration of bilirubin was increased relative to that of protein, net transfer of substrate from the protein to the membrane pool was observed. These findings indicate that bilirubin is efficiently transported by membrane-membrane transfer to hepatic microsomes, where it undergoes rapid conjugation. Bilirubin entering hepatocytes may partition between membrane and cytosolic protein pools, but as intracellular bilirubin concentration increases, the membrane pool is likely to provide a greater proportion of the substrate for glucuronidation. PMID- 6480592 TI - Electron transfer by ferredoxin:NADP+ reductase. Rapid-reaction evidence for participation of a ternary complex. AB - Rapid reaction studies presented herein show that ferredoxin:NADP+ oxidoreductase (FNR, EC 1.18.1.2) catalyzes electron transfer from spinach ferredoxin (Fd) to NADP+ via a ternary complex, Fd X FNR X NADP+. In the absence of NADP+, reduction of ferredoxin:NADP+ reductase by Fd was much slower than the catalytic rate: 37 80 s-1 versus at least 445 e-s-1; dissociation of oxidized spinach ferredoxin (Fdox) from one-electron reduced ferredoxin:NADP+ reductase (FNRsq) limited the reduction of FNR. This confirms the steady-state kinetic analysis of Masaki et al. (Masaki, R., Yoshikaya, S., and Matsubara, H. (1982) Biochim. Biophys. Acta 700, 101-109). Occupation of the NADP+ binding site of FNR by NADP+ or by 2',5' ADP (a nonreducible NADP+ analogue) greatly increased the rate of electron transfer from Fd to FNR, releiving inhibition by Fdox. NADP+ (and 2',5'-ADP) probably facilitate the dissociation of Fdox; equilibrium studies have shown that nucleotide binding decreases the association of Fd with FNR (Batie, C. J. (1983) Ph.D. dissertation, Duke University; Batie, C. J., and Kamin, H. (1982) in Flavins and Flavoproteins VII (Massey, V., and Williams, C. H., Jr., eds) pp. 679 683, Elsevier, New York; Batie, C.J., and Kamin, H. (1982) Fed. Proc. 41, 888; and Batie, C.J., and Kamin, H. (1984) J. Biol. Chem. 259, 8832-8839). Premixing Fd with FNR was found to inhibit the reaction of the flavoprotein with NADP+ and with NADPH; thus, substrate binding may be ordered, NADP+ first, then Fd. FNRred and NADP+ very rapidly formed an FNRred X NADP+ complex with flavin to nicotinamide charge transfer bands. The Fdred X NADP+ complex then relaxed to an equilibrium species; the spectrum indicated a predominance of FNRox X NADPH charge-transfer complex. However, charge-transfer species were not observed during turnover; thus, their participation in catalysis of electron transfer from Fd to NADP+ remains uncertain. The catalytic rate of Fd to NADP+ electron transfer, as well as the rates of electron transfer from Fd to FNR, and from FNR to NADP+ were decreased when the reactants were in D2O; diaphorase activity was unaffected by solvent. On the basis of the data presented, a scheme for the catalytic mechanism of catalysis by FNR is presented. PMID- 6480593 TI - Rat liver aldehyde dehydrogenase. I. Isolation and characterization of four high Km normal liver isozymes. AB - From normal rat liver mitochondrial and microsomal fractions, 4 distinct aldehyde dehydrogenase isozymes with millimolar substrate Km values have been purified and characterized. Two isozymes were isolated from mitochondria and 2 from microsomes. A mitochondrial aldehyde dehydrogenase with a substrate Km in the micromolar range was also identified. Subunit molecular weights for all millimolar Km isozymes is 54,000. The mitochondrial and microsomal millimolar Km isozymes are clearly distinguishable from each other by substrate and coenzyme specificity, pH velocity profiles, and thermal stability. By these same properties, the 2 isozymes from each organelle are virtually identical. The 2 mitochondrial isozymes can be distinguished by apparent molecular weight (I, 170,000; II, approximately 250,000), Km for NADP+, effect of inhibitors, and pI. The 2 microsomal isozymes are of the same apparent molecular weight (approximately 250,000), but are distinguishable by their Km values for benzaldehyde and NADP+, response to inhibitors, and pI. PMID- 6480594 TI - Rat liver aldehyde dehydrogenase. II. Isolation and characterization of four inducible isozymes. AB - The purification and properties of 4 inducible cytosolic rat liver aldehyde dehydrogenase isozymes are described. Based on their behavior during purification and their properties, the activities can be grouped into 2 classes. The isozyme inducible in normal liver by 2,3,7,8-tetrachlorodibenzo-p-dioxin and the tumor specific isozyme found in hepatocellular carcinomas have apparent molecular weights of 110,000, prefer NADP+ as coenzyme, and preferentially oxidize benzaldehyde-like aromatic aldehydes, but not phenylacetaldehyde. They also have identical pH profiles and responses to effectors. These isozymes differ slightly in isoelectric point and thermal stability. The normal liver phenobarbital inducible isozyme and the isozyme appearing during the promotion phase of hepatocarcinogenesis appear to be identical. Both have apparent molecular weights of 165,000, are NAD-specific and prefer aliphatic aldehydes. They can oxidize phenylacetaldehyde, but not benzaldehyde-like aromatic aldehydes. They also have identical pH and thermal stability profiles and responses to effectors. While the 4 inducible isozymes share identical subunit molecular weights (54,000) with the normal liver millimolar Km aldehyde dehydrogenases, they are distinctly different enzymatic species. The interrelationships of the various normal liver and inducible rat liver aldehyde dehydrogenases are discussed. PMID- 6480595 TI - In vitro acylation of rat gastric mucus glycoprotein with [3H]palmitic acid. AB - The incorporation of fatty acids into gastric mucus glycoproteins was studied by incubating rat gastric mucosal cell suspensions with [9,10-3H]palmitic acid and [3H]proline. The mucus glycoprotein polymer, secreted into the growth medium (extracellular) and that contained within the cells (intracellular), was purified from the other components of the secretion, thoroughly delipidated, and then analyzed for the radiolabeled tracers. Both pools of mucus glycoprotein, incubated in the presence of [3H]palmitic acid, contained radioactive label which could not be removed by gel filtration, CsCl density gradient centrifugation, sodium dodecyl sulfate-gel electrophoresis, or lipid extraction. Treatment of the purified mucus glycoprotein with 1 M hydroxylamine or 0.3 M methanolic KOH released the radioactivity, thus indicating that [3H]palmitic acid was covalently bound by ester linkage to the glycoprotein. The released radioactivity was associated mainly (87%) with palmitic acid. The incorporation ratio of [3H]proline to [3H]palmitic acid was 0.12:1.0 in the extracellular glycoprotein and 1.38:1.0 in the intracellular glycoprotein, which suggested that acylation of mucus glycoprotein occurs in the intracellular compartment after completion of its polypeptide core. The fact that incorporation of [3H]palmitic acid was greater in the glycoprotein subunits than in the glycoprotein polymer indicates that acylation takes place near the end of subunit processing but before their assembly into the high molecular weight mucus glycoprotein polymer. PMID- 6480596 TI - High-mobility group chromosomal proteins of wheat. AB - Four proteins have been extracted from purified chromatin of wheat embryos with 0.35 M NaCl. These proteins are soluble in 2% (w/v) trichloroacetic acid and thus meet the original operational requirements to be classified as "high-mobility group" (HMG) chromosomal proteins. The proteins have been characterized by one- and two-dimensional electrophoresis, amino acid analysis, and peptide mapping. Three of the proteins (HMGb, c, and d) share the mammalian HMG characteristic of being rich in both acidic and basic amino acid residues. Unlike their putative mammalian counterparts, these plant HMG proteins contain less than 7 mol % proline. The fourth wheat protein (HMGa) is rich in both proline and in basic amino acid residues. This wheat protein, however, contains only about half the proportion of acidic residues found in mammalian HMG proteins--a characteristic also found in the trout testis HMG protein, H6. Comparative peptide maps show that none of the wheat HMG proteins are degradation products of other HMG proteins or the H1 histones. The peptide maps have not, however, been useful in establishing homologies with mammalian HMG proteins. Wheat HMG proteins are released from DNase I-treated nuclei and co-isolate with micrococcal nuclease sensitive chromatin fractions. Similar observations concerning the HMG proteins of vertebrate animals have been considered consistent with a role for these proteins as structural components of actively transcribed chromatin. PMID- 6480597 TI - Differences in the sensitivity of carnitine palmitoyltransferase to inhibition by malonyl-CoA are due to differences in Ki values. AB - The hepatic carnitine palmitoyltransferase that is present on the outer surface of the mitochondrial inner membrane demonstrates hyperbolic substrate saturation curves with oleoyl-CoA in both fasted and fed rats. However, the addition of malonyl-CoA resulted in sigmoid substrate saturation curves, suggesting that malonyl-CoA induced the cooperative behavior. There was more of the outer carnitine palmitoyltransferase in liver mitochondria derived from fasted rats and that enzyme had a much greater Ki for malonyl-CoA than the enzyme from fed rats, but the Km values were apparently not different. The Dixon plot with mitochondria from fed rats, but not fasted rats, was curved upward, indicating cooperative inhibition by malonyl-CoA. Carnitine palmitoyltransferase of heart mitochondria had a Ki for malonyl-CoA that was much less than that of the liver enzyme and it did not change on fasting. Furthermore, no evidence for cooperative inhibition was found in the heart. The results of these studies indicate that carnitine palmitoyltransferase is not subject to substrate cooperativity and that malonyl CoA is not a simple competitive inhibitor of this enzyme but inhibits by a mechanism involving cooperative inhibition. The fasting-feeding cycle induces changes in the liver enzyme that alter its affinity for malonyl-CoA without changing its affinity for its acyl-CoA substrate. Carnitine palmitoyltransferase from heart appears to be different from that of liver and is apparently not subject to the same control mechanisms. PMID- 6480598 TI - Hemopexin-mediated heme uptake by liver. Characterization of the interaction of heme-hemopexin with isolated rabbit liver plasma membranes. AB - Plasma membranes isolated from rabbit liver retain the ability to interact specifically with heme-hemopexin. In this system, apohemopexin does not compete effectively with heme-hemopexin for binding. The membranes bind heme-hemopexin complexes with high affinity (KD = 6.8 X 10(-7) M) and with an apparent capacity of 2.3 pmol/mg of membrane protein. These membranes also retain the ability to remove heme from heme-hemopexin. The release of heme reaches a plateau after 15 30 min at 30 degrees C and does not involve metabolic energy, proteolysis of hemopexin or pH gradients. The apohemopexin formed is rapidly released from the membranes. The accumulation of heme is saturable and is affected by pH and temperature with maximum uptake occurring between pH 5.5 and 6.5 and at 30 degrees C. Interestingly, much more heme (approximately 25 pmol/mg of membrane protein) is accumulated than hemopexin at saturation, implying that the receptor can turn over several times and that a heme-binding component exists in the rabbit liver plasma membrane. PMID- 6480600 TI - Preliminary X-ray investigation of variant-2 scorpion toxin from Centruroides sculpturatus Ewing. Evidence of a reversible transition between crystal forms. AB - Crystals of Variant-2 scorpion toxin have been grown using seeding techniques from 30% 2-methyl-2,4-pentanediol at pH 9.2 and T = 4 degrees C. These crystals display a temperature-dependent, reversible phase transition near room temperature. The apparent space group for the high-temperature form is P3121 or P3221 with a = 48.8(1) A and c = 43.7(1) A, and with one molecule per asymmetric unit. At lower temperature, the crystals undergo a phase transition in which the space group remains the same but with c' (approximately equal to 2c) = 86.1(1) A. In addition, the low-temperature form displays several weak, diffuse reflections that correspond to a tripling of the a axis. The high-temperature form diffracts beyond 1.8-A resolution and appears to be suitable for a complete structural study. PMID- 6480599 TI - Different effects of tubulin ligands on the intrachain cross-linking of beta 1 tubulin. AB - When bovine brain tubulin purified in the absence of GTP and MgCl2 is reacted with N,N'-ethylene-bis(iodoacetamide) (EBI), a bifunctional analogue of iodoacetamide, three new electrophoretically distinct species of tubulin are generated, migrating ahead of beta 1-tubulin on gels containing Na dodecyl sulfate. All three bands appear to be derived from the beta 1 subunit of tubulin and not from the alpha or beta 2 subunit. Accordingly, the bands have been designated beta 1 s, beta 1, and beta 1s in order of increasing electrophoretic mobility. EBI appears to introduce two intrachain cross-links into beta 1 tubulin; the beta 1s band contains one of these cross-links, designated beta s, the beta 1 band contains the other cross-link, designated beta s, and the beta 1 s band contains both cross-links. Both cross-links appear to involve sulfhydryl groups. Colchicine, podophyllotoxin, and nocodazole completely inhibit beta formation while GTP, vinblastine, and maytansine enhance it. It contrast, formation of beta s is completely blocked by guanine nucleotides and by maytansine, while vinblastine inhibits this by 70%. Colchicine, podophyllotoxin, and nocodazole enhance beta s formation. These results show that tubulin has the unusual property of having two discrete sites which can be targeted by an alkylating agent with each site having its alkylation inhibited by a different set of ligands. The results are consistent with several models, including one where vinblastine and maytansine have overlapping binding sites on the beta subunit of tubulin relatively close to the GTP binding site. PMID- 6480601 TI - Identification of storage protein receptor and its precursor in the fat body membrane of Sarcophaga peregrina. AB - A previous paper (Ueno, K., Ohsawa, F., and Natori, S. (1983) J. Biol. Chem. 258, 12210-12214) showed that a storage protein receptor is present in membranes of the pupal fat body of Sarcophaga peregrina, whereas membranes of the larval fat body contain a cryptic receptor, and that 20-hydroxyecdysone is essential for activation of the cryptic receptor to bind and incorporate the storage protein. The present paper reports that the storage protein receptor is a membrane protein of the pupal fat body with a molecular mass of 120 kilodaltons, and that the cryptic receptor present in membranes of the larval fat body is a precursor of the active receptor with a molecular mass of 125 kilodaltons. It is suggested that when 20-hydroxyecdysone is secreted, it activates the process of conversion of the 125-kDa protein to the 120-kDa protein. Concomitant protein synthesis was not apparently necessary for activation of the storage protein receptor, suggesting that the target of 20-hydroxyecdysone in this case is the fat body membrane. PMID- 6480602 TI - The purification of rat liver arylhydroxamic acid N,O-acyltransferase. AB - Rat liver arylhydroxamic acid N,O-acyltransferase, a noninducible soluble enzyme that can transform N-hydroxy-N-2-aminofluorenes and N-hydroxy-N-acyl-4 aminobiphenyls into reactive derivatives capable of binding protein and oligonucleotides, has been purified greater than 3000-fold by sequential use of the following methods: homogenization and fractional centrifugation, ammonium sulfate precipitation, chromatography on DEAE-cellulose followed by Sephacryl S 200 filtration, preparative polyacrylamide electrophoresis, and preparative isoelectric focusing. These procedures allowed a 14% recovery of enzyme activity. The molecular weight of the enzyme, as estimated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, is 38,500. The isoelectric point, as determined by preparative and analytical flat-bed isoelectrofocusing, is 4.5; the pH optimum is 7.0. N,O-Acyltransferase showed a Km for N-hydroxy-N-acetyl-2 aminofluorene of 6.3 X 10(-6) M with a Vmax of 10.4 nmol of aminofluorene bound to tRNA/min/mg of protein. Activity was not inhibited by the esterase inhibitor paraoxon. Rat liver N,O-acyltransferase is an enzyme that is very unstable, due in part to labile sulfhydryl groups which easily oxidize in air. The enzyme cannot, however, be fully stabilized with the addition of dithiothreitol. PMID- 6480603 TI - Hydrophobic binding properties of bovine gallbladder mucin. AB - Hydrophobic binding properties of purified bovine gallbladder mucin were studied by fluorescence spectroscopy using 1-anilino-8-naphthalene sulfonate (ANS) and N phenyl-1-naphthylamine. The purified glycoprotein contained 75.5%, dry weight, as carbohydrate, 16.3% as protein, and 3.7% as sulfate; Mr = 2.2 X 10(6) was estimated by chromatography on Sephacryl S-500. Mucin contained a large number of low-affinity binding sites for these hydrophobic ligands. The dissociation constant, KD of mucin-ANS binding was 2.7 X 10(-5); each mucin molecule had approximately 42 binding sites for ANS. These binding sites were deduced to be on the unglycosylated portion of the protein core, as Pronase digestion completely eliminated binding. Reduction of mucin with 2-mercaptoethanol increased the fluorescence yield by formation of subunits with increased binding sites for the ligand. Increasing NaCl concentration (0.125 to 2.0 M) and decreasing pH (9 to 3) progressively increased fluorescence with the charged ligand ANS, suggesting that the binding site may have acidic groups which are shielded at high ionic strength or low pH. The fluorescent yield with N-phenyl-1-naphthylamine, an uncharged ligand, was an order of magnitude higher than with ANS. Bilirubin and bromosulfophthalein inhibited mucin-induced ANS fluorescence, but bile acids did not. Gallbladder mucin contains hydrophobic binding domains in the nonglycosylated peptide core that are involved in polymer formation and binding of biliary lipids and pigment. PMID- 6480604 TI - Differential compartmentation of magnesium and calcium in murine S49 lymphoma cells. AB - 28Mg2+ influx studies in S49 murine lymphoma cells indicate that only 2-3% of total cell Mg2+ content can be exchanged at isotopic equilibrium, implying compartmentation of the newly transported Mg2+. The nature of this compartmentation was examined using selective permeabilization of the plasma membrane with the detergent, digitonin. Control experiments demonstrated that the digitonin permeabilization procedure did not release mitochondrial and lysosomal components, alter mitochondrial respiration, or significantly change cell morphology. Thus, under appropriate conditions, the digitonin permeabilization technique allows determination of the amount of a particular cell constituent within the solute space of the cytoplasm. In nonproliferating cells at an extracellular Mg2+ concentration of 0.1 mM, newly transported Mg2+ equilibrates within 2 h with a small cytoplasmic Mg2+ pool comprising about 3% of the total cytoplasmic Mg2+ (about 2% of total cell Mg2+). The pool of Mg2+ does not equilibrate with bulk cytoplasmic or cellular Mg2+ for at least 16 h. The Mg2+ pool size is dependent on extra-cellular Mg2+ concentration, is saturable with increasing extracellular Mg2+, and reaches a maximal size of 6-7% of total cell Mg2+ at 2 mM extracellular Mg2+. Unlike Mg2+, newly transported Ca2+ is quickly sequestered in noncytoplasmic compartments. In proliferating cells, however, newly transported Mg2+ exchanges extensively with cytoplasmic Mg2+ over the course of 4 h, suggesting that compartmentation of Mg2+ may be dependent on proliferative status. PMID- 6480605 TI - Mechanism of formation of disulfide-bonded multimers of plasma fibronectin in cell layers of cultured human fibroblasts. AB - The free sulfhydryl groups of purified plasma fibronectin were blocked by alkylation with iodoacetamide in 3 M guanidine hydrochloride at pH 7.0 (to form fCam-fibronectin). 125I-fCam-fibronectin bound to cell layers of cultured human fibroblasts with kinetics similar to binding of 125I-labeled underivatized fibronectin. Once bound to the cell surface, 125I-fCam-fibronectin, like 125I fibronectin, became incorporated into a detergent-insoluble extracellular matrix. Matrix-bound 125I-fCam-fibronectin, like matrix-bound 125I-fibronectin, was present as disulfide-bonded multimers as well as disulfide-bonded dimers. These results indicate that the mechanism of formation of disulfide-bonded fibronectin multimers does not involve oxidation of free sulfhydryls. Catheptic D digests of matrix-bound fibronectin were analyzed by gel electrophoresis without and with reduction. In non-reduced digests, the disulfide-rich 70-kDa amino-terminal fragment was found in a large (greater than 300 kDa) complex. Thus, fibronectin multimer formation probably occurs by disulfide exchange in the amino-terminal portion of the molecule. PMID- 6480606 TI - Antibodies to synthetic peptides of human interferon-beta. Use in biosynthetic studies. AB - Two peptides from the amino terminus of human interferon-beta were synthesized corresponding to amino acids 1-21 and 18-45. The peptides were conjugated to bovine serum albumin, and rabbits were immunized with either the (1-21)- or the (18-45)-peptide conjugate. Antibodies to the synthetic peptides were detected in the sera using a radioimmunoassay with 125I-labeled peptide. Two of the antisera, one against peptide 1-21 and one against peptide 18-45, immunoprecipitated [35S]interferon-beta. The former was used to study the biosynthesis of interferon beta in human diploid fibroblasts. In cells induced with double-stranded RNA (poly(I:C] to synthesize interferon-beta, two intracellular proteins with estimated molecular weights of 23,000 and 18,000 were precipitated with the antiserum. Three exocellular proteins from the same induced cells were precipitated with molecular weights of 23,000, 18,000, and 10,000. Reduced amounts of the intra- and exocellular Mr = 23,000 component and enhanced amounts of the Mr = 18,000 component were observed when induced cells were treated with the glycosylation inhibitor tunicamycin. Neither the antibody to peptide 1-21, the antibody to peptide 18-45, nor a combination of both antibodies neutralized the interferon-beta antiviral activity. We conclude that the amino terminus of interferon-beta may not be involved in the binding of interferon-beta to its receptor. PMID- 6480607 TI - Evidence for direct insertion of fragments A and B of diphtheria toxin into model membranes. AB - The entry of diphtheria toxin into model membranes was studied using a membrane restricted photoprobe to monitor insertion. The results provided direct evidence that the A and B domains of diphtheria toxin can both insert into such membranes. Optimal binding was achieved with negatively charged liposomes at pH 3.6. Under these conditions, the A and B domains of nicked as well as unnicked toxin inserted. At 0 degrees C, only fragment B inserted although toxin was still optimally bound. At neutral pH, there was little binding of toxin, and fragment B inserted preferentially. Brief exposure of the toxin to pH 3.6 followed by adjustment of the pH to 7 and subsequent incubation of the toxin with vesicles at neutral pH greatly facilitated toxin binding as well as insertion of both A and B domains, indicating also that a pH gradient was not required for these processes. Data obtained from the tryptic fragmentation patterns and circular dichroism spectra indicated that exposure to acidic pH had induced a conformational change in the toxin which may have exposed hydrophobic regions. A similar conformational change may occur in vivo after acidification of cytoplasmic vesicles into which toxin is delivered by receptor-mediated endocytosis. This could facilitate insertion of toxin into the vesicle membranes and subsequent translocation of fragment A to the cytosol, where it causes inhibition of protein synthesis. PMID- 6480609 TI - A proposed index system for reporting rabies rapid fluorescent focus inhibition test titres. AB - In a trial to test the immunogenicity and the safety of a rabies human diploid vaccine it was found that the geometric mean titre (GMT) of individuals immunized with other rabies vaccines within two years of the trial was statistically significantly smaller than the GMT of individuals immunized with other rabies vaccines more than two years prior to the trial (Scheffe test, 5% level of probability). Since this result was unexpected, an unplanned analysis of the data was undertaken. Rapid fluorescent focus inhibition titres are expressed as international units per milliliter of serum (IU/ml). The IU/ml titres, based upon logarithmic calculations, are a coarse arithmetic measurement. A proposed index system for these titres smooths out this coarseness and permits meaningful statistical comparisons. PMID- 6480608 TI - Detection and purification of cytochromes P-450 in animal tissues with monoclonal antibodies. AB - Monoclonal antibody (MAb)-based radioimmunoassay (RIA) and immunopurification procedures were used to probe the immunochemical relatedness of cytochromes P-450 in tissues from different species. RIAs based on MAb 1-7-1 and MAb 1-31-2, both to the major 3-methylcholanthrene (MC)-induced rat liver microsomal cytochrome P 450, detected antigenically related forms of cytochrome P-450 in liver microsomes from MC-induced rats, C57BL/6 and DBA/2 mice, hamsters, and guinea pigs, and in lung and kidney microsomes of MC-induced rats. Individual cytochromes P-450 were also isolated from these microsomes by MAb-directed immunopurification. When bound to Sepharose, MAb 1-7-1 adsorbed two species of Mr 56,000 and 57,000 from liver microsomes from rats and C57BL/6 mice, while MAb 1-31-2 adsorbed only the Mr 57,000 polypeptide. These results reveal that livers from both rats and C57BL/6 mice contain a cytochrome P-450 (Mr 56,000) with the epitope for 1-7-1 and a cytochrome P-450 (Mr 57,000) with epitopes for both 1-31-2 and 1-7-1. Additional immunochemical relatedness between the cytochromes P-450 in different tissues was demonstrated by MAb-directed immunopurification of cytochromes P-450 from DBA/2 mouse liver (Mr 56,000), guinea pig liver (Mr 53,000), hamster liver (Mr 57,000), and rat lung (Mr 57,000). These results demonstrate the efficacy of MAb-based RIA and immunopurification procedures for simple and rapid detection and purification of cytochromes P-450 from a variety of tissues. PMID- 6480610 TI - Molecular sizing of individual polysaccharides in polyvalent pneumococcal and meningococcal vaccines by column chromatography and immunoelectrophoresis. AB - We determined the molecular size of meningococcal and pneumococcal polysaccharides in final vaccines, using a combination of column chromatography and simple rocket immunoelectrophoresis. We found a good correlation between the distribution coefficients obtained with UV monitoring or ELISA and immunoelectrophoresis. PMID- 6480611 TI - [Rapid method of testing the viability of BCG vaccine by determination of ATP]. PMID- 6480612 TI - A study showing a high degree of interlaboratory variation in the assay of human interferon. AB - Identical human fibroblast interferon samples were assayed in four different laboratories, in all of which the international reference standards were used. Up to tenfold differences in titer were observed between the laboratories. Differences of this magnitude make meaningful comparisons of clinical and other interferon studies difficult and clearly indicate the need for an internationally accepted standardized interferon assay system. PMID- 6480613 TI - The serological responses of calves to live Salmonella dublin vaccine--a comparison of different serological tests. AB - The serological responses to live Salmonella dublin vaccine was assessed in three groups of calves; three-day-old colostrum-deprived (3DO C-), three-day-old colostrum-fed (3DO C+) and three-month-old (3MO), by the following tests; serum agglutination test (SAT), indirect haemagglutination test (IHA), complement fixation test (CFT) and antiglobulin test (AGT). Serological activity was detected by all the tests in the 3MO calves. In the 3DO C+ calves no serological activity was detected by either the somatic SAT or IHA but low levels of CF and somatic AGT antibodies were produced. In 3DO C- calves serological activity, often at low levels, was detected by all the tests except the somatic SAT. High levels of flagellar agglutinins were detected in both groups of 3DO calves. It was concluded that with the exception of the flagellar SAT the tests were affected by the age of the calf and in 3DO calves also by the presence of colostral antibodies. However, the use of the SAT in 3MO calves would provide an indication as to the potency of salmonella vaccines. PMID- 6480614 TI - A comparison of the methods of the European Pharmacopoeia for the detection of Mycoplasma gallisepticum and Mycoplasma synoviae. AB - The methods specified in the European Pharmacopoeia for the detection of Mycoplasma synoviae and Mycoplasma gallisepticum as contaminants of vaccines were compared by investigating the serological responses of chicks inoculated with dilutions of mycoplasma cultures, these cultures being titrated in parallel in vitro. Inoculation by the intrathoracic route proved to be as sensitive as, or more sensitive than the other methods and was of similar sensitivity to the in vitro titrations for both agents. PMID- 6480616 TI - The finite displacements vector's method: an application to the scoliotic spine. AB - This paper presents a vectorial method to directly obtain the components of the screw displacement between two positions of a body in a three-dimensional space (position of the helical axis of motion, rotation around this axis and translation along it). This method can be applied either to the case of a bone, moving with respect to the reference frame, or to the case of the relative motion of a joint; it gives exact formulae even if the displacements are finite; it generalizes the results (already published) obtained for finite displacements in the plane. The involved computation is easy, and the use of this method deals with only a small magnification of experimental errors. The technique of a screw displacement is applied to the vertebral segments of a scoliolic spine. The necessary data is taken from a couple of in-vivo X-rays. The goals of this study are: first, to describe the shape of the spine at each step of its evolution and second, to quantify the evolution in time of any segment of the spine between two states. PMID- 6480615 TI - Immunization against influenza in humans using an oral enteric-coated killed virus vaccine. AB - By ingestion of subunit-killed influenza virus vaccine in the form of enteric coated capsules, local synthesis of secretory IgA (sIgA) antibody was stimulated in human nasal secretions. A fairly equal antibody response initiated by oral and intramuscular administration was demonstrated in the nasal secretions, although a systemic immune response was not elicited from ingestion of the vaccine. If the secretory antibody response resulted from absorption of antigen and transport to the respiratory mucosa, systemic (serum) antibody would be expected. Therefore these findings support the hypothesis that specialized collections of lymphoid cells in the small intestines have IgA precursor cells which circulate and populate distant mucosal sites. A number of studies have suggested that protection against mucosal infection by a variety of respiratory viruses correlates better with the presence and level of sIgA antibody than with serum antibody. The orally administered vaccine was associated with no more side effects than placebo, in contradistinction to the intramuscular route. Thus, the oral method of influenza vaccination could prove to be superior in providing for immunological protection due to equal secretory antibody stimulation, improved convenience and less toxicity. PMID- 6480617 TI - Joint forces in the human pelvis-leg skeleton during walking. AB - For the calculation of the forces in the hip, knee and ankle joints during walking the knowledge of the three-dimensional movements of the human body and of the forces between foot and ground is a prerequisite. It is shown how this information may be obtained and what accuracy is obtainable. For the calculation of the statically indeterminate system of the lower limbs, consisting of muscles, bones and joints an optimization method is applied. The optimization criterion is the minimization of the muscle forces. Measurements were taken with seventeen male and five female persons. The maximum joint forces are plotted against gait speed, body weight and body size. In addition some statistical distributions are presented. PMID- 6480618 TI - The static elastic properties of 45 human thoracic and 20 abdominal aortas in vitro and the parameters of a new model. AB - Segments of 45 human thoracic and 20 abdominal aortas, including 13 pairs, aged 30-88 yr at autopsy, were perfused with 37 degrees C Tyrode's solution at in-situ length. Diameter changes due to 20 mmHg pressure steps, between 20 and 180 mmHg, were measured to 1 micron accuracy with balanced transducers. Absolute diameter at 100 mmHg was measured to 50 micron accuracy. At 100 mmHg, cross-sectional area ranged from 2.6 to 7.6 for thoracic and from 1.0 to 3.2 cm2 for abdominal segments. Compliances ranged from 1.9 to 17 for thoracic and from 0.6 to 4.4 mm3/mmHg.cm for abdominal segments. An arctangent model with three free parameters A(p) = Am(1/2 + tan-1 [p-p0)/p1)/pi) explained over 99% of the variance in area with pressure for each aorta. Changes in compliance, characteristic impedance and propagation velocity are equally well described. Abdominal fits on the average appeared down scaled by a factor of 2 and shifted 20 mmHg towards lower pressures from paired thoracic (significant at p = 0.001). PMID- 6480619 TI - A contact-coupled finite element analysis of the natural adult hip. AB - A non-linear two-dimensional finite element model was used to study phenomena of stress redistribution in the natural adult hip resulting from parametric material property variations in the juxtarticular regions of the femoral head. Despite the geometrical simplifications employed, the intra-articular contact stresses (computed using the FEAP program) were found to be in reasonable qualitative agreement with previous in vitro data for the case of a normal hip. Generalized sclerotic changes in the subchondral plate, as reflected either in apparent modulus increases or in plate thickening, were found to have only minor effects on the computed contact stress distribution, although stress levels within the plate itself were markedly influenced. Localized subchondral plate sclerosis, by contrast, led to marked stress elevations in the cartilage immediately overlying the stiffened bone. Cartilage modulus increases caused increased load uptake for a given imposed deformation, but involved stress distribution increases which were very nearly linearly proportional to the increases in resultant load magnitude. Friction coefficient elevations had no noticeable effects on normal contact stress or upon overall load transmission, but involved complex, possibly slip-related, changes in intra-articular and cartilaginous shear stresses. PMID- 6480620 TI - Measurement of whole-body vibration by double-pulsed holography. AB - A technique for registering vibration and deformation patterns has been adapted for the measurement of whole-body vibration in humans. Double-exposure holographic interferometry produces three dimensional pictures of the body, allowing exact measurement of the subject's movement between the two pulses. In this study an interval of 600 microseconds between the two pulses was used, producing measurements with a resolution of less than 0.3 X 10(-6)m. The subject standing in a fixed posture, was exposed to the laser beams first without vibration and then with vibration. The picture without vibration is needed as certain movements due to life functions of the body such as heartbeat, blood circulation etc are involved therein. This basic pattern should be considered when analysing the pictures with vibration. Different types of vibration in various postures were studied. Tests were also conducted when a reflective coating was applied to the skin. The results show that the method is applicable for measuring whole-body vibration and suggests further tests with more modern laser equipment which is now available. Such equipment can produce pulses with a high repetition rate and of much better quality than those obtained in this study. Once coordinated to the heartbeat and to the working frequency of the vibrating object, a reliable analysis of whole-body vibration can be maintained. PMID- 6480621 TI - A study of rotational brain injury. AB - Of concern in the paper is an investigation on brain injuries which may occur owing to an input angular acceleration of the head. The study is based on the use of an improved mathematical model for the cranium. The eccentricity of the braincase is incorporated through the consideration of a prolate spheroidal shell as the representative of the skull. Also the dissipative mechanical behaviour of the brain material (as per the observations of experimenters) has been accounted for by considering the material contained in the shell as viscoelastic. The problem is formulated in terms of prolate spheroidal coordinates. The singularities of the governing equations of motion (when expressed in the prolate coordinate system) are removed by a suitable transformation of the concerned dependent variable, viz. the one that stands for the angular displacement of a representative point of the system. In the first place the solution of the boundary value problem is sought in the Laplace transform space, by employing a finite difference technique. Use of the alternating-direction-implicit method together with Thomas algorithm was made for obtaining the angular acceleration in the transformed space. The Laplace inversion is also carried out with the help of numerical procedures (Gauss quadrature formula is used for this purpose). The results of the parametric study are presented through graphs. The plots illustrate the shear stresses and strains in the brain medium. A meaningful comparison of the computational results with those of previous investigations indicate that the eccentricity of the braincase plays a significant role in causing injury to the brain. PMID- 6480622 TI - Improvement of mechanical properties of acrylic bone cement by fiber reinforcement. AB - Acrylic bone cement is significantly weaker and less stiff than compact bone. Bone cement is also weaker in tension than in compression. This limits its use in orthopaedics to areas where tensile stresses are minimum. We have attempted to improve the mechanical properties of PMMA by reinforcing it with metal wires, and graphite and aramid fibers. Normal, carbon fiber reinforced and aramid fiber reinforced bone cement specimens were tested in compression. Addition of a small percentage (1-2% by weight for carbon and up to 6% for aramid) of these fibers improved the mechanical properties significantly. Due to the improved mechanical properties of fiber reinforced bone cement, its clinical use may reduce the incidence of cement fracture and thus loosening of the prosthesis. PMID- 6480623 TI - Reversing flow in the aorta: a theoretical model. AB - The viscous boundary layer in a reversing flow in a curved tube is analysed with a view to study the reversing flow in the aorta at the beginning of the diastole. The velocity in the core is taken to vary with time as in a dog's aorta. The flow is considered to be quasi-steady long before the time of reversal. Near the time of reversal, the flow is governed by the diffusion equation--a balance between the unsteady inertia terms and viscous terms. The solution which ensures the continuity of the displacement thickness at the time of take over from the quasi steady solution to the diffusive solution, is obtained. The knowledge of the distribution of the shearing stress in the circulatory system is essential due to its relevance with regard to atheroma--a disease leading to the hardening of the arteries. With this in mind, the wall shear rate is obtained as a function of time at every cross-section of the tube. The shearing stresses at the inner bend and the outer bend are also plotted. The results are compared with those for the straight tube. PMID- 6480624 TI - Mechanical response of reconstituted, freeze-dried collagen under compressive loads. AB - The mechanical response under uniaxial compression of collagen discs, made from freeze-dried collagen reconstituted at acid pH, was investigated at 22, 29.5 and 35 degrees C. The pH during compression was maintained at the physiological level of 7.4. The fluid transport model developed by Bert (1970) was fitted to the data. Assumptions, made in the development of the model, were tested and the range of reliability of the model is discussed. The two fitting parameters of the model were found to be stronger functions of hydration than was previously reported. The compressive response of collagen was found to be only weakly influenced by temperature. At 35 degrees C there was evidence of thermal degradation. Some creep was noted at times greater than five half-times, but no attempt was made to quantify it. PMID- 6480625 TI - Dependence of jumping performance on muscle properties when humans use only calf muscles for propulsion. AB - Using optimal control techniques, maximum height jumps were simulated for humans who held their body rigid except for the ankle. Three dynamic models of ankle torque generation based on known calf muscle properties were used. Force and kinematics obtained from the simulations using nominal and perturbed parameters were compared with data obtained from humans who had performed this type of jump. One torque model incorporated the series elastic, force-length and force-velocity properties of muscle. Our results suggest that higher jumps would be achieved by those who have the most compliant and fastest contracting muscles. It was also found that height attained depended much more on the ability of muscles to generate isometric force at long lengths than at short lengths. Studies of forward and strictly vertical jumps using similar computer methods suggest that for any maximal jump the optimal strategy is first to achieve a unique state (position, velocity and acceleration) with the feet flat on the ground, and then to maximally activate one's calf muscles until lift-off. PMID- 6480626 TI - Control exerted by ligaments. AB - The function of the ligaments as local controllers, independent of the central nervous system, in maintaining the integrity of the joint is demonstrated by modelling the human knee in the sagittal plane, and studying its anterior posterior motion. In addition to the ligaments, the model includes the characteristic geometry of the joint surface and some muscle groups. The connecting reaction forces at the point of contact between the tibia and the femur are considered to be constraint forces due to three different surface motions--gliding, rolling and combined gliding and rolling. It is demonstrated that the ligamentous structure maintains these holonomic and nonholonomic constraints that describe the joint motion, and that stability of the knee joint is provided mainly by ligaments. Muscular structures further stabilize and contribute to joint movement. Computer simulation of rolling movement of the knee is presented to illustrate the importance of the ligaments for joint integrity and stability. PMID- 6480627 TI - Measuring the inertial properties of cadaver segments. AB - The purpose of this study was to devise and test a method of determining the inertial properties of frozen cadaver segments, including the principal moments of inertia. Balsa wood segment holding boxes were developed and tested on a variety of test objects and on one sixteen segment cadaver. The method was both time efficient and accurate, yielding absolute percentage errors of approximately 1% +/- 1% for each of the three principal moments of inertia based on 110 tests for each parameter. The time required to test each cadaver segment did not exceed 30 min. PMID- 6480628 TI - A technique for determining prosthetic joint contact areas. AB - A technique to determine the contact areas of total joint replacements has been developed. A thin film of petroleum jelly is deposited by the metallic component on the plastic component when load is applied. Fingerprint powder is then used to highlight the petroleum jelly coated area. Experimental data produced using this technique was found to be in good agreement with theoretical predictions. PMID- 6480629 TI - Carpal deviation in congenital ulnar deficiency. AB - In patients with hypoplasia of the ulna, the role of the fibrocartilaginous anlage of the ulna in the development of deformity is controversial. Between 1971 and 1982, we treated eight such patients with eleven affected extremities. We maintained them on a conservative regimen of static splinting, and surgery was not undertaken unless there was uncorrectable ulnar deviation at the wrist of 30 degrees or more. Resection of the anlage had to be performed in only one patient. Progression of uncorrectable ulnar deviation at the wrist rarely occurs in patients with ulnar deficiency; therefore, routine precautionary excision of the anlage is not justified. PMID- 6480630 TI - Percutaneous Kirschner-wire fixation of Colles fractures. A prospective study of thirty cases. AB - Thirty consecutive patients with a displaced Colles fracture were treated with closed reduction and percutaneous fixation with two Kirschner wires. There were no serious complications. Two of the thirty patients had a minor loss of reduction that did not compromise function. One of the twenty-eight patients who were available for one-year follow-up had a moderate loss of flexion and extension. No patient had a significant loss of rotation of the forearm. The study showed that additional fixation improves both the anatomical and the functional results after a Colles fracture. I recommend the use of percutaneous Kirschner-wire fixation if the articular surface of the radius is not comminuted into more than two fragments. PMID- 6480631 TI - Bone-mineral content in the lower limb. Relationship to cross-sectional geometry. AB - For this study, bone-mineral content and bone-mineral width were measured using photon absorptiometry at eleven locations in forty excised femora and tibiae obtained from an archaeological sample. An additional seventy-nine femora were scanned at the middle of the shaft and through the femoral neck. After scanning, the bones were sectioned at each location and cross-sectional areas and other geometrical properties were determined directly from section tracings. The results indicated that locational, sex, and age-related differences in bone mineral content were largely determined by variation in cortical area. Due to differences in bone geometry, variation in bone width does not reflect variation in cortical area, and as a consequence the use of bone width to standardize for volumetric or bone "size" differences produces misleading results in sex and age comparisons. In this study, decreases with age in the bone-mineral content and bone-mineral content:bone width ratio were similar to those observed in living populations. However, the bone-mineral content:cortical area ratio showed no significant decline with age for any cross section. Thus, the age-related changes in compact cortical bone appeared to be mainly volumetric, not densitometric. PMID- 6480632 TI - Kinematic total knee replacement. AB - We reviewed 124 consecutive kinematic condylar total knee replacements (in ninety one patients) at two to four years postoperatively. One hundred and eleven (90 per cent) were rated as good or excellent. The average active postoperative flexion was 106 degrees (range, 94 to 120 degrees). Twenty-two knees (18 per cent) had incomplete, non-progressive radiolucent lines, less than one millimeter in width, at the tibial bone-cement interface; these were considered insignificant. Restriction of stair-climbing ability in this series appeared to be a function of involvement of multiple joints rather than of patellar replacement, as the rheumatoid patients with resurfaced patellae performed the worst. The osteoarthritic patients with involvement of a single joint performed the best, regardless of whether the patella was resurfaced or not. When compared with a similar series of total knee replacements in which the tibial component was made entirely of plastic, less reaction at the bone-cement interface was found with the metal-backed kinematic tibial component. We suggest that this finding is clinical confirmation of in vitro studies that demonstrated the advantage of metal-backed tibial components. We concluded that this procedure, if meticulously performed, will give predictably good to excellent results with a low complication rate, a good postoperative range of motion, and a favorable appearing bone-cement interface at two to four years. PMID- 6480633 TI - High tibial osteotomy for varus gonarthrosis. A long-term follow-up study. AB - We evaluated the results in eighty-three patients (ninety-five knees) who had had a high tibial osteotomy for either unicompartmental osteoarthritis or osteonecrosis. The operations were performed between 1965 and 1976. The mean length of follow-up was 8.9 years (range, five to fifteen years). The early results were promising: at two years 97 per cent and at five years 85 per cent of the knees had either an excellent or a good result. At subsequent follow-up, however, only sixty knees (63 per cent) had an excellent or good result, and in the remainder recurrent pain had developed. Twenty-two knees (23 per cent) had been revised to a total knee arthroplasty because of pain. The alignment obtained by the osteotomy was not as important in determining the long-term result as we had previously believed. Although recurrent varus deformity was observed in more than one-quarter of the knees, it was not necessarily associated with an unsatisfactory result. The passage of time was the most important factor in determining the result, as only fifteen (37 per cent) of the knees that had been followed for more than nine years were pain-free. We now believe that total knee arthroplasty is a more suitable operation for patients who are more than sixty years old and that high tibial osteotomy should be reserved for patients who have a strenuous occupation or who wish to continue to participate in sports activities. PMID- 6480634 TI - Intravenous lidocaine for anesthesia in the lower extremity. A prospective study. AB - We prospectively studied the clinical applicability of intravenous lidocaine for regional anesthesia in the lower extremity in fifty-eight consecutive patients. The effectiveness of the anesthesia that was obtained for a variety of procedures done at or distal to the knee was rated as excellent or good in 94 per cent of the patients. No significant cardiovascular or neural complications were encountered, and the levels of lidocaine in the blood were well below the toxic range. We attribute the success of this method to the use of a large volume of fluid, double pretested tourniquets, and judicious premedication to delay the onset of discomfort caused by the tourniquet. PMID- 6480635 TI - The prediction of curve progression in untreated idiopathic scoliosis during growth. AB - We reviewed the cases of 727 patients with idiopathic scoliosis in whom the initial curve measured from 5 to 29 degrees. The patients were followed either to the end of skeletal growth or until the curve progressed. One hundred and sixty nine patients (23.2 per cent) showed progression of the curve. The incidence of curve progression was found to be related to the pattern and magnitude of the curve, the patient's age at presentation, the Risser sign, and the patient's menarchal status. We found no correlation between progression of the curve and the patient's sex, Harrington factor, rotational prominence, family history, or radiographic measurements. A progression factor was calculated using the three strongest correlations available at initial examination: the magnitude of the curve, the Risser sign, and the patient's chronological age. A graph and nomogram are presented that can serve as a guide for advising patients' families and for planning continuing care. PMID- 6480636 TI - The thermal effects of skeletal fixation-pin insertion in bone. AB - In human-cadaver cortical bone, we measured the maximum temperatures and the durations of temperatures in excess of 55 degrees Celsius during experimental insertion of five types of external skeletal-immobilization pins. Drill speed, pin-point design, and predrilling were the variables examined. Drill speed was found to have an effect on the maximum temperature and the duration of temperatures in excess of 55 degrees Celsius only in the immediate vicinity of the hole. Pinpoint design was a more significant factor, and predrilling was highly effective as a method of minimizing temperature elevation. PMID- 6480637 TI - Comparison of the effects of compression plates and external fixators on early bone-healing. AB - We used two mechanically dissimilar devices, compression bone-plates and unilateral-frame external fixators, in a standard canine osteotomy model; both methods were highly successful in achieving mature bone union. Bone union was studied by histological, physiological, and biomechanical means. At 120 days after injury, union was biomechanically less mature on the external fixator side. These tibiae had less intracortical new-bone formation (p less than 0.01), more bone resorption (p less than 0.045), and more bone porosity (p less than 0.04) when compared with paired tibiae that had been treated with compression plates. This higher level of bone turnover on the external fixator side was accompanied by an increase in blood flow (measured by clearance of 85Sr) (p less than 0.04). At the osteotomy site, pre-experimental or unlabeled bone and porosity were greater on the external fixator side and endosteal new-bone formation was greater on the plated side. Since the in vitro stiffness of the external fixator was less in all modes tested (compression, distraction, torsion, and anteroposterior bending) except lateral bending, it may be that the rigidity of the fixation is an important factor in early bone-remodeling of a healing osteotomy. PMID- 6480638 TI - The needle test for complete rupture of the Achilles tendon. AB - Several difficulties may be encountered in making a definitive non-operative diagnosis of a complete rupture of the Achilles tendon. In this paper, I describe a new test that directly determines the integrity of the distal ten centimeters of the Achilles tendon. This test is compared with the test described by Thompson and Doherty, and the occasional discrepancy between them is explained by observations that are based on examination of anatomical specimens. PMID- 6480639 TI - Probable stress fracture of the cuboid in an infant. A case report. PMID- 6480640 TI - Spontaneous rupture of the extensor mechanism causing ulnar dislocation of the long extensor tendon of the long finger. Two case reports. PMID- 6480642 TI - Disruption of the anterior cruciate ligament in a three-year-old child. A case report. PMID- 6480641 TI - Chronic recurrent multifocal osteomyelitis. A case report. PMID- 6480643 TI - Voluntary habitual dislocation of the hip. A case report with follow-up by computed tomography. PMID- 6480644 TI - Type-I complex dislocation of the first metatarsophalangeal joint--open reduction through a dorsal approach. A case report. PMID- 6480645 TI - Chronic post-rheumatic-fever arthritis (Jaccoud's arthritis) involving the feet. A case report. PMID- 6480646 TI - Pseudoaneurysm secondary to a protruding screw as a result of normal growth and remodeling following supracondylar osteotomy. A case report. PMID- 6480648 TI - Genu recurvatum: a possible complication after Osgood-Schlatter disease. Case report. PMID- 6480647 TI - Velban as treatment for disseminated eosinophilic granuloma of bone. Follow-up note after seventeen years. PMID- 6480649 TI - The education of future orthopaedists. PMID- 6480650 TI - Post-traumatic osteolysis of the pubic bone simulating a malignant lesion. PMID- 6480652 TI - Indications for the treatment of deep venous thrombosis following total knee replacement. PMID- 6480651 TI - Ipsilateral fractures of the femoral neck and shaft. PMID- 6480653 TI - Arthrography of the wrist joint. PMID- 6480654 TI - Failure of treatment of ununited fractures of the carpal scaphoid. PMID- 6480655 TI - Post-fracture pubic osteolysis simulating malignancy. PMID- 6480656 TI - Tarsal coalitions and peroneal spastic flat foot. A review. PMID- 6480657 TI - Ipsilateral fractures of the femur and tibia. A report of fifty-seven consecutive cases. AB - We treated fifty-seven consecutive ipsilateral fractures of the femur and tibia in fifty-four adults from 1968 through 1978. Twenty-one patients had concomitant life-threatening injuries, and in thirty-three extremities the fractures were open. All but one of the femoral fractures and about half of the tibial fractures were internally fixed. The length of hospitalization averaged five weeks. Local complications included one below-the-knee amputation, three deep infections, and four ununited fractures. A fat embolism syndrome was diagnosed in 13 per cent of the patients. At the last follow-up examination, at an average of 40.5 months after injury, the mean range of motion of the knee was 129 degrees. Over-all, a good or excellent functional result was achieved in about 80 per cent of the patients. The best results were achieved when both fractures were stabilized surgically. PMID- 6480658 TI - Dose reduction and government priorities. PMID- 6480660 TI - An analysis of bowel perforation in patients with intussusception. AB - A barium colon examination is recommended for the diagnosis and reduction of intussusception in children, except when bowel perforation is evident either radiographically or clinically. In our experience and contrary to recent reports neither radiographic evidence of bowel obstruction nor an age of less than six months is a contraindication. We reviewed 40 patients diagnosed as having had intussusception and found five children aged more than six months with perforations discovered at operation. Three of the five children had plain radiographic findings of small bowel obstruction as did nine other children. In four of the 12 children with evidence of small bowel obstruction a successful hydrostatic reduction of the intussusception was carried out. Barium studies were performed for diagnosis and therapy in eight children with ileo-colic intussusception aged six months or less, four of whom had evidence of small bowel obstruction. In five, including two with obstruction, reduction of the intussusception was successful. The major contraindication to barium examination is radiographic or clinical evidence of perforation. PMID- 6480659 TI - Cystic lesions of the adrenals: diagnosis and management. AB - Until recently, adrenal cysts were diagnosed at surgery or autopsy. Current imaging methods allow accurate preoperative diagnosis in symptomatic patients and may obviate surgery in the asymptomatic. Eighteen cystic lesions of the adrenal glands are described. Computed tomography was the most useful diagnostic test. Many cysts had typical appearances of a thin-walled, fluid-filled lesion with or without thin septa and mural calcification. Atypical features included central densities, which may be characteristic of intracystic hemorrhage, and wall thickening which should initiate a search for endocrinopathy and tumor. PMID- 6480661 TI - Non-obstructive colonic dilation: radiologic findings in 50 patients following colonoscopic treatment. AB - Fifty patients with acute onset of colonic dilatation without mechanical obstruction were evaluated before and after colonoscopic decompression. Colonic dilatation, as demonstrated radiographically, was segmental or consistent with mechanical obstruction in 33 (66%). Signs of impending cecal perforation were seen in five (10%) and these patients had colonoscopic decompression, tube cecostomy, or both. Following colonic decompression, cecal diameter may remain unchanged for two to four days, despite decreased abdominal girth and even shortening of the colon radiographically. Improvement in pain, distention, tenderness, fever and leukocytosis may precede radiographic improvement. The radiologist must recognize this entity, look for signs of impending perforation and signs of bowel shortening, with or without decompression after treatment. Barium studies of the colon should be avoided since they can hamper the endoscopic diagnosis and treatment of colonic dilatation. PMID- 6480662 TI - Barrett's esophagus: radiological and clinical considerations. AB - We reviewed the radiographic findings in thirty patients with columnar-lined (Barrett's) esophageal mucosa. Gastroesophageal reflux was observed in 90%, hiatal hernia in 83%, stricture in 80% and esophageal ulceration in 33%. Superficial nodular mucosal changes were detected on 50% of the air contrast esophagrams. Prominence of this pattern may be associated with dysplastic or early malignant change. In addition, four conditions associated with secondary lower esophageal sphincter incompetence were identified in our patient group. These were scleroderma, previous myotomy for achalasia, previous gastric surgery and long-term indwelling nasogastric tubes. PMID- 6480663 TI - Gastroesophageal reflux and transit scintigraphy: a comparison with esophageal biopsy in patients with heartburn. AB - A method for combining scintigraphic studies of esophageal transit and gastroesophageal (GE) reflux is presented. Thirty-two patients with symptoms of GE reflux were studied. The severity of their symptoms was compared to nuclear medicine studies and esophageal mucosal biopsy. Fifteen healthy volunteers were studied as a control group for scintigraphy. The sensitivity of reflux scintigraphy to detect GE reflux as determined by esophageal histology was 70% and its specificity 87%. No relationship was observed between the magnitude of symptoms and the volume of GE reflux. A higher incidence of esophageal transit abnormalities was observed in those patients with histologic features of GE reflux than in those with normal histology. The combination of esophageal reflux and transit scintigraphy provides a way of studying some of the esophageal motor abnormalities associated with GE reflux. For clinical purposes GE reflux scintigraphy seems unsuitable as a single screening test. PMID- 6480664 TI - Central bronchial displacement with large posterior pleural collections. Findings on the lateral chest radiograph and CT scans. AB - The central bronchi have a characteristic orientation and relation to each other on lateral chest radiographs and computed tomograms. Twelve patients with proven unilateral large pleural collections all demonstrated ipsilateral forward central bronchial displacement on their lateral chest radiographs. Each of the eight patients who had computed tomograms also had similar displacement. In a patient with a large area of opacity located in a posterior hemithorax, ipsilateral forward central bronchial displacement may be a clue indicating that the opacity represents a pleural collection. PMID- 6480665 TI - Radical external beam radiation therapy for prostate carcinoma. AB - Between 1970 and 1978, 202 patients with carcinoma of the prostate were treated with radical external beam radiation with curative intent. Intracapsular disease was present in 38% and the remaining 62% had disease extending through the prostatic capsule. The overall survival is 72% at five years, and despite the large number of patients with advanced disease the five-year disease-free survival is 46%. Significant prognostic factors include: i) tumor, grade, ii) extent of primary disease, iii) procedure done to determine diagnosis (TURP vs. needle biopsy) and iv) tumor dose. There was a significant improvement in survival at a minimum dose of 5000 Gy. Prostate carcinoma is radiosensitive and a dose-response relationship in treatment has been demonstrated by this review. PMID- 6480666 TI - Radiation oncology--the misunderstood specialty. AB - A shortage of radiation oncologists has been a problem in both Canada and the United States of America. The fundamental step to rectify this situation is the recruitment of interested medical students. A mail-in survey was sent to 214 third- and fourth-year medical students at the University of British Columbia to evaluate attitudes to and the level of understanding of radiation oncology. The response rate was 59%. Seventy-five percent of the students were planning postgraduate training in clinically orientated specialties with good lifestyle and availability of job opportunities. However, only 18% of the respondents considered radiation oncology as a possible specialty. This survey suggests that this lack of interest is the result of misconceptions about training in the practice of radiotherapy. To better inform the medical students, teaching clinics providing them with direct contact with radiation oncologists and their patients, are invaluable. In order to generate the correct image of the specialty and the types of patients encountered, teaching in an ambulatory care setting is not to be neglected. Distribution of information pamphlets describing the radiation oncology program and the nature of radiation oncology practice is also suggested as an efficient means of informing medical students. PMID- 6480667 TI - Dose and quality control (DQC) in diagnostic radiology. AB - Dose and quality control in diagnostic radiology can play an important role in reducing x-ray exposure and costs whilst maintaining a high level of imaging quality and diagnostic benefit. It can also become very costly. Current government regulations demand unnecessary accuracy in the measurement and performance of certain parameters of x-ray generators whilst ignoring others which are more important. They totally neglect imaging systems. We urge a more critical approach to the requirements for dose and quality control programs. We propose the exchange of information through a user's club and a less regulatory but equally important role for government. PMID- 6480668 TI - Hand osteoarthropathy in pianists. AB - We evaluated radiographs of the hands of 20 pianists. The radiologic manifestations arising from long-term stress and strain applied to the hands were recorded. The changes are characterized by: 1) alignment adaptation consisting of axial radial rotation of the digits, particularly the fifth but also the third and fourth, 2) degenerative changes at the distal interphalangeal DIP and metacarpophalangeal MCP joints, and 3) mechanical remodeling manifested as periostal thickening and flattening of the phalangeal tufts associated with sclerosis. These findings suggest the existence of an occupational entity which might be described as pianist's osteoarthropathy. PMID- 6480669 TI - Radiographic assessment of Harrington rod instrumentation for spinal fractures. AB - The surgical procedure for Harrington stabilization of spinal fractures is described. A retrospective review was carried out on 36 patients who underwent Harrington instrumentation for spinal trauma. The group comprised 21 burst fractures, 11 fracture-dislocations and four wedge-compression fractures. Satisfactory reduction was achieved in 13 patients, unsatisfactory reduction in 19 patients, and no reduction in four patients. Loss of reduction later occurred in seven of the patients with satisfactory initial reduction. Further loss of reduction also developed in nine patients in the remaining group without satisfactory reduction initially. Radiographically demonstrable causes for loss of reduction included technical errors allowing slippage of the hooks, improper placement of the hooks, and laminar fractures. PMID- 6480670 TI - Intracranial metrizamide mimicking white matter disease. AB - We report two patients in whom brain penetrance of grey matter by metrizamide, introduced for myelography thirty hours earlier, mimics the periventricular lucency of white matter disease on cranial computed tomography. PMID- 6480671 TI - Small nodular pattern in the lungs due to opportunistic toxoplasmosis. AB - We report a patient with widespread nodular densities in the lungs complicating massive infestation by Toxoplasma gondii in an immunologically compromised host. PMID- 6480672 TI - Pleural and extrapleural disease in Nocardia infections. AB - Pulmonary nocardiosis occurs most commonly in immunocompromised patients. Pleural involvement may be seen on a chest radiograph and may provide a clue as to the etiology of the infection, particularly if subcutaneous nodules or bone or joint symptoms are also present. PMID- 6480673 TI - Amiodarone-induced pulmonary toxicity. AB - Amiodarone hydrochloride, an investigational drug used to suppress ventricular arrhythmias, may cause pulmonary toxicity with associated radiographic abnormalities. Two patients are presented who illustrate the variability of these abnormalities. One of these patients died of respiratory failure while the other recovered after amiodarone was stopped and corticosteroid therapy was started. PMID- 6480674 TI - Colonic spasm: a possible mechanism for thumbprinting. AB - A patient with "colonic thumbprinting" on a contrast examination of the colon, typical of ischemic colitis both clinically and radiographically, is presented. Both surgical and pathologic evaluations were performed within hours of the contrast enema and revealed no relevant abnormality. Colonic spasm is a possible mechanism for this finding. PMID- 6480675 TI - Radiographic demonstration of a toxic agent. AB - The abdominal radiographs obtained on a young man attempting suicide by stabbing revealed an unusual opacity in the true pelvis, confirmed as being due to unsuspected carbon tetrachloride ingestion. This is the first known radiologic demonstration of oral ingestion of a rapidly acting toxic substance. PMID- 6480676 TI - Upper extremity involvement in Trevor disease. AB - We report a twenty-nine-month-old girl with Trevor disease (dysplasia epiphysealis hemimelica) involving the left humeral head and ipsilateral lower extremity. This is a disorder of growth of an epiphysis or ossification center and involvement of an upper limb is extremely rare. Advanced bone age is usually encountered in the affected extremity. PMID- 6480677 TI - Computed tomographic diagnosis of distal radio-ulnar joint disruption. AB - Distal radio-ulnar joint dislocation may be a difficult diagnosis using standard wrist radiographs. We report a patient in whom standard films did not convincingly demonstrate a dislocation which was well seen with computed tomographic scans of the wrist. Computed tomography may be the method of choice for demonstrating distal radio-ulnar joint dislocation when this is suspected clinically but not seen with standard films. PMID- 6480678 TI - Hypomagnesemia with chondrocalcinosis. AB - Two patients are described with calcium pyrophosphate crystal deposition and hypomagnesemia. There appears to be a meaningful association between the two findings, although the precise mechanism explaining this association is not clear. The identification of chondrocalcinosis on radiographs may be an important clue to the presence of hypomagnesemia. PMID- 6480679 TI - Calcified intraperitoneal and mediastinal implants in malignant ovarian teratoma. AB - We report the pathologic and radiologic findings in a 13-year-old girl with malignant teratoma of the ovary. Extensive calcified intraperitoneal and mediastinal implants were demonstrated by plain film radiography and computed tomography. PMID- 6480680 TI - Application of moire topography to mantle treatment. AB - We believe moire topography is a particularly suitable technique for establishing contours on patients receiving mantle treatment. We derive the fundamental moire equation from a novel, but simple, consideration of moire phenomena. Our apparatus is designed to give a difference in height of approximately 1.0 cm between successive moire fringes. Using an inclined plane test object, an accuracy of better than 3 mm is obtained. PMID- 6480681 TI - Preservation of myocardial ATP during cardioplegia: comparison of techniques. AB - Preservation of myocardial ATP enhances the heart's ability to resume normal function following aortic crossclamping (AXC). Preservation of this high energy substrate during 4 cardioplegia delivery techniques was evaluated and compared with changes occurring during 4 hours of continuous coronary perfusion. Dogs (31) were placed on cardiopulmonary bypass and transmural left ventricular biopsies obtained for control ATP measurements. Animals were then divided into five groups: Group I (n = 6): 4 hrs. of continuous coronary perfusion (CCP); Group II (n = 6): 3 hrs. continuous AXC, multidose blood cardioplegia (MBC); Group III (n = 6): 3 hrs. continuous AXC, multidose crystalloid cardioplegia (MCC); Group IV (n = 6): 2 hrs. intermittent AXC, single dose BC (SBC); Group V (n = 7): 2 hrs. continuous AXC, continuous perfusion BC (CBC). In each group, where applicable, myocardial biopsies were taken at 30 minute intervals during AXC, before and after cardioplegia injection, and 30 minutes following final unclamping and rewarming. Hearts in Group II (MBC) and V (CBC) showed greatest preservation of ATP stores (increases 1.1 +/- 1.2%, increases 1.8 +/- 0.9% respectively; p greater than .05) ATP levels rose as high as 23 +/- 2% (p less than .005) above control immediately following cardioplegia injection in Group II (MBC). Group IV showed poorest preservation of ATP (decreases 26 +/- 5%, p less than .01) with levels falling as much as 37 +/- 10% (p less than .01) during the period of AXC. Hearts in Group I (CCP) demonstrated a 15.6 +/- 7.5% decrease in ATP from control (p less than .05). Group III (MCC) also showed a steady decline in ATP declining 18 +/- 3% (p less than .005) from control. These data indicate that multidose blood and continuous-blood cardioplegia techniques will maintain normal myocardial ATP stores throughout the period of AXC. These groups actually show a slight rise in ATP as compared to 4 hrs. of continuous coronary perfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480682 TI - Early surgery for severe aortic regurgitation. AB - One hundred and fourteen consecutive patients who underwent aortic valve replacement (AVR) for isolated aortic regurgitation (AR) from 1965 to 1981 are presented. Sixty eight (60%) were preoperatively in NYHA class I-II and 46 (40%) were in NYHA class III-IV. Eighty-two patients had left and right heart catheterization prior to the operation and the severity of regurgitation was assessed angiographically in 93% of those in functional class (FC) I-II. Left ventricular (LV) end-diastolic volume index and end-systolic volume index were elevated even in the mildly symptomatic patients (156.1 and 61.0 ml/m2 respectively). The ratio of LV end-systolic pressure to LV end systolic volume index was diminished in the FC I-II patients. Two patients in FC III died in hospital (operative mortality: 1.7%) and there were 21 late deaths with a 5-year survival of 82.7%. Late survival differed significantly between patients who were preoperatively in FC I and II or III and IV (P less than 0.03). These data suggest that severe AR with altered LV function is an indication for early operation regardless of the presence of absence of symptoms. PMID- 6480683 TI - Evaluation of synthetic and biosynthetic conduits used as aorto-pulmonary shunts in growing pigs. AB - Synthetic and biosynthetic conduits 6 mm in internal diameter and 3 cm long were implanted as aorto-pulmonary shunts in 4 week old piglets. The synthetic conduit was made of Polytetrafluoroethylene (P.T.F.E.) manufactured by Gore-Tex; the biosynthetic graft was prepared by tanning bovine ureters and covering it with a polyester mesh. Two groups of six animals for each conduit underwent operation. Following implantation, when the animals were physiologically stable, the pressure and blood flow were measured in the pulmonary artery, conduit and aorta, and at the same time blood gases were obtained. These measurements were repeated four weeks later, following which the grafts were excised and processed for histological studies. All the conduits were patent, 4 weeks after implantation, but whereas there was little difference in the flows through the bovine grafts (506 ml/min) there was a marked reduction in the flow through the Gore-Tex conduit (235 ml/min). These differences could be related to the changes seen histologically. No drugs were used to affect patency of the conduits in this study. PMID- 6480684 TI - The results of surgery for active endocarditis of the native aortic valve. AB - Between 1968 and 1981, 40 patients with active endocarditis of the native aortic valve were treated by aortic valve replacement (A.V.R.). There were 8 postoperative deaths (hospital mortality 20%). This included 5 patients who had developed cardiogenic shock prior to surgery. Antibiotic treatment for less than one week and positive cultures on the excised valve had poor prognostic implications but tended to be associated with irreversible haemodynamic failure. Twenty five patients underwent A.V.R. following the onset of severe pulmonary oedema. The hospital mortality in this group was 28% and the 5 year actuarial survival 56% (+/- 11%). Fifteen patients who had developed premature closure of the mitral valve (P.C.M.V.) on M-mode echocardiography but who had no overt signs of cardiac failure underwent A.V.R. with a single death (7% hospital mortality). The 5 year actuarial survival in this group was 87% (+/- 9%). P.C.M.V. is a useful prognostic sign identifying those patients with endocarditis on the native aortic valve likely to benefit from early surgery. PMID- 6480685 TI - Occlusive arterial disease in young patients. AB - All the young patients (under 40 years) affected by occlusive arterial disease observed at the Istituto di Clinica Chirurgica II, University of Milan, during the last eleven years have been reviewed. About one third of these patients is affected by a form of arteritis; the others demonstrate the typical pattern of early atherosclerosis or an indeterminate condition which may represent an atherosclerotic complication superimposed on a basic arteritic lesion. The available therapeutic procedures are examined. They show that atherosclerotic disease more frequently permits a surgical reconstruction. The average rate of amputation is about the same in the two considered forms, ranging close to 7-8%. The 10 year follow up of these groups of young patients allowed us to analyze the rate of progression and evolution of these morbid conditions and the influence of the most important risk factors. PMID- 6480686 TI - Arterialization of the venous network of the foot through a bypass in severe arteriopathic ischemia. AB - With the object of saving a very ischemic extremity, when the classic procedures have been unsuccessful or impossible, the authors are using a modification of San Martin's operation. At present, we are making an A-V fistula with a graft interposed between the femoral or popliteal artery and the peripheral long saphenous vein at the foot or near to it. The distal valves are ruptured. In order to prevent the noxious venous overloading resulting from the distal end-to end anastomosis, it is important to replace it by an end-to-side anastomosis. Eight patients with intense continuous rest pain and necrotic lesions of the toes and heel have been operated on: 3 failures in spite of well functioning A-V fistula; 2 temporary improvements lasted 7 and 16 months when distal thrombosis of the A-V fistula occurred; 3 good results, maintained during 5 months, 4 3/4 years and 9 1/2 years respectively. Postoperative angiography and scintillography reveal a satisfactory retrograde distribution of blood in the fore foot except in the necrotic tissues. PMID- 6480687 TI - A new operation for aortic stenosis in the young: total left ventricular output through an apical-abdominal aortic shunt. A seven year follow-up. AB - Left ventricular outflow disease causes particular problems in the small child. Although aortic stenosis may be palliated by commissurotomy, valve replacement, if that appears necessary, is essentially not a practical procedure due to the small valve necessary to occupy the sub-coronary position. The combined lesion of aortic stenosis and regurgitation in childhood is an especially difficult lesion because any attempt to relieve the stenosis is extremely likely to increase the regurgitation. Sometime ago, we had the opportunity to manage a 22-month old youngster with severe congestive failure due to aortic stenosis with regurgitation. Because of the small size of the aortic root, it was elected to close the aortic valve and perform an apical abdominal aortic valve-containing shunt such that the entire left ventricular outflow was delivered to the abdominal aorta. The child has now been followed over seven years and is the subject of this report. PMID- 6480688 TI - Congenital arteriovenous fistula between the subclavian artery and the portal vein. AB - We report an arteriovenous fistula between the right subclavian artery and the portal vein in a 6 year old girl. Till now only two cases of similar anatomy have been described in literature to our knowledge. The operative and postoperative course were uneventful. PMID- 6480689 TI - Tubular crystals of acetylcholine receptor. AB - Well-ordered tubular crystals of acetylcholine receptor were obtained from suspensions of Torpedo marmorata receptor-rich vesicles. They are composed of pairs of oppositely oriented molecules arranged on the surface lattice with the symmetry of the plane group p2 (average unit cell dimensions: a = 90 A, b = 162 A, gamma = 117 degrees). The receptor in this lattice has an asymmetric distribution of mass around its perimeter, yet a regular pentagonal shape; thus its five transmembrane subunits appear to have different lengths, but approximately equal cross sections. The tubes grow by lateral aggregation on the vesicle surface of ribbons of the paired molecules. Both ribbons and tubes were sensitive to dispersal by the disulphide reductant, dithiothreitol. This observation and other evidence suggest that the basic pairing interaction in the tubes may be that of the physiological dimer, involving contact between delta subunits. PMID- 6480690 TI - Lipoprotein-heparin-fibronectin-denatured collagen complexes enhance cholesteryl ester accumulation in macrophages. AB - The sequestration of low-density lipoprotein (LDL) by components of the vascular extracellular matrix has long been recognized as a contributing factor to lipid accumulation during atherogenesis. The effects, however, that components of the extracellular matrix might have on LDL catabolism by scavenger cells have been little investigated. For these purposes we have prepared insoluble complexes of LDL, heparin, fibronectin, and denatured collagen (gelatin) and examined their effects on lipid accumulation, LDL uptake and degradation, and cholesteryl ester synthesis in mouse peritoneal macrophages. The results of these experiments have demonstrated that the cholesteryl ester content of macrophages incubated with a particular suspension of LDL, heparin, fibronectin, and collagen complexes is four- to fivefold that of cells incubated with LDL alone. The uptake of complexes containing 125I-LDL is rapid; however, in contrast to either endocytosed 125I-LDL or 125I-acetyl LDL, the degradation of complex-derived LDL is impaired. In addition, the uptake of complex-derived LDL stimulates the incorporation of [14C]oleic acid into cholesteryl oleate, however, the stimulation was a small fraction of that observed in cells incubated with acetyl LDL. Ultrastructurally, macrophages incubated with LDL, heparin, fibronectin, and collagen complexes did not contain many lipid droplets, but rather their cytoplasm is filled with phagosomes containing material similar in appearance to LDL-matrix complexes. These results indicate that components of the extracellular matrix can alter the catabolism of LDL by scavenger cells, suggesting that they may play a role in cellular lipid accumulation in the atherosclerotic lesion. PMID- 6480692 TI - Cell adhesiveness is related to tumorigenicity in malignant lymphoid cells. AB - Mouse lymphoma cells (S49) that grow in suspension culture were selected for increased tumorigenicity through continuous passages in syngeneic BALB/c mice. Developing tumors were classified as high grade malignant lymphoma, small noncleaved type. Variants were selected from these tumorigenic cells that were able to grow as a monolayer attached to their substrate, resembling, in this respect, fibroblastoid cells. Whereas the tumorigenic suspension-growing parental cells were able to induce progressive tumors with an inoculum as low as 100 cells per mouse, the adherent cells were unable to develop as tumors even at an inoculum of 1 X 10(8) cells per mouse. In addition, mice inoculated once with live adherent cells were immunized against 1 X 10(7) suspension-growing cells. Involvement of an immune response in the rejection of tumorigenic S49 cells was suggested by (a) adoptive transfer experiments in which spleen cells from immunized mice protected naive mice and (b) the appearance of antibodies in the sera of immunized syngeneic mice that specifically recognized both adherent and suspension-growing S49 cells and detected differences in [35S]methionine-labeled antigens from these cells. Antibodies raised in rabbits against adherent cells recognized three proteins of 34,000, 61,000, and 72,000 apparent molecular weight in radiolabeled adherent cell extracts that are either absent or present in small amounts in extracts of suspension-growing tumorigenic S49 cells. These findings, taken together with our previous report (Hochman, J., A. Katz, E. Levy, and S. Eshel, 1981, Nature (Lond.), 290:248-249), suggest the S49 system as a novel system for studying growth control in malignant lymphoid cells. PMID- 6480691 TI - Regulation of DNA repair in serum-stimulated xeroderma pigmentosum cells. AB - The regulation of DNA repair during serum stimulation of quiescent cells was examined in normal human cells, in fibroblasts from three xeroderma pigmentosum complementation groups (A, C, and D), in xeroderma pigmentosum variant cells, and in ataxia telangiectasia cells. The regulation of nucleotide excision repair was examined by exposing cells to ultraviolet irradiation at discrete intervals after cell stimulation. Similarly, base excision repair was quantitated after exposure to methylmethane sulfonate. WI-38 normal human diploid fibroblasts, xeroderma pigmentosum variant cells, as well as ataxia telangiectasia cells enhanced their capacity for both nucleotide excision repair and for base excision repair prior to their enhancement of DNA synthesis. Further, in each cell strain, the base excision repair enzyme uracil DNA glycosylase was increased prior to the induction of DNA polymerase using the identical cells to quantitate each activity. In contrast, each of the three xeroderma complementation groups that were examined failed to increase their capacity for nucleotide excision repair above basal levels at any interval examined. This result was observed using either unscheduled DNA synthesis in the presence of 10 mM hydroxyurea or using repair replication in the absence of hydroxyurea to quantitate DNA repair. However, each of the three complementation groups normally regulated the enhancement of base excision repair after methylmethane sulfonate exposure and each induced the uracil DNA glycosylase prior to DNA synthesis. These results suggest that there may be a relationship between the sensitivity of xeroderma pigmentosum cells from each complementation group to specific DNA damaging agents and their inability to regulate nucleotide excision repair during cell stimulation. PMID- 6480693 TI - Spatial organization of axonal microtubules. AB - Several workers have found that axonal microtubules have a uniform polarity orientation. It is the "+" end of the polymer that is distal to the cell body. The experiments reported here investigate whether this high degree of organization can be accounted for on the basis of structures or mechanisms within the axon. Substantial depolymerization of axonal microtubules was observed in isolated, postganglionic sympathetic nerve fibers of the cat subjected to cold treatment; generally less than 10% of the original number of microtubules/micron 2 remained in cross section. The number of cold stable MTs that remained was not correlated with axonal area and they were also found within Schwann cells. Microtubules were allowed to repolymerize and the polarity orientation of the reassembled microtubules was determined. In fibers from four cats, a majority of reassembled microtubules returned with the original polarity orientation. However, in no case was the polarity orientation as uniform as the original organization. The degree to which the original orientation returned in a fiber was correlated with the number of cold-stable microtubules in the fiber. We suggest that stable microtubule fragments serve as nucleating elements for microtubule assembly and play a role in the spatial organization of neuronal microtubules. The extremely rapid reassembly of microtubules that we observed, returning to near control levels within the first 5 min, supports microtubule elongation from a nucleus. However, in three of four fibers examined this initial assembly was followed by an equally rapid, but transient decline in microtubule number to a value that was significantly different than the initial peak. This observation is difficult to interpret; however, a similar transient peak has been reported upon repolymerization of spindle microtubules after pressure induced depolymerization. PMID- 6480694 TI - A single mutation in Chinese hamster ovary cells impairs both Golgi and endosomal functions. AB - A Chinese hamster ovary cell mutant DTG 1-5-4, was selected for pleiotropic defects in receptor-mediated endocytosis by methods previously described (Robbins, A. R., S. S. Peng, and J. L. Marshall, 1983, J. Cell Biol., 96:1064 1071). DTG 1-5-4 exhibited increased resistance to modeccin, Pseudomonas toxin, diphtheria toxin, Sindbis virus, and vesicular stomatitis virus, as well as decreased uptake via the mannose 6-phosphate receptor. Fluorescein-dextran labeled endosomes isolated from DTG 1-5-4 were deficient in ATP-dependent acidification in vitro. Endocytosis and endosome acidification were both restored in revertants of DTG 1-5-4 and in hybrids of DTG 1-5-4 with DTF 1-5-1, another endocytosis mutant exhibiting decreased ATP-dependent endosome acidification. Both DTG 1-5-4 and DTF 1-5-1 were blocked at two stages of infection with Sindbis virus: at low multiplicities of infecting virus, resistance reflected a block in viral penetration into the cytoplasm, but at higher multiplicities of infection the block was in virus release. Like endocytosis, release of Sindbis virus was increased in revertants of DTG 1-5-4 and in DTG 1-5-4 X DTF 1-5-1 hybrids. Decreased release of virus from DTG 1-5-4 correlated with defects in some of the Golgi apparatus-associated steps of Sindbis glycoprotein maturation: proteolytic processing of the precursor pE2, galactosylation, and transport to the cell surface all were inhibited. In contrast, mannosylation, fucosylation, and acylation of the Sindbis glycoproteins, and galactosylation of vesicular stomatitis virus and cellular glycoproteins occurred to similar respective extents in mutant and parent. Electron microscopic examination of Sindbis infected DTG 1-5-4 showed a remarkable accumulation of nucleocapsids bound to cisternae adjacent to the Golgi apparatus; virions were observed in the lumina of some of these cisternae. That the alterations in both endocytosis and Golgi associated steps of viral maturation result from a single genetic lesion indicates that these processes are dependent on a common biochemical mechanism. We suggest that endocytic and secretory pathways may share a common component involved in ion transport. PMID- 6480695 TI - Cell-specific expression of heat shock proteins in chicken reticulocytes and lymphocytes. AB - We have found that chicken reticulocytes respond to elevated temperatures by the induction of only one heat shock protein, HSP70, whereas lymphocytes induce the synthesis of all four heat shock proteins (89,000 mol wt, HSP89; 70,000 mol wt, HSP70; 23,000 mol wt, HSP23; and 22,000 mol wt, HSP22). The synthesis of HSP70 in lymphocytes was rapidly induced by small increases in temperature (2 degrees-3 degrees C) and blocked by preincubation with actinomycin D. Proteins normally translated at control temperatures in reticulocytes or lymphocytes were not efficiently translated after incubation at elevated temperatures. The preferential translation of mRNAs that encode the heat shock proteins paralleled a block in the translation of other cellular proteins. This effect was most prominently observed in reticulocytes where heat shock almost completely repressed alpha- and beta-globin synthesis. HSP70 is one of the major nonglobin proteins in chicken reticulocytes, present in the non-heat-shocked cell at approximately 3 X 10(6) molecules per cell. We compared HSP70 from normal and heat-shocked reticulocytes by two-dimensional gel electrophoresis and by digestion with Staphylococcus aureus V8 protease and found no detectable differences to suggest that the P70 in the normal cell is different from the heat shock-induced protein, HSP70. P70 separated by isoelectric focusing gel electrophoresis into two major protein spots, an acidic P70A (apparent pl = 5.95) and a basic P70B (apparent pl = 6.2). We observed a tissue-specific expression of P70A and P70B in lymphocytes and reticulocytes. In lymphocytes, P70A is the major 70,000-mol-wt protein synthesized at normal temperatures whereas only P70B is synthesized at normal temperatures in reticulocytes. Following incubation at elevated temperatures, the synthesis of both HSP70A and HSP70B was rapidly induced in lymphocytes, but synthesis of only HSP70B was induced in reticulocytes. PMID- 6480696 TI - Alternate patterns of doublet microtubule sliding in ATP-disintegrated macrocilia of the ctenophore Beroe. AB - We have used the unique properties of macrocilia from the lips of the ctenophore Beroe to test whether the ciliary beat cycle is caused by sequential activation of doublet sliding on opposite sides of the axoneme (Satir, P., 1982, Soc. Exp. Biol. Symp., 35: 179-201; Sugino, K., and Y. Naitoh, 1982, Nature (Lond.), 295: 609-611; Wais-Steider, J., and P. Satir, 1979, J. Supramol. Struct., 11:339-347). Macrocilia contain several hundred axonemes linked into rows by lamellae between doublets 3 and 8. These connections provide morphological markers for numbering the doublet microtubules in thin sections. Demembranated, detached macrocilia undergo ATP-induced sliding disintegration by extrusion of thick fragments and finer fibers from the proximal end. Disintegration can easily be followed with low-magnification brightfield or phase-contrast optics. Sliding occurs with or without added elastase, and is reversibly inhibited by vanadate. Thin sections through 16 ATP-disintegrated macrocilia showed two mutually exclusive patterns of doublet extrusion with equal frequency. Doublets 9, 1, and 2 or doublets 5, 6, and 7 were usually extruded, but not both groups. We conclude that both subsets of doublets slide by their own active arms, and that the two extrusion patterns represent alternate activation and inactivation of doublet sliding on opposite halves of the axoneme. These findings provide the first direct experimental support for a switching mechanism regulating microtubule sliding in cilia. PMID- 6480697 TI - Identification of two intermediates during processing of profilaggrin to filaggrin in neonatal mouse epidermis. AB - A major event in the keratinization of epidermis is the production of the histidine-rich protein filaggrin (26,000 mol wt) from its high molecular weight (greater than 350,000) phosphorylated precursor (profilaggrin). We have identified two nonphosphorylated intermediates (60,000 and 90,000 mol wt) in NaSCN extracts of epidermis from C57/Bl6 mice by in vivo pulse-chase studies. Results of peptide mapping using a two-dimensional technique suggest that these intermediates consist of either two or three copies of filaggrin domains. Each of the intermediates has been purified. The ratios of amino acids in the purified components are unusual and essentially identical. The data are discussed in terms of a precursor containing tandem repeats of similar domains. In vivo pulse-chase experiments demonstrate that the processing of the high molecular weight phosphorylated precursor involves dephosphorylation and proteolytic steps through three-domain and two-domain intermediates to filaggrin. These processing steps appear to occur as the cell goes through the transition cell stage to form a cornified cell. PMID- 6480698 TI - Adhesive multiplicity in the interaction of embryonic fibroblasts and myoblasts with extracellular matrices. AB - Neff et al. (1982, J. Cell Biol., 95:654-666) have described a monoclonal antibody, CSAT, directed against a cell surface antigen that participates in the adhesion of skeletal muscle to extracellular matrices. We used the same antibody to compare and parse the determinants of adhesion and morphology on myogenic and fibrogenic cells. We report here that the antigen is present on skeletal and cardiac muscle and on tendon, skeletal, dermal, and cardiac fibroblasts; however, its contribution to their morphology and adhesion is different. The antibody produces large alterations in the morphology and adhesion of skeletal myoblasts and tendon fibroblasts; in contrast, its effects on the cardiac fibroblasts are not readily detected. The effects of CSAT on the other cell types, i.e., dermal and skeletal fibroblasts, cardiac muscle, 5-bromodeoxyuridine-treated skeletal muscle, lie between these extremes. The effects of CSAT on the skeletal myoblasts depends on the calcium concentration in the growth medium and on the culture age. We interpret these differential responses to CSAT as revealing differences in the adhesion of the various cells to extracellular matrices. This interpretation is supported by parallel studies using quantitative assays of cell-matrix adhesion. The likely origin of these adhesive differences is the progressive display of different kinds of adhesion-related molecules and their organizational complexes on increasingly adhesive cells. The antigen to which CSAT is directed is present on all of the above cells and thus appears to be a lowest common denominator of their adhesion to extracellular matrices. PMID- 6480699 TI - Asymmetric distribution of the chemotactic peptide receptor on polymorphonuclear leukocytes. AB - The distribution of chemotactic peptide receptors on polymorphonuclear leukocytes (PMNs) was visualized using tritiated chemotactic peptide, N-formylmethionyl leucylphenylalanine, coupled to hemocyanin (HY-FMLP). This probe was biologically active and the number of HY-FMLP molecules bound to the cell in a saturable manner corresponded closely to the number of peptide receptors characterized for rabbit peritoneal polymorphonuclear leukocytes (Sullivan, S. J., and S. H. Zigmond, 1980, J. Cell Biol., 85:703-711). Cells exhibiting locomotion have a polar morphology easily recognized in the scanning electron microscope. HY-FMLP bound to these cells was asymmetrically distributed with the highest density of HY-FMLP bound to the midregion of the cell. There were very few particles bound to the tail regions. The binding to the leading ruffles was variable but usually less than to the midregion. Addition of high concentrations of uncoupled FMLP eliminated HY-FMLP binding, confirming that the hemocyanin observed was a marker for the saturable chemotactic peptide receptor. The asymmetry in receptor distribution was seen on cells that had been stimulated by low concentrations of either FMLP or another chemotactic factor, leukotriene B4. Thus, peptide binding to the receptor was not required for the development of the asymmetric distribution. The low density of receptors in the tail region of the cell was consistent with the decreased responsiveness of the tail to chemotactic stimulation (Zigmond, S. H., H. I. Levitsky, and B. J. Kreel, 1981, J. Cell Biol., 89:585-592). The receptor asymmetry may contribute to the polar behavior exhibited by polymorphonuclear leukocytes and would be expected to quantitatively modify the directional information available to a cell in a gradient of chemotactic peptide. PMID- 6480700 TI - Extracellular matrix organization in developing muscle: correlation with acetylcholine receptor aggregates. AB - Monoclonal antibodies recognizing laminin, heparan sulfate proteoglycan, fibronectin, and two apparently novel connective tissue components have been used to examine the organization of extracellular matrix of skeletal muscle in vivo and in vitro. Four of the five monoclonal antibodies are described for the first time here. Immunocytochemical experiments with frozen-sectioned muscle demonstrated that both the heparan sulfate proteoglycan and laminin exhibited staining patterns identical to that expected for components of the basal lamina. In contrast, the remaining matrix constituents were detected in all regions of muscle connective tissue: the endomysium, perimysium, and epimysium. Embryonic muscle cells developing in culture elaborated an extracellular matrix, each antigen exhibiting a unique distribution. Of particular interest was the organization of extracellular matrix on myotubes: the build-up of matrix components was most apparent in plaques overlying clusters of an integral membrane protein, the acetylcholine receptor (AChR). The heparan sulfate proteoglycan was concentrated at virtually all AChR clusters and showed a remarkable level of congruence with receptor organization; laminin was detected at 70-95% of AChR clusters but often was not completely co-distributed with AChR within the cluster; fibronectin and the two other extracellular matrix antigens occurred at approximately 20, 8, and 2% of the AChR clusters, respectively, and showed little or no congruence with AChR. From observations on the distribution of extracellular matrix components in tissue cultured fibroblasts and myogenic cells, several ideas about the organization of extracellular matrix are suggested. (a) Congruence between AChR clusters and heparan sulfate proteoglycan suggests the existence of some linkage between the two molecules, possibly important for regulation of AChR distribution within the muscle membrane. (b) The qualitatively different patterns of extracellular matrix organization over myotubes and fibroblasts suggest that each of these cell types uses somewhat different means to regulate the assembly of extracellular matrix components within its domain. (c) The limited co-distribution of different components within the extracellular matrix in vitro and the selective immune precipitation of each antigen from conditioned medium suggest that each extracellular matrix component is secreted in a form that is not complexed with other matrix constituents. PMID- 6480701 TI - ATP-induced gelation--contraction of microtubules assembled in vitro. AB - We report here an ATP-dependent formation and contraction, or syneresis, of a microtubule gel using microtubule proteins prepared from calf brains. Gel contraction is typically observable 15-30 min after ATP addition to microtubules assembled to steady state, and is complete after approximately 60 min, at which time the gel volume is reduced by as much as 75%. In contracted gels, microtubule bundles and aster-like structures are observable. Gelation-contraction requires only microtubule proteins present after purification by three cycles of assembly and disassembly. PMID- 6480702 TI - Electrical currents flow out of domes formed by cultured epithelial cells. AB - Domes are localized areas of fluid accumulation between a cultured epithelial cell monolayer and the impermeable substratum on which the cells are cultured in vitro. Dome formation has been documented in a variety of epithelial cell lines that retain their transepithelial transport properties in vitro. However, it is not known whether domes are predominantly areas of specific active transport, or, alternatively, are predominantly areas of relative weak attachment to the culture surface. In the present study we adapted a vibrating microelectrode, which can detect small currents flowing in extracellular fluid, to determine if current was flowing into or out of domes and thereby to determine if domes were specialized areas of active transport. We used alveolar type II cells as the main epithelial cell type because they readily form domes in vitro and because they transport sodium from the apical to the basal surface. We found that electrical current flowed out of domes. The direction of the current was independent of the size of a dome, of the age of an individual dome, and of the number of days in primary culture for alveolar epithelial cells. This current was inhibited by amiloride and ouabain and was dependent on sodium in the medium. We made similar observations (outward current from domes which is blocked by amiloride and by sodium substitution) with domes formed by the Madin-Darby canine kidney cell line. The data support the hypothesis that sodium is transported across the entire monolayer and leaks back mainly through the domes. We conclude that domes in epithelial monolayers are not predominantly special sites of active transport but are more likely simply areas of weak attachment to the substratum. PMID- 6480704 TI - Abstracts of papers presented at the twenty-fourth annual meeting. The American Society for Cell Biology. Kansas City, Missouri, 12-16 November 1984. PMID- 6480703 TI - Endothelial cell mitogens derived from retina and hypothalamus: biochemical and biological similarities. AB - Bovine retina and hypothalamus contain anionic endothelial cell mitogens that display unusual affinities for the negatively charged glycosaminoglycan heparin. Both growth factor activities are acidic polypeptides (pl's of 5.0) as determined by isoelectric focusing and DEAE-affinity chromatography. In spite of their anionic nature, the factors bound to heparin-Sepharose columns with high affinity and could be eluted only at high salt concentrations (0.9-1.1 M NaCl). The affinity of the retina-derived growth factor (RDGF) for heparin permitted a 15,000-fold purification of the mitogen in two steps: heparin-affinity chromatography and size exclusion high-performance liquid chromatography. RDGF and the anionic hypothalamus-derived factor (aHDGF) exhibit three major biochemical similarities including isoelectric point, (pl's of 5.0), heparin affinity (elution at 0.9-1.1 M NaCl) and molecular weight (18,000). Additionally, the two factors display similar biological activities, stimulating the proliferation of capillary and human umbilical vein endothelial and 3T3 cells but not vascular smooth muscle cells. We suggest that RDGF and aHDGF are related if not identical growth factor molecules. PMID- 6480705 TI - Kinetics of clonogenic melanoma cell proliferation and the limits on growth within a bilayer agar system. AB - Accurate descriptions of the kinetics of cell growth in semi-solid agar clonogenic systems have been difficult because the number of cells in colonies of different sizes is largely unknown. We stained and removed tumor cell colonies from agar, directly counted their cells, and established equations to quantitate the number of cells within colonies of different sizes. We used these equations to quantitate, in terms of cell number and volume, the total amount and kinetics of clonogenic cell proliferation from biopsies of human melanoma and cell lines of several different tumor types. Daily observations of cells in agar and serial photography indicated a 0- to 4-day delay in the onset of proliferation in agar followed by rapid growth and then abrupt cessation of proliferation. We quantified the extent of proliferation of cells from melanoma biopsies of seven patients and 11 cell lines after they were allowed to proliferate in agar until they stopped. Approximately 10% of cells divided one to five times while only 0.01% divided six to nine times. The total number of cells within the colonies at the end of growth was different while the total volume of cells within the colonies per plate was similar; approximately 10(9) microns 3 cellular volume per plate represents an upper limit for proliferation within the closed, nonrefed bilayer agar system. Previous replating studies using the same biopsy cells have shown that clonogenic melanoma cells can self-renew and have more proliferative capacity than that expressed during primary colony formation. Thus, the clonogenic assay only measured initial proliferative capacities. Furthermore, variable delays in the onset of proliferation may contribute to the heterogeneity of colony size within clonogenic assays. PMID- 6480706 TI - Characterization of monovalent ion transport systems in an insect cell line (Manduca sexta embryonic cell line CHE). AB - The monovalent ion transport systems of an immortalized insect cell line (CHE) have been investigated. These cells are unusual in that unlike most vertebrate cells, their normal extracellular environment consists of high potassium and low sodium concentrations. CHE cells maintained high intracellular [K+] through both a furosemide-inhibitable and a vanadate-inhibitable transport system. Intracellular exchangeable [Na+] was slightly lower than the extracellular [Na+] and was maintained at this level through a vanadate-sensitive transport system. Na+ uptake was also inhibited by furosemide: however, the stoichiometry of furosemide-sensitive Na+ uptake when compared with furosemide-sensitive K+ uptake indicated that these cations are not cotransported. 4,4'-Diisothiocyano-2,2' disulfonic acid stilbene (DIDS) inhibited Na+, K+, and Cl- uptake. Vanadate and furosemide decreased cytoplasmimic pH, while cytoplasmic pH increased in the presence of DIDS. A model is presented explaining how Na+, K+, Cl-, H+ and HCO3 fluxes are regulated in these cells. PMID- 6480707 TI - Release of endothelial cell-derived growth factor (ECDGF) by heparin. AB - Endothelial cells in vitro produce potent growth-promoting activities collectively known as endothelial cell-derived growth factor (ECDGF). These mitogens (including platelet-derived growth factor [PDGF]-like and non-PDGF-like species) support DNA synthesis and proliferation of smooth muscle cells and fibroblasts in the absence of other defined mitogens. The current study examines interaction of heparin and heparin-related polysaccharides with bovine aortic endothelial (BAE) cells and the levels of secreted growth-promoting activity. Heparin, dextran sulfate, and carageenan rapidly release non-PDGF-like ECDGF from BAE cell monolayers. The effective heparin concentrations closely correlate with amounts of exogenous 3H-heparin required for maximal binding to BAE cells. Both heparin binding and ECDGF release occur independently of incubation temperature. Inhibition of heparin binding by dextran sulfate and carageenan and the lack of inhibition by dextran, chondroitin sulfate, and dermatan sulfate imply a high degree of specificity of the interaction. In contrast to quiescent monolayers of BAE cells, migrating cells release lower levels of growth-promoting activity, and no ECDGF is released in response to heparin, although migrating cells bind the same levels of 3H-heparin as confluent monolayers. Partial characterization of the endothelial cell released mitogens indicates that the non-PDGF-like mitogen is associated with endothelial cell surfaces in contrast to the apparent constitutive release of PDGF-like mitogens. These results indicate that endothelial cells modulate production and release of specific mitogens in response to growth state. PMID- 6480708 TI - Amino acid activation of amino acid transport System N early in primary cultures of rat hepatocytes. AB - System N, a neutral amino acid transport system characterized in rat hepatocytes, shows significant changes in activity during the first 24 hr of primary culture (Weissbach, L., Handlogten, M.E., Christensen, H.N., and Kilberg, M.S. [1982] J. Biol. Chem. 257:12006-12011). Experiments presented in the present report demonstrate that during the first 12 hr of primary culture System N can be stimulated by individual amino acids in the culture medium by a cycloheximide insensitive mechanism. This enhanced activity results from an elevation in the Vmax of the transport system, and the magnitude of the increase is related to the concentration of the amino acid in the culture medium. Nonsubstrates as well as substrates of System N are effective, and trans-stimulation does not appear to play a role in this phenomena. Transport by Systems ASC, Gly, and L is enhanced by the presence of amino acids in the culture medium, but these systems are significantly less sensitive than System N. The results suggest that amino acids act at a posttranslational step to activate System N activity. PMID- 6480709 TI - Temperature-dependent transmembrane potential changes in cells infected with a temperature-sensitive Moloney sarcoma virus. AB - Normal rat kidney cells (NRK) infected with the temperature-sensitive (ts) transformation mutant of Moloney murine sarcoma virus yielded a clone of cells, 6m2, that exhibited a transformed morphology at 33 degrees C and a normal morphology at 39 degrees C. Transmembrane potential (Em) was measured fluorometrically using a cyanine dye diS-C3-(5). Fluorescence was inversely correlated with Em. Cells at 33 degrees C had lower Em. Em changes were recorded within 15 minutes of temperature shift from 33 degrees C to 39 degrees C in both directions, increasing in the 33 degrees C to 39 degrees C direction and decreasing in the 39 degrees C to 33 degrees C direction. Uninfected NRK cells when shifted under the same condition exhibited small fluorescence changes in the 33 degrees C to 39 degrees C direction. Shifting from 39 degrees C to 33 degrees C resulted in Em changes similar to those in 6m2 cells. Also studied was a cell line infected with a spontaneous revertant of the ts mutant, designated 54-5A4; it was transformed at both temperatures. Shifting from 33 degrees C to 39 degrees C in both directions yielded small changes. Transmembrane potential changes in 6m2 cells precede other transformation-specific changes that occur after a temperature shift. PMID- 6480710 TI - Factors affecting the generation of mast cells from multipotential colony-forming cells. AB - The cells responsible for the long-term in vitro generation of murine mast cells have been examined. Sequential analysis of all colony types obtained from cultures of spleen or bone marrow cells showed that only colonies derived from multipotential cells (mixed-erythroid colonies) or mast cell progenitors, contained cells responsible for mast cell generation in liquid cultures. Primary colony growth and subsequent maintenance of mast cells in liquid cultures was dependent upon pokeweed mitogen-stimulated spleen cell-conditioned medium (SCM). Mixed-erythroid colonies from 14-day cultures of spleen cells had the greatest capacity for mast cell generation. Analysis by clone splitting and transfer to high (20%) and low (2.5%) concentrations of SCM showed that the concentration of SCM used in either the primary colony culture or subsequent liquid culture phase altered both the proliferative capacity of the mast cells generated and the frequency of mast cell progenitors within individual mixed-erythroid colonies. Thus, mixed-erythroid colonies stimulated with 2.5% SCM contained the highest proportion of mast cell progenitors (34% of colonies) and when stimulated with 20% SCM, approximately fourfold higher numbers of mast cells were produced at weekly intervals from liquid cultures maintained in 2.5% SCM compared to parallel liquid cultures containing 20% SCM. These studies confirm the hemopoietic origin of mast cells and demonstrate that a factor(s) in SCM is able to modulate their proliferative potential. PMID- 6480711 TI - Effects of temperature on aggregation and the mitogen-induced exit of lymphocytes from the resting state. AB - We have determined the temperature dependence of the kinetics of entry into the first S phase of phytohemagglutinin-stimulated lymphocytes under conditions varying the stability of substrata over which the cells have settled. An exponential model was used to characterize entry into S phase. This model yields as parameters duration of lag period, t0, apparent first order rate constant for entry, k, and the number of cells committed to enter the first S phase, NA(t0). Values of t0 and NA(t0) show a 1.5-fold and 2.0-fold decrease and increase, respectively, over a 4 degrees C temperature range and are independent of variation in substrate stability. The temperature dependence of the apparent first-order rate constant, k, however, is strongly influenced by stability. The observed activation energy increases from 3.0 kcal to 37 kcal when the substratum is agitated. This correlates well with reduced adherence of multicellular aggregates in agitated samples. The temperature dependencies for these three parameters are all numerically different, indicating that these parameters are determined by different rate-limiting processes. We propose that the mechanism mirrored by k is linked to the adherence of multicellular aggregates to the substratum. PMID- 6480713 TI - Transmembrane potential and intracellular potassium ion activity in fetal and maternal liver. AB - We have compared transmembrane potentials (Em) of maternal liver with Em of fetal liver, and as an initial step to account for differences in Em, we have measured intracellular potassium ion activities (aiK) in both tissues. Paired segments of maternal and fetal (day 17) mouse liver were suffused (15 ml/min) with Krebs' physiologic salt solution equilibrated with 95% 02-5% CO2 (pH 7.3-7.4) at 37 degrees C. To measure Em, cells were impaled with open-tip microelectrodes filled with 0.5 M KCl. Intracellular voltage recordings that were stable +/- 2 mV for at least 10 s were considered valid impalements. Maternal liver mean Em = -41 +/- 1 (SEM) mV, n = V 10 animals. In contrast, fetal liver mean Em = -23 +/- 1 (SEM) mV, n = 10 animals. In the same segments we measured aiK with potassium-selective liquid ion-exchanger microelectrodes. Maternal liver mean aik = 95 +/- 7 (SEM) mM and fetal liver mean aiK = 62 +/- 4 (SEM) mM. in addition, Em and aiK of fetal liver increased to values comparable to those of maternal liver during the first 8 days of neonatal life. The differences of Em and aik between fetal and maternal liver, and the changes in these values that occur in the neonate, may result from activity of a membrane Na-K exchange pump that increases with tissue development. PMID- 6480712 TI - Effects of inhibitors of protein degradation on the rate of protein synthesis in Chinese hamster ovary cells. AB - In the absence of serum and amino acids, cultured Chinese Hamster Ovary cells released to the medium two thirds of the leucine produced by protein degradation. Because protein synthesis requires all the amino acids, the loss of leucine implies incomplete reincorporation of the other amino acids as well. Leupeptin (0.45 mg/ml) and chloroquine (up to 40 microM) inhibited protein breakdown by 21 and up to 41%, respectively, and resulted in proportional decreases in protein synthesis. Chloroquine abolished the stimulation of protein breakdown by amino acid deprivation. From the values of protein synthesis and leucine output with and without chloroquine, it is estimated that the stimulation of protein degradation not only permitted continuing protein synthesis but also increased amino acid output. In the presence of serum or amino acids protein breakdown was slower than in their absence and less sensitive to inhibition by chloroquine, but proportional effects on synthesis and degradation were still observed. It is suggested that protein degradation may be necessary for the maintenance of optimum intracellular concentrations of amino acids even in the presence of extracellular amino acids. PMID- 6480714 TI - Serum and substratum-dependent coupled loss of differentiated and tumorigenic phenotypes in B16-conv melanoma cells. AB - Clonal B16 mouse melanoma conv cells are tumorigenic spindle-shaped cells (S-type cells) exhibiting tyrosinase activity and melanosomes under usual culture conditions. When the cells passaged on glass substratum were plated for colony formation on plastic substratum in Eagle's minimum essential medium (MEM) with 10% calf bovine serum, most of them converted to fibroblastlike cells (F-type cells) with the coupled loss of differentiated and tumorigenic phenotypes. However, they continued to be S-type cells provided that they were plated on glass substratum. The conversion from S- to F-type cell was not induced with high frequency even on plastic substratum when the concentration of calf serum in the medium was low (1-2%). These results indicate that both plastic substratum and serum factor are requisites for converting the phenotypic expression of the conv cells. Partial characterization of the serum factor indicates that it is adsorbable to plastic substratum, inactivated at 70 degrees C for 10 min, salted out at 40% of saturated ammonium sulfate; in addition the factor seems to act on cells within 1 day after plating. PMID- 6480715 TI - Effect of hyperosmolarity on the activity of amino acid transport system L in avian fibroblasts. AB - The transport of selected neutral amino acids known as good substrates of amino acid transport System L has been studied in chick embryo fibroblasts exposed for 4 hours to hyperosmolar culture medium. The activity of the L system, as measured by initial rates of L-phenylalanine uptake, increased in hyperosmolarity treated cells when determined before any cell depletion of intracellular amino acids. This effect was lost after depletion but reappeared after reloading the cells with pertinent substrates of System L. This transport activity appeared to be related to the internal level of amino acids capable of exchange through System L. In hyperosmolarity-treated chick embryo fibroblasts a higher level of System L substrates was obtained during the reloading phase in comparison to control cells. This expanded amino acid pool reflected an increased activity of transport System A, an agency of amino acid mediation known to enlarge its capacity following a hyperosmolar treatment of chick embryo fibroblasts (see Tramacere et al., 1984). L-Methionine, a preferred substrate of both A and L systems, appeared to be involved in the coupling between the activity of amino acid transport Systems A and L in these cells. PMID- 6480716 TI - A requirement for cholesterol and its structural features for a human macrophage like cell line. AB - The lipid requirements of a human macrophagelike cell line were studied. The cells grew only about one generation in a medium supplemented with delipidated serum; during the growth the cholesterol content of the cells was depleted. Growth was restored by including in the medium serum lipids subjected to alkaline hydrolysis or cholesterol. The extent of growth was dependent on cholesterol concentration. No growth was obtained with 5-cholestene, 5-cholesten-3-one, cholesteryl chloride, coprostanol, beta-sitosterol, or stigmasterol. Very limited growth occurred with cholesterol methylether, epicholesterol, or beta cholestanol. Therefore, for optimal growth of these cells there is a stringent requirement for the structural features of cholesterol, which include a 3-beta OH group, a delta 5-double bond, a trans ring A/B configuration, and freedom of the side chain from bulky groups. This stringency far exceeds what was previously reported for other cells. Of the six sterols that failed to support growth at all, five were incorporated into cells moderately to extensively. This suggests that assembly of a functional membrane is impaired when these sterols are used as substrates for growth. PMID- 6480718 TI - Information requirements for chemists in the pharmaceutical industry. AB - The principal information needs of chemists in the pharmaceutical industry center around a substance, methods used for its characterization, its reactions, its physicochemical and biomedical properties, and its metabolic fate in biological media. Novelty searches for a specific chemical are critical because of the need for patent protection for product candidates. Chemical relatives are important, necessitating substructure searching. Therapeutic neighbors may give insight into its biological mode of action. The phases of drug discovery and development are used to indicate the diversity of the information needs of chemists and to emphasize the dual process of generation and use of information. PMID- 6480717 TI - Kinetic analyses of the membrane-bound alkaline phosphatase activity of hymenolepis diminuta (Cestoda: Cyclophyllidea) in relation to development of the tapeworm in the definitive host. AB - The specific activities of the alkaline phosphatase (APase), type I phosphodiesterase and 5'-nucleotidase activities associated with the brush-border plasma membrane of the tapeworm, Hymenolepis diminuta, decrease significantly as the tapeworm grows and matures. Kinetic analyses of the APase activity associated with membrane preparations from whole 6-, 12-, and 18-d-old H diminuta, and individual pieces of 18-d-old H diminuta cut into ten pieces of equal length, failed to demonstrate qualitative changes in the APase activity. Therefore, the decreased specific activities are apparently due to changes in the ratios of enzymatically active to enzymatically inactive membrane proteins (ie, quantitative changes in the membrane proteins) which occur as the tapeworm grows. PMID- 6480719 TI - [Surgical treatment of cancer of the cardia]. AB - Adeno-carcinoma of the cardia corresponds to an accurate definition. During a period of 20 years we have operated on 114 such tumours, and resected 88 of them, 44 by esophageal and proximal gastric resection (group I), and 44 by esophageal and total gastric resection (group II). The resection rate was 77%. Hospital mortality was 20 p. cent in group I and 27 p. cent in group II. There were 1 T1, 8 T2 and 77 T3 (on 86 specimens); 14 p. cent of tumour invasions were observed on the esophageal section (18 p. cent in group I, 9 p. cent in group II); 90 p. cent had lymphatic nodes invasion. Five year's survival was nil in group I, 5 patients survived in group II. Five year's cure can be obtained only in stages I et II (NO MO or NI MO) with total gastrectomy associated with omentectomy, lymphatic curettage of the three coeliac chains, resection of 8 cm of esophagus, and mediastinal lymphatic curettage. When the condition of the patient is poor, or for more evolved stages, proximal gastric resection associated with terminal esophagectomy is the best palliative treatment. PMID- 6480720 TI - [Femorotibial bypass. Apropos of 106 consecutive cases]. AB - Tibiofemoral bypass operations were performed in 106 patients with stage III or IV lower limb arterial insufficiency. Follow-up has been for from 1 to 14 years. Results of arteriography, the operative technique used and the choice of bypass material (which should be the internal saphenous vein for preference) are discussed. Permeability was still present in 73% of cases after one year, 66% after 3 years, 62% after 5 years and 57% after 10 years. The incidence of amputation was less than that of obstructed by-passes. Treatment failures are analyzed as a function of the distal network, i.e. the receiving artery, and as a function of distal lesions and material employed. Confirmation was obtained of the superiority of autologous venous bypass material, taking into account the negative selection in cases with a prosthetic shunt. A lower limb with arterial insufficiency and menaced with amputation can often be saved, even when arterial lesions extend beyond the popliteal segment. PMID- 6480721 TI - [Rectal adenocarcinoma in adults under 35 years of age. Apropos of 37 cases]. AB - Minimum follow up of 37 cases treated at the "Institut Gustave-Roussy (IGR)" over the last 10 years has been for more than 23 months. Twenty-three of these patients had been treated entirely by the IGR using surgery and radiotherapy (45 to 60 Gy). Excision was curative in 13 cases and palliative in 10. Several conclusions can be drawn: The relative frequency in inhabitants of mediterranean countries (particularly North Africa and Italy where this cancer is respectively 15 ans 17 times more frequent than in young Frenchmen) and in women; the absence of obvious predisposing factors; the frequency of mucosal colloid forms (57%), and the extent of the lesion at diagnosis (60%, of Dukes C2 and 20% of Dukes D) even when there was no delay between first symptoms and diagnosis; and the 2-year survival (45%) in the patients treated in the IGR alone, whereas it is 75% for the 285 patients over 35 years of age. Early diagnosis, including in young adults, is essential, as well as immediate radical surgery and radiotherapy. PMID- 6480722 TI - [Enteroid cyst of the spleen: a new entity? Apropos of 2 cases]. AB - The authors describe two cases of non parasitic cyst of the spleen of "enteroid" origin on histological examination. No similar cases have yet seen described in the medical literature that we consulted. The histology of these two cases is quite unusual in that cysts are multilocular and mucoid with a cylindrical mucus secreting epithelium similar to cystic tumours of the ovary. The outcome of the first case remains favorable four years after surgery. As in the case of mucoid or enteroid cyst of the ovary, a disembryological origin seems the most likely explanation of these cyst of the spleen. PMID- 6480723 TI - [Reconstructive microsurgery of the deferens duct. Experimental study of suture material]. AB - The choice of optimal suture material for reconstructive microsurgery of the deferens duct was investigated in the rat. The study was performed on normal deferens ducts and those dilated by proximal ligatures. The absorbable thread (10.0) studied provided a more satisfactory morphological and functional result than a non-absorbable single-filament thread of identical caliber. These findings suggest that this material should be used in clinical practice. PMID- 6480724 TI - [Surgery of arteritis in patients over 70 years of age]. AB - Case reports of 176 patients from a total of 385 operated upon for arteritis, and in the over 70 age group, were analyzed; operations for sympathectomy and to treat ruptured aortic aneurysms were excluded from the study. Of particularly poor prognosis were cases of acute ischemia and very severe ischemia requiring immediate amputation. In a general manner, amputations were of poor prognostic significance: in comparison, reconstructive surgery resulted in a lower mortality rate. Figures for mortality as a function of age showed that recovery surgery is often possible in patients of 80 or over. Moderate-term results were good in from 55.5% to 80.9% of cases as a function of type of operation performed. Continued progress during the 5-year period covered by this study has led to diminished mortality and a reduction in the number of amputations necessary. PMID- 6480725 TI - [Value of revascularization of the hypogastric artery in chronic vascular disorders of the lower limbs. Personal experience with 200 cases]. AB - Physiopathological studies combined with clinical experience have stimulated renewed interest in the hypogastric artery, a true circulatory center for the lower limbs but also a "spare wheel" in case of failure of aortofemoral revascularization. For these reasons it is considered that as with the deep femoral arteries the direct reestablishment of the hypogastric arteries should be a desired objective. To support this opinion, results of 200 direct revascularizations of the internal iliac artery are reported. These were conducted during aorto-ilio-femoral restoration, and the technique is now well established: either thrombo-endarterectomy (41% of cases); prosthetic by-pass (51% of cases) or exceptionally reimplantation (8% of cases). PMID- 6480726 TI - [Duodenal duplications in adults. Apropos of 3 cases]. AB - Duodenal duplication is a rare congenital malformation and it is quite exceptional for it to be discovered in adult life. Three recently observed cases are discussed and used as a basis for reviewing diagnostic and surgical therapeutic problems. Pathology provides confirmation of diagnosis. PMID- 6480727 TI - Paradoxical techniques in therapy. PMID- 6480728 TI - Lead and children's health--recent research and future questions. PMID- 6480729 TI - Extreme deprivation in early childhood--I. Diverse outcomes for three siblings from an extraordinary family. AB - An unusual family is described which has been studied for several years. Accounts are given of the later development of two sisters who had suffered severe social and emotional deprivation in infancy. One girl appears to have completely recovered. The other remains handicapped, mainly in language skills, and shows a variety of autistic features. She is also microcephalic as is their mother. The development of a half brother who was raised elsewhere is recounted. He is an albino, severely mentally retarded and autistic. The later discrepancies in development of these children are discussed, with reference to former case studies of extreme deprivation in early childhood. PMID- 6480730 TI - Extreme deprivation in early childhood--II. Theoretical issues and a comparative review. AB - Five previously published and one novel case history of children who suffered extreme deprivation in early childhood are reviewed. Aspects of cognitive, emotional and social development are subject to critical appraisal and three main issues, central to theories about the origins of developmental disorders, are addressed. Firstly, what minimal experiences during childhood are sufficient and necessary for normal psychological development? Secondly, are there critical periods in development during which inadequate exposure to certain experiences has long-lasting or permanent sequelae? Thirdly, what minimal compensatory influences are necessary to alleviate psychological handicaps resulting from an adverse early environment? PMID- 6480731 TI - Perinatal, neurological, environmental and developmental characteristics of seven year-old children with stable behaviour problems. AB - From a large sample of 7-yr-olds in Dunedin, New Zealand, a group of 52 boys and 32 girls with stable behaviour problems was selected and compared with the remainder of the sample. The groups did not differ in terms of perinatal problems except for a higher prevalence of being small for gestational age in the problem group. The mothers of the problem children tended to be younger, to have lower mental ability and poorer health than the rest of the sample. The families of the problem children were rated as having poorer relationships, and there was more parental separation and solo parenting in this group. Finally, the children with stable problems showed cognitive delays at age 7 yr. PMID- 6480732 TI - The relationship of activity level ratings and cognitive impulsivity to task performance and academic achievement. AB - The relationship of activity level ratings and cognitive impulsivity were analyzed in relation to performance of second-graders on several cognitive tasks and standardized achievement tests. Vocabulary was a strong and significant covariate on most dependent measures. In general, impulsivity-reflectivity had a far stronger effect on task performance and academic achievement than did activity level ratings, even when comparisons were made for groups with extremes of activity level ratings. The authors urge further research on the task approaches and compensatory strategies of children who are behaviorally hyperactive but cognitively reflective and academically successful. PMID- 6480733 TI - Aggressive and prosocial behaviours before and after treatment in conduct disordered children and in matched controls. AB - Aggressive and prosocial behaviours and responses to prosocial acts were examined in groups of conduct-disordered and normal children. The observations were repeated following therapeutic intervention. Before treatment, the clinic groups displayed greater levels of peer-directed aggression and responded inappropriately to social overtures. Following intervention, both clinic groups showed improved responsiveness to their peers' social overtures and the older clinic children reduced their aggression while the younger children did not. Independent evaluations of each child's medical file and case disposition revealed that the observational data served as a sensitive index of the status of the two clinic groups. PMID- 6480734 TI - Realising you don't understand: a further study. AB - Comprehension monitoring skills of younger (5- to 6-yr-old) and older (8- to 9-yr old) children were compared. Children examined ambiguous and incomplete pictorial instructions as to how to make two models, and were asked whether there was anything else they would need to know in order to make the models. Questions were answered, and their oral instructions recorded. Both age groups were equally likely to judge the instructions to be incomplete, but the younger children were apparently less able to recognise their lack of understanding. Differences found were taken as evidence of more active and detailed processing of the instructions by the older children. PMID- 6480735 TI - Effects of rapid urbanisation on child behaviour and health in a part of Khartoum, Sudan. AB - A study of child behaviour and health in a newly urbanised part of Khartoum was carried out in 1979-1980 on 245 children aged 3-15 yr. The same area had been investigated in 1965. Results show improvement in somatic health in older children. Behavioural symptoms increased more in boys than in girls, and more in older than in younger children, probably in proportion to the extent of their exposure to new external influences. In general there were still fewer behavioural problems in this population than has been reported from other developing and developed countries. Favourable aspects of community life still operating include extended family relations, durable marital commitments and mutually supportive communal interdependence and traditions of social control. PMID- 6480736 TI - Short communication: effects of environmental enrichment on the mental and psychomotor development of orphanage children. AB - A group of orphanage-reared children received extra interaction in 5-min daily sessions for 6 weeks. Their mental and psychomotor development (Bayley Scales) were compared to a matched group of infants who were subject to routines at the institution during the same period. Between-group comparisons revealed improved scores for the experimental group. Within-group comparisons indicated that the experimental group had a greater rate of improvement from pre- to post-test than the control group. The differences were present to some extent after a 6-month follow-up. Theoretical and policy implications are discussed. PMID- 6480737 TI - Purification of bovine rhodopsin by high-performance size-exclusion chromatography. AB - Bovine rhodopsin was purified from n-octylglucoside-solubilized retinas by high performance size-exclusion chromatography. In one chromatographic step, six protein fractions were separated with baseline resolution. The major fraction was identified as monomeric rhodopsin by absorption spectroscopy. Amino acid analysis of this fraction further supported the assignment. A comparison of the elution profiles of rhodopsin purified by this method with that purified by Concanavalin A-Sepharose 4B affinity chromatography suggested that rhodopsin from high performance chromatography was slightly purer than the conventionally purified rhodopsin. PMID- 6480739 TI - Isolation of a proform of porcine secretin by ion-exchange and reversed-phase high-performance liquid chromatography. AB - A polypeptide with secretin-like bioactivity has been isolated from upper small intestinal porcine tissue by ion-exchange and reversed-phase high-performance liquid chromatography (HPLC). The purification was followed by determination of biological activity. Its elution position in the ion-exchange HPLC indicated that it was less basic than secretin. Amino acid analysis showed that it contained an additional glycine residue as compared to secretin. Digestions by trypsin and subtilisin established that the polypeptide was a variant form of secretin in which the previously known secretin is extended C-terminally by a glycine residue. PMID- 6480738 TI - Micropreparative protein purification by reversed-phase high-performance liquid chromatography. AB - Micropreparative purification of the four subunits of phosphorylase kinase (molecular weights 16,680, 43,000, 113,000 and 132,000) by reversed-phase high performance liquid chromatography has provided quantities sufficient for some of the first structural studies of these proteins. The best yield from a 25 X 0.46 cm I.D. column was obtained on a packing material (5-microns C18) bonded under conditions resulting in a relatively low ligand density; of a total 250 micrograms of protein applied, 76% was recovered. Low recoveries from 5-30 micrograms sample loads suggest partial irreversible adsorption. Retention of protein by the column after an initial micropreparative separation adversely affects resolution and recovery on subsequent separations. Incorporation of gradient wash steps between sample injections was necessary to maintain column performance and to prolong usable column lifetime. The use of a short column with a large diameter (6 X 1 cm) gave increased loading capacity above 400 micrograms protein and enhanced recovery while maintaining good resolution. A less expensive reversed-phase support (17-micron C18) provided adequate resolution for this separation. PMID- 6480740 TI - Retention model for proteins in reversed-phase liquid chromatography. AB - This paper presents a retention model for proteins on an reversed-phase chromatography support in which retention is a function of the number (Z) of solvent molecules required to displace the solute from the surface. An equation is derived that relates the capacity factor of a protein to the displacing agent concentration and the stoichiometry of solvent-solute displacement. Experimental tests of the model indicate that each protein has a unique Z value and that Z is directly proportional to the molecular weight of a series of proteins when 60% formic acid is used as the mobile phase additive. This relationship is attributed to a direct relationship between Z and the contact surface area between polypeptide solutes and the support. Desorption curves for proteins also become more convex with increasingly molecular weight, as predicted by the retention model. In the solvent series of methanol, ethanol, propanol, the Z number decreases from the C1 to C3 alcohol. The Z number for any particular solvent is also related to other mobile phase additives, such as acids, and the concentration of additives. PMID- 6480741 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LVII. Analysis of radioiodinated thyrotropin polypeptides by reversed-phase high performance liquid chromatography. AB - The chromatographic behaviour of bovine and human thyrotropin, radiolabelled stoichiometrically with lactoperoxidase, on octadecylsilicas and other reversed phase n-alkylsilicas has been investigated. As part of this investigation the effects of a variety of elution systems on resolution and recovery have been examined. Analysis of the tryptic peptides of radioiodinated bovine thyrotropin (bTSH) preparations by reversed-phase high-performance liquid chromatographic mapping methods resulted in the separation of more than fourteen major radioactive peptide components. The data indicate that bTSH is radioiodinated with unequal incorporation into both the alpha- and beta-subunits. Further, assessment of the level of microheterogeneity of radiolabelled bTSH preparations can be achieved with these reversed-phase techniques. PMID- 6480742 TI - Ion-exchange, gel-filtration and reversed-phase high-performance liquid chromatography in the isolation of neurotensin-degrading enzymes from rat brain. AB - Brain and pituitary peptidases involved in the metabolism of neurotensin were identified by ion-exchange (TSK-545 DEAE) and gel-filtration (TSK-G4000 SW) high performance liquid chromatography (HPLC). Reversed-phase HPLC on radial compression cartridges was used in a rapid assay of neurotensin-hydrolysing activity in column fractions and at the same time the bond specificity of the activity was determined. Semipreparative isolation of the major enzyme which cleaves neurotensin at Arg8-Arg9 was carried out and some of its characteristics were determined. PMID- 6480743 TI - Isolation of thrombospondin released from thrombin-stimulated human platelets by fast protein liquid chromatography on an anion-exchange Mono-Q column. AB - Thrombospondin, a glycoprotein found in human platelet alpha granules, is thought to play a major role in platelet haemostatic functions. A rapid method to isolate thrombospondin for functional and structural studies was developed. Freshly prepared supernatants from thrombin-stimulated platelets were separated on an anion-exchange Mono-Q column on a fast protein liquid chromatography system. Detection of thrombospondin in the eluted peaks was performed using sodium dodecyl sulphate-polyacrylamide gel electrophoresis combined with silver staining and a solid-phase radioimmunoassay with monoclonal antibodies directed against thrombospondin and other platelet granule glycoproteins. Thrombospondin was isolated rapidly to a high degree of purity using the fast protein liquid chromatography Mono-Q system (20 min), compared with the time taken with other techniques. PMID- 6480744 TI - Isolation of influenza viral proteins by size-exclusion and ion-exchange high performance liquid chromatography: the influence of conditions on separation. AB - Constituent proteins of influenza virus and of vaccines containing whole virus or viral antigens (surface antigen vaccines) have been separated by size-exclusion high-performance liquid chromatography. Preparations of whole virus have also been examined by high-performance anion-exchange chromatography. The separations are influenced by the conditions employed and, in particular, by the nature of detergent used to disrupt the virus and that incorporated in the eluting solvent. Individual proteins are recovered with retention of immunological activity. The method is applicable to small portions of a single human dose of vaccine. PMID- 6480745 TI - Methodology for purification of large hydrophobic peptides by high-performance liquid chromatography. AB - To aid in structural studies of pig cardiac myosin light chains (L27 and L28), a procedure of ion-exchange chromatography (IEC) on Trisacryl M (noted for its high capacity) in combination with reversed-phase high-performance liquid chromatography (RP-HPLC) and volatile buffers has been developed. In contrast with other IEC methods (resins or HPIEC), the use of Trisacryl M facilitates subsequent peptide purifications by RP-HPLC. The advantage of the present combination of techniques is also that it enables the isolation of hydrophobic peptides in high yield, e.g., the N-terminal chymotryptic peptide from L27 was thus purified and, after sub-digestion with trypsin, its sequence has been established. PMID- 6480747 TI - Biologic activity of human chorionic gonadotropin following reversed-phase high performance liquid chromatography. AB - Human chorionic gonadotropin (hCG) was analyzed by reversed-phase high performance liquid chromatography (HPLC) using mobile phases previously described in the literature, as well as newly developed solvent systems. Fractions of hCG collected following reversed-phase HPLC were bioassayed by activation of adenylate cyclase to determine their biologic potencies. hCG retained only 10-60% of its biologic activity following reversed-phase HPLC, depending on the chromatographic conditions employed. A portion of the reduced biologic activity was attributed to dissociation of the alpha- and beta-subunits of hCG at the low pH of the mobile phases, since neutralization of the pH prior to lyophilization and bioassay increased the biologic potency of the chromatographed hormone. The remaining loss in biologic activity is presumably due to organic solvent denaturation. PMID- 6480746 TI - Determination of pseudouridine in tRNA and in acid-soluble tissue extracts by high-performance liquid chromatography. AB - A high-performance liquid chromatographic method to measure pseudouridine and other nucleosides in hydrolyzed unfractionated tRNA and in acid soluble tissue extracts is described. The method is based on the following steps: tRNA extraction and hydrolysis by a mixture of ribonuclease A, snake venom phosphodiesterase and bacterial alkaline phosphatase; nucleoside purification (in the case of acid soluble tissue extract) by affinity chromatography on a phenyl boronate gel column; nucleoside separation and quantitation by high-performance liquid chromatography on an octadecylsilane column by a reversed polarity gradient elution. The procedure allows a very accurate quantitation of pseudouridine and some other nucleosides, and its sensitivity is such that only 20 micrograms of tRNA are required. The method has been utilized to compare the pseudouridine content of hydrolyzed tRNA extracted from normal and lymphomatous murine thymus, as well as the pseudouridine content in acid soluble extracts from the same tissues. PMID- 6480748 TI - High-performance liquid chromatographic-amperometric determination of naloxone hydrochloride injection. AB - Naloxone hydrochloride has been measured in the injectable dosage form at 0.4 and 0.02 mg/ml using high-performance liquid chromatography with amperometric detection. This method was contrasted with an ultraviolet detection method at 229 nm and found to provide comparable recovery and linearity results. At the electrochemical detection limit of 0.1 ng injected a signal-to-noise ratio of 10.4 was found. PMID- 6480749 TI - Separation of E- and Z-isomers of clomiphene citrate by high-performance liquid chromatography using methenamine as mobile phase modifier. PMID- 6480750 TI - [Determination of methylthiouracil in bovine plasma with reverse phase high performance liquid chromatography]. PMID- 6480751 TI - Stability-indicating determination of tetrahydrozoline hydrochloride in ophthalmic solutions by high-performance liquid chromatography. PMID- 6480752 TI - Determination of thenoyl peroxide by high-performance liquid chromatography. PMID- 6480753 TI - Investigation of two fluorinated reagents for the analysis of selenium by gas chromatography. AB - As potential reagents for the determination of traces of selenium by gas chromatography, the compounds 4-fluoro-o-phenylenediamine and 4-trifluoromethyl-o phenylenediamine have been examined and compared with seven o-diamines previously reported for analytical purposes. Retention times of the fluoro-piaselenols are shorter than all other compounds but, with the electron-capture detector, their responses differ widely. However, the detection limit of the trifluoromethylpiaselenol compares favourably with the commonly used derivative, 5-nitropiaselenol. The analytical requirements of 4-trifluoro-o-phenylenediamine as a reagent, and the results of its application to the determination of selenium in various biological matrices, are presented. PMID- 6480754 TI - Determination of some tricyclic neuroleptics by reversed-phase high-performance liquid chromatography with ultraviolet and polarographic detection. AB - The liquid chromatographic behaviour of various neuroleptics from the classes of tricyclic dibenzothiepins, -oxepins, -selenepins and similar substances was studied in an ion-pair reversed-phase system using a C4180 chemically bonded stationary phase and a methanol-water-acetic acid mobile phase. The best separation was attained with 70% methanol, 1.8% acetic acid and water, containing 0.005 M sodium pentanesulphonate, 1.2 X 10(-4) M EDTA and 0.5 g/l Na2SO4. For the detection, an ultraviolet spectrophotometric and a polarographic detector were connected in series. The detection was carried out at 254 nm and at a potential of a dropping mercury electrode of -1.0 V (vs. Ag/AgCl). The UV detector is universal, while the polarographic detector does not respond to compounds simultaneously containing two heteroatoms (O, S) in the central seven-membered ring. The detection limits are of the order of one to tens of nanograms, the polarographic detector being somewhat more sensitive for most of the compounds; the error of the determination is a few per cent. The method was applied to the determination of isofloxythepin and oxyprothepin in pharmaceutical preparations. PMID- 6480755 TI - Separation of cyanogen bromide fragments from normal and abnormal human serum albumin by reversed-phase high-performance liquid chromatography. PMID- 6480756 TI - Sheep and goat brain phosphonolipids: isolation by thin-layer chromatography, identification and column chromatography. PMID- 6480757 TI - Measurement of maprotiline and oxaprotiline in plasma by high-performance liquid chromatography of fluorescent derivatives. AB - The antidepressant maprotiline and its hydroxylated analogue oxaprotiline were assayed in plasma by solvent extraction and formation of fluorescent derivatives, which were purified by thin-layer chromatography and quantitated by high performance liquid chromatography with fluorescence monitoring. The procedure possesses a high sensitivity, accuracy and reproducibility, and metabolites of the drugs did not interfere. PMID- 6480758 TI - Determination of pirlindole in plasma and urine by high-performance liquid chromatography. AB - A high-performance liquid chromatographic method is described for the analysis of pirlindole [2,3,3a,4,5,6-hexahydro-8-methyl-1H-pyrazino(3,2,1-jk)carbazole hydrochloride], a new antidepressive drug. The drug was extracted from plasma into dichloromethane, and the analysis was carried out on a reversed-phase column, the effluent being monitored by fluorescence detection. The method is selective and sensitive (limit of detection 1-2 ng/ml plasma). Urine analysis was done by direct injection of the diluted sample. The method was applied to the analysis of plasma and urine samples of eight healthy male volunteers who received a 75-mg oral dose of a tablet formulation of pirlindole. The method was also applied to a study in three beagle dogs which received pirlindole (1 mg/kg) by infusion (0.1 mg/kg/min) and orally (10 mg/kg) to estimate the absolute bioavailability of the drug. PMID- 6480759 TI - Gas chromatographic-mass spectrometric characterization of N-methylated basic amino acids in human urine. PMID- 6480760 TI - Determination of gamma-aminobutyric acid in physiological samples by a simple, rapid high-performance liquid chromatographic method. PMID- 6480762 TI - Gas chromatographic method for the routine serum monitoring of mexiletine. PMID- 6480761 TI - Rapid isocratic high-performance liquid chromatographic purification of platelet activating factor (PAF) and lyso-PAF from human skin. PMID- 6480763 TI - Profiles of strongly polar and less polar acids obtained from human blood, plasma and serum by two-step ultrafiltration. AB - A two-step ultrafiltration method combined with anion-exchange chromatography is described for the separation of lipophilic and strongly lipophobic acids occurring in human blood, serum and plasma. After treatment with diazomethane, the acid fractions are separated further by gas chromatography. The acids were identified by their mass spectra. Profiles obtained from the strongly acidic fraction of blood samples of healthy individuals are characterized by main peaks corresponding to organic phosphoric acid esters. The peaks are absent in plasma and serum. PMID- 6480764 TI - Use of electrochemical detection in the high-performance liquid chromatographic determination of hydroxylated ellipticine derivatives. PMID- 6480765 TI - [Microanalysis of two antifibrinolytics (epsilon-aminocaproic acid and tranexamic acid) by liquid chromatography and fluorometry]. PMID- 6480766 TI - Determination of the beta-adrenoceptor blocking drug sotalol in plasma and tissues of the rat by high-performance liquid chromatography with ultraviolet detection. PMID- 6480767 TI - Determination of the beta-adrenoceptor blocking drug bupranolol in plasma and tissues of the rat by high-performance liquid chromatography with ultraviolet detection. PMID- 6480768 TI - Determination of two metoprolol metabolites in human urine by high-performance liquid chromatography. PMID- 6480769 TI - High-performance liquid chromatographic determination of mepixanthone in serum. PMID- 6480770 TI - Simultaneous determination of antipyrine and metabolites in human plasma and urine by high-performance liquid chromatography. PMID- 6480771 TI - High-performance liquid chromatographic determination of 3,4-diaminopyridine in human plasma. PMID- 6480772 TI - A new procedure to analyze free fatty acids. Application to 20-mg brain tissue samples. AB - Fatty acids were analyzed by a new method which involved their isolation from hexane extracts of serum or brain tissue in aqueous potassium hydroxide (10 microliter) and methylation directly in this solution with methyl iodide. The resulting fatty acid methyl esters were partitioned into ethylene chloride (25 microliter) and were quantitated by gas-liquid chromatography. The procedure was documented by comparison with conventional methylation reactions on serum fatty acids. This method, which avoids thin-layer chromatography and which measures individual free fatty acid concentrations in 20-mg brain tissue samples, should be of particular value for examining regional free fatty acids in brain following ischemia and trauma. PMID- 6480774 TI - Reliable routine method for the determination of antidepressant drugs in plasma by high-performance liquid chromatography. AB - We describe a rapid and reliable method using high-performance liquid chromatography for the simultaneous measurement of plasma concentrations of currently prescribed antidepressants and their main metabolites (amitriptyline, nortriptyline, trans-10-hydroxy-nortriptyline, clomipramine, desmethylclomipramine, imipramine, desipramine, zimeldine, norzimeldine, doxepin, desmethyldoxepin, trimipramine and mianserin). The method involves a single extraction of plasma at pH 10.1 with hexane-acetonitrile (98:2), solvent transfer to and evaporation in a disposable glass tube and subsequent chromatography of the residue on a CN bonded-phase column using acetonitrile-methanol-phosphate buffer (pH 7.0) as mobile phase. Protriptyline is used as the internal standard. Calibration curves remain linear up to at least 200 micrograms/l, detection limits are 5 micrograms/l, absolute recoveries are over 92%, and precision (coefficient of variation) is 6.9%. Norzimeldine and 10-hydroxynortriptyline show lower recoveries, protriptyline and 10-hydroxynortriptyline higher detection limits. Adsorption to glassware and chemical decomposition during analysis are shown to be negligible. Psychoactive and other drugs frequently prescribed in combination with anti-depressants have been tested for their chromatographic properties under the same conditions. PMID- 6480773 TI - Simultaneous separation and sensitive determination of free fatty acids in blood plasma by high-performance liquid chromatography. AB - Fatty acids are separated by reversed-phase high-performance liquid chromatography after derivatization with a fluorescence reagent, 4-bromomethyl-7 acetoxycoumarin. Each derivative eluted from a column is successively hydrolysed by mixing it with an alkaline solution, and the produced fluorescence is detected. The derivatives of series of both saturated and unsaturated fatty acids (C6:0--C20:4) are simultaneously separated by a continuous gradient elution method using a methanol-based solvent containing acetonitrile. The quantitative detection of fatty acids is over a range of 5-1000 pmol per derivatization mixture. This method is applicable to the quantitative analysis of free fatty acids in normal human blood samples and blood samples from diabetic patients. Ten microliters of blood plasma are sufficient to carry out the determination. The analytical results show good recovery and good reproducibility. This sensitive method is very useful for the analysis of fatty acids in very low concentrations. PMID- 6480775 TI - High-performance liquid chromatographic assay of pirlimycin in human serum and urine using 9-fluorenylmethylchloroformate. AB - A reversed-phase high-performance liquid chromatographic (HPLC) assay method has been developed for determining pirlimycin in human serum and urine. The method involves chloroform extraction of pirlimycin free base followed by derivatization with 9-fluorenylmethylchloroformate to form a carbamate ester. The reaction is rapid, reproducible, and quantitative. 9-Fluorenylmethylchloroformate reacts with amines to form derivatives sensitive to both ultraviolet and fluorescence detection. Human serum and urine samples following 50-mg and 500-mg single oral doses of pirlimycin were analyzed. The samples were chromatographed on an RP-18 Spherisorb 5-micron, 250 X 4.6 mm I.D. reversed-phase HPLC column. The eluent for the serum assay was acetonitrile-water (58:42) containing 0.02% acetic acid, and for the urine assay was acetonitrile-methanol-tetrahydrofuran-water (48:2:1:49). Fluoranthene was used as an internal standard. The assay sensitivity by ultraviolet detection (lambda max = 264) was about 5 ng/ml and by fluorescence detection (lambda excitation = 270 nm, lambda emission = 300 nm) was 0.1 ng/ml. Statistical analysis indicates an average drug recovery of 101 +/- 4.2% from serum and 102.0 +/- 2.62% from urine. PMID- 6480776 TI - Characterization of artefacts produced by treatment of organic acids with diazomethane. AB - When alpha, beta-unsaturated acids and alpha-keto acids react with diazomethane not only are the corresponding methylates produced, but also diazomethane is added to the C = C double bond or to the oxo group. The gas chromatographic and mass spectral behaviour of these undesired products and some further artefacts produced in the hot inlet lines of a gas chromatograph are described. The mass spectra and retention indices allowed the structural assignment of several "unknown" compounds found previously in the methylated acid fraction of urine. A detailed analysis of the reaction of alpha-oxo acids with diazomethane revealed that, besides the already known oxirane methyl esters, homologous esters are also produced by an insertion reaction. PMID- 6480777 TI - Determination of N-acetyl-L-cysteine in biological fluids. AB - For determination of a drug in biological fluids, accuracy and sensitivity of detection of the adopted method are decisive parameters, but practical aspects such as time and necessary instrumentation are equally important. In the case of N-acetyl-L-cysteine, sample pretreatment can be kept at a minimum if sufficiently selective modes of derivatization, chromatography and detection are employed. Its concentration in serum is between 1 and 20 mumol/l; for quantitative analysis capillary gas chromatography and mass fragmentographic detection are employed. For urine with its ten-fold higher concentration the preferred method is reversed phase high-performance liquid chromatography after thiol-selective derivatization. PMID- 6480778 TI - Identification of diethylene glycol in sera from Egyptian children by frequency pulsed electron-capture gas-liquid chromatography. AB - Sera taken from fifteen patients (from Kerdasa village near Cairo, Egypt) infected with Schistosoma haematobium, with eggs present in the urine, were studied by frequency-pulsed electron-capture gas-liquid chromatography (FPEC GLC). Some of the patients were treated with metrifonate and again studied by FPEC-GLC. Diethylene glycol was detected in the sera of untreated patients infected with S. haematobium. This compound was identified by negative chemical ionization and electron-impact mass spectrometry. Initially we suspected that the build-up of diethylene glycol in these patients was caused by schistosomiasis infection. However, in a follow-up blind-coded study using FPEC-GLC, which included 37 sera from Kerdasa and Tamooh villages near Cairo, Egypt, we detected diethylene glycol in eleven samples, four of which were controls from the villages. These latter findings indicate that the source of diethylene glycol might be the environment or foodstuffs, but the specific source has not been determined. Regardless of the source, diethylene glycol could affect the health of these Egyptian children by causing a narcotic effect, increased bladder stones, and increased numbers of bladder tumours. PMID- 6480779 TI - Sensitive detection of amino acids in human serum and dried blood disc of 3 mm diameter for diagnosis of inborn errors of metabolism. AB - Sensitive high-performance liquid chromatographic determination of amino and imino acids in human serum (5 microliters) and dried blood (2.6-2.8 microliters) on a paper disc (3 mm diameter) of normal and abnormal newborns with inborn errors of metabolism (phenylketonuria, maple syrup urine disease and tyrosinosis) is described. Amino and imino acids in the biological specimens were extracted with ethanol and derivatized with 4-fluoro-7-nitrobenzo-2-oxa-1,3-diazole at 60 degrees C and at pH 8.0 for 1 min. The fluorescent derivatives were separated on mu Bondapak C18 and detected fluorometrically (530 nm/470 nm). The method was about one order of magnitude more sensitive than the similar method using o phthalaldehyde. The amino acid contents obtained by the proposed method were comparable to those obtained by the amino acid analyser with use of o phthalaldehyde. PMID- 6480780 TI - Rapid automated analysis of biogenic amines and their metabolites using reversed phase high-performance liquid chromatography with electrochemical detection. AB - A method is described for the rapid automated analysis of: dopamine and norepinephrine; the major dopamine metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid; and the indoles tryptophan, serotonin, and 5 hydroxyindoleacetic acid in less than 0.5 mg of brain tissue. Samples are deproteinized, injected directly onto a reversed-phase high-performance liquid chromatography column, and quantitated using an electrochemical detector with a glassy carbon electrode. High sample stability permits the use of an automatic sample injector at ambient temperatures. Depending upon the column particle size, sample run times are less than 7-12 min. Thus, over 50 duplicate samples can readily be measured in a single day with very little operator attention. The chromatographic system used also resolves epinephrine, and the catecholamine metabolites: 3-methoxytyramine, normetanephrine, and 3-methoxy-4 hydroxyphenylglycol; and with very little modification this assay also could be used to measure these compounds. PMID- 6480781 TI - Gradient reversed-phase high-performance liquid chromatographic separation of naturally occurring retinoids. AB - A gradient reversed-phase high-performance liquid chromatographic technique is described for the facile separation and quantitation of the naturally occurring retinoids: retinoic acid, retinol, and retinyl esters. An octadecylsilane column (Waters mu Bondapak C18) is used, with gradient elution from methanol--water (80:20) (solvent A) to 70% or 100% methanol--tetrahydrofuran (50:50) (solvent B) at 2.0 ml/min; detection is by absorbance at 325 nm. Analysis can be completed, with return to starting conditions, in 25-30 min. The method is inherently flexible: retinyl esters can be eluted as a group, with little resolution, by gradient to 100% solvent B, or mostly resolved by gradient to 70% solvent B; separation of retinoids more polar than retinoic acid can be achieved by use of greater proportions of water in solvent A. The separation of vitamin A compounds from extracts of human, rat, and pig liver and from rat kidney by this technique is described. PMID- 6480782 TI - Determination of nicotinic acid in serum by high-performance liquid chromatography with fluorescence detection. AB - A sensitive method for the determination of nicotinic acid in serum is described which employs high-performance liquid chromatography with fluorescence detection. Nicotinic acid and 2-chloronicotinic acid as an internal standard in deproteinized serum are reacted with N,N'-dicyclohexyl-O-(7-methoxycoumarin-4 yl)methylisourea in acetone to give the corresponding fluorescent 4-hydroxymethyl 7-methoxycoumarin esters. The compounds are separated by reversed-phase chromatography on LiChrosorb RP-18 with isocratic elution using aqueous acetonitrile containing a small amount of sodium 1-hexanesulphonate as a mobile phase. The detection limit of nicotinic acid in serum was 0.2 nmol/ml. The method requires only 100 microliters of serum. PMID- 6480783 TI - Simultaneous determination of metoprolol and metabolites in urine by capillary column gas chromatography as oxazolidineone and trimethylsilyl derivatives. AB - A method for the determination of metoprolol and its main metabolites in urine is presented. The method comprises derivatization of the aminopropanol side-chain with phosgene at alkaline pH and isolation in an organic phase at acidic pH. After trimethylsilylation, separation and quantification are performed by capillary column gas chromatography with flame ionization detection. The reaction is performed at pH 12 with 60 microliters of 2 M phosgene in toluene added in three portions. Diethyl ether--dichloromethane is used as extraction medium and bis(trimethylsilyl) acetamide as silylating agent. With spiked samples linear standard curves were obtained for metoprolol and three of its main metabolites with a detection limit varying between 4 and 20 mumol/l of urine. The method was applied to urine samples from a normal individual who had taken 292 mumol of metoprolol as tartrate. PMID- 6480784 TI - Development of a standardized analysis strategy for basic drugs, using ion-pair extraction and high-performance liquid chromatography. VI. Drug level determination in saliva. AB - Assay methods for measuring saliva levels of carbamazepine and its active metabolite, and of amidopyrine are developed using a standardized analysis strategy. Both assay methods include ion-pair extraction of the analytes with octylsulphate as the counter-ion and chromatography on a CN-bonded phase using a hexane--dichloromethane--acetonitrile--propylamine mixture as the mobile phase. Both methods are applied to patient samples. PMID- 6480785 TI - The application of reversed-phase high-performance liquid chromatography to in vitro drug metabolism studies with N-alkylarylamines. AB - Analytical procedures have been investigated for the separation, detection, identification and quantitation of some metabolites of N-benzyl-4-substituted anilines. Techniques based on gas-liquid chromatography were investigated and found to be unsatisfactory. By the use of reversed-phase high-performance liquid chromatography with gradient and ion-pairing techniques, methods were devised for the simultaneous analyses of a variety of metabolites. The method involves minimum sample work-up (acetonitrile precipitation) and allows easy and prompt analysis in biological media avoiding undue decomposition of unstable metabolites. PMID- 6480786 TI - Determination of omeprazole and metabolites in plasma and urine by liquid chromatography. AB - Omeprazole, a substituted benzimidazole and a new gastric acid inhibitor, has been determined in plasma and urine, together with three of its metabolites--the sulphide, the sulphone and the hydroxy compound. The methods comprise extraction from the biological materials with methylene chloride, followed either by direct injection of the extract onto a normal-phase liquid chromatography column or evaporation, dissolution and injection onto a reversed-phase system. The compounds were detected using ultraviolet spectrometry. The absolute recoveries obtained were mostly above 95%. The minimum determinable concentration for omeprazole was 20 nmol/l in plasma (relative standard deviation 10-15%) and 50 nmol/l in urine. The metabolites could also be determined at the same levels. PMID- 6480787 TI - Automated analysis of antiepileptic drugs in serum by column-switching high performance liquid chromatography. AB - An automated high-performance liquid chromatographic column-switching system is presented for the analysis of antiepileptic drugs in serum. Initial results show that a reversed-phase extraction column works best overall when fitted with screens versus frits, and when packed with porous 30-micron particles as opposed to a pellicular packing of similar size or with smaller porous particles. The continuous analysis of primidone for over 2000 serum samples is achieved at a rate of twelve samples per hour with a single analytical column. An analogous boxcar high-performance liquid chromatographic system is also assembled and used to analyze two of four injected antiepileptic drugs at a rate of 40 samples per hour. For 1000 of these analyses, the coefficient of variation is 1% without an internal standard. PMID- 6480788 TI - High-performance liquid chromatographic determination of bupivacaine in human serum. AB - A selective high-performance liquid chromatographic method for the determination of bupivacaine in human serum is described. The technique is based on a single extraction of the drug from alkalinized serum with a mixture of hexane isopropanol-chloroform. Desmethyldoxepin is used as internal standard. The chromatographic system consists of a home-packed Nucleosil C8 (10 microns) column; the mobile phase is acetonitrile--0.05 M potassium phosphate buffer (pH 3.3) (28:72, v/v). The method can accurately measure serum bupivacaine concentrations down to 20 micrograms/l using 500 microliters of sample. The coefficient of variation for intra-assay variability of bupivacaine is 2.1% (n = 13) and for inter-assay variability of bupivacaine 5.7% (n = 11) at 1.00 mg/l. The calibration graph is linear over the range 0.02-5.00 mg/l and the extraction efficiency is 91.8 +/- 3.8% (+/- S.D., n = 7). The method is accurate and sensitive for both clinical and pharmacokinetic studies on bupivacaine in man. The method is applied to the analysis of serum samples obtained from orthopaedic patients during both spinal and epidural analgesia. PMID- 6480789 TI - The effect of the presence of glucose on the determination of amino acids by gas chromatography. PMID- 6480790 TI - Measurement of homovanillic acid in human plasma by high-performance liquid chromatography with electrochemical detection. PMID- 6480791 TI - Determination of methylprednisolone and methylprednisolone acetate in synovial fluid using high-performance liquid chromatography. PMID- 6480792 TI - Determination of 3-deazaguanine in mice plasma by high-performance liquid chromatography. PMID- 6480793 TI - Quantitative determination of premazepam in human plasma by high-performance liquid chromatography. PMID- 6480794 TI - Separation and identification of a plasma and urinary mono-acetylated conjugate of chloroquine in man by ion-pair high-performance liquid chromatography. PMID- 6480795 TI - High-performance liquid chromatographic assay for aminoglutethimide and its acetylated metabolite in urine. PMID- 6480796 TI - Rapid determination of metronidazole in human serum and urine using a normal phase high-performance liquid chromatographic column with aqueous solvents. PMID- 6480797 TI - Simple and rapid high-performance liquid chromatographic analysis of cyclosporine in human blood and serum. PMID- 6480798 TI - Application of a rapid scanning plasma emission detector and gas chromatography for multi-element quantification of halogenated hydrocarbons. AB - A microwave induced plasma emission detector is used as an element-selective detector for gas chromatography. The spectrometer, which is fitted with a rapid scanning galvanometer mirror, is used to scan a pre-selected spectral window to provide information in the multi-element mode. This information is used to determine the per mole response of some elements as a function of molecular structure. Despite the low microwave powers employed, the response per mole appears to be independent of the molecular structure. Detection limits and linear dynamic ranges are determined by narrowing the spectral coverage to increase the sensitivity. Calibration curves are linear over several orders of magnitude and detection limits are at the pg/sec levels. PMID- 6480799 TI - Urinary molecular forms of human N-terminal of proopiomelanocortin: possible deglycosylation and degradation by the kidney. AB - The NH2-terminal fragment (hNT) of proopiomelanocortin is found predominantly as one molecular form of apparent mol wt of 12K in the circulation. Since the kidney may play an important role in the elimination and degradation of proopiomelanocortin-related peptides, we analyzed the urinary forms of immunoreactive hNT (IR-hNT) by molecular sieving and carbohydrate affinity (Concanavalin A-agarose) chromatography. RIA specific for the amino terminal portion and for the gamma 3-MSH (carboxy-terminal portion of hNT) were used in these studies. Molecular sieve chromatography revealed several forms of IR-hNT in the urine from normal subjects, patients with Nelson's syndrome, and patients with ectopic ACTH-secreting tumors. A considerable decrease in IR-hNT and IR gamma 3-MSH was found in the urine of a patient with ACTH deficiency and normal subjects during glucocorticoid suppression. In urine from normal subjects and a patient with lung cancer not causing Cushing's syndrome, the majority of amino terminal IR-hNT (66-83%) had apparent mol wts of 3-4K, 6-7K, and 8-10K, and did not cross-react with the gamma 3-MSH antiserum. Ten to nineteen percent of the total IR-hNT was eluted in the position of authentic hNT and reacted with the gamma 3-MSH RIA. In patients with Nelson's syndrome and those with ectopic ACTH syndrome, almost no intact hNT (less than 7% of the total) was present in urine; most of the IR-hNT appeared in the elution volumes with an apparent mol wt of 8 10K. In addition, smaller forms (6-7K and 3-4K) of hNT were also detected in the urine of these patients. The major form of urinary IR-gamma 3-MSH exhibited an apparent mol wt of 7-8K and did not correspond to any of the peaks of IR-hNT. Carbohydrate affinity chromatography (Concanavalin A-agarose) of smaller forms of IR-hNT revealed weak affinity to the lectin, which suggests loss of the carbohydrate moiety during renal excretion. We conclude that hNT in urine is present in extensively cleaved forms and that deglycosylation may be an important step in hNT degradation. These results support a role for the kidney in the catabolism of hNT. PMID- 6480800 TI - Twenty four-hour prolactin profiles and prolactin responses to dopamine in long distance running women. AB - Long distance women runners have a high incidence of oligoamenorrhea. In order to study the possible role of PRL in contributing to their menstrual dysfunction, we evaluated PRL secretion in eumenorrheic (n = 7) and oligomenorrheic runners (n = 9) who averaged 25-50 miles/week, as well as nonrunning women (n = 5) during the midfollicular phase of their cycles. Serum estradiol, progesterone, testosterone, FSH, LH, TSH, and T4 were similar among the three groups. The mean 24-h +/- SE PRL concentrations between the three groups: nonrunners, 12.9 +/- 0.6 ng/ml; eumenorrheic runners, 13.5 +/- 0.4 ng/ml; and oligomenorrheic runners, 15.0 +/- 0.8 ng/ml, were not significantly different. A dopamine (DA) infusion, 0.004 micrograms/kg X min, produced physiologic serum DA levels in these subjects. The nadir of serum PRL levels during DA infusion was similar in each group, which argues against an abnormality in dopaminergic tone in the runners with menstrual dysfunction. Our findings of normal 24-h PRL secretion and appropriate PRL responses to DA in women runners with menstrual dysfunction do not support a role for PRL in this disorder. PMID- 6480801 TI - Mechanism of hyperglycemia and response to treatment with an inhibitor of fatty acid oxidation in a patient with insulin resistance due to antiinsulin receptor antibodies. AB - Severe hyperglycemia and insulin resistance due to antiinsulin receptor antibodies developed over a period of 3 months in a 50-yr-old insulin-requiring diabetic patient. The hyperglycemia resulted from overproduction of glucose due to excessive rates of glycogenolysis and gluconeogenesis rather than decreased glucose utilization. Treatment with methyl-2-tetradecylglycidate, an inhibitor of fatty acid oxidation, resulted in a decrease in plasma glucose concentration. This was associated with a decrease in the rate of glucose production due to decreases in both gluconeogenesis and glycogenolysis rates, as well as an increase in the respiratory quotient. Plasma glucose concentrations continued to respond to the drug for the next 2 months until the sudden development of terminal hypoglycemia. The hypoglycemic action of the drug is consistent with the existence of an insulin-independent effect of fatty acid oxidation on glucose metabolism in man. PMID- 6480802 TI - Aromatase activity in cultured human genital skin fibroblasts. AB - Aromatase activity of human genital skin fibroblasts grown in cell culture was studied using both [1,2,6,7-3H] androstenedione (A) and [1-3H]A as substrates. With the former substrate the generation of [3H]estrogens was determined, whereas with the latter substrate, the formation of [3H]H2O was measured. Our results showed that the release of [3H]H2O from [1-3H]A provides an accurate and sensitive method for determining aromatase activity in cultured human skin fibroblasts. Because genital skin fibroblasts also possess marked 5 alpha reductase activity, we found that addition of an alternate substrate for 5 alpha reductase was necessary to prevent shunting of A from the aromatase pathway. Hence, all aromatase assays were carried out in the presence of 5 microM progesterone. Under these experimental conditions, no correlation was found between levels of 5 alpha-reductase and aromatase activities. The Michaelis Menten constant (Km) of the aromatase in cultured genital skin fibroblasts measured in the presence of A and added progesterone ranged between 10 and 39 nM, and the maximum velocity (Vmax) ranged between 0.14 and 1.46 pmol product/mg protein/h. These values are in good agreement with those previously described for adipose tissue stromal-vascular cells, suggesting that the aromatase complexes are similar in skin and adipose tissue. We conclude that skin may be an important site for aromatization of androgens to estrogens in men. PMID- 6480803 TI - Partial androgen resistance associated with secondary 5 alpha-reductase deficiency: identification of a novel qualitative androgen receptor defect and clinical implications. AB - We studied a family in which three brothers were born with ambiguous genitalia and had poor virilization at puberty. One patient (II-5) required less surgery to repair his hypospadias and is lean, muscular, and hairy compared to his brothers (II-1, II-2). Their adult levels of plasma testosterone (T) range from 765-2250 ng/dl. The plasma T to 5 alpha-dihydrotestosterone (DHT) ratios were 29 (n = 5) in patient II-1, 25 (n = 2) in patient II-2, and 14 (n = 2) in patient II-5, compared to 12 +/- 3 (SD) in normal men. The mean urinary etiocholanolone to androsterone ratios were 1.9 (n = 2) in patient II-1, 2.0 in patient II-2, and 1.3 in patient II-5, compared to 0.87 +/- 0.34 in normal men. The mean urinary ratios of 5 beta-tetrahydrocorticosterone to 5 alpha-tetrahydrocorticosterone were 0.98 (n = 2) in patient II-1, 1.25 in patient II-2, and 0.71 in patient II 5, compared to 0.53 +/- 0.22 in normal men. Genital skin fibroblasts (GSF) from patient II-1 had unusually low 5 alpha-reductase (5 alpha-R) activity (0.3 pmol/mg protein X h; n = 6), but those of patient II-5, a normal brother (II-3), and a sister (II-4; with impaired development of sexual hair) had normal values of 6.5 (n = 2), 9 (n = 3), and 9 (n = 2) pmol/mg protein X h, respectively. The maximum specific DHT receptor-binding activity (Bmax) and the rate constant of dissociation (k) of DHT-receptor complexes in the GSF from each of these individuals were normal, but the apparent equilibrium dissociation constants (Kd) for DHT were 1.16 +/- 0.28 (n = 4) in II-1, 0.39 +/- 0.20 (n = 6) in the sister, and it was 0.19 +/- 0.09 (n = 3) in the unaffected brother and 0.22 +/- 0.09 nM (n = 26) in normal men. The Bmax with the synthetic, nonmetabolizable androgen, methyltrienolone (R1881), and the k of R1881-receptor complexes were normal, but the Kd for R1881 in the GSF of II-1 was 1.4 nM (n = 2), compared to 0.16 +/- 0.05 (n = 8) in normal men, and prolonged exposure to R1881 failed to augment (up regulate) the basal R1881-binding activity in his cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6480804 TI - Effect of tamoxifen on stromal protein synthesis in the human prostate. AB - To test the hypothesis that estrogen may have significant biological effects on the human prostate, we studied the effects of in vivo administration of tamoxifen, an antiestrogen, on human prostatic stromal protein synthesis in vitro. This was done by measuring [3H]proline incorporation in vitro in stromal cells separated enzymatically with 0.5% collagenase and trypsin from hypertrophic prostatic tissue removed at surgery. A mechanical method for separation of epithelium and stroma was attempted, but cell damage resulted in very low incorporation of [3H]proline into protein. Twelve patients were given 20 mg tamoxifen twice daily for 10 days before surgery. The serum levels of tamoxifen at the time of surgery ranged from 200-500 pmol/ml. Control tissues (14) were obtained from untreated patients. Tamoxifen decreased stromal protein synthesis, as measured by counts per min/mg protein, to approximately one third of that found in control patients (control mean, 102,428; tamoxifen-treated mean, 34,111; P less than 0.01). These results support the concept that estrogen has a significant role in the regulation of stromal protein synthesis and the pathophysiology of benign prostatic hypertrophy. PMID- 6480805 TI - Morphometry and histology of gonads from twelve children and adolescents with the androgen insensitivity (testicular feminization) syndrome. AB - Gonadal histology was investigated by means of stereology and Conventional microscopy in 12 patients, aged 2 months to 19 yr, with the androgen insensitivity syndrome (AIS). Eight patients had the incomplete variant of the syndrome and 4 patients had the complete form. Testicular tissue was removed as a prophylactic measure in all patients. In 6 patients less than 5 yr of age testicular histology was normal, except for slightly decreased mean tubular diameters, and, in 1 of the patients, abnormal morphology of the germ cells including a carcinoma-in-situ pattern. The number of germ cells was within the normal range in these 6 patients. In contrast, in older patients (greater than 7 yr of age), germ cells were absent or present only in small foci. In patients with the complete AIS the testicular histology also was immature after puberty, whereas some maturation and subsequent degeneration was found in adolescent patients with the incomplete form of the syndrome. In addition, 2 of these latter patients had a carcinoma-in-situ germ cell pattern. Although patients with the AIS have no reduction of the number of germ cells during the first years of life, this syndrome is associated with abnormal morphology of the germ cells, including patterns of carcinoma-in-situ and impaired pubertal maturation of the seminiferous tubules and the germ cells, in older patients. PMID- 6480806 TI - Specific insulin binding sites in human ovary. AB - The strong association between hyperinsulinemic states of insulin resistance and ovarian hyperandrogenism has led to the suggestion that insulin might directly influence the function of the ovary. To assess this possibility, we have attempted to directly measure insulin receptors in the ovarian stroma of three patients who were operated upon for polycystic ovarian disease. 125I-insulin binding was easily detectable in fragments of ovarian stroma in each case. Specific binding was totally inhibited by pre-treatment with serum containing specific anti-insulin receptor autoantibodies (B-2). These data are consistent with the hypothesis that insulin can directly influence ovarian function. Further studies of insulin receptors and insulin action in human ovarian tissue could lead to a better understanding of the link between insulin resistant states and ovarian hyperfunction. PMID- 6480807 TI - Elevated urinary excretion of 18-oxocortisol in glucocorticoid-suppressible aldosteronism. AB - A radioimmunoassay procedure for the measurement of urinary 18-oxocortisol was developed. The antibody was raised against 18-oxocortisol 3-carboxymethyloxime BSA and had relatively high specificity, except for aldosterone (26.3%). The RIA required a preliminary HPLC purification using a Lichrosorb diol column eluted with toluene:acetonitrile:isopropanol:acetic acid (83:11.9:5.1:0.01). The eluate portion corresponding to 18-oxocortisol was evaporated and subjected to RIA. The RIA procedure had an intraassay variability of 11% when using a pool containing 10.8 micrograms/24 hr (n = 6) and 17% with a pool containing 3.28 micrograms/24 hr. The interassay variability was 11% (n = 4). The recovery of added 18 oxocortisol was 90 +/- 10%. The urinary excretion of 18-oxocortisol in 22 white normal subjects was 3.26 +/- 1.98 (SD) micrograms/24 hr (range 0.8 to 7.1 micrograms/24 hr). The mean excretion of 18-oxocortisol in 4 patients with glucocorticoid-suppressible aldosteronism (GSA) was 38.6 micrograms/24 hr (range 25.5 to 54.6 micrograms/24 hr). The excretion of 18-oxocortisol in 3 patients with adenomas producing primary aldosteronism (APA) varied between 11.1 to 17.3 micrograms/24 hr and in 3 patients with idiopathic aldosteronism (IA) varied between 2.5 to 10.6 micrograms/24 hr. 18-Oxocortisol excretion is increased markedly in the urine of patients with GSA: what role this relatively weak mineralocorticoid plays in the pathogenesis of their hypertension is unknown. Its elevation is probably a reflection of a postulated lack of involution of the 18 methyloxidase in the inner layers of the adrenal. PMID- 6480808 TI - Ideal conditions for hydrolysis of androstanediol 3 alpha, 17 beta-diol glucuronide in plasma. PMID- 6480809 TI - A human pituitary adenoma secreting thyrotropin and prolactin: immunohistochemical, biochemical, and cell culture studies. AB - A 43-yr-old woman, who had previously had a subtotal thyroidectomy, presented with hyperthyroidism and amenorrhea-galactorrhea due to a pituitary adenoma secreting TSH, TSH-alpha, and PRL. Her serum T4 concentration was 14 micrograms/dl; T3, 5.7 ng/ml, and TSH, 19-33 microU/ml. Serum TSH was not altered by TRH stimulation or T3 suppression. Basal plasma PRL levels were 19-27 ng/ml and plasma PRL doubled after TRH stimulation. A 900-mg pituitary tumor, removed by transphenoidal surgery, was studied in cell culture. After dispersion, tumor cells were maintained on an extracellular matrix produced by bovine corneal endothelial cells in a defined serum-free medium. The hormones released in the culture medium were analyzed by high pressure gel chromatography. Three fractions of tumor TSH were found, with respective apparent mol wts of 45,000 (11%), 28,000 (70%), and 20,000 (19%). Tumoral PRL eluted as a single peak of apparent mol wt of 24,000. Pharmacological studies of TSH, TSH-alpha, and PRL release using thyroid hormones (T3), dopamine agonist (bromocriptine), TRH, and cholera toxin yielded the following results: 1) T3 after 3 days of incubation produced a dose dependent inhibition of TSH, TSH-alpha, and PRL release. Maximal inhibition (81%) was obtained at 10(-9) M and half-maximal inhibition at 4-6 X 10(-11) M. 2) Bromocriptine produced rapid and partial inhibition of hormone release. Maximal inhibition (51%) was obtained at 10(-8) M and half-maximal inhibition at 5 X 10( 10) M. 3) TRH at 10(-8) M concentration significantly stimulated PRL release but it had no effect on TSH release. 4) Adenylate cyclase activation by 10(-11) M cholera toxin increased TSH (152%), TSH-alpha (150%), and PRL (220%). Immunohistochemical analysis of serial 2 micron sections of the tumor showed that: 1) TSH-alpha immunoreactive cells were the most numerous, 2) TSH-beta positive cells were always positive for TSH-alpha, 3) PRL immunoreactivity was found either uniquely in some cells and colocalized with TSH-alpha immunoreactivity in other cells. However, by electron microscopy, the tumor cells were thyrotrophs. These data indicate that in this patient's tumor: 1) cells secreting TSH were responsive in vitro to near physiological concentrations of thyroid hormones. 2) The colocalization of PRL and TSH-alpha immunoreactivities in some cells raises the possibility either of fusion of differentiated pituitary cells synthesizing distinct hormones or of transformation of less differentiated multipotential pituitary cells. PMID- 6480810 TI - Use of a highly sensitive and specific immunoradiometric assay for detection of human chorionic gonadotropin in urine of normal, nonpregnant, and pregnant individuals. AB - A highly sensitive and specific two-site immunoradiometric assay (IRMA) for hCG has been developed and applied to the detection of the hormone in the urine of normal nonpregnant and pregnant individuals. The IRMA uses a solid phase coupled monoclonal antibody to the hCG beta-subunit for extraction of hormone from urine. The hCG extracted is then directly quantified by the binding of an affinity purified and radiolabeled rabbit antibody that reacts with the unique COOH terminal peptide region of the hCG beta-subunit. The assay is capable of reliably and accurately measuring as little as 0.01 ng hCG/ml urine without interference from hLH. Assays of urine from normal men and nonpregnant women of reproductive age indicated that most individuals did not have detectable levels of hCG immunoreactivity, although a minority had minute amounts, with a mean value of approximately 0.01 ng hCG/mg creatinine. In contrast, all normal menopausal women studied had easily detectable levels of hCG immunoreactivity in their urine, with a mean value of 0.123 ng hCG/mg creatinine. A study of the excretion of hCG from three men injected with hormone for treatment of infertility indicated that after the first 24 h, hCG was cleared with a single exponential rate and was detectable to a level of 0.01 ng/ml. Application of the IRMA to measurements of hCG in the urine of two artificially inseminated patients indicated that the method was capable of detecting pregnancy as early as 9 days postovulation. The extreme sensitivity and specificity of the IRMA for urinary hCG in conjunction with the simplicity of assay performance and specimen collection should provide a substantial advantage over currently available methods for detection of early pregnancy and tumor monitoring. PMID- 6480811 TI - In vivo and in vitro effects of antiinsulin receptor antibodies. AB - We studied a patient with Acanthosis nigricans and the type B syndrome of severe insulin resistance. The patient's rates of basal glucose disappearance and appearance were both normal (2.2 and 1.7 mg/kg . min, respectively). FFA, betahydroxybutyrate, and acetoacetate concentrations were stable at 0.8, 1.0, and 0.3 mM, respectively, during a 2-h saline infusion after an overnight fast, indicating continued presence of insulin-like activity (ILA) in her serum. Infusion of insulin at rates of 2.7 and 27 U/h, raising peripheral insulin concentrations from 1400 to 4000 and 6000 microU/ml, respectively, had no effect on glucose disappearance and appearance or plasma concentrations of beta hydroxybutyrate, acetoacetate, and FFA, suggesting that the observed ILA was not caused by the patient's plasma insulin. To determine the source of the ILA we used the patient's serum containing antiinsulin receptor antibodies (AIRA) to study its acute (2 h) and chronic (24 h) effects on insulin binding and glycogen synthesis in rat hepatocytes in primary culture. Preincubation of hepatocytes with AIRA serum (diluted 1:100) inhibited insulin binding by 84% and 88% after 2 and 24 h, respectively. It increased U-[14C]glucose incorporation into glycogen by 40% and 52% after 2 and 24 h, respectively. These effects were not caused by insulin present in the patient's serum. We conclude that AIRA serum, in addition to causing severe insulin resistance through inhibition of insulin binding, also exerted strong and long lasting insulin-like effects. These findings are compatible with the patient's clinical features of absence of ketoacidosis despite severe insulin resistance, decrease in glucose concentrations during fasting, and postprandial hyperglycemia. PMID- 6480812 TI - Transitory increment in urinary free 19-nor-deoxycorticosterone after diuretic induced renin stimulation. AB - 19-Nor-deoxycorticosterone (19-nor-DOC) is a potent mineralocorticoid recently identified in human urine. The factors regulating 19-nor-DOC production are unknown; short term dietary sodium depletion or excess has little effect on 19 nor-DOC excretion in human subjects. This study sought to determine if more prolonged renin stimulation could increase 19-nor-DOC production. Six normal subjects were admitted to a metabolic unit. After a 5-day electrolyte balance period, hydrochlorothiazide (50 mg/day) was administered for 28 days. This treatment resulted in acute natriuresis, a more sustained hypokalemia, and secondary hyperaldosteronism lasting throughout the remainder of the study. Despite the sustained secondary hyperaldosteronism, however, urinary 19-nor-DOC extraction, measured by RIA, increased only slightly on day 3 and subsequently decreased to normal values throughout the remainder of the study (19-nor-DOC, 103 +/- 27 ng/day 0, 175 +/- 26 on day 3, 127 +/- 27 on day 28). The results of this study demonstrate only a minor and transient effect on diuretic-induced renin stimulation on 19-nor-DOC production. Therefore, the physiological regulation of 19-nor-DOC is largely independent of the renin-angiotensin system. PMID- 6480813 TI - Elevated production and metabolic clearance rates of androgens in morbidly obese women. AB - Blood production rates of testosterone, dihydrotestosterone (DHT), and 3 alpha androstanediol (3 alpha-diol) were found to be approximately 2-fold elevated in morbidly obese, nonhirsute, normally menstruating women. Values were intermediate between those found in normal women and those in a group of nonobese normally menstruating women with idiopathic hirsutism. Elevated androgen production rates in obese women were associated with 2- to 3-fold increases in MCRs, presumably due to decreased levels of sex hormone-binding globulin. Thus, increased production rates were offset by increased MCRs, resulting in plasma testosterone, DHT, and 3 alpha-diol concentrations that were similar in the obese and normal women. By contrast, women with hirsutism had increased production rates associated with elevated plasma androgens as well as increased MCRs. Urinary excretion of testosterone glucuronide and 3 alpha-diol glucuronide (3 alpha-diol G) were elevated in both obese and hirsute women, paralleling the increased androgen production rates. Despite increased production rates and excretion of androgens, obese women exhibited no menstrual abnormalities, hirsutism, or other signs of virilism. To explore the apparent ineffectiveness of increased androgen production to produce virilizing symptoms, we measured plasma 3 alpha-diol G levels as a measure of peripheral androgen action. The mean +/- SE plasma 3 alpha diol G was 53 +/- 8 ng/dl in obese women and 36 +/- 6 in normal women; by contrast, women with idiopathic hirsutism had levels of 440 +/- 99, a 12-fold elevation. Plasma testosterone glucuronide in obese and hirsute women were only 2 to 3-fold elevated, while plasma DHT glucuronide was not increased in obese women and was only 2-fold elevated in hirsute women. Thus, obesity is a state of increased androgen production and accelerated clearance. 3 alpha-diol G levels in obese women were only minimally elevated, in contrast to values in the hirsute women, perhaps reflecting the apparent androgen ineffectiveness. PMID- 6480814 TI - Leydig cell function in normal men: effect of age, life-style, residence, diet, and activity. AB - The decrease of plasma testosterone (T) in old age may be inherent to the aging process or secondary to environmental factors such as stress, minor illness, physical inactivity, etc. We determined plasma T, apparent free T, and gonadotropin levels in healthy men (n = 71), aged 26-90 yr living under identical conditions, i.e. as monks in a monastery. We found a highly significant age dependent decrease in morning and mean 24-h T and apparent free T levels and a moderate increase in gonadotropin levels; the nycthemeral variation in plasma levels was, however, decreased in the elderly. In a larger group of healthy normal men (n = 302), smokers had higher T levels than nonsmokers in all age groups; values were similar whether older men lived in a geriatric institution or in their home. Diet had no discernable effect on T levels, whereas in young men plasma T levels decreased more in response to stress such as hypoglycemia or myocardial infarction than in elderly subjects. Moderate physical training in men, convalescing from myocardial infarction, did not alter consistently plasma T levels. We conclude that the age-associated decrease in plasma T levels is inherent to the aging process. PMID- 6480815 TI - Presence of oxytocin and arginine vasopressin in human ovary, oviduct, and follicular fluid. AB - Oxytocin and arginine vasopressin (AVP) immunoreactivity in human ovary, oviduct, and follicular fluid were measured and found to coelute with the authentic peptides using both gel filtration column chromatography and reverse phase thin layer chromatography. In ovarian tissue, mean oxytocin and AVP concentrations were 0.48 and 0.24 ng/mg protein, respectively. These values are approximately 4000-fold higher than peripheral plasma levels. The concentration of oxytocin in the corpus luteum was approximately 6-fold greater (3.12 ng/mg protein) than that in ovarian tissue with no corpus luteum. In contrast, no significant difference in the concentration of AVP was found between corpus luteal and the remaining ovarian tissues. Follicular fluid contained 299 and 131 pg/ml oxytocin and AVP, respectively. These levels were 30-fold greater than the serum level of either peptide, suggesting ovarian synthesis of the neurohypophyseal hormones. In addition, immunoreactive oxytocin and AVP were detected in the oviducts (1.01 and 0.24 ng/mg protein, respectively); however, neither peptide was detectable in myometrial tissue (less than 0.02 ng/mg protein). Our results demonstrate the presence of high concentrations of oxytocin and AVP in human ovarian and oviductal tissues as well as follicular fluid and suggest that neurohypophyseal peptides have a paracrine role in the regulation of ovarian or oviductal functions. PMID- 6480816 TI - Cord serum thyroid-stimulating hormone and thyroglobulin levels decline with increasing birth weight in newborns. AB - Cord serum thyroglobulin (Tg) and TSH levels were related to birth weight in 3 groups of newborn infants composed of 101 infants. Serum free T3 index, free T4 index, and/or T4 also were determined. Group I consisted of normal term newborns (20 females and 19 males), whose mean +/- SD gestational ages (40.1 +/- 0.7 vs. 40.1 +/- 0.5 weeks) did not differ, but whose mean birth weights (3299 +/- 282 vs. 3757 +/- 447 g) differed significantly (P less than 0.005). In female infants, serum Tg levels (r = -0.401; P less than 0.05) and the log of TSH levels (r = -0.576; P less than 0.005) correlated negatively with birth weight, while Tg levels correlated positively with the log of TSH levels (r = 0.401; P less than 0.05). In contrast, none of these correlations was significant for male infants. However, T4 levels and birth weight correlated positively (r = 0.499; P less than 0.025) in male infants, but not in female infants. Group II consisted of newborns whose birth weights were less than 2500 g (19 females and 19 males). Mean birth weights of female (2032 +/- 301 g) and male (1850 +/- 413 g) infants did not differ significantly (P greater than 0.05). Both the Tg levels and the log of the TSH levels correlated negatively with birth weight in female (Tg, r = -0.891 and P less than 0.005; log TSH, r = 0.600 and P less than 0.005) and male (Tg, r = 0.849 and P less than 0.005; log TSH, r = -0.660; P less than 0.005) infants. Also, Tg levels correlated positively with the log of the TSH levels in female (r = 0.554; P less than 0.01) and male (r = 0.412; P less than 0.05) infants. Free T4 index levels correlated positively with free T3 index levels in female (r = 0.443; P less than 0.05) and male (r = 0.570; P less than 0.01) infants. Group III consisted of 12 normal female term newborns whose mean birth weight (3685 +/- 623 g) was not significantly (P less than 0.2) different from that of the males of group I, and 12 normal male term newborns whose mean birth weight (4104 +/- 248 g) was significantly (P less than 0.005) greater than that of the males of group I. Unlike in lower weight female or male infants, serum Tg levels did not correlate with birth weight or the log of TSH levels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6480817 TI - Actin tube formation: effects of variations in commonly used solvent conditions. AB - Crystalline tubular aggregates of actin spontaneously assemble in the presence of certain of the lanthanide ions. These tubes are now known to contain a high degree of structural order and it has been suggested that they may be sensitive to small changes in the primary sequence. However, there have been no detailed studies of the effects of solution conditions associated with their formation. In this report we systematically examine the effects of lanthanide ion concentration, ionic radius, adenosine nucleotide concentration, divalent cation concentration, pH, KCl concentration and incubation time. The stringent control of these parameters leads to a high degree of predictability of the structural parameters of the tubes and will thus be of use in identifying actin isozymes. PMID- 6480818 TI - The rate of polymerization of rabbit skeletal muscle actin is enhanced by polyethylene glycol. AB - The effect of polyethylene glycol on the kinetics of actin polymerization was determined by monitoring the enhancement in the fluorescence of pyrenyl-labelled actin. The polymerization of actin at 15 mM KCl was in addition followed by viscometry and light scattering. All three methods showed that the overall rate of polymerization of actin increased 3-4-fold when the concentration of polyethylene glycol was increased from 0 to 6% (ww-1). A further increase in polyethylene glycol concentration to 10% (ww-1) caused a relatively small contribution to the increase in the rate of polymerization. The enhancement of the overall rate of polymerization by polyethylene glycol was also reflected in a significant decrease in the lag time observed when the time course of polymerization was followed by viscometry and light scattering. The steady-state value of fluorescence enhancement and critical concentration of actin were also influenced by polyethylene glycol and the results showed that the extent of polymerization was increased by an increase in the concentration of polyethylene glycol in solution. The effect of polyethylene glycol on both rate and extent of polymerization persisted at physiological salt concentration (150 mM KCl, 2 mM MgCl2). Since the rate of elongation was affected only to a small extent by polyethylene glycol, we propose that its main effect is on nucleation. PMID- 6480819 TI - Attempts to transfer experimental allergic neuritis with lymphocytes. AB - Attempts have been made to transfer experimental allergic neuritis (EAN) both by the intraneural and the intravenous injection of cells derived from Lewis rats with the disease into naive recipients of the same strain. Lymph node cells obtained 12 and 15 days after inoculation with bovine dorsal root in Freund's complete adjuvant were injected intraneurally. A small number of demyelinated axons were observed, but clinical weakness was not evident. Lymph node cells, lymph node cells cultured with concanavalin A, or cultured spleen cells from animals with EAN were transferred intravenously to normal rats. Uncultured lymph node cells were transferred to X-irradiated animals. There were no clinical or histological differences between these recipients and controls receiving cells from rats inoculated with Freund's adjuvant alone. The findings are discussed in relation to previous reports of attempts to transmit EAN by cell transfer. PMID- 6480820 TI - Studies on terminal deoxynucleotidyl transferase and adenosine deaminase in myasthenic thymus. AB - Thymic function in myasthenic patients was examined using two biochemical markers which specifically define a population of cortisone-sensitive cortical thymocytes. The enzymatic activities of terminal deoxynucleotidyl transferase (TdT) and adenosine deaminase (ADA) were determined in 13 samples. High contents of both enzymes were found in young patients. The enzymatic activities were easily detectable also in the oldest patients, despite the morphological involution and the decrease in TdT which are known to occur with age in the normal thymus. TdT and ADA-containing cells were almost completely depleted in all the 3 treated patients by the corticosteroid treatment which provides a non surgical alternative to the elimination of this lymphoid population by thymectomy. The persistence of TdT and ADA activity in old age, and their inhibition by the corticosteroid treatment. PMID- 6480821 TI - Structural-functional relationships in diabetic nephropathy. AB - Renal biopsies in 45 patients with insulin-dependent diabetes mellitus (IDDM) were examined by semiquantitative light microscopy and quantitative electron microscopic stereologic morphometry. In these 14 males and 31 females, aged 13-52 yr, who had had IDDM for 2.5-29 yr there was no strong relationship between either glomerular basement membrane (GBM) thickness or mesangial expansion and duration of IDDM. There was only a weak relationship between the thickness of the GBM and expansion of the mesangium. Thus, GBM thickening and mesangial expansion in IDDM occur at rates that often differ from one another and that vary greatly among patients. The clinical manifestations of diabetic nephropathy, albuminuria, hypertension, and decreased glomerular filtration rate related poorly or not at all to GBM thickening. In contrast, all light and electron microscopic measures of mesangial expansion were strongly related to the clinical manifestations of diabetic nephropathy, although in the absence of these clinical findings, it was not possible to predict the severity of any of the diabetic glomerular lesions. Mesangial expansion had strong inverse correlations with capillary filtering surface area density. It is hypothesized that mesangial expansion could lead to glomerular functional deterioration in IDDM by restricting the glomerular capillary vasculature and its filtering surface. However, capillary closure, glomerular sclerosis, and interstitial fibrosis could also contribute to the clinical manifestations of this disorder. PMID- 6480822 TI - Cryoprecipitation of an anti-Pr2 monoclonal IgM cold agglutinin in the presence of GM3 ganglioside. AB - The mechanism of cryoprecipitation of a monoclonal IgM kappa cryoglobulin (Mou) with a cold agglutinin activity of Pr2 specificity has been studied. By immunodiffusion this cryoglobulin reacted (by its Fab' fragment) with micellar GM3, a ganglioside bearing the Pr2 antigenic determinant. In contrast to previous reports that indicated a possible temperature dependent self-association of IgM molecules via an immunological interaction leading to cold precipitation, we could not detect any affinity of this cryoglobulin for IgM when we used passive hemagglutination or an indirect enzyme-linked immunosorbent assay (ELISA). However, a GM3-like ganglioside could be extracted, by drastic methods, from the cryoglobulin studied at 22 degrees C, whereas no GM3 was extracted from two control cryoglobulins. Some minor gangliosides (representing less than 25% of total amount of bound gangliosides) were also extracted from Mou cryoglobulin and these gangliosides were shown to crossreact with GM3, as they specifically bind to Mou cryoglobulin by ELISA. After cryoprecipitation the serum still contained a monoclonal anti-Pr2 IgM kappa. A GM3-like ganglioside could be extracted from this purified IgM, and cryoprecipitability could be induced by the addition of a minute amount of micellar GM3. These results suggest that Mou cryoglobulin circulates as an immune complex and that cryoprecipitation may depend on unique IgM-GM3 (or IgM-GM3 cross-reacting gangliosides) complexes. PMID- 6480823 TI - Tumor promoters stimulate hyperplasia of microtubule organizing center and inhibit DNA synthesis in cultured cells. AB - Chemical tumor promoters induce significant morphologic changes in several cultured cell models. In this article we describe a new effect of two potent, chemically different tumor promoters, 12-O-tetradecanoylphorbol-13-acetate (TPA) and dihydroteleocidin B (DHTB) on cultured human HeLa and melanoma cells. Using immunofluorescence microscopy, we observed that TPA and DHTB induced a dramatic increase in the size (greater than or equal to 3X normal diameter) of the centrosome, a microtubule-organizing center, within 24 h of incubation. In HeLa cells the effect was serum- and dose-dependent, was observed in 76-92% of cells within 72 h of incubation, and was associated with an increase in cytoplasm nucleus ratio and proliferation of microtubules from the centrosome. The tumor promoters inhibited serum-induced DNA synthesis in both cell lines. Electron microscopy revealed the presence of clumps of microcentriole bodies or fragments adjacent to the intact centriole. PMID- 6480824 TI - Effects of acetyl glyceryl ether of phosphorylcholine (platelet activating factor) on ventricular preload, afterload, and contractility in dogs. AB - Acetyl glyceryl ether of phosphorylcholine (AGEPC), platelet activating factor, is a potent hypotensive agent that may mediate changes in blood pressure during anaphylaxis and may be involved in blood pressure variations of renal origin. This study was designed to characterize the hemodynamic mechanisms responsible for hypotension induced by this recently identified phospholipid. Intravenous administration of AGEPC to anesthetized open-chest dogs (n = 5) produced hemodynamic alterations which, for the purpose of analysis, were divided into three phases based on changes in the mean systemic blood pressure. During phase I (5-30 s) mean systemic blood pressure decreased to levels 5 to 10% below baseline values in association with a rise in cardiac output and a decrease in systemic vascular resistance. Phase II (30-90 s) consisted of a substantial reduction in systemic blood pressure to its nadir, 50% of baseline values, together with a decrease of similar magnitude in cardiac output and a rise in systemic vascular resistance. Phase III (90 s-60 min) exhibited a gradual recovery of mean systemic blood pressure toward normal with a several-fold rise in systemic vascular resistance and a continued low cardiac output. On the right side of the circulation, the predominant effect of AGEPC was a marked transient increase in pulmonary artery pressure in phase I, associated with an elevation of pulmonary resistance during phase II. Diethylcarbamazine blocked virtually all of these hemodynamic changes induced by AGEPC; FPL 55712 substantially blocked the rise in systemic vascular resistance in phase III. These results suggest that leukotrienes may mediate at least some of the hemodynamic effects induced by AGEPC, but further studies will be required when more specific leukotriene blocking agents become available. As assessed during phase III with the end systolic pressure-dimension relation, myocardial performance itself was diminished. The occurrence of an AGEPC-induced negative inotropic effect was further confirmed in isolated Krebs-perfused guinea pig hearts and isolated blood perfused rabbit hearts. The results indicate that the mechanism of AGEPC-induced hypotension is complex, affecting both vascular tone and the inotropic state of the myocardium. PMID- 6480825 TI - Factor V (Quebec): a bleeding diathesis associated with a qualitative platelet Factor V deficiency. AB - Studies were performed on a French-Canadian family afflicted with a bleeding disorder exhibiting an autosomal dominant inheritance pattern and a severe bleeding diathesis after trauma. Clinical laboratory coagulation tests were unimpressive; the only persistent abnormalities include mild thrombocytopenia and moderately reduced Factor V clotting activities. Some individuals had prolonged Stypven times when platelet-rich plasma was used, suggesting that their platelets could not support functional prothrombinase complex assembly. Detailed studies were performed by use of plasma and isolated, washed platelets from a sister and brother. Bioassay data indicate that both individuals had Factor V activities of approximately 40 and 36% of normal, respectively. A comparison of the Factor V radioimmunoassay and bioassay data on the brother's plasma indicated that the circulating amount of Factor V functional activity was low relative to Factor V antigen concentration (approximately 65-75%). In both individuals, the platelet Factor V functional activities were extremely low (2-4%) relative to antigen levels present as determined by radioimmunoassay. These discrepancies between Factor V activities and antigen concentration do not appear to be due to an unstable Factor V molecule or to the presence of a Factor V or Factor Va inhibitor or inactivator. Kinetics of prothrombin activation by use of purified clotting factors indicated that thrombin-activated platelets from both individuals supported prothrombinase complex assembly identical to controls in the presence of added purified Factor Va. Consequently, their bleeding diathesis appears to reflect their platelet, rather than their plasma, Factor V activity. These results suggest that platelet Factor V is an essential component in maintaining stable and prolonged hemostasis after trauma. PMID- 6480826 TI - New mutants of apolipoprotein E associated with atherosclerotic diseases but not to type III hyperlipoproteinemia. AB - We analyzed the heterogeneity of apo E in very low density lipoprotein from 58 hyperlipidemic subjects with or without atherosclerosis, 69 patients with ischemic heart disease, and 100 apparently healthy individuals. Apo E gene frequencies in the group of healthy individuals were comparable with those in German and American populations. The distribution of six common apo E phenotypes in the groups of hyperlipidemia and ischemic heart disease was similar to that in the healthy group. In addition to the three major isoforms of apolipoprotein E (apo E-4, E-3, and E-2) and the new one (apo E-5) which was recently found in this laboratory, we have discovered an additional series of components, which showed themselves as at least three bands on an isoelectric focusing gel in the region of E-VII through E-V, in four patients with hyperlipidemia and atherosclerosis. The new series of apo E components, named apo E-Suita, was identical with the ordinary apo E in its interaction with heparin-Sepharose gel and with anti-apo E antibody. The most basic component of apo E-Suita (E-VII) was the unsialylated form and other components (E-VI and E-V), the sialylated forms. Family studies revealed that apo E-Suita was determined by inheritance of a new apo E allele located at the same locus as the hitherto known apo E components. Apo E-5 and apo E-Suita isoproteins had isoelectric points more basic than apo E 3, the parent type, by two and four units of charge, respectively. While the apo E-Suita isoprotein had the same molecular weight as ordinary major apo E isoproteins, the molecular weight of the apo E-5 isoprotein was approximately 1,500-2,000 lower than the other apo E isoproteins by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The incidence of abnormal apo E components, including apo E-5 and apo E-Suita, was high among patients with hyperlipidemia and ischemic heart disease (7:127), while we could not find such components among 100 healthy individuals. Moreover, five of seven patients with the abnormal apo E had overt atherosclerotic disease. The findings suggest that these kinds of apolipoprotein mutation are closely related to the development of atherosclerosis. PMID- 6480827 TI - Subcellular localization of the large subunit of Mo1 (Mo1 alpha; formerly gp 110), a surface glycoprotein associated with neutrophil adhesion. AB - Mo1 alpha (formerly gp 110) is a neutrophil glycoprotein whose deficiency is associated with abnormalities in several neutrophil functions, including defects in adherence, chemotaxis, and phagocytosis. Examination of whole cells and subcellular components by the use of both immunological and electrophoretic techniques demonstrated that Mo1 alpha was located primarily in the specific granules but that a small portion was present in the plasma membrane, where it is exposed to the extracellular environment and can bind to anti-Mo1 antibody. During degranulation, Mo1 alpha is translocated from the specific granules to the plasma membrane, resulting in a 5-10-fold increase in the surface expression of this glycoprotein. These findings plus previous work suggest that plasma membrane associated Mo1 alpha is needed for a normal interaction between neutrophils and underlying surfaces, and raise the possibility that the increase in surface adhesiveness of neutrophils that have discharged their specific granules might be due in part to the increase in the amount of Mo1 alpha in the plasma membranes of these degranulated cells. PMID- 6480829 TI - Insulin receptor degradation is accelerated in cultured lymphocytes from patients with genetic syndromes of extreme insulin resistance. AB - Previous studies of the insulin receptor in disease states have utilized primarily techniques of equilibrium binding and, to a limited extent structural, analysis. Though techniques have been developed to study receptor degradation in normal cells, they have not been applied to disease states. In the present study we have examined insulin receptor degradation rate in B lymphocytes that were obtained from peripheral blood of normal subjects and patients with several syndromes of extreme insulin resistance. B lymphocytes were established in culture from each patient's peripheral cells by transformation with Epstein-Barr virus. The insulin receptors were surface labeled using Na125I/lactoperoxidase and the cells were returned to incubate in growth media. After varying periods of incubation, aliquots of cells were solubilized and the cell content of labeled receptor subunits were measured by immunoprecipitation with anti-receptor antibodies and NaDodSO4/polyacrylamide gel electrophoresis. The fall in 125I insulin receptor content approximated a single exponential and was quantitated as receptor subunit half-life (t1/2). In cell lines from four patients in whom the number of insulin receptors was reduced by greater than 90%, the rate of receptor loss was greater than normal (t1/2 equals 3.8 +/- 0.9 h vs. 6.5 +/- 1.2 h; mean +/- SD, P less than 0.01). However, a similar acceleration in receptor degradation was seen in cells from five patients with extreme insulin resistance but low-normal insulin receptor concentration (t1/2 equals 4.4 +/- 0.9 h). This group included cells from one patient with a qualitatively abnormal receptor. Thus, all the patients with genetic syndromes of insulin resistance had accelerated receptor degradation, regardless of their receptor concentration. By contrast, insulin receptors on cultured lymphocytes that were obtained from patients with extreme insulin resistance secondary to autoantibodies to the insulin receptor had normal receptor degradation (t1/2 equals 6.1 +/- 1.9 h). We conclude that (a) accelerated insulin receptor degradation is an additional feature of cells from patients with genetic forms of insulin resistance; (b) that accelerated insulin receptor degradation may explain the low-normal receptor concentrations that were seen in some patients with extreme insulin resistance; and (c) that accelerated degradation does not explain the decreased receptor concentration in patients with very low insulin receptor binding and, therefore, by inference, a defect in receptor synthesis must be present in this subgroup. PMID- 6480828 TI - Complement depletion accelerates the clearance of immune complexes from the circulation of primates. AB - Binding of immune complexes (IC) to erythrocytes in vitro is the result of interaction between C3b sites on the IC, and complement receptors type I (CRI) expressed on primate erythrocytes. Recent evidence indicates that primate erythrocytes can also rapidly bind large, preformed IC in vivo. This study was undertaken to determine if the binding of IC to baboon erythrocytes in vivo is complement dependent and to examine the effect of complement depletion on IC clearance from the circulation. The results indicate that complement depletion in vivo reduced the binding of IC to erythrocytes. There was relatively little binding of IC to leukocytes in both the complement-depleted and complement repleted condition. Thus, the majority of IC not bound to erythrocytes remained free in the plasma and, consequently, IC infusion during the complement-depleted state resulted in increased plasma IC concentrations. This was associated with a rapid disappearance of IC from the circulation. By contrast, in the normal or complement-repleted state, a large fraction of the IC became bound to erythrocytes during IC infusion, which resulted in lower plasma IC concentrations. Under these conditions, a more gradual rate of disappearance of IC from the circulation was observed. The relatively abrupt clearance of IC from the circulation in the complement-depleted state could not be accounted for by increased hepatic or splenic uptake. These data indicate that, in contrast to previous studies in nonprimates, complement depletion in primates results in accelerated removal of IC from the circulation. This suggests that factors such as hypocomplementemia and deficient expression of erythrocyte CRI, which are known to occur in certain IC-mediated diseases, may promote IC uptake by organs vulnerable to IC-mediated injury. PMID- 6480830 TI - Catabolism of very low density lipoproteins in experimental nephrosis. AB - The effects of experimental nephrosis in rats, produced by puromycin aminonucleoside, include an elevation of plasma levels of all lipoprotein density classes and the appearance of high density lipoprotein (HDL) rich in apoprotein (apo) A-I and deficient in apo A-IV and apo E. The hyperlipoproteinemia is associated with an increase in hepatic synthesis of lipoproteins. The possible role of decreased very low density lipoprotein (VLDL were obtained from nonfasting animals by ultracentrifugation at d 1.006 and included chylomicrons) catabolism and its relationship to the apolipoprotein composition of nephrotic high density lipoproteins (1.063 less than d less than 1.210, or 1.072 less than d less than 1.210 [HDL]) was explored. When 125I-VLDL was injected, the faster plasma clearance of lower molecular weight apolipoprotein B (apo BL) compared with that of higher molecular weight apo BH which is seen in normal rats was not observed in nephrotic rats. Less labeled phospholipid, apo C, and apo E were transferred from VLDL to higher lipoprotein density classes. Heparin-releasable plasma lipoprotein lipase and hepatic lipase activities were decreased by 50% in nephrotic rats compared with pair-fed controls. Perfusion of livers with medium that contained heparin released 50% less lipase activity in nephrotic rats than in controls. When heparin was injected intravenously, significant decreases in plasma levels of triglycerides and significant increases in levels of free fatty acids were observed in both groups of animals. In the nephrotic rats, 86% of the free fatty acids were in the lipoprotein fractions, as compared with 16% in the controls. Heparin treatment did not restore to normal the decreased apo BL clearance in nephrotic rats but it produced an increased amount of apo A-IV and apo E in the plasma HDL. In vitro addition of partially pure lipoprotein lipase to whole serum from nephrotic rats significantly increased the content of apo E in HDL. We conclude that the abnormal apoprotein composition of HDL in experimental nephrosis is the result of altered entry of apolipoproteins from triglyceride-rich lipoproteins, probably because of decreased lipolysis. PMID- 6480831 TI - Morphological evidence that high density lipoproteins are not internalized by steroid-producing cells during in situ organ perfusion. AB - Although it is clear that high density lipoproteins (HDL) can support steroidogenesis in several rat cell systems, questions still arise as to how HDL are processed by cells. In particular, it is not yet clear whether HDL are internalized by a pathway similar to that used for low density lipoproteins. This issue was examined in the present study using the luteinized ovaries of hormone primed immature rats in an in situ perfusion system. Ovaries were perfused for 2 120 min with 125I-labeled human or rat HDL and processed for autoradiographic studies at the light and electron microscopic level, or homogenized and used for isolation of subcellular membranes. The results show that the luteal cells of this tissue bind both human and rat HDL with great specificity. Moreover, the intact HDL particle does not appear to be internalized by the luteal cell during the period of perfusion: i.e., the protein moiety of the labeled HDL remains associated with the plasma membrane at all times. Evidence from the autoradiographs suggest, however, that with time, an increasing proportion of the plasma membrane-bound protein is associated with inverted microvilli, which are embedded within the cytoplasm and make close contact with structures of the interior of the cell. We speculate that HDL-cholesterol may be transferred at such sites. PMID- 6480832 TI - Disruption of the purine nucleotide cycle by inhibition of adenylosuccinate lyase produces skeletal muscle dysfunction. AB - Controversy exists as to whether the purine nucleotide cycle is important in normal skeletal muscle function. Patients with disruption of the cycle from a deficiency of AMP deaminase exhibit variable degrees of muscle dysfunction. An animal model was used to examine the effect of inhibition of the purine nucleotide cycle on muscle function. When the compound 5-amino-4 imidazolecarboxamide riboside (AICAriboside) is phosphorylated to the riboside monophosphate in the myocyte it is an inhibitor of adenylosuccinate lyase, one of the enzymes of the purine nucleotide cycle. AICAriboside was infused in 28 mice, and 22 mice received saline. Gastrocnemius muscle function was assessed in situ by recording isometric tension developed during stimulation. The purine nucleotide content of the muscle was measured before and after stimulation. Disruption of the purine nucleotide cycle during muscle stimulation was evidenced by a greater accumulation of adenylosuccinate, the substrate for adenylosuccinate lyase, in the animals receiving AICAriboside (0.60 +/- 0.10 vs. 0.05 +/- 0.01 nmol/mumol total creatine, P less than 0.0001). There was also a larger accumulation of inosine monophosphate in the AICAriboside vs. saline-treated animals at end stimulation (73 +/- 6 vs. 56 +/- 5 nmol/mumol total creatine, P less than 0.03). Inhibition of flux through the cycle was accompanied by muscle dysfunction during stimulation. Total developed tension in the AICAriboside group was 40% less than in the saline group (3,023 +/- 1,170 vs. 5,090 +/- 450 g . s, P less than 0.002). An index of energy production can be obtained by comparing the change in total phosphagen content per unit of developed tension in the two groups. This index indicates that less high energy phosphate compounds were generated in the AICAriboside group, suggesting that interruption of the purine nucleotide cycle interfered with energy production in the muscle. We conclude from these studies that defective energy generation is one mechanism whereby disruption of the purine nucleotide cycle produces muscle dysfunction. PMID- 6480833 TI - High dose androgen therapy in male pseudohermaphroditism due to 5 alpha-reductase deficiency and disorders of the androgen receptor. AB - We describe the clinical and biochemical features of six men with male pseudohermaphroditism due to androgen resistance. Each of the subjects had male gender behavior but incomplete virilization. The underlying defects in androgen metabolism were defined by studies of the 5 alpha-reductase enzyme and the androgen receptor in fibroblasts cultured from biopsies of genital skin. Four of the six have 5 alpha-reductase deficiency, and two have defects of the androgen receptor (the Reifenstein syndrome). The responses of these men to androgen treatment were assessed by monitoring nitrogen balance, plasma luteinizing hormone (LH) values, and clinical parameters of virilization including penile growth, potency and ejaculatory volume, muscle bulk, and growth of body and facial hair. In all of the subjects with 5 alpha-reductase deficiency and one man with the Reifenstein syndrome significant response occurred, as evidence by nitrogen retention, lowered plasma LH levels, and improved virilization, with doses of parenteral testosterone esters that raised plasma testosterone levels above the normal male range and brought plasma dihydrotestosterone levels into the normal male range. The subject who did not respond with clinical virilization nevertheless showed nitrogen retention in response to acute testosterone administration. This patient had a profound deficiency of the androgen receptor, whereas the man with a receptor defect who did respond clinically to therapy had normal amounts of a qualitatively abnormal receptor. We conclude that high dose androgen therapy may be of benefit in improving virilization, self-image, and sexual performance in subjects with 5 alpha-reductase deficiency who have male gender behavior and in some subjects with defects of the androgen receptor. PMID- 6480834 TI - Inherited incomplete deficiency of the fourth component of complement (C4) determined by a gene not linked to human histocompatibility leukocyte antigens. AB - We have studied a family in which the proband had systemic lupus erythematosus and selective incomplete deficiency of the fourth component of complement (C4) (2 5% of the normal level). An additional six healthy family members also had low C4 levels (2.4-24.1% of normal) but no evidence of lupus. This form of inherited C4 deficiency differs from that in previously reported families in that inheritance was autosomal dominant (rather than recessive), C4 levels were markedly reduced (but not undetectable), and there was no linkage to HLA, BF, or C4 structural loci, all known to be within the major histocompatibility complex. PMID- 6480835 TI - The schizophrenia-organicity (SC-O) and psychiatric-organic (P-O) MMPI scales: a review. AB - Reviewed the research on the MMPI Schizophrenia-Organicity (Sc-O) and Psychiatric Organic (P-O) Scales, measures developed to separate brain-damaged patients from schizophrenics and from functional psychiatric patients as a whole. Over 10 cross validations, the average Sc-O scale hit rate has been 69%, which suggests that it is a better differentiator of brain-damaged from schizophrenic males than most popular ability-based organicity tests. Hit rates for five studies that contrasted organic and psychiatric patients on the P-O scale also averaged 69%. The scales appear to be useful in both medical and psychiatric hospitals, but their validities in female samples are not well established. A system for making diagnostic decisions from ability and personality measures in combination is described, and evidence is cited that it improves on the hit rates achieved by either type of test alone. PMID- 6480836 TI - A portable Halstead-Reitan Category Test. AB - Provided plans and details for the construction of a portable and inexpensive version of the Halstead-Reitan Category Test so that its general utility for research and clinical applications may be increased. A prototype that can be used in conjunction with any slide projector is described and pictured. This version retains most essential characteristics (using slides, responsive apparatus) of the Category Test of the Halstead-Reitan Neuropsychological Test Battery, but has the advantages of both portability and low cost. PMID- 6480837 TI - Depression in multiple sclerosis as a function of length and severity of illness, age, remissions, and perceived social support. AB - Degree of depression found in 120 spinal multiple sclerosis (MS) outpatients was related significantly to selected illness, demographic, and social variables. The more depressed individuals tended to be more disabled, older, and, in particular, perceived their families and friends as providing less social support than those who were less depressed. Those who had experienced at least one remission were less depressed than those who never had had a remission. Contrary to hypothesized expectations, the results also suggested that the longer a patient has MS, the more depressed he will be. Such results raise implications for psychotherapeutic intervention in this population, as well as suggest the need for future investigations of the MS patient's body image, self-concept, and perception of disability. PMID- 6480838 TI - Application of the four-subtest WAIS-R short form with an older clinical sample. AB - Investigated the validity of the Arithmetic + Vocabulary + Picture Arrangement + Block Design subtest combination as an estimate of the WAIS-R Full Scale IQ in a sample of 55 elderly patients. The correlation between the short-form IQ and the WAIS-R Full Scale IQ was highly significant, r(53) = .95, p less than .001. A pairwise t-test computed between the mean IQs for the two forms was nonsignificant, t(54) less than 1. Approximately one-fourth of the Ss showed changes in intelligence classification levels when the short form was used. The short form does not provide a precise estimate of IQ; however, it appears to have clinical utility as a screening device to identify patients with atypical cognitive functioning. The short form correctly categorized 84% of the current sample with respect to the presence or absence of abnormalities on the full WAIS R. PMID- 6480839 TI - PPVT IQ validity in adults: a measure of vocabulary, not of intelligence. AB - Used partial correlation and multiple regression procedures to test the hypothesis that the PPVT IQ assesses more than vocabulary in adults. Ss were 84 inpatients from psychiatry and neurology wards. The relationships between the PPVT IQ and other measures of vocabulary, intelligence, memory, visual-motor speed and education were examined in the statistical analyses. Although these variables have significant simple correlations with the PPVT IQ, the multivariate analyses show that the Vocabulary Subtest of the WAIS-R is the only important variable. No other variable or variable combinations are able to account for further PPVT IQ variance after the effect of the Vocabulary Subtest is removed. The results support the use of the PPVT as a test of adult vocabulary, but not adult intelligence, and suggest that the PPVT may be useful as part of language assessment in patients with expressive language disorders. PMID- 6480840 TI - Competency mandate: a model for teaching skills in the administration of the WAIS R. AB - The Standards for Educational and Psychological Tests as well as other official policy statements of the American Psychological Association call for competent assessment skills. However, a thorough review of the literature evidences only a handful of models that transmit these mandates into practice. The MASTERY model, a competency-based training procedure, was employed in this investigation as a cost-effective means of actualizing these professional standards. This systematic procedure brought 31 graduate students in clinical psychology to criterion level for competent administration of the WAIS-R after less than 10 hours and two administrations. Practical and research implications of this training model for clinical psychology were discussed. PMID- 6480841 TI - Predicting WAIS-R scores from the Revised Beta for low functioning minority group offenders. AB - Investigated the use of the Revised Beta for predicting WAIS-R scores of low functioning minority group criminal offenders. Ninety black and Hispanic offenders who scored below 80 on the Beta were administered the WAIS-R. For the entire group, mean scores on the two measures were correlated only moderately and were not interchangeable. Offenders scored significantly lower on the Beta than on the WAIS-R. Subgroup analyses of blacks (N = 67) and Hispanics (N = 23) revealed that the Beta scores for the Hispanic offenders were not related significantly to either their WAIS-R Verbal or Full Scale scores. PMID- 6480842 TI - The utility of the modified WAIS in a clinical setting. AB - Utilized time-saving WAIS scoring procedures in two ex post facto investigations following approaches outlined by Vincent (1979) and Himelstein (1983). These procedures direct an examiner to use an S's results on the Information subtest as a criterion for determining the point of initial questioning on other scales. Study 1 followed exactly the procedure presented by Himelstein (1983), with an obtained correlation between modified WAIS and WAIS Verbal IQ of .993. In spite of the high correlation, however, significant distortion in results occurred for some Ss, Study 2 integrated and modified slightly the methodologies of Vincent (1979) and Himelstein (1983). Obtained correlations between modified WAIS and WAIS Verbal, Performance, and Full Scale IQs (N = 40) were each .998. The percentage of IQs that differed by more than 2 points between Modified WAIS and WAIS for Verbal, Performance, and Full Scale scores was 0%, 5%, and 2.5%, respectively. In addition, the procedure maintained the integrity of subscale configurations. PMID- 6480843 TI - Prediction of recidivism in young offenders after brief institutionalization. AB - Administered 100 delinquent adolescent boys a battery of tests that measured intelligence, mental control, self-concept and physical fitness. The battery of tests was administered at the beginning and at the end of short-term institutional placement (M = 6 months) and again 1 to 2 years after release from the institution. Significant prediction of prosocial behavior in the year after institutionalization was achieved by using tests that reflected mental control and academic achievement. Background variables such as race, socioeconomic status, family status, and previous criminal charges were not related significantly to presence or absence of antisocial behavior during the year after institutionalization. Implications for management and treatment are discussed. PMID- 6480844 TI - Irrational beliefs of shoplifters. AB - Shoplifting has become a serious problem for retail merchants and for the criminal justice system. In response to a local court's request for mental health intervention in this problematic area, the Lubbock Regional MHMR Center developed the Shoplifter Offenders Program (SOP), an innovative and novel approach designed to reduce recidivism among convicted adult shoplifters. The principles of Ellis' rational-emotive therapy (RET) served as the conceptual foundation for the intensive, 8-hour psycho-educational group counseling experience (N = 94). Results from the first year of SOP operation are presented, with particular attention paid to the irrational beliefs of shoplifters. PMID- 6480845 TI - The Urist Rorschach Mutuality of Autonomy Scale as an indicator of psychopathology. AB - The Urist Rorschach Mutuality of Autonomy Scale (MAS), which assesses development along a self-object differentiation and mutuality dimension, has shown considerable promise as an index of interpersonal relationship capacities. As such, MAS scores were predicted to correlate significantly with three measures of psychological pathology/health. The reliability of the scale was investigated with non-S Rorschachs and found to be satisfactory. Four-card Rorschachs from 60 previously hospitalized adults comprised the data source for the hypothesis test. Results suggest that the Mutuality Scale accurately reflects observed pathology severity at time of hospitalization and over a lifetime, but not at the time of assessment. Hence, the Urist MAS may indicate potential for pathology. PMID- 6480846 TI - Cigarette smoking outcomes at four years of follow-up, psychosocial factors, and reactions to group intervention. AB - Carried out a study on a sample of male smokers (N = 182) who were at high risk of coronary heart disease (CHD) in order to determine the variables that discriminated between successful and nonsuccessful quitters in a group intervention program designed to lower CHD risk factors. The analysis revealed that baseline level of smoking, life events, personal security, and selected group process variables were predictive of success or failure in the intervention program. Recommendations for future study and clinical application were discussed. PMID- 6480847 TI - Influence of depression and alcoholism on learning, recall, and recognition. AB - Tested four groups (N = 491) of male general hospital Ss with the AVLT to determine differences between alcoholic Ss and depressed Ss (measured by MMPI D). Those both depressed and alcoholic and those neither completed the four groups. Alcoholism lowers initial repetition, recall, and recognition scores; depression lowers only the first of these. Depth of depression is only suggestive as a variable. Beyond trial one depression does not affect AVLT performance, whereas alcoholism is more pervasive. PMID- 6480848 TI - Antecedent and attendant stimuli in smoking: implications for behavioral maintenance and modification. AB - Considerable research exists on biological and psychological explanations for smoking and evaluations of interventions. This research, which supports a psychological model of smoking maintenance, identified situations commonly associated with smoking and noted implications for intervention. College student (N = 34) and general public (N = 48) men and women smokers were questioned about the frequency, onset age, and daily situations associated with their habit. No sex differences were found in either sample for responses, and correlations between smoking rate and onset age or years of smoking were not significant. Chi square analysis indicated significant differences between samples in frequency with which common situational stimuli were associated with smoking. This behavior may be maintained as functionally autonomous, and effective intervention must sensitize smokers to elicitive situational stimuli as well as the smoking response. PMID- 6480849 TI - Evaluation of student performance in psychotherapy. AB - In 1970, the APA's Psychotherapy Curriculum and Consultation Committee on Psychotherapy Training recommended that the faculty of training programs should formulate and publish explicit criteria by which the student's practice of psychotherapy can be evaluated. An informal survey of advanced clinical psychology graduate students (N = 17) of an APA-approved program indicated that during their first year of psychotherapy training, 77% of the students either did not know the criteria used to evaluate their performance as psychotherapists or thought that the evaluation was based on the professor's personal biases. The issue of using client outcome vs. competence in explicitly specified therapeutic skills as evaluative criteria was discussed. A combination of both criteria was recommended for implementation in training programs. PMID- 6480850 TI - Perception of theoretically derived counseling approaches as a function of preference for counseling orientation. AB - Examined the relationship between preference for major counseling orientations and perception of counselor behavior in theoretically derived counseling interviews. Seventy-seven undergraduate students viewed demonstration interviews by Rogers and Lazarus, rated the counselor behavior on the Counselor Rating Form, and were assessed in their endorsement of seven major counseling orientations. A regression analysis performed on the preference scores for seven counseling orientations (predictors) in response to the counselor perception scores on the Counselor Rating Form showed a significant relationship only between the client centered orientation and Rogers. Lazarus was not predicted from any of the seven orientations. Additional analysis of the Counselor Rating Form data revealed that Lazarus was perceived as more expert, attractive, and trustworthy than Rogers. The results are discussed in relation to previous studies. PMID- 6480851 TI - Clinical judgments of easy vs. difficult clients by counselor trainees. AB - Thirty-one counselor trainees viewed videotapes of two actors portraying either an easy client (one who expressed intrinsic motivation for help, responded openly to questions and spontaneously elaborated on responses) or a difficult client. Trainees made 11 ratings of client functioning, likely response to treatment, and personal reactions to client. As expected, clients with a difficult interpersonal style were not regarded as more psychologically disturbed, but were rated as having less potential for change and less ego strength. They were rated as less likely to attend the next interview or to complete counseling and less likely to respond well to counseling. They also were less well-liked. Auxiliary analyses indicated that minority counselors (N = 9) appeared more optimistic about the results of counseling, though they anticipated equally much difficulty in working with the clients. A single interaction effect indicated that white counselor trainees saw less potential for change in the difficult vs. easy clients; minority Ss made no such distinction. PMID- 6480852 TI - The birth seasonality effect in nonschizophrenic psychiatric patients. AB - Several studies have suggested that patients with affective, neurotic, and personality disorders are particularly likely to have been born during the early months of the year. They suggest that seasonal factors may play a role in the etiologies of these disorders. However, Lewis and Griffin (1981) have suggested that the reported seasonal exaggerations in psychiatric patients' birthrates simply may reflect artifacts. We searched for seasonal trends in the birth patterns of neurotics (N = 989), alcoholics (N = 2,870), affective disorders (N = 320) and personality disorders (N = 713), both before and after controlling for these artifacts. No significant effect appeared. PMID- 6480853 TI - Associative response bias and severity of thought disorder in schizophrenia and mania. AB - Studied severity of thought disorder related to putative, exaggerated tendency of schizophrenics to respond to associative intrusions. Three groups of patients, paranoid schizophrenics, nonparanoid schizophrenics, and manics, participated in the investigation. The findings were: vulnerability to associative distractors is not specific to schizophrenia; performance deficit is more related to severity of thought disorder than to a specific diagnosis; degree of cognitive impairment was found to negatively influence verbal performance; the three groups of patients manifested equivalent levels of cognitive impairment. PMID- 6480854 TI - A cognitive peculiarity specific to schizophrenia. AB - Re-examined the finding of Wechsler that schizophrenic patients had reduced scores on his Picture Completion test (PC). Because PC is resistant to impairment and not known to be reduced in other groups, this finding, if confirmed, would represent a cognitive pattern specific to schizophrenics, unlike other cognitive peculiarities that have been attributed to them. Fifty schizophrenic patients taken at random were found to have PC scores very significantly lower than Vocabulary, while in a matched group of depressives and patients with personality disorders there was no difference. PMID- 6480855 TI - Psychological health of young adults who experienced early parent death: MMPI trends. AB - Psychological effects that result from childhood parent loss by death are of substantial clinical and research importance. Parent loss has been linked with various psychopathology, though little is known of its effects on subsequent psychological health (a) as a function of the child's sex; (b) in normal individuals; (c) where early parent separation also has occurred. This study provides data on the Minnesota Multiphasic Personality Inventory-168 (MMPI-168) that address these issues. Ss were normals (16 males and 16 females per group) divided into three groups: Early bereaved (up to age 7), late bereaved (ages 12 to 18), and nonbereaved. In 50% of the bereaved individuals, two or more MMPI-168 clinical scales were pathologically abnormal compared with 28% of controls. Significant parent loss by child's sex interaction effects were obtained on Psychopathic Deviate, Masculinity-Femininity, Psychasthenia, and Schizophrenia scales. A significant effect was found for early parent separation on the Schizophrenia scale. PMID- 6480856 TI - Self-report screening measures for depression in chronic pain patients. AB - Depression is prevalent among chronic pain patients, yet little is known about the ability of various self-report measures to detect this disorder in this population. This study investigated the relationship of several self-report depression scales (Beck Depression Inventory-standard and short forms, MMPI Depression, Depression subtle, and Depression obvious scales, and the Zung Self Rating Depression Scale) to clinician DSM-III diagnoses of major depressive disorder in 40 chronic pain patients. Thirty percent of the Ss met criteria for major depression. Sensitivity and specificity values obtained for each scale are presented. The standard and short forms of the Beck Depression Inventory and the Zung Self-Rating Depression Scale showed good sensitivity and specificity and were comparable in detecting major depression in this sample. PMID- 6480857 TI - Parental communication of Holocaust experiences and personality characteristics among second-generation survivors. AB - Examined communication concerning wartime experiences that went on in survivor families. Sixty-four Jewish children of survivors filled out questionnaires on parental communication, as well as the MMPI, Mosher's Forced Choice Scale of Guilt, and Hogan's Scale of Empathy. Findings indicate that mother's willingness to talk about her experiences and the frequency of her communication were related significantly to the presence of negative personality traits in the second generation. Guilt-inducing communication (by both parents), early experiential awareness of the Holocaust, and indirect communication about the Holocaust also were related significantly to negative characteristics. Father's willingness to talk about his experiences and the frequency of his communication, however, were related to positive factors among his offspring. When separated along gender lines, most forms of communication were related to negative personality factors for female, but not male, children of survivors. PMID- 6480858 TI - Diagnostic implications of markedly elevated MMPI Sc scale scores for nonhospitalized clients. AB - Evaluated the personal adjustment of counseling center clients (N = 60) whose MMPI's highest scale score was a Sc over 70. Analysis of case notes showed that while these clients posed more difficult counseling problems than the average client, the severity of disturbance was markedly less than one would expect from a sample with a mean Sc score of 91. An exploratory stepwise regression analysis indicated that chronic adjustment correlated significantly, R = .79, to an equation in which Sc, MA, R, DY, and Do had positive coefficients and HY, ES and CN negative coefficients. This regression equation also related significantly to the incidence of role identity problems, p less than .01; counselor judgment of client improvement, p less than .001; and bizarre ideation, p less than .001. Consideration of present client stress and prior adjustment factors was discussed as important in formulating less psychopathological interpretations for MMPI profiles with markedly elevated Sc scores. PMID- 6480859 TI - Role-playing techniques: the differential effect of behavior simulation interventions of the readiness to inflict pain. AB - Investigated the differential effect of two kinds of behavior simulation (role playing) interventions: The spontaneous and the mimetic-pretend, on the readiness and the responsibility attributions associated with delivering electric shocks to others (N = 25). Shocks were administered in a teaching situation using the Buss Aggression Machine in the "teacher-learner" paradigm. The results showed that the spontaneous Ss were more ego-oriented and more inhibited in administering shocks than the mimetic-pretend Ss. Unlike the latter Ss, who evinced task-oriented behavior and attributions, the spontaneous Ss assumed personal responsibility for their actions and evaluated the outcomes by minimizing their contribution. Implications for clinical use of role-playing are discussed. PMID- 6480860 TI - Occupational dream, relation to parents and depression in the early adult transition. AB - Assessed the impact of difficulty forming an occupational dream and relating to parents on depression among college students in their late teens and early twenties. Becoming independent of parents and forming an occupational dream are seen as two central issues during this period of life. Results from 64 students suggest that having to give up a valued dream, viewing one's relation to mother as authority-obeyer, and doing little exploring of occupational choices are related significantly to depression (p less than .0004). The significance of these results is discussed in light of theories of depression and the possible importance of different parenting styles for young adults who are facing the early adult transition. PMID- 6480861 TI - Personality and treatment effectiveness in anorexia nervosa. AB - Compared pre- and posttreatment MMPI profiles of 12 female inpatients with anorexia nervosa using a scale-by-scale analysis of variance. Significant changes in clinical scales and a validity scale confirmed observed behavioral change after treatment. In addition, pretreatment profiles obtained at a different hospital were remarkably similar, which suggests a common constellation of personality characteristics in anorexia nervosa. PMID- 6480862 TI - The relationship between WAIS PA and MMPI SI is mediated by MMPI PD. AB - Investigated the effects of MMPI PD on the relationship between WAIS PA and MMPI SI. WAIS PA performance and MMPI SI have been reported to be related negatively in university undergraduates (Schill, 1966) and related positively in psychiatric patients (Johnson, 1969). This study was derived from the assumption that Schill's undergraduates had higher MMPI PD than Johnson's patients. Data from 65 psychiatric hospital patients showed that the PA - SI relationship was negative in high PD Ss and positive in low PD Ss, in support of this assumption. Thus, WAIS PA performance does have clinical implications for assessing social involvement, but the interpretation of PA depends on MMPI PD. PMID- 6480863 TI - Living with cancer: the Cancer Inventory of Problem Situations. AB - With the recent improvement in cancer therapy, patients are living for extended periods of time. There is little information on the day-to-day problems that these patients experience. The paucity of such information is due to the absence of instruments specifically designed to document these problems. The authors have developed an instrument, The Cancer Inventory of Problem Situations (CIPS), and present a study of 84 cancer patients using the CIPS. Preliminary evaluation of the instrument in this small and heterogeneous group of patients demonstrates that cancer has a significant, extensive impact on psychosocial and physical functioning. Cancer patients have moderate to severe problems in personal care, activity management, involvement with the health care system, work, and interpersonal interactions. PMID- 6480864 TI - A factorial analysis of BDI scores. AB - Undertook a factorial analysis of the BDI on a sample of 214 male cardiac outpatients. The factor structure yielded three psychologically distinct dimensions interpreted as negative self-attitudes, physiological symptoms and sadness. The sample was divided into depressed and nondepressed subgroups in order to investigate whether the BDI factor structure is dependent on the range of BDI scores selected. While the first two factors from the nondepressed group's scores mimicked those for the full sample, in general the subgroups' factor structures provided no clear interpretation. PMID- 6480865 TI - The utility of an improved readability short form of the MMPI with elderly male patients. AB - Compared an improved readability short form of the MMPI (IRF) with the FAM and the MMPI-168 in a sample of 100 male veterans, aged 60 and over. The three forms were found to perform acceptably well in terms of measures commonly used to evaluate the statistical validity of MMPI short forms. Median correlations of short form estimates with the MMPI standard scales were .91, .90, and .89 for the FAM, MMPI-168, and the IRF, respectively. In comparison with the other two forms, the IRF was intermediate in the frequency of codetype matches, but was highest in rate of correct validity decisions. The IRF also showed the fewest significant differences between the means of the estimated MMPI scale scores and those that actually were obtained. It was concluded that although the results demonstrated no strong statistical advantage for any short form, the IRF, because of increased comprehensibility, might have a wider applicability, particularly among patients with whom short forms would be used most often. PMID- 6480866 TI - Social skills training and endogenous depression. AB - The clinical response to social skills training was studied in four women with definite endogenous depression (melancholia) to ascertain if a behavioral intervention could be effective with more severe and pervasive affective syndromes. Three of four patients responded to social skills training, although both patients available for longitudinal follow-up relapsed within 24 months post treatment. Implications for research and practice are discussed. PMID- 6480867 TI - General level of reinforcement. AB - A concept of General Level of Reinforcement (GLR) is introduced. This concept is defined as the number, quality and duration of reinforcements per unit time. The assumptions of this theory are discussed. A crucial assumption is that the theory is related to psychological and physiological well-being. Ways to measure general level of reinforcement are described, and clinical implications presented. Methods to increase the level of reinforcement, such as covert reinforcement and the Self-Control Triad, are specified. Finally, suggestions for research are provided. PMID- 6480868 TI - Standardization of the fear survey schedule based upon patients with DSM-III anxiety disorders. AB - The Wolpe-Lange Fear Survey Schedule was administered to 141 psychiatric outpatients who met the criteria for a primary Axis I diagnosis of one of the DSM III anxiety disorders. Standardization data were obtained for this instrument and their clinical and research implications are discussed. PMID- 6480869 TI - Ejaculatory incompetence: a theoretical formulation and case illustration. AB - Three theoretical formulations of ejaculatory incompetence have been proposed in the literature. They include: (1) aversive conditioned inhibition of the ejaculatory reflex, (2) an "autosexual" orientation associated with discrepant levels in the cognitive and physiological dimensions of sexual arousal, and (3) a discriminative learning model. These three models are discussed in relation to their theoretical and therapeutic implications. Clinical data supporting the discriminative view is presented. PMID- 6480871 TI - A lottery procedure to obtain alcoholics' self-reports after discharge. AB - A novel procedure to obtain high rates of follow-up information is presented in this study. After discharge, 24 alcohol abusers were asked to complete and mail a self-report information sheet every other week. To check the reliability of the data obtained, significant others in the clients' environment were asked to report on the same behaviors. The clients and the significant others were informed that every returned information sheet was a lottery ticket. There were two prizes of 1000 NOK ($ 150), one every 6 months. The 1-year follow-up results show that 96% of the clients' self-report sheets were returned. The lottery procedure therefore seems an inexpensive and easy way to ensure the receipt of follow-up data and consumes little time. PMID- 6480870 TI - Toward a behavioral assessment of anticipatory symptoms associated with cancer chemotherapy. AB - A tripartite assessment of nine patients experiencing either pretreatment nausea and vomiting, pretreatment nausea or posttreatment nausea and vomiting only was conducted. Three consistent patterns of response emerged: (1) patients with pretreatment nausea and vomiting reported elevated levels of nausea and anxiety and demonstrated increased levels of physiological arousal; (2) patients with pretreatment nausea reported elevated levels of nausea and anxiety but showed no evidence of increased physiological arousal; and (3) patients with posttreatment symptoms only evidenced low levels on all measures. These data are consistent with the hypothesis that a continuum of responses exists in patients undergoing chemotherapy ranging from no pre- or posttreatment symptoms to pretreatment nausea and vomiting. PMID- 6480872 TI - Data-based versus symptomatic formulation of treatment: the case of a dependent personality. AB - A 48-year-old female presented anxiety and avoidances following diagnosis of her daughter as diabetic. A comprehensive formulation of the case seemed unobtainable. Symptomatic treatment was thus initiated which led to improvement then relapse. Subsequent clinical observation led to a new formulation, namely, anxiety about independent decision making. This hypothesis was assessed. The patient was found to be excessively reliant on others and deficient in autonomous behavior. Accordingly, treatment was aimed at modifying anxiety about independent decision making, and this proved successful. Improvements maintained at an 11 month follow-up. The implications of this case for clinical practice are discussed. PMID- 6480873 TI - Teaching a six-year-old girl to swallow pills. AB - The present study used a modeling and shaping procedure to teach a 6-year-old girl to take pills. During one 45-min session, following instruction and modeling by the experimenter, the subject was presented candy hearts of increasing size, with reinforcers provided for successful swallowing. Maintenance and generalization of treatment effects were reported at home and at school. PMID- 6480874 TI - Single-dose pharmacokinetics and dose proportionality of oral cibenzoline. AB - The pharmacokinetics of cibenzoline were evaluated in four young healthy volunteers who received ascending oral doses of 65, 97.5, 130, 162.5, 195, 227.5, and 260 mg separated by one week. Cibenzoline plasma concentrations exhibited an apparent biexponential decline following oral absorption. Maximum plasma concentrations and area under the plasma concentration-time curve increased in proportion to the dose. The mean elimination half-life among subjects was independent of dose and ranged from 7.3 to 8.7 hours. Oral clearance ranged from 380 to 575 ml/min and was also independent of dose. A single pharmacokinetic equation was used to adequately describe the plasma concentration data over the entire range of doses for each subject, indicating dose-proportional and linear pharmacokinetics. PMID- 6480875 TI - Effect of the surface area of activated charcoal on theophylline clearance. AB - The effect of the surface area of activated charcoal on theophylline clearance was studied. Eight fasting, healthy men received intravenous infusions of either aminophylline (6 mg/kg, N = 3) or theophylline (5 mg/kg, N = 5) over 1 hour followed by either 5 Gm standard activated charcoal every 2 hours, 20 Gm every 2 hours, or 5 Gm PX-21 activated charcoal (with 3.6 times the surface area) every 2 hours. Theophylline t 1/2 and AUC with each regimen were respectively 6.3 +/- 0.5 (S.E.) hours and 88.9 +/- 8.4 mg/liter X hr with 5 Gm standard activated charcoal, 5.3 +/- 0.3 hours and 75.4 +/- 4.9 mg/liter X hr with 5 Gm PX-21, and 4.9 +/- 0.2 hours and 67.7 +/- 3.6 mg/liter X hr with 20 Gm standard activated charcoal. There was a relationship between the activated charcoal surface area and the reduction in theophylline t 1/2 and AUC. We conclude that the clearance of theophylline is related to the surface area of activated charcoal administered and that PX-21 may be a more potent activated charcoal product for enhancing theophylline removal. PMID- 6480876 TI - The effect of antiarrhythmic agents on myocardial contractility and arrhythmia frequency. AB - Most patients requiring antiarrhythmic therapy for ventricular arrhythmias have underlying organic heart disease which causes left ventricular dysfunction. Treatment of these patients' arrhythmias requires knowledge of the hemodynamic as well as antiarrhythmic effects of the available agents. These effects may differ during acute and chronic oral therapy. Several of the newer agents and quinidine are very effective in suppressing ventricular ectopic activity, allowing demonstration of drug effect during ambulatory monitoring. The clinical significance of this for prevention of sudden death has yet to be shown. However, prevention of ventricular tachycardia or fibrillation in the electrophysiology laboratory and suppression of ambient ectopy may generally be separate phenomena, as has been demonstrated for amiodarone. PMID- 6480877 TI - Can antiarrhythmic drugs cause arrhythmia? AB - The recognition that certain types of ventricular premature beats, specifically repetitive forms, may be forerunners of more serious tachyarrhythmias has led to the practice of prophylactic therapy with antiarrhythmic drugs to suppress these forms in patients who have underlying cardiac disease. Several antiarrhythmic drugs are available for oral therapy, and many others are undergoing investigation. The usefulness of these agents is often limited by frequent side effects, which include idiosyncratic and unpredictable reactions that are not related to drug level. One such effect is the aggravation of the arrhythmia being treated. Noninvasive drug testing in 245 patients for a total of 1024 single drug tests showed 113 studies (11 per cent) to have been aggravated by the antiarrhythmic drug. At least one drug was proarrhythmic in 78 patients (32 per cent). Aggravation of arrhythmia is a potentially serious drug complication that occurs with all antiarrhythmic agents. PMID- 6480878 TI - Zomepirac--aspirin interactions in man. AB - The pharmacokinetic interaction between zomepirac and aspirin was studied in 12 healthy males who received a single dose of 100 mg zomepirac sodium on days 1 and 5 and 975 mg aspirin every 6 hours on days 2 to 5. The results indicated that in the presence of salicylate, the peak concentration of zomepirac was depressed; peak time, AUC(0-24 hr), and clearance of total drug remained unchanged. Percentage unbound zomepirac was increased twofold. In the presence of zomepirac, the peak concentration and AUC of salicylate were increased and clearance decreased. The data suggest that zomepirac and salicylate compete with each other for the enzymes and/or cofactors involved in glucuronidation. This competition for metabolic clearance offsets the consequences of the zomepirac-salicylate interactions at the plasma protein binding sites. However, in light of increased unbound zomepirac as well as decreased clearance of unbound drug, concomitant therapy of zomepirac and aspirin is not advised. PMID- 6480879 TI - Effects of food on oxaprozin bioavailability. AB - Twelve healthy volunteers received single 1200-mg oral doses of oxaprozin while fasting and immediately after a standard breakfast in a two-period crossover design with three weeks between administrations. Oxaprozin plasma concentrations were monitored during a 10-day period after each dose. No statistically significant differences were noted between kinetic parameters obtained in the fasting and post-prandial states for mean peak plasma concentrations (Cmax, 103 vs. 109 micrograms/ml), absorption rate constants (ka, 1.1 vs. 0.8 h-1), or total AUC (7042 vs. 7066 micrograms/ml X hr). Compared with doses administered during fasting, postprandial doses led to a delay in the onset of absorption in the gastrointestinal tract (lag time t0, 24 vs. 9 min), but not in the peak time (tmax approximately 5 hours). Oxaprozin's mean residence time t was slightly shorter for subjects in the postprandial state (72 hours) than for those in fasting state (73 hours), probably because of the intrasubject variability in half-life (48 vs. 50 hours). The results of this study indicate that the ingestion of food has no effect on the bioavailability of oxaprozin. PMID- 6480880 TI - Methyldopa does not alter the disposition of digoxin. AB - To investigate whether methyldopa alters digoxin disposition, eight healthy subjects received methyldopa titrated to 250 mg t.i.d. or placebo in a double blind, cross-over manner for 16 consecutive days, with 0.25 mg intravenous digoxin coadministered on day 5 and 0.25 mg oral digoxin on days 9 to 16. Digoxin concentrations in plasma and urine were measured by RIA. Although assay sensitivity did not allow an adequate assessment of serum AUC(0-infinity) after intravenous administration, mean digoxin AUC(0-24) was 10.2 +/- 3.5 and 10.0 +/- 1.8 ng/ml X hr with placebo and methyldopa, respectively (P greater than 0.05). Mean urinary excretion after digoxin with or without methyldopa treatment was 0.204 +/- 0.34 and 0.197 +/- 0.38 mg, respectively. The mean steady-state serum concentrations of oral digoxin (AUC(0-24)/zeta) with and without methyldopa were 0.65 +/- 0.2 and 0.62 +/- 0.3 ng/ml, respectively. These data revealed no significant differences (P greater than 0.05) for various parameters with power of greater than 0.8 to detect meaningful differences of approximately 30 per cent. Thus, methyldopa did not alter digoxin disposition in healthy subjects, and a pharmacokinetic interaction in patients is unlikely. PMID- 6480881 TI - Cautiousness and hearing acuity in elderly women: a signal detection approach. AB - Hearing loss in elderly women was investigated with respect to measures of sensory and decision processes in an auditory signal detection task. A 1000Hz signal was used as the stimulus and a 6-point response category scale was employed. Subject biases were obtained from 6 normal hearing and 6 moderately hearing impaired elderly adults (65-76 yr). Results indicated that the subjects set a conservative criterion, regardless of hearing loss, and tended to use a binary decision process. PMID- 6480882 TI - Frequency perturbation characteristics of pulse register phonation. AB - Examination of some acoustic characteristics of sustained pulse register phonation in normal adults confirmed the existence of two distinct waveform patterns. Trains of similar, highly damped waves with relatively uniform spacing predominated, but the "dicrotic" pattern previously described accounted for about 15% of the total sample. Average differences in the periods of continguous cycles (jitter) were extremely large--on the order of 20% of the fundamental period. Jitter did not vary with fundamental frequency according to the pattern documented in modal register and, thus, jitter ratio is not a useful normalizing descriptor of pulse register perturbation. PMID- 6480883 TI - Relation between voice profile ratings and aerodynamic and acoustic parameters. AB - The present study sought to examine the relation between Wilson Voice Profile ratings and certain aerodynamic and acoustic variables. Subjects in this study were 20 adults with voice disorders and five adults with no voice disorders. A series of stepwise multiple correlations were used. The variance in perceptual ratings accounted for by aerodynamic and acoustic variables included in the present study ranged from 29% for tension ratings of connected speech to 81% for pitch ratings of connected speech for the female speakers. It is clear from the present findings that ratings on the Wilson Voice Profile are only partially accounted for by the variables included in the present study. PMID- 6480884 TI - The influence of reward on comprehension testing of 2-year-old children. AB - A procedure was devised in which a reward was hidden under the stimulus picture representing the correct answer to a comprehension task. Both accuracy and test retest reliability of the responses of 34 2-yr-old children were measured. Eight items tested comprehension of plural allomorphs /s/ and /z/, and eight evaluated the comprehension of word order in reversible subject-verb-object active sentences. The effects of the rewarded search procedure varied, depending on sex and the language structure that was tested. In those cases where the procedure significantly affected responses, the difference was in the direction of improved accuracy and reliability. PMID- 6480885 TI - Speech timing measures of severity, psychomotor retardation, and agitation in endogenously depressed patients. AB - Mean duration and frequency of pauses within speech, pauses between speakers, and vocal activity were measured in 28 endogenous depressive during a psychiatric interview. A factor analysis on these variables revealed two factors accounting for 50% and 24% of the variance, respectively. Factor 1 could be interpreted as a pause factor. The mean durations of both types of pauses had high negative loadings, whereas the frequency of vocal activity, simultaneous speech, and pauses, and the mean duration of vocal activity had high positive loadings on this factor. The degree of retardation (a measure for slowed mental and physical activity) also was related to this factor (r = -0.67, p less than 0.001), whereas the relation between the severity of depression and this factor could only be established under certain conditions. The second factor was interpreted as a fragmentation of speech factor. The frequency of switching pauses (between speakers) and of vocal activity had high positive loadings, and the mean duration of vocal activity had a high negative loading. No clear relationships could be demonstrated between the degree of agitation (a measure for mental and physical overactivity) and speech and pause variables. PMID- 6480886 TI - Measuring the social psychological health states of ambulatory chronically ill patients: hypertension and diabetes as tracer conditions. AB - Measures of social psychological health states were developed and tested for dimensionality, internal consistency, and generalizability on samples of ambulatory hypertensive and diabetic patients. Despite the existence of several measures of health status, none had been tested solely on ambulatory chronically ill patients. Therefore, to insure that sensitive, reliable measures were available to measure patients' responses to nursing interventions designed to increase ambulatory chronically ill patients' participation in their care of themselves, these measures were developed. The two scales were found to be reliable, generalizable, and valid, in that they were correlated with existing measures of symptom severity, psychological, and functional health status. The question of whether disease specific measures of health status are preferable to more general measures is discussed. PMID- 6480887 TI - Medical students' opinions concerning the health care system. AB - The opinions of freshman and senior medical students on major health system problems and policies were investigated in 1980-81. Responses of 214 freshmen and 203 seniors are reported in four major areas: (1) physician dominance of the health care system, (2) autonomy in patient care, (3) availability of services, and (4) preventive and social aspects of care. With respect to physician dominance, more seniors (63%) than freshman (44%) agree that physicians should determine health policy and that dominance of other health personnel is necessary (75%) and (61%). Professional review of patient care is generally acceptable to both classes, but more freshmen than seniors agree that evaluation should be a condition for relicensure. Less than a fifth of the students in either class believe that patients should be told as little as possible or that they should accept the authority of doctors without question. More freshmen than seniors consider the availability of medical care a major problem (76%) and (58%), and similar proportions believe it is the responsibility of government to assure access to all. Freshmen and seniors generally agree on the need for greater emphasis on prevention and social aspects of illness. Because of the important role played by physicians in the health care system, it is recommended that serious attention be devoted to education in this area, even though it may have a limited impact on professional attitudes. PMID- 6480888 TI - The role of student volunteers in door-to-door hypertension screening. AB - This study was part of a continuing effort to develop a community-based approach to health care. Student volunteers in seventh- and ninth-grade health classes were trained to take blood pressure measurements and then conduct door-to-door screening for hypertension. One group of student volunteers within each grade level screened households surrounding the school they attended (low-convenience condition), while another group of volunteers screened households adjacent to their own homes (high-convenience condition). The results from these screening methods were compared with the results obtained from a central-site neighborhood screening center. Chi-square tests on the proportion of households screened indicated that the high convenience door-to-door screening method was significantly more effective than either the low-convenience door-to-door method or the central-site screening method. The latter two methods were not statistically different from each other. Both seventh and ninth graders screened significantly more households in the high-convenience condition than in the low convenience condition. Ninth graders were superior to seventh graders in the high convenience, but not in the low-convenience, condition. PMID- 6480889 TI - Aspirin and its expensive substitutes: prescribing patterns and cost implications. AB - Relatively expensive nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed products, although many rheumatologists continue to recommend aspirin as the initial drug of choice for a variety of musculoskeletal problems. We reviewed 100 charts of patients given NSAIDs in a VA clinic to see how many had relative contraindications for aspirin, such as previous salicylate intolerance, peptic ulcer disease, gastrointestinal bleeding, or failure to respond to aspirin. Only 28% of patients on the expensive preparations had any of these problems noted in their charts. With an average retail cost difference of $14 to $29 per month, large potential savings exist for those who purchase anti inflammatory products, if physicians would initially prescribe aspirin for appropriate patients. PMID- 6480890 TI - Postgraduate preventive medicine: where do we stand today. AB - It appears that the specialty of preventive medicine is declining as a viable specialty, with inadequate numbers of practitioners and with a declining number of physicians entering residency training programs. However, additional data are needed to make rough estimates of the level of need in the future. Even without that data, we must begin to address the potential shortage in trained manpower, because there is a trend that cannot be ignored pointing to a potential shortage. Several points must be pursued. All medical students must be exposed to the excitement we all feel about preventive care. Our teaching programs in medical schools must be strengthened to assure that there is rigor in these programs and that the potential of preventive medicine is conveyed. It is imperative to examine the field to discover why so many of our self-designated specialists in preventive medicine are not board-certified. Obviously one reason could be that a hungry job market is taking individuals who have not been trained in preventive medicine; another reason could be that for some reason specialists in the field of preventive medicine may feel that board-certification is not necessary for their career goals. This issue raises many questions about the importance of academic training in preventive medicine. It also points to the importance of addressing mid-career training needs on the part of those self-designated specialists. The question of financing must be addressed as well. Efforts must be developed to assure that the preventive field is reimbursed by major third-party payors, Medicare and Medicaid. Perhaps through these reimbursement mechanisms a way could be found to provide, at least in part, resident stipends. In addition, other mechanisms must be developed to provide support for residents in training in preventive medicine. If as a people we are to fulfill our potential of healthiness and achieve the Objective For Health Promotion and Disease Prevention, we must have trained personnel to do the job. PMID- 6480891 TI - Knowledge of diabetes and glaucoma in a rural North Carolina community. AB - Effective use of time, money, and personnel in the delivery of health care services to rural areas requires baseline information on the target population with respect to the problem being addressed. Prior to the initiation of an educational program on diabetes and glaucoma, the Public Health Department of Davie County, North Carolina, conducted a survey of county residents to determine knowledge, attitudes, and practices concerning these illnesses. The goals of the survey were to determine (1) basic knowledge with respect to the nature of each illness, symptoms, and high-risk groups, (2) the stigma attached to each illness, and (3) health practices in terms of previous tests for diabetes and glaucoma and whether or not the respondents know where to go for such tests. Information was obtained through a telephone survey of randomly sampled households in Davie County. Results of the survey indicated that the level of knowledge for both diabetes and glaucoma is particularly low with respect to identification of high risk groups and symptoms, and approximately one-quarter of all respondents felt there was some stigma attached to diabetes and glaucoma. The lowest levels of knowledge were observed in the youngest and oldest respondents, males, the unmarried, and those with low levels of educational attainment. The differences in knowledge by age, marital status, and sex were found to be partially a function of differing levels of educational attainment. These data have provided information useful in the selection of content areas for the programs and in the identification of target populations for special emphasis. PMID- 6480892 TI - The use of asbestos-cement pipe for public water supply and the incidence of cancer in selected communities in Utah. AB - We tested the hypothesis that there is an association between the use of asbestos cement piping for drinking water supplies and the incidence of gastrointestinal and kidney cancer. Cancer incidence in 14 Utah communities that had used predominantly asbestos-cement piping for transporting their drinking water supplies for 20 years or more were compared to 27 Utah communities that had never used asbestos-cement piping. Cancer incidence was tabulated for 11 cancer sites for the years 1967-1976. Increased Standard Incidence Ratios (SIRs) were found for cancer of the kidney in men (SIR 192) and leukemia (a control site) in women (SIR 203). No increased SIRs were found for the opposite sex at these sites or for the other gastrointestinal sites singly or in combination. There was no increase in age-adjusted cancer incidence for the 11 sites in 4 of the 14 study communities that had used asbestos-cement piping for 30 years or more. Limitations of the study were that the water supplies were nonaggressive, and leaching from the pipes was minimal if at all. Furthermore, the latent period for observation was very short, suggesting that these results should be considered preliminary. PMID- 6480893 TI - How accurate are patient histories? AB - Recently there has been a large increase in the use of emergency rooms and screening clinics for the delivery of primary medical care. In these impersonal health care settings physicians must often rely on medical histories obtained from patients over the course of a few minutes without benefit of old records or previous acquaintance with the patient. Few data are available on the accuracy of these histories. In this preliminary investigation we used the history of past admission to the hospital as a marker for the validity of patient responses in an emergency room. Overall, 71 of 114 patients with known previous admissions gave accurate responses when asked why they had previously been admitted to the hospital (62 +/- 4.5 percent). Disease category appears to be a relevant factor in predicting the accuracy of the response, but the number of patients was too small to evaluate other subgroups of patients. Future studies should involve sufficient patients to evaluate the individual contributions of patient characteristics in predicting the accuracy of medical interviews. PMID- 6480894 TI - Relationships with the medical staff and aspects of satisfaction with care expressed by parents of children with cancer. AB - Seventy-four parents of children with cancer were asked to characterize the behavior of medical staff members with whom they interacted. Seven empirically distinct dimensions of staff behavior relevant to their relationships with parents were identified, including information transmission, clarity and honesty of communication, acceptance of parental efficacy, resolution of conflicts, personal contact with parents, empathy with the child, and staff competence. With respect to their experiences with the treatment of their child, parents also were asked to indicate their satisfaction with the medical staff in terms of changes in their respect and/or anger for the medical staff, changes in feelings about doctors, support received from doctors and nurses, and stress resulting from tense relations with the staff. The seven dimensions of parent-staff relationships were used as predictors in a series of multiple regressions employing these satisfaction measures as criteria. The overall quality of the parent-staff relationship was best predicted by positive personal contact. The strongest predictor of whether or not parents felt increased anger was staff empathy with child. Increased respect for the medical staff was predicted by a combination of information transmission and perception of staff competence. Experience of support by parents was best predicted by information transmission and staff acceptance of parental efficacy in treatment and decision making. This complex pattern supports the usefulness of disaggregating measures of staff behavior and parent satisfaction when examining the relations between medical consumers and service providers. PMID- 6480895 TI - Five-year findings of the Hypertension Detection and Follow-up Program: mortality by race-sex and blood pressure level. A further analysis. Hypertension Detection and Follow-up Program Cooperative Group. AB - The Hypertension Detection and Follow-up Program (HDFP) data are reported by diastolic blood pressure (DBP) stratum for four race-sex subgroups. For Stratum I (entry DBP 90-104 mm Hg) in each of the race-sex subgroups (black male, black female, white male, and white female). Stepped Care (SC) participants experienced a reduced mortality as compared to Referred Care (RC). For black males and females in all three entry DBP strata, mortality was lower in the SC than RC. Only in three subgroups did the SC mortality exceed RC: Stratum II (entry DBP 105 114 mm Hg) white females and Stratum III (entry DBP 115 + mm Hg) white males and females. Possible explanations for these deviant findings are discussed. The HDFP was designed to determine the difference in total 5-year mortality between SC and RC; subgroup analyses may be subject to large chance variation and must be interpreted with great caution. The value of vigorous treatment of "mild" hypertension (Stratum I) in males and females, black and white, and the value of treatment for all blood pressure strata in blacks are confirmed by this analysis. PMID- 6480896 TI - Identifiable neurons in the locust central nervous system that react with antibodies to serotonin. AB - A detailed account is given of a number of neurons in the locust central nervous system that react with antibody raised to serotonin-albumin complex. The antibody was applied to a series of frozen sections of locust ganglia and visualized by using the peroxidase immunohistochemical procedure. The neurons described include certain afferents and their related neuropiles, a small number of efferents and several systems of interneurons, some of which are segmentally repeated, some run from the brain through the whole nerve cord, while others are confined to the brain. It has been possible to identify many of the neurons from previous descriptions obtained from cobalt, Golgi, and osmium ethyl gallate methods. PMID- 6480897 TI - Neuropeptides and astroglia in intracerebral hippocampal transplants: an immunohistochemical study in the rat. AB - The rat hippocampus and fascia dentata contain neurons and terminal fields that react immunohistochemically with antisera raised against the peptides somatostatin, cholecystokinin (CCK), and enkephalin. Neurons with overlapping distribution synthesize acetylcholinesterase (AChE) as shown histochemically after systemic administration of diisopropylfluorophosphate (DFP). We used these techniques to examine the organization of peptidergic neurons and fibers and AChE positive neurons in transplants of late embryonic and early postnatal rat hippocampi inserted into the brain of immature and adult rats. The astroglial organization was examined using an antibody raised against the astroglial marker, glial fibrillary acidic protein (GFAP). Eighty percent of the transplants were recovered. Within the transplants the peptidergic neurons, and the AChE-producing neurons retained their characteristic distributions. An organotypical astroglial pattern was also retained with some indication of a higher than normal density of cells and processes. The transplant neuropil displayed characteristic patterns of terminal field-like staining with the enkephalin and CCK antibodies. An enkephalin-like reactivity characteristic of the large mossy fiber terminals was found in the normal mossy fiber zones. A similar staining, but of smaller particle size, was found in and above the granule cell layer. It corresponded to the aberrant, supragranular mossy fiber projection, known to form after denervation of the dentate molecular layer. Also the CCK-like reactivity of the transplant neuropil was distributed in laminar patterns characteristic of the different subfields. Deviations from the normal patterns again followed known principles for lesion-induced aberrant nerve growth. Normalization of the enkephalin and CCK staining patterns in the dentate molecular layer was observed in transplants with intimate contact with the host dentate molecular layer or entorhinal cortex, but only in immature recipients, and not in every case. The staining was typically of the enkephalin-reacting lateral perforant path and the CCK-reacting medial perforant path and distributed in normal, mutually exclusive laminae in the dentate molecular layer. An invasion of the transplant dentate molecular layer by heterologous, host enkephalin- and CCK-like reacting afferents in transplants located in the host basal ganglia was limited at most. Outgrowth of CCK and enkephalin reacting transplant fibers into the host brains was not observed in this study.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6480898 TI - The distribution and synaptic organization of serotoninergic elements in the inferior olivary complex of the opossum. AB - Immunohistochemistry and high-resolution autoradiography were used to analyze the distribution and synaptic organization of serotonin (5HT) - containing elements in the inferior olivary complex of the opossum. Immunoreactive beaded varicosities are present throughout the olivary complex. The densest 5HT immunostaining is present in subnucleus b of the caudal medial accessory nucleus. The rostral principal olive is sparsely populated with immunoreactive elements. Fine beaded fibers arborize throughout the neuropil of all the olivary nuclei except in subnucleus b of the caudal medial accessory nucleus where they also circumscribe neuronal cell bodies. In addition, a distinct population of large beaded fibers are occasionally encountered in the neuropil of the medial accessory nucleus. Ultrastructurally, labeled profiles that correspond in size to the smaller beads (less than 1 micron) contain tubulovesicular elements, large dense-cored vesicles, and clear vesicles. In contrast, larger profiles (greater than 2 microns) are characterized by numerous clear synaptic vesicles. Synaptic junctions were encountered in only 2% of the labeled elements. The majority of the labeled profiles were in juxtaposition to small-diameter dendrites (less than 2 microns) except in the caudal medial accessory nucleus, where they also were found in apposition to olivary cell bodies. Our results, when compared with other accounts, indicate that rather than major differences in the nuclear distribution of serotonin between species, there are differences in the density of serotoninergic elements in specific nuclei of the mammalian inferior olive. Based on the size of the labeled profiles and the distinct vesicle populations, our data suggest there are at least two populations of 5HT varicosities that are in juxtaposition to olivary neurons. Further, boutons containing 5HT primarily interact with the distal dendrites of olivary neurons except in the caudal medial accessory nucleus where cell bodies are in apposition to 5HT varicosities. PMID- 6480899 TI - The effects of capsaicin applied to peripheral nerves on responses of a group of lamina I cells in adult rats. AB - In adult rats, the sciatic and saphenous nerves on one side were treated topically with capsaicin. The capsaicin treatment had the effect of increasing the latency for withdrawal of the foot from hot water; 11-22 days later, the animals were decerebrated, and cells in the superficial dorsal horn of the lumbar cord with axons projecting in the contralateral dorsolateral funiculus (DLF) were examined electrophysiologically on the treated and untreated sides of the cord. HRP was applied to cut axons of the DLF at C4, in other rats, and retrograde labelling of cells in the lumbar cord indicated that most or all of the recordings in the capsaicin-treated animals were likely to originate from lamina 1. The dorsal horn cells, with receptive fields on the foot, showed decreased responses to electrically evoked afferent impulses in C fibres and grossly altered receptive fields. After capsaicin treatment, the proportion of cells responding to C afferents fell from 83% to 14%. The proportion responding only to C afferents and not to A afferents fell from 9% to 0%. The receptive fields (RFs) of these cells showed two gross abnormalities; 32% of the cells on the treated side had no apparent RF or an ill-defined, intermittent RF, whereas such cells were rare on the untreated side or in intact animals. By contrast 49% of the cells had grossly expanded RFs with an average area of 430 mm2 against the normal average size of 130 mm2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480900 TI - Cerebellar cortical efferent fibers in the North American opossum, Didelphis virginiana. I. The anterior lobe. AB - The distribution of cerebellar corticonuclear and corticovestibular fibers from the anterior lobe of the North American opossum, Didelphis virginiana, was studied using the Fink and Heimer ('67) technique. Corticonuclear fibers from medial areas of anterior lobe project into the medial cerebellar nucleus (NM) in a topographically organized manner. Fibers from lobules II and III enter rostral and rostrodorsal NM, while those from lobules IV and V terminate in progressively more caudal parts of the nucleus. Collectively the terminal fields in NM for axons from lobules II-V occupy about the rostral two-thirds of the nucleus. Those areas of lobules II-V of opossum that project into NM presumably correspond to zone A of cat and primate. Cerebellar corticovestibular fibers originate from cortex located immediately lateral to areas projecting to NM. The predominance of corticovestibular projections into the lateral vestibular nucleus suggests the presence of a B zone and identifies its points of interface with the A zone. The results further suggest that zones A and B overlap at their respective margins. In contrast to other mammals studied to date, zones A and B of opossum anterior lobe are comparatively wide. Corticonuclear fibers to anterior and posterior interposed nuclei and to the lateral cerebellar nucleus (NL) originate from relatively narrow lateral portions of anterior lobe. These results also suggest that the intermediate cortex of opossum anterior lobe is not clearly divisible into individual zones C1,C2 or C3. The cortical area that innervates NL is very narrow and presumably corresponds to zone D of other forms. PMID- 6480901 TI - Cerebellar cortical efferent fibers in the North American opossum, Didelphis virginiana. II. The posterior vermis. AB - The projection pattern of corticonuclear and corticovestibular fibers from vermis lobules VI-X of the North American opossum, Didelphis virginiana, was studied using a modification of the Fink and Heimer ('67) technique. The evidence suggests that corticovestibular projections in opossum are ipsilateral and exit the cerebellum via the juxtarestiform body. Lobules VI and VII contribute few, if any, corticovestibular projections. Corticovestibular fibers from lobule VIII are sparse to moderate and those from lobules IX and X are numerous. The main targets of corticovestibular fibers are the superior and spinal vestibular nuclei with some input to the medial vestibular nucleus, particularly from lobules IX and X. Although degenerated axons course through the lateral vestibular nucleus, they do not appear to terminate therein. Corticonuclear fibers from lobules VI-X are ipsilateral and terminate in the caudal and caudoventral one-third of the medial cerebellar nucleus (NM). Fibers from lateral areas of some vermal lobules appear to enter contiguous parts of the immediately adjacent posterior interposed nucleus. Although each lobule projects into a specific area of caudal and caudoventral NM when the terminal fields for lobules VI-X are superimposed, it is apparent that they are largely coextensive. This is in contrast to the pattern seen in projections from the anterior vermis. The results further indicate that zones A and B are present in lobules VI-X of opossum. PMID- 6480902 TI - A developmental gradient of dendritic loss in the avian cochlear nucleus occurring independently of primary afferents. AB - Cochlear nerve axons and their target neurons in nucleus magnocellularis (NM) of the chicken undergo extensive parallel structural transformations during development. Between embryonic days 12 and 17 (E12-E17), each immature highly branched axon condenses into a mature calyxlike ending applied to a single NM neuron. Simultaneously, NM neurons are transformed from multipolar cells with many long dendrites into spherical unipolar neurons with only an axon. We tested the hypothesis that cochlear nerve input is necessary for the transformation of NM cells by surgically destroying one otocyst on E3, thereby preventing formation of the nerve. Nucleus magnocellularis neurons from embryos at E11-E12, E13-14, and E17-18 were stained by horseradish peroxidase injected into their axons or by a Golgi-Hortega method. In camera lucida drawings, the number of dendrites on each cell was counted and the cell's position along the posterior-to-anterior and lateral-to-medial axes of the nucleus quantified. At E11-12, neurons throughout NM on both the deafferented and normally innervated sides of the brain have about ten dendrites. At E13-14, there is a steep spatial gradient in dendritic number bilaterally; cells at anteromedial positions have about two dendrites, while cells in posterolateral positions have an average of nine dendrites. By E17-18, only 14% of the neurons on either side have a dendrite, and these cells are evenly distributed throughout the nucleus. We conclude that cochlear nerve axons are not required for normal spatio-temporal gradients of dendritic loss, even though the absence of these axons causes severe atrophic changes in NM.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480903 TI - Projections to the frontal cortex from the posterior parietal region in the rhesus monkey. AB - The projections to the frontal cortex from the various subdivisions of the posterior parietal region in the rhesus monkey were studied by means of autoradiographic technique. The rostral superior parietal lobule (area PE) projects to the dorsal areas 4 and 6 on the lateral surface of the frontal lobe as well as to the supplementary motor area (MII) on its medial surface. The caudal area PE sends its connections to dorsal area 6 and MII. The projections from the medial parietal cortex (areas PEc and PGm) are similar to those of the superior parietal lobule but they tend to concentrate in the more rostral part of dorsal area 6, MII, and in the cingulate gyrus (area 24). The most caudal part of the medial parietal cortex also projects to area 8. The anteriormost part of the inferior parietal lobule (area PF) projects to the ventral area 6, including the caudal bank of the lower branch of the arcuate sulcus, to the ventral area 46 below the sulcus principalis, and to the frontal and pericentral opercular cortex. The middle inferior parietal lobule (areas PFG and PG) projects to the ventral part of area 46 and area 8, whilst the posteriormost inferior parietal lobule (caudal PG and area Opt) is connected with both dorsal and ventral area 46, dorsal area 8, as well as the anteriormost dorsal area 6, and the cingulate gyrus (area 24). PMID- 6480904 TI - Developing descending neurons of the early Xenopus tail spinal cord in the caudal spinal cord of early Xenopus. AB - The enzyme horseradish peroxidase (HRP) was used to describe and identify neurons, axons of which initiate the earliest descending pathways of the tail spinal cord of Xenopus embryos and larvae. Spinal cords were pierced at different rostrocaudal levels with fine insect pins coated with HRP. The resulting pattern of cellular labeling indicated that primitive sensory (Rohon-Beard) axons were at the lead of developing descending tracts followed by axons of primary motor neurons. Axons of these two neuron types travel in widely separated fascicles located dorso- and ventro-laterally, respectively. Subsequently, axons of several morphologically distinct intersegmental interneurons establish several additional fascicles positioned dorsal to the descending motor axons. Descending supraspinal axons appear only later. The distinctive morphological characteristics of each of the early descending cell types are illustrated along with some stages in their early differentiation. These observations establish the temporal pattern by which new axons are added to descending pathways beginning with the simplest level of the amphibian spinal cord and determine the identity of neurons to which axons at early stages in this sequence belong. PMID- 6480905 TI - Segmental variation in the arborization of identified neurons in the leech central nervous system. AB - Mechanosensory and motor neurons in the central nervous system of the leech have been examined by intracellular injection of horseradish peroxidase and electrophysiological mapping of their peripheral fields to determine how the arborizations of homologous cells are influenced by their segmental position. The branching patterns of annulus erector (AE) motoneurons in ganglia near the head and tail were found to be more extensive than those of cells in midbody ganglia. As in midbody ganglia, the peripheral fields of AE motoneurons in adjacent ganglia near the head and tail overlapped extensively, but the subfields innervated by individual branches of a single AE motoneuron showed little or no overlap. No AE motoneurons were found in the head ganglion or in the 20th and 21st free segmental ganglia. The branching pattern of touch-sensitive mechanosensory cells showed a similar segmental variation; touch cells in ganglia near the head and tail had more extensive arborizations than those in midbody ganglia. The rostrocaudal position along the cord at which the branching pattern changed from that characteristic of midbody ganglia to one with a more extensive arborization differed for different types of neurons. These findings demonstrate that a cell's pattern of arborization is not determined by a simple segmental difference between ganglia and suggest that during development neurons respond individually to cues that vary along the length of the cord. PMID- 6480906 TI - Selective loss of neurites during differentiation of cells in the leech central nervous system. AB - The arborizations of annulus erector (AE) motoneurons in the central nervous system of the leech, Hirudo medicinalis, have been examined during embryogenesis to determine how segmental differences in their branching patterns arise. Early in development AE motoneurons all along the ganglionic chain had a similar central arborization, with major branches extending both rostrally and caudally along the connectives that link adjacent ganglia. As the embryo grew, the processes in the connectives elongated but failed to increase significantly in caliber and eventually atrophied and were lost. This sequence of events did not occur uniformly along the cord, however. AE motoneurons in midbody ganglia lost both anterior and posterior branches, cells near the head lost only their posterior branch, while cells near the tail lost only their anterior branch. In this way, the selective atrophy of neurites during development produced a systematic segmental difference in the morphology of homologous cells. PMID- 6480907 TI - Localizing spinal-cord-projecting neurons in neonatal and immature albino rats. AB - According to results from the horseradish peroxidase (HRP) method of tracing neuronal connections, the spinal cords of neonatal and immature rats receive a large number of descending projections from the first cervical cord segment, various brain-stem nuclei, and deep cerebellar and diencephalic nuclei. All these projections are present at birth, though at this age some of them are not fully established. Thus, only a few cells in the trigeminospinal, solitariospinal, tectospinal, and cerebellospinal groups were labeled after HRP injection in the lumbosacral or cervical cord segments in neonatal animals. They were clearly labeled in older, immature animals. The labeled neurons in other descending pathways appeared to be equal in density in neonatal, immature, and adult rats. This visual impression was stregthened by the counts of neurons in the interstitial nucleus of Cajal, which showed no significant difference in the number of labeled neurons in the three age groups. However, counts of labeled cells in the lateral vestibular nucleus and nucleus of the posterior commissure showed that there is a steady rise in the number of labeled neurons as the animals increase in age. PMID- 6480908 TI - Autonomic nervous system innervation of thymic-related lymphoid tissue in wildtype and nude mice. AB - A study was undertaken to determine the source and terminal distribution of the autonomic nervous system (ANS) innervation of lymphoid tissue in the mediastinum of male and female B10 and Balb/c wildtype and syngeneic nude (nu/nu) mice. Acetylcholinesterase (AChE) histochemistry was used to localize this hydrolytic enzyme in neural tissue and glyoxylic acid fluorescent histochemistry was used to characterize catecholaminergic (CA) innervation. The thymus was innervated by AChE-positive fibers of the vagus, the recurrent laryngeal, and the phrenic nerves. Catecholaminergic innervation was derived from the stellate ganglia and other small ganglia of the thoracic sympathetic nervous system chain. Whereas intrinsic AChE-positive innervation of the thymus was evident at the cortico medullary boundaries and under the capsule, CA innervation was observed along the trabeculae with perivascular plexuses at the cortico-medullary boundaries and interlobular septa. Free CA fibers were noted in the medulla and in the cortex, where they were often proximal to cortical autofluorescent (CAF) cells. The rudimentary thymus of the adult nude mouse received limited ANS innervation. Only a few CA or AChE-positive fibers were evident, with the majority of fibers associated with the acinar cells of the gland. Mediastinal lymph nodes in male and female wildtype mice varied in their distribution and were frequently found clustered around nerves and ganglia. The intrinsic innervation of lymph nodes by AChE-positive fibers was confined to the subcapsular marginal sinus, with a few vascular-associated fibers in the parenchyma. Catecholaminergic perivascular plexuses were present in the hilar zone, whereas some free fibers were noted under the capsule and in the parenchyma. The mediastinal lymph nodes of male and female nude mice when compared to the lymph nodes of male and female wildtype mouse were found to be increased in number and in distribution. Clusters of these lymph nodes were found in close proximity to ANS tissue. The intrinsic innervation of the nude mediastinal lymph nodes was comparable to that present in the wildtype mouse tissue. The functional implication of these data is discussed with regard to nervous:immune system interactions. PMID- 6480909 TI - Cortical connections of the middle temporal visual area (MT) and the superior temporal cortex in owl monkeys. AB - The connections of the middle temporal visual area (MT) and an adjoining superior temporal visual region (ST) were investigated with injections of 3H-proline and horseradish peroxidase (HRP) in adult owl monkeys. Injections in MT revealed an extensive pattern of intrinsic connections that appeared to be organized in a series of bands across MT. MT was found to project ipsilaterally to an array of visual areas including the first (V I) and second (V II) visual areas, the dorsolateral visual area (DL), and the dorso-medial visual area (DM). When injection sites and projection zones were related to previously described retinotopic maps, it was apparent that the projections of MT to these fields were largely homotopic. Other projections were to posterior parietal cortex, the dorsointermediate visual area (DI), the ventral visual area (V), and possibly the medial visual area (M). In addition, dense projections to cortex on the rostral border of MT were used to define a new subdivision of visual cortex, the superior temporal visual region (ST), as the major projection zone of MT. Callosal connections of MT were mainly to MT, with some terminations in DL and ST. Injections of 3H-proline into ST revealed a diffuse projection to largely layer I of MT, and dense projections to posterior parietal cortex, cortex in more rostral parts of the superior temporal sulcus, ventromedial inferior temporal cortex, and the region of the frontal eye fields. Callosal projections were largely to ST cortex of the other cerebral hemisphere. The results place MT and V II in distinctly different processing chains. While both MT and V II receive the major cortical outputs of V I, V II relays to DL and DL relays to subdivisions of inferior temporal cortex. In contrast, the most significant cortical target of MT appears to be to ST, which relays to posterior parietal cortex and other targets. PMID- 6480910 TI - Rostral ventrolateral medulla: selective projections to the thoracic autonomic cell column from the region containing C1 adrenaline neurons. AB - Anterograde, retrograde, and combined axonal transport methods were used to describe the descending efferent projections of a region of rostral ventrolateral medullary reticular formation important in cardiovascular control. We have termed this region, which contains C1 adrenaline-synthesizing neurons, the nucleus reticularis rostroventrolateralis (RVL). Efferent projections from the RVL innervate all segmental levels of the thoracic intermediolateral and intermediomedial columns as shown using retrograde transport of lectin-conjugated horseradish peroxidase (HRP) or fast blue dye, and anterograde transport of either HRP or labeled amino acids. The projection is highly specific in that there are no projections to thoracic dorsal or ventral horns. This innervation corresponds to the distribution of preganglionic sympathetic neurons in the intermediolateral column. In particular, terminals surround neurons projecting to the adrenal medulla, as demonstrated by combined anterograde and retrograde transport methods at the light level. Terminals containing phenylethanolamine-N methyl transferase (PNMT) were mapped using immunocytochemical techniques. PNMT labeled terminals were present at all levels of thoracic intermediolateral column, in a distribution similar to that of the descending projections from the RVL. We have previously shown using double label techniques (Ross et al., '81 '83), that many of the spinal projections of the RVL originate from C1 neurons. These data support our suggestion that certain bulbospinal neurons within the RVL, in particular the C1 neurons, are crucial for tonic vasomotor control. PMID- 6480911 TI - Genesis of neurons in the dorsal lateral geniculate nucleus of the cat. AB - Neurons that will ultimately form the dorsal and ventral lateral geniculate nuclei, the medial interlaminar nucleus, the perigeniculate nucleus, and the nucleus reticularis of the cat undergo their final cell division beginning on, or slightly before, embryonic day 22 (E22) and ending on, or before, E32. Early in this period, neurogenesis proceeds for all of these geniculate nuclei, whereas only in the dorsal lateral geniculate nucleus does cell birth continue until E32. Distinct spatiotemporal gradients of cell birth are not obvious within any of the individual geniculate nuclei. For the dorsal lateral geniculate nucleus in particular, and for the other geniculate nuclei in general, neurons born early in this period exhibit a full range of adult soma sizes, including large and small neurons. Neurons born late in this period exhibit only small adult somas. The location and size of a neuron within the dorsal lateral geniculate nucleus provide clues to that cell's functional properties. On the basis of presently available information regarding the relationship between structure and function of neurons in the cat's dorsal lateral geniculate nucleus, the findings described here suggest that all functional classes of neurons in the dorsal lateral geniculate nucleus are born at the same time throughout most of this period. PMID- 6480912 TI - Genesis of morphologically identified neurons in the dorsal lateral geniculate nucleus of the cat. AB - Neurons in the dorsal lateral geniculate nucleus of the cat can be grouped into five morphological classes based on a variety of structural characteristics. These same structural characteristics can serve as morphological signatures for the three physiological classes (X, Y, W) of neurons found in this nucleus. The purpose of this study was to determine if a relationship exists between the birthdate of neurons within the dorsal lateral geniculate nucleus and the adult morphology of those neurons. Seven cats, each of which had received a single injection of 3H-thymidine, were studied. A total of 2,138 Golgi-impregnated neurons were identified in the dorsal lateral geniculate nuclei of these seven cats; 1,517 of these neurons were successfully resectioned and recovered, of which 385 (25%) were found to contain the 3H label. Neurons from each of the five morphological classes were labeled in each of the six animals that received a 3H thymidine injection between embryonic day 24 (E24) and E28. Class 3 and class 5 neurons were labeled in a cat injected with 3H-thymidine on E30. These findings demonstrate that the development of the morphological class of a neuron in the dorsal lateral geniculate nucleus is independent of the time of its final cell division. Further, given the relationship that exists in the cat's dorsal lateral geniculate nucleus between neuronal structure and function, the present findings suggest that the different physiological classes of cells found in this nucleus undergo their final cell divisions throughout most of the period of neurogenesis except that the functional role of neurons born late in this period may be more restricted. PMID- 6480913 TI - The interconnections of the inferior colliculi through their commissure. AB - Much is known of the sources and manner of termination of ascending and descending input to the inferior colliculus (IC) but its commissural connections are less well understood. Most studies of the commissure have utilized small lesions or tracer deposits; while all agree that commissural axons terminating in the IC do so in its superficial and dorsomedial sectors, it is not clear where projecting cell bodies are located in the IC. The present study attempted total infiltration of the commissure of the cat IC with horseradish peroxidase (HRP) in an effort to label all neuronal somas whose axons cross in the commissure. The distribution of labeled cells after the brachium of the IC (BIC) was cut unilaterally and infiltrated with HRP was also examined to enable comparison of the locations and approximate proportions of cells projecting to the contralateral IC and medial geniculate body (MGB). The cells giving rise to commissural axons form an array tilted dorsally from caudal to rostral that spreads mediolaterally through the central nucleus into the external nucleus of the IC, but largely excludes the dorsomedial sector at posterior levels. A similar distribution of labeled cells, but with reduced numbers, is found when large HRP deposits are made in the contralateral BIC. These results, in conjunction with those from studies of the terminations of commissural axons made by others, suggest that the interconnections of the inferior colliculi through their commissure are complementary, rather than reciprocal. PMID- 6480914 TI - Postnatal maturation of nonpyramidal neurons in the visual cortex of the cat. AB - A Golgi study of nonpyramidal neurons in the visual cortex of kittens aged from 1 to 80 days revealed that different neuronal types undergo a differential sequence of maturation. The earliest nonpyramidal cells to differentiate are large multipolar cells of layers 3-5, which appear around birth and whose axons gradually establish long lateral, intracortical connections. They are followed by spiny stellate cells of layer 4, which appear in the first postnatal, week, and by neuroglioform cells in layers 4 and 5, a cell type which at 10 days displays a highly differentiated axonal plexus. In general, most classes of local axon cells can be identified by the end of the second week, though still possessing a very immature morphology, the axonal-tuft cells of layer 2 maturing later, in the third week. With some exceptions, most neurons exhibit an adultlike axonal arborization by the end of the first month; however, immature chandelier terminals are observed until the 40th day, and in kittens aged from 30 to 80 days, the vertical terminal segments of chandelier cells are larger than in the adult. Some neuronal types seem to present an exuberant growth of axonal fibers in the late postnatal period and a subsequent reduction up to the adult stage. PMID- 6480915 TI - Anterograde degeneration in the superior colliculus following kainic acid and radiofrequency lesions of the macaque pulvinar. AB - Several studies have reported behavioral deficits following thermocoagulation of the primate pulvinar. However, these deficits may have resulted from damage to corticotectal fibers as they pass through the pulvinar. To evaluate this possibility and to determine whether kainic acid can be used to destroy pulvinar cells without damaging corticotectal fibers, we compared anterograde degeneration in the superior colliculus following kainic acid and radiofrequency lesions of the pulvinar. Kainic acid injections into the pulvinar produced total loss of neuronal perikarya within the inferior and lateral pulvinar. Four to 7 days following the kainic acid lesions, terminal and fiber degeneration within the superior colliculus was no greater than that produced by control injections of saline. By contrast, thermocoagulation lesions of the inferior and lateral pulvinar produced dense fiber and terminal degeneration throughout the superficial and intermediate layers of the superior colliculus. We conclude that whereas thermocoagulation of the pulvinar severely damages the corticotectal tract, kainic acid lesions spare these fibers of passage. Thus kainic acid lesions should provide an effective tool for studying the functional significance of the pulvinar. PMID- 6480916 TI - Peripheral configuration and central projections of the lateral line system in Astronotus ocellatus (Cichlidae): a nonelectroreceptive teleost. AB - The lateral line system of Astronotus ocellatus comprises one trunk canal, one tail canal, and three head canals. The sensory receptors on the head are innervated by rami of the dorsal anterior, ventral anterior, and posterior lateral line nerves, and those along the trunk and tail by rami of the posterior lateral line nerve. The peripheral configuration of lateral line canals and nerves was examined in whole mount preparations, the central connections of restricted groups of endorgans studied using HRP and degeneration methods, and the neuronal morphology and cytoarchitecture of the lateralis region investigated with Nissl, silver, and Golgi methods. Neurons of the lateralis cell column are diffusely arrayed and of variable morphology. They are oriented primarily in the transverse plane and, with the exception of a dorsal lamina of large multipolar cells, are not organized into zones. Lateralis fibers bifurcate on entering the brainstem, course in lateral tracts, and give off medially directed collaterals to terminate in the ipsilateral nucleus medialis and nucleus caudalis. In addition, fibers terminate in the eminentia granularis of the cerebellum, but only fibers supplying endorgans in the head canals penetrate the granule cell zone of the cerebellar corpus. Fibers supplying sense organs in adjacent canals overlap in their central endings, whereas fibers of distantly separated receptors do not overlap. The rami supplying trunk and tail canal organs do not project as far rostrally in the central neuropil as do the other rami. Endings of posterior lateral line fibers lie dorsal to those of the anterior lateral line nerves, and some lateralis fibers terminate within the confines of the magnocellular, descending, and posterior nuclei of the octavus column. Although there is spatial order to the lateralis projections, there is no clear somatotopic organization in the lateralis region. PMID- 6480917 TI - Cortical projections to nuclei adjacent to the oculomotor complex in the medial dien-mesencephalic tegmentum in the monkey. AB - Cortical projections to cell groups surrounding the oculomotor complex were studied by using the retrograde and anterograde capabilities of the horseradish peroxidase (HRP) technique in old and new world monkeys. Fluid HRP injections or transcannular solid polyacrylamide HRP gel implants were made into the oculomotor nucleus (OMN) and adjacent nuclei to label retrogradely corticofugal neurons that project to this region, and cortical HRP gel implants were made in various areas of the frontal lobe to label anterogradely the trajectories and terminations of cortico-paraoculomotor projections and thus to confirm the retrograde findings. Projections to the paraoculomotor cell groups in the medial dien-mesencephalic tegmentum originate almost exclusively from the frontal lobe. Both retrograde and anterograde studies confirmed that the prearcuate cortex in the concavity of the arcuate sulcus, including the frontal eye field, and, to a lesser extent, suprarcuate rostral dorsal area 6 cortex and the dorsomedial convexity (area 9), project to the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) in the dorsal region of the prerubral field, nucleus of Darkschewitsch (ND), medial accessory nucleus of Bechterew (NB) and dorsomedial parvocellular red nucleus (dmPRN). The premotor area 6 and motor area 4 cortex, on the other hand, give rise to projections that target a larger portion of the parvocellular red nucleus, extending rostrally into the ventral region of the prerubral field, and a rather intense projection to the ND. The interstitial nucleus of Cajal (IC) was distinguished more by its light, or lack of, projections from the frontal cortex. The inferior parietal lobule (IPL, area 7) which has certain common physiological properties with the frontal eye field (FEF area 8) related to the oculomotor system, lacked retrogradely labeled neurons in all cases where transcannular gel implants into the OMN eliminated the possibility of HRP uptake in the corpus callosum or other structures traversed in needle injections, suggesting that the IPL affects eye movement primarily through its rostrally directed corticocortical associational connections with the FEF. In additional cases, the ND-NB-dmPRN configuration of cells that receives FEF input is shown to project to the inferior olivary complex (i.e., is pre-olivo-cerebellar), whereas riMLF and IC give rise to descending projections in the MLF, which target extraocular muscle motor nuclei, vestibular complex, and spinal cord. The results are discussed in terms of the potential role of the cerebral cortex in eye movement mechanisms. PMID- 6480918 TI - Cortical projections to the paramedian tegmental and basilar pons in the monkey. AB - The efferent connections of the cerebral cortex to paramedial tegmental and basilar pons were studied in the monkey by using the retrograde and orthograde capabilities of the horseradish peroxidase (HRP) technique. Six capuchin monkeys (Cebus apella) received transcannular pontine HRP gel implants to retrogradely label the cells of origin of corticopontine projections. Four additional capuchin monkeys, one rhesus (Macaca mulatta), and one cynomolgus (Macaca fascicularis) monkey, received HRP gel implants in premotor (area 6), frontal eye field (FEF, area 8), superior (area 5), and inferior (area 7) parietal lobules to orthogradely label the course and termination of corticopontine projections, and thus to confirm the retrograde studies. The brains were processed according to the tetramethylbenzidine (TMB) protocol of Mesulam ('78) and studied with darkfield microscopy. Premotor (area 6) frontal cortex and FEF (area 8) were found to be the main sources of cortical inputs to the ipsilateral paramedian basilar pons, whereas FEF, dorsal prefrontal convexity, and dorsal medial prefrontal (granular frontal association) cortex were the main sources of bilateral projections to the paramedian pontine tegmentum. The medial portion of the nucleus reticularis tegmenti pontis (NRTP), considered to be a tegmental extension of the basilar pontine gray, also received its principal cortical input from the frontal lobe. Parietal cortex, on the other hand, was observed to project to lateral NRTP and lateral basilar pons. Although the possibility exists of convergence of frontal and parietal eye field efferents in the NRTP, the frontal eye field and prefrontal cortex appear to be the principal source of cortical projections to the paramedian pontine tegmentum, which contains the physiologically defined PPRF (paramedian pontine reticular formation), an important preoculomotor center. The results are discussed primarily with regard to their significance for potential cortical influence on the oculomotor system. PMID- 6480919 TI - Central projections from cat suboccipital muscles: a study using transganglionic transport of horseradish peroxidase. AB - Central projections of suboccipital muscle nerves were examined following exposure of cut peripheral nerves to the tracer horseradish peroxidase. Labelled fibers entered the C1 and C2 dorsal roots and accumulated in the dorsolateral part of the dorsal funiculus. Many labelled fibers entered the grey matter of C1 to C3 in ventrally directed bundles which passed medially to the base of the dorsal horn. No terminal labelling was apparent in superficial layers of the dorsal horn. However, labelled fibers ramified extensively throughout medial parts of the intermediate laminae, in and around the central cervical nucleus. Labelled fibers also projected toward the ventral horn. In cats subjected to ventral root section at the time of peripheral nerve exposure, a modest distribution of reaction product was observed deep in the ventral horn. In cats which did not undergo ventral root section, anterograde projections in the ventral horn were obscured by the simultaneous retrograde filling of motoneurons both in the ventromedial nucleus and on the medial and lateral borders of the gray matter. Labelled axons also coursed rostrally into the medulla where they formed a circumscribed bundle between the main cuneate nucleus and the spinal nucleus of V. Three consistent regions of HRP deposition could be identified at medullary levels. Dense accumulations of reaction product were present in circumscribed regions of the external cuneate nucleus (ECN) throughout its rostrocaudal extent. A second zone of dense labelling occurred in the intermediate nucleus of Cajal, where it appeared to form a continuing column rostral to the central cervical nucleus in C1-C3. Sparse labelling was restricted to a third zone in the ventrolateral part of the main cuneate nucleus. PMID- 6480920 TI - Somatic and visceral primary afferents in the lower thoracic dorsal root ganglia of the cat. AB - Anterograde transport of horseradish peroxidase (HRP) through somatic and visceral nerves was used to estimate the proportions of somatic and visceral dorsal root ganglion (DRG) cells of the lower thoracic ganglia of the cat. A concentrated solution of HRP was applied for at least 5 hours to the central end of the right greater splanchnic nerve and of the left T9-intercostal nerve of adult cats. Some animals remained under chloralose anaesthesia for the duration of the HRP transport time (up to 53 hours) whereas longer HRP application and transport times (4-5 days) were allowed in animals that recovered from barbiturate anaesthesia. Visceral DRG cells were found in approximately equal numbers in all ganglia examined (T7-T11). Population estimates were obtained for the T8 and T9 ganglia where visceral DRG cells were found to be 6.2% (T8) and 5.2% (T9) of the total cell population. In contrast, somatic DRG cells were found in large numbers in the ganglia examined (T8 and T9) where they amounted to over 90% of the cell population. Measurement of cross-sectional areas and estimates of cell diameters of the DRG cells showed greater proportions of large somatic cells (diameter greater than 40 micron) than of large visceral cells. Similar distributions of cell size were found for both somatic and visceral DRG cells with diameters less than 40 micron. These results show that the proportion of visceral afferent fibres in the dorsal roots that mediate the spinal cord projection of the splanchnic nerve is very small. Since viscerosomatic convergence in the thoracic spinal cord is very extensive, the present results suggest considerable divergence of the visceral afferent input to the central nervous system. PMID- 6480921 TI - Cerebellar efferents in the lizard Varanus exanthematicus. I. Corticonuclear projections. AB - The organization of the cerebellar corticonuclear projections, i.e., the projections from the Purkinje cell layer to the cerebellar nuclei and the vestibular nuclear complex, was investigated with the horseradish peroxidase (HRP) technique in the lizard Varanus exanthematicus. After HRP slow-release gels were implanted in the cerebellar nuclei or various parts of the vestibular nuclear complex, the following longitudinally oriented zones of labeled Purkinje cells could be distinguished: a medial zone projecting to the medial cerebellar nucleus; an intermediate zone projecting to the vestibular nuclear complex, especially the ventrolateral vestibular nucleus, but probably also the dorsolateral vestibular nucleus; a caudolaterally located area of the cerebellar cortex projecting to the lateral cerebellar nucleus; and the flocculus and the adjacent lateral part of the Purkinje cell layer with projections to the middle and caudal parts of the vestibular nuclear complex, i.e., the descending and ventromedial vestibular nuclei. All projections of the Purkinje cells appeared to be strictly ipsilateral. It can be concluded that in reptiles a longitudinal organization of cerebellar corticonuclear projections exists, which may be basic for terrestrial vertebrates. PMID- 6480922 TI - Lipodystrophia centrifugalis abdominalis infantilis. A follow-up study. AB - To determine the course and prognosis and also to reexamine the clinical and histologic features of lipodystrophia centrifugalis abdominalis infantilis, originally described by Imamura et al in 1971, a questionnaire was sent to 94 dermatology and pediatric departments in Japan. Data on 86 cases collected from 44 departments confirmed the unique and distinct features of this disease: onset by age 3, development of the lesion in the groin, axillae, or their surroundings, presence of slightly inflammatory areas around the depressed one, and histologically, loss of subcutaneous fat in the depressed area with panniculitis in the surrounding area. The depressed lesions were found to enlarge centrifugally for several years and to involve a large part of the abdominal and/or chest wall. However, the enlargement was found to stop spontaneously by age 13, and the depressed area tended to undergo recovery thereafter. PMID- 6480924 TI - An epidemic of scabies with unusual features and treatment resistance in a nursing home. AB - An epidemic of scabies affecting elderly patients on one ward of a nursing home is described. The outbreak was characterized by a high degree of contagion and treatment resistance among patients suffering from malignant diseases and receiving immunosuppressive therapy. The clinical picture was unusual, with papules surmounted by scabies burrows and a high percentage of persistent nodular lesions. The origin of the outbreak was probably a patient with an exfoliative psoriasis, treated with an aromatic retinoid and potent topical corticosteroids. In view of the high recurrence rate, follow-up may be advisable especially in elderly patients. PMID- 6480923 TI - Selenium sulfide in tinea versicolor: blood and urine levels. AB - The safety of topical selenium sulfide lotion in man has been demonstrated previously. Twenty male patients with a diagnosis of tinea versicolor were randomly assigned to two parallel groups who applied selenium sulfide lotion or the vehicle to the entire skin surface, excluding mucous membranes, for 10 minutes once daily for 7 consecutive days. Blood and urine selenium levels were determined before and after treatment and showed no significant differences between the active drug and vehicle groups on any study day. It would appear that no significant absorption of selenium took place as a result of this treatment regimen. PMID- 6480925 TI - Dermal Merkel cells in the nevus of Ota and leopard syndrome. AB - We observed dermal Merkel cells around vellus hair follicles in one patient with nevus of Ota and one with leopard syndrome. These Merkel cells were in contact with Schwann cells and nerve endings in the dermis. The question of whether or not Merkel cells exist normally in adult dermis remains unanswered. However, their presence in these abnormal conditions suggests that normally they do occur in the dermis but go undetected because their numbers are so few or they are in a form not readily identifiable by currently available methods. PMID- 6480926 TI - Collagen injections for aging skin lines (wrinkles). AB - It appears that benefit from collagen injections accrued to a large percentage of patients who responded to our questionnaire. It is interesting that 70% did not forward any information. Of those who reported benefit, the benefit lasted less than a year and was, in fact, within the 6-month range. Still, a large percentage of those responding were enthusiastic about further injections to correct their wrinkling. PMID- 6480927 TI - Lichen aureus: a hemosiderin tattoo associated with perforator vein incompetence. AB - We present evidence that lichen aureus results from extravasation of red blood cells into the dermis caused by incompetence of an underlying perforator vein. The sudden appearance of the lesion suggests a "blow out" of the microvasculature of the lower dermis caused by failure of the valves in the perforator vein. This incompetence of the perforator vein induces a permanent reversal in normal blood flow. The consequent continuous high pressure in the cutaneous microvasculature is responsible for long-term leakage of red blood cells. Digestion of the extravasated red cells by macrophages leaves an "auto-tattoo" of insoluble hemosiderin granules, which produce the distinctive golden or burnt orange color of lichen aureus. PMID- 6480928 TI - A new skin manifestation of progressive systemic sclerosis. AB - This paper describes a pigmentary abnormality found in three patients with progressive systemic sclerosis. This consists of pigment retention over superficial blood vessels in an area of depigmentation. Sequential clinical observations demonstrated the dynamic nature of this abnormality, and on the basis of thermographic examination in one patient, we suggest that local thermal mechanisms may affect its development. This abnormality has been seen only in patients with progressive systemic sclerosis. PMID- 6480929 TI - Is "localized epidermotropic reticulosis" (Woringer-Kolopp disease) benign? PMID- 6480930 TI - Subungual epidermoid carcinoma. AB - Subungual Bowen's disease and squamous cell carcinoma are not as rare as has been implied by earlier literature. The course of the lesions is protracted. Clinically the diseases may mimic onychomycosis, chronic paronychia, eczema, verruca vulgaris, pyogenic granuloma, subungual exostosis, or malignant melanoma. Histologic examination is the key to diagnosis. As only two metastases have occurred in 110 patients, subungual epidermoid carcinomas should be regarded as low-grade malignancies that can be managed by conservative surgical ablation. The microscopically controlled excision technic (Mohs chemosurgery) is ideal for these tumors. Amputation of the affected digit is too drastic, especially when the thumb, the most common site, is involved. PMID- 6480931 TI - Mechanoanesthesia for intradermal injections. PMID- 6480932 TI - Anthralin therapy for psoriasis. PMID- 6480933 TI - Mohs' surgery using permanent sections. PMID- 6480934 TI - Practical management of widespread, atypical keratosis pilaris. PMID- 6480935 TI - Chemical composition for saltpeter. PMID- 6480936 TI - Paroxysmal pruritus. Its clinical characterization and a hypothesis of its pathogenesis. AB - In dermatologic literature generally, itching, that familiar sensation that evokes a desire to rub or scratch, has been attributed almost without exception to something occurring in the skin: e.g., an insect bite, ringworm, contact dermatitis, urticaria, lymphoma, provocation by bile salts in jaundice. Itching in such instances is almost invariably relieved quite promptly, even if only temporarily, by rubbing or scratching with only moderate vigor, not enough to damage the skin, or at most to damage it only superficially. No one scratches a mosquito bite, hives, ringworm, or even lichen planus to the point of bleeding and scarring. Winkelmann and Muller suggested in 1964, "In rare instances, the itching response does not reside in the skin...but may be analogous to phantom limb sensations." I believe that this is a common phenomenon that is characteristic of several familiar, common skin disorders, that can be readily identified from the patient's history, and that serves to explain some otherwise mysterious clinical features of those disorders; in particular, why they are regularly scratched to the point of oozing, bleeding, scarring, or lichenification. PMID- 6480937 TI - Self-healing juvenile cutaneous mucinosis. AB - A case of self-healing juvenile cutaneous mucinosis is presented. It demonstrates typical features of the disease: early age of onset, infiltrated plaque lesions of the head and torso, nodules of the face and periarticular regions, rapid onset accompanied by inflammatory phenomena, and spontaneous resolution over a few months. Skin biopsy showed the deposition of the mucin, hyaluronic acid, mainly in the upper reticular dermis, and a mild increase in fibroblasts and mast cells. Results of studies of B and T lymphocytes were normal. Although three cases have been reported in Europe, to our knowledge this is the first reported case in the English-language literature. PMID- 6480938 TI - Angiolymphoid hyperplasia demonstrating extensive skin and mucosal lesions controlled with vinblastine therapy. AB - Since Kimura's original description of an unusual subcutaneous disorder with distinctive histologic features of vascular and lymphoid proliferation, numerous descriptions of diseases with similar features have been reported. A variety of descriptive labels, including Kimura's disease, angiolymphoid hyperplasia (ALH) with eosinophilia, atypical pyogenic granuloma, papular angioplasia, and histiocytoid hemangioma, have been applied to these diseases. Although this information has broadened our understanding of the clinical and pathologic spectrum of ALH, the etiology and/or pathogenesis remains unknown. Our case report illustrates the wide range of clinical features of ALH, demonstrating extensive lesions on skin and mucosa. The extreme histologic variability with regard to eosinophils, lymphoid infiltrates, and vascular alterations is also illustrated. Dramatic response to vinblastine sulfate treatment has not been previously reported and may provide a viable treatment alternative in selected patients. PMID- 6480939 TI - Low-sulfur hair syndrome associated with UVB photosensitivity and testicular failure. AB - A 16-year-old male patient had a syndrome that included growth retardation, mental retardation, hair shaft abnormalities, neurosensory hearing loss, contractures of the fifth fingers, ultraviolet B (UVB) photosensitivity, small testicular size, and elevated levels of follicle-stimulating hormone. Reduced hair sulfur content and a characteristic pattern of light and dark birefringent bands, seen when hairs were viewed with polarization microscopy, were typical of the low-sulfur hair syndrome. UVB photosensitivity and testicular failure have not previously been identified as components of this syndrome. PMID- 6480940 TI - Pulmonary disease in idiopathic urticarial vasculitis. AB - A 45-year-old woman developed chronic urticaria clinically and cutaneous necrotizing vasculitis histologically, with arthralgias, abdominal pain, angioedema, hemoptysis, and pleuritic chest pain. An open lung biopsy revealed a leukocytoclastic vasculitis of the pulmonary venules, which may be etiologically associated with the chronic obstructive lung disease detected in this patient by pulmonary function tests. The documentation of pulmonary disease in patients with urticarial vasculitis emphasizes the potentially serious nature of this disorder and the need for careful diagnosis and prompt, vigorous treatment. PMID- 6480941 TI - Metastatic epidermotropic squamous cell carcinoma of the vagina. AB - Epidermotropic carcinomas are neoplasms with an unusual but specific propensity for invading and intimately associating with the epidermis. A unique case of squamous cell carcinoma of the vagina with epidermotropic cutaneous metastases is described. PMID- 6480942 TI - Solitary fibrofolliculoma. AB - We present a case of solitary fibrofolliculoma. Histopathologic findings of this entity are characteristic: in the dermis a central hair follicle is surrounded by a thick mantle of fibrotic and mucinous stroma, and numerous thin, anastomosing bands of follicular epithelium extend into this stroma. This entity has been described as occurring only multiply; to our knowledge, this is the first case report of a solitary fibrofolliculoma. PMID- 6480943 TI - Multiple melanomas occurring in a patient with xeroderma pigmentosum. AB - Xeroderma pigmentosum (XP) is associated with an increased frequency of cutaneous malignancies including malignant melanoma. We report a patient who developed eleven primary melanomas and numerous highly atypical nevi in addition to the basal cell carcinomas and squamous cell carcinomas more commonly seen in patients with XP. PMID- 6480944 TI - Cutaneous bronchogenic cyst with papilloma and sinus presentation. AB - The thirty-eighth case of bronchogenic cyst in the skin is reported in a 5-year old boy. This is the first case report of cutaneous bronchogenic cyst presenting as a distinct, pedunculated growth with a sinus tract at the base. Embryogenesis, differential diagnosis, and treatment are discussed. PMID- 6480945 TI - Cutaneous cryptococcosis without evidence of systemic involvement. AB - As many as 15% of cases of systemic infection with Cryptococcus neoformans have cutaneous involvement. The existence of primary cutaneous disease is controversial. We report a patient with cutaneous cryptococcosis without evidence of visceral involvement at the time of diagnosis. She has been followed up for 5 years and remains free of systemic involvement. Cutaneous cryptococcosis does not always signify systemic disease. PMID- 6480946 TI - Pre-Kaposi's sarcoma. AB - Clinically uninvolved skin in a homosexual patient with acquired immunodeficiency syndrome and Kaposi's sarcoma showed abnormal vascular proliferation (pre Kaposi's sarcoma). The diagnostic and therapeutic implications of this finding are discussed. PMID- 6480947 TI - Sterilization and care of surgical instruments and supplies. AB - Adequate instrument handling and sterilization are important aspects of office surgery. Heat sterilization is the most reliable choice. The steam autoclave is highly recommended. Dry heat is effective but can pose some storage problems. Gas sterilization is useful for heat-sensitive materials but not practical for the private office. Cold "sterilization" is not reliable for incisional surgery. In addition to proper sterilization modality selection, the surgeon must observe important standards of instrument care, packing, and storage. PMID- 6480948 TI - Annular subacute cutaneous lupus erythematosus responsive to dapsone. AB - Two patients with annular subacute cutaneous lupus erythematosus were treated with dapsone. Development of new lesions was prevented and steady improvement was noted, with eventual complete resolution of skin eruptions. PMID- 6480949 TI - Histologic patterns of congenital nevocytic nevi and implications for treatment. AB - The therapeutic problems associated with congenital nevocytic nevi (CNN) have lead to a flurry of interest in neonatal dermabrasion. This is based on the theory that nevus cells at birth are superficial and accessible to dermabrasion and that they later migrate into the deeper dermis. We studied twelve patients with CNN, including seven patients less than 3 months of age, with serial biopsies taken over a period of 15 months. In addition, four neonates with giant CNN underwent dermabrasion, and biopsies were obtained pre- and postoperatively. The histologic features of CNN and the implications for treatment are discussed. Our results are inconsistent with the idea of migration of nevus cells into the dermis during infancy. Dermabrasion of giant CNN at an early age may improve the cosmetic appearance; however, it will not remove most nevus cells and is not recommended as an effective treatment for the prevention of melanoma. PMID- 6480950 TI - Pigmentary demarcation lines associated with pregnancy. AB - Pigmentary demarcation lines are borders of abrupt transition between more deeply pigmented skin and that of lighter pigmentation. Two patients developed these lines on the lower extremities during pregnancy. PMID- 6480951 TI - Sodium lauryl sulfate irritant patch tests. III. Evaporation of aqueous vehicle influences inflammatory response. AB - Patch tests with aqueous solutions of the irritating detergent sodium lauryl sulfate (SLS) elicit varying degrees of inflammation from subject to subject and from site to site. For an investigation of the causes of this variability, two patch tests with 10% aqueous solutions of SLS were applied to adjacent areas of ventral forearm skin of eighteen volunteers. In one test the water vehicle was allowed to evaporate from the patch test unit before the patches were applied. After 22 hours the patch tests were removed, and 2 hours later the degree of inflammation was graded. Less inflammation was present at the site of the dry patch test in fifteen of eighteen subjects, and the score of inflammation between each pair was significantly less at the dry patch test site (p less than 0.001). These studies show that evaporation of water from aqueous solutions can influence the irritating potential of SLS on human skin. PMID- 6480952 TI - Herpes zoster and occult malignancy. AB - Herpes zoster and malignancy have both been associated with conditions of immune suppression. It has been well documented that herpes zoster occurs more frequently in patients with a previously diagnosed malignancy, especially lymphoma. To determine whether there is an increased frequency of malignancy subsequent to the diagnosis of herpes zoster, we studied fifty outpatients with herpes zoster and compared them with fifty control patients with psoriasis. In a follow-up period ranging from 24 to 68 months, one individual in the herpes zoster group developed a subsequent malignancy, in comparison to none in the control population and to 1.5 cancer cases expected in the general population. These results support the view that herpes zoster is not a marker for an occult malignancy. PMID- 6480953 TI - Comparison of cinnarizine, cyproheptadine, doxepin, and hydroxyzine in treatment of idiopathic cold urticaria: usefulness of doxepin. AB - Randomized double-blind trials using doxepin and several conventional antihistamines were carried out for treatment of patients with idiopathic cold urticaria. In the first double-blind trial, eight of nine patients preferred doxepin (10 mg three times daily) to cinnarizine (10 mg three times daily). In the second double-blind trial, the results of ice cube tests suppressing the effect of cyproheptadine (4 mg three times daily), doxepin (10 mg three times daily), and hydroxyzine (10 mg three times daily) did not statistically differ. However, doxepin was subjectively the most effective and it had fewer side effects than other treatments that were compared. Doxepin effectively suppressed the wheal and itching responses and shortened the duration of the wheal response in the ice cube test in all patients with cold urticaria who were studied. PMID- 6480954 TI - Mucinous syringometaplasia. AB - This is a clinicopathologic study of six patients with mucinous syringometaplasia, which was diagnosed histologically. Biopsies revealed a focal invagination of the epidermis lined by squamous epithelium, with one or several eccrine ducts leading into the vagination. The eccrine duct epithelium contained mucin-laden goblet cells, and there was mucinous syringometaplasia of the underlying eccrine coils. This histopathologic change was associated with two types of clinical lesions: (1) verrucous lesions, consistent with those described by previous authors, and (2) lesions suggestive of basal cell carcinoma, which have not been described with this pathologic entity in previous publications. PMID- 6480955 TI - Osteomyelitis complicating Mohs' chemosurgery. AB - We report a case of osteomyelitis complicating Mohs' surgery for recurrent basal cell carcinoma of the forehead. The need for immediate versus delayed repair after this type of surgery is discussed. It is evident that open, bone-exposed defects allowed to heal by secondary intention require meticulous wound care and follow-up. PMID- 6480956 TI - Update: Lyme disease--United States. PMID- 6480957 TI - Idiopathic calcinosis and vitiligo of the scrotum. PMID- 6480959 TI - Abstracts of papers presented at the 11th annual meeting of the Society for Cutaneous Ultrastructure Research. Helsinki, Finland, 17th to 20th June 1984. PMID- 6480958 TI - Actinic granuloma. An ultrastructural study of two cases. AB - Ultrastructural findings in 2 cases of actinic granuloma are presented. The changes observed at the periphery of the lesion and in the elastic fibers, with early stage of damage, were similar to those described in actinic elastosis. Later, an histiocytic reaction which was apparently directed against damaged elastic fibers was observed. The ultrastructure confirms the light-microscopic findings, but does not clarify the etiology of the lesion or its relation to granuloma annulare. PMID- 6480960 TI - Hepatic gluconeogenic and ketogenic interrelationships in the lactating cow. AB - Interrelationships between propionate, palmitate, and butyrate metabolism were investigated in vitro with [1-carbon-14] carboxyl substrates. Production of labeled glucose, ketone bodies, and carbon dioxide was used to estimate rates of bovine hepatic gluconeogenesis and ketogenesis. Incubations were with liver slices from eight lactating Holstein cows fed either a control or high concentrate-low fiber diet. Liver samples were acquired by trochar biopsy at 30, 60, 90, and 180 days postpartum. Ketone production from both palmitate and butyrate was highest in liver slices obtained at 30 days. Glucose production from labeled propionate was also highest in early lactation. The higher rates of gluconeogenesis and ketogenesis in early lactation were associated with higher hepatic carnitine palmitoyltransferase (EC 2.3.1.21) activity. Feeding the high concentrate enhanced gluconeogenesis from propionate and decreased ketogenesis from palmitate. Propionate addition (10 mM) to incubation media also decreased the total amount of palmitate oxidized [( carbon-14] dioxide plus [carbon-14] ketones). Diet had no effect on hepatic butyrate metabolism. Results indicated that ketogenesis is regulated via rate of long chain fatty acid transport into the mitochondria. Stage of lactation has a greater influence on long and short chain fatty acid metabolism than does diet composition. PMID- 6480961 TI - Effect of health status on culling and reproductive performance of Holstein cows. AB - Data were from 492 cows that calved between October 1976 and May 1977 in eight Holstein herds in Michigan. Cows were classified as those without any health related problems during lactation; those with minor reproductive health problems not serious enough to require veterinary treatment; and those with health problems severe enough to require veterinary treatment. Among primiparous cows 4.4, 16.2, and 19.1% were culled from healthy, minor, and problem groups, whereas among multiparous cows, these percentages were 11.2, 19.1, and 31.7. Among healthy cows 33.3, 38.9, and 27.8% of total culls were classified as production, reproduction, and other. Among minor and problem cows, these percentages were 31.6, 42.1, and 26.3 and 22.6, 58.5, and 18.9. The odds of being culled were 4.3 and 5.2 times as great as for first lactation cows in minor and problem groups and 1.9 and 3.7 times as great as for older cows in the two health-problem groups. Primiparous cows in healthy group averaged 50 days to first detected estrus, 68 days to first service, and 95 days open. Least squares means for performance of primiparous cows in minor and problem groups and of multiparous cows in healthy, minor, and problem groups, as deviations from healthy cows, was days to first service, 9.1, 24.0, 2.0, 12.1, and 9.1; and days open, -7.0, 15.2, 9.1, 1.8, and 12.6. Primiparous cows with health problems were at a higher risk of being culled than multiparous cows with health problems. PMID- 6480962 TI - Relationship between final temperature, thaw rate, and quality of bovine semen. AB - Relationships between thaw rate, thaw bath time, and initial bath and final seminal temperature with coefficients of determination .99 and .97 were: bath time = -.01 + 220.25(1/thaw rate); initial bath temperature = final seminal temperature - 7.29 + 390.05 (1/bath time). Ejaculates from 10 bulls were split and processed in egg yolk-citrate-glycerol, egg yolk-Tris-glycerol, and whole milk-glycerol. All semen was packaged and frozen in .5-ml French straws at -196 degrees C. Sixteen thaw treatments consisted of factorial combinations of four final seminal temperatures and four thaw rates. Treatments were assessed by post thaw acrosomal integrity after 3-h 37 degrees C incubation. Seminal quality improved with increasing final seminal temperature up to 31 degrees C and did not differ between 31 and 44 degrees C for any of the extenders. A slow thaw rate (3 degrees C/s) resulted in inferior quality for all extenders, and rates 11, 19, and 27 degrees C/s resulted in similar quality for citrate and milk extended semen. Acrosomal integrity was most for 19 degrees C/s in Tris extended semen. A significant factorial interaction existed for Tris and milk extended semen. Predicted acrosomal response of 57.7% across all extenders was at optimum final seminal temperature and thaw rate 37 degrees C and 18 degrees C/s. Bath temperature and bath time determine optimum thaw rate and final temperature of semen packaged in French straws and thus maximize seminal quality. PMID- 6480963 TI - Seasonal breeding in United States dairy goats. AB - Effects of breed, region, and interaction of breed with region on seasonality of breeding in United States dairy goats were studied. Reproductive performance data were from 76,350 official National Cooperative Dairy Herd Improvement Program records on Alpine, La Mancha, Nubian, Saanen, and Toggenburg does. Variables were month of conception, month of kidding, days open, and deviation of kidding date from March 1. Four northern regions were: 1, greater than or equal to 45 degrees latitude; 2, 40-45 degrees; 3, 35-40 degrees; and 4, less than or equal to 35 degrees. About 20% of Nubians conceived from January through August, whereas only 10% of Alpines and of Toggenburgs conceived during those months. La Manchas conceived most frequently in November whereas other breeds conceived most frequently in October. Each breed kidded most frequently in March. In September and October, 3 to 4% more conceptions occurred in Regions 1 and 2 than in 3 and 4, whereas in November, 7.3% fewer conceptions occurred in Regions 1 and 2 than in 3 and 4. In January, 13.2% of kiddings occurred in Region 4 compared to 5.6% in Region 1. Similarly, during July through December, proportionally more kiddings (11.8%) occurred in Region 4 than in Region 1 (5.2%). In the range of latitudes studied, differences in degree of seasonality due to breed, region, and interaction, although significant, were minor. PMID- 6480964 TI - Relationships between somatic cell counts and milk production. AB - The relationship between Dairy Herd Improvement program test-day milk yield and somatic cell counts in milk was analyzed in 34 dairy herds over 3 yr. Estimates of this relationship were more accurate when somatic cell counts were transformed to natural logarithms rather than actual. For 67,707 observations, test-day milk yield decreased with increasing somatic cell count. The decrease of milk yield for second and later lactations, as somatic cell count increased, was greater than for first lactations. When herds were partitioned according to herd milk production (greater than 7700, 6500 to 7700, and less than 6500 kg/yr), decrease of milk yield was linear with increasing somatic cell counts for herds averaging below 7700 kg milk. Regressions were linear, quadratic, and cubic for both parity groups in herds with high production, over 7700 kg/yr. Quarter samples were composited for each cow and cultured. Percentage of infected cows increased as somatic cell counts increased with greater infection rates above 400 X 10(3). PMID- 6480965 TI - Peripartum changes of plasma and milk vitamin A and beta-carotene among dairy cows with or without mastitis. AB - Over 12 mo we studied the relationship between peripartum concentrations of vitamin A and beta-carotene in blood plasma and milk of 93 Holsteins with or without subsequent mastitis. Blood was sampled daily from 7 days prepartum through 7 days postpartum and on alternate weeks through wk 10 of lactation. Milk samples were collected daily for 7 days postpartum and then biweekly for 10 wk. Somatic cell counts were on biweekly milk samples. Vitamin A and beta-carotene of blood plasma decreased rapidly prepartum to reach minimum concentrations at calving (vitamin A) or on day 4 to 6 postpartum (beta-carotene). Thereafter, both vitamin A and beta-carotene increased rapidly through 10 wk postpartum. Concentrations of vitamin A and beta-carotene in colostrum were higher than concentrations in milk. Cows with mastitis (somatic cells greater than 500,000 cells/ml milk) had lower vitamin A in blood plasma during days 0 to 7 and wk 2 and 4 postpartum than cows without mastitis. When data were analyzed with loge of somatic cell count as an independent regression variable, results were similar. In contrast to vitamin A, peripartum beta-carotene in blood plasma was higher among mastitic cows and was related to higher loge of somatic cell count. No significant difference was observed between mastitic and non-mastitic cows for vitamin A and beta-carotene in milk. Lower concentrations of plasma vitamin A and higher concentrations of beta-carotene during the immediate postpartum period were associated with higher milk somatic cell counts among dairy cows during lactation. PMID- 6480966 TI - Efficacy of an iodine backflush for preventing new intramammary infections. AB - Efficacy of an iodine backflush system for reducing new intramammary infection was tested in two 11-wk trials. Forty cows in each trial were paired by breed, age, stage of lactation, and intramammary infection status. Each pair was assigned randomly either to a group milked with clusters that were reverse flushed with water, 25 ppm iodine, water and air or to a group milked with clusters receiving no backflush treatment between cows. Backflushing clusters reduced infections caused by Corynebacterium bovis and coagulase-positive staphylococci in both trials. However, backflushing clusters produced no clear advantage for reducing new infections with coagulase-negative staphylococci, Gram negative bacilli, or streptococci (species other than Streptococcus agalactiae). No differences in somatic cell counts between experimental groups were observed. Teat cup liners and teat ends were swabbed after 120 and 1200 milkings/liner. Total microbial counts were significantly greater for liners that were not backflushed than from backflushed liners at each swabbing. However, no differences were significant between groups for mean teat end microbial counts in either trial. PMID- 6480967 TI - Effect of dietary calcium on selenium absorption by the nonlactating dairy cow. AB - Eleven nonlactating Holstein cows in late gestation were used to study the effect of dietary calcium concentration on apparent selenium absorption. Digestion trials with total collection helped to estimate apparent absorption of specific nutrients. Mean daily selenium intake ranged from 900 to 1700 micrograms per day. Regression analysis indicated apparent selenium absorption was maximum when dietary calcium was .8% of dry matter intake. Amounts of dietary calcium less or greater than .8% of dry matter intake reduced apparent selenium absorption. Dietary calcium quantitatively affected apparent selenium absorption in amounts of nutritional significance when selenium was provided from natural feedstuffs. PMID- 6480968 TI - Age-parity-season adjustment factors for milk and fat yields of dairy goats. AB - Dairy Herd Improvement records from 1976 through 1981 were used to obtain dairy goat age-parity-season adjustment factors for milk and fat yields. Only records from purebred and American Alpine, Nubian, Saanen, and Toggenburg does were used. Nubians were analyzed separately from other breeds. Factors were calculated for two parity groups, two seasons, and two regions. Mixed model equations were used to remove effects of doe, breed, and year. Only lactations of at least 120 days were used. Resulting curves showed maximum production between 24 and 50 mo of age. Does from the northeastern United States reached maximum production earlier than does from western states. PMID- 6480969 TI - Cryosurgical treatment of periungual warts. PMID- 6480970 TI - The Bernsco adapter. PMID- 6480971 TI - Malignant melanoma prognostic factors 6: distant metastases and length of survival. AB - Surgical resectability is the most important prognostic factor for determining the length of survival following distant metastases. Other important factors that derive prognostic significance from their correlation with surgical resectability include (1) number of metastatic sites, (2) performance status, (3) initial site of metastases, (4) interval between initial diagnosis of primary tumor and onset of distant metastases. Factors which have little or no prognostic value include location of the primary tumor, sex, age and histological characteristics of the primary tumor. PMID- 6480972 TI - Delayed wound healing with adhesive wound dressings. PMID- 6480974 TI - Histologic control of excised tissue edges in the operative treatment of basal cell carcinomas. AB - The edges of 742 basal-cell carcinoma specimens were evaluated histologically to assess subclinical extension and to ensure radical excision. This procedure is considerably simpler and faster than the time-consuming standard method of microscopically controlled surgery. No recurrences of lesions excised with this method were observed during a 31/2-year observation period. PMID- 6480973 TI - Delayed extensor tendon rupture: a complication of Mohs surgery. AB - A 63-year old man is presented who developed a ruptured extensor tendon of the hand 3 days following Mohs surgery (fresh tissue technique) for a recurrent squamous-cell carcinoma. Retrospective examination of this case led us to conclude that several different factors (partial tendon laceration, infection, and underlying medical problems) jointly contributed to this complication. These factors are discussed, along with recommendations for management of such cases. PMID- 6480975 TI - Verrucous Bowen's disease of the plantar foot. AB - A patient is presented with a recurrent plantar tumor present for 15 years. This hyperkeratotic exophytic tumor behaved historically and appeared clinically to be a verrucous carcinoma. Biopsy revealed Bowen's disease. The tumor was successfully treated with Mohs surgery. The tumor is presented due to its unusual location and its appearance that closely resembled verrucous carcinoma. The Mohs technique allows for total tumor ablation with maximal preservation of tissue in this important functional area. PMID- 6480976 TI - Chin-ball application of permethrin to cows for horn fly (Diptera: Muscidae) control. PMID- 6480977 TI - Laboratory and field evaluations of German cockroach (Orthoptera: Blattellidae) traps. PMID- 6480978 TI - Influence of a juvenile hormone analog on reproduction of normal and sterilized adult horn flies (Diptera: Muscidae). PMID- 6480979 TI - Susceptibility of the brown dog tick (Acari: Ixodidae) to fresh residues of acaricides: laboratory assays and comparison of susceptibility of different life stages of the lone star and American dog tick. PMID- 6480980 TI - Toxicity of avermectin B1 to larval yellowjackets, Vespula maculifrons (Hymenoptera: Vespidae). PMID- 6480981 TI - [Development of views on the natural focal nature of diseases and the current problems with this concept]. PMID- 6480982 TI - [Possible mechanisms of cell differentiation and morphogenesis in Metazoa]. PMID- 6480983 TI - [Effect of cerebrospinal fluid on the function of the isolated normal kidney and in a neurodystrophic process]. PMID- 6480984 TI - [Intratissular control of energy metabolism in the rat liver during starvation in the early period after a partial hepatectomy]. PMID- 6480985 TI - [Effect of age on the kinetics of the development of spontaneous and transplantable tumors and on chemotherapy effectiveness]. PMID- 6480986 TI - [Effect of a modifying factor and its combination with levorin on the fractional lipid composition of Crithidia oncopelti]. PMID- 6480987 TI - [Composition of neutral lipids, phospholipids and their fatty acids in mutant Candida tropicalis D-2 resistant to nystatin]. PMID- 6480988 TI - [Cytomorphological study of Streptomyces rimosus and Streptomyces sp. 5G in mono- and mixed cultures]. PMID- 6480989 TI - Perceptual integration of the murmur and formant transitions for place of articulation in nasal consonants. AB - This study reassessed the role of the nasal murmur and formant transitions as perceptual cues for place of articulation in nasal consonants across a number of vowel environments. Five types of computer-edited stimuli were generated from natural utterances consisting of [m n] followed by [i e a o u]: (1) full murmurs; (2) transitions plus vowel segments; (3) the last six pulses of the murmur; (4) the six pulses starting from the beginning of the formant transitions; and (5) the six pulses surrounding the nasal release (three pulses before and three pulses after). Results showed that the murmur provided as much information for the perception of place of articulation as did the transitions. Moreover, the highest performance scores for place of articulation were obtained in the six pulse condition containing both murmur and transition information. The data support the view that it is the combination of nasal murmur plus formant transitions which forms an integrated property for the perception of place of articulation. PMID- 6480990 TI - A reconsideration of acoustic invariance for place of articulation in diffuse stop consonants: evidence from a cross-language study. AB - This study explored the claim that invariant acoustic properties corresponding to phonetic features generalize across languages. Experiment I examined whether the same invariant properties can characterize diffuse stop consonants in Malayalam, French, and English. Results showed that, contrary to theoretical predictions, we could not distinguish labials from dentals, nor could we classify dentals and alveolars together in terms of the same invariant properties. We developed an alternative metric based on the change in the distribution of spectral energy from the burst onset to the onset of voicing. This metric classified over 91% of the stops in Malayalam, French, and English. In experiment II, we investigated whether the invariant properties defined by the metric are used by English speaking listeners in making phonetic decisions for place of articulation. Prototype CV syllables--[b d] in the context of [i e a o u]--were synthesized. The gross shape of the spectrum was manipulated first at the burst onset, then at the onset of voicing, such that the stimulus configuration had the spectral properties prescribed by our metric for labial and dental consonants, while the formant frequencies and transitions were appropriate to the contrasting place of articulation. Results of identification tests showed that listeners were able to perceive place of articulation as a function of the relative distribution of spectral energy specified by the metric. PMID- 6480991 TI - Perception of temporal differences in speech by "normal-hearing" adults: effects of age and intensity. AB - Many older people have greater difficulty processing speech at suprathreshold levels than can be explained by standard audiometric configurations. Some of the difficulty may involve the processing of temporal information. Temporal information can signal linguistic distinctions. The voicing distinction, for example, that separates pairs of words such as "rapid" and "rabid" can be signaled by temporal information: longer first vowel and shorter closure characterize "rabid"; shorter vowel and longer closure characterize "rapid." In this study, naturally produced tokens of "rabid" were low-pass filtered at 3500 Hz and edited to create vowel and (silent) closure duration continua. Pure-tone audiograms and speech recognition scores were used to select the ten best-hearing subjects among 50 volunteers over age 55. Randomizations of the stimuli were presented for labeling at intensity levels of 60 and 80 dB HL to this group and to ten normal-hearing volunteers under age 25. Results showed highly significant interactions of age with the temporal factors and with intensity: the older subjects required longer silence durations before reporting "rapid," especially for the shorter vowel durations and for the higher intensity level. These data suggest that age may affect the relative salience of different acoustic cues in speech perception, and that age-related hearing loss may involve deficits in the processing of temporal information, deficits that are not measured by standard audiometry. PMID- 6480992 TI - Detection of interaural phase shift between a subaudible and an audible tone. AB - Can a shift in interaural phase between a subthreshold signal and an audible contralateral probe tone affect perception of the probe? To obtain an answer, an 800-Hz tone was presented to both ears. The tone was presented continuously to one ear (-25 to + 10 dB SL) and in a sequence of four bursts per trial to the other ear (+ 10 dB SL). Interaural phase was reversed for either the second or the fourth burst in a 2 AFC task. Interaural phase-shift detection threshold (65% correct) varied with the intensity of the continuous signal; across subjects, this threshold varied from -21 to + 1 dB SL. When a 300-or 500-Hz masking tone was added to the ear with the continuous signal, phase-shift detection accuracy depended primarily upon the sensation level of the signal rather than its sound pressure level. These findings demonstrate temporal encoding at signal levels well below hearing threshold. PMID- 6480993 TI - Interaural octave phase-shift detection and aural harmonic distortion. AB - A continuous 400-Hz tone (60-75 dB SPL) and 250-msec bursts of an 800-Hz tone (10 dB SL) were delivered dichotically. Four out of nine listeners were able to detect a 180 degree interaural phase shift. When a subaudible continuous 800-Hz tone was added to the ear with the 400-Hz tone, interaural phase-shift detection depended on the phase relation of the added tone to the 400-Hz tone. These results are shown to be consistent with the hypothesis of aural harmonic distortion. PMID- 6480994 TI - Dynamic range and asymmetry of the auditory filter. AB - This experiment was designed to measure the shape and asymmetry of the auditory filter over a wider dynamic range than has been measured previously. Thresholds were measured for 2-kHz sinusoidal signals in the presence of two 800-Hz-wide noise bands, one above and one below the signal frequency. The spectrum level of the noise was 45 dB (re: 20 muPa), and the noise bands were placed both symmetrically and asymmetrically about the signal frequency. The deviation of the signal frequency from the nearer edge of each noise band varied from 0 to 0.8 times the signal frequency. Each ear of six subjects was tested, and the subjects' ages ranged from 22 to 74 years. The auditory filters derived from the data were somewhat asymmetric, with steeper slopes on the high-frequency side; the degree of asymmetry varied across subjects. The asymmetry could be characterized as a uniform stretching of the (linear) frequency scale on one side of the filter. The dynamic range of the auditory filter exceeded 60 dB in the younger listeners, but the dynamic range and sharpness of the filter tended to decrease with increasing age. PMID- 6480996 TI - The role of monaural frequency selectivity in binaural analysis. AB - The relation between the monaural critical band and binaural analysis was examined using an NoSm MLD paradigm, in order to resolve ambiguities about the width of the masking spectrum important for binaural detection. A 500-Hz pure tone signal was presented with a 600-Hz-wide band of masking noise to the signal ear. Bands of noise ranging in width from 25 to 600 Hz, or noise notches (imposed on a 600-Hz-wide band centered on the signal frequency) ranging in width from 0 to 600 Hz were presented to the nonsignal ear. All noise bands and notches were centered on 500 Hz, the frequency of the signal. The effects of varying bandwidth were radically different from those of varying notchwidth: the MLD changed from zero to approximately 8 dB over a bandwidth range of 400 Hz; for notchwidths, however, the MLD changed 8 dB over a range of only 50 Hz. The results support an interpretation that the fine frequency selectivity of monaural analysis is preserved in peripheral binaural interaction, but that a relatively wide frequency range of critical bands is scanned at a later stage of binaural processing. It was suggested that the wide spectral range of binaural analysis may provide a background against which binaural differences due to the signal are detected. PMID- 6480995 TI - Discrimination of fundamental frequency of synthesized vowel sounds in a noise background. AB - An experiment was carried out, investigating the relationship between the just noticeable difference of fundamental frequency (jndfo) of three stationary synthesized vowel sounds in noise and the signal-to-noise ratio. To this end the S/N ratios were measured at which listeners could just discriminate a series of changes in fo in the range from 10% to 0.5%. Similar measurements were obtained for pulse trains and for pure tones as a reference for the results. A measure of S/N ratio based on an approximation of the critical bandwidth appeared to provide a fairly good predictor of the masked threshold of each signal, measured in a second experiment. Using this measure, it was found that a given change in the fundamental of a pulse train could be discriminated at a lower S/N ratio than in a pure tone with a frequency equal to that fundamental. The results for the vowel sounds were found to be in between those for a low-frequency pure tone and those for a pulse train. Owing to the signal-generation method (viz., changing fo by changing the sampling frequency), three cues could in principle be used to discriminate a change in the fundamental of a vowel: A change in the residue pitch, a change in the pitch of a single prominent harmonic, or a change in the spectral envelope of the signal. It can be inferred from the results that the subjects used that particular cue which yielded best performance. Which cue was optimal depended not only on the vowel but also on fo and on the presented change in fo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6480997 TI - The accuracy of hair cell counts in determining distance and position along the organ of Corti. AB - The relationship between the density of hair cells (cells/mm) and measured distance along the guinea pig organ of Corti was determined using light microscopy and the surface specimen technique. It was demonstrated that the density of inner hair cells (IHC; mean 92.0 +/- 2.4) and 1st row of outer hair cells (OHC1; mean 118.7 +/- 2.3) did not show significant variation along the organ of Corti except within 0.5-1.0 mm of the apex and base where there was considerable variation between animals in the density of cells. There was a close relationship between the accumulated number of either IHC or OHC1 and distance from the base along the organ of Corti. Distances estimated by hair cell counts were similar to those determined by direct measurement. It is concluded that hair cell counts can be used to reliably estimate distances along the organ of Corti where accurate direct measurement is not possible, such as in scanning electron microscopy. PMID- 6480998 TI - Aspirin abolishes spontaneous oto-acoustic emissions. AB - Spontaneous oto-acoustic emissions (OAEs) were measured prior to, during, and following administration of aspirin. The dose schedule was three 325-mg tablets every 6 h for a total of 16 doses (3.75 days). In every subject studied, all spontaneous OAEs gradually diminished and then disappeared during the drug regimen. Emissions that were initially small disappeared within 14-20 h of beginning the drug regimen (3-4 doses), while initially large emissions took 40 70 h (7-12 doses) to disappear completely. In contrast, the initial size of an emission appeared unrelated to the time required for it to recover to full strength once drug administration ceased. The recovery process was highly idiosyncratic, with the emissions of some subjects returning to full strength within 24 h, while for other subjects, full recovery required several days. In two subjects having multiple emissions in the same ear, the relative sizes of the different emissions often changed greatly during the disappearance and recovery phases. When small frequency shifts appeared for these subjects, they appeared- and were in the same direction--for each of the multiple emissions. In a related experiment, the spontaneous emission was unchanged in one subject who took a drug that inhibits the intracellular entry of calcium ions (verapamil). PMID- 6480999 TI - An evaluation of the effectiveness of three hearing protection devices at an industrial facility with a TWA of 107 dB. AB - Three hearing protection devices [Siebe Norton Com-fit earplug, Flents Silenta model 080 earmuff, and E-A-R foam earplug] were compared for their effectiveness in preventing both daily temporary threshold shifts (TTS) and threshold variability between sequential annual audiograms for workers in an industrial environment with a TWA of 107 dB. Com-fit wearers showed significant TTS at 500 4000 Hz from the beginning to the end of the workday. Silenta wearers displayed significant TTS at 500 Hz and nonsignificant improvement at 6000 Hz. E-A-R wearers showed significant TTS at 1000-2000 Hz and nonsignificant improvement at 3000-6000 Hz. Statistical analysis indicated that the protection provided by the E-A-R plug was significantly better than that of the Com-fit plug at 500-4000 Hz, and significantly better than the protection of the Silenta muff at 500, 3000, and 4000 Hz. Employees' last four annual audiograms prior to the start of the TTS study were evaluated to compare the wearer groups' mean values of the %BWs statistic (sequential percent better or worse). Previous research indicates that the %BWs statistic for a properly protected population with past audiometric test experience will be less than 30%. The E-A-R group showed an acceptable %BWs value (26%), but the Silenta wearers (45%) and Com-fit wearers (53%) showed excess threshold variability in threshold measurements from year to year. PMID- 6481000 TI - A mechanism for the generation of cavitation maxima by pulsed ultrasound. AB - A train of 1-MHz pulses can generate maxima of cavitation activity [V. Ciaravino, H. G. Flynn, and M. W. Miller, Ultrasound Med. Biol. 7, 159-166 (1981)] at pulse lengths of 6 and 60 ms and at pressure amplitudes, PA, between 5.4 and 9.4 bars (or intensities between 10 and 30 W/cm2). Generation of maxima at PA between these limits on pressure amplitude implies that the increase in cavitation activity originates from gas nuclei with radii lying in a critical size range centered at about 0.08 micron. The mechanism proposed for this phenomenon suggests that nuclei in this critical range are unstabilized nuclei generated in one pulse and surviving to the next with an appreciable fraction of the survivors lying in the critical range. Transient cavities that grow from such small nuclei are shown to behave as isolated mechanical systems that on reaching maximum size collapse as imploding spheres. The maximum pressures reached in such imploding cavities would then approximate those calculated for the spherical collapse of cavities. The occurrence of the observed maxima is ascribed to the spherical collapse of transient cavities. PMID- 6481001 TI - The effects of stimulus duration on ABR and behavioral thresholds. AB - ABR and behavioral thresholds were estimated as a function of stimulus duration for three normal and two hearing-impaired subjects. Stimuli were 2000-Hz tone bursts with 0.5-ms rise/fall times and durations ranging from 1 to 256 or 512 ms. For both groups of subjects, ABR thresholds were independent of stimulus duration. Normal subjects showed greater improvement in behavioral thresholds as a function of duration than did subjects with hearing losses. Thus, it appeared that ABR and behavioral thresholds were affected differently by changes in stimulus duration and that the magnitude of these differences could depend upon the presence of hearing loss. These data indicate that temporal integration may be one factor which makes comparisons between ABR and behavioral thresholds complicated. In the present study, the magnitude of hearing loss, measured by the ABR, would have been underestimated if normal behavioral thresholds for short duration stimuli were used as the reference. PMID- 6481002 TI - Cause analysis of the Yokkaichi asthma episode in Japan. PMID- 6481003 TI - Comparative respiratory effects of ozone and ambient oxidant pollution exposure during heavy exercise. PMID- 6481004 TI - Air quality effects of residential wood combustion. PMID- 6481005 TI - Airway reactivity to sulfate and sulfuric acid aerosols in normal and asthmatic subjects. PMID- 6481006 TI - Using the HP-41CV calculator as a data acquisition system for personal carbon monoxide exposure monitors. PMID- 6481007 TI - Electrocardiographic changes of acute lateral wall myocardial infarction: a reappraisal based on scintigraphic localization of the infarct. AB - To determine how often acute lateral myocardial infarcts may be electrocardiographically "silent," a new approach was utilized in which subjects were selected by admission thallium scintigraphy. Thirty-one patients with their first infarction were identified with moderate to severe perfusion defects of the lateral and posterolateral walls, persistent over 7 days and associated with severe wall motion abnormalities. Patients with involvement of the anterior, septal or "inferior" regions were not included. In nine patients, the perfusion defect extended to the anterolateral wall: all developed ST elevation and Q waves in at least one of the "lateral" leads (I, aVL or V6) but none showed changes in the "inferior" leads (II, III or aVF). In the other 22 patients, the perfusion defect was limited to the lateral and posterolateral walls: only 12 showed ST elevations (inferior leads only in 7, lateral leads only in 2, both leads in 3) and only 9 developed Q waves (inferior in all). In 8 of these 22 patients, the infarct was silent in the sense that no ST segment elevation or Q waves were seen, although ST depressions or T wave inversions, or both, in all but one patient were compatible with subendocardial infarction. The results indicate that the standard electrocardiogram is insensitive to changes in the lateral and posterolateral regions. Additional diagnostic studies are needed for proper localization and sizing of acute myocardial infarcts. PMID- 6481008 TI - Submaximal exercise testing after stabilization of unstable angina pectoris. AB - To determine the prognostic value of exercise testing in patients with unstable angina pectoris, 125 hospitalized patients were prospectively evaluated soon after stabilization of their pain. Exercise testing was performed after exclusion of acute myocardial infarction and a pain-free period of at least 3 days (mean +/ SD 3.9 +/- 1.4). No complications were noted during or immediately after exercise testing. A positive test (angina or greater than or equal to 1 mm ST segment depression, or both) was noted in 60 patients (48%). During a 1 year follow-up period, 52 (87%) of these 60 patients had an unfavorable outcome (American Heart Association class III or IV angina, recurrent unstable angina, coronary artery bypass surgery, acute myocardial infarction or cardiac death) compared with 19 (29%) of the 65 patients with a negative test (p less than 0.001). The sensitivity and specificity of exercise testing in predicting outcome were 73 and 85%, respectively. The predictive value of a positive test was 87% and that of a negative test was 71%. Angina by itself during the exercise test was a reliable predictor of severe angina (class III or IV angina) at follow-up (sensitivity 92%, specificity 89%, positive predictive value 83% and negative predictive value 95%; p less than 0.001). The findings were not significantly affected by beta-adrenergic blocking agents or digitalis in the study sample. Thus, in patients with unstable angina which has been stabilized, the results of early submaximal exercise testing may be useful in predicting outcome in the first year after hospital discharge. Patients with a positive test result should be considered for further diagnostic studies. PMID- 6481009 TI - Segmental wall motion abnormalities in dilated cardiomyopathy: a common finding and good prognostic sign. AB - Fifty patients with idiopathic dilated cardiomyopathy were separated into two groups based on the presence of segmental or diffuse left ventricular wall motion abnormalities by radionuclide ventriculography. Investigation included a history and physical examination, electrocardiogram, chest X-ray film, M-mode echocardiogram, coronary angiogram and right ventricular endomyocardial biopsy. Patients with histologic evidence of myocarditis were excluded. Sixty-four percent of the patients had segmental and 36% had diffuse wall motion abnormalities. The group with segmental abnormalities showed significant differences in age (52.5 +/- 10.7 versus 37.8 +/- 14.6 years, p less than 0.001), New York Heart Association functional class III to IV (56 versus 89%, p less than 0.01), pulmonary capillary wedge pressure (14 +/- 9 versus 26 +/- 9 mm Hg, p less than 0.001), left ventricular end-diastolic dimension measured on echocardiogram (67 +/- 8 versus 77 +/- 11 mm, p less than 0.001), cardiac index (2.6 +/- 0.6 versus 2.0 +/- 0.5 liters/min per m2, p less than 0.01) and ejection fraction by radionuclide ventriculography (20 +/- 7 versus 13 +/- 5%, p less than 0.001). Patients with diffuse wall motion abnormalities had poorer histologic findings based on myocardial cell hypertrophy and nuclear changes (p less than 0.01) and a higher short-term mortality with a 1 year survival rate of 50% compared with 90% in patients with segmental wall motion abnormalities by life-table analysis (p less than 0.05). When data were reanalyzed excluding those patients with complete left bundle branch block, no significant change in any variable was detected. Segmental wall motion abnormalities, even when left bundle branch block is excluded, are common in dilated cardiomyopathy in the absence of coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481010 TI - Acute endocarditis in drug addicts: surgical treatment for multiple valve infection. AB - In 72 drug abusers surgically treated for acute infective endocarditis, 14 patients (19%) required surgical procedures on two valves. The predominant infecting organisms were Staphylococcus aureus and Pseudomonas aeruginosa (29%). In contrast to single valve infection, congestive heart failure was the most common operative indication (86%, p less than 0.05) and was uniformly present when both left-sided valves were involved. Surgery was performed 20 +/- 13 days after initiation of antibiotic therapy, yet 7 of the 14 patients had perivalvular abscess formation. In nine patients with solely left-sided infection, aortic and mitral valve replacements were performed. In five patients with bilateral infection, partial or complete tricuspid valvectomy was performed in conjunction with one aortic and four mitral valve replacements. Tricuspid valve competence was reestablished by valve insertion or anuloplasty in two patients, and these patients experienced less perioperative heart failure than did those with tricuspid excision alone. There was no early (less than 30 day) mortality. However, long-term follow-up revealed a reoperative incidence of 21% and a 36% late mortality rate due to prosthetic valve infection with or without dehiscence at 3 to 18 months (mean 7.2 +/- 6) after the initial operation. These late infectious complications were not related to infecting organism or prosthetic material in the tricuspid anulus, but did occur in four (57%) of seven patients with intracardiac abscess. The data indicate that multiple valve infection does not preclude successful early surgical therapy, maintaining tricuspid competence may be hemodynamically preferable, and reinfection in this addict population increases late mortality. PMID- 6481011 TI - On-line epicardial mapping of intraoperative ventricular arrhythmias: initial clinical experience. AB - An on-line automatic mapping system was developed for beat by beat display of epicardial activation during ventricular tachycardia induced at the time of cardiac surgery. A sock array of 110 button electrodes was used to record and display local activation on a video monitor at 8.3 ms intervals. On instant replay in slow motion, epicardial pacing sites were accurately localized to the nearest electrode. Local unipolar electrograms were also recorded, first from the sock array, then from an array of 16 transmural needle electrodes. The epicardial display was verified by retrospective manually derived maps using the recorded epicardial electrograms. In four patients with coronary artery disease and recurrent inducible ventricular tachycardia, earliest epicardial activation was located on slow motion replay within 1 minute. Subendocardial sites of early activation were located within 10 minutes by replay of electrograms from the needle array before ventriculotomy. Transmural and endocardial resection of these sites prevented inducibility of the tachycardia on postoperative electrophysiologic study in three of the four patients. There has been no clinical recurrence of ventricular tachycardia after 3 to 14 months of follow-up despite cessation of antiarrhythmic therapy in three of the patients. This technique has unique advantages over existing mapping methods. It provides beat by beat display of activation sequences so that clinical tachycardias that are short in duration or pleomorphic in configuration now become amenable to mapping. In addition, it markedly shortens total time on cardiopulmonary bypass. PMID- 6481012 TI - Effects of atrial fibrillation on myocardial blood flow in the ischemic heart of the dog. AB - Atrial fibrillation has a variable effect on myocardial blood flow in the intact heart. To assess its action on myocardial blood flow in the ischemic heart, measurements were made in nine dogs after ligation of the left anterior descending coronary artery before and during atrial fibrillation and with atrial pacing at the average ventricular response during atrial fibrillation. During atrial fibrillation, cardiac output decreased (from 2.4 +/- 0.2 to 1.5 +/- 0.2 liters/min, p less than 0.001) and mean aortic pressure decreased (from 90 +/- 9 to 72 +/- 7 mm Hg, p less than 0.001). Mean myocardial blood flow decreased from 63 +/- 9 to 51 +/- 9 ml/min per 100 g. Although myocardial blood flow decreased in ischemic myocardium (from 28 +/- 5 to 16 +/- 2 ml/min per 100 g, p less than 0.001), in nonischemic myocardium the changes were more variable (from 71 +/- 8 to 61 +/- 8 ml/min per 100 g, p = NS). During atrial pacing, mean and nonischemic regional myocardial blood flow were comparable with that in atrial fibrillation, whereas in the ischemic region, myocardial blood flow (20.3 +/- 3 versus 14.6 +/- 2.3 ml/min per 100 g, p less than 0.01) and left ventricular inner/outer layer ratio (0.43 +/- 0.07 versus 0.32 +/- 0.06, p less than 0.05) were lower. ST segment elevation increased with both atrial fibrillation (by 89 +/- 31%, p less than 0.05) and atrial pacing (by 51 +/- 28%). Thus, atrial fibrillation has an unfavorable influence on myocardial blood flow in the ischemic heart and worsens myocardial ischemia. This effect is at least in part due to the rapid ventricular rate. PMID- 6481014 TI - Studies on the possible mechanisms of lidoflazine arrhythmogenicity. AB - Lidoflazine is a calcium channel blocking agent that is effective and safe in the treatment of angina pectoris, but has been reported to be associated with sudden death when administered for the treatment of supraventricular arrhythmias. Studies were performed in dogs to determine if lidoflazine caused a rise in serum digoxin concentration that could cause arrhythmias or if it was directly arrhythmogenic. Dogs received chronic injections of digoxin and then digoxin in combination with lidoflazine. No increase in digoxin concentration was found. Dogs also underwent programmed electrical stimulation while not receiving medications and then after incremental doses of lidoflazine administered intravenously. Lidoflazine did not cause spontaneous ventricular tachycardia and did not lower the threshold of ventricular tachycardia induction. Combined administration of lidoflazine and digoxin did not facilitate arrhythmia induction. These studies do not support a digoxin-lidoflazine interaction or a direct arrhythmogenic action of lidoflazine. PMID- 6481013 TI - Comparative effects of propranolol, timolol and metoprolol on myocardial infarct size after experimental coronary artery occlusion. AB - The effects of equiblocking doses of three beta-adrenergic blocking agents, propranolol, timolol and metoprolol, on myocardial infarct size were evaluated in 28 dogs after acute experimental coronary artery occlusion. Heart rate, arterial pressure and arterial free fatty acid concentration were measured in an attempt to evaluate their effects on the extent of myocardial injury. The zone at risk of infarction in each dog 1 minute after left anterior coronary artery occlusion was assessed by injecting highly radioactive albumin microspheres into the left atrium, and the hypoperfused zone was determined by autoradiography. After 15 minutes, the dogs were randomized into four groups: control dogs (n = 7), propranolol-treated dogs (1.2 mg/kg intravenously, n = 7), timolol-treated dogs (0.2 mg/kg intravenously, n = 7) and metoprolol-treated dogs (1.2 mg/kg intravenously, n = 7). After 6 hours, the dogs were killed. The left ventricle was sliced and stained with triphenyl-tetrazolium chloride for measurement on infarct size. The same slices were then autoradiographed for measurement of the hypoperfused zone. The percent of hypoperfused zone that evolved to infarction (the ratio of infarct size to hypoperfused zone) was 90.4 +/- 1.9% in the control group, 72.4 +/- 2.4% in the propranolol-treated dogs (p less than 0.05 versus control group); 57.9 +/- 4.4% in the timolol-treated dogs (p less than 0.01 versus control group; p less than 0.05 versus propranolol) and 54.4 +/- 3.7% in the metoprolol-treated dogs (p less than 0.01 versus control group; p less than 0.05 versus propranolol). Thus, propranolol, timolol and metoprolol reduced myocardial infarct size in dogs by 20, 36 and 40%, respectively, after experimental coronary artery occlusion. Metoprolol and timolol protected the ischemic myocardium more effectively than did propranolol. PMID- 6481015 TI - Functional assessment of the Fontan operation: combined M-mode, two-dimensional and Doppler echocardiographic studies. AB - Combined M-mode, two-dimensional and Doppler echocardiographic studies were used to assess the postoperative status of 33 patients who had undergone the modified Fontan procedure. Twenty-four patients had surgical repair with use of a simple direct right atrium to pulmonary artery anastomosis. The remaining patients had repair with use of a prosthesis or associated Glenn shunt. Twenty-seven patients were studied early in the postoperative period (2 months or less) and the remaining patients were studied up to 6 years postoperatively. A total of 36 examinations were performed. Of the 33 patients, 13 had tricuspid atresia, 12 had double inlet left ventricle with hypoplastic right ventricular outlet chamber and 8 had complex lesions with atrioventricular canal, double outlet right ventricle or a hypoplastic ventricle. Postoperative assessment by M-mode and two dimensional echocardiography demonstrated normal or mildly reduced ventricular function (ejection fraction greater than 40%) in 22 patients. In 24 patients, a "normal" flow pattern was observed in the pulmonary artery by pulsed Doppler echocardiography, with predominant diastolic flow and accentuation by atrial systole somewhat similar to the venous flow pattern observed in the superior vena cava. "Abnormal" flow patterns (disorganized systolic flow, absence of atrial waves and little or no increase with inspiration) were observed in nine patients with reduced ventricular function or residual shunt. Continuous wave Doppler study also demonstrated mild dynamic subaortic obstruction in two patients. Combined pulsed and continuous wave studies showed atrioventricular valve insufficiency in 10 patients. Follow-up studies revealed a satisfactory clinical course in most patients. Three patients died approximately 4 to 8 months after their Fontan operation. PMID- 6481016 TI - Stress testing for comparison of synthetic patch aortoplasty with resection and end to end anastomosis for repair of coarctation in childhood. AB - Excellent clinical results have been achieved by both resection with end to end anastomosis and synthetic patch aortoplasty for the repair of coarctation of the aorta in older children. Increasing experience with exercise stress testing in the postoperative evaluation of patients with coarctation has allowed the discovery of less obvious differences between the two procedures. To evaluate these differences further, the stress tests of 50 postoperative patients who underwent coarctation repair were reviewed: 26 patients with end to end anastomosis and 24 with synthetic patch aortoplasty. Twenty normal control subjects were similarly exercised. Systolic blood pressure in the arm and leg was evaluated before and after the test. Heart rate, electrocardiogram and arm blood pressure were monitored during the test. The mean arm systolic blood pressure was higher at all points of measurement in the patients who underwent repair by end to end anastomosis than in the group who underwent patch aortoplasty. These systolic pressure differences reached statistical significance only for standing arm blood pressure before exercise (p less than 0.05) and for supine arm systolic blood pressure immediately after exercise (p less than 0.01). There was no difference in arm-leg pressure gradient between the two study groups before exercise; however, after exercise the group with end to end anastomosis had significantly higher arm-leg pressure gradients (p less than 0.001). Significant differences between the two types of repair not apparent at rest were found immediately after exercise. The long-term prognostic importance of an exercise induced arm-leg blood pressure gradient remains to be determined. However, exercise stress testing is sensitive in demonstrating these differences. PMID- 6481017 TI - Nonsurgical correction of a "frozen" disc valve prosthesis using a catheter technique and intracardiac streptokinase infusion. AB - An immobile disc of a Bjork-Shiley valve prosthesis positioned within a right ventricle to main pulmonary artery conduit was restored to normal function through mechanical tugging of a balloon catheter combined with selective right ventricular streptokinase infusion. PMID- 6481018 TI - Family history as an independent risk factor for coronary artery disease. AB - The risk of family history of ischemic heart disease independent of other well described risk factors has remained difficult to quantitate. Significant coronary artery disease was determined by coronary arteriography to be present in 223 patients and absent in 57 control subjects. Age, sex, blood pressure, serum cholesterol, cigarette smoking and the presence of diabetes and left ventricular hypertrophy on the electrocardiogram were tabulated for each patient and the data used to assign a risk score based on the American Heart Association multivariate model. Subjects were stratified and matched according to risk score to estimate risk of family history independent of familial aggregation of these seven other risk factors. Angina, myocardial infarction, cardiac death and any ischemic heart disease were ascertained in 1,319 first degree relatives. Odds ratios for overall, stratified and matched comparisons of these end points in relatives of patients and control subjects ranged between 2.0 and 3.9 (p less than 0.01 for all comparisons), indicating a higher frequency of all ischemic heart disease end points in relatives of patients with documented coronary artery disease. Life table comparison of patients at lowest risk with those at higher risk showed significantly greater cumulative frequency and earlier age of onset of all ischemic heart disease end points in relatives of low risk patients. These observations indicate that some of the risk associated with family history is independent of familial aggregation of other known risk factors and suggest that the independent effects of family history may be most important in individuals who otherwise are at low risk. PMID- 6481019 TI - Primary dysfunction of the afferent limb of the arterial baroreceptor reflex system in a patient with severe supine hypertension and orthostatic hypotension. AB - A 33 year old man with a history of recurrent episodes of orthostatic dizziness since adolescence was noted to have a supine blood pressure of 200/120 mm Hg and a standing blood pressure of 90/60 mm Hg. Results of extensive laboratory studies for secondary hypertension were negative. Studies of the autonomic nervous system function revealed normal plasma catecholamines, cold pressor test and response to 4 minute 30% of maximal static handgrip contraction and an appropriate increase in heart rate on intravenous injection of atropine. In contrast, the heart rate response to phenylephrine and sodium nitroprusside infusion, carotid massage and graded neck suction with an airtight chamber was very abnormal, indicating marked dysfunction of the afferent limb of the arterial baroreceptor reflex system. Methyldopa decreased the supine hypertension and increased the standing blood pressure. PMID- 6481021 TI - Left ventricular outflow obstruction: a complication of mitral valvuloplasty. AB - Thirty-two patients with severe mitral regurgitation underwent Carpentier mitral valvuloplasty. Postoperatively, three of these patients developed clinical and echocardiographic evidence of left ventricular outflow tract obstruction. None of these patients had asymmetric septal hypertrophy or preoperative echocardiographic demonstration of systolic anterior motion of the mitral valve. Outflow obstruction postoperatively was caused by systolic anterior motion of the mitral valve. Because this potential complication of Carpentier mitral valvuloplasty produced significant hemodynamic effects in two patients, echocardiography should be routinely performed after this operation. PMID- 6481020 TI - Lymphocytic myocarditis presenting as unexplained ventricular arrhythmias: diagnosis with endomyocardial biopsy and response to immunosuppression. AB - During a period of 18 months beginning in January 1982, a total of 65 patients were referred to the Miami Heart Institute for evaluation of either aborted out of hospital sudden death, ventricular tachycardia resistant to standard clinically directed antiarrhythmic medication programs or high grade ventricular arrhythmia (Lown class greater than or equal to IV B) with or without syncope. After complete evaluation including cardiac catheterization in all but 1 patient, 17 patients were identified in whom no obvious cardiac disease could be found. Twelve of the 17 underwent right ventricular endomyocardial biopsy. Six of the 12 biopsies demonstrated clinically unsuspected lymphocytic myocarditis (Group A). Findings in three of the remaining six biopsies were consistent with an early cardiomyopathy and in three were completely normal (Group B). Retrospective review of the clinical, laboratory, electrophysiologic, hemodynamic and angiographic data failed to identify a marker that reliably separated Group A from Group B patients. In addition to antiarrhythmic therapy guided by laboratory electrophysiologic study, all Group A patients were treated with prednisone and azathioprine. After 6 months of immunosuppression, all patients with myocarditis were reevaluated in the hospital without antiarrhythmic medication. Ventricular tachycardia/fibrillation could not be provoked in the laboratory during repeat electrophysiologic testing in five of the six patients. Repeat myocardial biopsy after all immunosuppressive therapy had been discontinued revealed absence of inflammation associated with varying degrees of residual interstitial fibrosis. There were no deaths. It was concluded that a patient with an otherwise clinically silent lymphocytic myocarditis can present with potentially life threatening ventricular arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481022 TI - Exercise stress tests and the CASS. PMID- 6481023 TI - American College of Nutrition. 25th annual meeting. Symposium on nutritional management of gastrointestinal and liver diseases and other advances in clinical nutrition. September 20-22, 1984, Boston, Massachusetts. Program and abstracts. PMID- 6481024 TI - President's plenary address. On curiosity: a developmental approach. PMID- 6481025 TI - Treatment planning in child psychiatry. PMID- 6481026 TI - Stage-related models of psychotherapy with children. PMID- 6481027 TI - Dropout from adolescent psychotherapy: a preliminary study. PMID- 6481028 TI - An overview of the "Project Future" report: "Child Psychiatry: A Plan for the Coming Decades". PMID- 6481029 TI - A brief commentary on "Project Future". PMID- 6481030 TI - "Project Future": the way forward for child psychiatry? PMID- 6481031 TI - The New York Longitudinal Studies model of temperament: gender differences and demographic correlates in a French-speaking population. PMID- 6481032 TI - Behavior assessment of the syndrome of autism: behavior observation system. PMID- 6481033 TI - Adverse health behaviors and depressive symptomatology in adolescents. PMID- 6481034 TI - Psychiatric disturbance in serious delinquents. PMID- 6481035 TI - Children's beliefs about reactions to parental divorce. PMID- 6481036 TI - Long-term psychological follow-up of patients after corrective surgery for tetralogy of Fallot. PMID- 6481037 TI - Children's Depression Inventory: investigation of procedures and correlates. PMID- 6481038 TI - Termination of parental rights--ethical issues and role conflicts. PMID- 6481039 TI - National Nutrition Monitoring System. AB - This issue contains three articles and two related reports on the National Nutrition Monitoring System (NNMS), an umbrella designation for a variety of activities carried out primarily by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture. Uses of NNMS data are legion; some examples are provided. Full exploitation of NNMS data has been hampered by lack of coordination, delays in processing, and limited understanding on the part of the nutrition community. There has been recent progress in coordinating NNMS activities. Improved understanding among members of the nutrition community will require continued educational efforts. PMID- 6481040 TI - National Nutrition Monitoring System: a congressional perspective. AB - A national nutrition monitoring system can serve as a basic epidemiological tool necessary to examine the linkages between food consumption patterns, nutritional status, and health status. The major component of the 1981 Joint Implementation Plan for a Comprehensive National Nutrition Monitoring System (NNMS) includes the interlocking of the study design and data analysis of the National Health and Nutrition Examination Survey and the Nationwide Food Consumption Survey to begin in 1987. Congress needs the information from the NNMS to formulate and evaluate the consequences of nutrition and health policies, regulations, and programs. PMID- 6481041 TI - National Nutrition Monitoring System: implications for public health policy at FDA. AB - The National Nutrition Monitoring System (NNMS) plays an essential role in major nutrition activities of the Food and Drug Administration (FDA). In relation to the current sodium initiatives, it permits the measurement over time of changes in the sodium content of the food supply and in typical diets; in sodium labeling in the marketplace; in public awareness, concerns, and practices; and in the prevalence of hypertension and related factors, such as obesity. The FDA is responsible for U.S. fortification policy and its regulation. Currently, fortification policies and practices are being reexamined, largely on the basis of analysis and interpretation of data from the 1976-1980 second National Health and Nutrition Examination Survey, which is a core component of the NNMS. FDA studies that are components of the NNMS, such as a recent survey of dietary supplement consumption, provide comprehensive data in specialized areas. Department-wide nutrition programs are also heavily dependent upon the NNMS for monitoring capabilities. Two current activities that will rely on NNMS data are the monitoring of progress in the Nutrition Objectives for the Nation for the 1990s and the development of departmental policy regarding diet, nutrition, and degenerative diseases. PMID- 6481042 TI - Current hospital practices in clinical dietetics. AB - A study was undertaken to elucidate current practices in clinical dietetics. Objectives of the study were to (a) identify operational, functional, and attitudinal factors associated with clinical dietetic practice; (b) ascertain whether there is a link between practice and professional image; and (c) determine whether there are significant differences in practice between large and small hospitals, as reported by dietitians. A questionnaire was developed and sent to a stratified sample of 200 hospitals in which the chief clinical dietitian had agreed to participate in the study. Responses were received from 177 (88.5%) hospitals. Data indicate new trends in such areas as departmental organization, location of offices, dress, and involvement in the nutrition care of patients. Further changes are needed in the development and implementation of standards of dietetic practice, the management role of clinical dietitians, and the availability of computers to facilitate decision making in clinical practice. There are only a few differences in organization and practice between large and small hospitals. In comparison with 1972, clinical dietetic practice has changed remarkably. PMID- 6481043 TI - Nutrition knowledge and food practices of high school athletes. AB - The purpose of this study was to analyze the food practices and nutrition knowledge of high school athletes currently participating in interscholastic sports and to evaluate differences in terms of selected sports variables. The data for the study were obtained by a questionnaire administered to a sample of 943 athletes from randomly selected high schools in Connecticut. The stated hypotheses were tested statistically using analysis of variance, t-tests, and Pearson correlation coefficients where appropriate. The results of the study indicated that the female athletes had better knowledge of nutrition but poorer food practices than the male athletes. There were also significant relationships between sport forms, seasons, and nutrition knowledge and food practices. High school athletes perceived their best source of nutrition knowledge to be their parents. Results on the nutrition knowledge component of the instrument showed that out of 48 possible answers, the mean correct was 26.4, while out of a possible score of 5, the mean score for food practices was 2.2. Because a positive relationship existed between the number of sport seasons and nutrition knowledge and food practice scores, sport participation may be a catalyst for learning about nutrition. PMID- 6481044 TI - Taste acuity and zinc status in chronic renal disease. AB - The malnutrition often associated with progressive renal failure may be related to a progressive deterioration of taste acuity. To determine the relationships between taste acuity, zinc status, and progressive renal failure, 27 subjects were divided into three groups and classified as having mild, moderate, or severe renal failure, with creatinine clearance of 41 to 75, 15 to 40, and 5 to 14 ml/minute, respectively. The subjects were evaluated for recognition taste thresholds for sour and sweet by the Cornsweet method. Serum, urinary, and salivary levels for zinc were determined by atomic absorption techniques. Food diaries were kept for two days; intakes of protein and zinc were calculated from the diaries. There was a significant (p less than .01) inverse relationship between creatinine clearance and recognition taste thresholds for sour and sweet. Serum zinc levels were significantly lower (p less than .01) for subjects with severe renal failure than for subjects with mild renal failure. The subjects who ingested more protein also ingested more zinc. PMID- 6481045 TI - International food component data system. AB - The International Network of Food Data Systems planning conference recommends establishing nomenclature and a system of coding for use in INFOODS. The International Food Naming System would facilitate collection, tabulation, storing, and retrieval of information. The system consists of two files for each food: one describing the name in a standardized manner and another reporting chemical and biological data. The two files are linked by International Food Number (IFN). Food names consist of controlled terms called facets: origin, part, process, stage of maturity, and grade. Within each facet, such elements as genus, species, variety (scientific name) and generic name, breed or kind, and strain (English name) are defined. Elements are assigned numerical codes to facilitate sorting and storage. Carefully defined standard descriptions are used in each facet. Each descriptor is assigned an alphabetic code, an unlimited number allowing an open-ended flexible system. IFN may be incorporated into a computerized data management system and stored data searched and sorted for information retrieval on given parameters, e.g., country, state, laboratory, or kind of package. Data can be summarized to obtain averages, ranges, and standard deviations. Summarized data, linked with the International Food Names by the IFN, may be printed out in desired format. PMID- 6481046 TI - A nutrition fair cosponsored by dietitians and legislators. AB - A nutrition fair was held in New York City through the cooperative efforts of the local Consulting Nutritionists in Private Practice, the Greater New York Dietetic Association, and two state assembly members. This event was undertaken to market the services of registered dietitians and to enhance the dietitian's role in the local legislative arena. The three-hour fair provided a forum at which the public could obtain direct information and educational materials on various nutrition topics and receive referrals for further consultation. The attendees were mostly women (72%); 63% were in the 21 to 50 age group; and 32% were more than 50 years old. The public response was positive, and the majority of attendees found answers to specific questions. The collaboration of the dietitians and the legislators was also positive. The two assembly members were able to communicate with their constituents and to see how dietitians practice. PMID- 6481047 TI - Public perceptions of sodium labeling. PMID- 6481048 TI - The feedback lecture: matching teaching and learning styles. AB - As dietetic educators, we must provide flexibility for matching teaching and learning styles as part of the course. Figure 1 illustrates the provisions for the different learner types when using the feedback lecture. In accommodating for the different learning requirements in the dietetic lecture halls, the feedback lecture can be used to match teaching and learning styles. PMID- 6481049 TI - Circulating vitamins in Alzheimer's dementia as compared with other dementias. AB - Blood levels of 12 vitamins were compared in 55 patients with Alzheimer's disease and 58 control subjects (10 intellectually alert, 12 depressed, 28 multi-infarct dementias, 8 with other specific dementias). No significant differences in vitamin blood levels were found between the Alzheimer's disease group and the control groups either individually or in total. Conventional parenteral vitamin treatment of seven patients with vitamin deficits did not benefit their cognitive state. Conventional vitamin malnutrition did not seem to contribute to the disability in these subjects. PMID- 6481050 TI - Aging, regional cerebral blood flow, and neuropsychological functioning. AB - Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers (56-88 years old), both healthy and demented, underwent the 133xenon inhalation rCBF procedure and were given the LNNB. The decrements in the gray matter blood flow paralleled decrements in performance on the LNNB. Using partial correlations, a significant proportion of shared variance was observed between gray-matter blood flow and the LNNB scales. However, there was much less of a relationship between white-matter blood flow and performance on the LNNB. This study suggests that even within a restricted age sample rCBF is related in a global way to neuropsychological functioning. PMID- 6481051 TI - Folate and vitamin B12 status in a healthy elderly population. AB - Folic acid and vitamin B12 nutritional status was examined in a group of 270 healthy elderly individuals using both dietary and biochemical measures. Of these 40 per cent had dietary intakes of folic acid that were less than half the recommended dietary allowance of 400 micrograms/day, and 13 per cent had intakes of less than half the recommended dietary allowance for vitamin B12 (3 micrograms/day). However, only 8 per cent had low plasma folates (less than 3.0 ng/ml) and only 3 per cent had RBC folates less than 140 ng/ml. Plasma true cobalamin levels less than 220 pg/ml were found in 3 per cent. None of these individuals showed any clinical signs of folate and/or vitamin B12 deficiency, and mean corpuscular volumes were not significantly greater than those for the entire population (90.8 +/- 4.1 fl). The correlations of intakes of folic acid and vitamin B12 with plasma or erythrocyte levels were moderate (about 0.5). It was also clear that those taking supplements had significantly greater blood levels than those not taking supplements, although the benefit of higher plasma or erythrocyte levels of these nutrients is not clear. The data indicate that folate and vitamin B12 status in free-living healthy elderly is not a major medical problem. PMID- 6481052 TI - Law and public policy. The case for the courts. PMID- 6481053 TI - Decision making in the care of terminally ill incompetent persons: concerns about the role of the courts. PMID- 6481054 TI - Attitudinal stumbling blocks to geriatric rehabilitation. AB - Attitudes held by geriatric patients, their families, and hospital staff are frequent obstacles to successful rehabilitation following acute illness. These attitudes interfere with patients' motivation for increasing physical independence and result in patients' becoming stranded at a more dependent level of function. Three distinct attitudes frequently encountered in geriatric rehabilitation are identified: the prejudice of ageism, the right of dependency, and the apathy of fatigue. Recognition of these attitudinal syndromes permits effective treatment interventions to enable poorly motivated geriatric rehabilitation patients to progress towards functional independence. PMID- 6481055 TI - Stroke resulting from nonvalvular atrial fibrillation. PMID- 6481056 TI - What should be taught in psychogeriatrics: a personal viewpoint. AB - Psychiatry is part of medicine. The goals of medical practice should endorse a biopsychosocial view of illness, and practitioners should accept responsibility for all phases of illness: from the acute stage through rehabilitation to recovery or chronicity. Bedside instruction should emphasize basic clinical skills in history taking and a standard examination that includes the mental state. Liaison psychiatry offers an opportunity for training in psychogeriatrics and for the psychiatrist to re-enter the medical setting in providing health care to the elderly. PMID- 6481057 TI - Postural hypotension in the elderly. AB - Postural hypotension is a common and important clinical disorder in the elderly population. The pathogenesis is multifactorial but is probably often due to changes in the autonomic nervous system, as well as to age-related changes in the cardiovascular and endocrine systems. In addition, the presence of multiple diseases and medications are common contributing factors. Standardized measurement of postural blood pressure and recording of heart rate and assessment of associated symptoms are essential for the clinical diagnosis. Evaluation and management depend on an initial thorough clinical review of problems. Usually elimination of offending medications and treatment of contributing medical disorders are adequate. Occasionally, use of volume expanders and newer experimental agents is indicated. Postural hypotension can be seen as a prototypical clinical disorder of the elderly. It reflects impaired homeostasis; its etiology is multifactorial and due to the effects of both age and disease; it is clinically protean; and it can result in falls, injury, and progressive decline if not recognized and treated early. PMID- 6481058 TI - Topical metronidazole therapy for infected decubitus ulcers. PMID- 6481059 TI - Female psychology and networking problems among female professionals. PMID- 6481060 TI - Medical students' feelings related to isolation and school environment. PMID- 6481061 TI - Sex differences in medical students' perceptions of clinical teaching activities. PMID- 6481062 TI - Social support networks and psychological adaptation of female and male medical students. PMID- 6481063 TI - The seduction theory controversy. PMID- 6481064 TI - Retinitis pigmentosa. PMID- 6481065 TI - Broken wheel acuity test: a new and valid test for preschool and exceptional children. AB - This study describes a new visual acuity test for preschool and exceptional children. It is independent of verbal responses, uses a forced-choice testing procedure, incorporates the psychometric design advantages of the Landolt ring, and can be administered at 3m (10 ft) in 5 to 7 minutes. The results support its construct validity in accurately measuring visual acuity levels and its clinical applicability for preschool and exceptional children. PMID- 6481066 TI - Multifocal lens decentration and size as a function of reading distance. AB - A new technique for bifocal size determination and decentration is discussed in detail. Tables based on bifocal power, reading distance and refracting power of the distance lens are presented in order to make bifocal lens selection less complicated. PMID- 6481067 TI - Scleroderma, keratoconjunctivitis sicca, and soft contact lens treatment. PMID- 6481068 TI - Ocular pathogenicity of Streptococcus pneumoniae. AB - Streptococcus pneumoniae is a Gram-positive organism that commonly is the etiologic agent for external ocular infections. The conjunctival response may be relatively mild or quite intense with abundant discharge. Pharmaceutical management with various topical antibiotics is extremely effective in resolving the infection. PMID- 6481069 TI - The interface of education, psychological and visual services in pediatric optometry. AB - Optometrists cannot effectively serve children with learning problems in isolation. Through integrated input from multidisciplinary sources, the optometrist can develop an appropriate vision care program for these children. PMID- 6481070 TI - Sentinel episcleral vessels. A clue to the diagnosis of asymptomatic ciliary body melanoma. PMID- 6481071 TI - Ophthalmic clinical abbreviations. AB - A glossary of terms useful to optometric practitioners is provided. This list contains abbreviated forms of the terms which should be useful for examining the information recorded from patients as well as for use in interprofessional communications including letters of referral. PMID- 6481072 TI - Office design--professional office of Michel D. Listenberger, O.D. PMID- 6481073 TI - Meeting the eye care needs of video display terminal operators. AB - The introduction of video display terminals into the workplace has brought about increased visual complaints and concern for worker's health and safety. Optometrists have a significant opportunity to provide a valuable service in this expanding area of occupational/environmental vision. This article discusses the visual, ergonomic and environmental factors which optometrists must be familiar with in order to meet the eye care needs of video display terminal operators. PMID- 6481074 TI - Silastic implant arthroplasty. Complications and their classification. PMID- 6481075 TI - Intraosseous lipoma of distal fibula. Biomechanical considerations for successful treatment. PMID- 6481076 TI - Psychological considerations of the surgical patient. An emerging issue. PMID- 6481077 TI - Considerations in pediatric surgery. PMID- 6481078 TI - Compression of the superficial peroneal nerve secondary to sleeping and sitting positions. PMID- 6481079 TI - Neuroma with causalgic symptoms. PMID- 6481080 TI - Molded shoes. A discussion. PMID- 6481081 TI - Character: a concept in search of an identity. AB - I have attempted to clarify the clinical usage of the concept of character. I have examined such terms as character trait, character, and character disorder. I have described various schemes of classification, and have proposed key definitions for the above terms. I have described the unique aspect of character, that is, its capacity to establish a relation between a superficial attribute and a deep structure. Finally, I have suggested that character represents the core of the individual from a particular point of view--a precipitate of a person's relations to the outside world. PMID- 6481082 TI - Working with shame in psychoanalytic treatment. AB - Shame is a central human affect, reflecting feelings of defect, inferiority, and failure of the self. It is, therefore, a proper focus for psychoanalytic treatment. Beginning with Freud's seminal attention to narcissism and the ego ideal, the possibility for studying shame and its relation to the ego ideal (i.e. the loving function of the superego) was inherent in psychoanalytic theory, but Freud's pursuit of intrapsychic conflict and the punitive superego postponed further elaboration of shame. Interest in the relation of the ego ideal to the superego (Hartmann, 1950; Reich, 1954), and in the ideal self (Sandler et al., 1963; Schafer, 1960, 1967) opened the way to further study of shame. Kohut's contributions, with their focus on narcissism and self-pathology, have given a language and perspective on self-deficits allowing elaboration of shame's place in psychoanalytic treatment. In this paper, I have focused on the treatment of shame in two patients. I suggest that shame lies at the very center of the narcissistic patient's pathology, with primary internal shaming (directed at the self's failures and inadequacies) permeating all aspects of the treatment. For the neurotic patient, shame is more circumscribed, reflecting partial failures of the self; it tends to be reactive, relating to passive withdrawal from internal conflict and castration fears, and is intermixed with oedipal manifestations. I have described clinical sequences that demonstrate my approach to working with shame in each of these patients. In both cases, the task is to recognize, acknowledge, accept, and investigate the patient's shame. Only after such empathic investigation can underlying conflictual and genetic derivatives be productively pursued. This sequence is often intuitively followed in analysis, but in this paper I have attempted to articulate more systematically shame's role in psychoanalytic treatment. PMID- 6481083 TI - Rational versus anagogic interpretation: xenophon's dream and others. AB - Freud's insistence that "a dream is a (disguised) fulfillment of a (suppressed or repressed) wish" has come under attack repeatedly. This principle, while never widely accepted, was nevertheless expressed, explicitly or otherwise, in the works of Homer, Herodotus, Plato, and other writers of the classical world. A detailed account of a dream of Xenophon's is employed to illustrate the capacity of a psychologically naive Athenian writer to reject anagogic interpretation in favor of a more soundly based understanding of his own dreams. This is followed with a discussion of "dreams from above," which are most likely to raise this particular issue, one of considerable clinical and theoretical importance. PMID- 6481084 TI - The two concepts of action and responsibility in psychoanalysis. AB - I have presented two major concepts of action and responsibility which have a role in psychoanalysis and have been confused in the recent literature. Intentional action is the general action concept concerning consciously, preconsciously, or unconsciously enacted goal-directed behavior. Deliberate action is a type of intentional action, performed consciously or perhaps preconsciously, that involves a choice among specific possible ways of achieving a goal. Persons are ethically responsible for their deliberations and also responsible as the agent, deliberate or not, of the manifestations of their personal characteristics. Responsibility for mere agency is not the same as ethical responsibility, but since it is easy to confuse these two concepts they may be hazardous as features of clinical dialogue. Finally, "free will" and "determinism" are discussed as issues that historically attend the above subject matter. "Free will versus determinism" is argued to be a false issue properly replaced by Freud's actual interest in the "overdetermined" multiple motivations of behavior. PMID- 6481085 TI - The neutrality of the analyst in the analytic situation. PMID- 6481086 TI - The relation between psychoanalytic theory and psychoanalytic technique. PMID- 6481087 TI - The relation between masochism and depression. PMID- 6481088 TI - Afferent innervation of the lower esophageal sphincter of the cat. Pathways and functional characteristics. AB - The sensory vagal and 'sympathetic' innervation of the lower esophageal sphincter (LES) has been investigated in cats using both electrophysiological and histochemical techniques. Histochemical studies produced evidence that 'sympathetic' afferents run in: (i) the splanchnic nerves; (ii) the sympathetic thoracic nerves; and (iii) the sympathetic cardiac branch. Electrophysiological studies allowed us to describe different kinds of LES receptors: (i) mucosal vagal receptors acting as rapidly adapting mechanoreceptors or as slowly adapting chemoreceptors; (ii) vagal and 'sympathetic' endings located in the muscular layers, adapting slowly and mainly activated by LES contractions; and (iii) vagal and 'sympathetic' endings located in the serous membrane behaving as rapidly adapting receptors sensitive to stretching. PMID- 6481089 TI - Reinnervation of a striated muscle by vagal sensory axons. AB - Fibres of the sterno-cleido-mastoid (s.c.m.) muscle normally innervated by effects of the accessory nerve have been reinnervated by afferent fibres of the vagus nerve after supranodose vagal-accessory nerve anastomoses or direct implantation of the vagus nerve into the s.c.m. in 58% of the rabbits, 60% of the cats and 75% of sheep in which experiments were performed. Afferents of the vagus growing from cell bodies of the nodose ganglion after severance of central connections can replace the efferent of motor supply to the muscle. Evidence that there was reinnervation of the s.c.m. muscle by vagal afferent fibres was provided from the observations that: (i) electrical stimulations of the anastomosed cervical vagus nerve elicited potentials in the s.c.m. muscle which were abolished by local anaesthesia or final section of the nerve proximal to the site of stimulation; (ii) discharges recorded as bursts of electromyographic potentials occurred during spontaneous movements of larynx, respiratory tract, oesophagus and stomach and on their mechanical or evoked stimulation; and (iii) horseradish peroxidase injected into the reinnervated s.c.m. muscle was detected in somata of ipsilateral nodose ganglia cells. The afferent fibres contributing to the reinnervation were confirmed to be cholinergic as transmission was blocked by gallamine and histochemical evidence obtained of cholinergic motor end-plates. Factors which may have limited the small extent of reinnervation--only one vagal sensory axon out of 600 is able to form functional connections--are discussed. PMID- 6481090 TI - The role of oesophageal and intestinal receptors in the control of gastric motility. AB - The aim of this work was to characterize the discharge pattern of vagal efferent fibers supplying the stomach, and the modifications of this pattern induced by stimulation of oesophageal or intestinal receptors. The experiments were performed on dogs in which the central end of the left thoracic vagus had been sutured to the peripheral end of the left phrenic nerve. In such preparations, the activity of the motor units of the reinnervated left hemidiaphragm indicated the activity of vagal efferent fibers. After the left hemidiaphragm had been transformed into subcutaneous muscle, it was possible to study, using electromyography, in the conscious dog, the discharge of efferent vagal fibers which originally supplied the stomach. All the gastric vagal efferent fibers presented a spontaneous discharge with a very low frequency (0.1 Hz less than f less than 5 Hz). The firing of some fibers was increased each time the gastric motility was enhanced: these fibers were considered to be excitatory fibers. In contrast, other fibers exhibited an opposite discharge pattern and they were considered to be inhibitory fibers. Among all the gastric fibers whose activity was recorded in this study, some of them presented a modification of discharge during the receptive relaxation of the proximal stomach produced by an oesophageal distension. The discharge of excitatory fibers was suppressed while that of the inhibitory fibers was markedly increased. Taking into account these modifications of discharge, parallel to the relaxation of the proximal stomach, it was assumed that these fibers originally supplied the gastric fundus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481091 TI - Role of vesical afferent nerve fibres involved in the control of internal anal sphincter motility. AB - The neural pathways involved in the interactions between urinary bladder and internal anal sphincter (IAS) were studied in anaesthetized spinal cats. Activation of vesical afferents produced in the IAS a reflex increase in the electrical activity and a reflex inhibition of the excitatory responses evoked by stimulation of one hypogastric nerve. Both reflexes are achieved partly in the lumbar spinal cord and partly within the inferior mesenteric ganglion. PMID- 6481092 TI - Reflex changes in sympatho-adrenal medullary functions in response to baroreceptor stimulation in anesthetized rats. AB - Effects of increased and decreased blood pressure on adrenal sympathetic nerve activity and catecholamine secretion were examined in anesthetized Wistar rats. Efferent nerve impulses were counted and adrenal venous plasma was collected just before and 30 s after the onset of hypotensive stimulation induced by bleeding (average decrease in systolic blood pressure over the stimulation period was 38 mm Hg) or a hypertensive stimulation induced by phenylephrine administration (average increase in systolic blood pressure over the stimulation period was 41 mm Hg). While nerve activity and epinephrine and norepinephrine secretion were not significantly altered by the change in blood pressure in baroreceptor denervated animals, there were increases in these variables (131.1% of control levels for epinephrine, 117.5% for norepinephrine, and 127.1% for nerve activity) in response to bleeding and a marked decrease (to 63.0% of control levels for epinephrine, 53.9% for norepinephrine, and 54.0% for nerve activity) in response to phenylephrine administration with baroreceptors intact. These changes were significant both with respect to control blood pressure levels and with regard to the effect of stimulation in the baroreceptor-denervated animals. The reflex responses in adrenal nerve and catecholamine secretion were generally proportional in magnitude. The present results are discussed with regard to the effects of somatic stimulation on nerve activity and catecholamine secretion. PMID- 6481093 TI - The role of cardiovascular and muscle afferent systems in control of body water balance. AB - Influences of afferent inputs from cardiovascular and muscle receptors on the activities of neurosecretory neurons in the hypothalamus, which secrete vasopressin (ADH) were studied. Recordings were made from identified neurosecretory neurons in the supraoptic (SON) and paraventricular nuclei (PVN) of cats and rats. Activation of baroreceptors in the carotid sinus and aortic arch and atrial receptors inhibited SON and PVN neuron activities, while activation of chemoreceptors in the carotid sinus excited them. Repetitive electrical stimulation of the carotid sinus and aortic nerves showed that weak stimulation produced excitation and stronger stimulation produced inhibition of SON and PVN neurons. Electrical stimulation of these nerves and the nucleus tractus solitarius (NTS) by a single or short train of pulses showed that 'fast' and 'slow' pathways between the NTS and the SON existed, while these two types of pathways were not observed between the NTS and the PVN. Evidence of direct connections from the NTS to the PVN was found by means of antidromic stimulation of the PVN. Electrical stimulations of group I afferent fibers from the gastrocnemius muscle did not change SON neuron discharges, while activation of group III and IV afferent fibers excited them. Injection of chemicals (NaCl, KCl, bradykinin) into arteries supplying the muscle excited SON neurons. The excitation disappeared after section of the muscle nerves. The results indicated that activation of small afferents from the muscle excites the SON neurons, leading to an increase in vasopressin secretion. All these studies show that afferent inputs from receptors in the cardiovascular system and in the muscle have modulatory effects on neurosecretory neurons, and participate in control of body water balance by regulating vasopressin secretion from the neurohypophysis. PMID- 6481094 TI - Role of sensory input in the control of food intake. AB - The role of the sensory input involved in the control of the food intake is briefly reviewed. Signals from mouth and throat, as well as signals from the gastrointestinal tract and the liver, are necessary but none of them are sufficient to induce satiation. The oral cues initiated by the food intake have a dual action on the feeding behavior. They first stimulate the intake in the hungry subjects. They sustain it until the amount of food ingested reaches the level necessary to equilibrate the energy balance. Finally, they participate, with the sensory input from the gastrointestinal tract, in the process inhibiting the food intake. The hedonic hypothesis of the food intake control is an attempt to explain this dual action of the peripheral alimentary analyzer in this homeostatic behavior. It was proposed that the alimentary pleasure or displeasure brought by alimentary stimuli acts as a drive for the food intake behavior. Indeed, in normal human subjects, the affective component of the alimentary sensations is not constant, but depends on the subjects' internal state. From pleasant, in subjects requiring some energy supply for long-term or short-term energy regulation, alimentary sensations become less pleasant or unpleasant in satiated subjects or in overfed subjects. This change of the affective component of a peripheral sensation, according to the internal state, was called: negative alimentary alliesthesia. Alliesthesia is a specific and reproducible phenomenon. It has been shown that the internal signal which induces negative alimentary alliesthesia depends on the carbohydrate concentration into the gastrointestinal tract, mainly into the duodenum. This signal may provide information related to the energy content of the ingested food. The neural or humoral nature of the transmission of this information from the gut to the brain is discussed. A neural link possibly involves the enteric glucidoreceptors recently described. In conclusion, the validity and the limits of the hedonic hypothesis of the food intake is briefly discussed. PMID- 6481095 TI - Independent glucose effects on rat hypothalamic neurons: an in vitro study. AB - The effects of changes in glucose concentration were studied on 256 ventromedial (VMH), 212 dorsomedial (DMH) and 59 lateral (LHA) neurons recorded from coronally oriented rat hypothalamic slices. When glucose concentration of the medium was increased (5.5-20 mM), these neurons exhibited 3 response patterns: excitation, excitation followed by inhibition, and inhibition. Twenty percent of neurons in VMH, 33% in DMH, and 41% in LHA responded to increases in glucose concentration. The majority in VMH and DMH were excited, and in LHA, inhibited. Only minor modifications of these ratios were obtained by isolating VMH from the other areas. In isolated DMH, equal numbers were excited and inhibited. Both glucose responsive and non-glucose-responsive neurons in VMH and DMH were identified by intracellular horseradish peroxidase staining. The dendritic arborizations of glucose-responsive neurons were richer than in non-glucose-responsive neurons. These results suggest that the different populations of glucose-responsive neurons in the VMH, DMH and LHA might have different functions in the regulation of glucose. PMID- 6481096 TI - [Echo-anatomy of the portal and umbilical vessels in the fetus]. PMID- 6481097 TI - [The value of ultrasound in feto-placental maturation]. PMID- 6481098 TI - [The unruptured luteinizing follicle syndrome]. PMID- 6481099 TI - [Tumor pathology of the vulva]. PMID- 6481100 TI - [Responsibility and status of midwives. Round table]. PMID- 6481101 TI - [Artificial insemination. Round table]. PMID- 6481102 TI - [Gynecologists and obstetricians in France. Demographic evolution from 1970 to 1983. Future perspectives]. PMID- 6481103 TI - [Anti-brucella agglutinins in aborted women]. AB - 52 (6.46 per cent) out of 805 women who aborted spontaneously in Gujarat state, India, were found to have positive Brucella agglutin. Infection with brucella was further confirmed by various serological tests (Rapid plate test, standard agglutination test, Rose Bengal test, Coombs' test, complement fixation test, indirect bacterial haemagglutination test, gel diffusion test and determination of C-reactive protein). Culturing 650 blood clots, 300 placentae and 800 samples of urine of women who aborted gave totally negative results. Women who were selected for this study immediately after admission to the Civil Hospital, Ahmedabad, India, came from rural areas and belonged to the farming community. They had a history of contact with animals and were of the lower socio-economic group. The relationship between brucellosis and spontaneous abortion is discussed. The aborted women would most probably have contracted the infection from their domesticated animals, since brucellosis is prevalent amongst the animals in the State of Gujerat. PMID- 6481104 TI - [Fever during labor]. AB - The authors have studied the progress of labour and the neonatal consequences for 100 patients who started labour with a high temperature. A control group consisted of 100 patients with normal temperature and the comparison showed that there was a raised risk of dystocia and of fetal distress during labour. The maternal and neonatal complications were studied in relationship to the aetiology, which was most frequently premature rupture of the membranes. The authors suggest the way these cases should be managed to lessen the maternal and neonatal risk which is associated with pyrexia in labour. These are: culturing blood, urine and a vaginal or, better still, endocervical swab; giving penicillin with gentamycin and metronidazole throughout the labour and in the first few days after delivery. Very careful monitoring should also be carried out. PMID- 6481105 TI - [Religion confronting insemination]. AB - The author attempts the difficult task of summarising the attitude of Catholicism, the Protestant religion, Jehovah's Witnesses, the Greek Orthodox and the Jewish Churches, as well as Islam, to artificial insemination, especially by donor. He discusses reasons for forbidding artificial insemination even from the husband because of onanism. He shows that the Protestant religion alone does not object to AIH and that its role as far as AID is flexible. As far as other religions AID is absolutely proscribed. PMID- 6481106 TI - [Stage 3 intra-epithelial cervical neoplasms. Conservative treatment using CO2 lasers or conization: analysis of 2 years' experience]. AB - Sixty four patients with stage III intra-epithelial neoplasia were seen in colposcopic clinic during a two years period. All were followed up for a minimum of 1 year (ranging 1 to 3 years). 28 patients 43.8%) were treated using the carbon dioxide laser in an ambulatory setting. In 36 patients (56.2%) a cone biopsy was first performed for therapy. Following laser treatment the failure rate is 7%, the failure and recurrence rate 14%. The CO2 laser appears to be an acceptable procedure for C.I.N. III lesions in young women. Selection of lesions is of paramount importance and should be able to reduce the number of therapeutic conizations. PMID- 6481107 TI - [Cesarean section preceding the 34th week of amenorrhea: maternal and fetal repercussions at the western university hospitals. Regional survey or 383 cesarean sections and 436 newborn infants out of 86,116 births in 5 years]. AB - This statistical enquiry carried out in a region of France by the University Hospital Services in Obstetrics and voluntarily devoid of bibliographical references, deals with a group that are particularly pathological and thus probably explains the seriousness of the prognosis for the newborn and the frequency of maternal morbidity following these early operations. 15% of serious maternal complications with severe neonatal pathology which was often heavy and responsible for the death of the fetus in 22.4% of the cases and the late sequelae in the newborn in more than 10% of cases, mad it important to seek for the inevitable link between the pathology and the length of gestation at the time of the operation. Only one in three children were alive without any sequelae after Caesarean carried out between 28 and 31 weeks, but more than 80% were alive when the operation was performed at 34 weeks. In view of these findings the authors suggest that each case should be considered very carefully before early Caesarean section is carried out, both from the advantages and disadvantages of this means of delivery for the baby as well as for the mother. Caesarean section before 30 weeks of amenorrhoea on an infant with an estimated weight of less than 1 000 grams is seldom to be recommended in view of the poor results for the newborn and in the absence of severe maternal pathology which requires immediate evacuation of the uterus. In view of the poor statistical results that have been analysed, early Caesarean section for fetal pathology and particularly for fetal distress when there is no adequate sophisticated means of resuscitating the baby should be lowered to the minimum possible figure. The comparative study of the notes shows that pathological conditions apparently similar to one another lead to occasions for carrying out very early Caesarean section, and also show that the outlook is different from the point of view of the immediate prognosis and a late prognosis for the newborn infant in view of the delay that has occurred before extracting the baby and of the facilities available to resuscitate the baby. PMID- 6481108 TI - Lung development in the nephrectomized ovine fetus. AB - The effect of fetal nephrectomy on lung development was studied in sheep. Fetal kidneys were removed early in the canalicular stage of lung development (95 to 99 days of pregnancy) and lung structure examined during the alveolar stage (125 to 134 days of gestation). Progesterone and estradiol 17 beta concentrations in maternal and fetal plasma were normal for gestational age, thus indicating that the ewes were not close to labour at the time the fetuses were removed. Mean body weight was significantly reduced in nephrectomized fetuses (P less than 0.05). Overall growth of the fetal lung was not markedly affected by fetal nephrectomy. However, compared to controls, alveolar airspaces were smaller in the cranial lobes of nephrectomized fetuses (P less than 0.05) and made up a smaller percentage of the parenchyma for the whole lung. There were fewer lamellar bodies per type 2 alveolar cell in nephrectomized fetuses (P less than 0.05), and more cells were without lamellar bodies (P less than 0.01). Umbilical venous thyroxin (T4) concentrations were lower in nephrectomized fetuses compared to control values (P less than 0.005). Plasma thyroxin concentration in nephrectomized fetuses correlated directly with thyroid weight (P less than 0.02). There was no significant difference in cortisol concentrations in maternal or fetal plasma or fetal tracheal fluid between the two groups. It is thus possible that the delayed lung development observed in nephrectomized fetuses was related to reduced thyroid activity. PMID- 6481109 TI - Heart rate pattern during respiratory pauses in normal infants during sleep. AB - We examined the pattern of heart rate during respiratory pauses in 10 normal infants at 1, 2, 3 and 4 months of age during sleep. Ventilation was recorded using barometric plethysmography and heart rate was measured using a precision R R preprocessor. Typically, during a respiratory pause, the R-R interval increases, reaches a maximum and then returns towards baseline within the period of a respiratory pause or shortly after. The R-R interval starts to increase within 1-3s after the onset of the respiratory pause. The magnitude of increase in R-R interval varies considerably and, in some cases, reaches up to 50% of baseline. More than 73% of respiratory pauses are associated with an increase in R-R interval in quiet sleep but only about 50% in rapid-eye-movement sleep. Screening all the R-R data in each study revealed also spontaneous fluctuations in R-R interval without respiratory pauses. These data suggest that in normal infants in the first 4 months of life a respiratory pause is more likely to be associated with an increase in R-R interval in quiet than in rapid-eye-movement sleep; the increase in R-R interval during a respiratory pause is not related to hypoxaemia and respiratory pauses are not the only events that are associated with an increase in R-R interval during sleep. PMID- 6481110 TI - Behavioural state influences the cardiovascular response to haemorrhage in lambs. AB - We investigated the effect of behavioural state on the cardiovascular response to an acute venous haemorrhage in 7 lambs aged 13 to 19 days. Each lamb had previously been anaesthetized and instrumented for measurements of electrocorticogram, electro-oculogram, nuchal and diaphragm electromyograms, pulmonary blood flow (electromagnetic flow transducer), aortic and right atrial blood pressures. The lambs were allowed to recover from surgery at least three days before they were studied. Measurements were made during a 1-minute control period and during a 1-minute experimental period that followed a 10 ml/kg body weight haemorrhage during quiet wakefulness, quiet sleep and active sleep; the haemorrhage took approximately 30s. Haemorrhage produced similar decreases in right atrial pressure and pulmonary blood flow during the three behavioural states. However, mean aortic pressure decreased more following haemorrhage during active sleep than during quiet sleep or quiet wakefulness. These results provide evidence that reflex control of the peripheral circulation is altered during active sleep compared to quiet sleep and quiet wakefulness in lambs. PMID- 6481111 TI - Effects of beta-adrenergic blockade on blood flow distribution during hypoxaemia in fetal sheep. AB - Hypoxaemia in fetal sheep causes a decrease in vascular resistance of the heart, brain and adrenal gland which results in increased blood flow to these organs. Placental blood flow is maintained. To investigate whether increased beta adrenergic activity during hypoxaemia is involved in these changes, the effects of propranolol on organ blood flows (using the microsphere method) and other cardiovascular variables were studied during fetal hypoxaemia (50% reduction of fetal haemoglobin saturation) in 5 chronically catheterized fetal sheep at 126 to 130 days of gestation. Beta-blockade during hypoxaemia caused a fetal bradycardia and a 30% drop in cardiac output. Placental and myocardial blood flows fell by 39% and 37% respectively. Total peripheral resistance increased by 35% mainly due to increased fetal placental vascular resistance. Heart and lung vascular resistances increased following propranolol. In 3 similarly catheterized animals, propranolol administered in the absence of hypoxaemia led to a 9% drop in cardiac output and placental blood flow but no redistribution of blood flow to fetal organs. It is concluded that the increased beta-adrenergic activity associated with fetal hypoxaemia limits the negative chronotropic effects of concomitantly increased vagal activity, maintains placental blood flow through its inotropic and chronotropic activity as well as by maintenance of placental vasodilatation and may be one of several factors which increase myocardial blood flow during hypoxaemia. PMID- 6481112 TI - Acute embolization of the uteroplacental circulation: uterine blood flow and placental CO diffusing capacity. AB - In an effort to determine to what extent the fetal sequalae following repeated embolization result from decreased area of placental exchange or from decreased uterine blood flow, we injected microspheres into the uterine circulation of the pregnant ewe. We measured total UBF continuously and sampled fetal blood gases in 6 chronically instrumented ewes following repeated injections of 1 to 2 million 25 mu microspheres into the common internal iliac artery at 30 min intervals. Embolization resulted in an immediate 25 to 30% drop in uterine flow, with partial recovery to about 85% of its control value within 30 min after injection. A linear relation existed between uterine blood flow and fetal O2 tension. A slightly accelerated decrease in O2 content with a more rapid increase in CO2 tension and [H+] was seen when uterine flow decreased below 150 ml X min-1 X kg fetal wt-1. Following repeated injections fetal descending aortic O2 tension and content decreased 34 and 82% respectively, while PCO2 and [H+] increased 28 and 84% respectively. Placental diffusing capacity for CO increased 117% after repeated embolization. Most of this increase could be accounted for by the fetal hypoxia and acidosis, although some of it may have resulted from distension or recruitment of vessels in the placental exchange area, or a more uniform distribution of placental blood flows. These studies suggest that the acute changes in fetal blood gas values following embolization result from a reduction in blood flow rather than from a reduced placental exchange area. PMID- 6481113 TI - The association of histologic gastritis with gastroesophageal reflux and delayed gastric emptying. AB - The aims of this study were to: 1) investigate the incidence of histologic gastritis in patients with gastroesophageal reflux (GER); 2) ascertain if gastritis in GER patients could be correlated with impaired gastric emptying; and 3) determine if the presence of histologic antral gastritis correlated with other parameters of esophageal and gastric function. Twenty-three GER patients, mean age 53.3 years (range 28-68 years) with subjective and objective evidence for GER; and 20 normal subjects (13 males and seven females), mean age 28.7 years (range 19-46 years), underwent upper gastrointestinal endoscopy. Antral biopsies obtained from the greater curvature were graded as: 0 = normal; 1 = chronic gastritis; 2 = chronic active gastritis; and 3 = chronic atrophic gastritis. All patients underwent a gastric emptying study using an isotope-labeled semisolid meal. Eighteen of the 23 GER patients (78%) had histologic gastritis compared to two (10%) of the normals. No subject had endoscopic evidence of gastritis. Gradings of histologic gastritis were significantly (p less than 0.05) correlated with delayed gastric emptying. Twelve GER patients had severe gastritis (grades 2 or 3) and their gastric emptying, 79.7% +/- 5.8 (mean +/- S.E.M.) retention of isotope at 90 minutes after the meal, was significantly slower (p less than 0.01) than the 11 GER patients with either grade 0 or 1 gastritis, 56.1% +/- 5.9 retention, or the normal subjects, 51.8% +/- 1.7. We conclude that: 1) histologic gastritis is associated with GER disease; and 2) slowing of gastric emptying can be significantly correlated with increased severity of histologic gastritis in GER patients. PMID- 6481114 TI - Choledochoduodenal fistula and choledocholithiasis: treatment by endoscopic enlargement of the choledochoduodenal fistula. AB - Choledochoduodenal fistula is an uncommon complication of choledocholithiasis. Five patients with this entity were treated by endoscopic enlargement of the choledochoduodenal fistula without complication. Choledochoduodenal fistula complicating choledocholithiasis seem to arise either from stone erosion through the bile duct into the duodenum or as a complication of vigorous instrumentation at the time of common duct exploration. In patients in whom endoscopic sphincterotomy cannot be performed because of inability to cannulate the ampullary orifice, endoscopic enlargement of the choledochoduodenal fistula can be performed safely. PMID- 6481115 TI - The effect of lactulose on psychomotor performance tests in alcoholic cirrhotics without overt hepatic encephalopathy. AB - Thirty-two alcoholic cirrhotics without clinical evidence of encephalopathy were randomized to lactulose or sucrose treatment in order to evaluate the effects of chronic lactulose therapy on five psychomotor performance tests. Statistically significant improvement was seen in three of the five tests in the lactulose treated group, while no significant improvement in any test was noted in the sucrose group. However, because of the limited extent of improvement in the lactulose treated group, problems with medication intolerance, and lack of improvement in complex psychosocial behavior, the impact of chronic lactulose therapy on mental function in cirrhotics without overt encephalopathy appears to be limited. PMID- 6481116 TI - Prednisone for chronic active hepatitis: pharmacokinetics and serum binding in patients with chronic active hepatitis and steroid major side effects. AB - The response of serum prednisolone to a single oral dose of 30 mg of prednisone was studied in 12 patients with chronic active hepatitis taking prednisone, and in six healthy volunteers. Five of the 12 patients developed major side effects with prednisone, and seven showed less or no side effects. The patients with major side effects generally had higher serum bilirubin and lower serum albumin levels than the others. Prednisolone peak levels were similar in the three groups. Unbound (free) serum prednisolone was higher at 2, 3, 4, and 8 hours, in patients with chronic active liver disease and major side effects, than in the other two groups. Studies in vitro showed that protein binding of prednisolone increased with increasing albumin concentrations, and that bilirubin could displace some bound prednisolone. We suggest that the association between major side effects, hypoalbuminemia, and hyperbilirubinemia in patients with chronic active hepatitis is attributable to increased serum unbound prednisolone caused by: 1) limited availability of binding sites (hypoalbuminemia), or 2) displacement of bound steroid by competition (hyperbilirubinemia). PMID- 6481117 TI - Abdominal manifestations of actinomycosis in IUD users. AB - The use of an intrauterine device (IUD) is associated with the presence of actinomyces in the female genital tract. Since IUD use is currently so prevalent, IUD-related pelvic inflammatory disease occasionally spreads to the rest of the abdomen. Two patients with abdominal actinomycosis in association with an IUD illustrate the problem; we review the general problem. PMID- 6481118 TI - Cheilitis antedating Crohn's disease: case report and literature update of oral lesions. AB - Oral lesions occur in an impressive number of patients with Crohn's disease. The lesions often precede the intestinal symptoms, and follow a variable course from asymptomatic to severe. They are important because of their association with Crohn's disease and the possibility that they could lead to an earlier diagnosis of Crohn's disease. We present a patient with cheilitis which preceded the recognition of colonic and perianal Crohn's disease by 7 years. The cheilitis responded to injection of steroids into the lips, but was unaffected by oral prednisone, sulfasalazine, azathioprine, and metronidazole. PMID- 6481119 TI - Transient cimetidine resistance. AB - We report the phenomenon of transient resistance to cimetidine in a 27-year-old healthy, asymptomatic woman who underwent a 5-day gastric intubation study as part of a research protocol. Despite normal blood levels after orally administered cimetidine, this subject had no gastric acid suppression in response to the drug on 2 days of the protocol. On two other occasions, however, she responded appropriately to cimetidine by raising her intragastric pH, reaching peak cimetidine blood levels that were similar to those on the days that she had not responded. The cause for this variable effect of cimetidine on intragastric pH is not known, but might reflect a cholinergic response to stress. Other mechanisms for cimetidine resistance are also discussed. PMID- 6481120 TI - Carcinoma of the colon, sclerosing cholangitis, pericholangitis, and bronchiectasis in a patient with chronic ulcerative colitis. AB - We report a patient with long-standing ulcerative colitis who developed carcinoma of the colon, sclerosing cholangitis, pericholangitis, and bronchiectasis over the course of 10-15 years. Occurrence of these rare conditions in the same patient supports their reported association and reemphasizes that there may be multisystem involvement in ulcerative colitis. PMID- 6481121 TI - Curious manifestations in cavernous hemangioma of the liver. AB - We report a cavernous hemangioma of the liver with some curious findings. Angiography showed a hypervascular lesion and the arterioportal shunt which commonly is regarded as a pathognomonic sign of malignancy. Laparoscopy showed a well-defined, reddish-purple elevated lesion with a central umbilication. As the patient was a painter and dealing with vinyl chloride monomer, we suspected the possibility of hemangiosarcoma. The lesion proved to be a cavernous hemangioma with central fibrous replacement probably in consequence of thrombosis of some cavernous spaces. PMID- 6481122 TI - Spontaneous chylous ascites of cirrhosis. AB - The spontaneous development of chylous ascites in patients with cirrhosis is documented, but its clinical features are not well defined. The incidence of this complication of chronic liver disease was 0.5% in ascitic patients in our liver unit. These patients were older than a control group with nonchylous cirrhotic ascites and, despite better liver tests, appeared to have a higher diuretic requirement. Several had disabling, recurrent spontaneous encephalopathy. The mechanism of chylous ascites in cirrhosis is probably portal hypertension causing lymphatic rupture; however, the fact that serum-to-ascites albumin gradients were similar in the two groups, indicating similar degrees of portal hypertension, suggests that other factors also play a role. Spontaneous transformation of previously clear ascites appeared to be associated with a poor prognosis. In contrast, the appearance of chylous ascites de novo in a cirrhotic patient appeared to have a more favorable outcome. Conservative management is recommended for most patients, as the degree of their liver disease appears to be the most important factor determining prognosis. PMID- 6481123 TI - Hospital staff privileges. PMID- 6481124 TI - Idiopathic portal hypertension. PMID- 6481125 TI - Hormonal influence of synthetic secretin and GIH-cholecystokinin on serum gastrin concentrations. PMID- 6481127 TI - Chromosome-linkage group correlation in Anopheles quadrimaculatus (Say). AB - Brown body (bw) is a recessive, autosomal mutant in Anopheles quadrimaculatus (Say). Independent linkage was noted between stripe (st+) and bw, and an epistatic interaction was noted for the altered expression of st+ in bw homozygotes. Reciprocal autosomal translocations and a Y-autosome translocation were used to assign bw to the left arm of chromosome 2 and st+ to the right arm of chromosome 3. PMID- 6481126 TI - Variation in pattern of mystacial vibrissae in mice. A quantitative study of ICR stock and several inbred strains. AB - We report on the variation in the pattern of mystacial vibrissae in ICR mice, of which one-half of the about 600 animals investigated showed one or more supernumerary whiskers (SWs). The SWs and their follicles--in all respects identical to the units of the standard pattern except for their smaller size- occurred at a restricted number of sites. In addition, a limited number of mice from two BALB/c strains were analyzed. Half of them also had one or more SWs, but mainly at one site. Mice of the C3H/HeJ and DBA/2J(a) strains were virtually without SWs, whereas animals from the NMRI strain were standard without exception. Nearly all animals of the C57BL/6J strain lacked between 1 and 4 vibrissae, always from one or two of the same adjacent sites. There was a slight overall predominance for the left side of the face to bear SWs and there was no clear-cut association with sex; the entire population was without obvious defects. The sites where extra or lacking whiskers occur are associated with the lines of fusion between the medial and the lateral nasal fold, and between the latter and the maxillary arch. Where tested, we always found a topologic equivalency between the pattern of the whisker follicles and the contralateral pattern of the "barrels"--multineuronal units in layer IV of the parietal cerebral cortex--whether the pattern was standard, "enriched," or lacking in elements. The data presented in this paper provided a basis for several studies carried out subsequently on animals that are the offspring of those characterized here, studies suggesting that the occurrence of supernumerary and of lacking whiskers has a genetic basis. PMID- 6481128 TI - Genetics of the fawn-hooded rat strain. The coat color dilution and platelet storage pool deficiency are pleiotropic effects of the autosomal recessive red eyed dilution gene. AB - The inheritance of coat color, hooded-coat pattern, and platelet storage pool deficiency of fawn-hooded rats was studied by crossing fawn-hooded rats with rats of other strains. It was determined that the tan coat color and the platelet storage pool deficiency were pleiotropic effects of the autosomal recessive red eyed dilution (r) gene. The hooded-coat pattern was determined to be the effect of a different autosomal recessive gene. It also was demonstrated that the tan coat color of fawn-hooded rats is a dilution and that the shade of the tan coat color expressed varied with the underlying coat color genes. PMID- 6481129 TI - H-Y antigen and the evolution of heterogamety. AB - In natural populations of platyfish, Xiphophorus maculatus, there are three sex chromosomes--W, X, and Y. Females may have one of three genotypes: WY, WX, or XX, and males may have either XY or YY. The W chromosome can be considered a modified X that blocks the male-determining function of the Y. The platyfish may represent an evolutionary stage at which female heterogamety arises through a single mutation, in the midst of a male heterogametic system. Our serological analysis revealed presence of H-Y antigen in XY and YY males, but not in XX, WX, or WY females, indicating that H-Y antigen may not be associated invariably with the heterogametic-type gonad--especially in transitional systems. PMID- 6481130 TI - Fertile male tortoiseshell cats. Mosaicism due to gene instability? AB - Two fertile male tortoiseshell Burmese cats with atypical coat color distribution were found to have normal 38XY karyotypes. Synaptonemal complex analysis of one of these cats revealed normal meiotic pairing. Progeny data indicated that both cats were transmitting both alleles at the sex-linked orange locus, but with unequal frequencies. For one of these cats, analysis of pedigree and progeny data indicated that gene instability at the orange locus was the only possible explanation for its mosaicism. A third male tortoiseshell Burmese cat with typical tortoiseshell phenotype was found to be 39XXY and sterile. PMID- 6481131 TI - Direct evidence for linkage of roan and extension loci in Belgian horses. AB - A bay roan Brabant Belgian stallion (ERn/ ern) was bred to eight chestnut American Belgian mares (ern/ ern), producing 57 foals. Thirty foals were bay roan, 25 were chestnut, one was bay, and one was chestnut roan. The recombination rate was 0.035 +/- 0.024, indicating fairly close linkage between the roan (Rn) and extension (E) loci. PMID- 6481132 TI - Genetic polymorphism of ceruloplasmin in the rat. AB - The genetic heterogeneity of ceruloplasmin in serum was studied in the progeny of the (LEW X BN)F1 X (LEW X BN)F1 rats. The results of the statistical analysis showed that the Hbb and c loci were linked. However, the autosomal Ces gene was not linked to the Hbb or c loci. The Ces gene was expressed in normal Mendelian pattern and had two alleles that manifested a low (Cesl) or high (Cesh) level of the enzyme in serum. The Cesl gene was expressed as a dominant in the F1 generation. Two phenotypes CES-H and CES-L were found in the F2 rats; the females in the parental strain and hybrid had higher ceruloplasmin concentration than the male rats. PMID- 6481133 TI - Evidence for separate gene loci (Es-1 and Es-Si) controlling serum esterases in rats. AB - The presence or absence of the Es-Si esterase (female specific sex-influenced esterase) in rat sera was reexamined by the zymogram technique using agarosegel electrophoresis. It was found that female rat sera of the BN/Kyo strain, which has been typed as the Es-Si esterase negative, display an esterase migrating between the Es-1A esterase and the Es-2C esterase. Using a specific alloantibody to the esterase, it was shown that this esterase is identical to the Es-Si esterase. Thus, BN rats are the first described inbred rats possessing the Es-Si esterase, as well as the Es-1A esterase. Mating experiments between BN rats and SHR rats confirmed a previous demonstration that the presence or absence of the Es-Si esterase is controlled by a single gene locus closely linked to the Es-2 locus where the Es-1 locus also is linked. A further survey with 39 strains by the present methods revealed that besides two sublines of the BN strain, E3/Han, LOU/Max and PVG/Max strains also possess both the ES-1A esterase and the Es-Si esterase. The results indicate that these esterases are controlled by separate gene loci. PMID- 6481134 TI - A red stripe mutant and its relationship in an allelic series in Anopheles quadrimaculatus. AB - A red stripe phenotype from a natural population of Anopheles quadrimaculatus (Say) was introduced into a laboratory colony by induced copulation. Genetic crosses made with the red stripe (strd) mutant showed it to be a member of an allelic series with stripe (st+) and nonstripe (st). The strd character is condominant with st+, and st is recessive to both strd and st+. PMID- 6481140 TI - Aspiration biopsy cytology: biopsy method of the eighties. PMID- 6481139 TI - Treatment of hypertriglyceridemia. A National Institutes of Health Consensus report abstract. PMID- 6481141 TI - Current status of bariatric surgery. PMID- 6481142 TI - Diet and cancer. PMID- 6481144 TI - Experimental medical devices, drugs and techniques. Their future social, medical and political implications (Part 3). PMID- 6481143 TI - Precocious puberty due to a diaper ointment. PMID- 6481145 TI - Diagnosis, evaluation and treatment of the child with a simple febrile seizure. PMID- 6481146 TI - Experimental medical devices, drugs and techniques. Their future social, medical and political implications (Part 4). PMID- 6481147 TI - Maternal mortality in Indiana: a report of maternal deaths in 1982. PMID- 6481148 TI - Topography and dynamics of receptors for acetylated and malondialdehyde-modified low-density lipoprotein in the plasma membrane of mouse peritoneal macrophages as visualized by colloidal gold in conjunction with surface replicas. AB - The topography and dynamics of receptors for acetylated (acetyl) and malondialdehyde-modified (MDA) low-density lipoprotein (LDL) in the plasma membrane of cultured mouse peritoneal macrophages were investigated using a new technique. Modified LDL labeled with gold particles was used to visualize LDL receptors in the plane of the plasma membrane in platinum-carbon surface replicas of critical point-dried cells. It was found that the native distribution of unoccupied acetyl-LDL receptors is diffuse, whereas unoccupied MDA-LDL receptors are preclustered in the plasma membrane. Competition and double labeling experiments suggest the existence of two distinct classes of receptor sites for acetyl-LDL and MDA-LDL. PMID- 6481149 TI - Glial fibrillary acidic protein in regenerating teleost spinal cord. AB - Immunohistological and ultrastructural studies were carried out on normal and regenerating spinal cord of the gymnotid Sternarchus albifrons, and in the brain and spinal cord of the goldfish Carassius auratus, to examine the distribution of glial fibrillary acidic protein (GFAP) in these tissues. Sections of normal goldfish brain and spinal cord exhibited positive staining for GFAP. In normal Sternarchus spinal cord, electron microscopy has revealed filament-filled astrocytic processes; however, such astrocytic profiles were more numerous in regenerated cord. Likewise, while normal Sternarchus spinal cord showed only a small amount of GFAP staining, regenerated cords were strongly positive for GFAP. Positive staining with anti-GFAP was observed along the entire length of the regenerated cord in Sternarchus, and was especially strong in the transition zone between regenerated and unregenerated cord. Both regeneration of neurites and production of new neuronal cell bodies occur readily in such regenerating Sternarchus spinal cords (Anderson MJ, Waxman SG: J Hirnforsch 24: 371, 1983). These results demonstrate that the presence of GFAP and reactive astrocytes in Sternarchus spinal cord does not prevent neuronal regeneration in this species. PMID- 6481150 TI - A perfusion-fixation procedure for the concurrent demonstration of Timm's, horseradish peroxidase (HRP), and acethycholinesterase (AChE) histochemistry. AB - The sulfide-silver method of Timm has been a widely used histochemical technique to demonstrate the presence of heavy metals in biological tissue, particularly in the central nervous system. However, the use of this method or its several modifications results in less than optimal morphological preservation and requires embedding the tissue in paraffin or freezing it and cutting it directly onto slides with a cryostat. These procedures can decrease the sensitivity and limit the application of other histochemical procedures, particularly when experiments necessitate processing large specimens or reaction procedures require techniques using free-floating sections. A perfusion-fixation protocol is described that yields sufficient fixation to cut whole frozen blocks of tissue with a sliding microtome, permits the use of free-floating sections, and allows the concurrent demonstration of horseradish peroxidase and acetylcholinesterase histochemistry without loss of sensitivity. The method consists of a short initial exposure to a sodium sulfide solution followed by a prolonged exposure to a combined sulfide-aldehyde fixative solution. PMID- 6481151 TI - Ultrastructural immunocytochemistry of particulate fractions using polyvinyl chloride microculture wells. AB - A method is described for immunoelectron microscopy of particulate subcellular fractions using polyvinyl chloride (soft) microculture wells as mechanical supports and reaction vessels. Appropriate quantities of particles are centrifuged onto the well bottoms, fixed and permeabilized if necessary, then labeled by standard procedures, fixed in glutaraldehyde and tannic acid, and prepared for thin section electron microscopy. The centrifugation, the fixations, and the embedment in Epon are discussed in detail. PMID- 6481152 TI - The significance of morphometric procedures in the investigation of age changes in cytoarchitectonic structures of human brain. AB - The investigations were performed on NISSL-stained cytoarchitectonic images of totally 78 human brains (aged between 18 and 111 years) in the frontal area 11 (inside sulcus olfactorius) with 60 samples and in the visual cortex (area 17) with 45 samples. The morphometric measurements were taken by using a semiautomatic equipment. The largest projection areas of neurons were digitized over a drawing mirror. The arrangement of fields made it possible to get values for the total cortex and its layering. During the calculation the age-dependent embedding shrinkage was paid attention to. Therefore, the values concern the fresh tissue. The neuronal and glial densities, the neuronal sizes and size distributions were calculated by using stereological and statistical principles. The results outline the following points: A basic description of the cytoarchitectonics is given in their qualitative and quantitative aspects. The individual variation shows high differences, which however, are in accordance with a normal statistical distribution. In area 11 we could find a significant difference of neuronal densities between males and females. The cell-sizes and the aging behavior are not different. In area 17 the amount of female brains was too small for statistics. The aging of both areas showed that the densities of neurons and glial cells do not decrease. A small increase may be possible. The neuronal sizes of area 11 are constant up to 60 years, then a distinct decrease can be observed. During aging the size decrease of neurons is very small in area 17. The layer III usually shows a distinct decrease of neuronal size during aging while layer V has a nearly constant size. The results were discussed and compared with other publications. The differences between our results and earlier publications seem to be mainly due to methodical problems. The older papers do and could probably not observe the stereological procedures of measuring and the age differences of the embedding procedures. The main result is that every gray structure of the brain has its own history. PMID- 6481153 TI - [Size of specific midbrain structures (external measurements)]. AB - Measurements are given from the crus cerebri, brachia colliculorum, trigonum lemnisci (inferius), colliculi cranialis et caudalis, lamina tecti, tegmentum mesencephali, fossa interpeduncularis, frenulum veli medullaris cranialis and exitzone of trochlear nerve. PMID- 6481154 TI - Comparison of brain structure volumes in insectivora and primates. IV. Non cortical visual structures. AB - The relative size of the eyes, optic nerves, chiasms and tracts, and of the dorsal nucleus of the lateral geniculate body is distinctly larger in Primates than in (theoretically) isoponderous Insectivora. Within Insectivora, the relative size is lowest in moles, medium in shrews and hedgehog-like tenrecs, and largest in hedgehogs. Within Primates, all relative sizes are on the average larger in simians than in prosimians: the eyes to a small degree, the lateral geniculate bodies moderately and the optic nerves considerably larger. The ratio between eyes and optic nerves is large in night-active primates and distinctly smaller in day-active forms, with no overlap. The only night-active simian (Aotus trivirgatus) is in line with night-active prosimians. The relative size of the non-cortical visual structures in man is in line with that of day-active simians, whereas two of the great apes (orang-utan and gorilla) are relatively low. The size of the visual structures appears to depend mainly on functional requirements and is not, or is distinctly less, related to differences in the evolutionary level. The size of the visual structures of tree-shrews (Scandentia) shows special features which are not found in Insectivora and Primates and is compatible with their separation from these orders. PMID- 6481155 TI - [Afferent connections of the visual cortex in the albino mouse]. AB - The afferent connections of the visual cortex of the albino mouse have been studied with the aid of the enzyme Horseradish peroxidase (HRP). Ipsilateral HRP positive cells have been found in areas 17, 18a, 18b and the temporal cortex; in the contralateral cortex, they were located in areas 17, 18a and in the temporal cortex, the greatest number of labeled cells being situated near the 17/18a border. Apart from the Nucleus dorsalis corporis geniculati, more thalamic nuclei project to the visual cortex; the Nucleus lateralis thalami, pars posterior contains regularly positive cells, whereas other nuclei (Nucleus lateralis thalami, Nucleus medialis thalami, pars lateralis, Nucleus ventralis thalami, pars lateralis and pars medialis) only in some cases show labeled cells. Sporadically, a few labeled cells were observed in the Nuclei medialis and lateralis tractus optici, Nucleus praetectalis thalami and the Nucleus centralis medialis. The afferent connections from the brain stem have not always been visualized. The most frequent afferent connections come from the Nucleus dorsalis tegmenti pontis, followed by the Nucleus reticularis tegmenti pontis and the Nucleus Locus coerulei. Occasionally, a few HRP-positive cells were found in the Nucleus ventralis tegmenti, Nucleus raphe dorsalis, Nucleus parabrachialis lateralis and in the Nucleus centralis superior. The morphology of the projecting neurons in different centres was studied and compared after HRP-filling and after Golgi-impregnation. PMID- 6481156 TI - Types of synapses and degeneration in the thalamic nucleus ventralis oralis posterior after cerebellar lesions in the squirrel monkey. AB - The thalamic nucleus ventralis oralis posterior (V.o.p) of Saimiri sciureus corresponds to the posterior basal part of the ventral lateral nucleus and is characterized by medium-sized nerve cells. Electron microscopic study revealed seven different types of synapses and the size of vesicles in each has been quantitatively determined. The synapse of type I LR (Large with Rounded vesicles) is considerably larger than the similar type IV MR (Medium-sized with Rounded vesicles) both contain round to ovoid vesicles and a large amount of mitochondria. Their contacts are asymmetric with presynaptic aggregations of synaptic vesicles. The type I LR synapses may also form button-like contacts (adhering junctions) without presynaptic accumulation of synaptic vesicles. The type II F (large with Flattened vesicles) symmetric synapses are formed by large boutons containing flattened vesicles and are partially encircled by astrocytic processes. The type III SR (Small with Rounded vesicles) bouton possesses small, nearly round till ovoid dense vesicles and forms a strongly asymmetric contact. In the type V SO (Small with Ovoid vesicles) bouton, the pleomorphic vesicles are larger than in type III and form asymmetric contacts with relatively small dendrites. Finally, two types of dendritic terminals were distinguished (VI and VII), which can be differentiated chiefly by the distribution of synaptic vesicles; VI DE (Dendritic terminal with Evenly distributed vesicles) and VII DC (Dendritic terminal with Clustered vesicles). Following hemicerebellectomy (4 experiments), only the type I LR and type IV MR synapses were found to be degenerated in the thalamic nucleus V.o.p. Similar degeneration was found in the ventral intermediate nucleus (V.im) which corresponds to the most rostral part of the VPL nucleus (VPLo). After three days survival, the forms of degeneration were largely neurofilamentous or pale, becoming mostly dark after four days. Degeneration of these same types of synapses appeared also in the nucleus ventralis oralis internus (V.o.i) and in the nucleus dorsalis intermedius (D.im), which lies above the ventral intermediate and ventrocaudal nuclei of the thalamus. These results are in good agreement with the findings in the light microscopic investigations if one considers the cyto- and myeloarchitectonic boundaries between the V.o.p and V.im. PMID- 6481157 TI - Subcortical projections of the pericruciate cortex of cat. An autoradiography study. AB - This communication deals with an autoratiographic analysis of two experiments in which multiple injections of 35S methionine were performed around the cruciate sulcus of cat. One case was studied in coronal sections and the other in sagittal sections. The thalamic projections include: (1) the anterior pole of nucleus reticularis; (2) the rostral pole of the ventral thalamus (VA and VL); (3) parts of the ventrobasal complex (VPLm and (VPM); (4) intralaminary centers, in particular CL; and (5) a region around the ventral end of the fasciculus retroflexus. Instead of a terminal projection, the latter appears to receive a system of collateral fibers which leave the cerebral peduncle at meso diencephalic levels. An intricate pattern of negatively outlined centers was found. One of them ("nucleus Q") appears as a relatively large, non-labelled field within the ventrobasal thalamus, surrounded by a "halo" of labelled territories from which it is separated by a sharp outline. Other circumscribed negatively outlined fields appear as "islands" interposed between CL and VL. Surprisingly, hardly any target structures were seen beyond the mesencephalon, with the exception of the ipsilateral pontine nuclei and the so called lateral reticular nucleus of the medulla oblongata, contralaterally. The pyramidal tract was well labelled at all levels indicating a large projection to the spinal cord. The reason why no cortico-reticular projections were labelled is not clear. PMID- 6481158 TI - Auditory and non-auditory subcortical afferents to the inferior colliculus in the rat. AB - Afferent projections to the rat inferior colliculus (IC) were studied by using the method of retrograde transport of horseradish peroxidase (HRP). Microinjection of HRP revealed an ordery arrangement of fiber projections between the cochlear and the central nucleus of IC; it entails a reversal of the dorso ventral nucleotopic organization. An indistinct dorso-lateral nucleotopic projection was found between the lateral superior olivary nucleus and the central nucleus. Small number of neurons in some brainstem non-auditory structures were always labeled: the parabrachial region of the midbrain lateral tegmentum, the pars lateralis of substantia nigra, dorsal part of the central gray matter at a caudal 2/3 level of IC, and deep layers of the superior colliculus, ipsilaterally, and the spinal trigeminal and posterior column nuclei, contralaterally. Small injection restricted within the external and pericentral nuclei (cortical zone) of IC resulted in a higher distribution ratio of labeled neurons in the non-auditory structures as compared with those in the central nucleus. On the other hand, the ratio in the brainstem auditory nuclei decreased definitely after HRP-injection within the cortical zone, with an exception of the ipsilateral central nucleus of IC which contained many labeled cells following the injections in the cortical zone. The present results suggest a dual function of the inferior colliculus. The central nucleus acts as a relay station in the main auditory system, while the cortical zone, with its converging auditory, visual and somatic inputs, may act as a subcortical integration center for acoustico-motor behavior. PMID- 6481159 TI - Alloimmune memory is absent in Hymeniacidon sinapium, a marine sponge. AB - The southern California sponge Hymeniacidon sinapium can recognize and reject transplanted allogeneic tissues. This species reveals a complex rejection response that involves cellular infiltration into the graft interface and a deposition at that site of a fibrous wall. The response then proceeds to a cytotoxic reaction in which the cells in the graft zone become necrotic and slough off, resulting in allogeneic tissue separation. The rate and intensity of this response varies with the genetic constitutions of the paired sponges and the temperature of the water. In experiments employing pre-sensitized second-set and unrelated third-party graftings, with changes in temperature, sensitization times, intervals before regrafting, and experimental sites, this species did not exhibit alloimmune memory (i.e., accelerated second-set rejection). When the allorejection described here for H. sinapium is taken in conjunction with rejection responses reported for other sponge species, it is apparent that sponges have two major methods for responding to allogeneic contacts: barrier formation or cytotoxicity. The rejection method seems to correspond with the presence or absence of immune memory, and may, in part, be correlated with habitat and frequency of contacts with "non-self." The development of the rudimentary immune system in metazoans is discussed in relation to the rejection of naturally transplanted tissues in addition to challenges from pathogens. PMID- 6481160 TI - An oligosaccharide biosynthetic defect in concanavalin A-resistant Chinese hamster ovary (CHO) cells that enhances NK reactivity in vitro and in vivo. AB - We have examined a concanavalin A-resistant (Con AR) Chinese hamster ovary cell (CR-7) that has a defect in the synthesis of asparagine-linked oligosaccharides and consequently an altered expression of membrane carbohydrate. The CR-7 mutant, which has a decreased ability to incorporate mannose into oligolipid and membrane glycoprotein and an increased membrane fucose, was more sensitive to natural killer (NK) cell lysis than the parental wild type (CHO-WT). Splenocytes mediating the lysis of the CR-7 line were asialo GM1+, nonadherent, IFN stimulatable, absent in the bg/bg mutant, and co-fractionated on Percoll density gradients with cells mediating lysis of the YAC-1 murine lymphoma. The increase in NK lysis correlated with enhanced binding of NK cells to the mutant determined by adsorption on tumor monolayers, cold target inhibition, and target binding analysis. A revertant of CR-7 (RCR-7), which showed wild-type levels of NK lysis, was intermediate in its ability to bind or cold target inhibit NK cells. The CR 7, CHO-WT, and RCR-7 lines were equally sensitive to hypotonic lysis and cytotoxicity by human lymphokine-activated killer (LAK) cells suggesting that the mutation did not nonspecifically alter membrane fragility. The NK-sensitive CR-7 line was less tumorigenic after subcutaneous injection in nude mice when compared with the parental CHO-WT or RCR-7 lines. This decreased tumorigenicity could be reversed by the i.v. injection of antiserum directed at the NK cell determinant asialo GM1. In conclusion, a ConAR tumor cell with a demonstrable oligosaccharide biosynthetic defect, exhibited enhanced NK lytic sensitivity and was poorly tumorigenic in vivo, a feature which may also be a consequence of its altered NK reactivity. PMID- 6481161 TI - Mitogen-induced human IgG subclass expression. AB - To investigate human isotype expression among lymphocyte populations, we have studied IgG subclass production by splenocytes, tonsil cells, and peripheral blood lymphocytes (PBL) after stimulation with a panel of nine mitogens. Response magnitudes varied with tissues: all mitogens produced the strongest responses with splenocytes and the smallest with PBL. In addition, the IgG subclass maximally stimulated by a particular mitogen also depended on the tissue studied. For example, LPS mainly stimulated IgG2 in PBL and IgG1 in spleen. Interestingly, the response patterns seen in splenocytes suggest a large and coordinate expression of IgG1 and IgG3 subclasses. Implications of these findings are discussed with respect to immunoglobulin gene organization and human disease states. PMID- 6481162 TI - Defective mononuclear phagocyte function in systemic lupus erythematosus: dissociation of Fc receptor-ligand binding and internalization. AB - Fc receptor-mediated mononuclear phagocyte system (MPS) clearance is impaired in systemic lupus erythematosus (SLE) and may contribute to the pathogenesis of the immune complex disease. To investigate the basis of MPS dysfunction, we have examined concurrent in vivo and in vitro Fc receptor function in 22 patients with SLE and 23 disease-free adults. Blood monocyte Fc receptor binding was increased rather than decreased as predicted by the saturation hypothesis of MPS blockade. Rosette formation of IgG-sensitized bovine erythrocytes (EA) with monocytes demonstrated increased Fc receptor-ligand binding in SLE (percent rosettes: 40 +/ 12 vs 27 +/- 8, p less than 0.001). Scatchard analysis of the binding of radiolabeled IgG oligomers to SLE monocytes indicated a mean receptor number 30% higher than control, although this did not reach statistical significance. Despite enhanced Fc receptor-ligand (EA) binding, Fc-mediated phagocytosis of EA was decreased in SLE (1.7 +/- 0.7 erythrocytes/monocytes/hour vs 2.6 +/- 1.0, p less than 0.004). This decrease in phagocytosis by blood monocytes from SLE patients was significantly greater than that attributable to the predominance in SLE of individuals with certain HLA B cell alloantigens and intrinsically lower phagocytic rates (p less than 0.05 for all groups). This decrease therefore represents a disease-acquired characteristic. Furthermore, the phagocytic rate of the four SLE patients with marked prolongation in MPS clearance was significantly lower than that of the eight patients with near normal clearance values (p less than 0.01). Saturation of Fc receptors by immune complexes does not explain impaired immune clearance in SLE. Our results indicate that despite increased binding of the EA ligand, Fc receptor-mediated phagocytosis is markedly impaired in SLE monocytes. This impairment cannot be explained on the basis of HLA-related differences in phagocytosis among lupus patients. The defect in phagocytosis of EA is most profound in those patients with the most significantly impaired MPS clearance. Thus, the dissociation of receptor-ligand binding and receptor mediated internalization may contribute significantly to the in vivo clearance defect in SLE. PMID- 6481163 TI - Activated macrophages secrete a soluble factor that inhibits mitochondrial respiration of tumor cells. AB - Conditioned supernatants (CS) obtained from activated murine peritoneal macrophages inhibit tumor cell mitochondrial respiration. EMT-6 cells exposed to CS were markedly inhibited in their ability to oxidize succinate (11.8 ng-atoms 02/min/10(6) cells base line; 3.2 CS treated), malate (15.4 base line, 3.6 CS treated), and tetramethylphenylenediamine (27.6 base line, 10.6 CS treated). The CS was also found to inhibit DNA synthesis in EMT-6 cells (98.9% inhibition of [3H]thymidine incorporation), but did not cause cell lysis. Mitochondrial respiration inhibition activity was not detected in CS until 4 hr; it reached a maximum at 18 hr and declined rapidly by 24 hr. EMT-6 cells recovered from inhibition if the CS was removed from culture, but no recovery was observed if the target cells were in continuous exposure to CS for 72 hr. Fractionation of CS by using a molecular exclusion column of Sephacryl S-200 resulted in the recovery of two peaks that showed respiration inhibitory activity. These peaks, eluting at 55,000 and 80,000 daltons, mediated the inhibition of malate and succinate oxidation and were cytostatic for EMT-6 cells. PMID- 6481164 TI - Naturally occurring autoantibodies to exoplasmic and cryptic regions of band 3 protein, the major integral membrane protein of human red blood cells. AB - Immunoglobulin G (IgG) of healthy human blood donors and IgG from pooled sera (Sandoglobulin) contain natural (auto)antibodies to band 3 protein, the major integral membrane protein of human red blood cells. Affinity-purified and 125I iodinated anti-band 3 antibodies bound specifically to band 3 protein on immunoblots from membrane proteins in the presence of unlabeled, absorbed IgG. Purified (auto)antibodies also bound nonspecifically to band 4.2 and weakly to band 5 and 6, when assayed with second antibody and 125I-iodinated protein A. The antibodies were directed to regions of band 3 protein that were cryptic and in part exoplasmic but with a low accessibility to surface modifications. The antigenic sites were located within the 65K, but not the 38K-dalton chymotryptic fragment of band 3 protein. Antigenic band 3 protein was equally present in membranes of young and senescent red cells. Hence, if these antibodies were involved in recognizing a few exoplasmic sites of band 3 protein on senescent red cells, antigen exposure would require alterations in band 3 accessibility (conformation, topology) rather than an enzymatic generation of antigenic sites. PMID- 6481165 TI - Estradiol regulation of secretory component in the uterus of the rat: evidence for involvement of RNA synthesis. AB - The present studies were undertaken to characterize the response of uterine secretory component (SC) to estradiol. Administration of estradiol for 3 days to ovariectomized rats before incubation of uterine tissues resulted in a marked accumulation of SC in the incubation media. When uteri from ovariectomized rats treated with progesterone or testosterone were incubated, very little SC accumulated in the media, indicating that the estradiol-stimulated increase is hormone-specific. When uteri from rats that received estradiol for 6 days were compared with uteri from 3-day treated rats, SC release during a 24-hr incubation period was the same. This finding indicates that in the presence of prolonged estradiol exposure, SC production continues. The estradiol-induced accumulation of SC in culture is not due to the release of pre-formed uterine SC. When tissue SC levels were measured after 3 days of estradiol treatment, very little tissue SC was found relative to that released into culture media during 24 hr of incubation. The addition of actinomycin D to the incubation media markedly inhibited SC release by uteri from estradiol-treated rats. The release of SC was also inhibited by alpha-amanitin, a known inhibitor of Type II polymerase. These studies demonstrate that estradiol stimulation of SC is markedly reduced by inhibitors of RNA synthesis, and suggest that estradiol regulation of SC is mediated through uterine mRNA synthesis. PMID- 6481166 TI - Differential binding of chemoattractant peptide to subpopulations of human neutrophils. AB - Binding of the fluoresceinated chemoattractant N formylmethionylleucylphenylalanyllysine to neutrophils was measured simultaneously with cell membrane potential by flow cytometry to determine how chemoattractant was bound by different populations of responding neutrophils. Cells exhibiting an apparent depolarization of membrane potential bound more chemoattractant than cells which did not respond or which exhibited a small hyperpolarization. Approximately 45% of the peptide bound to depolarized cells was displaced by unlabeled peptide, whereas only 3% was displaced from the nonresponding cells. By utilizing the well-known observation that extracellular fluorescein fluorescence is quenched by acid pH, it was determined that approximately one-half of the nondisplaceable peptide of both cell types was internalized, but a significant amount remained tightly bound to the extracellular membrane surface and accessible to lowering of the extracellular pH to 5.5. Treatment of cells with cytochalasin B to convert nonresponding cells to depolarizing cells also resulted in expression of displaceable binding by these cells, suggesting a close correlation between displaceable peptide binding and depolarization. Differential binding of chemoattractant among neutrophils and its modulation may account for observations of functional heterogeneity of neutrophils. PMID- 6481167 TI - Properties of prostaglandin-sensitive adenylate cyclase system of a murine macrophage-like cell line (P388D1). AB - The properties of basal and prostaglandin (PG)-stimulated adenylate cyclase of membrane preparations of P388D1 cells were investigated. Three partially purified membrane fractions were obtained by sucrose density gradient centrifugation at the final step of purification from crude homogenate. About 96% of the basal and 89% of PGE2-stimulated adenylate cyclase activity in the homogenate were recovered in three membrane fractions. Two lighter membrane fractions (I and II), which were enriched 11-fold and 8.4-fold in adenylate cyclase activity over crude homogenate, were pooled and subjected to various studies. Results suggested that the basal activity of the membrane preparations has, as in many other cell types, a relatively broad pH optimum (pH 7.5 to 8.5), requires Mg2+, which must be present in excess ATP, and is inhibited by Ca2+. Highly reactive sulfhydryl group(s), which may be present in the lipid bilayer, is required for the adenylate cyclase activity. Because both fluoride ions and GTP augment the enzymatic activity, P388D1 cell membrane adenylate cyclase must possess stimulatory guanine nucleotide-binding protein. The membrane preparations respond to exogeneously added PG by 1.5-fold to 3-fold increase in adenosine 3'-5' cyclic monophosphate (cAMP) production. The magnitude of PG-responsiveness was dependent on the types of PG and the order of potency in stimulation was PGE1 greater than PGE2 greater than PGI2. PGA1, B1, B2, F1 alpha, and F2 alpha stimulated adenylate cyclase only at the highest concentration tested. PMID- 6481168 TI - Pharmacologic effects on mouse isolated atria of immunoglobulins directed against class I histocompatibility antigens. AB - Sera from alloimmunized mice exert potent inotropic and chronotropic effects on mouse isolated atria. In this report, we present data showing that both total immunoglobulins and purified IgG from alloimmunized mice were able to exert per se these effects. The pharmacologic effects of IgG were parallel to its cytotoxic titer but not to its immunofluorescence titer. The specificity of the inotropic and chronotropic effects was studied by using several interstrain immunizations and target atria. It was observed that only the sera from mice immunized with H-2 disparate cells were able to exert pharmacologic effects on atria; these effects were evident not only on atria from the immunizing strain, but also on atria from other strains having identical H-2 but different backgrounds. Neither normal sera nor sera from animals immunized against non-H-2 differences were active. The effect of sera, total immunoglobulins, and purified IgG were blocked by propranolol, suggesting the involvement of beta-adrenoreceptor in the reaction. PMID- 6481169 TI - The modulation of expression of polypeptide surface antigens on developing schistosomula of Schistosoma mansoni. AB - Five low m.w. polypeptide antigens are expressed on the surface of freshly transformed schistosomula of Schistosoma mansoni, and were reproducibly identified by surface labeling with 125I by using IODOGEN and immunoprecipitating with immune mouse sera. These molecules have approximate m.w. of 38,000, 32,000, 20,000, 17,000, and 15,000. They correspond to antigens recognized previously by lactoperoxidase-catalyzed iodination. Analysis of the surface of developing schistosomulum demonstrated that the 38,000 and 17,000 dalton antigens were lost from the parasite surface during 48 hr of in vitro culture. This process was not dependent on the presence of host serum. The two antigens were not lost due to shedding into the culture medium but were apparently sequestered to a site where they were no longer available for surface labeling. The 32,000, 20,000, and 15,000 dalton antigens, however, remained exposed on the schistosomulum surface for up to 2 days of in vitro culture. The expression of two new antigens was also induced by culture in vitro: a doublet of approximately 45,000 daltons and an antigen of approximately 11,000 daltons. The expression of the former was dependent on the presence of serum. These results demonstrate that the development of the schistosomula surface is a complex process, with events both dependent and independent of the presence of serum. In addition, the expression of polypeptide antigens is not coordinated, and antigens are lost, retained, or appear on the schistosomulum surface during the early stages of maturation. PMID- 6481170 TI - Tuberculous endometritis. PMID- 6481171 TI - Urolithiasis in Udaipur (Rajasthan). PMID- 6481172 TI - Straight back syndrome--a pseudo heart disease. PMID- 6481173 TI - Genital prolapse (a review of 2003 operated cases). PMID- 6481174 TI - Gall bladder disease pattern in Punjab. PMID- 6481175 TI - Evaluation of cytology in unhealthy cervix. PMID- 6481176 TI - Dystocia due to impacted dysgerminoma. PMID- 6481177 TI - National Family Welfare Programme in India. PMID- 6481178 TI - Ornithine decarboxylase activity is inhibited by epidermal polyamine-dependent protein kinase-mediated phosphorylation. AB - Polyamine-dependent protein kinase in cytosol of pig epidermal cells was extracted. The fraction containing this enzyme exhibited multiple polypeptide bands on polyacrylamide gel electrophoresis, including 4 major polypeptide bands and several minor polypeptide bands. A 80 kilodalton (KD) polypeptide, one of the minor polypeptide bands, was phosphorylated by polyamine-dependent protein kinase. Authentic ornithine decarboxylase (ODC) exogenously added was separated into 2 subunits (80 KD and 40 KD) on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and a 80 KD polypeptide was also phosphorylated by polyamine dependent protein kinase. A 80 KD polypeptide of ODC comigrated with the polypeptide of cytosol which was phosphorylated by polyamine-dependent protein kinase. Kinetic study revealed that the ODC activity decreased as ODC was phosphorylated. Therefore, ODC activity was inhibited by epidermal polyamine dependent protein kinase-mediated phosphorylation. The overall results indicate that the rapid turnover of ODC might be regulated by a phosphorylation dephosphorylation reaction without new protein synthesis. PMID- 6481179 TI - Interaction of brown recluse spider venom on cell membranes: the inciting mechanism? AB - The venom from the brown recluse spider, Loxosceles reclusa, contains one or more factors which produce skin necrosis. A dermonecrotic factor with sphingomyelinase D activity was purified from the spider's venom sacs which produced skin necrosis when injected intradermally in rabbits. Adsorption of the dermonecrotic activity occurred following incubation with isolated membranes from different cell types or different species in a dose-responsive fashion. Since injection of the complex in rabbits produced skin necrosis, a specific antibody that inhibits the dermonecrotic activity and sphingomyelinase activity was used to identify the venom fraction on the plasma membrane of erythrocytes with electron microscopy. Initiation of cutaneous inflammatory reaction may result from high-affinity interaction of a venom component in the brown recluse spider venom and cell membranes. PMID- 6481180 TI - Cutaneous basophil hypersensitivity to inhalant allergens in atopic dermatitis patients: elicitation of delayed responses containing basophils following local transfer of immune serum but not IgE antibody. AB - Inhalant allergens applied to the skin of sensitive atopic dermatitis patients by means of a modified patch test technique, induce acute eczematous lesions. These lesions contain basophils, eosinophils, mononuclear cells, and neutrophils and represent an example of human cutaneous basophil hypersensitivity. The role of IgE antibody in this eczematous reaction was studied by systemic and local passive transfer experiments. Plasma with high IgE antibody when infused into patients with hypogammaglobulinemia as part of their replacement treatment resulted, post infusion, in cutaneous mast cell and blood basophil sensitization as measured by quantitative skin testing and leukocyte histamine release. Subsequent patch tests on these patients using the house dust mite antigen, antigen P1, produced macroscopic erythematous responses containing mononuclear cells, and eosinophils but not basophils. Local transfer of atopic dermatitis serum with high IgE antibody produced weak macroscopic responses and in these lesions mononuclear cells and both basophils and eosinophils were present. The serum activity which allowed transfer of basophil and eosinophil recruitment was heat labile. Specifically purified antibody to the mite antigen P1 (containing IgE and IgG antibody), when transferred, allowed eosinophil but not basophil recruitment to patch test sites. These results suggest that while the allergen induced patch test response may involve IgE antibodies, as well as the cells normally involved in delayed responses, another serum activity is also involved. PMID- 6481181 TI - Anaphylaxis in mast cell-deficient mice. AB - Evidence of a functional deficit in mast cell-deficient mice was sought by testing for the development of systemic anaphylaxis. W/Wv mast cell-deficient mice and wild type control animals were sensitized by injection of bovine serum albumin and subsequently challenged. Nine of ten W/Wv mast cell-deficient mice and 10/10 control mice demonstrated signs of anaphylaxis, including death. Although histamine levels were higher in control animals, no differences were noted before and after antigen challenge. The numbers of peripheral blood basophils were the same in W/Wv and wild type mice. These studies suggest that caution is necessary in the use of these animals to study disease. PMID- 6481182 TI - Activation of the alternative complement pathway by Fonsecaea pedrosoi. AB - Human sera were examined for evidence of complement activation by Fonsecaea pedrosoi. The serum that had been incubated with F. pedrosoi showed immunoelectrophoretic C3 conversion and generation of C5a, as measured by radioimmunoassay. C3 conversion and C5a generation did not occur in serum chelated with EDTA, or in serum heated to 56 degrees C for 30 min. Serum depleted of the heat (50 degrees C X 30 min)-labile factor B was also deficient in C3 conversion and C5a generation. Complement activation was not affected when the classical pathway was blocked by Mg++-EGTA. These studies indicate that F. pedrosoi can activate the complement system via the alternative pathway, with the resultant development of C5a. PMID- 6481183 TI - Induction of acute myoclonic encephalopathy in hamsters by subacute sclerosing panencephalitis virus. AB - Myoclonus is a characteristic neurological sign of subacute sclerosing panencephalitis (SSPE). Attempts were made to induce myoclonus in a large proportion of hamsters with a cell-associated strain of SSPE virus (the Biken strain) and thereby to establish an experimental model for study of the mechanism of development of this condition. When injected intracerebrally, Biken virus induced myoclonus within two to 14 days in 84% of the three- to nine-week-old hamsters tested. Electroencephalographic traces showed a periodic and synchronous discharge consisting of high-voltage slow waves and spikes that appeared coincidentally with myoclonus. Neurons in the cortex and thalamus of the affected animals had severely degenerated cytoplasm. Inflammatory changes, such as perivascular cuffing or infiltration of mononuclear cells, were not detected. Staining with immunoperoxidase revealed measles viral antigens in the cytoplasm and dendrites of the affected neurons. SSPE virus with the same properties as the parent virus was recovered from brain cells of sick animals by cocultivation with Vero cells. PMID- 6481184 TI - Increased energy expenditure by granulocytes during phagocytosis of Staphylococcus aureus compared with other staphylococci. AB - The heat produced by human neutrophils during phagocytosis of different strains of Staphylococcus was analyzed by a flow calorimetric technique. At the same bacteria/leukocyte ratio Staphylococcus aureus yielded heat effects about twice that of other saprophytic staphylococci tested. In parallel experiments the degree of phagocytosis of radiolabeled bacteria was evaluated: S. aureus strains were the least phagocytosed. These data indicate that, for a single phagocytosed bacterium, S. aureus strains yield heat effects three to four times greater than do the saprophytic staphylococci tested (P less than .001). Previous studies have shown that the heat produced by activated neutrophils derives essentially from the aerobic catabolism of glucose involved in the production of bactericidal O2 metabolites and is directly proportional to O2 consumption. The results reported here indicate that less efficient internalization of a staphylococcal strain is correlated with a greater energy expenditure for O2 metabolite formation during the metabolic burst. PMID- 6481185 TI - Antitoxin levels in botulism patients treated with trivalent equine botulism antitoxin to toxin types A, B, and E. AB - Serum levels of equine-botulism antitoxin to toxin types A, B, and E were measured in four type-A botulism patients who had received equine-botulism antitoxin. High circulating levels capable of neutralizing in excess of 1 X 10(8), 9 X 10(7), and 6 X 10(6) 50% mouse lethal doses of toxin of types A, B, and E, respectively, were detected. There was little depletion of type-A antitoxin even though two of the patients had circulating type-A toxin before treatment. The half-life for antitoxin persistence for one patient was calculated as being 6.5, 7.6, and 5.3 days for antitoxin types A, B, and E, respectively. Antitoxin levels were not proportionate to the amount (range, 2-4 vials) injected and did not appear to be affected by whether the route of administration was iv or im. Peak serum levels of antitoxin were 10-1,000 times higher than amounts needed to neutralize the toxin measured in the serum of these and other patients with botulism. PMID- 6481186 TI - Resistance of Vibrio vulnificus to serum bactericidal and opsonizing factors: relation to virulence in suckling mice and humans. AB - Vibrio vulnificus causes soft-tissue infections, gastrointestinal disease, and severe sepsis in humans. Bacterial and host factors in virulence have remained poorly defined. We found that blood culture isolates of V. vulnificus were completely resistant to the bactericidal effects of 10% normal human serum, in contrast to soft-tissue and environmental isolates that showed a mean 2.6 log10 decline during 120 min of incubation. Following opsonization by 10% normal human serum, mean uptake of blood isolates by normal human polymorphonuclear leukocytes during 20 min of incubation in vitro was 45.8% compared with 83.2% for isolates from other sites. Blood isolates were lethal for suckling mice (mean LD50, 1.3 X 10(6)) in contrast with isolates from other sites, which were less virulent (mean LD50, 1 X 10(9)); lethality correlated well with bacteremia at 6 hr. These studies show a close correlation between bacterial virulence for humans and suckling mice and suggest that resistance to the bactericidal and opsonizing effects of normal human serum may be important factors governing that virulence. PMID- 6481188 TI - Seroepidemiology of hepatitis B in Tennessee prisoners. AB - A prevalence serosurvey was performed on an 11.7% sample of the 6,503 adult male inmates in Tennessee prisons. On the basis of the sample, 0.9% of the prisoners possessed hepatitis B surface antigen, and 29.5% had one or more serum markers for hepatitis B virus (HBV). Thirty-two possible risk factors were analyzed for association with possession of HBV serum markers. The significant risk factors for possession of HBV markers in this population were found to be age, intravenous drug use while not incarcerated, intravenous drug use while incarcerated, race, education, military service history, and duration of prior and current imprisonments, in that order of importance. Given the modest contribution of incarceration to overall risk, mass immunization of prisoners against HBV seems unwarranted. Prisoners with unusually long sentences or who use intravenous drugs in prison are subgroups at particularly high risk. The logistic model can be used to target a serological screening and immunization program. PMID- 6481187 TI - Hematologic changes in brucellosis. AB - Hematologic abnormalities were studied prospectively in 38 patients with brucellosis. Anemia was found in 74% of patients, leukopenia in 45%, neutropenia in 21%, lymphopenia in 63%, and thrombocytopenia in 39.5%. Eight patients (21%) were pancytopenic; seven of these individuals also had splenomegaly. Bone marrow hypoplasia was not found. Bleeding complications developed in 26% of patients and were significantly associated with clotting abnormalities (low platelet count, low fibrinogen level, and/or prolongation of thrombin clotting time); i.e., bleeding occurred in approximately 50% of patients with marked clotting abnormalities but in no patients with normal clotting. Determination of fibrinogen levels at different stages of brucellosis led to a redefinition of the normal level for patients with this infection. Patients without clotting abnormalities had fibrinogen levels of 233-711 mg/100 ml (mean, 384 mg/100 ml), whereas patients with thrombocytopenia and prolonged thrombin clotting time had levels of 122-360 mg/100 ml (mean, 216 mg/100 ml; P less than .001) that increased to 233-519 mg/100 (mean, 360 mg/100 ml) when clotting values returned to normal. Lymphopenia was significantly correlated with the severity of clinical manifestations (bleeding and hepatic involvement). PMID- 6481189 TI - Hepatitis B virus DNA in serum of pregnant women with HBsAg and HBeAg or antibodies to HBe. PMID- 6481190 TI - [Clinical study on hemodynamic evaluation in the early postoperative phase and predictive factor of the postoperative low cardiac output syndrome after the valve replacement]. PMID- 6481191 TI - [Surgical considerations of tetralogy of Fallot from the aspect of peripheral pulmonary arteries]. PMID- 6481192 TI - [Prognosis of 10 cases of severe tricuspid regurgitation after open heart surgery for congenital heart disease]. PMID- 6481193 TI - [New theoretical approach to determining the time of application of mechanical ventricular assistance]. PMID- 6481194 TI - [Valve replacement in children]. PMID- 6481195 TI - [Clinical and hemodynamic assessment of the porcine xenograft valves in mitral position]. PMID- 6481196 TI - [Comparative study of various cardioplegic arrest in the blood-perfused canine papillary muscle preparation--disadvantage of multiple aortic cross-clamping and advantage of blood cardioplegia containing glucose at high concentration]. PMID- 6481197 TI - [Correlation between body surface isopotential maps and location of accessory conduction pathways in Wolff-Parkinson-White syndrome]. PMID- 6481198 TI - [Surgical repair of atrial septal defects with absence of right superior vena cava and persistent left superior vena cava]. PMID- 6481199 TI - [Two-stage operation of extensive thoraco-abdominal aortic aneurysm]. PMID- 6481200 TI - [Total exclusion of the right heart: report of a successful case]. PMID- 6481201 TI - [New method for correction of Taussig-Bing anomaly]. PMID- 6481202 TI - [Postoperative pulmonary hypertensive crisis in a case of transposition of the great arteries (type I): the effectiveness of tolazoline hydrochloride]. PMID- 6481203 TI - [Surgical treatment of dissecting aneurysm of the aorta]. PMID- 6481204 TI - Dynamic observation of immunosuppressive activity in lung cancer patients (phase I study of immuno-modulation and metastasis). PMID- 6481205 TI - [Reconstruction for benign esophageal strictures]. PMID- 6481207 TI - [Symposium: thoracic surgery]. PMID- 6481206 TI - [Future prospect of thoracic surgery]. PMID- 6481208 TI - Experimental approach to diabetic obesity. PMID- 6481209 TI - Purpura fulminans. PMID- 6481210 TI - Health problems of Southeast Asian refugees. PMID- 6481211 TI - Propranolol for episodic dyscontrol syndrome. PMID- 6481212 TI - Fibronectin-induced agglutination of Staphylococcus aureus correlates with invasiveness. AB - Studies on the interactions of staphylococci with fibrinogen, fibrin split products, and prothrombin have formed the basis for the clumping tests for coagulase and fibrin degradation products. We investigated the role of another circulating protein, fibronectin, in clumping Staphylococcus aureus. Fibronectin is a dimeric glycoprotein with high molecular weight that is present in both blood and tissue and is involved in opsonization, clotting, healing of wounds, cell-to-cell attachment, and differentiation. Each fibronectin molecule has two S. aureus binding sites, thus allowing lattice formation. We defined conditions under which fibronectin will cause agglutination of S. aureus. Strains of S. aureus that were most easily clumped had the largest number of fibronectin receptors. Trypsinization or gentle sonication removed the fibronectin binding and agglutinating receptors from S. aureus. These treatments did not alter viability, which suggests that binding is a superficial component of the organisms. Invasive fibronectin-binding strains were from a wide variety of phage types. Twenty two S. aureus isolates from patients with invasive disease were more readily agglutinated and had a greater number of fibronectin binding sites than 19 noninvasive strains (p less than 2.5 X 10(-4)). This suggests that the pathogenicity of S. aureus invasion may be enhanced by binding of bacteria to tissue fibronectin or by agglutination of bacteria by plasma fibronectin. Thus, the fibronectin receptors on S. aureus that mediate agglutination might also permit invasion of host tissues. PMID- 6481213 TI - Application of mechanical impedance measurements to the study of dysfibrinogens. AB - Most techniques of clot detection do not give information about the mechanical properties of the forming clot. A procedure was developed by which the dynamic loss modulus, or mechanical impedance, of a solution of fibrinogen could be continuously monitored during clot development. This method was then applied to the analysis of purified preparations of normal fibrinogen and two dysfibrinogens. Both thrombin and reptilase were used as clotting agents, and unique tracings of clot impedance vs. time were generated for each dysfibrinogen. The functional defect was known in each case, and the clot impedance tracings were able to distinguish between abnormalities in the release of fibrinopeptides A and B. Mechanical impedance measurements were shown to complement other types of analyses now used in the characterization of dysfibrinogens. In particular, they distinguished between dysfibrinogens that appeared similar by more conventional laboratory methods. PMID- 6481214 TI - Evaluation of red blood cell filterability test: influences of pore size, hematocrit level, and flow rate. AB - To improve understanding of the basic principles of the red blood cell filtration test, we studied the influence of pore size, flow rate, and hematocrit level. Suspensions of washed red blood cells in Ringer's solution with hematocrit values of 5%, 10%, and 15% were pumped at flow rates of 0.42 and 0.82 ml/min through polycarbonate filters with pore sizes of 2.6 +/- 0.2, 4.5 +/- 0.6, and 6.9 +/- 0.8 micron (mean +/- SD). The initial pressure generated at the filter was normalized for pressure reading obtained with cell-free Ringer's solution at the same flow rate and used for the calculation of the relative resistance of one red blood cell in a pore. This measurement was independent of the flow rate and the hematocrit level, but it varied inversely with the pore size: 175.1 +/- 62.5, 5.2 +/- 1.2, and 2.4 +/- 0.8 for the 2.6, 4.5, and 6.9 micron pores, respectively. Plugging of filter pores as evidenced by progressive pressure rise at constant flow was a prominent feature for 2.6 micron filters, but was not significant for 6.9 micron filters. At the flow rates studied, less than 1% of the filtered red blood cells showed morphologic changes or underwent hemolysis. We found that 2.6 micron filters are most sensitive in detecting altered red blood cell filterability induced in vitro and occurring in vivo. These results may help to define an optimum filtration test for clinical investigations. PMID- 6481215 TI - Effect of cholestasis on hepatic transport of 99mtechnetium p-isopropyl iminodiacetic acid. AB - Hepatobiliary imaging with 99mTc-p-isopropyl-iminodiacetic acid (PIPIDA) and other acetanilidoiminodiacetic acid derivatives is a frequently used clinical tool in evaluating patients with jaundice. However, there has been little objective assessment of the effects of cholestasis on hepatic transport of acetanilioiminodiacetic acid derivatives. In our studies, transport of 99mTc PIPIDA by isolated rat hepatocytes obtained from animals with extrahepatic obstruction secondary to bile duct ligation or intrahepatic cholestasis induced by ethinyl estradiol therapy was determined. Uptake constants for 99mTc-PIPIDA by hepatocytes isolated from livers of animals with ligated bile ducts were significantly decreased compared with uptake by liver cells from sham-operated controls (0.0030 +/- 0.0003 vs. 0.0089 +/- 0.0010 femtomole X 10(6) cells-1 X min 1 X pmol/L-1; p less than 0.001). Hepatocytes isolated from livers of animals given ethinyl estradiol also demonstrated significantly reduced 99mTc-PIPIDA uptake compared with controls given propylene glycol (0.0034 +/- 0.0002 vs. 0.0060 +/- 0.0004 fmol X 10(6) cells-1 X min-1 X pmol/L-1; p less than 0.001). Fractional rates of efflux of the study compound from hepatocytes preincubated with 99mTc-PIPIDA were significantly decreased in experiments using ethinyl estradiol (p less than 0.005) but did not differ significantly from controls in studies of bile duct ligation. 99mTc-PIPIDA uptake was significantly decreased in the presence of high bile salt concentrations (100 to 200 mumol/L), but unconjugated bilirubin concentrations as high as 200 mumol/L (approximately 12 mg/dl) had no effect on hepatocyte uptake of the ligand. The finding that cholestasis significantly impairs hepatocyte uptake of 99mTc-PIPIDA provides a possible explanation for the clinical observation that a patent biliary tree and normal serum bilirubin level are not always sufficient to ensure normal hepatobiliary imaging. These data also suggest that elevation of bile acid levels during cholestasis may either contribute to impaired uptake of hepatobiliary imaging agents or serve as a marker of cholestasis-induced abnormalities in the liver functions responsible for hepatic transport of these compounds. PMID- 6481216 TI - Low molecular weight proteinase inhibitors. III. Quantification and isolation of activity from benign and malignant human breast tissue samples. AB - Both normal and malignant breast tissue contain proteinase inhibitors. Extracellular proteins produced by tumors have been demonstrated to be qualitatively similar to their counterparts in normal tissue, but they are often present in significantly less quantity than in normal tissue. In our investigation, normal breast tissue extracts were shown to contain significantly greater inhibitory activity directed against the degradation of casein by trypsin in the isolated fraction of the extracts compared with extracts from malignant tissues. The molecular weight of this isolated fraction is approximately 17,000 daltons. Our observations suggest that malignancy is accompanied by a reduction in the net inhibitory activity of this proteinase inhibitor. PMID- 6481217 TI - Hepatic vitamin D 25-hydroxylase inhibition by cimetidine and isoniazid. AB - Cimetidine interaction with cytochrome P-450 may reduce binding affinity of some drugs, causing reduced metabolism of substrates such as diazepam and warfarin. Isoniazid also inhibits hepatic mixed function oxidase activity and has been reported to depress circulatory levels of hydroxylated vitamin D metabolites. Because hepatic vitamin D 25-hydroxylase is considered to be a cytochrome P-450 dependent enzyme, we examined the effect of cimetidine and isoniazid on hepatic vitamin D 25-hydroxylase activity in vitro in the rat. The assay system employed whole liver homogenates from rats deficient in vitamin D and chromatographic separation of radiolabeled substrate and product. Cimetidine and isoniazid were incubated with liver homogenates prior to the addition of 12 nmol/L final concentration of tritiated vitamin D. In addition, assays were performed in rats deficient in vitamin D given cimetidine or isoniazid 1 hour before sacrifice. Both cimetidine and isoniazid inhibited vitamin D 25-hydroxylase activity in vitro. Vitamin D 25-hydroxylase activity was depressed to 75%, 65%, and 55% of control values by cimetidine at 3, 6, and 10 mmol/L concentrations, respectively, and to 81%, 53%, and 35% by isoniazid at 1, 5, and 10 mmol/L. In vivo intraperitoneal administration of 120 mg/kg cimetidine depressed vitamin D 25 hydroxylase activity by 22%, and the same dose of isoniazid inhibited activity by 26%. The effect of long-term cimetidine therapy on vitamin D metabolism requires further evaluation. PMID- 6481218 TI - Measurement of plasma fibronectin in patients who develop the adult respiratory distress syndrome. AB - Depletion of plasma fibronectin has been observed in certain clinical conditions predisposing to the adult respiratory distress syndrome and has been associated with cardiopulmonary dysfunction in experimental lung injury. We evaluated prospectively the relationship between plasma fibronectin concentration and the development of the adult respiratory distress syndrome in patients known to be at high risk. Although plasma fibronectin levels in participants at study entry were lower in this population (mean 258 +/- 132 micrograms/ml) than in normal volunteers (461 +/- 127 micrograms/ml, p less than 0.0025), there was no difference between patients who subsequently developed the adult distress syndrome (mean 255 +/- 149 micrograms/ml) and those with similar illness or injury who did not develop the syndrome (260 +/- 126 micrograms/ml). Fibronectin concentration was not further depressed even after development of adult respiratory distress syndrome and did not correlate with degree of pulmonary dysfunction. These data suggest that fibronectin depletion is not an important determinant of respiratory failure in humans. Patients with sepsis syndrome had significantly lower plasma fibronectin levels than those without sepsis (187 +/- 119 micrograms/ml vs. 273 +/- 131 micrograms/ml, p less than 0.05), suggesting a possible role for fibronectin in the pathogenesis of sepsis. PMID- 6481219 TI - Monoclonal antibody-induced murine hemolytic anemia. AB - A panel of 11 IgG monoclonal antierythrocyte antibodies was generated by fusing spleen and bone marrow cells from unimmunized New Zealand black mice with the nonsecreting murine plasmacytoma cell line P3.X63.NS1. The monoclonal antibodies were detected by indirect hemagglutination of unaltered erythrocytes from several strains of mice. Seven of the antibodies cross-reacted with rat erythrocytes, but none of the antibodies agglutinated erythrocytes from any other species tested. Seven of the monoclonal antibodies were also capable of fixing rabbit complement. In vivo studies utilizing these 11 IgG-secreting hybridomas were performed in syngeneic BALB/c mice. Mice injected with nine of the hybridomas showed positive direct antiglobulin test results but did not become anemic. In contrast, hybridoma 114, secreting an IgG3 antibody, and hybridoma 245, secreting an IgG1 antibody, were both capable of mediating an acute, rapidly fatal hemolytic anemia. Intraperitoneal injection of hybridomas 114 and 245 resulted in positive direct and indirect antiglobulin test results, decreased hematocrit level, and reticulocytosis 3 to 6 days after cell injection. The mice survived a mean of 8 days, and death was associated with severe anemia and spontaneous erythrocyte agglutination. Autopsy studies revealed hepatosplenomegaly, small mesenteric tumor (hybridoma) mass, and no ascites. The liver and spleens were characterized histologically by erythrophagocytosis, extramedullary hematopoiesis, and hemosiderin deposition. Acute hemolytic anemia in BALB/c mice mediated by hybridomas 114 and 245 represents a new animal model that can be used to further define the mechanisms of immune hemolytic disease. PMID- 6481221 TI - Single stage reconstruction of radiation injury of the chest wall by a latissimus dorsi musculocutaneous flap. PMID- 6481220 TI - Glycosylated hemoglobins in heterozygotes and homozygotes for hemoglobin C with or without diabetes. AB - Glycosylated hemoglobin in red blood cell hemolysates of five patients homozygous for CC, 18 patients with SC condition, and 13 patients heterozygous for Hb C with or without insulin-dependent diabetes mellitus were separated by Bio-Rex 70 chromatography. The various glycosylated components were identified by analysis of the hemoglobin components for ketoamine and phosphate, in vitro glycosylation studies, and by the quantitative differences in the minor components between the participants with and without diabetes. The percentages of Hb A1a + b, Hb A1c, and Hb C1c were significantly increased in the Hb C heterozygote with diabetes. Similarly, the percentages of Hb S1a + b and Hb S1c were elevated in the SC patient with diabetes. It was noteworthy that the levels of these components became normal after adequate control of diabetes. Moreover, the levels of Hb C1c in the CC participants and Hb S1c (Hb S1c/total Hb S) in the SC patients were significantly higher than the Hb S1c levels previously reported in patients with sickle cell anemia. These findings might reflect the fact that CC and SC patients have less severe hemolytic anemia. Moreover, the relative proportions of Hb A1c and Hb C1c were nearly the same in Hb C heterozygotes, which indicated that Hb A and Hb C were glycosylated in vivo to approximately the same extent. PMID- 6481222 TI - High school athletic injuries. An unrecognized need for specialized care. PMID- 6481223 TI - The behaviour of the keratinizing epithelium in tympanoplasty. PMID- 6481224 TI - Ciliary beat frequency of human middle-ear mucosa measured in vitro. AB - Brush biopsies from the middle-ear (ME) and nasal mucosa were taken from a 4-year old girl with complete situs inversus, recurrent otitis media and tonsillitis, who underwent tonsillectomy, adenoidectomy and bilateral myringotomy with insertion of ventilation tubes. Ciliary beat frequencies (CBF, Hz.) of the ME and nasal samples, measured by a photoelectric system equipped with a fiber-optic probe, were 9.5 Hz. (+/- 1.2) and 13.7 Hz. (+/- 4.1) respectively. These values are similar to CBF of nasal samples obtained from normal subjects. In vitro CBF assessment is a useful investigative tool for the study of mucociliary activity in the ME, as in patients suspected to have ciliary dyskinesia syndrome. PMID- 6481225 TI - The saccus endolymphaticus in the rabbit. Further studies. PMID- 6481226 TI - Further observations on nasal mucosal changes in scleroderma. A histochemical and electron microscopic study. AB - The respiratory nasal mucosa of patients with scleroderma showed several ultrastructural and histochemical changes. These included initial goblet cell hyperplasia, loss of cilia and microvilli, exfoliation of the superficial epithelial layers, increased glandular activity in cases with squamous metaplasia and fibrous tissue deposition in the lamina propria. These changes seem to be related to the duration of the disease, whose nature and pathogenesis are still uncertain. PMID- 6481227 TI - Results of salvage surgery following radical radiotherapy for laryngeal carcinoma. AB - The results of management of squamous cell carcinoma of the larynx are reported. All patients were initially treated by radical radiotherapy. Glottic tumours responded well, while supra- and sub-glottic tumours did not show good response. All radiation failures and recurrences were managed by total laryngectomy. Post operative survival periods of five years or longer were recorded in 57 per cent of the patients. PMID- 6481228 TI - Pressure neuropathy of the facial nerve: A case report with light and electron microscopic findings. PMID- 6481229 TI - Half nose. AB - A very rare abnormality is reported of congenital absence of the right half of the nose in combination with microphthalmia, coloboma, epiphora and median cleft of the alveolus. PMID- 6481230 TI - Osteosclerotic plasmacytoma of maxillary bone (orbital floor). AB - Plasma cell neoplasms have been classified as multiple myeloma, solitary plasmacytoma and extramedullary plasmacytoma. They are usually considered as osteolytic lesions of bone except for the rare occurrence of osteosclerotic lesions. This paper describes the first reported osteosclerotic plasmacytoma of the maxillary bone and orbital floor. The difficulties in establishing a diagnosis and the relationship to other plasma cell neoplasms are discussed. Osteosclerotic plasmacytomas are a rare variant of plasma cell tumors which usually produce osteolytic lesions rather than bony sclerosis. Sixty-eight patients with the osteosclerotic variant have appeared in the world literature, with an overall incidence of about 1 per cent in a large series of plasma cell neoplasms (Dreidger and Pruzanski, 1979). There have been only six previous cases of solitary osteosclerotic plasmacytomas reported (Morley and Schweiger, 1964; Roberts et al., 1974; Rodriguez et al. 1976; Rushton, 1965; Schneinker, 1938; Brigham Medical Review, 1961) involving spine, sternum, or rib. None have previously been reported in the head and neck area. Plasma cell tumors have been classified into multiple myeloma, solitary plasmacytomas of bone, and extramedullary plasmacytomas. Multiple myeloma is a disseminated plasma cell malignancy characterized by the production of homogeneous immunoglobulins (whole or fragments) which appear in the serum and urine. Plasma cell tumors can also occur as solitary plasmacytomas, usually in bone, but also in soft tissue. With time, most solitary plasmacytomas develop disseminated disease with all the characteristics of multiple myeloma (Wiltshaw, 1976). Extramedullary plasmacytomas arise in soft tissue rather than bone, and primarily occur in the head and neck region. Clinically, they remain localized and less frequently develop into disseminated myeloma. PMID- 6481232 TI - Intracranial complications of frontal sinusitis. A report of two cases. AB - Two cases are reported of intracranial complications of sinusitis, unusual nowadays. They were caused by osteomyelitis of the frontal bone following chronic frontal sinusitis. These cases were distinguished by complete destruction of the posterior wall of the sinus involved: in one of the cases there was an acute central neurological disturbance caused by a cerebral abscess; in the other patient, who came for consultation because of a Pott's Puffy tumour, a sizeable epidural abscess was found. PMID- 6481231 TI - Opportunistic pasteurella multocida meningitis. AB - Pasteurella multocida bacteraemia and meningitis followed elective surgery on the sinuses. The organism is thought to have been derived from close contact with dogs, and the infection responded to appropriate antimicrobial drugs, the patient making a complete recovery. PMID- 6481233 TI - Leiomyoma of the trachea: report of case and review of the literature. PMID- 6481235 TI - The learning disabled adolescent and young adult: an overview and critique of current practices. PMID- 6481234 TI - Dynamics of swallowing in tetanus. AB - An 82-year-old man developed an uncommon type of swallowing disturbance with tetanus. Initially, he could masticate his food but could not pass it into the esophagus. The mechanism of swallowing in this patient was studied radiologically and endoscopically. The disturbance in the second stage of deglutition was associated predominantly with his advanced age and the slow clinical progress of the tetanus. The patient was cured by treating the disease. PMID- 6481236 TI - A comparative study of the California Achievement Test (Forms C and D) and the KeyMath Diagnostic Arithmetic Test with secondary LH students. PMID- 6481237 TI - Predicting school readiness from stroke directions in children's printing. PMID- 6481238 TI - Cognitive and linguistic strategies in children with reading disabilities in an oral storytelling test. PMID- 6481239 TI - Prevalence of hyperkinesis: a comparison of three rating scales. PMID- 6481240 TI - Hair mineral content as a predictor of learning disabilities. PMID- 6481241 TI - Child-centeredness. PMID- 6481242 TI - Diphosphatidylglycerol in experimental acute alveolar injury in the dog. AB - Acute alveolar injury closely resembling that seen in humans was induced in dogs by subcutaneous injection of N-nitroso-N-methylurethane. Necrosis of alveolar epithelial cells was observed during early injury. Proliferation of immature epithelial cells which began during early injury and became massive after peak injury was followed by their differentiation to mature type II cells during recovery. Quantities of diphosphatidylglycerol (DPG) and of phosphatidylglycerol (PG) in alveolar lavage and in post-lavage lung tissue were measured. An increase in tissue DPG coincided with a sharp decrease in tissue and lavage PG during early injury. DPG was not detectable in the lavage. During late recovery, tissue DPG increased threefold over controls. This increase was accompanied by persistence of a 50% decrease in tissue PG and 83% decrease in lavage PG. Biosynthesis of DPG and PG in isolated lung mitochondria demonstrated that DPG was formed from PG in the presence of CDP-diglyceride. These findings suggest that the low level of PG in the surfactant complex during acute alveolar injury is due to increased turnover of PG to DPG in the lung. PMID- 6481243 TI - Effects of fat ingestion on high density lipoprotein profiles in human sera. AB - Serum concentrations of triacylglycerol, apolipoprotein A-I, apolipoprotein A-II, HDL2, and HDL3 were determined in sera of nine normolipidemic adult males, just before and 3, 5, and 8 hr after ingestion of 250 ml of cream (100 g of triacylglycerol). In all individuals a rapid hypertriglyceridemic response was observed. Triacylglycerol concentrations increased from 624 +/- 124 mg/liter of serum to 1435 +/- 350 mg/liter of serum 3 hr after cream ingestion. In most individuals the hypertriglyceridemic response was followed by a decline in serum triacylglycerol concentration to below basic levels. As a result of cream ingestion, small but statistically highly significant increases in serum cholesterol and apolipoprotein A-I concentrations were observed that persisted till the end of the observation period. In most individuals a small rise in the apolipoprotein A-II concentration in serum was also present. Marked changes were observed in serum HDL as illustrated in the HDL absorption at 280 nm and cholesterol profiles obtained by single-spin rate-zonal density gradient ultracentrifugation of the sera. Due to a prominent increase in phospholipids (up to about 18%) and a smaller increase in protein (up to about 6%), flotation rates and concentrations of HDL2 as well as HDL3 increased. These changes in HDL subclass flotation characteristics and chemical composition are best explained by uptake of surface material from chylomicrons by existing HDL2 and HDL3 particles. The data do not support a previously proposed concept in which HDL3 is converted into HDL2 by uptake of surface remnants formed during catabolism of triglyceride rich lipoproteins. PMID- 6481244 TI - Age-related decreases in tissue sterol acquisition are mediated by changes in cholesterol synthesis and not low density lipoprotein uptake in the rat. AB - The present investigation compared plasma cholesterol levels and lipoprotein profiles, and absolute rates of sterol synthesis and low density lipoprotein (LDL) uptake in various organs of immature (4 weeks old) and mature (15 weeks) rats. The plasma cholesterol level and its distribution among the major lipoprotein density fractions were similar in both groups. Using [3H]water as a substrate for measuring sterol synthesis in vivo, the content of newly synthesized cholesterol (3H-labeled digitonin-precipitable sterols; [3H]DPS) was several fold higher in all tissues of the young, compared to the old, rats when normalized per g of tissue. In contrast, whole-body [3H]DPS content was identical at 29.5 and 29.3 mumol/hr in young and old rats, respectively, despite a 4.4-fold difference in body weight (102 vs. 453 g). The importance of different organs to total-body sterol synthesis remained similar with increasing age although the skin (11 vs. 24% of total) rather than the small bowel (15 vs. 8%) became the second most important organ after the liver (49 vs. 45%) in the older animals. When LDL uptake was determined in these same organs, using constant infusion technique, the rates of clearance were higher only in the adrenal glands, adipose tissue, and skin of the young animals; whereas these rates were essentially the same in the liver and gastrointestinal tract, the two organs that are quantitatively most important for LDL catabolism. Even when these clearance rates were normalized to the whole organ or to 100 g of body weight, the differences in LDL uptake in the two age groups were minor compared to the major decrease in rates of cholesterol synthesis that were observed with aging. Finally, calculation of absolute rates of tissue cholesterol acquisition from both sources indicated that, in most organs, the majority of tissue cholesterol was derived from local synthesis rather than from LDL uptake in both age groups and that, with increasing age, total cholesterol acquisition decreased several-fold primarily as a consequence of the diminished rate of sterol synthesis. These studies demonstrate that with growth and aging in the rat there is a dramatic decrease in the rate of tissue cholesterol synthesis while the uptake of LDL cholesterol remains essentially unchanged. PMID- 6481245 TI - Conversion of erythro-D-sphinganine to its [1-2H1] and [1-3H1] derivatives. AB - A convenient chemical synthesis of erythro-D-[1-2H1] sphinganine and erythro-D-[1 3H1]sphinganine is described. The approach utilizes a stereospecific starting material (natural sphinganine prepared from bovine brain sphingomyelin) and applies a sequence of selective protection of functional groups yielding 2 acetamido-3-O-benzoyloctadecan-1-ol. Oxidation of the primary alcohol to an aldehyde followed by NaB2H4 or NaB3H4 reduction and hydrolysis of the protective groups yields erythro-D-[1-2H1]sphinganine or erythro-D-[1-3H1]sphinganine. The synthetic intermediates and isotopically labeled sphinganines are characterized by infrared analysis, 1H-nuclear magnetic resonance, optical rotation, and gas liquid radiochromatographic and mass spectral fragmentation analyses. The [1-2H1] and [1-3H1] derivatives were obtained with overall yields (and isotope enrichments) of 11% (min. 84 mol% 2H1) and 8% (60 mCi/mmol), respectively. PMID- 6481246 TI - Compositional and molecular species analysis of phospholipids by high performance liquid chromatography coupled with chemical ionization mass spectrometry. AB - High performance liquid chromatography (HPLC) was combined with chemical ionization mass spectrometry (CIMS) by the use of a moving-belt interface. The technique was employed for the analysis of naturally occurring phospholipids. Positive and negative ion mass spectra of various phospholipids such as phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, phosphatidylinositol, phosphatidylglycerol, and sphingomyelin were obtained in the chemical ionization mode with ammonia or methane as the reagent gas. Specific ions for individual phospholipid "bases" were identified. These ions were used in specific ion monitoring of the phospholipids during HPLC-CIMS. CIMS of each phospholipid also provided extensive information on the molecular species of the individual class of phospholipids. Relative abundance of different molecular species of each phospholipid as determined by CIMS agreed well with the results obtained by gas-liquid chromatography. Rat brain phospholipids were analyzed by HPLC-CIMS in about 15 minutes. Routinely, about 5 micrograms of individual phospholipid was analyzed by HPLC-CIMS, however, with specific ion monitoring the method provides a detection capability at the subnanogram level. PMID- 6481247 TI - Presence of monohydroxy bile acids in the urinary precipitates: a pitfall in the analysis of urinary bile acids. AB - The importance of the method of handling the urinary precipitates frequently present in urine samples, especially after freezing-thawing, for bile acid analysis is emphasized because of the presence of a considerable proportion of monohydroxy bile acids such as lithocholic and 3 beta-hydroxy-5-cholenoic acids. Filtration of the urinary precipitates may lead to the underestimation of these important bile acid species. PMID- 6481249 TI - Acquired immunodeficiency syndrome: highlights on the diagnosis and management of opportunistic infections. PMID- 6481248 TI - High performance liquid chromatography of platelet-activating factors. AB - Silica and C18 reverse phase high performance liquid chromatography (HPLC) were used to fractionate synthetic molecular species of 1-O-alkyl-2-acetyl-sn-glycero 3-phosphocholine (AGEPC) and semi-synthetic platelet-activating factor (PAF) synthesized from beef heart plasmalogens. A single coincident peak from silica HPLC was observed for either a mixture of synthetic AGEPC's with alkyl chain lengths from C12 to C18 or for beef heart-derived PAF. This peak was well separated from other classes of phospholipid standards including 2 lysophosphatidylcholine and 3H-labeled lyso-PAF. Subsequently, the synthetic AGEPC mixture or beef heart PAF was separated into individual species on a C18 reverse phase column. Beef heart-derived PAF was fractionated into at least four molecular species of PAF activity which had similar retention times as the radioactivity of 3H-labeled beef heart PAF. Approximately 56% of the radioactivity of 3H-labeled PAF was found in the fraction with a similar retention time as 1-O-hexadecyl-2-acetyl-sn-glycero-3-phosphocholine, 10% as 1-O octadecyl-2-acetyl-sn-glycero-3-phosphocholine, 11% as 1-O-pentadecyl-2-acetyl-sn glycero-3-phosphocholine, and 13% in an unidentified fraction which eluted after C-16-AGEPC. The unidentified fraction did not correspond to any of the homologous series of synthetic AGEPCs with saturated alkyl chain lengths from C12 to C18. Recoveries of radioactive phospholipids from silica or reverse phase columns were greater than 95%. PMID- 6481250 TI - Psychosocial issues for people with AIDS. PMID- 6481252 TI - The coming abundance of physicians--the national outlook. PMID- 6481251 TI - Acquired immunodeficiency syndrome (AIDS): an epidemiologic and clinical overview. PMID- 6481253 TI - Recent developments in Georgia relating to "wrongful pregnancy" actions. PMID- 6481254 TI - The MAG Scientific Assembly--Georgia's premier forum for specialty society education. PMID- 6481255 TI - Differential diagnosis and management of the chronically somatizing patient. PMID- 6481257 TI - Physician surplus and the new medical marketplace--contemporary challenges to medical education. PMID- 6481256 TI - Persistent pleural effusion complicating sarcoidosis. PMID- 6481258 TI - Physician participation in cardiopulmonary resuscitation training. PMID- 6481259 TI - The cyanotic newborn: keys to early diagnosis and emergency management. PMID- 6481260 TI - The present status of management of primary breast cancer. PMID- 6481261 TI - Student paper competition focuses on medical informatics. PMID- 6481263 TI - A prospective study of percutaneous transhepatic cholangiography (P.T.C.) with Chiba needle: morbidity and mortality. PMID- 6481264 TI - Glycosylated hemoglobin by colorimetry in normal subjects, diabetics, and nondiabetics. PMID- 6481262 TI - The effects of three techniques of tubal occlusion on ovarian hormones and menstruation. PMID- 6481265 TI - The response of adrenal gland in tuberculosis. PMID- 6481266 TI - Clinical experience with adriamycin and vincristine in the treatment of hepatic metastases. PMID- 6481267 TI - Opportunistic fungal infection of the burn wound. PMID- 6481268 TI - Tuberculous ulcers of nose and tongue in children. PMID- 6481269 TI - McCune-Albright syndrome: report of a case. PMID- 6481270 TI - The study of acute non-calculous cholecystitis. PMID- 6481271 TI - Comparison between colorimetric and column chromatographic methods for the determination of glycosylated hemoglobin. PMID- 6481272 TI - A comparison of buprenorphine and morphine for immediate postoperative pain relief in Thai patients. PMID- 6481273 TI - Cerebellar tissue embolism associated with birth injury. PMID- 6481274 TI - Hepatic malignant hemangioendothelioma with cardiac tamponade. PMID- 6481275 TI - Gastric teratoma: a case report. PMID- 6481276 TI - Erythrocyte acetylcholinesterase activity in patients with congenital heart diseases. PMID- 6481277 TI - Fluctuations in T-wave morphology and susceptibility to ventricular fibrillation. AB - Susceptibility of the ventricles to fibrillation has been related to the degree of spatial inhomogeneity in the repolarization process. We studied the pattern of beat-to-beat fluctuations in ventricular repolarization processes in order to determine whether a relationship also exists between the temporal variability of ventricular repolarization and susceptibility to ventricular fibrillation. We used the morphology of the T-wave recorded in surface and epicardial leads as a measure of the ventricular repolarization process. The Ventricular Fibrillation Threshold (VFT) was used as the standard measure of cardiac susceptibility to fibrillation. In dog experiments, T-wave morphologic indices were computed on 1,024 sequential beats. Histogram, autocorrelation and power spectrum analyses were performed on the sequence of T-wave morphologic indices. A series of 27 experiments were performed on 20 dogs in which VFT was reduced by several different interventions--hypothermia, tachycardia and coronary artery ligation. For all three interventions we observed the same characteristic change in the pattern of T-wave morphology fluctuations. In particular, we found that as the VFT was reduced, a pattern of T-wave alternans developed. This pattern was generally not detectable by visual inspection of the ECG. It was, on the other hand, easily quantified in terms of a T-wave alternans index (TWAI) which we computed from the power spectrum of the T-wave fluctuations. In 26 of the 27 experiments, measured VFT decreased (p less than .001); in 20 of these experiments the TWAI computed from the surface ECG increased (decreased) when VFT decreased (increased) (p less than .01). In 17 experiments epicardial electrograms were recorded. In 16 of these experiments VFT decreased (p less than .001). In 16 of these 17 experiments TWAI computed from the epicardial ECG increased (decreased) when the VFT decreased (increased) (p less than .001). We conclude that statistical analysis of fluctuations in ECG complex morphology may provide a sensitive probe of ventricular vulnerability to fibrillation. PMID- 6481278 TI - Racial variations in electrocardiograms and vectorcardiograms between black and white children and their genesis. AB - Despite a general clinical impression that the ECG of black children differs from that of white children, none of the normal standards in children have taken race into consideration. Biographic data, blood pressure, hemoglobin, ECG, Frank VCG and echocardiogram were obtained in 244 normal children (124 blacks and 120 whites) aged 3-17 years and 144 measured parameters and 57 computed variables were analyzed. The children were divided into age groups of 3-5, 6-10, 11-14, and 15-17 years. The 15-17 year age group was small and therefore excluded. In the 3 5-year age group there were no sex differences (p greater than 0.05) nor were there any differences (p greater than 0.05) observed between black and white children. No significant sex differences were seen in 6-10-year-olds. However, the amplitude of the R wave in lead I, S in V1 and V4, and the sums of SV1 and RV6 as well as SV1 and RV5 on the ECG, and X to the left and Y to the inferior on VCG were greater in black than in white children (p less than 0.01). In 11-14 year-olds many sex-related differences were seen in each race. R in leads I, II, AVL, AVF and V4, S wave in V1 and V4R, and the sums of SV1 and RV5 as well as SV1 and RV6 in the ECG, and Y inferior and Z anterior in the VCG were higher (p less than 0.01) in black males than white males. However, no differences (p greater than 0.05) were observed between black and white 11-14-year-old girls. To understand the causes of these differences, comparisons of the biographic data, blood pressure, hemoglobins and echocardiograms were made. The height, weight, body surface area, chest circumference, AP diameter of the chest, and diastolic and systolic blood pressure were similar (p greater than 0.1) in all groups. The hemoglobin level was lower in black than white children (p less than 0.05). However, this difference was seen in all age-sex subgroups, suggesting that hemoglobin level was not responsible for the ECG-VCG differences. The LV posterior wall in diastole was thicker and the anterior chest wall to mid-LV distance was shorter in black than in white children in age-sex subgroups in which ECG-VCG differences were observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481279 TI - Vectorcardiographic features of acute right ventricular infarction. AB - A total of seven patients with acute inferior or inferior-posterior transmural myocardial infarction who had cardiac scintigraphically confirmed right ventricular (RV) involvement was studied. Series of vectorcardiographic tracings were taken using the Frank lead reference system from the second day after onset of acute symptoms; we found that in patients with acute inferior and RV infarction, the magnitude of the planar ST vector was greater than or equal to 0.15 mV and the projection of the ST vector pointed either to the right-anterior or right-posterior direction in the horizontal (H) plane. The serial spatial ST vector changed its direction either: 1) from right-anterior-inferior octant to right-posterior-inferior octant or vice versa; or 2) from right-posterior inferior octant to right-anterior-superior octant. The larger the magnitude of the rightward ST vector, especially right-anterior direction in the H plane, the greater the probability of acute RV infarction. In patients with acute inferior posterior and RV infarction, the magnitude of the ST vector in the H plane was greater than or equal to 0.2 mV. The spatial ST vector pointed to the right posterior-inferior octant and its direction did not change from the original octant in the serial tracings during the course of the acute stage. Our data suggest that vectorcardiography--a non-invasive, non-nuclear polluting, and economical method--has shown great potential to become, in the near future, the primary non-invasive diagnostic test of choice for acute RV infarction. PMID- 6481280 TI - The electrocardiogram in patients with acute myocardial infarctions treated with intracoronary Streptokinase infusion. AB - In 37 consecutive patients with acute myocardial infarction undergoing Streptokinase infusion and acute coronary angiography, the electrocardiographic findings were compared with the findings during angiography. All 15 patients with an occluded right coronary artery demonstrated an electrocardiographic pattern of an acute inferior wall myocardial infarction, and 12 of 13 patients with an occluded left anterior descending coronary artery exhibited a pattern of an acute anteroseptal wall myocardial infarction. In six out of nine instances of an occluded circumflex artery, an inferior infarction pattern evolved, and in three cases, an anteroseptal wall myocardial infarction was demonstrated. precordial ST segment depression more than 1 mm in patients with acute inferior wall myocardial infarction did not correlate with disease of the left anterior descending coronary artery as suggested by others. The specificity of this finding was only 25 percent with a predictive value of 60 percent. PMID- 6481282 TI - Co-existing tachycardia and bradycardia dependent incomplete and complete right bundle branch block: evidence for diffuse conduction system involvement. AB - A case of co-existing tachycardia and bradycardia dependent incomplete and complete right bundle branch block (BBB) is reported. The degree of BBB was related to the duration of the preceding cycle length. In addition, more diffuse conduction system disease was suggested by evidence of sino-atrial and His Purkinje conduction abnormalities. PMID- 6481281 TI - Application of the single moving dipole inverse solution to the study of the Wolff-Parkinson-White syndrome in man. AB - The single moving dipole (SMD) inverse solution was performed in 28 patients with the Wolff-Parkinson-White preexcitation syndrome to see if the calculated position of the SMD during the initial delta wave could indicate the site of the underlying accessory pathway. This site was first estimated to be at one of eight locations around the atrioventricular ring, from the patient's QRS and ST segment body surface potential maps, as has been described by others. Next, SMD parameters were calculated during the delta wave so as to approximate, on a numerical torso model, the patient's body surface potential map. Visualization of the calculated position of the SMD around the atrioventricular ring was done by projecting it on a plane parallel to this ring. This plane corresponded to the most basal transverse section of a heart model present in the torso model. One limitation was the use of non-varying heart and torso models for all patients. As a result, the SMD technique lacked the precision to separate accessory pathway sites into eight atrioventricular locations. However it was capable of distinguishing between patients belonging to the larger classes of right-sided, posterior, and left-sided preexcitation, formed by combining adjacent atrioventricular accessory pathway locations. With more accurate heart and torso models, it may be possible to increase SMD resolution so as to locate accessory pathway sites deep within the heart. This would represent an advantage over the surface potential map approach which only identifies the site of earliest epicardial breakthrough associated with the accessory pathway. PMID- 6481283 TI - The circular reference system revisited. PMID- 6481284 TI - Adrenal changes in genetically hypothyroid mice. AB - The adrenocortical X-zone was very poorly developed in young female mice homozygous for the hypothyroid, hyt, mutation, Feeding the mice thyroid powder resulted in the development of an X-zone. This subsequently degenerated in the same way as the X-zone found in the normal litter-mates of the mutants. We suggest that the adrenocortical effects may be due to changes in prolactin stimulation consequent upon the lack of response to thyrotrophin of the mutants. PMID- 6481285 TI - Effect of parathyroid hormone and calcitonin on the cytoplasmic spreading of isolated osteoclasts. AB - Osteoclasts, the major agents of bone resorption, were isolated from neonatal rat bone, and the cytoplasmic spreading of these cells was measured after incubation in the presence or absence of hormones or other cell types. Salmon calcitonin, which inhibits osteoclastic bone resorption, reduced spreading in a dose dependent manner and caused significant inhibition at concentrations as low as 6.7 pg/ml. Parathyroid hormone (PTH) had no effect on the spreading of isolated osteoclasts but if osteoblasts and osteoclasts were co-cultured the addition of PTH caused a marked increase in spreading at concentrations of 0.025 i.u./ml and above. The results suggest that while calcitonin is a direct inhibitor of osteoclastic activity, PTH may stimulate osteoclasts through a primary action on osteoblasts. PMID- 6481287 TI - Changes in plasma prolactin in male starlings during testicular regression under short days compared with those during photorefractoriness. AB - Male starlings which had fully developed testes under 11-h daily photoperiods were subjected for 10 weeks to daylengths either increasing or decreasing by 30 min per week. In both cases testicular regression occurred; in the former case this was complete due to photorefractoriness, and was accompanied by a postnuptial moult and a marked (P less than 0.01) rise in plasma prolactin concentration. In the latter case the rate of gonadal regression was slow and variable and no moulting was observed. Plasma prolactin remained very low. Eventually the birds which had experienced decreasing photoperiods were transferred to long (16 h) days; they were shown to be photosensitive since their testes redeveloped rapidly. There was also a rise in plasma prolactin, the birds eventually showed the full testicular regression characteristic of photorefractoriness, and moulting occurred. These results show that raised prolactin secretion is not associated with short-day-induced testicular regression but only with long-day-induced photorefractoriness. PMID- 6481286 TI - Progesterone interaction with eosinophils and with responses already induced by oestrogen in the uterus. AB - Progesterone pretreatment decreases oestrogen-induced uterine eosinophilia and other non-genomic responses that are possibly mediated by eosinophils. To investigate the mechanisms of this interaction, the present study describes the effects of progesterone on oestrogenic responses already induced by oestrogen treatment and the in-vivo and in-vitro effects of progesterone on blood eosinophils. Progesterone treatment of oestrogen-pretreated animals potentiated uterine eosinophilia 24 h after progesterone treatment but decreased it at later times and increased eosinophil degranulation in vivo. In addition, progesterone degranulated blood eosinophils in vitro. These findings demonstrate interaction of progesterone with oestrogenic responses mediated by eosinophils. Progesterone interaction with other oestrogenic responses was analysed for comparison; evidence is shown suggesting a role of eosinophils in oestrogen-induced uterine luminal fluid accumulation. PMID- 6481288 TI - Production rate, metabolic clearance rate and blood concentration of progesterone in conscious and anaesthetized pregnant rats. AB - Both production rate and metabolic clearance rate (MCR) of progesterone may vary rapidly and so effect short-term changes in blood concentration of the hormone. Here, a constant infusion and sampling technique was used to estimate these three characteristics of progesterone metabolism in seven conscious and ten anaesthetized rats on day 16 of pregnancy. After steady state was achieved, four samples were collected during a 1-h period from each rat. Mean values for production rate and MCR of progesterone in conscious rats were 14.0 +/- 1.4 mumol/day and 63.2 +/- 6.2 litres/day respectively. Both values were substantially reduced in anaesthetized rats (8.6 +/- 0.8 mumol/day and 39.4 +/- 3.4 litres/day respectively) and so blood concentration was unchanged. The production rate was positively related to the total mass of luteal tissue (common correlation coefficient, r = 0.61, P less than 0.05). There were no consistent changes in the three characteristics with time but variation within rats was high. The estimated coefficients of variation for production rate, MCR and blood concentration within rats were 26, 18 and 17% in conscious and 27, 20 and 23% in anaesthetized rats respectively. Short-term changes in production rate and MCR generally were in the same direction (P less than 0.05). This reduced variation in blood concentration which would otherwise have occurred if production rate and MCR were unrelated. The pregnant rat is clearly capable of rapid shifts in production rate, MCR and blood concentration of progesterone and the positive relationship between production rate and MCR has a homeostatic effect on blood concentration. PMID- 6481289 TI - Effect of calcitonin on salivary phosphorus and calcium excretion in sheep. AB - Three thyroidectomized sheep were infused intravenously with porcine calcitonin at a rate of 30 mi.u./h per kg and three sham-operated sheep were infused with vehicle for 5 h. Saliva was collected from the left parotid duct by cannulation for 10 min in every hour. Salivary secretion rates were not changed in either thyroidectomized or sham-operated sheep throughout the experiment. Before the infusion, salivary phosphorus excretion was less in thyroidectomized sheep than in sham-operated animals. Calcitonin infusion increased salivary phosphorus excretion and decreased serum phosphorus concentrations in thyroidectomized sheep. Vehicle infusion did not affect salivary phosphorus excretion in sham operated sheep. Serum concentrations and salivary excretion of calcium were decreased by calcitonin infusion into thyroidectomized sheep but were not changed in sham-operated sheep infused with vehicle. Calcitonin infusion increased serum parathyroid hormone concentrations in thyroidectomized sheep after the decrease of serum calcium concentrations. However, vehicle infusion did not affect serum parathyroid hormone concentrations in sham-operated sheep. There was little change of cyclic AMP excretion during the experiment in either thyroidectomized or sham-operated sheep. It is concluded that calcitonin increases salivary phosphorus excretion in sheep. PMID- 6481291 TI - Prolactin stimulates steroidogenesis by human luteal tissue in vitro. AB - Human luteal tissue recovered from varying stages of the luteal phase was minced and incubated for 3 h and the effect of human chorionic gonadotrophin (hCG), prolactin and hCG + prolactin on progesterone and oestradiol production measured. While hCG generally enhanced both progesterone and oestradiol synthesis, prolactin alone at either 20 or 200 micrograms/l had no significant effect on steroidogenesis. When prolactin was added along with hCG in four of six corpora lutea, however, progesterone production significantly increased and in three of six corpora lutea oestradiol production was increased above that induced by hCG alone. It is concluded that prolactin may play some role in the control of steroidogenesis by the human corpus luteum. PMID- 6481290 TI - Evaluation of the biological properties of parathyroid hormone and analogues in a vascularly isolated parotid gland-based assay. AB - Infusion of bovine parathyroid hormone (bPTH) preparations into the arterial blood supply of the vascularly isolated parotid gland in anaesthetized sheep increases salivary phosphate concentration and gland blood flow rate with rapid onset and offset of action. These responses have been used as a bioassay for PTH and PTH analogues and for assessing the properties of an in-vitro inhibitory analogue [Nle-8, Nle-18, Tyr-34]bPTH-(3-34)amide. [Nle-8, Nle-18, Tyr-34]bPTH-(1 34)amide at 10(-9) to 10(-8) mol/l was four to five times more potent than bPTH(1 34) on both salivary phosphate and blood flow assays. Human PTH(1-34) was not significantly more potent than bPTH(1-34). The [Nle-8, Nle-18, Tyr-34]bPTH-(3 34)amide analogue had very slight agonist activity at 3 X 10(-7) mol/l and at a 100:1 ratio of analogue to PTH it completely inhibited the action of bPTH(1-34) on phosphate secretion and gland blood flow. It caused partial inhibition at 10:1 and had no evident effect at 1:1. These results differ from previous in-vitro results and indicate that the preparation may be valuable for evaluation of agonist and antagonist analogues of PTH. The vascularly isolated parotid gland of the sheep permits repeated random testing of analogues in a control-test-control sequence and the results indicate high sensitivity to PTH in a rapidly reactive in-vivo system with two responding parameters. PMID- 6481292 TI - Properties and ontogeny of the glucocorticoid receptor in the placenta and fetal lung of the sheep. AB - The cytosolic glucocorticoid receptor of ovine placental zona intima has been characterized and measured between day 51 of pregnancy and term, and levels compared with those in fetal lung. By ion-exchange and gel-filtration chromatography the molybdate-stabilized receptor was found to be an acidic molecule with Stokes radius approximately 8 nm; these physicochemical characteristics of the ovine placental receptor are comparable to those of receptors in glucocorticoid target tissues from nonruminants. Concentrations of cytosolic receptor in placenta (mean, 139 fmol/mg protein) were lower than those in fetal lung (627 fmol/mg) at all stages of gestation investigated. To some extent this difference was accounted for by a twofold higher concentration of protein in placental cytosols compared with those from fetal lung. In both tissues, cytosolic receptor concentrations were maximal between days 91 and 130, when fetal adrenal steroid secretion is low; receptor concentrations decreased before term. Fetal hypophysectomy, which resulted in prolonged gestation, raised receptor concentrations in placenta, but not in fetal lung. In both tissues, apparent dissociation constants for [3H]dexamethasone binding to glucocorticoid receptors were in the range 0.5-7.1 nmol/l; these dissociation constants did not change consistently between day 100 and term. In whole-cell preparations of placenta and fetal lung incubated in vitro there was time-dependent specific binding of [3H]dexamethasone by nuclei, and binding of labelled cytosolic receptor to isolated nuclei occurred at all stages of gestation investigated. Binding of [3H]dexamethasone by cytosolic receptor from placenta and fetal lung was inhibited by progesterone and 17 alpha-hydroxyprogesterone, as well as by cortisol, cortisone, 11-deoxycorticosterone and 11 beta-hydroxyprogesterone; 20 alpha-hydroxyprogesterone and 17 alpha,20 alpha-dihydroxypregn-4-en-3-one were less effective. In experiments to evaluate the possible antagonistic action of progesterone in whole-cell preparations, uptake of [3H]dexamethasone by nuclei was increased up to twofold in placental minces incubated with aminoglutethimide or epostane, when progesterone synthesis was reduced by 98 and 92 per cent respectively. Nuclear uptake in minces of fetal lung was blocked by concentrations of progesterone found in placenta. The existence of a placental glucocorticoid receptor confirms that fetal cortisol may act directly on the placenta to induce the enzymatic changes controlling the onset of labour.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481293 TI - Ovarian-splenic autotransplantation: evidence that oestrogen does not inhibit hepatic somatomedin generation. AB - This study was designed to test the hypothesis that oestrogens inhibit growth by reducing hepatic somatomedin generation. We have attempted to deliver oestrogen preferentially to the liver by transplanting ovarian tissue into the spleen. Four groups of rats were compared: intact, ovariectomized, ovariectomized with successful ovarian transplants, and animals where due to adhesions between the transplant and body wall and/or viscera oestrogens reached the general circulation. Plasma levels of LH and FSH, uterine weights, ovarian weights and vaginal smears supported this classification of animals. Ovariectomy increased body weight, body length, bioassayable serum somatomedin levels and 35SO4(2-) uptake into costal cartilage in vivo compared with intact rats and animals with adhesions. Preferentially exposing the liver to oestrogen did not suppress the increased growth, serum somatomedin activity or uptake of 35SO4(2-) in vivo observed in ovariectomized animals. The results suggest that the presence of oestrogen in the general circulation is associated with growth suppression and lowered somatomedin bioactivity while the presence of oestrogen in the hepatic portal circulation has little effect on body growth. We conclude that oestrogen does not appear to inhibit growth in the rat by influencing the release of somatomedin from the liver. It also seems that serum somatomedin concentration may not reflect liver somatomedin generation but overall production throughout the body. PMID- 6481294 TI - Effects of hypobaric hypoxia on the Leydig cell population of the testis of the rat. AB - A group of ten young adult male Wistar albino rats was exposed to hypobaric hypoxia at a barometric pressure of 380 mmHg for 28 days. After this period their testes were of smaller weight (and volume) in comparison with matched controls (1.220 vs 1.553 g; P less than 0.005). Histological examination revealed degeneration and sloughing of spermatogenic cells in occasional tubules. Quantitative methods also revealed a marked difference in the volume of the testis occupied by Leydig cells. These were of a significantly smaller total volume in the hypoxic animals (0.046 vs 0.083 ml; P less than 0.001) and this could not be accounted for merely by the smaller overall testicular volume. PMID- 6481295 TI - Progesterone, androstenedione and oestradiol content of theca and granulosa tissues of the four largest ovarian follicles during the ovulatory cycle of the hen (Gallus domesticus). AB - The progesterone, androstenedione and oestradiol contents of the theca and granulosa tissues of the four largest follicles in the ovarian hierarchy of the hen were determined. The granulosa tissue contained significantly (P less than 0.05) more progesterone and less androstenedione and oestradiol than the theca tissue. The content of progesterone was greatest in the granulosa tissue of the first three follicles in the hierarchy and in each of these follicles there was a peak in progesterone content of the granulosa 4 h before ovulation. The theca of the second, third and fourth follicles and the granulosa of the third and fourth follicles contained significantly (P less than 0.05) more androstenedione than either tissue in the largest follicle. The content of androstenedione was maximal approximately 8 h before ovulation in both tissues of the second and third follicles. The content of oestradiol in the granulosa did not vary as follicles changed position within the hierarchy or during the ovulatory cycle. The oestradiol content of the theca tissue remained constant during the third and fourth positions in the hierarchy and declined throughout the second and first positions until a nadir was observed approximately 20 h before ovulation. It was concluded that the synthesis of androstenedione and oestradiol ceases in both follicular tissues after the follicle is exposed to the penultimate preovulatory surge of LH and that progesterone production is stimulated in the granulosa of the three largest follicles at the time of the preovulatory release of LH. PMID- 6481296 TI - Role of prolactin in the photoperiodic control of moulting in the mink (Mustela vison). AB - Beginning at the summer solstice adult female mink were maintained in long- or short-day photoperiods and treated with bromocriptine or prolactin. In control females kept under natural lighting conditions the moult coincided with the seasonal decrease in prolactin and resulted in the growth of a dense winter coat which was completed by the end of November. Long days, which slowed the decrease in plasma prolactin relative to animals in the natural photoperiod, induced a more or less complete moult followed by growth of a thin summer coat. On the contrary we observed an accelerated decrease in plasma prolactin concentrations followed by an early and brief moult in females kept under long days but treated with bromocriptine and in females under short days. The growth of a dense winter coat was completed by the end of September in all the females of the short-day group and in six of eleven females treated with bromocriptine. In the other five females, moult was followed by the growth of a summer coat. These results may suggest that the decline of prolactin after the summer solstice is responsible for the onset of the autumn moult, but the early, abbreviated moult and the growth of a winter coat observed in females kept under short days and treated with prolactin do not seem to support this hypothesis. However, the huge non physiological levels of prolactin measured in the plasma of these females and the appearance of abnormal white under-hairs might suggest that the hormonal balance in this group was completely disturbed by the treatment. The physiological role of prolactin in the seasonal moulting cycle in mink is discussed. PMID- 6481297 TI - Coding responses and the generalization of matching to sample in children. AB - Two experiments studied the conditions of stimulus control necessary for the generalization of relational matching to sample. Matching required the selection of comparison shapes rotated 90 degrees clockwise from the orientation of the corresponding sample. In Experiment 1, five children were taught to: (a) code the orientations of samples, (b) transform sample codings to account for the 90 degree rotation, and (c) repeat the transformed sample coding response to a comparison. High levels of generalization occurred with a set of novel stimuli for which stable sample-coding responses were initially available. In another novel set, where stable sample-coding responses were not initially available, low levels of generalized matching were recorded. Matching performance improved after stable coding responses were trained. In Experiment 2, two children and three adults were trained in a form of the matching task that produced poor generalization despite the presence of stable sample-coding responses. Retraining to modify the stimulus control exerted by these coding responses produced an immediate improvement in generalized matching to sample. Results suggest that the generalization of matching is dependent on structure of stimulus control that the component responses exert on each other. PMID- 6481298 TI - Accuracy versus speed in the generalized effort of learning-disabled children. AB - Reinforcement of effortful performance in a given academic task has been found to increase the subsequent performance of other academic tasks. The learned-effort hypothesis assumes that individuals learn which dimensions of task performance are correlated with reinforcement of high effort, and generalize across tasks. Therefore, reinforcement of increased effort in a given dimension of one task should result in greater generalized effort in the same dimension of transfer performance than in another dimension. In accord with this view, preadolescent learning-disabled students who received points for high reading accuracy subsequently produced more accurate drawings and stories than did students whose points had been based upon high reading speed or upon mere completion of the reading task. Students who received points for high reading speed subsequently constructed stories more quickly than did children whose points had been based upon high reading accuracy or upon reading-task completion. Consistent with the more explicit and frequent feedback for accuracy than for speed in most academic tasks, generalized accuracy was much more durable than generalized speed. PMID- 6481299 TI - Pentobarbital self-administration in rhesus monkeys: drug concentration and fixed ratio size interactions. AB - Performances of three rhesus monkeys were reinforced by the oral delivery of pentobarbital and studied as functions of fixed-ratio size and drug concentration. Pentobarbital solutions and water were concurrently available on identical reinforcement schedules from separate liquid-delivery systems during 3 hour sessions. Under a fixed-ratio 16 schedule of drug availability, a descending series of drug concentrations was tested (4, 2, 1, 0.5, 0.25, 0.125, and 0.0625 mg/ml, followed by a retest at 4 mg/ml). Partial concentration series beginning with the highest concentration were repeated with fixed-ratios of 32 and 64, with a fixed-ratio 128 for two monkeys, and with fixed-ratio 256 for one. At each fixed-ratio value, response rate and number of drug deliveries were inverted U shaped functions of pentobarbital concentration. Drug intake (mg/kg/session) increased directly with drug concentration. As the fixed-ratio size was increased, the number of liquid deliveries decreased. For each drug concentration, when the numbers of drug deliveries at fixed-ratios of 32, 64, and 128 responses were plotted as percentages of those obtained at fixed-ratio 16, the following orderly relationship emerged: the higher the drug concentration, the less that drug deliveries were decreased by increases in fixed-ratio size. This relationship indicates an increase in reinforcing efficacy with increases in pentobarbital concentration. PMID- 6481300 TI - Bias of phencyclidine discrimination by the schedule of reinforcement. AB - Pigeons, trained to discriminate phencyclidine from saline under a procedure requiring the bird to track the location of a color, received cumulative doses of phencyclidine, pentobarbital, or d-amphetamine with a variety of schedules of reinforcement in effect (across phases). When the same second-order schedules were used to reinforce responding after either saline or phencyclidine administration, stimulus control by phencyclidine did not depend on the schedule parameter. When different second-order schedules were used that biased responding toward the phencyclidine-correlated key color, pigeons responded on the phencyclidine-correlated key at lower doses of phencyclidine and pentobarbital than when the second-order schedule biased responding toward the saline key color. A similar but less marked effect was obtained with d-amphetamine. Attempts to produce bias by changing reinforcement magnitude (duration of food availability) were less successful. A signal-detection analysis of dose-effect curves for phencyclidine under two of the second-order schedules employed suggested that at low doses of phencyclidine, response bias is a major determinant of responding. As doses were increased, position preferences occurred and response bias decreased; at higher doses both response bias and position preference decreased and discriminability increased. With low doses of pentobarbital, responding again was biased but increasing doses produced position preference with only small increases in discriminability. At low doses of d amphetamine responding also was biased, but bias did not decrease consistently with dose nor did discriminability increase. These experiments suggest that the schedule of reinforcement can be used to bias responding toward or away from making the drug-correlated response in drug discrimination experiments, and that signal-detection analysis and analysis of responding at a position can be used to separate the discriminability of the drug state from other effects of the drug on responding. PMID- 6481301 TI - Delayed signal detection, differential reinforcement, and short-term memory in the pigeon. AB - In two discrete-trial delayed-detection experiments, six pigeons were trained on dependent concurrent variable-interval schedules. Pecking a red side key was reinforced when the brighter of two white lights (S1) had been presented on the center key, and pecking a green side key was reinforced when the duller of two white lights (S2) had been presented on the center key. Incorrect responses were red side-key pecks following S2 presentations and green side-key pecks following S1 presentations; these resulted in three-second blackouts. In Experiment 1, the time between presentation of S1 or S2 on the center key and the onset of the red and green side keys was varied nonsystematically from 0.06 seconds to 19.69 seconds across experimental conditions. Stimulus discriminability decreased as the stimulus-choice delay increased. A rectangular-hyperbolic function better described this decrease in discriminability over time than did a negative exponential function. In Experiment 2, at each of three stimulus-choice delays (0.06, 3.85, and 10.36 seconds), relative reinforcer frequency for correct responses to the red and green side keys was varied by changing the values of the dependent concurrent variable-interval schedules. The sensitivity of choice to relative reinforcer frequency was independent of the decrease in stimulus discriminability with increasing stimulus-choice delay. PMID- 6481302 TI - Glycolipids of the mouse peritoneal macrophage. Alterations in amount and surface exposure of specific glycolipid species occur in response to inflammation and tumoricidal activation. AB - We have characterized the major glycolipid constituents of the mouse peritoneal macrophage, and have demonstrated that alterations in the amount and in the accessibility of specific glycolipid species to galactose oxidase/NaB3H4 labeling, an indicator of glycolipid surface exposure, occur in response to inflammation and as a consequence of activation to a tumoricidal state. The key findings are: (a) Asialo GM1, a major neutral glycolipid constituent of all macrophage populations examined, is accessible to galactose oxidase/NaB3H4 labeling on the surface of TG-elicited and BCG-activated macrophages but not on resident macrophages; (b) GM1 is the predominant ganglioside constituent of the mouse macrophage. Resident macrophages contain two distinct GM1 species, as determined by cholera toxin binding, while TG-elicited and BCG-activated macrophages contain an additional GM1 species. Differences in the relative amounts of these GM1 species, as well as in their accessibility to galactose oxidase/NaB3H4 labeling, exist among the macrophage populations. These observations suggest that both a chemical and spatial reorganization of surface glycolipids occurs in response to inflammation and tumoricidal activation. PMID- 6481303 TI - Increased cytotoxicity of normal rabbit serum for lectin-resistant mutants of animal cells. AB - Plant lectins are cytotoxic and can be used to select for mutants of animal cells that exhibit structural changes in cell surface carbohydrates reflecting glycosylation defects. We isolated eight lectin mutants of Chinese hamster ovary (CHO) cells that appear to represent three different phenotype classes. These lectin mutants were much more sensitive to the cytotoxic action of normal rabbit serum (NRS) than were the parental cells. This increased cytotoxicity was heat sensitive, specifically absorbed, and inhibited by simple and complex carbohydrates. No killing was observed under conditions in which only the alternate complement pathway was active. An NRS-resistant subclone that was isolated from one lectin mutant was shown to have also regained wild type behavior when tested with the lectins. The possibility that naturally occurring antibodies in rabbit serum are reacting with incomplete carbohydrate chains on the surface of the lectin mutants is discussed. PMID- 6481304 TI - Defective membrane potential changes in neutrophils from human neonates. AB - In an attempt to determine the mechanism of the profound defect in chemotaxis observed in the polymorphonuclear leukocytes (PMN) of human neonates, we have examined membrane potential changes and alterations in free intracellular calcium following chemotactic factor stimulation. Following exposure to formyl-methionyl leucyl-phenylalanine (FMLP), PMN from adult donors (11) showed a marked change in membrane potential (31%) as determined by fluorescence emission using the cyanine dye, 3-3-dipentyloxacarbocyanine [DiOC5(3)]. In marked contrast, FMLP-stimulated PMN from 10 human neonates failed to show any significant change in membrane potential (1-2%). Using the calcium-sensitive probe Quin 2/AM, FMLP induced an increase in fluorescence of up to 51% in adult PMN (10). In contrast, the change in intracellular free calcium induced in neonatal PMN was much less (32%; P less than 0.01). These results suggest that the profound defect in chemotactic responsiveness of PMN from human neonates may result from an inability of these cells to undergo changes in membrane potential following inflammatory mediator stimulation. PMID- 6481305 TI - A radioimmunoassay for digoxin in human urine. AB - We report a digoxin radioimmunoassay in human urine employing commercially available reagents. The calibration curve has a mean correlation coefficient of 0.994 and is linear up to 16.0 micrograms/l. The average coefficients of variation between and within the runs are 3.6% and 3.5% respectively. The assay has a recovery of 101.4% and 98.9% at low and high levels of digoxin excretion respectively. Dihydrodigoxin at concentrations of 4, 8 and 16 micrograms/l has relative cross reactivities of 12.0%, 7.7% and 4.8% respectively. The assay was applied to compare within-patient and between-patient variability during treatments with Lanoxin and Lanoxicaps at steady-state. Precision, sensitivity, broad range linearity, convenience of commercially available reagents, insignificant cross reactivity of dihydrodigoxin with the digoxin antibody complex and urinary digoxin excretory data at different dilutions validate our assay for routine monitoring of urinary digoxin. PMID- 6481306 TI - Further evaluation of the SG test strip for estimation of urinary osmolality. AB - The mass densities of 2000 urines from children and 2000 urines from adults were determined with the new test strip, Multistix SG, and the results were compared with osmolality measurements. Normal urinary parameters were investigated for possible interference with the test strip reading. Variations in the pH and ionic composition of urine considerably influenced the test strip reading, whereas nonionic compounds, such as glucose and urea, showed practically no interference. For patients on a normal diet and without metabolic diseases, the new test strip is more appropriate than urometry for the determination of the mass density of the urine. PMID- 6481307 TI - Comparison of several regression procedures for method comparison studies and determination of sample sizes. Application of linear regression procedures for method comparison studies in Clinical Chemistry, Part II. AB - In part I of this series (H. Passing & W. Bablok (1983), J. Clin. Chem. Clin. Biochem. 21, 709-720) we described a new biometrical procedure for the evaluation of method comparison studies. In part II we now discuss its properties and compare them with those of other established procedures by means of a simulation study. We demonstrate that the reliability of the results not only depends on the sample size but also on the sampling distribution, the precision of the methods, and the concentration range covered by the samples. Linear regression and principal component procedures are either inadequate or not as reliable as our new procedure. The appropriate sample size is discussed and recommendations are given. PMID- 6481308 TI - The sugar spectrum of human cholesterol gallstones, mixed and pigment gallstones: combined quantitative analysis of neutral sugars, N-acetylhexosamines, hexuronic and N-acetylneuraminic acids by capillary gas-liquid chromatography. AB - Glycoproteins were investigated in different types of biliary calculi by a methanolysis procedure of the carbohydrate moiety, the formation of 2,6-dinitro-4 trifluoromethylbenzenesulphonate derivatives of N-acetylhexosamines and N acetylneuraminic acid, followed by separation, identification and quantification of the liberated monosaccharides using capillary gas-liquid chromatography. This indirect method avoids several analytical problems caused by the presence of bile pigment derivatives; unless these are carefully removed they interfere strongly in the measurement of protein. The carbohydrate contents were much higher in pigment stones than in cholesterol and mixed stones. Rhamnose, a non-mammalian monosaccharide, was identified in most samples, but was significant increased in pigment stones, indicating a bacterial history of this stone type. PMID- 6481309 TI - Placental alkaline phosphatase in tumour tissue and serum. AB - Using immunochemical techniques, alkaline phosphatase isoenzymes were determined in tissue samples of breast carcinomas and carcinomas of the gastrointestinal tract. In breast carcinomas only 19% of the patients expressed significant placental alkaline phosphatase activity, compared with 78% in gastrointestinal tumours. The intestinal isoenzyme was found in 50% of the breast carcinomas and in nearly all of the other examined tissues. The two isoenzymes usually represent 1% of the total alkaline phosphatase activity, but in a few cases they may constitute between 10 and 90%. In the serum of the patients under examination, elevated total alkaline phosphatase activity was found in only 7%, and elevated placental alkaline phosphatase in 6% of the cases. No cases of elevated serum intestinal alkaline phosphatase were found. We therefore consider that serum placental alkaline phosphatase is a poor tumour marker for a general screening. PMID- 6481310 TI - Effect of magnesium injection on foetal development. AB - Pregnant rats were subcutaneously injected twice daily with 1.5 ml 150 mmol/l MgCl2 beginning at day 5 of gestation. By this treatment development of foetal liver and pancreas was enhanced. In the foetal liver, there was a precocious glycogenolysis combined with a precocious development of the smooth endoplasmic reticulum (ER) and an irregular arrangement of the rough ER. In the pancreas, the development of secretory granules was enhanced. In alizarin red-stained and cleared specimens, the foetal skeleton was less calcified. The injected Mg2+ remained extracellular. Altered hormonal secretion and/or an altered activity of the regulatory enzymes of glycogen metabolism induced by the increased extracellular Mg2+ concentration are discussed as possible mechanisms for enhanced foetal liver development. PMID- 6481311 TI - Renal and hepatic extraction of carboxyl-terminal immunoreactive parathyrin in normal man. AB - We measured the carboxyl-terminal immunoreactive parathyrin (parathyroid hormone) in samples from twenty catheterized patients with hypertension. The radioimmunoassay reacted equally well with intact parathyrin and carboxyl terminal parathyrin fragments. The renal arterio-venous extraction ratio (extraction ratio = arterio-venous concentration difference divided by the arterial concentration) of endogenous carboxyl-terminal immunoreactive parathyrin equalled that of inulin, with mean values for both of 0.17. The carboxyl-terminal parathyrin fragments have about the same molecular weight as inulin, and they are extracted exclusively by glomerular filtration, whereas intact parathyrin is extracted by both peritubular uptake and glomerular filtration. The findings therefore agree with a high proportion of circulating carboxyl-terminal parathyrin fragments in normal man. The mean extraction ratio of endogenous carboxyl-terminal immunoreactive parathyrin across nine livers was 0.16. Some of the hepatic extraction might be due to cleavage and uptake of intact parathyrin, which constitutes about 15% of the circulating immunoreactive parathyrin, but the findings suggest that the liver also extracts and metabolizes the circulating carboxyl-terminal parathyrin fragments in normal man. PMID- 6481313 TI - International Federation of Clinical Chemistry (IFCC) and International Union of Pure and Applied Chemistry: a basic education and training framework for medical laboratory technicians in clinical chemistry. PMID- 6481312 TI - [Immunoglobulin G synthesizing lymphocytes in the cerebrospinal fluid in multiple sclerosis and non-inflammatory diseases of the nervous system]. AB - In 208 patients, the IgG-synthesizing lymphocytes of the CSF were demonstrated with immunocytochemical methods. These cells were found in 59 of 111 patients with multiple sclerosis. Their frequency of appearance was dependent on the duration of the disease and its clinical severity. A comparative laser nephelometric examination of serum and CSF, together with CSF cell diagnosis, demonstrated that IgG-synthesizing lymphocytes were present in 12% of the patients without simultaneous local IgG production within the CNS. These cases showed mostly very short clinical courses. IgG-synthesizing lymphocytes were absent from the CSF of 97 patients with non-inflammatory diseases of the nervous system. PMID- 6481314 TI - Flexible sigmoidoscopy. PMID- 6481315 TI - Learning to live without practice denominators. PMID- 6481316 TI - Adoption: the family physician's role. PMID- 6481317 TI - Why flexible sigmoidoscopy instead of rigid sigmoidoscopy? AB - Representative outcome studies describing the procedures of rigid sigmoidoscopy and use of the 60-cm flexible sigmoidoscope are summarized. Subspecialist outcomes are compared with those obtained by family physicians. Family physicians consistently obtain similar insertion depths and diagnostic yields, although comparison is difficult because of referral bias and inconsistency regarding the reporting of hyperplastic polyps. No complications have been reported to date. Low physician and patient compliance with suggested guidelines for sigmoidoscopic examination may be partially responsible for unchanged five-year survival rates for colorectal cancer over the last 30 years. Preliminary studies indicate that the 60-cm flexible sigmoidoscope has improved compliance in at least one setting. Longitudinal cost-benefit studies should be performed in primary care settings. PMID- 6481318 TI - Clothing factors and vaginitis. AB - Associations of clothing factors and vulvovaginal symptoms, signs, and microbiology were sought in 203 women seeking care at a university family medicine clinic. Clothing factors studied were use of panty hose, underwear for sleep, cotton lining panels, and pants vs skirts. Women wearing and not wearing panty hose had similar rates of vaginitis symptoms and signs, but yeast vaginitis was about three times more common among wearers. Relationships of other clothing factors to vaginitis were not found. Nonspecific vaginitis was not found to be related to clothing. PMID- 6481319 TI - Multicenter study of family physician prescribing. AB - The objective of this study was to examine differences in prescribing characteristics among four Iowa family practice offices, each associated with family practice residency programs. This prospective study collected data over a four-month period, utilizing duplicate, carbon-copy prescriptions. The prescriptions were tabulated according to individual drug and therapeutic categories. Differences in prescribing frequency among offices were analyzed using chi-square 2 X 2 contingency tables. The number of prescriptions written at each office (designated A through D) were as follows: A, 1,034; B, 1,449; C, 2,965; and D, 2,335. The most frequently prescribed drug category was systemic antibiotics, followed by cough, cold, or allergy products, analgesic and anti inflammatory drugs or muscle relaxants, diuretics, and topical anti-infectives. There were statistically significant differences in the frequencies of these categories among offices. The most frequently prescribed drug was amoxicillin at offices A, B, and C, and erythromycin at office D. There were statistically significant differences in the frequencies of the top ten drugs at each office. From these data the family practice faculty and clinical pharmacists can identify therapeutic areas that may require additional educational emphasis for the resident. PMID- 6481320 TI - Serum drug level utilization review in a family medicine residency program. AB - A total of 161 tests, comprising six of the most commonly ordered serum drug levels (SDLs) in a family medicine residency program, were audited retrospectively by a review panel. Audit criteria assessed the appropriateness of three factors associated with this laboratory test ordering procedure: (1) indication for the level, (2) procedure and documentation, and (3) physician utilization of the results. There were no statistically significant differences (P less than .05) when comparing the percentage of appropriate indications and uses with the individual drug levels ordered or with the number of years in practice. However, this audit indicated that a large number of therapeutic decisions were based upon information obtained from improperly ordered SDLs. Also, lack of proper documentation and charting of SDLs appeared to hamper optimal continuity of care in a clinic where patients were seen by several physicians. It is suggested that educational and administrative strategies may be effective in promoting better ordering and use of laboratory tests by family physicians in the future. PMID- 6481321 TI - Clinical hypothesis testing in family practice: a biopsychosocial perspective. AB - Recent studies of the clinical problem-solving process have demonstrated the importance of hypothesis generation and testing in shaping the nature of information gathering, differential diagnosis, and therapeutic decision making. Family physicians and other primary care physicians are often faced with complex and undifferentiated illness problems that require them to go beyond the traditional biomedical model and entertain an expanded range of psychosocial hypotheses. In this paper the authors draw upon clinically relevant behavioral and social science research and propose several biopsychosocial hypotheses that have proven useful in the management of family practice patients. Seven illustrative case studies are presented, and some implications of this biopsychosocial paradigm for practice, research, and teaching are discussed. PMID- 6481322 TI - Alcoholism curriculum development: an examination of the process. AB - Alcoholism is one of several topics that may be integrated into family medicine clerkship teaching. This article focuses on the process of curriculum development in alcoholism. The process is traced from its beginnings in a third-year clerkship to its integration into the medical school curriculum and other areas of medical education. Strengths and pitfalls in this project are discussed. Enlisting community support and field testing newly developed strategies are emphasized as successful methods. Less successful in this project, though equally important, are faculty development and long-term evaluation. Recommendations for curriculum development in similar projects are made. PMID- 6481323 TI - Office audiometry. AB - The selection of appropriate hearing test procedures is dependent upon the goals chosen by the practitioner and the skills of the examiner. Office audiometry is superior to tuning-fork tests and provides unique information for diagnosis and management. PMID- 6481324 TI - Cyclic breast pain. PMID- 6481325 TI - Cerebral cysticercosis of the fourth ventricle: a problem in primary care diagnosis. PMID- 6481326 TI - Stress of transition from residency training to clinical practice in the military setting. PMID- 6481327 TI - Adverse drug reaction reporting and the family physician. PMID- 6481328 TI - Firing patterns of closer motoneurons during reflex activity in the dimorphic claws of the lobster Homarus americanus. AB - The in vivo firing patterns of the fast closer excitor (FCE) and slow closer excitor (SCE) motoneurons to the dimorphic claws of the lobster Homarus americanus were analyzed during reflex closure activity by identifying postsynaptic potentials in muscle fibers with known motor innervation. Three types of claw activity were observed: slow closure, rapid closure, and maintained closure. Slow closure and rapid closure in both claws were mediated by SCE and FCE, respectively. In the cutter, maintained closure was mediated only by SCE; in the crusher, both FCE and SCE could maintain closure. The homologous SCEs displayed no significant differences in activity; in both claws, they fired at medium-to-high frequency. The homologous FCEs did display different spike frequencies during claw closure. The crusher FCE fired at high frequencies; the cutter FCE fired at much lower frequencies. Such in vivo differences in axon activity between homologous FCEs are correlated with claw dimorphism and with the population of muscle fiber types. PMID- 6481329 TI - Neuromuscular relationships during claw regeneration in Californian snapping shrimp. AB - We have examined the innervation patterns of the two excitor axons to the closer muscle in the dimorphic (snapper and pincer) claws of Californian snapping shrimp (Alpheus californiensis). In both claws the fast-closer excitor (FCE) axon supplies all of the closer muscle fibers. The slow-closer excitor (SCE) axon, however, makes functional connections only with fibers on the dorsal and ventral margins, which are composed of slow-type fibers in the large snapper claw and of intermediate-type fibers in the smaller pincer claw. The central band of fast fibers in the pincer closer muscle is not innervated by the SCE. During claw regeneration, the closer muscle is initially composed of a population of fast fibers in the pincer and intermediate-type fibers in the snapper. The innervation patterns of the two excitatory motor axons in regenerating claws at this stage are the same as in fully developed claws. During the first intermolt period some fast-closer muscle fibers in the pincer claw differentiate into intermediate-type fibers, but the axon innervation patterns do not change. If the correlation between SCE axon innervation pattern and the regional distribution of different muscle fiber types is indicative of nerve-muscle interactions, the present data suggest that the trophic influence must proceed from nerve to muscle. PMID- 6481330 TI - Inability of newt epidermal cells to migrate over concanavalin A-coated substrates. AB - Pieces of coverslip glass coated with various proteins were implanted under one edge of a fresh skin wound on adult newt hind limbs so that the implant served as wound bed for migrating epidermal cells as they attempted to form a wound epithelium. Despite the fact that concanavalin A (Con A) receptors could be demonstrated on newt epidermal cells with fluorescein isothiocyanate (FITC) conjugated lectin, Con A-coated implants supported practically no migration, an even poorer response than the modest amount of migration that occurred on uncoated glass. Coomassie blue staining verified that the lectin formed a complete film over the glass, and peroxidase binding assays showed that even after several hours in the wound, the Con A binding sites for mannose were still available. Migration on fibrinogen-coated glass (a good migration substrate) was not affected by placing the implants next to Con A-coated implants. Thus, the failure to migrate on Con A cannot be explained by soluble Con A effects from lectin leaching off the implants. These data suggest that linkages between cell surface mannose and the substrate are not part of the strategy by which newt epidermal cells migrate. PMID- 6481331 TI - Injury, nerve, and wound epidermis related electrophoretic and fluorographic protein patterns in forelimbs of adult newts. AB - Polyacrylamide slab gel electrophoresis and [35S]methionine fluorography were used to examine proteins in regenerating newt limbs, amputated denervated limbs, unamputated denervated limbs, and separated blastema mesodermal core and wound epidermis. A total of 27 protein electrophoretic bands were obtained from amputated limbs and 24 bands from unamputated limbs. Amputation resulted in the appearance of 4 new bands and the loss of 1 band as compared to unamputated limbs. These 5 banding differences were apparent on stained gels 3 days postamputation and were maintained through 10 weeks postamputation (complete regenerate stage). Only one band in unamputated limbs was always detectable on fluorographs, whereas virtually all of the stainable bands of amputated limbs were visible on fluorographs. Amputation clearly stimulated a marked, generalized increase in the synthesis of limb proteins. The 5 amputation induced changes were equally evident in stained gels of both innervated and denervated limbs. Amputated denervated limbs possessed a full set of fluorographic bands (including the 5 differences) through 18 days postamputation. However, denervation without amputation was not sufficient to alter the stainable banding pattern. Wound epidermis and mesodermal core both displayed the 5 banding differences and had identical banding patterns with the exception of one epidermal specific band. This band was also present in whole limb skin but was absent in unamputated mesodermal limb tissue. This was the only band of unamputated limbs that was consistently detectable by fluorography. It is concluded that amputation induces nerve independent changes in protein synthesis that are common to both mesodermal core and wound epidermis. These changes may represent preparation for cellular proliferation. PMID- 6481332 TI - Stump currents in regenerating salamanders and newts. AB - We report here that a variety of salamanders and newts from differing habitats all drive a steady ionic electric current out of the forelimb stump tip after forelimb amputation. Several hours after amputation the density of this stump current ranges from about 10 to 100 microA/cm2 in most species, and declines with time. In most cases, the magnitude of the stump current is dependent on the concentration of Na+ in the external medium (an artificial pondwater), suggesting that the well-known Na+ -dependent transcutaneous voltage described in amphibia (particularly frogs) is the EMF for this stump current. These measurements add to those previously reported for the North American red spotted newt (Notophthalmus viridescens), and suggest that electrical changes following amputation of urodele limbs are widespread among members of this group. PMID- 6481333 TI - Contractile activation in scorpion striated muscle fibers. Dependence on voltage and external calcium. AB - Excitation-contraction coupling was characterized in scorpion striated muscle fibers using standard microelectrode techniques as employed in studies on vertebrate skeletal muscle. The action potential of scorpion muscle consists of two phases of regenerative activity. A relatively fast, overshooting initial spike is followed by a prolonged after-discharge of smaller, repetitive spikes. This after-discharge is accompanied by a twitch that relaxes promptly upon repolarization. Twitches fail in Na-free, tetrodotoxin (TTX)-containing, or Ca free media. However, caffeine causes contractures in muscles paralyzed by Na- and Ca-free solutions. Experiments on muscle fibers voltage-clamped at a point with two microelectrodes in Na-free or TTX-containing media indicate that: (a) the strength-duration relation for threshold contractions has a shape similar to that in frog muscle, but mean values are displaced approximately 20 mV in the positive direction; (b) tetracaine exerts a parallel effect on strength-duration curves from scorpion and frog; (c) contractile activation in scorpion is abolished in Ca free media; and (d) the contractile threshold is highly correlated with the occurrence of inward Ca current for pulses of all durations. Thus, the voltage dependence of contractile activation in scorpion and frog muscle is similar. However, the preparations differ in their dependence on extracellular Ca for contraction. These results are discussed in relation to possible mechanisms coupling tubular depolarization to Ca release from the sarcoplasmic reticulum in vertebrate and invertebrate skeletal muscle. PMID- 6481334 TI - Electrophysiological evidence for acidic, basic, and neutral amino acid olfactory receptor sites in the catfish. AB - Electrophysiological experiments indicate that olfactory receptors of the channel catfish, Ictalurus punctatus, contain different receptor sites for the acidic (A), basic (B), and neutral amino acids; further, at least two partially interacting neutral sites exist, one for the hydrophilic neutral amino acids containing short side chains (SCN), and the second for the hydrophobic amino acids containing long side chains (LCN). The extent of cross-adaptation was determined by comparing the electro-olfactogram (EOG) responses to 20 "test" amino acids during continuous bathing of the olfactory mucosa with water only (control) to those during each of the eight "adapting" amino acid regimes. Both the adapting and test amino acids were adjusted in concentrations to provide approximately equal response magnitudes in the unadapted state. Under all eight adapting regimes, the test EOG responses were reduced from those obtained in the unadapted state, but substantial quantitative differences resulted, depending upon the molecular structure of the adapting stimulus. Analyses of the patterns of EOG responses to the test stimuli identified and characterized the respective "transduction processes," a term used to describe membrane events initiated by a particular subset of amino acid stimuli that are intricately linked to the origin of the olfactory receptor potential. Only when the stimulus compounds interact with different transduction processes are the stimuli assumed to bind to different membrane "sites." Four relatively independent L-alpha-amino acid transduction processes (and thus at least four binding sites) identified in this report include: (a) the A process for aspartic and glutamic acids; (b) the B process for arginine and lysine; (c) the SCN process for glycine, alanine, serine, glutamine, and possibly cysteine; (d) the LCN process for methionine, ethionine, valine, norvaline, leucine, norleucine, glutamic acid-gamma-methyl ester, histidine, phenylalanine, and also possibly cysteine. The specificities of these olfactory transduction processes in the catfish are similar to those for the biochemically determined receptor sites for amino acids in other species of fishes and to amino acid transport specificities in tissues of a variety of organisms. PMID- 6481335 TI - Independence of apical membrane Na+ and Cl- entry in Necturus gallbladder epithelium. AB - Transepithelial fluid transport (Jv) and intracellular Na+ and Cl- activities (aNai, aCli) were measured in isolated Necturus gallbladders to establish the contribution of different proposed apical membrane entry mechanisms to transepithelial salt transport. In 10 mM HCO3-Ringer's, Jv was 13.5 +/- 1.1 microliter X cm-2 X h-1, and was significantly reduced by a low bicarbonate medium and by addition of amiloride (10(-3)M) or SITS (0.5 X 10(-3)M) to the mucosal bathing solution. Bumetanide (10(-5)M) was ineffective. Bilateral Na+ removal abolished Jv. The hypothesis of NaCl cotransport was rejected on the basis of the following results, all obtained during mucosal bathing solution changes: during Na+ removal, aNai fell 4.3 times faster than aCli; during Cl- removal, aCli fell 7.5 times faster than aNai; amiloride (10(-3) M) reduced aNai at a rate of 2.4 +/- 0.3 mM/min, whereas aCli was not changed; bumetanide (10(-5) M) had no significant effects on Jv or aCli. The hypothesis of Na-K-Cl cotransport was rejected for the same reasons; in addition, K+ removal from the mucosal bathing solution (with concomitant Ba2+ addition) did not alter aNai or aCli. The average rate of NaCl entry under normal transporting conditions, estimated from Jv, assuming that the transported fluid is an isosmotic NaCl solution, was 22.5 nmol X cm-2 X min-1. Upon sudden cessation of NaCl entry, assuming no cell volume changes, aNai and aCli should fall at an average rate of 4.8 mM/min. To compare this rate with the rates of Na+ and Cl- entry by ion exchange, the Na+ or Cl- concentration in the mucosal bathing solution was reduced rapidly to levels such that electroneutral cation or anion exchange, respectively, should cease. The rate of Na+ or Cl- entry before this maneuver was estimated from the initial rate of fall of the respective intracellular ionic activity upon the mucosal solution substitution. aNai and aCli decreased at initial rates of 3.7 +/- 0.4 and 5.9 +/- 0.8 mM/min, respectively. The rate of fall of aNai upon reduction of external [Na] was not affected by amiloride (10( 3) M), and the rate of fall of aCli upon reduction of external [Cl] was unchanged by SITS (0.5 X 10(-3) M), which indicates that net cation or anion exchange was, in fact, abolished by the changes in Na+ and Cl- gradients, respectively. I conclude that double exchange (Na+/H+ and Cl-/HCO-3) is the predominant or sole mechanism of apical membrane NaCl entry in this epithelium. PMID- 6481336 TI - A possible mechanism for the cellular coaggregation between Actinomyces viscosus ATCC 19246 and Streptococcus sanguis ATCC 10557. AB - The cells of Actinomyces viscosus ATCC 19246 (Av19246) and Streptococcus sanguis ATCC 10557 (Ss10557) coaggregated immediately after mixing in 40 mM-Tris/HCl buffer. Optimal conditions were pH 7.5 in the presence of Ca2+ at 0.1 mM or higher. Na2 EDTA and its analogues, Na2MgEDTA and Na2MnEDTA at 7.5 mM inhibited the coaggregation. Trypsin and heat treatment impaired the reactive site on Av19246 cells, but not on Ss10557 cells. The coaggregates, once formed, dissociated gradually during extended incubation at 37 degrees C; this was prevented by addition of sufficient Ca2+. The disaggregation appears to be a spontaneous denaturation of the proteinaceous reactive site on Av19246 cell surface. Thus, the coaggregation involves the interaction of a lectin-like substance on the surface of Av19246 with a carbohydrate site on Ss10557. Native Ss10557 cell walls possessed reactivity with Av19246 cells but 5% (w/v) TCA extracted cell wall residues did not. A carbohydrate moiety extracted from Ss10557 exhibited a high potency in blocking coaggregation, and coaggregates were dissociated upon addition of the carbohydrate. Lactose, galactose and N-acetyl-D galactosamine (the latter two are major constituents of the antigen extract) also significantly inhibited the coaggregation, but the other antigen components, glucose and rhamnose, did not. Relative inhibitory activity, expressed as molar potency, of carbohydrate antigen, lactose, galactose and N-acetyl-D-galactosamine respectively, was approximately 26 X 10(3):16:4:1. Ss10557 cells and cell walls reacted only with a Ricinus communis (castor bean) agglutinin-120 but not with Glycine max (soybean) agglutinin, Arachis hypogaea (peanut) agglutinin or Phaseolus vulgaris agglutinin (phytohaemagglutinin).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481337 TI - Isolation of an antigenic oligosaccharide fraction from Leptospira interrogans serovar canicola with a monoclonal antibody. AB - An oligosaccharide fraction containing the antigenic determinant of lipopolysaccharide antigen (TM antigen) from Leptospira interrogans serovar canicola, recognized by a monoclonal antibody (CT3) which agglutinates serovars canicola and broomi, was isolated by formic acid and successive sulphuric acid hydrolyses. Separation of the antigenic compounds was done by Bio-Gel P-2 and Sephadex G-25 gel filtration, and high-performance liquid chromatography with two different columns. The fraction finally obtained was a mixture of two oligosaccharides, both of which migrated as a single spot having a slightly higher mobility than an authentic tetrasaccharide (stachyose) on thin layer chromatography. The fraction contained rhamnose, arabinose and two major and two minor unknown sugars which were shown to be N- or O-acetylated and/or O methylated sugars by nuclear magnetic resonance. The fraction inhibited the binding of CT3 antibody with TM antigen in enzyme-linked immunosorbent assay and microscopic agglutination of serovar canicola with the antibody. The inhibitory activity was destroyed by periodate oxidation or mild alkaline treatment, but was resistant to sodium borohydride reduction. PMID- 6481338 TI - Distinctive electrophoretic and isoelectric focusing patterns of esterases from Yersinia enterocolitica and Yersinia pseudotuberculosis. AB - Esterases of 53 strains of Yersinia enterocolitica sensu stricto, including five previously defined biotypes, and 30 strains of Yersinia pseudotuberculosis were analysed by horizontal polyacrylamide-agarose gel electrophoresis and by isoelectrofocusing in thin-layer polyacrylamide gel. Esterase bands were defined by their range of activity towards several synthetic substrates, their resistance to heat and to di-isopropyl fluorophosphate. The two species were characterized by distinct electrophoretic patterns of their esterases. The apparent molecular weights of the heat-resistant esterase of Y. enterocolitica and of the major heat resistant esterase of Y. pseudotuberculosis, as determined by polyacrylamide gradient gel electrophoresis, were estimated to be 52 000 and 250 000, respectively. On the basis of electrophoretic mobilities and isoelectric points of esterases produced by strains of Y. enterocolitica, five principal zymotypes were observed: two for strains of biotype 1, two for strains of biotypes 2 and 3, respectively, and only one for strains of both biotypes 4 and 5. The zymotypes of strains of biotypes 2, 3, 4 and 5 appeared to be more closely related to one another than to zymotypes of strains of biotype 1. Variations in number or mobility of bands observed within each biotype of Y. enterocolitica and within some serotypes of Y. pseudotuberculosis could represent an additional marker for epidemiological analysis. PMID- 6481339 TI - A method for isolation of protoplasts from dermatophytes. AB - A method has been developed to isolate protoplasts from dermatophytes using Novozym 234. A simple technique of flotation in MgSO4 has been adapted to separate protoplasts from incubation mixture. Electron microscopic studies confirmed the absence of cell wall material on these protoplasts. The recovery of DNA from protoplasts was higher than from mycelia. PMID- 6481340 TI - [Autosomal fragile sites]. AB - It is possible to distribute the 17 autosomic fragile sites presently known in three categories according to their sensitivity: BrdU-sensitive sites (10q25, 16q22, 17p12), distamycin A-sensitive sites (16q22, 17p12) and folate- and thymidilate-sensitive sites (2q11-q14, 3p14, 6p23, 7p11, 8q22, 9p21, 9q32, 10q23, 11q13, 11q23, 12q13, 16p12, 16q23, 17p12, 20p11). Four fundamental problems are discussed, first the relation between the presence of a fragile site and the phenotype, secondly the incidence of autosomic sites, third the origin of fragility (particularity of DNA structure, defect of the DNA/proteins binding and abnormal arrangement of chromatin, abnormality of the metaphasic scaffold) and fourth the localization of fragile sites. PMID- 6481341 TI - [Variations in the presence of a fragile site on X--fra(X)--according to cases and methods used]. AB - In the nearly last two years, using ten different media combinations in our research for the fragile X, we have observed cytogenetic variations, the knowledge of which may be useful for correct diagnosis. This experience, based on more than 6000 metaphases in 41 cases, includes 5 typical probands, 4 obligate and 4 possible heterozygotes, 19 deficient psychopaths, and 9 controls. Three main techniques were retained as shown in the text. In this study a fragile site was documented on 239 chromosomes of the C or X group, among which 180 could be specifically identified by trypsin Giemsa banding. Of these 180 fragile sites, X involvement was shown in 101 cells, and 55 other lesions were found to affect a chromosome 6. In our experience, none of 1180 cells from 9 control individuals were positive. It thus may be that under rigorous culture conditions the occurrence of one single fragile X at q27 or q28 is suggestive of the presence of the underlying mutation. In 19 cases studied because of mental and psychotic problems, nonetheless considered as clinically negative, only 2 out of 2510 cells had a fragile X, whereas frequency among cytogenetically verified X in our positive cases varied from 4 to 20% cells. We have come to distinguish five variations in the cytogenetic aspect of this site on the X, shown from A to E in a figure, two of which (D and E) may not have been described before. In rare cases this fragility usually seen as a chromatid or isochromatid gap may be present as a break with a resulting "double minute" found elsewhere in the metaphase field.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481342 TI - [Mental retardation and fragile X chromosome. Clinical and cytogenetic study of 3 families]. AB - Genetic, clinic and biologic features from three families with Xq fra syndrome are described. First, the authors give their experience for the best ways of culture in order to see the fragile site. Then, they insist upon the main points of each family: in the first, two women have a mental retardation; in the second, a prenatal diagnosis could be made; in the third, treatment with folic acid did not change the IQ but improves the behaviour of two brothers. PMID- 6481343 TI - [In vitro fertilization and human embryo transfer: biological problems]. AB - Optimal results in in-vitro fertilisation procedures can only be achieved using both meiotic competent, mature oocytes and spermatozoa with a high fertilization potential. This situation is not verified in the overwhelming number of couples submitting to IVF-ET. Many of the steps in the gametes maturation processes need to be urgently clarified in order to reach optimal fertilization rates. PMID- 6481344 TI - [Indications for in vitro fertilization and embryo transfer]. AB - The main indications of IVF-ET, i.e. tubal sterility, idiopathic infertility and male infertility are critically discussed. Tubal sterility is in our opinion the only clear clinical indication. The IVF-ET application in cases of idiopathic infertility can be considered as an empirical therapeutic approach. According to our own results and those of other authors, male infertility is the most questionable indication to IVF-ET. PMID- 6481345 TI - [Medical genetics and in vitro fertilization with embryo transfer]. PMID- 6481346 TI - Suicide among schizophrenics. Who is at risk? AB - Schizophrenic patients are at high risk for suicide. Most of the clinical features of the illness which have been associated with suicide remain speculative. This study provides an empirical test of hypothetical risk factors from the literature. Results indicate that schizophrenic patients who kill themselves have high internalized standards of performance which are often congruent with past educational attainments. They are also realistically aware of the effects of their illness, feel inadequate in relation to their goals, and fear further mental disintegration. Their affect is depressed, and they express hopelessness about the future. Suicidal ideation and explicit suicide threats often precede death. These results can be used to assess suicide risk among schizophrenic patients. PMID- 6481347 TI - Transsexualism and physical deformity. AB - This is the first published case study of a transsexual male with a rare orthopedic condition whose transsexualism was directly related to his severe orthopedic disability. In 1976, the patient, a 28-year-old single Caucasian male with a college education, was diagnosed as having progressive pseudorheumatoid arthrotropy of children (a very rare orthopedic disorder which also affected his sister). At this writing, he is 4 feet 9 inches tall and has multiple skeletal deformities, including twisted and gnarled joints; he wears braces on both legs, has had total hip replacements, is barrel chested, and has had many surgical procedures over his lifetime. The patient's presenting problems, his medical and social-psychological history, psychological testing results, and summaries of his 7-year supportive-expressive psychotherapy are presented. The patient endured a painful childhood in which children stared at him and ridiculed him for being a "funny little man." His sister, who had the same condition, was spared this teasing and humiliation. He came to believe that as a girl/woman he would be more socially acceptable (like his sister). Since age 11 he has cross-dressed and entertained hopes of becoming female. Psychological testing suggested that he viewed sexual transformation as leading away from a life of deformity and pain to an imagined state of perfection in which his primary narcissistic injury would be repaired. It is suggested that the patient's "transsexualism" evolved slowly as an adaptation to his profound physical deformity and his perceived status as a crippled and handicapped male.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481348 TI - Complex partial seizures presenting as a psychiatric illness. AB - A 36-year-old woman was treated for a wide variety of psychiatric illnesses over a span of two decades before a diagnosis of complex partial seizures was made. Her history included poor impulse control, rage attacks, multiple suicide attempts, rapid mood swings, depression, and psychotic episodes. Bulimia, panic attacks, severe obsessive-compulsive symptoms, and multiple somatic complaints were also present. In retrospect, these symptoms could be attributed to complex partial seizures with cognitive and affective symptomatology, automatisms, and psychosensory symptoms, and were controlled by anticonvulsant medications. Therefore, so-called "purely" psychiatric disorders should not be diagnosed before a diagnosis of limbic epilepsy (however, this might be labeled, e.g., complex partial seizure, psychomotor seizure, psychical seizure, or temporal lobe epilepsy) has been considered. PMID- 6481349 TI - Day/night changes of pineal gland volume and pinealocyte nuclear size assessed over 10 consecutive days. AB - Previous studies aimed at elucidating day/night changes of pineal gland size and pinealocyte nuclear volume have yielded contradictory results. The aim of the present investigation was to examine the above parameters over a period of 10 successive days, at 6-hour intervals under a lighting regimen of LD 12:12 (7 a.m. to 7 p.m.). It was found that changes in pineal gland volume could not be correlated with the light/dark phases; instead, a rhythm with a two-day period was encountered. Pinealocyte nuclear volume, by contrast, showed clear circadian changes, exhibiting troughs during photophase and peaks during scotophase. In this experimental series, the karyometric results conformed to the melatonin forming rhythm in the rat pineal gland as reported in the literature. PMID- 6481350 TI - Effects of 3-acetylpyridine on the adrenal medulla of the mouse. AB - In the present work, the effects of 3-acetylpyridine (3-AP) on the adrenal medulla were investigated for biochemical and morphological changes. Adrenaline- and noradrenaline-storing cells treated with 3-AP one day previously had lost almost all their granules. A large number of lipoid droplets appeared in the cytoplasm. At the same time, the concentrations of adrenaline and noradrenaline cells were significantly decreased below control values (P less than 0.01). However, these significant changes were ameliorated 19 days after 3-AP treatment. Morphologically and biochemically, the adrenaline- and noradrenaline-storing cells had recovered completely at 35 days. PMID- 6481351 TI - Conduction block in a branching axon innervating two muscles under physiological conditions. AB - The escape reflex of the lobster consists of a series of tail flips resulting from alternating activity of the abdominal flexor and extensor muscles. Electromyographic (EMG) activity was recorded from the medial (DEAM) and the lateral (DEAL1) deep abdominal extensor muscles during free swimming. During the escape response, the muscles were active either synchronously or separately, at frequencies of 100-120 Hz. This activity pattern could be generated either by central programming, or by a peripheral mechanism such as frequency-dependent differential conduction block into one of the two branches of the common excitor axon (C.Ex) innervating these muscles. In order to explore the latter possibility in a living animal, we left the DEAM and DEAL1 muscles innervated only by the C.Ex from the tested segment. This was accomplished by manually cutting all other axons in the nerve under visual control. During escape responses in six successfully dissected animals, we found 27 sudden failures of the DEAM responses and only three in DEAL1. The failures were usually preceded by an increase in the delay of the response. These findings strongly suggest that conduction block occurs in the M branch innervating the DEAM under physiological conditions. PMID- 6481352 TI - Low temperature increases gain in the fish oculomotor system. PMID- 6481353 TI - Hematopoietic system in paraplegic patients with end-stage renal disease. PMID- 6481354 TI - Studies of mesenchymal healing processes in central nervous system wounds. PMID- 6481355 TI - Management options for flexion deformity of hand and wrist in patients with central cord syndrome. AB - A patient with ten year old central cord syndrome developed some active wrist and finger extension. A flexion deformity of the wrist, however, prevented use of this motor return. The surgical options considered were flexor slide versus STP procedure versus flexor tendon lengthening. Flexor tendon lengthening was done with good functional results. PMID- 6481356 TI - Kinetics of the removal of ferric ion from transferrin by aminoalkylphosphonic acids. AB - The kinetics of ion removal at 25 degrees C in 0.1 M Tris, pH 7.4 by a series of phosphonic acids have been evaluated. The initial rate of iron removal is first order in ferric-transferrin, but shows a hyperbolic dependence on the concentration of the phosphonate ligand. At high ligand concentrations the reaction is clearly biphasic, and the data are interpreted in terms of nonequivalent rate constants for iron removal from the two transferrin iron binding sites. Rate constants for three phosphonic acid ligands are approximately 0.025 min-1 and approximately 0.007 min-1 for the faster and slower binding sites. The results are discussed in relation to the conformational change mechanism for iron removal from transferrin proposed by Coward et al. [21]. PMID- 6481357 TI - A phytochemical screening procedure for sweet ent-kaurene glycosides in the genus Stevia. AB - Altogether, 110 species of the genus Stevia, comprising both herbarium and fresh leaf samples, were screened for the presence of sweet ent-kaurene glycosides, using a combination of tlc and hplc, followed by gc/ms. Stevioside and rebaudiosides A and C were detected in a Stevia rebaudiana herbarium specimen collected in Paraguay in 1919, and stevioside was observed as a constituent of a Stevia phlebophylla herbarium specimen collected in Mexico in 1889. Steviol glycosides were not detected in any of the other 108 Stevia species studied. The phytochemical results obtained in this study are correlated with those of preliminary organoleptic tests on the sweetness of these Stevia samples, and the chemotaxonomic implications of the present findings are discussed. PMID- 6481358 TI - Constituents of Cannabis sativa, XXV. Isolation of two new dihydrostilbenes from a Panamanian variant. AB - Two new dihydrostilbene compounds (named cannabistilbenes I and II) were isolated from a polar acidic fraction of a Panamanian variant of Cannabis sativa grown in Mississippi. The structure of cannabistilbene I was shown to be 3,4'-dihydroxy-5 methoxy-3'-(3-methylbut-2-enyl)-dihydrostilben e (1) from spectral data which was confirmed by synthesis. There is spectral evidence to indicate that cannabistilbene II could be represented by either structure 3 or 4. PMID- 6481359 TI - Potential anticancer agents XXXI. N-demethylation of fagaronine. AB - Fusion of fagaronine (1) afforded N-demethyl fagaronine (2) and two minor desmethyl products. Through examination of spectral properties and derivatization, the structures were deduced to be 3, a tetramethoxy derivative, and 5, a derivative bearing a hydroxy (rather than a methoxy) group at position 8. Acetylation of 2 afforded a monoacetate derivative (4), and similarly, a diacetate (6) was produced from 5. Compounds 2-6 were substantially less cytotoxic than 1, as judged by KB or P-388 cell culture assays, supporting the functional importance of the quaternary nitrogen atom. The results obtained to date for fagaronine in tumor panel-testing are also presented, and the marginal cytotoxic activity demonstrated by compounds 5 and 6 against cultured P-388 cells is discussed in terms of mechanisms of action of the parent compound. PMID- 6481360 TI - Additional alkaloids of Pachygone ovata. AB - Pachygone ovata (Menispermaceae), indigenous to the sandy seashores of southern India, is a woody climber whose fruits have been used as a rodenticide and fish poison. Chromatography of the extract of the roots resulted in the reisolation of the alkaloids liriodenine, coclaurine, trilobine (1), and magnoflorine and the isolation of stepholidine, coreximine, isoboldine, norjuziphine, and nortrilobine (2). Nortrilobine (2) is a new dibenzo-p-dioxin bisbenzylisoquinoline alkaloid whose structure was established by a consideration of spectral data and conversion to isotrilobine (3). PMID- 6481361 TI - On the active principles of the spurge family, X. Skin irritants, cocarcinogens, and cryptic cocarcinogens from the latex of the manchineel tree. AB - From the hydrophobic fraction of the latex of Hippomane mancinella, weak or nonirritant mixtures of esters of polyfunctional diterpene parent alcohols of the tigliane and daphnane types were isolated belonging to the structural type of "cryptic" irritants. The cryptic factor group M'z (tigliane type) represents 12 deoxyphorbol-13,20-diesters, and the cryptic factor groups M'y and M'x (daphnane type) represent mixtures of 9,13,14-orthoesters-20-esters of resiniferonol and 5 beta-hydroxyresiniferonol-6 alpha,7 alpha-oxide, respectively. All of them carry in the 20-position homologous long-chain fatty acids, ranging from C15 to C26. They may be "activated" by mild transesterification reactions yielding corresponding irritant factor groups with free hydroxyl functions at C-20. From the hydrophilic fraction of the latex, the irritant factor M3 (tigliane type) and the factor group Mx (daphnane type) were isolated. According to spectral data, factor M3 represents the 13-(hexadeca-2,4,6-trienoic acid) ester of the parent 12 deoxy-5 beta-hydroxyphorbol-6 alpha,7 alpha-oxide. Factor group Mx consists of two esters inseparable by tlc (silica gel). One is identical with huratoxin; the other represents a hexadeca-2,4,6-trienoic acid orthoester. Mx is also obtained by transesterification of M'x and exhibits irritant and tumor-promoting activity comparable to that of TPA. Some aspects on structure activity relations are deduced from selected chemical-reaction products of factor group Mx. PMID- 6481362 TI - Trichothecenes, 1: The synthesis of 4-deoxyverrucarol from verrucarol and diacetoxyscirpenol. AB - 4-Deoxyverrucarol (4) has been synthesized for use in studies for the preparation and development of monoclonal antibodies for trichothecenes. Both verrucarol (1) and anguidine (2) have been converted to deoxyverrucarol (DOVE) (4) by deoxygenation at C3 and at C3 and C4, respectively. PMID- 6481363 TI - Withaphysalin D, a new withaphysalin from Physalis minima Linn. var. indica. PMID- 6481364 TI - A fluorometric assay of trans-cinnamaldehyde in cinnamon. PMID- 6481365 TI - Isolation of a new monoterpene conjugated triterpenoid from the stem bark of Albizzia julibrissin. PMID- 6481366 TI - Antitumor agents, 65. Brusatol and cleomiscosin-A, antileukemic principles from Brucea javanica. PMID- 6481367 TI - Isolation and structural studies on the alkaloids in flowers of Catharanthus roseus. PMID- 6481368 TI - Furanocoumarins from Maquira calophylla. PMID- 6481370 TI - The effects of movement velocity, mass displaced, and task certainty on associated postural adjustments made by normal and hemiplegic individuals. AB - The activation times for trunk and leg muscles were examined in normal and left hemiplegic subjects who raised their right arms at different velocities in self paced or reaction time conditions. Activity in these postural muscles preceded arm displacement, and they were activated in a similar sequence during all types of rapid movements. The presence and sequencing of associated postural adjustments were more variable during slow movements. PMID- 6481369 TI - The neuromuscular features of acromegaly: a clinical and pathological study. AB - A study of the neuromuscular features of acromegaly was performed in six patients. Clinical assessment was supplemented by quadriceps force measurements, plasma creatine kinase (CK) activities, electromyography (EMG) and nerve conduction studies. Muscle mass was measured by urinary creatinine/height indices (CHI) and cross sectional area (CSA) of thighs and calves on computed tomography. Quadriceps force/unit cross sectional area was derived. Needle biopsies of vastus lateralis were studied by histochemical and ultrastructural methods. Mean fibre area (MFA) and fibre type proportions were measured. Most of the subjects studied had muscle pain and proximal muscle weakness confirmed by quadriceps force measurements. This occurred in the absence of muscle wasting, as shown by cross sectional area measurements and normal or raised creatinine/height indices. "Myopathic" features were demonstrated by needle biopsy in half the patients and occasionally by electromyography and raised plasma creatine kinase activity. Abnormalities on needle biopsy included variation in fibre size, type 2 fibre atrophy and large type 1 MFA relative to type 2 MFA. Electronmicroscopy showed the non-specific findings of increased glycogen accumulation, excess lipofuscin pigment and myofilament loss. PMID- 6481371 TI - Short-latency somatosensory evoked potentials in degenerative and vascular dementia. AB - Short-latency somatosensory evoked potentials (SEPs) were recorded from 54 patients with dementia as compared to 32 age-matched controls. SEPs were generally normal in patients with senile dementia of Alzheimer type, while patients with multi-infarct dementia showed a prolonged central conduction time, an increased latency of both N13 and N20 and a reduction of the primary cortical response amplitude. These findings suggest that recording SEPs may be useful in the differential diagnosis between degenerative dementia and multi-infarct dementia. PMID- 6481372 TI - Low dose choline chloride in cerebellar degeneration. AB - Sixteen patients with cerebellar degeneration were treated with oral choline chloride for six weeks at doses of 3 and 6 g daily. Two patients improved with choline but another four improved with placebo. Choline chloride in a dose of 3-6 g daily is no better than placebo in improving ataxia due to cerebellar degeneration. PMID- 6481373 TI - Cerebral function before and after extra-intracranial carotid bypass. AB - Thirty-eight patients had their cerebral function measured before and after extra intracranial carotid bypass surgery using the Halstead-Reitan neuropsychology test battery. Two composite indices of cerebral function for each patient showed them to be impaired before operation. There was no improvement in the composite measures after operation to match that previously demonstrated after carotid endarterectomy. This may reflect the greater pre-operative cerebral impairment of the extra-intracranial group. PMID- 6481374 TI - Myasthenic pseudo-internuclear ophthalmoplegia due to penicillamine. PMID- 6481375 TI - Pontine ataxic hemiparesis, a lateral penetrator syndrome? PMID- 6481376 TI - Giant global intracranial aneurysm in an infant. PMID- 6481377 TI - Occlusion of the anterior choroidal artery. PMID- 6481379 TI - Significantly lower mean plasma total biopterin in 18 patients with senile dementia of Alzheimer type. PMID- 6481378 TI - Neurosarcoidosis presenting as major depression. PMID- 6481380 TI - Focal paroxysmal kinesigenic choreoathetosis. PMID- 6481381 TI - Indomethacin-responsive episodic cluster headache. PMID- 6481382 TI - Spontaneous ear pain as the initial presenting manifestation of giant cell arteritis. PMID- 6481383 TI - Behavior disturbances during recovery from herpes simplex encephalitis. PMID- 6481384 TI - Intracerebral haemorrhage complicating dural arteriovenous fistula: a report of two cases. AB - Two patients presented with unilateral peri-orbital pain, proptosis, chemosis and external ophthalmoplegia. They were shown to have dural arteriovenous fistulae related to the cavernous sinus. Intracerebral haemorrhage occurred in both patients within 18 months of presentation; this gave rise to focal seizures and signs of unilateral hemisphere dysfunction. The haematomas were in the region drained by the superficial middle cerebral vein ipsilateral to the shunt and are presumed to have been the result of locally raised venous pressure. PMID- 6481385 TI - Palatal myoclonus--its remote influence. AB - Four patients with palatal myoclonus were examined electromyographically. Surface EMG was recorded simultaneously from several myoclonic muscles and the correlation between their rhythmic discharges was shown. The possible existence of a remote influence of palatal myoclonus was tested by recording soleus and anterior tibial H-reflexes and seeking a correlation of their amplitudes with the rhythm of palatal myoclonus. Two cases, both with additional severe spasticity in the legs, showed rhythmic variation of the soleus H-reflex amplitude corresponding with that of their palatal myoclonus. This suggests that the neural mechanism generating the visible myoclonus has much more extensive effects. PMID- 6481386 TI - One-and-a-half syndrome in ischaemic locked-in state: a clinico-pathological study. AB - Five patients with "locked-in" syndrome and dysconjugate palsy of horizontal gaze were studied. In all cases internuclear ophthalmoplegia due to dysfunction or destruction of the median longitudinal fasciculus was combined with an ipsilateral gaze palsy, producing the "one-and-a-half" syndrome. Clinical and electro-oculographic examination suggested involvement of the paramedian pontine reticular formation when all ipsilateral saccades were abolished, when exotropia of the contralateral eye was present, and when vestibular stimulation showed full conjugate deviation to the damaged side. Involvement of the abducens nucleus was suggested when the palsy of ipsilateral gaze was not dissociated on vestibular stimulation. In three cases these clinical deductions were confirmed by the pathological study, which showed a corresponding destruction of the median longitudinal fasciculus, paramedian pontine reticular formation and abducens nucleus. In one case the one-and-a-half syndrome evolved into a total horizontal gaze palsy, which corresponded to involvement of the abducens nucleus contralateral to the initially destroyed paramedian pontine reticular formation. Vertical oculocephalic response disappeared, because of destruction of the median longitudinal fasciculus on both sides (bilateral internuclear ophthalmoplegia). Patients with the locked-in syndrome provide a unique situation in which complex pontine oculomotor disturbances may be studied, because consciousness is preserved. In these patients, dissociated and dysconjugate oculomotor palsy may have been underestimated. PMID- 6481387 TI - The differential diagnosis of congenital nystagmus. AB - The decision whether a nystagmus is congenital or acquired may be difficult and is of importance in patients presenting with neurological complaints. In this article, established diagnostic criteria are critically reviewed with particular emphasis on types of nystagmus waveform and their relationship to pursuit and optokinetic responses. Attention is drawn to certain acquired nystagmus which may have similar features which have hitherto been accepted as pathognomonic of congenital nystagmus. Symptoms due to congenital nystagmus are discussed and related to the oculomotor abnormalities. The importance of the characteristics of congenital nystagmus are evaluated for use in differential diagnosis. PMID- 6481388 TI - Multiple sclerosis presenting with progressive visual failure. AB - Progressive visual failure as the presenting feature of multiple sclerosis is described in five patients. The clinical features did not permit a distinction from visual loss due to compression. The finding of oligoclonal bands in the CSF at presentation is a useful pointer to the diagnosis, but is not specific and full investigation to exclude treatable causes of visual loss is essential. PMID- 6481389 TI - Evidence for cardiovascular autonomic nerve dysfunction in multiple sclerosis. AB - In 21 patients with multiple sclerosis and 20 healthy controls, the following tests of autonomic function were examined: (1) variation in heart rate during deep breathing, (2) the variations in heart rate and systolic blood pressure during a standardised Valsalva manoeuvre, (3) the changes in heart rate and systolic blood pressure during arm ergometry starting at 30 W with increments of 20 W every 3 min. In the control subjects the maximum variation in heart rate from inspiration to expiration was greater than 16 beat/min (range 17-43). In patients with multiple sclerosis, five had a maximum variation in heart rate of less than 13 beat/min which was considered as the lower limit of normal. The Valsalva ratio in the control subjects ranged from 1.33-3.24. Four patients had Valsalva ratios of less than 1.30. In patients with multiple sclerosis the heart rate and systolic blood pressure responses to exercise were attenuated significantly in four and seven subjects respectively. It is concluded that a significant number of patients with multiple sclerosis show evidence of autonomic dysfunction involving the cardiovascular system. PMID- 6481390 TI - Presenile dementia with motor neuron disease in Japan: clinico-pathological review of 26 cases. AB - The clinico-pathological findings of 26 cases of presenile dementia with motor neuron disease in Japan are reviewed. The characteristic features include: (1) Progressive dementia with slowly progressive onset in the presenile period. (2) Neurogenic muscular wasting during the course of illness. (3) A duration of illness to death of from one to three years. (4) Absence of extrapyramidal symptoms and definite sensory deficits. (5) No characteristic abnormalities in the CSF or EEG. (6) No known parental consanguinity of familial occurrence. (7) Non-specific mild degenerative changes throughout the CNS without evidence of cerebrovascular disease or primary degenerative dementia, but with the presence of pathological findings of motor neuron disease. The possibility that this is a new disease entity is suggested. PMID- 6481391 TI - The brief scale for anxiety: a subdivision of the comprehensive psychopathological rating scale. AB - A rating scale suitable for recording anxious symptoms is described. It is a subdivision of the Comprehensive Psychopathological Rating Scale and comprises 10 items, all of which are rated on a 7 point scale. It is suitable for the rating of pathological anxiety alone or for anxiety occurring in the setting of other psychological or medical disorder. PMID- 6481392 TI - Contribution of perceptual motor dysfunction to construction and tracing disturbances in Parkinson's disease. AB - Patients with Parkinson's disease and controls traced patterns of increasing complexity presented on a vertical transparent screen. Some patterns were presented with missing segments which subjects were required to fill in. Digitising equipment quantitated movements for computer analysis. Subjects also completed a brief test of general intellectual function, a construction test and an assessment for depression, and the severity of patients' Parkinsonian signs and symptoms was rated. Patients performed more poorly than controls on complete patterns, and their errors increased more sharply than controls on patterns with missing segments. Patients' errors, but not those of controls, in filling in missing segments were uniquely related to performance on construction tasks. Other aspects of patients' tracing performance correlated with the severity of their Parkinsonian symptoms. These findings suggest that there is an underlying perceptual motor deficit in Parkinson's disease that affects performance on both tracing and construction tasks. PMID- 6481393 TI - Vascular catastrophe following the Dandy McKenzie operation for spasmodic torticollis. AB - Delayed brain stem ischaemia following operation for spasmodic torticollis, is described. The mechanism for this catastrophe is considered and a hypothesis proposed which might allow its prediction and prevention. The overall results, the side and complications of this operation are summarised. PMID- 6481394 TI - Speech symptoms associated with early signs of Shy Drager syndrome. AB - Speech disturbances reflecting impaired laryngeal control were found in ten patients whose autonomic dysfunction was associated with central neurological disease (Shy Drager Syndrome). In contrast, ten patients with progressive autonomic failure without evidence of CNS involvement had no difficulties on speech function tasks in comparison with normal controls. Presence of speech symptoms may aid in the clinical differentiation between patients with pure autonomic dysfunction and those with central neurological involvement. PMID- 6481395 TI - Experimental demyelinating optic neuropathy induced by intra-neural injection of galactocerebroside antiserum. AB - The morphological changes induced by microinjection of galactocerebroside (Gal-C) antiserum into the rat optic nerve are described. Light and electron microscopic observations were made 2-20 days post-injection. The severity and extent of the lesion varied according to the volume of antiserum injected and the depth of penetration into the nerve. With small volumes of antiserum (1-3 microliters), primary demyelination was the principal change found from 2 days onwards and by 10 days there was evidence of remyelination by oligodendroglia. Some fibres undergoing Wallerian-type degeneration were also found. The injection of larger volumes of antiserum (5-10 microliters) produced a more extensive lesion with marked axonal degeneration in addition to demyelination at the periphery of the lesion. These findings show that Gal-C antiserum can cause demyelination of central nerve fibres when the blood-brain barrier is bypassed. PMID- 6481396 TI - Survival of oligodendrocytes in chronic relapsing experimental autoimmune encephalomyelitis. AB - Demyelinated plaques of chronic relapsing experimental autoimmune encephalomyelitis (EAE) have been examined in Strain 13 guinea pigs. Oligodendrocytes could be identified within these lesions adjacent to naked axons and astrocytic processes. Oligodendrocytes were identified both ultrastructurally and immunocytochemically. Many of these cells showed bizarre shapes and myelin within their cytoplasm. The survival of oligodendrocytes within these lesions suggests that the myelin sheath, not the oligodendrocyte, is the primary target in autoimmune demyelination. A similar sequence of events has been proposed in multiple sclerosis, for which chronic relapsing EAE serves as a laboratory model. The persistence of myelinating cells in areas of chronic demyelination and gliosis might have significant reparatory implications. PMID- 6481397 TI - New approach to study of in vitro toxicity of multiple sclerosis and other sera. AB - The in vitro effects of MS and control sera were quantified by the measurement of radiolabel released from myelinated cultures of rat cerebellum and compared with a visual assessment of myelin damage. Radiolabel release gave a sensitive index of serum effects in vitro which was free of the score assignment decisions that are associated with the visual assessment of myelin damage. Examination of the patterns of radiolabel release elicited by MS and control sera on cultures labelled with either L-[5-3H]tryptophan or galacto-D-[6-3H]cerebroside indicates that MS serum effects are not simply a stronger expression of the weak control serum effects. PMID- 6481399 TI - Polymyositis presenting with respiratory failure. AB - A 36-year-old woman presented with a 3-month history of increasing dyspnoea, culminating in respiratory failure due to paralysis of respiratory muscles. She required assisted ventilation. Subsequently, mild limb and neck weakness was noted. Muscle biopsy of the right vastus lateralis showed polymyositis. The patient died suddenly and the postmortem revealed polymyositis with predominant involvement of the diaphragm and intercostal muscles. PMID- 6481398 TI - Behavior of sarcotubular system formation in experimentally induced regeneration of muscle fibers. AB - To examine the behavior of transverse (T)-tubule formation in experimentally induced regenerating fibers, a local anesthetic, bupivacaine hydrochloride, was injected directly into the rat soleus muscle to cause myonecrosis. The regenerating fibers following necrosis were then examined by electron microscopy using lanthanum nitrate which clearly demonstrated the sarcotubular system. In the early stage of regeneration within 7 days after muscle necrosis, the T tubules seemed to be composed of markedly proliferated subsarcolemmal caveolae with occasional honeycomb structure formation. Around 10 days, the T-tubules in regenerating fibers were tortuously and irregularly arranged with focal dilatation in diameter, and extended longitudinally along the axis of well organized myofibrils. As the regenerating fibers matured, the sarcotubular system, irregular in course and in shape, gradually became organized into a regular transverse position against the myofibrils, along with a marked decrease in longitudinally arranged tubular components. These morphological findings of the early T-tubule formation seen in the present study were similar to those found in early myogenesis, and in biopsied muscles from cases of polymyositis and progressive muscular dystrophy. PMID- 6481400 TI - More on the relevance of animal tumor models: immunogenicity of transplantable leukemias of recent origin in syngeneic strain 2 guinea pigs. AB - The immunogenicity of four transplantable leukemias was evaluated in syngeneic Sewall-Wright strain 2 guinea pigs. The L76 and KSL leukemias are considered appropriate models for the assessment of immunogenicity because of their recent origin and unknown (natural) etiology. The chemically induced K77 leukemia of recent origin and the long-passaged L2C leukemia of unknown etiology could be classified as experimental tumors prone to artifactual immunogenicity. Our studies clearly show that naturally occurring guinea pig leukemias are potentially immunogenic, although to a lesser degree than experimental leukemias. These findings are in contrast to previous studies in mouse and rat tumor models, which showed that naturally occurring tumors were essentially nonimmunogenic, thereby raising questions about the relevance of animal tumor models to human cancer. PMID- 6481401 TI - Minimal activity of recombinant clone a interferon in metastatic colon cancer. AB - Twenty-one patients with advanced measurable colorectal carcinoma were treated with interferon (rIFN-alpha A) intramuscularly at 50 X 10(6) units/m2 thrice weekly. No patient had received chemotherapy for metastatic or recurrent disease. The average age of the patients was 60 years, and the mean initial performance status was 85 (Karnofsky scale). Nineteen patients were evaluable for response. One patient showed complete resolution of pulmonary nodules and stable liver metastases after 3 months of therapy. The other 18 patients developed progressive disease after 1-3 months of treatment. Toxicity was substantial but manageable; fevers, chills, fatigue, elevated serum glutamic-oxaloacetic transaminase, anemia, and mild leukopenia were common. rIFN-alpha A is minimally active against metastatic colorectal carcinoma. PMID- 6481402 TI - In vitro expression of suppressogenic and enhancing activities in human colon cancer cells. AB - The presence of immunoregulatory factors in a human colon cancer cell line, LS174T, was exhibited in mitogenic and immunogenic assays. The simultaneous presence of stimulatory and suppressive factors in the spent media of LS174T colon cancer cells was shown. Opposing suppressive and stimulatory activities were extractable from viable tumor cells and found in 3 M KCl extracts fractionated by isoelectric focusing. Suppressogenic activity was demonstrated in concanavalin A and phytohemagglutinin mitogenesis in both human and murine lymphocytes; the blastogenesis of mixed lymphocyte culture reactions was suppressed, while responses of immune cells were not. Naive lymphocytes were stimulated or not affected by the same spent media. The factors appeared to require cell viability for optimal expression and were not species specific. These results further illustrate the complexity of tumor cell-host cell interactions and emphasize the need for in vitro assays to measure, characterize, and exploit the factors. PMID- 6481403 TI - Intramembrane organization of synapses in the lobster stretch receptor organ. AB - The intramembrane organization of axodendritic and neuromuscular synapses in the lobster stretch receptor organ was investigated by freeze-fracturing. Based on ultrastructural criteria which are known to be correlated with physiological properties, we identified three types of synapse: the inhibitory axodendritic, the inhibitory neuromuscular, and the excitatory neuromuscular synapse. Although these synapses have some features in common, each has a characteristic arrangement of intramembrane particles in both the presynaptic and postsynaptic membranes. All three have, in their presynaptic membranes, aggregates of P-face particles and associated depressions representing sites of synaptic vesicle exocytosis, features which together define active zones. However, in the inhibitory axodendritic synapse the P-face contains short ridges in this region. These ridges may occur singly or in pairs oriented in V-shaped configurations. The ridges are decorated with particles along their entire length. In the inhibitory neuromuscular synapse, no ridges are present. Clusters of particles are present, but they are scattered randomly over a large expanse of presynaptic membrane. In the excitatory neuromuscular synapse, isolated clusters of particles are associated with the P-face and are occasionally located on circular elevations of the membrane. The postsynaptic membrane also shows structural diversity in the three types of synapse. In the inhibitory axodendritic synapse, there is no apparent specialization. However, in the inhibitory neuromuscular synapse, P-face particles are arranged in double rows which are separated by particle-free strips of membrane. In the excitatory neuromuscular synapse, particles are confined to a narrow band that borders the synaptic cleft. This band is demarcated by a single intermittent strand of particles arranged in the direction of the long axis of the muscle fibre. Therefore, intramembrane specializations of both the presynaptic and postsynaptic membranes are sufficiently distinctive that three different types of synapse can be recognized. PMID- 6481405 TI - Morphometric analysis of glomus cells within the recurrent laryngeal nerve of the rat. AB - An endoneurial paraganglion located in the recurrent laryngeal nerve of the rat was found in 17 of 20 nerves studied. The median size of the paraganglia was estimated to be 0.8 X 10(6) micron 3. The number of type I like cells within a paraganglion ranged between 8 and 24. Altogether, 120 endoneurial dense-cored vesicle cells from 8 paraganglia were subjected to a morphometric analysis at the ultrastructure level. The mean vesicle profile diameter was estimated to be 101.3 nm and only one type of granulated cell could be distinguished. The volume density of the dense-cored vesicles was estimated to be about 6%, a value amounting to two to three times that in the carotid glomus. Moreover, the mean cell profile area of vesiculated cells of recurrent laryngeal nerve exceeds that of the cells of the carotid glomus. PMID- 6481404 TI - Freeze-fracture morphology of the vestibular hair cell--primary afferent synapse in the chick. AB - The intramembrane specializations at vestibular hair cell-primary afferent synapses have been identified and characterized in complementary freeze-fracture replicas from prehatch and hatchling chick cristae and maculae. Hair cell protoplasmic (P) faces at sites where presynaptic bodies are present exhibit small, tightly packed arrays of 9 nm particles. Hair cell external (E) faces have corresponding arrays of pits. Multiple arrays are often observed in contiguity. Opposite the presynaptic bodies, postsynaptic afferent boutons and calyces exhibit a more extensive array of scattered, irregular E-face particles. Corresponding P-fracture faces of afferent boutons and calyces display little topographical specialization opposite these E-face arrays, which are presumed to be the intramembrane correlate of the postsynaptic density. Examination of complementary replicas has allowed identification of the intramembrane synaptic specializations for all membrane faces at the synaptic apposition. PMID- 6481406 TI - Membrane specialization and axo-glial association in the rat retinal nerve fibre layer: freeze-fracture observations. AB - The ultrastructure of non-myelinated ganglion cell axolemma within the retinal nerve fibre layer of adult rats was examined by thin section and freeze-fracture electron microscopy. Most of the axolemma within the nerve fibre layer does not exhibit any membrane specializations; intramembranous particles are partitioned with a density of approximately 1750 microns-2 on the P-fracture face and approximately 225 microns-2 on the E-face of the non-specialized axolemma. The nerve fibres also exhibit specialized foci of axolemma, at which the axons are abutted by the tips of blunt, radially oriented processes from Muller cells. At such sites of axo-glial association, an electron-dense undercoating is present beneath the axon membrane. Freeze-fracture analysis revealed a substantial increase in the density of E-face particles (greater than 500 microns-2) at sites of association between the tips of blunt glial processes and the axon. These findings demonstrate that non-myelinated axolemma of the retinal nerve fibre layer can exhibit spatial heterogeneity, with patches of node-like membrane at regions of specialized association with glial cell processes. On the basis of their morphological similarity to nodes of Ranvier, we suggest that these specialized axon regions represent foci of inward ionic current. PMID- 6481407 TI - Viability of retinal ganglion cells after optic nerve crush in adult rats. AB - The response of retinal ganglion cells to optic nerve crush was examined in the hooded rat. Intracranial nerve crush produces a transient shrinkage of the retinal ganglion cells during the first several weeks postoperatively but partial recovery of cell size then appears to occur. This transient response is considered to be a direct response to axotomy. Retrograde transport of horseradish peroxidase (HRP) is clearly demonstrated at 2 weeks postoperatively. Transport of newly synthesized protein progressively decreases over the first 2 postoperative months. The ganglion cell therefore retains viability for at least the first few weeks after axotomy. Loss of 60% of the neurons in the ganglion cell layer occurs between 3 and 7 months postoperatively. This late occurring retrograde response is considered to result at least in part from loss of sustaining trophic influences rather than as a direct result of the lesion. PMID- 6481408 TI - Lectin-ferritin binding on dystrophic and normal retinal pigment epithelial membranes. AB - Phagocytosis in the rat retina is a process which involves uptake of shed photoreceptor outer segments by the overlying retinal pigment epithelium (RPE). In rats with inherited retinal degeneration, there is a defect in phagocytosis. One aspect of this phagocytic defect may be an alteration in glycoconjugate containing membrane components on RPE membranes which mediate this phagocytic interaction. Lectin binding sites have been studied in order to localize the distribution of glycoconjugates on pigment epithelial microvilli in normal and dystrophic retinas and to determine if there are differences in the dystrophic retinas which would provide a clue about the defect. The following ferritin conjugated lectins were used in this study: Concanavalin A (Con A-fe) or lens culinaris haemagglutinin (LcH-fe) for mannosyl-containing glycoconjugates; and wheat germ agglutinin (WGA-fe) for n-acetylglucosamine and sialic acid-containing glycoconjugates. Control tissue was incubated in the lectin in the presence of its competitor sugar. The number of ferritin particles or lectin-ferritin binding sites per micrometre of microvillous membrane was quantified from electron micrographs using a computer and a digitizing tablet. The number of WGA-fe binding sites on normal RPE microvillous membranes (56.0/micron) was statistically equivalent to the dystrophic membranes (48.8/micron). The number of Con A-fe binding sites on normal (27.3/m) and dystrophic RPE (26.7/micron) was also the same. A dramatic difference in LcH-fe binding sites was demonstrated on normal (1.5/micron) as compared to dystrophic RPE (19.1/micron). Our results indicate that more mannosyl residues are accessible on dystrophic microvillous membranes and, based on what is currently known about LcH binding, that these residues belong to glycoconjugates having fucosyl-containing carbohydrate cores. The data also suggest that in normal animals without a phagocytic defect such fucosyl-containing glycoconjugates are not as accessible and may be masked by other sugar residues in the oligosaccharide chain. PMID- 6481409 TI - Intact and sympathectomized carotid bodies of long-term hypoxic rats: a morphometric ultrastructural study. AB - The ultrastructure of the carotid body after exposure to hypoxia (10% O2) for one, two or three weeks was investigated morphometrically. The study was performed on rats after unilateral removal of the superior cervical ganglion. The normally occurring bimodal distribution of type I cells, representing cells with small vesicle profile diameters (SVC) and large vesicle profile diameters (LVC) respectively, changed after one week of hypoxia into a unimodal population. After one or two weeks of hypoxia the diameter range of dense-cored vesicle (DCV) profiles in type I cells was not different from that of DCV profiles in control LVC. After three weeks of hypoxia the DCV vesicle size was intermediate between those of control SVC and LVC. The volume density of DCV decreased after one week but returned to initial values after two and three weeks of hypoxia. At two or three weeks of hypoxia, however, the total cell volume was increased about 1.4 times which should reflect an increase of the total content of DCV at these times of exposure to hypoxia. An increased mean area of cell profiles indicates a hypertrophy of the type I cells, but no signs of hyperplasia could be detected. The ganglionectomy did not cause any remarkable changes compared to the intact carotid body except for a higher volume density of DCV during the early periods of hypoxia. It is inferred from the study that the increased total mass of type I cell tissue during long-term hypoxia is due to a hypertrophy of the cells. Furthermore, the type I cells can increase their storage capacity for catecholamines during hypoxia by an increase in the size and number of DCV. PMID- 6481410 TI - Coated vesicles are associated with acetylcholine receptors at nerve-muscle contacts. AB - Cholinergic synapses form between ciliary neurons and cultured myotubes. We have identified these synaptic contacts using alpha-bungarotoxin conjugated to horseradish peroxidase (alpha BTX-HRP). The enzymatic reaction product was limited to a small portion of the sarcolemma in direct apposition to the nerve terminal. Multiple neuronal processes contact the region of the myotube containing acetylcholine receptors (AChRs). At the early stages of nerve-muscle contacts neuronal processes protrude into the coated pits of the myoplasm. Numerous coated pits and coated vesicles were found beneath these early contacts. These vesicles may be involved in the transport of protein molecules at the newly formed cholinergic structures. PMID- 6481411 TI - Degenerative and regenerative changes in the trochlear nerve of goldfish. AB - The features of unlesioned and lesioned trochlear nerves of goldfish have been examined electron microscopically. Lesioned nerves were studied between 1 and 107 days after cutting or crushing the nerve. Unlesioned nerves contained, on average, 77 myelinated axons and 19 unmyelinated axons. The latter were found in 1-2 fascicles per nerve. A basal lamina surrounded each myelinated axon and fascicle of unmyelinated axons. The numbers of myelinated axons, fascicles of unmyelinated axons and basal laminae varied by less than 5% over the intraorbital extramuscular segment of the nerve. Following interruption of the nerve, by either cutting or crushing, all of the axons and their myelin sheaths began to degenerate by 4 days in the distal nerve-stump. Both abnormally electron-dense and electron-lucent axons were observed. Both Schwann cells and macrophages appeared to phagocytose the myelin sheaths. Following a lesion, the Schwann cells and their basal laminae persisted in the distal nerve-stump. In crushed nerves, the basal laminae surrounding myelinated axons formed 97%, on average, of the Schwann tubes in the distal stump. The perimeters of the basal laminae were of similar size to those in the proximal stump, at least for the first 8 days after crush. In crushed nerves, single myelinated axons in the proximal nerve-stump gave rise to multiple sprouts, some of which reached the site of crush by 2 days, the distal stump by 4 days and the superior oblique muscle by 8 days. The regeneration of the unmyelinated axons was not examined. In both crushed and transected nerves, nearly all of the sprouts in the proximal and distal stumps were found within the basal laminae of Schwann cells, even though the spouts were disorganized in the transected region where there were no basal laminae. The growth cones of the regenerating axons were always found apposed to the inner surface of the basal laminae, which may have provided an adhesive substrate that directed their growth. Terminal sprouts from the ends of myelinated axons in the proximal stump accounted for the majority of the regenerating axons in the distal stump, as only a few collateral sprouts were found in the proximal stump, and only a small amount of axonal branching was found within the distal stump itself. The largest axons in the distal stump were remyelinated first, and the number of remyelinated axons increased progressively between 8 and 31 days after crush, at which time there were about twice as many as in unlesioned nerves.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481412 TI - Synaptic organization of the outer plexiform layer of the turtle retina: an electron microscope study of serial sections. AB - Neural connections in the outer plexiform layer of the Pseudemys turtle retina have been studied by electron microscopy of serial ultrathin sections. While the distinguishing features of the photoreceptors have been described elsewhere, in this paper we describe the patterns of connectivity between identified second order neurons and identified photoreceptors or amongst second order neurons themselves. Basal telodendria emitted from double cone pedicles interconnect the two members of the double cone. Three morphologically different types of junction are made between bipolar cells and cone pedicles. H1 horizontal cells can be distinguished from H2 horizontal cells and synapses occur between them. Axon terminals of H1 cells are presynaptic to H1 cell bodies. Photoreceptors, H1 cell bodies and H1 axon terminals engage in electrical junctions while chemical synapses occur from both types of horizontal cell to bipolar cells. On rare occasions, bipolar cell dendrites were seen to be presynaptic to other bipolar cell dendrites. The significance of some of these contacts for the electrophysiological findings on the OPL of the turtle retina is discussed. PMID- 6481413 TI - Stellate neurons in rat dorsal cochlear nucleus studies with combined Golgi impregnation and electron microscopy: synaptic connections and mutual coupling by gap junctions. AB - Stellate neurons in the outer two layers of the rat dorsal cochlear nucleus (DCN) were studied by the Golgi-EM method. Stellate cell bodies are usually spherical or ovoidal and range from 9 microns to 14 microns in mean diameter. The smallest cells are situated underneath the ependymal layer and the largest cells in layer 2. Primary dendrites are short, thin and smooth and arise abruptly from the perikaryon, without a tapering main stem. Meandering secondary and tertiary dendrites extend in all directions, carry few pleomorphic spines lacking a spine apparatus and often show artifactual beading. The axons are impregnated only for a short distance (10-45 microns). The nucleus is indented, the nucleolus varies in position, and the chromatin, evenly dispersed in the centre, forms small clumps along the nuclear envelope. The cytoplasm is rich in free polyribosomes and contains scattered cisterns of granular endoplasmic reticulum. Varicosities of thin fibres, containing round synaptic vesicles, form asymmetric synapses on perikarya, dendritic shafts and spines of stellate cells. Such fibres run parallel to the long axis of the DCN or are oriented radially and are interpreted as axons of cochlear granule cells. Two kinds of bouton containing pleomorphic vesicles, one kind electron lucent and the other electron dense, form symmetric synapses on perikarya and dendritic shafts of stellate cells. The lucent boutons occur more frequently than the dense boutons, especially on the distal dendritic branches. The boutons with pleomorphic vesicles presumably represent terminals of local circuit neurons, probably the stellate and cartwheel cells. In addition, stellate cells show numerous dendro-somatic and dendro-dendritic appositions characterized by gap junctions and puncta adhaerentia. Most of the dendrites involved in these appositions resemble stellate cell dendrites and it is concluded that DCN stellate cells are coupled electrotonically with one another. The axons of stellate cells acquire a thin myelin sheath. Since the Golgi impregnation did not stain axons of stellate cells past this point, we were unable to demonstrate the synaptic targets of stellate cells. PMID- 6481414 TI - Adult-onset mixed myopathy with nemaline rods, minicores, and central cores: a muscle disorder mimicking polymyositis. AB - A woman, aged 75 years, presented with a 15-year history of progressive, generalized, painful muscle weakness and wasting. Clinical and laboratory investigation revealed a sporadic muscle disorder. Muscle biopsy showed a mixed pattern of nemaline myopathy with minicores and central cores and severe atrophy of type-1 and type-2 fibers. A trial of immunosuppressive treatment did not improve her condition, which clinically mimicked chronic progressive polymyositis. Mixed myofibrillar myopathies of this type have so far only been described among the group of congenital myopathies. PMID- 6481415 TI - Treatment of cryptococcal meningitis with pulmonary granuloma. AB - Two patients with co-existing meningeal and pulmonary cryptococcosis were successfully treated by pulmonary resection and chemotherapy. Under cover of miconazole and 5-fluorocytosine, pulmonary mass lesions were successfully removed despite the fact that the patients had meningitis. The patients recovered from meningitis immediately after the surgical procedures and show no recurrence of meningeal symptoms more than 2 years after the operation. It appears that early removal of a pulmonary cryptococcal focus combined with antifungal agents may give a quite favourable outcome for meningitis. PMID- 6481416 TI - Hallervorden-Spatz syndrome restricted to the pallidal nuclei. AB - The case history is presented of a man who died at the age of 38 years and had been suffering from severe torsion dystonia and a hypokinetic-rigid motor disturbance since the age of 10. The pathological findings were isolated pallidal degeneration with demyelination and moderate neuronal loss, iron pigment accumulation and spheroid bodies in both pallidal nuclei. In addition the zona reticularis of the substantia nigra was hypoplastic and not affected. The red nucleus, the dentate nucleus and the zona reticularis of the substantia nigra showed iron depigmentation. The rare condition of non-familial Hallervorden-Spatz syndrome, without involvement of the zona reticularis and the cerebral cortex, was considered to be the diagnosis. PMID- 6481417 TI - Isoelectric focusing of CSF proteins and the future evolution of multiple sclerosis: a clinical follow-up. AB - A clinical follow-up covering a period of 5-10 years after onset was performed in 150 patients with optic neuritis or other potential onset symptoms of MS. Thin layer isoelectric focusing had been used for the initial CSF-protein analysis. No evidence for a more probable alternative diagnosis appeared in 147 patients while a non-MS diagnosis was established in 3 patients. Among these 147 subjects the planned follow-up was accomplished in 131 patients, but not in 16. An evolution into clinically definite MS occurred in 59 subjects, in whom oligoclonal CSF immunoglobulin was found in 92%. Further clinical activity without spatial dissemination--i.e. lesser degrees of diagnostic probability for MS--were found in 35 patients in whom oligoclonal CSF immunoglobulin components were detected in 86%. Among the 131 patients with a complete follow-up, 45 remained free from further clinical activity; oligoclonal CSF immunoglobulin components occurred in 40% of these patients. The frequency of further clinical activity with or without spatial dissemination was significantly higher in subjects exhibiting oligoclonal CSF immunoglobulin components than in those without such changes. PMID- 6481418 TI - On the diagnostic value of different CSF investigations in multiple sclerosis. AB - An assessment was made of the relative values of different methods of calculating intrathecal IgG synthesis in multiple sclerosis. In 60 patients with definite, probable or possible multiple sclerosis the IgG/protein and IgG/albumin ratios, the IgG index, the Tourtellotte formula and the graphic evaluation according to Reiber were applied. All the patients had oligoclonal IgG in the CSF. Reiber's method was the most sensitive, yielding 66% of abnormal findings. Only the cell count showed significant differences between active and inactive stages. There was a correlation between the cell count and the daily rate of intrathecal IgG synthesis and between the latter and the number of oligoclonal bands in CSF, but none of these parameters correlated with duration of disease or the number of previous bouts. PMID- 6481419 TI - Delayed cerebral pseudo-tumoral radionecrosis following scalp-tumour irradiation. Case report and review of literature. AB - A case of delayed radionecrosis of the brain is reported, following irradiation of a scalp dermatofibrosarcoma. Signs and symptoms were those of an intracranial neoplasm and appeared 5 years after an irradiation dosage of 1890 rets. Twenty seven similar cases were gathered from a survey of the literature. Surgical excision was the treatment of choice and led to cure or improvement in 20 cases. Analysis of doses and fractionation revealed excessive irradiation in all but one of the cases. PMID- 6481420 TI - The spirochetal etiology of lymphocytic meningoradiculitis of Bannwarth (Bannwarth's syndrome). AB - In all the sera of four patients with meningoradiculitis of Bannwarth admitted to the neurological department of the University Clinic Grosshadern in Munich in 1983, we found antibodies against Ixodes dammini spirochetes. In three patients antibodies were also present in the CSF. In one patient, we isolated spirochetes from the CSF and demonstrated specific IgG antibodies in serum and CSF. This spirochete was morphologically indistinguishable from the I. dammini spirochete and a spirochete isolated from the thick I. ricinus in the Munich area. Despite distinct differences in the clinical manifestation of Lyme disease when accompanied by neurological complications and meningoradiculitis of Bannwarth, we suggest that both diseases are caused by spirochetes. PMID- 6481421 TI - Brain-stem involvement in multiple sclerosis: a comparison between brain-stem auditory evoked potentials and the acoustic stapedius reflex. AB - Brain-stem auditory evoked potentials (BAEPs) and the acoustic stapedius reflex (ASR) were recorded in 68 patients with definite, probable and possible multiple sclerosis (using the definitions of McAlpine). The high incidence of abnormal results, 68% and 60%, respectively, pointed to the diagnostic value of these two measures in detecting brain-stem dysfunction. Combination of the methods increased the diagnostic yield to 85%. Since in part the same brain-stem generator sites underlie BAEPs and the ASR, it was considered that a study of their correlation might serve to increase the reliability and validity of these techniques. There was 71% agreement overall between results from the two measures. Furthermore, 72% of the joint BAEP and ASR abnormalities corresponded in detection of the brain-stem lesion site. It was concluded that the combined approach may supply powerful, complementary information on brain-stem dysfunction, which may aid in establishing the diagnosis of multiple sclerosis. PMID- 6481423 TI - Autopsy study of cerebral complications of congenital heart disease and cardiac surgery. AB - Detailed histological investigation of the brains of 45 neonates, infants and children who had died of various congenital heart defects revealed that the damage to the white matter occurred mostly below 3 months of age, while that to the grey matter occurred above this age. The lesions (glial fatty metamorphosis, telencephalic leucoencephalopathy, focal white matter necrosis, focal nerve cell pyknosis and symmetrical cortical necrosis) were often combined with each other. The necroses were generally not a consequence of microembolization. Various cerebral complications occurred in most of the patients who had undergone cardiac surgery. However, the various cerebral lesions each had several causes and in general the accumulation of predisposing damaging noxae resulted in more serious changes. PMID- 6481422 TI - Pergolide therapy in Parkinson's disease. AB - A total of 26 patients were treated with pergolide mesylate, a semi-synthetic ergot derivative with the property of direct dopamine activity. Of these patients, 18 suffered from late failure of L-dopa, while the remaining 8 had never before been treated with L-dopa. The aim of the trial was to study the activity of pergolide, either by giving it to untreated patients or by reducing as much as possible the L-dopa given in patients with parkinsonism. Adverse effects and failure rate were reduced by slowly increasing the daily dosage, by giving considerable dose flexibility whenever side-effects were manifest, and by the use of relatively low doses (mean of 3.8 mg in the L-dopa-group and 2.9 in the other group). At present, from 26 patients, 13 (50%) still remain in the study for an average treatment period of 16 months (3 weeks to 25 months for the group as a whole). All patients experienced a beneficial effect from pergolide, especially during the first months of treatment, in selfcare, rigidity, gait and automatic movements. Slight or no improvement was seen in tremor, speech and posture. The most frequent side-effects were nausea and vomiting (in the initial phase of the treatment), insomnia and psychotoxic reactions (mostly periods of confusion accompanied by visual hallucinations and paranoid illusions). The study indicated that pergolide mesylate is a useful additive for treatment of parkinsonism, but special attention should be paid to the important psychotoxic adverse effects that may appear, even at a low dose. PMID- 6481424 TI - A syndrome resembling limbic encephalitis, associated with bronchial carcinoma, but without neuropathological abnormality: a case report. AB - A patient, suffering from an oat-cell bronchial carcinoma, presented with complex partial seizures, complete loss of recent memory, mild disorientation and confabulation. There was no complaint of anxiety. The rest of the neurological examination and four computed tomographic scans of the head were normal. Repeated EEG recordings were abnormal. Antiepileptic and antipsychotic treatment led to full remission within 10 days. Post-mortem examination of the brain revealed no pathological changes. PMID- 6481425 TI - Complications associated with intra-arterial BCNU administered in combination with vincristine and procarbazine for the treatment of malignant brain tumors. AB - We have used intra-arterial (i.a.) 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) either alone or as part of adjuvant chemotherapy in patients with malignant brain tumors over a 3 year period (1979-1982). The i.a. BCNU technique was used 111 times to infuse 134 arteries in 37 patients. These patients, 28 cases with glial tumor and 9 cases with brain metastasis, received i.a. BCNU in combination with Vincristine and Procarbazine every 6 weeks. Complications encountered were transient and included: periorbital erythralgia or occipital-nuchal pain in 23 (62%), mild confusion and disorientation in 14 (38%), and ipsilateral conjunctival edema in 10 (27%). Reversible myelosuppression was not found. Our findings suggest that BCNU (100 mg/M2) may be given by i.a. infusion in combination chemotherapy without persistent severe untoward effects with a cumulative dose of 700 mg/M2. PMID- 6481426 TI - Penetration of VP-16 (etoposide) into human intracerebral and extracerebral tumors. AB - VP-16 100 mg/m2 was given intravenously to 10 patients undergoing surgical resection of intracerebral tumors, and the drug was assayed in resected tumor using high pressure liquid chromatography. VP-16 concentrations varied from undetectable (less than .1 microgram/g) to 5.9 micrograms/g (mean, 1.4 microgram/g). VP-16 concentrations in tumors were lower than concurrent plasma concentrations. In addition, intracerebral tumors had a lower concentration of VP 16 than did extracerebral tumors (mean VP-16 concentration, 3.9 micrograms/g) from 7 patients receiving VP-16 50-100 mg/m2 intravenously. Plasma pharmacokinetics of VP-16 were different in our patients with intracerebral tumors than in previously studied patients with extracerebral tumors and it is unclear what role this may played in variability of tumor VP-16 concentrations. VP-16 concentrations were similar in glioblastomas and brain metastases. Specimens from patients with small cell undifferentiated carcinoma of the lung had the highest VP-16 concentrations. A patient who had both viable and necrotic tumor resected during an occipital lobectomy had a higher drug concentration in the necrotic than in the viable area of tumor. In addition, VP-16 concentration decreased as a function of distance into brain from the tumor. Based on our data, VP-16 might be expected to have less activity against intracerebral than against extracerebral human tumors. PMID- 6481427 TI - Polyamines in human brain tumors. A correlative study between tumor, cerebrospinal fluid and red blood cell free polyamine levels. AB - Polyamine levels have been studied in brain tumor patients. We focused our study on the relationship between tumor, cerebrospinal fluid (CSF) and red blood cell (RBC) polyamine levels. Our results are the following: Polyamine levels in CSF are consistently increased, whatever the histological type may be. The highest tumoral concentrations are found in medulloblastoma. In glioblastomas, the RBC spermidine levels are higher than in the other types of tumors and there is a highly significant correlation between the spermidine/spermine ratio in tumor and RBC. Therefore, RBC polyamine determination might be of clinical interest in the monitoring of patients with glioblastomas. PMID- 6481428 TI - Misonidazole neurotoxicity in rats: Part I. Evaluation of misonidazole neurotoxicity in rats by analysis of brain stem auditory and cortical evoked potentials. AB - The effects of misonidazole (MISO) on brain stem evoked potentials (BAEPs) and cortical evoked potentials (CEPs) were evaluated in 16 Sprague-Dawley rats treated with the agent. As found in previous studies, serial BAEP values were diagnostic of the onset of MISO toxicity before clinical signs and symptoms appeared. However, MISO had no effects on CEPs, which remained essentially unchanged through the course of the experiment. At histologic examination, significant changes were found in the area of the brain stem, but there was no histologic evidence of damage to cortical or subcortical structures caused by MISO administration. The results of this study suggest that the neurotoxic effects of MISO are species-specific, and that while the rat model may be useful for comparison of the relative toxic effects of nitroimidazole radiosensitizers, it is not a model suited for measurement of neurotoxicity caused by MISO in humans and nonhuman primates. PMID- 6481429 TI - Misonidazole neurotoxicity in rats: Part II. Effect of pre- and intermittent treatment with pentobarbital on misonidazole neurotoxicity in the rat. AB - Rats pretreated for 5 days with 50 mg/kg of pentobarbital tolerated statistically significant higher doses of misonidazole before the onset of misonidazole-induced neurotoxicity than rats treated intermittently with the same dose of pentobarbital. Presumably in pretreated rats, pentobarbital induced an increase in the activities of hepatic microsomal enzymes that led to a more rapid metabolism of misonidazole than in rats treated only intermittently. PMID- 6481430 TI - Experiments on functional role of peripheral input to motor cortex during voluntary movements in the monkey. AB - The functional role of sensory input to the motor cortex was studied by interrupting two major input pathways. One was the dorsal column, which sends the input directly through the thalamus to the motor cortex, and the other was the sensory cortex, which transfers its input through association fibers. Removal of the sensory cortex produced very little motor disturbances and the function recovered within a week. Section of the dorsal column produced some motor deficit, but the deficit was not severe and the animals recovered nearly completely within 2 wk. Combination of dorsal column section and sensory cortex removal produced severe motor deficits. These consisted of loss of orientation within extrapersonal space and loss of dexterity of individual fingers. These deficits never recovered within the duration of observation, which lasted 4-5 wk. It is concluded that the direct sensory input from the thalamus plays an important role in the control of voluntary movements, but loss of its function can be compensated by the input from the sensory cortex. The possible neuronal basis for the observed motor deficits is discussed and it is proposed that the sensory input functions by selectively changing the excitability of cortical efferent zones before and during the execution of voluntary movements. Recovery of motor function following dorsal column section occurred in parallel with the recovery of sensory input to the motor cortex. The recovered function and sensory input disappeared again following section of the association fibers from the sensory cortex. Neuronal mechanism for this observation is also discussed. PMID- 6481431 TI - Phasic and tonic modulation of impulse rates in gamma-motoneurons during locomotion in premammillary cats. AB - To determine the role of gamma-motoneurons in the control of locomotion, we isolated single units from nerves to triceps surae muscles in the premammillary cat. The limb used for recording was largely denervated, except for the muscles of interest, and fixed in place, while the other three limbs walked on a treadmill. One type of gamma-motoneuron (13 units) had a high impulse rate at rest, which changed little on average during walking, but was deeply modulated with each step (phasically modulated gamma-motoneuron or gamma p). Another type (19 units) had a low impulse rate at rest, which increased greatly on average during walking, but was not highly modulated with each step (tonically modulated gamma-motoneuron or gamma t). Peak gamma p rates generally occurred after peak EMG, often near the peak of tension. In contrast, peak gamma t activity generally preceded peak electromyograms (EMG). No significant difference was observed in conduction velocities for the two types of units. At rest all gamma t units were excited by natural stimulation of the fur over a large part of the body surface, whereas 3 of 11 gamma p units were inhibited. During locomotion the same natural stimuli had no observable effect on either type of unit. By recording in continuity from fine branches of the lateral and medial gastrocnemius nerves and stimulating ventral root filaments in continuity, we identified dynamic and static gamma-motoneurons in terms of their effects on muscle spindle afferents. After cutting the nerve branch distally and other ventral root filaments supplying the muscle, the resting discharge of dynamic and static gamma motoneurons was recorded and found to correspond to that of the gamma p and gamma t units, respectively. Other evidence is presented for a correspondence between phasically and tonically modulated units and dynamic and static gamma motoneurons, contrary to some suggestions in the literature. PMID- 6481432 TI - Repetitive firing in layer V neurons from cat neocortex in vitro. AB - Input-output relations of large neurons from layer V of cat sensorimotor cortex were studied in an in vitro slice preparation using steps and ramps of intracellularly injected current. Depolarization attained during the interspike interval (ISI) was compared to the voltage levels required to activate a previously described (29) persistent sodium current (INaP). INaP was studied using a single-electrode voltage clamp in the same cells tested for firing behavior. Following an injected current step, firing rate declined smoothly to a steady level with a time course that was approximately exponential in most cells (tau, 9-43 ms). In most cells, the relation between firing rate and injected current (f-I relation) consisted of two linear segments, both for adapted, steady firing and for early intervals during adaptation. The slope of the steeper, initial (or sole) linear segment of the f-I curve averaged 26.2 Hz/nA during steady firing and was steeper when plotted for early interspike intervals. The variation of the depolarization at which spike initiation occurred (firing level) and the membrane potential between rhythmic spikes was examined during adaptation and steady firing. In most cells, firing level rose rapidly during a rhythmic train to a steady value. The steady firing level attained remained unchanged over a wide range of steady firing rates. Nevertheless, the mean depolarization during the interspike interval (V) increased approximately linearly with steady firing rate. Even at the slowest firing rates, V is sufficient to activate INaP. The use of injected current ramps demonstrated that neocortical cells were sensitive to rate of change of stimulus current (dI/dt) as well as its amplitude (I). The use of ramps followed by steady currents demonstrated that the repetitive response lagged behind changes in stimulus parameters and did not reach a steady state even during slow ramps; i.e., the response depended on time as well as on I and dI/dt. Instantaneous firing rate during the ramp increased linearly with time for a wide range of ramp slopes (dI/dt). The instantaneous firing rate of early interspike intervals was also linearly related to ramp slope for small ramp slopes. In spite of these linear relationships, quantitative analysis indicated that firing rate during ramp stimulation cannot, in general, be described by a simple linear combination of separate amplitude- and rate-dependent terms. The repetitive firing properties of the in vitro neurons are compared to those of in vivo neocortical neurons and other cell types.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481433 TI - Cable properties of layer V neurons from cat sensorimotor cortex in vitro. AB - The passive cable properties of neurons from layer V of cat neocortex were studied in an in vitro slice preparation using current-clamp techniques and a single-microelectrode voltage clamp. Neurons were examined in the presence and absence of several agents that block time- and voltage-dependent conductances. The charging response to an injected current pulse was well fitted by a single exponential in 12 of 17 cells examined. By itself, this result would suggest that most of the neurons are isopotential. However, the existence of a nonisopotential region was demonstrated in all neurons examined using two alternative, independent methods: application of voltage-clamp steps and current impulses. The decay of the capacitive charging transient following a voltage-clamp step reflects charge redistribution solely in the nonisopotential region and had a mean time constant about 17% of the membrane time constant, tau m. The voltage decay following a current impulse was always fitted by (at least) two exponentials, the shorter of which was about 9% of tau m. These results suggest that a nonisopotential region exists but is electrotonically short, of relatively low-input conductance, or both, independent of a particular neuron model. Adopting Rall's (23, 24) idealized neuron model (isopotential compartment attached to a finite-length uniform cable) resulted in a mean value for the equivalent electrotonic length (L) of the nonisopotential compartment of 0.72 space constants from voltage-clamp data and 1.21 space constants from impulse response data. A dendrite-to-soma conductance ratio (p) of 2-4 was obtained from either procedure. There were no significant differences in the cable parameters between normal cells and those where conductance-blocking agents were present. A specific membrane resistance (Rm) ranging from 2,300 to 11,700 omega X cm2 was estimated by assuming values of specific membrane capacitance reported in the literature. We conclude that large layer V neocortical neurons in vitro are electrotonically compact in the voltage range near resting potential and in the absence of significant tonic synaptic input. In this respect, their electrotonic cable properties resemble those of other mammalian neurons in vitro. PMID- 6481434 TI - Influence of globus pallidus on arm movements in monkeys. I. Effects of kainic acid-induced lesions. AB - The role of basal ganglia output via the globus pallidus (GP) was examined in monkeys trained to make rapid arm-reaching movements to a visual target in a reaction-time task. When neurons in the globus pallidus were destroyed by injection of kainic acid (KA) during task execution, contralateral arm movement times (MT) were increased significantly, with little or no change in reaction times (RT). The slowed movements were associated with a generalized depression in the amplitude and rate of rise of electromyographic (EMG) activity in all the contralateral muscles studied at the wrist, elbow, shoulder, and back, but there was no change in the sequential activation of these muscles. The most profound and persistent increases in movement time occurred when neurons were destroyed in the ventrolateral and caudal aspects of the internal as well as external pallidal segment. These results suggest a role for globus pallidus output in scaling the magnitude and/or buildup of EMG activity without affecting the initiation or the sequential organization of the programmed motor output. PMID- 6481435 TI - Influence of globus pallidus on arm movements in monkeys. II. Effects of stimulation. AB - The effect of changing basal ganglia activity with electrical stimulation in and around the globus pallidus (GP) was studied in monkeys trained to make rapid arm reaching movements to a visual target in a reaction time task. As was the case following kainic acid (KA) lesions of the globus pallidus (30), stimulation changed movement times (MT) without affecting the pattern of sequential activation of muscles involved in the task or, in most cases, the reaction times (RT). Stimulation in the ventrolateral internal segment of the globus pallidus (GPi) or in the ansa lenticularis reduced movement times, whereas stimulation at many sites in the external pallidal segment (GPe), dorsal GPi, and putamen increased movement times for the contralateral arm. These results are consistent with the hypothesis that arm movements are speeded up when the critical output of GPi is increased and arm movements are slowed down when critical GPi output is reduced, either by an inhibitory process (via stimulation-induced activation of inhibitory elements presynaptic to GPi) or by destroying GPi neurons (via kainic acid). The influence of the basal ganglia on the scaling of electromyographic (EMG) amplitude, as opposed to the spatiotemporal organization of EMG activation, is discussed. PMID- 6481436 TI - Blinking and associated eye movements in humans, guinea pigs, and rabbits. AB - Recordings of upper eyelid movements in humans, guinea pigs, and rabbits demonstrated that all three species displayed qualitatively similar patterns of eyelid movement. The relation between amplitude, duration, and maximum velocity in rabbits and humans was nearly identical. Guinea pig blinks were faster than those of rabbit and man. Electromyographic (EMG) recordings in humans demonstrated that the orbicularis oculis muscle participated in downward movement of the upper eyelid during blinks and eyelid closure but did not participate actively in the downward lid movement occurring with gaze changes. When looking straight ahead, the estimated stiffness and viscosity of the upper eyelid were 10 g/mm and 0.38 g X s X mm-1 for humans and 1.17 g/mm and 0.062 g X s X mm-1 for rabbits. Upward and abducting rotations of the eye accompanied blinks in rabbits and guinea pigs. Simultaneously, the eyeball retracted (translational movement) into the orbit. These translational and rotational eye movements resulted from contraction of the retractor bulbi muscle and cocontraction of antagonistic extraocular muscles. The data suggested that humans also retracted the eye during voluntary blinks. The retraction produced a rotation of the eye toward a "primary position" rather than a rotation in one specific direction. The relationship between the maximum velocity, duration, and amplitude of the down phase of a blink may be expressed as a single equation, maximum velocity = c X average velocity, where c is a constant. The same relationship, with a similar value for c, also describes saccadic eye movements and rapid skeletal movements. This implies that all three movements employ comparable neural mechanisms. PMID- 6481437 TI - Receptive-field properties and laminar distribution of X-like and Y-like simple cells in cat area 17. AB - We examined the spatiotemporal organization of excitatory regions in 197 simple receptive fields from cat area 17 using the peristimulus time response-plane technique of Stevens and Gerstein (53). With this method we observed a striking similarity between the spatiotemporal organization of excitatory regions in simple receptive fields and the excitatory centers in X or Y geniculate receptive fields. This observation suggested to us the possibility that individual simple receptive fields may be differentially innervated by either X or Y geniculate afferents. To test this hypothesis, we devised a quantitative measure that could characterize the excitatory regions in simple receptive fields as being X-like or Y-like. This measure was based on an understanding of the spatiotemporal organization of geniculate X and Y receptive fields. Further evidence supporting this division of simple cells was derived from additional physiological and anatomical comparisons. When compared to Y-like simple cells, X-like simple cells, as a group, gave a more sustained response to standing contrast, had smaller excitatory regions, and preferred slightly slower moving stimuli. A comparison of the properties of end-zone inhibition and directional selectivity showed no additional difference between X-like and Y-like simple cells. We found a correlation between the laminar position of X-like and Y-like simple cells and the known patterns of termination of X and Y geniculate afferents. Y-like simple cells were found in layers III, IVab, and VI, but not in layer IVc, whereas X like simple cells were found in layer III, all parts of layer IV, and layer VI. Inhibitory regions appeared to play a major role in defining the spatiotemporal structure of simple receptive fields and they further acted to diminish differences between the spatial widths and velocity sensitivities of X-like and Y like simple cells. These data are discussed in terms of a parallel model of geniculostriate convergence and support the hypothesis that the X and Y systems, which originate in the retina, are maintained in parallel at the level of simple cells in striate cortex. PMID- 6481438 TI - Periodic simple cells in cat area 17. AB - Quantitative, high-resolution static receptive-field plots (response planes) in cat area 17 revealed simple cells whose receptive fields were composed of four to six excitatory regions alternating in space with up to seven inhibitory regions. The size, shape, and spacing of the excitatory regions within these receptive fields were highly regular, giving the receptive field a periodic appearance in space. We call these periodic simple cells. A periodic simple cell's response to moving stimuli could, in general, be anticipated from the detailed spatiotemporal map of excitatory and inhibitory regions provided by response planes. This observation suggests that periodic simple cells, like the more common simple cells composed of one to three excitatory regions, sum spatially distributed inputs in a roughly linear manner. Based on a quantitative assessment of the spatial distribution and time course of response of single excitatory regions within periodic receptive fields, as described in the previous paper, we characterized periodic simple cells as either X-like or Y-like. Furthermore, we found that periodic simple cells classified as X-like gave a more sustained response to standing contrast and had significantly smaller excitatory regions than those cells classified as Y-like. Periodic simple cells were found in layer III and at the border between layers III and IVab. It is suggested that these cells, which reside outside the primary zone of geniculate termination and include both X-like and Y-like types, may be constructed hierarchically from the convergence of lower order simple cells. In the spatial-frequency domain, periodic simple receptive fields were predicted to have bandwidths at half maximum ranging from 0.80 to 1.4 octaves. By comparison, the predicted bandwidths of cells composed of two or three excitatory regions ranged from 1.6 to 4.3 octaves. Thus as additional excitatory regions are added to the receptive fields of simple cells, their bandwidth narrows in the spatial-frequency domain. PMID- 6481439 TI - Recruitment order of motoneurons in stretch reflexes is highly correlated with their axonal conduction velocity. AB - Motor units of soleus and medial gastrocnemius (MG) muscles were studied in pairs during stretch reflexes in the decerebrate cat to determine the relation between their recruitment orders and axonal conduction velocities. In 97% of soleus pairs, the motor unit with the lower axonal conduction velocity was recruited first. Since the soleus is a homogeneous muscle in the cat, differences in motor unit type are, therefore, not a sine qua non for orderly recruitment nor is recruitment random within homogeneous populations of motor units, as recently proposed (28). In the medial gastrocnemius, a heterogeneous muscle, the same high correlation (97%) between recruitment sequence and conduction velocity was observed. Thus, the factors that determine recruitment order in heterogeneous muscles are as closely correlated with axonal diameter as they are in homogeneous muscles. Comparison of axonal conduction velocities in our sample of MG units with those in three samples of type-identified MG units studied by other investigators also suggests that motor-unit type is not the critical factor controlling the sequence of activation in heterogeneous muscles. It is concluded that the combined effects of all presynaptic and postsynaptic factors that determine susceptibility to discharge in motoneurons during stretch reflexes are strictly correlated with their axonal conduction velocities, as predicted by the size principle. PMID- 6481440 TI - Stiffness of cat soleus muscle and tendon during activation of part of muscle. AB - Experiments have been carried out on the soleus muscle and its tendon in the anesthetized cat. Measurements of isometric tension and muscle stiffness were made during contraction of whole or part of the muscle in response to stimulation of ventral root filaments. In an attempt to determine the distribution of tension in different portions of the tendon during activation of only part of the muscle, the free tendon of insertion was split longitudinally into two halves and a strain gauge attached to each piece. From a large number of measurements, it was found that the mean fraction of tension recorded in one-half of the tendon remained about the same, over a wide range of tensions. However, the scatter of values, which increased as the portion of muscle contracting was reduced, was greater than expected if muscle fibers were randomly distributed throughout the muscle. Measurements of muscle and tendon stiffness were made from length and tension changes during stretch of the actively contracting muscle. Ventral root stimulation that engaged 20% or more of the muscle yielded a value for tendon compliance (0.09 mm/N), which was the same as for stimulating the whole muscle. This result suggested that for contraction of portions as small as 20% of the muscle, fibers were effectively attached to the whole tendon, indicating that tendinous attachments of individual muscle fibers ran independent of one another over only a short distance and were bound together over most of their remaining course. It was concluded that groups of muscle fibers selected by stimulation of ventral root filaments are not entirely randomly distributed throughout the muscle. However, for groups representing larger fractions of the total tension, (greater than 20%) the distribution is uniform enough and the connections between their tendinous attachments firm enough for the force applied by such a group to act through a tendon compliance, which is the same as that seen by the whole muscle. PMID- 6481441 TI - Receptive-field properties of neurons in middle temporal visual area (MT) of owl monkeys. AB - Response properties of single neurons in the middle temporal visual area (MT) of anesthetized owl monkeys were determined and quantified for flashed and moving bars of light under computer control for position, orientation, direction of movement, and speed. Receptive-field sizes, ranging from 4 to 25 degrees in width, were considerably larger than receptive fields with corresponding eccentricities in the striate cortex. Neurons were highly binocular with most cells equally or nearly equally activated by either eye. Neurons varied in selectivity for axis and direction of moving bars. Some neurons demonstrated little or no selectivity, others were bidirectional on a single axis, while the largest group was highly selective for direction with little or no response to bar movement opposite to the preferred direction. Over 70% of neurons were classified as highly selective and 90% showed some preference for direction and/or axis of stimulus movement. Neurons typically responded to bar movement only over a restricted range of velocities. The majority of neurons responded best to a particular velocity within the 5-60 degrees/s range, with marked attenuation of the response for velocities greater or less than the preferred. Some neurons failed to show significant response attenuation even at the lowest tested velocity, while other neurons preferred velocities of 100 degrees/s or more and failed to attenuate to the highest velocities. Response magnitude varied with stimulus dimensions. Increasing the length of the moving bar typically increased the magnitude of the response slightly until the stimulus exceeded the receptive-field borders. Other neurons responded less to increases in bar length within the excitatory receptive field. Neurons preferred narrow bars less than 1 degree in width, and marked reductions in responses characteristically occurred with wider stimuli. Moving patterns of randomly placed small dots were often as effective as or more effective than single bars in activating neurons. Selectivity for direction of movement remained for the dot pattern. for the dot pattern. Poststimulus time (PST) histograms of responses to bars flashed at a series of 21 different positions across the receptive field, in the "response plane" format, indicated a spatially and temporally homogeneous receptive-field structure for nearly all neurons. Cells characteristically showed transient excitation at both stimulus onset and offset for all effective stimulus locations. Some cells responded mainly at bright stimulus onset or offset. PMID- 6481442 TI - Response properties of striate cortex neurons in cats raised with divergent or convergent strabismus. AB - Recordings were made from striate cortex in five groups of cats that had been raised with strabismus produced by sectioning the extraocular muscles. These groups included animals reared with exotropia, unilateral or bilateral esotropia, and esotropia combined with lid suture of the unoperated eye. In addition, a group of esotropes was studied in which the unoperated eye was removed a few hours prior to recording. For comparison, five normal adult cats were also studied. In each of the above groups, cells were sampled in the representations of the central and peripheral visual fields in area 17 ipsilateral and contralateral to the deviated eye. We mapped the receptive field of each responsive cell, determined its ocularity, and tested it for selectivity. Confirming previous work, we found a marked loss of cortical binocularity in cats raised with strabismus. On average only 7% of the neurons that we recorded could be driven by both eyes. This percentage was relatively constant at all cortical locations that were studied and was not influenced by whether cats had been reared with exotropia, unilateral esotropia, or bilateral esotropia. The percentage of selective cells driven by the deviated eye in exotropes or esotropes did not appear to be different from normal at most cortical locations (but see 5, below). In addition, we did not observe any bias in the axial preference of selective cells in strabismic cats when compared with normal adult cats. In both exotropes and esotropes the deviated eye drove fewer cells when compared with the proportion that are driven by one eye in normal cats. In exotropes this deficit did not vary at different cortical representations of the visual field. In esotropes, however, this deficit was graded, being least in the representation of the peripheral visual field in area 17 contralateral to the deviated eye, intermediate in the representations of the central visual field in the contralateral and ipsilateral hemispheres, and greatest in the representation of the peripheral visual field in ipsilateral area 17. Furthermore, only when recording from the peripheral field representation in the ipsilateral hemisphere did we encounter significant numbers of cells driven by the deviated eye that lacked normal selectivity. Since it is possible that deprivation of the converged eye during development might account for the deficits noted above, we attempted to evaluate this factor using several independent lines of evidence. First, we could find no correlation between the angle of esotropia and the ability of the deviated eye to drive ipsilateral cortical cells representing the peripheral visual field.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481444 TI - Nonlinear viscosity of human wrist. AB - Nonlinear viscous properties of stretch and unloading reflexes in the human wrist were examined using constant-velocity ramp stretches and releases in the range between 5 and 500 mm/s. Subjects were asked to oppose an initial flexor preload and were instructed not to intervene voluntarily when the changes in position were applied. Electromyographic (EMG) activity and net force exerted by the wrist were measured. Although subjects were instructed not to intervene to the applied stretches, even well-practiced subjects sometimes showed unintended triggered reactions, which character could be assisting or resisting. A trial comparison method was used to detect and eliminate responses contaminated by unintended reactions. Ramp stretches further loaded the preloaded flexor muscles. Responses of EMG and force increased steeply initially but after about 1-cm displacement, the slope of these responses decreased to a lower value and remained constant during the remainder of the 5-cm ramp. For higher stretch velocities, the magnitudes and slopes of the responses of EMG and force increased but less than proportionally with ramp velocity. Except for the initial transient, EMG in the loaded flexor muscles and force responses could be described by a product relationship between a linear position-related term and a low fractional power of velocity, after a correction was made for delays in the reflex arc. Mean value of the exponent in the power function of velocity was 0.3 for EMG and 0.17 for force. For higher preloads, incremental responses of force to constant-velocity stretches, plotted as a function of wrist position, shifted to higher values and the slope of increase of force with position became somewhat steeper. This upward shift of the force trace reflects a change of apparent threshold of the stretch reflex. Ramp releases shortened and unloaded the preloaded flexor muscles and stretched the initially inactive extensor muscles. Flexor EMG activity declined progressively with a time course that was independent of velocity. Extensor EMG response depended on preload. At high preloads, there was no activity except for some bursting at the highest velocities. At low preloads, EMG activity was initially absent but started part way through the ramp. The increase of activity was somewhat greater for higher ramp velocities. Force responses to shortening ramps depended on preload. At high preloads, force responses superimposed at all of the low velocities but fell to slightly lower forces at the higher velocities. At low preloads, force traces again superimposed for low velocities and at high velocities only during the initial part of the response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481443 TI - Effects of strabismus on responsivity, spatial resolution, and contrast sensitivity of cat lateral geniculate neurons. AB - Rearing cats with esotropia is known to cause a number of deficits in visual behavior tested through the deviated eye. These include a loss of orienting response to stimuli presented in the nasal visual field of the deviated eye, a reduction in visual acuity, and a general reduction in contrast sensitivity at all spatial frequencies. To assess the involvement of the lateral geniculate nucleus (LGN) in these deficits, we measured the following: 1) the visual responsiveness of lamina A1 cells with peripheral (more than 10 degrees from area centralis) receptive fields in three esotropic and three normal cats and 2) the spatial resolution and contrast sensitivity of lamina A X-cells with central (within 5 degrees of the area centralis) receptive fields in six esotropic and six normal cats. For comparison, we also measured LGN X-cell spatial resolutions in four exotropic cats and in two cats raised with an esotropia in one eye and the lids of the other eye sutured shut (MD-estropes). Recordings from the lateral portion of lamina A1 in esotropic cats yielded similar numbers of visually responsive cells with far nasal receptive fields as were seen in normal animals. Peak and mean response rates to a flashing spot also were normal. In addition, no differences were found between esotropes and normals in the percentages of X- and Y-cells encountered. These results suggest that the loss of orienting response to stimuli presented in the nasal field (12, 20) is not due to a loss of neural responses in the LGN of esotropic cats. In addition, they suggest that decreases in cell size in lamina A1 of esotropic cats (13, 36; R. E. Kalil, unpublished observations) are not accompanied by marked functional abnormalities of the cells and that cortical abnormalities ipsilateral to the deviated eye (22) are likely to have their origin within striate cortex itself. Recordings from lamina A cells with receptive fields near area centralis revealed that the average X-cell spatial resolution in esotropes (2.1 cycles/deg) was significantly lower than that in normal cats (3.1 cycles/deg). This reduction was seen in all esotropic cats tested and was due both to an increase in the proportion of X-cells with very low spatial resolution and to a loss of X-cells responding to high spatial frequencies (greater than 3.25 cycles/deg). The average spatial resolution of X cells driven by the deviated eye in MD-esotropes fell midway between those of esotropes and normals. In exotropes, mean X-cell spatial resolution was normal.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481445 TI - Afferent specific localization of muscarinic acetylcholine receptors in cingulate cortex. AB - The laminar distribution of acetylcholine receptors in rat cingulate cortex and their localization to axons of neurons in the anterior thalamic nuclei (ATN) were evaluated with the muscarinic antagonist [3H]propylbenzilylcholine mustard (PrBCM) in vitro. Specific binding of PrBCM in granular area 29 was heterogeneous, with a 57% variation from the highest binding in layer Ia to the lowest in layer II-III. In contrast, binding in area 24 was homogeneous, with only a 14% variation. The heterogeneity of PrBCM binding almost exactly duplicated the distribution of termination of ATN afferents in layers I to IV of area 29c. Four experiments indicated that 50% of the excess binding in layers Ia and IV was due to axonal receptor sites. First, ATN lesions abolished 41% and 27% of total specific binding in layers Ia and IV, respectively. Second, an undercut procedure that totally deafferented layers I to Va showed changes similar to those following ATN lesions, suggesting that other afferents to these layers may not have muscarinic receptors associated with them. Third, the sequence of losses in receptor binding and acetylcholinesterase (AChE) activity was evaluated 2, 3, 5, 9, and 14 days following ATN lesions. Since AChE was present in ATN axons, as evidenced by early postlesion losses, the correlation of both losses as well as previous analyses of axon degeneration in this cortex confirmed that these receptors were in axons. Fourth, binding peaks in layers Ia and IV remained in area 29c following destruction of virtually all neurons with the neurotoxin ibotenic acid. This is the first evidence that the activity of a major neocortical thalamic afferent may be regulated by axonal acetylcholine receptors. PMID- 6481446 TI - Pheromonally induced release of luteinizing hormone in male mice: involvement of the vomeronasal system. AB - Evidence has accumulated demonstrating that the vomeronasal (accessory olfactory) system mediates intraspecific chemosensory communication in several mammals. For example, the neuroendocrine effects of priming pheromones in females and the behavioral responses to signaling pheromones in males are disrupted in mice with damage to the vomeronasal system. The experiment reported here examined the potential involvement of the vomeronasal system in the neuroendocrine reflexes observed in male mice following exposure to female and chemosensory stimuli. Excision of the vomeronasal organ (VNO) or sham VNO ablation was performed on sexually experienced males. Next, consecutive blood samples were withdrawn through chronic, intracardiac cannulas while the males were exposed to female mouse urine and then to an ovariectomized female. Plasma levels of luteinizing hormone (LH) were measured in the sequential samples by radioimmunoassay. Removal of the VNO did not affect the spontaneous pattern of episodic LH release that is characteristic of male mice. Reflexive release of LH following the urine stimulus was blocked in males lacking the VNO, but the female stimulus did cause LH responses in these mice. Our results therefore demonstrate that the VNO mediates pheromonally induced release of LH in male mice and that additional cues which emanate from behaving females also effectively stimulate a hormonal response in sexually experienced males. PMID- 6481447 TI - An electron microscopic analysis of the trans-synaptic effects of peripheral nerve injury subsequent to tooth pulp extirpations on neurons in laminae I and II of the medullary dorsal horn. AB - To examine the effects of peripheral nerve injury on second-order neurons in laminae I and II of the medullary dorsal horn, tooth pulps of all mandibular teeth in adult cats on one side were extirpated. This procedure severed and removed the receptors and terminal branches of the primary trigeminal neurons which innervate the tooth pulps of these teeth. The empty pulp chambers were then filled with dental cement to prevent regeneration. At 30 and 60 days postoperatively, membrane-lined cavities had formed inside many of the small caliber dendrites of second-order neurons in laminae I and II. Cavity formation occurred mainly in dendritic shafts less than 2 micron in diameter and involved dendrites with synaptic vesicles as well as those without synaptic vesicles. The cavities extensively hollowed out these dendrites, often occupying more than half the cross-sectional diameter of the shafts and extending for appreciable distances in the long axis of the shaft. The process of cavitation ultimately resulted in the destruction of the affected dendrites. Many cavities became patent to the intercellular space with the cavity membrane establishing continuity with the dendritic membrane. Many cavities often formed in a single dendrite, and such severely cavitated dendrites became reduced to a trabeculated shell which ultimately fragmented into several small pieces. The presence of synaptic connections from a number of different kinds of axonal endings, including scalloped and dome-shaped endings, was not sufficient to prevent cavitation. The actual severing of synaptic connections on the cavitated dendrite appeared to be a relatively late event in the process since small pieces of dendritic debris could still be found clinging to their axodendritic synapses. Evidence that dendrites were being lost from the neuropil was most readily apparent in many of the disrupted glomeruli in lamina II in which many of the scalloped depressions in the central axonal endings that normally contained small dendrites were empty. Many central axonal endings remained in synaptic contact with only a single dendrite which often showed signs of cavitation. Such central endings showed only subtle remaining traces of their normal scalloped contours. This study demonstrates that injury to the distal branches of primary trigeminal neurons which innervate tooth pulps resulted in trans-synaptic degenerative changes in the dendritic arbors of second-order neurons which destroyed fine caliber higher order dendrites. PMID- 6481448 TI - Synaptic excitatory and inhibitory interactions at distal dendritic sites on mitral cells in the isolated turtle olfactory bulb. AB - The olfactory nerves terminate exclusively on the distal dendritic tufts of mitral cells in the olfactory bulb, which makes this a favorable model for analysis of synaptic responses in distal dendrites. Intracellular recordings of responses to olfactory nerve volleys have been obtained in the isolated turtle olfactory bulb. Single mitral cells usually responded with excitatory postsynaptic potentials (EPSPs) to volleys in two different bundles, indicating convergence from separate receptor neuron populations. Paired volleys revealed long-lasting inhibition of a test EPSP by a conditioning volley. This could be shown to be independent of the inhibition of mitral cells by granule cell interneurons in the deeper layers. The results suggest that excitatory and inhibitory synaptic interactions in the glomerular layer are important in the processing of olfactory inputs. The results also provide an exception to the classical doctrine that synaptic inhibition is preferentially sited near the cell body and axon hillock in order to control impulse generation there. Our findings of inhibitory actions on distal dendrites of mitral cells may provide a model for similar actions on distal dendrites of other central neurons. PMID- 6481449 TI - Pathfinding by neuronal growth cones in grasshopper embryos. III. Selective affinity of the G growth cone for the P cells within the A/P fascicle. AB - The growth cone of the G neuron selectively fasciculates upon specific axon bundles in a stereotypic sequence as it navigates through the developing central nervous system of the grasshopper embryo. It turns and extends anteriorly in the contralateral neuropil of the second thoracic ganglion at a specific choice point where it fasciculates with the A/P axon bundle which contains the axons of the A1, A2, P1, and P2 neurons. We previously hypothesized (Raper, J. A., M. J. Bastiani, and C. S. Goodman (1983) J. Neurosci. 3: 20-41) that this fascicle, or subsets of axons within it, were specifically labeled and that the G neuron was determined to follow this labeled pathway. Here we report on an ultrastructural analysis of the interactions between the G growth cone and its filopodia with the cells of the A/P fascicle at the choice point. As G reaches its choice point, its filopodia are in more frequent contact with the A/P fascicle in comparison to the other longitudinal axon fascicles. Within the A/P fascicle, the tip of G's growth cone is found to be closely associated with the P and not the A axons. Furthermore, before the G growth cone climbs onto the A/P fascicle, its filopodia show a selective affinity for the P axons as compared to the A axons. Another specific interaction involves selective filopodial insertions; only filopodia from the P cells were found to insert into the G growth cone and induce coated pits and vesicles. These findings suggest that G is able to distinguish the A/P fascicle from other axon bundles and, moreover, is able to distinguish the P axons from the A axons. The companion paper (Raper, J. A., M. J. Bastiani, and C. S. Goodman (1984) J. Neurosci. 4: 2329-2345) presents experimental results based on specific axon ablations that further support this hypothesis. PMID- 6481450 TI - Pathfinding by neuronal growth cones in grasshopper embryos. IV. The effects of ablating the A and P axons upon the behavior of the G growth cone. AB - In the companion paper (Bastiani, M. J., J. A. Raper, and C. S. Goodman (1984) J. Neurosci. 4: 2311-2328), we show that as the G growth cone reaches its choice point and turns anteriorly on the A/P fascicle, its filopodia demonstrate selective affinity for the A/P fascicle as compared to the other approximately 25 longitudinal axon fascicles, and within the A/P fascicle itself, G's filopodia selectively contact the P axons as compared to the A axons. These results support the hypothesis that the A/P fascicle, and, moreover, subsets of axons within it (Ps versus As), are specifically labeled and that the G growth cone is determined to follow a particular labeled pathway. We tested the "labeled pathways" hypothesis by specifically ablating these axons and examining the subsequent behavior of the G growth cone in embryos grown in culture. Ablation of the A and P axons prevents G from growing more than a short distance anteriorly, although the G growth cone is within grasp of many other longitudinal axon fascicles. Ablation of only the P axons has a similar effect; the G growth cone behaves normally if only the A axons are ablated. Transmission electron micrograph semiserial section reconstructions of experimental embryos further indicate that G's growth cone behaves abnormally when the A and P axons, or only the P axons, are ablated. The G growth cone branches extensively in the lateral and ventral neuropil without it or its filopodia showing a high affinity for any other axon fascicle. These results indicate that the G growth cone is able to distinguish the A/P fascicle from the other longitudinal axon fascicles in the developing neuropil. Moreover, the results suggest that within the A/P fascicle the G growth cone is able to distinguish the P axons from the A axons. PMID- 6481451 TI - Redistribution of acetylcholine receptors on developing rat myotubes. AB - The mechanism of formation of acetylcholine receptor (AChR) clusters at developing mammalian endplates was investigated in vitro, using intercostal muscles from embryonic rats. The muscles were explanted in organ culture with the spinal cord attached, as described previously (Ziskind-Conhaim, L., and M. J. Dennis (1981) Dev. Biol. 85: 243-251). AChRs on the myofibers were labeled with [125I]-alpha-bungarotoxin shortly before clusters appeared and subsequently were cultured in unlabeled toxin for 1 day. Autoradiography of the cultured fibers demonstrated the presence of labeled clusters of AChRs indicating that the AChRs in the newly formed clusters arise from AChRs that had previously been uniformly distributed on the muscle surface. PMID- 6481452 TI - Alterations in neural cell adhesion molecules during development of different regions of the nervous system. AB - Several cell adhesion molecules involved in neuron-neuron and neuron-glia interactions have been identified in our laboratory and have been shown to undergo cell surface modulation. In the case of the neural cell adhesion molecule (N-CAM), it has been found that during development the molecule is converted from a microheterogeneous embryonic (E) form containing 30 gm of sialic acid/100 gm of polypeptide to several distinct adult (A) forms containing one third as much of this sugar. In vitro analyses indicate that this change is accompanied by a 4 fold increase in the rate of N-CAM homophilic binding. In the present study of the mouse and the chick, alterations of N-CAMs occurring as a result of E----A conversion, prevalence modulation, and changes in antigenic state during the development of different neural regions were analyzed by the use of highly specific polyclonal and monoclonal antibodies combined with anatomical dissection and several new quantitative assays. We made the following observations. The relative concentration of N-CAM changed during development, with the highest concentration (2.8 times the adult level) occurring around the perinatal period. Each brain region followed a similar pattern of change but according to a different time schedule. While conversion from the E to the A forms of N-CAM occurred mainly during the first 3 postnatal weeks in mice, the relative conversion rates were distinctly different in various neural tissues. The extreme examples are dorsal root ganglia, which already displayed the A forms at birth, and the diencephalon and tectal region, which still retained some E forms in the adult. A cephalocaudal maturation gradient of E----A conversion was observed in the spinal cord and dorsal root ganglia. Differences in the antigenic determinants of N-CAMs from different neural tissues were detected by two independent monoclonal antibodies. Finally, in some adult neural tissues, one of the three A forms was found to be dominant. These results establish that during development there are definite quantitative and qualitative differences among N CAMs from various neural tissues. The data are consistent with the hypothesis that alterations in the relative amounts and forms of N-CAM play major roles in neural morphogenesis, possibly by altering the rates of adhesion among neurons and their processes. PMID- 6481453 TI - Localization of active sites along the myelinated goldfish Mauthner axon: morphological and pharmacological evidence for saltatory conduction. AB - Injections of Lucifer Yellow (LY) and horseradish peroxidase (HRP) were made within the myelin sheath of the goldfish Mauthner axon to determine the domains of individual oligodendrocytes. Long segments of the myelin sheath were stained with both markers. The lengths and locations of these sheath segments were analyzed in whole mount preparations (LY) or in reconstructions of serial vibratome sections (HRP). The termination sites of individual myelin sheaths, relative to gross anatomical landmarks of the brain, were consistent within and between all fish studied. In particular, the average locations of the termination sites were separated by 2.2 to 2.6 mm and corresponded to the brain regions where active site foci have been previously localized electrophysiologically. Individual sheath segments generally spanned the entire distance between adjacent active sites. The node-internode-node structure of the Mauthner axon that is suggested by these findings was further tested by ejecting tetrodotoxin (TTX) at various discrete rostral-caudal locations just outside the fiber. Large all-or nothing components of the antidromic action potential were rapidly blocked (within seconds) only when the TTX ejections were made within a few hundred micrometers of the active site foci. The amplitudes of these blocked components are also consistent with predictions based upon previous electrophysiological analyses which demonstrated an active site spacing of 2.2 to 2.6 mm, a space constant of 5.0 mm, and a safety factor of 6 for impulse propagation. It is concluded from these morphological, pharmacological, and electrophysiological observations that the Mauthner axon possesses nodes separated by 2.2 to 2.6 mm and that a single oligodendrocyte spans an internodal region. Although nodal ultrastructure remains to be described, these results rule out the possibility that each of the short (approximately 50 micron), closely spaced (average separation = 155 micron) axon collaterals is a site of action current production. PMID- 6481454 TI - Evidence implicating substantia nigra in regulation of kindled seizure threshold. AB - We studied the effects of microinjected drugs and brainstem lesions on motor and limbic seizures in the kindling model of epilepsy. The duration of motor seizures was determined by timing the colonic and tonic movements of the extremities. The duration of limbic seizures was determined by measuring afterdischarge recorded on the electroencephalogram. Bilateral microinjection of a gamma-aminobutyric acid (GABA) agonist, muscimol, into the area of the substantia nigra (SN) markedly suppressed both motor and limbic seizures induced by stimulation of amygdala, olfactory structures, or lateral entorhinal cortex. Microinjection of saline did not suppress seizures. The suppressive effect of muscimol: (i) dissipated after several hours and was dependent on dose; (ii) was due to an elevation of the seizure threshold, since typical seizures could be elicited with electrical current far exceeding the threshold; and (iii) exhibited spatial specificity since muscimol injections 1 to 2 mm dorsal to the SN or into neocortex did not suppress the seizures. The actions of muscimol were probably mediated by its GABA agonist properties, since microinjection of an irreversible inhibitor of GABA transaminase (gamma-vinyl GABA) into the area of the SN also suppressed kindled seizures. Destruction of brainstem structures was produced by microinjection of the neurotoxin, N-methyl-D,L-aspartate. Seizures were markedly suppressed in animals with bilateral destruction of the SN but not in animals in which the SN was spared bilaterally. We interpret the data to indicate that the SN is the site at which the GABA agonists and lesions act to raise the threshold for kindled seizures. The suppression of limbic seizures indicates that this brainstem nucleus can regulate the intrinsic neuronal excitability of hemispheric sites. PMID- 6481455 TI - Present status of angiography in the diagnosis of spontaneous cerebral haemorrhages. PMID- 6481456 TI - A comparison of pluridirectional tomography and high resolution CT in exploration of the middle ear. PMID- 6481457 TI - Sacral meningeal cysts. A radio-clinical study based on 8 personal cases. PMID- 6481458 TI - Factor analysis in gated cardiac studies. AB - Factor analysis of dynamic structures (FADS) can automatically provide "physiological" factors related to anatomical structures that have different temporal behavior, even if these structures overlap; it also yields images corresponding to the factors' spatial distributions. In normal patients, two significant cardiac factors, corresponding to the atria and the ventricles, may be extracted. A third significant factor can be obtained when additional dynamic structures exist. However, the method does not provide an estimate of the background. It becomes part of the factors, but it does not modify their shapes. FADS has been applied to 45 gated cardiac studies. Results obtained by FADS were compared with those obtained from the amplitude and the phase of first-harmonic Fourier analysis (FA). The joint results were compared with the final diagnosis, established by real-time echocardiography and/or ventriculography. In normal patients, good agreement was obtained between the two approaches. On the whole set of patients, FADS was significantly better than FA (by sign test: p less than 5%). PMID- 6481459 TI - Should single-phase radionuclide bone imaging be used in suspected osteomyelitis? AB - The records of 69 patients who had 86 delayed, static radionuclide bone images for suspected osteomyelitis were studied to determine the effects of this procedure on diagnosis and treatment. Sensitivity, specificity, and positive predictive value were lower than reported in several other studies. When osteomyelitis was unlikely, imaging was either negative or falsely positive and rarely affected treatment. In 46 cases where osteomyelitis was more likely, imaging potentially changed therapy in 19 but was unhelpful or misleading in 15. One third of the interpretations were "equivocal" and these were incorrect four times more often than "definite" readings. Two false-positive images led to unnecessary surgeries, and one patient with negative images died with unrecognized osteomyelitis. Static-phase images with "definite" interpretations, particularly when negative, are specific, but "equivocal" studies may lead to diagnostic and therapeutic errors. When osteomyelitis is improbable, imaging rarely changes diagnosis or therapy. PMID- 6481460 TI - Prolonged iodine clearance with a depletion regimen for thyroid carcinoma: concise communication. AB - Prior studies suggested iodine depletion as a means of enhancing radioiodine uptake into metastases from well-differentiated thyroid cancer. Data are not available regarding the secondary effects of this maneuver on iodine clearance and on total-body radiation. Accordingly we have measured inorganic iodine clearance, total body iodine, tumor and total-body retention of radioactive iodine before and during a diet-and-diuretic regimen designed to induce iodine depletion. Total-body iodine decreased by 25% to 66% (p less than 0.05). The amount of radioiodine taken up and retained by tumor tissue increased 146% (range 48-243%) following the depletion regimen in three studies (two patients). However, because the iodine clearance decreased by 56% (range 40-71%), the total body radiation per standard 150-mCi dose increased by 68% (range 19-111%). Consequently, the increase in lesion irradiation relative to the increment delivered to the total body was only 46% (range 24-82%). We conclude that iodine depletion regimens are less effective than prior studies suggest. PMID- 6481461 TI - Scintigraphic appearance of axillofemoral and femorofemoral bypass grafts. AB - The scintigraphic appearance of axillofemoral and femorofemoral bypass grafts was reviewed in three cases in which the grafts were patent and intravascular radiotracers defined their course. In a fourth case, the axillofemoral graft was occluded and an aberrant vessel was identified (probably acting as a physiological shunt). PMID- 6481462 TI - Heterotopic bone formation (myositis ossificans) and lower-extremity swelling mimicking deep-venous disease. AB - A quadriplegic patient with a swollen leg was suspected of having deep-venous thrombosis, and was studied with radionuclide venography (RNV) and contrast venography. Focal narrowing of the femoral vein, seen on RNV, was due to extrinsic compression. Although soft-tissue radiographs were normal, Tc-99m diphosphonate imaging established the diagnosis of early heterotopic bone formation (myositis ossificans), which was responsible for the venous compression. Clinically this inflammatory process can mimic deep-venous thrombosis, and should be considered in evaluating patients at risk for both heterotopic bone formation and deep-venous thrombosis. PMID- 6481463 TI - Respiratory gating by impedance plethysmography. PMID- 6481464 TI - Re: Clinical assessment of a radioimmunoassay for free thyroxine using a modified tracer. PMID- 6481466 TI - Re: Improved intrinsic resolution: does it make a difference? PMID- 6481465 TI - Re: Does bone measurement on the radius indicate skeletal status? PMID- 6481467 TI - Analytical performance of the ARIA II automatic system for TSH assay. PMID- 6481468 TI - Clinical usefulness of serum ferritin measurements in lung cancer patients. PMID- 6481469 TI - Right ventricular outflow obstructions due to a fibrocalcified pericardial band. PMID- 6481470 TI - 131I total body scan and serum thyroglobulin assay in the follow-up of surgically treated patients affected by differentiated thyroid carcinoma. PMID- 6481471 TI - The role of the nutritionist in Third World agricultural policy planning. PMID- 6481472 TI - Accumulation of linoleic and gamma-linolenic acids in tissue lipids of pyridoxine deficient rats. AB - Young male Sprague-Dawley rats were fed diets containing added pyridoxine . HCl at 22 mg/kg (control), 0 mg/kg or 88 mg/kg for 6 weeks. In comparison with control or pyridoxine-supplemented (+PN) rats, growth of the pyridoxine-deficient (-PN) rats was significantly less after 2 weeks. After 6 weeks, liver weight was higher but thymus and epididymal fat weights, in relation to body weight, were significantly lower in -PN compared to control rats. In -PN rats, phospholipid levels of linoleic and gamma-linolenic acids were increased, but arachidonic acid was decreased compared to controls in plasma, liver, thymus and skin. In liver triglycerides from -PN rats, all essential fatty acids (n3 and n6) were increased compared to both control and +PN rats. The n3 essential fatty acids were significantly increased in plasma, liver, and thymus phospholipids in the +PN compared to control rats. These results support previous reports of an effect of pyridoxine on essential fatty acid metabolism and suggest that both linoleic desaturation and gamma-linolenic acid elongation may be impaired in -PN rats. In addition, the accumulation of essential fatty acids in the liver triglycerides of -PN rats suggests that essential fatty acid turnover between triglyceride and phospholipid may be influenced by pyridoxine. PMID- 6481473 TI - Interference in the development of a secondary immune response in mice by zinc deprivation: persistence of effects. AB - The purpose of this study was to determine the effects of a moderate period of zinc deficiency on the secondary responses of mice primed with antigen prior to nutritional insufficiency. Adult A/J mice were primed with sheep red blood cells (SRBC) 2 weeks prior to being placed on zinc-deficient, zinc-adequate or intake restricted diets. After 28 days some of the mice in each treatment group were given a second injection of SRBC. Deficient mice could produce only 43% as many IgG anti-SRBC plaque-forming cells (PFC) per spleen as could the zinc-adequate or restricted-fed mice. To compare the secondary response of cells from each dietary group in a uniform environment, additional mice were killed as a source of primed splenocyte for transfer to irradiated hosts. Compared to controls, splenocytes from deficient mice gave suboptimal secondary responses even in normal irradiated hosts. Finally, the remaining mice were provided with zinc-adequate diet for a period of 4 weeks to allow for repair of the memory response, but it was only partially restored by this means. The data suggest that zinc deficiency may have destroyed a substantial portion of SRBC memory cells. PMID- 6481474 TI - Empty body component gain of rats grown at different rates to a range of final weights. AB - Rate of gain by final weight response surfaces for gain of empty body water, protein, lipid and ash were defined with data from 62 male Sprague-Dawley rats. Rats were fed for 21 days at 100, 88, 76, 64, 52 or 40% of ad libitum intake within each of five initial weight groups ranging from 84 to 286 g. Forty additional rats were killed at the beginning of the growing period to provide initial estimates of amount and composition of empty body weight. Water in the gain decreased (P less than 0.05) and lipid increased (P less than 0.05) with increasing final weight. Gains of protein and ash were not significantly affected by final weight. Gains of water, protein and lipid increased (P less than 0.05) linearly with increasing rates of gain. The relationship between rate of gain and composition of gain was not affected by different final weights. Averaged across final weight, at all rates of gain each gram of gain was composed of about 66.9% water, 18.8% protein, 10.6% lipid and from 1.0 to 2.5% ash. Thus, each additional unit of gain per unit time was composed of the same amount of water, protein, lipid and about the same amount of ash. Therefore, over the stage of growth examined, these results demonstrate that the rates at which rats grow do not influence the composition of their gain to a particular weight. PMID- 6481475 TI - The binding of dietary protein by sorghum tannins in the digestive tract of pigs. AB - The effects of reconstitution of sorghums on dry matter, energy, protein and amino acid digestibilities, and the nature of protein binding by sorghum tannins during digestion were investigated. Grains from a high and a low tannin sorghum were reconstituted by adding 30% (wt/wt) distilled water to the grain and stored at 25 degrees C for 20 days with an acetic-propionic acid mixture added to deter fungal growth. Another lot of grain from the same sources was untreated and used as control. The sorghum grains were then incorporated at an 85% level in diets for a digestibility trial with pigs cannulated at the terminal ileum. The digestibilities of dry matter, protein and amino acids at the terminal ileum were lower than the corresponding values measured over the total digestive tract. Reconstitution improved the digestibilities of dry matter, energy, protein and amino acids in the high but not low tannin sorghum diets. The improvement in digestibility of individual amino acids ranged from 7.5 to 23.5%. The tannin associated proteins were more hydrophobic than the dietary protein. The results suggest that hydrophobic bonding is important in the formation of tannin-protein complexes in the digestive tract of pigs. PMID- 6481476 TI - The effect of protein levels on the response of weanling rats to dietary pectin. AB - We have previously proposed that the inhibiting effects of pectin on feed consumption and growth might be due in part to the reduction it causes in protein digestibility. The present work was intended to test this hypothesis by feeding higher levels of protein in order to compensate for the lower digestibility. We fed diets containing 10, 20 and 30% casein (initial levels) and 0, 4.8, 16.7 and 28.6% pectin (by diet dilution). Despite the higher casein levels, pectin strongly inhibited the animals' feed intake, growth, protein efficiency ratio (PER), net protein ratio (NPR) and net protein utilization (NPU) as well as protein and energy digestibilities. Apart from determining the base (zero pectin) level of the various parameters measured, the dietary casein level in itself did not influence the effect of pectin on feed intake, digestible energy intake, protein digestibility, body weight growth or parameters of protein utilization such as PER, NPR and NPU. We thus cannot conclude that these effects of pectin were to any major extent secondary to the reduction in protein digestibility observed in these animals. PMID- 6481477 TI - Absorption and tissue distribution of lead in thiamin-replete and thiamin deficient rats. AB - Previous experimental results revealed that thiamin (vitamin B1) reduced lead (Pb) toxicity in calves and decreased tissue lead content in lead-treated calves and rodents. The objective of this experiment was to study the uptake and tissue distribution of lead in rats deprived of thiamin or given excess thiamin and to determine the effect of thiamin on lead absorption. Rats were divided into four groups and fed a thiamin-deficient or thiamin-supplemented diet. The thiamin replete group also received daily injections of thiamin hydrochloride. Experimental diets were fed for 5 weeks, after which the rats were administered 10 muCi of 203Pb acetate (25 micrograms lead) and killed 6, 24, 48 or 72 hours later. Lead content and concentration of tissues increased twofold in the thiamin replete group at 24 hours after dosing, but returned to control values 24 hours later. Tissue lead concentration of the thiamin-depleted group was slightly depressed at 24 hours after dosing, but this trend was reversed at the end of the experiment. Tissue lead concentrations in the pair-fed control group were three to seven times greater than in the other treatment groups 6 hours after dosing. The results indicate that thiamin facilitated absorption and increased the amount of lead initially taken up by tissue. Thiamin may also promote more rapid release of lead from tissues. PMID- 6481478 TI - Changes in the levels of marker expression by mononuclear phagocytes in zinc deficient mice. AB - To define the effects of dietary zinc deficiency on mononuclear phagocytes young adult A/J mice were fed zinc-deficient, zinc-adequate, or restricted amounts of a zinc-adequate diet for 28 days. The deficiency did not affect the total number or the percentage of nonspecific esterase (NSE)-positive cell populations in the blood or peritoneal cavity of the mice; however, the total numbers of leukocytes and NSE-positive cells in the spleen were reduced in the deficient and restricted mice to about 50% of the zinc-adequate group. In the peripheral blood of deficient mice, the percentages of adherent cells expressing Fc (FcR) and complement (CR) receptors were five and two times greater, respectively, than zinc-adequate controls. The FcR-bearing cells of the spleens of zinc-deficient mice were also increased twofold over controls. Adherent cells from the peripheral blood and spleen of zinc-deficient mice were able to phagocytize a slightly greater number of latex particles than cells from the zinc-adequate or restricted mice. The presence of zinc in fetal bovine serum did not enhance the ability of mononuclear phagocytes from deficient mice to engulf latex in vitro. PMID- 6481479 TI - Influence of dietary fatty acid concentration and geometric configuration on murine mammary tumorigenesis and experimental metastasis. AB - To investigate the influence of fatty acid geometric isomers on the growth and experimental metastasis of mammary tumors, mice were fed diets containing fat high in either cis or trans fatty acids. The cis fat was prepared to have a fatty acid composition similar to that of the trans fat; both were provided at 5 or 20% (by weight) of the diet. Line 168 mammary tumor cells were transplanted: 1) subcutaneously into female BALB/c mice to observe the effects of dietary fat on latency and local tumor growth, and 2) intravenously to observe influences on experimental metastasis. No differences in the latency or rate of primary tumor growth were observed among the groups fed the diets containing cis or trans fatty acids. In addition, there were no differences in fatty acid composition except the levels of trans-C18:1 in the primary tumor cells among the groups fed the experimental diets. Livers and spleens from animals fed both the 5 and 20% cis diet contained significantly more viable radiolabeled tumor cells than those fed the trans diets. Although body weight and composition were not significantly different among the groups, livers from animals fed the diets containing trans fatty acids were significantly heavier than those fed diets containing only cis fatty acids. Thus, trans fatty acids behaved similarly to cis fatty acids with respect to promotion of transplantable mammary tumor growth but trans fatty acids were less effective than cis fatty acids in promoting the blood-borne implantation and distant survival of the tumor cells. PMID- 6481480 TI - Absorption, distribution and endogenous excretion of zinc by rats fed various dietary levels of inorganic tin and zinc. AB - Three studies were designed to determine the effects of various levels of tin (less than 1, approximately 100, approximately 200, approximately 500 and approximately 2000 micrograms tin/g diet) and zinc (approximately 15, approximately 30, approximately 52 micrograms zinc/g diet) on the metabolism of zinc by growing rats. Retention of zinc in tibia, kidney, liver and plasma was decreased significantly when rats consumed greater than or equal to 500 micrograms tin/g diet. Tibia zinc levels were also sensitive to lower levels of dietary tin, i.e., even 100 micrograms tin/g diet when rats were fed 51.8 micrograms zinc/g diet. Apparent absorption of zinc was significantly less when rats were fed approximately 200 or approximately 500 micrograms tin/g diet rather than a control diet containing 15.8 micrograms zinc/g diet and significantly less when rats were fed approximately 500 micrograms tin/g diet rather than approximately 200 micrograms tin/g diet with 29.7 micrograms zinc/g diet. The effect of dietary tin on fecal excretion of endogenous zinc and true absorption of zinc seemed to be dependent on the dose. Rats fed approximately 2000 micrograms tin/g diet lost significantly more zinc of endogenous origin in the feces than control animals. A significant decrease in true absorption of zinc was observed among those rats fed approximately 500 micrograms tin/g diet with 29.7 micrograms zinc/g diet. Increased consumption of zinc resulted in decreased apparent absorption of zinc, increased losses of endogenous zinc in the feces, and decreased true absorption of zinc. PMID- 6481482 TI - Effects of dietary protein and exercise on brown adipose tissue and energy balance in experimental animals. AB - The effects of exercise and of dietary protein level on energy metabolism and brown adipose tissue (BAT) activity were investigated in weaning male mice. Mice were fed diets providing low (7.5%), adequate (12.5%) or high (25%) levels of dietary protein. Half of the animals in each dietary group were given moderate exercise by swimming. The lower the level of dietary protein, the greater the increase in food intake, energy expenditure, body fat and BAT mass; however, total-carcass energy, food efficiency and BAT activity were not affected by the level of dietary protein. In experiment 2, BAT was compared in mice swimming at 33 degrees C and 36 degrees C with non-exercised controls. In a third experiment, energy balance and BAT activity were compared in rats exercised at 36 degrees C and in paired weight gain (PWG) rats whose food intake was restricted to achieve weight gains equal to that of the exercised rats. PWG rats maintained carcass energy content equal to that of the controls and significantly greater than the exercised rats by decreasing energy expenditure. Moderate exercise did not affect food intake, whereas rigorous exercise decreased energy intake. Exercise did not affect BAT mass or thermogenic activity; however, mild cold stress did increase BAT activity. Exercise decreased body fat, carcass energy and food efficiency without affecting BAT. PMID- 6481481 TI - Tissue glutathione as a cyst(e)ine reservoir during cystine depletion in growing rats. AB - Previous data suggest that liver glutathione (GSH) serves as a cyst(e)ine reservoir in rats starved or fed cyst(e)ine-deficient diets. In the present study we investigated whether extrahepatic tissue GSH concentrations also decreased during cystine (Cys-Cys) depletion and whether excess dietary cystine increased tissue GSH and cysteine (Cys) concentrations. Five groups of growing rats (80-100 g) were fed diets containing crystalline L-amino acids differing in methionine (Met) and cystine (Cys-Cys) content for 15 days. All diets were isonitrogenous (1.3 g/100 g diet) and provided the minimum Met (0.17%) required by growing rats. Diet 1 provided 0.17% Met and 0% Cys-Cys, diet 2 (the recommended diet) provided 0.17% Met and 0.26% Cys-Cys, diet 3 provided 0.50% Met and 0% Cys-Cys, diet 4 provided 0.17% Met and 0.39% Cys-Cys and diet 5 provided 0.17% Met and 0.52% Cys Cys. Diets 2 and 3 were isosulfurous at 3.3 mmol/100 g diet. Diets 4 and 5 provided 50 and 100%, respectively, more Cys-Cys than required when 0.17% Met was present. Animals fed diet 1 (Cys-Cys depletion) had significantly decreased (P less than 0.05) liver, muscle, spleen, heart and thymus GSH concentrations, whereas brain, small intestine and erythrocyte GSH concentrations remained unchanged. Although brain and small intestine Cys concentrations were not affected by Cys-Cys depletion, spleen, heart and liver Cys concentrations decreased significantly (P less than 0.05). Feeding Cys-Cys above the requirement level did not increase GSH and Cys concentrations of any tissue except liver where Cys levels were elevated. The data indicate that liver, muscle, spleen, heart and thymus GSH serve as Cys reservoirs during Cys-Cys depletion. PMID- 6481483 TI - Age-related changes in activities of the superoxide dismutase enzymes in tissues of the sheep and the effect of dietary copper and manganese on these changes. AB - Activities of the copper-zinc- and manganese-containing superoxide dismutase enzymes (CuSOD and MnSOD) were studied in tissues of the sheep to determine the dependence of these activities on sheep age, and their relationship to tissue and dietary mineral concentrations. Tissue samples were obtained from day-old through 16-week-old lambs from flocks grazing pastures normal or high in copper and manganese, and from adult sheep. In liver, lung, heart, kidney and skeletal muscle, activities of CuSOD and MnSOD in day-old and week-old lambs were only half those measured in 16-week-old and adult sheep. Activities in 4-week-old lambs were intermediate between these two groups except for heart tissue, in which activities were not increased until lambs were 16 weeks old. For all age groups, heart and skeletal muscle had low activities of CuSOD. Minimal age related changes were observed for CuSOD activities in erythrocyte and brain tissues. The low enzyme activities evident in most tissues of day-old lambs, occurred in the presence of apparently adequate tissue copper and manganese concentrations. Concentrations of these minerals in lamb tissues were equal to or greater than those observed in older sheep and although these concentrations increased considerably with increased pasture mineral concentrations, enzyme activities were unchanged. Age-related increases in tissue CuSOD and MnSOD activities, occurring as normal developmental processes, may be important factors in diseases attributed to uncontrolled tissue peroxidation in sheep. PMID- 6481484 TI - Kinetic characteristics of beta-carotene uptake and depletion in rat tissue. AB - Rats were fed a semi-purified diet supplemented with 0, 0.002, 0.02 and 0.2% beta carotene (BC) for 21 weeks, followed by a 5-week depletion period. At various time points liver, adrenal, ovary, lung, heart, kidney, plasma, skin, brain and muscle were analyzed for BC content. The results indicated a dose-response effect between ingested BC and BC tissue content. The tissue saturation levels of BC, and time to reach saturation were determined in animals fed 0.2% BC diets. The half-life for BC was also determined. There was no apparent relationship among tissue content, rate of uptake and rate of depletion of BC. Each tissue studied was different. The absence of BC in fat suggests to us that BC distribution is not simply a matter of deposition into lipid depots. There was a wide range in tissue levels of BC; liver had the greatest value with 50 micrograms/g tissue, and muscle had the lowest value with 0.03 micrograms/g tissue. Plasma was saturated within 3 days, whereas liver, adrenal and ovary had not yet reached saturation at 147 days. The half-life varied from less than 3 days for plasma to 18 days for muscle. PMID- 6481485 TI - Blood flow into brown fat of rats is greater after a high carbohydrate than after a high fat test meal. AB - Postprandial oxygen uptake of whole animals and rate of blood flow into the scapular and cervical brown adipose tissue (BAT) of Osborne-Mendel male rats (200 g) were compared for those receiving a high carbohydrate meal or an equicaloric high fat meal. Blood flow was determined by the use of radiolabeled microspheres injected into the left ventricle of anesthetized animals, 2-3 hours after the test meal. In vivo oxygen uptake was elevated by about 10% (P less than 0.05) and blood flow by more than 100% (P less than 0.05) in the group receiving the high carbohydrate meal compared to the high fat meal. The rate of blood flow into tissues other than brown fat was not significantly altered by the composition of the test meal. These tissues included heart, gastrocnemius and soleus muscles, GI tract and white adipose tissue. Our data suggest that a high carbohydrate meal is more thermogenic than a high fat meal, and that the difference in the magnitude of the thermic effect produced by the two meals is paralleled by a corresponding difference in brown fat thermogenesis. PMID- 6481486 TI - Absorption by the rhesus monkey of phenylalanine methyl ester and species differences in its metabolism by blood, plasma and intestinal mucosa. AB - Phenylalanine methyl ester (PM) is a decomposition product of the sweetening agent aspartame. The potential for absorption of PM was examined following intragastric and intraduodenal administration of 20-mg doses of [14C]PM to rhesus monkeys implanted with hepatic portal vein cannulae. Small amounts of unchanged PM (less than 0.1 micrograms/ml) were detected in portal and peripheral blood samples during the first 1-2 hours after administration, but none was detectable (less than 0.001 micrograms/ml) at later times. Comparison of the areas under the PM and total 14C blood concentration-time curves indicated that only 0.2% of the administered PM reached the portal blood unchanged, and 0.1% or less reached the peripheral blood unchanged. Blood and plasma from monkeys and humans hydrolyzed PM in vitro at very similar rates, but plasma PMase activity was much higher in the dog and rat than in the monkey or human. Hydrolysis of PM by intestinal mucosa homogenates was also faster for the rat and dog than for the monkey. The in vitro results suggest that absorption of intact PM in the human would be no greater than that found in the monkey. PMID- 6481487 TI - Trace element studies in weanling rats: maternal diets and baseline tissue mineral values. AB - The initial nutritional status of experimental animals can influence their response to subsequent dietary regimens. In the present study, we determined the variations in minerals in diet NIH-31, a breeding colony stock diet, and in tissues of weanling rats nursed by dams fed this diet. Inductively coupled plasma atomic emission spectrometry (ICP-AES) was used to determine nine elements (Ca, Cu, Fe, K, Mg, Mn, Na, P and Zn) in diet and in liver, kidney, spleen, duodenum and femur from 22- to 26-day-old rats. Wet digestions were performed in mixtures of nitric, perchloric, and sulfuric acids (diets and soft tissues) or nitric and perchloric acids (femur). Solution concentrations ranged from less than 25 ng/ml for the trace elements to greater than 100 micrograms/ml for the major elements. Large variations in mineral content were found between batches of commercially prepared NIH-31 diet; relative amounts of Cu, Fe, Mn and Zn varied markedly. Significant differences in concentrations of major and trace minerals in liver, kidney, spleen and duodenal tissue were found among groups of weanling rats obtained from the same supplier at different times. Mn was readily quantitated in all tissues except spleen, where it was below detection limits. The precision obtained with the ICP-AES methodology has significant advantages for establishing variations in tissue mineral levels. PMID- 6481488 TI - Zinc deficiency-induced changes in rat parotid salivary proteins. AB - This study was undertaken to determine the effects of zinc deficiency on rat parotid salivary proteins. Male rats were fed a pelleted diet containing either 40 ppm Zn (ad libitum- and pair-fed control groups) or 0.9 ppm Zn (zinc-deficient group) for a period of 4 weeks. At the time they were killed, stimulated parotid saliva was collected and analyzed for concentration and composition of secretory protein. In addition, gland specimens were examined ultrastructurally, and liver and serum samples were assayed for zinc concentration. The zinc-deficient group exhibited retarded body growth, decreased appetite and significantly lower serum and liver zinc concentrations. The most significant finding in the saliva of the deficient animals was the marked reduction in acidic proline-rich proteins. Parotid gland secretory activity also seemed reduced. Morphologically, distinctive secretory granules were observed in the acini of the deficient animals. The altered composition of salivary secretory proteins coupled with a diminished flow rate may, in part, be responsible for the increased susceptibility to dental caries in zinc-deficient rats. PMID- 6481489 TI - Energy balance, thermogenesis and brown adipose tissue activity in tube-fed rats. AB - Young adult male rats were given a portion (42%) of their normal daily food intake by stomach tube (tube-fed), but they were also allowed free access to the same powdered diet. Total metabolizable energy intake was identical to that of controls, but tube-fed rats gained 25% weight and 50% more body energy than controls over 15 days. Total energy expenditure and resting oxygen consumption, measured during the latter part of the day, were reduced in tube-fed rats. Intubated animals showed a lower thermogenic response to noradrenaline and depressed activity of the mitochondrial proton conductance pathway in brown adipose tissue (assessed from GDP-binding), but brown fat mass, protein content, the density of beta-adrenoreceptors in brown fat cell membranes and plasma triiodothyronine (T3) levels did not differ between groups. These data indicate that the enhanced energetic efficiency and fat deposition of tube-fed rats is due to a lower energy expenditure, resulting, at least in part, from lower levels of thermogenesis in brown adipose tissue. PMID- 6481490 TI - Effect of sucrose solution drinking option on the development of obesity in rats. AB - Energy intakes, body weights, body fat index and intrascapular brown adipose tissue (IBAT) were examined in adult male Hooded-Wistar rats given a sucrose solution drinking option and one of five solid diets for 33 days: 1) a 12% fat, starch diet; 2) a 12% fat, sucrose-starch diet; 3) a 40% fat, starch diet; 4) a 60% fat, starch diet; or 5) an 80% fat diet. The effect of the sucrose solution drinking option varied depending on the solid diet. For the low fat carbohydrate diets the sucrose solution decreased solid food intake, increased body weight and increased the body fat index without significantly increasing total energy intake. For the high fat, low carbohydrate diet the sucrose solution decreased solid food intake, decreased body weight, decreased the body fat index and significantly decreased total energy intake. The development of the IBAT was decreased as a result of increasing the fat component of the diet. The sucrose solution drinking option opposed the inhibitory effect of the fat component and induced development of the IBAT. Assessment of the increase in the ratio of body weight to unit of energy intake indicated that the sucrose drinking option increased the potential to gain weight. PMID- 6481491 TI - Triacylglycerol secretion in rats: validation of a tracer method employing radioactive glycerol. AB - A two-compartment model was developed to analyze the temporal changes in plasma triacylglycerol (TG)-specific radioactivity after injection of [2-3H]glycerol into rats. The analysis, which yielded fractional rate constants of TG secretion, was tested in rats fed diets either adequate or deficient in essential fatty acids (EFA) and containing either glucose, fructose or sucrose as the dietary carbohydrate. The method of analysis appeared valid, first, because of a close agreement between experimental and computer-fitted TG-specific radioactivity curves, and second, because the fractional rate constants obtained were quite similar to fractional rate constants determined previously by the Triton WR-1339 technique in rats maintained on identical diets. The results show that EFA deficiency increased the fractional rate constant of TG secretion 1.7-, 1.8- and 3.3-fold and the rate of TG secretion 1.8-, 1.6- and 1.4-fold when the dietary carbohydrate was glucose, sucrose and fructose, respectively, in comparison with control rats fed diets supplying these same carbohydrates but adequate in EFA. In the latter groups, the rates of plasma TG secretion were in the range of 0.14 0.17 mg/min per 100 g body weight, and the rate of secretion in the fructose-fed rats was only 20% higher than in the glucose-fed rats. PMID- 6481492 TI - Occupational asthma caused by styrene. PMID- 6481493 TI - VDUs and relative annoyance from high frequency noise. PMID- 6481494 TI - Limits of accuracy of death certificate identification of occupation. PMID- 6481495 TI - Shiftwork and the length and quality of sleep. AB - Previous investigators have reported that amount and quality of sleep are reduced in the shiftworker. The finding that night and morning shifts lead to shortened sleeping hours is replicated in this study. Overall sleeping time, however, was not found to be different for workers on different shift schedules or for shiftworkers and nonshiftworkers. The correlation between length and quality of sleep was very low. Length of sleep was not predicted well by factors such as stress at work, noisiness of sleeping room, drinking coffee, and smoking cigarettes, although these and similar predictors were strongly related to quality of sleep. Shiftwork was found to have a consistent effect on quality of sleep, even when other variables were controlled. quality of sleep, even when other variables were controlled. PMID- 6481496 TI - 'Truth in packaging?' The unwrapping of epidemiologic research. PMID- 6481497 TI - Stress among crane operators. PMID- 6481498 TI - Thyroid function and lead: no clear relationship. AB - It has been suggested that the nonspecific symptoms of inorganic lead intoxication are related to the effects of the blood lead on thyroid function. A cross-sectional study of the thyroid function status of a stable work force with long-term exposure to inorganic lead was conducted. No statistically significant relationship between blood lead and thyroxine (T4) or an estimate of "free T4" was identified. These results and those of another recent study cast doubt on the existence of any direct, easily identifiable relationship between moderate blood lead level elevations and the usual measurements of thyroid function. PMID- 6481499 TI - Symptoms consistent with carpal tunnel syndrome among hotel and restaurant workers. PMID- 6481500 TI - Hearing loss and intermittent noise exposure. AB - Previous studies of occupational hearing loss have led to the belief that a typical hearing loss pattern results regardless of the noise source. Classically, the frequencies between 3,000 and 6,000 Hz are affected first. Subsequently, as the exposure continues, the hearing loss spreads to involve lower frequencies (speech) and 8,000 Hz. Although it has been assumed that this progression is typical for occupational hearing loss, it must be remembered that these studies were based chiefly on continuous exposure to noise in areas such as textile mills and paper factories. Practical experience in industry and review of millions of audiograms have shown that the classic audiogram is not as common as generally thought, especially in workers subjected to intermittent noise exposure such as chipping. In this investigation, 12,000 workers were screened to find 295 who met the strict criteria, the most important of which was intermittency of noise exposure. Most of the subjects were exposed to jackhammer noise that peaked at about 118 dBA. The study reveals a substantially different pattern of hearing loss from that reported previously. Intermittent exposure to intense noise results in very severe loss in high frequencies but relatively little or no hearing loss in the lower frequencies, even after many years of exposure. It remains to be determined whether this pattern of hearing loss results from intermittent exposure to all types of noise or only from those kinds investigated in this study. It is speculated that frequent rest periods permit the ear to protect itself from damage in the speech frequencies. This concept opens many possible avenues for preventing hearing handicap in industrial situations. PMID- 6481501 TI - Development of a standardized pulmonary function evaluation program in industry. AB - In industries where there are occupational exposures to dusts, fumes, and gases, employers should monitor periodically their employees' respiratory health, using both spirometric pulmonary function tests and respiratory symptoms questionnaires. To incorporate the recent American Thoracic Society recommendations of standardization in these areas into an industrial pulmonary function evaluation program, a three-day standardized pulmonary function evaluation course was developed by a respiratory epidemiologist with extensive spirometry experience and was offered to many of Alcoa's domestic plant medical departments. The course included spirometric pulmonary function testing and use of the ATS-DLD-78A respiratory symptoms questionnaire. The major points covered in the course, the quality control follow-up of the course, and the need for such a standardized pulmonary function evaluation program in a large company are described in this report. PMID- 6481502 TI - Four-year evaluation of workers exposed to trimellitic anhydride. A brief report. AB - In a four-year clinical, immunologic, and environmental study of trimellitic anhydride (TMA) exposure in a single plant, 20 workers exposed to TMA powder were evaluated in 1979 and a total of 32 workers were evaluated from 1979 to 1983. Two distinct groups emerged before and after workplace control improvements were made in 1979. Seventeen of the original 20 workers were available for longitudinal study through 1983. Annual clinical evaluations and serum radioimmunoassays for total antibody binding and specific IgE binding to 125I TM-HSA (human serum albumin) were performed on all 32 workers. In 1979, six workers had antibody against TM-HSA, three had the late respiratory systemic syndrome, and two had TMA induced allergic rhinitis or allergic rhinitis and asthma. One worker had antibody against TM-HSA without illness. Fifteen additional workers were evaluated longitudinally after institution of several workplace control measures. Four of these 15 workers had TMA exposure prior to environmental improvement and joined the study in 1982. The remaining 11 workers joined the study in 1982 and had at least two years of TMA exposure in the modified workplace. None of these 11 workers developed a TMA-induced immunologic syndrome or significant total or specific IgE antibody binding to 125I TM-HSA. PMID- 6481503 TI - Fetal death and maternal occupation. An analysis of birth records in the State of Washington. PMID- 6481504 TI - A subject index for occupational medical literature. AB - A subject classification system for organizing files of occupational medical literature is described. In the hierarchical system, based on a textbook integrated index, each subject is assigned a numerical code and articles are coded for filing. Computerized management of the file is discussed. PMID- 6481505 TI - Spectral efficiency of blackness induction. AB - The spectral efficiency of blackness induction was measured in three normal trichromatic observers and in one deuteranomalous observer. The psychophysical task was to adjust the radiance of a monochromatic 60-120' annulus until a 45' central broadband field just turned black and its contour became indiscriminable from a dark surrounding gap that separated it from the annulus. The reciprocal of the radiance required to induce blackness with annulus wavelengths between 420 and 680 nm was used to define a spectral-efficiency function for the blackness component of the achromatic process. For each observer, the shape of this blackness-sensitivity function agreed with the spectral-efficiency function based on heterochromatic flicker photometry when measured with the same 60-120' annulus. Both of these functions matched the Commission Internationale de l'Eclairage V lambda function except at short wavelengths. Ancillary measurements showed that the latter difference in sensitivity can be ascribed to nonuniformities of preretinal absorption, since the annular field excluded the central 60' of the fovea. Thus our evidence indicates that, at least to a good first approximation, induced blackness is inversely related to the spectral luminosity function. These findings are consistent with a model that separates the achromatic and the chromatic pathways. PMID- 6481506 TI - Objective technique for the determination of monochromatic aberrations of the human eye. AB - The subjective crossed-cylinder aberroscope method of Howland and Howland [J. Opt. Soc. Am. 67, 1508 (1977)] has been modified by the addition of a beam splitter and a camera to permit direct photographic recording of the distorted retinal image of the aberroscope grid. The ocular aberration can then be deduced from direct measurements of the grid distortion. Preliminary results on 11 subjects confirm earlier findings that comalike, third-order aberrations are more important than spherical or other fourth-order aberrations in degrading the retinal image and for the average subject, the diffraction-limited pupil size is approximately 3 mm. This new objective method for measuring wave aberration yields significantly less variance in population estimates of the coefficients of the wave-aberration polynomial than that of the previous subjective method. PMID- 6481507 TI - Fracture of long bones: rate effects under singular and combined loading states. AB - This study was undertaken to determine the effect of loading rate on bone failure under singular and combined loading states. Using the entire loading range of an Instron Materials Testing Machine, 190 pairs of canine radii were tested. One bone of each pair was subjected to either torsional or a combination of axial and torsional loads, and compared with a control specimen. Compressive loads of 4.6 and 11.5 N were utilized. Torque to failure and energy data versus loading rate were plotted. As loading rate increased, the torque and energy values were found to increase, reach a peak, and then decline at higher rates. Fractures produced under the combined state of loading are representative of those clinically found in human trauma situations. PMID- 6481508 TI - Intrinsic tendon fibroplasia: documentation by in vitro studies. AB - There has been considerable controversy concerning the capacity of tendons to heal intrinsically without adhesion formation. To help clarify this issue, a tissue culture model was developed to study the potential of tendon fibroblasts to proliferate and migrate. Avian flexor tendons, isolated free of sheath and all synovial components, were maintained in sterile culture plates with Dulbecco's Modified Eagle Medium. After 5 days in culture, the 2 mm tendon biopsies were analyzed for DNA synthesis [( 125I])iododeoxyuridine incorporation) and migration of fibroblasts out of the explant (planimeter analysis). DNA synthesis was maximal on day 5 in culture, and tendon fibroblasts were observed migrating from the biopsy within 48 h. Addition of cells from plasma resulted in a significant increase in fibroblast migration, and the presence of fibrin in the plasma clot was an absolute requirement for the migratory process. These findings further support the hypothesis that injured tendons can heal by an intrinsic healing process in addition to healing by adhesion formation. PMID- 6481510 TI - A study of factors influencing muscle activity about the knee joint. AB - Several factors influencing the myoelectric activity of muscles surrounding the knee joint were studied using fine-wire monopolar electrodes. The muscles studied included the vastus lateralis, vastus intermedius, rectus femoris, vastus medialis, gracilis, sartorius, biceps femoris, semimembranosus, semitendinosus, tensor fasciae latae, medial head of the gastrocnemius, and lateral head of the gastrocnemius. Muscle activity was measured in response to unidirectional loads tending to flex and extend the knee, and to combined loads of flexion-adduction, flexion-abduction, extension-adduction, and extension-abduction. Results indicate that the individual muscle responses are dependent upon the direction, magnitude, and combination of external moments, as well as on the flexion angle of the knee joint. Muscle response appeared to be influenced by certain intrinsic mechanical characteristics of the knee joint that tend to change the moment arms of the muscles as the knee moves. For example, the substantial changes in quadriceps myoelectric activity with knee flexion, with constant load applied, can be related to the movement of the tibial-femoral contact changing the lever arm of the quadriceps mechanism. This study indicates that the mechanics of the knee joint must be taken into consideration while attempting to interpret or predict the load response of muscles crossing the knee joint. PMID- 6481509 TI - Tendons and ligaments: a morphological and biochemical comparison. AB - The purpose of this study was to compare selected rabbit tendons and ligaments morphologically and biochemically. Five representative structures from each of six age- and sex-matched rabbits were compared. Biochemical analyses included total collagen, reducible collagen cross-links, quantitative collagen typing, DNA, and glycosaminoglycans. Histological and chemical differences were demonstrated between the tendons and the ligaments. Smaller differences were also found between the individual ligaments (collateral and cruciate) and between the two tendons (patellar and Achilles) that were examined. These findings suggest that ligaments are more metabolically active than tendons, having more plump cellular nuclei, higher DNA content, larger amounts of reducible cross-links, and the presence of more type III collagen, as compared with tendons. They also contain slightly less total collagen than tendons and more glycosaminoglycans. We conclude that the tendons and ligaments studied have unique histological and biochemical characteristics, despite their gross similarities. Relatively increased metabolic activity in ligaments, implied by our findings, may be species specific, age related (transient), or may truly represent a structural expression of functional need for more rapid adaptation. Further investigation of other similarities or differences between particular ligaments (or tendons) is indicated, and attention is directed toward the importance of such variables in development of models for tendon and ligament studies. PMID- 6481511 TI - Joint position sense in total knee arthroplasty. AB - Seventeen postoperative total knee arthroplasty (TKA) patients were evaluated using two tests of knee joint position sense. Young controls and age-matched controls underwent identical tests. The TKA patients also underwent gait analysis, including foot switch stride analysis, and clinical evaluation using a standard scoring system. Results showed statistically significant decreases in joint position sense from young controls to old controls, and further significant decreases with joint disease; however, no further worsening was noted as a result of TKA. The abnormal gait parameters seen in TKA patients correlated as well with position sense as with clinical score. Strongest correlations were seen when a combined clinical and proprioceptive score was compared with gait parameters. In spite of alleviation of pain and correction of deformity, normal gait and function are not typically achieved after total knee replacement. Irreversible loss of joint proprioceptive function due to the disease process may be a major factor in the discrepancy between clinical and functional outcomes of total joint arthroplasty. Furthermore, loss of proprioception and the resulting abnormal gait patterns may place increased stress on components and contribute to loosening. In addition, an association between degenerative joint disease and decline in proprioception is suggested. PMID- 6481512 TI - Long-term measurement of muscle function in the dog hindlimb using a new apparatus. AB - The objective of this study was to develop an apparatus for reliable, reproducible, and minimally invasive measurements of long-term, myoneural function. Twenty conditioned dogs were anesthetized and placed supine with one hindlimb secured in a boot apparatus. The hindpaw was attached to a force transducer that was connected to a recorder for continuous monitoring of torque. Muscles within the anterolateral compartment were stimulated by percutaneous electrodes over the peroneal nerve near the fibular head. This elicited isometric dorsiflexion of the hindpaw. Twitch and tetanic torques correlated positively with dog weight whereas other skeletal-muscle function parameters (time to peak tension, one-half relaxation time, and endurance) were independent of dog weight. Muscle function results were consistent with an overall compartmental composition of 30% Type I and 70% Type II fibers. Repetitive testing of twitch and tetanic torques in the dog legs yielded coefficients of variance of 3-4% (intraday) and 7% (interday). Thus, about one-half of the interday variability may be accounted for by diet, exercise, and other physiological conditions that change daily. The apparatus was also used to detect myoneural degeneration following tourniquet ischemia. The results indicate that this procedure for evaluating muscle function yields reliable and quantitative results noninvasively, and thus allows long-term testing of muscle function in normal and diseased hindlimbs of dogs. PMID- 6481513 TI - Compressive loads in the lumbar vertebral column during normal level walking. AB - The longitudinal compressive load acting on the L3-L4 spinal motion segment was investigated during normal level walking for a range of speeds of progression. Forces were predicted using experimental data from photogrammetric measurements of upper body segmental motion and inertial properties, along with a biomechanical model of the trunk. A partial validation of the results was obtained using records of the electrical activity of the trunk muscles and intradiscal pressure information available in the literature. Experiments were carried out in five normal young male subjects. Results showed that the L3-L4 motion segment is subjected to cyclic compressive loads. The maximum and minimum values of this load vary with walking speed from approximately 1.0 to 2.5 and from 0.8 to 0.2 times body weight, respectively. Relevant peaks occur with a frequency ranging approximately from 1.3 to 2.5 Hz. Muscular action is mostly concentrated in the trunk extensors, which show a burst of activity at the time of ipsilateral toe-off. PMID- 6481514 TI - Articular cartilage deformation following experimental synovitis in the rabbit hip. AB - The development of transient synovitis in the hips of young children occurs quite frequently. This experiment examined the effects of a model synovitis on the deformability of articular cartilage of the immature rabbit hip. At 1, 2, 3, and 4 weeks following synovitis, there was an increase of cartilage deformability on both the acetabular and femoral sides of the joint. This increased deformability may alter force transmission to the underlying bone and its contained vascular structures. PMID- 6481516 TI - Traction therapy in patients with herniated lumbar intervertebral discs. PMID- 6481515 TI - Clinical application of basic research on continuous passive motion for disorders and injuries of synovial joints: a preliminary report of a feasibility study. AB - Since 1970, when the concept of continuous passive motion (CPM) was originated by one of the authors (R.B.S.), he and a succession of his research fellows have investigated its biological effects on the healing and regeneration of articular tissues in a wide variety of experimental models in rabbits. From this basic research he concluded that CPM is well tolerated, seems to be painless, stimulates the healing and regeneration of articular tissues, prevents joint stiffness, and permits the normal healing of arthrotomy incisions. Beginning in 1975, one of the authors (H.W.H.), and in 1978, the remaining authors, (from two additional Canadian cities) applied the knowledge from the basic research on CPM to the orthopaedic care of human patients. The CPM devices for humans (CPM Mobilimbs), which have been designed in collaboration with University of Toronto engineers, include, to date, devices for the ankle-knee-hip, the elbow, and the finger. Indications for CPM in patients have been the immediate postoperative management following such operative procedures as open reduction and internal fixation of fractures, arthrotomy and arthrolysis for post-traumatic arthritis, synovectomy, surgical drainage for septic arthritis, release of extraarticular contractures, metaphyseal osteotomies, total joint replacement, and ligamentous reconstruction. The case reports of nine selected patients are presented as examples of the clinical application of CPM. These patients have been relatively free of pain, have maintained the increased motion gained at operation, and have accepted the application of CPM well. There have been no complications of CPM; the operative wounds have healed well and the period of hospitalization has not been prolonged. The authors believe that the clinical application of CPM is feasible and that the clinical and radiographic results of CPM in these patients are encouraging. Long-term, prospective clinical investigations (including control patients in whom CPM is not used) will be required to assess the efficacy of CPM in relation to the various stated indications. PMID- 6481517 TI - Long time follow-up of patients operated on for sciatica with combined disc removal and spinal fusion. PMID- 6481518 TI - [A factor analysis of tinnitus-related tone--an evaluation of tinnitus based on onomatopoeia]. PMID- 6481519 TI - [Clinical significance of esophageal web in Plummer-Vinson syndrome]. PMID- 6481520 TI - [Osteoma of the temporal bone--a case report]. PMID- 6481522 TI - [Diagnosis of tinnitus]. PMID- 6481521 TI - [Transepiglottic pharyngolaryngotomy]. PMID- 6481523 TI - [Functional roles played by lateral vestibular neurons during controlled locomotion in the mesencephalic cat]. PMID- 6481524 TI - Yorkshire Regional Lymphoma Histopathology panel: analysis of five years' experience. AB - Five years' experience of operating a Regional Lymphoma Histopathology Panel is described. During this period, approximately 1400 cases were registered of which nearly 1200 were confirmed as malignant lymphoma. Complete concordance of diagnosis was achieved between submitting pathologists and the Panel in two thirds of cases of Hodgkin's disease and just over half of non-Hodgkin's lymphoma. Most discrepancies in diagnosis were found to be of clinical importance in terms of prognosis and/or therapeutic management of patients. In approximately two-thirds of such instances disagreement arose because of wrong assignment of tumour grade within the main lymphoma class but in one-third of cases the main class of lymphoma was wrongly designated. Panel members experienced similar diagnostic problems as submitting pathologists although to a lesser extent. The existence of the panel has not reduced the proportion of cases causing diagnostic difficulty for submitting pathologists or panel members during the 5 year study period. The principal cause of death was ascertained from death certificates and autopsy findings in nearly half the cases dying during the study period. In approximately half of these infection (largely pulmonary) played a major role while most of the remainder died of various cardiovascular, pulmonary or renal disorders. There was no specific pattern relating to the main lymphoma class. It is concluded that whilst the panel fulfils a useful function in resolving diagnostic difficulties and standardizing lymphoma diagnosis its role is restricted somewhat by the limitations imposed by conventional morphological assessments. PMID- 6481525 TI - Functional and morphologic studies of the adrenal cortex and kidney in ovine toxaemia of pregnancy. AB - Functional and morphologic studies of the adrenal cortex and kidney have been carried out in pregnant sheep with spontaneous or dietary restriction-induced ovine toxaemia. It was found that proteinuria was an inconstant feature and no animal showed glomerular lesions analogous to those found in human preeclampsia; thus ovine toxaemia cannot be regarded as a precise experimental model for human toxaemia of pregnancy. The elevation of blood cortisol levels and the morphologic appearance of the adrenal zona fasciculata found in such animals suggest an adrenal response comparable to that caused by adrenocorticotrophic hormone. In addition, animals with severe disease showed evidence of stimulation of the renin angiotensin-aldosterone system as reflected by elevated blood renin and aldosterone concentrations and raised renal juxtaglomerular indices. Ultrastructural changes in the adrenal zona glomerulosa and renal juxtaglomerular myoepithelioid cells in toxaemic animals resembled those described in non pregnant sodium-depleted sheep. The finding of juxtaglomerular peripolar cell mitoses and granule exocytosis, the latter only being previously observed in sodium depleted sheep, together with the ultrastructural changes in the adrenal zona glomerulosa and juxtaglomerular myoepithelioid cells, suggest that sodium depletion may play a role in this disease. PMID- 6481526 TI - Cutaneous and pulmonary histopathological responses to platelet activating factor (Paf-acether) in the guinea-pig. AB - The effect of synthetic Paf-acether has been studied in guinea-pig skin, following intradermal injection, and in guinea-pig lung, following intravenous administration. Histopathological responses to Paf-acether were assessed by both light microscopy and electron microscopy. In addition, plasma protein extravasation and platelet accumulation were quantitatively assessed using radiolabelling techniques. Intradermal injection of Paf-acether, but not lyso Paf, elicited acute increased vascular permeability, accompanied by intravascular accumulation of platelets and neutrophils. There was evidence, 2-8 h after intradermal injection of Paf-acether, of perivascular infiltration with neutrophils. At 24 h there was a mixed cellular infiltrate comprising mononuclear cells in addition to neutrophils. Following systemic administration of Paf acether, aggregates of platelets in close association with neutrophils were evident within the pulmonary vasculature. Intravenous injection of Paf-acether, but not lyso-Paf, caused intrathoracic accumulation of radiolabelled platelets. These results suggest that Paf-acether has properties consistent with those of a mediator of inflammation. PMID- 6481527 TI - Ferritin deposition in the glomerular deposits of focal glomerular sclerosis in the rat. AB - The glomerular lesions of focal sclerosis clinically associated with a steroid resistant nephrotic syndrome, are of unknown origin. IgM and C3 deposits and electron dense material found in areas of sclerosis are not convincing evidence of an immune pathogenesis. These deposits have been studied in a rat model of focal sclerosis induced by uninephrectomy and repeated aminonucleoside administration. Sclerotic lesions closely resembling human disease developed in the remaining kidney. There was a severe progressive proteinuria. Seventy-eight days after initial aminonucleoside injection 65 per cent of glomeruli were sclerotic with IgM, IgG, C3 and fibrinogen deposits, and electron dense deposits by electron microscopy. To study macromolecule in this model of focal sclerosis, ferritin uptake 4 and 24 h after intravenous ferritin given at 77 days was compared in focal sclerosis rats with control rats without sclerosis (uninephrectomy plus saline-only injections). In focal sclerosis rats sclerotic areas contained massive accumulations of ferritin. In unaffected segments of sclerotic glomeruli, and normal glomeruli of focal sclerosis rats, ferritin concentration was no different from controls. Abnormal ferritin trapping in areas of sclerosis suggests that the presence of IgM and C3 may be due to a similar mechanism, and is not indicative of an immune pathogenesis for focal sclerosis. PMID- 6481528 TI - Pigmented villonodular synovitis associated with psoriatic polyarthropathy: and electron microscopic and immunocytochemical study. AB - A case of pigmented villonodular synovitis in a patient with psoriatic polyarthropathy was studied by means of light microscopy, electron microscopy and immunocytochemical techniques. The lesion consisted of mononuclear phagocytes with features intermediate between type A and type B cells, two types of multinucleate giant cells, an abnormal vasculature, extravasated fibrin and erythrocytes. An unexpected feature was the presence of a mononuclear cell whose cytoplasm contained intermediate filaments and reacted strongly to antisera to cytokeratins. Such a cell type has not previously been described in this condition and its significance is unclear. The findings support the theory that the pathogenesis of PVNS involves leakage of blood through abnormal vessels resulting in the local accumulation and proliferation of mononuclear phagocytes, connective tissue cells and unidentified cytokeratin positive mononuclear cells. The aetiology of the vascular damage, however, remains unknown. PMID- 6481529 TI - Management of childhood lead poisoning. PMID- 6481530 TI - Myocardial dysfunction in children with acute meningococcemia. AB - Acute meningococcemia is frequently associated with cardiovascular collapse of uncertain cause. Review of the records of 12 consecutive children revealed clinical evidence of myocardial dysfunction in six (50%). Subsequently myocardial function was prospectively assessed clinically and echocardiographically in 12 children. Seven (58%) of the 12 children had echocardiographic evidence of myocardial dysfunction as defined by a depressed left ventricular shortening fraction (LVSF). The mean LVSF in these seven children was 0.25 +/- 0.03, as compared with the mean LVSF of 0.39 +/- 0.7 in the remaining children. The LVSF estimate of myocardial function strongly correlated with cardiac output as measured by standard thermodilution (r = 0.98, P less than 0.01). Acute meningococcemia was not fatal in those children without evidence of myocardial dysfunction. In contrast, three of the seven children with evidence of myocardial dysfunction died. In four children, echocardiographic evidence of left ventricular dysfunction preceded cardiovascular collapse and clinical recognition of myocardial dysfunction. In children with an initially low LVSF, recovery of LVSF was associated with survival. Children with acute meningococcemia may have impaired myocardial function as indicated by depressed LVSF, resulting in low cardiac output despite normal intravascular volume. Thus, in addition to restoring intravascular volume, knowledge of the status of myocardial function may help direct therapy toward optimizing myocardial contractility. PMID- 6481531 TI - Improvement of left ventricular dysfunction after control of persistent tachycardia. AB - Five children are described who had persistent, chronic tachycardia and left ventricular dysfunction manifested by decreased left ventricular percent fractional shortening on echocardiogram (five patients) cardiomegaly on chest roentgenogram (three), ventricular or atrial hypertrophy on ECG (three), and symptoms of congestive heart failure (three). After antidysrhythmia therapy and control of the tachycardia, signs and symptoms of congestive heart failure resolved in two infants. Moreover, in each patient signs of cardiomegaly resolved on chest roentgenogram, hypertrophy resolved on ECG, and the fractional shortening improved to normal (mean 20.2% +/- 2.4% SEM before vs 36.2% +/- 2.4%, P = 0.02, after treatment). Evaluation in the child who has dilated cardiomyopathy should include assessment of heart rate and rhythm. Moreover, when persistent tachycardia is found in an asymptomatic child, evaluation of left ventricular function is indicated. PMID- 6481533 TI - Decline of serum antibody in splenectomized children after vaccination with pneumococcal capsular polysaccharides. AB - Asplenic persons are at increased risk of overwhelming sepsis caused by Streptococcus pneumoniae. Vaccination with polyvalent pneumococcal polysaccharide has been shown to stimulate a nearly normal antibody response in these individuals, indicating that active vaccination might prevent pneumococcal disease in this population. To obtain information on the duration of protective levels of pneumococcal antibody, 33 asplenic children were vaccinated and antibody levels were measured at intervals for up to 4 1/2 years after vaccination. Significant antibody decline was observed in children who had undergone splenectomy because of trauma, but antibody decline was not observed in children whose spleens had been removed because of hereditary spherocytosis. There was a highly significant difference in rates of antibody decline among the 12 antibody serotypes measured: types 1, 4, 6A, 7F, 8, 19F, and 23F showed the greatest decline. Based on measured rates of antibody decline, subprotective antibody levels (antibody nitrogen less than 300 ng/ml) for types 7F, 8, and 19F would be reached 1 to 2 years after vaccination; type 6A never reached the protective level; and antibodies against the remaining eight types either were within the protective range initially or did not show significant decline. Asplenic children may benefit from revaccination with certain antigen types (7F, 8, and 19F) 1 to 2 years after initial vaccination. PMID- 6481532 TI - Congenital pernicious anemia: report of seven patients, with studies of the extended family. AB - Seven children ages 1 1/2 to 12 years with congenital pernicious anemia were detected in an extended Mexican family. All affected children had megaloblastic anemia accompanied by low serum B12 and normal serum folate levels. Gastric fluid analysis in six patients revealed normal gastric acidity and absent intrinsic factor. Serum antibodies to intrinsic factor or parietal cells were also absent. Schilling tests performed in six of the seven patients yielded abnormal results. Of the three patients in whom gastric biopsy was done, two had normal histologic findings (including examination by electron microscopy) and one had mild atrophy. All patients responded rapidly to parenterally administered vitamin B12 therapy. In addition, 170 family members were screened for the defect with complete blood counts and serum B12 levels. Such screening detected pernicious anemia in two of the children, but no other abnormalities that could be attributed to pernicious anemia were found in other family members. Based on the family pedigree, autosomal recessive inheritance is likely. The variability of age of presentation in this family is noteworthy and suggests that expression may be modified by still undefined factors. PMID- 6481534 TI - Vitamin A: a newly recognized human teratogen. Harbinger of things to come? PMID- 6481535 TI - Staphylococcal tracheitis and toxic shock syndrome in a young child. PMID- 6481536 TI - Incidence and duration of lactose malabsorption in children hospitalized with acute enteritis: study in a well-nourished urban population. PMID- 6481537 TI - Pink pearly papules: an epidemiologic study. PMID- 6481538 TI - Relationship of vitamin A (retinol) status to lung disease in the preterm infant. AB - Plasma concentrations of retinol and retinol-binding protein were measured at birth in 91 preterm infants. In 64% of these babies retinol values were less than 20 micrograms/dl, suggestive of vitamin A deficiency. Forty-seven of these infants were observed with sequential measurements of retinol and retinol binding protein through 21 days of age. In babies with respiratory distress syndrome retinol values were similar to those in babies without respiratory distress syndrome. The retinol binding protein levels were lower on the third day of life in babies with respiratory distress syndrome. Babies who developed bronchopulmonary dysplasia had lower concentrations of retinol at birth (P less than 0.05) and on day 21 (P less than 0.05) than did babies who did not develop bronchopulmonary dysplasia, despite receiving recommended intakes of vitamin A. Many preterm infants are deficient in vitamin A at birth, and failure to correct this deficiency may contribute to the development of chronic lung disease. PMID- 6481539 TI - Systemic Candida infections in infants in intensive care nurseries: high incidence of central nervous system involvement. AB - The clinical courses in 27 infants with culture or autopsy evidence of systemic candidiasis were reviewed. Twenty-two infants (group 1) had persistent signs of sepsis and clinical deterioration or died before institution of antifungal therapy. Five infants (group 2) improved markedly before culture results were reported, and recovered without systemic antifungal therapy. Fourteen infants in group 1 (64%) had central nervous system infection. Of four patients in whom CNS involvement was diagnosed only postmortem, antemortem cerebrospinal fluid from three was abnormal despite sterile cultures; no antemortem CSF was obtained in the other. In meningitis caused by susceptible organisms addition of flucytosine sterilized CSF within 5 days, although prior amphotericin monotherapy had been unsuccessful. Of 14 patients in group 1 who received systemic antifungal therapy, only one died with Candida infection. Toxicity from antifungal agents occurred in 11 of 13 successfully treated infants, but was reversible in every case except one by modifying the dosage. Our data indicate that (1) CNS infection is very common in infants with systemic candidiasis, (2) combined flucytosine amphotericin therapy may facilitate treatment of CNS infection and should be the initial therapy for systemic candidiasis in infants, (3) Gram stains of CSF and urine enhance early diagnosis, (4) isolation of Candida from normally sterile body fluids in high-risk infants should be considered pathogenic and therapy initiated unless the clinical course strongly suggests otherwise, and (5) toxicity from antifungal agents is common but usually reversible. PMID- 6481540 TI - Corticosteroid therapy in thrombocytopenic infants of women with autoimmune thrombocytopenia. PMID- 6481541 TI - Neonatal pancytopenia and severe combined immunodeficiency associated with antenatal administration of azathioprine and prednisone. PMID- 6481542 TI - Blood pressure monitoring in neonates: comparison of umbilical and peripheral artery catheter measurements. PMID- 6481543 TI - Continuous naloxone infusion for opiate poisoning in infancy. AB - I report the successful treatment of severe infantile opiate poisoning with continuous naloxone infusions. Two infants, one aged 12 months and the other 3 days, were intoxicated with 100 mg normethadone and 5 mg morphine, respectively. They were given constant infusions of 0.04 and 0.16 mg/kg/hr for 2 1/2 and 5 days, respectively. Continuous naloxone infusion should be considered in the management of severe opiate poisoning. PMID- 6481544 TI - Continuous naloxone infusion in two neonates with septic shock. PMID- 6481545 TI - Primidone therapy in refractory neonatal seizures. PMID- 6481546 TI - Observing child abuse. AB - Evidence from a study conducted at the New York Foundling Hospital and Albert Einstein College of Medicine, as well as previous research by the investigators, shows that abusive mothers are insensitive to the moods and signals of their children. A quantitative analysis of videotaped interaction sequences of 12 mother-child dyads indicated that abusive mothers spend less time looking at their children, are less focused in their attention on them, barrage them with words and actions that are unmodulated by the child's response, are physically coercive, and spend more time issuing directives and orders than mothers from similar backgrounds who do not physically abuse their children. We suggest that child abuse is part of a complex interaction system characterized by lack of mutual attunement between caretaker and child, of which acts of physical violence are dramatic exemplars. These data support the view that in order to ameliorate parenting skills of abusive parents, interactive patterns that appear early in the caretaker-child relationship must be understood and addressed. PMID- 6481547 TI - Panic attack syndrome. AB - Panic attack syndrome in four generations of a family and in six additional pediatric patients is reported. The syndrome appears to have an autosomal dominant mode of inheritance. Diagnosis of panic attack syndrome in children has not been reported previously, but the existence of this disorder has been noted for at least 100 years under various synonyms. There is substantial evidence that the syndrome has an endogenous origin and is therefore a biochemical illness. The triggering effect of sodium lactate infusion and the alleviation of symptoms by use of monoamine oxidase inhibitors or beta-blocking agents support this view. Imipramine hydrochloride, propranolol hydrochloride, phenelzine sulfate, and alprazolam are often useful in the treatment of panic attacks, and except for propranolol, any of them may be effective against depression also. PMID- 6481548 TI - Preliminary report on neurodevelopmental screening in children previously at risk for sudden infant death syndrome. PMID- 6481549 TI - A fascinoma. PMID- 6481550 TI - Erratum: renal clearance of gentamicin in cystic fibrosis. PMID- 6481551 TI - Restoration of complement function by plasma infusion in factor I (C3b inactivator) deficiency. PMID- 6481553 TI - Arterial catheterization in neonates. PMID- 6481552 TI - Consumption coagulopathy after gold therapy for JRA. PMID- 6481555 TI - Digoxin and indomethacin in preterm infants with PDA. PMID- 6481554 TI - Treatment of neonatal passive immune thrombocytopenia. PMID- 6481556 TI - Systemic carnitine deficiency simulating Reye syndrome. PMID- 6481557 TI - Fetal hydantoin syndrome and malignancy. PMID- 6481558 TI - Mean Apgar scores. PMID- 6481559 TI - The developing colon and nutrition. PMID- 6481560 TI - Cryptosporidium and the enteropathy of immune deficiency. PMID- 6481561 TI - Biochemical quantification of crypt hyperplastic villous atrophy by aldolase activity assay. AB - Aldolase activity with the two substrates fructose-1-phosphate and fructose-1,6 diphosphate was measured in the homogenate of small intestinal biopsy specimens from children with different malabsorptive diseases (celiac disease, cow's milk protein intolerance, infectious diarrhea, giardiasis, and Crohn's disease) and controls. It is demonstrated that the ratio of fructose-1,6-diphosphate/fructose 1-phosphate activity, which reflects the relative amounts of the crypt enzyme aldolase A (EC 4.1.2.13) and the villous enzyme aldolase B (EC 4.1.2.7), correlates very well with both the ratio of crypt to villous height (correlation factor r = 0.92) and the mitotic index (r = 0.80). PMID- 6481562 TI - Ultrastructural study of alterations in the small intestinal epithelium of children with acute diarrhea. AB - We studied the ultrastructure of the jejunal epithelium of six children suffering from acute episodes of gastroenteritis. Ultrastructural alterations of the jejunal mucosa occurred in practically all of the fragments analyzed, although the intensity of the abnormalities observed varied considerably. In most of the patients the alterations were confined to the microvilli, which appeared shortened and tufted in comparison with controls. These ultrastructural alterations are nonspecific and may represent a general response of the intestinal mucosa against different noxious agents. Severe alteration of the epithelial cells was observed in only one patient. In this case the cytoplasm contained multiple vacuoles that may correspond to dilated endoplasmic reticulum. It is hypothesized that the small intestinal lesions observed in these patients may allow penetration of food antigens, resulting in the appearance of food intolerance frequently described in children suffering from acute diarrhea. PMID- 6481563 TI - Manometric guidance in suction biopsy of the esophagus in children. AB - Esophageal histological observation is the most reliable indicator of esophagitis. Biopsy specimens obtained by endoscopic grasp forceps are sometimes inadequate for histologic evaluation, and established methods for determining the location of suction biopsies have been imprecise or inconvenient. A method was developed employing manometric control to locate the site of suction biopsies performed with the Quinton multipurpose suction biopsy instrument. With the use of this technique, biopsies were performed in 40 children without failure and without complication. PMID- 6481564 TI - Gastrointestinal transit time and anorectal manometry in children with fecal soiling. AB - Fifty-three children with chronic idiopathic constipation, 32 with fecal soiling and 21 without soiling, were investigated by total gastrointestinal transit time (TGITT) and anorectal manometry (ARM). TGITT and ARM were also performed, respectively, in 46 and 32 healthy subjects. Twenty-two of the 32 children with soiling were successfully managed by medical treatment and toilet training. TGITT was significantly longer in all constipated children than in normal children. Furthermore, some parameters of anorectal motility (threshold volume, amplitude of threshold inhibitory anal reflex) of the patients differed markedly from those measured in controls. Rectal compliance was significantly higher in children with fecal soiling than in children with constipation without soiling and healthy controls. In the successfully treated children, soiling disappeared, TGITT normalized, and anorectal variables changed significantly. It is concluded that TGITT is useful in assessing the degree of constipation. Electromanometry of the anorectum is of great help in the diagnosis of functional constipation by excluding aganglionosis; furthermore, it provides additional information allowing better understanding of the mechanisms involved in functional constipation in children. PMID- 6481565 TI - Clinical manifestations of congenital syphilitic hepatitis: implications for pathogenesis. AB - To study the clinical course and biochemical features of congenital syphilitic hepatitis, the records of all 22 pediatric patients admitted to North Carolina Memorial Hospital between 1969 and 1979 with a positive maternal, cord blood, or serum VDRL were reviewed. Of the seven infants identified with symptomatic congenital syphilis, five had clinical and biochemical evidence of liver dysfunction. All five were jaundiced (peak bilirubin ranged from 8.4 to 29.8 mg/dl, in each case greater than 40% conjugated). Peak transaminase elevation ranged from seven to 150 times normal. Serum glutamic-oxaloacetic transaminase exceeded serum glutamic-pyruvic transaminase in each infant, the difference ranging to 7,400 U. The onset of illness did not occur until after treatment had been initiated in two of these five cases. Liver dysfunction increased with treatment in all four infants with serial enzyme determinations. Liver dysfunction also persisted for more than 6 weeks after adequate treatment in two cases. Liver biopsy 5 weeks after treatment in another infant showed giant cell hepatitis. These observations suggest that treatment can potentiate liver dysfunction in congenital syphilis and that viable treponemes are not necessarily essential in the pathogenesis of the hepatitis. PMID- 6481566 TI - Bile acid malabsorption in cystic fibrosis with and without pancreatic insufficiency. AB - Serum conjugated cholic acid (CCA) and conjugated chenodeoxycholic acid (CCDCA) fasting levels were measured in 30 children with cystic fibrosis (CF) without liver involvement, and mean levels were not significantly different from control values. In seven children (four with partially corrected pancreatic insufficiency and three without pancreatic insufficiency) serum levels of both primary bile acids (BAs) were also measured after the ingestion of a standard liquid meal; the values were then compared with those for total and fractional fecal BA excretion. The CCA mean peak increase was significantly reduced in patients with pancreatic insufficiency (p less than 0.01), as well as in those without pancreatic insufficiency (p less than 0.05), as compared to controls. The CCDCA mean peak increase was reduced only in patients with pancreatic insufficiency (p less than 0.01). Fecal results confirmed serum data, showing a significantly increased excretion of cholic and deoxycholic acids in patients without pancreatic insufficiency as compared to controls (p less than 0.02), despite a similar total BA excretion. In patients with pancreatic insufficiency, total fecal BA levels were markedly increased compared to control values (p less than 0.001); the fecal percentage of chenodeoxycholic and lithocholic acids was greater than that recorded in patients without pancreatic insufficiency (p less than 0.05), in agreement with the different behaviour of serum CCDCA postprandial curves for the two groups of patients. The results are consistent with selective malabsorption of cholic acid in CF, independent of the presence of pancreatic insufficiency; they confirm the usefulness of serum BA postprandial determinations in measuring BA malabsorption. PMID- 6481567 TI - Effect of temperature and length of storage on serum-stimulated and serum independent lipolytic activities in human milk. AB - Milk was collected from five mothers. Upon collection, serum-stimulated and serum independent lipolytic activities were determined. The milk samples were aliquoted and stored at 25, 4, -20, and -70 degrees C. After storage for 3, 6, 12, and 24 h, serum-stimulated and -independent activities were again determined and compared with the initial activities. Storage at 25 degrees C resulted in a significant (p less than 0.05) decrease in lipolytic activity. Serum-stimulated activity decreased 83.4% and serum-independent activity decreased 66.9% over the 24-h period. Storage at 4 degrees C resulted in a significant (p less than 0.05) decrease of 22.6% in serum-stimulated activity and a 7.2% decrease in serum independent activity. No significant changes were observed in milk stored for 24 h at -20 and -70 degrees C. Milk was stored at -20 and -70 degrees C for an additional 1, 2, and 4 weeks. Serum-stimulated lipolysis did not change significantly over the 4-week period. Serum-independent lipolysis increased significantly (p less than 0.05) with storage time. Storage at -20 degrees C resulted in an increase of 20% and storage at -70 degrees C resulted in an increase of 36% over the 4 weeks. PMID- 6481568 TI - Measurement of milk yield in the lactating rat from pup weight and weight gain. AB - A new method was developed that enables milk yield to be estimated from pup weight and pup weight gain in well-nourished rats. Daily milk yield, body weight, and daily weight gain were measured over 4-5-day periods in 38 suckling pups aged 3-13 days postpartum. Each 24-h period was divided into consecutive 6-h cycles, during which dams and pups were separated for 4 h and then reunited for 2-h suckling intervals. Daily milk yield per pup was calculated from pup weight gain during the four suckling intervals for each 24-h period, and corrected for insensible weight loss of the pups. The following equation, relating pup milk yield to pup weight and weight gain, was obtained by stepwise forward multiple regression analysis: yield = 0.0322 + 0.0667 (weight) + 0.877 (gain); where yield is daily yield per pup (g/pup/day), weight is pup weight (g), and gain is pup weight gain per day (g/day) (n = 174; F = 552.3; p less than 0.001; r2 = 0.866). Per litter milk yield can be obtained by multiplying per pup yield by litter size. Using this equation, dams fed a stock diet and nursing eight pups were estimated to have produced 29.5 ml of milk on day 10 of lactation. This value is similar to yields measured by more laborious methods. SEs of yield estimates calculated with this method represent 1-3% of predicted yield values. The new method gives useful estimates of rat milk yield during the first 2 weeks of lactation from measurements that are more easily obtained than is the case with other methods. PMID- 6481569 TI - Manometric demonstration of aberrant right subclavian artery associated with dysphagia. AB - An aberrant right subclavian artery was associated with unusual manometric findings in a 2-year-old girl with dysphagia. Awareness of this entity and its manometric characterization are useful for physicians evaluating patients with dysphagia. PMID- 6481570 TI - Small bowel obstruction in chronic granulomatous disease. AB - Intestinal obstruction, enteritis, and colitis have been reported in patients with previously documented chronic granulomatous disease (CGD). We describe here an 11-year-old boy whose initial presentation was compatible with inflammatory bowel disease. A mild but persistent dermatitis was his only other manifestation of CGD. PMID- 6481571 TI - Extended intestinal aganglionosis in siblings. AB - In this paper we report two cases of extended intestinal aganglionosis in siblings, a condition that could be considered a severe variety of Hirschsprung's disease. PMID- 6481572 TI - The possible adverse effect of the use of aluminum hydroxide in chronic diarrhea. PMID- 6481573 TI - Fetal surgery in the primate II. Uterine electromyographic response to operative procedures and pharmacologic agents. AB - Preterm labor and late gestation fetal loss remain significant barriers to clinical fetal surgery. To investigate the response of the gravid uterus to anesthetic and tocolytic agents and surgical procedures, 27 chair-restrained pregnant rhesus monkeys from 123 to 152 days gestation (term 168 days) underwent implantation of electrodes to monitor uterine electromyographic (EMG) activity. Seven had electrodes placed at the time of hysterotomy for placement of intraamniotic pressure catheters, without disturbing the fetus; 12 at the time of hysterotomy for placement of fetal carotid and jugular catheters. Eight had electrodes placed as an initial procedure to study the uterine EMG response to one or more of the following procedures performed subsequently: amniocentesis, maternal laparotomy without uterine manipulations, hysterotomy without fetal surgery, and hysterotomy with fetal surgery. A total of 43 procedures was performed. Preterm labor and delivery were induced in 1 of 15 (6.7%) monkeys who underwent procedures with minimal uterine manipulation (electrode placement, amniocentesis, and maternal laparotomy), in 3 of 8 (38%) monkeys who had hysterotomies without fetal surgery, and in 11 of 20 (55%) monkeys who had hysterotomies with fetal manipulation. The difference between those undergoing minimal uterine manipulation and those undergoing hysterotomy (with and without fetal surgery; fetal loss in 14 of 28, 50%) is statistically significant (P = 0.01). In animals undergoing hysterotomy, frequent coordinated contractions (type I EMG pattern) emerged as the animal awoke. The uterine activity was inhibited by halothane anesthesia, but not by either preoperative indomethacin or postoperative ritodrine infusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481574 TI - The effect of chick embryo hyperflexion on tracheoesophageal development. AB - Chick embryos were hyperflexed by placement of a ligature at two critical stages in the development of the foregut, in order to test the theory that esophageal atresia and tracheoesophageal fistula result from embryonic hyperflexion. Only one "H-type" tracheoesophageal fistula was found. There were no significant disturbances of either tracheal or esophageal growth. PMID- 6481575 TI - The fate of the grafted quail Mullerian duct in the chick embryonic coelom. AB - Recent morphological analyses of Mullerian duct regression suggested that some ductal cells might survive, in contrast to the previous view that regression was an example of "programmed cell death." The present study was designed to demonstrate survival of Mullerian duct cells after regression, and to map migration into local or distant tissues. Seven or eight-day-old chick embryos received intraabdominal grafts of Mullerian ducts from seven- or eight-day-old quails, creating chick-quail chimeras. Three or four days later the abdomen was serially sectioned and examined histologically using a modified Feulgen stain. Sixty-six of the 230 grafted embryos survived (29%). After sectioning, grafts were found in 34 of the 58 embryos in the body wall, peritoneum or mesenephros, with several adherent to the hosts' Mullerian ducts. Twenty female embryos contained grafts, all of which were developing normally. Fourteen male embryos contained grafts in various stages of regression. Regression was more advanced in mesonephric or body wall grafts while free intraperitoneal grafts showed the least regression. Migration of quail cells was striking when seen in grafts placed in the mesonephros or adherent to the host Mullerian duct. In these, regressing quail cells migrated into and became incorporated in adjacent chick mesenephros. Migration patterns were seen also in non-regressing cells in female hosts, where quail cells "homed" to the host chick Mullerian duct structures. PMID- 6481576 TI - Cryotherapy of subglottic hemangioma. AB - The natural history of the hemangioma is spontaneous regression; therefore, most lesions require no treatment. The large occlusive subglottic hemangioma which presents before the age of 6 months, however, may be life-threatening. Two infants with subglottic hemangiomas with complete upper airway obstruction were treated successfully with cryotherapy, after tracheostomy. In each case the cryoprobe was placed transbronchoscopically on the subglottic hemangioma at -80 degrees C. for 30 to 45 seconds, the freezing interval varying with the age of the patient. One infant is asymptomatic and has had the tracheostomy tube removed. The other infant, after successful cryosurgical treatment, died from an unrelated illness. The histopathology of the larynx 3 1/2 months after cryotherapy of the hemangioma showed tracheal reepithelialization, active regeneration of cartilage with maintenance of luminal diameter, minimal submucosal fibrosis, and minimal residual hemangioma. Cryotherapy for subglottic hemangiomas offers many advantages including hemostasis, controlled local surgical injury, subsequent rapid healing of tissues with minimal fibrosis, and preservation of lumen without stricture. Previous forms of therapy which have been supplanted include radiotherapy, injection of sclerosing substances, systemic steroids, and surgical excision. Carbon dioxide laser is an effective therapeutic modality that we reserve for selected smaller hemangiomatis lesions of the subglottic area. PMID- 6481577 TI - Staphylococcus epidermidis sepsis in pediatric patients: clinical and therapeutic considerations. AB - This report concerns 60 children with documented Staphylococcus epidermidis sepsis. There were 34 boys and 26 girls, ages 2 weeks to 15 years. The primary diagnosis included malignancy (13), congenital (13) or acquired (11) gastrointestinal disorders, prematurity (7), cardiac defect (5), hydrocephalus (2) and miscellaneous (9). Clinical presentation included fever (54), tachycardia (15), lethargy (20), hypotension (8), irritability (6), increased gastric residuals (6) and apnea/bradycardia (3). A documented source of sepsis was noted in 56 patients, including percutaneous central venous catheters (23), Broviac catheters (17), umbilical arterial catheters (6), wound (3), V-P shunt (2), cardiac defect (2), cholangitis (1), chest tube (1) and peripheral arterial line (1). There were six sepsis-related deaths, four in premature infants. Two of six infected subclavian catheters were treated successfully with vancomycin. Infection was successfully cleared in 20 of 23 infected Broviac catheters with vancomycin through the line. However, six were eventually removed for tract infection (1), persistent fever (2), and Candida sp. infection (3). Although once considered a non-pathogenic skin contaminant, S. epidermidis has emerged as a serious pathogen in hospitalized, immunosuppressed, premature and malnourished pediatric patients. Indwelling catheters enhance the likelihood of infection in these patients. Aggressive antimicrobial therapy is vital in this potentially lethal infection. Vancomycin proved efficacious in this series. PMID- 6481578 TI - Laboratory basis for the medical management of necrotizing enterocolitis (NEC). AB - Necrotizing enterocolitis (NEC) is a serious condition affecting the neonate that may be responsive to medical management. This study evaluates the efficacy of supplemental oxygen (FiO2 40% and 50%), systemic antibiotics (ampicillin and gentamicin, cephamandole) and oral antibiotics (trimethoprim-sulfamethoxazole, neomycin and gentamicin) in a weanling rat bowel ischemia model induced by a transient (one minute) occlusion of the superior mesenteric artery. Animals were evaluated for overall survival, duration of survival, presence of bowel necrosis or perforation at seven days. Mortality in ischemic controls was 83.8%. This was reduced to 52% by FiO2 of 50%, and 40% with systemic ampicillin and gentamicin (with or without FiO2 50%) (P less than .001). Length of survival was 3.4 days in controls and increased from 5.4 to 5.9 days in rats given FiO2 50% and/or ampicillin and gentamicin (P less than .001). The incidence of bowel necrosis in controls was 60% and was reduced to 25% in rats given systemic ampicillin and gentamicin and 23.3% with 50% FiO2 and the same antibiotics (P less than .001). Systemic cephamandole and oral antibiotics had no beneficial effects. PMID- 6481579 TI - The "critical" neonate with diaphragmatic hernia: a 21-year perspective. AB - We have seen a modest improvement in the survival of a homogeneous group of critically ill newborns with congenital diaphragmatic hernia since 1979. Twenty seven "critical" infants have been treated who developed respiratory distress shortly after birth, required urgent resuscitation, and could not be stabilized before operation. Two died with other anomalies that appeared incompatible with prolonged survival. Ten of the 27 lived. This survival contrasts with that of only two of 17 similarly affected babies treated from 1962 to 1978. In addition, there has been no operative mortality outside of this "critical" group since 1979; whereas six noncritical babies died between 1967 to 1978. Our current therapeutic plan includes the early establishment of a respiratory alkalosis and vasodilator therapy before or during transport. Postoperatively we have attempted to maintain the baby's arterial pH greater than 7.5, Pco2 less than 25 to 30 and the PO2 approximately 150 torr. The most effective ventilatory parameters have been a rate of 130, PEEP of 5 and an inspiratory:expiratory ratio of 1:1. Peak airway pressures are kept as low as possible. Pharmacologic and ventilator therapy are weaned slowly, and intensive support has been required for at least 48 hours in each baby. Retained secretions and atelectasis of the hypoplastic lung persisted for two to several weeks postoperatively. Two babies that are one year or older still appear to have severely hypoplastic lungs on chest x-ray. M mode echocardiography has been used to measure ventricular ejection periods. The right ventricular systolic time interval correlates with the degree of pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481580 TI - Hirschsprung's disease in the newborn. AB - Hirschsprung's disease has become a more common cause of newborn intestinal obstruction in the past 30 years. In a group of 137 newborns with intestinal obstruction the most common diagnosis was necrotizing enterocolitis. The second most common cause, however, was Hirschsprung's disease. We have reviewed 26 infants with aganglionosis who presented at 32 days of age or less between 1972 and 1978. The average age at presentation was 8.3 days. There were 21 males and five females. Five infants had long-segment or total colonic disease. There was only one premature infant (34 weeks, 1840 g). The mean birthweight in the series was 3.6 kg. Six children had a family history of a congenital anomaly (23%). Three of these had a family history of Hirschsprung's disease (12%). Nine infants (35%) had associated congenital anomalies. Four of these newborns had Down's syndrome, and all four had a cardiac anomaly as well. Fifteen newborns presented with emesis (58%) which was bilious in nine (35%) cases. Seventeen babies (65%) had abdominal distension at the time of presentation. Eleven infants passed a meconium stool by 24 hours of age (42%), and 15 had passed meconium by 48 hours (58%). Twenty-two of 24 (92%) barium enema examinations available prior to diagnosis were diagnostic of Hirschsprung's disease. All of the 23 suction rectal biopsies were positive. All 26 patients underwent a colostomy or ileostomy following diagnosis. There was no enterocolitis and no mortality. All 26 patients have had an endorectal pullthrough performed at a mean age of 11.8 months without major complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481581 TI - Surgery of acquired lobar emphysema in the neonate. AB - Surgical treatment for pulmonary interstitial emphysema (PIE) has been reported with increasing frequency. We have done pulmonary lobectomies in 14 neonates with the localized form of PIE. This type of treatment was successful in 11 patients. Two patients expired in the hospital and one showed no improvement. Another six very compromised patients with diffuse PIE were treated during the same period with multiple visceral pleurotomies. Only one survived. Infants with diffuse PIE are usually poor surgical candidates, while those with acquired lobar emphysema (ALE) have been treated successfully with lobectomies. PMID- 6481583 TI - Total parathyroidectomy and autotransplantation for tertiary hyperparathyroidism in children with chronic renal failure. AB - An association between chronic renal failure and skeletal deformities in the adolescent patient was first documented by Lucas in 1883. Since then it has been established that the kidneys play a major role in the regulation of calcium, phosphate, and parathyroid hormone, and that chronic renal failure is characterized by profound alterations in the normal metabolic homeostasis of the human body. With the hyperphosphatemia of uremia, compensatory hyperparathyroidism is also a well known complication. Due to these factors, loss of normal renal function ultimately leads to derangement in mineral and bone metabolism resulting in severe skeletal deformities. Reports in the English literature suggest that the changes of renal osteodystrophy are much more pronounced in the pediatric patient, as compared to those in the adult. In the last two decades, renal transplantation has come to be recognized as a satisfactory modality for controlling renal failure and its complications. This procedure is often not available as an option, however, in small patients, especially those under three years of age. The pediatric nephrologist is often forced to manage these patients for long periods with conservative therapy, in an attempt to control the ravages of renal osteodystrophy. The problem becomes unmanageable when the compensatory hyperparathyroidism proceeds to autonomy. When this occurs, despite maintenance of normal serum calcium levels, the renal osteodystrophy progresses rapidly, producing pain, deformities and growth retardation. At this point, the condition is often refractory to medical management and resection of parathyroid tissue remains the only satisfactory modality for control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481582 TI - The decreasing incidence of pneumothorax and improving survival of infants with congenital diaphragmatic hernia. AB - In the 6-year period between 1977 and 1982 inclusive, 75 newborn infants with congenital diaphragmatic hernia of Bochdelek underwent corrective surgery during the first 24 hours of life. A total of 40 infants (53%) survived. Beginning in January 1980, a standardized approach to care including early use of mechanical ventilation and paralysis with pancuronium as well as dopamine use prior to any Priscoline infusion, was instituted. To determine whether these approaches improved outcome, term infants without malformations from the years 1977 to 1979 were compared with a similar group treated after institution of standardized care between 1980 and 1982 inclusive. The infants were comparable in all respects, but survival improved from 45% to 82% between the two periods (P less than 0.03). There was an associated decrease in the incidence of pneumothorax (45% in first period; 14% in second period) paralleled by a concomitant increase in pancuronium use (18% and 85%, respectively). Although factors responsible for the improved survival are multifactorial these data indicate the detrimental effect of pneumothorax on outcome and the beneficial effect of a standardized approach to care using conventional intensive care techniques. PMID- 6481584 TI - Morgagni hernias during infancy: presentation and associated anomalies. AB - Morgagni hernias during infancy are associated with significant respiratory symptoms as well as other congenital anomalies, particularly congenital heart disease. During the past 6 years we have had the opportunity to treat five infants less than 1 year of age with Morgagni hernias. A review of the literature revealed an additional seventeen detailed case reports of infants with Morgagni hernias. Each of our patients was symptomatic as were all but two of those previously reported. These patients presented with tachypnea, dyspnea, and cyanosis which was very similar to the presentation of Bochdalek hernias seen during infancy. Thirteen of 16 patients in whom detailed descriptions of associated anomalies were given including four of our own patients, had significant congenital anomalies. Nine involved the heart, including three infants with dextracardia, three with ventricular septal defects, and two with anomalous pulmonary venous return. Five infants were retarded, including three with Trisomy 21. Two of the previously reported patients had large omphaloceles and other stigmata of Cantrell's syndrome. All but one of the patients reported, including ours, had a hernia sac. The liver, colon, and small bowel were most commonly found in the hernia sac; however, the presence of the stomach and spleen have been reported. While both the transabdominal and transthoracic approaches to Morgagni hernias have been advocated and, indeed, repair of the defect can be accomplished through both approaches, the transthoracic approach allows better exposure of incarcerated viscera, particularly the frequently found anomalous left lobe of the liver. PMID- 6481585 TI - The effect of intrauterine esophageal ligation on growth of fetal rabbits. AB - Babies with pure esophageal or duodenal atresia weight less than normal babies at birth. Whether this is due to the obstruction to fetal swallowing or some other cause is not known. To determine how intrauterine interruption of swallowing affects fetal growth, we developed a model of esophageal atresia in the fetal rabbit. Twenty-five time-mated rabbits at 24 days gestation were anesthetized with halothane and ketamine. The uterus was exposed through a midline abdominal incision. The head and neck of the fetus in the distal end of one horn were isolated through a 2-cm hysterotomy. Biparietal diameter (BPD) was measured and the esophagus was isolated and ligated through a midline cervical incision. The fetus in the distal end of the opposite horn underwent sham operation. Four days later, cesarean section was done. The newborn rabbits were weighed, and crown/rump length and BPD were measured. Ligation of the esophagus was confirmed by re-exploration of the neck. Three does died under anesthesia and two aborted. From the remaining 20, 156 fetuses were recovered, of which 135 were alive. One set of operated fetuses was dead, leaving 19 pairs for analysis. There was a statistically significant reduction in weight gain (31.7 +/- 1.3 g to 29.1 +/- 0.9 g, P less than 0.05) following interruption of the esophagus but linear growth was unchanged. Obstruction to normal fetal swallowing may account for the low birth weight with normal head circumference reported in babies with esophageal and duodenal atresia. PMID- 6481586 TI - Management of obstructive tracheal disease in children. AB - Fifty-two patients from seven weeks to 15 years of age were treated for congenital (six patients) or acquired (46 patients) tracheal lesions. Twenty underwent tracheal resection and reconstruction: congenital stenosis 3 (5 to 9 yr), postintubation stenosis 9 (11 to 15 yr), TEF 1 (15 yr), posttraumatic 2 (9 to 15 yr) idiopathic 1 (14 yr) and primary tumors 4 (8 to 15 yr). There were two carinal resections. There were two deaths and two postoperative stenoses, one of which was corrected later, giving 17 final good results. Thirty-two patients were treated nonoperatively. PMID- 6481587 TI - A summary of preoperative and postoperative cardiorespiratory performance in patients undergoing pectus excavatum and carinatum repair. AB - Preoperative and postoperative pulmonary function tests and progressive work exercise performances were compared for fourteen pectus excavatum and five pectus carinatum patients who underwent operative repair. No changes could be documented in the pectus carinatum patients. The excavatum patients demonstrated a small improvement in total lung capacity (P less than .02) and a significant improvement in maximal voluntary ventilation (P less than .001). In addition, the exercise performances were improved for the excavatum patients postoperatively as quantitated both by the total exercise time and the maximal oxygen consumption (P less than .01). In addition, at any given work rate, the excavatum patient demonstrated a lower heart rate and higher minute ventilation after operation. These findings support the hypothesis that both the restricted cardiac stroke volume and the increased work of breathing that have been described in pectus excavatum patients can be ameliorated by operative intervention. PMID- 6481588 TI - Surgical complications in Henoch-Schonlein Purpura. AB - Intestinal intussusception, perforation, and infarction constitute the major surgical complications in Henoch-Schonlein Purpura (HSP). This report reviews the surgical experience in 13 patients of the 58 treated for HSP at our institution in the past 10 years. In addition, the reported surgical cases of anaphylactoid purpura in the pediatric age are analyzed. Attention is focused on observations not previously emphasized in regard to the timing of the surgical event in relation to the cutaneous manifestation of HSP. PMID- 6481589 TI - The problem of recurrent thyroglossal duct remnants. AB - The removal of a thyroglossal duct or sinus is a common pediatric surgical operation. It has been taught that if the duct remnant is removed down to and including the middle third of the hyoid bone, the "correct" operation has been done. The three authors have an experience totaling over 60 years in pediatric surgery during which time they operated on 270 thyroglossal duct cysts and sinuses. In this group were 27 recurrences of which three belonged to the authors. Most recurrent thyroglossal duct remnants were found to have the middle third of the hyoid bone still in place, and with its removal the patients were cured. However, during this period of time, there were thyroglossal duct cysts and sinuses which recurred in spite of the "correct" surgical procedure having been done. These patients had all been operated on between three and five times thus creating a difficult and unusual problem. The solution to these recurrent thyroglossal duct cysts and sinuses were deeper excisions to remove residual tracts deep to the previously removed hyoid bone, and/or wider excisions to excise previously missed respiratory epithelial remnants which deviated laterally from the midline. The latter tissue was found to be a more centrally directed branchial cleft sinus. PMID- 6481590 TI - Reconstruction of the microtic ear. AB - Although microtia occurs in only 1:7000 to 8000 births, this major congenital ear deformity can result in significant psychological trauma for the affected child. Reconstruction of this complex deformity represents one of the greatest challenges to the reconstructive surgeon. Based on the pioneering work of Tanzer and Brent, the techniques have matured to the point that consistently good results can be obtained and many of the resultant problems associated with the deformity avoided. In classic microtia, a sausage-shaped vestige is made up of a rudimentary lobule and various additional remnants. The external canal is usually absent. Where hearing is normal in the opposite ear, it is not necessary to reconstruct the middle ear or external canal on the affected side, and these procedures may compromise the result of the external ear reconstruction. The staged reconstruction of the microtic ear, which can begin at 5 years of age, involves: placement of an autogenous cartilage framework; rotation of the lobule, formation of a conchal depression and tragal reconstruction; limited elevation of the helical rim; and minor final adjustments. The cartilage is placed during the first stage to make maximal use of the non-scarred elastic skin in the area of the skin pocket. This allows better splicing of the lobule in the second stage. The use of a very thin skin flap over the framework allows heightened definition of cartilage detail, better skin-cartilage coaptation, and at appears to play a vital role in preventing late deformation of the cartilage framework.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481591 TI - Indications and techniques of upper gastrointestinal endoscopy in infants and children. AB - Review of 98 endoscopies done over a 4-year period demonstrated that these procedures aided in the diagnosis and management of infants and children with upper gastrointestinal disorders. Endoscopic indications included evaluation of the esophagus in gastroesophageal reflux, achlasia, and lye ingestion; and evaluation of biliary and pancreatic diseases. Other indications included diagnosis of the site of upper gastrointestinal bleeding and treatment of esophageal varices with sclerotherapy, esophageal strictures with steroid injection and removal of foreign bodies. The majority of the procedures were done under sedation. There were no complications. PMID- 6481592 TI - Symptomatic gastroduodenal pancreatic rest in children. AB - Since 1979 nine children have undergone excision of gastroduodenal pancreatic rest. In three, these lesions were incidental findings at the time of unrelated surgery. The remaining six underwent resection for relief of abdominal symptoms. There were four boys and two girls. The ages ranged from 4 months to 13 years. Symptoms were directly related to age. Three children (6 months, 8 months and 4 years) were admitted for recalcitrant post-prandial vomiting. The remaining three (11, 12, and 13 years) were hospitalized for chronic midabdominal pain. Contrast radiographic studies were normal in three. An antral filling defect was noted in one and edematous proximal duodenum with poor peristalsis in the remaining child. Endoscopic examination and biopsy documented pancreatic rest in all six cases. All were located in the immediate vicinity of the pylorus. The size ranged from 0.5 to 2 cm in diameter. Each child subsequently underwent excision with relief of symptoms. Pancreatic rest is functioning pancreas. Its presence in the prepyloric region may incite pylorospasm, delayed emptying and gastric distention and become clinically apparent with vomiting and/or abdominal pain. Documentation of gastroduodenal pancreatic rest in the symptomatic child with an otherwise normal evaluation may warrant excision. PMID- 6481593 TI - Selective denervation of the S-A node in the treatment of progressive central vagal bradycardia. AB - The condition of central hypervagism and central vagal bradycardia, up to now, have been largely overlooked. Selective surgical vagal denervation of the SA node for progressive central and local episodic reflex arc bradycardia, via right thoracotomy, is a well-tolerated procedure even in the debilitated child. The bradycardia must, of course, be atropine-responsive. It appears to be a valuable alternative to pacemakers, especially because of the necessity of using the sequential type in this form of heart block. Our follow-ups are from 8 months to 13 years in seven children (five central and two peripheral). Up to now, in an admittedly small series, there has been only one recurrence of bradycardia. This was from crossover left vagal innervation of the SA node. The incidence of this is 10% to 15%. It responded to right cervical vagotomy, following a preliminary diagnostic novocain block. We hope that these findings may lead to more awareness and investigations of conditions due to autonomic dysfunction--both central and peripheral--which may help among other conditions in the elucidation and prevention of sudden infant death syndrome (SIDS) and other related problems, and that this surgical approach will be a definitive means for the control of refractory, persistent, or recurrent vagal bradycardia. PMID- 6481594 TI - Blunt hepatic injury and elevated hepatic enzymes: a clinical correlation in children. AB - During a recent prospective nonrandomized comparison of noninvasive imaging techniques in 100 children with suspected major blunt abdominal injury, an interesting subset of patients was defined. Of 95 hemodynamically stable patients, 44 were found to have immediate elevation of hepatic enzymes (SGOT, SGPT greater than 30 IU). Nineteen of these children (43%) were subsequently shown to have significant liver injuries. No child with a liver injury had normal enzymes on admission. The level of enzyme elevation (SGOT chi 890 +/- 142 IU, SGPT chi 536 +/- 105 IU) in those with liver injuries is significantly greater than those without injury (SGOT chi 273 +/- 44 IU, SGPT chi 115 +/- 19 IU) (P less than or equal to 0.0001 SGOT. P less than or equal to 0.0001 SGPT). Our study has allowed definition of a group of children who are at significant risk for liver injury based on immediately available serum determinations of GOT and GPT. We have begun to use this information in our institution to select children for further noninvasive imaging. We recommend that these studies be obtained emergently in all children with suspected upper abdominal trauma. PMID- 6481595 TI - In biliary atresia duct histology correlates with bile flow. AB - Three basic types of microscopic biliary structures at the portahepatis were distinguishable in infants with biliary atresia: bile ducts, collecting ductules of biliary glands, and biliary glands. Correlation between the type of biliary structure and the quantity and quality of post-operative bile flow was possible in 23 instances. At 2 weeks after operation, the 11 patients in whom a bile duct was identified had a daily bile flow of 68.0 +/- 11.5 mL. Bilirubin concentration in the bile was 13.6 +/- 3.3 mg/dL and total daily bilirubin excretion was 8.77 +/- 2.74 mg. In contrast, bile flow in 12 patients having only collecting ductules and/or biliary glands in the porta hepatis was 19.1 +/- 3.9 mL and bilirubin concentration in bile was 1.7 +/- 0.3 mg/dL. Thus, total daily bilirubin excretion was 0.34 +/- 0.08 mg (P less than 0.001). Postoperative cholangitis occurred only in patients with ducts. It is concluded that only bile ducts communicate with the intrahepatic biliary system and drain bile after hepatic portoenterostomy. PMID- 6481596 TI - Stimulation of bile output by gastrointestinal hormones following portoenterostomy for biliary atresia. AB - For biliary atresia portoenterostomy with externally draining conduit provides a model for quantitation of hepatic excretory function and for assessment of the physiologic response of the intrahepatic biliary system to gastrointestinal hormones in a human hepatopathologic condition. Four patients with biliary atresia were serially evaluated from 2 weeks to 43 months following total bile diverting portoenterostomy. A fifth patient with no bile flow provided a control for these studies. The pattern of Rose Bengal excretion for three patients with a satisfactory clinical course was different from that of a fourth patient with highly variable flow and persistent cholestasis. Marked volume and bicarbonate concentration increases in bile were noted 30 to 45 minutes after secretin infusion but only in the four patients with bile flow. The volume response to glucagon was more diffuse. Bilirubin and bile acid concentrations decreased in the stimulated bile flow periods and hourly outputs of these cholephils were not increased above basal. During two intervals of low bile output, secretin markedly increased bile flow in the patient with persistent cholestasis establishing the patency of the hepatoenteric anastomosis (functional obstruction) in contrast to the lack of secretin response in the control (structural obstruction). PMID- 6481597 TI - The Thal fundoplication for gastroesophageal reflux. AB - The technique of anterior fundoplication for gastroesophageal reflux originally described by Alan Thal has been used in our institution in 605 patients. The description of the technique is the purpose of this paper. A brief description of the results in these 605 patients are also presented. PMID- 6481598 TI - One last response to the Rorschach test: a second chance to reveal oneself. AB - This paper explores a technical procedure, that of asking for one more response after the patient has given response(s) to Card X of the Rorschach. This "one last response" in the context of "ending" is discussed. Endings have many meanings but the ending of the Rorschach can be more than just a relief to the weary patient and/or tester who may have been experiencing the disquieting inner workings of the patient's unconscious. The ending of the Rorschach with the additional "one last response" can be the source of valuable clinical questions and inferences applicable to treatment. PMID- 6481599 TI - The Rorschach H response and object relations. AB - Developmental theory, cognitive psychology, and object relations theory now offer a general conceptual framework for integrating diverse research findings on the Rorschach human response and for highlighting the developmental significance of interpersonal relationships and their formative contribution to building psychological structure. A comprehensive study of the human response on the Rorschach utilizing three dimensions of Blatt's Concept of the Object Scale (accuracy, differentiation, content) demonstrates that a systematic assessment of object relations--of concepts of self and others--is an important core issue in personality development and useful in making distinctions among diagnostic groups (neurotics, outpatient borderlines, inpatient borderlines, schizophrenics). The results illustrate that particular developmental and cognitive properties of human responses produced on the Rorschach show distinct patterns of differential impairment related to type and severity of psychopathology. PMID- 6481600 TI - Relationship of the repression-sensitization scales to anxiety. AB - Two scales used to assess repression-sensitization (R-S) and three standard measures of anxiety were administered to 105 clients. Multiple correlation analysis showed Byrne's R-S scale to correlate .90 with the composite of STAI Trait and the EPI Neuroticism scale. It was concluded that the R-S scale is essentially a measure of trait anxiety. PMID- 6481601 TI - Psychometric prediction of psychiatric learning. PMID- 6481602 TI - Identifying schizophrenia by means of scale 8 Sc of the MMPI. AB - A sample of 38 schizophrenic inpatients was found to achieve significantly higher mean scores on Scale 8 of the MMPI relative to 38 schizophrenia-spectrum and 38 control patients regardless of whether K- or non-K-corrected scores were used. However, when patients were individually classified by means of a cutting score (greater than or equal to 70), only K-corrected scores accurately discriminated between schizophrenic and control patients at a statistically significant level. PMID- 6481603 TI - A comparison of male and female alcoholics with an MMPI classification system. AB - The present study was designed to determine if an MMPI classification system developed for male alcoholics could be successfully extended to female alcoholics. Males and females were compared on the following measures: classifiability, Hs, D, and Mf scales, age and marital status. The results showed that although the examined classification system could be utilized with only limited success, the proportions classified for males and females were similar. A revised classification system resulted in greater classifiability of both males and females. Hs and D scales did not differ between the sexes, but Mf scales did. No differences were found in marital status between males and females. In general, the psychotic and psychopathic alcoholics were younger than the other alcoholic groups, with the neurotics and unclassified alcoholics being the oldest. PMID- 6481604 TI - The Goldberg neurotic-psychotic rule and MMPI 2-7-8 patients. AB - In a population of VA Medical Center psychiatric inpatients with 2-7-8 MMPI high point triads, the Goldberg Index (Neurotic-Psychotic) led to lesser, rather than greater, diagnostic accuracy in identifying patients with nonschizophrenic or schizophrenic diagnoses. It was found, however, the Goldberg diagnostic predictions for the 23.4% of the population at the extremes of this dimension (less than 40 or greater than or equal to 100) were quite accurate (86.7% correct), with intermediate cases showing no correspondence between diagnosis and Goldberg score. It was concluded that the Index might be useful if predictions are only made for patients with these extreme scores. PMID- 6481605 TI - Correlates of social anxiety in college students and homosexuals. AB - The relationship between social anxiety and measures of trait anxiety, self concept, locus of control, repression-sensitization and depression was examined in volunteer college student (39 males and 53 females) and homosexual (51 males and 11 females) samples. Social anxiety was significantly related to all variables of interest, except depression. Within both samples, subjects high in social anxiety had an external locus of control, were low in positive self concept, and were high in both sensitization and anxiety. The correlational patterns were remarkably similar in both samples, and sensitization emerged as the best single predictor of social anxiety for both college and homosexual groups. Results are discussed in terms of theoretical predictions, previous studies of social anxiety, and implications for personality assessment. PMID- 6481606 TI - Locus of control in children of divorce. AB - Scores on the Nowicki-Strickland Locus of Control Scale for Children (N-SLOCSC) were compared for third and fifth grade boys and girls from intact versus maritally disrupted family backgrounds. Significant main effects for each independent variable revealed that fifth graders more than third, boys more than girls, and the marital disruption more than the intact group, exhibited higher internality in their locus of control scores. These findings strongly suggest that experiencing a parental divorce in childhood has a significant influence on generalized perceptions of personal control and effectance, perceptions which may ultimately mediate both short- and long-term outcomes in children's post-divorce adjustment. PMID- 6481607 TI - Content interpretation re: Salley and Teiling's "Dissociated rage attacks in a Vietnam veteran: a Rorschach study". AB - Not necessarily belying usual symbolic interpretation of Rorschach content, Rorschach responses may represent a concrete experience reflecting a traumatic incident in the patient's past. This possibility should be considered particularly when the response in any way suggests undue preoccupation with the integrity of the body. PMID- 6481608 TI - [Biologic availability of vincamine from tablets with a hydrophilic matrix. II]. PMID- 6481609 TI - [The pharmacist facing his future]. PMID- 6481610 TI - [Drugs of the future]. PMID- 6481611 TI - [Food and drugs]. PMID- 6481612 TI - Prediction of blood levels following oral administration of weakly acidic drug particles such as sulfa drugs in rabbits from the in vitro dissolution behavior. AB - Prediction of blood levels following oral administration of weakly acidic drug particles such as sulfa drugs from data obtained in in vitro dissolution tests of drug suspensions was studied in the rabbit. The relationship between in vivo and in vitro dissolution rates or between absorption rate and in vitro dissolution rate was investigated. The drug absorption from aqueous solution was suggested to be rate-limited by the gastric emptying rate because the initial absorption rate constant in a biexponential time course of aqueous solution for the amount unabsorbed vs. time plot was almost the same among 9 of the 10 drugs tested, except for sulfacetamide. This indicated that when the in vivo dissolution rate constant is much slower than the initial absorption rate constant of aqueous solution, the time course of blood levels for the solid drug will deviate from that of aqueous solution. Based on the consideration, the critical in vitro dissolution rate constant corresponding to the initial absorption rate constants of aqueous solution was calculated by means of statistical analysis using the relationship between in vivo and in vitro parameters. The validity of this prediction was examined using four high-solubility drugs, and it was found that the prediction could be done whether the in vitro dissolution medium was distilled water or 0.1 N HCl solution. Although in the present study, the experiment was done using an aqueous suspension form in the rabbit, the applicability of this prediction method to other dosage forms and to the case of humans is discussed. PMID- 6481613 TI - Radioimmunoassay for serum levels of an anti-androgen TSAA-291 (Oxendolone) in rats. AB - A simple radioimmunoassay method was established to determine serum levels of a steroidal anti-androgen, TSAA-291 (Oxendolone, 16 beta-ethyl-17 beta-hydroxy-4 estren-3-one) utilizing ether-extract of serum. Using an antiserum raised against TSAA-291-3-oxime-BSA conjugate in a rabbit, a standard curve was obtained in the assay range from 30 pg to 12 ng/tube. Intra- and inter-assay coefficients of variation were calculated to be 11 and 21%, respectively. Recovery rate of unlabeled TSAA-291 was 84%. Cross-reaction with endogenous steroids was less than 0.2%. TSAA-291 estimates were compared with those determined after further purification on a Celite column, or with those assayed with a gas-liquid chromatograph. The difference between these estimates was less than 16 and 25%, respectively, suggesting little contribution of the metabolites of TSAA-291 to the estimates by the radioimmunoassay. After successive treatments of male rats with TSAA-291 in an aqueous suspension in daily doses of 5, 15 and 50 mg/kg body weight for two weeks, serum TSAA-291 levels were determined by the radio immunoassay and calculated to be 22.7, 76.9 and 194.9 ng/ml, respectively. PMID- 6481614 TI - Comparison of antispasmodic effect of synthetic lysolecithins with various fatty acid moieties on guinea pig ileum. AB - Non-competitive antispasmodic effects of 8 kinds of synthetic L-alpha lysolecithins (1-O-acyl-2-lyso-sn-glycero-3-phosphocholine, LPC) with various fatty acid moieties were examined upon the spasmodic actions of histamine and acetylcholine on guinea pig ileum. Five-min pretreatment of the gut with the synthetic LPC was required to be effective. With increase of the concentration of a synthetic LPC for pretreatment of the ileum, the slope of the dose-response curve of histamine or acetylcholine added cumulatively became more gentle, the maximal contraction was suppressed apparently, and which were associated with the shift of the curve to the higher concentration of the stimulants. Of LPCs with saturated fatty acid palmitoyl-LPC showed the strongest effect, followed by myristoyl-, stearoyl-, lauroyl- and decanoyl-LPCs in order. Incorporation of cis double bond into the C18 fatty acid chain of LPC resulted in slight decrease of the antispasmodic effect. The relaxating effect of LPCs on perfused rabbit ear vessel preparations was similar in order. PMID- 6481615 TI - When are social judgments made? Evidence for the spontaneousness of trait inferences. AB - Do people make trait inferences, even without intentions or instructions, at the encoding stage of processing behavioral information? Tulving's encoding specificity paradigm (Tulving & Thomson, 1973) was adapted for two recall experiments. Under memory instructions only, subjects read sentences describing people performing actions that implied traits. Later, subjects recalled each sentence under one of three cuing conditions: (a) a dispositional cue (e.g., generous), (b) a strong, nondispositional semantic associate to an important sentence word; or (c) no cue. Recall was best when cued by the disposition words. Subjects were unaware of having made trait inferences. Interpreted in terms of encoding specificity, these results indicate that subjects unintentionally made trait inferences at encoding. This suggests that attributions may be made spontaneously, as part of the routine comprehension of social events. PMID- 6481616 TI - Attitude accessibility following a self-perception process. AB - Self-perception processes have been postulated to occur only to the extent that initial attitudes are weak. The present research asked whether the outcome of such a process is a strengthening of the attitude in question. Two experiments investigated the accessibility of attitudes from memory following self-inference from behavior. Experiment 1 examined the consequence for attitude accessibility of reviewing and considering previously performed religious behaviors that were recent and primarily unmanded versus distant in time and "manded" in nature. Experiment 2 involved the performance of a new behavior that was either required or freely chosen. In each case, control subjects either did not review prior behaviors or did not perform a new behavior. In both experiments, attitude accessibility, as measured by the latency of response to attitudinal inquiries, was enhanced by the consideration or performance of unmanded behavior, but not by manded behavior. The relevance of this finding to issues regarding attitude behavior consistency and attitudinal persistence is discussed. PMID- 6481617 TI - Misattribution and speech anxiety. AB - It has been reported that misattribution can enhance the social behavior of shy subjects. By extrapolation, misattribution should also calm speech-anxious subjects and improve their speechmaking. We therefore crosscut misattribution versus control and high versus low speech anxiety, and assessed the impact on nervous behavior and speechmaking. Misattribution did not significantly affect most of the behavior of subjects making speeches. We discuss the implications of these findings for misattribution when personality traits are involved. PMID- 6481618 TI - Influence of individual and group identity salience in the global self-esteem of youth. AB - Does a content-free measure of global self-esteem tap the same self-esteem dimensions as that measured by self-evaluations on specific dimensions that are then combined into a summated scale? We address this question by using a sample of 1,528 7th, 9th, and 11th graders. Nine specific self-ratings (e.g., "I am smart" and "I am GOOD-LOOKING") were combined into a scale that used various weightings, in an attempt to maximize correlations with global self-esteem measured by two content-free scales. The correlations do not exceed .453, suggesting that measures based on summations of a large number of specific self ratings tap a somewhat different phenomenon than content-free global scales. The most effective weighting of specific dimensions for predicting global self-esteem depended on group identity salience rather than individual identity salience- that is, group means of the importance of the separate self-evaluation dimensions were used rather than each subject's own self-rating of the importance of that dimension. This result held even when interactive models of weighting were used. PMID- 6481619 TI - Measuring desire for control of health care processes. AB - We conducted three known-groups studies to obtain discriminant validity information among potential self-report measures of the construct desire for control over health care processes. In the first study we looked at types of preparation for childbirth; in Studies 2 and 3 we investigated choice of a place in which to die and signing a Living Will. With none of the measures could we adequately distinguish those who had signed a Living Will (or intended to) from those who did not intend to sign one. The best discriminator of a choice of a place to die (hospital vs. home or hospice) and type of preparation for childbirth (Lamaze vs. other types of classes vs. no classes) was the Information subscale of Krantz's Health Opinion Survey (KHOS; Krantz, Baum, & Wideman, 1980). With the Behavioral Involvement subscale of the KHOS and our newly designed situation-specific measure of desire for control, we could only inconsistently discriminate among the groups. The generalized measure, Burger and Cooper's (1979) Desire for Control Scale, did not help us to discriminate among these groups. Correlations of these measures with demographic variables are provided and discussed. PMID- 6481620 TI - Construct accessibility and depression: an examination of cognitive and affective factors. AB - Two studies in which the parameters of construct accessibility in depression were examined are reported. In Experiment 1, depressed and nondepressed subjects were required to name the colors of tachistiscopically presented depressed-content, neutral-content, and manic-content words. Because of the predicted accessibility and interference effects of the depressed-content words, the depressed subjects were expected to demonstrate longer response latencies to these words than to the non-depressed-content words. This response pattern was found for the depressed subjects; the nondepressed subjects did not demonstrate differential response latencies. In Experiment 2, a mood-induction paradigm was used to investigate whether the interference effects obtained in Experiment 1 were due to temporary mood differences between the depressed and nondepressed subjects, or were a function of more stable depression-associated patterns of information processing. Although predicted group differences were obtained on a mood adjective checklist, no effects were found for task performance. These results suggest that transient mood is not a sufficient explanation for the results obtained in Experiment 1. The implications of the present findings for the understanding of both construct accessibility and depression are discussed, and directions for future research are suggested. PMID- 6481621 TI - The action of cholinomimetic substances on impulse conduction in the habenulointerpeduncular pathway of the rat in vitro. AB - The effects of some cholinomimetic substances and their antagonists on the peak height of compound action potentials recorded from the terminal region of the habenulointerpeduncular pathway have been studied using a rat brain slice preparation. Carbachol and acetylcholine (ACh) depressed the peak height of the compound action potential and increased the latency to peak. The nicotinic agonists nicotine and dimethylphenylpiperazinium depressed the peak height of the compound action potential while muscarine and glutamate had no effect. The depressant effect of carbachol was blocked by the nicotinic antagonists hexamethonium, mecamylamine and d-tubocurarine but not by atropine. Physostigmine enhanced the effects of ACh and, to a lesser extent, carbachol. In the presence of physostigmine, carbachol or ACh initiated a spontaneous oscillation of the amplitude of the compound action potential which was Ca2+ dependent and was blocked by mecamylamine. It is concluded that depression of the amplitude of the compound action potential is due to activation of presynaptic nicotinic receptors. The results are discussed with reference to possible cholinergic mechanisms in the habenulointerpeduncular pathway. PMID- 6481622 TI - Co-release of enkephalins and precursors with catecholamines from the perfused cat adrenal gland in situ. AB - We have compared the nature of the enkephalin-like material derived from proenkephalin present in the intact cat adrenal gland with the material co released with catecholamines from the perfused adrenal in response to splanchnic nerve stimulation and to perfusions with solutions containing acetylcholine (ACh) or high potassium chloride (KCl). In cat adrenals most of the enkephalin-like material was in the form of large enkephalin-containing peptides. Free (met)enkephalin immunoreactivity represented only 25% of the total (met)enkephalin immunoreactivity as determined by enzymatic digestion of large enkephalin-containing fragments. Electrical stimulation (15 Hz) of the splanchnic nerve or perfusion of the gland with ACh (0.1 mM) or KCl (50 mM), applied for 10 min, induced an immediate release of free (met)enkephalin immunoreactivity, (met)enkephalyl-arg-phe immunoreactivity, and of large (met)enkephalin-containing peptides. The release by all three modes of stimulation followed a pattern that paralleled the output of catecholamines. A rapid fatigue of all secretory processes developed during the stimulation periods, similar to that observed for catecholamines. During splanchnic nerve stimulation, each nanomole of catecholamine output was accompanied by the output of 0.4 pmol free (met)enkephalin immunoreactivity, of 1.1 pmol total (met)enkephalin immunoreactivity and of 0.1 pmol (met)enkephalyl-arg-phe immunoreactivity. Analysis of the perfusate by high-pressure liquid chromatography revealed that (met)enkephalin, (met)enkephalyl-arg-phe and (met)enkephalyl-arg-gly-leu were released in molar ratios of 4 to 1 to 1 which is similar to the ratio found in the precursor, proenkephalin. The ratio of total (met)enkephalin immunoreactivity to free (met)enkephalin immunoreactivity in the perfusate was the same (approximately 2.7) during two successive periods of splanchnic nerve stimulation separated by 10 min. When release was evoked by increasing the K+ concentration to 50 mM-KCl, this ratio was increased more than twofold compared with that obtained by electrical stimulation of the splanchnic nerve. Analysis of the perfusate by gel filtration showed that, during splanchnic nerve stimulation, 47% of the total (met)enkephalin immunoreactivity eluted in fractions containing fragments of low molecular weight. When KCl was used as stimulus only 12% of total (met)enkephalin immunoreactivity eluted in these fractions. The results indicate that the nature of the released peptides depends on the type of stimulus used to evoke release.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481623 TI - The actions of gamma-aminobutyric acid, glycine and their antagonists upon horizontal cells of the Xenopus retina. AB - We examined the effects of gamma-aminobutyric acid (GABA) and glycine and their respective antagonists, picrotoxin and strychnine, upon the membrane potential and light-evoked responses of the type H1 horizontal cell of the Xenopus retina. This horizontal cell receives mixed input from rod and cone receptors. Under control conditions the mean membrane potential was -37.8 +/- 9.7 mV. Addition of 5 mM-GABA to the superfusate hyperpolarized the cell by 4.0 +/- 2.6 mV within 3-5 min; addition of 0.5 mM-picrotoxin depolarized the cell by 4.3 +/- 2.1 mV. Prolonged (greater than 15 min) exposures to the drugs elicited more pronounced changes in membrane potential. GABA and picrotoxin affected primarily the cone dependent input to the H1 horizontal cell. Under dark-adapted conditions, response wave forms were essentially unaltered by the drugs, but when the horizontal cell was moderately or fully light adapted, GABA reduced and picrotoxin enhanced the cone-dependent component of its response to light. Long term (greater than 15 min) exposures to GABA and picrotoxin elicited changes in response kinetics usually associated with dark and light adaptation, respectively. Glycine, at bath concentrations of 0.6 mM or greater, depolarized horizontal cells by 21 mV on average and reduced or abolished their light response. This action did not occur in the presence of 0.1 mM-strychnine. When all light-evoked activity was blocked by 20-40 mM-magnesium, the depolarizing action of glycine still occurred. Thus, glycine appears to act directly upon the horizontal cell membrane. Neither GABA nor glycine, nor their respective antagonists, affected the spatial extent of the horizontal cell receptive field. PMID- 6481624 TI - Resonance at the wrist demonstrated by the use of a torque motor: an instrumental analysis of muscle tone in man. AB - The resonance of the relaxed wrist for flexion-extension movements in the horizontal plane has been investigated by using rhythmic torques generated by a printed motor. In the normal subject the resonant frequency of the wrist is ca. 2 Hz unless the torque is reduced below a certain critical value when the system is no longer linear and the resonant frequency rises. This critical torque level, and the damping are both less in women than men. The resonant frequency is uninfluenced by surgical anaesthesia. With added bias the increase of resonant frequency at low torques still occurs although the hand is now oscillating about a displaced mean position. It follows that the stiffening implied by this elevation of resonant frequency for small movements is neither the result of pre stressing of the muscles nor of reflex activity. With velocity feed-back of appropriate polarity the system will oscillate spontaneously at its resonant frequency. If the peak driving torque is progressively reduced the resonant frequency increases abruptly, indicating that the system has stiffened. Perturbations delivered to the wrist may reduce its stiffness. The postural system is thixotropic with a 'memory time' of 1-2 s. The resonant frequency is elevated in voluntary stiffening. PMID- 6481625 TI - Ultradian rhythm of growth hormone secretion and sleep in the adult male rat. AB - The correlation between growth hormone (GH) secretion and the sleep-wakefulness cycle in the adult male rat was studied by serial blood sampling at 10 min intervals. Electroencephalograms (e.e.g.s) recorded continuously during the blood sampling were scored into wakefulness and sleep, and the amount of sleep for every 10 min was plotted against the GH value as assessed by radioimmunoassay. The power spectrum analysis and the least-squares method applied to the time series of GH concentrations in the control rat revealed that the mean (+/- S.E. of the mean) periodicity was 2.93 +/- 0.10 h for the period from 00.00 to 12.00 h in five rats and 2.85 +/- 0.06 h for the period from 12.00 to 24.00 h in eight rats. For the animals in which the e.e.g. was recorded simultaneously with blood samplings from 12.00 to 24.00 h, the cross-correlation analysis performed between the time series of the amount of sleep and the GH value revealed a significant positive correlation at time lags of 0-10 min in six and at time lags of 20-50 min in four out of fourteen rats. The number of animals having a positive correlation at short time lags seemed relatively less, but in most animals, there was observed a definite relationship that each GH peak occurred with a consistent time lag ranging from 40 to 70 min following the onset of sleep cycle. Sleep deprivation performed from 13.00 to 16.00 h during the sampling period from 11.00 to 19.00 h was effective in preventing high-level GH pulses which otherwise should appear during this time of the day. Concurrent measurements of corticosterone concentrations in the sleep-deprivation experiment revealed that peak values of corticosterone secretory episodes were not influenced by sleep deprivation. These findings indicate that the GH secretion in the adult rat is also correlated with the sleep-wakefulness cycle, although somewhat differently from the immature rat. PMID- 6481626 TI - Two-component desensitization of nicotinic receptors induced by acetylcholine agonists in Lymnaea stagnalis neurones. AB - The kinetics of desensitization induced by different agonists of acetylcholine (ACh) as well as the kinetics of recovery from densensitization, have been studied using the voltage-clamp technique in isolated, identified Lymnaea stagnalis neurones. Desensitization follows the sum of two exponentials: one fast and one slow. The time constant of the fast desensitization component (tau Ids) under ACh application is in the range of seconds at room temperature (18-23 degrees C). It increases upon cooling (Q10 = 2.8 +/- 0.9), decreases with increasing ACh concentration and is independent of membrane voltage. The time constant of the slow component of densensitization (tau Ids) is in the range of tens of seconds. It decreases with increasing drug concentration and is weakly dependent upon temperature (Q10 = 1.3 +/- 0.4). The relative amplitude of the fast component, estimated by back extrapolation to the position of the peak current, increases with agonist concentration and decreases upon cooling. Recovery from desensitization follows the sum of two exponentials with time constants (tau Ir and tau IIr) of the order of seconds and minutes, respectively. Cooling prolongs the slow component (Q10 of tau IIr is approx. 3) and reduces its contribution during recovery. A comparison of the desensitization induced by various agonists indicates that for the small monoquaternary agonists the onset and recovery of desensitization resemble the onset and recovery observed with ACh. For more bulky agonists, like ethoxysebacylcholine, sebacylcholine and suberylcholine, the decay of the response during prolonged application of the agonist may involve an additional blocking process. PMID- 6481627 TI - Differential effects of ischaemia and hyperkalaemia on myocardial repolarization and conduction times in the dog. AB - The role of increased extracellular K+ concentration ([K+]o) in the production of the early electrophysiological changes induced by myocardial ischaemia, was evaluated by recordings of monophasic action potentials and the paced endocardial evoked response. Changes in the duration of local repolarization and conduction time were evaluated during ischaemia, K+ infusion and hypoxia. Raising [K+]o levels in systemic arterial blood from 3.4 +/- 0.5 mmol l-1 to 5.9 +/- 1.5 mmol l 1 produced a similar shortening of repolarization as was seen during ischaemia. Prolongation of conduction time occurred only when the [K+]o levels rose to 8.8 +/- 1.3 mmol l-1. The conduction time slowing during acute ischaemia was always greater and occurred at lower [K+]o levels than that produced by K+ infusion at rates equivalent to the post-ischaemic myocardial venous effluent. Monophasic action potential amplitude and upstroke velocity were reduced in ischaemia but not markedly affected by the increase in [K+]o. Absolute reduction in repolarization time during K+ infusion was more marked at the apex than at the base in the epicardial recordings. The superimposition of hypoxia on hyperkalaemia resulted in marked slowing of repolarization and conduction time. Many but not all of the early electrophysiological abnormalities of acute ischaemia in the intact heart can be related to raised [K+]o. PMID- 6481628 TI - Observations on the time course of the electromyographic response reflexly elicited by muscle vibration in man. AB - Surface electromyography has been used to study the initial reflex response of various muscles to vibration, applied to their tendons, when the subject was already contracting them voluntarily. The response at the onset of vibration was of a latency appropriate for Ia monosynaptic action and was always highly phasic with an initial wave rising far above any maintained increase in electromyogram (e.m.g.) activity; its duration was typically well below 20 ms in the rectified average. Thus, there is nothing peculiar, in this respect, about flexor pollicis longus for which such behaviour has already been described, and used to draw certain wide-ranging conclusions about the stretch reflex. Theoretical considerations, developed in an Appendix, show that quite apart from the operation of any inhibitory mechanisms such a phasic response is to be expected from a population of tonically discharging motoneurones when there is a step increase in the level of their excitatory drive. PMID- 6481629 TI - Form, function and intracortical projections of spiny neurones in the striate visual cortex of the cat. AB - We have studied the neuronal circuitry and structure-function relationships of single neurones in the striate visual cortex of the cat using a combination of electrophysiological and anatomical techniques. Glass micropipettes filled with horseradish peroxidase were used to record extracellularly from single neurones. After studying the receptive field properties, the afferent inputs of the neurones were studied by determining their latency of response to electrical stimulation at different positions along the optic pathway. Some cells were thus classified as receiving a mono- or polysynaptic input from afferents of the lateral geniculate nucleus (l.g.n.), via X- or Y-like retinal ganglion cells. Two striking correlations were found between dendritic morphology and receptive field type. All spiny stellate cells, and all star pyramidal cells in layer 4A, had receptive fields with spatially separate on and off subfields (S-type receptive fields). All the identified afferent input to these, the major cell types in layer 4, was monosynaptic from X- or Y-like afferents. Neurones receiving monosynaptic X- or Y-like input were not strictly segregated in layer 4 and the lower portion of layer 3. Nevertheless the X- and Y-like l.g.n. fibres did not converge on any of the single neurones so far studied. Monosynaptic input from the l.g.n. afferents was not restricted to cells lying within layers 4 and 6, the main termination zones of the l.g.n. afferents, but was also received by cells lying in layers 3 and 5. The projection pattern of cells receiving monosynaptic input differed widely, depending on the laminar location of the cell soma. This suggests the presence of a number of divergent paths within the striate cortex. Cells receiving indirect input from the l.g.n. afferents were located mainly within layers 2, 3 and 5. Most pyramidal cells in layer 3 had axons projecting out of the striate cortex, while many axons of the layer 5 pyramids did not. The layer 5 cells showed the most morphological variation of any layer, were the most difficult to activate by electrical stimulation, and contained some cells which responded with the longest latencies of any cells in the striate cortex. This suggests that they were several synapses distant from the l.g.n. input. The majority of cells in layers 2, 3, 4 and 6 had the same basic S-type receptive field structure. Only layer 5 contained a majority of cells with spatially overlapping on and off subfields (C- and B-type receptive fields).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481630 TI - Characteristics of ionic binding by rat renal tissue in vitro. AB - A study has been made of Na+ and Cl- binding in metabolically inhibited slices of rat renal cortex and outer medulla incubated in modified Krebs phosphate bicarbonate Ringer solution. At pH 7.35 in control media (cortex, 147 mmol Na+/l, 105 mmol Cl-/l; outer medulla, 187 mmol Na+/l, 145 mmol Cl-/l) cortical slices bound (mean) 171 nmol Na+ and 56.7 nmol Cl-/mg solute-free dry weight; outer medullary slices bound 188 nmol Na+/mg and negligible amounts of Cl-. In both regions, Na+ was exchangeable on a 1:1 basis for K+ or Li+ in media containing equal concentrations of each cation: Na+ was completely displaced by La3+. In cortical slices in media containing equimolar Cl- and other monovalent anions, binding occurred according to the sequence acetate less than or equal to salicylate less than or equal to Cl- less than SCN-; Cl- was completely displaced by PO4(3-). When medium pH was lowered, Na+ binding was markedly reduced in both regions, whereas Cl- binding increased (and became significant in outer medulla). In NaCl solutions, Na+ binding capacity was saturated at control Na+ concentrations. When [Na+] was progressively reduced (iso-osmolality being maintained by addition of urea), bound Na+ in both regions was nearly linearly related to log medium [Na+]. Raising medium osmolality with urea caused decreased Na+ binding and increased Cl- binding in both regions. Na+ binding in both regions was significantly reduced by pre-treatment with chondroitinase ABC. Binding of both ions was independent of temperature within the range 2-37 degrees C. The possibility is raised that renal ionic binding might influence vectorial ion transport by affecting free ion activity in the region of the transporting cells. PMID- 6481631 TI - Developmental aspects of steroid-induced ammonia release from isolated sections of rat intestine. AB - Release of ammonia from isolated intestinal sections of adult male rats is higher than that measured using immature animals. The increase appears to be Na+ dependent and develops during the spurt of growth at puberty. Developmental changes in Na+-dependent ammonia release from isolated sections of the intestine and growth of the small intestine in male and female rats have been compared. Intestinal growth increases far more rapidly than body weight and in the males critical developmental changes occur early during weaning and during puberty. In females the major change is at weaning and little further change occurs during puberty. Treatment of young animals with aldosterone or testosterone increases the Na+-dependent ammonia release precociously. Dose-response effects of testosterone and aldosterone in distal sections of the small intestine have been compared. PMID- 6481632 TI - Electrical membrane responses to secretagogues in parietal cells of the rat gastric mucosa in culture. AB - Fragments of the gastric fundus of 6-8-day-old rats were maintained in tissue culture. From the explant, adhered to a plastic substrate, epithelial cells migrated and developed to form a monolayer colony. Histological and histochemical studies as well as indirect immunofluorescence studies using anti-parietal cell antibodies testified to the presence of parietal cells in the monolayer during the first week. These parietal cells were distinguished by their vesicular cytoplasmic structures using phase-contrast or differential interference-contrast microscopy. Acridine Orange, an optical probe of H+ accumulation, was taken up preferentially by these parietal cells, exhibiting orange fluorescence within the cells on the third day of culture, in response to stimulation with gastrin, histamine and carbachol. The resting potential of these cultured parietal cells was about -20 mV. On day 2-4 of culture, the cell membrane became hyperpolarized (up to -30 to -40 mV) in response to gastrin, carbachol or histamine in the presence of isobutylmethyl-xanthine (IMX). During hyperpolarization, the membrane resistances decreased significantly. The amplitude and the polarity of secretagogue-induced responses were found to be dependent on the extracellular concentration of K+ (but not Na+ and Cl-). The carbachol-induced responses were inhibited by atropine but not curare. The responses induced by histamine plus IMX were blocked by cimetidine but not pyrilamine. Neither atropine nor cimetidine affected the gastrin-evoked responses. It is concluded that rat parietal cells have separate receptors for acetylcholine (muscarinic), gastrin and histamine (H2), and that an increase in the membrane permeability to K+ is closely associated with the responses of these receptors under these in vitro conditions. PMID- 6481633 TI - Low-calcium field burst discharges of CA1 pyramidal neurones in rat hippocampal slices. AB - Incubation of rat hippocampal slices in solutions containing low Ca2+ and increased Mg2+ rapidly blocked synaptic responses and increased spontaneous firing of all the principal neurones. More remarkably, a rhythmic and synchronous bursting discharge developed, which was restricted to the CA1 population of pyramidal neurones. These 'field bursts' or 'spreading excitation' were rapidly abolished by restoring the Ca2+ to 2 mM, by increasing the Mg2+ to 6 mM or by decreasing K+ from 6 to 3 mM. The CA1 pyramidal cells depolarized after the change to the low-Ca2+ solution by about 10-20 mV. Individual field bursts were associated with a further depolarization of 10-12 mV surmounted by a burst of action potentials at about 20/s. This transient depolarization shift, recorded extracellularly as a negative field, could be attributed to the increase of [K+]o during the bursts, reaching 9-10 mM as measured by ion-sensitive electrodes. The bursts were followed by a hyperpolarization, seen extracellularly as a small soma positive field, which was attributed to an electrogenic pump and/or a Ca2+ activated K+ conductance. Stimulation of the tightly packed pyramidal cell axons in the alveus elicited a train of population spikes, instead of the single spike normally seen, and could trigger a full field burst. Recordings of the alvear tract volley suggested that the repeated spikes arose within the pyramidal cells. Multiple recordings from CA1 revealed that field bursts usually, but by no means always, started near the caudal (subicular) end of the area. They spread through the cell layer at 0.04-0.12 m/s. The most rapid propagation was seen when the bursts had an abrupt onset; slower propagation (1-10 mm/s) occurred when the bursts started gradually, which generally was the case near the sites of burst initiation and termination. Usually the action potentials within each burst were synchronized into population spikes which spread across CA1 at 0.04-0.15 m/s. The site of initiation and the extent of the spread of these population spikes varied during each burst, as did their amplitude. The degree of spike synchronization was enhanced by various treatments expected to increase neuronal excitability. Measurements of transmembrane potential during the burst confirmed the role in the generation of population spikes of ephaptic or field interactions between the pyramidal cells. It is proposed that the increased firing of all neurones is due to the block of tonic inhibition, depression of after-hyperpolarization and to increased membrane excitability.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481634 TI - Location and function of voltage-sensitive conductances in retinal rods of the salamander, Ambystoma tigrinum. AB - The functional role and spatial location of voltage-sensitive conductances that modify the light-evoked electrical signals were studied in retinal rods of the tiger salamander. An isolated rod was drawn into a suction electrode for recording membrane current and impaled with an intracellular electrode for recording membrane potential and passing current. A bright flash gave a rapid initial hyperpolarization that relaxed to a smaller plateau. Simultaneously the dark current of the outer segment was shut off with the time course of a rounded step function. This characteristic difference between the wave forms demonstrates that the voltage relaxation does not result from reopening of light-sensitive channels. The voltage relaxation in (2) did not require light or interruption of the dark current, as the wave form was duplicated by suddenly switching off a depolarizing current injected during steady saturating light. This is explained if the relaxation depends purely on voltage-sensitive conductances. The voltage response to a dim flash reached its peak value before the current response. The voltage wave form was predicted assuming that the recorded photo-current drove a linear high-pass filter with parameters derived from analysis of the voltage response to injection of a current step. When the intracellular voltage was changed by current injection the slope resistance of the outer segment slowly declined to a lower level, indicating that the outer segment contains a voltage sensitive conductance. When a current step was injected in bright steady light, the current recorded from the outer segment consisted of a capacity component proportional to dV/dt and a small extracellular leakage current but no detectable ionic current. This supports other evidence indicating that light-sensitive channels comprise the main or exclusive ionic conductance of the outer segment. The behaviour in (5) is explained if the light-sensitive channels themselves are slowly opened by hyperpolarization and closed by depolarization. Analysis of the current-injection experiments suggests that most of the high-pass filtering in a rod results from the action of voltage-sensitive conductances located in the inner segment. Addition of 10 mM-CsCl to the Ringer solution abolished the relaxation in the voltage response to a bright flash but left intact the high pass filtering of small signals. This would be explained by a selective block of one of two sets of voltage-sensitive channels in the inner segment or by a voltage-sensitive block of one kind of channel. PMID- 6481635 TI - Strychnine blocks transient but not sustained inhibition in mudpuppy retinal ganglion cells. AB - Transient and sustained inhibitory synaptic inputs to on-centre, off-centre, and on-off ganglion cells in the mudpuppy retina were studied using intracellular recording in the superfused eye-cup preparation. When chemical transmission was blocked with 4 mM-Co2+, application of either glycine or gamma-aminobutyric acid (GABA) caused a hyperpolarization and conductance increase in all ganglion cells. For both amino acids, the responses were dose dependent in the range 0.05-10 mM, with a half-maximal response at about 0.7 mM. Glycine and GABA sensitivities were very similar in all three types of ganglion cells. The response to applied glycine was selectively antagonized by 10(-5) M-strychnine and the response to applied GABA was selectively antagonized by 10(-5) M-picrotoxin. In all ganglion cells, 10(-5) M-strychnine eliminated the transient inhibitory events which occur at the onset and termination of a light stimulus. The block of transient inhibition was associated with a relative depolarization of membrane potential and decrease in conductance at these times. Strychnine had no effect on membrane potential or conductance in darkness or during sustained inhibitory responses to light. Picrotoxin (10(-5) M) did not block transient inhibitory events in any ganglion cells, but did affect other components of their responses. The results suggest that in all three classes of ganglion cells transient inhibition, but not sustained inhibition, may be mediated by glycine or a closely related substance. PMID- 6481636 TI - Intracellular free magnesium in neurones of Helix aspersa measured with ion selective micro-electrodes. AB - Cytoplasmic free Mg2+ concentration, [Mg2+]i, was measured in identified neuronal cell bodies of the suboesophageal ganglia of Helix aspersa, using Mg2+-selective micro-electrodes. In calibration solutions, the electrodes showed significant interference from K+, but not from Na+, or Ca2+, at concentrations found intracellularly. Therefore, in order to calibrate the electrodes properly, it was necessary first to obtain an accurate value for intracellular free K+ concentration [( K+]i). The mean value for [K+]i was 91 mM (S.E. of the mean +/- 2.2 mM, n = 8), measured with K+-sensitive 'liquid ion exchanger micro electrodes'. In seven experiments, which met stringent criteria for satisfactory impalement and electrode calibration, the mean [Mg2+]i was 0.66 mM (S.E. of the mean +/- 0.05 mM). The mean [Mg2+]i in cells that had spontaneous spike activity was not significantly different from that in quiescent cells. If Mg2+ was in electrochemical equilibrium, the ratio [Mg2+]i/[Mg2+]o would be about 55. Mg2+ is therefore not passively distributed across the neuronal membrane and an outwardly directed extrusion mechanism must exist to keep [Mg2+]i low and constant, even in cells undergoing spike activity. PMID- 6481637 TI - Interneurones in the Xenopus embryo spinal cord: sensory excitation and activity during swimming. AB - The dorsolateral spinal cord of embryonic Xenopus laevis has previously been shown to contain two anatomical classes of interneurones with dendrites in the dorsal tract where they could be contacted by the central axons of Rohon-Beard cells (Roberts & Clarke, 1982). The activity of these neurones within the dorsolateral spinal cord has been examined using intracellular micro-electrodes. Following electrical stimulation of Rohon-Beard neurites within the ipsilateral skin, dorsolateral neurones receive a short-latency, compound, excitatory post synaptic potential (e.p.s.p.). The amplitude of the e.p.s.p. depends upon the number of Rohon-Beard cells stimulated. The e.p.s.p. consists of early and later components. The early components may result from monosynaptic connexions from Rohon-Beard cells, the later components from some unidentified interposed neurones. During episodes of fictive swimming the dorsolateral neurones are inhibited by rhythmic inhibitory post-synaptic potentials. Following Rohon-Beard neurite stimulation, neurones in the contralateral spinal cord receive e.p.s.p.s. These contralateral e.p.s.p.s are probably one of the post-synaptic effects of one of the dorsolateral neurone classes. The results suggest that the dorsolateral neurones are responsible for amplifying and distributing the primary afferent signals of Rohon-Beard cells, and may be involved in the initiation of swimming and reflex movements. PMID- 6481638 TI - Developmental changes in intra-enterocyte cation activities in hamster terminal ileum. AB - Intracellular Na+ and K+ activities have been determined under visual control in enterocytes located at known positions along hamster ileal villi in vitro. The intracellular K+ activity found in enterocytes migrating over the basal third of villi was significantly less than that found in older enterocytes (83 and 113 mM respectively). The intracellular Na+ activity remained unaffected by the state of enterocyte development (32 mM throughout). Extracellular K+ and Na+ activities measured close to the luminal surface of the intestine were always similar to those measured in the bulk of the bathing medium. There was, however, a small difference in K+ activity detected between the bulk solution and solution near the luminal surface of enterocytes (3 . 4 and 3 . 6-3 . 7 mM respectively). Na+ activity in the villus core was also similar to that of the bathing medium. The brush border membrane content of sucrase-isomaltase, determined cytochemically, was found to increase rapidly as enterocytes migrated over the basal third of the villus and to plateau at a point roughly equivalent to that where intracellular K+ activities became maximal. The numerous ways by which enterocytes might control their intracellular K+ concentrations during development are emphasized. Attention is nevertheless drawn to the close correspondence seen between different aspects of brush border membrane development and the ability of enterocytes to maintain high internal concentrations of K+. PMID- 6481639 TI - Effects of hind limb nerve section on lumbosacral dorsal horn neurones in the cat. AB - The sciatic and saphenous nerves of one hind limb were sectioned in young adult cats anaesthetized with halothane. Between 19 and 55 days later, under chloralose anaesthesia, dorsal horn neurones in the L6 and L7 segments were recorded and their receptive field properties examined. In seven animals recordings were made from identified spinocervical tract, post-synaptic dorsal column and dorsolateral funicular neurones as well as from neurones that did not project through these pathways. Thirty-one neurones were intracellularly stained with horseradish peroxidase, and fifty-three were recorded extracellularly and located by reference to stained cells. In two animals (both 31 days after nerve section) no attempt was made to identify axonal projections of the dorsal horn neurones in order to avoid any effects of cervical cord search stimuli on the cells' properties, but all isolated extracellularly recorded units were examined. On the side ipsilateral to the nerve sections 143 units were recorded. In all experiments, neurones in the medial three-quarters of the dorsal horn had no discernible cutaneous, mechanosensitive receptive fields between 19 and 55 days after nerve section. There were only two exceptions to this generalization, one neurone being one of the most rostral cells in the sample (in caudal L5) and the other being one of the most caudal cells (in caudal L7). We present evidence to show that neither of these two neurones had inappropriate receptive fields in terms of the somatotopic organization of the dorsal horn. All other neurones with receptive fields on the skin were appropriately located in the somatotopic map laid out in the dorsal horn. There was no evidence for gross anatomical changes in the dendritic trees of dorsal horn neurones following sciatic and saphenous nerve sections. We have been unable to confirm that, following loss of cutaneous receptive fields by peripheral nerve section, dorsal horn neurones in adult cats acquire 'inappropriate' receptive fields. Possible reasons for this are discussed. PMID- 6481640 TI - Source and concentration of extracellular adenosine triphosphate during haemostasis in rats, rabbits and man. AB - A new technique was developed for the measurement of extracellular free ATP in very small samples of whole blood using the luciferin-luciferase enzyme system. The method had a very low background corresponding to approximately 10(-16) mol ATP. ATP was measured in blood as it emerged during haemostasis following precise puncture of rat and rabbit arteries and after standardized incisions of human skin by the Simplate device. The initial concentration of free ATP in blood emerging 2-4 s after vascular injury was about 2 X 10(-7) M in rats and rabbits and about 2 X 10(-6) M in humans. The free-ATP concentration increased to 2 X 10( 5) M 3-5 min after injury and these increases could be prevented by heparin (20 u./ml). The source of the initial free ATP was identified as damaged cells in the injured vessel wall. Sufficient ADP, both released as such with ATP and generated by enzymic dephosphorylation of ATP, would be present at the site of injury to initiate haemostatic aggregation of platelets. PMID- 6481641 TI - A comparison of spontaneous and nerve-mediated activity in bladder muscle from man, pig and rabbit. AB - Spontaneous activity in bladder muscle strips from man, pig and rabbit has been compared using an in vitro superfusion technique. Field stimulation was used to study nerve-mediated activity. Bladder muscle strips from all areas of the rabbit bladder displayed rhythmic spontaneous activity. Spontaneous activity was regularly present in strips from the trigone region in man and pig, but was present in only 18 and 19% respectively of strips from the dome of the bladder. Strength-duration curves in the presence of tetrodotoxin (10(-7) g/ml) were constructed. The 'chronaxie' of the muscle was found to be considerably shorter than that of other smooth muscles, ranging from 6.1 ms in the rabbit to 12.9 ms in man. Frequency-response curves were constructed using trains of stimuli. The responses were not antagonized by hexamethonium (10(-4) M), but were markedly inhibited by tetrodotoxin (10(-7) g/ml), indicating that the responses were mediated by excitation of post-ganglionic nerves. Physostigmine (10(-7)-5 X 10( 6) M) produced a dose-related increase in the contractile response to field stimulation in all three species. Atropine (10(-8)-10(-6) M) produced an inhibition of the contractile response, but the maximum degree of inhibition differed considerably between the species. In the rabbit, 58% of the control response was attained, whilst in the pig this was only 22%. Atropine completely abolished nerve-mediated contractions in human bladder muscle. Phentolmaine (10( 7)-2.5 X 10(-7) M) had no significant effect on the frequency-response curve in any of the three species, and did not depress the atropine-resistant component in rabbit and pig. It is concluded that nerve-mediated activity in human bladder muscle is exclusively cholinergic, in contrast to most other mammals studied in which there is a significant non-cholinergic component. The finding of a shorter chronaxie in bladder muscle than in other smooth muscles suggests important differences in its physiological properties that merit further investigation. PMID- 6481642 TI - Exchange area and surface properties of the microvasculature of the rabbit submandibular gland following duct ligation. AB - The exchange area of the submandibular salivary gland microvasculature has been measured to allow the value of microvascular permeability (P) to hydrophilic solutes to be calculated from previous measurements of permeability-surface area (PS) products. Glands whose ducts had been ligated for 2 weeks and the contralateral control glands were perfusion-fixed with a modified Karnovsky's fixative after perfusion with a solution containing cationized ferritin, and examined with transmission electron microscopy. Stereological techniques were used to estimate the surface area of the exchange vessels on random thin sections from four control and four duct-ligated glands. The mean exchange surface area in control glands was 512 cm2 g-1 and 336 cm2 g-1 in duct-ligated glands. The fenestral density was calculated to be 0.57% of the exchange surface in control glands and 0.30% in duct-ligated tissue. Molecules of cationized ferritin appeared bound to the luminal surface of the microvascular endothelium, including the surface of the fenestrae to a depth of about 25 nm in both control and ligated glands. These experiments have shown that the exchange surface area of the fenestrated endothelium of the submandibular salivary gland is comparable to that in cardiac muscle but the permeability (P) to small solutes is about 10 times greater. Following ligation of the salivary gland duct, solute permeability falls and an explanation of this, based on the reduced surface area and the nature of the permeability-flow relationship for small solutes is offered. PMID- 6481643 TI - Tension receptors with vagal afferent fibres in the proximal duodenum and pyloric sphincter of sheep. AB - Single-unit afferent activity was recorded from the hepatic-duodenal branch of the vagus nerve of chloralose-anaesthetized sheep during acute electrophysiological experiments. The impulse activity of sixty-seven slowly adapting mechanoreceptors situated in the muscularis externa of the proximal duodenum and pyloric sphincter was synchronous with alterations in electromyographic and tension records. Afferent units were excited during passive distension, compression and drug-induced increases in muscle tension, thus satisfying the criteria for 'in series' tension receptors (Iggo, 1955). From the responses to compression some evidence was found for the existence of separate populations of tension receptors with different mechanical thresholds. Two fibre populations were found: non-myelinated (0.70 +/- 0.26 S.D. ms-1) and myelinated (7.6 +/- 1.6 S.D. m s-1). Mucosal application of solutions of hydrochloric acid, volatile fatty acids, alkali and amino acids, and mucosal probing modified the activity of most units. These changes were reduced by anaesthesia of the mucosa. It is concluded that tension receptors in the sheep duodenum occupy a position 'in series' with longitudinal muscle, and that their activity can be modified by the particulate and chemical composition of chyme by a mechanism involving local nerve plexuses. The activity of tension receptors is compared with that of two other mechanoreceptor classes located serosally (five units) and in the lesser omentum (eleven units). Receptors in neither of these two classes were directly excited by active contraction of the duodenum. PMID- 6481644 TI - Excitation of the cardiac vagus by vasopressin in mammals. AB - In unanaesthetized sheep, the sensitivity of the baroreceptor-cardio-inhibitory reflex was greater when intravenous vasopressin was used to raise blood pressure, than when intravenous phenylephrine was used to raise blood pressure. This difference was still evident in animals in which beta-adrenergic blockade had been carried out using propranolol. In the presence of combined beta-adrenergic and muscarinic blockade, a direct negative chronotropic effect of intravenous vasopressin could not be demonstrated. It was concluded, therefore, that intravenous vasopressin enhanced cardiac vagal tone. This effect of vasopressin on efferent cardiac vagal tone was confirmed directly in anaesthetized dogs by recording from single cardiac vagal efferent fibres. Furthermore, recordings from single carotid sinus baroreceptor fibres did not demonstrate a direct action of vasopressin on the sensitivity of the baroreceptors. However, the pressor effect of vasopressin is associated with a greater increase in efferent cardiac vagal discharge than that seen when equipressor doses of phenylephrine are given, or when blood pressure is raised by a similar amount by inflation of an intra-aortic balloon. Studies in isolated guinea-pig atrial preparations and in anaesthetized rabbits and dogs, revealed no consistent peripheral action of vasopressin on the action of the vagus at the heart. PMID- 6481645 TI - Relaxation of rabbit psoas muscle fibres from rigor by photochemical generation of adenosine-5'-triphosphate. AB - Correlations have been made between the mechanical and biochemical descriptions of muscle relaxation. Skinned muscle fibres in the rigor state were incubated in a solution containing P3-1-(2-nitro)phenylethyladenosine-5'-triphosphate, 'caged ATP', an inert photolabile precursor of ATP, and free Ca2+ concentration less than 10(-8) M. The mechanical response of the fibre was monitored during relaxation initiated by liberating ATP with a pulse of 347 nm light from a frequency-doubled ruby laser. Tension first dropped and then rose briefly, before finally declining to the relaxed level. Stiffness, in phase with a sinusoidal length change, declined monotonically after the laser pulse. Out-of-phase stiffness increased briefly after a delay, then returned to the base line during the final relaxation. The development of the out-of-phase stiffness signal was taken as evidence that during the relaxation some cross-bridges were present with properties similar to those in an active contraction. The tension rise and slower phase of relaxation can be explained by a mechanism in which some of the cross bridges reattach, generate force and finally detach in the absence of Ca2+ ions. In this model cross-bridge attachment is facilitated by protein co-operativity within the myofilaments. Detailed analysis of the mechanical transients makes other possible models for the initial tension rise unlikely. Stretching or releasing fibres prior to photolysis changed the time course of the early parts of the tension transient without significant effect on the later phases or on stiffness. The tension records from stretch, release and isometric trials converged to a final common time course of relaxation. Analysis of the convergence of tension records provided a means for measuring the cross-bridge detachment rate from the thin filament as a function of ATP concentration. The apparent second-order rate constant for detachment was at least 5 X 10(5) M-1 S-1 at 20-22 degrees C. The final relaxation rate was less dependent on ATP concentration than the early convergence. The results indicate that ATP binding and cross-bridge detachment from the nucleotide-free intermediate of the cross bridge cycle are rapid compared to the cross-bridge cycling rate. PMID- 6481646 TI - Initiation of active contraction by photogeneration of adenosine-5'-triphosphate in rabbit psoas muscle fibres. AB - Mechanical and biochemical descriptions of the muscle cross-bridge cycle have been correlated. Skinned muscle fibres of rabbit psoas muscle in rigor were incubated in solutions containing approximately equal to 30 microM-Ca2+ ions and P3-1-(2-nitro)phenylethyladenosine-5'-triphosphate, 'caged ATP', an inert photolabile precursor of ATP. ATP was liberated from caged ATP within the fibres by pulses of 347 nm radiation from a frequency-doubled ruby laser. The mechanical responses of muscle fibres to the rapid increase of ATP concentration were monitored. Tension dropped briefly and then rose above the rigor value to the level characteristic of a steady active contraction. Liberation of ATP decreased in-phase stiffness (measured at 500 Hz) from the rigor level to a maintained value intermediate between rigor and relaxed values. Out-of-phase stiffness increased to a maintained level indicating a phase lead of tension with respect to imposed length oscillations. Rigor tension was varied prior to photolysis by slight alterations of fibre length. Tension traces starting at different rigor tensions converged to a common tension level at the same rate, whether or not Ca2+ was included in the medium. These data suggest that the rate of cross-bridge detachment by ATP from the rigor state is not influenced by Ca2+. Analysis of the tension records, in terms of sequential detachment and reattachment reactions, provided a measure of cross-bridge reattachment rate and an alternate measure of the detachment rate. Detachment from the rigor state was approximately proportional to the ATP concentration, with a second-order rate constant of at least 5 X 10(5) M-1 S-1. Reattachment with force generation had no detectable dependence on the concentration of ATP liberated by photolysis. A simple kinetic model of the cross-bridge cycle in terms of chemically defined intermediates was compatible with most of the experimental data. The ATP dependence of cross-bridge detachment, the kinetics of maintained cross-bridge reattachment in the presence of Ca2+, and transient reattachment and final relaxation in the absence of Ca2+ were explained. In this model, reversibility of cross-bridge attachment and the steps leading to force production allow the relatively high observed detachment rate to be accommodated with other data relating to active contraction. These data include the steady ATPase rate of active muscle fibres and the fewer attached cross-bridges in active contractions compared to rigor. PMID- 6481647 TI - Efferent control of cochlear inner hair cell responses in the guinea-pig. AB - The efferent crossed olivocochlear bundle (c.o.c.b.) was electrically stimulated during intracellular recordings from cochlear inner hair cells in anaesthetized guinea-pigs. The effect of c.o.c.b. stimulation was to decrease the magnitude of the inner hair cell depolarizing component (d.c.) and alternating component (a.c.) receptor potentials evoked by tone bursts at the characteristic frequency. At low sound pressure levels, the decrease in receptor potentials caused by c.o.c.b. stimulation was equivalent to decreasing the sound intensity by 9-24 dB. C.o.c.b. stimulation usually had a similar effect on the compound action potential of the auditory nerve. The change in inner hair cell membrane resistance during moderate-level sound was measured for sound alone and when sound was accompanied by c.o.c.b. stimulation. Sound alone produced a greater membrane resistance change than sound with c.o.c.b. stimulation, in proportion to the d.c. receptor potential during the same conditions. The time course of the c.o.c.b. effect was slow, with 50-250 ms required for a full effect and for recovery. The effects of varying the frequency and voltage of electrical stimulation were similar for the d.c. receptor potential and for the compound action potential. For sounds of high level and for frequencies well below the characteristic frequency, c.o.c.b. stimulation was less effective in reducing receptor potentials. Frequency tuning curves for the d.c. receptor potential taken during intervals of continuous c.o.c.b. stimulation showed decreases in sensitivity primarily in the tip segment of the tuning curve. When no sound stimulus was present, the resting membrane potential was relatively unaltered during c.o.c.b. stimulation. The resting membrane resistance did not change during c.o.c.b. stimulation. Since the c.o.c.b. innervates mainly the outer hair cells, these results strongly suggest that changes in outer hair cell activity can influence the receptor potentials of inner hair cells and thus alter the transmission of acoustic responses to the central nervous system. PMID- 6481648 TI - The intramural pelvic nerves in the colon of dogs. AB - The intramural pelvic nerves of the dog colon were studied morphologically and electrophysiologically. These nerves emanate from the pelvic plexus, and ascend between the muscle layers along 57.5% of the colon's length. Many thin branches connect with Auerbach's plexus. Most of the nerves responded bilaterally with compound action potentials of A delta and C fibres to stimulation of the sacral dorsal roots, and with those of C fibres to stimulation of the ventral roots. Mean conduction velocities of the A delta and C fibres were 9.0 and 0.9 m/s, respectively. Distension of a section of colon at up to 85.0% of the length of the colon from the anus activated afferent fibres, and electrical stimulation of points at up to 102% of this length elicited responses in efferent fibres. In dogs in which the continuity of the colonic wall was interrupted by a ligature but the nerves were left intact, the intramural pelvic nerves were found to convey centrifugal activities of the recto- and ano-colonic reflexes to the proximal colon, and centripetal and centrifugal activities of the colo-colonic reflex. PMID- 6481649 TI - [Intracellular compartments and topogenesis of membrane proteins]. PMID- 6481650 TI - A study of urethritis in males with special reference to Ureaplasma urealyticum (T-strain mycoplasma). PMID- 6481651 TI - Serodiagnosis of toxoplasmosis by indirect haemagglutination test. PMID- 6481652 TI - Bacteriological study of neonatal septicaemia cases and their in vitro sensitivity to antimicrobial agents. PMID- 6481653 TI - Split gel technique of polyacrylamide gel disc electrophoresis for comparing two biological fluids. PMID- 6481654 TI - Thyroglossal cyst (a clinicopathological evaluation with special reference to its malignant potential). PMID- 6481655 TI - Retrocaval ureter presenting as an acute abdomen (a case report). PMID- 6481656 TI - Intestinal atresia (report of 4 cases). PMID- 6481657 TI - Solitary metastatic malignant stricture of the ileum: a rare cause of small bowel obstruction (a case report). PMID- 6481658 TI - Gastroschisis in pregnancy (a case report). PMID- 6481659 TI - Toxic megacolon: survival without colectomy (a case report). PMID- 6481660 TI - Benign sickle cell anaemia (a case report). PMID- 6481661 TI - The utility of prolonged respiratory exhalation for reducing physiological and psychological arousal in non-threatening and threatening situations. AB - To determine whether slowing and altering the respiratory pattern is an effective means for reducing physiological and psychological arousal, subjects participated in one of three treatment conditions in which they reduced their respiration rate to 6 cpm and either inhaled quickly and exhaled slowly, inhaled slowly and exhaled quickly, or spent equal amounts of time inhaling and exhaling. Other subjects participated in a distraction control condition or in a no-treatment control condition. Arousal was measured during a practice period, a threat (electrical shocks) anticipation period, and a threat confrontation period. The results indicated that the breathing manipulations were not effective in reducing arousal during the practice period, but that inhaling quickly and exhaling slowly was consistently effective for reducing physiological (skin resistance) and psychological (subjective cognitive) arousal during the anticipation and confrontation periods. PMID- 6481662 TI - Physical fitness level and autonomic reactivity to psychosocial stress. AB - Two studies explored the influence of aerobic fitness level on autonomic reactivity to psychosocial stress. Experiment 1 employed a correlational, repeated measures design. A total of 45 men who were physically trained, untrained, or training were tested at three-week intervals over nine weeks. The measure of autonomic reactivity was lability in electrodermal activity during two speeded mental tasks designed to induce psychosocial stress. In the initial test session, trained subjects showed faster autonomic recovery from this stress than did untrained or training subjects; in subsequent test sessions involving the repeated administration of the same tasks, the three groups were indistinguishable. Experiment 2 employed 60 subjects who were randomly assigned to 10-week aerobic exercise, meditation, or music appreciation programs. In each session, two psychosocial stressors selected from a battery of six tasks were counterbalanced across treatments and sessions. Over the course of the study, participants in the exercise program improved significantly in physical fitness and also showed faster recovery in the electrodermal response. This quicker autonomic recovery may allow the aerobically fit to cope more effectively with emotional stress. PMID- 6481663 TI - Type A behaviour in patients with chest pain: test-retest reliability and psychometric correlates of Bortner scale. AB - Ninety-nine patients with chest pain and a presumptive diagnosis of coronary heart disease were assessed within 24 hr of angiography using a standardised psychiatric interview, personality inventory and Bortner Type A questionnaire. Ninety-six of the 99 patients completed the Bortner scale 4 months later, when test-retest reliabilities were 0.84 for both the 65 men and 31 women. There were significant correlations between Bortner score and measures of both psychiatric morbidity and neuroticism in men; and those items on the Bortner scale denoting speed and impatience were most highly correlated with neuroticism. None of these associations were noted in women. Men with normal or near-normal coronary arteries had higher measures of extraversion, neuroticism and Type A score than those with important occlusions, suggesting an association between insignificant coronary artery disease, "complaint behaviour" and raised Type A score. The findings question the unitary nature of Type A behaviour, and suggest an important association between the behaviour pattern and the personality dimension of neuroticism in men. PMID- 6481664 TI - Psychosocial outcome one year after a first myocardial infarction. AB - Psychosocial outcome in terms of mental state, health preoccupation, leisure activity, avoidance behaviour, sexual activity and attitude towards life and the future one year after a myocardial infarction (MI) was studied in 177 consecutive male, able-bodied patients below 61 yr of age with a first MI. Questionnaires and a brief interview covered the psychological and social data while the somatic variables were recorded in a standardized medical examination. Emotional distress, self-reported symptoms, avoidance behaviour, overprotection, pessimism and a diminished sexual activity were frequent, indicating a poor adaptation. These disturbances were apparent two months after the MI and remained stable. Psychological factors were stronger determinants of maladjustment than smoking, angina pectoris and recorded somatic illness. Neither severity of the infarction nor social and demographic factors determined maladjustment. Intervention must take place early and be directed to psychological factors as well as to the cardiac condition. PMID- 6481666 TI - Mood changes associated with behavioral treatment of obesity. PMID- 6481665 TI - Time-limited thematic group with post-mastectomy patients. AB - Twenty-four post-mastectomy women participated in thematic time-limited groups. About half of the women reported that the groups helped them a lot, and in these women a significant decrease in psychological distress, especially anxiety and depression, was found. In the few who reported they were not helped, an increase in psychological distress was found, especially in hostility. The main concerns of the post-mastectomy women are described, as well as the need to develop predictors about who can benefit from time-limited groups. The preliminary data seems to indicate that patients became less prone to improvement with time (after the operation) and that patients who have the wish to share their experience with others do especially well in groups. PMID- 6481667 TI - Peripheral embolic phenomena from proximal arterial disease. PMID- 6481668 TI - Upper limb vascular injuries. PMID- 6481669 TI - Surgical management of hydatid disease of the lung. PMID- 6481670 TI - Pleurectomy for recurrent pneumothorax. PMID- 6481671 TI - Incidence of tuberculous neck masses in the central zone of Saudi Arabia. PMID- 6481672 TI - Elective splenectomy. Indications and complications in 102 patients. PMID- 6481673 TI - Bacterial myositis and pyomyositis. PMID- 6481674 TI - Surgical treatment of ischial pressure sores. PMID- 6481675 TI - Arthroscopic removal of loose bodies from the knee. PMID- 6481676 TI - Temperature: a poor diagnostic indicator in abdominal pain. PMID- 6481677 TI - Serum "cardiac" enzyme levels after laparotomy. Of value in the diagnosis of postoperative myocardial infarction? PMID- 6481678 TI - Bilateral renal arterial malformation in a haemophiliac. PMID- 6481679 TI - Unusual combined pathology in a femoral hernia. PMID- 6481680 TI - Post-traumatic small bowel stenosis. PMID- 6481681 TI - False aneurysm causing non-union of a closed femoral shaft fracture. PMID- 6481682 TI - Double gallbladder. PMID- 6481683 TI - Prostatic secondary paraplegia. PMID- 6481685 TI - Richter's hernia in a direct inguinal sac in a female. PMID- 6481684 TI - Haemobilia and haemoperitoneum. A complication of a solitary gallstone. PMID- 6481686 TI - The effect of microwave-induced whole-body hyperthermia on the mucosa of mouse small intestine. PMID- 6481687 TI - Airborne radionuclides onto pine needles collected in the vicinity of the nuclear power plant. PMID- 6481688 TI - Host cell reactivation of ultraviolet light irradiated adenovirus 5 in fibroblasts from patients with Cockayne syndrome: a study with six Japanese cases. PMID- 6481689 TI - [Evaluation of the role of angiography in the diagnosis and surveillance of hepatic alveolar echinococcosis]. AB - The authors recall the main pathologic and physiopathologic data necessary to understand the angiographic patterns of hepatic alveolar echinococcosis, by means of a rereading of a personal series of 37 cases. They show that this affection has a diagnostic angiographic shape which associate four signs: avascular aspect of the lesions, regular invasion of vessels, presence of a collateral circulation, absence of neovascularisation. Digestive angiography stays a good diagnostic method for the parasitosis, when epidemiological context, ultrasound or CT scan gave no explicit conclusion. It keeps an interest in the preoperative evaluation and in the supervision of portal vein. PMID- 6481690 TI - [Peculiar clinical and x-ray computed tomographic aspects in Sturge-Weber disease. Bilateral occipital calcifications without facial angioma]. AB - Early and specific data on the typical calcifications seen in Sturge-Weber's syndrome are provided by computed tomography. The importance of this investigation is emphasized by the fact that standard radiographs and arteriography do not always produce clearcut results--facial angioma, epilepsy, mental retardation, hemiplegia, hemianopsia--the symptomatology can be less evident and even minimal. PMID- 6481691 TI - [Posttraumatic esophagopericardial fistula]. AB - The outcome in a case of esophagopericardiac fistula due to a closed chest injury was spontaneously favorable, the absence of infective complications probably resulting from adequate antibiotic therapy. PMID- 6481692 TI - [Dense intracerebral cholesteatoma in computed x-ray tomography. Apropos of a case]. AB - The authors report a case of cholesteatoma which is uncommon on account of its dense appearance on the C.T. scan and its temporal localization. PMID- 6481693 TI - [Value of a new apparatus for percutaneous vertebral bone biopsy]. AB - Percutaneous vertebral trephine biopsy is a valuable investigation. A new type of trephine needle for vertebral biopsy is described in this paper. This trephine needle is introduced on the thin needle used for local anesthesia, following a procedure similar to vascular catheterism. Thus, the same puncture is used for local anesthesia and bone biopsy. Therefore, local anesthesia is more effective and the biopsy procedure is much safer, particularly at the thoracic level where vital organs are very close to the spine. A very practical handle design for advancing the trephine needle on the guide wire makes the biopsy procedure easy and precise. This trephine needle enhance indications of this potentially valuable procedure. PMID- 6481694 TI - [Liquid embolization of the renal artery with absolute ethanol]. AB - Absolute ethanol is a new agent for use in embolization which has demonstrated excellent efficacy, is simple to manage, and above all is innocuous in case of reflux into the aorta. A part from provoking irreversible occlusion of the complete renal artery circle, embolization with ethanol provokes direct cellular toxic necrosis comparable with a true mummification. This is of fundamental importance during palliative embolization for renal cancer or in all cases of medical nephrectomy for non-neoplastic disease. Results of the use of liquid embolization of the renal artery with absolute ethanol are presented, the technique, described, and mechanisms of action analyzed based on histologic findings. PMID- 6481695 TI - [Computers in radiology for the management of x-ray computed tomographic files]. PMID- 6481696 TI - Sera from women with histories of repeated pregnancy losses cause abnormalities in mouse peri-implantation blastocysts. AB - Incubation of peri-implantation mouse blastocysts in the presence of untreated human sera resulted in destruction of the blastocysts. Heating the serum resulted in deactivation of the non-specific toxic factor. Whereas heat-treated serum from women with normal obstetrical histories, and men, supported normal trophoblast attachment and outgrowth, sera from women with reproductive dysfunction resulted in inhibition of attachment or disruption of the trophoblast cells. The inner cell masses were not adversely affected by the sera which were toxic to trophoblast. Fractionation of a serum sample by affinity chromatography resulted in removal of the toxic factor with the IgG fraction. Absorption of the toxic serum with human trophoblast membranes resulted in serum that supported trophoblast outgrowth indicating that the toxic factor was an antibody directed against trophoblast antigens. PMID- 6481697 TI - Lymphocyte alloantigens of the horse. II. Antibodies to ELA antigens produced during equine pregnancy. AB - Evidence is presented for a reproducible maternal immune response to histocompatibility antigens during equine pregnancy. Mares were stimulated as a result of pregnancy to produce cytotoxic antibodies to paternal lymphocyte alloantigens. The majority of these antibodies were directed against antigens of the equine lymphocyte antigen (ELA) system, which is the major histocompatibility complex (MHC) of the horse. In 16 experimental pregnancies produced using 12 mares and 4 stallions which had been typed for ELA antigens, there was correlation between ELA incompatibility between sire and dam and the appearance of antibody in the serum of the dam as a result of pregnancy. In ELA incompatible pregnancies, antibody was first detected very early in pregnancy, usually by day 60 in a 336-day gestation. The appearance of antibody following shortly the development of the endometrial cups, which can be seen macroscopically for the first time between days 38 and 40. The strength (titre) of the cytotoxic antibody response appeared to vary with the paternal ELA antigens expressed by the fetus. Circulating antibody to 'third party' alloantigens generated during prior pregnancies did not alter the kinetics of the appearance of antibody in a current pregnancy. Evidence for an anamnestic response was obtained in second pregnancies in which the histocompatibility difference between mare and fetus was the same as in the first pregnancy. However, this accelerated response did not occur before the time of formation of the endometrial cups. Serum samples from approximately 90% of parturient mares on horse farms in New York State contained antibody reactive with paternal lymphocyte alloantigens. PMID- 6481698 TI - Cryotherapy for treatment of genital condylomata during pregnancy. AB - Cryotherapy for treatment of genital condylomata acuminata was safely and successfully employed on 34 pregnant women in the second (4 cases) and third (30 cases) trimesters of pregnancy. No fetal, maternal or neonatal complications occurred during or following cryosurgery. No recurrences were observed before or six weeks following delivery. Cryotherapy eliminated the need for elective cesarean section in many patients with genital condylomata. Cryotherapy can be safely employed on pregnant women on an outpatient basis irrespective of the gestational period. PMID- 6481699 TI - Advanced hidradenitis suppurativa of the vulva. A report of three cases. AB - Advanced suppurative hidradenitis resulting from chronic, progressive, inflammatory involvement of apocrine sweat glands often fails to respond to conservative treatment. Extensive surgical excision of all the infected areas with aggressive postoperative wound care in two of three patients provided relief from this debilitating disease. Skin grafting promoted wound healing in addition to improving cosmetic results. Advanced chronic hidradenitis suppurativa of the vulva should be treated with surgery, and conservative management is justifiable only if preparatory to surgical excision. PMID- 6481700 TI - Sugar chromatography studies in recurrent Candida vulvovaginitis. AB - Because of the apparent increase in vulvovaginitis caused by Candida species, the chronic disability caused by this infection and its stubborn resistance to current therapy, a study of 100 women was undertaken to attempt to gain insight into the role of dietary sugar ingestion in the pathogenesis of this disease. Urinary sugar patterns of glucose, arabinose and ribose were elevated. These excretion patterns correlated well with the excessive oral ingestion of dairy products, artificial sweeteners and sucrose. Eliminating excessive use of these foods brought about a dramatic reduction in the incidence and severity of Candida vulvovaginitis. PMID- 6481701 TI - Association of Fanconi's anemia and squamous-cell carcinoma of the lower female genital tract with condyloma acuminatum. A report of two cases. AB - Two young women had Fanconi's anemia and genital human papillomavirus infection associated with multicentric genital neoplasia. One of these women represented the first documented case of death from vaginal squamous carcinoma associated with Fanconi's anemia. In these two women an apparent biologic compression of the natural history of vulvar and vaginal carcinoma was observed. The finding of condyloma acuminatum in both of them prior to the onset of carcinoma suggests a partial causal association. Involvement of the cervix, vagina, vulva and perianal epithelium by the oncogenic process implies that a field effect occurred in those areas. PMID- 6481702 TI - Effects of lateral recumbency and sitting on the first stage of labor. AB - We compared uterine activity in lateral recumbency and the sitting position during the first stage of labor in a group of nulliparas. Lateral recumbency was accompanied by more intense, less frequent and more efficient uterine contractions than sitting. Patients preferred sitting for the first half of labor and lateral recumbency for the second. No adverse fetal reaction was noticed in either position, judging from the fetal heart rate. An increase in maternal pulse rate during sitting could have indirectly indicated some compression of the prevertebral vessels. Maternal position clearly affects several parameters of labor, and its selection should be based upon maternal comfort, uterine contractility and efficiency, and hemodynamic repercussions. PMID- 6481703 TI - The effect of estrogen on monoamine systems in the fetal rat brain. AB - The effect of a pharmacologic dose of estrogen on brain monoamine systems in the rat fetus was determined using a semiquantitative measure of histofluorescence. Pregnant rats received a subcutaneous injection of cottonseed oil alone or estradiol (E2) in cottonseed oil just before the monoamine systems began to develop. The fetuses were delivered abdominally and killed on day 22 of gestation. A study of four major monoamine areas of the brain with a glyoxilic acid preparation showed that intrauterine exposure to E2 has a significant effect on the monoamine organization of the fetal hypothalamus. No treatment effects were noted in the areas of locus coeruleus, substantia nigra and corpus striatum. The litter sizes of the E2-treated rats and the body weights of the fetuses were much lower than those of the control group. The effect of E2 on monoamine distribution in the fetal hypothalamus may explain the reported disturbances of reproductive function and sexual behavior seen after perinatal exposure to high doses of estrogen in humans. PMID- 6481704 TI - Fetal heart bradycardia associated with the vacuum extractor. A case report. AB - The vacuum extractor has been gaining acceptance in the United States. As a result, physicians are becoming aware of potential problems with its use. We treated a patient for fetal bradycardia attributable to the negative pressure of the vacuum apparatus. This type of fetal heart bradycardia can be distinguished from "true" fetal distress by disconnecting the vacuum apparatus and observing the fetal heart rate response. Bradycardia caused by the negative pressure of the vacuum apparatus returns to normal after instrument disconnection. PMID- 6481705 TI - Oral contraceptives and neoplasia. PMID- 6481707 TI - Pill formulations and their effect on lipid and carbohydrate metabolism. PMID- 6481706 TI - The relationship of estrogen and progesterone to breast disease. AB - The rising incidence of breast cancer, coupled with awareness of the effects of hormones on breast tissue, has resulted in fears that estrogen, progesterone or both incite or adversely affect benign and malignant breast disease. An intensive review of the hormone physiology of the breast and of the numerous studies on hormones and breast disease reveals that estrogen and especially oral contraceptives not only do not cause breast cancer but may have a slight protective effect. Also, the overwhelming evidence is that the risk of benign breast disease is substantially reduced in both current and prior users of oral contraceptives. PMID- 6481708 TI - Nutrition and the pill. AB - Apart from their gynecologic influence as birth control agents, oral contraceptives (OCs) have been shown to affect a number of metabolic and nutritional processes, some insignificantly and others beneficially. The use of contraceptive pills has been shown to decrease the physiologic levels of six nutrients--riboflavin, pyridoxine, folacin, vitamin B12, ascorbic acid and zinc- and to increase the levels of four others--vitamin C, iron, copper and vitamin A. Women who take OCs and have adequate diets need little or no supplemental vitamins. Vitamin and mineral increases caused by OCs do not require treatment. PMID- 6481709 TI - Oral contraception for the adolescent. AB - Sexual activity among unmarried women aged 15-19 living in metropolitan areas rose 66% in the 1970s. Additionally, teenage pregnancies average 1.2 million yearly. However, based largely upon a 25% increase in contraceptive use, the pregnancy rate among teenagers declined 15% between 1973 and 1978. The data on the use of various contraceptive methods by women aged 15-19 show the Pill to be the first choice (1,539,000). Oral contraceptives are safest for young women, with rare risks of serious cardiovascular complications and no deaths reported from cardiovascular disease for women under 18. In contrast, the mortality risk associated with childbirth for this age group is 11.1 deaths per 100,000 live births. Noncontraceptive health benefits associated with oral contraceptive use, such as a 50% decrease in the risk of developing pelvic inflammatory disease, resulting in a protective effect on future fertility, is an excellent rationale for prescribing the Pill for young women who are sexually active. The pill of choice should be one with low doses of both estrogen and progestin yet doses high enough to minimize break-through bleeding, for such bleeding is the most frequent cause of discontinuation. Adolescents require careful screening for contraindications to Pill use prior to initial prescription plus frequent follow up and monitoring so as to minimize side effects and maximize compliance and continuation of use. PMID- 6481710 TI - Rationale for a triphasic oral contraceptive. PMID- 6481711 TI - Mesosalpingeal vessel ligation for conservative treatment of ectopic pregnancy. PMID- 6481712 TI - Renewal and change. The 1983 AAGL presidential address. PMID- 6481713 TI - Direct-vision chorionic villi biopsy for prenatal diagnosis in the first trimester. AB - A technique for chorionic biopsy under direct vision has been developed. It involves the transcervical insertion of a fetoscope into the extraamniotic space during continuous saline infusion. With this technique, not only is contamination with maternal tissue easily avoided, but it is even possible to select by direct vision just those villi considered most suitable for cultivation in vitro--i.e., villi rich in blood vessels and with an abundance of surface buds. As of November 1983 the technique had been used for diagnosis in 21 cases. In 19 pregnancies allowed to continue after sampling there was one fetal loss, and one woman gave birth to a healthy infant in the 39th week. PMID- 6481714 TI - Panoramic hysteroscopy with directed biopsies vs. dilatation and curettage for accurate diagnosis. AB - Sixty-six women underwent panoramic hysteroscopy prior to dilatation and curettage. In 51 of these patients, a directed biopsy was performed through the hysteroscope. The indications for surgery were abnormal bleeding, postmenopausal bleeding, leiomyoma with bleeding, follow-up for adenomatous hyperplasia, infertility with bleeding and lost intrauterine devices with bleeding. In 48 cases the results of hysteroscopy and curettage were in agreement. Hysteroscopy revealed more information than curettage in 16 patients, whereas curettage revealed more information than hysteroscopy in only 2. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of pathology in the uterine cavity. PMID- 6481715 TI - Ovabloc. Five years of experience. AB - Female sterilization with the Ovabloc was performed on 438 women in five years. The complications, failure rate and pregnancy rate are discussed. PMID- 6481716 TI - Prognostic value of tuboscopy vs. hysterosalpingography before tuboplasty. PMID- 6481717 TI - Endometriosis associated with appendiceal intussusception. A report of two cases. AB - While endometriosis is a commonly encountered surgical problem, involvement of the gastrointestinal tract is infrequent and appendiceal involvement rate. Intussusception of the appendix is more frequent. Accordingly, the concurrence of appendiceal endometriosis and intussusception is remarkable. We treated two such patients. The clinical presentation of these patients is varied, with most having abdominal pain, nausea and diarrhea. Asymptomatic cases may be found at surgery for unrelated problems. Correct diagnosis preoperatively is uncommon and most likely when the patients also have a palpable mass. PMID- 6481718 TI - Uterine prolapse complicating pregnancy. A case report. AB - A patient developed uterine prolapse during pregnancy. Conservative management consisted of bed rest and use of a pessary. A viable infant was delivered at 30 weeks' gestation following premature rupture of the membranes. A review of the literature suggests that maintaining conservative treatment of these patients throughout pregnancy can result in uneventful, normal, spontaneous delivery. PMID- 6481719 TI - Controlled trial of clinical utility of serum salicylate monitoring in rheumatoid arthritis. AB - A crossover double-blind controlled trial was performed on 36 patients with rheumatoid arthritis to assess the necessity for serum salicylate monitoring in determining optimal dosage. There was no clinically or statistically significant increase in the clinical improvement of patients associated with serum monitoring but potentially toxic serum levels occurred without tinnitus when serum monitoring was not used. PMID- 6481720 TI - Studies on the metabolism of D-penicillamine and its interaction with probenecid in cystinuria and rheumatoid arthritis. AB - Four patients with recurrent cystine stones and 5 with rheumatoid arthritis (RA) were studied. After a single dose of D-penicillamine to cystinuric patients, cystine excretion decreased considerably. Cysteine-penicillamine mixed disulfide (CSSP) and penicillamine disulfide (PSSP) metabolites appeared within 1-2 h (CSSP/PSSP approximately equal to 4.8-8.6). In RA, cystine excretion remained negligible (CSSP/PSSP approximately equal to 1.4-2.9). With daily D-penicillamine in RA (CSSP/PSSP ratios were usually greater than 7 in those with favorable clinical response. CSSP/PSSP ratios may help to predict prognosis and adjust penicillamine dosage. Coadministration of probenecid is contraindicated in hyperuricemic cystinuric patients because of increased cystine and decreased CSSP and PSSP excretion. PMID- 6481721 TI - Inhibition of prostaglandin E synthesis by steroidal and nonsteroidal antiinflammatory drugs in human synovial fibroblast cultures. AB - Human synovial fibroblasts were "activated" by poly (I) X poly (C) to overproduce prostaglandin E (PGE). Hydrocortisone, diclofenac, indomethacin and ibuprofen inhibited PGE production in a dose dependent manner. Diclofenac (0.2 microgram/ml) had an effect similar to that of 1 microgram/ml of indomethacin and a stronger one than that of 0.5 microgram/ml hydrocortisone and 0.2 microgram/ml ibuprofen. Addition of hydrocortisone with either indomethacin or diclofenac had a synergistic inhibitory effect on PGE production. We suggest that this is an additional model for the study of PGE effect of antirheumatic drugs. PMID- 6481722 TI - Measurements of spinal mobility in the sagittal plane: new skin contraction technique compared with established methods. AB - A new skin contraction (10 cm segment) method for measuring segmental and "total" spinal movement in the sagittal plane is described and compared with the modified Schober test, finger-floor distance and goniometry. Three consecutive 10 cm segments are marked out along the spine from the lumbosacral junction with the patient in full flexion. The amount of contraction occurring within each segment is measured after maximal spinal extension. Skin contraction correlated significantly with comparable measurements by other methods. Interobserver variation was not significant. Mean patient measurement time (+/- SD) was 124 +/- 59 seconds. The 10 cm segment method was found to be more sensitive than other available clinical techniques for detecting loss of spinal mobility in ankylosing spondylitis. PMID- 6481723 TI - Osteonecrosis after high dosage, short term corticosteroid therapy. AB - A retrospective review was made of 66 patients who had undergone neurosurgical treatment for intracranial aneurysms and who had been treated with high doses of corticosteroids to reduce postoperative cerebral edema. At a mean followup time of 50.3 months, one patient had developed bilateral osteonecrosis of the hips, among 44 who were available for followup. PMID- 6481724 TI - Sarcoid arthritis in a North American Caucasian population. AB - Thirty-two of 150 Caucasian patients (21%) with sarcoidosis studied had articular symptoms. Twenty-one had acute sarcoid arthritis with bilateral ankle arthritis/periarthritis. Joint symptoms resolved within 4 months and none developed chronic arthropathy or progressive systemic sarcoidosis. Eleven patients developed articular involvement during the course of chronic pulmonary sarcoidosis manifested by bilateral hilar adenopathy in 8 and parenchymal disease in 9. Joint symptoms were generally transient, however, persistent synovitis in excess of one year was seen in 2 patients. Acute sarcoid arthritis confers a favorable prognosis in North American Caucasians. Differences from previous American series likely reflects the racial compositions of the population studied. Sarcoid arthritis less often evolves during the course of chronic systemic sarcoidosis and even then rarely progresses to a chronic arthropathy. PMID- 6481725 TI - The neck-tongue syndrome: occurrence with cervical arthritis as well as normals. AB - The syndrome of unilateral occipital pain with simultaneous ipsilateral tongue dysesthesia on sharp turning of the neck, recently reported in 4 otherwise normal young adults, is now described in 3 additional instances; one without disease and one each having degenerative spondylosis and ankylosing spondylitis. The originally proposed anatomical explanation for the syndrome, interconnections between the lingual and hypoglossal nerves and the C2, C3 nerve roots, is consistent with this syndrome complex arising from arthritis affecting the C1-C2 C3 articulation. PMID- 6481726 TI - Ewing's sarcoma presenting as monoarthritis. AB - A 22-year-old woman presented with a monoarthritis which mimicked septic arthritis. Synovial biopsy showed chronic synovitis. The synovial fluid was macroscopically purulent but was subsequently shown to contain malignant cells arising from a Ewing's sarcoma of the distal femur. This case indicates that malignancy should be considered in the differential diagnosis of an unexplained monoarthritis, and documents a monoarthritis as the presenting feature of Ewing's sarcoma. PMID- 6481727 TI - Lymphomatoid granulomatosis presenting as polyarthritis. AB - Polyarthritis in lymphomatoid granulomatosis is rare. We report a patient with lymphomatoid granulomatosis who presented with polyarthritis and nodular cutaneous lesions. PMID- 6481728 TI - Myelopathy in Reiter's disease. AB - A 21-year-old male presented with fevers, polyarthritis, dysuria and rash. Neurologic examination indicated myelopathic changes below the T12 spinal cord level. These changes were present during the acute course of his illness but were not evident after 8 weeks of treatment. We are unaware of reports of myelopathy associated with Reiter's disease. PMID- 6481729 TI - Neuropathic arthropathy (Charcot joints) due to cervical osteolysis: a complication of progressive systemic sclerosis. AB - A patient with progressive systemic sclerosis who presented with a painless, destructive joint disease consistent with a neuropathic arthropathy is described. Roentgenogram of the cervical spine revealed marked osteolysis of C1 and C2 which allowed the odontoid process to migrate upward, compress and produce atrophy of the cervical spine cord. We suggest that these changes were responsible for the development of the neuropathic joints. PMID- 6481730 TI - Protrusio acetabuli in Marfan's syndrome: report on two patients. AB - Marfan's syndrome is a hereditary disorder of connective tissue, involving the ophthalmic, cardiovascular and musculoskeletal systems. Two cases are described in which protrusio acetabuli was a major problem. Otto pelvis should be considered as one of the musculoskeletal manifestations of Marfan's syndrome. PMID- 6481731 TI - Clinical and biochemical variables in RA patients on NSAID therapy. PMID- 6481732 TI - Sympathetic synovial effusion associated with septic prepatellar bursitis: synovial fluid analysis with therapeutic implications. PMID- 6481733 TI - Pulmonary necrobiotic nodule. PMID- 6481734 TI - Relapsing polychondritis associated with recurrent oral ulceration. PMID- 6481735 TI - Coexistence of temporal arteritis and rheumatoid arthritis. PMID- 6481736 TI - Animals in the aetiology of asthma. PMID- 6481737 TI - Quantum physics and the philosophy of medicine. PMID- 6481738 TI - Operative cholangiography--techniques and inadequacies. AB - The effectiveness of three methods of operative cholangiography in outlining biliary anatomy was assessed in 60 patients undergoing routine cholecystectomy for gallbladder calculi. X-rays were scored according to bile duct visualization and an overall score calculated. There were no statistically significant differences between the three groups. However, ductal opacification was inadequate in a majority of patients. It is suggested that closer cooperation with the radiologist and more emphasis on technique are required if cholangiography is used to identify unsuspected calculi. PMID- 6481739 TI - Intussusception of invaginated Meckel's diverticulum. AB - Two middle-aged patients are reported who came to laparotomy with a presumptive diagnosis of small bowel tumour. There was no overt evidence of small bowel obstruction in either case. They were found at laparotomy to have intussusception of an invaginated Meckel's diverticulum. This condition should be considered in the differential diagnosis of ileal tumours. PMID- 6481740 TI - Medical confidence, the law, and computers: discussion paper. PMID- 6481741 TI - What makes doctors use computers?: discussion paper. PMID- 6481742 TI - Lumbar abscess resulting from tuberculosis of the spine. PMID- 6481743 TI - Haemochromatosis following prolonged oral iron ingestion. PMID- 6481744 TI - Adenocarcinoma of small bowel in 12-year-old girl. PMID- 6481746 TI - Severe atopic eczema, recurrent pneumococcal meningitis and recurrent eczema herpeticum. PMID- 6481745 TI - Adult Reye's syndrome. PMID- 6481747 TI - Erythema ab igne in chronic pancreatic pain. PMID- 6481749 TI - Sore mouth caused by electrogalvanic current. PMID- 6481748 TI - Adverse reaction to combined therapy of MAOIs and tricyclics. PMID- 6481750 TI - Haemorrhagic shock and encephalopathy syndrome: epidemic of a new disease. PMID- 6481751 TI - Argon laser in the treatment of port wine stains. PMID- 6481752 TI - Surgical treatment of morbid obesity. PMID- 6481753 TI - Things aren't what they seem. PMID- 6481754 TI - Temporary loop ileostomy. AB - A refinement of the technique for constructing the temporary loop ileostomy using a subcutaneous absorbable bridge is described. This leaves the skin surface uncluttered and allows immediate fitting of a watertight appliance. Clinical experience in 22 patients confirms that this is a safe, simple defunctioning stoma with few complications and in our practice has also replaced the loop colostomy as the covering stoma for difficult colorectal anastomoses. PMID- 6481755 TI - Hypercalcaemia in Cleveland: a hospital-based survey. AB - Over a period of six months all reports in the South Tees Health District of serum calcium levels greater than 2.70 mmol/l were extracted and patient records examined to establish the associated diseases and patterns of management. A total of 235 reports were evaluated, and after exclusion of doubtful cases 196 patients were included in the study. No cause had been identified in 57 (29%). Many of these were elderly females in whom hypercalcaemia may have been due to primary hyperparathyroidism, but parathyroid hormone levels had not been measured. Of those in whom a diagnosis had been made, 62 (45%) were associated with malignancy and 50 (36%) with chronic renal failure. 72% of cases of hypercalcaemia reported to general practitioners and 13% of those reported to hospital doctors were not investigated further. Despite the inclusion of serum calcium estimation on routine biochemical profiles, many cases of hypercalcaemia are being ignored or not investigated further. The study emphasizes the need for a reliable screening test for primary hyperparathyroidism. PMID- 6481756 TI - Crystal deposition in the knee and great toe joints of asymptomatic gout patients. AB - Crystal deposition in asymptomatic knee and first metatarsophalangeal (MTP) joints has been studied in 31 patients with previously proven gout. All had had clinical gout in their MTP joints but their knee joints had never been the site of acute gout. Knee arthroscopy was performed permitting synovial membrane inspection, photography and biopsy. Crystalline material was seen in 9 knees (28%) and confirmed histologically as monosodium urate (MSU) in 4 (12.5%). Synovial fluid analysis on 26 samples using a polarizing light microscope demonstrated MSU crystals in 4 (12.5%) and calcium pyrophosphate dihydrate (CPPD) in 2 (6%). Fluid aspirated from 27 of the metatarsophalangeal joints revealed MSU crystals in 14 (52%) and no CPPD crystals. PMID- 6481757 TI - Prevalence of mental illness among mentally handicapped people: discussion paper. PMID- 6481758 TI - Pseudoxanthoma elasticum-like skin changes induced by penicillamine. PMID- 6481760 TI - Episodic prepatellar bursitis with asthmatic attacks. PMID- 6481759 TI - Oncogenes--implications for human cancer. PMID- 6481761 TI - N-allyl analogues of phencyclidine: chemical synthesis and pharmacological properties. AB - Several N-allyl derivatives of 1-phenylcyclohexylamine (PCA) were prepared, and their pharmacology was briefly characterized. The mono- and diallyl derivatives had phencyclidine-like activities in mice but were less potent behaviorally than phencyclidine (PCP). None were PCP antagonists. In vitro these compounds were competitive inhibitors of butyrylcholinesterase (BChE) and protected against inhibition by DFP. In addition, these agents displaced tritiated N-methyl-4 piperidyl benzilate from mouse-brain homogenates and inhibited the effects of acetylcholine on isolated guinea pig ileum. None of these in vitro effects correlated with their PCP-like behavioral activity in vivo in mice. PMID- 6481762 TI - Conformationally restrained fentanyl analogues. 2. Synthesis and analgetic evaluation of perhydro-1,6-naphthyridin-2-ones. AB - Conformational flexibility of the N-acyl portion of fentanyl-type analgetics was restricted through the synthesis of novel perhydro-1,6-naphthyridin-2-one derivatives. Neither the cis-fused derivative (5a), the trans-fused derivative(5b), nor the enamide 8a possessed analgetic activity in the mouse tail flick assay, reaffirming the sensitivity of this portion of 4-anilidopiperidine analgetics to conformational restraint. PMID- 6481763 TI - Preparation of 7-(1,3,4-oxadiazolyl)-6,14-endo-etheno-6,7,8, 14 tetrahydrothebaines and related compounds as potential analgesics. AB - General procedures for the preparation of 7 alpha-(2-substituted-1,3, 4-oxadiazol 5-yl)-6,14-endo-etheno-6,7,8,14-tetrahydrothebaines are described. Substituents include alkyl, aryl, amino, cycloamino, and alkylthio functions. Many of these and related compounds show analgesic activity intermediate between codeine and morphine in the Hendershot and Forsaith writhing test. An unsuccessful attempt was made to synthesize 7 beta-(1,3,4-oxadiazol-2-yl)-6,14-endo-etheno-6,7,8,14- tetrahydrothebaine. PMID- 6481764 TI - Dichloro[1,2-bis(4-hydroxyphenyl)ethylenediamine]platinum(II) complexes: an approach to develop compounds with a specific effect on the hormone-dependent mammary carcinoma. AB - Stereoisomeric dichloro [1,2-bis(4-hydroxyphenyl)ethylenediamine]platinum(II) complexes (meso-3a, (+/-)-3b, (+)-3c, (-)-3d) and their N,N'-dibutyl derivatives (meso-4a, (+/-)-4b, (+)-4c, (-)-4d) were synthesized and tested on antitumor activity. The most active compound, 3d, shows a modest inhibition of the [3H]estradiol receptor interaction and causes a marked effect on the growth of the hormone-dependent human MCF 7 breast cancer cell line. It is also active on the hormone-independent human MDA-MB 231 breast cancer cell line, on the ADJ/PC6 plasmacytoma of the Balb/C mouse, and on the L 5222 leukemia of the BD IX rat. Apparently the inhibition of the MCF 7 cell line is not mediated by the estrogen receptor system. Histopathological studies on 3d revealed very low toxicity. PMID- 6481765 TI - Synthesis and evaluation of (17 alpha,20E)-21-[125I]iodo-19-norpregna 1,3,5(10),20-tetraene-3,17 -diol and (17 alpha,20E)-21-[125I]iodo-11 beta-methoxy 19-norpregna-1,3,5(10),20-tetraene-3,17-diol (17 alpha-(iodovinyl)estradiol derivatives) as high specific activity potential radiopharmaceuticals. AB - Two 17 alpha-[125I]iodovinyl estradiol derivatives 4b,d possessing high specific activity have been prepared and tested as potential radiopharmaceuticals. The use of the 3-acetyl derivatives 2c,e and the replacement of iodine monochloride with sodium iodide and Chloramine-T in THF/phosphate buffer (pH 7.0) permitted us to synthesize no-carrier-added (17 alpha,20E)-21-[125I]iodo-19-norpregna 1,3,5(10),20-tetraene-3,17-d iol (4b) and (17 alpha,20E)-21-[125I]iodo-11 beta methoxy-19-norpregna-1,3,5(10),20-tetraene-3,17-diol (4d) with 50% radiochemical yield and high purity. Although the specific activity represents only half of the theoretical value in some cases, this modified approach is a substantial improvement over the previously published method. Our preliminary distribution studies indicate that although both 4b and 4d localize in the tissues known to have a large concentration of estrogen receptors, 4d accumulates in higher amounts in target tissues and provides a high target to nontarget ratio. PMID- 6481766 TI - A water-soluble cholesteryl-containing trisgalactoside: synthesis, properties, and use in directing lipid-containing particles to the liver. AB - The synthesis of a trisgalactoside-terminated cholesterol derivative is described. Tris(galactosyloxymethyl)-aminomethane is coupled to cholesterol by using glycyl and succinyl as intermediate hydrophilic spacer moieties. The resulting cholesteryl ester dissolves easily in water, forming monodisperse micelles. When added to dispersions of liposomes or plasma lipoproteins in water, the substance becomes incorporated rapidly into these structures, causing an increase of their buoyant density. Liposomes or low-density lipoproteins, preloaded with the substance, are rapidly cleared from the circulation and taken up by the liver after intravenous injection in rats. This uptake is inhibited by N-acetylgalactosamine but not by N-acetylglucosamine, indicating the specificity of this process. PMID- 6481767 TI - Molecular analysis of hexahydro-1H-indeno[1,2-b]pyridines: potential antidepressants. AB - Biological tests indicate hexahydro-1H-indeno[1,2-b]pyridines to be potential human antidepressants with additional stimulating properties. Two diastereomeric series with H4a,H5-trans,H4a,H9b-cis and H4a,H5-cis,H4a,H9b-cis configurations have been tested biologically. The results revealed that the H4a,H5-cis,H4a,H9b cis series and the ortho-substituted 5-phenyl H4a,H5-trans,H4a,H9b-cis compounds lack activity. Neither the conformation with lowest potential energy nor any other electron-derived parameter correlate with these data. The only relevant difference between the active and the inactive compounds detected thus far is the rotational barrier of the phenyl in the 5-position. The conclusion was reached that certain conformations, which do not resemble those of lowest potential energy, cannot be adopted by the inactive compounds. Therefore, the interaction of the drug with the binding site, responsible for its biological activity, appears to be governed by a dynamic process. This process is characterized by a transformation of the conformation of lowest potential energy to one with an energy content above the minimum. PMID- 6481768 TI - Antiinflammatory activity of N-(2-benzoylphenyl)alanine derivatives. AB - A series of N-(2-benzoylphenyl)alanine derivatives were synthesized and tested for antiinflammatory activity in the Evans blue-carrageenan induced pleural effusion assay. The target compounds were envisioned to bind to a receptor site on the cyclooxygenase enzyme by a mechanism first proposed by Appleton and Brown. Of the 21 compounds prepared, two were found to be one-tenth as potent as indomethacin in the pleurisy model and one compound was tested and found to be weakly active in the adjuvant arthritis model. PMID- 6481770 TI - Total chemical synthesis and antitumor evaluation of 4-demethoxy-10,10 dimethyldaunomycin. AB - The novel anthracycline analogue 4-demethoxy-10,10-dimethyldaunomycin was prepared in nine chemical steps from 5,8-dimethoxy-2-tetralone. It proved to be inactive as an antitumor agent in the mouse P388 lymphocytic leukemia model. PMID- 6481769 TI - Synthesis and murine antineoplastic activity of bis[(carbamoyloxy)methyl] derivatives of pyrrolo[2,1-a]isoquinoline. AB - The synthesis of 4,5-dihydropyrrolo[2,1-a]isoquinolines is reported. A key intermediate in the synthesis of 8-methoxy-4,5-dihydropyrrolo[2,1 a]isoquinolines, 6-hydroxy-1,2,3,4-tetrahydroisoquinoline-1-carboxylic acid (6), was prepared by using a regiospecific phenolic cyclization reaction. The P388 lymphocytic activity is reported for 1,2-bis(hydroxymethyl)-5,6-dihydro-8-methoxy 3-methylpyrrolo [2,1-a]isoquinoline bis(isopropylcarbamate) (11a), 1,2 bis(hydroxymethyl)-5,6-dihydro-8-methoxy-3-methylpyrrolo[2,1-a ]isoquinoline bis(cyclohexylcarbamate) (11b), 1,2-bis(hydroxymethyl)-5,6-dihydro-3 methylpyrrolo[2,1-a]isoqui nol ine bis(methylcarbamate) (13a), 1,2 bis(hydroxymethyl)-5,6-dihydro-3-methylpyrrolo [2,1-a]isoquinoline bis(ethylcarbamate) (13b), and 1,2-bis(hydroxymethyl)-5,6-dihydroxy-3 methylpyrrolo[2,1-a]isoq uin oline bis(cyclohexylcarbamate) (13c); all of the compounds were active. Compound 11a was tested in an expanded tumor panel and was shown to be active against B16 melanocarcinoma, CD8F1 mammary, L1210 lymphoid leukemia, colon 38, and MX-1 human tumor breast xenograft systems. PMID- 6481771 TI - Antihypertensive activities of phenyl aminoethyl sulfides, a class of synthetic substrates for dopamine beta-hydroxylase. AB - Four sulfur-containing analogues of phenylpropylamine were synthesized and evaluated as substrates for dopamine beta-hydroxylase (DBH) and monoamine oxidase (MAO). All four phenyl aminoethyl sulfides were shown to be good substrates for DBH whereas only the two analogues not possessing a methyl group alpha to the terminal amino group were substrates for MAO. All four analogues were tested for acute antihypertensive activity in an animal model for hypertension, the spontaneously hypertensive rat (SHR). Two of the analogues, both of which should partition readily across the blood-brain barrier, did not appreciably reduce systemic blood pressure in the 6-h testing period. However, the two analogues that were designed to be relatively restricted to peripheral sites of action caused a dramatic drop in blood pressure in SHR of 25% within 1-1.5-h postinjection, with the analogue designed to be both restricted to the periphery and MAO inactive, causing a more prolonged antihypertensive activity. PMID- 6481772 TI - Carbocyclic analogues of xylofuranosylpurine nucleosides. Synthesis and antitumor activity. AB - (+/-)-4 alpha-Amino-2 alpha,3 beta-dihydroxy-1 alpha-cyclopentanemethanol (6), the carbocyclic analogue of xylofuranosylamine, was synthesized from the previously reported 4 alpha-acetamido-2 alpha,3 alpha-epoxycyclopentane-1 alpha methanol. Amine 6 was converted to (+/-)-4 alpha-[(5-amino-6-chloro-4 pyrimidinyl)amino]-2 alpha,3 beta-dihydroxy-1 alpha-cyclopentanemethanol (7) by condensation with 5-amino-4,6-dichloropyrimidine. From 7, the carbocyclic analogues of xylofuranosyladenine and xylofuranosyl-8-azaadenine were prepared. In contrast to 9-beta-D-xylofuranosyladenine and its 8-aza analogue, the corresponding carbocyclic nucleosides were resistant to deamination by adenosine deaminase. The carbocyclic 8-aza derivative 10 exhibited significant in vivo antitumor activity which varied according to treatment schedule. PMID- 6481773 TI - Health care institutions: survival in a changing environment. AB - The health care system in the United States has been altered by recent economic and political events, including a major recession and a retrenchment in federal nonentitlement spending programs. The economic recovery and the continuing high federal deficits prompt new questions about both the future expansion and the distribution of health spending. Long-term economic forecasts and public opinion polls suggest that health will consume a growing share of the national resources. Nevertheless, the level of health spending will not grow as rapidly as in the past, and the distribution of that spending may also change. Because of these changes, the growth in health spending will not guarantee the survival of existing institutions. New competitive forces and revised reimbursement mechanisms will lead to a redistribution of the health dollar, and this redistribution will create both risk and opportunity for America's important health care institutions and their health professionals. PMID- 6481774 TI - Changes in the concept of informed consent in medical encounters. AB - The author in this article reviews recent changes in the conceptualization of informed consent in medical encounters to help provide a better understanding of the concept itself and of some difficulties that exist in philosophical justifications for the requirement of informed consent. PMID- 6481775 TI - The influence of the attending physician on indirect graduate medical education costs. AB - In the study reported here, the author compared the hospital charges of three groups of patients in one combined university/community hospital: private patients with a community attending physician; teaching patients with a community attending physician; and teaching patients with a faculty attending physician. Control of case mix differences was accomplished by selecting four surgical diagnosis related groups, modifying these groups through use of the International Classification of Diseases procedure codes, and using patient demographic, health status, and severity of illness control variables. The results of the study indicated that teaching patients with a faculty attending physician had significantly higher hospital charges, while teaching patients with a community attending physician had similar charges as compared with the private, nonteaching patients. The higher charges were attributable to increase ordering of diagnostic tests and differential use of supplies and equipment. The level of resident supervision by attending physicians appeared to be influential in determining total charges incurred by the teaching patients. PMID- 6481776 TI - Clinical competence certification: a critical appraisal. AB - The American Board of Internal Medicine has requested that residency program directors certify the clinical competence of their candidates. The clinical evaluation exercise (CEX) is one component of the overall certification process. During 1980-1982, 120 residents at the University of Michigan Hospitals participated in a CEX. The results show recurrent inadequacies among the residents in eliciting the social and family histories and performing the mental status and neurologic examinations. The ability to elicit a complete medical history correlated (p less than .01) with communication skills. In three of four specific organ examinations, the ability to perform a technically correct and complete physical examination correlated with the accuracy of the residents' findings (p less than .05). Separate evaluations by senior faculty members generally did not correlate with the residents' performance on the CEX. Analysis of the program described here showed that it requires considerable faculty time, requires training of evaluators to develop interrater reliability, and raises questions as to the validity of the CEX. As national certification boards integrate a formal clinical component into the certification process, such problems need to be addressed and rectified. PMID- 6481777 TI - Changes in life-style characteristics, health, and mood of freshman medical students. AB - A comprehensive questionnaire on life-style was completed by 104 of 184 freshman medical students at orientation and again seven months later. Life-style changes during this period were related to physical-psychological health and affect-mood changes. There was a decrease in the following characteristics: physical activity, salt and bread consumption, sleep and interrupted sleep, general health, leisure, and recreational activities. During the studied time period, few students maintained a balanced diet. There was an increase in perceived stress as the school year progressed and a tendency to improve coping effectiveness. This increase in coping effectiveness was associated with improved health and mood. Enjoying medical school more, feeling more competent as a medical student, and questioning the desire to enter medical school less were also related to improved health and mood. PMID- 6481778 TI - Reduced-schedule pediatric residency training. AB - Reduced-schedule residency training is an option deemed desirable by many residents and medical students applying for residencies. The number of such positions offered through the National Resident Matching Program and through independent arrangements made between residents and program directors is, however, quite small compared with the total number of residency positions available. In this paper, the authors review the national experience with reduced schedule residency training during the past decade and present data concerning 15 pediatric residents at the University of Rochester Strong Memorial Hospital who chose a reduced-schedule training option between 1977 and 1984. The advantages and disadvantages of the implementation of this option from the perspectives of the residents choosing it, the residents who did not, and the faculty members are presented. Reduced-schedule training for selected residents and programs is an attractive and viable option. PMID- 6481779 TI - Academic origins of medical school applicants and entrants, 1980-1982. PMID- 6481780 TI - Concordance of medical school course grades and NBME Parts I and II examination subject test scores. PMID- 6481781 TI - Faculty development in family medicine: a survey of needs and resources. PMID- 6481782 TI - Cost of residents' decisions on actual patients and in simulated encounters. PMID- 6481783 TI - Educational value of an ambulatory care experience for medical students. PMID- 6481785 TI - A simple hypnotic approach to treat test anxiety in medical students and residents. PMID- 6481784 TI - Failures in comprehensive diagnosis by senior medical students. PMID- 6481786 TI - Faculty perceptions of the McMaster M.D. program. PMID- 6481787 TI - Changes in informed consent: how far and how fast? PMID- 6481788 TI - The residency interview. PMID- 6481789 TI - Studies of natural killer cells in pregnancy. II. The immunoregulatory effect of pregnancy substances. AB - This study was performed utilizing a standard 51Cr-release cytotoxicity and a single cell assay against K-562 NK-sensitive target cells. Pregnancy sera and amniotic fluids, were found to decrease human natural killer (NK) activity. Pregnancy sera were able to inhibit overall NK activity of partly purified peripheral blood lymphocytes in a dose dependent fashion. However, the exposure of effector cells to concentrations higher than 20% did not further increase the serum's suppressive activity. Sera taken from preeclamptic pregnancies had a similar inhibitory effect as those from normal pregnancies. Amniotic fluid was found to be even more suppressive than pregnancy serum. Using a single cell cytotoxicity assay we determined that neither serum nor amniotic fluid affected potentially cytotoxic target binding cells ("pre"-NK). The relative number of conjugates with dead target was, however, significantly depressed under the influence of pregnancy serum and to an even greater extent by amniotic fluid. Both pregnancy substances were also able to decrease the number of conjugates with dead target in an interferon-augmented population of lymphocytes. Our investigation indicates that the suppressive effect of amniotic fluid and pregnancy serum on NK activity is based on a blocking effect exerted at the killing capability of the active NK cells. PMID- 6481790 TI - A murine model of squamous intraepithelial neoplasia. AB - Focal areas of intraepithelial neoplasia were induced in the skin of mice by 1 intraperitoneal injection of urethane followed by twice weekly topical applications of 12-0-tetra-decanoyl phorbol-13-acetate (TPA). Microscopic lesions with histologic characteristics of intraepithelial neoplasia were seen in all animals after 11 weeks of TPA application. Fluorescence microscopy verified the increased DNA content of these lesions. This easily produced animal model of premalignant disease might be valuable in the preclinical testing of topically applied antineoplastic agents. PMID- 6481791 TI - Response of the popliteal lymph node to reinfection of the hind foot pad of the mouse with Mycobacterium marinum. AB - In C57BL mice inoculated with Mycobacterium marinum in the right hind foot pad 2 weeks earlier ("previously infected mice"), inoculation of M. marinum into the left hind foot pad was followed by accelerated enlargement of the left popliteal node. Popliteal-node lymphocytes harvested from previously infected donors, labeled with 3H-uridine in vitro, and infused intravenously into previously infected recipients at the time of reinfection in the left hind foot pad homed on the left popliteal node. Similarly, there was an accelerated increase of the number of labeled lymphocytes in the left popliteal node of previously infected mice infused intravenously with 3H-thymidine 24 or 48 hr after reinfection in the left hind foot pad. Accelerated enlargement of the lymph node and the early accumulation of labeled lymphocytes in the popliteal lymph node draining the foot pad reinfected with M. marinum appeared more likely to have resulted from influx and accumulation of lymphocytes than from local proliferation, especially as the lesion of the left hind foot pad is a very modest one, and the quantity of antigen in the left hind foot pad and draining node is very small. The accumulation of lymphocytes, which is the cause of the accelerated node enlargement, appears to require the presence of both antigen and antigen-reactive lymphocytes. PMID- 6481792 TI - Defective cellular immune responses in lupus nephritis. AB - To determine whether patients with systemic lupus erythematosus (SLE) and active nephritis have more profound defects in cellular immune responses, we studied cell-mediated immunity (CMI) in 12 patients with lupus nephritis (LN) and 11 patients with chronic mesangial proliferative glomerulonephritis (CGN) without renal insufficiency. The LN patients had a significant depression in CMI, characterized by impaired delayed hypersensitivity skin reactivity to keyhole limpet haemocyanin (KLH), decreased percentage of T cells and diminished lymphocyte transformation to phytohaemagglutinin (PHA). The levels of concanavalin A (Con A)-induced suppressor cell activity (SCA) were significantly lower in LN patients compared with those in normal controls and those in CGN patients. The levels of all CMI parameters for the 6 LN patients with the nephrotic syndrome (NS) were significantly more decreased when compared with those of the 6 LN patients without NS. In contrast, the CMI levels in CGN patients with or without NS did not differ from normal subjects. These findings may lend further insight into the understanding of the immunoregulatory defect in LN. PMID- 6481794 TI - The comparative specificity of the inner and outer substrate transfer sites in the choline carrier of human erythrocytes. AB - The substrate specificities on the inner and outer surfaces of the cell membrane have been compared by determining the relative affinities, inside and outside, of a series of choline analogs. The results of two different methods were in agreement: (1) the carrier distribution was determined in the presence of a saturating concentration of an equilibrated analog, using N-ethylmaleimide as a probe for the inward-facing carrier; (2) the degree of competition was measured between an equilibrated analog and choline in the external solution. The carrier sites are found to have markedly different specificities: the outer site is more closely complementary to the structure of choline than is the inner, and even a slight enlargement of either the trimethylammonium or hydroxyethyl group gives rise to preferential binding inside. It is also found that a nonpolar binding region, which is adjacent to the outer site, is absent from the inner site. As the transport mechanism involves the exposure of only one site at a time, first on one surface and then the other, it follows that an extensive reorganization of the structure of the substrate site may occur during the carrier-reorientation step, or alternatively that two distinct sites may be present, only one of which is exposed at a time. PMID- 6481793 TI - Partitioning of paracellular conductance along the ileal crypt-villus axis: a hypothesis based on structural analysis with detailed consideration of tight junction structure-function relationships. AB - Current models of intestinal transport suggest cells which absorb ions are located on the villus while secretory cells are located in the crypt and putatively have paracellular pathways which are highly conductive to Na+. One approach to assess possible variation in small intestinal paracellular conductance along the crypt-villus axis is to morphometrically analyze the structural aspects of crypt and villus tight junctions (TJs) which relate to paracellular resistance. Such detailed analysis of junctional structure in this heterogeneous epithelium would permit one to compare intestinal TJ structure function relationships with those in a structurally simpler epithelium such as that of toad urinary bladder. This comparison would also be of considerable interest since previous similar comparisons have failed to consider in detail the geometric dissimilarity between these two epithelia. We applied light, electron microscopic, and freeze-fracture morphometric techniques to guinea pig ileal mucosa to quantitatively assess, for both crypts and villi, linear TJ density, relative surface contributions, and TJ strand counts. Mean linear TJ densities were 76.8 m/cm2 for crypt cells and 21.8 m/cm2 for villus absorptive cells. Mean TJ strand counts were 4.45 for undifferentiated crypt cell TJs and 6.03 for villus absorptive cell TJs. The villus constituted 87% and the crypt 13% of total surface. We utilized these data to predict paracellular conductance of crypts vs. villi based on equations derived from those of Claude (P. Claude, J. Membrane Biol. 39:219-232, 1978). Such analysis predicts that 73% of ileal paracellular conductance is attributable to the crypt. Furthermore, we obtained literature values for paracellular resistance in mammalian ileum and toad urinary bladder and for toad bladder TJ structure and linear density and constructed a relationship which would allow us to more accurately compare TJ structure function correlates between these two epithelia. Such a comparison, which considers both surface amplification and TJ structure and distribution in these epithelia, shows that one would predict in vitro measured values for paracellular resistance should be approximately two orders of magnitude less in mammalian ileum than in toad urinary bladder. This predicted discrepancy (115-fold) correlates well with the observed difference (100-fold).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481795 TI - Alterations in phospholipid polymorphism by polyethylene glycol. AB - The fusogen polyethylene glycol is shown to alter the polymorphism of dimyristoyl phosphatidylcholine, soybean phosphatidylethanolamine, bovine phosphatidylserine, egg phosphatidylcholine/cholesterol mixture, dilinoleoylphosphatidylethanolamine/palmitoyl-oleoylphosphatidy lcholine mixture, and egg lysolecithin. Suspension of these lipids in 50% polyethylene glycol (mol wt = 6000) reduces both the lamellar and the hexagonal II repeat spacings as measured by X-ray diffraction. An increase in the gel to liquid crystalline and bilayer to hexagonal transition temperatures are observed by freeze-fracture, X ray diffraction, differential scanning calorimetry and 31P NMR. Freeze-fracture electron micrographs revealed different bilayer defects depending on the physical states of the lipid. Lipidic particles in mixtures containing unsaturated phosphatidylethanolamine is eliminated. Some of the influences of polyethylene glycol on lipids may be explained by its dehydrating effect. However, other nonfusogenic dehydrating agents failed to produce similar results. These findings are consistent with the proposal that close bilayer contact and the formation of bilayer defects are associated with the fusogenic properties of polyethylene glycol. PMID- 6481796 TI - John Henryism and blood pressure differences among black men. II. The role of occupational stressors. AB - In this study, the effects of psychosocial job stressors on the resting blood pressure (BP) of 112 black male workers were examined. The subjects resided in a rural, poor, predominantly black community in eastern North Carolina. The job stressors included unemployment, lack of job security, lack of job success, the perception that wages earned were too low for the work performed (and inhibited anger about unfair wages), and the perception that being black had hindered chances for achieving job success. The effect-modifying influence of on-the-job social support, and John Henryism, on several of these relationships was also examined. For systolic blood pressure, a main effect was observed for job security, and an interaction effect was observed for employment status and time of day of interview. For diastolic blood pressure, significant interactions were observed for job success and John Henryism, and for job success and the perception that being black had hindered chances for achieving job success. These findings further clarify under what conditions John Henryism may be associated with higher BPs in this sample of black men. These findings also shed light on the emotional pathways through which selected job stressors may influence resting BPs in these men. PMID- 6481797 TI - Findings on a relationship between type A behavior and headaches. AB - Based on answers to a headache questionnaire college women were classified on a two-dimensional array according to their relative frequencies of both vascular (migraine) and tension (muscle contraction) pain. The various groups were then compared on a measure of the coronary-prone Type A behavior pattern. In two independent surveys, one with 237 respondents and one with 206 respondents, increasing frequencies of both types of headaches were significantly associated with higher scores on the Type A scale from the Jenkins Activity Survey. The findings support prior data from a client population, also reported, and suggest appropriate therapeutic interventions for headache relief. They also clearly show that a behavior pattern which has been associated with coronary artery disease now can be considered to have implications for other problems as well. PMID- 6481798 TI - Enhanced psychophysiological responses of type A coronary patients during type A relevant imagery. AB - This study used imagery instructions to examine cardiac patients' physiological responses to Type A-relevant situations. Twenty Type A and Type B patients, classified by the Jenkins Activity Survey (JAS), were presented both "Type A" and "Neutral" imagery scripts, followed by the administration of the Structured Interview (SI). Subjects rated each scene for vividness and their emotional reaction to the image. Heart period, pulse transit time, finger temperature, finger pulse volume, frontalis EMG, neck EMG, forearm flexor EMG, and forearm extensor EMG were monitored throughout the experiment. Results showed that (a) Type A's had greater heart period and neck EMG responses to Type A scenes compared to Neutral scenes, (b) Type A's had faster pulse transit times and lower finger temperatures than Type B's throughout the imagery task and the SI, (c) both Type A's and Type B's rated Type A scenes as more emotionally arousing than Neutral scenes, and (d) although the pattern of results was the same when subjects were classified by the SI, results were no longer statistically significant. PMID- 6481799 TI - A brief methodological comment on possible inaccuracies induced by multimodal measurement analysis and reporting. AB - The use of multiple response system measurement adds an important dimension to behavioral medicine research. However, multiple measurement can result in problems in both analyzing and reporting outcome data. Problems in analysis include the increasing of chance findings as the measurement number increases. Problems in reporting include a blurring of response categories when general labels are used, a biased emphasis on the minority of variables showing experimental differences, and a misleading tendency to base comparative conclusions on general labels which do not accurately represent all data measured. Some examples of these problems from methodologically sound studies are described and alternative ways of dealing with the findings from multiple measurements are suggested. PMID- 6481800 TI - An Autonomic Nervous System Response Inventory (ANSRI): scaling, reliability, and cross-validation. AB - The Autonomic Nervous System Response Inventory (ANSRI) was designed to elicit individuals' self-reported patterns of peripheral physiological response to emotion-provoking stimuli. Fifty-one items reflecting such responses were rated as having been present (1 = absent to 5 = intense) during prototypical emotional situations drawn from experience, which were reconstructed and imagined by a subject. Items were rated for each of five conditions, four of which were emotions (fear, anger, sadness, joy) and one of which was an activation control condition (physical activity). Scales were developed to describe the relative activity of different physiological response systems: P scales based on physiological coherence of items and F scales based on factor analytic item clusters. The derivation and contents of the scales are described, and the following psychometric data are reported: test-retest reliabilities and internal consistency coefficients (original and cross-validation samples), factor analyses, and cross-validation of factors. Data indicate that the ANSRI and most of its scales are sufficiently reliable and replicable to warrant validity research. PMID- 6481801 TI - Arthroscopy--a review of 220 cases. PMID- 6481802 TI - Radiological seminar CCXXXIX: solitary thyroid nodule rationality of diagnostic tests. PMID- 6481803 TI - Structure of tomato bushy stunt virus. V. Coat protein sequence determination and its structural implications. AB - We report the chemically determined sequence of most of the polypeptide chain of the coat protein of tomato bushy stunt virus. Peptide locations have been determined by comparison with the high-resolution electron density map from X-ray crystallographic analysis as well as by conventional chemical overlaps. Three small gaps remain in the 387-residue sequence. Positively charged side-chains are concentrated in the N-terminal part of the polypeptide (the R domain) as well as on inward-facing surfaces of the S domain. There is homology of S-domain sequences with structurally corresponding residues in southern bean mosaic virus. PMID- 6481804 TI - Structure of satellite tobacco necrosis virus after crystallographic refinement at 2.5 A resolution. AB - The structure of the protein subunit of satellite tobacco necrosis virus has been solved at 3.7 A resolution. We have now crystallographically refined the original model and extended the resolution ot 2.5 A in order to get a model accurate enough to explain the details of the subunit interactions. The refinement was done with a novel method utilizing the icosahedral symmetry of the virus particle. The final model shows a complicated network of interactions, involving salt linkages, hydrogen bonds and hydrophobic contacts. In addition, we have located three different metal ion sites in the protein shell, linking the protein subunits together. These sites are probably occupied by calcium ions. One site is found in a general position near the icosahedral 3-fold axis of the virus. The ligands form an octahedral arrangement, with two main chain carbonyl oxygens (0 61 and 0-64), one carboxylate oxygen (OD1 from Asp194) of the same subunit and a second carboxylate oxygen (OE1 of Glu25) from a 3-fold related subunit. Two water molecules complete the octahedral arrangement. A second site is on the icosahedral 3-fold axis and is liganded by the carboxylate oxygens of the 3-fold related Asp55 residues. The third metal ion site is found on the 5-fold axis, liganded by the five carbonyl oxygens of Thr138 and two water molecules. We are unable to locate the first 11 N-terminal amino acid residues, which point into the virus interior. No interpretable density for RNA has been found, indicating that the nucleic acid of the virus does not have a unique orientation in the crystal. PMID- 6481806 TI - Packing of collagen molecules modified with 2-propanol. AB - X-ray diffraction data of collagen molecules modified with 2-propanol favour a quasi-hexagonal lateral packing over a quasi-tetragonal one. PMID- 6481805 TI - Macrofiber structure and the dynamics of sickle cell hemoglobin crystallization. AB - Fibers of deoxyhemoglobin S undergo spontaneous crystallization by a mechanism involving a variety of intermediate structures. These intermediate structures, in common with the fiber and crystal, consist of Wishner-Love double strands of hemoglobin S molecules arranged in different configurations. The structure of one of the key intermediates linking the fiber and crystal, called a macrofiber, has been studied by a variety of analytical procedures. The results of the analysis indicate that the intermediates involved in the fiber to crystal transition have many common structural features. Fourier analysis of electron micrographs of macrofibers confirms that they are composed of Wishner-Love double strands of hemoglobin molecules. Electron micrographs of macrofiber cross-sections reveal that the arrangement of the double strands in macrofibers resembles that seen in micrographs of the a axis projection of the crystal. This orientation provides an end-on view of the double strands which appear as paired dumb-bell-like masses. The structural detail becomes progressively less distinct towards the edge of the particle due to twisting of the double strands about the particle axis. Serial sections of macrofibers confirm that these particles do indeed rotate about their axes. The twist of the particle is right handed and its average pitch is 10,000 A. The effect of rotation on the appearance of macrofiber cross-sections 300 to 400 A thick can be simulated by a 15 degrees rotation of an a axis crystal projection. The relative polarity of the double strands in macrofibers and crystals can be determined easily by direct inspection of the micrographs. In both macrofibers and crystals they are in an anti-parallel array. On the basis of these observations we conclude that crystallization of macrofibers involves untwisting and alignment of the double strands. PMID- 6481807 TI - Cryo-electron microscopy of vitrified insect flight muscle. AB - Frozen hydrated sections of vitrified unstained insect flight muscle in the rigor and relaxed states were studied by cryo-electron microscopy. High resolution images with good contrast were obtained. As judged from direct images and from the comparison of optical diffractograms with X-ray diffraction patterns obtained from glycerinated muscle fibres, the vitrified specimen is well preserved. Preparation artifacts encountered in conventional plastic sections are avoided. The preservation of the relaxed structure also seems better than in freeze-etched replicas as the 14.5 nm repeat of crossbridges on thick filaments is easily visible. PMID- 6481808 TI - Architectural and histochemical analysis of the semitendinosus muscle in mice, rats, guinea pigs, and rabbits. AB - The architectural and histochemical properties of the anatomically distinct compartments of the semitendinosus muscle (ST) of mice, rats, guinea pigs, and rabbits show that the ST is composed of two separate compartments aligned in series--a distal compartment (STd) and a proximal one (STp). The STp is further subdivided into a ventral head (STpv) and a dorsal head (STpd). The muscle fibers were arranged in parallel to the line of muscle pull within each compartment. The STd has the longest and the STpv the shortest fibers in all species. The physiological cross-sectional area and the estimated tetanic tension was greatest in the STd. Based on the staining pattern for myosin ATPase (alkaline preincubation) and an oxidative indicator (NADH or SDH), the STpv has the highest percentage of slow-oxidative (SO) or SO plus fast-oxidative-glycolytic (FOG) fibers of any portion of the muscle. The differences in fiber-type distributions and architectural designs of the separate compartments suggest a specialization of function of the individual compartments. PMID- 6481809 TI - Morphological basis of the feeding mechanics in the shingle-back lizard Trachydosaurus rugosus (Scincidae, Reptilia). AB - This report details certain morphological aspects of the feeding system of the lizard Trachydosaurus rugosus, an opportunistic omnivore, as a first step toward a functional characterization of its masticatory system. The skull is relatively solid and internally well braced; its anterodorsal elements are tightly tied to the integument and covering osteoderms. There is potential for intracranial kinesis and streptostyly. At small gapes, mandibular movements seem to be restricted to relatively simple, hingelike actions by a series of mechanical stops. The dentition features a progression of smaller to larger teeth posteriorly along the tooth row. The jaw adductor musculature is massive; other jaw muscles are relatively simple. The external adductor mass is particularly noteworthy in that it is subdivided into four mechanical units by a complex internal tendon tract (the coronoid aponeurosis). The internal adductor is composed of two separate gross muscles, pseudotemporalis (PST) and pterygoideus (PT). Each of these is subdivided into two main units by aponeurotic sheets, the PST by parts of the coronoid aponeurosis and the PT by a separate series. The form of the aponeurotic system in Trachydosaurus confounds the separation and identification of the adductor muscles and their component parts along the lines of traditional nomenclature, and underscores the need for separating criteria based on homology from those reflecting morphological and possibly functional divisions. PMID- 6481810 TI - Motor units of the primary ankle extensor muscles of the opossum (Didelphis virginiana): functional properties and fiber types. AB - Motor units of the medial gastrocnemius (MG) and the single lateral gastrocnemius/soleus (LG/S) muscles of the opossum (Didelphis virginiana) were found to have uniformly slow contraction times relative to homologous muscles of the cat. Though a broad range of peak tetanic tensions was found among motor units from both muscles, most of the motor units were quite large relative to tension of the whole muscle. Comparison of the relative sizes of motor units showed that those of LG/S are significantly larger and slower than the units of MG. This suggests that the motor units of the two muscles may be differentially recruited during different behaviors. All of the MG and LG/S motor units were highly or moderately resistant to fatigue. Histochemical staining for NADH diaphorase activity indicated consistently high levels of the enzyme in all of the fibers of both muscles. Apparently, all of the fast motor units consist of fast oxidative/glycolytic (FOG)-type muscle fibers. Our data provide functional evidence that the types of myofibrillar ATPase demonstrated by Brooke and Kaiser ('70), are not necessarily correlated to physiological classification of fiber types as slow oxidative (SO), fast oxidative/glycolytic (FOG), and fast glycolytic (FG) (Peter et al., '72). Perhaps compartmentalization of muscle fiber types may be a first step in the separation of muscles into multiple heads during the evolution of specialization to diverse locomotor habits among the mammals. PMID- 6481811 TI - The myocardial non-esterified fatty acid controversy. PMID- 6481812 TI - Radionuclide ventriculography: usefulness in evaluating alterations in ventricular function. AB - Radionuclide ventriculography allows the visualization of the right and left ventricles, the objective quantitation of right and left ventricular function at rest and during stress, and an evaluation of the influence of a variety of different physiologic, pharmacologic, and surgical interventions on global and regional ventricular function. The further development of tomographic imaging devices and sophisticated associated computer systems should allow sensitive three-dimensional analysis of global and segmental ventricular function and evaluations of the interrelationships between myocardial perfusion, metabolism, and function. PMID- 6481813 TI - Myocardial tissue free fatty acids. AB - Myocardial ischaemia, whether produced by coronary artery ligation or by hypoxic low-flow perfusion of the isolated rat heart, has been shown to be associated with a significant depression in mitochondrial function, as well as an increase in tissue free fatty acid (FFA) levels. Although the effects of FFA on mitochondrial oxidative phosphorylation function in vitro are well established, it has not yet been shown that increased tissue FFA levels are causing the depression in mitochondrial function in ischaemia. Using the isolated perfused rat heart, several experiments were performed to gain more information regarding (i) the validity of the Dole FFA extraction technique; (ii) controlling factors; (iii) the relationship between tissue FFA and mitochondrial function and (iv) sources of tissue FFA in ischaemia. Significant elevation of tissue FFA was achieved by perfusion with (i) substrate-free Ringer and (ii) phosphatidylcholine. Elevation of tissue FFA obtained by perfusing with long chain fatty acids was due to extracellular accumulation. Reduction of tissue FFA levels was observed by perfusing with (i) albumin, (ii) glucose, insulin and propranolol. Our results also suggest that lysosomal involvement could cause the increase in tissue FFA levels in myocardial ischaemia. PMID- 6481814 TI - The effect of ischaemia on the activity of pyruvate dehydrogenase complex in rat heart. AB - The effect of ischaemia on the concentration of active pyruvate dehydrogenase complex has been investigated in glucose perfused hearts of normal rats fed a normal diet or a high fat diet or starved for 48 h; and in hearts from alloxan diabetic rats. Global ischaemia induced by low flow (approx. 1 ml/min) lowered the concentration of active complex under most of the experimental conditions employed. Parallel studies showed that anoxia and K+ arrest of the heart had effects similar to that of ischaemia and suggested that hypoxia and decreased mechanical activity of the heart may be responsible for effects of low flow ischaemia. Evidence is reviewed that the effects of low flow ischaemia, K+ arrest and anoxia may be mediated through activation of pyruvate dehydrogenase kinase by increased reduction of mitochondrial NAD+. In hearts of normal rats on a normal diet, global ischaemia induced by zero flow and regional ischaemia induced by coronary artery ligation increased the concentration of active complex. Evidence is given that this may result from a combination of anoxia and acidosis. In aerobic perfusions at 60 mmHg, concentrations of active complex were ranked in the order: normal diet greater than high fat diet greater than 48 h starved greater than alloxan diabetic. This order was maintained when the concentration of active complex was increased by perfusion at 120 mmHg or lowered by global ischaemia induced by zero flow. PMID- 6481815 TI - Uniform sarcomere behaviour during twitch of intact single cardiac cells. AB - Behaviour of sarcomere length was analysed in different regions of single cardiac cells (n = 249) of the ventricle, both at rest (n = 144) and during twitch contractions (n = 57). At rest, regional distribution of sarcomere length proved to be uniform. In the leaky cell (n = 48), resting sarcomere length was not affected over longer periods of time (up to 2 h), nor by lowering the ATP concentration (from 5 mM to 2.5 mM and 500 microM), nor by increasing free calcium within subactivating ranges (5, 20, 60 microM). No statistical differences could be detected between resting cell dimensions and sarcomere length between cells isolated from left and right ventricle (n = 64), nor between cells from epicardial or endocardial layers (n = 80). During twitch contraction in the intact unloaded cardiac cell (n = 32), sarcomere lengths in different regions were analysed every 20 ms and behaved synchronously, presenting arguments for uniformity during the myocardial contraction-relaxation cycle in the free lying intact cardiac cell. PMID- 6481817 TI - An SEM examination of granule cell migration in the mouse cerebellum. AB - The inward migration of external granule cells (EGC) from the pial surface of the developing cerebellum to form the (internal) granule cell layer was examined using SEM. Cerebella from male mice ranging in age from days 1-20 were fixed, then fractured through the developing pyramid region. EGC were initially unspecialized cells, forming 2-3 layers at the pial surface. EGC layers increased to 6-8, granule cells in the deeper regions elongated, and a prominent space formed between superficial and deep (premigratory) strata. During peak migration (days 8-12), nests of 4-6 EGC were associated with Bergmann glial fibers (BF) of the Golgi epithelial cells, which crossed molecular and EGC layers to terminate as spiny endfeet at the pial surface. Fibrils of extracellular material (ECM) often linked both premigratory and migrating EGC with a nearby BF. The molecular layer thickened considerably and the parallel fibers were traversed by an increasing number of Bergmann fibers and Purkinje cell processes during this period. As active migration slowed (days 13-20) and EGC reached their destination below the Purkinje cell layer, they lost their polarity and were enmeshed in ECM. The role of the Bergmann fibers and extracellular material in granule cell migration is considered. PMID- 6481816 TI - Incorporation and distribution of 3H oleic acid in the isolated, perfused guinea pig heart made hypoxic. AB - Improved methods of autoradiography and lipid extraction have been used to study the influence of hypoxia on the fate of radioactive fatty acids in the isolated guinea pig heart. Evidence is provided that hypoxia causes a shift of the rate limiting step from transport into the cell to oxidation in the mitochondria. This leads to an increased radioactivity in myocardial free fatty acid and in the cytosol. Radioactivity in the mitochondria is decreased and disappears more slowly. At the same time, there is an increased radioactivity in lipid droplets and in triacylglycerol. There is no evidence of a specific location of radioactivity in the sacroplasmic reticulum. PMID- 6481818 TI - A brain synaptic dopamine-binding protein: isolation and partial characterization. AB - A dopamine-binding protein (DABP) has been purified from the rat brain cortex to homogeneity. Solubilization of the DABP from the synaptosomal membranes (P2M) by cholic acid, subsequent agarose gel filtration of the cholic acid extract to separate phospholipids from the DABP, and lastly DA affinity chromatography successfully resulted in a purified DABP with approximately 0.006% yield in protein concentration and 0.03% yield in specific [3H]-DA binding. The specific [3H]-DA binding of the purified DABP was 117 fmol/mg protein/10 min with a 4.6 fold purification compared with the whole homogenate. The purified DABP had an Rf value of 0.67 on native disk polyacrylamide gel and it gave one single polypeptide subunit on the SDS gel with an Rf value of 0.63. The apparent molecular weight of this single subunit was estimated to be 34.5 kilodaltons. The elution patterns from either DA- or ADTN-affinity (2-amino-6,7-dihydroxy-1,2,3,4 tetrahydronaphthalene-affinity) columns indicated that this DABP had higher affinity for DA agonists than for DA antagonists. Photoaffinity labeling of [3H] DA to this DABP in the P2M fraction and the specific [3H]-DA to the purified DABP demonstrated a nanomolar range affinity corresponding to either D2 or D3 receptors. These data suggested that the purified DABP could be related to either D2 or D3 receptors in the brain. PMID- 6481819 TI - Fetal calf serum-mediated inhibition of neurite growth from ciliary ganglion neurons in vitro. AB - Embryonic chick ciliary ganglion (CG) neurons cultured in fetal calf serum containing medium have been previously reported to extend neurites on polyornithine (PORN) substrata precoated with a neurite-promoting factor (PNPF) from rat schwannoma-conditioned medium. On PORN substrata alone, however, no neuritic growth occurred. This was interpreted as evidence that PORN was an incompetent substratum for ciliary neuritic growth. In this study, we now find that an untreated PORN substratum allows neuritic growth in serum-free defined medium. When PNPF was added to PORN, a more rapid and extensive neuritic response occurred. After 5 hr of culture, a 60% neuritic response occurred on PNPF/PORN, whereas no neurons initiated neurites until 10-12 hr on PORN. The inhibitory effect of fetal calf serum noted above on PORN could be obtained in part by pretreating the substratum with serum for 1 hr. Maximal inhibitory effects in the PORN pretreatment were achieved after 30 min and were not further improved by treatments up to 4 hr. Bovine serum albumin was also found to inhibit neurite growth on PORN to about 60% of the inhibition obtained by an equivalent amount of serum protein. Fetal calf serum was shown to cause a 15% reduction in the percentage of neurons bearing neurites after its addition to 18-hr serum-free PORN cultures and to cause statistically significant reductions in neurite lengths measured 2 hr later. PMID- 6481821 TI - Effect of ethanol on uptake of trichloroethylene in isolated perfused rat liver. AB - The effect of ethanol on uptake of trichloroethylene in isolated perfused rat liver was investigated. The uptake of trichloroethylene was measured in both phenobarbital (PB) non-treated and PB treated rat livers. Furthermore, for PB treated rat livers, the fluorescence of reduced pyridine nucleotides, oxygen consumption, and scanning reflectance spectrum were measured in the liver, perfused with Krebs-Henseleit buffer saturated with a 92%O2-5%CO2-3%CO gas mixture. The uptake of trichloroethylene was decreased by 6.0% in the PB non treated rat liver and 10.6% in the PB treated rat liver following the addition of ethanol. This uptake decrease was thought to arise mainly from the inhibitory effect of ethanol on mixed-function oxidation in the liver because of the corresponding decrease in oxygen consumption and absorbance difference delta A450 490nm. The inhibition was considered to be due to interference with electron transfer to the complex of substrate and cytochrome P-450. Increase in intracellular NADH might also affect the formation of trichloroacetic acid since the reduction of NADH in the cytosol attained a maximum with 20 mM ethanol. PMID- 6481820 TI - Effects of exogenous GM1 and GD1a on S20Y neuroblastoma cells. AB - The effects of exogenous GM1 and GD1a on S20Y murine neuroblastoma cells were assessed by monitoring morphology, tumorigenicity, mitotic index, and plating efficiency. S20Y cells were seeded at a density equivalent to 5 X 10(4) cells per 35-mm tissue culture dish; 38-42 hr after seeding (preconfluent stage) the cells were treated for 12 hr with 100 micrograms of ganglioside per ml of medium in which the serum content was reduced from 10% to 0.5%. Analysis of the cell lipids indicated that added ganglioside became tightly associated with the membrane during the 12-hr exposure. GM1 treatment resulted in increased projections on the cell surface and fine structures projecting from the cell processes. GD1a treatment resulted in a reduction in the cellular mitotic index. Plating efficiency was reduced by both GM1 and GD1a. Neither ganglioside affected tumorigenicity of the S20Y cells. Twelve hours after removal of the added ganglioside and exposure of the cells to normal medium, the ganglioside composition of the membranes from treated cells approached that of the controls, and the ganglioside-induced effects had been reversed. These results suggest that addition of specific gangliosides induces different cellular responses and that these changes are dependent upon the continued presence of the ganglioside. PMID- 6481822 TI - Similarity of chloropeptide to phalloidin in toxicity to isolated hepatocytes. PMID- 6481823 TI - Involvement of adrenergic and serotonergic nervous mechanisms in allethrin induced tremors in mice. AB - Oral or intravenous administration of allethrin, a synthetic derivative of the pirethrin-based insecticides, produces neurotoxic symptoms consisting of mild salivation, hyperexcitability, tremors and convulsions which result in death. Intracerebroventricular injection of allethrin to mouse at about one-nineth the dose of intravenous administration, produced qualitatively identical but less prominent symptoms, indicating that at least some of the symptoms may be originated in the central nervous system. To investigate the mechanism of action of the compound, we studied the ability of agents which alter neurotransmission to prevent or potentiate the effect of convulsive doses of technical grade (15.5% cis, 84.5% trans) allethrin. Intraperitoneal pretreatment with drugs which block noradrenergic receptors or norepinephrine synthesis, such as pentobarbital, chlorpromazine, phentolamine, phenoxybenzamine and reserpine, depressed the tremor induced by allethrin. The inhibitory effect of reserpine was reversed by phenylephrine. Both the serotonergic blocker, methysergide, and the serotonin depletor, rho-chlorphenylalanine, potentiated the effect of allethrin. The potentiating effect of methysergide was antagonized by 5-hydroxytryptamine. However, intracerebroventricular administration of methysergide was ineffective in potentiating the effect of allethrin. alpha 2- and beta-adrenoceptor blockers, muscarinic antagonists, GABA mimenergics and morphine had no effect. These results suggest that allethrin produces its neurotoxic responses in mice by acting on the brain and spinal levels. Furthermore, adrenergic excitatory and serotonergic inhibitory mechanisms may be involved in the neural pathway through which the allethrin-induced tremor is evoked. PMID- 6481824 TI - Some toxic properties of a carcinogenic pyrrolizidine alkaloid, petasitenine. AB - Some toxic properties of petasitenine, a hepatocarcinogenic pyrrolizidine alkaloid, were confirmed in 3 parts of studies. Electron microscopic observation of rat liver on the stage of acute toxicity following administration of a toxic dose of petasitenine disclosed the distinctive changes i.e., nucleolar segregation, degradation of endoplasmic reticulum such as formation of concentric whorls in the liver cells. Biochemical test for the mitochondrial function in the isolated mitochondria from rat liver cells revealed on inhibitory effects of petasitenine in the respiratory system, indicating that minor changes of mitochondria on the pyrrolizidine alkaloid may be induced by some other indirect factor. Investigation for the effect of petasitenine on the cell cycle of the cultured cell line from the human carcinoma showed some inhibitory effects in the appearance of cells in S-phase or M-phase, suggesting a possibility that toxicity of petasitenine will be developed in the tissues other than the liver or in the species apart from rodents. PMID- 6481825 TI - The possible role of squalene and its peroxide of the sebum in the occurrence of sunburn and protection from the damage caused by U.V. irradiation. AB - To clarify the role of squalene peroxide in the occurrence of skin damage from sunburn, the optimum condition of squalene peroxidation and the effect of squalene peroxide on cutaneous tissue were examined. Peroxidation of squalene was more easily induced than palmitoleic acid and oleic acid in the unsaturated lipid occurred in sebum. The peroxidation of squalene gradually occurred by U.V. irradation, and it is parallel to increases in the malonyldialdehyde production (production of lipoperoxide). This peroxidation easily carries out in the case of high temperature (40 degrees C than 30 degrees C), and in the case of low pH. Good correspondence was recognized among the spectrum of natural daylight, U.V. absorption spectrum of squalene and erythema curve. Squalene and its peroxide have an important role in the occurrence of sunburn, and/or protection from damage caused by U.V. irradiation. PMID- 6481826 TI - Organ-specific susceptibility to clastogenic effect of urethane, a trial of application of whole embryo culture to testing system for clastogen. AB - Urethane has been known for its transplacental carcinogenic effect in mice. Whether or not the treatment of urethane affects embryonic growth and development and induces chromosome aberrations in the embryonic cells in vitro was investigated using the mouse whole embryo culture method. Reports on experiments in vivo showed that lungs and liver were target organs of carcinogenic effects of urethane. In the present experiment, organ (lung and liver)-specific susceptibility to clastogenic effect of urethane was observed in cultured embryonic cells. Further, it is stressed that urethane induced chromosome breaks at concentrations lower than the threshold value for the retardation on embryonic growth and development. Comparing with clastogenic effect of 4NQO on cultured embryonic cells, the clastogenic action of urethane was examined to point out its characteristic feature as a clastogen with special reference to the carcinogenic effects obtained by in vivo experiment. PMID- 6481827 TI - The role of packing and planned reoperation in severe hepatic trauma. AB - Liver lacerations are the most common intra-abdominal injury that leads to death, and control of hemorrhage remains the primary problem in lowering mortality from severe hepatic trauma. We retrospectively reviewed operative trauma cases in which liver packing and planned reoperation were used as temporizing measures in hemodynamically unstable patients. These cases were compared to patients closely matched for age, sex, type of trauma, and associated injuries but who did not undergo liver packing and planned reoperation. Preliminary data support our contention that liver packing and planned reoperation is a valuable adjunct for the management of hemorrhage from severe hepatic injury without incurring increased morbidity or mortality. This technique is useful for the experienced trauma surgeon to arrest hemorrhage and gain hemodynamic stability before attempting definitive care and for the community hospital surgeons who after gaining hemodynamic control would like to transfer the patient to a tertiary care facility. PMID- 6481828 TI - Empyema occurring in the multiply traumatized patient. AB - During an 11-month period 31 cases of nosocomial empyema were identified in 29 of 741 multiply traumatized patients who remained in our unit for more than 3 days. Nosocomial empyema was defined as purulent culture-positive material drained from the pleural space after five days' hospitalization. All patients had fever and leukocytosis. Possible risk factors included previous aspiration in five patients but none developing pneumonia, prior respiratory tract infection in nine but none with the same pathogen as their empyema, prior antibiotic use in over 50% of the patients, and severe head or chest injury in two thirds of the patients. Thirty eight pathogens were recovered: S. aureus, 14; beta-streptococci, three; Pseudomonas, six; Klebsiella, two; Enterobacter, two; E. coli, two; other Gram negative bacilli, six; and anaerobes, three. Fourteen infections were polymicrobic and bacteremia occurred in 42% of the patients. Of these 29 patients, 27 had chest tubes inserted for fluid in the pleural cavity before development of empyema; nine for hemo- or pneumothorax secondary to chest trauma, 11 for pneumothorax while on ventilators, and seven for unexplained sterile pleural effusion. If empyema complicated a prior hemothorax it was usually caused by Staphylococcus aureus and occurred about 10 days after draining blood from the pleural cavity. If empyema was a complication of pneumothorax or serothorax it was usually due to Gram-negative organisms colonizing the upper respiratory tract and occurred within 4 days of draining the fluid. Sixteen per cent of all patients who had chest tubes placed for fluid in their pleural cavity subsequently developed empyema.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481829 TI - Emergency bay thoracotomy. AB - In recent years, there has been increased debate on the indications for and value of thoracotomies done in the Emergency Department for victims of trauma. The current literature, unfortunately, does not resolve many points of contention surrounding this procedure. Using strict terms to define Emergency Bay Thoracotomy (EBT), 89 consecutive patients seen over a 2-year period in a Trauma Unit were retrospectively reviewed and analyzed. Eighty-five per cent of the patients had no vital signs on arrival, yet the procedure proved to be valuable in sustaining life in 17% of patients, two thirds of whom were discharged, 90% with normal findings. A progressive increase in survival rate was observed with increased use of the procedure. A review of the prognostic factors found in this study and comparison with other published studies indicates that clear definition of the patient population and patient status is essential before aggregated data are used as a basis for therapeutic policies. Educational and research efforts must focus on determining which patients have zero prognosis after initiating resuscitation, rather than on denying care to any group, even when only a few will respond. PMID- 6481830 TI - Thromboxane interaction with cardiopulmonary dysfunction in graded bacterial sepsis. AB - The relationship between plasma levels of thromboxane A2, radioimmunoassayed as thromboxane B2 (TxB), and cardiopulmonary dysfunction in graded bacterial sepsis was investigated. Five adult female pigs under anesthesia were intubated and allowed to breathe room air spontaneously. Femoral arterial, venous, and pulmonary artery catheters were inserted. After a 60-minute control period Aeromonas hydrophila (1.0 X 10(9)/ml) was infused intravenously at 0.2 ml/kg/hr, gradually increasing to 4.0 ml/kg/hr over 4 hours. Arterial and mixed venous blood gases, hemodynamic measurements, and TxB plasma concentrations were obtained during the control period, at 10, 20, 30, 45, and 60 minutes and at 30 minute intervals thereafter. Cardiac index increased significantly from control at 20 minutes, remained above control levels for 1 hour, and then declined to significantly low values at 150 minutes. TxB was increased from control at 20 minutes, rising to four times control at 120 minutes. Mean arterial pressure, pulmonary capillary wedge pressure, left ventricular stroke work, paO2, and pvO2 decreased significantly during the experiment. Pulmonary artery pressure and pulmonary vascular resistance increased significantly. Changes in TxB were significantly cross-correlated with changes in cardiac index, pulmonary vascular resistance, stroke volume, left ventricular stroke work, and paO2. TxB elevations led the cross-correlated variables by 0 to 60 minutes. Pulmonary vascular resistance cross-correlated with mean arterial pressure and cardiac index. TxB is increased early in graded bacterial sepsis. Changes in TxB appear to precede impaired cardiopulmonary function. The data suggest that TxB is involved in the detrimental hemodynamic effects of early septicemia. PMID- 6481831 TI - Muscle ischemia and hypothermia: a bioenergetic study using 31phosphorus nuclear magnetic resonance spectroscopy. AB - Following traumatic limb amputation it is common clinical practice to maintain the ischemic tissues in a hypothermic state until surgical reimplantation. Of all extremity tissues, muscle is the most sensitive to ischemia; it is therefore imperative that reperfusion be established before diffuse muscle necrosis. Although it has been shown both clinically and experimentally that hypothermia prolongs the viability of ischemic skeletal muscle, the presumed mechanism by which this occurs has not been confirmed at the cellular level. This study was undertaken to quantify the effect of conventional iced-saline hypothermia on anaerobic cell metabolism and high-energy phosphate depletion in traumatically devascularized muscle. METHODS: Phosphorus nuclear magnetic resonance spectroscopy (31P NMR) was employed to noninvasively monitor cellular phosphocreatine (PCr), ATP, and intracellular pH over time in ischemic cat hindlimb muscle under room temperature (22 degrees C) and 1 degree C hypothermic conditions. RESULTS: Muscular PCr depletion was significantly retarded by tissue hypothermia but the rate of ATP depletion was not. A progressive, severe cellular acidosis was observed in the room-temperature muscle. Iced tissue cooling produced a dramatic initial rise in cell pH which significantly reduced the absolute degree of subsequent acidotic changes. SIGNIFICANCE: These findings question our understanding of hypothermic tissue preservation, which has generally been assumed to work on the basis of decreased tissue metabolism, thus conserving critical cellular ATP levels. The empirical benefit derived by cooling muscle in an iced medium may actually be related to the cellular alkalinization produced by tissue cooling, as this significantly mitigates the profound acidosis that would otherwise occur. PMID- 6481832 TI - Maximum survival in pediatric trauma: the ideal system. AB - One hundred consecutive pediatric trauma deaths (0.01-18 yrs) were analyzed for their survival potential in an optimally functioning EMS/Trauma system in Mobile, Alabama (1980-1982). Thorough evaluation of all phases of care by paramedic run sheets, ER records, hospital records, and autopsy reports, revealed that 47/100 victims could have never survived due to the extreme nature of their injuries, and 53/100 victims had the potential of surviving if the EMS/Trauma system functioned optimally. Errors in care were identified in those cases deemed potentially salvageable. Identification phase errors were found in 79% of potentially salvageable victims. Field treatment errors occurred in 36%, transport errors in 23%, and definitive care errors in 17% of those considered to be potentially salvageable. By evaluating where in an EMS/Trauma system errors occur and then by correcting those errors, it should be possible to minimize the mortality rate in pediatric trauma. PMID- 6481833 TI - Plasma fibronectin response to sepsis: mobilization or synthesis? AB - Plasma fibronectin (PFN) is a high molecular weight adhesive glycoprotein. Following trauma or sepsis PFN is acutely depleted, with rapid restoration of normal or supranormal levels after 24 to 48 hours. Cecal ligation with perforation provides an animal model of surgical trauma combined with polymicrobial sepsis. The present study examines whether this PFN level restoration 6 to 24 hours postoperatively is associated with de novo PFN synthesis and how this response is altered by pre-existing protein-calorie deprivation. Thirty-six adult male rats were divided into four groups: I- Controls, II--Prefasted Controls, III--Ligated, IV--Prefasted and Ligated. Control and experimental groups received intracardiac 35S-methionine 2 hours postoperatively. Plasma fibronectin (PFN) levels, PFN specific activity, plasma total protein, and total protein specific activity were determined at 0, 6, 24, and 48 hours postoperatively. Ligated rats (Groups III & IV) demonstrated significant PFN level increases 24 to 48 hours postoperatively (p less than 0.01 0.05). Despite a significant preoperative PFN level depression in prefasted rats (Groups II & IV), the 24-48 hours response to cecal ligation was not significantly altered. PFN specific activity was significantly increased among the operative groups 6 hours postoperatively, demonstrating de novo PFN synthesis following cecal ligation and perforation. PMID- 6481834 TI - Ibuprofen and diphenhydramine reduce the lung lesion of endotoxemia in sheep. AB - Endotoxin (0.75 micrograms/kg) was administered to unanesthetized sheep with and without premedication with ibuprofen, a cyclooxygenase inhibitor, and diphenhydramine, an antihistamine. The effect of the endotoxin on cardiopulmonary and lung lymph data and their alteration by the drug regimen was assessed. The cardiopulmonary responses to endotoxin can be defined into two phases. In phase I there is an elevation in protein-poor lung lymph flow, in pulmonary artery pressure (PA), and in hematocrit, and a reduction in cardiac index and leukocyte count. Phase II occurs late and shows much the same changes as phase I except that the PA is not as high and the lymph protein is increased. The drug combination (ibuprofen and diphenhydramine) virtually eliminates the phase I response. The phase II changes in lymph flow and protein content are affected by diphenhydramine but not ibuprofen. The cardiovascular changes which occur during this period are not affected by either agent. PMID- 6481835 TI - Recommended helmet removal techniques in a cervical spine injured patient. AB - Helmet removal techniques in the absence of C-spine injuries have been developed and promulgated. Utilizing a cadaver model, these techniques were demonstrated to adversely affect pre-existing C-spine injury. Removal of helmets with cast cutters is recommended. PMID- 6481836 TI - Superior mesenteric artery and vein injuries from blunt abdominal trauma. AB - During an 8-year period, from 1974 to 1982, 13 patients were treated for superior mesenteric vascular injury secondary to blunt abdominal trauma. Ten male and three female patients ranged in age from 18 to 68 years (average age, 42.7 years). Six patients presented in profound shock, two presented in cardiopulmonary arrest, and five presented with mild shock. The 13 patients had an average of 3.2 associated intra-abdominal injuries. Six patients had devitalized bowel as a direct consequence of injury to the superior mesenteric vessels. One patient developed intestinal necrosis postoperatively from thrombosis of the superior mesenteric vein which led to extensive small bowel resection. The blood replacement ranged from 2 to 30 units, averaging 11.7 units per patient. Operative procedures included lateral arteriorrhaphy (five patients) and venorrhaphy (11 patients). Four patients required combined vessel repair and one patient required ligation of both vessels and bowel resection. The mortality rate of 57% was primarily due to massive acute hemorrhage, which was larger than could be accounted for by the associated intraabdominal injuries. Free intraperitoneal hemorrhage from the valveless portal system, which can carry up to 60% of cardiac output, causes massive bleeding until abdominal tamponade supervenes. PMID- 6481837 TI - Conservative treatment of ipsilateral supracondylar femoral fracture after total knee arthroplasty. AB - Conservative as well as operative treatment has been proposed for fractures above a knee prosthesis. Three cases are reported and an explanation for the fractures on a mechanical basis is given. Our results shows that closed treatment also leads to satisfactory results, avoiding the risks of extensive surgery. PMID- 6481839 TI - Vertebral artery transection from blunt trauma treated by embolization. AB - Transection of a vertebral artery due to blunt trauma is infrequently seen. This report emphasizes the importance of angiography to confirm clinical suspicion. Hemostasis was achieved by embolization with a coil at angiography, a technique not previously described for vertebral artery transection. PMID- 6481838 TI - Traumatic pulmonary pseudocysts and paramediastinal air cyst: two rare complications of blunt chest trauma. AB - Traumatic pulmonary pseudocysts and paramediastinal air cysts due to closed chest trauma are very uncommon. Minor clinical symptoms and major radiologic signs are characteristic of this form of injury to the lung parenchyma. Treatment of combined pseudocysts and pneumatocele in a 17-year-old girl is described. Chest X ray and computed tomography provided the diagnosis. No surgical treatment was required. Intensive bronchial toilet and PEEP-assisted respiration by mask were followed by recovery. This condition must be differentiated from lung abscesses after infected hematomas, specific cavities, or congenital pulmonary cysts. PMID- 6481840 TI - Late thoracic outlet syndrome secondary to pseudarthrosis of the clavicle. AB - Successful resolution of a late thoracic outlet syndrome secondary to pseudarthrosis of the clavicle was accomplished by surgical resection of the pseudoarthrosis and mid 3 cm of the clavicle, following conservative therapy which did not alleviate the symptoms. The patient was a 28-year-old woman. Arteriography demonstrated the lesion. A shoulder dislocation preceded the thoracic outlet syndrome; a congenital pseudarthrosis may have been present. PMID- 6481841 TI - Factors affecting outcome in pancreatic trauma. PMID- 6481842 TI - Bacterial monitoring of fluidised beds. PMID- 6481843 TI - Management protocols for nonpenetrating gunshot wounds. PMID- 6481844 TI - Frontiers in understanding burn injury. Proceedings of a conference. National Institutes of Health, Bethesda, Maryland, 6-28 September 1983. PMID- 6481845 TI - What are the functions of skin lost in burn injury that affect short- and long term recovery? PMID- 6481846 TI - What are the uses of stable isotopes or mass spectrometry in the study of burn injury? PMID- 6481847 TI - How might nuclear magnetic resonance be used in the in vivo monitoring of energy metabolism and substrate flow? PMID- 6481848 TI - What objective measures are there for evaluating pain? PMID- 6481849 TI - What are the research priorities in the behavioral areas for burn patients? PMID- 6481850 TI - Can collagen metabolism be controlled? AB - The rate of repair of severely burned tissue may be limited by the availability of both non-damaged connective tissue cells and factors which control their movement and proliferation. Supplementation of wounds with chemotactic and growth factors contained in a matrix support may be useful in accelerating the healing of these wounds. Addition of dermal fibroblasts to this matrix may also be beneficial in preventing the formation of contracted scars. Future studies directed at identifying and isolating these factors and testing their efficiency in in vivo wound systems should prove useful in developing new approaches to severe wound care and for individuals who suffer from poor wound healing such as diabetics or aged people. PMID- 6481851 TI - Temporal peak intensity as a critical parameter in ultrasound dosimetry. AB - The in vitro effect of microsecond pulses of ultrasound is studied in mammalian cells using two different biologic endpoints. The frequency of sister chromatid exchanges (SCE) is unchanged in Chinese hamster ovarian cells insonated with a stationary transducer for 1-30 minutes at an SPTA intensity of 0.1 W/cm2. Raising the temporal average intensity to 2 W/cm2 by increasing the pulse repetition frequency alone still has no effect, whereas a change in temporal peak intensity produces an increase in SCE after insonation for only 1 minute. From experiments involving aggregation of platelets in suspension around acoustically active hydrophobic pores, pulse duration is found to be a more effective factor than the pulse repetition frequency. Results of the two studies show the biologic response to be strongly dependent on temporal peak intensity and pulse duration, but weakly dependent on duration of exposure. The temporal average intensity as a singular dosage specification is considered to be a poor indicator of potential nonthermal bioeffects associated with microsecond pulses. PMID- 6481852 TI - Interaction of polymorphonuclear leukocytes and viruses in humans: adherence of polymorphonuclear leukocytes to respiratory syncytial virus-infected cells. AB - The nature of neutrophil-respiratory syncytial virus (RSV) interaction was investigated by assessing factors that influence neutrophil adherence to RSV infected tissue culture monolayers. The adherence of neutrophils to infected cells was directly proportional to the degree of RSV replication as evidenced by infectious virus production, cytopathological changes, or viral antigen appearance. Sixty-one percent of the neutrophils adhered to the RSV-infected cells as compared with 52.7% on noninfected monolayers (P less than 0.05). The addition of RSV-specific antibody markedly increased polymorphonuclear leukocyte adherence to 88.5% (P less than 0.001). Complement in the absence of antibody augmented polymorphonuclear leukocyte adherence, but to a lesser degree, 69.0% (P less than 0.025). Arachidonic acid metabolism appeared to play a critical role in the adherence process; thromboxane was the single most important arachidonic acid metabolite. Inhibition of thromboxane synthesis reduced antibody-dependent polymorphonuclear leukocyte adherence on RSV-infected cells to 52.3% (P less than 0.025). These observations suggest a role for neutrophils in RSV infection. It is proposed that neutrophils may participate in RSV infection at the site of viral replication through the attachment to infected cells and the subsequent release of mediators of inflammation. PMID- 6481853 TI - La Crosse virions contain a primer-stimulated RNA polymerase and a methylated cap dependent endonuclease. AB - Purified La Crosse virions in vitro were found to transcribe their negative polarity (-)RNA genomes. This polymerase activity was stimulated by oligonucleotides such as (A)nG, cap analogs such as m7GpppAm, and natural mRNAs such as alfalfa mosaic virus RNA 4. For (A)nG- and alfalfa mosaic virus RNA 4 stimulated reactions, evidence is presented that these RNAs stimulate activity by acting as primers for viral transcription. The cap analogs appear to stimulate activity via an alternative mechanism. Purified La Crosse virions were also found to contain an endonuclease which specifically cleaves alfalfa mosaic virus RNA 4 when this RNA contains a methylated cap group. PMID- 6481854 TI - Role of cholesterol in fusion of Semliki Forest virus with membranes. AB - The low pH-triggered membrane fusion activity of Semliki Forest virus is dependent on the presence of cholesterol in the target membrane. When liposomes containing phospholipids and cholesterol analogs were used, fusion activity was observed with steroids which did not have a planar nucleus or an isooctyl side chain at C-17, but fusion activity was not observed when analogs which lacked the 3 beta-OH group were used. Binding of virus to liposomes at low pH was similarly, but not totally, dependent on the presence of a 3 beta-OH sterol. PMID- 6481855 TI - Transcription of intracisternal A-particle genes in mouse myeloma and Ltk- cells. AB - In vivo- and in vitro-synthesized RNA from the murine plasmacytoma MOPC-315 was found to hybridize to all regions of a 7.2-kilobase-pair intracisternal A particle (IAP) gene. IAP-specific transcripts were also detected in mouse Ltk- cells, but not in cells derived from normal tissues (kidney, liver, spleen) of 6 week-old BALB/c mice. Three RNA species of 7.2, 5.3, and 3.8 kilobases were identified by Northern blot analysis of MOPC-315 polyadenylated RNA. The 7.2- and 5.3-kilobase transcripts were found in greater levels in nuclear as compared with whole cell RNA, suggesting the involvement of one or more of the following mechanisms: RNA processing, preferential nuclear transport, or differential RNA stability. We show that the primary IAP transcript is initiated within the long terminal repeat by hybridization analysis with restriction digests of cloned IAP DNA and [gamma-S]pppApNp ... RNA synthesized in nuclei with [gamma-S]ATP as the RNA initiating probe. Low concentrations of alpha-amanitin (2 micrograms/ml) inhibited IAP RNA synthesis by greater than 90%, suggesting that RNA polymerase II is responsible for IAP transcription. PMID- 6481856 TI - Mapping of the amino terminus of the H-1 parvovirus major capsid protein. AB - The amino terminus of VP2', the major capsid protein of the parvovirus H-1, was identified and mapped to the H-1 genome. The protein initiates at the start codon at nucleotide 2797 and is translated uninterrupted to the stop codon at nucleotide 4582. The primary sequence predicts a protein of 593 amino acids (65,500 daltons) with an amino acid composition which very closely matches the experimentally determined composition of the pure protein. The data suggest that the VP2' mRNA has a 5' leader sequence of ca. 650 bases and that protein translation initiates downstream from the sole splice junction. PMID- 6481857 TI - Identification of multiple forms of the noncapsid parvovirus protein NCVP1 in H-1 parvovirus-infected cells. AB - Analysis of extracts of H-1 parvovirus-infected cells with virus-specific antiserum led to the identification of two forms of the noncapsid virus protein NCVP1. These two proteins had apparent molecular weights of 84,000 (NCVP1) and 92,000 (NCVP1') and were structurally related, based on their immunological reactivity and on peptide map analysis. Both of these proteins appeared early in the virus infection, about the same time that capsid proteins appeared. NCVP1' was a highly phosphorylated protein which was apparently derived from NCVP1 via a post-translational event. Phosphoserine was the predominant phosphorylated amino acid in NCVP1' and appeared to be localized in one site or a few sites on the protein. The possible involvement of these noncapsid proteins in parvovirus DNA replication is discussed. PMID- 6481859 TI - Instrumental evolution of the valve incision method of in situ saphenous vein bypass. AB - The previously stated advantages of the valve incision method of in situ saphenous vein arterial bypass have now been confirmed by others. However, this method has been limited by its time-consuming technical demands. Considerable experience with this bypass in conjunction with retrograde serial valve disruption with instruments of similar design principle (by Hall and Cartier) has been accumulated in Europe. However, the combination of the trauma of blunt valvular fracture and the sensitivity of endothelium to frictional shear has precluded use of these instruments in veins less than 4 mm in size, and the results have not been significantly better than those obtained with reversed vein bypass. An instrument (valve cutter) that achieves serial valve incision safely and consistently without mandatory exposure of each valve site has now been developed. Of the last 166 consecutive bypasses, the saphenous vein was suitable for use of this instrument in 116 instances (70%). The patency of these bypasses as determined by life-table analysis has shown no significant difference when compared with bypasses performed under similar conditions in which the cutter was not used. On the basis of this investigative and clinical experience, the majority of in situ saphenous vein arterial bypasses can be safely facilitated and simplified by use of this instrument. PMID- 6481858 TI - Local thrombolysis in the treatment of arterial graft occlusions. AB - Nineteen patients with 20 occluded arterial bypass grafts were treated with local infusion of streptokinase. Grafts treated included four aortofemoral graft limbs, 14 femoropopliteal or femorotibial grafts, one axillofemoral graft, and one transpubic femorofemoral graft. Complete lysis of thrombus was possible in 12 patients, partial lysis in five patients, and no lysis in two patients. Thrombolytic therapy was thought to be beneficial in the management of 14 patients. In two of these 14 only thrombolysis was required to restore and maintain graft patency, and in an additional two patients angioplasty was performed after thrombolytic therapy with no subsequent therapy necessary. In three patients who were initially poor operative risks, surgery could be postponed. Thrombolysis revealed the probable cause of thrombosis in 12 patients. Complications included four bleeding episodes, two of which were significant. There were no significant embolic complications. Unsuccessful thrombolytic therapy did not result in worsening of ischemia in any patient. Local infusion of thrombolytic agents is a useful adjunct in the management of occluded bypass grafts. PMID- 6481860 TI - Suprarenal placement of vena caval filters: indications, techniques, and results. AB - Preferred treatment for thromboembolism when heparin fails or is contraindicated is infrarenal inferior vena cava (IVC) interruption. In the present study suprarenal Greenfield filters were placed in 11 patients in whom routine infrarenal IVC interruption would have been inadequate therapy. As identified by IVC venography, nine patients, including two patients with renal vein thrombi and proteinuria, had partially attached IVC thrombi extending to or above the orifices of the renal veins. One patient had multiple life-threatening pulmonary emboli (PE) on anticoagulation therapy without a known source of emboli and a large patent ovarian vein, and another had an ovarian vein thrombus. Five patients (45%) had a contraindication to heparin therapy, and five (45%) had recurrent PE on anticoagulants. In follow-up (range 3 to 26 months, mean 12.3 months) there has been no documented or suspected recurrent PE, change in renal function, or peripheral edema. There were two deaths secondary to malignancy. IVC patency was demonstrated in all patients studied. Eight patients continue to receive anticoagulants. Based on our clinical experience, our data suggest that suprarenal filter placement is indicated in the following situations: (1) recurrent thromboemboli despite anticoagulation therapy with IVC thrombi extending to or above the renal veins, renal vein thrombosis, previous IVC interruption, or a large patent left ovarian vein or (2) documented perirenal IVC thrombi when anticoagulation therapy is contraindicated. The results of this study indicate that when thromboemboli originate at or above the level of the renal veins in the IVC, suprarenal IVC filter placement is effective therapy. PMID- 6481861 TI - The risk of vascular surgery in a metropolitan community. With observations on surgeon experience and hospital size. AB - From 1978 through 1981 complete perioperative information concerning a total of 10,189 peripheral vascular procedures performed in northeastern Ohio was recorded in the computer registry of The Cleveland Vascular Society. This report is an analysis of mortality and morbidity rates for all 5686 operations involving carotid endarterectomy (N = 2646), lower extremity revascularization (N = 1987), and abdominal aortic aneurysm resection (N = 1053). The operative mortality rate was 1.2% for carotid reconstruction, 2.8% for femoropopliteal or distal bypass, 3.5% for aortofemoral revascularization, and 11.9% for aortic aneurysm resection (elective operations 6.5%; emergency operations 32.9%). Postoperative strokes occurred after endarterectomy in 2.7% of patients having preoperative neurologic symptoms and in 2.0% of those with asymptomatic carotid stenosis. Lower extremity amputation was unavoidable in 1.5% of patients after aortofemoral reconstruction and in 6.0% after femoropopliteal or distal bypass. Statistical testing indicated that the operative mortality rate was not related to the respective size of the 27 hospitals involved in the survey. The relative annual experience of the 29 participating surgeons significantly influenced only the mortality rate of elective aneurysm resection and the amputation rate after femoropopliteal or distal revascularization. This study suggests that the results of major arterial reconstruction in metropolitan areas may be expected to be comparable to those of published series if the responsible surgeons are specifically trained and maintain an active interest in the field of vascular surgery. PMID- 6481862 TI - Correlation of operative findings with angiographic and noninvasive hemodynamic factors associated with failure of polytetrafluoroethylene grafts. AB - The causes of autogenous saphenous vein (ASV) graft failure have been well described and are predominantly due to stenosis of the ASV graft during the first year after implantation. Distal atherosclerotic disease is a late cause of ASV graft failure. Furthermore, with failure of the ASV graft the clinical and hemodynamic status of the limb usually reverts to the preoperative state. To better define the causes and hemodynamic consequences of polytetrafluoroethylene (PTFE) graft failure, we reviewed the pathologic findings at surgery and compared these with arteriograms made prior to and after occlusion and sequential noninvasive hemodynamic studies in 36 patients with failed PTFE grafts (greater than 30 days after operation). Distal atherosclerotic disease was the most frequent cause of PTFE failure (23 of 36 limbs, or 64%), and it appeared as early as the first 6 months after implantation. Doppler pressures after PTFE failure deteriorated significantly (p less than 0.05) at the thigh, calf, and ankle levels. A blinded comparison of preoperative with postoperative arteriograms revealed significant progression of disease. Because of significant involvement of the popliteal artery in our series, treatment of intimal hyperplasia with patch angioplasty (seven cases, or 19%) was short lived and sequential extension was required. Distal atherosclerotic disease therefore appeared to be the most common cause of PTFE graft failure and occurred much earlier after implantation than with ASV graft failure. Deterioration of the hemodynamic state of the limb correlated with this high degree of distal atherosclerotic disease. PMID- 6481863 TI - Detergent-extracted small-diameter vascular prostheses. AB - The exact mechanism that leads to thrombosis of small-diameter vascular prostheses (less than 4 mm X greater than 6 cm) is unknown. This report presents preliminary patency and healing data on a sequential detergent-extraction technique for the preparation of autogenous small-diameter microvascular grafts. Fifteen carotid interpositional allografts (3 to 4 mm X 4 to 6 cm) were implanted in 15 mixed species adult greyhounds. Ninety days after implantation grafts were perfusion-fixed in situ, harvested, and evaluated by light microscopy and scanning and transmission electron microscopy. Two categories of acellular vascular matrix grafts were evaluated: non-cross-linked and cross-linked (1% carbodiimide). By objective morphologic analysis with blind random view, histologic sections were rated from 0 to 4 in five categories believed to be important for graft healing and patency. Overall graft patency was 80% (12 of 15), and there was no significant difference between cross-linked and non-cross linked grafts. Non-cross-linked grafts were superior to cross-linked grafts in all areas of histologic evaluation except immunogenicity (p less than 0.01). Most important, non-cross-linked grafts demonstrated complete endothelial coverage (p less than 0.001). There was no significant difference (that is, normal) between control autografts and non-cross-linked grafts; however, there was a significant difference between control autografts and cross-linked grafts in all parameters except immunogenic reaction (p less than 0.01). PMID- 6481864 TI - Current status of thoracic dorsal sympathectomy. AB - This article summarizes over 20 years of experience (1962 to 1982) with cervical sympathectomy (thoracic dorsal sympathectomy) in 46 patients undergoing 68 sympathectomies. All operations were performed through an anterior supraclavicular approach. Indications for surgery were intractable Raynaud's disease (26 patients), atherosclerotic obliterative arterial disease (five), causalgia (five), posttraumatic sympathetic dystrophy (seven), collagen vascular disorders (eight), hyperhidrosis (12), occupational-related digital thrombosis (four), and thrombosis secondary to intra-arterial injection (one). The incidence of complications and side effects, both temporary and permanent, including Horner's syndrome, is reviewed in detail. Particular reference is made to the various surgical techniques of managing the stellate ganglion; four patients had two-third to three-fourth resection of the stellate ganglion down to and including the T-3 thoracic ganglion, two had preservation of the stellate ganglion and resection of the T-2 through T-4 ganglia, seven had excision of the entire stellate ganglion down to and including the T-4 ganglion, seven had resection of the lower third of the stellate ganglion down to and including the T 4 ganglion, and 48 had removal of the lower half of the stellate ganglion down to and including the T-3 ganglion. The study reviews the literature germane to anatomic considerations and suggests revisions in current texts and atlases. By retrospective analysis of the records and a follow-up questionnaire, which provided an 86% follow-up (average 8.4 years), the paper points to the distinctive clinical characteristics of the different groups within the population undergoing the operation and provides guidelines for patient selection and conclusions on the place for this operation in the management of vascular diseases involving the upper extremity. PMID- 6481865 TI - Aortofemoral or femoropopliteal revascularization? A prospective evaluation of the papaverine test. AB - Proper selection of suprainguinal vs. infrainguinal arterial revascularization in patients with multilevel disease requires hemodynamic assessment. In such patients hemodynamic evaluation of the aortoiliac system cannot be made accurately with either arteriography or current noninvasive techniques. One hundred six lower extremities underwent preoperative triplane arteriography, measurement of Doppler-derived segmental blood pressures, measurement of common femoral intra-arterial pressure, and intra-arterial injection (30 mg) of the vasodilator papaverine hydrochloride prior to arterial bypass. Common femoral intra-arterial pressure was monitored continuously before and after papaverine injection. The resting femoral/brachial pressure index (FBI) and the maximum change in this index (% delta FBI) following papaverine injection were calculated. To be considered improved postoperatively, claudicants required an increase in treadmill walking time of greater than or equal to 50%, whereas patients operated on for limb salvage required an increase in the thigh/brachial pressure index (TBI) of greater than or equal to 0.15 for suprainguinal revascularizations and an increase of TBI to greater than or equal to 0.9 for infrainguinal revascularizations. In the first 41 extremities (phase I), receiver operator characteristic analysis revealed a % delta FBI greater than or equal to 15% to be optimal in the detection of hemodynamically significant aortoiliac disease. In phase II (65 limbs) this discriminant value for % delta FBI was assessed prospectively. In phase I, in which the choice of supra- vs. infrainguinal bypass was determined arteriographically, only 80% of the extremities were improved; in phase II, in which supra- vs. infrainguinal bypass was determined by the papaverine test, 98% of extremities were improved (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481866 TI - Rigid intraluminal prosthesis for replacement of thoracic and abdominal aorta. AB - From December 1976 to April 1983, 55 patients underwent operations in which intraluminal ring grafts were used for replacement of thoracic and abdominal aortic aneurysms. Twenty-eight patients had dissections, and 11 had ascending aneurysms. There were 10 descending aneurysms; three of these were traumatic. There were two arch aneurysms, three abdominal aneurysms, and one thoracoabdominal aneurysm. The follow-up period was 78 months with a mean follow up period of 24 months. There were six postoperative deaths and six late deaths. No evidence of complications of thrombosis, migration, erosion, or pseudoaneurysm resulting from the ring within the 78-month follow-up period was seen, and we conclude that this is a safe, reliable, quick method for replacement of the aorta in certain well-defined situations. PMID- 6481867 TI - Operative management of renovascular hypertension. Results after a follow-up of fifteen to twenty-three years. AB - From March 1960 through January 1968, 71 patients underwent operations for renovascular hypertension at our center. There were three operative deaths in 94 procedures. Primary nephrectomy was performed in 26 patients. Attempted revascularization of 62 kidneys was successful in 46 (74%). In 13 (87%) of the 15 cases considered operative failures, the patients underwent either secondary nephrectomy (11) or repeat revascularization (two). Based on the results of the final operation, initial blood pressure response (1 to 6 months postoperatively) in the surviving patients indicated 44% cured (30 patients), 40% improved (27), and 16% unchanged (11). The sequential clinical, functional, and anatomic follow up evaluations to time of death or to date are available in 66 of the 68 patients (97%) who survived operation and form the basis of this report. Fifteen- to 20 year arteriographic follow-up in 16 patients revealed one late neointimal anastomotic stenosis and an additional three aortic suture line false aneurysms in Dacron aortorenal grafts. During this 15- to 23-year follow-up, 71% of atherosclerotic (AS) patients and 23% of fibromuscular dysplasia (FMD) patients died. Cardiovascular (CV) morbid events occurred in 77% of AS patients and in 19% of FMD patients. The cumulative incidence of death and CV morbid events during follow-up is examined by Kaplan-Meier life tables and Cox's proportional hazards regression analysis in these respective groups to identify preoperative markers predictive of longer event-free survival in relation to blood pressure benefit by operation (for example, focal vs. diffuse AS, presence of cerebrovascular disease, ischemic heart disease, left ventricular hypertrophy seen by electrocardiography, azotemia, smoking, diabetes, and hyperlipidemia).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481868 TI - Combined valve replacement and myocardial revascularization. AB - Combining valve replacement with coronary artery bypass (CABG) for significant concomitant disease remains a controversial subject. To determine the operative results following combined valve replacement and CABG, we evaluated 201 patients seen consecutively between July 1977 and June 1982. CABG for vessels with greater than 70% stenosis was performed with aortic valve replacement in 106 patients, with mitral valve replacement in 82, and with aortic and mitral valve replacement in 13. There were 143 men and 58 women; the mean age was 67 years. Nine operative deaths (8.5%) occurred with aortic valve replacement and CABG: 5 of 25 (20%) when cardioplegia was not used and 4 of 81 (4.9%) with cardioplegia (p less than 0.01). The operative mortality rate for isolated aortic valve replacement without coronary disease during the same period was 5.9% (10 of 168). The late actuarial survival rate is similar for aortic valve replacement alone or aortic valve replacement and CABG. There were no operative deaths among patients having undergone aortic and mitral valve replacement and CABG; the rate was 15% (9 of 60) in patients having undergone aortic and mitral replacement and CABG. The operative mortality rate was 21.9% for mitral valve replacement and CABG (18 of 82). Rheumatic disease was present in 14 of these patients, two of whom had early deaths (14.3%), both after repeat mitral operations; 11 mitral valve replacements and CABG were done for degenerative mitral regurgitation with no deaths, and the remaining 57 patients had ischemic mitral regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481869 TI - Vascular surgery: a brief look back and then to the future. PMID- 6481870 TI - Late results following surgical management of vascular graft infection. AB - Ninety-two patients underwent surgical treatment for 59 prosthetic graft infections and 33 secondary aortoenteric fistulas. Definitive treatment was accomplished with a low perioperative mortality rate (14%). Long-term follow-up confirmed that most patients were cured of their infection or fistula, and 88% of the patients who survived the perioperative period (67 of 76) had no further evidence of infection when followed up from 10 months to 12 1/2 years postoperatively. The 12% late mortality rate (9 of 76) was secondary to persistent infection and aortic stump disruption. When perioperative and late deaths in both groups are combined, 67 of 92 patients (73%) were cured of their prosthetic graft infection. Factors associated with a favorable prognosis for survival and cure of infection were autogenous reconstruction and possibly staged operative repair. Poor prognosis for survival and cure of infection resulted from aortic stump disruption, persistent infection, and retained graft material. Significant morbidity (amputation and multiple operative procedures) was related to the severity of underlying vascular disease, the inadequacy of extra-anatomic reconstruction, and in some cases progression of vascular disease. The major challenges in the treatment of graft infection at present are the preoperative identification of limited graft infection and the successful management of the interrupted aorta. Complex and innovative reconstructive procedures continue to be necessary to ensure limb salvage and remain a considerable technical challenge. Nonetheless, the prospects for cure as reported in this series justify an aggressive operative approach. A successful outcome following definitive treatment of these devastating complications is possible for the majority of affected patients. PMID- 6481871 TI - Carotid endarterectomy without a shunt: the control series. AB - Nine hundred forty carotid endarterectomies were performed without the use of a temporary indwelling shunt. Six patients (0.6%) died, all from stroke; 17 other patients (1.8%) had another stroke, and 21 patients (2.2%) had temporary neurologic symptoms. Complete x-ray films detailing the opposite internal carotid artery and carotid artery back pressure were available for 783 operations. Correlation of stroke to back pressure, status of the contralateral internal carotid artery, preoperative neurologic deficit, and carotid clamp time was examined. Statistical analysis demonstrated significantly increased neurologic complications only if the systolic carotid back pressure was less than or equal to 50 mm Hg or the contralateral internal carotid artery was occluded. Analysis to determine if these factors were dependently related showed that when both a contralateral carotid occlusion and a carotid back pressure of less than or equal to 50 mm Hg coexisted (82 patients), the rate of permanent deficit was 11.0% compared with 2.8% when either factor was singly present and 0.9% when neither factor was present. No statistical difference exists between the group with only a single factor and those with neither factor. When a temporary shunt is not used during carotid endarterectomy, the risk of neurologic complication is increased if both a contralateral internal carotid artery occlusion and a carotid back pressure of less than or equal to 50 mm Hg coexist. The use of a shunt in this patient population may be beneficial. PMID- 6481872 TI - Surgical therapy for recent total occlusion of the internal carotid artery. AB - From January 1980 until May 1983, 24 patients had surgical exploration of the carotid bifurcation for suspected recent total occlusion of the internal carotid artery (ICA). All patients had recent onset of neurologic symptoms related to the ipsilateral cerebral hemisphere. Selective carotid angiography determined preoperative total occlusion of the ICA. Because surgery failed to reopen the ICA in nine patients, they had endarterectomy of the external carotid artery. Fifteen patients had initially successful thromboendarterectomy of the ICA. Prior to patient dismissal, patency was documented by B-mode ultrasound or digital subtraction angiography (DSA). All 15 patients had another B-mode ultrasound scan or DSA at least 45 days after thromboendarterectomy. On reexamination four ICAs were reoccluded, but only one patient became symptomatic. There were no operative deaths and no increase in preoperative neurologic deficits. The natural history of patients with total occlusion of the ICA is variable. The most important factor influencing a therapeutic decision is the patient's neurologic status. This study supports an aggressive, early surgical intervention for recent total occlusion in carefully selected patients. PMID- 6481873 TI - Abdominal aortic aneurysms: the changing natural history. AB - The records of all patients with abdominal aortic aneurysms (AAAs) in a Midwest city with a stable population over a 30-year period were reviewed. There were 296 patients (196 men and 100 women) for an incidence of 21.1 aneurysms/100,000 person-years. The median age at diagnosis was 69 years for men and 78 years for women. Seventy-eight percent of patients were asymptomatic at the time of diagnosis; their aneurysms were incidental findings. Rupture occurred in 60 patients (20.3%). Thirty-six patients (12.2%) had rupture of the aneurysm as the presenting complication. For previously diagnosed aneurysms that subsequently ruptured, the average period from diagnosis to rupture was 48.7 months. Rupture occurred in only two aneurysms smaller than 5 cm. The overall mortality rate from rupture was 15.5%. Evaluation of data (including autopsy reports) by decade revealed an absolute increase in the incidence of AAAs in the population under study. More aneurysms of all sizes occurred from 1971 to 1980 than in the previous two decades combined. Although ultrasound examination has increased the detection of small aneurysms, the incidence of aneurysms 7 cm or larger at the time of diagnosis has also increased; the frequency of rupture was greatest in the last decade. To compare the data of the population-based study with the statistics for patients seen in a referral practice, the records of 616 patients from a referral population were also reviewed. In the referral population the ratio of men to women was 5:1, and the age at diagnosis was lower for both groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481874 TI - Natural history of carotid artery disease on the side contralateral to endarterectomy. AB - The natural history of the nonoperated carotid artery opposite an endarterectomy was examined in 134 patients by means of ultrasonic duplex scanning over a period extending to 48 months. None of the nine deaths that occurred during follow-up was stroke related. A total of 22 arteries showed progression of disease over this period. By life-table analysis the mean annual rate of progression for all categories of disease was 12.6% and 7.4% for progression to a diameter reduction greater than 50%. Disease progression was more rapid in patients under 65 years of age. Symptoms occurred in 13 patients for an overall incidence of 10% and a mean annual rate estimated at 5%. All symptoms indicated transient ischemic attacks; there were no strokes. There was a strong relationship between the development of symptoms and stenoses greater than 80% either at the initial examination or secondary to progression. No correlation was found between the presence of bruits or their change over time and the progression or appearance of symptoms. Conservative management of nonoperated vessels opposite an endarterectomy appears appropriate until symptoms develop or a lesion greater than 80% is detected. PMID- 6481875 TI - Is routine angiography necessary prior to carotid endarterectomy? AB - The records of 111 consecutive patients undergoing evaluation for possible carotid endarterectomy at the University of Rochester were reviewed. All patients had noninvasive evaluation (oculoplethysmography-Gee and direct, continuous-wave Doppler ultrasonography) as well as selective carotid angiography. Patients were grouped by clinical presentation to ascertain the relative importance of angiography in determining the need for surgery. Arteriography added nothing to clinical and noninvasive evaluation in over two thirds of patients with hemispheric cerebral symptoms or asymptomatic carotid bruits. In contrast, we found that almost all patients with nonhemispheric symptoms required angiography for adequate evaluation prior to surgery. The implication of these findings on preoperative evaluation of patients with carotid surgery is discussed. PMID- 6481876 TI - Differential management of acute peripheral arterial ischemia. AB - Retrospective study of 140 consecutive cases of nontraumatic acute ischemia of the extremities of 48 hours or less duration emphasizes differences in diagnostic features, treatment, and results among 71 patients with arterial embolism (11% mortality rate) and 69 with acute atherosclerotic thrombosis (3% mortality rate). The following principles of management have evolved. (1) Although it is often difficult, differentiation between embolisms and acute thromboses is important. (2) Preoperative angiography is useful. (3) Immediate heparinization is indicated. However, it is not a suitable substitute for a necessary operation. (4) Long-term heparin therapy (instead of operation) does not produce better results for an embolism. However, it is useful for recent acute thrombosis with a viable limb. (5) Thrombectomy alone is not sufficient for acute atherosclerotic thrombosis. (6) Completion angiography is required. (7) Embolisms are more dangerous than acute thromboses, probably because of more serious accompanying cardiac lesions. PMID- 6481877 TI - Late survival after abdominal aortic aneurysm repair: influence of coronary artery disease. AB - To evaluate long-term survival in relation to preoperative risk factors, we reviewed 1112 patients undergoing abdominal aortic aneurysm (AAA) repair from 1970 to 1975. A 6-to 12-year follow-up was obtained on 1087 patients (97.7%) by chart review, death certificates, autopsy reports, and questionnaires returned by patients and referring physicians. Preoperatively 24% of patients had a history of prior myocardial infarction, 19.9% had a history of angina, and 40.4% were hypertensive. Emergency operation for ruptured aneurysm was performed in 6.5% and for expanding aneurysm in 3.4% of patients. The survival rate at 5 years was 67.5% and at 10 years was 40.7%. Cardiac-related problems were the most frequent cause of death (38%); 23% died of myocardial infarction and 15% from other heart disease or sudden death. Other causes included neoplasm (14.6%), other ruptured aneurysm (8.2%), and stroke (6.8%). Cause of death was unknown in 19.6%. A significant correlation of reduced survival time was noted in patients with advanced age and those with evidence of heart disease or hypertension. For patients without preoperative evidence of heart disease or hypertension, the 5 year mortality rate from myocardial infarction was 3.7%, compared with 11.7% for those with a positive history of hypertension and heart disease (p = 0.0001). For patients with no preoperative evidence of hypertension or heart disease, the length of survival after AAA repair was the same as that expected for the general population with the same age and sex composition. This study supports the contention that coronary angiography and prophylactic coronary bypass grafting should be performed selectively. Decisions regarding the need for coronary revascularization should be based on symptoms, noninvasive testing, and selective coronary angiography because aneurysmal disease alone is not shown in this study to increase the risk of death from myocardial disease. For patients with clinical findings of coronary artery disease, an aggressive diagnostic approach appears to be justified. PMID- 6481878 TI - Monitoring with two-dimensional transesophageal echocardiography. Comparison of myocardial function in patients undergoing supraceliac, suprarenal-infraceliac, or infrarenal aortic occlusion. AB - When the aorta must be temporarily occluded at the suprarenal or supraceliac levels during surgery, the resulting large increase in afterload may make the myocardium ischemic, even though systemic and pulmonary artery pressures and cardiac output are maintained at normal levels. These traditional indices of myocardial well-being do not appear to be sufficiently sensitive, since cardiac complications are still the most frequent cause of perioperative death and morbidity after aortic reconstruction. To evaluate two-dimensional transesophageal echocardiography as a monitor of myocardial well-being, we studied 24 American Society of Anesthesiologists physical status class III or IV adult patients who were undergoing aortic reconstruction and occlusion at the supraceliac (n = 12), suprarenal-infraceliac (n = 6), or infrarenal (n = 6) level. In addition to traditional monitors, we used a gastroscope tipped with a special 3.5 MHz two-dimensional echocardiographic transducer (Diasonics) that was placed in the esophagus to give a cross-sectional view of the left ventricle through the base of the papillary muscles. The hemodynamic effects of clamping the aorta were managed by administration of vasodilating drugs, anesthetics, and fluids to keep systemic and pulmonary arterial pressures normal. Occlusion at the supraceliac level caused major increases in left ventricular end-systolic and end diastolic areas, decreases in ejection fraction, and frequent wall motion abnormalities; these changes were not detected by conventional monitoring devices. Occlusion at the suprarenal-infraceliac level caused similar but smaller changes, and occlusion at the infrarenal level caused only minimal cardiovascular effects. We conclude that the two-dimensional transesophageal echocardiogram offers promise as an intraoperative monitoring device. PMID- 6481879 TI - Homologous veins as an arterial substitute: long-term results. AB - From 1968 through 1982, 129 homologous vein grafts were used in 91 patients in the following positions: 75 in the femoropopliteal, tibial, or peroneal artery; 38 in the aortocoronary artery; 13 in the aortopulmonary artery; and one each in the atrioventricular fistula, carotid-subclavian artery, and brachial-radial artery. In the lower extremity patency ranged from 0 to 121 months (mean 22.4 +/- 4.4 months). All grafts were performed for limb salvage, and 75% of the patients had undergone previous operations. Cumulative patency by the life-table method showed that while 50% of grafts occluded by 1 year, 60% of the remaining grafts continued to be functional for more than 5 years. Fifty percent of the aortocoronary bypass grafts studied were occluded at 1 year. Eight of the 13 systemic pulmonary artery shunts were patent at time of death, revision, or total correction. Multiple revisions and thrombectomies are required to maintain patency of homograft veins. The outcome is variable and unpredictable. The inconsistency is due to the antigenicity of the graft. If one is committed to the necessary efforts required to ensure long-term patency, the homologous saphenous vein is a suitable substitute when autogenous tissue is unavailable. PMID- 6481880 TI - Arterial wall thromboxane: dominance after surgery predisposes to thrombosis. AB - Ibuprofen reduces early occlusion and surface thrombogenicity of small-diameter polytetrafluoroethylene (PTFE) grafts in sheep. The following experiments were designed to determine the effects of cyclooxygenase inhibition by ibuprofen on long-term patency and arterial wall and graft neointima prostaglandin synthesis. Crossover PTFE grafts (internal diameter 4 mm) were interposed between the carotid arteries of 18 sheep. Nine animals were used as controls, and nine received ibuprofen, 10 mm/kg intravenously, 1 hour prior to surgery and then every 8 hours for the duration of the experiment. Grafts were removed either when they became occluded or routinely at 60 days. Arterial segments adjacent to anastomoses were removed at graft insertion and at graft removal for assay of arterial wall production of the prostaglandins 6-keto-PGF1 alpha and thromboxane B2 (TxB2). There was no difference in patency between control animals (four out of nine) and ibuprofen-treated (five out of nine) animals. Arterial segments removed before the administration of ibuprofen produced 2.59 +/- 1.48 nM/mg protein/20 min of 6-keto-PGF1 alpha and 2.59 +/- 1.38 nM/mg protein/20 min of TxB2. A single dose of ibuprofen reduced the levels of 6-keto-PGF1 alpha to 0.30 +/- 0.12 nM/mg protein/20 min and the levels of TxB2 to 0.78 +/- 0.41 nM/mg protein/20 min (p less than 0.01). When the grafts were removed, control animals showed a reduction of 6-keto-PGF1 alpha to 1.69 +/- 0.86 nM/mg protein/20 min, whereas TxB2 levels remained unchanged at 2.54 +/- 1.23 nM/mg protein/20 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481881 TI - The value of radionuclide angiography as a predictor of perioperative myocardial infarction in patients undergoing abdominal aortic aneurysm resection. AB - To define the group of patients at high risk for myocardial infarction (MI) and death associated with abdominal aortic aneurysm repair, resting gated blood pool studies were obtained on 50 such aneurysm patients preoperatively. The results indicated that three groups could be distinguished among these patients by cardiac ejection fraction. Group I (n = 25) had preoperative ejection fractions ranging from 56% to 85%. None of the patients in group I suffered an acute perioperative MI. Group II (n = 20) comprised patients with ejection fractions ranging from 36% to 55%. There was a 20% incidence of MI in group II but no cardiac deaths. Group III included five patients with ejection fractions ranging from 27% to 35%. There was an 80% incidence of perioperative MI in these patients, with one cardiac death and one cardiac arrest. All perioperative MIs occurred within the first 48 hours after surgery. In addition there was a 50% incidence of perioperative MI among all those patients who were 80 years of age or older. These results indicate guidelines for the management of patients undergoing abdominal aortic aneurysm repair based on their preoperative ejection fraction. The data further suggest that the noninvasive gated blood pool method of determining ejection fraction may serve a more broadly useful function in helping to determine which of those patients about to undergo major surgical procedures are at high risk for perioperative MI. PMID- 6481882 TI - Carotid endarterectomy for nonhemispheric symptoms: predictors of success. AB - Over a 4-year period 335 patients underwent 402 carotid endarterectomies: 227 (56%) for carotid territory symptoms, 107 (27%) for nonhemispheric symptoms, and 68 (17%) for asymptomatic lesions. In 317 four-vessel arteriograms, proximal subclavian and/or vertebral lesions were found more frequently in the nonhemispheric group (80 of 97, or 82%) than in the carotid territory group (110 of 220, or 50%; p less than 0.05). EEG changes after carotid clamping occurred more often in the nonhemispheric group (15 of 65, or 23%) than in the carotid territory group (16 of 140, or 11%; p less than 0.001). The perioperative stroke rate was independent of whether nonhemispheric or carotid territory symptoms were present preoperatively (2.8% vs. 3.5%). Follow-up ranged from 1 month to 4 years. Carotid endarterectomy was successful in ameliorating symptoms in patients meeting the criteria for "classic" vertebrobasilar insufficiency more often than in patients not meeting these criteria (73% vs 43% asymptomatic at 24 months). Carotid endarterectomy was successful in patients with carotid stenoses of greater than 60% diameter reduction more often than in patients with smaller stenoses (77% vs. 36% asymptomatic at 24 months). Carotid endarterectomy appears justified in patients with nonhemispheric symptoms when classic vertebrobasilar insufficiency and/or hemodynamically significant carotid stenoses are present. PMID- 6481883 TI - Depressed cardiovascular function and altered platelet kinetics following protamine sulfate reversal of heparin activity. AB - This investigation documented the hemodynamic effects of rapid intravenous and intra-arterial administration of protamine sulfate, altered platelet kinetics associated with intravenous protamine sulfate administration, and a possible method of reducing protamine sulfate-induced hypotension. Thirty-six anesthetized dogs underwent continuous hemodynamic monitoring prior to heparinization (150 U/kg) and for 30 minutes after rapid reversal with protamine sulfate (1.5 mg/kg over 10 seconds). Platelet counts, platelet aggregation, and serum thromboxane B2 levels were also assessed. Intra-arterial protamine sulfate administration caused fewer adverse hemodynamic changes than intravenous administration, including significantly (p less than 0.05) reduced falls in mean arterial pressure (-10 vs. -35 mm Hg), cardiac output (-0.2 vs. -0.6 L/min), femoral artery blood flow (+ 34 vs. -16 ml/min), and superior mesenteric artery flow (+ 107 vs. -48 ml/min). Thrombocytopenia following protamine sulfate administration was the same in the two groups. Marked hypotension accompanying intravenous protamine sulfate administration was completely attenuated by a small dose of protamine sulfate (0.75 mg/kg) administered prior to heparinization. Similarly, the thrombocytopenia caused by intravenous administration was significantly lessened by protamine sulfate pretreatment (74% vs. 23% reduction; p less than 0.01). These observations have important implications for both experimental and clinical use of heparin and protamine sulfate. PMID- 6481884 TI - In vitro observations of greater saphenous vein valves during pulsatile and nonpulsatile flow and following lysis. AB - A significant number of saphenous vein femoral-popliteal bypass graft failures have been attributed to flow abnormalities caused by venous valves. Seventy-seven greater saphenous vein valves were observed and photographed through a 0-degree choledochoscope during pulsatile and nonpulsatile flow. No valve was seen to lie flat against the vein wall. With pulsatile flow the valves were noted to close during diastole. Stasis was noted within the valve cusps. Twenty-three valves produced photographs of sufficient quality to allow measurement of the luminal obstruction caused by the valves. This valvular obstruction represented 61% +/- 12% of the total vein lumen. Fifty venous valves were lysed by five different techniques: the microscissors, the Connolly vein stripper, the Mills valvulotome, the venotomy valvulectomy of Hall, and eversion valvulectomy. The first three methods created valvular incompetence, but flaps of valve cusps were observed to disturb flow and place potentially thrombogenic surfaces within the vein lumen. Valvulectomy, whether by venotomy or eversion, removed the valve cusps satisfactorily. PMID- 6481885 TI - Utility of transcutaneous oxygen tension measurements in peripheral arterial occlusive disease. AB - The use of transcutaneous oxygen tension (TCpO2) measurements to objectively and noninvasively diagnose peripheral arterial occlusive disease (PAOD) and to aid in the planning of vascular surgery was investigated. Thirty-two normal subjects and 100 patients with PAOD were studied. TCpO2 values decreased with age; when normalized by measurements on the chest, they did not. Absolute and normalized values of TCpO2 were equally effective in identifying the presence of PAOD and accurately characterized different degrees of severity (claudication vs. rest pain vs. impending gangrene; p less than 0.001). This was true even in diabetic patients, in whom tests based on hemodynamic function were less reliable. Healing of amputations was observed when TCpO2 greater than or equal to 38 mm Hg either preoperatively or after reconstruction; failure to heal in the absence of infection was associated with TCpO2 less than or equal to 38 mm Hg. The need for revascularization was associated with TCpO2 less than 30 mm Hg. A similar distribution of TCpO2 values was associated with success vs. failure of ulcer healing. TCpO2 is a useful complement to standard hemodynamic tests in the diagnosis and management of PAOD and, in addition, provides some distinct advantages. PMID- 6481887 TI - Certification: presidential address. PMID- 6481886 TI - Composite sequential bypasses to the ankle and beyond for limb salvage. AB - Composite grafts of polytetrafluoroethylene (PTFE) and saphenous vein were used for sequential bypasses to the ankle and foot in 35 men and 19 women (mean age 66.5 years). Presenting symptoms were rest pain (25), digital gangrene (19), and ischemic ulcer (10). Thirty-one tibial and 23 pedal bypasses were done and were followed up to 48 months (mean 26.4 months). The ankle pressure index rose from 0.31 +/- 0.11 preoperatively to 0.77 +/- 0.21 postoperatively. Mean graft flows were 34.8 ml/min. Composite sequential grafts took 51 minutes longer to perform than femoral-tibial vein grafts. Patency rates by the life-table method were 81.4% at 2 years and 72.4% at 4 years. Graft failures after the first 10 weeks usually led to amputation. Use of PTFE as an inflow conduit permits otherwise inadequate lengths of saphenous vein to be used for anastomosis to delicate distal vessels and takes advantage of the vein's ability to tolerate low flows. Our experience suggests that the excellent patency rates make sequential bypasses a reasonable option for limb salvage. PMID- 6481888 TI - Minimizing the risks of carotid endarterectomy. AB - In 1971 this study was undertaken to determine optimal methods and guidelines for lowering the mortality and neurologic complication rates associated with carotid endarterectomy. Of 570 carotid endarterectomies, 481 (84%) were performed under local anesthesia to provide continuous neurologic monitoring and to permit operation on the very elderly and poor-risk patient. In 418 of these procedures carotid stump pressures (CSPs) were measured with patients awake to determine the level of back pressure sufficient for brain protection during operative occlusion. Selective shunting was necessary in 40 (8%) of these cases. Of 78 patients with a CSP of 0 to 25 mm Hg, only 39 (50%) required shunting. Only one patient with a pressure greater than 25 mm Hg (29 mm Hg) needed a shunt. The CSP/brachial blood pressure (BBP) index was calculated for 410 procedures. Of 97 patients with a CSP of 0 to 30 mm Hg, only 31 required a shunt (CSP/BBP index 0.01 to 0.18). No shunt was necessary for an index greater than 0.18. Patients with a contralateral occlusion or severe stenosis required a shunt six times more frequently than those with unilateral disease. For 570 procedures the overall mortality rate was 0.7% and the neurologic complication rate was 0.9%. When local anesthesia was used for 481 procedures, there was only one death (0.2%). For 74 asymptomatic lesions there were no deaths or stroke. Neurologic monitoring under local anesthesia and CSPs are reliable indicators for selective shunting. Multiple-risk factors influence the outcome of carotid endarterectomy, but most can be avoided. PMID- 6481889 TI - External carotid endarterectomy. AB - Forty-nine external carotid revascularization procedures were performed in 36 patients. Indications included transient ischemic attacks, amaurosis fugax, and the procedure as a prelude to extracranial-to-intracranial bypass. Twenty patients had a preoperative neurologic defect. Twelve patients were classified as having bilateral and 24 as having unilateral carotid disease. Unilateral external carotid endarterectomy was performed in 29 patients, with the remaining patients undergoing procedures for additional occlusive lesions. Five patients had operation-related strokes (one death). Three of eight patients with bilateral disease and a preoperative neurologic defect had a stroke. Five additional patients had late neurologic events. Although technically easy, external carotid thromboendarterectomy should be advised with caution in patients with identifiable risk factors. PMID- 6481890 TI - Influence of the contralateral carotid artery on neurologic complications following carotid endarterectomy. AB - To examine the effect of contralateral carotid artery stenosis on postoperative events, a retrospective review was made of 451 patients undergoing 510 carotid endarterectomies during a 6-year period. Three degrees of contralateral carotid stenosis were identified radiologically: 0% to 49%, 50% to 99%, and totally occluded. Each group was further separated into two categories according to preoperative symptoms. "Low risk" included asymptomatic lesions, transient ischemic attacks, and nonhemispheric symptoms; "high risk" described poststroke patients and urgent operations. The results show the incidence of stroke or death was not increased in patients with severely stenosed or occluded contralateral vessels in either low- or high-risk patients (p = 0.741 and p = 0.561, respectively). Patients in the high-risk category, however, had a significantly higher risk of postoperative complications than patients in the low-risk category (p less than 0.001). The study reaffirms that preoperative indications have a major influence on surgical outcome and suggests that the status of the contralateral artery has little bearing on postoperative events. PMID- 6481891 TI - Atherosclerotic extracranial carotid artery aneurysms. AB - Twenty-four atherosclerotic extracranial carotid artery aneurysms were encountered in 21 patients during a 25-year period. These represented 46% of all extracranial carotid artery aneurysms diagnosed at the University of Michigan during this period. Neurologic symptoms including amaurosis fugax, transient ischemic attacks, and stroke were present in 50% of the patients. An asymptomatic pulsatile neck mass occurred in 33%. Surgical therapy was undertaken for 18 aneurysms, and nonoperative treatment was pursued in the remaining six aneurysms. Operative therapy included 14 aneurysmectomies and four aneurysmorraphies. There were no surgical deaths. Transient perioperative neurologic deficits affected three of these patients (17%), and one individual (5%) experienced a permanent deficit. Transient cranial nerve deficits occurred in three patients (17%), and a permanent deficit was noted in one patient (5%). During a 7.6-year follow-up period no late strokes occurred among patients who were operated on. Nonoperative therapy was associated with three ipsilateral strokes during a mean follow-up period of 6.3 years. Atherosclerotic extracranial carotid artery aneurysms were associated with an exceptionally high stroke rate (50%) if treated nonoperatively. Prevention of late stroke justifies surgery, although perioperative neurologic deficits may accompany this therapy more often than with nonatherosclerotic carotid artery aneurysms. PMID- 6481892 TI - Massive hemangioma in infants: therapeutic considerations. AB - Eight infants were treated for massive symptomatic hemangioma over a 6-year period. The hemangiomas were located in the liver in five infants and in the upper arm, lower leg, and face in one newborn each. Symptoms included congestive heart failure in six infants and platelet trapping in three newborns. Prednisone and surgical excision were curative in six of the eight patients, while two of the eight died of sepsis, congestive heart failure, and continued platelet trapping. Radiation therapy and arteriographic embolization were of limited value. PMID- 6481893 TI - Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair. AB - The presence of periprosthetic gas on computerized axial tomography (CT) of the abdomen following abdominal aortic reconstruction has been proposed to be a reliable indicator of prosthetic graft infection, a complication that requires intervention entailing significant mortality and morbidity. To evaluate the reliability of this finding in the early postoperative period, prosthetic grafts in 26 patients undergoing elective aneurysm repair were evaluated with postoperative CT examinations. Serial scans were obtained at mean intervals of 3, 7, and 52 days postoperatively. The presence or absence of periprosthetic air on CT scan was noted, and the results were correlated with aneurysm size as determined by preoperative ultrasound examination of the abdominal aorta or by measurements made during operation. Mean aneurysm size was 6.1 cm (range 4.5 to 10.6 cm). Periprosthetic air was demonstrated in 17 (65%) of the 26 patients studied within 1 week postoperatively. Patients with aneurysms larger than 6.0 cm were more likely to demonstrate periprosthetic air then those with smaller aneurysms (chi 2 = 5.024, p = 0.025). All patients found to have periprosthetic air had spontaneous resolution by late CT scanning obtained a mean of 52 days postoperatively (range 21 to 85 days). One patient died in the early postoperative period and two did not return for late scans. Only one patient demonstrated periprosthetic air as late as the thirty-second postoperative day, and this air had resolved by the seventieth postoperative day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481894 TI - Role of medial lamellar architecture in the pathogenesis of aortic aneurysms. AB - The human abdominal aorta is particularly susceptible to the formation of aneurysms with atrophic walls. This aortic segment normally has fewer medial lamellar units than would be expected for a mammalian aorta of comparable diameter as well as far fewer medial vasa vasorum than would be expected for an aortic wall of comparable thickness. To test the hypothesis that ischemia and/or loss of normal lamellar architecture are predisposing factors for aneurysm formation, we used the pig thoracic aorta, which is furnished with 75 medial layers and vasa supplying the outer two thirds. Vasal blood flow was surgically ablated, and crushing injury was used to reduce the number of intact lamellar units. Mural ischemia alone resulted in necrosis of cells in the medial zone furnished by vasa but did not lead to aneurysmal dilatation, and all the fibrous tissue layers persisted during the 2-month observation period. Mechanical injury resulted in aneurysms in both ischemic and nonischemic aortic segments, but only if fewer than 40 intact lamellae remained and the average tension per lamellar unit exceeded three times the normal value of 1316 +/- 202 dynes/cm (4543 +/- 1624 for ischemic and 4087 +/- 871 for nonischemic segments; p less than 0.01 for each). We conclude that a critical reduction in the number of intact lamellar units results in aneurysmal dilatation. Protracted medial ischemia due to intimal plaque formation in the avascular abdominal aorta may eventually reduce the number of intact lamellae and favor the development of aneurysms. PMID- 6481895 TI - Composite sequential grafts in severe ischemia: a comparative study. AB - From October 1978 to June 1983, 64 sequential bypass grafts were performed in 59 patients with limb-threatening ischemia. These patients were classified into three study groups as follows: reversed saphenous vein graft alone (12), composite sequential (proximal polytetrafluoroethylene [PTFE] and distal vein) graft (30), and PTFE graft in entirety (22). Graft patency was confirmed in all cases by serial Doppler ankle pressure measurements or by angiography. Cumulative life-table patency rates were then compared over a period of 27 months. The patency rates for composite sequential grafts using a distal short segment of vein were statistically indistinguishable from those for bypasses performed entirely with saphenous vein. These yielded a patency rate of 80% at 1 and 2 years. In contrast, the 1- and 2-year patency rates of the PTFE sequential grafts were 52% and 47%, respectively (p less than 0.05). Composite sequential bypasses using an otherwise inadequate segment of saphenous vein are a sound alternative revascularization procedure, with a patency rate comparable to that of reversed saphenous vein bypasses. PMID- 6481896 TI - Extended autogenous profundaplasty and aortofemoral grafting: an alternative to synchronous distal bypass. AB - The success of aortofemoral reconstruction in patients with superficial femoral artery occlusion depends on the restoration of satisfactory inflow to the profunda femoris artery (PFA). When significant occlusive disease exists within this vessel, two options exist: femoral-distal bypass or reconstruction of the PFA. In 165 aortofemoral reconstructions for occlusive disease, 29 limbs (9%) underwent an extended autogenous profundaplasty. The cumulative 5-year patency rate of autogenous reconstructions was 86%, with a 72% limb salvage rate without distal bypass. Two limbs were amputated early for sepsis with patent grafts. One early and one late femoral-popliteal bypass was performed. Groin wound complications, primarily lymphoceles and wound edge necrosis, were numerous (38%). There were no graft infections. Relief of ischemic symptoms was achieved regardless of patency of the popliteal artery. Furthermore, noninvasive testing, clinical history, and angiography failed to accurately predict the results. In patients with advanced PFA disease undergoing aortofemoral grafting, the extended autogenous profundaplasty is a durable procedure with excellent relief of ischemic symptoms. PMID- 6481897 TI - Lower limb ischemia in young adults: prognostic implications. AB - Fifty patients (41 men and nine women) less than 36 years of age were evaluated for lower limb ischemia. Claudication was the presenting symptom in 30 patients (60%) and distal ulceration in 20 (40%). The mean age was 28.3 years. Premature atherosclerosis was present in 24 patients (48%) and thromboangiitis obliterans in 12 (24%). Other causes included a variety of unusual etiologies. Risk factors were analyzed. Twenty-two patients with claudication underwent arterial reconstruction; three had sympathectomy. Arterial reconstruction was possible in only three patients with ulceration; 17 had sympathectomy. No operative deaths or early amputations occurred. Follow-up averaged 13.5 years. Twenty-four patients with claudication were improved, three were unchanged, one developed ulceration, one required late amputation, and one was lost to follow-up. Four patients with ulceration were improved, one was unchanged, 14 required late amputation, and one was lost to follow-up. Ten patients, all with atherosclerosis obliterans, developed coronary artery disease; five died of myocardial infarction. No patient developed cerebrovascular disease. We conclude that reconstructive arterial surgery for claudication can be performed with low risk and a strong likelihood of long-term improvement. Most patients presenting with ulceration, however, will ultimately require amputation. Patients with atherosclerosis obliterans are at risk for coronary artery disease and death of myocardial infarction. PMID- 6481899 TI - Introduction to symposium on transvenous vena cava interruption. PMID- 6481898 TI - Effect of primary renal disease in patients with renovascular insufficiency. AB - The effect of laboratory evidence of renal parenchymal abnormality on the results of renal revascularization in 83 patients with renovascular hypertension was determined. Primary renal disease (PRD) was defined as an abnormal urinalysis (proteinuria, hematuria, or casts) in the absence of urinary infection, or decreased renal function (elevated serum creatinine level greater than 1.5 mg/dl and/or decreased creatinine clearance). All patients were hypertensive on medical therapy preoperatively. Patients were defined as cured if postoperative diastolic blood pressure (BP) was less than 90 mm Hg on no medication and improved if BP less than 90 mm Hg on medication. Sixty-six patients (80%) were cured or improved following revascularization. Of 45 patients (63%) with evidence of PRD preoperatively, 28 (62%) were cured or improved compared with 33 patients without PRD, of whom all (100%) were cured or improved (p less than 0.001). Each of five patients with transplant renal artery stenosis had two operations; four were cured or improved. The serum creatinine level was elevated preoperatively in 37 cases. Eighteen of the 37 (49%) improved to within normal limits following operation. Fifteen patients had simultaneous bilateral renal artery revascularization, and 12 (80%) were cured or improved. Fourteen patients (17%) had concomitant vascular procedures: aortobifemoral bypass (seven), abdominal aneurysm resection (five), femoral endarterectomy (one), and aortoiliac bypass (one). Twelve of these 15 patients had PRD, and 8 of the 12 (67%) were cured or improved. Only one death occurred in the perioperative period. Thirty-eight patients (46%) had been treated for hypertension for more than 12 months before referral.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481900 TI - Hunter vena cava balloon: rationale and results. AB - The majority of patients with venous thromboembolism are successfully managed with anticoagulation therapy, but certain patients require inferior vena cava (IVC) interruption. Traditional open operations on the IVC have important disadvantages, among which are significant morbidity and mortality. Twenty years ago work began to develop a transvenous method to interrupt the IVC. As the requirements for a safe and effective method were defined, it became apparent that the best approach would be with a catheter-delivered detachable balloon secured by hyperinflation in the distensible IVC. The concept of a "filter" was discarded because of predicted problems with thrombosis, induced embolism, and device migration. We have treated 135 patients with the Hunter IVC balloon. Sick patients tolerate the procedure, and it is highly effective in preventing pulmonary embolism. Leg morbidity is acceptable, parallels the extent of the phlebitis, and is lessened by leg care and simultaneous anticoagulation therapy. Long-term results with follow-up to 13 years are excellent. PMID- 6481901 TI - The bird's nest filter: a new percutaneous transcatheter inferior vena cava filter. AB - The bird's nest filter is a new transvenous stainless steel inferior vena cava filter designed for percutaneous introduction. The filter design eliminates the technical problems associated with other transvenous filters and produces an effective nonthrombogenic barrier to potential pulmonary emboli. PMID- 6481902 TI - Current indications for and results of Greenfield filter placement. AB - Review of the indications for and results of Greenfield filter placement for protection against thromboembolism in 260 patients shows that the most common indication remains a contraindication to anticoagulation therapy (35%) or recurrent thromboembolism in spite of anticoagulation therapy (31%). Prophylaxis in the absence of embolism is a less common indication (18%), but increasingly favorable experience by others with the filter in place of anticoagulation therapy in the elderly may alter the approach to these patients. Although two patients with massive embolism who had undergone pulmonary embolectomy died postoperatively, no deaths occurred as a result of filter placement. Only one of the remaining 35 patients who died (14%) within 2 weeks of filter placement had suspected recurrent embolism. Follow-up studies in 99 patients extending to 100 months showed only two early and no late occlusions of the filter, for a long term patency rate of 98%. The recurrent embolism rate of 5% is comparable to that of previously reported experience and appears to be independent of the use of long-term anticoagulation therapy. PMID- 6481903 TI - AIDS, associated disorders pose complex therapeutic challenges. PMID- 6481904 TI - Leads from the MMWR. Rubella and congenital rubella syndrome--United States, 1983 1984. PMID- 6481905 TI - Leads from the MMWR. Chronic diarrhea associated with raw milk consumption- Minnesota. PMID- 6481906 TI - Use of HMOs. PMID- 6481907 TI - Adenocarcinoma of the lung in patients younger than 35 years. PMID- 6481908 TI - On-site physician staffing in a community hospital intensive care unit. Impact on test and procedure use and on patient outcome. AB - To determine whether on-site physician staffing changed test and procedure use and improved patient outcome in a community hospital intensive care unit (ICU), we studied all ICU admissions for matched periods before and after the staffing change. Compared with the 463 year-1 patients, the 491 year-2 patients were no more likely to receive life-support interventions (respirators, dialysis, or pacemakers), but had substantially more monitoring interventions, such as pulmonary artery catheters (22% v 2%, P less than .0001) and arterial catheters (9% v 0%, P less than .0001). After controlling for factors that predicted death (age, mental status at time of admission, reason for ICU admission), year-2 patients were significantly more likely to survive the ICU and subsequent hospital stay (P = .01). Nearly all of the improvement of survival rate took place among patients with intermediate likelihoods of death; this improved survival rate persisted at the 12-month follow-up (P = .01). PMID- 6481909 TI - Association of rectal and urethral colonization with urinary tract infection in patients with indwelling catheters. AB - To assess the role of antecedent rectal and urethral colonization in the pathogenesis of catheter-associated urinary tract infections, we prospectively studied 64 patients, obtaining urine, rectal, and urethral cultures on study entry, two days later, and every four days thereafter. Of 55 patients who remained catheterized for at least three days, urethral colonization with the same microorganism present in bladder urine was observed in the sampling period preceding the onset of bacteriuria in 12 of 18 infections in women and five of 17 in men. Rectal colonization with the infecting strain preceded bacteriuria in 14 of 18 infections in women and five of 17 in men. The identity of the urinary, urethral, and rectal isolates was confirmed by speciation, serotyping, antibiograms, and biotyping. We conclude that rectal and periurethral colonization often precedes catheter-associated bacteriuria, especially in women, and that effective preventive measures aimed at transurethral infection should be developed. PMID- 6481910 TI - The acquired immunodeficiency syndrome. Commentary. Council on Scientific Affairs. PMID- 6481911 TI - Diagnosis of acute, diffuse pulmonary infiltrates. AB - Patients with acute, diffuse pulmonary infiltration that may be infectious or noninfectious present a major diagnostic-treatment challenge. Many options are available during the sequence of diagnosis and treatment. Our bias is to proceed rapidly to the more specific and sensitive invasive diagnostic procedures if clinical and laboratory data are indicative of diffuse involvement or immunosuppression, because a positive outcome appears to be affected by early intervention with appropriate antimicrobial drugs. Such an approach also avoids administration of a potentially toxic and unnecessary antimicrobial "shotgun." Each physician must consider the local expertise and resources available; in our view, however, the patient is best served by, "erring" on the side of early use of invasive procedures. PMID- 6481912 TI - Unpasteurized milk. The hazards of a health fetish. AB - Meaningful differences in nutritional value between pasteurized and unpasteurized milk have not been demonstrated, and other purported benefits of raw milk consumption have not been substantiated. Conversely, the role of unpasteurized dairy products in the transmission of infectious diseases has been established repeatedly. To effectively counsel patients attracted by the health claims made for raw milk, practicing physicians must understand both the rationale used by proponents of raw milk and the magnitude of the risk involved in drinking raw milk. PMID- 6481913 TI - Anticoagulants and abdominal pain. The role of computed tomography. AB - The development of abdominal pain in the patient receiving anticoagulants, especially with a documented drop in hematocrit levels, almost certainly indicates a major hemorrhage. If loss of blood from the GI tract is not documented, some form of internal bleeding must have occurred. Unfortunately, the site of the bleeding is frequently unclear. Even small hemorrhages in critical locations (eg, the adrenal gland) can have serious consequences. In the obese patient, a rectus sheath hematoma may remain hidden at the time of repeated physical examinations. Generally, the cause of a mass palpated or perhaps demonstrated by conventional radiological studies cannot be diagnosed accurately. Computed tomography can demonstrate the size and location of the mass and its relation to normal intra-abdominal structures. By careful evaluation of the attenuation coefficient, it is possible to establish the definitive diagnosis of hemorrhage. Should the attenuation value of a mass be insufficiently high to diagnose hemorrhage conclusively on the initial scan, serial scans demonstrating a decrease in size and/or attenuation of the mass confirm the diagnosis of hemorrhage. In our opinion a negative CT examination is a reliable indicator that such a bleeding complication has not occurred. PMID- 6481914 TI - Prolonged delirium after metrizamide myelography. PMID- 6481915 TI - Disseminated herpes simplex virus infection in pregnancy. Successful treatment with acyclovir. PMID- 6481916 TI - Critical care medicine. The past and changes in the future. PMID- 6481917 TI - A new factor that promotes blood vessel growth? PMID- 6481918 TI - New century of achievement awaits unique National Institutes of Health. PMID- 6481920 TI - From Army book collection to largest medical library. PMID- 6481919 TI - Contempo '84. PMID- 6481922 TI - Leads from the MMWR. Mumps--United States, 1983-1984. PMID- 6481921 TI - Prolonged suppression of cough after inhalation of lidocaine in a patient with sarcoid. PMID- 6481923 TI - Leads from the MMWR. Campylobacter outbreak associated with certified raw milk products--California. PMID- 6481924 TI - Hepatitis B infection in other hospital personnel. PMID- 6481925 TI - Drug trapping in intravenous infusion side arms. PMID- 6481926 TI - Hypothyroidism-associated cholestasis. PMID- 6481927 TI - Continuity of outpatient medical care in elderly men. A randomized trial. AB - P6 an outpatient repeatedly sees the same practitioner, is his care influenced? This double-blind randomized trial examines the effects of outpatient health care provider continuity on the process and outcome of the medical care for 776 men aged 55 years and older. Participants were randomized to two different groups of provider care: provider discontinuity and provider continuity. The outcome of the continuity group was significantly different from that of the discontinuity group. During an 18-month period, patients who had been randomized to the continuity group had fewer emergent admissions (20% v 39%) and a shorter average length of stay (15.5 v 25.5 days). These patients also perceived that the providers were more knowledgeable, thorough, and interested in patient education. We conclude that continuity of outpatient provider care for men aged 55 years and older results in more patient satisfaction, shorter hospitalizations, and fewer emergent hospital admissions. PMID- 6481928 TI - The assessment of diagnostic tests. A survey of current medical research. AB - To study current diagnostic test evaluation, 129 recent articles were assessed against several well-known methodological criteria. Only 68% employed a well defined "gold standard." Test interpretation was clearly described in only 68% and was stated to be "blind" in only 40%. Approximately 20% used the terms sensitivity and specificity incorrectly. Predictive values were considered in only 31% and the influence of disease prevalence and study setting was considered in only 19%. Overall, 74% failed to demonstrate more than four of seven important characteristics and there was an increased proportion of high specificities reported in this group. Articles assessing new tests reported high sensitivities and specificities significantly more often than articles assessing existing tests. These results indicate a clear need for greater attention to accepted methodological standards on the part of researchers, reviewers, and editors. PMID- 6481929 TI - Low birth weight across generations. AB - The relationship between maternal birth weight and infant birth weight was studied in the Buffalo cohort of the Collaborative Perinatal Project (n = 1,348). Regression techniques were used to control for confounders. Compared with infants of mothers who had weighed 8 lb or more at birth, infants of mothers who had weighed 6 to 7.9 lb, 4 to 5.9 lb, and less than 4 lb at birth were 99 g, 244 g, and 170 g lighter, respectively. The adjusted odds ratios of giving birth to an infant of birth weight less than 2,500 g, with mothers of birth weight 8 lb or more as the reference group, were 3.46 and 1.66 for mothers of birth weight 4 to 5.9 lb and 6 to 7.9 lb, respectively. There were no infants less than 2,500 g among the 24 women who had weighed less than 4 lb at birth. These data suggest a possible role of genetic and familial factors in determining birth weight. PMID- 6481930 TI - Clinical laboratory responses to reduced funding. AB - Economic forces have been set in motion by recent legislation that are very likely to reduce available funds for clinical laboratories in hospitals. The effect of these impending developments on patient care is of great concern to clinicians and laboratorians. There is a range of available coping strategies that have broadly different consequences for the traditional role of the laboratory in patient care. The first seeks to preserve existing test ordering and reporting behavior by employment of straight cost cutting in the laboratory. The second calls for consciously determined selective degradation in laboratory services and functions. The third depends on decreased utilization of the laboratory achieved by indirect or direct intervention by laboratorians on the free ordering practices of clinicians. The fourth involves reorganization of the laboratory with new institutional relationships that variably affect laboratory function. PMID- 6481932 TI - Aortic and mitral regurgitation. How to evaluate the condition and when to consider surgical intervention. PMID- 6481931 TI - Doctor-patient communication. Clinical implications of social scientific research. AB - Research in the social sciences has clarified the nature and problems of doctor patient communication. The development of adequate communication skills is now a goal of training programs in the primary-care specialties. Social structural barriers impede effective communication, however, and information giving remains problematic. Doctors tend to underestimate patients' desire for information and to misperceive the process of information giving. The transmission of information is related to characteristics of patients (sex, education, social class, and prognosis), doctors (social-class background, income, and perception of patients' desire for information), and the clinical situation (number of patients seen). Doctors' nonverbal communication abilities are associated with outcomes of medical care such as satisfaction and compliance. Regarding the sociolinguistic structure of communication, doctors often maintain a style of high control, which involves many doctor-initiated questions, interruptions, and neglect of patients' "life world." Training programs and standards of clinical practice should emphasize that improved doctor-patient communication is both desirable and possible. PMID- 6481933 TI - Leukopenia in Still's disease. AB - Two patients, one a 14-year-old girl and the other a 20-year-old man, with typical manifestations of juvenile rheumatoid arthritis had leukopenia and thrombocytopenia, two heretofore unreported findings. The presence of leukopenia should not be used to exclude a diagnosis of Still's disease. PMID- 6481934 TI - Outpatient needle localization and biopsy for nonpalpable breast lesions. AB - We reviewed 101 consecutive biopsy specimens of nonpalpable breast lesions obtained by needle localization. Forty-six biopsies were done on outpatients under local anesthesia and 16 more on inpatients under local anesthesia. The remaining 39 biopsies were performed on inpatients under general anesthesia. The complications and accuracy of the outpatient procedure were acceptable and comparable to those of the inpatient procedure. In our institution, there is almost a fivefold cost increase for the performance of this procedure under general anesthesia as an inpatient. We recommend that surgeons and radiologists work together to perfect preoperative localization techniques, and we strongly support the concept that this procedure should be performed on outpatients under local anesthesia for the majority of patients with nonpalpable mammographic abnormalities. PMID- 6481935 TI - Chronic dermatitis simulating small-plaque parapsoriasis due to cyanoacrylate adhesive used on fingernails. PMID- 6481937 TI - Continuity counts. PMID- 6481936 TI - Death is not the enemy. PMID- 6481938 TI - Nonbacterial thrombotic endocarditis as a cause of cerebral and myocardial infarction. AB - Clinicopathologic correlations of nonbacterial thrombotic endocarditis (NBTE) were studied with special reference to their pathogenetic role in cerebral and myocardial infarction. In 2340 cases of consecutive autopsies of the aged, NBTE was observed in 217 cases or 9.3%. The age distribution of NBTE revealed a gradual increase with advancing age. The underlying diseases of NBTE were malignant neoplasm (51.6%), infection (28.3%) and other diseases (20.1%). The incidence of NBTE in each cancer was high in cancers of the colon (16.2%), pancreas (15.2%), gall bladder or bile duct (14.1%) and lung (13.0%). The vegetations of NBTE were found on the aortic valve in 46.1%, on the mitral valve in 40.6% and on the both valves in 8.3%. The incidence of myocardial infarction and scar was 51.2% in the NBTE group, while it was 38.6% in the non-NBTE control group (p less than 0.02). This difference was marked in patients with a small infarction (10.6% vs. 5.3%) and a myocardial scar (30.4% vs. 19.0%). The grade of coronary stenosis was less in the NBTE group than in the control group (p less than 0.001), suggesting that the origin of the myocardial ischemic lesion was embolism from NBTE. The incidence of large cerebral infarction was 14.7% in NBTE and 9.2% in the control group, and that of medium sized cerebral infarction was 35.0% and 23.6% respectively. In this latter group, cortical infarction comprised 57.9% in the NBTE group and 26.6% in the control group. In large cerebral infarction, cerebral atherosclerosis was less severe in NBTE than in the control group (p less than 0.001), also suggesting an embolic mechanism. Disseminated intravascular coagulation was found in 41.9% of NBTE.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6481939 TI - Is regional ventricular wall work determined from regional force and shortening always consistent with the law of conservation of energy? AB - Contractile properties of a ventricular wall region have often been analyzed by regional force, shortening, and work. Regional force cannot be measured directly and is often indirectly determined from ventricular pressure and geometry, although regional shortening can be measured directly. Regional work can be calculated from these force and shortening values. We examined whether the calculated regional work, which may be mechanically reasonable, is also reasonable from an energetics viewpoint. We calculated regional contractile power (time rate of work) from the regional force and shortening velocity and integrated it globally over the entire ventricular wall, using some conventional geometric models of the ventricle and assumptions of ventricular wall mechanics. We then compared this globally integrated power with the stroke power of the entire ventricle determined directly from ventricular pressure and volume. Results show that the globally integrated regional power is not always identical with stroke power, depending on the model and assumptions used. Therefore, the regional ventricular wall work determined from the regional force and shortening is not always consistent with the law of conservation of energy. PMID- 6481940 TI - A study on the cardiodepressant action of a beta-blocking agent carteolol in heart-lung preparation of the dog. AB - Direct cardiodepressant activities of three beta-blockers, carteolol, pindolol and propranolol, were estimated using heart-lung preparation of the dog. Beta blocking doses of these drugs to inhibit the positive chronotropic effect of isoproterenol by 50% were 2.2 micrograms for carteolol, 4.0 micrograms for pindolol and 21 micrograms for propranolol. Cardiac performance of the preparation was not influenced by up to 1 mg of these three beta-blockers. After 10 mg of these drugs, the cardiac function curves were shifted rightward and downward indicating the heart failure. It was doubtful, however, that this result indicated the cardiodepressant action of beta-blockers, for the preparation showed spontaneous deterioration without beta-blocker treatment. The influences of these beta-blockers on the compromised heart-lung preparations showed essentially similar results. In conclusion, direct cardiodepressant activity of the beta-blocker, if any, was exerted with far more large doses than their beta blocking doses. The implication of the results in clinical use of beta-blockers, especially in relation to heart failure, was discussed. PMID- 6481941 TI - An autopsy case of rheumatoid arthritis with aortic steno-insufficiency, angina pectoris and severe heart failure. AB - Although nonspecific pericarditis, myocarditis, valvulitis, and coronary arteritis are known as cardiac lesions that accompany rheumatoid arthritis (RA), there have been few reports of the occurrence of clinically severe valvular disease. We report here the case of 69-year-old man with a 25-year history of RA who died of acute left-sided heart failure complicating to aortic steno insufficiency and angina pectoris. Autopsy findings revealed the coincidence of a congenital bicuspid aortic valve with chronic inflammation, fibrosis and calcification; eccentric hypertrophy and myocardial fibrosis of the left ventricle; 75% luminal narrowing of the proximal portion of the coronary artery due to atherosclerosis, and narrowing of the small arteries of the cardiac muscle due to angitis. It is deduced that the coronary artery lesions, aortic valve lesions and myocardial lesions were aggravated by the bicuspid aortic valve, changes with ageing and corticosteroid therapy. PMID- 6481942 TI - Assessment of left ventricular function in ischemic heart disease. The relation between pressure decay during the isovolumic relaxation phase and regional wall motion abnormality. AB - We examine whether regional wall motion abnormality (RWMA) could contribute to the slowed relaxation rate of the left ventricle (LV) in patients with coronary artery disease (CADpts). Simultaneous observations were made on the time constant (Tc) of the isovolumic pressure decay and left ventriculography at the control period and after right atrial pacing. Subsequently, the subjects investigated were divided into 3 groups, i.e. normal subjects (Group I, n = 8), CADpts with normal wall motion during the control period (Group II, n = 21), and CADpts with RWMA during the control period (Group III, n = 28). The latter two groups were further divided into two subgroups according to the presence (Group IIa and IIIa) or absence (Group IIb and IIIb) of pacing-induced RWMA. We measured Tc by a method of exponential analysis that could estimate the asymptote. During the control period, Tc was significantly prolonged in Group III (82 +/- 26 msec) than that in Group I (60 +/- 6 msec) and Group II (63 +/- 12 msec). Tc was prolonged in proportion to the extent of RWMA during the control period. Immediately after right atrial pacing, Tc was markedly prolonged in Group IIa (from 61 +/- 12 to 90 +/- 20 msec, p less than 0.001) and in Group IIIa (from 73 +/- 26 to 95 +/- 34 msec, p less than 0.001). The post-pacing prolongation of Tc was closely correlated with the extent of post-pacing RWMA. From these results, it is postulated that RWMA may play an important role as a causes of the altered LV relaxation in CADpts. PMID- 6481943 TI - Evaluation of effects of aging, training and myocardial ischemia on cardiac reserve by exercise echocardiography. AB - Exercise tolerance and heart response were examined by cross-sectional echocardiography before and during exercise tests to assess the effects of aging, training and myocardial ischemia on the cardiac reserve of 40 healthy men, 20 athletes and 25 patients with angina on effort. The cardiac response to exercise can be divided into 4 types according to parameters derived from a short axis section echocardiogram. Type A: The left ventricular end-diastolic volume (LVEDV) increased slightly in the early stage of exercise, and thereafter, the cardiac response was maintained by a gradual increase of myocardial contractility and heart rate. Type B: Initial response to exercise was similar to Type A, but cardiac output was maintained only by an increase of heart rate under additional exercise load. Type C: LVEDV, LVESV (left ventricular end-systolic volume) and contractility remained virtually unchanged throughout the exercise. Type D: The contractility decreased from the early stage of the exercise, and LVEDV and LVESV increased. Most young subjects and all athletes showed Type A response, while in the aged healthy subjects the Type B response was more frequent. Anginal cases tolerating 125-watt load responded as Type B or C, and those tolerating only 75 watts showed Type C or D. All patients in Type D had multi-vessel disease. PMID- 6481944 TI - A possible role of hypokalemia in the manifestation of high QRS voltage and sinus bradycardia in patients with primary aldosteronism. AB - We analyzed electrocardiograms obtained from 29 Japanese patients with primary aldosteronism (PA) and in 106 patients with essential hypertension (EHT). QRS voltage was higher (p less than 0.05) and heart rate was slower (p less than 0.01) in cases of PA. A significant reduction in QRS voltage and a significant increase in heart rate were observed after short-term potassium replacement or after short-term administration of spironolactone, preoperatively, and within 2 to 4 weeks after the removal of aldosteronoma. These significant changes in QRS voltage and heart rate were always accompanied by significant increases in the serum potassium concentration but not always by a reduction in blood pressure. The long-term follow-up of EHT-patients showed a slower reduction in their high QRS voltage, despite effective antihypertensive therapy. Thus, hypokalemia, in addition to hypertension, may be relevant to the high QRS voltage in PA. There also appeared to be a relationship between hypokalemia and bradycardia. PMID- 6481945 TI - [Spinal cord circulation and anesthesia. 2. Control of spinal cord blood flow and the influences of pharmacological agents related to anesthesia]. PMID- 6481946 TI - [The effect of lidocaine on neurobehavior of neonates]. PMID- 6481947 TI - [Negative inotropic effects of lidocaine in children]. PMID- 6481948 TI - [Comparisons of a new opioid agonist-antagonist "cyclazocine" and morphine in anesthesia for patients undergoing open-heart operation]. PMID- 6481949 TI - [Clinical study of dual-mode independent lung ventilation with HFJV]. PMID- 6481950 TI - [Catecholamine and metabolic response to abdominal surgery during propranolol infusion in man]. PMID- 6481951 TI - [Blood coagulation during halothane anesthesia and neuroleptanalgesia]. PMID- 6481952 TI - [Dosage reduction of bupivacaine in epidural anesthesia for obstetrics by two catheter technic]. PMID- 6481953 TI - [Comparison of nozzles placed proximally and distally in the airway for high frequency jet ventilation]. PMID- 6481954 TI - [Anesthetic management of a patient with anorexia nervosa]. PMID- 6481955 TI - [Clinical studies on netilmicin]. AB - Netilmicin (NTL), a new semisynthesized aminoglycoside, was evaluated in 11 episodes of infection in 10 patients, who had severe underlying diseases, such as acute myocardial infarction, cerebral infarction, malignancy and hepatic cirrhosis. The infection was bacteremia in 3 cases, urinary tract infections in 3 cases and respiratory tract infections in 5 cases. NTL was administered intramuscularly at a dose of 100 mg twice a day for 3 to 14 days. Overall clinical efficacy was only 40%, including excellent in 2 cases, good in 2 cases, fair in 3 cases and poor in 3 cases. Bacteriologically, 2 episodes of E. coli, 2 of S. marcescens and 1 of K. pneumoniae were eradicated, whereas, 2 of P. aeruginosa were decreased, and 1 of K. pneumoniae and 1 of P. rettgeri were persisted. Transient eosinophilia was observed in 1 case, and also nephrotoxicity was encountered in 1 case. PMID- 6481956 TI - [Clinical effect of cephems: cefoperazone in the treatment of postoperative infections]. AB - Cefoperazone (CPZ) has a broad antibacterial spectrum against Gram-positive, negative aerobic and anaerobic organisms, it is also highly active against Pseudomonas sp. and Enterobacter sp. which are hardly susceptible to current cephalosporins. The clinical studies on CPZ were performed in postoperative wound infections and abdominal cavity infections, and the following results were obtained. Overall clinical effect: The rates of effectiveness were 100% in postoperative wound infections and 71.4% in abdominal cavity infections. Bacteriological effect: The rates of eradication were 90% in postoperative wound infections and 80% in abdominal cavity infections. Side effects: Any side effects on marked changes in laboratory findings were not observed in any of the cases treated with CPZ. Based on the above results, we considered that CPZ is a highly useful antibiotic for the treatment of postoperative infections. PMID- 6481957 TI - [Clinical evaluation of carbenicillin in a daily dose of 10 g in chronic airway infections]. AB - Carbenicillin (CBPC) was evaluated in 4 patients with chronic airway infections and 2 with infections secondary to lung cancer. The daily dose of CBPC was 10 g for all patients. The following results were obtained. Three out of 4 patients with chronic airway infections showed good response. Both cases with infection secondary to lung cancer showed good response. The overall effectiveness rate was 83.3%. There were no side effects or abnormal laboratory values related to carbenicillin therapy. CBPC is still considered to be a drug of choice for the initial acute exacerbation of chronic airway infection and for infections secondary to lung cancer. PMID- 6481958 TI - [A pharmacokinetic investigation of sisomicin administered intramuscularly to children]. AB - For the purpose of studying the pharmacokinetic profile of sisomicin (SISO) and the proper conditions for its administration to children, SISO was administered intramuscularly to 10 infants aged less than 1 year, 16 young children and 18 school children at doses of 1.0, 1.5 and 2.0 mg/kg and its serum and urine levels were determined by bioassay. The mean peak levels of SISO in serum appeared at 1/4 hour in the infants, irrespective of the dose; the mean peak levels were 2.27, 3.05 and 4.83 micrograms/ml after the 1.0, 1.5 and 2.0 mg/kg doses, respectively. In the young children, the mean peak levels appeared at 1/4 hour after the 1.0 mg/kg dose and at 1/2 hour after both the 1.5 mg/kg and 2.0 mg/kg doses. The mean peak levels were 2.82, 3.80 and 6.43 micrograms/ml, respectively. In the school children, the mean peak levels appeared at 1/2 hour after all the doses and were 4.34, 5.31 and 6.87 micrograms/ml, respectively. The mean peak levels were in the order of school children greater than young children greater than infants and were dose-dependent. In the infants, the mean urinary recovery was 43.7% for the 1.0 mg/kg dose and 31.2% for the 1.5 mg/kg dose; in the young children, 50.5, 35.9 and 65.6% for the 1.0, 1.5 and 2.0 mg/kg doses, respectively; and in the school children, 54.2, 50.2 and 56.7%. Using the observed serum levels, the pharmacokinetic parameters were calculated according to the one-compartment open model theory. (1) The mean elimination rate constants (K) were calculated at 0.60, 0.67 and 0.56 hr-1 for the infants, young children and school children, respectively. There were found no great differences among the above 3 age groups. The mean absorption rate constants (ka) were 18.5, 7.6 and 5.9 hr-1 and the apparent volumes of distribution per kg body weight, Vd (L/kg), 0.44, 0.26 and 0.22 L/kg, respectively. These 2 parameters were significantly greater in the infants than in the young children and school children. The maximum serum concentration (Cmax) and the time when the concentration reaches a maximum (Tmax) were substantially in agreement with the observed values. The half-lives (T1/2) were 1.16, 1.03 and 1.23 hours for infants, young children and school children, respectively, and did not differ significantly among the 3 groups. A serum level simulation curve constructed by plotting the mean values for K, ka and Vd did not reveal any substantial deviation from the observed values.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6481959 TI - [Results of sputum cytology in bronchogenic carcinoma--a correlation with patient survival]. AB - In a study of 65 of patients with bronchogenic carcinoma who had thoracotomy over a 5-year period, cytodiagnosis by 3-day consecutive sputum cytology was reported positive for malignant cells in 55.4%. Data analysis revealed that the overall cytodiagnosis correlated with clinical stage, tumor size, site of origin, topography and histologic types. From the histologic standpoint, the site of origin was significantly related to the positive cytology in patients with squamous cell carcinoma among factors influencing the results of sputum cytology. On the other hand, there was a correlation of tumor size and the positive cytology in patients with adenocarcinoma. In addition, poor prognosis related to the positive cytology in adenocarcinoma cases in terms of the relationship between the results through sputum examination and survival. The authors emphasized that sputum cytology has proven to be a valuable factor for determining prognosis, especially in patients with adenocarcinoma. PMID- 6481960 TI - [Cytotoxic activity of large granular lymphocytes (LGL) infiltrated into metastatic tumors of lung cancer]. AB - Large granular lymphocytes (LGL) showing Leu 7 and weak E rosettes were separated from two metastatic tumors of lung cancer. Weak cytotoxic activity of these cells was recognized against autochthonous tumors, but never against K-562 cells. After OK-432 therapy, this cytotoxicity was not enhanced, but antibody dependent cell mediated cytotoxicity (ADCC) of peripheral blood mononuclear cells of the patient was induced against metastatic tumors. These signs may suggest that specific immunotherapy should be available for these cancers. PMID- 6481961 TI - [pm Gastric cancer and modes of invasion to the pm layer]. AB - Two hundred and eighty-eight cases of gastric cancer, whose deepest layer of cancerous invasion was the tela muscularis propria (pm), were divided into the following 4 types according to modes of invasion to the pm layer: 1) minimal invasion type (45 cases, 16%); 2) localized invasion type (128 cases, 44%); 3) diffuse invasion type (98 cases, 34%), and 4) vascular invasion type (17 cases, 6%). This classification of modes of invasion to the pm layer was useful and reflected the gross findings of cancer, grade of vascular invasion and prognosis quite well. PMID- 6481962 TI - [Studies on the results of operations for carcinoma of the sigmoid colon]. AB - Of 734 patients with colorectal cancer operated on during the past 21 years, 142 had carcinoma of the sigmoid colon. Curative resections were performed in 103 patients and non-curative resections in 22, the resection rate being 88.0%. Among 103 patients with curative resection, resection of the sigmoid colon was performed in 79, and their 5-year survival rate was 84.6%. Eight patients died within 5 years due to recurrence. Many of them had the constricting type macroscopically and Dukes C with positive lymph node metastasis. Therefore, in such cases, resection of the sigmoid colon with extended lymph node dissection or left hemicolectomy should be performed. PMID- 6481963 TI - [Relationship between histological classification and local control rate in cases of carcinoma of the uterine cervix]. AB - One hundred and seven cases (53 of fast neutrons and 54 of photons) of stage 3b and 4a carcinoma of the uterine cervix wer treated by irradiation between November, 1975 and November, 1979 at the National Institute of radiological Sciences Hospital. These cases were analyzed with regard to the relationship between histological types (K.L.S. and R.S. classification) and local control rate. Local control rates of fast neutrons and photons were 75% and 67% in general materials, 78% and 58% in L type classification, 55% and 52% in R type and 85% and 76% in S type, respectively. There was no significant difference between the neutrons and the photons. PMID- 6481964 TI - [Occurrence of carcinoma of the vulva and vagina following irradiation of cervix carcinoma]. AB - Six patients with carcinoma of the vulva and 3 with carcinoma of the vagina following radiation therapy for cancer of the cervix were analyzed. The interval between irradiation and diagnosis of the second tumor varied from 5 to 23 years. Despite the lack of having detailed information on irradiation factors in all patients, circumstantial evidence from this study suggests that radiation therapy may have contributed to the development of carcinoma of the vulva and vagina in some of the patients. Close follow-up patients treated for squamous carcinoma of the genital tract must emphasize inspection for new lesions. The incidences previously reported in the literature are also reviewed for comparison. PMID- 6481965 TI - [Induction of tumor necrosis factor (TNF) by OK-432]. AB - The induction of tumor necrosis factor (TNF) by OK-432 was investigated. The results were as follows: Serum from OK-432 injected into NZW rabbits treated with LPS was cytotoxic to tumor cells in vitro. With respect to the target cell spectrum this factor was cytotoxic to L929, Lewis, M7609 and K562, but not to Chang liver cells, HMV cells or HeLa cells. The cytotoxic activity of this factor was found to be M.W. 48,000 on H.P.L.C., and the pI was revealed to be 5.4 by isoelectric focusing. These results were consistent with previously reported findings on TNF. PMID- 6481966 TI - [Clinical evaluation of tissue polypeptide antigen in patients with esophageal, stomach and colon cancer]. AB - Serum tissue polypeptide antigen (TPA) levels were measured in 33 patients with esophageal cancer, 39 with stomach cancer and 50 with colon cancer. At the same time five glycoproteins, namely immunosuppressive acidic glycoprotein (IAP), alpha 1-antichymotripsin (alpha 1-ACT), acid soluble glycoproteins (ASP), sialic acid and carcinoembryonic antigen (CEA), were measured for comparison. The mean TPA values were 59.0 +/- 15.4 U/l in 61 normal subjects, 103.6 +/- 104.2 U/l (positive rate, 24.2%) in esophageal cancer patients, 111.9 +/- 49.8 U/l (71.8%) in stomach cancer patients and 124.8 +/- 195.5 U/l (40%) in colon cancer patients. The serum TPA levels in patients with stomach cancer rose with an increased number of involved lymph nodes and with a higher degree of infiltrative growth and increased with the advancement of tumor growth postoperatively. Serum TPA levels correlated well with those of alpha 1-ACT, IAP and ASP in stomach cancer patients and with those of CEA, ASP and sialic acid in colon cancer, but not in esophageal cancer patients. It is suggested that the serum TPA might represent one of the reactant proteins and/or tumor-associated antigens that appear to be dependent upon the cancer status. PMID- 6481967 TI - [So-called carcinosarcoma of the breast--report of 4 cases]. AB - Four cases of so-called carcinosarcoma of the breast were studied histopathologically. The patients were females aged 44, 37, 44 and 77 who were admitted to the Cancer Institute Hospital for breast tumors. Histologically, the tumors showed proliferation of sarcomatous cells with relatively small amounts of papillotubular carcinoma or scirrhous carcinoma. There were transitions between the sarcomatous portion and carcinoma. Two cases showed squamous metaplasia merging into the sarcomatous component, whereas the other 2 showed transition from adenocarcinoma to sarcomatous element. Lymph nodal metastases in 2 cases were papillotubular carcinoma. One patient died of lung and brain metastases, and autopsy revealed only sarcomatous element. PMID- 6481968 TI - [So-called gastric carcinosarcoma--a case of chondrosarcomatous undifferentiated in the metastatic foci]. AB - A case of so-called gastric carcinosaroma in a 70-year-old man was presented. The primary tumor measuring 5.6 X 5.4 cm was located in the gastric antrum and had the appearance of Borrmann 2 type. A massive metastatic tumor was found in the pyloric lymph nodes. Histologically, the primary tumor was predominantly composed of papillary adenocarcinoma invading to the muscle layer with lymphatic and vascular involvements. Atypical spindle cells occasionally intervened between carcinoma nests. The metastatic tumor consisted of mixed papillary adenocarcinoma and well differentiated chondrosarcoma with transitional areas by atypical spindle cells. Therefore, it was suggested that sarcomatous components in the present case were derived from carcinoma cells by undifferentiated. Three cases of gastric carcinosarcoma reported in Japan were reviewed, and their histogenesis was discussed as compared with the present case. PMID- 6481969 TI - [A child with successfully treated posterior mediastinal endodermal sinus tumor]. AB - A 15-month-old boy with posterior mediastinal endodermal sinus tumor is reported. The patient was admitted with recurrent hemothorax, and his serum alpha fetoprotein level was 29,520 ng/ml. After removal of the posterior mediastinal tumor, VAC therapy (vincristine, actinomycin D, cyclophosphamide) was started. The chemotherapy was continued 18 months. The patient continues to do well with no sign of tumor and a normal alpha-fetoprotein level 53 months after the operation and 35 months after the completion of therapy. He is the youngest patient documented in the literature and successfully treated for mediastinal endodermal sinus tumor. PMID- 6481970 TI - [Pancreatic cancer in father and daughter]. AB - A 77-year-old male patient was admitted because of jaundice and general malaise. Exploratory laparotomy disclosed pancreatic head cancer with invasion to the intrapancreatic bile duct. Three months later, his daughter, aged 51, was admitted for evaluation because of body weight loss and back pain. CT scan disclosed 3 low-density areas in the pancreas with irregular margins and multiple low-density areas in the liver. Pancreatic cancer with liver metastasis was confirmed by autopsy. In familial pancreatic cancer, it is essential that genetic in addition to environmental factors be examined in pancreatic carcinogenesis. PMID- 6481971 TI - [Progress on blood cell counting, with special reference to volumetric analysis and its related problems]. PMID- 6481973 TI - [Clinical evaluation of automatic analysis of blood cells. Cytochemical method in flow system]. PMID- 6481972 TI - [Clinical evaluation of automatic analysis of blood cells. Pattern recognition]. PMID- 6481974 TI - [Development and problems in laboratory blood coagulation and fibrinolytic tests]. PMID- 6481975 TI - [Development of laboratory examination for hemostasis and thrombosis and its problems. Platelet function tests]. PMID- 6481976 TI - [Analysis of plasma proteins in hematological diseases]. PMID- 6481977 TI - [A case of erythrocytosis associated with massive hydronephrosis]. PMID- 6481978 TI - [An autopsy case of myelofibrosis with myeloid metaplasia terminating in blastic transformation with chromosomal aberration (i(17q))]. PMID- 6481979 TI - [Bolus methylprednisolone therapy for aplastic anemia: a case report]. PMID- 6481980 TI - [Myasthenia gravis and neurotransmitters]. PMID- 6481981 TI - [Diabetes insipidus and neurotransmitters]. PMID- 6481982 TI - [Parkinson's disease and neurotransmitters]. PMID- 6481983 TI - [Changes of neurotransmitter levels in epilepsy, with special reference to kindling models]. PMID- 6481984 TI - [Classification of glomerular diseases--autopsy and biopsy of the kidney]. PMID- 6481985 TI - [Pathological studies of the kidney glomerulus]. PMID- 6481986 TI - [Ultrafiltration of the kidney glomerulus and permeability of macromolecular substances]. PMID- 6481987 TI - [Regulation of the glomerular filtration rate]. PMID- 6481988 TI - [Key points in preparation of renal biopsy specimens]. PMID- 6481989 TI - [Immunopathological studies on pathogenesis of acute glomerulonephritis]. PMID- 6481990 TI - [Clinical studies of acute glomerulonephritis (pathogenesis, clinical course and result of tests)]. PMID- 6481991 TI - [Treatment of glomerulonephritis]. PMID- 6481992 TI - [Chronicity of acute glomerulonephritis]. PMID- 6481993 TI - [IgA nephropathy and purpura nephritis]. PMID- 6481994 TI - [Anti-glomerular non-collagen glycoprotein antibody in nephritis]. PMID- 6481995 TI - [Viral nephritis]. PMID- 6481996 TI - [Asymptomatic glomerulonephritis]. PMID- 6481997 TI - [Hereditary nephritis]. PMID- 6481998 TI - [Definition and classification of nephrotic syndrome]. PMID- 6481999 TI - [Nephrotic syndrome in children]. PMID- 6482000 TI - [Nephrotic syndrome in the aged--with special reference to primary nephrotic syndrome]. PMID- 6482001 TI - [Immunological studies on glomerulonephritis and nephrotic syndrome]. PMID- 6482002 TI - [Abnormal coagulation and fibrinolytic activities in glomerulonephritis and nephrotic syndrome]. PMID- 6482003 TI - [Prognosis of glomerulonephritis and nephrotic syndrome]. PMID- 6482004 TI - [Experimental glomerulonephritis and nephrotic syndrome]. PMID- 6482005 TI - [Glomerular diseases and hypertension]. PMID- 6482006 TI - [Glomerular diseases and diabetes mellitus]. PMID- 6482007 TI - [Morphological changes of the kidney glomerulus in autoimmune diseases]. PMID- 6482008 TI - [Glomerular diseases and liver diseases]. PMID- 6482009 TI - [Glomerular diseases and myeloma and amyloidosis]. PMID- 6482010 TI - [Glomerular diseases and heart diseases]. PMID- 6482011 TI - [Glomerular diseases associated with malignant tumors]. PMID- 6482012 TI - [Drug-induced glomerular diseases]. PMID- 6482013 TI - [Glomerular diseases associated with disseminated intravascular coagulation]. PMID- 6482014 TI - [glomerular diseases and pregnancy]. PMID- 6482016 TI - [Idiopathic renal bleeding]. PMID- 6482015 TI - [Chance proteinuria and hematuria]. PMID- 6482017 TI - Survival of patients with superficial bladder cancer after treatment: a 10-year retrospective follow-up study. AB - The clinical aspects of 64 patients with superficial bladder cancer (Ta, T1, T2 according to the TNM classification, International Union against Cancer or Stage O, A, B1 according to Marshall) admitted to the Tsukuba University Hospital were analyzed retrospectively. Treatment of these patients was mainly by transurethral surgery. The overall 10-year survival rate was 73%. Eight patients died and four of them showed an invasive change, the so-called metamorphosis, during the follow up period. Patients with papillary, pedunculated tumors had better survival rates than those with papillary, sessile tumors. Patients with tumors less than 1 cm in size had better survival rates than those with tumors 1-3 cm in size. There were no statistical differences in survival rates between patients with single and multiple tumors. Up to seven years from surgery, the patients with T2 tumors had lower survival rates than those with Ta-T1 tumors. The patients with grade I tumors had better survival rates than those with grade II tumors. There were no significant differences in recurrence rates related to the grade of the tumor. It is thought that the prognosis of superficial bladder cancer in our series depended mainly on the shape, size, number, depth and grade of the tumor. PMID- 6482018 TI - Reconstruction of the esophagus by microvascular surgery. AB - After esophagectomy, free jejunal autografts were used for reconstruction in 11 patients and pedunculated colons in two patients. A microvascular technique was applied immediately after the resection. A vascular anastomosis gave a new blood supply for the free jejunal graft, and in the case of the pedunculated colon gave support to improve circulation. During the grafting procedure, neither cooling nor heparinization was needed. No graft failures have occurred. The main complication of free jejunal grafts was leakage of the proximal anastomosis of the bowel, but all three leakages healed spontaneously. Two supportive vascular anastomoses for the pedunculated colons were effective and caused no complication. All 13 patients could eat regularly at the time of their discharge. PMID- 6482019 TI - Evaluation of the TNM classification of stomach cancer and proposal for its rational stage-grouping. AB - The present TNM Classification with the provisional stage-grouping for stomach cancer, which was adopted in 1978, was evaluated for compatibility in respect to survival by using 15,589 stomach cancer patients registered in Japan from 1969 to 1973. Adequacy and usefulness were shown in all categories of T, N, M, pT and pN, individually. Important irrationality in accordance with the TNM General Rules was recognized in both the provisional TNM and p.TNM stage-groupings. More adequate stage-grouping was searched for and is discussed according to the results of statistical analysis of the patients' survival and the principle of the TNM General Rules. New TNM and p.TNM stage-groupings were proposed as the best ones at present. PMID- 6482020 TI - Mucin-producing carcinoma of the thyroid gland--a case report and review of the literature. AB - Mucin-producing carcinoma of the thyroid is rare and its histogenesis has been debated. The first case was reported by Diaz-Perez et al. (1976). We herein report the sixth case of mucin-producing carcinoma of the thyroid which was discovered in a 72-year-old Japanese woman. This patient was admitted with a 10 year history of a lump in the right anterior neck, which started to grow suddenly two months before diagnosis. The pathological diagnosis at biopsy was anaplastic carcinoma. A course of radiation therapy followed by chemotherapy resulted in no response. She died of two months after admission. At autopsy, the main tumor was found in the right lobe of the thyroid with metastasis to the lungs and liver. Histologically, the tumor was composed of mucin-secreting glandular cells and nests of epidermoid cells with keratinization and infrequent formation of intercellular bridges. Mucin was demonstrated both intracellulary and extracellulary. PMID- 6482021 TI - A case of colon cancer metastasizing to the spleen. AB - A case of colon cancer metastasizing to the spleen is reported. The patient was a 43-year-old man who was laparotomized under the diagnosis of colon cancer. The tumor of the transverse colon showed a small ulcer and polypoid projections. Poorly differentiated adenocarcinoma was noted in the mucosa. Marked tumor metastasis was found in the parenchyma of the spleen and the peripancreatic, portohepatic, mesenteric and periaortic lymph nodes. The literature on the incidence and mechanism of metastasis to the spleen was reviewed, and metastasis to the spleen was found to be not infrequent at a late or advanced stage of cancer. PMID- 6482022 TI - A case of gastric cancer achieving a complete response by chemotherapy. AB - An 80-yr-old man with advanced gastric cancer was admitted on September 10, 1982. He received no surgery owing to a moderate attack of bronchial asthma, hypertension and cardiac, pulmonary and renal function disturbances. Chemotherapy was started after discharge. The treatment regimen was the oral administration of 5-fluorouracil tablets at a dose of 200 mg a day, every day. Endoscopic examination 10 weeks after the initiation of chemotherapy revealed complete regression of the tumor and the biopsy specimen revealed no cancer cells. Since then, X-ray and endoscopic examination have been performed every two to three months. The patient is still well without relapse of the disease. PMID- 6482023 TI - [Preventive medicine and laboratory medicine]. PMID- 6482024 TI - [Hemostatic and hematological laboratory tests in future]. PMID- 6482025 TI - [Current status and the future prospect of clinical laboratory medicine]. PMID- 6482026 TI - [Specialization of clinical pathology]. PMID- 6482028 TI - [Clinical pathology and its future]. PMID- 6482027 TI - [Some problems in the practice of clinical pathology]. PMID- 6482029 TI - Standardization in haematology. PMID- 6482030 TI - [Study on the stability of drugs used in catecholamine therapy]. PMID- 6482031 TI - [Clinical application of HbAI measured by affinity column method, with special reference to diabetic nephropathy]. PMID- 6482032 TI - [A study on the precardiac vibration. I. Normal patterns]. PMID- 6482033 TI - [Computed tomography in the diagnosis of renal pelvic tumors]. PMID- 6482034 TI - [Esophago-hypopharyngeal barium study with laryngo-hypopharyngeal discomfort- usefulness of rapid sequence camera]. PMID- 6482035 TI - [Multiple primary cancers of the esophagus]. PMID- 6482036 TI - [Results of studies on head and neck cancer. 2. Application of the guideline proposed by Japan Society of Head and Neck Tumor]. PMID- 6482037 TI - [Cancer registration system inside the hospital and oncological statistics in the radiological department]. PMID- 6482038 TI - [Necessity of radiologists in a general hospital]. PMID- 6482039 TI - [A case of a foramen magnum tumor--value of coronal section in metrizamide myelography]. PMID- 6482040 TI - [A case of calcified epidural hematoma]. PMID- 6482041 TI - [A case of traumatic cerebrospinal fluid rhinorrhea diagnosed by RI cisternography]. PMID- 6482042 TI - [An interesting case of esophageal leiomyoma]. PMID- 6482043 TI - [A case of retrocaval ureter]. PMID- 6482044 TI - [Myocardial sarcoidosis diagnosed by thallium scintigraphy]. PMID- 6482045 TI - [Radiation therapy for cervix cancer]. PMID- 6482046 TI - [Diagnostic imaging in emergency medicine. Record of a symposium. Morioka City, 1983]. PMID- 6482047 TI - [Diagnostic imaging in emergency medicine]. PMID- 6482048 TI - [Significance of the existence of emergency department in the hospital and its organization]. PMID- 6482049 TI - [What the emergency department expects of the radiological department--clinical cases]. PMID- 6482050 TI - [The role of diagnostic imaging in emergency medicine]. PMID- 6482051 TI - [Head injury]. PMID- 6482052 TI - [Chest injury]. PMID- 6482053 TI - [Non-traumatic chest disease]. PMID- 6482054 TI - [Non-traumatic abdominal disease: significance of plain abdomen film]. PMID- 6482055 TI - [Radiographic diagnosis of rounded atelectasis]. PMID- 6482056 TI - [Pulmonary scintigraphy of diffuse panbronchiolitis]. PMID- 6482057 TI - [Radiotherapy of cervix carcinoma. 2. Postoperative radiotherapy and management of recurrence]. PMID- 6482058 TI - Collison 6-jet nebulizer: choice for the certification test of the class II biological safety cabinet. AB - Three types of nebulizers, one plastic, one glass and Collison 6-jet nebulizers were tested, to select an appropriate nebulizer for the certification of the class II biological safety cabinets (BSC). Performance of the plastic and glass refluxing nebulizers were found to be both inconsistent from one to another, and not provide reproducible results. The Collison nebulizers, on the other hand, showed little variations and provided reproducible results. In addition, the Collison nebulizer generated constant spray volume when the fluid level in the reservoir was varied. To determine optimum discharge velocity of the Collison nebulizer, nebulizers with an outlet diameter of 10, 12, 14, 16 and 18 mm were tested. For the personnel protection test, the main stream of aerosol sprayed from the Collison nebulizer with 14 mm outlet internal diameter hit the intersection of the test cylinder and the front opening. Each nebulizer with an outlet diameter of 12 to 16 mm located at the level of lower edge of the front window delivered aerosols more efficiently at the intersection than when located at 14 inches above the work surface. The aerosol from the 10 or 18 mm diameter nebulizers showed an inappropriate distribution. For the product protection test, the nebulizer with 14 mm outlet diameter showed the best distribution pattern around the test cylinder. In the cross contamination test, this nebulizer outperformed the 10 or 18 mm for class II BSC's without side wall effect. According to these results, the Collison nebulizer with 14 mm of internal diameter nozzle was found appropriate for the biological certification tests of the class II BSC. Exception was the cross contamination test of class II BSC with a side air intake between the internal side wall and the work surface, in which the nebulizer with 10 mm nozzle was the choice. PMID- 6482059 TI - Reevaluation of the biological certification test for the class II biological safety cabinets. AB - The biological collectors for the biological challenge tests of the class II biological safety cabinets (BSC) described in the National Sanitation Foundation Standard No. 49 (NSF 49) were reevaluated. These tests are designed to evaluate personnel and product protection, and cross contamination control capabilities of BSC's. In the personnel protection test, the sampling efficiency of the impingers was approximately 1/10 of that the slit-to-agar samplers located at the same position. In the personnel protection test, the collection efficiency of the top pair impingers was 90% less than that of the middle pair of impingers (see text for placement location). Depending on the construction of the cabinet, the ratio of spores collected in the middle and the lower pair of impingers, and in the slit samplers varied considerably, from 98:7 to 3:40. In the product protection and the cross contamination tests, the number of colonies collected in a column of agar plates decreased by factors of 1/10 to 1/30 by deviating one column from the outlet of the impinger. In the cross contamination test, the nebulizer located at the division point distributed spores approximately 100 mm further from the side wall than that located at the midpoint of the internal side wall. For the class II BSC which has the air intake between the side wall and the work plate, the Collison 6-jet nebulizer with an outlet diameter of 10 mm (discharge velocity at 0.7 kg/cm2 = 1.8 m/s) was the choice instead of that of 14 mm (0.8 m/s), since the discharge velocity of aerosol from the nebulizer strongly affected the result of the cross contamination test. PMID- 6482060 TI - [Aging and adrenocortical function]. PMID- 6482061 TI - [Neuropsychiatric symptoms and CT findings in Alzheimer type dementia. Clinicoradiological correlation]. PMID- 6482062 TI - [The validity of the estimated maximal oxygen intake by different indirect methods in middle-aged and elderly men]. PMID- 6482063 TI - [Ultra-weak chemiluminescence of human blood]. PMID- 6482064 TI - [Aging and thyroid function]. PMID- 6482065 TI - [Assessment of the exposure of pest control operators to organophosphorus pesticides. Organophosphorus pesticides in blood and alkyl phosphate metabolites in urine]. AB - Pest control operators usually spray pesticides in small areas such as a kitchen in a restaurant and are exposed to various pesticides, especially those of the organophosphorus (OP) type. In order to evaluate their occupational exposure to OP pesticides during the work, OP pesticides in blood and alkyl phosphate metabolites in urine of these operators were analyzed and the relationship between pesticide exposure and analytical results were studied. OP pesticides in blood were analyzed by gas chromatography with flame photometric detector (FPD GC) after separation of phospholipid in blood with silicagel column chromatography. OP pesticides were not detected in any blood samples (the limit of detection was 1 ng/ml). Dimethylphosphate (DMP) and dimethylthiophosphate (DMTP), being urinary metabolites of OP pesticides, were analyzed by FPD-GC after benzyl derivatization. This method eliminated interfering peaks in gas chromatograms. The ratio of two isomeric derivatives of DMTP was found to be constant. Both DMP and DMTP of the exposed group were significantly higher than those of the non-exposed group, DMP being higher than DMTP. The ratio of DMP to DMTP in the fenitrothion-dichlorvos-exposed group was significantly higher than that in the fenitrothion-exposed group. It was considered that the ratio might reflect a result of pesticide exposure. The urinary metabolites of OP pesticides tended to become lower with the lapse of time since the last exposure. However, small amounts were detected in a few samples even 5 days after the last exposure. PMID- 6482067 TI - [Analysis of mortality patterns in an area supplying tunnel workers away from home. Part 2. Mortality patterns among tunnel workers]. AB - In order to clarify the long-term effect of tunnel work on the health of its workers, we examined its cause-specific mortality pattern. The subjects were 418 males who died after the age of 30 in 1977 in the southern part of Oita Prefecture, where many men come and work away from home as tunnel workers. Death certificates, 418 in number, presented to the health center were used to examine the causes of death. Occupational careers and life histories of the subjects were obtained by interviewing their families or relatives in 1980. The interviews were successfully carried out with 356 subjects (85.2%). The subjects were divided into two groups. One group was consisted of 73 males who had engaged in the tunnel work (tunnel workers) and the other was of 283 males without experience of tunnel work (others). Proportional mortality ratio (PMR) and proportional mortality classified by age were compared between the two groups. The mean ages at death were also compared among these two groups and all Japanese males over 30 years of age. The results were as follows. The proportion of the deaths of "tunnel workers" among the total deaths in the area surveyed was correlated to the regional rate of tunnel workers and the distribution of pneumoconiosis due to tunnel work. These results show that many tunnel workers suffering from pneumoconiosis had returned to their home area before they died. Excess deaths from the ICD category I; infective and parasitic diseases (000-136), tuberculosis (010-019) and silicotuberculosis (010) were found among the "tunnel workers."(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482066 TI - A follow-up study on the lung disorders of rush (igusa) farmers exposed to "sendo" dust. AB - In the process of "tatami" mat production, from cultivating to weaving, rush farmers are exposed to "sendo" (dyer's earth) dust using it to prevent fading of the "tatami" mat color. It has been found that the workers tend to develop a relatively early stage of pneumoconiosis after about 20 years of this work. In 1980, 51 male (58.6 years old) and 37 female (54.4 years old) rush farmers, some of whom were previously examined in 1970, were re-examined for lung disorders. Chest X rays in the 1980 showed, 49.0% of males and 62.2% of females over 1/0 according to the 12 point profusion scale with irregular small opacities being dominant, a significant increase in the prevalence rates of pneumoconiosis compared with 1970 values (p less than 0.01 for both males and females). A relatively high prevalence of respiratory complaints and/or lung function impairment was also found. However, there were no severe cases and no significant changes were seen to have occurred during the seventies by those tests. It was also observed that increases in lung disorders during the decade were more common in the female workers. These findings suggest that the pathogenesis of rush farmer's pneumoconiosis might be in the histological changes of bronchial and/or alveolar walls by the deposition of "sendo" dust. The present study revealed that the lung disorders in the rush farmers may be associated with long-term inhalation of "sendo" dust, and the introduction of more suitable dust control measures in that processing must be actively pursued in the near future. PMID- 6482068 TI - [Intrapulmonary reactions of workers exposed to dust and ozone]. AB - Forty-one dust-and-ozone-exposed and 37 nonexposed workers, belonging to the Research and Development Division of a photo-copier manufacturing industry, were examined to assess the effect of the exposure to carbon, iron and resin dust and ozone in the air of the work environment by means of questionnaires on their physical condition, smoking habits and exposure history by interview, chest X rays, testing of ventilatory functions, transcutaneous PO2 (tcPO2) test and H2O2 induced hemolysis test. The following results were obtained. Respirable dust concentrations in the air of the work place were 0.1-1.0 mg/m3, total dust concentrations 0.2-2.0 mg/m3, and ozone concentrations 0.004-0.06 ppm (0.008-0.12 mg/m3). According to the Japanese Classification of Radiographs of Pneumoconioses, the exposed workers showed a higher rate of profusion 0/1 and over, and category 1 and over (1/0 and over) than the nonexposed workers. Ventilatory function testing revealed no difference between exposed workers and nonexposed workers, but small airway narrowing was suspected in smoking workers in comparison with nonsmoking workers. Transcutaneous PO2 showed no difference between exposed and nonexposed workers, between smoking and nonsmoking workers, and between any of the paired six combinations out of the four groups of workers, i.e., nonsmoking and nonexposed, nonsmoking and exposed, smoking and nonexposed, and smoking and exposed. It was estimated by H2O2-induced hemolysis test that smoking and/or dust exposure, especially long-term exposure, gave rise to aggravation of fragility of the erythrocyte membrane by lipid peroxidation with ozone or active oxygen produced by the reaction of dust and alveolar macrophages. The questionnaire was considered indispensable to ascertain the workers' exposure history. No worker in this work environment showed clinical signs indicating a need for medical care or home response. There results may indicate that in resolving the pathogenesis of pneumoconiosis further studies will be required on the prevalence rate of profusion 0/1 and over (or category 1 and over) under low concentrations of dust exposure and on the intrapulmonary reactions induced by low doses of dust exposure. PMID- 6482069 TI - [Inhibitory activities of tri-ortho-cresyl phosphate (TOCP) against cholinesterase and neurotoxic esterase]. PMID- 6482070 TI - Serological thermo-stability of M- and N-active sialoglycoprotein preparations from OM and ON human erythrocytes. PMID- 6482071 TI - [Serum haptoglobin levels in healthy and diseased individuals]. PMID- 6482072 TI - [Relation of secreting isohemagglutinins in saliva and dental caries]. PMID- 6482073 TI - [Species identification of old bloodstains (approximately 60-670 years old) using antisera to human-Hb and -serum]. PMID- 6482074 TI - [Sudden death in methamphetamine abusers: a histological study of the heart]. PMID- 6482075 TI - [A new high performance liquid chromatographic method of phenethylamines and amphetamines using fluorescamine]. PMID- 6482076 TI - [Medico-legal analysis of volatile poisons from severely burned organs. 1. A basic study on toluene]. PMID- 6482077 TI - [Studies on the late complications after injection and identification of unknown artificial injected materials]. PMID- 6482079 TI - Detection of cannabinoids by gas chromatography/mass spectrometry (GC/MS). Part III. Negative ion chemical ionization GC/MS of cannabinoids in human materials. PMID- 6482078 TI - Postmortem changes in the concentrations of cyanide and thiocyanate. PMID- 6482080 TI - Application of monoclonal anti-A and anti-B antibodies to the blood grouping of blood stains. PMID- 6482081 TI - [Medico-legal studies of leucine aminopeptidase. I. Enzymatic activities of leucine aminopeptidase and acid phosphatase occurring in human semen and certain species of plants]. PMID- 6482082 TI - [Medico-legal studies of leucine aminopeptidase. II. Enzymatic properties of leucine aminopeptidase occurring in human semen and certain species of plants]. PMID- 6482083 TI - [Determination of methamphetamine and amphetamine in biological fluids and hair by gas chromatography]. PMID- 6482084 TI - [A study on postmortem changes of triglycerides in adipose tissues]. PMID- 6482085 TI - [Experimental studies on effects of organic solvents in living body: changes of the tissue tetrahydrofuran concentration in rats and histological observations after tetrahydrofuran inhalation]. PMID- 6482086 TI - [On a cadaver mummified within 25 days]. PMID- 6482087 TI - Pharmacological studies of FUT-175, nafamstat mesilate. I. Inhibition of protease activity in in vitro and in vivo experiments. AB - FUT-175, 6-amidino-2-naphthyl p-guanidinobenzoate dimethanesulfonate (nafamstat mesilate), a novel synthetic protease-inhibiting agent, was studied to determine its in vitro effects against various proteases and other enzymes, as well as to determine its in vivo protease inhibitory effects. FUT-175 was found to inhibit, in an intense, specific and reversible way, the enzyme activities of trypsin, C1r, C1s, thrombin, kallikrein and plasmin with IC50 values of the order of 10( 6)-10(-8) M. FUT-175 also inhibited complement-mediated hemolysis, including both classical and alternative pathways, sites of inhibition being on C1r and C1s as evidenced by the intermediate-cell technique. In animal model reactions in which the complement system is known to be involved as pathogenetic factors, e.g., Forssman shock, Forssman cutaneous vasculitis, zymosan-induced paw edema, endotoxin shock and local Shwartzman reaction, FUT-175 was highly effective in that, for example, intravenous dosing at 3 mg/kg could completely protect guinea pigs from the lethal Forssman shock. FUT-175 was also found to be effective in trypsin-induced shock in mice, in lethality due to thrombin-thrombosis in mice and in kinin formation in the inflammatory process in rats. PMID- 6482089 TI - Differential effects of anti-inflammatory agents on lysosomal cysteine proteinases cathepsins B and H from rat spleen. AB - The reactivity and specificity of commonly used anti-inflammatory agents with lysosomal cysteine proteinases cathepsins B and H purified from rat spleen have been investigated. Of the different agents tested, flufenamic acid and indomethacin were known to be potent inhibitors of cathepsin B. A half-maximal inhibition of the activity of cathepsin B was achieved at drug concentrations of 7.6 X 10(-5) M of flufenamic acid and 4.0 X 10(-4) M of indomethacin. The inhibition by these two agents was of a non-competitive type with benzyloxy carbonyl-phenylalanyl-arginine-4-methyl-7-coumarylamide (Z-Phe-Arg-MCA) as a substrate. The maximal inhibitory potencies of these agents for the cathepsin B activity were observed at pH 7.0. At pH values between 4.5 and 6.5, the inhibitory potencies were less than at pH 7.0. No preincubation time was needed for the reaction between these agents and cathepsin B. In contrast, cathepsin H was not affected by these two drugs even at the drug concentration of 10(-3) M at pH values between 4.5 and 8.0. Other anti-inflammatory agents including aspirin, sodium salicylate, phenylbutazone and prednisolone were found to be poorly or scarcely inhibitory for both cathepsins B and H. PMID- 6482088 TI - Effects of etafenone on myocardial energy metabolism as studied by an organ redoximeter and biochemical analyses. AB - Direct recording of reduced nicotinamide adenine dinucleotide (NADH) fluorescence was conducted with an organ redoximeter in isolated perfused guinea pig heart. Cross-clamping of the aortic inflow line resulted in an increase in NADH fluorescence. After etafenone (10(-6) M), there was a significant prolongation of the time to the detectable or the maximum increase in NADH fluorescence. The magnitude of the increase in NADH fluorescence tended to be reduced (135% as compared with 145% in the control group). Supplemental chemical analyses revealed a significant increase in creatine phosphate, adenosine triphosphate (ATP) and total adenine nucleotide in the etafenone-pretreated group 15 min after postischemic reperfusion, although the ischemia-induced changes were not improved by this compound. It was suggested that the better recovery of myocardial high energy phosphate levels produced by etafenone was brought about by a decrease in oxygen consumption due to a decrease in mechanical performance of the heart and possibly by a better resynthesis of ATP. PMID- 6482091 TI - Effects of trimebutine maleate (TM-906) on electrical and mechanical activities of smooth muscles of the guinea-pig stomach. AB - The effects of trimebutine maleate (TM-906) on electrical and mechanical activities of smooth muscles of the guinea-pig stomach were investigated using a microelectrode and isometric tension recording methods. TM-906 (2 X 10(-5) M) depolarized the membrane of smooth muscles in the antrum to about 10 mV. From the current-voltage relationship and changes in membrane potentials in various [K]0, the TM-906-induced depolarization is considered to be mainly due to a decrease in the K-conductance. TM-906 increased the amplitude of the first spike potential and regularized the rhythm of slow waves. These excitatory effects are presumably due to the K-channel-blocking action during the repolarizing phase of the spikes and to the depolarization. TM-906 reduced the amplitudes of mechanical activities and slow waves. These inhibitory effects are presumably due to the inhibition of Ca-release from storage sites and to the block of Ca-influx. The biphasic effects are possibly due to the local anesthetic properties. TM-906 modified neither the membrane potential nor the membrane conductance of circular muscles in the fundus. This may mean that the circular muscles in the fundus lack the K-channel sensitive to TM-906. PMID- 6482090 TI - Effect of sodium propionate on the contractile response of the rat ileum in situ. AB - Effects of short-chain fatty acids (SCFA) on the contractile response of rat ileum were studied in vivo. The contractile response was estimated by means of changes in the intraluminal pressure under the isometric condition. Intravenous administration of sodium salts of propionate, butyrate, valerate or caproate produced biphasic contractions: an initial phasic contraction and a subsequent tonic contraction. The effect of propionate was studied in detail. A sigmoid dose response curve was obtained for the phasic contraction. Atropine, hexamethonium and tetrodotoxin inhibited the phasic contraction, while neostigmine vigorously enhanced it. On the other hand, the tonic contraction was not inhibited by atropine, hexamethonium or tetrodotoxin. Repeated administration of propionate at intervals of less than 3 min led to tachyphylaxis, and this tachyphylaxis disappeared by about 10 min. These results suggest that SCFA induced the biphasic contraction of the rat ileum, probably by neurogenic and myogenic mechanisms. PMID- 6482092 TI - Effects of ritodrine hydrochloride, a beta 2-adrenoceptor stimulant, on uterine motilities in late pregnancy. AB - Ritodrine hydrochloride (ritodrine) is a beta 2-adrenoceptor stimulant which has been effectively prescribed for the prevention of premature labor. The present studies were carried out to investigate the effects of ritodrine on uterine motility in rats and rabbits during gestation, as compared with those of isoproterenol and isoxsuprine. The results were as follows: 1) Spontaneous movements and evoked contractile responses of isolated rat uterus (19-20th days of gestation) were suppressed by 10(-9) - 10(-6) M ritodrine. The potency of ritodrine was approximately 10 times more than that of isoxsuprine and 100 - 1,000 times less than that of isoproterenol. 2) When these drugs were administered to pregnant rats or rabbits intravenously, the tocolytic potency was in the following order: isoproterenol greater than ritodrine greater than isoxsuprine. 3) Ritodrine induced hypotension and tachycardia, but these effects were less than those of isoproterenol and isoxsuprine. 4) The effects of isoproterenol and ritodrine were almost prevented by pretreatment with propranolol, but those of isoxsuprine were only partially or not affected. These results suggest that ritodrine is effective in preventing the uterine contractions in rats and rabbits and that it has less effect on the circulatory system than isoproterenol and isoxsuprine. It is also concluded that ritodrine produces these effects through activation of beta-adrenoceptors. PMID- 6482093 TI - Effects of latamoxef and methyltetrazolethiol on gamma-glutamylcarboxylase activity. PMID- 6482094 TI - Predominant negative inotropic effect of UTP on dog cardiac muscle. PMID- 6482095 TI - [Acute extrinsic malfunction of prosthetic valves]. PMID- 6482096 TI - [Mitral valve prolapse and its complications]. PMID- 6482097 TI - [A rare complication of St. Jude Medical valve in aortic position. Suggestion of the valve orientation]. PMID- 6482098 TI - [Patch enlargement reconstruction of the right ventricular outflow tract without cardiopulmonary bypass. The use of newly devised "wire-guided knife"]. PMID- 6482099 TI - [Repair of sternum separation after cardiac surgery. A new method by iliac bone transplantation]. PMID- 6482100 TI - [Haptoglobin administration for severe hemoglobinemia after open heart surgery]. PMID- 6482101 TI - [Treatment of DeBakey IIIb type dissecting aneurysm. Thromboexclusion and bilateral axillo-iliac bypass]. PMID- 6482102 TI - [A case report of traumatic chylothorax successfully treated by thoracic duct ligation]. PMID- 6482103 TI - [Thymic hyperplasia with hypergammaglobulinemia. Report of a case]. PMID- 6482104 TI - [Mechanical valve replacement for secondary tricuspid regurgitation. Report of 4 cases]. PMID- 6482105 TI - [A case report of left ventricular-right atrial shunt with ventricular septal defect]. PMID- 6482106 TI - [Clinical conference at the 3d Department of Surgery, Nara Medical University. 2. Case of atrial septal defect showing an abnormal left atrial echo: non-cyanotic heart defect associated with heart failure, pulmonary hypertension and insufficient growth in an infant]. PMID- 6482107 TI - [A study of urodynamics. XI-1. Urodynamic assessment of neurogenic bladder after a radical hysterectomy]. PMID- 6482108 TI - [Laminin (a basement membrane-specific glycoprotein) in bladder carcinomas]. PMID- 6482109 TI - [Urogenital anomalies in patients with Sotos syndrome]. PMID- 6482110 TI - [A basement membrane antigen isolated from renal cell carcinoma, and its localization in the tissue]. PMID- 6482111 TI - [Cytophotometric investigation of DNA-content in bladder carcinoma: (1) Correlation of DNA-content with histopathological findings and its value in cytologically negative cases]. PMID- 6482112 TI - [Computer tomography and urinary calculi. 1. Clinical evaluation of intrarenal microlith]. PMID- 6482113 TI - [Three-dimensional urethral pressure profile. IV. Stereographic Urethral Pressure Profile (Stereo-UPP)]. PMID- 6482114 TI - [Fine-needle aspiration cytology of retroperitoneal lymph nodes in malignant urogenital tumors]. PMID- 6482115 TI - [Clinical study of interstitial cystitis. I-(I). The clinical and pathological observations of the contracted bladder caused by interstitial cystitis and tuberculosis]. PMID- 6482116 TI - [Clinical experience with a syndrome of renal failure, growth retardation and renoureteral dysmorphism]. PMID- 6482117 TI - [Clinical and pathological study on postoperative metastases of renal cell carcinoma]. PMID- 6482118 TI - [On reflux nephropathy--clinical and pathological study]. PMID- 6482119 TI - Gene expression of triploidy in six adult intersexual chickens. PMID- 6482120 TI - Tissue and blood eosinophilia in mast cell-deficient Sl/Sld mice infected with Trichinella spiralis. PMID- 6482121 TI - A case of multilocular echinococcosis in a horse. PMID- 6482122 TI - Hepatic fibrosis produced in rats by repeated intraperitoneal injections of swine serum. PMID- 6482123 TI - Treatment and clinicobiochemical observations of cows affected with fat necrosis. PMID- 6482124 TI - Histological development of the paracloacal vascular body in the male embryo of muscovy duck, Cairina moschata. PMID- 6482125 TI - Changes in histamine concentration of ruminal contents and plasma in cattle fed on a formula feed and rolled barley. PMID- 6482126 TI - Immunohistochemical studies on the antigen localization and the germinal center formation in mouse lymph nodes. PMID- 6482127 TI - Possibility of saturation in renal excretion after high dose of intravenous sulfamonomethoxine in pigs. PMID- 6482128 TI - Hepatic abscess formation in cattle inoculated with Fusobacterium necrophorum. PMID- 6482129 TI - The macaque monkey as an experimental paratenic host for Paragonimus westermani (Kerbert, 1878) Braun, 1899. PMID- 6482130 TI - Isolation of the leukocyte chemotactic factors in the extract of adult Metastrongylus apri. PMID- 6482131 TI - Vagal afferent activities corresponding to respiratory cycle in rats. PMID- 6482132 TI - Morphology of spontaneous cardiac tumors in Fischer 344 rats. PMID- 6482133 TI - Body and organ weights of Macaca fuscata and Macaca cyclopis. PMID- 6482134 TI - Antibiotic susceptibility of Clostridium septicum isolated from chickens and cattle. PMID- 6482135 TI - Dicroceliasis in the wild Japanese serow, Capricornis crispus. PMID- 6482136 TI - Diplostomulum of Pharyngostomum cordatum in the muscle of a raccoon dog Nyctereutes procyonoides. PMID- 6482137 TI - Proliferative hemorrhagic enteropathy detected at an abattoir in Kagoshima. PMID- 6482138 TI - Multiple papilliform proliferation of the endocardium of the chordae tendineae cordis in cattle. PMID- 6482139 TI - Effects of overweight and habitual drinking on serum transaminase levels. PMID- 6482140 TI - Comparison of immunological responses and survival periods in cancer patients treated with intradermal and intramuscular injection of the streptococcal preparation OK-432. PMID- 6482141 TI - Anemic changes in lead-exposed workers after onset of exposure. PMID- 6482142 TI - [Tuberculosis in dialysis patients. 13. Clinical findings which led to the diagnosis of tuberculosis]. PMID- 6482143 TI - [Clinical studies on lung diseases due to atypical Mycobacterium]. PMID- 6482145 TI - [Treatment of infants with congenital heart defects in critical condition during the first year of life]. PMID- 6482144 TI - [Studies on lung diseases due to non-tuberculous mycobacteria in Japan. (Report of the year 1982 of the Mycobacteriosis Research Group of the Japanese National Chest Hospitals). Isolation of various species that caused lung diseases]. PMID- 6482146 TI - [Value of the left atrium emptying index for evaluation of diastolic function of the left ventricle]. PMID- 6482147 TI - [Disorders of baroreflex regulation of the heart rate in conscious rabbits in chronic stenosis of the ascending aorta]. PMID- 6482148 TI - [Echocardiographic picture of paravalvular fistula of a semi-circular prosthesis MKCh-2-27 fixed in the mitral position]. PMID- 6482149 TI - [Transition of prevalent retrograde excitation of the atria to atrioventricular dissociation during paroxysmal ventricular tachycardia]. PMID- 6482150 TI - [Atypical course of myocardial infarction in a young man]. PMID- 6482151 TI - [Elimination of drug-resistant supraventricular tachyarrhythmia by transvenous electrodestruction of the atrioventricular junction]. AB - The authors report on the first successful employment of transvenous electrodestruction of the atrio-ventricular junction in patients with supraventricular tachyarrhythmias resistant to the drug and electroimpulse therapy. The procedure of transvenous electrodestruction in six patients consisted in making a discharge of 250-350 J from a stationary R-synchronized defibrillator in the area of the compact atrio-ventricular node or the proximal portion of the His bundle. All patients were implanted R-banning ECS-222 Li. The follow-up period after the operation varied from 2 to 6 months. The patients reported no disturbances in cardiac performance and palpitation over this period. PMID- 6482152 TI - [Repeated operations on the heart in patients with a history of mitral commissurotomy]. AB - The article analyzes the results of surgical treatment of 262 patients, with 160 of them having undergone closed mitral recommissurotomy. One hundred and two patients were operated on under conditions of assisted circulation. The conduction of repeated closed operations is justified in uncomplicated forms of mitral restenosis. In cases of marked calcinosis and regurgitation on the mitral valve, left atrial thrombosis and attended defects, surgery must be performed with extracorporeal circulation. PMID- 6482153 TI - [Clinical aspects, diagnosis and surgical correction of congenital aortopulmonary septal defect]. AB - Characteristic signs of a rare abnormality of the major vessels, an aortopulmonary septum defect, are described. This pathology is associated with shunting and discharge of blood from the left to the right and an early development of pulmonary hypertension. The clinical course of the defect depends on the degree of the hemodynamic impairment in the pulmonary circulation. It has been elucidated that aortography with catheterization and contrast examination of the right portions of the heart is the method of choice in the diagnosis of this defect. Surgical correction of the defect is the only radical method of treatment. The long-term results of surgical treatment are promising. PMID- 6482154 TI - [Ebstein's anomaly associated with pulmonary stenosis]. AB - Although Ebstein's anomaly occurs mostly in isolation, in 2 to 5% of cases it is combined with pulmonary artery stenosis. This combination noticeably aggravates the natural course of the disease and complicates the diagnosis of the pathology. On the basis of five observations the authors present the specific differential diagnostic signs which help to make the correct diagnosis. The key role in the identification of combined forms of Ebstein's anomaly is played by the catheterization of the cardiac chambers and by angiocardiography. PMID- 6482155 TI - [Angiocardiographic anatomy of the outlet of the right ventricle in tetralogy of Fallot]. AB - The angiocardiographic findings obtained from 85 patients with Fallot's tetrade are analyzed. In 35 patients the results are compared with anatomical data. The authors have identified four major types of the defect and the anatomical structures involved in the construction of the blood outflow passways into the pulmonary circulation in Fallot's tetrade. PMID- 6482156 TI - [Surgical treatment of septic endocarditis]. PMID- 6482157 TI - [Therapeutic value of pratsiol and its effect on indicators of central and peripheral hemodynamics in patients with hypertension]. AB - Thirty-eight patients with stage IIB essential hypertension have been studied to determine the therapeutic activity of prazosine (pratsiol, "Orion" company, Finland) and its influence on the parameters of the central and peripheral hemodynamics. It has been established that following the oral administration of the drug, a hypotensive effect develops in 90-120 min and lasts for about six h. After a three-week course of treatment, the arterial pressure in the majority of patients decreased due to a reduction in the total peripheral resistance and the tone of the resistant vessels (arterioles). Simultaneously, there was an increase in the heart rate, end diastolic and stroke volumes and in the cardiac output. In a smaller portion of patients, the arterial pressure decreased due to the predominant reduction in the venous tone; the elasticity of the veins increased sharply, the end diastolic stroke and minute volumes diminished. The heart rate and total peripheral resistance showed no statistically significant changes. It has been established that pratsiol acts as an arterial and venous vasodilator and that it is advisable to use the drug in combination with beta-blockers and diuretics. PMID- 6482158 TI - [Effect of streptodecase and heparin on the state of hemostasis in patients with acute myocardial infarction]. AB - The article deals with the effect of the intravenous administration of streptodekase with heparin on the hemostatic system in patients with acute myocardial infarction. The data obtained are compared with the corresponding parameters in patients treated with native streptokinase. The advantages of the new thrombolytic drug over ordinary streptokinase are shown: a one-time administration of the whole therapeutic dose of streptodekase allows a significant simplification of the thrombolytic therapy scheme; streptodekase induces prolonged activation of fibrinolysis (up to 5-7 days) without any signs of its subsequent depression and with the minimum inhibition of blood coagulation. The specific selective influence of streptodekase on the fibrinolytic system helps to obviate hemorrhagic and thromboembolic complications characteristic of native streptokinase. In addition, low antigenicity and toxicity of streptodekase ensure the absence of any allergic and adverse side effects in patients treated with the drug. PMID- 6482159 TI - [Clinical evaluation of dynamic scintigraphy of the myocardium with Tl-201 in patients with acute myocardial infarction]. AB - Thirty-six patients hospitalized because of suspicion for acute myocardial infarction (AMI) were examined within the first 24 hours after symptoms of the disease manifested themselves and during the follow-up on days 5-6 and 28-30. Myocardial perfusion was examined using the technique of perfusion myocardial scintigraphy with 201Tl. In cases of an uncomplicated course of AMI, the scintigrams showed a reduction in the area of perfusion defects (a positive time course) whereas when the disease progressed the scintigrams reflected a negative time-course expressed in an expansion of the area of perfusion defects. When the scintigrams taken within the first 24 hours of AMI and over the follow-up period showed extensive perfusion defects, the time-course of the disease was severe with a large number of complications, the prognosis being usually poor. The pattern of the thallium scintigraphic picture at various periods of AMI was demonstrated to be heterogeneous. The degree of the perfusion defect, the time course of its changes during the follow-up can be predictive in relation to the development of circulation insufficiency and mortality. PMID- 6482160 TI - [Effect of various doses of aspirin after a single and long-term administration on platelet aggregation in patients with ischemic heart disease]. AB - A study of 169 patients with coronary heart disease has shown that the duration and intensity of the inhibition of platelet aggregation following the single administration of 0.5, 1 and 1.5 g of aspirin is largely determined by the dose used. It has been established that in individuals sensitive to aspirin, the intake of 0.5 g of the drug causes a marked inhibition of platelet aggregation lasting for over 24 hours. A year-long follow-up of patients with myocardial infarction receiving 0.5 g of aspirin daily has demonstrated that platelet aggregation is consistently depressed throughout the entire period of observation. PMID- 6482161 TI - [Roentgenologic evaluation of myocardial contractility in heart valve diseases]. AB - The authors compare the roentgenological findings with the parameters of contractility obtained during heart catheterization in 49 patients with mitral valvular disease and aortal valvular disease. The parameters are shown to be correlated with regard to the nature of valvular damage, characteristics of the impairment of the intracardiac hemodynamics and myocardial contractile function. Certain tendencies of this dependence are tabulated. PMID- 6482162 TI - [Functiono-morphological changes in the cardiovascular system in acute occlusion and after revascularization of the cranial mesenteric artery]. AB - A total of 56 experimental dogs with small intestine ischemia following the recovery of the blood flow were studied comprehensively for the cardio- and hemodynamic parameters as well as for myocardial contractility and bioelectric activity. Histologic, histochemical and histoenzymologic examination were carried out. Longer periods of ischemia were associated with the depletion of the cardiac functional reserve. The recovery of the blood flow following 6 to 12-hour long ischemia without corrective measures was accompanied by severe hypovolemia, marked dystrophic and metabolic changes in the myocardium as well as by diminished cardiac activity. PMID- 6482163 TI - [Myocardial changes in short-term hyperthermia]. PMID- 6482164 TI - Characterization of glomerular permeability and proteinuria in acute hypertension in the rat. AB - The effects of acute angiotensin II (AII) induced hypertension on renal hemodynamics, urinary excretory rates, and clearances of endogenous proteins, together with colloidal iron staining and numerical density of differently charged ferritins in glomerular basement membrane (GBM) have been studied. AII decreases para-aminohippurate clearance (63%) more than glomerular filtration rate (GFR) (42%), resulting in an increased filtration fraction (54%). Simultaneously, large increments in the excretory rates and clearances of albumin and IgG2a occur. The number of native ferritin particles per unit volume of GBM and its different layers increases significantly in both superficial and juxtamedullary glomeruli as a result of acute hypertension. In contrast, the number of cationized ferritin particles per unit volume of GBM as well as colloidal iron staining of GBM and adjacent cell membranes remain unchanged, irrespective of AII treatment. The results demonstrate that acute AII-induced hypertension enhances glomerular permeability to proteins of different size and shape in the absence of detectable alterations in the fixed negative charges of the GBM. Since both RBF and GFR are decreased, the increased transglomerular passage of proteins in acute hypertension appears to be due to an increase in the pore size of the glomerular filter, induced possibly by either high intracapillary pressure and/or a direct action of AII on GBM constituents. PMID- 6482165 TI - Unaltered anionic sites of glomerular basement membrane in aminonucleoside nephrosis. AB - Quantitative electron microscopic autoradiography was employed to determine the changes in the binding of 125I-cationic ferritin (CFI, pI approximately 7.2 to 7.4) to the anionic sites of the glomerular basement membrane (GBM) of rats following the induction of nephrosis. Animals were rendered nephrotic by a single intravenous injection of puromycin aminonucleoside (PAN) and sacrificed 0, 7, 14, and 21 days after its administration. CFI (10 mg/mCi/100 g body weight) was given intravenously. The kidneys were subsequently fixed by perfusion and processed for electron microscopic autoradiography. The mean grain densities over the GBMs on 0, 7, 14, and 21 days of PAN nephrosis were 1.50 +/- 0.04, 1.49 +/- 0.05, 1.50 +/ 0.05, and 1.51 +/- 0.04, respectively. These results indicate that there are no significant alterations in the anionic sites rich in heparan sulfate proteoglycan during the entire course of PAN nephrosis. PMID- 6482166 TI - Extracellular fluid expansion and autoregulation in nephrotoxic serum nephritis in rats. AB - Previous studies of the early autologous phase of bilateral nephrotoxic serum nephritis (NSN) in rats showed that whole kidney and single nephron glomerular filtration rate (GFR) were maintained at normal levels despite a 60% reduction in the product of surface area and hydraulic permeability (Kf). Factors responsible for this compensation were an increase of net ultrafiltration pressure, due primarily to an increased glomerular capillary pressure (PGC). This study was designed to investigate some possible causes of the compensation. Rats with bilateral NSN and normal GFR had an increased extracellular fluid volume (ECFV) 2 weeks after induction of NSN; control subjects did not change. To determine whether this ECFV expansion was responsible for triggering the compensation, we developed a unilateral NSN model with one diseased and one normal kidney. Unilaterally diseased rats did not experience an increase of ECFV. Values of Kf were 0.069 +/- 0.012 nl sec-1 mm Hg-1 in control subjects, 0.037 +/- 0.005 in bilateral NSN, and 0.043 +/- 0.006 in unilateral NSN. The elevation in PGC was the same in unilateral NSN as in bilateral NSN subjects and the same was true for the hydrostatic pressure difference across glomerular capillaries (delta P). Furthermore, in paired measurements on both kidneys of rats with unilateral NSN, PGC was significantly higher in the unilaterally diseased kidney than in the nondiseased kidney; sham control subjects had no difference. These results are interpreted to indicate that the signal that causes elevation of net ultrafiltration pressure is not a consequence of a systemic effect of NSN, but arises within the diseased kidney itself. To determine whether that signal involved some change in the mechanisms mediating autoregulation measurements were made of the response of whole kidney GFR and RBF to acute changes in arterial BP. Control rats and rats with NSN autoregulated both GFR and blood flow equally well. Tubuloglomerular feedback was studied by microperfusing loops of Henle and measuring proximal stop-flow pressure and early proximal flow rate. Stop-flow pressure was 4.0 mm Hg higher in rats with NSN at a loop perfusion rate of 10 nl/min, approximately the same difference that was found by direct measurement of PGC, but the sensitivity of response to changes in perfusion rate was the same in NSN as in control subjects. Finally, end proximal tubule flow rate was higher in NSN than in control subjects reflecting decreased proximal reabsorption. Thus, a normal feedback mechanism receives a signal that should cause afferent arteriolar constriction in NSN rats.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6482167 TI - Distribution of N-acetyl-beta-D-glucosaminidase isoenzymes along the rabbit nephron. AB - Total N-acetyl-beta-D-glucosaminidase (NAG) activity has been measured in microdissected glomeruli (G) and tubular segments [proximal convoluted tubule (PCT), pars recta (PR), medullary thick ascending limb (MAL), and cortical collecting tubule (CCT)] of the rabbit kidney, by a fluorimetric method using synthetic substrate. Selective activity of the isoenzyme NAG B was also determined. Isoenzyme profiles of NAG were obtained by electrofocusing on each segment. Characterization of the isoenzymes was performed by chromatofocusing and thermosensitivity experiments on PCT. Total NAG activity, mainly composed of NAG A, was low in glomeruli and two and one-half to four times higher in PCT than in other segments, in which comparable activities were found. NAG B was detectable all along the nephron. It represented a very small fraction of total NAG, except in PCT where it was more abundant (20 to 30%). Electrofocusing revealed the presence of a minor form (NAG I) all along the nephron. Chromatofocusing and thermosensitivity studies indicated that NAG I could represent imperfectly solubilized NAG A rather than a well defined entity. From these results, it could be suggested that the reported increase in urinary excretion of NAG B after renal injury may reflect the intensity of proximal tubular lesions. PMID- 6482168 TI - Early effects of gentamicin, tobramycin, and amikacin on the human kidney. AB - The early alterations at the level of the proximal tubule of the human kidney caused by the three most currently used aminoglycosides, gentamicin, tobramycin, and amikacin, were studied. A prospective, randomized, and comparative approach using multidisciplinary methods was used. The patients received either no treatment or one of the three aminoglycosides at a therapeutic dose for 4 days preceding nephrectomy for neoplasia partly involving one kidney. The three aminoglycosides studied induce an early lysosomal phospholipidosis. Gentamicin and tobramycin cannot be distinguished on the basis of drug tissue accumulation, lysosomal overloading, or effect on lysosomal phospholipase A1. Amikacin induces significantly lower lysosomal overloading and no loss of phospholipase A1 activity. PMID- 6482169 TI - Dialysis-associated ischemic heart disease: insights from coronary angiography. AB - We reviewed the records of 44 dialysis patients who had undergone one or more coronary angiograms to determine the frequency with which symptomatic ischemic heart disease (IHD) and significant coronary artery narrowing coincided and to determine those factors which were associated with the coronary atherosclerotic process. Thirty-four patients were catheterized for angina pectoris or myocardial infarction. Of this group, 53% were found to have significant narrowing of coronary arteries. This group was older than the group with trivial or no coronary artery occlusion and their duration of dialysis was shorter. All the patients with significant coronary occlusion were white and the majority were adult males. Discriminant function analysis revealed that the presence of significant coronary artery occlusion could be predicted with high sensitivity and specificity by the following variables: older age, white race, male sex, the presence of symptomatic IHD prior to the onset of dialysis, increased total serum cholesterol, abnormal left ventricular wall motion, and reduced alkaline phosphatase. We also found that the occurrence of symptomatic IHD far exceeded the presence of significant atherosclerotic coronary artery narrowing. We suggest that this may result from several dialysis-associated alterations in oxygen delivery and myocardial oxygen consumption. PMID- 6482170 TI - Dense intramembranous deposit disease: new pathologic features. AB - The pathologic and clinical features of 16 patients with dense intramembranous deposit disease are described. By light microscopy nine patients had membranoproliferative glomerulonephritis, five had focal segmental necrotizing glomerulonephritis with segmental epithelial crescents, four of whom also had a prominent tubulointerstitial nephritis, and two had focal segmental mesangial proliferative glomerulonephritis. The patients with membranoproliferative glomerulonephritis and one with focal segmental mesangial proliferative glomerulonephritis had easily recognizable dense intramembranous deposits by optical microscopy. The patients with focal segmental necrotizing glomerulonephritis and one with focal segmental mesangial proliferative glomerulonephritis did not have recognizable peripheral loop dense intramembranous deposits even under oil immersion. In patients with membranoproliferative glomerulonephritis ultrastructural examination revealed extensive capillary wall dense intramembranous deposits. Immunofluorescence revealed diffuse double linear staining along the capillary walls and "mesangial rings" of C3. In the patients with focal segmental necrotizing glomerulonephritis and one with focal segmental mesangial proliferative glomerulonephritis the immunofluorescence study suggested a diagnosis of dense intramembranous deposit disease because of the segmental double linear staining of the capillary walls and "mesangial rings" of C3, but the diagnosis was only established by fine structural analysis where occasional peripheral loop and prominent paramesangial basement membrane dense intramembranous deposits and mesangial nodular deposits were identified. Clinical features prior to biopsy included nephrotic syndrome in eight patients, an acute nephritic syndrome in six patients, and asymptomatic proteinuria and hematuria in two patients. Five of six patients with an acute nephritic presentation had focal segmental necrotizing glomerulonephritis. The acute renal insufficiency in these patients was transitory and appeared to be related to a prominent acute tubulointerstitial nephritis present in four of the biopsy specimens. Depressed serum C3 levels were present in patients with membranoproliferative glomerulonephritis; patients with focal segmental lesions were normocomplementemic. Because of the "atypical" light microscopic features in six of our patients, we support the suggestion that membranoproliferative glomerulonephritis, type II be replaced by the term 'dense intramembranous deposit disease' for this glomerulopathy with variable clinical and histologic features. PMID- 6482171 TI - Parathyroid and bone response of the diabetic patient to uremia. AB - Biochemical and radiologic indices of bone disease were assessed in 26 insulin dependent diabetic patients and 28 nondiabetic patients with endstage kidney disease. The two groups were comparable in age, sex, duration of renal failure, and length of time on dialysis. Diabetic patients showed significantly lower serum calcium and immunoreactive parathyroid hormone (iPTH) levels than nondiabetic patients. iPTH was not related to total serum calcium, but was positively correlated with serum phosphorous (r = 0.37, P less than 0.05 and r = 0.54, P less than 0.005, in nondiabetic and diabetic patients, respectively). iPTH correlated with alkaline phosphatase (r = 0.59, P less than 0.0009) and calcitonin (r = 0.51, P less than 0.05) only in nondiabetic patients. Osteitis fibrosa was noted radiologically in 30% of nondiabetic patients and in none of the diabetic patients (P less than 0.03). Bone morphology in eight diabetic patients who underwent iliac bone biopsy was characterized by reduced trabecular and osteoid bone volume, no woven bone, and marked reduction in indices of bone formation and resorption. The small amount of bone and lack of osteomalacia are a unique feature of the diabetic patient with chronic renal disease. The long-term sequelae of low bone turnover and reduced circulating iPTH may present a special problem to the long term diabetic survivor on the current therapies of uremia. PMID- 6482172 TI - Plasma lipoproteins and lecithin:cholesterol acyltransferase distribution in patients on dialysis. AB - Plasma lipoproteins and LCAT activity were studied using a single spin density gradient separation and an exogenous substrate enzyme assay in 41 patients on chronic hemodialysis and in 11 normal subjects. The plasma HDL cholesterol was markedly decreased (33 vs. 63 mg/dl, P less than 0.001) while total and LDL cholesterol were unchanged in the patients. Plasma LCAT activity was significantly lower in the patient group (42 vs. 59 nmoles/4 hr/ml, P less than 0.001), but the distribution of activity (studied in 13 dialysis patients and 12 control subjects) was not different between the two groups: 90% being associated with HDL and VHDL lipoprotein fractions. To examine the possible genetic influence on the development of hypertriglyceridemia in the patient group, we examined the ratio of apolipoproteins E3/E2 and CII/CIII in ten of the patients and another group of 13 control subjects. The frequency of heterozygotes for E3 deficiency was not different between the patient (one of ten) and the control (two of 13) groups. While the patient group had lower CII/CIII ratio, the figures did not reach statistical significance. The low LCAT activity in the face of higher plasma triglycerides and low HDL may contribute to impaired lipolysis previously documented in uremic patients. A follow-up study performed 1 year after the initial study confirmed the decreased HDL (51 vs. 71 mg/dl, P less than 0.01) and LCAT activity (50 vs. 59 nmoles/hr/ml, P less than 0.02) in an exogenous substrate system (N = 20). LCAT measured using the endogenous substrate was not significantly different from the control group (49 vs. 55 nmoles/hr/ml).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482173 TI - Diffuse proliferative lupus nephritis: identification of specific pathologic features affecting renal outcome. AB - Prerandomization renal biopsy specimens were examined in 102 patients upon entry into prospective therapeutic trials of lupus nephritis in an attempt to identify early predictors of renal failure outcome. All 11 renal failures occurred among the 72 individuals with diffuse proliferative or membranoproliferative glomerulonephritis (DPGN/MPGN); thus, these patients were at modestly, but significantly, increased risk of endstage renal disease compared to those with focal proliferative, membranous, or mesangial glomerulonephritis. Considering the low incidence of endstage renal disease among patients with DPGN/MPGN, we sought to refine the prognostic information obtained from renal morphology by semiquantitative scoring of individual histologic features and by derivation of composite histologic scores specified by Activity (AI) and Chronicity (CI) Indices. Among the 72 patients with DPGN/MPGN, the composite AI was more strongly predictive of renal failure than were the individual active histologic features; cellular crescents and extensive fibrinoid necrosis yielded positive associations, while endocapillary proliferation, leucocytic exudation, and hyaline thrombi in glomeruli and interstitial inflammation by themselves did not emerge as useful prognostic indicators. However, chronicity items (glomerular sclerosis, fibrous crescents, tubular atrophy, and interstitial fibrosis) considered individually, as well as in the composite CI, were highly predictive of renal failure outcome. Particularly striking was the prognostic value of tubular atrophy; all 11 renal failures were among the 43 patients with tubular atrophy on prerandomization renal biopsy. While no single pathologic variable improved outcome predictions among those with tubular atrophy, examination for interactions among variables revealed that glomerular sclerosis and cellular crescents had a synergistic effect which augmented the prognostic information derived from analysis of tubular atrophy alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482174 TI - Foot process fusion and glomerular filtration rate in minimal change nephrotic syndrome. AB - Reduced glomerular filtration rate (GFR), not due to hypovolemia, has been reported in patients in the proteinuric phase of the minimal change nephrotic syndrome (MCNS). A group of children with MCNS was studied to investigate the possible relationship between the fusion of glomerular epithelial foot processes and the reduction in GFR. The degree of foot process fusion was estimated as the harmonic true mean of foot process width and the length density of epithelial slit pores as determined by quantitative electron microscopic stereology. In the patients investigated GFR ranged between 40 and 127 ml/min/1.73 m2 body surface area, the filtration fraction between 6.9 and 22.5%, and the serum albumin concentration between 14 and 46 g/liter. The mean foot process width, which varied between 330 and 870 nm, showed a close correlation with GFR (r = -0.859) and the filtration fraction (r = -0.812), as well as with the serum albumin concentration (r = -0.756). As expected, a reduction of epithelial slit pore length occurred concomitant with the broadening of the foot processes. These results agree with the hypothesis that the reduction in the total length of glomerular epithelial slit pores, due to the fusion of foot processes, results in a reduced glomerular capillary permeability to water and small solutes. PMID- 6482175 TI - Robert F. Pitts Memorial Lecture. Mechanisms coupling the absorption of solutes and water in the proximal nephron. PMID- 6482176 TI - Idiopathic IgA nephropathy. PMID- 6482177 TI - Impaired myocardial lipid metabolism in phosphate depletion. AB - This study examines the effects of phosphate depletion on myocardial carbohydrate, lipid, and phospholipid metabolism. Rats were studied after 4 (short-term) and 8 to 12 weeks (long-term) of selective dietary phosphate restriction. Myocardial biopsy samples were examined for glucose-6-phosphate and glycogen to evaluate carbohydrate pathways, and for glycerol phosphate and mitochondrial fatty acid oxidation and phospholipid contents to evaluate lipid and phospholipid turnover. The fall in cellular inorganic phosphorus was associated with a fall in myocardial glycogen, glucose-6-phosphate, glycerol phosphate, and cytidine triphosphate, as well as the contents of phosphatidylcholine, phosphatidylethanolamine, and total phospholipid phosphorus. These observations demonstrate impaired phospholipid metabolism, probably at the biosynthetic level. The oxidation of long-chain and short-chain fatty acids is also impaired in phosphate depletion, further demonstrating impaired lipid metabolism. The abnormal phospholipid metabolism may be compatible with the changes in cellular membrane described in phosphate depletion. PMID- 6482178 TI - Reversible changes of tubular cell and basement membrane in drug-induced renal cystic disease. AB - To delineate changes in the development and regression of renal cystic disease, sequential studies were done in rats fed 2-amino-4,5-diphenyl thiazole (DPT). Kidneys were perfusion fixed with either aldehyde fixative alone or with the addition of ruthenium red (RR). Tissues were processed for light and electron microscopy. Light microscopy sections were stained with alcian blue and eosin and hematoxylin. Initially, cellular proliferation and, later, cystic transformation of collecting tubules were observed. The structural changes in tubular cells preceded alterations in the basement membrane and consisted of an increase in smooth and rough endoplasmic reticulum and free polyribosomes, prominence of Golgi complexes, and an increased number of lysosomes. These findings are suggestive of changes in the biosynthetic, secretory, and degradative mechanisms of the cell. With time, the tubular basement membranes became progressively thicker and laminated with concomitant loss of alcian-blue- and RR-staining. When DPT-treated animals with renal cystic disease were placed on a normal diet, tubular cell and basement membrane morphology and alcian-blue- and RR-staining returned to normal and cystic changes regressed. These findings are compatible with altered synthesis and degradation of tubular basement membranes in this model of cystic disease. PMID- 6482179 TI - Growth in children with chronic renal failure on conservative treatment. AB - Statural growth and its relationship with degree of renal insufficiency were studied in 42 children and 5 infants with chronic renal failure (CRF). Most of the children had a congenital disease or were already ill in the neonatal period. Average GFR was 34 ml/min/1.73 m2 at the beginning and 16 ml at the end of the follow-up period, which averaged 4.3 years (1 to 12 years). Most patients grew at a normal rate; only 3 out of 42 children (7%) and 3 out of 5 infants lost one standard deviation or more during the follow-up period. No correlation was found between the degree of GFR and growth velocity. Catch-up growth was observed only for a 12-month period in 4 children with a bone age of 7 to 8 years. In 10 out of 11 children who reached puberty while under observation, a normal pubertal growth spurt was observed. Suitable and comprehensive controls and treatment can arrest growth retardation in the great majority of children with CRF after the first few years of life, regardless of their GFR. Achievement of a normal growth pattern in infants with CRF during the first year(s) of life remains a major unsolved problem. PMID- 6482180 TI - Acetate and bicarbonate hemodialysis in patients with and without autonomic dysfunction. AB - To test the contribution of bicarbonate (Bi) to hemodynamic stability during hemodialysis (HD), we compared the effects of ultrafiltration dialysis with bicarbonate and with acetate under conditions of high-sodium (141 mEq/liter) and low-sodium (130 mEq/liter) dialysate concentrations in 12 stable HD patients. Group 1 was patients (N = 5) who had normal findings on autonomic testing; group 2, patients (N = 7) who had abnormal findings on autonomic testing. All patients and staff were unaware of which dialysis was being used. During the high-sodium dialysate studies, changes in mean blood pressure (MBP), cardiac output (CO), and orthostatic tolerance to standing after HD were similar in both groups of patients with both acetate and bicarbonate dialysate. When the studies were repeated under low-sodium dialysate conditions, several differences emerged between acetate and bicarbonate HD. In group 1, the frequency of adverse symptoms upon standing after HD were reduced with bicarbonate (P less than 0.05). In group 2, bicarbonate HD prevented a significant decrease in orthostatic MBP after HD. These results suggest that bicarbonate affords no greater hemodynamic stability than does acetate if a dialysate sodium of 141 mEq/liter is used. With lower sodium dialysate, bicarbonate appears to provide a modest improvement in decreasing orthostatic symptoms and signs in patients with and without autonomic insufficiency. PMID- 6482181 TI - Cardiovascular and metabolic responses to submaximal exercise in hemodialysis patients. AB - Eight chronic hemodialysis (cHD) patients and six healthy sedentary controls (C) were exercised for 60 minutes at 52 +/- 8% (cHD patients) and 48 +/- 4% (C) of their maximal oxygen consumption levels. Plasma lactate levels at rest and during exercise were comparable in both groups. Respiratory exchange ratios were lower in cHD patients, but they increased during exercise to levels comparable to those of the C group. Despite comparable heart rates at rest, exercise of similar intensity led to lower heart rates at 30 and 60 minutes in cHD patients compared to C (P less than 0.05). The cHD patients had higher systolic and mean arterial pressures at rest than did C (P less than 0.05), but during exercise the increments in systolic and mean blood pressures were lower in cHD patients than they were in C (P less than 0.05). In spite of these blunted cardiovascular responses, plasma catecholamines increased during exercise in both groups. Plasma glucose levels were similar in both groups during exercise in spite of significantly higher plasma levels of insulin and glucagon in cHD patients throughout the exercise session (P less than 0.01). These data demonstrate that chronic cHD patients can exercise at a modest intensity for a prolonged period of time without untoward cardiovascular or metabolic responses. Their poor exercise response does not appear to be related to an inadequate activation of the sympathoadrenal system. PMID- 6482182 TI - [Recommendations for the therapy of endemic worm infestation in childhood]. PMID- 6482183 TI - [Muscle hypotonia in early childhood with special reference to its occurrence in cerebral movement disorders]. PMID- 6482184 TI - [A rare cause of hematuria: parahemophilia]. PMID- 6482185 TI - [Sensitivity of phenylketonuria screening]. PMID- 6482186 TI - [Capillaroscopy and studies of the fingernails in diabetic children]. PMID- 6482187 TI - [Spastic bronchitis in early childhood--an obituary!]. PMID- 6482188 TI - [Bilharziasis of the juvenile urinary tract]. PMID- 6482189 TI - [Epidemiology and symptomatology of malignant testicular tumors in children]. PMID- 6482190 TI - [Zinc determination in the serum and urine in children with mucoviscidosis]. PMID- 6482191 TI - [Nomenclature of the most important bronchial diseases in childhood]. PMID- 6482192 TI - [Acute postoperative hepato-renal insufficiency]. PMID- 6482193 TI - [Early complications of surgical treatment of tumors of the liver, biliary tract and pancreas]. PMID- 6482194 TI - [Diagnostic errors in spontaneous rupture of the esophagus]. PMID- 6482195 TI - [Left-side resection of the pancreas based on its surgical anatomy]. PMID- 6482196 TI - [Automatic device for cooling the pancreas]. PMID- 6482197 TI - [Cryosurgery of acute destructive pancreatitis]. PMID- 6482198 TI - [Device for surgical interventions on the major duodenal papilla]. PMID- 6482199 TI - [Universal probes for intraoperative examination of extrahepatic bile ducts]. PMID- 6482200 TI - [Treatment of patients with incompletely formed intestinal fistulas]. PMID- 6482202 TI - [Calculous cholecystitis complicated by non-clostridial anaerobic infection]. PMID- 6482201 TI - [Cholecystectomy in a patient with artificial pacemaker]. PMID- 6482203 TI - [Isolated injuries of the gallbladder]. PMID- 6482204 TI - [Cholelithiasis complicated by mechanical jaundice and situs inversus of the internal organs]. PMID- 6482205 TI - [Solitary cyst of the liver in a child]. PMID- 6482206 TI - [Giant pancreatic cystadenoma]. PMID- 6482207 TI - [Combined echinococcosis of the liver and diaphragm]. PMID- 6482208 TI - [Primary actinomycosis of the liver]. PMID- 6482209 TI - [Acute internal hemorrhage in pregnancy]. PMID- 6482210 TI - [Comparative evaluation of the effectiveness of forced intra-arterial and intravenous diuresis in acute pancreatitis]. PMID- 6482211 TI - [Surgical tactics in an accessory pancreas]. PMID- 6482212 TI - [Extracorporeal sorption detoxication in the complex treatment of pancreonecrosis]. PMID- 6482213 TI - [Atypical methods of endoscopic papillosphincterotomy]. PMID- 6482214 TI - [Antibacterial treatment of acute cholecystitis in middle-aged and aged patients]. PMID- 6482215 TI - [Surgical treatment of acalculous cholecystitis]. PMID- 6482216 TI - [Internal biliary fistulas and gallstone ileus]. PMID- 6482217 TI - [Transillumination choledochoscopy in biliary tract surgery]. PMID- 6482218 TI - [Cholangioscopy through the cystic duct]. PMID- 6482219 TI - [Internal drainage of the biliary tract in benign lesions of the distal part of the common bile duct]. PMID- 6482220 TI - [Diagnosis and surgical treatment of cavernous hemangioma of the liver]. PMID- 6482221 TI - [Diaphragmatic hernia with prolapse of the liver]. PMID- 6482222 TI - [Omentoplasty of residual cavities of the liver]. PMID- 6482223 TI - [Therapeutic tactics in acute pancreatitis]. PMID- 6482225 TI - [Relaxation of the diaphragm and its clinical significance]. PMID- 6482224 TI - [Angiographic diagnosis of injuries of the liver and spleen]. PMID- 6482226 TI - [Serum leucine aminopeptidase activity in suppurative diseases]. PMID- 6482227 TI - [Correction of disorders of hemostasis in children with suppurative-infectious diseases]. PMID- 6482228 TI - [Complications of cholelithiasis caused by large calculi]. PMID- 6482229 TI - [Errors in the diagnosis of destructive forms of acute pancreatitis]. PMID- 6482230 TI - [Problems and errors in the diagnosis and treatment of suppurative-inflammatory diseases related to allergic reactions to drugs]. PMID- 6482231 TI - [Errors in the diagnosis of acute appendicitis]. PMID- 6482232 TI - [Late abscesses after appendicitis]. PMID- 6482233 TI - [Appendicitis with symptoms of acute intestinal infections]. PMID- 6482234 TI - [X-ray-endovascular surgery--new direction in the prevention and treatment of surgical diseases]. PMID- 6482235 TI - [Efficacy of using antibiotic-impregnated synthetic prostheses in vascular surgery]. PMID- 6482237 TI - [Open method of treating diffuse suppurative peritonitis]. PMID- 6482236 TI - [Hemosorption in the complex treatment of disseminated forms of peritonitis]. PMID- 6482238 TI - [Surgical model of acute suppurative peritonitis]. PMID- 6482239 TI - [Combined x-ray-endoscopic examination in the diagnosis of fistulas of the large intestine]. PMID- 6482240 TI - [Device for measured compression of the intestine]. PMID- 6482241 TI - [Dumping syndrome in children]. PMID- 6482242 TI - [Perforation of the rectum and sigmoid after electrocoagulation via a rectoscope]. PMID- 6482243 TI - [Torsion of the appendix in a child]. PMID- 6482244 TI - [Rare case of foreign body of the appendix]. PMID- 6482246 TI - [Acute appendicitis in late middle-aged and elderly patients]. PMID- 6482245 TI - [Prognostic value of several indices of immunologic and nonspecific reactivity in postoperative peritonitis]. PMID- 6482247 TI - [Treatment of acute appendicitis]. PMID- 6482248 TI - [Late results of treating acute appendicitis]. PMID- 6482249 TI - [Complex treatment of peritonitis caused by non-clostridial anaerobic bacteria]. PMID- 6482250 TI - [Acute appendicitis of a subhepatic appendix]. PMID- 6482251 TI - [Treatment of appendiceal infiltrates in children]. PMID- 6482252 TI - [Serum antitryptic activity in acute appendicitis]. PMID- 6482253 TI - [Features of changes in leukocyte and serum enzyme activity in acute appendicitis]. PMID- 6482254 TI - [Immunologic indices in surgery on organs of the abdominal cavity]. PMID- 6482255 TI - [Surgical treatment of gastrointestinal fistulae]. PMID- 6482256 TI - [Late results of surgical treatment of rectal fistulae]. PMID- 6482257 TI - [Microcirculatory disorders in patients with external intestinal fistulas and their correction]. PMID- 6482258 TI - [External intestinal fistulas]. PMID- 6482259 TI - [Drainage of the abdominal cavity]. PMID- 6482260 TI - [Subtotal resection of the large intestine with lowering of ascending colon into the anal canal]. PMID- 6482261 TI - [Surgical correction of anal sphincter incompetence in children]. PMID- 6482262 TI - [Microlymphocirculatory disorders in diffuse peritonitis]. PMID- 6482263 TI - [Rehabilitation of patients with chronic paraproctitis]. PMID- 6482264 TI - [Developmental anomalies of the intestine in the adult]. PMID- 6482265 TI - [Surgical tactics in injuries of the perineum with an extraperitoneal wound of the rectum unassociated with labor]. PMID- 6482267 TI - [Clinical picture and treatment of colonic deviations to the right]. PMID- 6482266 TI - [Surgical treatment of rectal diseases in diabetics]. PMID- 6482268 TI - [Diagnosis and treatment of torsion of the appendices epiploicae of the large intestine]. PMID- 6482269 TI - [Evaluation of the tonus of the large intestine in disorders or absence of the obturator apparatus]. PMID- 6482270 TI - [Prevention of ischemic damage to the small intestine]. PMID- 6482272 TI - [Surgical treatment of acute thrombosis of hemorrhoidal nodules]. PMID- 6482271 TI - [Cryosurgical treatment of complicated chronic hemorrhoids]. PMID- 6482273 TI - [Surface morphology relations between corneal endothelial cells of various sizes]. AB - Investigations of polymorphous corneal endothelium layers with the semi-automatic image analysis system "Videoplan" show that the perimeters of the large cells are more nearly circular than those of the neighboring small cells. The consequences of these observations are discussed with regard to the functional reserves of cells of different sizes and to the decompensation of the corneal endothelium after severe damage. PMID- 6482274 TI - [Pattern ERG and VECP following optic neuritis in childhood]. AB - Pattern ERGs and pattern VECPs were recorded in 12 patients who had suffered from optic neuritis in childhood. When each individual's eyes were compared, the eye with the longer P100-latency in pattern VECP was found to have the smaller amplitude in pattern ERG. The latency differences correlated with the amplitude differences. These findings confirm that after optic neuritis the amplitude of pattern ERG is reduced. PMID- 6482275 TI - [Regeneration of the corneal endothelium in the rabbit--preliminary trials--I]. AB - It has been demonstrated in a long-term experiment that the corneal endothelium of the rabbit is capable of repairing severe mechanical lesions several times. The more severe the lesion, the longer it takes to heal. The endothelium "broke down" for the first time after the sixth endothelial lesion was inflicted and so on after the tenth, eleventh and twelfth endothelial lesion. The regeneration time was prolonged considerably. Sometimes a "restitutio ad integrum" occurs and the cornea clarifies; sometimes one sees a retrocorneal membrane, which can also lead to clarification of the cornea. Plastic platelets implanted in addition (PVAL or HEMA copolymers) do not influence the time required for regeneration of the endothelium. In other tests these plastics proved to be nontoxic to the endothelium. PMID- 6482276 TI - [Inflammatory eye changes in the mouse caused by herpesvirus. Changes caused by the cytopathogenic effect. An animal model]. AB - The reproducible inflammatory changes caused by infection with herpes simplex virus (Eidolon-Virus) in the anterior segment in mice represent a useful model. They are very similar to severe inflammation of the eye, as seen in herpes simplex infection. The method used by the authors to damage the corneal epithelium with a local anesthetic is similar to human pathology, in which a disturbance of the protective function of the corneal epithelium also facilitates infection by herpes simplex virus as well. The changes described are a starting point for further investigations. PMID- 6482277 TI - [Cyclic esotropia in an adult]. AB - The authors describe a 46-year-old man who suddenly developed a typical cyclic esotropia. The most unusual aspects of this case were the late onset of the condition and the unilateral high myopia associated with a severe amblyopia of the squinting eye. The 24-hour-periods of deviation were accompanied by a very disagreeable flicker in the esotropic eye. The onset of this extremely unusual disorder and rare form of esotropia usually occurs at 2 to 4 years of age. To the best of our knowledge only 2 cases of cyclic esotropia have been described in adults hitherto. PMID- 6482278 TI - [Pattern and light electroretinograms in branch occlusions of the central retinal artery]. AB - Electroretinographical responses to brightness (H-ERG, Ganzfeld illumination) and pattern reversal (M-ERG, illuminating an area of 20 degrees) were recorded in two cases of occlusion of the temporal inferior branch of the retinal artery. While the H-ERG exhibited essentially normal responses, the M-ERG was markedly disturbed. With central fixation the amplitude of response to pattern was decreased by more than 50 percent. With peripheral fixation (14 degrees) exposing most of the diseased part of the retina, the M-ERG was extinguished, whereas in the fellow eye pattern responses were present. The findings strongly support the notion that the M-ERG at least partly reflects the activity of retinal ganglion cells. PMID- 6482279 TI - [Experiences with intracapsular cataract operation in myopic patients]. AB - This paper reports on postoperative results and follow-up in 74 eyes of 51 patients suffering from myopia of between -5 and over -20 D. They underwent intracapsular cataract surgery for presenile or senile cataract. The operations were performed under local anesthetic after oculopression; a microscope was used. Only in 2 cases was there a loss of vitreous during the operation. After a 5-year follow-up a defect in the anterior membrane of the vitreous was found in 7 eyes. Forty-one eyes attained a visual acuity of between 0.4 and 1.0. Careful intracapsular cataract extraction by a skilled surgeon is justifiable for myopic patients. Degenerations of the periphery of the retina were easy to coagulate with the laser after the operation. PMID- 6482280 TI - [Experiences with anterior chamber lens implantation following intracapsular cataract extraction]. AB - The present paper reports on experience gathered with the first 140 implantations of the Kelman II anterior chamber lens following intracapsular cataract extraction (ICCE). The technique of ICCE combined with lens implantation is described; the possible complications and the advantages of this new lens type are pointed out. With smooth implantation there have so far been no serious complications due to the lens, such as keratopathy, lens dislocation, secondary glaucoma, chronic iritis or membrane inflammation. The IC technique excludes the possibility of secondary cataract. PMID- 6482281 TI - [Comparison of results of iridencleisis and covered goniotrepanation]. AB - Monolateral fixed iridencleisis and goniotrepanation with a scleral flap are reliable long-term pressure-regulating procedures for all forms of primary glaucoma. They involve little risk of complications. Goniotrepanation with a scleral flap is a technically simpler procedure and is preferred because of the good results obtained with it. Iridencleisis seems to offer advantages only in cases of protracted acute glaucoma. PMID- 6482282 TI - [A variable cross cylinder with extended scale]. AB - The graduation of the scale on the Stoke's Cylinder lens can be influenced by using an additional spherocylindrical lens for improved readability of lower strength corrections. Furthermore, it is possible to spread the scale graduation to show a double-angle marking, again by using an appropriate spherocylindrical combination. PMID- 6482283 TI - [A new function of the non-pigmented epithelium of ciliary processes in the formation of aqueous humor]. AB - The invagination of the optic vesicle has, as one of its consequences, the apposition of the apices of the nonpigmented and pigmented epithelia of the ciliary processes of the eye. There are well developed intercellular ciliary "channels" formed at the apices of these cells. Embryologically the ciliary epithelia are homologous to the epithelia of the choroid plexus, a characteristically differentiated ependyma. These epithelial cells have a polarity. For example, the supranuclear region of the nonpigmented epithelia has Golgi apparatus. While stimulation of the epithelia of the choroid plexus by beta adrenergics or cholera toxin increases the rate of production of cerebrospinal fluid, similar stimulation of the adenylate complex within the ciliary epithelia decreases aqueous humor production. When the secretory function of the nonpigmented epithelial cell is activated, fluid is probably reabsorbed from the posterior chamber and secreted apically into the intercellular ciliary channels, in accord with cell polarity, thereby reducing net aqueous inflow. The fluid may enter the ciliary stroma thereafter and thus may become part of what may be called "uveal scleral" flow, or in this instance, uveal flow. The anatomy, physiology, and chemistry fit this hypothesis and form the basis for new investigations of a two-way transport across the ciliary epithelia. PMID- 6482284 TI - [Biometry of the lens with respect to age and cataract morphology. Evaluation of Scheimpflug photos of the anterior segment]. AB - Thickness of the lens, cortex and nucleus or nucleus with supranuclear layer, respectively, were determined for 58 controls aged 11-69 years (115 lenses), and for 175 patients aged 30-86 years with different types of cataract (247 lenses). Measurements of the densitograms of Scheimpflug photos (taken along the optical axis, magnified 10-fold) were performed, accurate to 0.5 mm (corresponding to 0.05 mm original size). The cataractous lenses were grouped in 5 morphological classes and 3 degrees of opacification (density according to the Scheimpflug photos). As regards normal lenses, the present authors' findings correspond to earlier findings of Niesel et al. (1976). Deviations from the normal pattern are found in typical cortical cataract (water-cleft and spokes cataract, wedge-shaped cataract) where nucleus and nucleus with supranuclear layer are thinner than the normal lenses, while with nuclear cataracts and mixed types the opposite is the case. In eyes with posterior cortical opacities no increase in the thickness of the anterior cortex is found with aging. With the true nuclear cataracts the increase in the thickness of the anterior cortex is negligible. The degree of opacification is closely related to an increase in the thickness of the nucleus and supranuclear layer, which implies a decrease in the thickness of the anterior cortex. Water-clefts and spokes of larger size cause the anterior cortex to become thinner. In eyes with wedge-shaped cataracts the different degrees of opacification did not affect the parameters measured. PMID- 6482285 TI - [Amebic keratitis: clinico-histopathologic case report]. AB - The present paper describes a case of amebic keratitis in a 63-year-old female patient, who had been wearing hard contact lenses to correct myopia. The clinical course was characterized by early superficial corneal infiltrates accompanied by a marked iritis and excruciating pain. Later a ring abscess developed, combined with a disciform infiltration of the deep central stroma and a recalcitrant superficial corneal ulcer. The disease ran a very chronic course over more than 3 months. After various conservative treatments including topical steroids, antibiotics, antimycotic, and antiviral drugs, a penetrating keratoplasty had to be performed. The histopathologic examination of the corneal button revealed many encysted amebas and a few trophozoites which were classified by direct immunofluorescence as belonging to the genus Acanthamoeba (Hartmannella). Six months after keratoplasty the eye was quit without any signs of recurrence. As far as the authors know, this is the first reported case of an amebic keratitis associated with contact lenses. PMID- 6482286 TI - [Fat embolism of retinal arteries following acute pancreatitis]. AB - Fat embolism is well known in traumatic skull fractures, chest compression and long bone fractures. Inkeles and Walsh (1975) first described fat embolism of retinal vessels following acute pancreatitis. Fat embolism of ocular vessels in this disease is presumably due to enzymatic destruction of omental tissue. The patient described here fell ill with acute pancreatitis after years of alcohol abuse; he noticed a considerable deterioration in vision. This was a result of fat embolism of the retinal arteries. Multiple cotton wool spots around the optic nerve and in the macular area, combined with some intraretinal hemorrhages, were seen at ophthalmoscopic examination. The pathogenesis of fat embolism of choroidal and retinal vessels following acute pancreatitis is discussed in brief. PMID- 6482287 TI - [Results of direct coagulation of the ciliary body and cyclodialysis in hemorrhagic glaucoma]. AB - This paper discusses direct coagulation of the ciliary body as a microsurgical method for treatment of hemorrhagic glaucoma. During a follow-up period of 6-12 months intraocular pressure was lowered in all cases from an average of 42.8 mm Hg. Of the 26 patients operated on, 25 were subsequently free of pain. Stabilization of visual acuity was achieved in two-thirds of the cases. The surgical procedure is simple and involves little risk. PMID- 6482288 TI - [Filtering trepano-trabeculectomy with sponge-like scar]. AB - Filtering trepanotrabeculectomy (TTE) is a modification of the operation after J. Fronimopoulos. A triangular scleral flap is created which is approximately one half as thick as the sclera. Trepanation is performed with a 2 mm trephine. The scleral edge of the trepanation opening is heat-cauterized. Filtering TTE was performed on 36 eyes - 17 with glaucoma simplex, 16 with congestive glaucoma, and 3 with secondary glaucoma. Fifty percent of the eyes thus treated had narrow chamber angles. Regulation of IOP was achieved in 96% of the cases. Intraoperative and postoperative complications were rare, with the exception of choroidal detachment (13.8%). The fundamental requirement for regulation of IOP is a well-formed, active filtering bleb, developing as a result of the spongelike scar which is protected by the scleral flap. The scar creates a connection between the anterior chamber and the subconjunctival space. PMID- 6482289 TI - [Laser trabeculoplasty: report on 53 cases]. AB - A report is given of laser-trabeculoplasty in 62 eyes of 53 patients. Results suggest that approximately 25% of eyes were not improved. In the 75% which were improved, the majority needed to carry on with treatment, but approximately 11% of the total were able to stop all treatment. PMID- 6482290 TI - [Independence of retinopathy and optic atrophy in the DIDMOAD syndrome]. AB - A brother and a sister with DIDMOAD syndrome (diabetes insipidus, diabetes mellitus, optic atrophy, deafness, etc.) are described. The 15-year-old girl was suffering from severe optic atrophy, severe sensorineural hearing loss but only slight diabetic retinopathy. The 16-year-old boy presented with symptoms which were the opposite: slight optic atrophy, slight sensorineural hearing loss but severe diabetic retinopathy. These complementary impairments of neuronal and (diabetic) retinal function suggest that optic atrophy and retinopathy develop independently in DIDMOAD syndrome. PMID- 6482292 TI - [ERG and VECP in chronic progressive external ophthalmoplegia]. AB - Eleven patients suffering from chronic progressive external ophthalmoplegia (CPEO) were examined by means of electroretinography (ERG) and the visually evoked cortical potential (VECP) with flash and checkerboard-reversal stimuli. One patient exhibited a Kearns-Sayre syndrome, and in two patients fundoscopy revealed pigmentary retinopathy; the fundi of the other 8 patients were normal. In 3 of the patients with pigmentary retinopathy the ERG was slightly disturbed or normal, the P100 latency in the VECP being normal. In three out of 8 patients without retinal pigmentary changes the ERG indicated retinopathy. In 2 cases this was the only finding offering an explanation for the reduced visual acuity. One patient exhibited a considerably prolonged P100 latency in the pattern-reversal VECP of one eye, which might have been indicative of lesions of the visual pathway associated with CPEO. PMID- 6482291 TI - [Capsulotomy with the diathermy scalpel (2)]. AB - Temperatures were measured with a newly designed bipolar electrode ("Cap-Stamp"). Since the results were satisfactory it was possible to introduce the new method in extracapsular cataract surgery on human. Initial clinical results are reported, the advantages of the new instrument are discussed and the "Cap-Stamp" is compared with conventional instruments. PMID- 6482293 TI - [Use of videoangiography of the retina]. AB - A system is presented with the help of which high-quality visual presentation of fluorescein angiographies is possible. The individual elements of the unit are described (TV camera, light source, adapter for the TV camera, fundus camera, video recorder, video timer). The filming process is less strenuous for the patient than serial angiography since he is no longer dazzled by high-intensity light. The pictures are available immediately after filming, thus eliminating both the cost of developing and the delay involved. The examiner can make picture adjustments during filming. The high degree of resolution of this examination method in proportion to the time required for it makes a precise analysis for the physiological and pathological hemodynamics of the retinal- and choroidal blood vessels possible. PMID- 6482294 TI - [Connatal ptosis: a symptom of the syndrome of multiple pterygium and arthrogryposes]. AB - Report on a 56-year-old female exhibiting features of the multiple pterygium syndrome, e.g., puffiness and ptosis of the upper lids, hypertelorism, pterygium of the metacarpophalangeal joints, hypomobility of joints, short stature, obviously inherited as an autosomal recessive trait. In differential diagnosis distal arthrogryposis has to be considered. It is not known whether the intravitreous hemorrhage from which this patient suffered is associated with the disorder. PMID- 6482295 TI - [Blind spot syndrome in convergent strabismus of the horror-fusionis type]. AB - With reference to a case of convergent squint with early onset it is shown that a blind spot syndrome may develop if - in spite of sensory adaptation to the angle of squint - the patient lacks sufficiently deep suppression and the suppression scotoma is very small. PMID- 6482296 TI - [A case of recurrent hyphema in pseudophakia]. AB - A short time after a cataract operation without complications in which a 4-loop Binkhorst lens was implanted in a 66-year-old patient, recurrent hyphema with subsequent elevation of intraocular pressure occurred. Therapy with pilocarpine was found to be very effective. PMID- 6482297 TI - [Corneal endothelial cell losses following implantation of Simcoe posterior chamber lenses]. AB - Using the Roberts and Koester wide field specular microscope 42 eyes with cataract were examined before and after implantation of Simcoe posterior chamber lenses. A 9.7% loss of endothelial cells was found postoperatively. PMID- 6482298 TI - [Posterior eye changes in pregnancy. Retinal punctate hemorrhage, a specific sign of EPH gestosis?]. AB - The author reports on 6 pregnant women suffering from punctate hemorrhage in either one or both eyes, in each case distal to the optic disk. Spontaneous resorption occurred post partum. This retinal sign may be specific in EPH gestosis. PMID- 6482299 TI - [A new instrument for the injection of silicone oil into the vitreous body]. PMID- 6482300 TI - [Ophthalmological experiences with automobile drivers with inadequate vision]. AB - A total of 369 ophthalmological practices were asked to report the number of patients seen within one test week who drove their cars but did not satisfy minimum legal requirements for diurnal visual acuity applicable for applicants for a West German Class 3 driver's license. There were 471 such patients. From this number it can be calculated that approximately 570 000 individuals (+/- 9%) drive cars in the Federal Republic of Germany with inadequate visual acuity. An analysis of the questionnaire produced the following results: Fifty percent of these patients are less than 62 years of age. The main cause of inadequate visual acuity is age. In younger drivers refractive errors were the prime cause and in most cases correction with glasses was possible. In older drivers the loss of acuity was mainly due to opacities of the lens which for the most part could not be corrected by spectacles. Two-thirds of the drivers with inadequate visual acuity consider their vision to be "sufficient" or "good" for driving; younger drivers are more self-critical than older ones. Only 31% of these drivers stopped driving at night of their own accord. As many as two-thirds of the drivers who consider their acuity to be "insufficient" drive their cars during darkness. The authors show that the findings in patients suffering from severe loss of visual acuity must in principle also be valid for patients with minor visual impairments who still meet the minimum legal requirements. This agrees well with published statistical investigations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482301 TI - [Visual acuity and traffic accidents]. AB - In the first part of the study it was established that professional truck or bus drivers whose central photopic visual acuity in one or both eyes is less than 0.7 differ distinctly from their colleagues with fully adequate or only slightly reduced photopic vision in that they are involved in accidents more frequently (the difference is statistically significant, and in some respects highly significant). This applies in particular to accidents after 15 years' driving (known as late accidents) and accidents of the following types: priority infringements, ramming from behind, turning, and changing lanes. The first hypothesis on which the study was based, namely that accidents become more frequent as central photopic vision deteriorates, was confirmed. The second part of the investigation, which was likewise carried out with license-holders who drove professionally, produced a similar result: Drivers with considerably reduced twilight vision and/or considerably increased susceptibility to glare are more frequently involved in certain accidents at night than those who fully satisfy the minimum requirements for these visual functions. In particular, it was established that almost every fifth professional driver involved in a night time collision with another road user (ramming, side-to-side collisions) has severely diminished twilight vision and that one out of four have increased susceptibility to glare. Thus, the second hypothesis, i.e., that the number of night-time accidents increases as twilight vision deteriorates and the driver's susceptibility to glare increases, seems fully confirmed. PMID- 6482302 TI - [Retinoblastoma--clinical diagnostic errors]. AB - The author discusses clinical and histological findings in 6 patients whose complaints had been wrongly diagnosed, out of 91 patients in whom a retinoblastoma had been diagnosed at the ophthalmo-pathological laboratory of the University Eye hospital in Utrecht between 1960 and 1981. In 6 other cases the diagnosis was doubtful. All the cases occurred before 1974. The faulty diagnoses were: spontaneously necrotized retinoblastoma, congenital anomaly, retinal detachment, infection with toxocara canis, sarcoidosis, and angiomatosis retinae. Three patients are still living. If the diagnosis is not certain a blind eye should be removed without delay. PMID- 6482303 TI - [Risks in heart catheterization and angiocardiography in infancy and childhood]. AB - The results of cardiac catheterization with or without angiocardiography in 689 infants and 1311 children and adolescents were reviewed. In the first week of life 14,81% of the patients died within or after 24 hours of the procedure, 7,41% in the first month of life, 2,78% in the first year. And on the whole the mortality was 0,95%. Four expired after the first month of life and none after the fourth. All those infants who expired were in poor general condition with severe cyanosis and congestive heart failure. PMID- 6482304 TI - [Hemodynamics and histology of the lung in 175 ventricular septal defects]. AB - Lung biopsies obtained during operation from 175 patients with isolated or combined ventricular septal defect were examined histologically. The degree of the pulmonary hypertensive vasculopathy was classified according to the Heath and Edwards-grading. These morphological findings were compared to the hemodynamic data (pulmonary/systemic ratios of systolic pressure, resistance, and flow as well as mean pulmonary artery pressure). Pressure and resistance showed a good correlation to the histological changes. The combination of both variables, however, did not further improve the prediction of the severity of the vascular lesions. No relation was found between flow and pulmonary vasculopathy. Higher grades of the vasculopathy were associated with systolic pressure ratios exceeding at least 0.65, in most patients with even marked higher ratios. On the other hand an elevation of pulmonary blood pressure of pulmonary arterial resistance does not mean a more severe vasculopathy implicitly, since there were some patients with a considerable hemodynamic hypertension without at least severe histological changes. We conclude that patients with a systolic pulmonary pressure not exceeding about 75% of systemic pressure have a very low risk of a morphologically fixed hypertension. Therefore an urgent operation of such patients to prevent fixation of the pulmonary hypertension seems not to be necessary. PMID- 6482305 TI - [Surgical treatment of congenital abnormalities of the right heart]. AB - The surgical treatment of complex congenital malformations of the right heart is described and discussed with regard to the following heart diseases: tetralogy of Fallot (FT), transposition of the great arteries (TGA), tricuspid atresia (TA), single ventricle (SV). The results of the patient material of Goettingen were focused on the right ventricular function. With reference of the FT-correction a residue pulmonary stenosis is considered to be better tolerated than a residual pulmonary insufficiency. The long-term results (observation time from 4 to 17,5 years) proved that the right ventricle (RV)-function can adapt itself to pressure load. Adequate growth to the hypoplastic right ventricle is documented due to right ventricular volume load after operative repair. The Fontan procedure for TA and SV has revealed that the inactivation of the right ventricular pumpunction has not resulted in negative effect on the function of the systemic ventricle, patients clinical conditions and exercise testing have improved. PMID- 6482306 TI - [Short-term-interval stress following corrective operations in tetralogy of Fallot]. AB - 21 clinically asymptomatic children aged 5.5 to 15.5 years were examined by bicycle exercise 1 to 9 years after surgical repair for tetralogy of Fallot. The results were compared to normal values gained from 169 healthy children (10 age groups of girls and boys). Submaximal exercise testing was performed in three stages of 1, 2 and 3 Watts per kg body weight, followed by 2 minutes of recovery. The following results were gained: 7 of the 21 patients showed rhythm disturbances during the exercise testing. Only three of them had documented arrhythmias before this date. Another 3 children with normal exercise test had arrhythmias in their former history. Thus total incidence of documented arrhythmias is 48 percent in contrast to only 1.2 percent in the control group. Using this weight related exercise test the heart rates of the patients were significantly lower during exercise than those of the control group. The differences are most evident during the maximal exercise period. The ability of LVET-shortening with increasing heart rates was significantly reduced in the patients. PEP was significantly prolonged. Both phenomena lead to a relatively shorter diastole than in normal subjects. This must result in a hemodynamical disturbance under the conditions of high frequencies. Blood pressure monitoring is not very valuable for the interpretation of hemodynamic changes. There are signs of alterations of hemodynamics as well as of the heart rhythm in the patients after surgical repair for the tetralogy of Fallot, even if the patients feel very well. By short time submaximal exercise testing it is possible to detect these alterations. PMID- 6482307 TI - [Mucoviscidosis screening by determination of immunoreactive trypsin]. AB - Immunoreactive trypsin (IRT) was measured radioimmunologically in samples of blood dried on filterpaper of 18 417 newborns. In 221 samples (1.2%) the concentration exceeded 80 ng/ml whole blood. In these cases we asked for a further sample of blood dried on filterpaper and for further clinical tests. Cystic fibrosis (CF) was confirmed in three babies, one of these died from meconium ileus. The IRT-concentrations did not drop significantly in 4 and 6 weeks respectively in the 2 patients, whereas this was the case in 192 babies without CF. Our data suggest that the determination of IRT may be developed into a highly specific screening method for CF provided that optimal reagents are selected and that blood is collected during the 4th or 5th week of life. PMID- 6482308 TI - [Abstracts of the 10th Symposium on Pediatric Intensive Care, 26-28 April 1984, Berlin]. PMID- 6482309 TI - [Parathyroid carcinoma]. AB - The parathyroid carcinoma is a rare cause of primary hyperparathyroidism. It deserves special attention in regard to diagnosis and treatment. Within a period of 10 years we observed 117 patients with primary hyperparathyroidism (pHPT) at the University Hospitals of Ulm and Heidelberg. In five patients a parathyroid carcinoma was found, corresponding to an incidence of 4.4%. In four of five patients no clinical signs were evident preoperatively indicating a parathyroid malignancy. PMID- 6482310 TI - Renal glycosuria in patients with the nephrotic syndrome. AB - Transient or persistent renal glycosuria may occur in patients with the nephrotic syndrome. In an attempt to elucidate its mechanism, glucose titration experiments were performed in 20 nephrotic patients. The type A titration curve was found in one and type B in four patients with severe organic changes and low glomerular filtration rate. The remaining subjects displayed a particular type of curve (type C) characterized by a low point of splay but an otherwise almost physiological tracing. In type B and C patients the maximal rate of reabsorption per ml glomerular filtrate (TmG/GFR) was significantly increased and correlated inversely with the filtration fraction. In these patients the point of splay correlated with the glomerular filtration rate and the sodium clearance, but not with the plasma albumin concentration or the rate of proteinuria. These observations suggest that type A was due to diffuse tubular atrophy, and type B to increased nephron heterogeneity resulting from chronic organic changes. Type C was presumably caused by a potentially reversible alteration of the late proximal or distal glucose transport related to the nephrotic syndrome itself. PMID- 6482311 TI - Effect of cimetidine on the hepatic extraction of indocyanine green, the portal pressure and the systemic circulation in patients with cirrhosis of the liver. AB - The effect of cimetidine on hepatic and systemic haemodynamic parameters was studied in seven patients with portal hypertension due to alcohol-induced cirrhosis of the liver and in one patient with peliosis hepatis following oral contraceptive steroids. The intravenous administration of cimetidine (350 mg as bolus, followed by 2 mg/min over 60 min) reduced the hepatic extraction of continuously infused indocyanine green (ICG) by 27%; this was statistically significant (P less than 0.01). Since the ICG clearance, calculated independently of hepatic perfusion, was lowered by 19%, this effect seems to be mainly due to a reduced capacity of the liver to remove the dye from the blood, rather than due to changes in perfusion. Cimetidine did not influence the elevated portal pressure in the patients with cirrhosis, or the normal pressure in the patient with peliosis hepatis. No significant effect was observed on heart rate, mean arterial pressure, pulmonary artery pressure, pulmonary capillary pressure and cardiac output. These studies indicate that the reduction of the hepatic ICG extraction following cimetidine is more the result of an inhibited capacity of the liver to remove the dye than of changes in the hepatic perfusion or in the systemic circulation. PMID- 6482312 TI - Disposition of oxazepam in patients on maintenance hemodialysis. AB - The pharmacokinetics of a single 30-mg oral dose of oxazepam was evaluated in seven patients with chronic renal failure on maintenance hemodialysis and in seven healthy controls matched for age and sex. Based on total (free plus bound) serum oxazepam concentrations, elimination half-life was prolonged in renal patients compared to controls (22 vs 8 h, p less than 0.001) and volume of distribution increased (3.0 vs 1.4 1/kg, p less than 0.02). However, total clearance was similar between groups (1.8 vs 1.9 ml/min per kilogram). These findings were confounded by the increased oxazepam free fraction in serum of renal failure patients (10.3%) as compared to healthy controls (4.3%). Correction for differences in binding indicates similar distribution of unbound oxazepam between groups, but reduced clearance of pharmacologically active unbound oxazepam in renal patients (18 vs 45 ml/min per kilogram). Oxazepam dosage, therefore, may require downward adjustment for renal failure patients on hemodialysis. PMID- 6482313 TI - Different synovial fluid fibronectin levels in rheumatoid variants. AB - A circulating high-molecular-weight glycoprotein called fibronectin plays a part in cell adhesion and migration before phagocytosis and in morphology, differentiation, and metabolism in inflammatory synovial effusions of patients with rheumatic diseases. A technique of nephelometric immunoassay, based on the measurement of an antigen-antibody reaction, was applied to the analysis of fibronectin concentrations in synovial fluids from 20 patients with rheumatoid arthritis (RA) and other diseases (non-RA). RA synovial fluids have a significantly higher concentration than the specimens obtained from Yersinia arthritis patients (n = 12). The mean concentration of other synovial fluids, from 12 patients with osteoarthritis of the knees, did not significantly differ from the synovial fluids of control values obtained from patients who underwent meniscectomy. There was a considerably negative correlation between fibronectin levels and overall indices of inflammatory activity, such as Ritchie articular indices or a whole number of painful rheumatoid arthritis joints. However, a particularly distinct correlation was obtained when raised fibronectin levels were compared with the inflammatory activity of the knee joint, from which the specimen was aspirated. Thus, these findings suggest that the measurements of fibronectin in synovial fluid may be of some differential-diagnostic value in rheumatoid variants, but may only serve as an indicator of inflammatory activity if the joint, from which the specimen is obtained, is taken into account. PMID- 6482314 TI - Effect of pacing duration on right ventricular effective refractory period in man. AB - This study was performed to assess the dependence of the effect of the duration of stimulation on the effective refractory period (ERP). ERP was determined in 12 patients after four consecutive stimuli as well as after continuous stimulation for 1 min applying a constant stimuli interval of 600 msec. After 1 min stimulation all patients showed a significant (P less than 0.01) decrease of the ERP with 236 +/- 23 SD msec in comparison to the ERP of 271 +/- 26 SD msec after four consecutive stimuli. Although it is well established that ERP depends on the previous cycle length, it is additionally influenced by the stimulation duration, as shown in this study. This must be considered when ERP or other electrophysiological parameters of the right ventricle are investigated. PMID- 6482315 TI - [Comparison of various methods for determining glycosylated hemoglobins]. AB - Determination of glycosilated haemoglobin (HbA1) has become an important parameter for the control of diabetes mellitus. Although several methods are available today, some are time consuming and complicated and may lead to differing results. Two methods, the thiobarbituric-acid (TBA) method and microcolumn chromatography, were compared with the reference method, high performance liquid chromatography (HPLC), with respect to precision, accuracy and practicability. Seventy different blood samples from diabetics were analysed. Using the TBA method, good results were achieved which were generally consistent with those of the reference method (r = 0.90); there were no significant differences in values determined with the two methods. However, the TBA method requires an inordinate amount of work. Microcolumn chromatography is better suited to the needs of physicians in private practice. Results with this method also correlate well with those of the reference method (r = 0.92) when the labile aldimine fraction has been removed by dialysis of the sample. Quality control can be performed using either lyophilized or deep-frozen control samples. PMID- 6482316 TI - [Food allergy and other adverse reactions caused by food]. AB - Adverse reactions to foods are not infrequent. They may be mediated by immunological mechanisms (food allergy) or non-immunologically (idiosyncrasy, pseudo-allergy, intolerance). Furthermore toxic effects of foods have to be clearly distinguished from food allergy as well as poorly defined conditions such as hyperkinesis or "tension-fatigue syndrome", the causal relation of which to foods is not well established. The diagnosis of food allergy includes convincing history, positive provocation and demonstration of immunological sensitization (mostly IgE, however other types of immune reactions may also be of importance. In the treatment of food allergy specific elimination diets as well as pharmacotherapy with the use of mast cell blocking agents are recommended. In single cases oral hyposensitization may be tried. PMID- 6482317 TI - [Cutaneous nodular Kaposi sarcoma following kidney transplantation and immunosuppression]. AB - Five months after renal transplantation and an immunosuppressive trial with azathioprine and methylprednisolone, a black African female developed a cutaneo nodular Kaposi's sarcoma that occurred symmetrically on the lower legs, thighs and forearms. Intensive search for visceral involvement was negative. Histologically, the nodes consisted of spindle cells; there were many new vessel formations with proliferation of atypical endothelial cells. After therapy with cytostatica and x-rays there was a time-limited disappearance of the Kaposi's sarcoma; 1 year later a relapse developed on the left lower leg. Field radiotherapy with accelerated electrons in a single dose of 8 Gy was successful. There is a greater incidence, in the literature, of Kaposi's sarcoma in immunosuppressed patients with organ transplants. Treatment with immunosuppressive substances is probably significant in the development of the Kaposi's sarcoma in those patients. PMID- 6482318 TI - [Thrombocyte function and plasma coagulation following poisoning with organophosphates]. AB - In nine patients suffering from organophosphate intoxication, platelet function and blood coagulation parameters were investigated. Thrombocyte function was impaired in all patients, characterized by a diminished platelet shape change. Platelet shape change was also inhibited in rats and after oral administration of 10 mg/kg parathion. Thrombocytopenia and coagulation abnormalities (diminished fibrinogen, plasminogen and anti-thrombin III) were more pronounced in cases with severe intoxication. In five of nine patients a marked bleeding tendency was observed. The bleeding tendency in organophosphate intoxication is probably mainly caused by the defective platelet function. Patients with this intoxication should receive heparin only for special indications; haemoperfusion is of doubtful value since this procedure may itself produce haemostatic defects. PMID- 6482319 TI - [Age-dependent accumulation of lead in teeth]. AB - Teeth from people aged 5-73 years old, who differ in their occupational type of exposure to lead and who live in different areas of Dortmund, were collected in 1980/81 and were investigated by means of flameless atomic absorption spectrometry. The major result obtained from the 163 permanent and 22 deciduous teeth studied was a statistically significant dependence of the lead content of the permanent teeth on the donor's age. This was superior to all other influences, showing an increase of 3.4% per year of life. There were no sex specific differences, and no correlations with height and body weight were found. To find different lead concentrations within samples of teeth of various living areas and various occupational types of exposure would have required more variation in these variables than was available in the population of our study. It must be emphasized that the reliability of the measured values of dental-lead concentration greatly depends upon the methodical and analytical procedures used, especially because of the overall lead contamination. The analytical method we finally used is described. The factors which influence the dental lead concentration are discussed. The investigation of whole teeth is tolerable. The age-dependent values of the lead content of teeth could be a useful indicator of the overall lead uptake especially in continuous low level lead exposure. Under the conditions described, at least 150 permanent teeth are needed to compare samples of different regions or periods. PMID- 6482321 TI - Influence of nicotine on N-nitrosomethylurea-induced mammary tumors in rats. AB - The possible influence of nicotine tartrate on carcinogenesis induced by N Nitrosomethylurea (NMU) in the mammary gland of female Sprague-Dawley rats was investigated. NMU given i.v. at a single dose of 50 mg/kg on day 52 induced a 100% yield of mammary tumors. Additional subcutaneous administration of individual doses of 0.5 mg/kg of nicotine on days 46-52 and 55-145 (twice a week), respectively, did not modify the NMU-induced carcinogenesis. No further tumors developed in untreated and nicotine-treated animals, thus giving no evidence that nicotine can influence chemical-induced tumors. PMID- 6482320 TI - [Anti-HBc IgM in acute and chronic hepatitis B virus infection]. AB - Hepatitis B core antigen (HBcAg) synthesized in E. coli was used for determination of immunoglobulin M class-specific antibodies against HBcAg. It was found that 98% of cases with acute hepatitis B surface antigen (HBsAg) positive hepatitis type B were anti-HBc immunoglobulin M (IgM) positive. Atypical hepatitis B was detected in 33% of anti-HBc-positive HBsAg-negative cases with acute hepatitis. Anti-HBc IgM was positive for 6 months in acute resolving hepatitis type B, whereas cases resulting in chronic hepatitis B remained anti HBc IgM-positive for up to 900 days. Chronic HBsAg carriers with severe liver disease had anti-HBc IgM more often than individuals with minor liver damage; 83% of HBsAg-positive liver cirrhoses, 63% of chronic aggressive hepatitis, 50% of HBsAg-positive liver carcinoma, but only 17% of chronic persistent hepatitis or 7% of healthy blood donors were anti-HBc IgM-positive. Determination of anti-HBc IgM is useful in detecting atypical hepatitis B virus infections without HBsAg in serum and, with some restrictions, in discriminating acute and chronic hepatitis type B. PMID- 6482322 TI - Vasopressor systems during smoking in humans. AB - In this study we correlated the effects of cigarette smoking on the activity of vasopressor systems in humans with changes in heart rate and blood pressure and compared them with changes observed after physical exercise or graded norepinephrine infusion. No relationship was established between changes in either plasma angiotensin II or vasopressin concentration and the hemodynamic parameters, although there was a small increase in both hormones during smoking. In contrast, heart rate (r = -0.245, p less than 0.01, n = 136) was negatively related to plasma norepinephrine concentration during the smoking of five cigarettes. A comparable, negative correlation, although much closer, was found during graded norepinephrine infusion between heart rate and norepinephrine concentration (r = -0.682, p less than 0.001), whereas both parameters were positively related under conditions of physical exercise (r = 0.866, p less than 0.001). In an attempt to block the assumed nicotine-induced sympathetic stimulation, smoking experiments were carried out after acute beta blockade (200 mg metoprolol orally). There was a parallel shift of heart rate and blood pressure to lower values. However, beta blockade did not abolish the smoking induced rise in blood pressure and heart rate. At the present time no direct evidence is available for a nicotine-induced increase of norepinephrine concentration at postsynaptic receptors during smoking in humans.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482323 TI - Influence of smoking on the plasma lipoprotein profile. AB - Smoking and hypercholesterolemia, or more specifically hyper-beta lipoproteinemia, are well established risk factors for the early development of atherosclerotic disease. The presence of both factors augments the potential risk. The question arises, therefore, as to whether cigarette smoking has a direct effect on the plasma lipoproteins and, in particular, on the atherogenetic low density lipoproteins. In this study, the influence of cigarette smoking on the lipoprotein profile was investigated in a defined cohort of 6,543 male industrial workers aged 40-59 years, consisting of 2,434 smokers and 3,975 non smokers. The effect of smoking on the lipoprotein profile showed no significant changes in LDL and only slight changes in the other lipoprotein fractions. Other factors, such as alcohol intake, body weight, and general life style seem to have a greater influence on HDL-cholesterol than smoking. It is concluded that smoking does not significantly alter lipid metabolism and that minor differences observed between smokers and non-smokers are due to a variety of factors, rather than a reflection of a direct metabolic relationship. PMID- 6482324 TI - Influence of smoking on cellular lipid metabolism. AB - Smoking and hyper-beta-lipoproteinemia, are well-established risk factors for the early development of atherosclerotic disease. The presence of both factors augments the potential risk. Since the influence of smoking on the plasma lipoprotein profile in humans seems to be either absent or minor, we were interested in whether cigarette smoking develops a direct influence on lipid metabolism at the cellular level. Our findings showed that smoking has no effect on either the high affinity LDL receptor activity or on the activity of HMG-CoA reductase, acid lipase, or cholesterol ester hydrolase. PMID- 6482325 TI - HDL phosphatidyl choline and cigarette smoking. AB - The influence of cigarette smoking on the concentration of HDL phosphatidyl choline was tested in 1,546 male and 778 female employees in Westfalia, and the results were compared with the influence of cigarette smoking on the concentration of HDL cholesterol. Three subgroups were established for comparison: non-smokers = persons who had never smoked; ex-smokers = persons who had in the past been smokers but were now non-smokers; and smokers = persons who at present smoked cigarettes. Neither male nor female smokers proved to have different HDL phosphatidyl choline values when compared to non-smokers or ex smokers, whereas male and female smokers were found to have decreased HDL cholesterol values when compared to non-smokers (p less than 0.01) or ex-smokers (p less than 0.05). In female smokers a correlation was found between HDL phosphatidyl choline values and the number of cigarettes smoked every day (r = 0.12, p less than 0.05). PMID- 6482326 TI - Acute influence of smoking on plasma lipoproteins. AB - This study was designed to investigate acute effects of smoking on plasma lipoproteins. Twelve fasting smokers inhaled the smoke of two cigarettes. Blood samples were taken before and 30 min after smoking. Triglycerides decreased in plasma from 136.8 +/- 39.8 to 108.0 +/- 34.9, in VLDL from 79.8 +/- 31.4 to 58.4 +/- 28.5 mg%. Cholesterol fell in HDL3 from 29.9 +/- 5.0 to 26.6 +/- 5.8 mg%. Determination of HDL-cholesterol with the phosphotungstic acid precipitation method revealed a reduction from 45.7 +/- 10.2 to 40.3 +/- 11.1 mg% after smoking. All C-apoproteins decreased in VLDL as an entity. Apoprotein A-I was diminished in plasma from 137.5 +/- 23.1 to 118.2 +/- 25.4, and in HDL3, from 97.1 +/- 12.1 to 85.0 +/- 13.1, apoprotein A-II in plasma from 28.6 +/- 8.9 to 24.7 +/- 6.9 and in HDL3 from 21.1 +/- 8.4 to 17.4 +/- 5.7 mg%. Zonal ultracentrifugation of D less than 1.063 g/ml lipoproteins confirmed the influence of smoking on VLDL. In LDL, an increase in cholesterol esters, mainly cholesterol linoleate, from 57.3 +/- 30.2 to 67.4 +/- 25.9 mg% was observed after smoking. The HDL2 subclass was shifted toward a slightly lighter hydrated density, but the major effect of smoking was seen in HDL3. Total cholesterol decreased from 30.5 +/- 7.3 to 22.3 +/- 6.6 mg%, due to a fall of all major cholesterol esters from 23.7 +/- 7.2 to 15.8 +/- 6.9 mg%. HDL3-phospholipids were reduced from 74.9 +/- 37.0 to 46.0 +/- 23.9 mg%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482327 TI - Development of specific tolerance to nicotine infusions in dogs on chronic nicotine treatment. AB - Chronic smoking in humans and continuous nicotine application in animals do not induce hypertension, although the acute effects of nicotine are sympathoadrenal activation and elevation of blood pressure. In conscious dogs with a carotid artery loop preparation, we studied whether chronic nicotine application induced tolerance to the acute effects of nicotine test infusions. Nicotine was applied as salicylate via subcutaneously implanted osmotic minipumps at a dosage of 1 microgram/kg/min = 1.44 mg/kg/day, corresponding to heavy smoking in humans. Chronic treatment in eight dogs for 5-8 weeks did not modify resting heart rate and plasma levels of free catecholamines, but significantly increased plasma levels of conjugated dopamine by 100%. Mean arterial pressure at rest was elevated in the 2nd week by 6mm Hg, but did not increase further. Sham treatment (n = 8, sodium salicylate in equivalent dosage) was without effect. Acute test infusions of nicotine (3 and 10 micrograms/kg/min i.v.) caused acute rises in mean arterial pressure (by 12 and 28 mm Hg), heart rate (by 9 and 18 bpm), plasma norepinephrine (by 36 and 68%), plasma epinephrine (by 110 and 180%) and led to plasma nicotine levels of 31 and 95 ng/ml. Chronic nicotine treatment attenuated the hemodynamic and partially abolished the hormonal effects without affecting the nicotine plasma levels obtained with these test infusions, but it did not modify the hemodynamic effects of a norepinephrine test infusion. The data demonstrate the development of a specific, reversible tolerance to the acute sympathoadrenal activation by nicotine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482328 TI - Acute effects of nicotine on hemodynamic and metabolic parameters of isolated, perfused hearts of guinea pigs and rats. AB - Nicotine infused in concentrations greater than 10(-6) M exerted a dose-dependent negative inotropic effect on isolated, perfused hearts of guinea pigs (Langendorff and working heart preparations). This effect became manifest after an initial positive inotropic and positive chronotropic response had subsided. Furthermore, the stimulation of cardiac contractility by norepinephrine (concentration less than 10(-7) M) was attenuated by nicotine in the guinea pig heart, but not in isolated, perfused hearts of Sprague-Dawley rats. Nicotine inhibited the positive inotropic effect of catecholamines according to the order norepinephrine greater than epinephrine greater than isoproterenol. In no case did nicotine have a marked negative chronotropic action. Changes in coronary flow, oxygen consumption, and the release of lactate and adenosine were in keeping with the state of myocardial activity in the presence of nicotine. The drug did not significantly alter myocardial uptake or release of norepinephrine during expression of its negative inotropic action. Prazosin, phentolamine, cocaine, and hexamethonium suppressed both the nicotine-induced transient stimulatory response and the negative inotropic effect in norepinephrine stimulated hearts. In the presence of theophylline and at high perfusate calcium levels (7.5 mEqu/l) the negative inotropic effect was alleviated. The cardiodepressive action of nicotine may possibly evolve from a weak blockade of beta 1-adrenoceptors. Direct modifications of myocardial Ca2+-transport could not be observed. PMID- 6482329 TI - Compartmentation and hemodynamic effects of nicotine in isolated, perfused guinea pig hearts. AB - Tachyphylaxis with respect to the positive inotropic and positive chronotropic effects of nicotine in isolated perfused hearts of guinea pigs was found to persist for 3 and 10 min, respectively, after discontinuation of intracoronary infusion of nicotine (5 X 10(-5) M). The longer duration of chronotropic tachyphylaxis correlated with a slower release of nicotine from the tissue of the right atrium in comparison to the washout from the ventricular myocardium. A similar disparity in washout between atrial and ventricular tissue was found for inulin. Thus, greater perfusion of the ventricular tissue, not a difference in affinity for nicotine, seems to account for the more rapid recovery of the inotropic response to nicotine. The apparent volume of distribution of nicotine in both atrial and ventricular myocardium was about 2 ml/g wet weight; uptake and release of nicotine was rapid. Kinetic analyses of coronary venous washout yielded four components, indicating that nicotine is distributed in at least four (kinetically defined) compartments within the ventricular myocardium. Washout from the largest tissue compartment was controlled by the rate of perfusion of the vascular space, as demonstrated by comparison with washout of erythrocytes, inulin, sucrose, and urea from the heart. Hexamethonium reduced the nicotine content of this fast-emptying compartment from 85-57 nmol/g (prelabeling concentration of nicotine 5 X 10(-5) M), giving an upper estimate for the number of specific nicotine binding sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482330 TI - [Clinical significance of determining lactate and malate dehydrogenase isoenzymes and hepatic ultrastructure in acute liver failure]. PMID- 6482331 TI - [Basic indices of intragastric pH measurement and basis for the atropine test]. PMID- 6482332 TI - [Unrecognized ulcer of the stomach and duodenum]. PMID- 6482333 TI - [Combined fluorographic and electro-x-ray studies in the detection of chronic nonspecific lung diseases in outpatients]. PMID- 6482334 TI - [Hypercholesterolemic xanthomatosis]. PMID- 6482335 TI - [Diagnosis of Peutz-Jeghers syndrome]. PMID- 6482336 TI - [Case of severe allergic reaction to manilyl]. PMID- 6482337 TI - [Long-term remission of leukoencephalitis during treatment with imuran]. PMID- 6482338 TI - [Development of an obstructive syndrome in bronchial asthma patients treated with non-steroidal anti-inflammatory agents]. PMID- 6482339 TI - [Various clinical and organizational aspects of the work of a therapeutist]. PMID- 6482340 TI - [Blood clotting factors and cerebral hemodynamics at the initial signs of cerebral circulatory disorders]. PMID- 6482341 TI - [New methods of immunocorrective therapy of various diseases of the internal organs]. PMID- 6482342 TI - [Thromboembolic complications of bioprosthesis of the mitral valve of the heart]. PMID- 6482343 TI - [Role of x-rays of the organs of the thoracic cavity in studying the hemodynamics of pulmonary circulation in ischemic heart disease]. PMID- 6482344 TI - [Long-term anticoagulant therapy in acute iliaco-femoral venous thrombosis]. PMID- 6482345 TI - [Rheology of the blood and thrombosis of the major arteries of the extremities]. PMID- 6482346 TI - [Thromboembolic complications in glomerulonephritis]. PMID- 6482347 TI - [Role of lesions of the renal tubules and insterstices in the progression of renal failure]. PMID- 6482348 TI - [Acute disorders of cerebral circulation in food poisoning]. PMID- 6482349 TI - [Significance of indices of plasma osmolarity in clinical practice]. PMID- 6482350 TI - [Informative value of the erythrocyte sedimentation rate]. PMID- 6482351 TI - [Hemorrhagic syndrome in acute leukemia]. PMID- 6482352 TI - [Isolated irradiation of the blood in rheumatoid arthritis]. PMID- 6482353 TI - [Analysis of physicians' errors in the practice of oncology]. PMID- 6482354 TI - [Permanent single-loop ileostomy after removal of the large intestine for diffuse polyposis]. PMID- 6482355 TI - [Combined colonoscopic and radiometric diagnosis of recurrences of cancer of the large intestine]. PMID- 6482356 TI - [Value of determining several biochemical indices, indices of the blood clotting system and microelement levels in the evaluating the severity of viral hepatitis]. PMID- 6482357 TI - [Various possibilities for using computer dialogs in biomedical research]. AB - Problems involved in the development of interaction software for biomedical investigations and in the preparation of experimenters for using a computer in the interactive mode are discussed. An interaction program for data analysis is suggested. The program is used to build an interactive modification that makes it possible to carry out a computer-aided verification of the mechanisms of erythropoiesis regulation in space flight. It is shown that a simple interactive terminal facility can be employed in the software of biomedical investigations, taking into account changes in the requirements placed by users and their experience of computer interaction. PMID- 6482358 TI - [Compensatory-adaptive reactions of regional hemodynamics to weightlessness during a long space flight]. AB - This paper discusses regional hemodynamics and vascular regulation during and after space flights of over 3 months in duration. Mechanisms of cardiovascular adaptation to weightlessness are described. The postflight differences in the recovery of regional hemodynamics seem to depend on the individual characteristics, age-related changes of the cardiovascular system, as well as the countermeasures and rehabilitation measures performed during and after flight. PMID- 6482359 TI - [Features of the functional capabilities of the bodies of older persons exposed to simulated space flight factors]. AB - In response to simulated space flights cardiovascular and metabolic changes of 86 volunteers, aged 40-49 and 50-56, were similar to those of young people (25-39 years old). In most aged test subjects, the changes produced by 8-day head-down tilt (-8 degrees) and 7-day water immersion were moderate and reversible. This type of variation of the adaptive-compensatory reactions give evidence that aged people have sufficiently high functional capabilities. Nevertheless, 36% test subjects, aged 40-49, and 50% test subjects, aged 50-56, displayed certain features suggesting a reduction of the adaptive-compensatory capabilities (functional reserves) as a result of age-related and atherosclerotic changes of the cardiovascular system. PMID- 6482361 TI - [Effect of space flight factors on bone marrow cells in the rat]. AB - The effect of space flight factors, weightlessness in particular, on the genetic structures of bone marrow cells of rats flown for 18.5 days on Cosmos-1129 was investigated. Chromosome aberrations were measured on postflight days 6 and 25. The frequency of unstable chromosome aberrations was similar in the flight, synchronous and vivarium rats. Karyotyping of metaphase plates revealed chromosome aberrations in the flight and synchronous rats. Exposure to weightlessness did not influence the mutagenic effect in bone marrow cells of the rats. PMID- 6482360 TI - [Effect of water-salt dietary supplements on tolerance to head-pelvis acceleration after 7 days of "dry" immersion and during normal motor activity]. AB - The effect of water-salt supplements as an agent increasing human tolerance to head-to-feet acceleration with a slow onset was examined. The test subjects were rotated in a 7.25 m arm centrifuge after 7-day dry immersion or normal motor activity. The water-salt supplements were given at a dose of 0.15 g NaCl and 18 ml water per kg body weight (with the total daily dose consumed in four fractions). During immersion fluid retention was significantly higher than during normal activity (818 +/- 139.7 ml versus 478 +/- 69 ml). Water-salt supplements consumed produced a positive effect on tolerance to head-to-feet acceleration. During centrifugation after water-salt supplementation the physiological responses were less strained. Water-salt supplements taken on the last immersion day increased the tolerance level as compared to the control. The amount of the fluid retained in the body was found to be inversely proportional to the tolerance level. It is concluded that water-salt supplements may be recommended to increase tolerance to head-to-feet acceleration in aerospace medicine. PMID- 6482362 TI - [Dynamics of several indices of carbohydrate and lipid metabolism during the period of readaptation after prolonged restriction of movement]. AB - Eighty-seven white rats were exposed to prolonged hypokinesia. On 90th hypokinesia day the content of cholesterol, free fatty acids and acetone bodies increased and the content of sugar and triglycerides decreased in blood, the content of glycogen decreased and the content of cholesterol increased in liver and skeletal muscles. On the 15th day after exposure most parameters returned to normal. However, glucose-6-phosphate dehydrogenase in liver and adipose tissue increased and remained elevated till recovery day 60. On the 30th recovery day the changes were similar to those during hypokinesia. On the 90th recovery day the content of triglycerides, cholesterol and acetone bodies in blood grew and the content of triglycerides and glycogen in muscles increased. PMID- 6482363 TI - [Bile-forming function of the liver in the white rat]. AB - White male rats were exposed to hypokinesia of 4 to 30 days in duration. The exposure led to a moderate hypersecretion of gall which was more distinct in autumn and winter. The synthesis and secretion of gallic acid increased. The excretion of cholesterol also grew. The ratio of tauro- and glycoacids shifted in favor of the latter. The cholate cholesterol coefficient increased. These changes in gall formation during hypokinesia are closely related to disorders in lipid and carbohydrate metabolism, as well as in adrenal function. PMID- 6482364 TI - [Response of the ventricular system of the brain to anti-orthostasis and occlusion of the jugular veins]. AB - Twenty test subjects were subdivided into two groups with respect to the reactions of brain ventricles to a preliminary head-down test (-30 degrees). Group 1 consisted of subjects who showed ventricular enlargement, headache and nausea; Group 2 included subjects without these reactions. The test subjects were also exposed to tests with neck vein occlusion. The first (continuous) test was performed at +40 mm Hg for 5 min; the second (step) test was carried out from +10 to +50 mm Hg for 2 min at each step. The results obtained demonstrate that an inadequate venous outflow from the cranial cavity influences brain ventricles; the data also give evidence that changes in compensatory mechanisms can be detected using occlusion tests. PMID- 6482365 TI - [Effect of hyperoxia and increased environmental gas density on the contractile function of the right of the heart]. AB - Rheocardiography, phonocardiography, and electrocardiography were used to investigate right ventricle function of 16 test subjects exposed to various gas atmospheres under increased pressure. During short-term exposures the adverse effect of an increased pressure on the contractile function of the right ventricle grew in the following order: hyperoxia--normoxic nitrogen-oxygen atmosphere--compressed air. PMID- 6482366 TI - [Changes in the energetics of muscle contraction as a result of hyperoxia]. AB - Using a highly sensitive thermometric method (1 X 10(-5) degrees C/mm), it was found that the heat production of a single isometric contraction of an isolated diaphragm of the rats exposed to 99% O2 at normal pressure for 3 and 6 hrs significantly differed from the norm: after 3 hr hyperoxygenation muscle heat production increased almost three-fold, and after 6 hr hyperoxygenation it decreased almost two-fold. The increase is regarded as a result of oxygen potentiated increase of energy expenditures involved in a contraction and of a decrease of the performance of muscle contraction. The decrease is considered as a consequence of the primary in economical energy expenditures by an intensively working muscle represented by the diaphragm and of a reduced viability of the muscle preparation incubated in vitro. PMID- 6482367 TI - [Hemo- and neurodynamics of the human brain during exposure to moderate hypoxic hypoxia]. AB - Synchronous electro- and rheoencephalography were used to study tolerance to moderate hypoxic hypoxia for 30 min at an altitude of 5000 m without additional oxygen supply. As test subject, men with autonomic-vascular dystonia (29-39 years old), 15 men over 40 (41-56 years old), and 16 essentially healthy controls (23 36 years old) were used. The aged volunteers (41-56 years old) did not differ from the controls with respect to their tolerance to hypoxic hypoxia. The men with early symptoms of hypertonic-type dystonia also showed high tolerance to hypoxic hypoxia. The subjects with hypotonic-type dystonia displayed lower tolerance. PMID- 6482368 TI - Multiagent chemotherapy for children with advanced neuroblastoma. A comparison of high-dose cyclophosphamide, vincristine and adriamycin therapy with James' therapy plus adriamycin. PMID- 6482369 TI - Use of a gadolinium filter on an X-ray contrast examination. PMID- 6482370 TI - Intracranial pressure in a case of isolated fourth ventricle. PMID- 6482371 TI - Four cases of frontal encephalomeningocele in neonates. PMID- 6482372 TI - Cardiovascular effect of electro-acupuncture. PMID- 6482373 TI - Diagnostic exercise. Mange due to Sarcoptes scabiei. PMID- 6482374 TI - A comparison of chromium-51 and iron-59 for estimating erythrocyte survival in the cat. AB - Erythrocyte survival studies were conducted on eight, normal, healthy, 1-year-old male specific-pathogen-free cats using both chromium-51 and iron-59 simultaneously. The chromium-51 procedure gave a half-life value of 11.1 +/- 0.9 days. This was considerably lower than would be expected on the basis of the experimentally determined iron-59 erythrocyte survival time of 51.2 +/- 14.9 days. The results of this study indicated that there was considerable loss of the chromium-51 label in the cat other than that from senescence alone. An analysis of the chromium-51 disappearance curve indicated that there were two exponential disappearance rates for the chromium-51 label and, in the absence of cell death, approximately 67% of the label was lost with a rate constant of 0.02 per day and 33% was lost with a rate constant of 0.1 per day. An equation is presented which models the loss of chromium-51 label which could be used to calculate erythrocyte survival from a chromium-51 disappearance curve. Blood volume measurements, hemograms, bone marrow differential results, and iron kinetic values also were determined and the results presented. While a reasonable approximation of the erythrocyte life span could be made by correcting the chromium-51 values for losses other than senescence, the iron-59 procedure would be the preferred method in cats. PMID- 6482375 TI - Lung volume and compliance in neonatal rats. AB - Lung volumes and static lung compliance were measured in decapitated three day old neonatal Long Evans' rat pups. Compliance was measured in situ (open chest method) using a water manometer and syringe system. Mean total lung capacity at 20 cm H2O pressure (TLC20) was 0.678 ml. Minimum lung volume after experimental inflation was 0.197 +/- 0.048 ml, and vital capacity was 0.56 ml (Vmax20). The mean lung compliance value for the approximate tidal loop (between 3 and 12 cm H2O) equalled 26.2 microliters air/cm H2O for the inflation limb and 23.1 microliters/cm H2O for the deflation limb. PMID- 6482376 TI - Characterization of spontaneous amyloidosis of Syrian hamsters using the potassium permanganate method. AB - Amyloid from 16 Syrian hamsters with spontaneous age-related systemic amyloidosis retained affinity for Congo red dye after treatment with potassium permanganate. Serum electrophoresis showed a slight rise in gamma globulins without a monoclonal spike. Bence-Jones proteins were not present in the urine. There was no histological evidence of plasmacytosis. Amyloidosis could not be associated with chronic inflammation. The lack of apparent etiology of this amyloid and its resistance to potassium permanganate treatment suggests that it is a primary non AA amyloid. This finding varies with a report suggesting that the spontaneous amyloidosis of aged Syrian hamsters is associated with the AA fibril. PMID- 6482377 TI - Atropine esterase status of laboratory mice. AB - Fifty eight inbred strains of laboratory mice and two species of wild mice [Mus castaneus (inbred) and Peromyscus maniculatus bairdii (closed colony)] were tested for the presence of atropine esterase by the microhematocrit tube test of Tucker and Beattie. The results show clearly that laboratory mice do not have significant levels of atropine esterase as determined either by the microhematocrit tube test or by the agar plate test, and therefore that under these conditions atropine esterase is not a polymorphic variant as has been demonstrated clearly in the rabbit. PMID- 6482378 TI - Swine as replacements for dogs in the surgical teaching and research laboratory. AB - Commercially produced swine were successfully used to replace dogs in several surgical research projects at The Johns Hopkins University School of Medicine. They were especially successful as replacements for dogs in the basic operative surgery course offered as an elective to medical students. Advantages of swine over dogs included anatomic and physiologic characteristics shared with man, better health, and economic considerations. PMID- 6482379 TI - An inexpensive caging method for miniature swine suitable for trace-element studies. AB - An inexpensive and durable caging system for swine was developed for trace element studies. The caging system has proven to be suitable for up to four miniature swine and was housed in a barn. PMID- 6482380 TI - Long-term blood access by catheters implanted into arteriovenous fistulas of sheep. AB - Reliable long-term blood access in sheep was provided by implanting one or two catheters into the high velocity blood flow in the vein draining an arteriovenous fistula created in the neck. Thrombosis of the catheterized vein occurred in only one of 31 cases in which a catheter with rounded intravascular tip was used, as compared with seven in 10 cases using a sharp-tipped catheter. The mean duration of placement for all rounded-tip catheters was 228.6 days. Extrusion from the vessel occurred with 3 of 8 short catheters (2 cm intravascular length), but only after a period of more than seven months of implantation. Using a program of trice-weekly disinfection of the skin exit site, exterior portion of the catheter, and catheter lumen resulted in failure of only two catheters due to infection. Rounded-tip catheters with 5 cm intravascular length had 75% life table functional rate at 15 months. Implantation of two catheters permitted extracorporeal circulation at flows of up to 300 ml/min using a blood pump to withdraw blood from one catheter while simultaneously returning it through the second. PMID- 6482381 TI - House mouse mites infesting laboratory rodents. AB - Liponyssoides sanguineus, principal vector of Rickettsia akari, infested mongolian gerbils (Meriones unguiculatus) mice (Mus musculus) and laboratory reared egyptian gerbils (Meriones libycus). Only a few mites were present on each animal and no manifestations of disease were observed. Numerous mites were present in the bedding. PMID- 6482382 TI - A rapid method for repeated collection of blood from the tail vein of rats. AB - A method was developed for obtaining serial blood samples from the tail vein of rats. Seventy microliters of blood were collected at the rate of approximately one sample per minute for the quantitative determination of whole blood clearance of radiolabeled compounds. The technique was rapid, reproducible, and kept stress to the test animals at a minimum. PMID- 6482383 TI - A modified voluntary running wheel for laboratory animals. AB - A running wheel was modified to allow voluntary access by rats from their cage. The modification served as a useful addition for exercise related studies. PMID- 6482384 TI - Spontaneous Reye's-like syndrome in BALB/cByJ mice. AB - In five spontaneous outbreaks, sixty-four BALB/cByJ mice developed Reye's-like syndrome 4 to 33 days after introduction into mouse rooms known to harbor a variety of indigenous murine viruses. The clinical course lasted 24 hours and consisted of progressively deteriorating consciousness and hyperventilation, usually leading to death. Mice killed and necropsied while stuporous or comatose had serum ammonia levels of 2524 +/- 179 versus 66 +/- 8 micrograms/dl for control BALB/cByJ mice. Necropsy findings included swollen, diffusely pale yellow livers with panlobular microvesicular fatty change, pale renal cortices with epithelial fat droplets of the proximal convoluted tubules, and Alzheimer type II astrocytosis of the neocortex, corpus striatum, hippocampus, and thalamus. In three of the five outbreaks involving 66% of affected animals, mice had active coronaviral enteritis. Electron microscopic changes in hepatocytes, neocortical astrocytes, and neurons were similar to or identical with those described for the acute phase of Reye's syndrome in man. The epizootiology of these outbreaks and the apparent synchrony between Reye's syndrome-like illness and the stage of intestinal coronavirus infections in some of these outbreaks suggest that one or more naturally occurring murine viruses were of etiologic significance. PMID- 6482385 TI - Effects of streptozotocin-induced diabetes on the rat parotid gland. AB - The structure of the rat parotid gland was studied in male rats from 4 hours up to 1 year after induction of diabetes by the administration of streptozotocin (STZ, 65 mg/kg). Blood glucose and triglyceride levels were markedly increased, and plasma insulin levels were significantly decreased within 24 hours after STZ. The earliest detectable alteration in acinar cell structure was the presence of small lipid droplets in the basal cytoplasm at 24 hours. Lipid accumulation continued, reaching a peak at 4.5 months after STZ, when the acinar cells contained large lipid vacuoles. By 1 week the Golgi apparatus was enlarged and GERL was prominent at the trans Golgi face. Membrane-bound cytoplasmic crystalloids occurred in acinar cells 1 month after STZ administration and were numerous in older animals (10 to 12 months). These crystalloids occasionally were reactive for trimetaphosphatase, a cytochemical marker for lysosomes. Similar crystalloids as well as large, dense, phagosome-like bodies were also present in the striated duct cells. Macrophages containing acinar cell debris and crystalloids were frequently observed, often in association with the intercalated ducts. Focal alterations in the basement membranes, consisting of multiple layers, loops, and amorphous patches, and "redundant" folds, occurred as early as 2 months and were relatively frequent 10 to 12 months after STZ administration. These results suggest that maintenance of the normal structure and function of the rat parotid gland may, in part, be insulin dependent. PMID- 6482386 TI - Type II epithelial cells of the lung. VII. The effect of ascorbic acid and glutathione. AB - Ascorbic acid and glutathione deficiencies during the isolation of tissue cells could compromise metabolic functions involving their participation. This possibility was assessed by supplementing the medium used in the isolation of rabbit pulmonary type II cells with varying concentrations and combinations of ascorbic acid, glutathione, and glutathione's constituent amino acids, glutamine, cysteine, and glycine. Isolated type II cells were monitored for changes in their biosynthetic capabilities by examination of 3H-choline and 3H-leucine incorporation into phospholipids and proteins. In the presence of glutathione's constituent amino acids and low concentrations of ascorbic acid (0.056 and 0.56 mM) incorporation of radiolabeled choline and leucine by isolated type II cells was decreased by 50% compared with unsupplemented controls. Morphologic examination revealed that type II cells isolated in the presence of glutathione's constituent amino acids had reduced surface membrane blebbing and dilation of endoplasmic reticulum cisternae compared with unsupplemented controls. Intracellular glutathione levels in these cells was also increased by 100% compared with those isolated without the constituent amino acids. Type II cells isolated in the presence of ascorbic acid and the constituent amino acids attached to culture dishes with a 5-fold greater efficiency compared with unsupplemented controls. The supplementation of type II cell's isolation media with ascorbic acid and glutathione's constituent amino acids produces several beneficial affects possibly through reducing intracellular oxidant damage, although other mechanisms of action cannot be ruled out. PMID- 6482387 TI - Ontogeny of neuroendocrine cells in human fetal lung. I. An electron microscopic study. AB - An electron microscopic study of human fetal lung was undertaken to describe the ontogeny of neuroendocrine (NE) cells and neuroepithelial bodies (NEBs) and to determine their relationships to the developing nervous system. Lungs of 34 fetuses and 22 newborns were examined. Putative NE cells appeared prior to 8 weeks of gestation but, by 10 weeks, differentiated into NE cells and NEBs. Between 13 and 24 weeks the number of NE cells and NEBs increased, and subpopulations of NE cells were identified: a small population of cells that reached from basement membrane to lumen and NE cells associated with an electron dense epithelial cell. Material past 24 weeks of gestation was obtained from live born infants who died at various postnatal ages. Much of this material represented acute pulmonary damage in which NE cells were difficult to identify. As chronic lung disease developed, NE cells, singly and in groups, were easily identified in regenerating conducting airways. Growing axons associated with both NE cells and NEBs appeared as early as 10 weeks of gestation. Rare cholinergic, adrenergic, and nonadrenergic-noncholinergic terminals were identified in contact with NE cells and deep within NEBs. Afferent axon terminals were not identified with certainty. The data presented demonstrate innervation to at least some NE cells and NEBs throughout fetal life. It has been proposed that NE cells and NEBs are intrapulmonary neuroreceptors with paracrine secretory function. The present study suggests more complicated mechanisms integrated with the autonomic nervous system, inducing reflex activity at the level of the central nervous system. A tropic role for NE cells in the developing and regenerating lung is proposed. PMID- 6482388 TI - Correlation of morphologic and biochemical observations in human lipomas. AB - Our studies of 107 patients with 133 lipomata showed that the male to female ratio for single lipoma was 1.2:1, and for multiple lipoma it was 3.5:1. More than 40% of the men and 30% of women with multiple lipoma had a family history of lipoma. Specimens from 23 patients were analyzed for lipid and protein content. Adipose tissue from lipoma had somewhat more lipid per gram of wet weight than adjacent normal tissue (75.0 versus 72.8%) or 16 additional control adipose tissue samples, from patients undergoing elective abdominal surgery (71.5%), but the differences were not statistically significant (p = 0.085). There were no differences in protein content. In 13 men the lipoprotein lipase activity of lipoma was markedly higher compared with the adjacent normal adipose tissue (40.4 +/- 15.5 versus 14.0 +/- 11.7 nmoles/gm/minute at 37 degrees C, p = 0.001) or to control adipose tissue (9.6 +/- 7.2 nmoles of free fatty acid/gm/minute at 37 degrees C, p = 0.001). It is likely that the high lipoprotein lipase activity of lipoma contributes to the growth of the tumor. Morphologically, there were no clear distinguishing features between the adipocytes of lipoma, adjacent normal adipose tissue, or control adipose tissue. However, the numbers of more immature type or preadipocytes (mesenchymal cells) appeared to be more numerous in lipomata compared with the control tissues. No differences in immunologic reactivity could be detected using antisera to fat cell membranes from lipoma or control adipose tissue. PMID- 6482389 TI - A new model of cerebral arteriosclerosis induced by intimal injury using a silicone rubber cylinder in rabbits. AB - We designed a new model for studies on atherogenesis in cerebrovascular systems. Myointimal thickening in the rabbit cerebral arteries was induced following intimal injury produced by a silicone rubber cylinder with nylon thread and which was injected from the bifurcation of the right external and internal carotid arteries to embolize either the intracranial internal carotid or middle cerebral artery. Fifteen minutes after the cylinder had been removed, there was a denudation of the endothelium, and platelets adhered to the exposed subendothelium at the site of embolization of the cylinder. Within 3 days, this denuded surface was completely covered by regenerated endothelial cells, and intimal thickening was not observed. After 7 and 28 days, there was a striking myointimal thickening composed of smooth muscle cells in the fibroelastic stroma in the injured region. Permeability of the regenerated endothelium to horseradish peroxidase continued to be enhanced through the intercellular junctions and by increase of vesicular transport after the regenerated endothelial cells had completely covered the denuded area. These findings suggest that enhancement of permeability of plasma constituents of the regenerated endothelium plays an important role in the atherogenesis of cerebral arteries. PMID- 6482391 TI - Occupational health and young adults in the 1980s. PMID- 6482390 TI - More effective prevention in occupational health practice? PMID- 6482392 TI - The employment problems of people disabled by schizophrenia. PMID- 6482393 TI - Sickness absence in an ambulance service. PMID- 6482394 TI - Asbestos in hospitals. PMID- 6482395 TI - The evaluation of an environmental remodeling program on a psychiatric geriatric ward. PMID- 6482396 TI - Parental anxiety and children's attendance at emergency departments in relation to the child's birth order. PMID- 6482397 TI - Health and wealth in four societies. PMID- 6482398 TI - Personal versus impersonal methods for recruiting blood donations. PMID- 6482399 TI - The effect of television on national suicide rates. PMID- 6482400 TI - Consistency of effects of slow rate and pauses on aphasic listeners' comprehension of spoken sentences. AB - The effects of intrasentence pauses and slow speaking rate on aphasic listeners' comprehension of spoken low- and high-difficulty sentences were investigated. Aphasic subjects heard commands spoken at a normal rate, at a slower than normal rate, and with inserted 4-s pauses. Subjects' performance was measured weekly for 4 consecutive weeks. The effects of pauses and slow rate on subjects' performance were not consistent across subjects or within subjects across sessions. Type of aphasia, time postonset of aphasia, and overall severity of comprehension deficit were not strongly related to aphasic listeners' responses to pauses or slow rate. PMID- 6482401 TI - Management of sentence production demands. AB - This study examined the effects of variations in language complexity on young children's phonological accuracy and consistency of target words. A more general intent was to understand better the way in which developmental level and children's tolerance of speech variability influenced the management of processing demands. Seven children aged 22-34 months were seen six times over a 4 month period. During these sessions, children were presented with an elicited imitation task consisting of 18 stimulus words, each of which occurred in eight sentences of varying language complexity. Younger children in Language Stage III were found to be more influenced by changes in language complexity than older children in Language Stages IV and V. Within-stage differences were also found. Moreover, in contrast to previous research, children showed as many improvements in phonological accuracy with increases in language complexity as they did decreases in phonological accuracy. It was suggested that between-stage differences were primarily caused by differences in developing speech, language, and cognitive abilities, whereas within-stage differences were primarily caused by differences in the extent to which children tolerated variability in their speech. Based on this contention, some speculations were offered concerning the way in which normal and disordered children manage processing demands. PMID- 6482402 TI - Distribution of stuttering in sentences: relationship to sentence length and clause position. AB - The purpose of this study was to analyze the influence of sentence length and clause position on stuttering in the complex sentences of two languages--English and Kannada. Ten monolingual adult stutterers read 20 sets of sentences while 10 bilingual adult stutterers read 40 sets of sentences (20 sets in each of the two languages). Each set consisted of a short sentence and two long sentences. Results indicated that (a) a clause placed at the beginning of a sentence was stuttered more often than the same clause placed at the end of the sentence and more than the same clause as an isolated sentence; (b) a clause placed at the beginning of a sentence was stuttered more often than the same clause placed at the end of a sentence, irrespective of sentence length; and (c) stuttering occurred more often on the first clause of a sentence than on the second in proportion to the difference in word length between the two clauses. These results suggest that the occurrence of stuttering might be related to the demands that speech makes on motor planning, particularly at the beginning of sentences, and might have significance for the speech breakdown views on stuttering. PMID- 6482403 TI - Lower-lip EMG and displacement during bilabial disfluencies in adult stutterers. AB - The purpose of this study was to describe the temporal patterns and spectral characteristics of antagonist lip muscle EMG and lip displacement during bilabial disfluencies in adult stutterers. Selective EMG recordings were obtained in five adult stutterers of mentalis and depressor labii inferior motor units (MENT and DLI) that were activated in a reciprocal manner during fluent speech. During disfluencies (N = 91) these same motor units were activated primarily in a reciprocal manner or DLI was not activated. These findings are not consistent with previous reports that stutterers' disfluencies involve cocontraction and overall increases in the activation levels of antagonist muscles. Spectral analysis of bilabial disfluencies revealed peaks at 5-9 Hz in the MENT EMG spectra of the five subjects and at 5-6 Hz in the displacement spectra of two subjects. A refinement in the classification of stutterers' disfluencies is suggested on the basis of individual differences in lip EMG and displacement spectra, and the mechanisms of stuttering tremor are discussed. PMID- 6482404 TI - Development of topic manipulation skills in discourse. AB - This study investigated the manipulation of discourse topic in spontaneous conversation in three age groups. Subjects consisted of six dyads of peers at each of the following age levels (years:months): 5:0-5:11, 9:0-9:11, and adults. Fifteen min of discourse were taped, transcribed, and analyzed for each age level. Patterns of topic introduction, reintroduction, maintenance, and shading were considered at each age level. Although considerable variation within groups was evident, the results suggested several developmental trends. The number of topics introduced and reintroduced in the sampling period decreased with age, whereas the proportion of topics maintained increased with age. Additionally, subjects maintained topics for longer sequences of utterances with increasing age. Topic shading also increased with age. These results are discussed with regard to patterns of development, and clinical implications are considered. PMID- 6482405 TI - Children's speech revisions for a familiar and an unfamiliar adult. AB - Initial characterizations of the communicative abilities of preschoolers stressed their egocentric nature. Recently, however, even 2-year-olds have been observed to adjust their speech appropriately in situations in which the listener provides feedback by signaling noncomprehension. The current study had an adult signal noncomprehension to the requests of 2-year-old Stage I and Stage II children. Each child interacted with a familiar (mother) and an unfamiliar adult. The children repeated their requests about one third of the time and revised them about two thirds of the time. Stage I children elaborated their requests significantly more often than Stage II children. The familiarity of the adult listener had no effect on the way Stage II children revised their requests, but the Stage I children's revisions contained novel lexical items more often when they were interacting with the unfamiliar adult. Both of these findings may have resulted from the fact that the more conversationally skilled Stage II children relied on verbal-conversational cues, which were the same for both adult interactants in this situation. The Stage I children may have been less aware of these conversational cues, relying on general social cues such as familiarity of the interactant. The results are discussed in terms of the potential role of different types of adults in the language acquisition process. PMID- 6482406 TI - Profiles of communicative and cognitive-social abilities in autistic children. AB - The purpose of this study was to examine profiles of communicative and cognitive social abilities in a small group of autistic children functioning in the prelinguistic and early stages of language development and to compare them with those of normal children functioning at similar stages of language development. The results of measures in the cognitive-social areas of communicative intent, tool use, imitation, and play and in language comprehension demonstrated uneven development for the autistic subjects. A functional analysis of communicative behaviors indicated that, despite a wide variation in communicative means, the autistic subjects displayed a relatively homogeneous profile of communicative functions that was both quantitatively and qualitatively different from the normal profile. Explanations for the heterochrony in communicative and cognitive social development of these autistic children are discussed. PMID- 6482407 TI - Word recognition with segmented-alternated CVC words: a preliminary report on listeners with normal hearing. AB - Consonant-vowel-consonant (CVC) monosyllabic words were segmented at the approximate phoneme boundaries and were presented to subjects with normal hearing in the following sequence: (a) the carrier phrase to both ears, (b) the initial consonant segment to one ear, (c) the vowel segment to the other ear, and (d) the final consonant segment to the ear that received the initial consonant. A computer technique, which is described in detail, was used to develop the test materials. The digital editing did not alter appreciably the spectral or temporal characteristics of the words. A series of four experiments produced a list of 50 words on which 10% correct word recognition was achieved by listeners with normal hearing when the vowel segment or the consonant segments of the words were presented monaurally in isolation. When the speech materials were presented binaurally--that is, the vowel segment in one ear and consonant segments in the other ear--word-recognition performance improved to 90% correct. PMID- 6482408 TI - Role of mothers' expansions in stimulating children's language production. AB - Mothers' expansions were examined for their role in structuring conversational contributions and facilitating spontaneous imitations and productions of two-term semantic relations not previously used by their children. The subjects were four 2-year-old boys in late Stage 1 of linguistic development and their mothers. The investigation consisted of two studies. Study 1, a descriptive analysis of mother child conversation, showed a contingent relationship between mothers' expansions and their children's use of spontaneous imitations. Study 2, an experimental procedure using a multiple baseline treatment design, showed that an increase in the mothers' expansions was systematically related to an increase in the children's initial spontaneous imitations of two-term semantic relations. Results also indicated that following the increase in spontaneous imitations, spontaneous productions of the two-term relations increased and were maintained, whereas spontaneous imitations subsequently decreased. PMID- 6482409 TI - Psychophysical tuning curves in normal-hearing listeners: test reliability and probe level effects. AB - Psychophysical tuning curves (PTCs) were obtained from 19 normal-hearing listeners using a computer-controlled, modified Bekesy tracking procedure which employed a minimum standard error stopping rule. Using an objective procedure, 2000-Hz PTCs were quantified on five dimensions (Q10, tip-to-tail difference, d1 oct, low-frequency slope, and high-frequency slope), and the test-retest reliability of each measure was assessed. To provide a basis for future comparisons between normal-hearing and hearing-impaired listeners, these measures were obtained as a function of increasing probe level. PMID- 6482410 TI - Tone-glide discrimination: normal and hearing-impaired listeners. AB - Speech sounds vary rapidly in frequency, and the status of the auditory system might be expected to influence the processing of time-varying signals. Two experiments were undertaken to determine the effect of sensorineural hearing loss on the discrimination of frequency-varying sinusoids which are analogous to second formant transitions and contiguous steady-state portions of consonant vowel and vowel-consonant syllables. A transformed up-down procedure was used to estimate the difference limen of the glide (transition) portions of the stimuli. In Experiment 1, it was found that three of the four normal hearers exhibited larger difference limens for stimuli with glides preceding fixed-frequency (steady state) portions than for comparable glide-following conditions. Subjects with sensorineural hearing loss did not show this effect consistently. In Experiment 2, the possibility of temporal masking of the glide segment by the fixed-frequency segment was explored. Large individual differences in temporal masking effects were observed for both normal-hearing and hearing-impaired subjects. Temporal masking could account for some, but not all of the differences in discriminability of glide-preceding and glide-following conditions. It appears that audiometrically similar sensorineural hearing losses can differentially affect temporal masking and discrimination of the tone glides. PMID- 6482411 TI - Partner age as a variable in the conversational performance of specifically language-impaired and normal-language children. AB - The language used by a group of 4 1/2-6-year-old specifically language-impaired (SLI) children, a group of same-aged normal-language (NL) children, and a group of younger NL children were observed in three dyadic contexts: with an adult female, with a peer, and with a toddler. Ten measures were selected to analyze the children's performance across partner contexts. The results revealed that the SLI children were as assertive in the conversations as were the children in the same-aged NL group. Further, the SLI children modified their language in the same manner and to the same extent as the same-aged NL children on all but three measures: use of internal state questions, mean length of utterance, and mean preverb length. Their ability to adapt their speech based on the age-related characteristics of the partner appeared at times to be greater than that of the younger NL children. PMID- 6482412 TI - Influence of lung volume on the airflow-intensity relationship. AB - This study reports airflow-intensity relationships observed in crescendo and decrescendo phonations produced at three fundamental frequency levels by 10 men. The purpose of the investigation was to study the possible influence of lung volume on airflow-intensity relationships. Of the 30 decrescendo phonations, 26 showed statistically significant correlation coefficients and none showed significant negative correlations. The crescendo phonations, however, showed greater inter- and intrasubject variability. Of the 30 crescendo phonations, 16 showed statistically significant positive correlation coefficients and 6 showed significant negative correlations. Because lung inflation varied directly with intensity in the decrescendo task and indirectly in the crescendo task, it was concluded that lung volume does influence the consistency and strength of relationship between airflow and intensity. The findings are discussed in terms of the influence of lung volume on the relative contributions of glottal resistance and expiratory force to the regulation of subglottal pressure. PMID- 6482413 TI - Application of theory of signal detection to dichotic listening. AB - Listener performance during dichotic listening to CV nonsense syllables was assessed with a Yes/No target-monitoring task that provides both hit and false alarm information. The ear advantage was described by a metric, P(C)maxRE - P(C)maxLE, that is relatively insensitive to a listener's criterion or bias toward "yes" or "no" responses. One half of the listeners in two experiments had a significant right-ear advantage. The potential influence of listener criterion on measures of the ear advantage in conventional dichotic listening experiments is discussed. PMID- 6482414 TI - Temporal gap detection in sensorineural and simulated hearing impairments. AB - The objectives of this study were to assess the effect of the configuration of a hearing loss on gap detection and to determine if hearing impairment affects temporal resolution, per se. The minimum detectable gap duration, MDG, in a low pass (cut-off at 7 kHz) noise was measured monaurally as a function of sound pressure level in six listeners with normal hearing, seven with hearing impairments of primarily cochlear origin, and eight with impairments simulated by masking. The impaired listeners' MDGs at 80 and 90 dB vary from about 3.5 ms (equal to the normal MDG) to about 8 ms and show little correlation with their average HL. At lower levels, the MDG is enlarged for all impaired listeners owing to the decreased SL of the noise. Most of the enlargement of the MDG could be reproduced by presenting a normal listener with a masking noise spectrally shaped to simulate the impaired listener's audiogram. However, at high levels, some impaired listeners performed worse than their simulated-loss counterparts, indicating that temporal resolution per se may be reduced in some, but not all, impaired listeners. PMID- 6482415 TI - A procedure for phonetic transcription by consensus. AB - A consensus transcription procedure is presented, and representative data are reported. The procedure includes explicit response definitions for mapping narrow phonetic transcription onto dichotomous, nonerror/error scores and 17 rules for obtaining consensus between two transcribers. The data include descriptive statistics for consensus rule use based on over 18,000 sounds transcribed during a normative study of speech sound acquisition in children aged 3-6 years. Validity and reliability issues in phonetic transcription are discussed. PMID- 6482416 TI - Postmasking effects of sensorineural tinnitus: a preliminary investigation. AB - In this study we provide some preliminary results of our attempt to measure the perception of tinnitus after the termination of a masker. The minimum level to mask tinnitus was determined for a 1-s masker in 10 subjects with sensorineural tinnitus. A continuous masker (parametrically varied in duration, frequency, and level) was then presented to the ear ipsilateral to the tinnitus. At the termination of the masker, subjects were required to press a button when their tinnitus "first returned" and a second button when it returned to "normal loudness." These response times were recorded automatically, and subjects reported what they heard after each trial. At low-level and short-duration maskers, the tinnitus typically was heard immediately after the masker termination. At higher levels and longer durations, different responses were observed. In two subjects, a silent interval was present after the masker, then the tinnitus returned at a softer loudness before returning to its premasker loudness. In one subject, the tinnitus was louder after the masker, and gradually returned to its premasker loudness. In another subject, the tinnitus returned immediately after the masker, but was softer than before. It then gradually increased to its premasker loudness. In the other two subjects, the tinnitus returned immediately to its normal loudness when the masker was terminated at all masker levels and durations. Higher level and longer duration maskers generally produced greater effects. Masker frequency, however, had little effect. PMID- 6482417 TI - Effect of formant frequency onset variation on the differentiation of synthesized /w/ and /r/ sounds. AB - The purpose of this study was to assess the use of psychophysical transformations for analyzing the differentiation of /w/ and /r/ sounds of children and adults. Stimuli from Adult and Child manifolds, consisting of 25 synthesized /Cej/-type utterances with different F2 and F3 onset frequencies, were presented in random order to eight naive subjects. Subjects rated the stimuli on a four-point scale between good /r/ and good /w/. Correlations between mel transformations and Bark transformations of the F3-F2 differences among the stimuli and their percent /r/ responses were close to or greater than .90. Predictions of percent /r/ responses derived from regression analyses based on mel transformations and Bark transformations of F3-F2 differences among stimuli indicated that some sounds identified as /w/ for /r/ substitutions could be differentiated from /w/ sounds. The category boundaries between /r/ and /w/ were estimated to be 5.0 Bark for adult stimuli and 5.7 Bark for child stimuli. PMID- 6482418 TI - Breast cancers: estrogen and progesterone receptor status as a predictor of in vitro chemotherapeutic response. AB - Although clinical observations have shown that estrogen receptor-positive (ER+) breast tumors are more responsive to hormonal therapy than ER-negative (ER-) tumors, it remains controversial whether ER status can predict chemotherapeutic response. To determine if there was any correlation between estrogen and progesterone values and in vitro chemosensitivity to various anticancer drugs, clonogenic (CA), estrogen (ERA), and progesterone (PRA) assays on breast cancers were performed on 100 patients. Clonogenic assays were performed using the double layer soft agar technique with continuous drug exposures. ERAs and PRAs were performed using the charcoal-coated dextran method. Chemosensitivity was defined as 50% inhibition of colony formation. ERA was considered positive if greater than or equal to 5 fmole/mg cytosol and PRA positive if greater than or equal to 10 fmole/mg cytosol. Significant tumor growth (greater than 30 colonies/plate) was achieved in 81/100 assays. ERA and PRA values were not predictive of colony formation in vitro. Of all agents or combinations of agents tested (L-PAM, 5-FU, MTX, adriamycin, vinblastine, cis-plat, FAC, CMF), only the response to 5-FU correlated significantly with ERA. Eight of 11 (73%) of the ER- tumors were sensitive to 5-FU, whereas only 6/20 (30%) of ER+ tumors were sensitive (P less than 0.05). ER- tumors were also more likely to be sensitive to CMF (P = 0.09) and adriamycin (P = 0.07) than ER+ tumors. PRA values were not predictive of chemosensitivity, nor did combining PRA and ERA enhance the predictive value of ERA alone. PMID- 6482419 TI - A reliable rat model of the delayed hypersensitivity skin test response. AB - A model of the delayed type hypersensitivity response (DTH) has been developed in Sprague-Dawley rats. The sensitizing and skin test antigen is keyhole limpet hemocyanin (KLH). This antigen produces 99% sensitization and the response is maintained in 98% of the animals for up to 3 months. In four animals the DTH response was maintained greater than 1 year. The response can be abrogated with protein deprivation and restored with refeeding. The skin test method of DTH assessment correlates with an alternate technique of radiolabeled cell accumulation in the ear (r = 0.95, P less than 0.001). This model should prove useful in evaluating the role of the DTH response in measuring host resistance to infection. PMID- 6482420 TI - Bile reflux and degree of gastritis in patients with gastric ulcer: before and after operation. AB - The incidence and degree of bile reflux and gastritis has been measured in normal subjects and in patients with gastric ulcer before operation and after treatment by highly selective vagotomy with ulcer excision, Billroth 1 partial gastrectomy, and truncal vagotomy and drainage. Before operation patients had significantly higher (P less than 0.001) bile acid concentrations in the stomach than normal subjects. Treatment by highly selective vagotomy resulted in significantly lower bile acid concentrations than those before operation and those found after Billroth 1 partial gastrectomy. Antral and body gastritis was significantly less in normal subjects than in the preoperative and all postoperative groups. There was no significant difference in antral or body gastritis between the preoperative gastric ulcer patients and the patients after any of the surgical procedures despite the significant differences in bile acids. Though highly selective vagotomy in the treatment of gastric ulcer results in a reduction in duodenogastric reflux of bile there is no improvement in the gastritis that is present. PMID- 6482421 TI - Delineation of myocardial ischemia in an isolated blood-perfused rabbit heart preparation. AB - Isolated perfused heart preparations provide controlled conditions for the study of myocardial respiration and metabolism. Most studies utilize a hemoglobin-free perfusate which requires high arterial oxygen tension and high coronary perfusion rate. A blood-perfused rabbit heart preparation using an "assist" rabbit to maintain blood homeostasis has been developed which is suitable for respiratory, metabolic, and spectroscopic studies of myocardial function under controlled conditions. Fluorescence emission of reduced nicotinamide adenine dinucleotide (NADH) from the surface of blood-perfused rabbit heart was photographed to delineate areas of myocardial ischemia detectable as NADH fluorescence from reduced mitochondria. Blood reperfusion of ischemic myocardium resulted in disappearance of NADH fluorescence. Reocclusion of the coronary artery resulted in the same pattern and amplitude of NADH fluorescence. PMID- 6482422 TI - Liver blood flow after partial hepatectomy in the pig. AB - The role of liver blood flow in liver regeneration remains controversial. This study in 17 pigs documents the total hepatic blood flow, and portal and arterial components measured with an electromagnetic flowmeter, the portal pressure, and the cardiac output for 6 days after partial hepatectomy (PH) or sham operation. There was a twofold increase in total flow immediately after PH which rose to three- to fourfold by the second postoperative day. Thereafter values decreased but remained elevated above preoperative values; no similar increase was noted in sham animals. The increase in flow was both absolute as well as relative to the proportion of liver remnant remaining. The portal component increased from 74 +/- 3% preoperatively to 84 +/- 3% (P less than 0.05) on the second postoperative day, and portal pressure was apparently increased. These changes in flow precede the previously documented maximum regeneration response between Days 3 and 4. The factors resulting in the increased flow may be responsible in part, for regeneration. PMID- 6482423 TI - The effects of ileal resection with cholecystectomy on bile salt metabolism in the prairie dog. AB - The adverse effects of ileal resection on bile salt metabolism may be aggravated by cholecystectomy. Female prairie dogs had either sham laparotomy, cholecystectomy, distal 50% small bowel resection, or cholecystectomy and distal 50% small bowel resection. After 4 weeks the common bile duct was cannulated and bile collected for up to 12 hr. Bile salt pool size and synthetic rate were measured from the washout curve. Bile salt, phospholipid, and cholesterol concentrations were determined. Bile salt pool size was reduced after cholecystectomy and after ileal resection. Cholecystectomy plus ileal resection further lowered the pool size, increased the synthetic rate, and increased the proportion of secondary bile salts. Cholecystectomy increased the synthesis and the concentration of bile salts in hepatic bile and altered the proportions of biliary lipids. Ileal resection decreased the concentration of hepatic bile salts with the formation of noncholesterol stones. The drastic reduction in pool size with the combined operation might be expected to lead to fat malabsorption. The higher concentration of bile salts after the combined operation compared with ileal resection alone reflects a possible beneficial effect of cholecystectomy. PMID- 6482424 TI - A model of cyanotic heart disease: functional, pathological, and metabolic sequelae in the immature canine heart. AB - To assess the etiology of depressed ventricular function in cyanotic congenital heart disease, an experimental model in immature puppies was devised in which the left atrial appendage is directly anastamosed to the distally banded pulmonary artery. The preparation results in significant cyanosis during a 3-month study period (PO2 = 91 +/- 4 vs 43 +/- 3, hematocrit = 33 +/- 3 vs 55 +/- 5). Compared to age- and weight-matched unoperated controls, cyanotic animals developed significant depression of biventricular ejection fraction (P less than 0.05), increased heart weight indexed for body weight (P less than 0.05), increased right ventricular weight (P less than 0.02), and increased right ventricular free wall thickness (P less than 0.05). There was no alteration in ventricular volumes. In addition, mean myocardial stores of high-energy phosphate compounds were unaltered. The model allows a reproducible level of hypoxemia to be produced in young animals, utilizes no prosthetic materials, and allows future experiments to be performed to ascertain the metabolic response of the cyanotic myocardium to exercise or surgically induced ischemia. PMID- 6482425 TI - Platelet activation by human pancreatic fluid. AB - The effects of human pancreatic fluid (HPF) on platelet aggregation and activation were studied. HPF, obtained at operation from nine patients with chronic pancreatitis and two with pancreas cancer, was pooled, lyophilized, and adjusted to a concentration of 1 mg protein/cc of 0.9% saline after dialysis. Platelet aggregation was evaluated by measuring platelet count after iv administration of HPF to five rabbits in concentrations ranging from 0.2 to 2.0 mg/kg. Platelet activation was evaluated by adding 0.1-ml aliquots of pooled HPF in various concentrations to 0.9 ml of human platelet-rich plasma. After a 15-min incubation at 37 degrees C, the platelets were removed by centrifugation and the supernatant examined for platelet-release products. Serotonin was measured by high-performance liquid chromatography (HPLC) and platelet factor 4 and thromboxane B2 were measured by radioimmunoassay. A significant decrease in rabbit platelet count signifying platelet aggregation was seen after iv administration of 1.0 mg/kg (P less than 0.05) and 2.0 mg/kg (P less than 0.001) HPF. Platelet activation was confirmed by a significant increase (P less than 0.05) in serotonin, platelet factor 4, and thromboxane B2 at almost all concentrations of HPF. This study indicates that HPF induces platelet aggregation and activation and suggests that platelet contact with pancreatic exocrine fluid may have both local and systemic effects that are important in the pathophysiology of acute pancreatitis. PMID- 6482426 TI - Corticosteroid binding by fetal rat and rabbit lung in organ culture. AB - To further characterize glucocorticoid action in fetal lung cells, we investigated corticosteroid metabolism and binding in explants of fetal rat and rabbit lung. Cortisone (E) was concerted to cortisol (F) and bound by receptor with a time course only somewhat slower than for F. Production of F (0.243 pmol/min/mg DNA) was the same in male and female rabbits and was not affected by prior exposure to glucocorticoid in utero or in culture. The t 1/2 for dissociation of nuclear-bound [3H]F was 84 min on changing the culture medium and 21 min on addition of excess non-labeled dexamethasone. Dissociation of [3H]dexamethasone was approx 5-fold slower by both procedures. The KD for nuclear binding of dexamethasone, F, E, and corticosterone in rabbit lung were 0.7, 7.3, 6.8 and 70.6 nM, respectively. In rat lung, the KD for dexamethasone was 6.8 nM. The concentrations of dexamethasone and F required for half-maximal stimulation of phosphatidylcholine synthesis were similar to the KD values. Dexamethasone binding capacity (sites/mg DNA) increased with age in both rat (+103% increase from day 16 to 22) and rabbit (+47% between day 23 and 30). Receptor concentration was the same in both sexes, and there were no developmental changes in non-specific binding, nuclear:cytoplasmic distribution, or KD. In 27-day rabbit fetuses, the rate of choline incorporation was higher in lungs with greater binding capacity. We conclude that (1) E is rapidly converted to F in rabbit lung to become an active glucocorticoid, whereas corticosterone probably has little physiologic activity, (2) there is a species difference in the affinity of dexamethasone binding which is reflected in responsiveness (3) there is no difference between sexes in E conversion, receptor capacity, or phosphatidylcholine synthesis, and (4) the concentration of binding sites per lung cell increases during fetal development. We suggest that developmental increases in both F production and receptor may be important factors in the expression of endogenous glucocorticoid effects. PMID- 6482427 TI - Induction of DNA synthesis in cultured rabbit uterine cells by estradiol and inhibition of the estrogen response. AB - Addition of 17 beta-estradiol to primary cultures of rabbit uterine cells resulted in the induction of DNA synthesis. This phenomenon is present only in cells cultured at low density. Culture medium taken from high density cultures inhibited it, suggesting that those cells produce a soluble estrogen-inhibiting factor. PMID- 6482428 TI - Relative binding affinity of steroids for the corticosterone receptor system in rat hippocampus. AB - In cytosol of the hippocampus corticosterone displays highest affinity for the sites that remain available for binding in the presence of excess RU 26988, which is shown to be a "pure" glucocorticoid. A rather high affinity (greater than or equal to 25%) was found for 11 beta-hydroxyprogesterone, 21-hydroxyprogesterone, 5 alpha-corticosterone, 19-nor-deoxycorticosterone, 11-deoxycorticosterone and cortisol. A moderate affinity (greater than 5% and less than 25%) was displayed by about 14 steroids among which progesterone, aldosterone, 9 alpha fluorocortisol and dexamethasone. Corticosterone also shows highest affinity to plasma transcortin and thymus cytosol in the presence of RU 26988. However, the rank-order in affinity by the competing steroids was distinctly different from that observed in the hippocampus; cf. aldosterone and dexamethasone displaced [3H]corticosterone from sites unoccupied by RU 26988 in the hippocampus but not from transcortin or sites in thymus cytosol. In thymus cytosol some potent glucocorticoids have higher affinity for the [3H]dexamethasone labeled sites than dexamethasone. The binding of [3H]dexamethasone in thymus cytosol is completely abolished in the presence of a 100-fold excess of RU 26988. We conclude that our data support the evidence for RU 26988 as a selective ligand for glucocorticoid receptors. RU 26988 leaves binding sites available with highest affinity for corticosterone in hippocampus cytosol that are distinct from transcortin-like sites as found in thymus cytosol or from plasma transcortin. PMID- 6482429 TI - Testosterone, dihydrotestosterone and estradiol-17 beta levels in maternal and fetal plasma and in fetal testes in the rat. AB - In Sherman rats testosterone, dihydrotestosterone (DHT) and estradiol-17 beta levels were measured in maternal and fetal plasma of both sexes during the last 5 days of gestation and in the fetal testes from day 14.5 of pregnancy using celite microcolumn chromatography and radioimmunoassay. All the plasma testosterone concentrations in males were at least 4 times higher than in their female littermates. In male fetuses, levels of plasma testosterone were maximum on day 18.5 (mean = 1.42 ng/ml) and declined thereafter (mean = 0.85 ng/ml on day 21.5). In female fetuses and in mothers, levels were consistently very low (mean less than 0.2 ng/ml). Plasma DHT titers in fetal plasma of the two sexes and in maternal plasma were consistently minute. Plasma estradiol-17 beta levels in fetuses did not differ between sexes; they were higher than maternal levels; there was a prepartum increase both in fetuses and their mothers. Testicular testosterone content became detectable on day 15.5, increased to reach a peak on day 18.5 (mean = 2.3 ng/testis) and remained at this plateau throughout the end of gestation. Intratesticular DHT and estradiol-17 beta were in minute concentrations. From these data we conclude that, in fetal rat, (1) DHT in genital tract is entirely formed in situ during masculinization, (2) among the three plasma steroids assayed, only testosterone can play a determining role in sexual differentiation. PMID- 6482430 TI - Preparation of specific antiserum to estriol 3-sulfate 16-glucuronide. AB - The preparation and antigenic properties of estriol 3-sulfate 16-glucuronide bovine serum albumin (BSA) conjugate in which the hapten is linked to the carrier through an (O-carboxymethyl)oxime bridge at the C-6 position on the steroid nucleus, have been described. Coupling of 6-oxoestriol 3-sulfate 16-glucuronide acetate-methyl ester 6-(O-carboxymethyl)oxime with BSA by the activated ester method followed by removal of the protecting groups with alkali provided the desired conjugate. The antisera raised against the conjugate in rabbits were highly specific to the double conjugate, estriol 3-sulfate 16-glucuronide, discriminating from ring A or D monoconjugated and unconjugated estrogens. The specificity of antisera elicited has been discussed on the basis of stereochemistry of the hapten-[C-6]-BSA conjugate. PMID- 6482431 TI - Activation of [3H]estradiol--and [3H]H1285-receptor complexes: effect of salt versus ATP on molybdate-stabilized estrogen receptors. AB - The activation by salt or ATP of [3H]estradiol- and [3H]H1285-receptor complexes from rabbit uterus and their binding capacity to DNA-cellulose, phosphocellulose and ATP-Sepharose has been studied. The estrogen-receptor was prepared in 1 mM molybdate which stabilized the receptor; but both salt- and ATP-transformation of estrogen receptors occurred. The binding of molybdate-stabilized cytosol [3H]estradiol-receptor complexes to the various resins revealed that salt activation by 0.3 M KCl caused the greatest binding (5-6-fold) to DNA-cellulose as compared to other resins. However, 5 mM ATP-dependent activation of receptor complexes resulted in preferential binding to ATP-Sepharose. Activated cytosol [3H]H1285-receptor complexes bound all the resins to a lesser degree when compared to [3H]estradiol-receptor complexes. Partially purified receptor complexes also showed different resin-binding patterns for salt- and ATP-mediated activation. These findings suggest that salt-activation is different than ATP activation. Further, the differential magnitude of [3H]estradiol- and [3H]H1285 receptor activation suggests that estrogen-receptor complexes are "fully" activated as compared to "partially" activated antiestrogen-receptor complexes. PMID- 6482432 TI - The impact of television advertising on alcohol consumption: an experiment. AB - A videotaped indoor soccer game was shown to 125 men college students, ostensibly to evaluate the sport's televiewing appeal. Different versions of the videotape included zero, four or nine beer commercials. Refreshments, including beer, were available to the subjects. Half the subjects had immediate access to beer, and half had access delayed by one half hour. Exposure to the first few commercials increased consumption; however, continued exposure did not. Over the entire experiment, advertising had no significant effect on total beer consumption. Delayed access to beer led to compensatory beer consumption, notably in the third half hour. The results of the present study were interpreted as not supporting strong concern about television advertising's impact on immediate consumption of available alcohol. The results suggest that experiments on alcohol advertising are likely to produce negative results where drinking is measured over a substantial period (e.g., an hour or more), and positive results where drinking is measured over a brief period (e.g., half an hour or less). PMID- 6482433 TI - Drunken drivers in longitudinal perspective. AB - The lives of men convicted for driving while intoxicated (DWI) were compared with those of other men who spent their childhoods in the same neighborhoods. The comparisons were based on interviews, questionnaires and agency records. Although not distinguishable by their age at first conviction, the men convicted for DWI were more likely to have been convicted for serious crimes. They were also more likely to be alcoholics. As children, they were less likely to have appeared to be insecure or dependent. During adolescence, those who would later be convicted for DWI were more likely to have parents who were inconsiderate and aggressive, and who fought with one another. The men convicted for drunken driving seemed independent and relatively self-confident, both during early childhood and in middle age. Their history of antisocial behavior belies a view that these men have inadvertently risked the safety of others during an unaccustomed lapse in self-control. PMID- 6482434 TI - Relationship between reasons for drinking and customary drinking behavior. AB - In 80 subjects (28 women), a factor-analytic investigation of the relationship between the reasons for drinking and customary drinking behavior revealed that solitary drinking is associated with drinking in order to forget personal shortcomings, drinking to forget problems and disappointments, and drinking to be less concerned with what others think. Positive skewness proved to be a valid index of deviant drinking practices and motives. Some incidental findings indicated that heavy beer consumption occurs most among young men. PMID- 6482435 TI - Similarity of university students' and their parents' attitudes toward alcohol. AB - It is proposed that older adolescents become more sensitive to parental norms about alcohol use. Seventy-two father-mother-daughter triads and 30 father-mother son triads rated structural attitude statements about alcohol and drinking. Factor analyses yielded six dimensions of attitudes toward alcohol. Sons and parents had similar attitudes overall, with perceptions differing more on the sociability factor. There were a larger number of differences in the attitudes of parents and their daughters, especially concerning women drinking, moderate uses of alcohol and social status benefits from drinking. Daughters' attitudes were more likely to be different from both parents' attitudes than were sons' attitudes. The attitudes of daughters toward alcohol were discussed with reference to changes in women's roles and differences in their education and lifestyle. PMID- 6482436 TI - Relationship between the course of primary alcoholism in men and family history. AB - Structured interviews were conducted with 453 men primary alcoholics and with up to two resource persons for each patient to investigate the association between the sex of an alcoholic parent and the course of alcoholism in the subject. Earlier and more severe alcohol-related and antisocial problems were found among subjects with any alcoholic parent than among those without an alcoholic parent. The highest level of problems was noted for subjects with both parents alcoholics. There were few differences between the sons of alcoholic fathers and the sons of alcoholic mothers but the latter demonstrated significantly more drug misuse. PMID- 6482437 TI - Impaired memory for treatment-relevant information in inpatient men alcoholics. AB - Inpatient alcoholics (N = 54 men), nonhospitalized members of an Alcoholics Anonymous group (N = 15 men) and nonalcoholic inpatients (N = 10 men) were shown a 55-min film on alcoholism and were subsequently given memory tests for recall and recognition of information from the film. The performance of the inpatient alcoholics was impaired relative to that of the controls. Alcoholics who were tested earlier in treatment performed worse than those tested 3 or more weeks after their last drink. These results suggest that treatment-relevant information may not be well remembered by alcholics until they have been in treatment for at least 2-3 weeks. PMID- 6482438 TI - Do alcoholics give valid self-reports? AB - Self-reports on drinking among alcoholics (100 men inpatients) were compared with descriptions of their consumption given by collaterals (one friend or relative each) at 10 points during an 18-month follow-up study. The correlations between the two were only moderate; barely one-half of the variance in the alcoholics' self-reports corresponded to the collaterals' assessments. Patients underestimated collaterals' descriptions about three times as often as they overestimated them, but their over- and underestimations appeared to be of roughly equal size. The relationships between alcoholics' and collaterals' reports tended to be curvilinear. Among subjects whom the collaterals had described as abstinent or controlled drinkers, patients' and collaterals' assessments were similar but patients' descriptions grossly underestimated collaterals' reports when uncontrolled consumption was reported by the latter. The results support a moratorium on the use of patients' self-reports in follow up studies on alcohol consumption. PMID- 6482439 TI - Self-reported intoxication among Hispanics in northern California. AB - Self-reported intoxication among Hispanics in northern California was studied through three independent surveys of the general population conducted between 1977 and 1980 in three counties of the San Francisco Bay area. All of the surveys followed the same sampling plan and only probability techniques were employed. A total of 634 adult respondents who identified themselves as Hispanics served as subjects. In the sample, 20% of the men and 5% of the women reported becoming intoxicated at least once a month, rates twice as high as in the general U.S. population. Consistent with this increased frequency of intoxication, Hispanics also had attitudes toward intoxication more liberal than those found in another study of the California general population. Intoxication was more frequent among the young and among heavier drinkers, and it was also a significant predictor of alcohol-related problems. It is suggested that intoxication be studied carefully because of its association with alcohol-related problems. PMID- 6482440 TI - Factors associated with patient dropout from an outpatient alcoholism treatment service. AB - Treatment dropout was studied in 172 patients (40 women) of an outpatient alcoholism treatment program. The best predictors of dropout were the length of delay between appointments, and variables related to symptom levels such as the number of prior alcohol-related arrests, the use of illicit drugs and scores on the Michigan Alcoholism Screening Test. Of lesser importance, but in line with previous findings, were sociodemographic variables such as age, the level of social stability and the presence of dependents at home. No personality variables were found to be relevant. It is suggested that treatment programs can improve attendance by reducing the delay with which services are offered and by changing certain characteristics of treatment personnel. PMID- 6482441 TI - Seasonal changes in alcohol consumption and related problems in Iowa, 1979-1980. AB - What happens to heavy-drinking and problem-drinking rates when per-capita alcohol sales (apparent consumption) increase and decrease is examined. A panel of individuals were interviewed at three 6-month intervals: winter of 1979, summer of 1979 and winter of 1980. Respondents were questioned about their drinking related behavior in the 30 days prior to each interview. Although per-capita alcohol sales increased from winter to summer and decreased from summer to winter, heavy-drinking and problem-drinking rates changed relatively little, usually in the opposite direction of the sales change. Few of the new problem drinkers appearing from season to season also became new heavy drinkers. These findings were interpreted to mean that the Single Distribution model, relying exclusively on restricting sales to prevent alcohol misuse, is underspecified. There is much to be learned about how aggregate sales changes come about and how sales changes interact with other factors to affect problem-drinking rates. PMID- 6482443 TI - Utility of the MMPI-168 with men inpatient alcoholics. AB - The ability of the MMPI-168 to estimate full-scale high-point code types was evaluated in 772 men inpatient alcoholics. Although concordance of code types was found to be 35% across the entire sample, concordance rates of specific codes varied from 78% for the 2-4/4-2 type to only 15% for the 7-8/8-7 type. The MMPI 168 also underestimated the frequency of many full-scale code types. Overall, the data indicated that the MMPI-168 should be used very cautiously with alcoholics when the goal is to estimate full-scale code types. PMID- 6482442 TI - Nephrectomy enhances alcohol-induced hypoglycemia in fasted rats. AB - Male Wistar rats (N = 84) weighing 230-270 g were fasted 48 hr. Equal groups were controls, nephrectomized bilaterally and sham-operated. Equal subgroups were then given 4.0, 6.0 or 7.5 g of alcohol per kg of body weight or water by orogastric intubation. Blood glucose levels did not decrease significantly after nephrectomy alone or after the 4.0 g/kg dose. Blood glucose declined significantly more in the nephrectomized than in the sham-operated rats at 90 and 180 min after the 6.0 g/kg dose. Blood glucose decreased significantly in both the nephrectomized and sham-operated rats after the 7.5 g/kg dose. PMID- 6482444 TI - Primary carcinoma of Stensen's duct: recognition and management with literature review. AB - Primary carcinoma of Stensen's duct is a rare neoplasm with only 15 cases reported in the English literature since 1927. The authors present a recent additional patient and discuss their criteria for the determination of true primary ductal lesions based upon clinical presentation, operative findings, and tumor histology. This method of selection, most particularly involving electron microscopy in the reported case, is necessary to define whether the lesion originates from the ductal epithelium. All previously reported cases were reviewed, together with the actual pathologic slides in four available cases. Only ten were retained as primary ductal lesions. Most important, this analysis clarifies the natural history of these neoplasms and reinforces a recent theory of histogenesis of salivary gland tumors. In light of these findings, a rational treatment plan can be suggested. PMID- 6482445 TI - Effects of intravenous versus intraatrial administration of doxorubicin on the function and structure of the heart. AB - To evaluate the relationship of toxicity of doxorubicin to route of administration, we studied 21 mongrel dogs which were randomly assigned to one of three groups: 1) a control group undergoing intraatrial indwelling catheter placement but no drug therapy; 2) an IV group receiving weekly doxorubicin by peripheral IV bolus administration; and 3) a catheter group receiving weekly doxorubicin through an indwelling intraatrial catheter. After 8 weeks all dogs were evaluated hemodynamically and then sacrificed. Sections of right ventricle were evaluated by light and electron microscopy. Although no hemodynamic alterations were found in any of the three groups, significant ultrastructural damage consistent with doxorubicin cardiac toxicity was demonstrable in four of the six evaluable catheter dogs receiving intraatrial doxorubicin, but in none of the other 13 dogs evaluated. This finding suggests that the intraatrial administration of doxorubicin may lead to cardiac toxicity at a lower cumulative dose than noted with peripheral IV administration. PMID- 6482446 TI - Ovarian teratoma with peritoneal and lymph node metastases of mature glial tissue: a benign condition. AB - The presence of widespread intraperitoneal metastases in patients with ovarian tumors usually indicates advanced disease. However, this is not always the case. A rare type of ovarian tumor, ie, mature solid teratoma, may be associated with intraabdominal metastases of mature glial tissue (gliomatosis peritonei). In spite of such metastases, the prognosis in patients with this tumor is excellent, regardless of the mode of therapy. In these patients radical surgical treatment, eg, bilateral salpingo-oophorectomy, is unnecessarily destructive, and therapy for the metastases is not required. PMID- 6482447 TI - Renal cell carcinoma presenting as skeletal muscle mass. AB - Solitary muscle tumor, representing the first manifestation of metastatic renal cell carcinoma, is rare. A case report of a tumor mass in the left posteromedial arm, which proved to be metastatic from the right kidney, is presented. The incidence of this condition among patients presenting as a soft tissue sarcoma may be about 1%. PMID- 6482448 TI - Tumor embolism as the first manifestation of cancer. AB - Major tumor emboli (obstructing segmental or larger branches of the pulmonary artery) are a rare mechanism of spread of cancer to the lungs. Less frequently are tumor emboli the cause of respiratory failure and death. The present case of major tumor embolism as the initial manifestation of cancer is unusual for the chronicity, documentation of recurrence, and tissue pathology encountered. In retrospect, we can describe clues which may arouse suspicion of tumor embolism in future cases. PMID- 6482449 TI - Primary neuroendocrine carcinoma of the skin (Merkel's cell carcinoma). AB - Primary neuroendocrine carcinoma of the skin (Merkel's cell carcinoma) is a rare tumor. Until recently 86 patients with this tumor have been described. Two cases of this tumor are presented. This neoplasm has a high propensity for lymphatic as well as hematogenous metastases. It presents as a dermal or subcutaneous nodule. Awareness of this condition may lead to earlier diagnosis and improved survival. PMID- 6482450 TI - Surgical treatment of carcinoma of the breast: IV. Prognosis according to extent of involvement of the axillary lymph nodes. AB - This is a retrospective study of 462 patients who had masectomy and axillary dissection for carcinoma of the breast during 1971-1980. Actuarial analysis of relapse rates up to 5 years showed that the extent of involvement of axillary lymph nodes was the most important prognostic factor. Among patients without any axillary metastasis, those with tumor smaller than 2 cm, colloid, or other less common carcinomas had significantly better prognosis than those with other lesions. Patients younger than 45 years old had higher relapse rate. Among patients with four or more positive axillary nodes, those with tumors smaller than 9 cm or those with nine or fewer positive nodes also had lower relapse rate than those with larger tumors or more positive nodes. Adjuvant systemic chemotherapy has improved the prognosis of patients with four or more positive nodes. Our findings are discussed and compared to those reported in the literature. PMID- 6482451 TI - The management of cardiac tamponade in patients with breast cancer. AB - Six patients with disseminated breast cancer and cardiac tamponade were treated with a pleuropericardial window and in four patients with systemic chemotherapy. The median survival of these six patients was 17 months (range 1-50 months). These results indicate that aggressive therapy in patients with cardiac tamponade and breast cancer can lead to prolonged survivals. PMID- 6482452 TI - Multilocular cyst of the kidney: a case report. AB - A 69-year-old female was referred to Roswell Park Memorial Institute for management of a right kidney tumor. Her evaluation included excretory urography, ultrasound, computerized axial tomography (CT scan), and selective renal angiography. Fine needle aspiration cytology was felt to be consistent with primary renal cell carcinoma. In spite of the radiological appearance of a benign lesion, a right radical nephrectomy was performed because of the positive cytology on fine needle aspiration. The pathological diagnosis was a solitary multilocular cyst of the kidney. PMID- 6482453 TI - Carcinosarcoma of the heart. AB - A unique intracardiac tumor arising in the left atrial wall is described. The patient presented with the classical clinical features of left atrial myxoma. The resected tumor was histologically malignant and showed features of a carcinosarcoma, a tumor type which has not previously been reported to arise in the heart. Histogenetically, this tumor may represent the malignant counterpart of cardiac myxoma. PMID- 6482454 TI - The effect of immunity on pulmonary metastasis of a methylcholanthrene-induced fibrosarcoma and three of its clones. AB - A 3-Methylcholanthrene (MC)-induced fibrosarcoma and three of its clones were investigated for their metastatic potential in normal and tumor immune mice. The growth rates of the four tumors in vivo were similar. However, the mean survival times of the tumor-bearing mice were markedly different. Clone 10, the most immunogenic, showed very high metastatic potential and short survival, while clone 27, the least immunogenic, produced few metastases, resulting in much longer survival. Moderate numbers of metastases were produced by highly immunogenic 3-AM (parental tumor), and poorly immunogenic clone 34. Spleen cells from mice bearing highly immunogenic tumors lost their ability to neutralize tumors by day 28 after tumor inoculation, while those from mice bearing poorly immunogenic tumors remained cytotoxic, indicating that highly immunogenic tumors also induced immune suppression in the hosts. Immunization with specific tumors decreased the number of pulmonary metastases by 3 to 35-fold. Immunization with tumors that shared antigens provided protection against metastatic tumors as well as the local tumors. In contrast, immunization with antigenically different tumors gave no protection. PMID- 6482455 TI - Reassessment of technical and biological factors in paranasal sinus carcinoma. AB - Twenty-seven patients with paranasal sinus carcinoma were analyzed. Local control with radiation alone was poor, with most patients failing centrally within the primary site. With preoperative radiation local control is 60%. Previous reports have emphasized failure at superior sites--particularly the orbit. The pattern of local failure in our series is predominantly various medial sites inclusive of intact or exenterated orbit. The surgically nonremovable medial structures are best encompassed by a three-field radiotherapy technique (weighted anterior and two laterals). PMID- 6482456 TI - Comparison of patient profiles from a comprehensive cancer center and the general population. AB - Differences in cancer patient profiles between cases seen at comprehensive cancer centers and those seen in the general population are seldom assessed by means of reliable and systematically collected data. This report compares the characteristics of patients treated at Roswell Park Memorial Institute in Buffalo with all reported patients diagnosed in the Western New York population. Data for this study were generated from the Roswell Park Tumor Registry and the Western New York Tumor Registry. The findings indicate that patients presenting for treatment at Roswell Park Memorial Institute, compared to the WNY cancer patient population, are more frequently diagnosed with rare tumors, are younger, and manifest later stage disease. These data may have implications for the planning and evaluation of cancer patient services at the community level. PMID- 6482457 TI - Fibromyxomatous pseudotumor of the scrotum. AB - An unusual scrotal mass occurring in a 72-year-old man is described. Clinically and grossly, the lesion appeared to be a neoplasm. However, microscopically the mass was composed of fibromyxomatous tissue that appeared to be degenerative rather than neoplastic in nature. PMID- 6482458 TI - Blood transfusion and disease-free survival in carcinoma of the breast. AB - A retrospective study was undertaken to determine the effect of perioperative blood transfusion on disease-free survival rates in patients with carcinoma of the breast. The charts of 81 patients participating in a NSABP breast cancer protocol at The Mt. Sinai Medical Center, Cleveland, Ohio, were reviewed. There was no statistically significant difference in disease-free survival between those patients receiving blood transfusions and those that did not when considering the entire group of patients or subgroups based upon age, nodal status, estrogen receptor status, or progesterone receptor status. However, the subgroup of patients receiving tamoxifen chemotherapy, especially those with positive estrogen receptors, had significantly reduced disease-free survival (P less than .05) when given blood transfusions. These results suggest an adverse effect of blood transfusion on disease-free survival in breast cancer patients treated with tamoxifen chemotherapy. PMID- 6482459 TI - The influence of cryosurgery and electrocoagulation upon metastatic spread. AB - An experiment was performed to investigate the hypothesis that cryosurgery or electrocoagulation of a tumor can have an inhibitory effect upon the metastatic process. Prior investigation had shown that both electrocoagulation and cryosurgery were as effective in causing a local cure of tumor as local excision. An intravenous injection of tumor cells was given a week after local treatment of 10-day-old subcutaneous tumors had been administered, and 2 weeks later the number of lung metastases was counted. No extra beneficial effect of cryosurgery or electrocoagulation upon the metastatic process could be demonstrated, neither with the antigenic tumor system used nor with two nonantigenic systems. PMID- 6482461 TI - Scrotal calcinosis: calcification of epidermal cysts. AB - The so-called idiopathic scrotal calcinosis does not appear to be idiopathic, but rather a process of dystrophic calcification of epidermal cysts. We report a case that would be otherwise called "idiopathic" where we found squamous epithelial lining around the calcified masses. Literature is reviewed in support of the view that the calcified scrotal nodules are related to epidermal cysts. PMID- 6482460 TI - Malignant feminizing Leydig cell tumor. AB - A patient with a feminizing malignant Leydig cell tumor is presented. Hormonal assays revealed increased production of prolactin, estradiol, and total estrogens. Eleven years after the onset of his disease he remains clinically well. PMID- 6482462 TI - Benign cysts of the parotid gland. AB - Benign cysts of the parotid gland are rare. They present with equal distribution between males and females as unilateral painless swelling in the area of the parotid gland without fixation to the overlying skin or involvement of the facial nerve. These cysts can be congenital, acquired, or occasionally may arise from surrounding structures. The preoperative diagnosis is very difficult and the treatment of choice consists of superficial parotidectomy. Our 10-year experience with benign cyst of the parotid gland at Roswell Park Memorial Institute is presented in this paper. PMID- 6482463 TI - Intraoral melanoacanthoma. AB - A 39-year-old black woman noted a pigmented lesion on her right buccal mucosa of which she had been previously unaware. Physical examination revealed a 2.0 X 1.8 cm uniformly pigmented, macular to slightly plaque-like, symmetrically folded, indented lesion. Histologic examination revealed a hyperplastic mucous membrane containing numerous dendritic melanocytes at all levels. No pleomorphism or cytological atypia was recognized and no fibrosis was present in the corium. The case was diagnosed as "melanoacanthoma." PMID- 6482464 TI - Metastasizing basal cell carcinoma developing in a gunshot wound in a black man. AB - Both basal cell carcinomas that arise in blacks and those that metastasize are rare, and development of this tumor is an uncommon, late complication of trauma. We report a case of a 70-year-old black man with a basal cell carcinoma arising in a gunshot wound in a shoulder and metastasizing to axillary lymph nodes. Histologically, the tumor was of the metatypical type. PMID- 6482465 TI - Tension at the heme: a mathematical treatment of hemoglobin cooperativity. AB - The unique feature of this model is that both the fractional saturation and the free energy change are handled within the framework of the tension-displacement mechanism for hemoglobin co-operativity proposed by Perutz (1970, 1972), i.e. heme iron movement and associated changes in the protein globin internal tension, tau. Physically, tau is the force applied by the protein globin on the proximal histidine, preventing the iron stereochemistry from attaining the geometry preferred in the bound state. It is assumed that a change in position of the heme iron on ligand binding displaces the protein globin proportionately, thereby decreasing tau at neighboring sites; the resulting energy change is assumed to be delocalized throughout the flexible protein globin rather than localized at the heme group per se. The physical interpretation of the model parameters has important implications with regard to data analysis: first, structural data is used to fix the molecular displacements lt and lr; second, jt/jr provides a measure of the protein's intrinsic (i.e. tau = 0) affinity for the bound ligand, and third the set [Ei] is a property of the hemoglobin molecule only and can be determined, in principle, using structural data and optical absorption spectra. The calculated protein globin internal tension in the tense, unbound state (approximately 2 X 10(-5) dyne), determined from the fractional saturation data of Joels & Pugh (1958), is very similar (approximately 3.2 X 10(-5) dyne) to the value estimated by Hopfield (1973) from free energy considerations. PMID- 6482466 TI - Myocardial stress equations: fiberstresses of the prolate spheroid. AB - There are occasions in physiological research and medical practice where it is desirable to estimate the average fiberstress in a chamber wall, knowing only the pressure and dimensions. Because the contribution of a strained wall element to pressure depends on its location whereas its contribution to average stress is independent of location, an equation of this kind must involve an assumption about the stress distribution. When applied to a particular chamber, it will give an exact result only if the chamber's stress distribution is in some sense like that of the model for which the equation was derived. Since the fibers of biological chambers are continually being deposited and resorbed, they tend to exhibit similar stretches under the average conditions of the chamber. To the extent that this is so, P = (2/3) sigma v ln V0/Vc, is the best simple fiberstress equation for biological chambers. (P = transmural pressure, sigma v = volume-averaged fiberstress, V0 = volume enclosed by outside surface, Vc = cavity volume). It expresses the pressure-dimension-average-fiberstress relation of a chamber of any shape whose stresses exhibit the simplest possible distribution. One can add a term to the right side to account for the influence of stress profile complexities. That term takes the form of a moment whose value is zero at one state of distension. This "stress moment" expresses the unequal weighting of complexities on the two sides of the midwall isobar. Judging from the sarcomere length profile of the left ventricular wall, the stress moment is zero and the average fiberstress equation above is exact for average developed stress (without a second term) when cavity volume is somewhere near end-diastolic. Moreover, the departures from the relation (the effects of stress moment) are small so long as the inner and outer stresses do not differ by a factor greater than two. PMID- 6482467 TI - Periodic and non-periodic responses of a periodically forced Hodgkin-Huxley oscillator. AB - Membrane potential responses of a Hodgkin-Huxley oscillator to an externally applied sinusoidal current were numerically calculated with relation to bifurcation parameters of the amplitude and the frequency of the stimulating current. The Hodgkin-Huxley oscillator, or the Hodgkin-Huxley axon in the state of self-sustained oscillation of action potentials, was realized by immersing the axon in calcium-deficient sea water. The forced oscillations were analysed by the stroboscopic plots and/or the Lorenz plots. The results show that the periodically forced Hodgkin-Huxley oscillator exhibits not only periodic motions (harmonic or sub-harmonic synchronization) but also non-periodic motions (quasi periodic or chaotic oscillation), that the motions were determined by the amplitude and the frequency of the stimulating current, and that the characteristic motions obtained in the present study were in reasonable agreement with those of our previous results, found experimentally in squid giant axons. Also, two kinds of routes to the chaotic oscillations were found; successive period-doubling bifurcations and formation of the intermittently chaotic oscillation from sub-harmonic synchronization. PMID- 6482468 TI - Hypothetical entropy-driven mechanism for self-regulation of the size and division of primitive cells, suggesting the origin and nature of mesosomes. AB - It is proposed that, when a critical cell radius was reached, spontaneous invaginations caused by adhesion of adjacent nodes in membranes rippled by Brownian bombardment, became progressive due to re-orientation of self-seeking molecules. Some circumstantial bacteriological evidence is adduced; the significance of mesosomes is discussed. PMID- 6482469 TI - On temperature factor and the effect of viscosity on blood temperature in the arteries. AB - A mathematical theory which could be used to explain a clinical observation in some sickle-cell anemia patients is proposed. It is shown that if the energy stored in the elastic walls of the artery of such a patient is accompanied by thermal effects, then the existence of a local hot spot on the body of a sickle cell anemia patient could be due to shock formation even when the viscosity of the blood is zero. On the other hand, if the energy stored is not accompanied by thermal effects, then a jump in the temperature can only occur if the viscosity is not zero. We give the location of such a jump in the temperature and the time of its occurrence in both cases. PMID- 6482470 TI - Evolutionarily stable strategies in food selection models with fitness sets. AB - Most current models for optimal food selection apply to ecological and behavioural optimization. In this paper optimal food selection theory is extended to apply to evolutionary optimization. A general evolutionary model for optimal food selection must incorporate the concept of fitness sets--or that variables, changing as a result of natural selection in evolutionary time, cannot, in general, vary independently of each other. A "Charnov type" optimal food selection model with a fitness set is investigated, and evolutionarily stable strategy (ESS) solutions of the evolutionary variables (i.e., the efficiencies of using available food types) are found. From this analysis it follows that the relative frequency of various food types in the environment may, under specified conditions, influence the evolutionarily optimal diet. Secondly, the analysis demonstrates that a food type not in the optimal diet may, in evolutionary time, be added to this by becoming more abundant. Thirdly, it follows from the analysis that the ecological result of MacArthur and Pianka, that food types are worth eating even if there is competition for them, is not generally applicable when referring to an evolutionary time scale. Finally, it is pointed out that for the diet to be an ESS, it is necessary that the consumer's density is stable and that the consumer's population dynamics are subjected to some density-dependent factor. PMID- 6482471 TI - A hierarchical polar coordinate model for epimorphic regeneration. AB - In the framework of polar coordinates three rules are postulated which can describe epimorphic regeneration in amphibian limbs. The rules can be seen as an extension of the polar coordinate model. When cells with different positional values are confronted, cell proliferation at the junction restores the continuity of positional values. Reestablishment of continuity is associated with the eventual congruence of the intercalating cell sequence with the host or graft, or both. The intercalating contours can be simple or twisted. The possible contours are graded within a plausible hierarchical scheme where congruent paths are favored versus non-congruent paths and simple contours are favored versus twisted contours. The model correctly predicts the multiplicity, position and different structures of supernumerary outgrowths resulting from both contralateral graftings and 180 degrees ipsilateral limb rotations. Development and regeneration of mirror-symmetric limbs are also accounted for. Several other experimental results are in agreement with the model. Many model predictions and correlations still remain to be tested. PMID- 6482472 TI - Enzyme reactions at the surface of living cells. I. Electric repulsion of charged ligands and recognition of signals from the external milieu. AB - The dynamic behaviour of a polyelectrolyte-bound enzyme is studied when diffusion of substrate or diffusion of product is coupled to electric repulsion and to Michaelis-Menten enzyme reaction. The definition of the classical concepts of electric partition coefficients and Donnan potential of a polyelectrolyte membrane has been extended under global non-equilibrium conditions. This extension is permissible when a strong repulsion exists of substrate and product by the fixed negative charges of the membrane. Coupling between product diffusion, electric repulsion and enzyme reaction at constant advancement may result in a hysteresis loop of the partition coefficient as the product concentration is increased in the reservoir. This hysteresis loop vanishes as the rate of product diffusion increases. No hysteresis loop may occur when electric repulsion effects are coupled to substrate diffusion and reaction. The existence of multiple values of the partition coefficient for a fixed concentration of product implies that the membrane may store short-term memory of the former product concentration present in the external milieu. The occurrence of hysteresis generated by coupling enzyme reaction, product diffusion, electric partition effects at constant advancement of the reaction may be viewed as a sensing device of product concentration in the external milieu. Surprisingly, non linearities required to generate this sensing device come from electrostatic effects and not from enzyme kinetics. PMID- 6482473 TI - Enzyme reactions at the surface of living cells. II. Destabilization in the membranes and conduction of signals. AB - The dynamics of a bound-enzyme reaction is studied when the diffusion of both the substrate and the product is coupled to their electric repulsion and to enzyme reaction. Contrary to what is occurring when substrate diffusion is uncoupled with electric repulsion and enzyme reaction, no hysteresis loop of the partition coefficient exists. The electric partition coefficient monotonically declines as substrate or product concentration is increased in the reservoir. The random perturbation of a steady state may generate a localized destabilization of substrate and product concentration. This destabilization must propagate in the membrane and may be viewed as the conduction of a signal. These conduction phenomena are entirely due to electric effects. In the absence of these effects, the system is homeostatic, that is it returns back to its initial steady state after a perturbation. Obviously under these conditions conduction of signals cannot occur. Increasing the ionic strength of the external milieu tends to stabilize the system and to suppress conduction effects in the membrane. PMID- 6482474 TI - Noisy neural nets exhibiting memory domains. AB - Previous studies with probabilistic neural nets in which the neural connections are set up by means of chemical markers, revealed the existence of multiple memory domains. We generalized these studies by considering the intrinsic noise of the systems, caused by the spontaneous release of synaptic transmitter substance. A simple mathematical model is developed, which yields characteristics of multiple memory domains analogous to those occurring in noiseless nets. PMID- 6482475 TI - Optimum strengths for bones liable to fatigue and accidental fracture. AB - Limb bones are liable to fail by fatigue, due to stresses imposed repeatedly in activities such as running. They may also be broken by larger stresses which occur occasionally in accidents. Too weak a bone will probably fail but too strong a bone is unduly heavy. A mathematical model predicts optimum strengths for bones subject to the hazards both of fatigue and of accidents. When accidents are mild and predictable, fatigue is the more important hazard. When they are large and unpredictable they are the more important hazard and stronger bones are generally preferred, but in extreme cases it may become advantageous to dispense with the bone. There is a restricted range of circumstances in which fatigue and accidents are both important hazards. The strengths of many limb bones seem surprisingly low, in the light of the theory and of current knowledge of the fatigue properties of bone. PMID- 6482476 TI - A drug used in traditional medicine. Harpagophytum procumbens DC. I. Scanning electron microscope observations. AB - Histological characteristics, as observed by scanning electron microscope, of the secondary roots of Harpagophytum procumbens DC. (Pedaliaceae), a drug widely used in South African traditional medicine, specially by Bushmen, Hottentots and Bantu, are described in detail. It has been possible to reveal some morphological elements that, together with superficial granular material containing harpagoside and harpagide, allow drug identification. PMID- 6482477 TI - A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. AB - In conscious normotensive rats the dried crude methanolic extract of Harpagophytum procumbens secondary roots caused a significant dose-dependent reduction of arterial blood pressure. The decrease was significant only at higher doses given by gavage (dried extract = 400 mg/kg). At the same time a decrease of heart rate was observed. In the same experimental conditions, harpagoside presented an activity lower than doses of Harpagophytum procumbens extract containing corresponding quantities of harpagoside. In spontaneously beating Langendorff preparations of rabbit heart, the Harpagophytum procumbens methanolic extract caused a mild decrease in the heart rate with a concomitant mild positive inotropic effect at lower doses but a marked negative inotropic effect at higher doses. The coronary flow decreased at higher doses only. The negative chronotropic and positive inotropic effects of harpagoside were comparatively higher with respect to that of the extract, whereas harpagide had only a slight negative chronotropic effect and a considerable negative inotropic one. Both in experiments on intact rats and on isolated rabbit heart, the Harpagophytum procumbens extract also demonstrated a protective action with regard to arrhythmias induced by aconitine, and particularly to those provoked by calcium chloride and epinephrine--chloroform. PMID- 6482478 TI - Anti-hyperglycaemic effect of an extract of Myrtus communis in streptozotocin induced diabetes in mice. AB - Intraperitoneal injection of streptozotocin (150 mg/kg) in mice produced an initial transient hyperglycaemia at 2 h followed by a second hyperglycaemic phase after 48-72 h which persisted throughout the 7-day observation period. An ethanol water extract of Myrtus communis (2 g/kg) administered intragastrically 30 min before streptozotocin abolished the initial hyperglycaemic without affecting the second phase. Myrtus extract given prior to streptozotocin and repeated at 24 h and 30 h, did not allow hyperglycaemia to develop until after 48 h. Administration of Myrtus extract 48 h after streptozotocin significantly reduced the hyperglycaemia and this effect was maintained by its repeated administration. Myrtus extract had no effect on the blood glucose level of normal mice. These studies confirm the "folk-medicine" indication of Myrtus extract as potentially useful in the treatment of diabetes mellitus. PMID- 6482479 TI - Effects of the extracts of Desmodium adscendens on anaphylaxis. AB - Desmodium adscendens, used by herbalists in Ghana for the treatment of asthma, is anti-anaphylactic in vitro. As the plant material is administered orally, in vivo studies of its anti-anaphylactic property were undertaken using the guinea-pig. The results show that both aqueous and ethanolic extracts of D. adscendens, when taken orally, reduce anaphylactic contractions, interfere with histamine-induced contractions, and reduce the amount of smooth muscle stimulating substances released from lung tissue of guinea pigs. PMID- 6482481 TI - Study of anti-inflammatory activity in the leaves of Nyctanthes arbor tristis Linn.--an Indian medicinal plant. AB - Nyctanthes arbor tristis Linn. (Harsingar) is widely used as a decoction in the Ayurvedic system of medicine for treatment of sciatica and arthritis, but it has not yet been screened scientifically. In the present study, the water soluble portion of the alcoholic extract of the leaves of Nyctanthes arbor tristis (NAT) was screened for the presence of anti-inflammatory activity. NAT inhibited the acute inflammatory oedema produced by different phlogistic agents, viz. carrageenin, formalin, histamine, 5-hydroxytryptamine and hyaluronidase in the hindpaw of rats. The acute inflammatory swelling in the knee joint of rats induced by turpentine oil was also significantly reduced. In subacute models, NAT was found to check granulation tissue formation significantly in the granuloma pouch and cotton pellet test. Acute and chronic phases of formaldehyde induced arthritis were significantly inhibited. NAT was also found to inhibit the inflammation produced by immunological methods, viz. Freund's adjuvant arthritis and PPD induced tuberculin reaction. Thus anti-inflammatory activity in leaves of Harsingar supports its use in various inflammatory conditions by the followers of the Ayurvedic system of medicine. PMID- 6482480 TI - Ethnopharmacology of some Buddleja species. AB - Buddleja species play a minor role in the ethnopharmacology of several areas of the world where they are indigenous. Phytochemical investigation of the genus has been somewhat neglected but a picture is emerging of the type of constituents which are present in reasonable quantities, namely iridoid and flavonoid glycosides. Many of the uses of Buddleja in folk medicine such as a topical antiseptic and a diuretic can be partially explained at least by the known biological activity of compounds identical or similar to those found in the genus. Other reputed uses are, as yet, without explantation due to the incomplete state of knowledge of the chemistry and, to an even greater extent, the pharmacology of Buddleja. PMID- 6482482 TI - Effect of alkaloids of Solanum melongena on the central nervous system. AB - Crude alkaloidal fraction isolated from the leaves of Solanum melongena was screened for its effects on the central nervous system. It exhibited significant analgesic effect and some CNS depression but no anticonvulsant action. The analgesic effects were of non-narcotic type. LD50 was estimated to be higher than 1 g/kg i.p. in mice. PMID- 6482483 TI - Martinella (Bignoniaceae): a widely used eye medicine of South America. PMID- 6482484 TI - The role of the surgeon in the intensive care unit. PMID- 6482485 TI - Computed tomography. An effective technique for mediastinal staging in lung cancer. AB - Computed tomographic scans of the chest were utilized to stage mediastinal disease in 148 instances of bronchogenic carcinoma considered for resection in 146 patients. Nodes greater than or equal to 1.5 cm in diameter were interpreted as abnormal. All nodes positive by computed tomography were evaluated by mediastinoscopy, anterior mediastinotomy, or thoracotomy. All patients with negative computed tomographic findings underwent thoracotomy without prior surgical staging. Patients undergoing thoracotomy were divided into two groups. In Group I (first 51 instances) routine mediastinal exploration was not carried out; in Group II (last 97 instances) the mediastinum was explored in every patient and nodes were submitted for histopathological study. The computed tomographic and pathological findings on the mediastinal lymph nodes were compared. The sensitivity, specificity, and accuracy of computed tomography in Group I were 88%, 94%, and 92%, respectively, in Group II 75%, 89%, and 86%, and in the combined group, 80%, 91%, and 88%. The positive predictive index in Group I, Group II, and in the combined group was 88%, 69%, and 77%, respectively. It was lower for central than peripheral lesions (74% versus 88%) and was lowest for lesions in the right upper and left lower lobes. The negative predictive index was greater than 90% for all groups and all tumor sites except the left upper lobe, where it was 89%. Ten patients had false-positive scans, three with old mediastinitis and seven with postobstructive pneumonia; nine of the 10 had central lesions, and seven of these lesions were located in the right upper lobe. Eight patients had false-negative scans; six had para-aortic, subaortic, or postsubcarinal nodes. These nodes would not have been accessible to mediastinoscopy. In only one patient with false-negative nodes would routine mediastinoscopy have prevented thoracotomy and resection. Computed tomographic staging of mediastinal disease is indicated for all patients with lung cancer in whom operation is contemplated. Computed tomography directs the most appropriate staging procedure for patients with positive findings and obviates invasive staging for patients with negative findings. PMID- 6482486 TI - Survival following resection for second and third primary lung cancers. AB - The performance of sequential resections and the consideration of new lesions as second or third primary lung cancers remain controversial issues. Criteria to define these as new primary lesions depend upon a difference in histologic types, a prolonged interval between initial and second or third resections, and location in the contralateral lung or a different ipsilateral lobe. Ninety patients have undergone multiple resections for bronchogenic carcinoma from 1960 to December, 1983. There were 10 examples of synchronous lesions and the remaining 80 were metachronous with the longest interval between resections being 17 years, 4 months. The initial surgical procedure was pneumonectomy in 11, lobectomy in 43, sleeve lobectomy in eight, segmentectomy in 27, and carinal resection in one. At the second operation, the procedures were segmentectomy in 55, lobectomy in 11, completion lobectomy in six, and completion pneumonectomy in 15. Two patients had sternotomy with bilateral resections and one patient had a tracheal resection. At the third operation, the procedures were segmentectomy in seven, completion lobectomy in two, and completion pneumonectomy in two. In 20 patients undergoing the second procedure and three undergoing a third resection, a different cell type was identified. The perioperative mortality following the second operation was seven of 90 patients (8%) and there were no deaths in those patients undergoing three resections. The cumulative survival rate following second resection in 80 patients with metachronous tumors was 33% at 5 years and 20% at 10 years. These data support continued aggressive surgical approach to second and third primary lung cancers. PMID- 6482487 TI - Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children. AB - Five infants with long tracheal stenosis were operated upon by means of a pericardial patch tracheoplasty. The approach was through a median sternotomy with extracorporeal circulation for respiratory support. In four, the obstruction was due to complete rings; in the other, there was an associated tracheal trauma which had occurred during resuscitation. This patient requires prolonged stenting with a tracheostomy tube. All others are asymptomatic postoperatively, with the longest follow-up being 22 months. There were no deaths or infections. We conclude from this experience that median sternotomy provides an excellent approach to the trachea, that autogenous pericardium is advantageous, and that there is no need for prolonged tracheal stenting in most patients. PMID- 6482488 TI - Early and late prognosis after reoperation for prosthetic valve replacement. AB - From 1969 to 1983, 89 patients underwent replacement of a prosthetic heart valve, an average of 66 months after initial implantation, because of primary failure of the prosthesis in 39 patients (44%), endocarditis in 16 (18%), systemic valve related complications in 16 (18%), and periprosthetic leaks in 13 (15%). In the remaining five patients (5%), a prosthesis was removed concomitantly with the replacement of another native heart valve. A mechanical valve was replaced in 64 cases (72%) and a bioprosthesis in 25 (28%). Forty-six of the prostheses (52%) were in the mitral position, 37 (42%) were in the aortic position, and six patients (6%) underwent replacement of two prostheses. Preoperatively, four patients were in Functional Class I, 21 in Class II, 37 in Class III, and 27 in Class IV. There were 19 early deaths (21.3%). Early mortality was significantly higher with aortic (35.1%) than with mitral prosthetic valve replacement (8.7%, p less than 0.01). Preoperative diagnosis had a significant correlation with mortality, which was higher with infective endocarditis (62.5%) than with all other indications for operation (12.3%, p less than 0.001). No correlation was found with the preoperative clinical class of the patients. During the time period of this study, there was a marked decline in the mortality rate, which decreased from 29.2% prior to 1979 to 7.4% during the last 2 years (p less than 0.05). Actuarial survival was 60% at 5 years and 38% at 10 years after reoperation. Among the 53 survivors followed up for an average of 39 months, 47 (88.9%) remained in Class I or II and six were in Class III (11.3%) at last follow-up. A second prosthetic valve replacement (third valve replacement) was required in eight patients, three of whom died at re-replacement. Recent improvements in myocardial protection techniques, in the treatment of prosthetic valve endocarditis, and increased surgical experience have contributed to decrease the risk of reoperation for prosthetic valve replacement. Late results are similar to those of a first valve implantation. PMID- 6482489 TI - New generation tissue valves. Their in vitro function in the mitral position. AB - The in vitro function of six tissue valves from four manufacturers has been assessed. One porcine bioprosthesis (Carpentier-Edwards supra-annular) and five pericardial valves (Edwards, Hancock, Ionescu-Shiley, Ionescu-Shiley low-profile, and Mitral Medical Mitroflow) were tested. Valve function was measured in a pulse duplicator simulating conditions of sinus rhythm (60, 80, and 120 beats/min and stroke volume 70 ml) and supraventricular tachycardia (200 beats/min and stroke volume 30 ml). Under each of these test conditions, mean transvalvular pressure, regurgitation, and transvalvular energy loss were determined and used to compare valve function. The porcine valve showed the largest mean transvalvular pressure during forward flow. The total energy loss of this valve, however, was not the largest for the valves tested. The total transvalvular energy loss ranged between 3% and 12% for all valves and conditions. For all valves, energy loss and regurgitation were greatest during simulated tachycardia. PMID- 6482490 TI - Late results after Starr-Edwards valve replacement in children. AB - Selection of types of prosthetic heart valves for children remains controversial. The case histories of 50 children surviving valve replacement with Starr-Edwards prostheses between 1963 and 1978 were reviewed to evaluate the long-term performance of mechanical valves. The 31 boys and 19 girls ranged from 6 months to 18 years in age (mean 10.4 years); 19 patients had had aortic valve replacement, 24 patients had had mitral valve replacement, and one patient had had both. Among the six patients who had had tricuspid valve replacement, four had corrected transposition, so that the tricuspid valve was the systemic atrioventricular valve. Mean (+/- standard deviation) follow-up interval was 7.9 +/- 4.9 years (maximum 17 years). For all patients, the 5 year survival rate was 86% +/- 6%. At 10 years postoperatively, the survival rate (+/- standard error) was 90% +/- 7% after aortic valve replacement and 76% +/- 8% after systemic atrioventricular valve replacement. At follow-up, 39 patients were alive, and 38 were in New York Heart Association Class I or II. Of the 11 deaths, four were valve-related. Seven patients had major (requiring hospitalization) thromboembolic events, and five patients had minor transient neurological symptoms suggesting thromboembolism; 50% of these patients were not taking warfarin (Coumadin) at the time of the thromboembolic event. The incidence of late (greater than 30 days) thromboembolism was 5.3 per 100 patient-years after aortic and 2.0 per 100 patient-years after systemic atrioventricular valve replacement. At 10 years postoperatively, 66% +/- 15% of patients who had had aortic valve replacement and 91% +/- 6% of those who had had systemic atrioventricular valve replacement were free of thromboembolism. The excellent long-term survival, absence of mechanical failure, and relatively low rate of thromboembolism with this prosthesis contrast with our experience with biological valves, in which 41% of children required reoperation in 5 years. Currently, mechanical valves, such as the Starr-Edwards prostheses, are our preferred valves for pediatric patients. PMID- 6482491 TI - Double-inlet ventricle: morphologic analysis and surgical implications in 32 cases. AB - We analyzed, using a sequential segmental approach, 32 cases of double-inlet ventricle to assess the feasibility of surgical "correction" by either ventricular septation or a modified Fontan procedure. Twenty-two hearts had two atrioventricular valves, connected to a left ventricle in 19, a right ventricle in two, and a solitary indeterminate ventricle in one. Septation was possible in only 13. In contrast, the Fontan procedure seemed feasible in 20. The remaining 10 specimens had double inlet via a common valve to the left ventricle in two, the right ventricle in six, and an indeterminate ventricle in two. Seven of these had right atrial isomerism. Ventricular septation was not considered a possibility in these hearts. The Fontan procedure combined with atrial septation was a possibility in seven cases. From the morphologic stance, although the modified Fontan procedure seemed suitable in most cases, a significant number of hearts with two atrioventricular valves were suitable for ventricular septation. PMID- 6482492 TI - Protein-losing enteropathy after Fontan operation. AB - Generalized edema resulting from severe protein-losing enteropathy occurred in three patients 12, 15, and 17 months after the Fontan operation. One patient originally had tricuspid atresia and the other two, univentricular heart disease. At operation a conduit had been inserted between the right atrium and pulmonary artery. Apart from the protein loss, the patients were in good health. The cardiac catheterization data obtained 0.8 to 2.4 years (median 1.3 years) after operation in the three patients with protein-losing enteropathy were compared with those of 18 patients in whom Fontan's operation had been performed because of tricuspid atresia (eight patients) or univentricular heart disease (10 patients). All had atriopulmonary connections. The mean right and left atrial pressures and systemic blood flows measured by dye dilution in the patients with and without protein-losing enteropathy did not differ. However, the patients with protein-losing enteropathy had a higher diastolic right atrial pressure. Since maximal antegrade flow in the superior vena cava after Fontan's operation occurs during atrial diastole, these observations suggest that an increase in diastolic right atrial pressure may result in protein-losing enteropathy because of impairment of blood flow and therefore congestion in the superior vena cava, subclavian vein, and thoracic duct. PMID- 6482493 TI - A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. AB - A new angiographic method for quantitative standardization of cross-sectional area of bilateral pulmonary arteries, the PA-index, and retrospective analysis of the PA-index in different types of operative procedures are presented. This study included 40 subjects in the normal control group, 46 patients in the tetralogy group, 26 patients in the Rastelli group, and 15 patients in the Fontan group. The normal value of the PA-index was 330 +/- 30 mm2/BSA and was consistent in a wide range of body surface areas from infancy to adolescence. The PA-index in the tetralogy and Rastelli groups ranged from 100 to 400 mm2/BSA. There were no early deaths in the tetralogy group, but the incidence of low cardiac output was higher in patients with a smaller PA-index, especially when the PA-index was less than 150 mm2/BSA. Low cardiac output was more severe in the Rastelli group. The operative mortality was significantly affected by the PA-index. In the Rastelli group, all of the patients with a PA-index of less than 200 mm2/BSA died, whereas the mortality rate in patients with a PA-index of more than 200 was only 6% (p less than 0.01). The mortality rate was not influenced by any other factors, such as aortic cross-clamp time or age at operation. In the Fontan group, two patients with a PA-index of less than 250 mm2/BSA died of severe heart failure, and 12 of 13 patients with a PA-index of more than 250 survived (p less than 0.01). Our results indicated the validity of the PA-index in predicting the postoperative prognosis of the various entities. In tetralogy, all patients with a PA-index over 100 mm2/BSA can undergo correction safely; in Rastelli operation, those with a PA-index under 200 should have a palliative procedure first, whereas those with a PA-index over 250 can be considered good candidates for the Fontan procedure. The PA-index may also serve a useful guide in comparing surgical results from different institutions with patients having anomalies of varying severity. PMID- 6482494 TI - Repair of subdiaphragmatic total anomalous pulmonary venous connection without cardiopulmonary bypass. AB - Two neonates with asplenia syndrome, subdiaphragmatic total anomalous pulmonary venous connection, and pulmonary stenosis underwent a palliative operation without cardiopulmonary bypass. With the use of a side-biting clamp, and anastomosis was created between the pulmonary venous confluence and the right atrium. (Since children with asplenia syndrome have common mixing lesions, pulmonary venous drainage to the right atrium is not physiologically detrimental.) The descending vertical vein was ligated. A systemic-pulmonary shunt was performed. Both infants were discharged from the hospital less than 1 week after the operation. Both infants subsequently died, at 4 months and at 16 months of age. At autopsy, pulmonary venous drainage was unobstructed, with a surgical orifice 86% to 90% of the aortic anulus. We conclude that, in infants with asplenia syndrome and obstructed total anomalous pulmonary venous drainage, relief of pulmonary venous obstruction can be accomplished without cardiopulmonary bypass. PMID- 6482495 TI - Thrombosis of an aortic porcine xenobioprosthesis associated with familial antithrombin III deficiency. AB - Thrombosis of a porcine xenobioprosthesis in the aortic position associated with antithrombin III deficiency has not been reported. Admittedly a rare coagulation abnormality, it should be suspected in patients with previous tendencies or family history toward spontaneous thrombosis, especially in those with Scandinavian ancestry. Special precautions should be taken if a cardiac operation becomes necessary. PMID- 6482496 TI - Intrapericardial diaphragmatic hernia after subxiphoid epicardial pacemaker insertion: case reports. AB - The first two cases of intrapericardial diaphragmatic hernia following a subxiphoid epicardial pacemaker insertion are reported. Factors deemed responsible for this rare complication in one case were previous gastrectomy with a resulting paucity of omentum, and entrance into the peritoneal cavity during the pacemaker procedure. PMID- 6482497 TI - Elective femoro-femoral bypass for operations on the heart and great vessels. AB - Femoro-femoral bypass with "circulatory arrest" is no longer used in routine cardiac operations. Its use today is normally limited to operations wherein access to the arch of the aorta is required or the thoracic aorta is to be temporarily occluded. We have recently encountered three patients presenting with complications of previous operations. In all three, the use of this technique allowed us to approach the defect safely. PMID- 6482498 TI - Valve replacement in the Third World. PMID- 6482499 TI - Multivessel coronary revascularization utilizing bilateral sequential internal mammary arteries. PMID- 6482500 TI - Percutaneous drainage of lung abscess. PMID- 6482501 TI - Immobilization of Bjork-Shiley disc valve. PMID- 6482502 TI - Theory and operation of a single microelectrode voltage clamp. AB - The theory of operation of a discontinuous single-electrode voltage clamp using an ideal microelectrode (infinite response speed) and fixed (current-passing) duty cycle has been previously described. In this paper, the theory is extended by considering a microelectrode which has a finite response speed, by allowing the duty cycle to be variable, and by considering the clamp noise. Formulate are derived for the relationships between the step response, the steady-state error, the steady-state ripple, and the stability, in terms of the cycling frequency, the duty cycle, the open loop gain, and the electrical resistance and capacitance of the microelectrode and the cell membrane. In addition, the amplification of the microelectrode noise by aliasing is analysed, the error due to incomplete decay of the microelectrode voltage is described, and the accuracy of averaging the peak current measurement is established. To achieve the fastest dynamic response and the smallest steady-state error, the cycling period should be made as small as possible, and the open-loop gain should be as large as possible, consistent with stability. Incomplete decay of the microelectrode voltage destabilizes the clamp, and can introduce a significant clamp error. The choice of duty cycle is a compromise between reducing the noise and the step response time while avoiding design problems in the current output circuit. The output noise is amplified by aliasing. It can be minimized for a given output filter cutoff frequency by keeping the cycling frequency as high as possible, and by the use of an anti-aliasing filter whose cutoff frequency must be set for each microelectrode. PMID- 6482503 TI - Video and scanning microdensitometer-based imaging systems in autoradiographic densitometry. AB - The characteristics of computer-assisted imaging devices (CIDs) incorporating charge-coupled device cameras, vidicon cameras and scanning microdensitometers (SMDs) are compared. Advantages of vidicons include their low cost, the option of real-time imaging, continuously variable optical magnification and the wide choice of available vidicon elements. Disadvantages include densitometric non linearities and, with some vidicons, lack of dynamic range. A CID comprising a laboratory minicomputer, image processing device, vidicon and SMD scanners and our 'PANDA' image analysis routines is described. Software corrections for vidicon errors are evaluated by comparing the densitometric accuracy of the CID receiving input from the vidicon camera and from the SMD. The scanners exhibit similar densitometric accuracy and linearity, and acceptable between-session repeatability. It is concluded that densitometric precision of a corrected vidicon scanner is not the limiting factor for quantitative autoradiographic densitometry. PMID- 6482504 TI - Haematological changes induced by direct contact over a coated activated charcoal: in vivo and in vitro study. AB - In evaluating biocompatibility, haematological changes induced by ACCM in vivo and in vitro were studied. Twenty minutes after the start of haemoperfusion a significant fall in white blood cell number was found. After 60 minutes the leucopenia still occurred. In a previous work we suggested that complement activation is at least one of the possible mechanisms responsible for these phenomena. Moreover, our data showed a significant decrease in platelet number after 60 minutes of haemoperfusion. During the in vitro study, we found, using citrated blood, a significant correlation between aggregation response to ADP and collagen, either at different ACCM doses or at various periods of incubation. Our results suggest that the fall in platelets is due to platelet aggregation. The haemocoagulation study may have clinical importance in high-risk patients when haemoperfusion is required. PMID- 6482505 TI - Experimental studies of the anatomical and functional characteristics of kangaroo aortic valve bioprostheses. AB - In many tests done in vitro and in vivo on porcine aortic valve grafts, high pressure gradients were found under normal as well as under stress conditions. The transvalvular pressure difference is due to the immobility of the right aortic porcine leaflet that is fixed tightly to the muscular septum of the ventricle. Our own studies of 24 kangaroo hearts show different anatomical features: the right leaflet is practically free in this movement. Thus the maximum orifice area of the kangaroo aortic valve is reduced by only 24.2 per cent, whereas the porcine valve shows a reduction of 36.5 per cent. This difference proved to be highly significant (P less than 0.001). Therefore, in cooperation with Hancock Laboratories, kangaroo aortic valve grafts were tested as xenotransplants, using a pulse duplicator. The first results show that larger orifice areas are achieved by kangaroo valves one or two sizes smaller than their porcine counterparts. PMID- 6482506 TI - Study of the biological films formed during the pitting of aluminium in human plasma. AB - Film formation during the pitting corrosion of aluminium in human plasma is studied using conventional electrochemical techniques complemented with scanning electron microscopy as well as energy-dispersive x-ray, electron microprobe and immunoelectrophoresis analysis. The anodic polarization curve of aluminium in human plasma at 37 degrees C shows a passive region related to a low corrosion rate that extends up to -0.66 V (s.c.e.). At more positive potential values than 0.66 V, the breakdown of the oxide protective film occurs due to the chloride anions, leading to an intense localized dissolution of the metal (pitting corrosion). Scanning electron microscopy of the metal surface reveals a thick non adherent precipitate covering pits of a crystallographic feature. Energy dispersive x-ray and the microprobe analysis show the presence of aluminium, chloride and carbon signals. Immunoelectrophoresis of the precipitate resuspended in physiological solution shows a strong protein denaturization. Results suggest that the corrosion products are formed during pitting by the interaction of the saturated AlCl3 salt present within the pits and the adsorbed plasma proteins. PMID- 6482507 TI - Cardiovascular simulation models. PMID- 6482508 TI - Effect of hypermagnesemia on circulating plasma parathyroid hormone in patients on regular hemodialysis therapy. AB - This study was designed to assess the influence of magnesium on circulating plasma immunoreactive parathyroid hormone (iPTH) in end-stage renal disease. 20 patients receiving regular hemodialysis therapy underwent plasma measurements of iPTH and 25-hydroxycholecalciferol (25-OHCC) concentrations before and 10 weeks after the magnesium concentration in the dialysate was increased from 0.75 to 1.50 mmol/l. This resulted in a 36% rise in the mean predialysis plasma magnesium concentration from 1.25 to 1.70 mmol/l (p less than 0.001) and a 23% fall in the mean plasma iPTH concentration from 546 to 418 ng/l (p less than 0.001). Mean plasma concentrations for calcium, phosphate, and 25-OHCC also decreased, but these changes were not significant. In conclusion, we have demonstrated that a rise in plasma magnesium concentration from elevated to significantly higher levels reduces circulating plasma iPTH in normocalcemic uremic patients with initially both normal and raised plasma PTH levels. PMID- 6482509 TI - Role of dietary potassium and magnesium in diuretic-treated patients with cardiac insufficiency. AB - The role of daily dietary intake of potassium and magnesium in the maintenance of potassium balance was studied in 104 digitalized outpatients with chronic cardiac insufficiency receiving 50 mg hydrochlorothiazide twice daily for 6 weeks. The food consumption data were collected once a week by the 24-hour recall method during the 1st, 2nd and 3rd weeks of the investigation. Serum potassium and magnesium values were followed throughout the study, and total body potassium was measured at the end. During the hydrochlorothiazide treatment, potassium and magnesium levels decreased significantly (p less than 0.001). 46% of the patients became hypokalemic (serum potassium less than or equal to 3.5 mmol/l), hypokalemia being more common (64%) in the patients with a concomitant decrease ( 0.063 +/- 0.08 mmol/l) in serum magnesium values. Mean intake of potassium and magnesium was 3.4 g and 299 mg in females and 4.2 g and 380 mg in males, respectively. There was no significant difference in the daily intake of potassium and magnesium between the patients becoming hypokalemic and those remaining normokalemic. PMID- 6482510 TI - On the therapeutic mechanism of Mg2+ in digitoxic arrhythmias and the role of cardiac glycosides in Mg depletion. AB - In 9 (of 17 attempted) experiments (8 aborted due to premature tissue death), transmembrane electrical activity was recorded from canine false tendons superfused with Mg-free Tyrode's solution to simulate hypomagnesemia. Oscillatory after-potentials (OAP) developed similar to those seen after exposure to 2 X 10( 7) M ouabain, a short-lasting (0.5-1 time the duration of an action potential) OAP that often reached threshold superimposed on a long-lasting (3-4 times as long as the short) OAP. Both forms of OAP were shown to be Ca2+-dependent, as both were prevented by 10(-7) M nifedipine, but only the short OAP were abolished by nifedipine once they had appeared, while high (5 mM = 10 times normal) Mg2+ both prevented and terminated short and long OAP in digitoxic preparations. Results suggest that cardiac glycosides may deplete Mg from the myocardium. The mechanism of the therapeutic action of Mg2+ in digitalis intoxication is discussed in light of its involvement in Ca2+ sequestration by the sarcoplasmic reticulum. PMID- 6482511 TI - A four-year comparison of continuous ambulatory peritoneal dialysis and home hemodialysis: a preliminary report. AB - All patients who received initial dialysis therapy by either continuous ambulatory peritoneal dialysis (CAPD) or home hemodialysis between January 1979 and January 1983 were retrospectively compared for adequacy of dialysis, morbidity, and survival. In this study group, 30 patients had home hemodialysis and 21 patients had CAPD; the mean ages of the patients in these two groups were comparable. Both methods of treatment provided adequate dialysis, as shown by results of serial laboratory studies. The number of days of hospitalization per year at risk was twice as great for the patients on CAPD as for those on home hemodialysis; peritonitis was responsible for this difference. The survival was similar in both groups at 32 months of therapy. Death was clearly related to coexisting morbid events other than dialysis in the home hemodialysis group; however, one of the two deaths in the group on CAPD seemed to be indirectly related to the treatment of peritonitis. These findings suggest that CAPD, when compared with hemodialysis, (1) provides adequate dialysis, (2) is accompanied by greater morbidity (hospitalization), and (3) may introduce a morbid event (peritonitis) that may adversely affect survival. PMID- 6482512 TI - Results of treatment of center hemodialysis patients. AB - Four hundred eighty-three patients were maintained by hemodialysis in an outpatient hemodialysis center at the Mayo Clinic between 1963 and 1977. Although only 18 patients had experienced a myocardial infarction and 6 had had a cerebral infarction before beginning dialysis, 30 subsequently had acute myocardial infarction and 45 had a stroke. These two complications accounted for 48 of the 98 deaths that occurred during maintenance dialysis. Despite such complications, 183 patients were employed, 124 remained active at home or at school, and 115 were totally disabled. Survival of patients maintained solely by dialysis was 52% at 5 years. For the group as a whole, including patients who received their first allograft, the survival rate at 5 years was 65%. PMID- 6482513 TI - Surgical pathology of pure aortic stenosis: a study of 374 cases. AB - The gross surgical pathologic features of the aortic valve were reviewed in 374 patients who had had clinically pure aortic stenosis and aortic valve replacement at our institution during the years 1965, 1970, 1975, and 1980. The most common cause of aortic stenosis, accounting for 46% of our cases, was calcification of a congenitally bicuspid valve. In the remainder, stenosis was produced by postinflammatory fibrocalcific disease (including rheumatic disease) in 35%, by degenerative calcification of an aging valve in 10%, and by calcification of a congenitally unicommissural valve in 6%. The cause of aortic stenosis was indeterminate in 4%. Valvular lesions included various degrees of dystrophic calcification, commissural fusion, and cuspid fibrosis. Calcification tended to occur more extensively and at a younger age in men than in women. Furthermore, it tended to produce stenosis and to necessitate valve replacement earliest in patients with unicommissural valves (mean age, 48 years), later in those with bicuspid or postinflammatory valves (mean age, 59 and 60 years, respectively), and latest in those with degenerative stenosis (mean age, 72 years). In our study, the relative incidence of postinflammatory aortic stenosis remained unchanged from 1965 to 1980, despite the steadily decreasing incidence of acute rheumatic fever reported in western countries. Our data suggest that (1) the incidence of chronic rheumatic heart disease has not yet begun to decrease appreciably, (2) many episodes of acute rheumatic fever may be subclinical, or (3) some forms of nonrheumatic aortic valve disease may produce gross alterations indistinguishable from those of classic chronic rheumatic valvulitis. PMID- 6482514 TI - Intraoperative and external beam irradiation with or without resection: Mayo pilot experience. AB - At our institution, intraoperative radiation therapy (IORT) with an electron beam has been administered as a single boost dose of 1,000 to 2,000 cGy (rad) in combination with 4,500 to 5,000 cGy (rad) of fractionated external beam irradiation. From April 1981 to July 1983, 50 patients received such treatment, and results are analyzed in detail in this article. All patients had locally advanced disease (initially unresectable for cure, residual after resection, or recurrent), and the main disease sites were gastrointestinal (pancreatic, colorectal, and biliary tumors) and soft tissue (sarcomas). Disease-free survival to date has been excellent in our colorectal and biliary subsets of patients. Although local progression has not been a major problem in patients with unresectable pancreatic lesions, failures in the liver and peritoneal cavity have been excessive, and treatment strategies have been altered in an attempt to decrease the frequency of such failures. Although both short-term and long-term morbidity are acceptable, pilot trials with use of radiation-dose modifiers are planned to determine whether the therapeutic ratio of local control to associated complications can be improved even further. PMID- 6482515 TI - Disease associations: need for increased scrutiny of the literature. PMID- 6482516 TI - George S. Malouf MD. 124th elected president of Med-Chi. Interview by Ann Wintriss. PMID- 6482517 TI - Correlation of DNA repair synthesis with ageing in mice, evidenced by quantitative autoradiography. AB - Fibroblasts from C57B1/6 female mice of different age have been treated with short-wave ultraviolet light. The amount of unscheduled DNA synthesis in the fibroblasts, determined by quantitative histoautoradiography, decreases with the donor's age. This result is discussed with regard to an increase in nuclear area and modifications of cell population dynamics with age. Moreover, differences between individuals of the same age group with regards to unscheduled DNA synthesis have been observed. PMID- 6482518 TI - Excessive intake of copper: influence on longevity and cadmium accumulation in mice. AB - Feeding copper gluconate in the drinking water to C57BL/6J male for a lifetime decreased the mean survival times by 14.4% when given at a concentration of 5 X 10(-3) M (317 ppm copper). The maximum life span was reduced by 12.8% (from 986 to 874 days). Survival data at lower copper concentrations are also reported. Serum, brain, heart and kidney copper concentrations were unaltered by feeding 5 X 10(-3) M copper gluconate. Only liver concentrations increased. Cadmium concentrations in liver and kidney of 168-, 406- and 644-day-old mice were essentially unchanged after feeding copper gluconate for 104 days. We conclude that chronic consumption of copper does not prevent or reduce the normal accumulation of cadmium found in aging mice. PMID- 6482519 TI - Lysosomal activity in the aging rat liver: II. Morphometry of acid phosphatase positive dense bodies. AB - Hepatocytes from 3-, 12- and 36-month-old rats were studied in situ with cytochemical and morphometrical techniques to obtain information about the intralobular and age-dependent variation in lysosomal volume. An increase with age was found for the lysosomal volume density. This increase is evident throughout the lobule, but occurs at different rates in the centrolobular and peripheral areas. It is most pronounced in the centrolobular area, resulting in a lysosomal volume density of 7.1% in old rats, compared to 3.6% in the peripheral area of the liver lobule. Both the size and the number of individual lysosomes contribute to the overall effect. Most dense bodies, including lipofuscin containing aggregates in senescent animals, exhibit acid phosphatase activity. Our results suggest that the use of enzyme activity as a marker may yield higher values for lysosomal volume density than morphologic characteristics alone. The alleged homogeneity of the liver as a source of hepatocytes for studies on isolated cells must be questioned when lysosomal functions are concerned. PMID- 6482520 TI - Cellular and clonal aging in the suctorian protozoan Tokophrya infusionum. AB - Quantitative methods for the study of aging in single organisms of the suctorian protozoan Tokophrya infusionum are described. New cell lines are initiated by metamorphosis of a ciliated embryo to form a sessile adult. The life history of adult cells consists of a sequence of age-related stages, culminating in cessation of reproduction and feeding, and eventual death. Lifespans of single cells were measured and were found to range rather widely about a mean, even when the cells compared were closely related within a single lineage. Variation appears to be inherent in the aging process in Tokophrya. Clones of Tokophrya undergo a gradual deterioration on a scale many times longer than the lifespan of individual cells. Lifespans of individual cells were determined when each of two clones were relatively young and later when their reproductive vigor had begun to decline. In both cases, the lifespan of individual cells were strikingly reduced in the old, as opposed to the young clones. The two types of senescence are thus experimentally separable, but nonetheless coupled phenomena. The similarity of aging in Tokophrya to that of other protozoa, fungi, and tissue culture cells is described and possible mechanisms are discussed. PMID- 6482521 TI - Functional deterioration of mouse liver ribosomes during aging: translational activity and activity for formation of the 47 S initiation complex. AB - The translational activities of ribosomes from young and old mouse livers were examined in an assay system dependent on rabbit globin mRNA. Old ribosomes showed 30-40% lower activity than young ribosomes. This observation, together with our previous findings (N. Mori, D. Mizuno and S. Goto, Mech. Ageing Dev., 10 (1979) 379-398), suggests functional deterioration of ribosomes of old animals. To examine the mechanism of the deterioration, the activities for formation of the initiation complex of 40 S ribosomal subunits in the livers of young and old mice were examined in vitro. The activity was found to be 15-20% lower in old mice (21 months old or more) than in young ones. This fact partly explains the decreased activity for ribosomal protein synthesis in old mice. PMID- 6482522 TI - Age-related changes in glucose metabolizing enzymes in spleen, thymus, and pulmonary lavage cells from F344 rats. AB - Healthy male Fischer 344 rats were sampled at 6, 12, 18, and 24 months of age. There was no gross pathological evidence or deviations in body weight, hematology, or clinical chemistry that were indicative of disease. Mixed populations of thymus, spleen, and pulmonary cells were obtained for enzymatic analyses. Key enzymes from the hexose monophosphate shunt, glycolysis and the tricarboxylic acid cycle were evaluated to determine if there were tissue specific or pathway-specific changes that occurred during aging. The enzyme responses among the tissues were not consistent during the aging process. Generally the activities of the glucose metabolizing enzymes in thymus and pulmonary lavage cells decreased with age whereas they increased in the spleen cells. Between 18 and 24 months enzymes representative of all three glucose metabolic pathways decreased in pulmonary lavage cells, whereas the decreases in thymic cells were mainly restricted to glycolytic enzymes. By contrast there were two- to ten-fold increases during aging in all of the splenic enzymes measured except malate dehydrogenase. The alterations in tissue enzyme activities probably reflected the changing cellular populations during aging, and in the thymic and pulmonary lavage cellular environment resulted in a loss of energy production by glucose oxidation, compared to the vigorous activity maintained in spleen. PMID- 6482523 TI - Open-field behaviour, growth rate and life span in the black-hooded rat. AB - The life span of the black-hooded rat has been studied in relation to two behavioural variables: (1) habituated level of responding; and (2) emotional reactivity in the open-field arena. The results indicate a relationship between the open-field measures and life span and also with growth rate measures. PMID- 6482524 TI - Effects of procaine on the oxidative phosphorylation of brain mitochondria from senescent rats. AB - Senescence affects cerebral metabolic functions. Various drugs have been tested to counteract the effects of aging on the brain. In this paper, we studied the influence of treatment using procaine, 1 mg per 100 g body weight, injected over a period of 3 days, to both young and old rats, on the phosphorylative oxidation properties of cerebral mitochondria. Respiratory activity decreased significantly in the brain of old rats. This reduction of oxygen consumption measured in the presence of glutamate, reached 31% in state 4, 25% in state 3 and, in the presence of succinate, 23% in state 4 without significant changes in state 3. The injection of procaine into young rats induced a significant increase of oxygen consumption rate with both glutamate and succinate as substrates. The same treatment administered to old rats was followed by a rise in respiratory activity, with values close to those observed in young control rats. Although the mechanism of action of procaine is not yet clear, there is some evidence that it interacts with membrane phospholipid sites. Therefore, it may be concluded that procaine facilitates oxygen transport towards the mitochondrial matrix by modifying the membrane structure in both old and young rats, although, in the latter case, this increase is not intended to improve the energetic properties of the mitochondrion. PMID- 6482525 TI - The effect of osmotic challenge and subsequent rehydration on the aging hypothalamo-neurohypophyseal system. A quantitative morphological study of the supraoptic nucleus. AB - The neurons of the supraoptic nucleus (SON) of male C57BL/Icrfat mice at 6 or 28 months of age were examined from normally hydrated, osmotically loaded and osmotically loaded/rehydrated animals. Using quantitative morphological techniques it was shown that the majority of the ultrastructural variables investigated were controlled in the same way in the SON neurons of young and old mice. The major exception was the mitochondrial compartment which although maintaining a constant proportion of the volume of the SON cell did show a significant reduction in the number of mitochondria in the old group, particularly during the osmotic challenge period of the experiment. The "lipid" body compartment of the SON neuron also behaved differently in the cells from the older age group. This study when viewed in conjunction with previous investigations suggests that these SON neuroendocrine neurons from old animals are able to produce hormone until late in the life-span. However, other aspects of cellular activity appeared to be altered when judged by morphological criteria. It is concluded that the SON neurons from these old mice are able to synthesize hormone-containing organelles to the same concentration as the cells from a younger animal. However, the efficiency of the process, or at least the efficiency of concomitant cellular processes, must be questioned in view of the alterations in the rough endoplasmic reticulum, mitochondrial and lysosomal systems. PMID- 6482526 TI - Antigen handling in ageing. III. Age-related changes in antigen handling by liver parenchymal and nonparenchymal cells. AB - This is a continuation of our earlier studies on antigen handling and the ageing process which have shown the liver to be a major site of antigen retention in the body. This paper reports on the uptake and cellular distribution in relatively pure isolates of the principal cell types of the liver of [35S]sulfanilate-azo bovine serum albumin (35S-BSA) injected into F-344 rats of ages 4, 12 and 28 months. In all three cell types [hepatocytes (H), Kupffer cells (K) and endothelial cells (E)] antigen retention peaks in the 12-month age class and then exhibits a significant decline in the 28-month age class; K and E cells retain more antigen per cell than do H cells. All three cell types metabolize antigen to nucleopeptides and this transformed antigen is immunologically active; K and E cells metabolize antigen to nucleopeptides more effectively than do H cells. A significant age-related difference is found when nucleopeptides from either H, K or E cells are used to stimulate an antigen-specific lymphoproliferative response in vitro: nucleopeptides from 4-month and 12-month rats stimulate the proliferation of lymphocytes to a significantly higher degree than do nucleopeptides from 28-month old rats. The experiments therefore identify in all three cell populations an age-related defect in antigen uptake and in metabolism of antigen to bioactive nucleopeptides, and they demonstrate that the nonparenchymal cells are more effective in antigen retention and in metabolism of antigen to nucleopeptides than are parenchymal cells. Further, the experiments support the thesis that the liver must be considered to be a principal part of the total immune system, its role much more fundamental than heretofore recognized. PMID- 6482527 TI - Altered degradation of intracellular proteins in aging human fibroblasts. AB - Confluent cultures of fibroblasts at different population doubling levels were incubated with [14C]leucine for 2 days and with [3H]leucine for 2 h to label long lived and short-lived proteins, respectively. Proteolysis was then measured in the presence of excess unlabeled leucine to prevent reutilization of the isotope. Catabolism of long-lived proteins was reduced in senescent cells when measured in media without fetal bovine serum, insulin, fibroblast growth factor, or dexamethasone. In contrast, degradation of short-lived proteins was increased in senescent cells but only when measured in the presence of serum, hormones, and growth factors. Further experiments with cells of varying ages indicate that in unsupplemented medium half-lives of long-lived proteins lengthened by as much as 20 min per population doubling and in supplemented media half-lives of short lived proteins decreased by 4 min per population doubling. The reduced catabolism of long-lived proteins in senescent cells cannot be explained by age-related changes in protein secretion or cell death during degradation measurements. These alterations in proteolysis may have major effects on protein content and composition in senescent cells. PMID- 6482528 TI - Heterogeneity of protein-synthesis initiation factors in developing and aging rat brain. AB - Protein synthesis initiation factors from rat brain were assayed in vitro through the formation of the initiator Met-tRNA X initiation factor 2 X GTP ternary complex. The initiation factor showed different intrinsic activity with increase in age. This difference was elicited by additions of high-salt ribosomal-wash protein to incubation mixtures that were already saturated with protein preparations from brains of older animals. This qualitative difference was further documented by examining the sensitivity of the activities of the initiation factor to spermidine and to temperature. The sensitivity to these effectors varied with age. By fitting an exponential decay model to data from the temperature experiments, it was possible to demonstrate that the preparations of the initiation factor from older brains behaved as a multicomponent system. The brain preparations from older animals contained at least two subpopulations of initiation factor. The fractions of these two gross subclasses varied, inversely one to the other, with age. PMID- 6482529 TI - Optical endpoint sensing in an automatic whole blood clotting timer. PMID- 6482530 TI - Design of a multichannel solid-state recorder and its application to temperature measurement. PMID- 6482531 TI - Mathematical model of the single-fibre action potential. PMID- 6482532 TI - Comparative analysis of modelled extracellular potentials. PMID- 6482533 TI - New hypotheses on the mechanism of cancer growth and regression (computer simulation study). PMID- 6482534 TI - Estimation of muscle force from intramuscular total pressure. PMID- 6482535 TI - Mechanical impulse system for myotatic reflex investigation. PMID- 6482537 TI - Multiplexed data-acquisition module for use in the accelerated life testing of cardiac pacemakers. PMID- 6482536 TI - Evaluation of intraluminal EMG electrodes for the oesophagus and gastrointestinal tract. PMID- 6482538 TI - Digital temperature controller for low-temperature light microscopy. PMID- 6482539 TI - Effects of multiple scattering and peripheral circulation on arterial oxygen saturation measured with a pulse-type oximeter. PMID- 6482540 TI - What does photoplethysmography measure? PMID- 6482541 TI - [Prevalence of serum markers of hepatitis B virus in medical and non-medical personnel in a general hospital]. PMID- 6482542 TI - [Limits of respiratory resuscitation]. PMID- 6482543 TI - [Mitral valve surgery]. PMID- 6482544 TI - [Plasma arginine-vasopressin values in 3 patients with myxedematous coma and hyponatremia]. PMID- 6482545 TI - [Sarcoidosis and primary biliary cirrhosis]. PMID- 6482546 TI - [Sarcoidosis and Raynaud's phenomenon]. PMID- 6482547 TI - [Schistosomiasis in the region of Maresme]. PMID- 6482548 TI - [Tricuspid insufficiency as a clinical manifestation of hyperthyroidism]. PMID- 6482549 TI - [Familial deficit of antithrombin III and mitral valve prolapse]. PMID- 6482550 TI - [Group G streptococcal bacteremia. Apropos of a case]. PMID- 6482551 TI - [Diffuse cutaneous form of lepromatous leprosy]. PMID- 6482552 TI - [Hemoglobin, carboxyhemoglobin and oxyhemoglobin saturation curves in healthy smokers]. PMID- 6482553 TI - [Diagnosis, health education and frequency of follow-up visits among hypertensive adults in the region of Murcia]. PMID- 6482554 TI - [Secondary intracranial hemorrhage associated with amyloid angiopathy]. PMID- 6482555 TI - [Multivesicular rosettes, a possible marker of acquired immunodeficiency syndrome (AIDS) in the endothelial cells of the splenic sinusoids]. PMID- 6482556 TI - [Raynaud's phenomenon and anti-centromeric antibodies]. PMID- 6482557 TI - [Reactive arthritis caused by Campylobacter jejuni in a patient with circulating immune complexes]. PMID- 6482558 TI - [Spontaneous pneumothorax as the initial manifestation of a bronchogenic carcinoma]. PMID- 6482559 TI - [Chronic mitral insufficiency, infectious arthritis and rupture of the chordae tendineae]. PMID- 6482560 TI - [Multiple evoked potentials in the diagnosis of brain death]. PMID- 6482561 TI - [Lactic acid in the ascitic fluid of patients with liver cirrhosis]. PMID- 6482562 TI - [Medical emergencies. Analysis of 18,240 patients treated in the emergency service of a general hospital in a one-year period]. PMID- 6482563 TI - [Psychiatric morbidity in patients with neoplasms of the breast]. PMID- 6482565 TI - [Current state of the treatment of cancer of the breast]. PMID- 6482564 TI - [Treatment of uremic pruritus in patients undergoing periodic hemodialysis with photochemotherapy]. PMID- 6482566 TI - [Familial study of porphyria variegata through its presentation in an adolescent]. PMID- 6482567 TI - [Nephrologic complications caused by lead poisoning]. PMID- 6482568 TI - [Behavioral medicine: physician-patient communication]. PMID- 6482570 TI - [3 new cases of lead poisoning. Diagnostic considerations]. PMID- 6482569 TI - [Chronic kidney failure, hyperproteinemia and vascular risk]. PMID- 6482571 TI - [Detoxification of heroin addicts with clonidine with a regimen of domicilary hospitalization]. PMID- 6482572 TI - [Medical treatment of metastatic spinal cord compression]. PMID- 6482573 TI - [Pancreatitis caused by Ascaris lumbricoides]. PMID- 6482574 TI - [Pneumococcal vaccine in recurrent bacterial meningitis]. PMID- 6482575 TI - [Pyomyositis: apropos of 2 new cases]. PMID- 6482576 TI - [Acute subdural hematoma. Review of 101 cases]. PMID- 6482577 TI - [D-penicillamine therapy in rheumatoid arthritis: adverse reactions with 2 different administration regimens]. PMID- 6482578 TI - [Prevalence of arterial hypertension and its distribution in the population of Murcia]. PMID- 6482579 TI - [Loss of amino acids caused by hemofiltration]. PMID- 6482580 TI - [Senile dementia: arteriosclerosis or Alzheimer disease?]. PMID- 6482581 TI - [Chronopathology]. PMID- 6482582 TI - [A peculiar case of congenital hepatic fibrosis]. PMID- 6482583 TI - [Hellenic influence in medical language]. PMID- 6482584 TI - [The cavitary image as an uncommon radiologic manifestation in Q fever]. PMID- 6482585 TI - [Cyclophosphamide treatment of parotid swelling in Sjogren syndrome]. PMID- 6482586 TI - [Acquired factor X deficiency in primary amyloidosis]. PMID- 6482587 TI - [Non-alcoholic steatohepatitis associated with malnutrition]. PMID- 6482588 TI - [Tuberculoid leprosy in the migratory population of Maresme]. PMID- 6482589 TI - System design of summary records compiled by clinicians in a hospital information system. PMID- 6482590 TI - Reproducibilities of blood chemical data for AMHTS examinees. PMID- 6482591 TI - The design of a medical record system based on plastic surgery. PMID- 6482592 TI - Calcium stone risk determination by computer. PMID- 6482593 TI - [Cimetidine effective in herpes zoster]. PMID- 6482594 TI - [Mushroom poisoning by amatoxin--current diagnosis and treatment]. PMID- 6482595 TI - [Health effects of arsenic]. PMID- 6482596 TI - [Improved health in Zimbabwe's rural areas as a result of the rural development project]. PMID- 6482597 TI - [Laser surgery in glaucoma]. PMID- 6482598 TI - [Numb fingers and its clinical diagnosis--viewpoints in hand surgery]. PMID- 6482599 TI - [Occupational vibration injuries--a survey and management]. PMID- 6482600 TI - [Are infrared rays a cause of white fingers?]. PMID- 6482601 TI - [Programmable pacemaker. There are many advantages but also disadvantages]. PMID- 6482602 TI - [Unusual localization of torsion of the appendix epiploica]. PMID- 6482603 TI - [Health risks of exposure to fungal infections in construction workers]. PMID- 6482604 TI - [Mild hypertension--risks and therapeutic strategies]. PMID- 6482605 TI - [Hydralazine in chronic heart failure]. PMID- 6482606 TI - [How reliable is female sterilization? 211 pregnancies after 35,599 operations]. PMID- 6482607 TI - [Female sterilization--safe and irreversible?]. PMID- 6482608 TI - [The need for integrated psychogeriatric services]. PMID- 6482609 TI - [What is new in plastic surgery of the head and neck for the practicing otorhinolaryngologist?]. AB - On examples the plastic facial surgery is shown as an multidisciplinary territory, whereby main points are set. Most important for the oto-rhino laryngology is the ear and nose correction as whereas the possibility to use collagen injections, the problems of secondary Rhinoplastics, the esthetic corrections in the area of the throat and head (dermabrasio, eye lid corrections, face lifting, hair transplantation) and considerations about education and advanced training. The maxillo facial surgery puts out the dento-alveolic dysgnathies, the ophthalmology the eye lid corrections. The experimental surgery can contribute to the still open questions, whether in the future in plastic operations allogene transplantates can fill the place of autogenous material or not. PMID- 6482610 TI - [Congenital aplasia of the nasal columella and cartilaginous septum]. AB - The case of a young man with congenital aplasia of the columella and the cartilaginous septum is demonstrated. The reconstruction by means of a tube pedicle from the upper arm and the further correction of the nose are described. PMID- 6482611 TI - [Papilloma inversum of the nose and paranasal sinuses. Clinical aspects and histology of 22 personal cases]. AB - Report on 22 cases of inverted papilloma. The common site of origin of the tumours is the lateral nasal wall and with a few exceptions they are benign. They become dangerous if they invade the bony structures of the face skeleton, especially the hard palate and the orbit. The therapy of choice is lateral rhinotomy with an "en bloc" resection of the lateral wall of the nose and the ethmoid of the invaded side. In that case the prognosis is good. The classifications by Schneider and Skolnik only define the size of the tumour but do not give an indication of prognosis; they are, therefore, unnecessary. PMID- 6482612 TI - [Results of fluorescein nose endoscopy in the diagnosis of cerebrospinal rhinorrhea]. AB - To establish the diagnosis of cerebrospinal rhinorrhoea 45 patients were examined via intrathecal fluorescein-dye studies. Rhinorrhoea was suspected after head injuries and surgery of the base of the skull. The diagnostic procedure was in accordance with the technique of Messerklinger. In 8 patients a fluorescent secretion was detected and a CSF-leakage operatively proven. The result of the fluorescein tests, the x-ray tomographies and the RIHSA-studies are compared. The fluorescein technique is shown to be a useful diagnostic tool in the diagnosis of cerebrospinal leaks. PMID- 6482613 TI - [Rhinogenic neuropathia of the optic nerve due to muco- and pyoceles of the sphenoid sinus and posterior ethmoid cells]. AB - 16 cases (18 eyes) of rhinogenous optic neuropathy due to muco-pyoceles in the sphenoid sinus and posterior ethmoid cells are reported. The clinical symptomes of this condition are characterized as follows: 1) acute or chronic progressive visual disturbance, 2) ophthalmoscopically normal or oedematous disc in the acute stage and optic atrophy in the chronic stage, 3) central scotoma or inferior hemianopsia in the visual field, 4) good recovery of vision in the cases with mucoceles, occasionally no recovery of vision in the cases with pyoceles, 5) oculomotor as well as abducent palsy and exophthalmos; occasionally, 6) past history of optic neuropathy and nasal operation, 7) few rhinologic complaints, 8) rhinoscopically: swelling, obstruction and/or polyp in the middle meatus, and 9) CT scan showing homogeneous mass in the sphenoid sinus and/or posterior ethmoid cells. The causative factor of the visual disturbance due to pyoceles might be caused not only by compression but also by inflammatory infiltration and vascular disturbance. Recurrence of rhinogenous optic neuropathy is frequent. PMID- 6482614 TI - [Cervically-induced symptoms of the Klippel-Feil syndrome]. AB - Klippel-Feil syndrome is a congenital deformity disease caused by disturbances of the growing together of the mesenchymal preliminary vertebrae which are mostly located in the regions of the cervical spine and shoulder. Short neck and wryneck (torticollis), as well as limited motion of the neck and reduced mobility of the cervical spine, are the most striking findings on clinical examination. Vertigo, disturbed sound conduction and perception, as well as combined loss of hearing, tinnitus and paralysis of the facial nerve can occur although otoscopic findings may be normal. Differential diagnosis is effected by means of the typical x-ray film of the cervical spine and the vertebrobasilar transition. Functional anomalies of the vertebral arteries are determined via x-ray angiography. Neuro otological syndromes can be explained by congenital deformities of the middle ear, cochlea, peripheral vestibular organs and internal auditory canal; mainly, however, by a "vascular" cervical syndrome, which, in this particular case, explains the cochlea symptoms. Vertigo and dizziness can also be caused by a pathological irritation of cervical proprioceptive sensory organs through deformities of the skeleton. PMID- 6482615 TI - [Standardization of electronically evaluated Romberg tests]. AB - A procedure is presented here permitting calibration of examinations recording postural changes. With the help of physical calibration a "posturographic unit" (PU) can be defined. "Biological" calibration is not only facilitated for shifting of the centre of gravity of the body, resulting in swaying, but also practically for all other parameters describing postural stability. The advantages of this method are demonstrated. It is pointed out that it is now possible to compare the results of various authors using different measuring devices. PMID- 6482616 TI - [Inclinometry as a method of registering postural reactions]. AB - Posturography is compared with inclinometry in four experimental conditions: Romberg's test, voluntary body sway, induced pendular body sway and galvanic stimulation. For all methods an agreement between the recorded curves can be seen. Inclinometry seems to be suitable for practice in spite of some possibilities of error. For scientific research, posturography should be preferred. PMID- 6482617 TI - [When should an ear not be operated on]. AB - Despite the low morbidity of modern middle ear surgery there are some limitations in indication. The age of the patient, the function of the Eustachian tube, the fibrotic middle ear, the cleft palate, the glomus tumour, Meniere's disease and "the last hearing ear" of the patient are discussed as far as middle ear surgery is concerned. PMID- 6482618 TI - [Mondini-type petrous bone dysplasia as a cause of spontaneous otoliquorrhea]. AB - A case of fistula formation in a congenitally deformed petrous bone is described. This case demonstrates the diagnostic problem of deafness with spontaneous cerebrospinal fluid otorrhoea causing recurrent meningitis. Methods of diagnosis and therapy are discussed and the value of hypocycloidal polytomography is stressed. PMID- 6482619 TI - [Therapy of otogenic and rhinogenic meningitis]. AB - There is no clear statement in literature on the problem of indication for surgery in cases of otogenic or rhinogenic meningitis. It is the aim of the present study to determine if and under what conditions conservative therapy alone is efficient and when surgery is absolutely indicated. The cases of 115 patients with endocranial complications, who were treated at our clinic over a period of 22 years, were evaluated; their number per year is significantly continually decreasing. The patients were subdivided into four groups: 1. otogenic/operated, 2. otogenic/non-operated, 3. rhinogenic/operated, 4. rhinogenic/non-operated. The individual groups were then compared in respect of 8 different parameters. The main cause of the disease in Group 1 was the chronic inflammation, in Groups 2 and 3 the acute inflammation and in Group 4 the new trauma. The status localis, the state of consciousness and the number of liquor cells were the most important parameters for establishing the diagnosis "meningitis", while the rigidity of the neck, the body temperature and the x-ray film yielded less reliable findings. On the basis of the results of our study we come to the conclusion that cause and progress of meningitis are decisive factors for the indication for surgery. We consider that immediate surgery (with high doses of antibiotics) is necessary in unconscious patients and in chronic inflammations as the cause of the meningitis. In all other cases treatment should be effected consisting of high doses of antibiotics, with thorough observation of the patients, and the patient should be operated on only if the disease aggravates or fails to improve within the first few days. PMID- 6482620 TI - [Interferon in the treatment of recurrent laryngeal papillomas]. AB - The authors present their first experiences in the treatment of recurrent laryngeal papillomas with human leukocyte Interferon (HLI). Because of the impossibility of avoiding recurrences, the results were not satisfactory in most of the cases. The schedule for therapy has not yet been determined definitely. PMID- 6482621 TI - [Treatment of laryngeal hemangiomas in children]. AB - Based on 3 observations of our own and a survey of 171 cases reported in the literature, the clinical, diagnostical and therapeutical aspects of subglottic haemangioma in infants are presented. By obstructing subglottic air passage these tumours can threaten life and often require tracheostomy. Mortality rate reported in literature is still high (19%). Because of their spontaneous regression capillary subglottic haemangiomas do not require further active treatment. PMID- 6482622 TI - Posterior choanal atresia: a syndromal disorder. AB - Posterior choanal atresia has a significant incidence of associated defects. Recently a constellation of defects, bearing the acronym of CHARGE, has been described. Its entities are (ocular) Coloboma, Heart defects, Atresia choanae, Retarded growth and development, Genital hypoplasia and Ear anomalies or hearing loss. Some of these have been previously noted. There are 26 patients in this series, none having the entire CHARGE association, but 7 had several; 3 of the 7 had bilateral choanal atresia. One other patient had a chromosomal defect with an associated heart defect. Two patients had cardiac and other visceral defects. Seven had base of skull abnormalities, 3 of whom had elements of CHARGE, and 9 had congenital hearing loss. Five were normal. CT scan suggests a growth disturbance of the basicranium in some of the patients. PMID- 6482623 TI - Reconstruction of post-traumatic sinus osteomyelitis. AB - Osteomyelitis with a fistulous tract of the left fronto-nasal area. The patient received an Anzio Beachhead WW II right fronto-nasal injury repaired with a lucite cranioplasty. A staphylococcal infection involved the remnant of the left frontal sinus with a fistula at the nasion near the orbital ridge. Bone scan revealed increased activity consistent with osteomyelitis. Patient was treated with intravenous oxacillin. The lucite skull prosthesis was removed 2 weeks after admission via the bilateral osteoplastic coronal flap approach with fat obliteration of the residual frontal sinus. The intravenous oxacillin was maintained for 48 days and the patient was discharged. The patient was later readmitted for a cranioplasty using a preformed tantalum plate. The nasal flange of the tantalum caused a deformity that did not allow the patient to wear his glasses. His third admission was for reconstruction of the tantalum and nasal deformity via a W-shaped incision. PMID- 6482624 TI - Fine-needle aspiration biopsy: efficacy in the diagnosis of head and neck sarcoidosis. AB - The authors report the usefulness of fine-needle aspiration biopsy to establish the diagnosis of sarcoidosis in patients with palpable disease in the head and neck areas. Aspiration biopsy proved to be a simple and quick method for establishing this diagnosis in the eight cases reported in this series. Interpretation of cytologic smears with identification of typical sarcoid-like granulomas proved to be quite easy. No complications occurred secondary to use of this technique. PMID- 6482625 TI - Relationship of laryngeal dimensions to body size and gestational age in premature neonates and small infants. AB - The larynges of 27 infants weighing between 250 gm and 9160 gm were studied. Twenty-two neonates were from 24 to 40 weeks' gestational age. Five subjects died more than 6 weeks post partum but were included because of their small size. Relationships of larynx size to the standard clinical measurements of crown-heel length, crown-rump length, head circumference, and gestational age were developed. Cartilage size relationships to these measurements were found to be linear. Glottic length related linearly to crown-rump length but related in a curvilinear way to crown-heel length, head circumference, and gestational age. A guide to the choice of endotracheal tube sizes for small infants is suggested. PMID- 6482627 TI - Modified tracheoesophageal diversion for chronic aspiration. AB - Breakdown of the normal protective function of the larynx, either through primary laryngologic or neurologic causes, leads to chronic aspiration, recurrent pneumonitis and possibly death. In this paper we discuss the existing surgical treatments for chronic aspiration. Tracheal separation and trecheoesophageal diversion are discussed, as are the difficulties of using these procedures in patients with pre-existing tracheostomies. A modification of tracheoesophageal diversion is presented whereby this procedure can now be utilized in those patients with pre-existing tracheostomies. The modified tracheoesophageal diversion is performed in five patients successfully. Since most patients have already had tracheotomies in an attempt to control aspiration, we feel that our technique of modified tracheoesophageal diversion enables this group of patients to benefit from this procedure as well. PMID- 6482626 TI - Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis. AB - Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually compromised. The management of such patients presents a challenge to the otolaryngologist-head and neck surgeon. Numerous surgical procedures have been developed in an attempt to improve the patients's airway insufficiency without leaving him with a breathy, weak voice. Arytenoidectomy is currently the most reliable method of treating patients with bilateral vocal cord paralysis. Although both endoscopic and external approaches have been described for performing an arytenoidectomy, the endoscopic technique is more desirable since it requires no incision and theoretically allows for the immediate assessment of airway size. The addition of the CO2 laser to the surgical armamentarium offers certain refinements to the technique of endoscopic arytenoidectomy. Eleven patients with bilateral vocal cord paralysis of the larynx have been treated by endoscopic laser arytenoidectomy by the authors utilizing a technique developed by the two senior authors and subsequently taught to over 200 participants of the CO2 laser workshops sponsored by the Department of Otolaryngology-Head and Neck Surgery at Northwestern University Medical School; 10 of the 11 patients have been successfully decannulated. The technique and problems of this operation will be discussed. PMID- 6482628 TI - T3 glottic cancer: options and consequences of the options. AB - This report is a review of 106 Stage III glottic cancers treated surgically from January 1971 through December 1980. For analysis of recurrence and cause of death, the patients were assigned to four subgroups as well as considered as a single group. The subgroups were T3,N0, transglottic, all T3 glottic cancers regardless of prior treatment, and all T3 glottic cancers without prior treatment. Of the entire group, 8% either were not dead or had died of something other than cancer; 91% of patients with T3,N0 cancers without prior treatment either were alive or had died of another cancer. In the other subgroups the survivorship was between 80% and 91% with the exception of those with transglottic cancers. The findings in this study are discussed in light of the current controversies related to the stage of disease, particularly the issue of radical radiation with surgery for salvage for T3 glottic cancer. PMID- 6482629 TI - Computed tomography in nasal and paranasal sinus disease. PMID- 6482630 TI - Reconstruction of the laryngopharynx and cervical esophagus. AB - The historical evolution of reconstruction of the cervical esophagus and laryngopharynx over the past 100 years is documented. The impact of these technical achievements is contrasted to the failure to improve the 5-year survival rate of 24%. While the clinician awaits new protocols of treatment to improve survival statistics, the thrust of the surgical oncologist is to develop a reliable method of reconstruction which meets specific minimal criteria. The following objectives should be achieved: Reconstruction should not limit the effectiveness of the ablative technique. Short hospitalization and one stage techniques are superior. Technique mortality and morbidity must be low. A 10-year institutional study using the Montgomery 2-stage technique is presented. In contrast, comparative literature data analysis of all methods of laryngopharyngocervical reconstruction indicates that single stage techniques offer a greater advantage. This study suggests that visceroplasty (stomach), free jejunal transfer, and single stage reconstruction, using the pectoralis myocutaneous flap, approach the previously established criteria more effectively than others. A new technique (1-stage), using partial tubulation of the pectoralis major myocutaneous flap, is recommended for regional reconstruction of the cervical esophagus and pharynx. In order to decrease the pressure and torsion on the vascular pedicle of the pectoralis major myocutaneous flap and increase its predicted length, partial resection of the ipsilateral clavicle is proposed. PMID- 6482631 TI - Spontaneous cerebrospinal fluid otorrhea and rhinorrhea coexisting in a patient with meningitis. AB - Congenital (spontaneous) cerebrospinal fluid fistulae are uncommon, potentially dangerous, pathological conditions. Most present in childhood with repeated bouts of meningitis, although presentation in adulthood with an asymptomatic nasal mass has been well documented. Radiologic work-up of the patient will usually reveal an abnormality in either the labyrinth or the base of the skull. A patient is presented who had both spontaneous cerebrospinal fluid otorrhea and rhinorrhea. Three anatomic defects were identified as potentially accountable: a round window fistula, a meningoencephalocele and an empty sella turcica. PMID- 6482632 TI - Planned preoperative radiation therapy vs. definitive radiotherapy for advanced laryngeal carcinoma. AB - In the period 1970-1980 inclusive, 191 patients with T3T4 laryngeal carcinoma (glottic: 63 and supraglottic: 128) received either definitive radiation therapy (RT) (60-65 Gy in 6-7 weeks) or planned preoperative radiation therapy (25 Gy in 5 equal daily fractions of 5 Gy) followed by laryngectomy with or without neck dissection (RT + S). Selection for RT vs. RT + S was based on medical operability and/or patient's refusal to undergo surgery. All patients are evaluable with minimum of 2 years observation. Crude 5 and 10-year survival probability for 32 patients with glottic localization who received RT is 55% and 38% vs. 65% and 65% respectively for 31 treated with RT + S. For 52 patients with supraglottic site who received RT, the 5 and 10-year survival is 44% and 44% vs. 82% and 60% for 76 patients treated with RT + S. PMID- 6482633 TI - Accuracy of fine needle aspiration biopsy in neck masses. AB - One hundred thirty-eight fine needle aspirations (FNA) of neck masses were performed during a four-year period (1979-1982). The pre-existing literature was reviewed. An accuracy rate of 85% in FNA of neck masses was found, and a 100% accuracy rate in cases of benign tumors of the neck and developmental cysts of the neck was found. PMID- 6482634 TI - Meningioma of the parapharyngeal space: a unique extension of intracranial tumor. AB - A 45-year-old woman with a meningioma growing in the parapharyngeal space is reported. Her initial symptom was a stuffy feeling in the right ear and swelling of the right parapharynx. The parapharyngeal mass was biopsied, and a frozen section diagnosis suggested a paraganglioma. On electron microscopy, however, the tumor cells failed to show secretory granules, and represented a prominent interdigitation of the cytoplasm with occasional desmosomal attachments. Based on these features the tumor was diagnosed as a meningioma. Thereafter a mass lesion in the temporal lobe of the brain was detected by computerized tomography of the brain. The extracranial extension of the meningioma may occur in some occasions, but such cases in which the infiltrative portion in the parapharyngeal space was initially discovered have been rarely reported. PMID- 6482635 TI - Head and neck and plastic surgery. A targeted problem and its solution. Cautery tonsillectomy--saves time. PMID- 6482636 TI - Difficult nasogastric intubations. PMID- 6482637 TI - A rational approach to the neck in cervicofacial rhytidectomy--a guide to planning skin undermining, platysma surgery, and lipectomy. PMID- 6482638 TI - Otology and neurotology. A specific issue and its solution. Removal of human middle ear homografts en bloc. PMID- 6482639 TI - [Early detection of stomach cancer in a high-risk population group--a 5-year prospective study]. AB - In two population groups a 5-year-study including X-ray examination, endoscopy and biopsy was performed taking into account high risk factors, which do allow early diagnosis of gastric carcinoma. One group was a control group as far as the gastrointestinal tract was concerned, the other group was a high risk group. In the control group no tumor was found throughout the period of 5 years, in the high risk group however three early carcinoma of the stomach and one borderline lesion were detected. These results show, that regular control of high risk patients allows early diagnosis of gastric carcinoma. PMID- 6482640 TI - [Gastric mucosa heterotopias in the upper gastrointestinal tract]. AB - Heterotopic gastric mucosa does occur in the upper gastrointestinal tract more often than has been thought up to now. Such heterotopic gastric mucosa was systematically looked for in inpatients and outpatients. Islets of heterotopic gastric mucosa were found in 125 patients in the cervical esophagus, in most cases a few centimeters below the esophageal entrance, and in 135 patients such islets of polypoid morphology were found in the duodenal bulbus. Histological analysis done in biopsy specimens taken from the cervical esophagus showed mucosa typical for the gastric corpus in 62 cases, a mixture of glandular tissue from the fundus and mucoid glands in 32 patients, and exclusively mucoid glands in 3 cases. Just superficial mucosa tissue (pits, epithelium) were found in 10 cases, in 14 patients the islets of gastric mucosa were not hit during the biopsy procedure, in 4 cases no biopsy was done. Heterotopic gastric mucosa tissue in the bulbus usually had a diameter of a few millimeters and polypoid morphology; these lesions were located postpylorically in the bulbus and measured more than 5 mm in diameter only in 10 cases. Whereas duodenal heterotopic gastric mucosa probably has no clinical relevance hydrochloric acid producing islets of gastric mucosa in the cervical esophagus may give rise to peptic lesions. PMID- 6482641 TI - [Incidence of peptic ulcer in an inpatient angiologic patient sample]. AB - Incidence of peptic ulcers in hospitalized patients with arterial occlusive disease without history or clinical symptoms of ulcer disease was 32% and four times higher than in patients with acute phlebothrombosis. Possible etiological factors could be: decreased blood perfusion of gastric or duodenal mucosa because of generalized arteriosclerosis, intake of ulcerogenic drugs, chronic abuse of nicotine, and stress due to the underlying arterial occlusive disease. Patients with inflammatory vascular disease are affected as often as are patients with arteriosclerotic disease. Routine endoscopic examination of the upper GI-tract should be performed in such patients in order to exclude potential bleeding sources before treatment with fibrinogen lowering drugs is started. PMID- 6482642 TI - [Treatment of colorectal cancer in the last 35 years--perioperative requirements and postoperative results]. AB - The development of colorectal surgery during the last 35 years was analyzed on the basis of case reports of a University Surgical Department. It was found, that lethality of the procedure was reduced during this period and that the number of tumor resections per year increased. In cases of carcinoma of the rectum extirpation of the rectum was reduced in favour of deep resection of the tumor in the recent time. In addition the analysis showed, that time of hospitalization was definitely reduced. Postoperative results have improved considerably due to improved methods of preparing the intestinal tract for surgery, due to preoperative prophylactic treatment with antibiotics--this reduces the postoperative need of antibiotics rather definitely--but only due in a limited extent to change of suturing techniques. The extent of pre- and postoperative diagnostic and therapeutic procedures increased, which however was justified because results improved quite definitely. PMID- 6482643 TI - [Esophageal tuberculosis]. AB - Tuberculosis of the esophagus is a rare disease, occurring in most cases secondary to tuberculosis of other organs. A hyperplastic, a granular, and an ulcerous form can be discerned macroscopically. There are neither specific clinical symptoms and signs nor typical X-ray or laboratory findings; examination of bioptic specimens also does not allow establishing a diagnosis in many cases. A case report is given of a patient with ulcerous tuberculosis of the esophagus; the clinical course and diagnostic problems are described. Diagnosis was established in this case after a secondary abscess of soft tissue had appeared. PMID- 6482644 TI - [Ulcer perforation in Meckel's diverticulum]. AB - Ectopic gastric mucosa can be found in 40-80% of Meckel's diverticula; parietal cells producing acid are not inhibited by regulatory factors, giving rise in some cases to ulcers, which may perforate. A case report of a patient with a perforated ulcer in a Meckel's diverticulum is given. Meckel's diverticula should be removed surgically when they are diagnosed or when they are found by chance during surgery because of the risk of complications. PMID- 6482645 TI - The effect of desmethylimipramine on the metabolism of norepinephrine. AB - Eleven normal volunteers were given an acute and two chronic doses of desipramine (DMI). The plasma norepinephrine (NE), 3-methoxy-4-hydroxyphenylglycol (MHPG), and dihydroxyphenylglycol (DHPG) concentrations were measured before and during drug administration. DMI reduced plasma concentrations of MHPG by 13% and DHPG by 17%. After two weeks of drug administration, the MHPG/NE ratio was reduced, and there was a significant negative correlation with the concurrent drug concentration. These results suggest that DMI: (1) reduces the turnover of NE; and (2) diminishes the oxidative deamination of NE. In addition, the drug concentration response relationship indicates that the effects of uptake inhibition may not be maximal until concentrations in the apparent therapeutic range are achieved. PMID- 6482646 TI - Inhibitory effects of quinidine on rat heart muscarinic receptors. AB - Quinidine inhibited binding of the labelled agonist [3H]oxotremorine M [( 3H]Oxo M) and the labelled antagonist [3H]N-methylscopolamine [( 3H]NMS) to rat heart muscarinic receptors. Kinetic studies demonstrated that quinidine decreased the association rates (I50: 4 and 7.5 microM) and dissociation rates (I50: 100 and 68 microM) of [3H]Oxo-M and [3H]NMS, with different potencies. These cooperative effects explained the low Hill coefficients and apparent selectivity of quinidine competition curves. PMID- 6482647 TI - Abnormalities in plasma catecholamine response and tissue catecholamine accumulation in streptozotocin diabetic rats: a possible role for diabetic autonomic neuropathy. AB - Plasma catecholamine levels, determined by high performance liquid chromatography, were elevated in response to blood withdrawal in normal rats. Such a response was also observed in streptozotocin diabetic rats 2 and 6 weeks after disease onset, but was no longer seen at 13 weeks. Tissue (adrenal, heart, skin, kidney) catecholamine levels in diabetic rats were increased at 6 weeks as well as at 13 weeks. These abnormalities were corrected by insulin treatment in at least a part of diabetic rats. The present data suggest that there might be a catecholamine accumulation, which is later accompanied with an impairment of catecholamine secretion, in diabetic rats, and they gave a basis for an inference that similar changes might play some role in the pathogenesis of diabetic autonomic neuropathy in man. PMID- 6482648 TI - The bicuculline-like properties of dopamine sulfate in rat brain. AB - To determine whether the convulsive action of intraventricularly injected dopamine sulfate, a dopamine metabolite present in rat brain and human cerebrospinal fluid, could be due to its interaction with GABAergic pathway, we compared the convulsive effect of dopamine sulfate with that of bicuculline in the conscious rat and determined the interaction of dopamine sulfate with [3H] GABA binding and uptake in rat brain tissues. The results showed that the convulsive effects of dopamine sulfate and of bicuculline could be abolished by GABA agonists diazepam and muscimol, but not by DA antagonists haloperidol and metoclopramide. In addition they were additive. Both dopamine 3-O-sulfate and dopamine-4-O-sulfate, like bicuculline, could displace sodium-independent [3H] GABA binding to rat brain synaptic membranes (IC50 = 400 microM) but had no action on GABA uptake. DA sulfate had no effect on [3H] strychnine binding to rat brain homogenates. This evidence together with the structural resemblance between dopamine sulfate and GABA suggested that the convulsive activity of dopamine sulfate may result from its interaction with central GABA receptors. PMID- 6482649 TI - Dual action of morphine on cold-stimulated thyrotropin secretion in male rats. AB - The effect of morphine infused into 4 hypothalamic locations and the periaqueductal gray (PAG) on cold-stimulated thyrotropin (TSH) secretion was studied in male rats. Morphine decreased TSH cold-response when infused into the 3rd ventricle (1-20 micrograms/rat) or the median eminence (5 and 10 micrograms/rat). Infusions bilaterally into the anterior hypothalamus (1-10 micrograms/side) or PAG (1 and 10 micrograms/rat) were ineffective, while those given into the posterior hypothalamus (1 and 5 micrograms/side, but not 10 micrograms/side) significantly enhanced TSH cold-response. Naloxone pretreatment (2 or 5 mg/kg, s.c.) reversed the decreasing effect of morphine in the 3rd ventricle (1 microgram/rat) and the increasing effect of morphine in the posterior hypothalamus (1 microgram/side). We conclude that morphine has a dual hypothalamic action on cold-stimulated TSH secretion: an inhibition periventricularly, and a stimulation in the posterior hypothalamus. PMID- 6482650 TI - Adenosine uptake sites in dog heart and brain; interaction with calcium antagonists. AB - [3H] Nitrobenzylthioinosine (NBI) binding is characterized in dog heart and brain. Evidence is presented suggesting that [3H]NBI is binding to the adenosine uptake site in both tissues. Physiologic studies in open-chested dogs clearly demonstrate that NBI acts as a coronary vasodilator, consistent with an action at the adenosine uptake site. The binding is reversible, saturable and of high affinity (KD = 0.78 +/- .06 nM for heart and 0.52 +/- .05 nM for brain). Both dipyridamole and hexobendine are high potency inhibitors of [3H]NBI binding in heart and brain while other antihypertensives and vasodilators such as propranolol and nitroglycerin have no effect. The inhibition of [3H]NBI binding observed with dipyridamole was competitive indicating that both agents are acting at the same site. The dihydropyridine calcium antagonists also inhibited binding with a lower potency than the adenosine uptake blockers. Non-dihydropyridine calcium antagonists were much less potent in this regard. The inhibition of [3H]NBI binding observed with the dihydropyridine calcium antagonists was non competitive suggesting that the calcium channel and adenosine uptake site may be coupled to each other. PMID- 6482651 TI - Naltrexone precipitated opiate withdrawal in methadone addicted human subjects: evidence for noradrenergic hyperactivity. AB - The noradrenergic alpha-2 receptor agonist, clonidine, suppresses many of the effects of opiate withdrawal in both humans and other animals and this is consistent with the data indicating important interactions of opiate and noradrenergic systems in brain. This evidence supports the hypothesis that central noradrenergic hyperactivity is involved in the expression of major signs and symptoms of the opiate withdrawal syndrome, but to date clinical studies have not provided biochemical data consistent with this idea. In order to assess whether naltrexone precipitated opiate withdrawal in methadone addicted human subjects is associated with changes in noradrenergic function, a double-blind study was completed in which 15 methadone-dependent subjects received naltrexone and 8 subjects received placebo. Signs and symptoms of the opiate abstinence syndrome increased significantly in the 15 subjects who received naltrexone compared with the 8 who received placebo. Plasma concentrations of free MHPG also increased significantly in those subjects who took naltrexone compared to the placebo treated subjects. In addition, withdrawal signs and symptoms were significantly correlated with plasma MHPG concentration. Since several compounds which suppress central noradrenergic activity also reduce the severity of the withdrawal syndrome, the noradrenergic hyperactivity suggested by the present clinical study may be a functional mechanism for at least part of the opiate withdrawal syndrome. PMID- 6482652 TI - Decreased defence against free radicals in rat heart during normal reperfusion after hypoxic, ischemic and calcium-free perfusion. AB - Excessive formation of free radicals possibly plays an important role in the origin of irreversible damage of the heart after hypoxic, ischemic or Ca2+-free treatment. The effect of these treatments on the activity of superoxide dismutase and the glutathione system was studied on isolated rat heart. These activities reflect the protective capacity of the heart against reactive substances. In addition the peroxidation of lipids is determined in the treated hearts using malondialdehyde formation as an indicator. All experiments were performed using a Langendorff-apparatus with recirculating perfusion. The observed changes in the components of the glutathione system and superoxide dismutase activity both after hypoxic, ischemic and Ca2+-free perfusion, as measured upon reperfusion, indicate a decrease in cellular defense mechanisms in the heart against free radicals. The effect was most pronounced upon Ca2+-repletion after a period of Ca2+-free perfusion. No malondialdehyde could however be detected either in the tissue of the treated hearts or in the perfusate. Our data give reason to expect beneficial effects of an adequate pharmacological treatment, which replenishes the cellular defence systems. PMID- 6482653 TI - The ability of certain anorexic drugs to suppress food consumption depends on the nutrient composition of the test diet. AB - The effects of five anorexic agents on food consumption were tested in rats offered single, isocaloric, isonitrogenous diets differing in carbohydrate content. Three of the test agents, d-amphetamine, benzphetamine and chlorphentermine, are sympathomimetic and cause CNS stimulation; the others, MK 212 and d-fenfluramine, are thought to facilitate serotonin-mediated neurotransmission. At ED50 doses, the sympathomimetic drugs reduced food consumption whether the test diet was rich (75% dextrin) or poor (25% dextrin) in carbohydrate. In contrast, MK-212 and d-fenfluramine failed to reduce consumption of the 25% dextrin test diet. These observations suggest that anorexic drugs like d-amphetamine and d-fenfluramine do not act via a common "amphetamine receptor," and are compatible with earlier observations, made on rats given diet pairs simultaneously, that enhanced serotoninergic neurotransmission selectively suppresses appetite for carbohydrates. PMID- 6482654 TI - Genetically obese C57BL/6 ob/ob mice respond normally to sympathomimetic compounds. AB - The suggestion that defective thermoregulatory thermogenesis in the genetically obese (ob/ob) mouse is due to a low thermic response to noradrenaline has been investigated using both noradrenaline and the longer-acting sympathomimetic compounds, ephedrine and BRL 26830A. Below thermoneutrality (23.5 degrees C) the metabolic rate of obese mice was lower than that of their lean littermates, whereas at a thermoneutral temperature (31 degrees C) the metabolic rate of the obese mice was as high as that of lean mice. This confirms the view that the ob/ob mouse has defective thermoregulatory thermogenesis. However, in C57BL/6 mice, this defect is not due to a failure to respond to noradrenaline, because at 31 degrees C the maximum thermic effects of noradrenaline, ephedrine and BRL 26830A were as high in obese as in lean mice and at 23.5 degrees C they were higher in obese than in lean mice. Furthermore, the response of brown adipose tissue to beta-adrenoceptor stimulation appears normal since noradrenaline caused a normal rise in brown adipose tissue temperature, and treatment with noradrenaline or BRL 26830A in vivo caused a normal increase in GDP binding by brown adipose tissue mitochondria. At 31 degrees C propranolol depressed metabolic rate equally in lean and obese C57BL/6 mice, whereas at 23.5 degrees C it depressed metabolic rate more in lean than obese mice. In contrast to C57BL/6 mice, Aston ob/ob mice showed a reduced thermic response to noradrenaline. These results suggest that defective thermoregulatory thermogenesis in the ob/ob mouse is primarily due to a reduced ability to raise sympathetic tone, but in some strains an additional failure in the thermic response to noradrenaline may develop. PMID- 6482655 TI - Marked behavioral and biochemical sensitivity to lesion size in the posterior cortex of the rat. AB - Unilateral focal cortical suction lesions of varying diameter from 0.7 to 2.0 mm were made in the right posterior lateral cortex of rats. Only the 1.0 mm lesion size resulted in spontaneous postoperative hyperactivity. This increased activity was accompanied by significant elevations in substantia nigra and caudate nucleus dopamine concentrations. Other lesion sizes did not affect behavior or brain biochemical concentrations in this fashion. These results suggest a functional organization in this area of posterior cortex which affects both neurochemistry and behavior. PMID- 6482656 TI - Unreliability of the rat stomach fundus as a predictor of hallucinogenic activity in substituted phenethylamines. AB - A series of three isomeric 2,4,5-substituted monoethoxy dimethoxy phenylisopropylamines were compared for their contractile effect in the rat fundus as potential antagonists to the effect of serotonin in the fundus. The three isomers were also evaluated for their discriminative stimulus properties in rats that had been trained to discriminate injections of saline from LSD tartrate (0.08 mg/kg). The drug discrimination studies revealed that the 2,5-dimethoxy-4 ethoxy substitution was most potent in rats, consistent with the reported clinical activity of this isomer in man. By contrast, of the three isomers examined, this was the weakest in eliciting a contraction in the fundus. None of the compounds antagonized serotonin induced contractions, and it was not possible to determine pA2 values. Questions are raised about the determination of pA2 values for partial agonists and it is concluded that the fundus is not a reliable model for prediction of hallucinogenic activity of phenethylamines. PMID- 6482657 TI - Specific in vivo binding of 77Br-brombenperidol in rat brain. AB - The in vivo binding of the radiobrominated neuroleptic brombenperidol in rat brain was studied. The accumulation of the radiolabeled neuroleptic was high in the striatum and relatively low in the cerebellum, cortex, and blood. Striatal binding of brombenperidol was saturable and displaced by subsequent administration of benperidol. The rationale for the development of 75Br brombenperidol as a radiopharmaceutical for the non-invasive imaging of cerebral dopamine receptor areas is presented. PMID- 6482658 TI - Clonidine reduces elevated cerebrospinal fluid catecholamine levels in patients with essential hypertension. AB - Cerebrospinal fluid (CSF) catecholamines were measured in normotensive patients and in patients with mild to moderate essential hypertension. CSF-norepinephrine (NE) concentrations were 50% lower in the normotensive individuals (127 +/- 28 vs. 240 +/- 23 pg/ml) (P less than 0.01). In hypertensive patients, CSF-NE was inversely related to age (r = -0.68; P less than 0.01) and directly related to plasma NE (r = 0.61; P less than 0.05). Clonidine (450 mcg/day for 2 weeks) significantly reduced CSF-NE (-40%) in hypertensive patients. In addition, it decreased blood pressure, plasma and urinary NE. Urinary VMA was not affected by clonidine. No correlation was observed between clonidine effects on BP and on plasma or CSF catecholamines. This study indicates that patients with essential hypertension have elevated levels of CSF-NE which are reduced after treatment with clonidine. The elevation of CSF-NE suggests that central (spinal?) noradrenergic activity may be increased in patients with mild to moderate essential hypertension, and that can be reduced by treatment with clonidine. PMID- 6482659 TI - Effect of platelet activating factor (PAF) on blood flow distribution in the spontaneously hypertensive rat. AB - A dose-dependent decrease in mean arterial blood pressure was produced in spontaneously hypertensive rats by intravenous PAF infusion. Heart rate was monitored, while cardiac index and regional blood flow were quantitated during maintenance of the PAF-induced hypotension using the radioactive microsphere method. Our results suggest that PAF administration is associated with specific changes in vascular resistance, since estimated blood flow was decreased to certain organs or tissues, but remained unchanged in others. Therefore, the hypotension observed during PAF infusion is dose-dependent, and is contributed to by decreases in vascular resistance in specific organs. PMID- 6482660 TI - Weak binding of 10-hydroxymetabolites of nortriptyline to rat brain muscarinic acetylcholine receptors. AB - The relative affinities of nortriptyline (NT) and its 10-hydroxymetabolites to rat brain muscarinic acetylcholine receptors have been determined by competition with 3H-quinuclidinyl benzilate binding. It is shown that the major NT metabolite, E-10-OH-NT, has only 1/18 the affinity of NT for the muscarinic receptor. Since this metabolite is equipotent to NT in inhibiting neuronal noradrenaline uptake, it is suggested that it might be of clinical value as an antidepressant by virtue of having less anticholinergic side-effects than NT itself. PMID- 6482661 TI - Ca(phosphatidate)2 can traverse liposomal bilayers. AB - Phosphatidic acid can act as Ca2+ cross-membrane ionophore without the necessity of previous autoxidation. The apparent PA-CA2+ dissociation constant is 3 X 10( 3), i.e., in the range of extracellular Ca2+ concentration. There is at least 100 fold preference for Ca2+ over Mg2+. Ca2+ transfer rates are proportional to the square of phosphatidic acid concentration in the bilayer. Removal of the fatty acid ester CO groups reduces the Ca2+ ferrying rate by more than 90 percent. It appears that the cation is held in a cage formed by phosphate and carbonyl oxygens of two PA molecules. In this coordination complex both Ca2+ and the phosphatidic acid headgroups are dehydrated, and the Ca(phosphatide)2 assembly becomes lipid-soluble and can traverse the bilayer. PMID- 6482662 TI - Stressors produce a concurrent decrease and increase in reflex amplitude in rats treated with naloxone. AB - The effect of inescapable foot-shock on the tail-flick response and on the startle response to brief shocks and brief tones was studied in rats. In the first experiment, 25 minutes of inescapable foot shock (stressor) produced a significant increase in tail-flick latency which was antagonized by the opioid antagonist naloxone (2.0 mg/kg). In the second experiment, the startle response to an electric shock to the tail was significantly diminished by the stressor, and this effect was not significantly reduced by naloxone. However, the size of the startle response to a brief tone was significantly increased in rats treated with naloxone. Thus, rats injected with naloxone had a decreased startle to shock but an increased startle to tone following inescapable foot shock. Finally, tones which preceded shocks by one second produced a facilitation of the startle response to the shocks in tests that followed exposure to the stressor. This facilitation was not affected significantly by naloxone. These results indicate that the changes in the startle response following the stressor were not mediated exclusively by endogenous opioids. PMID- 6482663 TI - Effects of porcine gastrin releasing peptide (GRP) on canine antral motility and gastrin release in vivo. AB - The effect of GRP on the in vivo canine antrum was investigated. GRP caused a dose-dependent increase in antral gastrin output which was not significantly altered by administration of tetrodotoxin. The higher doses of GRP administered also caused excitation of antral motility which was abolished by tetrodotoxin, a finding in contrast to previous in vitro results demonstrating bombesin-induced antral smooth muscle contraction to be tetrodotoxin-resistant. These data suggest that in the in vivo canine model GRP causes antral gastrin release via non neurally mediated mechanisms (probably by acting directly on the G-cell) and excites antral motility via neurally-mediated mechanisms. PMID- 6482664 TI - Inhibition of Na+-coupled solute transport by calcium in brush border membrane vesicles. AB - Intracellular Ca++ is known to influence Na+ flux in luminal membranes. Abnormally elevated Ca++ levels in some cells is believed to be the primary pathophysiologic defect in cystic fibrosis (CF). This in turn is thought to alter Na+ transport which accounts for certain clinical manifestations of this disease. Two Na+-dependent intestinal transport mechanisms have been reported to be suppressed or missing in CF. To examine whether alterations in cell Ca++ may account for these findings, studies were performed to examine the influence of Ca++ on Na+-solute co-transport across intestinal luminal membranes. Purified brush border membrane vesicles prepared from rat small bowel were preincubated in either Ca++-free buffer or buffer containing 2.5 mM CaCl2. Ca++ loaded vesicles showed marked inhibition of Na+ co-transport of taurocholic acid, taurochenodeoxycholic acid, glucose and valine when compared to controls. The uptake of Na+ was also significantly reduced by intravesicular Ca++. These data demonstrate that intravesicular Ca++ inhibits Na+-coupled solute transport as well as Na+ influx across intestinal brush border membranes. These data suggest that intracellular Ca++ may suppress Na+-dependent solute absorption in the intestine. Results presented here further support the theory that elevated intracellular Ca++ may account for intestinal malabsorption and other altered transport phenomena reported in CF. PMID- 6482665 TI - Caudate electrochemical response following amphetamine administration in pigtail monkeys. AB - In vivo electrochemical and heart rate (HR) recordings following amphetamine (AMPH) (0.8 mg/kg) and saline administration were made from caudate in four young adult pigtail (M. nemestrina) monkeys using linear sweep voltammetry. One hour following drug injection, two familiar humans served as test stimuli, and were visually exposed to the animals for 15-minute epochs each. One was threatening to the animals, and one was not. AMPH produced a significant increase in height of the electrochemical peak thought to represent oxidation of dopamine and its metabolites. Heart rate (HR) decreased during the time the peak height was increasing. HR and peak height increased during presentation of both humans under both AMPH and saline conditions. However, peak height increase under AMPH, but not saline, conditions discriminated the negative from neutral stimulus. The findings demonstrate that AMPH administration induces a significant increase in the height of a major electroactive peak in the caudate nucleus of pigtail monkeys, and further that such amphetamine-induced increases can be manipulated by altering the affective and/or emotional state of the animal. PMID- 6482666 TI - Decreases in pineal melatonin content during the hibernation bout in the golden mantled group squirrel, Spermophilus lateralis. AB - The role of the pineal gland in modulating the rhythmic bouts of hibernation in the golden-mantled ground squirrel (S. lateralis) was explored by comparing pineal melatonin content in hibernating animals with that of euthermic animals at the same time of year. Significant decreases in pineal melatonin content were found in hibernating versus euthermic animals. In addition, significantly lower values for pineal melatonin were observed in hibernating animals that were sacrificed in the late bout period, just prior to expected spontaneous arousal, as compared to hibernating animals that were sacrificed on the first day of their respective bouts. A strong correlation was evident between pineal melatonin content and the duration of the individual hibernation bout. These data suggest that pineal melatonin may be important in determining the duration of individual bouts of hibernation in this species. PMID- 6482667 TI - Parathyroid hormone responses to the dopaminergic agonist 2-amino-6,7-dihydroxy 1,2,3,4-tetrahydronaphthalene. AB - Plasma parathyroid hormone (PTH) responses to the dopaminergic agonist 2-amino 6,7-(OH)2-1,2,3,4-tetrahydronaphthalene (ADTN) have been studied in cattle. During ADTN infusions PTH increased within min in a dose-dependent manner, while calcium remained unchanged. Prolonged administration of ADTN caused transient PTH responses and crosstachyphylaxis to the subsequent administration of the beta adrenergic agonist isoproterenol, but not to hypocalcemia, caused by infusions of ethylene-glycol-bis (beta-aminoethylether)-N,N'-tetraacetate. PTH responses were not modified by the beta-adrenergic blocking agent propranolol, infused in amounts earlier shown to suppress PTH responses to isoproterenol and epinephrine. In conclusion, the dopaminergic agonist ADTN caused a direct and transient stimulation of PTH secretion, not mediated by hypocalcemia or by beta-adrenergic receptors on parathyroid cells. However, crosstachyphylaxis to isoproterenol, but not to hypocalcemia, was observed. PMID- 6482668 TI - Discriminative stimulus properties of the serotonin agonist 1-(3 trifluoromethylphenyl)piperazine (TFMPP). AB - Using a standard two-lever drug discrimination procedure, twelve rats were trained to discriminate 1.0 mg/kg of the serotonin (5-HT) agonist TFMPP from saline. Once trained, the animals displayed a dose-related decrease in discriminative performance upon administration of lower doses of TFMPP. Tests of stimulus generalization were performed using the purported 5-HT agonist RU-24, 969 and 1-(2,5-dimethoxy-4-methylphenyl)-2-aminopropane (DOM). While TFMPP produced stimulus effects similar to those of RU-24,969, these effects seem to be dissimilar to those of DOM. The results of the present study suggest that the discriminative stimulus effects of TFMPP may involve a 5-HT1-related mechanism. PMID- 6482670 TI - Ionizing radiation induces opioid-mediated analgesia in male mice. AB - The effects of exposure to ionizing radiation on the nociceptive thresholds of CF 1 mice were examined. Significant increases in thermal response latencies, indicative of analgesia were observed after exposure to either high or low doses of radiation. However, the onset of analgesia occurred significantly more rapidly after treatment with the high doses. Administration of the opiate antagonist, naloxone, blocked and reversed the analgesic effects of both the high and low dose of radiation. These findings support the hypothesis that exposure to ionizing radiation results in opioid-mediated analgesia. PMID- 6482669 TI - Antagonism of effects of vasopressin (AVP) on inhibitory avoidance by a vasopressin antagonist peptide [dPtyr(Me)AVP]. AB - After training in two different passive avoidance tasks, the platform box of Ader and De Wied (1972) and the Jarvik box of Jarvik and Kopp (1967), rats injected with vasopressin immediately following the training trial showed a significant enhancement of retention 24 hours later. This vasopressin effect was reversed by high doses of the vasopressor antagonist, dPtyr(Me) AVP. These results support the hypothesis that the visceral afferent signals may be involved in the apparent memory-enhancing effects of AVP, but the high doses of antagonist required suggest that factors other than a simple reversal of the pressor effects of AVP may be important. PMID- 6482671 TI - Detection of only JH III in several life-stages of Nauphoeta cinerea and Thermobia domestica. AB - We have conducted a reinvestigation into both the identification and quantification of juvenile hormone (JH) from several developmental stages of the cockroach, Nauphoeta cinerea, and the firebrat, Thermobia domestica, using a gas chromatography-mass spectrometric (GC/MS) method. We detected only JH III in these animals in contrast to prior studies in which JH I, II, and/or III had been reported using a different scheme relying on HPLC purification and subsequent GC/MS analysis under chemical ionization (CI) conditions. Very high levels (approximately 800 ng/g) of JH III were found in N. cinerea embryos at stages after dorsal closure whereas first stadium nymphs and female penultimate stadium nymphs contained only low levels (approximately 1 ng/g and approximately 7 ng/ml respectively); in adult females at the stage of rapid oocyte growth approximately 150 ng JH III per ml of hemolymph was measured. T. domestica nymphs and egg laying adults contained only low levels (approximately 1 ng/g) of JH III. The results emphasize the caution which must be used in interpreting results of procedures for analysis of JH at parts-per-billion levels, and also enforce prior observations that the higher JH homologs are not present except in the Lepidoptera. PMID- 6482672 TI - The effect of althesin on plasma corticosterone levels. AB - Althesin in doses which produced anesthesia (4 and 6 ml kg-1, i.p.) produced biphasic changes in plasma corticosterone levels. Plasma corticosterone showed an increase (p less than 0.05) due to the stress of injection but returned to basal levels by 30 min. Subsequent to the anesthetic effect (approximately 30 min) corticosterone levels increased markedly (p less than 0.01). Althesin's effectiveness showed time of day effects, i.e., Althesin was more effective in the A.M. Rats given 6 ml kg-1 Althesin showed graded plasma corticosterone responses to stresses of varying intensity. Blood withdrawal and surgical stress evoked significant increases in plasma corticosterone but a 2-min holding stress had no effect on plasma corticosterone levels. Instrumented rats receiving supplemental injections (i.p.) presented patterns of plasma corticosterone which were different from those receiving supplemental infusions (i.a.). Whereas plasma corticosterone levels of rats receiving the continuous infusion of Althesin remained relatively constant, corticosterone levels of those which received supplemental injections tended to increase. Collectively, these data suggest that Althesins usefulness as an experimental anesthetic is limited to those studies which are not compromised by stress-induced pituitary-adrenal activity. PMID- 6482673 TI - Prediction of the relative in vitro sensitivity of 9L rat brain tumor cells to nitrosoureas by the sister chromatid exchange assay. AB - In an earlier study we showed that there is a good correlation between sister chromatid exchange induction and cell kill in 9L cells treated with certain nitrosoureas. In the study reported here, we treated four 9L cell lines that have different sensitivities to chloroethylnitrosoureas with 1,3-bis (2-chloroethyl)-1 nitrosourea, chlorozotocin, and ethylnitrosourea and determined the number of sister chromatid exchanges induced. Cell lines that were most sensitive to the drugs with respect to cell kill were also most sensitive to induction of sister chromatid exchanges for a given drug, and the assay based on sister chromatid exchange is therefore predictive of the relative sensitivity of these cells to the drugs used. PMID- 6482674 TI - Hypotensive response of ethanol in rats pretreated with disulfiram or nitrefazole. AB - The effect of disulfiram or nitrefazole pretreatment on ethanol induced hypotension was examined in urethane anesthetized rats. A relatively low dose of ethanol (150 mg/kg; i.p.) produced a characteristic hypotensive response in rats pretreated for various periods with disulfiram or nitrefazole. This hypotensive episode started 5-10 minutes following ethanol administration and lasted 40-60 minutes. The hypotensive response was not seen unless disulfiram or nitrefazole treatment preceded ethanol administration by a least 6-8 hours. The low dose of ethanol produced a plasma ethanol concentration of 10mg/100ml or less. One treatment with nitrefazole (200 mg/kg) rendered rats vulnerable to ethanol induced hypotension for 6 but not 8 days. One treatment with disulfiram (200 mg/kg) lasted 4 but not 6 days. In addition, the hypotensive response was greater in rats treated with nitrefazole than in rats treated with an equal dose (200 mg/kg) of disulfiram. PMID- 6482675 TI - Impaired activation of thermogenesis in the corpulent rat. AB - The capacity for non-shivering thermogenesis was measured in groups of 12 week old congenic lean and corpulent LA/N-cp rats of both sexes to determine if their obese state might be associated with an impairment in energy expenditure via non shivering thermogenesis. Body weights of the corpulent phenotypes were 1.6 to 1.8 times greater than those of the lean phenotype. Measurements of resting oxygen consumption were similar in lean and in corpulent rats, and were greater in female than in male rats. Isoproterenol stimulation resulted in a significant increase in oxygen consumption in lean rats, while the rates of oxygen consumption of isoproterenol-stimulated corpulent rats were unchanged. Acute exposure of male rats to a 5 degrees C cold environment resulted in significant decreases in colonic and in rectal temperature in both phenotypes, but body temperatures recovered more rapidly in lean than in corpulent rats. Urinary VMA excretion was greater in lean than in corpulent rats and increased following cafeteria-feeding in lean but not in corpulent rats. These observations are consistent with an impaired mechanism of sympathetically-mediated thermogenesis in the corpulent phenotype of the LA/N-cp rat, and which may be a contributing factor in the development of their obese state via a decreased capacity for energy expenditure. PMID- 6482676 TI - Suppression of gastric acid secretion by intracisternal bombesin does not require the ventromedial hypothalamus. AB - Intracisternal administration of the tetradecapeptide peptide bombesin suppresses gastric acid release. Other studies have shown that the ventromedial hypothalamus (VMH) may have an inhibitory role in gastric regulation. To determine if the inhibition of gastric acid secretion by intracisternally administered bombesin is mediated by the ventromedial hypothalamus, bombesin was injected intracisternally in rats with ventromedial hypothalamic lesions. Neither anterior nor posterior VMH lesions altered the effects of bombesin on gastric acid, concentration, volume, total output, or on serum gastrin. The bombesin-induced rise in gastric pH was very mildly attenuated by both lesions. The previous finding of enhanced gastric acid secretion after anterior VMH lesions was confirmed. The results suggest that the VMH is not crucial in the bombesin-induced inhibition of acid secretion. PMID- 6482677 TI - Species differences in monoamine oxidase-A and -B as revealed by sensitivity to trypsin. AB - Monoamine oxidase-A and -B of brain and peripheral tissues of human, dog, rat, and rabbit have been characterized with respect to kinetic parameters and response to limited trypsin treatment. MAO-A in all extracts was inactivated by trypsin to an extent that was species dependent, but not related to the nature of the tissue, to MAO-A/B ratios, or to kinetic parameters. MAO-B activity of human, dog, and rat was unaffected by trypsin under the conditions employed, but rabbit MAO-B was sensitive. Inactivation patterns obtained with the trypsin treatment described in this study provide additional evidence that structures of both MAO-A and MAO-B show species-specific variations. PMID- 6482678 TI - Stereoselective binding of disopyramide to human plasma protein. AB - The binding of racemic disopyramide and its two enantiomers to protein were compared in two samples of human plasma, two samples of freshly drawn serum and in a solution of alpha 1-acid glycoprotein. The binding of S(+)-disopyramide was higher at all concentrations as compared to to R(-)-disopyramide, and the binding of the racemate was intermediate. Differences in binding were due to differences in the association constant. PMID- 6482679 TI - Possible change in noradrenergic receptor sensitivity following methylphenidate treatment: growth hormone and MHPG response to clonidine challenge in children with attention deficit disorder and hyperactivity. AB - Growth hormone (GH) and 3-methoxy-4-hydroxyphenelethylene glycol (MHPG) response was measured hourly for 4 hours in 8 children with Attention Deficit Disorder with Hyperactivity (ADD+H) following an acute single-dose of clonidine. The clonidine challenge was repeated before, during, and one day after 12 weeks of treatment with methylphenidate (MPH). Before MPH treatment, the plasma growth hormone (GH) rose to 31.3 +/- 4.6 (Mean +/- SE) ng/ml; during MPH treatment, the GH peak was only 14.8 +/- 3.2 ng/ml; one day after discontinuation of MPH, GH rose to only 20.8 +/- 3.9 ng/ml. MHPG release was inhibited by clonidine in all treatment conditions but tended to be more decreased during MPH treatment. Some children with ADD+H may have hypersensitivity of the post-synaptic alpha-1 noradrenergic receptor which is diminished by MPH treatment. The extent to which these effects are pharmacological or represent a change in receptor sensitivity requires further study. PMID- 6482680 TI - Effect of aging on recovery of striatal dopamine receptors following N ethoxycarbonyl-2-ethoxy-1, 2-dihydroquinoline (EEDQ) blockade. AB - The recovery rate of striatal dopamine receptors following blockade by N ethoxycarbonyl-2-ethoxy-1, 2-dihydroquinoline (EEDQ) in vivo is reduced by 25-35% in striata from senescent Wistar rats when compared to mature counterparts. No differences in binding affinity for [3H]-spiperone were observed for the different age groups at various times after EEDQ injection. These results suggest that loss of striatal dopamine receptors during aging may be due to a decreased biosynthetic rate. PMID- 6482681 TI - [3H]nitrendipine binding to adrenal capsular membranes. AB - The physiologic regulation of aldosterone secretion is dependent on extracellular calcium and appears to be mediated by increases in cytosolic free calcium concentration in the zona glomerulosa cell. A specific role for voltage-dependent calcium channels was suggested by previous studies with the calcium channel antagonist verapamil. We therefore studied the [3H]nitrendipine calcium channel binding site in adrenal capsules. These studies revealed a single class of saturable, high affinity sites with KD = .26 +/- .04 nM and Bmax = 105 +/- 5.7 fmol/mg protein. Specific binding of [3H]nitrendipine was inhibited by calcium channel antagonists with potencies nitrendipine = nifedipine much greater than verapamil, while diltiazem had no inhibitory effect. In the rat, binding sites for [3H]nitrendipine were located in the adrenal capsule and medulla and were undetectable in the zona fasciculata. Physiologic studies with collagenase dispersed adrenal glomerulosa cells demonstrated that nifedipine selectively inhibited angiotensin-II and potassium-stimulated steroidogenesis. These observations suggest both a pharmacologic and physiologic role for the nitrendipine binding site in aldosterone production. PMID- 6482682 TI - Fatty liver caused by chronic alcohol ingestion is prevented by dietary supplementation with pyruvate or glycerol. AB - Earlier studies showed that the fatty liver, caused by feeding rats the Lieber DeCarli alcohol diet for four weeks, was prevented if the diet was supplemented with dihydroxyacetone (22 g/l), pyruvate (22 g/l) and riboflavin (2.2 g/l). In the present study, we observed that fatty liver was prevented if the alcohol diet was supplemented with glycerol and lactate (22 g/l each) and riboflavin (2.2 g/l). Hence, the prevention of alcoholic fatty liver by the dietary supplementation with dihydroxyacetone and pyruvate may not be related to their capacity to serve as hydrogen acceptors and to oxidize NADH produced during ethanol metabolism. When rats were fed the alcohol diet supplemented with either glycerol or pyruvate, the hepatic triglyceride (TG) levels were similar to those in rats pair-fed a Lieber-DeCarli control diet in which alcohol was replaced with an isocaloric amount of dextrins. Therefore, the prevention of fatty liver does not require the simultaneous presence of several supplements. Dietary dihydroxyacetone or riboflavin did not reduce alcoholic fatty liver. Supplementation of the ethanol diet with isocaloric amounts of lactate or glucose, instead of pyruvate, did not abolish the development of fatty liver but caused a marked reduction in the hepatic TG levels. Animals fed the alcohol diet consumed only small amounts of carbohydrate for long periods of time. Since the inclusion of glucose or its metabolites in the alcohol diet fed to rats caused a marked decrease in the liver TG content, it is likely that the production or prevention of fatty liver is related to carbohydrate metabolism. PMID- 6482683 TI - The effects of hypophysectomy and testosterone treatment on the composition and metabolism of testicular lipids. AB - The effects of hypophysectomy and of testosterone administration on lipid composition and metabolism of rat testicular tissue have been investigated. Increased concentrations of triacylglycerols and cholesterol were observed in testes of hypophysectomized compared to control (non-hypophysectomized) rats on the eighth day posthypophysectomy. Administration of testosterone maintained the concentrations of these lipids at about normal levels. The concentration of phospholipids was not affected by the hypophysectomy. Incorporation of 14C from 1 [14C] linoleate into testicular lipids was determined 24 hours after intratesticular injection. In hypophysectomized compared to control rats there was more 14C in C 16:0, C 20:2 and C 20:3 and less 14C in C 20:4 and C 22:4 of both phospholipids and triacylglycerols. After intratesticular injection of 1 [14C] eicosatrienoate there was more 14C in C 16:0 and C 20:3 and less 14C in C 20:4 and C 22:4 of both phospholipids and triacylglycerols of hypophysectomized compared to control rats. Intratesticular injection of 1-[14C]-arachidonate resulted in less 14C incorporation in C 22:4 in testes of hypophysectomized than in those of control rats. Treatment with testosterone did not affect the metabolism of any of the 14C-substrates. These results indicate that the testicular desaturation of C 20:3 to arachidonate, requiring a delta 5 desaturase, is inhibited by hypophysectomy and that testosterone by itself may control the concentrations of some testicular lipid classes but not the metabolism of the polyenoic acids. PMID- 6482685 TI - Primary portal venopathy in the golden hamster treated with low doses of dimethylnitrosamine. AB - Ingestion of dimethylnitrosamine in a low dose and for a limited period by hamsters resulted in primary intrahepatic pylephlebitis. The process began at 24 h and progressed within 2-4 weeks to narrowing and, eventually, to partial obstruction of the portal bed. The lesions were characterized by endothelial necrosis followed by infiltrations of lymphoid cells extending into the portal tracts. Superficial lesions of terminal hepatic veins and parenchymal changes occurred only after a lapse of, respectively, 2 and 4 weeks when restrictions of portal blood had been assumed. The parenchymal changes consisted of regional regenerative hyperplasia accompanied by subendothelial prolapse of hepatocytes into the wall of terminal veins. The lesions of the portal veins persisted for a prolonged period of time after the exposure to dimethylnitrosamine had ceased. These findings, associated with characteristic histological aspects, suggested secondary immune reaction following the initial toxic pylephlebitis. The possible relevance of the experimental results to understanding the nature of endemic portal venopathy in man is discussed with regard to pathogenesis and etiology. PMID- 6482684 TI - Squalene isolation by HPLC and quantitative comparison by HPLC and GLC. AB - A new procedure is described for isolating and measuring squalene in plasma and in several organs of the rat. The unsaponifiable material was fractionated by normal phase HPLC on a silica gel column using a mobile phase consisting of hexane/propanol-2/water. The eluate was monitored at 215 nm. The squalene in the hydrocarbon fraction thus collected was than quantified on an analytical column eluted with hexane. Squalene concentrations ranging from 3 to 200 micrograms per ml of plasma or per g of fresh tissue were accurately measured. The results obtained agree with those of the squalene assays carried out by gas chromatography on a packed or capillary column. PMID- 6482686 TI - Monoclonal gammopathy in chronic active hepatitis. AB - Immunoelectrophoresis was performed in 31 of 272 patients with chronic active hepatitis (CAH) because of an M-spike component (seven patients, 2.6%) or hypergammaglobulinemia (24 patients) revealing a monoclonal gammopathy (MG) in 11 patients. In addition, 50 randomly selected patients with CAH and no evidence for an M-spike component were tested by immunoelectrophoresis. In 13 patients (26%), an MG was found. The mean age of the 24 patients with MG was 57.4 years (range: 23-76). HBsAg was present in nine patients (37.5%), no HBV-marker was detected in ten patients (41.7%). The immunoglobulin class of MG was IgG in ten patients (41.7%), IgA in one patient (4.2%) and IgM in 11 patients (45.8%). In two patients, Bence Jones protein was found in either serum or urine. In only one patient was the MG associated with multiple myeloma, whereas none of the other 23 patients developed a malignant lymphoproliferative disease within the median observation period of 6 years. We conclude that there is an unexpectedly high prevalence of benign MG in patients with CAH. PMID- 6482687 TI - Advances in the treatment of porphyria cutanea tarda. Effectiveness of slow subcutaneous desferrioxamine infusion. AB - The authors present the results of long-term subcutaneous desferrioxamine (DFX) infusion in 16 porphyria cutanea tarda (PCT) patients who cannot undergo repeated phlebotomies because of severe liver damage, haemolytic anemia, cardiovascular impairment or pulmonary and bone tuberculosis. They employed an automatic, portable syringe pump for subcutaneous infusion (8-10 h) to overcome the short half-life of the drug. Photodynamic cutaneous lesions and hyperpigmentation quickly disappeared (2-3 months). Uroporphyrin excretion sharply decreased and normalized within 3-12 months. Also, serum iron and ferritin, as well as liver function, showed a significant improvement. The authors therefore propose subcutaneous DFX therapy in PCT treatment when phlebotomy is contraindicated. PMID- 6482688 TI - Quality assurance in haematology and blood coagulation testing. PMID- 6482689 TI - A whole blood control for Coulter electronic particle counters. PMID- 6482690 TI - A rapid-return regional quality assurance scheme for coagulation. PMID- 6482691 TI - Effect of hydroxyethylpiperazine N-2 ethane sulphonic acid (HEPES) on the thrombin clotting time and fibrin polymerisation. PMID- 6482692 TI - A direct enzyme-linked antiglobulin test for detection of red cell autoantibodies in auto-immune haemolytic anaemia. PMID- 6482693 TI - Clinical aspects of steroid receptor assays. PMID- 6482694 TI - Antithrombin III screening: necessity or extravagance. PMID- 6482695 TI - Localization of tumours using radiolabelled antibodies. PMID- 6482696 TI - An enclosed fixative preparation system. PMID- 6482697 TI - A simple questionnaire for use in computerizing bone marrow aspirate reports. PMID- 6482698 TI - External quality assessment: the effect and implications of favourable treatment of EQA samples. PMID- 6482700 TI - Evacuated blood collection tubes. PMID- 6482699 TI - Microchemotaxis: a procedure for embedding and ultrastructural study of migrating leukocytes within filter membranes. PMID- 6482701 TI - [Effectiveness of ferrocin in decreasing the resorption of radioactive thallium]. PMID- 6482702 TI - [Method of determining the plutonium content of wounds]. AB - The authors proposed a method for the determination of 239Pu in wounds based on the measurement of the intensity of UL-x-ray radiation with the mean energy of 17 kev and concomitant gamma-radiation of 241Am. The correlation of the intensity of the gamma-lines of 241Am with the energies of 26.4 and 59.6 key is used for the unequivocal determination of the depth of radionuclide deposit. The isolation in the range of the gamma-line with the energy of 26.4 kev was performed using differential x-ray filters made of silver and cadmium placed in turn in front of the scintillation detector while recording radiations from a studied wound. This method ensures the required accuracy (+/- 20%) of the operative determination of plutonium in wounds employing simple and easily handled equipment. PMID- 6482703 TI - [Effectiveness of radiotherapy and chemoradiotherapy of disseminated laryngeal cancer]. AB - The results of therapy of 112 patients with squamous cell laryngeal carcinoma, Stage III, were analysed. All the patients were given gamma-beam therapy by a split course. The first group was composed of 29 patients who received radiotherapy alone, 33 patients of the 2nd group also received chemotherapy with methotrexate, 5 mg daily, and 50 patients of the 3rd group were given radiotherapy and methotrexate, 60 mg once a week. Somewhat better short- and long term results were achieved in the 2nd group. Statistically significant difference was obtained depending on the immediate efficacy of radio- and chemotherapy: 5 year survival rates in complete tumor regression were 57.1 +/- 7,7%, and in the presence of a residual tumor 26.3 +/- 7.2%. Radiation reactions and complications were more frequently observed in patients on radiotherapy combined with methotrexate, 60 mg once a week. PMID- 6482704 TI - [Degree of radiation pathomorphosis of a tumor and the results of combination treatment of breast cancer]. AB - The long-term results of the combined therapy of 284 patients with infiltrative forms of breast cancer were correlated with the manifestations of radiation pathomorphosis in a tumor after preoperative radiation therapy at a single dose of 4 Gy, summary dose of 20 Gy. Surgical intervention was performed in 59% of the patients in the first 3 days after irradiation, in 30% of the patients in 4-9 days, in 11% in 10-20 days. The degree of radiation pathomorphosis was evaluated by the signs of disturbance of the general structure of the tumorous tissue and the structure of some cancer cells. The most significant changes in tumors were recorded 10-20 days after the termination of radiation therapy. An increase in the interval between the termination of irradiation and operation up to 20 days did not influence the long-term results of the combined therapy of patients with breast cancer. No correlation between the degree of radiation pathomorphosis and long-term results of combined therapy was revealed, therefore the qualitative determination of the degree of injury of tissue and cellular elements of a tumor cannot serve as an adequate criterion of efficacy of mean fractional radiation exposure in performing operation in the first 9 days after its completion. PMID- 6482705 TI - [Combined and radiation therapy of rectal cancer using metronidazole]. PMID- 6482706 TI - [The cardiovascular system at long periods after radiotherapy of lymphogranulomatosis]. AB - The cardiovascular system was analysed in 157 patients with Hodgkin's disease in a prolonged remission after radiation therapy including irradiation of the mediastinum. The revealed myocardial changes were equally often noted in different irradiation volumes of the heart within the range of 31 to 45 Gy. The number of changes was growing with time. Functional disorders of the pulmonary, hepatic and capillary vessels were also revealed. PMID- 6482707 TI - [Relation of the effectiveness of radiotherapy of cervix cancer to the magnitude of the absorbed dose]. AB - The results of therapy of 949 patients with cervical cancer are analysed. Therapy was provided in the form of a concomitant method, 60Co agents with low activity were used in intracavitary irradiation. It has been established that doses of 50 70 Gy ensure high 5-year survival rates of patients with Stage I cervical cancer. In patients with Stage II and Stage III cervical cancer survival rates were the highest within the range of 50-70 Gy. A further increase in the absorbed dose level deteriorated the survival rates of the patients, the frequency of local tumor control was not elevated. It is recommended that optimum dose levels be adhered to even during treatment of patients with disseminated cervical cancer. PMID- 6482708 TI - [Clinical significance of in vivo methods of examining lung cancer patients]. AB - The results of the visual evaluation of scintiphotography with MMA-99mTc and studies with 133Xe on 130 patients with different pulmonary pathology (90 with lung cancer) and 40 with nontumorous pulmonary diseases were considered. To improve the reliability of the visual evaluation, the zone and lung coefficients (Kz and K1) were proposed making it possible to raise the specificity of evaluation. The extent of disorders of the blood flow in the lungs was correlated with that of changes defined on the radiographs. In most patients with lung cancer, such disorders exceeded the extent of changes on the radiographs--64.4%. In nontumorous lesions the excess of changes was observed in focal processes (tuberculosis). PMID- 6482709 TI - [Multimodified radiotherapy. Short-term hyperglycemia and local hyperthermia in hypoxic radiotherapy of transplantable solid tumors]. PMID- 6482710 TI - [Radionuclide multicollector lymphography of the extremities]. AB - A study was made of the lymph flow rate and accumulation-absorption function of the inguinal and popliteal lymph nodes in healthy persons and in patients with leg and forearm bone fractures. The lymph flow rate in the leg of a healthy person is 9.1 = 10.8 cm/min, much more in the hip 13.7 = 16.1 cm/min, in the deep collector it was 2 = 3 times as less. The lymph flow rate in the forearm is equal 5.6 = 7.9 cm/min, in the shoulder 7.4 = 10.0 cm/min. After the fracture the lymph flow rate lessened for a short period of time (up to the 21 st day) in the vessels of the medial leg collector but increased in the lateral and deep collectors. In the upper limb the lymph flow rate decreased in the lateral and increased in the medial collectors. PMID- 6482711 TI - [Radionuclide sensitivity of a plastic scintillator]. AB - To determine experimentally the radionuclide sensitivity of the scintillation detector is not always possible. The reasons for the selection of the methodology of computing relative radionuclide sensitivity for a through-well scintillator is the purpose of the study. The design data are supported by the experimental results using standard radioactive solutions, the correlation between the design and experimental data being within the error +/- 5%. PMID- 6482712 TI - [Dependence of the sensitivity of combined intensifying film-screens on the voltage in X-ray tubes]. AB - The computed and experimental dependencies of the luminescence intensity of intensifying screens, their gain and the sensitivity of the screen-film combinations versus the X-ray tube voltage age compared. The computed data are in good agreement with the experimental results. The data make it possible to account for the hardness in the plots of efficiency for various intensifying screens, when roentgenograms are produced under manual and automated control. PMID- 6482713 TI - [Television microscopes for analyzing biological micro-objects]. AB - escriptions and specifications for fluorescence and two-chamber television microscopes are presented as well as the analyzers of video signals for them. The devices are intended for studying the biological activity of compounds used in medicine and pharmacology. PMID- 6482714 TI - [A sorption microfilter for blood transfusions]. AB - A special device is developed to purify the conserved blood from microaggregations and toxic agents. It also decreases the CO2 level and the citrate content. The device combines the properties of a microfilter and a sorption column. The specifications of the device are given. PMID- 6482715 TI - [A device for controlling the sterilization process]. AB - The method and the unit for handling the sterilization process in devices of the forced circulation are proposed. The unit ensures adequate sterility of medical products irrespective of the load of the sterilizing box. PMID- 6482716 TI - [Use of corrosion inhibitors during the sterilization and disinfection of medical instruments]. AB - The search of corrosion inhibitors reducing the corrosive action of the sterilizing and disinfecting media has been performed in order to protect instruments made of metals against corrosion during these processes. The program of the investigations includes potentiodynamic and potentiostatic measurements and full-scale tests. The infection of the sodium benzoate or potassium gluconate into the disinfecting chloramine solution and sterilizing hydrogene peroxide solution has been shown to improve the resistance to the corrosion for medical instruments made of carbon steel. PMID- 6482717 TI - [A device for use in podography]. AB - Described in the paper is the podographic unit for measuring a foot eversion angle and time- and phase-dependent parameters of foot swing and stance. It may be useful in examinations of sportsmen and young people, in mass population screening for detection of gait defects and their correction, in the course of diagnostic orthopedic studies of the lower limbs. PMID- 6482718 TI - [Laser treatment of the eyes of microsurgical needles]. AB - Experimental results of studies on ability to treat by laser beam holes into needles by 0.15-1.0 mm diameter made of steel are presented. Operating conditions such as radiant energy, pulse duration and frequency are specified. PMID- 6482719 TI - [Assessment of the demand for single-focus eyeglass lenses]. PMID- 6482720 TI - [Assisted circulation during electrostimulation of the heart]. AB - In the course of the assisted circulation combined with the electrocardiostimulation the comparative study has been carried out to estimate the following conditions of the cardiosynchronization for an assisted circulation device: a) at the R-wave on the patient's electrocardiogram, b) at the R-wave on the ECG when an artefact from the electrocardiostimulation is previously "cut", c) when the electrocardiostimulation pulse is used as that of the cardiosynchronization. A system for the assisted circulation is proposed where the cardiosynchronization is realized by a separator of the R-waves for the ECS, thus providing consistent cardiosynchronization under conditions of both electrocardiostimulation and restoration of the cardiac rhythm. PMID- 6482721 TI - [Device for controlling the radiation parameters of therapeutic sources]. AB - The unit is capable of providing the information on the man parameters of the radioactive sources, thus improving the reliability and accuracy when planning the treatment in radiotherapy. PMID- 6482722 TI - [Nuclear medicine devices from the Tesla firm]. PMID- 6482723 TI - [Unit complex for electrophysiological research and computer information input]. AB - A multichannel digital-to-analog system for polyfunctional physiologic studies requiring computer-ailed laboratory data processing is developed. The system performs an acquisition, conversion and recording of functional parameters. Built in the system additional units make it possible along with recording and digitizing the input information to record data on a tape recorder with further loading to a computer. Described in the paper is the unit complex that permits simultaneous recording the electric, locomotive and evacuant intestinal activity under experimental conditions and subsequent computer-aided data processing. PMID- 6482724 TI - [Nutritional problems among adults in the Sahel]. AB - A definite list of nutritional diseases can be ascribed to the adult people who live in the Sahel. It results from a food consumption rate which, though a decent energetic or caloric level, remains of little values because of some protein, trace element and vitamin deficiencies. Subclinical diseases that can only be detected through routine mass-examinations, are prevalent. But on the other hand, clinical diseases, the most typical and the most frequent of which is nutritional anemia, are of very frequent occurrence too. The usual disturbing factors of the precarious states of nutrition are pregnancy and lactation, the season of the gap and the associated infections. PMID- 6482725 TI - [Epidemiologic study of 2 foci of Schistosoma mansoni bilharziasis in Togo (Lama Kara and Kpalime). Comparative efficacy of oltipraz (RP 35972)]. AB - The authors note a very high prevalence of schistosomiasis mansoni in the two foci studied in Togo (Lama Kara in the North and Kpalime in the South-West); however, the prevalence is significantly higher in Lama Kara (79.5%) than in Klonou (54.7%); this was calculated on both coprological and serological basis. The parasite burden is identical in the two foci; but, the GMRT is higher in Lama Kara than in Klonou (31.7 and 8) which might be explained by a different immunogenicity of the two strains. It is noticed schistosomiasis mansoni might be responsible for hepatosplenomegaly found in the two foci, especially in Lama Kara, which might be explained by a higher virulence in this location. The treatment by oltipraz (RP 35972) had a 91.9% success rate in Klonou (similar to our results in Paris). However, in Lama Kara, even though the drug was taken with some food--increasing its biodisponibility--, the treatment was less effective at day 180 (76.5%). The authors wonder whether the difference of oltipraz efficiency between the two foci is based on a difference of biology between the two strains of Schistosoma mansoni in Lama Kara and in Klonou. PMID- 6482726 TI - [57 cases of infectious endocarditis: diagnosis, clinical course, prognostic factors]. AB - Through a retrospective study on 57 patients, the authors have studied the diagnosis signs, the clinical course, and the factors which affect the prognosis of bacterial endocarditis. Echocardiography has allowed them to establish a diagnosis with 72 p.c. of cases and the bacteriological investigations with 42 p.c. Out of these endocarditides, 39 were found on natural valves, 6 were associated with congenital cardiopathies, 9 followed the replacement of a valvula, and 3 were associated with endomyocardial fibrosis. Cardiac insufficiency (56 p.c.), and renal insufficiency (24 p.c.) were prevailing. The discussion turns on the diagnosis factors and the factors involved in the prognosis. Considering that the death rates were 64 p.c. with the patients who had undergone medical treatment and 14 p.c. with those who had undergone operations, the relevance of the surgical treatment has been emphasized. PMID- 6482727 TI - [The danger of infection and common medical pathology among adults in the Sahel. Niger as an example]. AB - In Niger, the infectious risk is of real concern in the field of the pathology of the adult, mainly caused by the major endemic diseases: Parasitic diseases such as malaria, bilharziasis, cutaneous leishmaniasis and recently visceral leishmaniasis, Bacterial diseases such as enterobacterial diseases, amibiasis, meningococcal diseases, tuberculosis, leprosy and treponematosis, Virus diseases such as arbovirus diseases and probably viral hepatitis. On the whole, the rate of occurrence and prevalence are not more significant than those in the neighbouring countries. On the other hand, diseases prevailing all over the world do not save the indigenous. Some recent hospital statistics demonstrate that the disease of the liver and the digestive system (28.8 pc), the respiratory diseases (16.49 pc), and the cardiovascular diseases (14.63 pc) are prevalent. PMID- 6482728 TI - [Failures in the treatment of T. gambiense trypanosomiasis in the Congo]. AB - The authors summarize the difficulties encountered in post-therapeutic follow-up of trypanosomiasis cases in the People's Republic of Congo. Systematic controls provide evidence of recontamination and relapses. The geographical distribution of cases indicates the existence of resistance in one village in the Niari district. Among the hypotheses advanced, resistance induced by pentamidine seems to be discarded. PMID- 6482729 TI - [Comparative efficacy of oltipraz (1 dose, 30 mg/kg) and the combination of niridazole (25 mg/kg) and metrifonate (10 mg/kg) against S. haematobium]. AB - PUGH (1978) and TEEDSALE et al. (1980) showed that an associated single dose of metrifonate (12.5 mg/kg) plus niridazole (25 mg/kg) gave good results on Schistosoma haematobium: the egg-reduction percentage ranged between 84.7 and 91.2. In Niger, we compared the effects of this medication to oltipraz in a single dose (30 mg/kg). We selected a dosage of 10 mg/kg of metrifonate and 25 mg/kg of niridazole. This trial was carried out during the minimal transmission period. --109 adults (greater than 15 years) received oltipraz and 159 this combined treatment. They were examined twice: 11/2 month and 6 months after treatment. At the first control, the cure rate was 26.7% for oltipraz and 23.3% for the combined treatment, the egg-reduction was respectively 77.1% and 41.3%. Six months after treatment, the cure rate was 43.5% for oltipraz and 27.7% for the combined treatment and the egg-reduction was 66.5% and 2.0% respectively. Following these results, the authors recommend against the combined treatment in Niger. They note that if, in some particular conditions, this medication can give good results (PUGH, 1978, TEESDALE et al., 1980) it is however necessary to include its test in future control projects. Also, they note the weak result obtained with oltipraz; but, in this case, the heavy endemic level and high egg loads might explain it, as well as the fact that the 30 mg/kg dosage was probably insufficient. PMID- 6482730 TI - Hospice and the new devaluation of human life. PMID- 6482731 TI - Psychotherapy with persons who are mentally retarded. PMID- 6482732 TI - Chylomicron and very low-density lipoprotein apolipoprotein B metabolism: mechanism of the response to stanozolol in a patient with severe hypertriglyceridemia. AB - Studies of simultaneous autologous 131I-chylomicron (Sf greater than 400) and 125I-very low density lipoprotein (VLDL) (Sf 20 to 400) apolipoprotein B (apo B) were performed both before (triglyceride level c 1500 mg/dL) and during treatment with stanozolol, a 17 alpha-methyl anabolic androgenic steroid (triglyceride level c 750 mg/dL) in a 74-year-old woman with a past history of recurrent chylomicronemic pancreatitis. Both before and during stanozolol treatment chylomicron apo B disappeared rapidly and directly, little appearing in VLDL and virtually none in intermediate (IDL) or low density lipoproteins (LDL). Multicompartmental analysis indicated that the great majority of chylomicron apo B was removed via an extremely rapid compartment (estimated fractional catabolic rate [FCR], 5.0/h), accounting for 66% before and 88% during stanozolol treatment. The remaining 131I-apo B decayed biphasically, with total Sf greater than 400 residence times of 8.6 hours before and 3.7 hours during stanozolol treatment. Hence, despite a moderately depressed adipose tissue lipoprotein lipase activity, the subject's hypertriglyceridemia did not appear to proceed solely from retarded chylomicron removal, nor was the dramatic decrease in triglyceride in response to stanozolol a function only of the acceleration of such removal. VLDL apo B kinetics were analyzed by a multicompartmental model featuring a rapid, stepwise delipidation chain which proceeds either rapidly to IDL and LDL or to a slowly turning over compartment within VLDL. While VLDL. apo B synthesis remained essentially constant, the major effect of stanozolol was a substantial reduction in the fraction of VLDL apo B diverted to this slowly turning over compartment, which decreased from 5.0% before to 1.2% during treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482733 TI - Selective urinary excretion of phosphatidyl ethanolamine in patients with chronic glomerular diseases. AB - Urinary phospholipids and lipoproteins in chronic glomerular diseases were analyzed. The subjects used were 26 patients consisting of 14 with chronic glomerulonephritis and 12 with nephrotic syndrome. Nine healthy normals served as controls. Phospholipids were isolated by one-dimensional thin-layer chromatography (TLC) using an internal standard for quantification and partially by two-dimensional TLC and, furthermore, quantified by two different methods to ascertain the kinds of phospholipids. Urinary lipoproteins were isolated by density gradient ultracentrifugation and analyzed by electrophoresis. The urinary excretion of phosphatidyl ethanolamine (PE) was recognized exclusively in the patient group and that of phosphatidyl serine (PS) in most cases with nephrotic syndrome. The daily urinary PE excretion rate was closely correlated to the urinary albumin excretion rate. However, phosphatidyl choline (PC) and sphingomyelin (SPH), which are main phospholipids in serum and red blood cell membranes, in most cases were hardly detected in urine. These observations were confirmed by two-dimensional TLC using valuable spot tests for identification of phospholipids and also by the two different quantification methods. In density gradient ultracentrifugation, urinary lipoproteins did not form such peaks as seen in the profiles of serum lipoproteins. The presence of urinary lipoproteins in two nephrotic patients has been shown, but although the method used was not very sensitive, it was suggested that lipoproteins were hardly excreted into urine as the lipoprotein deficient fraction (LPDF) (d greater than 1.21 g/ml), in which albumin is predominant. PE was found mainly in LPDF of urine, although the amount of PE in urinary lipoproteins was very limited.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482734 TI - The effects of exercise and a moderate hypercholesterolemic diet on plasma and hepatic lipoproteins in the rat. AB - Exercise generally has been found to produce beneficial effects on plasma lipid and lipoprotein profiles, but the mechanisms involved and possible dietary interactions have not been well defined. Weanling male Fischer 344 rats were assigned to three groups: normocholesterolemic diet sedentary (NS), hypercholesterolemic diet sedentary (HS), and hypercholesterolemic diet exercised (HE). Exercise consisted of treadmill running at 1.2 to 1.4 km/h at a 9% grade, six days weekly, for a 10-week experimental period. Lipoproteins from plasma and from a recirculating in situ liver perfusion system were then isolated and analyzed. The values of several parameters for HE tended to fall intermediate between HS and NS. Final total plasma cholesterol and liver cholesterol concentrations were significantly different among all three groups (HS greater than HE greater than NS). Plasma HDL-cholesterol and phospholipids and perfusate HDL-cholesterol production rate per gram liver were all significantly lower in HS v NS, with HE lying in between. Plasma HDL protein was lower in HS than in both other groups. Plasma total triglyceride levels were significantly lowered by exercise, but neither plasma nor perfusate VLDL triglyceride levels differed significantly among the three groups. Food intakes of HE and HS rats were similar, but HE rats had significantly lower final body weights. The results suggest that (1) exercise may ameliorate many of the changes in lipoprotein and cholesterol metabolism induced by a diet containing lard and cholesterol, and (2) some of these changes may be mediated by changes in hepatic lipoprotein production. PMID- 6482735 TI - Effects of perfusate leucine concentration on the metabolism of valine by the isolated rat hindquarter. AB - Rates of oxidation of valine and release of alpha-ketoisovaleric acid by hindquarters from rats fed a 9% casein diet were measured at intervals over 90 minutes. The hindquarters were perfused with medium containing between 0.03 and 10 mmol/L L-leucine; concentrations of valine and isoleucine were kept constant at 0.2 and 0.1 mmol/L, respectively. The rate of oxidation of [1-14C]valine increased two to threefold when the perfusate contained 0.8 or 1.0 mmol/L leucine but was depressed by 50% when the leucine concentration was 10 mmol/L. The rate of release of alpha-ketoisovaleric acid from the hindquarter was affected little by perfusate leucine concentrations up to 1.0 mmol/L, but release was depressed when perfusate leucine concentration was increased to 10 mmol/L. The rate of release of alpha-ketoisocaproic acid increased with increasing perfusate leucine concentration, as did intracellular alpha-ketoisocaproic acid and leucine concentrations. These results indicate that valine oxidation by the isolated perfused hindquarter is stimulated by a high perfusate leucine concentration (1.0 mmol/L), suggesting that this response contributes to the depressed plasma and tissue valine pools of rats fed a high-leucine diet. An excessively high concentration of leucine (10 mmol/L) suppresses valine oxidation, presumably by competing with valine for transmination or transport. PMID- 6482736 TI - The effects of caloric restriction or exercise cessation on the serum lipid and lipoprotein concentrations of endurance athletes. AB - The interaction of exercise and diet in determining the lipid profiles of endurance athletes is poorly defined. Since active men consume more calories than sedentary individuals, we examined the effects of caloric restriction alone or in combination with exercise cessation on the serum lipid levels of men running 16 km daily. For seven days before each study, subjects consumed diets composed of 15% protein, 32% fat, and 53% carbohydrate. During ten-day experimental periods, one group (n = 10) continued running and consumed the same diet containing 3670 kcal/day, while two other groups consumed an identical diet containing 20% fewer calories and either continued (n = 16) or stopped (n = 15) exercise training. High-density lipoprotein cholesterol (HDL-C) concentrations decreased 1% to 5% in all groups during the seven-day preliminary diet. Additional reductions in total HDL-C concentrations were similar in the control and exercise cessation groups, but HDL2-C level decreased 15% during exercise cessation. During caloric restriction and continued running, in contrast, HDL-C concentration increased 8% and the HDL2-C subfraction increased 23%. There was little change in levels of apolipoprotein A-I concentrations during any of the protocols, demonstrating that changes in HDL-C are not necessarily attended by changes in the major HDL apoprotein. Low-density lipoprotein cholesterol (LDL-C) level decreased 10% to 15% in all groups during the preliminary period. Only small additional reductions occurred in men who continued running. Exercise cessation, however, was associated with a 10% increase in LDL-C level after only two days of inactivity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482737 TI - Metabolic effects of medium- or long-chain triglycerides and high-protein, carbohydrate-free diets in Zucker rats. AB - The effects of protein levels and types of fat in the diet on the metabolism of lean and obese Zucker rats were studied. For 40 days the rats were fed ad libitum one of four diets: two "usual protein" diets (19% protein by weight) with 19.4% triacylglycerols, either long chain (UP-LCT diet) or medium chain (UP-MCT diet); and two high protein (64% protein), carbohydrate-free diets, again with 19.4% triacylglycerols (HP-LCT and HP-MCT diets, respectively). The energy intakes of the obese rats decreased about equally on the HP-LCT, UP-MCT, and HP-MCT diets. The daily weight gain, which was high in the UP-LCT rats, was lower when carbohydrates were replaced by proteins, or when LCTs were replaced by MCTs; furthermore, when these two changes were made together, their beneficial effects on body weight were additive. The lipid gain, too, was high with the UP-LCT diet and lower both with the high protein diets and with the MCT diets; again combining the two amplified the two individual effects, so much that the final lipid concentration in the body was lowered, whereas the concentration of water increased. Hepatic acetyl CoA carboxylase activity was low when the diet supplied plenty of LCTs, but replacing carbohydrates with proteins in such a diet produced an additional decrease in this enzymatic activity. When either a normal protein or a high protein diet supplied MCTs in place of LCTs, acetyl CoA carboxylase activity was high and similar to that found with a high carbohydrate diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482738 TI - Exercise activation of myocardial lipoprotein lipase in male and estrogen-treated female rats. AB - Lipoprotein lipase (LPL) is the rate-limiting enzyme in the utilization of plasma triglycerides by extrahepatic tissues. The present study examined the effect of estrogen upon the circadian rhythm of rat myocardial LPL and upon the endothelial bound and tissue components of rat myocardial LPL immediately after exhaustive exercise. Female rats were ovariectomized at 28 days. Estrogen replaced female rats (ER) received 17-beta-estradiol in sunflower oil (200 micrograms/100 g body weight/week for 4 weeks). Oil-injected female rats (OI) received sunflower oil (0.1 mL/100 g body weight/week for 4 weeks). Normal male rats (M) were studied for comparison. ER, OI, and M animals were killed every four hours starting at 8 AM. Estrogen treatment did not alter the circadian rhythm of LPL activity. A second group of animals were run to exhaustion on a motorized treadmill, starting at 9 AM. ER animals performed significantly more work (P less than 0.05) than OI or M rats. Liver glycogen concentration was reduced 96.8% to 97.8% from control in all three groups after exercise. Both the tissue and endothelial fractions of LPL activity were elevated after exercise in all three groups. Exercised ER females (116.3 +/- 9.0 units) had significantly higher cardiac tissue enzyme activity than exercised males (85.0 +/- 9.4 units). Heparin-releasable LPL activity in exercised ER rats (65.3 +/- 5.7 units) was 43% higher than in exercised M rats (45.5 +/- 5.6 units) and 53% higher than in OI female rats (42.6 +/- 8.1 units).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482739 TI - Halothane-lidocaine sequence for induction of anesthesia in infants. PMID- 6482740 TI - Undiagnosed myasthenia gravis in a parturient undergoing cesarean section- maternal and neonatal complications. PMID- 6482741 TI - Untoward side effects and toxicities of inhalational anesthetics. PMID- 6482742 TI - Emergency medicine: the twenty-third specialty. PMID- 6482743 TI - EMS in Michigan. PMID- 6482744 TI - Osteoporosis. PMID- 6482745 TI - A study of cyanide-insensitive respiration in the genus Dekkera and Brettanomyces. AB - Dekkera intermedia and Brettanomyces custersii were shown to have a respiratory pathway resistant to cyanide, antimycin A, and azide. This respiration remained sensitive to salicylhydroxamic acid (SHAM). The "cyanide-resistant" respiration was induced mainly at the end of the growth phase and could reach 50% of total respiratory capacity. The mitochondrial "petite colony" mutation had no effect on this oxidation pathway. The presence of this respiration pathway in these strains constitutes a compensation mechanism for the reducing activity of acetaldehyde dehydrogenase. This alternate pathway would thus be a fundamental element of the Custer effect, a characteristic feature of these strains. PMID- 6482746 TI - Environmental mycobacteria in Korea. I. Distribution of the organisms. AB - Environmental mycobacteria in Korea have been investigated by examining 54 soil, 111 house dust, 63 well water, and 98 sewage samples collected from 123 randomly selected areas in Korea during the fourth nationwide tuberculosis prevalence survey in 1980. A variety of mycobacteria were isolated from 76% of soil, 67% of sewage, 43% of well water, and 7% of house dust samples. Some samples yielded more than one species; thus 56 strains were obtained from soil, 107 strains from sewage, 48 strains from well water and 8 strains from house dust. Mycobacterium fortuitum was the most common species of environmental mycobacteria in Korea and the species was distributed equally in all types of samples tested. The M. terrae complex was also one of the common species of environmental mycobacteria and it seemed to be more abundant in water samples than in soil. Scotochromogenic slow growers M. scrofulaceum and M. gordonae were common microbes in soil and water samples, although the latter was more frequently detected in water samples. Scotochromogenic rapid growers M. flavescens and M.phlei, and photochromogenic rapid grower M. vaccae were isolated more frequently from sewage or water samples than from soil. Nonphotochromogenic rapid growers M. chelonei (chelonae) and M. smegmatis were isolated mostly from sewage and the former was rarely found in soil and well water samples. The clinically important species M. avium intracellulare complex was found less frequently in all types of test samples. PMID- 6482747 TI - Suppressor macrophages in lymphocyte proliferation of cynomolgus monkeys. AB - The present study demonstrated the presence of cells belonging to monocyte/macrophage lineage which suppressed mitogen-induced blastogenesis of peripheral blood lymphocytes in cynomolgus monkeys. Depletion of adherent or phagocytic cells from peripheral mononuclear cells caused a substantial increase in the blastogenic response of cynomolgus monkey lymphocytes whereas the same treatment led to marked reduction rather than enhancement in human lymphocyte blastogenesis. Addition of thioglycollate-elicited peritoneal exudate adherent cells as macrophages suppressed the blastogenic response of nonadherent lymphocytes in a dose-dependent manner. The suppressive effect was observed not only in autologous but also in allogeneic macrophages to the responder lymphocytes. Treatment of macrophages with silica, carrageenan or freezing thawing reduced their suppressive effect but there was no reduction with mitomycin C or indomethacin. No suppressive activity was detected in the cell free supernatant of macrophages cultured in the presence or absence of mitogens for up to 4 days. From these findings, it appeared that monocyte/macrophage lineage might be responsible for the observed suppressive effect on mitogen induced blastogenesis of cynomolgus monkey lymphocytes. PMID- 6482748 TI - [Exopolysaccharide of Mycobacterium flavum]. AB - Mycobacterium flavum 158a can produce exopolysaccharides whose quantity varies, depending on the culture age, from 88.2 to 186.8% of the cell biomass weight in a medium with sucrose and from 1.3 to 25.0% in a medium with a polysaccharide synthesized by the oligonitrophilic bacterium Pseudomonas sp. 158a. The absolute and relative content of exopolysaccharides in the cultural broth decreases during the intensive growth of M. flavum 158a. This appears to be caused by their assimilation as a carbon source in the processes of energy and constructive metabolism. The exopolysaccharides of M. flavum 158a contain galactose, glucose, mannose, fucose, xylose, ramnose and a lipophilic sugar X1 at the molar ratio 10:11:11:8:11:12:16 as well as a non-identified sugar X2 with the Rf below than that of ramnose. The exopolysaccharide of M. flavum 158a was shown to be heterogeneous. It is composed of at least 16 fractions differing in molecular mass (from 98,980 to 490 D), quantity (from 2 to 8), composition and percentage of the constituent monosaccharides. PMID- 6482749 TI - [Effect of emulsifiers released by yeasts multiplying on n-alkane media on their growth and microscopic organization]. AB - Bioemulsifiers and ether extracts from the cultural broth of yeast cells were used to study their effect of Candida lipolytica growth and ultrastructural organisation. When the emulsifiers and ether extracts were added to the growth medium, the lag phase was reduced but the growth rate did not change. The ether extracts increased the growth rate of C. lipolytica 374/2 and the final biomass yield of C. lipolytica 704. The ultrastructural organisation of C. lipolytica 374/2 cells changed under the action of the bioemulsifier added to the growth medium. PMID- 6482750 TI - [Intracellular and extracellular ribonucleases of Bacillus intermedius]. AB - Endocellular and exocellular ribonucleases were studied in Bacillus intermedius. Two fractions of ribonucleases (Rf 0.72 and 0.96) were found to be associated with the cellular surface and seven fractions (Rf 0.1, 0.17, 0.33, 0.45, 0.72, 0.82 and 0.96) were detected in the cytoplasm. RNAase with Rf 0,096 had the highest activity and was repressed by inorganic orthophosphate. This RNase accumulated in the cell during the stationary growth phase just as the free enzyme form did in the culture medium. The immunological characteristics of these enzymes were identical as was shown by immunochemical analysis. PMID- 6482752 TI - Nipping hepatitis B in the bud. PMID- 6482751 TI - [Lipid composition of Fusarium sambucinum grown in a fermenter on media with different carbon sources]. AB - The object of this work was to study the effect of media containing different carbon sources on the content of lipids and their fractions in the fungus Fusarium sambucinum grown in a fermenter. Molassa and ethanol were carbon sources. From 15.0 to 16.5% of lipids were found to be accumulated in the fungal mycelium. The content of neutral lipids varied from 47.3 to 68%. The fraction of neutral lipids was shown to contain fatty acid esters apart from sterols, triglycerides, free fatty acids and esterified sterols typical of the fungus. The greatest quantities of fatty acid esters were synthesized when the fungus grew on a medium with molassa. Linoleic, oleic and palmitic acids prevailed among other free and esterified fatty acids. PMID- 6482753 TI - Food poisoning. PMID- 6482755 TI - Sigmoidoscopy. A basic medical skill? PMID- 6482754 TI - The chronic outcome in anorexia nervosa. PMID- 6482756 TI - Prevention of vertical transmission of hepatitis B. The place of routine screening in antenatal care, and the case for immunization of infants at risk. AB - Many chronic carriers of hepatitis B virus acquire the infection from their mothers at birth; the risk is greatest if the mother either has acute hepatitis B or is a hepatitis Be antigen (HBeAg)-positive HBsAg carrier, but there is some risk also to the infants of mothers who do not carry HBeAg. At the Royal Women's Hospital, Melbourne, nearly 2% of women attending antenatal clinics are found to be carriers and, without immunization, approximately five infants per 1000 infants delivered (up to 15 infants annually) would also become carriers. Vertical transmission of hepatitis B can be prevented by a combination of passive and active immunization if infants at risk can be identified at or before birth. Routine screening for hepatitis B surface antigen in pregnant women is recommended, at least in institutions in which the patient population includes a high proportion of migrants, in whom the prevalence of hepatitis B carriage is relatively high. PMID- 6482757 TI - Salmonella food poisoning. AB - During an outbreak of Salmonella typhimurium food poisoning in September 1983, in Sydney, 10 affected subjects were admitted to the same hospital. On admission to hospital, all patients were severely dehydrated; two patients developed acute tubular necrosis, while a third patient had myopericarditis. Bacteraemia was confirmed in two patients, in one of whom no organisms were isolated from stool cultures. Antibiotic agents were administered to all patients, because of the unusually severe nature of the infection. This outbreak illustrates that salmonella gastroenteritis, although usually fairly mild and self-limiting, can be a virulent disease resulting in serious complications. Appropriate management should include careful initial assessment of suspected cases, vigorous correction of fluid and electrolyte disturbances, and judicious use of antibiotic agents when bacteraemia or severe toxaemic features are present. PMID- 6482758 TI - Anorexia nervosa. A follow-up investigation. AB - The majority of patients with anorexia nervosa regain a normal body weight after appropriate treatment, but the relapse rate is high, and the long-term outcome remains uncertain. The present study attempted to trace 49 patients (47 female, 2 male) with primary anorexia nervosa, all of whom had been managed by refeeding and supportive psychotherapy. The patients were contracted on two occasions. At the 22-month follow-up, 46 (94%) of the patients responded to a questionnaire. At the 102-month follow-up, 34 (69%) were interviewed by telephone. The outcome was reported as "good" by 18 patients (37%), as "intermediate" by 9 patients (18%); it was "poor" in 5 patients (10%), including one who had killed herself. No information was available for 16 patients (33%) who either could not be contacted or refused to cooperate. One patient had died by accident. PMID- 6482759 TI - Training in sigmoidoscopy. An assessment in three teaching hospitals. AB - To assess the standard of training in postgraduate sigmoidoscopy in Melbourne, a questionnaire was prepared and distributed to resident medical officers (RMOs) in three teaching hospitals. The survey showed that practical instruction in technique is inadequate, and that most individuals perform too few sigmoidoscopies to become competent at either examining or recognizing lesions. A substantial number of RMOs had never seen common and important lesions such as polyps or colorectal cancer. Most RMOs considered their training to be poor and stated that they lacked confidence in their ability to perform sigmoidoscopy. The current training programme needs detailed reassessment and improvement. PMID- 6482760 TI - Growth of Aboriginal infants. AB - Aboriginal infants at Cherbourg Aboriginal Settlement in Queensland now have growth rates which are similar to those of white Australian infants. The proportion of children under 90% of the standard weight-for-age appears to be the same as for white Australian children and meets the international standards. Apart from premature infants, no children have been found in the accepted "at risk" categories. PMID- 6482761 TI - Self-monitoring of blood glucose. A survey of long-term use. AB - A retrospective survey was carried out on all patients within the city of Wollongong who had obtained a home glucose meter in the two-year period from July 1981 to June 1983. From the responses, we found that 49% of patients were not using their meter in an optimal way. Between these patients and those who made optimal use of their meter, the only significant difference was that the former were less likely to have had a machine on loan before purchase. The high percentage of patients making less than optimal use of their home glucose meter indicates a need to review the manner in which these machines are obtained. PMID- 6482762 TI - Use of the ureteroscope in ureteral calculus manipulation. AB - The success rate of endoscopic manipulation of ureteral calculi is uncertain. The uncertainty arises because of selection procedures. A common reported figure is 50%, but this figure varies according to the selection procedure followed and the selection procedure depends on the anticipated difficulty of manipulation. The outcome of endoscopic manipulation performed as an initial procedure in a series of patients whose ureteral calculi required operative intervention is presented. A total of 33 calculi were successfully extracted by manipulation, including five in the upper ureter. The method failed to extract three calculi of which two were in the upper ureter. The success of this approach is attributed to the use of the rigid ureteroscope and the Meagher ureteral dilator, and to x-ray control. PMID- 6482763 TI - Effects of swimming on health. AB - An epidemiological study involving 893 people was undertaken during the 1980/81 summer period in the Richmond and Windsor region of New South Wales to determine the incidence of swimmers and non-swimmers reporting ear, eye, skin, throat and gastrointestinal complaints. Swimmers were found to report a greater incidence of ear and eye complaints than non-swimmers. Swimmers who swam in community pools were found to have a significantly higher incidence of earache compared to other swimmers. The findings of the study supported overseas work which suggests that the incidence of earache among swimmers may be a useful health indicator in the evaluation of waters for recreational use. PMID- 6482764 TI - Introduction and use of investigational anticancer agents in Australia. First progress report. Anticancer Subcommittee of the Australian Drug Evaluation Committee. AB - The Anticancer Subcommittee of the Australian Drug Evaluation Committee was established in 1978 to facilitate the obtaining of data on, and the supply of, investigational anticancer agents for use by Australian oncology units. The present report outlines the way in which the usage of specific drugs has developed. PMID- 6482765 TI - Pulmonary disease in a child caused by atypical mycobacteria. AB - A case of pulmonary (endobronchial) disease due to an atypical mycobacteria (MAIS complex) is reported. No previous reports of similar cases could be found in the Australian medical literature. PMID- 6482766 TI - Tyrosinaemia II. AB - Four cases of tyrosinaemia type II (Richner-Hanhart syndrome) are reported. This syndrome consists of corneal erosions, palmar and plantar hyperkeratoses, and sometimes mental retardation. Presentation with photophobia and dendritic corneal ulceration or circumscribed palmoplantar keratoderma should alert the physician to the possible diagnosis of tyrosinaemia II. Early diagnosis is important, as the clinical picture can be modified by dietary restriction. PMID- 6482768 TI - Childhood pneumonia in aborigines. PMID- 6482767 TI - Multifocal progressive neurological disorder caused by neoplastic angioendotheliosis. AB - The case of a 46-year-old woman who suffered a multifocal neurological illness, which rapidly progressed to dementia, is reported; the clinical signs were suggestive of multiple sclerosis. At necropsy, polyfocal cerebral white-matter lesions, associated with intravascular plugs of neoplastic cells which appeared to arise from the vascular endothelium, were found. The findings were typical of a rare form of malignant disease of the vascular endothelium known as neoplastic angioendotheliosis, which shows a striking predilection for the central nervous system. PMID- 6482769 TI - Mild hypertension. PMID- 6482770 TI - Diagnosis of panic disorder. PMID- 6482771 TI - Giardiasis in child-care centres. PMID- 6482772 TI - Hepatitis B marker tests. PMID- 6482773 TI - The changing face of pollen allergy in Queensland. PMID- 6482774 TI - Clinically important pollens of NSW and the ACT. PMID- 6482776 TI - Clinically important pollens of Tasmania. PMID- 6482775 TI - Allergenic pollens of Victoria. PMID- 6482777 TI - Pollen-producing plants of Tasmania. PMID- 6482778 TI - Pollens of clinical importance in the Adelaide region. PMID- 6482779 TI - Clinically relevant pollens known in Western Australia. PMID- 6482780 TI - Relationships between plants relevant to allergy. AB - This article gives background information on the taxonomic relationships between plants, for clinicians, patients and students of allergy. A list is provided of plants considered potentially allergenic either by inhalation of pollen or by ingestion of grain products. Distributions in Australia of plant species important in assessing pollen-related allergy, and the range of foodstuffs that contain cereal-grain protein, are also indicated. Particular emphasis is placed on the grasses because of their importance as producers of both grain and pollen. PMID- 6482781 TI - Effects of milk ingestion on young children with cow's milk allergy. A clinical study. AB - The effects of ingestion of cow's milk in young children with cow's milk allergy (CMA) is reported, following a recently concluded study of 100 infants and young children who were challenged and observed in a hospital environment. The existence of various immediate manifestations of this disease, and those that develop over hours or days following milk exposure, are highlighted. Attempts to define different syndromes, with the aim of aiding the clinical recognition of CMA, are also reported. PMID- 6482782 TI - Allergic reactions to foods in children. AB - Food reactions in children may be divided into two types: immediate and delayed. Cow's milk, egg and peanuts are the most commonly implicated foods. Immediate food reactions are associated with the presence of specific IgE antibodies to the food concerned, although detection of specific IgE is of no help in the diagnosis of delayed reactions. The only way to definitely confirm a food reaction is by elimination and rechallenge. Food reactions can be expected to improve naturally with time. PMID- 6482784 TI - Adverse reactions to foods. AB - The discovery of IgE in the mid-1960s resulted in a widespread view that allergy was the basis of most adverse reactions to food, but it is becoming increasingly clear that other, as yet poorly understood, mechanisms are responsible in the overwhelming majority of cases. This, together with the proliferation of popular literature on "food allergy" has resulted in considerable confusion in the minds of both the public and the medical profession on the subject. In the majority of patients presenting with food intolerance, recognized or otherwise, symptoms are precipitated by various small, non-immunogenic organic molecules present in the food as natural or added ingredients. These reactions are pharmacological rather than immunological in nature, although in some situations they may share a final common pathway with true allergic reactions, resulting in similar symptoms. PMID- 6482785 TI - Occupational asthma. AB - Occupational asthma is a hypersensitivity syndrome, and must be distinguished from non-specific aggravation of existing asthma. Probably only a minority of the causal agents produce sensitization by allergic mechanisms. The important clinical features of occupational asthma are the latent period before the onset of symptoms, the characteristic periodicity of symptoms, and the progressive increase in the severity of symptoms with continuing exposure. The diagnosis can usually be made from the history; serial measurements of peak expiratory flow will provide objective confirmation of the diagnosis. Identification of the agent responsible is desirable but not essential to the diagnosis, and specific bronchial challenge with the causal agent should be reserved for atypical cases. Symptomatic or prophylactic drug treatment should never be more than a short-term measure. The most effective treatment is for the patient to change his job. PMID- 6482783 TI - Extrinsic factors in atopic eczema. AB - The debate over the role of extrinsic allergens in atopic eczema has been enlightened in recent years by some well-controlled studies and improvements in our understanding of conditions which lead to hypersensitivity. This paper reviews some of these findings, which have preventative and therapeutic implications. No attempt is made here to review other aspects of this multifactorial disease, nor to enter into detailed discussion of dietary or allergen avoidance regimens, which have been covered in several recent reviews. Such regimens are not without risk, and require expert supervision. PMID- 6482786 TI - Allergy, allergens and allergen standardization. AB - Immediate, type 1 allergic reactions occur following interaction between allergen, immunoglobulin E (IgE), and the mast cell or basophil. Allergen-induced activation of these cells leads to the release of a number of mediators that are responsible for the symptoms observed during an allergic reaction. Recent progress in elucidating the structures, and in developing syntheses for platelet aggregating factor and the leukotrienes, promises to increase our understanding of the immunopharmacology of allergic and inflammatory reactions. The need for the standardization of allergen extracts is emphasized, and current activity in this area is highlighted. PMID- 6482788 TI - A plea for medical research. PMID- 6482787 TI - Anaphylaxis. AB - The clinical syndrome of anaphylaxis may be produced by a number of mechanisms. The life-threatening clinical features are angioneurotic oedema, bronchospasm, cardiovascular collapse and pulmonary oedema. The initial treatment consists of general resuscitation plus adrenaline. In shock, colloid solutions should be used to restore blood volume. The pulmonary oedema that occurs is a membrane oedema, and should be treated with artificial ventilation, positive end expiratory pressure, and volume replacement. After a reaction, all available tests should be used to determine the cause, and the patient should be given a warning letter describing the evidence for attributing his reaction to the determined cause. (This should be done in addition to the provision of any identification bracelet.) Pharmacological pretreatment is a valid preventive manoeuvre, but is not 100% reliable. PMID- 6482789 TI - Malaria. PMID- 6482790 TI - Malaria prophylaxis for travellers. PMID- 6482792 TI - Conventional ileostomy and the alternatives. PMID- 6482791 TI - The DES story. PMID- 6482793 TI - Diethylstilboestrol (DES) exposure in utero. AB - A clinical review of the first 200 patients who attended the DES Referral Clinic at The Royal Women's Hospital, Melbourne, has been undertaken. To date, clear cell adenocarcinoma has not been detected in patients attending the Clinic. Fifteen per cent of patients who allegedly were exposed in utero to diethylstilboestrol (DES) showed no clinical stigmata. Vaginal adenosis was found in 41% of patients. On its own, cytological examination of vaginal smears was found to be unreliable as routine screening for detection of adenosis. Painting of the cervix and vagina with Lugol's iodine proved to be a more reliable screening test. Colposcopy is recommended in all patients who are suspected of having been exposed in utero to DES. PMID- 6482794 TI - Surgical morbidity after ileostomy in New South Wales. AB - While there have been several overseas studies on the quality of life after proctocolectomy, data concerning patients who have undergone ileostomy and proctocolectomy in Australia are limited. For this reason, a questionnaire was sent to all members of the New South Wales Ileostomy Association. Of the 354 who replied, the indication for ileostomy had been ulcerative colitis in 82%, Crohn's disease in 10%, familial polyposis in 4%; and 4% had undergone proctocolectomy and ileostomy for some other reason. Ages ranged from 15 to 93 years. Most subjects, of whom 51% were female, had had their ileostomy for a median of 9.4 years. Immediate postoperative complications related to the ileostomy occurred in 23% of patients, the most common causes being obstruction and sepsis. The rate of readmission to hospital for complications of ileostomy was a high 48%; 25% had further surgery. In view of these results, the need for continued efforts to develop alternative methods is emphasized. PMID- 6482795 TI - Homozygous cystinuria in New South Wales. A study of 110 individuals with cystinuria ascertained by methods other than neonatal screening. AB - Homozygous cystinuria was ascertained in 110 individuals (44 men) from 78 families because of symptoms in the propositi. The most common renal symptoms were calculi which occurred in 91% of the propositi and in 52% of affected family members. One-third of patients had urinary tract infections. There was a high rate of renal morbidity at an early age; 16 patients had undergone nephrectomy at a mean age of 25 years (range, 12-40 years). Two-thirds of subjects had type I cystinuria on family testing--the same ratio as that reported in a previous study of cases detected by newborn screening in the same population--which eliminates genetic type as a risk factor for stone formation. On the basis of all data, a 62% probability of stone formation by the age of 25 years in patients with cystinuria was estimated. The patients were shorter than Australian controls, and an association between gout and cystinuria was found in adult men. PMID- 6482796 TI - Acute fluoride poisoning after ingestion of sodium fluoride tablets. AB - Between 1978 and 1983, at least 20 children with fluoride poisoning were admitted to two major children's hospitals in Brisbane. Data on telephone calls received by Poisons Information Centres in Australia about fluoride toxicity show that Brisbane, the water supply of which is not fluoridated, received approximately twice as many calls per head of population as were received in Sydney and Melbourne. Concern is also expressed at the standard of packaging of fluoride tablets currently marketed in Australia. A treatment plan for cases of acute fluoride poisoning after oral ingestion is presented. PMID- 6482797 TI - Maternal and childhood nutrition among Aborigines of the Kimberley region. AB - A cross-sectional anthropometric survey of 128 Aboriginal children under five years of age and of 388 Aboriginal girls and women of child-bearing age was undertaken in seven communities in the Kimberley Region of Western Australia. More than 20% of the children were undernourished, three individuals severely so. All but one of those who were undernourished were over 12 months of age. Less than 60% of the female subjects of child-bearing age had a satisfactory nutritional status; one-sixth were undernourished and one-quarter, mostly older women, were overweight. The findings indicate that poor nutrition is widespread among Aboriginal female subjects of child-bearing age. Maternal malnutrition may contribute significantly to unsatisfactory nutrition and health in Aboriginal infants and young children. PMID- 6482798 TI - Artificial ventilation for cardiopulmonary resuscitation. AB - The ability of 100 members of the nursing staff to administer artificial ventilation was tested on a manikin. Six techniques of artificial ventilation were used. A minimum minute volume of 6 L was chosen as the criterion for adequate ventilation. Eighty-eight per cent of nurses "passed" using mouth-to mouth ventilation, 66% "passed" using mouth-to-face-mask, 55% "passed" using the RM-1 injector system, 52% "passed" using the Mistviva injector system, while very low "pass" rates of 25% and 15% were obtained with the Air-Viva and Mapleson B circuits, respectively. It was concluded that mouth-to-mouth technique was the best form of ventilatory support provided by the nursing staff tested in this trial. In general, the use of mask systems should be restricted to highly trained staff members who have demonstrated continuing proficiency. PMID- 6482800 TI - Which pigmented moles should be removed in prepubertal-age children? A case for a conservative approach. AB - It is generally acknowledged that malignant melanoma is very rare in children before puberty, but recommendations for the treatment of pigmented moles often seem to discount this information. To document the frequency of malignant melanoma in Australian children of prepubertal age, several methods were used. These attempts showed the difficulty in obtaining completely valid figures, but sufficient information was collected to confirm the extreme rarity of malignant melanoma in this age group. It is, therefore, suggested that prophylactic removal of pigmented moles is generally not indicated in children before puberty, and that removal of a pigmented mole because of the possibility that malignant melanoma has developed should rarely be necessary in this age group. This information may help to reduce the concern that is often expressed about pigmented lesions in children, and to prevent unnecessary surgery. PMID- 6482799 TI - Management of Plasmodium falciparum malaria. AB - Measures of malaria control have proved inadequate in many parts of the tropics. The recent rise in the incidence of malaria has been associated with the spread of drug-resistant strains of Plasmodium falciparum. Chloroquine therapy is now ineffective in many parts of Asia and South America, and resistance to this drug is emerging in Africa. There are few alternative drugs available. Quinine remains effective against P. falciparum in Southeast Asia. Reappraisal of quinine therapy has led to important modifications in dosage recommendations and recognition of a major complication of severe malaria associated with its use--hypoglycaemia. Severe malaria has been neglected as a subject for clinical investigation, and there is little information available on which to base rational treatment. Most of the drugs used in addition to antimalarial agents for cerebral malaria have not been critically tested, except dexamethasone which has been shown to be harmful. Simple, but difficult to organize, intensive nursing of patients with cerebral malaria will improve the prognosis. However, even in the best hands, the mortality rate never falls below 20%. PMID- 6482801 TI - Care of the care-givers. PMID- 6482802 TI - In war against mosquito, man is losing ground. PMID- 6482803 TI - Ocular toxicity of quinine. AB - A case of ocular toxicity of quinine is described. The effectiveness of a number of treatment modalities is evaluated in the light of its pathogenesis and potential for spontaneous recovery of sight. PMID- 6482804 TI - Occupational hepatitis caused by methylenedianiline. AB - Four of the six workmen who were engaged in laying an epoxy resin based floor developed an acute hepatic illness; in two of these men, the illness recurred on re-exposure a few months later, and their convalescence period was prolonged. It was concluded that methylenedianiline, which was used as the curing agent for the epoxy resin, was the likely hepatotoxin on the basis of marked similarities of these men's symptoms and signs to those described in other published reports about toxic exposure to this compound. To date, there is no evidence of long-term liver damage caused by this widely used industrial chemical. PMID- 6482805 TI - Debendox and pregnancy. PMID- 6482806 TI - Aboriginal health. PMID- 6482807 TI - Malaria and chloroquine. PMID- 6482808 TI - Euthanasia for cancer patients: a non-debate. PMID- 6482809 TI - Acetazolamide and general anaesthesia. PMID- 6482810 TI - Epidemiology of peptic ulcer in Australia. PMID- 6482811 TI - Phenylbutazone off benefits list. PMID- 6482813 TI - Tracheostomy in early childhood. PMID- 6482812 TI - Blood pressure in children. PMID- 6482814 TI - Effect of 1-hexadecyl-2-acetyl-sn-glycero-3-phosphorylcholine on blood pressure by intra-lateral ventricular injection in the rat. PMID- 6482815 TI - Reduction of skin flora by pre-operative disinfection and bacterial recontamination of the skin, instruments and linens during operation. PMID- 6482816 TI - Cerebral blood volume changes in cats with acute increased intracranial pressure. PMID- 6482817 TI - Inhibition of acetylcholinesterase and pseudocholinesterase activities by trimethaphan. PMID- 6482818 TI - [Applicability of the nonspecific bronchial provocation test in epidemiology]. PMID- 6482819 TI - [Monitoring urinary excretion of ethylenethiourea (ETU) in rats treated with zineb]. PMID- 6482820 TI - Adverse environmental factors, peptic ulcer and chronic gastritis in a metalworking industry. PMID- 6482821 TI - [Ergonomic improvement of workplace in the rubber-soled shoe industry]. PMID- 6482822 TI - [Considerations in a case of occupational bronchial asthma caused by rye flour]. PMID- 6482823 TI - [Vaccinations for travel abroad]. PMID- 6482824 TI - [Skeletal complications in dialysis patients. Renal osteopathy in chronic hemodialysis]. PMID- 6482825 TI - [Drug therapy in elderly patients]. PMID- 6482826 TI - [Parkinson disease]. PMID- 6482827 TI - [Adverse effects of drugs on sexual behavior and fertility in males]. PMID- 6482828 TI - [Calcium antagonists in heart-circulatory therapy]. PMID- 6482829 TI - [Urinary incontinence: possibilities of drug therapy]. PMID- 6482830 TI - [Drugs with action on the bronchial tract]. PMID- 6482831 TI - The right to be allowed to die--self induced starvation and the right to die without undue misery. PMID- 6482832 TI - Standard of proof in medical negligence. PMID- 6482833 TI - Suction lipectomy. PMID- 6482834 TI - [Methemoglobin formation in the erythrocytes of mice as affected by primaquine metabolites and the protective action of antioxidants]. PMID- 6482835 TI - [Laboratory trials of the effectiveness of tropical larvivorous fish as agents for controlling mosquito larvae. 1. The principles of selecting the fish and trial methods]. PMID- 6482836 TI - [Dependence of larval and nymphal feeding of the taiga tick Ixodes persulcatus P. Sch. on the number of small mammals in the forests of the western Sayan]. PMID- 6482837 TI - [Dimethylphthalate metabolism in epidermal application of the preparation]. PMID- 6482838 TI - [Case of onchocerciasis in surgical practice]. PMID- 6482839 TI - A review of normal tissue hydrogen NMR relaxation times and relaxation mechanisms from 1-100 MHz: dependence on tissue type, NMR frequency, temperature, species, excision, and age. AB - The longitudinal (T1) and transverse (T2) hydrogen (1H) nuclear magnetic resonance (NMR) relaxation times of normal human and animal tissue in the frequency range 1-100 MHz are compiled and reviewed as a function of tissue type, NMR frequency, temperature, species, in vivo versus in vitro status, time after excision, and age. The dominant observed factors affecting T1 are tissue type and NMR frequency (V). All tissue frequency dispersions can be fitted to the simple expression T1 = AVB in the range 1-100 MHz, with A and B tissue-dependent constants. This equation provides as good or better fit to the data as previous more complex formulas. T2 is found to be multicomponent, essentially independent of NMR frequency, and dependent mainly on tissue type. Mean and raw values of T1 and T2 for each tissue are tabulated and/or plotted versus frequency and the fitting parameters A, B and the standard deviations determined to establish the normal range of relaxation times applicable to NMR imaging. The mechanisms for tissue NMR relaxation are reviewed with reference to the fast exchange two state (FETS) model of water in biological systems, and an overview of the dynamic state of water and macromolecular hydrogen compatible with the frequency, temperature, and multicomponent data is postulated. This suggests that 1H tissue T1 is determined predominantly by intermolecular (possibly rotational) interactions between macromolecules and a single bound hydration layer, and the T2 is governed mainly by exchange diffusion of water between the bound layer and a free water phase. Deficiencies in measurement techniques are identified as major sources of data irreproducibility. PMID- 6482840 TI - Performance characteristics of A 150 plastic-equivalent gases in A 150 plastic proportional counters for 14.8-MeV neutrons. AB - Two recently developed A 150 plastic-equivalent gas mixtures have been tested for suitability in proportional counter applications. Methane- and propane-based "tissue-equivalent" gases were also included for comparison purposes. Event-size weighted dose distributions were measured in a 14.8-MeV neutron beam. Resolution was found to be independent of gas mixture. Moreover the gains of the two A 150 mixtures were the same, and comparable to that of the methane-based gas mixture. The ionization yield per event size was also independent of the hydrogenous gas mixture employed. Neutron doses determined with the proportional counter were in reasonable agreement with those obtained from an ionization chamber. PMID- 6482841 TI - The use of multivariate regression analysis in contrast-detail studies of CT scanners. AB - Previous studies of the imaging performance of computed tomography (CT) scanners, and other imaging modalities, have failed to apply appropriate statistical methods to data analysis, thus impairing the accuracy and significance of results. Given that imaging performance involves a number of interrelated variables and an element of randomness, its empirical assessment requires multivariate regression analysis. This method is used here to analyze anew a set of contrast-detail data from a previous study on CT scanners. The main issues considered are the specification of the proper functional form linking perceptibility, dose and contrast, the estimation of the contrast and dose coefficients, and of scanner-specific constants to be used in computing indices of imaging quality. One of the main empirical findings is that the dose coefficient of the CT scanners studied is significantly less than that predicted by the theoretical model: 1/5 instead of 1/3. This result suggests that actual dose used in routine clinical studies could be reduced substantially without impairing much the quality of the images. On the other hand, the coefficient of contrast does correspond to its predicted value, i.e., 2/3. The methodology used here is not limited to the contrast-detail framework, but is applicable to, and indeed essential in, empirical studies of the performance of any imaging modality. PMID- 6482842 TI - The collection efficiency of an ionization chamber in a pulsed and magnetically swept electron beam: limits of validity of the two-voltage technique. AB - The two-voltage method of determining the collection efficiency of an ionization chamber exposed to a pulsed and magnetically swept electron beam depends upon the form of the saturation curve agreeing closely with the formula based on ionic conduction and negligible space charge. The possible disturbing effects of charge transport by free electrons and of overlapping pulses are discussed and the conditions to be satisfied for the reliable use of the method are defined and demonstrated experimentally. PMID- 6482843 TI - Analysis of variations in contrast-detail experiments. AB - Three sources of variability in a contrast-detail (CD) experiment have been quantitated: within-observer variance, between-observer variance, and sample variance. It is concluded that (1) it is more efficient to increase the numbers of replicated images and observers than to increase the number of readings; (2) sampling and between-observer variations are approximately equal; (3) one can expect approximately 10% standard errors in the measured value of threshold detail or threshold contrast in a CD experiment which employs four observers, four replicate image samples, and one reading per observer. PMID- 6482844 TI - Radiation dose in diagnostic radiology: Monte Carlo simulation studies. AB - We applied Monte Carlo calculations to determine the radiation dose absorbed in water phantoms. Monoenergetic incident x-ray beams with energies from 15 to 100 keV and phantom thicknesses from 5 to 20 cm were considered in this study. We calculated the spatial distributions of energy absorption in the phantom, the rad/R conversion factors, the average rad/R conversion factors, and the scatter to-primary ratios of absorbed dose. We also compared the relative absorbed doses under various imaging conditions when the transmitted radiation produced a given optical density on radiographic film. The information provided will be useful for the estimation of radiation doses in various radiographic procedures. PMID- 6482845 TI - Image quality of an analog radiation therapy simulator-based tomographic scanner. AB - The spatial resolution and noise level of images produced by a commercial analog tomographic scanner have been measured and compared to those of images reconstructed digitally from projections from the same detector. The full width at half maximum of the line spread function was 3.6 mm for images from the analog scanner and 1.1 mm for the digitally reconstructed images. The standard deviation of the CT numbers over a 10-cm2 circular area at the center of a large water phantom, calculated as a percentage of the linear attenuation coefficient of water, was 3.5% for the analog images, 15.4% for high-resolution digital images, and 3.2% for digital images reconstructed using a convolution filter which reduced the resolution to that of the analog images. The data contributing to each digital image were fewer than those contributing to each analog image by a factor of 10. The noise level did not depend on tube current in either the analog or the digital images. The utility of this analog device in radiation therapy planning will depend upon whether errors in contour localization resulting from transferring data from diagnostic CT scanners exceed the errors due to its poorer image quality. PMID- 6482846 TI - Relative dose efficiencies of antiscatter grids and air gaps in pediatric radiography. AB - The relative dose efficiencies (RDE) of various antiscatter grids and air gaps were determined for conditions simulating those found in pediatric radiography, using phantoms representing a newborn child, a 5-yr-old and a 10-yr-old child. Our data indicate than an air gap is best for the newborn, due to the low levels of scatter. The 8:1 fiber grid or 15.2-cm air gap without a grid can improve dose efficiency (DE) for the 5-yr-old child by 20%-25% relative to the 3.3-cm air gap and no-grid technique, while for the 10-yr-old child, DE can be improved by 40% with an 8:1 fiber grid. PMID- 6482847 TI - Application of the library least-squares analysis to whole-body counter spectra derived from an array of detectors. AB - The library least-squares method was applied to the analysis of gamma-ray spectra obtained from an array of 54 NaI(T1) detectors in a whole-body counter. The analysis of spectra which were obtained over a period of 8 yr demonstrates the applicability of the method despite inherent variations encountered in large counting systems. The elements of interest analyzed were total-body K, Ca, Na, Cl, and P. Least-squares fits obtained with library standards derived from distributed sources were better than those obtained from library standards derived from localized sources. PMID- 6482848 TI - Shortening the calculation time of photon dose distributions in an inhomogeneous medium. AB - A procedure is described for calculating photon dose distributions using convolutions of radiation interaction kernels with calculated fluence distributions. The advantages and disadvantages of the concept are discussed. PMID- 6482849 TI - Portal film quality: a multiple institutional study. AB - The variation in quality of the several thousand portal films submitted to the Quality Assurance Review Center (QARC) has been substantial. To ascertain the nature and severity of this problem, a detailed study of "whole brain" portal films which were taken at 23 different radiotherapy departments for patients entered on three national leukemia studies was performed. Each film was analyzed in two ways: (a) independent subjective evaluation by four experienced radiotherapists and (b) measurement of objective parameters. Scores from 416 evaluations together with measured parameters were stored in a data base system for easy statistical manipulation. The dependence of perceived film quality on these objective parameters has been correlated and is the subject of this report. PMID- 6482850 TI - Rapid in vivo localization of a lost brachytherapy seed. AB - We adapted a small sodium iodide scintillation detector for rapid, in vivo localization of a lost brachytherapy seed. Using the detector, we were able to locate and remove an Ir-192 seed that was not visible to the unaided eye. PMID- 6482851 TI - An improved optical backpointer for isocentric radiotherapy machines. AB - A simple optical backpointer has been designed as a retrofit for isocentric radiotherapy machines. Two lasers are used to project two fan beams of light which intersect in line with the central ray of the radiation beam. The system is mechanically rugged, and the projected cross is visible even in room light. PMID- 6482852 TI - [Schoenlein-Henoch syndrome. Clinical considerations on 275 cases]. PMID- 6482853 TI - [Nasal administration of glucagon in the treatment of neonatal hypoglycemia]. PMID- 6482854 TI - [Fractional excretion of sodium in healthy premature infants in the 1st month of life]. PMID- 6482855 TI - [Acute infectious diarrhea of bacterial etiology. Clinico-statistical considerations on 749 cases in children]. PMID- 6482856 TI - [Sigmoid volvulus: a rare pathology of pediatric significance. Presentation of 2 clinical cases]. PMID- 6482857 TI - Australia: inside out, upside down, down under, and outback. PMID- 6482858 TI - Some random thoughts on marketing and other things. PMID- 6482859 TI - Cold agglutinin disease. PMID- 6482860 TI - Sexual assault: the problem and its management. PMID- 6482861 TI - Management of breech presentation at term. A retrospective five year review to test guidelines of a management protocol. PMID- 6482862 TI - Mortician retrieval of donor globes. The Minnesota experience. PMID- 6482863 TI - Extracranial injuries in victims of blunt head trauma. PMID- 6482864 TI - Lymphokine: prospect as a cancer agent. PMID- 6482865 TI - Pseudocarcinoid syndrome due to medullary carcinoma of the thyroid. PMID- 6482866 TI - Diagnosis and management of diabetic retinopathy. Case reports. PMID- 6482867 TI - Preferred provider organizations. Part I--An overview. PMID- 6482868 TI - Hospital satellite clinics. Part IV--An excerpt from a study of Missouri health maintenance organizations, preferred provider organizations, hospital satellite clinics and freestanding emergency care centers. PMID- 6482869 TI - Congenital cardiac disease in dogs. AB - Aortic stenosis is a heritable cardiac anomaly most common in German Shepherds, Boxers and Newfoundlands, and less common in Pugs, English Bulldogs, Boston Terriers, Fox Terriers, Schnauzers and Bassets. Clinical signs are associated with secondary left-sided heart failure and include coughing, moist rales, exercise intolerance, arrhythmias and a weak femoral pulse. It causes an ejection type crescendo-decrescendo, systolic murmur best heard on the left side near the elbow. The ECG may be normal or may show signs of left ventricular hypertrophy, including an axis of less than 40 degrees, a QRS complex of greater than 60 seconds in duration, R waves greater than 3 mv in amplitude, ST segment slurring or depression, or T waves of an amplitude greater than 25% of that of R waves. A LAT radiograph usually reveals an enlarged cardiac silhouette, loss of the cranial cardiac waist, and normal pulmonary vasculature, while DV projections show an elongated cardiac silhouette, rounding of the left ventricular border, and a normal descending aorta. Nonselective angiocardiography reveals poststenotic dilatation of the aorta. Treatment of severely affected dogs involves surgical correction. PMID- 6482871 TI - An American CE program in Chile. PMID- 6482870 TI - Purchase examinations for performance horses. AB - Performance horses should be thoroughly examined before sale to detect any defects that could render them unsuitable for the purchaser's intended use. With the horse in its stall, the eyes, nasolacrimal puncta, external ear canals and mouth are examined, the rectal temperature measured and the heart, lungs, trachea and sinuses auscultated. Moving the horse out of the stall, the head, parotid glands, mandibular lymph nodes, larynx, neck muscles, jugular veins and cervical vertebrae are inspected. The scapula, point of the shoulder, withers, tuber sacrale and point of the hip are palpated, after which the ventrum, tail, and pelvic and thigh muscles are examined. Structures of all limbs and feet are palpated and inspected for disease and evidence of past surgery. The horse is then worked, on a longe line and under saddle, to evaluate limb carriage and gait. Radiography and other diagnostic procedures are performed as indicated. PMID- 6482872 TI - Bovine intestinal surgery. AB - A clear understanding of the surgical anatomy of the bovine intestinal tract is the most important factor in determining the degree of success to be achieved in the surgical management of intestinal disorders in cattle. However, bovine intestinal anatomy can be very difficult to comprehend, especially in cattle with intestinal distention and malposition. The abundance of mesenteric and omental fat and the compact nature of the mesentery make manipulation and exteriorization of many parts of the bowel difficult. Therefore, it is important to accurately identify specific surgical landmarks. A good working knowledge of the relevant surgical anatomy increases the level of confidence in one's surgical abilities and makes one more willing to consider surgical intervention in a cow with suspected GI dysfunction. PMID- 6482873 TI - Write on, Dr. Voith. PMID- 6482874 TI - Structural requirements for the pharmacological activity of nonsteroidal antiestrogens in vitro. AB - The structure-activity relationships of a tamoxifen (TAM) (Z-1-(4- beta dimethylaminoethoxyphenyl)1,2-diphenylbut-1-ene) series have been investigated. The tamoxifen derivatives were assayed in vitro by their modulation of estradiol (E2)-stimulated prolactin synthesis in primary cultures of dispersed rat pituitary gland cells. Monohydroxylation of TAM in position 4 of the stilbene ring system was found to be the optimal substitution for binding to the estrogen receptor [relative binding affinity (RBA) = 234] and to inhibit E2 (1 nM) stimulated prolactin synthesis (IC50 7 nM) by pituitary cells in primary culture. Substitution in positions 3 and 4 to form a catechol did not decrease affinity for the estrogen receptor (RBA = 252), and potency as an antiestrogen was maintained in the prolactin assay (IC50 20 nM) as long as oxidation of the catechol was prevented. All of the hydroxylated derivatives of tamoxifen tested were estrogen antagonists; however, removal of the alkylaminoethoxy side chain from TAM produced a full estrogen agonist with low potency (20 nM). In contrast, removal of the side chain from 4-hydroxytamoxifen (4-OH TAM) produced a partial agonist. A structural analogue of 4-OH TAM, 3-[beta-dimethylaminoethoxy]-11-ethyl 12-(4-hydroxyphenyl)5,6- dihydrodibenzo[a,e]-cyclooctene (7c) had a decreased potency (IC50 16 nM) compared with 4-OH TAM (IC50 4 nM in the same experiment) as an estrogen antagonist. If the side chain was changed from a dimethylaminoethoxy to glyceryl, antagonist activity was reduced (IC50 0.8 microM). An allyl side chain produced a compound with no antiestrogenic activity at concentrations up to 1 microM. An adaptation of Belleau's macromolecular perturbation theory is suggested to explain the interaction of agonists, antagonists, and partial agonists at the ligand binding site of the estrogen receptor. PMID- 6482875 TI - Effects of calmodulin antagonists on immune mouse lymphocytes. AB - The nature of the Ca2+ requirement of lymphocyte-mediated cytolysis (LMC) has been explored pharmacologically with a number of putative calmodulin antagonists. N-(6-Aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7), N-(6-aminohexyl)-1 naphthalenesulfonamide (W-5), trifluoperazine, and chlorpromazine were found to inhibit LMC (IC50 values = 8.9, approximately 50, 7.4, and 9.4 microM, respectively) at concentrations which were not detectably toxic to either the effector or the target cell. Pimozide inhibited LMC by 50% at 15 microM but caused a substantial decrease in lymphocyte ATP content and viability at this concentration. 1-[Bis(p-chlorophenyl)methyl]-3-[2,4-dichloro-beta-(2,4 dichlorobenzy loxy) phenethyl]imidazolium chloride (R 24 571, calmidazolium), which has been reported to be the most potent antagonist of isolated calmodulin, caused a marked decrease in lymphocyte ATP content and viability at concentrations greater than 4 microM and inhibited LMC only slightly at similar concentrations. Trifluoperazine sulfoxide and chlorpromazine sulfoxide were not inhibitory to LMC at less than or equal to 20 microM. LMC was inhibited in a sustained manner when cytolytic lymphocytes, but not target cells, were pretreated separately with W-7 or chlorpromazine at 37 degrees and were then washed free of exogenous drug prior to the start of the LMC assay. The above cellular effects of the calmodulin antagonists were reduced in magnitude when the serum concentration in the culture medium was increased (from 5% to 20%). The inhibition of LMC by micromolar concentrations of W-7, trifluoperazine, and chlorpromazine, as well as the relative inactivities of W-5 versus W-7 and of the sulfoxide derivatives of trifluoperazine and chlorpromazine, are consistent with calmodulin's being a lymphocyte receptor whose occupancy by Ca2+ is required for the performance of this cytolytic function. However, this conclusion must be tempered by the finding that even W-7, trifluoperazine, and chlorpromazine can exert nonspecific effects on the energy metabolism and viability of the cytolytic lymphocytes at concentrations of drug severalfold higher than those required to inhibit LMC. PMID- 6482876 TI - The influence of local anesthetics on molecular organization in phosphatidylethanolamine membranes. AB - The influence of the local anesthetics tetracaine (TTC) and procaine (PRC) on bilayers of specifically deuterated phosphatidylethanolamines (PE) has been studied by 2H and 31P NMR. Dimyristoylphosphatidylethanolamines (DMPE), deuterated at positions 2, 4, and 14 of the sn-2 chain, position 2 of the sn-1 chain, and in the ethanolamine headgroup, were mixed 1:1 with a semisynthetic egg PE and the effect of measured quantities of TTC and PRC on the 2H quadrupole splittings, spin-lattice relaxation times, and 31P chemical shift anisotropy were observed. Experiments were performed at pH 5.5, when the anesthetics are primarily charged, and at pH 9.5, when they are uncharged. Tetracaine was observed to disorder the hydrocarbon region of the bilayer and to induce a conformational change in the PE headgroup. Conversely, procaine had little or no effect on the hydrocarbon region and induced only a small change in the headgroup. These conformational changes and disordering effects, when adjusted for anesthetic partitioning, are essentially independent of the charge on the anesthetic. However, at pH 5.5 and low TTC/PE molar ratios (less than 0.1), the 2H NMR spectra showed two lipid environments--one corresponding to free PE and the other to PE in contact with TTC. Continued addition of TTC resulted in the eventual disappearance of the free PE signal and the corresponding growth of the signal from PE in contact with TTC. At pH 9.5, when TTC is uncharged, only one signal is observed. This indicates that at low pH, when TTC is primarily charged, it has a much slower rate of lateral diffusion in the PE bilayer. In mixtures of PE and phosphatidylserine, a conformational change in the headgroup was noted which was similar to that seen in the pure PE; however, there was no evidence for slow lateral diffusion of the anesthetics. The effects of TTC and PRC on the PE bilayer, when combined with our earlier study of the labeled anesthetics [Kelusky, E.C., and I.C.P. Smith, Biochemistry, 22:6011-6017 (1983)], indicate that TTC penetrates into the hydrocarbon portion of the bilayer whereas PRC sites only in the headgroup region. PMID- 6482877 TI - In vitro studies on the distribution of probucol among human plasma lipoproteins. AB - The role of human plasma lipoproteins as carriers in the blood transport of the cholesterol-lowering and water-insoluble drug, probucol, was investigated in in vitro studies. [14C]Probucol was incubated in whole human blood, a serum pool, individual diluted sera, and isolated protein and lipoprotein fractions. In whole blood, about 90% partitioned in plasma. Following ultracentrifugal fractionation of the serum, it was found that less than 5% distributed in the d greater than 1.20 protein fraction (albumin-rich fraction) and more than 95% in the lipoprotein fractions. The distribution of probucol in the lipoprotein fractions correlated with the lipoprotein total lipid volume under saturation conditions (incubation of isolated lipoprotein fractions) as well as nonsaturation conditions (fractionation of serum exposed to [14C]probucol). Incubation of the albumin-rich fraction and of apolipoproteins originating from the isolated lipoprotein fractions showed that they account for a negligible part in the interaction of probucol with blood components. The probucol uptake of individual sera was shown to be correlated to the lipid content of the serum. When probucol was incubated in erythrocyte suspensions containing variable amounts of lipoproteins, probucol partitioned less in erythrocytes as the lipoprotein concentration increased in the suspension. PMID- 6482878 TI - Studies on porphyrin metabolism in the kidney. Effects of trace metals and glutathione on renal uroporphyrinogen decarboxylase. AB - Uroporphyrinogen (urogen) decarboxylase catalyzes the decarboxylation of 8- to 4 carboxyl porphyrinogen during heme biosynthesis in mammalian tissues. The specific activity of renal urogen decarboxylase was shown to be approximately one third that of the hepatic enzyme and to be readily inactivated by HgCl2 following acute treatment or at concentrations as low as 50 microM in vitro. HgCl2 differentially inhibited the decarboxylation of 8- to 7- and 7- to lesser carboxylated porphyrinogens in the kidney, suggesting that at least a two-stage process is involved in the catalytic action of the renal enzyme. In contrast, neither lead nor iron compounds inhibited renal urogen decarboxylase in concentrations as high as 1 mM in the reaction mixture. GSH increased renal but not hepatic urogen decarboxylase activity by over 4-fold in vitro when measured as total porphyrinogen products produced, and preferentially accelerated the decarboxylation of 7- to 4-carboxyl porphyrinogen. GSH also protected the renal enzyme from HgCl2 inhibition. These findings suggest that renal urogen decarboxylase catalyzes porphyrin decarboxylation significantly less rapidly than the hepatic enzyme, is readily inactivated by mercuric chloride, and may be GSH dependent with respect to achieving optimal catalytic activity. These observations may be useful in characterizing the contribution of the kidney to the clinical manifestations of the inherited porphyrias and environmentally induced disorders of porphyrin metabolism. PMID- 6482879 TI - Reaction of mutagenic phenacetin metabolites with glutathione and DNA. Possible implications for toxicity. AB - The direct-acting mutagens, N-hydroxy-p-phenetidine and p-nitrosophenetole, are known to be metabolites of the analgesic phenacetin and may be responsible for its carcinogenic activity. In this study, the potential detoxification of these metabolites by glutathione was examined. Glutathione reacted rapidly with p nitrosophenetole, which was quantitatively converted to a single product as determined by high-pressure liquid chromatography. The analysis of the product by fast atom bombardment mass spectrometry and 500-MHz 1H-NMR spectroscopy established its structure as N-(glutathion-S-yl)-p-phenetidine. The same glutathione conjugate was also formed when N-hydroxy-p-phenetidine was incubated with glutathione. However, since conjugate formation from N-hydroxy-p-phenetidine occurred slowly and was decreased in the presence of an argon atmosphere as well as by higher levels of glutathione, it was concluded that the conjugate resulted from oxidation of the N-hydroxy arylamine to the nitrosoarene, which subsequently reacted with glutathione. N-(Glutathion-S-yl)-p-phenetidine was semistable in water (half-life, 6-7 hr) and very unstable in the presence of nucleophiles such as 10 mM glutathione (half-life, 7 min), quantitatively decomposing to p phenetidine. The conjugate was also very unstable in acidic buffers (half-life, 17 min, pH 5). Radiolabeled N-hydroxy-p-phenetidine, but not p-nitrosophenetole, was shown to bind covalently to calf thymus DNA in vitro, and 4 times more binding was detected at pH 5 than at pH 7. Glutathione did not significantly decrease binding of the N-hydroxy derivative at either pH, nor did purified ring radiolabeled N-(glutathion-S-yl)-p-phenetidine significantly bind to DNA at either pH. Thus, we hypothesize that an important detoxification pathway for phenacetin in vivo could involve the facile oxidation of N-hydroxy-p-phenetidine to p-nitrosophenetole, which then reacts rapidly with glutathione to form an excretable conjugate. PMID- 6482880 TI - [Immunoreactive trypsin in the serum of normal children and children with gastrointestinal diseases]. AB - Serum immunoreactive trypsin (IRT) was measured in cord blood and blood specimens of 156 healthy children of different age. These results were compared with the IRT of children with gastrointestinal disease. While IRT from newborn is significantly elevated, mean trypsin levels form older children do not differ from those found in adults. In acute pancreatitis too, as in renal failure, trypsin is elevated. Low trypsin values were estimated in acute hepatitis and Crohn's disease. In cystic fibrosis (CF) serum trypsin levels depend on the exocrine function of the pancreas. The IRT assay on dried blood-spots, seems to become a reliable and convenient neonatal screening test for CF in newborns. PMID- 6482881 TI - [Diagnostic value of CK-MB isoenzyme determinations in children with craniocerebral injuries and polytrauma]. AB - Total creatine kinase (CK) and its myocardial isoenzyme (CK-MB) were determined in 71 children with isolated acute head injury (N = 30), with head injury and polytrauma but without chesttrauma (N = 11) and with head injury and polytrauma including chest trauma (N = 30) on the second and third day after injury. Electrocardiograms were recorded in 56/71 children on each of the first three days in hospital. Elevations of CK-MB isoenzyme over 6% respectively over 10% of total CK are found as frequently in children with head injury without chest trauma as in children with head trauma and chest trauma. In addition there is no significant correlation between the level of the CK-MB and the incidence of ECG features characteristically associated with heart contusion. This study shows that the determination of CK-MB cannot be used as a criterion for diagnosing heart contusion in children with head injury. The finding of CK-MB in the serum of 53% children with isolated head injury exceeding 6% of total CK, and in the serum of 33% children exceeding 10% of total CK strongly suggests myocardial damage to be a frequent complication of cerebral damage with consecutive extreme sympathetic stimulation. PMID- 6482882 TI - [Psychosocial consequences of cancer in a child for its parents and siblings]. AB - Cancer in children leads to extreme situations not only for the child but for all members of the family. Fear of death quite often over years has severe psychosocial consequences for the sick child, its parents and siblings. Without sufficient help from the therapeutic team the family is usually not able, to cope with these problems. PMID- 6482883 TI - [Time of death in diseases with lethal outcomes in a pediatric surgery department and a pediatric hospital]. AB - Thirteen hundred twenty five deaths in children were investigated at the Dept. of Pediatric Surgery of the University Children's Hospital Munich and the University Children's Hospital Giessen in order to evaluate a possible correlation between time of death and time during the day. Subdividing according to age groups and pediatric-surgical and pediatric cases, there was no accumulation of deaths between 2 and 6 o'clock a. m. as could have been expected according to Aschoff. On the other hand, between 12 und 3 o'clock p. m. there was an increase of deaths which was partly statistically significant and in accordance with Aschoff's findings. One can deduce that during the early afternoon hours technical and nursing potentialities for compensation were not fully used, whereas this seemed to be the case during early morning hours. Therefore it should be attempted to optimize personal and technical expenditures particularly during the early afternoon hours. PMID- 6482884 TI - [Regression of a massive hydronephrosis in familial central diabetes insipidus treated with Adiuretin]. AB - A ten year old boy with hereditary pituitary diabetes insipidus presented with massive bilateral hydronephrosis, hydroureters and an extremely large bladder. Radiological investigations excluded a mechanical obstruction or vesicoureteral reflux. Treatment with the adiuretin analog DDAVP resulted in regression of the urinary tract changes after 5 months and an almost complete disappearance after 3 1/2 years. The urinary tract dilatation probably results from the large urine flows which exceed the capacity of the urinary tract causing a functional obstruction and residual urine. PMID- 6482886 TI - [As a pediatrician and infection specialist in Calcutta]. PMID- 6482885 TI - [Pharyngeal and esophageal perforations in newborn infants]. AB - In three newborn infants pharyngeal or esophageal perforations were due to injury caused by the obstetrician's finger in the infant's mouth to help deliver the head, by orogastric feeding tube, or by endotracheal tube. They all had in common respiratory distress and right-sided pneumothorax. The patients were treated medically with antibiotics, antifungal therapy and total parenteral nutrition. All perforations healed without surgical repair. PMID- 6482887 TI - [Ultrastructural changes in the supraotico-neurohypophyseal system of rats following destruction of the pituitary stalk]. PMID- 6482888 TI - [Electron microscopic study of liver cirrhosis associated with diabetes mellitus]. PMID- 6482889 TI - [Appearance of lamellar bodies in pulmonary cells from 8-12-week-old human fetuses under the effect of ambroxol in vitro]. PMID- 6482890 TI - [Scanning microscopy of the liver of experimental animals]. PMID- 6482891 TI - [Diffuse rheumatoid nodules in the skeletal musculature in rheumatoid arthritis]. PMID- 6482892 TI - [Successful identification from incomplete skull fragments]. PMID- 6482893 TI - Human fecal fractions can produce nuclear damage in the colonic epithelial cells of mice. AB - Nuclear toxicity of several known carcinogens and fecal fractions obtained from 10 healthy individuals was investigated in the colonic nuclear aberration (NA) assay using an intrarectal administration. Two known colon carcinogens, MNNG and DMAB, and a carcinogen of organs other than the colon, B(a)P, induced NA in a dose-related manner. Chromatographic fractions of feces from 10 donors were tested for their ability to produce NA. The dichloromethane fraction for several was active and yielded a significantly positive response which was dose-related. Our study demonstrated that the feces of some healthy individuals contain compound(s) which damage colonic nuclei in a similar manner to that seen with some known carcinogens. PMID- 6482894 TI - Apurinic/apyrimidinic endonuclease activities appear normal in the CHO-cell ethyl methanesulfonate-sensitive mutant, EM9. AB - A study of the apurinic/apyrimidinic (AP) endonuclease activities of a mutant line of CHO cells, EM9, and its parental cell line, AA8, was undertaken to determine if the defective DNA repair exhibited by the mutant cell line after exposure to ethyl methanesulfonate was due to a defective AP endonuclease activity. Phosphocellulose chromatography of cell extracts resolved the AP endonuclease activities of both cell lines into two peaks as seen previously in mouse and human cells. No difference was found between the mutant and parental cell lines in the relative amount of AP endonuclease activity present in the two peaks. PMID- 6482895 TI - Sister-chromatid exchange induction by sodium selenite: reduced glutathione converts Na2SeO3 to its SCE-inducing form. AB - Sodium selenite (Na2SeO3) is an anticarcinogenic/antimutagenic agent that exhibits carcinogenic/mutagenic properties in some short-term test systems used for the detection of DNA-damaging agents. One such test system is sister chromatid exchange (SCE) induction. Na2SeO3 induces SCEs only if red blood cells (RBCs) are present to 'activate' it to its SCE-inducing form. Here, the ability of reduced glutathione, a major component of RBCs, to serve as an RBC substitute in the activation of Na2SeO3 was determined. Reduced glutathione (10(-4) and 10( 3) M) was shown to be as capable as RBCs in activating Na2SeO3 (7.95 X 10(-6) M) to its SCE-inducing form. These data suggest strongly that the pathway normally utilized by RBCs in the metabolism of Na2SeO3 is the same as that in which Na2SeO3 is converted to its SCE-inducing form. PMID- 6482896 TI - Assembling a battery of assays to predict carcinogenicity: a case study. PMID- 6482897 TI - Effect of storage at 4 degrees on prepared Salmonella/microsome test plates. AB - Salmonella/microsome soft-agar overlay ('Ames' test) plates were prepared using the previously published 'York' method. Plates treated with either added 3 methylcholanthrene (3MC) or 3,3'-dichlorobenzidine (DCB) and Aroclor-induced rat liver S9 were stored at 4 degrees after preparation and removed at time intervals thereafter for incubation at 37 degrees. The number of 3MC-induced mutants in TA100 fell within 24 h of storage by 50% but then remained at this level until 96 h. Storage for a total of 336 h still showed some residual mono-oxygenase activity. On the other hand the ability to convert DCB to a mutagen for TA98 appeared to increase with storage, reaching a peak by 96 h. After this time the number of induced mutants fell until by 336 h the numbers were approximately equal to those plates which had not been stored in the cold. PMID- 6482898 TI - Screening test method for the determination of the in vitro activity of topical antimycotics. PMID- 6482899 TI - Experimental infection by Candida krusei (Cast.) Berkhout isolated from a case of corneal ulcer and its sensitivity to antimycotics. PMID- 6482900 TI - Candida krusei (Cast.) Berkhout from the draining sinuses in a human patient its drug sensitivity and pathogenicity. PMID- 6482901 TI - A study on the association of fungi in human corneal ulcers and their therapy. PMID- 6482902 TI - Sensitivity of clinical yeast isolates in Kuwait against a number of antifungal agents. PMID- 6482903 TI - Hair loss following kerion Celsi--a follow-up examination. PMID- 6482904 TI - Protein phosphorylation by intact Babesia bovis. AB - Babesia bovis rapidly incorporated [32P]orthophosphate into more than 30 polypeptide chains, the majority of which appeared to be membrane or particle bound. Phosphorylation occurred more rapidly in free parasites than in parasitized erythrocytes, suggesting the acceptor polypeptides were either babesial in origin or erythrocyte proteins were intimately associated with the parasite. Some characteristics of the phosphorylation system are described. The phosphorylation was little affected by dibutyryl cAMP or dibutyryl cGMP but was strongly inhibited by the calcium ionophore A23187, which also inhibited protein synthesis. Two dimensional electrophoresis of B. bovis extracts after pulse labelling with [35S]methionine or [32P]orthophosphate showed that all polypeptides phosphorylated in a 30 min period were also at least partially synthesized de novo within that period, suggesting that the phosphorylated species were babesial in origin. PMID- 6482905 TI - Kinetics of 4-aminobutyrate:2-oxoglutarate aminotransferase from Nippostrongylus brasiliensis. AB - A gamma-aminobutyric acid transferase (4-aminobutyrate:2-oxoglutarate aminotransferase; EC 2.6.1.19) preparation from Nippostrongylus brasiliensis was found to contain only one peak of enzyme activity with a highly basic pI of 10.5 when analysed by isoelectric focusing and chromatofocusing. This material was used in kinetic studies to demonstrate that the parasite enzyme reaction mechanism conforms to the usual binary, non-sequential ('Bi Bi Ping Pong') type found with aminotransferases. The Km for 4-aminobutyrate was 0.33 mM, the Km for 2-oxoglutarate was 0.57 mM and Ki for glutamate was 0.35 mM. In holoenzyme reconstitution experiments with the cofactor, pyridoxal 5-phosphate, the KD was 1.54 microM. The values are comparable to those reported for other tissues. Only 2-oxoglutarate could function as the keto acid substrate whereas several amino acids besides 4-aminobutyrate (beta-alanine, alpha-L-alanine, L-aspartate and L arginine) could apparently act as substrate although the possible presence of other amino acid:2-oxoglutarate aminotransferases was not excluded. In preliminary studies on the usefulness of conventional substrate analogues as parasite gamma-aminobutyric acid transferase inhibitors only canaline was effective. PMID- 6482906 TI - N-terminal amino acid sequence of the histidine-rich protein from Plasmodium lophurae. AB - We have determined the N-terminal amino acid sequence of the first 25 amino acids of the histidine-rich protein (HisRP) isolated from granules of the avian malaria parasite Plasmodium lophurae. The protein was purified from cytoplasmic granules and shown to be 65.2 mol % histidine, close to the previously described value of 73 mol % histidine (Kilejian (1974) J. Biol. Chem. 249, 4650-4655). Ten of the first 25 residues were histidine, five of which formed the sequence His-His-His His-His (positions 14-18). Also notable was the presence of eight acidic residues within the N-terminal 25 residues. HisRP contained no detectable carbohydrate. When the HisRP was biosynthetically labeled in cultured infected erythrocytes, incorporation of [3H]His greatly exceeded [3H]Ile. Labeled HisRP was not solubilized with 1% w/v Triton X-100 but could be solubilized with greater than or equal to 1% w/v sodium dodecyl sulfate. On sodium dodecyl sulfate polyacrylamide gel electrophoresis the [3H]His labeled protein migrated as a doublet (Mr 53 000 and 50 000). Only one of these bands (Mr 53 000) comigrated with the Coomassie Blue stained protein isolated by the acid-extraction procedure from purified granules. The amino acid composition of HisRP and presence of five contiguous histidine residues in the sequence studied here suggests that other sequences of several contiguous histidine residues must exist in this molecule. PMID- 6482907 TI - Amino terminal sequence homology among variant surface glycoproteins of African trypanosomes. AB - Amino terminal amino acid sequences were determined for eight variable surface glycoproteins purified from successive parasitemias of cloned Trypanosoma brucei. These sequences were compared by sequence alignment analysis with each other and with amino terminal sequences of variable surface glycoproteins from other clones of T. brucei, T. congolense and T. equiperdum. Contrary to previously held views, a remarkable degree of sequence homology was found among all sequences. In several cases the homology was greater between glycoproteins from different species than between glycoproteins isolated from successive parasite peaks, suggesting a common primordial gene for trypanosome variable surface glycoproteins. This amino terminal homology, taken together with homologies found in other regions of variant surface glycoproteins strongly suggests that their tertiary structures are conserved. PMID- 6482908 TI - Glucose transport in Leishmania donovani promastigotes. AB - Mid-log phase Leishmania donovani promastigotes accumulated 2-deoxy-D-glucose (2 DOG) via a carrier mediated transport system, maintaining an apparent Km of 24.4 microM and a Vmax of 3.12 nmol mg-1 protein min-1. D-Glucose but not L-glucose competitively inhibited the 2-DOG transport with an apparent Ki of 18.7 microM. Transport of 2-DOG was inhibited by 2,4-dinitrophenol and NaN3. The parasites maintained a 2-DOG gradient of at least 79 fold across the surface membrane, demonstrating the active nature of the transport system. PMID- 6482909 TI - Functional left ventricular aneurysm formation after acute anterior transmural myocardial infarction. Incidence, natural history, and prognostic implications. AB - To assess the clinical and prognostic importance of the early appearance of a functional left ventricular aneurysm after myocardial infarction, we used equilibrium radionuclide angiocardiography to study 51 patients with an initial anterior infarction. A functional aneurysm was defined as an area of systolic akinesis or dyskinesis with a distinct diastolic deformity and preserved adjacent wall motion. Functional aneurysms developed in 18 patients (Group 1). Left ventricular ejection fraction was comparable in this group and in the 33 patients without aneurysm (Group 2) (27.3 +/- 10 vs. 31.4 +/- 12 per cent). One-year mortality was markedly different, with 11 deaths (61 per cent) in Group 1 and 3 (9 per cent) in Group 2 (P less than 0.001). Six (55 per cent) of the deaths in Group 1 were sudden. Patients with a functional aneurysm appearing within 48 hours had the highest risk of dying (8 of 10). Thus, early formation of a functional aneurysm occurs frequently after anterior myocardial infarction and carries a high risk of death within one year that is independent of ejection fraction. In addition, the absence of a functional aneurysm identifies a large group with a low one-year mortality despite a markedly impaired ejection fraction. PMID- 6482910 TI - Inherited chondrodysplasia punctata due to a deletion of the terminal short arm of an X chromosome. AB - We studied two families with an inherited deletion of the short arm of an X chromosome (Xp) in which affected male offspring have epiphyseal stippling in infancy (chondrodysplasia punctata), nasal hypoplasia, ichthyosis, and mental retardation. The presence of ichthyosis and the apparent pattern of X-linked recessive inheritance prompted investigation of the short arm of the X chromosome through studies of genetic markers and focused cytogenetic analysis. Biochemical studies suggested that there was a deletion of three genes previously mapped to the X-chromosome short arm, including the steroid sulfatase locus, the Xg locus, and the M1C2X locus. Prometaphase chromosomes demonstrated a deletion of Xp at p22.32 in the affected boys, in their obligate-carrier mothers, and in 11 of 25 women at risk as potential carriers. The women carrying the Xp deletion had normal gonadal function and fertility but were shorter than the noncarriers in their families (P less than 0.00001). These findings have implications for the genetic organization of this portion of the human X chromosome and demonstrate that small cytogenetic abnormalities may account for disorders with apparent mendelian patterns of inheritance. PMID- 6482911 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 42-1984. A 29-year-old woman with a lytic lesion of a parietal bone. PMID- 6482912 TI - Undergraduate education in the medical specialties: the case of neurology. PMID- 6482913 TI - Whither neurology? PMID- 6482915 TI - Disabling positional vertigo. PMID- 6482914 TI - Continuous subcutaneous insulin-infusion pumps. PMID- 6482916 TI - Circulating heparin-like anticoagulants. PMID- 6482917 TI - Amphotericin B nasal spray as prophylaxis against aspergillosis in patients with neutropenia. PMID- 6482918 TI - Transfer of copyright. PMID- 6482919 TI - Private medical practice and the National Health Service. PMID- 6482921 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 43-1984. A 35-year-old woman with tracheal stenosis after treatment for Hodgkin's disease. PMID- 6482920 TI - Risk of infection after penetrating abdominal trauma. AB - To identify the risk factors for the development of postoperative septic complications in patients with intestinal perforation after abdominal trauma, and to compare the efficacies of single-drug and dual-drug prophylactic antibiotic therapy, we studied 145 patients who presented with abdominal trauma and intestinal perforation at two hospitals between July 1979 and June 1982. Logistic regression analysis showed that a higher risk of infection (P less than 0.05) was associated with increased age, injury to the left colon necessitating colostomy, a larger number of units of blood or blood products administered at surgery, and a larger number of injured organs. The presence of shock on arrival, which was found to increase the risk of infection when this factor was analyzed individually, did not add predictive power. Patients with postoperative sepsis were hospitalized significantly longer than were patients without infection (13.8 vs. 7.7 days, P less than 0.0001). Both treatment regimens--cefoxitin given alone and clindamycin and gentamicin given together--resulted in similar infection rates, drug toxicity, duration of hospitalization, and costs. PMID- 6482922 TI - Renovascular hypertension and azotemia. PMID- 6482924 TI - Survival after Mustard's operation. PMID- 6482923 TI - Angina pectoris. PMID- 6482925 TI - Therapy of ischemic cerebral vascular disease. PMID- 6482926 TI - More on untreated maternal hyperphenylalaninemia. PMID- 6482927 TI - More on necrotizing enterocolitis: pigbel in Papua New Guinea. PMID- 6482929 TI - Bicycle-seat hematuria. PMID- 6482928 TI - Exercise-induced asthma: observations on the initiating stimulus (correction of published data) PMID- 6482930 TI - More on diagnostic restraint. PMID- 6482931 TI - Health policy report. The NIH appropriation. PMID- 6482932 TI - Incidence and prognosis of unrecognized myocardial infarction. An update on the Framingham study. AB - Of 708 myocardial infarctions among 5127 participants in the Framingham Study, more than 25 per cent were discovered only through the appearance of new diagnostic evidence during routine biennial electrocardiographic examinations. Of these unrecognized infarctions almost half were "silent," and the others caused atypical symptoms. The proportion of all infarcts that were unrecognized was higher in women and in older men. Such infarcts were uncommon in persons with angina. Unrecognized infarctions were as likely as recognized ones to cause death, heart failure, or strokes. Recurrent infarctions were more common in women with recognized than with unrecognized infarcts, but this difference was not present in men. Recurrent infarctions were more likely to be recognized than were first infarctions. We conclude that unrecognized infarctions are common and have as serious a prognosis as recognized infarctions. PMID- 6482933 TI - Treatment of advanced non-Hodgkin's lymphoma with recombinant leukocyte A interferon. AB - We report the results of a trial of recombinant leukocyte A interferon in previously treated patients with non-Hodgkin's lymphoma who were no longer responsive to chemotherapy. Patients received recombinant leukocyte A interferon (50 X 10(6) U per square meter of body-surface area) by intramuscular injection three times weekly for three months or longer. Forty-five patients were enrolled in the study, and 37 were evaluated for a response. Thirteen of 24 (54 per cent) evaluable patients with low-histologic-grade non-Hodgkin's lymphoma had objective responses (nine partial responses and four histologically confirmed complete responses). Two of six (33 per cent) with intermediate-grade lymphoma responded (one partially and one completely), and one of seven (14 per cent) with high grade lymphoma had a partial response. The median duration of responses was eight months. Four of the five complete responders have continued to receive maintenance interferon and have been in complete remission for 3, 7, 9, and 12 months, respectively; one had a recurrence at a site of previous disease seven months after interferon had been stopped. Side effects were noted in most patients. All 16 responders had been heavily pretreated with combination chemotherapy, including doxorubicin in 8 of the 16. These results suggest that recombinant leukocyte A interferon may be an effective new therapy for some patients with low- and intermediate-grade non-Hodgkin's lymphoma. PMID- 6482935 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 44-1984. A 15-year-old girl with severe chronic liver disease of uncertain cause. PMID- 6482934 TI - Right-sided infective endocarditis as a consequence of flow-directed pulmonary artery catheterization. A clinicopathological study of 55 autopsied patients. AB - We studied 142 consecutively autopsied patients prospectively to determine the frequency and clinical importance of right-sided endocardial lesions in patients who had undergone flow-directed pulmonary-artery catheterization within one month of death. Of the 55 catheterized patients, 29 (53 per cent) had one or more right sided endocardial lesions: 12 (22 per cent) had subendocardial hemorrhage, 11 (20 per cent) sterile thrombus, 2 (4 per cent) hemorrhage and thrombus, and 4 (7 per cent) infective endocarditis. Of 41 lesions seen in the 29 patients, 23 (56 per cent) were located on the pulmonic valve, 6 (15 per cent) on the tricuspid valve, 6 (15 per cent) in the right atrium, 4 (10 per cent) in the right ventricle, and 2 (5 per cent) in the main pulmonary artery. All four patients with infective endocarditis had had positive antemortem blood cultures while the catheter was in place, but in only one had the diagnosis of endocarditis been suspected clinically. The unusual locations of the infected vegetations (on the pulmonic valve in three and in the right atrium in one) and the similar location of the uninfected lesions suggest that the infective endocarditis was a consequence of catheter-induced endocardial damage with concurrent or subsequent bacteremia. Among the 87 non-catheterized patients, there were two subendocardial hemorrhages and one resolving right atrial thrombus. We conclude that endocardial damage from flow-directed pulmonary-artery catheterization is common and that right-sided infective endocarditis should be suspected in bacteremic catheterized patients. PMID- 6482936 TI - High-dose corticosteroids for septic shock. PMID- 6482937 TI - Retroviruses in Kaposi-sarcoma cells in AIDS. PMID- 6482938 TI - Diabetes mellitus in offspring of diabetic mothers or fathers. PMID- 6482939 TI - Vascular complications in pancreatic diabetes. PMID- 6482940 TI - Propranolol and infarct size. PMID- 6482941 TI - Soft-tissue damage associated with intravenous phenytoin. PMID- 6482942 TI - Hyperkalemia during anesthesia. PMID- 6482944 TI - Computer-based medical-record systems in ambulatory practice. PMID- 6482943 TI - Allergy testing of multiple patients with a common syringe. PMID- 6482945 TI - Alterations in some biochemical processes in the organism of rats being under the influence of chlorfenvinphos administered in diets with variable protein content. AB - The different doses of chlorfenvinphos given in diets with low-protein and optimal-protein level to young Wistar rats of both sexes were, after 10 or 30 days, without the significant influence on the activity of several serum enzymes used as diagnostic markers in determining the liver damage or disease, as for example:sorbitol dehydrogenase, glutamic dehydrogenase, glucosephosphate isomerase (PHI), aspartate and alanine aminotransferase. Not even important changes were found in the activity of aromatic amino acids aminotransferases in the brain and in protein content in the brain and liver of rats fed diets contaminated with chlorfenvinphos, irrespective of the protein concentration in the diet. Only in some cases at the highest concentration of chlorfenvinphos in the diets the decreased activity of aromatic amino acids aminotransferases appeared in the liver, more evident in low-protein rats. The decrease of the PHI activity in the brain and the inhibition of acetylcholinesterase activity in the serum and brain depended mainly on the amount of chlorfenvinphos in the diets and to a lower degree on the amount of protein. All changes caused by chlorfenvinphos normalized during two weeks after its elimination from the diets. PMID- 6482946 TI - [Modification of maneb toxicity by chronic ethanol intake--prenatal toxicologic studies on a high-risk group]. AB - Rats, dose-dependent on maneb during pregnancy and lactation (20, 110, 200 or 290 ppm maneb in their food) obtained water or 20 percent alcohol to drink. The animals given pure water indicated no effect. Alcohol in combination with the same concentrations of maneb in the food raised embryotoxicity and produced retardation of the skeletons and postnatal growths in the F1-generation. There was dose-dependent coergistic effect in the breeding results from the alcoholic mothers. The practical significance of this over 15-fold higher susceptibility of alcoholic animals is discussed. PMID- 6482947 TI - No genuflection. PMID- 6482948 TI - How to reduce mortality? PMID- 6482949 TI - Ways with drug resistance. PMID- 6482950 TI - Repetitive sequences in structural genes. PMID- 6482951 TI - Ratites as oldest offshoot of avian stem--evidence from alpha-crystallin A sequences. AB - One of the most disputed issues in avian phylogeny is the origin of the ratites, the large flightless birds of the Southern Hemisphere (reviewed in refs 1-3). It is still not generally agreed whether the ostriches, rheas, emus and cassowaries, and probably kiwis, form a natural, monophyletic group, although much recent evidence supports this view. Also, their phylogenetic relationship with the other avian orders remains unresolved, comparative protein sequence studies might shed new light on this problem. Therefore, we determined the amino acid sequence of the eye lens protein alpha-crystallin A in ostrich, rhea and emu, and in representatives of 13 other avian orders. Comparison of these sequences with known alpha A sequences of mammals, reptiles, frog and dogfish provides strong evidence that the ratites, as a monophyletic assemblage, represent the first offshoot of the avain line. PMID- 6482952 TI - A six-armed oligomer isolated from cell surface fibronectin preparations. AB - Fibronectins are adhesive glycoproteins thought to mediate the attachment of cells to various substrates. Plasma fibronectin (PFN) is a dimer comprising subunits of molecular weight 220,000, connected by one or two disulphide bonds. Electron microscopy shows that PFN is a long, flexible strand, 2-3 nm in diameter and 140 nm long. Many cells in tissue culture elaborate an extracellular matrix of insoluble (highly cross-linked by disulphide bonds) fibronectin, and a variable amount of 'cell surface fibronectin' (CSFN) that can be extracted by mild urea treatment. This CSFN, soluble in 1 M urea and at high pH, is a mixture of dimers and disulphide-bonded oligomers. In the present study we have examined the structure of these molecules by electron microscopy. Oligomers were separated from dimers and contaminating proteins by zone sedimentation through glycerol gradients. We report that the CSFN dimers are identical in structure to PFN. In contrast, the oligomers have an elaborate and well defined structure that we call a 'hexabrachion': six arms emanating from a central globular particle. The arms are similar to PFN in being long, thin and flexible, but have several distinctly different features. PMID- 6482953 TI - In vitro fertilization: surrogacy ban by Victoria state. PMID- 6482955 TI - UK biotechnology: advertisement sails near wind. PMID- 6482954 TI - Toxic hazards in Britain. PMID- 6482956 TI - Genes-on. PMID- 6482957 TI - Mistreatment of laboratory animals endangers biomedical research. PMID- 6482958 TI - A step closer to the principles of eukaryotic transcriptional control. PMID- 6482959 TI - Messenger RNA pieced together. PMID- 6482960 TI - Amino acid transport systems. PMID- 6482961 TI - Role of paternal and maternal genomes in mouse development. AB - There has been much speculation on whether mammalian eggs with two male pronuclei can develop normally. Eggs with two female pronuclei can sometimes develop as far as the 25-somite stage but with only very meagre extraembryonic tissues. We suggested that the genome undergoes specific imprinting during gametogenesis and that some paternal genes may be necessary for normal development of the extraembryonic tissues, in which only the maternal X chromosome remains active. However, the need for the maternal genome for development to term is not yet unequivocally established. The detailed study described here demonstrates that while between 40 and 50% of heterozygous reconstituted eggs with a male and a female pronucleus develop to term, none of the eggs with two male pronuclei does so. Furthermore, embryos in the latter case are very retarded, even though the trophoblast develops relatively well compared with embryos having two female pronuclei. Our combined results indicate that while the paternal genome is essential for the normal development of extraembryonic tissues, the maternal genome may be essential for some stages of embryogenesis. PMID- 6482962 TI - Functional neuronal replacement by grafted striatal neurones in the ibotenic acid lesioned rat striatum. AB - In rats, striatal neuronal destruction by so-called excitotoxic amino acids, kainic acid or ibotenic acid (IA) produce neuropathological and neurochemical changes in the basal ganglia which resemble those seen in patients with Huntington's chorea. Such lesioned animals show a behavioural syndrome which is reminiscent of the cardinal symptoms of the disease, accompanied by a substantial increase in local cerebral metabolic activity in several striatal target structures within the extrapyramidal motor system. The study was designed to explore the potential of grafted fetal striatal neurones implanted into the IA lesioned striatum to compensate for the structural, neurochemical, metabolic and behavioural defects of IA-lesioned rats. Extending previous studies, we report here that such striatal implants can significantly ameliorate the lesion-induced locomotor hyperactivity and at least partly normalize the metabolic hyperactivity in the extrapyramidal neuronal system. PMID- 6482963 TI - Rifkin strikes against gene transfer experiments. PMID- 6482964 TI - Ethics, ethical committees and animal experimentation. PMID- 6482965 TI - Similarity between p15E of murine and feline leukaemia viruses and p21 of HTLV. PMID- 6482966 TI - Structure of the nucleosome core particle at 7 A resolution. AB - The crystal structure of the nucleosome core particle has been solved to 7 A resolution. The right-handed B-DNA superhelix on the outside contains several sharp bends and makes numerous interactions with the histone octamer within. The central turn of superhelix and H3 . H4 tetramer have dyad symmetry, but the H2A . H2B dimers show departures due to interparticle associations. PMID- 6482967 TI - Induction of hair growth by implantation of cultured dermal papilla cells. AB - Mammalian hairs are formed by differentiation and keratinization of cells produced in the epidermal matrix (Figs 3, 4). Using the rodent vibrissa follicle as a model, transplantation studies have shown that the dermal papilla, a discrete population of specialized fibroblasts, is of prime importance in the growth of hair. Papillae induce hair growth when implanted into follicles and can interact with skin epidermis to form new hair follicles. When grown in culture, papilla cells display singular morphological and behavioural characteristics compared with connective tissue cells from other skin sources. We report here that serially cultured adult papilla cells can induce the growth of hair when implanted into follicles which otherwise would not grow hairs. This finding presents an opportunity to characterize properties distinguishing the papilla cell population from other skin fibroblasts, and, more specifically, those which control hair growth. The eventual application of this work to human hair replacement techniques can also be envisaged. PMID- 6482968 TI - Monoclonal antibodies define differential ras gene expression in malignant and benign colonic diseases. AB - DNAS of some human tumours can transform NIH 3T3 fibroblast cells, thus demonstrating the transforming potential of human ras genes (Hu-rasHa, Hu-rasKi, and Hu-rasN, respectively Harvey, Kirsten and neuroblastoma ras genes). Only a small percentage of a given type of human carcinoma, however, scores positive in this assay system. Activation of ras and subsequent transformation of NIH 3T3 cells are either by a point mutation in the ras gene or enhanced expression of the normal, or proto-onc, ras gene. If the transformation of a given human tumour involves the enhanced expression of the normal or cellular ras gene and the resulting gene product, the tumour DNA would probably score negative in the NIH 3T3 transfection assay. In human colon carcinoma, for example, lesions at position 12 of Hu-rasKi have been found. None of nine colon carcinomas obtained at biopsy, however, contain the ras lesion at this position, using a Hu-rasHa probe; one other colon carcinoma does appear to contain amplified proto-onc ras, and other colon carcinomas do have increased levels of ras RNA. There are at least three explanations for these observations. Either very few colon carcinomas contain point-mutated ras, the lesion in the majority of colon carcinomas is at a position other than 12 or ras activation in many colon carcinomas involves the enhanced expression of either the point-mutated or proto-onc form of a ras gene. We have now used monoclonal antibodies directed against a synthetic peptide reflecting sequences of the human T24 ras gene product to define ras p21 protein expression in a spectrum of colonic disease states. Immunohistochemical analyses of individual cells within tissue sections reveal differences in ras p21 expression in colon carcinomas compared with normal colonic epithelium, benign colon tumours and inflammatory or dysplastic colon lesions. Our data suggest that ras p21 expression is correlated with depth of carcinoma within the bowel wall, and is probably a relatively late event in colon carcinogenesis. PMID- 6482970 TI - 'Z-RNA'--a left-handed RNA double helix. AB - In contrast to double-stranded DNA, there has so far been little evidence that double-stranded RNA can undergo major conformational transitions. We have investigated the conformation in different conditions of the double-stranded RNA molecule poly(G-C).poly(G-C), by NMR, circular dichroism and absorbance spectroscopy. We report here evidence obtained by these different spectroscopic techniques that poly(G-C).poly(G-C) undergoes a transition from the A-form to a left-handed Z-form in conditions of high ionic strength and at temperatures above 35 degrees C. This conformational transition may be of relevance to the biological situations in which double-stranded RNA occurs, such as in ribosomes and in some viruses. PMID- 6482969 TI - A Ca-dependent Cl- conductance in cultured mouse spinal neurones. AB - Long-lasting conductance changes triggered either by brief (millisecond) electrical stimuli and/or entry of calcium ions have been observed in a variety of excitable tissues. The electrical consequences of these events depend on the ion conductance affected and on the ion concentration gradient across the membrane, while the long-lasting nature of the change sustains the cell at either sub- or supra-threshold levels for activation of regenerative action potentials. We report here that many cultured mouse spinal neurones exhibit a voltage activated chloride conductance that lasts for seconds and is dependent on extracellular calcium, [Ca2+]0. This conductance may repolarize and stabilize the cell at a level subthreshold for generating action potentials, thus complementing the functional roles of Ca-dependent K+ conductances. PMID- 6482971 TI - US health research: NIH further subdivided. PMID- 6482973 TI - Animal rights. PMID- 6482972 TI - Health advice: Berkeley goes into business. PMID- 6482974 TI - Prizes (at last) for immunology. PMID- 6482975 TI - Machine-readable DNA sequences. PMID- 6482976 TI - The nature of tumour cell proliferation. PMID- 6482977 TI - [Thermodynamics of life from the point of view of technical thermodynamics and exergy]. AB - All living beings are, from the thermodynamic point of view, open, well regulated, and optimized systems with considerable internal irreversibilities. However scientific research is mainly based on closed systems. The theory of open systems is very well developed in engineering thermodynamics. Here the concept of "exergy"--the thermodynamic potential related to given surroundings--clearly distinguishes between the two concepts of the word "energy". PMID- 6482978 TI - [NMR in the 80s: new nuclei, new pulses]. AB - In recent years, nuclear magnetic resonance spectroscopy has been enriched by a large number of new experimental techniques which, on the one hand, have opened up new areas of applications in physiological chemistry and even medicine, and on the other hand resulted in considerable progress for nmr spectroscopy as a branch of molecular spectroscopy as a branch of molecular spectroscopy as it is used in chemistry. In this context, two aspects must be emphasized: The nmr spectroscopy of rare nuclei and the invention of two-dimensional methods. Both aspects will be treated using selected examples: nmr measurements for iron-57, chromium-53, and nitrogen-15 as well as new experimental techniques like polarization transfer, J resolved two-dimensional nmr spectra, two-dimensional shift correlations and multiquantum phenomena are discussed. Besides practical applications the basic physical principles of these techniques are briefly evaluated. PMID- 6482979 TI - Detection of impending intravascular thrombosis prior to the clinically overt event. PMID- 6482980 TI - The extrinsic ocular muscles in birds are derived from the prechordal plate. PMID- 6482981 TI - Structural and functional alterations caused at the extraneuronal level by sympathetic denervation of blood vessels. AB - The lateral saphenous vein of the dog and the rabbit ear artery were surgically denervated, by clamping the vessel or by removal of the superior cervical ganglion, respectively. Both procedures resulted in denervation of the vessels. The denervated, lateral saphenous vein was supersensitive to exogenous noradrenaline and inactivation of the amine (in oil immersion experiments) was slower in denervated vein strips than in control strips treated with cocaine. Incubation experiments with 3H-noradrenaline confirmed that denervated strips formed considerably fewer metabolites than control ones (in the absence or presence of cocaine) and that O-methylation of noradrenaline was reduced by about 50%. When the strips were incubated with 3H-isoprenaline, the denervated ones accumulated and metabolized isoprenaline to a lesser degree than control strips. Hydrocortisone did not reduce the accumulation of isoprenaline in the denervated vein and had only minor effects on O-methylation. The metabolism of noradrenaline and isoprenaline gradually recovered with time. In the ear artery, denervation was accompanied by a marked reduction in O-methylation, but not in accumulation, of isoprenaline. In both vessels there was a highly significant positive correlation between noradrenaline content and O-methylating capacity; in the saphenous vein accumulation of isoprenaline was also positively correlated to noradrenaline content. Morphological changes observed in the denervated vessels consisted essentially in dedifferentiation of smooth muscle cells (which attained larger dimensions, had an indented, large nucleus, augmented euchromatin and an increased amount of ribosomes), abundance of extracellular material and fibroblasts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6482982 TI - Interaction of ketanserin and its metabolite ketanserinol with 5HT2 receptors in pulmonary and coronary arteries of calf. AB - A comparison of 5-hydroxytryptamine (5HT)-induced contractions was made on cocaine-treated strips of bovine pulmonary arteries and large coronary arteries. The affinities of the 5HT2 antagonist ketanserin, its metabolite ketanserinol, yohimbine and rauwolscine were estimated for both arteries. Ketanserin was a competitive antagonist of the effects of 5HT in both arteries. The KB values ( log mol/l) were 9.5 for large coronary arteries and 9.4 for pulmonary arteries. Ketanserinol was also a competitive antagonist of the effects of 5HT in both arteries. The KB values (-log mol/l) were 6.5 for large coronary arteries and 6.4 for pulmonary arteries. A combination of ketanserin with ketanserinol antagonized the 5HT effects as expected from competition of the 3 drugs for a single class of receptor in both arteries. Yohimbine and rauwolscine were competitive antagonists of the effects of 5HT in pulmonary artery. The KB-values (-log mol/l) were 6.8 for yohimbine and 6.5 for rauwolscine. A combination of ketanserin with either yohimbine or rauwolscine antagonized the 5HT effects as expected from competition of all 4 drugs for a single class of receptors in pulmonary arteries. The evidence is consistent with the assumption that smooth muscle 5HT receptors of both pulmonary artery and large coronary artery are of the 5HT2 class. The reduction of the ketone of ketanserin to alcohol (i.e. ketanserinol) causes an approximately 1000-fold decrease in affinity for arterial 5HT2 receptors. Reported peak plasma levels of ketanserinol are too low (less than or equal to 10(-7) mol/l) in humans to account for a contribution of the metabolite to the blockade of 5HT effects by ketanserin. PMID- 6482983 TI - Corneal lesions induced by the systemic administration of capsaicin in neonatal mice and rats. AB - Following a single subcutaneous injection of capsaicin to neonatal mice, a high incidence of corneal lesions with opacity developed after a long latency. The intensity of the lesions progressed for about 1 month in animals which had received a high dose (50 or 100 mg/kg) of capsaicin. Although the intensity gradually decreased thereafter, 50% of animals still exhibited a visible opacity 6 months after treatment. Similar corneal lesions were also produced in neonatal rats which had been injected with capsaicin. It is suggested that the corneal lesions induced by capsaicin may be due to destruction of the trigeminal nerve. PMID- 6482984 TI - Possible involvement of capsaicin-sensitive sensory nerves in the regulation of intestinal blood flow in the dog. AB - The effect of capsaicin injected into the superior mesenteric artery has been studied on the intestinal blood flow in dogs. Capsaicin evoked a marked dose dependent increase in mesenterial blood flow in the dose range of 0.1-7 micrograms/kg. The intestinal vasodilatatory effect of capsaicin could invariably be demonstrated after pretreatment with adrenoceptor and dopamine receptor antagonists, as well as with the ganglion blocking agent hexamethonium. Pretreatment with atropine significantly reduced, but did not abolish the increase in intestinal blood flow elicited by capsaicin. Concomitant administration of somatostatin significantly inhibited both the atropine sensitive and the atropine-resistant components of the effect of capsaicin injected into the superior mesenteric artery. Our results indirectly support the assumption that the intestinal vasodilatatory effect of capsaicin may be mediated by substance P release from capsaicin-sensitive paravascular nerve fibres associated with the blood vessels of the gastrointestinal tract. It is suggested that sensory substance P-containing nerve fibres may be involved in the regulation of the vascular reactions of the gut. PMID- 6482987 TI - [Dislocation of the shoulder joint]. PMID- 6482985 TI - Mechanisms of the ergonovine-induced vasoconstriction in the rabbit main coronary artery. AB - The mean membrane potential of smooth muscle cells of the rabbit main coronary artery was -60.3 mV and an evoked action potential could be recorded in response to acetylcholine (ACh). Ergonovine or 5-hydroxytryptamine (5-HT) slightly depolarized the membrane and methysergide, a relatively selective antagonist for the 5-HT receptor, had a slight inhibitory action on these depolarizations. 5-HT produced larger contractions than ergonovine, and the concentration-effect relationships obtained for both agents shifted to higher concentrations following pre-equilibration with methysergide. ACh (10(-11)M) slightly hyperpolarized the membrane and relaxed the tissue, and high concentrations of ACh (greater than 10( 8)M) depolarized the membrane, increased the membrane resistance and produced a contraction. ACh but not ergonovine or 5-HT, produced a contraction in Ca-free EGTA-containing solution. Following a 60 min pre-equilibration with indomethacin, the ergonovine-induced contraction was markedly enhanced but the 5-HT- or ACh induced contractions were not. Removal of the endothelium by rubbing the vascular lumen enhanced the ergonovine- or ACh-induced contractions, but not those to 5 HT. The results obtained can be summarized as follows: ergonovine probably accelerates Ca influx and thereby produces contraction in the rabbit main coronary artery. This contraction is due to activation of the 5-HT receptor as an agonist, but the ergonovine-induced contraction is attenuated due to activation of the endothelium from which inhibitory prostanoid substances may be released. Ergonovine, therefore, may produce greater contractions in coronary arteries with damaged endothelium than in intact tissues. PMID- 6482986 TI - Intracellular mechanism of quinidine action on muscle contraction. A comparison between rabbit cardiac and skeletal muscle. AB - The mechanism of quinidine action on rabbit cardiac and skeletal muscle was examined with "functionally skinned" muscle-fiber preparations. By using these preparations we could correlate measurements of muscle tension with the effect of quinidine on the Ca2+ activation of the contractile proteins and on the Ca2+ uptake and release from the sarcoplasmic reticulum (SR). PMID- 6482988 TI - [Modified Bristow procedure in recurrent anterior shoulder dislocation caused by trauma]. PMID- 6482989 TI - [Psychophysiologic disorder in general practice. I. An epidemiologic study]. PMID- 6482990 TI - [Cowden's syndrome (multiple hamartoma syndrome)]. PMID- 6482991 TI - [Aseptic bone necrosis of the femur head in pregnancy]. PMID- 6482992 TI - [Is endoscopic follow-up of patients after gastrectomy worthwhile in preventing inoperable gastric stump carcinoma]. PMID- 6482993 TI - [Cardiotoxicity of doxorubicin in children]. PMID- 6482994 TI - [A swollen painful upper arm]. PMID- 6482995 TI - [Psychophysiologic disorders in general practice. II. Diagnostic and therapeutic management]. PMID- 6482996 TI - [Congenital diaphragmatic hernia (Bochdalek) in adults and in pregnancy]. PMID- 6482997 TI - [Gastroesophageal reflux in young children]. PMID- 6482999 TI - [An epidemic of keratoconjunctivitis]. PMID- 6482998 TI - [The surgical treatment of reflux esophagitis in adults]. PMID- 6483000 TI - [Testis tumor, an insidious disease]. PMID- 6483001 TI - [Staphylococcal scalded skin syndrome]. PMID- 6483002 TI - [Hysterectomy before the menopause and cardiovascular disorders]. PMID- 6483003 TI - [An epidermal cyst (monodermal teratoma) of the testes; a rare disorder]. PMID- 6483004 TI - [Conservative treatment of decubitus]. PMID- 6483005 TI - [The treatment of decubitus]. PMID- 6483006 TI - [Exotic diseases in the Netherlands; prevalence and prevention of their spread]. PMID- 6483007 TI - [Current aspects of abortion assistance]. PMID- 6483008 TI - [The Public Health Council on cost control in medical scientific research]. PMID- 6483009 TI - [Prolonging of bleeding time by the use of antibiotics]. PMID- 6483010 TI - [Intrauterine death or infant death shortly after birth: reporting and diagnostic aspects]. PMID- 6483011 TI - [Allergy for injectable corticosteroids]. PMID- 6483012 TI - [Vaccination against influenza]. PMID- 6483013 TI - [Asymptomatic widening of the mediastinum]. PMID- 6483014 TI - [Autotransplantation of spleen tissue following splenectomy]. PMID- 6483015 TI - [Colposcopy-aided biopsy for the detection of small lesions with severe dysplasia of carcinoma in situ in patients with a cervical smear of Pap grade IIIA]. PMID- 6483016 TI - [A patient with an abdominoscrotal hydrocele]. PMID- 6483017 TI - [Nuclear cardiology. I]. PMID- 6483018 TI - [The diabetic diet: no different from nutrition for healthy persons]. PMID- 6483019 TI - [The marathon; a justified challenge?]. PMID- 6483020 TI - [An intrathoracic tumor and skin disorders (benign thymoma and pemphigus)]. PMID- 6483021 TI - [Acquired immunodeficiency syndrome]. PMID- 6483022 TI - [DES, more than an oncological problem]. PMID- 6483023 TI - [Terson's syndrome]. PMID- 6483024 TI - [Oral anticoagulant treatment; which anticoagulant?]. PMID- 6483025 TI - [Fertility and pregnancy following intrauterine exposure to diethylstilbestrol]. PMID- 6483026 TI - [Drugs: what's in a name?]. PMID- 6483027 TI - [Is all of the Netherlands on phenprocoumon for thrombosis treatment? The computer simulation model as an aid]. PMID- 6483028 TI - [No more griseofulvin for pill users: another clinically important interaction?]. PMID- 6483029 TI - [Food and nutrition policy in Belgium; specifically, nutrition education and consumption behavior]. PMID- 6483030 TI - [Does diethylstilbestrol also affect the ovaries of the fetus?]. PMID- 6483031 TI - [Timely treatment of cerebrotendinous xanthomatosis, a hereditary disorder of cholesterol metabolism]. PMID- 6483032 TI - [Nerve damage following the operative correction of jaw abnormalities]. PMID- 6483033 TI - [Icterus of the newborn infant: a stubborn problem]. PMID- 6483034 TI - [Hepatitis B immunoprophylaxis; vaccination of newborn infants]. PMID- 6483035 TI - [Contact lenses and drug use]. PMID- 6483036 TI - [Modification of objectives in the education of the basic physician in Rotterdam (1973-1983)]. PMID- 6483037 TI - [The test diagram, a visual aid in the interpretation of tests results]. PMID- 6483038 TI - [Significance of increased immunoglobulin G levels in the cerebrospinal fluid of patients with multiple sclerosis]. PMID- 6483039 TI - [Should family physicians excise skin lesions suspicious of melanoma]. PMID- 6483040 TI - [Hypnogenic paroxysmal dystonia: epilepsy or a new syndrome?]. PMID- 6483041 TI - [Admissions, average hospital stay and number of patient days (bed occupancy)]. PMID- 6483042 TI - [Benign midtemporal epilepsy in childhood]. PMID- 6483043 TI - [A child with acute sodium fluoride poisoning]. PMID- 6483044 TI - [Epilepsy; prognosis and treatment]. PMID- 6483045 TI - [Selection of patients with scarce medical resources]. PMID- 6483046 TI - [The value of animal experiments in testing the acute toxicity of substances; a recommendation by the LD50 Commission of the Public Health Council]. PMID- 6483047 TI - [The sacrococcygeal teratoma: a wondrous tumor or a monster tumor]. PMID- 6483048 TI - [Blood contacts and puncture accidents in hospital workers; an indication for vaccination against hepatitis B?]. PMID- 6483049 TI - [Adjuvant chemotherapy in breast carcinoma]. PMID- 6483051 TI - [Treatment and management in syphilis]. PMID- 6483050 TI - [Diagnosis, treatment and follow-up of patients with treponematosis, especially syphilis]. PMID- 6483052 TI - [Transient ischemic attacks and the prevention of brain infarcts; treatment 1984]. PMID- 6483053 TI - Probable cures of adult acute leukemia using short term intensive investigational chemotherapy. PMID- 6483054 TI - Congenital heart disease--outstate Nebraska. PMID- 6483055 TI - Towards reducing the morbidity and mortality of the elderly bereaved. PMID- 6483056 TI - Fracture dislocation of the knee managed by closed reduction. PMID- 6483057 TI - Pregnant women with the expanded toxemia syndrome need special care. PMID- 6483058 TI - Benign fibrous tumors of lung: a brief review and review of five cases. PMID- 6483060 TI - Christ clown in the hospital circus. PMID- 6483059 TI - Physiologic evaluation of speech disorders. PMID- 6483061 TI - [Clinical aspects of the narcolepsy-cataplexy syndrome]. PMID- 6483062 TI - [Chronic paroxysmal hemicrania. A review based on personal cases]. AB - Chronic paroxysmal Hemicrania (CPH) is a headache syndrome first described in 1974. Since then about 60 cases have been reported in the world literature. CPH is characterised by headache attacks occurring daily and always strictly unilaterally. The frequency of the attacks varies from 5 to 30 per 24 hours, the single attack having an usual length of 2 to 30 minutes. The prompt response to indomethacin is the decisive diagnostic criterion of this headache syndrome. The clinical picture, the treatment, some aspects of the pathogenesis and the differential diagnosis of CPH are described by means of case reports. To our knowledge these are the first four cases reported in West Germany. PMID- 6483063 TI - [CT with high-dose contrast medium administration and delayed conduction and NMR tomography in the diagnosis of multiple sclerosis]. PMID- 6483064 TI - [Amount of circulating acetylcholine receptor antibodies in the course of myasthenia, following thymectomy and in immunosuppressive therapy]. PMID- 6483065 TI - [Differential diagnosis of isolated ptosis. Early myasthenia or denervation of the superior tarsal muscle?]. PMID- 6483066 TI - [The severity of disease and intensity of the immune response in multiple sclerosis]. PMID- 6483067 TI - CT findings in patients with gliomas, surviving more than 10 years. AB - After reviewing the latest CT scans of 23 mostly low grade glioma patients who survived more than 10 years after treatment, it was suggested that loss of the original tumour bulk and frequently the presence of porencephalic cavity replacing the original tumour, with a smooth lining which is not contrast enhanced is essential to assume a clinical "cure" in the case of intrinsic cerebral gliomas. In the case of gliomas growing within the ventricle or subarachnoid space, tissue with calcium deposit but without contrast-enhancement was noted, although the number of cases was limited. PMID- 6483068 TI - [Effect of methylprednisolone and dexamethasone on the prognosis and EEG in severe craniocerebral injuries]. AB - In a prospective investigation, the effect of dexamethasone in severe head injuries is compared with methylprednisolone. Twenty patients were examined by computer-tomography and electroencephalography. The EEG was evaluated by frequency analysis; a statistically significant difference could not be demonstrated between the dexamethasone and methylprednisolone group. PMID- 6483069 TI - [Bilateral giant aneurysms of the internal carotid artery--suspected as hypophyseal tumor in computerized tomography]. AB - Bilateral giant aneurysms of the internal carotid artery can be mistakenly diagnosed as pituitary tumour on the basis of the clinical presentation and CT findings. The authors report on one such case, in which the correct diagnosis was made via cerebral panangiography. PMID- 6483070 TI - Atypical pineal teratoma: clinical and computer tomographic features of two patients with disseminated ependymal lesions. AB - Two cases of atypical pineal teratoma (APT) with massive ventricular dissemination are reported; the diagnosis was based on CT appearances and characteristic neurological and endocrinological abnormalities. Both patients responded well to radiotherapy. The CT features and the management of these patients are discussed. PMID- 6483071 TI - [Course of the cranial nerves in the lateral wall of the cavernous sinus]. AB - The course and lengths or the cranial nerves in the lateral wall of the cavernous sinus (Parkinson's triangle) and their relations to the internal carotid artery are described. PMID- 6483072 TI - Clinicopathological study of acute subdural haematoma in the chronic healing stage. Clinical, histological and ultrastructural comparisons with chronic subdural haematoma. AB - Seven cases of acute subdural haematoma in the chronic healing stage, were studied clinicopathologically. Operation was not performed until 17-30 days after major trauma, and revealed subdural granulation tissue of irregular thickness, but no visible inner membranes. Although this capsule contained blood pigment and numerous macrophages, new haemorrhagic foci or eosinophilic infiltrations were extremely rare. Capsular vessels generally had thick vascular walls, distinct basement membranes and tight endothelial junctions. Perivascular blood substance was presumably not secondary haemorrhage from these vessels, but residue from the acute subdural haematoma itself. The possibility of transition from this haematoma to chronic subdural haematoma is discussed. PMID- 6483073 TI - [Renal toxicity of 9-hydroxy-2-methyl-ellipticinium]. AB - 9-hydroxy-2-methyl-ellipticinium (HME) is an intercaling agent mainly potent in metastatic breast cancer. Its almost complete lack of bone marrow toxicity is of greatest value. However, among 385 patients 20 cases of renal failure were observed: renal failure is gradual, non reversible except in four cases with acute renal failure. Histological and ultrastructural studies, performed in 8 cases, showed exclusively proximal tubular lesions, without glomerular or interstitial lesions. We have evidence that there is a relation between the cumulative dose and the severity of the lesions. A prospective study was done in 30 patients. An increase in enzymuria, proteinuria and glycosuria was observed in most patients after HME infusion. HME is an efficient drug in the treatment of bone metastases of breast cancer. Renal function should be carefully monitored during HME administration. PMID- 6483074 TI - [Hyperparathyroidism secondary to renal insufficiency: anatomo-clinical relations and the potential role of an aluminum overload]. AB - Severe secondary hyperparathyroidism is still observed at present in 5-10% of haemodialysis patients. It requires surgical correction. Fifty-eight haemodialysis patients had neck surgery and their 222 parathyroid glands analysed. The individual gland weight was comprised between 22 and 3880 mg (mean +/- SEM, 689 +/- 62 mg). Mean total parathyroid gland weight per patient was comprised between 2 and 3 g. Schematically, 4 types of gland architecture could be distinguished: diffuse hyperplasia alone; diffuse hyperplasia associated with incipient nodule formation; hyperplasia with pronounced nodule formation; and nodule formations alone. Total gland weight was significantly higher for the latter two histological forms than for the former suggesting transformation with time of pure hyperplasia to nodular hyperplasia. Patients with chronic pyelonephritis had a mean gland weight higher than that of patients with chronic glomerulonephritis (3308 +/- 498 mg versus 1824 +/- 358 mg, p less than 0.01). No relation was found between total gland weight and plasma calcium, phosphate or alkaline phosphatases. However, a weak relation existed between total gland weight and plasma immunoreactive parathyroid hormone. In addition, a negative relation was observed between highest prior plasma aluminium and gland weight when considering only patients with a gland weight less than 2000 mg. Parathyroid gland aluminium content was significantly higher in haemodialysis patients than in nonuraemic patients with primary hyperparathyroidism. A direct relation was found between parathyroid gland and bone aluminium. In conclusion, in haemodialysis patients with evolving hyperparathyroidism initially diffuse gland hyperplasia appears to be associated progressively with nodule formation. Circulating immunoreactive parathyroid hormone is positively related to total gland weight.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483075 TI - [Acetate dialysate: responsible for decrease in ultrafiltration in continuous ambulatory peritoneal dialysis]. AB - The authors report the follow up of ultrafiltration in 45 chronic renal patients treated by continuous ambulatory peritoneal dialysis from May 1978 to August 1983. 31 patients have been using acetate buffered dialysate, 14 patients lactate buffered dialysate. Ultrafiltration obtained with acetate fluid has always been less important compared with lactate fluid (p less than 0,001). This decrease has been observed in all the acetate patients and has worsened as a function of duration of treatment, whereas it has only been observed in 14,3% of the lactate dialysed patients. PMID- 6483076 TI - [Does the ferritin level have a practical value in chronically hemodialized patients?]. AB - In order to determine whether serum ferritin assay has any advantages compared with usual hematologic parameters, serum ferritin was assessed in 70 hemodialysed patients. It was positively correlated with the number of blood units infused, but there was no correlation with iron treatment, serum iron or the degree of anemia. However, the interpretation of the results is difficult, because of the large dispersion of serum ferritin levels. Therefore, the determination of serum ferritin concentration cannot be recommended as a current method to follow-up and manage anemic chronic hemodialysed patients, especially when the cost of the test is taken into account. PMID- 6483077 TI - [Bilateral renal oncocytoma]. AB - Renal oncocytoma, a benign tumour, is made up exclusively of oncocytes. These are large epithelial cells with granular eosinophilic cytoplasm extremely rich in mitochondria. Oncocytomas are very often mistaken for renal carcinomas, but due to their characteristic histological and ultrastructural features they are now diagnosed more frequently. We report a case of an unusual bilateral renal oncocytoma and describe briefly its clinical, radiological and pathological features. PMID- 6483078 TI - [Psychomotor development of children with pathology in the neonatal period]. AB - The authors subjected to a multiprofile analysis the psychomotor development and clinical status of 213 children in the third year of life in whom signs had been observed during their neonatal period of life suggesting brain injury. The control group included 206 children matched for age without any history of neonatal pathology. The investigations demonstrated statistically significantly more frequent occurrence of psychomotor development retardation or abnormalities in the neurological status in children from the studied group as compared with control children. Comparative investigations carried out at the age of 12, 24 and 36 months showed a gradual decrease of the indices suggesting psychomotor retardation or disturbances in central nervous system function. PMID- 6483080 TI - [Surgical treatment of cervical spondylosis]. AB - In the years 1971-1981 in the Department of Neurosurgery, Military Medical Academy 293 patients were treated surgically for cervical spondylosis. The author describes the methods of surgical treatment calling particular attention to the necessity of wide decompression of the nervous structures and vessels of the vertebral canal and good stabilization of the cervical spine using osseous grafts. In severe cervical myelopathy it is necessary to decompress the spinal cord and its vessels, both anterior and posterior. This is achieved in a two stage operation. The operation from anterior approach is always done in the first stage of the treatment. The results of surgical treatment of cervical spondylosis are reported. Good and very good results were obtained in 49.7% of cases, improvement in 46.6%, no improvement in 3.7%. Worsening of the neurological status was never observed. PMID- 6483079 TI - [Prognostic value of various pathological symptoms in the neonatal period]. AB - The authors analysed the prognostic significance of pathological signs observed in the neonatal life period evaluating the level of psychomotor development and the neurological status of 216 children aged 36 months in whom signs had been observed in the neonatal period suggestive of central nervous system injury. The studies demonstrated a statistically significant correlation between the level of psychomotor development and the neurological status of children at that age and the occurrence of pathological signs in the neonatal period. Thic correlation was particularly evident in children with low birth weight. PMID- 6483082 TI - [A case of the acinous form of meningeal cysticercosis]. AB - A case of chronic cerebrospinal meningitis is described which caused considerable diagnostic difficulties. Postmortem examination demonstrated parasitic character of the disease. Although all cysts were sterile, the authors suggest in the discussion that in the case the cause was infestation with the larval from of the canine tapeworm Taenia multiceps. PMID- 6483081 TI - [Neuropsychological changes in cerebral ischemia after treatment by the microneurosurgical method. Preliminary report]. AB - The results of neuropsychological examinations are reported in 35 patients with ischaemic cerebral syndromes subjected to microneurosurgical treatment with creation of anastomoses between extracranial and intracranial arteries. A great number of psychic function disturbances were found in them occurring characteristically in lesions of the frontal and temporal lobes. In the groups of patients with transient ischaemic attacks and prolonged reversible ischaemic attacks these disturbances regressed mostly after the operation, parallelly with sings of focal lesion. In the group of patients with completed stroke in most cases an improvement was observed in the psychic functions despite lack of neurological improvement. The results of neuropsychological examination in cases of ischaemic cerebral syndromes indicate thus the necessity of extending indications to microneurosurgical treatment in patients with evidence of completed stroke. PMID- 6483083 TI - [Congestive papilledema caused by marked narrowing of the superior ophthalmic vein]. AB - In the reported case eye fundus changes and symptoms suggested initially increased intracranial pressure. The cause of choked disc was recognized relatively late, after phlebography. Thrombosis of the upper ophthalmic vein causes papilloedema with or without haemorrhages on the disc and around it. Vision may be normal or slightly impaired. There are no inflammatory changes in the orbital soft tissues or exophthalmos. Fundus changes are not different from those caused by raised intracranial pressure. PMID- 6483084 TI - [A case of myelopathy of probable vascular origin with favorable outcome]. AB - The reported case was observed in a 62-year-old female in whom a syndrome of vascular disturbances developed suddenly in the area vascularized by the artery of Adamkiewicz. In the analysis of the pathological mechanism of these changes compression injury, myelitis, pelvic phlebothrombosis were excluded. Thrombosis of the artery of Adamkiewicz due to atheromatosis of the spinal arteries, was diagnosed. The atheromatous process involves the anterior spinal artery in 4% of subjects aged from 60 to 70 years. PMID- 6483085 TI - [Internal carotid artery aneurysm in the sella turcica area simulating pituitary tumor]. AB - A giant aneurysm of the internal artery is described which was situated in the sella and simulated hormonally inactive hypophyseal adenoma. Axial computer tomography demonstrated a hypophyseal tumour. During operation from intranasal approach through sphenoid sinus massive haemorrhage developed but was controlled with fibrin sponge. Postoperative angiography demonstrated a giant aneurysm of the internal artery situated in the sella. Although this location of aneurysm is exceptionally rare, each case of inactive hormonally pituitary adenoma should be subjected before the operation to cerebral angiography. PMID- 6483086 TI - [Rupture of a cerebral aneurysm into the lateral ventricle during angiography]. PMID- 6483087 TI - [Spontaneous resorption of an epidural hematoma. Description of 2 cases]. AB - Two patients with subacute epidural haematomas without shifted ventricular system are described in whom the diagnosis was made by computer tomography 8 and 9 days after trauma. Both patients were treated successfully checking the progress with computer tomography and using agents reducing brain oedema. PMID- 6483088 TI - [Tissue concentrations of biogenic amines in brain tumors and their distribution]. AB - In recent years, considerable interest has been directed towards the role of neurotransmitters in various types of brain dysfunctions. There are increasing experimental and clinical evidences that disturbances in the metabolism of central monoamine play an important role in the pathogenesis of brain diseases. Brain tumors are thought to affect and change the neurotransmitter function of the surrounding cerebral tissues. In this study, we tried to analyze and accumulate data about tissue concentrations of biogenic amines in brain tumors and their distribution. Samples from thirty-four intracranial tumors removed at operations were studied. The concentrations in tumor tissues were measured by high performance liquid chromatography systems which were equipped with electrochemical detection (LCEC) and were particularly well suited for the separation and the measurement of the concentration of norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT), and their metabolites; homovanillic acid (HVA), 5-hydroxyindolacetic acid (5-HIAA) and 3-methyoxy-4 hydroxyphenylethyleneglycol (MHPG) in brain tissues. NE levels were under 3ng/g in twenty-five of thirty cases. DA levels were not detected in more than half of the cases. 5-HT levels varied from 0 ng/g to 166.4 ng/g. HVA levels were detected in one glioblastoma, one metastatic tumor, one meningioma and one hemangioblastoma. 5HIAA levels were not detected in most cases except for two meningiomas and one malignant lymphoma. Distribution of tissue concentrations of biogenic amines and their metabolites in four demarcated brain tumors was studied. Samples for determination of tissue concentrations were taken from tumor tissue at central, middle, and peripheral or adjacent portion from the edge of tumor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483089 TI - [Facial palsy following head injury: topognosis, prognosis and indications for surgical decompression]. AB - It is a common experience that the facial nerve is affected in closed head injury. 781 patients with head injury were treated at Kobe Central Municipal Hospital over a period of 5 years from January 1977 to April 1982, and facial palsy occurred in 25 cases (3.2%). The male to female ratio was 22: 3 and age ranged from 9 to 78 (average 36). The patients were studied, using radiological, topognostic and electrodiagnostic methods. Facial nerve decompression was done in 5 cases and 20 cases were treated conservatively. Results were as follows. The overall rate of complete recovery was 64% (16 of 25 cases). In the conservative treatment group, all patients with incomplete paralysis and normal maximal stimulation test (MST) recovered completely. With complete paralysis, if the initial nerve excitability (MST) was normal, recovery could be expected by conservative treatment. Even if the patients had abnormal nerve excitability (MST) at first, complete recovery could be observed, when signs of recovery could be elicited and normalization of MST occurred within 3 weeks from the onset of the palsy. In severe cases, even with abnormal MST from the onset, complete or partial recovery can be expected after surgery. Therefore, microsurgical decompression of the facial nerve is indicated in the following cases: patients with complete paralysis and no response to MST from the onset. patients with complete paralysis and deteriorating response to MST 1 month after onset. Maximal stimulation test is a good guide for determining the necessity for surgical intervention. PMID- 6483090 TI - [Diagnosis of pituitary microadenoma by magnification carotid angiography and intercavernous sinus venography]. AB - Carotid angiography was performed on 12 cases of pituitary microadenomas at 2.3 X magnified frontal projection and 3.0 X magnified lateral projection. Magnification carotid angiograms were analyzed to determine the pathologic findings in 12 cases on 23 sides. Carotid angiograms demonstrated compressed posterior pituitary gland in 3 of 12 cases and 4 of 23 sides which resulted from the expansion of pituitary microadenomas. But carotid angiogram failed to demonstrate any evidence of tumor stain, abnormal capsular arteries or hypertrophied inferior hypophyseal arteries. These results suggested that magnification carotid angiography was not a useful diagnostic procedure for the detection of pituitary microadenomas. Intercavernous sinus venography was performed on 12 cases of pituitary microadenomas. The technique consisted in catheterization into the inferior petrosal sinus after puncture of the femoral vein. Injection of 10 ml. of contrast medium into the inferior petrosal sinus at a rate of 5 ml. per second. The base projection is most demonstrable and routinely used. Intercavernous sinus venography identified the presence of microadenoma in 10 of 12 cases and false negative in two cases. Nine of 12 cases demonstrated narrowing, interruption and disappearance of the anterior and inferior intercavernous sinuses. Only 3 of 12 cases demonstrated narrowing of the posterior intercavernous sinus and nine cases demonstrated compression signs of the venous strips of the cavernous sinus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483091 TI - [Case of aneurysmal bone cyst of the skull]. AB - A case of aneurysmal bone cyst of the right temporal bone was reported. The patient was a 36-year-old male who was admitted to our hospital with complaints of decreased right hearing and transient impairment of the right vision. A large tumor was palpated on the right temporal bone. Neurological examinations revealed right auditory loss, along with right facial weakness of peripheral type, and minimal pyramidal signs on the right side. The results of the laboratory examination proved to be normal. Neuroradiological examinations tended to be quite impressive. Plain x-ray films of the skull showed a blow out appearance of the right temporal bone and a bone decay in the right middle fossa, the right anterior clinoid process, and the posterior half of the right zygomatic arch. Angiograms revealed a right temporal extradural mass lesion without vascularity. CT scans showed a moderately enhanced mass lesion of soap bubble appearance in the right middle fossa. Surgical treatment was done under the diagnosis of extradural bone tumor. The operative findings disclosed many cysts containing bloody fluid and xanthochromic fluid. Numerous multinucleated giant cells, spindle cells, and foam cells were found in the microscopic examination. On the basis of macroscopic and microscopic findings, the patient was diagnosed as having an aneurysmal bone cyst. The aneurysmal bone cyst of the skull is very rare and sixteen cases have been reported in detail. This case had two interesting points, one was the transient impairment of visual acuity and the other was the CT findings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483092 TI - [Case of calcified prolactinoma combined with Rathke's cleft cysts]. AB - A case of chromophobe adenoma with capsular calcification combined with Rathke's cleft cysts is presented. A 28-year-old woman presented with a seven-year history of amenorrhea. Several months before admission to our department of neurosurgery on November 6, 1982, she developed galactorrhea and difficulty in reading because of visual failure. Neurological examination on admission revealed bitemporal hemianopsia, visual disturbance, left optic atrophy. Plain skull films and CT scan showed suprasellar capsular calcification. The patients hormonal status was assessed pre- and postoperatively. The basal serum prolactin (PRL) level was elevated at 790ng/ml, but other hormone basal plasma levels were within normal limits despite decrease in FSH, LH, The LH, FSH and PRL demonstrated a blunted response to LH-RH (100 micrograms). Both TSH and PRL demonstrated a blunted response to TRH (500 micrograms). The GH showed no response to insulin tolerance test (0.1 U/kg). On November 24, right frontal craniotomy was performed. A grayish bulging mass was noted surrounded by a calcified layer(2-3 mm) in the suprasellar region. When incised this calcified hard layer, showed multi-small cysts with yellow fluid. Under the cyst layer, there was a soft mass which was curetted easily. Histologically, under the ossified layer, there were multi-small cysts, lined by a single layer of ciliated columnar epithelium. The central soft mass was regarded as a chromophobe adenoma with no calcified body. Following partial removal of the tumor, there was prompt improvement in clinical signs and plasma PRL level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483093 TI - [Case of postoperative subdural tension pneumocephalus]. AB - In this paper, a case with subdural tension pneumocephalus secondary to bifrontal craniotomy and VP shunt for ruptured Acom aneurysm is reported. In this patient, the mechanisms for entry of air into the subdural space and producing mass effect (Tension pneumocephalus) seem to be one way valve mechanism and negative pressure due to excess of CSF drainage owing to shunting system. Only 29 reported cases of tension pneumocephalus following surgery were found in an extensive review of the literature. We discussed about the clinical symptoms and signs, therapy, and especially about the mechanisms leading to this condition, and prevention for it. PMID- 6483094 TI - [Reconstruction of the large scalp defect by free flap transplantation]. AB - The reconstruction of a large scalp defect is extremely difficult on many occasions and repeated operations or a long-term hospitalization is often required. In addition, unsatisfactory results are not unusual. However, it is now possible to perform reconstruction by a one-stage operation of free tissue transplantation (free flap) using microsurgical vascular anastomosis which has rapidly developed in the past ten years. We performed reconstructions applying latissimus dorsi musculocutaneous, greater omentum, groin and scapular flaps. The advantages with the free flap are: (1) one-stage reconstruction is possible; (2) no restrictions on the postoperative position, (3) the flap, which is independent of the blood supply from the recipient, well survives on the recipient with an insufficient blood supply and (4) the damage at the donor site can be minimized. On the other hand, its disadvantages are as follows: (1) the operation requires microsurgical vascular anastomoses; and (2) recipient vessels should be normal. The above report was based on favorable results we obtained in 6 cases of reconstruction with free flap applying microvascular techniques. PMID- 6483095 TI - [Repeated transient paraparesis due to solitary spinal epidural arterio-venous malformation. A case report]. AB - A case of spinal epidural AVM with unusual clinical course was presented. A 28 year-old male had repeated episodes of paraparesis and complete recovery in several hours. Metrizamide myelography revealed the dorsal epidural mass at the level of L2 and L3. Accidental epidurogram during the procedure indicated extradural angioma. Surgical intervention proved solitary spinal epidural AVM. Ninety-nine cases in literature were reviewed. Among them, 14 cases of spinal epidural hematoma were due to ruptured angioma which were verified histologically. Others were unknown causes. Age distribution was discussed. It was suggested that the younger patients in the group of unknown causes might have angiomas. It was emphasized that it should not be overlooked even the insignificant transient symptoms and should schedule the extensive radiological examination in such cases. PMID- 6483096 TI - [Surgical treatment of cerebral paragonimiasis miyazakii]. AB - An operated case of cerebral paragonimiasis miyazakii was reported. A 25-year-old man was admitted to our hospital on Jan. 25, 1982, because of weakness, sensory disorder and focal convulsion of the right upper limb. He complained of slight headache but had no sign of meningeal irritation nor inflammation. CT scan revealed a left parietal low density mass with irregular ring-like contrast enhancement. Left carotid angiogram showed stretched arteries around the mass. Laboratory findings were normal except for eosinophilie (17%). Chest X-P was normal. Operation was performed under diagnosis of glioblastoma on Aug. 6, 1982. The tumor was well-circumscribed and had a firm capsule which containing necrotic substance. The tumor was removed totally and the bone flap was also removed since slight brain swelling was seen. Histologically it proved to be a granuloma and four eggs of helminth were found in the necrotic tissue. Post operative state of the patient was satisfactory and cranioplasty was performed 3 weeks later. On Aug. 31, he began to complain of chest pain, cough and hemosputum, and chest X-P disclosed a nodular shadow in the lower lobe of the right lung. Paragonimiasis was strongly suspected because he had a history of having three fresh-water crabs (Potamon dehaani) 18 months before. But not egg was found in either sputum nor stool. Skin test with paragonimus westermani antigen was highly positive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483097 TI - [Studies on recurrence of cerebral aneurysm after operation]. AB - It seems to be well established that the direct surgical treatment of intracranial aneurysm such as clipping, trapping and wrapping the aneurysm. These operations have brought about excellent results but are not perfect because recurrent aneurysm and rebleeding of aneurysm have been reported shortly after the operation. However, it is very rare that subarachnoid hemorrhage arising from recurrent aneurysm long time after the operation, authors have experienced 3 cases of recurrent aneurysm in the same region long after the surgery. Two cases were readmitted to our hospital following repeat episode of subarachnoid hemorrhage. Carotid angiogram showed a new small aneurysm locating about the same place where previously operated aneurysm was situated. One of them showed development of new aneurysm at the anterior communicating after 4 years artery the neck clipping, the other one was recurrent aneurysm 9 years after the neck clipping of aneurysm at the anterior communicating artery. Two cases were treated by reclipping and got well. It has been reported in the articles that 20 cases of recurrent aneurysm were located about the same place where previously clipping aneurysm was performed. Causes of such recurrence of already clipped aneurysm could be divided into two groups. First group was considered that the treatment was unsatisfactory, because the clip had been improperly placed. The other group was considered as mechanical failure of aneurysmal clip that resulted in "slipped out," or "broken clip", and local fragility of the arterial wall adjacent to clip edge. Last case had a giant pseudoaneurysm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483098 TI - [Surgery of trigonal tumor]. PMID- 6483099 TI - [Changes in energy metabolism and spinal cord blood flow following severe spinal cord injury]. AB - Using a rat severe spinal cord injury model, serial determinations of local spinal cord blood flow and energy metabolism including ATP, ADP, AMP, energy charges, local tissue oxygen consumption and changes in pH values in the injured spinal cord tissue were compared topographically. Initially, following injury, energy metabolism was increased with increased ATP utilization and within 30 minutes energy metabolites were severely depleted. By 2 hours after spinal cord injury, a state of severe anaerobic metabolism was associated with the depletion of energy metabolites. This severe state of metabolic disruption and energy metabolite depletion, especially ATP, was followed by a progressive disturbance of spinal cord blood flow. By 3 hours following injury, the disturbances of spinal cord blood flow and energy metabolism were equal in severity. This study suggested that in the severely injured rat spinal cord, an initial depletion of energy metabolites creates a disruption of metabolic function which results in a progression of pathophysiological factors including. PMID- 6483100 TI - [Surgery of vertebral artery aneurysm at the origin of posterior inferior cerebellar artery--with special reference to operative technics in cases with difficulty in direct operation]. AB - Twenty-two patients with posterior inferior cerebellar artery (PICA) aneurysms were treated in our department from 1965 to 1982. Except for six cases with peripheral PICA aneurysms, all aneurysm were located on the vertebral artery at the origin of PICA (VA-PICA aneurysm). Direct approach to the aneurysm was carried out in 11 cases out of 16 with VA-PICA aneurysm. We encountered difficulties in access to the aneurysm in 5 cases (case 2,4,6,13,15) and in clipping procedures in 4 cases (cases 6, 7, 10, 15). Surgical procedures through either bilateral (case 2,4) or unilateral suboccipital craniotomy included exploration in 1 case; wrapping in 1, proximal vertebral artery clipping in 3 and neck clipping in 6. These difficulties encountered during operation were evaluated in relation to angiographical findings. The aneurysms located between 0 to 5 mm from the midline or more than 21 mm from the lateral point of the foramen magnum could be reached with difficulty through unilateral suboccipital craniotomy (Figure 3,4). The aneurysms with the dome directed posteriorly had to be treated carefully because of their possible adhesion to or invagination into the medullar oblongata. The aneurysms with the dome directed medially were difficult to be clipped because they existed on the opposite side of the vertebral artery. Although all aneurysms overlying the lower third of the clivus, even on the midline, can be exposed through unilateral suboccipital craniotomy, great care should be taken especially to the aneurysms located in high position, with the dome directed medially or posteriorly, and with the distal vertebral artery running medially.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483101 TI - [Transcallosal approach to para-ventricular tumors]. AB - Our experience with the transcallosal approach to para-ventricular tumors is reviewed and our operative technique is described. A group of 7 patients with a variety of tumors affecting the lateral ventricle, 3rd ventricle and basal ganglia have been treated using an anterior transcallosal approach. Using a posterior transcallosal approach, we operated upon 2 patients with thalamic tumors. The anterior part of the body of the corpus callosum is divided in the anterior transcallosal approach and the posterior part of the body of the corpus callosum is divided with preservation of the splenium in the posterior transcallosal approach. The division amounting to approximately 2-3 cm is sufficient exposure. With the exception of tumors affecting the basal ganglia, thalamus and anterior 3rd ventricle, complete excision of each lesion was effected. There were no operative deaths. The complications in this group of patients were primarily related to the nature and location of the primary tumor, but four complications were directly related to the transcallosal approach. Venous infarctions occurred in 2 patients and subdural fluid collections occurred in 2 patients. Therefore, planning of the flap placement and the extent of brain retraction must be based on preoperative angiographic assessment of parasagittal venous tributaries. We performed some detailed studies of the interhemispheric transfer of somesthetic and perceptual motor tasks, as well as psychometric testing post-operatively in 2 patients. No significant clinical deficit subsequent to dividing the anterior part of the body of the corpus callosum could be demonstrated. The results and clinical material indicate that transcallosal approach is a safe, feasible alternative in the management of the tumors in these regions. PMID- 6483102 TI - [Three cases of infra-optic course of the anterior cerebral artery]. AB - Three cases of rare anomalous cerebral artery originating from internal carotid at the level of ophthalmic artery to join the anterior cerebral artery were presented. Case 1. A 32-year-old woman was admitted following subarachnoid hemorrhages. Cerebral angiography disclosed the anterior communicating artery aneurysm and the anomalous vessel originating at rt. carotid siphon to join anterior cerebral artery. Case 2. A 37-year-old woman was admitted with rt. hemiparesis and aphasia. Cerebral angiography revealed the anomalous vessel originating at rt. carotid siphon to join contralateral anterior cerebral artery. Case 3. A 22-day-old male infant with enlarged head was admitted and cerebral angiography was performed. Anomalous vessel originating from internal carotid at the level of ophthalmic artery joined to the azygos anterior cerebral artery. There were only sixteen reported cases of this anomaly including our three cases. Seven aneurysms were associated in six cases, in which four were located in anterior communicating system. The fact that among the cases of this anomaly, ophthalmic artery used to not have normal stem but be fed from middle meningeal or middle cerebral artery suggested that the anomalous vessel had the common stem with ophthalmic artery at certain embryonic stage. These considerations led us to the conclusion that this anomalous vessel might originate from the remnant of anastomotic loop between primitive dorsal and ventral ophthalmic artery. PMID- 6483103 TI - [Unilateral visual field defect due to optic nerve compression by non-sclerotic internal carotid and ophthalmic arteries. A case report]. AB - A case of unilateral visual field defect due to optic nerve compression by non sclerotic internal carotid and ophthalmic arteries was reported. A 14-year-old boy was admitted to our department because of constricted visual field of the right eye. The right ophthalmic artery originated from more distal portion of the internal carotid artery than usual on angiogram. CT, PEG and other roentgenologic examinations revealed no abnormalities. But the possibility of para-sellar tumor still remained, so the right optic nerve was explored by a right frontotemporal approach. The optic nerve was found to be compressed not by any sort of mass lesion but by the non-sclerotic internal carotid and ophthalmic arteries against the rim of the optic canal. Then a microsurgical unroofing of the optic canal was performed to relieve the nerve from the compression. The decompressed upper surface of the nerve was found to be discolored yellow-white. Unfortunately, no improvement in the visual field was obtained after operation. Visual field defect due to vascular compression of the optic nerve has been discussed in only several reports. There have been only 8 cases of surgically treated unilateral visual field defect due to vascular compression. Most of them were the results of compression by the sclerotic or fusiformly enlarged internal carotid arteries and were found in the patients of middle age. Four cases presented with lower half visual field defects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483104 TI - [An arachnoid cyst in the left lateral ventricle]. AB - Generally arachnoid cysts are congenital in origin and found over the cerebral convexity, in the major fissures, and in the folded portions of the brain wherever the arachnoid membrane extends. Including other central nervous system (CNS) cysts, the location of these cysts has implications as to their origin, for examples, intracerebral cysts generally are ependymal cysts, while extracerebral cysts are mostly arachnoid cysts. An 8-month-old boy was admitted to our department because of enlarged head and developmental retardation. Computerized tomographic scan (CT) revealed remarkable hydrocephalus and a relatively high dense, round lesion between the lateral ventricles. During surgery the cyst was found to arise from the left ventricular floor. Histologically the cyst wall was arachnoid membrane. PMID- 6483105 TI - [A case of Marfan's syndrome with a ruptured distal middle cerebral aneurysm]. AB - A case of ruptured distal middle cerebral aneurysm is reported, A 20-year-old man with Marfan's syndrome suffered from sudden loss of consciousness. A CT scan and cerebral angiogram revealed a distal middle cerebral aneurysm with a large intracerebral hematoma. The aneurysm was clipped and the hematoma was evacuated successfully. This case is presented and the literature related to the aneurysm associated with Marfan's syndrome is reviewed. PMID- 6483106 TI - [CT findings and surgical treatment of atlanto-axial rotatory fixation: a case report]. AB - A case of atlanto-axial rotatory fixation (AARF) was presented in a 19-year-old female who developed sudden onset of neck pain and limitation of neck movement after direct carotid angiography for seizure disorder. Neurological examination was negative except for cock-robin posture and mild hypesthesia and hypalgesia in left C2 distribution. Plain films of the cervical spine disclosed abnormal alignment of C1-C2 and possible rotational dislocation. Bilateral selective vertebral angiography showed marked anterior and posterior displacement of left and right vertebral artery, respectively, at the level of C1. On CT metrizamide myelography, there was clockwise rotation of C1 on C2 with locked facet on the left but no evidence of cord compression was found. With diagnosis of AARF, manual reduction under general anesthesia and with fluoroscopic control was first attempted without success. Therefore, the patient underwent open reduction by using high speed air-drill and posterior fusion of C1 to C3 with acryl and wire. Postoperative course was uneventful and the patient went back to work as a computer operator in three months. The etiology of AARF was described by many authors, but in our case, congenital hypogenesis of transverse and alar ligaments plus minor trauma was most suggested. For neurological manifestations of AARF, occipital neuralgia, headache, neck pain, limitation of neck movement and cock robin posture were reported, but the cock-robin posture was most characteristic and was an important symptom for the early diagnosis. In neuroradiological findings of AARF, plain CT and CT metrizamide myelography are very useful. Because they clearly demonstrate the degree of rotation and interlocking of atlanto-axial joints, and the presence of cord compression. PMID- 6483107 TI - A Golgi study of cerebellar atrophy in human chronic alcoholism. AB - When processed by the rapid Golgi method, a significant reduction (P less than 0.002) of the dendritic arborization of Purkinje cells located at the tips of the folia of the rostral vermis was demonstrated in four human cases of cerebellar atrophy, related to chronic alcohol consumption. Except for isolated damaged Purkinje cells located on the depth of the sulci of the rostral vermis in all but one case, no significant differences were observed between alcoholic cases and controls of comparable ages among Purkinje cells located in the remainder of the vermis or the cerebellar hemispheres. These results suggest that structural changes, which precede neuronal death and cell loss, are present in Purkinje cells of the rostral vermis in human cerebellar alcoholic degeneration. PMID- 6483108 TI - Kainic acid seizures and the reversibility of calcium loading in vulnerable neurons in the hippocampus. AB - The threshold pathological changes in the rat hippocampus following systemic administration of kainic acid (12-15 mg/kg) have been studied in relation to i the duration of EEG seizure activity and ii calcium accumulation in post-synaptic neurons, using the oxalate-pyroantimonate method. The reversibility of the pathological changes and calcium loading has been studied from 40 min to 48 h after the termination of seizure activity. Little or no changes were visible 2-3 h after 12 mg kainic acid per kg, but changes were obvious in most hippocampi directly after 2-3.5 h of seizure activity induced by 15 mg kainic acid per kg. These consisted of generalized swelling of perineuronal and perivascular astrocytic processes, neuronal hyperchromasia and microvacuolation, and swelling of CA1 basal dendrites. 'Ischaemic cell change' occurred in a small number of pyramidal neurons. Calcium accumulated in mitochondria of basal dendrites and in the soma of pyramidal neurons in CA1 and CA3. Astrocytic and dendritic swelling and mitochondrial calcium accumulation were rapidly reversed during 40 min of seizure suppression with diazepam. Calcium accumulation in astrocytic processes recovered more slowly (greater than or equal to 4 h). After a recovery period of 24-48 h, ischaemic cell changes were seen only in very occasional pyramidal neurons. The pattern of pathological changes is very similar to that seen after L allylglycine or bicuculline-induced seizures. If the dendritic and other changes are a direct consequence of agonist actions at excitatory amino acid receptors (pre- or post-synaptic) then similar actions must be occurring in seizures induced by agents acting primarily on GABAergic inhibition. PMID- 6483109 TI - CT findings in spastic cerebral palsy. Clinical, aetiological and prognostic aspects. AB - After the introduction of cranial computed tomography (CT) it is now possible by an atraumatic procedure to evaluate the pathophysiological findings in children suffering from cerebral palsy (CP). The aim of this study is to describe the cranial CT findings in children with CP and relate these to CP-type, grade of handicap, aetiology, and presence of other functional cerebral defects. The CT examination was performed in 83 children with spastic CP (44 boys and 39 girls). Fifty-seven children (67%) had pathological CT. There was no statistically significant difference between the frequencies of pathological CT findings in the groups with tetraplegia, diplegia, and paraplegia. The frequency of pathological CT findings was increasing with increasing severity of the motor handicap (p less than 0.05). There were significantly more children with pathological CT findings among CP children suffering from epilepsy, than among CP children without epilepsy (p less than 0.05). The CP children with the lowest IQ, had numerical more pathological CT findings but there was no significant difference among pathological CT findings in CP children with oligophrenia compared to the rest of the group. Infarction, its sequelae and hemiatrophy were much more frequent in patients with hemiplegia (p less than 0.001) compared to the other CP-types. The most frequent pathological CT finding was atrophy (44 cases among 56 pathological CT). Central atrophy with enlargement of the ventricular system or parts of this was found in 39 children.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483110 TI - Paroxysmal visual disturbances of epileptic origin and occipital epilepsy in children. AB - A special form of partial occipital epilepsy clinically resembling migraine and possibly related to the benign focal epilepsies of childhood has recently attracted attention (Gastaut 1982) but its existence is still debated. To approach this problem, in a group of 195 children with idiopathic partial or generalized epilepsy we have studied those who had visual complaints as part of their seizures (twelve children) and those who also had migraine (four children). The clinical and electroencephalographic features of these children were analyzed together with those of another group of thirty children diagnosed as migraine accompagnee in which an EEG had been obtained (3/30, i.e. 10% had paroxysmal spike-waves: one centrotemporal focus, two generalized spike-waves). One child with the type of epilepsy described by Gastaut (1982) as partial benign occipital epilepsy (phosphenes, moving lights, headaches and occipital high voltage biphasic spike-waves blocked by eye opening on the EEG) was found in the epileptic group whereas the other children of this group, including those with associated migraine, had other types of epilepsy. This "new" type of epileptic syndrome can be distinguished from symptomatically resembling entities but its place needs to be further defined. PMID- 6483111 TI - Developmental changes in dichotic right ear advantage (REA). AB - A cross-sectional, dichotic listening study of 210 right-handed, middle-class children four to ten years old used thirty pairs of one-syllable words and thirty pairs of four-syllable numbers to assess the developmental course of ear asymmetry. A significant decrease in REA for both word and number pairs was found. Although right-ear and left-ear performance both increased with age, the developmental gain in left-ear performance was greater than the gain in right-ear performance, thus resulting in a decrease in REA with age. The results are discussed with respect to investigations which found no change in REA during development and a structural model based on the development of interhemispheric connectivity is proposed to explain the findings. PMID- 6483112 TI - Fasciculation of the eyelids: an additional clue to clinical diagnosis in spinal muscular atrophy. AB - Fasciculation of the eyelids was observed in five of eleven children with spinal muscular atrophy (SMA); two had severe SMA and three were of intermediate severity. Three other children with intermediate SMA and the two children with mild SMA did not show eyelid fasciculations. This could provide an additional clinical sign to tongue fasciculation and hand tremor in the diagnosis of SMA in childhood. PMID- 6483113 TI - Childhood psychosis in a case of Moebius syndrome. AB - A case of a five-year-old boy with Moebius syndrome, mild-moderate mental retardation and childhood psychosis (possibly infantile autism) is described. This is probably the first case ever of concomitant Moebius syndrome and childhood psychosis to be reported. Brainstem dysfunction is proposed as a common denominator in the neurologic and psychiatric syndrome. PMID- 6483115 TI - Proceedings of the symposium: GABA mechanisms and their clinical significance. Cambridge, U.K. 26-28 July, 1984. PMID- 6483114 TI - Cortical subacute necrotizing encephalomyelopathy. A study of two patients with mitochondrial dysfunction. AB - Two patients are reported who presented with progressive impairment of neurological and intellectual function, and intractable fits. In both the disease ran a fluctuating course. There was evidence of mitochondrial dysfunction, serum levels of pyruvate and lactate being four to six times normal. Involvement of mitochondria in different organs was suggested by histochemical and ultrastructural investigations of muscle and heart tissue. The children died at nine years and twelve months, respectively. In both autopsy revealed cardiomyopathy and renal abnormalities. The brain showed severe lesions indistinguishable from subacute necrotizing encephalomyelopathy (SNE), the brunt of which was borne by the cortex. PMID- 6483116 TI - Binding of [3H]apomorphine to an aporphine binding site as well as to dopamine sites in tissue from bovine caudate nucleus. AB - Binding of the tritiated dopamine (DA) agonists, apomorphine (APO) and a dihydroxyaminotetralin (ADTN) to a membrane preparation from the caudate nucleus of calf brain was compared. Binding of [3H]dihydroxyaminotetralin at small (nM) concentrations followed simple, monophasic inhibition (over 80% at less than 500 nM) by concentrations of apomorphine between 50 pM and 1 mM. Inhibition of the binding of [3H]apomorphine by dihydroxyaminotetralin was more complex, and included in component with a low (microM) affinity for dihydroxyaminotetralin accounting for approx. 20% of total binding. The kinetics of binding of the ligands to high-affinity sites were virtually identical (apparent Kd = 0.81 nM; Bmax = 211 fmol/mg protein) and could not be distinguished by curve-fitting techniques adapted to analysis by microcomputer. In contrast, the binding of [3H]apomorphine with a "blank" defined by excess (10 microM) dihydroxyaminotetralin could be resolved into the same high-affinity component and a lower-affinity site (Kd = 124 nM; Bmax = 5740 fmol/mg). The pharmacology of the lower-affinity binding of [3H]apomorphine was evaluated by coincubating with 0.5 microM dihydroxyaminotetralin to "mask" high-affinity sites, and was compared to high-affinity binding of [3H]apomorphine and [3H]dihydroxyaminotetralin. The high-affinity binding was stereoselective for DA receptor agonists and antagonists. The pharmacology of the lower-affinity site resembled no known DA receptor type and showed highest affinities for aporphines but was not stereoselective and reacted weakly and nonspecifically with dihydroxyaminotetralin, DA, other catecholamines and neuroleptics. Thus, [3H]apomorphine, under certain conditions, may detect an aporphine binding site of uncertain pharmacological significance, as well as high-affinity DA agonist (D 3) sites. PMID- 6483117 TI - Feline analgesia following central administration of opioids. AB - Activity of opioids in cats was assessed by employing the tail-flick method. Microinjection of morphine (100 micrograms) or etorphine (2.5 micrograms) into the ventrolateral periaqueductal gray (VLPAG) region resulted in significant analgesia. Smaller doses of morphine (10 and 50 micrograms) or etorphine (0.62 and 1.25 micrograms) were without significant effect. Methadone likewise produced no significant analgesic action in doses as large as 360 micrograms in the ventrolateral periaqueductal gray. Rank order potency, i.e. etorphine greater than morphine much greater than methadone, was similar following systemic administration. Increased latency of tail-flick response after injection of etorphine was diminished by administration of naloxone, either systemically or centrally, thus indicating a specific opiate-mediated response. PMID- 6483118 TI - Effect of fentanyl and naloxone on the P300 auditory potential. AB - The effect of fentanyl (opioid agonist) and naloxone (morphine antagonist) on the amplitude, area and latency of the P300 auditory potential was studied in patients undergoing minor surgical procedures. Fentanyl (5.0 micrograms/kg), naloxone (3.0 micrograms/kg) and isotonic saline (for control) were injected intravenously through a catheter just before surgery, and following a single blind procedure and three different pharmacological paradigms with three consecutive conditions each: (1) initial baseline (C), saline (S) and late baseline (C'); (2) C, fentanyl (F) and C'; (3) C, naloxone (N) and C'. Fentanyl significantly reduced the amplitude and area with no changes in the latency of small (S) and large (L) P300 potentials. Concomitantly, fentanyl increased the number of omitted counts of the target tones of the "odd ball" P300 test and the spatial threshold of the two point discrimination test in patients with small and large P300 potentials. Naloxone significantly increased the amplitude and area and decreased the latency of the small P300 potential and decreased the amplitude and area with no changes in latency of the large P300 potentials. Concomitantly, naloxone decreased the number of omitted counts of the patients with small but not large P300 potentials and decreased the spatial threshold in patients with both small and large P300 potentials. Neither fentanyl nor naloxone produced systematic changes in the evaluation of pain and hearing of patients with small and large P300 potentials. Although dramatic changes in pulse, blood pressure, respiration and EEG were found in some cases immediately after the administration of fentanyl and naloxone, these changes were not consistent and were not present at the time other tests were performed. PMID- 6483119 TI - Cyclobenzaprine: effect on tonic vibration reflexes in local tetanus cat preparations. AB - Local tetanus was induced by the injection of toxin into the gastrocnemius-soleus muscle of cats. After 48 hr, longitudinal vibration of the muscle was used to elicit a reflex contraction (tonic vibration reflex, TVR). In other experiments, electrical stimulation of various regions of the central nervous system served to elicit contraction of the muscle alone or to facilitate a vibration (150 mu at 300 Hz)-induced tonic vibration reflex. In contrast with normal animals, tonic vibration reflex responses in local tetanus preparations of decerebrate cats were augmented after transection of the spinal cord at Cl. In decerebrate local tetanus preparations, a dose-related reduction of tonic vibration reflex responses, induced at all frequencies and amplitudes of muscle vibration, was observed after doses of 0.5 to 3.5 mg/kg (i.v.) of cyclobenzaprine. Muscle contractions induced by stimulation of the medial reticular formation and facilitation of tonic vibration reflex responses were more sensitive to the action of cyclobenzaprine than were similar responses activated through stimulation of Deiters' lateral vestibular nucleus. In spinal preparations, tonic vibration reflex responses were only moderately reduced after similar doses of cyclobenzaprine. Contractions induced by stimulation of the spinal cord (T6) and facilitated tonic vibration reflex responses were only moderately reduced, whereas the post-stimulus-induced facilitations were considerably attenuated. Thus, experiments in local tetanus preparations support further the concept that the major site of action of cyclobenzaprine is supraspinal, whereas its action upon spinal structures contributes to its overall skeletal muscle-relaxant activity. PMID- 6483120 TI - The effect of a glycine derivative (CP 1552-S) on kindled seizures in rats. AB - The effects of the glycine derivative, CP 1552-S (2-N-pentylaminoacetamide hydrochloride) were evaluated for potential anticonvulsant activity in rats which were cortically- or amygdaloid-kindled. Large doses (300-600 mg/kg, i.p.) of CP 1552 given 30 min before stimulation resulted in significant reductions in duration of afterdischarge after both partially-developed and fully-developed cortically-kindled seizures. The largest dose tested (600 mg/kg, i.p.) markedly reduced the duration of the elicited afterdischarge and the severity of seizure. This dose was associated with prestimulation sedation and a 50% incidence of post afterdischarge spontaneous, electrical seizure activity. Against kindled amygdaloid seizures, CP 1552-S significantly reduced the duration of afterdischarge at 300 mg/kg (i.p.) without modifying the seizure and without prestimulation behavioral or electrical effects. The largest dose tested (600 mg/kg, i.p.) resulted in a significant reduction of the elicited duration of afterdischarge but was associated with a 25% incidence of prestimulation spontaneous electrical seizure activity and a 45% incidence of post afterdischarge electrical seizure activity. When CP 1552-S (30-300 mg/kg, i.p.) was administered daily, prior to the amygdaloid kindling stimulus, no difference was noted in the rate of acquisition of the kindled amygdaloid response. It is concluded that the glycine derivative CP 1552-S, has little anticonvulsant activity against the acquisition or development of kindled amygdaloid seizures. It appears to have significant anticonvulsant effects against both cortically- and amygdaloid-kindled afterdischarges with little effect on the behavioral severity of the seizure. Further, large doses of CP 1552-S appeared to result in paradoxical post-afterdischarge and possibly prestimulation electrical seizure activity. PMID- 6483121 TI - Interaction between probenecid and two lipid-soluble barbiturates in the rat. AB - The effect of pretreatment with probenecid (200 mg/kg, i.p.) on the sensitivity of the central nervous system (CNS) to thiopental and hexobarbital was investigated with an EEG-threshold method. The threshold dose was significantly decreased by pretreatment with probenecid for thiopental but not for hexobarbital. This was due to an increased penetration of thiopental into the CNS, but for hexobarbital an increase in penetration could also be demonstrated by analysis of brain and serum concentrations after infusion of an equal dose of barbiturate. The concentrations in brain at the EEG-threshold were not influenced by pretreatment with probenecid for either of these barbiturates, which shows that there was no synergism between these barbiturates and probenecid due to the depressant effect of probenecid on the CNS. PMID- 6483122 TI - Selective 5HT-2 antagonists inhibit serotonin stimulated phosphatidylinositol metabolism in cerebral cortex. AB - Evidence suggests that the serotonin 5HT-1 receptor site is functionally linked to adenylate cyclase in the brain, but a biochemical effector system which is linked to the serotonin 5HT-2 receptor site has not been found. In the present paper we report an investigation of 5HT stimulated phosphatidylinositol (PI) hydrolysis in rat cerebral cortex and have found that selective 5HT-2 antagonists (pizotifen and ketanserin) block 5HT's effect upon PI metabolism. These data suggest that 5HT stimulated PI hydrolysis is mediated by the 5HT-2 binding site. PMID- 6483123 TI - Raphe lesions modify ethanol's effects on plasma corticosterone and NEFA. AB - Male rats received dorsal or median raphe electrolytic lesions or sham operations. Ten days later subjects received 3.0 g/kg ethanol or saline and were decapitated 30 minutes later. Both dorsal and median raphe lesions significantly increased corticosterone and non-esterified fatty acid levels. Ethanol significantly increased corticosterone and non-esterified fatty acid levels in rats with dorsal or median raphe lesions. Dorsal raphe lesions significantly attenuated the elevating effect of ethanol on corticosterone. These results confirm, in part, previous pharmacological studies and suggest the effects of ethanol on corticosterone, but not non-esterified fatty acid, involve serotonergic neurons. PMID- 6483124 TI - [Encounters: books and children (12-15 years old) in orthophonic rehabilitation]. PMID- 6483125 TI - [Verbal creations in children from 4 to 6 years of age]. PMID- 6483126 TI - [Update of a vocabulary list used in language evaluation]. PMID- 6483127 TI - [Voluntary and reflex eye movements in dyslexic children]. PMID- 6483128 TI - [Language used for the description of images in primary school children]. PMID- 6483129 TI - [Hands and miming, or nonverbal communication in the education of deaf children]. PMID- 6483130 TI - [Current aspects of learning to write in 5-year-old children]. PMID- 6483131 TI - Solitary eosinophilic granuloma of the skull. AB - Solitary eosinophilic granuloma of the skull is a rare lesion, the natural history of which has not been defined completely. By a retrospective chart review, 26 patients were identified as having a solitary eosinophilic granuloma of the skull at first presentation to our institution between 1946 and 1982. Characteristically, the patient noted an enlarging, tender skull mass during the several weeks to several months before the initial assessment. Laboratory findings were normal except for 1 case of eosinophilia. Radiographically, the abnormality consisted of a punched-out, well defined, lytic lesion most commonly seen in the parietal or frontal bone. Whole body bone scans or bone surveys were used to rule out further lesions. The definitive diagnosis was made by histological examination, which showed the characteristic histiocytes, eosinophils, and multinucleated cells of eosinophilic granuloma. The usual treatment consisted of a craniectomy or curettage perhaps followed by local, moderate dose radiation therapy. The follow-up period ranged from 1 month to 25 years and averaged 8 years; in that time, 8 patients (31%) developed additional lesions. Of these 8 patients, only 3 were older than 3 years at the time of the first recurrence. Based on a review of our own patients and those reported in the literature, we stress that a solitary eosinophilic granuloma of the skull may foreshadow future disease elsewhere and is not an easily dimissed local disease, especially in children. After the initial treatment, we recommend careful long term follow-up and treatment of additional lesions with radiation therapy. PMID- 6483132 TI - 5-hydroxytryptamine injected intraventricularly fails to influence the brain water content. AB - Measurement of the content of brain water and electrolytes after the intraventricular administration of 5-hydroxytryptamine in rats, with and without exposure to osmotic stress, failed to show water accumulation in the brain parenchyma. It is suggested that elevation of serotonin in the cerebrospinal fluid--resembling pathological situations such as subarachnoid hemorrhage--does not play a primary role in brain edema formation. PMID- 6483133 TI - Declaration of brain death in neurosurgical and neurological practice. AB - A survey of neurosurgeons and neurologists assessed physician practices in the declaration of brain death. Ninety-four per cent of the respondents thought that the diagnosis of brain death was legitimate; most thought that it was justified by a failure of somatic survival after brain death. Fifty-four per cent of the respondents had made the diagnosis themselves 1 to 5 times a year. The criteria used to make the diagnosis varied significantly among the respondents. Most required the absence of a pupillary reflex (88%), the absence of a corneal reflex (85%), a lack of ventilatory effort with disconnection of the ventilator (84%), and the absence of eye movements with head turning (80%). Fewer required an absent cough reflex (61%) or gag reflex (69%), dilated pupils (59%), a body temperature under 90 degrees F (56%), or a blood barbiturate level of zero (43%). Over 65% required an isoelectric electroencephalogram; 29% required only one, and 36% required two electroencephalograms 24 hours apart. Twenty-six per cent required absent deep tendon reflexes. The time required for the declaration varied from 6 to 24 hours. There was wide variation in the response to a hypothetical situation in which the family of a patient fulfilling brain death criteria did not want death to be declared. Seventy-eight per cent of the respondents would continue ventilatory support, although about a third of these would declare the patient dead while doing so. Only 6% would stop the ventilator despite the family's wishes. These results substantiate a wide variation in the actions of neurologists and neurosurgeons in brain death declaration. This has important implications for decisions about death in neurology and neurosurgery. PMID- 6483134 TI - Modified crossed leg raising test and sciatica. AB - A modification of the crossed leg raising test has been helpful in identifying patients with intervertebral disc disorders. Simultaneous flexion of the neck and elevation of the contralateral leg produced pain in the ipsilateral (presenting) sciatic notch in five patients with either free fragments or herniated disc found at operation. All patients were symptom-free postoperatively. PMID- 6483135 TI - Temporary neurological deterioration after extracranial-intracranial bypass. AB - Five patients who experienced temporary neurological deterioration after extracranial to intracranial bypass procedures are reported in detail. These patients suffered transient ischemic attacks or more prolonged deficits usually of a different nature than the preoperative symptoms. All patients had a good outcome and the spells ceased; the neurological deficits improved within a maximum of 2 weeks. Obvious causes of deterioration such as intra- or extracerebral hematomas, occlusion of a previously stenotic vessel, or graft occlusion were ruled out by computed tomography and angiography in each case. Intraoperative causes of neurological deterioration such as anesthetic effect, hypotension, and temporary occlusion of the cortical vessel or sacrifice of its small branches were not likely to be the cause of the deficits because in each case, the patient awoke satisfactorily and deterioration occurred hours to days later. In each case, postoperative angiography showed good perfusion of at least one major division of the middle cerebral territory. Anticoagulation with heparin in three patients did not change the clinical course. In one patient who was not anticoagulated, embolism could have been responsible for a single prolonged ischemic event, but in the other patients thromboembolism does not seem likely to have been responsible for the deficits. The cause of the deterioration in these patients remains unexplained. We speculate that hyperperfusion of chronically ischemic brain tissue and shifts in the watershed region resulting from the new flow pattern after bypass grafting are two mechanisms that may have been of importance in the etiology of these deficits. PMID- 6483136 TI - A quantitative assessment of the brain stem auditory evoked response during intraoperative monitoring. AB - The brain stem auditory evoked response (BAER) was monitored intraoperatively in 11 patients with tumors of the posterior fossa. A technique for the objective quantitative assessment of the BAER based on the variance of the phase angle between small group averages is described. The resulting component synchrony measure corroborated standard peak latency and amplitude changes of the BAER during operative manipulation. A discussion of the replication and use of the objective measure is presented. PMID- 6483137 TI - High dose naloxone produces cerebral vasodilation. AB - In this study, 12 dogs were anesthetized with sodium pentobarbital, and blood flows were determined using the radioactive microsphere technique. Ten dogs were first made acutely hypertensive by the infusion of norepinephrine and demonstrated preserved cerebral autoregulation. The administration of naloxone, 10 mg/kg i.v., in these animals produced a significant increase in cerebral blood flow and a proportional drop in cerebrovascular resistance with no change in the cerebral metabolic rate of oxygen or the electroencephalogram. Two additional spontaneously hypertensive dogs demonstrated a similar response to naloxone. These results suggest that high dose naloxone produces cerebrovasodilation either directly or through the inhibition of cerebral autoregulation. PMID- 6483138 TI - Ventriculoperitoneal shunts in high risk newborns weighing under 2000 grams: a clinical report. AB - Fifty-three low birth weight high risk newborns who developed progressive hydrocephalus despite a trial period of intermittent lumbar punctures underwent cribside ventriculoperitoneal shunt placement. They all weighed less than 2000 g at the time of shunting (mean, 1308.6 g +/- 398.2 SD). The operative procedures were performed at a mean age of 31.5 days +/- 16.1 (SD). There were no deaths in this series. During the nursery stay, 14 patients required operative revisions for obstruction. The most common problem was infection, which occurred in 13 (24.5%) after the primary intervention and in another 5 of the 14 (35.7%) patients who required revision. The overall infection rate/patient was 26.9%. Shunt removal and intensive antibiotic therapy cured the infection in all but 1 patient. Premature, low birth weight newborns may undergo ventriculoperitoneal shunting, but close follow-up for complications such as infection and shunt obstruction is always required. PMID- 6483139 TI - Giant cell reparative granuloma of the cranial vault: exceptional bone lesion. AB - Giant cell reparative granuloma (GCRG) is an uncommon nonneoplastic lesion of bone. It is even rarer in the bones of the skull, particularly in the calvarial bones. Originally considered to be peculiar to the jawbones, GCRG has been described in some other locations, such as the short tubular bones of the hand and the facial (paranasal) bones. Only one GCRG has been found in the skull, this one in the temporal bone. The authors were unable to find a report of such a lesion in the bones of the calvarium. The etiology of GCRG is unknown, but it is believed to result from a traumatic intraosseous hemorrhage or periosteal reaction. A GCRG was diagnosed in a 31-month-old male infant who presented with a nonpainful, slow-growing, right frontal swelling, apparently related to a head contusion that had occurred 21 months earlier. The lesion was removed surgically. The main differential diagnosis is giant cell tumor. PMID- 6483140 TI - Meningioma with intracerebral hematoma. AB - A case of spontaneous intracranial hemorrhage associated with a meningioma is presented. Intracranial hemorrhage has been reported to be associated with meningioma in 45 cases. A comprehensive review of the subject is presented. The importance of the diagnosis of associated hemorrhage and subsequent surgical intervention is emphasized. PMID- 6483141 TI - Spontaneous posterior fossa subdural hematoma as a complication of anticoagulation. AB - We report a patient in whom a spontaneous subdural hematoma developed in the posterior fossa during anticoagulation therapy for mitral valve disease. This rare complication of anticoagulation has been reported in only three other patients. PMID- 6483142 TI - Cerebral aneurysm rupture during neurosurgery. AB - The author describes a technique providing mechanical rather than manual support to a suction tube for improved control of aneurysm hemorrhage during operation. This results in increased precision, fewer hand movements, reduced reliance upon other operating room personnel, decreased trauma to tissues as a result of multiple manipulations, reduced anxiety for the surgeon, and a shorter operating time. PMID- 6483143 TI - Acute extradural hematoma and pneumocephalus. PMID- 6483144 TI - Effect of alcohol intoxication on the diagnosis and apparent severity of brain injury. AB - Because alcohol intoxication is common among brain-injured patients, we performed this study to determine the extent to which alcohol alters the initial assessment of brain injury severity in these patients by depressing the level of consciousness. The Glasgow coma scale was used to measure the level of consciousness of 257 brain-injured adults admitted to the University of Virginia Hospital, both on arrival in the emergency room and 6 to 10 hours later. Improvement in the level of consciousness between the first and second measurements was significantly related to the blood alcohol concentration on admission. Patients with the highest blood alcohol concentrations showed the greatest improvement. Most of this effect occurred in patients with a blood alcohol concentration of 0.20% or higher. Alcohol intoxication is a potential source of bias in the clinical classification of brain injuries according to severity. PMID- 6483145 TI - Prognosis of the so-called "diffuse" cerebellar astrocytoma. AB - The term "diffuse cerebellar astrocytoma" was originally introduced by Russell and Rubinstein to describe that minority of cerebellar tumors microscopically similar to the cerebral hemispheric astrocytoma. The aim of this study was to verify some recent reports warning against the less favorable long term prognosis of the "diffuse" form of the cerebellar astrocytoma. We reviewed our series of cerebellar astrocytomas in children and collected 49 cases operated on before 1966 (i.e., with a follow-up ranging from a minimum of 15 years to 29 years). In addition, we reexamined all recurrent cerebellar astrocytomas observed during a 30-year period, looking for the eventual occurrence of the "diffuse" form. In the first group, 10 cases (20%) were classified as "diffuse" and 39 cases (80%) were classified as "classic". However, in 3 cases largely featuring a diffuse pattern, we also noted some areas of the classic type. These two subgroups showed no significant differences in patient sex and age, the incidence of macrocysts, the surgical technique used, the eventual x-ray therapy, and the long term functional results (P greater than 0.05). When we studied recurrent tumors that were reoperated on, we did not find any case showing histologically the "diffuse" pattern. To conclude, we cannot agree with the pessimism about the ominous long term prognosis of the diffuse cerebellar astrocytoma. In our opinion, the so called diffuse cerebellar astrocytoma does not exist as a separate clinicopathological entity. PMID- 6483146 TI - Adenosine triphosphate-induced arterial hypotension in the dog. AB - This study was designed to investigate the potential use of adenosine triphosphate (ATP), a naturally occurring vasodilator, for producing profound intraoperative hypotension. Six mongrel dogs were anesthetized with morphine, nitrous oxide, and oxygen, paralyzed with pancuronium, and ventilated to a PaCO2 of 40. The mean arterial pressure was lowered to 40 mm Hg with an intravenous infusion of ATP (10.6 +/- 3.5 (SE) mg/kg/minute). Blood flow was determined using the radioactive microsphere technique. Measurements were made before and 20, 40, and 60 minutes after the induction of hypotension and after a 40-minute recovery. Infusion of ATP to lower the mean arterial pressure to 40 mm Hg resulted in a reduction of mean arterial pressure of 64% and an increase in heart rate of 11% accompanied by frequent cardiac arrhythmias. However, cardiac output decreased only 8%. Myocardial flow increased 137%, kidney flow decreased 71%, and masseter muscle flow increased 333%. A severe metabolic acidosis developed with a reduction in pH from control values of 7.39 +/- 0.03 to 7.16 +/- 0.03 after 60 minutes of hypotension. The cerebral metabolic rate of oxygen, determined using the oxygen content of the sagittal sinus, was not affected. Cerebral hemisphere blood flow decreased 21%, caudate nucleus flow decreased 31%, and corpus callosum flow decreased 43%. Blood flow to the brain stem and cerebellum was unchanged. Hypotension was readily induced, maintained, and reversed using ATP, without apparent tachyphylaxis. However, the profound metabolic acidosis and cardiac arrhythmias that occurred may be serious contraindications to the use of this agent clinically. PMID- 6483147 TI - Dural arteriovenous malformations and intracranial hemorrhage. AB - Intracranial hemorrhage is seen less frequently with dural than with intraparenchymal arteriovenous malformations (AVMs). We report 6 cases of intracranial hemorrhage among our past 10 patients with dural AVMs. A literature search provided 27 other cases of intracranial hemorrhage from a total of 213 reported dural AVMs. Although hemorrhage was relatively infrequent (7.5%) with dural AVMs located primarily within a major venous sinus, bleeding episodes occurred in 20 of the 39 (51%) cases of malformation outside a major sinus. There was primary leptomeningeal venous drainage in all cases with hemorrhage, and a large variceal dilatation was seen in 14 cases (42%). Dural AVMs located outside a major sinus are uncommon, and they have a propensity for serious intracranial hemorrhage. PMID- 6483148 TI - Radical removal of lipomas of the conus and cauda equina with laser microneurosurgery. AB - Ten patients with ages ranging from 4 weeks to 21 years presented with a subcutaneous lumbosacral mass noted at birth. After spinal high resolution ultrasonography or computed tomography to determine the extent of neural involvement and the length of the tumor mass in the spinal canal, the patients underwent operation. Rectal electromyographic continuous monitoring was used in all for assessment of the S-2 and S-3 function during dissection. Carbon dioxide laser microneurosurgery was used in all operations. Radiating energy was used for the subcutaneous mass removal (40 to 60 W), the intracanalicular dissection (1 to 5 W), and the intraconus dissection (1 to 3 W). A radical removal was obtained in all. Postoperative cerebrospinal fluid fistula occurred in 1 patient and was successfully treated. Wound dehiscence that healed with secondary closure occurred in 2 patients. Would infection that required treatment with systemic antibiotics and topical therapy occurred in 1 patient. Paraplegia occurred in 1 patient. This was the single very significant complication of this series. It was thought to have occurred because of the polymer used to seal the tenuous dura mater at the time of closure. We conclude that, with carbon dioxide laser microneurosurgery, the lipomatous tumors can be removed safely from the neural structures of the conus and cauda. PMID- 6483149 TI - Role of computed tomography in the management of vasospasm after subarachnoid hemorrhage. AB - The role of computed tomography (CT) in the management of vasospasm from subarachnoid hemorrhage was evaluated in 242 consecutive cases with CT performed within 7 days after hemorrhage. Only 20% of these cases did not show a detectable subarachnoid hemorrhage on CT. Subsequent angiograms showed vessel narrowing in 56% of the cases; associated clinical deterioration was noted in 34% of the cases. On later CT, clear ischemic areas were detected in 20% of the cases. A strict correlation between the amount of cisternal blood and the subsequent development of vasospasm was observed: although absent or thin cisternal depositions were rarely associated with vasospasm, consistent or thick depositions were frequently linked to vasospasm (72% of the cases) and to ischemic disturbances (51% of the cases), as well as to clear ischemic areas on later CT (30% of the cases). Regarding the morphology of the cisternal blood collection, the risk of developing vasospasm was at its lowest (42%) for depositions only in the frontal interhemispheric fissure and was at its highest (79%) for depositions in multiple cisterns. The site of cisternal deposition corresponded closely to the area of ischemia on later CT. The persistence of subarachnoid blood more than 72 hours after hemorrhage probably increases the risk of vasospasm, although our data are not conclusive. The definition of a CT scan "at risk" for vasospasm--based on the previous findings--gives practical advantages: proper selection of patients in regard to timing of operation, closer observation and the possibility of prophylactic treatment in patients "at risk," and more adequate evaluation of different therapeutic modalities for vasospasm. With regard to the last point, the incidence of vasospasm was not statistically different between two groups of patients uniformly "at risk": the first group submitted to early operation and the second awaiting operation. PMID- 6483150 TI - Depression of circulating blood volume in patients after subarachnoid hemorrhage: implications for the management of symptomatic vasospasm. AB - The result of 42 blood volume determinations made with autologous red blood cells labeled with chromium-51 are reported. The subjects consisted of 11 control patients and 25 patients with recent subarachnoid hemorrhage (SAH). The mean red blood cell volume (RBCV) and the total blood volume (TBV) for female patients after SAH were significantly lower than corresponding control values (P less than 0.01). No depression of blood volume was found in males as a group. Seventy-two per cent of females had below-normal RBCV and 50% had below-normal TBV. Fifteen patients demonstrated angiographic vasospasm or signs of cerebral ischemia. Only 1 patient with asymptomatic vasospasm had a below-normal RBCV or TBV, whereas 6 of 7 patients with symptomatic vasospasm had a subnormal RBCV or TBV. The mean RBCV and mean TBV for female patients with symptomatic vasospasm were significantly lower than corresponding control values (P less than 0.02) and lower than values for female patients with asymptomatic vasospasm (P less than 0.05). The data suggest that volume status may be the important differential between asymptomatic and symptomatic vasospasm. Delayed ischemic deficits can be expected to develop in patients who have both spasm of the intracranial vessels and decreased TBV. Patients with normal blood volume are far less likely to experience cerebral ischemia, even if vasospasm develops. PMID- 6483151 TI - Reanalysis of central cervical cord injury management. AB - Early investigators indicated that conservative management was superior to operative intervention in the treatment of central cord injuries. Their clinical data suggested that operative treatment, in fact, worsened the condition. Recent experience with this clinical entity, however, indicates that in selected patients operative intervention may be of value in improving the rate and degree of motor recovery. A retrospective study of all individuals admitted to our hospital (Delaware Valley Spinal Cord Injury Center) with central cervical spinal cord injury was done (28 patients). One-half had been treated with medical therapy alone (Group I); the others were treated both medically and surgically (Group II). Medical therapy consisted of intravenous mannitol, dexamethasone, and sodium bicarbonate given during the acute phase of the injury. Both groups were immobilized using either a halo or a Philadelphia collar. Criteria for entry into the surgical group were one or both of the following: (a) failure to improve progressively after an initial period of improvement, with persistent compression of neural tissue visualized on myelography and (b) unacceptable instability of the spinal bony elements. The patients were given neurological scores based on the motor power of the major muscle groups. The stability of the spine was scored using the Panjabi-White scale. The two groups were compared using Student's t test and the two-factor analysis of variance. There was no significant difference in initial neurological scores between the groups. The surgical groups had a higher incidence of instability of the bony elements of the cervical spine, as judged by the Panjabi-White scale.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483152 TI - Postoperative evaluation of extracranial-intracranial arterial bypass by means of ultrasonic quantitative flow measurement and computed mapping of the electroencephalogram. AB - As an objective evaluation of extracranial-intracranial (EC/IC) bypass operation, we studied 10 patients with occlusive cerebrovascular disease after EC/IC bypass operation using ultrasonic quantitative flow measurement (UQFM) and the computed mapping of the electroencephalogram (CME). After the operation, to evaluate the efficacy of the bypass operation, we studied all patients by UQFM and CME before and during compression of the superficial temporal artery (STA). In a control series of cases, the change in common carotid blood flow during STA compression was not statistically significant, and the findings of CME were unchanged during STA compression. In the cases with bypass surgery, reduction of the common carotid blood flow during STA compression was obvious and statistically significant (P less than 0.001). Additionally, in 5 of the 10 cases, the CME findings were aggravated during STA compression. Therefore, in these 5 cases the brain with bypass seems functionally dependent upon the bypass flow. It is suggested that the EC/IC bypass is effective at least in these 5 cases. The UQFM and the CME, which are noninvasive and simple, are very useful for postoperative evaluation of EC/IC bypass grafts from a hemodynamic and functional point of view. PMID- 6483153 TI - Bipolar intimal tacking device. AB - A bipolar electrocoagulating device has been designed to thermally tack arterial intimal flaps to the artery wall. The device was tested on intimal flaps created in the rabbit descending aorta. The vascular segments were tested for patency and the thermal tack points were examined on a scanning electron microscope. The tack points were shown to be of sufficient tensile strength and to have minimal thrombogenicity. PMID- 6483154 TI - Perichiasmal tumors: diagnostic and prognostic features. AB - A review of 49 tumors compressing the intracranial optic nerve, optic chiasm, or optic tract revealed that the majority of patients had symptoms and signs of visual loss predominantly affecting one eye. Seventy-seven per cent of patients had a relative afferent pupillary defect (RAPD), and 96% had a hemianopic defect in at least one eye. All patients had either a RAPD or a hemianopic defect. The junctional pattern of visual field defects was nearly as common (39%) as the classic bitemporal pattern (46%). Many fields contained a mixture of nerve fiber bundle and hemianopic defects; the hemianopias tended to obscure the coexisting nerve fiber bundle defects. Poor preoperative acuity predicted a relatively poor postoperative acuity, but 95% of the patients had 20/40 or better acuity in at least one eye after operation. PMID- 6483155 TI - Comparison of systemic and cerebrovascular effects of isoflurane and halothane. AB - This study was carried out to compare the cerebral and systemic circulatory effect of halothane and isoflurane. Six mongrel dogs were anesthetized with 1.3 minimal alveolar concentration (MAC) (1%) halothane and were compared with six mongrel dogs anesthetized with 1.3 MAC (1.5%) isoflurane. Likewise, 6 dogs anesthetized with 1.7 MAC (1.3%) halothane were compared with 6 dogs anesthetized with 1.7 MAC (2%) isoflurane. Blood flow (using the radioactive microsphere technique) and cardiovascular measurements were obtained 2 hours after the induction of anesthesia and were repeated 5 more times at hourly intervals. The heart rate was similar in all groups of dogs, except that it was significantly lower with 1.7 MAC halothane. The mean arterial pressure was statistically higher with isoflurane at both concentrations than with halothane. The cardiac index was similar in all groups, except with 1.7 MAC isoflurane, when it was higher. At the early measurements, total cerebral blood flow (CBF) was above "normal" levels in all groups. At 1.3 MAC, the total CBF tended to be lower with isoflurane, but did not reach statistically significant levels. Blood flow decreased over time in all groups. The cerebral vascular resistance (CVR) mirrored the changes in blood flow, showing no difference between agents at 1.7 MAC, but the CVR with isoflurane was significantly higher at 1.3 MAC than it was with halothane. Regional cerebral blood flow showed marked differences. Regional flow to the hemispheres and the cortical gray matter showed that isoflurane tended to produce lower blood flow, particularly at the 1.3 MAC concentration. The reverse was true in the posterior fossa structures, with the brain stem and cerebellum showing higher blood flows with isoflurane, particularly at 1.7 MAC. Isoflurane may have several advantages over halothane for neurosurgical procedures. PMID- 6483156 TI - Inexpensive signal averager for evoked potentials based on a small personal computer: a technical note. AB - The authors report their development of a relatively inexpensive signal averager for evoked potentials based on an Apple home computer. PMID- 6483157 TI - Primary intrasellar germinoma in a woman presenting with secondary amenorrhea and hyperprolactinemia. AB - A 32-year-old woman with secondary amenorrhea was found to have an elevated level of serum prolactin, partial diabetes insipidus, and a subtle visual field defect. A primary intrasellar tumor was noted on the computed tomographic scan. Although the tumor had some characteristics of a prolactinoma, transsphenoidal exploration revealed a primary germinoma. The tissue diagnosis led to appropriate treatment with radiotherapy. The tumor regressed, and the patient had a spontaneous pregnancy. Had dopamine agonists been used initially, amelioration of the hyperprolactinemia and delay in the proper diagnosis and treatment would have occurred. PMID- 6483158 TI - Steroids and head trauma. AB - A review of recent experimental and clinical trials on the effect of steroids on the outcome of head-injured patients reveals no statistical benefit in double blind trials. Small subgroups of patients may benefit, but this needs further evaluation. PMID- 6483159 TI - High dose barbiturate therapy in neurosurgery and intensive care. AB - To assess the uses of high dose barbiturate therapy in neurosurgery and intensive care, the authors have undertaken a concise survey of relevant experimental investigations and a comprehensive review of published clinical experiences. PMID- 6483160 TI - Microvascular decompression for tic douloureux. PMID- 6483161 TI - Comments on "Declaration of brain death in neurosurgical and neurological practice". PMID- 6483162 TI - Effects of doxefazepam on normal sleep. An EEG and neuropsychological study. AB - The effects on sleep of a putative hypnotic, benzodiazepine (doxefazepam), were studied in 7 healthy volunteers. Subjects were administered placebo or the active compound at 10-, 20-, and 40-mg oral dose prior to 13 consecutive nights during which they slept in the EEG laboratory. Full-night EEG recordings were obtained, and the hypnogram was determined. The subjective characteristics of sleep (quality, dreams, etc.) were defined by self-administered rating scales; neuropsychological and quantitative waking EEG measurements were performed before drug/placebo administration and in the morning following the final awakening, in order to identify possible signs of 'hangover'. Volunteers thereafter slept at home for 15 nights, self-administering 10 mg doxefazepam each night, and returned to the laboratory for 2 additional full-night sleep recordings. The drug plasma concentration was monitored during the study. Doxefazepam (10 mg) reduced the number of intermediate awakenings and the shifts between distinct sleep phases; single 20- or 40-mg doses or a 2-week administration of 10 mg doxefazepam increased significantly the total sleep duration and the percent duration of the phase 2 and the synchronized sleep and decreased the percent duration of phase 1 and of the intermediate awakenings. Volunteers reported an improvement in the subjective 'quality' of sleep, while evident signs of 'hangover' were not observed. The compound appeared to be of potential use as a sleep regulator. PMID- 6483163 TI - Psychiatric assessment of children. I. Diagnostic method. AB - An account is given of a diagnostic method which appears to be little known in child psychiatry. It is based on observable deviations in facial expression and motor functions. In the author's opinion it helps to distinguish depressions of different origin as well as symptoms suggesting mild brain lesions. PMID- 6483164 TI - Psychiatric assessment of children. II. Comparison with mothers. AB - An attempt is made to demonstrate the relevance of a diagnostic method described in a preceding paper by comparing observations in 95 children aged 7-8 with independent findings in their mothers. The mothers had been chosen at random and exhaustively studied by another team at the time of the pregnancies which resulted in the birth of the children of our study. PMID- 6483165 TI - Effects of clomipramine infusion on sleep in depressed patients. AB - Sleep structure of 10 endogenous depressed patients was investigated before and after clomipramine treatment. Clomipramine significantly reduced REM time, increased REM latency and induced dissociation between the tonic and phasic events of REM sleep, without affecting any of the other sleep parameters. The REM suppressing effect was most prominent on the third night after beginning treatment. PMID- 6483166 TI - Cerebral function in hyperthyroid patients. Psychopathology, psychometric variables, central arousal and time perception before and after thyreostatic therapy. AB - Psychopathology, psychometric variables, central arousal and time experience were studied in 30 hyperthyroid female outpatients. While these patients could be significantly discriminated in several of the above-described measures during the acute state of the disease, the intergroup differences disappeared after thyreostatic therapy. The thyroxine level was correlated with elevated beta activity and the latter with variables of psychopathology and time experience. Hormonal dysbalance in hyperthyroidism is discussed as a biological substrate for neurophysiological changes which in turn causes deterioration in mood and behavior. PMID- 6483167 TI - Effect of naloxone on dopamine uptake and release in vitro in the striatum. AB - The opiate antagonist naloxone (NX) can inhibit the stereotyped behavior elicited by the directly acting dopamine (DA) agonist apomorphine, while potentiating the same behavior induced by amphetamine, an indirect DA agonist. Since NX does not appear to bind to striatal 3H-DA receptors, these effects may be mediated by an indirect action exerted by naloxone on the nigrostriatal pathway. To confirm this, the effect of NX on DA uptake in striatal homogenates was assessed in vitro, and also the effect of NX on DA release in both striatal synaptosomes and slices. While NX had no effect on its own in either of these preparations, it was able to significantly enhance the release of DA induced by d-amphetamine. Since NX has no effect by itself on either behavior or DA release, it appears that NX can exert an active effect on the release of striatal DA only if the nigrostriatal pathway is in a state of arousal (e.g. by amphetamine). PMID- 6483168 TI - Visual hemi-inattention after ventrolateral thalamotomy. AB - Ten patients undergoing left ventrolateral thalamotomy (LVLT) and 11 patients undergoing right ventrolateral thalamotomy (RVLT) for Parkinsonian or essential tremor performed a test of visual searching for parallel lines before and after surgery. On average RVLT caused impairment of searching only on the left side. LVLT affected searching on both sides, with the impairment being slightly more marked on the right side, The tendency to initiate searching from the side ipsilateral to the lesion increased after VLT. The results indicated that unilateral VLT caused hemi-inattention in visual searching, which deficit is possibly related to the transient motor neglect usually observed in the extremities contralateral to VLT. PMID- 6483169 TI - Hemispheric asymmetry in use of semantic category information. AB - When two pictures of common objects were presented sequentially, the second was named more quickly if both were members of the same semantic category. This semantic priming effect occurred only when both pictures went directly to the left hemisphere. If the target or prime stimulus was presented to the left visual field--right hemisphere, no priming effect was observed. These results suggest that semantic category information is activated and used by the left hemisphere of the brain. PMID- 6483170 TI - Event-related potentials and the phonological processing of words and non-words. AB - Event-related potentials (ERPs) were recorded during a task which required subjects to discriminate between rhyming and non-rhyming visually presented pairs of letter strings, consisting of equal proportions of word-word and word-non-word combinations. Pair members were presented sequentially with an interstimulus interval of 1.56 sec. As in a previous study [Rugg, M. D., Brain Lang. In press], ERPs elicited by rhyming and non-rhyming words were differentiated by a late negative component (N450) in waveforms following the non-rhyming words. This effect was greatest over the midline and the right hemisphere. The same rhyme/non rhyme difference was also observed, to an equal extent, in ERPs elicited by non words. It is concluded that N450, presumed to be related to the "N400" component observed under conditions of semantic incongruity [Kutas, M. and Hillyard, S.A., Science 207, 203-205, 1980] does not seem to depend on linguistic processing at the semantic level for its modulation. PMID- 6483171 TI - Global versus local processing: is there a hemispheric dichotomy? AB - A major dichotomy proposed for lateralized information processing is that the right and left cerebral hemispheres are "global" and "analytic" processors respectively. Here three experiments employed a tachistoscopic recognition paradigm with letter patterns varying in size and composition. No visual field asymmetries in RT were found in the first two experiments, although statistical power was high and a Stroop-like effect ("global precedence") was supported. Experiment 3 resulted in a right field advantage for vocal naming responses yet no asymmetry for manual responses, suggesting that both hemispheres can recognize global and local patterns, but that introduction of a laterally controlled response independently determines asymmetry. PMID- 6483172 TI - Autonomic recognition of names and faces in prosopagnosia: a neuropsychological application of the Guilty Knowledge Test. AB - A prosopagnosic was shown two sets of faces, one comprised of famous personalities, the other of family members. After he was allowed to visually inspect each face, he was given five names, one of which was correct. Skin conductance was continuously recorded. He could not identify any of the faces spontaneously, and performed at chance level when given multiple choice names. However, electrodermal responses indicated far more accurate discrimination between correct and incorrect names, suggesting that the patient "recognized" facial identity at the psychophysiological level. Neuropsychological mechanisms for this phenomenon, which in this case involve multiple visual-limbic interrelationships, are postulated. The method appears useful for studying islands of spared recognition ability in associative agnosia. PMID- 6483173 TI - Relationship between changes in hemispheric advantage during familiarization to faces and proficiency in facial recognition. AB - Female college students were given a task involving the recognition of initially unfamiliar faces which were tachistoscopically presented to one or the other visual field. Subjects who showed a left visual field advantage made fewer errors than those who showed a right visual field advantage both at the very beginning of the task, when the faces were totally unfamiliar, and at the end of the task, when the faces were relatively familiar; however, during intermediate phases of familiarization, there was no difference in number of errors between subjects with right and left visual field advantages. The results support our previously proposed view that there are shifts in the processing of facial information, beginning with a relatively undifferentiated holistic type of right hemisphere processing, progressing to an analytic mode of left hemisphere processing and culminating in a mode of right hemisphere processing in which distinctive features are incorporated into an articulated whole. The results further suggest that the direction of hemispheric advantage shown at different periods in the course of familiarization is related to level of proficiency. PMID- 6483174 TI - Right hemisphere interference during negative affect: a reaction time study. AB - Two experiments are described in which simple reaction times (RTs) to lateralized visual stimuli were measured in normal subjects during negative affect and during recollection of everyday life scenes. In both experiments the mental activity produced a remarkable increase of RTs with respect to a control situation without interfering activity. During production of the negative affect there was a selective lengthening of RTs mediated by the right hemisphere. The role of the right hemisphere in producing emotions is discussed. PMID- 6483175 TI - Differential cerebral speech lateralization in Crow Indian and Anglo children. AB - Sixty pairs of dichotically presented CV syllables were administered to matched samples of bilingual Native American Crow and monolingual Anglo subjects. While sex and grade were not significant factors, a significant variance was found between the performance of the bilingual Native American Crow and the monolingual Anglo subjects. As predicted (1) the bilingual children demonstrated a more symmetrical cerebral representation for language processing than the monolingual children; and (2) the bilingual primary Crow speakers had a greater right hemisphere involvement in receptive language processing than the monolingual English speakers. Possible factors influencing these results are discussed. PMID- 6483176 TI - The effect of familial sinistrality on perceptual learning. AB - Perceptual learning as measured by adaptation to prismatically displaced vision was contrasted in groups of familial sinistral (FS) and familial dextral (FD), strongly right-handed adult females. The FS group exhibited significantly larger target pointing and eye positioning adjustments than the FD group. Further, only the FS group showed transfer of training from the hand used during prism viewing to the unobserved one. PMID- 6483177 TI - Sex differences in lateralization in the domestic chick. AB - Age-related changes over the first 8 days of life in the intensity of fear response which is evoked in domestic chicks by a standard visual stimulus follow the same course in male chicks using the right eye and in female chicks using the right or left eye. Changes in left-eyed male chicks follow an entirely different course. Tests involving visual discrimination and habituation confirm the specialization of the (right-sided) neural structures fed by the left eye in males. This pattern of sex difference is formally comparable with the specialization of the right hemisphere in boys described by Witelson (Science 193, 425-427, 1976). PMID- 6483178 TI - Pathological left-handedness and ambiguous handedness: a new explanatory model. AB - A new model is presented which attempts to explain three pathological handedness phenotypes: pathological left-handedness (PLH), pathological right-handedness (PRH) and ambiguous handedness (AH). Revisions in the original model of PLH were prompted in order to account for reports of a raised incidence of both manifest left-handedness and AH in more severely retarded and/or brain-injured populations -namely, autistic. The new model generates specific predictions on the likelihood of different etiological subgroups within these disorders. PMID- 6483179 TI - Interaction between lateralization of memory and probe stimulus in the recognition of verbal and spatial visual stimuli. AB - The aim of the study was to sort out whether in normal subjects hemispheric asymmetries in memory encoding arise at the input or at the recognition stage of verbal (diagrams of letters) and spatial patterns (diagrams of stars) in a 3 X 3 virtual matrix. Target and probe stimuli were tachistoscopically presented to the same or the opposite hemisphere. Letters, but not stars, were better recognized in a crossed condition in which targets were flashed to the right and probes to the left hemisphere. The finding suggests that the right hemisphere (but not the left) is capable of adding specific, possibly mnestic, resources to the first stage of letter processing. PMID- 6483180 TI - Hemispheric specialization for language in the congenitally blind: the influence of the Braille system. AB - The functional cerebral organization of two groups of congenitally blind persons of different age and schooling was studied by testing their dichotic listening to pairs of digits. The younger congenitally blind group showed a comparable level of performance to their control counterparts; however, older subjects shifted their initial right ear advantage to an increased left ear performance as they progressed in the mastery of the Braille system. As this system is founded on spatial strategies, we can conclude that this shift is related to the activation of some right hemispheric linguistic mechanisms. PMID- 6483181 TI - Interhemispheric differences in same versus different judgments upon presentation of complex visual stimuli. AB - An experiment is reported which was aimed at investigating interhemispheric differences upon tachistoscopic presentation of Same vs Different stimuli, i.e. pairs of 16-side Vanderplas and Garvin figures selected for their complexity, unfamiliarity and lack of verbalization. The right hemisphere was found to be faster and more accurate in Same judgements and the left hemisphere in Different judgements. These findings seem to further confirm the assumption that the right hemisphere would mostly use a holistic strategy and the left hemisphere an analytic strategy. PMID- 6483182 TI - Differences in face touching by Japanese and British people. AB - The face touching behavior of Japanese and British subjects was compared under three different conditions, viz. listening to a lecture, listening to music and without a specially assigned task. The results showed that (1) British people did more frequent face touching than Japanese people and left hand usage was more prominent, while the Japanese did not show a hand difference in either the lecture listening or the no-task condition, (2) the duration of face touching did not differ between Japanese and British and (3) British people touched their chin and mouth frequently while Japanese touched their nose and eyes frequently. From these results the hypothesis of cross-cultural difference of cerebral functioning between the Japanese and the British was examined. PMID- 6483183 TI - Writing postures in left-handers: inverters are hand-crossers. AB - A behavioural approach shows that the inverted hand-writing posture typical of many left-handers is one element of a well-patterned bimanual strategy including (i) counterclockwise rotation of the page; (ii) horizontal orientation of the active forearm on the page; and (iii) positioning of the non-writing hand just below the beginning of the line of writing. The strategy as a whole is liable to represent an adaptation to the necessity of writing with an adduction movement, rather than the symptom of any neurological particularity. PMID- 6483184 TI - Failure to replicate the Scott et al. finding of reversed ear dominance in the Native American Navajo. AB - The apparent universality of left hemisphere language specialization in neurologically normal right-handed persons has been questioned by Scott et al. (Neuropsychologia 17, 89-92, 1979). They found that Native American Navajos had a significant left ear advantage on the dichotic C-V task, while Anglo Ss had a right ear advantage. We attempted to replicate this finding with essentially the same task, more Ss and four times as many trials. Results showed a very clear right ear advantage in Navajos. While we had previously questioned the Scott et al. conclusion on the basis of visual laterality test findings, present results directly contradict those of Scott et al. PMID- 6483185 TI - Cortico-visceral interrelationships during periodic activity of the stomach. AB - In chronic experiments on five dogs with stomach fistulas and bipolar electrodes (6-8 pairs) symmetrically implanted in the cranial bones we recorded simultaneously the activity of the stomach balloonographically and the electroencephalogram using the Nikhon Koden encephalograph with automatic analysis of the frequency spectrum within five ranges: 2-4, 4-8, 8-12, 12-20, and 20-30 oscill/sec. The correlation between the frequency spectrum of the EEG and the phases of periodic activity (PA) cycles of the stomach in the form of a regular shift in the predominance of fast (during contraction periods) or slow (during resting periods) components and its changes under the influence of atropine and food stimulants have been described. The EEG complexes typical of periods of contraction or resting are regarded as cortical correlates of the PA under conditions of good adaptation of the animals to the experimental situation. The changes in the correlation under conditions of actions used indicate a firmer association between the PA EEG correlates with other components of the PA rather than with the motor function of the stomach. PMID- 6483186 TI - Participation of emotional structures of the brain in the regulation of gastric secretory function. AB - The influence of the self-stimulation (SS) positive-reinforcement zones of the brain on the secretion of gastric juice was investigated using eight adult dogs with gastric fistulas. An intracerebral-S3 instrumental response was developed after implanting concentric (bipolar) electrodes into various zones of the reward system (hypothalamus, mammillary bodies, ventral thalamic nucleus, commissura grisea media, internal capsule, nucleus of the stria terminalis, and the crus cerebri). A normal acidity of the stomach contents was found in five dogs after surgery during the interdigestive period and a sharply elevated acidity in three dogs. A large quantity of thick foamy mucus and a turbid juice was secreted 3-5 min after the onset of SS. Self-stimulation did not alter the pH of the stomach contents in dogs with an initially normal pH, while it normalized this parameter in dogs with an initially elevated acidity. Bilateral supradiaphragmatic vagotomy in the animals of the latter group shifted the pH in the alkaline direction; however, the pH was completely normalized only as a result of intracerebral SS. Thus, positive emotional excitation associated with the stimulation of various reward zones normalized the acidity of the stomach contents; moreover, this response was not associated with the efferent systems of the vagus nerves. PMID- 6483188 TI - Quantitative light microscopic autoradiographic localization of cholinergic muscarinic receptors in the human brain: brainstem. AB - We have investigated the localization of muscarinic cholinergic receptors in the brainstem of eight patients free of neurological disease following quantitative autoradiography of microtome sections of postmortem tissue labeled in vitro with N-[3H]methyl scopolamine as a ligand. Receptor densities were quantified by microdensitometry with the aid of a computer assisted image analysis system. Our results reveal a heterogeneous distribution of receptor sites. High concentrations of muscarinic cholinergic receptor sites were associated with many nuclei and areas of the brainstem including the nucleus facialis (VII), hypoglossus (XII), ambiguus, the motor trigeminal nucleus (V), the nucleus solitarius, the nucleus of the lateral lemniscus, the superior and inferior colliculi, the sensory trigeminal nucleus (substantia gelatinosa), the pontine nuclei, the parabrachial nuclei, some tegmental nuclei and the periaqueductal gray matter. Very high concentrations of N-[3H]methyl scopolamine binding sites were also localized in the ventral tegmental area, the nucleus paranigralis and the nucleus ovalis. Receptor densities varied between individual brains although the relative distribution of the densities in the different nuclei was the same for all of the brains examined. Most of the brainstem nuclei containing muscarinic cholinergic receptors were enriched in high affinity agonist binding sites as shown by characteristic displacement of the ligand with carbachol. Exceptions were the substantia nigra, the nucleus olivaris inferior and the substantia gelatinosa of the fifth nerve. Receptor density values and pharmacological characteristics obtained in the cortex and basal ganglia in our cases are in good agreement with previously reported values in humans, using conventional biochemical methods. This indicates that procedures used in the autoradiographic technique are not detrimental to the pharmacological characteristics and densities of muscarinic cholinergic receptors. Our results thus clearly show the feasibility of using these techniques for the localization and quantification of muscarinic cholinergic receptors in human brain postmortem material. Furthermore, our findings indicate the potential involvement of the muscarinic cholinergic effect of acetylcholine in the normal function of many brainstem centers, including motor and sensory nuclei, visual and auditory relay nuclei and cardiovascular and respiratory-related nuclei. PMID- 6483187 TI - Effects of enkephalins and their analogs on gastric secretion. AB - The effects of enkephalin analogs on gastric secretion were studied. It was found that gastric secretion stimulated by histamine was significantly increased under the influence of the enkephalin analog Tyr-D-Ala-Gly-Phe-(NO2)NH2. The enkephalin analog Tyr-Gly-Gly-Phe-Leu-D-Arg increased the amount of gastric juice and the secretion of pepsin, but the hydrochloric acid debit was lower than in experiments with perfusion of histamine alone. Another enkephalin analog, Tyr-D Ala-Gly-Phe-D-Leu-Arg, introduced simultaneously with histamine, significantly lowered the secretion of gastric juice only 90-105 min after the beginning of perfusion. PMID- 6483190 TI - Development of synapses on pyramidal and multipolar non-pyramidal neurons in the visual cortex of rabbits. A combined Golgi-electron microscope study. AB - A combined Golgi-electron microscope method was used to study the ultrastructural maturation of synapses on identified pyramidal and multipolar non-pyramidal neurons in the visual cortex of young and adult rabbits. In samples of 10 (time of eye opening), 14, 20 day old and 7 month old animals, fully impregnated pyramidal neurons within the layers II-V and multipolar non-pyramidal neurons mainly located in lower layer III and layer IV was studied. We found that synapses in 10 and 14 day old animals were occasionally immature in appearance. They were characterized by either a poorly defined postsynaptic band or equal rims of pre- and postsynaptic electron-dense material and could therefore not be classified as Gray type I or II. The distinction between both types of synapses was easier at day 20 and in the adults when the postsynaptic band of the asymmetrical (type I) synapses had become remarkably thicker. In pyramidal neurons the cytoplasmic organelles increased in number during development. Although a few symmetrical synapses were present on dendritic spines of pyramidal neurons in 14 and 20 day old animals, all pyramidal neurons exhibited the same types of synapses on specific sites of their neuronal surface. They received exclusively type II synapses on their somata, type I synapses on their dendritic spines and both types of synapses on their dendritic shafts. However, in the adult animals the frequency of occurrence of type II synapses, especially on basal dendritic shafts, had increased. In some cases only type II and no type I synapses were present. A striking finding in all young and adult animals was that synapses at the borderline between somata and apical dendritic shafts as well as on dendritic spines were frequently complex or interrupted. The characteristic ultrastructural features of adult spine-free and sparsely spiny multipolar non pyramidal neurons e.g. the many cytoplasmic organelles and type I and II synapses on somata and on dendrites were already present at day 10. After day 10 the number of organelles and synapses increased prominently and in adult animals the different types of synapses on dendrites were located at relatively short intervals of about 4 microns. In contrast with the dendritic shafts of pyramidal neurons many asymmetrical synapses were observed on dendritic shafts of the non pyramidal neurons analysed in the adult animals. Furthermore, it appeared that the number of synapses on these non-pyramidal neurons is about twice that on pyramidal neurons in day 20 old animals and about four times in adult animals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6483189 TI - Binocular interaction in the fetal cat regulates the size of the ganglion cell population. AB - During fetal development of the cat's visual system there is a marked overproliferation of optic nerve axons. In utero binocular interaction contributes to the severity of fiber loss since removal of an eye during gestation attenuates axon loss in the remaining optic nerve. The purpose of the present study was to determine whether this reduced loss of optic nerve fibers is due to a failure of retraction by supernumerary axon branches or to a reduction in ganglion cell death. To resolve this issue, we compared the number of ganglion cells and optic nerve fibers in adult cats which had one eye removed at known gestational ages. Retinal ganglion cells were backfilled with horseradish peroxidase and counts were made from retinal wholemounts. The axon complement was assessed with an electron microscopic assay. In the retinas of a normal cat we estimated 151,000 and 152,000 ganglion cells. The optic nerves of two other normal cats contained approximately 158,000 and 159,000 axons. In comparison, an animal enucleated on embryonic day 42 had 180,000 ganglion cells and 178,000 optic nerve fibers, while in an animal enucleated on embryonic day 51 the corresponding estimates were 182,000 and 190,000. The close agreement between cell and fiber counts indicates that axonal bifurcation does not contribute appreciably to the axon surplus in the optic nerve of prenatally enucleated cats. These results demonstrate that prenatal binocular interaction regulates the size of the mature retinal ganglion cell population. PMID- 6483191 TI - Synaptic characteristics of identified pyramidal and multipolar non-pyramidal neurons in the visual cortex of young and adult rabbits. A quantitative Golgi electron microscope study. AB - The visual cortex of 20 day old rats and rabbits has been considered as mature on the basis of the observations that the dendritic arborization and the overall synaptic population have almost reached their adult stage in these animals. In the present study we have investigated the visual cortex of 20 day and 7 month old (adult) rabbits in order to determine whether this apparent adult appearance also holds for the synaptic organization of individual neurons. Neurons mainly located in layers III and IV of the primary visual cortex (area 17) were Golgi impregnated, gold toned and deimpregnated and were then, after embedding in plastic, sectioned serially. The number and length of synaptic profiles, and the length of the neuronal boundaries were analysed in every tenth section. From these counts and measurements the size distribution of the synaptic discs, the number of synapses per 100 micron2 neuronal surface and the receptive surface expressed as the percentage of the total neuronal surface covered with synaptic contacts were estimated using stereological methods. At both ages studied, the density of synapses was significantly higher for the non-pyramidal neurons than for the pyramidal neurons. Differences in the amount of receptive surface were parallel to the differences observed for the number of synapses per 100 micron2. At day 20 the receptive surface of the non-pyramidal neurons was significantly larger than that of the pyramidal neurons. The receptive surface of the non pyramidal neurons in the adult stage was not only larger than that of the pyramidal neurons in the adults, but also larger than that of the day 20 non pyramidal neurons. From our results the following conclusions can be drawn: (1) The synaptic input received by the pyramidal neurons is mainly established at day 20 of postnatal life, i.e. prior to the establishment of adult visual behaviour. (2) The non-pyramidal neurons complete their maturation in a later stage than the pyramidal neurons. (3) Medium to large sized synaptic contacts are newly formed after day 20 and are mainly added to the synaptic population on dendrites of non pyramidal neurons. (4) The specific increase in the number of synapses on non pyramidal neurons is discussed in relation to intracortical inhibition which is thought to be important for the fine regulation of visual function during development. PMID- 6483192 TI - Localization and organization of geniculocortical and corticofugal fiber tracts within the subcortical white matter. AB - Reciprocal connections are formed between the dorsal lateral geniculate nucleus and the striate cortex in the mammalian visual system. The question of whether fibers of these corticopetal and corticofugal pathways are segregated or intermingled within the white matter is still open. In order to examine the organization of these fiber tracts within the white matter, we have used orthograde axonal transport of radiolabelled proteins and neuronal degeneration following kainic acid lesions in the geniculocortical and corticofugal pathways of the rat. Within the white matter the two pathways reside in different layers and are segregated from one another over a significant portion of their course, geniculocortical fibers lying in the external sagittal stratum and corticofugal fibers lying in the internal sagittal stratum of the white matter. In addition, the corticofugal pathways projecting to subcortical structures appear fasciculated in both the transport and the degeneration studies suggesting that axons of cortical output neurons are organized into fiber bundles. The separation of fibers within the white matter may be of potential use for selectively stimulating afferent and efferent pathways in electrophysiological studies in situ and in cortical slice preparations. In addition, the corticofugal fiber bundles may play an important role in guiding axons therein to appropriate targets during axonogeneis and may carry the output of columnar units within visual cortex. PMID- 6483193 TI - Retinal ganglion cells that project to the dorsal lateral geniculate nucleus in the macaque monkey. AB - Horseradish peroxidase was deposited in the optic nerve to retrogradely label and reveal the dendritic form of all classes of ganglion cell, or it was injected into the dorsal lateral geniculate nucleus to reveal only those classes projecting to the thalamus. The results were compared with those of the accompanying paper in which the ganglion cells projecting to the midbrain are selectively revealed. Two major classes of ganglion cells are described, the P alpha and P beta cells. For both classes dendritic field size increases with eccentricity from the fovea and there is no overlap in the two classes at any given eccentricity. Cell body size shows a similar mean difference but with a slight overlap. Both cell bodies and dendritic fields are larger along the temporal horizontal meridian than the nasal horizontal meridian, for P alpha and for P beta cells, but these differences are reduced when naso-temporal differences in ganglion cell density are taken into account, that is, size correlates closely with density. Injections restricted to the parvocellular layers of the lateral geniculate nucleus labelled almost exclusively P beta cells, whereas injections confined to the magnocellular layers labelled almost exclusively P alpha cells. As midbrain injections label no P beta cells and few P alpha cells it can be shown that about 80% of ganglion cells are P beta cells projecting to parvocellular lateral geniculate nucleus, and that about 10% are P alpha cells projecting to magnocellular layers. The coverage factor, that is the number of cells covering each point on the retina, varied from 1.9-2.3 for P beta cells, and from 2-7 for P alpha cells. Comparing the results with those of comparable investigations on cats and rabbits shows a much clearer segregation of the terminal targets of different classes of ganglion cell in monkeys, the greatest difference being the absence in the monkey of a projection to the geniculate from gamma- and epsilon-like cells. Further, axons which branch and innervate both thalamus and midbrain are rare in monkeys but common in other mammals. Comparing the results with those from physiological investigations suggests that the P beta cells correspond to colour-opponent cells, whereas P alpha cells correspond to the achromatic broad-band magnocellular cells. PMID- 6483194 TI - Retinal ganglion cells that project to the superior colliculus and pretectum in the macaque monkey. AB - Horseradish peroxidase was injected into the superior colliculus or pretectum or both in order to label, by retrograde axoplasmic transport, the retinal ganglion whose cells axons innervate the dorsal midbrain. The dendrites of ganglion cells were sufficiently well-labelled to reveal their overall morphological characteristics. It was therefore possible to compare the number and form of ganglion cells projecting to the midbrain with the total population of ganglion cells as revealed by optic nerve injections, and with ganglion cells labelled by injections in the lateral geniculate nucleus. We found that not more than 10% of all retinal ganglion cells project to the superior colliculus in the macaque monkey. This percentage varies little over the retina, being about 6% of all ganglion cells near the fovea and increasing slightly with eccentricity. The superior colliculus does not receive a projection from P beta cells and only a few P alpha cells terminate there. The majority of cells which project to the superior colliculus have a small- to medium-sized cell body and sparsely branched dendritic tree. We have called them P gamma and P epsilon cells by analogy with the gamma cells and epsilon cells in the cat's retina. Anatomically the P gamma and P epsilon cells are heterogeneous, which would be consistent with the physiological heterogeneity found for ganglion cells which project to the midbrain in monkeys. PMID- 6483196 TI - Ascending and descending internuclear connections of the trigeminal sensory nuclei in the cat. A study with the retrograde and anterograde horseradish peroxidase technique. AB - The distribution of cells of origin of ascending and descending internuclear connections in the trigeminal sensory nuclei was studied by the retrograde horseradish peroxidase technique in the cat. The termination of collaterals of these ascending axons was also studied by the anterograde transport of horseradish peroxidase. Following injections of horseradish peroxidase into the ventral part of the principal sensory nucleus and the adjacent reticular formation many small neurons were labeled ipsilaterally in the whole area of the caudal portion of the nucleus interpolaris and in laminae III and IV of the nucleus caudalis. Labeled neurons were also found in laminae I and V. Injections limited to either nucleus oralis, the ventral part of the principal sensory nucleus and the medial parabrachial nucleus labeled similar types of neurons in the above regions with a topographic relationship; neurons in the dorsal part of the nuclei caudalis and interpolaris project, dorsally, to rostral portions of the trigeminal sensory nuclei while those in the ventral part of the nuclei caudalis and interpolaris project ventrally. Anterograde labeling of axons arising from the nucleus caudalis demonstrates that the axons ascend in the intranuclear bundles and the adjacent reticular formation, and give off collaterals to the nuclei interpolaris and oralis, and the ventral part of the principal sensory nucleus. Injections limited to the nucleus caudalis labeled small neurons in the rostral portion of the nucleus oralis and the caudal portion of the nucleus interpolaris. The present study suggests that these ascending and descending internuclear connections of the trigeminal sensory nuclei may modulate transmission of afferent inputs to various projection sites, such as thalamus, superior colliculus, cerebellum and spinal cord. PMID- 6483195 TI - Effects of veratridine, tetrodotoxin and other drugs that alter electrical behaviour on secretion of melanocyte-stimulating hormone from melanotrophs of the pituitary pars intermedia. AB - Since melanotrophs are electrically active and exhibit spontaneous Na spikes, a study was made of the effects, on melanotroph secretion, of drugs known to influence electrical properties. The output of melanocyte-stimulating hormone was measured from perifused neurointermediate lobes of mice or melanotrophs dispersed from such lobes of mice or rats. Veratridine (200 microM), which is known to increase Na permeability in a variety of cells, caused a large, although transient, increase in secretion from the melanotrophs that required extracellular Ca2+ and was blocked by the Na-channel blocker tetrodotoxin (1 microM). Tetraethylammonium (10 mM), which blocks K channels and thus prolongs the duration of the action potential in many cells, also stimulated secretion in the melanotrophs in a Ca-dependent manner. This response was not, however, blocked by tetrodotoxin, and is thus not attributable to prolongation of Na spikes in these cells. Moreover, tetrodotoxin did not inhibit basal secretion. The stimulant effect of veratridine on secretion in melanotrophs and its suppression by tetrodotoxin suggests that voltage-dependent Na channels can participate in the regulation of hormone output in these cells of the pituitary pars intermedia. However, the apparent lack of effect of tetrodotoxin on basal secretion suggests that the spontaneous Na spikes previously observed in these cells are not required for promoting the Ca influx which other evidence shows is important for basal secretion. PMID- 6483197 TI - [The level of ammonia and its metabolites in the brain in experimental hepatic encephalopathy induced by long-term administration of thioacetamine and during recovery]. PMID- 6483198 TI - Electron microscopy of hepatogenic encephalopathy in rats induced by thioacetamide intoxication. PMID- 6483199 TI - [Gamma-aminobutyric acid (GABA) metabolism in the rat brain in experimental hepatic encephalopathy induced by carbon tetrachloride]. PMID- 6483200 TI - [Myelin pathology in the pt rabbit]. PMID- 6483201 TI - [Malignant schwannoma in children. Pathomorphology and clinical epicrisis]. PMID- 6483202 TI - [Hurthle cell carcinoma of the thyroid gland with metastases to the central nervous system]. PMID- 6483203 TI - Acetylcholinesterase activity in rat brain after exposure of the animals to raised temperature of the environment. PMID- 6483204 TI - Ultrastructural alterations of the grey matter structures of the brain due to experimental manganese intoxication. PMID- 6483205 TI - The effect of manganese on the ultrastructure of pituicytes in vitro. PMID- 6483206 TI - [Chronic pancreatitis. Modern surgical views. Clinical contribution]. PMID- 6483207 TI - [Ileo-anal canal-ano-stomy. Cases of four school and recent modifications]. PMID- 6483208 TI - [Carcinoma of the male breast]. PMID- 6483209 TI - [Proposal of a diagnostic protocol for gastric lymphoma]. PMID- 6483210 TI - [Cancer of the surgically treated stomach. Etiopathogenetic and clinical considerations]. PMID- 6483211 TI - [Microvascularized scapular skin flap for covering a continuous lesion of the scalp]. PMID- 6483212 TI - [Spontaneous rupture of the esophagus. A case treated late with success by protecting the suture with dehydrated dura mater. Description of a personal technic]. PMID- 6483213 TI - [Primary lymphoma of the stomach. Review of the literature and presentation of a clinical case]. PMID- 6483214 TI - [Intestinal duplication in the adult]. PMID- 6483216 TI - [Repair of benign stenosis of the juxta-cardial esophagus with a pedunculated gastric "patch" graft. Experimental study]. PMID- 6483215 TI - [Esophageal leiomyomas. Review of the literature and case records from our institute]. PMID- 6483217 TI - [Control of reflux esophagitis in gastroresected patients. Medical treatment with alginic acid]. PMID- 6483218 TI - [Disseminated familial rectocolic adenomatous polyposis]. PMID- 6483219 TI - [Curve of plasma disappearance of bromosulfophthalein after a single injection. Control of cirrhosis patients after elective portosystemic derivation]. PMID- 6483220 TI - [Index of multifactorial risk in adult subjects subjected to surgical intervention]. PMID- 6483221 TI - [Gunshot wounds]. PMID- 6483222 TI - [Apparently solitary plasmacytoma of the thorax]. PMID- 6483223 TI - [Considerations apropos of 2 cases of primary adenocarcinoma of the duodenum]. PMID- 6483224 TI - [A case of malignant melanoma of apparently primary duodenal localization]. PMID- 6483225 TI - [Surgical treatment of chronic calcified pancreatitis]. PMID- 6483226 TI - [Liver resection in primary gallbladder cancer]. PMID- 6483227 TI - [Anuloplasty in the correction of functional tricuspid insufficiency]. PMID- 6483228 TI - [Ligation of the hepatic artery. Elective and emergency procedures]. PMID- 6483229 TI - [Cold thyroid nodules]. PMID- 6483230 TI - [The importance of the type of surgical exeresis on survival in breast cancer. Possibility of polychemotherapy]. PMID- 6483231 TI - [Early gastric cancer. Clinical contribution]. PMID- 6483232 TI - [Tumors of the retroperitoneal space]. PMID- 6483233 TI - [Abdominal hernias in patients undergoing continuous ambulatory peritoneal dialysis]. PMID- 6483234 TI - [Aorto-mesenteric compression. Presentation of a clinical case treated by intestinal derotation. Review of the literature]. PMID- 6483235 TI - [Acute volvulus of the cecum. A rare case of occlusion in a young patient]. PMID- 6483236 TI - [Ambulatory treatment of obesity with modified fasting (Modifast)]. AB - 52 obese subjects, 17 to 65 years old, 42.5 +/- 23.37 percent mean body weight excess, were treated with a very low-calorie diet (1020 KJ = 240 Kcal/day), containing whole egg protein (g 33), disaccharides (g 25.5), vitamins and minerals (Modifast). The diet was well tolerated by all subjects, without important side effects, and the following significant mean weight losses were registered: -kg 3.4 +/- 1.1 after 1 week (52 subjects); -kg 5.4 +/- 1.4 after 2 weeks (38 subjects); -kg 8.7 +/- 1.4 after 4 weeks (20 subjects); -kg 11.8 +/- 1.6 after 6 weeks (7 subjects); -kg 17.3 +/- 0.8 after 10 weeks (2 subjects); -kg 20.4 after 13 weeks of treatment (1 subjects). A significant reduction of plasma glucose, cholesterol and triglycerides were detected at the end of the dietary treatment, in contrast plasma uric acid concentration rose significantly but within the normal limits. Modified fasting with protein-carbohydrate supplementation (Modifast) may be successfully and safely prescribed also to obese out-patients, provided a careful patient selection, a weekly clinical and biochemical examination and a daily potassium supplementation (20-30 mMol) are performed. PMID- 6483237 TI - [Benign metastasizing leiomyoma of the uterus. Case report]. AB - We have reported a "benign metastasizing uterine leiomyoma" case in a 55-year-old woman still living with "benign" metastases (lung, skin, lymph nodes, bone and perhaps the brain) 14 years after the first uterine myomectomy. PMID- 6483238 TI - [Hepato-biliary emergencies]. PMID- 6483239 TI - [Vascular emergencies in the pathology of the digestive arteries]. PMID- 6483240 TI - [Toxic megacolon]. PMID- 6483241 TI - [Irrigation-lavage of the peritoneum in acute generalized peritonitis. Our experience]. PMID- 6483242 TI - [Problems in the detection of the undesirable effects of drugs]. PMID- 6483243 TI - [Drug-induced pathology. Clinical contribution]. PMID- 6483244 TI - [Psychosomatic disorders considered from an internist viewpoint. I. Nosographic aspects and diagnostic problems]. AB - After a brief introduction regarding the nosography of psychosomatic disorders and the main reasons that have little by little discouraged non-psychiatric physicians to deal with this type of pathology, considering its high incidence among all the areas of general practice, the Authors go on discussing the diagnostic problems and pointing out the most important aspects concerned with these. The Authors conclude by warning not to over-value the effects obtained with an antidepressant especially when it is set up only on the basis of the ex juvantibus principle. The Authors also invite their colleagues general practitioners to take greater care in the fight for prevention and treatment of these disorders, side by side with the psychiatrist. PMID- 6483245 TI - [Role and importance of antidepressants in general medicine. Bibliographic review and case contribution]. AB - Starting from the consideration that communications relating to antidepressant drugs are chiefly reported by psychiatrists and that such reports deal with cases that we don't find in general practice, or at least marginally, the authors go on considering again their material consisting of 944 patients treated with antidepressants alone or associated with tranquilizers and/or with neuroplegic sedatives, hoping to gather usefull informations for a better definition of the role of these drugs in this large nosographic area. The authors could, therefore, by that way: confirm the high incidence of psychosomatic disorders among all the professional areas concerned with general practice; confirm the clear prevalence of the less symptomatic forms; verify in a high percentage of cases the coexistence of an organic disorder in way of progress or in outcome; confirm the double role of these drugs, diagnostic (ex-juvantibus) and therapeutical; suggest a third role of nosographic nature. PMID- 6483246 TI - [Irritable colon and psychosomatic disease]. AB - The authors, after having considered the close likeness between the collateral clinical picture described by others in regard to the irritable colon syndrome and the outstanding one pointed out by them in many cases of psychosomatic disorders, have analyzed again a large number of personal cases diagnosed as "psychosomatic" in order to find possible relations between these two unwholesome conditions. At the end of their examination, after having ascertained that the "Irritable colon" has not to be considered an isolated disease but a syndrome caused by many factors, hinged on a predisposing condition likely of constitutional nature, the authors remark how it may nest in the folds of a psychosomatic disorder and sometimes be its outbreaking feature. The authors by this way, don't want to conclude identifying the I.C. with a psychosomatic disorder and suggest that in such cases one may take this syndrome as the main manifestation of a condition marked by an impairment of the digestive tract motility inside a psychosomatic disorder with a somatic expression of this apparatus. PMID- 6483247 TI - [Surgical treatment of chronic lesions of the anterior crossed ligament of the knee. With special reference to the Lindemann-Bousquet technic]. PMID- 6483248 TI - [Isolated tuberculosis of the sternocleidomastoid muscle in patients mastectomized for breast adenocarcinoma: is it a justifiable entity?]. PMID- 6483249 TI - [Bile-dependent gastrointestinal dyspepsia]. AB - "Indigestion" caused by organic and functional alterations in the biliary ways was examined. The difficulty of accurately identifying this form of dyspepsia, whose frequency explains the interest it arouses, is emphasised. Dyspepsia attributable to dyskinesia of the biliary ways and post-cholecystectomy syndrome is specifically analysed. After a review of the results obtained by the medical and surgical treatment of biliary dyspepsia, a more accurate nosologic and pathogenetic classification of the disease is recommended, together with a more detailed definition of the action mechanism of the biliary acids. PMID- 6483250 TI - [Fiber bronchoscopy in the diagnosis of bronchopulmonary tumors. Evaluation of the diagnostic efficacy of a cyto-histologic protocol in an ambulatory center]. AB - An examination was made of the series of 439 lung tumours diagnosed ambulatorially at the Turin Social Health Dispensary to assess the diagnostic return from several techniques (cytology of the sputum, bronchial aspirate and brushing; histology on a biopsy specimen) used singly or in combination. It was also sought to determine the increase in sensitivity obtained by adding technique to each one other, and to establish the overall sensitivity of the protocol. It was found that biopsy was the most sensitive technique (91% in tumours visible by fibrobronchoscopy). The single cytological techniques displayed a lower sensitivity than in the literature, and there was no significant difference among them. The most sensitive combination was brushing + sputum (89.2%), while the sensitivity of the protocol as a whole was much the same as that reported in the literature. In the case of fibrobronchoscopically visible lesions, multiple biopsies (preferably 3) may be sufficient, whereas combination of the three cytological techniques is necessary to ensure acceptable sensitivity with regard to invisible lesions. PMID- 6483251 TI - [The anti-rubella immune state of the adult female population of Local Health Unit 26 of the Piedmont Region. Prospects for a vaccination campaign]. AB - 500 serum samples were collected from women in child-bearing age and tested for HI titer against rubella virus. 6.8% had no protective level, that is less than 1/32. A vaccination program is discussed. PMID- 6483252 TI - [Mebendazole in the therapy of human hydatidosis. Evaluation of the results obtained in 9 patients with pulmonary localization]. AB - Nine patients with pulmonary cysts of echinococcus varying in size have been treated with Mebendazole. When the cysts were small or medium in size a complete disappearance or an important reduction was observed, whereas in four patients in which the cyst was big in size the treatment did not cause any decrease in size. The Authors point out the efficacy of the Mebendazole in the small or medium size cysts if the drug is given at high doses and for a long period. Nevertheless the use of this drug may be suitable also in the treatment of big size cysts together with surgical treatment to avoid possible secondary local or distant implant and in all cases of human inoperable echinococcal cyst. PMID- 6483254 TI - [Considerations on a rare case of C.R.E.S.T. syndrome]. AB - A rare case of C.R.E.S.T. syndrome with evident pulmonary interstitial fibrosis is presented. PMID- 6483253 TI - [2 cases of tularemia observed at Monte Amiata]. AB - Two cases of tularemia caused by direct contact with an infected hare are described. Recent epidemiological discoveries about the disease are reported with reference to other known foci in Tuscany and the measures taken to control and isolate the infected areas. PMID- 6483255 TI - [5 cases of Legionella pneumopathy from various districts]. PMID- 6483256 TI - [Use of 125-I fibrinogen in the screening of postoperative deep vein thrombosis]. PMID- 6483257 TI - [Gastric emptying time and continuous endogastric pH measurement. Presentation of a method]. PMID- 6483258 TI - [Dynamic measurement of pH. Its role in the study of gastric function]. PMID- 6483259 TI - [Scintigraphic studies in the follow-up of splenic ruptures]. PMID- 6483260 TI - [A new solution for orthograde intestinal lavage]. PMID- 6483261 TI - [Use of mechanical staplers in surgery of the digestive tract. Personal experience]. PMID- 6483262 TI - [Observations on the use of mechanical staplers in surgery of the digestive tract]. PMID- 6483263 TI - [Methylene blue in broncho-fibroscopy]. PMID- 6483264 TI - [Surgical treatment of reflux esophagitis]. PMID- 6483265 TI - [The use of intra-operative electromanometry in the surgical treatment of the functional pathology of the esophagus]. AB - Intra-operative esophageal manometric evaluations are examined. The data refer to: extramucosal myotomy by thoracotomy; hiatal hernia repair by laparatomy; pharingo-crico-myotomy by cervicotomy. The utility of this intra-operative measurement clearly appears, especially in order to an immediate evaluation of surgical correction. PMID- 6483266 TI - [Esophageal motor changes in patients with Raynaud's phenomenon and suspected scleroderma. Electromanometric and serologic evaluations]. AB - Esophageal motor dysfunction in patients with collagen disease, although rather frequent, presents difficult etiopathogenetic arrangement. By means of esophageal manometric evaluation and immunopathologic study the Authors observed 44 patients with Raynaud's phenomenon idiopathic or joined with Scleroderma. From collected data the utility of esophageal manometry in early diagnosis is pointed out. PMID- 6483267 TI - [Combined pH-manometry in the diagnosis of gastroesophageal reflux. Considerations on 200 cases]. PMID- 6483268 TI - [Findings on the behavior of the esophagus after selective and superselective truncal vagotomy. Experience with 200 cases]. PMID- 6483269 TI - [Gastroesophageal reflux of mixed type]. AB - Gastroesophageal reflux has been showed both clinically and experimentally to be especially damaging esophageal mucosal layer when the elements which make up reflux are gastric content and bilio-pancreatic juice. PMID- 6483270 TI - [Advantages of the systematic combined use of endoscopy, monitored pH measurement and aimed biopsy in the study of gastroesophageal reflux]. AB - The Authors refer their experience using endoscopy, biopsy and 24 hours pHmetry associated in 62 patients with symptomatology of reflux. In 21 cases it was shown different grades of esophagitis, in 12 cases reflux potentially pathological. The Authors refer that this association in studying reflux is very comfortable for every Department. PMID- 6483271 TI - [Behavior of the upper esophageal sphincter in patients with slipped hiatal hernia]. PMID- 6483272 TI - [Effect of a slipped hiatal hernia on the activity of the lower esophageal sphincter and of the abdominal portion of the esophagus. A pH-manometric study]. PMID- 6483273 TI - [Esophageal transmucosal potential difference in patients with peptic and alkaline esophagitis]. PMID- 6483274 TI - [Histopathology of reflux esophagitis at an early phase. Study and significance of intraepithelial eosinophilia]. AB - The diagnosis of reflux esophagitis in the early stage is not easy because endoscopy rarely shows evident findings and histology of biopsy specimens still appears unclear and doubtful. Usual histopathological findings are reported and most available diagnostic criteria are discussed, on the basis of the literature and personal experience. Intraepithelial eosinophils are a possible marker of early reflux esophagitis: its diagnostic usefulness is outlined. PMID- 6483275 TI - Long-term effects of early undernutrition on reactivity of the rat parietal association cortex. AB - Cortical reactivity of the parietal association area was studied in undernourished rats after short and long rehabilitation periods. Undernutrition was induced during lactation by increasing litter size from 8 to 18 pups per nurse. At either 40 or 100 days of age, cortical chronaxie, and both fatigability and latencies of direct cortical evoked responses were determined. At the two ages, results showed that early postnatal malnutrition induced higher chronaxies, greater fatigability and longer latencies of the responses compared with normal animals, indicating the existence of long-term functional alterations of that cortical area. PMID- 6483276 TI - Lipid peroxidation in developing rat brain during undernutrition. AB - The effect of undernutrition has been studied in relation to lipid peroxidation, both in vitro and in vivo, in the brain of developing rats. Lipid peroxidation in brain homogenates as well as in the mitochondrial fraction of brain was significantly higher in undernourished groups than in controls. This difference was maximal at the 12th postnatal day. Following rehabilitation for two weeks, this increased lipid peroxidation in brains of undernourished rats could no longer be observed. Determination of malonaldehyde levels in vivo did not show an appreciable difference between control and undernourished animals. PMID- 6483277 TI - Dissociation of the locomotor and hypotensive effects of adenosine analogues in the rat. AB - Rats implanted with chronic indwelling cannulae were injected in the lateral cerebral ventricle with two adenosine analogues and the effects on spontaneous locomotor activity and blood pressure recorded. Both analogues produced dose related decreases in locomotor activity, with 5'-N-ethylcarboxamidoadenosine (NECA) exhibiting slightly more potent depressant activity than (-)-N-(1-methyl-2 phenylethyl)adenosine (L-phenylisopropyladenosine) (L-PIA). NECA and L-PIA also produced dose-related reductions in blood pressure but the threshold dose for hypotensive activity was 10-100-fold higher than the dose required for depression of spontaneous locomotor activity. The depression of locomotor activity and the hypotensive effect of both analogues were antagonized by parenteral injections of caffeine. These results show that the hypoactive and hypotensive effects of adenosine analogues can be dissociated and that methylxanthines probably exert an antagonism of central adenosine receptors in the rat. PMID- 6483278 TI - Evolution of myelin sheaths: both lamprey and hagfish lack myelin. AB - Modern views of agnathan phylogeny consider Petromyzoniformes and Myxiniformes to belong to distinct classes that diverged from a common ancestor at a remote period, perhaps in the lower Cambrian, greater than 600 million years ago. Both are more primitive than elasmobranchs, holocephalans and bony fishes. Myelin is well developed in elasmobranchs and other fishes but was reported to be lacking in the spinal cord of lampreys. In order to search further for possible early myelin in some part of the nervous system of one of the agnathan stems, or for further evidence that it first appeared in chondrichthians, we extended the sampling to many parts of the brain and cord of hagfish. Transmission electron microscopy was used as a nearly ideal criterion. We find no trace or forerunner of the spiral, multilaminate glial wrapping. Many axons are embedded within one or more glial cells, like unmyelinated fibers in other vertebrates, or lie contiguously in bundles without an obviously complete glial investment. True myelin must be presumed to have been invented within the vertebrates, in ancestors of the living cartilaginous fishes after the agnathans branched from the vertebrate stem. PMID- 6483279 TI - Antagonism of 5-hydroxytryptamine-evoked excitation in the superficial dorsal horn of the cat spinal cord by methysergide. AB - Ionophoretically applied methysergide was tested on 9 units excited by 5 hydroxytryptamine (5-HT) recorded in the superficial dorsal horn of cat spinal cord. In all cases, methysergide produced a prolonged and repeatable antagonism of the excitatory action of 5-HT, but it had no effect on glutamate-evoked activity or on that caused by adequate stimulation of the receptive field. This result supports the proposal that excitation by 5-HT is a direct synaptic effect, and not a 'non-specific' action. PMID- 6483280 TI - Structural specializations in cat of chronically demyelinated spinal cord axons as seen in freeze-fracture replicas. AB - Axons in chronically demyelinated spinal cord lesions, induced by ethidium bromide injection, display patches of intramembranous particles and indentations resembling nodal and paranodal axolemmal specializations respectively. Both occur in the marginal region of the lesions where the demyelinated axons are intimately associated with astrocytic and oligodendrocytic processes, and probably correspond to the aberrant node-like and paranodal junctional complexes seen in thin sections of this region. Demyelinated axons in the center of the lesion, which are not in contact with glial processes, do not display these membrane specializations. PMID- 6483281 TI - Reaggregation of embryonic chick retina cells: pigment epithelial cells induce a high order of stratification. AB - We report here that, in comparison to aggregates from retinal cells alone, addition of pigmented epithelial cells to retinal cells in rotary culture results in a pronounced increase of spatial order. A particularly high level of organization is found in about 15-20% of the aggregates. In these 'retinoids' the main layers characteristic of developing in vivo retinae can be distinguished in correct sequential arrangement on the basis of morphological criteria and by using acetylcholinesterase histochemistry [5, 6, 15], peanut agglutinin-lectin binding [11] and Lucifer Yellow staining [7-9]. PMID- 6483282 TI - Development and degeneration of retina in rds mutant mice: the electroretinogram. AB - In mice, homozygous for the retinal degeneration slow (rds) gene, the photoreceptor cells lack outer segment disc structures, contain low amounts of rhodopsin, and degenerate slowly, while the inner retinal layers remain intact. The electroretinogram (ERG) from 1-month-old mutant mice shows a lower than normal amplitude but the time-to-peak is normal. The ERGs from mutant mice of 2-3 months and 6-7 months of age show a further decline in response amplitude as the receptor cell population is depleted with progress of degeneration while the time to-peak increases. The ERG is absent in 1-year-old mutant mice which have lost their receptor cells completely. The possible morphological correlations of the ERG and its components in the rds mutant mice are discussed. PMID- 6483283 TI - Localization of motoneurons innervating the muscle of the hard palate in the rat: a horseradish peroxidase study. AB - Using the horseradish peroxidase-technique, the myotopical arrangement of motoneurons innervating the transverse palatine muscle in the rat was studied. It appears that this muscle is innervated by axons from cells located in the ipsilateral intermediate subnucleus of the facial motor nucleus. By nerve transection and electrophysiological experiments it is shown that the transverse palatine muscle is innervated by the inferior as well as the superior buccolabial branch of the facial nerve. PMID- 6483284 TI - Effects of histamine inhalation and airway vibration on phrenic nerve activity in rabbits. AB - Experiments were performed on 8 rabbits under urethane-chloralose anesthesia. Histamine aerosol (5%) administered into the trachea by a cannula produced tonic activity of the phrenic nerve, with discharges also being evident during the expiratory phase. Airway vibration (100 Hz) inhibited this tonic activity and caused silence during the expiratory phase. PMID- 6483285 TI - Neonatally bulbectomized rats with new olfactory-neocortical connections are anosmic. AB - Rats with one olfactory bulb removed when neonates and the second bulb removed when adults were tested on tone-light discrimination and odor detection tasks. On the neonatally operated side reconstituted olfactory receptor cell axons penetrated the frontal neocortex or portions of the anterior olfactory nucleus, and formed glomerular-like structures. On the adult operated side there was extensive scar formation which prevented in-growing sensory axons from contacting the brain. All experimental animals acquired the tone-light discrimination but failed to show any evidence of odor detection. These results indicate that reconstituted olfactory projections which terminate in the frontal neocortex or anterior olfactory nucleus do not support olfaction. PMID- 6483286 TI - The development of motilin-like immunoreactivity in the rat cerebellum and pituitary as determined by radioimmunoassay. AB - Motilin-like immunoreactivity (MLI) was determined in cerebelli and pituitaries of the rat from 4 days before birth to about 6 months after. Cholecystokinin (CCK)-like immunoreactivity was measured in the same pituitary samples for comparison. MLI concentration was highest 4 days prenatally in both tissues, while total tissue MLI content was higher after birth. Cerebellar MLI content was maximal from day 14 to 40, while pituitary MLI content increased gradually with age, roughly paralleling the increase in tissue protein. Pituitary CCK was detectable only postnatally; its concentration was maximal between days 19 and 29, and decreased substantially in older animals. The presence of detectable MLI in pituitary before birth is consistent with the observation that MLI can be visualized by immunocytochemistry in anterior pituitary somatotrophic cells, which are known to be active producers of growth hormone before and after birth. The presence of MLI before birth in cerebellum is consistent with the localization of MLI in Purkinje neurons, known to be formed before birth. The presence of MLI in the cerebellum before birth and its marked increase in content during the period of synaptogenesis are suggestive of a possible role of motilin in development. PMID- 6483287 TI - Choice, as opposed to latency, measures in avoidance suggest that vasopressin and oxytocin do not affect memory in rats. AB - Latency measures from passive avoidance studies are frequently used as an index of memory. Thus, vasopressin (VP) is thought to enhance memory, since it has been shown to increase re-entry latencies. Conversely, several substances, such as oxytocin (OT), are supposed to have amnestic effects since they may decrease latencies. We describe a novel avoidance design, which allows latency to be assessed, but also permits the animal to re-enter into a distinctive compartment where shock had not been experienced (choice measure). Latency scores indicated that VP may improve memory, but the choice index suggested that this was not the case. PMID- 6483288 TI - Adenosine deaminase in convulsions along with its regional, cellular and synaptosomal distribution in rat brain. AB - Adenosine deaminase activity was determined in enriched neuronal, glial and synaptosomal fractions in three regions of rat brain. It was found to be equally distributed in cortical neurons and synaptosomes. Appreciable activity was observed in glial cells. A significant increase in the activity of this enzyme was observed in three brain regions in rats subjected to leptazol convulsions. No significant change, however, was found in the pre- or post-convulsive periods. These results are discussed in relation to the possible degradation of adenosine, a neuroinhibitory substance and to the possible production of inosine, an initiator of seizure activity in low amounts and depressor of the same in high amounts. PMID- 6483290 TI - Determining snacking patterns and snack nutrient quality. PMID- 6483289 TI - The effects of capsaicin on the early outward current in identified snail neurones. AB - An investigation of the action of capsaicin (CAP) on the early outward current (IA) in identified neurones of Helix pomatia was performed using the single electrode clamp. CAP (60-300 microM) caused a dose-dependent reduction of the IA currents in LPa3 and RPa3 neurones both in normal and Na-free solutions. There was also a marked shortening of the time constant for the inactivation of IA, and a 5-10 mV shift in the hyperpolarizing direction of the curve relating the steady state inactivation of IA to membrane potential. The equilibrium potential for IA was not changed in up to 300 microM CAP solutions. PMID- 6483291 TI - Preterm milk is at least as nutritious as formula. PMID- 6483292 TI - Vitamin E deficiency in children with chronic cholestasis. PMID- 6483293 TI - The invasive potential of carcinoma in situ of the cervix. AB - Nine hundred and forty-eight patients with carcinoma in situ (CIS) of the cervix diagnosed histologically have been followed from five to 28 years. Among the 817 patients who had normal cytology follow-up, 12 (1.5%) developed invasive carcinoma. A second group of 131 patients continued to produce abnormal cytology consistent with cervical neoplasia, and 29 (22%) of them developed invasive carcinoma of the cervix or vaginal vault. Patients with continuing abnormal cytology after initial management of CIS of the cervix are 24.8 times more likely to develop invasive carcinoma than women who have normal follow-up cytology. Further, when compared with the population at large, the chances of patients with normal follow-up cytology developing invasive cervical or vaginal vault carcinoma increase 3.2-fold over women who have never had CIS of the cervix. PMID- 6483294 TI - Delay in delivery: influence of gestational age and the duration of delay on perinatal outcome. AB - The potential benefits to be gained in neonatal survival and freedom from serious morbidity by delaying delivery at various gestational ages was explored by examining the results of studies of neonatal mortality and subsequent morbidity published from 1978 and 1984. The major benefits were found to occur between 24 and 27 weeks' gestational age. In general, little benefit was found in delaying delivery after 34 weeks' gestational age. PMID- 6483295 TI - Evaluation of seven- to nine-year-old children exposed to ritodrine in utero. AB - Twenty children who had been exposed to ritodrine in the management of preterm labor between 24 and 34 weeks' gestational age were examined at seven to nine years of life and compared with matched control subjects. No significant differences were detected in factors of growth, neurologic findings, and psychometric testing. PMID- 6483296 TI - Characteristics of uterine activity during the breast stimulation stress test. AB - Characteristics of uterine activity produced by nipple stimulation were studied in 185 consecutive breast stimulation stress tests. Adequate contractions were produced in 95.6% of tests. Exaggerated uterine response (contractions occurring more than once every two minutes or lasting more than 90 seconds) was present in 45.5% of the patients. Twenty-one percent of the patients with such uterine activity also had a fetal heart rate (FHR) deceleration (hyperstimulation breast stimulation stress test), without adverse fetal outcome. The time in minutes from start of nipple stimulation to the first contraction (stimulation contraction interval) was recorded for each patient. Significant difference was not observed in the stimulation contraction interval distribution between the groups with and without exaggerated uterine activity. The authors conclude that there is a relatively high incidence of exaggerated uterine activity response to the breast stimulation stress test and that close surveillance of mother and fetus is warranted during antepartum nipple stimulation. PMID- 6483297 TI - Patterns of obstetric procedures use in maternity care. AB - The use of seven obstetric procedures was studied in two institutions that use different approaches to maternity care. The study population included 796 women delivering at Booth Maternity Center and 804 women with similar sociodemographic characteristics delivering at Thomas Jefferson University Hospital during 1977 and 1978. Several differences were found between the two institutions. The majority of selected procedures were used more often at Thomas Jefferson University Hospital than at Booth Maternity Center. The greatest differences were found for women at low intrapartum risk, while differences were smallest for women at high prenatal and intrapartum risk. The two institutions differed in their use of procedures for women at various levels of prenatal and intrapartum risk. The findings suggested that most of the differences did not reflect different levels of risk in the populations served, but were due to other unidentified factors. PMID- 6483298 TI - Umbilical cord prolapse. AB - Umbilical cord prolapse complicated one of 385 pregnancies occurring at the University of Colorado Health Science Center between 1969 and 1982. Whereas malpresentation of the fetus is frequently associated with prolapse of the funis, nearly 50% of all cases occurred in vertex presentations. Obstetric intervention is associated with nearly one in five cases of cord prolapse and represents a readily preventable cause of maternal and perinatal morbidity. PMID- 6483299 TI - Clinical value of glycosylated serum protein and glycosylated hemoglobin levels in the diagnosis of gestational diabetes mellitus. AB - Glycosylated serum protein and glycosylated hemoglobin levels were compared to the oral glucose tolerance test to determine their relative sensitivity in identifying women with gestational diabetes mellitus. The mean glycosylated serum protein level (0.49 +/- SD 0.07 nmol hydroxymethylfurfural per milligram protein) of 17 pregnant women with normal glucose tolerance and the mean value (0.54 +/- SD 0.06 nmol hydroxymethylfurfural per milligram protein) of eight pregnant women with gestational diabetes mellitus were statistically different (P less than .05). However, there was such an overlap between these groups that individuals could not be categorized as normal or as having gestational diabetes mellitus on the basis of the glycosylated serum protein level. There was no difference in glycosylated hemoglobin levels between 41 women with normal glucose tolerance and 12 women with gestational diabetes mellitus. This study concluded that glycosylated serum protein and glycosylated hemoglobin determinations are not as sensitive as the glucose tolerance test in detecting gestational diabetes mellitus as it is now defined. PMID- 6483301 TI - Coexistence of ovarian neoplasms and endocervical adenocarcinoma. AB - The coexistence of ovarian neoplasms and adenocarcinoma of the cervix occurs more often than generally realized. Of 390 women with adenocarcinoma of the cervix, the ovaries were available for histologic review in 161. Neoplasms were present in the ovaries of 25 of the 161 women (16%). Eleven carcinomas were metastatic to the ovary, and 14 (9%) were independent primary tumors. These included four benign cystic teratomas, four benign epithelial tumors, and six primary carcinomas. The 54 women with endometrioid adenocarcinomas of the cervix were especially prone to ovarian carcinoma because four (7%) had coexistent or subsequent endometrioid carcinoma in the ovary. PMID- 6483300 TI - Pregnancy complications in Sioux Indians. AB - The poor health status of Sioux Indians residing on reservations in South Dakota has been recognized for many years. The present report documents evidence of a high incidence of socioeconomic health-related disorders and pregnancy-related complications by comparing 342 pregnant white women and 405 pregnant Sioux Indian women. In collaboration with the Aberdeen Area Indian Health Service, beginning in 1976, a program was initiated to identify, assess risks, and provide patient management for pregnant Sioux Indians. This prenatal consultative program has proved effective in the reduction of fetal and infant mortality. PMID- 6483302 TI - Characterization and survival of patients with serous cystadenocarcinoma of the ovaries. AB - Factors affecting survival of 241 patients with ovarian serous carcinoma diagnosed and/or treated at New York University Medical Center from 1960 through 1980 are analyzed. Characteristics independently correlated with a favorable prognosis include low tumor stage and grade, presenting sign of a mass, and omentectomy. Patients under 50 years of age have a lower mortality rate (corrected for stage and grade) than older women. The presenting complaints of patients with a poor survival include nausea and/or vomiting, anorexia, and abdominal swelling. For patients with stage I disease neither bilaterality (stage Ib versus Ia) nor transcapsular extension of tumor adversely affected prognosis. However, patients with stage I disease with ascites appear to have a survival experience similar to patients with stage III disease. PMID- 6483303 TI - Treatment of endometrial adenocarcinoma complicated by previous Watkins transposition operation: a report of three cases. AB - Three patients with endometrial adenocarcinoma complicated by previous Watkins transposition operations were treated at the University of Minnesota. Adequate diagnostic uterine dilatation and curettage necessary for proper staging was difficult or impossible because of the anatomic distortion caused by the prior surgery. Moreover, in one patient in whom the anatomic changes were not recognized, surgical treatment resulted in incomplete removal of tumor. The Watkins transposition operation should be considered a possible cause of technical difficulty during dilatation and curettage of any patient with a history of vaginal surgery. If the transposition surgery has been performed, difficulty in removing the uterus should be anticipated. PMID- 6483304 TI - Malignant transformation of vaginal endometriosis. AB - A well-documented case of extraovarian endometriosis undergoing malignant transformation is presented. A vaginal focus of endometriosis was biopsied over a 13-year interval during which time progression from benign to malignant disease was observed. Exogenous estrogen replacement was administered throughout the interval of transformation. The pathology, pertinent literature, and implications of the present case are discussed. PMID- 6483305 TI - Hypothesis relating catecholamine release to changes in electrode pH during fetal scalp monitoring. PMID- 6483306 TI - Clinical management of spinal cord injury. PMID- 6483307 TI - Treatment of the cervical epithelium. PMID- 6483308 TI - Studies on the calcium antagonistic action of tetrandrine: VIII. Antagonistic effects of tetrandrine on ouabain-induced contraction of coronary arterial strips. PMID- 6483309 TI - Studies on the calcium antagonistic action of tetrandrine: IX. Effects of tetrandrine on action potential and contraction of isolated guinea pig papillary muscles. PMID- 6483310 TI - A new species of genus Orthellia from China (Diptera: Muscidae). PMID- 6483311 TI - Effect of intrauterine devices on menstrual blood loss. PMID- 6483312 TI - A comparison of the therapeutic effects of gastroesophageal devascularization and portal systemic shunt in the treatment of portal hypertension. PMID- 6483313 TI - Effects of some toxic metals on hepatic microsomal mixed function oxidase system of the rat. PMID- 6483314 TI - Echocardiographic study of Marfan's syndrome. PMID- 6483315 TI - Standardization of lymphocyte transformation to antigen. PMID- 6483316 TI - General level and distribution of the intra- and extra-erythrocytes sodium concentration in a population and their relationship with blood pressure. PMID- 6483317 TI - Measurement of pyloric sphincter pressure with miniature transducer under fiber gastroscope. PMID- 6483319 TI - [Importance of functional studies for the early detection and prevention of eye diseases in preschoolers]. PMID- 6483318 TI - Special form of collagen fibrils. PMID- 6483320 TI - [Morphofunctional body status of preschoolers suffering from strabismus and asthenopia]. PMID- 6483321 TI - [Visual function study of young children]. PMID- 6483322 TI - [Contrast sensitivity study of preschoolers]. PMID- 6483323 TI - [New method and device for free-space cyclotropometry]. PMID- 6483324 TI - [Method and the results of studying the absolute accommodation volume of preschool children]. PMID- 6483325 TI - [Results of studying the fusion capacity of preschool children suffering from concomitant strabismus]. PMID- 6483326 TI - [Color perception in nursery-age infants]. PMID- 6483327 TI - [Role of diploptics in treating concomitant convergent strabismus in preschool children]. PMID- 6483328 TI - [Plastic operations on the orbit in posttraumatic enophthalmos with dislocation of the eyeball]. PMID- 6483329 TI - [Results of restorative plastic operations with a tissue autograft in the case of a deficient conjunctival sac cavity for the wearing of a prosthesis]. PMID- 6483330 TI - [Exacerbating factors and an analysis of their joint effect on the formation of adhesions and the appearance of tractional retinal detachment following the diascleral removal of intraocular fragments]. PMID- 6483331 TI - [Clinical aspects and treatment of postoperative keratopathies]. PMID- 6483332 TI - [Corneal sensitivity of patients following anterior radial keratotomy]. PMID- 6483333 TI - [Astigmaticity of the optical structure of emmetropic eyes]. PMID- 6483334 TI - [Characteristics of the clinical manifestation of closed-angle glaucoma]. PMID- 6483335 TI - [Rheoophthalmography in hypothyroidism]. PMID- 6483336 TI - [Effect of laser radiation on regenerative processes in the anterior epithelium of the cornea in injuries]. PMID- 6483337 TI - [Mirror microscopy in the study of regeneration of the posterior epithelium of the cornea in relation to different substitutes for the aqueous humor]. PMID- 6483338 TI - [Eye injuries as a cause of disability in workers in agricultural production]. PMID- 6483339 TI - [Organization of prophylactic work among preschoolers in Krivoy Rog]. PMID- 6483340 TI - [Edema of the optic disk of varying origin in view of the biomicroscopic data]. PMID- 6483341 TI - [Blue nevus of the skin of the lower eyelid and of the conjunctiva of the left eye]. PMID- 6483342 TI - [Case of an atypical lesion of the eyes in hereditary familial galactosemia]. PMID- 6483343 TI - [Long-term presence of a wooden foreign body in the orbital cavity]. PMID- 6483344 TI - [Honey treatment of postherpetic opacities of the cornea]. PMID- 6483345 TI - [Therapeutic physical exercise in the combined treatment of eye burns in children]. PMID- 6483346 TI - [Current tasks in preventing disability in connection with a single system of organizing the rehabilitative treatment of eye patients in the Ukrainian SSR]. PMID- 6483347 TI - [Medical and socio-vocational rehabilitation of patients with traumatic cataracts]. PMID- 6483348 TI - [Various aspects of preventing disability as a consequence of crystalline lens injury]. PMID- 6483349 TI - [Intraocular correction in preventing disability from crystalline lens injury]. PMID- 6483350 TI - [Ocular hydrodynamic characteristics of long-lived persons]. PMID- 6483351 TI - [Possibility of using cellulose derivatives as a protector of the endothelium in a cataract operation]. PMID- 6483352 TI - [Use of intraocular correction in cataract and myopia]. PMID- 6483353 TI - [Luminescent and dark disk symptom in central serous chorioretinopathy]. PMID- 6483354 TI - [Histological and electron microscopic studies of the healing of the iris in iridoplasty]. PMID- 6483355 TI - [Effect of chlorophyll phonophoresis on the dehydrogenase activity of the corneal anterior epithelium in alkali burns]. PMID- 6483356 TI - [Eye changes in hop growers]. PMID- 6483357 TI - [Experience in training future physicians for performing health education work among the population to prevent eye diseases and injuries]. PMID- 6483358 TI - [Effectiveness of microsurgical operations in far-advanced open-angle glaucoma]. PMID- 6483359 TI - [Device for the diagnosis of intraocular tumors]. PMID- 6483360 TI - [A table for the x-ray localization of eye foreign bodies in the operating room]. PMID- 6483361 TI - [Simple possibilities for prolonging the local action of eyedrops]. PMID- 6483362 TI - [Immediate and late results of 350 microsurgical operations in primary glaucoma]. PMID- 6483364 TI - [Early glaucoma detection in district health care facilities]. PMID- 6483363 TI - [Clinical aspects and treatment of xerophthalmia in tropical countries]. PMID- 6483365 TI - Changes with advance of age of the human maxillomandibularis, zygomaticomandibularis and superficial temporalis. PMID- 6483366 TI - Electron microscopic studies of the lung of the salamander, Hynobius nebulosus: 1. A scanning and transmission electron microscopic observation. PMID- 6483367 TI - Studies on the arterial vasculature in the floor region of the mouth and the submandibular region of the crab-eating monkey using the plastic injection method. PMID- 6483368 TI - A histological study of the development of human dental laminae. PMID- 6483369 TI - An investigation of yellow fluorescent lines observed in human dentinal hard tissues. PMID- 6483370 TI - Intraocular lenses in myopes. AB - A series of 40 consecutive myopic eyes with intraocular lens implants of 13.0 diopters or less was examined with regard to visual result, complications and accuracy of commonly used lens implant power formulas. Recommendations are given for the use of implants in myopic patients as well as the various approaches to visual rehabilitation of the anisometropia in the fellow eye following surgery. PMID- 6483371 TI - Observing posterior capsule lens haptics in living postoperative eyes. AB - The cycloscope, an aid for observing the ciliary body, was used to study lens haptic fixation in 100 living eyes (200 haptics). Although the whole aspect of the lens could be viewed in only about 20 haptics (10%), in 102 haptics (51%), judgment about whether fixation was in or out of the bag could be made based on the relationship of the visible part of the lens haptic and the surrounding tissues. Thus, the method was found to be useful in studying the fixation mechanism of posterior chamber lens haptics in living postoperative eyes. Two cases of J-loop posterior chamber lens implantation studied by cycloscopy are reported. PMID- 6483372 TI - Toxicity of intravitreal antiviral drugs. AB - Two systemic agents, vidarabine and acyclovir, were tested for ocular toxicity in intravitreal injection and vitrectomy infusion solutions. On the basis of this study we recommend using up to 30 mcg/0.1 ml of vidarabine as an intraocular injection or 8 to 16 mcg/ml in vitrectomy infusion fluid. For acyclovir, 80 mcg/0.1 ml as an intraocular injection or 40 mcg/ml in vitrectomy infusion fluid may be a therapeutic adjunct for managing viral retinitis. PMID- 6483373 TI - Papillomas of lacrimal drainage system: a clinicopathologic study. AB - This paper presents a clinicopathologic review of Schneiderian papillomas in the lacrimal drainage system, nasal cavity, and paranasal sinuses. The embryologic, histopathologic, and clinical aspects of these lesions are discussed. A more practical classification for the papillomas of the lacrimal drainage system, offering a better understanding of their histogenesis and an easy follow-up system, is proposed. PMID- 6483374 TI - Color prints from color slides. PMID- 6483376 TI - The advantages of controlled recession over free weakening procedures on oblique muscles. PMID- 6483375 TI - Miniprobe for lacrimal sac temperature measurement. AB - The hypodermic probe is presented as a portable and easily used instrument for assessing the temperature within the lacrimal drainage system. Its size makes it practical for clinic or office use. It is also acceptable to the patient and may be performed immediately prior to lacrimal syringings. We suggest that lacrimal sac temperatures may be readily measured and are helpful in assessing the degree of inflammation or the presence of mucus in the lacrimal sac. PMID- 6483377 TI - First credit for eye wick? PMID- 6483378 TI - Local fibrinolytic activity of human optic nerve vessels. AB - The local fibrinolytic activity of the human optic nerve vessels was investigated in 25 eyes obtained at autopsy using Todd's fibrinolysis autography. The veins generally showed higher fibrinolytic activity than the arteries except for the central retinal vessels, as was the case in the systemic blood vessels. Out of 25 cases, 6 (24%) showed a lower activity in the central retinal veins than in the arteries, 7 (28%) a higher activity in the veins than in the arteries and in 12 (48%) the tendency was transitional. PMID- 6483379 TI - A new method of measuring in vivo the lens transmittance, and study of lens scatter, fluorescence and transmittance. AB - We propose a new method to measure in vivo nuclear transmittance using scanning photometry, thus complementing its present application in measuring lens scatter and fluorescence. We compared our method of measuring the transmittance with a previously reported in vivo method and found an adequate correlation. We then measured the fluorescence, scatter and transmittance of lenses without cataract and those with as much as a mild yellowing. The three phenomena correlated with age. In addition, this study allowed a correlation of the three phenomena with each other, indicating that the loss of transmittance of the nucleus cannot be explained by its thickening alone but that changes in its composition must take place. Finally, a preliminary study on diabetics showed early onset of the process responsible for the increase in lens fluorescence. This process did not seem to be accelerated in diabetics in comparison with normals. The nuclear scatter appeared to increase more rapidly with age in nondiabetics as compared to diabetics. This preliminary study suggests mainly that scanning photometry can be used to study aging and pathologic changes in the lens. PMID- 6483380 TI - Elemental profiles in cryosections and frozen-dried bulk specimens of the normal lens. AB - Energy-dispersive X-ray analysis was used to obtain distribution profiles of Na, K, Cl, P and S in rapidly frozen-dried bulk specimens, and in cryosections of the normal rat lens. Na and Cl are highly concentrated in the capsule, and K and P, in the epithelial cells. Profiles of the entire radius of a lens show relatively high concentrations of K and P in the outermost cells of the lens, with decreasing concentrations through the cortex, and a minimum throughout the nuclear region. S, on the other hand, shows increasing concentrations at deeper locations, with maximum values throughout the nuclear region. PMID- 6483381 TI - Ion exchange column chromatographic investigation of free amino acids in tears of healthy adults. AB - Free amino acids were determined quantitatively in tear fluid and serum samples from the fasting blood of 21 healthy men (aged 22-45 years) and 22 women (aged 21 56 years). Protein was removed from tears and serum by adding an equal volume of 5% sulfosalicyclic acid, and the amino acids were separated by ion exchange column chromatography. None of the 43 subjects showed any evidence of liver damage, kidney or metabolic disease. Men had significantly higher valine, isoleucine and histidine concentrations than women. The range of normal values was determined from these findings. PMID- 6483382 TI - Biochemical study of cholesteatoma and cholesterol granuloma--occurrence of delta 7-cholestenol in the tissues of cholesteatoma. AB - Qualitative and quantitative analyses of sterol derivatives in the tissue of cholesteatoma and cholesterol granuloma were performed by gas-liquid chromatography, mass spectrometry and mass fragmentography after the extraction of total lipids with organic solvents. Cholesterol was the major component in both tissues. The molar ratios of cholesterol to lipid-bound phosphorus in cholesterol granulomas were higher than those in cholesteatomas. In addition, delta 7-cholestenol (lathosterol) was contained in all tissues of cholesteatoma examined. However, cholesterol granuloma tested did not contain delta 7 cholestenol, indicating that the metabolism of cholesterol differed from that in cholesterol granuloma. PMID- 6483384 TI - Salivary phosphohexoseisomerase activity in health and salivary gland diseases. AB - The attitude of phosphohexoseisomerase (PHI), a glycolytic enzyme, in parotid and submandibular saliva of healthy human control subjects of different sex and age was studied flow rate dependent. The results obtained from this group were compared to the PHI activity measured in the saliva of patients suffering from salivary gland diseases. Significantly elevated salivary PHI levels were found in chronic sialadenitis, while in sialadenosis, parotid gland infarction and parotid cysts the enzyme activity was within the normal range. Single patients suffering from parotid gland tumors showed elevated PHI values. A possible role of salivary PHI activity for the differential diagnosis of salivary gland diseases is discussed. PMID- 6483383 TI - Morphology of denervated human facial muscles. AB - 17 biopsies of denervated facial muscles, the zygomatic, the orbicularis oris and the levator labii muscles, showed atrophic myofibers in most cases. There was loss of fiber typability when applying the NADH, the MAG and the alkaline ATPase reactions. The acid ATPase preparations allowed differentiation of myofibers into type I and type II without subtypes. Contrary to normal facial muscles that are richly endowed with motor endplates, no neuromuscular junctions were observed in denervated muscle fibers except one example which might have been obtained by false sampling from the marginal area of denervation or might be the result of partial reinnervation due to sprouting axons from the neighborhood. There was no correlation between the degree of muscle fiber atrophy and the duration of the paralysis. However, fibrosis corresponded to length of denervation. The presence of highly atrophic muscle fibers even 36 years after denervation indicates that the final aim of facial nerve surgery, namely the reinnervation of denervated facial musculature may still be achievable. However, endomysial and perimysial fibrosis may have a considerable impact on the final outcome of such facial nerve surgery. Unsatisfactory correlation between morphological and clinical as well as electromyographical findings in denervated facial muscles requires individual morphological study of each biopsy to assess the probable outcome of reconstructive facial nerve surgery. It therefore appears reasonable even in long standing facial paralysis, to biopsy denervated facial muscles before or during surgical reanastomosation of the facial nerve. This study provides hints that morphological examination of denervated facial muscles may supplement clinical, electrophysiological, and possibly biochemical diagnostic findings. PMID- 6483385 TI - Pressure chamber tests for selection of aircrew. AB - The Eustachian tube function requested from flying personnel today is generally regarded as acceptable if hearing and otoscopic findings are normal and there is no history of ear disease. Since increasing performance of modern aircrafts place more rigorous demands on the equilibrating capacity of the Eustachian tube and difficulty to clear the ears already is the most common cause of temporary grounding among flying personnel, the present requirements for tubal function might gradually get more and more inefficient. Inability to equilibrate in flight may lead to temporarily reduced hearing, acute ear pain and alternobaric vertigo that will affect the pilot's capacity and thus constitute a problem of flight safety. A testing procedure that makes it possible to continuously measure the middle ear pressure in subjects with intact eardrums during simulated flights in a pressure chamber would introduce a possibility to find basic medical standards of Eustachian tube function to be used in the selection of flying personnel. Student pilots, accepted for primary flight training, were examined in the present study by such a method. A comparison is made with the results of other tests of the Eustachian tube function in order to find out the relevance of the latter tests in the selection of flying personnel. The results are presented and discussed. PMID- 6483386 TI - [Analgesic laser therapy of patients with post-traumatic and involutional lesions of the musculoskeletal system]. PMID- 6483387 TI - [Endoprosthesis in protrusion coxarthrosis]. PMID- 6483388 TI - [Characteristics of bone regeneration after hip endoprosthesis by the Sivash method]. PMID- 6483389 TI - [Characteristics of therapeutic measures in injuries of ballet dancers]. PMID- 6483390 TI - [Lateral hyperpressive syndrome of the patella]. PMID- 6483391 TI - [Synovial cyst of the popliteal region]. PMID- 6483392 TI - [Torsion of the knee joint under normal and pathological conditions]. PMID- 6483393 TI - [Recurrences after conservative treatment of congenital clubfoot]. PMID- 6483394 TI - [Treatment of children with post-traumatic contractures of the elbow joint]. PMID- 6483395 TI - [Experimental study of the reaction of paraosseous tissues of the elbow joint after cryosurgery]. PMID- 6483396 TI - [Surgical treatment of hip joint dysplasia by incomplete angular osteotomy of the pelvis]. PMID- 6483397 TI - [Activities of the methodological seminar]. PMID- 6483398 TI - [Problems in the causes and prevention of wounds and injuries]. PMID- 6483399 TI - [Microsurgery in traumatology and orthopedics: new possibilities and new problems]. PMID- 6483400 TI - [Remote results of the surgical treatment of dysplastic coxarthrosis]. PMID- 6483401 TI - [EEG changes in acute and chronic liver diseases]. PMID- 6483402 TI - [Hormone secretion and tumor tissue in patients with acromegalic prolactinoma]. PMID- 6483403 TI - [Monotherapy of epileptic patients]. PMID- 6483404 TI - [Stress fracture of the pubic bone following total hip endoprosthesis insertion]. PMID- 6483405 TI - [Preparation for colonic examinations]. PMID- 6483406 TI - [Diagnostic problems of paraquat poisoning]. PMID- 6483407 TI - [Disorders of falling asleep and staying asleep (insomnia)]. PMID- 6483408 TI - [Characteristics of the blood pressure reflex control in carotid sinus hyperesthesia associated with hypertension]. PMID- 6483410 TI - [Complete repair of hypospadias]. PMID- 6483409 TI - [Thyroid manifestation of multiple myeloma detected by aspiration cytology]. PMID- 6483411 TI - [Repair of cartilage injuries and osteochondral fractures with fibrin glue]. PMID- 6483412 TI - [Erythema dyschromicum perstans (ashy dermatosis)]. PMID- 6483413 TI - [ECG changes in hyperosmolar diabetic coma]. PMID- 6483414 TI - [Paradoxical effects of submaximal and supramaximal doses of caerulein on the pancreas]. PMID- 6483415 TI - [Criticism of a partial multiphasic population screening (a rational proposal for an optimal solution)]. PMID- 6483416 TI - [Significance of out-of-wedlock births]. PMID- 6483417 TI - [Possibilities of the surgical management of duodenal ulcer hemorrhage and perforation with special reference to selective proximal vagotomy]. PMID- 6483418 TI - [The effect of cervical fructose levels on postcoital tests]. PMID- 6483419 TI - [Role of the Harrington operation in the management of spinal fractures]. PMID- 6483420 TI - [Hysterosalpingography using a Foley catheter]. PMID- 6483421 TI - [Hormonal characteristics of physiologic and insufficient corpus luteum function]. PMID- 6483423 TI - [Orthograpy of Hungarian medical terminology]. PMID- 6483422 TI - [Importance of the early recognition of breast cancer based on 3000 operated cases]. PMID- 6483424 TI - [Hypersomnia, disorders of the sleep-wakefulness rhythm and other sleep disorders]. PMID- 6483425 TI - [Diagnostic value of C-reactive protein in premature infants under 1500 g]. PMID- 6483426 TI - [To tell or to conceal the truth?]. PMID- 6483427 TI - Symposium on skull base surgery. PMID- 6483428 TI - Neuroradiology of the skull base. AB - Newer imaging modalities, especially high resolution computed tomographic scanning, have radically altered and expanded the role of radiology in the evaluation and management of lesions affecting the skull base. The location, extent, and tissue characteristics of these lesions can be determined with greater precision than ever before. When necessary, diagnostic and therapeutic angiography can be performed more rapidly and more safely with digital subtraction techniques. In the near future magnetic resonance imaging may prove to be an even more precise imaging tool than computed tomography. Magnetic resonance studies may also determine physiologic and biochemical properties of lesions that are not possible to evaluate with any other techniques. PMID- 6483429 TI - Surgery of the posterior fossa. AB - The last 20 years have brought many advances in surgical approaches to the posterior cranial fossa as well as improved surgical technique. The purpose in this article has been to describe the commonly used approaches and to discuss the major advantages and disadvantages. PMID- 6483430 TI - Surgery in craniocervical dysplasia. PMID- 6483431 TI - Surgery in lesions of the petrous apex. AB - It is fortunate that lesions of the petrous apex are rarely encountered. The occult nature of the local disease and the poorly localizing clinical features favor a delayed diagnosis. Its site deep to the labyrinth and facial nerve and its proximity to the internal carotid artery and brain stem potentially make surgery a risky prospect. The reconciling of preservation of neurologic function and adequate surgical exposure requires an extensive knowledge of temporal bone anatomy and surgical approaches. PMID- 6483432 TI - Management of cranial nerve injury following surgery of the skull base. PMID- 6483433 TI - Surgical reconstruction after extensive skull base surgery. AB - Skull base surgery is a rapidly expanding surgical subspecialty bringing together the sophisticated surgical skills of the neurotologist-head and neck surgeon and the neurosurgeon. Newly described surgical approaches to the skull base have made possible greater surgical ablation of the skull base region, resulting in large defects and thus heightening the need for reconstructing these regions. Prevention of cerebrospinal fluid leaks is the most important aspect of reconstruction and is achieved most readily when possible by dural patch grafts of fascia lata, coverage of the dura with soft tissue, and preservation of the soft tissue utilizing skin or split thickness skin grafts. Soft tissue may be in the form of free fascia lata grafts, pedicled galeal flaps, or local or regional skin flaps. Defects of the skull base larger than a few square centimeters are best reconstructed with local or regional skin flaps or musculocutaneous flaps. These flaps lend sufficient structural support so that bone support is not usually required. Subsequent cranioplasty, when necessary, can provide protection to those regions of the brain that are more susceptible to blunt trauma. PMID- 6483434 TI - Spinal fluid leakage after skull base surgical procedures. PMID- 6483435 TI - Pain following surgery of the skull base. PMID- 6483436 TI - [Surgical treatment of partial hearing loss]. PMID- 6483437 TI - [Combined treatment of advanced head and neck cancer using 5-fluorouracil and irradiation in the so-called synchronized cell cycle]. PMID- 6483438 TI - [Fine-needle biopsy in the diagnosis of head and neck tumors. Cyto-histological correlations]. PMID- 6483439 TI - [Chronic atopic rhinitis as a preliminary stage of asthma. Fate of patients after several years' observation]. PMID- 6483440 TI - [Tonsillectomy and adenoidectomy in children under general anesthesia]. PMID- 6483441 TI - [Sarcoidosis of the nose]. PMID- 6483442 TI - [Case of pemphigus of the oral mucosa with complete remission after treatment with corticosteroids and immunosuppressive agents]. PMID- 6483443 TI - [2 cases of distant metastases melanoma of the skin to pharyngeal mucosa]. PMID- 6483444 TI - [Tympanosclerosis. II. Treatment]. PMID- 6483445 TI - [Coagulation studies in mucoviscidosis]. PMID- 6483446 TI - [Alcohol-induced liver damage in a 3-year-old child]. PMID- 6483447 TI - [Kidney agenesis in 2 generations. On the problem of humane genetic counseling in Potter syndrome]. PMID- 6483448 TI - [Usefulness of protein hydrolysates for the dietary treatment of phenylketonuria]. PMID- 6483449 TI - [Alpers syndrome (a case report)]. PMID- 6483450 TI - Cognitive modification of pain: information in combination with N2O. AB - The present study sought to discover whether information clarifying how the analgesic/sedative drug nitrous oxide (N2O) works would result in increased analgesic responses to painful stimuli when various concentrations of N2O were administered. Subjects were provided with high and low levels of information regarding the action and use of N2O as an analgesic and sedative. Absolute sensation threshold (AST), pain threshold (PTh), and pain tolerance (PTo) to tooth pulp shock were measured in microamperes during administration of each of 3 concentrations of N2O (15%, 30%, and 45%, with oxygen). Subjects rated stimulus intensity and stimulus aversiveness in response to a fixed painful stimulus, and completed questionnaires regarding the perceived efficacy of N2O and their subjective mood state throughout the session. The marked differences observed in pain reports between the high information group and the control group confirm that providing information to people receiving a drug for pain relief yields higher sensation thresholds, pain thresholds, and tolerance of pain. In addition, we observed that in the presence of N2O an equivalent fixed painful stimulus will be perceived as less painful after appropriate information is provided. These findings suggest that experimentally influencing thought processes, in combination with an analgesic, can have the effect of increasing analgesia. PMID- 6483451 TI - Perception of pulpal pain as a function of intradental nerve activity. AB - The purpose of the present investigation was to find neurophysiological correlates of pain perception. The magnitude and time course of perceived pain was successfully related to the neural discharge evoked by rapid cooling of the tooth surface in 6 dental patients whose lower incisors were to be extracted for prosthodontic reasons. Two cavities were prepared on the facial surface of human lower incisors. The cavities were deepened using hand driven instruments until the pulp was visible through a thin layer of dentin. A metal tube was placed in contact with amalgam on each cavity bottom and fixed in place by composite filling material. The tubes were connected to standard equipment for electrophysiological recordings by a flexible circuit. The magnitude of perceived pain was assessed by a cross-modality matching to finger span in combination with sensory verbal pain descriptors and magnitude estimation. The striking agreement between the integrated nerve activity, probably of the A delta type and pain perception, is of great importance from the methodological point of view since it strongly argues in favor of the appropriateness of the techniques applied here to elucidate the neural substrate of some types of nociception and also to evaluate various means of relieving such pain. PMID- 6483452 TI - Relationship between psychopathology and graduated spinal block findings in chronic pain patients. AB - The current study was undertaken to investigate the relationship between response to a graduated spinal block and the presence of psychopathology. Subjects consisted of 25 chronic pain patients who had received a graduated spinal block as part of their evaluation. Each was categorized along two dimensions by independent raters based on blind review of hospital records. Dimensions were (1) response to graduated spinal block (appropriate or inappropriate) and (2) presence of clinically significant psychopathology (definitive, probable or none). Results showed that subjects were well distributed across the two dimensions. A 2 X 3 chi-square comparison failed to show a significant relationship between the two dimensions. However, females and subjects with spontaneous pain onset were found to exhibit significantly more inappropriate responses to spinal blockage. It was concluded that there was no consistent relationship between the presence of psychopathology and response to the graduated spinal block. PMID- 6483453 TI - Evaluation of a daily activity diary for chronic pain patients. AB - The present study examined the reliability and validity of a daily activity diary for chronic pain patients. The diary assesses various postures and activities including time spent lying, sitting, or standing/walking, the use of pain relief devices, time spent in pain relief activities, and the use of analgesic medications. The methodology compared patient self-report on the daily activity diary to spouse observations of the same activities. In addition, patient self report of uptime/downtime was compared to the objective assessment of uptime/downtime by an automated electromechanical device. Reliability coefficients for the daily activity diary categories were all positive and statistically reliable as were correlations between patient and spouse ratings on lying down time, time spent standing/walking, and pain intensity. Also, patient self-report of medication use correlated significantly with spouse pill count. Finally, the correlation between patient report of lying down time and downtime as measured by the electromechanical monitor was also positive and highly significant. These results indicate that the daily activity diary is a reliable and valid instrument for the assessment of daily activity patterns of chronic pain patients in their natural environment. These results are discussed in relation to other research and the use of daily diaries for assessment and treatment outcome research with this population. PMID- 6483454 TI - Global appropriateness of pain drawings: blind ratings predict patterns of psychological distress and litigation status. AB - Previous studies examining pain drawings of low back pain patients have shown conflicting results in predicting elevations of MMPI scores. A study of 82 patients whose drawings were rated only for overall, anatomical appropriateness was conducted using the SCL-90 rather than the MMPI as the psychological assessment instrument. Significant differences were found between appropriate and inappropriate drawings; however, these differences seem to reflect differences in cognitive style of coping with pain as opposed to psychopathology. The implications and limitations of the study are discussed. PMID- 6483455 TI - Levels of urinary N-acetyl-beta-D-glucosaminidase (NAG) activity versus arterial hypertension. PMID- 6483456 TI - Effects of chronic alcohol ingestion on catalase activity in rat testis. PMID- 6483457 TI - Halothane-induced hepatic necrosis. A case report. PMID- 6483458 TI - Epidemiological aspects of epilepsy in the children of a Piedmontese district (Alba-Bra). PMID- 6483459 TI - Malignant colo-jejunal fistula. PMID- 6483460 TI - Evaluation of load transmission by removable partial dentures. PMID- 6483461 TI - Gastric acid secretion in Zollinger-Ellison syndrome. PMID- 6483462 TI - Impairment of lecithin:cholesterol acyltransferase (LCAT) activity in hemodialyzed subjects. I. No evidence of plasma LCAT-inhibiting factors. PMID- 6483463 TI - Over-distension therapy of the bladder in paraplegic patients using self catheterisation: a preliminary study. AB - Over-distension therapy was performed in 60 patients during the period of spinal shock after complete spinal cord injury. Forty-five developed upper motor neurone (UMN) hypo-active decompensated bladder function and 39 achieved satisfactory social activity without urinary incontinence using self-catheterisation. Self catheterisation appeared a safer and more comfortable means of urinary management than trigger voiding in paraplegics with complete spinal cord injury. This is a preliminary communication as it is hoped that a comparative study will follow in due course. PMID- 6483464 TI - Nicergoline in the treatment of neuropathic bladder dysfunction: a preliminary report. AB - We have employed the alpha blocking drug Nicergoline in 14 patients with neuropathic bladder dysfunction of the upper motor neurone type. The oral administration of 15-30 mgrs/day of this drug over a period of 9.5 months significantly improved the urodynamic parameters, with an increase of bladder capacity, a disappearance or amelioration of uninhibited bladder contractions and a decrease in urethral pressure, profile urethral length and residual urine. Two patients with vesico-ureteral reflux present before treatment showed radiological improvement after Nicergoline administration. Tolerance of Nicergoline had been excellent without appreciable side effects. In conclusion, Nicergoline seems to be active and well tolerated in the pharmacological treatment of neuropathic bladder dysfunction. PMID- 6483465 TI - Programme of active education in the psycho-social integration of paraplegics. AB - This is a programme involving active education in which not only those with paraplegia but also their families participate. The purpose is to break down the psycho-social isolation barrier of the patient and, thereby, resulting in minimal dependence upon his surroundings. Also, presented are the results of tests made of the persons participating in this project. These tests indicate the efficacy of the method in obtaining the desired results. PMID- 6483466 TI - Comprehensive education for those concerned with spinal cord injury patients. AB - The Commonwealth of Virginia has established a comprehensive programme for the management of the spinal cord injury (SCI) patients from the moment of injury through all aspects of rehabilitation into long-term follow-up. An average of 200 new patients are registered per year. A major emphasis of our programme has been the education of the patients and their relations and friends by means of group education of the patients and family follow-up contact, 'Family Days,' group lectures on selected topics, individual discussions, and discharge conferences. Audio-visual aids augment the programme. Patients are provided with printed literature on SCI for their own review and this is subsequently discussed with them. We have worked with the Emergency Rescue Team on early management; and education on prophylaxis has been carried out in the school systems statewide. Public awareness of the problems of the physically handicapped has been encouraged. Through our follow-up clinic we are attempting to reach the community facilities and community physicians, making them aware of the problem of SCI and discussing with them facilities that are available to assist in their management. While much has been accomplished we still have a long way to go. PMID- 6483467 TI - II. Coping with spinal cord injury. AB - Paraplegia creates social, sexual and emotional problems, and the impact of these was investigated in an interview study of 22 male and female paraplegics. Of particular concern was the way in which individuals were coping with the difficulties confronting them. People used a number of strategies for dealing with other people and their attitudes, and for readjusting sexually. In dealing with their own personal feelings about their disability, ways of coping were varied and included suppression, denial and repression, resignation and acceptance, positive thinking and independence and assertiveness. No specific recommendations can be made about ways of coping that will be most adaptive, since these will depend upon the individual and his or her circumstances. What is important for counselling, however, is to recognise the range of coping strategies that are available, and to be able to guide the individual toward those which effect the best match between their needs and the demands of the situation. PMID- 6483468 TI - Halo-body device. AB - A halo-body system is described which has been developed at Princess Margaret Rose Orthopaedic Hospital in Edinburgh. The system is easy to apply and consists of a standard halo, linked to malleable plates by two hollow vertical rods. These rods are connected to the ring by swivel joints which allow for the movements of flexion and extension. The malleable plates are incorporated into the plaster jacket which rests upon the iliac crests. The results of 13 patients who have had this system applied are discussed and include patients who have sustained fractures of the cervical spine or who have had bone destruction from metastatic disease or from infection. Using this type of system there have been few complications and the patients have benefitted from easy mobilisation. PMID- 6483469 TI - [Serological diagnosis of an infestation caused by the early developmental stages of botfly larvae (Oedemagena tarandi) in reindeer]. AB - Undertaken investigations have shown that the antigen prepared from larvae of O. tarandi is diagnostically effective and stricktly specific only to this infection in the reaction of indirect hemagglutination (RIHA). The experiments have proved the possibility of practical use of RIHA as a principal method of early diagnosis of infection of reindeer caused by O. tarandi. PMID- 6483470 TI - [Embryonic development of Trichocephalus trichiurus and Eucoleus oesophagicola (Nematoda, Trichocephalida)]. AB - The embryonal development of Trichocephalus trichiurus and Eucoleus oesophagicola is described. Clevage of both species is full, bilaterally-symmetrical, determined. At the two blastomere stage the epidermis material is localized in the anterior one. The development of both species lacks the rhomb figure characteristic of nematodes. The mouth opening breaks independent of blastopore. The stylet anlage formation was noted for T. trichiurus. PMID- 6483471 TI - [Method of disinfecting plague-infected fleas in preparation for electron microscopic study]. AB - During fixation of fleas infected with plague agent (with preliminary cut heads, limbs and posterior part of the abdomen) in 2.5% glutaric dialdehyde or 2% osmium tetroxide their disinfection was obtained in two days. After double fixation with 2-hour exposure in each of these fixators disinfection of the material was acheived only after additional 2-day maintenance in 70% ethyl alcohol. Fleas, which had been placed into fixators or in 70% ethyl alcohol after double fixation without preliminary dissection, were disinfected completely only in 10 days. PMID- 6483472 TI - [Signs of the disseminated intravascular coagulation syndrome in the early postresuscitation period in patients with massive blood loss and trauma]. PMID- 6483473 TI - [Disorder of the coagulating activity of afferent and efferent lymph from the popliteal lymph node in burn injury in dogs]. PMID- 6483474 TI - [The sympathetic nervous system, hemocytes and tumor growth]. PMID- 6483475 TI - [Effect of vagotomy on energy metabolism in the stomach muscle tissue of rats]. PMID- 6483476 TI - [Effect of hypoxia and hypoperfusion on the contractile function of the isolated heart working under various loads]. PMID- 6483477 TI - [Myocardial protein metabolism in different periods of experimental hypokinesia in rats]. PMID- 6483478 TI - [Effect of vitamin D on the development and generalized spread of adjuvant arthritis in rats]. PMID- 6483479 TI - [Characteristics of the inflammatory reaction to Freund's complete adjuvant in experimental neurogenic immunodeficiency]. PMID- 6483480 TI - [Glucocorticoid and antiglucocorticoid functions in acute diseases]. PMID- 6483481 TI - [The trend of hormonal shifts in the acute stress reaction in monkeys with different reactivities]. PMID- 6483482 TI - [The osmoregulatory function of the kidneys in chronic nephritis]. PMID- 6483483 TI - [Mineral metabolism of bones in osteomyelitis]. PMID- 6483484 TI - [Lysosome participation in the recovery processes in the liver following physical loading]. PMID- 6483485 TI - [Mechanisms of blood oxygenation disorders in the lungs and their correction]. PMID- 6483486 TI - [Transport and barrier protective functions of the lymphatic system in peritonitis and antibiotic therapy]. PMID- 6483487 TI - [Effect of environmental factors on platinum microelectrode readings in calibration solutions]. PMID- 6483488 TI - [Glycosylated hemoglobin as an index of the duration of hyperglycemia in diabetes mellitus patients]. PMID- 6483489 TI - [Correlational analysis of the indices of cardiac contractile function and its biochemical characteristics in experimental coronary insufficiency]. PMID- 6483490 TI - [Coefficients for the standardization of gas volumes]. PMID- 6483491 TI - [In vivo study of human chemotaxis]. PMID- 6483493 TI - The pediatrician's role in sports medicine. PMID- 6483492 TI - [Analysis of systemic hemodynamic changes in the victims of severe mechanical injuries in the early stages of traumatic disease]. PMID- 6483494 TI - The team physician. PMID- 6483495 TI - The pediatrician and athletic injuries. PMID- 6483496 TI - Drugs and the adolescent athlete. AB - The pediatrician performing a preparticipation physical examination on an adolescent athlete should discuss the use of ergogenic aids. This could be with all of the athletes present in the case of the mass screening examination, or in private during the preferred office-based physical examination, whether preparticipation or health maintenance. Knowing which sport the youth is active in can lead to the drugs most likely being misused being emphasized by the physician; ie, androgens in the case of weightlifting and football, and amphetamines in competitive events like swimming, football, and track. Not only should the risks be discussed (an unsuccessful way to influence adolescents' behavior), but the drugs' degree of ineffectiveness should be stressed. Finally, and possibly at least as importantly, the moral question of a competitor attempting to gain an "illegal edge" should be addressed. PMID- 6483497 TI - The athletic adolescent with amenorrhea. PMID- 6483498 TI - Chronic knee pain in the athlete. PMID- 6483500 TI - Symposium on recurrent pain in children. PMID- 6483499 TI - Recurring pain in the pediatric athlete. AB - Increased interest in youth sports and in physical fitness has led to greater awareness of the pain syndromes that occur in the pediatric athlete. This article examines various pain syndromes in the athlete by anatomic region and offers guidelines for management. PMID- 6483501 TI - Tolazoline pharmacokinetics in lambs. AB - Tolazoline has often been administered experimentally to lambs without consideration of its pharmacokinetics. We have used a chemically specific assay to determine tolazoline pharmacokinetic parameters in lambs after pulse and infusion doses: alpha = 0.184 +/- 0.046 (min-1), beta = 0.010 (pulse) and 0.0098 (infusion) +/- 0.0010 (min-1), Vdarea = 2534 +/- 688 ml/kg (pulse), and Vdss = 2890 +/- 342 ml/kg (infusion). The following doses can be used to reach steady state plasma tolazoline concentrations: loading dose (microgram/kg) = 2890 X desired concentration (microgram/ml); infusion rate (microgram/kg X min) = 2890 (.010) X desired concentration (microgram/ml). These doses were used to produce 68 steady-state concentrations from 0.25 to 10.0 micrograms/ml. Clearances at steady state averaged 166 ml/min or 27.1 ml/min X kg at 2-17 days but increased markedly by 4 weeks of age. Using these doses, tolazoline-receptor interactions can be studied at constant plasma concentrations that approximate constant receptor concentrations. PMID- 6483502 TI - Effects of hypoxia on norepinephrine uptake by developing rabbit lung. AB - Pulmonary extraction of radiolabeled norepinephrine (NE) was evaluated in newborn rabbits aged 1 to 3 days. Twenty pups were raised from birth in an hypoxic environment (FiO2 = 0.16-0.17) and 10 were raised in room air for study as controls. NE extraction was measured using an isolated, perfused lung technique. In hypoxic animals, average percent removal of NE was significantly reduced (p less than 0.05) as compared to controls while pulmonary pressures were increased (p less than 0.05) compared to controls. The data suggest that hypoxia reduces the ability of the lung to clear norepinephrine. This may be a factor in systemic and pulmonary vasomotor responses to hypoxia. PMID- 6483503 TI - Pulmonary and systemic vascular responses to tolazoline in neonatal and mature calves. AB - Tolazoline was infused intravenously (2 mg/kg over 2 minutes) in awake neonatal and mature calves. In normoxic pulmonary normotensive neonatal calves, tolazoline induced minimal hemodynamic changes, except for an immediate bradycardia. Tolazoline caused increases in systemic arterial pressure and vascular resistance and a bradycardia in normoxic normotensive mature calves. Calves were also made hypoxic, by breathing 12% O2 by facemask, in order to produce pulmonary hypertension. In hypoxic pulmonary hypertensive neonatal calves, tolazoline induced transient pulmonary vasodilation, a reduction in systemic arterial pressure, and marked bradycardia. Similarly, tolazoline caused reductions in pulmonary and systemic arterial pressure and bradycardia in hypoxic pulmonary hypertensive mature calves. Pentobarbital anesthesia in neonatal calves induced marked hemodynamic changes but did not alter the cardiovascular responses to tolazoline. A significant correlation was found between the baseline pulmonary arterial pressure and the magnitude of the pulmonary depressor response to tolazoline when all interventions were evaluated. Thus, tolazoline induced transient pulmonary vasodilation in pulmonary hypertensive calves but simultaneously caused profound transient bradycardia, particularly in neonatal calves. PMID- 6483504 TI - The protective effect of carnitine in human diphtheric myocarditis. AB - Carnitine, an important cofactor in the transport of fatty acids to the interior of cell mitochondria, is depleted in myocardial tissue of guinea pigs submitted to diphtheric toxin administration. Mortality rates were reduced in these animals by supplying exogenous amounts of carnitine. The accumulation of fatty acids in the cytoplasm of human heart cells reported in cases of diphtheria suggests that carnitine might possibly be depleted in human myocardium as well. For the purpose of studying the effect of carnitine administration, 132 diphtheric patients were randomly divided into two groups, one of them (carnitine-treated group, n = 73) receiving DL-carnitine, 100 mg/kg/day during 4 days after admission, in addition to routine treatment, which was prescribed for this and the control group (n = 59). The presence of myocardial damage was evaluated by clinical, electrocardiographic, radiological, and enzymatic criteria. Carnitine administration resulted in decreased incidence of heart failure (P = 0.0475), of pacemaker implants (P = 0.0256), and of lethality indexes due to myocarditis (P = 0.013). We suggest that carnitine can play an important role in the treatment of diphtheric patients. PMID- 6483506 TI - Vasopressin concentration in amniotic fluid as an index of fetal hypoxia: mechanism of release in sheep. AB - Hypoxia is a potent stimulus to the release of vasopressin in fetal sheep, and plasma concentrations of the hormone correlate inversely with fetal oxygenation. Since the fetal kidney contributes to vasopressin clearance, we propose that measurement of increased amounts of vasopressin in amniotic fluid would be indicative of fetal hypoxia. Therefore, we measured concentrations of vasopressin in amniotic fluid under resting conditions, during and after fetal hypoxia, and with intravenous and intra-amniotic administration of vasopressin in 15 chronically instrumented fetal lambs between 111 and 141 days gestation. In the resting state, mean (+/- SE) vasopressin concentrations in amniotic fluid (1.6 +/ 0.3 pg ml-1) did not differ from those in maternal (1.4 +/- 0.4 pg ml-1) or fetal (1.8 +/- 0.2 pg ml-1) plasma. Following exposure of the ewe to 10% O2 or partial occlusion of the umbilical cord, vasopressin concentrations in fetal plasma increased significantly (P less than 0.001) to 200 +/- 59 pg ml-1 with a delayed increase in amniotic fluid concentrations (P less than 0.03) to 15.8 +/- 4.5 pg ml-1. This rise in concentration of vasopressin in amniotic fluid was sustained for at least 24 h and levels at that time were highly correlated with peak plasma concentrations (r = 0.83; P less than 0.001). Intravenous infusion of vasopressin into the fetus was accompanied by an equally significant (P less than 0.02) and sustained increase of vasopressin in amniotic fluid. Following intra amniotic injection of vasopressin, levels remained increased for at least 24 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483505 TI - Regulation of upper airway maintaining muscles during progressive asphyxia. AB - The electromyographic activity of an upper airway muscle (genioglossus, GG) and the diaphragm were studied in 10 adult and three young anesthetized rabbits during progressive asphyxia induced by airway occlusion. Results were similar for both age groups. Peak inspiratory activity of GG muscle increased more than that of the diaphragm during both the hyperpnea and gasping (P less than 0.05). The increase in GG activity during gasping was not significantly different from that during hyperpnea even though an important stimulus, arousal, was absent during gasping. During end stage asphyxia, as the strength of gasps grew weaker, the rate of loss of GG muscle activity was greater than that of the diaphragm. However, GG activity remained greater than that of the diaphragm at the time of the last spontaneous gasp. As asphyxia progressed, inspiratory duration and the inspiratory contour of integrated electromyogram activity of both muscles changed. These data indicate differences in the control mechanism of the genioglossus and diaphragm during acute severe asphyxia. Increased upper airway muscle activity seen during gasping should help preserve upper airway patency and facilitate autoresuscitation by gasping. These observations of coordinated changes in timing and activity of two functionally different respiratory muscles support the concept that gasping is a highly organized function of the respiratory centers. PMID- 6483507 TI - Growth-related changes in oxygen uptake and heart rate during progressive exercise in children. AB - Although body size and muscle mass increase considerably during growth in children, certain aerobic responses to exercise appear to be regulated so that the delivery of oxygen to muscle is maintained at optimized levels. We proposed that the relationship between oxygen uptake, (VO2) and heart rate (HR) was one of the regulated responses. We further hypothesized that the increase in VO2 per increase in HR during progressive exercise would differ in subjects of different size, but when normalized to body weight would be constant since changes in muscle mass are highly correlated to changes in body mass. To test this, we performed a cross-sectional study of 107 normal children, 50 girls and 57 boys ranging in age from 6 to 17 years. The protocol consisted of a continuously increasing work rate on a cycle ergometer, to the limit of the child's tolerance (ramp forcing function). Gas exchange was measured breath-by-breath for the determination of VO2, and heart rate was measured beat-by-beat. We used linear regression techniques to determine M, the slope, and B, the y intercept of the equation: VO2 = M X HR - B. In both boys and girls, M increased significantly with body weight, but when normalized for body weight (M/kg), there was no systematic change with increasing weight or age, the mean value being 0.33 +/- 0.10 ml/min/kg (SD). The mean value for the boys was 0.37 +/- 0.10 which was significantly greater than that of the girls (0.29 +/- 0.08, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483508 TI - The relationship between the branched chain amino acids and their alpha-ketoacids in maple syrup urine disease. AB - Plasma branched chain amino acid levels and their respective ketoacid analogues were determined in seven maple syrup urine disease patients ranging in age from 12 h to 12 years. One hundred one pairs were analyzed. There was a high degree of correlation between the amino acid and its ketoacid analogue at every amino acid level. The coefficient of correlation (0.84) was highest for leucine-alpha ketoisocaproic acid. The ratio of ketoacid analogue to amino acid, (0.87), was also the greatest for leucine. The close correlation implies that adequate monitoring for therapy can be accomplished by the use of the technically simpler and more rapid determination of the plasma branched chain amino acids. PMID- 6483509 TI - Vasodilators and ventricular septal defect: comparison of prazosin, minoxidil, and hydralazine in a chronic lamb model. AB - The volume overloading of the left ventricle which results from left to right (L R) shunting through a ventricular septal defect (VSD) may be reduced by pharmacologic agents which lower systemic vascular resistance (Rs) in excess of pulmonary arteriolar vascular resistance (Rpa). To study agents capable of decreasing the L-R shunt through systemic vasodilatation, we created a chronic lamb model with VSD and administered three vasodilators, prazosin (0.05 mg/kg), hydralazine (0.75 mg/kg), and minoxidil (0.25 mg/kg). Prazosin increased the Rpa while lowering Rs, resulting in an increase in Rpa/Rs by 43% (p less than or equal to 0.005). Prazosin decreased the pulmonary flow (Qp) slightly, decreased L R shunt by 16%, reduced the pulmonary to systemic flow ratio (Qp/Qs) by 22% (p less than or equal to 0.005), and lowered the left atrial mean pressure (LA) by 16% (p less than or equal to 0.005) with no effect on heart rate. Hydralazine lowered the Rpa and Rs equally and thus did not change the Rpa/Rs or the volume of L-R shunt (7.6 versus 8.1 liters/min/m2). No change in LA was seen with hydralazine but heart rate increased from 162 to 200/min (p less than or equal to 0.01). Minoxidil did not change the L-R shunt (6.9 versus 6.8 liters/min/m2) and, in general, produced effects intermediate between prazosin and hydralazine. The data support a selective systemic vasodilation with prazosin, a property not shared by either minoxidil or hydralazine, which results in a reduction of shunting and left ventricular volume overloading in lambs with VSD.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483511 TI - Pulmonary antioxidant enzyme maturation in the fetal and neonatal rat. II. The influence of maternal iron supplements upon fetal lung catalase activity. AB - It was observed that the lung catalase activity of premature (day 21 of gestation; term = 22 days) rat pups is affected by maternal iron intake. Pups from control dams receiving Purina Lab Chow and water ad libitum have only 50% of the lung catalase activity of pups from dams who received 1 mg/kg parenteral iron dextran daily from day 7 to day 20 of gestation. Other oxygen-protective enzymes, copper-zinc and manganese superoxide dismutase, glutathione peroxidase, and glucose-6-phosphate dehydrogenase, were unaffected by maternal iron supplements. PMID- 6483510 TI - Studies of lipids, lipoproteins, and apolipoproteins in Menkes' disease. AB - Three patients with Menkes' disease, an inherited disorder of copper transport, were studied to determine whether the copper deficiency was associated with a lipoprotein disorder. Hypocuprinemia was documented in all three cases. Two patients had severe copper and ceruloplasmin deficiencies, whereas the third patient had a less severe deficiency. Hypertriglyceridemia was observed in the first patient, and elevations in triglyceride, cholesterol, apolipoprotein B (ApoB), and apolipoprotein C-III (ApoC-III) occurred predominantly in the very low density lipoprotein fraction (VLDL). This patient had normal lipoprotein lipase activity but mild glucose intolerance. The second patient had a borderline high cholesterol level with normal plasma triglycerides and apolipoproteins, whereas the third patient appeared to have normal total cholesterol but slightly higher triglycerides with elevated plasma apolipoprotein E (ApoE). No striking differences were observed in the chemical composition of all lipoprotein subfractions between patients and controls except that the neutral lipid content of VLDL was higher in patients than in controls. The ApoB was initially normal in molecular weight but degraded faster than the controls during storage. The appearance of the major low density lipoprotein (LDL) fraction of the first two patients was opaque white, in contrast to clear yellow in the third patient and in the age- and diet-matched controls. This abnormal appearance of LDL in these patients was associated with low plasma levels of beta-carotene and ceruloplasmin. These findings suggest that decreased serum copper levels may be associated with lipid and lipoprotein abnormalities and may enhance lipid peroxidation of LDL accounting for the color change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483512 TI - The effects of tolazoline on the distribution of cardiac output in normoxemic and hypoxemic lambs. AB - We measured cardiac output and its distribution (microspheres), blood gases and pH, heart rate, and pulmonary and aortic pressures in three groups of 1- to 3-day old lambs. Group I consisted of six animals who had these measurements made during both control (normoxemic) and hypoxemic (PaO2 25 +/- 3 mm Hg) periods. Hypoxemia increased the pulmonary artery pressure 70% (p less than 0.01). This elevation in pulmonary arterial pressure lasted as long as the animals were hypoxemic (90 min). Hypoxemia had no effect on cardiac output, mean systemic arterial pressure, heart rate, or the rate-pressure product of the left ventricle. Blood flow to the heart increased an average of 228% (p less than 0.05); flow to the brain increased 233% (p less than 0.05); flow to the skin decreased 35% (p less than 0.05) after 60 and 90 min of hypoxemia. Blood flow to the remaining organs was uneffected by hypoxemia. Group II consisted of four animals who were given 1, 5, and 10 mg/kg/h of tolazoline (Priscoline) intravenously while normoxemic. There was no effect on the pulmonary arterial pressures or blood gases and pH. Tolazoline (5 and 10 mg/kg/h) reduced systemic arterial pressures an average of 22% (p less than 0.05). Tolazoline (1 mg/kg/h) reduced blood flow to the spleen 48% and that to the brain by 20% and increased flow to the body 32% (p less than 0.05). Five mg/kg/h of tolazoline decreased renal and brain blood flow 35 and 20%, respectively (p less than 0.05) while that to the body and liver increased 26 and 48% (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483513 TI - A longitudinal study of rhesus monkey (Macaca mulatta) milk composition: trace elements, minerals, protein, carbohydrate, and fat. AB - The concentrations of iron, copper, zinc, calcium, magnesium, sodium, potassium, protein, carbohydrate, and fat were analyzed in milk from rhesus monkeys (Macaca mulatta) during the course of lactation. Concentrations of iron, copper, zinc, magnesium, sodium, potassium, and protein were higher in milk of early lactation (colostrum) than in mature milk, while concentrations of calcium increased with lactation time. Concentrations of zinc in monkey colostrum and mature milk were similar to that of human milk, while iron, copper, calcium, and protein concentrations were higher than in human milk. PMID- 6483515 TI - Who should provide primary health care to children: pediatricians or family medicine physicians? PMID- 6483514 TI - Application of receiver-operator analysis to diagnostic tests of iron deficiency in man. AB - The objective of the present report is to demonstrate the use of receiver operator characteristics (ROC) analysis in the selection of diagnostic tests for iron deficiency in a specific population. Conventional ROC curves were prepared with true positive fraction (TPF) and false positive fraction (FPF) determined by the application of different cut-off points for four indicators of iron status. ROC plots were then transformed into normal deviate scales. The advantages of Gaussian transformation of TPF and FPF when underlying decision functions are normally distributed are: the ROC curve is a straight line; and the separation between the two distributions and shape of these distributions can be simply quantitated as intercepts and slopes. In the present study, pretreatment hemoglobin concentration was the most robust diagnostic indicator of iron deficiency as operationally defined by a response of hemoglobin to iron treatment. Free erythrocyte protoporphyrin was a more sensitive and specific predictor than either serum ferritin or transferin saturation when a stringent operational definition of iron deficiency was used. These findings illustrate the utility of ROC analysis in discriminating between diagnostic indicators having different degrees of accuracy. PMID- 6483516 TI - Recognition of neonates by facial-visual characteristics. AB - A series of experiments investigated the salience of newborn infants' facial visual features for recognition and sex identification. Within 33 hours post partum, mothers recognized photographs of their own offspring when presented with those of unrelated neonates. Furthermore, adult subjects were able to match photographs of unfamiliar mothers and their infants, and determine the sex of neonates, at a greater than chance level of accuracy. Although recognizable facial features are presumably genetically determined, maternal recognition of offspring probably results from brief exposure and familiarization as well as physical resemblance between the infant and other familiar family members, including the mother herself. PMID- 6483517 TI - A survey of pediatric resident training programs 5 years after the Task Force report. AB - Twenty-nine pediatric residency training programs responded to a survey with detailed descriptions of the scheduled rotations before and after the Report of the Task Force on Pediatric Education. This survey documented some changes in the overall structure of residency programming in that all programs demand 3 years of general pediatric training. Little if any changes were noted in the traditional emphasis on inpatient and neonatal training. Some changes in content area have been noted, namely a modest increase in the experiences in adolescent medicine. The survey failed to demonstrate any trend indicating increased emphasis on training experiences in the "new morbidity." PMID- 6483518 TI - Twin transfusion syndrome causing cutaneous erythropoiesis. AB - Two cases of twin transfusion syndrome are described in which the donor twin exhibited blueberry muffin-like macules and papules associated with cutaneous erythropoiesis. No evidence was found in either case for intrauterine viral infection, the most common cause of cutaneous erythropoiesis. Cutaneous erythropoiesis is these two cases is considered to be due to persistence or reactivation of fetal dermal erythropoiesis secondary to prolonged, severe intrauterine anemia. PMID- 6483519 TI - Radiologic manifestations of malabsorption: a nonspecific finding. AB - Children demonstrating a radiologic malabsorption pattern on small bowel follow through study performed for other reasons are frequently subjected to intensive gastrointestinal investigations, even in the absence of clinical manifestations of malabsorption. To determine the usefulness of this radiologic finding, the clinical findings of all patients with the typical malabsorption pattern on small bowel follow-through examination were reviewed retrospectively. The presence of a malabsorption pattern was based on three radiologic criteria: flocculation and segmentation of barium, thickening of mucosal folds, and dilation of intestinal loops. Thirteen patients fulfilled the criteria for radiologic malabsorption pattern, but six (46%) had no clinical evidence of malabsorption, according to 3- to 5-day fecal fat analysis. In addition, five of these patients had normal mucosal histologic findings on duodenal biopsy. It was concluded that radiologic malabsorption pattern is a nonspecific finding, and in the absence of other clinical features suggestive of malabsorption or growth failure further investigations may not be justified. PMID- 6483520 TI - Erratic absorption of a slow-release theophylline sprinkle product. AB - The bioavailability and absorption pattern of theophylline from a slow-release theophylline sprinkle preparation were investigated in 12 asthmatic children both in fasting conditions and after a standardized meal. Theophylline given intravenously was used as a reference. Theophylline from the slow-release theophylline product was well absorbed under fasting conditions, but both absorption pattern and bioavailability were severely affected by concomitant food intake: a delay in absorption was found and the bioavailability was reduced from 91% (fasting) to 44% (P less than .001). The erratic absorption of theophylline after food intake complicates safe therapy with the preparation and calls attention to the fact that it is not sufficient to investigate the absorption characteristics of slow-release theophylline preparations under fasting conditions only. PMID- 6483522 TI - The pediatrician's guide to computer videodiscs. AB - Computer-videodisc technology is currently redefining the uses and possibilities of media-assisted education. A specific videodisc program developed for use in pediatric education is described; the present state of videodisc technology is explained; possible future medical applications of this technology are suggested. PMID- 6483521 TI - Transcutaneous oxygen tension during nonnutritive sucking in preterm infants. AB - The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants. PMID- 6483523 TI - Intellectual malnutrition: American schools and the pediatrician's duty. PMID- 6483524 TI - 'Failure to thrive' or the failure to define. PMID- 6483525 TI - Coronavirus? PMID- 6483526 TI - Bacterial flora of breast-fed infants. PMID- 6483527 TI - Vitamin E toxicity. PMID- 6483528 TI - A pediatrician's program for the prevention of dental caries in the first years of life. PMID- 6483529 TI - Effect of maternal-fetal platelet incompatibility on fetal development. PMID- 6483530 TI - A believer in phototherapy. PMID- 6483531 TI - Report of the Task Force on the Assessment of the Scientific Evidence Relating to Infant-Feeding Practices and Infant Health. PMID- 6483532 TI - Report of the Task Force on the Scientific Evidence Relating to Infant-Feeding Practices and Infant Health. Executive summary. PMID- 6483533 TI - Trends in breast-feeding. PMID- 6483534 TI - Breast-feeding, birth interval, and infant health. PMID- 6483535 TI - [Morphometric examination of gastric and duodenal mucosa in children with gastroduodenitis]. PMID- 6483536 TI - [Pathogenesis of chronic gastritis in children]. PMID- 6483537 TI - [Lysozyme activity and immunoglobulin level in the duodenal contents of preschool children with chronic gastroduodenitis]. PMID- 6483538 TI - [SDH activity in biopsy specimens of gastric mucosa and lymphocytes of children with chronic gastroduodenitis]. PMID- 6483539 TI - [Intestinal absorption in children with gastric and duodenal diseases]. PMID- 6483540 TI - [Inflammatory changes in the jejunal mucosa of children with chronic enteritis]. PMID- 6483541 TI - [Diagnostic value of ileoscopy and morphometric examinations of the ileal mucosa in children with ileitis]. PMID- 6483542 TI - [Clinical features and morphometric characteristics of the large intestine mucosa in children with chronic colitis]. PMID- 6483543 TI - [Blood coagulation system in children with diseases of the large intestine]. PMID- 6483545 TI - [Imbalance of aggression and protective factors in the gastric juice in children with exacerbated peptic ulcer]. PMID- 6483544 TI - [Indicators of carbohydrate-containing biopolymers in children and adults with peptic ulcer and in their relatives]. PMID- 6483546 TI - [Complications of peptic ulcer in children]. PMID- 6483547 TI - [Organization of legal services in a municipal pediatric polyclinic]. PMID- 6483548 TI - [Drug-induced disease--Lyell's syndrome and agranulocytosis--in a young child]. PMID- 6483549 TI - [Nosological principles and classification of infection]. PMID- 6483550 TI - [Indicators of resistance and the functional state of the digestive system in children]. PMID- 6483551 TI - [Factors in the progression of gastric and duodenal diseases in children]. PMID- 6483552 TI - Vibrotactile pattern recognition and discrimination at several body sites. PMID- 6483553 TI - Change of a frame of reference with velocity in visual motion perception. PMID- 6483555 TI - Perceived numerosity: a comparison of magnitude production, magnitude estimation, and discrimination judgments. PMID- 6483554 TI - Masking by light and the sustained-transient dichotomy. PMID- 6483556 TI - Response-dependent effects on near-threshold detection performance: saccades versus manual responses. PMID- 6483557 TI - Effects of arousal on human visual dominance. PMID- 6483558 TI - Performance differences among the intervals in forced-choice tasks. PMID- 6483559 TI - The category effect in visual search depends on physical rather than conceptual differences. PMID- 6483560 TI - Cross-modal effects on visual and auditory object perception. PMID- 6483561 TI - Auditory induction of discrete tones in signal detection tasks. PMID- 6483562 TI - Vibratory temporal integration as a function of pattern discriminability. PMID- 6483563 TI - Categorical perception, category boundary effects, and continuous perception: a reply to Hary and Massaro. PMID- 6483565 TI - Hemispheric mediation of same-different judgments. PMID- 6483564 TI - A neural-holographic model of sensory and memorial oblique effects. PMID- 6483566 TI - The placenta in pregnancies complicated by diabetes mellitus. PMID- 6483567 TI - Congenital malformation in offspring of diabetics. PMID- 6483568 TI - The morphology of ventricular septal defects. AB - Ventricular septal defect (VSD) is the most common congenital cardiac lesion, occurring either in isolation or in hearts containing more complex lesions. Usually, the defect is between two ventricles, each of which is connected to a separate atrium and to a separate great artery, and surgical or spontaneous closure of the VSD basically corrects the circulation if the effects of any associated lesion are ignored. In other situations, the VSD is an integral part of the circulation, either because the atria connect to only one ventricle or because the ventricles give rise to only one patent great artery or else both great arteries arise from the same ventricle. When in such circumstances the circulation is VSD-dependent and the defect cannot be surgically closed without bypassing it with a conduit or similar device. In all of these situations, the VSD takes one of three basic forms. Usually, the VSD abuts directly upon the fibrous skeleton of the heart formed by the conjoined rings of the cardiac valves. The membranous part of the ventricular septum is an integral part of this skeleton, and these defects are termed perimembranous. These defects do not always occupy the same part of the septum. They may extend mostly into either the inlet, trabecular, or outlet parts of the muscular septum, or else be confluent extending into two or all these parts. Less commonly, VSD may be exclusively contained within the muscular septum. Such muscular defects can also be confined to either the inlet, trabecular, or outlet parts of the septum. They may be multiple or coexist with one of the other types. The third and least common type is a VSD which is roofed by the conjoined rings of the aortic and pulmonary valves because of absence of the outer septum. Such a defect may have a muscular posteroinferior rim or may extend to become perimembranous. Identifying a defect as perimembranous or muscular, together with its location relative to the different parts of the muscular septum, gives at the same time information concerning the site of the conduction axis in relation to the defect and its chances of spontaneous closure. PMID- 6483569 TI - The classification and mechanisms of spontaneous abortion. AB - This classification of spontaneous abortions, based on placental rather than embryonic or fetal morphology, does not entail detailed embryological or histological techniques. It is readily adaptable to routine pathological laboratory practice. The advantages that may accrue from proper examination of spontaneous abortions are numerous and include provision of both clinical and epidemiological data pertinent to the immediate management of the aborting patient, as well as basic information that may clarify the mechanisms underlying the major complications of pregnancy which contribute to perinatal mortality in developed societies. The pathology of the placenta in groups 1 and 2 is seen as a possible indicator of the mechanisms leading to spontaneous abortions in man. The lesions are not seen in isolation but are viewed as a logical progression related to the time at which normal development ceases. The key and unifying concept in the hypothesis is the role of the villous circulation in the maintenance of normal trophoblastic function. In the earliest abortions, the villous circulation never develops, resulting in microscopic hydatidiform or hydropic change within the villus and attenuation of the trophoblast, while embryonic or fetal death following the establishment of a villous circulation results in the sequential changes characteristic of group 2 cases. Although the majority of embryonic and fetal deaths still remain unexplained, the hypothesis suggests a mechanism by which the abnormal conceptus may determine the outcome of pregnancy without invoking the concept of maternal rejection. Verification and extension of this hypothesis will require correlation of clinical, endocrinological, and morphological data. The histopathologist has failed to keep pace with advances in modern obstetrics during the last decade, particularly in the field of early pregnancy wastage, thus reinforcing the clinical opinion that morphological examination of abortions has little to offer in the clinical management of these cases. If counseling and therapy are to be based on scientific concepts rather than on empirical data, it is essential that this deficiency be rectified. PMID- 6483570 TI - Colloidal structures of O/W creams. AB - O/W creams with crystalline gel structures (Water Containing Hydrophilic Ointment DAB 8, Non-ionic Hydrophilic Ointment DAC and a stearate cream) were investigated by means of small angle X-ray diffraction, differential scanning calorimetry, thermogravimetry and freeze fracture technique in combination with Transmission Electron Microscopy (TEM). It was found that these bases are building up two different colloidal gel structures, a hydrophilic gel phase and a lipophilic gel phase, each of them forming a coherent network. The hydrophilic gel phase is characterized by an interlamellar water layer; this interlamellarly fixed water is in a dynamic equilibrium with the bulk water phase. The lipophilic gel phase immobilizes mainly the inner (dispersed) phase. So the O/W creams presented here are supposed to be four-phase systems. The ratio of interlamellarly fixed water and bulk water, which may be determined easily by means of thermogravimetry, is found to be an important quality criterion for these O/W creams. The desired properties of water release of such a cream may be chosen by shifting the ratio of interlamellarly fixed water and bulk water. PMID- 6483571 TI - Effects of methoxy groups in the NI-substituent of sulfonamides on the pathways of elimination in man. The acetylation-deacetylation equilibrium and mechanisms of renal excretion of sulfisomidine, sulfamethomidine and sulfadimethoxine. AB - Sulfisomidine, sulfamethomidine, sulfadimethoxine and their corresponding N4 acetyl derivatives were administered to man. The percentages of acetylation and deacetylation and those of protein binding, the half-lives of elimination and the apparent and true renal clearance values were measured. No acetylation phenotype could be demonstrated in these compounds. Methoxy substitution in the NI pyrimidine group of sulfisomidine affects predominantly the renal clearance value and mechanism of the parent compound but has no influence on the renal clearance of the N4-acetyl derivatives. The renal clearance value of sulfisomidine is 232 +/- 33 ml/min, of sulfamethomidine 21.60 +/- 16.4 ml/min and of sulfadimethoxine 10.87 +/- 10.44 ml/min. The renal clearance values of the corresponding N4 acetylsulfonamide derivatives are 314 +/- 91 ml/min, 342 +/- 63 ml/min and 202 +/ 65 ml/min respectively. Tubular reabsorption, caused by methoxy substitution in the NI-pyrimidine ring, lowers the rate of elimination and increases the half life. The half-life of sulfisomidine is 8.5 +/- 0.5 h, of sulfamethomidine 27.8 +/- 5.3 h and of sufadimethoxine 34.6 +/- 10.4 h. PMID- 6483572 TI - The essential oil of Ducrosia anethifolia (DC.) Boiss. Chemical composition and antimicrobial activity. AB - The essential oil from herb of Ducrosia anethifolia (DC.) Boiss., growing wild in Iran, was investigated by LSC, GLC and GC-MS. The oil consisted mainly of aliphatic compounds. alpha-Pinene, myrcene and limonene were main components of the hydrocarbons present in the oil, while n-decanal, n-dodecanal, n-decanol, trans-2-dodecenal, and cis-chrysanthenyl acetate were the major oxygen-containing constituents. The oil and the main oxygen-containing aliphatic components showed a remarkable antimicrobial activity against gram-positive bacteria, a yeast, and some dermatophytes. PMID- 6483573 TI - Electrical properties of oligodendrocytes in culture. AB - The electrical properties of immunocytologically identified oligondendrocytes from embryonic mouse spinal cord maintained in culture for 3 to 6 weeks studied by passing current and recording potential changes with two separate intracellular electrodes. The average input resistance was 3.3 M omega and ranged from 0.7 to 16 M omega (n = 35). The input resistance increased by 19% with depolarization and decreased by 9% with hyperpolarization of 25 mV. The membrane time constant determined from the slope of the late exponential tail was 3.45 +/- 2.5 ms SD (n = 15). The specific membrane resistance of three cells was determined by a simplified square pulse analysis combined with measurement of membrane area. Membrane area was estimated from photomicrographs of cells injected with Lucifer Yellow CH and stained with the cell surface-reactive antibody 04 and from electron micrographs. An average specific membrane resistance of 1.3 X 10(3) omega cm2 and specific capacitance of 1.7 mu F/cm2 were calculated. Increasing [K+]o depolarized the cells and decreased the input resistance and the time constant. PMID- 6483574 TI - Renal processing of low molecular weight proteins. AB - Previous renal clearance studies provided quantitative data concerning renal reabsorption of proteins while the simultaneous processes of renal accumulation and degradation remain, to a great extent, insufficiently investigated. Thus, it was the aim of this study to measure renal reabsorption of egg-white lysozyme at various lysozyme concentrations and to relate the corresponding accumulation and degradation of lysozyme to the lysozyme transport rates in intact rats and isolated perfused rat kidneys. Lysozyme (with 125I-lysozyme in certain experiments), was continuously infused i.v. or added to the perfusate to achieve plasma (or perfusate) concentrations of lysozyme (PLY) of approximately 50, 500 or 1000 mg X 1(-1) for periods of time varying between 3 and 120 or 150 min. Clearances of inulin and lysozyme or the total content of radioactivity and the trichloroacetic acid (TCA)-soluble radioactivity in the kidney tissue were determined at the end of clearance or accumulation periods. Additionally the perfusate concentration of the metabolite tyrosine was measured by high performance liquid chromatography (HPLC). The reabsorption rates of lysozyme (TLY) were concentration-dependent in both intact rats and isolated perfused rat kidney. After 25 min of lysozyme infusion, the lysozyme reabsorption rates amounted to 37, 245 and 331 micrograms X min-1 X g-1 kidney at the above lysozyme concentrations. After the same infusion time, the accumulation rates of lysozyme were 8, 59 and 118 micrograms X min-1 X g-1 kidney. The difference between the transport rate and accumulation rate should represent the renal degradation rate of lysozyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483575 TI - Distribution of elements in the pancreatic exocrine cells determined by electron probe X-ray microanalysis. AB - We measured the intracellular electrolytes of acinar cells by making electron probe X-ray microanalysis of hydrated and dehydrated sections of freshly frozen dog pancreas. The concentrations of electrolytes in the cytoplasm were: Na 4.8 +/ 2.1, K 132 +/- 15, Cl 14 +/- 4.7, P 165 +/- 36, S 19 +/- 2.8 and in zymogen granules: Na 6 +/- 5, K 60 +/- 16, Cl 31 +/- 20, P 36 +/- 8, S 172 +/- 25, Ca 7 +/- 5 (mean +/- S.D. mmol/kg wet weight). The cytoplasm, which is rich in rough endoplasmic reticulum, had low Na and high K concentrations, as compared with levels in the acinar cells of other exocrine glands such as the submandibular gland, the bulk of which is occupied by secretory granules. Though the representative feature of secretory granules was a high S content, occasionally low S peaks of spectra from secretory granules were obtained. These findings may reflect the content of mature zymogen granules and immature condensing vacuoles. Pilocarpine stimulation increased cytoplasmic Na, Cl and Ca and decreased K levels in the pancreatic acinar cells. This indicates that secretory stimulation increases the permeability of the cell membrane to Na, Cl and K ions and that there is a simultaneous Ca release from the intracellular Ca stores such as zymogen granules and endoplasmic reticulum, and/or Ca influx from the extracellular space. PMID- 6483576 TI - Aldosterone-induced sodium transport in lower intestine. Effects of varying NaCl intake. AB - Short-circuit current (SCC) and electrical potential difference (PD) were measured in two epithelia of the lower gut of the domestic fowl, coprodeum and colon, mounted in vitro in the Ussing-chamber. The birds were suddenly switched from a low-NaCl to a high-NaCl diet, and 24 h aldosterone treatment (3 X 42.7 micrograms/kg i.m.) given from zero to 5 days after dietary change. The effects on SCC and PD of addition of amino acids, and later amiloride, to the bathing media were measured, because a low-NaCl-diet which releases endogenous aldosterone, inhibits amino acid stimulation (in colon) and induces amiloride inhibition of SCC and PD (in both coprodeum and colon). Birds were slaughtered 4 h after the last injection as single injections of aldosterone showed maximal change of SCC and PD, and maximal amino acid and amiloride effects, at that time. Control intramuscular injections of aldosterone showed a mono-exponential decline of the plasma concentration with a half time of 47 min. In colon the aldosterone treatment induced the low-NaCl diet pattern of the transport parameters regardless of the delay after resalination. In coprodeum SCC declined gradually with time and reached 25% of the value at low-NaCl diet when aldosterone was given 5 days after resalination. The data suggest that colon maintains a high flush of sodium through the epithelial cells regardless of whether the entry is via the amiloride-blockable sodium channel or the non-electrolyte stimulated pathway.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483578 TI - Twitch characteristics in relation to muscle architecture and actual muscle length. AB - The length dependence of twitch time characteristics is quantified for several skeletal muscles of the rat: lateral gastrocnemius, medial gastrocnemius, plantaris, soleus and semimembranosus. It is shown that muscle architecture influences the length dependent behaviour of twitch time characteristics of muscles. Twitch contraction time is less susceptible to length changes of the muscles than the twitch relaxation time. With the exception of the relaxation time in the second part of the relaxation, the twitch time characteristics behave different with respect to their dependence on fibre length, in fact muscles that differ in architecture. It is concluded that twitch time characteristics are dependent on the actual muscle length and therefore should be determined at a well defined length. PMID- 6483577 TI - Mechanisms of hypoxia-induced decrease of load dependence of relaxation in cat papillary muscle. AB - Relaxation of mammalian cardiac muscle is very sensitive to the prevailing load, but becomes largely load-independent during hypoxia. This effect was previously ascribed to a delayed removal of activating myoplasmic calcium. To further elucidate the underlying mechanisms of this effect of hypoxia, relaxation was now studied in 26 cat papillary muscles, in which hypoxia-induced decrease of load dependence of relaxation was compared with the effects of low [Ca2+]o (1.0, 0.5, 0.375 mM), verapamil (1 microM) and nifedipine (0.1 microM). Load dependence of relaxation was quantified by comparing force and time coordinates at the onset of the isometric relaxation phase in several after-loaded isotonic twitch contractions with the relaxation of the isometric control contraction. Hypoxia, low [Ca2+]o, verapamil and nifedipine decreased load dependence of relaxation. Although low [Ca2+]o, verapamil and nifedipine had a more marked negative inotropic effect on the contraction phase than hypoxia, the decrease of load dependence with hypoxia was significantly more pronounced and it included two phases: an early and fast drop, followed by a slower and longer-lasting decrease. The early fast phase was neutralized in low [Ca2+]o and also diminished after administration of verapamil or nifedipine. An impaired calcium reuptake by the sarcoplasmic reticulum would underly only the second phase of decreased load dependence. The first phase on the other hand originated mainly from changes in the isometric relaxation of the papillary muscles. PMID- 6483579 TI - Neural effects of systemic hypoxia on hindlimb vascular resistance in sinoaortic denervated cats. AB - The effects of systemic hypoxia on the neurogenic component of hindlimb vascular resistance were studied in six sinoaortic-denervated, anesthetized cats with intact central nervous system. Hindlimb perfusion pressure (PP) was measured under conditions of constant flow of normoxic blood from a donor cat. The neural component of the PP was estimated from the change in PP upon administration of hexamethonium (10 mg/kg i.v.). Ventilation of the recipient cat with 12.5% and 10% O2 was associated with an average 35 +/- 15% (SEM) and 13 +/- 10% decrease, respectively, of the estimated neural component of the PP. In contrast ventilation with 7.5% and 5% O2 produced increases of 27 +/- 7% and 58 +/- 10%, respectively, of the estimated neural component of the PP. Both the vasodilator and vasoconstrictor responses were abolished by hexamethonium (10 mg/kg i.v.). The vasodilator response appeared to be due to withdrawal of alpha-adrenergic tone since it was eliminated by constant infusion of phentolamine to the hindlimb (45 micrograms/ml blood/min). We conclude that, in addition to the already known sympatho-excitation seen in the sinoaortic-denervated cat during severe systemic hypoxia, there is also a sympatho-depressant effect which dominates at more moderate levels of systemic hypoxia. PMID- 6483581 TI - Chemical energy usage during stimulation and stretch of mammalian smooth muscle. AB - High energy phosphate usage was measured in the rabbit taenia coli subjected to stimulation and stretch (0.12 Lo/min) and was compared to that observed previously under isometric conditions. When the muscle was bathed in a medium containing 1.9 mM Ca2+, stretch during the period of initial force development substantially decreased the rate of chemical energy usage compared to that under isometric conditions. When crossbridge cycling rate under isometric conditions was increased by incubation of the muscle in a medium containing 4.5 mM Ca2+, there was a greater decrease in rate of high energy phosphate usage during stretch compared to isometric conditions. The low energy usage during stretch occurs even though average active force output was approximately 40% higher than that under isometric conditions. During the period of subsequent force maintenance when both energy usage and crossbridge cycling rate under isometric conditions were low, there was no significant effect of stretch on the average rate of energy usage at either Ca2+ level. These results are consistent with the hypothesis that during stimulation and stretch in smooth muscle, crossbridge attachment and force production can occur even though the actin-activated myosin ATPase activity normally associated with isometric force development is greatly suppressed. PMID- 6483580 TI - Ca2+ can affect Vmax without changes in myosin light chain phosphorylation in smooth muscle. AB - The effects of elevated [Ca2+]o on crossbridge cycling rate, measured as maximum velocity of shortening (Vmax) and high energy phosphate usage (delta approximately P), and on the degree of phosphorylation of the 20,000-dalton light chain of myosin (MyLCP) during an isometric tetanus were determined in the rabbit taenia coli at 18 degrees C. In an normal Krebs medium (1.9 mM Ca2+) the average rate of delta approximately P during force development is 4 X higher than during force maintenance. In 4.5 mM Ca2+-Krebs, the average rate of delta approximately P increases by 100% during force development and during force maintenance above that observed in normal Krebs medium, with no significant change in force output. Vmax increased in the high Ca2+ medium, in good agreement with the corresponding rates of delta approximately P, but without any significant change in the degree of MyLCP. Also, in both high and low calcium media, Vmax decreased with tetanus duration as did the delta approximately P; however, the degree of phosphorylation was not directly related to the average rate of energy usage during the two phases of the tetanus. Therefore, in intact smooth muscles Ca2+-dependent and time-dependent changes in Vmax and average rate of delta approximately P can occur without corresponding changes in MyLCP. Modulation of crossbridge cycling rate may be accomplished by a Ca2+-dependent process in addition to MyLCP. PMID- 6483582 TI - Interscapular brown adipose tissue blood flow in the rat. Determination with 133xenon clearance compared to the microsphere method. AB - The xenon clearance method was adapted to continuous measurement of interscapular brown adipose tissue (ISBAT) blood flow in anesthetized rats. The ISBAT-blood partition coefficient for xenon was determined to 3.6 ml X g-1. The blood flow values obtained by Xe clearance were compared with flow values obtained concomitantly by the microsphere technique in 17 cold acclimated rats, at ISBAT blood flows between 0.1 and 6 ml X g-1 X min-1. Variations in blood flows were obtained by infusion of noradrenaline at different rates. The blood flow values obtained from the xenon clearance method showed a close correlation to the blood flow values determined with microspheres. Y = 0.98. X + 0.15 (r = 0.96, P less than 0.001). The Xe clearance method has the advantages compared to the microsphere technique that it permits continuous monitoring of the blood flow and does not require the sacrifice of the animal. PMID- 6483583 TI - Body temperature of huddling newborn Zucker rats. AB - Daily mean core temperature (Tc) in huddling Zucker rat pups reared at 25 degrees C revealed the onset of a significantly lower Tc in fa/fa pups on day 6. The difference between any pup's Tc and the mean Tc of that half of the litter with the highest Tc on any given day was an early marker for genotype. Calculating the mean difference for any 2 consecutive days from day 6 onwards gave values for each fa/fa pup that were outside the 99% confidence limits for the individual observations in the Fa/- pups. PMID- 6483584 TI - Anesthesia selectively reduces hypoglossal nerve activity by actions upon the brain stem. AB - Alcohol as well as anesthetic and sedative agents depress the respiratory activity of the hypoglossal-genioglossal system more than that of the phrenic diaphragmatic system. The mechanisms for this selective depression remain unclear. To evaluate the contribution of pathways traversing the spinal cord, the response of phrenic and hypoglossal nerve activities to 0.5% halothane was obtained in decerebrate cats before and after transection of the spinal cord at T1 and again following transection at C1. Halothane produced a much greater decrease in hypoglossal than phrenic activity before and after spinal cord section at T1. Following cord section at C1, which eliminates phrenic activity, 0.5% halothane still produced a marked depression of hypoglossal activity. Therefore, the selective depression of the hypoglossal-genioglossal system does not depend on spinal mechanisms and appears to be mediated in the brain stem. PMID- 6483586 TI - A method for in situ measurement of ionic concentration in picoliter samples of renal tubular fluid. AB - A method permitting rapid and frequent determination of the total ionic concentration in renal tubular fluid samples, by measuring sample electrical impedance, is described. No special electrodes or sophisticated equipment are required. Since picoliter volumes are sufficient for measurement, tubular fluid dynamics are not significantly disturbed by the sampling procedure. The sample is aspirated into the tip of the standard glass micropipette and its ionic concentration, in the range of 100-1000 mmol/l, can be determined by any sensitive impedance-measuring device. In the present studies the Wheatstone bridge of the Wiederhielm apparatus for pressure measurement in micropuncture studies was used for the purpose. The obvious limitation of the method is that the measurements do not include non-electrolytes and cannot differentiate between individual ion species. PMID- 6483585 TI - Bicarbonate movement across basolateral membrane vesicles from rat jejunum. AB - The self-orienting Percoll-gradient centrifugation was used to separate basolateral membranes (BLMs) from rat jejunal enterocytes. Bicarbonate uptake into osmotically active BLM vesicles was studied by a rapid filtration technique. The time course of [14C] -labelled bicarbonate uptake was followed for 30 min at 18 degrees C and at pH 8.2. Bicarbonate uptake was fast, not saturable and stimulated by countertransport. This work demonstrates that it is possible to determine bicarbonate flux across BLM vesicles at pH and temperature values close to usual experimental conditions. Together with simple diffusion, bicarbonate would cross the BLM of the enterocyte via a carrier-mediated diffusion process. PMID- 6483589 TI - Otto Bock powered wrist rotator incorporated with the Systemteknik child size electric hand. AB - This report deals with the incorporation of the Otto Bock powered wrist rotator with the Systemteknik child's size electric hand to gain an additional degree of freedom. Technical details are provided and a case study involving a 5-year old girl with bilateral shoulder disarticulation is presented. PMID- 6483588 TI - Reaction times of normal subjects and amputees with below-knee and above-knee prostheses during stepping. AB - Reaction times (RTs) of nine normal subjects and 11 amputees with prosthetic limbs were examined in standing posture and during stepping movement. There were significant differences of RTs between standing and stepping, and between the phases of the stepping cycle in both the normal subjects and the BK or AK amputees with prosthetic limbs. The attentional demand during stepping movement and the applicability of probe RT procedure to assess prosthetic limb were briefly discussed. PMID- 6483587 TI - Calcium-dependent atrial slow action potentials generated with phosphatidic acid or phospholipase D. AB - Phosphatidic acid (PA) formed following phosphatidylinositol hydrolysis has been proposed as a necessary step in receptor-mediated Ca2+ flux. This study demonstrates that PA generates Ca2+-dependent slow action potentials (APs) in rat atrium partially depolarized with 22 mM K+. The slow response was not due to release of endogenous catecholamines or prostaglandin formation since propranolol and indomethacin failed to attenuate the PA-induced slow AP in normal and reserpinized rats. PA-induced slow APs demonstrated Ca2+-dependence such that increasing [Ca2+]o from 0.5 to 5.0 mM caused the amplitude of the slow AP to rise linearly with the logarithm of [Ca2+]o. Phospholipase D (PLD) but not phospholipase C, was able to induce a slow AP, possibly through PA formation. Adenosine attenuated the PA and PLD-induced slow response and aminophylline reversed these effects. The observation that PA and PLD generate Ca2+-dependent slow APs in depolarized rat atrium supports a role for PA mediating Ca2+ influx. PMID- 6483590 TI - The use of flexible polyurethane foam in orthotics. AB - The casting of flexible polyurethane foam into a wide range of customised shapes has been found to offer a relatively straightforward solution to a number of problems associated with providing support for the physically handicapped. This note describes the techniques used for the production of such supports and reports on clinical experience of their use. A suitably prepared plaster cast of the patient, obtained in the usual way via vacuum consolidation of polystyrene beads, forms the lower surface of a wooden moulding box. Suitable quantities of the two chemicals, an isocyanate and a polyol, are then thoroughly and rapidly mixed together before being poured into the moulding box over which a weighted lid is placed to contain the foam and to improve its consistency. After removal, the finished product can then be trimmed and if necessary covered with fire retardant leathercloth. To date polyurethane foam mouldings have been used with considerable success as seat cushions, seat backs and as spinal body supports which allow a patient to be nursed prone and supine following spinal fusion. PMID- 6483591 TI - Upper limb weakness in children with Duchenne muscular dystrophy--a neglected problem. AB - The problems of upper limb weakness in young people with Duchenne muscular dystrophy are not generally appreciated. In a series of 12 young people it was found that the strengths of the shoulder and elbow muscles were approximately 4% of those of a normal control group. A counterweight and a motorised system of arm suspension is described which permits the young person to make proper use of their arms. PMID- 6483592 TI - Lower extremity telescopic orthosis--LETOR. AB - A telescopic orthosis is described which seems to provide a particularly useful and effective aid during primary rehabilitation in paraplegia. PMID- 6483593 TI - Assessment of tissue viability in relation to the selection of amputation level. AB - Assessment of the optimum level of amputation of an ischaemic limb can be exceptionally difficult. For this reason there has been an intensive effort, particularly in the past 20 years, to find suitable non-invasive ancillary methods to aid in the amputation level selection. This paper reviews three separate research and development areas which have evolved simultaneously in our laboratory: skin partial oxygen pressure, skin blood flow, and infrared thermography. The physiological basis for each of these measurements is discussed along with the merits and demerits of each. PMID- 6483594 TI - Thermography as a means for quantitative assessment of stump and phantom pains. AB - Exact differentiation into stump and phantom pain is required when pain is reported after amputation. In a majority of cases appropriate treatment can improve the pain. Thermography is simple and gives a good indication of the circulation in the stump without operative intervention. It provides a key to the nature of the pain in stump and phantom. Although typical patterns occur for pain in the stump or phantom, in this study the thermographic image could confirm the presence of phantom pain, but it could not rule out errors or false statements. PMID- 6483595 TI - Shape sensing as an educational aid for student prosthetists. AB - An automatic method of measuring the shape of plaster replicas of residual limbs has been developed. This instrument enables the full three-dimensional shape to be digitized and stored on computer. The shape modifications produced by student prosthetists are examined by requesting the computer to draw sections of the unmodified replica with corresponding sections following modification superimposed. This paper reports experiences with the use of this instrument as a teaching aid for student prosthetists. PMID- 6483596 TI - A preliminary report on the use of cane and bamboo as basic construction materials for orthotic and prosthetic appliances. AB - Cane and bamboo have been found to be viable and alternative basic construction materials for orthotic/prosthetic appliances and rehabilitation aids. Amongst the appliances made, the night splint and the upper limb splints have proved effective in field trials. The lower limb orthoses and prosthesis however are still at an experimental stage. Of the rehabilitation aids, walkers, crutches and wheelchairs have been found to be remarkably useful, cheap and light. PMID- 6483597 TI - Biomechanical study of a knee-ankle-foot-orthosis for hemiplegic patients. AB - A knee-ankle-foot-orthosis (KAFO) has been developed which incorporates a genucentric knee joint and a similarly designed ankle joint. This paper describes a clinical evaluation of its practical use on 120 hemiplegic patients over a six year period from 1979 to 1984. PMID- 6483598 TI - [CT of intrathoracic neurogenic tumors]. PMID- 6483599 TI - [The evaluation of the anterior extrapleural line in various mediastinal mass lesions]. PMID- 6483600 TI - [Combination radiotherapy and chemotherapy of primary lung cancer]. PMID- 6483601 TI - [Development of the head and neck immobilization device, using rigid polyurethane foam]. PMID- 6483602 TI - [Increased accumulation of adriamycin in mouse 3T3 cells with hyperthermia]. PMID- 6483604 TI - [An experimental study of stereofluoroscopy using the lenticular sheet]. PMID- 6483603 TI - [Improvement of the immobilization method in combination with a rigid urethane foam supporter and a thermoplastic cast]. PMID- 6483605 TI - [A sensitivity-compensated intensifying screen for chest tomography with simultaneous demonstration of lung field, hilum and mediastinum]. PMID- 6483606 TI - [Detectability of renal cysts by intravenous urography. Comparison with computed tomography]. PMID- 6483607 TI - [Problems in current usage of contrast media. Questionnaire of testing and management on emergency]. PMID- 6483608 TI - [Computed tomography of esophageal cancer--CT classification and diagnosis of metastasis]. PMID- 6483609 TI - [Evaluation of alveolar dead space in pulmonary embolism by using functional images]. PMID- 6483610 TI - [Evaluation of image qualities of magnification radiographs of the gallbladder and cerebral blood vessels by information spectra]. PMID- 6483611 TI - [Improvement of image quality in digital fluorography by geometrical magnification]. PMID- 6483613 TI - [A likely explanation of the etiology of AIDS]. PMID- 6483612 TI - [Spatial resolution of digital input images from radiographs--CRT output]. PMID- 6483615 TI - [Dependence on moderate doses of benzodiazepines--a medical syndrome or a moral reaction?]. PMID- 6483614 TI - [Can terminal uremia be prevented or delayed?]. PMID- 6483616 TI - [Follow-up study of subjective and social sequelae after operations for lumbar disc prolapse]. PMID- 6483618 TI - [A one-sided or two-sided significance test?]. PMID- 6483617 TI - Periodic mass screening for breast cancer. PMID- 6483619 TI - [Women physicians and their working conditions]. PMID- 6483620 TI - [Increased coordination of the postgraduate education of the Scandinavian physicians desirable]. PMID- 6483621 TI - An investigation by 1H NMR spectroscopy into the factors determining the beta:alpha ratio of the product in 2'-deoxynucleoside synthesis. AB - By following the course of the reaction between a suitably-protected base and a chlorosugar in an NMR tube at 250 MHz, it has been shown that the products are consistent with those expected from an SN2 mechanism with inversion of configuration at the anomeric carbon of chlorosugar. In order to achieve high yields of beta-2'-deoxynucleoside, the crystalline alpha-chlorosugar used must react swiftly so that anomerization of the sugar moiety is kept to a minimum. If the base is sufficiently reactive (e.g. 5-methyluracil, uracil), then no catalyst is required and chloroform is the preferred solvent. Using equimolar quantities of the reactants, almost quantitative yields of nucleoside can be obtained in one hour with a beta:alpha ratio greater than 4. With an excess of base, the beta:alpha ratio can be increased even further. With less reactive bases (e.g. 5 nitrouracil, 5-acetyluracil), addition of catalyst can increase the rate of condensation more than the rate of anomerization or decomposition of the sugar. ZnCl2 (0.1 equivalents) has been found to give satisfactory results, although the slower the reaction, inevitably the more alpha-2'-deoxynucleoside is formed. Essentially pure alpha-2'-deoxynucleoside can be isolated in high yield by allowing chlorosugar to anomerize by letting it stand in a polar solvent (acetonitrile) before addition of the base. PMID- 6483622 TI - A rapid deprotection procedure for phosphotriester DNA synthesis. AB - An equimolar solution of aldoxime and tetramethylguanidine at 70 degrees C removes both the base and phosphate protection from oligonucleotides prepared by solid phase phosphate triester technology. The rate of cleavage from the succinyl linkage commonly used for solid phase synthesis is also increased. The method is simpler, faster and more easily automated than existing methods. PMID- 6483624 TI - [The normal thyroid gland in the scintigram: size and form variants, thyroid dystopia]. AB - Quantitative data about the size of the normal thyroid gland are presented: height, width and area of the right and left lobe are scintigraphically different. The calculated weight varies depending on the correction factor. Displaced thyroid tissue is found in the center line, whereas iodine accumulating tissue located in the lateral neck should lead to a suspicion of carcinoma. PMID- 6483623 TI - The methylation state of 2 muscle-specific genes: restriction enzyme analysis did not detect a correlation with expression. AB - To examine the possible role of DNA methylation in the modulation of expression of genes involved in the differentiation of muscle cells, we compared the methylation state of a number of CpG sites in the rat skeletal muscle actin and myosin light chain 2 genes, in muscle and nonmuscle cells, and in proliferating myoblasts and differentiated myotubes of the myogenic cell line L8. No correlation was detected between the state of methylation of these sites and the expression of the two genes. Essentially the same pattern of DNA methylation was observed, in the sites examined, in DNA from muscle, kidney and stomach. In DNA extracted from cultures of proliferating mononucleated myoblasts, as well as from differentiated multinucleated fibers of the myogenic cell line L8, the two genes were more methylated than in other tissues. PMID- 6483625 TI - [Modification of the FT4-level and the nonspecific peripheral thyroid parameter by heparin]. AB - Heparin produces changes in FT4-levels both in vivo and in vitro as determined by commercial kits. Methods utilising the principle of equilibrium dialysis show significant increases whereas methods using T4-tracer analogue techniques reveal marked decreases in FT4-values. Possible clinical side-effects of heparin administration such as heparin-induced hyperthyroidism and tachyarrhythmias are discussed. The present results confirm the FT4-decreasing effect of in vivo and in vitro administration of heparin with FT4-RIAs based on the tracer analogue technique; however, the unspecific peripheral thyroid parameter of systolic time intervals did not reveal any tendency towards hyperthyroidism. Also the discrepant results dependent on the method used, indicate that, following heparin administration FT4-levels do not reflect that hormone concentration is relevant to the metabolism of the whole body. PMID- 6483626 TI - [Quantitative resting radionuclide-ventriculography for multifactorial analysis of left ventricular function]. AB - Results from 388 patients, examined with quantitative equilibrium radionuclide ventriculography (qERNV) at rest, were stored in a data bank system and evaluated statistically. The value of time and velocity parameters [ejection time (ET), filling time (FT), time ES to peak filling rate (TpFR), mean (mER) and peak (pER) ejection rate, peak filling rate (pFR)] were evaluated in patients with coronary heart disease (CHD, with and without history of earlier myocardial infarction) or with cardiomyopathy (CMP). Significant (p less than 0.025) changes vs. normal in CHD I/II were obtained from pER, pFR, ET, in CHD III from gEF, EDV, mER, pER, pFR, in CHD IV from gEF, EDV, mER, pER, pFR, in patients with infarction or with CMP from gEF, EDV, mER, pER, pFR, ET and TpFR. Resting qERNV revealed a sensitivity in diagnosing a CHD (stages I-III) by mER of 30-59%, by pER of 40 65%, by pFR of 48-60% and by ET of 58-61%, which was higher than the sensitivity of gEF (19-56%). PMID- 6483627 TI - [Measurement of mean retention times of 99mTc-labeled HSA-millimicrospheres in the liver--clinical results in patients with operated breast cancer]. AB - Human serum albumin millimicrospheres labeled with 99mTc-pertechnetate were used for evaluation of their mean retention time in the hepatic RES cells. For this purpose the retention function was derived from the liver time-activity curves by deconvolution analysis. Measurements in 50 patients with operated breast cancer revealed significantly shorter retention times in patients with extrahepatic metastases in comparison with patients without evidence of metastases or recurrences. Discriminant analysis of the retention times combined with other investigated parameters such as relative organ size and extraction fraction of the liver and spleen, age, weight and height of the patient, proved the method to be diagnostically valuable. In the examined group of patients metastases could be demonstrated with a sensitivity of 100% and a specificity of 92%. PMID- 6483628 TI - [Varying results of different procedures for determining the FT4 concentration in serum before and after heparin administration]. AB - After application of heparin FT4 was determined by various methods in patients undergoing hemodialysis, and the results were compared with those obtained before application of heparin. Using ultrafiltration (Amicon) and the Dow-Lepetit test a significant increase in FT4 concentration could be registered at all times after heparin application. By use of the Corning test a non-significant increase in FT4 concentration was found one hour after heparin application. When the Amerlex method was employed no change in FT4 concentrations was detectable. Most probably, the observed increase in FT4 concentration after heparin application does, in fact, occur. PMID- 6483629 TI - [Varying results of different procedures for determining the FT4 concentration before and after the administration of contrast media]. AB - After application of contrast media a rise in FT4 concentration was detected by use of the ultrafiltration method (Amicon) and the Dow-Lepetit method, especially after injection of Biliscopin, whereas the determination of FT4 concentration with the Amerlex method revealed a significant drop in FT4 concentration after contrast medium application. The results obtained with the Dow-Lepetit test have to be regarded as correct. The decrease detected by the Amerlex test is probably the result of a changed affinity of albumin to the labeled T4. Within 1 hr after application of contrast media blood for the determination of FT4 should not be collected. PMID- 6483630 TI - A comparison of the cyclic anhydride and mixed anhydride methods for 111In-DTPA chelation to monoclonal antibodies. AB - The cyclic anhydride (CA) and the mixed anhydride (MA) of DTPA were synthesized and used to chelate 111In to an antimelanoma monoclonal antibody. The CA and MA methods showed mean labeling efficiencies of 25.7 and 20.5%, respectively (p = NS). The binding efficiency of labeled antibody to human melanoma cells in tissue culture also was similar (means = 52 and 50%, respectively, p = NS), as was tumor uptake in nude mice at 96 hrs post-injection (16%-CA vs 12%-MA). The method required less complicated chemical syntheses, much less preparation time, and the product was stable over a much longer period. The results suggest that the CA method is preferable for bifunctional chelate labeling of monoclonal antibodies with 111In-DTPA. PMID- 6483631 TI - [Contamination of human skin by radionuclides]. AB - Insight into the mechanisms of contamination is a necessary prerequisite for efficient and meaningful decontamination. The incorporation of anorganic ions into human skin has been studied with aqueous solutions of radionuclides. Within 30 min of wetting about 1 microliter fluid per cm2 skin area penetrates into the capillary spaces of the horny layer, promoted by surface-active properties of the sebaceous lipids. Adsorption onto horny layer constituents is especially important for polyvalent cations. In general it is dependent on pH and on the ionic charge. For all substances in aqueous solution the structure of the horny layer causes a nearly exponential decay of concentration with depth of penetration (about 100:1 across the horny layer at 1 mg keratin/cm2 skin area). This is the reason for the very low penetration rates. The results may be used to establish some rules for skin decontamination. PMID- 6483632 TI - [Intraoperative localization of pheochromocytoma metastases using 131I-meta benzylguanidine]. PMID- 6483633 TI - [Pneumonia caused by gram-negative bacteria. Diagnostic and prognostic aspects]. PMID- 6483634 TI - [Skin reactivity to dinitrochlorobenzene in patients with atopic asthma]. PMID- 6483635 TI - [Significance of age in the analysis of respiratory neoplasm mortality]. PMID- 6483636 TI - The once-daily theophylline controversy. PMID- 6483637 TI - Theophylline QID, TID, BID and now QD? A report on 24-hour dosing with slow release theophylline formulations with emphasis on analyses of data used to obtain Food and Drug Administration approval for Theo-24. AB - Dosing intervals for slow-release theophylline preparations depend on the rate of formulation absorption, the rate of patient elimination, and clinically acceptable fluctuations in serum concentration. Three products, two new to the United States market, have received approval by the Food and Drug Administration (FDA) for 24-hour dosing claims. Data submitted to the FDA for Theo-24 (Searle) suggest slow but incomplete absorption in single-dose studies, and multiple-dose studies confirm incomplete absorption relative to plain theophylline tablets. Fluctuations in serum concentration expressed as a percentage of the trough value at steady state with Theo-24 given once daily in the morning ranged from 48 to 1371% among 18 subjects; 13 of the 18 had greater than 100% fluctuation, which is the upper limit for fluctuations that can stay within the 10- to 20-micrograms/ml therapeutic range. Among another 18 subjects with somewhat slower and less variable rates of elimination, fluctuations ranged from 40-168% at steady state, with 4 of 18 greater than 100% during daily dosing with Theo-24; all subjects had fluctuations less than 100% (39-92%) when they were given Theo-dur tablets every 12 hours. Theo-dur tablets have also received FDA approval for once daily administrations, but only 1 of 14 subjects in a submitted study had fluctuations less than 100% and thus was able to stay within the therapeutic range. No data were available on the absorption of Uniphyl, also approved for once-daily dosing, but large fluctuations in serum concentration are apparent from advertisements for the European product Uniphyllin, and are also suggested by presentations on Uniphyl at a recent scientific meeting. Current standards for receiving FDA approval for 24-hour dosing appear to be inconsistent with the pharmacodynamics and pharmacokinetics of theophylline and fail to consider the greater risks from variability in absorption when a single, large daily dose is taken. PMID- 6483638 TI - Dose dependency for absorption and elimination rates of theophylline. Implications for studies of bioavailability. AB - Dose dependency for absorption and elimination rates of theophylline were examined by administering 2-mg/kg and 6-mg/kg doses of a theophylline solution to 8 adult volunteers. The area under the concentration-time curve extrapolated to infinity after the lower dose was 84% of that calculated after the higher dose. This is associated with a decrease in the slope of the terminal portion of the elimination curve to varying degrees after the higher dose in all 8 patients (p less than 0.001). A significantly smaller fraction of the higher dose was absorbed at 15 minutes (0.46 vs. 0.77, p less than 0.002), but the differences were trivial by 30 to 45 minutes. Dose dependency for elimination may cause changes in a steady-state serum concentration during multiple dosing that is disproportionately larger than changes in dosage. In addition, the slower elimination at higher serum concentrations may confound the assessment of bioavailability of slow-release formulations when the doses used result in a substantial disparity in the range of serum concentrations attained for the slow release formulation and the reference. The use of unequal doses adjusted to provide similar peak serum concentrations appears to minimize this potential error. PMID- 6483639 TI - Analgesic effect of acetaminophen, phenyltoloxamine and their combination in postoperative oral surgery pain. AB - In this factorial study, 148 outpatients with pain after oral surgery were randomly assigned, on a double-blind basis, a single oral dose of acetaminophen 650 mg, phenyltoloxamine 60 mg, a combination of acetaminophen 650 mg with phenyltoloxamine 60 mg, or placebo. Using a self-rating record, subjects rated their pain and its relief hourly for 6 hours after medication. Measures of total and peak analgesia were derived from these subjective reports. The acetaminophen effect was significant for every measure of total and peak analgesia. The phenyltoloxamine effect was not significant for any measure of analgesia. Although efficacy was lower for the acetaminophen-phenyltoloxamine combination than for acetaminophen alone, for every variable, the contrast for interaction was not statistically significant. The results of this study differ from those of previous studies in patients with headache and musculoskeletal pain. All adverse effects were transitory and consistent with the known pharmacologic profiles of the study medications or the backup analgesic. PMID- 6483640 TI - Fluphenazine decanoate-induced cholestatic jaundice and thrombocytopenia. PMID- 6483641 TI - Safety of indos. PMID- 6483642 TI - [Control of blood viscosity--reality and hopes]. PMID- 6483643 TI - [Peritonitis in patients with renal failure treated with peritoneal dialysis]. PMID- 6483644 TI - [Effectiveness of intermittent peritoneal dialysis conducted by the manual method using commercially available dialysis fluid]. PMID- 6483645 TI - [Rolitetracycline pharmacokinetics in patients with chronic renal failure]. PMID- 6483646 TI - [H3-cholesterol distribution in the erythrocytes and serum lipoproteins in patients with chronic renal failure]. PMID- 6483647 TI - [Osteomalacia in renal failure]. PMID- 6483648 TI - [Effect of intraperitoneal administration of furosemide and sodium nitroprusside on the elimination of water, sodium and potassium during peritoneal dialysis]. PMID- 6483649 TI - [Arterial hypertension in urinary tract infections]. PMID- 6483650 TI - [Selected parameters of the complement system in chronic active hepatitis and liver cirrhosis]. PMID- 6483651 TI - Brain-endocrine interaction V. The Schmitt brain symposium. "Neuropeptides: central and peripheral". Proceedings of the Fifth Brain-Endocrine Interaction Symposium. Wurzburg, Federal Republic of Germany, July 27-29, 1983. PMID- 6483652 TI - Development of the catecholamine innervation of the supraoptic nucleus in the Brattleboro rat. AB - The ontogenetic development of the noradrenergic innervation of the supraoptic nucleus was studied in the Brattleboro rat at late postcoital and early postnatal ages. This genetic mutant offers a useful model for analysis of neuronal development because of the absence of a specific peptide component of identifiable target neurons and has been used presently to eliminate the possibility that such substances are essential for the establishment of normal connectivity during postnatal development. In this model, catecholamine varicosities were seen in juxtaposition to vasopressin-deficient perikarya during the initial phases of postnatal development, but these varicosities gradually decreased in number suggesting the possibility that the target neuron peptide, or some functional aspect of the neuron, may be necessary for the normal maintenance of this neuronal interaction. PMID- 6483653 TI - In vitro and in vivo studies on development and regeneration of vasopressin neurons. AB - The present paper reviews recent work conducted in our laboratory on vasopressin neurons either grown in culture or transplanted into vasopressin deficient rats. The in vitro model of reaggregated cell culture used the anterior hypothalamus, including vasopressin neurons of the SON from normal timed-pregnant LE rats of similar ages used in our in vivo model. Various cells were co-cultured with their known target tissue, the posterior pituitary to analyze further the influence of the target tissue on hormone production. At a designated end point, cultured cells were fixed and stained immunocytochemically for vasopressin and neurophysin. Radioimmunoassay of the samples was performed for vasopressin quantification. Hypothalamic cells from all ages produced vasopressin (VP). The co-culturing of hypothalamus with posterior pituitary produced a significant increase in VP. Correlative transplantation studies were conducted using timed pregnant Long-Evans (LE) rats at various days post coitus (dpc) and neonatal tissue from 0- and 5-day old rat pups. Animals survived about 40 days then were perfused and their brains processed for vasopressin and neurophysin thick-section immunocytochemistry. The results showed that the capability for survival of younger grafts was much greater than that of older tissue. With this paper, we have shown that the reaggregation of anterior hypothalamic cells in a culture system can be used for microassay of neurosecretory activity. These data suggest a close correlation between the ability of a neuron to survive transplantation and its stage of development. With the present studies, we have shown that neurons not fully differentiated maintain a greater degree of plasticity than older tissue and are better able to survive the rigors of transplantation and that various manipulations of environmental factors have an effect on brain development at critical times. PMID- 6483654 TI - Symposium on clinical pharmacology I. PMID- 6483655 TI - Electroconvulsive therapy in the 1980s. AB - Electroconvulsive therapy (ECT) has generated more controversy and strong feelings than any other psychiatric modality in use today. This review presents the facts upon which each reader can make a rational decision as to the advantages and disadvantages of ECT. PMID- 6483656 TI - [Effect of health resort treatment on carbohydrate and calcium and phosphate metabolism]. PMID- 6483657 TI - [Viscosity and osmotic pressure of whole blood in workers exposed to occupational hazards (mainly mechanical vibration and noise)]. PMID- 6483658 TI - [Roentgenostructural phase analysis of urinary calculi. III. Heterogeneity of the phase composition of urinary calculi]. PMID- 6483659 TI - [Preliminary evaluation of diagnostic fine-needle aspiration biopsy of the liver and pancreas conducted under the control of computerized tomography]. PMID- 6483660 TI - [Value of cytological examinations in the diagnosis of cancer of the large intestine]. PMID- 6483661 TI - [Results of the surgical treatment of neoplasms of the large intestine in the opinion of patients]. PMID- 6483662 TI - [Mesenteric lymphadenitis of the ileocecal region simulating acute appendicitis]. PMID- 6483663 TI - [Case of Zellweger syndrome with situs inversus of the viscera]. PMID- 6483664 TI - [Fractures of the cervical spine in Bechterew's disease]. PMID- 6483665 TI - [Spinal injuries in sports]. PMID- 6483666 TI - [Possibilities of the rapid evaluation of the foot arch using a device based on television projection]. PMID- 6483667 TI - [Surgical treatment of pruritus ani]. PMID- 6483668 TI - [Idiopathic internal biliary fistulas]. PMID- 6483669 TI - [Bacterial flora in acute appendicitis]. PMID- 6483670 TI - [Unilateral exophthalmos]. PMID- 6483671 TI - [Effect of exercise therapy on basic spirometric indicators in children with asthma treated at a seaside health resort]. PMID- 6483672 TI - [Complications of chronic compression of the trachea]. PMID- 6483673 TI - [Herpes zoster in children treated for Hodgkin's disease]. PMID- 6483674 TI - [Effect of levamisole on peripheral blood neutrophils in patients with neoplasms]. PMID- 6483675 TI - [Higher incidence of cutaneous tuberculosis and difficulties in its diagnosis]. PMID- 6483676 TI - [Goiter as the first symptom of Hodgkin's disease]. PMID- 6483677 TI - [Acute bone marrow and liver damage during treatment with clozapine]. PMID- 6483678 TI - [Chronic lead poisoning caused by environmental pollution]. PMID- 6483679 TI - The endometrium of infertility. A review. AB - Almost all functional disturbances involved in sterility result in morphological changes in the endometrium. Since hormone levels fluctuate depending upon various biorhythms, the histological examination of the endometrial biopsy is the most reliable parameter for evaluating the cause of infertility. A major subdivision can be made into anovulatory and ovulatory infertility. The anovulatory cycle is most frequently caused by a polycystic ovary syndrome, less frequently by gonadal dysgenesis, receptor or enzyme deficiencies, ovarian neoplasms, autoimmune reactions, or the luteinized unruptured follicle syndrome. Histologically the endometrium, depending upon the amount of estrogen secreted and reacting, is atrophic, resting, deficiently or irregularly proliferated or hyperplastic at the end of a menstrual cycle. A limited and deficient luteinization within a non ovulating insufficient follicle may also result in abortive secretion which must be differentiated from deficient secretion following ovulation. In ovulatory infertility an absolute or relative progesterone deficiency results in a deficient secretory phase with delayed maturation of glands and stroma. The delay in maturation may be dissociated in the presence of an insufficient corpus luteum with absolute progesterone deficiency or coordinated when progesterone secretion is normal but counteracted by too much estrogen, as from a preceding persistent follicle. Since in these instances ovulation is delayed, the coordinated delay in maturation of the endometrium is only apparent. A truly delayed coordinated maturation may occur when the progesterone cannot fully act because of a preceding deficient proliferation. In addition, cyclic asynchrony with shortened or prolonged menstrual cycles may cause infertility by altering the endometrium so the blastocyst cannot implant. Rare non-functional endometrial changes as causes of infertility may be tuberculous endometritis, polyps or true neoplasms. PMID- 6483680 TI - Intestinal metaplasia of the gastric mucosa in autopsies of Chilean adults. AB - The frequency and characteristics of intestinal metaplasia of the stomach were studied in autopsy material of 68 Chilean adults, with ages ranging from 30 to 79 years. Metaplasia was found in 76.5% of the cases, which is in agreement with the high frequency of metaplasia reported from other geographic areas of high incidence for gastric cancer. Of those stomachs with metaplasia, 90.4% had involvement of the lesser curvature, 88.5% of the antral region, and only 3.8% did not show the condition in those two areas. The metaplasia extended to less than half of the length of the mucosa in 85.6% of the sections with this change, showing that it is mainly a patchy and multifocal condition. In subjects older than 50 years, intestinal metaplasia was more extended and severe, and involved with a relative higher frequency the greater curvature and both anterior and posterior walls of the stomach. PMID- 6483681 TI - Aganglionosis of the colon. Morphologic investigations in 524 patients. AB - 2014 biopsies and surgical specimens of 524 patients with suspected aganglionosis of the colon were analyzed using enzyme histochemical techniques for acetylcholinesterase and lactate dehydrogenase. The diagnosis could be confirmed in 70 patients. Hypoganglionosis was found in 6, neuronal dysplasia (or hyperganglionosis) in 2, and a complete lack of intramural neurons and nerve fibers in 1 patient. The disease was found to occur most often during the first year of life (65.7%) and to be more common in males than females (3.3:1). Enzyme histochemistry is useful for the final diagnosis of aganglionosis provided the biopsy contains mucosa and parts of the submucosa of the colon. PMID- 6483682 TI - The adenoma-carcinoma sequence in AMMN-induced colonic tumors of the rat. AB - There is general agreement today that most colorectal carcinomas develop from adenomas via the so-called adenoma-carcinoma-sequence. There has however in addition been a discussion regarding the possibility of carcinomas arising "de novo". The aim of the present study was to find out alterations preceding carcinomas in animal experiment and to demonstrate possible similarities to man. For colonic tumor induction in 40 male Sprague-Dawley rats the local acting nitrosamine-derivative acetoxymethyl-methylnitrosamine was instilled intrarectally once a week for 6 weeks in a dosage of 2 mg/kg bodyweight. 14 weeks after the end of the tumor induction those 28 animals, that had developed endoscopically recognizable tumors, were randomized into two groups. The animals from group I were sacrificed 3 weeks, the animals from group II 20 weeks later, that is 23 and 40 weeks after the start of the experiment. At histopathologic examination an increase of the number of tumors per animal and a doubling of the mean tumor diameter could be observed in group II. The most severe findings (adenoma, adenoma with dysplasia, carcinoma) were more pronounced in group II. "De-novo" carcinomas without residues of benign adenomas were not found. It could be demonstrated, that chemically induced colonic tumours produced in the way described, develop in a fashion quite similar to the conditions found in man via the adenoma-carcinoma-sequence. PMID- 6483683 TI - Combined production of mucus, amines and peptides by goblet-cell carcinoids of the appendix and ileum. AB - Goblet-cell carcinoids are particular mucus-producing tumors combining features of typical carcinoids and adenocarcinomas. The immunoreactivity of five goblet cell carcinoids of the appendix and one tumor of the ileum for 5 hydroxytryptamine (5-HT, serotonin), glucagon, somatostatin, substance P (SP), neuron-specific enolase (NSE), lysozyme, secretory component (SC) and carcino embryonic antigen (CEA) was compared with that of the mucosa of the appendix (n = 24) and ileum (n = 12), and of typical carcinoids (appendix: n = 10; ileum: n = 3). The goblet-cell carcinoids were consistently lysozyme-, SC- and CEA-reactive and contained weakly NSE reactive endocrine cells, while typical carcinoids were lysozyme-, SC- and CEA-negative, but strongly NSE- reactive. Two goblet-cell carcinoids were glucagon-reactive, one displayed SP-reactivity, one malignant tumor was reactive to the alpha-chain of glycoprotein hormones; six of ten typical appendix carcinoids were SP reactive, as were the three typical ileum carcinoids. Using the immunogold technique combined with the alcian-blue reaction, the presence of 5-hydroxytryptamine (5-HT) and mucus was demonstrated within the same cell. These findings suggest histogenetic differences between goblet-cell carcinoids and typical carcinoids; the former are possibly derived from undifferentiated stem cells, whereas the latter probably arise from endocrine cells in the mucosal stroma. PMID- 6483684 TI - Red pulp arterial terminals in congestive splenomegaly. A morphometric study. AB - A quantitative analysis of the red pulp arterial terminals (comprising arterioles = penicilli, arterial capillaries and sheathed capillaries) has been carried out in congestive splenomegaly occurring in active chronic hepatitis, hepatic cirrhosis and idiopathic portal hypertension. Comparisons have been made with control spleens surgically removed for accidental trauma. Red pulp volume enlargement appears to be associated with a progressive lengthening of arterial terminals, which present a length density similar to that of normal spleens. Moreover, a different rearrangement of the various components of the arterial tree is present: in particular, the percent and absolute volumes of arterioles and arterial capillaries show a higher increase than those of sheathed capillaries. The present study points out the involvement of arterial terminals in the pathological rearrangement of the red pulp in congestive spleens, so supporting the hypothesis that splenomegaly does not result simply from passive congestion. PMID- 6483685 TI - Coated and uncoated lung mineral fibres in subjects with and without pleural plaques at autopsy. AB - The lung concentration of coated and uncoated mineral fibres of more than 10 micron in length was determined by light microscopy in 57 autopsied subjects (23 out of which professionally exposed to asbestos) with pleural plaques but no other asbestos-related diseases. Comparisons were made with 57 controls matched for sex, age and smoking habits, who did not show any asbestos-associated diseases or history of previous occupational exposure. Subjects with pleural plaques had a median concentration of coated fibres consistently greater than that observed in those without. However, no substantial differences were found between the two studied groups when uncoated and total fibres were considered. The present study suggests that the factors related to the fibre coating and to the pleural plaque formation may be indirectly connected, but not necessarily restricted to the number and nature of the fibres, or to the professional or environmental conditions of exposure. PMID- 6483686 TI - What's new in mycotic bone and joint diseases? AB - Deep fungi exhibit different degrees of aggressiveness toward joints and bone, most likely depending on the individual make-up of the respective organism. Immunodepressed patients have a propensity to bone and joint involvement by sporotrichosis, cryptococcosis and candidiasis. African histoplasmosis, blastomycosis and coccidioidomycosis are the main mycoses to produce osteoarthritic complications. Arthralgias as part of primary mycotic infection are seen in histoplasmosis capsulati and in coccidioidomycosis. The recognition of the specific agent by morphologic, cultural and serologic methods changes potentially the prognosis and treatment of patients. PMID- 6483687 TI - Surgical staging in carcinoma of the prostate: the RTOG experience. Radiation Therapy Oncology Group. AB - One hundred thirty-six patients with carcinoma of the prostate entered on phase III RTOG studies (RTOG 75-06 and RTOG 77-06) between 1976 and the end of 1980 underwent staging lymphadenectomy prior to irradiation. The operative reports and histological findings have been reviewed in order to determine the patterns of intrapelvic tumor spread and to correlate the type of surgical procedure and the extent of lymphatic dissection with the incidence and type of postirradiation complications (primarily genital and lower extremity lymphedema). The surgical procedures were classified into three categories according to extent: 1) biopsy only, 2) limited (diagnostic) dissection, and 3) complete (therapeutic) dissection. The incidence of postirradiation lymphedema was found to be strongly dependent upon the extent of dissection. Patients undergoing limited (diagnostic) dissection followed by pelvic irradiation have a 25-30% risk of developing this debilitating complication. In patients undergoing complete (therapeutic) dissection followed by pelvic irradiation lymphedema has been observed in 66% of cases. PMID- 6483688 TI - Nonsteroidal serum factors involved in the regulation of the proliferation of canine prostatic epithelial cells in culture. AB - Canine prostatic epithelial cells were cultured in primary monolayers in order to define those factors that induce a proliferative response at the cellular level. Cultures were performed in a serum-free medium or in a medium supplemented either with fetal bovine serum or dog serum in the presence or absence of several sex steroids (androstenedione, testosterone, dihydrotestosterone, 3 alpha- and 3 beta androstanediols, epitestosterone, epidihydrotestosterone, estrone, estradiol, and progesterone). Cell proliferation was observed in the absence of serum and exogenous steroids. The rate of cell division was serum dependent and steroid independent. Pretreatment of sera with charcoal had no effect on their mitogenic activities. Cells maintained in an endocrine milieu prior to tissue dispersion and throughout the whole procedure proliferate to the same extent as those deprived of hormones, whether free of serum or added supplements. The addition of insulin (2 micrograms/ml), dog prolactin (up to 25 ng/ml) and zinc (10(-8) to 10( 2) M) in a serum-free medium did not induce cell responsiveness to steroids. Dihydrotestosterone, 3 alpha-androstanediol, and estradiol alone or in combinations known to induce the growth of the canine prostate in vivo were ineffective in vitro. The proliferative responses to sera were time and concentration dependent, and dog serum was more potent than fetal bovine serum. Thus, humoral factors other than steroids, prolactin, insulin, or zinc may be of importance in the activation of epithelial cells involved in the development of prostatic hyperplasia and adenocarcinoma. PMID- 6483689 TI - Effects of prostatic secretion on reduced sugars in human seminal plasma. AB - Glucose and fructose levels were determined enzymatically in liquefied human seminal plasma (whole or collected in three fractions) and in preparations obtained by DEAE ion-exchange chromatography on whole seminal plasma. When these secretions or DEAE-extracted preparations were overloaded with fructose, the level of glucose increased. This increase is greater in fraction I of split ejaculates than in fractions II and III, and is greater in solutions containing elements of prostatic secretion obtained chromatographically than in whole seminal plasma. Using increasing quantities of fructose in the overloading test, glucose levels reached a maximum, suggesting that the process of conversion of fructose into glucose appears to be related to an enzymatic process. Other experiments suggest that the sperm-free fraction I of split ejaculates and compounds obtained from seminal plasma by ion-exchange chromatography contain enzymes of prostatic origin that are involved in the conversion of fructose to glucose. PMID- 6483690 TI - Antagonistic effect of androgen on prostatic cell death. AB - Androgen, besides having the well-established agonistic ability to stimulate prostate cell proliferation, also has an antagonistic ability to inhibit prostatic cell death. This statement is based upon the observations that 1) only 2.1% of the total prostatic cells die per day when serum testosterone level is sufficient for chronic maintenance of the gland; 2) 3 days following castration, when serum testosterone level is less than 10% of the intact value, the percentage of total prostatic cells now dying per day is increased tenfold to a value of 20.8%; and 3) this high rate of prostatic cell death can be inhibited following castration if serum androgen level is appropriately maintained by exogenous testosterone treatment. The serum testosterone level needed to antagonistically inhibit prostatic cell death (ie, 1.4 +/- 0.1 ng/ml) is more than twofold lower than that needed to antagonistically stimulate prostatic cell proliferation (3.3 +/- 0.4 ng/ml). Due to this dose difference, it is experimentally possible in castrated rats to inhibit prostatic cell death selectively without simultaneously stimulating cell proliferation and still completely prevent the rapid involution of the prostate following castration. These results suggest that the rapid involution of the prostate following castration is predominantly due to a decreased antagonistic effect of androgen on prostatic cell death rather than to a decreased agonistic effect of androgen on prostatic cell proliferation and that these two androgenic effects are distinct processes in the prostate. PMID- 6483691 TI - Medicine: an apt preparation for public office. PMID- 6483692 TI - Occupational asthma. Update on a proliferating problem. AB - The list of agents known or suspected to cause occupational asthma is increasing almost daily. Potency, dose, and size of the population exposed determine the magnitude of the problem in any given industry. Investigation involves determining whether asthma is present, whether it is occupational, and what agent is responsible. Management of occupational asthma must be approached on an individual basis and at an industry-wide level. PMID- 6483693 TI - Office laboratory equipment. Should you consider automation? PMID- 6483694 TI - Priorities in health promotion. Combating the epidemic of preventable illness. PMID- 6483695 TI - Immunization: a shot in the arm for travelers. PMID- 6483696 TI - Zinc supplementation. Evidence of growth stimulation in sickle cell disease. PMID- 6483697 TI - Innovations in drug delivery. AB - With recent innovations in pharmaceutical technology, important new methods of drug delivery have joined established ones. Prolonged-release oral preparations can provide precisely controlled drug delivery, which permits less frequent dosage of drugs with a short elimination half-life and thus improves compliance. These preparations also can narrow fluctuations in plasma levels, which maximizes efficacy and minimizes toxicity. Sustained-release intraocular and transcutaneous preparations offer similar advantages. Infusion pumps provide predictable systemic delivery of drugs that cannot be given orally or transcutaneously. Further innovations can undoubtedly be expected. When the therapeutic alternatives include a prolonged-release preparation, its potential advantages should be weighed against its potential disadvantages. Although some of these preparations cost more, this disadvantage may be outweighed by potential advantages. PMID- 6483698 TI - Hyperbaric oxygen use. Update 1984. AB - The fact that as many as 60 new hyperbaric oxygen chambers are being established each year in the United States indicates the extent of interest in this relatively new therapy. In 1983 the Hyperbaric Medicine Committee of the Undersea Medical Society revised its classification of conditions being treated by hyperbaric oxygen (HBO), dividing them into two categories: category 1, conditions for which HBO treatment is known to be effective and is third-party reimbursable, and category 2, conditions for which such treatment is unproved experimentally or clinically and is not reimbursable. In the future many of the conditions in category 2 may be reclassified as category 1, which would allow HBO treatment to be third-party reimbursable. PMID- 6483699 TI - Erythrocytosis. A guide for rapid evaluation. PMID- 6483700 TI - Tuberculous meningitis in the elderly. AB - Six cases of tuberculous meningitis, all occurring in patients over the age of 65, are described. All patients presented with an acute illness, primarily with a confusional state. Headache was a symptom in only two patients and the cases were not confined to ethnic minority groups. The mortality was 50%. PMID- 6483702 TI - Relapse of lymphoma in the heart after a 10-year remission. AB - A 71-year-old woman presented with intractable cardiac failure 10 years after receiving treatment for lymphoma. Extensive investigations failed to demonstrate a recurrence of her disease, but resolution of her cardiac failure following a trial of chemotherapy and subsequently a cross-sectional echocardiogram suggested intracardiac relapse. This was later confirmed at autopsy. Cardiac metastases should be suspected in patients with malignant disease who develop signs or symptoms related to the heart. PMID- 6483701 TI - Exposure to sunlight and vitamin D deficiency in Saudi Arabian women. AB - Plasma 25-hydroxy cholecalciferol (25-OH vitamin D) concentrations were measured in 31 adult Saudi Arabian women who presented with acute minor illness. Patients with chronic diseases, malignancy and overt metabolic bone disease were excluded from this study. The median plasma 25-OH vitamin D concentration was 6 ng/ml (range: 2-18 ng/ml). Only three subjects had a concentration within the normal range (10-55 ng/ml). Plasma 25-OH vitamin D concentrations were significantly lower in subjects living in apartments than in those living in villas or rural areas (P less than 0.02). When direct questioning was used to assess exposure to sunlight, plasma 25-OH vitamin D concentrations were significantly lower in those subjects whose average exposure was less than 30 min daily than those whose exposure was more than 30 min daily (P = 0.002). Our findings confirm the importance of inadequate exposure to sunlight in the aetiology of vitamin D deficiency. Social customs may contribute to this deficiency in spite of abundant sunshine. Direct questioning to assess the adequacy of sunlight exposure is an essential part of history taking in cases of suspected vitamin D deficiency. PMID- 6483703 TI - Thymoma presenting as a middle mediastinal mass. AB - A case of a middle mediastinal mass which proved to be a thymoma is presented. The diagnostic difficulties that middle mediastinal masses produce and the investigations used to delineate them are discussed. PMID- 6483705 TI - An unusual presentation of sarcoidosis--spontaneous haemopneumothorax. AB - Pneumothorax is a very rare complication of early stage sarcoidosis. A young man is reported with a left sided spontaneous haemopneumothorax and a right apical pneumothorax in association with early sarcoidosis. PMID- 6483704 TI - Toxoplasmosis associated with digital vasculitis and immunodeficiency--a dilemma in diagnosis. AB - We present a case of acquired toxoplasmosis associated with severe digital vasculitis--a previously unreported finding. The rise in Toxoplasma gondii antibody titres may have been attenuated by impaired cellular immunity, and this poses a problem for diagnosis. PMID- 6483706 TI - Renal carcinoma in Lindau's disease. AB - A case of Lindau's disease is presented where renal carcinoma was detected 2.5 years after surgical removal of a cerebellar haemangioblastoma. This patient had no retinal lesions. The importance of screening for renal carcinoma in patients showing one or more manifestations of the disease and screening relatives is emphasized. PMID- 6483707 TI - Coeliac disease with autoimmune haemolytic anaemia. AB - Two patients are described who have developed autoimmune haemolytic anaemia in association with their coeliac disease. Autoimmune haemolytic anaemia may represent an extension of immunological disorders linked with coeliac disease, centred on the histocompatibility antigen B8. PMID- 6483708 TI - Massive gastric distension in acute pancreatitis--a report of two cases. AB - Massive gastric distension was diagnosed in 2 patients with acute pancreatitis. Both showed signs of severe peripheral circulatory failure, and responded well to intravenous fluid replacement and nasogastric aspiration. A review of the literature revealed only 2 previously reported cases. The possible mechanisms linking the pathogenesis of these 2 conditions are discussed. PMID- 6483709 TI - Vulval adhesions causing urinary incontinence. AB - An elderly patient complained of urinary incontinence which was found to be due to vulval fusion. Surgical division followed by local oestrogen cream was curative. PMID- 6483710 TI - Haemodialysis and charcoal haemoperfusion in acute inorganic mercury poisoning. AB - A 29-year-old gardener developed acute renal failure following the ingestion of 'Mersil', a combination of mercurous and mercuric chloride, achieving a plasma mercury concentration of 22,000 nmol/litre (400 micrograms/litre). Haemodialysis and charcoal haemoperfusion were ineffective in removing mercury despite prior treatment with the chelating agent dimercaprol. The acute renal failure resolved after 10 days and there are no residual sequelae. PMID- 6483711 TI - Disulfiram-induced hepatitis--report of a case and review of the literature. AB - Disulfiram has been used as an adjunct to the treatment of chronic alcoholism since 1948. We report a young woman who developed clinical, biochemical and histopathological signs of a liver hypersensitivity reaction. A review of the literature is also presented. PMID- 6483712 TI - Effect of selection for fertility of frozen-thawed semen in chickens on the fertility of fresh and stored semen. AB - Studies were conducted using 68 males from the seventh generation of a line of meat-type breeder chickens selected for increased duration of fertility of frozen thawed semen and 69 males of the randomly selected control line. These chickens were used to determine the presence or absence of differences between the selected and control lines with respect to fertility and spermatozoal motility when the semen was subjected to the following preinsemination treatments: 1) frozen in a diluent containing 13.6% glycerol; 2) frozen in a diluent containing 1.7% glycerol; 3) fresh undiluted; 4) fresh diluted; 5) diluted and stored for 24 hr; and 6) diluted and stored for 48 hr. Semen from each male was inseminated into 4 to 6 White Leghorn tester hens per experiment. The effects of genotype (line) by preinsemination semen treatment interaction on fertility and spermatozoal motility were also examined. When semen was frozen (Treatments 1 and 2), the selected line had significantly (P less than .01) higher duration of fertility, percent fertility for 7 days postinsemination, and percent fertility for the duration of fertility and spermatozoal motility than the control line. For fresh semen (Treatments 3 and 4), the selected line had significantly (P less than .01) higher fertility estimates and spermatozoal motility than the control line except for percent fertility for the duration of fertility (P greater than .05) of undiluted semen. For stored semen (Treatments 5 and 6), the selected line only had significantly (P less than .05) higher duration of fertility after 24 hr storage and percent fertility for the duration of fertility after 48 hr storage than the control line.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483713 TI - Reproductive performance of broiler breeders exposed to cycling high temperatures from 17 to 20 weeks of age. AB - Forty male and 240 female broiler breeders were placed in cages within environmental chambers (20 males or 40 females per chamber) at 14 weeks of age. Chamber temperatures were maintained at 21.3 +/- 2.5 C, and relative humidity (RH) ranged from 40 to 50%. Ventilation rate was approximately 47.2 liters/sec per chamber, and light was provided from 0600 to 1800 hr. Feed was restricted daily according to industry recommendations, and water was provided ad libitum. From 17 to 20 weeks of age, control (C) chambers were kept at constant 21.0 +/- 1.4 C with 45 +/- 5% RH, and heat-treated (HT) chambers were cycled from 24.4 +/- 5.5 C (45 +/- 5% RH) during 1800 to 0800 hr to 36.0 +/- 2.8 C (15 +/- 5% RH) during 0800 to 1800 hr. Body weights were recorded at biweekly intervals. At 18 and 20 weeks of age, blood samples and rectal body temperatures were obtained randomly from five fasted birds per chamber at 0800 and 1400 hr. From 20 to 60 weeks of age, all birds were kept in individual cages in a conventional fan ventilated house. Maximum temperature never exceeded 30 C, and average RH was 65.0%. Reproductive parameters were monitored and body weights were obtained at 4 week intervals. There were no significant treatment effects for body weight, body temperature, or differential leukocyte counts. Hematocrits were significantly lower for HT females than controls, and heat treatment did not result in consistent changes in plasma glucose or total proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483714 TI - Increasing hatchability of turkey eggs by matching incubator humidity to shell conductance of individual eggs. AB - One of the most important factors determining hatchability of avian eggs is the proper water balance of the eggs during incubation. In turkey eggs, a total diffusive water loss (F) of 12 +/- 1% SD initial egg mass in 28 days, yielded maximal hatchability irrespective of the combination of eggshell water vapor conductance (G) and incubator humidity (PI), which brought about this water loss. A good correlation was found between G as obtained at the beginning of incubation and the final F in a given PI. The G in a random sample of 1256 fresh turkey eggs was normally distributed around the mean of 18.70 +/- 2.87 SD milligrams (100 g X day X torr)-1 (Coefficient of variation = 15.3%). The distribution of G in eggs with dead in the shell embryos had, in addition, two more peaks of G values [around 22.5 and 13.0 mg (100 g X day X torr)-1]. When eggs were sorted into low (less than 17), medium (17 to 20), and high (greater than 20) G categories, and incubated at low (19.4), medium (26.6), and high (33.9) torr PI, respectively, hatchability increased by a factor of 1.08. Poor hatchabilities were obtained in mismatching humidities and conductances. It seems that hatchability success may be experimentally improved if a correct rate of water loss is fitted to sorted eggs during incubation. PMID- 6483715 TI - CL 259,971: a potent new polyether anticoccidial. 1. Battery efficacy and safety. AB - The anticoccidial activity of CL 259,971, a new polyether ionophore produced by Actinomadura yumaense sp. nov, has been demonstrated against six species of poultry Eimeria, tested individually or in mixed species infections. Statistically significant activity was obtained against some species with as little as 2.5 ppm of drug. The optimal treatment level, however, was determined to be 5 ppm. At this level, performance was comparable to 100 or 120 ppm of monensin. CL 259,971 is coccidiocidal and affects the early asexual stages of the life cycle of E. tenella. Fed to uninoculated cockerels in batteries at 10 ppm for 7 weeks, CL 259,971 permitted numerically superior weight gains when compared with 200 ppm of monensin. PMID- 6483716 TI - CL 259,971: a potent new polyether anticoccidial. 2. Floor-pen trials. AB - Three floor-pen trials have confirmed the high anticoccidial activity of CL 259,971 as first reported in batteries. The optimal dosage level was shown to be 5 ppm in the diet. At this level, excellent anticoccidial activity was observed with no adverse effect on weight or performance. The results indicated that 5 ppm of CL 259,971 provided efficacy and performance comparable to arprinocid or monensin, which were used for comparison in these trials. PMID- 6483717 TI - A cage-related foot pad dermatitis in dwarf and normal-sized single comb white Leghorn layers. AB - Studies were conducted to determine if wire cage floors were involved in producing a foot pad dermatitis in dwarf and normal-sized Single Comb White Leghorn layers. Dermatitis scores were found to be higher for dwarf birds reared in cages versus litter floors. The use of plastic-coated cage floor inserts and wooden perches reduced the incidence of dermatitis in caged dwarf birds. Normal sized layers consistently exhibited a lower incidence of dermatitis than did dwarf hens. PMID- 6483718 TI - Photoinduced buphthalmic avian eyes. 1. Continuous fluorescent light. AB - Numerous investigations of light induced avian buphthalmia using incandescent light have not defined an etiology. Chickens raised from 2 weeks of age in continuous fluorescent light developed shallow anterior chambers and buphthalmos within the first month of treatment. Chickens raised in continuous fluorescent light developed ocular enlargement similar to that reported in chickens raised in continuous incandescent light. Corneal diameters and axial globe lengths were an inconsistent means of documenting ocular enlargement. Iridocorneal angles were narrowed on scanning electron microscopy. PMID- 6483719 TI - Fluorosis in the laying hen. AB - One hundred fifty Single Comb White Leghorn hens of two strains previously selected for either high eggshell strength (HES strain) or low eggshell strength (LES strain) were treated for 8 weeks with sodium fluoride added to a practical type corn-soybean meal basal diet at 0, 300, 600, 900, or 1200 ppm. The HES strain was found to be more sensitive to fluorosis than the LES strain. High levels of dietary fluoride produced greater decreases in feed consumption, egg production, eggshell breaking strength, eggshell weight, and eggshell thickness in the HES strain than in the LES strain, despite the fact that the absolute intake of fluoride was greatest in the LES strain. Fluoride treatment significantly increased bone magnesium content in both strains and plasma phosphorus in the HES strain but did not significantly affect bone breaking strength or the concentrations of total calcium, ionized calcium, or magnesium in plasma of either strain. High fluoride treatment (1200 ppm) reduced the growth of HES progeny after 8 weeks of treatment of the hens, but LES progeny were not affected. These results suggest that the decreased sensitivity of the LES strain to fluoride may relate to its relatively greater (ca. 14%) volume of bone in which most absorbed fluoride is deposited. PMID- 6483720 TI - Influence of phase feeding available phosphorus on egg production characteristics, carcass phosphorus content, and serum inorganic phosphorus levels of three commercial layer strains. AB - An experiment was conducted to obtain information on the concept of progressively decreasing dietary phosphorus levels (phase feeding) on the performance of three different commercial layer strains. Dietary available phosphorus (AP) levels of .15, .30, or .45% were fed continuously from 22 to 70 weeks of age. Concurrently, a diet containing .35, .25, and .15% AP was phase-fed during age intervals of 22 to 34, 34 to 50, and 50 to 70 weeks, respectively. Dietary AP levels did not significantly affect egg production except the .15% AP level, which significantly reduced egg production when compared with the other three dietary AP treatments. Efficiency of feed utilization was significantly superior for hens phase-fed AP compared with hens fed the other AP treatments. There were no differences in egg weight or mortality due to dietary AP. Eggshells were significantly thicker when hens received .15% AP. The .15% AP and phase-fed regimen resulted in hens with significantly lower body weights at the end of the experiment. Hens fed .30% AP and phase-fed AP had significantly lower carcass ash and phosphorus levels. Serum phosphorus levels corresponded directly to dietary AP levels. There were no significant differences in egg production due to strain nor were there any strain by dietary treatment interactions that influenced production traits. Significant strain differences were noted in feed efficiency, egg weight, carcass ash, and carcass phosphorus. PMID- 6483721 TI - Use of plasma and egg yolk biotin of white Leghorn hens to assess biotin availability from feedstuffs. AB - A linear relationship (r greater than .98) was found between the level of dietary biotin and plasma and egg-yolk biotin in White Leghorn hens after feeding the experimental diets for 2 weeks. This shows high reliability of these parameters as indicators of biotin availability. When plasma and egg yolk biotin were used to assess biotin availability in feedstuffs, they indicated low values for wheat (0%) and sorghum (10 to 20%) and high values for corn (75 to 100%), soybean meal (100%), and meat and bone meal (85%). When these parameters were used to assess commercial poultry diets, they indicated values for a "layer" diet of 75 to 100% and for a "broiler" diet of 81 to 92%. Pelleting gave an increase in biotin availability of 10% over the mash diet. This method for assessing biotin availability promises to be simple, economic, rapid, and reliable. PMID- 6483722 TI - Plasma triglyceride and glucose clearance in broiler-type and white Leghorn chickens with different degrees of adiposity. AB - Broiler-type and White Leghorn chicks were given diets containing 30.5, 26.2, or 22.3% protein with and without addition of 5% corn oil during an 8- to 9-week conditioning period. The absolute weight of the abdominal fat pad was greater in the broiler-type birds on all dietary treatments. As a percentage of body weight the abdominal fat pads were similar in broiler-type and White Leghorn birds only when the diet contained 30.5% of protein without added oil. Following a 16-hr fast, plasma glucose was higher in the broiler-type than in the White Leghorn birds, whereas plasma triglyceride concentrations were higher in White Leghorns. In birds refed a high-fat meal, plasma glucose showed little change except in the broiler chickens previously fed the 30.5% protein diet without added oil. In these birds plasma glucose declined over a 5-hr period to reach a mean value of 130 mg/100 ml. Plasma triglyceride concentrations in both breeds were markedly elevated within 45 min of refeeding with a high-fat meal, but the peak concentrations were higher in the White Leghorns than in the broiler-type birds. Previous consumption of the high-oil diet increased postprandial triglyceride concentration in the plasma of the broiler-type but reduced it in the White Leghorn chickens. The difference in response of the chickens of the different genetic stocks is attributed to differences in the development of the activities of the systems associated with 1) fatty acid absorption and movement of triglycerides from the intestinal mucosa to the circulation and 2) clearance of plasma triglycerides to the adipocytes as a result of lipoprotein lipase activity. PMID- 6483723 TI - Lead toxicity in the chick as affected by excess copper and zinc and by Eimeria acervulina infection. AB - Several experiments were performed with young chicks to evaluate lead (Pb) toxicity and its effect upon copper (Cu) and zinc (Zn) toxicosis in the presence or absence of Eimeria acervulina infection. Toxic levels of Pb (3300 mg/kg) and Cu (500 mg/kg) or Zn (2000 and 4000 mg/kg) were added to completely adequate corn soybean meal diets, while duodenal coccidiosis was produced by multiple crop inoculations of 4 X 10(5) sporulated E. acervulina oocysts. Both Pb and Cu depressed gain and feed efficiency while concomitant coccidial infection reduced these parameters further. Moreover, E. acervulina increased the concentration of liver Cu and kidney Pb. Although Pb supplementation slightly decreased the accumulation of liver Cu, additional Cu tended to increase the deposition of Pb in the kidney in both infected and uninfected birds. Similarly, chick performance was significantly reduced by excess dietary Pb or Zn, although coccidiosis slightly ameliorated the growth depression caused by toxic levels (4000 mg/kg) of Zn. Although 4000 ppm Zn and coccidial infection reduced the deposition of Pb in the kidney, this interaction was not evident when 2000 mg/kg Zn was fed to infected chicks. It is evident that Pb toxicosis in the chick is affected little by excess dietary levels of either Cu or Zn. PMID- 6483724 TI - Choline and methionine supplementation of layer diets varying in protein content. AB - Two experiments were conducted with White Leghorn laying hens to evaluate choline and methionine addition to diets containing various crude protein (CP) levels. Corn-soybean meal diets containing 25 g/kg meat and bone meal were used in all experiments. Either choline or methionine supplementation at 1.0 g/kg improved egg production and feed:egg ratio of hens fed 140 g/kg CP from 23 to 35 weeks of age in Experiment 1. The magnitude of response from methionine was significantly greater than that from choline. Egg production and feed: egg ratios were not affected by these supplements in diets containing 160 g/kg CP. Added methionine also improved egg yield and egg weight at both levels of CP, whereas choline had no effect. In Experiment 2, .5 g/kg choline or methionine increased egg weight of hens fed 140 g/kg CP from 33 to 45 weeks of age, but these supplements had no effect in diets containing 160 g/kg CP. In phase 2 of this experiment, either choline or methionine at 1.0 g/kg improved egg production and egg yield of hens fed either 150 or 130 g/kg CP from 45 to 57 weeks of age. The responses from methionine were greater than those from choline. Methionine also improved egg weight at the lower protein level, whereas choline had no effect. The results of this study indicate that laying hens respond to either dietary choline or methionine supplementation; the response to methionine was greater, however, than the response to choline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483725 TI - The roles of protein level and diet form in water consumption and abdominal fat pad deposition of broilers. AB - Two experiments were conducted to investigate the possible relationship of water intake and water/feed ratios in explaining abdominal fat changes associated with changes in dietary protein level and diet form. In Experiment 1, day-old male chicks from two commercial broiler stocks were fed diets containing 26, 22, and 17% protein from 0 to 19 days of age. Chicks fed the 26% protein diet consumed more water, had higher water/feed ratios, and had less abdominal fat than chicks fed lower protein diets. Chicks fed the 22% protein diet were intermediate to the 26 and 17% protein treatments in water consumption, water/feed ratios, and abdominal fat. In Experiment 2, day-old male chicks from two commercial broiler stocks were fed a diet in either mash or crumbled form from 0 to 20 days of age. Chicks fed crumbles had heavier body weights, consumed more feed and water, and had more abdominal fat than birds fed the mash diet. Superior body weights of birds fed the crumbled diet appeared to be due to higher relative growth rates immediately after hatch. PMID- 6483726 TI - Responses to dietary self selection and calories in liquid form by weight selected lines of chickens. AB - Feed intake of adult White Plymouth Rock male chickens from lines selected for high (HW) and low (LW) juvenile body weight was examined as a function of dietary self selection, glucose solutions in lieu of water, and environmental temperature. More energy was consumed by LW males allowed to select between high protein and high energy diets and when glucose solutions were provided in lieu of water, than on complete diets. In contrast, these regimens had relatively little influence on caloric intake in the HW line. On split diets, protein consumption was reduced in both the HW and LW lines, indicating that both populations overconsumed protein when fed complete diets. PMID- 6483727 TI - Two methods for serial blood sampling from unrestrained, undisturbed turkeys with notes on the effects of acute stressors on plasma levels of prolactin. AB - A method was developed for chronic cannulation of the atrium of the turkey. Two methods, one employing a headmount swivel-tethering system and the other a backmount swivel-tethering system, were developed for serial bleeding from cannulated turkeys kept in an environmental cubicle. To validate the methods for serial bleeding from undisturbed, unrestrained turkeys, the effects were examined of several stressors on plasma prolactin (PRL) levels in adult toms. Serial bleeding at 2-min intervals followed by withdrawal of one sample of 50 ml at 2 hr after initiation of bleeding had no effect on plasma PRL. Water deprivation for 24 hr or intraatrial infusion of hypertonic saline had no effect on plasma PRL. Intraatrial injection of 10 mg/kg of epinephrine bitartrate resulted in a significant elevation of plasma concentrations of PRL. PMID- 6483728 TI - Catabolism of phospholipids by chicken seminal components after storage. AB - The possibility of an activation of chicken spermatozoal phospholipase A2 during in vitro storage of undiluted semen was investigated. After storage for periods up to 24 hr at 5 C, the ability of semen to catabolize added phosphatidylcholine labeled on the 2nd carbon of glycerol with 14C oleic acid was assessed. Neither spermatozoa nor plasma from undiluted chicken semen was found to be capable of catabolizing added 14C labeled phosphatidylcholine, regardless of the storage period. No enzyme activity was evident when fresh semen was incubated under various assay conditions to determine the influence of cholic acid, calcium, and the type of phospholipid substrate on phospholipase A2 activity. The influence of spermatozoal protease activation on phospholipase A2 activity from undiluted chicken semen and from Naja naja naja was also investigated and found to have no influence on phospholipase A2 activity. PMID- 6483729 TI - A surgical technique for serial blood sampling or continuous infusion of adult turkey hens. AB - A technique for cannulating the jugular vein of turkey hens is described. The procedure is relatively easy to perform with no deleterious effects elicited by the procedure. Cannulae have remained patent for up to 1 month. PMID- 6483730 TI - The influence of feeding program on peak production and avoiding sudden declines in production with broiler breeders. AB - Production parameters were examined for 49 commercial broiler breeder flocks. Data from the flocks were divided into two groups based on whether or not an adequate increase in body weight was maintained through peak production. Hens making steady and adequate weight gains peaked at a significantly higher rate of egg production and maintained a rate of 80% egg production or above for ten times longer than those with inadequate gains. The hens making adequate gains maintained 70% or above for almost twice as long as those with inadequate gain. PMID- 6483731 TI - Drinking water treatment with a commercial preparation of a concentrated Lactobacillus culture for broiler chickens. AB - Three hundred male broiler chicks were used to determine the effects of supplying Lactobacillus in the drinking water. The product used, Biomax 40TM, was a fresh frozen, pure culture of Lactobacillus containing 40 X 10(9) cfu/ml. Water treatments consisted of continuous lactobacilli dosing (CD) and skip-a-day lactobacilli dosing (SAD). A control group (C) received no lactobacilli. Each treatment and control contained two pens of 50 chicks each and were fed for a duration of 7 weeks. At the termination of the experiment, weights of the wet viscera, and wet and dry small intestines of the broilers revealed no significant differences between treatments and control. Surface pH readings taken from crop and duodenum showed that there was no significant difference (P greater than .05). Microbiology performed on duodenal contents revealed higher numbers of lactobacilli for CD and SAD broilers than for C broilers. The liver biotin contents of the lactobacilli-treated broilers were not significantly different from those of the controls. Body weights were not changed by either treatment, although they were greater for the CD broilers than for the SAD broilers. No difference was observed in feed conversion (feed/gain). PMID- 6483732 TI - Time of mating behavior by males from lines of chickens selected for high and low mating frequency. AB - Male mating behavior was measured in lines of chickens selected for high or low mating frequency and in the randombred base population at various times throughout the day. Males were observed singly with flocks of five randombred hens for two 5-min trials at 0800, 1100, 1400, and 1700 hr. Behaviors measured were attempted mountings and completed matings. Line by time interactions were not significant. High-mating line males mated more than randombred controls, which mated more frequently than low-mating line males. The highest percentage of matings was completed in the late afternoon. Low-mating line males exhibited increased mating behavior with additional experience. PMID- 6483733 TI - Fear-related responses of white Leghorn hens of several genetic stocks in five bird cages and associations with quantitative traits. AB - Hens of 8 genetic stocks derived from a common foundation population were compared at three ages for latency to recover from tonic immobility (TI) and from an avoidance response following exposure to a metronome. Body weight, feather score, and egg-production traits also were measured. A total of 350 hens was involved and individuals of the same genetic stock were kept together in 5-hen cages from 19 to 70 weeks old. The TI and metronome avoidance tests were conducted in three rounds at mean ages of 35, 48, and 61 weeks. Hens of stocks with increased egg mass, resulting from selection, did not differ from unselected controls for TI or avoidance responses. Straincross hens also did not differ from parental strain means for these fear-related behaviors. Time to recover from induced TI decreased with repeated testing at 13-week intervals. Hens exposed to the metronome a second time within the first round recovered more rapidly than did those tested in this way for the first time. Previous indirect exposure to the metronome also resulted in reduction in avoidance time. Correlation analysis revealed only a moderate association between TI and avoidance responses (r = .23, P less than .01). Avoidance responses were not associated with any other quantitative trait in the 5-hen cage environment. Duration of TI was moderately associated with body weight (r = .22, P less than .01) and had a complex relationship with total egg mass produced, which was associated with the interval in cages prior to testing. There was no apparent correlation of TI and egg mass when TI was measured on 35-week-old hens, heterogeneity of correlations was present among genetic stocks tested at 48 weeks, and a negative association was detected when TI tests were conducted at 61 weeks (r = -.46, P less than .01). PMID- 6483735 TI - The influence of daylength, body weight, and age on the reproductive ability of broiler breeder cockerels. AB - June-hatched broiler breeder cockerels of two strains were evaluated for reproductive performance in mating pens from 22 to 48 weeks of age. Two light programs with maximum daily daylengths of 15.5 or 16.5 hr were studied. An increase in the light day to 16.5 hr did not significantly affect the male reproductive traits except in number of completed matings and percent packed sperm volume (PSV). The males on 16.5 hr of light had significantly fewer completed matings than did the males on 15.5 hr. Strain 1 males on 16.5 hr produced significantly more spermatozoa at 35 and 40 weeks of age than males on 15.5 hr of light. Male body weights of both strains were significantly lower at 30 weeks of age on the longer daylength. Body weights of cockerels in all treatment groups increased with aging. The range in male body weight markedly influenced the percentage of producing cockerels with aging. During the late egg cycle, the number of producing males increased as body weight increased. The overall mean age of peak in the percentage of males in semen production was 44 weeks of age, which was 7 weeks later than peak egg production. Hatchability was significantly lower for male Strain 2, which had a higher percent PSV and a higher number of attempted matings than did Strain 1. Body weight was significantly correlated with male vent feather-wear at all ages and with the percentage of producing males at 48 weeks of age. The percentage of producing males was correlated with vent feather-wear, evert score, semen volume, and PSV. These results emphasize the importance of body weight selection for optimum breeding flock performance. PMID- 6483734 TI - Ea-A and Ea-E cellular antigen genes in Leghorn lines resistant and susceptible to acute cecal coccidiosis. AB - The purpose of the work was to explore the diversity and function of alloantigens in chickens differing in genetic resistance to acute cecal coccidiosis, Eimeria tenella (ACC). This paper describes A and E alloantigens, products of linked loci Ea-A and Ea-E, worked out in Leghorn lines R and S, previously selected for respective resistance and susceptibility to ACC. The R line possesses high frequency haplotypes A7E5 and A9E1 with very low frequencies of the recombinants. The S line possesses almost totally different haplotypes ranging from high to low frequency, respectively: A9E3, A9E5, A9E2, and A11E1. Alleles A7 and A11 were differentiated only by fortuitous production of an A reagent in other work on a commercial broiler line, suggesting that alloantigen variability in chickens is a continuum spanning varietal differences. The AE recombinants in both lines remained at very low frequencies for many generations after selection was suspended. Discussion is given for selection having been the most probable force producing nearly unique AE haplotypes in each of the two lines, largely from different cis-trans relations between similar A and E alleles. Thus, interactions of the A and E regions appeared to have been essential to the seeming action of AE on genetic resistance to ACC. The A and E antigens are shown to develop contemporaneously in ontogeny in the earliest generations of embryonic erythrocytes, further suggesting that AE is a coordinated functional complex. PMID- 6483736 TI - Effects of heat stress on day-old broiler chicks. AB - Short-term heat stress can occur when chicks are transported from the hatchery to growing facilities. Two experiments were conducted to determine the possible effects of short-term heat stress on growth and feed conversion of broiler (Hubbard X Hubbard) chicks. The heat stress was accomplished by placing chicks in Jamesway 252 incubators at dry bulb temperatures ranging from 40 to 45 C for variable times. Growth, feed consumption, and mortality were measured for 16 days following the heat stress. Short sublethal heat stress significantly reduced growth rate to 16 days in these experiments without any effect on feed conversion ratio. The results indicate that the hatchery industry should avoid overheating chicks even for periods as short as 1 hr. PMID- 6483737 TI - Influence of toe-clipping and stocking density on laying hen performance. AB - Three experiments were conducted to investigate the influence of toe-clipping and bird density on laying hen performance. Toe-clipping was done on day-old chicks by removal of the digital claws from the front toes. Toe-clipped (TC) and intact (IN) pullets were assigned randomly to laying cages (Experiments 1 and 2, 19 weeks of age) or housed in similar body weight groups (Experiment 3, 18 weeks of age) at caging densities of either 4 (465 cm2/hen) or 5 (372 cm2/hen) hens per cage. Experiment 3 body weight groups were: heavy (greater than or equal to 1475 g), medium (greater than or equal to 1375 g, but less than 1475 g), light (greater than or equal to 1275 g, but less than 1375 g), and extra light (less than 1275 g). Body weights were determined at various ages during the grow-out and egg-laying periods. Beginning at 22 weeks of age, average daily egg weight, feed consumption, feed conversion, hen-day egg production, and mortality measures were made for 12 periods of lay of 28 days each. In Experiments 1 and 2, IN pullets were consistently heavier throughout the grow-out period and consumed significantly more feed during the egg laying period than TC birds. Significantly greater average daily egg weights were found in IN than in TC hens in Experiment 1 but not in Experiment 2. Increasing the number of hens from 4 to 5 hens per cage resulted in a significant reduction in feed intake and body weight gain in Experiments 1, 2, and 3. In Experiment 1, mean daily egg weight was significantly increased (.11 g) upon crowding. In Experiment 2, crowding elevated mortality. In Experiments 1 and 2, but not 3, a significant toe treatment by bird density interaction was observed for hen-day egg production. The IN birds had lowered hen day egg production rates when crowded than when they were afforded more space, whereas hen-day egg production was elevated in crowded TC hens when compared to TC hens housed at the less crowded density. In Experiment 3, an initial (4 weeks of age) significant depression in pullet body weight was found in the TC pullets but disappeared by the 8th week. Feed usage was also significantly greater in IN than in TC hens in Experiment 3. Toe treatment did not affect any other hen performance variable measured. Egg weight, feed intake, and feed conversion measures varied by body weight groups. In general, the heavier hens consumed more feed and laid heavier eggs, but they were less efficient in converting feed into eggs. PMID- 6483738 TI - Quantitation of intestinal D-xylose absorption in normal turkeys. AB - Both a standard method and a modified micromethod of quantitating intestinal D xylose absorption were successfully performed in turkeys. Absorption peaks and curves for both tests closely resembled those observed in humans. The micromethod was preferred because it could be performed in poults as young as 3 days of age, required a smaller sample size, and was more economical and less time-consuming. Both tests were suitable for experimental and clinical determination of small intestinal absorptive function in the turkey. PMID- 6483739 TI - Feeding BAY Vi 7533 to hens. AB - BAY Vi7533 (2-chloro-N-[[[4-(trifluoromethoxy)phenyl] amino] carbonyl] benzamide) was fed to White Leghorn and Vedette Mini-broiler breeder hens at concentrations ranging from 0 to 25 ppm in the ration. Concentrations of 15 and 25 ppm resulted in greater than 95% mortality of house flies, Musca domestica L., seeded as larvae into the droppings. Concentration of 25 ppm reduced egg production in the White Leghorn but not in the Vedette Mini-broiler hens. At each concentration (except 5 ppm for Vedette Mini-broilers) residues of the compound were detected in the eggs. These residues, however, had no adverse effects on fertility or hatchability of the eggs. PMID- 6483740 TI - Effect of different levels of dietary sorbic acid on general performance and incidence of leg abnormalities of commercial broilers reared to roaster weight. AB - Two thousand male, day-old Hubbard chicks were housed in 20 pens (13.5 m2) to evaluate the effects on performance and leg abnormalities of feeding 0, 200, 400, and 600 g/ton dietary sorbic acid during the starter, grower, and finisher periods. These levels of dietary sorbic acid had no significant effect on live body weight, feed conversion, mortality, or the incidence of leg abnormalities of these chicken broilers reared to roaster weight. PMID- 6483741 TI - Calculation and evaluation of energy: amino acid ratios for the egg-production type hen. AB - Published equations for estimating the daily energy needs of laying hens were combined with published equations for estimating the daily amino acid needs to derive estimated energy:amino acid ratios for laying hens at different stages of production and environmental temperatures. Two feeding trials were conducted using various percentages of the suggested ratios to determine their applicability. The results of these studies indicate that the calculated energy:amino acid ratios appeared to support production levels comparable with those of hens fed higher nutrient levels. The use of temperature-adjusted energy:amino acid ratios appears to be a valid and feasible means of formulating diets to meet the changing nutritional needs of laying hens. PMID- 6483742 TI - Effect of a high-protein diet fed prior to the onset of lay on performance of broiler breeder pullets. AB - The influence of protein level (154 versus 181 g/kg) in a prelayer diet fed from 134 to 181 days of age on the subsequent performance of hens was studied with two strains of broiler breeders. Birds given the prelayer diet of 181 g protein/kg showed higher egg production, 110 versus 101 eggs per bird, and a lower requirement for amount of feed per egg. The differences were noted mainly in the period 35 to 50 weeks of age. No differences were observed in age at 50% production, egg weight, incidence of cracked eggs, hatchability, or mortality. PMID- 6483743 TI - Eimeria acervulina infection and the zinc-cadmium interrelationship in the chick. AB - The purpose of this study was to evaluate the effects of Eimeria acervulina infection (duodenal coccidiosis) on cadmium (Cd) toxicity and zinc (Zn) status in the young chick. Additions of Cd (45 mg/kg) were made to diets that contained either 0 or 52 mg/kg supplemental Zn (from ZnCO3). Duodenal coccidiosis was produced by multiple crop inoculations of 4 X 10(5) sporulated E. acervulina oocysts. Growth and efficiency of feed utilization were reduced by dietary Cd addition while concurrent coccidial infection reduced these parameters further. Addition of Cd also increased Cd content of liver and kidney and depressed hemoglobin, hematocrit, and plasma Zn content. Coccidial infection exacerbated tissue Cd deposition and depressed hematological parameters further. Although dietary Zn addition ameliorated some of the adverse effects of Cd toxicity, Cd administration tended to enhance tissue Zn deposition. Administration of Cd enhanced synthesis of metallothionein. PMID- 6483744 TI - Relationship of plasma corticosterone and adrenal cholesterol and corticosterone to the production of soft-shelled and shell-less eggs. AB - Two experiments were conducted to determine if plasma corticosterone and adrenal cholesterol and corticosterone levels differed among hens that laid soft-shelled (SS) or shell-less (SL) eggs when compared with hard-shelled (HS) egg layers. For Experiment 1, four groups of White Leghorn hens were bled at 22 to 34 weeks of age in the morning (0600 to 1200 hr) and at 66 to 74 weeks of age in the morning and evening (1500 to 1900 hr). Group 1 consisted of birds that had just laid SS or SL eggs, whereas Group 2 hens had SS or SL eggs in utero. Groups 3 and 4 represented hens with HS eggs in their uteri and hens that had just laid HS eggs, respectively. For Experiment 2, adrenal cholesterol and corticosterone levels were assayed in high (18+%) and low (0%) incidence SS plus SL egg layers at 73 and 78 weeks of age. Both younger and older hens that laid SS or SL eggs in the morning had similar plasma corticosterone concentrations when compared to HS egg layers. Morning plasma corticosterone levels were significantly higher among hens that laid an egg when compared to hens with eggs in utero, regardless of whether the egg was SS, SL, or HS. However, plasma corticosterone levels of hens producing SS or SL eggs in the evening were significantly higher than levels of hens that laid evening HS eggs. Evening HS egg layers demonstrated the oviposition related peak in plasma corticosterone, but concentrations were 1 ng/ml higher among the evening SS or SL egg layers. Adrenal cholesterol and corticosterone concentrations were similar between high and low incidence SS plus SL layers at either age. It is postulated that evening production of SS or SL eggs is a consequence of elevated plasma corticosterone. PMID- 6483745 TI - The effect of supplementation of daylight with artificial light from various sources and at two intensities on the egg production of two lines of geese. AB - Three light sources: Cool-White (C), Vita-Lite (V), and tungsten (T), each at two intensities (20 or 50 lx), were used to supplement light to 16 hr in a 24-hr cycle for geese maintained in open-shed pens. Two lines of mixed breeds of geese, white and grey, were used and egg production was followed from the 27th week of age through 6 months of the laying period. A significant increase in egg production was found under the C light illumination. At 20 lx, egg production was significantly higher than at 50 lx. No difference in egg production was found between the two lines of geese; however, significant interactions were found between light sources, intensities, and geese lines, as exhibited by different patterns of egg production. Light intensity had the greatest effect until peak egg production had been reached; thereafter, egg production was influenced mainly by the light source. PMID- 6483746 TI - Androgen concentrations in testicular and peripheral blood in the male Japanese quail. AB - Two experiments were conducted in which the concentrations of testosterone and dihydrotestosterone (DHT), an active metabolite of testosterone, were studied in the general circulation and in the testicular effluent. In the first experiment, blood samples taken from adult male quail were analyzed by radioimmunoassay for androgen and DHT concentrations; from these data, testosterone concentrations were calculated. The average concentration of androgen was 4238 pg/ml plasma. The average ratio of DHT/testosterone was .75. In the second experiment, steroid concentrations were compared in blood samples taken from the testicular vein and from the general circulation. Androgen concentrations in the general circulation were 36% of that obtained for the testicular effluent. In addition, testosterone and DHT concentrations in the general circulation were 36 and 46%, respectively, as high as concentrations in the testicular vein. Comparison of the average ratios of testosterone/DHT in the general versus testicular plasma revealed a higher ratio in the general circulation (.73 vs. .51, respectively). These results provide additional evidence for testosterone as the major male steroid secreted by the gonads. In addition, the relative concentration of DHT in the quail, which is higher than documented for most species, was higher in the peripheral than in the testicular circulation. This may indicate peripheral metabolism of testosterone to its active metabolite, DHT, and could have implications as to the availability of DHT for its target tissues. PMID- 6483747 TI - The effect of aminoglutethimide on steroid secretion, ovulation, and luteinizing hormone release in the hen. AB - An injection of 200 mg aminoglutethimide (AG)/kg body weight (BW) given 9 hr before spontaneous midcycle ovulation reliably blocked ovarian steroidogenesis and ovulation. Reduction of the dose to 100 mg AG/kg BW or injection of either dose 7 hr before ovulation partially blocked steroidogenesis and failed to reliably inhibit ovulation. Both doses of AG given either 7 or 9 hr before ovulation completely inhibited estradiol-17 beta secretion. Plasma concentrations of progesterone were partially reduced by 100 mg AG/kg BW and were completely suppressed by the 200 mg/kg BW dose of AG. Plasma testosterone levels were depressed only by 200 mg AG/kg BW. Plasma corticosterone levels were elevated following all injections of AG. In the absence of ovarian steroidogenesis, the plasma concentration of luteinizing hormone either remained stable or decreased slightly. Estradiol-17 beta synthesis or release is not required for ovulation, because, in some cases, ovulation occurred in the absence of this hormone. Derangement of the ovarian hierarchy usually occurred when AG was given 7 hr but not 9 hr before ovulation. PMID- 6483748 TI - Anatomy of the Corpus vasculare paracloacale of the male turkey. AB - The copulatory apparatus of the male turkey consists of two parts: the Phallus nonprotrudens, composed of the paired Corpora phallica lateralia and Plicae lymphaticae, and the paired Corpora vascularia paracloacalia. The Corpus vasculare paracloacale receives its vascular supply and drainage from the Arteria (A.) and Vena (V.) pudenda interna, respectively, and its innervation from the Nervus pudendus internus. During sexual stimulation lymph produced in the Corpora vascularia paracloacalia rapidly flows through the lymph sinuses into larger lymph channels located in the Phallus nonprotrudens producing tumescence. With detumescence, the lymph flows cranially from Phallus nonprotrudens into the Vasa lymphatica pudenda interna, which parallels the A. and V. pudenda interna. PMID- 6483749 TI - Feed restriction during the growing period, forced molt, and egg production. AB - An experiment was conducted to examine postmolt laying performance of White Leghorn hens that had been subjected to feed restriction from 8 to 20 weeks of age. During the postmolt period, birds in all forced-molt (FM) groups consistently had higher percent hen-day egg production than the control birds. Within the FM groups, birds that had previously been restricted fed during the growing period at the rate of 70% of the control group's consumption (R70-FM) consistently had higher percent hen-day egg production during most of the postmolt period than the nonrestricted fed birds (Ad lib.-FM). Significant (P less than .05) improvements in albumen height and shell thickness were observed 4 weeks after the FM period. When premolt, molt, and postmolt periods were combined, R70-FM birds had the highest percent hen-day egg production and the best feed efficiency of any group. PMID- 6483750 TI - Poor inhaler technique may be perpetuated by clinical staff. PMID- 6483752 TI - Cancer genes. PMID- 6483751 TI - Hallucinations associated with amoxycillin? A case report. PMID- 6483753 TI - Antibody-guided therapy of cancer. PMID- 6483754 TI - Trace elements in human health. PMID- 6483755 TI - Computed tomography updated. PMID- 6483756 TI - The microcomputer: an advance in medical writing. PMID- 6483757 TI - Preparing children for hospital. PMID- 6483758 TI - One mother's view. PMID- 6483759 TI - A consultant in a health centre. PMID- 6483760 TI - Childfile--a local computerised child health system. PMID- 6483761 TI - Preparation for paediatric surveillance. A survey of trainee general practitioners. PMID- 6483762 TI - The diabetic boy at boarding school. PMID- 6483763 TI - [Sensitivity of lung function parameters in the evaluation of bronchial hyperreactivity in children]. PMID- 6483764 TI - [Measurement of nonspecific airway hyperreactivity using cold air hyperventilation provocation--evaluation of a new method]. PMID- 6483765 TI - [Specific bronchial reactivity following long-term specific immunotherapy in children and adults]. PMID- 6483766 TI - [Respiratory regulation in healthy children and in children with cystic fibrosis in an exercise test]. PMID- 6483768 TI - [Elastic properties of the juvenile lung]. PMID- 6483767 TI - [Respiratory pattern of the premature infant]. PMID- 6483769 TI - [Possibilities and limits of the occlusion pressure method in the measurement of airway resistance in childhood]. PMID- 6483770 TI - [Value of child bronchologic studies]. PMID- 6483771 TI - [3 decades of child bronchoscopy: indications, technic and results]. PMID- 6483772 TI - [Assessment of stridor and tracheal stenosis in the neonate and infant]. PMID- 6483773 TI - [Diagnosis of Chlamydia trachomatis infections in the perinatal period and in infancy by counterimmunoelectrophoresis]. PMID- 6483774 TI - [Exogenous allergic alveolitis caused by inhalation of avian antigens]. PMID- 6483775 TI - [Pyopneumothorax as a complication of fibrinous suppurative pleuropneumonia]. PMID- 6483776 TI - [Risks of asthma drug therapy in pregnancy]. PMID- 6483777 TI - [ARDS--acute respiratory distress syndrome of the adult]. PMID- 6483778 TI - [Flow behavior of hypoxically damaged erythrocytes in lung diseases]. PMID- 6483779 TI - [Oral provocation with inhalation allergens in exogenous allergic bronchial asthma?]. PMID- 6483780 TI - [Measurement of airway resistance with non-plethysmographic methods]. PMID- 6483782 TI - [Sibling position, personality and psychiatric disorder in children and adolescents]. PMID- 6483781 TI - [The institution and the ecosystem--aspects of child psychiatric problem solving]. PMID- 6483783 TI - [Supervision in the group]. PMID- 6483784 TI - [Aggressive behavior in 1- to 2-year old children from the viewpoint of the mother]. PMID- 6483785 TI - Improved direct molecular diagnosis and rapid fetal sexing. AB - Adaptations of the techniques of modern molecular biology to prenatal diagnosis has opened new avenues for the detection of genetic diseases. We have taken advantage of the rapid adhesion of colony forming cells in cultured amniotic fluid samples to develop an improved method for molecular diagnosis. By employing the cell adherence regime sickle cell diagnosis using Mst II can be undertaken directly. In addition, hybridization with a cloned repetitive sequence that is of Y origin and has limited autosomal homology permits rapid fetal sexing in 3 to 4 days without compromising conventional cytogenetic or biochemical analysis. This combination of techniques provides a useful adjunct to convential prenatal genetic diagnosis in the second trimester. PMID- 6483786 TI - Parental response to mid-trimester therapeutic abortion following amniocentesis. AB - This article reports the results of a retrospective study designed to examine the responses of couples to genetic amniocentesis and subsequent therapeutic abortions due to birth defects. Fourteen women and 12 men were interviewed by experienced interviewers using a structured format designed by the authors, and each interview was audiotaped for later rating. The 5 raters (all women) were instructed to independently rate each interview using forms designed by the authors to elicit information about many aspects of the participant's individual responses as well as perceptions of spouse's responses to the process of pregnancy, amniocentesis, therapeutic abortion, and sequelae. Ratings of all 5 raters were conjoined and an homogeneous narrative was constructed for each interview. Results indicate, in general, that the respondent couples coped well with this experience. In fact 70 per cent of the respondent couples described their marital relationships as becoming closer as a result of their experience. Only a few participants reported long-term deleterious effects. Most couples coped by relying on relatives, friends, and occasionally, professional counsellors. In addition, most participants in this study suggested ways to improve the medical and psychological aspects of this experience. PMID- 6483787 TI - Creatine kinase estimation in pure fetal blood samples for the prenatal diagnosis of Duchenne muscular dystrophy. AB - This paper compares the results of a survey of plasma creatine kinase (CK) activity measured in fetuses at-risk for Duchenne muscular dystrophy (DMD) with a reliable control series. Only pure fetal blood samples obtained by fetoscopy at between 17-24 weeks gestational age were used. Of the at-risk group 19 male pregnancies, mostly at low risk for DMD, proceeded to term with a normal outcome; there was no significant difference between their fetal plasma CK activities and the control group. Another 21 male pregnancies were terminated. This group included the highest risk mothers and hence was expected to contain a significant proportion of affected fetuses. The fetal plasma CK activity range was overlapping but significantly higher than the control group. No grossly elevated CK value was obtained. We conclude that, on average, DMD fetuses at this gestational age have higher plasma CK activity than controls. The problems of applying this finding to the prenatal diagnosis of DMD are discussed. PMID- 6483788 TI - Chromosome analysis of first trimester chorionic villus biopsies prepared by a maceration technique. AB - A technique for the culture of chorionic villi for cytogenetic studies is described which is simple, reliable, rapid, and suitable for routine laboratory use. This method eliminates the need for multi-stage and time-consuming procedures inherent in previous techniques which have been developed for this tissue. Cultures suitable for analysis were obtained in an average of sixteen days and the risk of maternal cell contamination was evaluated. Results of cultures initiated from 50 chorion biopsies obtained by transcervical blind aspiration at a weekly termination clinic are presented, and the potential use of this technique as a routine procedure is discussed. PMID- 6483789 TI - Selective survival of only the healthy fetus following prenatal diagnosis of thalassaemia major in binovular twin gestation. AB - Selective feticide is the procedure of choice when, in twin binovular pregnancy, only one of the fetuses is shown to be affected. As the probabilities for this condition are almost 1:2 when the genetic disease is due to homozygosity for two autosomal recessive genes, the problem is expected to occur frequently among the ever increasing number of couples seeking prenatal diagnosis of thalassaemia and the haemoglobinopathies. The present report is the first case of this condition and the ninth in the overall medical literature. PMID- 6483790 TI - Immunoreactive trypsin level in fetoscopically-obtained cord sera of second trimester fetuses. AB - Immunoreactive trypsin (IRT) has been assayed in cord blood collection by fetoscopy from fetuses with estimated gestational ages of between 16-24 weeks. Eighty per cent of the specimens contained more than 5 ng/ml of IRT indicating pancreatic synthesis of trypsin by mid-term. A prenatal test for cystic fibrosis based on IRT estimation might be valid if the onset of pancreatic dysfunction associated with the disease also occurs at mid-trimester. PMID- 6483791 TI - Prenatal diagnosis of a 46,XX/47,XX, + 12 mosaic. AB - A case of true mosaicism 46,XX/47,XX,+ 12 was diagnosed prenatally. The pregnancy was terminated in the 21st week of gestation and the aberrant cell line was rediscovered in cultured fetal tissue. However, a detailed examination of the fetus did not disclose any significant physical malformation. PMID- 6483792 TI - Amniotic band syndrome in second trimester associated with fetal malformations. AB - The possibility of severe fetal malformations, including neural tube defects, secondary to early amniotic rupture followed by formation of fibrous bands (amniotic band syndrome) is a well-known entity. The fact that these pregnancies are usually uneventful makes prenatal diagnosis difficult, but routine determination of serum alphafetoprotein, followed by ultrasound scanning, may detect some of the malformations. We present a case, where detection of a neural tube defect led to induced second trimester abortion of a fetus severely affected by this syndrome. There appeared to be a causal relationship between maternal trauma and the amniotic rupture. PMID- 6483793 TI - Potential for prenatal diagnosis of biotinidase deficiency. PMID- 6483794 TI - [Classification problems and differential histologic diagnosis in malabsorption syndrome in childhood]. PMID- 6483795 TI - ["Limited" Wegener granulomatosis in a child with primary involvement of the lung]. PMID- 6483796 TI - [Ichthyosis uteri with and without neoplasia]. PMID- 6483797 TI - [Unusual pleural involvement in a metastasizing thymoma]. PMID- 6483798 TI - [Cancer prevention. Errors and confusions]. PMID- 6483799 TI - [No reflow phenomenon of the heart and microcirculatory coronary insufficiency]. PMID- 6483800 TI - [Dermatofibrosarcoma protuberans: a variant myxoid]. PMID- 6483801 TI - [Epidemiology of refusal to permit an autopsy]. PMID- 6483802 TI - Some applications of chiral liquid affinity chromatography using bovine serum albumin as a stationary phase. AB - The enantioselectivity excerted by many proteins can be utilized for direct optical resolution in liquid chromatographic processes whereby the protein is used as a stationary phase. Bovine serum albumin (BSA), covalently bound to a suitable support, has been shown to act as a chiral discriminator for a variety of racemic organic compounds in aqueous buffers. Columns packed with BSA-silica can be used for determination of enantiomeric composition in aqueous solvents at very low concentrations by HPLC. This technique opens up new possibilities for the preparative isolation of micrograms amounts of enantiomers and for studies of stereoselectivity and mechanisms in enzymatic and microbial reactions. PMID- 6483803 TI - The use of lectin affinity chromatography for the selective isolation of plasma membranes. PMID- 6483804 TI - Isolation of protein uH2A using a one step preparative gel electrophoresis. AB - A one step electrophoretic procedure for the isolation of protein uH2A has been devised which may improve the overall yield. The improvement involves elimination of intermediate steps which might result in the decrease of the yield. The method may serve as an alternate to the conventional methods and can also be used successfully for the isolation of several different proteins. PMID- 6483805 TI - Bead centrifuge tube inserts--a semi-quantitative theory. AB - A semi-quantitative theory is proposed for the sedimentation of particles in centrifuge tubes filled with polymer beads acting as sedimentation aids. The theory concerns the attainment of approximate sedimentation-diffusion equilibrium in minimum time of centrifugation. It is shown empirically that the time to reach this state is approximately proportional to the diameter of the polymer beads as predicted by the theory. PMID- 6483806 TI - Preparation of [14C]uridine 5'-diphosphate and [14C]guanosine 5'-diphosphate. AB - Procedures have been developed for the routine enzymatic synthesis of [14C]UDP and [14C]GDP from commercially available enzymes and [14C]UMP and [14C]GMP. Using high pressure liquid chromatography, the products are recovered in high yield (60 80%) and with high purity. The [14C]UDP and [14C]GDP are utilized as substrates for ribonucleotide reductase. PMID- 6483807 TI - Reproducible preparation of a wheat germ cell-free system. AB - This study has examined whether the conditions used for the precipitation of plant mRNPs are suitable for the reduction of endogenous template activity in the wheat germ cell-free system. These results have led to a modification of the procedure for the preparation of the wheat germ system that allows the consistent preparation of an active in vitro translation system with low endogenous activity. PMID- 6483808 TI - Large scale preparation of selected glucose oligomers and polymers by gel filtration chromatography. AB - A method for isolating relatively large quantities of glucose oligomer and polymer subfractions from a corn starch hydrolysate is described. Employing large columns of Bio-Gel P-2 (40-80 microns) at room temperature, we can prepare each day 0.5 to 1.2 grams of oligomeric fractions containing three to four adjacent homologues. The columns are homemade, require no flow adapters, and are operated by gravity elution with water as the solvent. The means for avoiding and overcoming potential difficulties, such as microbial contamination and declining flow rate, are described. With the use of the described method, we can operate a single column continuously for up to twelve months. PMID- 6483809 TI - Separation and qualitative recovery of major proteins from a single sample of skeletal muscle. AB - The major soluble and myofibrillar proteins of skeletal muscle were separated into five fractions by extracting a single sample with solutions of increasing ionic strength and pH. After separation of myoglobin, other soluble proteins, and myosin, an acetone powder was prepared from the residue; the extractions were continued to yield actin and the troponin-tropomyosin complex. From 200 g of skeletal muscle the average recoveries were: total sarcoplasmic proteins, 4.5 g; myoglobin, 0.55 g; myosin, 2.7 g; actin, 0.1 g; and troponin-tropomyosin complex, 17.5 mg. The method was designed for investigating the effects of physical or chemical treatment of whole muscle or whole animals by monitoring changes in individual muscle proteins. This is particularly desirable for comparisons of amino acid composition, since naturally occurring levels of methylated histidine and lysine vary in vertebrate muscle among species, among individual members of a species, and among muscle types. PMID- 6483810 TI - The measurement of glucocorticoid receptors in human placental cytosol. AB - Cytosol preparations of human term placenta in Tris-HCl buffer containing dithiothreitol were incubated with [3H]dexamethasone at 4 degrees C. Under these conditions the specific binding of [3H]dexamethasone was low when compared with cytosol preparations of sheep fetal lung or ovine placenta. The inclusion of sodium molybdate in the homogenization buffer and the removal of endogenous steroids by treating the cytosol with charcoal before incubation led to a faster and increased uptake of [3H]dexamethasone by human placenta. Scatchard plot analysis of the data showed that the placenta possesses a single class of high affinity (Kd = 13 +/- 2 nM) low-capacity (193 +/- 34 fmol/mg protein) binding sites for [3H]dexamethasone. The binding of [3H]dexamethasone was reversible and was not due to plasma contamination. The specificity of the binding sites was confirmed by competition experiments in which the highest displacement of [3H]dexamethasone from the binding sites was caused by natural and synthetic corticosteroids. These findings indicate that the human placenta at term contains specific glucocorticoid receptors in high concentrations. PMID- 6483811 TI - An extensive lysosomal system in the maternal epithelium of the porcine placenta. AB - The material comprised 64 placentae from 19 Danish Landrace sows representing gestational stages from 16 to 112 days. The maternal epithelium was examined by means of light and electron microscopy to describe the morphology of the irregular electron-dense bodies and membrane whorls and their relation to gestational stages. Incubation for acid phosphatase demonstrated their lysosomal nature. Electron micrographs of serial sections followed by reconstructions and freeze-fracturing demonstrated their three-dimensional structure and relation to transfer tubules. In the early stages, during the development of fetal vascularization, the maternal epithelium was dominated by inclusions of lipids and glycogen, which can easily be transferred to and utilized by the embryo. The development of an extensive lysosomal system, consisting of irregular electron dense bodies, membrane whorls and transfer tubules, indicates that cellular digestion is an important factor in the transfer and subsequent fetal utilization of maternal nutriments in the last two-thirds of gestation, and that this development is apparently related to anatomical and physiological changes during gestation. PMID- 6483812 TI - Morphogenesis and fine structure of the near-term placenta of Talpa europaea: I. Endotheliochorial labyrinth. AB - Morphological studies of placentation of Talpa europaea confirm an antimesometrially orientated discoidal and chorioallantoidic placentome. This placentome, near term, shows a villous labyrinthine zone with interspersed haematomal areolae on its fetal side, a centrally located fetomaternal junctional zone, and a uterine gland zone towards the myometrium. As shown by light and electron microscopy the interhaemal membrane in the labyrinthine zone develops to an endotheliochorial placentation type. It consists of a prominent maternal endothelium, a distinct interstitial layer, which contains some endometrial debris and is interrupted by some endotheliochorial contact points, a bilayered trophoblast with a thin syncytial and a larger cytotrophoblastic component, and a small fetal endothelium. Disintegration of endometrial epithelium takes place at the areolar glandular mouths and in the junctional zone where a decidual cell reaction can also be observed, but no decidual cells become integrated into the labyrinth. In the spectrum from epitheliochorial to haemochorial placentation, Talpa europaea exhibits a less endotheliochorial type of placentation than is the case with carnivores. PMID- 6483813 TI - A high molecular weight species of placental alkaline phosphatase in human syncytiotrophoblast microvilli. AB - A high molecular weight form of human placental alkaline phosphatase has been detected in extracts of placenta at term by electrophoresis in starch gels containing 0.5 per cent Triton X-100. The enzyme has a mobility intermediate between the previously described A and B forms of the enzyme and has been called the 'M' form of placental alkaline phosphatase. The M form is the major form of the enzyme found in microvilli extracted from syncytiotrophoblast, though trace amounts of membrane-associated M form can be found in extracts of placentae which had previously been experimentally depleted of microvilli. The M form is present in both of the two recently described subfractions of placental microvilli (see Davies, Parry and Sutcliffe, 1981; Truman, Wakefield and Ford, 1981). A variety of experiments show that the M form is not an artefact of extraction. The characteristic mobility of the M form in starch/Triton gels is the same, whether the microvilli are extracted in butanol, chloroform/methanol, Nonidet P40, Triton X-100 or Na deoxycholate. Serological, heat-stability and genetic studies showed that the A and M forms contain the same enzymatic polypeptide. Gel filtration of butanol/H2O and butanol/saline extracts of microvilli provided an estimated molecular weight of the A form of 127000 and of the M form of 725000; these values were unaffected by the presence of Triton in the medium. PMID- 6483814 TI - The effect on pregnancy of treatment with antibodies against pregnancy-associated murine protein I (PAMP-I) in inbred and outbred mice. AB - Intravenous injection of small amounts of monospecific rabbit IgG against pregnancy-associated murine protein I (PAMP-I) induced abortion in mice where there was a histocompatibility difference between mother and fetuses. No abortion could be induced in inbred mice by a similar treatment. The maternal serum level was found to be higher in inbred than in outbred mice. The abortive dose of antibodies did not influence the serum levels of PAMP-I. Histological examination of uterine, placental and liver tissue showed only morphological changes in the placental tissue of mice which aborted due to the treatment with anti-PAMP-I antibodies. PMID- 6483815 TI - Short communication: beta-hydroxybutyrate dehydrogenase activity in human placenta. AB - It has been shown that mitochondria isolated from human placenta contain beta hydroxybutyrate dehydrogenase activity. The properties of the beta hydroxybutyrate dehydrogenase from human early placenta are very similar to those of the enzyme isolated from other mammalian tissues. PMID- 6483816 TI - Metabolic integrity of the isolated perfused lobule of human placenta. AB - Tissue levels of lactate, pyruvate and the adenine nucleotides were measured in samples of human placenta obtained (1) immediately on delivery, (2) after perfusion on the maternal side for one hour, and (3) after a corresponding period of warm ischaemia. Metabolic activity in the isolated perfused placental lobule was assessed in terms of these tissue metabolites and by measuring protein synthetic rate by means of determining the incorporation of a labelled amino acid. Perfusion was found to lower significantly the lactate level whereas ATP was maintained at comparable levels with those in the placenta just after delivery. Perfused placental ATP levels are lower than in vivo levels seen in other tissues with high metabolic rates such as rat liver, kidney and also in guinea-pig placenta. Protein synthetic rate was found to be lower than that observed in other fetal tissues. PMID- 6483817 TI - [Results of a longitudinal study of coronary diseases in occupational exposure to carbon disulfide]. AB - A seven-yer longitudinal study was carried out on the risk of coronaropathy origination in workers, exposed to increased carbon sulphide concentrations. Increased number of the subjects with manifestations of positive and probable IHD was observed among those exposed no increase was observed among the controls. The significance of carbon sulphide as a basic and potentiating risk factor to smoking and hypertension cannot be still determined. PMID- 6483818 TI - [Lung tissue in intratracheal exposure to mine dust]. AB - The experiment was performed 64 albino female rats by a single, intretracheal treatment with 50 mg mine dust. Dynamic biochemical studies were carried out - by 3th and 6th months of the experiment. The data obtained were compared with the changes observed in the positive controls - DQ12 and Ti02 The activity of the oxidation-reduction enzymes and hydrolytic ones was enhanced, the content of sulphhydryl groups and soluble proteins was increased. The results obtained are an evidence of the advancing metabolic disturbances in pulmonary tissue, being better manifested by 6th month of the experiment. PMID- 6483819 TI - [Joint effect on the body of ultrahigh-frequency electromagnetic energy and noise]. AB - A brief review is presented of the new views and methodological approach in hygienic standardization of the combined effect of the physical factors of the environment - ultrahigh frequency electromagnetic energy and noise. In the determination of the biological significance of the factors with their isolated or combined effect and integral logarithmic scale was introduced for the levels studied - the value of the factors, expressed in dB. The results from noise effect of the order 80 dB [A], ultrahigh frequency (UHE) - electromagnetic energy (P = 60 microW/cm2) and their combination reveal the ratio of the restoration periods I:I.9:2.6. Reduced to the logarithmic scale, the identical noise levels and UHF- electromagnetic energy (according to the exemplary result) have different biological significance. If the biological significance of noise is accepted as unity then the activity of the electromagnetic energy from UHF-range is with I.35 higher than that of the noise. With the combined effect of those factors reduced to an integral scale of the levels, the relative biological significance of the noise, electromagnetic energy and their combination has the values I:I.35:2.I. In that way of processing and analysis of the results from multiprofile researches the combined effect of the physical factors could be standardized. PMID- 6483820 TI - [Nitrate content in the soils and vegetable crops in the villages of one district]. AB - The authors determine the content of nitrates in soil samples and the vegetables grown on them (lettuce, spinach, onion, garlic) via sensitive spectrophotometric methods with phenodisulphonic acid and reduction with cadmium column. The lowest nitrates content was established in the soil samples and vegetables grown by AIC, followed by the private arms, and the highest - in the green-horse vegetables and soil samples, owing mainly to the technology of production. PMID- 6483821 TI - [Health status of 6- and 7-year-old 1st-graders studying under the new program of the Ministry of Public Education]. AB - Medical follow-up was realized, during the first school year, on six- and seven years old, first grade school-children, with the purpose to study effect on the health state of the training accordint to the new programme of Ministry of Education. Both groups of school-children observed, were trained according to identical plans and programmes but the organization of the school environment and regimen of the six-year old pupils were more favourable from sanitaryhygienic point of view (smaller number of pupils in the classes, more favourable microclimate in the class rooms, school furniture consistent with the age, conditions for afternoon sleep). A tendency to relatively better hialth state among the 6-years old, first grade pupils was established within the frames of the first grade, regardless of their younger age. That is mainly associated with the better training conditions guaranteed. The follow-up of the school-children is planned to continue during the following school-years. PMID- 6483822 TI - [Age-related characteristics of hemoglobin and erythrocytes in 7- to 17-year-old pupils]. AB - A total of 1100 students, aged from 7 to 17 (50 boys and 50 girls from each age group) were covered wigh the study. The following indices were studied: hemoglobin concentration in blood and erythrocyte count. The results reveal that the average values of hemoglobin and erythrocytes in the boys and girls, aged from 7 to 17, are similar and gradually grow with age. Considerably higher values were found in the boys within the age period 14-17. Our results of hemoglobin of the students, aged 7-17, are lower then those of the foreign authors. The same lower values were established (according to literature data) about the adult population in our country, necessitating additional studies and elucidation of that fact. PMID- 6483823 TI - [Changes in the volume of acquired and processed information of students with regard to age]. AB - Some aspects of the functional state of the higher nervous system and capacity for work are analyzed in the present paper, by work that is fixed in volume and duration. The capacity visual-motor analyzer, the speed, quality and accuracy of the processed information were more precisely established in 161 students from grades 9, 10 and 11, trained at 19 Unified Secondary Polytechnical School, Sofia. The table of Hartridge was used for that purpose. The results as a whole reveal a reduced volume of the acquired information as well as the accuracy of the processed information after the classes in the age groups studied, with no essential discrepancies in the indices discussed. PMID- 6483824 TI - [Physical work capacity of electronics workers (the assembling and checking of printed circuit boards)]. AB - The physical capacity for work of electronic workers that assembly and check up the printed was determined. The physical capacity for work of the female assembly workers is assessed to be moderate and that of the operators-very good. A reduction of the maximum oxygen consumption with 0.375 ml/kg per year was established in the female assembly-workers, in the age group 21-40. The results obtained are discussed in connection with the unfavourable effect of the reduced motor activity during work, taken as base for the elaboration of measures for the improvement of the physical capacity for work. PMID- 6483825 TI - [Physical factors of the work environment. Changes in the aorta in experimental exposure to noise and atherogenic diet]. AB - An experimental study was carried out on the effect of noise with intensity 85 and 95 dB on the changes in the vascular walls of albino rats of an atherogenic diet (cholic acid, cholesterol and vitamin D2) in the course of 30 daws. The single effect of noise did not induce essential deviations in aortic metabolism and structure. The atherogenic diet caused segmental increase of intracellular substance, disorientation of tissue elements, destruction of smooth muscular cells, accompanied by activation of anaerobic oxidation processes, increase of the quantity of collagenous proteins with reduced globular and elastin proteins content. The noise, with an intensity of 95 dB intensifies the alterations in the vascular wall to the origination of medionecroses. PMID- 6483826 TI - [Importance of the phonetic structure of words for their intelligibility under noisy conditions]. AB - It was exeperimentally established that the understanding of the one- and two syllable words depends on their phonetic structure (the presence of definite combinations of letters) as well as on the place of the accent. The force of the pronouncing of the separate words was also established not to essentially affect their understanding. The work is aimed at the working out an operator's word stock so that the words easily vulnerable by noise to be substituted for their synonyms or avoided. PMID- 6483827 TI - [Dynamics of cholinesterase inhibition in methylparathion poisoning]. AB - The inhibition of cholinesterase (ChEA) and acetylcholinesterase activity (AcChEA) in blood and brain of albino rats was followed up after repeated exposure to methylparathion (MP). An abrupt reduction of ChEA and AcChEA was observed by 30 th and 90 th min after the single peroral administration of 32 mg/kg MP. Furthermore, the reduction was most manifested with ChEA, where the activity was reduced with 71 per cent, AcChEA was reduced to 54 per cent. By 24 th h after the administration of the dose ChEA was significantly higher than the value in the control animals. That could be explained by a quick reactivation of enzyme activity. No clinical picture of intoxication was observed during that period. AcChEA in blood and brain remained strongly reduced, both by 24 th hour after the single MP quantity administered and during the following observation periods--till 14 th day. After the discontinuation of MP administration, a slow tendency to increase of AsChEA values was observed, being strongly decreased as compared the level of the enzyme in the control animals. The reduction of ChEA and AcChEA is associated with the appearance of non-identified metabolites of MP inhibitors of ChEA with Rf 0. I and 0.65 during the first periods--to 90 min. On 14 th day, after 13-days administration, metabolites with Rf 0.15 and 0.4 were confirmed in chromatogram, besides the main spot with Rf--0.26 (corresponding to MP). Due to the considerable ChEA reduction, prior to the manifestation of the clinical picture of intoxication, ChEA determination in blood could be an early index for confirming the exposure to organophosphoric compound. PMID- 6483828 TI - [Changes in the biochemical indices of workers exposed to vinyl chloride and dichloroethane]. AB - Complex laboratory investigations were carried out to 280 workers from a plant, exposed to vinylchloride and dichlorethane. Some hematological indices were followed up (hemoglobin, erythrocytes, leukocytes and platelets) and liver function (GGTP, GOT, GPT, AP, OCP and blood glutathione). Again GGTP and blood platelets significance was confirmed as a diagnostic sign of VCh disease. The inhibitory effect of VCh upon the OCP in the workers exposed is confirmed for the first time. OCP is proposed to be included in Instruction 099. A new case of VCh disease was diagnosed, where the combined effect of VCh and dichlorethane is admitted. PMID- 6483829 TI - [Morphological and biochemical changes in the connective tissue in chronic chloroacetophone poisoning]. AB - The qualitative and quantitative characteristic of the connective tissue of aorta of albino rats was followed up, the rats having been treated with phosphororganic pesticide chloracetophon in doses I/20 and I/100 LD50 for six months. With the effect of the lower dose, disturbances were observed, affecting mainly the components of the main intercellular substance--glycoproteins and glycosaminoglycans. The higher dose leads to disturbances in the quality and quantity of the fibrous structures--elastin and collagen on the background of changed ratio sulphated GAG/non-sulphated GAG. The changes observed are an evidence for an accelerated ageing of the vascular aortic wall under the effect of chloracetophon and should be given consideration for its hygienic standardization. PMID- 6483830 TI - [Experimental assessment of the risk for offspring in lead exposure]. AB - Multigenerational studies were carried out on albino rats obtained from parent progeny - female-intact and male-perorally exposed to lead acetate, in the drinking water - 0.2 mg/kg (group I) and 20 mg/kg (group II); the data were compared with a control group. Changes were found in each progeny as follows : in PI - reduced erythrocyte count, increased reticulocytes (group II); enhanced ATP activity in brain homogenates (group II), as will as increased disulphide groups in homogenates from brain, liver and testis (group II), highly reduced indices of fertility - 50% and of gestation - 62% (group II), in 100% level of the same indices in the control animals respectively. In P2 - reticulocytosis, reduced CytO in homogenates of liver, reduced activity of ATP and SucDH, enhanced activity of LDH and G6PDH in brain homogenates (group I), reduced fertility index - 67% versus 100% of the controls. In P3 - increased erythrocyte count (group II), changes in the electrophoretic protein profile of serum (group II); reduction of ChEA (groups I and II) and CytO (group II) in liver, reduced ChEA in brain (group II). The results obtained suggest an eventual high real and potential risk for the human generation, when the males are exposed to considerable concentrations (doses) of lead under working conditions. PMID- 6483831 TI - [Experimental study of the teratogenicity and embryotoxicity of endodan]. AB - An experiment was carried out on albino rats for the assessment of the effect, during gestation, of the fungicide endodan (ethylene - thiuram monosulphide) on the intrauterine and postnatal development of the progeny. A low teratogenic and embryotoxic activity was established after a single treatment with I/2 LD50 on 13 th gestation day. The preparation is with a pronounced cumulative effect in a daily administration of 1/5, 1/10 and 1/20 LD50, manifested by clinical symptomatics and lethality of a part of the pregnant animals. Via tests for the assessment of the behaviour, deviations in the functional state of the nervous system of the progeny were established, with no changes in the integral indices - viability and body weight gain during the postnatal period. PMID- 6483832 TI - [Functional changes in the visual analyzer of female personnel in quality control of ampules]. AB - The state of the visual apparatus as well as the changes in the functional state of the visual functions, due to the work performed, were studied in 60 female workers checking up the quality of ampoules. The eyes were clinically examined with a view to detection of eye diseases. The results revealed a high percentage of complaints from the visual system, high visual strain, due to the small size of the details to be checked and the irregular illumination of the visual field and the high rate of work. Pathological changes were found in the anterior segment and fundus of the eyes in a great number of the workers. Recommendations are proposed for the optimization of the work in that kind of activity. PMID- 6483833 TI - [Assessment of the occupational risk to workers engaged in the manufacture of divinyl-styrene rubber]. AB - The production of synthetic rubber, one of the varieties of petro-chemical branch in our country, is new and very prospective. The Bulgarian synthetic rubber is synthesized from petroleum products divinyl and styrene. After the hygienic assessment of the technological processes, a complete characteristic of labour conditions was made and the character of the working process was studied of the main occupations of the workers, attending the installations of Synthetic Rubber Plant. The exposure to occupational noxae was determined and the existing occupational risk was evaluated. The toxico-chemical substances, benzene, styrene and divenyl, are with the highest significance among the factors of the working environment. The data on the health state of the workers are reported and recommendations are proposed for the restriction of the effect of the occupational factors. PMID- 6483834 TI - [Organization of treatment of tuberculotic and alcoholic patients]. PMID- 6483835 TI - [A radioimmunologic method of studying thyroid function in patients with pulmonary tuberculosis]. PMID- 6483836 TI - [Serum alpha-tocopherol and serotonin levels in patients with tuberculosis of the female genitals]. PMID- 6483837 TI - [Intraosseous pressure indicators in the diagnosis of spinal cord compression in patients with tuberculous spondylitis]. PMID- 6483838 TI - [Surgical treatment of tuberculosis of the lymph nodes located in the posterior wall of the omental bursa]. PMID- 6483839 TI - [Secretory function of the stomach in patients with tuberculosis of the respiratory organs]. PMID- 6483840 TI - [Comparative evaluation of various methods of urinary diversion in complicated forms of tuberculosis of the urinary tract]. PMID- 6483841 TI - [Organ-saving operations in renal tuberculosis]. PMID- 6483842 TI - [Effectiveness of the surgical treatment of tuberculosis of the respiratory organs and restoration of work capacity in workers in jobs with risk of pneumoconiosis]. PMID- 6483843 TI - [Effectiveness of pyrazinamide combined with rifampicin and ethambutol in animal experiments]. PMID- 6483844 TI - [Detection of patients with chronic nonspecific respiratory tract diseases and tuberculosis among workers of a large industrial plant by using primary automated screening]. PMID- 6483845 TI - [Ferrous oxide-initiated chemoluminescence and changes in urinary oxygen level in patients with pulmonary tuberculosis]. PMID- 6483846 TI - [Comparative analysis of the causes of death in patients with pulmonary tuberculosis and chronic alcoholism subjected to surgical treatment and those not operated on]. PMID- 6483847 TI - [Stereoauscultation of the lungs and heart]. PMID- 6483848 TI - Systematic diagnostic interviewing of children: present state and future possibilities. AB - The use of the structured diagnostic interview in child psychiatry is reviewed in relation to the need for a consistent data base in research and practice. The main criticisms of structured interviews with children, and the specific need to take account of developmental factors in design are discussed. Several interview schedules based on DSM III criteria are available to meet different needs and these are described. Test-retest and inter-rater reliability depend on the training of the interviewers. Validity likewise depends on experience and training in the use of the DSM III classification. Diagnostic discrepancies that arise in parent and child interviews, and the general issues of diagnostic validity in child psychiatric research are discussed. It is argued that thorough testing of the available instruments would appear to have more value at the present time than the design of new instruments. PMID- 6483849 TI - Prolactin, aggression and hostility: a discussion of recent studies. AB - Several studies are summarized in which the relationship of high prolactin levels and self-rated anger-hostility was examined. The Symptom Questionnaire, a state measure which contains an anger-hostility scale, was included in all studies. Women with hyperprolactinemic amenorrhea were found to have higher hostility scores than amenorrheic women with normal prolactin levels. In another study, hyperprolactinemic women were found to have higher hostility scores than female family practice patients, random employees and there was a nonsignificant trend for higher hostility scores than in female nonpsychotic psychiatric outpatients. In both studies, depression and anxiety were also significantly higher. When bromocriptine, a prolactin lowering drug, was administered to hyperprolactinemic women in a double blind crossover study, there was a significant and progressive decrease of hostility, depression and anxiety while on bromocriptine, parallel with the decrease in prolactin and no change on placebo. Post-partum women who had high prolactin levels were significantly more hostile than a control group of employees and as hostile as hyperprolactinemic women. Hyperprolactinemic males were no more hostile than controls. The relationship of prolactin to post-partum aggression in mammals is briefly reviewed. The findings are inconclusive; in the three species studied, postpartum aggression is perhaps enhanced, but does not depend on high prolactin levels. There are no studies on the relationship of prolactin levels and violence in women. Hostility associated with high prolactin levels in postpartum women is perhaps a phylogenetic remnant which may have had the evolutionary advantage of protecting the young. PMID- 6483850 TI - Animal models of depression: an overview. AB - Although animal models cannot replicate human psychopathology in every detail, they should properly be conceived as experimental systems in which selected and specific questions can be investigated in ways impossible to do in humans. In considering the general kinds of animal models, distinctions must be drawn among those designed to simulate specific signs or symptoms, those designed to test a specific etiological theory, those designed to study underlying behavioral and neurobiological mechanisms, and those whose principal purpose is to permit pre clinical drug evaluation. If, for example, drug evaluation is the first concern, the empirical validity of the model in predicting the therapeutic efficacy of drugs is primary, whereas the mechanisms responsible for inducing the syndrome, and behavioral similarity issues become secondary. The available models of depression are reviewed in the light of their specific advantages and limitations, including those induced pharmacologically, maternal and peer separation, learned helplessness, chronic stress, changes in dominance hierarchy, intra-cranial self-stimulation, conditioned motionlessness and behavioral despair models. Since multiple variables are involved in the etiology of depressions, animal models offer the possibility of evaluating their main effects and interactions in a controlled prospective manner. While caution is required in cross-species reasoning, there are nevertheless guidelines, and the continuing development of a comparative approach in Psychiatry has great potential. PMID- 6483851 TI - Measurement of overjet and overbite. PMID- 6483852 TI - Stimulated salivary flow rate in relation to size and sex. PMID- 6483853 TI - Dentists and special dental technicians in the supply of complete denture services in Finland. PMID- 6483854 TI - [The distribution of dentists and population trends in Finland 1970-1980]. PMID- 6483855 TI - [Dental extraction movements and their action times. Strain gauge measurements of rocking and twisting movements in relation to tooth extraction, including observations on the length of the action time]. PMID- 6483856 TI - [Connective tissue cell metabolism in periodontitis]. PMID- 6483857 TI - Reactivity and antibody responses of volunteers given two or three doses of pneumococcal vaccine. AB - Pneumococcal antibody responses and adverse reactions were assessed in 12 healthy volunteers who received either two (10 volunteers) or three (2 volunteers) doses of pneumococcal polysaccharide vaccines at 1 or 2 year intervals. The volunteers were given hexavalent (types 1, 3, 4, 7F, 8, 12F) octavalent (types 14, 19F added) nonavalent (type 5 added), and tridecavalent (types 6A, 6B, 9N, 18C, 23F added; type 5 removed) pneumococcal vaccines. Local and systemic reactions following any of the vaccines, either first, second, or third doses, were low, and these were mild; fever did not occur. Twelve volunteers received types 1, 3, 4, 7F, 8, and 12F in two doses of vaccine, and four volunteers received types 14 and 19F in two doses of vaccine. Primary immunization induced significant antibody rises to these antigens in most volunteers, but a second dose of vaccine did not further increase antibody levels to the same antigens; when it also contained new antigens, antibody rises usually developed to these antigens. Although the data are limited to detailed studies of only 12 persons, the results suggest that additional studies of this issue would seem appropriate. PMID- 6483858 TI - The effect of acetaldehyde concentrations on the relative rates of formation of acetaldehyde-modified hemoglobins. AB - The effect of various concentrations of acetaldehyde (0, 0.05, 0.1, 0.25, 0.5, 1.0, and 5.0 mM) on the relative rates of formation of hemoglobin acetaldehyde adducts detected in fractions eluted from cation exchange high-pressure liquid chromatography (HPLC) was investigated. When the hemoglobin and acetaldehyde mixtures were incubated at 37 degrees C for various time intervals up to 24 hr, increased amounts of HbA1c could be observed after 2 hr incubation with 1 mM or greater concentrations of acetaldehyde, or after 4 hr incubation with at least 0.5 mM acetaldehyde. An increase in the HbA1a + b fraction was not observed with 4 hr incubation time until the acetaldehyde level reached 1 mM. The HPLC method detected no difference in minor hemoglobins from alcoholic and normal subjects. Incubation of red blood cells at 37 degrees C for 1 hr with six consecutive pulses of 0.05 mM [14C]acetaldehyde showed no differences in the amounts of minor hemoglobins determined chromatographically at various pulse intervals. However, the measure of the 14C-label incorporation into hemoglobin showed that adducts eluting in the HbA1a+b fraction were formed at a faster rate than those eluting in the HbA1c or HbA0 fraction, respectively. The specific activities of the HbA1a+b fractions at 2, 4, and 6 pulses were 34, 128, and 949 cpm/mg hemoglobin; those of the HbA1c fraction were 15, 58, and 174 cpm/mg hemoglobin. This evidence of modification of hemoglobin by physiological levels of acetaldehyde from 14C label incorporation suggests that an assay more sensitive than chromatographic separation of adducts might be clinically useful in detecting alcoholism or monitoring alcohol detoxification programs. PMID- 6483859 TI - Hypoxic moderation of renal hypertension in the miniature swine. AB - Eleven male Yucatan miniature swine were subjected to unilateral renal artery constriction (RAC) with an intact contralateral kidney. Five pigs remained at laboratory altitude of 1524 m and served as normoxic, hypertensive controls (NH) while the other six (HH) were subjected to a simulated altitude of 4267 m for 9 weeks to determine the effect of hypoxia on the development of renal hypertension. Systemic blood pressure was increased less in HH as compared with NH. Data from three sib-pairs represented in each treatment group suggested a diverse, apparently familial response to RAC. The hypertensive process, irrespective of treatment groups, included a diminution of free circulating serum thyroxin and an increase in serum sodium. Hypoxia moderates renal hypertension in the miniature pig primarily via a decrement in stroke volume and cardiac output. PMID- 6483860 TI - Effect of antiorthostatic suspension on interferon-alpha/beta production by the mouse. AB - Mice were suspended in a model that simulates weightlessness that occurs during prolonged space flight. After 1 and 2 weeks of suspension in an antiorthostatic (head-down tilt) position, the mice were challenged with polyriboinosinic polyribocytidylic acid to induce interferon-alpha/beta. Interferon production was severely reduced in mice that had been suspended. When mice were allowed to recover in cages for a week following removal from suspension, they recovered their full interferon-production capacity. Mice suspended in an orthostatic (horizontal) position did not have their interferon production capabilities affected, which indicates that stress per se was not a major component in the effects of antiorthostatic suspension on interferon induction. PMID- 6483861 TI - Cartilaginous metaplasia of the thoracic aorta of control turkeys and exacerbation by beta-aminopropionitrile. AB - Seventeen of sixty distal extremities of the thoracic aortas of 12-week-old control male turkeys and 37 of 40 distal extremities of the aortas of turkeys fed 0.07% beta-aminopropionitrile (BAPN) from 4 to 12 weeks of age contained areas of cartilaginous metaplasia when examined by light microscopy. The cartilaginous areas were generally elongated and located in the subendothelium of control turkeys, but a roundish area of cartilage was occasionally evident in the deep media. The magnitude of chondroplasia was enhanced by feeding BAPN; the extensive lesion usually extended from the subendothelium to deep in the media. Regardless of treatment, chondrocytes were pleomorphic, contained vacuoles, and had cytoplasmic processes. The cells were separated by pools of proteoglycans and connective tissue. The ultrastructure of chondrocytes in the aortas of both treatment groups was typical of this cell type. They had undulations or projections of the cell membranes. The cisternae of endoplasmic reticulum were dilated and contained electron-translucent material which was similar to extracellular proteoglycans. Golgi apparatus, free ribosomes, mitochondria, glycogen granules, filaments, and a centriole also were present in the cytoplasm. The extracellular matrix, which included collagenous and elastic fibers and also delicate fibrils and interconnecting matrix granules, separated adjacent chondrocytes by spaces of varying size. PMID- 6483862 TI - A correction: inhibitory activity in the conditioned medium of embryonic chick bones is due to thymidine. AB - Earlier studies from this laboratory suggested that embryonic chick bones in organ culture released into the culture medium a specific inhibitor of bone cell proliferation as defined by inhibition of [3H]TdR incorporation into DNA. Dialysis and membrane ultrafiltration experiments suggested that the inhibitory substance (IS) had a molecular weight between 6000 and 14,000. However, subsequent studies on the purification of IS have revealed that the inhibitory activity in bone-conditioned medium is of lower molecular weight and has several properties in common with thymidine (TdR): (1) IS coeluted with [3H]TdR upon gel filtration chromatography on Sephadex G-10. (2) IS bound to charcoal but not to cation or anion exchange resins. (3) Bone-conditioned medium decreased incorporation of [3H]TdR into the free [3H]TdR pool of cells in monolayer culture. (4) Conditioned medium inhibited [3H]TdR incorporation into [3H]thymidine monophosphate in a reaction catalyzed by thymidine kinase. The equivalent concentration of TdR in conditioned medium as estimated by thymidine kinase assay was sufficient to account for the reduction in [3H]TdR incorporation into bone cell DNA. No evidence was found for a specific inhibitor of bone cell proliferation other than TdR. Hence we conclude that the inhibitory effect of IS is due to dilution of [3H]TdR by nonradioactive TdR. Furthermore, media conditioned by several tumor cell lines also contained a low-molecular-weight component which inhibited [3H]TdR incorporation. The results suggest that organ- and cell-conditioned media can contain significant concentrations of TdR which can artifactually inhibit [3H]TdR incorporation in cell proliferation assays. PMID- 6483863 TI - Effects of long-term implantation of vaginal concretions on the cervicovaginal epithelium of mice. AB - In two experiments, neonatal female BALB/cCrgl or BALB/cfC3HCrgl mice were given subcutaneous injections of 5 micrograms 17 beta-estradiol or sesame oil for the first 3 days of life and were ovariectomized at 60 days of age, at which time vaginal concretions (Experiments I and II) or silica (Experiment II) were implanted intravaginally. Mice were examined at 12 months of age. Three abnormal cervicovaginal epithelial responses were noted: persistent vaginal stratification/cornification (PVS); prominent vaginal squamocolumnar junction (SCJ); epithelial pegs, downgrowths, or lesions (dysplasias). PVS, not present in unimplanted controls, occurs in at least half of the members of the neonatally estrogen-treated groups; implants of concretions or silica did not increase its incidence significantly. Although SCJ was observed in implanted but not in unimplanted controls, its incidence was significantly higher in neonatally estrogen-treated mice than in either control group. The elevated incidence in neonatally estrogen-treated mice was not increased further by implantation of concretions or silica. In neonatally estrogenized mice, the subsequent implantation of a concretion significantly increased the incidence of cervicovaginal abnormalities. Increased PVS and SCJ are teratological consequences of neonatal exposure to a small amount of estrogen; on the other hand, increased dysplasias may, in part, be responses of the estrogenized vaginal epithelium to the concretions. PMID- 6483865 TI - Changes in hypothalamic and pituitary content of immunoreactive alpha-melanocyte stimulating hormone during the gestational and postpartum periods in the rat. AB - alpha-Melanocyte-stimulating hormone (alpha-MSH) was measured in the mediobasal hypothalamus (MH), median eminence (ME), preoptic-suprachiasmatic area (POA-SCN), anterior (AL), and posterior lobes (PL) of the pituitary gland during the gestational and postpartum periods in the rat. The content of alpha-MSH in the MH and POA-SCN compared to estrous levels was lower during the later days of gestation and decreased further in the MH during lactation in association with the elevated plasma prolactin (Prl). Distinct increases in the ME content of alpha-MSH compared to estrous levels occurred on Days 8 and 12 of the gestational period and Day 14 of the postpartum period. A significant increase in PL content of alpha-MSH compared to Days 5-11 and 17-20 occurred on Day 4 of gestation, and no significant changes were detected in the AP concentration of alpha-MSH throughout the period studied. In vitro, PLs and ALs from females on Day 4 of gestation secreted more alpha-MSH into the incubation medium than tissues from animals on Day 20. These results suggest that alpha-MSH of both brain and pituitary origin may play a role in mediating some of the physiological changes which occur during pregnancy and lactation. PMID- 6483864 TI - Effect of pituitary hollow fiber units and thyroid supplementation on growth in the little mouse. AB - Hollow fiber units containing allogeneic pituitary cells were implanted intracranially into heterozygous (lit/+) and homozygous, mutant (lit/lit) C57BL/6J "little" weanling mice. Over the 48 days of the experiment, heterozygous mice with pituitary cell implants had a lower percentage weight gain than control mice. Homozygous, mutant mice with cell implants, however, made significant weight gains over mutant controls. Long bone lengths were lower, and organ and carcass weights were higher, in heterozygous mice receiving pituitary cell implants than in control mice, but corresponding measurements in mutant mice with and without implants were not significantly different. Supplementation of the diet with thyroid powder increased the percentage weight gain during the latter half of the 48-day period in both genotypes with and without implanted cells. Thyroid-supplemented mutant mice with pituitary cell implants had significantly higher organ and carcass weights than other mutant groups. The little mouse may serve as a model for pituitary studies and for the treatment of isolated growth hormone deficiency type 1 in man. PMID- 6483866 TI - Postvagal potentiation of the chronotropic effect of norepinephrine. AB - Following termination of vagal stimulation, heart rate increases above control (postvagal tachycardia). This phenomenon has been attributed to vagally mediated release of norepinephrine in the sinus node region, although other contributory factors may be important. The possibility that, during the postvagal period, the chronotropic efficacy of norepinephrine is enhanced was investigated. Mongrel dogs (N = 6) were pretreated with reserpine in order to minimize postvagal tachycardia and hence allow reliable detection of enhanced responsiveness to norepinephrine. The dogs were then anesthetized with chloralose, autonomically decentralized, and instrumented to record electrocardiogram, aortic blood pressure, and electrograms from right atrium and right ventricle. Thirty-, forty , or sixty-second infusions of norepinephrine were administered via the sinus node artery. The mean cycle length decrease produced by norepinephrine alone was 95 msec (which corresponds to a heart rate increase of + 19.6 bpm). After a 30 sec period of vagal stimulation, norepinephrine infusions produced a cycle length decrease of 139 msec (+32.5 bpm). These results are significant at the P less than 0.05 level. It is concluded that norepinephrine infusions produce a significantly greater magnitude of tachycardia when administered postvagally. It is proposed that this postvagal potentiation of the chronotropic effect of norepinephrine may contribute to postvagal tachycardia. Indeed, there may be a synergistic relationship between this phenomenon and vagally mediated release of norepinephrine in the mediation of postvagal tachycardia. PMID- 6483867 TI - Thyroxine and triiodothyronine in milk of cows, goats, sheep, and guinea pigs. AB - Milk was collected for the first 21 days of lactation twice daily from dairy cows and once daily from goats, sheep, and guinea pigs. Thyroxine (T4) and triiodothyronine (T3) were extracted from 100 microliter of milk using acidified ethanol. T4 and T3 were reconstituted in 100 microliter buffer and measured by radioimmunoassay. Concentrations (ng/ml) of T4 and T3 for milk of cows, goats, sheep, and guinea pigs, respectively, were: 0.97 and 0.94, 1.24 and 0.52, 0.99 and 0.79, and 1.41 and 0.53. T4 concentration for guinea pig milk was significantly higher than for cow and sheep milk, but not for goat milk (P less than 0.05). T3 was found in higher concentration in milk of cows and sheep than in milk of goats and guinea pigs (P less than 0.05). Species differences in conversion of T4 to T3 in mammary gland cells are suggested. Summations of T4 and T3 concentrations in milk indicated no differences among the four species. Regression analyses of changes in milk production, T4 and T3 concentrations, total T4 and T3 in milk per day, and ratios of T4 to T3 revealed variations in patterns. Concentrations of T4 or T3 tended to decrease as lactation progressed over 21 days. Total T3 tended to increase, and the ratio of T4 to T3 tended to decrease. Amounts of T4 and T3 available to offspring from milk were calculated to be minor sources (4 to 7%) of total requirements for maintenance of metabolic functions. PMID- 6483868 TI - Immunological specificity, anergy and immunoregulation. PMID- 6483869 TI - Immunology of anergy and systemic lupus erythematosus. PMID- 6483870 TI - Role of molluscan lectins in recognition processes. PMID- 6483871 TI - Recognition proteins, receptors, and probes: invertebrates. Proceedings of a symposium, Recognition and Receptor Display: Lectin Cell Surface Receptors and Probes. December 28, 1983, Philadelphia, Pennsylvania. PMID- 6483872 TI - Tunicate leucocyte receptors and hemolymph lectins. PMID- 6483873 TI - Distribution, specificity and macromolecular properties of tunicate plasma lectins. PMID- 6483874 TI - Cell recognition processes in the differentiation of embryonic sea urchins. PMID- 6483875 TI - Lectin-mediated modulation of lymphocyte functions. PMID- 6483876 TI - Role of cellular and humoral components in the encapsulation response of Biomphalaria glabrata to Schistosoma mansoni sporocysts in vitro. PMID- 6483877 TI - Immunobiological significance of invertebrate lectins. PMID- 6483878 TI - Limax flavus agglutinin: properties of a sialic acid specific lectin and its biomedical application. PMID- 6483879 TI - Recognition receptors in annelids. PMID- 6483880 TI - Lectins of the Limulidae and hemagglutination-inhibition by sialic acid analogs and derivatives. PMID- 6483881 TI - Sex-specific agglutination of human erythrocytes by body fluids from marine invertebrates and fishes: a preliminary study. AB - Agglutinins in body fluids from several invertebrate and vertebrate (fish) species demonstrated a rare specificity in reacting differently with erythrocytes from human females and males. The body fluids from these animals may provide readily available reagents to study the little known sex-specific components on cell surfaces. PMID- 6483882 TI - Chemical regulation of immunity in veterinary medicine. Proceedings of a symposium held in Bethesda, Maryland, September 19-20, 1983. PMID- 6483883 TI - In vivo assays for immunotoxicity studies. PMID- 6483884 TI - Modulation of coccidial infections by drugs. PMID- 6483885 TI - Effects of immune modulation on Dirofilaria immitis infection in the dog. PMID- 6483886 TI - Effects of feed additives and feed contaminants on the susceptibility of chickens to viruses. AB - Several feed additives and contaminants are recognized which may alter avian immune responsiveness or disease resistance. Exposure of poultry to such chemical substances may in some instances explain the failure of vaccines to confer expected levels of disease resistance and may explain certain flock health problems associated with infectious agents generally presumed to be commensals. Limited studies with BHT and ethoxyquin did not associate decreased resistance to NDV infection with dietary intake of either substance. Conversely, dietary intake of BHT protected chickens against NDV infection, and the protection may have resulted at least in part from direct antiviral activity of BHT. Exogenous histamine administered in the diet increased mortality associated with avian reovirus infection, but the clinical significance of this observation is unknown. PMID- 6483887 TI - The evaluation of cell-mediated immunity in vivo. AB - This paper has briefly described the history, mechanisms and in vivo measurements of cell-mediated immune responses. The focus of this paper was to examine the methods available to measure cell-mediated responsiveness in domestic animals. It was concluded that a practical way of evaluating the integrity of the cellular response would be to combine the measurement of an anamnestic response with the measurement of the cellular response following active immunization with an antigen. The anamnestic response can be evaluated by measuring the response to a battery of antigens given intradermally. In this case the animals (presumably or actually) have had previous exposed to these antigens. The measurement of an induced cell-mediated immune response could be accomplished concurrently by cutaneous sensitization and challenge to a low molecular weight hapten. By using both of these procedures, the ability of the animal's immune system to develop both a primary and secondary response to an antigen can be evaluated in vivo. PMID- 6483888 TI - Phagocyte function evaluation following exposure to test agents. PMID- 6483889 TI - Modification in the antibody-dependent cellular cytotoxicity as influenced by chemicals. AB - With the increased use of chemicals in health related sciences, there is a need for a better understanding as to how these chemicals interact with the immune system. The purpose of this review was to bring together published information on the effects chemicals have on antibody-dependent cellular cytotoxicity (ADCC). This immunoeffector mechanism requires the interaction of both the humoral (antibody) and cellular components (expressing Fc receptors on the plasma membrane) with the specificity being determined by the antibody. Most of the chemicals tested and mentioned in this review are those that are currently used in chemotherapy, antibiotic and drug regimes and in the maintenance of anesthesia. The major point that emerges from this review is that while a great deal of information has been obtained, there is also a good deal of conflicting information. Furthermore, the mechanisms of action are not fully understood or are unknown in many cases. Further work, therefore, is needed to ascertain the importance and relevance of these chemicals in interfering with the ADCC phenomenon and the mode of action of these chemicals within the ADCC mechanism. PMID- 6483890 TI - Suppression of bath immunization in rainbow trout by contaminant bath pretreatments. PMID- 6483891 TI - Overview of known chemical immunotoxicants. PMID- 6483892 TI - Feed additives and feed contaminants as immunotoxicants. PMID- 6483893 TI - Effect of steroids on immunologic function. AB - There is need to recognize that steroids are not only drugs, but also are endogenous hormones that have important regulatory functions. When administered as drugs, the steroids can have profound effects upon immunologic function. The protean nature of these effects reflects the complexity of the immune system with positive and negative regulation of immunologic reactivity. Predictive effects will only be possible when there is complete understanding of the mechanistic basis for immune responses and the cell-specific actions of steroids. PMID- 6483894 TI - Drugs as inadvertent immune modulators. PMID- 6483895 TI - Effect of antibiotics on humoral immune response in domestic poultry. PMID- 6483896 TI - The immunotoxicity of selected environmental chemicals, pesticides and heavy metals. AB - It is an established fact that certain environmental chemicals, pesticides and heavy metals can alter the immune response of laboratory animals and probably humans as well. In some instances, the immune system appears to be exquisitely sensitive to these agents compared to other toxicologic parameters. Both stimulation and suppression of immune responses have demonstrated in contaminant exposed animals. Although the majority of data accumulated to date pertains to effects in small laboratory rodents, there is little reason to believe that similar quantifiable effects do not occur in domestic and food-producing animals due to basic functional similarities of the immune system of mammals in general. PMID- 6483897 TI - Consequences and implications to FDA regulations of immune modulation by chemicals. PMID- 6483898 TI - Immunotoxic effects of diethylstilbestrol (DES) and cadmium chloride (CAD) on host resistance: comparison with cyclophosphamide (CPS). PMID- 6483899 TI - Vaccine adjuvant effects, and immune response, to synthetic polymers MVE and poly ICLC. PMID- 6483900 TI - Leucogenenol as an immunoregulating hormone. PMID- 6483901 TI - Modification of the pharmacokinetics of MVE-2 to enhance its effects on host resistance. PMID- 6483902 TI - Biological characterization of MVE-2 and poly ICLC. PMID- 6483903 TI - Use of the graft-versus-host reaction as an in vivo assay for cell-mediated immunity. PMID- 6483904 TI - Bladder cancer. Part A: Pathology, diagnosis, and surgery. Proceedings of the First International Symposium on Tumors of the Urinary Bladder. Paris, France, July 4-6, 1983. PMID- 6483905 TI - Epidemiology of bladder cancer. PMID- 6483906 TI - Metastatic patterns of bladder carcinoma. AB - The authors reviewed 227 new bladder cancers from two main hospitals in Beirut Lebanon. They analyzed the morphologic features of these tumours, insisting particularly on the number, the size, the site, the grade, the stage, the mode of spread and the vascular permeation. The latter four factors appear to be directly related to the metastatic spread of these tumours. The metastatic patterns are summarized, regional lymph node metastases being the main problem because of therapeutic implications (radical surgery, radiotherapy and chemotherapy). The problems of generalized carcinoma, unusual lymph node metastases and solitary distant metastases are also considered. PMID- 6483907 TI - Defining prognostic parameters for urothelial tumors of the bladder. PMID- 6483908 TI - Clinical features of bladder tumours (based on two large series). PMID- 6483909 TI - Nuclear magnetic resonance imaging and bladder cancer. PMID- 6483911 TI - Classification of bladder cancer. PMID- 6483910 TI - Lymphography and percutaneous fine needle node aspiration biopsy in the staging of bladder carcinoma. AB - Forty-two patients with infiltrating bladder tumor were submitted to pedal lymphography with percutaneous fine needle node aspiration biopsy on an out patient basis. Of 41 evaluable patients, 59% had a positive lymphangiogram. Adequate material was obtained in 81% of the patients. Of 12 patients with a normal lymphography, none had a positive aspiration whereas 40% of the positive lymphangiograms correlated with a positive aspiration. The high rate of positive lymphangiogram negative aspirate is attributed to inflammatory changes due to previous TUR of the tumor. Twenty-one patients were submitted to radical cystectomy: 12 negative aspirations correlated with 11 negative lymphadenectomies, and 4 positive aspirations with 4 positive lymphadenectomies. There was no mortality and only mild morbidity in this series. Lymphography with fine needle percutaneous node aspiration biopsy has a role in the pre-operative staging of bladder carcinoma. Positive pelvic wall lymph nodes upgrade bladder carcinoma from a local to a systemic disease that is no longer amenable to any form of local treatment. Nodal assessment is therefore critical to treatment planning in order to spare the N+ patients unnecessary radical surgery. Pelvic lymph nodes have been evaluated, in the past, radiologically by bipedal lymphography or C.A.T. scanning. The high false positive and negative rates of these procedures (Benson et al., 1981; Boccon-Gibod et al., 1982) preclude their routine use (Correa 1982; Walsh et al., 1980).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483912 TI - Role of selected mucosal biopsies in the evaluation of patients with bladder cancer. PMID- 6483913 TI - Evaluation criteria: a protocol to study patterns of care and their effects in patients with transitional cell carcinoma of the bladder (protocol 1). PMID- 6483914 TI - Superficial TCC bladder cancer: the impact of tumor differentiation on recurrence, progression and survival. PMID- 6483915 TI - Fluorescence cystoscopy. PMID- 6483916 TI - Classification of patients with bladder cancer: clinical versus pathologic staging. PMID- 6483917 TI - Partial cystectomy for bladder tumours. PMID- 6483918 TI - Tumor recurrence following partial cystectomy. PMID- 6483919 TI - Radical cystectomy at Roswell Park Memorial Institute. Preoperative and post operative observations. AB - Between January 1979 and March 1983, 63 consecutive patients underwent cystectomy and urinary diversion for primary carcinoma of the bladder at Roswell Park Memorial Institute (RPMI). Fifty-five patients had transitional cell carcinoma, 6 squamous cell carcinoma and 2 adenocarcinoma of the bladder. Twelve patients with bladder cancer were found to have adenocarcinoma of the prostate on the pathological specimen. Preoperative radiation was given to 41 patients. Thirty six patients received 4000 rads preoperatively followed by radical cystectomy, 5 patients received 2000 rads. Thirteen patients received 6000 rads as curative treatment and underwent salvage cystectomy and colon conduit because of failure. There was no operative mortality. Severe complications in the early postoperative period occurred in 19 instances, some patients having more than one complication. Late complications necessitating surgical correction occurred in 5 patients. Although radical cystectomy is effective in controlling the local disease, most patients still died of metastatic transitional cell carcinoma. PMID- 6483920 TI - Indications for systematic urethrectomy. PMID- 6483921 TI - Epithelial abnormalities of urinary bladder. AB - We have called attention to certain epithelial lesions of the bladder characterized as proliferative, metaplastic, and neoplastic. In the first group are included hyperplasia, von Brunn's nests, papillary cystitis, papilloma and inverted papilloma. The second category includes squamous metaplasia, mucous metaplasia, and tubular metaplasia. These two categories, while benign, are indicative of agitated sick mucosa and may progress to neoplasia. The neoplastic changes consist of carcinoma involving the surface epithelium, von Brunn's nests, papillary cystitis, and/or cystitis cystica. PMID- 6483922 TI - Pathology of bilharzial bladder cancer. AB - Retrospective review of bladder carcinoma at this institution has revealed a high incidence of squamous cell carcinoma associated with bilharzia infection as has been found in other Mideast and African countries. Associated inflammatory and epithelial metaplastic changes were commonly noted and apparently represent early changes in the development of carcinoma, particularly in view of the progression from squamous metaplasia to in situ and infiltrating carcinoma observed in both bladder and ureter. The relationship between bilharzia infection and the development of bladder carcinoma has been postulated to be related to several factors; however, as yet the specific etiologic relationship and pathogenesis have not been defined. PMID- 6483923 TI - [Pyrrolizidine alkaloids in medicinal plants of Boraginaceal: Borago officinalis L. and Pulmonaria officinalis L]. PMID- 6483924 TI - [Psychotropic drugs. II. Determination of cannabinoids in Cannabis sativa L. and in cannabis products with high pressure liquid chromatography (HPLC)]. PMID- 6483925 TI - [The use of pH-endoradio probes as model drug forms--gastric transit time and pH profile following preoral application]. PMID- 6483926 TI - [Statistical analysis of dissolution curves: controlled liberation forms]. PMID- 6483927 TI - [The effect of two antitissue horse sera on two ulcer models in the rat]. PMID- 6483928 TI - The influence of polyethylene glycol molecular weight variation on the properties of glutethimide-polyethylene glycol solid dispersions. PMID- 6483930 TI - Effect of d-amphetamine and diazepam on the greeting behavior of rhesus monkeys (Macaca mulatta). AB - The greeting behavior of rhesus monkeys (Macaca mulatta) was evaluated in a pharmacological test. It was observed in pairs of juvenile subjects reunited after a separation of two days. The observational measures were the duration of greeting behavior (social grooming, social play, and huddling) and the frequency of presentations, mounts and solicitations. d-Amphetamine (0.2 and 0.1 mg X kg-1) was found to shorten the duration of greeting behavior and increase the frequency of presentations and mounts. Diazepam (1 and 0.5 mg X kg-1) was found to prolong the duration of greeting behavior. PMID- 6483929 TI - Evidence for a direct dopaminergic effect of lisuride. AB - The discriminative stimulus properties of the clinically important ergot derivative lisuride hydrogen maleate were studied by training 2 groups of rats to discriminate 0.04 mg/kg lisuride from saline and 0.16 mg/kg apomorphine from saline. Dose-response and substitution tests between these groups showed that lisuride and apomorphine are discriminated similarly by both groups and that lisuride is 5 to 9 times more potent. The dopaminergic agonists d-amphetamine, quipazine, bromocriptine, cocaine and cathinone did not substitute for lisuride. In antagonism studies, only the dopamine receptor blocker haloperidol attenuated the lisuride cue; the serotonin receptor blockers pirenperone and BC-105 were ineffective. These data indicate that the primary central action mediating the discriminative stimulus effects of lisuride was direct activation of dopamine receptors. PMID- 6483931 TI - Neurotensin and bombesin, a relationship between their effects on body temperature and locomotor activity? AB - Neurotensin and bombesin have been tested for their effects on body temperature and locomotor activity in an open field. Both peptides induce hypothermia and suppress ambulation and rearing. The time curves of the hypothermic effects of both peptides appear to be rather similar, although bombesin is a more potent hypothermic agent than neurotensin. The time curves of the effects on locomotor activity appear to be quite different. The suppressive effect of neurotensin on locomotor activity is relatively short lasting and reaches its maximum at approximately 32 minutes. The effect of bombesin follows a different time curve and shows two peaks, suggesting that two different mechanisms are involved in the suppressive action of bombesin on locomotor activity. Calculation of the correlation coefficients between the effects of neurotensin and of bombesin on body temperature and on locomotor activity (ambulation) suggest that a causal relationship between these two effects is not likely, in particular for neurotensin. PMID- 6483932 TI - Taste differences between cigarette smokers and nonsmokers. AB - In a series of taste tests, cigarette smokers allowed to smoke, cigarette smokers not allowed to smoke, and nonsmokers, rated the pleasantness and intensity of sugar, salt, and quinine solutions. One taste test was performed before, and three tests were completed after, ingestion of a glucose load. Before the glucose load, there were no significant differences between the groups in rating test solutions. After the glucose load, the smokers allowed to smoke significantly decreased their ratings of the pleasantness of very sweet solutions. In contrast, nonsmokers and smokers-not-smoking did not significantly decrease their ratings of the pleasantness of sweet tastes. None of the subjects significantly changed their intensity ratings after the glucose load, nor did they change their pleasantness and intensity ratings of salt and quinine solutions. PMID- 6483934 TI - Indomethacin potentiates the operant behavior suppressant and rectal temperature lowering effects of low doses of d-amphetamine in rats. AB - Prostaglandins (PGs) may be important in modulating the actions of d-amphetamine. To test this hypothesis male rats were pretreated with indomethacin to inhibit PG synthesis before d-amphetamine was injected. Indomethacin (5 mg/kg, IP) was found to be without direct effect upon fixed-ratio behavior or rectal temperature, but significantly enhanced the capacity of low doses of d-amphetamine to suppress behavior and lower temperature. These effects were not due to partial food deprivation or to an increase in the concentration of d-amphetamine in brain. It is concluded that one or more of the PGs modulate the central actions of d amphetamine, perhaps by modifying the release and/or reuptake of catecholamines, or through a postsynaptic action. PMID- 6483933 TI - Habituation of exploratory activity in mice: effects of combinations of piracetam and choline on memory processes. AB - The effects of various piracetam + choline combinations on an experimental model of memory were investigated. Mice were given two sessions in a simple photo-cell activity cage and the decrease in activity at the second session (habituation) served as an index of retention. Retention was facilitated by post-session administration of 2000 mg/kg piracetam IP and 50 mg/kg piracetam + 50 mg/kg choline IP. Similar injections of choline alone (10 to 200 mg/kg IP), piracetam alone (10 to 1000 mg/kg IP) or other combinations of piracetam and choline were without effect. These results, consistent with those reported elsewhere, suggest that piracetam can interact with choline to facilitate memory processes in mice. PMID- 6483935 TI - Behavioral effects of oral versus intravenous administration of diazepam. AB - The behavioral effects of oral versus intravenous administration of diazepam were studied in 50 volunteers using a battery of memory, cognitive, mood and psychomotor tests repeated over a 4.5 hr period. Subjects received diazepam 0.2 mg/kg or placebo as capsules, commercial tablets or intravenous solution in a randomized double blind manner. While a quick onset of effects occurred with intravenous administration followed by the capsule and tablet oral administrations in that order, the recovery rate was similar for the 3 methods of administration. Contrary to many claims in the literature the effects of oral administration were substantial. Behavioral impairment was directly related to the magnitude of the memory component of the task. On many of the tasks the pattern of diazepam impairment was one of delayed improvement of performance, a pattern which would only be apparent with repeated testing. Subjects who received diazepam showed a paradoxical enhancement of recall for material learned before the drug. PMID- 6483936 TI - Normal pancreatic and intestinal enzymes in hypophagic growth-retarded rats that received dorsomedial hypothalamic lesions shortly after weaning. AB - Male weanling Sprague-Dawley rats received bilateral electrolytic lesions in the dorsomedial hypothalamic nuclei (DMNL rats). Sham-operated rats served as controls. After being fed lab chow for two postoperative weeks, the animals were divided into four groups. One group of DMNL rats and controls received a high caloric diet (high-fat diet, chocolate chip cookies, 32% sucrose solution, potato chips and marshmallows), whereas another group of DMNL rats and controls continued to receive lab chow. The experiment was terminated on the 185th postoperative day. In accordance with previous findings, DMNL rats, irrespective of diet, were lighter and shorter than controls. In addition, DMNL rats fed junk food were lighter than DMNL rats fed lab chow, and junk-fed controls weighed as much as chow-fed controls. Both DMNL rats and controls fed junk food were also shorter and showed higher carcass fat than their chow-fed counterparts. Also, DMNL rats fed junk food had less carcass fat than junk-fed sham-operated controls, whereas in accordance with previous findings, there was no difference between chow-fed DMNL rats and chow-fed sham-operated controls. Irrespective of diet, DMNL rats ate less calories than their respective sham-operated controls. Both absolute and percent pancreas weight and protein/pancreas were unaffected in DMNL rats but were reduced in both junk-fed groups in comparison with their chow fed counterparts. Both concentrations and contents of pancreatic trypsinogen, amylase and lipase were unaffected in DMNL rats but total activities of all three enzymes were dramatically reduced in the junk-fed compared with the chow-fed DMNL rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483937 TI - A simplified procedure for producing ethanol self-selection in rats. AB - Procedures almost exclusively involving the use of operant conditioning equipment have been successful in training rats to drink ethanol and establishing ethanol as a reinforcer. The present report describes a variation of this procedure which, in a relatively short period of time also establishes ethanol as a reinforcer, results in significant blood ethanol levels, but does not require extensive programming or recording equipment and is therefore more amenable to studies in which large numbers of animals are required. PMID- 6483938 TI - Endorphinergic modulation of neural reward systems indicated by behavioral changes. AB - Experiments were performed in rats expecting and/or having received rewards to see if naloxone-antagonizable changes occur in behavior. It was found that rats expecting to receive candy display a naloxone-blockable increase in nociceptive thresholds and a naloxone-sensitive increase in rearing. Similarly, water deprived rats expecting to receive water show a naloxone-blockable increase in rearing, whereas thirsty animals not expecting water show no changes in nociception or activity. Naloxone was also found to reduce the consumption of a highly palatable food and to diminish the performance of rats trained to wait in one place to receive candy. The latter indicates that the naloxone effect upon goal seeking is not dependent upon a decrease in general activity. Experiments in highly morphine-tolerant rats maintained on relatively constant morphine concentrations showed that these rats drink chocolate milk in the same way as placebo-treated animals. The same rats were found to fail to decrease their intake to the same extent as placebo-controls when water is substituted for the first time for chocolate milk given regularly every day. This points to the possibility that a negative action of endorphins, that is a decrease in release, decreasing consumption, upon a reduction in the palatability of an expected food, might be absent in highly tolerant animals. It is suggested that endogenous opiate(s) regulate mood as defined by the level of goal-seeking behavior, sensitivity to noxious stimuli and general activity. PMID- 6483939 TI - Behavioral effects of intracerebroventricular administration of LSD, DOM, mescaline or lisuride. AB - The effects on a fixed ratio-40 (FR-40) operant behavior of intracerebroventricular (ICV) administration of the hallucinogens lysergic acid diethylamide (LSD), 2,5-dimethoxy-4-methylamphetamine (DOM), mescaline or the non hallucinogenic LSD-analogue lisuride were compared with intraperitoneal (IP) administration. Infusion of LSD (8.5 to 34 micrograms) into the left lateral ventricle produced a dose-dependent decrease in reinforcers and an increase in 10 sec periods of non-responding (pause intervals). The time-course of LSD showed a shorter latency to onset after ICV than IP administration. The ED50 for doses increasing pause intervals by ICV administration was 15 micrograms. This disruption was greater than that produced by IP administration of equivalent doses of LSD (IP ED50: 19 micrograms). DOM (40 to 120 micrograms) infused into the lateral ventricle also produced a dose-dependent disruption of FR-40 behavior. ICV DOM also showed a rapid onset to peak effects, but a slower offset than LSD, and was 3 times more potent than systemic administration (ED50s: 58 micrograms ICV vs. 153 micrograms IP). Mescaline was much more potent in disrupting FR-40 behavior by the ICV route than by IP administration. The ICV ED50 for doses of mescaline increasing pause intervals was 74 micrograms, in contrast to an ED50 following systemic administration of 2251 micrograms, demonstrating a 30-fold difference in potency. Lisuride administered via the ICV route was no more potent than by IP administration with ED50s of 4 micrograms ICV and 4 micrograms IP. Lower doses of lisuride administered by both routes had a similar effect over time on pause intervals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6483940 TI - Attempted antagonism of adenosine analogue induced depression of respiration. AB - Intracerebroventricular (ICV) administration of the stable adenosine analogue 2 chloroadenosine (2CA) to hyperoxic halothane-anesthetized rats produced a dose dependent depression of respiration largely as a result of a decrease in tidal volume. Similar changes were noted after another adenosine analogue, phenylisopropyladenosine (PIA). Higher doses shifted the minute ventilation-PaCO2 curve to the right and decreased its slope. Bradycardia and hypotension were produced at doses which altered respiration. Neonatal destruction of brain serotonin or dopamine-containing nerve terminals did not alter the 2CA-induced respiratory depression. Naloxone significantly antagonized the respiratory and circulatory changes produced by 2CA though the changes produced by PIA were not significantly antagonized. Peripherally and intracerebroventricularly administered theophylline were largely ineffective in reversing the 2CA-induced respiratory depression. Thus, these data suggest that a major part of the respiratory depression produced by 2CA is due to indirect activation of opioid receptors. In contrast, very little of the respiratory depression after PIA is via mechanisms antagonized by naloxone. Thus, putative adenosine agonists appear to vary in the extent to which respiratory depression is provoked by interactions with opioid systems. PMID- 6483941 TI - Metronidazole influences the development of neural tolerance to ethanol. AB - The duration of the loss of the righting reflex (LoRR) was measured in Swiss Webster (SW) and DBA/2 mice following intraperitoneal injection of ethanol or metronidazole alone or together. A single injection of ethanol induced to short LoRR in SW mice and a long LoRR in DBA/2 mice. Metronidazole did not induce LoRR in either strain. When the mice were exposed daily to ethanol for five days, the duration of the LoRR was prolonged in SW mice and shortened in DBA/2 mice. This indicates the development of increased neural sensitivity to ethanol in SW mice and of neural tolerance to ethanol in DBA/2 mice. The response in SW mice to administration of ethanol and metronidazole together did not differ from their response to ethanol alone. However, the duration of the LoRR in DBA/2 mice injected repeatedly with the two drugs was longer than that observed with ethanol alone. Thus metronidazole appears to inhibit the development of neural tolerance to ethanol in DBA/2 mice but has no effect on ethanol induced LoRR in SW mice. PMID- 6483942 TI - Differential effects of d-amphetamine and scopolamine on the ontogeny of rearing. AB - Although rearing is ontogenetically an important behavior, very little is known about the neural bases of rearing. The role development of catecholaminergic and cholinergic neurons play in the ontogeny of rearing was investigated by examining rearing in infant, adolescent, and adult rats following various doses of d amphetamine (an indirectly acting catecholaminergic agonist) and scopolamine (a cholinergic muscarinic receptor antagonist). d-Amphetamine increased rearing in infants but not in adolescents and adults. These findings suggest that activation of catecholaminergic neurons increases rearing in infants but not in adolescents or adults. Scopolamine increased rearing in adolescents and adults but not in infants, indicating that blocking transmission of cholinergic neurons increases rearing in only older rats. PMID- 6483943 TI - [Synthesis of N alpha-(arylsulfonylglycylglycyl)-4-amidinophenylalanine amides as thrombin inhibitors]. AB - The headline compounds were prepared using N-arylsulfonylglycylglycine-4 nitrophenyl esters. Firstly these compounds were aminolized with 4-cyanphenyl alanine and thereby the N alpha-(arylsulfonylglycylglycyl)-4-cyanphenyl alanines got were transferred into the 4-nitrophenyl esters After aminolysis the desired hydroiodides of the headline compounds starting from the cyano compounds were prepared via the carbamoyl compounds and the thiomidic acid methyl ester hydroiodides. The arylsulfonylglycylglycine rest caused a decreasing of the inhibitor activity. PMID- 6483944 TI - Synthesis of some new 3,5-pyrazolidinedione derivatives of expected biological activity. AB - 4-Arylidene-1,2-diphenyl-3,5-pyrazolidinedione were synthetized. The alkyl and nitrile derivatives were also obtained. The structure of the synthesized compounds was elucidated by chemical and physical routes. PMID- 6483945 TI - Effect of some additives on the properties of phenazopyridine hydrochloride granules and their corresponding tablets. AB - The effect of the diluents, lactose and calcium carbonate and of the binders, syrup, gelatin, methylcellulose and Eudragit E on the physical properties of phenazopyridine hydrochloride (PNHCl) granules was evaluated. A correlation existed between the granules' physical properties and those of their compressed tablets. With regard to drug release, lactose-syrup 30% was the best of all diluent-binder combinations, followed by lactose-methylcellulose 4%. Also lactose was found to be superior to calcium carbonate in drug release when gelatin and methylcellulose were used as binders. Eudragit E was the best binder with calcium carbonate in this respect. On the other hand, the bioavailability of PNHCl in humans was the same when lactose was used with either gelatin, syrup or methylcellulose, but higher than that obtained with a combination of calcium carbonate and Eudragit E 15%. PMID- 6483946 TI - Simultaneous solubility and dissolution rate of sulfamethoxazole and trimethoprim in binary mixture. AB - The solubilities of trimethoprim in solutions with different pH values decreased in the presence of sulfamethoxazole, while that of the latter increased in the presence of the first. The dissolution rate of trimethoprim in HCl (0.1 mol/1) was the same in the presence and absence of sulfamethoxazole. That of sulfamethoxazole however, decreased in the presence of trimethoprim. The different reasons were explained. PMID- 6483947 TI - [Electrochemical reduction of the anthracycline antibiotic 5-iminodaunorubicin. Isolation and structural clarification of the reduction products]. AB - After electrochemical reduction of the potential cancer chemotherapeutic 5 iminodaunorubicine two new compounds, were isolated purely by chromatographic separation. Based on 1H-NMR, IR-, UV/VIS- and MS-investigations the one reaction product was identified as 7-desoxy-5-iminodaunorubicinone as expected, while the other was proofed as 9-acetyl-9,12-dihydroxy-4-methoxy-7,8,9,10-tetrahydroxy-6,11 naphthac enchinone. PMID- 6483948 TI - Essential oil of Psiadia arabica Jaub. et Spach. PMID- 6483949 TI - [Orienting studies of the formaldehyde residue in urologic instruments following sterilization with formaldehyde gas]. AB - At an orientating investigation the formaldehyde residue at catheters and tubing was defined after formaldehyde gas sterilisation and a varying dependence of the residue of the concentration of the agent solution, the sterilisation time and the tube resp. catheter material was found. The formaldehyde residues lay in the region of micrograms/cm2. They are higher as in the judgement of the equipment producer. The necessity of the investigation of toxicological importance of the residue is mentioned. PMID- 6483950 TI - [Plastic packs for drug preparations containing volatile oils. 88. Problems in filling plastic containers with liquid drug preparations]. PMID- 6483951 TI - [Annual rhythms of quality in drug production]. PMID- 6483952 TI - [Detection and determination of 3,7-dimethyl-6-(5-oxo-hexoxy)-2H-purine-2-one, a byproduct of pentoxifylline synthesis]. PMID- 6483953 TI - [The pharmacokinetics of propranolol]. PMID- 6483954 TI - [The effect of urea on the release of prednisolone from L/W and W/L salves with reduced drug concentrations]. PMID- 6483955 TI - Synthesis of some new fused azoles from pyrazolo[1,5-c]-astriazine derivatives. PMID- 6483956 TI - [Free amino acids in the pollen of Ambrosia artemisiaefolia (Compositae)]. PMID- 6483957 TI - [Frequency distribution of serum transaminase values]. PMID- 6483958 TI - Pubertal gonadal hormones in modulating the testosterone dependency of hepatic aryl hydrocarbon hydroxylase in female rats. AB - The responsiveness of the hepatic microsomal aryl hydrocarbon hydroxylase (AHH) to testosterone enanthate (TE; 2.5 mumol/kg/day for 9 days) was sex-dependent in adult rats, the enzyme being very resistant to TE in normal adult or ovariectomized females. Administration of testosterone propionate or diethylstilbestrol (1.45 mumol) to neonatal female rats at 1 and 3 days of age did not increase the responsivity to TE in adulthood. However, exposure of female rats to TE (5.0 mumol/kg/day) during the peripubertal period (35-50 days old) resulted in increased sensitivity to TE (+55.2%) when tested in adulthood. The responsivity was further potentiated (+109.3%) if the animals were ovariectomized at 28 days of age. Prepubescent ovariectomized females which received corn oil or estradiol benzoate (1.5 mumol/kg on alternate days) during puberty were not able to respond to TE significantly. These results suggest that the refractoriness of the hepatic AHH to testosterone in adult female rats is determined by the absence of testosterone, as well as the presence of estrogens, during puberty. PMID- 6483959 TI - Selectivity of cholestyramine treatment on hepatic mixed function oxidase activity. AB - The possibility that oral cholestyramine treatment might indirectly increase hepatic drug oxidations was investigated in rats using pentobarbital, antipyrine, zoxazolamine, and aminopyrine as probes of the hepatic mixed function oxidase system and in humans using amobarbital and antipyrine as probes. Cholestyramine pretreatment of rats for 5 days (87.5 mg/kg twice daily by stomach tube) shortened pentobarbital sleep times, decreased antipyrine-induced hypothermia, but did not influence either zoxazolamine paralysis times or the in vitro N demethylation of aminopyrine. Neither pentobarbital nor antipyrine pharmacokinetics in rats were affected by the cholestyramine pretreatment. Similarly, in two-way crossover studies with human subjects, a 5-day oral cholestyramine pretreatment (4 g 3 times daily) had no demonstrable effect on the pharmacokinetics of single doses of amobarbital (200 mg i.v.) or antipyrine (500 mg per os). After cholestyramine pretreatment, a trend toward diminished CNS depression produced by amobarbital was observed, but the effect was not statistically significant. The results suggest that hepatic mixed function oxidases in rats for which aminopyrine, antipyrine, pentobarbital, and zoxazolamine are substrates and that hepatic mixed function oxidases in humans for which amobarbital and antipyrine are substrates are not significantly affected by cholestyramine pretreatment. PMID- 6483960 TI - Effect of thiamin deprivation on the in vitro metabolic activation of benzo(a)pyrene. AB - Feeding a thiamin-deficient diet to male and female rats for 3 weeks alters the mixed function oxidases responsible for metabolizing benzo(a)pyrene and enhances the response of these enzymes to induction by phenobarbital or 3 methylcholanthrene. The caloric restriction observed in thiamin deprivation may be partially responsible for the enhanced metabolism in this condition but, as established in pair-feeding studies, was not responsible for the enhanced response to enzyme inducers seen in these animals. The degree of altered response was also seen to depend on the sex of the rat and on the substrate concentration of the incubation mixture. PMID- 6483961 TI - Factors influencing circadian rhythms in acetaminophen lethality. AB - Experiments were conducted to examine the effects of changes in lighting schedules and food consumption on circadian rhythms in acetaminophen lethality and hepatic glutathione levels in male mice. Under a normal lighting schedule (light: 06.00-18.00 h), male mice exhibited a circadian rhythm in acetaminophen lethality (peak: 18.00 h; nadir: 06.00, 10.00 h) and an inverse rhythm in hepatic glutathione concentrations (peak: 06.00, 10.00 h; nadir: 18.00 h). Under a reversed lighting schedule (light: 18.00-06.00 h) the glutathione rhythm was reversed and the rhythm in acetaminophen lethality was altered showing greater sensitivity to the drug. Under continuous light, there was a shift in the acetaminophen lethality and the hepatic glutathione rhythms. Under continuous dark, both rhythms were abolished. Under a normal lighting regimen, hepatic glutathione levels were closely correlated with food consumption; i.e., both were increased during the dark phase and decreased during the light phase. Fasting the mice for 12 h abolished the rhythms in acetaminophen lethality and hepatic glutathione levels; moreover, the lethality was increased and the hepatic glutathione levels were decreased. These experiments show that both lighting schedules and feeding can alter the circadian rhythms in acetaminophen lethality and hepatic glutathione levels in male mice. PMID- 6483962 TI - Quantitation by gas chromatography of the 1- and 4-hydroxy metabolites of midazolam in human plasma. AB - The imidazobenzodiazepine midazolam (MDZ), along with its 1-hydroxy and 4-hydroxy metabolites (1-OH-MDZ, 4-OH-MDZ) can be simultaneously quantitated by electron capture gas-liquid chromatography. After addition of diazepam as internal standard, alkalinized plasma samples are extracted into benzene-isoamyl alcohol. The organic extract is separated, evaporated to dryness, reconstituted, and chromatographed using 3% SP-2250 as the liquid phase. The identity of 4-OH-MDZ, not previously detected in human plasma in unconjugated form, was verified by negative-ion chemical ionization mass spectroscopy. After single oral doses of MDZ administered to humans, concentrations of MDZ and 1-OH-MDZ (alternatively named 1-hydroxymethyl midazolam) were similar, and both compounds were eliminated from plasma in parallel. Concentrations of 4-OH-MDZ were considerably lower, but this metabolite was also eliminated in parallel with the parent compound. PMID- 6483963 TI - Hoe 263, a new substance with calcium channel antagonistic activity. AB - Hoe 263 inhibited the contraction of the potassium-depolarized pulmonary artery of the guinea pig. In this experiment it was slightly more active than verapamil. The calcium uptake of the potassium-depolarized pulmonary artery was inhibited by Hoe 263 more effectively than by prenylamine. The upstroke velocity of the potassium-depolarized papillary muscle of the guinea pig was depressed with similar concentrations of Hoe 263 and verapamil. In the (3H)-nitrendipine binding test, Hoe 263 was effective at similar concentrations as prenylamine and verapamil. The positive inotropic effect of K-strophanthin was depressed by Hoe 263 at concentrations which were comparable with those necessary for verapamil. PMID- 6483964 TI - Ion microscopy, a method for imaging the distribution of trace elements in the lung. AB - Analytical ion microscopy, a method of surface microanalysis, is applied to the detection of trace elements in the lung. With this method it is possible to obtain images of the distribution of any element in lung tissue sections with a resolution of 0.5 micron and with very high sensitivity (of an order of magnitude 3 or 4 times greater than with X-ray microanalysis). Under these conditions it is possible to study at the microscopic level the penetration into the lung cells of mineral materials administered in physiological amounts. The images are formed by ion microscopy of atoms sputtered as charged particles from the specimen, and these atoms are selected by mass spectrometry. This technique has been applied to the detection of aerosols (diam. less than 1 micron) of rare earths (thulium or cerium chloride), inhaled in very small amounts (20-50 micrograms), in cells from the lung of a rat. Images of the distribution of these elements were obtained in a few seconds or minutes, when X-ray microanalysis gave either a weak signal or none at all. Their behaviour in the lung could be easily studied several weeks after the end of the inhalation. PMID- 6483965 TI - Morphometry of bone cell nuclei and their location relative to bone surfaces. AB - The shapes and locations of lining cells, osteoblasts and osteoprogenitors in sections of rat bone have been quantified by means of a digitiser. The nuclei of all three types of cells can be characterised by oblate spheroids (ellipsoids of revolution). The axis dimensions, their relative variations and the correlation between these parameters have been determined by computer simulation. The nuclear volume of progenitors (288 microns) is more than twice the volume of osteblasts and lining cells (127 microns and 113 microns, respectively). The true mean perpendicular distances of nuclei are 3.1 microns, 5.7 microns and 7.7 microns for lining cells, osteoblasts and progenitors, respectively. The probability densities for true perpendicular distances have been calculated and analytical expressions are given that formally characterise these densities. PMID- 6483966 TI - Effective energy in diagnostic radiology. A critical review. AB - The concept of effective energy, commonly used to characterise the photons in a roentgen beam exhibiting a distribution with respect to energy, is critically reviewed. Definitions are given in terms of equations which clearly demonstrate that values of effective energy depend on the physical quantity with respect to which they are calculated. Examples are discussed which quantify the errors which may result due to incorrect application of effective energy in deriving values for various physical quantities. For instance, the energy imparted to the patient in diagnostic radiology may be underestimated by as much as a factor of two. PMID- 6483967 TI - Discrimination between thorotrast and iodine contrast medium by means of dual energy CT scanning. AB - A dual-energy CT scanning method is proposed to discriminate between thorotrast and iodine contrast medium in patients suspected of having thorotrast deposits in the spinal canal as a consequence of myelography injections. The ratio of CT numbers at two X-ray tube voltages was used to distinguish the two materials in the analysis of dual-energy CT scanning. The K-edge of thorium was used to enhance the discrimination sensitivity. Theoretical analysis predicted the feasibility of the method and this was verified by experiment. The sensitivity for the discrimination between thorium and iodine is much higher than that achieved by the gamma-ray counting technique using a whole-body counter. This method, the ratio of CT numbers at two kV values, may be useful in other clinical applications. PMID- 6483968 TI - Limits to signal-to-noise improvement by FID averaging in NMR imaging. AB - We studied the improvement of signal-to-noise ratio (SNR) in NMR images by free induction decay (FID) averaging. We found that as the number of FIDS averaged increases, a region is reached where the image SNR levels off asymptotically. A theoretical explanation for this behaviour is offered. Agreement between experimental results and theoretical prediction is excellent. It is also pointed out that the exact location of the point at which further averaging does not pay off is dependent on the individual NMR imaging system used. PMID- 6483969 TI - A relationship between the percentage of calcium by mass and the effective atomic number of regions containing bone. PMID- 6483970 TI - Comment on 'A biological approach to the platelet survival curve'. PMID- 6483971 TI - The uptake and turnover of 90Sr in the human skeleton. AB - In the United Kingdom, measurements have been made of the concentration of 90Sr in human bone from 1955 to 1970, and in human diet since 1958. A correlation of these two series of observations has enabled estimates to be made of (i) the fraction of the dietary intake of 90Sr that reaches the skeleton, (ii) the rate of turnover of 90Sr in the skeleton, and (iii) the way in which both these parameters vary with age. The results may be used to predict future levels of 90Sr in human bone from measurements of the radionuclide in diet, and also to calculate the radiation doses received by tissues in bone from intakes of 90Sr and 89Sr. PMID- 6483972 TI - The significance of electron binding corrections in Monte Carlo photon transport calculations. AB - Many Monte Carlo simulations ignore coherent scattering events and utilise the Klein-Nishina free electron distribution, rather than the incoherent differential cross-section, for choosing the trajectories of incoherently scattered photons. We assess the accuracy of this model by comparing its results with those of the complete bound electron model (form factor approach), which simulates coherent scattering events, and uses the appropriate bound electron angular scattering distributions. Both analytic and Monte Carlo calculations demonstrate that use of the free electron scattering distributions significantly underestimates the angular distribution of scattered photon energy resulting from low and medium energy photons incident upon carbon, iron, and platinum barriers. In using the free electron approximations to calculate barrier transmission, significant errors occur only for primary photon energies below 100 keV. Implementation of the complete bound electron model reduces the computational efficiency of our Monte Carlo code by only 10-25%. PMID- 6483973 TI - Energy imparted to water slabs by photons in the energy range 5-300 keV. Calculations using a Monte Carlo photon transport model. AB - In diagnostic examinations of the trunk and head, the energy imparted to the patient is related to the radiation risk. In this work, the energy imparted to laterally infinite, 10-300 mm thick water slabs by 5-300 keV photons is calculated using a Monte Carlo photon transport model. The energy imparted is also derived for energy spectra of primary photons relevant to diagnostic radiology. In addition to values of energy imparted, values of backscattered and transmitted energies, quantities primarily obtained in the transport calculations, are reported. Assumptions about coherent scattering are shown to be important for values of backscattered and transmitted energies but unimportant with respect to values of energy imparted. Comparisons are made with other Monte Carlo results from the literature. Discrepancies of 10-20% in some calculated quantities can be traced back to the use of different tabulations of interaction cross-sections by various authors. PMID- 6483975 TI - The effect of apex-finding errors on factor images obtained from factor analysis and oblique transformation. AB - The use of an oblique transformation to obtain physiological factors from a factor analysis of dynamic studies has recently been suggested. The technique involves using an apex-seeking routine to enable these factors and their contribution images to be formed. This paper investigates the effects of errors in apex-finding on these factor images. In particular it is shown that, apart from scaling, the factor image obtained from a given apex is independent of the position of that apex (and hence is independent of its own factor). PMID- 6483974 TI - Electron dosimetry with thermally stimulated exoelectron emission (TSEE). AB - The dependence of exoelectron emission from BeO and Al2O3 on primary electron energy has been measured over the 200 keV to 1.2 MeV range. Two types of measurements are made, firstly with the isotopes 90Sr + 90Y, 147Pm, 204Tl, and secondly for BeO with monoenergetic electrons from an accelerator. The TSEE response of covered BeO-dosemeters (cover of 7 mg cm-2 polyethylene) is independent from electron energies in the 200 to 700 keV range for constant equivalent doses (ICRP 21). The experimental results for uncovered TSEE dosemeters and electron fluences are in agreement with calculations performed using a Monte Carlo program developed by Seltzer and Berger. The TSEE responses for electrons and photons in equivalent dose units are very similar. A lower detection limit of 20 mu Gy (absorbed dose in air) is found for this dosemeter. PMID- 6483976 TI - The use of cadmium telluride detectors for the qualitative analysis of diagnostic x-ray spectra. AB - A method is introduced for the evaluation of x-ray spectra from x-ray machines operating in the range 50-100 kVp using a cadmium telluride (CdTe) detector with low detection efficiency. The pulse height distribution obtained with this kind of detector does not represent the true photon spectra owing to the presence of K escape, Compton scattering, etc.; these effects were evaluated using a Monte Carlo method. A stripping procedure is described for implementation on a Univac 1100/82 computer. The validity of our method was finally tested by comparison with experimental results obtained with a Ge detector and with data from the literature; the results are in good agreement with published data. PMID- 6483977 TI - Variation with age of the dielectric properties of mouse brain cerebrum. PMID- 6483978 TI - Is energy imparted a good measure of the radiation risk associated with CT examinations? PMID- 6483979 TI - Charge storage effect on dose in insulating phantoms irradiated with electrons. PMID- 6483980 TI - Fluidotherapy and exercise in the management of sickle cell anemia. A clinical report. AB - Children hospitalized during sickle cell anemia crises suffer restricted range of motion secondary to vasoocclusive-induced pain and are almost always nonambulatory. Texas Children's Hospital, Houston, TX, now refers most of these children to the Physical Therapy Department at St. Luke's Episcopal Hospital, Houston, TX, for Fluidotherapy and general strengthening and increased endurance programs. The Fluidotherapy treatment and the exercise program have resulted in a marked reduction in the length of hospitalization (compared with length of hospitalization by the same patients during previous episodes) and have permitted a major reduction in the dosage of analgesics previously administered. Spine, trunk, and extremity range of motion and gait improved markedly with treatment. PMID- 6483981 TI - Physician knowledge and utilization of physical therapy procedures. AB - The purpose of this study was to assess physician knowledge and utilization of physical therapy procedures. We sent a questionnaire to 600 physicians in three medical specialties (neurology, orthopedic surgery, and physical medicine and rehabilitation), in four geographic regions of the United States. The usable return was 41 percent. Overall knowledge, technical knowledge, and professional knowledge scores were compared by medical specialty, region of the country, years in practice, and three measures of utilization using analysis of variance, student's t, and chi-square statistics. Physical medicine and rehabilitation specialists and physicians in practice 10 years or more had the most knowledge of physical therapy procedures. Respondents preferred a prescriptive relationship when referring patients to physical therapists, and they most often selected "technical" procedures traditionally associated with the profession rather than "professional" procedures when referring patients to physical therapy. Those practicing medicine in their specialty 10 years or more were more conservative in their referral preferences than those in practice less than 10 years. The implications for educational intervention concerning the professional role of the physical therapist are briefly discussed. PMID- 6483982 TI - Reduction of hypertonicity by early casting in a comatose head-injured individual. A case report. AB - The patient in this report sustained a closed-head injury. Within six days of the injury, he demonstrated generalized hypertonicity accompanied by alternating strong decerebrate and decorticate posturing. By Day 10 after injury, normal passive ROM could no longer be maintained using neurophysiological therapeutic techniques. Therefore, we applied plaster casts to both ankles. Within 24 hours of cast application, the patient's general hypertonus had decreased, and by 72 hours after casting, the patient demonstrated seemingly purposeful movements of the left extremities. Although casts have been used previously to maintain ROM or decrease contractures and to improve balance of muscle function of the joint that was immobilized, we believe that the marked, generalized reduction in tone in body segments far removed from the ankles was an important clinical observation. We explored several possible mechanisms for these observations. Because the usual casting conditions for reflex inhibition were not obtained with this patient, other factors were suggested to be important: total even pressure and neutral warmth. Research is currently in progress at the Medical Center Hospital of Vermont to study further the effects of plaster casting and to understand the mechanisms underlying the effects. PMID- 6483983 TI - Rolling board for treatment and evaluation of neurologically involved patients. Suggestion from the field. PMID- 6483984 TI - Role of soft orthosis in treating plantar fasciitis. Suggestion from the field. PMID- 6483985 TI - Clinical experience and cognition of a physical therapy procedure. AB - This investigation was designed to determine if clinical experience influences cognition of a physical therapy procedure. We hypothesized that experience in the application of a physical therapy procedure on patients would increase the student's cognition of that procedure. Twenty-two junior students in a physical therapy baccalaureate program were study subjects. A multiple-choice test pertaining to gait training was administered to all subjects as a pretest and posttest. The pretest was given after classroom instruction and laboratory practice in gait training; posttest was administered eight weeks later. During the interim eight weeks, 11 subjects completed 32 hours of clinical experience and 11 subjects had no clinical experience. Analysis of the results of posttest compared with pretest indicated that for these subjects, clinical experience did not increase cognition of gait training. PMID- 6483986 TI - Personality characteristics and expressed career choice of graduating physical therapy students. AB - We examined the personality characteristics of physical therapy students (N = 45) who had different career goals. We used the Myers-Briggs Type Indicator and a brief demographic information sheet to collect data at the conclusion of the 1982 spring semester. Analyses of variance indicated statistically significant differences (p less than .01) between those who desired careers as generalist clinicians versus specialist clinicians. The specialist group represented adaptive, curious problem solvers; the generalists demonstrated characteristics of precision, order, and preferences for routine procedure. The findings have implications for the job satisfaction of physical therapists and have ramifications for curriculum planning. PMID- 6483987 TI - Weight concerns. PMID- 6483988 TI - The rate of removal of sunlight-induced pyrimidine dimers from the DNA of cultured human diploid fibroblasts. PMID- 6483989 TI - Photorepair of pyrimidine dimers in the epidermis of the marsupial Monodelphis domestica. PMID- 6483990 TI - Wavelength dependence of inactivation and mutation induction to 6-thioguanine resistance in V79 Chinese hamster fibroblasts. PMID- 6483991 TI - Porphyrin accumulation by atheromatous plaques of the aorta. PMID- 6483992 TI - Studies on the photoprotective mechanism of butylated hydroxytoluene. PMID- 6483993 TI - Skin optics and phototherapy of jaundice. PMID- 6483994 TI - Electrophoretic separation of furocoumarin: DNA photoadducts. PMID- 6483995 TI - The alpha-chymotrypsin effect on various 9-aminoacridine fluorescent probe emission. PMID- 6483996 TI - Photoreactivation of ICR 2A frog cells exposed to solar UV wavelengths. PMID- 6483997 TI - Wavelength dependence for AMT crosslinking of pBR322 DNA. PMID- 6483998 TI - Forward scattering properties of human epidermal layers. PMID- 6483999 TI - Investigations on the mechanism of chlorpromazine phototoxicity: effects on lysosomes of cultured human fibroblasts. PMID- 6484000 TI - Influence of the location of tryptophanyl residues in proteins on their photosensitivity. PMID- 6484001 TI - Photochemical exchange reactions of thymine, uracil and their nucleosides with selected amino acids. PMID- 6484002 TI - Sister chromatid exchanges and chromosome aberrations in human cells induced by H2O2 and other photoproducts generated in fluorescent light-exposed medium. PMID- 6484003 TI - Changes in tertiary structure of calf-lens alpha-crystallin by near-UV irradiation: role of hydrogen peroxide. PMID- 6484004 TI - Photodynamic effects: porphyrin vs chlorin. PMID- 6484005 TI - A porphyropsin-like action spectrum from Xenopus melanophores. PMID- 6484006 TI - Ionic distributions and volume maintenance in human lymphocytes. AB - The equilibrium water contents and distributions of Na, K, Cl, Mg, Ca, and inorganic phosphate were studied under a variety of conditions that included 0 degrees C., low external K, ouabain and ATP-depletion. Net exclusion of Na was fully inhibited as manifested by a gain of cellular Na to a level greater than or equal to that in the environment. In none of these conditions did the cells swell in a manner expected in the classical pump-leak, double-Donnan concept of volume maintenance. Moreover, Na, K, Cl, and Mg fail to follow consistently a Donnan equilibrium in cells no longer able to exclude ions. Postulated volume-regulating mechanisms other than outwardly directed Na pumps, such as hydrostatic pressure, a Cl pump, altered charge or osmotic coefficient of proteins, and shrunken and swollen compartments did not explain the results. Therefore, we evaluated the data from the standpoint of a theory of cellular physiology in which cellular ions are adsorbed onto macromolecules. From these concepts and the data presented, a new theory of the maintenance and regulation of cellular volume, in which macromolecular salt-linkages provide a cohesive force, is discussed. PMID- 6484007 TI - A new method of SAR determination in animals exposed to microwave/radiofrequency radiation (MW/RFR). AB - Meaningful evaluation of physiological changes resulting from microwave/radiofrequency radiation (MW/RFR) exposure depends upon accurate dose level determination. Comparison of experimental results from different investigators also requires firm establishment of dose levels. Review of the current literature reveals considerable inconsistency in this area. Therefore, a reliable method of specific absorption rate (SAR) determination in living animals must be established. In this article, we propose a new procedure for SAR determination which does not interfere with other complementary measurements required during experimentation. This simple and reliable method utilizes both the rate of temperature increase during irradiation and the rate of cooling following exposure. Current experiments suggest that the proposed method is an effective technique for local and whole-body SAR determination and allows an accurate evaluation of MW/RFR bio-effects. PMID- 6484008 TI - Mercury concentration in the blood and organs of normal and acatalasemic mice after intraperitoneal injection of metallic mercury (203Hg0). AB - The total amount of mercury exhaled from acatalasemic mice in ten minutes after injection of metallic mercury was about 1.6 times higher than that of normal mice. The level of metallic mercury in the blood of acatalasemic mice was significantly higher than that of normal mice. The levels of mercury in the brain and liver in acatalasemic mice in ten minutes after injection of metallic mercury, and the brain/blood ratio or liver/blood ratio of mercury in acatalasemic mice were significantly higher than those of normal mice. These results suggest that metallic mercury in the blood readily passes through the blood-brain or blood-liver barrier. PMID- 6484009 TI - A comparison of corticoadrenal and gonadal responses to acute immobilization stress in rats and mice. AB - The effect of different periods of acute immobilization stress on circulating corticosterone and testosterone was studied in adult male rats and mice. Although initial corticoadrenal response to immobilization was similar in both species, this differed after a more prolonged exposure to the stress stimulus. This suggests that behavioral adaptation to long-lasting stimulation and/or effectiveness of corticosterone feedback on the hypothalamus-pituitary-adrenal axis could be different in those species. An inhibition of testosterone secretion after 5 hr of immobilization was observed in both rats and mice. However, mice seem to be more sensitive to stress-induced inhibition of testosterone secretion than rats. No evidence for a biphasic testosterone response to stress was found. PMID- 6484010 TI - Amygdaloid unit activity during classical conditioning of the nictitating membrane response in rabbit. AB - Single and multiple unit activity was recorded from the amygdaloid nuclei in awake unanesthestized rabbits during classical conditioning of the nictitating membrane (NM) response. Over half o the unit recordings from the amygdaloid complex demonstrated changes in firing rate following the presentation of the tone conditioned stimulus (CS) or corneal air-puff unconditioned stimulus (US). Of the unit records that were responsive to the training stimuli, 58% showed responses to the CS and 73% showed responses to the US. Amygdaloid responses to either the CS or the US tended to be a long latency (greater than 70 msec), long duration (greater than 250 msec), modest increase (less than 2 fold) in unit firing. There were no statistically significant differences between the spontaneous firing rates, response latencies, response magnitudes, or response type distributions seen during unpaired (control) and paired stimulus presentations. However, four of 18 single and multiple unit groups that were tested during both unpaired and paired training developed new or enhanced responses following the onset of paired training. All four of these records were from the basolateral or lateral amygdaloid nuclei. Although these few records did develop response alterations after CS-US pairing, the majority of the records indicated that essentially the same amygdaloid response patterns occur during unpaired training as during paired training. it is therefore unlikely that the critical neuronal changes that underlying NM conditioning occur within the amygdaloid complex. Other possible roles for the amygdaloid complex during conditioning are considered. PMID- 6484011 TI - Photically evoked potentials in the visual cortex following paradoxical sleep deprivation in rats. AB - Immediately following 72 hr of paradoxical sleep (PS) deprivation, the P3-N3 amplitude of the photically evoked response in the visual cortex was measured in waking rats. PS deprivation was achieved instrumentally by one of three different techniques: the classical platform, the multiple platform, or the pendulum technique. For each of the techniques a control condition was run additionally. The PS deprivation effect consisted of a decrement in the P3-N3 amplitude, which was interpreted as indicating an increase in tonic arousal having a depressing influence on cortical excitability. Concomitantly, a relatively large technique effect occurred, in which the difference between the two platform techniques on the one hand, and the pendulum technique on the other, was most apparent. The same factors did not influence behavioural activity taking place during the presentation of photic stimulation, but did during the preceding 5 min adaptation period. Although the present findings are in contrast with previous reports in animals, they may not be inconsistent with the basic idea of the neural excitability hypothesis of PS. PMID- 6484012 TI - Effects of stereoisomers of estradiol on food intake, body weight and hoarding behavior in female rats. AB - The effects of 17-alpha and 17-beta estradiol on food intake, body weight and hoarding behavior in ovariectomised rats were investigated. For five days, ten animals received subcutaneous injections of both isomers (10 micrograms/kg/day) in a counterbalanced design. Hoarding tests were conducted on the last three days of each 5-day injection period. 17-Alpha estradiol significantly reduced food intake but was without effect on body weight. 17-Beta estradiol reduced food intake significantly more than the alpha form and also significantly reduced body weight. These differential effects suggest that stereoisomers of estradiol may be acting on separate regulatory systems. The treatments did not change hoarding activity compared to pre-treatment levels. PMID- 6484013 TI - Interactions between aversive and rewarding effects of hypothalamic stimulations. AB - Interactions between aversive and rewarding effects of brain stimulations were studied by assessing the variation of both escape and approach responses induced in a shuttle box by applying electrical stimulations of various intensities simultaneously to a medial hypothalamic (MH) site and to a lateral hypothalamic (LH) site. The results obtained show that: (1) LH stimulation produces two effects whose relative strengths appear to depend on both the location of the stimulation site and the intensity applied: (a) a suppressant effect correlated with the rewarding effect, which reduces MH escape responding; and (b) an enhancing effect correlated with the aversive effect, which increases MH escape responding. (2) MH stimulation similarly produces two effects whose relative strengths vary with both the location of the stimulation site and the intensity applied: (a) an enhancing effect which increases LH approach responding and (b) a suppressant effect which decreases LH approach responding. (3) The above mentioned effects occur irrespective of whether the two stimulation sites (MH and LH) are ipsi- or contralateral to each other. These results suggest that the effects of LH stimulation on MH induced escape as well as those of MH stimulation on LH induced approach are related to the affective (aversive, rewarding) properties of the stimulation. PMID- 6484014 TI - Patterns of nutrient selection in rats with streptozotocin-induced diabetes. AB - The effects of experimental diabetes on energy intake, patterns of nutrient selection, water intake, body weight and body composition were examined in male Sprague-Dawley rats given ground Purina Chow or a dietary self-selection regime. Following adaptation to dietary conditions, a portion of the animals in each diet group were made diabetic by the administration of 45 mg/kg streptozotocin (STZ). The remaining animals in each group served as vehicle-injected controls. STZ reliably produced diabetes in rats on both dietary regimes. Immediately after the induction of diabetes, rats on the self-selection regime increased carbohydrate and protein intakes and decreased fat intake. Approximately three weeks after STZ administration, diabetic rats reduced carbohydrate intake and increased fat intake. Diabetic animals in both diet groups were hyperphagic and polydipsic relative to non-diabetic controls. During the first three weeks following STZ injections, energy and water intakes of diabetic animals in the two dietary conditions were similar. However, after this initial period, energy and water intakes of diabetic rats given the self-selection regime were significantly lower than those of diabetic animals given Purina Chow. PMID- 6484015 TI - Phase shifts of circadian rhythms in activity entrained to food access. AB - Rats anticipate daily 2 hr meals with a sharp increase in activity several hours prior to food availability. The present experiment examined the response to phase shifts of food access in rats with lesions of the suprachiasmatic nuclei (SCN). Following entrainment of activity to 2 hr of food per day, food access was phase delayed or phase advanced by 4, 6, or 8 hr. All rats responded to phase delays of 4 or 6 hr with an increase in the duration of anticipatory activity so that transients appeared mostly in activity onset. Following 8 hr phase delays, clear delaying transients in both activity onset and end were observed. Only a few rats showed advancing transients in activity after phase advances of food access. In response to 6 hr and 8 hr phase advances, 3 different responses occurred: (a) activity re-entrained to food access by the 2nd or 3rd day without clear intervening transients, (b) activity phase shifted by means of distinct delaying transients and (c) delaying transients occurred in one component of activity while a second component of activity appeared at the new phase position by the second or third day. These results provide further evidence that anticipation of food access is mediated by a circadian mechanism which is functionally independent of the SCN and illustrate some similarities as well as considerable differences between circadian rhythms entrained by feeding and those entrained by light-dark cycles. PMID- 6484016 TI - Endocrine changes induced by venipuncture in rhesus monkeys. AB - An animal-worn, remotely activated blood collection device was used to obtain estimates of baseline levels of testosterone (T), growth hormone (GH) and prolactin (PRL) from unrestrained and active male rhesus monkeys. As soon as possible after this baseline period, the males were captured and a final venipuncture sample was obtained. Venipuncture produced elevated GH levels compared to values obtained using the blood collection device, but was without detectable effect upon levels of T and PRL. Cortisol values, available only from a single animal, displayed an increase in response to venipuncture, much like that seen for GH. PMID- 6484017 TI - Together intracranial angiotensin and systemic mineralocorticoid produce avidity for salt in the rat. AB - Rats that have no need for sodium will run to small rewards of 3% NaCl solution in a runway after they have been treated with both a mineralocorticoid and angiotensin II. When given alone at the low doses used here, neither the mineralocorticoid nor the angiotensin produce the behavior. This result encourages the idea that it is a synergy of the hormones of sodium conservation, angiotensin and aldosterone, that apprises the brain of the need for salt and generates the appetite for the taste of salt. PMID- 6484018 TI - Passive and active avoidance behavior in the light-dark box test. AB - The temporal evolution of passive and active avoidance behaviors has been followed in rats, using the light-dark box test, by measuring step-through and exit latencies. The employed schedule consisted of three 7 day periods (free exploration, reinforced learning, forced extinction-retention). The data show clearly that the two learned behaviors are both rapidly established and exhibit significant differences only during extinction, active avoidance apparently depending on close temporal reinforcement. The diverse role of several behavioral and neurological mechanisms is hypothesized. PMID- 6484019 TI - Transitions in the dehydration-induced inhibition of milk intake in suckling rats. AB - The effects of acute cellular or extracellular dehydration on milk intake via suckling were determined in rats 5, 10, 15, and 20 days of age. Milk was made available 10 times to each rat pup by the intravenous infusion of oxytocin to anesthetized test dams. Prior to 15 days of age, milk intake was not affected by either intracellular or extracellular dehydration. In rats 15 days and older, however, both forms of dehydration reduced milk intake at the nipple. Thus, dehydration starts to inhibit suckling behavior at the onset of weaning, when food and water are both taken directly from the environment by the developing animal. PMID- 6484020 TI - Androgens and reproductive behavior in ovariectomized ring doves. AB - Eighteen ovariectomized ring doves (Streptopelia risoria) received subcutaneous silastic implants of either testosterone propionate (TP), 5 alpha dihydrotestosterone propionate (DHTP) or cholesterol. Birds were paired daily for 1-hr with intact males. Eleven days after implantation the pairs were observed. Both TP and DHTP activated wingflipping behavior in the females. None of the females showed receptive crouching. Aromatization of testosterone to estrogen does not appear to be involved in wingflipping in female doves. The results suggest that wingflipping in females is not as hormone specific as it appears to be in male doves. PMID- 6484021 TI - Some characteristics of urea accumulation in the renal cortex tissue of rats and dogs. AB - The urea concentration in the renal cortex ([RC]), liver ([L]) and skeletal muscle ([SM]) of non-diuretic Wistar rats was measured chemically and after an i.m. injection of 14C-urea and was compared with the plasma urea concentration ([P]). [L]/[P] and [SM]/[P] always equalled 1, irrespective of whether they were measured chemically or by means of radioactivity. [RC]/[P] was 2.81, again without any difference between chemical and radioactive measurement. The ratio of the chemically measured urea concentration in the renal cortex and plasma of mongrel dogs was 5.71, i.e. significantly higher than in rats (p less than 0.01). The intrarenal infusion of KCN, iodoacetate and ouabain did not alter it significantly (5.52, p greater than 0.05). Active transport, in whatever form, does not seem to be the cause of the high urea concentration in rat and dog renal cortex. PMID- 6484022 TI - Effect of a sudden and a slow concentration increase in plasma urea on its concentration in some tissues of the dog and rat. AB - The urea concentration in the renal cortex ([RC]) of pentobarbital-anaesthetized dogs was 5.71 times higher than the plasma concentration ([P]); the liver ([L]) and the skeletal muscle ([SM]) concentrations were the same as ([P]). Rapid infusion of 20% urea (1 g/kg b.w. within 1 min) was followed by a sudden increase in [P]; [RC] and [L] rose to values nonsignificantly different from [P] and remained non-significantly different for the whole 4 hours of the experiment; at the end, [P] was still about 10 times higher than before infusion. Surprisingly, [SM] 2 and 6 min after infusion was significantly lower than [P]; later they were the same. The experiment thus does not testify to the existence of active transport of urea in the RC. The permeability of the skeletal muscle membrane for urea is lower than that of the RC and liver. Chronic uraemia was induced in rats by transplanting the trigonum vesicae into the peritoneal cavity. In addition to the chemical determination of urea, 14C-urea (marked*) was also measured. [RC]/[P] and [RC*]/[P*] fell as [P] rose; [L], [L*] [SM] and [SM*] never differed from [P] or [P*]. Fluid [PF] collected in the peritoneal cavity had the same chemically determined and radioactive urea concentration as P, but it was hypoosmolar and had a lower [Na+] than P. These experiments likewise did not testify to active urea transport in the RC. It is not clear what caused the osmolarity and sodium gradient between the PF and P, but the peritoneal wall definitely did not act as a simple dialyzing membrane. PMID- 6484023 TI - Thyroid hormones influencing renal electrolyte excretion in saline loaded rats of different ages. AB - Thyroid hormones are involved in the postnatal development of kidney functions. The influence of pretreatment with thyroid hormones on renal electrolyte excretion was measured in rats of different ages. Pretreatment with triiodothyronine or tetraiodothyronine (10 micrograms/100 g b.wt. i.p. for 3 days, once a day) cannot alter the low sodium excretion in young rats receiving a saline load. In 33-, 55- and 105-day-old rats the pretreatment with thyroid hormones is followed by a preferential increase of renal sodium excretion. Both thyroid hormones are effective. PMID- 6484024 TI - Physiological casein and gluten protein requirements of growing rats. AB - Using mounting casein and wheat gluten protein values (0-40%) in the animals' diet, the optimum and minimum physiological daily doses were determined in 49-day old growing rats from changes in their body water, body nitrogen and protein intake. The optimum physiological doses were identical with the peak of linearity of the given parameters, which coincided with a 15% casein protein and a 20% gluten protein concentration in the diet. This was also confirmed by the maximum body amino acid values, which were found in animals given a 15% casein or 20% gluten protein diet. It was further confirmed by the finding of significantly elevated alanine aminotransferase and aspartate aminotransferase activity in the liver of animals with a higher intake of the above protein sources. The minimum physiological dose of the given protein was determined from the equations of the regression curves in the presence of zero changes in the body nitrogen or body water content. The optimum physiological daily doses of casein and wheat gluten protein were 3.25 g and 4.05 g respectively. The minimum physiological daily doses of casein protein were 268 mg (from body nitrogen changes) and 371 mg (from body water changes) and the minimum physiological daily doses of gluten protein were 892 mg (from body nitrogen changes) and 1,000 mg (from body water changes). The above indicators demonstrate, in the presence of higher and high dietary concentrations, that an intake of the given proteins over and above the optimum physiological daily dose is at the very least uneconomical (gluten), if not harmful (casein), making this a highly topical problem for further study. PMID- 6484025 TI - Effect of oestradiol on catecholamine-stimulated lipolysis. AB - The authors studied the effect of a single in vivo dose of oestradiol (OE) on adrenergic lipolysis in the epididymal adipose tissue of adult and juvenile male rats, and the effect of OE on plasma free fatty acids (FFA), cholesterol and beta lipoprotein levels at various intervals after its administration. It was found that OE injected 24 h beforehand in vivo (s.c.), in doses of 100 and 200 micrograms X kg-1 body weight, significantly potentiated the lipid-mobilizing action of the catecholamines noradrenaline (NOR) and isoprenaline (ISO) in adult rats (the action of ISO was potentiated more intensively); in addition, the adipose tissue became more sensitive to the action of NOR, but not of ISO. Raising the dose of OE to 400 micrograms X kg-1 did not enhance the potentiation of the lipolytic action of the catecholamines any further; on the contrary, the lipid mobilizing effect of the catecholamines was potentiated less than after half this dose. Following the s.c. injection of an oily OE solution, the lipolytic effect was potentiated after more than 7 h; the potentiation was strongest after 12 h, but only as far as the maximum attainable degree of lipolysis was concerned. Potentiation of adrenergic lipolysis was found only in adult male rats. In male rats weighing 130-150 g the lipolytic effect of catecholamines (in mumol/g adipose tissue) was significantly greater than in adult animals and the pre-administration of OE did not potentiate adrenergic lipolysis any further. Determination of plasma FFA, cholesterol and beta lipoprotein levels 1, 2, 4 and 6 hours after the s.c. injection of OE showed only nonsignificant changes (an increase in FFA and a decrease in cholesterol). The authors consider it important to distinguish between the effect of OE on catecholamine-stimulated lipolysis in depot adipose tissue and its effect on lipid metabolism. In their opinion, the dose-dependent effect of OE on muscular and metabolic adrenergic reactions could be one of the factors co-reversible for certain side reactions to steroid contraceptives. PMID- 6484026 TI - Visual evoked responses to pattern-reversal: the signal-to-noise ratio. AB - Visual evoked responses (VERs) to checkboard-reversal photic stimuli were recorded in 30 healthy experimental subjects with a mean age of 32 years. In 20 cases the stimuli were presented monocularly and in 10 cases binocularly. The estimated mean signal-to-noise ratio (SNR) of the individual VERs was found to be 0.245 +/- 0.092 for monocular stimulation and 0.444 +/- 0.23 for binocular stimulation. The power-based SNR of the averaged VERs was 24.5 and 44.4 respectively. The SNR was raised the most effectively by a new selective averaging variant applied after latency correction of the individual VERs; in the case of monocular stimulation the SNR rose to a mean 58.94 and in binocular stimulation to a mean 87.42. The mean proportion of discarded single VERs was 24%. PMID- 6484027 TI - Changes in some ultrastructural parameters of cortical synapses in the initial phases of kindling. AB - Repeated electrical stimulation of the sensorimotor region of rat cerebral cortex at 10 min intervals led to the development and progressive prolongation of self sustained after-discharges (SSAD). One minute after the third SSAD ended, an electronoptic morphological analysis of type I synapses after Gray from the second cortical layer of the homotopic area of the unstimulated hemisphere was carried out. In the experimental animals, an 11.7% increase in the area of the presynaptic bag and a 5.5% increase in its perimeter were demonstrated. The number of agranular synaptic vesicles per constant unit area fell by 70.8%. The area of the mitochondria in the presynaptic ending increased by 49.8% and their perimeter by 16.1%. The area of the postsynaptic element increased by 34.1% and its perimeter by 15.7%. Changes in the synapses are evaluated as manifestations of exhaustion and primarily as a manifestation of ion shifts during the epileptic seizure. The findings nevertheless also testify to incipient activation of restitution mechanisms in the structures of the synaptic apparatus within a very short time after termination of the seizure. PMID- 6484028 TI - Pharmacological investigations on Rhaponticum carthamoides. PMID- 6484029 TI - [The sensitizing capacity of composite plants. VII. Experimental studies with extracts and compounds of Chamomilla recutita (L.) Rauschert and Anthemis cotula L]. PMID- 6484030 TI - Tertiary indole alkaloids from fruits of Tabernaemontana dichotoma. PMID- 6484031 TI - Macrocyclic lathyrane type diterpene esters (jolkinols) from callus cultures and roots of Euphorbia lathyris. PMID- 6484033 TI - Inhibition of monoamine oxidase by hypericin. PMID- 6484032 TI - Plant anticancer agents XXXIII. Constituents of Passerina vulgaris. PMID- 6484034 TI - Lip pressure changes following lip repair in infants with unilateral clefts of the lip and palate. AB - The present study was designed to quantitatively assess lip pressure changes following cleft lip repair in infants with unilateral cleft lip, alveolus, and palate. Lip pressure measurements were taken using an electronic transducer system developed especially for this study. Lip pressure was monitored from 3 months (preoperatively) through 2 years of age in cleft and normal control children. Findings from the present study confirm the hypothesis that lip repair in infants with unilateral cleft lip and palate significantly increases lip pressure and that increased lip pressure remains significantly higher than in normal control children for the 2-year duration of the study. Thus increased lip pressure when the palate is unrepaired has to be considered as a factor modulating subsequent craniofacial growth. PMID- 6484035 TI - Tissue expansion in soft-tissue reconstruction. AB - Tissue expansion in soft-tissue reconstruction is described. The main principle is to develop donor tissue by expansion adjacent to the defect. Such a donor flap is doubled in size by intermittent injections of normal saline into the expander. After sharing the expanded flap for reconstruction, the donor site is well preserved, while the defect is reconstructed with contiguous tissue of similar texture, color, thickness, and sensation. There is minimal scar formation. Over 130 patients were reconstructed with expanded flaps. The average time of flap development was 3 to 6 weeks. PMID- 6484036 TI - Soft-tissue expansion: concepts and complications. AB - Soft-tissue expansion complements existing reconstructive techniques and provides new vistas for the plastic surgeon. The technique finds use for overcoming a shortage of tissue, for obtaining skin with special desirable qualities, for creation of flaps otherwise not possible because of the resultant donor site or limited vascularity, for creation of flaps with functioning muscle and overlying soft tissue, and for minimizing flap donor-site problems. Careful planning should include patient counseling, optimum incision placement, and time for a leisurely, complete expansion. The surgery can often be performed under local anesthesia and expansion is tolerated well. Patients should be counseled that the incidence of major complications in an unselected series is 1 in 4 patients. Major complications, however, typically result in a delay in reconstruction and not tissue loss. PMID- 6484037 TI - Venous drainage in the reverse forearm flap. AB - Venograms were performed in three cases of reverse forearm flap. The "crossover pattern" of the communicating branches between the two venae comitantes and the "bypass pattern" of the collateral branches of each vein have been demonstrated. These factors may explain the reverse drainage of venous blood, even though the valves of the vein are intact. Notably, the cephalic vein also shows a good communication with the deep venous system. Thus it can contribute another route for venous drainage in this flap. PMID- 6484038 TI - Assessment of microsphere technique for measurement of capillary blood flow in random skin flaps in pigs. AB - In this technical paper, we reviewed the theory and methodology of the radioactive microsphere technique for determination of cardiac output and regional blood flow. Furthermore, we described two experiments conducted to assess this technique for measurement of capillary blood flow in skin-flap research. Our experimental data thus far indicated that the radioactive microsphere technique provided highly reproducible measurements for determination of capillary blood flow in 4 X 10 cm acute and delayed random skin flaps constructed in pigs. The advantages and disadvantages of this laboratory technique were also discussed. PMID- 6484039 TI - Secondary critical ischemia time of experimental skin flaps. AB - Secondary ischemia time represents the interval between a postoperative vascular thrombosis of a free flap and its successful revascularization. Using an island flap model in pigs, the skin was found to tolerate an average secondary ischemia time of 7.2 hours. The safe secondary critical ischemia time (10 percent probability of necrosis) is 4.7 hours. This compares with the primary ischemia times of 13.1 hours (average) and 7.0 hours (10 percent necrosis). The discrepancies between these observed values are discussed. PMID- 6484040 TI - Comparing contracture rates: probability theory and the unilateral contracture. PMID- 6484041 TI - Massive deformation of the scrotal wall by idiopathic calcinosis of the scrotum. AB - Idiopathic calcinosis of the scrotum is a rare disease that may cause massive deformation of the scrotal wall. The first patient we present was also known to have neurofibromatosis. In the second patient we describe, nodules of idiopathic calcinosis of the scrotum were seen with walls that evidenced no epithelial lining, as well as calcification in epithelial cysts. At present, the only possible treatment is excision, and we excised the afflicted skin without problems in primary wound closure. PMID- 6484042 TI - Inverted-U incision for exploration of the distal phalanx. AB - A representation of a modified inverted-U incision over the dorsal aspect of the distal phalanx is presented. The incision consists of a curved, proximally based U-shaped flap and provides direct exposure of the extensor terminal tendon and distal joint articulation. Since the flap is proximally based, there is no danger of vascular compromise. It gives an excellent exposure without having to struggle with retractors, and it can be performed without the aid of an assistant. In our series, there has not been a single incident of complication, and the favorable appearance after healing makes this incision one of our favorites. PMID- 6484043 TI - Ultrasound and capsular contracture. PMID- 6484045 TI - The curved tip needle holder. PMID- 6484044 TI - Preseptal cellulitis in frontalis suspension for congenital ptosis. PMID- 6484046 TI - Reconstruction of the breast: coverage of the implant after subcutaneous mastectomy. PMID- 6484047 TI - [Selective attentional functioning as reflected in ERPs during syllable discrimination tasks (I). Results for normal control subjects]. PMID- 6484048 TI - [Facts and reform of "hard" psychiatric emergency service]. PMID- 6484049 TI - [Abnormal iron metabolism in the special type of hepatocerebral encephalopathy. I. Clinical and pathological findings of four cases of special type of hepatocerebral encephalopathy with hemochromatosis]. PMID- 6484050 TI - [Descriptive psychopathologic study of adult borderline patients]. PMID- 6484051 TI - [Day service for the mental patients by local governments]. PMID- 6484052 TI - [Increased 3H-muscimol binding in post-mortem brains of chronic schizophrenics]. PMID- 6484053 TI - [The statistics of mortality in a private mental hospital. The data for the years 1969-1982]. PMID- 6484054 TI - [Possibilities and limits of cranial computerized tomography for clinical psychiatry]. AB - The interpretation of the computer-tomogramm is of practical value for diagnostic, therapeutic and prognostic aspects (Seitz [21]). Brain-atrophy is a pathomorphological change caused by a number of facts. Only the consideration of the patient's age, the degree of hydratation, serious internal or neurological diseases, endo- or extotoxic variables respectively, postnarcotic incidents or minimal brain damage allows an interpretation in accordance with the psychopathological symptoms. PMID- 6484055 TI - [Borderline and narcissistic personality disorder--fashionable concepts or approaches to a new etiopathogenic and therapeutic understanding?]. AB - On the basis of the experience in own clinical practice with severe disturbance of personality and literature of this time about neurosis conceptional reflections are discussed the terms "borderline" and "narcissism". It is pointed out, that the described terms stimulate to psychological understanding of classes of abnormal personalities and to psychotherapy of these patients. PMID- 6484056 TI - [Central nervous system manifestations in patients with systemic lupus erythematosus. Review of pathogenetic aspects]. AB - CNS manifestation is considered as a diagnostic as well as prognostic important variation of SLE course. Disturbances of blood flow and immunopathologic process participate in its induction. Antineuronal antibodies and circulating immune complexes in liquor show tight relations to CNS involvement. PMID- 6484057 TI - [Inflammatory brain diseases in clinical practice]. AB - Over a period of twenty years all cases of inflammatory diseases treated in a neurological intensive-care unit were analysed in retrospective. For 90 cases of purulent bacterial meningitis, letality amounted to 30%. The need for agent oriented, intensive early treatment is discussed. At a reduced incidence of tuberculosis, meningitis tuberculosa is generally neglected. In the majority of cases patients suffering from "encephalitic syndrome" make high demands on intensive-therapeutic concepts, including interdisciplinary cooperation, due to high complication-rates and lack of causal therapy. In 95 cases, letality also amounted to 30%. PMID- 6484058 TI - [Morbidity rate in delirium tremens]. AB - On evaluating an analysis of 105 cases of delirium tremens over a period of five years in a psychiatric base-unit, the following findings were obtained: Delirium tremens, particularly in conjunction with secondary diseases, constitutes a life endangering medical emergency and requires intensive medical treatment. Letality was 8,57%. The morbidity-rate and the relapse-rate showed a clearly marked increase; the age of contracting the disease had its frequency peak between 30 and forty, i. e. earlier than in many other statistical surveys. Epileptic attacks as symptoms starting off or accompanying delirium occurred in almost one third of our delirium patients. The impact which these attacks have on the development in the course of process-like alcoholism was discussed. PMID- 6484059 TI - [Psychopathology and prognosis of puerperal psychoses]. AB - Psychopathology and prognosis of puerperal psychoses are discussed on the basis of 45 cases. Syndrome description is of special significance to therapy. Prognosis, on the whole, cannot be called favourable problems relevant to individual cases (suicidalism, delinquency) are indicated. PMID- 6484060 TI - [Cervical Amipaque myelography with lateral C1/C2 puncture with a conventional fluoroscopy device]. AB - The paper presents a method of carrying out cervical myelography by lateral C1/C2 puncture (LCP) using a conventional fluoroscopic device with an image intensifying TV-chain. The patient is deposited on a specially designed transverse table. The amount of time and picture-quality are equale to those for costly special apparatus. PMID- 6484061 TI - [Experiences with the indirect Clausen Test using NTA as an antigen in multiple sclerosis and other neurologic diseases]. AB - The present study based on the indirect Clausen-test using NTA and PHA as antigens contributed to therapy control and possibly prognosis assessment rather than to immunological differential diagnosis. PMID- 6484062 TI - [Early symptoms in schizophrenic patients in childhood and adolescence]. AB - The work deals with the observation of courses of 26 cases of schizophrenia in childhood and youth treated in the children's departement of the district mental hospital of Uchtspringe from 1975 to 1982. Two thirds of the total number were conspicuous by characteristics of an organic brain damage and broken homes before going to school, partly already in infancy. PMID- 6484063 TI - [Ethical principles and moral norms of psychiatric care in a socialistic society]. AB - Ethical postulates, which are intended to serve as orientation points for personal conduct, must be formulated clearly as demands, be related to the system of values on which they are based, and point out clearly the consequences of their being ignored and must therefore be connected with moral bans. The authors have tried to formulate such postulates for the most important ethical problems facing psychiatry in the GDR. These moral guidelines, which naturally infer moral bans, offer fuel for discussion as one step towards the establishment of a comprehensive code of ethics for psychiatrists. PMID- 6484064 TI - [Volume conduction in the electroneurographic study of arm and leg nerves]. AB - Two arm and two leg nerves in each of a group of healthy subjects were stimulated electrically and the muscle action potentials were taken from the corresponding regions by surface electrodes. Volumetrically conducted potentials appeared in almost all cases, and other nerves were stimulated at the same time in many cases. The resultant errors in the calculation of the speed of pulse transmission are considerable. The use of a concentric needle electrode is recommended for recording evoked muscle action potentials. PMID- 6484065 TI - [Ambulatory psychiatric treatment and suicide]. AB - From the few publications available in literature it is evident that suicide risk in psychiatric patients is considerably higher after their discharge from hospital than during inpatient treatment. The present study covers 21 recorded suicides of patients in a hospital outpatient ward for preliminary care and aftercare of psychiatric diseases. This figure represents 0.8% of all treated patients and corresponds to a suicide rate of 600 per 100.000 treatment episodes. At the time of suicide, 13 of these patients were still in outpatient treatment and 3 in the clinic. The others had been transferred or had discontinued treatment. Almost two-thirds suffered from psychoses belonging to the schizophrenic disease pattern. Contrary to what has been reported in literature, most of the suicides (almost two-thirds) occurred more than twelve months after their last hospital discharge. PMID- 6484066 TI - Are McCollough effects conditioned responses? PMID- 6484067 TI - Item selection for profiles: a reanalysis of an international profile of schizophrenia. PMID- 6484068 TI - Empathy in orphaned children. PMID- 6484070 TI - Post-traumatic stress: study of police officers involved in shootings. PMID- 6484069 TI - Validity of norms for drug addicts on the Rathus Assertiveness Schedule. PMID- 6484071 TI - Affective aspects of clinical reasoning: their importance in assessment of behavioral diagnoses in medical patients. PMID- 6484073 TI - Effects upon social perceptions of the insanity plea. PMID- 6484072 TI - Parental power and adolescents' drinking. PMID- 6484074 TI - The dissipation hypothesis of hypnotic amnesia: more disconfirming evidence. PMID- 6484075 TI - Relationship between androgyny and self-monitoring. PMID- 6484076 TI - Attitudes of fundamentalists toward homosexuality. PMID- 6484077 TI - Effect of treatment rationale and problem severity upon therapeutic preferences. PMID- 6484078 TI - Behavioral intentions to join a union: instrumentality X valence, locus of control, and strike attitudes. PMID- 6484079 TI - Comparison of defense mechanisms utilized in perception by congenitally blind and sighted respondents. PMID- 6484080 TI - More on scoring androgyny as a single continuous variable. PMID- 6484081 TI - Adolescent females' perceived parental sex-role attributes. PMID- 6484082 TI - Type A as a challenge-induced response: two-year follow-up. PMID- 6484083 TI - Perceived hassles and uplifts among nursing home residents. PMID- 6484084 TI - Psychosocial and medical factors influencing referral to an Israeli Air Force Base Mental Health Clinic. PMID- 6484086 TI - Fear of fat in runners: an examination of the connection between anorexia nervosa and distance running. PMID- 6484085 TI - Differences in employed women's anxiety, depression, and hostility levels according to their career and family role commitment. PMID- 6484087 TI - Humor preference and coping with stress. PMID- 6484088 TI - Conceptualizations of mental health. PMID- 6484089 TI - Using discriminant analysis to identify the noncognitive characteristics of high achieving medical students. PMID- 6484091 TI - Predicting probability of attaining fitness to stand trial. PMID- 6484092 TI - A possible difference between men's and women's sexuality. PMID- 6484090 TI - Scores on three MMPI alcohol scales of parents who receive child custody. PMID- 6484093 TI - Psychosocial assessment on a short-stay inpatient psychiatric unit. PMID- 6484094 TI - Brain growth theory and educational psychology. PMID- 6484095 TI - Discrimination of salivary olfactants by male Mesocricetus auratus. PMID- 6484097 TI - Personality factors related to self-reported lapse of attention during lectures. PMID- 6484096 TI - Effectiveness of communication skills training for dental students. PMID- 6484098 TI - Female homosexuals' need for dominance and endurance. PMID- 6484099 TI - The closing at Canadian Admiral: correlates of individual well-being sixteen months after shutdown. PMID- 6484100 TI - Evaluation of a methadone rehabilitation program. PMID- 6484101 TI - Can the type A behavior pattern be altered after myocardial infarction? A second year report from the recurrent coronary prevention project. AB - The feasibility of altering a Type A style of life was investigated in 1012 nonsmoking predominantly male postinfarction volunteers in the San Francisco Bay area. A total of 862 were randomly allocated into an experimental section receiving a combination of Type A and cardiac counseling, or a control section receiving cardiac counseling alone. The remaining 150 formed a nonrandom but statistically equivalent comparison section. Assessments of change in Type A behavior were made by the participant, his or her spouse, a work colleague, and an independent rater of a videotaped structured interview. Psychometric analyses indicated that these instruments were valid and reliable measures of Type A behavior. After 24 months, participants receiving Type A/cardiac counseling exhibited a significantly greater reduction in Type A behavior than the other two sections, and had a lower cardiovascular recurrence rate than the comparison section only. No differences among the three sections were observed in total cholesterol or resting blood pressure. The results suggest that Type A behavior can be altered by group counseling in postinfarction volunteers and that such alteration is superior to no group counseling at all in the secondary prevention of coronary heart disease. PMID- 6484102 TI - Growing older with cystic fibrosis: psychologic adjustment of patients more than 16 years old. AB - The 79 female and 147 male patients constituting the population with cystic fibrosis (CF) aged 16 years and older attending The Hospital for Sick Children were asked to complete the Cornell Medical Index (CMI) and Tennessee Self-Concept Scale (TSCS); 64 female (81%) and 112 male (76%) subjects participated. Analysis of CMI results showed 43% of female subjects to have moderate to severe emotional disturbance compared to 19% of male subjects. This female : male ratio for severity of emotional disturbance is found in ostensibly healthy groups, but the percentages of disturbance approach values for medical patient populations. The frequency of emotional disability is greater in those more than 20 than in those 16-19 years old. The TSCS results portray a generally normal self-concept except for scores of positive physical self and psychosis for patients aged 20 years and older; these scores approach psychiatric values, suggesting that some reality distortion facilitates emotional adjustment to adult life with CF. The TSCS and CMI results correlate significantly, indicating a connection between self-concept and emotional status. However, TSCS and CMI scores do not correlate with measures of disease severity except for correlations between lung function and physical self-concept in older male patients. These results suggest that psychologic functioning is independent of the degree of physical impairment in older patients with CF, with the long-surviving male patients more realistically appraising the limitations their disease imposes and utilizing denial and minimization to a lesser degree. Demographic data on the clinic population reveal that most patients aged 16 years and older cope with their intellectual, developmental, and socioeconomic tasks commensurate with normal age expectations. PMID- 6484103 TI - [Suicide in schizophrenic patients. Reflections of the genesis and prevention based on case examples]. PMID- 6484104 TI - [Emotional stress and migraine; an exploratory empirical study]. PMID- 6484105 TI - [Female reasons for hysterectomy]. PMID- 6484106 TI - [Self image and physician ideal of preclinical medical students]. PMID- 6484107 TI - [Psychotherapy for psychiatric patients of advanced age]. PMID- 6484108 TI - [Paradoxical prescription as a single crisis intervention in family therapy during individual treatment of a patient with anorexia nervosa]. PMID- 6484109 TI - [Concept of the "unfulfilled life" in the work of Viktor von Weizsacker]. PMID- 6484110 TI - [Significance of verbal medical information for anxiety reduction and knowledge: an empirical study of patients with uterine prolapse]. PMID- 6484111 TI - [Attitude correlates of participation in cancer prevention studies]. PMID- 6484112 TI - Ethnic differences in pregnancy outcome. PMID- 6484113 TI - Comparative study of the age standardized cancer ratio (A.S.C.A.R.) in Liberia, Cameroon and the Moshi District of Tanzania. PMID- 6484114 TI - Alcohol-related birth defects. PMID- 6484115 TI - The prevention of coronary thrombosis. PMID- 6484116 TI - Infection of the central nervous system by Listeria monocytogenes: a review of 54 adult and juvenile cases. AB - The clinical features in 54 juvenile and adult patients with Listeria monocytogenes infection of the central nervous system are described. Thirty-one of the patients had pre-existing chronic disease; the remainder were previously healthy. Twenty of the patients, the 'meningo-encephalitic group' developed focal neurological signs. The remaining 34, the 'meningitic group' exhibited no focal signs other than those caused by increased intracranial pressure. The 'meningitic group' differed from the 'meningo-encephalitic group' in that the cerebrospinal fluid white cell count, protein and glucose levels were markedly more abnormal and the prognosis worse. Evidence of septicaemia was found only in the 'meningitic group'. Meningo-encephalitis may represent a modified response to listerial infection typified by granulomatous rather than a suppurative response. The predominance of this response that was demonstrated in females may indicate partial immunity, the result of previous Listeria monocytogenes colonisation of the female genital tract. Listeria monocytogenes infection is treatable and should be considered in patients with meningitic or encephalitic illness. Repeated blood cultures may be required to establish the diagnosis. PMID- 6484117 TI - Ulcerative colitis: why is the mortality from cardiovascular disease reduced? AB - A recent mortality study of patients with ulcerative colitis showed significant deficits in deaths from cardiovascular disease and from respiratory disease in males. The reasons for the observed deficits have been examined by studying the risk factors in a consecutive series of 103 patients with ulcerative colitis using matched controls. The patients and controls were assessed for age, sex, social class, alcohol and tobacco consumption. Height, weight and blood pressure were recorded and fasting blood samples were taken for serum lipid estimation. Patients with ulcerative colitis had significantly lower systolic and diastolic blood pressures and the changes were particularly marked in patients with extensive colitis and after panproctocolectomy. After matching for age, sex and social class the patients with ulcerative colitis smoked significantly less than controls. Serum lipid measurements were similar in both groups. The lower blood pressure may be related to sodium and water depletion particularly in ileostomy patients and those with extensive colitis. PMID- 6484118 TI - Comparison of the renal and skeletal actions of calcitonin in the treatment of severe hypercalcaemia of malignancy. AB - The hypocalcaemic response to salmon calcitonin was separated into its renal and skeletal components during the treatment of 21 patients with severe hypercalcaemia complicating malignant disease. Inhibition of renal tubular calcium reabsorption by calcitonin may induce a rapid fall in serum calcium. The magnitude of this response depends in part upon the correction of volume depletion which is a common feature of hypercalcaemia from any cause. The adequacy of rehydration can be assessed from the relationship between serum calcium and the calcium excretion rate expressed in mumol/l glomerular filtrate (CaE). Not all patients show a good renal response to calcitonin and this may reflect secretions by the primary tumour of substances which inhibit the renal tubular actions of calcitonin. The response to rehydration may identify such patients and this has obvious practical implications for the choice of treatment. PMID- 6484119 TI - Renal function during lithium treatment. AB - Renal function tests were performed in 101 unselected patients who had been on lithium for two weeks to 12 years. None had a recorded episode of lithium intoxication. The glomerular filtration rate (GFR), was not correlated with the cumulative dose of lithium or the duration of use of other psychotropic drugs. Nine patients had creatinine clearances lower than predicted; in six of these, no cause was identified and the small reductions in GFR may have been related to lithium use. Urinary concentrating ability (Umax) declined with age, and total dose of lithium received. Although the concurrent use of neuroleptics did not significantly reduce the Umax, the total duration of treatment with these drugs showed a negative correlation. The results suggest that prolonged use of neuroleptics, particularly in patients treated with lithium, may be responsible for an irreversible reduction in urine concentrating ability. Microalbuminuria was present in 40 per cent of the patients, although the rate of albumin excretion was not correlated with duration of use of psychotropic drugs. beta 2 microglobulin excretion was only raised in nine of these patients, suggesting that increased glomerular permeability rather than impaired proximal tubular protein reabsorption was responsible for the proteinuria. The urinary excretion of beta 2 microglobulin and N-acetyl-beta-glucosaminidase were slightly increased in small numbers of patients, indicating little evidence for proximal tubular damage. Increased NAG excretion did not correlate with reduced distal tubular function. However, there was a tendency to higher urinary beta 2 microglobulin excretion in patients with a reduced Umax. PMID- 6484120 TI - The liver in systemic lupus erythematosus. AB - A 12-month prospective study was undertaken to determine prevalence and causes of clinical and subclinical liver disease in 260 SLE patients and 100 controls, and to look for concordance between 'unexplained' enzyme elevations and SLE activity. Hepatic status was assessed clinically and by tests of liver function with additional tests where indicated. In 76 per cent of patients there were no clinical or laboratory abnormalities. Liver enzyme elevations occurred in 23 per cent. In 15 per cent there were identifiable causes, and in 8 per cent the elevations were 'unexplained', compared with none in the controls. Four patients had persistent 'unexplained' mild transaminase elevations. Liver tissue available from 14 patients revealed no serious lesions. Data on 156 patients with more than four assessments were analysed. In 12 of 15 patients with 'unexplained' transaminase elevations, changes in SGPT levels were concordant with SLE activity. This study suggests that subclinical liver disease is a manifestation of SLE. PMID- 6484121 TI - Costs of accuracy determined by a maximal growth rate constraint. PMID- 6484122 TI - Reject analysis: its role in quality assurance. AB - A reject analysis has been undertaken for a 26 week period in the radiology department of an oncological centre. The overall reject and repeat rates are presented here, as well as those arising from individual examinations and X-ray rooms. The variations in reject rates for different examinations as a function of time are highlighted and the role of reject analysis in quality assurance is discussed. PMID- 6484123 TI - The developing profession of radiography and the ISRRT. PMID- 6484125 TI - Magnetic resonance imaging using a resistive system. PMID- 6484124 TI - 'Teach-in' on magnetic resonance imaging. PMID- 6484126 TI - Advice on acceptable limits of exposure to nuclear magnetic resonance clinical imaging. National Radiological Protection Board. PMID- 6484127 TI - The 10-day rule: a misnomer. PMID- 6484128 TI - The 10-day rule. PMID- 6484131 TI - [Theory and practice of the determination of the effectiveness of roentgen examinations--a complex analysis toward decreasing the frequency of requests for roentgen diagnosis. 1. Theoretical principles, concept illustration and examples]. PMID- 6484129 TI - The lateral cervical. PMID- 6484130 TI - A simple idea to save on film for eye radiography. PMID- 6484132 TI - [Combined use of droperidol and xylocitin in peripheral arteriography]. PMID- 6484133 TI - [A method of intramural lymphography of the esophagus and stomach]. PMID- 6484134 TI - [Changed value of roentgen diagnosis in arthritis urica]. PMID- 6484135 TI - [Differentiation of osteolytic processes of the facial skull using polycyclic tomography]. PMID- 6484136 TI - [Buschke-Ollendorff syndrome--combination of dermatofibrosis lenticularis disseminata with osteopoikilosis]. PMID- 6484137 TI - [Roentgen findings in serologically negative rheumatoid arthritis]. PMID- 6484138 TI - The flat vertebra L5. Dysspondylia of the lower lumbar spine. PMID- 6484139 TI - [Simplified algorithm for the classification of the thoracic images in surgical lung diseases]. PMID- 6484140 TI - Radiological diagnostics in Hungary. PMID- 6484141 TI - [Gonadal protection in computerized tomography?]. PMID- 6484142 TI - [Quantitative concepts for evaluating the effectiveness of roentgen diagnostic studies--predictive value]. PMID- 6484143 TI - [Determination of indications for selected roentgen studies. Results of a statistical analysis of 11 types of study--over-all view]. PMID- 6484144 TI - [Problems of effectiveness in roentgen diagnosis]. PMID- 6484145 TI - [Indications for i.v. excretory urography]. PMID- 6484146 TI - [Indications for roentgen diagnosis of the colon]. PMID- 6484147 TI - [Scientifically based indications in roentgen diagnosis--cholegraphy]. PMID- 6484148 TI - [Indications for roentgen studies of the thorax. Results of a statistical analysis]. PMID- 6484149 TI - [Indications for roentgen studies: "preoperative thorax"]. PMID- 6484150 TI - [Indications for the demonstration of the lumbar spine]. PMID- 6484151 TI - [Indications for roentgen studies of the cervical spine]. PMID- 6484153 TI - [Frequency of roentgen studies during the healing of distal radius and fibula fractures]. PMID- 6484152 TI - [Indications for roentgen studies of the skull after trauma]. PMID- 6484154 TI - [Analysis of indications for roentgen studies of the wrist in suspected fracture]. PMID- 6484155 TI - [Roentgen studies in occupational fitness and monitoring examinations and in other preventive examinations]. PMID- 6484156 TI - [Necessity for roentgen diagnosis in occupational fitness and monitoring studies in the construction industry]. PMID- 6484158 TI - [Methods and results of a representative survey of radiation exposure of the population from roentgen diagnostic procedures]. PMID- 6484157 TI - [Consequences of the new international radiation protection recommendations for national radiation protection regulations in medicine]. PMID- 6484159 TI - [Radiation dosage to personnel occupationally exposed to radiation during roentgen diagnosis]. PMID- 6484160 TI - Thoracic tuberculosis, mycobacteriosis, MERosis, and BCGosis in a cancer treatment center. AB - Radiographs and clinical records of 100 patients with tuberculosis or mycobacteriosis and six patients infected with Bacillus Calmette-Guerin (BCG) or methanol extraction residue of BCG (MER) were reviewed. Radiographic presentations were categorized. Tuberculosis or mycobacteriosis simulated pulmonary neoplasm in 64 patients. Tuberculosis or mycobacteriosis complicated pulmonary neoplasm, hematological neoplasm, or acquired immune deficiency syndrome in 27. Coincident tuberculosis or mycobacteriosis and bronchogenic carcinoma were encountered in seven. Bronchogenic carcinoma developed in an area of chronic stable tuberculosis in three. Miliary granulomatous lesions developed in four following MER immunotherapy and in two following BCG immunotherapy. Differentiating tuberculosis or mycobacteriosis from bronchogenic carcinoma, metastasis, or pneumonia was difficult and biopsy was often necessary. PMID- 6484161 TI - Gastric restrictive surgery for obesity: early radiologic evaluation. AB - This study was undertaken to determine the optimal radiologic examination techniques for the period immediately following gastric restrictive surgery to control obesity. Review of 450 examinations performed on 275 patients who underwent varied gastric restrictive procedures indicates that accurate evaluation requires prompt filming of the first swallow of contrast material in a specific initial patient position with only minimal fluoroscopic monitoring. It was found that the optimal patient position can be predicted, before contrast material is administered, by the orientation of the staples on an abdominal radiograph. Right posterior oblique (RPO) is the optimal starting position when vertical staple lines follow gastroplasty with a lesser curvature channel. Left posterior oblique (LPO) is optimal when horizontal staple lines follow gastroplasty. LPO is usually optimal when complex or confusing staple patterns follow gastric bypass operations and revisions of previous procedures to control obesity. However, RPO is the optimal orientation when the revision procedure is a vertical gastroplasty. PMID- 6484162 TI - The reticular pattern as a radiographic sign of the Barrett esophagus: an assessment. AB - A two-part retrospective study was conducted to assess the value of a reticular pattern as a sign of columnar-lined esophagus. Radiographic, endoscopic, and histologic findings were reviewed in 124 patients with known Barrett esophagus; then all barium esophagrams done at our institution during a 3 1/2 month period were reviewed and presence of a reticular pattern was correlated with available endoscopic and histologic data. In patients with known Barrett esophagus, the reticular pattern was found in 26% of double-contrast examinations. Twelve of these patients underwent careful esophageal mapping biopsies: the pattern was in squamous mucosa with ulceration in two, in columnar epithelium with ulceration in six, and in columnar epithelium without ulceration in four. In the group of 314 unselected patients who had double-contrast examinations, the reticular pattern was found in 26 (8%). Thirteen of the 26 had had endoscopy and biopsy: the site of the pattern was located in a squamous carcinoma in one, in squamous epithelium adjacent to squamous carcinoma in three, in squamous epithelium with esophagitis in five (two of whom had columnar mucosa distally), in normal squamous mucosa in one, and in columnar epithelium with esophagitis in three. The reticular pattern is a strong indicator of important esophageal disease, but is not specific for Barrett esophagus. PMID- 6484163 TI - Development of lymphoma in patients with Crohn disease. AB - The authors report 3 cases of lymphoma developing in patients with Crohn disease. Neither a cause-and-effect relationship nor a common etiology could be proven. PMID- 6484164 TI - Diabetes mellitus: the predominant cause of bilateral renal enlargement. AB - The authors reviewed 102 cases of bilateral renal enlargement seen on excretory urography (excluding hydronephrosis and duplex kidneys) to determine the clinical significance of this finding. Associated abnormalities were found in 48 patients, including diabetes mellitus in 29; nondiabetic obesity, large body structures, or chronic steroid use in 16; acromegaly in 1; and unknown etiology in 37, 2 of whom were found to have diabetes five years later. Because of the striking preponderance of diabetes in this study, a fasting blood glucose analysis is recommended for patients with unexplained bilateral renal enlargement on excretory urography. PMID- 6484165 TI - Bone lesions in systemic lupus erythematosus. AB - Routine joint radiographs of 125 patients with systemic lupus erythematosus were studied. A total of 121 patients had a clinical history of articular symptoms. Cystic bone lesions were found in 51 patients (41%). The lesions, which were typically located subchondrally in the small joints of hands and feet, appeared as well-defined radiolucent areas surrounded by either normal bone or a narrow sclerotic zone. Nutritional disturbance in the bones, caused by the vasculitis associated with systemic lupus erythematosus, is proposed as a possible pathogenetic mechanism of the cystic lesions. PMID- 6484166 TI - Low (type III) odontoid fracture: a new radiographic sign. AB - Dens fractures are frequently difficult to identify radiographically, particularly when it is only possible to obtain a lateral radiograph of the upper cervical spine. Further, when a dens fracture is identified in lateral projection, it is often difficult to distinguish the "high" (Type II) from the "low" (Type III) fracture. The authors describe an elongated "ring" density superimposed upon the body of the axis in the lateral cervical radiograph which, when horizontally disrupted, indicates a dens fracture and is a specific radiographic sign of the "low" variety. PMID- 6484167 TI - Aortic root abscess resulting from endocarditis: spectrum of angiographic findings. AB - Abscesses in the aortic root are a serious complication of infective endocarditis and require accurate diagnosis for antibiotic and surgical management. Nineteen cases of endocarditis of a native valve or prosthetic valve and adjacent abscess cavities were identified with angiography. Of 6 patients with endocarditis of a native valve, 5 had bicuspid aortic valves and all had severe aortic regurgitation. Of 13 patients with endocarditis of a prosthetic aortic valve, all had paravalvular regurgitation. Abscesses in the aortic root were saccular, ranged from 1 to 3 cm in diameter, and, depending on sinus of origin, extended beneath the main and right pulmonary arteries or into the interventricular septum or mitral anulus. Fistulas were detected into the mitral anulus in 8 patients, and into the right ventricle in 3 patients. No complications from the catheterization were recorded during the 48-hour follow-up. PMID- 6484168 TI - Bolus geometry and dynamics after intravenous contrast medium injection. AB - Studies of contrast medium bolus geometry and dynamics were carried out to provide data for optimizing the use of contrast medium in digital subtraction angiography (DSA) and dynamic CT. Apparatus for fast digital recording of x-ray attenuation profiles was used; this is a new digital imaging mode (Chronogram) available on a CT scanner. Variables studied were injection site, injection speed, contrast medium volume, and subsequent saline injection; peak time, full width at half maximum, and maximum contrast enhancement were recorded. Positioning of the catheter in the vena cava reduced peak time and increased enhancement. High injection speeds led to shorter peak times. An increase in speed from 4 to 8 ml/s caused markedly higher enhancement, while further increase did not add significantly to enhancement. For a given injection speed, enhancement was increased and the peak time delayed by using larger injection volumes. Injection of saline solution after intravenous contrast medium did not change results significantly. There was a statistically significant correlation between pulse rate and peak time; the faster the pulse rate the shorter the peak time. PMID- 6484169 TI - Monooctanoin perfusion treatment of intrahepatic calculi. AB - Seventeen patients who had intrahepatic calculi underwent perfusion with monooctanoin. While five patients responded with a decrease in size or number of calculi, only one had a complete response; 12 showed no response; and one died during the perfusion (however, the perfusion was not believed to have contributed to the death). Fifteen of the 17 patients required further treatment by a combination of basket extraction, oral administration of chenodeoxycholic acid, or surgery. The lack of response to monooctanoin perfusion was in part due to calculus composition. Because of the poor response to this treatment and the prolonged hospitalization generally required, monooctanoin is not recommended for dissolution of intrahepatic calculi. PMID- 6484170 TI - Monooctanoin perfusion for in vivo dissolution of biliary stones. A series of 11 patients. AB - Monooctanoin, a cholesterol solvent, was infused into the biliary system of 11 patients. Twenty-eight (74%) of 38 total stones responded to monooctanoin: 16 (42%) decreased in size, and 12 (32%) dissolved completely. Ten stones (26%) did not change in size. We attribute this to inadequate drug-stone contact, which was corrected by placement of the infusion catheter contiguous to the stone(s). The use of a second catheter for biliary drainage avoided the side effect of biliary colic and increased patient compliance. An infusion rate greater than 5 ml per hour invariably produced pain and diarrhea. There were no significant side effects from monooctanoin in any of our patients when a two catheter system and an infusion rate of 5 ml per hour or less were used. A major drawback to use of this still experimental agent is the prolonged hospital stay. This may be ameliorated when at home use of monooctanoin is approved. PMID- 6484171 TI - Neonatal herpes simplex pneumonia: radiographic findings. AB - The radiologic findings in the lungs of 16 hospitalized neonates with disseminated herpes simplex infection were retrospectively reviewed. A sequential picture was devised of four stages in the evolution of the pneumonitis of this hematogenous infection. The radiologic stages were: Stage I, normal chest; Stage II, prominent perihilar interstitial markings; Stage III, coalescent areas of pulmonary infiltrates; and Stage IV, diffuse alveolar and interstitial disease ("white-out" lungs). In general, the pulmonary abnormalities were widespread and without air trapping. Pleural effusions were noted in one case. All affected neonates died and antemortem clinical and radiological findings were correlated with multiple-organ postmortem histopathologic evidence of viral infection, especially with the associated pneumonia. PMID- 6484172 TI - Occlusive vascular disease associated with cerebral arteriovenous malformations. AB - Selective carotid angiography and computed tomography were used in a study of the association of occlusive vascular disease with cerebral arteriovenous malformations in 13 patients. The arterial occlusions ranged from focal stenosis in the major artery supplying the malformation to complete occlusion of the supraclinoid internal carotid artery with subsequent development of "moyamoya" collaterals. The majority of the arterial occlusions were proximal to the vascular malformation. Some, however, extended distal to the major branch supplying the arteriovenous malformation (AVM). Selective angiography with subtraction techniques defines the distinct angioarchitecture of these AVMs and the associated stenoses and collateral telangiectases. PMID- 6484173 TI - Magnetic resonance imaging of pituitary lesions using 1.0 to 1.5 T field strength. AB - Six patients with pituitary abnormalities and three normal volunteers were evaluated by high field superconductive (1.0, 1.4, or 1.5 Tesla) magnetic resonance (MR) imaging, low field resistive (0.12 Tesla) MR imaging, and contrast enhanced, high-resolution CT. Four macroadenomas, one microadenoma, and one empty sella were demonstrated. Their morphology and anatomic relationship to the visual pathway and the internal carotid and anterior cerebral arteries were best demonstrated by high field MR imaging. The low field resistive MR studies were least effective in showing the lesions. PMID- 6484174 TI - A strategy for magnetic resonance imaging of the head: results of a semi empirical model. Part I. AB - This paper is an introduction to lesion detection problems of MR. A mathematical model previously developed for normal anatomy has been extended to predict the appearance of any hypothetical lesion in magnetic resonance (MR) images of the head. The model is applied to selected clinical images to demonstrate the loss of lesion visibility attributable to "crossover" and "boundary effect". The model is also used to explain the origins of these problems, and to demonstrate that appropriate gray-scale manipulations can remedy these problems. Specifically, pulse sequences that cause lesions to be the brightest tissue in the image are shown to eliminate the problems of crossover and boundary effect. PMID- 6484176 TI - The facial nerve canal: CT analysis of the protruding tympanic segment. AB - The development and subsequent course of the facial nerve canal are complex. High resolution computed tomography (HRCT) provides an opportunity for the study of this often perplexing structure. Normal anatomy and normal variations of the facial nerve canal must be considered when examining patients who have facial nerve palsy referrable to the temporal bone. The author recommends direct axial and coronal imaging supplemented by sagittal and possibly oblique reformations. PMID- 6484175 TI - A strategy for magnetic resonance imaging of the head: results of a semi empirical model. Part II. AB - A semi-empirical model was used to identify specific pulse sequences that cause most lesions to appear distinctly brighter than normal tissues in magnetic resonance (MR) images of the head. Clinical trials confirm the utility of these sequences for patient screening. As a result, a strategy for effective and efficient MR imaging of the head is proposed. The previously described gray-scale model has been modified to account for the effect of image noise. By means of computer simulation, 13,800 different hypothetical cerebral lesions were imaged with a variety of pulse sequences. A number of conclusions resulted. First, two sequences are expected to be sufficient to visualize most intracranial lesions, a "diagonal" SE sequence (e.g., SE 2500/80) and an IR sequence with a short inversion time (e.g., IR 1800/200). These sequences are orthogonal, i.e., lesions missed by one are likely to be detected by the other. Second, signal averaging the screening sequences is expected to be more effective than optimized sequences when lesion tissue parameters differ little from brain. Finally, the effectiveness of unaveraged screening sequences suggests that improved signal-to noise ratio (SNR) is not necessary for the detection of most large lesions. Therefore, the increased SNR achievable through signal averaging or increased field strength might best be utilized to improve spatial resolution so that smaller lesions can be detected. PMID- 6484177 TI - The pituitary fossa: a correlative anatomic and MR study. AB - This study characterizes the normal appearance of the pituitary fossa in partial saturation magnetic resonance (MR) images. In sagittal images, the pituitary fossa appears inhomogeneous. Correlation of sagittal MR images in normal subjects with sagittal cryomicrotomic images in cadavers suggests that the highest intensity signal from the posterior-inferior pituitary fossa is due to a fat pad. This conclusion was supported by MR images and postmortem cryotome sections obtained in normal subhuman primates. The cause of the less constant, low intensity signal was less certain. The height of the pituitary gland in sagittal images was usually less than 8 mm, and the upper surface was flat or concave. PMID- 6484179 TI - Experimental pulmonary emboli detected using magnetic resonance. AB - Experimental pulmonary emboli that were labelled with non-magnetic barium threads and produced using aminocaproic acid were introduced into the internal jugular veins of five dogs. Transverse axial magnetic resonance (MR) images (0.35 T, 15 MHz) and CT scans (2.0 or 4.8 seconds, G.E. 9800 or 8800 scanner) were obtained from the lung apex to base in each animal. The MR images were gated to the cardiac cycle, and spin echo techniques were used (TR = gated to the cardiac cycle; TE = 28 and 56 msec). Nineteen sites of embolism were determined from the CT scans. Two observers, who had no knowledge of the number or position of the emboli, individually assessed the MR images and marked the sites of emboli on clear acetate overlays. Each observer detected 12 of 19 emboli (63%) and each had one false positive result. Of the 19 emboli, six were central or parahilar and 13 were in the outer two thirds of the lungs. Three (first observer) or four (second observer) of the seven false negative results were central. In retrospect, two central emboli were mistaken for hilar fat. One peripheral embolus was not visible, even in retrospect. The potential for MR to demonstrate relatively small pulmonary emboli has been shown. Clinical trials in patients seem warranted. PMID- 6484178 TI - Magnetic resonance imaging strategies for heart studies. AB - Given a suitable trigger signal, cardiac synchronized magnetic resonance (MR) imaging is simple to implement; however, single section techniques are not efficacious, especially when the heart rate sets the repetition interval. We demonstrate multi-section, double, and single-echo imaging, any of which rapidly covers the cardiac volume; 3-D modes capable of achieving very thin sections; and cycled multi-section imaging capable of efficaciously providing dynamic data on heart motion. These modes form a complementary, powerful set of options for clinical work. PMID- 6484180 TI - Pulmonary embolus: detection and follow-up using magnetic resonance. AB - Magnetic resonance imaging (MRI) of an angiographically confirmed pulmonary embolus was performed. The thrombus appeared as an intense intraluminal signal within the left descending pulmonary artery; this signal was absent on repeat examination after clot lysis. Because MR will not image flowing blood, it provides a potential method of non-invasive identification of stationary emboli within the pulmonary vascular tree. PMID- 6484181 TI - Magnetic resonance imaging systems: optimization in clinical use. AB - Magnetic resonance (MR) imaging confronts the user with a large number of options that can critically affect image quality. Among the most important parameters over which the user may exercise control are receiver frequency, tip angles, imaging and compensatory gradient strengths, the number of signals averaged, the number of phase encoding gradient steps, and the repetition times. All of these parameters were systematically varied and optimal values determined for a 0.5T Teslacon system, a task which employed both phantoms and normal volunteers. Under the normal conditions of tuning, the z-compensatory gradient presents the most critical adjustment. The compromise between image quality and time of study was also carefully examined, with the following determined as best: 192 gradient steps plus two signal averages for the head coil, or 192 gradient steps plus four signal averages for the body coil. PMID- 6484182 TI - The superior sinus of the pericardium: CT appearance. AB - On computed tomography, a mass-like density is often observed, just posterior to the ascending aorta, that occasionally has been mistaken for mediastinal lymph node enlargement. Cadaver studies confirmed this retroaortic structure to be an extension of the pericardial cavity, the superior sinus. Current anatomic texts sometimes depict this space without description. Anatomic studies revealed the presence of a superior sinus in all of the 28 cadavers studied. The mean cross sectional diameter of the sinus in a coronal plane was 2.5 cm with a range from 1.2 to 3.8 cm. Retrospective review of 116 consecutive adult chest computed tomographic examinations disclosed its presence in 49%. In 15% of the total, the size of the sinus was sufficiently large potentially to simulate mediastinal lymphadenopathy. This normal variant has a characteristic location, shape, and attenuation value by CT that should allow recognition and prevent misinterpretation. PMID- 6484183 TI - Patients with hemoptysis examined by Tc-99m sulfur colloid and Tc-99m-labeled red blood cells: a preliminary appraisal. AB - A prospective study of 16 patients with hemoptysis was conducted over a 2 1/2 year period. Technetium-99m sulfur colloid (Tc-SC) and technetium-99m-labeled red blood cells (Tc-RBC) were sequentially used to identify the general area of bleeding. Tc-SC accurately located the bleeding area in 3 patients and Tc-RBC identified the bleeding area in 8; there were no false-positive studies. Tc-SC scans were positive at 6-10 minutes and all patients had positive Tc-RBC studies. In general, the scans accurately located the source of bleeding as determined by bronchoscopy and/or surgery. Because of the small sample, statistically significant differences between both techniques were not ascertained. Both Tc-SC and Tc-RBC may prove to be helpful, minimally invasive imaging procedures for determining the general area of hemorrhage in patients with clinically significant hemoptysis. Although a trend suggests that Tc-RBC is a more sensitive method, further comparison is needed for corroboration. PMID- 6484184 TI - Liver-spleen studies with the rotating gamma camera. II: Utility of tomography. AB - A prospective comparison of conventional scintigrams and single-photon emission computed tomography (SPECT) studies of the liver and spleen was carried out. Care was taken to insure high-quality, artifact-free studies. Two hundred patients were imaged by both methods. A definitive diagnosis of normal was established in 86 cases, abnormal in 107 cases, and seven cases were indeterminate. All studies were read by two observers and graded as to degree and type of abnormality seen. ROC curves were constructed and errors of interpretation studied to identify problems. One observer showed no difference in performance between the two methods. The other showed a small improvement with SPECT. Image artifacts apparently contributed to errors of interpretation in 24 of 54 cases using SPECT. SPECT appears comparable with conventional scintigraphy and may improve specificity. Improvements are needed in SPECT imaging equipment and image display capability to realize fully the potential of SPECT. PMID- 6484185 TI - Osteoid osteoma: excision with scintimetric guidance. AB - The definite diagnosis of osteoid osteoma relies on the demonstration of the nidus, best shown by CT, which also provides precise preoperative localization of the nidus. While bone-block excision to remove the nidus is feasible in the long bones, there may be unacceptable sequelae in the vertebral column and small bones of the hands. By precisely localizing the nidus, radionuclide scintimetry permits excellent therapeutic results, with minimal morbidity. PMID- 6484186 TI - Oral contrast agents in CT of the abdomen. AB - Optimal opacification of the small bowel is important in the interpretation of abdominal CT. Two contrast agents, a barium suspension and an iodinated, water soluble material, were evaluated in a blind prospective study of 54 patients. A grading system of small bowel opacification was developed. There was no significant difference between the two agents in opacification of the small bowel. PMID- 6484188 TI - Pelvic and acetabular fractures: examination by angled CT scanning. AB - A new technique of direct angled CT scanning of pelvic and acetabular fractures is presented that allows visualization of the entire ring on a single image or two adjacent images. PMID- 6484187 TI - Monooctanoin dissolution of gallstones via a cholecystostomy tube. AB - Monooctanoin was infused through a cholecystostomy tube to dissolve multiple gallstones and re-establish cystic duct patency in a patient who was not a candidate for surgery. PMID- 6484189 TI - Manpower, entrepreneurs, and antitrust. AB - The problem of nonradiologists practicing radiology is discussed. The trend toward moving the practice of radiology out of the hospital and into the office setting favors the entrepreneur, radiologist and nonradiologist alike. Many clinicians are setting up offices with radiological facilities. Because of the threat of antitrust litigation, radiological societies may be discouraged from speaking out against this practice. PMID- 6484191 TI - 70th Scientific assembly and annual meeting: the Radiological Society of North America. Washington, D.C., November 25-30, 1984. Scientific sessions, refresher courses, works in progress. PMID- 6484190 TI - The Tc-99m thyroid index as an easily measured parameter of Tc-99m thyroid uptake. PMID- 6484192 TI - Brain tumor biology. PMID- 6484193 TI - Heterogeneity of tumor cell DNA content. PMID- 6484194 TI - Stem cell sensitivity. PMID- 6484195 TI - Brain tumor therapy. PMID- 6484196 TI - Immunotherapy of patients with glioma: fact, fancy, and future. PMID- 6484197 TI - Radiation necrosis. PMID- 6484198 TI - Novel fractionation schemes and high linear energy transfer. PMID- 6484199 TI - Stereotactic interstitial brachytherapy for malignant brain tumors. PMID- 6484200 TI - Human brain tumor xenografts. PMID- 6484202 TI - Hyperthermia--basic biology. PMID- 6484201 TI - Combined effects of drugs and radiation against tumor cells. PMID- 6484203 TI - Feasibility of microwave hyperthermia for brain tumor therapy. PMID- 6484204 TI - Feasibility of treating malignant brain tumors with focused ultrasound. PMID- 6484205 TI - Therapeutic potential for blood-brain barrier modification in malignant brain tumor. PMID- 6484207 TI - [High performance liquid chromatography of amino acids and polyamines utilizing NBD-F as a precolumn labeling reagent]. PMID- 6484206 TI - The potential of monoclonal antibodies as carriers of radiation and drugs for immunodetection and therapy of brain tumors. PMID- 6484208 TI - [Alpha #1----2 fucosidase of Bacillus fulminans]. PMID- 6484209 TI - [Almond alpha-L-fucosidases]. PMID- 6484210 TI - Synthesis and platelet aggregation inhibition activity of a series of enantiomeric bicyclo[3.2.0]heptane-6-oximinoacetic acids (1). AB - Opening of racemic epoxide (3) with (3S)- or (3R)-dimethyl-3-(dimethyl-t butylsilyloxy)oct-1-ynyl aluminum gave two regioisomers, which were separated chromatographically. The separated regioisomers, themselves mixtures of chromatographically inseparable diastereoisomers, were converted into their dicobalthexacarbonyl complexes, which were easily resolved and isolated by chromatography. The individual diastereoisomers were deprotected to give bicyclo[3.2.0]heptan-3-ones, whose absolute stereochemistry was assigned using circular dichroism. One of these compounds, (1R,2R,3S,5R,3'S)-3-(3'-hydroxyoct-1' ynyl)-bicyclo[3.2.0]++ +heptan-2-ol-6- oximinoacetic acid (11a) was 4.5 times more potent than PGE1 in inhibiting the ADP-induced aggregation of human platelets. The next most potent compound in this series was the "ent-15-epi" compound (11b), which was 0.034 times the potency of PGE1 in the platelet aggregation assay. PMID- 6484211 TI - Changes in thymidine uptake in the gastrointestinal tract of the rat following treatment with 16,16-dimethyl prostaglandin E2. AB - Thymidine uptake in the organs of the gastrointestinal tract of the rat was studied to determine if cell synthesis was involved in the increases in weight of the stomach, small intestine and colon which result from treatment with 16,16 dimethyl prostaglandin E2 (16,16-dimethyl PGE2). Animals were treated for 2 days with 16,16-dimethyl PGE2. They were injected with the 3H-thymidine, sacrificed and the organs of interest were removed. The total amount of tritium in the stomach, duodenum, jejunum, ileum, and colon was determined. Thymidine uptake was significantly increased in the duodenum (1.50 times), jejunum (1.53 times), and colon (1.40 times) but not in the stomach and ileum. The increases were dose related in the duodenum and jejunum. The colon showed a similar dose response pattern but the changes with dose did not reach significance. These results confirm and extend a previous report that 16,16-dimethyl PGE2 increased thymidine uptake in the duodenum but not the stomach. This is different from gastrin which has been shown by others to increase thymidine uptake in the stomach, duodenum, ileum and colon. PMID- 6484213 TI - Abstracts of the NATO Advanced Research Workshop on Icosanoids and Ion Transport. November 17-18, 1983 Paris. PMID- 6484212 TI - Study of mechanisms mediating contraction to leukotriene C4, D4 and other bronchoconstrictors on guinea pig trachea. AB - Contractions of guinea pig trachea in the absence and presence of indomethacin to LTD4 greater than LTC4 greater than K+ greater than histamine greater than acetylcholine were reduced following a 45 minute exposure of the tissues to calcium-free Krebs' solution (Ca2+-free Krebs' solution), were further reduced by a transient exposure to EGTA (1.25 mM) in Ca2+-free Krebs' solution and were virtually abolished when tested in the presence of EGTA (0.125 mM) in Ca2+-free Krebs' solution. In normal Krebs' solution (2.5 mM Ca2+) the Ca2+ entry blockers nifedipine (N) much greater than D-600 greater than verapamil (V) greater than diltiazem (D) almost completely abolished the contractions to K+ but blocked only a component of the maximum response to the other agonists. After exposure to Ca2+ free Krebs' solution for 45 minutes, any residual contractions to LTC4 & LTD4, were reversed by low concentrations of N (0.3 microM) or D-600 (2.1 microM). Leukotrienes appear to mobilize a superficial and a bound store of Ca2+ which gains entry through at least two types of Ca2+ channels (or mechanisms), one of which is blocked by N and D600. K+-induced contractions appear to be dependent on superficial and tightly bound Ca2+ but entry is solely through channels which are blocked by the Ca2+ entry blockers studied. Contraction to histamine and acetylcholine persisted following exposure of the tissues to Ca2+ free Krebs' solution but contractile activity was virtually abolished in Ca2+ free Krebs' solution containing EGTA. Residual contractions to histamine and part of the residual contractions to acetylcholine in Ca2+-free Krebs' solution were blocked by low dose N (0.3 microM) or D600 (2.1 microM). These findings suggest a major role for extracellular Ca2+ during spasmogen-induced contraction in this tissue. PMID- 6484214 TI - Temporal response of uterine prostaglandins to estradiol treatment in the ovariectomized-pregnant rat. AB - Previous studies in our laboratory have shown that 24 hours of estradiol treatment significantly enhanced uterine prostaglandin (PG)F, PGE and thromboxane B2 (TxB2) levels but had no effect on 6-Keto-PGF1 alpha (6KF) concentrations in ovariectomized-pregnant rats. One explanation for the lack of an augmentation in 6KF was a temporal difference in response (i.e. 6KF increased and decreased within the 24 hour period). To test this possibility rats were ovariectomized on day 19 of pregnancy and sacrificed 0, 4, 8, 12, 16, 20 and 24 hours after estradiol treatment. Uterine tissue and venous plasma were analyzed for PGs by radioimmunoassay. No significant (p greater than .05) alterations were detected for any of the uterine PGs at 0, 4, 8 and 12 hours. However, at 16 hours PGF, TxB2 and PGE all showed significant (p less than .05) increases (2.4, 3.4 and 2.1 fold, respectively) compared to 12 hours. In contrast, no significant augmentation in 6KF levels (p greater than .05, 1.3 fold) was detected at 16 compared to 12 hours although it was enhanced relative to 0 and 4 hours. In addition, PGF, TxB2 and PGE, but not 6KF, showed further increases 24 hours after estradiol administration. No alterations were found (p greater than .05) for any of the PGs in uterine venous plasma at the time points studied. In summary, uterine PGF, PGE and TxB2 net production appears to be more enhanced by estradiol treatment than 6KF at the time points studied. In addition, there is a slight, but significant, difference in the temporal response characteristics of 6KF compared to the other PGs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484215 TI - Effect of indomethacin in vivo on prostaglandin content of several rabbit tissues. AB - The prostaglandin (PG) content of several tissues and fluids from 6 day pregnant rabbits was evaluated following treatment with indomethacin or vehicle in vivo. PGE and PGF were measured by radioimmunoassay. More complete depletion of PGE and PGF was accomplished by 3 injections of indomethacin (s.c.) given during the 18 h before sacrifice at a dose of 10 mg indomethacin per kg body weight than was accomplished by 1 injection of the same amount of indomethacin (i.v.) 1.5 h before sacrifice. Levels of PGF were more easily depressed by indomethacin than were those of PGE. PG levels in the kidney and blastocysts were depressed to a greater extent by indomethacin than were those in the uterus, uterine fluid or peritoneal fluid. Evaluation of the effect of indomethacin on a particular physiological function should be interpreted with caution unless the extent of PG depletion in that tissue is also measured. PMID- 6484216 TI - A new PGE1 analogue (CL115,574) III. Effects on gastric acid and mucus secretion in man. AB - CL115,574, an analogue of PGE1, is a potent inhibitor of gastric acid secretion in animals. The effects of this compound on gastric acid and mucus secretion were studied in 8 male volunteers. The compound was well tolerated, and its maximally effective antisecretory dose (750 micrograms) inhibited pentagastrin stimulated acid secretion by approximately 40% over a 2-hour period, with stimulation beginning one hour after the drug was orally administered. CL115,574 proved to have a significant and sustained effect upon the stimulation of mucus secretion into gastric juice. Considering the possible role that mucus may play in mucosal cytoprotection, CL115,574 because of its antisecretory and mucogenic actions may prove to be an important clinical anti-ulcer compound. PMID- 6484217 TI - [Ecology of fungi in the work area and the incidence of mycoses in Polish railroad workers]. PMID- 6484218 TI - [Kaposi's sarcoma]. PMID- 6484219 TI - [Photochemotherapy of various types of psoriasis--evaluation of the durability of the results of treatment]. PMID- 6484220 TI - [Photochemotherapy of pustular psoriasis of the palms and soles]. PMID- 6484222 TI - [Psychoanalysis in West Germany]. PMID- 6484221 TI - [Clofazimine in the treatment of impetigo herpetiformis]. PMID- 6484223 TI - [Discontent in psychoanalysis and discontent with its criticism]. PMID- 6484224 TI - [Sad psychotropes?]. PMID- 6484225 TI - [Psychiatry in Africa between tradition and modern methods]. PMID- 6484226 TI - [Suicide and depression in Senegal and in Africa]. PMID- 6484227 TI - [Observations on traditional African medicine--report on an annually occurring celebration of the ill in Senegal]. PMID- 6484228 TI - [Compulsion in the service of self-preservation]. PMID- 6484229 TI - [The psychoanalytic rule of abstinence. From rule-bound to operational application]. PMID- 6484230 TI - [Transvestism in men]. PMID- 6484231 TI - [Transvestite symptom formation. Clinical contribution to the etiology, psychodynamics and analyzability of male transvestite patients]. PMID- 6484232 TI - [Radiological aspects of invasive pulmonary aspergillosis]. AB - The radiological features of invasive pulmonary aspergillosis, observed in 20 patients with hematologic malignancies, are reported. From the analyses of the initial signs and their modifications in the course of the disease it was possible to identify some aspects strongly suggestive of the mycotic nature of the pulmonary lesions. Rounded pneumonia and hemorrhagic infarction often complicated by cavitation with or without intracavitary nodule are the most suggestive aspects, and the latter carry good prognostic significance. PMID- 6484233 TI - [Urethro-vaginal reflux]. AB - The authors, after a review of few works found in literature, report 33 cases of urethro-vaginal reflux in girls. They analyse the radiological and clinical aspects of this phenomenon that can be considered as border line. Finally the authors point out that the urine collected through urine specimen collector could be contaminated by vaginal bacteria in connection with urethro-vaginal reflux. PMID- 6484234 TI - [Combination of arthrography and computerized tomography in the study of the femoro-patellar joint]. AB - 90 patients affected by knee pains underwent CT study of the femoropatellar joint as an adjunct to double contrast arthrography. CT findings proved to be useful for optimal evaluation of patellar malpositions and especially in the diagnosis of chondromalacia patellae. PMID- 6484235 TI - [Computerized tomography in the diagnosis of a herniated cervical disk ]. AB - A total number of 117 cervical herniated disks was observed in 103 patients. Among these, 30 underwent surgical treatment. A comparison is made between CT findings and myelographic and surgical data. Purpose of the investigation is to define the reliability of CT in the diagnosis of cervical herniated disk. The morphology, level and tomographic localization into the vertebral canal are described. Moreover the possible association with spondylosis and "narrow canal" is stressed. The diagnosis was correct in all operated cases (100%). The topographic description too was correct in all cases. In 3 patients the level diagnosis was mistaken. CT shows a higher degree of sensibility and specificity than myelography in the diagnosis of herniated disk in the cervical spine. PMID- 6484236 TI - [Computerized tomography in cerebellar atrophy]. AB - Among 5680 patients who had CT cranial scans at the Radiological Service of the Hospital of Pordenone we selected by their histories and clinical findings and CT images 31 patients showing the signs of a cerebellar atrophic process. We compared CT scans with clinical symptoms; we found a correlation in 71% among CT abnormalities and clinical findings; in 22.5% CT showed an infratentorial atrophy, but clinical symptoms were absent; in 6.5% the CT scans were normal, although was present a cerebellar syndrome. We conclude that CT is an important and significative method in the diagnosis of posterior fossa degeneration, taking so the place of pneumoencephalography. PMID- 6484237 TI - [Computerized dosimetry in curie therapy]. AB - Automatic treatment planning for calculation of absorbed dose in curietherapy has been performed at the Istituto Nazionale Tumori of Milano on a routine for some years. The radioactive implant is reconstructed from orthogonal or stereo roentgenograms, a tabular listing of doses or dose rates can be obtained on the grid of points and the isodose curves are automatically drawn with the projection of sources onto the selected planes of calculation by an interactive plotter. PMID- 6484238 TI - [Analysis of the reasons for the rejection of radiographic films in radiodiagnosis]. AB - After a study of quality control on about 30 radiological equipment and two dark rooms, we are now presenting an analysis of 1806 radiological examinations with 5011 films; the reject is 6.2%, namely 311 films. The analysis of the causes of the reject gives the following results: the more important cause is the error of exposure (52.7% of total reject), followed by geometrical and collimation defects (14.4%) and by the movement of the patient (13.2%). Our results are discussed and compared with other similar data. PMID- 6484239 TI - [Pathogenetic considerations on traumatic lesions of the base of the skull: fracture of the back of the sella]. PMID- 6484240 TI - [Complex systemic-pulmonary arteriovenous fistula]. PMID- 6484241 TI - [Cystic polypoid gastritis on a gastroenterostomy: apropos of a case]. PMID- 6484242 TI - [Lipoma of the diaphragm: tomodensitometric diagnosis]. PMID- 6484243 TI - [Persistence of the sciatic artery in an adult]. PMID- 6484244 TI - [Value of computerized tomography in the early detection of pelvic recurrences in patients subjected to resection of rectal cancer]. AB - Forty eight patients surgically treated for carcinoma of the rectum were by computed tomography (CT) during routine follow up to test the value if this procedure in the early diagnosis of pelvic recurrences. We used a protocol which schedules controls at different intervals for Dukes A e B and for Dukes C patients; CT showed pelvic recurrences in 13.3% of the Dukes A e B and in 50% of Dukes C cases. CT seems to be the most reliable presently available test in detecting early extraluminal recurrence after radical resection for rectal cancer. PMID- 6484245 TI - [Electrophysiologic study of pre-excitation syndromes in our environment (V)]. PMID- 6484246 TI - [Cells in the pleural fluid. Their use in the differential diagnosis of pleural effusion]. PMID- 6484247 TI - [Double primary neoplasms in the respiratory tract]. PMID- 6484249 TI - [Amyotrophic lateral sclerosis. Clinical evaluation and therapeutic response to ara-A]. PMID- 6484248 TI - [Transthoracic biopsy with a spiral needle. 2 years' experience]. PMID- 6484250 TI - [Oculomotor paralysis in bacterial meningitis. Incidence and prognostic value]. PMID- 6484251 TI - [Bacterial diuresis (colonies per minute) in the diagnosis of urinary infections]. PMID- 6484252 TI - [Primary aortoenteric fistula and severe postoperative hypertension]. PMID- 6484253 TI - [Leiomyosarcomas of the small intestine]. PMID- 6484254 TI - ["One-and-a-half" syndrome as a manifestation of a spontaneous hematoma of the brainstem]. PMID- 6484255 TI - [Acute muscular weakness secondary to the ingestion of clopamide]. PMID- 6484256 TI - [Interstitial pneumonitis and amiodarone]. PMID- 6484257 TI - [Insulin-dependent juvenile diabetes. Descriptive study in the Rhone Department]. AB - A systematic study of juvenile onset diabetes cases observed in the Rhone department between 1960 and 1979 indicates an annual incidence of 4.7/10(5) children from 0 to 15 years of age. This incidence is lower than that which has been reported for Great Britain and some Scandinavian countries. There was a surprisingly high incidence among immigrant children from North Africa (10.2/10(5) children) and also in some urban areas (middle-sized cities and the southeast suburb of Lyon). Farmers' children seem more often affected than others. The seasonal trend cited in earlier studies was also noted here for children between 5 and 15 years of age. These findings are compatible with the concept that environmental factors play some role in the onset of juvenile diabetes. PMID- 6484258 TI - [Methodologic contribution to determining maximum occupational exposure levels for asbestos. Exposure-risk relation and economic criteria]. AB - It is not easy to set exposure limits for industrial carcinogens when only biological and epidemiological criteria are used. Hence, criteria should also include relevant social and economical considerations. This paper, using asbestos exposure as an example, explains how the economic aspects of prevention may be taken into account. The methodology includes three stages: use of the exposure risk models in order to estimate the residual health effects associated with asbestos, according to various exposure limits, evaluation of costs of preventive measures required by these exposure limits, discussion of the exposure limits--a synthesis of the two preceding stages. PMID- 6484259 TI - [Model for evaluation of occupational mortality related to asbestos (the case of the asbestos industry in France between 1950 and 1980)]. AB - This article presents an evaluation model of the mortality attributed to asbestos occupational exposure. French workers exposed at least ten years between 1950 and 1979 constitute the population studied. Exposure-risk relations are used to estimate mortality from lung cancer, mesothelioma, or asbestosis, and the associated reduction of life expectancy among 76 groups (about 18,500 workers) defined by their level of asbestos exposure. The most important results are presented and discussed as are the main hypotheses regarding historical exposure parameters. PMID- 6484260 TI - [Elements of descriptive epidemiology on human brucellosis in North Corsica (France) (from 1976 to 1981)]. AB - Brucellosis constitutes a true public health problem in Upper-Corsica. The purpose of this epidemiologic study carried out in the department was to better determine the parameters of this endemic disease in order, first, to plan--and, later, to evaluate--the prophylactic measures adopted by the authorities concerned. The methodology was based upon the number of cases reported by general practitioners and by directors of pathology laboratories. The major result was to establish the fact that the disease very widely affects the general population. The majority of cases recorded are among urban dwellers, indirectly contaminated through the consumption of local, unsterilized, dairy products. Thus, preventive measures should concentrate principally on promoting improved inspection of the products concerned and on public health education. PMID- 6484261 TI - [Measurement of agreement between 2 judges. Qualitative cases]. AB - The degree of concordance between two observers in the qualitative case is represented by the kappa coefficient (with or without weighting). The practical use of kappa is specified. The variances of kappa estimates under the null hypothesis (independence of the classifications) and for any value of kappa are given, together with the conditions for their use in statistical testing. PMID- 6484262 TI - [Development of hydatid cysts in Southwest France during a 20 year period]. PMID- 6484263 TI - Assessing the contribution of changes in maternal age and parity to the decline in rates of reproductive mortality. PMID- 6484264 TI - [Economic analysis of the dissemination of a medical innovation: prenatal diagnosis by early amniocentesis as an example. Part 1. Epidemiologic, medical and socioeconomic bases. The dissemination of a diagnostic innovation]. AB - The article offers a detailed analysis of the characteristics of the supply and demand of prenatal diagnosis by amniocentesis in order to identify the major problems that must be faced in formulating a policy designed to diffuse the use of this technique. The data collected for the whole of France made it possible to evaluate exhaustively the increase in the number of prenatal diagnoses during the years 1972-1981; to determine the number and geographic distribution of the diagnostic centers; to identify the medical criteria justifying the examinations. A comprehensive survey covering all examinations performed in the Ile de France (Paris region) in 1979--which constituted 46.5% of all the prenatal diagnoses performed in France that year--made it possible to determine the predominant socioeconomic characteristics of the women who took this examination, revealing, particularly, the significant inequalities of access, with an underrepresentation of the least privileged socioprofessional categories. The confirmation of the influence of socioeconomic status on access to this medical innovation is further reinforced by the fact that usage rates vary widely according to place of residence; furthermore, it adds to the financial barriers implicit in any policy of having reimbursement of the examinations dependent upon Social Security conventions. A public health policy regulating the diffusion of this innovation must take into account the discriminatory aspects of the first phase of diffusion, as analyzed here. PMID- 6484265 TI - [Reimplantation of Vater's papilla; a new indication and technic]. PMID- 6484266 TI - [Etiologic study of alithiasic chronic cholecystitis]. PMID- 6484267 TI - [Value of the intravenous galactose test in the diagnosis of extrahepatic cholestasis]. PMID- 6484268 TI - [Surgical treatment of hepatic abscess]. PMID- 6484269 TI - [Incidence of inflammatory pancreatic injuries in 1,131 necropsies]. PMID- 6484270 TI - [Alpha 2-globulins in the biologic diagnosis of gastric carcinoma. Behavior of ceruloplasmin]. PMID- 6484271 TI - [Clinico-macroscopic correlations of gastroduodenal leiomyomas]. PMID- 6484272 TI - [Eosinophilic gastroenteritis: a case of 35 years' development]. PMID- 6484273 TI - [Villous adenoma of the duodenum with carcinomatous degeneration]. PMID- 6484274 TI - [Hepatic amebic abscess]. PMID- 6484275 TI - [Toxic megacolon in chronic inflammatory and idiopathic disease of the colon. When should surgery be practiced? What surgical intervention should be undertaken?]. PMID- 6484276 TI - [Surgical treatment of residual choledocholithiasis: our experience and results]. PMID- 6484277 TI - [Behavior of the motor neurons of the external oculomotor nucleus during vestibular stimulation in the waking cat]. AB - The electrical activity of abducens motoneurons during sinusoidal stimulation of the head has been recorded in alert cats. Recorded motoneurons were identified by their antidromic activation from the VIth nerve. The profile of motoneuronal firing rate showed a sinusoidal modulation leading eye position in the orbit. Motoneuron firing rate was decomposed in two separate components, proportional and in phase with eye position (k) and velocity (r), respectively. Time constant of each motoneuron, calculated from phase lead analysis, was similar to that calculated from k and r coefficients. Functional implications of described findings are discussed. PMID- 6484278 TI - Metabolic levels in dogfish gill tissue after zinc treatments. AB - Dogfish were subjected to acute (80 ppm/24 hours) and subacute (10 ppm/21 days) zinc treatments before measuring the ATP, glycogen, protein, and lactate levels. Acute treatment varies significantly the levels of all the metabolites tested while only protein content is significantly lower after subacute treatment. The results are discussed in relation to the hypoxia effect produced by the metal and the related responses of the fish. PMID- 6484279 TI - Choleretic response to hydrocortisone in the rabbit. AB - The influence of i.v. infusion of hydrocortisone sodium succinate on basal biliary secretion and maximal hepatic excretion of bilirubin was investigated in pentobarbitone anesthetized rabbits. Hydrocortisone caused an increase in bile flow and electrolyte secretion in basal conditions. When it was infused after a maximal load of bilirubin, its choleretic effect disappeared and the maximal excretion of bilirubin was not modified. Our data suggest that the effect of hydrocortisone on bile flow and composition takes place at canalicular level and is not directly related to the secretion of bile salts. PMID- 6484280 TI - Presence of immunoreactive glucagon in healthy and diseased human thyroid. Evidence of glucagon synthesis by this gland. AB - Significant amounts of immunoreactive glucagon (IRG) were determined in acid ethanol and acid-saline extracts of human thyroid. Glucagon content of healthy thyroid, expressed as ng/g wet tissue or pg/mg protein, was significantly greater after an acid-alcohol extraction than after an acid-saline one. Furthermore IRG in acid-alcohol extracts of healthy tissue was greater than in acid alcohol extracts of diseased thyroid, while with an acid-saline procedure glucagon content was greater in the extracts of pathological tissues. No significant differences in the IRG content between calcified or follicular thyroid nodules and nodular goiter were found. Aliquots of the tissue extracts, fractionated on Bio-Gel P-30 or Sephadex G-100 columns, gave a 3,500 mol wt immunoreactive peak suggesting the existence of a polypeptide with the same size and immunological properties as pancreatic glucagon. Also, active glucagon synthesis by pieces of thyroid was established by the incorporation of L3-H-tryptophan into a 3,500 mol wt polypeptide with specific immune reaction to 30K antiserum. These results suggest that thyroid gland could represent a source of extrapancreatic glucagon in men, and therefore contribute to the circulating levels of this hormone. PMID- 6484281 TI - [Lipolytic effect of serotonin in vitro]. AB - The lipolytic action of serotonin on isolated adipocytes from the adipose tissue of rats has been studied. The adipocytes were incubated in serotonin 10(-6) M. Changes both in concentration and composition of the free intra and extracellular fatty acids as well as diacylglycerides through liquid gas chromatography were evaluated at different intervals. A lower concentration of free fatty acids and diacylglycerides is produced during the first minutes of incubation as well as a subsequent increase in the concentration of both, which becomes greatest after 20 30 minutes. The composition of both lipidic fractions (FFA and DAG) into fatty acids at 5, 10, 20 and 30 minutes, is related to the composition of the triacylglycerides (TAG), since during the esterification process a decline in the DAG of linoleic and palmitoleic acid is observed, both acids arranging themselves preferably in the TAG 2 position. Whereas the inverse process occurs during lipolysis; i.e. an increase in the proportion of the acids in the 2 position. In the FFA fraction, a higher proportion of fatty acids, preferential by arranged in positions 1 + 3 of the TAG's is observed. Similarly a decrease is observed in the extracellular concentration of FFA in the presence of serotonin with respect to the controls, a fact which has been described by other authors. An analysis of the present data leads us to revise the possible role of "Cahill's cycle" (simultaneous activation of the DAG-acyl-transferase and the HSL-TAG-lipase) in the action of serotonin and other hormones. PMID- 6484282 TI - The action of L-cysteine in acute cobalt chloride intoxication. AB - A study in rats was made of the effects produced by L-cysteine on the acute toxicity of cobalt chloride given orally and intraperitoneally. The decrease in lethality was absolute for the different doses tested, except when the CoCl2 was given orally and L-cysteine intraperitoneally in which only 40% efficiency was obtained. No specially significant changes were observed in the blood parameters of the animals treated with the CoCl2-cysteine complex after one week. Significant differences were noted between serum parameters: glucose, triglycerides and cholesterol, measured in rats after twelve hours of receiving the CoCl2-cysteine complex, compared with the same parameters measured when the CoCl2 was given without complex. PMID- 6484283 TI - [Effect of diets supplemented with pork lard and vitamin C on cholesterol and triglyceride levels in young rats]. AB - Plasma cholesterol and triglycerides in young female rats fed for 5 weeks on three experimental diets containing vitamin C and/or lard in comparison with the commercial pellet diet, were studied. The rats fed vitamin C showed no change of body weight whilst the animals fed lard gained in body weight. The variations in comparison with control are statistically significant. Plasma levels, cholesterol and triglycerides increased significantly in rats fed lard supplements. The cholesterol and triglycerides content did not change significatively with supplementary ascorbic acid. PMID- 6484284 TI - [Variability of the sleep-wake cycle stages in the laboratory cat]. AB - In order to study the variability of the phases of the sleep-wakefulness cycle (SWC) in the laboratory cat, eight animals were implanted with the standard array of electrodes for EEG, EOG and EMG recordings. Six twenty-four-hour recordings were obtained from each cat at weekly intervals. Three recordings were carried out in the cat colony while the remaining three were obtained with the cat alone in the sound proof chamber. Furthermore, in four cats, other three longitudinal twenty-four-hour recordings were obtained in the sound-proof chamber. In all situations the animals were under a 12:12 light/dark regime and were fed once a day. Sleep recordings were scored according to the polygraphic criteria for wakefulness (W), drowsiness (D), slow sleep (SS) and paradoxical sleep (PS). In each situation a two way analysis of variance (animals and days) was made. Results showed that W, D and SS were the states of the SWC exhibiting the largest variability among animals, while PS was the most stable phase. Variations of the four states among the different days of weekly intervals were not significant. However, a significant increase in PS was observed on the first day in the cases with longitudinal recordings. PMID- 6484285 TI - Piretanide induced changes on transepithelial potential difference in the intestine of Mauremys caspica. PMID- 6484286 TI - Proceedings of the 1983 Laurentian Hormone Conference. PMID- 6484287 TI - [Current concepts concerning the oxygen affinity for hemoglobin]. PMID- 6484288 TI - [Evaluation of the prognosis and response to therapy in multiple myeloma]. PMID- 6484289 TI - [Hairy cell leukemia. Clinico-pathological study of 30 cases observed 1966 to 1979]. PMID- 6484290 TI - [Leukotrienes and asthma]. PMID- 6484291 TI - [Menstruation disorders in athletes]. PMID- 6484292 TI - [Estimation of the probability of survival of middle-aged men as a function of individual characteristics]. PMID- 6484293 TI - [Changes in the age structure of mentally handicapped patients in Sweden between 1973 and 1982]. AB - Analyzed for the first time in 1973, the age distribution in the Swedish mentally retarded population was reexamined in 1982. Within a decade considerable changes were found to have taken place, whereas the numbers of disabled persons as well as their share in the total population had remained the same. The share of children and, above all, young people up to age 20 is declining considerably per age group. This could be accounted for by the introduction, in the early 70ies, of prenatal diagnosis and its growing impact, as well as by a considerably higher share of abdominal deliveries. The age-group proportion of mentally retarded in the total population of the 25-34 year olds, on the other hand, is markedly higher today than it had been 10 years ago. This fact is thought to be associated with the introduction of antibiotics in Sweden in 1948. The life expectancy of the other, older mentally retarded persons, too, is higher today than in 1973. This is most obviously explained by the substantial improvements that have occurred since in the living conditions for mentally retarded persons. PMID- 6484294 TI - [Modern strategy for oncologic diseases in health resorts]. AB - Talking with cancer patients is a process situated in a special field of tension. The individual affected by cancer suffers in multiple ways: from his somatic disease, his emotional reactions to the condition, from an ever-present fear of disease recurrence or spread. The patient is afraid of a lack of acceptance on the part of his environment, of social isolation and communication deficits, of insufficiencies in his ability to cope with the condition. This is where "Mitseinsbehandlung" sets in, an empathic, holistic approach to treatment bearing on all the various planes at which help is required. This approach is described in more detail. PMID- 6484295 TI - [Psychosocial care of children and adolescents with chronic kidney disease (in a 2-year period)--problems, tasks, services]. AB - The psychosocial services provided over a period of two years to 24 children and young people with chronic renal insufficiency in various disease stages were analyzed on the basis of patient files. A total of 1475 contacts (units) were classified according to the four dimensions: (1) type of care provided, (2) problems dealt with, (3) contact persons, (4) disease stage. Variety and multitude of the individual psychosocial problems present demonstrate the scope for psychosocial activity. Supportive services (1) pertaining to the so-called disease-context (2) and, more specifically, personal contacts with the patients (3) in the dialysis stage (4) were found to prevail among the functions of the attending psychologist. Psychosocial services focussing on specific individual and/or practical issues had plainly been far more important in the care of the chronically ill children and their families, than approaches based on classical clinical psychology and psychotherapy. These findings have resulted in increased staffing for supportive services "on site" (i.e. during dialysis time), which has entailed greater latitude in the time available for dealing with relevant preventive aspects in preparing patients for dialysis and transplantation. PMID- 6484296 TI - Head-up tilt in the nonhuman primate. Effects of renal denervation. AB - Experiments were performed to determine the role of the renal nerves in mediating the antinatriuresis of head-up tilt in the nonhuman primate. Male Macaca fascicularis monkeys underwent chronic bilateral renal denervation or sham surgery and were allowed a 1- to 2-week recovery period. After that time, each animal was anesthetized with sodium pentobarbital and subjected to 40 min of 35 degrees head-up tilt. Renal perfusion pressure was maintained constant throughout the experiment. Tilt caused significant decreases in urine flow, sodium excretion and osmolar clearance and increases in urine osmolality in both groups. Creatinine and para-aminohippurate clearances decreased in the sham-operated animals but were unchanged in the denervated animals. Although the pattern of the renal excretory responses showed some group differences in that a significant antidiuresis and antinatriuresis occurred after 10 min of tilt in the sham operated group but not until 20 min in the denervated group, the magnitudes of these excretory responses were similar in both groups throughout the entire tilt procedure. These results suggest that, in this species, the renal nerves are not necessary for eliciting the overall antinatriuretic response to orthostasis but may have some minor involvement in the onset of the response. PMID- 6484297 TI - Studies on the nephron segment with reduced sodium reabsorption during starvation natriuresis. AB - The segment of the nephron where carbohydrate deprivation depresses Na transport leading to natriuresis was sought by a new clearance technique designed to measure segmental reabsorption in each portion of the human renal tubule. Experiments were performed during maximal water diuresis before and 4 days after carbohydrate withdrawal. Proximal reabsorption had fallen from 70 +/- 4 to 60 +/- 5 ml X min-1, p less than 0.05, by the 4th day of sugar deprivation, accounting for the natriuresis and the associated weight loss of 1.8 kg. By the 4th day of fasting, when Na excretion had returned to control levels, GFR had fallen nonsignificantly from 99 +/- 6 to 95 +/- 5 ml X min-1, while Na reabsorption along distal segments had risen. In fact, Na transport, expressed by the equivalent volumes of solute free-water generated, rose from 17.4 +/- 3.4 to 23.6 +/- 2.1 along the ascending limb of Henle's loop, and from 8.1 +/- 0.8 to 9.2 +/- 1.3 ml X min-1 X GFR-1 X 100 along the distal tubule. Thus, analysis of segmental Na transport by this method discloses that starvation natriuresis is a proximal tubular event, progressively counterbalanced by enhanced Na reclamation in more distal sites. Volume contraction and the attendant fall in GFR concur to curb delivery out of the proximal tubule which is matched by enhanced distal Na reabsorption till a new steady-state excretion is attained. PMID- 6484298 TI - Effects of volume expansion with Fluosol-DA on renal function of the nonhuman primate. AB - The renal responses to an intravenous infusion of a high 02 affinity fluorocarbon equal to 15% of the estimated blood volume was determined in 5 monkeys and 1 baboon. In response to the infusion, blood pressure, renal plasma flow and glomerular filtration rate did not change significantly while heart rate and central venous pressure increased transiently. Significant increases in sodium and potassium excretion and osmolal and free-water clearances occurred. The renal responses to Fluosol-DA (20%) mimic in general those observed when blood volume is expanded with isotonic isooncotic dextran solutions. PMID- 6484299 TI - Stereo-specificity of diuretic receptors in the nephron: a study of the enantiomers of indacrinone (MK-196) in man. AB - Urinary clearance techniques have been employed to compare the renal sites of action of three phenoxyacetic acid diuretics in man: ethacrynic (etacrynic) acid and the two enantiomers of indacrinone (MK-196). The effects of these compounds on fractional free-water clearance and reabsorption during maximal hydration and hydropenia, respectively, indicate that whilst ethacrynic acid and (-) indacrinone have their natriuretic site of action in the medullary portion of the thick ascending limb of Henle's Loop, the (+)-enantiomer of indacrinone acts in the 'cortical diluting segment' or early distal tubule. The natriuretic potencies of all three agents are different as is their effect on the renal handling of uric acid. Ethacrynic acid produces minor urate retention whilst both enantiomers of indacrinone produce uricosuria and hypouricaemia. The apparent difference in the renal sites of action of the enantiomers of indacrinone is discussed in relation to our current knowledge of stereo-selectivity in other pharmacological systems. PMID- 6484300 TI - Effect of loop of Henle flow rate on glomerular capillary pressure. AB - Studies were performed in male Munich-Wistar rats weighing a mean of 100 g to evaluate further the hemodynamic effects of changing loop of Henle flow rate. When late proximal flow rate was varied by microperfusion from the late proximal tubule, single nephron glomerular filtration rate (SNGFR) measured in the early proximal tubule fell from 17.2 +/- 0.86 nl min-1 at a perfusion rate of zero to 11.8 +/- 0.88 nl min-1 at a perfusion rate of 14 nl min-1. Further increases in loop flow did not further depress SNGFR. Glomerular capillary pressure (Pgc) was measured directly in superficial glomeruli while loop of Henle flow was varied. Elevating loop flow was followed by a rapid decrease in Pgc, which was reversible when flow was reduced. The mean response to maximum stimulation was a decrease in Pgc of 6.6 +/- 0.7 mm Hg, and the response was close to maximum at a perfusion rate of 14 nl min-1. Parallel changes in stop-flow pressure were observed. These findings, together with previous observations that increasing loop of Henle flow results in decreased single nephron blood flow, permit the conclusion that the dominant vascular response to elevated loop of Henle flow is constriction of the afferent arteriole. PMID- 6484301 TI - In vitro correlation of glutamine and glutamate renal ammoniagenesis during adaptation. AB - Renal slices from 191 rats in various states of acid-base balance were investigated for their ability to produce ammonia from both glutamine and glutamate. Under a variety of conditions, in three different type studies, a significantly similar correlation existed between ammonia adaptation from glutamine and glutamate. This relationship was maintained during acute and chronic acidosis and during alkalotic inhibition of renal ammoniagenesis. We conclude from our findings that ammonia adaptation in rats secondary to acute and chronic acidosis is similar, although incomplete during acute acidosis. Our results further support the hypothesis that the rate of glutamate deamination is a major mechanism for overall renal ammonia adaptation in rats during acid-base changes. PMID- 6484302 TI - Electrolyte balance, mode of delivery and plasma aldosterone levels in newborn lambs. AB - Plasma aldosterone, sodium (Na) and potassium (K) concentrations, daily Na and K intakes, and urinary and faecal excretion were measured during the first week of postnatal life in 9 lambs naturally born at term (145 days of gestation) and in 10 lambs delivered by caesarean section on day 145 (6 lambs) or on day 139 (4 lambs) of gestation. Plasma aldosterone, Na and K concentrations showed no significant variation during the experimental period in any group of lambs, and there was no significant difference concerning these parameters among the three groups. Na and K balances were always positive during the experimental period in naturally born lambs. It was negative on days 4 and 6 postdelivery in those delivered by caesarean section on days 145 and 139 of gestation, respectively. This was probably due to the lower daily Na and K intakes measured in these 10 lambs compared to the 9 control lambs: urinary output and urinary Na and K excretion were lower in the two groups of lambs delivered by caesarean section, while Na and K urinary concentrations were not different in any group. PMID- 6484303 TI - Effects of Maillard's reaction products on apparent mineral absorption in different parts of the digestive tract. The role of microflora. AB - 1.5 and 3% of Maillard's reaction products (MRP), prepared by heating glycine and glucose, were incorporated ino a semi-synthetic diet. The diet was sterilized by irradiation. MRP caused a change in apparent absorption of calcium and magnesium in germfree (GF) and conventional (CV) rats. The absorption of these minerals was reduced in the small intestine of CV and GF, perhaps due to the action of MRP on enterocyte metabolism. This effect was compensated for only in CV rats by increased absorption of these minerals in the cecum and the colon. The presence of microflora and the increase in cecal volume in CV rats suggested that MRP fermentation increased mineral absorption in the cecum and colon. However, although total apparent absorption of magnesium and phosphorus was higher in CV rats ingesting MRP, the urinary excretion of these minerals was also higher and their retention was not better. The effect of MRP in GF rats was not compensated for in the cecum, and mineral retention was significantly reduced in GF rats ingesting MRP. PMID- 6484304 TI - [Nutritional correction of an excess of unsaturated fatty acids in the body lipids of the growing rat]. AB - The use of hydrogenated coconut oil as a putative substance for correcting an excess of unsaturated fatty acids in reserve lipids was tested in growing rats. Young rats with a live weight of about 70 g were given diet A including 4% of sunflower oil which very rapidly created a triglyceride store containing 25 to 30% of linoleic acid (18:2 n-6). At different weights (200, 300 and 350 g), diet A was replaced by diet B containing 15% of hydrogenated coconut oil so that there was the same number of animals in each group. All the rats were killed at 400 g, and diet-A and B were compared as to final fatty acid composition of body lipids (i.e. values taken all during growth from 70 to 400 g). Hydrogenated coconut oil was a very effective substance for rapidly decreasing levels of reserve lipid linoleic acid and for increasing triglyceride melting-point. The impact on the decrease in total unsaturated fatty acid concentrations was more marked the earlier the diet was replaced. However, the latest replacements (at 300 and 350 g) still permitted 70 and 50%, respectively, of the maximal effect observed in rats eating diet B from 70 g. The present experiment shows that when coconut oil was introduced in the diet over a period corresponding to the last one-eight of total body growth in rat, the final concentrations of unsaturated fatty acids could still be considerably reduced, particularly that of linoleic acid. In the same way, there was increasing esterification of myristic acid (14:0), and especially of lauric acid (12:0), which appeared preferentially in sn-1 and sn-3 positions in triglycerides. This esterification of medium-chain fatty acids led to a modification in the mode of other fatty acid distribution. Analysis of liver phospholipids showed that when diet A was replaced above 200 g by diet B, there was no biochemical evidence of any deficiency of essential fatty acids of the n-6 series. PMID- 6484305 TI - Determination of plasma non-esterified fatty acids in herbivores and man: a comparison of values obtained by manual or automatic chromatographic, titrimetric, colorimetric and enzymatic methods. AB - Non-esterified fatty acid (NEFA) contents were determined (1) in cow, goat, mare and human plasmas or sera and (2) in bovine serum albumin solutions by thin-layer and gas-liquid chromatographic methods which were compared with 6 chemical methods of determination and 2 enzymatic methods (manual and automatic). The chemical methods combined two extraction techniques (isopropanol-heptane and silicic acid-diisopropyl ether) and three determination methods (titrimetry and colorimetry using either phenol red or copper soaps). Correlations between the nine various methods were high, but in some cases regression lines were different from the bissector and species-dependent. The putative occurrence of interfering compounds or the possible effect of between-species differences in NEFA composition have been discussed. The choice of a fast method depends primarily on practical considerations, but the need to standardize each method for a given species has been stressed. Automatic enzymatic assay seemed to be suitable for routine analyses. PMID- 6484306 TI - Relationship between rete testis fluid secretion and testicular structure in the ram. AB - A rete testis cannulation technique was used to compare the secretion of rete testis fluid with the production of spermatozoa and histological testicular parameters in Ile-de-France rams. Thirteen testes were cannulated and rete testis fluid variables were compared to histological variables of the same testis. The rate of flow of rete testis fluid was significantly (P less than or equal to 0.05%) correlated with testicular size, the area of the walls of the seminiferous tubules and the volume of the Leydig cells. These two latter factors accounted for 66% of the variation in the flow of rete testis fluid. PMID- 6484307 TI - [Effect of a short-term protein-free diet on endogenous nitrogen secretion: exocrine pancreas secretion in the pig]. AB - A protein-free diet is often used in animal experimentation to estimate the amount of total endogenous nitrogen secreted by the organism. To test the validity of this technique, we carried out a study on pigs describing the short term (8-day) effect of a protein-free diet on exocrine pancreas nitrogen secretion; this nitrogen was considered as representative of total endogenous nitrogen. After 11 pigs had been adapted to a balanced diet (14% protein), they were chronically fistulated in the pancreatic duct and duodenum. Pancreatic secretion and its various parameters (volume, total protein and chymotrypsin, trypsin, amylase and lipase activities) were measured over a first experimental period of 4 days, during which the pigs continued to receive the balanced diet, and over a second experimental period of 8 days during which they were given a protein-free diet. The results show that the amount of pancreatic protein did not change during the period the protein-free diet was given. After 2 days, chymotrypsin specific activity dropped, while amylase and lipase specific activities decreased little and slowly after 6 days. However, for short-term experiments, the protein-free diet proved to be an adequate technique for determining the production of total endogenous nitrogen in the digestion tract. PMID- 6484308 TI - Correlation between covalent attachment of C3 and calcium uptake in antibody stimulated L cells. AB - The nature of C3 binding to cell surfaces was examined in L cells treated with antibody and complement, immunological reagents which we have previously shown to be capable of producing stimulation of several important cellular processes. In the presence of serums containing C3 and under experimental conditions where complement activation could take place, selective binding of C3 to antibody treated L cells was observed (maximum 1.1 X 10(6) C3 molecules per cell). Under similar conditions there was a C3 dependent increased calcium uptake (3.4 pmol) by antibody treated cells. Purified C3 was able to selectively restore C3 binding to cells treated with serum depleted of C3 through C9. C7-deficient serum was almost as good a source of activated C3 as its normal serum counterpart. Strong chemical nucleophiles such as salicylhydroxamic acid, which are capable of covalently coupling to the labile internal thiolester of C3, prevented the binding of C3 to cells. We conclude that C3 is covalently bound to antibody and complement treated L cells, possibly serving as an important signal in subsequent enhancement of phospholipid metabolism, DNA synthesis, and cell growth. PMID- 6484309 TI - Effect of storage on the bioavailability of cephalexin from its capsules. AB - Three brands of locally available cephalexin capsules were stored in paper bags at 40 degrees C/90% relative humidity. Samples were taken at different time intervals and tested for the effect of storage on disintegration, dissolution and drug content for up to 70 days. Bioavailability testing was carried by administering the capsules to four volunteers before storage and after 70 days of storage. Two brands (A and B) showed increase in disintegration time associated with decrease in the rate of dissolution. The third brand (C) showed similar effect but later on irregular disintegration and dissolution were observed. Such behavior was found to be a result of storage effect on the capsule shell. No effect on drug content was observed for brands A and B but significant loss of activity was observed with some samples of brand (C). Bioavailability testing based upon urine analysis for excreted drug indicated that the rate but not the extent of drug absorption for brands A and B decreased by storage. The results with brand C showed serious fluctuations in absorption after storage for more than 25 days. These findings point out to the importance of proper formulation and protection of solid dosage forms handled in places where high temperature and humidity conditions are likely to exist. PMID- 6484310 TI - Polyacrylamide disc electrophoresis of human semen lactate dehydrogenase in the presence of sulfur compounds. AB - Total LDH-P and isozymes of ejaculates from virile men were ascertained following incubation at 37 degrees with solutions of various sulfur compounds (pH 7.2: initial concentrations up to 0.40 M) for periods of at least 18-24 hr. As based on polyacrylamide disc electrophoresis, inactivation of the testicular isozyme, LDH-X, was almost complete with penicillamine and its disulfide, somewhat less with GSH and GSSG, least with thioglycolate and its disulfide and inconsistent with cysteine, 2-mercaptoethanol and 2-mercaptoethylamine. The inactivation may stem from conformational changes rather than simple redox considerations, the findings being negative with 3-mercatopropionate, N-acetyl-penicillamine and thiodiglycolate. Thiophenoxyacetate, levamisole and dimethyl sulfoxide depressed total LDH and LDH-X was the principal component in the respective patterns for ejaculate concentrates. Sub-banding of LDH-1, LDH-2 and LDH-3 occurred in several of the gels employing phthalyltetrathioacetate to the exclusion of any effect on LDH-X; splitting was minimal in LDH-4 but was more prominent in gels from aspermic men. As in prior studies with serum, the sulfhdryl and disulfide compounds had little effect on LDH-P nor on the relative distribution of the isozymes in ejaculates from vasectomized men in which LDH-X was absent. PMID- 6484311 TI - Determination of aromatic amino acids by ion-pair reversed-phase liquid chromatography in human sera from healthy and phenylketonuric individuals. AB - A simple chromatographic procedure is described for simultaneous analysis of aromatic amino acids in serum samples obtained from normal individuals and from phenylketonuric patients. Quantitative measurement of phenylalanine, tyrosine, histidine and tryptophan is made in samples as small as 10 microliter after deproteinization with trichloroacetic acid. With phenoxyacetic acid as the internal standard, samples are analyzed by reversed-phase chromatography isocratically by an ion-pairing agent in the eluent, and the amino acids are detected with the UV detector at 210nm. Total analysis time was about 30 minutes. Using this method in serum samples from phenylketonuric patients phenylalanine was increased (as expected), and histidine was decreased, at a statistically significant level. PMID- 6484312 TI - Beneficial effect of taurine on congestive heart failure induced by chronic aortic regurgitation in rabbits. AB - Taurine (2-aminoethanesulfonic acid) is known to have a cardiotonic action. The present study was designed to see whether oral treatment with taurine could improve the status of congestive heart failure induced by aortic regurgitation. Nine rabbits were treated daily with taurine (100 mg/kg) after producing aortic regurgitation. Cumulative mortality at 8 weeks in the non-treated group was 52% compared with 11% in the taurine-treated group (p less than 0.05). Cardiac function (max dP/dt) was significantly decreased in rabbits with aortic regurgitation, whereas in taurine-treated rabbits, cardiac function was maintained the same as control. The present data suggest that taurine prevented the rapid progress of heart failure, and consequently prolonged the life expectancy. PMID- 6484313 TI - Protective effect of butylated hydroxytoluene on adriamycin-induced skin necrosis in the rat. AB - The effect of butylated hydroxytoluene (BHT) on adriamycin (ADR)-induced skin ulcers was investigated using rats. The application of BHT reduced the size of the skin ulcers by the following amounts: topical application (20%); intradermal injection (50%); repeated applications of BHT (82%). Additional studies are required to determine if BHT will be a modifier of ADR extravasation in cancer patients. PMID- 6484314 TI - Ca2+-transport in skeletal muscle sarcoplasmic reticulum of the chronically diabetic rat. AB - Ca2+-transport in fast skeletal muscle sarcoplasmic reticulum preparations was studied in experimentally-induced diabetic rats 90 days after treatment. A significant decrease in ATP-dependent oxalate facilitated Ca2+-uptake was observed in these animals at all free Ca2+ concentrations tested (0.1-2.0 microM). A concomitant elevation in the levels of both free carnitine and long chain acylcarnitine was also found. These observations paralleled results obtained in diabetic rat heart sarcoplasmic reticulum preparations and suggest a generalized pathophysiological mechanism affecting muscle tissue function in the diabetic animal. PMID- 6484315 TI - Effects of nicardipine and other Ca2+-antagonists on catecholamine transport into chromaffin granule membrane vesicles. AB - Nicardipine (10(-7)-2 X 10(-5) M) inhibited the transport of noradrenaline into chromaffin granule membrane vesicles in a concentration-dependent manner. This inhibitory effect of nicardipine was found to be appreciably stronger than that of other Ca2+-antagonists(diltiazem, nifedipine and verapamil) and was not due to the blockade of Ca2+-channel in the granule membranes. PMID- 6484316 TI - 3rd congress of the European Society of Pneumology. Basel, September 16-22, 1984. Abstracts. PMID- 6484317 TI - Effects of increasing metabolism by 2,4-dinitrophenol on respiration and pulmonary gas exchange in the duck. AB - The effects of pharmacologically elevated metabolism on respiration and parabronchial gas exchange were studied in the anesthetized, spontaneously breathing duck using 2,4-dinitrophenol (DNP), injected in successive single doses of 1.2-2.5 mg per kg body mass. Oxygen uptake, MO2, increased with the cumulative amount of DNP, reaching a sevenfold resting level at the highest DNP level tolerated, 15 mg/kg. Ventilation increased nearly as much as MO2, mainly by an increase in respiratory frequency, fresp. Cardiac output increased somewhat less than MO2, mediated by increases in both cardiac frequency and stroke volume. Arterial blood-gases showed little change; however, mixed venous PO2 dropped significantly, and PCO2 increased significantly, with stimulated metabolism. Pulmonary diffusing capacity, DO2, showed a significant rise with MO2, beyond that expected from a reduction of functional lung heterogeneity. The results show that pharmacological stimulation of metabolism can evoke responses in the respiratory and circulatory systems that are comparable to those observed with exercise. The mechanism by which parabronchial diffusing capacity increases during elevated metabolism remains to be investigated. PMID- 6484318 TI - Ventilatory and circulatory changes during cold exposure in the Pekin duck Anas platyrhynchos. AB - Inspired ventilation (VI), O2 uptake (VO2), body temperature (TB), arterial blood pressure and arterio-venous differences in blood gases and pH were measured in ducks. Anas platyrhynchos, during exposure to variable ambient temperature (Ta) +20, 0 and -20 degrees C. A stable TB was maintained at all Ta's VO2 increased from 12.07 ml O2 (STPD) X kg-1 X min-1 at 20 degrees C to 28.95 ml O2 X kg-1 X min-1 at 20 degrees C. The ventilatory requirement (VI/VO2) changed from 0.468 L X mmol-1 at 20 degrees C to 0.322 L X mmol-1 at -20 degrees C corresponding to a change in overall O2-extraction from 28.5 to 41.4%. The increase in VI during cold exposure resulted from an increased tidal volume while breathing frequency was unchanged. This caused a smaller fraction of the total inspired air being dead space ventilation during cold exposure. The changed ventilatory requirement was largely the result of an increased parabronchial O2-extraction, whereas the altered ventilatory pattern accounted for a smaller part (21%) of the decreased ventilatory requirement. Arterial and venous O2 content and PaO2 changed little with cold exposure while PVO2 increased significantly. Calculated values for cardiac output increased from 173.7 ml X kg-1 X min-1 at +20 degrees C to 431.4 ml X kg-1 at -20 degrees C. From a thermoregulatory point of view it seems significant that the increased heat production during cold exposure is followed by an increased oxygen extraction in the lungs and in increased cardiac output, rather than by a further elevation of ventilation. PMID- 6484320 TI - Ventilatory adaptation to metabolic alkalosis in adult awake potassium restricted rats. AB - The resting ventilation of awake rats, developing metabolic alkalosis as a result of sustained dietary potassium (K) restriction, was compared to that of age matched controls. Extending the measurements over 17 weeks and using adult rats indicated, as soon as the third week, a significant progressive fall in the minute ventilation of low K rats, which previous studies limited to a single time determination did not consistently ascertain. The ventilatory adaptation observed in all groups, as well as the superimposed respiratory compensation to metabolic alkalosis in low K rats, resulted only from frequency changes. In both groups, the duration of inspiration was inversely correlated with the age of the animals. The duration of expiration was stable in controls but increased significantly with time in low K rats. According to these data, the respiratory compensation to K-depletion alkalosis in the rat is achieved only through an adjustment in the timing component of the control of breathing. PMID- 6484319 TI - Laryngeal pressure receptors. AB - We studied the response characteristics of laryngeal pressure receptors in anesthetized dogs, breathing through a tracheal cannula, by recording single unit action potentials from the peripheral cut end of the internal branch of the superior laryngeal nerve. The larynx, with the rest of the upper airway, was isolated and cannulated separately for the application of distending and collapsing pressures. We identified receptors responding to either negative or positive pressure and a few responding to both. All these receptors showed a marked dynamic sensitivity and had the characteristics of slowly adapting mechanoreceptors. The majority of pressure receptors were active at zero transmural pressure and the gain of their response to pressure was higher at lower values, suggesting a role for these receptors in eupnea. Reflex alterations in breathing pattern and upper airway muscle activity during upper airway pressure changes, previously reported, are presumably mediated by the receptors described here. Moreover, these receptors may play a role in certain pathological states, such as obstructive sleep apnea, in which the upper airway is transiently subjected to large collapsing pressure. PMID- 6484321 TI - The regulation of flow of pulmonary fluid in fetal sheep. AB - The flow of fluid within the trachea of fetal sheep (121-135 days) has been measured using a newly developed flowmeter. The flowmeter, which is basically a miniature servo-controlled peristaltic pump, is connected in series with an extra corporeal tracheal loop. Integrated tracheal flow was measured for periods of at least 8 h in 5 control fetuses during which we determined its relationship to fetal breathing movements detected by EMG's of inspiratory muscles or tracheal pressure fluctuations. The overall flow of fluid away from the lungs was 14.4 ml/h; on average outward flow was 5.3 times greater during episodes of breathing movements than during apnea. Interruption of the motor innervation of the larynx in 5 fetuses led to a 25% reduction in mean overall flow and, compared with control fetuses, there was a reduction in net flow associated with breathing movements and an increased flow during apnea. These findings suggest that tracheal flow is normally retarded by a laryngeal mechanism during apnea, giving rise to an elevated pressure within the trachea and probably resulting in increased pulmonary distension. Paralysis of the fetus with gallamine triethiodide reduced the flow of liquid from the lungs and abolished variations in flow rate related to fetal electrocortical states. PMID- 6484322 TI - Alveolar liquid pressure measured using micropipets in isolated rabbit lungs. AB - The relationships among alveolar liquid pressure (Pliq), transpulmonary pressure (Ptp), and alveolar edema were studied in isolated rabbit lungs. Different amounts of edema were induced by instilling measured amounts of normal saline via the trachea. Micropipets were used in conjunction with a servonulling pressure measuring system to measure Pliq. Pliq was -1 cm H2O relative to alveolar air pressure (Palv) at Ptp of 3 cm H2O and decreased to -16 cm H2O at Ptp of 25 cm H2O. Pliq increased slightly as wet-to-dry weight ratio (W/D) of the lungs increased from 5.8 to 16. Alveolar surface tension estimated from these values of Pliq - Palv using an alveolar radius of curvature of 40 micron at Ptp of 25 cm H2O was consistent with the direct measurements of Schurch. In lungs made edematous by treating with oleic acid, values of Pliq were not different from those measured in lungs made edematous by normal saline instillation (control). Pressure-volume behaviour of the oleic acid treated lungs showed a marked reduction in lung volume at each Ptp value compared to the behavior in the control lungs. Most of this reduction in lung volume was removed by washing the airways with the bronchodilator, isoproterenol. We conclude that alveolar surface tension was not increased in the oleic acid treated lungs. The apparent increase in lung static recoil was most likely caused by the constriction of small airways. PMID- 6484324 TI - Immunology of ocular chlamydial infections. PMID- 6484323 TI - Regional circulatory responses to 96 hours of hypoxia in conscious sheep. AB - Exposure of adult ewes to normobaric hypoxia (PaO2 40 mm Hg) for 96 h led to increases of VE (+ 54%), while VO2 decreased by 48%. PaCO2 declined progressively to stabilize at 24 (+/- 1.5 SE) mm Hg by 24-48 h. Cardiac output (thermodilution) was elevated temporarily for 24 h (23-34%) but then returned to normoxic levels, while heart rate (28-42%) and pulmonary artery pressure (38-56%) were increased for the duration of hypoxia. Cerebral blood flow (radiolabelled microspheres) increased transiently for 48 h from 65.9 (+/- 4.4) to 100.4 (+/- 9.9) ml X min-1 X 100 g-1 with no change in its regional distribution. Coronary flow was elevated for the duration of hypoxia from 181 (+/- 15) to between 280 (+/- 33) and 350 (+/ 37) ml X min-1 X 100 g-1 with a more pronounced increment in right heart flow, and a decline in the endocardial/epicardial flow ratio. These regional flow increases resulted from a sustained decrease in pancreatic flow from 234 (+/- 11) to 125 (+/- 13) ml X min-1 X 100 g-1 for 96 h, with persisting decreases in splenic flow from 249 (+/- 30) to 100 (+/- 18), and in renal cortical flow from 787 (+/- 70) to 540 (+/- 31) ml X min-1 X 100 g-1, occurring at 48 and 72 h, respectively. Therefore, there is a redistribution of cardiac output during 96 hours of hypoxia with increased flows to heart and brain, and decreased flows to abdominal viscera. PMID- 6484325 TI - Ocular cysticercosis. Diagnostic and therapeutic problems. PMID- 6484326 TI - Recent findings concerning trachomatous pannus. PMID- 6484327 TI - Past and present in the diagnosis of trachoma and chlamydial ocular disease. Specific serum IgA antibodies in the diagnosis of active viral and chlamydial infections. PMID- 6484328 TI - Treatment of trachoma in light of its immunology. PMID- 6484329 TI - Worldwide prevention of blindness. PMID- 6484330 TI - [Manometry of the esophagus in patients with upper digestive manifestations]. PMID- 6484331 TI - Folate and vitamin B12 deficiency among parturients from Porto Alegre, Brazil. PMID- 6484333 TI - Acute psychosis secondary to bromocriptine treatment in a patient with a prolactinoma. PMID- 6484332 TI - [Combined familial hyperlipidemia. Study of a family]. PMID- 6484334 TI - [Mild form of Menkes syndrome]. PMID- 6484335 TI - [Clinical implications of snoring]. PMID- 6484337 TI - Workshop on pituitary pathology (2nd meeting of the Pituitary Pathology Club). Oaxtepec, Morelos (Mexico), June 19 to 22, 1984. PMID- 6484336 TI - [Data analysis and quality control in radioimmunoassays. Guide for evaluation of results]. PMID- 6484338 TI - [Patients with acquired immunodeficiency syndrome (AIDS) have peripheral blood lymphocytes expressing plasma-cell differentiation antigens]. PMID- 6484339 TI - [Reconstructive anterior frontal laryngectomy. Tucker's operation]. PMID- 6484340 TI - [Results of the surgical treatment of glottic cancers]. PMID- 6484341 TI - [Calearo's operation or translaryngeal glottic operation. Surgical principles and functional results. Preliminary study]. PMID- 6484342 TI - Myotomy of the cricopharyngeal muscle. A treatment for dysphagia and aspiration in neurological disorders. PMID- 6484343 TI - [Adenopathy in epithelioma of the piriform sinus. Apropos of 100 cases]. PMID- 6484344 TI - Radiology of the nasopharynx. PMID- 6484346 TI - Radiologic evaluation of malignant external otitis. PMID- 6484345 TI - [Negative pressure in the middle ear. Seasonal changes in normal children]. PMID- 6484347 TI - [Diagnostic value of stapedius reflex fatigue]. PMID- 6484348 TI - Radiologic abnormalities of malignant otitis externa. PMID- 6484349 TI - [Voluminous dentigerous cyst of the mandible]. PMID- 6484350 TI - Stapedial surgery. Recent developments in the clip-piston technique. PMID- 6484351 TI - [Pivalone and vasomotor rhinitis]. PMID- 6484353 TI - [Rotavirus infection in children of 2 cities of the state of Chiapas, Mexico]. PMID- 6484352 TI - [Development of the production of specific human immunoglobulins. III. Production of a test lot of specific anti-tetanus immunoglobulin]. PMID- 6484354 TI - [Antagonism of Streptococcus, Lactobacillus and Leuconostoc strains from fresh, unpasteurized cheeses against various enteropathogenic bacteria]. PMID- 6484355 TI - [Effect of phenol in PPD solutions on the results of cellular immunity tests]. PMID- 6484356 TI - [Atypical strains of Microsporum canis]. PMID- 6484358 TI - [Abstracts: 15th National Congress of Microbiology, Mexican Association of Microbiology. Veracruz, 3-7 June 1984]. PMID- 6484357 TI - [Elaboration of a national reference preparation of lyophilized tetanus antitoxin]. PMID- 6484359 TI - [Mortality and morbidity of treated arterial hypertension: a 7-year follow-up]. PMID- 6484360 TI - [Coronary steal with the use of dipyridamole in patients with obstructive coronary disease]. PMID- 6484361 TI - [Criteria of measurement of end systolic diameter and its relation to minimal ventricular diameter. Study with computerized echocardiography]. PMID- 6484362 TI - [Diagnosis and treatment: what do our patients know?]. PMID- 6484363 TI - [Idiopathic pulmonary hemosiderosis. Clinical case in an adult with respiratory function and an electron microscopy study]. PMID- 6484364 TI - [Health for all in the year 2000: illusion or reality?]. PMID- 6484365 TI - [Pre-operative assessment of the nutritional status in a rural hospital]. PMID- 6484366 TI - [Lung infiltration with eosinophilia, eosinophilic pneumonia or pulmonary eosinophilia?]. PMID- 6484367 TI - Energy expenditure of paraplegic marathon runners measured during a wheelchair marathon. AB - Wheelchair bound paraplegics tend to spend a sedentary life. They seem to be vulnerable to prolonged strenuous exertion because of their many physical handicaps such as metabolic depression, cardiovascular instability, urinary incontinence, pressure sores and so on. In commemoration of The International Year of the Disabled, The First Oita International Wheelchair Marathon was held in Autumn of 1981. This paper is to review the results of an experiment made at this half marathon. The course length was 21.1 km. Ten competitors were selected at random as the subjects for measuring energy expenditure during the race. As a preliminary examination, a work load test was performed by using a wheelchair treadmill to obtain a regression equation of the individual relationship between oxygen uptake and heart rates. The oxygen uptake of individuals during the race was estimated from the heart rates which were recorded by the small memory box fixed beneath the wheelchair. Six subjects were successfully examined. The results revealed that paraplegics safely tolerated the prolonged strenuous exercise. Their average oxygen uptake, mean heart rate and the lap time during the race were 34.17 +/- 8.11 ml/kg/min (mean +/- SD), 167.6 +/- 15.8 beats/min and 87.1 +/- 9.1 min respectively. Heart rate of the subjects was always very high during the race, although oxygen consumption was fairly low in comparison to able-bodied elite marathon runners. PMID- 6484368 TI - Verification of the health care region in Fukuoka Prefecture. AB - Because the change in the location of industries, if comprehensive health care is to be promoted, there is need to derive a methodology for finding the life cycle patterns of the residents and to set up health care regions from these results. Formally, health care had evolved within the prefecture or the Health Center administrative districts with each spectrum of health promotion, "disease prevention" and "diagnosis, treatment and rehabilitation" using fragmented and unrelated methods. However, there is need to designate the region for health care planning aside from the present units for administrative purposes. With this object in mind, Fukuoka Prefecture, which has experienced a dramatic change in industrial structure, was selected as an example. Regions were designated centering around the analysis of "socio-economic aspects" and "demographic characteristics". From the viewpoint of the relationship with the life style, the geographical extent of the activity of the residents was studied through the commuting areas. Based on this activity range and the geographical distribution of the industrial locations, a reasonable "Region for health care" was designated. The first quantitative approach to verify the results was made by using the weighted pair-group method and principal component analysis. And from the vantage of the Fuzzy Sets-theory, a multivariate technique centering around clustering analysis was next utilized to analyse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484369 TI - Comparative quality tests of two types of sustained release preparation of isosorbide dinitrate. AB - Two commercial sustained release preparations of isosorbide dinitrate (ISDN), capsules (preparation A) and tablets (preparation B), were tested for content uniformity and dissolution pattern. The deviations in contents of the single doses from the declared content ranged from -7.7% to +9.7% which conformed to the standard (+/- 15%) of the Japanese Pharmacopeia X (JP X). Dissolution tests were performed using the rotating basket method described in JP X. The dissolution medium were No. 1 and 2 solutions (pH 1.2 and 6.8, respectively) specified in JP X disintegration test, and 0.05 M phosphate buffer solutions (pH 3.0 and 5.0). The dissolution patterns of both preparations were independent on the pH of the medium. However, there was a marked difference between the dissolution rates of the two: after 8 hr of the test, the rates of preparation A were 85-89%, but those of preparation B were only 42-50%. From preparation A a somewhat constant release of ISDN continued until the 6 hr. ISDN was determined by the HPLC method. PMID- 6484370 TI - [A statistical approach to measure fitness by PWC170]. AB - This paper discusses measurements of physical work capacity. When the sample size is small, its model selection problem is difficult in the multiple regression analysis. Although the development of model selection may be correct, it is not always useful for practical data. Since the number of the parameters is large compared with the sample size, we shall discretize continuous data into categorical data and shall use the CATDAP program. PMID- 6484371 TI - Malum perforans pedis caused by spinal canal stenosis and spondylolisthesis. AB - A case of malum perforans pedis caused by spinal canal stenosis with spondylolisthesis in a 76-year-old female is reported with a brief review of literature. In our case, orthopedic and neurological evaluations were indispensable for correct diagnosis and treatment of the condition. PMID- 6484372 TI - Bioethics and health care in industrial society. AB - Due to rapid development, industrial societies must now make a fresh start based on a new idea of society which will enable them to survive the fast approaching 21st century. In this situation, health problems must be dealt with not only by medical science but also by research in other areas such as economics and technology. In fact, we are now in a situation in which problems of health and health care can no longer be solved without cooperation from these other research areas. What is most necessary is a new ethical standard. This can be developed through ideas based on a system of bioethics in which Occidental humanism and Oriental humanism are combined to a substantial degree. I believe that the establishment of this type of bioethics can lead to the successful institutionalization of health, health care and welfare for the 21st century. PMID- 6484373 TI - [Studies on industrial ecology at the Japan Industrial Policy Research Institute]. PMID- 6484374 TI - Occupational health in Japan--the future role of UOEH. PMID- 6484375 TI - Validity and treatment dilution in Zelen's single consent design. AB - Employing randomization theory, this note examines the manner in which a clinical trial employing Zelen's randomized consent design yields an estimated treatment effect free of selection bias. We also examine the concept of 'treatment dilution' in this design. PMID- 6484376 TI - Comparison of two statistical techniques for the surveillance of birth defects through a Monte Carlo simulation. AB - In a multi-hospital surveillance system for detecting increases in congenital malformation rates, the performance of the set technique applied individually to hospitals and of the cumulative sum (Cusum) technique applied to the aggregate of hospitals has been compared using a Monte Carlo method. The Cusum technique appears to be both more sensitive to real increases and less likely to issue false alarms. PMID- 6484377 TI - A classification of Scottish infants using latent class analysis. AB - This paper illustrates the use of latent class analysis to classify 50,000 infants into a small number of classes or case types, as a preliminary to a study of the allocation of neonatal hospital resources throughout Scotland. Information, extracted from a detailed neonatal discharge record, was summarized by 11 clinical and diagnostic catagorical variables. Statistical models incorporating 1 to 6 latent classes were then estimated using the EM algorithm. The 4 class model was chosen because it provided a good description of the data and the resulting classes had a medical interpretation. The factors influencing the choice of model are discussed and goodness of fit tests are presented. The stability of the classes was also investigated using random halves of the data and an earlier comparable data set. PMID- 6484378 TI - Goodness-of-fit based confidence intervals for estimates of the size of a closed population. AB - Methods for estimating the size of a closed population often consist of fitting some model (e.g. a log-linear model) to data with a missing cell corresponding to the members of the population missed by all reporting sources. Although the use of the asymptotic standard error is the usual method for forming confidence intervals for the population total, the sample sizes are not always large enough to produce valid confidence intervals. We propose a method for forming confidence intervals based upon changes in a goodness-of-fit statistic associated with changes in trial values of the population total. PMID- 6484379 TI - An application of ridge regression analysis in the study of syphilis data. AB - We provide a brief summary of the theory of ridge regression, regress reported rates of congenital syphilis on three stages of adult syphilis using both ridge regression and least squares techniques, and discuss the results. We also develop a principal components regression model for the same example and compare the results. The example demonstrates the usefulness of ridge regression to handle multicollinearity in data. Problems of overestimation and instability associated with ordinary least squares estimates of these non-orthogonal data diminish with use of the ridge regression techniques. PMID- 6484380 TI - A comparison of two methods for calculating expected mortality. PMID- 6484381 TI - Inflatable penile prostheses. PMID- 6484383 TI - [Natural history of chronic hepatitis B]. PMID- 6484382 TI - Penile prostheses: semirigid rod penile prostheses. PMID- 6484384 TI - [Anatomo-pathologic aspects of hepatitis B]. PMID- 6484385 TI - [Mycoses and asthenomycoses]. PMID- 6484386 TI - [Medicine in China: a biopsy]. PMID- 6484388 TI - [Therapeutic effects cannot be studied in a healthy person]. PMID- 6484387 TI - [Practical problems of urodynamics. I. Physiologic and physiopathologic principles of the lower urinary tract]. PMID- 6484389 TI - [Soft dressings and silicone dressings]. PMID- 6484390 TI - [The wound and its dressing. Dermatological requirements]. PMID- 6484391 TI - [Microbial ecological complications in the placement of dressings on the skin]. PMID- 6484393 TI - Semipermeable films as wound dressings. PMID- 6484392 TI - [The myofibroblast. A key cell in wound healing and in fibro- contractive diseases of the connective tissue]. PMID- 6484394 TI - [Management of dressings in the postsurgical ward]. PMID- 6484395 TI - [The fixation of dressings and related problems]. PMID- 6484396 TI - [The wound without a dressing]. PMID- 6484397 TI - [Normal and pathologic anatomy of the pituitary and pituitary adenomas]. PMID- 6484398 TI - [Possibilities and limits of microsurgery. Pituitary adenomas]. PMID- 6484399 TI - [Possibilities and limits of microsurgery of tumors of the sellar region. Meningiomas, craniopharyngiomas]. PMID- 6484400 TI - [Neuro-ophthalmology of the chiasmal syndrome]. PMID- 6484401 TI - [Pseudomembranous colitis]. PMID- 6484402 TI - [Parasitic colitis]. PMID- 6484403 TI - [Colopathies caused by laxatives]. PMID- 6484404 TI - [Collagenous colitis]. PMID- 6484405 TI - [Recurrent postoperative ulcers. Prospective endoscopic and therapeutic study]. PMID- 6484406 TI - [Dyspnea]. PMID- 6484407 TI - [Pneumatosis coli]. PMID- 6484408 TI - [Radiation-induced proctocolitis, the other side of the coin]. PMID- 6484409 TI - [What is your diagnosis? Basalioma]. PMID- 6484410 TI - [Occlusion of a malignant esophagobronchial fistula with an adhesive-anchored endoprosthesis]. PMID- 6484411 TI - [Endoscopic incidence of reflux esophagitis in a group of 20,467 patients]. PMID- 6484412 TI - [Insufficiency of the lower esophageal sphincter. Cause of reflux esophagitis]. PMID- 6484414 TI - [Handedness and various other laterality phenomena]. PMID- 6484413 TI - [Hemispheric man. Introduction]. PMID- 6484416 TI - [Cerebral dominance of left-handed subjects]. PMID- 6484415 TI - [Left hand preference as a result of an early cerebral lesion]. PMID- 6484417 TI - [Neuropsychological findings concerning the role of sex]. PMID- 6484418 TI - [Cerebral dominance and environmental factors: deafness and bilingualism...]. PMID- 6484419 TI - [Auditory cognition and cerebral dominance]. PMID- 6484420 TI - [Amusia and cerebral dominance]. PMID- 6484421 TI - [Technics of experimental neuropsychology for studying cerebral dominance]. PMID- 6484422 TI - [How should we conceive of cerebral dominance?]. PMID- 6484423 TI - [Coronary atherosclerosis: a challenge to take up]. PMID- 6484424 TI - [Indications and value of physical therapy for osteoarticular and neurologic diseases]. PMID- 6484425 TI - Phasic activity of the basolateral amygdala, cingulate gyrus, and hippocampus during REM sleep in the cat. AB - We analyzed the electrical activity of the basolateral amygdala (BLA), anterior and posterior regions of the cingulate gyrus (A-CG and P-CG), the dorsal hippocampus (DH), the anterior ventral thalamic nucleus (AVTN), and the sensory motor cortex during the rapid eye movements and ponto-geniculo-occipital (PGO) activity of REM sleep in cats in chronic preparation. Polygraphic recordings and computational perievent averages using the phasic contractions of the lateral rectus muscle (LR) of the eyeball as the triggering signal of the analysis were performed. We observed biphasic potentials (200-300 ms) of variable amplitude, related to the phasic phenomena of REM sleep, in the BLA, A-CG, P-CG, DH, and AVTN. The latencies of the potentials of these regions were always greater than those of the geniculate PGO activities. We propose that the recorded limbic potentials resulted from propagation of PGO activity and that this phenomenon may reflect the limbic structure of the hallucinatory, vegetative, and emotional components of REM sleep. PMID- 6484426 TI - Hypercapnia alters sleep state pattern. AB - Mild hypercapnia in the adult animal does not affect sleep pattern but more severe hypercapnia in the fetus increases the duration of REM sleep. Adult male rats were exposed daily for 2-3 h sessions at random to 6, 7, and 8% CO2 or room air. Breathing CO2 caused a 60% increase in sleep onset latency, a 28% decrease in sleep duration, but no change in percent time spent in REM. However, the duration of REM sleep episodes increased by 30%. Thus, in both fetal and adult animals severe hypercapnia appears to have a similar effect on sleep pattern. PMID- 6484427 TI - Daytime alertness in relation to mood, performance, and nocturnal sleep in chronic insomniacs and noncomplaining sleepers. AB - Nocturnal sleep was recorded prior to daytime testing that included the Multiple Sleep Latency Test, profile of mood states, card sorting, and Stanford Sleepiness Scale in 138 volunteers with the complaint of chronic insomnia and 89 noncomplaining sleepers ("normals"). In both groups daytime sleep tendency had no significant linear correlation either with any Minnesota Multiphasic Personality Inventory scale or with tension/anxiety and other moods assessed in the morning. In normals, speed of card sorting but not subjective sleepiness tended to correlate with sleep tendency. Given that physiological sleepiness is the most predictable consequence of sleep deprivation in normals, it is particularly interesting that 14% of the insomniac group are chronic insomniacs with no measurable daytime sleep tendency. Despite this lack of sleep tendency during the day, their nocturnal sleep was just as poor as insomniacs with greater daytime sleep tendency. The lack of daytime sleepiness seen in this subgroup may reflect a basic pathophysiological aspect of their insomnia. PMID- 6484428 TI - Middle latency auditory evoked potentials in sleep apneics during waking and as a function of arterial oxygen saturation during apneas. AB - In adults with obstructive sleep apnea middle latency auditory evoked responses were recorded as a function of apnea-related arterial oxygen desaturation both before sleep onset and during nocturnal sleep. In waking, wave Pa latency was normal in five of six subjects, and Pa amplitude was normal in all. During sleep apneas, wave Pa remained stable even during intervals of severe oxygen desaturation (e.g., 45-90% and 50-84% saturation in two subjects). Furthermore, wave Pa recorded immediately on awakening in the morning was unaltered compared with the response recorded just prior to sleep onset, despite a high frequency of nocturnal apneas in all subjects. These data indicate that repetitive nocturnal oxygen desaturation associated with severe obstructive sleep apnea syndrome has neither immediate nor cumulative measureable effects on the functioning of neurons that subserve the middle latency evoked response. These findings are discussed in relation to a possible cortical contribution to the middle latency response. PMID- 6484429 TI - Relationship between physical, psychological, social, and environmental variables and subjective sleep quality. AB - In a survey study of patients of a general practitioner the relationship between sleep quality and a heterogeneous set of other variables was examined. The data file was divided randomly, and a two-staged multiple regression analysis was performed on each half. The two resulting regression equations were cross validated on the data of the other data file. The variables mood, age, and use of medicine proved to have the most significant relationship to sleep quality. PMID- 6484430 TI - Sleep interruption and exercise. AB - Five men and five women participated in a study comparing the effects of sleep interruption with and without the imposition of physical activity. Subjects were awakened following the second REM period and returned to sleep 1 h later. In the IS condition they sat up and read during this period; in the ISE condition they exercised for 50 min at 60% VO2max. Relative to undisturbed sleep (US), IS resulted in a substantially shortened third non-REM (NREM) period, increased eye movement (EM) duration and density in the third REM period, and increased slow wave sleep (SWS) in the fourth NREM period. The loss of delta sleep in the shortened NREM period was compensated for by an increase in delta sleep in the fourth NREM period (r = -0.90). However, total SWS obtained after interruption was unchanged from US. The ISE condition induced increases in cardiac output and temperature during sleep. No consistent changes in SWS were observed relative to IS, but the duration of the third REM period was reduced as well as EM duration and density within that REM period. Since REM sleep propensity is typically highest during the metabolic nadir of early morning sleep, the suppression of tonic and phasic components of REM sleep after ISE was concluded to result from the exercise-induced increase of metabolism and body temperature during sleep. PMID- 6484431 TI - Automatic detection at the polygraph of malposition of the Hewlett-Packard ear oximeter. PMID- 6484432 TI - Importance of mazindol in the treatment of narcolepsy. PMID- 6484433 TI - [The SAG solution]. PMID- 6484434 TI - [Diagnostic laboratory procedures for patients with hemorrhage follow-up in intensive care units]. PMID- 6484436 TI - [Penile revascularization in the treatment of vasculogenic sexual impotence]. PMID- 6484435 TI - [Laboratory control of the effect of anti-vitamins K on blood coagulation]. PMID- 6484437 TI - [Surgical treatment of fibromuscular lesions of the renal arteries]. PMID- 6484438 TI - [Actinic arterial lesions: effects of a dose of 2000 rads on the iliac artery of rabbits]. PMID- 6484439 TI - [Therapeutic heparinization by subcutaneous route with individualized adjustment of the injected dose and of the time schedule of administration]. PMID- 6484440 TI - [Thompson's surgery in the treatment of lymphedema of the lower extremities]. PMID- 6484441 TI - [Endarterectomized arteries as vascular substitutes in reconstructive aorto-iliac and femoro-popliteal surgery]. PMID- 6484442 TI - [Subclavian vein. Anatomical repair for its puncture by infraclavicular route]. PMID- 6484443 TI - [Bronze baby syndrome. Report of 2 cases and re-evaluation of the problem]. PMID- 6484444 TI - [Technical management of difficult cholecystectomy]. PMID- 6484445 TI - Lactate levels in Brucella arthritis. AB - In this study the synovial fluid cell types and the synovial fluid lactate levels of patients with Brucella, septic rheumatoid, gouty and osteoarthritic mono arthritis are presented. It is shown that lactate levels coupled with the clinical picture and the cell type of the synovial fluid appear to be an early additional diagnostic marker for the differentiation between septic, inflammatory and brucella-induced mono-arthritis. PMID- 6484446 TI - DNA antibodies with and without complement-binding ability. AB - The relationship between immunoglobulin class and complement-binding ability of DNA antibodies was studied by indirect immunofluorescence and Crithidia luciliae (CL) as substrate in the sera of 28 patients with SLE and antibodies to CL-DNA. In 15 of 28 cases the antibodies bound complement and were IgG either alone or in combination with IgA and IgM. In the remaining 13 sera the antibodies were either IgA or IgM and did not bind complement. Only one of nine patients with nephritis had CL-DNA antibodies of IgM alone, whereas that was true for 10 of 19 patients without nephritis. The factors influencing the complement binding were further studied by using purified IgM rheumatoid factors. Their ability to 'mask' the IgG type CL-DNA antibodies and to inhibit the binding of complement was confirmed. These findings suggest that complement activation in SLE does not occur in patients with IgM-type anti-ds-antibodies or in patients with rheumatoid factor activity. PMID- 6484447 TI - The clearance of heat-damaged erythrocytes by the reticulo-endothelial system in systemic lupus erythematosus and rheumatoid arthritis. AB - Reticulo-endothelial function was assessed in 20 patients with active rheumatoid arthritis and 11 patients with systemic lupus erythematosus with regard to the clearance of heat-damaged erythrocytes (HDE). In contrast to previous reports, no correlations were found between disease activity, levels of circulating immune complexes and splenic function. There was no evidence of an obvious hypofunction in the reticulo-endothelial system of the spleen in patients with rheumatoid arthritis or systemic lupus erythematosus. Moreover, a splenic hyperfunction is suggested to be present in some patients. A method for measuring the specific uptake by the liver, spleen and the clearance rate (T 1/2) of the HDE is also described. PMID- 6484448 TI - Distribution of [3H]-D-penicillamine in mouse kidney. An autoradiographic study. AB - 3H-labeled D-penicillamine has been injected in mice in order to study by autoradiography its distribution in the kidney. The results show heavy accumulation of the drug in the epithelial cells of the proximal tubules of the kidney, whereas glomeruli and distal tubules do not show any significant accumulation. This peculiar tropism of penicillamine to proximal tubules is entirely consistent with the Heymann's nephritis model suggested by Bacon as a pathogenetic model for penicillamine-induced nephropathy. PMID- 6484449 TI - An overlap of diffuse fasciitis with eosinophilia and scleroderma. PMID- 6484451 TI - Glossary of chronobiology. PMID- 6484450 TI - Relapsing polychondritis with aortic arch aneurysm and aortic arch syndrome. AB - A case of relapsing polychondritis with aortic arch aneurysm and aortic arch syndrome is described. The pattern of vascular involvement supports the inclusion of relapsing polychondritis within the spectrum of systemic vasculitides. PMID- 6484452 TI - [Theoretical evaluation of the nutritive value of daily diets in boarding schools based on the results of laboratory analysis. IV. Group B vitamins]. PMID- 6484453 TI - [Cadmium and lead concentrations in potato samples from various regions of Poland]. PMID- 6484454 TI - [Effect of emissions in the region of the Stalowa Huta plant and power station on the content of various trace elements of selected vegetables and fruit. II. Lead, cadmium, zinc, copper, nickel and iron content of fruit]. PMID- 6484455 TI - [Comparative determination of the total mercury in food by the dithizone method and flameless atomic-absorption spectrophotometry]. PMID- 6484456 TI - [Obesity in schoolchildren and various environmental factors]. PMID- 6484457 TI - [Effect of carbendazyme (MBC) on spermatogonia of laboratory animals]. PMID- 6484458 TI - [Formation of polychlorinated dibenzofurans (PCDF) during pyrolysis of chlorophenols and various herbicides of Polish production]. PMID- 6484459 TI - [Effect of the quality of drinking water on the health status of the adult population in the area of irrigated fields in Wroclaw. Origin of the problem and methods of studies]. PMID- 6484460 TI - [Properties of technetium Tc 99m phytate complex--studies in vivo and in vitro]. PMID- 6484461 TI - [Effect of social environment on food habits under conditions of food rationing and new food prices. Studies of Warsaw's adolescents 1982]. PMID- 6484462 TI - Bronchography in patients with suspected lung malignancy. AB - Bronchography and flexible fiberoptic bronchoscopy (FFB) were performed on 95 patients with suspected lung malignancy. Finally, 66 of 95 lesions turned out to be malignant and 29 benign. Bronchographic diagnosis was correct in 46 of 66 cases of cancer (70%) but gave a false negative result in 20 malignant lesions and a false positive result in four benign lesions of which three had pulmonary tuberculosis and one hamartoma of the lung. It is concluded that bronchography is rarely indicated in central malignant lesions. In peripheral lesions bronchographic findings for malignancy are unreliable or negative. PMID- 6484463 TI - [Roentgenologic observation of the course following sternotomy]. AB - The course of healing after medial sternotomy can be controlled by means of tomography of the sternum. If healing progresses in a normal way, restitution can be seen in the region of the corpus sterni after about 20 days, whereas restitution in the area of the manubrium sterni is evident after 8 weeks only. Osseous absorption is a leading x-ray sign of disturbed restitution, the other leading sign being persistence of dehiscence of the sternum following sternotomy. PMID- 6484464 TI - [Thorotrast deposits in the RES of the liver and spleen--a rare but characteristic roentgen diagnosis]. AB - Finely reticulated or granulated shadows of liver and spleen, as well as metal dense shadows of abdominal lymph nodes are characteristic roentgen findings in thorotrastosis. Thorium dioxide (Thorotrast) was used as a contrast medium from 1930-1950. It yielded excellent contrast and was well tolerated, but due to its radioactivity and its long biological half-life it caused manifold late complications. The typical roentgen findings in thorotrastosis are illustrated by two cases; the importance of thorotrastosis is discussed on the basis of relevant literature. PMID- 6484465 TI - [Involvement of diaphragmatic lymph nodes in Hodgkin's disease]. AB - The authors report on a case of Hodgkin's disease with enlargement of diaphragmal lymph nodes. Detailed attention is paid to the anatomy, radiological diagnosis and differential diagnosis of these mediastinal lymph nodes. The clinical importance of this group of lymph nodes in Hodgkin's disease and in non-Hodgkin lymphomas is discussed. PMID- 6484466 TI - [Preservation of the voice after laryngectomy]. PMID- 6484467 TI - [Early diagnosis of neurinoma of the acoustic nerve]. PMID- 6484468 TI - [Angiomas of the face and neck. Clinical description and therapeutic principles]. PMID- 6484469 TI - [Can ear drops be ototoxic?]. PMID- 6484470 TI - [Sinus aspergillosis]. PMID- 6484471 TI - [The laser in ORL surgery: indications and limitations]. PMID- 6484472 TI - [Potential life years lost according to cause, in Fortaleza (Brazil), 1978-80]. PMID- 6484473 TI - [Mortality in Brazil in 1980]. PMID- 6484474 TI - [Evolution of immunoglobulins involved in the immune response of mice to Schistosoma mansoni]. PMID- 6484475 TI - [The psychologist, public health and preventive efforts]. PMID- 6484476 TI - [Female sterilization: free choice and oppression]. PMID- 6484477 TI - [Epidemiological aspects of mortality among patients with Hansen's disease in the State of Sao Paulo, Brazil (1931-1980)]. PMID- 6484478 TI - Postpartum thyroid dysfunction. PMID- 6484479 TI - Evaluation of dipsticks for the assessment of microhaematuria. AB - Three types of dipstick were evaluated for the detection of microhaematuria. One type showed no false positives with erythrocyte-free urine, and no false negatives with a urine erythrocyte concentration of 20 X 10(6)/l using 5-10 X 10(6)/l as limit. This pattern of readings was produced by all the observers, thus indicating that method variation was satisfactory. The two other types of dipstick were clearly less sensitive, and had less desirable characteristics. PMID- 6484480 TI - Reference intervals for urinary glucose in pregnancy. AB - Reference interval upper limits for glucose in urine from non-fasting pregnant women, estimated by a glucose dehydrogenase method are higher than for non pregnant women (1.4 mmol/l) and increase with gestational age: week 10-20, 2.0 mmol/l (n = 158); week 21-30, 2.3 mmol/l (n = 124) and week 31-42, 2.7 mmol/l (n = 245). The reagent strip Tes-Tape correctly identified glucosuria above a clinical decision limit of 7 mmol/l and reacted in two-thirds of urine samples with from upper reference interval to 8 mmol/l of glucose. The reagent strip Uristix in no case gave a positive reaction. PMID- 6484481 TI - Viability in split-skin biopsies measured by a surface oxygen electrode. AB - A method for the evaluation of split-skin biopsies with an oxygen electrode is described. A Clark-type polarographic electrode is placed in controlled contact with the tissue in a thermostabilized chamber specially constructed for the purpose. The electrode allows the monitoring of the adjacent tissue-oxygen tension. Recordings on fresh tissue at different temperatures and post mortem tissue are performed. Fresh tissue yields oxygen-tension falls comparable to in vivo investigations performed by the transcutaneous oxygen electrode. PMID- 6484482 TI - Creatine kinase isoenzymes in serum from children--especially focusing on CK-BB. AB - In 161 children with ages ranging from 7 months to 18 years the concentration of CK-BB in serum was measurable in 58%. The activity in serum of CK-BB (cCK-BB(S] in children varies with age and is not significantly influenced by seizure, epilepsy or body temperature. The values are most elevated during the first year of life and show a rapid fall, never reaching adult levels. Comparing mean cCK BB(S) values in children to growth charts the resemblance is striking. CK-BB is the only CK-isoenzyme that changes with age. We postulate that cCK-BB(S) is related to growth as a physiological phenomenon. CK-MB was found in serum in 7% of the children and could not be of cardiac origin. Therefore CK-MB cannot be regarded as cardiac specific in children. PMID- 6484483 TI - Synthetic protease inhibitors and post-ejaculatory degradation of human semen proteins. AB - Normal post-ejaculatory proteolytic changes in human seminal plasma rapidly distort its electrophoretic protein pattern. This invalidates the electrophoretic evaluation of the content in the secretion from the accessory sex glands. Both agarose and sodium dodecylsulphate polyacrylamide gel electrophoresis (SDS-PAGE) were used to study the proteolytic changes and how they could be modified by various synthetic protease inhibitors. Liquefaction of coagulated semen could be inhibited by adding o-phenanthroline directly after ejaculation, whereas neither neutrally buffered Na2EDTA, di-isopropylfluorophosphate (DFP), benzamidine, nor thiol reagents proved effective. Addition of the serine protease inhibitors DFP and benzamidine, o-phenanthroline, and iodoacetamide substantially retarded the proteolytic alterations of the proteins as demonstrated by both agarose electrophoresis and SDS-PAGE. We recommend that electrophoretic protein analysis of human semen be performed on ejaculates collected in vessels containing protease inhibitors. For routine analysis, the addition of benzamidine ensures sufficient stable proteins to permit reliable electrophoretic analysis of samples stored at room temperature for 4 h. PMID- 6484484 TI - Characterization of the predominant basic protein in human seminal plasma, one cleavage product of the major seminal vesicle protein. AB - From liquefied human seminal plasma, we purified the predominant basic protein which appears following liquefaction of coagulated semen. The protein was purified in the presence of di-isopropylfluorophosphate to retard its degradation. Heparin-Sepharose chromatography was followed by gel filtration (Biogel P 60) and by fast performance liquid chromatography on a reversed phase column (C8). The basic protein is a single polypeptide chain with an apparent molecular mass of 12.8 kDa, and has a pI value between that of trypsinogen (9.3) and cytochrome C (10.3). The protein contains no carbohydrate, is rich in histidine, glutamate, and lysine, but is devoid of both cysteine and methionine. The amino-terminal portion of the protein sequence is unique: H N K Q E G R D H D K S K G H F H R V V I H H K G G K A H R G-. A specific rabbit antiserum was raised against the 12.8 kDa basic protein. The protein was found to be unique to seminal plasma among all extracellular fluids examined. Three immunologically related 52 kDa, 71 kDa, and 76 kDa proteins were identified in seminal vesicle secretion when it had been reduced. Prostatic enzyme(s) degraded these proteins to the 12.8 kDa basic protein and several other basic proteins with apparent molecular masses below 18 kDa. PMID- 6484485 TI - Thyroid function evaluation in the mid '80s. PMID- 6484486 TI - Immunofixation of alkaline phosphatase-immunoglobulin complexes. PMID- 6484487 TI - Purification and storage of thyroglobulin. Two important factors influencing the radioimmunoassay for thyroglobulin. AB - The effect upon the assay of the quality of the thyroglobulin (Tg) used as standard and tracer was evaluated by comparison of two preparations, one purified with protease inhibitors added (Tg-PI) and the other without (Tg-O). Tg-PI proved more stable than Tg-O. After freezing in phosphate-buffered saline almost all 125I-Tg-O was found to have dissociated into 12 S Tg, while only about half the 125I-Tg-PI had done so. Storage in glycerol, 500 g/l, at -20 degrees C or freezing in goat serum improved the quality of the 125I-Tg markedly, but Tg-PI still remained more stable than Tg-O. In addition, the two antisera tested gave different results in the radioimmunoassay with Tg-PI and Tg-O. With one antiserum a gradual loss of Tg immunoreactivity occurred parallel to the dissociation of Tg, while no such effect was noted with the other antiserum. This difference is believed to depend on varying proportions of conformational antibodies in the antisera, the binding sites for the conformational antibodies being distorted by the dissociation of the Tg molecule, while the binding sites for the sequential antibodies remain intact. PMID- 6484488 TI - Effect of intravenous digitoxin on inotropy, haemodynamics and P-Q interval in ischaemic heart disease. AB - The haemodynamic and electrophysiologic responses to rapid intravenous injection of digitoxin (0.6 mg over 5 min) were measured in 6 patients with chronic coronary heart disease without clinical heart failure. Two minutes after end of injection peripheral resistance increased and stroke volume fell, while peak dP/dt in the right ventricle showed minimal increase. AV nodal conduction velocity decreased markedly. Thereafter, the peripheral resistance remained unchanged, stroke volume and peak dP/dt in the right ventricle increased slightly, while AV conduction remained stable. In 2 control patients stable values were found during 60 min. We conclude that digitoxin given intravenously as a single bolus injection induces an abrupt slight increase in peripheral resistance. Thereafter, a gradual increase in inotropy is found. The effect on the AV node appears rapidly and remains stable. PMID- 6484489 TI - Determination of activated plasma fibronectin using radioactive labelled collagen I. AB - The plasma concentration of biological active fibronectin was assayed by a protein binding assay using 125I-collagen I as ligand and heparin as activator. The standard curve is linear for a fibronectin range of 1.1-11 pmol (0.5-5.0 micrograms) and the coefficient of variation was less than 10%. The active or activable fibronectin was compared to the immunoreactive fibronectin in plasma from patients with various bacterial diseases. Similar concentrations were detected by the two assays suggesting that all the circulating fibronectin was functionally active. The assay was also applied to determine the structure function relationship of heparin and heparansulphate in activation of fibronectin. Low-sulphated heparansulphate from umbilical cords and heparin activated fibronectin but the effect was uncorrelated to anticoagulation activity. Only a small fraction of the heparin was actually capable of activating fibronectin. It is concluded that the assay is very convenient to detect biological active fibronectin and to elucidate the structure-function relationship of heparin and heparansulphate in activating fibronectin. PMID- 6484490 TI - A comparison between serum ferritin concentration and the amount of bone marrow stainable iron. AB - There was good parallelism between serum ferritin levels and the amount of bone marrow stainable iron in 123 patients with gastritis, gastric ulcer and duodenal ulcer. A serum ferritin concentration of about 20-25 micrograms/l is the approximate level below which stainable iron cannot be demonstrated in the bone marrow. PMID- 6484491 TI - Methods for determination of conjugated bilirubin in rat faeces. AB - Conjugated bilirubin was prepared from the faeces of germ-free (GF) rats by three different preparative methods. The bilirubin conjugate preparations were coupled with diazotized ethyl anthranilate and the formed ethyl anthranilate azopigments were quantified spectrophotometrically and separated by thin-layer chromatography (tlc). The most polar azopigment was purified by tlc and subjected to ammonolysis followed by tlc of the released saccaride. As a result of this procedure, only glucuronic acid was detected as the conjugating saccaride thus indicating that the most polar azopigment prepared from GF rat faeces was the delta ethyl anthranilate azopigment. Reference azopigments were prepared from GF rat small intestinal contents and subjected to separation by tlc. The azopigment pattern was very similar to the pattern obtained with the faecal azopigment preparations and a maximum of ten separated azopigment spots were detected. The findings indicated that, in addition to bilirubin glucuronides, other bilirubin conjugates with unknown structure are excreted with the faeces of GF rats. One of the preparative methods used for the preparation of conjugated bilirubin from GF rat faeces was tested on faeces from conventional (CONV) rats. From these preparations, no ethyl anthranilate azopigments were formed, thus indicating that faeces from CONV rats is devoid of conjugated bilirubin. PMID- 6484492 TI - Deconjugation of bilirubin conjugates and urobilin formation by conventionalized germ-free rats. AB - The amounts of conjugated bilirubin and urobilins/urobilinogen were determined semiquantitatively in faeces of germ-free (GF) rats during GF condition and after conventionalization by oral administration of faeces suspension from conventional (CONV) rats. The amount of bilirubin conjugates, detected as their ethyl anthranilate azopigments, decreased rapidly 1 day after conventionalization. Thin layer chromatography analysis of the corresponding faecal azopigment preparations showed that some azopigments started to disappear a few days after the conventionalization, indicating that their corresponding bilirubin conjugates were deconjugated by the bacteria in the intestine. On day 21 after conventionalization, only two azopigments were detected, namely the unconjugated and glucuronic acid conjugated dipyrroles of bilirubin, respectively, thus indicating the presence of only one bilirubin conjugate, the monoglucuronide. After 69 days no azopigments could be detected, indicating the total absence of conjugated bilirubin in these faeces samples. No urobilins were detected in faeces of the rats during their GF state, but these metabolites appeared in faeces one day after conventionalization and increased during a few days to a CONV level. PMID- 6484493 TI - The biomaterial-tissue interface: a morphological study utilizing conventional and alternative ultrastructural modalities. AB - The interface between oral tissues and ceramic endosteal dental implants was investigated in 36 experimental cases in dog jaws. Conventional electron microscopic modalities showed those tissues adjacent to the implants to be viable with no adverse cellular response to the biomaterial. A procedure to retrieve additional ultrastructural data from previously processed biological material was developed to expand upon these data. This included surface-etching with oxygen plasma of routinely processed electron microscopy specimens and formalin fixed histological specimens for scanning electron microscopy (SEM) study; and, cryofracturing of similar histological specimens for additional transmission electron microscopic (TEM) analysis. Results from these alternative protocols supported our observations from conventional studies of the direct association of bone and epithelia to the implant. In addition, they demonstrated a unique portrayal of the epithelial maturation patterns. Further, this alternative TEM method showed excellent retention of cellular integrity and demonstrated a hemidesmosomal-external basal lamina attachment apparatus at the junctional epithelial-implant interface. This latter composite attachment structure was not retained in our previous conventional microdissection procedures. Thus, the interface between oral tissues and the single crystal sapphire endosteal dental implant could be elucidated by these protocols. PMID- 6484494 TI - Scanning electron microscopic study of the epithelial-mesenchymal junction of the esophagus. AB - This is a study of the appearance by scanning electron microscopy of the stromal papillae and basal lamina at the epithelial-mesenchymal junction of the human esophagus. After incubation in 2N sodium bromide at 60 degrees C. for 1 hour, the squamous epithelium was removed gently under the dissecting microscope from esophageal specimens from six normal human esophagi. The remaining stromal surface covered by an intact smooth basal lamina was examined "en face" by scanning electron microscopy. Transmission electron microscopy confirmed that the separation following NaBr was between the basal cell plasma membranes and the basal lamina, and that the basal lamina and subbasal connective tissue were well preserved and attached normally to each other. Complex topographical patterns consisting of various numbers of simple and branched papillae and blade-like stromal folds were observed. Papillae had helical contours because of the spiral capillaries within them. Subepithelial capillaries were also visible as interconnecting linear ridges in the interpapillary zones. There was great variation in papillary length and patterns between individuals, but there was no difference in patterns or papillary length in sections taken from lower, middle, and upper portions of the esophagus in a given patient. These findings suggest that comparisons of absolute length of stromal papillae in different individuals should not be interpreted as a pathologic change. The results reveal an unexpected complexity in this epithelial-stromal interface. PMID- 6484495 TI - Embryology of the mouse from ovulation through peri-implantation stages in vitro. AB - Because mammalian embryos derive their nourishment from a placenta their early development is different from that manifested by embryos that develop outside the mother's body. Although development in mammals may be studied by using representative examples obtained by recovery methods, it is very fascinating to watch living embryos develop in the laboratory. Advances in culture techniques have made it possible to observe development of pre-implantation mammalian embryos entirely in vitro. The sequence of in vitro development may be interrupted at any time and selected specimens processed for scanning electron microscopy. Observation with the scanning electron microscope on developing mouse embryos revealed the mosaic nature of the oocyte and the dynamics of the egg membrane as egg activation proceeded from incorporation of the spermatozoon to extrusion of the polar body. During early cleavage the dividing cells remained attached to each other only by ionic attraction but prior to formation of the blastocyst the cells established extensive foci of junctional contacts. Interaction between blastocyst-stage embryos and uterine epithelial cells were approximated by co-culturing embryos with uterine cells and the SEM revealed the cell to cell interactions during peri-implantation development. PMID- 6484496 TI - Neutrophil and monocyte behaviour in three-dimensional collagen matrices. AB - Neutrophil granulocytes migrate rapidly into three-dimensional gels of native collagen fibres, the leading front of the cell population moving approximately 100 micron/hour when the cells are unstimulated. Migration occurs in the apparent absence of adhesion to collagen fibres, as neutrophils do not adhere to collagen coated glass and are unable to locomote over collagen-coated surfaces, probably due to lack of traction with the substratum. It would appear, therefore, that the mechanism of neutrophil movement through three-dimensional collagen gels is fundamentally different to the mechanism of migration over a planar substratum. Freshly isolated blood monocytes do not invade collagen gels. However, if monocytes are cultured on serum-coated plastic, approximately 80% of the cells spontaneously detach from the culture surface over a 48 hour period: these detached cells invade collagen gels, although at a much slower rate than neutrophils. PMID- 6484497 TI - Morphological and behavioral characteristics of two rat tumor cell lines with different metastatic capacities. AB - The morphological characteristics of two rat tumor cell lines were studied by means of scanning electron microscopy. While the ASML-cells (Ascites, Solid, Metastases, Lung) when spread via the lymphatic vessels form metastases in the lung, the AS-cells (Ascites, Solid) do not form secondary tumors. The ASML-cells do not attach on glass or plastic but grow in suspension; AS-cells, can be cultivated as monolayers. The ASML-cells form loosely packed clusters when they are shaken in a gyratory shaker, AS-cells produce well organized aggregates in which the intercellular contacts are very intensive. When a mixture of cells from both lines is aggregated the two types sort out and the line-specific aggregate or cluster is formed without interaction between the two types. ASML-cells remain spherical when confronted with pieces of the aortic wall and there are no signs of reaction with the underlying endothelial cells. The endothelium is drastically altered when AS-cells are seeded on top of the aortic wall: the tumor cells flatten, penetrate the endothelial layer and induce the endothelial cells to retract. These phenomena can also be seen in confrontations with the mesothelium of the diaphragm. As also cells from aggregates or clusters behave as the single cells we conclude that the newly formed heterotypic contacts are favored over homotypic ones. In addition they have proved to be more intensive. PMID- 6484498 TI - The effects of 10 Gy single-dose irradiation on the ciliated epithelium measured during and one-to-ten days following irradiation. A comparative physiological and morphological study. AB - Experiments recently done in this laboratory have shown that ionizing irradiation can result in an increase in the ciliary beat frequency of the trachea in vitro even during ongoing irradiation, implying an immediate stimulation of the physiological activity of the cells. This phenomenon is not fully understood and is by itself contradictory to general radio-biological concepts. Ultrastructural investigations on specimens taken immediately after irradiation (10 Gy) have, so far, not shown any changes. It has therefore seemed useful to extend the investigations by examining the effects of in vivo- irradiation (10 Gy) on rabbit trachea during the first 10 days after treatment. The following results have been obtained: Phase I: On days 1-3 after irradiation the beat frequency showed a slight increase (10%) within the irradiated part in comparison with a non irradiated area of the trachea. No pronounced ultrastructural changes were found these days. Phase II: On days 4-7 after irradiation the mucociliary activity was reduced in those places where it could be measured. The surface of the cilia assumed a generally destructed appearance with elongated cilia and disorganisation. TEM-pictures showed an increased amount of goblet cells and signs of membrane damage such as cytoplasmic extrusions at the apical end of the cells. Phase III: On days 8-10 after irradiation a normalization of the tissue gradually took place with a beat frequency returning to normal. The ciliary surface showed a recovery process which also could be observed in the TEM pictures. PMID- 6484499 TI - Morphological changes in L1210 leukaemic cells induced by hyperthermia. AB - The colonogenic survival of L1210 leukaemic cells was assessed by spleen colony assay after cells were heated for 5, 10, 15 or 30 minutes at 43 degrees C. Similar cells which were fixed within 60 seconds of heating by glutaraldehyde were examined by scanning electron microscopy (SEM). The appearance of heated cells was compared with unheated controls which had been stored for one hour at 37 degrees C, 4 degrees C, and 22 degrees C respectively. After a heat treatment of 15 minutes at 43 degrees C the clonogenic fraction is only 0.1 but the appearance of approximately half the cells examined by SEM was unchanged. Virtually every cell heated for 30 minutes at 43 degrees C was abnormal. Progressive changes in the cell membrane were seen, such as loss of microvilli, folding and corrugation of the cell membrane and development of blebs. The lethal injury to cells is probably damage to enzyme systems in the cell membrane and elsewhere in the cell which is expressed as loss of clonogenicity. It is noteworthy that some cells appear to have been sterilised before morphological changes were seen. Two explanations are possible. The lethal injury as expressed by sterilisation may precede morphological changes or alternatively as cells had been heated for only a short time (10 or 15 minutes) and fixed within 60 seconds of heating, insufficient time had elapsed for gross changes to develop. PMID- 6484501 TI - Scanning electron microscopy of the retina in an animal model of hereditary blindness. AB - Scanning electron microscopy was performed on retinas from normal and a mutant strain of chickens suffering from congenital blindness with retinal degeneration. Both surface and cryofractured transverse views of the retina were examined. Photoreceptors were generally seen to degenerate along a central to peripheral gradient: the more damaged receptors located centrally while areas of normal appearing photoreceptors were located toward the ora serrata. Pathological changes included deformed and missing outer segments and short, swollen inner segments. Reactive changes in overlying pigment epithelium (PE) were also noted over areas displaying advanced photoreceptor degeneration. PE changes included both hypertrophy and dystrophy of cells, detached cells, and formation of clusters or nodules along Bruch's membrane or in the sub-retinal space among photoreceptor inner segments. Among the 6 types of photoreceptors in the chicken retina (1 type of rod and 5 types of cones), more intact double cones were identified in areas undergoing retinal degeneration than other types. Double cones may be more resistant to the factor(s) involved in cellular death. PMID- 6484500 TI - Structural changes in auditory hairs during temporary deafness. AB - The stereocilia of auditory hair cells were examined with a scanning electron microscope during periods of noise-induced temporary threshold shift. The stereocilia in the tallest row of each tuft of the noise-exposed ears were clumped together compared with control ears. This suggests to us that clumping of the longest stereocilia might be a reversible mechanism of the hair cell to protect itself from overstimulation. The rate of recovery following exposure to noise was monitored by measuring the first neural component of the cochlear potential response. The duration of the noise was adjusted to ensure sufficient time to fix the ears during the period of temporary deafness. Alcian blue was added to the fixative to preserve the glycocalyx of the stereocilia. The experiments were done in the basal region of the auditory organ of the alligator lizard. This region is characterized by hair cells with long free-standing stereocilia. PMID- 6484502 TI - The effects of zinc deficiency on developing photoreceptors in the rat retina: a scanning microscopic study. AB - A study was undertaken to observe the effects of dietary zinc deficiency on the topographical morphology of developing photoreceptor (rod) cells in the sensory retina of the rat. Observations were made by means of scanning electron microscopy (SEM). Pups were utilized from three groups including (1) zinc deficient (2) pair-fed controls and (3) ad libitum controls. Animals ranged in age from birth to twenty days. Femur zinc levels were measured by flame atomic absorption spectrophotometry. A statistically significant increase in the number of photoreceptor cells continued through the 6th day, however, no morphological differences were noted among cells during the first 13 days. By day 14, outer segments appeared more elongated in ad libitum control tissues. No differences in outer segment length were apparent by day 20. PMID- 6484503 TI - Subcellular distribution of potassium in striated muscles. AB - Microanalytical experiments have been performed to answer the question whether the main cellular cation, K+, follows the water distribution in the striated muscle cell or whether K+ follows the distribution of negative fixed charges (beta- and gamma-carboxyl groups of aspartic and glutamic acid residues). Subcellular localization of K and/or of the K surrogates Rb, Cs, and Tl has been investigated by the following methods: Chemical precipitation of K with tetraphenylborate. Autoradiography of alkali-metals and Tl in air-dried and frozen-hydrated preparations. TEM visualization of electron dense Cs and Tl in sections of freeze-dried and plastic embedded muscle. X-ray microanalysis of air dried myofibrils and muscle cryosections. The experiments consistently show that K, Rb, Cs, and Tl do not follow the water distribution but are mainly accumulated in the A band, especially in the marginal regions, and at Z lines. The same sites preferentially accumulate Cs or uranyl cations when sections of freeze-dried, embedded muscle are exposed to these electron microscopic stains. It is concluded that the detected uneven distribution of K, Rb, Cs, and Tl in muscle is neither a freeze-drying artifact nor an embedding artifact and may result from a weak ion binding to the beta- and gamma-carboxyl groups of cellular proteins. PMID- 6484504 TI - X-ray microanalysis of rat exorbital lacrimal gland. AB - X-ray microanalysis was carried out on resting and stimulated rat exorbital lacrimal gland. The acinar cells of the resting gland are rich in calcium, which is localized in the secretory granules. In vitro stimulation with the cholinergic agonist carbachol leads to decreased cellular concentrations of K and increased concentrations of Na and Cl, concomitantly with intracellular vacuole formation. In vivo stimulation with pilocarpine leads after 90 min to loss of virtually all secretory material and also of the major part of the intracellular calcium. The secretory material is replenished after 24 h, and calcium levels in the acinar cells are then comparable to those in the resting gland. Chronic pilocarpine treatment induces significantly elevated calcium levels in the acinar cells of rat lacrimal gland. PMID- 6484505 TI - X-ray microanalysis of protein sulphydryl groups in chromatin. AB - A variety of evidence suggests that the protein sulphur in condensed chromatin tends to form disulphide bonds, whereas that in dispersed chromatin tends to exist as sulphydryl groups. X-ray microanalysis of mouse chromosomes showed a greater concentration of sulphur in heterochromatin than in euchromatin. Without the use of specific cytochemical reagents, it cannot be determined whether this sulphur in chromosomes is in the form of sulphydryls or disulphides. Two maleimides containing distinctive elements have been studied as X-ray cytochemical reagents for sulphydryl groups. Although adequate X-ray signals can be obtained from both, they give some non-specific staining, and do not appear to bind to all the available sulphydryl groups. PMID- 6484506 TI - The uric acid-whewellite association in human kidney stones. AB - Human kidney stones, composed almost exclusively of uric acid and whewellite, were studied using x-ray (powder and single-crystal) as well as scanning electron diffraction techniques. Whewellite--showing as a concentric aggregate characteristically marked by radial striations--is enclosed within a mass of uric acid, the crystallites of which grow with their b axis parallel to the radial direction of the striations. That axis corresponds to b (2 X 7.294 A) and tends to systematically superimpose over its uric acid counterpart (b = 7.40 A). Nonetheless no other such dimensional match was found for the other set of periodicities that characterize the uric acid whewellite interfaces, raising questions that a systematic epitaxial interaction could there take place. Selected uric acid-whewellite contacts and the crucial role of the "matrix" were also investigated. PMID- 6484507 TI - Mineralization of short term pericardial cardiac patch grafts. AB - Glutaraldehyde fixed patch grafts of bovine pericardium were implanted in myocardial windows in young (3-4 months old) sheep. The samples were retrieved after one to three weeks for study with scanning electron microscopy (SEM) and energy dispersive x-ray microanalysis (EDX). A layer of porous material (pseudoneointima, PNI), consisting mostly of a dense mesh of fibers interspersed with blood cells, was noted to form on the blood contacting surface of the graft. Four distinct sets of mineralization were noted in the retrieved grafts: (1) at the blood contacting surface of the PNI; (2) within the PNI at the junction between layers of PNI with differing densities; (3) near the junction of PNI and pericardium (but in the PNI); and (4) within the pericardium. In both the PNI and pericardium the mineral was shown by EDX analysis to contain both calcium and phosphorous indicating the mineral to be a calcium phosphate. Mineralization in the PNI differed from that in the pericardium; in the PNI it was deposited in discrete regions and apparently in association with thrombi while in the pericardium it was distributed diffusely within the collagen matrix, which may influence its formation. PMID- 6484508 TI - A study of raphide microstructure in relation to irritation. AB - Raphides from fourteen genera in seven families of flowering plants were examined using light and scanning electron microscopy. Raphides from an additional fifteen genera were described from literature. Of these thirty-four plants, fourteen were known to cause irritation. Barbs are associated with irritation in the families Araceae and Leeaceae, but not Vitaceae. Of the seventeen taxa described that contain raphides with barbs, six also have grooves on their crystals. The relationship between grooves and irritation is inconsistent. In seven examples in the family Araceae, raphides with grooves are associated with irritation. In three examples, one in the family Araceae and two in the Lemnaceae, raphides with grooves are present with little or no associated irritation. Plants that contain raphides without barbs or grooves are associated with irritation only if the raphides are greater than 180 microns in length. Four taxa that contain raphides longer than 180 microns without barbs or grooves are associated with irritation. However, nine taxa that contain raphides shorter than 180 microns without barbs or grooves do not cause irritation. It appears that raphide microstructure and size both contribute to irritation. However, the lack of a consistent association of barbs and grooves with irritation does not rule out the additional presence of a chemical toxin. PMID- 6484509 TI - [Visual hallucinations in the hemianopic field in homonymous hemianopsia]. PMID- 6484510 TI - [Protection of the water supply. Threshold values for waste water, biological tests, measures to be taken]. PMID- 6484511 TI - [Experiences with new regulations on the water laws]. PMID- 6484512 TI - [Biotests--current status and development: tests using fish--effect-related biotest methods--ecological tests]. PMID- 6484513 TI - [Biotests--current status and development: mutagenicity testing systems]. PMID- 6484514 TI - [The significance of ichthyofauna in the sanitation of still water]. PMID- 6484515 TI - [Aeration of water as aid in water protection--the Teltow Canal example]. PMID- 6484516 TI - [Aero-thermophilic stabilization of sewage sludge]. PMID- 6484517 TI - [The study "Organic Halogen Compounds in Water" by the Water Chemistry Section of the Association of German Chemists--task, work plan and comparison with the phosphorus study]. PMID- 6484518 TI - [Cellulose sewage--hazards, maximum content in sewage, preventive measures]. PMID- 6484519 TI - [Experiences with the inspection of sewage from nuclear power plants as an example for decreasing industrial waste water disposal]. PMID- 6484520 TI - [Semi-technical experiments for elimination of phosphates from sewage-treatment plant disposal]. PMID- 6484521 TI - [Model for evaluating hazardous substances in water and its possibilities for application]. PMID- 6484522 TI - [Sewage canals as a cause of ground-water hazards]. PMID- 6484523 TI - [Analysis of total parameters for the determination and evaluation of water pollution]. PMID- 6484524 TI - [The application of biotests using aquatic test organisms]. PMID- 6484525 TI - [Responsibility of the physician with regard to the third party in the treatment of schizophrenic patients]. PMID- 6484526 TI - [Self healing attempts by schizophrenic patients]. AB - There has effectively been no investigation, at a systematic empirical level, whether schizophrenics possess self-help capability. Clinical observation and self description would seem to make its existence likely. This will first be shown on hand of the pertinent clinical literature. In an own investigation, which was based on a "Model of Vulnerability" (Zubin and Spring, 1977), 40 schizophrenics were questioned in accordance to the formulation provided in the Frankfurt Complaint Questionnaire (Sullwold, 1977) about their compensatory efforts concerning subjectively experienced basic disorders Reaction time measurements served as indicators of schizophrenic vulnerability. All 40 patients reported awareness about compensatory efforts in regard to experienced disorders which they conceived to be danger signals. A clearly greater number of problem solving oriented (active) than non problem solving (passive avoidance) attempts were reported. They can provisionally be classified as "reinterpretation", "restructuring", "reality testing", "action displacement" or "search for action stereotypes". PMID- 6484527 TI - [Between the nature of schizophrenia and the care of schizophrenic patients]. PMID- 6484528 TI - [The old and new picture of the schizophrenic patient]. PMID- 6484529 TI - [Rorschach studies on the so-called epileptic character change]. AB - Structure, frequency, conditions and specificity of epileptic personality change have been estimated in very different ways. Psychological tests and statistical checks have been rare. The Rorschach-test claims to have the only tradition. 140 chronic epileptic patients without dementia were all investigated by psychiatrists and psychological tests. A specific epilepsy-syndrome could not be demonstrated, but nevertheless test-criteria of the organic psychosyndrome. They confirm and complete the psychological finding. PMID- 6484530 TI - [Psychodynamic aspects of schizophrenic negativism in individual psychotherapy]. AB - This is a report of the individual psychotherapy of a schizophrenic woman who has been cured after years of treatment. The report deals mainly with psychodynamic problems such as resistance and negativism. It shows that only a common view of such phenomena, which includes the therapist as well as the patient and establishes a symmetry of experience, can lead to those processes of identification and counter-identification which ultimatively are helpful to both the patient and his therapist. PMID- 6484531 TI - [Schizophrenia and systems therapy]. AB - The notion of Systems Therapy subsumes two different although closely interrelated issues. On the one hand Systems Therapy implies a systemic Eco Anthropology based upon Systems Science, i.e., a Systems Theory of man in and with his environment. On the other hand Systems Therapy is a theory and a practice of the therapeutic transformation of human systems, based upon a systemic Eco-Anthropology. Three basic concepts of Systems Therapy are presented here: the concept of the organism as a system, the concept of the eco-system, and the concept of the transactional field with its basic organization and its corresponding transactional patterns. These concepts are illustrated by many examples taken from case histories of schizophrenic patients and systems. The status quo of the scientific epistemic process in the field of schizophrenia is evaluated from the perspective of Systems Therapy in 1983. With rare exceptions English notions are not translated into German in order to avoid terminological errors and lack of precision. PMID- 6484532 TI - [Schizophrenia: theoretical and therapeutic approaches]. PMID- 6484533 TI - [Sociology and schizophrenia]. AB - From the spectrum of research contributed by the social sciences, the present article highlights some recent studies concerning the role of social factors and the interaction of social and biological factors in the etiology of schizophrenia. Open questions prevail over the settled questions. PMID- 6484534 TI - [The schizophrenic patient and his body: remarks on the psychosomatic economy of dissociative psychoses]. AB - For schizophrenic patients, memory and desire are not bodily experiences. Mnemonic traces can be mobilized only at the cost of acute psychotic disintegration of the Self. This paper emphasizes the importance of understanding the Ego structure, the narcissistic economy and psychotic defenses (denial, splitting) as a psychosomatic the organization. Indeed, during somatic illness we observe a reintegration of the body as the hinge between emotional and symbolic aspects of subjective experience. The author suggests that the psychosomatic viewpoint is particularly useful in understanding the clinical evolution of schizophrenia, in psychotherapeutic management of transference and in the elaboration of psychiatric care policies for such patients. PMID- 6484535 TI - [Phenomenology of schizophrenia]. PMID- 6484537 TI - The effect of postural scoliosis on lumbar apophyseal joints. AB - The effects of leg length inequality with postural scoliosis on the lumbar apophyseal joints was investigated by comparing paired left and right joints, using histological sections from cadavers having a leg length inequality of 1 cm or more, and cadavers having no leg length inequality. A statistical analysis of mid-joint geometry (articular cartilage and subchondral bone thickness) is made from mid-joint histological sections. The study clearly demonstrates that leg length inequality of 1 cm or more is associated with asymmetrical changes in joint cartilage and subchondral bone in the apical and lumbosacral apophyseal joints of the spine in postural scoliosis. PMID- 6484536 TI - Hepatotoxic effects of anti-rheumatic drugs in cultured rat hepatocytes. AB - Drug-induced liver injury has been suggested as a possible mechanism for the liver damage in rheumatic diseases. To evaluate the role of direct toxic action of drugs on hepatocytes, the effects of salicylate, chloroquine, prednisolone and indomethacin on LDH leakage from cultured rat hepatocytes were studied. Exposure for 24 h to the first two drugs induced liver damage, as reflected by LDH release, at concentrations 2-10 times as high as the therapeutic plasma levels in humans. Indomethacin and prednisolone at concentrations approx 50-100-fold higher than the therapeutic plasma levels, were not toxic to cultured hepatocytes. The data suggest that direct a toxic effect on hepatocytes is one possible mechanism of hepatotoxicity for salicylate and chloroquine, especially since the exposure time is much longer in humans than in the experimental model used here. PMID- 6484538 TI - Effect of D-penicillamine pre- and post-implantation treatment on formation of sponge-induced granulation tissue in rats. AB - DNA, collagen and sulfated glycosaminoglycans (GAGs) of rat sponge granulation tissue were studied after 42 days of D-penicillamine (D-pen) treatment at 100, 250 or 500 mg/kg/day, starting 10 days before or 28 days after induction of granulation tissue formation. The effects were compared with those observed when the same dosage was started at the onset of the granulation tissue formation and with pair-fed controls. D-pen stimulated the cell invasion into the sponge implants, as manifested by an increased DNA content, particularly with pre treatment. Pre-treatment reduced the net deposition of of collagen per cell as assessed by the lower hydroxyproline/DNA ratio, at the lower dose leading to reduced collagen concentration. The total amount of granulation tissue collagen remained essentially unaffected within the observation period. Salt-soluble collagen was augmented in a dose-dependent manner, irrespective of treatment protocol, signifying decreased collagen cross-linking. Both pre- and post implantation treatment enhanced the radiosulfate incorporation into sulfated GAGs, regardless of dose, whereas treatment from the day of sponge implantation had no effect. It is concluded that D-pen enhances the early connective tissue response to injury. Reduction of collagen cross-linking and net collagen deposition, concomitant with stimulation of the proteoglycan metabolism, may pertain to the antirheumatoid activity of D-pen. The observations suggest that long-term administration of D-pen, starting before new attacks of arthritis, may be most effective in controlling developing articular fibrosis. PMID- 6484539 TI - Fibroblast activation in scleroderma. AB - Skin fibroblast cultures started from 6 scleroderma patients and 5 controls were compared with respect to synthesis of collagen and glycosaminoglycans. Fibroblast strains started from skin biopsy material from patients with active localized disease exhibited appreciably increased synthesis of collagen, whereas cultures from old sclerodermatous areas showed normal or decreased rates for collagen synthesis. During subculturing, all fibroblast strains with a high initial rate of collagen synthesis exhibited a gradual decline to near-normal values by the 12th in vitro passage. No similar alterations were detected in glycosaminoglycan metabolism. The results suggest that fibroblast activation in scleroderma is due to exogenous factors; in cell culture their effects are lost and activation disappears. PMID- 6484540 TI - Immunoprecipitates used as a reagent for rheumatoid factors. AB - IgM and IgG rheumatoid factors (RFs) were purified by affinity chromatography and gel filtration. The preparations thus obtained were used as standards in a radio immunoassay for RF detection. In this assay, RFs were reacted with immunoprecipitates, and the RFs were detected with radiolabelled (F(ab')2 fragments specific for human IgM or IgG. The reproducibility of the assay was higher when RF content was expressed relative to the standards and not directly relative to tracer binding. It was found that the presence of IgM RF did not affect the measurement of IgG RF in this RIA, since the addition of neither mono- nor polyclonal IgM RF to a donor serum resulted in increased IgG RF measurements. 100 sera were analysed and were consistently positive in only one of the tests: sheep cell agglutination or latex fixation. The 75% of the sera which were positive only in the latex fixation test were positive for IgM RF in the radio immunoassay, indicating that RFs in this type of serum were not specific solely for human IgG. PMID- 6484541 TI - [Focal-segmental glomerulosclerosis in analgesic nephropathy]. AB - The presence and extent of focal-segmental glomerulosclerosis/hyalinosis (FSSH) was determined in 79 autopsy cases of analgesic nephropathy and correlated with the levels of proteinuria, serum creatinine and arterial blood pressure. FSSH was present in 77% of cases. The extent of FSSH correlates positively with increasing proteinuria and serum creatinine. The widely scattered pattern suggests a multifactorial pathogenesis for FSSH in analgesic nephropathy, including, for example, glomerular overload and arterial hypertension. Mesangial proliferative glomerulonephritis was observed in only two cases. PMID- 6484542 TI - [Antianginal effect of calcium antagonists, using nisoldipine as an example]. AB - The antianginal effect of nisoldipine was studied in 10 patients (mean age 52.3 years) with coronary artery disease. All patients developed ST-depression during bicycle exercise stress test and 7/10 patients had angina pectoris. The exercise test was stopped after a mean duration of 2.6 min at a work load of 117 watts (calculated working capacity 151 watts). Two hours after oral administration of 10 mg nisoldipine the bicycle exercise stress test was repeated at the same work load as during control. Only 3/10 patients had angina pectoris during the second stress test. After nisoldipine the resting heart rate was significantly higher (76 vs. 67 beats/min; p less than 0.05), systolic blood pressure was slightly lower (122 vs. 130 mm Hg; not significant) and diastolic blood pressure significantly lower (75 vs. 84 mm Hg; p less than 0.01) as compared to the control state. During exercise, heart rate (124 vs. 124 beats/min) and systolic/diastolic blood pressure (148/78 vs. 161/83 mm Hg) were not significantly different from control. However, ST-depression was significantly reduced (0.14 vs. 0.26 mV; p less than 0.001) after nisoldipine. Thus, nisoldipine shows a beneficial effect in patients with coronary artery disease by reduction of exercise-induced myocardial ischemia and improved exercise tolerance. The decrease in blood pressure and the increase in heart rate in the resting state are due to peripheral vasodilatation with afterload reduction. PMID- 6484543 TI - [Long-term therapy of the Parkinson syndrome]. AB - The various drugs available for the treatment of parkinsonism (anticholinergics, L-dopa plus decarboxylase inhibitor, dopamin agonists, amantadine, deprenyl) and stereotaxic surgery are briefly presented. The most important problems of longterm treatment, i.e. dyskinesias, mental disturbances, orthostatic hypotension, decrease of drug effect, on-off-phenomena, are discussed. Finally, some practical suggestions for therapy are given. PMID- 6484544 TI - [Automanipulation of disease. Self-induced, aggravated, simulated disease and automutilation]. AB - Self-induced physical and psychological symptomatology is reviewed in regard to differential diagnosis (DSM-III), epidemiology, interpretation, treatment and prognosis. The phenomenon of automutilation is discussed in the psychopathological context. PMID- 6484545 TI - [Acute ischemic syndrome of the foot following sclerotherapy of varicose veins]. AB - The inadvertent injection of the sclerosant into an artery is the most serious complication of sclerotherapy. Four cases are presented, in all of which the posterior tibial artery was involved with resulting necrosis of portions of the foot. In one case a below-knee amputation was necessary. The necrosis depends mainly on the amount of the injected sclerosant. A noteworthy improvement due to specific therapy seems rare and was seen in only one of our cases. In this instance regional fibrinolysis was performed, whereas in a second case this approach proved detrimental. It appears to be much simpler to prevent this severe complication by adequate injection technique. PMID- 6484547 TI - [Amnestic episodes. Analysis of 111 personal cases]. AB - A typical episode of transient global amnesia has been observed in 111 personal cases. In these elderly patients a sudden disturbance of memory, which may last several hours, makes it impossible for them to store fresh information. During this period there is also retrograde amnesia which covers a period of several weeks or months prior to onset of the acute episode. The disturbance ends suddenly and the retrograde amnesia gap fills up again. The age distribution, vascular risk factors and triggering mechanisms in these personal cases are described. 22 of 111 patients had 1 or more relapses, in one case after a 15 years' interval. It is our opinion that transient global amnesia is a vascular disturbance in the hippocampal region. One example of localized (ischemic) area in this region has been shown by computed tomography. PMID- 6484546 TI - [Preventive chemotherapy of intrapulmonary residual tuberculosis with isoniazid- example of failed compliance by the physician]. AB - Compliance with the recommendations of the Swiss Society for Tuberculosis and Lung Diseases regarding the treatment of patients with fibrotic pulmonary lesions with isoniazid was evaluated over the period March 1981-October 1982. 42 patients (mean age 53 +/- 16 years) were selected for preventive treatment. Diagnostic procedures were correctly performed in 22 patients (52.4%). 32 patients (76.2%) received the recommended drug initially. In 18 patients (42.9%) isoniazid was correctly prescribed for six months. In only 15 patients (35.7%) was the diagnostic and therapeutic approach correct. The reasons for these quality inadequacies on the diagnostic and therapeutic levels are discussed. PMID- 6484548 TI - [The treatment of headache]. AB - In symptomatic headache treatment is directed against the underlying disease. If this is impossible, its pathogenesis may still respond to treatment such as dexamethasone in inoperable brain tumor, simple psychotherapy in reactive emotional disorder due to intractability of the underlying disease, or migraine management where symptomatic headache is succeeded by migraine, as in posttraumatic headache. Primary headache-migraine, cluster headache, and cephalaea vasomotoria ("tension headache") require positive identification of the syndrome but this does not lead directly to proper treatment; assessment of severity and, where feasible, of the psychological situation is needed. The means are available to influence some of the mechanisms apparent in primary headache both by non-drug and by drug treatment, but the choice must allow for the fact that these methods are not specific but only a little more effective than placebo. Drug abuse is the principal danger in headache problems. It can be treated by tracking down the offending drug under cover of interval medication or, failing this, by abrupt withdrawal in a neurology ward followed by a period of several weeks' exile from the usual daily demands. A short description of drugs used in primary headache is given. PMID- 6484549 TI - [Basilar migraine]. AB - Basilar migraine is a well defined condition which is easily identified by a characteristic clinical picture such as headache associated with visual, cerebellar and brainstem symptoms. Occasionally, severe disturbances of consciousness may occur which blur this otherwise unequivocal clinical condition. Hence, diagnosis may be difficult. CT-scan, electroencephalography and lumbar puncture are then necessary in order to rule out more severe disorders. Treatment of this condition corresponds to the therapy of more common types of migraine. There is, however, no rationale for the administration of drugs conventionally used for migraine prophylaxis in patients with severe disturbances of consciousness, though treatment of brain edema with steroids may be helpful or occasionally even necessary. PMID- 6484550 TI - [Limiting values of serum thyroglobulin observed in athyrosis]. AB - Investigations in 6 cases of congenital or acquired athyreosis show that serum thyroglobulin determined in these cases by radioimmunology is not due to a determination artifact or to another protein, but that, with regard to immunoreactivity, molar mass and isoelectric point, it displays all the features of the standard thyroglobulin of thyroid origin and of the serum thyroglobulin of normal subjects. The authors conclude that small quantities of thyroglobulin are present in the serum of such patients, even where all the other criteria of athyrosis appear to be present. PMID- 6484551 TI - [Course and complications of rhabdomyolysis following heroin poisoning]. AB - A report is presented on two patients with massive rhabdomyolysis following heroin intoxication. Due to massive muscle edema of the lower legs, both patients needed early fasciotomy to prevent compression syndrome. The two cases followed a different course as regards complications and especially renal insufficiency and disorders of serum calcium and phosphorus regulation. Pathophysiology, prevention and therapy of complications are discussed. As a result of intensive physiotherapy, the long term functional outcome was satisfactory in both cases. PMID- 6484552 TI - [Prevention of bacterial endocarditis. Recommendations of the Swiss Work Group for the Prevention of Endocarditis]. AB - Recommendations of the Swiss Working Group for Prophylaxis of bacterial endocarditis. Despite the lack of definitive evidence for the efficacy of antibiotics in the prevention of bacterial endocarditis (BE) in man, it is accepted practice for antibiotics to be administered to patients at risk of developing BE following a diagnostic or therapeutic procedure which may cause bacteremia. The prophylactic regimens so far recommended are cumbersome and compliance is poor. An attempt is made to unify and simplify Swiss recommendations, taking into account the authors' own recent experimental results, pharmacological data, and clinical experience. It is proposed that the patients be classified into two risk groups: First, patients with congenital and acquired heart disease, previous palliative or non-definitive cardiac surgery, mitral valve prolapse with mitral insufficiency, and hypertrophic obstructive cardiomyopathy should be considered at moderate risk. For those patients a single dose of an orally administered antibiotic should be given 1 h before the procedure. The first choice antibiotic should be amoxicillin (3 g orally) for all procedures, except when S. aureus is likely to cause bacteremia (i.e. after drainage of abscesses, where flucloxacillin (2 g orally) should be used 1 h before the procedure). Amoxicillin is also recommended for patients receiving penicillin during the days prior to the procedure (for prevention of rheumatic fever, or for any other reason). Patients allergic to penicillin should be given 600 mg clindamycin orally 1 h before the procedure. Second, patients with valvular prosthesis or previous BE should be considered at high risk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484553 TI - [Prevention of endocarditis using amoxycillin, clindamycin or erythromycin. Pharmacokinetic observations]. AB - Current recommendations for antibiotic prophylaxis of bacterial endocarditis include oral amoxycillin, and erythromycin or clindamycin for the penicillin allergic patient. The authors report the serum concentrations and side effects which may be expected after the recommended oral doses of these compounds. Single doses of 3 g amoxycillin and 600 mg clindamycin, and two doses of erythromycin (1.5 g and 0.5 g 6 h apart) were administered in a random sequence to each of 12 volunteers. After administration, peak serum concentrations of amoxycillin and clindamycin were 27 mg/l and 5.5 mg/l respectively. Amoxycillin was eliminated more rapidly than clindamycin. Serum concentrations of erythromycin were below the sensitivity limit of the assay (0.03 mg/l) in 3 volunteers at 1 h and in 2 at 2 h. The mean peak serum concentrations was 3.1 mg/l. Peak levels were associated with gastrointestinal side effects such as nausea, abdominal cramps and vomiting. The implications of these findings are discussed with respect to use of these antibiotics for the prophylaxis of bacterial endocarditis. PMID- 6484554 TI - [Aneurysms of the abdominal aorta]. AB - Over the last 20 years, 170 patients have been operated on for infrarenal aortic aneurysm. Ninety-six were operated on electively. Seventy-four underwent emergency surgery, of whom 62 had a ruptured aneurysm. In elective surgery mortality was low, falling in recent years from 10.5 to 2.7%, due to systematic postoperative resuscitation in intensive care and growing experience in the field of aneurysm surgery. Emergency surgery for ruptured aneurysms is associated with a mortality of up to 56%, which is even higher for patients operated on at the hypovolemic shock stage. Presently, the most important aspect of abdominal aortic surgery is lowering of the number of ruptured aneurysms, since at this stage aneurysm resection is inevitably associated with high mortality. Improvement of prognosis requires early diagnosis, effective resuscitation in the intensive care unit, knowledge and prevention of postoperative complications, and teamwork between surgeons, physicians, anesthesiologists, hematologists and nephrologists. PMID- 6484555 TI - [Aorto-intestinal fistulas. 4 case reports]. AB - Four cases of aorto-enteric fistula are reported. The two primary types occurred after rupture of an aneurysm of the abdominal aorta into the duodenum and as a consequence of tumor infiltration of both the aorta and the intestinal wall in a woman with metastatic ovarian cancer. The two secondary types developed as a late complication of reconstructive surgery of the abdominal aorta. The condition was diagnosed or suspected on the basis of endoscopic findings in two cases. The pathogenetic role of graft infection in the development of secondary aorto enteric fistula is emphasized. The generally poor prognosis can be considerably improved if prompt resection of the graft is combined with axillo-bifemoral anastomosis. PMID- 6484556 TI - [How to treat hyperuricemia?]. AB - Among a normal population, 21.5% of men have a blood level of uric acid above 6.8 mg%. Half of these subjects also present concomitant elevation of at least one other biological parameter. Clinically they differ from normo-uricemic subjects by weight, level of blood pressure and a trend to diabetes. From the recent literature it appears that hyperuricemia by itself does not constitute a risk factor as far as renal and vascular diseases are concerned. However, prevalence of gouty arthritis and urinary stones correlates with the blood uric acid level. Therefore, treatment of asymptomatic hyperuricemia must be avoided, and side effects of the drugs weighed. Acceptable indications for treatment are frequent attacks of urolithiasis or arthritis poorly tolerated by the patients. PMID- 6484557 TI - [Pathogenesis of podotrochlosis]. PMID- 6484558 TI - [Statistics of the causes of loss under the cattle insurance system of the canton of Bern (1972-1978)]. PMID- 6484559 TI - [Spinal cord infarction following fibrocartilaginous embolism in the dog and cat]. PMID- 6484560 TI - [Diagnosis of pregnancy in cows based on progesterone determination in milk performed 3 times]. PMID- 6484561 TI - [Epizootology of the incidence of ascariasis in swine]. PMID- 6484562 TI - Isolation and sequence determination of goose pancreatic polypeptide. AB - Goose pancreatic polypeptide was isolated in crystalline form from goose pancreas. Its amino acid sequence was determined by Edman degradation and compared with avian pancreatic polypeptide. PMID- 6484563 TI - Total particulate matter in cigarette and bidi smoke. AB - It has been well established that smoking causes lung cancer and many other chest diseases. To study the harmful effects of smoking, an automatic smoking machine was developed in this laboratory. Cigarette smoke contains many known carcinogens. The amounts of various carcinogens are proportional to the total particulate matter. Hence variation in total particulate matter (TPM) of different brands of cigarettes, bidis and cheruts (Indian cigars) was studied for various smoking parameters. An attempt has been made to arrive at some intake values of TPM from cigarettes and bidis smoked by the automatic smoking machine under different simulated smoking conditions. PMID- 6484564 TI - Polycyclic aromatic hydrocarbons in Finnish sauna air. AB - The concentrations of polycyclic aromatic hydrocarbons (PAH) in the air of three different types of wood-heated saunas were studied. The highest concentrations were found in the smoke sauna (total PAH 170-1550 micrograms/m3, benzo[a]pyrene 4.6-20 micrograms/m3) the second highest in the preheated sauna (total PAH 50-90 micrograms/m3, benzo[a]pyrene 3.4-4.5 micrograms/m3) and the lowest concentrations in the sauna heated by continuous burning of wood (total PAH 25 micrograms/m3, benzo[a]pyrene below 0.1 micrograms/m3). The results clearly indicate that regular bathing in the smoke sauna and in the pre-heated sauna increases the intake of PAH compounds (e.g. benzo[a]pyrene and benzo[a]anthracene). PMID- 6484565 TI - Chromium, cobalt and lanthanum in lung, liver and kidney tissue from deceased smelter workers. AB - Lung, liver and kidney tissue concentrations of chromium, cobalt and lanthanum from 66 deceased copper smelter workers have been compared with 14 controls. Samples were taken in connection with ordinary autopsies at the local hospital. Neutron activation analysis was used. The mean exposure time for the smelter workers was 30 y, the mean time to date of death after termination of exposure was 7.4 y. A four-fold increase of chromium (p = 0.001) and a two-fold increase of cobalt (p less than 0.001) and lanthanum (p = 0.013) in lung tissue was found for smelter workers compared to controls. Of the smelters nearly one third died from malignancies (approximately 10% from respiratory cancer) and approximately 45% from cardiovascular disease. In the control group nearly 80% died from cardiovascular diseases and no malignancies were found. In lung tissues the concentration of chromium, cobalt and lanthanum did not decline with time after exposure had ended, indicating a long biological half-time. The causes of death could not be related to a single factor. The findings indicate a multifactorial genesis. PMID- 6484566 TI - Nitrate levels in drinking water in a wine producing area of Germany (F.R.G.). PMID- 6484567 TI - Use of antibiotics in animal feed challenged. PMID- 6484568 TI - Researcher's suit against NCI wins mixed judgment. PMID- 6484569 TI - Retarding effect of lowered heart rate on coronary atherosclerosis. AB - The role of heart rate in the development of coronary atherosclerosis was assessed in adult male cynomolgus monkeys (Macaca fascicularis). Heart rate was lowered in six animals by surgical ablation of the sinoatrial node. A sham procedure, which included all of the surgical steps except for sinoatrial node ablation, was carried out in eight animals. All of the monkeys were fed an atherogenic high cholesterol diet for 6 months, and heart rates were monitored repeatedly by telemetry during 24-hour test periods. Coronary atherosclerosis in animals with postoperative heart rates less than the preoperative mean for all of the animals that underwent surgery was less than half that of animals with heart rates above the mean or of diet-fed control animals not subjected to surgery. Groups did not differ in blood pressure, serum lipids, or body weight. These results suggest that heart rate in itself may contribute to the mechanisms by which behavioral patterns and physical training influence coronary artery disease. PMID- 6484570 TI - Regulation of a hybrid gene by glucose and temperature in hamster fibroblasts. AB - A novel eukaryotic hybrid gene has been constructed from the 5' sequence of a rat gene and the bacterial neomycin-resistance gene. After transfection into hamster fibroblasts, the neo transcripts can be induced to high levels by the absence of glucose. Furthermore, this hybrid gene can be regulated by temperature when it is introduced into a temperature-sensitive mutant cell line. PMID- 6484571 TI - Trends in analytical instrumentation. AB - Methods for deriving chemical information from a variety of systems and environments have changed dramatically in the last decade. Unique principles from physics, chemistry, and biology are the basis for sophisticated instruments that incorporate computers for data acquisition, reduction, and interpretation. Such analytical systems have shown orders-of-magnitude improvements in sensitivity, specificity, and speed, yet with greater simplicity and lower price. The increasing importance of analytical instrumentation requires reexamination of its coverage in educational curricula and of the role of the analytical chemist in its further development and application. PMID- 6484572 TI - Pyrolysis mass spectrometry of complex organic materials. AB - Pyrolysis mass spectrometry in combination with computerized multivariate statistical analysis enables qualitative and quantitative analysis of nonvolatile organic materials containing molecular assemblies of a complexity and size far beyond the capabilities of direct mass spectrometry. The state of the art in pyrolysis mass spectrometry techniques is illustrated through specific applications, including structural determination and quality control of synthetic polymers, quantitative analysis of polymer mixtures, classification and structural characterization of fossil organic matter, and nonsupervised numerical extraction of component patterns from complex biological samples. PMID- 6484573 TI - NIMH study finds one in five have disorders. PMID- 6484574 TI - Uncertainty of histologic classification of experimental tumors. PMID- 6484575 TI - Milwaukee Shoulder syndrome: eleven additional cases with involvement of the knee in seven (basic calcium phosphate crystal deposition disease). PMID- 6484576 TI - Severe, acute pulmonary disease in patients with systemic lupus erythematosus: ten years of experience at the National Institutes of Health. AB - The sudden development of diffuse pulmonary infiltration in a patient with SLE presents difficult diagnostic and therapeutic problems to the clinician. In the past ten years, we have seen eight patients with this problem. Neither roentgenograms nor clinical findings were specific. In six patients, pulmonary hemorrhage was found, but in only two of them did it exist alone. In the other four, heart failure, uremia, and coagulopathy complicated the findings. In one patient, P carinii was the cause; in one congestive heart failure, which was not obvious clinically or radiologically, was the cause. Three patients died: one of uncomplicated pulmonary hemorrhage, one with pulmonary hemorrhage occurring during the treatment of pneumonia due to L bozemanii, and one with pulmonary hemorrhage and multiple complications including sepsis due to Candida. On the basis of this experience, we have recommended a plan of action for physicians facing this problem. PMID- 6484577 TI - Ovarian cancer treatment: progress or paralysis? PMID- 6484578 TI - Mitoxantrone as first-line chemotherapy for advanced breast cancer: results of a European collaborative study. AB - A total of 134 patients with advanced breast cancer and no prior chemotherapy for advanced disease were treated with mitoxantrone, 14 mg/m2 intravenously every 3 weeks. Of these, 99 could be evaluated for response and all for toxicity. Six patients achieved a complete response and 29 a partial response, the overall response rate being 35% (95% confidence limits 25% to 45%). The median time to treatment failure was greater than 46 weeks. Mitoxantrone was well tolerated. Nausea and vomiting occurred in 40% of patients, but these were seldom severe. Total alopecia occurred in only six patients. Four patients developed clinically significant evidence of cardiotoxicity after cumulative doses of 174 to 256 mg/m2. Mitoxantrone offers comparable efficacy and less acute toxicity than the most active single agents currently used in the treatment of advanced breast cancer. PMID- 6484579 TI - Biologic and biochemical effects of mitoxantrone. AB - Mitoxantrone (1,4-dihydroxy-5,8-bis[(2-[(2-hydroxyethyl)-amino]-ethyl) amino] 9,10-anthracenedione dihydrochloride) is a representative of a new class of chemical compounds with antineoplastic activity. It was one of a number of polycyclic aromatic compounds tested at the American Cyanamid Laboratories and was the most effective and potent derivative synthesized. Mitoxantrone produced significant increases in life span and long-term survivors when tested against P388 and L1210 leukemias, B16 melanoma, and colon tumor 26 transplanted into mice. In comparative animal trials, it proved more effective than most of the other agents tested, including doxorubicin, cyclophosphamide, methotrexate, cytarabine, and 5-fluorouracil. It was also active against intravenously implanted L1210 leukemia, in contrast to doxorubicin, though this is considered to have a similar mode of action. Mitoxantrone also demonstrated moderate activity against sublines of the mouse leukemias, which were resistant to anthracyclines. Significant therapeutic synergism against P388 leukemia was observed when mitoxantrone was administered on the same day as methotrexate and cytarabine or in sequence with cyclophosphamide, cisplatin, or vincristine sulfate. Mitoxantrone is active intraperitoneally, intramuscularly, subcutaneously, and intravenously, but oral activity has not been demonstrated. Although dose schedule did not appear critical, treatment every 4 days X 3 appeared to be the most effective. The mechanism of action of mitoxantrone has not been fully elucidated, but it is known to inhibit DNA and RNA synthesis. In cell culture, mitoxantrone induces nuclear aberrations with chromosomal scattering and morphologic alterations similar to those induced by doxorubicin. Drug-induced cell kill was not phase specific. Experiments with a resistant human colon carcinoma cell line (WiDr) indicated that resistance may be due to alterations of the cell membrane with decreased uptake. Mitoxantrone has markedly less cardiotoxicity than doxorubicin, and this may be linked to the fact that the drug does not induce free radical formation but inhibits lipid peroxidation. PMID- 6484580 TI - Mitoxantrone in malignant lymphoma. AB - Two phase II trials of mitoxantrone in refractory malignant lymphoma have been conducted. In the first of these, mitoxantrone (5 mg/m2) was given weekly for 6 weeks, and in the second, 14 mg/m2 was administered every 3 weeks. The first trial was conducted by the Southeastern Cancer Study Group (SECSG), and the second was a multicenter trial sponsored by Lederle Laboratories. Of the 80 patients entered in the SECSG trial, 47 could be evaluated for response and 43 for toxicity. Granulocyte nadirs below 1.9 X 10(9)/L were recorded in 18 patients. Four partial responses and no complete responses were obtained. These results contrast with those of the high dose study in which 41 patients were entered, and 28 of these were evaluated for response. Responses were obtained in 15 patients (2 complete, 13 partial). Side effects on this 3 weekly dose regimen were minimal. WBC nadirs ranged from 1 to 4.3 X 10(9) cells/L (mean 2.5 X 10(9)/L). Three patients experienced mild nausea and vomiting, and two had mild alopecia. These preliminary data indicate that mitoxantrone has significant activity in malignant lymphoma. All of the responding patients had received extensive prior therapy, many of them with anthracyclines in combination or as single agents. The higher response rate to mitoxantrone given at 14 mg/m2 every 3 weeks suggests that careful consideration should be given to dose when this drug is examined further in phase III trials. PMID- 6484581 TI - Mitoxantrone in refractory nonHodgkin's lymphoma. A Southwest Oncology Group study. AB - A phase II study of mitoxantrone in nonHodgkin's lymphoma was conducted by the Southwest Oncology Group between July 1981 and May 1982. The study involved 37 patients with histologically proven nonHodgkin's lymphoma, who were not eligible for higher priority protocols but had clearly measurable disease. Patients received mitoxantrone, 12 mg/m2 at intervals of 3 weeks, with a 10% increase in dose in the absence of myelosuppression and a 17% reduction for a WBC of less than 2 X 10(9) cells/L or a platelet count of less than 50 X 10(9)/L. The median number of previous regimens was three. Doxorubicin, in a median dose of 242 mg/m2 (range 12 to 650 mg/m2) had been previously given to 34 of the 37 patients. The Pathology Panel for Lymphoma Clinical Studies reviewed 31 (84%) of the lymphomas. Four of the ten follicular, small cleaved cell lymphomas responded compared with one of nine diffuse, large cell lymphomas. The median duration of response was 231 days. A median of two doses of mitoxantrone (range 1 to 18) was given. The median WBC nadir was 5.1 X 10(9)/L (range 04. to 9.4 X 10(9)/L), and the median lowest WBC for all doses was 2.4 X 10(9)/L (range 0.4 to 16 X 10(9)/L). Among 17 patients with a first WBC nadir of less than 3 X 10(9)/L, there were three partial responses compared with four responses (one complete, three partial) from nine patients with a WBC over 3 X 10(9)/L. There were seven responses (one complete, six partial) among 23 patients who had received up to three previous regimens, whereas only two of 14 patients receiving more than three previous regimens responded (one complete, one partial response). The response rate was independent of the previous dose of doxorubicin with five responses out of 23 patients who received a total dose of less than 300 mg/m2 and four responses out of 14 patients who received greater than 300 mg/m2. These data are compatible with the hypothesis that mitoxantrone alone is active against previously treated low-grade lymphomas and that the response rate is independent of the total dose of prior doxorubicin received and the degree of myelosuppression. Mitoxantrone may not be cross resistant with doxorubicin. PMID- 6484582 TI - Some aspects of sexual knowledge and sexual behavior of local women. Results of a survey. 1. General sexual knowledge and attitude to abortion, pregnancy and contraception. PMID- 6484583 TI - Emergency transvenous pacing at the bedside. An experience with 61 patients. PMID- 6484584 TI - Psychiatric emergency service in a Malaysian general hospital. PMID- 6484585 TI - Ovarian tumours in pregnancy. A review. PMID- 6484586 TI - Computed tomography of hepatic cavernous hemangioma. PMID- 6484588 TI - Acute bronchial asthma: a pattern of admissions. PMID- 6484587 TI - Vomiting after anaesthesia for termination of pregnancy in Chinese. PMID- 6484589 TI - Oral hypoglycaemic drugs. A forgotten cause of serious hypoglycaemia. PMID- 6484590 TI - The bulbocavernosus reflex in diabetic impotence. PMID- 6484591 TI - Perforated chronic duodenal ulcer in children. PMID- 6484592 TI - Pathological pulmonary systemic hypervascularisation--a case report. PMID- 6484593 TI - The rehabilitation of a child after severe head injury. A case report. PMID- 6484595 TI - Metaphyseal cortical irregularities in children: a new perspective on a multi focal growth variant. AB - The occurrence of metaphyseal cortical irregularities in adolescents in many different bones indicates a commonality of these lesions as a variation of normal growth, rather than a stress or avulsive by-product. The histologically recognized incomplete nature of the metaphysial cortex in children offers an attractive explanation for this phenomenon. PMID- 6484594 TI - Common oversights in the evaluation of the patient with multiple injuries. AB - The causes of commonly occurring diagnostic oversights in the multiple injured patient are reviewed. A systematic approach to the multiple injured or unconscious patient is offered which includes a standard series of radiographs, "a trauma survey", and knowledge of commonly associated injuries. The identification of certain skeletal injuries should automatically suggest the possibility of other associated skeletal, visceral, or vascular injuries. Oversights could be significantly reduced by obtaining a standard series of radiographs, specifically looking for evidence of commonly missed injuries and always considering the possibility of frequently associated injuries. PMID- 6484596 TI - Can a calcaneal morphologic index determine the degree of osteoporosis? AB - The proposal that a scoring system of the radiographic trabecular patterns of the os calcis could be related to degree of osteoporosis was tested. The technique fails as it showed no correlation with actual bone density determined by a Compton scatter technique and because of a low level of observer concordance. Possible reasons for the poor performance of the index developed in India when applied to North Americans are discussed. PMID- 6484597 TI - Dosimetry of computerized tomography in the evaluation of hip dysplasia. AB - The usefulness of computerized tomography (CT) in the assessment of hip dysplasia has recently been given attention in the literature and concern regarding radiation dose has been raised. This study was undertaken to measure the radiation dose, both in and out of plaster, for plain films, arthrography, tomography, and CT. A method is suggested to reduce dosage by 80% without compromising diagnostic information. Our experience with 25 scans of patients aged 4 months to 39 years is presented. PMID- 6484599 TI - Case report 281. Low-grade cartilaginous tumor with "skip lesion". PMID- 6484598 TI - Case report 275. Neurilemmoma right foot. PMID- 6484600 TI - Case report 282. Epidural lipoma at the level of T8. PMID- 6484601 TI - Case report 283. Hemangioendothelioma (malignant) of femur. PMID- 6484602 TI - Case report 284. Osteolytic cortical metastasis in the femur from bronchogenic carcinoma. PMID- 6484603 TI - Case report 285. Femur and cerebellum. PMID- 6484604 TI - Roentgenographic-pathologic correlation of diffuse sclerosis in Ewing sarcoma of bone. AB - Roentgenographic review of the first 210 cases of Ewing sarcoma (ES) in the Intergroup Ewing Sarcoma Study revealed that 37.6% of cases had evidence of diffusely increased intraosseous density or diffuse sclerosis (DS). In these cases the sclerosis was usually mixed with various patterns of lysis and/or combined with a periosteal reaction. A radiograph blinded histologic review of selected biopsies showed an 83% incidence of dead bone compared to 23% in those without DS. Ten percent of the cases with DS had appositional new bone formation on dead bone whereas none of the cases without DS showed such reactions. Pathologic explanation of the roentgenographically identified diffuse sclerosis in ES has not been previously well documented in the medical literature. PMID- 6484605 TI - Role of radiologic imaging in management planning of giant cell tumor of bone. AB - The radiologic studies of 24 patients with giant cell tumors were evaluated with respect to their ability to determine tumor extent and to influence management. Computed tomography (CT) was the most accurate method for detecting soft tissue tumor extension, and conventional tomography was the best technique for evaluating penetration of subarticular cortical bone. Detection of these findings led to performance of en bloc tumor resection rather than curettage and grafting in patients with lower extremity tumors. Arthrotomography was helpful in some instances in detecting cartilage and joint invasion by tumor, joint invasion being an indication for extra-articular rather than transarticular tumor resection. Scintigraphy was not as accurate as conventional tomography or CT in determining intraosseous tumor extent because of increased tracer uptake beyond the true tumor limits in several cases. Angiography has been largely replaced by CT in evaluating giant cell tumors. PMID- 6484607 TI - Anthropology and primary health care in developing countries. PMID- 6484606 TI - Contrast examination as a prognostic factor in the treatment of solitary bone cyst by cortisone injection. AB - Local injection of radiopaque medium demonstrated the presence of intracystic fibrous septa in 13 patients with solitary bone cyst. Contrast examination was helpful in predicting the response of solitary bone cysts to treatment by injection of methylprednisolone-acetate (MPA). As the number of septa increased, an increased difficulty in obtaining an equal distribution of MPA inside the cyst and a higher incidence of incomplete healing of the cyst was encountered. PMID- 6484608 TI - Citizen participation overplanned: the case of a health project in the Guatemalan community of San Pedro la Laguna. AB - Citizen involvement is a widely endorsed but often elusive goal in community betterment projects. An initiative by the major of San Pedro attracted funds to build a clinic and hire a doctor and attracted an American health educator to direct the project. Contrary to plan, the director's insistence on creating a representative community committee discouraged rather than increased participation. The case chronicles the interplay of interests and strategies and points toward potentially more productive approaches to issues of leadership, factionalism and public participation. PMID- 6484609 TI - Can socio-cultural information improve health planning? A case study of Nepal's assistant nurse-midwife. AB - Nepal's Assistant Nurse-Midwife program demonstrates some of the consequences of ignoring social and cultural information in health planning. Partly in response to national and international pressures to develop careers for women, the program was designed to train young women to provide maternal and child health care in rural areas. But traditional expectations about women, which are widely known, have impaired the program's effectiveness. Thus, even when cultural information is relevant and available--in fact, common knowledge--it still may not influence health planning. This case study pinpoints crucial planning issues in primary health care and recommends changes that could make the Assistant Nurse-Midwife's role more appropriate to its social and cultural setting. PMID- 6484610 TI - Primary health care in Sierra Leone. AB - Two pilot primary health care programmes are compared. One is primarily concerned with covering the national population by the year 2000; the other is more concerned with community participation and culturally-appropriate health care organisation. Strengths and weaknesses of the two pilot programmes are assessed in relation to national financial constraints, epidemiological patterns, and the socio-cultural structure of rural chiefdoms. The comparison concludes with specific recommendations for a national programme which incorporates the best of both pilot programmes. PMID- 6484611 TI - Will primary health care efforts be allowed to succeed? AB - It is suggested that the consequences of following Primary Health Care (PHC) principles as guidelines for health care development must of necessity lead to socio-economic and political restructuring in most countries. We are well aware that health status is determined more by the social and economic situation of population groups than by curative health services. The holistic approach of primary health care includes a concern with such factors. PHC, if it is to succeed, must ultimately lead to a reduction in the greater benefit for the few to the greater benefit for the many. This will receive strong opposition. The situation of a PHC programme in Guatemala is presented as a case of PHC efforts which were succeeding being violently opposed. This is compared with PHC development efforts in Tanzania where, unlike Guatemala, there has been a conscious effort at restructuring the society and where national development policies are in tune with PHC principles. The future of PHC in Tanzania will depend more on whether or not the organization and management of selection, training and implementation processes, and the minimal available resources, will lead to success, than on whether or not it will be allowed to succeed. It is concluded that the situation in most countries comes closer to that of Guatemala than of Tanzania and that many people and institutions in hierarchial, non egalitarian societies will spend a great deal of energy to prevent PHC programmes from succeeding. This forces us to consider the promotion of PHC in a much more serious manner than we might wish. PMID- 6484612 TI - Evaluating primary health care and nutrition programs in the context of national development. AB - This paper illustrates an evaluation model incorporating research techniques of both primary health care and social anthropology. The case in point is the Jamaican Government's Community Health Aide Programme, which employs over 1300 auxiliary health workers to serve the low-income population of the island. The study demonstrates a cardinal principle of the anthropological approach--a grounded and holistic understanding of the social and environmental context is necessary to translate data into useful information. The study demonstrates connections between the distribution of care, the power of the cosmopolitan medical profession, and the Jamaican political patronage system. Finally, the impact of the program is assessed on child growth measures against the background of the Jamaican economy as it evolved from 1970 to 1980. PMID- 6484613 TI - Project community diagnosis: participatory research as a first step toward community involvement in primary health care. AB - 'Community participation' and 'bottom up planning' have become fashionable themes in international health circles. However, in the absence of sociocultural perspective these themes remain largely rhetoric. In this paper, a deprofessionalization of social science is advocated in the service of participatory research as a first step towards community involvement in primary health care. Deprofessionalization is suggested as an adjunct to, not a replacement for in-depth professional social science research. An exploratory community diagnosis of health project conducted in rural south India is described. During the project, lay researchers received rudimentary social science field training and collected data on health behaviour deemed important to health planners as well as the health concerns of the community. Illustrative data, generated by the project is presented on the rural poors' utilization of government health facilities, their attitudes towards Primary Health Centre staff, and their ideas about how a proposed community health worker scheme could best serve them. PMID- 6484614 TI - Ethnomedicine and oral rehydration therapy: a case study of ethnomedical investigation and program planning. AB - Diarrheal disease prevention and diarrheal disease control with oral rehydration therapy are major goals of the World Health Organization and the international health community. This paper promotes the use of ethnographic research in this endeavor. It illustrates the use of ethnography in a diarrheal disease prevention and control program in Honduras by illustrating how knowledge of local beliefs and practices partially shaped promotion efforts. It confirms the validity of the original ethnographic findings by reporting the results of a survey conducted two years after program onset. PMID- 6484615 TI - Strategies and outcomes of introducing a mental health plan in Brazil. AB - Prior to 1978, the majority of Brazilians suffering from mental illness had no recourse other than hospitalization in inadequate institutions. The government introduced an official plan which stressed primary health care delivery of mental health services. This paper describes the role of the anthropologist in different stages of the implementation of this plan and the research conducted in informal and formal health systems, utilization patterns, public health conditions in a Northeastern Brazilian favela and strategies for integrating formal and informal mental health resources in this favela. The problems involved in carrying out primary prevention in mental health and strategies for articulating medical and non-medical healing systems are analyzed. PMID- 6484616 TI - Appropriate research for primary health care: an anthropologist's view. AB - In Primary Health Care (PHC) projects, it has become customary to conduct all purpose surveys early in the project. These are usually based on questionnaires administered to a relatively large sample of the population and elicit information on demography, living conditions, health status, sanitary facilities and socio-economic attributes of the population, in addition to providing baseline data on the indicators of program success. It is recommended that a distinction be made between different types of data collection efforts and that consideration be given to the timing of such surveys so as not to raise community expectations. Early in the project a survey of demographic characteristics and health indicators may be appropriate. However, major surveys of living conditions and health problems are better delayed until the program is in operation and such surveys can be used as mechanisms for community participation, motivation and education. The limitations on the use of questionnaires is discussed. Because anthropological methods are more suited to the skills of health promoters and yield valuable behavioral data, it is suggested that anthropologists encourage the use of these alternatives to questionnaires. The use of participant observation, life stories, interviews, mapping and essays are discussed in the context of PHC programs. PMID- 6484617 TI - Peripheral health workers are central to primary health care: lessons from Papua New Guinea's aid posts. AB - This paper examines the nature of the service offered by Papua New Guinea's primary health workers and analyses the factors that influence their performance. The structural position of these peripheral health workers in the health care system set limits to the effectiveness of current Health Department policy in determining the quality and availability of local services. Instead a variety of factors are found to be important. These include the individual attributes of health workers, the expectations that their clients have of them, local priorities in health, the relationship between attitudes to health and illness and the perceived value of Western medicine, and aspects of local social organization. The implications for policy of the findings are discussed. PMID- 6484618 TI - The role of maternal and child health clinics in education and prevention: a case study from Papua New Guinea. AB - This paper describes a behavioural study of the infant nutrition and family planning education components of selected maternal and child health clinics in Madang Province in Papua New Guinea. Staff of six (6) clinic teams were observed during 18 rural and urban clinics and the content and length of the nurses' interactions with the 254 mothers of 340 children recorded. Three-quarters (71%) of the interactions took less than 2 minutes. Family planning advice was rarely given. The amount of time the nurse spent with mother and child primarily depended on whether the child was sick or well, rather than on his/her nutritional status. Nutritional advice, when offered (to mothers of 27% of children below 80% WFA), was given in response to WFA alone, independently of health status, age and rate of growth. It is suggested that the low priority given to nutrition and family planning education is the result of inadequate supervision, complex reporting systems, the routine nature of the work, preference of nurses for structured clinical tasks and nurses' attitudes to clients and contraception. Clinics would be more effective if oriented around problems rather than tasks, and families rather than individuals. This would also give nurses the satisfaction of seeing the goals and results of their work. It is suggested that the MCH system would benefit from innovative pilot programmes which address the special problems of remote areas and derive from primary health care principles. PMID- 6484619 TI - National security and the health of people: human needs and the allocation of scarce resources. PMID- 6484620 TI - Values in health care. AB - The first part of the paper is concerned with the health care values of various groups; namely, those which are resource oriented, disease oriented, political decision-makers, organized sellers and purchasers of health care and patients. These groups are further divided according to selected political/ideological and socio-economic characteristics, essentially along capitalist and socialist lines. Some of the ways in which the values held by these groups are determined, formulated and, by implication at least, changed and the political, economic and other bases for some of their practical applications are identified. The second part of the paper focuses upon values in public health education and related practice. It is argued that to become more useful to the 'health of the public' the new public health worker will have to become more activist, assuming an adversarial stance toward the market economy in capitalist countries and oppressive governmental structures everywhere. A wider integration of knowledge concerning the effects of health of all types of economic, social and political practices is required; this, in turn, would contribute to the emergence of alternative forms of public health analysis and practice. The recognition of wider forms of public health leadership should follow, coupled with organizational changes directed at the greater participation of popular groupings in all types of public health activities. PMID- 6484621 TI - Life-style and health: some remarks on different viewpoints. AB - Within the framework of the medical model of health and disease the factor 'life style' plays a central role in the genesis of important disorders such as myocardial infarction or lung cancer. Two central issues, however, have been left unconsidered by most of the research done by medical epidemiologists: Disease, as a rule, has not one single but several causes; it is multifactorial in its etiology. This means that alongside 'life-style' there are other factors influencing pathogenesis. In this way we can explain, for example, the empirical finding that the classical risk factors only explain a minor amount of the morbidity and mortality due to coronary disease. A number of social and psychological factors influence those types of human behavior, which are known to have an adverse effect on health. The influence of age, sex, social status and parental and peer-group models have been empirically demonstrated. Social epidemiological research could contribute to a clarification and supplementation of the above-mentioned relationships leading to an improvement in our knowledge upon which to found preventive intervention. Social epidemiologists view health adverse behavior as the consequence of social stress, that the individual attempts to cope with via smoking, drinking, etc. In the individual's social environment there exist numerous models, as well as informal pressures leading to such behavior. We should know more about the acute and chronic strains in the transition to adolescence and in later stages of the life-cycle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484622 TI - Assessing recent developments and opportunities in the promotion of health in the American workplace. AB - The purpose of this paper is to offer, as a basis for discussion, a review of the two main interpretations of what constitutes the meaning and scope of health promotion in the workplace. The two interpretations analyzed are: (a) the individual-based lifestyle approach and (b) the environmental-social approach. This paper discusses the limitations of the individual-based lifestyle approach which postulates an individualistic and fragmentated vision of the process of health in the workplace. In contrast, the environmental-social approach provides a more comprehensive framework of reference in which the socioeconomic, environmental and political components are integrated in the primary prevention strategies of health promotion in the workplace. Under this health alternative it is crucial that workers or their representatives be included as full participants in the overall process of planning, organization and implementation of promotion of health in the workplace. PMID- 6484623 TI - Working conditions and health: social epidemiology, patterns of stress and change. AB - This paper does not attempt to review stress research but to highlight contrary positions. Arguments about central questions such as exposure vs disposition, social factors vs the constitutional make-up has lead to refinements in methodology. However, investigations seldom do justice to these ideals discussed. It should be a conditio sine qua non when estimating the effects of dispositional factors to consider exposure which could change dispositions or interact with them. Also it becomes obvious that when investigating working life a limited view of risks factors only must faile because job latitudes and support are of salient importance. Concerning changes in working life our methodological flights of fancy are confronted with the limited horizon and world of a mole. PMID- 6484624 TI - Assessment and implementation of health care priorities in developing countries; incompatible paradigms and competing social systems. AB - This paper addresses conceptual issues underlying the assessment and implementation of health care priorities in developing countries as practised by foreign development agencies coping with a potentially destabilizing unmet social demand. As such, these agencies mediate the gap between existing health care structures patterned around the narrow needs of the ruling classes and the magnitude of public ill-health mass movements thrive to eradicate with implications for capitalism at large. It is in this context that foreign agencies are shown to intervene for the re-assessment and implementation of health care priorities in developing countries with the objective of defending capitalism against the delegitimizing effects of its own development, specifically the persistence of mass disease. Constrained by this objective, the interpretations they offer of the miserable state of health prevailing in developing countries and how it could be improved remains ideological: it ranges between 'stage theory' and modern consumption-production Malthusianism. (a) Developing countries are entering into a new pattern of public health which derives from their unique location in the development of capitalism, more specifically in the new international division of labor. Their present position affects not only the pattern and magnitude of disease formation but also the effective alleviation of mass disease without an alteration in the mode of production itself. (b) In the context of under-development, increased productivity is at the necessary cost of public health. Orienting health care priorities in line with belief in the instrumentality of profit for eradicating the diseases of under-development is ideological and counterproductive. Public health improvement is basically incompatible with production-consumption Malthusianism from which the leading 'Basic Needs' orientation in the assessment and implementation of health care priorities derives. Marx said that "Countries of developing capitalism suffer not only from its development but also from its under-development". Rephrasing Marx, this paper points out that developing countries suffer not only from the under development of capitalism but also from its development. PMID- 6484625 TI - The family as a resource unit in health care: changing patterns. AB - Medicine has long asserted that the family is one of the principal units of medical care. Concurrent with a resurgence of interest in holistic medicine, there has been a major increase in attention being paid to the role of the family unit in health care. There are, however, very few examples of how this interest has been put into practice, nor is it evident that it is reflected in teaching or graduate training programs. This paradox persists in spite of the growth of family medicine as a primary care discipline, especially in North America. The results of three studies are summarized to support the impression that, in general, these 'family specialists', along with other primary care practitioners (e.g. pediatricians), know relatively little about the structure or functioning of the families of patients they treat. The findings also suggest that there is little relationship between such knowledge and various indicators of the processes or outcomes of medical care. The question then arises whether such knowledge is lacking because it is truly of little value clinically, or whether these findings reflect methodological limitations in research of this kind. Intuitively it is reasonable to suppose that such a relationship does exist, and there is an extensive body of well-documented theory to support this view. How relevant such knowledge could or should be in practice, is an issue of particular importance in the context of the rapid changes taking place in the nature of the family itself.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484626 TI - Set and serendipity in the detection of drug hazards. AB - This paper deals with influences which affect the recognition of drug hazards and examines the policy implications of the analysis. Decision-making about the control of potentially dangerous medicines presents problems for policy makers. Action in this area provokes controversy because the interests of those concerned differ widely and because judgements are made in the face of uncertainty. The problem can be described in terms of models derived from signal detection theory. The signal (an adverse drug reaction, ADR) must be differentiated from background noise (disease due to other causes). This approach directs attention to the two general factors that influence detection: the discriminability of the signal and the observer's operating criterion. How clearly an ADR can be discriminated from other illness largely depends on the nature of the reaction, but the criterion is determined by social and behavioural forces including the costs and benefits of each type of decision. These in turn depend on the interests and attitudes of the institutions involved. It is concluded that detection of drug-induced disease is hampered by the attitudes of those charged with monitoring the effects of drugs. The shared assumption that medicines are good produces an excessively high criterion for the recognition of their dangers. PMID- 6484627 TI - The continuity of moral reform: community mental health centers. AB - Contemporary involvement of citizens in the formation of mental health policies continues a long history of influential lay advocates achieving desired reforms. The Community Mental Health Centers Program arose from, and also recognized, the citizens' movement for community care. This legislation mandated and encouraged citizen membership on the governing boards of local centers. The influence of these citizen bodies is seen in the diversity and continuing evolution of the local centers structurally, in orientation and in services provided. Three examples from original field research are provided to illustrate. PMID- 6484628 TI - Village health workers in Java, Indonesia: coverage and equity. AB - Village health workers are often the main vehicle for promoting the primary health care approach in developing countries. Services provided by these workers are expected to be more appropriate to the health needs of populations than those of clinic-based services, to be less expensive and to foster self-reliance and local participation. Because village workers are more accessible and acceptable to clients in their communities, they are expected to improve the overall coverage of services as well as equity--increased service use by poorer individuals and households. This paper presents research on coverage and equity from village health worker programs in Java, Indonesia. Rural health and nutrition projects in Java using village-level volunteers with limited training have grown since the early 1970s to include large national programs managed by the government's rural health system. Volunteer village workers are now the most extensive link between the rural population and the formal health service structure. Previous research on coverage and equity of these village worker activities is reviewed and results from the author's own study are presented. Services provided by village health workers achieve significantly higher levels of population coverage than similar clinic-based services. In most cases, village workers show no bias towards better-off clients and they may favor poorer beneficiaries. These findings show that village workers are meeting the coverage and equity objectives of the primary health care approach. However, some of the research reviewed raises questions about the ability of village worker activities to maintain these results over a longer period. The rapid expansion of these programs requires continued research, not only on coverage and equity, but also on health outcomes, costs, and participation. PMID- 6484629 TI - Geographic distribution and demographic correlates of colorectal cancer mortality in Sydney, New South Wales. AB - Colorectal cancer (CC) has the highest incidence of any internal malignancy in Australia and is a major cause of death. A knowledge of the geographic distribution of CC will aid in the identification of high risk groups for whom diagnostic and treatment facilities should be provided and may give clues to aetiological factors. Total CC deaths and age-standardized mortality ratios for Local Government Areas in Sydney, Australia were mapped and the relationships between mortality and selected demographic measures were examined. Several statistically significant zero-order correlation coefficients were found but multiple regression analysis showed a dominant independent negative effect of distance from the centre of the city on CC mortality. No substantial independent effects of demographic variables were observed. The existence of presently unmeasured environmental aetiological factors is postulated. PMID- 6484630 TI - The supply and utilization of dental services. AB - In this article the question is addressed whether regional differences in the supply of dental manpower influences the utilization of dental services. The percentage of the population that visits the dentist, is indeed higher in regions with a higher density of dentists. The number of people that visit a dentist is higher among privately insured patients than among the publicly insured. We have constructed a simple model of the behavior of dentists and patients to find out whether this difference is influenced by the supply of dental manpower. On the assumption that dentists prefer the treatment of privately insured patients we predict a greater difference between publicly and privately insured patients in regions with a lower density of dentists than in regions with a higher density. The data dose not unequivocally support this prediction. A second assumption is that differences between social groups in the chances of uptake of regular treatment influence the behavior of patients on future points in time. To find out whether the limited data we have, support this assumption, we have looked at the differences between privately and publicly insured patients in regions that show an important change in density. The results of this analysis are not as predicted. PMID- 6484631 TI - Experiences of puberty development. AB - This paper presents some of the findings from a study regarding sex education which I have conducted with 500, 14-16 year-old pupils in a school district in the southern part of Denmark. The specific focus of the paper is on the pupils' experiences of puberty development; both the physical and psychological transformations undergone and the differences in the experiences of boys and girls. The psycho-social aspects of menstruation and the relative importance of various sources of sex information are also discussed. The findings show that the pupils have a stronger need and desire for sex education which emphasizes the psycho-social dimensions of puberty development than specific technical information. It is therefore suggested that sex education place more emphasis upon these psycho-social dimensions and that this may influence the promotion of more responsible sexual behavior. PMID- 6484632 TI - Health promotion in general practice: new themes in traditional settings. PMID- 6484633 TI - Risks, survival and trends of malignant melanoma among white and blue collar workers in Sweden. AB - All persons in Sweden, classified as white or blue collar workers in the 1960 Population Census, were followed up for the period 1961-1973 with regard to the occurrence of cancer. The SMRs were calculated for 50 tumour sites and it was found that the crude classification of occupations into white or blue collar workers was particularly important for malignant melanoma risk. The number of malignant melanoma cases among blue collar workers was significantly lower than expected while it was significantly higher than expected among the white collar workers. This was true for men as well as for women. The SMRs were calculated to be 87 and 141 (men) and 79 and 117 (women), respectively. Comparing the relative survival probabilities it was found that white collar workers had a higher probability of survival than blue collar workers. This might indicate that the difference in occurrence could be dependent on early detection as well as differential risk. The incidence of malignant melanoma is increasing faster than any other kind of tumour in Sweden. For the period 1961-1970 the incidence rate increased two-fold for blue collar workers and more than two-fold for white collar workers (men). In absolute terms the white collar workers in the age group 45-64 had an appreciably faster increase in incidence over this period compared to all other groups studied. PMID- 6484634 TI - [Social inequality in deaths in Great Britain and in France]. AB - In this paper data are compared on differential mortality for working men in the United Kingdom and France, for the years 1970-1972 (U.K.) and 1966-1971 (F). Differential mortality in the United Kingdom is described in 'occupational mortality' published by O.P.C.S.; mortality according to 'Categories socio professionnelles' has been studied for a large cohort by INSEE (National Institute of Statistics and Economic Studies). The comparison between those two sets of data leads to the following conclusions: social differences in death rates seem to be larger in France than in United Kingdom. the main causes of death responsible for these inequalities differ in the two countries: respiratory diseases are the main cause in U.K.; in France, accidents and alcohol-related death lead to the largest inequalities. We discuss the difficulties of comparison between countries: some of the apparent differences may relate to the fact that, in France, mortality data concerns a cohort followed since 1954, while British data comes from a transversal survey. Another point of difference is the fact that foreigners are not included in the French study. In every country where data exist on the subject, inequalities in health are found. The reasons why these inequalities exist, and what should be done to reduce them, is a matter for discussion. The purpose of this paper is to contribute to the debate, by throwing light on some aspects of the observed differences. PMID- 6484635 TI - An illness behavior paradigm: a conceptual exploration of a situational adaptation perspective. AB - A situational-adaption perspective is developed as a basis of an analytic illness behavior paradigm. The situational-adaption perspective is derived from the ideas of Dubos wherein health is viewed as adaption and the interactionist conception of the defined social situation. The situational-adaption perspective is then applied to symptomatic episodes where signs and symptoms are contained in everyday situations without direct medical consultation, everyday illness behavior; to illness experiences where coping necessitates medical consultation, acute illness behavior; to chronic diseases where adjustment and long-term care are necessary, chronic illness behavior; and to emergent life threatening illness episodes which require definitive medical care, life threatening illness behavior. For each of these illness behavior types a primary process, role behavior and patient-practitioner relations are specified. PMID- 6484636 TI - A survey of those who care for the elderly at home: their problems and their needs. AB - One thousand and sixty-six over 70s were interviewed in their own homes, 256 of the subjects had main carers who were non-statutory. These informal carers of the dependent elderly were then interviewed to examine the nature of the care that they provided, the assistance both formal and informal that they received and the consequences such caring had on their quality of life. The evidence from this study supports the view that the family is the main source of assistance to dependent elderly; usually the woman in the family. Very little assistance, either informal or formal, was received by the carers. Consequently there was a great deal of distress and psychological morbidity among the carers. PMID- 6484637 TI - Hospital units as social contexts: effects on maternal behavior. AB - This paper examines the impact of different styles of nursing in maternity units on maternal behavior. These styles are found to be independent of the units' formal organizational characteristics and to vary depending on specific nursing tasks. The degree to which unit management affords opportunities for individualized patient teaching probably has the greatest impact on maternal behavior. Forty-five mothers, closely matched on ethnicity, age, marital status, socioeconomic status and parity, who delivered in three different hospital units, were observed systematically while feeding their infants. The investigators' observations, supplemented by measures of nurse task conceptions and perceptions of work structure, were used to characterize each unit. Analyses of variance, in which each hospital represented a fixed level of treatment, showed that mothers in the moderately supportive unit were significantly more affectionate and responsive towards their infants, and behaved less passively towards them, than mothers in units where nursing work was highly routinized or where zeal for innovation predominated. The moderately supportive unit also significantly diminished the effects of social class and of prior experience with children on affectionate maternal behavior. The threat to validity posed by self-selection of mothers into hospital units was accounted for by the selection of hospitals owned by one prepaid group plan, each serving socioeconomically similar populations in different catchment areas, and by data from the mothers which showed that plan membership and hospital selection were governed by financial considerations and geographical convenience. The findings provide evidence that the social context of the hospital unit--particularly the opportunity for individualized interaction between nurse and patient--may have an effect on early maternal behavior which is independent of the mother's own characteristics. PMID- 6484638 TI - How to stay well in Tzintzuntzan. AB - In this paper the basic principles of humoral pathology in Tzintzuntzan, Michoacan, Mexico are outlined, and related to the strategies people follow to avoid illness. It is suggested that most Latin American accounts of humoral pathology are deficient in their failure to give due weight to thermal temperature, as well as to the metaphoric qualities embodied in the 'hot-cold dichotomy'. Emphasizing preventive rather than therapeutic measures highlights a basic, usually overlooked, characteristic of humoral pathology: whereas the well known 'principle of opposites' explains therapies, a diametrically-opposed 'principle of the avoidance of opposites' explains most behavior when people are well. Although scientific medicine is now first choice for villagers for therapy, explanation of illness continues to be based on humoral principles. Since people believe humoral principles account for what has happened to them, and since they believe that humoral precepts in prevention give them a high degree of control over their health, it is likely that humoral pathology--at least as a belief system--will flourish for a long time to come. PMID- 6484639 TI - Infant mortality and infant care: cultural and economic constraints on nurturing in northeast Brazil. AB - The Brazilian 'Economic Miracle' has had an adverse effect on infant and childhood mortality which has been steadily rising throughout Brazil since the late 1960s. An analysis of the reproductive histories of 72 marginally employed residents of a Northeast Brazilian rural shantytown explores the economic and cultural context that inhibits these mother's abilities to rear healthy, living children and which forces them to devise 'ethnoeugenic' childrearing strategies that prejudice the life chances of those offspring judged 'less fit' for survival under the pernicious conditions of life on the Alto. it is suggested that the selective neglect of children is a direct consequence of the selective neglect of their mothers who have been excluded from participating in the national economy. The links between economic exploitation and maternal deprivation are further discussed with reference to the social causes of the 'insufficient breastmilk syndrome' and the commercial powdered milk dependency of these women. PMID- 6484640 TI - Food ideology and eating behavior: contributions from Malay studies. AB - A study of food ideology and eating behavior in a Malay village demonstrates that the relationship between belief and action is complex and not always predictable. Over-reliance upon stated beliefs, and generalizations derived from particular ecological settings, have influenced investigators into making universal and logical statements about Malay eating behavior and its health consequences--a logic which, however, does not always jibe with reality. Food ideology, like any other portion of a belief system, is subject to innovation, interpretation and rationalization, and contains within it 'rules to break rules' which assure the continued integrity of the symbolic system by patterning what might otherwise be seen as rifts in its fabric. An understanding of eating behavior must be based both on a knowledge of the subsidiary, as well as primary, clauses of food ideology, and on direct observation of the behaviors elicited by these beliefs and modified by the setting, the situation and the individual. PMID- 6484641 TI - The buccra-massa and the little man's broker in a Jamaican sugartown: implications for community health education. AB - In societies that have been historically stratified by class, interclass communication is frequently hampered by behaviors of higher status people that lower status people interpret as denigrating. To escape what they perceive as denigration, lower status people may attempt to avoid interclass interaction, and, when it is unavoidable, adopt such strategies as not making direct eye contact, saying very little except what they think the higher status people want to hear (including flattery), and using a lower status peer as an intermediary. Such behavioral patterns have important implications for the design of health services programs. This paper presents a case study of such interaction difficulties observed during 13 months of anthropological research in a Jamaican town. The lower status people in the town of Haversham (a pseudonym) refer to this avoidance behavior as the 'buccra-massa'. The antonym of buccra-massa is 'buck-the-massa'. 'Buck-the-massa' is characterized by being able to look higher status people in the eye and boldly engage them in conversation. Lower status persons who are known for bucking the massa are frequently used as intermediaries in cross-class interactions. Because Havershamians refer to higher status men as 'big men' and to lower status men as 'little men', the author calls the intermediaries used by lower status people in Haversham, 'little man's brokers'. The author argues that the buccra-massa and buck-the-massa behavioral traditions had their roots in the complex and extreme social inequalities of the slavery period in Jamaica. It is further argued that economic difficulties in Jamaica since the slavery period have contributed to the persistence of these behavioral dynamics to the present day. The buccra-massa/buck-the-massa behavioral complex is often manifested in health care settings in Jamaica. Thus, the author suggests that the little man's broker can be very useful in promoting less threatening, and therefore more effective, interactions between the clients and the staff of health and other human service programs. He notes that while staffmembers often view brokering behavior as trouble making, many of the clients they wish to serve view this same behavior as bucking-the-massa. It is a mistake, according to this analysis, to ignore the little man's broker. As this case of Jamaica shows, accomplished brokers can choose to exert their extensive influence against utilization of services offered by specific programs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6484643 TI - CME revisited; why Italy? PMID- 6484642 TI - The role of health beliefs in compliance with physician advice to quit smoking. AB - The Health Belief Model has been proposed to account for patient compliance with therapeutic regimens. The purpose of the present study was to evaluate the utility of this theoretical formulation in accounting for compliance with physician advice to quit smoking among patients with pulmonary disease. Three hypotheses were examined: (1) probability of cessation of smoking is positively related to strength of Health Beliefs; (2) Health Beliefs can be used to explain relationships observed between other variables and compliance; (3) reason for smoking accounts for discrepancies between Health Beliefs and compliance. Results from a prospective study of 308 patients supported hypothesis 3, partially supported hypothesis 1, and did not support hypothesis 2. It was concluded that this conceptual formulation is useful in this context, but that explanations based on arousal level may be more appropriate. PMID- 6484644 TI - Dishonesty in medicine. PMID- 6484645 TI - Gastric microbial flora in patients with gastrointestinal disease. AB - We designed a prospective study to test the hypothesis that the stomach may be a bacterial reservoir in some patients and function as a potential source of aspiration-induced bacterial pneumonia. Quantitative cultures of fasting gastric contents were obtained in 100 consecutive patients having fiberoptic endoscopy for evaluation of gastrointestinal disease. Culture results were correlated with gastric pH and gastrointestinal pathology. Patients with gastric ulcer disease had a significantly higher incidence of bacterial growth than those with duodenal ulcer. Patients who had had gastrectomy were more likely than any others to have gram-negative bacilli in their stomach. A somewhat high frequency of other common pneumonic pathogens in gastric contents was also noted. The significance of these findings in the production of pneumonia in the elderly is discussed. PMID- 6484646 TI - Opsonic fibronectin after operation or trauma: effect of hemodilution and duration of operation. AB - Fibronectin is an essential opsonin for phagocytosis of nonbacterial particulate matter by the reticuloendothelial system (RES). Fibronectin deficiency causes RES phagocytic depression and repletion of fibronectin reverses RES depression. Fibronectin depletion has been linked with multiple organ failure after surgery and trauma in patients with intra-abdominal infection. The mechanisms for fibronectin depletion have not been established. Plasma fibronectin levels were measured in 29 patients requiring operation after trauma and 15 patients undergoing elective abdominal operations. Opsonic fibronectin fell in the immediate postoperative period and on the first postoperative day in both groups. Total fluid replacement, blood loss, and operative time did not correlate with depression in fibronectin levels after trauma, although a weak correlation may exist between total fluid administration and fibronectin concentration in postoperative patients. Total fluid replacement, blood loss, and operative time may be contributing factors, but are not the major determinants of fibronectin deficiency after trauma or operation. PMID- 6484647 TI - Sequelae of tubal ligation: an analysis of 75 consecutive hysterectomies. AB - Seventy-five consecutive patients undergoing hysterectomy subsequent to elective sterilization were studied regarding the occurrence of the post-tubal-ligation syndrome of pelvic pain and/or menorrhagia. Twenty patients were clinically considered to have the syndrome. In none of the patients operated on specifically for menstrual abnormalities could the findings be remotely attributed to the sterilization procedure. Five of the 20 patients had pelvic varicosities and one had pelvic adhesions that may have been a consequence of previous sterilization and conceivably the cause for the pelvic pain for which the patients were undergoing hysterectomy. I question the legitimacy of the post-tubal-ligation syndrome as a reason for hysterectomy. PMID- 6484648 TI - Management of attention deficit disorder. AB - Attention deficit disorder occurs in 5% to 10% of school-aged children. Retrospective studies have shown an increased incidence of academic and social failure in untreated children. This paper reviews the natural course of the disorder and describes some therapeutic interventions. PMID- 6484649 TI - Myofascial trigger points in persistent posttraumatic shoulder pain. AB - Persistent pain and disability after injuries to the shoulder sometimes create a difficult diagnostic and therapeutic problem. In many such cases, myofascial trigger points seem to cause symptoms. Three cases in which pain had persisted for eight to 33 months after injury illustrate the manifestations of posttraumatic myofascial trigger point disorders. Trigger points are located by finding discrete foci of tenderness in muscles. Trigger points may be palpably firmer than surrounding muscle, forming nodules; they may twitch in response to palpation and may refer pain to a specific area when stimulated. Failure to recognize the myofascial source of pain can lead to erroneous diagnoses of articular, neurologic, or emotional disorder. Current pathophysiologic theories about trigger points may explain the persistence and topographic spreading of pain after muscular injuries. Appropriate treatment of myofascial trigger points can relieve chronic pain and disability. PMID- 6484650 TI - Cimetidine usage for unlabeled conditions in an ambulatory care service. AB - With the intent of cost containment, we conducted a survey of cimetidine usage in the Ambulatory Care Service of our Veterans Administration Medical Center. During a period of six months, this drug was prescribed for 132 patients. Only about 20% received cimetidine for FDA approved conditions. Treated conditions not approved by the FDA (unlabeled) included undiagnosed abdominal pain, past peptic ulcer disease, reflux esophagitis, and a variety of other conditions. Fourteen percent of the patients had demanded the drug. Irrespective of whether a confirmed diagnosis was present or not, most patients taking cimetidine had symptomatic relief. It is unclear whether more regulations or improved physician education would be the better method to control improper and unnecessary use of a drug that is generally safe but has potentially serious side effects. PMID- 6484651 TI - Predicting the outcome of hospitalization for elderly persons: home versus nursing home. AB - Fifty elderly persons who had been admitted to an acute care hospital from home and discharged to nursing homes were compared with 50 elderly persons who had been admitted to the same hospital from home and discharged to home during the same period. Discriminant function analyses were done to predict discharge status from patient characteristics at the time of admission as well as later in the hospital stay. Discharge status was predicted correctly for 88% of men and 75% of women, using patient characteristics available at the time of admission. When certain characteristics available later in the hospital stay were added, prediction improved to 98% for men and 86% for women. PMID- 6484652 TI - Splenic trauma: a trial at selective management. AB - The experience with splenic trauma at the Metropolitan Nashville General Hospital and at Vanderbilt University Hospital between 1972 and 1983 is the subject of this report. Of 154 emergency cases involving splenic injury, 134 were due to blunt trauma, with 20 cases resulting from penetrating injury. In 124 patients, exploratory laparotomy was done immediately after resuscitation and evaluation. Splenectomy was done in 113 (92%) cases, and in ten cases the spleen was repaired. Thirty patients (19.4%) were initially managed by observation of vital signs, serial hematocrit determinations, and serial physical examination. Of these 30 patients, 21 (70%) required exploratory laparotomy for continued bleeding after observation of 12 hours to six days. Eighteen of this group had splenectomy, and three had splenorrhaphy. Nine (5.8% of the total and 30% of the observed group) were successfully managed nonoperatively. Complications were encountered in 53 of the total 154 cases. There were 19 deaths (12.3%), 11 of them from head injuries. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems. Nonoperative management of suspected splenic injury should be reserved for patients in stable condition and with few if any associated injuries. PMID- 6484653 TI - Hyponatremia induced by thiazide-like diuretics in the elderly. AB - We have presented five episodes of hydrochlorothiazide-induced hyponatremia in three elderly nursing home patients. Fortunately all our patients survived. The common use of thiazide diuretics in this population and the nonspecific symptoms that follow toxicity make it imperative to monitor closely elderly patients who are taking thiazide diuretics. PMID- 6484654 TI - Primary Wegener's granulomatosis of the trachea: radiologic manifestations. AB - This is the third reported case of Wegener's granulomatosis of the trachea occurring as the primary initial event in a young patient. Roentgenographic findings consisted of a 3 cm intraluminal mass with extensive tracheal narrowing. In a young patient with inspiratory stridor, a mass causing narrowing of the trachea, and a course complicated by symptoms of vasculitis, the possibility of Wegener's granulomatosis should be considered. PMID- 6484655 TI - Ampicillin-associated seizures. AB - Two patients had ampicillin-associated seizures. Although they had complex medical problems, the high serum concentrations of ampicillin at the time of seizures without their recurrence after discontinuing the antibiotic suggest that the seizures were related to the ampicillin therapy. PMID- 6484656 TI - Pheochromocytoma in pregnancy: diagnosis and collaborative management. AB - Antenatal diagnosis and appropriate management of pheochromocytoma complicating pregnancy offers a reduction in mortality for both mother and fetus. We have presented the successful management of such a case, emphasizing the close collaboration between obstetricians, pediatricians, anesthesiologists, surgeons, and internists that is mandatory for a successful outcome. PMID- 6484657 TI - Venous aneurysm. AB - A 19-month-old girl had a congenital aneurysm of the neck vein. We attribute the pathogenesis of venous aneurysm to a defective vascular wall. The treatment of choice is simple surgical excision. PMID- 6484658 TI - Kwashiorkor in Baltimore. AB - Advanced cases of malnutrition are rare in the United States. Since it is rarely suspected, a correct diagnosis of malnutrition, even in extreme form, may easily be missed. We present a recent case of the kwashiorkor form of the syndrome of protein-energy malnutrition to emphasize its diagnostic features and to enhance early recognition and initiation of proper therapy. The misunderstanding of a physician's recommendations by a teen-aged mother may have initiated this illness. PMID- 6484660 TI - Adenomyoma of the stomach. AB - We have described three cases of adenomyoma of the stomach. These benign lesions are found almost exclusively in the antrum or pylorus and are composed of combinations of ducts, glands, pancreatic tissue, and smooth muscle. Malignancy arising in adenomyomas is rare. PMID- 6484659 TI - Bony expansion in skeletal metastases from carcinoma of the prostate as seen by bone scintigraphy. AB - We have presented three patients who had bony expansion due to metastatic carcinoma of the prostate demonstrated by roentgenography and bone scintigraphy. Bony expansion must be differentiated from the blooming phenomenon which may occur in areas of high radioactivity. Bony expansion is not specific for Paget's disease, but also occurs in many other benign and malignant conditions. PMID- 6484661 TI - Ileosigmoid knot. AB - A 30-year-old black man had emergency surgery for an acute abdominal condition. Intraoperative diagnosis of an ileosigmoid knot was made and gangrenous bowel was resected, with ilioileostomy, reanastomosis, end colostomy, and Hartmann pouch. PMID- 6484663 TI - Hairy cell leukemia: a case of cryptococcosis appearing as hairy cell meningitis. AB - Hairy cell leukemia has rarely been shown to involve the central nervous system. We have reported a case of hairy cell leukemia with apparent hairy cell meningitis, later found to be cryptococcal meningitis. Spinal fluid abnormalities, including the hairy cell pleocytosis, resolved with treatment of the cryptococcal infection. PMID- 6484662 TI - Bilateral anterior dislocation of the shoulder. PMID- 6484664 TI - Median and ulnar nerve palsies after infiltration of intravenous fluid. PMID- 6484665 TI - Metoclopramide-induced parkinsonism and severe edema. PMID- 6484666 TI - Massive lapiduria. PMID- 6484667 TI - Barium appendicitis revisited. PMID- 6484668 TI - Professionalism and the quality of medical care. PMID- 6484669 TI - Electroconvulsive therapy for depression. PMID- 6484670 TI - Impact of early recognition on outcome in nonpenetrating wounds of the small bowel. AB - During a recent ten-year period, 20 patients were treated for nonpenetrating, small-bowel trauma requiring resection. Despite the relative infrequency of this injury, jejunoileal trauma must be suspected in all patients sustaining blunt force to the abdomen. Physical signs suggesting major intra-abdominal wounds usually occur at admission or immediately thereafter, provided the patient is alert. Patients with altered sensorium or equivocal findings should undergo diagnostic peritoneal lavage. Laboratory investigation is not helpful in detecting small-bowel wounds. Plain roentgenography is indicated, but was diagnostic in only 20% of patients in this series. The high incidence of associated injuries accounts for the substantial morbidity (70%) in this series. Early operation improves survival. PMID- 6484671 TI - Duodenal rupture due to blunt trauma: a problem in diagnosis. AB - In our review of ten cases of duodenal disruption due to blunt trauma, we found a 30% mortality. Since early diagnosis would have lowered morbidity and mortality, a high index of suspicion needs to be maintained, combined with an aggressive diagnostic approach. Successful operation demands thorough duodenal exploration and facility with different methods of management. PMID- 6484672 TI - Foreign bodies of the upper gastrointestinal tract: current management. AB - The popularity of the flexible esophagogastroduodenoscope prompted us to reevaluate our management of foreign bodies. In this paper we report our experience and update treatment guidelines. In our series (from December 1975 to May 1982), 74 foreign bodies were removed: 12 with the rigid endoscope, 60 with the flexible endoscope, and two surgically. There was no morbidity or mortality. In the age group 1 to 10 years, there were 15 patients, while the age group 11 to 88 years had 59 patients. Although the rigid endoscope is less expensive and has a larger operating channel, the advantages of the flexible instrument are numerous. Foreign bodies of the pharynx and at the level of the cricopharyngeus muscle are best managed with a rigid endoscope; foreign bodies of the esophagus can be managed with rigid or flexible instruments, but are more easily managed with the latter. Foreign bodies of the stomach and duodenum that require removal can be managed only with the flexible panendoscope. PMID- 6484673 TI - Malignant tumors of the small bowel. AB - The four common types of small bowel malignancies have different clinical presentations, routes of metastatic spread, and prognoses, and may require selective treatment. A review of our experience over a 16-year period revealed 45 cases: 16 adenocarcinomas, 13 carcinoids, nine leiomyosarcomas, five lymphomas, and two fibrosarcomas. Adenocarcinomas tend to occur in the upper part of the small intestine, cause obstruction and occult blood loss, and metastasize to the regional nodes and liver. Carcinoids generally begin in the distal portion of the small bowel, may form rather large metastatic masses and cause obstruction from a metastatic mass or intussusception, and are often multiple. Leiomyosarcomas develop in any part of the bowel, may present a primary mass, gross hemorrhage, or perforation, and have blood-borne metastases. Lymphomas tend to occur in the distal part of the small bowel, with pain or mass formation, and spread via the lymphatics. Critical analysis of the clinical presentation and findings should allow preoperative recognition of the specific pathologic type. PMID- 6484674 TI - Sleep disorders among psychiatric outpatients. AB - Mental health clinics, particularly the ones serving middle-aged and elderly patients, are usually confronted with serious problems of insomnia, which could trigger or aggravate physical or emotional ailments. It could also lead to drug dependence or contribute to polypharmacy. In this study, we have attempted to make a profile of the insomniacs of a VA Mental Hygiene Clinic and to correlate several variables found in common among the patients. Our work indicated that certain drugs such as benzodiazepines were more effective than others. It also indicated that certain types of insomnia, such as that with frequent awakenings, were more amenable to treatment. PMID- 6484675 TI - Incest and physician responsibility. AB - This paper examines the epidemiologic, psychologic, and clinical aspects of incest, and emphasizes the need for action by physicians. The apparent increase in the incidence of this emotionally damaging experience makes it essential for the physician to understand the dynamics of incest, individually and in the family, so as to be prepared to meet the needs of the patient and the community. This paper stresses the responsibility of the physician in the intervention of the immediate trauma and in the prevention of its continuation or recurrence. Ways in which the physician, because of his close contact with the family, may fill this role are discussed. PMID- 6484676 TI - Neglect of syphilis in hospitalized patients. AB - Of 9,375 inpatients consecutively discharged from a major university hospital during a six-month period, 2,912 (31%) had a serologic test for syphilis (STS) before or during hospitalization. Seventy-five patients (2.6%) had reactive serology, and further testing confirmed the diagnosis of syphilis in at least 56 patients (75%). Forty-seven (84%) of the 56 patients were aged 40 or more, and 32 (57%) were women; seven (12.5%) had a spinal tap. A history of venereal disease was recorded for only 20 patients (36%), and 16 had a positive history of venereal disease or exposure. Forty-three percent of patients with reactive serology, including those with a biologic false-positive reaction, had proper management, including treatment when indicated. Only 16 (28%) of the 56 patients with syphilis had evidence of adequate therapy either before, during, or after hospitalization. We conclude that STS is frequently omitted in the evaluation of hospitalized persons, and that even with evidence of positive serology, the diagnosis, proper interpretation, and therapy are often ignored. PMID- 6484677 TI - Malaria: recent experience in a community. AB - Although a global resurgence of malaria has occurred along with the appearance of drug resistant organisms, this illness rarely is encountered by physicians in the United States. We report our experience with 15 cases of malaria seen during the last five years. The diagnosis should be considered in any febrile patient who has visited or resided in an area endemic for malaria, has received a transfusion, or is a narcotic addict. Confirmation of the diagnosis is obtained by blood smears for malaria parasites. Treatment is determined by the species and drug resistance of the parasite. Chemoprophylaxis is urged for visitors to countries endemic for malaria. PMID- 6484678 TI - Squamous cell carcinoma of the fingers treated with chemosurgery. AB - Squamous cell carcinomas of the fingers are uncommon tumors. While most of them pose little threat of metastasis, the clinician should know which tumors are likely to metastasize. Conservative surgical excision is the treatment of choice for squamous cell carcinoma of the finger. We present 19 cases treated conservatively with chemosurgery. PMID- 6484679 TI - Acute myocardial infarction in elderly patients. AB - We conducted a retrospective chart review on 50 patients under age 65 (average age 52.9 years) and 55 patients over 65 (average age 75.6 years). The older patients were much more likely to have atypical pain or no pain (38% vs 4%, P less than .0001). They were less likely to have electrocardiographic QRS changes (47% vs 72%), but more likely to have congestive heart failure (44% vs 16%, P less than .01). In 25% of the older patients, no diagnosis was made in the first 24 hours, as compared to 8% of the younger group. The increased mortality in the older group (16% vs 4%) approached statistical significance (P = .08). We conclude that the manifestations of acute myocardial infarction are more subtle in the elderly, with a higher proportion of atypical chest pain and nondiagnostic electrocardiograms, but the elderly are more likely to have congestive heart failure. PMID- 6484680 TI - M-mode echocardiographic abnormalities in Rocky Mountain spotted fever. AB - Rocky Mountain spotted fever is a serious acute systemic illness frequently complicated by cardiac involvement. To evaluate the spectrum of myocardial dysfunction, we obtained M-mode echocardiograms on nine consecutive patients with Rocky Mountain spotted fever within 72 hours of admission. Seven of the nine patients had echocardiographic evidence of impaired left ventricular function; two of the seven had no other evidence of cardiac involvement. The extent of impairment of left ventricular function reflected the clinical severity of the illness. Left ventricular myocardial dysfunction is a frequent complication of Rocky Mountain spotted fever. Echocardiography may provide the only clinical evidence of cardiac involvement in these patients. PMID- 6484681 TI - Bacterial colonization of amniotic fluid in patients with intact membranes during labor. AB - Amniotic fluid from gravidas with intact membranes was obtained for bacteriologic culture at the time of cesarean section. The incidence of positive cultures from patients not in labor was 8%. When the length of labor was eight hours or less (mean 6.1 hours) and the membranes were intact, the incidence of positive cultures was 37%; in patients whose length of labor was 12 hours or less (mean 9.7 hours) with intact membranes, 55% of cultures were positive. The incidence of endomyometritis in patients with bacterial growth from the amniotic fluid cultures in each group was 33%, 33%, and 45%, respectively. PMID- 6484682 TI - Adult respiratory distress syndrome: radiologic manifestations and course. AB - During a 36-month period, the serial chest x-ray films of 26 patients with the adult respiratory distress syndrome (ARDS) were evaluated for the patterns of onset, course, and follow-up appearance when possible. An exudative phase appearance can be recognized, which can clear. The exudative phase appearances are (1) a bilateral, homogeneous, white-out alveolar appearance; (2) an asymmetric consolidative appearance; and (3) a central perihilar ("bat-wing") consolidative appearance. This progresses to a proliferative phase manifested on chest x-ray film as an interstitial appearance that must not be confused with fibrosis, as the chest x-ray film may return to normal. PMID- 6484683 TI - Pulmonary artery malformation syndrome. AB - We present a case to illustrate that pulmonary artery malformation is a potential diagnosis in patients with nonresolving perfusion defects. The diagnosis can usually be made by the history, physical examination, chest roentgenogram, and ventilation-perfusion scanning. If the patient's clinical symptoms are inconsistent with the scan, then pulmonary angiography is warranted. Pleuritic chest pain, hypoxemia, and a perfusion defect are nonspecific and should not be interpreted as indicative of pulmonary embolism but only that it has not been ruled out. Anticoagulation is risky because these patients are already at increased risk for pulmonary hemorrhage and hemoptysis. PMID- 6484684 TI - Gastrocnemius musculotendinous rupture: a condition confused with thrombophlebitis. AB - Over a 24-year interval I have seen 22 cases of rupture of the medial head of the gastrocnemius muscle where it inserts into the soleus aponeurosis. The rupture may result in a swelling that is easily confused with thrombophlebitis and result in unnecessary hospitalization and anticoagulant therapy with its attendant expense and possible complications. The process is self-limiting and heals without sequelae in three to six weeks. PMID- 6484685 TI - Physicians' responsibility in the drug development process. PMID- 6484686 TI - Suppurative pylephlebitis due to pseudodiverticulosis coli. AB - Patients manifesting suppurative pylephlebitis and intrahepatic abscess formation secondary to pseudodiverticulosis coli and acute diverticulitis are uncommon, but have very high morbidity and mortality. As illustrated by this case report, the symptoms and signs such a patient manifests are nonspecific and the diagnostic modalities available may be insufficiently sensitive. The therapeutic options available at present are excision and drainage of any detected extrahepatic or intrahepatic septic focus and prolonged antibiotic administration. PMID- 6484688 TI - Acute anterior spinal epidural abscess. AB - We have reported a case of acute spinal epidural abscess, an uncommon cause of pain in the neck and back. The typical progression from spinal ache to paralysis may be halted if the diagnosis is suspected and prompt radiologic and surgical interventions are initiated. PMID- 6484687 TI - Acquired double pylorus. AB - We have reported two cases of double pylorus or duplicated pyloric channel as an unusual complication of peptic ulcer disease. It is usually noted as an incidental finding on x-ray films or at endoscopy. Double pylorus seems to be an acquired lesion arising from gastric ulceration and does not necessarily require surgical correction. PMID- 6484689 TI - Neuroblastoma in an adult. AB - Neuroblastoma in adults is probably a more frequent disease than is generally recognized, owing to difficulties in the microscopic diagnosis. It has no sex predominance and has occurred in patients aged 18 to 72 years. Based on the results in the patient we have described, cyclophosphamide and prednisone would seem an effective and well tolerated chemotherapeutic combination. PMID- 6484690 TI - X-linked neonatal myotubular myopathy. AB - We have described a family with X-linked myotubular myopathy that was clinically manifest in the neonatal period and compared it with the clinical picture and course of the disease in similar reported cases. Clinical expression of the disease in the newborn period is not always lethal. Despite a fatal outcome in the family reported here, a review of the literature indicates that aggressive treatment of short-term respiratory insufficiency at birth is justified. PMID- 6484691 TI - Idiopathic retroperitoneal fibrosis with diffuse involvement: further evidence of systemic idiopathic fibrosis. AB - We have presented a fatal case of idiopathic retroperitoneal fibrosis with an unusual diversity of systemic involvement, providing further evidence for the concept of systemic idiopathic fibrosis. Although the definitive cause of this disorder remains unknown, laboratory findings in this patient suggest an autoimmune process. PMID- 6484692 TI - Fine needle aspiration and cytology in the preoperative diagnosis of branchial cyst. AB - A patient was referred for an asymptomatic neck mass presumed to be a thyroid mass. Fine needle aspiration and examination of the aspirate provided the preoperative diagnosis, which led to early surgical treatment and avoided unnecessary sodium levothyroxine therapy. PMID- 6484693 TI - Adrenal pseudocyst in a hypertensive patient. AB - An adrenal "mass" was discovered radiologically during a hypertensive evaluation. Because of the patient's labile hypertension, the mass was interpreted as a pheochromocytoma. Only at operation was the cystic and benign nature of the lesion appreciated. Pathologically, it proved to be a simple pseudocyst. PMID- 6484694 TI - Spontaneous cholecystocutaneous fistula. AB - We have reported a case of spontaneous cholecystocutaneous fistula that opened externally at the site of a healed surgical scar in the right upper quadrant. PMID- 6484696 TI - Pregnancy associated with exstrophy of the bladder and obstructive renal failure. AB - I have reported a case of pregnancy in a patient with exstrophy of the bladder. Early establishment of renal function and status is most important, and detailed counseling of the patient is preferred ideally before conception. The patient should be reassured that her defect has not been proven to have a genetic link. Patients with ureterosigmoidostomy diversion should be observed closely for renal obstructive symptoms. PMID- 6484695 TI - Elastofibroma arising in the foot. AB - Elastofibroma is a nonneoplastic proliferation of collagen and abnormal elastic fibers, with a marked predilection for the subscapular area. We have described an elastofibroma occurring in a previously unreported location, the plantar surface of the foot. Trauma has been implicated in the pathogenesis of these lesions, regardless of site, and our patient's history of intensive dance and aerobic exercise further supports this relationship. Although elastofibromas are rare, they may be considered in the differential diagnosis of fibrous lesions arising at sites of repetitive strenuous exercise or injury. PMID- 6484697 TI - Therapeutic options for synchronous malignancies of the colon. AB - We have reported the recent case of a patient with three synchronous colonic malignancies. A review of the literature suggests that multiple lesions of the colon, particularly ones that are benign, are not uncommon. The clinician should be aware of this association and be prepared to evaluate and manage appropriately patients with multiple colonic lesions. PMID- 6484698 TI - Biliary ascariasis. AB - We have described a case of biliary ascariasis with the uncommon complication of pancreatitis. Ideally, the diagnosis is made preoperatively by cholangiography. If conservative therapy fails, surgery is recommended. Proper therapy includes complete clearance of worms from the hepatobiliary tract and the intestine. Results are good with early diagnosis and treatment. PMID- 6484699 TI - XY gonadal dysgenesis with gonadoblastoma and dysgerminoma. AB - We present the clinical and endocrine findings in the case of a phenotypic woman with XY karyotype and gonadal dysgenesis. An examination of the gonads revealed bilateral gonadoblastomas, the right one almost completely replaced by a massive dysgerminoma. PMID- 6484700 TI - Hypokalemic periodic paralysis. AB - Hypokalemic periodic paralysis is an unusual disease that may begin dramatically. Although terrifying to the patient, the attacks can usually be controlled if the proper diagnosis is made. Although much has been done to determine the pathogenesis, many questions remain unanswered. PMID- 6484701 TI - Carpal tunnel syndrome associated with abnormal palmaris longus muscle. PMID- 6484702 TI - Endocarditis due to Veillonella alcalescens. AB - A 60-year-old man with a history of a benign heart murmur for 25 years had evaluation of six months of unexplained fever and heart disease. The fever responded to nonspecific antimicrobial therapy, but progressive aortic insufficiency necessitated aortic valve replacement. Although numerous preoperative blood cultures were negative, Veillonella alcalescens was isolated in pure culture from the excised valve. The patient remained well after two weeks of intravenous therapy with cephalothin and three months of oral therapy with penicillin. PMID- 6484703 TI - Pulmonary lobectomy for metastatic adrenocortical carcinoma: a 25-year survival. AB - A virilizing adrenocortical carcinoma was treated by excision of the primary tumor and later lobectomy for metastases to the lung. Virilization was abolished, fertility restored, and the patient is without evidence of recurrent tumor 25 years later. PMID- 6484704 TI - Infantile hepatic cholestasis with maternal Dubin-Johnson syndrome. AB - A pregnant patient had Dubin-Johnson syndrome. Although the mother had hyperbilirubinemia, there were no untoward fetal effects. The infant's neonatal course, however, was complicated by hepatitis with giant cell transformation. PMID- 6484705 TI - Complication of cholecystectomy. PMID- 6484706 TI - Preventing heart attacks. PMID- 6484707 TI - Epidemiology of giardiasis. PMID- 6484708 TI - [Dispensarization of patients with neoplasms of the large intestine]. PMID- 6484709 TI - [Improving medical services for children in rural communities]. PMID- 6484710 TI - [Scope and type of activities of specialists of the sanitary hygienic laboratories with regard to environmental control]. PMID- 6484711 TI - [Evaluation of the results of socialist competitive activities in public health institutions]. PMID- 6484712 TI - [Current methods of modeling used to determine the objectives of public health administration]. PMID- 6484713 TI - [Participation of the population in preventive measures]. PMID- 6484714 TI - [Development of deontological principles in medical practice]. PMID- 6484715 TI - [Education of the population with regard to sexual health]. PMID- 6484716 TI - [Current objectives of health resort treatment]. PMID- 6484717 TI - [Improving the effectiveness and quality of work of the State Pediatric Clinical Hospital]. PMID- 6484718 TI - [Role of the Central District Hospital in the organization of medical services for rural populations]. PMID- 6484719 TI - [Teaching the analysis of activities of hospitals and polyclinics]. PMID- 6484720 TI - [Improving the training of medical students in medical schools]. PMID- 6484721 TI - [Prediction of future trends in the training of a specialist in pediatrics and adolescent medicine]. PMID- 6484722 TI - [Method of grouping rural areas for developing and improving health services]. PMID- 6484723 TI - [The chlorpropamide-alcohol test in diabetes mellitus]. PMID- 6484724 TI - [Spontaneous rupture of the thoracic segment of the esophagus]. PMID- 6484725 TI - [Local post-traumatic sarcoid reaction]. PMID- 6484726 TI - [Lymphangiomatosis complicated by chylothorax]. PMID- 6484727 TI - [Hemodynamics in patients with liver cirrhosis and portal hypertension syndrome]. PMID- 6484728 TI - [Amputation of the limbs and fatal outcome in injuries of major vessels of the extremities]. PMID- 6484729 TI - [Ionized calcium level of the plasma in chronic ischemic heart disease]. PMID- 6484730 TI - [Complications of extracorporeal hemosorption and methods of their prevention]. PMID- 6484731 TI - [Early diagnosis of nephropathy in pregnancy]. PMID- 6484732 TI - [Integral indicators in the diagnosis and prognosis of infection]. PMID- 6484733 TI - [Clinico-morphological aspects of Klebsiella infections]. PMID- 6484734 TI - [Mosaicism in Klinefelter's syndrome]. PMID- 6484735 TI - [Value of complex instrumental examination of the cardiovascular system in patients with rheumatoid arthritis]. PMID- 6484736 TI - [Control of pulmonary edema caused by congestive cardiomyopathy]. PMID- 6484737 TI - [Hemosorption in patients with hepatic failure]. PMID- 6484738 TI - [Ischemic heart disease from the internist's viewpoint]. PMID- 6484739 TI - [Role of health resort treatment of duodenal ulcer after selective proximal vagotomy]. PMID- 6484740 TI - [Analysis of work of district therapists and methods for improvement]. PMID- 6484742 TI - [Classification and nomenclature of acute pneumonia]. PMID- 6484741 TI - [Diagnosis of tricuspid valve defects by recording low-frequency fluctuations in the pericardial region]. PMID- 6484743 TI - [Acute lung diseases caused by drug hypersensitivity]. PMID- 6484744 TI - [Availability of technological resources in Mexican medicine: results of a national survey]. PMID- 6484745 TI - [The utilization of technological resources in Mexican medicine. A survey of 73 medical units]. PMID- 6484746 TI - [Trends in pregnancies ending in cesarean section in the Federal District]. PMID- 6484748 TI - [Technical trends in nuclear spin tomography]. PMID- 6484747 TI - [Mortality in a rural population in Mexico and its relation to the use of medical services before death]. PMID- 6484749 TI - [Quality control in mammography]. PMID- 6484750 TI - [Mammographic-histologic comparison in breast cancer with special reference to minimal cancers]. PMID- 6484751 TI - [Progress in the diagnosis of femur head necrosis in adults]. PMID- 6484752 TI - [Can the development and maturation of the pelvic bones be used to support and amplify the determination of bone age in adolescents and young adults?]. PMID- 6484753 TI - [Is the general thoracic image in suspected rib fracture adequate?]. PMID- 6484754 TI - [Methods of quality assurance in computed tomography using test measurements on a CT/T-8800 as an example]. PMID- 6484755 TI - [Film cassette specially designed for radiotherapy simulation]. PMID- 6484756 TI - Surgical management of congenital heart disease. A review of 7 years' experience. AB - This is a review of the results of surgical treatment of congenital heart disease in children aged less than 12 years over the period 1975 - 1981 (1254 cases). The patients are divided into two groups, those treated between 1975 and 1979 (903 cases) and those treated in 1980 and 1981 (351 cases). Only 19,7% of the patients in the first group were under the age of 1 year, but 26,5% in the second group were in this age group. This reflects a change in policy and an attempt at surgical correction at a much younger age than was previously the case. Our present policy in cardiac emergencies in infants will be discussed. Despite the higher percentage of infants aged under 1 year who were treated in 1980 - 1981, the mortality rate was lower than that for the period 1975 - 1979. This probably reflects greater experience in the post-operative management of patients under the age of 1 year. PMID- 6484757 TI - Calcium supplementation during cardiopulmonary bypass in paediatric surgery. AB - This paper reports on the monitoring of plasma ionized calcium (Ca++) levels in children undergoing cardiopulmonary bypass (CPB) for open-heart surgery. The pump was primed with blood treated with either heparin or citrate-phosphate-dextrose (CPD). In certain cases calcium supplementation was used. In all cases a sudden drop in Ca++ levels took place at the start of CPB, followed by a slow recovery. In the patients who received heparinized blood the drop was slight (14%) and recovery fast (10 minutes), but in those who received CPD the drop was excessive (58%) and recovery was still incomplete after 1 hour despite supplementation with 0,5 g calcium gluconate per unit of whole blood. Different supplementation regimens were tried and the optimum was achieved by using 1 g calcium gluconate per unit of whole blood. This limited the drop in the Ca++ level to 42%, and recovery to prebypass levels took place within 45 minutes. PMID- 6484758 TI - Anaesthesia for paediatric cardiac surgery at the Red Cross War Memorial Children's Hospital. AB - Anaesthetic techniques for paediatric cardiac surgery are presented, with emphasis on the special problems of premedication, induction, certain specific conditions and anticoagulation. PMID- 6484759 TI - Treatment of advanced breast cancer with aminoglutethimide--response after previous tamoxifen treatment. AB - Thirty-one postmenopausal patients with advanced breast cancer either unresponsive to tamoxifen or progressing after responding to tamoxifen were treated with aminoglutethimide (1 000 - 1 250 mg/d) plus hydrocortisone replacement. The response rate was 33% in patients who had never responded to tamoxifen and 47% in patients who had previously responded to tamoxifen. The overall response rate was 42%. These results show that aminoglutethimide is an effective second-line hormonal treatment for patients with advanced breast cancer. PMID- 6484760 TI - Gastric emptying of a solid meal. AB - A simple, non-invasive technique for measuring gastric emptying of a solid meal in clinical practice is described. Cooked chicken liver labelled with a radioisotope is used. To establish the range of normal gastric emptying times 11 asymptomatic adults were studied. The effect of posture on solid emptying was also examined. PMID- 6484761 TI - Born before arrival. A study at the New Somerset Hospital, Cape Town. AB - A 3-month prospective study was undertaken to determine the factors which contribute to a baby being born before arrival (BBA) of the mother at hospital. The majority of the mothers of such babies were Black and lived in peri-urban areas of Cape Town. They were of higher parity, had experienced fewer complications during pregnancy, had shorter labours and had previously had more home deliveries than a comparative group of mothers. One-third of the babies were delivered in transit to hospital, and these babies had more major complications and a higher perinatal mortality rate than those born in hospital. The BBA rate of an area serves as an index of the accessibility of perinatal care. This index should be taken into account when reviewing and planning regional perinatal services. We believe that a BBA rate higher than 1,5% is unacceptable and merits investigation. PMID- 6484762 TI - Acute severe asthma. A prospective study of the precipitating factors in 40 children. AB - A prospective study was undertaken to determine the factors precipitating acute severe asthma in children attending the Red Cross War Memorial Children's Hospital, Cape Town. A comparison in terms of recent exposure to possible precipitating factors was made between 40 known asthmatics presenting with acute severe asthma and 40 known asthmatics who were clinically well. Exposure to known allergens had occurred in 7 cases. The time of onset of symptoms bore no relationship to meteorological changes in temperature, humidity or average pressure. Drug compliance in both groups was of the order of 50%. The majority of severe asthma attacks were associated with infection of the respiratory tract. The importance of infection as a precipitating factor in a severe asthma attack is discussed with reference to the cholinergic, adrenergic and immunological mechanisms. PMID- 6484763 TI - Does the natriuretic hormone play a role in hypertension in South African blacks? AB - It has been suggested that circulating natriuretic hormone may be important in the pathogenesis of essential hypertension by inhibiting the ouabain-sensitive Na+, K+-ATPase pump and that this effect should be more pronounced in low-renin hypertensives. We have studied serum and red blood cell sodium and potassium concentrations in vitro, before and after exogenous ouabain, in White normotensives and Black subjects with essential hypertension and in two groups of renal patients. No convincing evidence of sodium or potassium inhibition could be found in Blacks with either low-renin or high-renin hypertension. Striking inhibition was seen in the renal groups, supporting a circulating natriuretic factor, but there were anomalies within the renal groups, which suggest additional cell membrane abnormalities. PMID- 6484764 TI - Malignant mesothelioma--clinical and epidemiological features. A report of 80 cases. AB - The clinical and epidemiological features of 80 cases of malignant mesothelioma (as proved by examination of biopsy specimens) referred to the clinic at the National Centre for Occupational Health between January 1977 and June 1983 are reviewed. There was a positive history of asbestos exposure in 89% of cases. The mean survival time from diagnosis to death was 8,6 months and from the onset of symptoms to death 13,6 months. Survival time was unaffected by stage of the tumour, treatment, histological features, smoking status, presenting symptoms, presence or absence of effusion and asbestosis, side of the lesion, source of exposure and lag period from first exposure to diagnosis. The duration of survival was significantly affected by age at diagnosis, duration of asbestos exposure and the number, rather than the type, of treatment regimens used. Caution is advocated in interpreting these data since the number of cases was small and the study design was retrospective. A reference group of 546 cases notified over the same period was drawn from the records of the South African Asbestos Tumour Reference Panel. The incompleteness of national mesothelioma incidence data was noted, and an incidence figure of 7,2 per million per year was calculated from the best-available data for South Africa. This figure is an underestimate because not all diagnosed cases are reflected and, more important, significant numbers of cases are never diagnosed. The extent to which the compensation machinery functions is mentioned. PMID- 6484765 TI - Improvement in conditions at an amalgamation plant after an industrial hygiene survey. AB - After receipt of urine samples which showed higher than normal levels of mercury (Hg) from workers at a large goldmine, air samples were taken at the mine's amalgamation plant. These showed not only values higher than the threshold limit for Hg in air but also significant quantities of Hg on the worker's overalls. Recommendations were made for improvements and when these were completed samples were again taken at the plant. The mean Hg level in urine samples had dropped to one-third of its original value and concentrations in air were very much reduced. PMID- 6484766 TI - Air tamponade. A case report. AB - A 29-year-old man with post-traumatic cardiac tamponade resulting from the development of a tension pneumopericardium is described. To our knowledge this is the first such case reported in the literature. PMID- 6484767 TI - Crohn's disease of the oesophagus. A case report. AB - Crohn's disease is described as a disease which may involve the entire gastro intestinal tract from the mouth to the anus. Involvement of the oesophagus is well recognized but relatively rare. We wish to describe the unusual clinical presentation of intense dysphagia in a patient who was proved to have occult ileocolonic Crohn's disease. PMID- 6484768 TI - Anaesthesia for congenital lobar emphysema resection. A case report. PMID- 6484769 TI - Treatment of recurrent anterior shoulder dislocation by the modified Bristow Helfet procedure. PMID- 6484770 TI - Fertilization and cleavage in vitro of baboon oocytes. AB - Female chacma baboons (Papio ursinus) were subjected to ovulation induction with clomiphene citrate and human chorionic gonadotropin. Oocytes were recovered at laparotomy and matured in vitro. Sperm was collected by electrostimulation, processed and added to oocytes in culture. Fertilization, cleavage and early pre implantation development in vitro were recorded. Preliminary attempts to transfer embryos are described. Advantages and problems in establishing the baboon as a model for in vitro fertilization and embryo transfer are discussed. PMID- 6484771 TI - An evaluation of the pulse-contour method of measuring cardiac output. AB - The pulse-contour (PC) method continuously derives the cardiac output in litres per minute from the arterial pressure wave form by using a portable analogue computer. The reliability of the PC method in determining cardiac output was studied in 6 patients during anaesthetic induction for cardiac surgery. The results obtained with the PC method using the radial artery to register the arterial pulse wave were compared with cardiac output measurements using the more conventional thermodilution technique. The PC method would seem to offer a simple, clinically useful method for on-line monitoring of short-term variations in cardiac output. PMID- 6484772 TI - Cortical dysfunction as an aetiological factor in learning disability. AB - This study examines the relationship between learning disability, EEG changes, and events in the life history of the individual child which could cause cortical damage or dysfunction. One hundred children with learning disability were compared with 100 age- and sex-matched normal children identified by random selection. Each child underwent routine EEG studies. Abnormalities were detected in 71 of the learning-disabled group and in 29 of the controls. The incidence of abnormal pregnancy was 31% in children with learning disability and 10% in controls. Neonatal complications occurred in 29 learning-disabled children as opposed to 13 controls. Seventeen learning-disabled children had experienced seizures and 5 had a history of meningitis; comparable figures in the control series were 7 and 2 respectively. Nine learning-disabled children had a history of severe illness as opposed to 3 children in the control series. The results of this study indicate that a significant relationship exists between learning disability and a variety of circumstances associated with insults to the immature brain. These insults may account for the cortical dysfunction suggested by psychometric and EEG studies. PMID- 6484773 TI - The low-compression corset. AB - A low-compression lumbosacral corset is described in which a 2-litre inflatable chamber is attached behind the front panel of a conventional commercial corset. The corset is fitted to the patient and the paraspinal steel supports are removed. The chamber is then inflated to a low pressure (30 mmHg) and to approximately one-quarter to one-fifth of its volume. An increased thrust is produced on the abdominal viscera with consequent flexion of the lumbar spine and diaphragmatic 'lift' as well as increased patient comfort and improved fitting. The paraspinal steel supports are then refitted to the flatter lumbar curves. PMID- 6484774 TI - Ingestion of codeine and salicylic acid causing convulsions and coma. A case report. AB - A 3-year-old White child was admitted to the critical care unit in a coma after a generalized convulsion. Codeine and salicylic acid were present in his plasma. The possible aetiology and management are discussed. PMID- 6484775 TI - [Intracoronary thrombolysis using streptokinase in acute myocardial infarction. Pilot study of 12 cases]. PMID- 6484776 TI - [Use of androgens in acquired aplastic anemia. Retrospective study]. PMID- 6484777 TI - [Application of in vitro culture of granulocyte-monocyte colony-forming stem cells (CFC-GM) from bone marrow in the study of refractory anemias]. PMID- 6484779 TI - [Monosomy 7 in hematologic processes. Clinical and prognostic implications]. PMID- 6484778 TI - [Clinical presentation of infection in the granulocytopenic patient with acute leukemia. Analysis of 95 episodes of documented infection]. PMID- 6484780 TI - [Experience with a simple microchromatographic method for hemoglobin A2 quantification (Hb a2)]. PMID- 6484781 TI - [Results of a quality control program in hematology (2d evaluation)]. PMID- 6484782 TI - [Spontaneous remission of multisystemic histiocytosis X]. PMID- 6484783 TI - Ethical issues in treatment of patients with end-stage renal disease. AB - Ethical issues in the care and treatment of patients with end-stage renal disease are illustrative of problems that confront social workers who practice in a medical setting. Chief among these are dilemmas of informed consent and dealing with the problem patient. Patient advocacy may pose a conflict between respect for a patient's autonomy and acting in the patient's best medical interest. Pressures of resource allocation on a dialysis unit also require a just resolution. PMID- 6484784 TI - A social work perspective on ethical practice in end-stage renal disease. AB - Social workers increasingly are defining problems that they encounter in practice in health settings as ethical dilemmas. A distinction is made between those practice questions that can best be answered by an appeal to theoretical or empirical knowledge and expertise (clinical questions) and those which invoke values and ethical imperatives (ethical questions). End-stage renal disease poses in high relief the practice dilemmas that are encountered by social workers and offers an opportunity to explore and clarify issues in resolving them. Using an exchange framework as a basis for analysis, common ethical problems of end-stage renal services are discussed. PMID- 6484785 TI - Integration of medical and psychosocial needs of the home hemodialysis patient: implications for the nephrology social worker. AB - Good patient management of the medical and technical aspects of home hemodialysis may be inversely related to positive psychosocial adjustment to chronic renal failure. The following article explores the interaction between the patient's medical and psychosocial adjustment to home hemodialysis and suggests how the nephrology social worker might help enhance patient adjustment by working at the interface of the various disciplines on the nephrology team, and at the interface between the patient and the team members. PMID- 6484786 TI - Social work and AIDS. AB - AIDS (Acquired Immune Deficiency Syndrome) is a new contagious disease for which no cause or cure is known at present. The majority of people who have contracted AIDS is gay men. This paper examines individual and societal responses to this illness and to homosexuality that create issues for social work practice. These are unique to AIDS and at the same time exemplary of issues in all of health care. General principles of practice are applied to the specifics of dealing with AIDS and social work tasks with patients, families and significant others, health care staff, the community and policy makers are identified. PMID- 6484787 TI - The 1982 national survey of carcinoma of the breast in the United States by the American College of Surgeons. AB - The 1982 survey documented changes in the management of carcinoma of the breast in this country. If one compares the current survey results with the results of the 1978 survey, an inescapable conclusion is that there is a changing understanding of carcinoma of the breast and a willingness to apply new knowledge to clinical practice. These results also show the potential of the hospital Tumor Registry when records are systematically aggregated and data from different points compared. Future applications of this survey procedure and further analyses of these data may be used to document progress in the control of cancer. While useful for these purposes, it should be noted that these data are not intended, nor suited, for assessing the superiority of given treatments. They may not reflect the outcome that would result from a clinical trial. Comparisons made herein often involve patients who differed in many respects other than that on which the comparison was focused. However, within these constraints, the data may be useful for clinicians and scientists interested in the dynamic state of the treatment of carcinoma of the breast in large numbers of hospitals in the United States. PMID- 6484788 TI - Surgical management of ileosigmoid fistulas in Crohn's disease. AB - Thirty-two instances of ileosigmoid fistula complicating Crohn's disease were seen in a series of 231 patients treated for this disorder. Conservative surgical treatment, consisting of dissection of the inflammatory mass and oversewing of the remaining defects in the sigmoid was possible in 23 patients. There was no mortality and there were no anastomotic leakages or postoperative fistulas. A plea is made for avoiding sigmoid resection whenever possible. PMID- 6484789 TI - Osteonecrosis in the transplant recipient. AB - From 1969 to 31 March 1982, 1,769 organ transplants were performed by the University of Minnesota Transplant Service. Fifty-one patients had severe osteonecrosis develop requiring 83 total joint arthroplasties. Patients with diabetes were underrepresented in the arthroplasty population; this may be due to neuropathy masking some disease. All of the patients received dramatic relief from pain and experienced improved function. Only one surgical mortality occurred -a patient with sepsis. To minimize complications, prophylactic antibiotics were used, and most patients did not undergo prophylactic anticoagulation. The most common complication was dislocation of the hip, at five to eight times the rate of those in the nontransplant arthroplasty population. These can be minimized by avoiding the posterior lateral surgical approach and by meticulous capsular repair. Despite the youth and activity of these patients, component wear was not a problem. However, because of the multicentric nature of this disease, components and surgical approach should be chosen carefully. Incidence of severe osteonecrosis was highest among cadaver kidney recipients. No HLA identical kidney recipient had severe osteonecrosis develop. Consequently, we concur with previous authors that osteonecrosis may be caused by the higher dosages of immunosuppressive agents required to prevent rejection of HLA nonidentical organs. PMID- 6484790 TI - The use of computerized tomography scan in the staging and follow-up study of carcinoma of the rectum. AB - We have reviewed the CT scans of 30 patients who were evaluated for either primary or recurrent carcinoma of the colon and rectum in the pelvis. The results of our experience have shown that pelvic CT scans can provide accurate information regarding the extramural extension of carcinoma of the rectosigmoid undetected by other means. CT scans can detect significant ureteral pathology as accurately as can IVP and have essentially replaced the IVP in the preoperative evaluation of carcinoma of the rectum. Inflammation of the perirectal musculature, either by the effect of the local tumor or secondary to preoperative radiation, can make it difficult to determine if these structures are invaded by tumor. Tumor involvement, however, can be proved using CT localization and percutaneous fine needle aspiration biopsy techniques. During radiation therapy and chemotherapy, CT scans may also assist in treatment planning and may be the most reliable way of observing the objective response of the recurrent tumor in the pelvis. Finally, in the patient in whom the recurrent tumor does not produce abnormally high levels of CEA, the CT scan may be the only method by which the early and treatable recurrence may be detected. It is, therefore, appropriate to recommend that pelvic CT scan be a routine test for every patient who has had abdominoperineal resection or low anterior resection for carcinoma of the rectum and rectosigmoid. PMID- 6484791 TI - Reversal of jejunoileal bypass. AB - The postoperative course of 48 morbidly obese patients upon whom a JIB operation was performed is reported. The indications for reversal of the JIB, the reversal operations and the gastric restrictive operations performed upon these patients are described. The results of this clinical investigation indicate that serious sequelae develop in most patients treated by JIB indicating reversal. A simultaneous gastric restrictive operation should be performed upon most of these patients to help them prevent excessive weight gain after reversal of JIB. PMID- 6484792 TI - Netilmicin sulfate prophylaxis in the surgical treatment of renal stones. AB - The role of short course (three doses) and single dose peroperative antibiotic (netilmicin sulfate) prophylaxis were studied in 42 patients undergoing removal of renal calculi. In an untreated group, the urine sample taken preoperatively was infected in 37.5 per cent, but the removed stone demonstrated significant bacterial growth in 67 per cent, with a wound complication rate of 25 per cent. Use of antibiotic prophylaxis reduced the wound complication rate to 5 per cent. Satisfactory serum levels of the antibiotic were achieved during the operative period, with an acceptable rate of clearance of netilmicin sulfate from the blood stream. PMID- 6484793 TI - Sex related survival differences in instances of melanoma. AB - While data concerning melanoma survival differences between the sexes as they relate to anatomic site, stage and age is scattered throughout the literature, few single studies on one large population of patients with melanoma have specifically addressed all the confounding variables proposed to account for such sex related survival differences. Data were collected for 1,489 patients with melanoma observed at Duke University Comprehensive Cancer Center. Females had a more favorable prognosis than males. This survival difference could not be fully explained by differences in the anatomic site of the primary, Clark level of invasion, histologic type or ulceration of the primary lesion or age at diagnosis between males and females. There is growing epidemiologic and biochemical evidence that melanoma may be affected by sex hormones. PMID- 6484794 TI - Prognostic factors of carcinoma of the male breast. AB - The clinical course of 50 male patients with carcinoma of the breast was reviewed. The disease most commonly presented in the seventh decade of life. The clinical examination of the axilla proved to be inaccurate. Survival time was highly correlated with the pathologic stage of the lesion. The five year survival rate was 80 per cent for patients with Stage I disease and 67 per cent for those with Stage II disease. By contrast, only 25 percent of patients with Stage III disease were alive at five years and all of the patients with Stage IV disease had died of the disease by the five year point. It appears that the prognosis for male patients with carcinoma of the breast is good if the appropriate therapy is undertaken at an early stage. PMID- 6484795 TI - Sigmoidocystoplasty to augment bladder capacity. AB - Sigmoidocystoplasty with subtotal cystectomy was carried out in 14 patients with severe, symptomatic contracture of the bladder, refractory to other modes of therapy. Eight patients had excellent results, four showed improvement, two showed no improvement and required supravesical diversion. Indications for the procedures, complications and over-all results are discussed, with emphasis on our surgical technique. The possible advantages of sigmoidocystoplasty over ileal and ileocecal cystoplasty are noted. PMID- 6484796 TI - An autologous hemostatic agent. AB - The use of autologous muscle as a thromboplastic agent in operations upon the head and neck has proved to be a safe, cost effective means to accomplish hemostasis in an area where it is absolutely necessary. PMID- 6484797 TI - Surgical venous cannulation with Doppler ultrasound. AB - We describe herein a technique by which surgical venous catheterization ("cut down") is easily and quickly performed with a minimal incision even in the obese patient or patient with shock, with the help of a slightly modified Doppler apparatus. PMID- 6484798 TI - The use of skin staples to secure skin towels in areas difficult to drape. AB - The use of skin staples to secure the skin towels and drapes to patients undergoing procedures on the head and neck or other areas difficult to drape is described herein. PMID- 6484799 TI - A technique for renal preservation during suprarenal abdominal aortic operations. AB - Preservation of renal parenchyma during operative cross clamping of the suprarenal aorta is desirable. A simple method to perfuse the kidneys with a hypothermic solution is described. PMID- 6484800 TI - United States population outlook. PMID- 6484801 TI - Measurement of overweight. PMID- 6484802 TI - Central Surgical Association Presidential address: The wrong end. PMID- 6484803 TI - Delayed gastric emptying after operation for obstructing peptic ulcer disease: the influence of cimetidine. AB - We studied the factors related to delayed gastric emptying after operation for obstructing peptic ulcer disease. The records of 76 consecutive patients who underwent operation for obstructing peptic ulcer were examined retrospectively. Delayed gastric emptying (unable to tolerate solid food for at least 2 weeks after operation) occurred in 11 of 76 patients (14.5%). It was not related to the type of operation performed, including procedures that employed truncal vagotomy. It did not correlate with the preoperative severity of obstruction, duration of preoperative nasogastric decompression, or the nutritional status of the patient. Delayed emptying occurred in four of six patients (66.7%) with insulin-dependent diabetes mellitus but only 10 of 70 patients (14%) without insulin-dependent diabetes (p less than 0.001). It was seen in six of 16 patients (37.5%) receiving long-term cimetidine therapy (more than 3 months) but only five of 60 patients (8.3%) not receiving long-term cimetidine therapy (p less than 0.01). Patients receiving long-term cimetidine therapy had an average number of 2.3 prior hospitalizations for ulcer disease while those not receiving long-term cimetidine therapy had an average of 1.4 prior admissions (p less than 0.01). Thus we advise against the long-term use of cimetidine in chronic peptic ulcer disease complicated by obstruction. Patients with diabetes mellitus who require insulin appear to be at particular risk for delayed gastric emptying after operation for obstructing peptic ulcer. PMID- 6484804 TI - Near-total pancreatectomy for chronic pancreatitis. AB - Eighty-seven patients underwent distal subtotal or near-total (80% to 95%) pancreatectomy (NTP) during a 25-year period for management of intractable pain resulting from chronic pancreatitis. Alcoholism affected the majority of patients and 20% of cases were idiopathic in origin. Ten patients (12%) exhibited insulin requiring diabetes before operation. The perioperative mortality rate was 3.4%. Significant improvement or complete pain relief was achieved in 75% of patients while 14% remained narcotic dependent. Forty-four patients (51%) required insulin postoperatively, with an average insulin requirement of 35 U per day. Thirty late deaths occurred 2 to 15 years after operation, 12 (40%) of which were related to complications of pancreatic insufficiency or persistent alcoholism. Five patients (8.5%) required completion pancreatectomy 6 months to 4 years after NTP for complications relating to persistent pancreatitis. NTP provides effective pain relief in the majority of patients with chronic pancreatitis. While this procedure can be performed with a low operative mortality rate, the high incidence of endocrine and exocrine insufficiency after operation may contribute to late deaths. Consequently, this procedure should be performed only when the underlying disease has functionally destroyed the pancreas or when lesser procedures have failed to provide adequate pain relief. PMID- 6484805 TI - Intersphincteric proctectomy. AB - Conventional proctectomy for inflammatory bowel disease is followed by delayed perineal wound healing in 20% to 63% of patients and sexual dysfunction in up to 17%. Although described several times since 1967, intersphincteric proctectomy is a technique used by very few surgeons in the United States. Accurate and safe rectal mobilization is easily accomplished by dissection within the intersphincteric plane, resulting in minimal damage to the pelvic floor and pelvic nerves and a much smaller perineal wound. The records of 58 patients who underwent rectal excision were examined. Proctectomy was performed in a conventional fashion for 30 patients and an intersphincteric proctectomy was performed for 28 patients. Of the 30 conventional procedures, 20 were for ulcerative colitis and 10 were for Crohn's disease. There was complete healing of the perineal wound in 70% of the patients at 6 months and in 73% at 1 year. There were four residual deep sinus tracts. Of the 15 men, three developed impotence, one permanently. Of the 28 patients who underwent intersphincteric proctectomy, 17 had ulcerative colitis, eight had Crohn's disease, two had incapacitating proctitis, and one had cancer of the midrectum. There was complete healing of the perineal wound in 84% of the patients at 6 months and in 84% at 1 year. There were no residual deep sinus tracts. Of the 15 men, one developed impotence that resolved after 1 year. Only one patient complained of persistent anal discomfort. The morbidity rate from intersphincteric proctectomy is low and we recommend more widespread use of this technique. PMID- 6484806 TI - Searching for the best weight reduction operation. AB - At the University of Minnesota under the supervision of one staff surgeon both jejunoileal bypass (JIB) and gastric bypass (GIB) operations have been performed for weight reduction in morbidly obese individuals. During the last 14 years 727 patients underwent end-to-end (40 to 4 cm) JIB and more than 570 patients underwent GIB. This report is based on a comparison of 205 JIBs performed between July 1975 and July 1979, 106 Alden-loop type GIBs (GIB-loop) performed between July 1975 and July 1979, 53 loop GIBs with enteroenterostomies between the limbs of the loop (GIB-EE) performed between May 1980 and May 1981, and 57 Roux-en-Y GIBs (GIB-Roux) performed between May 1981 and May 1982. Adequate weight loss occurred in 80% of the patients who returned for follow-up in all groups. The percentage of excess body weight loss was similar for the first year (65% for JIB, 62% for GIB-loop, 69% for GIB-EE, and 71% for GIB-Roux). The operative mortality and the immediate morbidity rates were uniformly low. The long-term complications for JIB were 37.7% arthralgia, 7.1% oxalate urolithiasis, 5.6% incisional hernia, and 1.4% liver failure. The complications for GIB-loop were 10.2% nausea/vomiting, 1.9% bile reflux gastritis, and 2.8% anastomotic problems; for GIB-EE 23% nausea/vomiting, 7% bile gastritis, 4.6% incisional hernia, and 3.7% anastomotic problems; and for GIB-Roux 16% nausea/vomiting and 1.7% anastomotic problems. The anastomotic problems consisted of afferent loop obstructions and stomal stenosis; there were no leaks. At 1 year plasma cholesterol reduction for JIB averaged 42% (p less than 0.001), GIB-loop 14% (p less than 0.001), GIB-EE 7% (NS), and GIB-Roux 17% (p less than 0.001). One year after operation 49% of 88 JIB patients showed progression of liver disease on sequential biopsy specimens and 20% improvement. In the 78 GIB patients with sequential biopsies, liver disease progressed in 8% and improved in 65%. In summary, comparable therapeutic weight reduction occurred with all the assessed procedures; however, the GIB-Roux was associated with far fewer serious long-term complications. At this time the GIB-Roux procedure is the weight reduction operation we recommend. PMID- 6484807 TI - The effects of reversal of jejunoileal bypass operations on hepatic triglyceride content and hepatic morphology. AB - Obesity is associated with significant hepatic steatosis, inflammation, and cirrhosis. These changes may be accentuated by jejunoileal bypass operations. This study is intended to determine if reconstruction of jejunoileal bypass operations alters hepatic triglyceride content and hepatic morphology. Eighty eight +/- 27 months after jejunoileal bypass, 26 patients underwent reconstruction for a variety of complications of the operation, including five patients with cirrhosis. At the time of reconstruction, hepatic triglyceride content was 132 +/- 13 mg/100 mg protein. After reconstruction, hepatic triglyceride content increased to 205 +/- 32 mg/100 mg protein in patients whose body weight increased and decreased to 84 +/- 6 mg/100 mg protein in patients whose body weight decreased. After reconstruction, hepatic inflammation decreased in 20 patients and hepatic fibrosis decreased in 17. These changes were not related to body weight changes. In five patients with cirrhosis at the time of reconstruction, one died of liver failure and hepatic morphologic findings improved in four after reconstruction of jejunoileal bypass operations. The results of this study suggest that reconstruction of jejunoileal bypass operations with weight loss or maintenance of body weight after reconstruction is associated with decreased fat in the liver. Approximately 65% of the patients will have improvement in hepatic morphologic parameters after reconstruction. Inflammation will be more greatly benefited than will fibrosis. In some patients, hepatic histologic abnormalities are unchanged or will progress despite reconstruction of jejunoileal bypass operations. PMID- 6484808 TI - Necrotizing enterocolitis: factors affecting mortality in 101 surgical cases. AB - One hundred one infants requiring operative treatment for necrotizing enterocolitis were evaluated for prenatal, perinatal, therapeutic, clinical, laboratory, radiographic, and operative factors as they relate to mortality. Infants less than 28 weeks gestation and those with birth weight less than 1500 gm had an increased mortality rate. The use of umbilical arterial catheters, high density premature formulas, and aminophylline (for apnea) had an adverse effect on survival. Persistent acidosis, oliguria, and abdominal wall erythema resulted in a significantly worse outcome. The presence of portal vein air on abdominal radiograph was associated with a 71% mortality rate. The survival rate in infants with localized involvement was 70%. Thirty-eight percent of patients had extensive bowel involvement and a greater than 95% mortality rate. Avoidance of enteral feedings, cautious use of umbilical artery catheters, and judicious application of pharmacologic agents in infants at risk for necrotizing enterocolitis is of importance with regard to prevention. While medical management is feasible in some cases, persistent acidosis, oliguria, abdominal wall erythema, and portal vein air are associated with advanced disease. Infants with these risk factors should be candidates for prompt operative intervention. PMID- 6484809 TI - Amino acid clearance and prognosis in surgical patients with cirrhosis. AB - To measure the effects of cirrhosis on amino acid (AA) flux and to assess the value of the central plasma clearance rate of amino acids (CPCR-AA) as a hepatocyte function test, 35 patients with cirrhosis were studied before and after operation. Fourteen of these patients died after the operation. CPCR-AA measures the number of milliliters of plasma cleared of AA per minute by the liver and other visceral tissues. It is the ratio of AA entry rate into plasma (from peripheral tissues plus infusion) to the arterial AA plasma concentration. Preoperative CPCR-AA measurements in 21 fasted patients with cirrhosis who were not infected revealed a pattern of AA plasma concentration and exchange similar to that previously observed in patients with sepsis with normal liver function. Whereas the concentration of AA in both groups was slightly lower than normal, the CPCR-AA of each was more than four times that of normal postabsorptive people (p less than 0.01). However, preoperative values of CPCR-AA in patients with cirrhosis who survived was 220 +/- 26 ml/M2/min while that in those who died was 97 +/- 16 ml/M2/min (p less than 0.001). Postoperative measurements remained relatively unchanged: survivors 212 +/- 24 ml/M2/min and those who died 89 ml/M2/min (p less than 0.0005). Measurements in vitro of the hepatic protein synthetic rate in liver biopsy specimens taken at operation correlated well with CPCR-AA values obtained immediately before operation in 10 patients (r = 0.73; p less than 0.01). Thus in patients with cirrhosis visceral amino acid uptake and hepatic protein synthesis are maximally stimulated. Nevertheless, if the preoperative CPCR-AA does not approach the value of 284 +/- 76 ml/M2/min previously observed in patients with sepsis who recover, the patient with cirrhosis is prone postoperatively to die of overwhelming infection and multisystem failure. PMID- 6484810 TI - Esophageal motility: effects of injection sclerotherapy. AB - The purpose of this project was to evaluate the acute and chronic effects of sclerotherapy on esophageal motility and function. We studied motility in eight patients before and after injection sclerotherapy of esophageal varices. We injected the varices with 5% sodium morrhuate twice during the first week and then at 1, 2, 3, and 6 months. Lower esophageal sphincter pressure, contraction wave amplitude, and duration were not altered by sclerotherapy. However, the length of the high-pressure zone increased significantly from 3.6 +/- 0.3 cm to 4.2 +/- 0.2 cm during the first 3 days after initial treatment, and sclerotherapy caused considerable distortion of peristaltic wave form. Also, esophageal peristaltic velocity decreased in three patients who complained of dysphagia and subsequently developed esophageal stricture. The strictures have responded well to dilatation, and in two patients velocity has even returned toward the baseline value. Reflux esophagitis has not been a problem. Esophageal motility is altered by sclerotherapy of esophageal varices. Stricture formation seems to be reversible after sclerotherapy is stopped or discontinued. PMID- 6484811 TI - Parathyroid response to hypocalcemia after treatment of hemorrhagic shock. AB - Hypocalcemia often follows resuscitation from hemorrhagic shock. The role of calcium supplementation is controversial, whereas, little data are available regarding the parathyroid (PTH) response. Therefore this response was studied in 41 injured patients who required 15 blood transfusions and 11.7 L balanced electrolyte solution during emergency room and operating room therapy. Postoperative reduced total calcium (7.5 +/- 0.8 mg/dl SD) and ionized calcium 1.85 +/- 0.2 mEq/SD) paralleled a rise in PTH (69.7 +/- 37 microliters Eq/ml SD) and the severity of insult as reflected by shock time and hypoalbuminemia. Renal function was normal. Increased PTH is probably homeostatic and belies the theoretical merits of calcium channel blocker administration after hemorrhagic shock. Calcium supplements may be of benefit during resuscitation when bone flow is low and calcium release from bone in response to PTH is reduced. PMID- 6484812 TI - Primary hyperparathyroidism, pregnancy, and neonatal hypocalcemia. AB - Primary hyperparathyroidism in the mother during pregnancy is known to result in a high rate of fetal complications; spontaneous abortions, still births, and neonatal tetany occur in excessive incidence. To understand the pathophysiology of neonatal hypocalcemia that accompanies this disorder, transplacental calcium dynamics were studied in female sheep during the last trimester of pregnancy and in their fetal lambs after hysterotomy. Calcium ion was shown to move rapidly across the placenta. However, this organ blocked the passage of both parathyroid hormone and calcitonin from the maternal and to the fetal circulations. Our studies support the hypothesis that in primary hyperparathyroidism maternal hypercalcemia results in fetal hypercalcemia, which leads to suppression of fetal parathyroid gland function. In such a situation, neonatal hypocalcemia would occur after birth when maternal calcium flow is interrupted. Parathyroidectomy performed in the mother, especially during the second trimester of pregnancy when operation is safest, would break this cycle and permit normal serum calcium homeostasis in the fetus. PMID- 6484813 TI - In situ vein bypasses to distal tibial and limited outflow tracts for limb salvage. AB - To better define the limits of tibial reconstruction with saphenous vein bypass, we have analyzed our experience with the in situ vein valve incision technique in 83 cases of bypasses to the ankle or foot and 13 cases of bypasses to discontinuous tibial vessels. Bypasses to the ankle and foot had a 36-month cumulative patency rate of 70.4%. No statistical difference was noted with the use of small-caliber veins. The length of the bypass did not prejudice the long term patency rate. Discontinuous tibial vessels can be used satisfactorily as an outflow tract for limb salvage. PMID- 6484814 TI - Factors influencing the risk of early and late serious infection in adults after splenectomy for trauma. AB - We reviewed the clinical course of 245 adults who underwent splenectomy for trauma to assess the risk of both early and late serious infection. Twenty-one patients (9%) had an early serious infection (sepsis) during hospitalization for splenectomy. The mortality rate was 62% in patients with early sepsis, and encapsulated bacteria were isolated from the blood of 43% of patients with sepsis. Only one of 58 patients with isolated splenic injury had sepsis (2%), and the risk of early sepsis increased when three or more concomitant injuries were present (p less than 0.05). Stepwise multiple regression analysis revealed that patients with injuries to the pancreas, colon, or central nervous system or with extremity fractures had an increased risk of sepsis (p less than 0.05). The risk of sepsis was not influenced by age, the type of injury, delay in operation, use of drains, or other individual injuries. Sufficient information was available to assess the risk of late serious infection for 140 surviving patients (63%). Follow-up ranged from 2 to 277 months. Three late infections occurred at 2, 8, and 15 years after splenectomy; two were due to Streptococcus pneumoniae. None of these patients died. There were no identifiable factors influencing the risk of late infection. These results suggest that the risk of early serious infection in adults after splenectomy for trauma is low when isolated splenic injury is present but that this risk is increased by both the degree of injury and the presence of certain associated injuries. Encapsulated bacteria are frequent pathogens in both early and late infections. The mortality rate related to an early septic episode is high, but the risk of late serious infection is low and is not related to identifiable factors that decrease host defenses. PMID- 6484815 TI - Value of colonoscopy after ureterosigmoidostomy. AB - Ureterosigmoidostomy (US) is an acceptable procedure for urinary diversion. Despite problems with ascending pyelonephritis, anal incontinence, and recently a reported 100- to 500-fold increase in the incidence of colonic carcinoma, the popularity of US is predicted to increase. The records of 110 patients who have undergone US at our institution have been reviewed. Invasive colon cancer developed at the site of ureter implantation in three of these patients. All patients had rectal bleeding and obstipation as initial symptoms. We have located 17 of our US patients and all consented to colonoscopy and urologic follow-up. At colonoscopy 41% of these patients had one to three polyps (0.5 to 6 cm) involving or near the site of the US. No polyps were seen proximal to the US sites. Polyps were histologically defined as tubovillous adenomas or mixed tubovillous transitional cell adenomas. A single patient with three 4 to 6 cm polyps had superficial adenocarcinoma found in two of the polyps. Recurrent polyps or dysplasia has not been found on follow-up examination. Despite the disadvantages of US, the likely increased popularity of this procedure mandates that all patients be followed regularly for polyps and cancer. Our data support the following recommendations: (1) surveillance colonoscopy should be started soon after US, and (2) conversion to an alternative diversion should be made if recurrent polyps, cancer, or dysplasia is found. Yearly colonoscopy and screening for occult blood must be part of the comprehensive follow-up on all patients after US. PMID- 6484816 TI - The solitary pulmonary nodule in the patient with breast cancer. AB - A solitary pulmonary nodule appearing in a patient with breast cancer, either past or present, is most likely to be a second primary cancer originating in the lung rather than a metastasis from the breast cancer. Between 1970 and 1983 there were at this institution 1416 patients with breast cancer and 579 patients with bronchogenic cancer, 198 of whom were women. Among the patients with breast cancer, 42 (or 3% of all of the patients with breast cancer) had a solitary pulmonary nodule either at the time of presentation of their breast cancer or during the follow-up period. Fifty-two percent of the solitary pulmonary nodules proved to be a primary lung tumor, 5% proved to be benign lesions, and only 43% proved to be metastatic breast cancer. Patients with breast cancer with solitary pulmonary nodules should have a diagnostic workup appropriate for lung cancer. Since adenocarcinoma has become the most common lung cancer cell type, the usual diagnostic tests may not allow a firm differentiation between primary lung and secondary breast cancer. Therefore if malignancy is proved or suspected, thoracotomy with appropriate resection is the treatment of choice in most patients with breast cancer, even at the initial appearance of the breast cancer. PMID- 6484817 TI - Accuracy of aspiration cytology in detecting breast cancer. AB - To evaluate the role of needle placement in determining accuracy and to establish criteria for clinical decision making, we used aspiration cytology to diagnose 49 palpable breast masses in patients undergoing excisional biopsy. Closed cytology, obtained by percutaneous aspiration, and open cytology, obtained by aspiration of the excised mass, were compared with histology. Nineteen (39%) of the breast masses were carcinoma. Unsatisfactory cytologic findings were frequent after both closed (37%) and open (24%) aspiration. Most of these aspirates were from mammary dysplasia, suggesting that acellularity rather than needle placement was responsible. Closed aspiration was falsely negative in one patient and falsely suggestive of cancer in five. If atypical, suspicious or malignant cytologic findings were considered to be carcinoma; closed cytology had high sensitivity (94%), low specificity (64%), and a false positive fraction of 36%. The positive predictive value was 76% and the negative predictive value 90%. Accuracy was 81%. If only suspicious or malignant results were considered positive, specificity and positive predictive value increased at the expense of sensitivity and negative predictive value but accuracy did not change. Even with optimal needle placement (open aspiration), accuracy of aspiration cytology was less than 90%. PMID- 6484818 TI - Rational management of malignant colon polyps based on long-term follow-up. AB - We reviewed the long-term results of management of 38 patients with carcinoma in colorectal polyps. Of these, 16 patients demonstrated malignant invasion of the lamina propria but not the muscularis mucosa (group I), and 22 patients showed malignant invasion of the muscularis mucosa (group II). Primary therapy for group I patients consisted of polypectomy in 12, local excision in one, and colonic resection in three. One patient had a subsequent abdominal-perineal resection and was found to have no residual disease and no lymph node involvement. Follow-up of the group I patients showed that 11 were alive and well (mean 5.8 years) and five died of unrelated causes (mean 5.2 years). Of group II patients, 12 underwent polypectomy, six local excision, and four colectomy. Of these 22 patients, 11 underwent further operation, including nine major bowel resections and two local re-excisions. None of these 11 patients had either residual tumor or lymph node metastases. One patient died of complications after abdominal-perineal resection. Follow-up showed that 18/22 group II patients were alive and well 5 to 15 years later (mean 7.5 years); four died of unrelated causes (mean 3.2 years). We then reviewed another group of 220 patients who had undergone resection for invasive colon cancer to relate the presence or absence of lymph node metastases to the depth of malignant invasion in the bowel wall. We found that 44% of this entire group had lymph node involvement. Of 36 patients with tumor confined to the bowel wall, nodal metastases occurred in only 22%. Of eight patients with malignancy superficial to the muscularis propria, only one had nodal involvement. We conclude that colon cancer tends to progress in an orderly fashion and the risk of nodal metastases increases with the depth of invasion. Carcinoma in a polyp represents a very early stage of colon cancer. We therefore recommend polypectomy as primary treatment for pedunculated polyps containing carcinoma either superficial to or invading muscularis mucosa. If histologic review demonstrates incomplete excision, lymphatic invasion, or poor differentiation, patients with lesions invading the muscularis mucosa should undergo formal colonic resection. PMID- 6484819 TI - [Informative value of electroencephalography in the evaluation of the work capacity of patients with chronic kidney diseases]. PMID- 6484820 TI - [Natural cytotoxicity in Sjogren's syndrome]. PMID- 6484821 TI - [Rate of progression of intracapillary chronic glomerulonephritis depending on the clinico-morphological type of the disease]. PMID- 6484822 TI - [Amyloidosis in sarcoidosis]. PMID- 6484823 TI - [Toxicokinetics of ethylene glycol during treatment of acute ethylene glycol poisoning]. PMID- 6484824 TI - [A case of the development of hypoplastic anemia in epidemic viral hepatitis]. PMID- 6484825 TI - [Chronic vitamin D poisoning]. PMID- 6484826 TI - [Nephritis masking systemic diseases]. PMID- 6484828 TI - [Predisposition to the development of nephropathies, their clinical course and HLA phenotype]. PMID- 6484827 TI - [Clinical aspects of various morphological forms of glomerulonephritis]. PMID- 6484829 TI - [Main aspects of studying lipid metabolism in clinical nephrology]. PMID- 6484830 TI - [Achievements and problems in nephrology]. PMID- 6484831 TI - [Leukocyte migration inhibition in nephropathies]. PMID- 6484832 TI - [Microcirculation and arteriosclerosis in chronic diffuse glomerulonephritis]. PMID- 6484833 TI - [Urea binding by serum proteins under normal conditions, in chronic renal failure and in the nephrotic syndrome]. PMID- 6484834 TI - [Disorders of blood coagulation and fibrinolysis in patients with chronic renal failure during treatment with hemodialysis, and methods of correction]. PMID- 6484835 TI - [Proliferative activity of bone marrow erythroid cells in chronic renal failure]. PMID- 6484836 TI - [Functional and morpho-histochemical characteristics of uremic gastropathy]. PMID- 6484837 TI - [Peroral sorbents in the treatment of chronic renal failure]. PMID- 6484838 TI - [Treatment of hyperphosphatemia in chronic renal failure]. PMID- 6484839 TI - [External respiratory function in patients with chronic renal failure treated with hemodialysis]. PMID- 6484840 TI - [Effect of hemodialysis and hemosorption on blood serum level of medium-molecular components in patients with chronic renal failure]. PMID- 6484841 TI - [Diagnostic difficulties in cancer of the renal parenchyma as seen by the internist]. PMID- 6484842 TI - [Changes in endocrine function of the kidneys in patients with stable hypertension after infusion of prostaglandins E]. PMID- 6484843 TI - [Phagocytic reactions in systemic lupus erythematosus]. PMID- 6484845 TI - Abstracts of papers presented at the twenty-fourth annual meeting of the Japanese Teratology Society. Tokyo, Japan, July 6-7, 1984. PMID- 6484844 TI - The neuroteratogenicity of procarbazine in the rat: behavioral, morphological, and neurochemical aspects. AB - Pregnant female Sprague-Dawley rats were treated from day 12 through day 15 of gestation with procarbazine, an antineoplastic drug, and their offspring were subjected to tests of locomotor development and behavior. Treatment levels ranged from 0.5 mg/kg/day, a dose that produced no abnormalities, to 10 mg/kg/day, a dose that caused a marked micrencephaly in the absence of other teratological changes. Despite marked morphological brain changes, preweaning locomotor development, as assessed by open-field swimming activity and vertical grid climbing, was normal in all offspring. Post-weaning passive avoidance learning and retention were also normal. Groups that had been treated prenatally with teratogenic doses (5.0 and 10.0 mg/kg/day) displayed less rearing behavior in the open field, while ambulation in the periphery of the open field arena was unaffected. Groups treated with subteratogenic doses (0.5 and 1.0 mg/kg/day) did not differ from control. In addition to the behavioral studies, sodium-dependent high-affinity choline uptake and choline acetyltransferase activity (CAT) were measured (per mg protein) in the cortex and hippocampus of animals that had been exposed prenatally to either teratogenic or subteratogenic doses of procarbazine. In spite of a substantial reduction in size of both brain structures in the group receiving a teratogenic dose, choline uptake and CAT did not differ from control. PMID- 6484846 TI - Enhanced visualization of soft tissues in the study of aborted fetuses through the use of xeroradiography. AB - As part of the diagnostic workup following an episode of fetal loss, it is generally recommended that fetal tissue be submitted for chromosome analysis and that the fetus be photographed and radiographed. Our recent clinical experience has suggested that, in those fetuses where size is compatible, xeroradiography may be superior to standard radiography. Xeroradiography utilizes principles similar to those in film radiology, with low-energy photon beams and relatively long exposure times. The physical characteristics of the beam and imaging system provide optimal soft tissue visualization. We have found this technique to be of use in studying a broad variety of abortuses with abnormalities. Examples of fetal abnormalities in which we have used this technique include acardia, neural tube defects, nuchal cystic hygroma, and arthrogryposis. In fetuses weighing 500 1,000 gm, the exposure settings are 25 MA, 1 second, 40 KVP. For larger fetuses the KVP should be increased by 1 or 2. This technique has not been useful for a complete body view of large fetuses due to the size limitations of the xeroradiographic cassette itself. PMID- 6484847 TI - Cardiac muscle development in mice exposed to ethanol in utero. AB - The purpose of the present research was to determine the effect of in utero ethanol exposure on cardiac muscle development. Pregnant albino mice (Swiss strain) at 8 days of gestation were divided into three groups: a normal group fed Purina lab chow for rodents and water ad libitum; an ethanol group fed the liquid diet ENSURE with 20% of the calories derived from ethanol (12.6 +/- 1.2 gm/kg body weight per day); and an isocaloric group pairfed ENSURE with 20% of the calories derived from sucrose. These diets were continued until birth, at which time the litter size, crown to rump length, and weight were recorded. Randomly selected neonatal pups from each litter were decapitated and their hearts immediately processed for transmission electron microscopy. Litter size, crown to rump length, and body weight of the ethanol-treated mice at birth were significantly less than normal but not less than pairfed controls. Ultrastructural evaluation of cardiac muscle from mice treated in utero with ethanol in comparison to that from both normal and pair-fed control animals revealed various degrees of morphological alterations. The most pronounced alterations were in mitochondrial structure and included an increase in mitochondrial volume per cytoplasmic volume and a marked decrease in the amount of inner mitochondrial membrane. Myofibrillar abnormalities were also evident in the ethanol group but not in either control group. These abnormalities included a decrease in the myofibril volume per cytoplasmic volume and a disruption in myofibril organization particularly the Z-bands. The ultrastructural alterations in the cardiac muscle from the ethanol treated group were not a result of malnutrition or dehydration as the pairfed group did not exhibit these changes. It is apparent from this study that exposure of mice in utero to ethanol can cause ultrastructural abnormalities in cardiac muscle cells. Whether these changes result in heart pathophysiology and persist to adulthood are not known. PMID- 6484848 TI - Prenatal repair of experimentally induced clefts in the secondary palate of the rat. AB - A refined technique of amniotic sac puncturing at day 16.2 (i.e., 16 + 2/10 days) of gestation was employed in order to produce a series of total clefts and rare forms of partial clefts in Sprague-Dawley rat fetuses. From a total of 410 fetuses of a precise, individually determined age, 95 upper jaws were examined in the scanning electron microscope and, in part, in serial Epon sections. All fetal heads were examined macroscopically. Total clefts were found in 48.9% of a total of 184 viable rat fetuses examined at day 17.8 of smear age and in 21.8% of a total of 211 fetuses examined at day 19.3. Partial clefts were observed in 14.1% and 18.5% of fetuses at days 17.8 and 19.3 of smear age, respectively. At day 19.3, 16.1% of the viable fetuses showed a very inconspicuous, small abnormality (with residual clefting and incomplete fusion with the nasal septum) in the region of the palatine foraminae. Morphological observations suggested that under conditions of detained palatal closure (1) fusion of the soft palatal shelves commences independently from and prior to fusion of the hard palate, (2) delayed palatal shelf fusion proceeding in the anterior direction may occur with or without remaining sickle-shaped clefts in the anterior hard palate, and (3) in fetuses with small sickle-shaped clefts, fusion of the palatal shelves with the nasal septum does not occur. The present data imply that an almost total prenatal repair and delayed closure of the secondary palate may occur in rats that, at day 16.2 of multiple analysis age, most certainly had a total palatal cleft resulting from tongue resistance. PMID- 6484849 TI - Teratology of intravaginally administered contraceptive jelly containing octoxynol-9 in rats. AB - Octoxynol-9, a nonionic surfactant used as a spermicidal agent in ORTHO-GYNOL (registered trademark) Contraceptive Jelly (Ortho Pharmaceutical Corporation, Raritan, NJ), was administered intravaginally to pregnant Sprague Dawley COBS CD rats at dosages of 0.5 mg/kg/day and 5 mg/kg/day (two-thirds and six times the clinical dosage) on days 6-15 of gestation in order to assess its teratogenic potential. Untreated, sham, and vehicle control groups were also incorporated into the study protocol. No meaningful differences were observed between the treated and control groups in maternal toxicity, maternal reproductive parameters, fetal toxicity, and the incidence of external, visceral, and skeletal malformations or developmental variations. It is concluded that octoxynol-9 is not embryotoxic or teratogenic when administered intravaginally to rats during organogenesis. PMID- 6484850 TI - Decreased placental monooxygenase activities associated with birth defects. AB - We have measured monooxygenase activities in placentas from 82 women who smoked throughout their pregnancies and correlated these with the presence or absence of major somatic anomalies. Monooxygenase activities toward benzo(a)pyrene and ethoxyresorufin in placentas from 18 abnormal infants were compared with activities in placentas from 64 concurrently studied normal infants. Placentas from normal infants were found to have high levels of monooxygenase activities and low apparent Kms toward ethoxyresorufin (10(-7) M), reflecting induction of cytochrome P-450 enzymes usually associated with maternal cigarette smoking. Placentas from the abnormal infants, however, had significantly lower monooxygenase activities and higher apparent Kms toward ethoxyresorufin (10(-5) M), indicating that induction of specific cytochrome P-450 systems occurred less frequently among placentas from abnormal infants. The reasons for this association are unclear. Apparent lack of induction of monooxygenase activity occurred most frequently in placentas from anencephalic infants but was neither exclusively nor consistently found with this defect. No specific maternal condition or environmental exposure associated with lack of monooxygenase induction was identified. PMID- 6484851 TI - Zinc amelioration of cadmium-induced teratogenesis in vitro. AB - Mouse embryos were exposed to cadmium (5.35 micrograms/ml) for either 0.5h or 1h and then transferred to fresh serum for the duration of the experiment. Embryos exposed for 0.5h developed numerous malformations that were primarily localized to the craniofacial region. Embryos exposed for 1h to the same level of cadmium all failed to thrive. In a separate series of experiments zinc (10 micrograms/ml) was added 15 minutes prior to the addition of cadmium. Embryos treated with cadmium for 30 min. after the addition of zinc, resulted in 15 of 16 embryos developing normally. The second group of embryos treated for 1h after preincubation with zinc resulted in 93% of the embryos surviving after 48h, albeit malformed. These results suggest that: 1) Exposure time to a teratogen is a critical parameter to consider when designing in vitro experiments 2) zinc is effective in protecting embryos against cadmium induced teratogenesis and 3) the whole embryo culture system is effective in demonstrating biological interactions between agents. PMID- 6484852 TI - The spontaneous occurrence of aortic arch and cardiac malformations in the white Leghorn chick embryo (Gallus domesticus). AB - Spontaneous aortic arch and cardiac malformations occur in White Leghorn chick embryos at a relatively high rate. Although this breed of Gallus domesticus is widely used for biomedical and biological research, no previous study has recorded the incidence of these defects. We found aortic arch malformations in 7.1% (14 of 196) and ventricular septal defects in 11.7% (23 of 196) of living embryos. Defects occurred alone or as a combined pattern. Our findings suggest that the cardiovascular defects in the chick embryo documented in past studies may, in some cases, have been part of normal spontaneous occurrence, rather than the major result of experimental manipulation. PMID- 6484853 TI - Teratogenicity in swine of the tobacco alkaloid anabasine isolated from Nicotiana glauca. AB - Nicotiana glauca, wild tree tobacco, induces arthrogrypotic congenital defects in piglets similar to those induced by Nicotiana tabacum, common tobacco. The present work was conducted to isolate the principal alkaloid of N. glauca, anabasine, in large quantity and good purity and to test the teratogenicity of the compound in pigs. The isolated compound was established to be anabasine and to be of suitable purity by chemical characterization. It proved to be teratogenic. Typical arthrogrypotic defects were induced in 21 of 26 offspring (three of three litters) when dams ingested 2.6 mg of the compound per kg body weight twice daily during the 43rd-53rd days of gestation. Of three dams dosed with 1.66 g/kg/day of the dried plant material during the 43rd-53rd days, one delivered deformed offspring representing one-third of all offspring in that group. These arthrogrypotic defects induced by anabasine were indistinguishable clinically from defects induced by either N. glauca or N. tabacum. In addition, anabasine at a dose of 2.6 mg/kg twice daily or N. glauca plant material at 1.66 gm/kg daily induced cleft palate in over three-fourths of offspring (100% of litters) when dams ingested either during the 30th-37th days of gestation or during longer periods that included those days. PMID- 6484854 TI - Glucocorticoid teratogenesis in mouse whole embryo culture. AB - Glucocorticoids, such as triamcinolone acetonide (TAC-A) and triamcinolone hexacetonide (TAC-HA), are potent inducers of cleft palate in vivo in various mouse strains when administered on day 11 of gestation, whereas they are poor or ineffective inducers of cleft lip when given on day 7. The purpose of the present study was to determine whether glucocorticoids are capable of interfering with early embryonic development in culture. CD-1 mouse embryos were cultured for 48 hours starting either on day 8 (plug day 0) with the embryo inside the yolk sac, or on day 10 with the embryo exteriorized from its functional yolk sac. At the end of the culture period, embryos were examined grossly for malformations and biochemically for altered DNA and protein levels. With the day 8 cultures, TAC-A produced a dose-dependent inhibition of growth along with malformations consisting of cardiac irregularities, abnormal rotation, and irregular neural tube closure. With the day 10 cultures, these malformations were not observed, presumably due to the advanced stage of development when the embryos were exposed to TAC-A; however, TAC-A did produce growth inhibition along with cleft lip. When TAC-HA was administered in vivo to pregnant donor females on day 7, in combination with TAC-A added on day 10 to the culture medium, there was a dramatic increase in the frequency of cleft lip along with other alterations in craniofacial appearance. Our results demonstrate that glucocorticoids are capable of directly affecting embryonic growth and development during the early stages of organogenesis. PMID- 6484855 TI - The influence of deoxycytidine monophosphate (dCMP) on the cytotoxicity of hydroxyurea in the embryonic spinal cord of the mouse. AB - On day 10 of pregnancy NMRI mice received an intraperitoneal injection of either 500 mg/kg hydroxyurea (HU) or 500 mg/kg HU plus 500, 700, 800, or 900 mg/kg deoxycytidine monophosphate (dCMP). Three hours after application of the substances, the animals received 5 microCi/g 3H-thymidine i.p. One hour later the animals were sacrificed and the embryos were removed. Autoradiographs of the embryos served to determine the percentage of necroses, labelled necroses, mitoses, labelled mitoses, and labelled neuroepithelial cells of the spinal cord. Optimal inhibition of HU effects was achieved by application of 700 mg/kg dCMP. The cytotoxic effects of HU on neuroepithelial cells could be partially but not completely inhibited by simultaneous application of dCMP. The duration of HU induced DNA synthesis inhibition was shortened after simultaneous dCMP application. A strong increase of the labelling index and shortening of the G2 phase duration of neuroepithelial cells after simultaneous application of HU and dCMP was striking as compared to the results obtained from untreated or HU treated animals. PMID- 6484857 TI - Novel accessory skull bone in fetal rats after exposure to aspirin. AB - Aspirin was administered by oral gavage to 25 gravid Sprague-Dawley rats on gestation day 10, as a single dose of 500 mg/kg, in a concentration of 50 mg/ml. The aspirin was suspended in a mixture of 0.5% w/v hydroxypropylmethylcellulose (Methocel E-4M) and 0.1% w/v polysorbate 80 (Tween 80). A control group of 25 gravid rats was given 10 ml/kg/day of the suspending vehicle alone, by oral gavage, on gestation days 6 through 15. C-sections were performed on gestation day 20. Approximately two-thirds of the fetuses were processed for skeletal examination with Alizarin Red S; the remaining fetuses were placed in Bouin's solution. Examination of the fetal skeletal specimens from the aspirin-treated group revealed a 20% fetal (43% litter) incidence of an accessory skull bone, located between the nasal and frontal bones. This structure ranged in size from a small, barely discernible, circular ossification site (less than 0.5 mm) to a relatively large, bilobate bone (approximately 2 mm). This anomaly has not been previously reported in fetal rats. PMID- 6484856 TI - Teratogenic effects of avidin-induced biotin deficiency in mice. AB - Teratogenic effects of maternal biotin deficiency were examined at different levels of severity by adding three levels of avidin (10, 20, or 40 mg/kg) in the basal diet. There was a considerable increase of fetuses with multiple congenital malformations (micrognathia, cleft palate, and micromelia) with increasing amounts of avidin. The dose-response relationship was observable in the incidence of each malformation as well. The body weight of live fetuses was also significantly reduced. However, the dams did not exhibit any typical signs of biotin deficiency, such as loss of hair, dermatitis, or nervous irritability. These results suggest that biotin is important for early embryonic development in the mouse. PMID- 6484858 TI - Reproductive and genetic effects of continuous prenatal irradiation in the pig. AB - The stem germ cells of the prenatal pig are highly vulnerable to the cytotoxic effects of ionizing irradiation. This study was conducted to determine whether sensitivity to killing was also marked by a sensitivity to mutation and how prenatal depletion of the germ-cell population affects reproductive performance. Germ-cell populations were reduced by continuously irradiating sows at dose rates of either 0.25 or 1.0 rad/day for the first 108 days of gestation. The prenatally irradiated boars were tested for sperm-producing ability, sperm abnormalities, dominant lethality, reciprocal translocations, and fertility. Prenatally irradiated females were allowed to bear and nurture one litter, then tested for dominant lethality in a second litter; germ cell survival and follicular development were assessed in their serially sectioned ovaries. Sperm production was not significantly affected in the 0.25-rad boars, but boars irradiated with 1.0 rad per day produced sperm at only 17% of the control level. Incidence of defective sperm was 4.9% and 11.1% in the 0.25 and 1.0 groups, respectively. Four of the 1.0-rad boars were infertile, but prenatal irradiation apparently caused neither dominant lethality nor reciprocal translocations in fertile males. Number of oocytes was reduced to 66 +/- 7% of control in the 0.25-rad gilts, but reproductive performance was unaffected and no dominant lethality was observed. Only 7 +/- 1% of the oocytes survived in the 1.0-rad group. Reproductive performance was normal for the first litter, but four of the 23 sows tested were infertile at the second litter and a significant incidence of dominant lethality was observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6484859 TI - Increasing importance of adjuvant surgery in inoperable lung cancer. PMID- 6484860 TI - Surgical management of Raynaud's phenomenon. PMID- 6484861 TI - Anemia in hypersplenism. PMID- 6484862 TI - Endemic (murine) typhus in Corpus Christi. PMID- 6484864 TI - PPO opportunities and pitfalls. PMID- 6484863 TI - The ultimate tax shelter: pension plans. PMID- 6484865 TI - Adjuvant therapy of breast cancer. PMID- 6484867 TI - Public/private cooperation in rural maternal child health efforts: the Lea County perinatal program. PMID- 6484866 TI - Hyperlipidemia in uremic children: response to peritoneal dialysis and hemodialysis. PMID- 6484868 TI - Attention deficit disorder with hyperactivity: normative data for Conners behavior rating scale. PMID- 6484869 TI - Transient neonatal hypothyroidism associated with maternal thyroiditis and hypothyroidism. PMID- 6484870 TI - Discovery of peer review proceedings. PMID- 6484871 TI - The population biology of bacterial viruses: why be temperate. AB - A model of the interactions between populations of temperate and virulent bacteriophage with sensitive, lysogenic, and resistant bacteria is presented. In the analysis of the properties of this model, particular consideration is given to the conditions under which temperate bacteriophage can become established and will be maintained in bacterial populations. The effects of the presence of resistant bacteria and virulent phage on these "existence" conditions for temperate viruses are considered. It is demonstrated that under broad conditions temperate phage will be maintained in bacterial populations and will coexist with virulent phage. Extrapolating from this formal consideration of the population biology of temperate bacteriophage, a number of hypotheses for the conditions under which temperate, rather than virulent, modes of phage reproduction are to be anticipated and the nature of the selective pressures leading to the evolution and persistence of this "benign" type of bacterial virus are reviewed and critically evaluated. Two hypotheses for the "advantages of temperance" are championed: (1) As a consequence of the allelopathic effects of diffusing phage, in physically structured habitats, lysogenic colonies are able to sequester resources and, in that way, have an advantage when competing with sensitive nonlysogens. (2) Lysogeny is an adaptation for phage to maintain their populations in "hard times," when the host bacterial density oscillates below that necessary for phage to be maintained by lytic infection alone. PMID- 6484872 TI - [Clinical aspects, diagnosis and therapy of adnexitis]. PMID- 6484873 TI - [Ascending genital infections in the female]. PMID- 6484874 TI - [Diagnosis and differential diagnosis of adnexitis]. PMID- 6484875 TI - [Psychosomatic aspects of inflammatory diseases of the pelvis]. PMID- 6484876 TI - [Contraception with the intrauterine pessary: risk of pelvic inflammatory disease]. PMID- 6484877 TI - [Human pharmacokinetic study of a sustained-release preparation of hydroquinidine: single and chronic administration]. PMID- 6484878 TI - [Pharmacokinetic and metabolic study of itanoxone in man]. PMID- 6484879 TI - [Effect of age and sex on the pharmacokinetics of paracetamol]. PMID- 6484880 TI - [Plasma assay of phenobarbital, pentobarbital and penthiobarbital by high performance liquid chromatography]. PMID- 6484881 TI - [Methods for studying the adverse effects of drugs. II. Profile and comparison of 5 methods for establishing causality]. PMID- 6484882 TI - [Complications caused by the sudden stopping of antihypertensive drugs (except beta-blockers)]. PMID- 6484883 TI - [Complications of the withdrawal of synthetic glucocorticoids]. PMID- 6484884 TI - [Problems related to the stopping of antidepressive agents and lithium]. PMID- 6484885 TI - [Withdrawal of drug addicts from opiates in general hospitals. Value of clonidine -30 cases]. PMID- 6484886 TI - [Absence of effect of josamycin on the pharmacokinetics of antipyrine]. PMID- 6484887 TI - [Drug-induced Lyell's syndrome]. PMID- 6484888 TI - [Is establishment of causality in drug surveillance reliable?]. PMID- 6484889 TI - [Chloroquine transfer to milk. A case]. PMID- 6484890 TI - Follow-up of patients with acute myocardial infarction treated with intravenous streptokinase. AB - The sequel of survivors after hospitalisation for an acute myocardial infarction was studied during the following 15 years in 48 patients treated with streptokinase and in 41 controls. No significant difference was seen in the morbidity or mortality during the first 6 months nor in the mortality thereafter. PMID- 6484891 TI - Vasoactive agonists prevent erythrocyte extravasation in thrombocytopenic hamsters. AB - The mediating action of selected vasoactive amines and their respective antagonists on vascular fragility, visible as cutaneous petechiae, was assayed with thrombocytopenic (TCP) hamsters. Serotonin (5-HT), norepinephrine (NE), epinephrine, dopamine and isoproterenol administered IP reduced petechiae significantly within 10 min; phenylephrine had no effect. Of the natural amines, 5-HT and NE were most effective in reducing petechial sensitivity to values obtained with untreated, normal animals; hence these two amines only were tested pharmacologically. Pretreatment of TCP animals with Ketanserin or propranolol, administered IP or IV, abolished any petechial inhibitory action of 5-HT and NE respectively; pretreatment with phenoxybenzamine reduced significantly the NE inhibition of petechiae, but to a lesser degree than propranolol. In contrast, atenolol, prazosin and yohimbine had no significant effect. Ketanserin abolished the action of NE, but adrenoceptor blockers had no effect on 5-HT-treated TCP hamsters. The results suggest that 5-HT and NE inhibition of petechiae may be receptor-mediated and that there may be receptor interaction. This was supported by the observation that non-additive subthreshold doses of 5-HT and NE, which individually did not prevent petechial formation in TCP hamsters, when combined totally inhibited petechiae. The theorized importance of endogenous 5-HT and NE to maintain postcapillary venule junctional integrity (site of petechial hemorrhaging) was also demonstrated by treating normal hamsters with drugs known to block or antagonize either 5-HT or NE uptake. In every instance petechial sensitivity rapidly occurred, and the loss of microvascular integrity in Ketanserin-treated hamsters mimicked quantitatively the petechial sensitivity observed with TCP animals. PMID- 6484892 TI - Abnormal prothrombin in the vitamin K-deficient rat. AB - Vitamin K is required for the post-translational formation of gamma carboxyglutamyl residues in the vitamin K-dependent plasma clotting factors. Interference with vitamin K action results in the appearance of undercarboxylated, "abnormal," forms of prothrombin in bovine and human plasma, but the extent of this response in the rat has been controversial. Development of amidolytic and immunochemical assays for rat prothrombin have now shown that plasma from vitamin K-deficient or Warfarin-treated rats contains a non-BaSO4 adsorbable (undercarboxylated) pool of prothrombin that is equivalent to between 5 and 10% of the normal plasma prothrombin concentration. PMID- 6484893 TI - Antithrombin III concentrate as adjuvant in DIC treatment. A pilot study in 9 severely ill patients. PMID- 6484894 TI - Synthesis of an affinity chromatography gel for AT III. Effect of purification of AT III-binding sequence of heparin. PMID- 6484895 TI - A functional photometric assay for plasma fibrinogen. AB - We have developed a photometric assay for fibrinogen concentration. The sample is mixed with a snake venom enzyme (Batroxobin) and fibrin formation is recorded turbidimetrically at 334 nm. Reaction conditions are such that a linear increase in absorbance is obtained over a concentration range of fibrinogen from 80-700 mg/dl. Higher or lower ranges can be measured by adjusting the sample volume. Calibration is performed with a single standard. Precision and accuracy are comparable with the usual clinical chemical methods. Experiments with plasma samples digested with streptokinase showed that interference of fibrinolytic split products (FSP) is less than using the Clauss method. Large amounts of FSP in the sample, however, delay the increase in absorbance. This phenomenon can be utilized for the additional estimation of the FSP-content of the sample. Results obtained with the present method corresponded well with those obtained using the method of Clauss. PMID- 6484896 TI - The formation of a thrombin-like material (TLM) following stimulation of leukocytes. AB - When thrombin, tissue thromboplastin or Russell's viper venom was added to a suspension of either lymphocytes or neutrophils containing normal plasma, aggregation of these cells ensued. The aggregate formed one gelatinous mass which was readily separable from the cell free supernatant, an aliquot of which caused platelet aggregation. This leukocyte derived platelet aggregatory substance had characteristics similar to thrombin but not AGEPC. When plasma deficient in Factor V was substituted for normal plasma, the platelet stimulatory substance was not produced. Substitution with plasma deficient in Factor VII, VIII, IX, X or XI was without effect. Thrombin clotting time measurements indicated a generation of activity, relative to thrombin, of about 3.0 U/5 X 10(6) cells. PMID- 6484897 TI - Oral contraceptives and surgery: reduced antithrombin and antifactor Xa levels without postoperative venous thrombosis in low-risk patients. AB - The effect of preoperative treatment with an estrogen containing oral contraceptive on the incidence of postoperative thrombosis (detected with 125I fibrinogen leg scanning) was examined in 221 patients aged 18-49 years who had elective or emergency general intra-abdominal or gynecologic surgery, 99 of whom were taking an oral contraceptive before their operation. Eighty-five percent of the contraceptive treated patients had taken their preparation until 1-7 days before surgery and the rest until within a month of surgery; 81% were taking preparations containing 30 or 50 micrograms estrogen. Postoperative thrombosis developed in 1 of the 122 patients who were not taking a contraceptive and in none of the 99 contraceptive treated patients. As the 95% confidence limits for the 0% thrombosis rate observed in the contraceptive treated patients are 0-3.7%, the added risk of postoperative thrombosis attributable to oral contraceptive treatment before surgery is very small in young women who are otherwise at low risk of thrombosis. Plasma antithrombin level (by immunoassay), antithrombin activity (by chromogenic substrate assay), and antifactor Xa activity (by clotting assay), were measured before surgery in 81 patients, 42 of whom had been taking an oral contraceptive. Contraceptive treatment significantly reduced all 3 assay results. Its most marked effect was on antifactor Xa activity, which was reduced by contraceptive treatment from 103 +/- 24% (range 68 - 172%) to 81 +/- 27% (range 24 - 155%; with less than 80% activity in 54%, and less than 50% activity in 15% of patients). These results suggest that reduced preoperative antifactor Xa activity has a low specificity for thrombosis after moderately extensive surgery in young, otherwise fit, oral contraceptive treated women. This test is therefore unlikely to be a clinically useful predictor for postoperative thrombosis in this group of patients. PMID- 6484898 TI - Two forms of alpha 2-antiplasmin: differences in KAV and isoelectric point. AB - The plasminogen-binding (PB-AP) and the non-plasminogen-binding (NPB-AP) forms of alpha 2-antiplasmin were assayed by a modified rocket electroimmunoassay technique using an intermediary gel containing kringles 1-3 from plasminogen. Gel chromatography of normal human plasma (HNP) showed differences in KAV between PB AP and NPB-AP. PB-AP had a KAV of 0.33 and NPB-AP a KAV of 0.39. Isoelectric focusing of HNP showed pI differences between PB-AP and NPB-AP. PB-AP was heterogeneous, with a main peak at pI = 4.69 and a minor peak at pI = 4.92, while NPB-AP had only one peak, at pI = 4.59. PMID- 6484899 TI - Quantitation of factor XIII by SDS polyacrylamide gel electrophoresis. AB - An electrophoretic method for the determination of f.XIII, based on the capability of f.XIIIa to cross-link fibrin clots (5) was studied, and the great sensitivity of the method confirmed. Thus, with suitable technical conditions, f.XIII activities less than 0.1% of that in normal human plasma could be detected. The results obtained in plasma from various patients and in f.XIII concentrates (cryoprecipitates) corresponded well with those obtained with the dansylcadaverine method (3) and with the urea solubility test, with two exceptions: In a patient with severe congenital f.XIII deficiency, only the present method was sensitive enough to detect any f.XIII-activity (about 0.1%), and in a patient with an inhibitor against f.XIIIa, the dansylcadaverine method failed to detect this. The present method is too laborious for routine screening, but is recommended as an alternative references method. It may prove especially suitable to detect minute amounts of f.XIII. PMID- 6484900 TI - Continuous registration of clot retraction and the influence of predisposition to thrombosis. PMID- 6484901 TI - [Inhouse occupational rehabilitation. Experience of 2 years of inhouse occupational rehabilitation in a municipality]. PMID- 6484902 TI - [Trace elements--what do we know? A review of some recent studies in Norway]. PMID- 6484903 TI - [Food-borne Salmonella oranienburg infection in Akershus and Sor-Trondelag]. PMID- 6484904 TI - [Positive Wassermann in the spinal fluid. Does it always mean neurosyphilis?]. PMID- 6484905 TI - [Occurrence of tinea pedis in military recruits]. PMID- 6484906 TI - [Intraspinal neoplasms]. PMID- 6484907 TI - [Local atrophy following injection of depot corticosteroid]. PMID- 6484908 TI - [Sterilizations in a community hospital]. PMID- 6484909 TI - [What methods are currently used in neuroanatomical research?]. PMID- 6484910 TI - [Laparoscopic tubal sterilization. Endothermy coagulation and cross-clipping]. PMID- 6484911 TI - [Polymer-fume fever. Current diagnosis in general practice]. PMID- 6484912 TI - [Climate therapy of psoriasis patients]. PMID- 6484913 TI - [Meeting of a committee on vitamins]. PMID- 6484914 TI - [Ionizing radiations from nuclear weapons]. PMID- 6484915 TI - [Detection of bladder neck weakness in women with urinary incontinence]. PMID- 6484916 TI - [Prognosis in cancer cases]. PMID- 6484918 TI - [Lumbar spinal stenosis. The use of treadmill in diagnostic work]. PMID- 6484917 TI - [Analytic electron microscopy. A research method used in diagnosis]. PMID- 6484919 TI - [Pain therapy in children. Extended discussion]. PMID- 6484920 TI - [Pain therapy in children with cancer]. PMID- 6484921 TI - [Choice of forms of anesthesia]. PMID- 6484922 TI - [Report of sickness and use of consulting physicians. A study at the Skedsmo social security office]. PMID- 6484923 TI - [Peroneal paralysis and necrosis of the distal foot in piglets: a sequela of a faulty injection technic]. AB - Necrosis of the distal parts of the hind-limbs was observed in well over one hundred piglets on a pig-breeding farm. The lesions were localized solely on the hind-limbs and unilateral in the great majority of cases. The clinical features of unilateral peroneal paralysis were observed in piglets from the sixth day of life. Sensory innervation distal to the hock was frequently absent in the leg involved. Both the mechanical injury on locomotion and the gnawing by pen mates of the piglets involved were regarded as causes of the extensive necrosis of the distal parts of the hind-limbs. The primary cause of the above lesions was found to in a faulty technique used in injection in the gluteus muscles of the piglets. PMID- 6484924 TI - [Newly seeded Italian rye grassland--photosensitization?]. PMID- 6484925 TI - [Ryegrass staggers--Lolium perenne (English ryegrass)]. PMID- 6484926 TI - [Antibiotic prophylaxis in small-animal surgery]. AB - Experimental studies in animals carried out by Burke in 1961 showed that antibiotics will only have a beneficial effect on primary wound infection when they are administered shortly before or after bacterial contamination. To ensure an optimal effect there should be an adequate concentration of a suitable antibiotic in the tissues at the time of contamination, i.e. during surgery. During operation, resistance to infection is considerably reduced, so that infection may be caused by an inoculum present in a rather low concentration which would be too small to have this effect in normal conditions. This reduced resistance to infection only continues until a few hours after operation. Prophylactic use of antibiotics therefore has to be continued until shortly after the final stage of the operation. A large number of clinical trials in human medicine definitely showed that short-term perioperative short-term perioperative prophylactic use of antibiotics causes a marked reduction in the incidence of postoperative septic complications. As long as clinical trials have not been done in small animal clinics, it would appear to be sensible to apply the abundant results obtained in experimental studies in animals and clinical trials in human medicine to small animal surgery. Prophylactic use of antibiotics is indicated when the risk of infection or the severity of possible complications outweigh the disadvantages of the regular use of antibiotics. The risk factors in the development of wound infection and the choice of antibiotics are discussed. PMID- 6484927 TI - [Usefulness of the determination of serum lysozyme levels in dogs with tumors]. AB - In a control group of fifty-three clinically healthy dogs of either sex and ranging in age from four to ten years, the serum lysozyme activity (SLA) showed a mean value of 1.2 mg/l with a range (+/- 2 SD) of 0.6-1.8 mg/l. SLA was measured in a turbidimetric assay using a microcentrifugal analyser. In dogs with a variety of neoplastic diseases, the histopathological diagnosis was compared with the SLA-level. In a large number of cases, the increased SLA-levels corresponded with malignancy in neoplastic disease. Measuring the SLA-level in dogs may be helpful in the diagnosis of malignancies. Proper clinical examination is essential in differentiating between some interfering diseases. PMID- 6484928 TI - [Is drowning really drowning?]. PMID- 6484929 TI - [From the Veterinary Chief Inspection of Public Health and the Direction of Veterinary Services. Resolution on the agricultural quality of medicated fodder]. PMID- 6484930 TI - [The philosophy of the legal responsibility of veterinarians]. PMID- 6484931 TI - [Liability, prostaglandins and Clostridium]. AB - A case of malignant oedema following injection of fenprostalene in cattle is reported. The question is asked whether the vasoconstrictive action of prostaglandins may predispose to the establishment of anaerobes. PMID- 6484932 TI - Familial Mediterranean fever: no linkage with HLA. PMID- 6484933 TI - HLA-A3 and -B7 in porphyria cutanea tarda. PMID- 6484934 TI - An in vitro model for studies of intercellular communication in cultured rat anterior pituitary cells. AB - The formation of intimate associations among different hormone-secreting cells within the rat adenohypophysis may serve as a possible site for physiologic regulation. In this report we describe a high density plating method which enables us to study cell-to-cell interactions within anterior pituitary cell cultures. Trypsin-dispersed pituitary cell suspensions attach rapidly (within 6 hr) and quantitatively (95-97%) to glass or plastic surfaces when plated in medium containing microM calcium concentrations (pH 7.6-7.8). Freshly plated cell suspensions obtained from female pituitary glands contained subpopulations of mammotrophs 49.3%, somatotrophs 30.3%, gonadotrophs 12.6%, corticotrophs 3.4% and thyrotrophs 1.5%. Epithelial cell colonies were formed during a 3-day culture period as the cells flattened and re-established contacts with neighboring cells. Freeze-fracture electron microscopic analysis of these colonies produced morphological evidence for direct intercellular contacts among the hormone secreting cells. Large areas of tight junctions and small gap junctions were identified on the membranes of the epithelial cells within these colonies. Cells which contained tight junctions usually contained microvilli and morphological signs of active hormone secretion. Small junctional plaques containing tightly packed intramembrane particles were also occasionally found on the membranes of cells which were actively secreting pituitary hormones. The high density plating procedure which is described in this report provides greater opportunity for cell cell interaction and thus may prove to be a useful model for evaluating the role of intercellular communication within this tissue. PMID- 6484935 TI - Mechanisms of nutritive endocytosis. III. A freeze-fracture study of phagocytosis by digestive cells of Chlorohydra. AB - Freeze-fracture was used to compare the ultrastructure of plasma with phagosomal membranes of digestive cells of green hydra. Changes in both the pattern and density of intramembrane particles (IMP) were evident during the transition from plasma to phagosomal membrane. Small particle-free regions and associated aggregates of three to eight IMP were observed in presumptive adherent and enveloping plasma membranes, as well as in fully formed phagosomal membranes. Larger particle-free regions were observed as rims around the tips of enveloping membranes which had nearly completed enclosure of particles. The density of IMP in newly formed phagosomal membranes was 1.5-fold greater than that in the parent plasma membrane from which they derived, and was greater also than in older phagosomal membranes. PMID- 6484936 TI - Cholesteric organization of DNA in the stallion sperm head. AB - The fine structure of chromatin in sperm heads was investigated by different microscopic techniques: in vivo examinations in the polarizing microscope, thin sections and freeze-fracture replicas observed by transmission electron microscopy. The freeze-fractured chromatin appears to be formed of superimposed lamellae, each one 330 A thick. These lamellae are parallel to the flattening plane of the sperm head. This situation was already described in other mammal spermatozoa and in particular in the bull and the rabbit. This work presents a new interpretation of this lamellated aspect. The chromatin structure of these spermatozoa is that of a cholesteric liquid crystal. This structure resembles that of a plywood, made of superimposed layers of parallel filaments, but instead of having a right angle between two successive layers, there is a progressive rotation and similar orientation occurs at each 180 degrees rotation. The apparent lamellae result from cleavages due to freeze-fracture between levels of parallel filament orientation. The thickness of lamellae corresponds therefore to the half helicoidal pitch of the cholesteric liquid crystal. This model is consistent with our observations by polarizing microscopy. The lamellation is not visible in thin sections of stallion spermatozoa. There are however biochemical methods to decondense chromatin and we are able to observe this lamellation in sections normal to the flattening plane of sperm heads. The methods used classically to decondense the sperm chromatin lead to extremely varied aspects which are discussed, some of them being closely related to the structure of cholesteric liquid crystals. PMID- 6484937 TI - The role of the heart-body and of the extravasal tissue in disposal of foreign cells in two polychaete annelids. AB - Sheep red cells injected into the coelom of the polychaetes Neoamphitrite figulus and Arenicola marina are phagocytosed by coelomocytes and conveyed to the heart body and extravasal ('chloragogen') tissue respectively. In the former case the phagocytes creep into the vessels, penetrate the heart-body tissue and bequeath the sheep red cells to the heart body cells. In Arenicola the phagocytes accumulate on the tips of the blind ending vessels and the red cells are similarly transferred to the extravasal tissues. These observations confirm that the heart-body and extravasal cells function not only in production of haemoglobin but in sequestering foreign material. PMID- 6484938 TI - Chitin helicoids accompany protein helicoids in the periostracum of a whelk, Buccinum. AB - The periostracum of the marine gastropod Buccinum has a helicoidal arrangement of its principal constituent which is a fibrous protein (Hunt and Oates, 1978). Chitin, chemically and physically identified, is present at a concentration of about 6% of the dry weight and can be seen in dispersates of whole periostracum as long fibrils and ribbons between 3 and 14 nm diameter. Deproteinization with hot alkali removes all protein leaving a chitinous 'ghost' of the periostracum. Dispersates, examined negatively stained, show only chitin fibrils and ribbons while sectioned material demonstrates a tenuous, part orthogonal, part helicoidal, architecture based on the chitin residue. The relative roles of the protein and polysaccharide components is speculated upon and comparisons with arthropod cuticle drawn. PMID- 6484939 TI - The ultrastructure of hemocytopoietic organs in the desert scorpion, Paruroctonus. AB - The light and electron microscopes were used to examine possible hemocytopoietic tissue in the desert scorpion, Paruroctonus mesaensis. Results agree with earlier light microscopic studies that cells are released into the blood from the two lateral lymphoid organs and the supraneural gland. The former are sacciform structures attached by their anterior ends to the diaphragm. The supraneural gland forms the thickened wall of the supraneural artery in the mesosoma from the first to the third abdominal ganglia. The lateral lymphoid glands have an acellular stroma in which are embedded granular and agranular cells. The stroma is apparently formed by specialized cells which release membranous cell fragments that become the matrix of the gland. Cells are released into the body cavity from the periphery of the two organs. The supraneural gland has a fibrous stroma in which are embedded a variety of cell types. The cells appear to be released in greatest abundance into the blood in the lumen of the gland. The gland has cells with opaque granules (0.9-1.4 micron diameter) and agranular cells of variable shape. The most abundant cell, possibly the stem-cell for the others, is about 10 micron diameter and often has processes of variable length. In addition, muscle cells at various stages of differentiation are found at the inner margin of the gland. These cells have thick and thin myofilaments (24-32 and 5-8 nm diameter) and dense bodies which sometimes become organized into sarcomeres with Z-bands before the cells are released into the gland lumen. The function of these muscle cells is unknown, but possibly they contribute to the maintenance of blood pressure and the release of cells into the blood from the inner margin of the gland. PMID- 6484940 TI - Ultrastructure of the accessory glands of gene's organ in the cattle tick, Boophilus. AB - The organization and ultrastructure of the accessory glands of the cattle tick, Boophilus microplus, are described. The glands consist of two groups of acinar cells situated on either side of Gene's organ. A single acinus consists of from eight to 12 cells and each cell is connected via an individual duct to pores on the dorsal surface of the mouthparts. The position of these pores is such that the secretion of the accessory glands is incorporated into the egg wax during oviposition. Each gland cell has striking quantities of smooth endoplasmic reticulum and numerous Golgi dictyosomes and appears to produce a secretion that is lipoidal in nature. Each cell secretes into its own individual lumen and is connected to a cuticular pore by a duct cell. PMID- 6484941 TI - Central nervous system features of a nicotine-resistant insect, the tobacco hornworm Manduca sexta. AB - The purpose of this study is to look for structural correlates of the demonstrated nicotine-insensitivity of larval Manduca sexta CNS, an insensitivity which is only slightly perturbed by desheathing (a technique used to disrupt perineurial diffusion barriers). The general organization of the hornworm ganglion is found to conform to the conventional insect pattern, but the following points are noted and discussed in terms of their potential relationship to nicotine-insensitivity: the damage caused to perineurial cells by desheathing is extremely localized, with cells immediately adjacent to the torn region showing good ultrastructural integrity; ionic lanthanum does not gain access to the subperineurial extracellular space following desheathing; lanthanum penetrates the ganglion in the cytoplasm of tracheal cells damaged peripherally during desheathing, but is excluded from the extracellular space surrounding such tracheal cells; smooth endoplasmic reticulum is much in evidence in perineurial cells and tracheal cells, sites where it might be implicated in nicotine detoxification; individual basal perineurial cells appear to cover extensive regions of the ganglion, thereby limiting intercellular diffusion. PMID- 6484942 TI - Ultrastructure of the pre-implantation shark yolk sac placenta. AB - During ontogeny, the yolk sac of viviparous sharks differentiates into a yolk sac placenta which functions in gas exchange and hematrophic nutrient transport. The pre-implantation yolk sac functions in respiration and yolk absorption. In a 10.0 cm embryo, the yolk sac consists of six layers, viz. (1) somatic ectoderm; (2) somatic mesoderm; (3) extraembryonic coelom; (4) capillaries; (5) endoderm; and (6) yolk syncytium. The epithelial ectoderm is a simple cuboidal epithelium possessing the normal complement of cytoplasmic organelles. The endoplasmic cisternae are dilated and vesicular. The epithelium rests upon a basal lamina below which is a collagenous stroma that contains dense bodies of varying diameter. They have a dense marginal zone, a less dense core, and a dense center. The squamous mesoderm has many pinocytotic caveolae. The capillary endothelium is adjacent to the mesoderm and is delimited by a basal lamina. The endoderm contains yolk degradation vesicles whose contents range from pale to dense. The yolk syncytium contains many morphologically diverse yolk granules in all phases of degradation. Concentric membrane lamellae form around yolk bodies as the main yolk granules begin to be degraded. During degradation, yolk platelets exhibit a vesicular configuration. PMID- 6484943 TI - The ultrastructure of the renal corpuscle of a lizard. AB - The few and small renal corpuscles of the lizard Podarcis (= Lacerta) taurica are composed of a tuft of three to four capillaries (glomerulus), Bowman's capsule and mesangium. The thin interdigitated capillary endothelial cells are, in most regions, in contact with the mesangium. In some regions, however, they rest on a bilaminate basement membrane with an electron-dense lamina densa and a less dense lamina rara. Bowman's capsule is composed of visceral and parietal layers. The epithelial cells (podocytes) of the visceral layer bear trabeculae connected to pedicels with microvilli. The pedicels rest on a bilaminate basement membrane which in some regions has a double-layered densa with connecting bands. Generally, this basement membrane is thicker than that of the capillary endothelial cells. The mesangium is composed mostly of irregular satellite cells with large nuclei and cytoplasmic processes, but also has smaller cells with kidney-shaped nuclei and cytoplasmic processes containing microfilaments. The mesangium cells are embedded in a collagenous matrix which extends to invade the area between the epithelial basement membrane and the capillary endothelium. These observations are discussed in relation to the structure and function of vertebrate renal corpuscles with special reference to the mesangium. PMID- 6484944 TI - A freeze-fracture study of the papillary layer of the rat incisor enamel organ. AB - After tooth enamel has been secreted it undergoes maturation or hardening. This process is mediated by ruffled and smooth-ended ameloblasts and associated papillary layer cells. The cells of the papillary layer are characterized by large numbers of mitochondria, coated vesicles, microvilli, and gap junctions. These features have led numerous investigators to speculate that the papillary layer is an ion-transporting epithelium. We have conducted freeze-fracture studies of the rat papillary layer in order to better characterize the surface features of these cells. The cell membranes of the papillary cells contained large numbers of intramembrane particles of various sizes ranging from 4 to 9 nm in diameter. Gap junctions were present at the cell surface and in the cytoplasm in the form of annular gap junctions. The intramembrane particles or connexons of both types of gap junctions were about 8-9 nm wide and were either packed randomly or present in the so-called 'crystallized' state. At the interface between smooth-ended ameloblasts and papillary layer cells, a well-developed zonula occludens was present along the basal surfaces of the ameloblasts and several large gap junctions were formed between the two cell types. The capillary network associated with the papillary layer was characterized by a thin endothelium containing large numbers of fenestrations. PMID- 6484945 TI - [Experiences with dairy cows, sheep and deer as an alternative to dairy animal raising]. PMID- 6484946 TI - [Pathology of marine mammals]. PMID- 6484947 TI - [Virus disinfection in laboratory and veterinary practice]. PMID- 6484949 TI - [Mycoses in childhood]. PMID- 6484948 TI - [Ameloblastic odontoma in a cow]. PMID- 6484950 TI - [The lymphatic system and lymphography in birds (2)]. PMID- 6484951 TI - [Nematodes as a cause of beak deformity in paradise cranes (Anthropoides pardisea)]. PMID- 6484952 TI - [Limb fractures in trotters. 2. Frequency, distribution and treatment results]. PMID- 6484953 TI - [Trichophyton verrucosum infection in horses]. PMID- 6484954 TI - [Podotrochilitis. Etiology of lameness in cattle: preliminary report]. PMID- 6484955 TI - [Hoof injury in a horse stepping on a nail]. PMID- 6484956 TI - [Classification of glaucoma in the dog]. PMID- 6484957 TI - [Combined injection-inhalation anesthesia for intra-abdominal interventions in the dog in veterinary practice]. PMID- 6484958 TI - [Vibriosis and furunculosis. 2 fish diseases of rainbow trout in intensive aquacultures]. PMID- 6484959 TI - [State and control of Aujeszky's disease in West Germany]. PMID- 6484960 TI - [Teratoma in a heifer]. PMID- 6484961 TI - [Myxosarcoma in a heifer]. PMID- 6484962 TI - [Possibilities for the use of gonadotropic hormones in swine]. PMID- 6484963 TI - [Pigeons with implanted lead bullets. Effect on delta-aminolevulinic acid dehydratase and determination of corrosion]. PMID- 6484964 TI - [Beak trimming in chickens. A procedure for an innervated area]. PMID- 6484965 TI - [X-ray study of the hock of healthy foals. A contribution to late diagnosis]. PMID- 6484966 TI - [Meckel's diverticulum as the cause of intestinal obstruction in the horse]. PMID- 6484967 TI - [Topography of the guttural pouch (diverticulum tubae auditivae) in the horse]. PMID- 6484968 TI - [Initial results of thermographic studies in the diagnosis of lameness in horses using an infrared thermograph]. PMID- 6484969 TI - [Myelopathy in large-breed dogs]. PMID- 6484970 TI - [A mammary adenocarcinoma with skeletal metastasis in a female dog]. PMID- 6484971 TI - [Surgical technic of ventral cervical fusion in the dog and its results]. PMID- 6484972 TI - [Diseases of fresh-water fish as an impairment of fish for human consumption]. PMID- 6484973 TI - [Veterinarian's options and restrictions during and following the administration of drugs to food-producing animals]. PMID- 6484974 TI - On the new secretor status recognized by saliva specific ABH antigens. AB - The present authors have reported that each of ABH antigens of saliva consisted of saliva specific antigen and common antigen between saliva and red cells. Using saliva specific anti-A and B, 77 samples of A,B and AB groups could be determined as strong secretor (Se) or weak secretor (se). Frequency of Se was 62% for A group saliva, 45% for B, and 76% for A antigen and 75% for B antigen of AB group saliva, respectively. The secretor status of twenty-four O salivas could not be determined by saliva specific anti-H. Compared with the ordinary secretor system, some subjects belonging to Se in the ordinary system were typed as se in the new system, whereas all se saliva (three cases) in the ordinary system were typed as se in the new system. PMID- 6484975 TI - Electron microscopic and functional studies on platelets in gray platelet syndrome. AB - The ultrastructure and functions of platelets and megakaryocytes in 8 patients of a family with gray platelet syndrome were investigated. Hemostatic examinations on these patients revealed prolonged bleeding time, decreased platelet retention rates and decreased platelet aggregation rates induced by ADP, collagen, Ristocetin and epinephrine. Marked decreases in ATP and ADP release in response to these agents were also noted. Clinical and coagulation studies on this family suggested that the hereditary nature of the syndrome is autosomal dominant. Platelets and megakaryocytes in the peripheral and bone marrow blood smear from the patients showed peculiar gray color by May-Giemsa stain due to a deficiency of alpha-granules. Electron microscopic examinations revealed slightly enlarged platelets containing a deficient amount of alpha-granules, whereas dense bodies and mitochondria appeared normal. Several morphological abnormalities of patient's platelets, such as aggregates of dense tubular systems, circular arrays of dense tubular systems, an area of cytoplasmic sequestration with an enclosing membrane, clumps of dense material and remnants of Golgi apparatuses were recognized. Megakaryocytes showed normally developed Golgi zones, defective alpha granule synthesis and liberation of abnormal platelets as shown in the peripheral blood smear. PMID- 6484976 TI - Classification and heredity of diabetes among Japanese patients with diabetes found before 30-year-old. AB - Classification and family history of diabetes were examined in 551 Japanese patients whose diabetes were found before the age of thirty. These patients were treated at the Diabetes Center of Tokyo Women's Medical College from 1976 to 1981. Among those 551 diabetics, 198 patients were classified into insulin dependent diabetes mellitus (IDDM) and 337 into non-insulin-dependent diabetes mellitus (NIDDM). IDDM was found mainly in the group of diabetics whose onset of diabetes was before the age of fifteen. The number of NIDDM was significantly increased after the age of twenty. Family history of diabetes was much less in the IDDM group than in the NIDDM group in the first degree relatives. To compare the family history of IDDM with that of NIDDM, 148 diabetics were selected from those 551 patients. The selected diabetics had the onset of the disease before 20 years of age, their present age was between 20 and 40, and the duration of diabetes of these patients was three years or longer. Six of the selected 75 diabetics with IDDM had parents with NIDDM and two of these 75 patients had siblings with IDDM. Thirty-nine of the selected 73 diabetics with NIDDM had positive family history of NIDDM alone. And the selected diabetics with earlier onset of IDDM showed higher risk for IDDM case in their siblings. PMID- 6484977 TI - Possible role of the pineal gland in pituitary prolactin secretion in female rats. AB - Wistar female rats housed under conditions of 12 hr dark/12 hr light were pinealectomized (PX) or underwent sham-operation (SO) 21 days after ovariectomy, on the 7th or on the 15-17 th day of pregnancy. Serum and pituitary prolactin (PRL) levels in ovariectomized (OVX) rats were determined 9 days after pinealectomy. In the case of OVX rats receiving estrogen and progesterone injections (OVX-EP), PRL levels were determined 48 hr after injection administered 7 day after pinealectomy. PRL levels in pregnant rats were determined on the 20th day of pregnancy and in postpartum rats, on the 3rd day following parturition. As compared with the SO control, pinealectomy resulted in a significant decrease in the serum PRL level in the OVX-EP rats but in a significant increase in that level in the OVX, pregnant and postpartum rats. In OVX-EP rats, exogenous estrogen raised the serum PRL level less in PX than in SO rats, probably because the pineal gland is closely related to the facilitation of PRL secretion by estrogen. The high estrogen level in OVX-EP rats seemed to trigger pineal stimulation of PRL release, but low estrogen levels in OVX and postpartum rats or markedly high levels of progesterone in pregnant rats on the 20th day are thought to cause pineal inhibition. PMID- 6484978 TI - The effect of protamine on serum complement activity in aminonucleoside nephropathy. AB - Combined administration of protamine sulfate (Ps) and aminonucleoside (AN) to rats causes severe nephrotic syndrome and, histologically, focal glomerular sclerosis. These changes are more distinct than those produced by AN alone. While the exact mechanism of Ps acting on AN nephropathy is not known, marked hypocomplementemia was observed regularly after the Ps + AN injection, suggesting that complement is activated and consumed in the kidney. It is suggested that complement may play an important role in AN + Ps nephropathy. PMID- 6484979 TI - Relative advance of eye movement to the target in the rightward tracking in schizophrenics. AB - Time relationship between the horizontal smooth pursuit eye movement (SPEM) and tracking target in the leftward or rightward tracking was investigated in 28 normal and 25 chronic schizophrenic subjects. Normal subjects were more liable to show a relative advance of SPEM in relation to the target in the leftward pursuit than in the rightward pursuit. These findings suggest that the spatial task such as SPEM depends more on the right hemispheric function in normal subjects. On the other hand, many of schizophrenic subjects showed a relative advance of SPEM to the target in the rightward pursuit. These findings suggest the dominance of the left hemispheric function in eye tracking tasks in schizophrenic subjects. The finding in the present study would support the hypothesis of the left hemispheric overactivation in the schizophrenic patients. PMID- 6484980 TI - Effect of hypothermia upon the electrocochleogram and auditory evoked brainstem response. AB - The effects of hypothermia upon electrocochleogram (ECochG) and auditory evoked brainstem response (ABR) were studied in 10 children who underwent the open heart surgery under hypothermic anesthesia. The latencies of N1, waves III and V in response to click of 115 dB p.e. SPL were prolonged at the rate of 0.12 +/- 0.02, 0.25 +/- 0.04 and 0.43 +/- 0.05 msec/degree C, respectively. The N1 amplitude was initially increased, returned to the precooling value at about 26 degrees C and decreased thereafter. SP was increased in amplitude by hypothermia and never disappeared throughout the observation. At the time of rewarming, SP appeared first, followed by N1 and finally by waves III and V. The results obtained in the present study were discussed in the light of the sensitivity of the sensory hair cells, peripheral nerves and CNS to the hypothermic condition. PMID- 6484981 TI - Urometric evaluation of intramural ureter function with continual ureteral perfusion. AB - Urometry provides a valuable test of ureteral function wherein intraureteral pressure changes associated with ureteral peristaltic contraction are recorded via a fine catheter inserted through the bladder into the ureter. An attempt was made to evaluate the function of the intramural ureter by analysis of urometric wave pattern of resting pressure recorded during the phase of no ureteral peristaltic contraction with continual instillation of sterile water via the catheter at a constant rate. By this technique, the length of functional intramural ureter (FUimL) was estimated to be 10-15 mm and the resting pressure in the intramural ureter (Pr) was between 5 and 10 mmHg in patients with possibly normal intramural ureter (4 ureters). In cases of chronic dysuria with cystographic evidence of morphologic changes in the bladder and with no vesicoureteral reflux (VUR), the FUimL was 5 mm and the Pr 2-3 mmHg. The corresponding values were 5 mm and 1 mmHg with a ureter showing VUR. The data obtained indicated that the product of these parameters, FUimL X Pr, may reflect the function of intramural ureter. The method reported herein being procedurally simple requiring no particular apparatus provides a remarkably valuable test for the evaluation of function of intramural ureter which has been virtually impracticable. PMID- 6484982 TI - High yield of platelet-rich plasma from CPD blood compared to ACD blood. AB - The yields of platelet-rich plasma (PRP) obtained by centrifugation of CPD (citrate-phosphate-dextrose) blood and ACD (acid-citrate-phosphate) blood were compared. The volumes of PRP from 5 ml blood in test tubes and 200 ml blood in bags were larger by 4% and 4.5%, respectively, when CPD was used as an anticoagulant. In addition, the number of platelets in PRP from CPD blood was higher than that from ACD blood. These data suggest that the optimal centrifugal condition for CPD blood should be different from that for ACD blood. PMID- 6484983 TI - Corporate reorganization: nonprofit tax-exempt hospitals. PMID- 6484984 TI - Metabolism and cytotoxicity of acetaminophen in hepatocytes isolated from resistant and susceptible species. AB - Acetaminophen (APAP) disposition was studied in vitro using hepatocytes isolated from rats, hamsters, rabbits, and dogs, species that vary markedly in susceptibility to the hepatotoxicity of this drug. Metabolism was assessed by concurrent measurements of glutathione depletion and protein adduct formation (activation pathway) and of total aqueous metabolite production (detoxication pathways). Cytotoxicity was monitored by cell count and by lactate dehydrogenase (LDH) release to culture medium. In agreement with whole animal studies, hepatocytes from hamsters were very susceptible to APAP-induced toxicity whereas rat and rabbit hepatocytes were resistant. In vivo data were unavailable for the dog, but dog hepatocytes were also relatively resistant. Parameters of APAP metabolism generally correlated with the species susceptibility ranking; however, no single parameter was an ideal index of the sensitivity observed. As predicted by the cytotoxicity data, hamster hepatocytes produced more covalent adducts of APAP, were depleted of GSH more rapidly, and detoxified APAP by formation of polar metabolites at a slower rate than rat hepatocytes. On the other hand, rabbit hepatocytes had no detectable covalent adducts, retained higher amounts of GSH, and metabolized more APAP to polar conjugates than the other species. Dog hepatocytes formed low amounts of both covalent adducts and conjugates. These studies indicate that interspecies comparisons using isolated hepatocytes to study xenobiotic metabolism and the resulting cytotoxicity are feasible, but for a clear understanding of observed differences, it is necessary to study the interrelationships between the toxication and detoxication pathways of metabolism. PMID- 6484985 TI - Time course of cadmium-induced ultrastructural changes in rat liver. AB - Ultrastructural changes in rat liver were studied 1, 2, 4, 6, 8, and 10 hr after administration of a single, high dose of Cd (3.9 mg Cd/kg, iv) or after repeated administration of a lower dose (0.5 mg Cd/kg, sc, 6 days/week for 6 months). These dosing regimens have been previously shown to produce hepatotoxicity and result in large accumulations of Cd in liver. In addition to light and electron microscopy, plasma enzyme activities indicative of liver injury, namely alanine (ALT) and aspartate (AST) aminotransferase, were determined at the aforementioned times. One hour after an acute dose of Cd, electron photomicrographs of liver showed dilation of the rough endoplasmic reticulum with concomitant loss of membrane-associated ribosomes, nucleolar condensation, and an increase in the number of perichromatin granules. At later times (4 and 6 hr), ultrastructural changes included mitochondrial swelling associated with matrical inclusions, further dilation and vesiculation of rough endoplasmic reticulum, and presence of a fibrillar material within cytoplasm. In contrast to changes observed after single administration of Cd, the predominant hepatic lesions in rats injected repeatedly with the metal over 6 months were interstitial fibrosis, nuclear enlargement, and an increase in number and predominance of nucleoli. Ultrastructural evidence of nuclear alterations included condensation of nucleoli and an increase in the number of perichromatin granules. These results indicate that Cd interferes with hepatic protein synthesis early after injection of a large dose, and that further degenerative changes occur later and possibly in response to protein inhibition. Although severe degenerative changes in liver were not evident in rats chronically exposed to the metal, Cd-induced changes in nuclei and nucleoli also indicate the likelihood of altered protein synthesis. PMID- 6484986 TI - Teratogenicity in vitro of two deacetylated metabolites of N-hydroxy-2 acetylaminofluorene. AB - In previous studies [E. Faustman-Watts, J. C. Greenaway, M. J. Namkung, A. G. Fantel, and M. R. Juchau (1983) Teratology 27, 19-28] an embryo culture system was utilized to investigate the role of biotransformation in the embryotoxicity of 2-acetylaminofluorene. For this investigation, the capacity of two deacetylated metabolites of N-hydroxy-2-acetylaminofluorene (N-OH-AAF) to produce malformations in cultured whole rat embryos is reported. The relative capacities of N-hydroxy-2-aminofluorene (N-OH-AF) and 2-nitrosofluorene (NF) to elicit embryotoxic effects, including embryolethality, malformations, growth retardation, and alterations in macromolecular content, were assessed and compared with effects produced by N-OH-AAF and bioactivated 2-acetylaminofluorene (AAF). Qualitatively similar patterns of malformations were produced by NF and N OH-AF. At initial concentrations greater than 60 microM, both deacetylated compounds caused abnormalities in axial rotation (flexure), decreased viability, and decreases in embryonic DNA and protein content. Both chemicals were active in the absence of a bioactivating system. AAF produced a different spectrum of defects, and was active only in the presence of a complete monooxygenase system. The malformations produced by bioactivated AAF included abnormally open neural tubes; flexure abnormalities were rarely observed. The primary defect elicited by N-OH-AAF was prosencephalic hypoplasia. This chemical was active without an added bioactivating system. Temporal studies demonstrated that exposure of embryos to NF (128 microM) for as little as 2 hr was sufficient to elicit embryotoxic effects. None of the individual metabolites appeared to be solely responsible for the interruptions of neural tube closure produced by bioactivated AAF. PMID- 6484987 TI - Effects of metals and organic compounds on hepatic glutathione, cysteine, and acid-soluble thiol levels in mullet (Mugil cephalus L.). AB - The hepatic acid-soluble thiol content of striped mullet (Mugil cephalus) exposed to cadmium (10 mg/liter seawater), mercury (200 micrograms/liter), fluorene (100 micrograms/liter), dibenzofuran (750 micrograms/liter), or a 20% water-soluble fraction of a No. 2 fuel oil, and of winter flounder (Pseudopleuronectes americanus) exposed to pentachlorophenol (200 micrograms/liter) for up to 3 weeks was determined. Exposure to these chemicals caused an elevation of hepatic acid soluble thiol content over control values. Similarly, the acid-soluble thiol content was 1.75 times control values 24 hr after injection with acetaminophen (40 mg/100 g body wt, ip). In contrast, hepatic acid-soluble thiol concentrations did not fluctuate after feeding or during short-term starvation, or after acute or chronic physical trauma. Thus, the increase in hepatic acid-soluble thiols observed in mullet appears to be a specific response to chemical insult. The effect of chemical exposure on specific thiols can vary with the compound under investigation. Glutathione accounted for most of the acid-soluble thiol increase observed in mullet exposed to oil, whereas other acid-soluble thiols were also elevated after exposure to cadmium. Injection of [14C]glycine into cadmium- and oil-treated mullet showed that hepatic uptake of this amino acid substrate and its incorporation into hepatic glutathione increased after chemical exposure. The proportion of the total [14C]glycine in the liver incorporated into glutathione was unchanged after oil exposure, but was significantly increased in cadmium exposed fish. These results suggest that chemicals may elevate glutathione content by enhancing the hepatic uptake of amino acid substrates and also the activity of biosynthetic enzymes. PMID- 6484988 TI - The effect of intraovarian injection of benzo(a)pyrene on primordial oocyte number and ovarian aryl hydrocarbon [benzo(a)pyrene] hydroxylase activity. AB - The effect of intraovarian (io) injection of benzo(a)pyrene (BP) on primordial oocyte number, ovarian aryl hydrocarbon hydroxylase (AHH, EC 1.14.14.1) activity, and hepatic AHH activity and P-450 content was investigated in C57BL/6N (B6) and DBA/2N (D2) mice. Ovaries were exteriorized through dorsolumbar incisions under ether anesthesia, and 1.0 microliters of corn oil or corn oil containing BP was injected directly into the ovary. Bilateral io injection of BP was ovotoxic in a time and dose dependent manner. Primordial oocyte destruction was maximal 8 days after injection in both B6 and D2 mice. Unilateral io injection of BP destroyed oocytes only in the treated ovary. The threshold dose for primordial oocyte destruction was similar in both strains, approximately 50 ng/ovary. However, ED50's were different; 1.1 micrograms/ovary in B6 and 8.9 micrograms/ovary in D2 mice. Intraperitoneal treatment with alpha-naphthoflavone (80 mg/kg) inhibited the oocyte destruction by io treatment with BP (10 micrograms/ovary) in both B6 and D2 mice. In B6 mice, ovarian AHH activity was induced by BP in the treated ovary after either bilateral, or unilateral io treatment. However, io BP treatment did not change ovarian AHH activity in D2 mice. Hepatic AHH activity and P-450 content was not altered by io BP treatment in either mouse strain. These results strengthen the hypothesis that the ovary has the capability of metabolizing BP to ovotoxic products. PMID- 6484989 TI - The temporal relationship between behavioral and hematological effects of inhaled benzene. AB - The time-effect relationship of the behavioral and hematological changes caused by inhaled benzene was investigated in C57BL mice. Mice were exposed to air, or 100, 300, 1000, or 3000 ppm benzene in standard inhalation chambers employing dynamic vapor exposure techniques. Mice were exposed for 6 hr/day for the number of days necessary to achieve a minimum concentration X time (Ct) product of 3000 ppm-days. The intermittent exposure regimen of 6 hr/day was employed to simulate occupational exposure. The most sensitive behavioral index (milk-licking) was affected by the lowest concentration tested (100 ppm), while homecage food intake, hindlimb grip strength, and body weight were reduced only at 1000 and 3000 ppm. Some of these previously undocumented behavioral changes occurred as rapidly as hematological changes that have been considered hallmarks of benzene toxicity. A significant decrease in circulating lymphocytes occurred after exposure to all concentrations. Circulating red blood cells were variably affected by benzene, in that anemia resulted after 10 days exposure to 100 ppm and after 3 days exposure to 300 ppm but not after 3 days exposure to 1000 ppm or a single exposure of 3000 ppm. The data indicate a departure from Ct relationships, and suggest that exposure duration as well as daily dose may be an important factor in benzene toxicity. PMID- 6484990 TI - In vitro effects of benzene metabolites on mouse bone marrow stromal cells. AB - Benzene exposure can result in bone marrow myelotoxicity. We examined the effects of benzene metabolites on bone marrow stromal cells of the hemopoietic microenvironment. Male B6C3F1 mouse bone marrow adherent stromal cells were plated at 4 X 10(6) cells per 2 ml of DMEM medium in 35-mm tissue culture dishes. The growing stromal cell cultures were exposed to log 2 doses of five benzene metabolites: hydroquinone, benzoquinone, phenol, catechol, or benzenetriol for 7 days. The dose which caused a 50% decrease in colony formation (TD50) was 2.5 X 10(-6) M for hydroquinone, 17.8 X 10(-6) M for benzoquinone, 60 X 10(-6) M for benzenetriol, 125 X 10(-6) M for catechol, and 190 X 10(-6) M for phenol. We next examined the effect of benzene metabolites on the ability of stromal cells to influence granulocyte/monocyte colony growth (G/M-CFU-C) in a coculture system. Adherent stromal cells were plated and incubated for 14 days and then exposed to a benzene metabolite. After 3 days the medium and metabolite were removed and an agar:RPMI layer containing 10(6) fresh bone marrow cells was placed over the stromal layer. After incubation for 7 days the cultures were scored for G/M colony formation. Hydroquinone and benzoquinone were most toxic, while catechol and benzenetriol inhibited colony growth only at high doses. These results indicate that injured bone marrow stromal cells may be a significant factor in benzene-induced hemotoxicity. PMID- 6484991 TI - The effect of 2-methoxyethanol and methoxyacetic acid on Sertoli cell lactate production and protein synthesis in vitro. AB - Exposure to 2-methoxyethanol (ME) or its major metabolite, methoxyacetic acid (MA), results in spermatocyte depletion and testicular atrophy in experimental animals. The site of spermatogenesis is within the seminiferous tubule. Sertoli cells support spermatogenesis, synthesizing and secreting proteins, and metabolic substrates for utilization by differentiating germ cells in the seminiferous tubule lumen. One of these substrates, lactate, is preferentially metabolized by spermatocytes. Therefore, because germ cells are dependent upon the metabolic products of Sertoli cells, the effect of ME and MA on production of lactate and protein synthesis was measured in cultured rat Sertoli cells. Cell cultures were incubated with ME or MA at 0, 3, or 10 mM for up to 12 hr. No significant difference was seen in total protein synthesis as measured by [3H]leucine incorporation. ME and MA had no apparent effect on cell viability. However, lactate concentrations and rates of lactate accumulation were significantly decreased by MA, but not ME, at both 3 and 10 mM following incubation for 6, 9, and 12 hr. The results suggest that inhibition of Sertoli cell lactate production resulting from ME or MA exposure could account for the inhibitory action of these compounds on spermatogenesis. PMID- 6484992 TI - Influence of tansy ragwort (Senecio jacobaea), dietary copper, and feed restriction on the subcellular distribution of minerals in rat liver. AB - Young male rats were pair-fed diets containing 0 or 5% tansy ragwort (TR), with each diet containing 0 or 50 micrograms/g copper. Other animals given TR-free diets were also maintained as ad libitum controls. After 5 weeks of feeding these diets, the rats were killed for the determination of the trace metal contents of liver fractions. TR with no dietary copper supplement increased the calcium content of all hepatic fractions except nuclei and debris, but had no effect on the subcellular concentrations of copper, zinc, or iron. When 50 micrograms/g copper was included in the TR diet, the subcellular distribution of copper, iron, and calcium was altered. This alteration was shown by an increase (as compared to pair-fed controls given copper-supplemented diet with no TR) in the copper content of all fractions except cytosol, the iron content of all fractions, and the calcium content of mitochondria, microsomes, lysosomes, and cytosol. Feed restriction (pair-fed versus ad libitum controls) using diets with no additional copper produced an increase in the copper and calcium contents of mitochondria; the copper, zinc, and calcium contents of cytosol; and the calcium content of lysosomes. Addition of 50 micrograms/g copper to the diets abolished these effects of feed restriction. These findings suggest that the subcellular distribution of copper, zinc, iron, and calcium in rat liver is subject to perturbation by pyrrolizidine alkaloid-containing diet, dietary copper, and feed restriction. PMID- 6484993 TI - Carcinogenic and toxicologic effects of inhaled ethylene oxide and propylene oxide in F344 rats. AB - The chronic inhalation toxicity and carcinogenicity of ethylene oxide (EO) and propylene oxide (PO) were evaluated in a 2-year inhalation bioassay. Five groups of male weanling Fischer 344 rats, 80 per group, were exposed at 0 ppm (shared control; filtered air), 50 ppm EO, 100 ppm EO, 100 ppm PO, or 300 ppm PO (7 hr/day, 5 days/week) for 104 weeks. Body weights from rats exposed to EO and PO at all exposure concentrations were significantly reduced compared to controls. A statistically significant increase in mortality was observed in all groups of exposed rats compared to controls. Skeletal muscle atrophy in the absence of any sciatic nerve neuropathology was found in rats exposed at 100 ppm EO and 300 ppm PO. Statistically significant associations between EO exposure and an increased incidence of the following rat neoplasms were observed: mononuclear cell leukemia, peritoneal mesothelioma, and mixed cell brain glioma. Among rats exposed to PO there was a dose-dependent increase in the incidence of complex epithelial hyperplasia in the nasal passages, and two adenomas were detected in the nasal passages of rats exposed at 300 ppm PO. The incidence of adrenal pheochromocytomas was elevated in both PO exposure groups, but not in a dose related manner. All rat groups were affected by an outbreak of Mycoplasma pulmonis infection which occurred about 16 months into the study. This infection alone and in combination with the epoxide exposures affected the survival of rats in this study, and influenced the development of the proliferative lesions in the nasal mucosa of the PO-exposed rats. No treatment-related changes in any clinical chemistry or urinalysis indices were detected. PO exposure did not increase the incidence of the three neoplasms associated with EO exposure; however, adrenal pheochromocytomas and proliferative lesions of the nasal cavity were increased in rats exposed to PO. PMID- 6484994 TI - Sister-chromatid exchanges and chromosome aberrations in lymphocytes from monkeys exposed to ethylene oxide and propylene oxide by inhalation. AB - The ability of long-term exposures to inhaled ethylene oxide (EO) and propylene oxide (PO) to induce sister-chromatid exchanges (SCEs) and chromosome aberrations in peripheral lymphocytes of monkeys was investigated. Five groups of adult male cynomolgus monkeys were exposed at 0 (shared control), 50, or 100 ppm EO, and at 100 or 300 ppm PO (7 hr/day, 5 days/week) for 2 years. EO exposures at 50 and 100 ppm resulted in statistically significant increases in sister-chromatid exchange rates and in the incidence of chromosome aberrations in monkey lymphocytes. Both EO-exposed groups had increased numbers of SCEs/metaphase compared to controls, with the SCEs/metaphase of the EO 100 ppm group also significantly elevated versus the EO 50 ppm group. Variability of SCEs/metaphase within each monkey increased even more than the increase in total SCEs/metaphase group with increasing EO exposure. Chromatid-type aberrations were also significantly increased for both EO 50 and EO 100 ppm groups compared to controls. Statistically significant increases in the number of chromosome-type aberrations (excluding gaps) were found only in the EO 100 ppm group. Combined chromatid- and chromosome-type aberrations were increased in both EO 50 and EO 100 ppm groups. No group differences in the number of gaps were found. In lymphocytes from monkeys exposed at 100 and 300 ppm PO, there were no group differences compared to controls for any variable-chromatid or chromosome-type aberrations, gaps, or SCEs/metaphase. These results indicate that EO is a more potent clastogen than PO and demonstrate, for the first time, statistically significant effects of EO on both SCEs and chromosome aberrations in lymphocytes of nonhuman primates. PMID- 6484995 TI - Cadmium hypersusceptibility in the C3H mouse liver: cell specificity and possible role of metallothionein. AB - The possible involvement of metallothionein (MT) gene expression dysfunction was examined in a strain of mouse which is unusually sensitive to cadmium toxicity, the C3H. C3H mice, and the relatively cadmium-insensitive Swiss mice, were injected sc with 20 microM CdCl2/kg body wt. This dose caused liver damage, visible at the light microscopic level, in the C3H but not the Swiss mice. These studies showed that MT-I mRNA and MT protein accumulation, as well as binding of cadmium by MT, were very similar in the two strains. These data suggested that altered expression of MT in the hepatic parenchyma was not a factor in the C3H hypersusceptibility. An electron microscopic examination of the early effects of cadmium injection indicated that the primary targets for toxicity in the C3H liver may be the endothelial cells. It is hypothesized that the widespread damage seen at later times resulted, secondarily, from ischemia produced in response to endothelial cell damage. PMID- 6484996 TI - In vitro solubility and in vivo toxicity of gallium arsenide. AB - The in vitro solubilities of gallium arsenide (GaAs) and its metal oxides were arsenic(III) oxide greater than GaAs much greater than gallium(III) oxide. GaAs dissolution was also dependent upon the type and concentration of buffer anion. The amount of arsenic dissolved in 12 hr by various aqueous media was 0.2 M phosphate buffer greater than or equal to 0.1 M phosphate buffer greater than Krebs-Hensleit buffer greater than distilled H2O greater than HCl-KCl buffer. GaAs was apparently soluble under in vivo conditions. Blood arsenic concentrations in rats 14 days after intratracheal instillation of 10, 30, or 100 mg/kg GaAs were 5.5, 14.3, and 53.6 micrograms/ml, respectively; gallium was not detected at any doses. An increase in lung wet weight at 14 days was dose dependent with these organs retaining 17 to 42% of the dose as gallium or arsenic. Excretion of gallium and arsenic was limited to the feces. Urinary porphyrin concentrations and body weight, monitored as indices of toxicity, were significantly altered over the 14-day study. The analysis of porphyrins revealed that uroporphyrin replaced coproporphyrin as the primary urinary metabolite. Rats receiving 10, 100, or 1000 mg/kg GaAs po exhibited similar signs of toxicity. Blood arsenic concentrations at 14 days were 3.5, 6.8, and 17.6 micrograms/ml, respectively. Porphyria was increased, and body weight was decreased at 1000 mg/kg GaAs. These values were equivalent to those obtained with an intratracheal dose of 10 to 30 mg/kg GaAs. Our results showed that pulmonary and po exposure to GaAs resulted in systemic arsenic intoxication. The finding that urinary uroporphyrin concentrations were greater than coproporphyrin concentrations may serve as a sensitive indicator for GaAs exposure. PMID- 6484997 TI - Teratogenic effects of Ochratoxin A in rats with impaired renal function. AB - The teratogenic potential of Ochratoxin A (OA), was compared in impaired renal function (IRF) and sham-operated (SO) female rats. Surgical removal of approximately 70% of the total renal tissue was accomplished utilizing unilateral ligation/electrocoagulation procedures. Control animals were sham-operated. All animals were allowed a period of 27 days to recover post surgery. IRF rats exhibited normal mating tendencies and the pregnancy rate was 100%. A single, subcutaneous teratogenic dose of OA (1.75 mg/kg) on gestation day 7 resulted in significantly increased fetal resorptions, decreased fetal body weights and increased fetal malformations in both IRF and SO animals, although the incidence of gross malformations was greater in IRF rats. A subthreshold teratogenic dose (i.e. 1 mg/kg) did not produce any significant increase in embryotoxicity or fetal malformations in IRF animals compared to SO rats. PMID- 6484999 TI - Reduction to benzidine is not necessary for the covalent binding of a benzidine azodye to rat liver DNA. AB - The DNA binding of 2 benzidine azodyes, Congo Red and Direct Blue 6, was compared in rat liver. Both dyes showed binding consequent upon metabolism to benzidine, and in each case hydrolysis of the liver DNA yielded N-(deoxyguanosin-8-yl)-N' acetylbenzidine. The majority of Direct Blue 6-derived radioactivity bound to DNA was present as at least one other novel species. Our preliminary work on the major Direct Blue 6 DNA adduct suggests its structure may be disodium 8-amino-2 [4-(N-deoxyguanosin-8-yl)-aminobiphenyl-4'-yl] azo-1-hydroxynaphthalene-3,6 disulphonate. This adduct may form as a result of the susceptibility of the dye to hepatic azoreductase and its apparent existence may explain the observed potent carcinogenicity of dyes such as Direct Blue 6. PMID- 6484998 TI - Immunosuppression in weanling and adult Sprague-Dawley rats induced by acute exposure to 3,3',4,4'-tetrachloroazoxybenzene. AB - The acute immunomodulatory effects of the environmental and occupational contaminant, 3,3',4,4'-tetrachloroazoxybenzene (TCAOB), were investigated on selected immune parameters in weanling and adult Sprague-Dawley rats. Significant immunotoxic effects were found 17 days after 4 doses of 25 mg/kg TCAOB, administered i.p. The main non-immune toxic effects were decreased body, kidney, heart and testis weights, and a simultaneous increase in liver weight. The immune parameters showing significant suppression were: thymic weight, splenic plaque forming cell populations and function, pertioneal macrophage chemiluminescence, and bone marrow cellularity. Weanling animals were affected by TCAOB to a greater extent than adults on both the multiple and single dose regimens. The immunotoxic effects were found to be qualitatively similar to those of its isosteric analog, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). The results demonstrate that TCAOB is a very potent immunotoxic compound and may have long-term effects after a single exposure. This study is the first investigation into the effect of TCAOB on immune functions. PMID- 6485000 TI - Toxic effects of the antifertility agent gossypol in male rats. AB - In the present investigation the influence of gossypol on the male sex function and toxicology in the rat have been studied. Gossypol was injected daily for 5 weeks to adult male rats of the Sprague-Dawley strain with 1 or 10 mg/kg body wt. The low dose of gossypol (1 mg/kg body wt.) did not have any effect on the following parameters: plasma testosterone concentrations, body growth, kidney weights, sex organ weights (ventral prostate, seminal vesicle, epididymis), testicular weights, blood flow to testes, epididymides and ventral prostate as measured with the microsphere technique, intraarterial blood pressure and morphology of testis and epididymis. The plasma testosterone response to acute LH injection was not significantly different in gossypol-treated rats when compared to control rats. The high dose of gossypol (10 mg/kg body wt) caused signs of tubular degeneration, retarded body growth, markedly reduced testosterone concentrations, involutions of the ventral prostate and seminal vesicles and gastrointestinal disturbances. After 5 weeks of treatment the mortality rate was 13%. It is concluded that gossypol is a very toxic substance in rats, since only a 10-fold increase of a non-effective dose caused serious side effects in addition to its antifertility effects. PMID- 6485001 TI - Separation of wasting syndrome and lethality caused by 2,3,7,8-tetrachlorodibenzo p-dioxin. AB - Twenty rats were administered LD50 doses of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) i.p. (60 micrograms/kg). Two days later 10 rats were started and maintained on a diet containing 5% hexadecane, whereas the other 10 rats continued receiving basal diet. Dietary hexadecane increased the mortality rate of rats from 60 to 100%. All animals destined to die showed a biphasic body weight and food intake pattern. The first 16 days after dosing were characterized by progressive weight loss which went hand in hand with increasing appetite suppression. No animal died during this initial phase. After day 16, rats overcame their loss of appetite, started eating and stabilized their body weight. During this second phase, lasting from day 16 to day 40, mortality progressed to 60 and 100% in the controls and hexadecane-treated rats, respectively. No body weight loss or change in food intake was observed in any of the surviving animals. Data indicate that TCDD-induced wasting syndrome is due to appetite suppression. However, wasting syndrome does not seem to be the ultimate cause of lethality. PMID- 6485002 TI - Viridicatumtoxin mycotoxicosis in mice and rats. AB - LD50 studies of viridicatumtoxin were done in rats and mice using oral, intraperitoneal (i.p.), and subcutaneous (s.c.) routes. Mice were given oral doses of viridicatumtoxin up to 350 mg/kg body weight and rats were given doses of viridicatumtoxin up to 150 mg/kg. No deaths occurred in the animals dosed by the oral route. Hepatic alterations of hydropic change and necrosis of centrolobular hepatocytes were observed in mice given 250, 300, or 350 mg/kg viridicatum toxin and were more severe in the mice given the higher doses. No histopathologic alterations were present in the rats dosed orally. Mice were given doses of viridicatumtoxin up to 300 mg/kg, s.c., and rats up to 400 mg/kg. No deaths occurred in the animals dosed by this route. Microscopic alterations in both mice and rats were limited to the injection sites and consisted of coagulation necrosis. The single-dose, 72-h i.p. LD50 for the mouse and the rat was 70 mg/kg and 80 mg/kg respectively. Histopathologic alterations in mice given viridicatumtoxin i.p. included fibrinous peritonitis, large subcapsular areas of hepatic necrosis, single-cell hepatocytic necrosis, splenic lymphoid depletion, and vacuolar degeneration of the myocardium. Rats had splenic lymphoid depletion and fibrinous peritonitis. PMID- 6485003 TI - Biological availability of lead in a paint aerosol. 1. Physical and chemical characterization of a lead paint aerosol. AB - This study was conducted to determine the physical and chemical characteristics of an aerosol of lead-based paint, generated in an industrial spray operation, that might influence the biological availability of lead present in inhaled aerosols. Paint aerosols were collected, and mass-size distribution was determined using a portable cascade impactor under actual occupational conditions. Approx. 2% of the particulate mass collected was in the respirable range (less than 10 micron mean aerodynamic diameter), although the maximum airborne concentration of lead was found to be 2-3 mg/m3. The lead concentration in a dried aerosol was very resistant to chemical digestion. Analysis by X-ray diffraction, atomic absorption spectroscopy and inductively coupled plasma emission spectroscopy showed approx. 11% lead by dry weight, although the wet weight concentration of lead reported by the manufacturer was 12.8%. PMID- 6485004 TI - Biological availability of lead in a paint aerosol. 2. Absorption, distribution and excretion of intratracheally instilled lead paint particles in the rat. AB - Four groups of rats received by intratracheal instillation (1) a lead chromate paint particulate suspension, (2) lead tetraoxide suspension, (3) lead acetate solution, or (4) saline. Lead-dosed animals received an equivalent dose of 1 mg lead/kg body weight. Distribution of lead was monitored through assays of urine, feces, and tissues (lung, bone, muscle kidney, liver) obtained at post-mortem 5 weeks after exposure. Delta-aminolevulinic acid dehydratase (ALA-D) activity was measured to determine the effect of lead on heme biosynthesis. The vast majority of the dosed lead in the paint matrix remained in the lung. In contrast, in the lead acetate-dosed animals, little remained in the lung, but significant elevations were found in bone and kidney. Blood ADA-D was significantly depressed in the lead acetate-treated animals, but was not significantly different from control animals in the animals dosed with lead paint or lead tetraoxide. These findings suggest that lead chromate in an alkyd resin paint matrix is poorly absorbed from the lung compared with lead acetate and lead tetraoxide. PMID- 6485005 TI - Age-dependent retention of [14C]DDT in the brain of the postnatal mouse. AB - Postnatal mice, at the age of 0 (newborn), 3, 7, 10, 15, 20 and 55 days, were given a single administration of dichlorodi[U-14C]phenyltrichloroethane [( 14C]DDT; 1.48 MBq/kg body wt.) per os. They were killed 24 h or 1 week post treatment and the amount of radioactivity in the brain was measured. The most pronounced retention was found in mice receiving [14C]DDT on the tenth postnatal day. The activity found after 1 week was as high as that observed after 24 h, and it was also highest in this age category even though older mice displayed a higher activity 1 day after administration. PMID- 6485006 TI - Effects of DDT on muscarine- and nicotine-like binding sites in CNS of immature and adult mice. AB - Immature (10 days of age) and adult (60 days of age) mice were given a single peroral administration of 0.5 mg p,p'-DDT/kg body wt. or a fat emulsion vehicle. The mice were killed 24 h or 7 days post-treatment and the muscarine- and nicotine-like binding sites were measured in the cerebral cortex and in the cerebellum using [3H]quinuclidinyl benzilate ([3H]QNB) and [3H]alpha-bungarotoxin ([3H]alpha-BTX), respectively, as ligands. A significant decrease in the [3H]QNB binding to the muscarine-like receptors in the cerebral cortex was seen in the 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT)-treated adults after 7 days. The effects on the muscarine-like receptors appeared to be different in the immature mice compared to the adults, showing an increase between 24 h and 7 days post-treatment in the immature and a decrease in the adults. No change was seen on the nicotine-like receptors. PMID- 6485007 TI - Renal ammonia metabolic response in the rat to repeated ethanol loading. AB - Lactate dehydrogenase (LDH), succinate dehydrogenase (SDH), aspartate aminotransferase (AAT), glutamate dehydrogenase (GDH), AMP deaminase, ornithine transcarbamylase (OTC), arginase and glutamine synthetase (GS) activities were increased in the kidney of the rat during repeated ethanol loading. The significance of these findings is discussed. PMID- 6485008 TI - Chronic effects of perchloroethylene on the composition of lipid and acyl groups in cerebral cortex and hippocampus of the gerbil. AB - Continuous exposure of Mongolian gerbils to perchloroethylene (PCE) (120 ppm) for 12 months in an inhalation chamber caused no changes in body or brain weights. The protein content, the concentration of lipid phosphorus or cholesterol were unaltered in the cerebral cortex and hippocampus. However, a small change in the fatty acid pattern of phospholipid was observed. In the phosphatidylethanolamine of cerebral cortex and hippocampus a decrease was found among the long-chain, linolenic acid-derived, fatty acids. The ratio 22:4 (N-6)/22:5 (N-3) was increased, indicating a shift towards the corresponding linoleic acid-derived 22 carbon fatty acids. The observed changes among poly-unsaturated fatty acids are similar to those appearing after peroxidation and either protein or essential fatty acid malnutrition. However, an attractive explanation for the changes is that they represent a response to the fluidizing properties of PCE. PMID- 6485009 TI - Impact of methyl parathion toxicity and eserine inhibition on acetylcholinesterase activity in tissues of the teleost (Tilapia mossambica)--a correlative study. AB - Acetylcholinesterase (AChE) activity and acetylcholine (ACh) content of muscle, gill, liver and brain tissues of control and methyl parathion-exposed (MPE) fish were determined. In addition, in vitro concentrations of eserine necessary to produce inhibition of AChE equivalent to in vivo inhibition by sublethal amounts of methyl parathion (MP) were also investigated. AChE activity decreased in all tissues, while ACh content showed a corresponding increase. These observations indicate disruption of nerve impulse conduction. The in vitro effect of eserine on AChE activity differed with the type of MP action. These results are discussed in relation to the sensitivity and extent of innervation of various tissues. PMID- 6485010 TI - Absorption of 3-nitropropanol and 3-nitropropionic acid from the digestive system of sheep. AB - When 3-nitropropanol (NPOH) was injected into the rumen (30 mg/kg), abomasum (10 mg/kg) or small intestine (10 mg/kg) of sheep, it was rapidly absorbed and converted to 3-nitropropionic acid (NPA). The reticulo-rumen was the major site of absorption for the miserotoxin aglycone but the abomasum and the small intestine also had the capacity to absorb NPOH. When NPA was injected into different regions of the alimentary tract, the reticulo-rumen was also the major site of absorption. Absorption of NPA or NPOH from the small intestine was much more rapid than from the abomasum. Plasma levels of NPA and inorganic nitrite were higher after dosing with NPOH than with NPA indicating a more rapid rate of uptake of the aglycone. PMID- 6485011 TI - Effect of dietary vitamin E on nitrite-treated rats. AB - The effect of dietary vitamin E on cellular responses to nitrite was studied in rats. One-month-old male Sprague-Dawley rats were fed a basal vitamin E-deficient diet with or without 100 ppm vitamin E and 1000 ppm sodium nitrite (NaNO2) for 9 weeks. In addition to a high mortality rate, nitrite-fed rats maintained on a vitamin E-deficient diet exhibited a marked increase in liver necrosis, tubular nephrosis and myodegeneration, as well as greater biochemical and hematological alterations when compared to the control animals. No animal mortality or histopathologic lesions in any tissues were observed in rats receiving a vitamin E-supplemented diet with or without nitrite. The results suggest that depletion of vitamin E renders rats more susceptible to the adverse effect of nitrite, and that nitrite administration potentiates deficiency of vitamin E in rats. PMID- 6485013 TI - A comparison of mirex-induced liver growth to liver regeneration. AB - In intact rats given a single oral dose of mirex there was a dose-dependent increase in liver weight which peaked at 4 days. There were increases in hepatic RNA and protein, but DNA content per liver and DNA synthesis as measured by [3H]thymidine incorporation were unchanged. In partially hepatectomized rats dosed with mirex 24 h post-surgery, there was a dose-dependent increase in relative liver weight which peaked at 5 days. In partially hepatectomized rats simultaneously dosed with mirex, [3H]thymidine incorporation into DNA was unaltered. However, in rats dosed with mirex 24 h prior to partial hepatectomy, there was a 50% reduction in [3H]thymidine incorporation into hepatic DNA. PMID- 6485012 TI - Disposition of [14C]2,3-dichloropropene in Fischer-344 rats after oral or intraperitoneal administration. AB - 2,3-Dichloropropene (2,3-DCP), a component of commercial fumigants and nematocides, was mixed with [14C]2,3-DCP and given to rats by peroral (p.o.) or intraperitoneal (i.p.) administration. Urine, feces, and expired air were collected over 72 h. Excretion of radioactivity in urine predominated over other routes, with 66% to 75% of the dose excreted in 72 h. Feces contained from 13% to 21% of dose. 8% of the dose was exhaled as 14CO2. At the end of 72 h, only 2% to 3% of the dose remained in the carcass with the highest concentrations of 14C in liver, kidney, testes, and lung. Approx. 91% of the p.o. dose was absorbed from the gastrointestinal (GI) tract. PMID- 6485014 TI - Effect of deoxynivalenol (vomitoxin) on the humoral immunity of mice. AB - The effects of vomitoxin (deoxynivalenol; DON) on the immune system were studied in groups of weanling male Swiss Webster mice administered by gavage 0.75, 2.5, and 7.5 mg of vomitoxin per kg body weight. Untreated controls and solvent controls (propylene glycol, ethanol, and distilled water in a ratio of 4:1:5) were also included in this study. Serum antibody (IgM) levels to sheep red blood cells (SRBC) were significantly reduced in the treatment groups compared to the control groups. Plaque-forming cell (PFC) numbers were also lower in the treated groups compared to the control groups. Furthermore, vomitoxin at a dose of 0.75 mg/kg resulted in a significant increase in the albumin, albumin/globulin ratio and a decrease in the alpha-2 globulin fraction compared to the control groups. Administration of 7.5 mg/kg of vomitoxin resulted in deaths, due to toxicity, in all animals of this group within 3 weeks. These preliminary findings are indicative of a potential effect of vomitoxin on the immune system which could have serious implications to man. PMID- 6485015 TI - The effect of buthionine sulfoximine, an inhibitor of glutathione synthesis, on hepatic drug metabolism in the male mouse. AB - Buthionine sulfoximine significantly reduced the hepatic non-protein sulfhydryl (NPSH) content of male B6C3F1 mice within 2 h after intraperitoneal (i.p.) injection. This treatment did not affect the activity of several hepatic microsomal and cytosolic enzymes responsible for xenobiotic metabolism. Pretreatment of mice with buthionine sulfoximine (2 mmol/kg) increased the hepatotoxicity of chloroform, but did not affect the hepatotoxicity of carbon tetrachloride. These findings suggest that buthionine sulfoximine can be a useful agent for studying the role of glutathione (GSH) in hepatic biotransformation of xenobiotics. PMID- 6485016 TI - Teratogenicity of 2,3,7,8-tetrachlorodibenzofuran in BXD recombinant inbred strains. AB - A series of recombinant inbred strains called BXD [produced from a cross between C57BL/6J (B6) and DBA/2J (D2)] were given single i.p. doses of 0.6 mg/kg 2,3,7, 8 tetrachlorodibenzofuran (TCDBF) on day 12 of gestation. The uteri were examined in late gestation with respect to resorptions and fetal death, and fetal malformations. The strains of the B6-type with respect to Ah-locus (Nos. 5, 6, 8, 11, 12, 14, 16 and 29) that are Ah-responsive, exhibited cleft palates in 80-100% of all fetuses, while hydronephrosis occurred at a rate of 20-70%. These two types of malformation are well recognized from earlier experiments with 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) and its structural analogues, including TCDBF. In the strains of D2-type with respect to Ah-locus (Nos. 2, 15, 19, 21, 22, 24, and 31), which are Ah-nonresponsive, no cleft palates occurred. One strain (No. 2) had a few (17%) fetuses with hydronephrosis. The frequency of fetal deaths and resorptions were relatively low, but slightly higher among B6-strains than D2 strains. The results indicate an association between the genes producing malformations by TCDBF and the Ah-locus. PMID- 6485018 TI - Trivalent chromium is neither cytotoxic nor mutagenic in permeabilized hamster fibroblasts. AB - BHK cells became reversibly permeable by a 30-min incubation in hypertonic medium. During permeabilization they were exposed to water-soluble Cr(VI) (K2Cr2O7) and Cr(III) (CrCl3). Thymidine uptake in the intracellular nucleotide pool, DNA replication, DNA damage and repair and sister-chromatid exchanges (SCE) were examined to detect the cytotoxic and genetic effects of Cr compounds. Cr(III) remained inactive also in permeabilized cells. An apparent induction of DNA damage by Cr(III), suggested by the Painter's test, was considered unreliable. Cr(VI) cytotoxic and genetic activity was enhanced in permeabilized cells, as demonstrated by increased inhibition of DNA replication and higher frequency of SCE. PMID- 6485017 TI - Ozone exposure, food restriction and protein deficiency: changes in collagen and elastin in rodent lung. AB - Two groups of weanling or young adult rats were fed ad lib casein-based diets containing 4 or 16% protein. Food was restricted in a third group (fed the 16% protein diet) to the amount consumed daily by rats (adult or weanlings) fed the 4% diet. After 3 weeks (weanlings) or 1, 3 or 5 weeks (adults), one-half of the rats in each group were exposed to 0.64 ppm (1.28 mg/m3) of ozone for 7 days (23.5 h each day). Several parameters were then evaluated related to lung connective tissue metabolism including: (1) total lung hydroxyproline, (2) total lung elastin, (3) apparent rates for lung collagen synthesis and elastin accumulation and (4) lung and body weights. In general, the response to protein deficiency and food restriction was more pronounced than to ozone exposure. Protein deficiency and food restriction resulted in decreased lung size and collagen content. However, the ability of lung to respond to ozone (in relative terms) was not altered by changes in diet as assessed by changes in lung weight or the collagen synthetic rate. PMID- 6485019 TI - Glutathione and glutathione S-transferases in rat liver after inhalation of halothane and enflurane. AB - Male Sprague-Dawley rats were exposed in inhalation chambers to halothane and enflurane in concentrations from 50 ppm-1000 ppm (0.0025-0.05 minimum alveolar concentration; MAC) 6 h a day for 3-9 days. Repeated subanaesthetic concentrations were used to avoid effects of general anaesthesia and to increase the metabolized fraction of the inhaled anaesthetics. Exposure to 0.05 MAC of halothane (500 ppm) and enflurane (1000 ppm) for 9 days reduced the activity of glutathione S-transferases. A decrease in liver concentration of reduced glutathione (GSH) was observed after inhalation of enflurane, probably caused by metabolic release of inorganic fluoride. The results indicate a decreased detoxifying capacity of rat liver under the given conditions. Inhalation of occupational related concentrations of the anaesthetics (50 ppm) did neither affect the activity of the transferases nor the concentration of GSH in rat liver. PMID- 6485020 TI - Effects of di-2-ethylhexyl phthalate on lipid composition of serum and testis in rats. AB - Dietary administration of di-2-ethylhexyl phthalate (DEHP; 2%) to male rats caused testicular atrophy. Serum non-esterified fatty acid increased while cholesterol, triglyceride and phospholipid decreased in treated rats. Testicular concentration of cholesterol and non-esterified fatty acid increased in DEHP treated rats. Fatty acid composition of phospholipid and triglyceride were also changed. These changes were similar to those in rats fed a zinc(Zn)-deficient diet. PMID- 6485021 TI - Lipid composition and monooxygenase relationship in liver microsomal membranes from rats fed unbalanced diets. AB - The cholesterol and phospholipid content of microsomal membrane from rats fed either a high lipid (H1) (30% lard) or a low protein (Lp) diet (6% casein) have been compared with those from rats fed a standard (St) diet (22% casein, 5% lard). For each diet, half of the group was treated with Phenochlor DP6. A significant increase in the phospholipid cholesterol ratio was observed in rats fed a high lipid diet or treated with DP6. These effects tend to increase the microsomal membrane fluidity. The protein deficiency decreased the phospholipid/cholesterol ratio and then the fluidity of the endoplasmic reticulum membrane. The specific activity of cytochrome P-450 to hydroxylate aniline which is independent to the enzymic form of cytochrome P-450 was closely correlated with the viscosity status of the microsomal membrane. PMID- 6485022 TI - Nitrate balance and biosynthesis in the ferret. AB - The net biosynthesis of nitrate in the ferret was demonstrated to be 8.89 to 10.3 mumol/kg bw/day. Nitrate balance studies indicated that, because of metabolism, excretion of nitrate was lower than ingestion when oral doses were higher than 6.3 mumol/day. At nitrate ingestion levels of less than 6.3 mumol/day, excretion exceeded intake. Studies with 15N-labeled nitrate indicated that only 36% of the oral dose was recoverable as [15N]nitrate from urine. Oral doses of 15N-labeled ammonia resulted in the incorporation of the 15N label into nitrate in urine and feces. This demonstrates that ammonia can serve as a precursor to biosynthesized nitrate. An increase in nitrate excretion was seen when animals were treated with neomycin sulfate and mycostatin to reduce gut microflora populations. This increase was as large as 200%. Short-term studies indicated that dietary protein quality had little effect on nitrate excretion. PMID- 6485023 TI - Effect of alcohol intake on some disturbances induced by chronic exposure to carbon disulphide in rats. I. Behavioural alterations. AB - Female white Wistar rats were exposed to CS2 vapour (0.8 mg CS2/1 air) 11 months and to 10% ethanol as the only drinking liquid for the last 3 months of exposure. Spontaneous exploratory motor activity (SEMA), open-field behaviour, passive avoidance performance and the avoidance acquisition were tested. Ethanol did not change the exploratory motor activity and behaviour of CS2-exposed rats in the open-field and passive avoidance tests but it affected their performance in the conditioned avoidance test. The analysis of data suggests that ethanol may adversely affect memory and learning ability in CS2-exposed rats. PMID- 6485024 TI - Effect of dietary chronic cadmium exposure on cell-mediated immune response in rhesus monkey (Macaca mulatta). AB - Rhesus monkeys (Macaca mulatta) were daily exposed orally to cadmium (Cd) at 5 mg/kg body wt in diet for a period of 2 and 6 months. Significant amount of Cd accumulated in liver, kidney and spleen after its exposure to monkeys. Cell mediated immune response was assessed by the responsiveness of peripheral blood lymphocytes (PBL) to phytohemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM). Even after 6 months of exposure, Cd increased DNA synthesis, although not significantly, in unstimulated and mitogen stimulated lymphocytes. Stimulation Index (SI), however, decreased largely due to increased unstimulated [( 3H]thymidine incorporation) observed after Cd exposure. It, therefore, indicates that Cd is not immunosuppressive in primates, phylogenetically closer to humans. PMID- 6485025 TI - Scanning electron microscopy of plasma etched implant specimens. AB - Following surface etching of previously processed plastic embedded specimens containing hard and soft tissues and implanted biomaterials with oxygen plasma, the fine structure of the tissues can be examined by scanning electron microscopy. One micrometer plastic orientation sections (with the implant removed in processing) and 110 microns histological sections (with the implant in situ) were examined. Direct comparison can be made between the scanning and histological observations. An examination in situ of oral tissues next to the biomaterial was also made, care being taken to minimize damage to the specimen. The fine structure of intracellular organelles was examined in detail. The method allows consecutive gathering of histological and ultrastructural data from the same plastic embedded specimen. PMID- 6485026 TI - [Tasks of complex medico-legal investigation in cases of traffic accidents]. PMID- 6485027 TI - [Determination of shoe marks in cases of skin injuries]. PMID- 6485028 TI - [Postmortem changes in serum potassium and sodium levels of persons who died of combined injuries of the head, trunk and limbs]. PMID- 6485029 TI - [Postmortem changes in human teeth and their significance for the determination of different periods of interment]. PMID- 6485030 TI - [Pathogenetic role of the functional state of the stomach in sudden death in ischemic heart disease]. PMID- 6485031 TI - [Morphological changes in the lungs and cerebral blood vessels in acute alcoholic intoxication]. PMID- 6485032 TI - [Medico-legal diagnosis of acute ethylene glycol poisoning]. PMID- 6485033 TI - [Use of laboratory methods in medico-legal examination of the cadaver]. PMID- 6485034 TI - [Combined effects of carbon monoxide and cyanide compounds during combustion of plastic KN-1]. PMID- 6485035 TI - [Determination of the sex and shape of the face by examination of the mandible]. PMID- 6485036 TI - [Determination of blood groups by examination of human secretions in "paradoxical secretors"]. PMID- 6485037 TI - [Determination of Glm(1) antigen in human saliva by anti-Glm(1) goat sera]. PMID- 6485038 TI - [Specific resistance of hair affected by injury and disease]. PMID- 6485039 TI - [Use of the orthogonal function method for background suppression in forensic chemical determination of various herbicides in biological material]. PMID- 6485040 TI - [Method of isolation of veratrine from cadaveric material]. PMID- 6485041 TI - [Basic requirements for the classification of the harmful portions of blunt objects]. PMID- 6485042 TI - [Characteristics of fractures of long tubular bones in children]. PMID- 6485043 TI - [Medico-legal determination of age by the degree of tooth effacement]. PMID- 6485044 TI - [Closed injuries of internal organs in non-penetrating abdominal gunshot wound]. PMID- 6485045 TI - [Rare case of self-strangulation by a belt]. PMID- 6485047 TI - [Urgent problems in the mechanogenesis of injuries due to falls from high places]. PMID- 6485046 TI - [Death from cold exposure during narcotic coma]. PMID- 6485048 TI - [Democratization policy for nursing homes: the pitfalls of the well-balanced administrative composition]. PMID- 6485049 TI - [Managerial and democratic thinking can go together; the pitfalls of an administrative approach. A comment]. PMID- 6485050 TI - Kwashiorkor revisited: the pathogenesis of oedema in kwashiorkor and its significance. AB - Cicely Williams, in her original description of kwashiorkor, implied that deficiency of protein in the baby's food could be a main cause of the syndrome. The hallmark of kwashiorkor is oedema. According to the 'classical' theory, an inadequate intake of protein leads to a low plasma albumin concentration, which in turn causes oedema. This theory has been contested from several points of view: that hypoalbuminaemia is not the major factor determining the presence of oedema, and that there is no real evidence of dietary protein deficiency. The resolution of this question is of some importance from the point of view of public health diagnosis and prevention. A crucial point in the argument is the pathogenesis of oedema, which is discussed in some detail. Although it is clearly multifactorial, with electrolyte disturbances--potassium deficiency and sodium retention--playing an important role, it is contended that the classical theory is essentially correct. On the dietary side, recent experimental work supports the earlier view that the development of oedema depends on a relative deficiency of protein with a relative excess of energy. Comparisons of intakes with requirements are unconvincing in view of uncertainty about the validity of the estimates of children's needs for protein. PMID- 6485051 TI - Isolation of Yersinia enterocolitica and Y. intermedia from fatal cases of diarrhoeal illness in Bangladesh. AB - From three fatal cases of diarrhoeal illness in Bangladesh, Yersinia species were isolated from tissues at post-mortem examination. One patient was infected with Y. enterocolitica serotype 0:7, 8 and two patients were infected with Y. intermedia. These patients were infected also with other enteric pathogens. These findings suggest that Yersinia may be important as pathogens in tropical diarrhoea and as co-pathogens in serious disease. PMID- 6485052 TI - Enhanced parasitization of platelets by Plasmodium berghei yoelii. AB - In previous studies plasmodia have been found by electron microscopy within human platelets naturally infected with Plasmodium vivax and within platelets of mice infected intraperitoneally with P. berghei. In both situations the number of parasitized platelets was low. An enhancement of platelet parasitization was attempted in order to study in greater detail the mechanisms and implications of such a phenomenon. Various in vitro incubation mixtures of normal mouse platelets and free merozoites of the 17X strain of P. berghei yoelii failed to produce any recognizable parasitization of platelets. In vivo, however, large numbers of invaded platelets were obtained by the use of massive intraperitoneal inocula of plasmodia (5 X 10(8) infected erythrocytes). By the 5th day of infection the proportion of parasitized platelets was 13.2 times higher in the animals receiving the large dose than in those receiving the regular passage inoculum (6 X 10(6) infected erythrocytes). Ultrastructural study of 266 intrathrombocytic parasites over eight days of infection failed to show schizogonic maturation beyond the trophozoite state. PMID- 6485053 TI - First report of septicaemic melioidosis in Hong Kong. AB - Septicaemia due to Pseudomonas pseudomallei was found in five patients; it complicated pneumonia in three. Four patients were old and had diabetes mellitus; the fifth patient, though young, was immunocompromised by steroid therapy. The clinical features were indistinguishable from those of other Gram-negative septicaemia. Four of the patients died. This was the first report of septicaemic melioidosis in Hong Kong where the disease might be endemic. Soil sampling and serological survey gave further supporting evidence. Early treatment using a bactericidal anti-Pseudomonal cephalosporin, such as ceftazidime, was suggested for this life-threatening infection. PMID- 6485054 TI - Treatment of Schistosoma mekongi with praziquantel in Cambodian refugees in holding centres in Prachinburi Province, Thailand. AB - Eighty-four cases of schistosomiasis mekongi among Cambodian refugees in holding centres in Thailand received praziquantel at 30 mg/kg body-weight orally twice in one day. Those treated were admitted to hospital in order to observe side effects for 24 hours. Assessment of the efficacy of praziquantel was based on cure rates. Side effects observed consisted primarily of abdominal pain, anorexia, nausea, emesis and headache. These were generally mild and transient. Physical signs revealed mild hepatomegaly and splenomegaly. The cure rate obtained one month after treatment was 97.5% and by 2 to 12 months after treatment reached 100%. PMID- 6485055 TI - Serodiagnosis of human cysticercosis using a chromatofocused antigenic preparation of Taenia solium cysticerci in an enzyme-linked immunosorbent assay (ELISA). AB - Crude preparations of Taenia solium cysticerci were partially purified by a chromatofocusing procedure to obtain antigenic fractions that were shown to be active in the enzyme-linked immunosorbent assay (ELISA) with known positive cysticercosis sera. Evaluation of this antigen in the ELISA serodiagnosis of human cysticercus infection showed an 80% detection of clinically typical cysticercosis patients from West New Guinea, and gave no false positive results in healthy control subjects from either Papua New Guinea or the USA. Cross reactivity to sera from a panel of subjects with a variety of other parasitic infections was limited to convalescent sera from individuals with echinococcosis. Seroepidemiological screening of three selected tropical populations verified the presence of human cysticercus infection on Bali (Indonesia) and its absence on Guam (in the Mariana Islands) and on Mota Lava (in the Banks Islands of Vanuatu). The purified cysticercus antigen was more sensitive and more specific than crude cysticercus or whole worm preparations for the serodiagnosis of human cysticercosis. PMID- 6485056 TI - The disease spectrum in a Maldivian (Adduan) population. AB - The changing pattern of disease in the population of Addu Atoll, Republic of Maldives, Indian Ocean, is reviewed. Over 30 years the population has nearly trebled with an increasing percentage in those under the age of 15 years. Diarrhoeal diseases and respiratory infections are now the dominant health problems where previously malaria and filariasis were major causes of morbidity. These problems are discussed against a background of changing financial resources and standards of health care. PMID- 6485057 TI - On the epidemiology of yaws in African miners (1942). AB - Several points of interest arise from these unusual human yaws infections: (i) European miners contracted a treponemal infection from Africans with yaws and developed yaws; (ii) the infectious patients who started the minor epidemics in the outbreaks must have been relapses from prolonged latent early infections; (iii) the time taken for the treponemes, possibly only a few minutes, to penetrate the skin through a minor injury seemed to be less than six hours; (iv) transmission occurred only at the working rock face deep underground with a tropical climate, and not on the surface 1,630 metres above sea-level, where there were abundant opportunities; (v) the search for treponemes in the environment of the working place was restricted by the inability to culture the treponeme. PMID- 6485058 TI - Humoral and cell-mediated immune responses to leptospires in different human cases. AB - Humoral and cell-mediated immune responses (CMI) to leptospirosis were studied in different groups of human patients. These included clinically suspected cases of leptospirosis, patients with jaundice (HBsAg negative), cases of pyrexia of unknown origin (PUC) (Widal and blood culture negative for typhoid) and healthy blood donors. Humoral immune response was evaluated with nine live strains representing different serogroups of leptospires and CMI with lysates of four strains. The study showed that the CMI appeared earlier than the humoral response which might be useful in the early detection of the disease. As in the humoral immune response, cross reactions to different leptospires were also seen in CMI response. PMID- 6485059 TI - Habitat and seasonality of Psychodopygus wellcomei help incriminate it as a vector of Leishmania braziliensis in Amazonia and northeast Brazil. PMID- 6485060 TI - Urinary neopterin is elevated in patients with malaria. PMID- 6485061 TI - Leishmanial infections in Lutzomyia longipalpis and Lu. antunesi (Diptera: Psychodidae) on the island of Marajo, Para State, Brazil. PMID- 6485062 TI - Endemic Lassa fever in Liberia. I. Clinical and epidemiological aspects at Curran Lutheran Hospital, Zorzor, Liberia. AB - In a study to assess the epidemiological and clinical aspects of endemic Lassa fever (LF) in Liberia at Curran Lutheran Hospital (CLH), 44 cases were diagnosed by virological and serological techniques over a 22-month period. During one calendar month, testing of febrile patients admitted to the medical-surgical ward revealed six cases of LF, 13% of all febrile cases and 17% of those who were tested. As the study progressed the diagnostic skills of the hospital staff improved. The most common mistake was the diagnosis of a case of LF as pneumonia; the most potentially serious diagnostic problem was differentiating LF from typhoid fever, a readily treatable infection. LF may also mimic other diseases such as aseptic meningitis, pelvic inflammatory disease, gastroenteritis or arbovirus infection. We found a previously unreported symptom of LF, rib tenderness typical of costochondritis. The mortality rate in the medical-surgical ward was 5.4%; the over-all case-fatality rate was 13.6%. Women outnumbered men by nearly three to one, and had a higher mortality particularly noted in the pregnant. LF is common at CLH, and as many as 100 cases may occur annually at this hospital. PMID- 6485063 TI - Cholera in Gaza in 1981: epidemiological characteristics of an outbreak. AB - An outbreak of cholera involving 161 culture-positive cases of biotype El-Tor Serotype Ogawa occurred in the Gaza Strip in the summer and autumn of 1981. The signs and symptoms of the disease were mild to moderate in two thirds of the cases. In many of them the disease was so mild that the patients did not realize they had cholera. Another outstanding feature of the disease was the high percentage of family clustering. From constant monitoring of water, sewage, and vegetables we were unable to show that they played any part in the transmission. A case control study which specifically investigated these items showed no differences between cases and controls. Epidemiological investigation indicated that the disease was probably introduced into the area by a visitor from Jordan, where an epidemic was in progress. The first spread followed a wedding party and seems to have been caused by ingestion of contaminated soft drinks. Subsequent spread was probably caused mainly by carriers who were either asymptomatic or very mild cases. The actual transmission seems to have occurred from person to person, by food contamination, or by both. The authors believe, therefore, that the transmission of El-Tor cholera has many features in common with other bacterial diseases that are transmitted by the faecal-oral route. PMID- 6485064 TI - Primary amoebic meningoencephalitis in a young male from northwestern Mexico. AB - Primary meningoencephalitis caused by Naegleria fowleri was documented in a 16 year-old male from Mexicali in the state of Baja California in Mexico. In August 1978, seven days after sustaining moderate head trauma while swimming in a shallow, stagnant irrigation ditch on a hot summer day, the patient presented an acute illness with severe headache, fever and convulsions rapidly progressing into a comatose state. Actively moving trophozoites were observed in the spinal fluid on admission. The patient died shortly after admission to hospital on the third day of symptoms. Post-mortem examination revealed a meningoencephalitis with extensive destruction, haemorrhage and numerous parasites involving structures of the posterior fossa. Immunoperoxidase strains of trophozoites in meningeal and cerebellar tissue were positive for N. fowleri KUL and negative for N. gruberi, N. australiensis and Acanthamoeba rhysodes. This appears to be the first documented case of the disease in Mexico. PMID- 6485065 TI - A simple procedure for the isolation of leishmanial parasites and for the recovery of parasite virulence in avirulent stocks. PMID- 6485066 TI - Improvements in the miniature anion exchange centrifugation technique for detecting trypanosomes in domestic pigs. PMID- 6485067 TI - Spontaneous healing of Leishmania braziliensis braziliensis skin ulcers. PMID- 6485068 TI - Differentiation between Naegleria fowleri and N. lovaniensis using isoenzyme electrophoresis of aspartate aminotransferase. PMID- 6485069 TI - Recovery of young daughter sporocysts from snails infected with Schistosoma mansoni. PMID- 6485070 TI - Isolation of Mycobacterium avium complex from an opossum Didelphis marsupialis in Brazil. PMID- 6485071 TI - Metrifonate in pregnancy. PMID- 6485072 TI - Biomphalaria pfeifferi in Eastern Senegal Region, Department of Kedougou, Republic of Senagal, West Africa. PMID- 6485073 TI - Ascaris lumbricoides in English schoolchildren. PMID- 6485074 TI - First report of natural infection with quartan malaria parasite Plasmodium shortti in Macaca fascicularis umbrosa (= virus) of Nicobar Islands. PMID- 6485075 TI - Isoenzyme characterization of Leishmania isolates from human cases of cutaneous leishmaniasis in Urfa, south-east Turkey. PMID- 6485076 TI - A pilot study of surrogate tests to prevent transmission of acquired immune deficiency syndrome by transfusion. AB - Because of reports that acquired immune deficiency syndrome (AIDS) might be transmissible by blood transfusion, we studied potential surrogate tests that could be used for screening donors. Male donors at one volunteer blood center and two plasma centers were screened for total lymphocyte count, OKT3, OKT4, OKT8, OKT11, LEU-7, LEU-M2, antibodies to hepatitis B core (anti-HBc), cytomegalovirus (CMV), and herpes and circulating immune complexes. Total lymphocyte counts and the OKT11 were significantly lower in one plasma center. No significant differences were found for the other lymphocyte or monocyte tests. Low T4/T8 ratios, found in 20 percent of donors, did not correlate with other abnormalities. A small percentage (3.3%) of volunteer donors, 15.4 percent at one plasma center and 20.8 percent at a second plasma center, and 38.5 percent of the male homosexual donors were positive for anti-HBc (significant when comparing the male homosexuals to the volunteers at p = 0.032). Positive CMV and herpes titers were similar in the groups. Circulating immune complex levels greater than two standard deviations above the mean were found in 20 percent of the volunteer donors, 7.7 percent at one plasma center and 8.3 percent at the second plasma center, and none in the male homosexual population. Pearson product moment correlations showed reasonably good agreement among the lymphocyte tests. However, the anti-HBc, CMV, and herpes antibodies and circulating immune complex levels did not correlate with any of the other tests. Surrogate tests for AIDS are nonspecific and unlikely to be helpful in screening blood donor units. PMID- 6485077 TI - Platelet viability following storage for 5 days. Influence of holding whole blood for 8 hours at 20 to 24 degrees C before concentrate preparation. AB - Regional blood centers frequently need to hold units of whole blood at 20 to 24 degrees C for several hours after phlebotomy so that sufficient platelet concentrates can be prepared to meet the increasing need. We have evaluated the in vivo viability and in vitro properties of platelets that were prepared from whole blood drawn into citrate-phosphate-dextrose-adenine (CPDA-1) either immediately after phlebotomy or after an 8-hour hold at 20 to 24 degrees C. Platelet concentrates were stored for 5 days at 20 to 24 degrees C in polyolefin containers (PL 732, Fenwal) with end-over-end tumbler agitation. The autologous in vivo recovery (mean +/- SD) and one-half disappearance of 51Cr-labeled platelets prepared immediately after phlebotomy were 44.4 +/- 9.4 percent and 4.0 +/- 0.5 days, respectively. Platelets prepared after the delay of 8 hours showed a recovery of 44.5 +/- 8.4 percent and a one-half disappearance of 4.1 +/- 0.4 days. After 5 days of storage, platelet concentrates showed a mean pH of 7.21 +/- 0.20 when prepared immediately after phlebotomy, and of 7.22 +/- 0.15 when prepared after an 8-hour delay. Mean morphology scores were 280 +/- 33 and 302 +/ 27 for platelets from units prepared immediately after phlebotomy or after a holding period of 8 hours, respectively. Platelets underwent synergistic aggregation after 5 days of storage, independent of the length of time that the units of whole blood were held prior to centrifugation. These studies indicate that platelet concentrates prepared from units of whole blood held initially for 8 hours can be stored for 5 days at 20 to 24 degrees C and survive satisfactorily in vivo and retain in vitro characteristics. PMID- 6485078 TI - Mitogen response of lymphocytes in platelet concentrates. Effect of storage and adenine. AB - The mitogen responsiveness of lymphocytes obtained from platelet concentrates under standard platelet storage conditions was measured. Blastogenic response to phytohemaglutinin, concanavalin A, and pokeweed mitogen declined significantly during storage to 19, 51, and 26 percent respectively of original activity. The presence of adenine supplementation in the anticoagulant preservative solution did not significantly effect the mitogen responses. PMID- 6485079 TI - Red cell and platelet-bound IgG penicillin antibodies in a patient with thrombocytopenia. AB - A patient was found to have a positive direct antiglobulin test and thrombocytopenia while on a moderate dose of intravenous penicillin. Serological evaluation of the patient's red cells demonstrated that the positive antiglobulin test was due to antipenicillin antibody. This antibody also was demonstrated in the patient's serum. The patient's platelets had increased quantities of IgG; an eluate from her platelets gave positive test results with platelets treated with penicillin but not normal platelets. Her serum also reacted only with penicillin treated platelets. Multiple absorptions of her serum with red cells treated with penicillin reduced reactivity against both fresh red cells and platelets treated with penicillin. This patient demonstrated the coexistence of drug-induced immune phenomena directed against both red cells and platelets. PMID- 6485080 TI - A comparison of two behavioral influence techniques for improving blood donor recruitment. AB - This study was designed to test the viability of two multiple request techniques of behavioral influence for recruiting blood donors by telephone. The first technique utilizes a small antecedent request to encourage behavioral involvement and favorable disposition toward the target activity of the critical request to donate. The second approach frames the critical request as a concession following refusal of a very large request. The two techniques, dubbed the foot-in-the-door (FID) and door-in-the-face (DIF), respectively, were tested against a control condition on three donor groups: active donors, inactive donors, and nondonors. Thus, a three-by-three factorial design was used on 910 adults in a Midwest city. Although the DIF was outperformed by the control across all three donor groups, the authors recommend its continued study in face-to-face donor solicitation. Importantly, the FID approach produced more donations than the control condition among active donors (Z = 4.30; p less than .001), inactives (Z = 7.45; p less than .001), and nondonors (Z = 1.98; p less than .05). For managing the blood supply, the FID is particularly potent for rekindling donations from inactive donors. Additional research on means of penetrating the nondonor segment is recommended. PMID- 6485081 TI - The use of hepatitis B marker prevalences in regional blood center employees as a guide to vaccination policy. AB - Hepatitis B vaccination has been recommended for health care personnel having frequent contact with blood. Serologic markers of hepatitis B infection were studied in employees of this regional blood center to determine the prevalence of infection in our population. PMID- 6485083 TI - Granulocyte concentrates: leukapheresis vs. bone marrow aspiration. PMID- 6485082 TI - Treating severe hemapheresis donor reactions. PMID- 6485085 TI - Misleading effects of chloroquine. PMID- 6485084 TI - Increased yield of leukocytes from blood stored overnight. PMID- 6485086 TI - Acute hemolytic transfusion reaction due to ABO incompatible plasma in a plateletapheresis concentrate. PMID- 6485089 TI - Migrating Langerhans cells in human skin: mitogen and alloantigen presenting properties. PMID- 6485087 TI - Lectin in cannabis. PMID- 6485088 TI - Rapid temperature check for heat blocks. PMID- 6485090 TI - Cyclosporine: an overview. PMID- 6485091 TI - [Effect of hydroxyurea on the number of hematopoietic stem cells, stromal cell precursors and cell precursors of thymus lymphoid tissue in the bone marrow of mice during aging]. AB - The concentration of hemopoietic stem cells (colony-forming cells in the spleen - CFC-S) decreases in the bone marrow of CBA mice during ageing, whereas the concentration of precursors for stromal fibroblasts (colony-forming cells for fibroblasts-CFC-F) increases. The total numbers of nucleated cells, CFC-S and CFC F in the bone marrow of old mice essentially increase. Hydroxyurea, administered in vivo, does not effect the concentration of CFC-S, but it increases CFC-F concentration in the bone marrow of mice. Hydroxyurea produces just the same suppressive effect on the numbers of nucleated cells, CFC-S and CFC-F in the mice of different ages, and stimulates the capacity of bone marrow donors to repopulate the thymus of the irradiated young recipients. PMID- 6485092 TI - [Kinetic characteristics of the normal enterocyte population and in carcinogenesis]. AB - A correlation was revealed between the crypt cell proliferation changes and variations in adhesion among mature enterocytes at the extrusion zone: an increase in the proliferative activity is accompanied by a decrease in the cell adhesion, and vice versa. This dependence exists in the normal tissue and possibly serves for the epithelium protection from hypo- and hyperplasia. A distinctive feature of carcinogen treatment is the irreversible disturbance of the dependence. PMID- 6485093 TI - [Calculation of Steel's cell loss factor and of the parameters of cellular kinetics for a population with an exponential growth of the cell number and cell death at G0 phase with a probability equal to 1]. AB - The method of calculation of three cell kinetics parameters (the Steel's cell loss factor phi, the proliferative pool Pc, and the mean number m of the proliferating cells after mitotic division of one cell) was shown to be the same for the exponential growth state of cell number with cell death at the G0-phase, and for the exponential growth state with cell death occurring immediately after mitosis. The value of the mean number delta of non-proliferating cells that appeared after mitotic division of one cell is different for these two models of the exponential growth state with the equal values of the other three parameters (phi, Pc, and m). A method is proposed for calculating the parameter delta on the data of the percentage of labeled cells obtained in the experiments with continuous cultivation of cells in the nutrient medium containing 3H-thymidine. The kinetics of cell line HL-60 (the experimental data of Foa et al., 1982) can be described at the first approximation, by a model of the exponential growth state with the cell death at the G0-phase, with Pc = 0.80, phi = 0.24, m = 1.61, delta = 0.39, and the life time of the non-proliferating cells tQ = 24 hours. PMID- 6485094 TI - [Electron microscopic analysis of the structure of metaphase chromosomes after liposome treatment]. AB - The fine structure of the methaphase chromosomes from the Chinese hamster cell culture was studied after the incubation with lyposomes isolated from hen egg yolk phosphatidilcholine, or from the total rat liver phospholipid. It has been found that during incubation lyposomes surround chromosomes, form a multifold covering considerably decondensing the chromosome matrix. The data obtained indicate that the analogues of cell membrane - lyposomes - may be involved in the regulation of the structural organization of metaphase chromosomes. PMID- 6485095 TI - [Action of UV radiation on the surface of mammalian immunocompetent cells. III. Ultrastructural changes in the glycocalyx of mouse lymphocytes]. AB - The outer perimembrane layer of murine spleen lymphocytes were studied with electron microscopy. Mice were treated with short-wave (254 nm) and long-wave (365 nm) ultraviolet radiation in isoeffective lethal doses. The other perimembrane layers were stained with Alcian blue and Ruthenium red. The 254 nm UV treatment decreased the level of dye--sorption by these perimembrane layers, whereas no such effect was obvious after the 365 nm UV treatment. PMID- 6485096 TI - Serological studies with peste des petits ruminants and rinderpest viruses in Nigeria. AB - One hundred and ninety-five goat and 67 sheep sera collected from various parts of southern Nigeria were screened for neutralising antibodies to both the peste des petits ruminants (PPR) and rinderpest viruses. Neutralising antibodies against both viruses were found in the sheep and goat sera examined. Parallel titration of samples which neutralised both viruses indicated a primary infection with the PPR virus (PPRV). However, some samples which failed to neutralise PPRV neutralised the rinderpest virus (RV) indicating RV activity in sheep and goats in Nigeria. These findings are discussed in relation to the diagnosis of PPRV infection and the recent reappearance of bovine rinderpest in Nigeria. PMID- 6485097 TI - Serum-virus simultaneous method of immunisation against peste des petits ruminants. AB - Peste des petits ruminants (PPR) hyperimmune serum was prepared in cattle and used to protect goats against PPR. The serum was well tolerated by goats and 8 ml of serum was found to protect goats against 4 ml of pooled virulent PPR virus. A durable active immunity was conferred on goats when serum and virulent PPR virus were given simultaneously. Passive immunity lasted for 15 days. PMID- 6485098 TI - African swine fever in Malawi. PMID- 6485099 TI - Epidemiology of tick-borne diseases of cattle in Zimbabwe. II. Anaplasmosis. AB - A survey on the incidence of antibodies to Anaplasma marginale in one- to three year-old cattle was carried out in Zimbabwe using the capillary tube agglutination test. Antibodies were detected in all but one of 118 batches of sera collected from different localities throughout the country. There was no clear relationship between the frequency of occurrence of positive serological reactors, which was similar in both commercial and communal farming areas, and the incidence of clinical anaplasmosis. However, the highest numbers of cattle exhibiting positive reactions were generally recorded from the areas that were most heavily tick infested. There was evidence that wild ungulates may serve as reservoirs of infection as antibodies to A. marginale were detected in sera from buffalo (Syncerus caffer) and impala (Aepyceros melampus). PMID- 6485100 TI - Boophilus microplus tick burdens on grazing cattle in Colombia. AB - This study was conducted at Carimagua Research Centre in a well-drained savanna area in the eastern plains of Colombia. The objectives were to note the effect of ecological factors on tick burdens, principally the effect of the environment given by four grasses on the seasonal variations of tick populations. Adult female tick counts were carried out on heifers grazing four pastures and tick larvae on the grass detected by cloth dragging. Tick counts were significantly higher on animals grazing Brachiaria decumbens than those grazing Andropogon gayanus, Melinis minutiflora or native pastures. Tick larvae counts on the grass showed a similar tendency. Introduced grasses and intensification of production will require greater care to control tick infestations since increases in stocking rate and ground coverage could augment tick populations. PMID- 6485101 TI - Ovine internal parasitism in the Yemen Arab Republic. AB - Internal parasitism was studied in five flocks in different regions of the Yemen Arab Republic. Ewes and lambs were faeces sampled from the spring of 1977 to the spring of 1978 and helminth-free tracer lambs were subsequently run with three of the flocks from October 1978 to November 1979. The findings indicated that ovine helminthiasis and fascioliasis may be of importance with the following regional variations: Haemonchosis all the year round in the Tihammah coastal plain. Haemonchosis and trichostrongylosis in the periparturient period in the Southern Uplands and Western Foothills. Fascioliasis and nematodiriasis in the Inter Montane Plains of the Highlands. Possible control regimes are suggested for further investigation. PMID- 6485102 TI - Tsetse and trypanosomiasis survey of Southern Darfur province, Sudan. II. Entomological aspects. AB - Atsetse survey of Southern Darfur province, Sudan showed that the distribution of the only species present, Glossina morsitans submorsitans, had not appreciably altered over 10 years. Fly populations are most dense south of the Wadi Umbelasha but light infestations are found in the woodlands north of this riverine system to a latitude of about 10 degrees 15' N. Data are given on host availability which is thought to be the major factor determining tsetse distribution. The relative importance of tsetse and of tabanids as transmitters of bovine trypanosomiasis in the province is discussed. The evidence indicates that tsetse are very much more important and that cattle are most at risk of contracting infections during their dry season southerly migrations to the tsetse belts especially during their "Rushash" migration at first rains. Possibilities of tsetse control are discussed but in the short term trypanosomiasis control is most likely best achieved by chemical prophylaxis/therapy of cattle at risk. PMID- 6485103 TI - Acute Trypanosoma vivax infection of Ethiopian cattle in the apparent absence of tsetse. AB - Investigations of acute trypanosomiasis in a group of 1,200 cattle provided strong evidence for mechanical transmission by haematophagous flies other than tsetse. Although recently introduced cattle may have had previous contact with tsetse flies the incident occurred in an area remote from their known range. Mortality exceeded 6% before the outbreak was controlled by chemotherapy. Mechanically transmitted Trypanosoma vivax infection may be of widespread occurrence in eastern Ethiopia. PMID- 6485104 TI - Trypanosomiasis in camels in the sultanate of Oman. PMID- 6485105 TI - Internal parasitism in milk goats in Kenya. AB - Observations were made on individual cases and on herds showing the effects of internal parasitism on the health and productivity of Toggenberg and Saanan goats. The clinical reactions varied markedly being influenced by the degree of infestation and duration of illness. Typical cases showed emaciation, anaemia, oedema, weakness and sometimes diarrhoea and death. Faecal analyses were dominated by strongyle egg counts which rose progressively throughout the study period. Overstocking led to some animals being at greater risk. PMID- 6485106 TI - Production effects of the liver fluke Fasciola hepatica on weaner cattle in Papua New Guinea. PMID- 6485107 TI - Infectivity and pathogenicity of Fasciola gigantica in West African dwarf sheep and goats. AB - The infectivity and pathogenicity of Fasciola gigantica for sheep and goats were investigated in animals infected with single doses of between 200 and 2,000 metacercariae. Acute fascioliasis occurred in sheep infected with 1,000 to 2,000 cysts in which 10 to 17% of the cysts became established. The infected animals died 80 to 90 days after infection. In goats given the same infective doses death from acute fascioliasis occurred earlier (70 to 83 days after infection) and 12 to 38% of cysts became established. Subacute fascioliasis could occur in both hosts with an infective dose of 200 cysts, the animals surviving for more than 100 days. It therefore appears that F. gigantica is more infective for goats and that the disease was more severe in this host than in sheep. PMID- 6485108 TI - Serum enzyme activities in experimental Ondiri disease. PMID- 6485109 TI - Performance of Canadian Holstein-Friesian cattle in the humid forest zone of Ghana. II. Preweaning performance. AB - Birth weights, weaning weights and average daily gains of 97 calves born to 27 Holstein-Friesians imported from Canada were used. Adjusted mean birth weight, weaning weight and daily gain were 35.6, 104.6 and 0.5 kg respectively. Of the three variables studied sex of calf significantly influenced only birth weight whereas season of birth, sire of calf, parity of dam and year of birth significantly influenced weaning weight and daily gain but not birth weight. Sex, season, sire, parity and year all together accounted for 18.35, 43.49 and 46.09% of the variation in birth weight, weaning weight and daily gain respectively. Birth weight increased by 0.29 kg/day increase in gestation length and 0.027 kg/kg increase in calving weight, whereas weaning weight increased by 1.31 kg/kg increase in birth weight. Birth weights, weaning weights and daily gains observed here are similar to previous reports from other tropical environments. PMID- 6485110 TI - Crossbreeding cattle in beef production programmes in Kenya. I. Comparison of purebred Boran and Boran crossed with the Charolais, Ayrshire and Santa Gertrudis breeds. AB - Data collected on a privately owned ranch located in the Machakos District of Kenya at approximately 2 degrees latitude south of the equator at an elevation varying from 1,675 to 2,000 m were analysed on five breed groups of cows: (1) purebred Boran, (2) 1/2 Charolais-1/2 Boran (1/2 C-1/2 B), (3) 3/4 Boran-1/4 Charolais (3/4 B-1/4 C), (4) 1/2 Ayrshire-1/2 Boran (1/2 A-1/2 B) and (5) 1/2 Santa Gertrudis-1/2 Boran (1/2 SG-1/2 B). The maternal traits evaluated included age at first calving, calving interval, calf weight at weaning and cow productivity index (calf weight weaned annually per cow calving). Mean cow productivity index for all cows was 192 kg; for purebred Boran, 174 kg; for 1/2 C 1/2 B, 200 kg; for 3/4 B-1/4 C, 191 kg; for 1/2 A-1/2 B, 210 kg; and for 1/2 SG 1/2 B, 185 kg. Cow breed groups 1/2 C-1/2 B, 3/4 B-1/4 C, 1/2 A-1/2 B and 1/2 SG 1/2 B exceeded (P less than 0.01) purebred Boran by 14.9, 9.8, 20.7 and 6.3%, respectively, in cow productivity index. PMID- 6485113 TI - Survey of patients presenting to the government chest service in Hong Kong and the effects of active tuberculosis case-finding by publicity campaigns. Hong Kong Chest Service/British Medical Research Council. AB - A previous survey showed that many of the patients diagnosed in a Government chest clinic as new cases of active pulmonary tuberculosis had already attended one or more private practitioners, and that this often resulted in a considerable delay before first attending the Government clinic. Furthermore, outside the Government clinics the standards of investigation, diagnosis and treatment were found to be very variable and patients were, in general, ill informed about the Government chest clinics and the free service they offered. Active case-finding campaigns using television, radio, posters, and leaflets were therefore conducted in 1979 and 1981 and the effects of the campaigns monitored. The aim was to encourage people with a cough which had lasted for a month or more to attend a Government chest clinic for free advice and, if necessary, treatment. In the event, during and immediately after the campaigns there were only minor increases in the numbers of new clinic attenders and of patients with cough, and there were no detectable increases in new cases of tuberculosis. The campaigns failed, in particular, to persuade middle-aged and elderly men with cough and sputum to attend a clinic, although there is evidence that in this group there is a high incidence of tuberculosis requiring treatment. PMID- 6485111 TI - Liver copper concentrations in cattle in Salta province, Argentina. PMID- 6485112 TI - Survey of the previous investigation and treatment by private practitioners of patients with pulmonary tuberculosis attending government chest clinics in Hong Kong. Hong Kong Chest Service/British Medical Research Council. AB - A questionnaire was applied to 159 consecutive patients with smear-positive and 187 with smear-negative pulmonary tuberculosis attending the 8 full-time Government chest clinics in Hong Kong for the first time for their current illness, who had already attended a private practitioner at a private general practice, a private clinic, or an independent hospital, outside the Government or Government-subsidised Service. The aim was to obtain details of management by private practitioners, and in particular of the antituberculosis chemotherapy prescribed. The great majority (86%) of the patients had originally attended a private practitioner because of symptoms. Only 18% had had their sputum examined, although 76% had had a chest radiograph; 65% of the smear-positive and 71% of the smear-negative patients had been told that they had, or might have, tuberculosis. For 40% there was an interval of more than a month between their first attendance at a private practitioner and at a Government chest clinic. Only 11% of the patients were referred without delay to a Government chest clinic, and another 21% once tuberculosis had been diagnosed or suspected. The patients were asked to name the drugs they had been prescribed, to produce samples, or to identify them from a perspex board containing samples of all 49 antituberculosis tablets and capsules known to be available in Hong Kong at the time. In the event, only 11% of the patients could name some or all of their medicaments and only 7% could produce samples, although a further 76% were able to describe them with or without the aid of the perspex board. In all, 19% of the patients were definitely or probably prescribed an antituberculosis regimen, although this was not always an adequate regimen. The findings suggest that there is considerable scope for active case-finding aimed at encouraging patients who are likely to have tuberculosis to attend a Government chest clinic. PMID- 6485114 TI - Ferritin levels in patients with microcytic anaemia complicating pulmonary tuberculosis. AB - In a sample of 33 Nepali patients with microcytic, hypochromic anaemia complicating pulmonary tuberculosis, only 15% were iron deficient as judged by absence of stainable bone marrow iron. Individual ferritin levels in the iron deficient subjects were all within the normal range, although as a group their mean ferritin was significantly lower than in the non-iron deficient patients (104 micrograms/l v 349 micrograms/l p less than 0.05). It is suggested that in pulmonary tuberculosis ferritin synthesis is stimulated by the inflammatory process regardless of iron status and that the level of ferritin below which iron deficiency may be diagnosed is much higher than the accepted level of 15 micrograms/l. PMID- 6485115 TI - Qualitative differences in tuberculin reactivity in patients with tuberculosis, occupational contacts and non-contacts. AB - Qualitative differences in tuberculin reactivity between patients with pulmonary tuberculosis, occupational contacts and non-contacts were observed. An erythematous reaction at 6-8 hours was frequently observed in both patients and contacts but much less frequently in non-contacts. Itching and the presence of superficial bullae occurred principally in the contact group, and the erythematous reactions at 48 hours were largest in this group. Attention needs to be paid therefore to several characteristics, other than size, of the tuberculin reaction. PMID- 6485116 TI - Massive haemoptysis caused by Mycobacterium xenopi. AB - A 62-year-old man presented with haemoptysis and radiographic features compatible with pulmonary tuberculosis. His course was complicated by severe haemoptysis that required surgical lobectomy. Mycobacterium xenopi was cultured from sputum and lung tissue. The post-operative course was complicated by gastro-intestinal haemorrhage and the patient died. PMID- 6485117 TI - Lymphadenitis as a late complication of BCG vaccination. AB - Lymphadenitis is a relatively common complication following intradermal BCG vaccination, and usually occurs 6 to 9 months after injection. However, lymphadenitis following BCG given by the scarification method is rare. We report a case of BCG lymphadenitis occurring 11 and 18 years after vaccination by the scarification method. PMID- 6485118 TI - Contralateral pleural effusion during chemotherapy for tuberculous pleurisy. AB - A 46-year-old woman developed a right pleural effusion 8 weeks after standard chemotherapy for tuberculous pleurisy on the left side had been started. Pleural biospy demonstrated caseous granulomatous changes. The patient improved following continuation of the same treatment. PMID- 6485119 TI - Improvement of psychomotor epilepsy due to interaction of phenytoin-isoniazid. PMID- 6485121 TI - Cilia in the human kidney. AB - Utilizing transmission electron microscopy we have found multiple cilia with a 9 + 2 microtubular pattern (the same type found in the bronchial tree) in the renal tubules of four adults with the nephrotic syndrome. Each patient had a different pathologic diagnosis: amyloidosis, lipoid nephrosis, membranoproliferative glomerulonephritis, and focal segmental glomerulosclerosis. Previously, multiple renal tubular cilia with 9 + 2 architecture had been reported in patients with Burnett's syndrome, systemic lupus erythematosus, and congenital nephrotic syndrome. Additionally, we found multiple cilia in the metanephric tubules of 4 of 4 human fetuses. Pathologists should be aware that cilia with various microtubular patterns occur in human adult kidneys. PMID- 6485120 TI - Tannic acid binding of cell surfaces in normal, premalignant, and malignant squamous epithelium of the human uterine cervix. AB - Alterations in tannic acid (TA) binding capacity of cell surface carbohydrates in normal, premalignant, and malignant squamous epithelium of the human uterine cervix have been studied using electron microscopic visualization in combination with microdensitometric evaluation. While in normal epithelium there is distinct binding in four to five cell layers of the deep intermediate zone, cells of carcinoma in situ and invasive cancer lesions lack TA binding. In moderate dysplasia an intermediate reacting pattern is found. Deep intermediate cells in areas bordering the carcinoma in situ lesions do not show any binding, although their ultrastructure cannot be distinguished from similar cells in normal tissue. The TA deposition within the deep intermediate zone is probably related to the presence here of glycoprotein-containing membrane-coating granules. The finding that TA binding discriminates between cells in normal squamous epithelium and morphologically normal cells in juxtaposition with lesional areas in premalignant and malignant epithelium opens the possibility for a more reliable cytologic diagnosis of cervical epithelial neoplasia. PMID- 6485122 TI - Surface ultrastructure of the small intestine mucosa in children with celiac disease. I. Untreated disease and effects of long-term gluten elimination and challenge. AB - Forty-eight gut mucosa specimens from 27 children with celiac disease, diagnosed by means of conventional serial biopsies taken at different dietary conditions, were studied by means of scanning electron microscopy (SEM). The observations were correlated with those made by concomitant dissection microscope (DM), light microscope (LM), and transmission electron microscope (TEM) examinations. Five children with constitutional short stature served as controls. The results of the SEM analyses were in good conformity with the observations made by DM, LM, and TEM. In addition, SEM was found to offer further structural variables to be analyzed. In active celiac disease and after challenge with dietary gluten, which is necessary to establish the diagnosis of children, the lesions specifically observed by SEM were (1) a strikingly uniform destruction of the villi and a distortion of the enterocytes but with preserved extrusion zones, and (2) a decrease and disruption of the glycocalyx of the enterocytes with marked irregularity of the microvilli. After successful dietary treatment and despite a normalization of the gut mucosa by routine LM, SEM often disclosed persisting lesions of the enterocytes. It was concluded that by inclusion of SEM in the routine assessments of gut biopsy specimens in children with celiac disease, the diagnostic precision becomes increased. PMID- 6485123 TI - Ultrastructure of human respiratory cilia: a study based on serial sections. AB - Ultrastructure of human respiratory cilia was studied in ultrathin serial sections and in random fields of sections. The apex of the cilium had dense gray material under the plasma membrane, where the "central" pair of tubules (often slightly eccentrically placed) and the single peripheral tubules ended. Thereafter the cilium thickened gradually about 1 micron below the apex and after that remained reasonably constant. At about 0.5 micron below the apex was a transformation zone (0.1 micron long), where both double and single peripheral tubules were seen. Dynein arms were not seen in the transformation zone but occurred approximately 0.1 micron below it. In a cilium, one peripheral double tubule was absent in the transformation zone but was seen about 0.2 micron below. This resulted in an artificial 8 + 2 pattern in a few sections. In cross sections at levels with peripheral double tubules the mean of the minor axes of the cilia was 0.198 +/- 0.009 micron (+/- SD) calculated from the serial sections of one patient. In 20 patients the variation was greater and the mean was higher: 0.210 +/- 0.042 micron (+/- SD). PMID- 6485124 TI - Small cell tumor in a 24-year-old male. PMID- 6485125 TI - A fast method for processing biopsy material for electron microscopy. AB - A rapid method for fixation and embedding of biopsy material for electron microscopic examination has been developed. The procedure was simplified by fixing the biopsies with fixative in ready-to-use ampules and hastened by chemical dehydration in 2,2-dimethoxypropane. The procedure takes 4 h and yields excellent results. PMID- 6485126 TI - Amelanotic malignant melanoma. PMID- 6485127 TI - Cytoplasmic vacuoles. PMID- 6485128 TI - A cold stage for the Philips EM300 electron microscope. AB - A cold stage has been constructed for the Philips EM300 (and EM301) electron microscopes for investigating the structure of frozen-hydrated biological specimens. The stage entails minimal alterations to the instrument and is capable of a resolution better than 10 A at the normal operating temperature of -120 degrees C. Frozen specimens can be readily exchanged without condensation or warming up, and maintained in the stage over periods of several hours without detectable deterioration. PMID- 6485129 TI - Detection of X-rays and electron energy loss events in time coincidence. AB - Experiments are described in which characteristic X-rays are detected in coincidence with the electron energy losses that are responsible for these X rays. The possibility to use this technique for improving the detection limits of microanalysis is evaluated. It is concluded that, because of the occurrence of false coincidences, better than the state-of-the-art instrumentation will be required for most practical applications. PMID- 6485130 TI - The "quasi-thermal" mechanism for electron beam damage of n-paraffins. AB - Electron diffraction patterns from epitaxially grown microcrystals of n hexatriacontane, which are slightly damaged by the electron beam, strongly resemble those from the same material when it is warmed just below the pre-melt hexagonal phase. The identity of these diffraction patterns, which display a marked attenuation of lamellar 001 reflections but much less alteration of the strongest reflections, implies that both processes occur via the induction of chain defects which, in turn, generate chain-end voids in the crystal packing. Such defects, however, need not be identical for the two events. With warming they are probably the gtg-1 kink and the gauche chain conformers identified by infrared spectroscopy. The creation of trans vinylene groups during radiation damage will also increase chain flexibility, and perhaps induce the production of gtg-1 kinks. PMID- 6485131 TI - Dynamical electron scattering from negatively stained protein microcrystals. AB - Multislice n-beam dynamical calculations have been carried out at 20 and 15.6 A resolution to simulate the electron scattering from a negatively-stained protein microcrystal using a model based on the crystal structure of E. coli matrix porin. Images at t = 100 A, i.e. the thickness of reconstituted vesicle preparation, correspond to the projected potential of the kinematical structure. The kinematical model is valid at least to t = 500 A, beyond which the projected image symmetry does not correspond to the actual structure. If a crystallographic residual limit R = 0.20 is imposed, the electron diffraction intensity data correspond to the kinematical data up to t = 700 and 1000 A, respectively, for 15.6 and 20 A resolution. PMID- 6485132 TI - [Biomechanical studies of bone treated with intramedullary nailing, with special reference to possible axis deviations]. AB - The effect of a misalignement of a nailed bone on the stress distribution in the cross section is shown theoretically. Also for pure axial loading of the bone a superposed bending due to the misalignement produces large tension stresses as well in the nail as in the bone, when the fracture is not healed. After healing the stresses in the nail and in the bone are reduced striking. The removing of the nail does not increase the stresses in the bone significantly. PMID- 6485133 TI - [Perioperative antibiotic therapy--clinical experiences with a combination of mezlocillin/sisomicin in accident surgery]. AB - The clinical and bacteriological efficiency of the combination Mezlocillin and Sisomicin was studied in 25 patients from the Department of trauma. In 9 cases the combination of antibiotics was used for treatment of manifest infections. 16 patients received a prophylaxis before and after operation. Among them were patients with open fractures, with a large soft tissue damage, polytraumatized patients with multiple injuries or patients with pathological fractures. Dosage of Mezlocillin was 4 g every 8 h, and dosage of Sisomicin was 75 mg every 8 h. Mean duration of therapy was 6 days. In 24 cases the combination of antibiotics was successful. In one case occurred a postoperative haematoma without bacterial findings. In all infections (9 cases) isolated germs were achieved with the combination Mezlocillin and Sisomicin. PMID- 6485134 TI - [Hematogenous osteomyelitis of the femur in elderly patients--special forms of pathogenesis]. AB - We present two cases of hematogenous osteomyelitis of the femur in patients who have undergone vascular surgery. We describe the course of disease, the diagnostic considerations and the therapeutic measures. Typical is the painfullness without recognizing the cause during the first days, more or less signs of inflammation of the organism, elevation of ESR. Only with distinct delay there are local signs of inflammation. Not before ten days the normal x-ray shows periosteal reactions and areas of lysis, sooner you can find indications in the CT scan (gas, changed density). After combined antibiotic and surgical treatment one case is healed, in the other occurs spontaneous fracture and amputation, and because of relapse in the stump exarticulation. In the latter case, one of the essential factors for the poor outcome is the low blood perfusion of patients with vascular disease. PMID- 6485136 TI - [Treatment guidelines and results in severe open tibial fractures]. AB - 27 patients with compound fractures of the lower leg were treated according to the following scheme: Exact excision and surgical cleaning of the wound, reduction of the fragments without further exposure of the bone by additional incision, minimal osteosynthesis, stabilization by means of external fixation device and secondary closure of the accidental wound. During the last year we preferred the V-shaped arrangement in contrast to the tent shaped arrangement of the external fixation device as this minimizes the trauma to the extensor muscles of the foot. After external fixation combined with minimal osteosynthesis (n = 10) the patients had to stay in hospital for 6 weeks only. There was no infection at the incision of neither Steinmann-pins nor Schanz-screws and posttraumatic ostitis only in 1 case was seen. On an average only one secondary operation was necessary, a spongious bonegraft only at 3 patients. On an average the patients had the external fixation device for 5 months, bony union of the fracture was observed after 9 months. In case of external fixation without minimal osteosynthesis (n = 17) the patients had to stay in hospital for 16 weeks, 9 of them had infections at the incision of the Steinmann-pins, 9 of them developed posttraumatic ostitis with fistulae. On an average 4 secondary operations were necessary per patient and 9 patients needed a spongious bonegraft to get bony union of the fracture, which was reached on an average of 17 months. PMID- 6485135 TI - [Irreducible dislocations of the metacarpophalangeal joints]. AB - Within a period of twelve years, the authors have treated twelve patients with metacarpophalangeal joint luxations of thumb and long fingers which could not be reposed by conservative treatment. The case reports are presented in order to describe the problems posed by this relatively rare injury, the reasons hindering a reposition, and the treatment methods. This study is intended to underline the importance of early diagnosis and immediate surgical treatment in order to maintain the function of the joint. PMID- 6485137 TI - [Primary and secondary arthrodeses following talus fractures]. AB - In 18 cases out of 55 patients, who had been operated on talus fractures in our clinic, a primary or secondary arthrodesis of one or both adjacent joints had been necessary. We carried out a follow-up examination on those 18 patients. In 4 cases a primary or early secondary arthrodesis had been performed; the attempt to reconstruct the joint surfaces after the trauma would have been not promising. The indication of the secondary arthrodesis in the 14 patients is discussed. In all the patients there had been a bony healing of the arthrodesis in an adequate time, the gait pattern of the patients had been improved and they complained less pain. We conclude that in case of a not solvable complication after talus fracture like destroyed joint surfaces, secondary severe arthritis or bone necrosis early secondary arthrodesis should be considered as a measurement to avoid long periods of insufficient conservative treatment. PMID- 6485138 TI - [Fracture of the base of metatarsus V--conservative or operative treatment?]. AB - A follow-up study is given of 138 fractures of the base of the metatarsale V. In the years 1976-1980 124 of these fractures were treated conservatively, 14 operatively. In 1982 all patients were examined personally to find out the treatment with the best results. According to these results the authors consider the conservative treatment the preferable method. PMID- 6485139 TI - [Dislocation of the thumb saddle joint]. AB - Pure dislocation of the thumb joint is rare. The mechanism is a directed trauma along the 1. metacarpal joint in slight flexion. The reposition is simple. A anteroposterior view is necessary to ascertain the carpometacarpal joint of the thumb. PMID- 6485141 TI - On conservative treatment of subcapital fractures of the fifth metacarpal bone. PMID- 6485140 TI - [Traumatic hemipelvectomy--report of 2 cases]. AB - Report and progress of 2 traumatic hemipelvectomies in motor-cyclists with excluding extraperitoneal tearing of half of the pelvis and disrupture of the pelvic vessels. No intraperitoneal injuries, no hurt of the equilateral kidney or the urinary tract; one with complete anal incontinence because of disrupture of the perineal muscles, one case without permanent anal insufficiency. Especially preposition in motor cyclists high velocity and excluding direct influence of power to the concerning pelvic side and the corresponding lower extremity. PMID- 6485142 TI - Physiology of water immersion. PMID- 6485143 TI - Respiratory function during simulated wet dives. AB - This presentation focuses on the effects of static lung loading (SLL) on diver performance. It is noted that SLL may arise from depth differences between the diver's chest and his breathing gear. Studies are reviewed in which subjects undergoing wet, simulated dives in a pressure chamber were exposed to SLL ranging from 14.7 to -14.7 mmHg (+20 to -20 cmH2O) while breathing air at depths down to 58 m (190 ft). The subjects, assuming a prone or an upright position, performed leg exercise on an underwater bicycle ergometer. Various measurements of respiratory function were made. By applying a scoring scale for dyspnea it was found that in addition to being more pronounced as exercise and depth (gas density) increased, the dyspnea was most pronounced with negative SLL. Positive SLL alleviated the dyspnea. The dyspnea also tended to be more pronounced in the prone than in the upright posture. It was speculated that this may have been partly due to more of a compression effect on the extra thoracic airways by water pressure in the former than in the latter posture. There were no marked differences in gas exchange and end-tidal gas concentrations with different static lung loads, and it was hypothesized that differences in respiratory muscular strain may have accounted for the differences in dyspnea with different SLLs. That the dyspnea was inspiratory in nature would agree with the observation that positive SLL aiding inspiration would be perceived as beneficial. A breathing apparatus design that counteracts undesirable SLL is reviewed. PMID- 6485144 TI - Energy exchanges in water. AB - The thermal physical properties of water make water a medium of high heat transfer relative to air. This paper describes the body temperature pattern during immersion in still and moving water, the avenues for energy exchange, the energy transfer characteristics of humans, and the physiological means by which the body attempts to compensate for the excess heat loss in water. Fat is the major defense against cooling in water when exercising or shivering. Skeletal muscle is a significant additional factor during quiet rest. PMID- 6485145 TI - Decrease in body insulation with exercise in cool water. AB - Steady-state body insulation was measured in 7 healthy male subjects during rest and exercise for 3 h in water of 28 degrees C - 32 degrees C. At rest, maximal body insulation increased as a linear function of mean subcutaneous fat thickness by an amount approximately 4-fold what would be predicted from the physical insulation of fat alone. With arm plus leg exercise, body insulation declined as an exponential function of the exercise intensity, reaching approximately 25% of the resting value at work loads above VO2 = 1.2 liters.min-1. During exercise the relationship between overall body insulation and mean subcutaneous fat thickness was almost identical to that predicted from fat insulation and mean subcutaneous fat thickness was almost identical to that predicted from fat insulation alone. These results suggest that 75% of maximal body insulation in resting subjects is achieved by use of skeletal muscle as an insulative barrier and that the muscle component is increased with increasing fat thickness. This muscle insulation shell is lost during exercise. As a practical consequence, heat generated by muscular exercise in water colder than critical water temperature cannot offset cooling unless the exercise intensity is great. PMID- 6485146 TI - Cardiovascular and renal responses to head-out water immersion in canine model. AB - Water immersion (WI) of anesthetized dogs to the midcervical level in the vertical sitting position under thermoneutral conditions (38 degrees C) leads to generalized increases in regional blood flows (radiolabeled microspheres) to most tissues. The increased flows can be accounted for by increased local VO2 in some tissues (heart, respiratory muscle), or by local heating (skin, fat). However, an alteration in the relation between cardiac output (Q) and VO2 appears to play a role in the large flow increments observed in skeletal muscle and abdominal viscera in WT. Studies of conscious, chronically instrumented dogs during 100 min of thermoneutral WI at 37 degrees C in the quadruped position indicate that both left atrial and aortic transmural distending pressures and left ventricular contractile performance (LV dP/dtmax) increase, while total peripheral resistance is unchanged. Cardiac output increases largely in association with an increase of heart rate. In addition, urine flow, sodium excretion, and osmolal clearance all increased. The cardiovascular adjustments occurred more rapidly than the renal responses. These results indicate that the conscious dog may be useful for investigation of physiological mechanisms involved in the WI response. PMID- 6485147 TI - Synthesis of cytochrome P-450 in isolated liver cells during exposure to hyperoxia. AB - Mouse hepatocytes were separated within 15 min of the death of the animal. A method of determining cytochrome P-450 was developed and used to show that cells prepared quickly still contained normal levels of this pigment. Cells suspended in complete culture medium were exposed to various partial pressures of oxygen for 30 min. When exposed to anoxia there was a 30% loss of cytochrome; at 30-50 Torr, a 30% increase; to 150 Torr, a 10% decrease; and to 700 Torr or higher, 30% 60% increase. The time course of the increase, at those tensions at which it was obtained, showed the increase occurred for 1 to 2 h and was followed by a continual loss. This final loss was at approximately the same rate at all tensions, whether or not there was an initial rise. Thus the cytochrome P-450 levels of isolated hepatocytes show qualitatively the same response to varying oxygen tensions that they do in intact animals. PMID- 6485148 TI - Chromosome aberrations in divers. AB - The incidence of chromosome gain and loss and chromosomal aberrations has been measured in 48-h lymphocyte cultures of divers and control subjects as part of an overall research program to identify possible long-term health hazards associated with commercial diving. When the two diving groups, air divers (n = 77) and helium-oxygen divers (n = 76), are compared with two control groups, oil rig workers (n = 75) and nonoil industry controls (n = 52), 3.9% (6 out of 153) had an unusually high number of structural aberrations in a small portion of the dividing lymphocytes. Similar damage was not found in controls. The remaining 147 divers had a similar low incidence of chromosomal aberrations to the two control groups. The factors responsible for this phenomenon are not known, but several aspects of diving can effectively be ruled out. These are: direct effects of pressure, breathing mixture, radiographic exposure, and viral infection. The causative agent must be acting locally on lymphocytes after their last maturation division. Further studies are continuing on this topic in an effort to identify the causative factor or factors. PMID- 6485149 TI - [Rupture of the rotator cuff of the shoulder]. PMID- 6485150 TI - [Treatment of medial femoral neck fractures with the femur head prosthesis]. PMID- 6485151 TI - [Vario-head endoprostheses in femoral neck and para-femoral neck fractures]. PMID- 6485152 TI - [Causes and frequency of aseptic femur head necrosis following medial femoral neck fractures]. PMID- 6485153 TI - [Traumatology in a Third World country. Observations on the organization and course of surgical-traumatologic care in Kenya]. PMID- 6485154 TI - [Distal radius fractures at a municipal clinic. Causes, treatment and results]. PMID- 6485155 TI - [Bilateral fatigue fracture of the tibia]. PMID- 6485156 TI - [Colonic polyps: the state of the art. Study of polyps removed by colonoscopy]. PMID- 6485157 TI - [Platelets, prostaglandins, thromboses and cancer]. PMID- 6485158 TI - [Peroperative coagulation disorders in the cirrhotic patient and during partial hepatectomies]. PMID- 6485160 TI - [Merkel's tumor]. PMID- 6485159 TI - [Biliary cystadenoma. Apropos of a case]. PMID- 6485161 TI - [Multicentric reticulohistiocytosis]. PMID- 6485162 TI - [A rare complication of ileostomy: prestomal ileitis]. PMID- 6485163 TI - [Pilot study on the individualized and nonmutilating treatment of breast cancer (Personal experience at Hopital Saint-Luc from 1970 to 1976)]. PMID- 6485164 TI - [Intestinal ischemia associated with aorto-bifemoral bypass]. PMID- 6485165 TI - [Total knee arthroplasty with a Cloutier prosthesis]. PMID- 6485167 TI - [Over-utilization of tests: the responsibility of the laboratory]. PMID- 6485166 TI - [Evaluation of hepatic function using the aminopyrine breath test]. PMID- 6485168 TI - [Learning self care]. PMID- 6485169 TI - [Internal urethrotomy]. PMID- 6485170 TI - [The stiff-man syndrome: postural discharge of motor units]. PMID- 6485172 TI - [Maternal mortality in Quebec]. PMID- 6485171 TI - [Cryptococcosis and adrenal insufficiency]. PMID- 6485174 TI - [Fetal development]. PMID- 6485173 TI - [Perinatal and maternal mortality in the United States]. PMID- 6485175 TI - [Abortion and sterilization in the United States: demographic dynamics]. PMID- 6485176 TI - [Mental health and the immigrant worker]. PMID- 6485177 TI - [The decision to undergo tubal ligation]. PMID- 6485178 TI - Analysis of prostatic acid phosphatase in urine voided before and after massage of the prostate in infertile men. AB - Prostatic acid phosphatase (PAP) - a specific marker of prostatic secretion - has been analyzed by radioimmunoassay in samples of urine voided before and after massage of the prostate. In all patients there was an increase in urine PAP concentration after massage irrespective of the occurrence of expressed prostatic secretion. The mean PAP values increased from 4.9 to 45.8 micrograms/l. No significant change in urine creatinine concentration was observed. No lactoferrin was detected in the urine which should indicate that no secretion from the seminal vesicles was expressed into the urethra during massage of the prostate. Analysis of PAP in urine after massage of the prostate could increase the value of a urine sediment and microbial analysis in the investigation of male infertility. PMID- 6485179 TI - Extracorporeal shock-wave lithotripsy of kidney and ureteric stones. AB - Extracorporeal shock-wave lithotripsy (ESWL) has become a routine therapy for the management of stone patients at our department. Till now ESWL has been performed on 1,000 patients. Although the indications for this noninvasive treatment have been expanded significantly, 90% of the patients have been stone free after treatment, 9.3% have small remaining stone particles, while only 0.7% have to be operated on. There was no alteration of kidney function after treatment. ESWL has proven to be a safe alternative to surgical stone removal within an increasing indication range. PMID- 6485180 TI - Stereographic urethral pressure profile. AB - We developed a new system to record urethral pressure curves separately for the anterior, posterior, right and left walls of the urethra. It consists of a catheter with four channels running radially along the axis in 90 degree sectors from the bladder to the external urethral orifice and expresses the data stereographically with a computer system. We called the graph obtained by this recording system 'stereographic urethral pressure profile' (stereo UPP). The stereo UPP consists of a four-directional UPP, a urethral pressure tomogram and a urethral pressure relief diagram. It does not require any more time and manpower than the conventional UPP described by others and causes no pain to the patients. Moreover, this excellent three-dimensional system will enable even the nonspecialist to grasp the functional and morphological status of the urethra at one glance. PMID- 6485181 TI - Functional bladder neck obstruction in women. AB - Symptoms of bladder neck dysfunction in the female are rarely encountered. In 5 females, i.e., 0.6% of the female patients referred for urodynamic investigation, we found parameters consistent with bladder neck dysfunction. Prolonged opening time, slow stream, but otherwise normal voiding reflexes were the main features. PMID- 6485182 TI - Reactivation of the secretion from the prostatic gland in cases of reduced fertility. Biological study of seminal fluid modifications. AB - The efficiency of Pygenum africanum treatment was tested on a population where the acid phosphatase activity was shown to be reduced at two successive examinations. The treatment caused an increase in acid phosphatase activity and total protein secretion. However, the fact that the men who had IgA present in their ejaculate reacted more favorably to the treatment shows that Pygenum africanum is more efficient in cases where there is no prostate gland inflammation. PMID- 6485183 TI - Circulating immune complexes in patients with bladder cancer and other malignancies of the urogenital tract. AB - Sera from 70 patients with bladder cancer, 26 patients with kidney cancer, and 20 patients with prostate cancer were studied for the presence of circulating immune complexes (CIC) utilizing the human red blood cell (HRBC) radioimmunoassay. Elevated CIC levels were found in 32% of patients with bladder cancer, 30% of patients with kidney cancer, and 20% of patients with prostate cancer. For comparison, CIC was also measured in 37 sera from patients with bladder cancer by the polyethylene glycol precipitation complement consumption (PEG-CC) test. 13 of them (35%) had elevated CIC levels. The correlation between the results of the two tests was significant. There were significant correlations between CIC levels and the extent of tumor invasion and the degree of malignancy in patients with bladder cancer. The elevation of CIC level was also significantly associated with poor prognosis of these bladder cancer patients. It is proposed that measurement of CIC in patients with bladder cancer by the HRBC radioimmunoassay may be useful to evaluate their stage, degree of malignancy, and prognosis. PMID- 6485184 TI - The influence of epididymal agenesis on the development and maturation of the testis: experimental model and clinical correlations. AB - The August X Copenhagen (ACI) rat provides an excellent model to study the effect of congenital epididymal anomalies on testicular function. Despite epididymal absence, testicular maturation and function are unchanged until puberty. At puberty, with increased testicular fluid and spermatozoa output, involution of germinal epithelium occurs. This involution is similar to the changes seen with ligation of the efferent ductules of the epididymis. These findings suggest that in this mammalian model the testis functions normally until the pubertal period. At that time, because of proximal epididymal agenesis and failure to reabsorb testicular secretions, intratesticular hydrostatic pressure increases with rapid germinal epithelial atrophy. Clinical correlations are made in patients with epididymal abnormalities, especially in association with undescended testis. PMID- 6485185 TI - Assessment of immunological mechanism in infertility of the rat after experimental testicular torsion. AB - A necrotic torted testis left in the scrotum affects the contralateral testis, resulting in depressed fertility. It was suggested that testicular torsion provoked a systemic response of an immunologic nature. In order to prove this theory, 56 rats were operated. Ten had a sham operation, in 17 a testis was torted and excised after 24 h, and in 29 a testis was torted and excised after 24 h, and in 29 a testis was torted but left in situ till the sacrifice. Antisperm antibodies were not found in any phase of the experiment in the sham group. Using indirect immunofluorescence, antisperm-antibodies were found in the sera of 8/17 rats of the orchiectomy group and in 24/29 of the detorted group. In the direct immunofluorescence study, all the antibodies were localized in the tail of the spermatozoid. The antisperm-antibodies disappeared after 3 to 6 months. PMID- 6485186 TI - Testicular blood flow in experimental torsion and epididymo-orchitis measured by 133Xe clearance technique in rabbits. AB - Testicular blood flow was measured by intratesticular injection of 133Xe both under control conditions and in experimental 720 degree intravaginal torsion (10 rabbits) and in epididymo-orchitis (5 rabbits). The results were statistically compared with each other. The blood flow was 35.8 +/- 13.7 ml/100 g/min to the right testis and 35.4 +/- 12.7 ml/100 g/min to the left testis under control conditions. The blood flow decreased to 16% and 8% of the control values 1 h and 8 h after torsion respectively. In epididymo-orchitis testicular blood flow stayed within normal limits. There was a significant difference in blood flow between the torsion and epididymo-orchitis groups (p less than 0.001). Further investigation in man will demonstrate whether the 133Xe clearance method can be used in the differential diagnosis of these two pathologies. PMID- 6485188 TI - Management of regional lymph nodes in penile carcinoma. Five-year results following therapeutic groin dissections. AB - Twenty-two patients with squamous carcinoma of the penis underwent groin dissections for histologically proved inguinal lymph node metastases, either around the time that the primary tumor was treated (early therapeutic dissection, 14 patients) or later, after they had been clinically judged free of regional nodal metastases at diagnosis (late therapeutic dissections, 8 patients). Three- and five-year survival rates for the patients who underwent early therapeutic dissections were 71 per cent and 57 per cent, respectively, as opposed to 50 per cent and 13 per cent, respectively, for patients who underwent late therapeutic dissections. These findings suggest that a "wait and watch" policy in patients with clinically negative nodes at diagnosis is no longer justified. PMID- 6485187 TI - Effect of gossypol on bull spermatozoa in vitro. AB - Gossypol acetic acid in a concentration of 1,000 microgram/ml solvent is able to immobilize 1 ml of native bull semen (sperm concentration: 8.5 X 10(8)/ml; motility rate: 87.4%) within 30 min. After GAA treatment the spermatozoa show severe morphological damage on the membrane system, on the acrosomal complex and on the tubular complex of the end piece. The working mechanism of GAA can be assumed to be inactivation of enzyme activities or in direct reactions with plasma membrane material. PMID- 6485189 TI - Complications of groin dissection in penile cancer. Experience with 101 lymphadenectomies. AB - To assess the operative morbidity, we reviewed retrospectively 101 groin dissections performed in 67 patients for management of squamous cell carcinoma of the penis. No patients died, but only 18 per cent experienced no postoperative complications. Early complications included flap necrosis in 50 per cent, seroma in 16 per cent, wound infection in 14 per cent, lymphocele in 9 per cent, and thrombophlebitis in 6 per cent. Leg edema developed in 50 per cent of those operated on and remained severe in about one third of these. The frequency of complications has changed little over the thirty-five-year time span of the study and is not related to the extent of the surgical procedure. In view of the high operative morbidity, caution should be exercised against using the surgical procedure injudiciously. PMID- 6485190 TI - Reconstruction of umbilicus in bladder exstrophy. AB - A surgical method for reconstruction of the umbilicus in patients with bladder exstrophy is described. The technique is based on the surgical principle of eventual tubularization of a skin strip buried in the subcutaneous space. PMID- 6485191 TI - Economic impact of kidney stones in white male adults. AB - A large survey of patients hospitalized for kidney stones in the Carolinas and the Rocky Mountain states yielded information that can be translated into conservative estimates of cost of this disease. Hospital costs were estimated by considering number of surgeries, the approximate cost of various types of surgery, number of days hospitalized, and room rates. Work force costs were estimated from information on work days lost and income categories. Estimated recurrence rates for this disease are used to approximate the total cost, due to stones, for the next year for a current stone case. Each incident of stone disease costs, on the average, approximately $2,000, exclusive of recurrences. Hospital stays average four to five days. The average annual cost of recurrence for a current stone case is conservatively estimated to be in the $300 to $400 range. A conservative projection of these costs to the entire national population of white males in the age range of eighteen to sixty years yields an annual cost due to kidney stones approaching $315,000,000. PMID- 6485192 TI - Ureteral obstruction secondary to perianeurysmal fibrosis. AB - Ureteral obstruction secondary to perianeurysmal fibrosis is rare. We have added 3 cases to the 61 cases previously reported in the literature. Perianeurysmal fibrosis should be included in the differential diagnosis of ureteral obstruction particularly when there is medial deviation of the ureters. Abdominal ultrasound is a valuable screening test to confirm the presence of perianeurysmal fibrosis. Treatment must be individualized for each patient, but the majority of patients will benefit most from preoperative urinary drainage followed by aneurysmectomy and ureterolysis. PMID- 6485193 TI - Priapism: evaluation and treatment. AB - The authors analyze 35 cases of priapism treated in the University Hospital of Caracas and conclude that this condition is a surgical emergency because the long term results in regard to the preservation of the erectile function seem to be directly related to early drainage of the corpora cavernosa. We prefer shunting operations, particularly the glans-cavernous techniques, because of their technical simplicity. PMID- 6485194 TI - Hemodynamics of canine corpora cavernosa during erection. AB - Being able to induce erection by electrical stimulation of the cavernous nerves, we studied the hemodynamics of canine penile erection. Simultaneous recording of flow and pressure of the internal pudendal artery as well as pressure within the corpus cavernosum clearly demonstrated that increase of arterial flow preceded corporeal pressure increase. When saline was infused directly into the corpus cavernosum, with the aorta clamped, decreasing venous flow during erection could be demonstrated. Tumescence of the corpus cavernosum was found to be a result of active relaxation of sinusoidal spaces, active arteriolar dilatation, and active venous constriction. At full erection, there was still flow into and out of the corpus cavernosum, although it was reduced to only a fraction of a milliliter per minute. PMID- 6485195 TI - Modified Johnson basket for antegrade stone extraction. AB - A modification of a classic Johnson stone basket has been made, such that this basket can pass easily over an angiographic guide wire. With this modification, the Johnson stone basket is an excellent instrument for use in an antegrade or a retrograde fashion for retrieving impacted ureteral calculi. Eleven patients had ureteral calculi manipulated. Of the six ureteral calculi manipulated with standard retractable baskets, only three were successfully extracted from impacted positions. Of the five manipulated with the modified Johnson stone basket, however, four were successfully extracted. The modified Johnson stone basket is an essential instrument in percutaneous manipulation of ureteral calculi. PMID- 6485197 TI - Spontaneous disappearance and successive reappearance of renal cyst. AB - We report on a patient with a renal cyst which disappeared, reappeared ten years later, and then two years later the cyst was reduced in volume. PMID- 6485196 TI - Page kidney resulting from massive subcapsular hematoma. Complication of lumbar sympathetic nerve block. AB - The Page kidney is a recognized cause of hypertension. A massive subcapsular hematoma caused by a lumbar sympathetic nerve block resulted in a Page kidney. To our knowledge, this sequence has not been reported. Small hematomas may be treated conservatively, but massive subcapsular hematomas should be decompressed when the patient is clinically stable. Diagnostic features, therapeutic considerations, and pertinent references are discussed. PMID- 6485198 TI - Hypercalcemia associated with cancer of prostate without bony metastases. AB - Although hypercalcemia is sometimes found in carcinoma of the prostate with osseous metastases, it is rarely seen as a paraneoplastic manifestation of this neoplasm. We present a patient with such a tumor in whom severe hypercalcemia developed in the absence of detectable osseous metastases. PMID- 6485199 TI - Cyst of seminal vesicle associated with ipsilateral renal agenesis. AB - A case of cyst of seminal vesicle associated with ipsilateral renal agenesis in a twenty-three-year-old man presenting primarily with rectal symptoms is reported. The usual symptoms had been urinary bladder irritation and pain on ejaculation. The embryologic development of this rare entity is discussed. PMID- 6485200 TI - Parameatal ducts of glans penis. Structure, symptoms, and treatment of uncommon focus of infection. AB - It has been shown that persistent penile irritation and purulent discharge from around the urethral meatus may rarely be caused by inflammation of tiny tubular structures previously known as paraurethral ducts. They appear to be rare embryologic remnants which can be involved in the venereal disease complex. Local excision is the appropriate treatment if symptoms are not responsive to antibiotic therapy. PMID- 6485201 TI - Bilateral ureteropelvic junction obstructions in newborn identical twins. AB - Identical twin black females were born with bilateral ureteropelvic junction obstructions. Dismembered pyeloplasties performed in the neonatal period have apparently been successful. Although a tendency for bilaterality is more frequently reported in early infancy, the authors are unaware of a similar occurrence reported in identical twins. PMID- 6485202 TI - Bilateral testicular pain due to masturbation interruptus. AB - A case is reported of a young man with apparent idiopathic pain in the testicles, inguinal regions, and perineum. An unusual cause and mechanism were found. A personality of antisex attitudes with a sense of guilt and sex-suppressive tendencies was observed. These were the underlying but indirect factors in the causation of pain exposed only on inquiry into his personal habits; otherwise the pain most likely would have been labelled as "functional" or psychologic. PMID- 6485203 TI - Male infertility due to communicating bilateral varicoceles. PMID- 6485204 TI - Evaluation and treatment of dyssynergic bladder neck obstruction. Is synchronous pressure-flow cystourethrography necessary? AB - Eighteen male patients underwent unilateral bladder neck incision for relief of bladder neck obstruction. The presence of obstruction was determined by clinical symptoms, residual urine, and uroflowmetry only. The decision to perform bladder neck incision was based on the typical endoscopic appearance of the prostatic urethra and bladder neck. Sixteen of 18 patients (89 per cent) had normal postoperative uroflowmetry. Subjectively, all patients judged themselves improved by the procedure. In those patients who are judged to be obstructed by clinical symptoms and uroflowmetry, dyssynergic bladder neck obstruction may be diagnosed by classic endoscopic findings rather than the routine use of synchronous pressure-flow cystourethrography. PMID- 6485205 TI - Radiation nephritis and nephrotic syndrome. PMID- 6485206 TI - Generalized progressive retinal atrophy in two Akita dogs. AB - Two distantly related, two- to three-year-old male Akita dogs developed partial or complete night blindness which progressed to day blindness. Clinical features were attenuated retinal blood vessels, diffuse exaggerated tapetal reflex, and hyperreflective horizontal lines in the tapetal fundus. The principal histologic change was regional photoreceptor cell degeneration. Areas of moderately atrophic sensory retina alternated, concentrically to the papilla, with areas of severely atrophic retina. Ultrastructurally, there was disorganization of photoreceptor outer segments, retinal gliosis, focal loss with reorganization of the outer limiting membrane, and retinal invasion by pigment epithelium-derived macrophages. Clinical observations on five additional Akitas with generalized retinal atrophy suggest that the condition is heritable. PMID- 6485207 TI - Syncytial cells in canine parathyroid glands. AB - Multinucleated syncytial cells consisting of clusters of closely apposed, darkly staining nuclei and densely eosinophilic cytoplasm were present in parathyroid glands from 25 of 36 dogs (69%). They were most often located either peripherally in the parathyroid gland or adjacent to blood vessels. The numbers of nuclei per syncytial cell ranged from two to greater than 30. Syncytial cells had degenerative changes as suggested by vacuolated mitochondria, dilated rough endoplasmic reticulum, irregular nuclear outlines, and condensed nuclear chromatin. These ultrastructural changes contrasted sharply with adjacent chief cells that had well-preserved organelles. The presence of desmosomes and fragments of cell membranes between nuclei suggested that syncytial cells were derived from fusion of adjacent chief cells rather than nuclear division without cytokinesis. Syncytial cells were present in normal, hyperplastic, and inactive parathyroid glands from dogs. There were no significant correlations between the presence of multinucleated cells and age of dog, parathyroid histology, and changes in the concentrations of serum calcium, phosphorus, creatinine, or plasma parathyroid hormone. Syncytial cells occurred frequently in canine parathyroid glands regardless of the state of activity of the gland or the concentration of plasma parathyroid hormone or serum calcium. PMID- 6485208 TI - Canine malignant melanotic schwannomas: a light and electron microscopic study of two cases. AB - Malignant, melanotic schwannoma of the spinal cord was diagnosed in two two-year old dogs. The neoplastic spindle cells were arranged in a herringbone or storiform pattern; the intracytoplasmic melanin varied in amount in different areas of the two neoplasms. Ultrastructural features including cytoplasmic lamellar premelanosomes and melanosomes, rudimentary cell junctions, scattered pinocytotic vesicles, and remnants of external lamina supported the diagnosis of melanotic schwannoma. PMID- 6485209 TI - Fibrodysplasia ossificans in three cats. AB - A disseminated disorder of epimysial connective tissue characterized by hyperplasia and ossification causing atrophy and displacement of skeletal muscles, entrapment of vessels and nerves, and progressive immobility is described in three domestic cats. The condition has some features in common with fibrodysplasia ossificans progressiva in man. PMID- 6485210 TI - Auricular chondropathy in aging rats. AB - An external ear lesion designated as auricular chondropathy in aging Crl:CD rats was reported. One hundred eighty (180) of 4,876 rats (3.7%) had ear deformity. Grossly, the ears were thickened, nodular, or disfigured. Both ears were affected in most rats. The lesions primarily involved the cartilaginous plate and were associated with two processes--chondrolysis and granulomatous inflammation. The detailed morphogenesis of the lesions is described, but the etiology of the lesions is unknown. Auricular chondropathy in rats and relapsing polychondritis in man are compared. PMID- 6485211 TI - Ependymoblastoma in a dairy calf. PMID- 6485212 TI - Diffuse myocardial fibrosis and congestive heart failure in an adult male chimpanzee. PMID- 6485213 TI - Mammary carcinoma with metastasis in a rhesus monkey (Macaca mulatta). PMID- 6485214 TI - Vertebral chordoma in two ranch mink. PMID- 6485215 TI - Benign chordoma (sacrococcygeal) in the rat: a light and electron microscopic study. PMID- 6485216 TI - An atypical spinal meningioma in a dog. PMID- 6485217 TI - Chondrosarcoma of the mitral leaflet in a dog. PMID- 6485218 TI - Spontaneous malignant hemangioendothelioma in two rabbits. PMID- 6485219 TI - Combined immunodeficiency in an Appaloosa foal. PMID- 6485220 TI - Amyloidosis associated with a calcifying ameloblastoma (calcifying epithelial odontoma) in a cat. PMID- 6485221 TI - Retinal atrophy in albino rats associated with Pituranthos triradiatus (umbelliferae)-induced photosensitization. PMID- 6485222 TI - Haematological and biochemical values in horses naturally infected with Strongylus vulgaris. AB - The concentrations of serum proteins (beta 1, beta 2, gamma, alpha 1, alpha 2 globulins and albumin) and absolute numbers of eosinophils, neutrophils and lymphocytes were examined in 64 naturally infected horses and ponies in which the number of larvae of Strongylus vulgaris in the cranial mesenteric artery and the severity of the lesion of verminous arteritis could be determined. The horses were grouped according to the number of larvae found and the severity of the arteritis. The results demonstrated that, although some significant deviation from a random distribution occurred in certain of the values (chi 2 test), there was considerable individual variation in the values obtained for individual animals within groups and overlap of the range of values between groups. Also the number of larvae present in the artery did not necessarily accurately reflect the severity of the arterial lesion. Thus, the parameters examined could not be used reliably to estimate the intensity of infection with S vulgaris in an individual animal. PMID- 6485223 TI - Lysogeny and the immunologically reactive proteins of Streptococcus equi. PMID- 6485224 TI - Distemper in vaccinated dogs. PMID- 6485225 TI - Avian anaesthesia. PMID- 6485226 TI - Methylprednisolone. PMID- 6485227 TI - Sexing ratite birds by cloacal examination. PMID- 6485228 TI - Bacterial population of the eyes of slaughter cattle. PMID- 6485229 TI - Mucosal disease in cattle. PMID- 6485230 TI - Marketing and the veterinary profession. PMID- 6485231 TI - 1983 graduates: employment survey. PMID- 6485232 TI - Avian paramyxovirus type 1 infection of racing pigeons: 3 epizootiological considerations. AB - During July to December 1983 birds in 192 racing pigeon lofts were confirmed as infected with paramyxovirus type 1 virus on the basis of disease signs alone when contact with infected cases was known (10) or with supporting serology (130), virus isolation (eight) or both (44). These outbreaks were mainly concentrated in south Wales (89) and Dorset (40). In all, 29 counties of Great Britain were involved. In the majority of outbreaks (69 per cent) activities associated with racing were strongly implicated in the spread of the disease but trade in birds, stray bird contact, loft visits and contact at shows were also possible methods of spread. Although considerable variation was seen in the pathogenicity of the viruses isolated from affected birds there were no apparent epizootiological links between isolates of similar virulence. PMID- 6485233 TI - Clinical uveitis and polyarthritis associated with Mycoplasma species in a young goat. PMID- 6485234 TI - Chronic udder oedema in milking cows and heifers. PMID- 6485235 TI - Tail docking and breed standards. PMID- 6485236 TI - Mucosal disease in cattle. PMID- 6485237 TI - Non-infective factors in the aetiology of synovitis in chickens. AB - A study was conducted to elucidate the relative susceptibility of broiler breed birds to synovitis and the relative resistance of laying breed birds to this disease. It was shown that difference in structure and chemical composition of fibrous connective tissue can be associated with this difference in susceptibility. A loose structure of fibrous connective tissue (common in broiler breed birds) appears to predispose to synovitis, whereas a compact structure (common in laying breed birds) can be associated with resistance to synovitis. The most fundamental approach to the synovitis problem would be the breeding of broiler breed birds with a compact structure of fibrous connective tissue. However, this approach does not seem to offer favourable prospects in the near future. For the present, synovitis resistance in broiler parents can be enhanced by practising a management scheme aiming at activation of the birds. PMID- 6485238 TI - A three year herd health and management program on thirty Dutch dairy farms. I. Objectives, methods and main results. AB - A herd health and management program was carried out from May 1974 to May 1977 on thirty Dutch dairy farms which did not have specific herd or management problems. The number of cows per farm varied between 40 and 160. There was a control group of thirty-one comparable farms. The farms were visited every six weeks by the veterinarian of the Animal Health Service Institute, the local agricultural adviser of the NAAS and the local veterinarian. The aim of the program was a whole farm approach. The program had a mainly advisory character and it was up to the farmer to follow the advice given, which was based on the theoretically optimal solution but adjusted to the farm situation. The basis of the administration of herd health was the Herd Fertility Chart. Farm inspection was by detailed observation. The program was primarily practical, and could be carried out by a well-trained local veterinarian. The data of the first (preparatory) year were compared with the results of the following two years. The improvement in income feedcosts margin on the program farms exceeded that on control farms by Dfl. 176 per cow (therefore Dfl. 460 per ha. and Dfl. 12,535 per man). Factor Analysis showed that the herd health and management program influenced especially data concerning fertility. However this did not affect the income feedcosts margin per cow. The program also had an important influence on culling due to health problems and on feedcosts per cow, both of which considerably affected the income feedcosts margin per man.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485239 TI - A three year herd health and management program on thirty Dutch dairy farms. II. Culling strategy and losses caused by forced replacement of dairy cows. AB - Cows are culled at a relatively low age, which causes considerable economic loss. The annual culling rate in the Netherlands has increased from 18.8 per cent in 1951 to 25-30 per cent of the average number of cows in more recent years. The productive life is now about 3.5 years. On the thirty farms of the program group and thirty-one farms of the control group, the main reasons for culling were reproductive failure followed by mastitis and teat injuries. About 60 per cent of culling was due to health problems, the other 40 per cent to low productive capacity, old age, poor workability etc. The annual culling rate varied per farm per year but also per month. The moment of culling in the current lactation, the slaughter value and the age differed per reason. The calculated loss of forced replacement consists of reduction in both production prior to culling and slaughter value. Additionally, there is an idle production period due to lack of an immediate replacement. The biggest loss is caused by lost future income. There was a considerable difference per farm in the loss caused by culling for health problems. A low culling rate due to health problems was associated with longer longevity and a relatively lower loss. Tangible effects due to changes in the farm culling policy may not be evident for some years. The reduction in loss of culling in the program farms compared with the controls was small because the duration (2 1/2 years) of the herd health and management program was too short.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485240 TI - A three year herd health and management program on thirty Dutch dairy farms. III. Economic evaluation of fertility control. AB - Fertility control was part of a herd health and management program on thirty dairy farms in the province of Overijssel. A comparable control group of thirty one farms was available. After two years of application of the program the improvement in income feedcosts margin per cow on the program farms exceeded that on control farms by Dfl. 176. Within the large variation in income between the farms it was not possible to accurately distinguish the effects of the different aspects of the program, despite the use of detailed techniques such as Factor Analysis: thus another approach to determine the income effect of fertility control was necessary. The total loss per farm due to sub-optimal fertility was determined, using calving interval data, forced replacement data and norm-loss rates. From computation of this loss on program and control farms, the income effect of fertility control was deduced. Excluding the cost of the program, a significant (P less than 0.01) positive effect of fertility control on the total calculated loss due to sub-optimal fertility was determined (average Dfl. 25.50 per cow, or about Dfl. 1,700 per farm, after two years of program application). This income effect differed considerably between farms with an initial good or poor situation regarding fertility. The program contributed more to the improvement of insufficient or moderate fertility than to the prevention of a deterioration in herds with excellent fertility, although on the latter farms the total program had a considerable positive effect. PMID- 6485241 TI - A three year herd health and management program on thirty Dutch dairy farms. IV. Special aspects. AB - The ultimate objective of a herd health and management program must be optimal farm net profit. Maximal profit can be expected by carrying out a program based on a whole farm approach. A simple and well-ordered registration system is one of the most important aspects for the success of a program. Experiences with the different registration systems of the program are discussed. In the future it is desirable to process the registered data by computer. The farmer should know the possibilities of the program in advance and must be motivated to carry out advice. When giving advice veterinarians have to take into account the specific circumstances on each farm and the objectives of the farmer. The veterinarian also has to be well-informed about the factors which influence the farm net profit and to this end cooperation with other experts is necessary. In this trial close cooperation between the veterinarian and agricultural adviser were seen as a very positive feature of the program. The program must be carried out at regular times in a fixed sequence, which covers complete herd health and farm management. The frequency of farm visits depends on the problems, farm size and the season. On average one visit per month will be sufficient for farms up to 100 dairy cows. Cooperation between farmer and veterinarian is one of the essential aspects. Frequent evaluation is very stimulating. The benefits of a herd health and management program were found to be substantial in this trial. Therefore the costs of the program can be considered by the farmer to be a sound investment. PMID- 6485242 TI - Excretion rates of sulfamethoxazole and N4-acetyl-sulfamethoxazole by fresh water turtles Pseudemys scripta elegans. AB - Sulfamethoxazole and N4-acetylsulfamethoxazole are excreted by fresh water turtles Pseudemys scripta elegans in a biphasic mode, characterized half-lives of 5 and 100 min. Acetylation and deacetylation reactions cannot be detected below a dose of 50 mg/kg. The mass balance of the dose administered is incomplete, only 30 per cent of the dose can be recovered as parent compound and metabolite. The sulfonamides must be mainly excreted by the faeces and may be metabolized in the gastro-intestinal tract. PMID- 6485243 TI - A severe reduction in egg laying in a flock of hens associated with trichothecene mycotoxins in the feed. PMID- 6485244 TI - Morphological and functional comparisons of Peyer's patches in different parts of the swine small intestine. AB - Fifteen conventional 8-week-old pigs were used to compare the morphology and function of Peyer's patches (PP) in different parts of the small intestine with special emphasis on the dome epithelium (DE). The comparisons were done by morphological observation through light and electron microscopy, and by the ability of the DE complex to phagocytize horseradish peroxidase (HRP). Dome epithelium of the PP in the jejunum was more superficially located in the mucosa in comparison with the ileum. The DE's of the ileum were much smaller, with an area of 3.7 micron2/DE, than that of the jejunum (18.4 micron2/DE). The number of DE areas/5 cm2 in the ileum was more than in the jejunum. However, the total surface area of DE/5 cm2 of PP, was larger in the jejunum (180.5 micron2) than in the ileum (55.6 micron2). Brown discoloration of diaminobenzidine hydrogenperoxide (DAB+H2O2)-treated PP specimens, after HRP inoculation, intensified with post-inoculation time from 20 s to 5 min. The brown pigment first appeared on the surface of microvilli and infiltrated into the dome. No morphological differences were observed between the jejunum and the ileum in 1 micron thick Epon-embedded specimens. Intramucosally, brown pigment was almost always found in DE areas. The pigmented areas were more numerous in the jejunum but the color intensity showed no obvious difference. By transmission electron microscopy, the electron dense materials (which were interpreted as the products of HRP and DAB+H2O2) were found between the microvilli of membraneous (M) cells, in the intercellular spaces of the DE, and in a form similar to intracytoplasmic vesicles in the cytoplasm of M-cell and DE complex lymphocytes. Our results confirmed that DE of PP had much stronger phagocytic activity than did the ordinary villous epithelium. This evidence indicates that the DE complex of PP in the swine intestine is immunologically important. PMID- 6485245 TI - Characterization of the bovine secondary in vitro antibody response. AB - In the present report, the bovine secondary in vitro antibody response to keyhole limpet hemocyanin is described. The induction of anti-KLH antibody was not dependent upon the presence of mitogen but was antigen specific (KLH vs ovalbumin). Furthermore, this response was dependent upon cell density (10(6) per well), antigen dose (1 to 10(-5) ug/culture) and time in culture (5 days). The antibody produced was specific for KLH as measured in several binding assays. An unresponsive state was detected with high concentrations of KLH (more than 10 ug per culture) which was not due to the formation of immune complexes but to the inactivation of B and/or T cells. The induction of the antibody response was dependent on the presence of macrophages (syngeneic or allogeneic) and their presence could not be replaced with 2-mercaptoethanol. PMID- 6485246 TI - Serodiagnosis of canine leptospirosis by solid-phase enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) to detect antibodies to Leptospira interrogans serotype canicola in dogs was developed and evaluated. Comparison of the ELISA with the microscopic agglutination test (MAT) showed that, during the first two weeks after an experimental infection with serotype canicola, the ELISA detected antibody at higher dilutions than the MAT. After the second week post infection both tests detected antibody at almost equal titres (r = 0.89). The outer envelope (OE) antigen of serotypes icterohaemorrhagiae, copenhageni and canicola was fairly serotype-specific, whereas the pellet (P) antigen showed more cross-reactivity. Both OE and P antigen of Leptospira biflexa strain Patoc I could be used as cross-reacting antigen in the ELISA. Compared to the MAT, the ELISA has some technical advantages. It is suggested that the ELISA would be useful as a screening test. PMID- 6485247 TI - Determination of specific anti-leptospiral immunoglobulins M and G in sera of experimentally infected dogs by solid-phase enzyme-linked immunosorbent assay. AB - The development and evaluation of an enzyme-linked immunosorbent assay (ELISA) to detect specific anti-leptospiral IgM and IgG in sera of dogs experimentally infected with Leptospira interrogans serotype canicola are reported. In all dogs specific anti-leptospiral IgM was detected from the second half of the first week after infection, the maximum being attained during the second week. Subsequently the IgM titre gradually decreased. Specific anti-leptospiral IgG was detected later and increased gradually to reach almost the same level as the IgM titre after two to three months. During the initial stage of the infection, when the microscopic agglutination titre was still negative or very low, a high IgM titre was accompanied by a negative or very low IgG titre in every case. After the initial stage a substantial IgG titre was also detectable. It is suggested that the test is suitable for serodiagnostic purposes, particularly for the diagnosis of a current infection in an individual. PMID- 6485248 TI - Antibodies against a tumour-associated antigen in an AKR lymphoma conditioned to grow in BALB/c mice. AB - An experimental model was used in which AKR lymphoma cells (L15) were conditioned to grow in BALB/c mice leading to tumour-bearing (progressor) and tumour rejecting (regressor) animals. The behaviour of antibodies present in the sera of these animals was studied using as antigen L15 cells or a soluble tumour associated antigen TEs. Both sera showed similar IIF and haemagglutinating activity. However differences were observed for the complement cytotoxicity assay. Regressor serum as well as a rabbit anti-tumour-associated antigen serum were strongly cytotoxic for the AKR lymphoma cells while progressor serum showed markedly lower activity. Specific antibodies against the tumour-associated antigen were purified. In both sera they were located mainly in IgG1 but also in IgG2. The purified antibodies agglutinated specifically sensitized sheep erythrocytes and reacted by indirect immunofluorescence with L15 cells but not with AKR thymocytes. It is suggested that two qualitatively different humoral immune responses are involved in the mechanisms leading to tumour enhancement or rejection. PMID- 6485249 TI - Immune response and reactions to various dose regimens for raising hyperimmune antisera in sheep. AB - To determine the optimum procedure for raising hyperimmune sera to tetanus toxin, three adjuvants, four antigen preparations and two routes of administration in various combinations were investigated in sheep. Oil-in-water adjuvants alone or in combination with aluminum gels were superior to aluminium gels on their own. This disadvantage of aluminium gels was partially but not completely abrogated when the frequency of doses was increased to three per week. Intensity of local reaction was strongly correlated with immune response; the more immunogenic a dose, the more reactive. Reactivity of oily adjuvants could be lessened by use of a more suitable route of administration, thus oily adjuvants appeared suitable for use when administered by the intraperitoneal route even though moderate to severe reactions resulted from subcutaneous injections. Of other variables investigated, toxin did not confer any advantage over toxoid as an immunogen, purified toxoid was a significantly better immunogen than unpurified toxoid and two large bleeds (30% of total blood volume each) every six weeks rather than 20 ml test bleeds did not affect the titre of the hyperimmune serum produced. PMID- 6485250 TI - Detection of antibodies against membrane-glycoproteins of swine erythrocytes after experimental infection with Mycoplasma hyopneumoniae. AB - During enzootic pneumonia of pig, antibodies against membrane glycoproteins of erythrocytes were detected with an enzyme-linked immunosorbent assay (ELISA). These antibodies arise simultaneously with the specific antibodies. They are not identical to cold agglutinins. PMID- 6485251 TI - In vitro reactivity to concanavalin A of bovine lymphocytes after cryopreservation. AB - Cryopreservation of bovine peripheral lymphocytes and its effect on the in vitro response to concanavalin A tested in a microculture system is described. Using DMSO as cryoprotectant in the medium, the cells were cooled to -30 degrees C at 1.3 degrees C/minute and further to -80 degrees C at 6 degrees C/minute and then rapidly to -196 degrees C by dropping in liquid nitrogen. The cells were recovered by rapid thawing in water at 30-35 degrees C and washed twice before use in the stimulation test. Ten percent DMSO had a much better protective effect than 5%; addition of 25% fetal bovine serum to the freezing had no favourable effect. In most of the 16 animals used in the experiments the frozen lymphocytes gave the same or a higher response to Con A than those kept in the DMSO containing medium at 4 degrees C for two hours. The responses of the frozen cells were comparable to those of fresh lymphocytes (kept at 4 degrees C for two hours in medium without DMSO). PMID- 6485252 TI - Influenza virus neuraminidase with hemagglutinin activity. AB - Isolated intact influenza virus neuraminidase (NA) molecules of the N9 subtype have been found to possess hemagglutinin (HA) activity which, at equivalent protein concentration, was fourfold higher than that of isolated hemagglutinin molecules of the H3 subtype. The amino-terminal sequence of the N9 NA is the same as in neuraminidases of the eight other influenza A virus NA subtypes previously reported. Viruses possessing N9 NA therefore have two different HA activities and antibody to either HA or NA alone was incapable of inhibiting hemagglutination by the virus. However, antibody to the HA of an H1N9 virus neutralized its infectivity as effectively as it neutralized H1N1 or H1N2 viruses whose neuraminidases have no HA activity. (Antibodies to N9 NA did not neutralize the infectivity of viruses with N9 neuraminidase). 2-deoxy-2,3-dehydro-N-acetyl neuraminic acid inhibited N9 NA activity but had no effect on the HA activity of the isolated N9 NA. One interpretation of this result would be that the HA and NA activities are located in separate sites. Pronase-released N9 NA heads form crystals suitable for X-ray diffraction studies and preliminary data to 2.9 A establish the space group as cubic, I432 with cell dimension a = 184 A. Data extend to beyond 1.9 A resolution, and these will be collected in the future. PMID- 6485253 TI - RNA and capsid accumulation in cowpea protoplasts that are resistant to cowpea mosaic virus strain SB. AB - Leaf protoplasts from the Arlington line of cowpea (Vigna unguiculata) support only a limited increase of cowpea mosaic virus strain SB (CPMV-SB), whereas cowpea severe mosaic virus, another member of the comovirus group, replicates efficiently in Arlington cowpea protoplasts. CPMV-SB replicates efficiently in protoplasts of cowpea line Blackeye 5. Some characteristics of the virus-specific resistance of Arlington protoplasts to CPMV-SB are reported. Differences between progeny CPMV-SB from Arlington and Blackeye 5 protoplasts were not detected. Inoculation with CPMV-SB RNA, rather than virions, did not make Arlington protoplasts fully susceptible. These results favor, for likely involvement in the CPMV-SB restriction phenomenon, events in the virus life cycle that occur after exposure of virion RNA to the cytoplasm and before assembly of particles is completed. The accumulation of CPMV-SB RNAs of both polarities was found to be depressed in inoculated Arlington protoplasts. However, (+)RNA (virion RNA polarity) accumulated to no lesser extent, per unit of (-)RNA, in Arlington protoplasts than in Blackeye 5 protoplasts. Capsid antigen accumulation, per unit of (+)RNA, was reduced in Arlington protoplasts as compared to Blackeye 5 protoplasts. A working hypothesis consistent with the above and other observations is that Arlington protoplasts have an inhibitory substance that interferes with the production or/and function of CPMV-SB specified proteins. PMID- 6485254 TI - Hepatitis B virus DNA forms in nuclear and cytoplasmic fractions of infected human liver. AB - Human liver tissues obtained at autopsy from two patients chronically infected with hepatitis B virus (HBV) were found to contain several distinct species of HBV DNA. Southern blot analysis using a nick-translated HBV [32P]DNA probe identified specific DNA bands migrating at the positions expected for linear double-stranded DNA of 3.6 and 2.0 kb. These DNA bands were shown to represent relaxed circular and closed circular (supercoiled) HBV DNA, respectively. In addition to these distinct bands several minor bands as well as a heterogeneous population of HBV DNA molecules were present. When infected cell nuclei were isolated, and the nuclear and cytoplasmic nucleic acid separately analyzed, the nuclear fraction contained the 2.0-kb DNA species. This species was shown to be supercoiled 3.2-kb HBV DNA by electron microscopy, restriction endonuclease digestion, and thermal denaturation. The cytoplasmic fraction contained DNA forms similar to those found in virions isolated from plasma (i.e., migration in the position of linear double-stranded molecules of 3.6 and 3.2 kb) and no supercoiled DNA was detected. Particles isolated from the cytoplasmic fraction were able to incorporate dNTPs into viral DNA sequences. Southern blot analysis of the nucleic acid isolated from the particles revealed the presence of HBV DNA forms migrating in positions expected for 3.6- and 3.2-kb linear double-stranded molecules as well as a heterogeneous population of HBV molecules. The 3.6- and 3.2-kb species were identified as relaxed circular and double-stranded linear genome-length HBV DNA. Digestion of the viral nucleic acid with pancreatic ribonuclease increased the electrophoretic mobility of a portion of the heterogeneous HBV molecules and resulted in the appearance of a distinct 1.9-kb DNA band suggesting the same viral DNA was complexed with RNA. Experiments to be reported elsewhere showed this DNA species to be genome-length minus-strand HBV DNA which was released from DNA-RNA hybrid molecules by RNase digestion. Thus, supercoiled HBV DNA exists free in the nucleus of infected liver cells and cytoplasmic particles contain relaxed circular and linear HBV DNA as well as a heterogeneous population of HBV DNA and DNA-RNA hybrid molecules, and a DNA polymerase reaction in the particles results in incorporation of dNTP into DNA strands of these molecules. PMID- 6485255 TI - [Current problems of training and specialization of physicians of military sanatoria]. PMID- 6485256 TI - [Improving the military patriotic education of medical students (analysis of material from the "Journal of Military Medicine") over a ten-year period]. PMID- 6485257 TI - [Improving the outcome of treatment of burns]. PMID- 6485258 TI - [Preventive use of antibiotics in various surgical diseases]. PMID- 6485259 TI - [Intensive therapy of patients with myocardial infarction]. PMID- 6485260 TI - [Prevention of zoonotic cutaneous leishmaniasis in the army]. PMID- 6485261 TI - [Laboratory methods of evaluating water quality]. PMID- 6485262 TI - [An active short-term orthostatic test for the determination of blood circulation of the lower limbs]. PMID- 6485263 TI - [Changes in muscle elasticity in sailors during sea voyages]. PMID- 6485264 TI - [Effect of various factors on the course and exacerbation of ischemic heart disease]. PMID- 6485265 TI - [Current problems of military traumatology and orthopedics]. PMID- 6485266 TI - [A method for determining the degree of leakage of water pipes]. PMID- 6485267 TI - [2 cases of aortic coarctation]. PMID- 6485268 TI - [Scientific methodological team of organizers of inventive and rational work]. PMID- 6485269 TI - [Methodological bases of the general theory of physical therapy]. PMID- 6485270 TI - [Electrocardiogram study during psammotherapy]. PMID- 6485272 TI - [Effectiveness of the combined treatment at Belokurikha health resort of hypertensive patients based on the hemodynamic type]. PMID- 6485273 TI - [Method of therapeutic physical exercises in industry for patients suffering from hypertension]. PMID- 6485271 TI - [Effect of a sauna on the hemodynamic processes in hypertensive patients]. PMID- 6485274 TI - [Effect of acupuncture therapy on external respiratory function in bronchial asthma patients]. PMID- 6485276 TI - [Treatment of facial neuritis patients with decimeter waves]. PMID- 6485275 TI - [Acupuncture therapy of transient disorders of cerebral circulation in the vertebrobasilar system]. PMID- 6485279 TI - [Therapeutic physical exercise in the combined therapy of ureterolithiasis patients at Truskavets health resort]. PMID- 6485277 TI - [Effect of ultrasound on the blood immunoglobulin level in chronic cystitis patients]. PMID- 6485278 TI - [Effect of naftusia mineral water at various temperatures on urination in rats]. PMID- 6485280 TI - [Comparative study of the optical properties of biological tissues in exposure to helium-neon and helium-cadmium laser radiation]. PMID- 6485281 TI - [Simulator of radon concentration for checking gamma radiometers]. PMID- 6485282 TI - [Effect of heparin electrophoresis on hemostasis in patients in the early period after operations on the abdominal organs]. PMID- 6485283 TI - [Rehabilitation treatment of cancer patients in ambulatory facilities]. AB - 325 patients radically operated on for cancer of the breast, stomach, colon and rectum were given a rehabilitative treatment at a specialized out-patient department of the Dispensary. As a result, postoperative disorders were eliminated in 55% of breast cancer patients, 83.8% of cases of colonic and rectal cancer and 76.6% of gastric cancer patients. These indexes appeared to be significantly higher than those in controls who had not received rehabilitative treatment. PMID- 6485284 TI - [The efficacy of outpatient examination of the female population for the early diagnosis of breast cancer]. AB - The report discusses the data on out-patient follow-up of female population at different stages within 1971-1979. The results were evaluated versus diagnostic and organizational procedures. PMID- 6485285 TI - [Lung cancer in men who have never smoked]. AB - Among 5,400 male patients with lung cancer examined at Oncological Dispensaries of Moscow and Khabarovsk in 1967-1982, 37 men (0.7%) had never smoked. The latter group was characterized by prevalent incidence of glandular form of cancer and a relatively high percentage of old and middle-aged patients. No difference in the localization, clinical picture, operability and resectability of tumor was established between male smokers with lung cancer and non-smokers. PMID- 6485286 TI - [Cancer of the gastric stump and its prevention]. AB - The paper deals with an evaluation of the condition of 216 cases of stomach resection of ulcer after Hofmeister-Finsterer and using valve anastomosis. Cancer of stomach stump was observed in cases of resection performed after Hofmeister Finsterer but did not occur in those of valve anastomosis. Postresection gastritis appeared to be more pronounced in the former cases. Sanation of bile ducts proved to be an important factor in prevention of postresection complications. A reflux anastomosis was shown to be the best method of prevention of stump gastritis. Cases of stomach resection for ulcer should be followed up during the entire survival time after operation. PMID- 6485288 TI - [Clinical manifestations of squamous cell carcinoma of the rectum]. AB - The report deals with an evaluation of the data on 107 cases of squamous cell carcinoma of the rectum. 63 patients (58.8%) had proctological diseases in their case histories. Anal carcinoma is being misdiagnosed at out-patient hospitals as some other proctologic lesion in 34.9%. This fact points to the staff's lack of knowledge of the clinical picture of squamous cell carcinoma of the rectum. Abdominal-perineal extirpation of the rectum was the most frequent procedure used in the treatment of squamous cell carcinoma. PMID- 6485289 TI - [Characteristics of the dissemination process in patients with serous cystadenocarcinoma of the ovaries]. AB - The terminal stage of the disease (tumor dissemination) was studied. Factors slowing down the process and therapy of patients with disseminated tumor are discussed. PMID- 6485287 TI - [Possibilities of the local removal of villous tumors of the large intestine]. AB - The study was concerned with the long-term results of local removal of villous tumors of large bowel in 144 cases. A statistical analysis of the treatment results versus such factors as patient's age, size and anatomical pattern of tumor, tumor invasion, villous tumor multiplicity and the concomittance of the latter with tubular adenoma of large bowel as well as the procedure of local removal furnished fresh evidence in support of local intervention provided tumor is free of invasive growth. Radical surgery should be indicated in cases of invasion or villous tumor growing per continuitatem. PMID- 6485290 TI - [The effect of vincristine on the morpho-functional state of the rat small intestine]. AB - The effect of vincristine treatment on the morphofunctional status of the small intestine was studied morphologically in 80 Wistar rats. The drug was found to possess a general toxic effect. Diarrhea was matched by the arrest of crypt cell proliferation at metaphase, lysis, a decreased disaccharidase activity and increased levels of cytoplasmic alkaline phosphatase and dipeptidyl(amino)peptidase-IV in enterocytes of the villi. Exudation and degenerated cell organellae prevailed in intramural nervous ganglion cells, smooth muscle cells of intestinal tunica muscularis and vessels and in endothelium. The said changes were transitory in epithelium, but never regressed in nervous structures. At later stages (6-12 months after vincristine, but never regressed in endothelium. The later stages (6-12 months after vincristine treatment), secondary dystrophic changes developed in the small intestine wall, being predominantly confined to neuromuscular and vascular elements. PMID- 6485291 TI - [Food allergy in patients with pruritic dermatoses]. AB - Allergological examination of 88 patients with pruritic dermatoses (eczema and neurodermite) and 55 control subjects has demonstrated an important role of food allergy in the pathogenesis of these dermatoses as well as a high percentage of latent food sensitization. Strawberry, citrus and chicken meat appeared to be the most frequently occurring food allergens. Gastrointestinal diseases identified in part of the patients were found to be conducive to the development of food allergy. PMID- 6485292 TI - [Effect of complete fasting on the coagulative and antioxidative properties of blood]. AB - The effect of 3- and 5-day fasting on coagulation blood properties, antioxidant system activity, and the content of oxidized hemoglobin was studied in 2 series of observations over 22 normal volunteers. Fasting was discovered to lead to the reduction of blood plasma and red cell coagulation, to the deterioration of platelet aggregation, rise in the oxidized hemoglobin content, and to the increase in red cell resistance to peroxide hemolysis. The changes revealed were shown to favour the maintenance of the blood in a liquid state, to lower the risk of intravascular coagulation and thrombus formation. PMID- 6485293 TI - [Actual nutrition and various indicators of the nutritional status of workers in the watch-making industry]. PMID- 6485294 TI - [Comparative evaluation of intestinal microflora in infants on artificial feeding with various milk formulas]. AB - The intestinal microflora was studied in 58 normal full-term infants kept on different types of feeding. The data obtained indicate that the transfer of infants from natural to artificial feeding was attended by changes in the intestinal biocenosis, with these changes being most demonstrable as a result of the use in the feeding of unadapted milk formulas. The feeding with adapted milk formulas (the acidophilic formula Malyutka, Malyutka with a new fatty composition, Detolact) compares very favourably with the feeding with unadapted formulas as regards its effect on the intestinal biocenosis. However, artificial feeding is inferior to natural feeding that exerts a more favourable action on the development of intestinal microflora, both anaerobic and aerobic. This attests to the necessity of further improvement of the biological properties of bady food. PMID- 6485295 TI - [Acid-soluble CoA and free amino acid levels in the liver of pantothenic acid deficient albino rats after separate and combined administration of panthotenic acid and cysteine]. AB - The feeding of white rats with a synthetic diet deprived of pantothenic acid (PAA) for 10 weeks led to a decrease in the content of acid-soluble CoA (AS-CoA) and to an increase in the liver taurine and glycine concentration. One hour after pantothenate injection (30 mg/kg) to PAA-deficient animals the level of AS-CoA rose by 96%, whereas after administration of an equimolar dose of cystein by 63%. Combined administration of CoA precursors did not result in summation of the effects. In all the cases of cystein injections, substantial changes were recorded in the structure of the liver amino acid pool, which were less marked if cystein was combined with pantothenate. It is assumed that the metabolism of cystein, glycine and, probably, that of alanine may depend on the changes in the CoA pool in hepatocytes. PMID- 6485296 TI - [Comparative studies on thiamine, pantothenic acid and nicotinic acid metabolism in the digestive system of rats]. AB - Thiamine is metabolized in the alimentary system to form phosphoric ethers, thiamine disulfide, thiochrome, and other unidentified products. The contents of the small intestine shows the same metabolites, among which thiamine sulfate in detectable in a greater amount. Labeled pantothenate administered parenterally is progressively metabolized largely to 4-phosphopantothenate, CoA and an unidentified metabolite which are detectable in the liver, in the mucous membrane and contents of the small intestine. Labeled nicotinate is metabolized to nicotinamide within the first 15 to 30 min of research, being metabolized to a less measure to the nucleotide forms of metabolites. The contents of the small intestine manifests the same metabolites, among which nicotinamide is predominant. It has been demonstrated that the basis of the retention of vitamins in the body is formed by their transport-metabolic transformations associated with metabolite reception in the biomembranes of the alimentary tract during recycling of different duration. PMID- 6485297 TI - [H3-25-hydroxycholecalciferol metabolism in rats with experimental femoral fractures]. AB - At the 3d day after femoral bone fracture in rats, the concentration of 3H-25 OHD3 injected intraperitoneally 18 h before sacrifice was 25 and 60% higher in the kidneys and small intestinal mucosa, respectively, whereas the incorporation of the label in 1,25(OH)2D3 in the blood serum and small intestinal mucosa was 50 and 70% higher as compared with intact control. The binding of 3H-25-OHD3 in the diaphysis and epiphysis of the fractured bone was 2-3 times as increased at the 3d and 10th days after fracture. A similar but less marked increase in the accumulation of 3H-25-OHD3 was recorded in the paired intact bone of rats with femoral fractures. Incorporation of the label from 3H-25-OHD3 in 1,25(OH)2D3 and 24,25(OH)2D3 in the epiphyses of the fractured bone as well as in the epiphyses and diaphysis of the intact bone of rats with femoral fractures was 1.5-2 times as increased at all the times of the observation period (3, 10, 28 days after fracture). PMID- 6485299 TI - [Sterols from Pacific Ocean squid]. PMID- 6485300 TI - [Amino acid and vitamin composition of camel meat]. PMID- 6485298 TI - [Toxicological characteristics of disodium salt of N-lauroyl-L-glutamic acid--a surface-active agent used in the food processing industry]. AB - To synthesize the disodium salt of N-lauroyl-L-glutamic acid (LG-Na2), use was made of the chloranhydride method with some modifications. The yield of the product was 85%. LG-Na2 possesses good surface-active properties and an emulsifying effect. The critical concentration of micelloformation of LG-Na2 is 6 10(-3) mol/l. LG-Na2 is a non-toxic compound. It is not cumulated in the animals' body. The LD50 for albino rats per os exceeds 10 000 mg/kg, that for mice 6500 mg/kg. It was shown in subacute experiments in rats that LG-Na2 did not produce any substantial influence on the animals' status or on some biochemical and morphological indicators of blood and organs. The authors suggest a tentative level of a safe oral action of LG-Na2 on man (10 mg per kg bw/day). LG-Na2 is likely to be widely used in food industry. PMID- 6485301 TI - [Home diet therapy of patients with peptic ulcer]. PMID- 6485305 TI - What has operations research to offer to blood services? What has been achieved to date? How can more of the potential be realized? PMID- 6485303 TI - Leukapheresis in a patient with Sezary syndrome. AB - A patient with Sezary syndrome refractory to cytotoxic agents underwent leukapheresis on the Aminco continuous flow centrifuge. Five procedures were performed over a 15-day period. A total of 6.9 X 10(9) cells were removed. The patient's skin lesions and lymphadenopathy regressed. Repeated removal of the buffy coat by leukapheresis has not resulted in thrombocytopenia. It is concluded that cytapheresis may be effective in this clinical condition even when the peripheral leukocyte count is normal. PMID- 6485302 TI - Erythrocyte membrane vesiculation and changes in membrane composition during storage in citrate-phosphate-dextrose-adenine-1. AB - Serial studies were made of the membranes of the erythrocytes and the vesicles shed during storage of blood in polyvinyl chloride containers for 35 days in citrate-phosphate-dextrose-adenine anticoagulant. Special precautions were taken to eliminate artifacts created by contaminating leukocytes, platelets and red blood cell ghosts. A total of 15.6% of the cholesterol and 5.2% of the phospholipids of the membranes was lost with no gross change in the gel electrophoretic patterns. The quantity of vesicles found in the supernatant plasma increased during storage and their membranes were characterized by the absence of spectrin, ankyrin, and periodic acid Schiff bands 2 and 3. The ratio of lipids to protein in the vesicles increased as they accumulated perhaps reflecting a rearrangement of the erythrocyte membrane constituents during prolonged maintenance at 4 degrees C. PMID- 6485304 TI - Milne, a new low-frequency antigen. AB - A new low-incidence red cell antigen (Milne) has been detected. The antigen is inherited as an autosomal dominant and is not controlled by MNSs, Kell, Duffy, or Se. Anti-Milne is not uncommon and is often found in sera containing antibodies to other low-frequency antigens. PMID- 6485306 TI - WHO guidelines for drinking-water quality. PMID- 6485307 TI - World Health Day 1984. Children's health--tomorrow's wealth. PMID- 6485308 TI - Quality control of drugs. Certification Scheme on the Quality of Pharmaceutical Products moving in International Commerce. Participating countries--supplementary list 4. PMID- 6485309 TI - Vaccines used in the EPI: indications and contraindications. PMID- 6485310 TI - The role of food safety in health and development. PMID- 6485311 TI - Isolated torsion of the Fallopian tube. PMID- 6485312 TI - An unusual mixed bezoar in a child. PMID- 6485314 TI - Acquired immune deficiency syndrome (AIDS) in a Jamaican. PMID- 6485313 TI - Ileo-colic volvulus. PMID- 6485315 TI - The elderly. PMID- 6485316 TI - After-hour calls in family practice in Barbados. PMID- 6485317 TI - Some aspects of paediatric trauma in Trinidad. PMID- 6485318 TI - Intrapartum infusion of oxytocin and glucose water and neonatal jaundice. PMID- 6485319 TI - Trial to observe the adverse reactions to alphathesin. PMID- 6485320 TI - Suggestions for increased job satisfaction for doctors and for improved patient care. PMID- 6485321 TI - Anaemia in antenatal patients in Montserrat. PMID- 6485322 TI - Clinico-pathological study on the nephrotic syndrome in Jamaican children. PMID- 6485323 TI - [Value of determining the oxygen saturation of mixed venous blood in myocardial infarction]. PMID- 6485324 TI - [Diabetes as a risk factor in the surgical treatment of biliary tract diseases]. PMID- 6485326 TI - [Detection of HBs antigen in blood donors by electroimmunoprecipitation and passive hemagglutination methods]. PMID- 6485325 TI - [Sensitivity to antibiotics of bacterial flora isolated under aerobic conditions in cases of acute odontogenic perimaxillary inflammation]. PMID- 6485327 TI - [Course of labor in breech presentation and its complications]. PMID- 6485328 TI - [Pedicled left-sided pericardial coelomic cyst]. PMID- 6485329 TI - [Cystic lung in Ehlers-Danlos syndrome]. PMID- 6485330 TI - [Multiple symmetrical and multistructural arthropathies in a patient with syringomyelia]. PMID- 6485331 TI - [Dermoid cyst of the retroperitoneal space]. PMID- 6485332 TI - [Bleeding from ruptured varicose vein on the posterior uterine wall imitating a prematurely detached placenta]. PMID- 6485333 TI - [Effect of controlled exercise on atrial electrocardiographic findings in patients after myocardial infarct during rehabilitation treatment at a sanatorium]. PMID- 6485334 TI - [Clinical and laboratory follow-up of patients after splenectomy]. PMID- 6485335 TI - [Fate and condition of infants born in breech presentation]. PMID- 6485336 TI - [Histoclinical evaluation of adnexal endometriosis]. PMID- 6485337 TI - [Ganglioneuroma--a rare mediastinal tumor]. PMID- 6485338 TI - [Ilio-lumbar syndrome]. PMID- 6485339 TI - [Gunshot wound of the paranasal sinuses and nasal cavity]. PMID- 6485340 TI - [Acute renal failure in interstitial nephritis]. PMID- 6485341 TI - [Early form of anal cancer in an 11-year-old boy]. PMID- 6485342 TI - [Congenital toxoplasmosis in the form of severe anemia]. PMID- 6485343 TI - [Necrotizing enteritis in infants]. PMID- 6485345 TI - Evaluation of various types of needle biopsies of the thyroid. PMID- 6485344 TI - Follow-up evaluation of thyroid function after thyroidectomy for thyrotoxicosis. PMID- 6485346 TI - A prospective controlled study of fine-needle aspiration and Tru-cut needle biopsy of dominant thyroid nodules. PMID- 6485347 TI - Prognostic value of nuclear DNA content in papillary thyroid carcinoma. PMID- 6485348 TI - Measurement of nuclear DNA content in thyroid diagnosis. PMID- 6485349 TI - The density test for the intraoperative differentiation of single or multigland parathyroid disease. PMID- 6485350 TI - Assessment of parathyroid graft function after autotransplantation of fresh and cryopreserved tissue. PMID- 6485351 TI - Parathyroid autografts--morphology and function: six years' experience with parathyroid autotransplantation in uremic patients. PMID- 6485352 TI - Successful resection of intrathoracic metastases from two patients with parathyroid carcinoma. PMID- 6485353 TI - Further experience with Pseudo-Zollinger-Ellison syndrome: its place in the management of neuroendocrine duodenal ulceration. PMID- 6485354 TI - Prediction of healing time as an aid to the management of open granulating wounds. PMID- 6485355 TI - Internal drainage of intractable malignant pleural effusions. PMID- 6485356 TI - Screening for occult fecal blood: results of an initial voluntary community screening campaign. PMID- 6485357 TI - Assessing the psychological being of the Jewish immigrant. PMID- 6485358 TI - A functional classification and stepped care management of orthostatic hypotension. PMID- 6485359 TI - Thyroid antibodies in suspected autoimmune thyroid disease: lack of clinical utility of the antithyroglobulin antibody test. PMID- 6485360 TI - Catatonia and encephalopathy following a disulfiram overdose. PMID- 6485362 TI - Lasers and cutaneous medicine. PMID- 6485361 TI - Fatal necrotizing enterocolitis in a neonate with DiGeorge syndrome. PMID- 6485363 TI - Interstitial lung disease caused by chronic nitrofurantoin reaction; case report. PMID- 6485364 TI - Fishing for a thumb--an unusual replantation. PMID- 6485365 TI - Hemodynamic monitoring in a small, rural community hospital. PMID- 6485366 TI - The health professions in industrial countries: a comparative statistical analysis. PMID- 6485367 TI - The World Health Organization policy on fellowships. PMID- 6485368 TI - Human resources for health for all. PMID- 6485369 TI - Early complications of legal abortions, Canada, 1975-1979. PMID- 6485370 TI - Childhood cancer mortality: international comparisons 1955-1974. PMID- 6485371 TI - Prevalence and causes of blindness in Nepal. The Nepal Blindness Survey Team. PMID- 6485372 TI - India's regional demography. PMID- 6485373 TI - [Physiopathologic and clinical aspects of unconsciousness]. PMID- 6485374 TI - [Diagnostic procedure in unconscious patients]. PMID- 6485375 TI - [Cerebral protective aspects in the emergency treatment of unconscious patients]. PMID- 6485376 TI - [Differential diagnosis of consciousness disorders in acute alcoholic intoxication and chronic alcoholism]. PMID- 6485377 TI - [Principles of preclinical pain treatment of emergency patients]. PMID- 6485378 TI - [Are local pain elimination procedures for emergency patients at the emergency site and during transportation really contraindicated?]. PMID- 6485379 TI - [Analgesia and anesthesia with ketamine at the emergency site and in transport]. PMID- 6485380 TI - [Experiences with nitrous oxide analgesia in emergency care]. PMID- 6485381 TI - [Recommendations for an educational concept for physicians in emergency medicine]. PMID- 6485383 TI - [Current significance of tube endoscopies of the respiratory and digestive tracts]. PMID- 6485382 TI - [Organization of a leading facility of fast medical care]. PMID- 6485384 TI - [Case history contributions to the current symptomatic picture of tuberculous diseases]. AB - The problem of quick and early detection of tuberculosis in old persons deserving increasingly special attention is discussed by the hand of eight observations. Differential diagnosis of generalized forms and isolated extrapulmonary organ tuberculosis is particularly difficult. Incorrect interpretation of signs and symptoms, default of examinations crucial for right diagnosis and above all, not considering tuberculosis in the diagnostic process explain error and often subsequent death due to failing the diagnosis of tuberculosis. In the examples represented the difficulties in making the right diagnosis, the change of the clinical features and course of disease, and the reasons for misinterpretation of these forms are shown. Relevant conditions and diagnostic procedures referring to the diagnosis of tuberculosis in old people are reviewed as chronic disabling ailments, drugs reducing resistance, pulmonary fibrotic lesions all sometimes followed by exacerbation of pulmonary or lymph node tuberculosis and subsequent haematogenous generalization, and as the tuberculin testing and repeated examinations for tubercle bacilli. PMID- 6485385 TI - [EMG method in assessing diaphragmatic paralysis in a miner as an occupational disease]. AB - A diaphragmatic palsy of a miner as an occupational accident happened during backdrawing pit props out of a low seam. For this trauma an excessive stretching of the spinal roots of the n. phrenicus with simultaneous presence of osteoarthrotic alterations in the area of the cervical vertebra was held responsible. The investigation of the cervical muscles on the side of palsy demonstrated a depressed activity corresponding to the radicular phrenicus palsy. PMID- 6485386 TI - [Liver and kidney damage in rifampicin and ethambutol treatment]. AB - Case report on a 40 years old patient with pulmonary tuberculosis, in whom a treatment with Rifampicin plus Ethambutol has caused a transient hepatic and renal failure. By histology a chronic aggressive hepatitis and a destruction of renal tubular epithelium could be found. The etiologic role of Rifampicin is believed to be probable. Pathomechanism and differential diagnosis are discussed. PMID- 6485387 TI - [Thrombotic complications originating in the lung in chronic respiratory insufficiency]. AB - 34 patients, died of chronic respiratory insufficiency, as a result of chronic obstructive pulmonary disease (COPD), are the subject of clinical-anatomical analysis. In 18 (53 +/- 17%) of them could be found thromboembolic complications more often developed as subacute or chronic intravascular coagulation, but evident changes could not be always met in the clotting system. The most characteristic feature is the raising of fibrin-degradation products and the reduction of antithrombin III. The necessity of dynamic trace of coagulation and haemorrheological data in patients with COPD in the stage of heavy chronic respiratory insufficiency is emphasized. PMID- 6485388 TI - [Surgical results in bronchiectasis in adults]. AB - The data of a complex examination of 180 adults with bronchiectases were analysed before operation and in later periods. The study comprises clinical, roentgenological and endoscopic examinations, the investigation of the ventilatory function and of the haemodynamic of the pulmonary circuit. It could be shown, that actually patients with small more blurred forms of disease are predominant. After surgical treatment, in most cases the state of health condition had substantially improved or had remained the same as before operation. The elimination of the pathological suppurative focus in the lung brought on a stabilisation of the pulmonary artery pressure, in a third of the patients operated even a decrease of the pressure down to normal values. The preservation of the superior segment of the lower lobe was of positive influence on the adaption of the architectonic of the bronchial tree. The functional parameters after such operations were the best in comparison to other kinds of pulmonary resection. PMID- 6485389 TI - [Sarcoidosis of the parietal pleura--a contribution to the pathogenesis of intrathoracic sarcoidosis]. AB - Sarcoidosis is a frequent systemic disease with various appearances and unknown etiology. The diagnosis of intrathoracical sarcoidosis can be made with considerable accuracy by means of X-rays and endoscopic and bioptic methods. In the international literature there exist very great differences concerning the pleural involvement in sarcoidosis. Potential causes and hypotheses of the modality of the involvement of the parietal pleura with noncaseating epitheloid granulomas are discussed. PMID- 6485390 TI - [Use of rapid microscopic sputum diagnosis in clinical practice]. AB - A total of 222 unselected expectorated sputum samples obtained from patients with various diseases of the respiratory tract was examined microscopically following the method of Murray and Washington. Based on standardized criteria of evaluation of gram-stained smears direct microscopic examination is a simple and reliable method providing primary information, and can be recommended for bedside diagnostics. PMID- 6485391 TI - [Priorities in the treatment and nursing of patients with urogenital tuberculosis]. AB - With the regression of tuberculosis of the respiratory tract a marked reduction of urogenital tuberculosis caused by the known late manifestations resulted, too. In 1981 152 new cases of urogenital tuberculosis were registered in GDR being an incidence rate of 0.91 per 100,000 inhabitants. The total duration of antibiotic therapy could be reduced from previously two years to 9 months. Inspite of using highly effective aggressive antituberculotic drugs the portion of persons with nephrectomy in our hospital amounted to 27%. Superinfection with nonspecific germs and by formation of stones in the urinary tract complicated the later course of disease. 18% among 567 patients showed a nonspecific mixed infection and additional 8% had stones in the urinary tract. Complications occurred in 50% of the cases with residual kidneys. Cases of delayed diagnosis have become more frequent in the last 8 years. The prognosis of the illness is decisively determined by early diagnosis, by adequate therapy and intensive urological nephrological dispensairic care. PMID- 6485393 TI - [Types of bronchial reaction to analgesics]. AB - Bronchial reaction of asthma bronchiale patients (n = 102) to analgesics was tested by oral exposure to acetylsalicylic acid. 73 patients produced no changed bronchial response to the exposure test. Ventilation parameters improved in 12 patients. In cases in which analgesics intolerance had been recordable from case histories (n = 17), acetylsalicylic acid doses were carefully increased in a stepwise approach to identify the threshold dose required for inset of bronchoconstriction. The average triggering threshold dose was found to be 200 mg. In patients with normal analgesics tolerance products of arachidonic acid metabolism seem to have no effect on bronchial tonus. The observed dilating effect of analgesics may, possibly, be associated with elimination of a cyclooxygenase metabolite with relevance to bronchoconstriction. Inducer of analgesics intolerance is the shift of arachidonic acid metabolism in favour of the route of lipoxygenase. Of importance is possibly a free proteolytic activity (inhibitor deficiency) with increased basic release of arachidonic acid. PMID- 6485392 TI - [Detection of the incidence of increased sensitization to molds in patients with bronchial asthma and allergic rhinitis]. AB - The incidence of sensibilization against extracts of moulds produced by VEB SSW Dresden was investigated by intracutaneous tests in 354 persons (controls and patients - adults and children - with bronchial asthma and allergic rhinitis). Even in the nonallergic controls the tests were positive in 20-30%. Patients with asthma and rhinitis were significantly more often positive than controls with Mucor, Cladosporium and mixed-mould. There was no difference between the groups with Aspergillus and Penicillium. Testing with extract of mixed-mould is not effective. Positive results with the individual moulds were not excluded although the test with mixed-mould was negative. There was no essential difference in the incidence of sensibilization between adults and children with bronchial asthma using mould extracts of VEB SSW Dresden. PMID- 6485394 TI - [Implementation and evaluation of the inhalation antigen test in the diagnosis of exogenous allergic alveolitis]. AB - By the aid of antigen inhalation challenge test 16 patients with precipitating antibodies to bird antigens (pigeons, hens, budgerigars) and the supposed diagnosis of extrinsic allergic alveolitis (EAA) were examined. Criterions for the evaluation of the objective parameters (FEV1, FVC, Ros, body-temperature, number of leukocytes) were established. The combination of objective parameters and subjective symptoms leads to the evaluation of the challenge test. Different types of bronchial response (monophasic and dual-responses) were observed after inhalation of antigens. In 7 cases the diagnosis of EAA was proved to be true according to the challenge test results. If there are no typical alterations in chest-x-rays and no alterations of ventilatory function, the antigen inhalation challenge test is the method of choice in the diagnosis of EAA. PMID- 6485395 TI - [Results of combined blind pleural biopsy and cytology in the differential diagnosis of pleural effusions]. AB - In 80 patients with pleural effusion of uncleared aetiology cytological, bacteriological and chemical examinations of punctate were combined with blind pleural biopsy. Malignant pleural diseases were verified via pleural biopsy in 48% and in combination with pleural biopsy and cytology in 93% of the cases. About one third of the tuberculosis pleural effusions could be diagnosed histologically. Blind pleural biopsy can be recommended as a method of low risk in differential diagnosis of pleural effusions. PMID- 6485396 TI - [Is scleroderma without silicosis also an occupational disease?]. AB - Clinical, roentgenological and lung-physiological findings in 5 patients with progressive scleroderma are reported. All of them showed an intensive exposure to crystalline silica of many years however without evidence of a silicosis. Criteria for legal recognition as an occupational disease are intensity and duration of quartz dust exposure. Legal recognition in the G.D.R. can be achieved in a special procedure called "Sonderentscheidverfahren". PMID- 6485397 TI - [Fatigue fractures of the 1st rib and their combination with spontaneous pneumothorax]. AB - The pathogenesis and the causal atraumatic mechanism of uni- and bilateral stress fractures of the first rib in 4 cases of young men will be discussed. In 3 cases the discovery of these fractures has been the result of mass x-ray survey alone without complaints by the patients. As a causal factor there must be supposed a permanent strain and (or) an overstrain of the mm. scaleni. At a 15-year-old schoolboy we found a combination of bilateral fracture of the first rib and bilateral spontaneous pneumothorax. In this case we suppose that an overstrain of the mm. scaleni medius and anterior is responsible for the fractures of the rib, and an abrupt distension of the pleural cupola by the m. scalenus minimus - occurring among 72% of all European children - for spontaneous pneumothorax. Minimal subpleural emphysematous bullae adherent to the pleural cupola might be ruptured by this distension. This mechanism is probably also responsible for other cases of spontaneous pneumothorax, in which no stronger physical strains of the patient were preceding. PMID- 6485398 TI - [Recommendations for the therapy of tuberculosis]. PMID- 6485399 TI - [Regular, standardized patient surveys within the scope of inpatient medical care at a health facility--a leading instrument for increasing quality of care]. PMID- 6485401 TI - [Significance of the neuropsychiatric invalidism profile of the Ueckermunde district with reference to rehabilitation]. PMID- 6485402 TI - [Inhalation uptake of industrial solvents in physical work]. PMID- 6485403 TI - [The Borg Scale as an instrument for the detection of subjectively experienced stress in industrial medicine laboratory and field studies]. PMID- 6485400 TI - [Methodologic studies on the development of an influenza dispensary for risk patients with cardiovascular diseases]. PMID- 6485404 TI - [Urinary catecholamine excretion for the evaluation of physical stress]. PMID- 6485405 TI - [Incorporation of psychophysiologic pallesthesiometry into the diagnostic method inventory of industrial medical care of vibration-exposed workers]. PMID- 6485406 TI - [Possibilities and results of industrial psychologic cooperation in the industrial health advisory process--a report of experiences]. PMID- 6485407 TI - [Detection of volatile carcinogenic nitrosamines in foods with an instrumental combination of the gas chromatograph and thermal energy analyzer]. PMID- 6485408 TI - [Evaluation of an analysis instruction for the detection of volatile carcinogenic nitrosamines in foods with the instrumental combination of the gas chromatograph and thermal energy analyzer]. PMID- 6485410 TI - [Continuous permeative benzene dosing of variable concentrations in the ppm range]. PMID- 6485409 TI - Prevention of lead intoxication by vitamin-B complex. PMID- 6485411 TI - [Quality control in serodiagnosis]. PMID- 6485412 TI - [In vitro activity of azlocillin and mezlocillin]. PMID- 6485413 TI - [Statistical estimation of the maximum value of the concentration of particulate air pollution]. PMID- 6485414 TI - [Effectiveness of preventive influenza vaccination in patients at the cardiovascular dispensary]. PMID- 6485415 TI - [Prenatal toxic effects of drinking water pollutants]. PMID- 6485416 TI - Spectrophotometric determination of nitrite. PMID- 6485417 TI - Spectrophotometric determination of chlorine after fixing in alkali. PMID- 6485419 TI - [HDL and LDL cholesterol changes in psychological stress in relation to stress experience]. AB - During examinations and after a three-month examination period the changes of the parameters of fat metabolism were investigated depending upon stress experience before examinations. Students with a distinct stress experience showed a higher total cholesterol and LDL-cholesterol as well as a higher LDL/HDL-cholesterol quotient within a concrete examination. After the examination period in this group a higher LDL/HDL-cholesterol quotient and a lower HDL-cholesterol level was established in comparison to the group with an insignificant stress experience. A positive dependence on the initial value of the parameters of fat metabolism consists only in the group with distinct stress experience. According to these results also stress has an influence on the reactions of the fractions of cholesterol. PMID- 6485418 TI - [Metabolic effects of orotic acid]. AB - Orotic acid is an important representative of the pyrimidines, the pathophysiological importance of which is less well-known in comparison to the purines. Increases of the excretion of orotic acid in the urine are found e.g. in enzyme defects of the urea cycle, of the orotate phosphoribosyl transferase or the orotidin-5'-monophosphate decarboxylase. Numerous enzymatic systems of the liver are influenced by supply of orotic acid. Toxic influences on the liver may be reduced by orotic acid. In rats orotic acid induces a fatty degeneration of the liver by disturbances of the secretion of lipoproteids. The oxidation of fatty acid by hepatic mitochondria is also reduced by orotic acid. In the blood a decrease of the serum lipid concentrations develops. The effect of the orotic acid in combination with clofibrinic acid was controlled in the double-blind test in patients with hyperlipoproteinaemias. In patients with hyperlipoproteinaemia type V a drastic decrease of the serum lipid concentrations developed and the chylomicrons disappeared from the fasting serum. PMID- 6485420 TI - [Change in the concentration of lipoprotein parameters following swimming training in health resort patients]. AB - On 197 patients who were admitted to a sanatorium for the purpose of a heart and circulation cure the influence of a daily swimming training, 20-30 minutes 6 times a week with intensities of about 50-60% VO2 max, on the lipid and lipoprotein spectre, respectively was investigated. In the whole group of patients HDL-cholesterol (HDL-C) did not change. In patients with increased risk n = 40 (initial HDL-C: lower than 0.91 mmol/l) HDL-C significantly increased in the course of the cure. In group I n = 157 (without increase of HDL-C) as well as in group II n = 40 (with increase of HDL-C) LDL-cholesterol significantly decreased. The lipid index after Klimov and the quotient LDL-C/HDL-C decreased at the end of the treatment and they showed the most distinct change in group II. The separation of the lipoproteins by disc electrophoresis and the establishment of their percental distribution resulted in a decrease of the beta-lipoproteins and an increase of the alpha-lipoproteins for the two groups (I and II). The quotient beta-lipoprotein/alpha-lipoprotein also significantly decreased in the two groups. For the apolipoproteins A and B in group II no statistically ascertained changes of concentration were established. At the end of the treatment in group I apolipoprotein B highly significantly decreased, while apolipoprotein A did not change. In accordance with the cholesterol index also the reduction of the apolipoprotein index apo B/A was significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485421 TI - [Effect of thyroid hormones on noradrenaline-stimulated lipolysis in obesity]. AB - 11 extremely adipose patients were over 4 days loaded with a noradrenalin infusion of 0.1 microgram/kg body weight/minute over 60 minutes before and after a daily application of 200 micrograms tri-iodothyronine. The determination of the free fatty acids and of glycerin resulted in a significant elevation basally as well as after stimulation with noradrenalin. Thus the lipolytic influence of the thyroid hormones is confirmed under in-vivo-conditions. The possible mechanisms of lipolysis in the fatty tissue are discussed on the basis of literature. PMID- 6485422 TI - [Normal values for heart rate and blood pressure]. AB - In man heart rate and blood pressure show a dependence upon age, the heart rate additionally still upon the degree of stress of the cardiovascular system after an operative intervention and a disease, respectively. These dependences, in heart rate for reasons of calculation referred to the body surface and not to age, can be brought into mathematical connections. Thus it is possible to establish for every patient an optimum value for these two parameters. PMID- 6485423 TI - [A method for the determination of the osmotic fragility of erythrocytes]. AB - A method for registration of the haemolysis of erythrocytes as a measure for their osmotic resistance is presented. The technical realization is performed by means of a cuvette head-piece for holding a filter, which separates the investigation material from water. A cuvette insertion guarantees the regular construction of a haemoglobin gradient, serving as a measure for haemolysis, which is photometrically measured in the Spekol (VEB Carl Zeiss JENA) and registered by means of the compensation tape writer G 1 B 1 (VEB Carl Zeiss JENA). 0.3-0.4 ml investigation material are used. The expenditure of time amounts to about 20 minutes. PMID- 6485424 TI - [Effect of fluoride on the skeletal system]. AB - The chronic fluoride intoxication in man and animal may cause so different diseases of the bones as osteosclerosis, osteomalacia, secondary hyperparathyroidism and osteoporosis--partly in combination. On the basis of own examinations and of literature an own theory is developed which tries to explain these 4 contrary findings on the bone. According to this theory the fluor dosage, the calcium and vitamin D deficiency, differences of the species, duration of the fluoride supply and an individual sensitiveness to fluoride play an important role. Fluor has an effect on the 3 constituents of bones: osteoblasts, osteoclasts and the bone material. PMID- 6485425 TI - [Sex ratio in the spectrum of chronobiopathology]. AB - With regard to the deficiency of representative data on the different course of the ischaemic heart disease depending upon sex a total statistics (death data) of the GDR for 5 years was elaborated and compared with the total mortality since 1903 to 1958 of the area of the former German Reich, the GDR and the FRG with still-born and deceased babies. Here conspicuous synchronous courses depending upon the season were the result. The female sex quite generally predominates the well-known course of the season of all individual mortality data, whereas the males are somewhat more endangered during the summer months. The differences established between the sexes proved in most cases as significant, in larger groups as highly significant. Moreover, the statistical reference guarantees an up to now not proven representativeness . The result of the distribution characteristics within the 10 categories examined renders possible cautious conclusions concerning the causal connection of the process. PMID- 6485426 TI - [Dietary iodine deficiency in East Germany]. AB - The human organism depends on exogenic supply of iodine. The alimentary supply with iodine is not sufficient in the GDR. The deficiency leads to an endemic struma. The causes are among others as follows: small geochemical offer of iodine with low iodine content of vegetable and animal products and of drinking water as well as moderate consume of fish. The most favourable possibility as to cost for the abolition of the iodine deficiency is the use of a stable iodized kitchen salt (potassium iodate instead of potassium iodide). The gradual introduction of such a salt is started. Also after the improvement of the iodine supply representatives of human medicine, veterinary medicine and agriculture should in interdisciplinary cooperation devote themselves to the problems of a controlled optimum supply of iodine and the fight against endemic struma. PMID- 6485427 TI - [Kidney changes in patients with proliferative diabetic retinopathy]. AB - On 42 patients (25 males, 17 females) at the age of 46.1 +/- 13.4 years with a proliferative diabetic retinopathy clinical and laboratory examinations were performed for the proof of a renal lesion. This disease was found in 59.5% of the cases. In the foreground of the pathological findings were a proteinuria, a restriction of the creatinine clearance and of the concentration power of the kidneys as well as the hypertension. The diabetic nephropathy had its peak of frequency between the 50th and 60th year of age and showed significant relations to the duration of diabetes as well as to be early age of manifestation. Close ophthalmological and nephrological examinations, particularly of the juvenile diabetics, should render possible an early recognition and treatment of the diabetic microangiopathy. PMID- 6485429 TI - [Monstrous hemangiopericytoma of the lung]. AB - Report on a monstrous haemangiopericytoma of the left lung in a 76-year-old woman. On the basis of the observation the authors enter the frequency, localization, morphology, cellular and clinical differential diagnosis, prognosis and therapy of these tumours. PMID- 6485428 TI - [Development of collateral circulation in arterial occlusions in advanced age]. AB - Plethysmographic course controls in 15 male patients at the age between 70 and 76.5 years showed that the maximum of the collateral blood supply in arteriosclerosis in the femoral region is reached 1-2 years at the latest after vascular occlusion. The peak-flow-values measured confirm the possibility of efficient collaterals also at older age. When there is a bad early compensation of the artery occlusions, we intended to test in time, whether or not a percutaneous transluminal angioplasty or a local thrombolysis are possible. Furthermore, in 100 male patients with arteriosclerotic disturbances of the blood supply of the legs the plethysmographic measurement of the reactive blood supply showed that the internationally usual haemodynamic subdivision into degrees of severity also concerns the age group between 60 and 75 years. With progressing Fontaine-stage a decrease of the reactive blood supply (first-flow, peak-flow) and an increase of the peak-flow-time were found. PMID- 6485430 TI - [The pancreatic lipase/colipase system]. AB - Pancreatic lipase (triacylglycerol-acylhydrolase EC 3.1.1.3) hydrolyzes triglycerides on the lipid-water-boundary surfaces of micelles. The adsorption of the pancreatic lipase to the triglyceride boundary surfaces is inhibited by bile acid salts. Whereas colipase can be bound to boundary surfaces covered by bile acids and to pancreatic lipase. Colipase eliminates the inhibitory effect of physiologic concentrations of bile acid salts on the activity of lipase. The lipolysis by pancreatic lipase is characterized by activation of products and a biphasic kinetics. Extrapancreatic lipases of tongue, pharynx, oesophagus and stomach evoke the lipolysis of the fats contained in food. PMID- 6485431 TI - [Immunoprevention of hepatitis B in children of HBsAg-positive pregnant patients]. AB - Children of hepatitis-B-surface-antigen-positive women are, depending upon the degree of maternal infectivity, exposed to a very different risk of hepatitis B. In the GDR the rate of infectious pregnant women is low. The serious consequences of a perinatal hepatitis B, which very often leads to a chronic course and virus carriers, may widely by prevented by immunoprophylaxis. Various methods for the establishment of a risk are described. The hepatitis-B-surface-antigen screening in 28 127 pregnant woman showed 20 = 0,07% of carriers of findings, 4 out of them HBeAg-positive. From the performance of the passive immunisation in 6 babies of HbeAg-positive mothers and 2 newborn without maternal HBe- or anti-HBe-proof and from the results of the control of 17 children, who were not immunized, when there was an anti-HBe-positiveness or when there was no proof of HBe-markers, result recommendations for practice. PMID- 6485432 TI - [Lidocaine elimination and dose adjustment in acute heart infarct and heart insufficiency]. AB - In 40 patients with an acute myocardial infarction a prolonged lidocaine infusion was indicated. The dosage of lidocain was done according to the body-weight. Patients suffering from a heart insufficiency received the anti-arrhythmic drug with a reduced dose referring to the degree of severity. The lidocaine-plasma content was determined by means of a gas-chromatographic method. Furthermore, the half-value time, the clearance and the distribution coefficient were computed. Despite the reduction of the dose the plasma contents were highest in patients with manifest heart insufficiency. As we expected, the half-value time was shorter in the patients with infarction without heart insufficiency than in the patients with manifest heart insufficiency. The behaviour of the total clearance was analogous in the adequate groups of patients. The lidocain dosage performed which referred to more recent investigations of the behaviour of the half-value time after prolonged infusion is regarded as more precisely in comparison to the previous proposals. Corresponding to the findings got, a dosage scheme is given for patients with myocardial infarction and heart insufficiency, which should allow a secure and effective treatment. PMID- 6485433 TI - [Indirect study of oxygen consumption of the heart muscle]. AB - The connection between the inner heart action in form of the double product and the physical functional capacity in watt (PWC) was controlled in patients with chronic ischaemic heart disease. For this purpose 64 patients with an average age of 47 years in the pulmological institute Mosdos and 25 patients with an average age of 53 years in the clinic for internal medicine of Berlin Humboldt University underwent a bicycle ergometer load. The double product, calculated from the systolic blood pressure and the heart rate, was regarded as measure for the myocardial oxygen consumption. It was established that there is a correlation between the inner heart action measured at the lover load level and the physical functional capacity in watt achieved simultaneously or later. PMID- 6485434 TI - [Behavior of pulmonary artery pressure during ergometer stress in sitting position in patients with ischemic heart disease]. AB - In 40 patients (33 men, 7 women) at the age of 62 +/- 9 years with acute definitive myocardial infarction after the end of the rehabilitation phase I a Pulmoflex catheter was introduced through an arm vein into the pulmonary artery. After having measured the rest values in lying position the systolic, diastolic, end-diastolic and mean pressure of the pulmonary artery in sitting position were established. After this the continuous pressure determination during increasing ergometer loading in sitting position was performed. At the transition into sitting position the systolic pressure of the pulmonary artery decreased by on an average 4 Torr, while the diastolic and end-diastolic values remained constant. In the trend the mean value decreased by 2 Torr. During the ergometry the pressure values could be recorded in good quality. With increasing load all measuring values continuously increased. Thus it was possible to determine the blood pressure in the pulmonary artery during the ergometer load in the physiological and for the practice more evident sitting position. PMID- 6485435 TI - [Step-wise diagnosis of primary and secondary lymphedema]. AB - The diagnosis of the lymphatic oedema is possible by means of non-invasive methods. The degree of severity of the lymphatic oedema can already be assessed within the basic diagnostics (anamnesis, clinical findings). The recognition of secondary lymphatic oedemas is important, particularly of those due to tumours of pelvic organs. Indications and contraindications of other diagnostic methods (plethysmography, dye test, computer tomography, sonography, lymphography) in diseases of the lymphatic vessels are presented. PMID- 6485436 TI - [Reye syndrome--a status review of current concepts of its pathogenesis]. AB - In Europe Reye's syndrome is a rather rare but often fatal disease affecting children and teenagers. Whereas an association with an antecedent viral illness has been documented, our knowledge concerning etiology and pathogeneseis remains sparse. A significant association between salicylate-medication during prodromal illness and RS has well been documented without demonstration of a causal relationship. The metabolic disturbance appears to stem from an acute mitochondrial lesion following a so far not fully understood viral, toxic or multimodal attack. Similar mitochondrial lesions are encountered in hypoglycin- or aflatoxin-intoxication. Consequently the intramitochondrial steps of the urea cycle are blocked leading to its breakdown in the scene of a tremendous nitrogen load flooding the organism with ammonia. A number of suspected pathogens are being discussed of which ammonia seems most capable of inducing the neurologic symptoms of RS probably in conjunction with elevated free fatty acids. PMID- 6485437 TI - Prolonged cholestatic jaundice and leukopenia associated with piroxicam. AB - A case of prolonged cholestatic jaundice and leukopenia occurring in a 60 year old wh piroxicam--a non-steroidal antiinflammatory agent--is reported. Histological examination of liver biopsy revealed pronounced canalicular and intracellular bile retention. After discontinuation of the drug serum bilirubin declined to normal values over a period of 10 weeks. PMID- 6485438 TI - [Secretin and cholecystokinin: hormonal action on the concentration of vasoactive intestinal polypeptide and gastrin in human subjects?]. AB - There is little, and partially contradictory information about the mutual hormonal effects of peptides. With the help of volunteers we investigated the influence of a new synthetic secretin (1 CU/kg/h, 0 to 120 min.) alone and in combination with GIH-CCK (1 IU/kg/h, 60 to 120 min.) on the concentration of VIP (n = 13) and gastrin (n = 20). Six of the volunteers were subjected to a randomized cross-over study under NaCl infusion in which both peptides were determined. The VIP concentration was not significantly influenced (31 +/- 3 - 34 +/- 4 - 38 +/- 4.5 pg/ml, p greater than 0.05) by either secretin (0 to 60 min.) or by secretin and CCK (60 to 120 min.). In contrast, secretin induced a significant fall in the gastrin level (30 +/- 2 vs. 24 +/- 2 pg/ml, p less than 0.05). With an additional administration of CCK there was a significant rise in gastrin (75 min.: 46 +/- 3 pg/ml, p less than 0.005) with a decline in peptide levels at the end of the infusion (135 min.: 23 +/- 2 pg/ml, p less than 0.005). The cross reactivity with GIH-CCK and CCK-octapeptide was 2.4 and 3% respectively. The increase in gastrin is not regarded as being due to cross reaction with CCK. This may be due to either contamination of the CCK preparation by other peptides which exert an influence on the gastrin level or the CCK induced release of bile. PMID- 6485439 TI - Pancreatic polypeptide response to sham feeding in man. AB - The relationship between gastric acid secretion and the release of pancreatic polypeptide (PP) during modified sham feeding was studied in 29 duodenal ulcer patients and 10 healthy controls. Ulcer patients showed higher basal plasma PP levels than age-matched controls (p less than 0.01). Acid secretion and PP levels were stimulated in the majority of patients and controls during sham feeding; however, no correlation was found between basal and vagally stimulated acid secretion and basal PP levels. Gastrin levels did not change in both groups. It is concluded from the present study that changes in plasma PP levels do not reflect sham feeding induced stimulation of the parietal cells. PMID- 6485440 TI - [Pancreatic polypeptide--an indicator of vagal tonus in the gastrointestinal tract and pancreas?]. PMID- 6485441 TI - [39th annual meeting of the German Society for Digestive and Metabolic Diseases in conjunction with the 16th annual meeting of the German Society for Gastroenterologic Endoscopy. Berlin, 4-6 October 1984. Abstracts]. PMID- 6485443 TI - [New modifications in end-to-end anastomosis between the esophagus and small intestine in animal experiments]. AB - A new modification of an end-to-end anastomosis between esophagus and small intestine is described. The anastomosis intramural shifted step by step does not lead to any insufficiency or stenosis as well in the animal experiment. Long-term results are still expected. This technique has already been proved for entero anastomoses in the patient. PMID- 6485442 TI - [Isolated acinus cells in the significance of ischemia in the pathogenesis of acute pancreatitis]. AB - Additionally to the pancreatic edema short-time ischemia represents an essential factor in formation of an experimentally induced acute pancreatitis. The consequences of such an ischemia at the guinea pig pancreas on the cellular energy metabolism were investigated in isolated exocrine cells. It was shown that intact acinus cells can be isolated as well as from normally perfused and ischemic pretreated pancreata. The energy metabolism was characterized by the difference between resting and maximum respiration after stepwise uncoupling. This parameter represents a dynamic measure and allows an estimate of the load capacity of the cellular energy metabolism. Exocrine cells isolated after ischemia (20 minutes), had a smaller load capacity than cells from normally perfused pancreata. This indicates an alteration of energy supply after ischemia. The consequences of this reduced supply on energy dependent repairing and protective mechanisms are discussed in terms of the pathogenesis of acute pancreatitis. PMID- 6485444 TI - [Treating wounds and preparation for operations in experimental surgery]. AB - Experiences about the preparation and the accomplishment of experimental animal operations are reported by reason of many own animal operations. Reproducible and representative animal experimental results require the appropriate preparation of the operating area, the pre-operative, intraoperative, and postoperative care of animals, an undisturbed healing process, and a lot of serious specialities. PMID- 6485446 TI - [Pathogenesis of systemic lupus erythematosus: effect of aromatic amines]. PMID- 6485445 TI - [Xenogeneic transplantation of human malignant melanoma under high-dose immunosuppression]. AB - The application of methotrexate led in Wistar rats to the known toxic effects. Malignant human melanoma cells can be transplanted in pretreated animals by contribution of the immunosuppression by means of Azathioprine. The transplanted tumors spread and proliferate in the organism of the receiver. PMID- 6485447 TI - [Fasciitis eosinophilica--transition to an unusual scleroderma (scleroderma fasciitis)]. AB - Eosionophilic fasciitis (EF) was observed in a girl who suddenly developed indurations of the limbs accompanied by hypergammaglobulinaemia and peripheral eosinophilia. The deep fascia was impressively thickened and infiltrated with numerous inflammatory cells showing focal accumulations of eosinophils. The disease was progressive in spite of application of corticosteroids, and within three years, symmetrical sclerodermatous lesions developed on the face and trunk, going along with a severe sclerodactyly without Raynaud's phenomenon, as well as contractures of the upper and lower limbs causing complete disability. Visceral involvement was slight (decreased motility of the esophagus and restriction of pulmonal function); slight calcium deposits were disclosed at the soft tissue of the ankles; and nuclear antibodies of the speckled type appeared in a titer up to 320. The fascia was still the most involved tissue, but there was no peripheral or tissue eosinophilia. EF seems to be a special variant within the broad spectrum of scleroderma; and although it usually has a benign course, it may change into an unclassified variety of scleroderma and lead to severe disability. PMID- 6485448 TI - [Transient acantholytic dermatosis (Grover)]. AB - Case report about a 79 year old man with transient acantholytic dermatosis (TAD). Review of the literature of Grover's disease. PMID- 6485449 TI - [HLA typing in patients of German origin with recurrent benign aphthosis and Behcet's disease]. AB - HLA-pattern was analysed in 60 patients with recurrent benign aphthosis (RBA), in another 14 suffering from Behcet's disease (BD) and in 200 healthy individuals, all of German origin. High prevalence rates of HLA-A2, HLA-B5 and HLA-Cw3 haplotypes were found in patients with RBA, yet significant only for HLA-Cw3 (p = 0.01). HLA-B5 was shown in none but two German patients with BD. These results are discussed with particular regard to reports on racial differences of HLA patterns in the populations of several continents including patients with aphthous disorders. PMID- 6485450 TI - [Clinical variability of polyvinylpyrrolidone dermatosis]. AB - Several pharmaceutics on the market contain polyvinylpyrrolidone (PVP). As the high-polymeric parts of the PVP molecules cannot be eliminated after parenteral or subcutaneous application, they accumulate in the organism. PVP residues in the dermis cause a considerable variability of skin changes, ranging from deposits nearly without reactions up to swelling, papules, granulomas and pseudotumors. PMID- 6485452 TI - [Side effects and risks of phototherapy]. AB - Interference factors of UV-therapy are among others the absolutely unknown biological activities of visible and ultra red wavelengths, which represent the main part of the energy emitted from all UV-sources. They produce a rise of the skin surface temperature up to 42-44 centigrades immediately followed by a reticulate erythema as well as a proliferative response of basal cells, which goes synchronously with that after SUP or UVA application but does not result in hyperproliferation. Acute side effects are direct toxic activities of UV-light with sunburn, up to severe bullous reaction, but without scarring; exacerbation of UV-sensitive dermatoses, internal diseases, and modulations of the immune system. PMID- 6485453 TI - [Fluorescent lamps from the actinic viewpoint]. AB - Fluorescent lamps for general lighting purposes cannot produce UV erythema or direct pigmentation whereas sun lamps used for tanning are comparable to the actinic effects of natural radiation at a clear summer day. Chronic effects due to fluorescent lighting have not been proved so far. PMID- 6485451 TI - [Macrophotography in transmitted light. Contribution to an analysis of horizontal structures of pigmented skin tumors]. AB - Macrophotography leads to better comprehension of the horizontal plane of pigmented skin lesions. It issues supplementary data for early clinical diagnosis and differentiation of malignant skin tumors. Strong contrast and increased depth of field in transmitted light can give additional data. PMID- 6485454 TI - [Treatment of naevus flammeus lateralis by infrared contact coagulation]. AB - Twelve patients with port wine stains were treated with the infra-red contact coagulator. Good cosmetic results were achieved after nine treatments on the average. We obtained a distinct or nearly complete blanching of the port wine stains without conspicuous scar formation. PMID- 6485455 TI - [Continuous plasma filtration. Experiences in the treatment of pemphigus vulgaris]. AB - By means of continuous plasmafiltration, considerable and rapid improvement could be achieved with regard to the skin lesions as well as antibody titers of a patient suffering from pemphigus vulgaris. Apart from plasmafiltration, treatment with azathioprim and steroids proved to be effective. Neither significant side effects nor infectious complications have been observed. PMID- 6485456 TI - [Regression of plantar warts following treatment with diphencyprone]. AB - Therapy-resistant plantar warts of 8 patients have been topically treated with diphencyprone, a new potent contact allergen. Three of the patients showed only one single aggregation of warts, which completely disappeared within two or three months after start of treatment. In the other five patients who had multilocular warts, a controlled trial was performed. In three of these patients only the treated warts resolved whereas the untreated ones persisted. In one case all warts disappeared already during the period of sensitization, and in the fifth patient the warts persisted without any change. PMID- 6485457 TI - [Biomechanical studies of human and animal skin in vivo and in vitro]. AB - With the help of biomechanical and biochemical methods, the dependence of human and rat skin on maturation and aging could be demonstrated in excised samples. Ultimate load, tensile strength, and modulus of elasticity showed a sharp increase during maturation and a slow decrease during aging, in both rat and human skin. In both species, ultimate extension revealed a similar behaviour, but the increase during maturation was less pronounced. The age-depending changes of the mechanical parameters in rat skin were influenced by anisotropic properties, which at least partially could be explained by the existence of the skin muscle layer in rats. Tensile strength of skin was closely correlated with the contents of insoluble collagen, e.g. the degree of cross linking. There was, however, no correlation between tensile strength and the contents of soluble collagen, glycosaminoglycans, or elastin. Further experiments like hysteresis, relaxation, and creeping behaviour indicated that plasticity and viscosity of skin both decrease during maturation and aging. Taking into account the experimental conditions, the results gained "in vivo" correlate with those obtained "in vitro". PMID- 6485458 TI - [The thyroid gland, the parathyroid gland and the skin]. AB - Hormones of the thyroid gland (thyroxine, tri-iodothyronine) control the metabolism of cells and tissue of the body, while parathormone and calcitonine are balancing the intra- and extracellular levels of calcium and phosphorus by governing some metabolic functions of bones, kidney and small intestine. Growth, maturation and metabolic homeostasis of the organism depend, among other intrinsic factors, on a normal production and secretory rate of both thyroidal and parathyroidal hormones. Clinical conditions of hyperthyroidism induce 1. increased metabolic turnover of the body with transcutaneous heat loss, 2. disordered growth of hairs and nails, 3. hyperpigmentation of skin, 4. pruritus with or without urticaria. Pretibial (usually symmetrical) myxedema may be associated with conditions of either hyper- or hypothyroidism (e.g., Hashimoto's thyroiditis); if combined with bilateral exophthalmus and acropachyderma of fingers and toes, it is called Diamond syndrome, or E.M.O. syndrome. In hypothyroidism, the skin feels chilly and dry, looks pale, and may present follicular keratoses with or without secondary eczema. The hair appears dull and sparse due to disordered anagen phase. Skin wounds heal with delay. Diffuse myxedema originates in the papillary and periadnexal connective tissue and eventually extends to the dermis as a whole. Clinical conditions of hyperparathyroidism rarely cause secondary calcification of the skin; they may induce severe pruritus, particularly in secondary hyperparathyroidism due to renal failure. Impetigo herpetiformis or generalized pustular psoriasis, resp., may be set off by excessive surgical removal of the goiter. Congenital maldevelopment of both thymus and parathyroid gland leads to cellular immune deficiency with secondary chronic muco-cutaneous candidosis. PMID- 6485459 TI - [Behcet disease with inner ear involvement]. AB - Behcet's disease may also insolve the inner ear. We report on a 24-year-old man having suffered from defective hearing already since two years after onset of Behcet's disease. During the follow-up period, vertiginous attacks, tinnitus, as well as feeling of pressure in both ears have been additionally observed. PMID- 6485460 TI - [Monilethrix: exclusive involvement of body hair]. AB - In a family suffering from monilethrix, at first sight only one generation seemed to be affected, suggesting a recessive mode of inheritance. A thorough examination of the scalp and body hair of all family members, however, revealed three other affected persons in two more generations proving autosomal dominant transmission. We consider this observation an additional argument against the existence of a recessive type of monilethrix which has been postulated in the past. PMID- 6485461 TI - [Dowling-Degos disease]. AB - On the basis of a case report, we discuss diagnosis and differential diagnosis of Dowling Degos disease. Of special importance seems to be differentiation from acanthosis nigricans, because the patients may be saved straining and expensive clinical examination. PMID- 6485463 TI - [Differential diagnosis of partial lipodystrophies]. AB - Based on recently published findings there can be differentiated three disease entities of partial lipodystrophies. We report on two special courses differing from the progressive lipodystrophy by sparing the face. The main clinical and laboratory findings as well as pathogenetic concepts are discussed. PMID- 6485462 TI - [Significance of gallium scintigraphy in tumors and granulomatosis of the skin]. AB - Scintigraphy with gallium has proved useful as a screening method for the diagnosis of certain malignant tumors and systemic diseases. One single scintigraphic investigation is able to detect almost all organs of a man. We checked this radiopharmacon with regard to its usefulness in dermatology. Gallium scintigraphy shows high sensitivity concerning verification and localization of metastases of malignant melanome as well as B- and T-cell lymphomas. Moreover, gallium is effective in controlling the therapie of sarcoidosis. PMID- 6485464 TI - [Echocardiographic monitoring of acute myocardial infarct following intracoronary streptolysis treatment]. AB - Two-dimensional echocardiography is helpful in the detection of wall motion abnormalities and in the evaluation of time courses of regional function due to interventions. Of 301 patients with acute myocardial infarction treated with selective intracoronary infusion of streptokinase, 229 (76%) revealed a totally occluded infarct related vessel at the first angiography. In 64 patients a two dimensional apical long-axis view of good technical quality could be obtained after admission, on the 1st, 2nd and 3rd day and again in the 4th to 6th week and the 9th to 14th month after the acute intervention. The collective was divided into two subgroups according to the different time interval between the beginning of symptoms of infarction and the reopening of the occluded vessel. 35 patients had a total time of occlusion of less than 4 hours (group A), while in 29 others this time exceeded 4 hours or thrombolysis was unsuccessful (group B). Using a computer system, the center of gravity of the end-systolic frame of the left ventricle was used as an inner fix point. 10 end-systolic and end-diastolic area segments were constructed. Regional wall motion was determined as a percentual change of the enclosed area, normalized to the end-diastolic area (% delta F). The ejection fraction was calculated using a disc method. In group A the ejection fraction increased from initially 46 +/- 9% to 51 +/- 8%, 52 +/- 8% (p less than 0.05) and 53 +/- 8% (p less than 0.01) on the 1st, 2nd and 3rd day, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485466 TI - [Error magnitude of measurement sensors in air segment plethysmography]. AB - Besides examining the properties of the material involved, this investigation assesses the so-called static and dynamic measurement errors of sensors used for air segment plethysmography. The static error which has been found with the new BN sensors amounts to 8% (old models: 31%-44%). The folding of the interior membrane of the sensor resting upon the skin, which increases proportionately to the stiffness of the material, is discussed as a source of error. If a lockable steel wrapping is employed as an exterior cover for the sensors, the static measurement error decreases by 30%-50%. These results suggest a recommendation to use a metal wrapping for the sensors as described above even with routine air segment plethysmographic examinations, and additionally to correct by mathematical means the static measurement error (which has to be determined for each sensor individually). The measurement error of the sensors of the new BN series amounts to less than 5% for a frequency of not more than 0.5 Hz; this means that blood flow values amounting to more than 50 ml/(min X 100 ml) are indicated correctly with respect to the actual frequency. If the usual linen covering is used instead of the steel cover, the linearity of the frequency is only valid up to 0.1 Hz--the corresponding blood flow value being 15 ml/(min X 100 ml). PMID- 6485467 TI - [Evaluation of air segment plethysmography using computer tomography]. AB - The measurement of tissue volume in the calf area carried out by computer tomography and planimetry showed a nearly elliptic form, an average bony part of 9.9 ml (9.3%), and an average tissue volume of 97.7 ml (90.7%). When compared with the tissue volume approximation (cylinder formula) the tissue volumes thus specified were too large. The error, depending on the circumference of the calf, was about 5 to 15%. There was a difference of 5% between the venous capacity measured by computer-tomography on the one hand and air segment plethysmography on the other. The reason for this is found in the varying density of veins in the examined area. The application of the sensor on the skin caused an average reduction of 5.4% in total volume and thus in the blood volume of about 59% in the examined area. The pressure-dependent venous capacity was measured with and without application of the sensors on the skin and controlled by computer tomography. The results showed an average difference of only 2.1%. Thus it is obviously unimportant for the results of the investigation presented, if the venous capacity is measured on the basis of the reduced total volume caused by the application of the sensors on the skin. With regard to the computer tomographical and planimetrical control and the error of measurement discussed, the results suggest a sufficient precision of the venoextensiometry measuring the pressure-dependent venous capacity. PMID- 6485465 TI - [Occlusion of the right coronary artery with acute right heart infarct and cardiogenic shock]. AB - In a 42-year-old patient with an acute inferior infarction the right coronary artery was recanalised by intracoronary streptokinase 4 hours after the onset of symptoms. In spite of early reperfusion the patient developed an extensive myocardial infarction and died three days later from cardiogenic shock. Autopsy revealed an almost complete necrosis of the right ventricle including the inferior interventricular septum and the adjacent left ventricular wall. Diagnostic and therapeutic problems in the so-called dominant right ventricular infarction are discussed. PMID- 6485469 TI - [Sympathetic activity in patients with coronary insufficiency]. AB - Twelve healthy control subjects, 9 cardiac patients with normal central hemodynamics, 9 patients with impaired left-ventricular contractility during exercise, and 10 patients with impaired contractility and coronary insufficiency (anginal pain and ST-segment depression of ECG) were investigated. Central hemodynamic values (Swan-Ganz catheter) as well as free plasma catecholamines noradrenaline and adrenaline were simultaneously determined at rest and during incremental exercise. At rest, no significant differences were observed between all groups. The cardiac patients with normal central hemodynamics also did not show any significant differences in their plasma catecholamine responses during exercise as compared with healthy control subjects. Patients with impaired left ventricular contractility, indicated by a significantly increased pulmonary capillary wedge pressure, as reference value of increased left ventricular end diastolic pressure, both with negative and positive indicators of coronary insufficiency during exercise, showed significantly higher noradrenaline levels at identical work loads than control subjects. However, adrenaline responses were only significantly higher in patients with positive indicators of coronary insufficiency during exercise. The noradrenergic responses may be triggered by a borderline reduction of cardiac output as well as by increased pressures in the low-pressure system. The over-proportional adrenergic responses may be an indicator of precordial anginal pain and anxiety. This reaction is seen to be significant for a further increase in myocardial oxygen demands and anginal pain. PMID- 6485468 TI - [Clinical relevance of the so-called arteria lusoria in childhood]. AB - Although arteria lusoria is relatively frequent, symptomatic cases are rare in childhood. Symptoms are not caused by the retroesophageal course of the vessel itself, but by additional anomalies of the other branches of the aortic arch, above all by the pretracheal course of the equilateral arteria carotis communis. In very rare cases, the anomalous right arteria subclavia passes between esophagus and trachea and may cause threatened impending respiratory disturbances together with an aberrant course of the arteria carotis. The diagnostic and therapeutic procedure is discussed; the development of pulmonary hypertension in vascular respiratory disturbances is pointed out. PMID- 6485470 TI - [Central venous injection of large amounts of contrast media--advantages of a low osmolar contrast medium in experimentally-induced pulmonary hypertension]. AB - Intravenous administration of contrast material is a prerequisite for the imaging of the cardiovascular system with computed tomography and digital subtraction techniques. Fatal side effects after intravenous contrast injection, particularly in patients with pulmonary hypertension, have been reported repeatedly. The object of this study was to compare hemodynamic side effects of a conventional, ionic contrast medium (amidotrizoate; 2.1 osmol/kg) and a modern, non-ionic compound (iopamidol; 0.8 osmol/kg) after intravenous bolus injection (1.5 ml/kg). Experiments were carried out in 10 open-chest dogs with pulmonary normotension and hypertension induced by embolisation. Under control conditions (PPA = 19.9 mm Hg) both contrast media produced marked pulmonary and peripheral vasodilation. Major effects were seen after amidotrizoate (RPULM 60.3%, RPERI 32.1% vs 72.5% and 70.4% of controls). In pulmonary hypertension (PPA = 44.2 mmHg), iopamidol had similar hemodynamic effects compared to control conditions. In contrast, amidotrizoate initially led to a significant increase in pulmonary pressure and resistance (PPA = 118.6%; RPULM = 141.7%) followed by a delayed depression of right ventricular function (dP/dt = 65.3%; PRVED = 180.9%). Resuscitation was required in 3 dogs with pulmonary hypertension after amidotrizoate injection. Because of these unfavorable hemodynamic side effects of the conventional high osmolality contrast medium in animal experiments, it can be expected that modern compounds with low osmolality pruduce smaller side effects during diognostic interventions in patients with pulmonary hypertension. PMID- 6485471 TI - [Significance of the detection of echocardiographic vegetation for the clinical course and prognosis of infectious endocarditis]. AB - 52 patients with infective endocarditis and manifestations on 62 valves were examined by echocardiography between January 1978 and May 1983. In 34 patients (65%) vegetations were visible at least on one valve, in 10 patients (19%) the result was doubtful and in 8 patients (16%) no vegetations could be seen. In a comparison of echocardiographic and intraoperative or autopsy findings, with doubtful results left out, the over-all sensitivity was 96%, specifity 44% and reliability 83%. There was no statistically significant difference in echocardiographic results between patients who were operated upon or treated medically. Patients with positive echocardiographic vegetations had no statistically significant higher risk of embolism. Morphological aspects of the vegetations had no influence on clinical course and prognosis either. All 12 patients (23%) who died had positive echocardiographic vegetations. Yet the difference from the surviving group was not significant. Hence, echocardiography is a sufficiently sensitive and reliable method for the detection of vegetations in patients with infective endocarditis. However, echocardiographic findings alone are of no consequence in medical or surgical treatment, arterial embolization or prognosis. PMID- 6485472 TI - [Echocardiographic study for optimizing therapy with physiologic heart pacemakers -the relevance of mitral valve motion]. AB - The hemodynamic effects of the AV-intervals 50, 150 and 250 ms were studied in 19 patients with VDD pacemakers and compared to VVI stimulation and 12 normal individuals. LV dimensions and systolic and diastolic time intervals were measured with echo-phonoapexcardiography. The amplitude of LV-contraction, LV enddiastolic diameter, PEP, LVET and PEP/LVET significantly improved with physiological pacing when compared to VVI-stimulation. The optimal AV-interval was 50 ms in 8 patients, 150 ms in 7 and 250 ms in 4. Mitral valve closure (128 +/- 13 ms) and PEP (193 +/- 19) were grossly delayed in comparison to normal individuals. With increasing AV-intervals PEP and the onset of rise in the apexcardiogram were not changed but mitral valve closure occurred earlier, being 128 +/- 13 ms at AV = 50, 82 +/- 36 ms at AV = 150 and 20 +/- 73 ms at AV = 250. Simultaneously LV-filling time normalized for cycle length decreased from 50 +/- 5% to 45 +/- 8% and 38 +/- 10% respectively. In the presence of early mitral valve closure there was a late mitral notch, which occurred 10 +/- 20 ms after the onset of rise of the apexcardiogram. Thus the onset of the isovolumic contraction period was defined. In patients with VDD pacemakers therefore, echocardiography allows measurements of LV function, of the late onset of systole, and of mitral valve closure, which depends on the previous PR-interval. These values need to be considered in programming the optimal AV-interval and cannot be derived from normal individuals. PMID- 6485473 TI - [Fetal echocardiography--possibilities and limits]. AB - Actual possibilities and limitations in fetal echocardiography (two-dimensional and impulse-Doppler technique) based on our own experiences in 53 cases are described. Morphological analysis was almost successful after the 22nd week of gestation, in 11.3% the imaging was inadequate as the result of unfavorable ultrasound viewing. In twins especially the morphological analysis of the second fetus was more difficult. Clear morphological differentiation from the important parts of the fetus heart was possible after the 30th week of gestation in the majority of cases. From 47 sonographically judgeable fetal hearts 3 were classified as malformations. One of them could be confirmed by autopsy (ventricle septal defect combined with cor monatrium), the second case clinically/echocardiographically postpartally respectively (atrial septal defect secundum type). On the other hand the third pathological diagnosis of fetal echocardiography (single ventricle) could not be confirmed post-natally. As the result of this preliminary study fetal echocardiography can currently provide some important clues for the selection, perinatological treatment and care in birth of the child with a potentially higher risk factor. Additionally the authors point out the possibilities of complex functional analysis of the fetal heart under different pharmacological treatment. PMID- 6485474 TI - [A transient right ventricular thrombus following myocardial infarct of the posterior wall--diagnosis using 2-dimensional echocardiography]. AB - We present a right ventricular thrombus formation following a left ventricular posterior wall myocardial infarction; diagnosis was achieved by two-dimensional echocardiography. Follow-up revealed the decreasing echogenity of the thrombus and lastly its resolution. PMID- 6485475 TI - [Stress and coping with stress in the aged]. PMID- 6485476 TI - [Stressors as the cause of gerontopsychiatric diseases]. AB - It is permitted to apply concepts of stress theory to clinical geropsychiatry. Biographical factors, health, illness, organic and psychosocial factors of immediate and indirect kind are very important on development and course of geropsychiatric disease. Special significance has the influence of aging. Quantity and quality of stressors must be judged as non-specificial causal factors. Treatment depends on ascertained factors. The interpretation is explained on examples of depression, dementia, and institutionalism syndrome. PMID- 6485477 TI - [Reactions to health stress in middle and advanced adulthood]. AB - Psychological reactions and their 'hierarchies' regarding the own health status were analysed in a sample of 81 survivors of the Bonn Longitudinal Study on Aging and in different clinical samples (patients suffering from hemophilia, renal failure, heart infarction, stroke, and schizophrenia). The longitudinal analysis of the health-related response hierarchy points to a high degree of consistency of these reactions over time. Comparing the response hierarchies of the aged sample as related to different areas of life stress (such as housing, income, family, health problems), the author finds a high degree of discriminative competence in coping with stress. The same is true for the response hierarchies of the patient groups. This high degree of situation-specific selectivity in patterns of responses to chronical disease should be studied more intensively from theoretical as well as clinical-practical points of view. PMID- 6485478 TI - [Stress and stress management in home relocation of the elderly]. AB - This report includes the theoretical approach and some empirical findings of a study in which the relocation of elderly persons to old-age institutions is interpreted from the perspective of environmental psychology and life-event research. It is hypothesized that the psychological effects of relocation are a result of the confrontation with stressful environmental features of the institution, the subjective appraisal of the situation, and the coping strategies of the individual. 13 different coping strategies of the elderly residents were differentiated by content analysis of interviews. Bivariate relations were analyzed between coping strategies and the following variables: stressful institutional environment, perceived stress, beliefs about personal control, and depression. From the psychological point of view, especially those findings seem to be important that show coping strategies implying a renunciation of personal control correlates with greater perceived stress. In institutions with greater autonomy, residents show more problem-focused coping behavior in stress situations, whereas in institutions with reduced autonomy residents seem to prefer cognitive coping strategies. PMID- 6485479 TI - [Care of chronically ill geriatric patients with the cooperation of relatives]. AB - In the first stage of the project "assistance of relatives for the care of chronically ill people" in context of the National Research Programme No 8 (Economy and efficacy of the Swiss Health System) a representative random sample of elderly longterm patients was arranged in Basle and the situation regarding their relatives investigated. Altogether 473 relatives were contacted. Finally 343 interviews with next-of-kin were held and as many questionnaires filled out. The main aim of the questioning in the first part of the study was to know who would be able to participate in the care at the hospital on a part-time basis. Basing on the results, it may be presumed that about 30% of the relatives of chronically ill patients who have regular personal contact with them are ready and willing to participate actively in a co-operative model set-up of a nursing institution. In the second stage the way should be paved for the management of a pilot-station. During the research programme between 1983 and 1985, the model idea should be examined for its practicability. Afterwards it can be judged if the basic idea of the project evidences a real progress or remains a social medical utopia. PMID- 6485480 TI - [Peculiarities of crisis intervention with marital partners in the 2d half of life]. AB - Marital therapeutic procedures can be reduced to two fundamental psychotherapeutic orientations: Communication and behavior therapy. From these, we selected four strategies of treatment. They concerned training in goal orientated, conflict-orientated, feedback-orientated and goal-plus feedback orientated dialogue of the partners. There is no knowledge about the possible effects with regard to spouses of the second half of life. So we analyzed these strategies empirically with eight groups of different variables for a sample of 20 dyads. Their disturbances and disharmonies existed many years. A goal-oriented treatment is the most effective of all the strategies. A combination of communication-therapeutic and behavior-therapeutic elements proves itself to be an overstrain for couples of the studied group of age. PMID- 6485481 TI - [Rehabilitative treatment of cerebral apoplectic insults in advanced age and evaluating its effectiveness--results of a model project]. AB - This report is of a two year study of stroke rehabilitation. Given certain conditions with specialized personnel and equipment the rehabilitation of elderly stroke patients can be managed co-operatively in hospitals and old age care centres. The rehabilitation of stroke affected is based on the support of multidisciplinary diagnosis and interdisciplinary teamwork between physicians, physiotherapists, occupational therapists, speech therapists, psychologists and social workers. Each patient requires an individual treatment program. In this study were 72 patients ranging in age from 42-87 years, average age 73 years. They had been judged as progressively degenerative and helpless following their stroke and consequently regarded as patients for a nursing home. Following special rehabilitation treatment 75% (54 patients) had improved enough that it was possible for them to return to their homes. Only 12.5% (9 patients) had to remain in a nursing home. 6.6% (4 patients) transferred to an old people's home. 6.9% (9 patients) were readmitted to hospital because of additional serious complications. The average duration of rehabilitative treatment was 72.3 days. The degree of hemiplegia and the patients ability to lead their own active daily independent life was reviewed before and after rehabilitation and used as control. 76.6% showed an improvement in their motor function. 61.1% returned to their own independent daily life as measured by ADL-Indices. (a. Barthel Index, b. ADL-Index-Katz-, c. Patient Classification for Long Term Care-Jones-, d. Crichton Royal Behavioural Rating Scale-Robinson-.).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485482 TI - [A questionnaire for the detection of psychiatric and somatic complaints in the elderly]. AB - A questionnaire of psychic and somatic complaints for the elderly is presented. This questionnaire assesses with 8 factors the following symptoms cluster: depression, anxiety, cognitive disturbances, somatic complaints, social problems, sleep problems, psychotic experiences, and sexual disturbances. These subscales are reliable and valid measures. This measure is helpful in particular in epidemiological research and also in clinical day-to-day practice. PMID- 6485483 TI - [Urinary incontinence in the aged]. AB - Urine incontinence in elderly patients can be observed in about 7% of men and 12% of women. Short review of the anatomy of the urinary bladder, continence mechanism, micturation and bladder innervation. Description of urodynamic examination and the various forms of incontinence with differentiation between extrasphincteric urinary leakage (ectopic ureter, fistula) and incontinence due to weakness of the sphincter or detrusor dysfunction. Discussion of the detrusor function in "neurogenic bladder" as cause of incontinence in many diseases of elderly people (apoplexia, M. Parkinson, diabetes etc.). Briefing of the therapeutic possibilities. PMID- 6485484 TI - [Diagnostic strategies in pre-field studies]. PMID- 6485485 TI - [The question of a false-structured ceruloplasmin in Wilson's disease]. PMID- 6485486 TI - [The use of solidified thrombocytes as control material for thrombocyte counting on the Laborscale and Picoscale]. PMID- 6485488 TI - [Principles of rational laboratory diagnosis]. PMID- 6485487 TI - A modified micromethod for determination of cathepsin activity in blood serum. PMID- 6485489 TI - [Simplification of serial enzyme activity determinations in the diagnosis and control of acute myocardial infarct]. PMID- 6485491 TI - Lamination of the superficial layers of the rabbit's superior colliculus. PMID- 6485490 TI - Ascending anterograde degeneration of some rabbit spinal cord tracts after ischemic damage. PMID- 6485492 TI - Acid hydrolase distribution in sensitised and naive macrophages in vivo and in vitro. PMID- 6485493 TI - [Relations between histomorphometric parameters of the human submandibular gland, thyroid gland and kidney]. PMID- 6485494 TI - [Ultrastructure of the basement membrane of Geoplana carinata Riester 1938 (Platyhelminthes--Turbellaria)]. PMID- 6485495 TI - Effects of chemosterilants on the reproductive organs of the dog-tick, Riphicpehalus sanguineus (L). PMID- 6485496 TI - Histomorphological study of the thyroid gland in juvenile and adult (non-breeding and breeding) female soft-shelled turtles (Lissemys punctata puctata). PMID- 6485497 TI - Neurosecretory system of the thoracic ganglion and its relation to testicular maturation of the crab, Potamon koolooense (Rathbun). PMID- 6485498 TI - [Demonstration of exogenous horseradish peroxidase in the main part of male and female rat kidney]. PMID- 6485499 TI - Alveolar epithelial cells of the mammary gland of lactating Myotis myotis: an ultrastructural study. PMID- 6485500 TI - [Growth in body height and weight in boys and girls of school age with special reference to social class. II: Practical studies]. PMID- 6485501 TI - [Biomechanical significance of arm length and body mass for a suspended manner of locomotion]. PMID- 6485502 TI - [Kinesiologic studies of brachiation in white-hand gibbons (Hylobates lar)]. PMID- 6485503 TI - The testing of an allometric center model of craniofacial growth. PMID- 6485504 TI - Physical anthropology of two tribal groups of Amazonic Peru (with reference to artificial cranial deformation). PMID- 6485505 TI - [Papillary ridges of palmar interdigital fields--aspects of bilateral asymmetry]. PMID- 6485506 TI - Transferrin subtyping by isoelectrofocusing in three West Bengal populations. PMID- 6485507 TI - [Inflammatory joint diseases and collagenoses]. PMID- 6485508 TI - ["Critical compression pressure" or optimal drainage pressure]. PMID- 6485509 TI - [Clinically occult breast findings with special reference to the early detection of breast cancer]. PMID- 6485510 TI - [Cases from the edema consultation]. PMID- 6485511 TI - [Unconventional concepts of treatment in diseases of the lymphatic system]. PMID- 6485512 TI - [Differences between spleen and thymus cells of rats with respect to the effects of ethidium bromide on unscheduled DNA synthesis (DNA repair synthesis) and nucleoid sedimentation]. AB - To get further insight into the causes of differences between rat splenic and thymic cells with regard to DNA repair synthesis, scheduled (SDS) and unscheduled (UDS) DNA synthesis as well as nucleoid sedimentation of the cells were investigated under the influence of ethidium bromide (EB, 1-1000 micrograms/ml). At concentrations of greater than or equal to 25 micrograms/ml, EB inhibited SDS of both cell species and UDS of thymic cells; much higher additions of the drug (greater than 200 micrograms/ml) were needed to diminish UDS of splenic cells, lower EB-concentrations (25-175 micrograms/ml) stimulating the UDS of the splenic cell preparation. - The sedimentation rate of splenic and thymic cell nucleoids within neutral sucrose gradients had a biphasic dependence on the EB concentrations. As compared to thymic cells however, preincubation of splenic cells with 50-250 micrograms EB/ml resulted in a significant greater (15-30 percent) sedimentation distance. - The results suggest that a relationship exists between the stimulation of UDS and the ability of cells to establish a greater DNA compactness in the presence of EB. PMID- 6485513 TI - A granulopoiesis inhibitor partially purified from large-scale serum-free cultures of porcine leukocytes. AB - A method is described for the partial purification of a granulomonopoiesis inhibitor derived from 200 l-batches equivalent to 1 kg or 2 X 10(12) leukocytes of porcine blood. Serum-free conditioned media were concentrated and separated via ammonium sulfate precipitation, acetone partitioning, ultrafiltration and gel chromatography. The active substance revealed a molecular mass of 500-700 Da and was not thiol-dependent, thus contrasting it with previously-reported granulopoiesis inhibitors. Inhibition of colony formation in an in vitro myeloid stem cell assay using various colony-stimulating factors showed that mature granulocytes and monocytes were equally affected. Apparent lack of cytotoxicity was suggested using a new reversibility test. PMID- 6485514 TI - Thermal diffusion as a mechanism for biological transport. AB - Accumulated experimental information is used to assess the possible significance of thermal diffusion to mass transport in living matter. Possible thermal gradients across membranes, a single living cell, and an ensemble of such cells (e.g. an organ, tumor, etc.) are estimated. The corresponding model calculations, although not describing the biological process in detail, lead to conclusions about the possibilities for thermal diffusion as follows. Adequate thermal gradients to support substantial thermal diffusion could exist across biological membranes. Thermal diffusive flow would become significant when ordinary Fickian diffusion is sufficiently suppressed, e.g. in more concentrated systems near critical points of solution (i.e. near incipient phase separations). Conditions favorable to thermal diffusion functioning as a mechanism for active transport appear possible. Thermal diffusion appears much more important for transport into and out of an ensemble of cells than into or out of a single cell. Such mass transport by thermal diffusion could assume a sizable magnitude for an ensemble of cells with the dimensions of an organ or a tumor. PMID- 6485515 TI - Contract medicine: what's in it for you? PMID- 6485516 TI - Viruses and arthritis. PMID- 6485517 TI - Wrong perspective. PMID- 6485518 TI - Waiting for the other shoe to drop. PMID- 6485519 TI - Management of obesity. PMID- 6485520 TI - Food safety: regulations, research, and results. PMID- 6485521 TI - Anorexia nervosa. PMID- 6485522 TI - Foraging for food. PMID- 6485523 TI - [Mechanical and biomechanical prerequisites of chronic venous insufficiency]. PMID- 6485524 TI - [Transcutaneous oxygen pressure during intra-arterial infusions]. PMID- 6485525 TI - Transcutaneous oxygen tension in chronic venous insufficiency syndrome. PMID- 6485526 TI - [Morphologic changes in Dardik venous transplants]. PMID- 6485527 TI - [Vascular injuries in the area of the pelvis and the leg--reconstruction, complications and operative results]. PMID- 6485528 TI - Prevention of venous leg ulcer recurrence by a simplified procedure of perforator ligation in ambulant practice. PMID- 6485529 TI - Surgical treatment of the subclavian steal syndrome by the transthoracal approach. PMID- 6485530 TI - [So-called cystic adventitia degeneration of the popliteal artery with pedicle connection to the knee joint (case report)]. PMID- 6485531 TI - [Opsonin deficiency as the cause of disorders of phagocytic reactions of neutrophils in staphyloderma patients]. PMID- 6485532 TI - [Changes in lymphocyte and neutrophil rosette formation in patients with microbial eczema and tinea pedis]. PMID- 6485533 TI - [Immunoglobulin factor reacting with components of epidermal basement membranes of patients with basal cell carcinoma]. PMID- 6485534 TI - [Peroxidation of membrane lipids in experimental photochemotherapy]. PMID- 6485535 TI - [Teaching dermatovenereology in Algeria]. PMID- 6485536 TI - [Determination of the number of spontaneous rosette-forming neutrophils as an additional differential-diagnostic test in palmo-plantar pustular psoriasis]. PMID- 6485537 TI - [Perspectives in the use of products of processing ether oil-yielding plants for the treatment of chronic dermatoses]. PMID- 6485538 TI - [Diagnosis of infectious diseases in dermatological practice]. PMID- 6485539 TI - [Characteristics of the clinical course of erysipelas and various indicators of nonspecific resistance in middle-aged patients]. PMID- 6485540 TI - [Pathomimesis]. PMID- 6485541 TI - [A case of pemphigus foliaceus after thymectomy]. PMID- 6485542 TI - [Liquid nitrogen cryotherapy in dermatology]. PMID- 6485543 TI - [Conservative treatment of Peyronie's disease with vitamin E and hydrocortisone]. PMID- 6485544 TI - [Treatment of chronic gonorrheal urethritis in men using a specially constructed irrigator]. PMID- 6485545 TI - [Causes of the development of tertiary syphilis]. PMID- 6485546 TI - Guidelines for investigating alcohol problems and developing appropriate responses. PMID- 6485547 TI - [Bases for predicting epizootics among rodents in a natural plague focus]. PMID- 6485548 TI - [The function of the capsule in yeasts]. PMID- 6485549 TI - [Compensatory acceleration of the functional maturation of the melatonin secreting structures in Rana arvalis tadpoles]. PMID- 6485550 TI - A tentative classification of agricultural foods exposed to roadside lead contamination. AB - A systematic study of vegetables and other agricultural products used as foods, was performed, in order to suggest a tentative classification of products exposed to roadside lead pollution from automobile exhausts. A hyperbolic two-parameter function is used as an empirical model to describe the decrease in lead content with the distance from the line source. Regression analysis of the linearized function allows the estimation of the parameters. Polluted products are classified by means of cluster analysis. PMID- 6485551 TI - [Thallium in wine--trace element vinogram of thallium]. AB - The ultra trace element Thallium is regularly found in very low quantities in wine, in red wines with 0.2 micrograms T1/1 about twice as much as in white wines. Certain hints the origin and behaviour of such low T1-contents can be derived from additional investigations (soil, location, fertilizer, influence of wine making). A correlation between T1 and K is known, but above that it can be shown, that similarly to Rb certain parts of the grape (grape, flesh, peel) are richer in T1 and that thereby the higher content of T1 in red wines can be explained. Slightly higher T1-levels are found in wines which grow next to cement plants or on abandoned mines. The Anodic Stripping Voltammetry in EDTA-containing base solution has proved effective for the determination of very low levels in the investigated samples. Wine and similar samples are decomposed with H2SO4 H2O2. After extraction as T1(III) bromide Thallium is measured by anodic stripping-voltammetry. The preceding separation of T1 from soil samples or the like is achieved by evaporation analysis. PMID- 6485552 TI - Rapid determination of chlorobutanol in milk by glass capillary gas chromatography. AB - A rapid method for the determination of chlorobutanol(1,1,1-trichloro-2 methylpropan-2-ol) in milk is described. The method is based on a steam distillation solvent-extraction technique and a quantitative determination of chlorobutanol by gas chromatography using a glass-capillary column coated with Carbowax 20M and 2,2,2-trichloroethanol as internal standard. The detection limit is 1 pg and recoveries of chlorobutanol are between 93 und 99%. Fifty-two milk samples have been analysed. PMID- 6485553 TI - [Analysis of residues of the fungicide cymoxanil in grapes using multicolumn HPLC]. AB - Residues of the contact fungicide Cymoxanil in grapes were determined by a multidimensional multicolumn high pressure liquid chromatography technique (MC HPLC). The sample pretreatment is a simple water extraction. Further clean-up and trace enrichment of an aliquot of the aqueous acidic sample solution is performed on-line via an automatized microprocessor controlled MC-HPLC system. In the range of 0.05-2.0 mg/kg grapes good linearity is achieved. Recoveries of Cymoxanil added to untreated grapes range between 70% and 80% at 0.05 and 2.0 mg/kg values, respectively, with a reproductibility of s +/- 3% at 0.2 mg/kg (n = 5). The total time for analysis is approximately 30 min. PMID- 6485554 TI - [The analysis of polysaccharides used as food additives. VIII. Simple qualitative and semiquantitative procedures for the determination of alginates in food]. AB - For a rapid and specific assay of alginate, the isolated polysaccharide is split by methanolic hydrochloric acid, the reaction products are separated on silica gel plates and visualized by an uronic acid specific naphthoresorcinol hydrochloride acid reagent. With the solvent ethylacetat/tert. butanol/water (68 + 23 + 9, v/v/v) the Rf-values of the hydrolysis compounds of alginate differ distinctly from those of the other uronic acids, which are constituents of commercial polysaccharides. The method had been tested successfully on a series of different foods (e.g. propyleneglycol alginate in beer). PMID- 6485555 TI - [Organochlorine pesticide residues in raw and roasted coffee and their degradation during the roasting process]. AB - An analysis method for determination of organochloro pesticides in green and roasted coffees was developed. 17 Arabica and 2 Robusta coffees originating from 11 countries were investigated. With the exception of two samples the amounts of pesticide residues found in the green coffees were considerably lower than the amounts permitted, according to the "Hochstmengenverordnung". In 2 coffees no residues were detectable. The residues were reduced to insignificant amounts during the roasting process. The degradation rates ranged from 85% to 100%. Since the residues detected in all of the roasted coffees were insignificant, no further investigation of the corresponding beverages was necessary. PMID- 6485556 TI - [Determination of deoxynivalenol and nivalenol in cereals at the microgram/kilogram range]. AB - A method is described for the determination of Deoxynivalenol (DON) and Nivalenol (NV). A liquid chromatographic clean-up step is followed by silylation of the extract and the trimethylsilylether are determined by gas-chromatography-mass spectrometry (GC-MS), monitoring the characteristic ions in the negative chemical ionisation mode. 71% of 42 food-samples were contaminated with DON and 38% with NV. The highest contamination detected was 2000 micrograms/kg DON and 120 micrograms/kg NV in a wheat bran sample. Deoxynivalenol and Nivalenol in concentrations of 10 micrograms/kg can be detected easily by this method. PMID- 6485557 TI - [Subchronic toxicity testing of mold-ripened cheese]. AB - The biological effects of known mycotoxins of Penicillium roqueforti or P. camemberti and other still unknown, but potentially toxic metabolites in mould ripened cheese (commercial samples of Blue- and Camembert cheese) were investigated. High amounts of mycelium (equivalents of 100 kg cheese/man and day) were fed to mice in a subchronic feeding trial. The following parameters were determined: development of body weight, organ weights, hematology, blood plasma enzymes. No signs of adverse effects produced by cheese mycotoxins could be detected after 28 days. No still unknown toxic metabolites could be demonstrated. From these results no health hazard from the consumption of mould ripened cheese, even in high amounts, appears to exist. PMID- 6485558 TI - [Analysis of recent trends in cardiovascular mortality in Switzerland]. AB - During the last decade (1970-1980), the cardiovascular mortality rate, based on the mention of a cardiovascular disease as the primary cause of death, has decreased in all age groups in Switzerland. This decrease is greater in the female population. However, the mortality rate of ischemic heart diseases continues to increase in the 60 plus age group. If all deaths where a cardiovascular disease is reported, as either the primary or immediate cause, are considered, the decrease is less marked. The reason seems to be an increase in the number of deaths due to cancer, where a cardiopathy is reported as the immediate cause. PMID- 6485559 TI - [Infant mortality in Switzerland: status and evolution of differences between cantons since 1901]. AB - Both levels and trends of infant death rates differ among the Swiss cantons between 1901 and 1980. These differences seem to persist, since one groupe of cantons stays consistently above, and another group below the mean values. Some socio-economic and demographic correlates of the inter-cantonal differences are analyzed. PMID- 6485560 TI - Risk of maternal death in Indonesia and Sweden. Patterns and trend in 3D display in teaching. AB - Epidemiological study of maternal death in Indonesia and Sweden suggests a link between two unrelated data sets. Fifty years ago ('1930'), the Swedish maternal death risk exhibited a pronounced J-shaped pattern by maternal age; and a similar pronounced J-shaped pattern is observed 50 years later in Indonesia for women with prolonged/obstructed labor attended at the top referral and teaching institutions. Epidemiological documentation of 'North data sets' may possibly be used for teaching on factors affecting 'South mortality transition'. The documentation of a 'North-South transition' could accelerate the current dynamics of needed mortality decline by pointed programmatic intervention. The two figures are self-contained reference baselines. PMID- 6485561 TI - [Projection of hospitalization rates based on VESKA diagnostic statistics 1982]. AB - A method is presented for extrapolating the hospitalization rates for all Switzerland, using both VESKA diagnostic statistics and hospital administration data. The method is applied to chronic and obstructive lung diseases for the year 1982. A total of 33,430 hospitalizations is estimated with this diagnosis. PMID- 6485562 TI - [Prevalence of hysterectomy and cancer of the uterus in the population of Tessin canton]. AB - The study presents an analysis of the prevalence of hysterectomy during the year 1982 in Canton Ticino, where the rate (507) per 100'000 women is double that found in the West Midlands area of Great Britain (P less than 0,001). No statisticaly significant difference is found in the mortality rate or morbidity rate for tumour of the cervix and body of the uterus. PMID- 6485563 TI - [Sex differences in demands made on medical services. Results of the SOMIPOPS health survey]. AB - Data of the nationwide health survey SOMIPOPS show a higher number of physician visits for females than for males. Females report a total annual rate of 6,6 visits per person while males made 4,8 visits per person. Females have seen a gynecologist once a year. They report higher perceived morbidity than males which is considered to be the principal determinant of use of health services. Visits made for disorders of the female reproductive system accounts for 13,9% of the female visits. Preventive reasons for the last visit are more frequent among females. PMID- 6485564 TI - [Disability and type of assistance for the aged in a mountainous region]. AB - Based on identical interviews, the frequency of functional disability and the type of help for the handicapped is compared between the aged populations of a Swiss mountain valley and of an urban area. Functional disabilities are more frequent in the mountain population. When help is needed, the aged in the mountain area receive it from their spouse or another family member, whereas help in urban circumstances is provided by spouses or by institutions. PMID- 6485565 TI - [Evaluation of the level of dependency of persons placed in establishments for chronic patients. Development of a survey instrument and studies of validity, pertinence and performance]. AB - With the aim to achieve a more equitable budgetary allocation to nursing homes, an instrument for the evaluation of the patients' dependency has been developed and tested in 55 institutions, for a total of about 23000 observations. Statistical analyses show that the internal validity of the gathered data is quite good. The tool criteria are judged relevant by experts, and the tool performance is adequate: its use should permit the constitution of groups (clustering) of nursing homes homogeneous from the point of view of their nursing care load. PMID- 6485566 TI - [Street vaccination]. AB - Since 1982 drug addicts in the Canton of Zurich have been vaccinated against hepatitis B (HB) free of charge. Up to December 1983, 1480 doses of vaccine were administered to 1270 individuals (an average of 1.2 doses per person). About 700 vaccinations took place directly on the streets of Zurich. The article will discuss the epidemiological data of HB in the drug addict population and also the methodology and difficulties of the Streetwork Vaccination. In addition to immunization, the most important requisite for lowering the incidence of HB would be the possibility for drug addicts to buy injection material themselves. PMID- 6485567 TI - [The proposed law on safeguarding of data--a threat to medical-epidemiologic research in Switzerland?]. AB - The draft of the new law on the confidentiality of personal data severely curtails medical and epidemiological research. This might be detrimental and dangerous to public health. The project therefore has to be amended. PMID- 6485568 TI - [Consequences of presbyopia for the dynamics of sight and work at a terminal]. AB - For 100 persons of different age the visual charge for the accommodation was examined by an objective procedure. Already at the age of 40 the dynamic range of accommodation decreases. This decrease could be a reason for the loss of mobility during work at VDUs, as it has been observed in a group of persons aged 40 to 55 years. PMID- 6485569 TI - [Physiological effects of needle guns on the hand-arm system]. AB - Physiological effects and sensations of four air actuated needle-pistols of different constructions on the hand-arm-system were explored (n = 4). As no reliable standards of injurious effects are known, only comparative conclusions can be drawn. All parameters showed a significant diminution of vibration effects when using a machine constructed with a shock absorber. PMID- 6485570 TI - [Occupational accidents in Switzerland since 1921 in relation to the economic evolution]. PMID- 6485571 TI - [Indoor air pollution by polynuclear hydrocarbons from tobacco smoke]. AB - An orientation study on concentration levels of PAH in a closed space was carried out with concern about ventilation and quantity of cigarettes smoked. Emission factors of PAH and their methyl derivatives in the main and side-streams of light and heavy cigarettes were determined. PMID- 6485572 TI - [Sampling and determination of aldehydes in ambient air]. AB - A method for the determination of aldehydes involving the formation of their 2,4 dinitrophenylhydrazones on solid adsorbents and subsequent HPLC/UV analysis with internal standard was tested with dynamically generated samples and applied in a few real situations. The sampling train is suitable for personal sampling. PMID- 6485573 TI - [Program of prevention and health promotion among young inhabitants of Vaud from 16 to 19 years]. AB - The first part of the presentation deals with a new school health program for adolescents 16 to 19. The second part focuses on a prospective evaluative study of the validity of hypertension detection among adolescents, which is part of this new program. PMID- 6485574 TI - [Bernese runner study '84--methodology, response rate and comparison between respondents and nonrespondents]. AB - Over 7000 joggers (competitors of a 10 miles-road-run were studied by questionnaire. The response-rate of 83,6% (76,1% after reviewing) was probably due to the far-going integration of the survey in the running-event. The respondents were significantly older and (after age correction) faster runners than the non-respondents. No significant differences in response-rate could be found between men and women and between French and German speaking joggers. PMID- 6485575 TI - [Evaluation of nutritional intake of proteins, lipids and carbohydrates by the adult population resident in Geneva]. AB - Compared with the dietary recommendations, the adult population of Geneva seems to have an excessive lipid intake and an insufficient intake of carbo-hydrates. This phenomenon is more conspicious in younger adults than in the elderly. PMID- 6485576 TI - [Dietary lipids and serum lipids in adolescents, based on the Geneva study of the precursors of atherosclerosis]. AB - The relationship between serum lipids and nutrition, physical activity and body mass index were studies with a multifactorial analysis of variance in a group of 160 adolescents of both sexes (Table I). These relationships are complex and difficult to demonstrate; they give rise, however, to certain considerations of presumptive characteristics possibly linked with adolescence. PMID- 6485577 TI - [Psychosocial determinants of dietary habits]. AB - To the nutritional-scientific point of view of consumption habits is opposed the sociological one and briefly explained. It is discussed that only a greater knowledge of psychosocial determinants would make it possible to influence eating habits. A project for the collection of these determinants is presented. PMID- 6485578 TI - [Development conditions and development status of 10-year-old children in Basle]. AB - Children from the "Basle Kindergarten Study" (born 1971-73) were re-examined during their 4th year of primary school, i.e. at the age of ten (1981-84) (Follow up of a representative sample of 10% of all children in the first year of kindergarten). The aim of this study is to analyse differences in physical and psycho-social development of children living in different conditions, particularly between immigrant and Swiss children. First results are discussed. PMID- 6485579 TI - [Development over 10 years of children with birth weight less than 1501 g]. AB - 170 Children born between 1971 and 73 and hospitalised at the neonatal intensive care unit of the Hospital for Children of the University of Basel because of very low birth weight and/or IRDS are re-examined at the age of 10 years. First analyses show high mortality amongst the children with very low birth weight (38% of 122 died up to the age of 10 years) and a physical development (weight and height) below that of a representative sample of children of the same age. PMID- 6485580 TI - [Swiss continuing education meetings for school physicians. An evaluation of preferences for selected subjects]. AB - The group "school health physicians" of the Swiss Society for Social- and Preventive Medicine has organized since its foundation in 1981 two meetings; Basle in 1982, and Zurich in 1983. Questionnaires were handed out on both occasions on source and extent of experience as school health doctors. The questions included views on the meetings in general and on the various topics discussed. Participants were also asked to write down suggestions for future meetings. The following subjects discussed were voted to be "important" or "very important" by at least two thirds of the participants: ophtalmologic mass examinations; health education as an important new factor for school health physicians as evidenced by the anti-smoke-campaign in Baselstadt schools; round table-discussion on the currant importance of school-health medicine; certification of fitness for schooling by the school doctor; growth and development of the child on startin school; psychomotor disorders and their effects on children starting school. The third meeting, scheduled for September 27th 1984 in Lausanne, which will include for the first time a morning session, will deal with topics selected by the participants of the Basle and Zurich meetings: orthopedic problems at school age and their prevention; a report on school sports and high-performance sports. PMID- 6485581 TI - [Internal/external locus of control and early examinations for cancer diagnosis]. AB - The Health Locus of Control (HLC) Scale was translated into german and factoranalyzed. Two factors were found: internal and external locus of control. A significant correlation between external locus of control and cancer control examinations could be shown for women. PMID- 6485582 TI - [Changes in conflict reaction mechanisms in juvenile delinquents in a therapeutic milieu]. AB - An institution of execution of measures is passing through changes towards a therapeutic community. The effect of this change is assessed in terms of elopements and illness episodes. The conflict reactions seem to change from leaving the institution without permission towards physical illness during the 6 year period observed. Reasons for this change are discussed. PMID- 6485583 TI - [Health care and needs of adolescents: an international comparison]. AB - From a comparison between canadian, american, french and swiss studies on health needs and care of adolescents, the author discusses the difficulties one has to resolve when measuring health status and health care utilization of a population. PMID- 6485584 TI - [Determination of the time of death by measurement of rectal temperature of corpses suspended in water]. AB - Twenty-nine corpses were subdivided into three groups. Normally from the 3rd h post mortem on, they were suspended undressed in a tub holding 1,000 l in nearly still water of temperatures approximately 20 degrees, 10 degrees and 0 degrees C. The rectal temperature was measured, normally until the 33rd h post mortem. Time of death was calculated by means of the mathematical analytical two-exponential formula suggested by Marshall and Hoare (1962), in the version used by Brown and Marshall (1974). The adapting parameters of the formula were standardized according to the principle of Henssge (1979, 1981) and related to standardization by adjusting factors to body weight stated for standard values of cooling, i.e., undressed corpses in calm air. After termination of the post mortem temperature plateau, it was found that undressed corpses suspended in water of temperatures of approximately 20 degrees and 10 degrees C cool as quickly as undressed corpses of half the body mass in calm air of the same temperatures. As to the duration of the post mortem temperature plateau in water suspension time from the time of death, it may only be indirectly concluded that it is linked to the subsequent speed of cooling in the same way which is well known in the case of air cooling. Statistical standard values are given concerning the differences between the computed and the real times of death. Unexpectedly, the experiments in water at approximately 0 degrees C yielded distinctly slighter temperature which were especially marked at rectal temperatures up to approximately 11 degrees C in corpses of great body mass and small body surface in proportion to and equally, without regard to body mass. As an explanation of this, a decrease in the thermal conductivity of the subcutaneous adipose tissue in connection with a decrease in tissue temperature is discussed. PMID- 6485585 TI - [Stages of postmortem formation of washerwoman's skin--results of systematic qualitative and quantitative experimental studies]. AB - The development of washerwoman's hands depends upon the length of submersion. Until now there have been no results published on the qualitative and quantitative time-related changes with regard to washer-woman's hands. The fingertips of 50 hands from 35 corpses were qualitatively examined at early postmortem (1-4 h after death). The quantitative investigations were confined to the tips of the middle fingers. Submersion of the hands in water at 37 degrees C was interrupted at intervals of 10 min, 30 min, 60 min, 2 h, 3 h, 4 h, 6 h, 10 h and 24 h for a period of 30s-1 min. The width of three adjoining ridges of the skin were measured in three defined areas of the middle fingertips and photographs were taken. Quantitative results: No relevant differences were seen in the changes of the width of the skin ridges between the right and left hand after submersion in water; there was no specific difference between the sexes. During the soaking process the skin ridges influence each other. The age of the individual corpse has no influence on the change in width of the skin ridges. Concerning the qualitative test results, six time-limited stages could be classified: stage I: physiological dry state; stage II: softened state; stage III: swollen and compressed state; stage IV: partial wrinkle covering; stage V: epidermal lysis; stage VI: loss of relief outlines. PMID- 6485586 TI - [Textile changes in passenger clothing induced by seat belts at 50 km/h frontal impact]. AB - Sixteen dummies wearing seat belts were exposed to an impact of 50 km/h. Their clothing was examined for traces of melting and other textile changes caused by the seat belt. Such marks were found in the thorax area in 87.5% of the cases and in the pelvis area in 44%. They were located at protruding parts of the body, i.e., parts exposed to high pressure caused by the seat belt. PMID- 6485587 TI - [Affect processing in psychosomatic patients. I]. AB - The present article reports the results of an empirical investigation concerned with specific characteristics of psychosomatic patients. Subjects suffering from ulcus duodeni or from colitis ulcerosa designated as psychosomatic patients. Controls were chosen from among neurotic patients and from among patients with only somatic illness. Against the background of the criticism with regard to the scientific approaches so far, our own approach was conceived as an experiment. Film episodes of two contrating (friendly versus unfriendly) interactions between physician and patient were offered to the test subjects as triggering situations. The contents of these film segments were organized in a manner calculated to produce an affective embarrassment in the psychosomatic patients. The reactions of the test subjects were inventoried on two levels. One of the levels of investigation was geared to cognitive processes by the application of Hofstatter's list of polarities (1955, 1973). In this case the psychosomatic patients distinguished themselves from the two control groups in that they misinterpreted the differences in the affective contents of both film sequences. On the other level of investigation subconscious processes were recorded by the application of Gottschalk's analysis of verbal contents. In this context all three groups in the investigation reacted in a similar manner to friendly connotations in the behaviour of the physician, namely with hidden aggressions. The results infer an affective resonance of the investigated psychosomatic patients on a subconscious level which, however, does not become evident on the conscious cognitive level. PMID- 6485588 TI - [Problems in Life-event research from its psychodynamic aspects]. AB - The present essay gives a survey of theory of the Life-Event-research up to now with special relevance to psychiatric diseases, which was developed by sociology and behaviourism. There is some evidence that the originally epidemiologic orientated approach, which is restricted to relation Life-Event - disease, will now be extended by establishing of a "subjective" and social factor in form of Coping Processes, the Cognitive Models, the interactions are resources of Social Network. But till now there was no possibility for any differentiation between cause and result. This traditional approach, which is restricted to the objectives, covers differences in individual characters and creates arbitrariness in research whereby a wrong praemiss was taken as a basis, namely the postulated homogeneous of characters by which each event will produce the same deleterious effect. In comparison with that a psychodynamic viewpoint favours the "Selbst Relvanz" of events. By this mean an interpretation of events is senseless if they are not applied to individual character structure and development through which "early" Life Events will be of great account. With the aid of a clinical example it will be demonstrated by a psychodynamic viewpoint how the deleterious effects of specific Life Events are comprehensible by applying them to individual development and object relations. By that there is possibility of calling specific triggering events for the break out of Schizophrenia (beginning/finishing of a "love relation"; a new daily burden) and of associating certain clinical pictures of Schizophrenia to certain macroscopic and microscopic Life Events. PMID- 6485589 TI - [Fluctuations in the "evenly hovering attention" and their therapeutic processing]. AB - For epistemological and empirical reasons, Freud's "evenly hovering attention" has to be understood as an advice that the analyst should remain open for new observation. It is a recommendation against having preconceived ideas and biases. In fact, the analyst's attention is regulated by conscious and unconscious selections. It is subject to considerable changes in the analyst's cognitive processes. His countertransference influences his attention. The patient in turn reacts consciously or unconsciously to the variations of the analyst's attention. It is therefore necessary to interpret those changes and sometimes to admit them. This recognition supports the reality testing of the patient in the analytic situation. Otherwise malign regressions or denials and other defensive processes might occur. We give an example of the changes in the "evenly hovering attention" of an analyst and their handling. PMID- 6485590 TI - [Family therapy aspects of ulcerative colitis and Crohn disease]. AB - Comparing 55 families of adolescents suffering from either colitis/ileitis or asthma/neurodermatitis the following aspects have proven characteristic for the interactional processes of the gastroenterologically sick group: Strong family cohesion (binding). Fusion within the family, isolation from the environment. Low development potential (rigidity). The treatment of the whole family thus follows a strategic approach characterized by hypothesizing circularity, neutrality and systems changing interventions. PMID- 6485591 TI - [Psychosomatic aspects of psoriasis: affectivity and conflict]. AB - With a sample of 32 patients with psoriasis--compared with 22 control-persons- possible disturbances of the development of affectivity in the childhood of the patients were investigated (cluster- and factor-analysis). By this an essential point in psychosomatic theories could be explained: the inhibition of an immediate psychic discharge of affects. Further investigation concerned the question--, of how far conflict-coping-behavior of psoriatic patients is characterized by denial of reality, excessive repression and over-adjustment. Disturbed affective development and pathological conflict-behavior together may result in a chronic overstrain of psychic structures--as a correlate of the psychosomatic illness. Our results show a pathological conflict-behavior and a disturbed development of affectivity in the genesis of psoriasis. We found two subtypes of psoriatic patients with specific character-traits--whereas a typical personality could not be found. PMID- 6485592 TI - [A comparison of the psychosocial status of 125 abortion patients before and after the termination of pregnancy]. AB - We described in a former study (Volume 3, 1982) the cases of 228 abortion patients, their psychosocial data and the conflicts from which the unwanted pregnancies, which are interrupted, arise. A follow-up study took place 18 to 24 months after the abortion. The crucial point of the follow-up investigation was the development of the relationship, newly wanted or unwanted pregnancies, the practice of contraception, the psychological coming to terms with the abortion as well as the re-evaluation of the conflict situations described in the earlier study. With these results we tried to understand the consequences of an abortion and to determine important parameters for the obligatory consultation prior to the abortion. PMID- 6485593 TI - [Development of creativity]. PMID- 6485594 TI - [Problems in bacterial hospitalism]. AB - All over the world nosocomial infections are increasing at an enormous rate. With 30% urology takes second place, after intensive care units. Nearly 40% of these infections start in the lower urinary tract, and more than 7% are the direct cause of death. Attention is drawn to the increased financial burden caused by these complications. A consideration of the causes (above all uncritical use of antibiotics for prophylaxis and therapy) is followed by a discussion of the success of a change in policy concerning antibiotics and improved hospital hygiene in our own department. Lessening the selective pressure led to a very significant reduction of nosocomial problem germs and an increase in germ sensitivity, besides saving up to 80% of antibiotics. PMID- 6485595 TI - [Clinical significance of urinary tract infection caused by Providencia stuartii]. AB - Out of 75 patients in whom nosocomial infection of the urinary tract occurred following operation for disturbance of micturition 43 (57.3%) suffered clinically manifest inflammatory complications, however only in 26 cases (34.6%) was this germ the cause. In the remaining 17 cases there were superinfections. From these results it is concluded that the isolated Providencia stuartii strains were not very virulent. In cases of asymptomatic providencia-bacteriuria the authors consider specific antibacterial therapy to be indicated only if the excretion of germs does not cease spontaneously after micturition has been restored to normal. PMID- 6485596 TI - Is it possible to cultivate the agent of Tyzzer's disease (Bacillus piliformis) in cellfree media? PMID- 6485597 TI - Ultrastructural studies on experimental alcoholic heart disease in rats. PMID- 6485598 TI - A comparison of the survival (LD50/30) of a number of inbred mouse strains after X and cobalt-60 gamma irradiation. PMID- 6485599 TI - [Experiences in laboratory breeding of various arthropods]. PMID- 6485600 TI - [Measurement of motor activity of mice divergently selected for body mass using acoustic methods]. PMID- 6485601 TI - Distribution of cardiac output in the late pregnant guinea pig during anaesthesia with ketamine. PMID- 6485602 TI - [Genetic drift in outbred animal populations]. PMID- 6485603 TI - [Extreme Ebstein's anomaly]. AB - The incidence of Ebstein's anomaly among patients with congenital heart disease is about 0.5 and 1% among autopsy cases. Among 279 autopsy cases with congenital heart disease of the period from 1978 to 1982 we found 3 Ebstein's anomalies. The reported case is a rare combination of Ebstein's anomaly with ventricular L-loop, corrected transposition of the great arteries, atresia of aortic valve, hypoplasia of the aorta and of the aortic arch, coarctation of the aorta and septum secundum defect. Such a case has not been communicated in the literature. The case is described and the embryological development of the abnormalities is discussed. PMID- 6485604 TI - [Multidimensional analysis of automatically measured karyometric data on pituitary adenomas]. AB - 131 pituitary adenomas (50 growth hormone-secreting adenomas, 19 prolactinomas, 7 adenomas associated with Cushing's disease and 55 endocrine-inactive adenomas) have been investigated morphometrically and densitometrically by use of a system for automated microscope picture analysis (AMBA). To classify the adenomas as good as possible we used a hierarchically structured classifier which uses the measured parameters. The adenomas associated with Cushing's disease differed mostly from the inactive tumors in their karyometric features. We found similar differences for growth hormone-secreting adenomas, whereas prolactinomas showed only small differences. Partly clear differences by multidimensional analysis appeared between adenomas associated with Cushing's disease, somatotropic adenomas and prolactinomas. Most of the clinically inactive tumours (37/55) showed similarities with the active adenomas. Only in 18 inactive tumors we could not find feature combinations corresponding with those of endocrine-active adenomas. PMID- 6485605 TI - [Malformations of the urogenital system in autopsy material of children]. AB - As a result of the autopsy reports of the Pathological Institute of Muhlhausen in the twenty-year-period from 1960 to 1979 there were 6.4% (n = 293) malformations of the urogenital system among 4,561 autopsies of still-born and live-born children up to their 16th year of age. Besides anomalies of the genital system, anomalies of the lower urinary tract, cystic kidneys, anomalies of kidney forms and dystopia as well as kidney agenesis were most commonly observed. The malformations were classified and discussed according to nature, combinations and sex differences, importance for mortality as well as with respect to territorial and time distribution. PMID- 6485606 TI - [Congenital pulmonary lymphangiectasis]. AB - 3 cases of congenital pulmonary lymphangiectasis are described. A girl, now 3 years old, underwent at the age of 4 weeks a resection of the left superior lobe of the lung which was singularly involved. A male newborn died 4 h after birth and showed the typical affection of both lungs. A second male infant died 19 d after birth and had an isolated involvement of the left lung. Post-mortem examination additionally revealed in both boys a cardiovascular malformation. Histologically, we especially observed a papillar endothelial hyperplasia in a dilated lymph vessel in case 1 and multinuclear giant cells of the foreign-body type in case 3. In the literature, there are reported 99 cases of congenital pulmonary lymphangiectasis. Including our case, a unilobar or unilateral involvement is described in only 8 cases. The congenital pulmonary lymphangiectasis occurs more often in males than in females (1.8 : 1). 90 out of 93 life-born children suffering from this malformation died, 57 of them during the perinatal period. However, cardiovascular malformations, which were observed in 53 cases, are playing an important role as the cause of death. The aetiology of the congenital pulmonary lymphangiectasis remains unknown. There are 4 different theories concerning the pathogenesis, namely, a persistence of early fetal lymphatic vessels, a missing connection between primitive lymphatic vessels, a hyperplasia of lymphatic ducts and, last but not least, a passive dilatation of the lymph vessels because of venous or lymphatic congestion. PMID- 6485607 TI - [Giant cell angiitis of the brain]. AB - A report is given on a 25-year-old man who was admitted to the hospital because of severe headache (CSF: 280 cells per mm3, 90% lymphocytes, later normal). Headache persisted for one year when acute deterioration occurred. The CSF showed 140 cells per mm3 (100% lymphocytes), 1 g% protein. Improvement of the patient's state after corticosteroid therapy. 9 months later he interrupted the intake of prednisolon and provoked exacerbation of the disease with motor and sensor disturbances. 21/2 years after the beginning of the symptomatology he suddenly developed cerebral coma and died. The autopsy revealed ischemic necrosis of both the left and the right thalamus, hemorrhage with destruction of the left-sided thalamus, nucleus caudatus, internal capsula and rupture into the lateral ventricle. Histologically, preparations from all parts of the brain revealed granulomatous angiitis of arteries, capillaries and veins with fibrinoid necrosis, infiltration of lymphocytes, histiocytes, epitheloid and plasma cells as well as numerous giant cells. Microaneurysms were found frequently. The inflammatory process showed various stages of the development indicating that more and more vessels had been involved at different times. Contrasting to giant cell arteritis of A. temporalis, in giant cell angiitis of the brain the blood sedimentation rate is frequently normal. In all reported cases, vessels of the leptomeninges were involved. Therefore, leptomeningeal biopsy is regarded as diagnostic procedure. The own observation as well as data of the literature demonstrate that giant cell angiitis of the brain is distinct from temporal arteritis (Horton's disease), not only because of differences in location, but also because of differences in age incidence and prognosis. It is supposed that giant cell angiitis is not a nosological entity, but the expression of different etiologic and pathogenetic mechanisms. PMID- 6485608 TI - [Postoperative complications of the radiation-exposed intestine]. AB - Intestinal complications after radiotherapy cannot be avoided. Side effects of radiotherapy should be differentiated from injuries following correct application of radiation. Acute changes are usually transient. There is only a small incidence of major intestinal radiation injuries, amounting to less than 3%. Exact preoperative diagnostics is advisable in planning corrective operative procedures. The postoperative mortality rate is about 30%, operative procedures must be individualized, staged procedures are recommended. PMID- 6485609 TI - [Radiation sequelae in the intestine from the viewpoint of the gynecologic radiologist]. AB - Irradiation of the cervix uteri for carcinoma means to apply a high radiation dose and to irradiate the connective tissue and neighbouring organs. Reactions of these tissues cannot be completely avoided. An exploratory laparotomy is often required in order to differentiate between recurrence and radiation reaction. PMID- 6485610 TI - [Ileus in the aged]. AB - From 1973 to June 1982, 218 patients older than 70 years (148 women, 70 men) suffering from acute bowel obstruction were seen at our Dept. The mortality rate came up to 33%. Main causes of the ileus were incarcerated hernias and colonic obstruction (25% each). In case of an incarcerated hernia the authors emphasize early operation and colostomy in case of colonic obstruction due to tumour stenosis. PMID- 6485611 TI - [Rare forms of extraperitoneal abscess and fistula formation]. AB - Though a retroperitoneal abscess can be caused by a number of malignant as well as inflammatory diseases, there do not exist more than a few anatomically preformed pathways for its further proceeding. These ways are described in detail. Therefore, the clinical appearance is nearly always identical: especially abscess and/or empyema of the hip and thigh are leading symptoms. PMID- 6485612 TI - [Cyst of Gartner's duct as a surgical problem]. PMID- 6485613 TI - [Intraluminal intubation of the small intestine for the therapy and prevention of adhesion ileus]. PMID- 6485614 TI - [Psychological and sexual effects of hormonal contraceptives--results of a survey]. AB - Subject of our examination are emotional-affective, vegetative and psycho-sexual disturbances which are possibly caused by oral contraceptives. 511 women, taking different oral contraceptives, were questioned. For that purpose we used a schedule of sociological dates, attitudes and complaints devised by ourself and connected with a part of Bottcher's Introversion-Neurotizism-Rigidity Questionnaire. Neurotic and introverted persons are tending to suppose a connection between the "Pill" and certain inconvenient sensations as affective disturbances, diminished concentration, dyssomnia and an avoidance behavior in sexuality. But the results of investigation gave also evidence for a distinct increase of sexual unaffectedness without disadvantageous uninhibition. A classification of the disturbances relative to the particular drugs did not reveal any differences within our cases. The sample "Gravistat" had significantly raised scores of neurotizism and here can also be observed an increase of inconvenient psychical disturbances. We recommend to give better information on the mode of action of the respective contraceptives. In cases of neurotic attitude a psychotherapeutical consultation between doctor and patient may diminish psychosexual disturbances as symptoms of the application of oral contraceptives. PMID- 6485615 TI - [Indications and technic of operative vaginal delivery in vertex presentation]. AB - In operative vaginal delivery in vertex presentation we pay attention to a separation in the indication for using a forceps or using a vacuumextractor. A delivery with a vacuumextractor is recommendable only in a flexion of the fetal head, in a low obstetrical resistance and with slow tractions. A delivery with a forceps is recommendable even in a deflexion of the fetal head, in a high obstetrical resistance and in fetal distress situations. A comparison in 2 collectives, each of a time period of 5 years, shows an interesting difference. In collective 1 (1963 to 1967) the frequency of forceps deliveries was 2.2% and of vacuumdeliveries was 3.2%. In collective 2 (1978 to 1982) the frequency of forcepsdeliveries was 4.1% and of vacuumdeliveries was 0.4%. Caused by a separation of the indication and by a consequent fetal monitoring there was an improvement in fetal and maternal morbidity and mortality. Using a handle in forceps delivery the procedure is more easy and less harmful for the baby. PMID- 6485616 TI - [Use of small neuroleptanalgesia sub partu]. AB - Application of 0.1 mg Fentanyl and 5 mg Droperidol iv. (obstetric neurolept analgesia) causes an enduring pain relief. Labor is not influenced. The obstetric neuroleptanalgesia appears to accelerate labor indirectly. The condition of the fetus will be not affected by obstetric neuroleptanalgesia. In respect of this obstetric neuroleptanalgesia can be recommended as a method of analgesia during parturition. PMID- 6485617 TI - [Cardiotocography practice 6]. PMID- 6485618 TI - [Extracorporeal fertilization and embryo transfer]. AB - At first some problems of topic terms are demonstrated because the method is transferred from rodents and cattle. Therefore we should not term it a biotechnical but a biomedical approach involving the specific human and ethic aims. The eF and ET method is described and characterized as a systemic one which makes possible to improve the chances of numerous infertile couples and to elucidate some problems of early embryonic development. In spite of the tendency to standardize and to alleviate the method there is no reason to estimate it easy. In 1983 our three GDR groups performed 20 ET's over all but without an ongoing pregnancy until now. PMID- 6485619 TI - [Sperm metabolism, sperm vitality and cryopreservation]. AB - Out of publications of the last two years some one concerning cryopreservation with clinical-practical relevance were reviewed: Storage at -80 degrees C caused different alterations of activity of the intracellular enzymes. The glucose-6 phosphate-dehydrogenase is the first enzyme which leaves the cell at damage of the cellular membrane. The intracellular concentration of ATP is decreased and the AMP/ADP-rate is increased by the cryopreservation. The cryopreserving process seems to cause an activation of acrosomal proteases of spermatozoa. The damage of cells by cryopreservation is a result of the disturbance of the integrity of membrane and of the loss of ATP and Mg++. Stimulators of spermatozoal motility (caffeine, kallikrein) as a constituent of the cryopreserving medium do not increase the fertilizing capacity of the cryopreserved spermatozoa. Investigations using vitale radiolabelled spermatozoa showed a rate of 4:3 between fresh and cryopreserved spermatozoa in vivo in the upper female genital tract. The penetration test with zona-free hamster oocytes does not allow a prognosis of cryotolerance of the cells. A correlation between rate of penetration and spermiogram is unsure. The cryopreservation of oocytes and embryos is practicable. PMID- 6485620 TI - [Current status of in vitro fertilization, indications and current problems]. AB - Report about experiences with in vitro fertilization and embryotransfer at the second department of obstetrics and gynecology University of Vienna and study group of extracorporal fertilization. Methodic could be simplified in some details. Results are better with increasing experience. Stimulation treatment using clomiphene-HMG-HCG is done individually. PMID- 6485621 TI - In vitro fertilization: problems in culture conditions and embryo transfer. AB - Review about the second and third step of in vitro fertilization and embryo transfer. The success rate is influenced by many factors of culture conditions (water, culture medium, plastics and glassware etc.) and by technical details of embryo transfer. PMID- 6485622 TI - [First experience with an in vitro fertilization program at the Rostock University Clinic of Gynecology and Obstetrics]. AB - In vitro fertilization as an aid in diagnosis and treatment of the sterile couple has been used at the university clinic of gynecology and obstetrics in Rostock since the beginning of 1983. 17 women were treated in the first series of in vitro-fertilization and embryo transfer in September and October 1983. After treatment with clomiphene and HCG in 16 women one or more oocytes were harvested. In 14 women one or more oocytes were fertilized. Embryo transfer was performed in five cases. No pregnancy resulted. The causes of the low cleavage rate and possibilities for improvement of the results are discussed. PMID- 6485623 TI - [Results of the operative treatment of tubal sterility]. AB - 82 women with tubal sterility were treated microsurgically. Pregnancy rate increased from 10.3 per cent to 22.8 per cent in cases of salpingostomy and fimbrioplasty. PMID- 6485624 TI - [Bilateral gonadoblastoma in a case of Turner syndrome with 40,XO monosomy]. AB - A case of bilateral gonadoblastomas in a 45,XO patient with features of Turner's syndrome is presented. The case stresses the importance of a careful laparoscopic evaluation of the pelvic cavity and a biopsy of both streak gonades is strongly recommended also in patients with 45,XO karyotype. PMID- 6485625 TI - [Methods of ovulation induction]. AB - Basing on the mechanism of the endocrine regulation of the reproductive events in the women causes and therapy of the endocrine sterility are discussed. Causes of endocrine sterility are divided into the entities hyperprolactinemic, hyperandrogenemic, hypo- and dysgonadotropic hypogonadism. Concerning these disturbances the specific therapeutic opportunities with the inhibitor of the prolactin secretion, with antiandrogenes, corticosteroids, antiestrogens, gonadotropins or gonadotropin-releasing hormone, respectively, are summarized. With a proposed scheme for diagnostic and therapeutic use an effective and economic proceeding in the treatment of the endocrine caused female sterility is intended. PMID- 6485626 TI - [Clinical pathology of prolactin-forming hypophyseal adenomas]. AB - On the basis of own material and data of the literature problems of the classification of pituitary adenomas are discussed. Special emphasis is laid on typical light and electron microscopical as well as immune histochemical criteria of prolactinomas. Clinical and morphological aspecte of microadenomas and adenomatous hyperplasias are briefly described. PMID- 6485627 TI - [Serum plasminogen levels and timing of ovulation]. AB - During diagnosis and treatment of female sterility, plasminogen and fibrinogen degraduation products were measured from patient's vein blood in the cycle of menstruation on the days round menstruation. On the days round ovulation and also before beginning of menstrual bleeding an elevated plasminogen level by unchanged fibrin(ogen) degraduation products was found. Therefore the plasminogen modulation as a causal factor for the rupture of follicles is discussed. PMID- 6485628 TI - Epidemiology and ecology of sporotrichosis in Japan. AB - Some characteristics in epidemiology and ecology of sporotrichosis in Japan are summarized as follows: 1) In some areas of Japan, sporotrichosis shows relatively high incidence. 2) Frequent onset of the infection in the cold season. 3) Preponderance of the infection in females. 4) Preponderance of the infection in children and aged persons. 5) Predilection of lesions on the face of children as well as on the upper extremity in the case of adolescent and adult patients. 6) Familial occurrence. 7) High frequency of demonstration of the parasite in tissue. PMID- 6485629 TI - Ecological and epidemiological aspects of aspergilli pathogenic for man and animal in Berlin (West). AB - A summary of five years of experimental and clinical mycological work in Berlin (West) is presented. The subjects of this research include: Soil of potted indoor plants as a habitat for aspergilli; exposure of sensitive patients suffering from different basic diseases to Aspergillus spores; polyene-producing streptomycetes beside aspergilli in the rhizosphere of potted plants and their role; and ecological and clinical significance of atypical Aspergillus strains isolated from clinical specimens. Reference is also made to the role of nuts as source of infection and as a baiting technique. PMID- 6485630 TI - Leucinostatins, peptide mycotoxins produced by Paecilomyces lilacinus and their possible roles in fungal infection. AB - Peptide mycotoxins "leucinostatins" were obtained from the culture strains of Paecilomyces lilacinus, which were isolated both from soil and a case of human oculomycosis. Comparative studies of the symptoms of experimental keratomycosis caused both by the inoculation of P. lilacinus and by direct administration of leucinostatins into the infection model in rabbit suggested the possible role of leucinostatins in the inflammatory response of invaded tissues. Leucinostatin was formerly reported as a single entity. However, in the course of the structural studies, leucinostatin was found to be a complex of two closely related components, and the structures of the both mycotoxins were determined. Both of the mycotoxins possessed high toxicity to experimental animals. The intraperitoneal and oral LD50 values in mice were 1.8 and 5.4 to 6.3 mg/kg by a single administration. Toxicological studies showed that leucinostatins have some potent effects on liver cells after oral administration. It was also found that leucinostatins exhibit strong uncoupling activity on rat liver mitochondrial system. PMID- 6485631 TI - Lipid and wall amino acid composition in the classification of Rothia dentocariosa. AB - Seven strains of Rothia dentocariosa were degraded by acid methanolysis and the nonhydroxylated fatty acid methyl esters released were examined by thin-layer and gas chromatography. The fatty acid profiles were composed of iso-, anteiso- and straight chain saturated fatty acids with 12-methyltetradecanoic (anteiso-C15), 14-methylpentadecanoic (iso-C16), 14-methylhexadecanoic (anteiso-C17) and hexadecanoic acid (C16) as major components. A small scale integrated procedure was used for the sequential extraction of isoprenoid quinones and polar lipids. The latter were examined by two-dimensional thin-layer chromatography and all of the test strains contained diphosphatidylglycerol, phosphatidylglycerol and two uncharacterised glycolipids. In all cases the major isoprenoid quinones were unsaturated menaquinones with seven isoprene units. Analyses of the cell wall amino acid composition using gas chromatography showed that the strains contained 2.5 to 5 moles of alanine and 1 mole each of glutamic acid and lysine. The chemical data support the integrity of Rothia dentocariosa and can be used to separate it from all other actinomycetes especially those which contain lysine in the wall peptidoglycan. PMID- 6485632 TI - [Hemolytic effect of Listeria innocua on sheep erythrocytes]. AB - The influence of culture medium composition on hemolytic effects produced by Listeria innocua on sheep blood agar has been investigated. Neither alpha- nor beta-hemolysis could be observed around L. innocua colonies grown on sheep erythrocyte agar lacking glucose. However, green zones of hemolytic phenomena were observed around colonies grown on such agar which contained 0,6% (w/v) glucose. By using L. innocua cell suspensions and culture filtrates this glucose associated hemolysis only occurred in media which were weakly buffered (1 m M Na PBS). This hemolytic phenomenon was attributed to the resulting acidification of the culture medium caused by the metabolic breakdown of glucose by Listeria. The results of this study demonstrate the necessity of including adequate buffer conditions when assaying the hemolytic property of a Listeria strain. It was found that the addition of 20 mM Na-PBS to the assay medium was sufficient to eliminate artificial "acidic-hemolysis". Moreover, the hemolysis observed with known hemolytic Listeria strains was unaffected by this buffering, as was in fact the case even when conditions of higher buffering capacity were employed. By testing in this manner, no evidence has been found which would suggest the existence of an hemolysin, either intra- or extracellular, produced by Listeria innocua. An accurate method for the determination of hemolysis caused by strains of the genus Listeria is proposed. This method of assaying hemolysis in a liquid grown medium has proven effective in determining the hemolytic properties of strains which appeared negative or questionable on blood agar as well as strains which in virulence tests were negative. The ability to accurately assess the hemolytic properties of Listeria strains, is essential in determining the association of Listeria hemolysin with pathogenicity of this genus. Together with current investigations on the genetics of hemolysin production by Listeria the determination of hemolytic activities will eventually allow to understand better the pathogenic principle of hemolytic strains of Listeria monocytogenes. PMID- 6485633 TI - [A simple method for the rapid detection of bacterial hyaluronidase in K hyaluronate-containing gel]. AB - For detection of hyaluronidase activities we investigated several groups of bacteria. The bacteria were inoculated on a 1,5% agarose gel in Petri plates of 4 cm diameter or gel discs of 7 mm diameter, containing 0,1% of K-hyaluronate as well as nutritient medium, and were incubated for 2-20 h at 37 degrees C in a moist chamber. Subsequently some ml of a 10% solution of cetylpyridiniumchloride were poured on the gel to precipitate the polymere hyaluronate. If the hyaluronate was depolymerized by hyaluronidase, a translucent area was visible around the colonies. We found out, that a gel layer of 1 mm was sufficient to detect the small amounts of hyaluronidase, which were produced by bacteria within an incubation time of 2 h. These results were confirmed by incubation for 20 h and in some cases 36 h. The hyaluronidase production by different anaerobic Clostridium strains was always proved after a 20 h growth period. The bacteria were inoculated with the whole loop of a self made platin sowing wire loop. By this method quantitative differences of hyaluronidase activities between different strains of bacteria could be detected. PMID- 6485634 TI - [Plasmid-mediated pathogenicity factors of Yersinia enterocolitica from the epidemiological viewpoint]. AB - In an attempt to evaluate the epidemiological significance of Y. enterocolitica strains isolated from domestic animals with latent infections, i.e. from swine (31), dogs (9), cats (2), and the environment (2) were compared, in respect of their pathogenic properties, with reference strains (27) from human patients. The results did not contradict the assumption of animals being a source of human infections. In general, these strains of the serovars 0:3 and 0:9 possessed a virulence plasmid with a molecular weight of 46 Mdal (+/- 3 Mdal), irrespective of their origin from humans or domestic animals with latent infections. There was a consistent correlation of the presence of the virulence plasmid and of positive reactions in Laird's and Cavanaugh's autoagglutination test (1980) (Tab. 1): The strains harbouring this plasmid were calcium dependent on MOX agar (18) as well. These strains were capable of colonizing the intestine of mice in a modified mouse diarrhea model (Fig. 1). In these latently infected mice low titers of species-specific antibodies were detected. It was possible to select plasmid harbouring substrains out of heterogenic strains, which had undergone conversion to plasmidless isogenic variants when applying the modified mouse diarrhea model. In a newly developed "macrophage-virulence-test", strains harbouring the virulence plasmid were able to multiply within the macrophage of mice (Fig. 4, 5) with cytopathogenic effects. In a modified Sereny-test European strains of the serovars 0:3 and 0:9 were shown to be invasive in the conjunctival epithelium of guinea pigs' eyes as an additional plasmid-associated property (Fig. 3). European strains of atypical biochemical or serological patterns (among them Y. intermedia, Y. frederiksenii) as well as some strains of the serovars 0:3 and 0:9 did not harbour the virulence plasmid. These plasmidless strains were altogether negative regarding the pathogenic properties mentioned above. Long-term in vitro subcultivation of strains correlated well with the frequency of plasmidless strains: isolates cultivated for a number of years, in contrast to newly isolated strains, hardly harboured virulence plasmis. PMID- 6485635 TI - Experimental Treponema hyodysenteriae infection of mice. AB - Factors such as strain, fasting period, sex and age of the animals, and challenge dose were examined for their effects on the development of infection with Treponema hyodysenteriae in mice. Among mice tested, Ta:CF#1 mice were the most susceptible to the infection. Ta:CF#1 mice developed gross cecal lesions by a single oral dose ranging 10(2)-10(7) colony-forming units of T. hyodysenteriae without preinoculation fast. Oral challenge with 10(7) colony-forming units of the treponeme resulted in the development of gross lesions in all the mice at day 10. The number of T. hyodysenteriae in the feces and cecum of the mice reached the highest level at day 7 and 10, respectively; the levels lasted until day 21, the termination of the experiment. Macroscopic, microscopic and scanning electron microscopic findings of the lesions were similar to those of swine dysentery. These studies indicate that the Ta:CF#1 mice may be used as an excellent in vivo model system for swine dysentery. PMID- 6485636 TI - [Bacteriological characterization of gingivitis-inducing plaque depending on different sugar levels of the diet]. AB - In a time period of 21 days an experimental gingivitis was induced in 8 volunteers. Four volunteers received a carbohydrate-reduced, the other 4 persons a carbohydrate-enriched diet. Clinical investigations on the development of plaque and gingivitis and bacteriological examinations of the supragingival microflora were performed simultaneously. The change in the composition of the supragingival plaque-microflora were nearly independent of the amount of food carbohydrate. In the beginning of the experiment all volunteers had an almost pure streptococcal microflora but during the course of the experiment, the supragingival flora developed to a complex microflora with 50% anaerobes. The reduction of the number of streptococci was accompanied by an increase in the number of Gram-negative rods and actinomycetes. The development of gingivitis in persons with carbohydrate-enriched food was more rapid than in persons with carbohydrate-reduced food. It was striking that the occurrence of clinical symptoms correlated with the increase of the number of Actinomyces viscosus in the plaque material. PMID- 6485637 TI - Survey of resistance to metals and volatilization activity of Hg-resistant R plasmids in Citrobacter isolated from clinical lesions in Japan. AB - Clinical isolates of Citrobacter (277 strains) were studied for the resistance to four metals and four drugs. The distribution patterns of their susceptibility to Hg, Cd and As clearly revealed two peaks, but only a single peak of resistance to Pb. The frequencies of resistance to Hg, Cd, As, SM, TC, CP and KM were 31.8, 94.2, 57.8, 51.3, 44.8, 35.7 and 28.9%, respectively. And we selected 88 mercury resistant strains, and they were tested for their ability to transfer the resistance to the mercury and drug sensitive recipients of E. coli K12-ML1410-Nx and E. coli JE17-Rif. Among 88 strains of Hg resistant Citrobacter, 80 R plasmids with Hg resistance could be demonstrated. It should be noted that transferable R plasmids with Hg resistance were demonstrated in 91% of the Hg-resistant isolates. Furthermore, we tested the volatilization of mercury by strains containing these mercury resistance plasmids, by using radioactive 203Hg2+. All of these isolates of Citrobacter have volatilization activity of Hg2+. Also, all of these volatilization activity is inducible. PMID- 6485638 TI - Some aspects of virus shedding by rainbow trout (Salmo gairdneri Rich.) after waterborne infection with viral haemorrhagic septicaemia (VHS) virus. AB - VHS virus shedding after experimental waterborne infection of rainbow trout was quantified by measuring virus infectivity in blood, faeces, and urine of catheterised fish. Virus shedding by urine with relatively high yields of infectious virus could be demonstrated during acute VHS until death, but not by faeces. Trout, which were vaccinated against VHS or had survived the disease but showed no detectable humoral antibodies, may excrete infectious virus via urine for more than 30 days and without any signs of VHS after a secondary challenge infection. These results reveal the development of a carrier status of rainbow trout after VHS exposure. PMID- 6485639 TI - Active hepatitis B immunization with an experimental German vaccine. I. Immunogenicity studies in healthy adults. II. The primary 19 S and 7 S responses to HBsAg in healthy adults. III. Immunogenicity studies in hemodialysis patients. AB - The immunogenicity of an experimental german hepatitis B vaccine has been evaluated in 343 healthy adults. Three doses of vaccine induced anti-HBs antibodies in 94 to 100% of the vaccines. Different batches and doses of vaccine did not significantly influence the seroconversion rates at the end of the vaccine trial. Higher doses were followed by more rapidly and more vigorously occurring anti-HBs-levels. Significant differences were noticed between the 40 micrograms- und the 10- or 8 micrograms-doses. Variation of schedules (0-1-6 or 0 1-5) did not result in significant differences. Batch-no. I/B 070881 induced significant lower anti-HBs levels than batch-no. II/310781. Females developed significant higher anti-HBs values than males, younger vaccinees higher than older vaccinees. Rate zonal ultracentrifugation analysis of anti-HBs-positive sera collected after vaccination regularly revealed anti-HBs of the IgM class in case of early and high immune response to the vaccine. Individuals characterized by a late onset of anti-HBs production developed anti-HBs antibodies of the IgG class only. The vaccine induced an anti-HBs response in 64 to 75% of hemodialysis patients. The conversion rates and the achieved anti-HBs levels were significantly higher in young and/or female patients than in old and/or male patients. PMID- 6485640 TI - Active hepatitis B immunization with an experimental German vaccine. IV. Reactogenicity studies in healthy adults and in hemodialysis patients. AB - Reactogenicity testing was performed accompanying vaccination with the experimental German Hepatitis B Vaccine. 509 individuals, among them 343 healthy adults and 166 hemodialysis patients, were vaccinated with three doses of vaccine. The evaluation of questionnaires indicated that local and systemic adverse reactions were of low intensity and short duration. The rates of reactions were highest following the first and lowest after the third vaccination. The vaccine did not induce immunopathological alterations. The vaccine was non-infectious and thus not the cause of hepatitis B infections nor of other viral or bacterial infections. PMID- 6485641 TI - [Spontaneous spinal epidural hematomas]. AB - Until now, reports have been given on 249 spontaneous spinal epidural haematomas. Two own cases are included in the submitted analysis. In approximately 78 per cent, the disease begins with pain and radicular disturbances according to the lactation of the haematoma, in 18 per cent with a primary to the location of the haematoma, in 18 per cent with a primary transverse syndrome. The incidence peak is seen around the 60th year of liefe. Men are taken ill more frequently than women, the ratio being 5:3. At the age of 10 to 50 years, the ratio is 3:1. In one third of the patients, no cause of the disease can be detected. One quarter of the patients were given anticoagulants. The prognosis depends on the interval between the first symptoms and the transverse lesion of the cord with paraplegia as well as the time of the operation. For the myelon region (C 1-L 1), the remission rate obtained by an operation within 24 hours after formation of the transverse syndrome is bad in about 34 per cent, for the caudal region (L 2-S 1) it is better in approximately 57 per cent. It the operation is carried out within eight hours, the remission rate is about 84 per cent. In most cases, the disease is diagnosed with a delay and the patients are referred for a surgical treatment too late. PMID- 6485642 TI - [Normal and pathologic semiology of the anterior choroidal artery]. AB - In the normal individual, the anterior choroidal artery (ACA) has a rather fixed angiographic trajectory, but in patients with intracranial tumors it almost invariably has a modified course, the nature of the modification being dependent on the topography of the lesion. Authors employ the parameters used up through the present for objectivating the course of the anterior choroidal artery, and add others of theirs own, especially in regard to the relative location of various points on the vessel (rather than their isolated positions). A total of 28 measurements were taken for each of the 132 angiographic series studied: 31 normal individuals and 101 with diverse intracranial lesions. Every value was entered into a computer along with (by numerical coding) personal data, incidental factors and, in the pathological series, the topography of the preferrent (primary) lesion and secondary lesion (tumoral extension), as well as the possible coexistence of hydrocephaly and/or transtentorial herniation. This procedure allowed for an exhaustive analysis of each factor involved, which could be studied individually or in combination within each of the groups and subgroups established. In this way the extensive results could be readily interpreted. PMID- 6485643 TI - [Experimental thromboses of the internal carotid artery in animal experiments as a prerequisite for model studies of acute cerebral ischemia]. AB - Thrombotic occlusions of the cerebral arteries are in a high degree participating in the development of cerebral infarction. Their treatment is problematic because the use of thrombolytics may be detrimental to the cerebral tissue. In many cases, these thromboses cannot be reached surgically. Suitable animal models are necessary for achieving advances in this acute life-threatening disease. An animal-experimental model of a thrombosis of the arteria carotis interna is presented. For producing a coagulative thrombosis, autologous blood is used after previous electric activation in vitro which after re-injection behaves like a thrombogenic substance. PMID- 6485644 TI - 3H-leucine incorporation into subcellular fractions of human brain tumors. AB - In vitro incorporation of 3H-leucine into proteins of subcellular fractions of brain tumors has been investigated. Protein-bound radioactivity of nuclei and soluble fraction significantly increased compared to values of the normal brain. Moreover, the study demonstrated that microsomes, the most active fraction in protein synthesis in the normal tissue, always showed lower values than neoplastic nuclei. The pattern of 3H-leucine subcellular uptake obtained in brain tumors might suggest some similarities to that seen in the early phases of brain maturation. PMID- 6485645 TI - [Current status and trends in the development of neurosurgery]. AB - After a short historical survey will be reported about the actual position of neurosurgery, with special aspects to problems of operative techniques. The consequences of the tendencies of development of neurosurgery are discussed. PMID- 6485646 TI - [Behavior of Newcastle disease virus in the airborne state. 1. Experimental study of particle binding of the virus]. PMID- 6485647 TI - [Behavior of Newcastle disease virus in the airborne state. 2. Estimation of aerogenic dissemination]. PMID- 6485648 TI - [Experimental leptospiral vaccines. Serological findings in rabbits]. PMID- 6485649 TI - [Determination of bacterial flora in stall air]. PMID- 6485650 TI - Simple production of staphylococcal enterotoxins (SET) with chromatofocusing and isoelectrofocusing in flat bed gels. PMID- 6485651 TI - Incidence of coccidiosis in horse-mackerel (Trachurus trachurus, T. mediterraneus, T. picturatus) and sardines (Clupea pilchardus) from the North Aegean Sea. PMID- 6485652 TI - [Cerebrosides and sulfocerebrosides in the brain of insectivorous mammals]. AB - Brain cerebrosides (C) and sulfocerebrosides (S) of Insectivora, which represent the most ancient and primitive order of placentary mammals, were first studied. The content of C and S is higher in hedgehogs (Erinaceus europaeus, E. auritus) and mole (Talpa europaea) brains as compared to shrew (Sorex araneus) brain. Hydroxy fatty acids predominate over normal fatty acids in C of all studied insectivora brains. The fatty acid content of C and S of the Insectivora brains is similar in being rich in palmitic, stearic and behenic normal acids and hydroxybehenic and hydroxylignocerinic acids. Hydroxy fatty acids of C and S are more saturated and they have a longer chain (sum C24-26 acids) than the normal acids. C and S of insectivora and primate brains are compared. The data may be of importance for the understanding of the biochemical evolution of the nervous system of mammals. PMID- 6485653 TI - [Action of the salts of univalent thallium on the liver mitochondria of the rat]. AB - Using light scattering and electron microscopic techniques, studies have been made of the swelling of liver mitochondria in isotonic sucrose solutions containing different concentrations of nitrate or acetate of monovalent thallium. It was concluded that the injurious effect of thallium on the mitochondria is associated with both its penetration into intramitochondrial space, and interaction of the external thallium with mitochondrial membranes. PMID- 6485654 TI - [Surface structure of the otolithic organs of the tadpole of the clawed toad Xenopus laevis]. AB - Beginning from the blastula and tail bud stages, 15 larvae of the clawed toad were kept in three EMKON containers at temperature 15 degrees for 8-9 days. Structure of the hair cells and otolith membrane of the larval otolithic organs was examined with a light microscope, TEM and SEM. In contrast to previous studies, it was found that at the stages mentioned larval otolithic organs are presented not by two, but by three maculae, i.e. the utricular, saccular and lagenar ones with two otoliths. Saccular and lagenar maculae are covered by a common otolith membrane. Separate otoconia may loose from the otolith membrane, this process being enhanced by fixation. Within the maculae, receptor cells differ with respect to the structure of hair bundles. Basing on the morphology of ciliary tufts, 4 types of the hair cells were identified. However, TEM examination did not reveal significant differences in the ultrastructure of these types of cells. Maculae of the three otolithic organs varied in the cell type patterns and cell polarization. No continuous row of the immature hair cells was found along the perimeter of the maculae. PMID- 6485655 TI - [Electrophysiologic study of the hypothalamo-thalamic connections in the rat]. AB - In acute experiments on rats, studies have been made of the pattern and peculiarities of the evoked potentials in different thalamic nuclei. It was found that most short-latent high amplitude evoked potentials during stimulation of the posterior hypothalamus are recorded in the antero-ventral and medio-dorsal thalamic nuclei. In the posterior lateral nucleus, under the conditions employed, no evoked potentials were observed. PMID- 6485657 TI - [Principles of hospital infection control]. AB - The demographic, socio-hygienic, immunological, genetic, microbiological and epidemiological aspects of the problem of hospital purulent inflammatory diseases (PID) are considered. The main causes contributing to the high level of PID are analyzed. The main ways for decreasing PID incidence in medical institutions, comprising a complex of organizational, prophylactic and therapeutic measures introduced by stages, are outlined. PMID- 6485656 TI - [Electrophysiologic study of the ascending connections of the hippocampus with various neocortical zones in the rabbit]. AB - In acute experiments on rabbits studies have been made on functional connections of hippocampal fields CA1 and CA3 with various zones of the neocortex. It was shown that these hippocampal structures are most closely connected with the limbic ancient associative cortex, as well as with the parietal and temporal regions. In the sensorimotor cortex, the EPs were rather irregular. Fields CA1 and CA3 exhibit different projections to the mentioned regions of the neocortex. PMID- 6485658 TI - [Current problems of immunoprophylaxis of infectious diseases and standardization of medical immunobiological preparations]. AB - The state of immunoprophylaxis in the whole of the USSR and in individual Union Republics in 1981-1982 is ralyzed. The connection between an increase in diphtheria, pertussis and measles morbidity and the widening of the scope of contraindications to vaccination has been revealed. The optimum vaccination tactics in Union Republics with regard to differences in their climatic conditions and demographic situation is planned. The problems of the standardization of prophylactic and therapeutic immunobiological preparations are considered. Organizational measures leading to the improvement of their quality are outlined. PMID- 6485659 TI - [Live vaccines against influenza and measles]. AB - The advantages of live attenuated vaccines over inactivated vaccines in the prophylaxis of some viral infections are shown: attenuated vaccines, apart from their ability to stimulate systemic humoral immunity, are capable of the mobilization of cytotoxic killer reactions with the participation of T lymphocytes and macrophages, the stimulation of local secretory immunity and long term immunological memory. The organizational drawbacks of the modern vaccinal prophylaxis of influenza and measles with the use of live vaccines manufactured in the USSR are analyzed and effective ways for the elimination of these drawbacks are proposed. PMID- 6485660 TI - [Various aspects of the chemotherapy of bacterial infections]. AB - The principles of rational antibiotic therapy in modern conditions are considered. The mechanism of action of the main antibiotics widely used for the treatment of infectious diseases and indications to the use of combined antibiotic therapy are analyzed. Good prospects for the use of immunomodulators and agents inhibiting microbial cell enzymes in a number of pathological conditions are shown. PMID- 6485661 TI - [Implementation of the recommendations of the XVI All-Union Congress of Microbiology and Epidemiology and current goals in the field of infectious disease control in the USSR]. PMID- 6485662 TI - [Urgent problems in the organization of malaria prophylaxis]. AB - The causes contributing to the appearance of local cases of malaria and to the isolated foci of this disease in some of the southern republics of the USSR are analyzed. Modern means for the control of this infection are considered. The complex of measures necessary for the final liquidation of malaria in the USSR, the CMEA countries and the developing countries of socialist orientation are outlined. PMID- 6485663 TI - [Symposium on the teaching of epidemiology and microbiology at various medical school faculties]. PMID- 6485664 TI - [Status and tasks of goal-oriented planning of research with regard to the problem of diphtheria]. AB - The work deals with the prospects of scientific research in the prophylaxis of diphtheria. The authors consider the necessity of creating the complex goal oriented program of scientific research, such program being the basis of forward planning. PMID- 6485665 TI - [Electron microscopic study of the interaction of Yersinia pseudotuberculosis with macrophages and HeLa cells]. AB - The comparative electron-microscopic study of early stages of the interaction of Y. pseudotuberculosis virulent strain (No. 282) with "professional" (macrophages) and "nonprofessional" (HeLa cells) phagocytes has been carried out. The character of the intimate mechanism of this interaction has been found to be essentially different. The common feature for both systems is the adsorption of bacteria and their penetration into cells due to phagocytosis. But the subsequent fate of Y. pseudotuberculosis is different. In HeLa cells they are isolated from the cytoplasm by multilayer membrane structures, thus remaining morphologically intact. In macrophages the destruction of the microbe in phagolysosomes occurs. PMID- 6485666 TI - [Analysis of the seasonality of acute intestinal diseases with regard to the detection of dysentery by antigen indication]. AB - Coincidence in the seasonal changes of the registered morbidity in dysentery and in other acute intestinal diseases is observed. The occurrence of Shigella antigens, detected with the use of erythrocyte diagnostic reagents, in the excreta of patients with the clinical diagnosis of dysentery and patients with other acute intestinal disease has a seasonal character, its peak coinciding with the period of increased morbidity in bacteriologically confirmed dysentery. The correction of monthly morbidity levels in dysentery and in other acute intestinal diseases with due regard for the proportion of Shigella antigens in the findings, made in the groups of patients with the clinical diagnosis of dysentery and with the diagnosis of other acute intestinal diseases for the corresponding month, has revealed that the actual morbidity in other acute intestinal diseases has a less pronounced seasonal character in comparison with the registered morbidity. This fact substantiates the statement that in the group of patients with other acute intestinal diseases a large proportion of such diseases is, actually, of a noninfectious nature. PMID- 6485667 TI - [Sputum microflora in acute pneumonia based on the data from a quantitative study]. AB - In this work the data obtained in the quantitative investigations of sputum samples from 106 miners having acute pneumonia are presented. These investigations were carried out twice at the peak of the disease to determine the possible infective agent. The virological study of nasal impression smears by immunofluorescence and the serological study of paired sera made it possible to establish the viral and bacterial nature of the disease in 12% of cases. The expediency of the quantitative investigations of sputum, carried out twice, in combination with the study of the biological properties of opportunistic microorganisms was shown. Streptococcus pneumoniae proved to play the most important etiological role in the appearance of acute pneumonia in miners. This infective agent was detected in 82% of patients by the inoculation of sputum samples in "diagnostic" dilutions (10(-5) and higher). The associations of pneumococci with staphylococci, hemolytic bacteria and Neisseria were found to be capable of playing a significant role in the development of acute inflammation in pulmonary tissue, especially in those cases when these associations were isolated from highly diluted sputum (10(-5)). PMID- 6485668 TI - [Determination of Staphylococcus species-specific antigens by using erythrocyte reagents]. AB - Species-specific (Staphylococcus aureus and S. epidermidis) antigenic and antibody erythrocyte diagnosticums have been prepared. Various tests made with the use of these diagnosticums have demonstrated that the activity of specific antigens is higher in hydrochloric acid extracts than in trichloroacetic and phenolic ones; this activity is linked with undialyzed components and depends on the peculiar features of the strain. PMID- 6485669 TI - [Standardization of cholera vaccine and preparation of a national reference standard]. AB - The antigenic potency of the proposed national reference preparations in comparison with that of the corresponding international reference preparations was studied by means of the active protection test in mice. The antigenic potency of the proposed national reference preparations for Inaba and Ogawa was found to be the same or even greater than the antigenic potency of the international reference preparations for cholera vaccine. A high level of antigenic activity was observed during comparison of a production lot of cholera divaccine with the international reference preparation and the national reference preparation in parallel tests. The proposed national reference preparations for Inaba and Ogawa may be used for evaluating the antigenic potency of the lot of cholera vaccine produced in Bulgaria as the standard preparation. PMID- 6485670 TI - [Cowpox in man]. AB - Two cases of human infection caused by vaccinia virus were recorded in the Rzeszow province (Poland), this infection being absent both in this province and in the whole country for many years. The diagnosis was based on the investigation of isolated samples (from one female patient) and the identification of the causative agent by its biological properties and the results of the analysis of its genome, made with the use of restrictases, as well as on the results of the serological investigation. Of the two female patients, one suffered from a prolonged and severe infection in her eye, the other had a lesion on the backside of her hand. Apart from local lesions, systemic phenomena (fever, malaise, headache) were observed in both patients. The authors state that, most likely, rodents were the source of infection in these two cases. This is confirmed by the fact that wild rodents (rats, mice) caught in the focus of infection show the presence of antibodies to orthopoxviruses. PMID- 6485671 TI - [Tolerance induction by the peroral administration of protein antigens]. AB - The possibility of inducing systemic tolerance in animals by feeding them with ovalbumin and human serum was studied on mice, rats and rabbits. Antibodies to ovalbumin, human serum albumin and immunoglobulins (IgG, IgA, IgM) were determined by the passive hemagglutination test in the sera of the test and control animals after the second immunization made through a parenteral route. Tolerance to all the antigens under study was obtained in mice and rats, while in rabbits such feeding was found to produce the priming effect. The degree of tolerance was the greater, the more was the dose of the antigen and the longer was the period of feeding. Different proteins showed varying tolerogenic activity; the same degree of tolerance in mice was obtained by feeding them with IgG in a dose of 0.3-0.5 mg and with ovalbumin or human serum albumin in a dose of 6-12 mg (per gram of body weight). Tolerance was determined on day 3 after the course of feeding was over; in 3 weeks tolerance essentially decreased, and in 1.5-2 months it was replaced by normal reactiveness. Tolerance induced by the oral administration of antigens proved to be immunologically specific. PMID- 6485672 TI - [Immunomodulating action of levamisole in influenzal infection in mice]. AB - The time of the activation of the regulatory lymphocyte subpopulation in the spleen and the influence of levamisole on the course of influenza infection in mice were studied in parallel. The study revealed that the final effect of the immunomodulating action of levamisole was determined by the concrete phase of the regulatory activity of lymphocytes. At the same time the injection of the preparation at the peak of helper activity induced a transitory decrease in antibody formation and, in the fatal form of the infection, a rise in the death rate among the animals. The probable role of levamisole-activated macrophages in the transitory suppression of immune response in mice during influenza infection is discussed. PMID- 6485673 TI - [Immunological indices of viral hepatitis patients and the prognosis for the time periods of aspartate and alanine transaminase normalization]. AB - The work presents the results of the correlation analysis and the regression equation between the number of T-lymphocytes, the levels of IgA, IgM, IgG and the dynamics of the fall of the alanine and asparagine transaminase levels; the work also presents the results of the leukocyte migration inhibition test and the data on the duration of the presence of asparagine transaminase and alanine transaminase in the blood. The relationship between the normalization of enzymatic samples from the liver and the immune status in patients with viral hepatitis A and B is shown. PMID- 6485674 TI - [Cellular immune reactions to the multiple administration of a chromatographic inactivated influenza vaccine in an experiment]. AB - The administration of inactivated chromatographic influenza vaccine to mice in three injections induced the formation of the pronounced clone of antigen reactive lymphocytes, detected in the leukocyte blast transformation test. Slight fluctuations in the phytohemagglutinin level and lipopolysaccharide response in mice subjected to multiple immunization with the inactivated vaccine indicated that this preparation produced no damaging effect on the T- and B-lymphocyte populations. PMID- 6485675 TI - 1H NMR spectra of trypsin inhibitors from seeds of Cucurbitaceae plants. Resonance signals of methyl groups. AB - 1H NMR spectra (250 MHz) of four trypsin inhibitors isolated from seeds of Cucurbitaceae plants were studied. It was found that structural differences between the inhibitors from the genus Cucurbita and from the genus Cucumis consist, among others, in the presence in the former group of a valine residue strongly shielded from the solvent. PMID- 6485676 TI - Inhibition of 2-oxoglutarate metabolism by lithium in the isolated rat kidney cortex tubules. AB - 2-Oxoglutarate metabolism in the isolated rat kidney cortex tubules was inhibited by lithium at 5 mM concentration, and at pH increased from 7.1 to 7.6. The metabolism of pyruvate and acetylcarnitine to citrate and 2-oxoglutarate was enhanced by lithium and the increased pH value. The content of 2-oxoglutarate in the renal tubular cells was lowered by lithium but increased at elevated pH values. Both the intracellular pH value and bicarbonate ion concentrations in renal tubular cells were increased by lithium in the medium containing 2 oxoglutarate. The results obtained indicate that lithium disturbs renal metabolism by intracellular alkalization, with a simultaneous inhibition of the inflow of dicarboxylic substrates to the renal tubular cells. PMID- 6485677 TI - Fragment couplings with stepwise couplings in solid-phase synthesis. Synthesis of a fragment of human leukocyte interferon. PMID- 6485678 TI - [The EAA stapler in esophageal anastomoses]. AB - Use of the EEA stapler for oesophageal anastomoses. Since december 1980 we performed with the EEA stapler 25 oesophago-jejunostomies after total gastrectomy for gastric cancer. Operative mortality was 8%. No anastomitic leak was observed. Three patients presented anastomotic stenosis: 2 of these were due to neoplastic recurrence. No particular technical difficulties occurred during the operations. The use of the EEA stapler improves the safety of oesophageal anastomoses and facilitates their realisation. PMID- 6485679 TI - [Evaluation of medical and surgical treatment of intussusception in children apropos of a review of 100 consecutive cases]. AB - Evaluation of medical and surgical treatment of intussusception in children (a revue of 100 consecutive cases). The authors analysed 100 consecutive cases of intussusception hospitalized in the Department of Paediatric Surgery of the Brugmann University Hospital in Brussels. 90 baryum enemas were performed, 43 of which were curative, 57 children were operated upon. Their age varied from 3 months to 10 years, but 77% of the children were less than 2 years old. The authors paid particular attention to the observations of children who had surgical treatment. This study points out the importance of early diagnosis and treatment. After a delay of 24 hours, 81% patients needed surgery compared to 41% of those who presented earlier. PMID- 6485680 TI - [Acute appendicitis: the benefit of a wait-and-see attitude]. AB - Acute appendicitis. Acute appendicitis is often suspected but in 70% of the cases the complaints to an other diagnosis. Aggressive therapy is therefore not indicated. A 12 to 24 h observation allows to avoid surgery and complications which are not exceptional. PMID- 6485681 TI - [Volvulus of the stomach]. AB - Volvulus of the stomach. On occasion of three observations the volvulus of the stomach is studied in the light of recent advances of the literature. Different types of gastric volvulus are defined by etiopathogenic analysis. Symptomatology and diagnosis are examined and possibilities of treatment are emphasized. The therapeutic behaviour which is required towards this rare affection is discussed. PMID- 6485682 TI - [Formation of a phytobezoar following surgery of the stomach. Review of the literature]. AB - Phytobezoar after partial gastrectomy. An observation on phytobezoar formation after partial gastrectomy, attended by an intestinal obstruction is presented. According to a review of the literature bezoar formation following gastric surgery seems to develop in the stomach after vagotomy, and rather in the small intestine after partial gastrectomy. The etiopathogenesis of this phenomenon is analysed, and the physiopathology, the clinical manifestation, the diagnosis and therapeutic possibilities of this affection are discussed. PMID- 6485683 TI - Early and late postoperative sequelae after surgery for carcinoma of the breast. AB - During a 4-year period, the authors performed 621 operations on 606 patients, suffering from carcinoma of the breast. The types of operations and their indications are described. Early postoperative complications of all kind appeared in only 6%, while lymphorrhoea and lymphocele were noted in 30% of the cases. Systematic measurements for early arm swelling indicate a fifty-fifty range. Follow-up study on 379 patients reveals the minor incidence of 8,9% of chronic lymphoedema. No statistic relationship between early swelling of the arm and chronic lymphoedema can be recognized. PMID- 6485684 TI - Quantification of creatine phosphokinase and its isoenzyme MB, serum glutamic oxaloacetic transaminase and lactic dehydrogenase from different sources during aortic valve replacement procedure. AB - The diversity of conditions inducing an increase in CPK-MB, CPK, LDH and SGOT allows investigation of the quantitative evolution in cardiac patients during heart surgery. In nine patients submitted to valve replacement, three samples were taken respectively: one from the superior and the inferior caval veins and one another from the coronary sinus and immediately centrifuged. The sera were processed to quantitate the CPK, CPK-MB, LDH and SGOT through the three periods of observation. The three sites intended to explore the possible other sources of CPK-MB released at surgery: superior vena cava accounts for upper body regions, inferior vena cava for lower body regions and the coronary sinus for the heart itself. The three sites compared separately through the three periods did not show any significant differences. Only comparing the pre-CPK values to their homologous obtained during and after cardiopulmonary bypass, very evident differences could be registered (P less than 0,05 and less) for CPK, CPK-MB and LDH. While SGOT remained totally unchanged through the three periods. The evolutive CPK, CPK-MB and LDH increase accounted for high sensitivity of these enzymes to the variations of conditions during cardiac surgery. It is highly possible that other sources of CPK-MB could be dissiminated in the body and capable to produce valuable enzymatic amounts during and after cardiac surgery and that the heart is not exclusively alone in releasing this enzyme during cardiac ischemic arrest and in other circumstances. The real importance of CPK-MB principally and of CPK would be surestimated as conclusive parameters in diagnosis of myocardial damages during cardiac procedures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485685 TI - Horseshoe kidney and abdominal aortic aneurysm. AB - Three cases of horseshoe kidney associated with an abdominal aortic aneurysm are reported. The pathology, diagnosis and management are discussed. The review of the literature indicates that successful treatment depends on an accurate knowledge of the blood supply to the kidney. PMID- 6485686 TI - Inguinal hernia repair leading to the diagnosis of internal male pseudohermaphroditism. AB - Surgical hernia repair in an apparently normal man leaded to the diagnosis of internal male pseudohermaphroditism after removal of a cystic structure which proved to be a remnant of the Mullerian duct on microscopic examination. The diagnosis was confirmed at explorative laparotomy in search of the second testicle. The terminology of the condition is reviewed and the therapeutic attitude is discussed. PMID- 6485687 TI - Pedal cycling accidents--mechanisms and consequences. A study from northern Sweden. AB - During one year, 447 persons attended the University Hospital of Umea (Sweden) because of bicycling accidents. The incidence was highest in children, falling with advancing age. The most common accident was falling off a bicycle on an uneven or slippery road. Collisions and objects interfering with the rear or front wheel were also common causes. A high percentage of the injuries involved the head, and one-third of these were major injuries. Almost one-fifth of the injured received in-patient care (average 6 days) and a similar number were paid sickness benefit (average 26.5 days). Costs for treatment and benefit were estimated as approx. 2200 Swedish kronor (SEK) per injured person (1 USD = 4:30 SEK, 1979, and 1984 = 8:20 SEK). PMID- 6485688 TI - Platelet trapping and haemodynamics in unilateral and bilateral experimental pulmonary macroembolism. AB - Cat lungs were embolized with autocoagulated autologous blood clots and the platelet-trapping ability of the lung vessels and the haemodynamic responses were studied. Embolization was bilateral or strictly unilateral. It elicited on average a twofold increase in 51Cr-labelled platelets in embolized parts of the lungs. Microscopy revealed platelet aggregates in arteries with diameter 50-100 microns. A temporary decrease in systemic platelets immediately postembolus was found. In the nonembolized lung at unilateral embolization the pulmonary platelet aggregation did not occur and no haemodynamic response was detected, indicating that platelet-aggregating substances or humoral factors did not recirculate from affected to unaffected parts of the lungs. PMID- 6485689 TI - Serum thyroglobulin in differentiated thyroid carcinoma. AB - Serum thyroglobulin (S-Tg) concentrations were measured in 262 patients with differentiated thyroid carcinoma. Analysis of S-Tg with respect to histology showed that the follicular variety of carcinoma had the highest S-Tg values preoperatively and postoperatively when metastases were found. The S-Tg levels during thyroxine treatment accurately predicted the results of 131-I total body scan in all but two cases. In another patient both S-Tg and total body iodine scan were negative at the time when metastases were discovered at X-ray examination. All but two patients with negative scan had S-Tg less than 10 micrograms/l, whereas patients with metastases had values between 11 and greater than 5000 micrograms/l. In patients with residual thyroid bed uptake the S-Tg range was from less than 2 to 84 micrograms/l. The authors conclude that determination of the S-Tg level can replace total body iodine scan in most patients who have undergone ablative therapy for differentiated thyroid carcinoma. PMID- 6485690 TI - The autogenous vein graft as popliteal artery substitute. Long-term follow-up of cystic adventitial degeneration. AB - In three patients operated on for intermittent claudication in 1953, 1954 and 1956, respectively, the pathology causing the obstruction was localized cystic adventitial degeneration of the popliteal artery. On examination 27 to 30 years postoperatively the grafts were all patient, but showed some widening and irregularity. The vein grafts had thus stood a rather long test of time. There were no signs of relapse of the non-atherosclerotic disease of the femoro popliteal artery. None of the patients had any history of knee injury or joint swelling. PMID- 6485691 TI - The concentrating function of the feline gallbladder after truncal vagotomy. AB - Truncal vagotomy is associated with a raised incidence of cholesterol gallstone disease and increase in the size of the gallbladder and of the bile acid pool. Investigations of hepatobiliary function in man and mammals after truncal vagotomy have not established if the enlarged gallbladder is simply dilated, or if the absorptive capacity of the mucosa has changed. We studied the concentrating function of the gallbladder with a perfusion technique in anaesthetized cats three weeks and three months after intrathoracic truncal vagotomy and compared the results with a control group. The histology of the gallbladder was studied with light microscopy. Three weeks after vagotomy the gallbladder size, histologic picture and concentrating function did not differ from observations in the control cats. Three months after the vagotomy the gallbladder was slightly enlarged, sludge was found in the luminal contents, an inflammatory response was seen in the mucosa and the net rate of water absorption was increased two to three times compared with the controls. Possible mechanisms in the increased rate of net water absorption are tentatively discussed. PMID- 6485692 TI - A method for measuring the size of the gastric outlet in obesity surgery. AB - A simple method was evolved for measuring the gastric outlet size following surgery for obesity. Measurements are made through a fiberoptic endoscope, using a Fogarty catheter. A "phantom" study showed the method to be accurate and superior to endoscopic estimation without a reference balloon. High interexaminer and intraexaminer reproducibility was confirmed by independent measurements in patients. PMID- 6485693 TI - Perforation of the small intestine in early postlaparotomy course. AB - In three patients with signs of abdominal catastrophe four to five days after abdominal surgery, a repeat laparotomy disclosed perforation of the small intestine. Causes of small-bowel perforation are discussed and possible mechanisms are proposed for the three presented cases--iatrogenic perforation, compression injury, deep sutures and thermal injury. PMID- 6485694 TI - Interregulations between the immune system and the central nervous system: physiological and pathological consequences. PMID- 6485695 TI - Peritoneal mesothelioma: case report and review of the literature. PMID- 6485696 TI - Atherosclerotic aortic stenosis simulating a coarctation of the aorta. PMID- 6485697 TI - [Electrocardiographic abnormalities and cerebromeningeal disorders]. PMID- 6485698 TI - Pneumococcal endocarditis. PMID- 6485699 TI - Potential hazard of nasogastric tube. PMID- 6485700 TI - How should we proceed when a hypertension is discovered? PMID- 6485701 TI - Drugs recently released in Belgium. PMID- 6485702 TI - Lack of melatonin action on testosterone production by superfused rat interstitial cells. AB - The direct effect of increasing doses of melatonin (10(-8) to 10(-5) M) on testosterone production by superfused rat interstitial cells was studied. A constant basal testosterone output was observed for approximately 3 h after the initial high release. A continuous hypothalamo-pituitary stimulation induced a rapid testosterone response reaching peak values in 40-60 min, then decreasing progressively. Basal testosterone release was not modified by 20 or 140 min melatonin infusions. Furthermore, melatonin induced no alteration of the stimulative testosterone response when directly infusing the cells. This study demonstrates that melatonin in vitro has no direct effect on testosterone production by adult rat interstitial cells. It would seem, therefore, that the well known inhibitory influence of melatonin on rat reproductive function is not produced by a direct effect on Leydig cells. PMID- 6485703 TI - Isolation of two different pools of pituitary prolactin. AB - Two pools of prolactin (Prl) were isolated from the pituitary gland. One readily soluble after homogenization and the other sedimented with secretory granules. In ovariectomized-oestrogen treated rats the latter represents the major Prl fraction of pituitary and can be recovered as immunoreactive Prl after extraction in 2.5 M urea. By correlation of electron microscopy, chromatography and RIA, evidence is gathered that the soluble fraction is constituted by monomeric (little) Prl and that secretory granules contain Prl in a polymerized form (big). PMID- 6485704 TI - Prolactin and growth hormone secretion in chickens: stimulation by histamine and inhibition by gamma-aminobutyric acid. AB - Anterior pituitary glands from chickens (Gallus domesticus) were incubated with or without single, mediobasal chicken hypothalami in medium containing histamine, alone or together with the antagonist diphenhydramine or in medium containing gamma-aminobutyric acid (GABA), alone or together with the antagonists bicuculline or picrotoxin. The release of prolactin (Prl) and growth hormone (GH) was measured by homologous radioimmunoassay. Histamine had no direct effect on the release of either hormone but stimulated Prl (in a dose-related way) and GH release when anterior pituitary glands were co-incubated with hypothalami. Diphenhydramine also had no direct effect on Prl or GH secretion but blocked the stimulatory effect of histamine on hypothalamus-induced Prl and GH release. When anterior pituitary glands were incubated without hypothalami, GABA, bicuculline and picrotoxin had no effect on the release of Prl or GH. However, GABA inhibited the release of both hormones in a concentration-related manner, when anterior pituitary glands were co-incubated with hypothalami. This inhibition was blocked by both bicuculline and picrotoxin. These results suggest that histamine and GABA may be involved in controlling the secretion of Prl and GH from the avian pituitary gland, possible by modifying the secretion of hypothalamic releasing and/or release-inhibiting hormones. PMID- 6485705 TI - Maintenance of differentiated sheep thyroid cells in primary culture for three months. AB - A method is described which permits culture of primary thyroid cells without subculture for at least 100 days. Cultures are maintained without medium changes for the entire period, and concentrated glucose is added to replenish energy supplies at carefully defined intervals. The cells retain morphological and functional differentiation shown by light and electron microscopy, PAS positive histochemistry, iodine uptake and T4 production for at least 100 days. After this time fairly sudden death of the cultures occurs. Possible mechanisms for the effect are postulated. The technique should make it possible to study long-term effects of drugs/radiation on differentiated cultures without the need for continuous subculture. PMID- 6485706 TI - Analysis of immunoreactive and biologically active human parathyroid hormone peptides by high-performance-liquid-chromatography. AB - A combination of high-performance-liquid-chromatography (HPLC), sensitive radioimmunoassays and a homologous in vitro bioassay was used to characterise human parathyroid hormone (hPTH)-peptides in human parathyroid adenoma and plasma. Chromatography of several synthetic hPTH-peptides allows the calibration of the HPLC column. On the basis of sequence hydrophobicity the elution position of peptides can be predicted. A model for the determination of the minimal peptide sequence of each peptide has been developed which based on immunological and physico-chemical properties allows the characterisation of unknown hPTH peptides. Using this technique the heterogeneity of circulating hPTH-peptides in human plasma has been examined. Plasma extracts from healthy individuals, osteoporotic, hyperparathyroid and pseudo-hyperparathyroid patients were investigated. A uniform pattern in the heterogeneity of hPTH-peptides was detected. Using parathyroid adenoma as reference disease specific changes were characterised. PMID- 6485708 TI - Resistant ovary syndrome and fertility. AB - The authors report two cases of women with resistant ovary syndrome who were hospitalized because affected by secondary amenorrhoea. The development, in these women, of secondary sexual characteristics was normal. Neither x-ray of the sella turcica nor examination of the visual fields revealedany abnormalities. They had a normal female karyotype (46/XX). The plasmatic gonadotrophin levels, especially of FSH, were markedly raised. Administration of GnRH elicited strong responses in FSH and LH, corresponding to what is normally seen in post-menopausal women. The concentration of 17 beta-estradiol in the serum was low. The prolactin levels were normal. The patients were subjected to laparoscopy with ovarian biopsy. The ovaries were small but without morphological abnormalities. The hystological picture, similar in both ovaries, showed a cortical zone of normal appearance with an ordinary number of primordial follicles. Both patients received therapy by estrogens (epimestrol). After a period from three to seven months they showed normal ovulatory menstrual cycles. Now one of these women is pregnant. PMID- 6485707 TI - Estrogen in the treatment of abnormal cervical mucus infertility. AB - The effects of intravaginal estrogen treatment on the cervical mucus and PCT were investigated in ten primarily infertile patients. The abnormal cervical mucus was the only demonstrable factor of their infertility. The duration of the infertility had ranged from 5-10 years. In four cases the percentual and progressive motilities of the spermatozoa improved and the number of spermatozoa rose in the PCT. Three of the patients conceived during the test cycle. In addition the effects of intramuscular estradiol-benzoate on the cervical mucus and PCT were investigated in clomiphene-treated patients. No differences were found between the test and the control cycle. PMID- 6485709 TI - In vitro decondensation of the human spermatozoan nucleus and image analysis. Quantitative data on the kinetics of in vitro decondensation of the human spermatozoan nucleus. AB - The authors subjected 14 human sperm samples to decondensation in vitro. They analyzed the images of a total of 9,681 objects as a function of time of decondensation. The discussion bears on the heterogeneity of the process of chromatin decondensation in human spermatozoa, on the influence of the zinc/fructose ratio in the seminal fluid and on the role of the period during which the spermatozoa are left in contact with the fluid. PMID- 6485710 TI - Degree of endosalpingeal deciliation (by S.E.M.) in hydrosalpinx is not prognostic for post-surgical fertility. AB - In 21 infertile patients, operated on for bilateral hydrosalpinges, multiple tubal biopsies, removed during surgery, were studied by light microscopy and scanning electron microscopy. Compared with control biopsies, taken from 12 fertile women, all cases but one showed flattening or loss of major and minor mucosal folds and epithelial deciliation. However postsurgical fertility rate, after 1-3 years follow-up, is not proportional to the percentage of ciliated cells. PMID- 6485711 TI - [The place of genetics in digestive pathology]. PMID- 6485712 TI - [The place of genetics in infantile diarrhea]. PMID- 6485713 TI - [Mucoviscidosis. Digestive manifestations in the child and monosymptomatic forms]. PMID- 6485714 TI - Genetics and heterogeneity in coeliac disease. PMID- 6485715 TI - HLA, blood groups and gastrointestinal diseases. PMID- 6485716 TI - [HLA antigens in Crohn disease]. PMID- 6485717 TI - Genetic aspects of inflammatory bowel disease and gastrointestinal cancer. PMID- 6485718 TI - [Anatomo-pathologic classification of cancer of the esophagus]. PMID- 6485719 TI - [The value of fibroscopy in the diagnosis of tumors of the esophagus]. PMID- 6485720 TI - [Radio-surgical treatment of superficial cancer of the esophagus. Apropos of 26 cases]. PMID- 6485722 TI - [Clinicopathological study on suitable operations for early gastric cancer]. PMID- 6485721 TI - [The place of radiotherapy in the treatment of cancer of the esophagus]. PMID- 6485723 TI - [Histologic and microangiographic studies on experimental tumors of the esophagus in rats (on the carcinogenic processes and growth patterns of esophageal carcinoma)]. PMID- 6485724 TI - [Morphological studies on the lymphatics of the large intestines--with special reference to their distribution and the electron microscopic structure of the intramural lymphatics]. PMID- 6485726 TI - [A clinical study of patients with Habu-snake bites]. PMID- 6485725 TI - [Prognosis and indication in the cases of reconstruction of esophagus through the posterior mediastinal route with a gastric tube for carcinoma of thoracic esophagus. with special reference to the depth of invasion to adventitia]. PMID- 6485727 TI - [Choice of operation for patients with duodenal ulcers, based on gastric acid secretion patterns measured by a pH-meter]. PMID- 6485728 TI - [Histochemical studies on esophageal cancer. Comparison with experimental esophageal cancer in rats and esophageal cancer in humans]. PMID- 6485729 TI - Studies on the dynamics of active populations of the sheep tick, Ixodes ricinus L. in Co. Wicklow, Ireland. PMID- 6485730 TI - Per- and postoperative monocyte and lymphocyte functions: effects of combined epidural and general anaesthesia. AB - Monocyte-mediated cytolysis and thymidine uptake in phytohaemagglutinin stimulated lymphocytes during and after hip replacement performed under combined epidural- and general anaesthesia were studied using in vitro culture techniques. Monocyte-mediated cytolysis was unchanged during operation but was significantly reduced on the first postoperative day, coinciding with an increasing serum cortisol which indicates an incomplete epidural analgesia. However, there was no significant correlation between the increased cortisol concentration and the reduction of cytolysis. Lymphocyte proliferation was unchanged both during and after operation. These findings indicate that the presence of anaesthetic agents during surgery does not influence the studied functions of monocytes and lymphocytes. This supports the hypothesis that monocyte and lymphocyte depression during surgery under general anaesthesia alone is due to the trauma-induced stress reaction. The difference between postoperative suppression of monocytes and lymphocytes in this study indicates that monocytes are more vulnerable to surgical stress than lymphocytes. PMID- 6485731 TI - Effect of lignocaine on the responses produced by depolarizing agents at the chick neuromuscular junction. AB - The effect of lignocaine on the depolarization and contracture responses produced by acetylcholine (ACh) or tetraethylammonium (TEA) was studied in the isolated chick biventer cervicis (BVC) nerve-muscle preparation using the moving fluid electrode technique. Lignocaine (37 mumol X 1-1-1.8 mmol X 1-1) produced concentration-dependent contractures in the chick BVC muscle. The contractures produced by lignocaine were not accompanied by membrane depolarizations. ACh (5.5 mumol X 1-1-11.0 mmol X 1-1) and TEA (0.48-24.0 mmol X 1-1) produced concentration-dependent depolarizations and contractures in the chick BVC muscle. Lignocaine (0.93 mmol X 1-1) greatly reduced the responses produced by ACh, while it markedly increased the contracture responses produced by TEA. The depolarizations produced by TEA were reduced in lignocaine (0.93 mmol X 1-1). It was concluded that the local anaesthetic lignocaine produces contractures in the chick BVC muscle. Lignocaine potentiates the contractures produced by TEA, while it greatly reduces those produced by ACh. PMID- 6485732 TI - Atropine vs glycopyrrolate during reversal of pancuronium block in patients anaesthetized with halothane. AB - Atropine 0.015 mg kg-1 and glycopyrrolate 0.0075 mg kg-1 were compared as antimuscarinic agents during reversal of pancuronium block with neostigmine 0.03 mg kg-1 in 30 patients anaesthetized with thiopental-N2O-halothane and undergoing minor surgery. In patients treated with atropine-neostigmine, the frequencies of bradycardia and junctional rhythm were relatively high and about the same as those reported by us previously in patients anaesthetized with thiopental-N2O fentanyl. As in our previous study, glycopyrrolate seemed to have advantages over atropine during reversal of pancuronium block: the incidences of bradycardia and junctional rhythm were significantly less in patients treated with glycopyrrolate. Recovery from anaesthesia, as assessed by the awakening after discontinuation of N2O and halothane administration, and the incidence of postoperative nausea and vomiting, were not significantly different between the atropine and glycopyrrolate groups. PMID- 6485733 TI - Intravenous infusion of halothane dissolved in fat. Haemodynamic effects in dogs. AB - Eight harrier dogs received an i.v. infusion of halothane dissolved 1:9 in a fat emulsion for i.v. nutrition (Intralipid, Vitrum). The rate of infusion was adjusted to maintain end-tidal halothane concentrations of 0.7% and 1.4%. At 1.4%, mean arterial pressure decreased to 76 +/- 8 mmHg (10.1 +/- 1.0 kPa) (mean +/- s.e.mean) from a pre-infusion value of 122 +/- 6 mmHg (16.2 +/- 0.8 kPa) (P less than 0.01). The concomitant decrease in cardiac output was 39% and left ventricular maximum dp/dt decreased by 50% (P less than 0.01). Changes in systemic vascular resistance and pulmonary arterial pressure were small. The haemodynamic responses during halothane inhalation, to corresponding end-tidal concentrations, were similar. Arterial and mixed venous halothane concentration increased in proportion to end-tidal concentration. There were no changes in arterial PO2 during the halothane-in-fat infusion. Triglyceride concentrations in plasma increased 12-fold. Haemodynamic recovery after the infusion was fast. We conclude that the halothane-in-fat infusion caused a dose-dependent depression of myocardial contractility and arterial pressure, similar to that seen during inhalation, and that end-tidal concentration could be used for control of the infusion rate. PMID- 6485734 TI - General anaesthesia with halothane and drug absorption. The effect of general anaesthesia with halothane and diazepam on postoperative gastric emptying in man. AB - The effect of general anaesthesia with halothane on postoperative absorption of paracetamol was measured in seven patients, after minor surgery on the extremities. Gastric emptying, estimated indirectly by the rise in serum paracetamol following oral administration of the drug, was significantly delayed after general anaesthesia with halothane compared with gastric emptying when general anaesthesia with halothane was not administered. It was furthermore demonstrated that absorption of paracetamol and therefore gastric emptying were normal or nearly normal when diazepam 15 mg was given orally to the same patients 2 weeks later. PMID- 6485735 TI - Epidural anaesthesia does not delay early postoperative gastric emptying in man. AB - The effect of epidural anaesthesia on early postoperative gastric emptying was measured in seven patients, after minor surgery on the extremities. Gastric emptying, estimated indirectly by the rise in serum paracetamol following oral administration of the drug, was not delayed following epidural anaesthesia. It was furthermore demonstrated that gastric emptying was normal or nearly normal when diazepam 15 mg was given orally to the same patients 2 weeks later. PMID- 6485736 TI - Reaction time course during weaning from respirator treatment. AB - Ten patients who developed disturbed mental function during respirator weaning were studied. They were investigated during respirator treatment and 1 h after start of spontaneous ventilation with continuous reaction time measurements and clinical ratings. During the spontaneous ventilation the reaction times increased and the patients experienced fatigue. PaCO2 was higher and PaO2 was lower than during respirator treatment. A significant correlation was found between individual differences of reaction times and arterial blood gas levels in the two conditions, whereas no general correlation between reaction times and arterial blood gas levels could be established. The findings must be considered tentative, but the results of this study indicate the value of continuous reaction time measurements for quantitative assessment of mental status during respirator treatment. PMID- 6485738 TI - Enflurane, isoflurane and the eye. AB - The intra-ocular pressure was monitored in ophthalmological patients in whom nitrous oxide/oxygen anaesthesia was supplemented with an inspired concentration of 1% enflurane (10 patients) or 0.7% isoflurane (10 patients). These concentrations are proportionate to 0.6 MAC in oxygen. Both agents caused a significant decrease in intra-ocular pressure, enflurane by a mean of 3.1 mmHg (0.4 kPa) and isoflurane by 2.1 mmHg (0.3 kPa). There was no significant difference between agents. Isoflurane offers an alternative to enflurane in surgery when intra-ocular pressure is of importance. PMID- 6485737 TI - Isoflurane and enflurane in long anaesthesias for plastic microsurgery. AB - Isoflurane and enflurane as main anaesthetics at 0.5-0.7% end-tidal concentrations in 70% N2O/30% O2 supplemented with fentanyl maintained smooth basal anaesthesia in ASA I-II patients during long (6-11 h) plastic surgery (n = 7 + 6) as well as during shorter (2-4 h) operations (n = 5 + 5). There were no statistically significant differences in haemodynamic parameters between isoflurane and enflurane patients, although mean arterial pressure was somewhat lower and heart rate higher in the isoflurane patients during the course of long anaesthesias. Both isoflurane and enflurane patients had to be given extra colloids and occasionally vasodilators to maintain peripheral temperature during the long anaesthesias. No clinically adverse renal or hepatic effects were seen, but the liver enzyme activities of four isoflurane and enflurane patients increased after the long anaesthesias. The highest serum inorganic fluoride concentration was 44 mumol/l in the enflurane patients and 5.6 mumol/l in the isoflurane patients. PMID- 6485739 TI - Large airway response to cemented arthroplasty: relationship to hypoxaemia. An experimental study in dogs. AB - Alteration in airway smooth muscle tone has been implicated in the mechanism of hypoxemia, pulmonary hypertension and changes in dynamic thoracic compliance after total hip arthroplasty (THA). We used the pressure within a water-filled cuff of an endotracheal tube as a continuous measure of changes in tracheomotor tone during THA in mongrel dogs, while intermittently assessing gas exchange abnormalities. In all 16 dogs the instillation of polymethylmethacrylate (PMMA) into the femoral medullary shaft resulted in tracheal dilation. In ten dogs we demonstrated simultaneous hypotension, hypoxemia and increase in shunt fraction (Qs/Qt) after THA. In six dogs the medullary canal was thoroughly lavaged prior to PMMA injection, and no hypoxemia, hypotension or increased Qs/Qt was found in spite of persisting tracheomotor relaxation. We conclude that these well documented gas-exchange abnormalities are not mediated by changes in large airway tone. Since the hypoxemia was abolished by medullary lavage in our animal model, we suggest that this syndrome is mediated by alterations in lung perfusion and associated small airway constriction and not by changes in large airway smooth muscle tone. PMID- 6485740 TI - The duration of pain relief after penile block to boys undergoing circumcision. AB - Bupivacaine plain, 2.5 mg/ml, was used for a nerve block of the dorsal nerves of the penis. Satisfactory postoperative analgesia was obtained in 24 of 28 boys undergoing circumcision. Eighteen of the 24 boys with a successful nerve block did not require analgesics during the first 24 h postoperatively. All blocks were performed by the surgeon just before surgery. PMID- 6485741 TI - Comparison of three hypotensive anaesthetic methods for middle ear microsurgery. AB - Three hypotensive anaesthetic methods were compared in 123 patients undergoing middle ear microsurgery. Hypotension was induced with halothane (1 vol.%), nitroprusside (4.4 micrograms/kg/min) or the combination of halothane (0.5 vol.%) and nitroprusside (1.2 micrograms/kg/min). The compensatory rise in the heart rate was controlled with a beta-adrenergic receptor blocking agent, practolol, the mean need for which was 0.03 mg/kg in the halothane group and 0.1 mg/kg in the other groups. The mean duration of the hypotensive period ranged from 79 to 107 min in the groups. During the hypotension, the average mean arterial pressure ranged from 55 to 60 mmHg (7.33 to 8.00 kPa) and the mean heart rate from 67 to 79 beats/min in the groups. The PaO2 value in the nitroprusside and halothane + nitroprusside groups, but not in the halothane group, decreased statistically and in some cases clinically significantly. The only peroperative side effects were ECG changes (mostly junctional rhythm), the incidence of which ranged from 16 to 24% in the groups. The mean values for the degree of haemostasis rated by the otologist on a visual analogue scale between poor (0 mm) and excellent (100 mm) were 90, 73 and 89 mm in the halothane, nitroprusside and halothane + nitroprusside groups, respectively. Recovery in the halothane group was statistically highly significantly longer than in the other groups. No rebound hypertension occurred in any of the groups after discontinuation of the hypotension. The most common side effect was nausea + vomiting, the incidence of which ranged from 15 to 26% in the groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485742 TI - The response of the awake spontaneously hypertensive rat (SHR) to acute blood loss. AB - In order to evaluate experimentally if the presence of hypertensive disease is an additional risk factor in connection with emergency situations including blood loss, awake spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) were subjected to standardized acute haemorrhage (35% of blood volume) via an aortic catheter. Mean arterial blood pressure (MAP), blood gases, acid base balance, blood glucose and haematocrit values were followed and the 5-h survival rate was determined. In the early posthaemorrhagic phase similar plasma refill, as evidenced from haematocrit readings, was seen in SHR and WKY. Hyperglycaemia occurred in both groups but the hyperglycaemic response was only moderate and transient in SHR. The inability of SHR to maintain hyperglycaemia was intimately correlated to early appearance of metabolic acidosis and short posthaemorrhagic survival times. Determination of liver glycogen content of unbled SHR and WKY indicated that the deficient hyperglycaemic response in SHR was not due to inadequate glycogen stores but rather to poor liver perfusion resulting in liver hypoxia. Since spontaneous hypertension in rats in many ways is considered to be similar to essential hypertension in man, these findings suggest that human hypertensive disease constitutes a considerable risk factor in connection with acute haemorrhage. PMID- 6485743 TI - Fade in voluntary muscle contractions of patients with sequelae after poliomyelitis. AB - The isometric contraction pattern was followed in three female and two male patients with lower motoneuron paralysis due to sequelae from poliomyelitis in 1942-48. In uninstructed contractions, force increased slowly to an almost horizontal level which could be kept up for as long as desired. During rapid maximal voluntary contractions, a "biphasic" mechanogram was seen in 49% of 204 contractions, with a first maximum after 0.3 s (0.1-0.9), separated by a notch from a second maximum after 1.1 s (0.3-2.3). In the rest of the contractions, force could not be generated rapidly, despite the intention of the subjects, and a single maximum in the mechanogram was seen after 0.9 s (0.2-2.4). In contractions where a biphasic contraction pattern was seen, the electromyographic activity was greatest during approximately the first one half second of the contraction. In the other contractions the electromyographic activity was about the same during the whole contraction. The results suggest that the mechanograms are composed of a high innervation threshold, fast phasically active component, and a low innervation threshold, slow tonically active component. Fade represents the waning of tension in the phasically active component present in some contractions, while this component appears to be eliminated by poliomyelitis in other muscle contractions. PMID- 6485744 TI - Transient neurological symptoms associated with mononuclear pleocytosis of the cerebrospinal fluid. AB - Brief episodes of neurological dysfunction may sometimes occur in an afebrile patient with no overt vascular disorder, nor any history of previous migraine. In such a case, the cerebrospinal fluid (CSF) may exhibit a predominantly lymphocytic pleocytosis with plasma cells and an increased protein content indicating a lesion of the blood-brain barrier. This syndrome of remitting hemispheric dysfunction is accompanied by migraine-like headache. The available evidence suggests that an aseptic meningitis is the triggering event. PMID- 6485745 TI - Lymphocytapheresis therapy in multiple sclerosis, a preliminary study. AB - 10 patients with definite multiple sclerosis (MS), most of them with the chronic progressive type, were treated with lymphocytapheresis during one year. The DSS (Disability Status Scale) improved in 4 patients during the intensive phase of treatment, remained stable in 5 patients and deteriorated in one. The NSS (Neurological Status Scale) showed a stabilisation for the majority of the neurologic functions. Using the ISS (Incapacity Status Scale), an improvement was measured in 6 patients, a stabilisation in one and a deterioration in 3. Exacerbations could not be prevented by lymphocytapheresis. PMID- 6485746 TI - Second Scandinavian meeting on cerebrovascular disease. September 14-25, 1984, Copenhagen, Denmark. PMID- 6485747 TI - Carbamazepine and bone mineral metabolism. AB - The status of bone mineral metabolism was studied in 21 epileptic out-patients receiving carbamazepine as the sole anticonvulsant drug. Hypocalcaemia was found in 3, hypophosphataemia in one and elevated serum alkaline phosphatase in 4 of the cases. Serum 25-hydroxyvitamin D values were significantly lower in the patients than in the controls. No statistically significant difference was observed in bone mineral density between the patients and controls. Histomorphometric analysis of the iliac crest cancellous bone did not reveal any statistically significant difference in the amount of trabecular bone or osteoid between the patients and controls, but the patients had an increased amount of trabecular resorption surfaces. An increased amount of osteoid, suggesting histological osteomalacia, was found in 2 of the 18 biopsies. We conclude that epileptic out-patients receiving carbamazepine therapy have vitamin D deficiency and may develop osteomalacic changes in their skeleton. PMID- 6485748 TI - Antibodies against oligodendrocytes in serum and CSF in multiple sclerosis and other neurological diseases: 125I-protein A studies. AB - Antibodies against oligodendrocytes were determined in pairs of unconcentrated CSF serum from 12 patients with multiple sclerosis (MS) and 25 control patients including 10 with aseptic meningoencephalitis (AM), using a 125I-protein A microassay. Antibody levels in serum and in CSF did not differ between MS and controls. Calculating the antibody index equal to (CSF/serum antibodies against oligodendrocytes):(CSF/serum albumin) in analogy to the CSF IgG index, thereby compensating for influence of serum antibody concentration as well as altered blood-brain barrier, no evidence was obtained for intrathecal antibody production in the patients with MS. Those with AM had higher antibody index values, probably reflecting intrathecal synthesis. Antibodies against oligodendrocytes seem to be a regular component of CSF and serum in neurological diseases; intrathecal antibody production is less frequent in MS than in AM. PMID- 6485749 TI - Clinical correlates of abnormal brain-stem auditory evoked responses in multiple sclerosis. AB - Brain-stem auditory evoked responses (BAERs) were examined in 178 patients with multiple sclerosis (MS) and compared to the frequency of abnormalities in visually evoked responses (VERs) and in CSF electrophoresis. In clinically definite MS, BAERs were abnormal in 61% and a significant relationship was noted between disability due to MS and the frequency and severity of BAER abnormalities. In suspected MS, BAERs showed evidence of a second lesion in 14% whereas VERs indicated a second lesion in 24%. Abnormal BAERs in patients with suspected MS with brain-stem signs were significantly associated with the presence of truncal and limb ataxia. In progressive possible MS, abnormal BAERs were found in 49% but indicated a second lesion in 35% of patients and were significantly related to the duration of illness. In progressive possible MS, abnormal VERs but not abnormal BAERs, were significantly associated with the presence of CSF oligoclonal IgG banding. Normal BAERs in association with clinical brain-stem abnormalities were found in 24% of patients with clinically definite MS, 50% with suspected MS and 33% with progressive possible MS. PMID- 6485750 TI - Measurement of total and specific IgE levels in the management of a family exhibiting a high incidence of keratoconus. AB - A prospective survey of a family, some of whose members were suffering from keratoconus, has been assisted by estimating serum levels of total and specific immunoglobulin E. In this family of twelve there were initially 2 keratoconus sufferers identifiable clinically, and they both had raised serum levels of total and specific IgE. Of three other younger siblings with high levels of IgE 2 have become, over the course of the study period, patients requiring regular review due to established early keratoconus. The third, as yet, has no clinical evidence of altered corneal stroma. We consider, therefore, estimation of total and specific serum immunoglobulin E to be an objective test with the potential for indicating high risk patients within selected groups. The patients thus identified may have established keratoconus or may progress to develop the condition. PMID- 6485751 TI - Human tears: glucose instabilities. AB - Using a photometric method, a comparative analysis based on 717 human tear samples was made between systematically collected non-reflex, open eye tears and tears associated with prolonged eye closure (sleep), as well as for certain reflex provoking conditions (mild mechanical irritation, irritating vapours and osmotic imbalance). Although the closed eye tear glucose mean for the 8 young adults studied was found to be less than their open eye mean (5.01 versus 7.50 mg%), those two values were not found to be significantly different. However, statistical comparisons made between non-reflex open eye tears and the mechanical, irritating vapour and osmotic responses were found to be different at the P less than 0.05 level of significance, a higher mean concentration being found for the mechanical and osmotic conditions, and a lower mean concentration for the vapour induced condition. PMID- 6485752 TI - Corneal burns: a quantitative comparison of acid and base. AB - A quantitative comparison is made of the effects of two of the most completely dissociating representatives from the pH spectrum, sodium hydroxide and hydrochloric acid, on oxygen uptake by the corneal epithelium. Based on initial observations, a 6 to 1 time ratio in the exposure period (acid, 60 seconds; base, 10 seconds) was found necessary to localize and define similar aerobic effects by the 2 agents on their concentration scales. A further dosage adjustment factor was required, a 5/1 concentration ratio of acid to base, to achieve near parity of the major depressive thresholds of those 2 agents, as well as to illustrate in the resulting graphical model several unique features of each in their aerobic effects on corneal tissue at lower concentrations. PMID- 6485753 TI - Daily contact lens wear. A three year follow-up. AB - One hundred subjects wearing contact lenses (mainly soft lenses) on a daily basis for non-medical reasons were followed for 3 years. Visual performance was very satisfactory. The lenses were replaced at an average interval of 20.3 months. During the 3 year period 18 patients suffered from eye disease/changes, 17 of which had to be treated by an ophthalmologist: 8 cases of conjunctivitis, 5 cases of virus keratitis, 4 cases of corneal oedema (2 caused by overwear of lens, 1 by a too step fit and 1 by intolerance despite a perfect fit), and 1 case of unacceptable vascular reaction. Some of the infections might not have been related to contact lens wear. All changes healed well with no sequelae. One patient was hospitalized for 2 days. Each incident required 2.8 visits to an ophthalmologist and 7.4 weeks of discountinued lens wear, on the average. Details from patient history and objective findings recorded at the first examination of subjects accepted for lens wear did not seem to correlate well with later eye disease/changes. 11 subjects stopped lens wear. This was in no case mandatory, the most common reason being decreasing motivation. The results appear quite satisfactory. PMID- 6485754 TI - Hydrophilic contact lenses in corneal disorders. AB - Hydrophilic 'bandage' lenses were fitted in 107 patients with corneal disorders not satisfactorily responding to conventional medical treatment. An over-all beneficial effect on both ocular discomfort, visual acuity and corneal disorder was found (P less than 0.002). Regarding each group separately only patients with bullous keratopathy and those with corneal ulcers achieved a significant reduction of ocular discomfort (P less than 0.002) and a significant improvement of visual acuity (P less than 0.05 - P less than 0.01). In bullous keratopathy corneal oedema was significantly reduced by concomitant use of contact lenses and 5% NaCl eye drops (P less than 0.01). Significant improvement of corneal disorder occurred in patients with corneal ulcers and in those with corneal lacerations (P less than 0.002 and P less than 0.01, respectively). Complications included corneal vascularization (7.5%) and keratitis/keratoconjunctivitis (5.6%). Prophylactic use of topical antibiotics appeared necessary only in dry eye disease. PMID- 6485755 TI - Changes of the corneal endothelium following intracapsular cataract extraction with implantation of semiflexible anterior chamber lenses. I. Results of the early post-operative period. AB - A consecutive group of 103 patients with senile cataract underwent intracapsular cataract extraction and implantation of a semiflexible anterior chamber lens. After 6 month of follow-up, there was an average decrease of 20% +/- 15% in central corneal endothelial cell density and an average vertical disparity of 32% +/- 20% between central and superior endothelial areas. The endothelial cell loss was not correlated with pre-operative cell density. There was a positive correlation between age and cell loss and between age and vertical disparity. Findings in eyes with cornea guttata did not differ significantly from those without guttata. Anterior vitrectomy did not increase endothelial cell loss significantly. Maintenance of a deep anterior chamber by pre-operative oculopression or by instillation of Na-hyaluranate had no significantly different effect on the corneal endothelial cell loss. PMID- 6485756 TI - The influence of pregnancy on diabetic retinopathy with special regard to the reversible changes shown in 100 pregnancies. AB - A prospective study of the eyes of 75 diabetic women during the course of 100 pregnancies is presented as a contribution to the, as yet, still unresolved question concerning the influence of pregnancy on diabetic retinopathy. Fifty patients in the material had a retinopathy prior to pregnancy, proliferations were present in 2 of them. During the course of the pregnancy, proliferative changes developed in 4 patients, and a background retinopathy developed in a further 4 patients. Special interest is placed on the transitory changes in the retinopathy that occurs in a number of these patients. In the present material this has occurred in 23 patients, all of whom had a retinopathy. This is especially apparent in the form of soft exudates, haemorrhages and retinal oedema. In marked cases a characteristic feature was an obvious capillary change. This transitory capillaropathy is considered as being the cause of this temporary increase in the severity of the retinopathy. The changes regressed in all of the 23 patients. The results confirm that pregnancy can hardly be considered to influence the further course of a background retinopathy. Even though the question as to whether pregnancy can influence the course of a proliferative retinopathy still remains open, evaluation of both the present and previous materials suggest that pregnancy by and large does not aggravate the 'average' progression of a proliferative diabetic retinopathy. PMID- 6485757 TI - The prevalence of retinopathy in insulin-dependent juvenile-onset diabetes mellitus--a fluorescein-angiographic study. AB - A fluorescein-angiographic study was performed comprising all 171 insulin dependent diabetics with debut at less than or equal to 40 years of age who were census registered on the island of Gotland 1981-82. Children under 15 years of age were excluded. The overall prevalence of diabetic retinopathy was 66%, being 11% at 0-5 years duration of diabetes, 42% at 6-10 years, 84% at 11-15 years, 90% at 16-30 years and 100% after 30-years duration. Proliferative retinopathy was first seen after 11 years duration, it had a prevalence of 18% and was twice as common in females as in males. Neovascularization was seen in 25% of patients with IDDM debut at less than or equal to 20 years of age and in only 7% of those with IDDM debut at 21-40 years (P less than 0.01). Pigment epithelial defects were found in 91 subjects (56%). PMID- 6485758 TI - An acute ocular inflammatory reaction induced by intravitreal bovine serum albumin in presensitized rabbits: the effect of phentolamine. AB - An acute inflammatory reaction in the uvea was challenged by an intravitreal injection of bovine serum albumin (BSA) in presensitized rabbits. During the observation time of 3 h, intraocular pressure (IOP) increased, anterior uveal blood vessels were dilated, miosis was produced, and as a sign of the breakdown of the blood aqueous barrier, protein content in the aqueous humour was increased. In the contralateral eye, the reaction consisted of an increase in IOP and a disruption of the blood aqueous barrier. As an evidence of the immunological mechanism of this acute reaction, presensitized animals intravitreally injected with saline or unimmunized rabbits which were injected with BSA showed no significant changes in IOP, pupillary diameter or protein content in aqueous humour. Phentolamine significantly reduced protein leakage into the anterior chamber of the experimental eye. It also significantly inhibited the increase in IOP and protein leakage in the contralateral eye. The present findings demonstrate that a hypertensive inflammatory phase is present in the acute experimental uveitis. The mechanisms of the reaction and the mode of action of phentolamine are discussed. PMID- 6485760 TI - Visual evoked response and alcohol intoxication. AB - Twelve eye healthy test persons were followed for 2 h after alcohol intake by frequent recordings of visually evoked pattern responses (VER's) and simultaneous determinations of the blood alcohol concentrations. VER's were recorded with a stimulus of 14' and 110' check size, and for both check sizes steady state (15 shifts per sec) and transient responses (2 shifts per sec) were analyzed. In the transient responses we found a general increase in latencies after alcohol intake, but only in one stimulus modality (2 shifts per sec, 14' check size) was the deviation statistically significant. The steady state responses showed a large pre-alcoholic variability both in amplitudes and in latencies. No change was discernible after alcohol intake. No correlation was found between the various levels of alcohol concentration and any of the VER parameters. The minor changes of the VER found in this study using a patterned stimulus are discussed and compared to the findings in earlier studies using a flash as well as a patterned stimulus. PMID- 6485759 TI - Oscillatory potentials, flash and pattern-reversal electroretinograms in amblyopia. AB - Oscillatory potentials (OP), flash and pattern-reversal electroretinograms (ERG) were recorded in 8 adult patients with amblyopia (visual acuity 0.3 or less) and 10 age-matched normal controls. No significant differences were observed in OPs between amblyopic and opposite eyes and normal controls. The pattern-reversal ERGs were significantly reduced in all amblyopic eyes. No significant side difference was found in the flash ERGs. The observed amplitude reduction in the pattern-reversal ERG might reflect dysfunction of the retinal ganglion cells, which have been supposed to be the main source of this type of ERG. No electrophysiological evidence could be demonstrated for a disturbed retinal function prior to the ganglion cell level. PMID- 6485761 TI - The frequency distribution of earliest glaucomatous visual field defects documented by automatic perimetry. AB - 2500-3000 eyes with ocular hypertension, with or without established glaucoma in the fellow eye, were followed with automatic perimetry for several years. Forty five eyes showed a documented change from repeated normal fields to reproducible glaucomatous visual field loss. The location of the defective points in the first pathological field of each eye was registered. The resulting frequency distribution is shown and discussed. PMID- 6485762 TI - Absolute versus relative evaluation of the caloric test results. AB - A comparative study of clinical cases elucidates the value of "relative" and "absolute" evaluation of the caloric test results, using both parameters slow phase velocity (SPV) and frequency. It is shown that combining both techniques of evaluation, using both parameters, contributes to obtain more nuanced dysfunction patterns. Unilateral peripheral vestibular hypofunction can only be evaluated by using SPV in a relative way according to the formula of Jongkees. Absolute evaluation by both parameters provides indications for central components. PMID- 6485763 TI - [Emergencies in orbital complications of sinusitis]. AB - Sixty to 80% of orbital infections are secondary to sinusitis. That sinusitis can be everwhelming. Some symptoms must incite us to a quick response: the general state of the patient, his temperature, chemosis, cornean anaesthesia, mydriasis, ocular motor palsy, exophthalmia. We believe that ocular motor palsy and exophtalmia are imperative symptoms. In such cases, it is not only necessary to drain the sinuses, but also to explore the orbit by an external approach with an antibiotic cover. PMID- 6485764 TI - Dizziness and headache. AB - Dizziness and headache have been known to be associated in both adults and children, since early this century. Otoneurological examination of headache sufferers at the University of Modena Headache Centre revealed a high percentage of ENG alterations indicating a mainly bulbo-pontine vestibular disorder. The lesion, which is more significant on the side more affected, is modified during attacks and with time. The authors suggest that in these patients migraine and dizziness have a common pathogenesis in alterations of neuromediators and/or their receptors and that ENG may be useful in evaluating headache. PMID- 6485765 TI - [Nasal tumor in pregnancy]. AB - From the description of a nasal giant bleeding polyp developed during pregnancy, the authors insist on the similitudes between nasal and gingival lesions that are to be connected with a particular hormonal climate. PMID- 6485766 TI - Management of squamous cell carcinoma of the pyriform sinus. PMID- 6485767 TI - [Cholesteatoma in children]. PMID- 6485768 TI - [Simultaneous registration of electrocochleography and early auditory evoked potentials using surface electrodes]. PMID- 6485769 TI - [Auditory damage and occupational deafness]. PMID- 6485770 TI - [The larynx and sarcoidosis]. PMID- 6485771 TI - [Laryngotracheal stenosis in the adult]. PMID- 6485772 TI - [Homeopathy as seen by a nonhomeopathic otorhinolaryngologist]. AB - After 50 years of medical practice, I have widened my horizon and am interested in any method that can relieve a patient's suffering. Be it an official or a parallel therapy. If Homeopathy is more and more successful it is because of the many failures in official medicine (Allopathy), especially regarding chronic diseases. Certain patients who are intoxicated by all sorts of drugs, consult the homeopath in search of cure. The homeopath believes that the general symptoms incriminated by experimental intoxication are the same as those manifested by the sick person, and they therefore prescribe the same medecine to obtain the cure. It is the methode of "similars". For example when a patient who has not been intoxicated by Belladonna presents the same symptoms of intoxication, Belladonna is prescribed by the homeopath. What is to be thought of Homeopathy? If we have not studied and experimented it sufficiently, it is illogical to criticise it. Prejudice is the practitioner's greatest enemy. To study Homeopathy is extremely arduous and requires daily study, because for Homeopathy even more than any other medical method: "One must study every day, because one forgets every day". PMID- 6485773 TI - A prospective 12-year follow-up study of children with wheezy bronchitis. AB - Eighty children with wheezy bronchitis were followed prospectively for 12 years. At the end of the follow-up period only 22 (28%) still had symptoms of asthma. Forty-three children (54%) had ceased to wheeze before the age of 3 years, four children between 3 and 7 years of age and 11 children between 7 and 11 years of age. Of the 22 children who still had asthma, all but one were much improved, although 70% of them noticed asthmatic symptoms during exercise. Heredity for asthma/wheezing, allergy, the occurrence of eczema, and onset of wheezing after 18 months of age were associated with an increased risk of persistent asthma. Allergy had developed in 59% of the children with persistent asthma and in 10% of those who had stopped wheezing. Serum IgE was above the mean +1 SD in 45% and above the mean +2 SD in 24% of the children at the end of the 12-year follow-up. A serum IgE above the mean +2 SD was found in 8 of 13 children with asthma combined with proven allergy, but only in 1 of 9 children with asthma without allergy. Surprisingly, 8 of 48 children who had stopped wheezing and had no clinical allergy had as high IgE levels as the children with asthma and allergy, which reduced the allergy predictive value of a high serum IgE to 36%. Some of these high IgE levels seemed to be a family trait. PMID- 6485774 TI - Idiopathic pulmonary haemosiderosis in Swedish children. AB - During the 3 decades 1950-1979 onset of idiopathic pulmonary haemosiderosis occurred in 10 Swedish children. Complete records were available from the eight children with onset during 1960-1979, which indicates that the yearly risk of onset is 0.24 case per million children. The first symptoms started at the mean age of 5.8 years (range: 10 months-11 years). From the beginning all children had a severe microcytic, hypochromic, sideropenic anaemia. Pulmonary symptoms were present from the beginning in four children (but haemoptysis in only one) and developed in the remaining children after 1 1/2-2 1/2 years. Various therapeutical regimens were tried. Iron therapy seemed of temporary beneficial effect and most children seemed to benefit from prednisone therapy during disease bouts, although the effect of the therapy in the long run could not be determined. The four children with onsets during the 1960s died of their disease after 2-13 years. The four children with onset during the 1970s are still alive. One of them--a 20-year-old female, has for two years complete clinical remission and has normalized haematological, X-ray and pulmonary function data. PMID- 6485775 TI - Lung function after repair of congenital diaphragmatic hernia. AB - To study lung development after repair of congenital diaphragmatic hernia 20 patients operated on between 1960 and 1976 were followed-up at 6-22 years of age. All had had an uneventful postoperative course, had no concomitant disease and were subjectively well with an ordinary physiological performance. The investigation showed a mean increase of residual volume by one third of predicted normal values. Fractional perfusion and ventilation were reduced by 20% on the hernia side compared with the contralateral side. Functional impairment owing to pulmonary hypoplasia was ruled out by the existence of a normal working capacity and maintenance of a normal alveolar gas exchange during exercise on a high work load. PMID- 6485776 TI - Surgery of the ill, extremely low birthweight infant: should transfer to the operating theatre be avoided? AB - The transportation of seriously ill, extremely low birthweight (less than 1 000 g) infants with conditions requiring surgery can be hazardous. In two such infants, considered to be too ill to be transferred to the operating theatre, surgery was carried out on the neonatal unit. The outcome was good in both cases. Peri-operative management is described in detail. PMID- 6485777 TI - A comparison of the zinc, copper and manganese status of very low birth weight pre-term and full-term infants during the first twelve months. AB - During a longitudinal study, hair samples and dietary intake data were collected from 50 pre-term (mean birth weight = 1054 +/- 234 g, mean gestational age = 29 +/- 2.5 weeks) and 60 full-term infants (mean birth weight = 3509 +/- 269 g, mean gestational age = 40 +/- 1 weeks) at 3, 6 and 12 months of age. Mean daily zinc, copper and manganese intakes were calculated using three-day dietary records and test-weight data for the breast-fed infants. Hair samples were analyzed for these elements by instrumental neutron activation analyses. The medium hair zinc concentration in the pre-term group at six months (81 micrograms/g) was lower (p less than 0.05) than that of the full-term group (144 micrograms/g) and was associated with lower mean dietary zinc intakes at 3 and 6 months. At 12 months, the median hair copper (12.5 micrograms/g) and manganese (0.18 micrograms/g) concentrations for the pre-term were lower (p less than 0.05) than those of the full-term infants (Cu = 16.5 micrograms/g; Mn = 0.25 micrograms/g) and were also associated with low dietary copper and manganese intakes. PMID- 6485778 TI - Catecholamine surge and metabolic adaptation in the newborn after vaginal delivery and caesarean section. AB - The immediate postnatal metabolic adaptation and sympatho-adrenal activation were studied in infants delivered vaginally or by elective caesarean section. Vaginally delivered infants showed high catecholamine levels at birth compared to infants born by caesarean section under epidural or general anaesthesia. Umbilical arterial glucose levels were significantly higher in the vaginal group than in both caesarean section groups. At 30 min, all groups showed a marked decrease with several infants showing asymptomatic hypoglycaemia in the caesarean section group. C-peptide levels showed no difference at birth but later became significantly higher in the vaginal group. Although the levels of free fatty acids and glycerol were low at birth, they were significantly higher in the vaginal group. In all groups they increased substantially with time. Considering the marked differences in catecholamine levels, the differences in metabolic adaptation were unexpectedly small. This implies an attenuated metabolic response to sympatho-adrenal stimulation in the newborn. PMID- 6485779 TI - Elevation of plasma concentrations of arginine vasopressin following perinatal asphyxia. AB - Hypoxic ischemic encephalopathy is a major cause of mortality in neonates. Studies in experimental subjects have shown differing responses of plasma arginine vasopressin to hypoxia. Plasma arginine vasopressin levels, serum osmolality, urine osmolality and fluid intakes were measured in thirteen asphyxiated and nineteen control newborn infants during the first seventy-two hours of life. In the asphyxiated infants plasma arginine vasopressin was found to be elevated as compared to control infants on days one (p less than 0.001) and two (p less than 0.007) but not on day three of life. Urine osmolality was also elevated in the study patients on days one (p less than 0.01) and two (p less than 0.001) but not on day three, in spite of equal intakes of fluid on day one in both groups and significantly diminished fluid intake on days two and three in the study patients. Serum osmolality was not different between the two groups on any day studied, and was felt to be on the basis of diminished intake in the study infants. The data presented in this study support the concept that arginine vasopressin release occurs following perinatal asphyxia in term newborn infants. PMID- 6485780 TI - Influence of variations in the ambient humidity on insensible water loss and thermoneutral environment of low birth weight infants. AB - Total evaporative water loss, transepidermal as well as respiratory water loss was measured in 8 infants on day 1, 11 infants from day 2 to 8 and 8 infants after day 8. Measurements were performed at two levels of humidity, either vapor pressure of 16 or 25 mmHg (2 133 or 3 333 Pa). Evaporative water loss was 40% lower at the higher humidity. Neither metabolic rate nor body temperature showed a significant difference between the two levels of humidity. The effect of the change in humidity on the neutral thermal environment was calculated, the neutral temperature being 0.05 degrees C lower when the vapor pressure is increased by 1 mmHg (133.3 Pa). We conclude that a high humidity is of limited value in nursing infants born after 30-40 weeks. PMID- 6485781 TI - IgG subclass concentrations in preterm neonates. AB - Serum IgG subclass concentrations were measured in 158 sera from preterm, appropriate for gestational age, infants born between 27 and 37 weeks of gestation, pregnancy, delivery and neonatal period being uncomplicated in all cases. At birth the IgG subclass concentrations were inversely correlated to the degree of prematurity. The IgG subclass concentrations decreased mainly proportionately during the neonatal period. The most immature infants born before the 30th week of gestation had critically low concentrations of all IgG subclasses. All immature infants, already in the first week after birth, showed capacity for IgG1 and IgG3 synthesis. PMID- 6485782 TI - Clinical course and renal function in minimal change nephrotic syndrome. AB - Thirteen unselected children with the minimal change nephrotic syndrome were followed for 11 months-7.5 years, during which time 32 renal function tests were performed. Glomerular filtration rate (GFR) was determined as clearance of inulin using a standard clearance technique. The children had between zero and 34 relapses and three developed steroid resistance. Three patients had severe but reversible complications related to the corticosteroid therapy. Chlorambucil was given to four patients, of whom three with steroid resistance had lasting remissions, whereas one patient with frequent relapses had only transient improvement. The GFR was decreased at the first episode in six patients, whose clinical course did not differ from that of the others. None had a decreased GFR later in the course of the disease. It is concluded that reduced GFR at the onset of the minimal change nephrotic syndrome is reversible and does not imply an unfavourable outcome. PMID- 6485783 TI - Frequent myocardial lesions in Shwachman's syndrome. Eight fatal cases among 16 Finnish patients. AB - A total of 16 children with Shwachman's syndrome were studied over a period of 17 years. Eight cases were detected in autopsy at 6 to 15 months; all had died of cardiac failure due to myocardial lesions. The left ventricles showed necrosis of myofibres in large areas and the pancreas was atrophic and replaced by adipose tissue. The other eight patients included two siblings of deceased cases. Only one of these showed transient cardiac failure and no significant nutritional deficiencies were found. They had steatorrhoea due to failure of the exocrine pancreas and either constant (6 cases) or cyclic (2 cases) neutropenia. The steatorrhoea improved with age. Pyogenic infections, mainly otitis media were frequent during the first three years of life. Measurements of humoral and cell mediated immunity were normal, but in addition to low numbers of neutrophils, the neutrophilic chemotaxis was depressed in all seven patients tested. Skin lesions, hepatic inflammation, and growth tended to improve with age. The family data of the patients is consistent with an autosomal recessive trait inheritance. PMID- 6485784 TI - The silent ductus arteriosus in idiopathic respiratory distress syndrome. AB - Among 425 pre-term low birthweight babies who survived more than 48 hours there were 130 with idiopathic respiratory distress syndrome, 73 of whom received ventilation for their disease. The ductus arteriosus was considered patent by clinical criteria in 41 of these babies, all but 1 of whom had a murmur. Of the remaining 32 infants there were 2 babies only who died and both were found to have a patent ductus arteriosus which had not been detected clinically. Another baby died whilst being ventilated for idiopathic respiratory distress syndrome and although autopsy information is not available it seems likely that factors other than a patent ductus arteriosus caused death. The mean age of murmur detection in those ventilated infants considered to have a patent ductus arteriosus was 6 days (range 2-19). Infants without a murmur or other features of a ductus arteriosus did not require to be ventilated beyond day 7 with the exception of the 2 fatalities already mentioned. Thus, relying on clinical criteria and particularly on the presence of a murmur, if sought often, rarely results in missing or seriously delaying the diagnosis of patent ductus arteriosus in babies with severe idiopathic respiratory distress syndrome. PMID- 6485785 TI - Serum gliadin antibodies for detection and control of childhood coeliac disease. AB - Serum gliadin antibodies of the IgA and IgG isotypes were determined by means of the diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) in children during different phases of coeliac disease. Fourteen children were studied before onset of dietary treatment, 16 during a period of gluten-free diet and 16 during gluten challenge. The control groups consisted of 44 children with other gastrointestinal diseases and 14 children without gastrointestinal disorders. All of the children studied had been subjected to small-intestinal biopsy. On the basis of the results obtained in this study the diagnostic sensitivity with regard to untreated coeliac disease was found to be 100% and the diagnostic specificity 97%. In 10 coeliac children followed during the phases of diagnostic evaluation antibody levels decreased in all during dietary treatment and increased in 8 during a subsequent gluten challenge. It is suggested that determination of IgA and IgG gliadin antibodies by means of DIG-ELISA may be used as a diagnostic test for coeliac disease in children and that this test may be useful in monitoring the dietary treatment in children with known coeliac disease. Moreover, the DIG-ELISA is an inexpensive and technically simple method. PMID- 6485786 TI - The incidence of congenital malformations in various socioeconomic groups in Sweden. AB - The incidence of congenital malformations reported to the Register of Births during 1976-77 in various socioeconomic groups were studied combining the informations from the birth register with that from the 1975 census (including occupation of the mother, income of the family, type of family and housing standard). The total population of 190 024 infants were divided into three groups; 6915 infants (3.6%) were assigned to the most privileged group (group I) and 26 430 (13.9%) to the less privileged group (group III). The total incidence of 5.01% of any malformation did not differ significantly between the groups. Neither was any variation found for specific malformation types, such as neural tube defects, cleft palate or morbus Down. PMID- 6485787 TI - New data on the wake-sleep rhythm of children aged from 2 1/2 to 4 1/2 years. AB - In this paper, data concerning the duration of night and nap sleep of 107 children aged from 2 1/2 to 4 1/2 years are analysed. Data were collected over a period of 9 months and showed a significant negative correlation between night and nap sleep. The reduction in the amount of nap sleep throughout the year was related to the decrease in the frequency of naps. However, its duration remained constant. The variations in the duration of the night and nap sleep were also analysed in relation to the week day and the month of the year and socio ecological factors. PMID- 6485788 TI - From breastmilk to family food. Infant feeding in three Swedish communities. AB - The feeding habits of 312 Swedish infants have been followed longitudinally from birth to one year of age. The duration of breastfeeding had increased in comparison with the low figures in the beginning of the 1970s. Complementary foods were usually introduced from three months of age. At the age of 6 months all infants received complementary foods such as semi-solids and solids and about 90% were given follow-up formula. Parents belonging to higher socioeconomic strata were more prone to act in accordance with general feeding recommendations, e.g. regarding breastfeeding duration, time of introduction of complementary foods and gluten-containing foods and the use of sucrose-rich foods. PMID- 6485789 TI - Milk composition of low birth weight infants' mothers. PMID- 6485790 TI - Aagenaes's syndrome in an Italian child. PMID- 6485792 TI - Repair of the mouse synovial membrane after chemical synovectomy with osmium tetroxide. AB - Repair of the synovium of the mouse knee joint following intra-articular injection with osmium tetroxide has been studied by light and electron microscopy. Within a first few days after osmium tetroxide injection complete necrosis of the synovial intima and inflammatory response in the subintimal connective tissue occurred. The resurfacing of the denuded synovium was performed by proliferation of immature synovioblasts which appeared to be derived from mesenchymal cells in the transition zone. The synovial intima completely restored the original structure, while repair of the subintimal tissue was accomplished by a scarring. PMID- 6485791 TI - Cardiac involvement in cystic fibrosis revealed by a ventricular arrhythmia. AB - Cardiac involvement in cystic fibrosis (CF) is characterized by acute cardiac failure in the infant with myocardial fibrosis found on pathological examination. In the older child with chronic pulmonary disease, cor pulmonale tends to predominate the clinical picture. We report the case of an adolescent with CF presenting with ventricular arrhythmia. Cardiac scan, repeated echocardiograms and Holter monitoring were suggestive of an infiltrative process. We propose this case to be similar to those of CF in infants with cardiac involvement. PMID- 6485793 TI - Extratubular efflux and nephropathy. AB - The extratubular efflux of periodic acid-Schiff (PAS) positive material is used as a histological indicator of intrarenal reflux, and correlation of the PAS positive material and interstitial as well as glomerular changes were analyzed in 114 surgical specimens consisting of renal calculi, hydronephrosis, vesicoureteral reflux, and others. (1) The incidence of extratubular efflux was apparently higher in the kidneys of hydronephrosis. (2) PAS positive material was seen not only in the interstitium but also flowed into the venous and lymphatic spaces. (3) Potent interstitial mononuclear cell infiltration and larger amounts of PAS positive material were seen in the kidneys showing a moderate grade of hydronephrosis rather than renal calculi. (4) Global glomerular sclerosis was the most frequent glomerular lesion, and segmental sclerosis and crescentic epithelial reaction in a small number of glomeruli were also noted. These results imply that intrarenal reflux could play an important role in the development of various renal tissue injuries. PMID- 6485794 TI - A pathological study of fulminant hepatic disease. AB - Among 4,030 autopsies, 67 cases of fulminant hepatic failure were selected and studied from a pathological viewpoint. No sex difference in incidence was seen and the patients' age ranged very widely from 3 months to 78 years, showing comparatively high risk in the 20 s and 30 s in both sexes. Hepatitis virus was the most common cause, followed by toxic chemicals, shock, etc. Histopathological study revealed severe and extensive hepatic cell necrosis as the most conspicuous and common change of the liver, which was pathomorphologically quite similar to that experimentally produced by focal intravascular coagulation in rabbit. This evidence, as well as pathological findings of the other organs obtained at autopsy and the patients' reported clinical course, including laboratory data, were consistent with our proposal of a pathological disease entity, fulminant liver disease, which corresponds to the clinical symptom-complex known as fulminant hepatic failure. It is suggested that the characteristic feature of acute, severe and extensive hepatic cell necrosis which is seen in such cases is probably a result of an anoxic state caused in most instances by intrahepatic circulatory disturbances. Besides, we consider that fulminant liver disease can be regarded as a group of systemic diseases with the main focus of illness in the liver, rather than a specific disease of a single organ, the liver. PMID- 6485795 TI - Histologic transformation in extranodal non-Hodgkin's lymphoma. AB - Histologic transformation in the course of non-Hodgkin's lymphoma (NHL) has been reported to occur in 18 to 30% of the cases. Less favorable prognosis in cases with initial low grade malignancy followed by emergence of high grade malignancy has been previously described. In the previous literature, the histologic transformation has been examined mostly in nodal NHL. In the present study, histologic transformation in the course was investigated on 20 cases with early extranodal NHL. All these 20 cases were diffuse lymphomas, and were composed of 7 cases with low grade malignancy and 13 cases with high grade malignancy. Histologic transformation was not observed in any of these cases. These findings indicate that the frequency of histologic transformation is much lower in extranodal NHL than in nodal NHL. The prognostic significance of these findings is also discussed. PMID- 6485796 TI - A study on the mesothelial cell kinetics in pleural effusions by DNA cytophotometry and autoradiography with tritiated thymidine. AB - On 34 samples of pleural fluid a cell kinetic study of mesothelial cells was carried out by Feulgen-DNA cytophotometry and the autoradiographic estimation of 3H-thymidine uptake. The generation time of mesothelial cells in malignant effusions was found to be shorter than in non-malignant ones, thought he cellular activity for both effusions was essentially the same. Furthermore, with the development of complicating pleuritis from the early stage to the fibrino-fibrous stage, the appearance rate of 3H-thymidine labeled and activated mesothelial cells in the DNA synthetic phase changed quite differently in both effusions. The differences were thought to be due to neoplastic invasion itself or inflammatory reactions to the neoplastic growth. PMID- 6485797 TI - Junctions between intraepithelial carcinoma and non-neoplastic tissue of the esophagus. Light and electron microscopic studies. AB - This report describes light and electron microscopic observations in 11 patients with intraepithelial carcinomas concomitant with invasive squamous cell carcinomas of the esophagus. The junctions between the intraepithelial carcinomas and non-neoplastic tissues were examined using an electron microscope. Vertical sections through the basal laminae revealed intraepithelial carcinomas with bulky outgrowths and simple replacement histological patterns. The bulky outgrowths contained many pseudopodial cytoplasmic projections from the tumor cells through the basal laminae, while the simple replacement patterns included rare small breaks in the basal laminae. Horizontal sections parallel to the basal laminae showed that the cells of the poorly differentiated squamous cell carcinoma were readily distinguishable from the non-neoplastic cells in the surface layer of the esophageal epithelia and distinctly smaller and darker than the normal prickle cells. At most of the junctions, mesenchymal cells, degenerated cells, and amorphous material separated the tumor cells from the non-neoplastic epithelial cells. However, tumor cells were occasionally attached directly to normal epithelial cells with well-developed desmosomes. Ductal involvement of the carcinomas was found in the submucosal esophageal gland proper. The tumor cells invaded between the ductal cells and basal laminae, and neoplastic cells were also directly attached to the benign ductal cells by poorly-developed desmosomes. The host-tumor junctions in the intraepithelial carcinomas of the human esophagus consisted of basal laminae with hemidesmosomes and pseudopodial projections, mesenchymal cell accumulations and direct attachments with desmosomes. PMID- 6485798 TI - Leiomyomatosis in the pelvic lymph node and peritoneum. AB - This paper is concerned with a rare clinical entity, i.e. leiomyomatosis of pelvic promontory lymph node in a 50-year-old Japanese woman and leiomyomatosis peritonealis disseminata in a 41-year-old one. Despite such daughter nodules, all of the leiomyomas showed benign histological features. Morphogenesis of the discontinuous leiomyomas was discussed in relation to pelvic endometriosis. Because of a favorable prognosis in the leiomyomatosis, no more aggressive therapy than that necessary to extirpate the tumor is recommended. PMID- 6485799 TI - Pigmented storiform neurofibroma. AB - A case of pigmented storiform neurofibroma is presented. The lesion was present in the right loin of a 35-year-old Japanese woman. Grossly, a round, slightly elevated, approximately 1.5 cm in diameter tumor showed a red-purplish coloration of the central part of the overlying skin without ulceration. The characteristic storiform pattern and scattered melanin-containing cells were the relevant features for histological diagnosis. To our knowledge, our case is the second reported case in Japan. The histogenesis and its relationship with tumors of neural crest origin is briefly discussed. PMID- 6485800 TI - Basal cell epithelioma occurring in an epidermal nevus. AB - An unusual case is presented of a thirty-year-old woman in whom basal cell epithelioma developed from a preexisting localized epidermal nevus in the scalp. The epidermal nevus was not associated with any abnormal pilosebaceous complexes. PMID- 6485801 TI - Leiomyosarcoma of pulmonary truncus. AB - Insidious and progressive right heart failure of obscure origin warrants differential diagnosis of primary sarcoma of the pulmonary artery in patients of both sexes and 20 years of age and older. We report a case of primary leiomyosarcoma of the pulmonary truncus in a 67 years old woman. She had been well in general until when she started having fluctuating and progressive right heart failure three years ago. Clinical data included systolic murmurs in the pulmonary valve area, right ventricular hypertrophy, diminished x-ray density of the pulmonary vasculature, moderate elevation of serum LDH, alkaline phosphatase, and uric acid, and prolonged or unobtainable circulation time from the arm to lungs. The immediate cause of death was attributable to right heart failure due to pulmonary arterial stenosis caused by a locally invasive leiomyosarcoma apparently arising in the pulmonary truncus. Contributing to this right heart failure were 280 ml of serosanguinous pericardial effusion and fibrinous pericarditis. PMID- 6485802 TI - Malignant mediastinal myxoid tumor and renal cell carcinoma. AB - A 69-year-old man with a malignant mediastinal myxoid tumor and a right renal cell carcinoma died from bilateral compression atelectasis after a two months' clinical course. The mediastinal tumor simulated a myxoid malignant fibrous histiocytoma (MFH) because of great pleomorphism of tumor cells, although the histological differential diagnosis of myxoid MFH, other myxoid sarcomas, and metastatic renal cell carcinoma was very difficult. Three reported cases of primary mediastinal MFH are briefly reviewed. PMID- 6485803 TI - Regional lymph node involvement in benign renal angiomyolipoma. AB - A case of angiomyolipoma of the kidney with the involvement of regional lymph nodes and adjacent adipose tissue is reported. Histology of the tumor was essentially benign in either location. During three years of follow-up period, no recurrence or distant metastasis has appeared. It was considered that the tumor was benign and that the regional lymph node involvement probably represents a multicentric hamartomatous or choristomatous growth. In such an example, it is suggested that additional treatment such as radiation or chemotherapy should be avoided until a definitive evidence of distant metastasis is obtained. PMID- 6485804 TI - Siblings with carbamyl phosphate synthetase I deficiency. AB - This paper concerns with two autopsied cases of siblings who died from cerebral disturbances. In these patients hyperammonemia developed in the neonatal phase due to carbamyl phosphate synthetase I (CPS I) deficiency. The patient in Case 1 was admitted 2 days after birth because of oliguria and vomiting. Hyperammonemia developed and she died on the 43rd day. In Case 2 hyperammonemia developed from the 2nd day after birth and she expired on the 42nd day. In both cases the diagnosis of CPS I deficiency was established from autopsy findings of the liver. PMID- 6485805 TI - Pineocytoma. Observation of an autopsy case by electron microscopy and cell markers. AB - An autopsy case of a 69-year-old female with pineocytoma was reported. The tumor showed neuronal differentiations, which were confirmed not only by light microscopy and electron microscopy, but also by a cell marker of neuron-specific enolase. In addition, existence of astrocytes in the tumor which distributed sparsely was ascertained by electron microscopy and cell markers such as S-100 protein and glial fibrillary acidic protein. PMID- 6485806 TI - Malignant mesenchymoma of the esophagus. AB - This is a case report of a malignant mesenchymoma of the esophagus in a 50-year old Japanese man. The tumor was a sessile polypoid mass showing a downward invasion limited to the submucosa of the esophagus. Histologically, the lesion contained rhabdomyosarcomatous and osteosarcomatous areas, in addition to an ill defined fibrosarcomatous element. In contrast with reports of carcinosarcoma up to the present, this tumor lacked any invasive lesion of an epithelial malignancy. The morphogenesis of these tumor groups was discussed from a hamartoblastomatous standpoint. PMID- 6485807 TI - A simple turbidimetric method for specific measurement of Staphylococcus aureus lipase activity. AB - We have developed a simple semiquantitative method for measuring Staphylococcus aureus lipase activity. Enzymatic activity is measured as the decrease in spectrophotometric absorbancy in a lipid emulsion after incubation with the sample. The sensitivity, precision and accuracy are adequate for routine purposes. The assay is rapid and simple and does not require advanced technical equipment. PMID- 6485808 TI - Transmission of toxoplasmosis via milk from lactating mice. AB - Lactating mother mice were infected with an avirulent strain of Toxoplasma gondii. When the milk from these mice was exposed to HCl, it was found that some of the parasites present were "acid-resistant" cystozoites. Hence there is an obvious risk of acquiring toxoplasmosis by consuming milk from infected donors. PMID- 6485809 TI - Septicaemia in granulocytopenic patients caused by multiresistant diphtheroid rods. A study of two cases. AB - Two cases of septicaemia in granulocytopenic patients are reported. Both were caused by multiresistant aerobic (JK-group) diphtheroid rods. The bacterial isolates were resistant to all commonly used antibacterial agents but showed good sensitivity to vancomycin and rifampicin. These agents should be included in the routine sensitivity testing of such isolates and diphtheroids should always be reported by the routine laboratory for granulocytopenic patients. PMID- 6485810 TI - [Benzylisoquinoline alkaloid reactions with barbiturates. Reaction of papaverine with sodium phenobarbital. III. Avoidance of incompatibility by using the beta cyclodextrin inclusion complex]. PMID- 6485811 TI - [Determination of glucose in solutions for parenteral administration by enzymatic and spectrophotometric micromethods]. PMID- 6485812 TI - [Effect of microcrystalline cellulose on the properties of phenobarbital tablets]. PMID- 6485813 TI - [Allopurinol preparations for intravenous injection]. PMID- 6485814 TI - Modifiers of carcinogenesis. The Danish Ministry of Environmental Protection. Proceedings of the symposium in Copenhagen, September 22-23, 1983. PMID- 6485815 TI - Regulatory aspects of modifiers in carcinogenesis: an introduction. PMID- 6485816 TI - Dietary modifiers: occurrence of modifiers in food and drink and consequences for implementation of regulatory procedures. PMID- 6485817 TI - Modifiers of carcinogenesis. Aim and scope of the conference. What shall we consider a modifier? PMID- 6485818 TI - Activity of gut invertase in phytophagous, saprophagous and carnivorous insects. AB - The effect of hydrogen-ion concentration, temperature, substrate concentration, enzyme concentration and incubation period on invertase activity of Dactylosternum hydrophilioides, Catharsius molossus and Pheropsophus occipitalis has been studied. The optimum invertase activity was observed at pH 6.5, 6.8 and 6.0 and at temperatures 35, 38 and 37 degrees C in D. hydrophiliodes, C. molossus and P. occipitalis, respectively. With the increase in substrate (sucrose) concentration, an increase in invertase activity was recorded. For invertase activity estimation, 4% sucrose concentration was found suitable in these insects where an increase in enzyme concentration increases the invertase activity. The invertase activity also increases with lengthening of the incubation period but after some time it remains constant in the phytophagous, saprophagous and carnivorous insects. The activity of invertase in phytophagous, saprophagous and carnivorous insects shows their independent nature as regards the pH and temperature. PMID- 6485819 TI - Dynamics of eye fundus changes in two types of experimental brain oedema. AB - During the experimentally induced cerebral oedema and intracranial hypertension the eye fundus changes have been evaluated in generally anaesthetized rats. Cerebral oedema was caused either by means of an osmotic or cryogenic method. Dynamics of the observed ocular changes were indirectly correlated with the origin, development and regression of the cerebral oedema caused by both different etiologic factors. PMID- 6485820 TI - Essential features of endocardial and myocardial morphology: SEM and TEM studies. AB - The conducting pathway of the ferret's myocardium and endocardium was studied under the electron and scanning microscope. Comparisons between the two methods showed that the scanning microscope is well suited for those dimensional demonstration of biological material. Contrary to a relative absence of interspecific differences in endocardial morphology, there is a strong variation of this morphology related to the intracardiac localization of the endocardial cells. The following findings were obtained. S.e. microscopically, it was observed that the endocardium of the sino-atrial node region is not smooth, and that, more likely, it shows rough surfaced profiles. The electron microscopic study shows that the cells of the S-A node are elongated. The S-A node is located at the junction of the superior vena cava with the right atrial wall. It consists of nodal fibres which are embedded in a richinterstitial connective tissue (Figs 1-8). The Purkinje fibres originate from large bundles in the region of the right and left atrioventricular valve in the area where heart muscle fibres were originally described by Purkinje (Purkinje, 1845); these fibres, meanwhile, have become synonymous with cells of the generalized conducting system. The Purkinje fibres consist of a poorly developed contractile apparatus and contain unorganized, fine, filamentous material (Illustration 1). The SR is poorly developed, transverse tubules are absent. S.e. microscopically, one can visualize the trabecular system and the sinusoids. The trabeculae obtain muscle fibres rich in contractile material and transverse tubules. The trabeculae appear to be tendonous (chordae tendineae), especially when they freely traverse the ventricular cavity (Fig. 16). The interventricular septum (the muscle fibres from this region) takes its origin from large bundles in the region of the right and left atrioventricular valves. The endocardium of the interventricular septum is filled with large numbers of plasma-lemma folds (Figs 17, 18). The endocardium which covers the papillary muscle has a thickness of 0.5 micron. The endocardial cells lie on the myocardium so close and so thin that the surface relief and part of the atriation of the myocardium are visible (Figs 13-15). PMID- 6485821 TI - Effect of erythrocyte transfusion on the circulation of Guerin carcinoma-bearing rats. AB - In Guerin carcinoma-bearing rats during tumour growth cardiac output and blood flow to several organs were increased whereas TPR, vascular resistance of some regions and haematocrit gradually decreased. In response to erythrocyte transfusion the anaemia of tumour-bearing rats was considerably improved or corrected, however, the parameters for systemic and regional circulation were only partially restored. We presume that the circulatory "hyperkinesis" of tumour bearing rats is partly due to the anaemia but also an unknown factor must be considered. The blood perfusion of the Guerin carcinoma was not affected by the erythrocyte transfusion thus it is feasible that the tumour vasculature is maximally dilated even with a normal haematocrit of the host. PMID- 6485823 TI - The role of the phase relation between the atrial excitatory waves in determining the functional refractory properties of the atrioventricular node. AB - Through programme stimulation of the two basic inputs of the atrioventricular node (AVN)--crista terminalis and interatrial septum--different spatial and temporal relations between the excitatory waves passing from the atrium into the node were modelled in intact rabbit heart preparation. The essential role of the spatial-temporal organization for the determination of the refractory properties is demonstrated. The functional refractory curves depend not only on the basic rhythm, but also on the direction of the atrial excitation front. It is shown that interaction of the input waves is possible in intact preparation as well. At optimum phase regimes combined stimulation of the two inputs leads to prolongation or shortening of the initial H1H2 interval. The qualitative characteristic of the observed effects is very varied. It is defined predominantly by the stimulation programme, but it does not depend on which of the two inputs the basic rhythm is applied. The view is expressed that in order to obtain a more accurate characterization of the AVN-conduction, it is necessary to consider the interaction of the atrial excitatory waves arriving at the posterior and anterior inputs of AVN and the reflection of this interaction on its refractory properties. PMID- 6485822 TI - Experimental pharmacological study of three species from genus Salvia. AB - Fifteen extracts isolated from three species of genus Salvia were studied: two from Salvia officinalis, seven from Salvia triloba and six from Salvia verbenaca. Their effects on the blood pressure of cats and spontaneously hypertensive rats were examined. The smooth-muscle effects of the extracts were studied on isolated segments of guinea-pig ileum. The effects of some of the extracts on hexobarbital anaesthesia were investigated. Applied intravenously and duodenally, aqueous alcohol extract of Salvia officinalis causes moderate but prolonged lowering of the blood pressure in cats. Decoction of Salvia triloba also possesses a similar effect (in experiments on spontaneously hypertensive rats). Most of the extracts isolated from Salvia officinalis and Salvia triloba inhibit to various degrees smooth-muscle contractions induced by acetylcholine, histamine, serotonin and BaCl2, whereas extracts of Salvia verbenaca usually potentiate them. Substances isolated from Salvia triloba prolong hexobarbital sleep. Future studies of substances isolated from Salvia officinalis and Salvia triloba are promising with a view to their spasmolytic and hypotensive actions. There exist marked interspecies differences in the pharmacological effects of biologically active substances isolated from genus Salvia. PMID- 6485824 TI - Changes in the Bereitschaftspotential due to subsequent voluntary autotriggered stimulus. AB - The Bereitschaftspotential (BP) has been studied in two different tasks: simple voluntary isometric flexion/opposition of the thumb and same movement, followed by a mild electrical shock over the median nerve, autotriggered by the movement itself. When the two tasks were organized in separate series, the subject being told about the outcome of the movement beforehand, it was found that: The BP started later; Its amplitude was smaller; The maximum negatively (N2) was smaller, when expecting electrical shock compared to simple voluntary contraction. The decrease was more pronounced over the postcentral areas. When the sequence of the autotriggered electrical shocks was equiprobably intermixed with the simple voluntary presses in single series it was found that virtually no difference existed between different potential measures. This differential influence of equal physical requirements with different subjective sequels upon the potentials related to voluntary movements implied the preferential role of the subject's attitude and state of preparedness upon the brain potentials. Both the elevated stress level and the selective suppression in specific cortical areas might take place in tasks with predictable unpleasant electrical shock. PMID- 6485825 TI - Mechanisms of disassembly of a mixed function oxygenase system in liver endoplasmic reticulum: I. The role of peroxidation of membrane phospholipids. AB - It was demonstrated that endogenous lipid peroxidation (LPO) is an effective mechanism of disassembly of endoplasmic reticulum membranes and cytochrome P-450 (P-448) in the liver. The rate of cytochrome P-450 (P-448) degradation in vivo can be regulated by free radical scavengers. The constitutive forms of cytochrome P-450 (P-448) are less sensitive to LPO induced in vivo or in vitro than the inducible ones. PMID- 6485826 TI - Mechanisms of disassembly of a mixed function oxygenase system in liver endoplasmic reticulum: II. The interrelation between lipid peroxidation and proteolytic degradation of cytochrome P-450. AB - The degradation of cytochrome P-450 as a result of proteolytic action of trypsin is a biphasic process. Lipid peroxidation (LPO) increases the rate of the fast phase of cytochrome P-450 degradation and its accessibility to protease. The efficiency of this process depends on the mode of LPO induction and decreases in the following order: NADPH----NADH----ascorbate-dependent LPO. The induction of the monooxygenase system increases the efficiency of proteolysis. LPO and proteolysis seem to be mutually enhancing processes which provide for a high efficiency of cytochrome P-450 degradation. LPO can be regarded as a triggering mechanism which makes various forms of cytochrome P-450 accessible to endogenous proteases. PMID- 6485827 TI - Influence of Ca2+ on the voltage dependent mechanosensitivity of the hair cells in the lateral line organs of Xenopus laevis. AB - The influence of the transepithelial voltage (Vt) on the degree of synchronization (DOS) of afferent spikes from lateral line organs to mechanical stimulation has been examined in the isolated voltage clamped skin of Xenopus laevis. With 1 mM CaCl2, 5 mM MOPS-KOH (pH = 7.1) in the apical solution and Ringer's solution on the serosal side of the skin, changes in Vt from -60 mV to 65 mV (inside relative to outside) lead to a nonlinear reduction in DOS to a minimum value, where the afferent spikes were no longer time-locked. Beyond this value of Vt, DOS increased until at Vt = 100-120 mV DOS was again reduced. The reduction of DOS to the minimum value was associated with a monotonic increase in the mean phase of DOS, which abruptly changed approximately 180 degrees as the minimum was passed. Change in the apical Ca2+ concentration from 0.1 mM to 10 mM increased the Vt at which the minimum value was attained, by 39 mV. The voltage dependency of DOS is in agreement with a model where the driving force for the receptor current across the apical membrane of the hair cells controls the generation of time-locked afferent spikes to mechanical stimulation. The Vt, at which the minimum value of DOS was attained, is then equivalent to the reversal potential across the apical membrane. The influence of the apical Ca2+ concentration on this Vt may be caused by the change in the gradient of Ca2+ or change in the ionic selectivity of the transduction channels. PMID- 6485828 TI - Skeletal muscle sympathetic activity at rest in trained and untrained subjects. AB - The effect of physical training on muscle sympathetic activity (MSA) was studied by comparing resting levels of MSA in 8 well-trained racing cyclists and in 8 age matched untrained subjects (mean age 22 yrs). In addition, MSA was determined for 5 untrained subjects before and after an 8-week training program on cycle ergometers (training group). Recordings were made from the peroneal nerve at the knee with the subject in recumbent position. The well-trained cyclists were characterized by a clearly higher maximal oxygen uptake (VO2 max) and lower heart rate at submaximal exercise (180 W) than their untrained counterparts. These variables were also significantly changed with training in the training group. In contrast, there were no training-related effects on MSA. Thus, MSA expressed as either the number of sympathetic bursts/100 heart beats (+2%, NS) or bursts/min ( 10%, NS) did not differ between the well-trained cyclists and the untrained controls. Furthermore, no changes in MSA occurred with training in the training group (bursts/100 heart beats: +8%, NS; bursts/min -2%, NS). Individual variations in MSA were large and independent of training state. It is concluded that differences in physical conditioning do not account for the large inter individual differences in MSA in resting man. PMID- 6485829 TI - Role of airway resistance in the control of ventilation during exercise. AB - To analyze the interdependence of respiratory drive, ventilation and airway resistance during exercise, mouth occlusion pressure (P0.1), minute ventilation (V) and mean inspiratory flow (VT/TI) were studied in eight normal subjects performing cycle-ergometer exercise at loads ranging from 0 W to 200 W under two different ambient conditions: 1) during oxygen breathing at 1.3 ATA, and 2) during air breathing at 6 ATA (PO2 = 1.3 ATA). Comparison of measurements at 6 ATA with those at 1.3 ATA indicated that a 4.2-fold increase in respired gas density (D) had little or no influence on the V and VT/TI responses whereas P0.1 at any given VT/TI was increased by a factor of 1.9. In both conditions, P0.1 increased at a faster rate than VT/TI as the work load increased. At loads higher than 40 W, the relationship between P0.1, D and VT/TI was found to approximate the equation P0.1 = K X D0.5(VT/TI)1.4, where K is a constant that varies among subjects. The results indicate that the ratio P0.1/(VT/TI), an estimate of respiratory impedance, increased with both D and VT/TI. Evidence is presented that the respiratory drive was reflexly enhanced in response to loading as airway resistance increased with D and/or VT/TI. We conclude that neural mechanisms compensating for internal flow-resistive loading play an important role in the control of ventilation during exercise, both at normal and at raised air pressures. PMID- 6485830 TI - Spontaneous variations in arterial blood pressure, heart rate and sympathetic nerve activity in conscious normotensive and spontaneously hypertensive rats. AB - In the present study we have recorded spontaneous variations in mean arterial blood pressure (MAP), heart rate (HR) and mean rectified splanchnic nerve activity (SNA) in conscious undisturbed normotensive Wistar Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). The variability in blood pressure was not significantly different but HR variability tended to be lower in SHR. The variability in SNA expressed as % change from mean value was not significantly different between SHR and WKY. By computer techniques the correlation between HR, MAP and SNA could be calculated during spontaneous variations of these parameters. The slope of the regression line correlating HR and SNA was significantly steeper in SHR than in WKY (0.73, 0.47 resp.). Thus a certain change in HR was associated by a greater change in SNA in SHR compared with WKY. Spontaneous changes in SNA could be divided in principally two different patterns. One typical pattern was a rise in SNA in parallel with a drop in MAP. This pattern was most likely triggered by the arterial baroreceptors and was called a "baroreceptor-pattern". Marked spontaneous excitations in SNA and HR was also observed during natural behaviours such as eating, drinking and explorative behaviour, a so called "centrally mediated pattern". PMID- 6485831 TI - Force development in muscle strips of the disused and nondistended rat urinary bladder. AB - In rats the flow of urine was diverted from the bladder over a period of 7-10 days. Active length-tension curves of muscle strips of such disused bladders did not differ from those of controls, provided lengths were related to optimum length for force development. When, however, lengths were related to length in situ the active length-tension curves were shifted to the left. The muscle strips of the disused bladders showed a higher degree of stiffness than those of controls. The present findings are related to previous ones made on disused but distended bladders showing changes in the opposite direction. Taken together they demonstrate the importance of filling and periodic emptying for the preservation of normal length-tension relations in the bladder. PMID- 6485832 TI - Cardiovascular responses to face immersion and apnea during steady state muscle exercise. A heart catheterization study on humans. AB - The cardiovascular adjustments to face immersion and apnea (FIA) in human beings during steady-state muscle exercise (163 and 98 watt) have been investigated. Using a triple lumen flow directed catheter inserted into the pulmonary artery we were able to measure cardiac output (CO) by thermodilution technique, pulmonary arterial pressure (PPA) right atrial pressure (PRA) and left ventricular filling pressure (PAD). Phasic arterial blood pressure (BP) was measured via a cannula in the radial artery. A 12 lead ECG was recorded continuously. FIA caused an immediate rise in BP (median 61%), the highest level being 25.33 kPa. CO during the last half of FIA was reduced by 49% (range 46-59, n = 7) systemic vascular resistance increased by median 200% (range 111-280). Myocardial oxygen demand determined by the heart rate pressure double product fell from median 33.6 to 16.8 (163 W) and 28.5 to 19.1 (98 W) given as beats/min X kPa X 10(2). Mean reduction was by 42%. PPA and PRA immediately increased and remained constant until a further pronounced increase was seen towards the end of FIA when pulmonary vascular resistance (PVR) went up. PACO2 and PAO2 at the end of 30 sec FIA (163 W) was 10.0 and 5.6 kPa, respectively, values which expectedly would cause pulmonary vasoconstriction. Our findings demonstrate that humans are able to make principally the same cardiovascular adjustments to diving as aquatic mammals, although the response patterns are slower and less efficient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6485833 TI - Endurance training augments the stimulatory effect of epinephrine on oxygen consumption in perfused skeletal muscle. PMID- 6485834 TI - In vitro autoradiographic studies of 3H-alpha-bungarotoxin and 3H quinuclidinylbenzilate binding in rat hind limb muscles. PMID- 6485835 TI - Characteristics of dopamine and GABA transport in primary cultures of astroglial cells. AB - Primary astroglial cultures were grown from newborn rat cerebral hemispheres. Cultures, aged 7 and 14 days, were analysed with respect to their capacity to accumulate radioactive GABA and dopamine. Concentrative high-affinity uptake, showing Na+-dependence was observed for GABA where Km and Vmax were not significantly altered with age of the culture. No Na+-dependent high-affinity transport of dopamine was observed. The addition of 0.1 mM dibutyryl-cyclic-3'-5' adenosinemonophosphate (dB-cAMP) after removal of fetal calf-serum reduced the Vmax as well as the Km of 3H-GABA uptake. The ionic dependence of 3H-GABA and 3H dopamine was not significantly altered following this treatment. The results are difficult to interpret in terms of a potentiated differentiation of the cells. PMID- 6485836 TI - Different nerve responses in consecutive sections of the arterial system. AB - Isometric responses to nerve stimulation and to applied noradrenaline were compared in isolated ring preparations of three consecutive types of rat arteries, viz. the aorta, the superior mesenteric artery and 200-micron branches of the latter. Intramural nerves were activated by graded electrical field stimulation; obtained responses were blocked by tetrodotoxin, phentolamine or prazosin. Also direct muscle activation could be accomplished, using impulses of long duration. In the aorta responses to nerve stimulation were sluggish, could reach only 30-40% of the maximal noradrenaline response and single impulses were ineffective. In the small resistance arteries, neurogenic responses matched the maximal noradrenaline responses and distinct, rapid contractions occurred to single nerve impulses. The superior mesenteric artery was intermediate in these respects. By contrast, on direct muscle activation all vessels responded to single impulses with rapid contractions that differed little in velocity. Pharmacological inhibition of transmitter reuptake increased noradrenaline sensitivity most in the small arteries, but nerve responses were most enhanced in the superior mesenteric artery. These regional differences, probably reflecting decreasing neuromuscular distance with decreasing vessel size, imply that generalizations concerning the relation between responses to nerve stimulation and to exogenous noradrenaline cannot be made from one vascular model only. PMID- 6485837 TI - Renal blood flow and vasodilatory ability prior to and following release of 24 hours bilateral ureteral obstruction in rats. AB - Increased renal vascular resistance (RVR) is evident after 24 hours of uni- and bilateral ureteral obstruction (UUO and BUO). However, to what extent the RVR increase is due to vascular damage versus functional vasoconstriction, or whether obstructed kidneys possess the ability to reduce RVR in response to vasodilatory stimuli, is not clear. During 24 hours of BUO renal blood flow (RBF), recorded electromagnetically, was reduced to about 70% of control and continued to fall by another 18% during 1/2-1 hour after release of BUO. Infusion of imidazole, a thromboxane A2 synthetase blocker, did not reduce RVR after release of BUO. Whereas RBF autoregulation in response to reduced perfusion pressure was impaired, maximal proportional renal vasodilation induced by acetylcholine was increased, both prior to and after release of BUO, as compared to control and UUO. These different renal vasodilatory responses indicate that the RVR increase during BUO is largely due to a functional vasoconstriction that impairs autoregulatory vasodilation. In contrast, the RVR increase during UUO is probably mainly due to structural damage which does not prevent autoregulation of the RBF level attained. PMID- 6485838 TI - Vasopressin release in response to acute hypotension induced at different time intervals in the conscious sheep. AB - The renal arginine vasopressin (AVP) excretion in response to acute systemic hypotension induced by intravenous infusion of sodium nitroprusside (SNP) (30-40 micrograms/kg min-1) at different experiment intervals (0, 2, 4, 7 and greater than or equal to 12 days) was studied in the conscious hyperhydrated sheep. During the first post-infusion hour, 2.5 times more AVP was excreted in response to hypotension induced at greater than or equal to 12 day intervals than that observed at intervals of 0-7 days. No interexperimental time dependence of the AVP response to SNP infusion was seen with intervals of 0-7 days. The attenuated AVP release obtained with reduced experiment intervals (0-7 days) was accompanied by shorter antidiuresis and a less accentuated natriuresis during the post hypotensive period in comparison to what was observed with greater than or equal to 12 day experiment intervals. There were no interval-dependent differences in maximal fall of mean arterial pressure, or onset and recovery of the hypotension induced by SNP administration. It is suggested that acute systemic hypotension causes such a massive AVP release that more than one week is needed for complete restoration of a releasable neurohypophyseal pool of the hormone. PMID- 6485839 TI - [Cerebral atrophy, diagnosis using tomodensitometry compared with the new Wechsler intelligence scale in a psychiatric population]. AB - In a psychiatric service, the present compares results of a simple psychometric test (in this case the new Wechsler Adult Intelligence Scale - WAIS) with those obtained from a brain CT Scan in two groups of 20 patients showing cerebral atrophy vs. twenty patients with normal CT Scan. Results show there exists a rather complex relationship between the cerebral atrophy scan and the intellectual deterioration. The performance to WAIS appears as globally lessened in cerebral atrophy cases. As for the cerebral rating scale, lower scores are registered only in vocabulary and similitudes in cerebral atrophy cases. Psychometric deterioration, according to scales and to formulation of "applicable" or "no-applicable" to age does not apply to the tests given in the course of the present study of cerebral atrophy. PMID- 6485840 TI - Response to dexamethasone in affective disorder outpatients. AB - Plasma cortisol suppression following 1 mg dexamethasone administration was investigated in patients with affective disorders. Twenty-nine depressed outpatients, 8 bipolar depressed inpatients during manic or hypomanic phase, and twelve healthy volunteers entered the study. Depressed patients were divided into 2 groups according to Research Diagnostic Criterio of Spitzer et al. (1978). The first group consisted of 10 patients affected by minor depressive disorders. The second group was formed of 19 patients with major depressive disorders (7 bipolar, 12 unipolar). No difference between patients and controls was found in baseline 4.00 p.m. serum cortisol levels. Healthy volunteers, patients with minor depressive disorders and bipolar subjects in manic or hypomanic phase showed normal suppression. On the other hand, only 42% of patients with major depressive disorders showed suppression. These results suggest that altered response to dexamethasone is a state-dependent phenomenon. Moreover, a dexamethasone suppression test is able to identify subgroups of suppressor in affected patients. PMID- 6485841 TI - Depression and endogenicity. AB - There is evidence from genetic and clinical studies, especially from therapeutic response to biological treatments, that endogenous or constitutional factors are important in some types of depressive illnesses. Unipolar depression is inherited differently from bipolar depression; monozygotic twins have a higher concordance rate than dizygotic twins. Endogenous depressions are cyclic in nature: the length of phases as well as the length of cycles are log-normally distributed. The effectiveness of antidepressants and ECT in endogenous depression points to a biochemical disorder. The author discusses the distinction between endogenous and exogenous depressions or between psychotic and neurotic depressions by reporting the work of Brown and others on "significant vs. stressful" events and on increased vulnerability. PMID- 6485842 TI - Urine excretion of methoxy-hydroxyphenylglycol: a method of measure. AB - A very good correlation is found between 24 hs urine excretion of MHPG and a single early morning sample. This last method appears to be sufficient for clinical purpose and much easier and safer. PMID- 6485843 TI - [Psychological aspects of anti-Semitism in fascist writers]. AB - We feel sure that the different psychoanalytical interpretations concerning antisemitism as a general phenomenon or concerning the personality of the antisemite each contain part of the truth. We simply wish to show that one of the possible explanations of antisemitism is to be found in narcissistic disturbances of the personality. We study four fascist writers: Louis-Ferdinand Celine, Lucien Rebatet, Robert Brasillach and Pierre Drieu La Rochelle. We come to the conclusion that the racist and antisemitic attitudes of these writers are caused by a lack of empathy and that this becomes a party to narcissistic disturbances of the personality. PMID- 6485844 TI - [Postpregnancy psychoses in Kinshasa. Various clinical and hormonal aspects]. AB - Some clinical and hormonal points of view about forty post-partum psychotics are the object of this study. We have pointed the relatively young age of the patients and the heredo-familial factors importance. From a clinical point of view, we must notice the prevalence of sharp delirious blasts and of depression with regard to western studies. The hormonal study incomplete could not put into evidence the importance of this etiopathogenic. PMID- 6485845 TI - Deaths among child and adolescent psychiatric patients. AB - Of 1,206 patients treated during the period 1970-1980 in a department of child psychiatry in a large city in Sweden 24 (2%) (14 boys and 10 girls) had died by the end of 1981. Twenty-one of these (88%) died of "injuries following external violence and poisoning", of whom 15 (63%) were suicides. Twenty subjects (83%) had grown up in surroundings characterised by one or more psychosocial stress factors. The study indicates a possible link between psychosocial background factors and deaths from "injuries following external violence and poisoning". PMID- 6485846 TI - Women with nonorganic psychosis: mental disturbance during pregnancy. AB - Rates of mental disturbance during pregnancy were studied in 88 index women with a history of nonorganic psychosis and 104 demographically similar control women. The sources of information were the woman's own report at interview during pregnancy, the interviewer's assessment and, for index cases, psychiatric record notations relevant to the pregnancy period. Highly significantly increased rates of active mental disturbance were identified for index women, as compared with controls, based both on the woman's own report and on the interviewer's assessment. Most disturbed were women with a history of Schizophrenia, Cycloid, Postpartum and Other Psychoses, and only those index women with a history of Affective Illness did not differ from controls. Only one third of the index cases were in contact with a psychiatrist during pregnancy, and high rates of active mental disturbance were identified at interview even in those index women without psychiatric contact. PMID- 6485847 TI - Women with nonorganic psychosis: pregnancy's effect on mental health during pregnancy. AB - The effect of pregnancy on women's mental health during pregnancy was studied by interview with 88 pregnant index cases with a history of nonorganic psychosis and 104 demographically similar pregnant controls, and by psychiatric records for the subsample of index cases with relevant information. Controls generally reported experiencing no change or only a slight worsening of mental health due to pregnancy, while index differentially reported improved or considerably worsened health. In total, worsening was more common than improvement in the index cases, and especially in those with a history of Schizophrenic, Psychogenic, Postpartum and Other Psychoses. Psychiatric record information suggested predominantly more improvement in the subsample with information, but this bore little systematic relation to the same women's reports at interview during pregnancy. PMID- 6485848 TI - Offspring of women with nonorganic psychosis: mother-infant interaction at three days of age. AB - Mother-infant interaction during a feeding was studied at about 3 days of age in 51 index mother-infant pairs in which the mother had a history of nonorganic psychosis and in 73 demographically similar control pairs. Interaction was significantly more negative and deviant in index than control cases, index mothers establishing a significantly more negative emotional climate and less harmony in feeding, evidencing more tension and uncertainty, and showing less social contact toward the infant. Index infants showed significantly less social contact toward the mother and index pairs less reciprocal visual contact than did controls. While the Schizophrenic, Cycloid and Nonendogenous Psychoses groups each differed from their matched controls on a number of variables, the Affective group was not in any way more negative than its controls on interaction. PMID- 6485849 TI - Contact difficulties and experience of loneliness in depressed patients and non psychiatric controls. AB - Contact difficulties and the experience of loneliness have been studied in a sample of 110 depressed patients and in non-psychiatric controls (n = 98). The results indicate significant differences between these groups. Furthermore, significant correlations between loneliness, contact difficulties and social network variables occurred. The patient sample showed relationships between loneliness and severity of the depressive syndrome. PMID- 6485850 TI - The availability of confiding persons for depressed patients. AB - The availability of confiding persons both within and outside the household has been investigated in a series of 110 depressed patients and of 98 non-psychiatric controls. The depressive sample has been classified into diagnostic subgroups of unipolar, bipolar, reactive-neurotic and unspecified type of depression. The depressives reported lack of confidants to a significantly higher degree. The only difference among the diagnostic subgroups emerged for the bipolar patients who had about the same availability of a confiding relationship outside the household as the controls. PMID- 6485852 TI - The use of treatment contracts in short-term psychiatric care. AB - Two different treatment contracts, one with and one without active patient cooperation were compared during two 4-month periods on a short-term psychiatric ward. Attitudes and symptoms were measured at admission after 5 days and at discharge by an independent rater and by self-ratings. The length of stay was similar during the two periods. Patients with cooperation contracts showed a significantly larger reduction of anxiety compared with the others. Patients benefitting most from a cooperation contract were those with socio-psychological treatment contract objectives and those treated in a basic activation group. It is concluded that treatment contracts with an active patient cooperation on a short-term psychiatric ward are useful especially for patients not primarily suitable for specific psychotherapy or specific psychopharmacological treatment. PMID- 6485851 TI - Long term course and outcome of the Agra cases in the International Pilot Study of Schizophrenia. AB - The course and outcome at a 13-14-year follow-up of the Agra cases in the International Pilot Study of Schizophrenia (IPSS) was observed by two methods: i) through a mailed questionnaire to assess the key respondents own perception of their state, ii) by a thorough clinical examination and assessment using standard instruments. The results of these two methods were compared and no significant difference found. Based on the second method it was found that 46% of schizophrenics and 43% of manic-depressives had one or two episodes during the first 5 years after inclusion and none in the subsequent period of 8 to 9 years (up to the present follow-up). The results indicate that the illness loses its intensity over a period of years. Mortality among schizophrenics was higher than the expected rate in a general population. The suicide rate was similar to that reported in other studies. PMID- 6485853 TI - Psychologic tests in the evaluation of psychic changes after myelography with metrizamide. AB - The possibility of using psychologic tests to demonstrate psychic changes following myelography with metrizamide was investigated in 15 patients. The tests were made before and after the examination. The results revealed psychic changes of cognitive nature to occur both at 6 and at 24 hours after myelography. Of the tests used determination of the reaction time gave most significant results. Subjectively the patients considered themselves better 24 hours after the examination than after 6 hours. This was not confirmed from the test results--an observation indicating the sensitivity of the test instruments used. Thus, these appear to be well suited to study cognitive changes caused by the contrast media used in this particular type of examination. Since the tests are repeatedly performed, the effect of habituation and of learning cannot be avoided. However, when applied in groups of patients, in whom the effects of different contrast media are compared, the disadvantages of these specific effects can be neglected. PMID- 6485854 TI - Hydrostatic reduction of childhood intussusception. The role of adjuvant glucagon medication. AB - The value of glucagon to facilitate hydrostatic reduction of childhood ileo-colic intussusception was tested in a series of 188 consecutive cases. Sixty-nine patients selected at random received 0.05 mg glucagon/kg body weight intramuscularly before attempts at reduction were started. The rate of successfully accomplished reductions was 84 per cent in the test group and 76 per cent in the control group (not significant). The time for accomplished reduction was approximately equal in the two groups. After 3 unsuccessful attempts at hydrostatic reduction patients in the control group received glucagon. The subsequent attempt at reduction proved successful in slightly more than every second case. No complications occurred. In general, glucagon was not found to improve the rate of employed reductions nor on the time necessary for reduction to take place. The investigation indicated, however, that there may be a limited benefit of adjuvant medication of glucagon. After two unsuccessful barium enemas glucagon administration is therefore recommended before a third attempt at reduction is performed. PMID- 6485855 TI - Conventional abdominal radiography as a means to rule out ileo-caecal intussusception. AB - The experiences gained with conventional radiographic examinations as a means of excluding childhood ileo-caecal intussusception are presented. According to these, a supplementary barium enema is indicated a) in patients under 6 months of age, b) in patients presenting with scant intestinal gas, c) in patients where the caecum cannot be outlined, d) in patients with a possible mass lesion of the colon, e) in patients with obstruction presumably due to intussusception, and f) in patients with discrepancy between the clinical and radiologic findings (1, 4). In all other patients the barium examination is not used. The key to a successful application of this protocol is a thorough familiarity with the limitations and potentials of the conventional abdominal examination. PMID- 6485856 TI - Ischemia of the childhood femoral and humeral head epiphyses following osteomyelitis. A hypothesis on its cause. AB - Two cases are reported of osteomyelitis in the proximal end of the femur and humerus, respectively, with subsequent reduction of the blood supply to the corresponding head. A hypothesis is presented to explain the genesis of the ischemia, and the implications on treatment of osteomyelitis of the hip and shoulder regions. PMID- 6485857 TI - Mammographic fine needle biopsy of non-palpable breast lesions. AB - Results with a previously described device for fine needle biopsies of non palpable breast lesions are reported. During the past 5 years 182 biopsies were performed and 133 of these yielded diagnostic cell material. In the series, 41 carcinomas were found and fine needle biopsy in all demonstrated malignant or probably malignant cells. In the biopsies evaluated as benign or probably benign, malignancy has not been found during the observation period of 4 to 59 months (mean 21.5 months). The device described is cheap and biopsy is easily performed and, if necessary, repeated in a short time. The diagnostic accuracy is high and carcinomas as small as 3 mm in diameter have been diagnosed. PMID- 6485858 TI - Heart volumes in healthy middle-aged men. A seven-year prospective investigation. AB - The heart volume was followed over a 7-year period in 819 healthy men aged 40 to 59 years. The subjects were selected on the basis of unremarkable clinical findings and technically satisfactory films on two occasions 7 years apart. On both occasions the mean heart volume in the upright position was 390 ml/m2 (96.6% below 500), uninfluenced by age, and moderately larger in subjects with high physical fitness. Inclusion of subjects who were healthy during the baseline examination, but who developed heart disease or other diseases during the follow up period, would have increased the mean heart volume by 15 ml/m2. Latent coronary heart disease did not influence the heart volume, but intercurrent myocardial infection increased the follow-up volumes significantly. PMID- 6485859 TI - Stripping of the deep circumflex iliac artery. A rare complication to percutaneous catheterization of the femoral artery. AB - In connection with a percutaneous retrograde heart catheterization via the femoral artery, the guidewire was captured in the deep circumflex iliac artery. On withdrawal of the guidewire stripping of the artery occurred. Occasionally this artery is catheterized unintentionally. Fluoroscopy used as a routine during the introduction of guidewire into the femoral artery could prevent catheterization of the deep circumflex iliac artery. PMID- 6485860 TI - Streak artifacts in dynamic CT. A phantom study of the anterior upper abdomen. AB - Experiments with a body phantom during dynamic CT scanning with the Somatom 2 CT scanner indicate that the periodic streak artifacts seen on the anterior part of the liver in patients are caused by peristalsis of the stomach and resulting motion of the air fluid level. Therefore, the attenuation values of the anterior portion of the liver artifactually oscillate around the baseline value during the dynamic series of scans. This artifact is produced by a change in the position of the stomach air fluid level and is dependent on the direction of tube rotation. The mean of the artifactually oscillating attenuation readings is close to the mean density but usually useless in dynamic CT because the attenuation values change so rapidly in the dynamic phase that averaging measurements also will cause errors. PMID- 6485861 TI - Intravenous computed tomographic cholangiography in acute cholecystitis. A comparison with conventional cholangiography. AB - Forty-nine patients with clinical signs of acute cholecystitis underwent conventional and computed tomographic cholangiography. Among 39 patients with signs of contrast medium in the biliary system at both examinations there was a diagnostic discrepancy in only one patient. Conventional radiography demonstrated cholecystopathy in this patient while contrast medium in the gallbladder and an acute pancreatitis were found at computed tomography. Ten patients with an indeterminate conventional cholangiography had a conclusive computed tomographic examination. Twenty of 30 patients with an abnormal computed tomographic cholangiography underwent cholecystectomy and all had diseased gallbladders. All 17 patients with histopathologically confirmed acute cholecystitis had signs of subserosal edema and/or changes in the omental fatty tissue adjacent to the gallbladder at computed tomography. A layer of tissue of water-density adjacent to the gallbladder and/or changes in omental fatty tissue were also seen in one patient with congestive heart failure and in one with a penetrating duodenal ulcer. None of the 19 patients with a normal computed tomographic cholangiography had a proven acute cholecystitis. PMID- 6485862 TI - Radiographic assessment of anatomic deviations in lumbar spondylolysis. AB - A series of 202 patients (133 men, 69 women) with spondylolysis were examined with respect to radiographic variables describing lumbosacral lordosis, size of lumbar vertebrae, transverse processes and disc height. An age-standardized and sex-stratified comparison was made with a control group of 170 subjects (68 men, and 102 women) without lumbar spine disorders. The difference in lumbosacral lordosis between the spondylolysis and control groups was considered to be secondary to olisthesis, and to lack an etiologic role for the genesis of lysis. The lengths of the transverse processes and their distances to the crista iliaca posterior demonstrated no differences between the groups and therefore did not seem relevant to the context of the pathogenesis of spondylolysis. The fifth lumbar vertebra in the spondylolytic patients was more wedged and less wide than in the controls. The question of the primary or secondary nature of this change has not yet been clearly elucidated, and should be given further attention. The spondylolytic patients demonstrated a decrease in the height of the L5-S1 disc much earlier than the controls, and the degree of narrowing of the disc space was much more marked. PMID- 6485863 TI - Tibial torsion measured by computed tomography. AB - The clinical methods for measuring tibial torsion are based on the assumption that the proximal tibial tilt invariably is 0 degrees, an assumption which proved to be false in 38 legs examined using computed tomography. The conventional radiologic methods have not gained general acceptance. The various CT methods available for measurement of tibial torsion were investigated and have indicated too wide a variation to be clinically useful. At present, no reliable method for measuring tibial torsion seems to be available. PMID- 6485865 TI - [Coronary intensive care units]. PMID- 6485864 TI - Segmental hepatic arterial occlusion with absolute ethanol in domestic swine. AB - Four to five ml of absolute ethanol was injected into a segmental hepatic artery in eight pigs to study the occlusive effect on the hepatic arterial system. Liver cell damage was indicated by a transient moderate elevation of liver enzymes. Follow-up angiography at various time intervals showed persistent occlusion of intrahepatic arteries at different levels in all pigs and occlusion of the common hepatic artery in four. Reconstitution of the intrahepatic arterial circulation via abundant intrahepatic collaterals was, however, observed. Microscopic examinations demonstrated arterial thrombi and necroses in the vascular walls as well as a great variation in the extent of liver parenchymal damage. PMID- 6485866 TI - Effects of chronic irritation of splanchnic nerves on pancreatic juice secretion in dogs. PMID- 6485867 TI - [Influence of thermal treatment in psychosis]. PMID- 6485868 TI - [Blood N-acetyl-beta-glucosaminidase activity in diabetes mellitus]. PMID- 6485869 TI - [The value of simple radiography of the chest in the diagnosis of heart disease]. PMID- 6485870 TI - Halothane aggravation of chronic liver disease. PMID- 6485871 TI - ECG changes during lithium therapy. A prospective study. AB - The influence of long-term lithium treatment on the ECG was investigated in 53 consecutive patients. An ECG was recorded prior to and 4 and 12 months after institution of lithium therapy. The most frequently observed change during treatment was flattening or inversion of the T wave. Heart rate decreased and P-Q interval increased slightly during therapy. There was no change in the S-T segment or the Q-T interval corrected for heart rate. Our data indicate that well monitored lithium treatment of patients with serum lithium concentrations of about 0.6 mmol/l does not cause serious ECG abnormalities. In the absence of symptoms or signs of heart disease, routine monitoring of ECG is not necessary during lithium treatment. PMID- 6485872 TI - Gastric ulcer and risk of cancer. A five-year follow-up study. AB - In 1976, 121 patients with benign gastric ulcer and 13 with gastric carcinoma were diagnosed in our department by endoscopy, cytology and directed biopsies. At a 5-year follow-up, 78 of these patients were re-examined with endoscopy and biopsies. None had developed gastric cancer during the observation time. Of the 78 patients who underwent endoscopy, 16 had gastric ulcer, 2 duodenal ulcer and 27 atrophic gastritis, including 3 with moderate dysplasia of the gastric mucosa. The patients with ulcer had remarkably few symptoms. Only few data are available concerning the postulated link between gastric ulcer disease and gastric malignancy. The cancer-ex-ulcere hypothesis seems to be a medical dogma. However, well planned prospective studies with endoscopic follow-up of gastric ulcers are needed to elucidate the question properly. PMID- 6485873 TI - Permanent pacemaker treatment in older age groups. AB - Of 693 patients on permanent pacemaker treatment between 1962 and 1981, 282 (40.7%) were above the age of 75. Of this number, 142 patients were 75-79 years, 95 80-84 years and 45 85-93 (mean 87) years old at the time of the first pacemaker implantation. The patients were followed for 13-154 months (mean 37.1) with special attention being paid to morbidity and mortality after the implantation. Complications occurred in 65 (23%) of the elderly patients, with no significant difference between the three age groups. Excessive threshold rise with stimulation failure (6%) and infections or skin erosions (4.9%) were the most frequent complications. Mortality increased in all age groups during the first 6-12 months compared with the age- and sex-matched Norwegian population. Five-year survival rates were 56, 32 and 25% respectively. We conclude that cardiac pacemaker treatment in the elderly is a safe symptom-relieving therapeutic procedure and that the prognosis for these patients is similar to that for their fellow senior citizens after the first year of treatment. PMID- 6485874 TI - Cardiac dysrhythmias in patients with acute myocardial infarction. Relation to serum potassium level and prior diuretic therapy. AB - A series of 676 patients with acute myocardial infarction were evaluated with regard to initial serum potassium level, prior diuretic therapy and occurrence of cardiac dysrhythmias during their first 24 hours in a coronary care unit. Serious dysrhythmias (ventricular tachycardia, ventricular fibrillation, and asystole) were significantly more frequent in hypokalemic patients. In this regard no differences were observed between patients on or off prior diuretic therapy. PMID- 6485875 TI - No liver 99Tc-tin-colloid uptake in primary sclerosing cholangitis. AB - A 99Tc-tin-colloid scintigraphy showed no uptake of the radiopharmaceutical in the liver of a patient with jaundice. The diagnosis was later established as primary sclerosing cholangitis. PMID- 6485876 TI - Charcoal hemoperfusion for treatment of serious carbamazepine poisoning. AB - A case of severe carbamazepine intoxication (total dose 80 g) is reported. Because of deep coma and cardiovascular symptoms, intensive care and hemoperfusion were employed. The carbamazepine hemoperfusion clearance rate was 80-90 ml/min, but due to a probable ongoing absorption from the gut the effect of hemoperfusion was limited. Long hemoperfusion periods are recommended due to the pharmacokinetic pattern of carbamazepine. PMID- 6485877 TI - Lack of effect of exogenous or endogenous gastric inhibitory polypeptide on the elimination rate of Intralipid in man. AB - Six healthy subjects were studied by means of an intravenous fat tolerance test on three occasions, in the fasting state, in the postprandial state, and during an intravenous infusion of gastric inhibitory polypeptide (GIP). No effects on the elimination rate of Intralipid were seen either by endogenous or exogenous GIP. PMID- 6485878 TI - Concentrations of trace elements in human blood serum from different places in Norway determined by neutron activation analysis. AB - The concentrations of As, Fe, Hg, Sb, Se and Zn in 281 serum samples from people living in nine municipalities in Norway were determined by radiochemical neutron activation analysis. The concentrations of Br, Cl, Cs, Na, Rb, Se and Zn were determined in another set of 157 serum samples from four of the municipalities by instrumental neutron activation analysis. Higher arsenic concentrations were found in the coastal districts than in inland municipalities; otherwise no significant difference in mean values was observed between the districts. Except for Na-Cl and Rb-Cs, none of the elements was significantly correlated with any other element studied. PMID- 6485879 TI - Plasma vasopressin, cortisol, and growth hormone concentrations in relation to surgery in the suprasellar region. AB - Posterior and anterior pituitary functions were assessed in 8 patients before, during, and after surgery for tumors in the suprasellar region. Preoperatively, all patients but one responded adequately to an osmotic stimulus with a rise in plasma vasopressin (AVP) and all but one showed adequate cortisol response to adrenocorticotropic hormone (ACTH) and hypoglycemia. During surgery a transient rise was seen in plasma levels of AVP (5 out of 8 patients), cortisol (7 out of 8 patients) and growth hormone (4 out of 8 patients). This response could be predicted from the preoperative stimulation tests. Postoperatively the AVP response to osmotic stimuli was impaired in 4 out of 5 patients, although urine volume had returned to normal after a transient polyuric phase. The response of plasma cortisol to ACTH was still adequate but lower than preoperatively. PMID- 6485880 TI - Improved cardiac performance during exercise following hydralazine treatment in chronic heart failure. AB - Nine male patients with stable chronic heart failure of different etiology and optimally treated with digoxine and diuretics were given hydralazine, 50 mg b.i.d., during three months. Hemodynamic parameters were evaluated during upright submaximal exercise. An increase in cardiac index due to an increased stroke volume was noted following the first dose of hydralazine. After three months' treatment, cardiac index was further increased. The arteriovenous oxygen difference was initially unchanged, but significantly decreased following long term treatment. These findings may indicate different effects of hydralazine acutely and after long-term treatment. It is suggested that the initial increase in blood flow is directed mainly to regions other than the exercising muscles, while more blood is directed to the muscles after long-term treatment. A possible mechanism to explain this postulated difference is discussed. PMID- 6485881 TI - Leg muscle circulation by 133Xenon clearance as a predictor of cardiovascular disease in an aged population. AB - In a 10-year cardiovascular survey of an unselected population aged 70 at entry. 133Xenon clearance was carried out in the anterior tibial muscle in both legs after maximal exercise during ischaemia in 211 men and 166 women. The maximal blood flow and the delay time (Ti) until this was achieved were measured. Using multivariate Cox's regression analyses with mortality from cardiovascular diseases (CVD) and CVD events in the eighth decade as end-points, and maximal blood flow, Ti, distal pulse abnormality and intermittent claudication as possible predictors, high Ti was found to be an independent predictor of both end points in both sexes. In further multivariate Cox's regression analyses including other possible CVD risk markers, high Ti was of individual predictive value for excess total mortality, excess CVD mortality and excess CVD events in both sexes. It is concluded that high Ti by 133Xenon clearance at the age of 70 is a powerful predictor of future CVD events. PMID- 6485882 TI - Interobserver variation in assessment of respiratory signs. Physicians' guesses as to interobserver variation. AB - Interobserver variation was studied for 11 respiratory signs and for the diagnostic conclusions made on the basis of these signs. Two physicians each, with and without knowledge of the patient's history, performed physical examination of the lungs in a total of 202 unselected patients from a department of internal medicine. The interobserver variation was calculated as the kappa coefficient, using a modified method that made it possible to calculate the interobserver variation for a pair of observers made up by varying physicians. No difference was demonstrated between the kappa coefficients obtained for examinations performed with and without knowledge of the history. The kappa values for the signs ranged from -0.04 to 0.58, and for the diagnoses from 0.15 to 0.68, i.e., expressed by kappa values, poor agreement. In a questionnaire study we asked a number of physicians from departments of internal medicine to guess the size of the interobserver variation for the 11 respiratory signs examined. A total of 47 physicians (90%) returned the questionnaire and the answers showed that the physicians markedly underestimated the interobserver variation. PMID- 6485883 TI - Hemodialysis and cell toxicity in vitro related to plasma triglycerides, post heparin lipolytic activity and free fatty acids. AB - Plasma triglyceride (TG) concentrations, post-heparin lipolytic activities and the free fatty acid (FFA) pattern of uremic and normal plasma were compared and correlated to plasma toxicity as measured by the effect on human mononuclear phagocytes cultured in vitro. Plasma TG concentration and FFA: albumin molar ratios were significantly higher in uremic plasma, and a correlation was found between TG concentrations prior to heparinization and post-heparin FFA concentrations. Uremic plasma toxicity was significantly correlated to increased post-heparin FFA: albumin molar ratio. The post-heparin lipoprotein lipase activity in uremic plasma collected 120 min after heparinization was higher than in normal plasma. Qualitative and quantitative experiments in vitro showed increased plasma toxicity with increasing FFA: albumin molar ratios. The proportion of unsaturated FFA in uremic post-heparin plasma increased compared to saturated FFA during incubation for 96 hours. Altered lipid metabolism after systemic heparinization thus seems to be important for the cell toxicity of uremic plasma in vitro. PMID- 6485884 TI - The effect of systemic heparinization on plasma lipoproteins and toxicity in patients on hemodialysis and continuous ambulatory peritoneal dialysis. AB - The lipid patterns of plasma from 6 patients on hemodialysis (HD) and 6 patients on continuous ambulatory peritoneal dialysis (CAPD) were compared and correlated to plasma toxicity as measured by the survival of human macrophages cultured in vitro. The median values for plasma triglycerides (TG), cholesterol, low density lipoprotein (LDL) cholesterol, apolipoprotein B and lipolytic activities (lipoprotein lipase and hepatic lipase) were insignificantly higher in CAPD plasma than in HD plasma. The median high density lipoprotein (HDL) cholesterol/LDL cholesterol ratio was significantly higher in HD plasma than in CAPD plasma. In both groups systemic heparinization was followed by a significant increase in free fatty acids and in plasma toxicity. The difference in plasma toxicity was insignificant. In the whole group of patients (n = 12) toxicity in post-heparin plasma was correlated to pre-heparin very low density lipoprotein (VLDL) TG, but not to LDL TG. Separately post-heparin toxicity in CAPD plasma was correlated to pre-heparin total TG, VLDL TG and post-heparin LDL TG. PMID- 6485885 TI - [Histochemical studies on the alkaline and acid phosphatase content of the synovial tissue of swine with erysipelas]. PMID- 6485886 TI - [Ecology of the causative agent of brucellosis]. PMID- 6485888 TI - [Isolation of gibberellic acid]. PMID- 6485887 TI - [Bacitracin biosynthesis by Bacillus licheniformis 16]. PMID- 6485889 TI - [Growth kinetics of a Candida tropicalis population cultured on a solid nutrient medium]. PMID- 6485890 TI - [Role of Varroa jacobsoni Oudemans in the bee family as a carrier of microorganisms]. PMID- 6485891 TI - [Current clinical picture of erysipeloid and virulence of the causative agent]. PMID- 6485892 TI - Implantation of a strip of fascia in the venous wall. AB - In 12 adult rabbits, according to the pull through technique a strip of muscular fascia was implanted in the wall of the femoral vein. Of 11 of these animals, sacrificed at intervals varying from 0 days to 3 months after the operation, the area of implantation was removed and histologically studied. Two cases showed wound infection and one case, moreover, venous thrombosis. Among the other 9 cases, in 2 specimens the end of the strip was found to lie within the venous wall, while in the remaining 7 specimens the strip protruded into the venous lumen. In the latter cases, the strip proved to be firmly attached to the venous wall within 4 days; within the same time the protruding part of the strip became completely covered by venous endothelial cells. Loose connective and fatty tissue adherent to the strip only disappeared, when the end of the strip freely floated in the streaming blood. PMID- 6485893 TI - Gap junctions in the heart of the adult Protopterus aethiopicus. AB - In thin sections and in freeze-fracture replicas small and sparse gap junctions appear to be developed on the longitudinal plasma membrane of Protopterus cardiac cells near a macula or fascia adhaerens. By thin-section electron microscopy, they had septalaminar profiles with a length between 0.042 and 0.260 micron. In freeze-fracture images they appear on the P-fracture face as maculate particle aggregations with complementary pits on the E-fracture face. Particles with a central intercellular channel could be observed. The average center-to-center distance between neighbouring particles or pits is 10.05 +/- 1.87 nm (N = 2429). The diameter of the junctional maculae in replicas lies between 0.037 and 0.229 nm. The particle packing density increases in larger maculate aggregations, while particle-free areas emerge which could be related to the degradation or reformation of gap junctions Atypical configurations of gap junctions observed in the myocardium of lower vertebrates are rarely encountered in this primitive vertebrate. PMID- 6485895 TI - Proceedings of the 128th meeting of the Netherlands' Association of Anatomists, held at the University of Utrecht, October 29, 1983. PMID- 6485894 TI - [Development of the nasal septum in rabbits. III. Quantitative observations on cells and intercellular substance]. AB - With the aim to further characterize the various regions of the nasal septum, the following measurements were made: In the thin anterior region and in the thick regions in the middle and posterior parts of the septum the quantitative relationships between cells and intercellular substance as well as the size of the cells were determined. The material used, included transverse and horizontal sections through the nasal septum of rabbits of ages of 1 day and 2, 4, 6, 8, 12 and 24 weeks. The results showed that in the thin anterior region the relationship between cells and intercellular substance remains constant, while in the two thick regions the amount of intercellular substance proportionately increases. In the thick regions, the cells are always larger than in the thin region. The rapid growth of the cells between the 4th and the 6th week coincides with a growth-spurt of the whole head. PMID- 6485896 TI - Enzyme histochemical changes in retinal ganglion cells and the optic nerve after goldfish optic nerve lesion. A regenerative and hypertrophic phenomena study. AB - After sectioning of the goldfish optic nerve a number of enzyme histochemical changes are observed in the hypertrophied retinal ganglion cells and in the optic nerve. Between one and eighteen days postoperatively an increase in the amount of acid phosphatase reaction product is noted. The enhanced activity decreased to normal first in the optic nerve, followed by the optic tract and tectum. Four days postoperatively higher levels of activity were noted in the hypertrophic retinal ganglion cells for the enzymes NADH tetrazolium reductase, cytochrome oxidase, glutamate dehydrogenase and lactate dehydrogenase. The same enzymes also showed an activity increase in the lesioned optic nerve after four to ten days postoperatively, beginning at the cut and gradually spreading towards the optic tectum. Between fifteen and eighteen days the activity dropped to normal in the hypertrophic retinal ganglion cells, while in the lesioned nerve raised levels of reaction products could be seen till days thirty-five and/or forty-five. It was concluded that the degeneration of the optic pathway is marked by the increase of acid phosphatase activity, whereas the process of regeneration is characterized by an increase of NADH tetrazolium reductase, cytochrome oxidase, glutamate dehydrogenase and lactate dehydrogenase activities. The possible functional implications of these enzymes in the regenerative phenomena are discussed. PMID- 6485897 TI - Thalamic mechanisms underlying acquisition of latch-box problems in the white rat. AB - Acquisition of a bolt latch and/or hook latch was impaired in rats with mediodorsal, ventromedial, lateral, ventrolateral, midline or parafascicular thalamic lesions, but not in rats with anterior or ventrobasal thalamic lesions. The results suggest that the motor thalamus may extend to territories beyond the ventrolateral nucleus. PMID- 6485898 TI - Mathematical description of the electrical activity of a single neuron. AB - The analysis of the electrical activity (trains of spikes, volleys) of single neurons is proposed in form of a pattern function. From the pattern function and its variance it is possible to obtain full statistical description of volleys including the density distribution of spikes in the volley. An algorithm for finding the pattern function and the estimate of variance from a set of experimentally obtained volleys is given. Preliminary physiological conclusions for phrenic motoneurons are derived. PMID- 6485899 TI - Low atropine dose increases the frequency of hippocampal theta activity. AB - The influence of two doses (6 and 3mg/kg) of atropine (A) on hippocampal theta activity (TA) induced by means of reticular stimlulation was studied in waking rats with implanted electrodes. The higher dose of A depressed TA and the lower dose reduced markedly its incidence. The frequency of TA remaining after A administration increased significantly. The results suggest that A acts in a different way upon the mechanisms responsible for the occurrence of TA and its frequency. An accidental finding was that' A prolongs paroxysmal hippocampal EEG induced by reticular stmimulation. PMID- 6485900 TI - Amplitude discriminator for biological impulses. AB - A simple amplitude discriminator with two ways of triggering DC-level monitoring is described. This system is based on easily available inexpensive integrated circuits. PMID- 6485902 TI - Conduction time in central somatosensory pathway: an improved technique. PMID- 6485901 TI - The velocity-response curves of the cat's superior colliculus neurons. AB - The velocity-response curves of the cat's superior colliculus neurons responding to moving stimuli mere studied quantitatively. They were fitted by logarithmic Gaussian curves described by three parameters: optimal stimulus velocity, amplitude and dispersion of the curve. Since reversal of the stimulus movement direction changed neither optimal stimulus velocity nor dispersion of the velocity tuning curve, then the fourth parameter, directional asymmetry, is postulated to describe fully, in conjunction with three parameters mentioned above, the dependence of the neuron response to velocity and direction on the stimulus motion. All parameters were roughly normally distributed and uncorrelated with each other in the sample of cells investigated. Some implications of our results for the classification of cells, and some arguments for population coding? against single cell trigger feature coding are discussed. PMID- 6485903 TI - Cervical SEPs from musculo-cutaneous nerve stimulation. PMID- 6485904 TI - Ophthalmoplegia plus with late onset. Histochemical, ultrastructural, metabolic and electrophysiopathological study of a case. PMID- 6485905 TI - Epileptic seizures and cerebrovascular disorders: a clinical-EEG-CT study. PMID- 6485906 TI - Large middle fossa arachnoid cyst and subdural hematoma with late decompensation. PMID- 6485907 TI - Long-term trial of levamisole on ataxia-telangiectasia: effect on the immunological and clinical parameters. PMID- 6485908 TI - "Double crush" mechanism impairing a nerve revealed by studies of the motor axon reflex and M wave terminal phase. A case report. PMID- 6485909 TI - Subcortical SEPs in upper cervical cord compression. A case report. PMID- 6485910 TI - Peculiar congenital myopathy in two siblings. Congenital fibre type disproportion or type II fibres hypotrophy? PMID- 6485911 TI - Multiple cerebral metastases clinically presenting as subarachnoid hemorrhage. PMID- 6485912 TI - [Notes for a phenomenology of love]. PMID- 6485913 TI - [Psychosomatic sterility in women: a contribution to its study]. PMID- 6485915 TI - [Experience with preverbal psychotherapy in a group of chronic psychotic patients]. PMID- 6485914 TI - [Stress reactivity among patients admitted to a general hospital]. PMID- 6485916 TI - [Liver function in alcoholic patients treated with cyanamide]. PMID- 6485917 TI - [Cellular kinetics and oncologic physiopathology in prostatic carcinoma]. PMID- 6485918 TI - [Extracorporeal renal lithofragmentation by shock waves in the treatment of renal lithiasis. Current results on 1,050 patients]. PMID- 6485919 TI - [Comparative epidemiologic study of renal lithiasis in gypsy and non-gypsy populations: influence of diet]. PMID- 6485920 TI - [Complications of total cystectomy for carcinoma of the bladder]. PMID- 6485921 TI - [High mortality caused by urothelial cancer and occupational exposure. A study of proportional mortality]. PMID- 6485923 TI - [Multilocular renal cyst in childhood. Apropos of a case]. PMID- 6485922 TI - [Levels of progesterone in the serum and semen: correlations with the seminogram and levels of 17 alpha-hydroxyprogesterone in the serum and semen]. PMID- 6485924 TI - [Vesical carcinoma, predominantly urothelial, with pseudosarcomatous reaction]. PMID- 6485925 TI - [Acute urinary retention in a woman secondary to didelphic uterus with unilateral vaginal perforation]. PMID- 6485926 TI - [Metastatic tumors of the penis: apropos of a case]. PMID- 6485927 TI - [Ureteral obstruction: intensity of the obstruction and anatomofunctional response]. PMID- 6485928 TI - [Minimum fertility age]. PMID- 6485929 TI - [Psychological aspects of children with bronchial asthma]. PMID- 6485930 TI - [Sociomedical problems of drug abuse in Great Britain--prevention and therapy (results of a study trip)]. PMID- 6485931 TI - [Diagnosis of the intelligence structure and ability to concentrate of children with and without brain dysfunction using Horn's achievement test]. PMID- 6485932 TI - Cellular activation: biochemistry and immunoregulation. 5th European Workshop on Inflammation, Cologne, Federal Republic of Germany. PMID- 6485933 TI - [High incidence of pterygium in welders]. PMID- 6485934 TI - [Studies on experimental central serous chorioretinopathy. Fluorescein angiography and histopathology during the course of spontaneous remission]. PMID- 6485935 TI - [Retinal detachment combined with choroidal detachment as a preoperative complication. 2. Treatment and prognosis]. PMID- 6485936 TI - [Characteristic movement of epithelial cells at the limbus during the wound healing process after thermal burn]. PMID- 6485937 TI - [Preferential looking of infants and younger children with ocular diseases]. PMID- 6485939 TI - [Studies on the short latency visual evoked potential. 2. Evaluation of the Fourier and dynamic topographical analysis]. PMID- 6485938 TI - [Role of dorsal raphe nucleus on relay neuron in lateral geniculate nucleus]. PMID- 6485940 TI - [Reverse enzyme-linked immunosorbent assay for detection of specific anti toxoplasma immunoglobulin M antibodies]. PMID- 6485941 TI - The value of a diuretic load in assessment of the pathological pelviureteric junction. PMID- 6485942 TI - Lithiasis in horseshoe kidney. PMID- 6485943 TI - [Kidney sarcomas. Description of an unusual case of leiomyosarcoma with metastatic diffusion]. PMID- 6485944 TI - [Cellulo-lymphadenectomy in tumors of the kidney]. PMID- 6485945 TI - [Bilateral ureteral obstruction caused by an accumulation of mycelia in a newborn infant]. PMID- 6485946 TI - [Cure in primary megaureter in children under medical treatment. Apropos of 5 cases]. PMID- 6485947 TI - [Polyps of the ureter. Clinical course and surgical treatment]. PMID- 6485948 TI - [Tuberculous stricture of the lower ureter. Treatment using intravesical insertion of the ureter (the so-called bell baton)]. PMID- 6485949 TI - [Ureteral endometriosis]. PMID- 6485950 TI - [2 ureteral fistulas cured by percutaneous nephrostomy alone]. PMID- 6485951 TI - [Importance of ileo-renal reflux in ureterostomy using the Bricker method]. PMID- 6485952 TI - Cryosurgery of prostatic carcinoma. PMID- 6485953 TI - [Testicular syphilis]. PMID- 6485954 TI - [Malignant Sertoli cell tumor of the testis]. PMID- 6485955 TI - About two cases of leiomyosarcoma of the spermatic cord. PMID- 6485956 TI - [Studies of the cellular immune response in patients with urinary bladder carcinoma. X. Evaluation of serum IAP and ASP levels]. AB - Serum levels of immunosuppressive acidic protein (IAP) and acid soluble glycoprotein (ASP) were measured in 48 patients with urinary bladder carcinoma and 51 control subjects. Both IAP and ASP levels were significantly higher in the patients than in the control subjects, and the increase of these two serum substances seemed to be closely related to grading and staging of urinary bladder carcinoma. In many patients, serum IAP and ASP levels decreased after resection of tumors. There was an inverse correlation between IAP or ASP level and phytohemagglutinin (PHA)-induced lymphocyte blastogenesis (stimulation index, SI). This suggested an immunosuppressive effect of these serum factors. After chemotherapy of urinary bladder carcinoma, both IAP and ASP levels would decrease. It is suggested that serum IAP and ASP levels could be good indicators for evaluating the effect of chemotherapy. PMID- 6485957 TI - [Histological study of cases of bladder cancer and chronic cystitis with difficulty in cystoscopic diagnosis]. AB - Twenty-seven cases in which cancer could not be distinguished from chronic cystitis were reviewed. These cases were divided into those with and those without a past history of bladder tumor. The high frequency of hyperplasia in the group with a history of bladder tumor suggested that hyperplasia may be a precursor of papillary tumor. On the other hand, proliferative lesions such as cystitis cystica and metaplasia were encountered in the group with no history of bladder tumor and 50 percent had symptoms of chronic cystitis. These findings suggested that proliferative lesions in the bladder developed by inflammatory irritation. Urinary cytology was done in 18 cases. Cytology was positive in 2 of the 3 cases of transitional cell carcinoma. Therefore, urinary cytology was useful, but it did not provide distinction in two cases of follicular cystitis and a case of squamous metaplasia was false positive. PMID- 6485958 TI - [Clinical study of squamous cell carcinoma of the bladder]. AB - Clinical and statistical observations were made on 15 cases of squamous cell carcinoma of the bladder experienced at our department during the past 19 years. The patients were 10 men and 5 women ranging in age from 41 to 80 years (median: 65.1 years). Forty percent of the chief complaints was bladder irritability without macrohematuria. The prognosis was very poor. Three-year and five-year survival rates were 32.3% and 26.1% respectively. PMID- 6485959 TI - [A study of 65 cases of urinary tract injury]. AB - Since 1968, we experienced 65 cases of urinary tract injury. These include a rare case of traumatic renal artery thrombosis which was later followed by renovascular hypertension, a rare case of complete ureteral disruption, and 2 cases of renal injury which were first treated conservatively but were nephrectomized later because of rebleeding. These cases are reported and discussion is made about the relationship between the clinical findings and the indication of nephrectomy. We used endoscopic management (Yasuda method) in the cases of complete disruption of posterior urethra accompanied by pelvic fracture and obtained good results. PMID- 6485960 TI - [A study on non-sterile intermittent self-catheterization for voiding dysfunction following radical uterine or rectal carcinoma surgery]. AB - To determine the effectiveness of non-sterile intermittent self-catheterization, a study was made of 35 patients who had radical surgery of the carcinoma of the uterus or rectum between January, 1978 and October, 1982. These cases were divided into 2 groups; (1) early instituted group of 27 patients who used self catheterization within 3 months following surgical intervention; (2) late instituted group of 8 patients who received drug treatment for more than 3 months after surgical treatments and then used self-catheterization. After the introduction of self-catheterization, urinary tract infection was evaluated on the basis of the incidence of pyuria defined as more than 5 white blood cells per high magnification field. In 16 of the 35 patients, the incidence of pyuria ranged from 0 to 20 per cent. Regarding prognostic results in the first group the application of self-catheterization, 6 patients had a residual urine ratio ranging from 0 to 20 per cent and were able to void at will. Uroflometry was performed in 9 patients in the first group. In 8 of these patients, UP max values increased 3 months after self-catheterization as compared with those before self catheterization although their values were still lower than normal. Non-sterile intermittent self-catheterization can shorten the stay in hospital and enable the patient to live a catheter-free life. PMID- 6485961 TI - [Clinical studies of antimicrobial prophylaxis of recurrent urinary infection in women. Long-term, low-dose pipemidic acid for prophylaxis]. AB - The prophylactic efficacy of long-term, low-dose antimicrobial treatment in urinary tract infection (UTI) was studied. Fifty-eight female adult patients with a history of at least two recurrent episodes of UTI in the past year were entered into this study, and the prophylactic regimen was not started until the existing UTI had been eradicated. Patients took 250 mg of pipemidic acid (PPA) daily at bedtime after voiding for 6 consecutive months. Incidence of recurrence of UTI in 48 patients with uncomplicated UTI and 10 patients with complicated UTI decreased to 0.15 and 0.29 per year, respectively, during the treatment compared with 3.5 per year before the treatment. At the end of the 6 months of prophylactic treatment, the patients were divided into two groups by the envelope method. Seventeen patients were treated for a further 6 months and 11 patients were followed up without further medication. Prophylactic efficacy of UTI was obtained in both groups, and there was no significant difference in the incidence of recurrence between the two groups. These findings suggest that the 6-month period of prophylaxis might be sufficient. Examination of the periurethral swab showed that E. coli and Klebsiella sp. were decreased during the treatment. This prophylactic treatment produced no resistant strains. Urinary levels of PPA in the morning urine of patients administered 250 mg of PPA at bedtime averaged 513 micrograms/ml. These values were about 2 times higher than those found in the evening urine after administration of the same dose in the morning. PMID- 6485962 TI - [Clinical experience with methylcobalamin (CH3-B12) for male infertility]. AB - CH3-B12 was administered daily (1,500 micrograms/day, for 4 to 24 weeks) to 26 infertile male patients who visited our clinic from January to December, 1982. It was not administered, however, to patients with azoospermia. Semen analysis was conducted from 8 weeks after the administration of CH3-B12. Sperm concentration increased in 10 cases (38.4%), total sperm counts increased in 14 cases (53.8%), sperm motility increased in 13 cases (50.0%) and total motile sperm count increased in 13 cases (50.0%). Semen volume, however, could not be evaluated due to wide variation. Serum LH, FSH and testosterone were unchanged. Judging by our criteria, 11 cases (42.3%) improved, 11 cases (42.3%) were unchanged and the remaining 4 cases (15.4%) had aggravated. PMID- 6485963 TI - [Studies on an oral calcium loading test in upper urinary tract stone formers]. AB - An oral calcium loading test was performed on 55 patients with upper urinary tract stones to find absorptive or renal hypercalciuria. The mean urinary calcium excretion level of this patient group was significantly greater than that of a control group of 10 patients without abnormal upper urinary tract. Idiopathic hypercalciuria defined as more than 250 mg per day in males and more than 200 mg per day in females was observed in 13 patients; 4 patients with absorptive hypercalciuria, 6 patients with renal hypercalciuria and 3 patients of origin unknown hypercalciuria. Five of the 6 patients with renal hypercalciuria had recurrent and/or multiple urolithiasis. From these results, this test was considered to be useful in the discrimination between absorptive and renal hypercalciuria. PMID- 6485964 TI - [Renal blood flow in rabbit using hydrogen clearance method]. AB - The local renal blood flow in rabbits was determined by means of hydrogen gas clearance. Simultaneously, to clarify intrarenal redistribution during ischemic renal failure, renal vessels were occluded for some period. Namely, the rabbits were divided into three groups according to the duration of warm ischemia, which was 30, 60 and 120 minutes. The cortical and paramedullary blood flow were 215.0 +/- 29.8 and 145.6 +/- 26.3 ml/min/100 g, respectively, in the control group. In the three ischemic groups, each renal blood flow was only reduced by about 30% after 10 minutes following release of occlusion. In cases of ischemia of 30 or 60 minutes, no distinct intrarenal redistribution was seen. However, in 120 minute ischemia a slight decrement of cortical blood flow occurred after 40 minutes following release of clamp. Hydrogen gas clearance can be used to measure regional blood flow repeatedly. This method should be clinically applicable. PMID- 6485965 TI - [Dynamic urinary flow images in patients with ileal loop diversion assessed by I 123-hippuran scintigraphy. Detection of ileoureteral reflux]. AB - To evaluate upper urinary tract and ileal loop functions, dynamic urinary flow studies using I-123 hippuran were performed in 52 kidneys of 27 patients with ileal loop urinary diversion. Analysis of regional renograms enabled easy assessment of the cortical, pelvic and loop functions. Normal pattern was found in 33 cortices (63.5%), 22 pelvis (45.8%) and 14 loops (51.9%). Most of the abnormal findings in the upper urinary tract were delayed excretion and/or retention of the pelvic and ureteral urines. Diagnosis of ileoureteral reflux under normal physiological circumstances was made to compare the pelvic and loop curves. Small peaks and/or irregular spike waves observed in the down slope of the pelvic curve concurrently with the increased activity of the loop curve indicate a production of the ileoureteral reflux associated with ileal movement. This reflux was noted in 22 of the 27 cases (81.5%). Bilateral reflux was evident in 3 cases, and unilateral reflux in 19 cases. Ileoureteral reflux was noticed in 14 of the 15 cases (90%) in which retrograde loopography was performed. Although bilateral reflux was found in 8 cases, the hippuran study revealed bilateral in only one case, unilateral in 5 and no reflux in 2. Thus, I-123 hippuran scintigraphy consisting of sequential renal images, loopograms and regional renograms enables the diagnosis of ileoureteral reflux and obstructive uropathies and is a useful tool to detect functional complications of the upper urinary tract in patients with ileal loop diversion. PMID- 6485966 TI - [clinical studies on primary renal pelvic tumors]. AB - The 15 cases of the primary renal pelvic tumors treated at our Hospital between 1974 and 1983, were reviewed retrospectively. The patients ranged in age from 41 to 74 years old (average: 58.3 years old). There were 11 males and 4 females, the ratio being 2.8:1.0. The affected side was left in 9 cases and right in 6 cases. The most frequent symptom was macrohematuria, which was seen in 12 cases (80%). The major finding of IVP was non-functioning kidney, which was seen in 8 cases (53.3%). Positive urinary cytology was obtained in 8 cases (53.3%). As the surgical method, total nephroureterectomy with bladder cuff was performed in 8 cases, nephroureterectomy in one case and nephrectomy in 6 cases. Histologically, 14 cases were transitional cell carcinoma and one case was squamous cell carcinoma. Simultaneous urothelial tumors were seen in the bladder of 2 patients. A subsequent ureteral tumor was found in one of the 7 cases in which ureters were resected incompletely, and subsequent bladder tumors were found in 8 of the 15 cases receiving surgical treatment in the follow-up period. All of tumors were found within 2 years after operation. Over-all actual survival rates at 1, 3 and 5 years were 87%, 67%, 48%, respectively. Three and 5 year actual survival rates were 100%, 100% respectively for the low stage group and 59%, 29% respectively for the high stage group. Three and 5 year actual survival rates were 100%, 78%, respectively for the low grade group and 44%, 27% respectively for the high grade group. Among several factors, stage and grade of the tumor were the most influencing factors for prognosis. PMID- 6485967 TI - [Clinical studies on primary ureteral tumors]. AB - The 15 cases of the primary ureteral tumors treated at our Hospital between 1974 and 1983, were reviewed retrospectively. The incidence of primary ureteral tumors among the outpatients in our urologic clinic was 0.15%. The patients ranged in age from 50 to 75 years old (average: 65.5 years old). There were 11 males and 4 females, the ratio being 2.8:1.0. The right ureter and the lower third of the ureter were involved more frequently than other areas. The most frequent symptom was macrohematuria which was seen in 12 cases (80%). The major finding of IVP was non-functioning kidney, which was seen in 11 cases (73.3). Positive urinary cytology was obtained in 9 cases (60%). Twelve patients underwent nephroureterectomy with bladder cuff or total cystectomy. Histologically, all cases were transitional cell carcinoma. Simultaneous urothelial tumors were seen in the bladder in 4 cases (26.7%). The over-all actual survival rates at 1, 3 and 5 years were 59%, 42%, 42%, respectively. The 5-year actual survival rate was 63% for the low grade group and 0% for the high grade group. The 5-year actual survival rate was 82% for the low stage group and 0% for the high stage group. Among several factors, grade and stage of the tumor were the most influencing factors for prognosis. PMID- 6485968 TI - Renal hemangioma. AB - Four cases of renal hemangioma are presented. Renal hemangioma is difficult to detect because this benign vascular tumor never demonstrates any abnormalities on renal arteriography. Computed tomography in two resected cases of cavernous hemangioma revealed a low-density mass without any enhance effect, while the others diagnosed by the selective renal arteriography demonstrated no abnormality on computed tomography. We postulate that both angiographic and computed tomographic appearances of the renal hemangioma could depend on its vascular components. Related reports are also reviewed. PMID- 6485969 TI - [Inflammatory vesicosigmoidal fistula. A case report]. AB - Clinical course of a case of inflammatory vesicosigmoidal fistula is presented. The patient, a 44-year-old-male, had chief complaints of pollakisuria and pain upon voiding. Fistula was identified with colon-fiberscopic examination. Primary resection of lesion was performed and postoperative course was uneventful. Histological findings of the specimen were compatible with those of nonspecific inflammation. There was no evidence of neoplastic change. Twenty nine cases of inflammatory vesicosigmoidal fistula were reported in the recent 5 years. It was remarkable that the cases of vesicosigmoidal fistula due to sigmoidal diverticulitis have increased. PMID- 6485970 TI - [A case of retroperitoneal liposarcoma]. AB - A 77 year-old woman presented with the chief complaint of a mass in the right upper quadrant. The examination on admission including IVP, echography, Ga scintigraphy, barium enema, CT scan, and angiography revealed that the right kidney and ascending colon were displaced by the mass. Under the diagnosis of retroperitoneal tumor, operation was carried out. Most of the mass was resected with the right kidney. The pathological diagnosis of the resected tumor revealed well differentiated liposarcoma. Convalescence was uneventful and the patient has been well and free from disease for 14 months. Based on our experience and the review of the pertinent literature in English and Japanese, we emphasize the importance of definite surgery and close follow up, as liposarcoma is frequently recurrent. PMID- 6485971 TI - [Prolapse of ureteral tumor]. AB - We present three cases of prolapse of ureteral tumor. Prolapse of a ureteral tumor is usually associated with antegrade intussusception of the ureter, and is thought to be a sign of noninvasiveness. In such a case segmental ureterectomy may be justified. PMID- 6485972 TI - A case report of Crohn's disease with sigmoido-vesical fistula. AB - Urological complications in Crohn's disease are relatively common conditions. However, a few cases with sigmoido-vesical fistula as a complication of the disease have been reported. We experienced a case of a 16-year-old boy with pneumaturia due to sigmoido-vesical fistula as a complication of Crohn's disease. PMID- 6485973 TI - [A case of fracture of the penis]. AB - A case of fracture of the penis was presented. A 44-year-old man in the state of morning erection, suddenly heard an abnormal cracking sound while he rolled over in bed. He immediately felt pain of the swelling penis. Surgery was carried out soon after he was admitted. Postoperative course was uneventful, except for slight pain on erection. The Japanese literature was reviewed, and the clinical statistics on 208 patients were summarized. PMID- 6485974 TI - [A case of "verrucous hyperplasia"; a vesical leukoplakia showing unusual macroscopic and histological findings]. AB - A patient who had vesical leukoplakia with unusual macroscopic and histological findings was studied. The mucous membrane of the urinary bladder in this patient showed a tumor-like proliferation similar to verrucous hyperplasia which is often found in the oral mucosa. We propose a new classification of vesical leukoplakia, dividing it into three groups, atrophic, hypertrophic and verrucous types. The atrophic type has a heavily keratinized, flat and thin type of epithelium with features resembling lichen sclerosis et atrophius. Histologically, it shows a variable degree of hyperkeratosis but no parakeratosis. The hypertrophic type has histological characteristics resembling features of leukoplakia in sites elsewhere in the body, which is marked by hyperkeratosis and irregular hyperplasia of the prickle cell layer with lengthening and abnormality in shape of rete pegs. The verrucous type has very rare features of coral shape, white color and verrucous proliferation. Histologically, this type shows severe hyperkeratosis, parakeratosis and elongation of the rete pegs, but no irregular invasion can be observed. PMID- 6485975 TI - [Case of radiation treatment in retroperitoneal hemangiopericytoma]. AB - A 48-year-old woman came to our hospital with complaint of macroscopic hematuria and left lower abdominal pain, on January, 27, 1982. She complained of lower abdominal oppressive pain, but no abdominal tumor was palpated on physical examination. Vaginal examination revealed a stony hard and nodular tumor which was not movable, and as large as a man's fist, on the left side of uterine cervix. IVP revealed left nonfunctioning kidney. Cystoscopy revealed no abnormal finding but left ureteral catheterization could not be done. CTscan revealed intrapelvic homogenous mass which could not be identified from uterus. Pelvic angiography revealed an encasement of the left uterine artery, and moderate hypervascular tumor which deviated the obturatorius artery. Under the diagnosis of retroperitoneal tumor, operation was done on March, 8, 1982. The tumor existed in the retroperitoneal space, and was as large as a man's fist. It was not a movable mass, venous dilatation was found on its surface, and severe adhesion was found between the lateral side of the tumor and the left external iliac artery. So only biopsy was done. Histopathological diagnosis of the specimen was hemangiopericytoma. She received postoperative radiation therapy with total dose 5,000rad in 5 weeks. Now about 2 years have passed, vaginal examination revealed no tumor, and CTscan revealed diminishment of the tumor. Generally radiotherapy is not considered to be effective for hemangiopericytoma, but sometimes it is. Thus preoperative vascular embolization with surgical resection and postoperative radiotherapy or chemotherapy are considered to be necessary for successful treatment of hemangiopericytoma. PMID- 6485976 TI - [A case of the coexistence of renal cysts and renal cell carcinoma associated with direct invasion of the liver (stage IV)]. AB - A 63-year-old male was admitted with a complaint of right abdominal mass. A right renal tumor associated with direct invasion to liver and with lobulated cystic lesion and renal solitary cyst were diagnosed preoperatively by aortography and computed tomography. Transperitoneal radical nephrectomy and partial resection of liver metastasis were performed. Histological diagnosis was clear cell carcinoma with dilated tubuli. Tumor invasion to the inferolateral portion of the liver and to the renal solitary cyst wall were demonstrated by both gross and microscopic examinations. The coexistence of tumor and cyst in the same kidney is rare. Our case probably had both the type I and II or III tumors according to Gibson classification. Twenty months after radical nephrectomy, pulmonary metastases were detected by chest x-ray, tomography and bronchial arteriography. All metastatic lesions were replaced by fibrous change 7 months after the four bronchial arterial infusions (BAI) of ADM 30 mg and irradiation with a dose of 5,000 rads to each lesion. After 9 tumor-free months, recurrence of pulmonary metastases were pointed out by chest x-ray and tomography. They (four coin lesions) were treated with anticancer therapy, mainly irradiation and twice insufficient BAI. Three of them were occupied entirely by fibrous change and another solid one remained in the right pulmonary apex without enlargement for the past 4 months. Radical nephrectomy and partial resection of the liver for the primary renal cell carcinoma with direct invasion to liver, BAI and irradiation for the two pulmonary metastases have kept the patient alive for 4 years. PMID- 6485977 TI - [Effect of SA-504 subtle granules on renal or ureteral calculi]. AB - The effect of the antispasmodic agent, SA-504 subtle granules, was studied. Ninety mg per day of timepidium bromide subtle granules was given orally to 17 patients with renal or ureteral calculi for no less than fourteen days. SA-504 subtle granules as well as the capsule showed good antispasmodic effect and stimulated spontaneous passage of ureteral calculi. No subjective or objective side effects were observed. PMID- 6485978 TI - [Long-term cinoxacin therapy for chronic complicated urinary tract infection]. AB - Twenty-two patients with chronic complicated urinary tract infections were treated with 400 to 1,200 mg/day cinoxacin for 2 to 12 months. Assessment of drug efficacy was based on monthly urinalysis. Clinical response rates were "excellent" in 32.3%, "good" in 27.9%, and "poor" in 39.8% of the participants. Overall effective rate reached 60.2%. No cases of side-effects or toxicity were seen. Long-term cinoxacin therapy is both safe and effective in the treatment of chronic complicated urinary tract infections. PMID- 6485979 TI - Intraventricular conduction defects in acute myocardial infarction: incidence, prognosis, and therapy. PMID- 6485980 TI - Atrial parasystole and amiodarone. PMID- 6485981 TI - Prolonged hemodynamic effect of furosemide in congestive heart failure. PMID- 6485982 TI - Radiation-induced coronary artery disease. PMID- 6485983 TI - Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil: an ECG-electrophysiologic entity. PMID- 6485984 TI - Absent right pulmonary artery with atrial septal defect. PMID- 6485985 TI - Multiple coronary-to-pulmonary artery fistulas with progressive aneurysmal dilatation. PMID- 6485986 TI - Hypocalcemic acute myocardial failure secondary to rapid transfusion of citrated blood. PMID- 6485987 TI - Detection of thrombosed aortic Bjork-Shiley valve by two-dimensional echocardiography. PMID- 6485988 TI - Transient right atrial thrombus resulting in pulmonary embolism detected by two dimensional echocardiography. PMID- 6485989 TI - Dura mater valve endocarditis related to retained fragment of postoperative temporary epicardial pacemaker lead. PMID- 6485990 TI - Diastolic fluttering of interventricular septum in left atrial sarcoma. PMID- 6485991 TI - Transient ST segment elevation during anaphylactic shock. PMID- 6485992 TI - AV block induced by drinking cold liquids. PMID- 6485993 TI - Sinus node dysfunction during coronary vasospastic angina. PMID- 6485994 TI - Two-dimensional echocardiographic findings in double-chambered right ventricle. PMID- 6485995 TI - Adhesive pericarditis with unusual systolic click. PMID- 6485996 TI - Detection and management of coronary artery disease in the asymptomatic population. PMID- 6485997 TI - Thromboxane A2 in acute myocardial infarction. AB - We evaluated the presence of thromboxane B2, the stable metabolite of thromboxane A2, early in the course of acute myocardial infarction (AMI) in both animal and patient studies. In an open-chest model, the left anterior descending artery (LAD) was isolated and the great cardiac vein was cannulated in nine dogs. Following occlusion of the LAD, there was an increase in thromboxane B2 concentration from 0.77 +/- 0.0093 to 1.79 +/- 0.46 pmol/ml (p less than 0.05) and 1.96 +/- 0.48 pmol/ml (p less than 0.05) at 1 and 5 minutes, respectively, following coronary occlusion. At 30 and 60 minutes after occlusion there was no significant increase compared to the baseline. In 17 patients with AMI the mean thromboxane B2 concentration was 0.96 +/- 0.13 pmol/ml at 4.88 +/- 0.40 hours after the onset of chest pain. In 12 patients with sequential samples before and after restoration of patency of the occluded vessel, the initial concentration was 0.71 +/- 0.058 pmol/ml. At 5 minutes after restoration of patency thromboxane B2 concentration was 1.1 +/- 0.17 pmol/ml (p = 0.05). One hour later a return to baseline was noted (0.82 +/- 0.75 pmol/ml). Two patients with the highest thromboxane B2 concentrations (2.0 and 2.6 pmol/ml) were unable to have successful recanalization. We conclude that generation of thromboxane A2 occurs during the early stages of AMI and may be an important pathophysiologic phenomenon in AMI. PMID- 6485998 TI - Contrasting incidence, inducibility, and transmural sites of origin of ventricular arrhythmias during acute coronary occlusion and reperfusion. AB - The incidence, inducibility, and sites of origin of ventricular arrhythmias were studied in 16 open-chest dogs. The dogs were placed on cardiopulmonary bypass. Electrograms from ischemic endocardium and epicardium and normal epicardium were recorded with bipolar composite electrodes. Burst pacing was used to induce arrhythmias. Dogs were studied in the control state, 15 minutes after left anterior descending coronary artery occlusion, and during reperfusion performed after 20 minutes of occlusion. Ventricular fibrillation was seen more commonly (in 8 of 14 dogs) during reperfusion than during occlusion (in 4 of 13 dogs). Continuous fragmented electrical activity was first recorded on the ischemic zone epicardium in six of eight episodes during occlusion arrhythmias and on the endocardium in 25 of 33 episodes during reperfusion. These data may relate to the effects of varying degrees of ischemia and reperfusion on conduction characteristics of the respective layers. PMID- 6485999 TI - Electrophysiologic effects of amiodarone: experimental and clinical observation relative to serum and tissue drug concentrations. AB - Oral amiodarone is a potent antiarrhythmic agent with a slow onset of action. Its electrophysiologic properties following chronic administration are well known, but its acute electrophysiologic actions are poorly defined. The objectives of the present study were to correlate the electrophysiologic actions of intravenous amiodarone in humans with the acute and chronic effects of the drug relative to plasma and tissue concentrations of the drug. In humans (n = 10), 5 mg/kg intravenous amiodarone (serum concentration 6.50 +/- 3.34 micrograms/ml at 10 minutes; 2.13 +/- 0.71 micrograms/ml at 20 minutes, n = 7) increased the AH interval by 16.4% (p less than 0.005), the antegrade effective refractory period (ERP) of the atrioventricular (AV) node by 14.4% (p less than 0.025), and the functional refractory period (FRP) of the AV node by 15.5% (p less than 0.005). The ERP or FRP of the atrium of the right ventricle was not significantly changed; there was no effect on the HV interval or the QT and R-R intervals of the ECG. In rabbits (n = 11) given 10 mg/kg intravenous amiodarone (mean +/- SD serum concentration 0.49 +/- 0.17 micrograms/ml; mean myocardial concentration 7.0 +/- 1.9 micrograms/gm, n = 3), there were no significant effects on the ECG intervals. In isolated rabbit sinoatrial (SA) node, atria, and AV node (three preparations) superfused with 5 X 10(-6)M amiodarone (3.41 micrograms/ml), there was no effect on the action potential duration (APD) or other parameters of the transmembrane potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486000 TI - Transient U wave inversion during variant angina. AB - We studied the prevalence and clinical significance of transient U wave inversion in 43 patients with variant angina. Twenty-four patients (group A) had ST segment elevation in the anterolateral and 19 patients (group B) had this finding in the inferoposterior leads of the ECG during spontaneous angina. In none of these patients was U wave inversion present on the resting 12-lead ECG in the absence of anginal attack. During anginal attacks, U wave inversion developed in association with ST segment elevation in 16 patients (66.7%) of group A but in no patient of group B. To exclude the possibility that a transient rise of systolic blood pressure during angina caused U wave inversion, treadmill exercise testing was done in the 16 patients after the discontinuation of antianginal drugs. In 12 of the 16 patients, exercise testing did not produce angina or U wave inversion despite a marked elevation of systolic blood pressure. These results indicate that transient U wave inversion frequently develops with anterolateral ischemia but not with inferoposterior ischemia during attacks of variant angina. It is likely that transient U wave inversion was caused by myocardial ischemia but not by a rise of blood pressure during angina. PMID- 6486001 TI - Evaluation of noninvasive tests for identifying patients with preexcitation syndrome at risk of rapid ventricular response. AB - Intermittent preexcitation, block in the accessory pathway after intravenous injection of ajmaline or procainamide, and block in the accessory pathway during exercise usually exclude a short antegrade refractory period of an accessory pathway in patients with the Wolff-Parkinson-White syndrome. This report describes three patients with these findings suggestive of a relatively long antegrade effective refractory period of the accessory pathway in whom life threatening ventricular response occurred during atrial fibrillation. In the first patient with a pattern of intermittent preexcitation, rapid ventricular response with wide QRS was present during atrial fibrillation. In the second patient in whom preexcitation disappeared after intravenous injection of ajmaline or procainamide as well as during exercise testing, atrial pacing showed 1:1 conduction over the accessory pathway at a cycle length of 220 msec and the shortest R-R interval during induced atrial fibrillation was 190 msec. The third patient, with no evidence of preexcitation during sinus rhythm, presented antidromic reciprocating tachycardia and atrial fibrillation with life threatening ventricular response, the minimal R-R interval being 220 msec. Noninvasive tests in the preexcitation syndrome lack sufficient prognostic sensitivity. The evaluation of ventricular response during induced atrial fibrillation represents the most reliable means of identifying such patients at risk. PMID- 6486002 TI - The effect of electrode position on atrial sensing for physiologically responsive cardiac pacemakers. AB - Fully automatic pacing systems rely on accurate identification of spontaneous atrial signals for physiologically responsive pacing. These signals must be discriminated from far-field ventricular activity, which might otherwise be sensed in the atrium. To amplify on the previously reported superiority of bipolar signals and high-impedance circuitry for atrial sensing, we studied the effects of various intraatrial electrode positions on the atrial and ventricular contribution to electrograms recorded in this chamber. Compared with other intraatrial endocardial sites, right atrial signals were greatest in amplitude and slew rate in the appendage (RAA), averaging 3.3 +/- 0.41 mV and 1.15 +/- 0.16 V/sec (mean +/- SEM), respectively. These values were substantially higher than in the low atrium (p less than 0.001 and 0.0005 for amplitude and slew rate, respectively) and the high lateral atrium (p less than 0.05 for slew rate). Appendage atrial electrograms also had significantly higher amplitude and slew rate than far-field R waves recorded here (p less than 0.0001 for both). Additionally, the greatest difference in spectral content between atrial and far field ventricular signals was also observed in the RAA. Thus, parameters in the domain of both time and frequency identified the RAA as the superior location for atrial sensing. Except for phrenic nerve problems with pacing, the HRA also appears to be a suitable electrode location for sensing. These considerations are germane in light of a growing number of atrial active and passive fixation leads now being employed for physiologic pacing. PMID- 6486003 TI - Limitations of visual assessment of redistribution in thallium images. AB - Potential limitations of visual assessment of redistribution in thallium (TI) images were studied and results were compared with computer assessment of redistribution. A four-section phantom filled with TI was imaged (300K counts, 128 X 128 matrix) with appropriate background activity and scatter material. Activity in a "defect" section (DS) was varied from 20% to 100% of reference sections (RS). After interpolative background correction, pseudo "initial" and "late" image pairs (N = 35) were photographed on polaroid film and read by three "blinded" observers using an 0-2, 1/2 step, scale (0 = absent and 2 = normal activity). Scan defects were detected by all readers when DS activity was less than or equal to 59% of RS activity. No reader detected a defect when DS activity was greater than or equal to 67% of RS activity. All "initial" defects were detected by computer analysis. Visual assessment of "initial" DS:RS activity ratio did not correlate well with DS:RS activity ratio of the phantom. In contrast, computer assessment of "initial" DS:RS activity ratio correlated well with phantom DS:RS activity ratio (r = 0.96, p less than .0001). Although 22 of 27 scan pairs with partial (N = 26) or full (N = 1) redistribution were correctly identified as showing redistribution by at least two of three observers, the extent of redistribution was not estimated well by visual analysis. Thus, visual assessment of absolute change ("initial"-to-"late") in DS:RS activity ratio showed considerable scatter in relations to actual changes in DS:RS activity ratio of the phantom.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486004 TI - Can areas of myocardial ischemia be localized by the exercise electrocardiogram? A correlative study with thallium-201 scintigraphy. AB - In order to determine whether areas of ischemia identified by thallium-201 scintigraphy could be localized by exercise ECG, we studied 54 patients with stable coronary heart disease. All 54 patients had exercise-induced thallium-201 scintigraphic defects. Their exercise ECG test results were compared to their thallium-201 images and also to 14 low-risk normal subjects. Exercise data were analyzed for spatial ST vector shifts, using a computer program in order to most accurately classify ST segment depression and elevation. Thallium-201 ischemic defects detected in our patients included areas in the septum and the inferior, lateral, and anterior walls. Twenty-six of these 54 patients also had coronary angiography for classification and comparison as having either localized or generalized disease. None of the scintigraphic ischemic sites or angiographic diseased areas could be specifically identified by exercise-induced ST vector shifts. Therefore, the surface exercise ECG has limitations in localizing ischemia to specific areas of the myocardium. PMID- 6486005 TI - Limitations of quantitative phase analysis of radionuclide angiograms for detecting coronary artery disease in patients with impaired left ventricular function. AB - Phase analysis of radionuclide ventriculograms is used for identifying ischemic wall motion abnormalities. Myocardial segments with an abnormal phase, that is, delayed onset of wall motion, can be localized on a phase distribution image, and the synchronicity of left ventricular (LV) wall motion can be assessed from a histogram of LV phase distribution. The standard deviation of the LV peak on this histogram (SDP-LV) describes the width of the peak and is used as an index of the synchronicity of wall motion. We examined in this study the sensitivity of SDP-LV for identifying coronary artery disease (CAD) and its specificity in patients with normal and various degrees of LV impairment. A total of 84 patients were studied. Forty-five patients had CAD and 39 had congestive cardiomyopathy or valvular heart disease. Patients were grouped according to their LV ejection fraction (EF). In group I (37 patients) resting LVEF was equal to or greater than 50%, in group II (24 patients) it ranged from 35% to 50%, and in group III (23 patients) it was less than 25%. SDP-LV was highly specific in groups I and II for CAD with sensitivities of 48% and 89% at rest that increased with exercise to 88% and 100%. In group III patients, SDP-LV remained highly sensitive but was no longer specific for CAD. Therefore, in severe LV impairment, phase analysis does not aid in distinguishing CAD from other causes of ventricular dysfunction. By contrast, phase analysis is highly sensitive and specific for CAD in patients with normal or moderately depressed LV function. PMID- 6486006 TI - Right ventricular function evaluated by radionuclide angiography in acute myocardial infarction. AB - Radionuclide angiographic studies were performed in 26 patients with a first myocardial infarction, 11 with anterior and 15 with an inferior location. Right ventricular (RV) and left ventricular (LV) ejection fractions (EF) were determined. Mean LVEF in anterior infarctions (33.2 +/- 7.3) was lower than in inferior myocardial infarctions (59.9 +/- 10.2) (p less than 0.001). Mean RVEF in the anterior infarct group was 41.3 +/- 15.1 and in the inferior myocardial infarction group 33.7 +/- 12.8 (p = NS). RVEF was less than 40% in 11 of 15 (73%) with inferior and 7 of 11 (66%) with anterior myocardial infarction. The ratio of LVEF:RVEF was 0.84 +/- 0.19 in the anterior and 2.13 +/- 1.28 in the inferior myocardial infarction group (p less than 0.001). LVEF correlated with RVEF in patients with anterior infarcts (r = 0.77; p less than 0.05) but not in those with inferior myocardial infarction (r = 0.14). RV regional wall motion abnormalities were observed in the inferolateral zones in 10 of 15 (66%) with inferior and in none of the 11 patients with anterior myocardial infarctions (p less than 0.001). Inferoseptal wall motion abnormalities were observed in 3 of 15 (20%) with inferior and 6 of 11 (56%) with anterior myocardial infarctions (p = NS). RV dysfunction in the inferior infarctions is probably an expression of primary RV dysfunction rather than secondary to LV dysfunction. RV dysfunction was proportional to LV dysfunction in the anterior infarction group and was often accompanied by RV septal contraction abnormalities. PMID- 6486007 TI - Effects of the presence or absence of preceding angina pectoris on left ventricular function after acute myocardial infarction. AB - Left ventricular (LV) function was evaluated in 31 patients, who had total occlusion of the left anterior descending coronary artery and less than 70% stenosis of the other two major coronary arteries or any branch. Fifteen of 31 patients had a history of angina pectoris before acute myocardial infarction (AMI) and 16 of 31 patients had no history of angina pectoris before AMI. The patients with angina pectoris before AMI had a significantly better ejection fraction, percentage of abnormally contracting segment, and regional wall motion than those without angina pectoris before AMI. These data suggest that the symptom of angina pectoris before AMI could be a favorable sign in preserving LV function when the patients subsequently had AMI. PMID- 6486008 TI - Coronary angiography during exercise-induced angina with ECG changes. AB - Coronary angiography was performed at rest and during bicycle exercise immediately after the onset of angina and significant ST segment elevation or depression in the ECG. Of 11 patients, six showed significant reduction of coronary lumen diameter at the site of organic stenosis; mean values of stenosis (range) before and during exercise were 55% (25% to 88%) and 98% (89% to 100%), respectively. Five patients did not have any diameter change of the organic lesion; mean values of stenosis (range) before and during exercise were 84% (74% to 89%) and 84% (73% to 92%), respectively. Excluding the areas of these stenoses, diameters of left main coronary artery, proximal, middle, and distal left anterior descending, circumflex, and right coronary artery segments were measured before and during exercise. Diameter in each coronary artery segment during exercise was not significantly changed from that before exercise, both in the groups with and without diameter reduction. Exercise provoked a localized worsening of coronary artery stenosis without changing the diameter in the remaining artery. These findings suggest that the worsening of stenosis might be caused by a regional abnormality of the coronary artery that is not necessarily related to the degree of organic stenosis. PMID- 6486009 TI - Transtelephonic electrocardiographic monitoring: reliability in detecting the ischemic ST segment response during exercise. AB - The ECG detection of ST segment depression during maximal treadmill exercise has diagnostic and prognostic significance in coronary artery disease. This study of 200 consecutive patients undergoing Bruce exercise testing for chest pain documents the ability of a transtelephonic ECG system, capable of storing segments of ECG memory during exercise, to reliably record ST segment depression detected during simultaneous exercise testing (sensitivity 79%; specificity 99.6%). Of the three transtelephonic ECG systems tested, the modified precordial V5 snap-on lead most accurately reflected ST segment amplitude and morphology with no "false positives" (specificity 100%) and few "false negatives" (sensitivity 78%). Therefore, this system is a potentially important clinical tool for accurately and conveniently monitoring coronary patients during exercise outside the hospital (e.g., following myocardial infarction) as well as for providing useful clinical information for ambulatory patients with undiagnosed sporadic chest pain. PMID- 6486010 TI - Body surface isopotential maps in old anterior myocardial infarction undetectable by 12-lead electrocardiograms. AB - Body surface isopotential maps were recorded in 30 normal subjects and 32 patients with clinical evidence of old anterior myocardial infarction but without ECG findings of infarction. Position of the minimum in maps was compared at 5 msec intervals from the onset of QRS between the normal and infarction groups. A significant difference in the mean position of the minimum was observed at 5, 10, 15, 20, and 25 msec (p less than 0.001). The minima for the two groups achieved their clearest separation at 15 msec. Twenty-six of the 32 infarction patients showed the minima on the anterior chest, but 29 of the 30 normal subjects showed the minima on the back. These findings suggest the highly specific usefulness of body surface maps for the diagnosis of the presence of old anterior infarction undetectable by 12-lead ECGs. PMID- 6486011 TI - Directional variability in the R wave response during serial exercise testing in patients with coronary artery disease. AB - The reproducibility of the direction of R wave amplitude response to exercise was analyzed in patients with coronary artery disease. Forty-three serial exercise tests were performed by 10 patients with exertional angina pectoris and documented coronary artery disease (CAD). Seventeen tests (37%) resulted in no change or an increase in R wave amplitude (abnormal response). Twenty-six tests (63%) resulted in a decrease in R wave amplitude. The direction of the R wave amplitude response was variable in at least one exercise test in 7 of 10 patients with CAD, all of whom had reproducible ischemic ST segment responses during serial testing. The inconsistent R wave response in these patients was unrelated to heart rate, workload, or duration of exercise. Because of the variability in the directional R wave response during serial exercise testing in CAD patients, we conclude that the R wave response during exercise is unreliable for the detection of CAD or ischemia-related myocardial dysfunction. PMID- 6486012 TI - Evaluation of habitual excessive alcohol consumption on myocardial infarction risk in coronary disease patients. AB - Overt coronary heart disease does occur at times in a setting of alcoholism. In an attempt to test the hypothesis that habitual excessive drinking may have an aggravating effect upon coexisting ischemic heart disease and may help precipitate new coronary events, we compared myocardial infarct prevalence among heavy drinkers and non-heavy drinkers with angiographically documented coronary artery disease. Infarct prevalence was found to be higher for heavy drinkers than for non-heavy drinkers under age 60 years, after controlling for differences in smoking habits and underlying atherosclerosis severity. A reversal in trend which may be due to the operation of selective factors causing premature coronary death among alcoholics was observed for individuals above age 60 years. These results, although open to differing interpretations, are consistent with the notion that heavy drinking has a destabilizing effect upon preexisting ischemic heart disease and may increase acute coronary event risk. PMID- 6486013 TI - Prescription drug abuse and misuse: primary prevention programs are needed. PMID- 6486014 TI - New ideas for pharmacy's "Foundation Organization". An interview with APhA President John F. Schlegel [by John Covert]. PMID- 6486015 TI - Improving patient compliance. PMID- 6486016 TI - Extemporaneous compounding: promotional and legal aspects. PMID- 6486017 TI - Concerning the case of United States v. American Pharmaceutical Association and Michigan State Pharmaceutical Association Civil No. G75-558, CA5, W.D. Michigan. PMID- 6486018 TI - Influence of baseline ejection fraction and success of thrombolysis on mortality and ventricular function after acute myocardial infarction. AB - The efficacy of streptokinase (STK) thrombolytic therapy was prospectively evaluated in 77 consecutive patients presenting within 9 hours of onset of acute myocardial infarction. Serial left ventricular (LV) ejection fraction (EF) was assessed by radionuclide ventriculography, initially (acute) and at 1 month (late). The role of initial LVEF was examined by comparing patients with an acute LVEF greater than or equal to 50% (type I) with those with LVEF less than 50% (type II). Sixty-five patients (84%) had total coronary occlusion and received STK. Initial successful reperfusion was achieved in 34 patients (52%), but repeat angiograms at 10 to 14 days revealed persistent patency in only 27 patients. Within the type I and type II classification, 2 patient subgroups were compared: Group A had successful and persistent thrombolysis and group B had initial failure of thrombolysis or in-hospital reocclusion. There was no significant change in global LVEF in any group from acute to 1 month follow-up: group IA- acute EF = 56 +/- 2% (mean +/- standard error of the mean), late EF = 55 +/- 2% (p = not significant [NS]); group IB--acute EF = 58 +/- 1%, late EF = 55 +/- 2% (NS); group IIA--acute EF = 35 +/- 2%, late EF = 4 +/- 4%, (NS); group II B- acute EF = 36 +/- 2%, late EF = 41 +/- 3% (NS). No patient with an acute EF greater than or equal to 50% died, i.e., group IA patients (n = 7) or group IB patients (n = 13).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486020 TI - Validity of serum total cholesterol level obtained within 24 hours of acute myocardial infarction. AB - The relation of a serum cholesterol level obtained during acute myocardial infarction (AMI) to the patient's usual baseline level is unclear. Many physicians tend to ignore cholesterol levels measured during AMI and will wait several months before obtaining a repeat cholesterol measurement; in many instances this delays interventional programs. Using the Framingham study cohort of patients, the records of all persons sustaining AMI were reviewed. Eighty three patients were identified who had total cholesterol (TC) levels recorded within 2 years of AMI, within 24 hours of hospitalization for AMI and within 2 years after hospital discharge. In these persons, there was no statistically significant difference in the TC values measured at these 3 times. Thus, TC levels drawn within the first 24 hours of AMI accurately reflect a baseline level and can be used in instituting intervention programs. PMID- 6486019 TI - Systemic markers of fibrinolysis after unsuccessful intracoronary streptokinase thrombolysis for acute myocardial infarction. Does nonreperfusion indicate failure to achieve a systemic lytic state? AB - Reasons for the failure of intracoronary streptokinase (STK) to result in coronary thrombolysis were examined in 45 patients with acute myocardial infarction presenting with angiographic evidence of total coronary occlusion. In 25 patients (group A), clot lysis was initially successful; in 20 (group B), reperfusion was unsuccessful. The STK dosage in group A ranged from 84,000 to 310,000 units (mean 188,000 +/- 12,000); STK dosage in group B ranged from 160,000 to 360,000 units (mean 267,000 +/- 11,000 [p less than 0.05]). Before therapy, levels of fibrin degradation products and serum fibrinogen were normal in all patients. After intracoronary STK, fibrin degradation products and serum fibrinogen levels changed similarly in both groups. Eight-five percent of patients in group B had evidence of a systemic fibrinolytic state. These data suggest that higher doses of STK administered in the same manner are unlikely to result in an increased reperfusion rate. Systemic hematologic markers of fibrinolysis are not helpful in explaining the success or failure of intracoronary thrombolysis. PMID- 6486021 TI - Estimation of inferobasal myocardial infarct size by late activation abnormalities of the QRS complex. AB - This report describes the relation of myocardial infarct (MI) size in the left ventricular inferobasal wall, measured at necropsy, to late activation abnormalities of the QRS complex, measured by computerized spatial vectorcardiography. Fifteen patients with single inferobasal MIs and 10 patients with no evidence of heart disease were studied. The percentage of MI in the inferobasal wall was significantly related to the vectorcardiographic abnormalities noted late (i.e., 31 +/- 13 ms before the end of the QRS waveform) (r = 0.96, p less than 0.00001). The integral of the vector magnitudes during late abnormal activation significantly predicted the amount of MI in the basal inferior wall (r = 0.88) and in the basal inferior wall plus the outer, subepicardial half of the transmural middle inferior, lateral and inferoseptal walls (r = 0.91). The additional information obtained from late activation of the QRS complex contributed more significance to the estimation of the left ventricular inferobasal MI size than the abnormalities commonly noted during early activation (i.e., during the Q wave). PMID- 6486022 TI - Hemodynamic effects of intravenous diltiazem with impaired left ventricular function. AB - The acute hemodynamic effects of intravenous diltiazem were studied in 8 patients with coronary artery disease, left ventricular (LV) failure (New York Heart Association functional class III), a rest ejection fraction (EF) less than 40% or a cardiac index less than 2.4 liters/min/m2. Hemodynamic measurements and LV angiograms were performed at rest before and after the administration of diltiazem, 0.5 mg/kg, administered at a speed of 5 mg/min. Diltiazem treatment induced a decrease in heart rate from 68 +/- 12 to 55 +/- 9 beats/min (p less than 0.001). Mean aortic pressure decreased from 94 +/- 14 to 81 +/- 15 mmHg (p less than 0.05). Thus, the pressure-rate product significantly decreased under the influence of the drug, from 8,791 +/- 2,465 to 6,342 +/- 1,808 beats mm Hg/min, (p less than 0.001). Diltiazem induced no significant change of LV end diastolic pressure, pulmonary wedge pressure, cardiac index and LV stroke work index. Systemic vascular resistance decreased (p less than 0.01), whereas pulmonary vascular resistance showed no change. End-systolic volume diminished (p less than 0.02), which accounts for the increase of stroke volume and ejection fraction (p less than 0.001). Disorders of regional contractility were not aggravated by diltiazem, and even improved in individual cases. Thus, intravenous diltiazem may be used safely in patients with heart failure. However, in view of the marked bradycardic effects seen in some cases, heart rate should be carefully monitored. PMID- 6486023 TI - Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy. AB - Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy. PMID- 6486024 TI - Atrial conduction: effects of extrastimuli with and without atrial dysrhythmias. AB - The effects of cycle length and stimulation site on intraatrial conduction and refractoriness were evaluated in patients with and without atrial flutter (AFI) or fibrillation (AF) using the extrastimulus technique. Nineteen patients with spontaneous sustained AFI or AF were compared with 19 control patients. Programmed stimulation was performed at the right atrium and coronary sinus at drive cycle lengths of 600 and 450 ms. The atrial effective refractory period was similar in the patients with atrial dysrhythmias and the control group. The right atrial effective refractory period at a drive cycle length of 600 ms was significantly shorter in patients with AF (211 ms) than in patients with AFI (235 ms, p = 0.05). The conduction time of late (coupling intervals more than 50% of the drive cycle length) premature impulses was similar in the patients with atrial dysrhythmias and the control group. However, early extrastimuli (coupling intervals less than 50% of the drive cycle length) at a drive cycle length of 600 ms produced significantly more intraatrial conduction delay in the patients with atrial dysrhythmias than in the control patients. At a drive cycle length of 450 ms, similar delays in intraatrial conduction occurred in the patients with and without atrial dysrhythmias because of an increase in the maximal-observed intraatrial conduction delay in the control patients. This study shows that delay in conduction of early premature atrial stimuli at a drive cycle length of 600 ms is a marker of patients with spontaneous AFI and AF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486025 TI - Prevalence and prognosis of exercise-induced nonsustained ventricular tachycardia in apparently healthy volunteers. AB - Although exercise-induced ventricular tachycardia (VT), whether sustained or nonsustained, is usually associated with significant organic heart disease, its prevalence, associated characteristics and prognostic significance in an asymptomatic, unreferred community-dwelling population are unknown. Therefore, the prevalence of VT associated with maximal treadmill exercise was assessed in 597 male and 325 female volunteers, aged 21 to 96 years (mean +/- standard deviation 54 +/- 16), from the Baltimore Longitudinal Study on Aging who were without apparent heart disease. Ten subjects, 7 men and 3 women, with exercise induced VT were identified, representing 1.1% of those tested; only 1 was younger than 65 years. All episodes of VT were asymptomatic and nonsustained. In 9 of 10 subjects, VT developed at or near peak exercise. The longest run of VT was 6 beats; multiple runs of VT were present in 4 subjects. Two subjects had exercise induced ST-segment depression, but subsequent exercise thallium scintigraphic results were negative in each. Compared with a group of age- and sex-matched control subjects, those with asymptomatic, nonsustained VT displayed no difference in exercise duration, maximal heart rate, or the prevalence of coronary risk factors or exercise-induced ischemia as measured by electrocardiography and thallium scintigraphy. Over a mean follow-up period of 2 years, no subject has developed symptoms of heart disease or experienced syncope or sudden death. Thus, exercise-induced VT in apparently healthy subjects occurs almost exclusively in the elderly, is limited to short, asymptomatic runs of 3 to 6 beats usually near peak exercise, and does not portend increased cardiovascular morbidity or mortality rates over a 2-year period of observation. PMID- 6486026 TI - Facilitation of ventricular tachyarrhythmia induction by isoproterenol. AB - Ventricular tachyarrhythmia induction was facilitated during infusion of isoproterenol in 21 of 60 patients with ventricular tachycardia (VT) or ventricular fibrillation (VF) in whom programmed electrical stimulation alone failed to reproducibly induce sustained ventricular tachyarrhythmias. Of 44 patients with no ventricular tachyarrhythmias induced before isoproterenol infusion, 11 had a sustained ventricular tachyarrhythmia and 1 patient had unsustained VT induced by isoproterenol alone or by programmed stimulation during the infusion. In 9 of 16 patients in whom nonreproducible or unsustained ventricular tachyarrhythmias were induced before isoproterenol infusion, more reproducible or more sustained ventricular tachyarrhythmias were induced during the infusion. Tachyarrhythmia induction was facilitated by isoproterenol in 20 of 40 patients with sustained VT clinically, but in only 1 of 20 patients with unsustained VT or VF clinically. Among patients with sustained VT clinically, those with exercise-provoked VT and those who had not been tested with stimulation at a second right ventricular site or in the left ventricle were more likely to have induction facilitated by isoproterenol. Drugs effective against induction of isoproterenol-facilitated ventricular tachyarrhythmias were identified in 13 of 25 trials. These drugs were effective during a mean follow-up of 17 months in 7 of 9 long-term trials. PMID- 6486027 TI - Congestive heart failure with normal systolic function. AB - Although there have been isolated reports of congestive heart failure (CHF) with normal systolic function, the prevalence and characteristics of this condition have not previously been described. Accordingly, 188 patients with CHF undergoing radionuclide ventriculography were prospectively evaluated. Sixty-seven (36%) had a normal ejection fraction (EF) of 0.45 or greater, and 121, an abnormal EF of less than 0.45. Of these, 72 (55 with an abnormal EF [group I] and 17 with a normal EF [group II]) were also reviewed for clinical characteristics. There was no demographic difference between groups, except that systemic hypertension appeared to be a contributing factor in 65% of the patients in group II, compared with 23% of the patients in group I (p less than 0.002). Echocardiographic left atrial emptying index, reflecting left ventricular compliance, was determined in 72 patients and 14 normal subjects. Left atrial emptying index in normal control subjects was 0.93 +/- 0.11 (+/- standard deviation), compared with 0.41 +/- 0.18 in group I and 0.44 +/- 0.19 in group II patients (p less than 0.001 vs control in both groups). Thus, normal systolic function is common among patients with CHF. Diastolic dysfunction, consistent with a noncompliant left ventricle, was found in both CHF groups. PMID- 6486028 TI - Comparison of myocardial catecholamine balance in chronic congestive heart failure and in angina pectoris without failure. AB - To evaluate myocardial catecholamine balance in heart failure, systemic hemodynamics, coronary sinus blood flow, and arterial and coronary sinus venous norepinephrine (NE) and epinephrine (E) concentrations were determined in 30 patients with chronic left ventricular failure (CHF), and in 25 patients with angina pectoris (AP) but without heart failure. In the group with CHF, stroke work index was lower (CHF 20 +/- 9, AP 53 +/- 13 g-m/m2, p less than 0.001) and pulmonary capillary wedge pressure higher (CHF 28 +/- 8, AP 11 +/- 4 mm Hg, p less than 0.001), indicating depressed left ventricular function. Coronary sinus blood flow was similar in 2 groups (CHF 97 +/- 70, AP 73 +/- 32 ml/min, difference not significant). In the group with CHF, arterial (634 +/- 582 pg/ml) and coronary sinus venous (1,038 +/- 1,014 pg/ml) NE concentrations were significantly higher than in the group with AP (arterial 185 +/- 135, coronary sinus 231 +/- 167 pg/ml, p less than 0.001). The net myocardial NE release in patients with CHF was approximately 20 times higher than that in patients with AP (CHF 38,548 +/- 48,622, AP 2,245 +/- 10,242 pg/min, p less than 0.001). Arterial E and myocardial E uptake was similar in both groups. Although mechanisms for increased myocardial net NE release remains unknown, it probably represents enhanced cardiac sympathetic tone in response to heart failure. PMID- 6486029 TI - Detection of coronary artery disease in aortic stenosis by exercise gated nuclear angiography. AB - Because the clinical diagnosis of coronary artery disease (CAD) in the presence of aortic stenosis (AS) is difficult, the value of exercise gated nuclear angiography in detecting CAD in 33 patients with AS was assessed. Exercise left ventricular (LV) ejection fraction (EF) and wall motion analysis were evaluated after symptom-limited supine cycle ergometer exercise. Sixteen patients had severe AS (valve area 0.8 cm2 or less). Thirteen had significant associated CAD (50% or greater reduction in luminal diameter of 1 major coronary artery). Twenty patients had normal coronary arteriograms. All 10 patients with mild to moderate AS and normal coronary arteries had normal nuclear studies. Patients with CAD, regardless of the severity of AS, had a decrease in LVEF during exercise (12 of 13 patients) and regional wall motion abnormalities (11 of 13 patients). Abnormal exercise gated nuclear ventriculographic studies occurred in the absence of CAD in 10 of 20 patients, and all had severe AS (mean aortic valve area 0.8 cm2 or less, range 0.4 to 0.8). Ten had an abnormal LVEF response to exercise and 7 had exercise-induced abnormal wall motion. These findings suggest that the presence of an abnormal LVEF, whether in conjunction with an abnormal wall motion analysis, is indicative of further invasive evaluation; conversely, in those patients with a normal response of LVEF and normal wall motion during exertion, invasive studies may be safely deferred. PMID- 6486030 TI - Sensitivity and specificity of two-dimensional echocardiographic signs of mitral valve prolapse. AB - The sensitivity and specificity of previously described 2-dimensional echocardiographic signs of mitral valve prolapse (MVP) were assessed in 70 patients with MVP and in 100 normal control subjects. Specificity of individual signs was uniformly high, ranging from 88% for excessive motion of the posterior mitral ring to 100% for several signs including systolic arching in the parasternal long-axis view, excessive posterior coaptation and diastolic doming of the anterior mitral leaflet. Sensitivity of individual signs was low to moderate, ranging from 1% for whip-like motion of both mitral leaflets to 70% for excessive posterior coaptation of the mitral leaflets in the apical 4-chamber view. The highest sensitivity value (87%) was associated with the presence of systolic arching of 1 or both mitral leaflets in the parasternal long-axis view or systolic bowing of 1 or both mitral leaflets in the apical 4-chamber view or excessive posterior coaptation of the mitral leaflets or a combination. This increase in sensitivity was achieved without sacrificing specificity (97%). Thus, the individual 2-dimensional echocardiographic signs tested possess uniformly high specificity, but only low to moderate sensitivity; however, sensitivity can be markedly enhanced without sacrificing specificity by using selected combinations of echocardiographic signs. PMID- 6486031 TI - How important are dental procedures as a cause of infective endocarditis? AB - Eighteen pediatric patients with infective endocarditis (IE) were reviewed for "failure" of chemoprophylaxis; none had had a previous dental procedure. Surprisingly, published reports reveal a similarly low prevalence of dental extractions preceding IE, only 3.6% for 1,322 cases. Although bacteremia was associated with 40% of 2,403 reported extractions, it also was found in 38% of patients after mastication, and in 11% of patients with oral sepsis and no intervention. In a hypothetical month, ending with a single dental extraction, the cumulative exposure to these "physiologic" sources of bacteremia is nearly 1,000 times greater than it is from extraction. The current American Heart Association recommendations for intramuscular or intravenous chemoprophylaxis are impractical, and the discomfort and inconvenience may impede good dental care. The Committee also implies that gingival bleeding allows bacterial access to the blood stream, whereas experimental studies establish the lymphatics as the only access. Although oral chemoprophylaxis for major dental procedures appears prudent, the British regimen of a single dose of amoxicillin administered orally is much simpler and probably more effective. However, scrupulous oral and dental hygiene is undoubtedly superior in preventing IE than any chemoprophylaxis regimen. PMID- 6486033 TI - The univentricular atrioventricular connection: getting to the root of a thorny problem. AB - Most hearts described as "single ventricle" or "univentricular heart" possess 2 ventricular chambers, even though 1 is usually described as an "outlet chamber." This stems from the wide acceptance that the criterion of a single ventricle is the presence of a double-inlet atrioventricular (AV) connection. In recent years, using this criterion, an attempt was made to show how hearts with double-inlet right ventricle or "classic tricuspid atresia" were (in terms of ventricular morphology) just as univentricular as "single ventricle with outlet chamber." This attempt brought still further confusion to an already contentious topic. The root of the problem clearly is the injudicious use of the adjective "single" or "univentricular." Conventionally it is used to describe the ventricular mass. In most hearts with double-inlet connection it is not the ventricles that are univentricular; it is the AV connection. The concept of a univentricular AV connection, then, appropriately groups hearts with double-inlet along with those having absence of 1 AV connection. It distinguishes this entire group from those other hearts with biventricular AV connections (each atrium connected to its own ventricle). The term "univentricular AV connection" is thus a collective one for all those hearts in which the atria connect to only 1 ventricle. Confusion will be completely removed if individual hearts are described for what they are in terms of AV connection and ventricular morphology (for example, double-inlet left ventricle with rudimentary right ventricle rather than single ventricle with outlet chamber). PMID- 6486032 TI - Early and intermediate-term (10-year) results of surgery for univentricular atrioventricular connection ("single ventricle"). AB - One hundred sixteen patients with "single ventricle" underwent 147 operations between 1967 and July 1982, with an actuarial survival rate (hospital deaths are included in all actuarials) at 10 years of 66%. One hospital death (2%) occurred after 45 primary "classic" shunting operations, and the 10-year actuarial survival was 85%. There were no hospital deaths after atrial septectomy or pulmonary artery banding, and the 10-year actuarial survival rate after these as initial procedures was 76% and 74%, respectively. Thirteen of 36 patients (36%) who underwent ventricular septation between 1967 and November 1, 1983, died in hospital. Among the 13 with the ideal morphologic characteristics of double inlet left ventricle without major associated cardiac anomalies, and without the need for valve replacement or a valved extracardiac conduit, there were no hospital deaths and a late survival rate of 77% (confidence limits 59 to 90%). Sixteen of 73 patients (22%), including those with tricuspid atresia, undergoing the Fontan type procedure between 1967 and November 1, 1983, died in hospital. Multivariate analysis indicates that cardiac morphologic patterns other than tricuspid atresia are risk factors for hospital death in this group. The 10-year actuarial survival rate among the 73 patients was 71%, but only 1 death (associated with reoperation) occurred more than 2 months after operation. Ninety-seven percent of all surviving patients are in New York Heart Association functional class I or II, as are 100% of those who underwent septation and 96% of those who underwent the Fontan-type procedure. PMID- 6486034 TI - Interruption of the aortic arch and coarctation of the aorta: pathogenetic relations. AB - The pathologic anatomic features and associated cardiac anomalies of 63 cases of interruption of the aortic arch (IAA) type A (54 reported and 9 observed) and 145 cases of type B (124 reported and 21 observed) were analyzed and compared with those seen in 57 autopsy cases of infant coarctation of the aorta (CA). There was no significant sex predominance within the 3 groups and the prognosis without surgery was uniformly poor. Ventricular septal defect was much more common in IAA type B than in type A or CA. Anomalous origin of the subclavian artery and DiGeorge syndrome were commonly associated with IAA type B but were rare in type A and CA. Transposition of the great arteries and double-inlet left ventricle are less common in IAA type B than in types A and CA. On the basis of these findings and the observation by Le Lievre and Le Douarin that neural crest cells contribute significantly to the formation of the visceral arch system and associated organs, we postulate that IAA type B may be a manifestation of a developmental error involving the neural crest, as is the DiGeorge syndrome. We believe IAA type A and CA to be closely related anomalies that may be prenatally acquired and pathogenetically distinct from IAA type B. PMID- 6486035 TI - Anatomic and functional "obstruction" of the outflow tract in atrioventricular septal defects with separate valve orifices ("ostium primum atrial septal defect"): an echocardiographic study. AB - Left ventricular (LV) outflow tract (OT) obstruction can be treacherous in any form of atrioventricular (AV) septal defect. The properties of the LVOT were investigated echocardiographically in 64 patients with separate valve orifices ("ostium primum atrial septal defect") who had survived corrective surgery. M mode and cross-sectional echocardiographic (echo) images were made of the LVOT. The degree of malalignment of the aorta with the ventricular septum, the left atrium-aortic ratio, the fractional LV shortening and the diameter of the LVOT were recorded. Fixed anatomical obstruction was found in 3 patients, consisting of muscular bands or abnormal attachment of tension apparatus. Malalignment of the aorta with the ventricular septum was found in 62% of the patients. The diameter of the LVOT was smaller than that of the aortic root in 71% of the cases. The mean diameter of the LVOT was 92 +/- 27% (range 35 to 143%) of the aortic root diameter. Because its walls are mainly muscular, the LVOT constricts during systole. The mean end-systolic diameter of the LVOT was 77 +/- 22% (range 23 to 129%) of the aortic root diameter. Sequential measurements showed that the LVOT constricted gradually, but the velocity of constriction in patients with the most severe narrowing showed a distinct maximum in the first fifth of systole. In conclusion, a series of elements contribute to a potentially perilous arrangement of the LVOT in patients with AV septal defect. This intrinsically narrow tunnel was constricted during systole by its muscular walls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486036 TI - Incidence and significance of early pericardial effusions after cardiac surgery. AB - Echocardiography (echo) is frequently performed postoperatively to evaluate patients suspected of having cardiac tamponade or pericarditis. The overall incidence and significance of echocardiographic pericardial effusions (PE) early after cardiac surgery are unknown. Therefore, M-mode and 2-dimensional (2-D) echo were used to study 39 stable patients 4 to 10 days after cardiac surgery. Twenty two patients (56%) had unequivocal moderate-to-large PEs. PEs were identified on serial chest x-rays in only 6 patients. PEs were significantly more common after heavy postoperative bleeding, and occurred in 16 of 19 patients with more than 500 ml of total chest tube output; only 6 of 20 patients with chest tube output less than 500 ml had PE. There was no correlation of PE by echo with pericardial friction rubs, chest pain or atrial arrhythmias. Elevated erythrocyte sedimentation rate did not correlate with PE by echo or clinical pericarditis. In 1 of 22 patients with PE, tamponade developed, and the patient required reoperation on day 5; the other 21 were discharged without related therapy. Thus, early postoperative PEs are common and related to postoperative bleeding. Because they do not correlate with symptoms of pericarditis and rarely lead to tamponade, their identification is usually of limited clinical significance. PMID- 6486037 TI - Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver. AB - Twenty patients with biopsy-proved alcoholic cirrhosis of the liver and no cardiac symptoms entered a noninvasive investigation program in which cardiac performance was evaluated. One patient was excluded from the study because of a significant ethanol content in the serum at the time of investigation and 4 patients were excluded because of significant electrocardiographic ST-segment changes during exercise testing. Fifteen patients (12 men, 3 women, median age 47 years) who had abstained from alcohol drinking for at least 2 months were studied by exercise testing, echocardiography, measurement of systolic time intervals and left ventricular (LV) radionuclide ejection fraction (EF) at rest and during submaximal exercise. Twelve healthy persons of the same age served as control subjects. Heart rate at rest was significantly elevated in the patient group, median 90 beats/min (range 62 to 128) vs 73 beats/min (range 61 to 89) (p less than 0.02). No significant differences were found in physical work capacity and systolic time intervals, and echocardiographic parameters did not differ with the exception of left atrial dimension (median 36 mm [range 22 to 47] in the patient group and 31 mm [range 17 to 38] in the control subjects, p less than 0.05). No significant difference was found in LVEF at rest. During exercise, however, the median LVEF increased only 6% in the patients versus 14% in the control subjects (p less than 0.05). The results of this study suggest that patients with alcoholic liver cirrhosis, although free of cardiac symptoms, may have a latent or preclinical cardiomyopathy that is manifest during physical stress. PMID- 6486038 TI - Clinical applications of a new type of real-time two-dimensional Doppler flow imaging system. AB - The clinical significance of a newly developed real-time 2-dimensional (2-D) Doppler flow imaging technique was assessed. In the instrumentation of the echocardiograph, the pulsed Doppler mechanism was incorporated in a wide-angle, phased-array system. The Doppler flow signals obtained from the cardiac chamber were processed on the basis of the autocorrelation principle. The direction, velocity and variance of the intracardiac blood flow were calculated in real time and displayed in the color-coded mode on the television screen, and were superimposed on the 2-D echocardiographic image of the heart. The technique was used in 20 healthy subjects and 100 cardiac patients. The new technique clearly visualized the whole aspect of intracardiac blood flow by the cine mode in real time; thus, the technique may be called Doppler cineangiocardiography. The mitral inflow and the aortic ejection flow were clearly demonstrated. A regurgitant jet from the valve orifices was dynamically visualized as seen in the cineangiogram. The spatial orientation and extent of the regurgitant jet were easily assessed. The jet stream through the stenotic mitral orifice was well imaged in the left ventricular cavity, showing a variety of stream directions. Intracardiac shunts in ventricular septal defect and atrial septal defect were clearly visualized. The defect could be localized on the interventricular septum on the basis of the site where the shunt flow spurted, although the echocardiographic interruption was not demonstrated in the 2-D echocardiographic image of the cardiac structure. Although some technical problems remain, our new technique greatly improves the diagnostic efficacy of ultrasound. PMID- 6486039 TI - Evaluation of "ischemia at a distance": effects of coronary occlusion on a remote area of left ventricle. AB - The effect of coronary occlusion on blood flow and function in a remote zone of the left ventricle was studied in 21 open-chest dogs. Group A consisted of 6 dogs not undergoing left circumflex (LC) coronary artery cannulation. The other 15 dogs underwent cannulation of the LC artery followed by partial occlusion to 40 mm Hg diastolic perfusion pressure. Of these dogs, 7 with constant perfusion pressure (group B) were separately evaluated from 8 with declining perfusion pressure (group C). Sequentially more proximal left anterior descending (LAD) occlusions were performed in each group. Blood flow in the LC zone remained unchanged in group A after sequential LAD occlusions, whereas in groups B and C distal and proximal LAD occlusions caused progressive reduction in LC flow. Although in group A segment shortening improved in the LC zone after distal LAD occlusion, in groups B and C progressive impairment in segmental shortening was observed in the LC zone after distal and proximal LAD occlusions. Thus, in the setting of critical coronary stenosis in a zone, total occlusion in another coronary artery can initiate a series of events leading to decreased blood flow in the territory of the stenotic coronary artery, resulting in ischemia and impaired segmental function. PMID- 6486040 TI - Dissociation between two-dimensional echocardiographic left ventricular wall motion and myocardial salvage in early experimental acute myocardial infarction in dogs. AB - This study was designed to evaluate whether the effects of coronary reperfusion with or without a pharmacologic agent could be detected in the early hours after infarction by 2-dimensional (2-D) echocardiography applied in a manner analogous to its clinical use. Proximal left anterior descending coronary occlusion was performed in 24 dogs, and the dogs were then randomized into 3 groups. In group 1 (n = 8), coronary occlusion was maintained for 6 hours; in group 2 (n = 8), coronary occlusion was maintained for 2 hours and was followed by 4 hours of reperfusion; in group 3 (n = 8), 2 hours of coronary occlusion were followed by 4 hours of reperfusion but methylprednisolone (30 mg/kg intravenously) was also administered 15 minutes after coronary occlusion. At 6 hours, 2-D images were obtained through the closed chest wall and the percentage of the left ventricular wall motion abnormalities was determined at 4 short-axis levels. The mass at risk was defined by in vivo Monastral blue injection and infarction by triphenyltetrazolium chloride staining. The mass of necrosis was 74 +/- 4% (mean +/- standard error of the mean) of the mass at risk in group 1 and was smaller in groups 2 and 3, 44 +/- 6% and 35 +/- 4%, respectively (p less than 0.01). Percent necrosis of the left ventricle was 22 +/- 3% in group 1, 15 +/- 3% in group 2 (difference not significant) and 10 +/- 2% in group 3 (p less than 0.05 vs group 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486041 TI - Mechanism of protection from atherosclerosis by verapamil in the cholesterol-fed rabbit. AB - Seventy-two rabbits were separated into groups to receive no drug, subcutaneous verapamil, metoprolol, hydralazine, metoprolol and hydralazine, or oral verapamil in 1 of 3 doses daily for 10 weeks. They also received a high-cholesterol diet and had serum triglyceride, cholesterol, and verapamil levels measured twice during the study. Blood pressure (BP), heart rate and weight were measured every 10 days. Approximately 60% of the rabbits given verapamil had detectable levels of the drug in their serum. This group had significantly less severe atherosclerosis in their aortas at the time they were killed, even though they had significantly higher cholesterol levels than the other groups. This group also did not have different BP than the other groups (except for the subcutaneous verapamil group). Thus, protection from atherosclerosis by verapamil in the cholesterol-fed rabbit is not the result of lowering of BP. PMID- 6486042 TI - Factors affecting accuracy of in vitro valvar pressure gradient estimates by Doppler ultrasound. AB - Doppler ultrasound is used successfully in clinical situations for noninvasive measurement of pressure changes across stenotic cardiac valves. However, situations that might lead to errors in measurement have not been identified. This study determines the effect of flow rate, viscosity, orifice shape and size on the calculation of Doppler transvalvar gradient. Pressure gradient is usually computed from the equation P1-P2 = 4 X Vmax2, where P1-P2 is the gradient and Vmax is the maximal jet velocity measured by Doppler ultrasound. An in vitro model was developed with interchangeable orifices that permitted the jet to be detected by an in-line Doppler transducer. The model allowed alteration of flow rates, viscosities and pressure gradients. When P1-P2 as predicted by Doppler was compared with that measured by manometers (PM), excellent correlations were obtained for triangular orifices of areas as small as 78.5 mm2 (r = 0.95) and for circular and elliptical orifices to as small as 50.2 mm2 (r = 0.99). For smaller orifices, P1-P2 correlated poorly with PM. Good correlation was found between P1 P2 and PM, with flow rates ranging from 0.7 to 8.4 liters/min (r = 0.97) with a 10-mm diameter circular orifice (area = 78.5 mm2). No observable differences were found in the accuracy of the equation between high and low flow rates. Viscosity had no effect on the accuracy of the P1-P2 comparison with PM over the range evaluated (1 to 10 cp). It is concluded that the modified Bernoulli Doppler gradient equation provides accurate results in the usual clinical situation when an orifice permits true jet formation. PMID- 6486043 TI - Acute myocardial infarction with normal coronary arteries. PMID- 6486044 TI - Electrical alternans of giant U waves with multiple electrolyte deficits. PMID- 6486046 TI - Outlet strut fracture of a Bjork-Shiley prosthesis in the mitral position. PMID- 6486045 TI - Recurrent ventricular tachycardia associated with QT prolongation after mitral valve replacement and its association with intravenous administration of erythromycin. PMID- 6486047 TI - Noninvasive recognition of functional pulmonary atresia by echocardiography. PMID- 6486048 TI - Echocardiographic characteristics of pulmonary and aortic valve motion in the Eisenmenger's syndrome from ventricular septal defect. PMID- 6486049 TI - Diagnosis of constrictive pericarditis by pulsed Doppler echocardiography. PMID- 6486051 TI - Diuretic-induced hypokalemia in uncomplicated systemic hypertension. PMID- 6486050 TI - Constrictive pericarditis late after the Beck operation. PMID- 6486052 TI - Inducible ventricular tachyarrhythmias in canine myocardial infarction. PMID- 6486053 TI - Left ventricular dysfunction discriminated noninvasively beat-to-beat. PMID- 6486054 TI - Effects of enhanced afterload and contractile state on the left ventricular late systolic wall stress-dimension relation. PMID- 6486055 TI - The case for exercise. PMID- 6486056 TI - Trends in coronary heart disease. PMID- 6486057 TI - Usefulness of exercise. PMID- 6486058 TI - Measure of Bayes' theorem. PMID- 6486059 TI - Familial Uhl's anomaly. PMID- 6486060 TI - Carotid sinus hypersensitivity: beneficial effect of dual-chamber pacing. PMID- 6486061 TI - Cardiovascular effects of coffee and caffeine. PMID- 6486062 TI - Plasma MB creatine kinase in soccer players. PMID- 6486063 TI - Univentricular hearts. PMID- 6486064 TI - Ajmaline cardiotoxicity. PMID- 6486065 TI - Intercoronary collaterals without obstructive coronary artery disease. PMID- 6486066 TI - Mechanism for improved hemodynamics with dual-chamber pacing in patients with carotid sinus hypersensitivity. PMID- 6486067 TI - Changes in the fine structure of rat visceral yolk-sac placenta during prolonged pregnancy. AB - Visceral yolk-sac membranes were obtained surgically from viable rat fetuses which had been retained experimentally in utero in lactating animals for as long as 3 days beyond delivery of their littermates. They were examined with the electron microscope. The fine structure of the yolk-sac placental membrane (i.e., the tissues separating vitelline capillary lumina from the uterine cavity) remained unimpaired during the delay period. Progressive changes included a decrease in the height of the endodermal epithelium, but a thickening of the basement membrane underlying it by repeated replication of the subepithelial basal lamina and an increase in collagen fiber content in the reticular lamina. Transcytosis across the endothelium of the capillaries of the peripheral vitelline circulation remained unchanged throughout the delay period; endocytosis of materials, presumably maternal serum proteins, from the uterine cavity into the apices of the endodermal epithelium, however, decreased with time. At the oldest stage (26 days post-coitum) most endocytosed materials had been stored for hydrolysis in large subapical vacuoles which were identified as secondary lysosomes; and evidence of uptake from the uterine lumen was essentially absent. Accordingly, placental transport of protein by the visceral yolk sac of the rat can be regarded as a perinatal process. The action of an elaborately developed and well-preserved Golgi apparatus in both cellular mechanisms, viz., digestion of maternal proteins and protein transfer, was inferred. PMID- 6486068 TI - The tracheobronchial epithelium of the bonnet monkey (Macaca radiata): a quantitative ultrastructural study. AB - Since there are major differences between the airway epithelium of man and that of common laboratory species, the tracheobronchial epithelium of the bonnet macaque was characterized to evaluate its usefulness as a model for study of human conducting airways. This study compared the light microscopic, scanning electron microscopic, and ultrastructural appearance of epithelium from the posterior membranous and anterior cartilaginous trachea and mainstem bronchus. Population densities, epithelial volumetric densities, and frequency distributions of cross-sectional areas of nuclei were determined for cell types present on electron micrographs. Four epithelial cell types were distinguished by ultrastructural criteria. Basal cells were 31% of the population and were similar to those described in other species. Ciliated cells were also similar to those of other species and composed 41% of the population; their nuclei were larger than those of other cell types. Mucous goblet cells had large numbers of secretory granules with electron-dense cores and a lucent periphery. They were only 8% of the population by nuclear count but composed 20% of the epithelial volume. The fourth cell type had multiple small vesicles containing small amounts of granular material and was termed a "small mucous granule cell." Small mucous granule cells (16% of the population) were present in greater numbers than mucous goblet cells but were a smaller proportion of the epithelial volume (8%). While population densities of cell types determined from transmission electron micrographs did not vary between sample sites, scanning electron microscopy demonstrated longitudinal streaks of secretory cells in the posterior trachea suggesting that regional differences in epithelial organization exist. We conclude that the macaque extrapulmonary airway epithelium differs from published descriptions of laboratory rodents in both cell types present and relative abundance of those cell types. Although detailed quantitative studies of human extrapulmonary airways are not available, the primate airways resemble those of man in both the types of cells present and the complexity of pseudostratification. PMID- 6486069 TI - Endocytosis in nonciliated epithelial cells of the ductuli efferentes in the rat. AB - The nonciliated cells lining the ductuli efferentes presented three distinct cytoplasmic regions. The apical region contained, in addition to cisternae of endoplasmic reticulum and mitochondria, two distinct membranous elements. The tubulovesicular system consisted of dilated tubules connected to the apical plasma membrane and subjacent distended vesicular profiles. The apical tubules, not connected to the cell surface, consisted of numerous densely stained tubules of small size which contain a compact, finely granulated material. The supranuclear region, in addition to a Golgi apparatus and ER cisternae, contained dilated vacuoles, pale and dense multivesicular bodies, as well as numerous dense granules identified cytochemically as lysosomes. The basal region contained the nucleus and many lipid droplets. The endocytic activity of these cells was investigated using cationic ferritin (CF) and concanavalin-A-ferritin (Con-A ferritin) as markers of adsorptive endocytosis; and native ferritin (NF), concanavalin-A-ferritin in the presence of alpha-methyl mannoside, and horseradish peroxidase or albumin bound to colloidal gold for demonstrating fluid phase endocytosis. These tracers were injected separately into the rete testis, and animals were sacrificed at various time intervals after injection. At 1 min, CF or Con-A-ferritin were seen bound to the apical plasma membrane, to the membrane of microvilli, and to the membrane delimiting elements of the tubulovesicular system. Between 2 and 5 min, these tracers accumulated in the densely stained apical tubules and at 15 min in the dilated vacuoles. Between 30 min and 1 hr, the tracers appeared in multivesicular bodies of progressively increasing density, whereas at 2 hr and later time intervals, many dense lysosomal elements became labeled. The tracers for fluid-phase endocytosis showed a distribution similar to that for CF or Con-A-ferritin except that they did not bind to the apical plasma membrane, microvilli, or membrane delimiting the tubulovesicular system. At no time interval were any of the tracers observed in the abluminal spaces. Thus, the nonciliated epithelial cells of the ductuli efferentes are actively involved in fluid-phase and adsorptive endocytosis, both of which result in the sequestration of endocytosed material within the lysosomal apparatus of the cell. PMID- 6486071 TI - Toward a psycho-structural theory: hypnosis and the structure of dreams. PMID- 6486070 TI - Development of the vascular bed in the rabbit ear: scanning electron microscopy of vascular corrosion casts. AB - The development of the vascular bed in the rabbit ear was investigated using vascular corrosion casts from animals of various ages. Examination of the casts revealed that the arrangement of the major auricular arteries and veins was determined before birth and was maintained during postnatal growth of the ear. Furthermore, the number of arteries branching off the central ear artery and the lateral arteries did not increase with increasing ear length. Scanning electron microscopic examination of lateral segments of adult ear casts revealed many anastomoses between marginal arteries and veins. These arteriovenous anastomoses (AVAs) occurred singly, in pairs, or in clusters of three to six. Their size and shape were variable, even in the same cast. The central segment of many AVA casts showed surface impressions of endothelial cell nuclei which were different from the impressions on adjacent arteries and veins. Arteriovenous anastomoses were also detected in ear casts from animals as young as 8 days. The density of AVAs in lateral ear segments ranged from 95-165 cm-2 in 8- to 11-day-old rabbits to 80 115 cm-2 in adults. However, estimates of the total number of AVAs in the lateral ear margin indicated that AVAs continued to be formed at a steady rate during growth of the ear. During the early neonatal period the cutaneous capillary plexuses developed prominent tufts projecting toward the skin surface, which were apparently associated with developing hair follicles. These capillary tufts were not seen in casts from fetal or adult rabbits. PMID- 6486072 TI - Plethysmographic demonstration of rapid vasodilation by direct suggestion: a case of Raynaud's disease treated by hypnosis. PMID- 6486073 TI - Utilizing the creative unconscious in the treatment of hypodermic phobias and sleep disturbance. PMID- 6486074 TI - Hypnotizability and volunteering for hypnosis experiments. PMID- 6486075 TI - Eight steps to self-hypnosis. PMID- 6486076 TI - Hypnosis as dissociation: methodological considerations and preliminary findings. PMID- 6486077 TI - Auto-hypnosis as a defense against coercive persuasion. PMID- 6486078 TI - A comparative study of hypnotherapy and psychotherapy in the treatment of methadone addicts. PMID- 6486079 TI - Misuse of hypnosis: a factor in psychopathology. PMID- 6486080 TI - Effect of zinc supplementation on copper status in adult man. AB - The effects of zinc supplementation on the copper status of healthy adult men, as assessed by the activities of the copper-metalloenzymes, plasma ferroxidase (ceruloplasmin), and erythrocyte Cu,Zn-superoxide dismutase, were determined. The subjects were given either two daily doses of 25 mg zinc or placebo for 6 wk. No significant differences in the plasma copper levels or the ferroxidase activities between the supplemented and control groups could be detected at 2, 4, or 6 wk. Plasma zinc increased and erythrocyte Cu,Zn-superoxide dismutase decreased in the supplemented group, the difference between the groups becoming significant at 6 wk (p less than 0.05). This suggested that the zinc supplements decreased the copper status of the experimental group. PMID- 6486081 TI - Vitamin E is delivered to cells via the high affinity receptor for low-density lipoprotein. AB - The high affinity receptor for low-density lipoprotein (LDL) is demonstrated to function as a mechanism for delivery of vitamin E to cells. After incubation for 24 h with lipoprotein-depleted serum (which induces LDL receptor synthesis), and then incubation for 24 h with an increasing amount of LDL (from 10 to 250 micrograms of protein per ml), the tocopherol contents of normal fibroblasts increased in a saturable fashion from 19 to 103 ng of tocopherol per mg cell protein. In contrast, similarly incubated LDL receptor-negative fibroblasts (from a patient with the homozygous form of familial hypercholesterolemia) only increased from 18 to 39 ng of tocopherol per mg. Estimation of the amount of LDL degraded from the cellular tocopherol uptake by normal cells yielded values virtually identical to the actual values of protein degradation as measured using 125I-LDL. PMID- 6486082 TI - Hydrogen gas excretion after sucrose gavage in the fasted rat. AB - The effect of a 3-day fast on the functional ability of the adult rat to hydrolyze and absorb sucrose was determined. The evaluation was based on previous studies which have shown the total amount of hydrogen gas (H2) excreted by the animal to reflect the extent of undigested carbohydrate entering the colon from the small intestine. H2 excretion was measured using a gas chromatographic technique in experimental (72 h fasted) and control (12 h fasted) animals after administration of sucrose by gastric gavage. Total H2 excretion was 3-fold higher in the experimental animals (n = 5) than in the controls (n = 5) (p less than 0.005) indicating a significant increase of sucrose malabsorption in the experimental animals. Administration of a second dose of sucrose 8 to 9 h after the first dose (refeeding) resulted in markedly decreased malabsorption relative to the first administration in both experimental (n = 2) and control (n = 2) animals. These results suggest that a 3-day fast markedly impairs the ability of the intestine to hydrolyze and absorb sucrose and that refeeding rapidly restores the ability to utilize this substrate. H2 excretion was similar between experimental and control animals after the administration of lactulose, a nonabsorbed and nondigested carbohydrate, suggesting that the observed results of the sucrose studies were independent of any possible changes in the intestinal microflora. PMID- 6486083 TI - Effect of different linoleic acid intakes on prostaglandin biosynthesis and kidney function in man. AB - Prostaglandin (PG) biosynthesis and kidney function was investigated in 24 adults (23 to 32 yr) during isocaloric formula diet periods, for 2 wk each, providing a linoleic acid supply of 0, 3, 3.5, 4, 6, 8, 13, 17, 18, or 20% of total energy intake. Total protein intake (15 energy %) was constant, as well as 5 g NaCl, 3 g KCl, and 0.6 g cholesterol per 2200 kcal formula diet. The amount of PG metabolites, PG-E, sodium, and creatinine in 24-h urine increased with augmented linoleic acid intake. Comparing a linoleic acid intake of 0 and 20 energy %, an increase of sodium (8%) and creatinine (16%) in 24-h urine was found on the 5th day of high linoleic acid supply. Coincidently a stimulated PG biosynthesis could be measured. Potassium, water, and PG-F excretion showed no relation to linoleic acid intake. It is concluded that linoleic acid in the diet stimulates PG-E biosynthesis in man, leading to effects in systems which control renal function, and may have clinical relevance for the sodium and potassium balance in man. PMID- 6486084 TI - Absorption of nutrient energy in southern Indian control subjects and patients with tropical sprue. AB - Fecal energy excretion was measured by bomb calorimetry, in a group of 30 healthy volunteers and 15 patients with tropical sprue, to determine the absorption of nutrient energy. The mean energy absorption in the healthy volunteers (91.6%) was less than in similar subjects in temperate climates. The reduction of energy absorption in the volunteers, who all have tropical enteropathy, suggests that this condition leads to wastage of 5% of energy intake. In patients with tropical sprue the energy absorption was significantly lower. A strict metabolic balance study was not essential to detect energy malabsorbers. PMID- 6486085 TI - Sodium and potassium intake and balance in adults consuming self-selected diets. AB - Twenty eight adults, 12 men and 16 women, participated in a 1-yr study designed to assess daily nutrient intake accurately. All subjects lived at home, consumed self-chosen diets, and maintained a detailed daily dietary record throughout the year. During four 7-day balance studies, one in each season of the year, meals, beverages, urine, and feces were analyzed for sodium and potassium content by atomic absorption spectrometry. Total intakes averaged 3.4 g/day for sodium and 2.8 g/day for potassium. The Na:K ratio for all diets analyzed averaged 1.3. Nutrient densities of sodium and potassium were 1.8 and 1.5 g/1000 kcal, respectively. Apparent absorptions of sodium and potassium were 98 and 85%, respectively, and did not change significantly over the wide range of intakes. Average urinary excretions of sodium and potassium were 86 and 77% of total intake, respectively. Mean metabolic balances were positive for sodium, +0.47 g/day, and potassium, +0.28 g/day. The data of this study provide useful information concerning the dietary intakes, excretions, and balances of sodium and potassium for adults based on analytic determination. PMID- 6486086 TI - Vitamin A status of the newborn in relation to gestational age, body weight, and maternal nutritional status. AB - Studies were made of the vitamin A status of newborn as judged by cord serum vitamin A in relation to gestational age, birth weight, and maternal vitamin A status in 130 + 79 mother-infant pairs belonging to low and high income groups in urban Baroda. The mean values for maternal serum vitamin A (microgram/dl, mean +/ SE) in the two groups were 21.8 +/- 0.59 (n = 130) and 29.3 +/- 0.80 (n = 79), respectively. The corresponding values for cord serum vitamin A were 13.8 +/- 0.40 and 19.6 +/- 0.64 for full-term infants and 7.5 +/- 0.44 and 12.9 +/- 0.80 for premature infants. Even for comparable levels of maternal serum vitamin A, differences were found between income groups regarding birth weight and cord serum vitamin A. Mothers of premature infants had lower levels of serum vitamin A than those of full-term infants suggesting maternal vitamin A status to be one of the correlates of prematurity. Significant correlations were found between cord serum vitamin A, maternal serum vitamin A, gestational age, and growth status. These studies suggest that a poor vitamin A status is one of the features associated with a higher prevalence of prematurity and intrauterine growth retardation found in poorly nourished populations. These findings stress the importance of satisfactory vitamin A supplies to pregnant and nursing mothers to prevent vitamin A deficiency and growth retardation in the progeny. PMID- 6486087 TI - Influence of growth status and placental function on birth weight of infants born to young still-growing teenagers. AB - To investigate the determinants of fetal maturation of infants born to adolescent mothers, we studied the obstetric population attended at the Maternity Hospital of Lima, Peru. From this population we selected for inclusion in this study a sample of 412 adolescent mothers ranging in age from 13 to 15 yr. These subjects were selected because the anthropometric measurements of their parents were obtained at the time the adolescents were being attended for delivery. Based on the height measurements of the teenagers' mothers and fathers, the adolescents were classified as either still growing or growth completed depending on whether their height was less or greater than their mothers' height. Infants of young adolescent mothers who had not completed their expected growth in height were significantly lighter in birth weight than those born to adolescent mothers who had completed their growth. Multiple regression and path analyses revealed that the effects of weight gain and placenta weight on birth weight were more effective among the infants born to adolescent mothers who had not completed their growth in height. These data suggest that the reduction in birth weight among immature still-growing adolescents may result from both a decreased net availability of nutrients and/or an inability of the placenta to function adequately for active fetal growth, which results in a retarded fetal growth. PMID- 6486088 TI - New standards of weight and body composition by frame size and height for assessment of nutritional status of adults and the elderly. AB - The study includes measurements of height, weight, triceps skinfold, subscapular skinfold, upper arm circumference, and elbow breadth of a cross-sectional multiracial sample of 21,752 subjects aged 25 to 74 yr derived from the data sets of the first and second National Health and Nutrition Examination Surveys (NHANES I and NHANES II). Based on these data, percentiles of weight, skinfolds, and bone free upper arm muscle area by height, sex, and frame size were established for all races combined in two groups: adults aged 25 to 54 yr and the elderly aged 55 to 74 yr. These new standards can be used to differentiate those who are at risk of being obese and undernourished. It is recommended that assessment of anthropometric nutritional status and health status of contemporary adult and elderly populations be made with reference to the present standards in conjunction with age correction factors. PMID- 6486089 TI - Comparison of the fat content and fat globule size distribution of breast milk from mothers delivering term and preterm. AB - The fat content and the fat globule size distribution of human preterm milk samples were analyzed and compared with data of previously analyzed samples of term milk. A negative correlation was found between the fat content and the gestational age. In both term and preterm milk three subpopulations of fat globules could be observed. The subpopulations of small (1 to 15 microns) and large globules (8 to 13 microns) were larger in preterm milk, but decreased slower throughout lactation. The average diameter was identical in both milks and increased with advancing lactation. The fat surface, which also depends on the fat content, increased with decreasing gestational age. However, no correlation between the specific fat surface area and the gestational age was found. Compared to human milk, commercial infant formulas have a smaller average fat globule diameter and a larger specific fat surface area. PMID- 6486090 TI - Diet, smoking, social class, and body mass index in the Caerphilly Heart Disease Study. AB - Associations between smoking habit, social class, body mass index, and diet were examined in 493 men aged 45 to 59 yr, selected from the general population and who had completed a 7-day weighed dietary record. Smokers were lighter than nonsmokers and had a lower body mass index. There was no difference in energy intake, but in general, smokers had lower intakes of vitamins, minerals, and dietary fiber. Exsmokers had similar intakes to nonsmokers. Manual workers tended to be shorter, had a higher body mass index, higher intakes of energy and carbohydrates, and lower intakes of vitamins and minerals than nonmanual workers. Social class had a greater effect than smoking habit on intakes of energy and carbohydrates, whereas smoking habit had the greater effect on intakes of minerals and vitamins. Body mass index was associated negatively with sucrose intake and positively with protein intake, smoking habit, and social class being less important determinants. PMID- 6486091 TI - Total body composition by dual-photon (153Gd) absorptiometry. AB - The lean-fat composition (%FATR) of soft tissue and the mineral mass of the skeleton were determined in vivo using dual-photon (153Gd) absorptiometry (dose under 2 mrem). A rectilinear raster scan was made over the entire body in 18 subjects (14 female, 4 male). Single-photon absorptiometry (125I) measured bone mineral content on the radius. Percentage fat (%FATD) was determined in the same subjects using body density (from underwater weighing with correction for residual lung volume). Lean body mass (LBM) was determined using both %FATR and %FATD. Percentage fat from absorptiometry and from underwater density were correlated (r = 0.87). The deviation of %FATD from %FATR was due to the amount of skeletal mineral as a percentage of the LBM (r = 0.90). Therefore, skeletal variability, even in normal subjects, where mineral ranges only from 4 to 8% of the LBM, essentially precludes use of body density as a composition indicator unless skeletal mass is measured. Anthropometry (fatfolds and weight) predicted %FATR and LBM at least as well as did underwater density. The predictive error of %FATR from fatfolds was 5% while the predictive error in predicting LBM from anthropometry was 2 to 3 kg (3%). PMID- 6486092 TI - Radioisotopic studies concerning the efficacy of standard washing procedures for the cleansing of hair before zinc analysis. AB - Various standard procedures were investigated in relation to the removal of exogenously applied 65Zn from human hair and endogenously incorporated 65Zn from rat hair. Human hair was found to adsorb zinc and a variety of other metal ions from aqueous solutions in a manner which suggested some ion-exchange capacity. Uptake of zinc varied considerably between human hair samples, but in most cases accumulation of zinc occurred rapidly and often resulted in hair zinc levels several-fold higher than found in control samples. Extraction of zinc and other metal ions was greatest after treatment with disodium EDTA and sodium lauryl sulfate than after washing with water or aqueous Triton X-100. However, no procedure effectively removed all exogenous zinc, while all treatments extracted varying proportions of the endogenous zinc component. Because of the inability of standard washing procedures to remove exogenous zinc without reducing endogenous or indicator zinc levels, use of hair zinc analyses to indicate nutritional zinc status are inadvisable if hair zinc contamination is likely to have occurred. PMID- 6486093 TI - Report on Clinical Nutrition Research Units. AB - The National Institutes of Health support seven Clinical Nutrition Research Units, which are designed to create or strengthen nutrition research, training, and education through coordinated effort, intellectual stimulation, and use of shared resources. Research at the participating institutions focuses on the role of nutrition in cancer, cardiovascular disease, renal disease, digestive diseases, cystic fibrosis, diabetes, and other illnesses. Contributing substantially to the development of this nutrition research base have been Clinical Nutrition Research Unit-supported pilot studies, core laboratories, and new investigators. In the clinical setting, Clinical Nutrition Research Unit Nutritional Support Services assist in the care of patients receiving total parenteral nutrition and those with anorexia nervosa, burns, cancer, and a spectrum of nutrition-related problems. Participation of Clinical Nutrition Research Unit staff in training activities range from undergraduate, graduate, and postgraduate education courses for medical students and other health professionals to continuing education workshops, lecture series, and information programs for professional and lay audiences. PMID- 6486095 TI - The size of California nonmigrant Mexican-American children. PMID- 6486096 TI - Diet, nutrient intake, and metabolism in populations at high and low risk for colon cancer. PMID- 6486094 TI - Recommended therapeutic guidelines for professional weight control programs. AB - At the present time there are no established guidelines to serve as standards for the operation of weight control programs. This increases the possibility that some programs may be conducted in a fashion that is unethical, jeopardizes patient health, and lacks credibility. As a first step toward developing such standards, a panel was organized by the International Congress on Obesity to describe minimum recommended features of professional weight control programs. The present report served as a supporting document for the summary statement and describes recommended guidelines for the treatment of obesity encompassing diet, physical activity, and behavior modification with psychological support. The role of drugs and surgery is not considered in this report. For the average patient it is suggested that three components of therapy--diet, exercise, and behavioral/psychological support--be prescribed together since they are closely interrelated, interdependent and mutually supportive. PMID- 6486098 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Nutrient intake. AB - A 3-day diary with portion sizes weighed by the subject and a 24-h recall were obtained on 50 sets of subjects: Seventh-day Adventist lacto-ovo-vegetarians and nonvegetarians, and general population nonvegetarians, matched on age (+/- 5 yr), sex, marital status, education, type of milk preferred, and an index of the frequency of dairy and egg product use. An additional 18 unmatched persons who follow a pure vegetarian dietary pattern (use no meat, fish, fowl, dairy, or egg products) were recruited into the study. The rational for the dietary methods used is presented and details of each of the methods used are given. The results of the nutrient analysis of the 24-h recall and 3-day diary are presented. The 3 day nutrient intake means for the four groups are compared to the sex-specific recommended daily allowance both with and without supplements. The contribution of nutritional supplements to the nutrient intake is discussed. All groups show adequate or excess intake levels of calories, protein, and fat when either the 24 h recall or the 3-day diary values are considered. The higher intake of calories noted among nonvegetarians can be explained by a higher intake of both fat and protein in these groups. A, B, and C vitamin levels (3-day dairy estimates) are adequate both with and without supplements. Calcium intake is much below recommended levels for pure vegetarian females. Iron intake is low for all females. A heme iron source does not improve the intake levels for nonvegetarian females. A comparison of these results with prior reports of nutrient intake among Seventh-day Adventists is presented. PMID- 6486097 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Population: demographic and anthropometric characteristics. AB - A study was designed to compare nutritional and metabolic parameters on subjects with a spectrum of vegetarian and nonvegetarian dietary patterns. The method of selection of the study population, the description of its characteristics, and the data collection protocol are described. Anthropometric measurements of vegetarians and nonvegetarians are reported and compared with previously reported measurements on similar populations. PMID- 6486099 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Laboratory analysis of 3-day composite of food samples. AB - In a study designed to characterize dietary patterns of vegetarian and nonvegetarian populations, chemical analysis of 3-day composite food samples showed lower fat content of food of vegetarians than that of nonvegetarians; pure vegetarians had the lowest. Unsaturated fatty acids were highest in the food of the pure vegetarian group. No significant difference was seen in percentage protein of the food consumed by male vegetarians and nonvegetarians while the food of female vegetarians was of lower protein content than that of the nonvegetarians. The relationship of these findings to the lower incidence of colon cancer in vegetarian populations remains to be determined. PMID- 6486100 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Relationship of diet to serum lipids. AB - Serum cholesterol, high-density lipoprotein cholesterol, and triglycerides of three groups of Seventh-day Adventists (SDAs)--true vegetarians, lacto-ovo vegetarians, and nonvegetarians--and the general population were measured and related to age, sex, and diet. True vegetarian SDAs had the lowest cholesterol levels while cholesterol levels of the other three groups were similar. Triglyceride levels were highest in the true vegetarian SDAs and lowest in general population. Cholesterol levels rose with increasing age while percentage of high-density lipoprotein cholesterol fell. Female SDAs in all three dietary groups had higher cholesterol levels than males. In all four groups percentage of high-density lipoprotein cholesterol was higher in females than in males. In the male subjects, cholesterol levels varied linearly and inversely with carbohydrate intake. Protein and fat intake in true vegetarian SDAs and lacto-ovo vegetarian SDA groups were lower than in the nonvegetarian SDA and general population groups. The differences in protein and fat intake were reflected in elevations in serum cholesterol levels. In the female subjects, cholesterol levels were also inversely correlated with carbohydrate intake but not as distinctly as in the males. True vegetarian SDA females ingested less protein and fat than the other three groups and exhibited lower serum cholesterol levels. Cholesterol levels in lacto-ovo vegetarian SDA, nonvegetarian SDA, and general population female subjects were similar and did not reflect differences in protein or fat intake. The true vegetarian dietary lifestyle resulted in lowest cholesterol levels, however, if it was breeched to the least extent, cholesterol levels rose. Thus, intake of skim, low fat, or whole milk resulted in similar serum cholesterol levels as did low or high egg consumption. PMID- 6486101 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Dietary cholesterol, beta-sitosterol, and stigmasterol. AB - Cholesterol and fat are implicated as dietary factors enhancing the risk for colon carcinogenesis. Plant sterols such as beta-sitosterol when added to diets of experimental animals treated with colon carcinogens reduce tumor yields and counteract the proliferative changes associated with carcinogenesis. The question of whether the diet of human populations at low risk for colon cancer is mirrored in their sterol composition is addressed in this study. Four study groups consisting of 18 Seventh-day Adventist (SDA) pure vegetarians, 50 SDA lacto-ovo vegetarians, 50 SDA nonvegetarians, and 50 general population nonvegetarians were selected from the greater Los Angeles basin, and 3-day composite diets were analyzed for their sterol composition. The most significant index of dietary sterol status is the ratio, beta-sitosterol + stigmasterol/cholesterol (plant sterol/cholesterol ratio). The values for the four groups ranged from 0.49 to 16.0 (general population nonvegetarians = 0.49; SDA-nonvegetarians = 0.98; SDA lacto-ovo vegetarians = 3.26; SDA pure vegetarians = 16.0). The data also show that the absolute amounts of cholesterol consumed as a factor by itself might not be as significant as its relationship to total plant sterols in the diet. PMID- 6486102 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Metabolism of bile acids. AB - High levels of fecal bile acids have been associated with populations at high risk for developing colon cancer. In this study, 168 subjects were drawn from populations that show low and high mortality from colon cancer [pure vegetarians, lacto-ovo vegetarians, and nonvegetarians Seventh-day Adventists (SDA) and demographically comparable group from the general population]. Lyophilized aliquots of 3-day stool samples were examined for levels of primary (cholic and chenodeoxycholic acids) and secondary (deoxycholic and lithocholic acids) bile acids. Total bile acids (mg/g lyophilized stools) were statistically different among dietary groups: SDA pure vegetarians 2.16 +/- 0.32, SDA lacto-ovo vegetarians 3.66 +/- 0.41, SDA nonvegetarians 4.39 +/- 0.44, general population nonvegetarians 6.04 +/- 0.75; but were similar when stool weights, body weights, and fat intake were taken into account. The most striking difference was evident in the ratio of secondary to primary bile acids: when compared to SDA pure vegetarians, both SDA lacto-ovo vegetarians and SDA nonvegetarians had twice the ratio while values for general population nonvegetarians were five to six times. The data indicate that these differences in excretion patterns among dietary groups reveal distinctly characteristic metabolic features associated with diet and lifestyle. PMID- 6486103 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Comparison of serum hexosaminidase levels. AB - Elevated levels of serum hexosaminidase (beta-2-acetamido-2-deoxy-D-glucoside; N acetamidodeoxy-D-glucohydrolase, EC 3.2.1.30)(HEX) have been found in patients with cancer. In view of the reported low levels of colon cancer among Seventh-day Adventists (SDA) we determined levels of total HEX, and its heat-labile (HEX-A) and heat-stable (HEX-B) isozymes in vegetarian SDA, lacto-ovo vegetarian SDA, nonvegetarian SDA, and the general public. Lowest levels of total HEX and highest percentage of HEX-B were found in vegetarian SDA. The levels in the other three groups were comparable, and these differences were seen at all age levels. Female subjects exhibited significantly lower total HEX levels than the males but the percentage of HEX-B was the same. PMID- 6486104 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. In situ bromination for the separation of the cholesterol cholestanol pair in human fecal extracts. AB - Neutral sterols from human feces were fractionated by thin-layer chromatography and by gas-liquid chromatography (GLC). A simple thin-layer chromatography procedure for the separation of cholestanol from cholesterol is described. This technique, involving in situ bromination of sterols on thin-layer chromatography plates, converts cholesterol and other unsaturated sterols to the corresponding dibromides. Under these conditions, the cholestanol-cholesterol pair which is normally indistinguishable on thin-layer chromatography and gas-liquid chromatography, is separated. Final quantification of the sterols was carried out by gas-liquid chromatography. PMID- 6486105 TI - Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Amberlite XAD-2 in the determination of human fecal bile acids. AB - A procedure for the isolation and quantification of the major bile acids in human feces is described. The methodology involves the use of a combination of thin layer chromatographic and gas-liquid chromatographic techniques. Human stools generally contain pigments that interfere with the separation and recovery of steroids. These pigments found in the saponifiable extract were removed in the step preceding thin-layer chromatography by using Amberlite XAD-2 in an unconventional manner. The sample, dissolved in ethyl acetate, was run through a column of Amberlite resin on which the pigments were adsorbed. There was a dramatic improvement in the recovery of the acidic steroids by this technique. Final quantification of the bile acids in the form of their methyl ester trifluoroacetates was carried out by gas-liquid chromatography. The sensitivity of this step is such that 1 microgram of lithocholic acid gave a full-scale deflection. PMID- 6486106 TI - Barbara Snell Dohrenwend memorial lecture. The epidemiology of economic stress. PMID- 6486107 TI - Toward a differentiated view of burnout: personal and organizational mediators of job satisfaction and stress. AB - This study examined the relationships between the characteristics of the human service work environment, workers' attitudes towards their jobs, and their reported attitudes and behaviors towards clients. The sample consisted of 168 workers employed in a range of human service programs in the Northeast. Job enriching characteristics were found to be related to workers' levels of job involvement, job satisfaction, and personal accomplishment, but had little relationship to reported levels of emotional exhaustion. Job stressors were clearly associated with higher levels of emotional exhaustion, but were not related to levels of work involvement or accomplishment. Feedback from clients was central to determining the amount of accomplishment workers felt and their commitment to clients. By contrast, feedback from staff strongly related to workers' job satisfaction. Finally, higher levels of involvement with clients were associated with decreased resistance to the stresses of human service work while general job involvement was associated with increased resistance to such stress. PMID- 6486109 TI - Resources, life events, and changes in positive affect and depression in older adults. AB - Hypotheses from a prospective conceptual framework were tested on a sample of 1,166 adults, age 55 and older, who were interviewed three times at 6-month intervals. Older adults with stronger resources had significantly more positive psychological states initially than those with weaker resources, and this advantage was maintained regardless of the levels of life events. There were significant main effects for desirable events and for undesirable events. Those with higher desirable events showed less decline in positive affect. Contrary to the "booster" hypothesis, there was no significant interaction between resources and desirable events. There was a significant interaction between resources and undesirable events on depression but detailed analyses showed that increases in depression over time were limited to the combined condition of weak resources and high levels of undesirable events. Weak resource persons with low or moderate undesirable events, in fact, showed modest improvements in depression. PMID- 6486108 TI - Changes in staff satisfactions after increases in pay, autonomy, and participation. AB - Changes implemented at three youth treatment facilities consisted of salary increments, salary increments plus increased staff autonomy, or salary increments plus increased participation in decisions. Measures of satisfaction were obtained before and after these changes. Salary increments were followed by increased levels of satisfaction with pay and overall satisfaction. Increasing autonomy or participation led to higher satisfaction with work. Difficulties encountered during implementation of the high-autonomy procedures led to decreased satisfaction with supervisors. Implementation of the high-participation procedures was followed by decreased satisfaction with co-workers. PMID- 6486110 TI - The identification of alcohol problems: socioeconomic status differences in social norms and causal attributions. AB - It was hypothesized that the identification of abnormal behavior requires an internal causal attribution for actions that violate shared social norms. It was further hypothesized that socioeconomic status (SES) groups would differ in problem identification, due to differences in their norms and causal attribution biases. Attributions of causality for alcohol use and inferences of an alcohol problem were examined in socioeconomically different communities that differed in their social norms for alcohol consumption. For all respondents problem identification required that alcohol use be attributed to causes internal to the person. However, the lower SES sample was generally biased toward attributing alcohol use to external causes, in contrast to an "internal" bias among higher SES respondents. The latter were also more sensitive to norm violations in their problem identification. These differences led higher SES respondents to more readily identify an alcohol problem. PMID- 6486111 TI - Determining the need for mental health services in rural areas. AB - This study examined the need for mental health services as reported by rural consumers in DHHS Region V. It compared social indicator and consumer survey methods of determining need. Data were collected by mailed questionnaires and personal interviews from a probability sample of 3,057 rural residents. The need for mental health services was found to be no greater than that which has been reported for other residential areas. The social indicator method was found to be a poor predictor of need when compared to the consumer survey. PMID- 6486112 TI - Gallbladder dynamics in response to various meals: is dietary fat restriction necessary in the management of gallstones? AB - An estimated 20 million Americans have gallstones the majority asymptomatic. Yet traditionally many are often placed on low-fat or fat-free diets, presumably to reduce the risk of biliary colic. To assess the gallbladder dynamics in response to various meals, we studied 15 subjects (ages 21-54), each on 4 separate days. After an overnight fast, each subject was given, at random, either a breakfast containing greater than 30 g fat, less than 15 g fat, totally free of fat, or an infusion of C-terminal octapeptide of cholecystokinin. Gallbladder ejections at regular time intervals were measured using real time ultrasonography and the sum of cylinders technic corrected for the gallbladder shape. Considerable variability in the gallbladder dynamics and time response was noted with all the stimuli. However, among various meals, there were no statistically significant differences in the mean maximum ejection fraction or the mean maximum ejection time (p greater than 0.10). The mean maximum ejection fraction after cholecystokinin was somewhat greater (0.01 less than p less than 0.05) than that after meals, but the mean maximum ejection time was similar (p greater than 0.10). We conclude that the gallbladder dynamics in response to various meals are independent of a meal's fat content. Since the passage of gallstones into the cystic or common duct (biliary colic) is a random event unrelated to the type of food, fat-restricted diets offer no significant therapeutic advantage in the management of the large population with asymptomatic gallstones. PMID- 6486113 TI - Nonfunctional paraganglioma of the pancreas. AB - A patient with nonfunctional paraganglioma situated adjacent to the pancreas is presented. The clinical picture, the laboratory studies, as well as the gross appearance of the tumor and a frozen section at operation were not diagnostic. Internal drainage of the cystic tumor, assumed to be a pseudocyst of the pancreas, was done. Excision was performed when the diagnosis was histologically and ultrastructurally established. The microscopic and the electron microscopic features of this rare neoplasm are discussed. Excision of the tumor is recommended as the treatment of choice because of the malignant potential that does not correlate well with the histological appearance. PMID- 6486114 TI - Pathological study on livers with noncirrhotic portal hypertension and portal venous thromboembolic occlusion: report of seven autopsy cases. AB - Seven adult autopsied cases with noncirrhotic portal hypertension and thromboembolic occlusion of the large extra- and intrahepatic portal veins are presented. There were two types of portal venous occlusion: old thromboembolic occlusion (group A, two cases) and fresh thromboembolic occlusion (group B, five cases). In group A the occlusion was complete and the affected veins, which were identified clearly by elastic fiber stains, were characteristically shrunk to cause a long-standing portal hypertension. Extra- and intrahepatic collaterals were prominent. In group B the extra- and, sometimes, intrahepatic larger portal veins with fresh thromboemboli revealed variable degrees of phlebosclerosis, probably resulting from organization of repeated portal venous thromboemboli. These sclerotic changes further extended into the medium-sized and smaller intrahepatic portal veins. The latter and other hepatic morphology resembled those of idiopathic portal hypertension without larger portal venous occlusion (group C). Thus, in group B the widespread involvement of the portal venous system by thromboembolic events, particularly the smaller ones, might be important not only for the development of portal hypertension but also for understanding the hepatic pathology of idiopathic portal hypertension. PMID- 6486115 TI - Spontaneous bacterial peritonitis associated with cardiac ascites. AB - A patient who developed fatal spontaneous bacterial peritonitis associated with cardiac ascites is reported. Spontaneous bacterial peritonitis most frequently occurs in patients with decompensated cirrhosis of alcoholic or nonalcoholic type. Although there are reports of spontaneous bacterial peritonitis occurring in patients with nephrotic syndrome, or with acute or chronic hepatitis, there appear to be no reports of spontaneous bacterial infection developing in cardiac ascites. PMID- 6486116 TI - Volvulus of the transverse colon. AB - A volvulus of the transverse colon in a 78-year-old woman is reported. The diagnosis is established by abdominal film and barium enema with surgical confirmation. Women are more commonly affected than men. There is a higher mortality rate for volvulus of the transverse colon than for either sigmoid or cecal volvulus. PMID- 6486117 TI - Gastroenterology and the law. PMID- 6486118 TI - Vitiligo and primary biliary cirrhosis. PMID- 6486119 TI - Colorectal polyps in pattern makers. PMID- 6486120 TI - Biological monitoring: the employer's dilemma. AB - The industrial workplace contains many potential health hazards that not only can cause great harm to workers, but also can destroy the employers' economic stability. Often these hazards are documented and dealth with, but frequently they are unknown. When health-conscious employers monitor the physical well-being of their employees in an effort to avoid the terrible personal and economic costs these hazards can produce, they may be supplying their employees with the documentation necessary to recover financially for their industrial illnesses. This Article analyzes this dilemma confronting employers. It describes the many factors employers must consider when deciding whether to institute a monitoring process that takes full advantage of technological developments in medical care. The Article suggests an approach employers may take until some of the disincentives surrounding the implementation of monitoring are removed. PMID- 6486121 TI - Limits of guardian treatment refusal: a reasonableness standard. AB - The debate concerning the legal and ethical bases of guardian refusal of medical treatment on behalf of incompetent patients often ignores critical distinctions among types of patients and guardians. For example, patients who have expressed preferences regarding treatment while competent are distinguishable from patients who have always lacked the competency requisite to expressing a treatment preference. "Bonded guardians," whose relationship with the patient preexisted guardianship, should have a different role in the decision-making process than "non-bonded guardians," who were strangers to the patient prior to the guardian ward relationship. This Article proposes criteria for guardian treatment refusal on behalf of incompetent patients. Under the model for guardian decision making presented here, bonded guardians should be preferred over non-bonded guardians, and bonded guardians should be allowed discretion to make treatment choices, limited only by a standard of reasonableness policed by the courts. The Author presents legal and ethical justifications for the bonded guardian's heightened role. Finally, he considers the proper roles of health professionals, hospital ethics committees, and judges in the decision-making process. PMID- 6486122 TI - The insanity defense: effects of abolition unsupported by a moral consensus. AB - The insanity defense reflects the moral judgment that some criminal defendants do not deserve criminal sanctions because of mental incapacity. This Note examines the alternative formulations, such as guilty but mentally ill and diminished responsibility, that some states have enacted in the face of growing controversy over the insanity defense. It observes that the alternatives, if used in lieu of the insanity defense, distort the criminal law and do not comport with the legal doctrine of responsibility, which eschews punishing mentally ill defendants. The Note concludes that the insanity defense should not be abolished unless the moral consensus changes regarding the criminal responsibility of mentally ill defendants. PMID- 6486123 TI - Heckler v. Campbell and the grid: are disability claimants entitled to examples of suitable jobs? AB - The Social Security Administration promulgated the medical-vocational guidelines (the grid) in 1978 in order to improve consistency and efficiency in disability claim adjudications. The grid takes administrative notice of the availability of jobs suited to claimants' capabilities, eliminating the need to make such a determination on a case-by-case basis. In Heckler v. Campbell, the Supreme Court held that the grid is valid and that the Secretary of Health and Human Services cannot be required to give specific examples of jobs available in the national economy. In so doing, the Court reversed the Second Circuit, which had required the Secretary to give claimants examples of jobs suited to their individual characteristics to assure them adequate notice of the issues involved in their hearings. This Case Comment contends that the Supreme Court misperceived the Second Circuit's purpose in requiring the Secretary to provide specific examples of available jobs. Nonetheless, the Comment argues that the Supreme Court decision does not foreclose requiring such examples to assure adequate notice and to aid in resolving adjudicative factual issues. This Comment concludes that such a requirement would improve the efficiency, accuracy and consistency of Social Security disability determinations. PMID- 6486124 TI - Role of nifedipine in the treatment of resistant hypertension. Comparison with hydralazine in hospital outpatients. AB - In a double-blind, randomized crossover study, the daily administration of 30 to 90 mg of nifedipine lowered blood pressure in a dose-related fashion in 14 patients already taking a beta receptor blocker and diuretic. The duration of the hypotensive response to 20 mg of nifedipine in capsule form, giving as a "step three" drug to five of these patients, was six to eight hours. A survey of 122 patients with resistant hypertension treated long-term with nifedipine and a control group of 102 similar patients treated with hydralazine revealed that nifedipine at an average dose of 40 mg daily caused a fall in blood pressure similar to that achieved with hydralazine in a dose of 86 mg daily. The side effect profile of both drugs was also similar. Nifedipine may be a useful alternative to existing step-three antihypertensive drugs. PMID- 6486125 TI - Cellular actions and pharmacology of the calcium channel blocking drugs. AB - The calcium channel blockers represent a group of diverse chemical structures that block calcium-selective channels in the plasma membranes of a variety of excitable cells. As the calcium fluxes carried by these channels allow the calcium ion (Ca2+) to gain access to the cell interior, where calcium serves as an activator messenger, calcium channel blockers generally act to inhibit cell function. By reducing the depolarizing currents caused by the entry of positively charged Ca2+ into the negatively charged interior of resting cells, the calcium channel blockers also inhibit excitatory processes that depend on calcium entry across the plasma membrane. These principles account for most of the effects of calcium channel blockers on the cardiovascular system. The calcium channel blockers inhibit contractile function in the heart and vascular smooth muscle and, because the initial depolarizing currents in the sinoatrial and atrioventricular nodes are carried by calcium channels, slow the heart rate and prolong atrioventricular conduction. The negative inotropic and vasodilatory effects of the calcium channel blockers, both of which can reduce systemic blood pressure, offer a theoretic basis for their potential use in the treatment of hypertension. The tissue specificity exhibited by some of the calcium channel blockers may enhance their therapeutic value in selected hypertensive patients. Of the three calcium channel blockers now available for use in the United States (diltiazem, nifedipine, and verapamil), diltiazem and verapamil are approximately equipotent in inhibiting calcium channel function in the heart and vascular smooth muscle, whereas nifedipine is more potent in smooth muscle. This tissue specificity can be used to advantage in the management of hypertension. These pharmacologic principles underlie the growing appreciation of the potential value of the calcium channel blockers in the treatment of hypertension. PMID- 6486126 TI - Calcium entry blockers for the treatment of severe hypertension and hypertensive crisis. AB - Calcium entry blockers (diltiazem, nifedipine, and verapamil) are currently indicated for the treatment of patients with vasospastic and chronic stable angina pectoris. The calcium entry blocking actions of these drugs cause potent peripheral vasodilatory and antihypertensive effects in human subjects. The drugs have proved beneficial in the treatment of patients with severe hypertension and hypertensive emergencies. Single oral, sublingual, and intravenous doses of these drugs have been shown to rapidly and smoothly reduce blood pressure in adults and children, without significant untoward effects. The absolute reduction in blood pressure with treatment appears to be inversely correlated with the pretreatment blood pressure level, and few episodes of hypotension have been reported. Combinations of calcium entry blockers with other antihypertensive regimens have also proved effective. Some patients experience a mild increase in heart rate with nifedipine, an effect that appears to be inversely related to age. Side effects are minimal and not life-threatening. Continuous hemodynamic monitoring of patients does not seem necessary in most cases. The role of calcium entry blockade in the treatment of hypertensive emergencies still needs to be established in relation to other available approved drug regimens for this condition. PMID- 6486127 TI - Peripherally acting analgesics. AB - The therapeutic effect of aspirin and the other nonsteroidal anti-inflammatory drugs derives from the peripheral inhibition of prostaglandin synthetase. Aspirin produces irreversible inhibition, whereas the inhibition triggered by the other nonsteroidal anti-inflammatory drugs is reversible. Despite proved analgesic efficacy, use of aspirin and the nonsteroidal anti-inflammatory drugs may be accompanied by a wide range of side effects of a potentially serious nature. For relief of pain, there appears to be no clear-cut superiority of one nonsteroidal anti-inflammatory drug over another, and patients who fail to respond to one class of nonsteroidal anti-inflammatory drugs may respond to a representative of another class. As with aspirin, it is difficult to demonstrate the superiority of higher doses of these agents over the lower doses. The side-effect profile of non narcotic analgesics favors acetaminophen, presumably because its inhibition of prostaglandin synthetase occurs centrally. Acetaminophen does not appear to have the same potential for toxicity that is seen with aspirin and other nonsteroidal anti-inflammatory drugs. At dosages up to 4 g per day, acetaminophen compares favorably in analgesic potency to aspirin and other nonsteroidal anti inflammatory drugs, and it should be considered the treatment of choice for mild to-moderate pain. Safe conditions for the analgesic use of nonsteroidal anti inflammatory drugs in children and pregnancy have not been established. Because it is virtually free of side effects, acetaminophen may be the mild analgesic of choice for the pregnant patient. It has been used safely for years in children. Only a limited number of analgesic studies have been conducted in children. The results of analgesic studies carried out in adults are generally recognized as applicable to pain relief in children. PMID- 6486128 TI - Neurophysiology of pain and pain modulation. AB - An endogenous central nervous system pain-modulating network, with links in the mid brain, medulla, and spinal cord, has recently been discovered. This system produces analgesia by interfering with afferent transmission of neural messages produced by intense stimuli. Although other neurotransmitters are involved, the analgesia produced by this system depends on the release of endogenous opioid substances, generically referred to as endorphins. The system is set in motion by clinically significant pain--such as that resulting from bony fractures or postoperative pain. The analgesia network monitors the pain and controls it at the level of the spinal cord. Complex psychologic factors play an important role in the variability of perceived pain, partly because of their ability to trigger this pain-suppressing system. For example, this system contributes to the analgesic potency of placebo administration and is also activated by stress. Knowledge of this analgesia system has greatly expanded our understanding of the mechanisms underlying pain management. Opiates, like morphine and meperidine, produce analgesia by mimicking the action of endorphins in the pain. Tricyclic drugs may produce analgesia by enhancing the nonendorphin links of the same system. Future research on this system will provide new insights and, consequently, new approaches to the management of pain. PMID- 6486129 TI - Role of opioid analgesics. AB - The clinical pharmacology of the narcotic-type analgesics is discussed in depth. Relative analgesic potency, peak and duration of analgesia, oral potency, and adverse effects are reviewed, With an emphasis on the clinical application of this knowledge. The differences among psychologic dependence, physical dependence, and tolerance are carefully delineated. Guidelines are provided for using narcotic-type analgesics in the management of patients with cancer. PMID- 6486130 TI - Combination analgesics. AB - Six rationales for using combination analgesics are identified, but most combinations are formulated with two rationales in mind: enhancement of analgesia and reduction of adverse effects by combining two analgesics with different mechanisms of action. Acetaminophen and aspirin are the mainstays of oral analgesic combinations. There is substantial evidence that combining an optimal dose of acetaminophen or aspirin with an oral opioid such as codeine, hydrocodone, or oxycodone produces an additive analgesic effect greater than that obtained by doubling the dose of either constituent administered alone. There is also some evidence that the adverse effects produced by such combinations are less than would be produced by an equi-analgesic dose of a single constituent. The physician need not be confined to existing fixed-ratio combinations; he or she may extemporize to the patient's advantage by co-administering acetaminophen, aspirin, or other nonsteroidal anti-inflammatory drugs with available oral opioids and, in select situations, co-administering oral or injectable analgesics with psychoactive drugs. PMID- 6486131 TI - Physician-patient communication. AB - Physicians can better manage pain patients by improving their own awareness of the psychodynamics of pain behavior. Pain may be influenced by socioeconomic and cultural factors as well as prior personality characteristics. Patients may indulge in "pain games" that can result in what may be described as the "quack crock" syndrome. The stress response to continuing pain, a vicious cycle of denial, anger, and depression, can be approached by the physician through the use of proper listening and educational techniques that help the patient to understand and better deal with his or her situation. Patients may then begin to take an active part in the recovery process. PMID- 6486132 TI - Treatment of headache in primary care practice. AB - Although chronic recurring headaches are usually benign, every headache should be viewed with concern, and every effort should be made to determine the cause of the headache. Medical emergencies and serious neurologic disease can also present as headache. A careful history should be taken and a neurologic examination conducted for each patient whose presenting complaint is headache. Diagnosis and treatment of migraine, cluster, and tension headaches are discussed. PMID- 6486133 TI - Pain and inflammation. AB - The traditional "aspirin first" approach to the treatment of osteoarthritis and rheumatoid arthritis is undergoing serious reappraisal. Aspirin and acetaminophen are equipotent in their analgesic efficacy; however, aspirin is associated with a higher incidence of side effects. Acetaminophen should therefore be used as first line therapy for the treatment of osteoarthritis since reduction of pain is the primary therapeutic objective. Analgesic doses of aspirin (up to 3,900 mg per day) do not produce an anti-inflammatory effect and thus are not beneficial in the treatment of rheumatoid arthritis. Only high doses of aspirin (4 to 6 g per day) used for a sustained period produce an anti-inflammatory effect. Since many patients with rheumatoid arthritis cannot tolerate long-term use of anti inflammatory doses of aspirin, it may be preferable to initiate therapy with one of the newer nonsteroidal anti-inflammatory drugs. PMID- 6486134 TI - Diagnostic bias and toxic shock syndrome. PMID- 6486135 TI - The kindly stress of hospitalization. PMID- 6486136 TI - Folate metabolism and chromosomal stability in the fragile X syndrome. AB - Folate metabolism and the effects of folic acid on chromosome stability were studied in four related patients with the fragile X syndrome. In three adults, uptake and subsequent utilization of folate compounds for conversion of deoxyuridylate to thymidylate by marrow cells and stimulated lymphocytes, and the affinity and maximal transport velocity of erythrocyte membrane carriers, were normal. Numbers of sister chromatid exchanges and double-stranded DNA breaks were comparable in cells from patients and control subjects, but both were increased after incubation in folate-deficient media. In vitro expression of the fragile site was strikingly reduced by oral folate therapy. It is concluded that the folate-sensitive chromosomal defect in this syndrome is limited to a specific site, Xq28, and there is no generalized tendency to frequent DNA breaks or recombination. Although expression was modified by folic acid treatment in the patients, no consistent abnormality of folate metabolism could be identified. PMID- 6486137 TI - Course of renal pathology in patients with systemic lupus erythematosus. AB - Evaluation of the course of lupus nephropathy by serial kidney biopsy in 50 patients revealed a complex pattern of transitions from one histologic class to another. A high rate of transformations (56 percent) was observed, with fewer than half the patients remaining in the original category. Although the general trend was towards transformation to a less severe lesion (WHO classes III and IV transforming into classes II and V), this was certainly not the rule for all individual classes. These transformations were rarely predictable on the basis of available clinical, laboratory, or pathologic information, and were less common in younger patients. These results help clarify the pathologic behavior of lupus nephropathy in the modern therapeutic era and highlight the value of pathologic examination for the planning and evaluation of therapy in selected patients. PMID- 6486138 TI - Mammographic parenchymal patterns and risk of breast cancer in postmenopausal women. AB - A case-control study was conducted to assess whether certain "high-risk" mammographic parenchymal patterns are associated with the increased occurrence of breast cancer in postmenopausal women. Patients in the case group included 105 women with histologically confirmed breast cancer; subjects in the control group included 104 women with fibrocystic breast disease and 103 women with clinically normal breasts. All mammographic results were evaluated "blindly" by a radiologist who classified the breast parenchyma into "high-risk" and "low-risk" categories according to the criteria proposed by Wolfe. These data showed a similar proportion of allegedly "high-risk" breast parenchymal patterns among patients in all three groups. The finding that breast parenchymal patterns are not associated with an increased risk of breast cancer in women 50 years of age or older is consistent with the results of earlier studies in which the association is present only in younger, premenopausal women, and is absent in older, predominantly postmenopausal women. Consequently, it is concluded that these parenchymal patterns should not be used to select postmenopausal women for breast cancer screening programs, or to guide the evaluation of postmenopausal women with breast lumps or symptoms. PMID- 6486139 TI - Gynecomastia in a hospitalized male population. AB - Two hundred fourteen hospitalized adult men, aged 27 to 92, were examined for the presence of palpable gynecomastia. The overall prevalence was 65 percent. Gynecomastia was bilateral in all but 11 subjects. The prevalence was greatest in the 50 to 69-year-old group (72 percent). It was lower in the 70- to 89-year-old (47 percent, p less than 0.01) and the 30- to 49-year-old (54 percent, p less than 0.05) groups. The prevalence of gynecomastia increased with body mass index. More than 80 percent of those with a body mass index of 25 kg/m2 or greater had gynecomastia. The diameter of breast tissue also increased with increasing body mass index (r = 0.52, p less than 0.001). The decreased prevalence of gynecomastia after the seventh decade could be explained by the lower body mass index in this group. The youngest group did not have a lower body mass index; an independent age factor appeared to be present. Because of the high overall prevalence of gynecomastia, independent effects of diseases or medications could not be determined. It is concluded that palpable bilateral gynecomastia is present in most older men, is correlated with the amount of body fat, and does not require clinical evaluation unless symptomatic or of recent onset. PMID- 6486140 TI - Hospital-acquired bloodstream infections with Staphylococcus epidermidis. Review of 100 cases. AB - During a seven-year study period, 1976 to 1982, this prospective surveillance program detected 108 episodes of nosocomial bacteremia caused by coagulase negative staphylococci (seven per 10,000 admissions). Chart reviews were subsequently performed in 100 patients primarily to define the patient population and determine outcome of infection. Seventy-two patients had at least two culture bottles that showed growth of coagulase-negative staphylococci plus one or more cultures that showed growth at another site or on a vascular catheter. Most of the patients were in the early or later stages of life: 20 were premature infants, 20 additional infants were under one year of age, and 35 patients were 50 years of age or older. Seventy-three patients were in intensive care areas at the time of the infection. The mortality for the 100 patients studied was 34 percent, with a rate of 9 percent per week after infection. Ninety-three patients had arterial or central lines in place prior to bacteremia and, in 36 reviewed, the mean duration of use of each type of catheter (5.1 days or more) was longer than recommended. In 56 percent of 46 catheters cultured semiquantitatively, there was growth of coagulase-negative staphylococci. The presence of coagulase negative staphylococci in the blood is associated with significant mortality in hospitalized patients. No longer can their presence in the blood be disregarded as mere contaminants, especially in patients in critical care units. PMID- 6486141 TI - Side effects of systemic cyclosporine in patients not undergoing transplantation. AB - Twenty-six patients with ocular inflammatory disorders of presumed autoimmune origin were treated with oral cyclosporine. Cyclosporine is a potent T cell regulatory agent that has been utilized extensively in organ transplantation. In general, the patients in this study did not have chronic debilitating illnesses that are observed in organ transplant recipients, did not receive corticosteroids in addition to cyclosporine, and did not undergo any surgical procedure during their treatment. This study describes the observed adverse reactions in this group of patients not undergoing transplantation. The reported side effects of cyclosporine in organ transplant recipients have included nephrotoxicity, hepatotoxicity, infections, lymphoma, hirsutism, gingivitis, and central nervous system toxicity. Side effects were observed that were similar to those in previous reports, but the severity of the nephrotoxicity and hepatotoxicity appeared to be less. Nephrotoxicity occurred in eight patients and hepatotoxicity occurred in one patient. No lymphomas were seen. Hypertension and anemia each were observed in six patients. In addition, previously unreported effects of hyperuricemia, elevated sedimentation rate, and hidradenitis were observed. However, the overall severity of the side effects did not seriously affect the usage of cyclosporine in the patients in this study. Cyclosporine may be useful in the treatment of other autoimmune diseases. PMID- 6486142 TI - Evaluation of sleep-disordered breathing. Is polysomnography necessary? AB - To determine whether polysomnography is necessary to assess the presence and severity of sleep-disordered breathing, bedside observations by physicians were compared with the results of polysomnography in 37 patients with clinically suspected obstructive sleep apnea. Physician observations correlated with objective findings from polysomnography in detecting the presence of obstructive apnea (p less than 0.01), and had a high specificity and positive predictive value. The 20 patients correctly identified by clinical observation had a longer duration of apneic episodes (p = 0.02), increased severity of snoring (p = 0.02), resuscitative snoring (p less than 0.02), and paradoxic thoracoabdominal movement (p less than 0.05). However, 11 other patients with sleep-disordered breathing were not identified clinically; therefore, the sensitivity (64.5 percent) and diagnostic accuracy (70.3 percent) of brief clinical observation were low. Furthermore, the physicians' determinations of the severity of the condition on the basis of bedside estimates of disordered breathing rate, duration of episodes, and the degree of associated hemoglobin oxygen desaturation did not correlate with objective measurements. These findings suggest that a single, brief clinical observation alone is an ineffective screening procedure for detecting obstructive sleep apnea. PMID- 6486143 TI - Lectin-like factor and co-factor in serum from cystic fibrosis heterozygotes. AB - Previous attempts to use an assay for a serum lectin-like factor as a carrier test for the cystic fibrosis gene have not been successful because food intake and effects of serum storage have interfered. A revised method for detecting the lectin-like factor employs the serum IgM fraction, rather than whole serum, separated on an S-300 Sephacryl gel filtration column. Elevated lectin titers were found in 95 percent of 43 obligate heterozygotes, 89 percent of patients with cystic fibrosis, 64 percent of siblings of patients with cystic fibrosis, and 5 percent of 60 control subjects. Lectin activity was shown to be associated with the IgM fraction of serum and to result from the binding of a low-molecular weight co-factor to IgM. Unbound co-factor was also detected in a serum fraction from 81 percent of the heterozygotes and 88 percent of the cystic fibrosis homozygotes, and in a urine fraction from nine patients with cystic fibrosis who had positive serum lectin activity, but not in any urine sample from heterozygous subjects. The presence of co-factor in the urine of cystic fibrosis homozygotes suggests higher serum levels of this agent that spill over into the urine. Intravenous antibiotic therapy removes the lectin and co-factor from blood and urine for variable periods of time, suggesting a beneficial effect of antibiotics in cystic fibrosis apart from their antibacterial action. Detection of the lectin and co-factor are useful in screening for cystic fibrosis carriers, although the somewhat subjective biologic assay requires much experience to achieve reliability. PMID- 6486144 TI - Nonrandom occurrence of single-vessel coronary artery disease. AB - The location of obstructive coronary artery lesions in single-vessel disease is nonrandom. The circumflex coronary artery is protected relative to the right coronary artery. This may have important implications regarding the causation of coronary obstructive lesions. PMID- 6486145 TI - Interpreting the fractional excretion of sodium. AB - In most normal subjects, the fractional excretion of sodium is usually less than 1 percent but may be raised with an increase in salt intake. In acutely azotemic patients, a low fractional excretion of sodium usually indicates a prerenal process that is responsive to volume repletion. However, such a low fractional excretion of sodium also can be seen with azotemia due to hepatic or cardiac failure, as well as acute glomerulonephritis, pigment nephropathy, contrast nephrotoxicity, polyuric renal failure associated with burns, acute obstruction, renal transplant rejection, and occasionally non-oliguric acute renal failure, none of which is a volume-responsive process. A fractional excretion greater than 1 percent in acutely azotemic patients usually indicates intrinsic renal injury, but is consistent with volume depletion in patients receiving diuretics or in some patients with chronic renal insufficiency. Similarly, a low quotient in acute renal parenchymal injury is usually interpreted to indicate widespread tubular integrity, but is consistent with several different pathophysiologic processes. The fractional excretion of sodium must be interpreted in light of the specific clinical setting and other laboratory data to be useful in patient management. PMID- 6486146 TI - Post-marketing studies of drug efficacy: how? AB - This report reviews the 100 most recently approved drugs in order to quantify the frequency with which post-marketing studies of drug efficacy can be performed experimentally and non-experimentally. These drugs represent 131 potential drug uses. Of them, the absolute efficacy of 89 (68 percent) could be evaluated from clinical observations. Of the remaining 42, six (14 percent) could be studied experimentally or non-experimentally, six (14 percent) only experimentally, one (2 percent) only non-experimentally, and 29 (69 percent) by neither technique. Answers to all questions of relative efficacy required formal research. Of these, 94 (72 percent) could be studied using either experimental or non-experimental techniques. The remaining 37 (28 percent) could be studied experimentally only. Thus, clinical observations and non-experimental research can contribute a large proportion of the information about drug efficacy still needed after marketing. PMID- 6486147 TI - Obstructive jaundice due to radiation-induced hepatic duct stricture. AB - A case of obstructive jaundice due to radiation-induced hepatic duct stricture is reported. The patient received postoperative radiation for left adrenal carcinoma, seven years prior to this admission. The sequelae of hepatobiliary radiation and their management are discussed briefly. PMID- 6486148 TI - Neurocrest and colonic tumors: new clinical syndrome. Report of three cases. AB - This report describes three patients with both multiple intestinal polyps and tumors of neural crest origin. This combination of findings may represent a new clinical syndrome. The embryologic relationships between tumors derived from endoderm and tumors derived from neurocrest are described. An inherent defect in tissue proliferation or repair is postulated to explain the abnormal growth in these two different cell lines. PMID- 6486149 TI - Reversible acute cardiac injury during cefoxitin-induced anaphylaxis in a patient with normal coronary arteries. AB - This report describes a 64-year-old patient who had electrocardiographic evidence of acute cardiac injury but no ensuing myocardial infarction as a complication of systemic anaphylaxis from intravenous cefoxitin. Coronary angiography subsequently demonstrated essentially normal findings except for anomalous origin of the right coronary artery from the left sinus of Valsalva. There is believed to be only one previous report of coronary angiography in a patient who had a myocardial infarction complicating an anaphylactoid reaction to radiographic dye; in that patient, angiography showed coronary atherosclerosis. The possible role of coronary vasospasm in cardiac injury complicating anaphylaxis is discussed. PMID- 6486150 TI - Rhabdomyolysis in thyroid storm. AB - This is the first reported case of thyroid storm complicated by rhabdomyolysis with acute reversible renal failure. The only possible causes for the rhabdomyolysis were inherent features of thyroid storm. Although hyperthyroid patients characteristically have normal or low serum levels of muscle enzymes, this case report demonstrates that rhabdomyolysis with elevated serum levels of muscle enzymes can occur with hyperthyroidism. An appreciation of the potential for rhabdomyolysis in hyperthyroidism should facilitate prompt initiation of aggressive therapy for myoglobinuria and thereby limit the severity of acute renal failure in these already very sick patients. PMID- 6486151 TI - Hyponatremia due to cerebral salt-wasting syndrome. Combined cerebral and distal tubular lesion. AB - A 76-year-old white man was evaluated for a syndrome of hyponatremia, hypotension, and high urinary sodium excretion. There was evidence of inappropriate secretion of antidiuretic hormone and renal salt wasting in the presence of a normal glomerular filtration rate. He had a distal tubular acidification defect and unresponsiveness to standard doses of mineralocorticoids. The renin aldosterone axis was normal, as were thyroid and adrenal function. The patient could not dilute the urine, nor excrete a standard water load. Renal concentrating ability was normal, but there was no additional response to exogenous vasopressin. With modest salt restitution, the patient continued to lose large quantities of sodium in the urine, resulting in severe postural hypotension. Renal biopsy showed normal glomeruli with distinct degeneration of the distal tubules. There was no evidence of an acute inflammatory interstitial nephritis. The patient did not respond to therapeutic doses of mineralocorticoid (fludrocortisone), but treatment with water restriction, increased salt intake, and large doses of mineralocorticoids resulted in a normal serum sodium level and blood pressure. This case falls in the category of "cerebral salt wasting" syndrome. The cause was a combination of idiopathic secretion of antidiuretic hormone and distal tubular degeneration resulting in pseudohypoaldosteronism. PMID- 6486152 TI - Vitamin D metabolism and bone histomorphometry in a patient with antacid-induced osteomalacia. AB - A patient with hypophosphatemic osteomalacia secondary to ingestion of large amounts of phosphate-binding antacids is presented. Vitamin D metabolites were measured during the course of his illness and recovery and demonstrated an initially elevated concentration of 1,25-dihydroxyvitamin D, an undetectable level of 24,25-dihydroxyvitamin D, and a normal level of 25-hydroxyvitamin D. These metabolites returned to normal levels when the hypophosphatemia was corrected. Bone histomorphometry showed osteomalacia with increased resorption. The possible role of altered vitamin D metabolism in the pathogenesis of this disorder is discussed. PMID- 6486153 TI - Myxedema coma during long-term amiodarone therapy. AB - Amiodarone is a potent new antiarrhythmic drug that has multiple effects on thyroid function, including inhibition of extrathyroidal triiodothyronine production and rarely, iodine-induced hypothyroidism. This report describes a man with recurrent ventricular tachycardia in whom hypothyroidism developed during amiodarone therapy and who died of probable myxedema coma. Parenteral and oral thyroxine therapy promptly reduced serum thyroid-stimulating hormone concentrations without increasing the patient's very low serum triiodothyronine concentration. This response to thyroxine suggests that thyroxine itself may have biologic activity and participate directly in regulation of thyrotropin secretion. Because amiodarone-induced hypothyroidism may be life-threatening, thyroid function should be monitored before and during amiodarone therapy, and the drug discontinued or appropriate therapy instituted if hypothyroidism develops. PMID- 6486154 TI - Endobronchial lymphocytic infiltration. Unusual manifestation of chronic lymphocytic leukemia. AB - This report describes a patient with chronic lymphocytic leukemia followed over a 15-year period. The distinctive feature of her course was the infiltration of the bronchial wall by malignant lymphocytes, which produced endobronchial obstruction, atelectasis, and infection. Symptomatic improvement occurred following local irradiation and steroid therapy. A review of the literature establishes that the development of endobronchial infiltration during the course of chronic lymphocytic leukemia and other lymphoproliferative disorders is distinctly uncommon. PMID- 6486155 TI - Toxoplasmosis presenting as panhypopituitarism in a patient with the acquired immune deficiency syndrome. AB - A 57-year-old man with a prior episode of lymphatic toxoplasmosis presented with signs of anterior panhypopituitarism, which was confirmed by standard endocrinologic evaluation. The diagnosis of central nervous system toxoplasmosis was established by brain biopsy after nondiagnostic serologic and radiographic studies. At autopsy, the anterior pituitary was necrotic, with Toxoplasma abscesses in neighboring brain structures. Clinical and laboratory data met the criteria for the acquired immune deficiency syndrome. Although this is the first reported case of toxoplasmosis presenting as panhypopituitarism, future cases may be identified since central nervous system toxoplasmosis is being recognized more frequently in patients with immunodeficiency. PMID- 6486156 TI - Water intoxication in a psychotic patient with normal renal water excretion. AB - A psychotic patient with hyponatremia and obtundation following short-term ingestion of large amounts of water was found to have maximally dilute urine, and underwent brisk diuresis until the serum osmolality returned to normal. This is the first report of normal renal diluting capacity as documented by measurement of urine osmolality in a water-intoxicated, schizophrenic patient, and demonstrates that normal renal diluting mechanisms may on occasion be overwhelmed by massive water ingestion. PMID- 6486157 TI - New concepts in hypertension therapy. Proceedings of a symposium. Maui, Hawaii, February 6-8, 1984. PMID- 6486158 TI - Systemic and regional hemodynamic effects of acute and prolonged treatment with urapidil or prazosin in normotensive and spontaneously hypertensive rats. AB - The regional and systemic hemodynamics of urapidil and prazosin were investigated after intravenous (1 mg/kg or 0.01 mg/kg, respectively) and prolonged (three weeks) oral treatment (20 mg/kg a day or 2 mg/kg a day, respectively) in normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats. Following intravenous administration, both urapidil and prazosin decreased mean arterial pressure, mediated through a decrease in total peripheral resistance and accompanied by a transient increase in heart rate in both strains. The changes in regional circulations were more widespread after urapidil, but of longer duration after prazosin. Prolonged administration of urapidil or prazosin resulted in a significant decrease in mean arterial pressure and total peripheral resistance only in SHR. With urapidil treatment, the decrease in vascular resistance was distributed throughout all circulations, with no change in heart rate or cardiac index. Heart rate increased in WKY rats and cardiac index increased in SHR following prazosin treatment. Cardiac mass remained unchanged following treatment with either drug. PMID- 6486159 TI - Central and peripheral cardiovascular actions of urapidil in normotensive and Goldblatt hypertensive animals. AB - The central effect of urapidil on mean arterial blood pressure, heart rate, and reflex tachycardia was studied in anesthetized normotensive and Goldblatt hypertensive dogs and anesthetized cats. The administration of 1 mg intracisternally of urapidil decreased blood pressure and heart rate in normotensive dogs, whereas 2 and 4 mg decreased heart rate and returned blood pressure to the control level. Reflex tachycardia evoked by the intravenous administration of bradykinin was suppressed in a dose-dependent manner by urapidil. In the anesthetized cat, urapidil was administered intracisternally (50 to 400 micrograms) and had no effect on heart rate. The reflex bradycardia elicited by central vagal nerve stimulation was accentuated by urapidil given intracisternally, but this only occurred in the presence of beta adrenoceptor blockade with propranolol. PMID- 6486160 TI - Founder's Award speech. PMID- 6486161 TI - Bacteremic pneumococcal pneumonia in the elderly. AB - Pneumococcal pneumonia is an increasingly important disorder of the elderly. We reviewed, retrospectively, the clinical and laboratory manifestations of 29 elderly patients with bacteremic pneumococcal pneumonia during a five year period and surveyed the capsular serotypes of all blood isolates. Pneumococcal pneumonia frequently presented with subtle manifestations in these elderly patients: 50% lacked historical features suggestive of pneumonia at the time of diagnosis. A common presentation was fever, altered mental status and dehydration. Recognizing this will allow earlier diagnosis and initiation of therapy. Sixty percent of patients had potential pulmonary pathogens other than pneumococcus in cultures of sputum at the time of pneumococcal bacteremia. Reversible abnormalities of liver function were frequent. Sixty-nine percent of pneumonias were caused by serotypes included in the commercially available vaccine. Continued surveillance of pneumococcal serotypes is important to determine if the widespread use of the vaccine will result in an increased incidence of infection by serotypes which are not in the vaccine. The high mortality associated with pneumococcal pneumonia (31% in this series), particularly in the elderly, emphasizes the need for an effective vaccine. PMID- 6486162 TI - Supply dependency of oxygen uptake in ARDS: myth or reality? AB - Several reports state that oxygen uptake changed in direct correlation with changes in total oxygen delivery to the tissues in the adult respiratory distress syndrome (ARDS). Oxygen uptake appeared to be limited by oxygen delivery even at normally adequate levels so that uptake was abnormally dependent on supply. These reports are discussed with respect to whether or not such a result could have been due to errors in measurement or to mathematical coupling by relating two quantities that shared a common variable. Having rejected that proposition, animal experiments are cited in which abnormal oxygen supply dependency was produced by microembolization. The accompanying loss of reactive hyperemia and inability to extract oxygen were consistent with a progressive loss of recruitable capillaries. Evidence is presented that the potential for embolization in ARDS is greatly enhanced by activation of the complement and arachidonic acid cascades as well as by the xanthine oxidase system. The resultant use of molecular oxygen by non-ATP producing oxidase systems might also account for the increase of supply dependent oxygen demand in ARDS. PMID- 6486163 TI - Cavitary pneumonia due to Yersinia enterocolitica in a healthy man. AB - A previously healthy 51-year-old man was admitted to the hospital because of pulmonary infiltrates of the right upper lung field with cavitation. Blood cultures were sterile. Sputum and stool cultures grew Yersinia enterocolitica. The patient was treated with intravenous ampicillin and recovered. Review of the literature yielded five previously reported sputum-positive cases of Y. enterocolitica pulmonary infections in patients with significant underlying diseases. All patients recovered. PMID- 6486164 TI - The first Meckel oration: on the causes of morphological differences in a population of guinea pigs. AB - The first morphological abnormality considered here was of a very superficial sort: deviations from the smooth coat of wild cavies and most guinea pigs. The deviations of "rough-furred" individuals range from a single irregularity or a single pair of rosettes to the "full rough" pattern. Roughness may be restricted to the hind toes, forehead, or hair around the eyes or belly, or (very rarely) to a small area on one side of the back. There is no indication of gene control in the last, and no analysis of the only strain (in Professor Castle's laboratory) that I have seen, of roughness restricted to the belly. A dominant gene, R, in combination with a semidominant modifier, M, account for the fancier roughs (R-MM toes only, R-mm full rough). A gene, st, that is completely dominant in the absence of R, semidominant in its presence, was descended from 3 animals from outside the colony. It accounts for a large forehead rosette, usually with a small white spot in front of its center. A statistically semidominant gene, Re, with extremely irregular, often asymmetric penetrance tends to cause rosettes about the eyes. This arose by mutation late in the history of the Whitman colony. It is strengthened by presence of R MM. Considerable variation occurs in the numbers of dorsal rosettes of R Mm and R mm. These have not been analyzed satisfactorily because the genetic differences are confounded by nongenetic ones. It is not practicable to summarize briefly all of the complex interaction effects of these factors, but it may be noted that the most surprising one had to do with genes St and R. The forehead rosette due to rr St closely resembles that of R mm (except for the absence of the pleiotropic white spot). The combination, R mm St St, shows none of the expected enhancement but instead shows nearly complete cancellation of the rosette. Moreover, the anterior dorsal rosettes of R mm st st are much reduced and seemingly shoved backward and laterally to give a large smooth shield back of the ears. St St also reduces the usual dorsal pair of rosettes of R Mm. With St st, all of these antagonistic effects are weaker and less regular. Another morphological deviation to be considered was the fairly common restoration of an atavistic little toe.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6486165 TI - Gross anatomical studies of a newborn infant with the Meckel syndrome. AB - A male infant with the Meckel syndrome was studied anatomically. The findings were compared to those from eight trisomy 13 cases to determine whether or not the superficial similarities between the two syndromes were matched by similarities in the internal variations. Emphasis was on the head and limbs. In the head, major differences were found in the nasal bones, mandible, and tongue. In the limbs, the skeletal variations were more severe in the Meckel syndrome infant, but he lacked the muscle variations diagnostic of trisomy 13. PMID- 6486166 TI - Meckel syndrome in different populations. AB - We report on 18 infants from 13 families where the infant was affected with the Meckel syndrome. The parents belong to various national groups--Russians, Byelorussians, Poles, Ukranians, Letts, and Tatars. One child was from an incestuous union (half-sister and half-brother), in 4 families the parents were natives of the same or neighboring villages; other parents apparently were not related. Excluding 3 couples from Central Russia, the Ukraine, and Tatary, the other 10 families were the inhabitants of the Moscow region, Byelorussia, and Latvia. In 3 of these families at least one grandparent was of Tatar descent. At the same time the frequency of Tatars in these regions is less than 1%. Using the Newton binomial distribution it was shown that the hypothesis about equal frequency of the Meckel syndrome gene among Tatars and other national groups under study may be excluded completely, and therefore the alternative hypothesis about an unusually high frequency of this gene among Tatars must be accepted. Such analysis may be useful for comparative evaluation of gene frequencies in populations which cannot be studied directly. PMID- 6486167 TI - The Meckel syndrome: clinicopathological findings in 67 patients. AB - A nationwide study on the Meckel syndrome (MS) was carried out covering retrospectively the years 1970-1979 and prospectively the years 1980-1981. Sixty seven cases from 48 Finnish families were found. The clinical and pathological findings were studied. Cystic dysplasia of the kidneys was present in all the cases where sufficient information was available. In all 41 cases with specimens available from the liver, a typical fibrotic change with proliferation and dilatation of the bile ducts was found. This series and a review of the literature give convincing evidence that cystic dysplasia of the kidneys with fibrosis of the liver is a constant finding in the "true" Meckel syndrome. In conclusion, it is proposed that cystic dysplasia of the kidneys with fibrotic changes of the liver and occipital encephalocele or some other central nervous system malformation are considered as minimal diagnostic criteria of MS. Thus, a histologic investigation of the kidneys and liver is essential in diagnosing MS in doubtful cases. Heterozygote manifestations were not found. PMID- 6486168 TI - The Meckel syndrome in Finland: epidemiologic and genetic aspects. AB - Estimates of the incidence of the Meckel syndrome (MS) from different parts of the world vary from 1:140,000 to 1:13,250 births. In this nationwide study performed in Finland, the incidence of 1:14,400 births was found by retrospective ascertainment during the period 1970-1979, while the incidence was 1:8,500 births when prospective monitoring was performed in 1980-1981. The most probable incidence in Finland is about 1:9,000 births. Autosomal recessive inheritance of MS is confirmed in this study. The ratio of affected sibs, corrected for truncate complete ascertainment, was 0.261. No consanguinity between parents was found, as marriages between close relatives are rare in Finland and the ancestors were not traced back far enough to find remote consanguinities. PMID- 6486169 TI - Genetic counseling in Becker type X-linked muscular dystrophy. I. Theoretical considerations. AB - The prior probability of any woman being a carrier for Becker muscular dystrophy (BMD) has been calculated. If mu is the mutation rate in female germ cells and v the mutation rate in male germ cells, this probability is 34/3 mu + 20/3v. For all X-linked diseases with a fitness f the prior probability (H) is: (formula; see text). PMID- 6486170 TI - Genetic counseling in Becker type X-linked muscular dystrophy. II: Practical considerations. AB - A frequent problem of genetic counseling in Becker muscular dystrophy (BMD) is the differential diagnosis between BMD and the autosomal recessive benign limb girdle muscular dystrophy (LGMD) if the pedigree pattern is not typical of X linkage. In this situation, the a priori probability that a woman and her husband may be heterozygotes for LGMD can be shown to be 80 mu/a (mu = mutation rate in BMD; a = incidence ratio between BMD and LGMD). In addition, the age-corrected serum creatine kinase (CK) values of all female relatives are also important for the risk calculation of a woman being carrier of BMD. PMID- 6486171 TI - On the statistical determination of major gene mechanisms in continuous human traits: regressive models. AB - We consider the analysis of a continuous trait measured on human families and pedigrees to elucidate the mechanism of underlying major genes. Thinking in terms of the naturally Markovian structure of the dependencies in pedigrees rather than variance components, we describe natural classes of regressive models that are computationally feasible. These models can accommodate wide generalizations of the residual variation, and so should provide a stronger basis than other models proposed to date for inferring the segregation and linkage relationships of major genes. PMID- 6486172 TI - A prenatally detected inv dup(15). AB - An extra G group-like chromosome was found in an amniotic fluid cell culture. With multiple banding techniques it was identified as inv dup(15). BUdR incorporation was used to determine the lateral asymmetry of the marker, which consisted of 2 distal spots arranged contralaterally, consistent with DNA polarity conservation in chromosome rearrangements. PMID- 6486173 TI - A private view of heterozygosity: eight-year follow-up study on carriers of the Tay-Sachs gene detected by high school screening in Montreal. AB - We surveyed 264 persons (132 carriers, 132 matched noncarriers) screened for Tay Sachs heterozygosity during 1974-76 in a program directed at senior high school students in Montreal. Among 198 who apparently received the questionnaire in 1982, the response rate was 42% (38 carriers, 45 noncarriers; age range 21-26 yr). Respondents and nonrespondents had no apparent demographic differences. Of eight unable to remember their genotype only one was a carrier (these persons were excluded from the study). The subjects were: single (75%), married (20%), engaged (3%), divorced (1%); 32% of carriers were engaged or married vs 16% of noncarriers. (There were no carrier couples in our sample, but one such couple, who married after being screened in the high school program, requested amniocentesis in 1981.) Only three of the 12 spouses or fiance(s) of carriers have not been tested (vs 3 of 6 noncarrier partners). Only 19% of carriers now attach any "worry" to heterozygosity (vs 46% at the earlier time of test disclosure, P = 0.001); carriers with spouses or fiance(e)s are less "worried" than unattached carriers. Only 3% of carriers claim they would change marriage plans if their fiance(e) was also a carrier. Carriers and noncarriers uniformly approve (96%) genetic screening for themselves and for other mutant genotypes; 92% of carriers and 95% of noncarriers approve being screened in high school. These findings indicate that Canadians screened in high school: 1) have largely positive attitudes toward genetic screening long after the experience, and 2) are making appropriate use of the test result. PMID- 6486174 TI - Linkage of skeletal dysplasia gene to t(2;8)(q32;p13) chromosome translocation breakpoint. PMID- 6486175 TI - Taxonomy of family life styles: II. Homes with slow-learning children. AB - A battery of instruments dealing with family social environment and family and child characteristics and behavior was administered to 218 families with slow learning children in EMR and educably handicapped programs. Cluster analysis was performed on family environment variables. Seven unique family clusters, each with distinctive patterns of characteristics, were identified: child-oriented, cohesive; learning-oriented, high residential quality; low disclosure, unharmonious; disadvantaged, noncohesive; achievement-oriented, low residential quality; expression-oriented with few sociocultural interests; and outerdirected with little achievement-orientation. Comparisons among the clusters and ethnographic/interviewer observations revealed significant differences in other family and child characteristics and behavior. Development of a classification system for families with retarded children was discussed. PMID- 6486176 TI - Infants' home environments: a study of screening efficiency. AB - The predictive efficiency of Caldwell's Home Observation for Measurement of the Environment (HOME) with a sample of infants from low-income families at-risk for developmental retardation was assessed. The home environments of 51 infants were assessed with the HOME at 6 and 18 months. Multiple discriminant functions composed of the six HOME subscale scores predicted whether the child would be low IQ (below 75), low average (75 to 89), or average to superior (90 and above) at age 3. At both 6 and 18 months, the discriminant function of the HOME was found to be moderately sensitive in identifying children in the low-IQ group (62% correctly identified); 56% were false positives. Additional research is necessary to differentiate with precision among families at elevated risk levels. PMID- 6486177 TI - Implications of sensory stimulation in self-destructive behavior. AB - The self-stimulatory and social theories of self-destructive behavior of autistic, schizophrenic, and mentally retarded individuals were examined. The self-stimulatory theory states that self-destructive individuals obtain a form of sensory stimulation or reinforcement from the behavior itself. An extension of this theory, which is also presented in this paper, explains specifically how these individuals acquire sensory stimulation from such deviant behavior. By damaging the nerve structure of the skin, the tactile sensory threshold for physical input is lowered. This increase in the skin's sensitivity enables individuals to obtain sensory stimulation by repeatedly depressing the damaged area. In addition, I have proposed that the behavior may initially be a form of self-stimulation but subsequently may be operantly reinforced by the caretaker's concern for the individual. PMID- 6486178 TI - A true experiment evaluating adult skill training for severely mentally retarded secondary students. AB - Skill acquisition by secondary-level severely mentally retarded students was assessed on functional community and living skills task analyses. Students were trained in natural settings according to a behavioral analysis of the curriculum into systematic teaching and error-correction procedures. Classroom training in the district high school supported the teaching that occurred in the community. The evaluation of student performance on specific skills was done using random assignment to training and control conditions in a cross-over design. Students showed significantly greater gains on those tasks for which they were trained than on those for which they were not. In addition to this specific skill training, a daily checklist showed significant progress by all students on a broad array of skill sequences. Discussion stressed the contribution of the project to ideologically appropriate public school programs for severely mentally retarded students, to behaviorally based instructional technology, and to evaluation using true experimental designs. PMID- 6486179 TI - High school students' attitudes and actions toward "slow learners". AB - The relationship between high school students' attitudes and their involvement in their school's peer-tutoring program for "slow learners" was examined. Predictions about how attitudes would be related to behavior were derived from theories about attitude-behavior consistency. Results showed, as predicted, that students' attitudes toward people who receive tutoring were unrelated to their peer-tutoring behavior, whereas there was a trend for their attitudes toward their own tutees to predict whether they met with their tutees. Consistent with Ajzen and Fishbein's (1973) theory, however, the best predictor of peer-tutoring behavior was students' intentions to tutor. Moreover, both intentions and behavior were correlated with students' attitudes toward this behavior. These results were interpreted as demonstrating the value of using an empirical validated theoretical approach to predicting behavior toward slow learners. PMID- 6486180 TI - Regular- and special-education teachers' judgments about mentally retarded children in an integrated setting. AB - A three-way design was used to determine whether teachers' judgments about mentally retarded children would be related to characteristics of the children, characteristics of the teacher, and/or characteristics of an integrated free-play setting. Independent variables were integration ratio, area of teacher's specialization, and target child. The dependent variable was teachers' judgments about handicapped children in an integrated setting. Subjects were 15 regular education teachers and 15 special-education teachers who taught at the primary school level. Judgment ratings by regular-education teachers depended both on the characteristics of the target child and the integration ratio in the free-play activity. Special-education teachers' judgments also were influenced by characteristics of the child observed but not the integration ratio. PMID- 6486181 TI - Training reaction and movement times of moderately and severely mentally retarded persons in aiming movements. AB - The effect of information feedback of movement components on the reaction time (RT) and movement time (MT) of mentally retarded adults performing a discrete movement aiming task was investigated. We anticipated that specific training and informational feedback on the RT portion of the RT-MT task would more effectively reduce RT, despite aiming requirements of the movement. Results suggested that specific training and feedback on RT decreased both RT and MT components of the task, whereas specific training on MT reduced only MT. The data were discussed with respect to the differential effects of training on subject populations at varying levels of intellectual capacity. PMID- 6486182 TI - Improving profoundly mentally retarded adults' performance on a position discrimination. AB - The relative importance of stimulus manipulations antecedent to or consequent on the response was investigated in three experiments related to position discrimination. In the first experiment, two different stimuli (either a piece of candy or a toy cat) were hidden under one of three boxes in full view of 2 profoundly mentally retarded adults. The behavior of uncovering the hidden object was measured using a combined multiple baseline and reversal design. In Experiment II, an entire unit of profoundly retarded adults was screened to determine the prevalence of the effects observed in Experiment I. In Experiment III, an attempt was made to determine whether the difference in antecedents (candy vs. kitty) or consequences accounted for the superior performance when the candy was hidden. In this experiment, using a reversal design with four profoundly retarded adults, we found that the antecedent manipulation (hiding the candy vs. hiding the toy cat) resulted in better performance than did the manipulation of the consequence (handing subjects the candy or allowing them to uncover and consume it). PMID- 6486183 TI - Speed of information-processing and structural limitations by mentally retarded and dual-diagnosed retarded-schizophrenic persons. AB - Three experiments were conducted in an investigation of information-processing capabilities of mentally retarded adults, nonretarded children (mental age control), and nonretarded adults (chronological age control). In all experiments, one of two target stimuli was presented to the center and to the right or left of central fixation. Subjects were required to detect the presence of a stimulus in a yes-no forced-choice paradigm (Experiment 1), identify which of the two targets had been presented in a forced-choice discrimination paradigm (Experiment 2), or distinguish between the targets in a forced-choice discrimination task when the target was preceded by, presented stimultaneously with, or followed by a patterned noninformational masking stimulus. The findings support the theory of a structural defect in mentally retarded persons that results in slow information processing. PMID- 6486184 TI - Clinical responses to psychopathology of mentally retarded persons. AB - Effects of the label "mentally retarded" on clinical judgment were examined. Doctoral level psychologists of varying orientations and levels of experience with mentally retarded persons were exposed to a brief therapy transcript that was labeled or unlabeled. Analyses of variance revealed that the mentally retarded label resulted in ratings of less severity of psychopathology, first treatment choices that were more behavioral in nature, and attributions of greater importance to the client's level of intellectual functioning in the assessment process. The results were interpreted as representing diagnostic labeling bias. PMID- 6486185 TI - Performance of EMR and learning-disabled students on the brigance, peabody, and wide range achievement tests. AB - Achievement test results are commonly used for making educational decisions for students labeled mildly mentally retarded, educationally retarded, and learning disabled. Teachers frequently assume that individual achievement tests are comparable. High correlations between achievement tests are typically reported and drawn from scores obtained primarily from regular student populations. When these tests are given to special populations, in this case mildly mentally retarded and learning-disabled students, the specific abilities of the pupils interact with aspects of the test items. In the present study, significant differences were found on the subtests of three tests that were designed to measure the same area of achievement. PMID- 6486186 TI - Effects of vibratory, edible, and social reinforcement on performance of institutionalized mentally retarded individuals. AB - The relative effectiveness of verbal praise, vibration, and edible reward as methods of enhancing and maintaining performance on a perceptual-motor task was investigated. Sixty-six mentally retarded students were divided into high- and low-MA groups and randomly assigned to reinforcement conditions. Data analysis revealed that response rates for the low-MA students in the verbal condition reinforcement and the nonreinforcement phases were significantly lower than the response rates for the low-MA students in any phase of the edible or vibratory conditions. No significant difference in reinforcer effectiveness was observed across various phases for students in the high-MA groups. PMID- 6486187 TI - Comparison of three measures of adaptive behavior. AB - A comparison was made among three adaptive behavior scales. Teachers and parents completed the Adaptive Behavior Scale--School Edition and the Adaptive Behavior Inventory for Children, and 57 EMR and slow-learning students (Ns = 36 and 21, respectively) completed the Children's Adaptive Behavior Scale. Analysis of variance and t-test comparisons indicated higher ratings for the slow-learner group than for the EMR group on all three measures. Also, parents rated students as having better adaptive behavior skills than did teachers. These findings suggest that measures of adaptive behavior can differentiate EMR from slow learning children and that self-reports from parents on these measures may be somewhat unreliable. PMID- 6486188 TI - Oxytocin augmentation of dysfunctional labor. IV. Oxytocin pharmacokinetics. AB - Plasma oxytocin levels ([OT[p) were measured every 20 minutes during infusions of oxytocin. The initial dose of 1 mU/min was incremented, if necessary, by 1 mU/min at 40-minute intervals until sufficient contractility was obtained to effect cervical dilatation. The results demonstrated: the [OT]p rises linearly with each dose for the first 40 minutes of the infusion; there is no difference between the 40- and 60-minute sample values, suggesting that the peak [OT]p of each dose is achieved in 40 minutes; the increment in [OT]p required to produce effective contractility varies widely from 0.58 to 5.09 microU/ml; the plasma clearance rate varied from 11.2 to 32.5 ml/kg/min. Approximately 40 minutes is required for any particular dose of oxytocin to reach a "steady-state" [OT]p and the maximal uterine contractile response. The design of regimens for the augmentation or induction of labor should be based on this knowledge. PMID- 6486189 TI - Perinatal outcome following prior delivery in the late second or early third trimester. AB - Forty pregnancies in 37 women who were previously delivered of a live-born fetus between 20 and 32 weeks' gestation are reported here. Fourteen pregnancies were treated with cervical cerclage between 14 and 16 weeks. Twenty-six pregnancies were initially managed conservatively, but three of these patients had a McDonald cerclage placed between 18 and 23 weeks because of significant change in cervical effacement or dilatation. The risk of preterm delivery was 36% (5 of 14) in the cerclage group and 38% (10 of 26) in those patients managed conservatively. The perinatal survival rates were 93% (13 of 14) and 88% (23 of 26), respectively. These results are encouraging when it is considered that only 14% (9 of 64) of prior gestations (exclusive of spontaneous abortions and elective terminations) were carried to term and the perinatal survival rate was 28% (18 of 64). Although this study was nonrandom, these results also support the selective use of cervical cerclage on the basis of past history and physical examination. PMID- 6486190 TI - Hemodynamic measurements in preeclampsia: preliminary observations. AB - Ten patients with preeclampsia were monitored with a Swan-Ganz thermodilution catheter before the start of treatment. Reference data were obtained by right heart catheterization in four normal pregnant women. In the preeclamptic group the effects of volume expansion and vasodilatation were studied. All patients showed a low cardiac index, low pulmonary capillary wedge pressure, and a high systemic vascular resistance. Following volume expansion the pulmonary capillary wedge pressure and cardiac index rose to normal pregnant values whereas blood pressure showed no significant change and systemic vascular resistance decreased, but normal pregnant values were not obtained. Vasodilatation with dihydralazine resulted in a further decrease in systemic vascular resistance, a fall in blood pressure accompanied by a further increase in cardiac index with a stable pulmonary capillary wedge pressure. It is concluded that pregnant women with preeclampsia are unable to cope with a circulating volume necessary to maintain a cardiac index and ventricular filling pressure which is considered to be physiologic in normal pregnancy. In preeclampsia the capacity for vasodilatation is inadequate. PMID- 6486191 TI - Determinants of size at birth in a Canadian population. AB - Anthropometric, medical, and sociodemographic characteristics and smoking habit of a random sample of postpartum women in a Canadian population were determined. These characteristics were analyzed in relation to the birth size of their babies. With controls for gestational age and fetal sex, the following maternal variables were positively correlated with birth weight: prepregnant weight, weight gain in pregnancy, stature, bicristal and biacromial diameter, calf and upper arm circumference, and triceps and subscapular skinfold thickness. Smoking during pregnancy reduced birth weight by 13 gm per cigarette smoked daily. Similar associations of maternal size and smoking habit were observed with respect to infant length, head circumference, and chest circumference. The predictors of birth weight are proposed for use in adjusting upward or downward the population distribution of birth weight to reflect the individual characteristics of the mother. PMID- 6486192 TI - Blood flow and oxygen delivery to fetal organs as functions of fetal hematocrit. AB - The purpose of our experiments was to relate blood flow and oxygen delivery (blood flow x arterial blood oxygen concentration) to fetal organs as functions of fetal hematocrit. In 12 chronically catheterized fetal lambs, we observed two patterns of responses of fetal organs and tissues to isovolemic alterations in fetal hematocrit from 12% to 55%. In group 1 organs (brain, heart, adrenal glands), blood flows increased as hematocrit was either raised or lowered from normal such that oxygen delivery to these organs was stable over the entire range of hematocrits studied. In group 2 organs (gastrointestinal tract organs, spleen, kidneys, placenta, and carcass), blood flows varied little over the range of hematocrits from 12% to 40% or 45% but decreased at hematocrits greater than or equal to 40% to 45%. Because of these flow responses, oxygen delivery to these organs and tissues was maximal at hematocrits ranging from 32% to 38%. Our data indicate that the various organs of the unanesthetized fetal lamb respond in different ways to alterations in hematocrit. It is of particular interest that, in the great majority of the organs of the fetus, oxygen delivery is maximal at hematocrits considered normal for the fetal lamb in utero. PMID- 6486193 TI - Confirmation of the preoperative diagnoses for hysterectomy. AB - Few previous studies have examined the relationship between the preoperative and pathologic diagnoses for hysterectomy. To determine the percentage of preoperative diagnoses that were confirmed by pathologic examination, we analyzed data from the Collaborative Review of Sterilization, a multicenter study of hysterectomies and tubal sterilizations in women aged 15 to 44 years. Data were collected from patient interviews and chart reviews. Of the 1851 women included in this study, 1283 (69%) had abdominal hysterectomies and 568 (31%) had vaginal hysterectomies. Overall, 52% of the hysterectomies were performed for a preoperative diagnosis that could potentially be confirmed by pathologic examination. Pathologic examination actually confirmed the preoperative diagnosis of endometrial hyperplasia in 95% of the cases, cervical intraepithelial neoplasia in 89%, leiomyomas in 84%, pelvic inflammatory disease in 75%, adenomyosis in 48%, and endometriosis in 47%. Among all of the potentially confirmable diagnoses, 80% were confirmed. The remaining 48% of the women who had hysterectomies had preoperative diagnoses that were not amenable to confirmation by pathology. Most of these were for one of three diagnoses: menstrual bleeding disorders, pelvic pain, or pelvic relaxation. In 47% of these cases, pathologic examination showed leiomyoma or adenomyosis; no abnormalities were found in 38% of these cases. PMID- 6486194 TI - Ten-year prospective study in a management change of vulvar carcinoma. AB - A prospective study involving 71 cases in which operation for vulvar carcinoma was performed during a 10-year period is presented. Primary closure of the vulvar defect with the use of full-thickness transposition flaps reduced hospitalization without jeopardizing survival. This technique tends to increase the radical nature of the operation. Although complications involving groin breakdown were reduced, such complications remain a formidable challenge for newer techniques. The postoperative results have been superior to those of older methods. PMID- 6486195 TI - Stage IB adenocarcinoma of the cervix: metastatic potential and patterns of dissemination. AB - The metastatic potential patterns of dissemination have been investigated in 150 patients with Stage 1B adenocarcinoma of the cervix treated during a 20-year period from 1956 to 1977. All cases with the exception of one were treated with a combination of intracavitary radium implants followed by a radical surgical procedure with pelvic lymph node dissection. It was found that the incidence of pelvic metastases and distant recurrences and the survival rates were the same as in previously published reports for squamous cell carcinomas treated in the same manner. In one respect adenocarcinomas showed a significant difference when compared with squamous cell cancers: The incidence of residual tumor in the hysterectomy specimens after intracavitary treatment was much higher (30% versus 11%). This is considered a strong argument for surgical treatment of patients with early stages of adenocarcinoma of the cervix. PMID- 6486196 TI - Steroid hormone receptors in adrenal cortical carcinoma. PMID- 6486197 TI - Malignant hyperthermia in pregnancy. PMID- 6486198 TI - Routine cesarean section in twin gestation. PMID- 6486199 TI - A screening protocol for a prenatal population at risk for inherited hemoglobin disorders: results of its application to a group of Southeast Asians and blacks. AB - Several inherited hemoglobin disorders are present among certain racial subgroups of the United States population, particularly among blacks and Southeast Asians. Many of these disorders are unfamiliar to the obstetrician-gynecologist but may have important implications for care in pregnancy, including genetic counseling and prenatal diagnosis. A simple, effective screening tool was devised for detection of thalassemias and hemoglobinopathies in a prenatal clinic population. Use of the tool resulted in diagnosis of a hemoglobin disorder in 20% of a group of black patients; diagnoses included alpha-thalassemia trait, beta-thalassemia trait, hemoglobin C trait, hemoglobin S/C disease, hemoglobin S trait, sickle cell anemia, and hemoglobin Lepore. In a group of Southeast Asian patients, 39% had a hemoglobin disorder, including alpha-thalassemia trait, beta-thalassemia trait, hemoglobin E disease, and hemoglobin H disease. Implications for care are discussed. PMID- 6486200 TI - Cytoplasmic estrogen and progesterone receptor content of uterine sarcomas. AB - Analyses of cytoplasmic estrogen receptor and progesterone receptor were performed on tumor specimens from 32 patients with uterine sarcomas. While the median and maximal quantitative levels of binding were lower than those observed in endometrial carcinomas, examples of estrogen receptor- and progesterone receptor-positive as well as estrogen receptor- and progesterone receptor negative tumors were observed in all histologic categories of sarcomas. The presence of significant levels of estrogen receptor binding correlated (p less than 0.05) with the presence of progesterone receptor. The receptor binding status did not correlate with the histologic type of sarcoma, clinical stage, primary or metastatic tumor, presence of extrauterine metastases, age, previous exogenous estrogen therapy, mitotic count, or overall differentiation or nuclear differentiation of the sarcoma. The overall and nuclear differentiation of the carcinomatous elements of homologous mixed mullerian tumors did not correlate with receptor status. The presence of significant levels of estrogen receptor did demonstrate a trend (p less than 0.10) favoring enhanced survival through short term follow-up, but this trend was not demonstrated with survival beyond 36 months. Steroid receptor status did not otherwise affect prognosis or disease free survival. No correlation between receptor content and response to hormonal therapy or chemotherapy was observed. PMID- 6486201 TI - The presence of a meconium-like substance in second-trimester amniotic fluid. AB - Previous studies of the significance of meconium-stained second-trimester amniotic fluid have relied upon visual assessment of fluid color as the screening procedure followed by spectrophotometric analysis at 405 nm to confirm the presence of "meconium" (incidence of 1% to 3%). This assumes that in the absence of discolored fluid there is no "meconium." In the present study, prospective spectrophotometric analysis was performed on 123 serially obtained amniotic fluid specimens sampled at 15 to 19 weeks' gestation. The presence of an absorbing species peaking near 405 nm was observed in 91% of the samples. This substance is generally not present at term. Its presence does not correlate with pregnancy outcome and is of no prognostic significance. However, it is related to gestational age and placental implantation site. Further analysis supports the hypothesis that our tracings represent a variety of pigments derived from the metabolism of intra-amniotic hemoglobin resulting from the normal physiologic development of early pregnancy. PMID- 6486202 TI - Postasphyxial lung disease in newborn infants with severe perinatal acidosis. AB - The pulmonary course and respiratory management of 65 asphyxiated infants with at least one arterial pH less than or equal to 7.00 within the first 2 hours of life was determined. Asphyxia in the preterm and term infants in the absence of respiratory distress syndrome or meconium aspiration syndrome was associated with a transient respiratory insufficiency requiring assisted ventilation which markedly improved in the first 24 hours of life. In contrast, infants with asphyxia complicated by respiratory distress syndrome or meconium aspiration syndrome developed profound lung disease including pulmonary hemorrhage and persistence of the fetal circulation. The course of their illness was significantly worse than control infants without asphyxia. Ineffective neonatal resuscitation allowing for the development of meconium aspiration syndrome and persistent respiratory acidosis contributed to the severity of illness in more than 50% of the infants. Central nervous system pathologic conditions were present in asphyxiated infants with and without severe pulmonary disease. We conclude that severe asphyxia in the absence of underlying lung disease results in a predictable postasphyxial transient respiratory insufficiency, with marked improvement in the first 24 hours of life. PMID- 6486203 TI - Fetal lung liquid regulation by neuropeptides. AB - The fetal lung, filled with fluid during intrauterine life, is recognized as a site of fluid production, significantly contributing to amniotic fluid volume. To assess possible hormonal control of lung liquid production, we studied the effect of intravenous vasopressin or vasotocin on lung liquid production in chronically catheterized fetal sheep. Both vasopressin and vasotocin infusion resulted in a significant decrease in lung fluid production (38% and 40%, respectively) when compared to that in control animals receiving saline infusion. There was no significant change in lung fluid osmolality, sodium, or potassium. These findings suggest that lung liquid production in utero may be regulated by the fetus and that vasopressin or vasotocin may be of physiologic importance in lung fluid dynamics during the third trimester of ovine pregnancy and perhaps during parturition. PMID- 6486204 TI - Effect of meconium on the detection of phosphatidylglycerol. AB - Phosphatidylglycerol determination has been used as an additional parameter in the evaluation of fetal lung maturity. Meconium was added to aliquot samples of amniotic fluid after phosphatidylglycerol determination. On those amniotic fluid samples without phosphatidylglycerol, phosphatidylglycerol standard and meconium were added. Two-dimensional thin-layer chromatography was performed to detect the phosphatidylglycerol spot. Our results show that lightly stained meconium contamination of amniotic fluid does not hinder the detection of the phosphatidylglycerol spot on the chromatographic plate. PMID- 6486205 TI - Pheochromocytoma: antepartum diagnosis and management with tumor resection in the puerperium. PMID- 6486206 TI - Lack of association between vitamin intake during early pregnancy and reduction limb defects. PMID- 6486207 TI - Previous cesarean birth: management considerations in the patient with acute puerperal uterine inversion. PMID- 6486208 TI - Uterine strangulation of a premature infant. PMID- 6486209 TI - Induction of cytoplasmic progesterone receptor in human endometrial carcinoma transplanted into nude mice. PMID- 6486210 TI - Effects of betamethasone on white blood cells in patients with premature rupture of the membranes and preterm labor. PMID- 6486211 TI - Corneal endothelial changes in type I and type II diabetes mellitus. AB - Forty-six corneas from 25 patients who had had type II (adult-onset) diabetes for more than ten years were examined by specular microscopy with quantitative morphometric analyses of individual endothelial cells. Thirty-four corneas from 21 age-matched nondiabetic subjects were examined for comparison. We also examined 31 corneas from 17 patients with type I (juvenile-onset) diabetes and compared them to 41 corneas from 23 age-matched normal volunteers. The corneal endothelium in type II diabetes showed no difference in cell density but demonstrated a significantly higher coefficient of variation, a decrease in the percentage of hexagonal cells, and a low figure coefficient compared to an age matched nondiabetic population. Type I diabetes produced similar cell changes, but these changes occurred in the earlier decades. Moreover, we detected a significantly higher rate of cell loss in type I diabetes, resulting in a significant decrease in cell density in the fourth and fifth decades. These results clearly indicate that the diabetic endothelium is morphologically abnormal. The observed anatomic changes result in a less stable and more vulnerable cell layer, possibly explaining some of the persistent clinical changes in the diabetic cornea after surgical trauma. PMID- 6486212 TI - Stellate iron lines in the corneal epithelium after radial keratotomy. AB - Biomicroscopic examinations of the corneal epithelium of 54 patients who had consecutive radial keratotomy operations in the National Eye Institute Prospective Evaluation of Radial Keratotomy (PERK) study showed that abnormal stellate epithelial iron lines had appeared at the junction of the middle and inferior thirds of the cornea in 13 of 16 eyes (81%) examined six months after surgery, in 43 of 50 eyes (86%) examined 12 months after surgery, and in seven of nine eyes (78%) examined 24 months after surgery. The density and pattern of the deposits varied from a faint tan horizontal iron line studded with small branches to a dense yellow-brown deposit with eight radiating arms that extended between all of the incisions. Analysis of the configuration of the iron line and the central keratometric readings 12 months after surgery showed that the greater the reduction in the central keratometric measurement postoperatively, the more prominent the iron line. We attribute the occurrence and variation of the stellate epithelial iron line to irregularities in the surface of the cornea present in the first year after radial keratotomy. PMID- 6486213 TI - Opacification, vascularization, and chronic inflammation produced by hydrogel corneal lamellar implants. AB - Fourteen hydrogel lamellar implants were placed in rabbit corneal stroma. Within six months of implantation, all the rabbit eyes showed some opacification of the cornea, and several of the rabbits had vascularization along the lamellar interface with signs of chronic inflammation. Opacification and vascularization eventually appeared in all 14 eyes, regardless of the water content or oxygen permeability of the lens material. One rabbit was killed, and a histopathologic examination showed evidence of chronic inflammation and scarring. Because the rabbit's sensitivity to an inflammatory nidus makes it a good laboratory test animal, these rabbits' inability to tolerate some of the currently available hydrogel corneal lamellar implants may indicate that such material is unsuitable as a permanent implant for cosmetic refractive surgery in humans. PMID- 6486214 TI - An in vivo study of corneal surface morphologic features in patients with keratoconjunctivitis sicca. AB - We used wide-field color specular microscopy to study the corneal epithelium of 13 normal subjects and 13 patients with keratoconjunctivitis sicca. The frequencies of small, medium, and large cells were different in the two groups, with a shift to small cells in patients with keratoconjunctivitis sicca. Increased uptake of rose bengal dye, filaments, coarse mucus plaques, and pre exfoliative sheets were also found in the patients with keratoconjunctivitis sicca. These findings suggest accelerated epithelial cell loss from the surface of the eye in keratoconjunctivitis sicca. PMID- 6486215 TI - Determination of the normal range of exophthalmometric values for black and white adults. AB - We used the Hertel exophthalmometer to measure the degree of protrusion in 681 adults, ranging in age from 18 to 91 years. The 327 white and 354 black subjects had no history of orbital or endocrine disease, severe myopia (more than -7 diopters), or buphthalmos. The mean normal protrusion values were 16.5 mm in white men, 18.5 mm in black men, 15.4 mm in white women, and 17.8 mm in black women. Although protrusion values above 21 mm are usually considered abnormal, we found that the upper limits of normal were 21.7 mm for white men, 24.7 mm for black men, 20.1 mm for white women, and 23.0 mm for black women. These differences were statistically significant (P less than .025). No individual had more than 2 mm of asymmetry between eyes. PMID- 6486216 TI - The mode of progression of visual field defects in glaucoma. AB - We retrospectively studied 42 eyes of 42 patients with glaucoma to determine the pattern of progression of their visual field defects. In 33 eyes (79%) the scotomas became denser. Enlargement occurred in 22 eyes (52%) and 21 eyes (50%) developed new scotomas. Increased density of the scotomas was the only manifestation of change in ten eyes (24%), three eyes (7%) showed enlargement only, and six (14%) showed only new scotomas. Seventeen eyes (57%) with single hemifield involvement maintained a defective single hemifield throughout the follow-up period. PMID- 6486217 TI - Laser iridectomy in the management of chronic angle-closure glaucoma. AB - Nineteen eyes of 16 patients (12 men and four women ranging in age from 41 to 75 years) underwent laser peripheral iridectomy for treatment of uncontrolled chronic angle-closure glaucoma (25 to 62 mm Hg). Five of eight eyes (62.5%) with glaucomatous cupping but full visual fields attained postiridectomy intraocular pressures of less than 22 mm Hg with medical therapy. Seven of nine eyes (77.7%) that had both glaucomatous optic disk damage and visual field loss before iridectomy had controlled intraocular pressures with medical therapy after iridectomy. Because laser iridectomy is safer than trabeculectomy, we recommend that it be the initial procedure in the treatment of chronic angle-closure glaucoma. PMID- 6486218 TI - Effect of intraocular lens fixation on the blood-aqueous barrier. AB - We used slit-lamp fluorophotometry to evaluate the influence of various intraocular lens fixation sites on the blood-aqueous barrier in 106 eyes. After an average follow-up period of 1.1 years, eyes with anterior chamber lenses with closed or rectangular loops had a significantly higher concentration of fluorescein than did eyes with other types of implants (P less than .1 to P less than .001). In eyes with posterior chamber lenses, those with ciliary sulcus fixation had a significantly higher concentration of fluorescein than did those with intracapsular fixation (P less than .02). Compared with aphakic eyes without implants, eyes with any implant other than posterior chamber lenses with intracapsular fixation had significantly higher fluorescein concentrations (P less than .02 to P less than .001). These results indicated that the flexibility and the intraocular location of the lens loops are significant factors in securing the integrity of the blood-aqueous barrier of pseudophakic eyes. Posterior chamber lenses with intracapsular fixation caused the least trauma to the blood-aqueous barrier. PMID- 6486219 TI - Subretinal proliferation. AB - Subretinal proliferation is often present but less often identified as a component of proliferative vitreoretinopathy. Subretinal membranes form from retinal pigment epithelial cells and retinal glial cells that migrate into the subretinal space of eyes with long-standing retinal detachments. The membranes grow as sheets but break up into bands as the cells contract, with the stronger parts remaining intact. PMID- 6486220 TI - Surgical treatment of giant retinal tears with inverted posterior retinal flaps. AB - We treated 23 consecutive cases of giant retinal tears with inverted retinal flaps. We used pars plana vitrectomy together with an intravitreal bubble to unfold the posterior retinal flap, combined with cryotherapy to cause a chorioretinal adhesion and a broad scleral buckle. The vitrectomy was done after applying cryotherapy so viable retinal pigment epithelial cells in the vitreous cavity could also be removed. Thirteen eyes had giant tears measuring 90 to 180 degrees (Group 1), eight eyes had giant tears measuring 180 to 270 degrees (Group 2), and two eyes had giant tears larger than 270 degrees (Group 3). The retina was successfully reattached in 11 of the 13 eyes in Group 1, each of the eight eyes in Group 2, and one of the two eyes in Group 3. We believe that vitrectomy and lavage of the vitreous cavity after applying cryotherapy was important in reducing the incidence of proliferative vitreoretinopathy and improving our success rate. PMID- 6486221 TI - Multivariate analysis of prognostic factors in penetrating ocular injuries. AB - We used a multivariate statistical analysis to identify factors predicting visual outcome in 281 eyes that underwent primary repair of a penetrating ocular injury. Visual acuity of 20/800 or better on initial examination was the most important factor, with these eyes 28 times more likely to have a final visual acuity of 20/800 or better than eyes with initial visual acuities worse than 20/800. The effect of other factors differed depending on the initial visual acuity. In patients with initial visual acuities of 20/800 or better, youth (less than or equal to 18 years) was a significant predictor of final visual acuities of 20/50 or better. In patients with initial visual acuities worse than 20/800, a laceration limited to the cornea was the best predictor of good visual outcome. Absence of an expelled or subluxed lens and lacerations limited to a location anterior to the rectus muscle insertions were also important predictors of good visual outcome. When an intraocular foreign body was present these factors were no longer significant and older age (greater than 18 years) was the most important predictor of good visual outcome. PMID- 6486222 TI - Scleral buckling for retinal detachment in patients with retinoblastoma. AB - Three children (two girls and one boy) with bilateral retinoblastoma each developed a presumed rhegmatogenous retinal detachment in one eye. All three eyes had previously received radiation and cryotherapy. In each case the retinal detachment responded promptly to conventional surgical methods via scleral buckling in the area of treated retinoblastoma and presumed retinal break. All three eyes have retained useful vision for follow-up periods of 3.5 to 12 years. PMID- 6486223 TI - Lack of association between intraocular melanoma and cutaneous dysplastic nevi. AB - The occurrence of uveal and cutaneous malignant melanoma and the dysplastic nevus syndrome in the same individual suggests an etiologic relationship among these diseases. Thus, the dysplastic nevus syndrome could be viewed as marking an increased risk of both cutaneous and ocular melanoma. We postulated that if such a relationship exists, patients with both forms of melanoma should have a high prevalence of dysplastic nevi. We examined 44 patients (31 women and 13 men ranging in age from 20 to 80 years) with uveal melanoma for evidence of cutaneous melanoma and dysplastic nevi. We also examined photographs of 46 patients (24 men and 22 women ranging in age from 19 to 67 years) with nonfamilial cutaneous melanoma to determine the prevalence of dysplastic nevi. We found a 4.5% prevalence of dysplastic nevi in patients with uveal melanoma, significantly lower than the 41% prevalence in patients with cutaneous melanoma (two of 44 patients vs 19 of 46 patients). This study indicates that uveal and cutaneous melanoma are not etiologically linked through dysplastic nevi and suggests that patients with uveal melanoma are no more likely to have cutaneous dysplastic nevi than the general population. PMID- 6486224 TI - Cavernous hemangioma of the retina, cutaneous angiomas, and intracranial vascular lesion by computed tomography and nuclear magnetic resonance imaging. AB - In a 32-year-old man with a right-sided retinal cavernous hemangioma and cutaneous angiomas, computed tomography and nuclear magnetic resonance imaging confirmed the presence of cerebrovascular lesions. This supports the inclusion of cavernous hemangioma of the retina in the established group of neuro-oculo cutaneous phacomatoses. PMID- 6486225 TI - Light-induced maculopathy. AB - Photochemical retinal damage can result from the light of the operating microscope during cataract extraction with implantation of intraocular lenses. Three patients (a 47-year-old woman, a 73-year-old woman, and a 69-year-old man) who underwent cataract extraction with the Zeiss OMNI-6 operating microscope with internal incandescent coaxial illumination developed phototoxic retinal damage in the macular region. A posterior chamber lens was used in the first case, an anterior chamber lens in the second, and an iris-supported lens in the third. The photochemical damage was most evident in fluorescein angiographic studies, and Goldmann visual field studies documented scotomas in the affected areas. Final visual acuities were 20/40 in Case 1, 20/30 in Case 2, and 20/30 in Case 3. PMID- 6486226 TI - Macular reflexes in optic atrophy. AB - We investigated the annular reflex of the macula and the foveal reflex in 14 eyes with various degrees of optic atrophy by means of red-free fundus photographs. The patients ranged in age from 13 to 34 years (mean age, 25.9 years). We compared our observations with data obtained from 51 age-matched normal eyes. Optic atrophy was found to be associated with changes in the reflexes of the macular area. Alterations occurred in all eight eyes that had visual acuities of 20/50 or worse. Changes in the annular reflex of the macula were more significant in younger patients (less than or equal to 25 years of age) than in older patients. In the younger group, the annular reflex was blunt, distorted, and fragmented, and showed an irregular extension toward the foveal area, whereas in the old group it showed less specific attenuation. Fading of the foveal reflex was observed in both groups. Changes in the retinal reflexes of these patients result from alterations in the ganglion cell and nerve fiber layer and should be included among the signs of optic atrophy. They can help determine the extent of optic atrophy and can be useful clinical clues in children whose optic disks are difficult to examine. They should not be mistaken for signs of associated primary retinal disorders. PMID- 6486227 TI - The Pulfrich effect in anisometropic amblyopia and strabismus. AB - Using a device based on the Pulfrich effect, we examined 70 patients with various strabismus problems and 20 normal subjects for gross stereopsis. We found an excellent correlation between this dynamic stereopsis test and random dot stereograms. Additionally, in several instances the Pulfrich device was easier to use and interpret correctly than random dot stereograms. The Pulfrich effect can be elicited reliably in patients as young as 3 1/2 years of age. Three patients with anisometropic amblyopia and stereopsis were found to possess a spontaneous Pulfrich effect. PMID- 6486228 TI - Monocular nystagmus in infancy and early childhood. AB - Of 11 young children (six girls and five boys, ranging in age from 4 to 14 months) with monocular nystagmus, six were found to have chiasmal tumors whereas only four had spasmus nutans. Differentiating features between these two groups included decreased vision and optic nerve anomalies (including four cases of optic nerve hypoplasia) in the tumor group. However, we found that no consistent clinical finding absolutely separates these groups. We therefore recommend that all infants and children with monocular nystagmus or the other features of spasmus nutans should undergo computed tomographic scanning. PMID- 6486229 TI - Correlation between corneal endothelial morphology and function. PMID- 6486230 TI - Arecoline miosis. PMID- 6486231 TI - Acute retinal necrosis in an immunosuppressed patient. PMID- 6486232 TI - Orbital extension of choroidal melanoma within a short posterior ciliary nerve. PMID- 6486234 TI - Chorioretinal damage in onchocerciasis. PMID- 6486233 TI - The pic-forceps for removal of epiretinal membranes. PMID- 6486235 TI - Neodymium-YAG capsulotomy and potential blindness. PMID- 6486236 TI - Vitreous changes after neodymium-YAG laser irradiation of the posterior lens capsule or mid-vitreous. PMID- 6486237 TI - The negative coincidence of retinitis pigmentosa and proliferative diabetic retinopathy. PMID- 6486238 TI - Eleanor Clarke Slagle Lectureship, 1984: transformation of a profession. AB - Professional evolution includes a period of disunity, a phase when old values and concepts are being examined, and new perspectives emerge. Disunity can be a positive impetus for dynamic change. Transformation provides a higher level reintegration through which new understanding and progress unfold. Occupational therapy's transformation is now; it is time for careful analysis and creative synthesis. Transformation is a three-fold process of integration of past, present, and future into an upward spiral of professional development. Transformation is a constant flow of activities influenced by both internal and external factors. Although there are multidimensions that influence occupational therapy's transformation, three major components are inherent in the profession's paradigm shift: society's decline in patriarchal authority; decline in allegiance to a biomedical model; and shift in values, dimensions of practice, and education that form the reality of occupational therapy. Transformation of our profession will be a paradigm shift: in our value system of purposeful activity to a new perspective of occupation and occupational, in our quest to develop a unifying theory for recognition of the unifying force of values, in our concepts and theories to include the science of occupation and the art of purposefulness from total allegiance to scientific knowledge to include intuitive knowledge, from being an allied medical field to an independent health profession that is both educationally and medically related, from a biomedical model to a paradigm of wellness, in balancing of feminine and masculine values of human nature in organizing educational curricula and entry-level requirements that reflect our value system and predicted practice dimensions. PMID- 6486239 TI - A review of the Amiel-Tison neurologic evaluation of the newborn and infant. AB - Because occupational therapists are becoming more involved in infant assessment and intervention, there is a need for objective, prospective, and serially applicable evaluation tools. Amiel-Tison's Neurologic Evaluation of the Newborn and the Infant provides such a tool for use in the first year of life. This evaluation was developed to detect transient and permanent abnormalities in an infant's neuromotor development. Its main focus is to examine active and passive muscle tone. The test has interobserver reliability, is reproducible, and can be readily learned by occupational therapists. Although the evaluation is not standardized, it is clinically useful in neonatal units, developmental clinics, and research settings. This evaluation detects transient neuromotor problems in the first year of life that are associated with significant behavioral, neurological, and intellectual deficits when the children reach school age. Using this test, occupational therapists frequently involved with the assessment and management of children can play a crucial role in the first year of life by diagnosing and documenting abnormalities. PMID- 6486240 TI - Allied health team management of rheumatoid arthritis patients. AB - The use of a coordinated team of allied health professionals (AHPs) to treat patients with rheumatoid arthritis assigned to experimental groups (EG) and comparison groups (CG) was assessed. The EG patients were evaluated regularly by each AHP team member, whereas CG patients were seen by AHPs only upon referral. Of the 10 EG and 13 CG patients who remained in the study for 2 years, the EG patients initially exhibited somewhat greater disease activity than CG (as reflected by erythrocyte sedimentation rate and duration of morning stiffness). After 2 years, EG patients demonstrated less disease activity than at the outset, whereas CG patients either showed little change in these parameters or deteriorated during the study. Grip strength, which was initially similar in the two groups, improved in EG patients but decreased in CG patients, so that after 2 years a significant difference was noted between the two groups (p less than .05). Tendency to lose hand range of motion was also greater in CG than in EG patients. Some EG patients showed improvement in finger flexion deformities during the study. Furthermore, EG patients showed a greater tendency to acquire positive attitudes regarding themselves and family relationships. These results suggest that ongoing "team care" may be more efficacious than episodic use of AHPs in management of patients with mild rheumatoid arthritis. PMID- 6486241 TI - Ultrastructural damage associated with the Ca2+ paradox. The protective effect of Mn2+. AB - Hearts repleted with Ca2+-containing buffers after only a few minutes of Ca2+ free perfusioN display extensive ultrastructural damage and accumulate Ca2+. Ultrastructural damage includes separation of the intercalated disks, development of contracture bands, and splitting of the internal and external layers of the glycocalyx. In this study, the authors have used isolated spontaneously beating Langendorff perfused hearts to investigate whether Mn2+ alters the ultrastructural damage associated with Ca2+ repletion after Ca2+-free perfusion, previous studies having shown that it attenuates or abolishes the gain in Ca2+ which normally occurs under these conditions. Mn2+ added only at the time of Ca2+ repletion did not attenuate the ultrastructural damage. When Mn2+ (2 mM) was added during the Ca2+-free period or the Ca2+-free and Ca2+ repletion periods, however, the hearts were not as extensively damaged. The myofibrils were relaxed, and the intercalated disks were intact. However, splitting of the glycocalyx still occurred and was a prominent feature. These results indicate that splitting of the glycocalyx per se does not necessarily result in a massive gain in Ca2+ when Ca2+ is returned to Ca2+-depleted hearts. Possible mechanisms of action of Mn2+ are discussed. PMID- 6486242 TI - Evaluation of free radical effects and catecholamine alterations in adriamycin cardiotoxicity. AB - With the goal of evaluating the potential roles of free radicals and catecholamines in the pathogenesis of acute and chronic Adriamycin (ADR) cardiotoxicity, evidence was sought for myocardial free radical toxicity and alterations in myocardial catecholamine levels after acute and chronic administration of ADR to rabbits. In acute studies, male New Zealand white rabbits received intravenous ADR, 1.1 or 5 mg/kg per day for 1 or 3 days or 10 mg/kg for 1 day and were sacrificed 3-72 hours later. Because the glutathione glutathione peroxidase system is a major pathway for free radical detoxification, glutathione levels and glutathione peroxidase activity were measured. In the acute studies, ADR-treated rabbits exhibited significantly increased levels (up to 50%) of total and reduced glutathione, unchanged levels of oxidized glutathione, and a slight decrease in the percentage of oxidized glutathione. Major effects of dose and sacrifice interval were not observed. However, in animals receiving three injections of 5 mg/kg or one injection of 10 mg/kg ADR, myocytes exhibited fine vacuolization, due to lipid accumulation and dilatation of the sarcoplasmic reticulum, without evidence of coagulation necrosis. In the chronic study, rabbits received 1.1 mg/kg ADR twice weekly for up to 10 weeks. Levels of total and reduced glutathione were increased significantly by 23-36% after 9-12 and 16-20 injections without change in the percentage of oxidized glutathione. The mean percentage of myocytes with vacuolar-myofibrillar degeneration, the characteristic lesion of chronic ADR cardiotoxicity, was 0 after 5-7 injections, 3.3 after 9-12 injection, and 17.2 after 16-20 injections. Glutathione peroxidase activity was not reduced significantly in any group of acute or chronic ADR-treated animals. Tests for lipid peroxidation (malondialdehyde and ethane production) were negative in acute studies. Myocardial catecholamine levels were unchanged in acute and chronic ADR animals. Thus, the cardiac glutathione-glutathione peroxidase system is activated with ADR treatment at the onset of cellular damage, and cellular damage progresses without further alteration of this system, loss of glutathione peroxidase activity, or reduction in myocardial catecholamines in rabbit models of ADR cardiotoxicity. These findings suggest that free radical generation in the heart may contribute to ADR cardiotoxicity, but that other factors probably play a more important role in the pathogenesis of the myocardial damage. PMID- 6486243 TI - Quantitative indexes of aminonucleoside-induced nephrotic syndrome. AB - Aminonucleoside of puromycin (PAN) is known to cause altered glomerular permeability, resulting in a nephrotic syndrome in rats. The early sequence of this lesion was studied quantitatively, with the application of a new morphometric technique for determining epithelial foot process widths and a sensitive assay for quantifying urinary albumin excretion. Twenty-four hours following a single intraperitoneal injection of PAN, significant widening of foot processes was documented. Within 36 hours significant increases in urinary albumin excretion were observed. When control rats were examined, there was no clear correlation between epithelial foot process width and quantitative albumin excretion. However, in the PAN-treated animals, abnormal albuminuria only appeared in association with appreciable foot process expansion. These studies indicate that quantitative alterations occur in the rat glomerular capillary wall as early as 24 hours after PAN. Further studies of altered glomerular permeability may use these sensitive measures to more precisely define the temporal sequence and elucidate possible subgroups of experimental glomerular injury. PMID- 6486245 TI - Manipulation and pain tolerance. A controlled study of the effect of spinal manipulation on paraspinal cutaneous pain tolerance levels. AB - The response of paraspinal cutaneous pain tolerance levels to spinal manipulation has not been studied in an experimental model. This paper proposes such a model of pain tolerance measurement and describes the results of a controlled study of 50 assymptomatic subjects. The group receiving a spinal manipulation demonstrated a 140% increase in local cutaneous pain tolerance levels which was statistically significant (p less than 0.05). This is consistent with previous hypotheses regarding the mode of action of manipulation in the relief of spinal pain. PMID- 6486244 TI - Role of polymorphonuclear leukocytes in silica-induced pulmonary fibrosis. AB - Silicosis is usually attributed to fibroblast stimulation by secretion of damaged alveolar macrophages (AMs), but the role of polymorphonuclear leukocytes (PMNs) and of continuing cell injury in the pathogenesis has not been fully studied. Mice given intratracheal injections of 2 mg of silica received 3H-thymidine 1 hour before death at intervals to 20 weeks. Cellular populations and lysosomal content of lavage fluids were correlated with morphology, DNA synthesis, and collagen content of the lung. The initial response involved rapid PMN and AM recruitment to the alveoli. Some free particles crossed Type 1 epithelial cells, and silica was found in interstitial macrophages. Focal Type 1 cell damage was rapidly repaired by Type 2 cell proliferation. Although PMN numbers dropped after a few days, they never reached control levels and rose again after 8 weeks; the number of AMs fell to control values from 2 to 8 weeks, then increased again. Glucosaminidase and glucuronidase levels in the lavage fluid were much higher than control levels throughout the study. Increased DNA synthesis by interstitial cells occurred from 2 days to 20 weeks; increased collagen synthesis was found from 4 weeks onward. The continuing inflammatory response of the lung to silica suggests may contribute to fibroblastic stimulation. PMID- 6486246 TI - The Diabetes Alert study: growth, fatness, and fat patterning, adolescence through adulthood in Mexican Americans. AB - Diabetes Alert is a multidisciplinary genetic and epidemiological study of Type II (non insulin-dependent) diabetes in Texas Mexican Americans. We report the anthropometry of 1,155 individuals 10 to 70 or more years with particular reference to overweight, fatness, and anatomical fat patterning in the sample. Children ages 10-18 of both sexes are growing at the 50th percentile of the reference data (U.S. Health and Nutrition Examination Survey-1) for height, Wt/Ht2, and triceps and subscapular skinfolds. Adults are well below median height but well above median Wt/Ht2 and skinfolds. Prevalence of obesity (Wt/Ht2 greater than or equal to 30) among adults is typically 30% or higher by age 30. Diabetics compared to age/sex-matched non diabetics have shorter sitting heights, have more upper body fat (subscapular skinfold), have less lower body fat (lateral calf skinfold), and were heavier at maximum weight and at age 18. The ratio of lower to upper body fat distribution decreases over the life cycle, being highest at adolescence and lowest at ages 40-50 in both sexes. Our results show a precipitous weight gain after maturity in the sample and an association of diabetes with differences in anatomical fat patterning. The age-related changes in fat patterning need to be explained in terms of their ecological and genetic influences. PMID- 6486247 TI - Genetic correlations between sides and heritability of asymmetry for nonmetric traits in rhesus macaques on Cayo Santiago. AB - The use of nonmetric traits for estimation of biological distance is a long standing practice in biological anthropology. Nonmetric traits can be scored using either the individual or the side of the individual as the unit of measure. If sides of the individual are genetically correlated the use of sides would produce redundant genetic information. For this reason, Korey (Am. J. Phys. Anthropol. 53:19-23, 1980) argues for the use of individuals as the unit of measure for nonmetric traits. Ossenberg (Am. J. Phys, Anthropol. 54:471-479, 1981), however, argues that bilateral occurrence of nonmetric traits indicates greater genetic liability for the trait and that therefore the sides are the more biologically correct unit of measure. Genetic correlations for 13 cranial nonmetric traits are estimated for a sample of rhesus macaque skeletons from Cayo Santiago. In addition, heritability of asymmetry is estimated for these 13 traits as a test of Ossenberg's contention that asymmetry is genetically influenced. Significant genetic correlations between sides support Korey's contention that nonmetric traits should be scored by individual. Only two asymmetry heritabilities were significantly different from zero, providing no significant support for Ossenberg's contention that asymmetry is genetically determined. Our results support the theory that asymmetry represents a measure of the ability of an organism to buffer stresses. Therefore, a measure of the heritability of asymmetry is a measure of the heritability of the ability to buffer stresses. This ability does not appear to be heritable in this sample. PMID- 6486248 TI - Skin color comparisons among ethnic groups of college men. AB - Reflectance readings of skin color were taken on the medial aspect of the left upper arm. The subjects were United States college men between ages 18 and 27 years attending the University of South Carolina. Using the DSL 99 Reflectance Spectrophotometer, readings were obtained under controlled conditions at five settings (601, 603, 605, 607, 609). Ethnic groups studied included young men of 1) Northwest European White ancestry, 2) West African Black ancestry, and 3) Afro Black/Amerind ancestry. Means and variability statistics serve to describe the skin color distributions. Means were near 12 and 32 for filters 601 and 609 on men of West African Black ancestry, with corresponding means near 36 and 64 on men of Northwest European White ancestry. There was no overlapping of comparable frequency distributions from these two ethnic groups. Significance tests at P = .01 allowed acceptance of the hypothesis that skin color on the medial arm surface was darker for young men of Afro-Black ancestry than for those of 75% Afro-Black ancestry and 25% Amerind ancestry. Means from original data were compared with means from earlier studies on black and white males in Africa, America, and Europe. PMID- 6486249 TI - Severity of psychiatric symptoms as a predictor of benefits from psychotherapy: the Veterans Administration-Penn study. AB - One hundred ten nonpsychotic opiate addicts were randomly assigned to receive paraprofessional drug counseling alone, counseling plus cognitive-behavioral psychotherapy, or counseling plus supportive-expressive psychotherapy. Patients were classified low-severity, mid-severity, or high-severity on the basis of the number and severity of their psychiatric symptoms. Overall, the addition of professional psychotherapy was associated with greater benefits than was drug counseling alone. Low-severity patients made considerable and approximately equal progress with added psychotherapy or with counseling alone. Mid-severity patients had better outcomes with additional psychotherapy than with counseling alone, but counseling did effect numerous significant improvements. High-severity patients made little progress with counseling alone, but with added psychotherapy made considerable progress and used both prescribed and illicit drugs less often. PMID- 6486250 TI - Implications of family history of alcoholism, antisocial personality, and sex differences in alcohol dependence. AB - In this study of 210 male and female alcoholic inpatients, significant associations were found 1) between antisocial personality diagnosis and early onset of all stages in alcohol dependence; 2) between bilineal family history of alcoholism and greater frequency of the consequences of impaired control, withdrawal symptoms, and the pathologic symptoms associated with chronic alcoholism; and 3) between being female and older at onset of the initial, but not final, stages of alcoholism and having more symptoms associated with chronic alcohol use. Antisocial personality, type of family history, and sex of the proband were not interactive but contributed separate additive effects. PMID- 6486251 TI - Temperament and infant mortality among the Masai of East Africa. AB - On the basis of Western studies suggesting that infants with difficult temperaments are at greater risk for behavioral and physical disorders, the author postulated that Masai infants with difficult temperaments would be at greater risk in the harsh environment created by the sub-Saharan drought in 1974, which disrupted the life of the Masai people of East Africa and resulted in increased infant mortality. Two groups of infants with difficult and easy temperaments were defined and followed. Contrary to expectations, mortality was greater for the infants with easy temperaments. The infant's contribution, child rearing orientation, and feeding practices were factors influencing survival. PMID- 6486252 TI - The social integration of psychiatric patients in nursing homes. AB - The authors explored self-reports of the social integration of 163 chronically ill psychiatric patients who were admitted to 12 nursing homes over a 1-year period. Results suggest that nursing home care for psychiatric patients is custodial and institutional in character and that the social integration of such patients is generally low. Nursing home patients had lower scores than outpatients but not inpatients on a measure of social participation; they were similar to both these groups on measures of spending and employment. Levels of social integration changed little over 1 year, either for better or for worse. PMID- 6486253 TI - The need for tests of normal functioning in the psychiatric interview. AB - Physical medicine has a body of normal findings that make possible the definition of disease states. The routine procedures of psychiatry do not include any such tests of health. As a result, the psychiatric concept of illness has no stable base from which specific conditions can be described. The author suggests two human capacities, connectedness and self-protectiveness, that can be assessed by the psychiatrist in attempting to evaluate the patient's overall psychological health. PMID- 6486254 TI - Relationship between changes in plasma amino acids and depression in alcoholic patients. AB - The authors studied the relationship between changes in amino acid precursors of biogenic amines and depression in 42 alcoholic patients with a secondary depression. Tryptophan and amino acids competing with it for brain entry were measured in the plasma of depressed alcoholics, nondepressed alcoholics, and control subjects. The ratio of tryptophan to its competitors was significantly lower in depressed patients than in nondepressed patients and controls. The decreased ratio was due primarily to decreased tryptophan and increased tyrosine and phenylalanine values. A decreased tryptophan ratio is known to result in decreased brain tryptophan and may contribute to depression through a deficiency of brain serotonin. PMID- 6486255 TI - Seven-month clinical outcome of anhedonic and normally hedonic depressed inpatients. AB - Using a measure of capacity for pleasurable experiences (the Pleasure Scale), the authors compared at admission and 7-month follow-up 74 psychiatric inpatients meeting DSM-III criteria for major depression. Pleasure scores were stable over 7 months despite the fact that two-thirds of the sample recovered from depression. The subgroup of subjects who were most anhedonic at admission were more likely than the remaining subjects to show clinical recovery but persisted in exhibiting a lower pleasure score (even when the comparison was limited to recovered subjects). Pleasure scores were much better predictors of clinical recovery than were neuroticism scores. PMID- 6486256 TI - Validation of four definitions of melancholia by the dexamethasone suppression test. AB - The authors evaluated four sets of diagnostic criteria, the Newcastle Index, DSM III, RDC, and the Michigan Diagnostic Index, for the diagnosis of melancholia. Forty-nine depressed inpatients, all of whom met RDC for major depression, also received consensus diagnostic assessment for melancholia. The dexamethasone suppression test (DST) was administered before drug treatment began. Results showed that the sensitivity of the DST ranged from 39% to 48%, specificity from 80% to 100%, and diagnostic confidence from 66% to 100%. All four scales received validation, but DSM-III showed the lowest specificity and predictive value. PMID- 6486257 TI - Assessing borderline personality disorder with self-report, clinical interview, or semistructured interview. AB - The authors compared three methods of assessing borderline personality disorders. Test-retest reliability for the self-report Personality Diagnostic Questionnaire was adequate and compared favorably with the interrater reliability of the DSM III-oriented clinical interview and the semistructured research interview. The overall prevalence of personality disorders scored on the questionnaire was similar to that generated by the clinical interview. The specificity and sensitivity of the questionnaire for the diagnosis of borderline personality disorder were slightly higher than 60%, which suggests that it may be a useful and economical instrument for identifying patients with borderline personality disorder. PMID- 6486258 TI - Characteristics of assaultive patients in private hospitals. AB - A study of two large private psychiatric hospitals showed rates and patterns of assaultive behavior by patients comparable to those found earlier in a study of public hospitals; this was especially true in the hospital that admitted involuntary patients. The targets of assault were predominantly family members other than spouses or children and persons outside the family. Seclusion was commonly used to manage assaultive patients in the private hospitals and the seclusion rates were higher than those found for public hospitals, probably reflecting a staff preference for seclusion over heavy medication. The need for staff education and support in the management of assaultive patients exists in private hospitals as well as public hospitals. PMID- 6486259 TI - The 1982 first-year resident in psychiatry. AB - A 197-item questionnaire was distributed to the 541 medical students who matched into first-year postgraduate positions in psychiatry in 1982. The questionnaire obtained basic personal data, career plans before entering medical school, experiences in medical school, factors relating to selection of residency program, future plans, and attitude toward personal psychotherapy. The authors report the results for the 274 residents who completed the questionnaire (51% of the students). They explore the finding that first-year psychiatric residents do not plan careers in areas that the National Institute of Mental Health has defined as having priority--children and the aged. PMID- 6486260 TI - Platelet MAO activity in anorexia nervosa patients with and without a major depressive disorder. AB - Platelet MAO activity was determined in 33 anorexia nervosa patients. A subgroup of 15 patients who met Research Diagnostic Criteria for a concomitant major depressive disorder were found to have, both initially and after 5 weeks of treatment, significantly lower mean platelet monoamine oxidase (MAO) activity than 28 matched normal control subjects. In contrast, mean platelet MAO activity in the patients who did not meet criteria for major depressive disorder was similar to values in control subjects. The authors found that significantly more depressed patients had low MAO activity compared with nondepressed patients and controls. Platelet MAO activity may be useful in discriminating among subtypes of anorexia nervosa patients. PMID- 6486261 TI - Career patterns of female and male graduates of a psychiatric residency program. AB - The authors surveyed 122 recent graduates of the Massachusetts Mental Health Center to determine whether previously reported differences in career patterns between the sexes persist in younger psychiatrists. Some of the findings are consistent with previous studies, e.g., women work fewer hours than men, take more time off for child rearing, and are less often Board certified. However, women surveyed were not underpaid compared with men, and men showed a growing awareness of the conflicting demands of career and family. The significance of these findings and their implications are discussed. PMID- 6486262 TI - Course-related depressive syndromes in schizophrenia. AB - The authors evaluated 20 patients, diagnosed by Research Diagnostic Criteria after 1 week of hospitalization as having schizophrenia, weekly throughout their hospitalization. Four patients developed syndromes of depression after resolution of their psychoses: three manifesting a "minor" and one a "major" postpsychotic depressive syndrome. Four other patients went on to develop syndromes equivalent to major depression at a time when they were still actively psychotic, and their cross-sectional diagnoses were therefore changed to schizoaffective disorder, depressed type. The authors discuss the implications of these findings for diagnosis. PMID- 6486263 TI - Hyposthenuria as a marker for self-induced water intoxication and schizophrenic disorders. AB - Four patients with the syndrome of self-induced water intoxication and schizophrenic disorders, as well as inappropriate antidiuresis, are described. In each case, severe hyposthenuria preceded the clinical symptoms by 1 to 7 years. Hyposthenuria may be a marker for this syndrome. PMID- 6486264 TI - Consistent dexamethasone suppression test results with mania and depression in bipolar illness. AB - Dexamethasone suppression tests (DSTs) were given to nine bipolar patients in both depressed and manic phases of their illness. In seven patients DST results were consistent between episodes; six patients had positive tests in both depression and mania. PMID- 6486265 TI - Duration of ECT-induced tachycardia as a measure of seizure length. AB - The duration of ECT-induced tachycardia in 203 seizures of 28 patients was measured. Tachycardia duration was easily determined; it correlated highly with both motor (cuffed arm) and EEG seizure estimates. PMID- 6486266 TI - Susceptibility to backward masking in schizophrenic patients with positive or negative symptoms. AB - The authors used the backward masking paradigm to compare visual information processing in schizophrenic patients with predominantly positive or predominantly negative symptoms. The results indicate significantly slower information processing in patients with negative symptoms. PMID- 6486267 TI - Platelet MAO activity and age at onset of depression in elderly depressed women. AB - Platelet monoamine oxidase (MAO) activity was assayed in 38 elderly depressed women and 16 matched controls. The depressed women whose illness began at age 55 or earlier (N = 19) had significantly lower MAO activity than patients with later onset (N = 19) or controls. PMID- 6486268 TI - Lateralization of conversion symptoms in children and adolescents. AB - Of 11 children and adolescents with unilateral conversion symptoms, 10 showed symptoms on the right side of the body. Lateralization was found to be related to a patient's handedness. PMID- 6486269 TI - Ratio of serum prolactin to haloperidol and early clinical outcome in acute psychosis. AB - The ratio of the increase in serum prolactin concentration to steady-state haloperidol concentration in acutely psychotic women correlated with early clinical improvement. Correction of prolactin response for neuroleptic concentration may provide a better clinical predictor than either measure alone. PMID- 6486270 TI - Case report of de Clerembault syndrome, bipolar affective disorder, and response to lithium. AB - De Clerembault identified a syndrome associated with delusional loving, and it has since been described in association with various diagnoses including paranoia, schizophrenia, affective disorder, and mental retardation. The authors document its coexistence with bipolar disorder and its response to lithium. PMID- 6486271 TI - Case report of barbiturate-induced enhancement of methadone metabolism and withdrawal syndrome. AB - A methadone maintenance patient with a decreased plasma methadone level, possibly due to phenobarbital-induced acceleration of methadone biotransformation, experienced opioid withdrawal symptoms. This finding suggests that when phenobarbital is used with methadone the plasma methadone level must be monitored. PMID- 6486272 TI - Improved measurement of sleep stages. PMID- 6486273 TI - L-Glutamine and mania. PMID- 6486274 TI - Woman's role in Masters and Johnson program raises "serious ethical problem". PMID- 6486275 TI - Paternalism as a deontological position. PMID- 6486276 TI - The origin and treatment of rage attacks. PMID- 6486277 TI - Measuring the effects of solitary confinement. PMID- 6486278 TI - Danish data show weak genetic factor. PMID- 6486279 TI - Blue Shield responds to commentary. PMID- 6486280 TI - Confirmation of concurrent illnesses in posttraumatic stress disorder. PMID- 6486281 TI - Statistical "noise" in CAT scan measurements. PMID- 6486282 TI - Amoxapine in psychotic-delusional depression. PMID- 6486283 TI - Aphorisms of suicide and some implications for psychotherapy. AB - An aphorism is a pithy short statement stating a general truth. This article presents twenty aphorisms about suicide. One example: "There are many pointless deaths, but never a needless suicide." What is implied is that every suicide is an effort to redress certain unfulfilled, thwarted or frustrated psychological needs. (These include the needs for affiliation, avoidance of pain, succorance- among some twenty psychological needs that have been identified.) The psychotherapeutic implication of this particular aphorism is fairly obvious: Reduce the sense of frustration or effect some satisfaction of the frustrated needs of the suicidal individual and the elevated level of perturbation will be mollified sufficiently so as to drop below the lethal threshold of suicidal action. For the twenty aphorisms about suicide, some implications for response and the management of suicidal persons are suggested in order to prevent suicide. In addition a few general suggestions are offered for the management of suicidal persons. PMID- 6486284 TI - Attempted suicide in manic-depressive disorder. AB - Structured interviews were used to study rates of past suicide attempts among 123 outpatients treated for affective disorders. Subjects met the Feighner criteria for major affective illness, and bipolar and unipolar groups were identified in accordance with the Fieve-Dunner criteria. Although a small group (N = 6), the women with a history of hospitalization for depression and outpatient treatment for hypomania (BP II) had the highest rate of past suicide attempts. (66 percent). This confirms previous findings. Women showed higher rates overall (39 percent vs. 28 percent for men). Suicide attempters were found to be significantly younger than nonattempters, which is in line with previous reports that suicide risk is high early in the course of bipolar illness. A trend for attempters to have received their first treatment at a younger age suggests that early onset may be a risk factor. No differences in marital status were found between attempters and nonattempters. Males and females did not differ in number, seriousness, or lethality of attempts. PMID- 6486285 TI - The use of electroconvulsive therapy in suicidal patients. AB - Publications on the subjects of ECT and suicide stress the importance of ECT as a valuable treatment in appropriately selected cases of suicidal ideation or attempted suicide. There is no direct correlation between the degree of suicidality and the usefulness of ECT. In the management of cases with major affective disorder, particularly those showing delusions and vegetative signs, ECT should be considered early in the treatment. The presence of the potential for suicide provides an added incentive. However, suicidal threats or attempts on the part of patients with severe personality disorders are not likely to respond to ECT unless the picture is complicated by major depressive illness. In the absence of such affective illness, understanding and skilled psychotherapy are likely to be more effective. Antidepressant medication and ECT should be administered within a supportive, watchful, and compassionate setting. PMID- 6486286 TI - Psychotherapists as suicide survivors. AB - This paper examines the effects of a patient's suicide on the treating psychotherapist. Psychotherapists were found to react to a suicide with feelings of disbelief, guilt, and shock. This was followed by grief, shame, despair, anger, and a loss of self confidence. The psychotherapists interviewed were permanently affected in two ways. First, the experience remained vividly in their minds. Second, they tended to no longer minimize suicidal behavior, attempts, and gestures. The experience allowed the psychotherapist to confront his grandiose rescue fantasies and to question his sense of security. A support group for the surviving psychotherapists is recommended that would allow them the opportunity to talk about the death. Training programs that would encourage the explicit exploration of suicidal issues, including the patient's responsibility for suicidal behavior, should be established. It is believed that managing the feelings about a patient's suicide needs to become an active process. PMID- 6486288 TI - Perspectives on rehabilitative and educative-developmental psychotherapy. AB - Two approaches to psychotherapy from two different perspectives are explored: the rehabilitative and the educative-developmental. The goals of treatment, the therapist/patient role relationship and treatment techniques are delineated and illustrated by use of case material. Whether the focus is on self-image, specific learning, social interpersonal deficits, or on a spectrum of maturational arrests, if the focus of treatment is on disturbed functioning with the goals of reducing the impact of the defect than the work is more often rehabilitative than educative-developmental. A wide range of psychotherapeutic activities can be rehabilitative in nature whether the techniques used are exploratory or supportive. If the focus is on self-exploration with the goals of self understanding leading to conflict resolution then the work is educative developmental in nature. The significant differences between a therapeutic relationship based on an impairment model and an educative one are delineated. Other differences in approach between these two perspectives are also discussed. PMID- 6486287 TI - Outpatient management of the suicidal child. AB - Susceptible children may become depressed and suicidal in response to stressful social factors including loss or separation from parents, parental abuse, neglect, rejection, pressure, or a chaotic, disorganized family environment. Psychological factors that predispose children to suicidal behavior include inadequate ego-defenses to cope with feelings engendered by the adverse environmental circumstances. Often these children relate poorly to others and are excessively dependent. Outpatient management is possible if the parents are able to be appropriately supportive and protective. Intensive psychotherapy is often necessary to modify a basic depressive outlook on life and to resolve inner conflict about self-worth. The suicidal child must be helped to give up perfectionistic attitudes and to alter aggressive responses to loss and disappointment. Work with parents is important, particularly when the child's suicidal state is reactive to inappropriate parental behavior. Antidepressant drugs may prove to be a useful adjunct. PMID- 6486289 TI - Themes of mistrust and the posttraumatic stress disorder in Vietnam veterans. AB - The attitude of mistrust can frequently be observed in survivors of massive trauma, and is particularly pronounced in Vietnam combat veterans. Three interrelated factors that lead to mistrust are described. They are: the harsh realities of fighting in this guerrilla war, society's negative responses to the men after their return, and the psychosocial development of late-adolescent soldiers. When the attitude of cynicism predominates, the psychotherapeutic treatment more clearly focuses on adolescent themes of idealization and disillusionment. Two case studies with pronounced attitudes of mistrust are presented. The first case highlights the special difficulties of working with the veteran who is also profoundly cynical. The second case describes the defensive function that mistrust can serve by keeping out of awareness the images the veteran had of himself prior to the war. The data obtained from the veterans' respective dreams were especially useful in the diagnosis and treatment. PMID- 6486290 TI - International Symposium on the Immunology of Reproduction. Tel Aviv, Israel. October 21-25, 1984. Abstracts. PMID- 6486291 TI - Experimental infection with Rickettsia mooseri and antibody response of adult and newborn laboratory rats. AB - Quantitative studies of selected features of peripherally induced Rickettsia mooseri (= R. typhi) infection in Rattus norvegicus-derived white laboratory rats revealed a unique association between microbe and amplifying vertebrate host which appears to be especially conducive to maintenance of the enzootic cycle. Both adult and newborn (1-3 days old) rats were highly susceptible to percutaneous infection (ID50 = approximately 1 organism), but neither showed signs of disease or died even when inoculated with 10(4)-10(5) plaque-forming units. Gain in body weight of infected newborn rats was indistinguishable from that of uninfected newborn rats over the first 3 weeks of life. The course of the systemic infection, as measured by the rise and fall of R. mooseri titers in blood, brain and kidney and the serum antibody response, was almost identical in adult and newborn rats. Thus, despite their immaturity in certain immunological processes, newborn rats controlled postnatal R. mooseri infection about as well as did adult rats. The rickettsemic period of about 10 days corresponds to the period of infectivity of inoculated rats for fleas. Rickettsiae were not isolated from blood, brain or kidneys by methods employed for more than 4-5 weeks after infection. Serum antirickettsial antibodies persisted for at least 60 weeks postinfection, i.e., longer than the usual life span of rats in nature and, hence, are a valid measure of the cumulative experience of rat populations with R. mooseri infection. PMID- 6486292 TI - Spider (Latrodectus hesperus) poisoning through the conjunctiva. A case report. AB - Spider poisoning is usually a result of the direct bite, envenomation through the chelicera, of the spider. Reported is an unusual case in which poisoning occurred through the conjunctiva when a fragment from a smashed black widow spider (Latrodectus hesperus) flew into a patient's eye. In addition to an immediate local reaction involving the periorbital tissues, the patient experienced systemic effects. PMID- 6486293 TI - The relationship of American visceral leishmaniasis to ABO blood group type. AB - It has been hypothesized that the Leishmania use a system of camouflage or mimicry of human ABO blood group antigens to evade host defense mechanisms. In order to test this hypothesis, the distribution of ABO blood groups among healthy control donors and among patients with visceral leishmaniasis in northeastern Brazil was compared. No significant differences were found between patients with American visceral leishmaniasis and controls, indicating that ABO blood group type is not an important determinant in the development of clinically apparent visceral leishmaniasis in that area. The findings raise doubt about the validity of the original hypothesis. PMID- 6486294 TI - An evaluation of quantitative techniques for Schistosoma haematobium eggs in urine preserved with carbolfuchsin. AB - The objective of this study was to determine a suitable method for quantitating Schistosoma haematobium eggs in urine specimens preserved in carbolfuchsin. Using a 0.002% carbolfuchsin-phenol-alcohol solution as a stain/preservative for urine obtained from 30 patients infected with S. haematobium, we compared egg counts obtained with four quantitative techniques: Nytrel filtration, Nuclepore filtration, suction filtration and centrifugation. Centrifugation gave statistically higher values than all other techniques for absolute number of eggs recovered in the preserved urine. We also measure a statistical difference between the counts obtained from Nuclepore filtration of fresh urine and those established on an equivalent volume of preserved urine by Nuclepore and Nytrel filtration. The preserved urine frequently caused obstruction of both Nuclepore filters and Whatman No. 1 filters (used in suction filtration), rendering them technically difficult to use and less satisfactory than other methods. From the techniques we examined, we conclude that in field studies where preservation of urine is necessary, preparation of Nuclepore filters with fresh urine, or centrifugation of a carbolfuchsin-preserved urine, are the methods of choice for quantitation of specimens. PMID- 6486295 TI - Sensitivity and specificity of reagent strips in screening of Kenyan children for Schistosoma haematobium infection. AB - The reliability of using urinalysis reagent strips, which semi-quantitatively measure hematuria and proteinuria, to correctly select urine specimens found by microscopy to have Schistosoma haematobium eggs was studied in 359 previously unscreened Kenyan primary school children. The presence of and degree of hematuria and proteinuria were highly correlated with the presence of S. haematobium eggs and with egg counts in urine specimens. Hematuria was more strongly correlated with S. haematobium egg counts than was proteinuria. The ability of presence of hematuria or proteinuria, or both, to select all microscopically positive cases of urinary schistosomiasis for treatment was tested using sensitivity (ST) and specificity (SP) analysis. Selection of cases using 1) presence of hematuria alone, and 2) presence of either hematuria or proteinuria had the highest combined ST and SP (88% ST, 97% SP; 91% ST, 92% SP, respectively). Most of the few cases detected by microscopy but not by reagent strips had low egg counts. The presence of hematuria alone failed to detect only 12% of S. haematobium-positive cases (mostly low egg counts), and only 3% of S. haematobium-negative persons had urinary blood and would have received unnecessary treatment. Preliminary studies on the use of reagent strips to screen previously infected children 6 months after treatment, and the effects of seasonal variations in temperature and humidity on urine specimen volume, egg counts, and reagent strip results are also presented. The practical field use and cost of reagent strips in S. haematobium control programs are discussed. PMID- 6486296 TI - Seroepidemiology of schistosomiasis japonica by ELISA in the Philippines. II. Unreliability of stool examination in the measurement of incidence. AB - It was shown in a previous study that a single quantitative stool examination (by technics currently used in the Philippines) is so sensitive that it underestimated by 50% the prevalence of schistosomiasis japonica in children detected by a single serologic assay (ELISA). This paper proves that measurement of incidence of the infection among these same children by stool examination is unreliable as well. Three important sources of error in the measurement of incidence by stool examination are: (a) the inclusion of already infected children in the group of presumably uninfected children in which conversion (change from negative to positive) is being measured; (b) the insensitivity of stool examination in identifying those who do acquire infection among the initially uninfected; and (c) spontaneous, possibly temporary, stool reversion. An overestimation of incidence results from error (a) because already infected children have 5-7 times the tendency to convert than do uninfected children; error (b) tends to produce an underestimation of incidence since stool examination will detect only about one-half of the children who do become infected; while error (c) also tends to cause an underestimation of incidence and is dependent on the frequency of stool examinations--34% of the conversions observed by multiple examinations may not be detected in a single year-end examination. The equivalent sources of error are insignificant when ELISA is employed to measure incidence. In the 3 years of observation, the annual incidence of schistosomiasis japonica measured by ELISA showed no significant change (13.5%, 16.7%, and 15.6%); on the other hand, the annual incidence measured by stool examination showed a significant reduction from 37.5% down to 16.0% and 15.1%. Significant sources of error invalidate measurements by stool examination; it is therefore concluded that incidence measurements have failed to produce acceptable evidence of reduction in transmission in the area of study in the 3 years of control operations. We believe that insistence on relying almost exclusively on the parasitologic technic can result in an erroneous evaluation of the control program currently being implemented. PMID- 6486297 TI - Seroepidemiology of schistosomiasis japonica by ELISA in the Philippines. III. Selective mass chemotherapy with praziquantel in a control program. AB - After a pre-control (pre-treatment) prevalence rate of schistosomiasis japonica was established by stool examination and by ELISA in about 400 school children in school year 1979, annual prevalence rates were measured in the following 3 assessment years. From 54-80% of children found infected primarily by stool examination were treated with praziquantel 3-9 months before the assessment examinations. Both stool examination and ELISA showed statistically significant reductions of prevalence from the 1st to the 3rd assessment years (average reduction of 50% measured by stool examination and average reduction of 19% measured by ELISA). These reductions were expected as a result of the biologic activity of the effective schistosomicide; they are therefore not acceptable evidence of reduced transmission levels. By decreasing human sources of snail infection, an effective schistosomicide may have the epidemiologic impact of reducing transmission; assessment prevalence rates can be relevant indices of transmission levels only if the biologic effect of the schistosomicide is dissociated from its epidemiologic impact in a control program in which selective mass chemotherapy plays a dominant role. This dissociation was accomplished in this study by measurements in an essentially untreated group of "new" pupils, i.e., those who entered the school at the beginning of each assessment year. Overall prevalence rates among the "new" pupils did not show a significant reduction until the 3rd assessment year as measured by stool examination (reduction by 36% of pre-control level); as measured by ELISA, a significant reduction (by 15-17%) was detected in the 2nd and 3rd assessment years. The youngest children, and girls more than boys, were the most sensitive indicators of change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486298 TI - Vaccination of bovines against schistosomiasis japonica with highly irradiated schistosomula in China. AB - Vaccination of Chinese bovines (cattle and buffaloes) against schistosomiasis japonica with 36 kR gamma-irradiated schistosomula was done for laboratory challenge and for field trials in China. Altogether, 61 bovines were used. All experimental animals were vaccinated 2-3 times with 10,000 irradiated schistosomula per time. For the laboratory challenge, all experimental and control cattle were challenged with 500 normal cercariae and each buffalo, with 2,000 cercariae. The laboratory-challenged bovines were killed after 54-57 days of challenge; the bovines for the field trial in the lightly endemic area, after 5 months in the field; and the bovines for the field trial in the heavily endemic area, after 58-63 days. When the animals were killed, the number of mature worms in the vaccinated (experimental) and non-vaccinated (control) animals was recorded and the percentage of worm reduction in each group was calculated. The first group, consisting of three vaccinated and three non-vaccinated cattle, was given a laboratory challenge; the worm reduction was 71.6%. The second group, consisting of two vaccinated and three non-vaccinated buffaloes, was also given a laboratory challenge; the worm reduction was 74.4%. The third group, consisting of seven vaccinated and eight non-vaccinated buffaloes, was utilized in a field trial in a lightly endemic area; the worm reduction was 75.6%. The fourth group, consisting of eight vaccinated and nine non-vaccinated cattle, and the fifth group, consisting of nine vaccinated and nine non-vaccinated buffaloes, were pastured in a heavily endemic area. The worm reduction was 65.1% in the fourth group and 75.7% in the fifth group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486299 TI - In vivo microscopy of schistosomiasis. IV. The dynamics of the host-parasite responses to Schistosoma mansoni in the hypodermal tissues as observed in transparent chambers in two susceptible hosts during primary and challenge infections. AB - The migration of Schistosoma mansoni cercariae and schistosomules, and the cellular responses of the hosts to these parasites, in primary and challenge infections, were examined and cine-recorded in vivo in the hypodermal tissues in Algire chambers which had been inserted in dorsal skins of C3H/HeJ mice and cheek pouches of Syrian hamsters, and checked in serial sections. In hamsters, many cercariae penetrated blood vessels within minutes after being injected into their chambers, in contrast to mice, in which penetration into vessels was scanty during the first hour. Schistosomule penetration into blood vessels was slow in both species. To ascertain whether or not the cercariae that had rapidly penetrated blood vessels in hamsters were capable of producing the disease, the chambers were removed a few hours after infection had been induced. Eight to 10 weeks later it was found that the parasites had produced the disease, since egg granulomas were found in the liver of hamsters. The cellular reactions of the hosts to the parasites revealed that granulocytes adhered first and most extensively to the tails of cercariae in essentially equal amounts in primary and challenge infections, but the adherence of such cells to the body of cercariae was greater in challenge infections. Nevertheless, an appreciable number of cercariae in both naive and challenge-infected animals were free of granulocytes or had less than five cells adhering to them. Furthermore, granulocyte adherence to cercariae or schistosomules was not necessarily permanent; the latter were usually free of cells a few hours after infection had been induced. Another difference between naive and challenge infections was that cercarial motility was more rapidly depressed in the latter infections. PMID- 6486300 TI - Development and behavior of cultured Schistosoma mansoni fed on human erythrocyte ghosts. AB - Schistosomula and adults of Schistosoma mansoni were grown from cercariae in cultures differing only in the treatment of the red blood cells fed to the organisms. "Pink ghosts," containing about 5% of the original hemoglobin, were produced by hemolysis in water; "white ghosts" with no detectable hemoglobin were made in 5 mM phosphate buffer, pH 8. Early growth and development were more rapid and vigorous, and pairs formed more readily when pink ghosts, rather than intact erythrocytes were fed. Schistosomula remained stunted and undeveloped when fed with white ghosts. Attempts at reconstitution of the latter by addition of hemoglobin, concentrated erythrocyte lysate, or pressure-liquefied pink ghosts did not restore growth-promoting activity. Pink ghost-fed worms, particularly paired males, attached to the dish bottom by their acetabulum and oral sucker and travelled by an active looping motion. Substrates of collagen or fibrin or a mammalian cell monolayer did not affect this behavior. Such attachment and locomotion are interpreted as instinctive migratory behavior of schistosomes. PMID- 6486302 TI - Radiolabeling of Brugia malayi infective larvae in mosquitoes with 75Se methionine and detection of these larvae in tissues of the Mongolian jird by autoradiography. AB - Through preliminary experiments, an effective method for radiolabeling Brugia malayi-infected mosquitoes in order to produce labeled infective Brugia larvae was developed. Starting on the 6th day after the infective blood meal, mosquitoes were fed a 7% sucrose solution containing 100 microCi/ml 75Se-L-methionine for 5 days. Infective larvae, retrieved 2 days after this labeling period, averaged 381 +/- 136 counts/min. Jirds were infected with these infective, labeled larvae either by allowing infected mosquitoes to feed on uninfected jirds for 30 min or by inoculating jirds subcutaneously in the groin with washed larvae recovered from mosquitoes. Jirds were killed at various times after infection and were sliced into approximately 0.5 mm thick sagittal sections, which were dried and placed on X-ray film. Autoradiograms were developed after 30-60 days at 5 degrees C. In a sample of 26 inoculated jirds, approximately 30% of the infecting larvae could subsequently be accounted for as Ag degrees foci on autoradiograms. The Ag degrees foci representing larvae were apparent up to 2.5 weeks after infection. In jirds infected by mosquito feeding, the Ag degrees associated with the feeding site persisted for more than 6 weeks after infection. PMID- 6486301 TI - Comparative study of Schistosoma mansoni isolated from patients with hepatosplenic and intestinal clinical forms of schistosomiasis. AB - Six Schistosoma mansoni isolates obtained from the same endemic area were compared experimentally; three were from patients with the hepatosplenic form and three from patients with the intestinal form of schistosomiasis. The following features were analyzed in mice: body weight, liver and spleen weights, mortality, infectivity, number of S. mansoni eggs/female worm, egg distribution in the viscera, and hemogram. Three groups of mice, used as controls, were infected with the LE strain of S. mansoni which is routinely maintained in the laboratory. The group of isolates from patients with the hepatosplenic form of schistosomiasis did not show important differences in relation to those from nonhepatosplenic patients; in almost all features analyzed the differences among these six isolates were within the variation limits observed with the LE strain of S. mansoni. PMID- 6486303 TI - Cholera in Indonesia: epidemiologic studies of transmission in Aceh Province. AB - To determine the modes of transmission of cholera in the regency of Pidie, Indonesia, and to consider strategies for its control, we set up a laboratory to identify Vibrio cholerae 01 from patients with severe diarrhea in all government clinics in the regency and questioned culture-positive cases and neighborhood controls about possible exposures to V. cholerae 01. Between 12 July and 15 August 1982, 63 of 138 suspected cholera cases were confirmed by the laboratory; 53 of these patients were seen and followed up. We were unable to identify a single, indisputable mode of transmission for cholera which was amenable to immediate control. Nonetheless, a number of factors, including exposure to water from the Tiro-Sigli River and consumption of ice, were associated with disease. Other findings bring into question the value of current practices of chlorinating dugwells and disinfecting homes with Lysol during a cholera outbreak. The case control approach to investigating the mode of transmission of cholera has distinct limitations when applied in endemic setting where there may not be a single predominant vehicle of transmission, or where the vehicle such as river water is used by all and is only periodically contaminated. PMID- 6486304 TI - Wild Malaysian cynomolgus monkeys are exposed to hepatitis A virus. AB - Serum samples were obtained within 3 days of capture from 106 cynomolgus monkeys (Macaca fascicularis) in peninsular Malaysia. Fifty-two monkeys were trapped on the fringes of palm oil estates and 54 in dense primary jungle. Sera were tested for antibodies to hepatitis A virus (HAV) with a commercial radioimmunoassay. Twenty-four animals had detectable serum anti-HAV activity (6 of 52 from palm oil estate sites and 18 of 54 from primary jungle sites). Among monkeys at both sites, antibody prevalence was strongly correlated with animal weight: overall only four of 69 monkeys (6%) weighing less than 2.0 kg had serum anti-HAV antibodies, while 14 of 29 (48%) weighing 2.0 to 3.9 kg, and 6 of 8 (75%) weighing 4.0 kg or more, had serum anti-HAV antibodies. These data suggest that wild cynomolgus monkeys in Malaysian jungles become infected with HAV or an HAV like virus at a rate comparable to that of humans in the same region, and raise the possibility of a sylvatic cycle for HAV. PMID- 6486305 TI - Constitution and by-laws of the American Society of Tropical Medicine and Hygiene. PMID- 6486306 TI - Hayes Martin lecture. Vicissitudes of head and neck cancer. AB - In this study 136 of 167 patients (81 percent) with squamous cell carcinoma of the anterior tongue had no clinically evident neck node metastases. In 92 patients who received no elective treatment to the neck, 8 percent had recurrences at the primary site and 25 percent had recurrences in the neck with the primary site controlled. Three factors identify those patients at highest risk for harboring occult metastases: clinical size of the primary tumor, the presence of perineural invasion, and the sex of the patient (men fare worse). Patients with primary tumors of 1 cm or less in greatest diameter should not have elective treatment to the at-risk neck, patients with tumors greater than 3 cm in greatest diameter should receive treatment to the at-risk neck, and patients with cancer demonstrating perineural invasion should receive treatment to the at-risk neck. In the future, randomized controlled trials evaluating the efficacy of elective treatment to the at-risk neck should include only those patients at intermediate risk for harboring occult neck node metastases (that is, primary tumors 1 to 3 cm in greatest dimension without perineural invasion). Careful retrospective multifactorial analysis of the natural history and prognosis should always precede prospective, randomized trials to prevent the randomization of patients whose outcome can be predetermined on the basis of clinical and histologic characteristics. PMID- 6486307 TI - Lymphoma of the head and neck. A diagnostic dilemma. AB - The surgeon should remember that lymphoma may involve any tissue in the head and neck region. By maintaining a high level of suspicion when evaluating a tumor that appears to be more aggressive than expected (that is, multiple primary sites), the head and neck surgeon will expedite treatment of the patient with lymphoma. Aids in early diagnoses center around providing sufficient tissue to the pathologist by avoiding needle biopsy and piecemeal removal of the regional lymph nodes or obtaining undistorted representative tissue from extranodal sites. We stress the need for a continuing dialogue between the head and neck surgeon and the pathologist regarding early identification of the potential lymphoma patient, thereby preventing a diagnostic dilemma. PMID- 6486308 TI - A method for intraoperative identification of the recurrent laryngeal nerve. AB - Thyroid and parathyroid surgery is associated with a 1 to 6 percent incidence of injury to the recurrent laryngeal nerve. Electrical stimulation of the recurrent laryngeal nerve produces vocal cord motion that can be monitored by means of a double-cuffed endotracheal tube. Twelve patients underwent prospective evaluation with this monitoring system, and in all 12, the recurrent laryngeal nerve was accurately identified and localized. The nerve could be stimulated from a mean distance of 1.7 cm by a mean amperage of 1.3 mA. Postoperative indirect laryngoscopy demonstrated normal vocal cord function in all patients. PMID- 6486310 TI - Limited or selective nodal dissection for malignant melanoma of the head and neck. AB - Fifty-eight patients with invasive melanoma of the head and neck underwent regional nodal dissections by one surgeon from 1971 to 1981. Types of nodal dissections employed were radical neck dissection and modified radical neck dissection, alone or in combination, with selective nodal dissection of the parotid, jugular, suprahyoid posterior neck, or posterior triangle lymph node groups. Patients undergoing secondary nodal dissections had early recurrence (9 months versus 30 months) and earlier times of death (26 months versus 41 months). There was no demonstrable difference in morbidity, mortality, or rate of recurrence based on type of nodal dissection. There were no regional failures after selective nodal dissection alone when the nodes removed were negative. This limited study suggests that selective nodal dissection, alone or in conjunction with radical neck dissection or modified radical neck dissection, depending on the location and measurements of the primary lesion, allows accurate pathologic staging and apparent control of local disease with minimal morbidity. Longer follow-up and greater numbers are necessary for valid conclusions. PMID- 6486309 TI - Induction of hyperparathyroidism by radioactive iodine. AB - External irradiation to the head and neck has been associated with the emergence of hyperparathyroidism, due both to adenoma and hyperplasia since a single case report was published in 1975. A recent report indicates that there may be some association between hyperparathyroidism and radioiodine administered for thyroid disease. Eight patients are presented herein, all female and in middle age, who presented with hyperparathyroidism due to adenoma (six patients) or hyperplasia (one patient who had undergone radioiodine treatment). In three patients, the dose of radioiodine exceeded 30 mCi. The duration of latency ranged from 4 to 20 years. Associated thyroid disease included cancer, colloid nodules, and thyroiditis. All patients became eucalcemic and have remained so. Experimental results that have supported the influence of radioiodine on parathyroid hyperactivity do not appear completely applicable to the human model. It is believed that the low mitotic rate equivalent to low radiosensitivity may have protected the parathyroid gland somewhat from neoplastic change, although the association of thyroid carcinoma and parathyroid adenoma appears to be a significant expression of radiation exposure. It may be the lack of a pituitary stimulating hormone and the absence of an abscopal mechanism, as illustrated by irradiation to the thyroid, that explains the relative immunity of parathyroid behavior in the face of radioiodine exposure. Regardless of the frequency and validity of the association, it is important to recognize the possibility of the association illustrated by our case reports and scrutinize appropriate patients by intermittent serum calcium sampling, both for confirmation and possible detection of occult hyperparathyroidism. PMID- 6486311 TI - Changing trends in the management of squamous carcinoma of the tongue. AB - An analysis of 412 patients with primary squamous carcinoma of the tongue seen from 1969 through 1978 reveals that the age and clinical stage of patients with tongue cancer have remained constant when compared with previous reports from our hospital. The proportion of female patients has increased, and we are seeing more patients with tumors located in the base of the tongue. Treatment methods are changing. Mandible-sparing procedures were used more often, and significantly more patients received primary and adjuvant radiotherapy in the early study period. At the same time, there were fewer composite neck, tongue, and jaw resections and fewer laryngectomies, although more patients had elective treatment of the neck. The overall determinate cure rate has not changed since the 1957 through 1963 period. Age, sex, and adjuvant radiotherapy did not seem to affect survival. When patients with oral tongue primary lesions were compared with those with tumors in the base of the tongue, the prognosis seemed to be better in those with oral primary lesions when the patient had stage I or II disease. Finally, patients with tongue cancer have at least a 1 in 5 chance of development of a second aerodigestive tract malignancy and require lifelong scrutiny. Although current therapy results in lower morbidity, the proportions of patients with stage III and IV tumors remain high, and the cure rates remain disappointingly stable. PMID- 6486312 TI - Squamous carcinoma of the floor of the mouth. AB - We reviewed our experience with 320 patients treated for squamous cell carcinoma of the floor of the mouth from 1964 through 1977. The patients were evenly distributed according to clinical stage. Treatment consisted of surgery (77 percent of patients), surgery and adjunctive radiation therapy (19 percent of patients), or radiation therapy only (4 percent of patients). Most of the patients with favorable (T1) primary tumors had a simple peroral excision (78 percent) with marginal mandibulectomy when indicated (22 percent). Marginal mandibulectomy was still possible in many patients with T2 or T3 lesions (56 percent). Synchronous or metachronous second primary cancers were documented in 33 percent of the patients, most of which occurred in the head and neck region. Seventeen percent of the patients who had elective neck dissection had microscopic metastasis. More than a third of the patients with clinically positive nodes had negative neck specimens histologically. In patients with histologically positive nodes, 60 percent had involvement at multiple levels. The 5 year determinate cure for the entire group was 65 percent. According to stage, 88, 80, 66 and 32 percent of patients with stages I, II, III, and IV disease, respectively, were alive and well 5 years after treatment. This seems to be a significant improvement when compared with the last report from our hospital. PMID- 6486313 TI - Carcinoma of the cervical esophagus: changing therapeutic trends. AB - Carcinoma of the cervical esophagus is a lethal tumor because of its advanced stage at the time of diagnosis. The records of 71 patients with this disease treated at Memorial Sloan-Kettering Cancer Center from 1965 through 1980 have been reviewed herein. Epidermoid carcinoma was the prevailing histologic finding, and extramural penetration was present in 77 percent of the evaluable patients. Tracheal invasion and vocal cord paralysis were noted in 35 and 24 percent of the patients, respectively and were predictive of significantly decreased survival. Primary radiotherapy in doses greater than 5,000 rads produced short lived responses in 13 of 21 patients (62 percent). Surgery was performed in 45 patients (63 percent), including 35 esophagectomies for cure and palliative procedures in the 10 other patients. There were five operative deaths (11 percent), but only two followed esophageal resection (5.6 percent). Locoregional treatment failure, present in 46 of 52 evaluable patients (88 percent) at last follow-up, continues to be a major problem. Overall, the 5 year survival rate was 9.6 percent. The longest survival and best palliation was achieved with aggressive resection and immediate reconstruction using the transposed stomach (gastric pullup). PMID- 6486314 TI - Management of stage T3 and T4 glottic carcinomas. AB - Between 1959 and 1979, 242 patients with T3 and T4 lesions of the vocal cords were treated at our institution. Treatment consisted of total laryngectomy in all patients. Different modalities of regional node dissections were performed on 187 patients. In addition, 50 patients received irradiation with cobalt-60 postoperatively for specific features of the disease. In the group of 192 patients whose treatment consisted of surgery alone, 28 (14 percent) had recurrence in the neck and 10 (5 percent) had stomal recurrence. Of the patients treated with combined therapy, three (6 percent) had ipsilateral neck recurrences and one (2 percent) had stomal recurrence. For lesions staged N0, failure rates above the clavicles were 16 percent and 31 percent for patients with T3 and T4 lesions, respectively, in the group treated by surgery alone, 9 percent and 6 percent for patients with T3 and T4 lesions, respectively, in the combined therapy group. The rate of failure above the clavicles for lesions staged N+ was 32 percent in the group treated with surgery alone and 8 percent in the combined therapy group. In this study, a correlation was made between the failure rates above the clavicles and different clinical and histologic characteristics of the tumor, surgical findings, and the different modalities of cervical node dissection used. From analysis of the data, recommendations have been made for the selective treatment of patients with advanced glottic carcinomas. PMID- 6486315 TI - A transsternal approach to the upper thoracic vertebrae. AB - An anterior surgical approach to the upper thoracic vertebrae has been described. A T-shaped skin incision is used, with the horizontal limb 1 cm above the clavicle, and the vertical limb extending in the midline over the body of the sternum. A portion of the manubrium sterni, as well as the medial third of the clavicle, is resected; the avacular tissue plane between the carotid sheath laterally and the trachea and esophagus medially is developed to reach the prevertebral space. After surgery, immediate fusion is performed using the clavicle and manubrium. This procedure is well tolerated, and was associated with minimal morbidity and no mortality in a series of seven patients. PMID- 6486316 TI - Shoulder pain and function after neck dissection with or without preservation of the spinal accessory nerve. AB - To compare the difference in the degree of pain and functional disability of the shoulder in patients who underwent neck dissection for the treatment of head and neck cancer, 23 patients with and 12 patients without spinal accessory nerve preservation were evaluated with a questionnaire and a physical examination. In addition, to determine what effect radiation treatment has on pain and shoulder disability, eight patients who had whole neck radiation but no neck dissection were similarly evaluated. The results of this study show that, on the average, neck dissection patients with their spinal accessory nerve preserved have less pain in their shoulders, less functional disability, and stronger results on their physical examination than did those with their spinal accessory nerve sacrificed. It was also found that the patients who received whole neck radiation treatment without neck dissection had little pain, infrequent and insignificant functional disability, and normal strength on physical examination. PMID- 6486317 TI - Elective carotid resection for squamous cell carcinoma of the head and neck. AB - Patients with squamous cell carcinoma adherent to the carotid artery have a very poor prognosis, but some can be salvaged by aggressive surgical resection. Preoperative four vessel arteriography with intracranial views is mandatory to detect coexisting arteriosclerotic disease which may limit collateral perfusion of the ipsilateral cerebral hemisphere. Matas-type occlusive tests performed preoperatively are potentially dangerous and do not provide quantitative information that can be obtained intraoperatively by measuring internal carotid artery stump pressures. If the stump pressure is 50 mm Hg or greater, carotid reconstruction is unnecessary. A stump pressure of less than 50 mm Hg is an indication for reconstruction if the pharynx has not been entered during resection. If mucosal entry will be necessary and the stump pressure is less than 50 mm Hg, resection should not be carried out because of the increased risk of graft complications. Somatosensory evoked potentials predict cerebral tolerance to temporary interruption of flow but do not necessarily predict tolerance to permanent interruption of flow. Autogenous vein is the graft material of choice for reconstruction. In those patients not reconstructed, low-dose heparinization started before operation and continued for 10 days may lessen the likelihood of delayed stroke from embolization of a propagated thrombus in the carotid stump. PMID- 6486318 TI - Galeal-pericranial flaps in head and neck reconstruction. Anatomy and application. AB - Head and neck deformities of congenital, traumatic, or neoplastic cause often require reconstruction. At the University of Virginia over the past 14 years, we have used galeal, temporalis fascial, and pericranial flaps to correct these defects in more than 150 patients. Dissection of these flaps on both cadavers and reconstructive patients had demonstrated new anatomic findings different from those reported in standard textbooks. The galea is the most superficial layer of fascia. The pericranium is the next tissue layer. It is continuous above and separate from the temporalis muscle fascia. We may, therefore, consider three separate fascial layers for reconstruction. A rich vascular plexus arises from branches of the external and internal carotid arteries. Blood flow is axial to the galea and temporalis fascia. Pericranium has a dual supply from peripheral axial vessels and from perforating vessels from the overlying galea. Galeal, temporalis fascial, and pericranial flaps are reliable, thin, and supple and have a good arc of rotation and minimal donor site morbidity. They may be used to cover bone, cartilage, or implants, may be folded for bulk, may be used to carry blood to poorly vascularized recipient sites, or may be used to nourish bone, cartilage, skin, and mucosal grafts. Their versatility permits a wide variety of potential applications in head and neck surgery. PMID- 6486319 TI - Microvascular free tissue transfer in head and neck and esophageal surgery. AB - Successful reconstruction for excisional defects of the head and neck and esophagus was accomplished in 93 percent of our patients using microvascular free tissue transfer. Complete failure occurred in 7 percent of the patients. Major defects after head and neck cancer surgery constituted the main indication for use of microvascular free tissue transfer for reconstruction. Ninety-four percent of the patients had undergone an extensive excisional procedure. A wide range of cutaneous, myocutaneous, and osteocutaneous free flaps, as well as free bowel autotransfers were used. Complete failure was three times higher in the previously irradiated patients (4 of 41 patients) compared with nonirradiated patients (1 of 34 patients). Morbidity and mortality rates were consistent with expected ranges in patients who were undergoing major head and neck resection. Donor site complications occurred in 23 percent. Thin flaps are favored for reconstruction of anterior defects in the oral cavity, whereas bulkier flaps are more suitable for deeper defects in the oropharynx and hypopharynx. The advantages are both aesthetic and functional. The free jejunal autograft is considered the reconstructive method of choice for defects produced by laryngopharyngoesophagectomy. Highly developed and sophisticated microsurgical skills continue to be the mainstay of success. The implication of free tissue transfer failure, especially for defects of the upper aerodigestive tract, are impressive in terms of morbidity, mortality, and cost. These considerations limit the application of this method of reconstruction to centers that have sophisticated and productive reconstructive surgeons with microsurgical skills. PMID- 6486320 TI - Reconstruction after mediastinal tracheostomy. AB - Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutaneous flap to provide well-vascularized skin for anastomosis to the superior portion of the tracheostoma in nine patients. Whenever possible (eight patients), the trachea was transposed below the innominate artery to allow for slightly more mobility of the trachea and to remove the cartilaginous portion of the trachea from the artery. Among the eight elective operations reported herein, there were no postoperative deaths and only two minor wound-related complications. Among three patients who underwent emergency mediastinal tracheostomy, two patients died, one with an aneurysm of the innominate artery that ruptured several weeks postoperatively and the other with respiratory instability who could not be weaned from the respirator. These results suggest that use of the pectoralis major musculocutaneous flap and tracheal transposition decreases the risk of skin necrosis and resultant major vessel rupture. We advocate this approach in the reconstruction of the patient who requires mediastinal tracheostomy. PMID- 6486321 TI - Late problems after pharyngolaryngoesophagectomy and pharyngogastric anastomosis for cancer of the larynx and hypopharynx. AB - The late problems of 136 patients who had undergone pharyngolaryngoesophagectomy and pharyngogastric anastomosis were studied. The proportions of patients who required long-term thyroxine supplementation were 67 percent, 13 percent, and 5.3 percent of the patients who had total thyroidectomy, hemithyroidectomy, and no thyroidectomy, respectively. The proportions of patients who required calcium and vitamin D supplementation were 67 percent, 23 percent, and 17 percent, respectively. Speech rehabilitation was unsatisfactory. Alimentary functions were satisfactory in that the majority of patients were able to take in solid food. Although a sensation of obstruction of food was occasionally felt, no organic abnormality was found in any patient. Regurgitation was noted in 23 percent of the patients, and hematemesis was an occasional symptom of gastritis or gastric ulcer, although symptomatic gastric ulcer was found in only two patients. It is concluded that the long-term morbidity after this extensive procedure is mild and acceptable. The operation is recommendable for extensive tumors of the laryngopharyngeal region. PMID- 6486322 TI - Surface reconstructions from computerized tomographic scans for evaluation of malignant skull destruction. AB - The head and neck surgeon is dependent on radiographic technology to diagnose deformity, plan surgery, and evaluate operative results. The development of computerized tomographic scanning has facilitated osseous definition as well as allowed study of intracranial and extracranial soft tissue. Nonetheless, the computerized tomographic image slice format requires an educated interpreter and a fertile imagination for correlation with physical findings. We have created computer software that presents computerized tomographic data as surface images that resemble photographs of the patient or a specimen skull. The program runs on standard computerized tomographic scanners, requires no operator intervention, and is efficient in computation time and space. The surgeon can directly visualize the osseous deformity and mathematically relate it to the overlying soft tissue. The surface images can be viewed from a variety of perspectives, with or without selected structures, such as removing the body of the mandible in the pseudo-Water's projection to demonstrate the palate. The image data can be manipulated to obtain a variety of useful results beyond the images themselves. The addition of this technology to the preoperative evaluation and longitudinal follow-up of patients with head and neck cancer has increased our understanding of the extent of their malignancy. PMID- 6486323 TI - Transmandibular exposure of the skull base. AB - The combined transmandibular-transcervical approach to the skull base ensures a wide field exposure to the lateral and midline compartments of the middle cranial fossa with attendant vascular control. Splitting the lip and mandible in the midline and dividing the floor of the mouth structures along the lateral border of the tongue exposes the parapharyngeal space, infratemporal fossa (lateral compartment), and clivus, nasopharynx, and cervical spine (midline compartment). A variety of benign and malignant intracranial and extracranial skull base lesions have been treated using this approach. PMID- 6486324 TI - Surgical management of malignant tumors of the lacrimal gland. AB - Malignant lacrimal gland tumors are rare but serious and life-threatening neoplasms. Patients frequently present with symptoms of less than 1 year duration, often demonstrating rapid change during the 6 months preceding diagnosis. Pain and periorbital sensory changes are also reported by patients. Radiographically, bone destruction is a strong indication of a lacrimal gland malignancy as is ophthalmoplegia. Radical three-dimensional resection utilizing a cranioorbital approach offers the best chance for total tumor removal. Immediate reconstruction with a scalp flap is essential for primary healing, as well as esthetic balance of the orbital region. PMID- 6486325 TI - Perineural invasion in squamous cell skin carcinoma of the head and neck. AB - On review of 520 patients with 967 squamous cell carcinomas of the skin of the face treated at The University of Texas M.D. Anderson Hospital and Tumor Institute at Houston during a 10 year period, 14 percent of the patients were noted to have perineural extension of tumor. Study of the patients with perineural tumor demonstrated an increased incidence of spindle cell and adenosquamous cell types, an increased incidence of cervical lymphadenopathy and distant metastasis, and significantly reduced survival curves compared with those of patients with squamous cell skin carcinoma without perineural invasion. Tabulation confirmed that the maxillary and mandibular branches of the trigeminal nerve and the facial nerve were most commonly involved. For patients with squamous cell skin carcinomas with perineural invasion, aggressive therapy is recommended, specifically, resection of involved tissues and nerves and appropriate regional lymphadenectomy followed by postoperative radiotherapy. This plan affords the best opportunity for tumor control. The indications for exploration of the middle fossa of the intracranial portion of the trigeminal nerve deserve further study. PMID- 6486326 TI - [Loco-regional epidural pressure and differential intracranial pressure: value of monitoring in patients with a unilateral intracerebral lesion]. PMID- 6486327 TI - [Value of intracranial pressure monitoring during the acute phase of neurosurgical intensive care. Apropos of a case]. PMID- 6486328 TI - [Monitoring intracranial pressure in diffuse posttraumatic brain lesions. Value of the ventricular route (96 cases)]. PMID- 6486329 TI - [Measurement of loco-regional cerebral blood flow: an atraumatic method for neurophysiological study]. PMID- 6486330 TI - [Recording of cerebral perfusion pressure and an analog calculator for cerebral hemodynamics. Practical applications]. PMID- 6486331 TI - [Cerebral perfusion pressure in multimethod intensive care]. PMID- 6486332 TI - [Plateau waves and anoxo-ischemic crises. Clinical and physiopathological correlation (apropos of a case)]. PMID- 6486333 TI - [Vasoregulation disturbance during lidocaine poisoning]. PMID- 6486334 TI - [Influence of the position of the patient on intracranial pressure, cerebral perfusion pressure and prevention of gas embolism]. PMID- 6486335 TI - [Practical value of the study of the cerebral blood flow at the initial stage of subarachnoid hemorrhage: preliminary results]. PMID- 6486336 TI - [Endocranial biophysical parameters (intracranial pressure, flow velocity, blood pressure, cerebral perfusion pressure) in the complications of subarachnoid hemorrhage]. PMID- 6486337 TI - [Perfusion pressure and cerebral blood flow in severe head injuries]. PMID- 6486339 TI - [Median-term outcome of multiply-injured patients with cerebral involvement]. PMID- 6486338 TI - [Relation between intracranial pressure and residual carotid artery pressure during carotid clamping]. PMID- 6486340 TI - [Our experience with naloxone in standard neurosurgical practice]. PMID- 6486341 TI - [Anesthesia in children and infants for cerebral x-ray computed tomography]. PMID- 6486342 TI - [Cerebral perfusion pressure: limits of its value apropos of a case of cranio cerebral gunshot wound]. PMID- 6486343 TI - [Value of positive expiratory pressure during spontaneous respiration in neurotraumatology and neurosurgery]. PMID- 6486344 TI - [Changes in plasma enzyme activities and proteins in patients with severe head injuries. Effect of 2 sedative drugs: Gardenal and Gamma OH]. PMID- 6486345 TI - [Water and sodium metabolism in the patient with severe head injuries treated with sodium 4-hydroxybutyrate]. PMID- 6486346 TI - [Effects of injectable isosorbide dinitrate in perangiographic cerebral spasm]. PMID- 6486347 TI - [Anesthesia and intensive care for craniostenosis]. PMID- 6486348 TI - [Control of systemic blood pressure changes during surgery for retinal detachment. Comparison of neuroleptanalgesia with or without enflurane]. PMID- 6486349 TI - Do you dare to continue on the present track? PMID- 6486350 TI - Temporary hearing loss induced by combinations of intense sounds and nonsteroidal anti-inflammatory drugs. AB - Intense sounds were delivered to 11 subjects with normal hearing both before and during administration of standard doses of four nonsteroidal anti-inflammatory drugs. After four days of aspirin treatment (3.9 g daily), the subjects' resting hearing levels raised by about 10 dB. Administration of intense sounds that had previously been shown to produce about 12 dB of temporary hearing loss added increments of 10 to 15 dB to the aspirin-induced hearing loss. That is, the total temporary hearing loss produced by aspirin plus exposure to intense sound was about 10 to 15 dB greater than that produced by exposure to the intense sound alone. A similar effect was observed for sodium salicylate. After similar administrations of sulindac (400 mg per day) and diflunisal (750 mg per day), there was no corresponding increase in the sound-induced hearing loss. Under certain reasonable assumptions about underlying mechanisms, these findings suggest that persons taking moderate doses of aspirin or sodium salicylate may be at increased risk of noise-induced hearing loss. PMID- 6486351 TI - Effects of ketamine on the adaptive responses of second-order vestibular neurons of the cat. AB - The adaptive characteristics of 80 neurons in the vestibular nuclei of ketamine anesthetized cats were investigated. All types I and II neurons responded to stimulation of the horizontal semicircular canals by an 8 degree/sec2 stepwise angular acceleration of 40 sec. For the purpose of this study, vestibular adaptation was defined as a decline in response at a rate of greater than -0.01 spikes/sec/sec. According to this criterion, 71 neurons (89 per cent) behaved as adapting neurons, and nine (11 per cent) showed either no adaptation or reverse adaptation. The rate of adaptation varied from neuron to neuron; the average rate was -0.312 spikes/sec/sec. The average resting discharge rate, the maximum response level, and the average adaptation rate were compared with similar neural responses in barbiturate-anesthetized cats. Although the average resting discharge rates of the two groups showed no significant difference, the average adaptation rate and the maximum response level of the ketamine-anesthetized group were significantly higher than those of the barbiturate-anesthetized group. These data suggest that the gain of the second-order neurons is higher and more actively modulated in more alert (ketamine-anesthetized) cats than in barbiturate anesthetized cats. PMID- 6486352 TI - Laryngeal function. PMID- 6486353 TI - [Current state and perspectives of development of health resort services for gynecological patients in trade union sanatoria]. PMID- 6486354 TI - [Neurophysiological mechanisms of treatment of labor complications by acupuncture]. PMID- 6486355 TI - [The serotonin-monoamine oxidase system after treatment of uterine inertia by reflexotherapy]. PMID- 6486356 TI - [Main trends in the development of obstetrical and gynecological services for the rural female population]. PMID- 6486357 TI - [Reflexotherapy in reproductive system disorders of central origin]. PMID- 6486359 TI - [Reflexotherapy in combined anesthesia during cesarean section]. PMID- 6486358 TI - [Reflexotherapy in the treatment and prevention of uterine inertia in high risk of its development in women with labor fatigue]. PMID- 6486360 TI - [Use of acupuncture analgesia in obstetrical and gynecological operations]. PMID- 6486361 TI - [Reflex diagnosis of functional uterine and ovarian disorders after surgical procedures in tubal pregnancy]. PMID- 6486362 TI - [Acupuncture in cases of insufficient uterine involution and endometritis in the puerperium]. PMID- 6486363 TI - [Acupuncture-reflexotherapy in the treatment of infertility of hypothalamic origin]. PMID- 6486364 TI - [Use of acupuncture in chronic non-specific recurrent salphingo- oophritis]. PMID- 6486365 TI - [Vegetative indicators in flushing in the climacteric syndrome]. PMID- 6486366 TI - [Differential diagnosis of ovarian tumors]. PMID- 6486367 TI - [Obstetrico-surgical activity in EPH gestoses (a preliminary report)]. PMID- 6486368 TI - [Antithrombin III in normal pregnancy and late toxicoses]. PMID- 6486369 TI - [Use of ketalar--diazepam in the anesthesia of labor]. PMID- 6486370 TI - [Treatment of the complications of an anaerobic infection in obstetrics and gynecology using metronidazole (Flagyl)]. PMID- 6486371 TI - [Ultrasonic treatment of subacute inflammatory gynecologic diseases]. PMID- 6486372 TI - [Mud therapy of inflammatory gynecologic diseases and sterility of inflammatory etiology in Bulgaria]. PMID- 6486373 TI - [Spermatozoa concentration in the human split ejaculate]. PMID- 6486374 TI - [Mud therapy of chronic prostatitis in Pomoriye]. PMID- 6486375 TI - [A rare case in gynecologic practice]. PMID- 6486376 TI - Methylation of erythrocyte membrane phospholipid in patients with early-onset myotonic dystrophy. AB - Methylation of erythrocyte membranes was compared in 10 patients with myotonic dystrophy (MyD) and sex- and age-matched healthy controls. The incorporation of 3H-methyl groups into phosphatidylcholine (PC) increased with age in the controls. In all 5 patients with early-onset MyD, 3H-methyl incorporation into PC was significantly higher than in sex- and age-matched controls. In contrast, 5 patients with adult form MyD showed incorporation rates into PC that were not significantly different from the controls. Our findings may confirm the presence of differences in the methylation of cellular membranes in MyD patients with the adult- and early-onset forms of the disease. PMID- 6486377 TI - Ontogenic development of autoregressive component waves of waking EEG in normal infants and children. AB - Waking EEGs of 150 normal children aged from 20 days to 15 years were subjected to analysis. Discrete time series of an artifact free segment of the EEG record at 50 samples/sec for twenty seconds was generated and autoregressive (AR) and component analyses were carried out with a minicomputer PDP 11/40 (DEC). The results may be summarized as follows: 1) In the group of 1 year old and less, the power increased with the monthly age, whereas the bio-informing activity amount decreased. In those older than 1 year, both parameters showed maximal values at 1 year and then decreased with age, and the decreases were marked from 1 to 3 years. 2) The first- and second-order component activities of 129 and 677 waves, respectively, were obtained by applying component analysis to 152 EEG records. The frequency polygons of natural frequency of second-order component waves verified several modes, each of which was enhanced in the frequency range of the well-known delta 0, delta 1, theta 1, theta 2, alpha 1, alpha 2, beta 1, beta 2 and beta 3 waves, respectively. 3) The average percent-power of the delta wave (delta 0 + delta 1) decreased with age, especially from 1 to 3 years old, whereas those of beta- and alpha-waves increased with advancing age. That of the theta wave tended to increase from 2 to 4 years of age, and thereafter decreased gradually with increasing age. 4) With increasing age, the durations of damped oscillations were significantly lengthened in delta 1, alpha 1 and beta 3 waves, whereas that in the theta 1 wave was significantly shortened. 5) The bio informing activity amounts of alpha waves increased from 1 to 3 years with increasing age, whereas those of delta and theta waves decreased. No significant developmental change in the parameters, however, was observed in the beta wave. The results indicate that AR-power spectral and component analyses of EEG are sensitive methods for obtaining valuable information regarding the electrical brain maturation in childhood. PMID- 6486378 TI - Increased muscle action potentials by 5 Hz prolonged nerve stimulation in neurological and neuromuscular disorders--clinical usefulness for detecting underlying pathophysiology. AB - The time courses of changes in amplitudes of muscle action potentials (MAPs) obtained from gastrocnemius and soleus muscles by 5 Hz prolonged tibial nerve stimulation were studied. Subjects included muscular dystrophy (MD), spinal muscular atrophy, Issacs syndrome, idiopathic muscle spasms, psychiatric disorders such as autism and schizophrenia, and normal controls. In normal subjects, MAPs obtained at 5 minutes from gastrocnemius muscles was 87-102% of those at initiation of the stimulation. In soleus muscles, MAPs at 5 minutes was 95-105% of those at the beginning. In gastrocnemius muscles, MAPs increased in disorders such as Duchenne MD, Fukuyama type congenital MD, facioscapulohumeral MD, myotonic dystrophy, dermatomyositis, Kugelberg-Welander syndrome, viral myelitis, malignant hyperpyrexia, autism and schizophrenia. In soleus muscles, the increase of MAPs was demonstrated in Duchenne MD, Fukuyama type congenital MD, myotonic dystrophy and autism. MAPs remained within normal range in infants with Werdnig-Hoffman disease, Issacs syndrome and idiopathic muscle spasms. In two cases with Duchenne MD, MAPs obtained from gastrocnemius muscles reduced in amplitudes by the administration of dantrolen sodium. While the pathogenesis of the increased MAPs is not clear, several possible factors are discussed. It is considered that this 5 Hz examination may provide an important information for detecting the effect of dantrolen sodium on Duchenne MD, and it is also suggested that the examination will be a useful test for finding latent malignant hyperpyrexia. PMID- 6486379 TI - Fine structure based on the Golgi method of the abnormal cortex and heterotopic nodules in pachygyria. AB - The structure of the four-layer abnormal cerebral cortex and of the heterotopic cerebral nodules in pachygyria has been studied by means of the Golgi method. The external cellular layer is formed by neurons closely mimicking, in morphology and distribution, those observed in layers V-VI of the normal cortex, although major abnormalities in orientation of pyramidal cells are a prominent abnormal feature. The internal cortical cellular layer is composed of several neuron types in which no distinctive layered organization can be detected. Heterotopic cerebral nodules are formed by neurons of the cortical types with random orientation of their cellular processes. Some extrinsic axons have been demonstrated, thus suggesting lack of isolation of heterotopic nodules. PMID- 6486380 TI - Neurologic deterioration with progressive CT changes in a child with Kearns-Shy syndrome. AB - A case of the rare juvenile form of Kearns-Shy syndrome with progressive external ophthalmoplegia and lid ptosis, carditis, skeletal muscle weakness, seizures, mental subnormality, short stature, EEG abnormality and deafness is presented. Electromyography revealed a myopathic pattern. Histochemical studies on quadriceps biopsy specimens showed atrophy of type II fibers and "ragged-red fibers." On electron microscopy these muscle cells were seen to contain an increased amount of glycogen particles and abnormal mitochondria were increased in number and size. It is of interest that abrupt deterioration of neurological findings such as seizures, mental subnormality, speech disturbance and deafness was present in our case. Computed tomographic scanning showed progressive changes of cerebral atrophy, low density of cerebral white matter and basal ganglia calcification, which were well associated with the clinical deterioration. A review of the literature also indicated that some patients with this syndrome showed abrupt neurological deterioration in childhood. Involvement of the central nervous system in this syndrome has to be considered as the cause of sudden deterioration and death in childhood. PMID- 6486381 TI - Citrullinemia presenting as uncontrollable epilepsy. AB - We report the case of a 16-year-old girl with a variant form of citrullinemia who had been treated with anticonvulsants for uncontrolled epilepsy during the last 4 years. The diagnosis of citrullinemia was made because she had elevated values for serum citrulline (about 10 times control levels), elevated blood ammonia (over 400 micrograms/dl) and reduced activity of argininosuccinate synthetase in the biopsied liver tissue. Her EEG showed high voltage slow activity, but not triphasic waves, when she had high concentrations of blood ammonia. Treatment with a low-protein diet and sodium benzoate resulted in a normalized blood ammonia level, but her plasma citrulline levels remained unchanged. After the therapy she had neither convulsions nor seizure discharges on EEG, even when all anticonvulsant drug therapy was stopped. Thus it is suggested that hyperammonemia may account for the observed abnormal EEG findings, and triphasic waves on EEG are not always recorded in cases of hyperammonemia. PMID- 6486382 TI - A case of lissencephaly (agyria) syndrome with apnea--polygraphic study. AB - A 4-month-old infant with lissencephaly syndrome who was diagnosed on the basis of clinical symptoms and computed tomography experienced four apnea attacks during three polysomnographies. Apnea attacks were of two types. Type I apnea attacks were thought to be sleep apnea. The cause is unknown. Apnea was followed by tonic seizures due to hypoxia. Type II apnea attacks were thought to be epileptic apneic attacks, because they proceeded from the epileptic discharges in the right anterior temporal region (lead of electrooculogram). The origin of Type II apnea attacks was focused in the limbic system. PMID- 6486383 TI - Migration of a dissected peritoneal shunt catheter into the scrotum. AB - Migration of a dissected peritoneal piece of the shunting material into the scrotum was encountered in a 1-year-old boy who had received a V-P shunt. Removal of the migrated shunt tube by inguinal exploration and herniorrhaphy were performed, and another V-P shunt was installed simultaneously. This case was considered worthy of reporting as a rare complication of a V-P shunt, and the causal mechanism is discussed with a review of the literature. PMID- 6486384 TI - Fatal lipid storage disorder. AB - A 12-week-old female infant died from acute encephalopathy mimicking Reye syndrome. Because of positive serum hepatitis B surface antigen (HBs Ag) and perivascular inflammatory cell infiltration in the liver, she was diagnosed as having acute hepatitis. The most striking finding in the present case was extremely excessive lipid accumulation in the striated muscles including biceps brachii, tongue and cardiac muscles. The levels of serum, liver and muscle carnitine were within normal limits, though liver carnitine palmityl transferase (CPT) was markedly decreased in activity. Although the primary metabolic defect has yet to be elucidated, it is assumed that the fulminant hepatic failure induced lipid accumulation in the skeletal muscle by a certain abnormal lipid metabolism. PMID- 6486385 TI - [Rewarming from moderate to deep hypothermia: plasma catecholamine content, metabolism and circulatory function. 2 case reports]. AB - Two patients were rewarmed from hypothermia (esophageal temperature 27.2 degrees C, 27.5 degrees C respectively). The first case suffered from head-injury after alcohol ingestion and was deeply comatose. A metabolic or cardiovascular regulatory response to cold was not observed in this patient. The relationship between esophageal temperature and whole-body-oxygen consumption was quantified with a Q10 of 2.75 during rewarming (27.2-37.2 degrees C). His epinephrine levels were greatly elevated to 1,000 pg/ml whereas norepinephrine levels were only moderately increased to 250 pg/ml. Premature ventricular contractions (PVCs) during intubation or from the pulmonary artery catheter were not observed. The second patient was a 87 year old man with accidental hypothermia. He exhibited shivering at an esophageal temperature of 27.5 degrees C which indicated persistent thermoregulation. In contrast to the first case his norepinephrine levels were elevated to 1,500 pg/ml and his epinephrine levels only to 450 pg/ml. After onset of surface rewarming an additional increase in norepinephrine levels was observed and an increasing rate of PVC's (15/min) recorded, which ceased when temperature returned to normal. Our observations indicate that part of the cardiac complications during rewarming from deep hypothermia may result from thermoregulation and additional catecholamine liberation. PMID- 6486386 TI - [Short-term transtracheal jet for reversible support of respiration in the rat]. AB - A method is described for reversible controlled ventilation of rats by transtracheal catheter (20 or 22 G). A small rodent ventilator is used, rather then a jet ventilator, because the former enables the mixing of inhalation anesthetics with the carrying gas mixture. The method proved to be the most successful one for weaning from controlled ventilation after cardiac arrest and resuscitation of rats. In general, the method can be considered as an alterative to oral intubation and tracheotomy for controlled ventilation in rats. PMID- 6486387 TI - [An injury of the stellate ganglion following introduction of a canula into the inner jugular vein (Horner's syndrome)]. AB - A case of stellate ganglion injury after cannulation of the internal jugular vein is presented. Careful selection of external landmarks, maximal venous distension and proper direction of the needle can prevent this complication. PMID- 6486388 TI - [A vagus lesion as a complication of the catheterization of the internal jugular vein?]. AB - Internal jugular vein cannulation is reputed to be a safe procedure. This is a report on five cases in which lesions of the tenth cranial nerve occurred after internal jugular cannulation. The main symptoms are hoarseness, problems of deglutition and aspiration. PMID- 6486389 TI - [Arteriovenous fistula of the vertebral artery: a rare complication following central venous catheterization. A case report]. AB - Arteriovenous fistulas of the vertebral artery are in most cases caused by penetrating injuries. This report concerns a patient with ankylosing spondylitis, whose fistula most probably was brought about by puncture of the internal jugular vein for aorto-coronary-bypass surgery. PMID- 6486390 TI - [Carotid aneurysm following apparent complications in catheterization of the internal jugular vein]. AB - During resuscitation of a patient wih ruptured abdominal aortic aneurysm his right internal jugular vein was cannulated with a 12 gauge catheter-through cannula assembly (Cavafix 458, Braun-Melsungen), using a high central approach, without any apparent complications. Five weeks later a dissecting aneurysm of the right common carotid artery developed. From clinical, angiographic and histological data it is very likely that the aneurysm resulted from the catheterization procedure. PMID- 6486391 TI - [Fatal burn from a heated mat on the operating table]. AB - A number of heating mats were developed for use on operating tables in order to avoid hypothermia and incidental cardiocirculatory changes in patients undergoing prolonged surgical interventions. Because of inadequate technical safety devices, they can cause burns in patients. We report the case of a patient who, undergoing surgery for an aortobifemoral bypass, died of 2nd and 3rd degree burns after having been placed on a Maquet mat. Other possibilities which may lead to such severe burns are discussed. PMID- 6486392 TI - [The question of the effect of the intravascular volume of the intravenous administration of 40% sorbitol solution]. PMID- 6486393 TI - [Perioperative substitution therapy in congenital adrenogenital syndrome with salt loss]. AB - Patients with an inborn error of adrenal steroid synthesis suffer from primary adrenocortical insufficiency requiring corticosteroid replacement therapy and appropriate stress coverage. The case report of a two year old infant with congenital adrenal hyperplasia of the salt-losing type demonstrates the consequences of an accidental steroid underdosage. The necessity of increased cortisol replacement therapy in case of anesthetic procedures--even of short duration and without surgical measures--is underlined. The details of adequate perioperative steroid and i.v. fluid therapy in pediatric patients with congenital adrenal hyperplasia of the salt-losing type are discussed. PMID- 6486394 TI - [Isoflurane anesthesia in the Gottinger minipig. Hemodynamic and cardiac changes under controlled ventilation]. AB - 10 adult, female Gottingen minipigs were anaesthetized with isoflurane under controlled ventilation. A mixture of O2: N2O = 1:3 was used to vaporize isoflurane in an inspiratory concentration of 1.75-2.0 Vol%. Electrocardiogram, blood pressure, cardiac output and central venous pressure were continuously monitored. To determine the maximum rate of rise of intraventricular pressure (dp/dt max) as an indirect measure of myocardial contractility we placed a micro tip manometer in the left ventricle before and during (30 min value) the experiment. Acid-base balance was controlled by collecting arterial blood samples anaerobically. We found a negative chronotropic and marked inotropic effect of isoflurane on the heart-muscle. This probably is the main cause for the depression of arterial pressure, though peripheral vasodilatation has some effect. All cardiovascular changes were fully reversible within a few minutes of completing anaesthesia. After only 15 min all animals were fully conscious and data values had returned to control levels. Because of its deficient metabolism and toxicity isoflurane seems to be well qualified for use in experimental medicine in minipigs, especially when the animals require long or multiple exposure. But we recommend the use of isoflurane in combination with a basic anaesthesia, for example NLA or Ketamine to reduce cardiovascular depression. PMID- 6486395 TI - [Cuff protection for nasotracheal intubation]. AB - The passage of a tube through the nose to the epipharynx is potentially dangerous during the nasotracheal intubation because of the possibility of cuff damage, obstruction of the tube, the impossibility of advancing the tube and contamination. It seems therefore useful to protect the cuff e.g. by a finger stall, but using this procedure complications can occur which are reported. A better solution to protect the cuff will be shown. PMID- 6486396 TI - [Glycopyrrolate (Rubinol), an new substance with anticholinergic action]. PMID- 6486397 TI - A semi-automated protein assay for cell cultures. AB - A semi-automated modification of the protein determination procedure of O. H. Lowry, N. J. Rosebrough, A. L. Farr, and R. J. Randall (1951, J. Biol. Chem. 193, 265-275) is described. The assay is well suited to the analysis of the protein of adherent cultured cells. The procedure is carried out in 96-well microtest plates on protein solutions of 50 microliter or less, and can detect less than 0.5 micrograms of protein (equivalent to about 10(3) cultured cells). Optical densities are read and printed by an automatic microplate reader capable of processing 96 samples in less than 2 min. PMID- 6486398 TI - A rapid high-performance liquid chromatographic procedure for the simultaneous determination of methionine, ethionine, S-adenosylmethionine, S adenosylethionine, and the natural polyamines in rat tissues. AB - A method for the analysis of S-adenosyl-L-methionine (SAM) and S-adenosyl-L ethionine (SAE) and their major metabolites by high-performance liquid chromatography is described. The procedure allows the simultaneous analysis of the natural polyamines, putrescine, spermidine, and spermine, and some of the major amino acids, methionine, tyrosine, and tryptophan. The uv absorbance at 254 nm is used for the determination of the SAM and SAE analogs, whereas the polyamines and amino acids are analyzed by fluorescence detection after postcolumn derivatization with o-phthalaldehyde. The method allows SAM and polyamine determinations by direct injection of the tissue extracts without prepurification. The procedure is applied to study the effects of DL-ethionine treatment on the SAM, SAE, methionine, and polyamine levels in various tissues of rats. PMID- 6486399 TI - Purification of swine kidney alkaline phosphatase by immunoaffinity chromatography. AB - A homogeneous alkaline phosphatase preparation was obtained from swine kidney cortex by a simple purification step of immunoaffinity chromatography. The enzyme was purified 426 times that of the initial acetone powder with a recovery of 69.6% and a specific activity of 1206 units/mg of protein. The sodium dodecyl sulfate-gel electrophoretic pattern showed a single 80,000-Mr protein band as the monomer of the purified enzyme. PMID- 6486400 TI - Quantitation of human intestinal and liver/bone alkaline phosphatase in serum by rocket electroimmunoassay. AB - The separation and quantitation of the various human serum alkaline phosphatases has been largely by indirect and/or imprecise methods. A rocket electroimmunoassay method has been developed for the quantitation of the alkaline phosphatases, which uses enzymatic activity to detect the rocket and bromochloroindolylphosphate as substrate. The assay for intestinal phosphatase requires only one-dimensional electrophoresis, since the antibody to the intestinal enzyme does not cross-react with the other phosphatases. Both liver and bone enzymes give a line of identity when tested against antibody directed against the liver phosphatases, and these phosphatases require separation first by acrylamide gel electrophoresis before quantitation by crossed immunoelectrophoresis. Liver/bone enzyme levels in serum are easily detected within the linear range of the assay without concentration of the serum. The assay is 10-fold more sensitive than quantitation by acrylamide gel electrophoresis. The inability to detect circulating intestinal alkaline phosphatase in the serum of most fasting hospitalized patients has been documented by this sensitive assay, and the predominance of the liver isoenzyme has been confirmed. The assay should prove useful for determining the tissue of origin of serum alkaline phosphatases, and in providing quantitative data for physiological studies. It is not adaptable for automation and will not prove useful in the routine clinical laboratory. PMID- 6486401 TI - An alternative 7-ethoxyresorufin O-deethylase activity assay: a continuous visible spectrophotometric method for measurement of cytochrome P-450 monooxygenase activity. AB - A procedure to directly measure the cytochrome P-450-dependent 7-ethoxyresorufin O-deethylase activity with a visible spectrophotometer is described and compared to the standard fluorometric method. The two assays yielded identical results with both beta-naphthoflavone-treated mammalian (rat) and fish (scup, Stenotomus chrysops) liver microsomes. The assay takes advantage of a clean distinction in visible absorption spectra obtained for highly purified 7-ethoxyresorufin (substrate) and resorufin (enzymatic product). The purification and characterization of resorufin, the enzymatic product, are detailed, and its extinction coefficient (epsilon 572 = 73 mM-1 cm-1) provides for an accurate quantitation of enzyme activity. The large visible extinction coefficient of the product chromophore provides a high sensitivity for low-activity samples. The application of this enzyme assay in a visible spectrophotometer, along with the considerable evidence that a single aromatic hydrocarbon-inducible cytochrome P 450 isozyme is responsible for the catalysis, enhances the utility of this substrate in microsomal monooxygenase assays. The utility of the visible assay is further demonstrated by the simple determinations of the coupling ratio for 7 ethoxyresorufin oxidation in scup liver microsomes and the K1 for 7,8 benzoflavone and phenylimidazole inhibition of the enzymatic reaction. PMID- 6486402 TI - Measurement of tissue purine, pyrimidine, and other nucleotides by radial compression high-performance liquid chromatography. AB - A high-performance liquid-chromatographic (HPLC) method for the rapid separation of purine and pyrimidine nucleotides, NAD+, NADP+, FAD, FMN, UDP-Glc, UDP glucuronate, and ADP-ribose found in neutralized perchloric acid extracts of rat liver is described. Separation was achieved within 26 min on a radially compressed column of Partisil 10-SAX. The column was eluted with a gradient of sodium phosphate and sodium chloride. The sodium phosphate was purified by passage through tandem columns of anion- and cation-exchange resins to remove uv absorbing impurities. The sensitivity of this procedure is such that an amount of ATP contained in 10 micrograms of liver can be measured. The recoveries of all nucleotides were between 87 and 107%. In extracts of rat liver interfering substances were found to elute with GDP, and UDP eluted with NADP. Consequently, the tissue contents of UDP and GDP were determined in a second run by measuring the increase in UTP and GTP, respectively, following sample pretreatment with pyruvate kinase (PK). The tissue level of NADP+ was calculated as the difference between the total UDP and NADP+ peak and the increase in UTP following PK treatment. In those nucleotides amenable to enzymatic analysis, namely NAD+, AMP, UDP-Glc, UTP, and ATP, the tissue contents measured enzymatically were not significantly different from those determined by HPLC. However, ADP as measured with PK was found to be 15% higher compared to the HPLC determination. PMID- 6486403 TI - A simplified procedure for the preparation of tritiated GM1 ganglioside and other glycosphingolipids. AB - The ganglioside II3NeuAc-GgOse4Cer and other glycosphingolipids can be radiolabeled to high specific activity by the galactose oxidase-NaB3H4 procedure, by purifying the oxidized compounds prior to reductive labeling. The oxidized products are separated from nonoxidized compounds and detergents (Triton X-100 and sodium taurocholate) present during the enzymatic oxidation. Since the oxidized derivatives are separated, the final specific activity depends solely upon the specific activity of the NaB3H4 and the reduction conditions. PMID- 6486404 TI - A radiometric assay for 5-enolpyruvylshikimate-3-phosphate synthase. AB - A new assay for 5-enolpyruvylshikimate-3-phosphate synthase is described. This enzyme of the shikimate pathway of aromatic amino acid biosynthesis generates 5 enolpyruvylshikimate 3-phosphate and orthophosphate from phosphoenolpyruvate and shikimate 3-phosphate. The shikimate pathway is present in bacteria and plants but not in mammals. The assay employs a paper-chromatographic separation of radiolabeled substrate from product. The method is specific, is sensitive to 50 pmol of product, and is suitable for use in crude extracts of bacteria. This enzyme appears to be the primary target site of the commercial herbicide glyphosate (N-phosphonomethyl glycine). A procedure for the enzymatic synthesis of [14C]shikimate 3-phosphate from the commercially available precursor [14C]shikimic acid is also described. PMID- 6486405 TI - Protein diffusion coefficient measurements by laminar flow analysis: method and applications. AB - Laminar flow in an open tube leads to solute band spreading. This process is opposed by radial diffusion. The translational diffusion coefficient of a solute can be calculated from the band dispersion, tube length, and flow rate. No calibration is necessary. A simple apparatus was used to measure the diffusion coefficients of several small solutes and 18 proteins. Most results were within +/- 10% of literature values. Each determination required 7-90 min, depending on the magnitude of the diffusion coefficient. The amount of protein needed was approximately 25 micrograms. The diffusion coefficient data were useful for the estimation of molecular weights. PMID- 6486406 TI - Fluorometric determination of malonic acid with dicyclohexylcarbodiimide. AB - By using dicyclohexylcarbodiimide (DCC) as a reagent, a fluorometric method for the determination of malonic acid has been developed. The reagent combined with the acid to afford N,N-dicyclohexylbarbituric acid which reacted with glutaconic aldehyde, generated from the reaction of DCC with pyridine, to form a fluorophore. The fluorophore was then determined at lambda ex = 469 nm and lambda em = 562 nm. The calibration curve was linear from 2.5 to 25 nmol. The relative standard deviation obtained with 10 nmol of malonic acid was 5.77% (n = 10). The specificity is also discussed. PMID- 6486407 TI - Blotting intact immunoglobulins and other high-molecular-weight proteins after composite agarose-polyacrylamide gel electrophoresis. AB - A composite agarose-polyacrylamide gel containing urea and sodium dodecyl sulfate reliably resolved unreduced human immunoglobulins according to their molecular weight. Intact immunoglobulins and a number of other macromolecules were readily transferred to nitrocellulose paper by either capillary or electrophoretic blotting, although the latter technique was more effective. Conventional antigen probing as well as immobilized antibody studies can be performed on the nitrocellulose transfers. PMID- 6486408 TI - Preparation and characterization of radioactive monoiodotyrosine and diiodotyrosine derivatives of parathyroid hormone. AB - Highly purified native parathyroid hormone was iodinated by the enzymatic method and separated from unlabeled hormone by isocratic HPLC. The separation system used also resolved iodohistidine, monoiodotyrosine, and diiodotyrosine forms of the hormone from one another. A simplified procedure for direct bioassay of the carrier-free, high specific activity, mono- and diiodinated parathyroid hormone (PTH) by the renal membrane adenylyl cyclase method was also developed. Both labeled forms of the hormone are very potent in this assay, but the iodinated forms appeared to give a lower Vmax than the native hormone. The methods for iodination, separation and biological characterization of this PTH tracer are exceptionally facile, inexpensive, and convenient. PMID- 6486409 TI - Mobile-phase and temperature effects in the reversed phase chromatographic separation of proteins. AB - This paper explores the influence of mobile-phase and temperature effects on the gradient elution reversed phase chromatographic behavior of proteins. Using LiChrospher SI 500, bonded with n-butyl groups and a gradient in 1-propanol, 10 mM H3PO4, rapid separation and high mass recovery were obtained for a series of globular proteins. This protein separation and recovery are compared to those obtained when acetonitrile and acetonitrile plus 10 mM H3PO4 are used as eluting gradient solvents. In general, acetonitrile yielded lower recovery than 1 propanol, particularly for the more hydrophobic proteins, e.g., ovalbumin. For all three gradient solvents, little difference was observed in retention or recovery when the n-alkyl chain of the bonded phase varied. On the other hand, relative to the n-alkyl phases, a significantly lower retention of all proteins was found on more hydrophilic phases, e.g., cyano and nonendcapped n-butyl, when acetonitrile was the organic modifier, while in the case of 1-propanol, no retention difference was observed. Thus, column comparisons depend on the protein/mobile-phase combinations examined. The role of column temperature was also studied, and it was found that for certain proteins dramatic changes in peak shape occurred as a function of temperature. The influences of ionic strength and salt type were also studied. Protein mass recovery was shown to decrease with an increase in salt concentration; moreover, perchlorate was shown to have a larger effect in this regard than phosphate. In addition, salt concentration and type were found to influence peak shape greatly in certain cases. The results indicate the strong influences of mobile phase and temperature on chromatographic behavior, and some of the options available when this behavior is not satisfactory. Several protein separations are presented illustrating the power of the reversed phase approach. PMID- 6486410 TI - Radiochemical synthesis of DL-canaline and the colorimetric assay of canaline. AB - A procedure is available for the production of DL-[carboxy-14C]canaline from [14C]cyanide by reaction of ethyl N-hydroxyacetimidate and acrolein to form ethyl N-[3-oxopropoxy]acetimidate. The reaction product is converted to the nitrile and then to the hydantoin derivative of DL-canaline; alkaline hydrolysis produces the free amino acid (2-amino-4-aminooxypropionic acid). This procedure can be extended to the production of DL-[carboxy-14C]canavanine by guanidination of C-1 labeled DL-canaline with O-methylisourea. A markedly improved colorimetric assay for canaline has been achieved by a procedure involving carbamylation of canaline with cyanate to form O-ureidohomoserine (2-amino-4-ureidooxybutyric acid). Colorimetric analysis of the latter amino acid markedly enhances the sensitivity, reproducibility, and accuracy of the analysis of L-canaline from biological materials. PMID- 6486411 TI - Properties and applications of immobilized snake venom NAD glycohydrolase. AB - The NAD glycohydrolase (NADase) from Bungarus fasciatus snake venom was adsorbed on concanavalin A-Sepharose, and demonstrated to retain both hydrolase and transglycosidase activities in the bound form. The matrix-bound enzyme was stable to repeated washing with buffer and storage at 4 degrees C. The bound enzyme exhibited the same Km value for hydrolysis of nicotinamide-1,N6-ethenoadenine dinucleotide as previously measured with the soluble, purified form of the enzyme. The bound NADase was used repeatedly for a preparative-scale synthesis of 3-acetylpyridine adenine dinucleotide. It was further demonstrated that the immobilized enzyme could be prepared directly from crude snake venom, thus avoiding the time required for purification. The application of the immobilized snake venom NADase for the preparation of pyridine nucleotide coenzyme analogs has many advantages over procedures used previously for analog synthesis. PMID- 6486412 TI - Rapid purification and radioimmunoassay of cytosolic malic enzyme. AB - A very rapid and highly effective procedure has been devised for the isolation of homogeneous malic enzyme from rat liver cytosol. A combination of precipitation with 10 to 20% polyethylene glycol, ion-exchange chromatography on DEAE cellulose, and affinity chromatography on Procion Red HE-3B Agarose was used to prepare 3 to 4 mg of homogeneous malic enzyme from the livers of two rats in 18 h. In addition to introducing the advantages of simplicity, speed, and high yield (31%) the new method eliminates potentially denaturing steps (heat treatment, ethanol fractionation) and prolonged dialysis procedures used in other purification schemes. Malic enzyme purified by this new method was use to immunize rabbits. The resulting antibodies bound purified rat liver and mouse liver malic enzymes with very similar affinities and also avidly complexed cytosolic malic enzyme from two murine cell lines, 3T3-L1 preadipocytes and 3T3 C2 fibroblasts. When purified malic enzyme was incubated with lactoperoxidase, glucose oxidase and Na 125I 1.8 atoms of 125I were incorporated per molecule of enzyme with full retention of catalytic activity, subunit size, and immunoreactivity. The antiserum, the purified enzyme, and enzymatically iodinated 125I-malic enzyme were used to construct a sensitive, competitive binding radioimmunoassay for the measurement of malic enzyme mass in the range of 1 to 100 ng. PMID- 6486413 TI - Determination of N-7-[2H3]methyl guanine in rat urine by gas chromatography-mass spectrometry following administration of trideuteromethylating agents or precursors. AB - A gas chromatographic-mass spectrometric method has been developed for the determination of N-7-[2H3]methyl guanine in urine in the presence of large natural levels of N-7-methyl guanine. Urine is fractionated on heptanesulfonic acid-treated C-18 Sep-pak cartridges, followed by derivatization to give a volatile N-heptafluorobutyryl-O6-2,3,4,5, 6-pentafluorobenzyl derivative which is separated on an SE52 fused silica capillary column. Using N-7-ethyl guanine as an internal standard, the total amount of N-7-methyl guanine is determined by gas chromatography-flame ionization detection. The percentage of N-7-[2H3]methyl guanine is then measured by gas chromatography-mass spectrometry, enabling the amount of deuterated base to be determined. Preliminary experiments with [2H3]methyl methanesulfonate in rats showed measurable excretion of N-7 [2H3]methyl guanine. 4-(Di[2H3]methylamino)antipyrine alone gave no detectable amount of alkylated base, but coadministration of nitrite resulted in excretion of deuterated N-7-methyl guanine. PMID- 6486414 TI - Direct spectrophotometric analysis of hemoglobin in isoelectric focusing tube gels. AB - Methods are described for the direct spectrophotometric analysis of human oxyhemoglobin, deoxyhemoglobin, and methemoglobin focused in polyacrylamide tube gels. Visible absorption spectra (350-650 nm) of electrofocused hemoglobin bands were recorded using a diode array rapid-scan spectrophotometer. Direct optical sampling of gels allowed the identification of focused hemoglobin valency hybrids which contain two oxidized monomers per tetramer. PMID- 6486415 TI - An enzyme-linked lectin binding assay for quantitative determination of lectin receptors. AB - An enzyme-linked lectin binding assay (ELBA) has been developed for the detection of soluble lectin binding substances (receptors) and the determination of their relative affinity for the lectin. The assay is based on competitive binding to enzyme-labeled lectin of a known lectin receptor, bound to a solid phase, and unknown sample receptors. In this paper the assay is exemplified with the mannose/glucose-specific pea lectin, with the glycoprotein ovalbumin as its receptor, and with horseradish peroxidase (EC 1.11.1.7) as the enzyme used for labeling. Also a method was developed for the preparation of peroxidase-labeled lectin. Labeling was started by mixing equimolar amounts of lectin and periodate oxidized enzyme at pH 4.5 at a final concentration of 10(-4)M, after which conjugation was started by raising the pH to 9.5. This resulted in complete conjugation, after which the product could be diluted 50-500 times for application in ELBA. For the ELBA ovalbumin was adsorbed onto polystyrene microtiter plates. Sample receptors, added together with the enzyme-labeled lectin, inhibited binding of the latter to ovalbumin. Bound enzyme activity was colorimetrically determined after addition of o-phenylenediamine. Relative lectin affinity (KL) was expressed as (formula; see text) in which [X]50% is the concentration of sample receptor necessary to inhibit 50% of the binding of a certain amount of lectin, and [M]50% is the concentration of D-mannose necessary to inhibit 50% binding of the same amount of lectin. With this technique lectin affinity of both monovalent and polyvalent lectin binding substances can be estimated: low KL values mean high lectin affinity. PMID- 6486416 TI - Measurement of trimethylselenonium ion in human urine. AB - A comparison is made between two methods (ion-exchange chromatography vs a difference method) for the quantitative measurement of trimethylselenonium ion (TMSe) in human urine. It is shown that the difference method yields reliable data only if TMSe constitutes a relatively large fraction of urine selenium. Under normal conditions of selenium intake in man, accurate measurement of this important metabolite can, at present, be carried out only with the ion-exchange chromatographic procedure. Preliminary data from a human subject employing stable isotope tracer methodology are given to show that the fraction of urine selenium present as TMSe varies with the level of intake as well as other factors. PMID- 6486417 TI - New fluorogenic, photoactivable, heterobifunctional crosslinking thiol reagents. AB - Properties of newly synthesized crosslinking reagents (ACM) and their applications to proteins are studied (ACM is the abbreviation for a series of photoactivable and heterobifunctional crosslinking thiol reagents, each of which has two reactive groups, maleimide and azide). These reagents bind specifically to the sulfhydryl residues of proteins in the first reaction step. Upon photoactivation, the azide group of the coumarin ring reacts with side or main chains of the proteins, and thus intra- or intermolecular crosslinking can be elicited. In addition, the coumarin moiety of the reagents becomes highly fluorescent after photolysis. Therefore, the crosslinking products can be detected by fluorometry with high sensitivity in the pattern of sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Reaction of ACM with rabbit muscle aldolase led to extensive crosslinking between subunits of the enzyme and maximally 25% of the total subunits were found to be crosslinked to the dimer. PMID- 6486418 TI - Determination of aniline and metabolites produced in vitro by liquid chromatography/electrochemistry. AB - A method utilizing reverse-phase liquid chromatography/electrochemistry (LC/EC) was developed for the simultaneous determination of aniline and its hydroxylated derivatives, p-aminophenol, o-aminophenol, m-aminophenol, and N phenylhydroxylamine. To achieve separation of these compounds, a mobile phase of 3.0% dimethylformamide and 97.0% 0.05 M piperazine acetate, pH 5.4, containing 0.05 M KNO3 was developed. A procedure is also presented for the determination of p-nitrophenol, nitrobenzene, and nitrosobenzene, possible aniline metabolites in higher N-oxidation states, using reductive amperometric detection. The hydroxylated compounds, including the hydroxylamine, and nitrosobenzene are easily detected as metabolites of aniline in mouse liver slice or microsomal preparations. No prior extraction, preconcentration, or derivatization steps are needed for the determinations, which can be accomplished by a direct injection of the incubation mixture. The Km value for the hepatic aniline 4-hydroxylase activity in male Cox-Swiss mice microsomal preparations has been determined to be 0.52 mM; the Vmax value is 2.90 +/- 0.64 nmol min-1 mg microsomal protein-1. Detection limits for all compounds of interest are in the picomole range. PMID- 6486419 TI - Separation of some neutral lipids by normal-phase high-performance liquid chromatography on a cyanopropyl column: ubiquinone, dolichol, and cholesterol levels in sheep liver. AB - The normal-phase high-performance liquid chromatographic separation of neutral lipids into molecular classes was carried out on a cyanopropyl (CN) column eluted with isopropanol in hexane. Cholesteryl, retinyl, and dolichyl esters, triglycerides and vitamin E, ubiquinone, dolichol, phytol, and cholesterol eluted as separate peaks with 0.05% isopropanol in hexane. Cholesterol, retinol, diglyceride, and monoglyceride eluted as separate peaks with 0.75% isopropanol in hexane. These separations could not be achieved on a silica gel column. The method was used to assay sheep liver ubiquinone, dolichol, and cholesterol levels, that were determined as 77, 108 and 1864 micrograms/g wet wt, respectively. PMID- 6486420 TI - Addition of proteins to the cylindrical gel embedding medium for transverse molecular-weight markers in two-dimensional gel electrophoresis. AB - As an aid in the comparison of different complex mixtures of proteins resolved by two-dimensional electrophoresis, a simple method which results in the electrophoresis of molecular-weight standards as appropriately migrating, highly resolved bands extending across the entire second-dimension slab gel is described. The proteins to be used as markers are included in the molten agarose mixture used to affix the first-dimension cylindrical gel atop the second dimension slab gel. As the proteins which are resolved in the first dimension migrate through the second-dimension slab gel, the marker proteins also migrate, experiencing the same electrophoretic conditions as the sample proteins in the immediate vicinity. If the same protein is resolved in the first dimension and also used as a marker, it electrophoreses in the second dimension as a spot intersected by a band traversing the entire gel. This sensitive method is applied to a comparison of soluble seed proteins of two cotton species, Gossypium hirsutum and G. arboreum, using G. hirsutum seed protein as the molecular-weight marker. Other applications are described. PMID- 6486421 TI - Rapid assay for gamma-carboxyglutamic acid in urine and bone by precolumn derivatization and reversed-phase liquid chromatography. AB - A reversed-phase high-performance liquid chromatographic assay for the analysis of gamma-carboxyglutamic acid (Gla) in urine and bone protein hydrolyzates is described. The method employs precolumn derivatization with o-phthalaldehyde and mercaptoethanol. Gla was quantified by reference to an internal standard (beta carboxyaspartic acid). The "within-run" coefficient of variation of the assay for Gla in urine was between 2.1 and 3.4%, and that for bone protein hydrolyzates was 3.2%. The "between-run" coefficient of variation ranged from 4.1 to 5.5%. There was good agreement between the measurement of urinary Gla by high-performance liquid chromatography and amino acid analyzer. Free Gla could not be detected in serum. PMID- 6486422 TI - Bioluminescent determination of free fatty acids. AB - A simple, highly specific, and sensitive bioluminescent method for determination of free fatty acids in unextracted plasma or serum has been developed. The method is based on the activation of free fatty acids by acyl-CoA synthetase (EC 6.2.1.3). The pyrophosphate formed is used to phosphorylate fructose 6-phosphate in a reaction catalyzed by the enzyme pyrophosphate-fructose-6-phosphate phosphotransferase (EC 4.1.2.13). The triosephosphates produced from fructose 1,6 bisphosphate by aldolase are oxidized by NAD in the presence of arsenate to 3 phosphoglycerate. The NADH is detected via the bacterial NADH-linked luciferase system. Excellent agreement has been obtained by comparison with accepted methods. In addition, for the determination of serum free fatty acids, the method is particularly applicable for following lipolysis of isolated adipocytes. PMID- 6486423 TI - Quantitation of the major proteins of the human erythrocyte membrane by amino acid analysis. AB - The proteins of the human erythrocyte membrane have been separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, the resulting gel cut into 2 mm sections, and the amino acid content and composition of each slice measured using a sensitive method of amino acid analysis. The distribution of proteins among bands coincides closely with that estimated using staining intensity. Composition data for the major bands agree well with those reported for the purified proteins in all cases except that of band 4.5. Using quantitative amino acid analysis and resistive particle counting the total protein content of purified membranes was found to be 3.75 X 10(-13) g/cell, which is substantially less than previous estimates based on indirect methods. These data are used to calculate the number of copies of each major protein in a single erythrocyte. PMID- 6486424 TI - An enzymatic method for radiolabeling vertebrate vitellogenin. AB - Phosphoprotein kinases from Xenopus and chicken liver have been purified and these enzymes have been used to label Xenopus vitellogenin, a phosphoprotein, to high specific activity with [gamma-32P]ATP. The enzymes were isolated by (NH4)2SO4 fractionation followed by chromatography on DE-52 cellulose and phosphocellulose. This procedure resulted in greater than 20,000-fold enrichment for the enzymes. Both enzyme preparations were used to selectively label vitellogenin in the serum of estrogen-treated animals. Thus, isolation of the vitellogenin prior to radiolabeling was not necessary. The [32P]vitellogenin labeled in situ was incorporated by oocytes at a rate similar to [32P]vitellogenin labeled in vivo, was translocated to the yolk platelets, and was correctly processed into the yolk proteins. PMID- 6486425 TI - A single-step gel-filtration method for the isolation of procollagens from cell culture conditioned medium. AB - Procollagens are the major proteins secreted into the conditioned medium of cultured arterial smooth muscle cells. Methods for the isolation and quantification of these macromolecules have traditionally required preliminary salt precipitation of procollagens from the conditioned medium followed by cellulose ion-exchange chromatography. The method described here exploits the elongated conformation of soluble procollagens and allows the direct recovery of procollagens from culture medium by a single gel-filtration chromatographic step under nondissociating conditions. Procollagens are isolated in high yield and show minimal processing by procollagen N- or C-terminal peptidase activity. This method results in rapid recovery of highly purified procollagens, free of most proteoglycans or other products of smooth muscle cell metabolism. PMID- 6486426 TI - Isolation of human erythrocyte membranes in glucose solution. AB - A method is described for the preparation or removal of erythrocyte membranes from hemolysates by a glucose solution. The procedure is simple and rapid, requiring centrifugation at 8000g for 2 min. The preparation has microscopic shape and two-dimensional peptide patterns similar to those of the membrane isolated by conventional procedures (10,000g for 20 min). The present procedure is suitable for dealing with a bulky preparation or for removal of erythrocyte membranes from large volumes of hemolysates to purify enzymes and proteins of soluble or membrane fractions. PMID- 6486427 TI - Lowry method of protein quantification: evidence for photosensitivity. AB - Despite reports of its susceptibility to various interfering factors, the Folin Phenol protein quantification method of O. H. Lowry, N. J. Rosebrough, A. L. Farr, and R. J. Randall (1951, J. Biol. Chem. 193, 265-275) remains the most convenient and accurate method for routine protein determinations. Our findings indicate that the Lowry assay is also photosensitive which can result in a discrepancy of up to 10% in estimated protein concentrations, unless appropriate precautions are taken. PMID- 6486428 TI - Metal-ion-dependent hydrophobic-interaction chromatography of alpha-lactalbumins. AB - alpha-Lactalbumins from bovine, human, goat, sheep, and horse milk bind to phenyl Sepharose in the presence of EDTA and can be eluted by addition of Ca2+ (0.001 100 mM). This property has been utilized to purify these proteins in a one-step purification from milk whey. alpha-Lactalbumin purified in this manner has the same ultraviolet and proton nuclear magnetic resonance spectra as that purified by other methods. Using binding to phenyl-Sepharose as an assay, the conformation of bovine alpha-lactalbumin upon the addition of several metal ions that are known to interact with this protein was investigated. Lanthanides, Mn2+, Mg2+, and Cd2+ can substitute for Ca2+, whereas Zn2+, Al3+, and Co2+ cannot. Surprisingly, whereas lower concentrations of La3+, Mn2+, and Cd2+ (1 mM and less) caused elution from the hydrophobic support, higher concentrations (10 mM) were ineffective. These observations can be rationalized assuming the presence of two distinct metal-ion binding sites with different specificities. PMID- 6486429 TI - Direct observation of the distribution of fluorescent probes in phosphatidylcholine/cholesterol vesicles using flow microfluorometry. AB - The technique of flow microfluorometry has been extended to the study of small lipid complexes to assess either the lipid (hydrophobic) or aqueous (hydrophilic) compartments of selected natural or model membrane systems. sn-1-Palmitoyl-sn-2 oleoyl-phosphatidylcholine/cholesterol unilamellar vesicles, averaging 268 nm in diameter and containing varying concentrations of the synthetic lipophile probe, sn-1-palmitoyl-sn-2-12-[N-4-nitrobenzo-2-oxa-1,3- diazole]-aminocaproyl phosphatidylcholine (NBD-PC), were analyzed using an Ortho Series 50-H Cytofluorograf and an Ortho 2150 computer system. NBD-labeled vesicles were analyzed for green fluorescence and the intensity of scattered light, the later being analyzed both at low angle (2-5 degrees) and at 90 degrees to the incident beam. At the high amplification required for vesicle detection, background signals from the sheath buffer, nonspecific laser light, and electronic noise were observed. However, this background noise signal was removed by appropriately setting a discriminator window. Profiles of signals falling within this region were then constructed. For the settings selected, more than 98% of data recorded could be attributed to observations on vesicles. Size information from the intensity of scattered light was obtained by comparison of the sample with fluorescent microspheres after correcting for the particle-scattering function difference between hollow and solid spheres and for refractive index differences. Additionally, cytograms and profiles were constructed for vesicles containing 5 mM 6-carboxyfluorescein, 3',6'-dihydroxy-3-oxospiro(isobenzofuran-1(3H),9' (9H)xan then)-6-carboxylic acid, trapped in the aqueous core. Thus, the utility of flow microfluorometry has been extended to much smaller particle populations than studied previously by this technique.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486430 TI - Quantification of attached cells in microtiter plates based on Coomassie brilliant blue G-250 staining of total cellular protein. AB - A method has been developed to determine the relative or actual number of attached cells in microtiter plate wells without making direct cell counts. The procedure is based upon staining total cellular protein with Coomassie brilliant blue G-250, followed by measurement of absorbance at 630 nm in a spectrophotometer designed to read each well of a 96-well microtiter plate. No destaining of cells is required. A linear correlation exists (r = 0.970) between cell number and absorbance over a useful range. Intraplate well-to-well variation is acceptable (CV = 0.101). This method was used to measure the proliferative response of human vascular smooth muscle cells to human serum. It should be useful in other assays involving proliferation of attached cultured cells. PMID- 6486431 TI - Nucleotides in a single mammalian ovum or preimplantation embryo. AB - ATP, ADP, and AMP have been measured jointly on a single mouse ovum or preimplantation embryo using an ultramicrofluorescence technique. The method uses the traditional approach of enzymatic analysis based on changes in the concentrations of nucleotide cofactors, but eliminates the need for enzymatic recycling. It permits the measurement of as little as 10 fmol, and may be adapted for numerous metabolites. PMID- 6486432 TI - Reaction of S-(2-amino-2-carboxyethylsulfonyl)-L-cysteine with thiosulfate: synthesis of L-alanine sulfodisulfane and application to the determination of thiosulfate. AB - A new reaction of S-(2-amino-2-carboxyethylsulfonyl)-L-cysteine (ACESC) with thiosulfate is described. The reaction proceeded quantitatively in formic or acetic acid solutions, yielding equimolar amounts of L-alanine sulfodisulfane (2 amino-2-carboxyethyl sulfodisulfane) and L-alanine 3-sulfinic acid. L-Alanine sulfodisulfane was obtained as pure monosodium salt; the yield was 92% of the theoretical. A new method is described for the determination of thiosulfate. The method is based on the quantitative reaction between ACESC and thiosulfate, and L alanine sulfodisulfane, one of the reaction products, was determined using acid ninhydrin reagent 2 of M. K. Gaitonde (1967, Biochem. J. 104, 627-633). The recovery was over 95%. When samples contained sulfite in addition to thiosulfate, S-sulfo-L-cysteine (T. Ubuka et al., 1982, Anal. Biochem. 126, 273-277) was produced in addition to L-alanine sulfodisulfane by the treatment with ACESC. Both products were separated by a small Dowex 1 column and determined with the acid ninhydrin reagent 2. The recoveries were over 95%. The new method was applied to the thiosulfate sulfurtransferase reaction, in which thiosulfate, a substrate, and sulfite, a product, were determined separately. PMID- 6486433 TI - Strand separation of DNA fragments and their isolation from nondenaturing polyacrylamide gels. AB - A technique for rapidly and quantitatively denaturing double-stranded DNA employing urea and moderate heat is described. The single DNA strands are resolved on high-percentage nondenaturing polyacrylamide gels from which they can be recovered for Maxam-Gilbert sequence analysis. PMID- 6486434 TI - The use of phospholipid-impregnated millipore filters for recording nonelectrogenic cation flows in the presence of Men+/nH+ exchangers. AB - It has been shown that with a cation (K+, Na+, Ca2+) concentration gradient on a Millipore filter impregnated with a decane solution of phospholipid, in the presence of a Men+/nH+ exchanger (nigericin, monensin, A23187), addition of a protonophore induces the formation of an electric potential positively charged on the side where the concentration of the cation is lower. The formation of the potential is induced by the hydrogen ion concentration gradient in the filter and in the unstirred layers as a result of the Men+/nH+ exchange. In such a system, with a pH gradient on the filter in the presence of monensin and valinomycin, a potential is generated with the plus on the side of the lower concentration of hydrogen. The effect is the result of the formation of a potassium ion concentration gradient in the unstirred layers in the course of the K+/H+ exchange. It is concluded that phospholipid-impregnated filters can be used for search and identification of electroneutral membrane ionophores of the Men+/nH+ exchanger type. PMID- 6486435 TI - Fibroblast procollagen production rates in vitro based on [3H]hydroxyproline production and procollagen hydroxyproline specific activity. AB - In vitro procollagen production rates can be determined by culturing cells in the presence of [3H]proline and measuring the subsequent formation of [3H]hydroxyproline. Values of actual procollagen production can be calculated if the total radioactivity and the specific activity of the newly synthesized procollagen is known. A simple microanalytical method for measuring procollagen specific activity in order to determine procollagen production by lung fibroblasts in vitro is reported. Confluent fibroblasts (IMR-90) were cultured in fresh medium containing [3H]proline, and [3H]hydroxyproline production and prolyl hydroxylation were measured. Hydroxyproline specific activity of nondialyzable procollagen in culture medium as well as extracellular and intracellular free proline specific activity were determined by an ultramicromethod in which the radiolabeled amino acids were reacted with [14C]dansyl chloride of known specific activity [Airhart et al. (1979) Anal. Biochem. 96, 45-55]. Procollagen production rates were readily determined by this method using 5 to 20 microCi [3H]proline and approximately 10(6) cells. It was found that 3H-procollagen production rate into culture medium was constant after a lag of 1.6 h, while procollagen production rate (0.23 pmol/microgram DNA . h) was constant from time zero to 9 h. The specific activities of extracellular and intracellular free proline were not constant during the labeling period, nor were they equal to procollagen specific activity. These data indicate that free proline pool specific activities are not a valid measure of procollagen specific activity. The experimental approach described obviates the need to define or characterize the proline precursor pool from which procollagen is synthesized, and may be readily applied to determine fibroblast procollagen production rates in vitro. PMID- 6486436 TI - Glutathione content of cultured cells and rodent brain regions: a specific fluorometric assay. AB - The glutathione contents of cultured cells and rodent brain were determined by a fluorometric procedure which eliminates the interference of endogenous histidine containing compounds. Cultured neonatal rat and hamster astrocytes, human dermal fibroblasts, and mouse and rat brain regions were assayed. o-Phthalaldehyde forms a fluorescent complex with glutathione, oxidized glutathione, and histidyl compounds in the absence of added thiol. The reaction of histidyl compounds can be abolished by the addition of formaldehyde to the reaction mixtures. A 10-pmol quantity of glutathione can be measured in dilute formic acid extracts of milligram quantities of tissue. PMID- 6486437 TI - Purification of a human urinary carboxypeptidase (kininase) distinct from carboxypeptidases A, B, or N. AB - A carboxypeptidase which cleaves basic C-terminal amino acids from peptides was purified from concentrated human urine by a three-step procedure: chromatography on Affi-Gel Blue, arginine-Sepharose affinity chromatography, and gel filtration by HPLC on a TSK-G3000SW column. Urinary carboxypeptidase was purified 406-fold with an 11% yield and a specific activity of 49 mumol/min/mg with benzoylglycylargininic acid as substrate. It migrated as a single band of Mr 75,700 in polyacrylamide gel electrophoresis with sodium dodecyl sulfate. It cleaved benzoylglycylarginine, benzoylglycyllysine, benzoylglycylargininic acid, benzoylalanyllysine, and benzoylphenylalanyllysine at different relative rates than human plasma carboxypeptidase N, the Mr 48,000 active subunit of carboxypeptidase N or human pancreatic carboxypeptidase B. Urinary carboxypeptidase did not hydrolyze benzoylglycylphenylalanine, a substrate of carboxypeptidase A, but readily cleaved bradykinin with a Km of 46 microM and a Kcat of 32 min-1. Its activity was enhanced by CoCl2 and inhibited by cadmium acetate, o-phenanthroline, or DL-2-mercaptomethyl-3-guanidinoethylthiopropanoic acid. The enzyme had a pH optimum of 7.0 and its activity dropped at pH 6.0 by 60%. It was stable for at least 2 h at 37 degrees C (pH 8.0) but was unstable at room temperature below pH 4.5. The molecular weight, electrophoretic mobility, and activity of urinary carboxypeptidase was not affected by trypsin. The effect of pH and stability further distinguished the urinary carboxypeptidase from other human carboxypeptidases. Urinary carboxypeptidase was immunologically distinct from carboxypeptidase N when analyzed by the "Western blot" technique. Thus, human urine contains a basic carboxypeptidase, different from known carboxypeptidases, which may be released into the urine by the kidney. Here it could inactivate kinins and other peptides containing a basic C-terminal amino acid. PMID- 6486438 TI - Design and operation of a completely automated Beckman microsequencer. AB - A unique, efficient, and inexpensive system has been designed and built for the automatic conversion of anilinothiazolinone derivatives extracted from a Beckman spinning-cup sequencer with subsequent on-line high-pressure liquid chromatography separation of the phenylthiohydantoin derivatives. The Auto Converter-Auto Sampler system is controlled by a tape programmer or microprocessor and operates by transfer of the sample from the conversion vial into an HPLC injection loop by nitrogen pressure. Incorporation of a minor programming change on the sequencer allows the introduction of nitrogen vapor into the spinning cup during phenylisothiocyanate coupling. These modifications have resulted in a completely automated subnanomole protein sequencer. PMID- 6486439 TI - A sensitive high-performance liquid chromatographic-fluorometric assay for dihydrofolate reductase in adult rat brain, using 7,8-dihydrobiopterin as substrate. AB - A liquid chromatographic-fluorometric assay has been developed to study the role of dihydrofolate reductase in adult rat brain since low levels of the enzyme preclude measurement by current spectrophotometric procedures. This method involves in vitro incubation of desalted, cell-free brain extracts with 7,8 dihydrobiopterin, NADPH, and an NADPH-regenerating system. The tetrahydrobiopterin formed is quantitatively converted to pterin using alkaline iodine oxidation, and the pterin formed is separated by liquid chromatography and detected fluorometrically. The method is linear from 100 fmol to greater than or equal to 1 nmol of product, and the sensitivity is at least 100 times greater than that of existing spectrophotometric assays. Enzyme activity of desalted brain extracts is linear with both time (to 100 min) and protein (from 50 to 620 micrograms). The enzyme shows an absolute requirement for NADPH, does not use NADH, and is completely inhibited by 10 nM methotrexate. The Km of the enzyme for NADPH was found to be 7.5 microM, while the Km for 7,8-dihydrobiopterin was 88 microM. Since brain dihydrobiopterin reductase has the same properties as dihydrofolate reductase, this fluorometric procedure can serve as a sensitive assay for dihydrofolate reductase. PMID- 6486440 TI - Utility of the gas-phase sequencer for both liquid- and solid-phase degradation of proteins and peptides at low picomole levels. AB - The utility of the commercially available gas-phase sequencer for complete analysis of peptide samples was investigated. Using the program supplied with the instrument, significant extractive loss of samples in Polybrene was observed, even at input levels up to 500 pmol. In order to reduce this loss, the sequencer program was modified by increasing the phenylisothiocyanate (PITC)-coupling steps from two to three and lengthening the duration of ethyl acetate (S2) delivery while reducing the delivery rate. These changes gave improved results with peptides, e.g., all eight residues of angiotensin II were identified at the 25 pmol level. In addition, background contamination was decreased and repetitive yields were increased. The instrument was also found to function well with samples coupled to solid supports; however, some of the methodologies that work adequately for covalent attachment of peptides to solid supports at the level 1 10 nmol were found to give unacceptable coupling/sequenceable yields at or below the 100-pmol level. The coupling methods tried were (1) reaction of homoserine lactone with aminopropyl (AP)-glass, (2) reaction of alpha- and epsilon-NH2 groups with p-phenylenediisothiocyanate (DITC)-glass, and (3) reaction of alpha COOH groups with aminoaryl (AA)-glass via EDAC (1-ethyl-3,3'-dimethylaminopropyl carbodiimide). Of these, the first method gave combined yields of 42-94% while the latter two were only 9-35% efficient. The covalently bound samples provided sequence information even at the resulting low levels, e.g., 9/13 residues of dynorphin including Lys-13 at 11 pmol. In general, sequencer runs on solid-phase samples gave "cleaner" analyses and slightly higher repetitive yields (1-2%). Sequence information has also been obtained on peptides made by solid-phase synthesis prior to cleavage from the polystyrene support. With improved coupling efficiencies, solid-phase techniques would provide an alternative to immobilization of peptides in Polybrene films for low picomole level gas-phase sequencing. PMID- 6486441 TI - Identification and quantitation of fatty acid ethyl esters in biological specimens. AB - Fatty acid ethyl esters, recently described as enzymatic products of nonoxidative ethanol metabolism in the heart, may represent a mediator or marker of ethanol induced organ pathology such as alcoholic cardiomyopathy. This study was designed to develop a method for the extraction, quantitation, and definitive identification of fatty acid ethyl esters formed both in biological specimens and during enzymatic incubations. First, several potential sources of error were identified and characterized. Tissue extraction with alcohols led to the time, temperature, and concentration-dependent nonenzymatic formation of fatty acid alcohol esters. Contamination of both substrates, [14C]ethanol and 14C-fatty acid, used to measure enzymatically mediated fatty acid ethyl ester synthesis, could be removed by purification. Accurate quantitation of fatty acid ethyl esters in tissue was achieved using acetone as an extraction solvent, after which isolated lipids were thin-layer chromatographed on silica gel developed with an apolar solvent system (petroleum ether:diethyl ether:acetic acid, 75:5:1). Gas chromatography and mass spectroscopy identified individual fatty acid ethyl esters. The reproducibility of this assay was high, as assessed by quintuplicate determinations of fatty acid ethyl esters formed in liver and heart homogenates, a method with standard deviations 4 to 11% of the mean. PMID- 6486442 TI - High-performance liquid chromatographic measurement of exogenous thiosulfate in urine and plasma. AB - A simple technique using reverse-phase ion-pair liquid chromatography for measurement of exogenous thiosulfate is described. Accurate measurement of thiosulfate in plasma and urine was permitted by precolumn derivatization with monobromobimane, a substance that readily yields fluorescent compounds upon reaction with a variety of biologically important nucleophiles including glutathione, cysteine, and sulfite. Using an injection volume of 50 microliters, as little as 0.16 nmol of thiosulfate was reliably measured. The interassay precision of the method was reflected by a coefficient of variation of 7.7% while the coefficient of variation for interassay analysis was 2.6%. Recovery of thiosulfate from plasma was 96.9 +/- 3.2% and greater than 98% from urine. The simplicity, sensitivity, and precision of the method make it ideal for the study of thiosulfate and other important nucleophiles in body fluids. PMID- 6486443 TI - Normal-phase liquid chromatographic determination of alprazolam in human serum. PMID- 6486444 TI - Structural characterization of polycyclic aromatic compounds by combined gas chromatography/mass spectrometry and gas chromatography/Fourier transform infrared spectrometry. PMID- 6486445 TI - Mechanism of surfactant-induced changes in the visible spectrometry of metal Chrome Azurol S complexes. PMID- 6486446 TI - Directly measured signals as response variables in fluorescence polarization ligand binding assays. PMID- 6486447 TI - Simultaneous multielement analysis of microliter quantities of serum for copper, iron, and zinc by graphite furnace atomic absorption spectrometry. PMID- 6486448 TI - Tandem mass spectrometry for the trace determination of tryptolines in crude brain extracts. PMID- 6486449 TI - Effect of laser beam shape parameters on photothermal deflection densitometers. PMID- 6486450 TI - Ion-pair extraction of thiocyanate from plasma and its gas chromatographic determination using on-column alkylation. PMID- 6486451 TI - Polarographic catalytic hydrogen waves in aquocobalamin and methylcobalamin solutions. PMID- 6486452 TI - Resistance of nonaqueous solvent systems containing tetraalkylammonium salts. Evaluation of heterogeneous electron transfer rate constants for the ferrocene/ferrocenium couple. PMID- 6486453 TI - Determination of clobazam and desmethylclobazam in serum using high-performance liquid chromatography. PMID- 6486454 TI - Controlled-dispersion flow analysis in clinical chemistry: determination of albumin, triglycerides and theophylline. PMID- 6486455 TI - Identification and determination of copper--and zinc--protein complexes in blood plasma after chromatographic separation on DEAE-Sepharose CL-6B. PMID- 6486456 TI - Analysis of urine samples by electrothermal atomisation--atomic-absorption spectrometry: a comparison of natural and control material. PMID- 6486457 TI - Potentiometric stripping analysis of lead and tin with a continuous flow system. PMID- 6486458 TI - Differential-pulse polarographic determination of cholic acids. PMID- 6486459 TI - Comparison of flame atomic-absorption techniques for the determination of copper and zinc in fractionated blood plasma. PMID- 6486460 TI - Determination of 9,10-epoxystearate ester in intravenous solutions stored in poly(vinyl chloride) bags, using gas chromatography-single-ion monitoring mass spectrometry. PMID- 6486461 TI - Direct determination of lead in blood by laser-excited flame atomic-fluorescence spectrometry. PMID- 6486462 TI - Determination of calcium, magnesium and phosphorus in human stones by inductively coupled plasma atomic-emission spectroscopy. PMID- 6486463 TI - Speeding up determinations by electrothermal atomic-absorption spectrometry. PMID- 6486464 TI - Identification by thin-layer chromatography of dyestuffs based on benzidine, o tolidine or o-dianisidine in consumer fabric dye products. PMID- 6486465 TI - Determination of some antimalarial aminoquinolines by vanadium(V) titration. PMID- 6486466 TI - [Postnatal enlargement of the foramina rotundum, ovale et spinosum and their topographical changes]. AB - In the newborn the Canalis (Foramen) rotundus is about 2.5 mm and in 15-til 17 year-old about 3 mm in length. The Apertura interna postnatal develops in width from 2.06 to 3.50 mm and in height from 1.8 to 2.73 mm. From the median sagittal plane the medial rim of the Apertura interna is distant about 11.0 mm in newborns and in adults 16.47 mm on the right side and 17.63 mm on the left side. Moreover the angular distance of the axis of the Canalis rotundus just across the median plane and also just across the frankfurt plane were determined. In the newborn the Foramen ovale is about 3.85 mm and in the adults about 7.2 mm in length. The width extend from 1.81 mm in the newborn to 3.7 mm in adults. In the newborn the distance from the medial rim to the median sagittal plane is about 3.9 mm, in the adults at the right side 20.9 mm and at the left side 22.5 mm in length. In the newborn the Foramen venosum (Vesalii) is about 1.0 mm in length and in the adults at the right side about 2 mm and at the left side 1.4 mm. The width increases from 1.0 to 1.14 mm at the right side and to 1.3 mm at the left side. The mean distance opposite to the median sagittal plane increases between newborn time and the adults from 10.0 mm at the right side to 15.78 mm and at the left side from 10.75 to 17.62 mm. In the newborn the Foramen spinosum is about 2.25 mm and in the adults about 2.56 mm in length. The width extends from 1.05 mm to about 2.1 mm in the adults. The distance opposite to the median sagittal plane in the newborn run to about 18.2 mm and in the adults 28.08 mm at the right side and 29.76 mm at the left side. The maximum length of the "Canalis spinosus" increases from 2.85 mm in the newborn to 7.35 mm in the adults. The lateral rim of the Foramen rotundum has a mean distance of 20.0 mm opposite to the upper edge of the Processus zygomaticus above the Tuberculum articulare in the newborn and about 43.5 mm in the adults. The mean distance from the cited reference area to the lateral rim of the Foramen ovale increases from about 15 to 34.33 mm, and from that of the Foramen spinosum from 15.3 to 31.4 mm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6486467 TI - [Head hunting and hair witchcraft (Mummies 2)]. AB - In this second essay on mummies and embalment, 1 of the most primitive, but nevertheless very interesting examples of artificial mummification is described: the Tsantsas or shrunken heads of the Jibaro Indians of the basin of the High Amazon River. While the other head hunters dried, smoked or otherwise mummified the whole head of their victims, the Jibaros shrink the tsantsa to the size of a human first, maintaining the original features as much as possible. The technique of this laborious process is discussed, as well as the ideological backgrounds of head hunting and skull worship which induced primitive men to practice such cruel customs. Another very important factor in this complicated ideological framework, is the concept of the existence of a material soul, seated in the head and especially in the hair. Therefore, the use of hair witchcraft all over the world must be mentioned too, as it implicates the "spiritual value" of the tsantsas, according to the quantity and beauty of their hair. Maybe, the relationship between the size of the head and the length of its hair, was the reason why the Jibaros reduced the former to increase the latter. However, we can only admire these masterworks of the Indians whose motives for head hunting were not bloodthirst or cruelty, but deep spiritual concepts, as they are typical for primitive religions. PMID- 6486468 TI - [An anatomic variant of the inferior alveolar nerve in man]. AB - In one of 13 human heads, the right mandibular nerve showed the following anomalies: (1) A prominent anastomosis between the auriculotemporal nerve and the inferior alveolar nerve; (2) a delicate anastomosis between the madibular nerve and the aforementioned connection; and (3) a nervous connection between the inferior alveolar nerve and the lingual nerve. Moreover, the auriculotemporal nerve was unusually thick. The branches of the left mandibular nerve appeared normal. PMID- 6486469 TI - [Approximations of weight increase of the male and female Rattus norvegicus using Calhoun's (1952) data]. AB - After a short review on weight series of rats and their approximation by rather different growth functions data from Calhoun (1952) are submitted to thorough investigations applying 14 functions altogether, 4 of which yield a definite growth time. The results for the best approximations are complied for the male and female in 2 tables together with the parameters as gained by nonlinear regressions and characteristic data of rat growth. PMID- 6486470 TI - Remarks on the role of microtubules in enucleating normoblasts. AB - In enucleating normoblasts single microtubules are often arranged in a perinuclear position. Sometimes it seems that microtubules attach at the nucleus membrane. Also bundles of microtubules can be found, but a subplasmalemmal microtubular "hoop" does not exist. Colchicine does not influence the process of enucleation. It is concluded that microtubules do not participate in the expulsion of the nucleus during enucleation. PMID- 6486471 TI - Innervation of the levator scapulae, the serratus anterior, and the rhomboideus in crab-eating macaques and its morphological significance. AB - The origin, course and distribution of the nerves supplying the levator scapulae, the serratus anterior, and the rhomboideus were carefully examined in four body halves of crab-eating macaques. The levator scapulae arises from all the cervical vertebrae and is continuous with the serratus anterior, which arises from the upper ten ribs. The rhomboideus originates not only from the dorsal midline but also from the occipital bone. 6 segmental nerves from C3 to C8 innervate the 3 muscles: C3, C4, C5, and C6 innervate the levator scapulae; C6, C7, and C8 the serratus anterior; and C3, C4, C5, and C6 the rhomboideus. Each segmental nerve of supply originates as one or 2 branches from the dorsal surface of the corresponding root of the cervico-brachial plexus and runs dorso-caudally to enter the muscles. After supplying them, 6 or 7 branches pierce the levator scapulae and serratus anterior to reach the deep surface of the rhomboideus which they innervate. The upper segmental nerve tends to be distributed to the upper part of the muscle it innervates, while the lower segmental nerve is distributed to the lower part. According to the relationships between nerves and muscles, these 3 muscles may be regarded as the most medial of the dorsal musculature which is connected to the pectoral girdle and limb, as they are in man. It may surmised that the occipital portion of the rhomboideus and the caudal portion of the levator scapulae in crab-eating macapues correspond to the cranial portions of the levator scapulae and serratus anterior, respectively, in man. PMID- 6486472 TI - Variations in the shape of permanent maxillary lateral incisors in Sundanese. AB - During a survey in Java we found unusual shaped upper lateral incisors. A total of 110 school children shows 3 cases with pegging, approximately 20% with canine like shape. In all cases the lateral incisor was present. Compared with other publication the incidence of pegging is low, the canine-like variation never described as far as we know. PMID- 6486473 TI - [The coronary arteries of the dromedary]. AB - The arteries of 30 camel hearts were studied after injecting Rhodopas AX 85-15 and latex into the heart vessels, maceration with HCl vapour and careful dissection. The arteries of the dromedary heart are described in detail, the similarities and differences between the perissodactyls and arteriodactyls being taken into account. PMID- 6486474 TI - Peculiarities of the bones, muscles, and nervous system of the conjoined twins. AB - The peculiarities of the skeletal, muscular, and nervous systems of conjoined female twins (2 spines, one pelvis) is described judging from the examination of the 2 skulls, 2 vertebral columns, shoulder girdle of the intermediate connection between the trunks, deep muscles of the back, 2 separate central nervous systems, lack of changes in the muscles, of the anterior aspect of the thorax and anterolateral muscles of the abdomen; from what we have observed it is suggested that this is a case of uniovary twins whose separation began in the superior dorsal side but was incomplete in the ventral inferior parts. It is possible that this arose from accidents of fusion or fission of embryos. PMID- 6486475 TI - [Occurrence of cervical ribs in prenatal toxicologic studies with alcohol in mice]. PMID- 6486476 TI - Filamentous actin bundles in the kidney. AB - The distribution of filamentous actin bundles in the rat kidney was studied using a fluorescent phallotoxin label and transmission electron microscopy. The microvillous brush border lining proximal tubules, smooth muscle in renal vessels, and renal corpuscles were the structures most intensely labeled with rhodamine phalloidin. Closer evaluation of renal corpuscles revealed intense labeling of filamentous actin within podocyte foot processes enveloping the glomerular capillary loops. Rhodamine phalloidin also labeled basal bands of filamentous actin in the parietal epithelium and basal bands of actin in proximal and distal tubules. Finally, a band of filamentous actin was evident along the innermost aspect of the kidney capsule, within cells which often joined to form sinus-like compartments. PMID- 6486477 TI - Epithelial fusion during early semicircular canal formation in the embryonic zebrafish, Brachydanio rerio. AB - The developing inner ear of the teleost, Brachydanio rerio, provides an opportunity for observing an epithelial fusion between the apical surfaces of apposed epithelia in a vertebrate embryo in vivo. The developing otocyst was filmed for periods up to 4 days in unanesthetized embryos, and specimens were fixed at intervals and processed for light microscopy, TEM, and SEM. The semicircular canals are formed as a consequence of the union between the tips of three cylindrical projections from the wall of the otocyst, which grow toward corresponding bulges of a projection from the lateral wall. The epithelial cells covering the projections contain extensive rough endopasmic reticulum, exhibit apical junctional complexes, and are not underlain by a basal lamina. The core of each projection contains large amounts of flocculent and fibrillar extracellular material. After a period of growth and elongation, the tip of each projection contacts, and adheres to, the appropriate bulge to create a circular, flattened, bilayered, epithelial plate. Small, focal junctions form between the apposed apical cell surfaces within the plate during this period, but they are not numerous. Junctional complexes do develop, however, between apposed cells at the periphery of the plate. After 1-2 hours, the basal surface of the plate exhibit considerable alteration in contour. Adjacent cells within the plate then separate to allow continuity of the connective tissue components of the two structures. The observations of this study indicate that following an initial period of contact and adhesion, cellular reorientation and changes in junctional contacts between adjacent cells within the epithelial plate, rather than cell degeneration, are responsible for perforation of the plate. PMID- 6486478 TI - Distribution of plasmalemmal vesicles on arterial endothelial surface as determined by freeze cleavage. AB - The freeze-fracture technique was used to study the density and distribution of plasmalemmal vesicles at the endothelial surface of canine carotid arteries. The fractured surface of the endothelium can be divided into areas with vesicles (Aves) and areas without vesicles (Anves), the latter being located at the parajunctional zone. With morphometric analysis, Aves and Anves were found to be 75% and 25% of the endothelial surface, respectively. The average width of Anves (distance from the intercellular cleft) is approximately 0.4 micron. In Aves, the density of vesicles is 120 micron-2, and approximately 16% of Aves is covered by the vesicle orifices. The tight junctions appear as long and straight strands, 8 9 nm in width. The number of the strands varies from one to five. The gap junctions consist of closely packed particles 9-10 nm in size which form patches or plaques from 80 to 800 nm in size. These findings provide the quantitative information needed for the theoretical modeling of transendothelial vesicular transport of macromolecules. PMID- 6486479 TI - Pigmented cells in the leptomeninges of the cat. AB - Cells laden with pigment granules are described in the leptomeningeal tissues of the cat and kitten. These cells can be identified consistently by gross observation following vascular perfusion. The fusiform or stellate pigmented cells are most often found in association with the outermost layers of the arteries of the subarachnoid space. They are typically separated from the cerebrospinal fluid by an attenuated layer of pial cells. Vessels that are described as having pigmented cells along their course are the anterior and posterior cerebellar; the anterior, middle, and posterior cerebral; and the basilar. Electron microscopic studies confirm the presence of abundant pigment granules. The pigment granules are the predominant component of the cytoplasm. Few organelles are demonstrable except for a large central nucleus. The data provide support for the concept of neural crest contribution to leptomeningeal structures. Identification of this isolated, easily defined population of melanocytes may provide a model for further studies of neural crest distribution as well as experimental approaches to melanogenesis and melanoma production and control. PMID- 6486480 TI - Morphometry of the functional and regressing corpus luteum of the guinea pig. AB - A morphometric study of functional and regressing corpora lutea (CL) of guinea pigs (n = 5 per day) was performed on days 9, 12, and 16 of the estrous cycle. On day 9 the functional CL contained congruent to 750,000 cells, which included 565,200 +/- 56,700 (S.D.) endothelial cells or pericytes and 137,300 +/- 7,700 luteal cells. Between days 9 and 12 the only significant change suggesting the onset of regression was a reduction in vascular luminal surface area. During this time the number of luteal cells per CL increased to 204,400 +/- 34,800 (P less than .05), with an accompanying reduction in luteal cell volume from 19.8 +/- 1.8 to 14.4 +/- 2.4 pl/cell (P less than .01). The increase in cell numbers was explicable by cell division, with mitotic indices of 0.83% and 0.97% on days 9 and 12, respectively. Luteal volume was unaltered. Between days 12 and 16, the mean volume of a single CL fell from 3.98 +/- 0.2 to 1.42 +/- 0.3 mm3 (P less than .01) and luteal cell volume was reduced to 5.3 +/- 1.1 pl/cell (P less than .01). Between these 2 days the number of endothelial cells per CL fell from 539,900 +/- 75,500 to 144,400 +/- 63,300 (P less than .01), with an accompanying reduction in vascular luminal surface area and in the volume occupied by vascular lumina. The total number of luteal cells per CL was not reduced significantly. It was concluded that luteal cell numbers in the guinea pig increase up to the time of onset of luteal regression, and that during regression up to day 16, shrinkage of luteal cells is the major cause of loss of luteal volume. During regression, endothelial cell loss occurs much more rapidly than loss of luteal cells. PMID- 6486481 TI - Postpartum regeneration of the guinea pig endometrium: relationship to serum estradiol and progesterone concentrations. AB - The pattern of cell mitotic activity in the uterus of postpartum, pregnant guinea pigs was correlated with the associated changes in serum progesterone and estradiol levels between days 1-8 of pregnancy. Stromal and glandular epithelial mitotic patterns mimicked the associated fluctuations in serum progesterone and estradiol levels, respectively. No changes in myometrial mitotic activity were observed. The luminal epithelial mitotic index was apparently sensitive to the relative change in the ratio of progesterone-to-estradiol in circulation. These studies indicate that postpartum, endometrial preparation for blastocyst implantation depends on the proper priming of the uterus by both progesterone and estradiol in the guinea pig. PMID- 6486482 TI - Morphology of the erect glans penis in rats under various gonadal hormone conditions. AB - The scanning electron microscope (SEM) was used to compare erect and nonerect penile glandes of gonadally intact Norway rats (group I) and of castrated rats exposed to the following hormonal conditions: maintained with testosterone (T) filled Silastic capsules implanted subcutaneously (group T); maintained with implants of estradiol (E) for 8 or 12 days (group E1); maintained with E implants for 10 weeks (group E10); maintained with E implants for 9 weeks, then injected daily with testosterone propionate for 8 or 17 days (group E/T). As in previous SEM depictions of nonerect glandes of intact rats, spines projected toward the base of the glans at a shallow angle from the sulci of deep epithelial folds. In contrast, the folds on erect glandes of groups I and T were completely smoothed, and the spines were themselves erected. The penile cup formed at the distal end of the erect glans also contained spines; these were centrifugally directed at the rim and centripetally directed on the inner surface of the cup. The glandes of group E1 males were similar to those in groups I and T, with the spines showing no disorientation. Males in group E10 lacked spines in the cup and along most of the shaft of the glans, but erection revealed many sharp spines just proximal to the cup and on its rim. In group E/T, no papillae were detectable on the nonerect glandes, but erection revealed many small rounded papillae on the shaft and within the cup. The erection of the spines that occurs on the shaft and in the cup of the erect glans may facilitate previously proposed functions of the spines, including vaginal and cervical stimulation and removal of the copulatory plug. Our perfusion method may also facilitate estimation of the number, size, distribution, and hormonal sensitivity of penile papillae. PMID- 6486483 TI - Morphology of presumptive slowly adapting receptors in dog trachea. AB - The three-dimensional branching pattern and ultrastructure of afferent myelinated fibers and their terminals located in the trachealis muscle of the dog are described. The afferent endings are believed to be those of the slowly adapting stretch receptors of the trachea. They have structural features typical of mechanoreceptors: distal to the loss of myelin, their shape becomes more irregular and the cytoplasm is filled with mitochondria, glycogen, and osmiophilic bodies. In some places the cell membrane is attached directly to basal lamina without interposition of a Schwann cell. A bundle of unmyelinated fibers accompanies each myelinated fiber and continues for an undetermined distance beyond (luminal to) terminations of the myelinated fiber. The unmyelinated fibers contain many round, clear vesicles and a few dense-cored vesicles and are also attached directly to basal lamina in places. Three dimensional reconstruction of three receptors revealed three quite different branching patterns, but all included apparent rings as part of more or less contorted terminal regions (some neurons apparently having more than one terminal region). No obvious structural basis for the activation of receptors by transverse but not longitudinal stretch was found. PMID- 6486484 TI - Endocrine cell populations in the colon and rectum of cat, dog, and monkey: fine structure, immunocytochemistry, and distribution. AB - Comparative and quantitative ultrastructural studies of endocrine cells from the large bowel of European cat, beagle dog, and the monkey Callitrix jacchus were performed. The cat and monkey exhibited a roughly similar distribution of colonic endocrine cells with a frequency increasing toward the distal. On the contrary, the highest endocrine cell frequency in the dog colon was in the cecum. In the dog and monkey, enterochromaffin (EC) cells were predominant in all segments. In the cat, non-EC cells were predominant in the proximal colon. For each colonic segment, relative percentages of EC and non-EC cells appeared on the whole to be roughly stable between individuals of the same species. Three subtypes of EC cells were distinguished in each species. Non-EC cells were characterized by large variation in size and electron densities of their granules: Mean granule size per cell extended from 210 to 850 nm in cat, 310 to 770 nm in dog, and 130 to 470 nm in monkey. In each species, statistical analyses indicated that the non EC cell population was composed of two or more subpopulations. Some similarities were found between colonic endocrine cells of the monkey and man, whereas obvious differences appeared between the two carnivorous mammals. Immunocytochemical studies demonstrated the presence of cells containing enteroglucagon, somatostatin, or a pancreatic polypeptidelike substance in the colon of the monkey and the rectum of the three mammals. Correlative immunocytochemical and ultrastructural studies showed that the three kinds of immunostained endocrine non-EC cells in each species had rather round granules, with great electron densities. Some subpopulations, morphologically distinguished, did not react to any of the antisera used. This suggests either the existence of secretory cycle in some endocrine cells or, perhaps, the presence of peptides still unknown in this part of the gut. PMID- 6486485 TI - Brief periods of hypoxia can produce hepatic injury in rats. AB - To determine whether brief periods of hypoxia could produce hepatic injury, we pretreated Sprague-Dawley rats with phenobarbital, deprived them of food for 24 hr, and then exposed them to various hypoxic mixtures of nitrogen and oxygen for various lengths of time. Rats exposed to 6% oxygen for 15 or more minutes had centrilobular injury, the severity of which was directly related to the length of exposure (r = 0.71). Extrapolation of these data indicated that no injury would occur if exposures were less than 5 min. Experiments using lower concentrations of oxygen did not reveal hepatic injury, probably because death of the animals occurred before the appearance of detectable injury of the liver. Feeding animals before imposition of hypoxia markedly decreased the risk of hepatic injury. Whether patients who are deprived of food preoperatively and whose liver enzymes are induced incur an increased risk of hepatic injury from brief periods of hypoxia remains to be determined. PMID- 6486486 TI - Isoflurane does not prevent hepatic injury produced by halothane in rats. AB - We speculated that the inhibitory effect of isoflurane on the metabolism of halothane might reduce hepatic injury produced by halothane. To test this hypothesis we pretreated male rats with phenobarbital and 24 hr later exposed them to one of three types of anesthesia. One group of rats was anesthetized with 0.6 MAC isoflurane in 21-25% oxygen for 20 min, followed by exposure to 0.3 MAC isoflurane and 0.3 MAC halothane either in 9% oxygen for 46 min (n = 5) or in 12% oxygen for 60 min (n = 11). A second group of rats received 0.3 MAC halothane in 9% oxygen for either 46 min (n = 12) or in 12% oxygen for 60 min (n = 10). The third group received 0.3 MAC isoflurane in 9% oxygen for either 46 min (n = 12) or for 120 min (n = 8). The rats were killed 24 hr after the exposures and liver slides prepared. Histologic examination revealed that rats treated with isoflurane plus halothane, or with halothane alone showed a significant hepatic injury (P less than 0.005) when compared with those treated with isoflurane. Thus isoflurane failed to protect the liver from halothane-induced injury. PMID- 6486487 TI - Muscle electromechanical correlations during succinylcholine infusion. AB - The study was designed to compare the electromyographic (EMG) and evoked twitch tension (TT) responses in humans to train-of-four stimulation during neuromuscular blockade induced with a continuous succinylcholine infusion. Mean values of TT correlated well with EMG (r greater than 0.97), but several consistent discrepancies were noted. After the infusion was started but before the block was established, TT increased by up to 38%, which was accompanied by changes in the EMG signal indicative of repetitive activity. After stopping the infusion, TT but not EMG recovered to values greater than control, without changes in the shape of the EMG signal during the period of observation. This TT augmentation during recovery is consistent with a change in the contractile properties of muscle. Detection of phase II block was similar with EMG and TT (38.2 vs 41.3 min). Clinically, EMG and TT may be used interchangeably to evaluate neuromuscular blockade. In the research setting, the synchronous recording of both may help in understanding the mechanism of action of muscle relaxant drugs. PMID- 6486488 TI - Hemodynamic effects of ketamine in children with congenital heart disease. AB - Pulmonary and systemic vascular responses to ketamine (2 mg X kg-1, intravenously) were studied during cardiac catheterization in 20 children with congenital heart lesions. Pulmonary and systemic resistances (Rp, Rs), ratios between pulmonary and systemic flows (Qp/Qs), and left to right (L----R) and right to left shunts (R----L) were calculated before and after ketamine administration. Statistically significant (P less than 0.05) but clinically minor increases in heart rate (106.8 to 109.9 beats/min), mean pulmonary artery pressure (20.6 to 22.8 mm Hg), and Rp/Rs (0.12 to 0.14) were seen after ketamine. There were no significant changes in systemic arterial pressure, Rs, Qp/Qs, L--- R, R----L, or arterial oxygen or carbon dioxide tensions. No patient had any major untoward effects from ketamine administration. It is concluded that the hemodynamic alterations after ketamine administration in children undergoing cardiac catheterization are small and do not alter the clinical status of the patients or the information obtained by cardiac catheterization. PMID- 6486489 TI - Antagonism of diazepam by aminophylline in healthy volunteers. AB - Six healthy volunteers participated in a randomized, double-blind cross-over study of the effects of intravenous aminophylline on diazepam-induced sedation. Each subject participated in two phases and in each phase received either diazepam (15 mg intravenously) followed by placebo or diazepam followed by aminophylline (2 mg/kg intravenously). Critical flicker fusion times and reaction times were measured sequentially as indices of vigilance. Subjects also assessed their own vigilance on a visual analogue scale. Aminophylline given after diazepam significantly improved vigilance as measured by the visual analogue scale from 60 to 150 min after administration of diazepam, while total reaction time was significantly improved at 90, 210, and 270 min. There was no significant correlation between theophylline plasma levels and its effects on vigilance. PMID- 6486490 TI - Hematocrit and the solubility of volatile anesthetics in blood. AB - To clarify the effect of hematocrit on the solubility of volatile anesthetics in blood, we measured the blood-gas partition coefficients of isoflurane, enflurane, halothane, and methoxyflurane concurrently at 37 degrees C in blood from four adults. We measured the blood-gas partition coefficients in the plasma (hematocrit 0%) and packed red cell fractions (hematocrit 80%), and in four mixtures of these two fractions (hematocrits 10%, 25%, 40%, and 55%). The mixtures were prepared by recombining appropriate amounts of plasma and packed red cells from each adult. As hematocrit increased, the blood-gas partition coefficient of isoflurane decreased linearly (P less than 0.01), whereas that of enflurane increased linearly (P less than 0.05). The partition coefficient for isoflurane in plasma was 20% greater than that in packed red cells, whereas the partition coefficient for enflurane in plasma was 10% less than that in packed cells. The blood-gas partition coefficients of halothane and methoxyflurane did not change significantly between measurements in plasma and packed red cells. We conclude that hematocrit exerts a statistically significant effect on the blood gas partition coefficient of isoflurane and enflurane. PMID- 6486491 TI - Electrical nerve location: numerical and electrophoretic comparison of insulated vs uninsulated needles. AB - We compared the electrical characteristics of insulated and uninsulated needles in two models that simulate use of a stimulator for nerve localization. With a digital computer, we solved for and graphed the contours of constant electric field strength, defining regions of simulated tissue in which a nerve would become depolarized for a particular stimulation current. We found that with an uninsulated needle, these regions extend proximally along the needle shaft with their widest dimension located slightly shallow to the tip, but with insulated needles, the regions are almost circular and are centered slightly deep to the needle tip. We confirmed these findings by electrophoresis of bromphenol blue dye in polyacrylamide gel. We also found that the necessary stimulator current is much more dependent on the depth of needle insertion with uninsulated needles than with insulated needles. We conclude that the electrical characteristics of insulated needles are more favorable for successful nerve block. PMID- 6486492 TI - Comparison of insulated and uninsulated needles for locating peripheral nerves with a peripheral nerve stimulator. AB - This study was designed to compare the use of insulated and uninsulated needles with a peripheral nerve stimulator for locating a peripheral nerve in an anesthetized cat. The needles were mounted on a one-dimensional manipulator and both the saphenous and sciatic nerves were located. The tip of the insulated needle was consistently placed on the sciatic nerve. The tip of the uninsulated needle was placed 0.1-0.9 cm past the sciatic nerve. Injecting saline to assess the position of the tip of the needle relative to the sciatic nerve did not detect the needle being past the nerve. With the saphenous nerve preparation, both the needle and nerve were visible through the tissue. Using an insulated needle, the minimum current required to stimulate the nerve occurred when the tip of the needle touched the saphenous nerve. Using an uninsulated needle, the minimum current occurred when the tip was 0.1-0.8 cm past the nerve. The conclusion is that insulated needles more precisely locate the peripheral nerve than uninsulated needles. PMID- 6486493 TI - EEG changes due to unsuspected aortic dissection during cardiopulmonary bypass. PMID- 6486494 TI - Migration of tips of central venous catheters in seated patients. PMID- 6486495 TI - ECG-guided placement of sorenson CVP catheters via arm veins. PMID- 6486496 TI - Epidural autologous blood patch on an outpatient basis. PMID- 6486497 TI - Oxygen analyzers unreliable as disconnection alarms. PMID- 6486498 TI - Low thermodilution cardiac output due to an intracatheter septal defect. PMID- 6486499 TI - Regional cerebral glucose utilization during Althesin anesthesia. AB - The effect of Althesin, an anesthetic comprising two steroids, on regional cerebral function was determined by measurement of regional cerebral glucose utilization. Rats were anesthetized with an intravenous dose of 4, 8, or 20 mg total steroid/kg. These doses produced anesthesia for 12, 18, and 37 min, respectively. There were no physiologically significant effects of Althesin (20 mg/kg) on body temperature, blood pH, or blood gases. Blood pressure and heart rate decreased slightly after administration of Althesin. Althesin had a profound effect on glucose consumption in many, but not all, cerebral structures. The forebrain (especially cerebral cortex) was affected most, while the hindbrain was much less so or not at all. This pattern of functional depression is in accord with the minimal effects observed on physiologic variables. The effects of Althesin differ from those of other known anesthetics and suggest a unique mechanism. The possibility of action through naturally occurring steroid receptors is considered. PMID- 6486500 TI - Halothane-induced changes in the release and disposition of norepinephrine at adrenergic nerve endings in dog saphenous vein. AB - The effect of halothane on the release and metabolism of norepinephrine during resting conditions and in response to electrical stimulation at 2 Hz was studied in isolated superfused segments od dog saphenous vein. Liquid chromatography with electrochemical detection was used to measure endogenous norepinephrine overflowing in response to electrical stimulation and the content of norepinephrine remaining in the tissue after stimulation. In other preparations, norepinephrine stores were labeled with [3H]norepinephrine, and measurements were made of [3H]norepinephrine and its metabolites (separated by column chromatography) in superfusates. Radiolabeled metabolites of norepinephrine produced intraneuronally (3,4-dihydroxyphenylglycol) and extraneuronally (O methylated) were quantitated by liquid scintillation spectrometry. Electrically stimulated release and overflow of endogenous norepinephrine was decreased 11.9% at 0.75% halothane, 17.7% at 1.5% and 19.2% at 2.5% halothane. At each halothane concentration studied, the per cent of tissue NE content released in response to electrical stimulation was less. Halothane decreased the fraction of radioactivity lost during basal conditions and during stimulation. Less oxidative deamination of norepinephrine occurred in the presence of halothane. PMID- 6486501 TI - Effects of infrarenal aortic cross-clamping on renal hemodynamics in humans. AB - While the systemic cardiovascular consequences of infrarenal aortic cross clamping during aortic abdominal surgery are well documented, its repercussions on renal hemodynamics in humans have not been reported. In 12 patients, scheduled for elective aortic surgery, renal clearances, using 51Cr EDTA and 125I hippuran, were measured before, during, and after infrarenal aortic cross-clamping. A continuous infusion of mannitol 20% at a rate of 100 ml/h was administered throughout the study. Arterial and renal venous blood sampling, obtained at the midpoint of each period, permitted calculation of the extraction fraction of 125I hippuran and accurate determination of renal blood flow and its cortical extracortical distribution. Although cardiac output and systemic vascular resistance did not change significantly between the three study periods, infrarenal aortic cross-clamping decreased 125I hippuran clearance by 29 +/- 15% (P less than 0.05) and renal blood flow by 38 +/- 14% (P less than 0.001). Simultaneously, an increase of 75 +/- 31% in renal vascular resistance (P less than 0.05) was observed and the extraction fraction of 125I hippuran increased from 0.67 +/- 0.05 to 0.74 +/- 0.05 (P less than 0.01). All of these changes, which indicate global diminution of renal perfusion with a redistribution of renal blood flow toward the cortical compartment, persisted for at least 1 h after release of the aortic clamp. Early signs of renal tubular damage, such as the appearance of lysozyme and ligandine in the urine, however, were never observed. The authors conclude that infrarenal aortic cross-clamping produces profound and sustained alterations in renal hemodynamics and may be harmful in patients with impaired renal function or when surgical occlusion of the aorta is prolonged. PMID- 6486502 TI - Controlled hypotension with adenosine in cerebral aneurysm surgery. AB - The cardiovascular effects of adenosine-induced controlled hypotension were studied in 10 patients undergoing cerebral aneurysm surgery. Adenosine and its metabolites were measured in arterial plasma using high-pressure liquid chromatography. Whole body and cerebral arteriovenous oxygen content differences (AVDO2), arterial lactate levels, and arteriojugular lactate differences were determined. In order to reduce the dose requirement of adenosine, the patients were pretreated with the adenosine uptake inhibitor, dipyridamole (0.3-0.4 mg . kg-1). During the infusion of adenosine (0.14 +/- 0.04 mg . kg-1 . min-1) the mean arterial blood pressure decreased by 43%, from 82 to 46 mmHg, during a mean hypotensive period of 32 min, without signs of tachyphylaxis. The arterial adenosine level increased from 0.15 +/- 0.02 to 2.45 +/- 0.65 microM (P less than 0.01). Hypotension was caused by a profound decrease in peripheral vascular resistance (61 +/- 3%, P less than 0.01), which was accompanied by an increase in cardiac output (44 +/- 9%, P less than 0.01). Heart rate increased moderately by 16 +/- 5% (P less than 0.01). Pulmonary vascular resistance and central venous pressures were unaffected. Arterial lactate and PaO2 were unchanged, while whole body oxygen consumption was decreased by 13 +/- 4% (P less than 0.05). The AVDO2 across the brain was decreased by 37 +/- 5% (P less than 0.05) without signs of lactate formation. The authors conclude that adenosine rapidly induces a stable and easily controlled hypotension in humans by dilation of arterial resistance vasculature. PMID- 6486503 TI - Quantitative examination of the interaction of competitive neuromuscular blocking agents on the indirectly elicited muscle twitch. AB - Gallamine, metocurine, pancuronium, and d-tubocurarine were compared when given alone and in combination with isolated guinea pig nerve-lumbrical preparations stimulated via the nerve. The experimental design was set up to control the effects of variation among preparations, order of administration, and time of administration (i.e., fresh vs. older preparation). The result was an assay able to measure potentiation with a coefficient of variation of 3%. A format for a graphic presentation to summarize such results is presented and discussed. Two combinations, gallamine plus d-tubocurarine and gallamine plus pancuronium, showed no sign of an interaction beyond that to be expected from a simple competitive interaction. Two others, metocurine plus pancuronium and gallamine plus metocurine, showed about a twofold greater potency when combined than would have been expected. The last two sets, pancuronium plus d-tubocurarine and metocurine plus d-tubocurarine, showed a slight degree of potentiation. These studies demonstrate that the deviation from simple additivity seen in vivo persists when examined in a system free from artifacts associated with uptake and distribution in the whole organism. PMID- 6486504 TI - Clinical pharmacology of edrophonium in infants and children. AB - The dose-response relationship, onset, duration of action, atropine requirement, and pharmacokinetic variables of edrophonium were determined in infants and children during N2O-halothane anesthesia. The technique of steady state infusion of d-tubocurarine anesthesia. The technique of steady state infusion of d tubocurarine (dTc) was used to determine the ED50 for edrophonium (i.e., the dose producing 50% antagonism of 90% neuromuscular depression) in 4 infants (145 micrograms/kg) and 12 children (233 microgram/kg). The reported values for ED50 for edrophonium (obtained under similar anesthetic conditions) is 128 micrograms/kg for adults. These three dose-response curves do not differ statistically; however, there was greater variability among infants and children than adults. Time to peak antagonism was similar for all three age groups. Duration of antagonism was determined in six infants and six children and did not differ from the reported value for adults. The optimal dose and time of administration of atropine were established by administering edrophonium (1 mg/kg) and atropine (10-20 micrograms/kg) to 24 infants and children. The smallest changes in heart rate and systolic blood pressure occurred when atropine (10 micrograms/kg) was given 30 s before edrophonium. The pharmacokinetics of edrophonium (1 mg/kg) were studied in four infants and four children and were compared with published values for adults: distribution and elimination half lives and distribution volumes were similar for the three groups. Total clearance (ml.kg-1.min-1) was greatest for infants (17.8 +/- 1.2) compared with children (14.2 +/- 7.3) and adults (8.3 +/- 2.9). The authors conclude that the dose of edrophonium required toantagonize dTc-induced neuromuscular blockade is similar or possibly greater for infants and children than for adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486505 TI - A comparison of local rates of glucose utilization in spinal cord and brain in conscious and nitrous oxide- or pentobarbital-treated rats. AB - Local rates of glucose utilization in the spinal cord and brain were measured with the 2-[14C]deoxyglucose method in conscious and in paralyzed and mechanically ventilated pentobarbital- or 70% nitrous oxide-treated rats. In conscious animal lumbar spinal cord glucose utilization is only 40-50% that of the cerebral cortex and shows little laminar heterogeneity. Pentobarbital reduces and nitrous oxide increases the cerebral glucose utilization of most structures. The effect of paralysis and nitrous oxide analgesia on lumbar spinal cord glucose utilization is quantitatively similar to that produced in brain; 15-25% increases occur in most spinal cord laminae and cerebral structures. In contrast, the 10 20% reduction in spinal cord gray matter metabolism in the paralyzed and pentobarbital-treated animals is considerably less than the 20-50% depression measured in most brain structures. From these data the authors conclude that, relative to that of most cerebral structures, spinal cord metabolism is less sensitive to depression by barbiturates and suggest that differences in the cell populations of these tissues may account partially for this observation. PMID- 6486506 TI - Intraoperative hypoxia and hypotension caused by gastrografin-induced hypovolemia. PMID- 6486507 TI - Internal jugular vein function after Swan-Ganz catheterization. PMID- 6486508 TI - Complications of the Mayfield skull clamp. PMID- 6486509 TI - Short-term sterility of the pulmonary artery catheter inserted through an external plastic shield. PMID- 6486510 TI - The use of stylet in blind nasotracheal intubation. PMID- 6486511 TI - Seizure associated with induction of anesthesia with isoflurane. PMID- 6486512 TI - Prophylactic and therapeutic doses of dantrolene for malignant hyperthermia. PMID- 6486513 TI - A simple accurate technique for establishing zero reference levels for pressure measurements. PMID- 6486515 TI - Complex effects of isoflurane on baroreceptor reflex compounded by errors. PMID- 6486514 TI - Emergency equipment in labor suite. PMID- 6486516 TI - Does isoflurane really preserve baroreflex responsiveness better than halothane or enflurane? PMID- 6486517 TI - Noninvasive quantification of ambulatory venous hemodynamics during elastic compressive therapy. AB - Quantifying the hemodynamic results of elastic compression requires invasive and cumbersome techniques. Twenty lower extremities (normal, primary, acute and chronic post-thrombotic varicosities) were evaluated with quantitative photoplethysmography (PPG) prior and subsequent to initiating graded compression. The PPG transducer is placed against the stockings and the in vivo method of calibration is used to predict the results of compressive therapy on ambulatory venous pressure (AVP). (table see text) Noninvasive evaluation of patients with quantitative PPG techniques following compressive therapy may provide a better understanding of venous hemodynamics and a rational approach to selection of therapy. PMID- 6486518 TI - High out-put congestive heart failure as first manifestation of Osler-Weber-Rendu disease. AB - We present two cases of hemorrhagic hereditary telangiectasia (HHT) or Osler Weber-Rendu disease which started as heart failure. Both had multiple arteriovenous fistulas, one of them in a rare localization in this disease, a lower extremity. We conclude stressing the importance of thinking of HHT in the presence of obscure heart failure or arteriovenous fistulas and of looking for internal fistulas when faced by a HHT. PMID- 6486519 TI - Iliofemoral thrombosis in a case of chicken pox. AB - A case of iliofemoral thrombosis possibly related to chicken pox infection is reported. Treated with rest and anti-coagulants, the patient made a satisfactory recovery. PMID- 6486520 TI - Enlargement of the superior thyroid artery: an unusual cause for a cervical bruit. AB - An enlarged superior thyroid artery with increased blood flow to a large benign adenomatous goiter was found to be the cause of a bruit in the region of the right carotid bifurcation. We have not been able to find mention of this cause for a cervical bruit in the literature. PMID- 6486521 TI - Evaluation of quinidine short and long-acting in control of arrhythmias. AB - Twenty-one patients with arrhythmias responsive to quinidine were studied both with regard to consistency of response as determined by repeat Holter Monitoring and in half of these patients a comparison of short and long-acting quinidine was made. Holter Monitoring demonstrated greater than 60% reduction of ectopic activity in all but one patient and reproducibility varied by less than 10% in nineteen of twenty-one patients. Nine of eleven patients showed the same response to long-acting quinidine as compared to short-acting. Eight of nine patients having significant numbers of ectopic pairs showed a significant reduction with quinidine therapy, both short-acting and long-acting. PMID- 6486522 TI - Acute myocardial infarction in a thirty-six year old postpartum female. AB - A thirty-six year old woman who had an acute myocardial infarction during the early postpartum period is described. Review of literature on the incidence of postpartum myocardial infarction, the possible mechanisms and its clinical implications are summarized. PMID- 6486523 TI - Cardiac tamponade from central venous catheters. Report of a case and review of the English literature. AB - A case of acute cardiac tamponade caused by an internal jugular central venous catheter which was successfully treated is reported. The English literature is reviewed and shows that tamponade can occur up to 37 days after insertion and has a 65% mortality. The tamponade is usually caused by the actual infusate and not by blood. PMID- 6486524 TI - Nonsurgical removal of a kinked right coronary catheter. AB - Cardiac catheterization is a commonly performed procedure affording valuable data. Catheter related complications such as catheter knotting, fracture, and collapse have been reported. Occasionally surgery is needed to extricate an entrapped catheter when nonsurgical means are unsuccessful. We describe a case of kinking of a right coronary catheter during transfemoral coronary arteriography, so that the catheter could not be withdrawn. A simple, nontraumatic method facilitated removal of the kinked catheter and permitted completion of the procedure, obviating the need for surgery. PMID- 6486526 TI - Nomenclature of allergenic plants. I. PMID- 6486525 TI - Shallow left anterior oblique right coronary angiography: technique and applications. AB - A "new" shallow left anterior oblique view of the right coronary artery allows better visualization of the distal vessel in selected patients. This paper describes the angiographic technique; retrospective data suggest that the view is useful in approximately 20% of patients. An illustrative case is presented. PMID- 6486527 TI - Sudden death in adolescent asthma. PMID- 6486528 TI - Laryngeal spasm mimicking bronchial asthma. AB - The list of asthma masqueraders grows, emphasizing the need for a careful analysis of the patient suffering from cough, wheezing and/or dyspnea. The present case report describes a 23-year-old patient with spastic vocal cord adduction, initially treated as bronchial asthma. Severe disruption in her arterial blood gases was present. The vocal cord adduction persisted in spite of valium anesthesia. The patient's symptoms and signs were relieved with a tracheostomy. However, the vocal cord spasm persisted. PMID- 6486529 TI - Nature and incidence of serum precipitins against aeroallergens in non-atopic individuals. AB - Thirty-seven (74%) of 50 randomly selected non-atopic individuals gave precipitins against one or more of the seven common aeroallergen extracts surveyed by counterimmunoelectrophoresis. The precipitin lines could be absorbed out by antihuman IgG and homologous extracts, but were not affected by N-acetyl glucosamine, protein A, heterologous extracts, heating, anti-reactive protein, anti-IgA, or anti-IgM. Our data suggest that the precipitins to allergen extracts are probably IgG3 and are more prevalent than had been previously reported in non atopic individuals. PMID- 6486530 TI - IgE mediated anaphylaxis due to a psyllium-containing drug. AB - This is a case report of an IgE mediated anaphylaxis of an atopic person to the ingestion of a psyllium seed laxative. PMID- 6486531 TI - Time-course of response in exercise-induced bronchoconstriction. AB - To study the time-course of exercise-induced bronchoconstriction (EIB) in asthmatics, we have developed a method for continuous measurement of respiratory resistance using the forced oscillation technique during tidal breathing throughout the exercise challenge. Twenty-three out of 38 asthmatics were exercise responders and five of these responders showed an increase in resistance during exercise. The present technique may be clinically applicable in examination of different types of EIB and as a screening test. PMID- 6486532 TI - Diagnosis of parietaria pollinosis. AB - A prospective study of 54 patients showed that pollinosis due to parietaria is prevalent in Spain and frequently causes asthma and rhinitis. Because of its atypical clinical features, patients are often erroneously thought to have intrinsic asthma. False negative skin tests may occur, probably related to the type of extract used. This may contribute to a faulty diagnosis. The RAST is most useful for diagnosis. PMID- 6486533 TI - Positive intradermal tests to D-tubocurarine in patients with cholinergic urticaria. AB - Patients with cholinergic urticaria exhibit increased hypersensitivity to cholinergic drugs. In the present study, an attempt was made to determine whether these patients would also cross-react to various neuromuscular blocking agents having structures analogous with acetylcholine. The four patients tested showed positive skin tests for D-tubocurarine at concentrations of 1/10,000. None of the 10 subjects in the control group and none of the patients with urticaria had positive responses, not even to a 10-fold higher concentration of D-tubocurarine. These findings suggest that caution should be exercised in the use of neuromuscular blocking agents in patients with cholinergic urticaria. PMID- 6486534 TI - Myocardial infarction management with peripheral streptokinase. AB - The early management of myocardial infarction (MI) is undergoing a new evolution. Aggressive treatment and new invasive modalities have brought improved prognosis to these patients. Intracoronary administration of fibrinolytic agents is rapidly gaining wide acceptance. We report a pilot protocol for administration of peripheral intravenous (IV) versus direct intracoronary fibrinolytic agents in acute MI. Thirty patients with acute evolving MI were assigned consecutively to receive fibrinolytic therapy; 15 patients received intracoronary streptokinase and 15 received peripheral IV streptokinase at a dosage of 1.5 million units over a 30-minute period. Evaluation by clinical symptoms, ECG changes, and hemodynamic studies by angiography and radionuclide ventriculography indicated comparable and beneficial results for both groups. Patients assigned to the IV therapy were able to receive streptokinase therapy 1.5 hours earlier than those receiving intracoronary therapy, and they had a higher incidence of reperfusion. We conclude that IV streptokinase therapy may be preferable to intracoronary therapy in view of a higher reperfusion frequency, fewer complications, and greater ease of administration. With both treatment modalities, comparable improvement in left ventricular function was noted. Institutions that do not have invasive techniques available may well be the first to benefit from this method of myocardial salvage, and we encourage cooperation between emergency and cardiology departments. PMID- 6486535 TI - Cardiac arrest under age 40: etiology and prognosis. AB - Between January 1979 and December 1982, 84 patients between the ages of 1 and 39 years presented to the emergency department in a state of cardiac arrest. There were 58 male patients (69%) and 26 female patients (31%) in the group. Presenting rhythms were ventricular fibrillation (37%), asystole (37%), idioventricular rhythm (14%), heart block (4%), bradycardia (4%), ventricular tachycardia (3%), and electromechanical dissociation (3%). Thirty-two percent had bystander CPR. Of 21 patients initially resuscitated (25%), only four (5%) survived to discharge from the hospital. All survivors were neurologically intact. Seventy-five of the 80 patients who died (90%) underwent autopsy. Cause of death in the five remaining patients was inferred from clinical history. Etiologies of the cardiac arrests were the following: toxic exposure or ingestion (26%), atherosclerotic heart disease (23%), undetermined (11%), pulmonary embolism (6%), hemorrhage (6%), epilepsy (2%), cardiomyopathy (7%), myocarditis (2%), pneumonia (4%), and one case each of airway obstruction, asthma, peptic disease, and septic shock. Diverse etiologies should lead to a diagnostic search for reversible conditions in young patients. The prognosis for hospital discharge is poorer in the young population than is reported in our overall cardiac arrest population; however, numbers of neurologically intact survivors are similar in the young and the overall cardiac arrest population. PMID- 6486536 TI - Bystander CPR in prehospital coarse ventricular fibrillation. AB - Prehospital bystander cardiopulmonary resuscitation (CPR) was studied to determine if it affected the outcome of defibrillation. Four hundred twenty-one consecutive witnessed cardiopulmonary arrests presenting with the initial rhythm of coarse ventricular fibrillation treated by the Milwaukee County Paramedic System from January 1980 to June 1982 were analyzed. Pediatric, trauma, and poisoning patients and those receiving intravenous or endotracheal medications before defibrillation (58) were excluded. Immediate professional bystander CPR (physician, nurse, EMT) and citizen bystander CPR were compared to a control group receiving no bystander CPR until arrival of EMS personnel. A successful defibrillation occurred if defibrillation prior to administration of medication produced an effective cardiac rhythm with pulses. Eighty-eight of the 363 remaining patients (24%) converted with initial defibrillations. While the group receiving professional bystander CPR had a higher successful defibrillation rate than did the no-CPR group (35% vs 22%, P less than .04), citizen bystander CPR and no-CPR groups had similar successful defibrillation rates (24% vs 22%, no significant difference). One hundred eighty-six of the 363 patients (51%) were transported to a hospital with a rhythm and a pulse (a successful resuscitation). Ninety-seven of the 363 patients (27%) were discharged alive from the hospital (a save). Patients who were converted successfully using initial "quick-look" defibrillations were far more likely to be successfully resuscitated (79/88 [90%] vs 107/275 [39%], P greater than .0001) and to be discharged alive from the hospital (54/88 [61%] vs 43/275 [16%], P greater than .0001) than were those who required further advanced cardiac life support techniques.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486537 TI - Effect of varied training techniques on field endotracheal intubation success rates. AB - A pool of 146 mobile intensive care unit paramedics was divided into four equal groups and trained in the technique of direct laryngoscopic endotracheal intubation of cardiac arrest or deeply comatose patients. Group 1 was selected from supervisors and crew chiefs and trained as preceptors. The remaining paramedics were assigned to three other study groups. Groups 1 and 2 were trained with a didactic presentation followed by manikin practice, an animal laboratory exercise, and operating room experience. Group 3 had no OR experience; Group 4 had only didactic/manikin training. Intubations were observed by preceptors on scene. During the study period of 27 months, 689 of 763 patients (90.3%) were successfully intubated by 122 paramedics. While results suggest variation in skill levels according to training group (Group 1, 92.4%; Group 2, 87.6%, Group 3, 83.3%; Group 4, 76.9%), statistical analysis allowing for the variables of seniority and number of intubations performed by personnel failed to reveal differences in groups attributable to training programs. Complication rates were relatively low for all groups, the most common being prolonged intubation attempts. A significant improvement in the skill was seen as the study progressed when groups are pooled and compared. The findings suggest that endotracheal intubation of deeply comatose or cardiac arrest patients is a field procedure that can be performed safely and skillfully by well-monitored paramedical personnel. Operating room or animal laboratory experience may increase initial success levels, but these factors do not appear to greatly influence eventual performance or incidence of complications of the procedure. PMID- 6486538 TI - Ambulance utilization in Sweden: analysis of emergency ambulance missions in urban and rural areas. AB - Data concerning ambulance utilization in a rural and an urban region were registered in a computer. In both regions approximately 30% of missions were emergencies. In the urban area, 20% of the emergency missions were due to trauma, compared with 10% in the rural area (P less than .01). The major symptoms were unconsciousness (34%) and shortness of breath (24%) in the rural region, while in the urban region pain (32%) was the dominating symptom. The response time in emergency missions, used as a measure of the service level of the emergency medical system, was shorter in the urban area than in the rural area (P less than .01): less than 15 minutes in 93% of emergencies in the urban area (mean time, 8.1 minutes) and in 78% of emergencies in the rural area (mean time, 10.2 minutes). Ambulance utilization was higher (P less than .01) in the urban region (0.37 missions/ambulance/hour) than in the rural region (0.22 missions/ambulance/hour). The study indicates that there are great differences between urban and rural areas with respect to the incidence and character of ambulance missions. This difference must be considered when analyzing the cost effectiveness of emergency medical services. PMID- 6486539 TI - Clinical scoring does not accurately assess hypoxemia in pediatric asthma patients. AB - Management of acute asthma in the pediatric population is based almost entirely on clinical evidence of severity. Although pulmonary function testing has been advocated to improve evaluation, it is difficult in the pediatric patient and not routinely practiced. A clinical scoring system has been devised to help standardize evaluation, but has not been validated by comparison of the results of clinical scoring with those of arterial blood oxygen levels as determined by blood gas analysis. This study was undertaken to compare clinical scoring of pediatric asthma patients with the results of arterial blood gas analysis. Thirty eight children between the ages of 2 and 13 having 42 episodes of acute asthma were evaluated. The average age was 5.4 years. The average clinical score was 2.62; arterial blood for analysis was obtained in 37 (88%), with an average PaO2 of 81.7 mm Hg. None of the children had CO2 retention. There was no correlation between the clinical score of the children on presentation and the severity of hypoxia (correlation coefficient = -0.149). Comparison of age and arterial oxygen tension revealed a trend toward worsening hypoxemia with diminishing age from 6 to 2 years, which was not identified by clinical scoring. We conclude that clinical scoring is inaccurate for the assessment of hypoxemia in the pediatric age group. Arterial blood gas determination should be used to assess the severity of hypoxemia in the emergency treatment of pediatric asthma patients. PMID- 6486540 TI - "PALS for life!" A required trauma-oriented pediatric advanced life support course for pediatric and emergency medicine housestaff. AB - While advanced cardiac life support (ACLS) and advanced trauma life support (ATLS) courses have become accepted standards for physicians who care for the critically ill and injured patient, only recently have pediatric advanced life support (PALS) courses been developed. The American Academy of Pediatrics has shown renewed interest in pediatric cardiopulmonary arrest after impressive gains made in adult resuscitation. The American Heart Association filled a void by including new chapters on Pediatric and Neonatal Resuscitation in the Textbook of Advanced Cardiac Life Support, 1981. A joint committee of AHA and AAP is seeking to unify course objectives and materials for standard curriculum. Because trauma is the most common cause of death and disability in children, pediatric trauma life support measures should be incorporated into any program directed toward emergency physicians and pediatricians who function in an emergency department or rural primary care setting. The Department of Pediatrics and Surgery and its division of Emergency Medicine has developed and implemented a PALS curriculum which is different from most other programs in that emphasis has been placed on pediatric trauma in addition to traditional cardiac (ACLS) resuscitation. This 20 hour program combines a modified ACLS curriculum with specific pediatric trauma lectures and laboratory sessions. It includes a canine surgical procedure lab and modified ATLS skill stations. At the completion of the course, students are eligible for ACLS certification. In the two years in which the course was given, 39 pediatric houseofficers were enrolled in the course.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486541 TI - Impact of a nurses strike on a medical center emergency department. AB - A strike of registered nurses in a large voluntary teaching hospital required changes in prehospital and emergency department delivery of services. An explanation of how the strike was handled by one emergency department is offered, as are comments on implications for emergency physicians and lessons for future strike situations. PMID- 6486542 TI - Optic neuritis. PMID- 6486543 TI - Pasteurella multocida: bilateral septic knee joint prostheses from a distant cat bite. AB - We report a case of septic arthritis and bacteremia caused by the Gram-negative rod, Pasteurella multocida. The patient was superficially bitten by her cat, and within two years infection necessitated removal of both of her artificial knee prostheses. P multocida is found in the mouths of cats, dogs, and other domestic animals. The pathogenesis, prevention, and treatment of infections caused by this organism, and the question of prophylactic antibiotics are discussed. PMID- 6486545 TI - Women in emergency medicine. PMID- 6486544 TI - Successful treatment of paroxysmal supraventricular tachycardia with MAST. AB - We have noted that inflation of the military antishock trousers (MAST) successfully converted five of six patients with paroxysmal supraventricular tachycardia to normal sinus rhythm. In all patients the usual "vagal" maneuvers were tried first and were unsuccessful. MAST inflation may be a safe and useful addition to the traditional vagal maneuvers used to treat paroxysmal supraventricular tachycardia. PMID- 6486546 TI - Emergency medicine redux. PMID- 6486547 TI - SBS and SIDs. PMID- 6486548 TI - Method for rapid fluid replacement questioned. PMID- 6486550 TI - Domestic violence: an EMS-targeted clinical condition in California. PMID- 6486549 TI - On nuclear war and emergency health care. PMID- 6486551 TI - Seat belt study in the United Kingdom. PMID- 6486552 TI - Bretylium in hypothermia-induced ventricular fibrillation in dogs. AB - We undertook a study to determine the ability of intravenous bretylium to cause "chemical defibrillation" or facilitate electrical defibrillation of hypothermia induced ventricular fibrillation in the dog. Two groups of ten dogs were cooled to 22 C and placed into ventricular fibrillation. Following initiation of cardiopulmonary resuscitation, bretylium 15 mg/kg or normal saline was administered and the dogs were defibrillated according to a standard protocol. Both groups were equivalent in mean arterial pressure and arterial blood gases throughout the investigation. Seven dogs in each group were converted from ventricular fibrillation to an organized cardiac rhythm (P greater than .05). Despite the possible value of prophylactic bretylium in the setting of hypothermia, its use as active treatment for hypothermia-induced ventricular fibrillation in dogs does not seem to be beneficial. PMID- 6486553 TI - Screening for lung cancer--where are we now? PMID- 6486554 TI - Early lung cancer detection: summary and conclusions. PMID- 6486555 TI - A reinterpretation of the effect of temperature and water content of the inspired air in exercise-induced asthma. AB - To compare the importance of water loss with heat loss in the mechanism of exercise-induced asthma (EIA), we conditioned the air inspired during exercise to the same water content (Wi) while changing its temperature (Ti), and vice versa. We calculated separately the amount of heat and water required to bring the inspired air to alveolar conditions. Ten asthmatics ran for 8 min on 4 occasions in an environmental chamber. The air was conditioned to a Ti of 9 to 10 degrees C or 35 degrees C, with a Wi of 9 to 10 mg H2OL-1. The airway response to exercise was not significantly different when Ti varied by 25 degrees C, but the amount of water required to saturate the inspired air remained the same. However, the amount of heat required was significantly greater with cooler air (p less than 0.005). We conclude that it is the osmotic and not the cooling effects induced by the vaporization of water that is the more important factor determining EIA. PMID- 6486556 TI - Evaluation of single-breath helium dilution total lung capacity in obstructive lung disease. AB - We examined the effect of obstructive lung disease on the single-breath helium dilution method of measuring total lung capacity (TLC). In test results of 79 patients, we found this dilution method underestimated the TLC determined by a radiographic method by a mean of 2.3% in normal subjects, 10.4% in patients with mild, 21.8% in those with moderate, and 38.0% in those with severe obstruction. The ratio of forced expiratory volume in one second to forced vital capacity was used to group the patients; the differences in the degree of underestimation of TLC between groups were significant (p less than 0.05). In addition, we found a strong correlation between the degree of underestimation of TLC by the helium method and the severity of obstruction when patients were considered as a continuous population. Using a regression equation based on this correlation, we derived a method for correcting the helium dilution TLC. This allows use of this test in patients whose obstructive disease would otherwise render it inaccurate. PMID- 6486557 TI - Effects of abdominal and thoracic breathing on breathing pattern components in normal subjects and in patients with chronic obstructive pulmonary disease. AB - The purpose of this study was to assess the effect of voluntarily controlled breathing maneuvers on breathing pattern components measured noninvasively with the respiratory inductive plethysmograph. In normal subjects, these maneuvers included predominantly thoracic and abdominal patterns with and without visual reinforcement from video-displayed plots of rib cage versus abdominal loops. In patients with chronic obstructive pulmonary disease (COPD), only predominantly abdominal breathing without and with visual feedback was employed; the latter produced greater abdominal contribution to tidal volume. Voluntarily controlled breathing patterns led to increased minute ventilation (VI) in normal subjects because of variable changes of frequency and tidal volume. This increase in ventilation was achieved despite increased asynchronous and paradoxic motion between rib cage and abdominal excursions that would add to the work of breathing. Patients with COPD had heightened baseline respiratory center drive when compared with that in normal subjects, as evidenced by elevation of VI and mean respiratory flow (VT/TI). In contrast to normal subjects, abdominal breathing produced no change in VI and VT/TI for the group as a whole, but 6 of the 9 patients with COPD had decreases compared with natural breathing. This diminution of respiratory drive in some patients with COPD during voluntary abdominal breathing might relate to limitation of ventilatory response by the increased work of breathing caused by pulmonary hyperinflation, elevated airway resistance, and increased asynchronous and paradoxic motion of the rib cage to the abdominal excursions, and/or the mental activity required to perform the breathing maneuver might be inhibitory to respiratory drive. PMID- 6486558 TI - Assessment of asynchronous and paradoxic motion between rib cage and abdomen in normal subjects and in patients with chronic obstructive pulmonary disease. AB - Both scalar tracings and XY plots of rib cage (RC) and abdominal (AB) excursions were analyzed to detect asynchronous and/or paradoxic motion of one compartment with respect to the other in an effort to distinguish differences between normal subjects and patients with chronic obstructive pulmonary disease (COPD). An inspiratory asynchrony index (IAI) was obtained by connecting a straight line from beginning inspiration to end inspiration of the RC-AB loop, and dividing the area enclosed by the inspiratory portion by the tidal volume. In like manner, an expiratory asynchrony index (EAI) was computed. Values of IAI and EAI in the supine posture were greater in patients with COPD than in normal subjects, and such differences were consistently demonstrated during natural and voluntarily controlled abdominal breathing. Paradoxic motion as percent of volume or time period of inspiratory and expiratory compartmental excursions was indicated when RC or AB compartments moved in an opposite direction to the sum of the two. During natural breathing, paradoxic motion was almost absent in normal subjects and variably present in patients with COPD. Voluntarily controlled breathing patterns produced increased IAI, EAI, and paradoxic motion. Passive tilting from supine to the upright posture did not affect indexes in normal subjects but reduced asynchronous and paradoxic motion of the RC in patients with COPD. Other indexes of loop analysis, such as phase angle and maximal compartment amplitude/tidal volume, were not as consistent in distinguishing between normal subjects and patients with COPD during natural and voluntarily controlled breathing patterns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486559 TI - The effect of maintenance theophylline therapy on lung work in severe chronic obstructive pulmonary disease while standing and walking. AB - There is controversy whether routine use of theophylline is warranted in chronic obstructive pulmonary disease (COPD). Effects on spirometry are minimal, and subjective relief is difficult to document. Therefore, we undertook to study the pulmonary effects of theophyline using a functional approach, namely, its effects on the lung mechanics of a standing or walking patient. In a double blind, placebo controlled crossover study, 400 mg of slow-release theophylline (TheoDur) were given twice a day in 13 trials to 10 patients with severe COPD. Lung mechanics were calculated on a breath-by-breath basis by a pulmonary mechanics computer from esophageal pressures and flow. Expired volumes were simultaneously collected. Spirometry was then performed. On the placebo limb, the spirometric response to 0.5 mg terbutaline given subcutaneously was compared with the theophylline response. At a mean serum theophylline level of 12.3 micrograms/ml, theophylline produced in the entire group a mean reduction in the work of breathing done on the lung (WL) of 16% (p less than 0.002) while walking, but a significant effect while standing was not detected. During both walking and standing, the mean reduction in lung resistance (RL) was 15 to 16% (p less than 0.002). Minute volume (VE) was increased at borderline significance, with a mean reduction while walking of 19% in the ratio of WL to VE (p less than 0.002). In the individual patient, changes in WL were influenced more by changes in VE than by changes in RL; in fact, changes in WL correlated best with changes in the product of (VE)2 and RL. Theophylline produced a mean increase of 15% in forced expiratory volume in one second (FEV1) and 16% in forced vital capacity (FVC).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486560 TI - Effects of hydralazine on hemodynamics, ventilation, and gas exchange in patients with chronic obstructive pulmonary disease and pulmonary hypertension. AB - Reports on hemodynamic effects of hydralazine on pulmonary hypertension (primary or secondary) usually include cases with severe disease or with mixed varieties of pulmonary vascular disease. Serious side effects and death have been reported. Effects of this drug on ventilation and gas exchange are unknown. We investigated the short-term effects of hydralazine treatment on hemodynamics, ventilation, and gas exchange in a relatively homogeneous group of patients with severe chronic obstructive pulmonary disease and moderate exertional pulmonary hypertension (mean pulmonary artery pressure, 43 +/- 3 mmHg). Hydralazine produced significant improvement in cardiac index, total pulmonary resistance, and oxygen transport. We also observed significant improvement in alveolar ventilation (mean PaCO2, decreased from 47 +/- 2 to 40 +/- 3 mmHg at rest and from 51 +/- 3 to 43 +/- 3 mmHg during exercise). The severe exertional hypoxemia of the group (mean PaO2, 48 +/- 2 mmHg) improved significantly (mean PaO2, 57 +/- 3 mmHg). Four of 11 patients showed increased exercise tolerance after hydralazine. This change is probably related to a combined improvement in hemodynamics plus a newly observed improvement in gas exchange and ventilation. Three of 14 patients could not tolerate hydralazine because of marked tachycardia. Serious side effects were not observed in the remaining group. PMID- 6486561 TI - Circulating immune complexes in patients with mycoplasmal pneumonia. AB - Circulating immune complexes as measured by conglutinin (IgG-IC) and IgM rheumatoid factor (IgM-RF) were studied in 114 patients with mycoplasmal pneumonia (58 inpatients and 56 outpatients). The levels of IgG-IC and IgM-RF of the patients were significantly higher than those of 13 healthy control subjects. In addition, the levels of IgG-IC of the inpatients were significantly higher than those of the outpatients. The highest titers of IgG-IC were obtained 9 to 30 days after onset of disease, and the levels of IgG-IC were elevated during the time period when pulmonary changes were pronounced. The levels of IgM-RF were irrelevant to infiltration on chest radiographs. An analysis using density gradient centrifugation showed that the decrease of IgG-IC with intermediate size was associated with improvement of the disease. A possible pathogenic role of IgG IC in mycoplasmal pneumonia is discussed. PMID- 6486562 TI - Epidemiology of infection by nontuberculous mycobacteria. V. Numbers in eastern United States soils and correlation with soil characteristics. AB - Organisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) group were recovered in significant numbers from 63 soil samples collected from the floodplains of 4 major rivers in the eastern United States: Hudson (NY), James (VA), Savannah (GA, SC), and Tombigbee (AL, MS). The mean numbers of M. avium-intracellulare, M. scrofulaceum, and MAIS-intermediate biovars recovered increased significantly from the Hudson to the James to the Tombigbee and Savannah soil samples, agreeing reasonably well with previous findings on MAIS distribution in eastern U.S. waters and with the geographic distribution of naval recruits reacting to PPD-B and PPD-G, which is higher in the southeastern United States. From the Savannah and Tombigbee rivers, soils were collected throughout their lengths. The number of total MAIS and biovars recovered from the different soil sites varied widely and showed no obvious trends. However, statistical analysis revealed a highly significant correlation between high numbers of MAIS recovered and high acidity of the soils. Other soil characteristics, such as high total organic matter, high conductivity, and reduced moisture, were only weakly, if at all, correlated with high MAIS numbers. Whereas the general distribution of MAIS in these soils of the Northeast (NY), mid-Atlantic (VA), and Southeast (GA, SC, AL, and MS) might explain the geographic distribution of the naval recruits reacting to PPD-B and PPD-G, the distribution of MAIS in soils along the stretches of the 2 southeastern rivers was not correlated with the county-by county frequency of PPD-B reactive naval recruits in Georgia, South Carolina, Alabama, and Mississippi. PMID- 6486563 TI - Respiratory muscle dysfunction in myotonia congenita. AB - A patient with myotonia congenita (Thomsen's disease) presented with unpleasant sensations of tightness in the chest and dyspnea, which were maximal at the beginning of exercise and gradually improved as exercise progressed. Lung function tests and maximal static respiratory pressures were within normal limits. Precise electromyographic (EMG) and mechanical studies, however, demonstrated the increased excitability, impaired relaxation, and transient weakness of the respiratory muscles. These studies thus indicate that myotonia congenita may involve the respiratory muscles to the same extent as any other skeletal muscle, and that precise EMG studies are occasionally useful in determining the organic basis of respiratory symptoms. PMID- 6486564 TI - Effects of aminophylline on diaphragmatic fatigue during acute respiratory failure. PMID- 6486565 TI - Maximal respiratory pressures in children. PMID- 6486566 TI - Workup of neonatal intestinal obstruction. AB - An algorithm for the evaluation of a newborn with an intestinal obstruction was formulated. It is hoped that this will aid the practicing surgeon in rapidly and safely arriving at the proper diagnosis so that appropriate therapy can be promptly instituted. PMID- 6486567 TI - Incidence of positive inguinal lymph node cultures during peripheral revascularization. AB - Synthetic vascular graft infections occur more commonly at the inguinal incision, and there is contamination of the graft by transection of bacteria-laden lymphatics proximal to a distal extremity infection. In 45 consecutive peripheral revascularizations, significant positive inguinal lymph node cultures were not obtained in 30 normal extremities; two of 15 distally infected extremities demonstrated the same bacteria in the distal infection and the inguinal lymph node. Both patients subsequently developed graft infections. Inguinal lymph nodes proximal to a distal infection may harbor bacteria capable of causing a synthetic vascular graft infection. Consideration should be given to culture-directed rather than routine antibiotic prophylaxis under this circumstance. PMID- 6486568 TI - The major role of the operative cholangiogram within the indications for common bile duct exploration. AB - The accuracy of the clinical indications for common bile duct exploration was studied in a group of 495 patients. The patients were divided into two groups: operative cholangiography was performed in 5 per cent of cases in Group A and 62 per cent of cases in Group B. The results demonstrate the high efficiency of this procedure, its safety, accuracy (82%), and its effectiveness in the discovery of unexpected stones and in shortening of hospitalization. Analysis of the results point out the indications for intraoperative cholangiography: It should be carried out in all biliary tract operations, except for those in which other clinical indications for exploration already exist (palpable stones in the common bile duct or the combination of dilated common bile duct either with jaundice at the time of operation or with history of severe jaundice in the past). Under all other circumstances an operative cholangiogram should be performed. PMID- 6486569 TI - "Idiopathic" duodenal obstruction due to chronic pancreatitis. AB - Three cases of idiopathic duodenal obstruction due to chronic pancreatitis are described. Each received a different surgical treatment. One had a pancreatoduodenectomy because of the difficulty in distinguishing the benign mass from a malignant tumor, one had a cholecystectomy with conservative treatment and the third had a subtotal gastrectomy with a Billroth II anastomosis. All patients were free of symptoms from 1 to 4 years postoperatively. It is very important to establish the correct diagnosis before or during operation in the management of these patients. PMID- 6486570 TI - Gastric carcinoma after peptic ulcer surgery. AB - Gastric carcinoma following surgery for benign peptic ulcer disease is being increasingly reported. The authors have reviewed their experience at Saint Francis Hospital and Medical Center and Mount Sinai Hospital from 1970 to 1980 and found 319 cases of gastric carcinoma, 16 of whom had undergone previous surgical procedures for peptic ulcer disease, with an incidence of 5 per cent of gastric stump carcinoma. The average time interval for the development of gastric stump carcinoma was 17.4 years, ranging from 5 to 49 years. The average survival after the diagnosis was 4.6 months, making the prognosis uniformly poor, probably due to delayed diagnosis. Treatment modalities consisted of major and minor surgical procedures, medical therapy, and no treatment in some instances. It is recommended that all patients who undergo operations for peptic ulcers have careful long-term follow-up. Vague gastrointestinal symptoms occurring in these patients, especially 10 years or more after surgery, require endoscopy and biopsies of the gastric stump to exclude gastric stump carcinoma. PMID- 6486571 TI - Effects of corticosteroid on the healing bowel anastomosis. AB - Conflicting results have been reported as to whether or not wound healing is retarded following treatment with corticosteroids. The surgical literature is lacking information on the effects of steroids on the healing bowel anastomosis. It has seemed reasonable to evaluate the bursting pressure, blood supply, and histologic changes of the bowel anastomosis in rats systemically pretreated with various doses of steroids. Male albino rats were pretreated with corticosteroids for 14 days in 20, 10, and 5 mg/kg of hydrocortisone acetate (intramuscular injection). A small bowel loop was divided and reanastomosed in each group (10 test and 5 control animals). The anastomosis was subsequently tested after 4, 5, 7, and 10 days. Three different methods of testing were used: 1) bursting pressure; 2) microangiography; and 3) histologic study. Large doses of 20 and 10 mg/kg of steroid deteriorated the test rats, significantly reducing the healing process within these 10 days as compared with the control rats. The 5 mg/kg group showed differences in bursting pressure only between the 4th and 7th postoperative days (statistical significance). Microangiography and histologic changes were not significant between the test and control rats. These results demonstrate decreased bursting pressure in steroid pretreated rats between the 4th and 7th postoperative days. These results may have implications regarding the care of steroid treated patients undergoing intestinal surgery. PMID- 6486572 TI - Reduction of intestinal adhesions by postoperative peritoneal irrigation with dialysis solution. AB - In a canine experimental model in which intestinal adhesions were created by exposing the intestine to talc powder and autologous blood, the incidence of adhesion formation and the severity of adhesions were reduced tenfold when the abdominal cavity was irrigated with peritoneal dialysis solution three times daily for 4 days postoperatively. The mechanism of peritoneal dialysis solution in reducing the severity of adhesion appears to be related to the mechanical factors of washing out debris from the abdominal cavity, although it may also have a fibrinolytic effect. Long-term use of peritoneal dialysis solution may alter systemic fluid and electrolyte imbalance. Placing a small peritoneal dialysis catheter in the abdominal cavity at the conclusion of major abdominal operations and subsequent daily irrigation with peritoneal dialysis solution may be a helpful adjunct in reducing the incidence of postoperative adhesions. PMID- 6486573 TI - Method of isolation-perfusion of the liver in the pig. AB - A method was developed in the pig for isolation-perfusion of the liver using a pump-oxygenator that infused blood through the portal vein after vascular isolation and collected the hepatic venous effluent in a closed recirculating system. Portal and vena caval blood flows were diverted around the liver by an intracaval conduit or by an external shunt. Leakage from the perfusion circuit into the systemic circulation was measured using radioactive albumin tracer. Ten pigs were perfused for 30 or 60 minutes at 37 C or 41 C. Nine animals survived treatment with transient elevations of hepatic enzymes but with no clinical or pathologic signs of permanent hepatic damage. PMID- 6486574 TI - The healing and tensile strength of the gastroplasty staple line. An experimental study. AB - Inverted and everted staple lines, with and without division of the anterior gastric wall, were performed in 15 mongrel dogs to simulate reduction gastroplasty staple line. There were no significant differences in tensile strength and healing between staple lines at different postoperative periods. The tensile strength of the inverted staple line seemed to be stronger due to breakage of the adjacent gastric tissue. However, the tensile strength of the everted stapling without division of the gastric wall, which is used clinically, was almost equal to that of normal gastric tissue. In addition, there was satisfactory healing 4 weeks postoperatively in the everted stapling without dividing the gastric wall. These results suggest that the everted staple line without division of stomach is not inherently weaker to any significant extent than if the gastric wall was divided or inverted. The reported failure rate of this procedure may be due to other factors. PMID- 6486575 TI - Appendicitis in the aged. Is it really different? AB - The case reports, operative findings, and results of surgery in 77 patients aged 60 years and older who underwent surgery for histologically proven acute appendicitis were analyzed. Based on this analysis, it was concluded that the clinical picture of appendicitis in the aged does not differ from that observed in younger patients. However, in the aged the disease course seems to be more rapidly progressing toward perforation and abscess formation. An aggressive diagnostic attitude and early surgery seem the sole means by which mortality and morbidity of appendicitis in the aged can be lowered. PMID- 6486576 TI - Solvent perturbation and surface accessibility of the tryptophyl and tyrosyl groups in black-eyed pea trypsin and chymotrypsin inhibitor. AB - The solvent perturbation behavior of tyrosyl and tryptophyl residues in the black eyed pea trypsin and chymotrypsin inhibitor have been studied using several perturbants ranging in molecular diameter from 2.8 to 9.4 A. The single tyrosyl and the single tryptophyl residues of the protein appear to be largely exposed to solvent access. PMID- 6486577 TI - [Serum profile of bile acids in children with neonatal hepatitis and extrahepatic biliary atresia]. AB - A bile acid analysis by a fluorometric-enzymic method was carried out in serum from infants with neonatal hepatitis and biliary atresia. Serum bile acids were determined in 51 infants: 34 with extrahepatic biliary atresia and 17 with neonatal hepatitis syndrome. The following results were obtained: 1) There were no significant differences between neonatal hepatitis and biliary atresia concerning total serum bile acids. 2) The ratio of trihydroxylated to dihydroxylated bile acids in serum was less than one in 30 patients with biliary atresia and greater than one in 15 patients with neonatal hepatitis. 3) Conventional hepatic tests did not show any statistically significant difference between these types of patients. These results suggest that trihydroxy/dihydroxy bile acid ratio may be of clinical interest to differentiate biliary atresia from neonatal hepatitis in infants. PMID- 6486578 TI - [Effects of a municipal immunization program on the vaccination coverage in a school population]. AB - We report the results of a Municipal Immunisation Program in a industrial community. These results were evaluated through the School Health Program. Our immunisation policies resulted in a substantial increase of immunity covering with particular impact on the less wealthy social layers. Immunity rats rose from 32% to 71% of the population. We conclude that our program is an adequate policy for control of infection diseases. PMID- 6486579 TI - [Anti-measles antibodies in the first 2 years of life]. AB - In order to achieve a better understanding of the epidemiology of measles in Spain to foster vaccination policy in our country, we have conducted a serological survey of measles antibodies in children between birth and two years of life in the urban population of Madrid. Authors have established the rate at which maternal antibodies are lost in these children below 15 months of life. The results indicate that, in general maternal antibodies have already disappeared at 9 months. Vaccination can thus be indicated around this age. PMID- 6486580 TI - [Treatment of gastroenteritis dehydration with a gluco-electrolytic solution given orally in a hospital milieu]. AB - We analyze the therapeutical value of an oral glucoelectrolytic solution when treating 132 hospitalized patients ranging from 1 to 36 months of age, with acute diarrhea and/or dehydration. These children were offered ad libitum a solution containing: Na 50 mEq/l, K 30 mEq/l, CO3H 24 mMol/l, glucose 111 mMol/l, and saccharose 55 mMol/l, with an osmolarity of 300 mOsm/1. We observed a simultaneous clinical recovery and normalization of the hydroelectrolytic disturbances (p less than 0.05). Furthermore the differences in the ingested quantities by dehydrated and well hydrated children (p less than 0.05), or as expressed in ml/kg/hour during the first six hours compared with the following hours in the whole group (p less than 0.05), demonstrate a physiological recovers of the patient. We conclude that the use of these solutions should have priority over other treatment even in hospitalized patients. PMID- 6486581 TI - [Kawasaki disease: report of 6 cases]. AB - Six cases of children between 20 months and 6 years old, who suffer Kawasaki disease are presented. All of them had diagnostic parameters required by the Investigation Committee of this disease, with similar clinical symptoms as in other countries but with an upper average age (3 years old) to Japanese patients and nearer to that of the North American patients. It is important to emphasize the appearance of exanthema in one case, as well as a multiforme erythema exudative, a rare fact, and the observation, up to now not shown, of a positive rheumatoid factor in another two of the patients. All have undergone a good evolution without cardiovascular complications. PMID- 6486582 TI - [Atresia of the esophagus caused by bands]. AB - Authors report clinical and anatomopathological findings in two cases esophageal atresia. Authors found in one of them an anomalous vessel crossing the atresic cord and gastric epithelium in the lower pouch. Authors try to explain the pathogenesis of this atresia. PMID- 6486583 TI - [Gastric duplication. Presentation of 4 cases localized in the antropyloric region]. AB - Gastric duplications are very rare, especially those located at the pyloric region. Four cases are reported with gastric duplication in patients of two days, eight months, two and a half and three and a half years old, a review is made including symtomatology, diagnostic, treatment and anatomopathological studies. In all four cases post-operative evolution was satisfactory. PMID- 6486584 TI - [Intramural hematoma of duodenum. A complication of peroral duodeno-jejunal biopsy]. PMID- 6486585 TI - [Oto-palato-digital syndrome. Report of a case in a female]. PMID- 6486586 TI - [Waardenburg syndrome: neonatal diagnosis apropos of a case]. PMID- 6486588 TI - [Nanogram for the dosage of phenobarbital in children]. PMID- 6486587 TI - [Supraorbital eosinophilic granuloma. Local treatment with corticoids]. PMID- 6486589 TI - [The tuberculin test]. PMID- 6486590 TI - Respiratory tract symptoms as a clue to giant cell arteritis. AB - Although many manifestations of giant cell arteries are increasingly recognized, little attention has been paid to respiratory symptoms associated with this disorder. We report the cases of 16 patients with giant cell arteritis who had prominent symptoms related to the respiratory tract including cough, sore throat, and hoarseness. These symptoms were the initial finding in 10 patients and obscured the diagnosis in some instances, but resolved quickly when corticosteroids were given. It is estimated that 9% of patients with giant cell arteritis have prominent respiratory tract symptoms, which are the initial manifestation in 4%. This disorder should be considered in an older patient with a new cough or throat pain without obvious cause. PMID- 6486591 TI - Marked disparity between trabecular and cortical bone loss with age in healthy men. Measurement by vertebral computed tomography and radial photon absorptiometry. AB - To define age-related changes in bone mineral content in normal men, we measured radial (proximal and distal) and vertebral bone mineral content in 62 men aged 30 to 92 years. Radial bone mineral content (largely cortical bone) was measured by single photon absorptiometry, and trabecular vertebral content (T12, L1 to L3) by computed tomography. Radial bone mineral content fell gradually (2% to 3.4% per decade) with age, but vertebral trabecular content fell more rapidly (12% per decade). Body size was not associated with the rate of bone loss from the distal radial and vertebral sites, but men with lower surface areas lost bone more rapidly at the predominantly cortical proximal radial site. The fact that radial cortical bone mineral content falls much less rapidly than vertebral trabecular content with age and is also associated with surface area indicates that trabecular and cortical bone compartments may be independently modulated. Age related bone loss should not be considered a homogeneous process. PMID- 6486592 TI - Survival in chronic hepatitis B. An analysis of 379 patients. AB - Survival data from 379 patients with chronic hepatitis B were analyzed to determine life expectancy for the patient from the time of first contact. One hundred twenty-one patients had chronic persistent hepatitis, 128 had chronic active hepatitis, and 130 had chronic active hepatitis with cirrhosis. The frequency of symptoms (p less than 0.001), stigmata of chronic liver disease (p less than 0.001), and liver function test abnormalities (p less than 0.001) increased as the histologic features worsened, whereas the percentage of patients with circulating hepatitis B DNA polymerase declined (p less than 0.001). Women were uncommon in our series and had less severe disease than men (p less than 0.02). Fifty-one patients had died by the time of this analysis. The estimated 5 year survival rates were 97% for patients with chronic persistent hepatitis, 86% for those with chronic active hepatitis, and 55% for those with chronic active hepatitis with cirrhosis. The usual cause of death was liver failure and its sequelae. A multivariate analysis found age of 40 years or more, total bilirubin level of 1.5 mg/dL or more, ascites, and spider nevi to be factors that identified patients at a higher risk of death. The prognosis for patients with chronic hepatitis B is similar to that for patients with chronic hepatitis of other causes. PMID- 6486593 TI - Acromegaly and colon cancer. AB - The occurrence of colon cancer in 1 patient with acromegaly prompted a study of an additional 12 patients with acromegaly. In addition to the index case, 1 patient was retrospectively discovered to have colon cancer, and 1 was found to have colonic adenocarcinoma in the course of the study. One patient had a presumptive sigmoid polyp shown by barium enema but refused further studies. Eight patients received colonoscopy. Two patients had adenomatous polyps and 1 had two hyperplastic polyps. This study supports previously published data on the occurrence of colon polyps in patients with acromegaly and suggests that the incidence of colon cancer is much higher than that expected by chance. PMID- 6486594 TI - Lidocaine therapy with an exponentially declining infusion. Clinical evaluation of an optimized dosing technique. AB - A novel technique to achieve rapidly and continually maintain therapeutic lidocaine concentrations was designed according to known pharmacokinetic properties of the drug and was tested in 12 patients who required immediate lidocaine prophylaxis because of suspected acute myocardial infarction. The serum lidocaine concentrations achieved by this method remained within the therapeutic range (1.2 to 5.0 mg/L) in 83 of 84 determinations and showed little fluctuation over time for individual patients. Unlike previously recommended dose regimens for lidocaine, this technique uses an exponentially declining infusion and has the advantages of greater simplicity, less chance of medication error, and avoidance of rapid changes of lidocaine concentrations. Furthermore, similar methods can be applied when rapid attainment of stable plasma drug concentrations is needed for clinical or experimental pharmacologic studies. PMID- 6486595 TI - Prolonged intrahepatic cholestasis secondary to acute hepatitis A. AB - Viral hepatitis characterized by prolonged cholestasis has not been associated with a specific serologic marker. We report the cases of six patients presenting with a clinical syndrome typical of cholestatic hepatitis who were subsequently found to have acute hepatitis A. Usual features include pruritus, fever, diarrhea, and weight loss with serum bilirubin levels greater than 10 mg/dL, and a clinical course lasting at least 12 weeks. All patients recovered completely without sequelae. Knowledge of this unusual manifestation of hepatitis A may help avoid potentially invasive procedures involved in the evaluation of suspected obstructive jaundice and facilitate appropriate immunoprophylactic measures. PMID- 6486596 TI - Polythelia and testicular cancer. PMID- 6486597 TI - Exercise-induced amenorrhea and bone density. PMID- 6486598 TI - Possible interaction between amiodarone and phenytoin. PMID- 6486599 TI - Reversible central nervous system dysfunction due to tamoxifen in a patient with breast cancer. PMID- 6486600 TI - The effect of physician behavior on the collection of data. AB - Determining the patient's major reasons for seeking care is of critical importance in a successful medical encounter. To study the physician's role in soliciting and developing the patient's concerns at the outset of a clinical encounter, 74 office visits were recorded. In only 17 (23%) of the visits was the patient provided the opportunity to complete his or her opening statement of concerns. In 51 (69%) of the visits the physician interrupted the patient's statement and directed questions toward a specific concern; in only 1 of these 51 visits was the patient afforded the opportunity to complete the opening statement. In six (8%) return visits, no solicitation whatever was made. Physicians play an active role in regulating the quantity of information elicited at the beginning of the clinical encounter, and use closed-ended questioning to control the discourse. The consequence of this controlled style is the premature interruption of patients, resulting in the potential loss of relevant information. PMID- 6486601 TI - The humanities in medical education. AB - The importance of humanities in general education is generally acknowledged. With respect to premedical education, a major impediment has been the belief that gaining admittance to medical school is exceedingly difficult and, therefore, a student must major in the sciences. In compensation, the humanities have been introduced in medical schools either through compressed 6-year programs or as curricular or extracurricular options. Studies have shown, however, that approximately 50% of all applicants are admitted to medical schools and that the relatively small proportion of students who have majored in the humanities do somewhat better than average. With respect to medical schools, results of an examination of programs throughout the country suggest that strong extracurricular rather than curricular programs should be developed for the humanities. PMID- 6486602 TI - Acromegaly and cancer. PMID- 6486603 TI - Early detection of hereditary hemochromatosis. PMID- 6486604 TI - Physician investigators for academic medicine. PMID- 6486605 TI - Glycosylated hemoglobin assays in the management and diagnosis of diabetes mellitus. Health and Public Policy Committee, American College of Physicians. PMID- 6486606 TI - Registry for the microangiopathic hemolytic syndrome associated with cancer chemotherapy. PMID- 6486607 TI - A hemolytic-uremic syndrome with the acquired immunodeficiency syndrome. PMID- 6486608 TI - Thyroid nodules and needle biopsy. PMID- 6486609 TI - Thyroid function in older persons. PMID- 6486610 TI - Atropine and a hypertensive crisis. PMID- 6486611 TI - Judaism and medical ethics. PMID- 6486612 TI - [Use of thyrocalcitonin for the detection of familial medullary cancers in children]. AB - The preoperative diagnosis of medullary thyroid carcinoma (MTC) can be made by measuring serum calcitonin levels (CT). If the patient has a thyroid nodule- sporadic or familial MTC--the serum CT will be raised but in the familial form of the disease, the diagnosis should be made at a much earlier, subclinical stage when surgery can be curative: this is possible when raised hormone levels are observed after stimulation tests. However, as this form of cancer sometimes presents late, repeated stimulation tests are necessary, with all the difficulties that it implies, in all patients with normal hormone levels in whom it is impossible to exclude tumoral heredity, whether they belong to a family with a case of sporadic MTC or to a healthy branch of a family affected by heredity. PMID- 6486613 TI - [Value of the assay of plasma carcinoembryonic antigen and thyrocalcitonin in the detection of medullary cancer of the thyroid with amyloid stroma. Results of a familial survey of 47 subjects]. AB - During a study of 80 subjects from the same family, 47 persons underwent clinical examination and blood sampling for carcinoembryonic antigen and thyrocalcitonin. A preliminary investigation had shown that two members of the family had histologically confirmed amyloid stroma MTC, 2 others had probable malignant disease, 3 children died of intestinal obstruction in the neonatal period, and a fourth child operated for megacolon when 3 days old was the descendant of 2 subjects with probable thyroid carcinoma. Three years later, the study was updated and concentrated on the patients with the highest risk of developing malignant disease. The diagnosis was confirmed in one patient considered to have probable MTC. One case of malignant disease was discovered in a child considered to be normal 6 years previously. Three other patients, considered to be normal 6 years before had very probable MTC. These results indicated that familial investigations including plasma calcitonin measurements after pentagastrin stimulation, are valuable when amyloid stroma MTC is diagnosed in one member of the family. This test should be repeated periodically. The surgical indications in patients with abnormal responses should take into consideration the psychological context. PMID- 6486614 TI - [Detection of recurrence in patients with differentiated epithelioma of the thyroid]. AB - Two complementary methods are available for detection of tumour recurrence in patients with treated differentiated thyroid carcinoma: plasma thyroglobulin (Tg) measurement and I 131 total body scans (TBS). Tg is measured during T4 treatment: in patients with no thyroid tissue, detectable Tg levels indicated relapse requiring localisation by TBS. False negative results are rare but have been reported and therefore, it is useful to repeat Tg measurement after TSH stimulation in patients with undetectable Tg levels during T4 treatment. Patients with residual thyroid tissues and an elevated Tg level probably have tumour recurrence, but in most cases, Tg is within normal limits and no conclusions can be drawn. TBS in patients with no thyroid tissue is performed 2 weeks after withdrawal of T3. Patients with residual thyroid tissue have TBS performed after 3 injections of bTSH. Doses of 1 to 5 mCi of I 131 are given and TBS is carried out 3 days later? In conclusion, we can say that these two methods are complementary: Tg levels indicate the need for TBS. PMID- 6486615 TI - [Value of the assay of thyroglobulin for postoperative surveillance of differentiated thyroid cancers]. AB - Thyroglobulin has been evaluated among 30 control subjects and 81 thyroidectomized patients with differentiated thyroid carcinoma (50 papillary, 15 follicular, 16 mixed). 40 presented without residual thyroid tissue in the neck, 27 with residual tissue, 14 with metastases. Tg evaluation was performed on (78 dosages) and off thyroid hormone therapy (74 dosages), before and after withdrawal of thyroid medication in 25 patients. Tg was measured at different periods after surgical or radioiodine therapy of metastases (7 cases). The sera containing anti-Tg antibodies are rejected. The mean Tg levels was 11.9 +/- 8.5 ng/ml in the control group. In the group of patients with thyroid cancer, Tg levels were dependent on several factors: presence or not of residual thyroid tissue, presence or absence of a replacement therapy. All the patients on or off thyroid medication with metastases except one, presented with plasma Tg levels alone 5 ng/ml. In conclusion, plasma Tg appears as a good index for the research of metastases but only in patients without anti-Tg antibodies and residual thyroid tissue in the neck. Despite the existence of false negative results, a Tg undetectable in treated patients presenting a normal roentgen chest leads to avoid total body radioiodine scan and other usual radiologic investigations. On a opposite hand a plasma Tg greater than 50 ng/ml is highly suggestive of the presence of metastases. PMID- 6486616 TI - [Value of hormonal markers in the detection and therapeutic surveillance of malignant adrenal cortical carcinoma]. AB - The value of hormonal markers in the diagnosis and early and late surveillance of adrenocortical carcinoma was assessed in a series of 10 cases and from a review of the literature. Although hormonal investigation with measurement of precursors, performed whenever there is the least clinical suspicion of ACC, is of certain diagnostic value, the possibilities of postoperative controls have not yet been fully exploited: the results are difficult to interpret because of possible interference due to the secretion of the controlateral adrenal; plasma renin activity is rarely assessed in the late postoperative period. A general strategy of investigation and surveillance is proposed. PMID- 6486617 TI - [Tumors secreting choriogonadotropin in children]. AB - Fourteen cases of sexual precocity due to choriogonadotropin (hCG) secreting tumors are reported. One pineal and 4 gonadal tumors were observed in 5 girls, whilst 2 supra-sellar, 4 mediastinal, 1 gonadal and 2 hepatic tumors were observed in 9 boys. In all children, immunoreactive plasma LH was high (4 to 30 mIU/ml) but non-responsive to LH-RH, due to the presence of hCG (15 to 6,000 mIU/ml). In the 4 boys with mediastinal tumors the karyotype was 47,XXY. In girls, hCG secreting tumors are a uncommon cause of sexual precocity (less than 1 p. 100). In boys their incidence seems to be the same as the incidence of idiopathic precocious puberty, that is 21 p. 100 of sexual precocities due to androgenic secretion of testicular origin. PMID- 6486618 TI - [Products of exocrine secretion of the breast and breast cancer]. AB - The breast is an exocrine gland which secretes the proteins present in breast milk, such as casein and lactalbumin. The apocrine metaplasia which often accompanies cystic transformation may result in the production of proteins in the cystic fluid: GCDFP (Gross cystic disease fluid protein). The production of these proteins by breast cancer and their secretion into the blood enable them to be considered as markers of tumour differentiation. They are useful to the clinical oncologist as quantifiable parameters of tumour extension and response to treatment. In the future, they may provide an index of malignant transformation and hormone dependence. PMID- 6486619 TI - [Paraneoplastic hypercorticism]. AB - Paraneoplasic hypercorticism results from ectopic corticolipotropic secretion. Its incidence remains underestimated because of the latent clinical forms of Cushing's disease. In some cases the primary tumour (bronchopulmonary, thymic, pancreatic or other) presents late. The variability of hormonal secretion makes it difficult to interpret dynamic tests. Measurement of ACTH and LPH are useful diagnostic aids; more specific markers of ectopic secretion have recently been reported. When the primary tumour cannot be directly treated, the quality of survival may be improved by the use of synthetic anticortisol drugs. PMID- 6486620 TI - [Ecology of leishmaniasis in Southern France. 18. Enzymatic identification of Leishmania infantum Nicolle, 1908, isolated from Phlebotomus ariasi Tonnoir, 1921, spontaneously infected in the Cevennes]. AB - Out of 187 female Phlebotomus ariasi caught in the Cevennes focus of leishmaniasis 3 were found naturally infected with Leishmania. The infection in one of the three had spread from the midgut to the pharynx and proboscis. Stocks of Leishmania were isolated from two of the flies and 8 isoenzymes were examined. The newly isolated parasites were found to be indistinguishable from zymodeme 1 of Leishmania infantum s. st. PMID- 6486621 TI - Alcataenia fraterculae sp. n. from the horned puffin, Fratercula corniculata (Naumann), Alcataenia cerorhincae sp. n. from the rhinoceros auklet, Cerorhinca monocerata (Pallas), and Alcataenia larina pacifica ssp. n. (Cestoda: Dilepididae) in the North Pacific basin. AB - Three Cestodes representing two species of the genus Alcataenia Spasskaia, 1971 and a subspecies of Alcataenia larina (Krabbe, 1869) are described. Alcataenia fraterculae sp. n. (Cestoda: Dilepididae) was found in horned puffins, Fratercula corniculata (Naumann), and other species of seabirds from localities in the western Aleutian Islands, Gulf of Alaska, Bering Sea, and Chukchi Sea. Alcataenia cerorhincae sp. n. is described from the rhinoceros auklet, Cerorhinca monocerata (Pallas) in the eastern North Pacific Ocean and western Aleutian Islands. Alcataenia larina pacifica ssp. n. is recognized from species of Laridae and other seabirds in the North Pacific Ocean, Sea of Okhotsk, Bering Sea and the region of the Arctic Ocean near Bering Strait. It is distinguished from A. larina larina (Krabbe, 1869) by a greater number of testes, a longer cirrus sac, and variation in the position of the genital ducts which may be either dorsal to or between the osmoregulatory canals. A fraterculae and A. cerorhincae are most similar to A. larina and particularly to the North Pacific form A. l. pacifica. Generally specimens of A. fraterculae can be distinguished from the other taxa by larger rostellar hooks, a longer cirrus sac, and a combination of other characters. A. fraterculae, A. cerorhincae, and A. l. pacifica however represent a complex of cryptic species in which there is extensive overlap in some morphological characters. Results of a discriminant analysis among these nominal taxa were significant and, in combination with data about other morphological characters and host and geographic distribution, clearly indicated that these represent three species in the North Pacific basin. PMID- 6486622 TI - Scanning electron microscope study of mature and immature worms of a Sanguinicola sp. (Digenea: Sanguinicolidae). AB - A study was made of the morphological details of the tegument of mature (40-42 days) and immature (28 days) Sanguinicola sp. found in cyprinids of certain rivers of the province of Salamanca (Spain). In the adult worms, the entire tegument was covered with microvilli; the parasite showed various kinds of sensory organs, whose distribution is specified here. The lateral margins revealed strong denticules (except the anterior and posterior extremities) with spines and bristles. The immature worms showed a far simpler external structure; they lacked microvilli but did show orifices which could be sensory organelles. The lateral margins only showed the presence of spines. PMID- 6486623 TI - [Maintenance of a male and a female clone of Schistosoma mansoni by microsurgical transplantation of sporocysts. Reliability of the method]. AB - The long term maintenance (2 years) of a male clone and a female clone of Schistosoma mansoni by microsurgical transplantation of sporocysts allowed us to show that this technique is of great reliability: the postoperative survival of recipient snails at 60 days is greater than 75%; the mean of infection rate of the snails is 75% by the male clone sporocysts and 45% by the female clone sporocysts; the cercarial production of recipient snails is on average 441 cercariae per snail per day for the male clone and 530 cercariae for the female clone; the average worm recovery rate is 24,5%. PMID- 6486624 TI - [Reinfection of molluscs by protostrongylids : phenomena of limitation and facilitation]. AB - Land-snails (Otala lactea, Theba pisana, Cochlicella ventricosa and C. conoidea) previously infected experimentally by protostrongylids were reinfected at different time-lags, from one day to 126 days. The efficacy of daily reinfections was nil. The susceptibility of all species of snails was lowered for reinfection at short time-lags (up to 15 days) and enhanced for long time lags (over 21 days). The former phenomenon was called limitation and the latter, facilitation. It is suggested that limitation is related to the survival of penetrated first stage larvae and that facilitation is induced by a better penetration of first stage larvae. PMID- 6486626 TI - [Haplodiploidy of Oxyurida. Effects of this phenomenon in the life cycle]. AB - Chromosome behavior during gametogenesis and early cleavage is studied in two species of Thelastomatidae (Oxyurida), Hammerschmidtiella sp. and Thelastoma sp., parasites of diplopods. Both species are shown to be haplodiploid: male with 4 Thelastoma) or 5 (Hammerschmidtiella) chromosomes and double this number in the corresponding female. Haplodiploidy is now known in the 4 families of the Oxyurida and the author concludes that this form of reproduction is characteristic of the entire order. The Oxyuridan life cycle seems simple: 2 moults in the egg, no intermediate host, no extra-intestinal migration. However, several findings (some quite recent) indicate that this life cycle is often complicated by phenomena very closely adapted to host biology. The following particularities are analysed: 1) male progenesis; 2) laying of eggs in agglomerated packets; 3) peri-anal egg deposition; 4) poecilogony; 5) spanandry; 6) traumatic extra-genital insemination; 7) thelytoky. In a final chapter the author relates these adaptations to host biology and attempts to explain how they may have come to be favoured by natural selection during the course of evolution. PMID- 6486625 TI - [Traumatic insemination of Oxyuroidea of dermoptera and leporidae. Comparative morphological study. Considerations about phylogenesis]. AB - A morphological study of traumatic insemination in the genera Auchenacantha, a parasite of Dermoptera, and Passalurus, a parasite of Rabbits, revealed that the same phenomenon appeared twice in distinct lineages. In the Auchenacantha, adult females are inseminated in the vagina vera modified into a spermatic pouch. In the Passalurus insemination occurs in the ventral hypodermal field. Adult males probably mate with the female larval, stage four. PMID- 6486627 TI - [A new Spilotylenchus (Nematoda, Tylenchida : Allantonematidae) parasite of Spilopsyllus cuniculi (Dale) (Siphonaptera : Pulicidae), Siphonaptera of wild rabbits]. AB - Spilotylenchus beaucournui sp. n. is described and compared with the other species belonging to the genus Spilotylenchus. This nematode produce a locking of the oogenesis in female fleas. PMID- 6486628 TI - [A new Phlebotomus for Spain. Phlebotomus (Adlerius) mascittii Grassi, 1908]. AB - The authors have made the first discovery of Phlebotomus mascittii in Spain. The species was caught in Catalonia in the provinces of Gerona and Barcelona. Altogether 7 individual sandflies (4 male, 3 female) were collected (using oiled paper traps) in four separate sub-mediterranean sites (between 650 and 780 m). PMID- 6486629 TI - [Transposition of the great vessels. 4th Symposium on Pediatric Cardiology (Hopital des Enfants-Malades, Paris, 18-9 March 1982). Introduction]. PMID- 6486630 TI - [Physiopathology of the transposition of the great vessels]. PMID- 6486631 TI - [Detection of transposition of the great vessels in the newborn infant. From the first symptom to an assured diagnosis]. PMID- 6486632 TI - [Endocavitary study and treatment of transposition of the great vessels in the newborn infant]. PMID- 6486633 TI - [The Mustard operation for the treatment of transposition of the great vessels]. PMID- 6486634 TI - [The Senning technic in the treatment of transposition of the great vessels]. PMID- 6486635 TI - [Long-term results of the treatment of simple transposition of the great vessels by the Mustard operation]. PMID- 6486636 TI - [Late dysrhythmias following the Mustard operation. Prognosis and therapeutic approach]. PMID- 6486637 TI - [Medium-term results of the Senning operation applied to 127 cases of simple transposition of the great vessels]. PMID- 6486638 TI - [The problem of the pulmonary venous channel after the Senning operation]. PMID- 6486639 TI - Senning operation for transposition of the great arteries. Early and late results in Leiden. PMID- 6486640 TI - [2-stage anatomic correction of simple transposition of the great vessels]. PMID- 6486641 TI - [Anatomic correction of simple transposition of the great vessels or "physiologic" correction? A question of individual conscience]. PMID- 6486642 TI - [Echocardiographic study of complete transpositions of the great vessels]. PMID- 6486643 TI - [Physiopathology of transpositions of the great vessels with interventricular communication. Therapeutic implications]. PMID- 6486644 TI - [Results of atrial correction of transposition of the great vessels with interventricular communication]. PMID- 6486645 TI - [Anatomic correction of transposition of the great vessels with interventricular communication]. PMID- 6486646 TI - [Transpositions of the great vessels with pulmonary stenosis and intact interventricular septum. Anatomic aspects and therapeutic implications]. PMID- 6486647 TI - [Surgical treatment of transpositions of the great vessels with pulmonary stenosis and intact interventricular septum]. PMID- 6486648 TI - [Classic treatments of transpositions of the great vessels with interventricular communication and pulmonary stenosis]. PMID- 6486649 TI - [Anatomic correction of transposition of the great vessels with interventricular communication and pulmonary stenosis]. PMID- 6486650 TI - [Migrations between plastic containers and liquid pharmaceutical dosage forms: general criteria for the study, and methods of detection]. PMID- 6486651 TI - [Antifungal activity of higher plants. Action of 49 indigenous plants on 11 phytopathogenic fungi]. PMID- 6486652 TI - [Mercaptopyridinecarboxylic acids. Determination of acidity constants of 6 mercapto-3-pyridinecarboxylic acid]. PMID- 6486653 TI - [Scanning electron microscopy study of the degranulation of peritoneal mast cells by compound 48/80]. PMID- 6486654 TI - [Potentiometric assay of amino acids with copper in pharmaceutical forms]. PMID- 6486655 TI - [In vivo study of the antiseptic efficacy of an alcoholic solution of chlorhexidine digluconate]. PMID- 6486656 TI - [Fungal flora of 2 hospitals in Algiers. Determination and study of the pathogenic potency]. PMID- 6486657 TI - [Determination of the aluminum content of plastic materials for packaging extracorporeal dialysis solutions: study of the transfer between container and contents]. PMID- 6486658 TI - [Influence of formulation on the rate of theophylline liberation from hydrophilic matrices]. PMID- 6486659 TI - [Sedative effects of a new series of pyridazinones]. PMID- 6486660 TI - [Plants of New Caledonia. Alkaloids from Melodinus phylliraeoides Labill]. PMID- 6486661 TI - [Tetracycline complexes. Study of 1-1 complexes of iron III, cobalt II, copper II and nickel II with tetracycline, oxytetracycline, demeclocycline, doxycycline and minocycline]. PMID- 6486662 TI - [Plant growth inhibitory activity of semicarbazones derived from phenylthioacetaldehydes and phenylthiopropanones]. PMID- 6486663 TI - [Sequential determination by thermometric titration of Al3+, Ca2+ and Mg2+ in various antacid drugs]. PMID- 6486664 TI - Cervical thymectomy in the treatment of myasthenia gravis. AB - A retrospective review of 22 patients undergoing cervical thymectomy for myasthenia gravis is presented. Their ages ranged from 19 to 67 years. The male and female ratio as well as the severity of illness prior to operation were similar to other reported series. All patients were evaluated from the standpoint of clinical response to thymectomy, and the number and dosage of anti-myasthenic drugs required after operation. There was a statistically significant improvement in clinical status in the immediate postoperative period (P less than 0.05) and a further significant improvement was noted at six months (P less than 0.05). In addition, significant reductions in postoperative drug therapy were noted (P less than 0.05). Complications from cervical thymectomy were minimal and mortality was zero. An attempt was made to correlate histological findings with clinical results. Comparison is made to other series in the literature and the advantages of the cervical technique as the initial surgical approach are described. The data presented support a useful role for cervical thymectomy in the treatment of myasthenia gravis. PMID- 6486665 TI - Anaesthesia for transcervical thymectomy in myasthenia gravis. AB - A modified technique of total intravenous anaesthesia was used in the management of 22 patients with myasthenia gravis of varying severity undergoing therapeutic transcervical thymectomy. The relatively short-acting intravenous hypnotics, Althesin and etomidate were compared for induction of anaesthesia and for maintenance as a supplement to 50% nitrous oxide in oxygen. Moderately high doses (20 or 25 micrograms/kg) of the potent, synthetic opiate, fentanyl provided analgesia and a level of respiratory depression sufficient to facilitate control of respiration. The induction of anaesthesia was rapid and smooth, completed in under 5 minutes. Reflex response to surgical stimulation was suppressed for extremely variable periods. Complete recovery of consiousness, or adequate spontaneous respiration and of muscle tone was readily achieved, but was more rapid after Althesin (p less than 0.05). Postoperative problems were few. It is suggested that this technique of anaesthesia can provide optimum operating conditions with rapid, complete recovery and consequently low morbidity; the primary requirements of anaesthesia for therapeutic thymectomy. PMID- 6486666 TI - Stenosis at the choledochojejunostomy anastomosis following pancreatico duodenectomy when the common bile duct is of normal calibre. PMID- 6486667 TI - Comparison of early and late closure of transverse loop colostomies. AB - A retrospective study was made from the records of 100 consecutive patients who had closure of a temporary transverse colostomy at Addenbrooke's Hospital, Cambridge, between 1969 and 1982. Thirtyeight colostomies were closed early, approximately 2 weeks after the initial bowel resection and during the same hospital admission. The closure technique in the majority of cases involved resecting the bowel ends and performing a single layer anastomosis with interrupted Supramid. Statistically there was no difference in overall or individual complications, such as faecal fistulae and wound infections, in the early compared with the late colostomy closure group. The length of stay in hospital after closure was almost identical in both groups. This is true despite a higher proportion of operations in the early closure group being performed by less experienced surgeons. Early closure of a temporary colostomy is a relatively safe procedure and has obvious advantages for rehabilitation. PMID- 6486668 TI - The surgical anatomy of the marginal artery. AB - Two examples of the clinical importance of the marginal artery are given. They should alert the colorectal surgeon to the possibility of anatomical abnormalities leading to major complications in this surgical field. PMID- 6486669 TI - A technique for rubber band ligation of internal haemorrhoids. PMID- 6486670 TI - Vertical banded gastroplasty: operation for morbid obesity. AB - Modern stapling equipment makes it possible to perform the vertical banded gastroplasty without major technical difficulties. Follow-up to date confirms its efficacy as a weight reducing procedure in the morbidly obese. PMID- 6486671 TI - A haematuria diagnostic service in a district general hospital. AB - Four years experience of a haematuria diagnostic service in a District General Hospital, comprising 215 patients, has identified 42 new cases of bladder cancer, 5 of renal cell cancer and 3 of renal pelvis cancer. Urine and blood tests were non-contributory in their diagnosis but intravenous urography was diagnostic in the majority. The period of time between presentation to the general practitioner and treatment of the cancer has been reduced to less than the time normally spent on the Out-Patient waiting list. PMID- 6486672 TI - Incisional hernia and post thrombotic syndrome--an observed association. PMID- 6486673 TI - The cross-sectional shape and circumference of the human trachea. AB - To design a large-volume, low-pressure cuff it is essential to take into consideration cross-sectional shape and circumference of human trachea. Two hundred adult tracheas were dissected and autopsy specimens examined. Cross sectional tracheal shapes were studied and their circumference measured. There was a definite correlation between sex and the tracheal shapes studied. Forty five per cent of female tracheas were elliptical in shape and 38% were C shaped. The most common cross-sectional tracheal shapes in specimens obtained from male patients were the U shape (33%) and the elliptical (21%). Mean female tracheal circumference was 57.65 mm and mean male tracheal circumference was 68.75 mm. The implications of these findings are discussed and recommendations are made regarding cuff circumference and diameter. PMID- 6486674 TI - Experience with barbiturate therapy for cerebral protection during carotid endarterectomy. AB - Carotid endarterectomy was performed 28 times in 27 patients. All but one patient had symptomatic carotid artery disease, 59% had bilateral disease and 59% had associated intracranial disease. Barbiturate therapy was used as a means of cerebral protection during carotid artery cross-clamping. Neurological deficit occurred in two patients, being permanent in one patient (3.5%); both patients had bilateral carotid and intracranial disease and both had carotid stump pressures greater than 55 mmHg. No morbidity could be attributed to barbiturate usage. PMID- 6486675 TI - The pattern of postoperative analgesic administration in non-English speaking Asian women following caesarean section. AB - A survey of postoperative analgesic administration to non-English speaking Asian women following Caesarean section has shown significant differences when compared to English speaking Caucasian women. The main differences demonstrated were that analgesia was utilised for a shorter period (mean of 16 hours) and that a smaller number of doses were given to the Asian group. PMID- 6486676 TI - International standards for surgical implants. AB - Publication of international standards for surgical implants increases as does concern for quality assurance in their manufacture. The activities of ISO/TC150 are outlined. PMID- 6486677 TI - Scheduling in the operating theatre. AB - The effect of scheduling on the use of operating theatre time has been studied. Scheduling involved determining the average length of common operations and fitting them into the calculated available operating time. The technique has been shown to reduce significantly the variation in length of operating sessions, and it ensures the best use of available operating time. PMID- 6486678 TI - Knotted drainage tube: practical points in its prevention. PMID- 6486679 TI - Part-time higher professional training: an analysis of content. PMID- 6486680 TI - The management of acute colonic diverticulitis with suppurative peritonitis. PMID- 6486681 TI - [Tumorigenic activity, in mice, of a cell line from a goat sinus tumor]. PMID- 6486682 TI - Metabolic consequences of induced hypoxia in newborn lambs. AB - Metabolic and nutritional consequences of making newborn lambs breath a 5% oxygen, 95% nitrogen atmosphere during six hours after birth were studied. Blood samples were collected at the end of the treatment and two hours after every meal given 6 h 30, 12 h 30, 18 h 30 and 24 h 30 after birth. Rectal temperature, blood pH, packed cell volume and plasmatic glucose, lactate, triglycerides, non esterified fatty acids, inorganic phosphorus, uric acid and iron were measured. Comparison with control lambs established that all these parameters were strongly altered except packed cell volume and non-esterified fatty acids disturbed to a lesser extent. Nevertheless, in the last sample, taken after 26 h 30 of aerial life, no significant differences remained detectable, concerning the parameters quoted above. The exception was triglyceridemia, which was still higher in treated lambs, and could be due to lack of utilization of alimentary lipids. PMID- 6486683 TI - [Serum enzymology in the goat: the usual levels of CPK, LDH, ICDH and SDH]. AB - Using about 100 blood samples of dairy goats selected for their high level of milk production, the authors determined the enzymic activities of CPK, LDH, ICDH and SDH. The limits of the practical values of these parameters are (expressed in IU/l): CPK: 14-62; LDH pregnancy: 217-417, lactation: 300-586; ICDH: 2.3-14.8; SDH: 2.6-11.6. PMID- 6486684 TI - [Effect of temperature and humidity on gastrointestinal strongyle infestation of bovine pastures]. AB - Two pastures, one grazed by heifers and one by cows were sampled for larval counts from August to November 1982 at different intervals of time from seven days to half an hour. Ostertagia sp. and Cooperia sp. were highly dominant. The population level was higher in heifer pasture, but maximal and minimal numbers were observed the same days on the two pastures, close to and at a distance from the cow-pats. During the four months, numbers of larvae were higher during rainy weeks. The rain mainly had an effect on Ostertagia populations, the minimum temperature mainly on Cooperia. In more than 50% of observations made on two consecutive days, the number of larvae one day was less than twice (or half) of those observed the preceeding day. In one case out of ten this number was more than four times as great. This variation from one day to the other was correlated to the temperature magnitude. The rainfall had a positive or negative effect depending on its intensity. During the day-time, more larvae were observed in the morning, the population decreasing with air humidity. During these summer and autumn periods, climatic factors had effects mainly on larval migrations: lateral migrations from cow-pats to herbage, vertical migrations on grass. PMID- 6486685 TI - [Experimental infection of sheep with Salmonella abortus ovis: effect of the gestational stage]. AB - An inoculum of 1 X 10(10) S. abortus ovis was administered subcutaneously to non pregnant Pre-Alpine X Merino ewes (group 1 : 37 days before fecundation) and to pregnant ewes (groups 2 and 3: 33 or 89 days after fecundation). The proportion of abortions to gestations in each group was 0/9, 1/9, 8/10 respectively. In group 2, there was only one abortion which occurred 64 days after inoculation. In group 3, the average time between inoculation and abortion was 19 days; three ewes died of an S. abortus ovis septicaemia after abortion and placental retention. No S. abortus ovis was isolated from the ewes' rectal swabs or from the carcasses 3 to 9 months after inoculation or abortion. The kinetics of responses in antibodies fixing the complement or agglutinating the O or H antigens were comparable in all groups; after reaching a maximum in about one week the serological titers decreased rapidly. The clinical and bacteriological results show a relationship exists between the physiological state of the ewes' genital organs and the probability of experimentally obtaining an S. abortus ovis abortive infection. PMID- 6486686 TI - Welfare of confined sows. A roundtable in the CEC programme of coordination of research on animal pathology. St-Gilles, France, 26-27 May 1983. PMID- 6486687 TI - Effect of confinement, climatic conditions and litter parity on the seasonal variations of the fertility rate and prolificacy. AB - Prolificacy and fertility in sows were analysed according to the month of service, the regional locations of the herd, the type of building (confinement or open front) and the parity of the sows. Fertility varied throughout the year and was lowest in August, September and October. The regional location of the herd had little or no effect. Primiparous sows were less fertile than multiparous sows, regardless of the type of building. Results for closed buildings were better than those for semi-outdoor quarters. This difference was maximum (8%) for matings in August, September and October. Prolificacy also varied with season but was relatively unaffected by the type of housing. The largest litters were conceived in summer when the ovulation rate was highest. The extend of seasonal variation in prolificacy was higher in Brittany than in the South of France in which hot climatic conditions are more frequent in summer. The month of service and the type of housing appear to be the most important factors conditioning the annual productivity of sows. PMID- 6486688 TI - Improvement of piglet survival rate in relation to farrowing systems and conditions. AB - Two experiments were carried out in the same farrowing house with the aim of comparing the efficiency of two types of floors and in order to estimate the effect of bedding material on the performance of newborn piglets. In addition, the productivity data of our sow herd as well as those of the national herd, were analysed in order to study the effect of the farrowing system and piglet maturity at birth on the survival rate of the newborn. The main results clearly show the detrimental effect on piglet survival of using slatted floors at farrowing. Furthermore the mode of sow tethering during parturition directly affects the piglets losses between birth and weaning, i.e. 2.03 piglets/litter for tethered sows, 2.17 for caged sows, 2.30 piglets when using farrowing rails. Use of a bedding material has a positive influence on the survival rate: 83.1% for straw, 78.5% for shredded paper versus 68.5% in the case of an insulated concrete floor. Rearing of newborn piglets in a cold environment leads to a drop in the rectal temperature, a poor body carbohydrate utilization and a decrease in colostrum intake. This results in a poor immunity, a low survival rate and a growth rate depression. Search for optimal environmental conditions for the newborn piglet is more important than for the sow. An adequate management of farrowing houses is recommended involving tethering of the sows, extra heating of the pens when the piglets are born and during their first 3 weeks of life. PMID- 6486689 TI - Effect of housing system on sow productivity. AB - Three separate trials are described, each involving sows ranging in parity from first to tenth. In the first trial sows were penned either in individual stalls 2.1 m X 0.6 m or individually tethered in stalls 0.6 m wide, from mating to day 110 of pregnancy. Both groups were on insulated concrete floors partially slatted. Results indicate no difference in percentage of pigs born dead or survival to weaning or in post-weaning performance of sows. In the second trial sows were kept in farrowing pens 2.4 m X 1.6 m with the sow restrained in a farrowing crate 0.6 m wide or tethered by the neck in a partial crate 0.6 m wide from day 110 of pregnancy to weaning at 30 days of age. All pens were of insulated concrete without bedding with the rear 0.6 m slatted with cast iron slats. Results indicate no effect of pen type on percentage of pigs born dead, survival to weaning or in post-weaning sow performance. In the third trial sows were housed in groups of 4 on an insulated concrete floor without bedding or in individual stalls after weaning. Boars were present in adjoining pens in both cases. Group housed animals had poorer performance due to a combination of failure to show oestrus, lower conception ratio and loss through injuries due to fighting. Those that did show oestrus had the same weaning to oestrus period as stalled sows and produced slightly (but not significantly) bigger litters. PMID- 6486690 TI - Tethered versus loose sows: ethological observations and measures of productivity: II. Production results. AB - Production results as well as behaviour were registered in an experiment with tethered and loose housed sows. In two of the experimental groups the sows were neck-tethered during pregnancy. In one of these two groups the sows were also neck-tethered in a farrowing crate during farrowing and lactation (exp. group TT), while in the other group they were loose (exp. group TL). In the last two of the four experimental groups the sows were loose in social groups of 2 to 5 during pregnancy. In one of these two groups the sows were also loose during farrowing and lactation (exp. group LL), while in the other group they were neck tethered in a farrowing crate (exp. group LT). There were no statistically significant differences between the four groups in number of born alive or stillborn. Group LT, where the sows were tethered in the farrowing and lactation period only, had a significantly higher number of sows needing birth assistance and a tendency towards a higher incidence of MMA complex than the other three groups. No significant differences between the four groups were found in either number of pigs per litter at 7.21 and 56 days (weaning), or total number of dead or percentage dead pigs in the lactation period, or in number of traumatic pigs or pigs with arthritis. The group LT, however, had a strong tendency towards lower weaning weight per litter than the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486691 TI - Diseases affecting confined sows. Data from epidemiological observations. AB - Having described certain aspects of confinement in modern pig reproductive farms, the writers give a list of the main diseases in sows. Urinary problems are the most frequent. They can be linked to certain aspects of confinement, as can also be locomotory or respiratory troubles. This is not sufficient, however, to condemn modern conditions in reproductive pig farms but appropriate adjustments can be made to associate good health in the animals and satisfactory performances. The advantage of studies on the behaviour of sows is stressed, notably within the framework of ecopathological studies. PMID- 6486692 TI - Immunity changes in confined animals: a route to disease? AB - An intriguing and important biological question is how the immune system is subject to regulation by exogenous factors. In the mouse system, our laboratory has demonstrated that a wide variety of environmental stimuli, such as heat, cold, short-term restraint and conditioned-taste aversions, affect cell-mediated immune events in vivo. The reduction in cell-mediated immunity that is caused by restraint can be abolished by adrenalectomy or treatment with an inhibitor of corticosterone biosynthesis. We have therefore examined the effect of a short term restraint stressor on the immune system of pigs. Five-to-eight-week-old-pigs were restrained by placing them in an expanded-metal box for 2 h each day for 3 consecutive days. Restraint caused a significant increase in serum cortisol. Preliminary evidence indicates that restraint significantly reduced size of the thymus gland from 0.14% to 0.10% of body weight and also significantly reduced in vivo phytohemagglutinin-stimulated, cell-mediated reactions by 25%. Addition of cortisol at a concentration of 130 ng/ml to phytohemagglutinin and concanavalin A stimulated porcine lymphocytes in vitro reduced mitogenesis of splenocytes, peripheral blood lymphocytes and thymocytes. Although these data reflect changes in immune function caused by an acute environmental stressor in vivo and by cortisol in vitro, research from another laboratory indicates that longer-term restriction of pigs with tethers and farrowing crates can also decrease immune events.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6486693 TI - Injuries in confined sows. Incidence and relation with behaviour. AB - A survey has been carried out to determine if welfare relevant differences could be found between the various systems of individual housing (stalls and tethering by neck collar, neck harness and shoulder girth) for dry sows. The pattern of lesions on the integument has been used as an indicator for well-being. The set up of this way of assessing well-being, called the Ekesbo Method, has been described briefly. Except for neck collar tethering, the sows did not show major differences in lesion level. Neck collar tethering is therefore strongly discouraged. The other systems are, to a large extent, comparable. Yet a number of system dependent differences do occur. Initial adaptation to tethering can be a problem. Also, when the size of the system is not in good harmony with the body size, the number of lesions increased. Shoulder girth, especially in combination with fixing to the partition, slightly hampered the sows when getting up. Also floor design had an influence on the lesion pattern. Poor quality slats induced an increase in the number of lesions. Between full concrete floors and good quality slats no difference could be demonstrated. The Ekesbo Method seems to be a useful way to assess well-being in different environments. PMID- 6486694 TI - The welfare of confined sows: physiological, behavioural and production responses to contrasting housing systems and handler attitudes. AB - Experiments on individual and group housing, and the effects of man-animal interactions on the physiological, behavioural, productive and reproductive responses of pigs demonstrate first, that chronic stress can be measured in the pig, and second, the interactive nature of these responses. The effects of housing pigs in tethers, pairs, a group indoors, a yard and a paddock outdoors on their behaviour and physiology determined at intervals over 12 months showed that pigs housed in pairs exhibited a chronic stress response, evidenced by altered adrenal function. Behaviourally these pigs spent more time lying alone than pigs in other treatments, and there was a significant regression between lying alone behaviour and free corticosteroid levels. There was a similarity between treatments in the occurrences of active, inactive and resting behaviours and of various active behaviours. While the occurrence of inappropriate behaviours such as champing, biting and excessive manipulation of drinkers was generally low, it was higher in pigs housed indoors, particularly the tether and pair treatments. A comparison of the two most contrasting environments (tethers and paddock) showed no clear welfare advantage to housing dry, adult pigs in a more extensive (natural) environment. PMID- 6486695 TI - Serum cortisol concentrations in gilts and sows housed in tether stalls, gestation stalls and individual pens. AB - Three experiments were conducted to determine whether housing in tether stalls, gestation stalls or individual pens imposes a stress upon gilts and sows. Changes in serum cortisol concentrations were used as the indicator for stress. In the first experiment, gilts were placed in tether stalls and individual pens to determine cortisol concentrations after tethering and to see if this response was different from gilts that were previously tethered for two weeks. In the second experiment, gilts were tethered in order to determine if penning in tether stalls altered the circadian rhythm of cortisol. In the third experiment, breeding sows were placed in tether stalls, gestation stalls or individual pens to determine if a ten-hour profile of cortisol concentrations were altered and if such housing affected a sow's response to transfer to farrowing crates. The results indicate that the initial response to tethering varied among gilts and sows and this variation appeared to be due to previous penning and human handling experiences. When tethering was stressful, acclimation required up to four days. However, once acclimated, tethering resulted in higher morning concentrations which may be associated with the greater activity that occurs at this time. Housing in tether stalls, gestation stalls or individual pens was not a stress for breeding sows and did not alter sows' responses to transfer into the farrowing crate. PMID- 6486696 TI - Tethered versus loose sows: ethological observations and measures of productivity. I. Ethological observations during pregnancy and farrowing. AB - Ethological parameters were recorded from sows housed in the same room and allocated to four experimental groups: sows that were tethered during pregnancy as well as from one week before farrowing to 8 weeks after; sows that were tethered during pregnancy but were loose during farrowing and lactation; sows that were loose during pregnancy in social groups of 2-5 animals and tethered during farrowing and lactation, and sows that were loose during pregnancy as in group 3 and also loose during farrowing and lactation. By using a timelapse-film technique it was found that pregnant sows in all groups had a similar diurnal rhythm with peaks around feeding times. The animals lay down for 20 h or more per day, and their activity was reduced due to tethering during the pregnancy period itself and due to preceding periods of tethering during farrowing and lactation. With increasing environmental temperature the loose sows increased the time spent lying on the side at the expense of lying on the belly. The tethered sows, however, showed no such change, but contrary to the loose sows they increased their activity. Observations around feeding time revealed that the tethered sows showed more aggression and fewer non aggressive social elements than the loose sows. Additionally their eating time was longer. Rubbing the neck was less and lying unquietly more frequent in tethered sows. Finally tethering during pregnancy reduced exploration directed towards straw and floor and increased stereotyped bar-biting and chain-nippling. With increasing temperature rubbing behaviour and drinking increased in tethered but not in loose sows. Timelapse videorecording during the last 48 h prior to- and until the end of farrowing revealed that sows in all groups, no matter whether they were loose or tethered, showed a characteristical increase in nestbuilding activity until about 12-6 h before first piglet was born. Tethering in any period (pregnancy and/or farrowing lactation) resulted in an increased farrowing time by approximately 100 min. PMID- 6486697 TI - A means to assess nursing efficiency in the pig: the study of the milk ejection reflex. AB - We have recently devised a method for recording the intramammary pressure in conscious lactating sows. This technique allows for unambiguous detection of milk ejection, and permits correlation with hormone release and the behaviour of the sows and their piglets. Each milk ejection is characterized by an abrupt rise in intramammary pressure lasting 8-40 sec only. This is preceded 15-30 before by a rise in plasma concentrations of the hormone oxytocin. Milk ejections only occurred when the sow was nursing her litter, lying on her side and making her teats available. She usually grunted in a rhythmic manner, with a sharp increase in the frequency of grunts about 23 sec before milk ejection. Grunting ceased within 1 min thereafter. The whole litter had to be suckling to obtain a milk ejection, which occurred about 2-4 min after the onset of the initial phase of massage of the udders, and was coincident with a brief period of quiet suckling. Milk ejections occurred about every 45 min, i.e. only once per suckling period, eventhough the period could last over 15 min. They never occurred if the mother was not nursing, or if the piglets attempted to suckle too soon after a milk ejection. Out of 144 periods of suckling, over 20% of failures to eject milk were observed, in which case there was no oxytocin release in blood. Some "incomplete" sucklings happened with no apparent reasons, but their incidence was very high when the sow appeared to be disturbed. PMID- 6486698 TI - A case of "reversed cannibalism": the piglets damaging the sow. AB - Sows introduced to a new housing system containing farrowing pens with slatted floor showed increased occurrence of lesions of the vulvar region, caused by the piglets during the later stages of the lactation period. An investigation was undertaken in which the activity of the piglets, particularly rooting and investigatory behavior, was examined and compared to that of piglets kept on straw. Although the occurrence of vulvar lesions disappeared spontaneously before the conduction of the investigation, the results revealed that piglets on slatted floor spent significantly more time chewing on inappropriate objects such as other group members or the vulva of the sow, whereas the rooting and investigatory behavior of piglets raised on straw was almost exclusively directed towards the straw. The results confirm previous observations that piglets living in a relatively poor environment show a greater tendency to direct their activity towards inappropriate objects. If the housing system is otherwise healthy, the change in behavioral activity remains insignificant. If, however, other minor disturbances occur in the system, in the present case clinically insignificant lesions on the vulva of the sow caused by the new slatted floor, aggravation of the lesions can occur due to this change in piglet activity. PMID- 6486699 TI - How to delineate the sow's welfare needs. AB - The way in which farm animal welfare is appraised at present, as exemplified by the UK codes of welfare, suffers three faults; firstly welfare is not systematically analysed, secondly welfare requirements are described in little detail and thirdly there is no published technical justification for the recommendations. An approach which can overcome all of these problems is outlined in the paper. This approach sets out to describe sow welfare as the sow perceives it and, then to translate each welfare element into quantifiable variables with defined boundaries of welfare acceptability. Thirteen elements of welfare requirements are proposed for domestic sows. It is concluded that such an approach should improve the depth in which we investigate welfare requirements and give codes of recommendations more consistency over time and greater longevity. PMID- 6486700 TI - The identification of behavioural key features and their incorporation into a housing design for pigs. AB - An ethological approach is presented which aims at meeting the welfare requirements of domestic pigs by satisfying their motivations and behavioural needs. Based on the causation of behaviour, welfare may be defined by motivational balance and behavioural needs by environmental and behavioural key features that are essential for the performance of behavioural sequences. Ethological minimum requirements were determined from observations of adult and juvenile large-white pigs in semi-natural enclosures, in increasingly restricted and in conventional conditions. Obligatory features in the environment which consistently enabled the pigs to perform their frequent or regular sequences of behaviour were the design factors for the enriched pens. Each is composed of a nesting, an activity and a rooting area and includes a corridor connecting 4 neighbouring pens. Such an unit houses 4 familiar sows with their fattening offspring, a boar and replacements. Basic features of social structure of the outdoor reference groups were maintained in such pig families. The social contacts in stable family groups enhance the synchrony of heats and lactational oestrus. Thus 2.3 litters/year may be obtained if sows are well fed before mating. As there is no weaning check, the growers reach bacon weight for market around 155 days of age. The system shows, what basic ethological research may contribute to reach practical housing conditions which meet the main behavioural requirements of a species. PMID- 6486701 TI - An environmental model for sows: materializing physical and behavioural needs. AB - Animals experience welfare when their behavioural and physical needs are fulfilled. To enable an animal to show all kinds of behavioural patterns, the environment has to meet certain requirements. Satisfying physical needs generally results in good health. This also implies certain environmental characteristics. Behavioural and physical needs can therefore be translated into environmental characteristics, which constitute an environmental model. When it can be decided to what extent certain needs are essential for the animals, the necessity that certain environmental provisions are available within the animals environment can be derived. Essential needs correspond with provisions. These provisions should, from an animal welfare point of view, be available and together constitute a minimum environmental model. In this paper an attempt is made to draw up an environmental model for sows. Provisions are such that the occurrence of aberrations in behaviour and health should, to a large extent, be prevented. Therefore a lying area, space to walk, a feeding place, food, a dunging area, and stimuli for exploration are included in the model. Climatic conditions are favourable, and social behaviour, comfort behaviour and exploratory behaviour can be carried out. By comparing existing housing systems with this model, it is easy to find out whether minimal welfare requirements are met, and if improvements are thought to be necessary and in what direction these should be sought. PMID- 6486702 TI - Plasma catecholamines: experience with a single-isotope radioenzymatic assay. AB - The performance of a rapid and sensitive single-isotope radioenzymatic assay for plasma catecholamines, in a routine clinical chemistry laboratory, is reported and discussed. The value of plasma adrenaline and noradrenaline as tumour markers in the diagnosis, tumour localisation, and post-operative follow-up of four patients with phaeochromocytoma is emphasised. PMID- 6486703 TI - Preparation of a calibration material for specific protein assay (SPS-01). PMID- 6486704 TI - Blood pressure and chemistry: some correlations and apparent correlations. AB - The reported correlation between plasma calcium and blood pressure has been investigated in 412 young men and women. In this sample, it seemed to be due to a stronger correlation between blood pressure and plasma albumin. Blood pressures were also significantly correlated with plasma high-density lipoprotein in men and with plasma uric acid in women. PMID- 6486705 TI - Iron deficiency in a Northern Thai population: the effects of iron supplements studied by means of plasma ferritin estimations. AB - Iron deficiency is a common problem, particularly in developing countries, but traditional laboratory methods of detecting this condition are unreliable. The prevalence of iron deficiency in a Northern Thai population (pre-school, school children, adult women) has been assessed by means of plasma ferritin concentrations. The results were compared with prevalences based on blood haemoglobin concentrations. Estimations of prevalences based on plasma ferritin values were 10-24% in non-vegetarian and 49-71% in vegetarian groups, whilst those based on blood haemoglobin were 11-21% (non-vegetarian) and 24-50% (vegetarian). Dietary supplementation with iron produced dramatic rises in plasma ferritin in all of the groups studied. The effects on blood haemoglobin concentration and haematocrit were less marked. These results highlight the extent of iron deficiency in a Thai population and demonstrate the sensitivity of plasma ferritin as a test for detecting this condition and assessing the response to dietary supplementation. PMID- 6486706 TI - A monoclonal antibody-based immunoradiometric assay for h-LH. AB - An immunoradiometric assay (IRMA) for h-LH based upon an 125I-labelled mouse monoclonal antibody (MAb) to h-LH with an effective equilibrium constant of 5.8 X 10(9) l/mol is described. A total incubation time of 3 h at room temperature was required, separation by means of the sucrose layering procedure took a further 1 h and counting times were 1 min/tube. Using the first IRP for h-LH (prep. 68/40) as standard, the detection limit was 0.1 U/l serum and the within-assay CV for duplicate determinations was less than 10% over the range 1-280 U/l and less than 3% at 10-100 U/l. The epitope, with which the MAb reacted, shared structures, on the alpha- and beta-subunits of LH since the assay responded to the intact hormone, but not to either of the subunits. Specificity was greater than 100 000:1 for h-LH vs. h-FSH and greater than 10 000:1 for h-LH vs. h-TSH. h-CG and h LH were approximately equipotent. The results on 604 unselected samples were generally very similar to those found by RIA except at levels below 2 U/l for which the IRMA regularly gave lower results suggesting relative freedom from non specific serum effects. The new assay, based upon potentially limitless supplies of a very stable reagent offers advantages of speed, sensitivity, range, and precision over conventional RIA. The specificity appears to be excellent. Although there are marginally more steps the total staff involvement is less than with conventional methods employing centrifugation. PMID- 6486707 TI - Sensitive and specific morphine radioimmunoassay with iodine label: pharmacokinetics of morphine in man after intravenous administration. AB - Analysis of morphine in plasma by radioimmunoassay is complicated by interference from morphine metabolites, particularly morphine-3-glucuronide. This interference makes radioimmunoassay a poor technique to study the pharmacokinetics of morphine in man. The method described here is one which uses commercially available anti morphine antiserum and separating reagent with a simply prepared iodinated morphine derivative. Cross-reactivity to morphine metabolites is negligible and the method correlates well with HPLC. Results obtained for pharmacokinetic parameters after intravenous administration in man are in agreement with published data using GLC or HPLC. The method is inexpensive, simple and rapid; choice of a different antiserum could allow the method to be used for screening for drugs of abuse such as morphine, diamorphine, codeine and dihydrocodeine. PMID- 6486708 TI - Classification of hyperlipoproteinaemias by computer interpretation. AB - We have developed a microcomputer-based system for the classification and interpretative reporting of lipoprotein electrophoretic data. The decision logic takes into consideration the sex and age of the subject, the concentration of total cholesterol and triglyceride, the appearance of the serum after standing at 4 degrees C for 18 h or more and the type of lipoprotein abnormality observed from polyacrylamide disc gel electrophoresis to produce a phenotype according to the classification developed by Fredrickson and co-workers. As the hyperlipoproteinaemia may be primary or secondary to a number of associated conditions, these are included in the report with the six possible phenotypes. A high correlation (98.7%) between manual and computer interpretation was found for 152 consecutive cases of lipoprotein phenotyping. PMID- 6486709 TI - Addition of dehormonized, deproteinized plasma to glucagon RIA increases the steepness and sensitivity of standard curves. PMID- 6486710 TI - Which amniotic fluid lung function tests and who should do them? PMID- 6486711 TI - Validity of the Mellits and Cheek method for body-fat estimation in relation to menstrual cycle status in athletes and non-athletes below 22 per cent fat. AB - The present experiment tested the hypothesis that 22% body fat based on the Mellits and Cheek (1970) regression equation is a minimum or 'trigger' level of fatness required to maintain regularity of menstrual cycles. The validity of the regression equation was cross-validated against densitometric estimates of body fat in 30 athletes (track, gymnastic, crew) and 30 non-athletes who were below 22% fat. For the total sample, the validity correlation was r = 0.47 between body fat (density) and body fat (regression equation); it was r = 0.75 for athletes and r = 0.47 for non-athletes. For all subjects, 60% had regular menses, 27% were oligomenorrheic and 13% were amenorrheic. The lowest body fat (density) was 12.8% for an athlete with a regular cycle and 12.2% for an oligomenorrheic athlete. The results show that: the Mellits and Cheek (1970) height-weight based regression equation to determine fatness is not valid for women below 22% fat, and 13% body fat (not 22%), should be considered an upper-bound estimate of a minimum level of fatness associated with normal ovulatory cycles. PMID- 6486712 TI - Velocity and acceleration of height growth using kernel estimation. AB - A method is introduced for estimating acceleration, velocity and distance of longitudinal growth curves and it is illustrated by analysing human height growth. This approach, called kernel estimation, belongs to the class of smoothing methods and does not assume an a priori fixed functional model, and not even that one and the same model is applicable for all children. The examples presented show that acceleration curves might allow a better quantification of the mid-growth spurt (MS) and a more differentiated analysis of the pubertal spurt (PS). Accelerations are prone to follow random variations present in the data, and parameters defined in terms of acceleration are, therefore, validated by a comparison with parameters defined in terms of velocity. Our non-parametric curve-fitting approach is also compared with parametric fitting via a model suggested by Preece and Baines (1978). PMID- 6486713 TI - Tensor biometrics for changes in cranial shape. AB - D'Arcy Thompson's method of Cartesian transformations can be adapted to the biometric study of group differences and trends in shape. The key to this extension is the symmetric tensor, a mathematical representation of the linear deformation taking one triangle onto another. These tensors may easily be computed from data that come in the form of Cartesian coordinates of homologous landmarks, such as are customary in roentgenographic cephalometrics. This article shows how the tensors make possible the rigorous statistical analysis of populations of shapes without requiring the specification of particular shape measures in advance. Instead, the findings of a study include the extraction of particular shape measures most clearly manifesting the group difference or treatment effect under study. Only conventional multivariate statistical techniques, such as Hotelling's T2, are involved. Configurations of many landmarks can be analysed via the display of their mean difference as a biorthogonal grid pair, perusal of which leads to the selection of triangles of landmarks for more rigorous analysis. The techniques are exemplified in two cephalometric studies: the description and prediction of normal craniofacial growth, and a comparison of the craniofacial deformities associated with Apert's and Crouzon's syndromes. PMID- 6486714 TI - Family resemblance for normal pulmonary function. AB - Family resemblance for normal pulmonary function as measured by forced vital capacity and one second forced expiration volume is assessed using a path analysis model which incorporates sex differences in transmissibility of the phenotype from parents to offspring as well as in the effect of a correlated shared-sibling environment. Application of this model, called XTAU, to familial correlations indicates that transmissible factors, which may be genetic or cultural, accounts for 20-30% of the variation in these measures. Further, a pronounced same-sex-specific effect of the sibling environment is indicated which enhanced the observed correlation between same-sex siblings and diminished the observed correlation between opposite-sex siblings. These results are consistent with findings of twin studies of pulmonary function indicating high heritability for both FVC and FEV1.0. In addition, the complex multifactorial model of family resemblance for normal pulmonary function is shown to have implications for specifying causal models of pulmonary disorders such as asthma, bronchitis, allergic rhinitis, and chronic obstructive pulmonary disease. PMID- 6486715 TI - Changing isonymic relationships in Fylingdales parish, North Yorkshire, 1841 1881. AB - Lasker's coefficient of relationship by isonymy was used to analyse surname data taken from the 1841-1881 Census returns from Fylingdales parish, North Yorkshire. Relationships were measured between each of the occupational groups: mariner, fisherman, shipowner, farmer, agricultural labourer, alum works labourer and 'other'--with and between census years in each decade. Broadly, there is a clear differentiation of the population genetic structure in the parish over this whole period, and distinct clusters of 'maritime', 'agricultural' and 'other' jobs can be identified. In finer detail, the gradual breakdown of this pattern of genetic differentiation can be observed, as the fishing industry declined, the alum works closed, and as new farming families moved in to the parish. PMID- 6486716 TI - Quantitative estimation of serum proteins in newborn and their mothers. AB - The present study investigates the effects of factors such as birthweight, gestation and infants' sex on serum protein levels of newborn and their mothers. The mean concentration of serum proteins in newborn and their mothers was found to be similar. The levels of albumin were high with a corresponding decrease in the levels of globulins in infants which may be related to placental transfer of these molecules. A study of the relationship between birthweight and levels of maternal serum protein fractions revealed a positive correlation of the maternal albumin and a negative correlation of the maternal gamma component with the birthweight of infants. Premature infants showed higher levels of serum proteins than full-term infants, which may be due to an increased rate of degradation in the latter group. A decrease in the levels of serum proteins was observed in male infants and their mothers. PMID- 6486717 TI - Age at menarche in Sri Lankan Tamil girls in Jaffna. AB - Using the status-quo method and Probit analysis, the median age at menarche of Sri Lankan Tamil girls (N = 333) from a middle socio-economic group was estimated as 13.78 +/- 0.07 years with a standard deviation of 1.01 years. This is about one year later than the median for the urban and about six months earlier than the median for the rural girls of Sri Lanka of the 1950s. However, this median age estimate agrees well with the results of an urban Madras sample. The reliability of the present finding is discussed. PMID- 6486718 TI - [The effect of dietary lipids on microsomal electron transport proteins in the rat]. AB - Feeding a fat-free diet for 3 weeks decreases the activity of ascorbate:ferricytochrome b5 oxidoreductase and increases NADH:monodehydroascorbate oxidoreductase in rat liver microsomes. Contrary to Vmax, the apparent Km for monodehydroascorbate of the first enzyme was not depressed. The activity of ascorbate:ferricytochrome b5 oxidoreductase is increased by incubation with microsomal lipid extract, thus showing that the loss of activity results from dietary-induced changes of microsomal fatty acid composition. PMID- 6486719 TI - Metabolic balance of the ovine fetus during the fed and fasted states. AB - The present study was performed in order to quantitate the uptake and excretion of a number of metabolic substrates by the sheep uterus as well as the fetus during the fed and fasted states within the same animals. 5 dated Suffolk sheep were studied initially at least 7 days after surgical placement of catheters in the fetal umbilical artery and vein, as well as the uterine veins and maternal artery. During the fed state and after 5 days of complete maternal fasting, measurements were made of uterine and umbilical blood flow by the steady-state antipyrine method, and the concentrations of whole blood glucose, oxygen, ammonia, 23 amino acids and plasma urea nitrogen were assessed. The results indicate that free amino acids and glucose comprise the major substrates required by the fetal lamb during both the fed and fasted states. While a number of amino acids changed in concentration in both the maternal and fetal circulations, few amino acids demonstrated a significant change in uptake in either the umbilical or uterine circulations. Similarly, no changes were observed in the uptake of oxygen by either the fetus or the uterus, while glucose consumption by the fetus decreased substantially with a concomitant increase in urea production. Consumption of both glucose and oxygen by the uteroplacenta remained unchanged during fasting. Leucine is one of several amino acids which is metabolized to a significant extent within the uteroplacenta, and theoretically may play a role in modulating glucose metabolism within the placenta and fetus. PMID- 6486720 TI - Albumin-synthesizing capacity of hepatocytes isolated from rats fed diets differing in protein and energy content. AB - The rate of albumin synthesis has been estimated in hepatocytes prepared from groups of rats maintained on diets of different protein content. These diets were fed either ad libitum or at 50% restriction of ad libitum consumption. The data show that the physiological capacity of hepatocytes to synthesize albumin varies with dietary intake. Albumin production by cells prepared from animals fed ad libitum was directly related to the protein energy:total energy ratio of the food. Restricting consumption of the control diet to 50% of ad libitum intake did not reduce albumin synthesis rates, and similar restriction of the low protein diets ameliorated some of the depression in albumin production observed in hepatocytes isolated from animals fed the same diets ad libitum. The results are discussed with reference to the occurrence of hypoalbuminaemia in children with protein-energy malnutrition. PMID- 6486721 TI - Studies on the in vivo utilisation and the in vitro enzymatic reduction of methionine sulphoxide in rats and rat tissues. AB - The aim of the present study was to gather information on the utilisation of methionine sulphoxide as a source of methionine in the rat, and to find out where and to what extent reduction of methionine sulphoxide takes place. Carcass analysis of rats fed methionine sulphoxide and cystine as the only sulphur containing amino acids showed that methionine had been formed. This is taken as evidence for reduction and utilisation of methionine sulphoxide in rats. Enzymatic reduction of methionine sulphoxide in different rat tissues was not detected using various reducing agents and assay conditions. Bacteria were found to reduce methionine sulphoxide, with eventual secretion of methionine into the medium. The reduction was stereospecific as only L-methionine-l-sulphoxide was reduced. Weight gain and content of methionine sulphoxide in blood plasma and intestine were similar in rats fed in the presence or absence of antibiotics, indicating that bacteria in the intestine were not responsible for the utilisation of methionine sulphoxide in the rat. PMID- 6486722 TI - Relative bioactivity of alpha- and gamma-tocopherol calculated from respiration parameters in rat liver mitochondria. AB - In experiments with male wistar rats the influence of dl-alpha-tocopherol as well as dl-gamma-tocopherol on both the respiration of liver mitochondria and membrane lipid peroxidation has been investigated. For a test period of 8 weeks the animals were fed isoenergetic diets containing either no vitamin E or 46 mg d alpha-tocopherol equivalents/kg diet as dl-alpha-tocopherol (60 ppm) or dl-gamma tocopherol (480 ppm). The diets contained 6% of a synthetic triglyceride mixture rich in polyunsaturated fatty acids (about 60%). The measurements of the P/O ratios and corresponding respiratory control index (RCI) values for several substrates (alpha-ketoglutarate, malate/glutamate, succinate) indicated that under vitamin E-deficient conditions the mitochondria showed an increased respiratory intensity accompanied with an elevated lipid peroxidation. The oxidative phosphorylation itself was not affected. These deficiency symptoms could be normalized by the applied amounts of both tocopherols. In this respect dl-gamma-tocopherol showed a more distinct bioactivity than previously proposed. Based on the investigated parameters we calculated for dl-gamma-tocopherol an average bioactivity of 28% compared to that of dl-alpha-tocopherol. PMID- 6486723 TI - Effects of excess dietary L-cystine on the rat plasma lipoproteins. AB - The effects of excess dietary cystine on the cholesterol and protein contents of rat plasma lipoproteins are described. 5% L-cystine was added to a semisynthetic diet containing 23% casein and 0.05% cholesterol, to the same diet enriched with 1% cholesterol or containing tristearin instead of lard. Rats were fed the diets during 2 months. The addition of cystine led to an increase in the plasma cholesterol level of the rats fed with the basal diet (from 0.92 to 1.56 mg/ml). But it produced a reduction of this level in cholesterol-fed rats (from 1.71 to 1.49 mg/ml). These different changes in the total plasma cholesterol level are explained by the specific effects of cystine on each lipoprotein: whatever the diet, cystine supplementation reduced the chylomicron and VLDL cholesterol contents and increased that of LDL (especially LDL2: density 1.040-1.063) and HDL. This study allowed us to compare 2 conditions which lead to hypercholesterolemia but which have opposite effects on hepatic cholesterogenesis: the supplementation of the same basal diet with 1% cholesterol or 5% cystine. In cholesterol-fed rats, the major part (49%) of plasma cholesterol was found in the chylomicrons and VLDL while the LDL2 cholesterol content was low (0.07 mg/ml plasma). Conversely, cystine-fed rats had a low chylomicron and VLDL plasma content (both enriched in apoprotein E), whereas up to 33% of the plasma cholesterol were carried by LDL2. Thus the production of LDL2 in cholesterol and cystine-fed rats could be related to hepatic cholesterogenesis. PMID- 6486724 TI - Resistance of gnotobiotic nude mice to Listeria infection. AB - Unlike the acute and short-term course of experimental listeriosis in phenotypically normal (nu/+) mice, Listeria monocytogenes infection in conventionally raised athymic Nude mice results in chronic inflammation with persistence of bacteria and lesions in the internal organs such as liver and spleen. Although it could be shown that germfree Nude mice had no intestinal microbial flora and lacked measurable serum immunoglobulins, neither the course nor the histomorphology of experimental listeriosis differed significantly from that of their conventionally raised littermates. The results indicate that the typical response of Nude mice to Listeria infection is primarily determined by inborn factors and not by prior antigenic stimulation. PMID- 6486725 TI - Induction of complete and irreversible damage to malignant glioma cells by L-2,4 diaminobutyric acid. AB - L-2,4 Diaminobutyric acid (DAB), a non-physiological amino acid, induced an irreversible injury to human malignant glioma cells when incubated for 24h at an amino acid concentration of 6 mmol/l at 37 degrees C. The same treatment of the human glia cells did not result in any cellular damage; not even a concentration as high as 20 mmol/l of the amino acid under the same incubation conditions did affect these cells. However, a further increase in amino acid concentration above that level resulted in a gradual loss of viability among the human glia cells. An experimentally induced rat glioma cell line was also affected by DAB, although displaying less sensitivity than the human glioma cells, and complete cellular destruction was achieved at 16 mmol/l of DAB, i.e. well below the critical concentration for human glia cells. The destructive effect by DAB was pH sensitive. The N-methylated analogue of a - amino-isobutyric acid exerted a specific inhibitory action on DAB activity, but other amino acids were also inhibitory to various degrees at higher concentrations. Future clinical applications in the treatment of malignant brain tumours in man are discussed. PMID- 6486726 TI - Juxta-centromeric fragility of chromosomes 1, 2, 9, 16, and immunodeficiency. Special reference to the fragility of chromosome 2 and its oncogenic potential. AB - Juxta-centromeric fragility of chromosomes 1, 2, 9, 16, has been described at least thrice in unrelated patients in association with combined immunodeficiency. This association has been confirmed by our findings in both immunodeficient and cancer patients. In our opinion, both the fragility and the immunodeficiency are the results of persistent viral infections by certain DNA (i.e.: Herpes-, Papova ) viruses or RNA (retro-) viruses (i.e. HTLV), which are lymphotropic. The immunodeficiency may be due to virus-cell, cell to cell, or virus-virus interactions. According to our findings, centromeric fragility of chromosome 2 appears to have a particular oncogenic potential probably because of its location in proximity to immunoglobulins genes. We suggest that centromeric fragility of chromosomes 1, 2, 9, 16, may be one of the symptoms of an incipient Acquired Immunodeficiency Syndrome (AIDS) which will not necessarily develop fully. PMID- 6486727 TI - Studies on confrontation of different tumor cells with human diploid fibroblasts. AB - Cells of two HeLa sublines (HeLa 1 and HeLa S) and of the rat tumor cell variants AS and ASML were confronted with human diploid lung fibroblasts (WI38). This "bilayer" system was established to study various cell-cell and cell-substrate interactions including the adhesion and spreading process of tumor cells. In this model system we could demonstrate that the behavior of different tumor cells is dependent on the environment. On the other hand, we could find an independence from species or strain barriers. This was demonstrated in the xenogenic combination of rat tumor cells and human fibroblasts. PMID- 6486728 TI - Pre-Gardner's syndrome, thyroglossal cysts and undifferentiated tumor of neural crest origin. AB - A child with a malignant undifferentiated adrenal medullary tumor of neural crest origin, removed at six months of age, was treated with chemotherapy and is alive without evidence of cancer after seven years. He developed osteomas of the skull, a thyroglossal cyst and has had one episode of gastrointestinal bleeding. A three generation history of multiple colonic polyposis and colon cancer, osteomas, recurrent pancreatitis, and Wilms' tumor was elicited. One of three females in this family, with direct lineage from polyposis afflicted fathers, exhibited Gardner's Syndrome and Wilms' tumor. The constellation of tumors afflicting this family may represent an underlying defect of excessive cell proliferation affecting mesenchymal and neuroblastic tissue. These may be extracolonic conditions associated with Gardner's Syndrome. PMID- 6486729 TI - Lack of cellular differentiation with neoplastic-like proliferation in the limbs of the newt Cynops pyrrhogaster. AB - We report a case of a neoplastic-like proliferation of epidermal cells in the limbs of an adult newt. The undifferentiated cell mass infiltrated the mesodermal tissues. Possible effects of this event on limb regeneration are discussed. PMID- 6486730 TI - The induction of NB rat prostatic carcinomas. AB - The NB rat prostate adenocarcinoma model is one in which microscopic carcinoma can be induced via the use of testosterone and estrogen silastic implants. There is an incidence of large, grossly-positive tumors; which approaches 10% to 15%. Seventy-three percent of the animals subjected to this induction method for periods of 9 to 18 months developed at least microscopic carcinoma. The earliest appearance microscopic foci of carcinoma was after three months of implantation, in which one of 30 animals so treated did show carcinoma. However, 88% of the animals treated for 18 months or longer showed microscopic carcinoma. PMID- 6486731 TI - The interaction between different phorbol derivatives and cortisol. AB - Phorbol derivatives (phorbol-12,13-diacetate, phorbol-12,13-dibenzoate, phorbol 12,13-dibutyrate, and phorbol-12-myristate-13-acetate) interact with cortisol on a molecular basis. These molecular interactions are demonstrated via dexamethasone receptor assays and by changes in spectrophotometric characteristics when equimolar solutions of these phorbol compounds together with cortisol are compared to those of the pure solutions. The phorbol compounds characterized by modifications in the molecular ring structure and by substitution at position C20, lose the capacity to bind cortisol. The tumor promoting effects of phorbol compounds are apparently achieved, in addition to other well-known mechanisms, by neutralizing cortisol, thus suppressing its regulatory effect on cell proliferation. PMID- 6486732 TI - Studies on the endogenous activation and inhibition of hormone receptor reaction. AB - Activation and inhibition of estrogen and progestin receptor functions by endogenous biological factors present in the cytosol preparations were demonstrated by assaying mixed cytosol preparations from human breast tumors and immature rabbit uteri. Both activation and inhibition of receptor-hormone binding reaction could be observed by tumor-rabbit uterus or tumor-tumor combinations. The activation of tumor progestin receptor by rabbit uterus cytosol was markedly profound. PMID- 6486733 TI - A new test for phagocytosis of human alveolar macrophages in suspension, using 99mTc labelled human serum albumin particles. AB - Current studies on human alveolar macrophages (HAM phi) indicate that two subpopulations may exist: adherent and nonadherent HAM phi. Most works in the literature were done exclusively on adherent HAM phi. In order to obviate to the loss of nonadherent HAM phi, we elaborated a new test for measuring endocytosis in HAM phi suspensions. According to this method, HAM phi in suspension were allowed to phagocytize millimicrospheres of human serum albumin labelled with 99m Tc (0.2 less than 0 less than 0.5 m; TcK9R - Cis Sorin Biomedica). Bound activity was separated from free activity by centrifugation on PercollR. The resulting internatant ring was found to contain activity bound to HAM phi which had phagocytized human serum albumin millimicrospheres. HAM phi were characterized by morphology and cytochemistry. The method here presented allows the functional study of both adherent and non-adherent HAM phi populations. PMID- 6486734 TI - Epifocal dinitrochlorobenzene therapy in malignant melanoma (experience during the last eight years). AB - A total of 50 patients with primary malignant melanomas received epifocal DNCB therapy. In 46 cases the tumors disappeared completely. Therefore, we partly refrained from excision of the treated area. Only 4 melanomas of great thickness did not respond satisfactorily. In the treatment of cutaneous metastases, however, remission was achieved only in one case. The 5-year survival rate for primary tumors was 87.8 +/- 10.55%. We believe that DNCB therapy is indicated especially in superficially growing melanomas, patients with limited operability, or flat melanomas of acral localization, where the patients are spared mutilating operations. PMID- 6486735 TI - Total and lipid-bound sialic acid in the cerebrospinal fluid of patients with brain tumors. AB - Total sialic acid (TSA) and lipid-bound sialic acid (LSA) were determined in the cerebrospinal fluid (CSF) from 63 patients with various neurological diseases. Of these, 27 had brain tumors: 20 had glioma, and 7 pituitary adenoma. TSA levels were significantly increased in the CSF of 18 of the 20 glioma patients (p less than 0.001), while in the adenoma patients were indistinguishable from the controls; with a 90 and 0% test sensitivity respectively. Conversely, the LSA concentrations were significantly elevated, both, in the glioma and pituitary adenoma patients (p less than 0.001), with a 68 and 100% test sensitivity respectively. These preliminary data suggest that measurement of TSA and LSA in the CSF should prove useful for the diagnosis of brain tumors and, perhaps, in the follow-up of patients undergoing treatment for brain tumors. PMID- 6486736 TI - Phase I-II trial of gallium nitrate for advanced hypernephroma. AB - Gallium nitrate in doses of 100-200 mg/m2/day was continuously infused for 7 consecutive days to 12 patients with advanced hypernephroma. Since nephrotoxicity was moderate and no objective tumor response was observed in ten adequately treated cases, further trials with this agent for hypernephroma are unwarrented. PMID- 6486737 TI - Progressive cerebral ischemia antedates cerebrovascular symptoms by two years. AB - Prospective longitudinal cerebral blood flow values were serially plotted over a four-year interval against the course of cerebral ischemia before, during, and after onset of clinical symptoms. Of 161 normal subjects (mean age, 62 years), 86 were risk free and 75 had hypertension, heart disease, diabetes mellitus, and/or hyperlipidemia. Twenty-one subjects developed cerebrovascular symptoms during the prospective trial. Mean hemispheric cerebral blood flow values were significantly lower for at risk than for risk-free subjects. Symptomatic subjects showed lower values than those in either of the two asymptomatic groups at every session. Statistical analysis of cerebral blood flow values for symptomatic patients compared one and two years prior to onset of symptoms, at the onset of symptoms, and 1 year later showed reductions compared to asymptomatic risk-factored subjects tested in a similar prospective manner. Measurable declines in cerebral perfusion accompany development and progression of aortocerebral atherosclerosis prior to clinical appearance of signs and symptoms of cerebrovascular disease. If confirmed, these observations should permit the institution of preventive medical and/or surgical interventive measures and an evaluation of their outcome. PMID- 6486738 TI - Hexacarbon neuropathy: cell body changes are early, dynamic, and specific. AB - To study the evolution of cell body alterations during toxic neuropathy we exposed rats to the prototype neurotoxin 2,5-hexanedione and examined perikarya of lumbar dorsal root ganglia with electron microscopy and stereology at three stages of neuropathy. Compared to unintoxicated controls, neurons from rats with incipient (four weeks) and intermediate (six to seven weeks) neuropathy showed dispersion of Nissl substance and significant decreases (p less than 0.001) in the volume fractions of Nissl bodies, but not of mitochondria or Golgi apparatus. However, at advanced (twelve to fourteen weeks) stages the volume fraction of Nissl bodies had increased and no longer differed from that of controls; distinct chromatolysis-like changes also became prominent. To evaluate the specificity of this remodeling we compared current morphometric results to data from rats exposed to acrylamide monomer and found significant differences (p less than 0.001) in the volume fractions of Nissl bodies and mitochondria. We conclude: (1) in axonopathy, cell body remodeling occurs early and advances as a dynamic, evolving process, and (2) distinct differences in the patterns of cell body changes can distinguish the neuropathies studied, implying distinct cell body functions. PMID- 6486739 TI - Dystonia in 61-year-old identical twins: observations over 45 years. AB - We examined 61-year-old identical twin women of Jewish extraction with a probable autosomal recessive form of torsion dystonia. The dystonia in each was relatively mild and discovered only because a young relative developed dystonia. The twins were said to be discordant for dystonia, but personal evaluation led to the diagnosis of dystonia in both. Their slow course, with prolonged spontaneous remission in one twin, is in contrast to that described in most published reports. Although similar in mode of onset and initial course, the twins were dissimilar in age at onset, influence of pregnancy, diurnal variation in symptoms, need for medication, later course, and degree of disability at age 61. Normal plasma levels of norepinephrine and dopamine-beta-hydroxylase are consistent with autosomal recessive hereditary torsion dystonia. The importance of personal evaluation of key family members in establishing the correct genetic basis for a heterogeneous group of disorders, such as the hereditary dystonias, is stressed. PMID- 6486740 TI - Descending paralysis resulting from occult wound botulism. AB - A 30-year-old male drug abuser developed ophthalmoplegia, bulbar paralysis, and limb weakness responsive to edrophonium. However, potentiation of a low-amplitude evoked muscle action potential was produced with repetitive nerve stimulation at 10 Hz, and the clinical and electrophysiological data suggested the diagnosis of botulism. The source of botulism type B toxin was a clinically obscure cyst produced by subcutaneous infiltration of cocaine two weeks prior to the onset of symptoms. The patient improved with chronic administration of pyridostigmine bromide and plasmapheresis. Wound botulism may be underdiagnosed because of confusion with inflammatory neuropathy or myasthenia gravis. Neuromuscular transmission studies in patients with acute craniosomatic paralysis can prevent such oversights. PMID- 6486741 TI - Value of ultrasound for identification of acute hemorrhagic necrosis of thalamus and basal ganglia in an asphyxiated term infant. AB - An infant with profound intrapartum and postpartum asphyxia demonstrated striking bilateral echodensities in the region of the thalamus and basal ganglia on ultrasound scan. Neuropathological examination confirmed the presence of symmetrical areas of hemorrhagic necrosis involving the thalamus, caudate, putamen, and globus pallidus. The findings demonstrate the value of ultrasonography in the identification of this variety of perinatal hypoxic ischemic injury. PMID- 6486742 TI - Computed tomography in the diagnosis of Wernicke's encephalopathy: a radiological neuropathological correlation. AB - A case of Wernicke's encephalopathy with pathological verification is reported. Results of computed tomography scanning performed one day after admission of the patient, a male alcoholic, strongly suggested Wernicke's encephalopathy and were in agreement with the subsequent postmortem findings. PMID- 6486743 TI - Startle disease, or hyperekplexia. PMID- 6486744 TI - Thirteenth annual meeting: Child Neurology Society. October 11-13, 1984, Phoenix, AZ. Abstracts. PMID- 6486745 TI - [A number of sorbents useful for the sorption of cephalosporin C]. AB - The physicochemical and sorption properties of a number of sorbents made in the USSR and abroad were studied with respect to the recovery of cephalosporin C from a model solution. It was shown that the sorption capacity of a sorbent depended on its specific surface. The macroporous styrene divinylbenzene sorbents with a specific surface of more than 500 m2/g had the best sorption properties. PMID- 6486746 TI - [Regeneration of Nocardia orientalis protoplasts]. AB - A method for effective regeneration of the protoplasts of N. orientalis, a vancomycin-producing organism into viable cells on a rich organic medium was developed. The dependence of the regeneration on the conditions of the protoplast plating out and the level of the regeneration medium dehydration was studied. The highest positive effect was observed when the protoplasts were suspended in the agarized medium and then plated out on the regeneration medium dehydrated by 2.5 per cent. The frequency of the protoplast regeneration increased on addition of bovine serum albumin to the regeneration medium. The effect of bovine serum albumin depended on its concentration. When the albumin concentration was optimal (0.01 per cent) the regeneration amounted to 100 per cent. PMID- 6486747 TI - [Determination of the content of the antibiotic cephalexin by alkalimetry]. PMID- 6486748 TI - [Effect of a modifying factor on the sensitivity of Crithidia oncopelti to levorin]. AB - The paper deals with possible discovery of ways for increasing sensitivity of trypanosomides to polyenic antibiotics. The following substances were tested: sodium pyruvate and acetate, calcium salts, ascorbic acid and 1-valine. The total number of the cells and the number of the viable cells in the culture and their morphological characteristics were used as the criteria for estimation of the C. oncopelti sensitivity. It was shown that sodium acetate most actively modified the levorin effect on C. oncopelti. Its addition in a concentration of 40 mg/ml to the cultivation medium with levorin in a concentration of 1 microgram/ml induced a trypanocidal effect. With the use of levorin alone such an effect was observed when the antibiotic was used in a concentration of 10 micrograms/ml. The growth rate of the protozoon was decreased by 60-80 per cent as compared to the control. The number of the viable cells was lowered 4 times. The morphology of the culture markedly changed. This indicates that the presence of sodium acetate as a modifier in the culture medium allowed one to decrease 10 times the dose of levorin and to preserve the trypanocidal effect. PMID- 6486749 TI - [Use of sodium nucleinate and its combinations with bacterial polysaccharides for preventing the nephrotoxic action of aminoglycoside antibiotics]. AB - Possible prevention of the nephrotoxic effect of different doses of aminoglycoside antibiotics, such as monomycin, kanamycin and gentamicin was studied experimentally on chinchilla rabbits. Substances increasing the cell resistance (sodium nucleinate, prodigiosan and pyrogenal alone and sodium nucleinate combinations with the bacterial polysaccharides) were used. It was shown that sodium nucleinate prevented nephrotoxicity of the aminoglycosides in the doses 2.5 times higher than the therapeutic ones. The combined use of sodium nucleinate with pyrogenal or prodigiosan was most effective. It prevented the nephrotoxic effect of the antibiotics in the doses 5 times higher than the therapeutic ones. PMID- 6486750 TI - [Action of reumycin on the blood system in an experiment]. AB - The effect of reumycin, an antitumor antibiotic on the peripheral circulatory system and bone marrow was studied on albino rats. The drug was injected intraperitoneally in a dose of 25 mg/kg daily for 30 days. It was shown that reumycin had a comparatively low toxic effect on the peripheral circulatory system and hemopoiesis. It induced the signs of transitory anemia and did not suppress the regenerative capacity of the bone marrow. After the drug repeated use there was an increase in the platelet count and in the rate of blood coagulation. These signs vanished a month after the end of the treatment course. PMID- 6486751 TI - [Antibiotic sensitivity of the microflora isolated from surgical patients with suppurative processes]. AB - The pathological material from 77 surgical patients with purulent infections was assayed microbiologically and the properties of the pathogens were investigated. Multiple antibiotic resistance of the microflora monocultures and associations was shown. The aminoglycoside antibiotics and first of all gentamicin were the most effective. PMID- 6486752 TI - [Isolation and regeneration of Micromonospora olivoasterospora protoplasts]. AB - The conditions for preparation and regeneration of the protoplasts of M. olivoasterospora were developed. It was found that effective formation of the protoplasts required preliminary cultivation of M. olivoasterospora in the medium containing glycine in a concentration inhibiting its growth at least by 60-80 per cent. The strains studied markedly differed in their sensitivity to glycine and were highly sensitive to it. The efficacy of the protoplast formation depended on the culture age and increased with the use of the lytic enzyme 3 of Cytophaga dissolvens. The possibility and advisability of the use of prolonged lysis of the Micromonospora cell walls were shown. A rich organic medium was used for regeneration of the protoplasts. PMID- 6486753 TI - [Electron microscopic characteristics of the action of penicillin and vancomycin on Rickettsia conorii and Rickettsia akari in vitro]. AB - The possibility of L-transformation for two species of Rickettsia of the tick group (R. conorii and R. akari) was studied with light and electron microscopy. The experiments were performed on the cultures of L-cells (murine fibroblasts). Penicillin and vancomycin were used as the transforming agents. Electron microscopy revealed clear changes in the morphological structure of both species when the doses of penicillin and vancomycin were 50-100 and 250-1500 micrograms/ml, respectively. The antibiotics had a morphologically analogous effect on both species of Rickettsia. The resulting morphological structures were large oval spheroplast-like cells with significant expansion of the periplasmic space up to 1 X 1.75 micron under the effect of penicillin and 0.5 X 0.7 micron under the effect of vancomycin. R. akari was somewhat more sensitive to the antibiotics. Electron microscopy of the morphological changes in the Rickettsia induced by penicillin and vancomycin showed that they were similar to the changes observed in gram-negative bacteria on their L-transformation and to the penicillin forms of chlamydia (galprovia) and R. prowazekii. They may be considered as a phase of unbalanced growth and represent the initial stage of L transformation. PMID- 6486754 TI - [Introduction of the inoculum into the upper agar layer as an alternative method in determining microorganism sensitivity to antibiotics by diffusion in agar]. AB - A procedure for addition of the inoculum to the surface layer of semisynthetic agar was developed and recommended for the use in the assay of antibiotic sensitivity of microorganisms. The procedure differs from the alternative method of Barry et al. It is of special value when it is necessary to determine antibiotic sensitivity of the pathogens of highly contagious infections with the agar diffusion method. PMID- 6486755 TI - [Seasonal effectiveness of antioxidants in tetracycline lesions of the liver]. AB - The seasonal characteristic features of the efficacy of antioxidants in tetracycline affections of the liver were revealed in the experiments with 182 noninbred albino male rats. It was shown that sodium selenite had the most pronounced hepatoprotective effect in autumn and winter, while vitamin E was most effective in spring and summer. The combination of sodium selenite with vitamin E recovered impaired bile excretion in autumn, spring and summer. In winter, the recovery was less effective. It is concluded that the time factor plays a significant role in tetracycline hepatotoxicity and efficacy of antioxidants in tetracycline affections of the liver. PMID- 6486756 TI - [Analysis of the etiological structure and dynamics of antibiotic resistance in the causative agents of suppurative inflammatory diseases in the patients at a large general hospital]. AB - The structure of the causative agents isolated from patients with pyoinflammatory infections in 1980-1983 was analysed. It was shown that the surgical and urological infections were mainly caused by gram-negative bacteria. The other pyoinflammatory infections were mainly due to gram-positive cocci. A relatively high frequency of the strains of gram-negative bacteria, especially among Pseudomonas spp. and Enterobacter spp., resistant to aminoglycoside antibiotics, such as gentamicin, sisomycin and tobramycin with preserved sensitivity to amikacin and netilmicin in the majority of the strains was shown. Among the beta lactam antibiotics cephotaxim and cephalotin were most active against gram negative bacteria and staphylococci, respectively. The majority of the antibiotic resistant strains of gram-negative bacteria had analogous structures and levels of resistance to 7-12 antibiotics which might indicate the occurrence of 1-2 resistance plasmids among the clinical strains. PMID- 6486757 TI - [Use of semisynthetic penicillins and cephalosporins in trauma and orthopedic patients]. AB - The data on the use and clinical efficacy of semisynthetic penicillins and cephalosporins in the treatment of the traumatologic and orthopedic patients are summarized. PMID- 6486758 TI - Antimicrobial susceptibilities of 1,292 isolates of the Bacteroides fragilis group in the United States: comparison of 1981 with 1982. AB - A susceptibility survey of 537 strains of the Bacteroides fragilis group from eight centers in the United States was continued at the Tufts New England Medical Center in 1982. The results were compared with those of 755 organisms analyzed in 1981. Nine antimicrobial agents were tested by an agar dilution method. The respective percentages of resistance for 1981 and 1982 were as follows (%): cefoxitin, 8 and 10; moxalactam, 22 and 12; cefotaxime, 54 and 48; cefoperazone, 57 and 54; piperacillin, 12 and 7; clindamycin, 6 and 3; metronidazole, 0 and 0; chloramphenicol, 0 and 0; and tetracycline, 63 and 59. Regional differences in resistance rates were found. Declines in resistance to moxalactam, piperacillin, and clindamycin were noted at the participating hospitals. An outbreak of cefoxitin resistance was noted at the Tufts New England Medical Center, where the rate increased from 14 to 30%. The various species of the B. fragilis group had differing patterns of resistance; B. fragilis was the most susceptible species. Significant cross resistance among the beta-lactam agents was found. These data indicate the need to determine the susceptibility patterns of the B. fragilis group organisms within each hospital. PMID- 6486759 TI - Topical treatment of cutaneous herpes simplex virus infection in hairless mice with (E)-5-(2-bromovinyl)-2'-deoxyuridine and related compounds. AB - (E)-5-(2-Bromovinyl)-2'-deoxyuridine (bromovinyldeoxyuridine) was found to suppress the development of herpetic skin lesions and the paralysis and mortality associated therewith in hairless mice inoculated intracutaneously with herpes simplex virus type 1. This protective effect was achieved with bromovinyldeoxyuridine applied topically at 1, 3, or 10% in either dimethylsulfoxide (DMSO), Beeler base, Tween-glycerol-water, 5% Azone (1 dodecylazacycloheptan-2-one) in water, or 5% Azone in DMSO. The optimal vehicle was 5% Azone in DMSO, in which bromovinyldeoxyuridine was effective even at a concentration as low as 0.3%. In its protective activity against cutaneous herpes simplex virus type 1 infection in hairless mice, bromovinyldeoxyuridine was clearly superior to other established antiherpes compounds such as 5-iodo-2' deoxyuridine, 5-ethyl-2'-deoxyuridine, arabinosyl thymine, and arabinosyl (E)-5 (2-bromovinyl) uracil when formulated at 10% in DMSO or Azone-DMSO. However, no activity was noted with any of these drug formulations against cutaneous herpes simplex virus type 2 infection. In contrast, acycloguanosine (acyclovir) proved quite effective in the topical treatment of cutaneous herpes simplex virus type 2 infection when used at 10% in DMSO or at 5% in propylene glycol. PMID- 6486760 TI - Growth of group IV mycobacteria on medium containing various saturated and unsaturated fatty acids. AB - Seventy-one strains of 15 species of rapidly growing mycobacteria were studied for their susceptibilities to fatty acids with 2 to 20 carbons by the agar dilution method at pH 7.0. Most mycobacteria other than potential pathogens (Mycobacterium fortuitum and Mycobacterium chelonei) were resistant to saturated fatty acids, except for lauric acid (C12:0) (MIC, 6.25 to 25 micrograms/ml) and capric acid (C10:0) (MIC, 50 to 100 micrograms#ml). M. fortuitum and M. chelonei were substantially insusceptible to these fatty acids. Unsaturated fatty acids with 16 to 20 carbons, except for C20:5, were highly toxic to group IV mycobacteria other than M. fortuitum, M. chelonei, Mycobacterium smegmatis, and Mycobacterium phlei, these being highly resistant to all the unsaturated acids, except for C16:1, C18:3, and C20:5. Introduction of double bonds to C16 to C20 fatty acids caused a marked increase in their activities that depended on the increase in the number of double bonds, at least up to three or four. M. fortuitum and M. chelonei were more resistant to the unsaturated fatty acids (particularly to C20:3 and C20:4) than the other group IV mycobacteria. PMID- 6486761 TI - Treatment of influenza A (H1N1) virus infection with ribavirin aerosol. AB - In a randomized, controlled study of ribavirin aerosol treatment of influenza A(H1N1) virus infection among college students, treated patients had a significantly shorter duration of fever than control patients. There was a trend of more rapid recovery in treated patients. Virus shedding was similar in treated and control patients, declining gradually from a 50% tissue culture infective dose of 3.5 log10 per ml at admission to 1.8 log10 per ml at 53 h after admission. There was no local or systemic intolerance and no hematological or biochemical abnormalities associated with ribavirin treatment. PMID- 6486762 TI - Pharmacokinetics of intravenously administered ciprofloxacin. AB - A 100-mg dose of ciprofloxacin was given as an intravenous bolus injection to each of six healthy volunteers, after which the levels of this agent were measured in serum, blister fluid, and urine. After administration, distribution of ciprofloxacin was very rapid, and the mean distribution volume was very large (177 liters). The mean terminal serum half-life was 4.0 h. The agent penetrated blister fluid rapidly, with the mean maximum level being 0.53 micrograms/ml at 30 min, after which time the blister levels exceeded those in serum. The 48-h urinary recovery of ciprofloxacin was about 80%. PMID- 6486763 TI - Comparative inhibition of bacterial and microsomal 3-ketodihydrosphingosine synthetases by L-cycloserine and other inhibitors. AB - Eleven compounds were examined for their capacity to inhibit the first enzyme of the sphingolipid pathway, 3-ketodihydrosphingosine synthetase. Of these, L cycloserine was the most potent, affecting both bacterial and brain microsomal enzymes to a significant degree at 0.04 mM. D- and L-cycloserine irreversibly inactivated the enzyme, indicating a suicide substrate mode of action. L Cycloserine was a more potent inhibitor of the growth of Bacteroides levii than was D-cycloserine, indicating that inhibition of sphingolipid synthesis could be a factor in the growth inhibition. PMID- 6486764 TI - MBCs for Staphylococcus aureus as determined by macrodilution and microdilution techniques. AB - MBC testing of clindamycin, methicillin, cephalothin, gentamicin, and vancomycin with 67 clinical isolates of Staphylococcus aureus was examined by both standard macrodilution tubes and commercial microdilution trays. Standard macrodilution failed to give reproducible (99.9% killing) MBC results, even when a strictly defined protocol was followed. Continuous shaking during incubation resulted in regrowth of more colonies than did stationary incubation. Vortexing of incubated tubes before subculture resulted in regrowth of more colonies than did careful transfer of the contents to sterile tubes before vortexing and subculture. No significant difference in MBCs was demonstrated by the use of log-phase versus stationary-phase inocula. Use of the multiprong inoculator for subculture from commercial microdilution trays was unsatisfactory because, although antibiotics evaluated were inactivated by subculture to a pH 5.5 agar plate coated with a beta-lactamase solution, the volume of broth transferred by the prongs was small and inconsistent, ranging from 0 to 3 microliter. Subcultures of commercial microdilution panels with a 1-microliter loop, 10-microliter pipette, and 100 microliter pipette were also evaluated. Results of MBC testing were most reproducible when the entire 100-microliter volume was aspirated from commercial microdilution wells after stirring and the contents of each well were spread over a separate sheep blood agar plate. PMID- 6486765 TI - Moxalactam penetration into normal heart valve, cardiac vegetations, and myocardium in relation to protein binding and physiological distribution spaces. AB - Rabbits with catheters implanted in the left ventricle were given a single dose of moxalactam and sacrificed at various times thereafter for measurement of the concentration of this antimicrobial agent in serum, heart muscle, and various heart valves. Penetration into both extravascular sites was rapid; steady state was achieved within 5 min after the dose. Moxalactam showed essentially complete penetration into valve lesions, whereas concentrations in heart muscle were only 20% of those in serum. The physiological distribution of moxalactam in heart muscle was beyond the inulin space, but substantially lower than total body water. This myocardial distribution ratio was not predicted by the serum-free fraction or blood trapped in tissues alone, but was in good agreement with that of extracellular fluid plus blood trapped in tissues. The moxalactam distribution profile was most compatible with that of drugs which are excluded from cells but readily distributed throughout extracellular fluids. This explains its nearly complete penetration into heart valves as well as its incomplete penetration into heart muscle, since the two sites differ in their relative proportions of cells and extracellular fluid spaces. PMID- 6486766 TI - Tetracycline diffusion through phospholipid bilayers and binding to phospholipids. AB - The ability of tetracycline to pass through phospholipid bilayers by diffusion was investigated. Liposomes did not retain enclosed tetracycline. Accumulation of tetracycline was observed with liposomes containing entrapped Tet repressor protein. These results indicate that the drug can pass through lipid bilayers. The antibiotic was also shown to bind to liposomes and isolated phospholipids. PMID- 6486767 TI - Pulmonary catabolism of interferons: alveolar absorption of 125I-labeled human interferon alpha is accompanied by partial loss of biological activity. AB - The catabolism of interferon was examined in isolated rabbit lungs which were ventilated and perfused with homologous blood. Natural human interferon-alpha (HuIFN-alpha) from lymphoblastoid Namalwa cells or recombinant DNA-derived HuIFN alpha 2 were labeled with 125I, mixed with an excess of the respective cold interferons and added to the perfusion blood. Protein-bound and acid-soluble radioactivity, as well as antiviral activity, were measured at regular time intervals. During the first 3 h of perfusion, only very small fractions of the interferons disappeared from the perfusate, irrespective of whether lungs were inserted in the perfusion system. This indicated that catabolism of interferons in the pulmonary circulation was negligible. On the other hand, when the interferons were instilled into the bronchial-alveolar tree, absorption of antiviral activity differed from that of acid-precipitable protein-associated radioactivity. While most of the radioactivity was transferred into the perfusate, only 2% of antiviral activity of natural HuIFN-alpha and 30% of that of HuIFN-alpha 2 were recovered in the perfusate. In both cases acid-soluble radioactivity in the system reached about 10%. Since radioiodide, instilled in the bronchial-alveolar tree, was transported rapidly into the perfusate, this type of analysis did not help in locating the site(s) of degradation. Alveolar macrophages did not catabolize or inactivate interferons in vitro. PMID- 6486768 TI - Synonomy of the yeast genera Hansenula and Pichia demonstrated through comparisons of deoxyribonucleic acid relatedness. AB - The relationship between the genera Hansenula and Pichia was examined through comparisons of DNA relatedness among phenotypically similar species. Hansenula minuta and Pichia lindneri showed 75% DNA base sequence complementarity. In other comparisons, H. nonfermentans was found to share nearly 50% of its DNA sequences with both H. minuta and P. lindneri. Because of the high degree of relatedness observed, it is proposed that ability to assimilate nitrate, the sole distinction between Hansenula and Pichia, is of insufficient taxonomic value for the reliable separation of either species or genera. Hat-spored species of Hansenula H. et P. Sydow 1919 are being transferred to Pichia Hansen 1904. Species of Hansenula and Pichia with Saturn-shaped ascospores will be transferred to the genus Williopsis. PMID- 6486769 TI - The yeasts of British fresh sausage and minced beef. AB - Three hundred and eighty three yeasts isolated from samples of unsulphited or sulphited sausages and skinless sausages and minced beef were characterized in detail. Debaryomyces hansenii was the most commonly isolated yeast from most samples followed by Candida zeylanoides and Pichia membranaefaciens. The presence of sulphite in sausages did not appear to affect the numbers and range of yeasts present but did affect their relative proportions. A survey of one factory showed that meat intended for sausage production and equipment harboured the same range of yeasts that are found in the finished products. PMID- 6486770 TI - Gemmata obscuriglobus, a new genus and species of the budding bacteria. AB - A single strain of a budding bacterium was isolated from freshwater. The strain had a life-cycle, with a multitrichous swarmer stage, and produced a phase-dark inclusion of packed ribosomes and nuclear material. The mol % G + C of the DNA was 64.4 +/- 1.0. A new genus, Gemmata with the type species Gemmata obscuriglobus is proposed. The type strain is UQM 2246. PMID- 6486771 TI - Identification of Acetobacter strains isolated from spoiled lactic acid fermented meat food for pets. AB - Five Acetobacter isolates from lactic acid fermented meat food for pets were characterized by 177 morphological, physiological and biochemical traits. Four isolates were identified as A. pasteurianus, one as A. aceti. It is emphasized that access of such bacteria to lactic acid fermented foods should be avoided. PMID- 6486772 TI - Phage-typing scheme of Salmonella bareilly based on lysogeny. AB - A phage-typing system of Salmonella bareilly based on lysogeny is presented. In the present study which comprised 378 strains, fifteen different phage types named 'a' through 'o' were established. With this system 70.3% of the strains could be typed by using five indicator strains. PMID- 6486773 TI - Biological and clinical aspects of Pseudomonas. Abstracts. Netherlands Society for Microbiology. Antwerp, 14 April 1983. PMID- 6486774 TI - Ventromedial and lateral hypothalamic injections of naloxone or naltrexone suppress the acute food intake of food-deprived rats. AB - Experiments were conducted to determine the anorexigenic effects of ventromedial (VMH) and lateral hypothalamic (LH) injections of the mu-opiate receptor antagonists, naloxone and naltrexone, on food-deprived (20 h) rats. Lever pressing to obtain food pellets was measured in groups of hungry, male Sprague Dawley rats following VMH, LH or subcutaneous (SC) injections of saline, naloxone or naltrexone. VMH injections of either narcotic antagonist (5 and 10 micrograms/microliter) and LH injections of naloxone (5 and 10 micrograms/microliter) decreased the total 90-min food intake, compared to saline controls, due to suppressed feeding especially during the initial 30-min interval. Rats given SC injections of naloxone (10 mg/kg) also decreased their food intake compared to amounts eaten after SC saline was given. Decrements in food consumption relative to saline controls were similar following VMH or LH administration of naloxone. Moreover, the anorexia observed following VMH naloxone administration was similar to that found after VMH injections of equal doses of naltrexone. PMID- 6486775 TI - Drinking: a final common pathway? AB - Administration of either naloxone, an opioid antagonist (1 mg/kg i.p.), or clonidine, an alpha 2 adrenoceptor agonist (12 micrograms/kg i.p.), attenuated the dipsogenic responses of female rats to both angiotensin II (200 micrograms/kg s.c.) and isoproterenol (25 micrograms/kg s.c.). The effect of simultaneous administration of naloxone and clonidine at these submaximal doses was an additive attenuation of both angiotensin II- and isoproterenol-induced water intakes. The absence of a significant interaction between naloxone and clonidine to inhibit drinking suggests that they act by a similar mechanism. Yohimbine, an alpha 2 adrenoceptor antagonist (300 micrograms/kg i.p.), administered in combination with naloxone, reversed the antidipsogenic effect on angiotensin II induced drinking. These results provide further support for a role for alpha 2 adrenoceptors in laboratory-induced drinking in rats, and suggest the possibility that the antidipsogenic effect of naloxone is related to alpha 2 adrenergic mechanisms. A model to support these observations is presented in which two separate pathways for the induction of drinking (osmoreceptor- and angiotensin II induced) converge on a final common pathway. Since both naloxone and clonidine inhibit responses to stimulation of both pathways for drinking, these results suggest that their actions are likely to be at some point as yet undetermined on the final common pathway. PMID- 6486777 TI - Dual action of naloxone on feeding revealed by behavioural analysis: separate effects on initiation and termination of eating. AB - In two experiments observational analyses have been made of eating and other behaviours following naloxone administration. Naloxone produced a clearly defined profile of behavioural changes. Although rats became became more inactive it was demonstrated that this was not responsible for the inhibition of food intake. The drug reduced the latency to approach food and to initiate eating bouts. In addition, naloxone hastened the termination of eating in the test period. Therefore naloxone simultaneously increases one aspect of motivation for food, yet also promotes the onset of satiation. This profile of naloxone's anorexic action is quite different to that of traditional anorexic drugs such as amphetamine of fenfluramine. This dual action of naloxone, disclosed by these studies, may account for certain curious features of naloxone's effect on food intake. PMID- 6486776 TI - The effect of naloxone on schedule-induced and other drinking. AB - A dose-response study of the effect of naloxone on schedule-induced drinking confirmed that this type of drinking is resistant to the opiate antagonist at doses which depressed drinking induced by water-deprivation, hypertonic saline and salbutamol. Naloxone also failed to reduce intake of saline solution in the presence of scheduled food presentation. The findings support the suggestion that schedule-induced drinking is regulated by a system of neural control which differs from that involved in deprivation and other forms of drinking. It would appear that opiate receptors do not play a part in the regulation of schedule induced drinking. PMID- 6486778 TI - Nylon tube-immobilized creatinine iminohydrolase and glutamate dehydrogenase in serum and urine creatinine analysis. AB - Immobilized enzyme nylon-tube reactors incorporating creatinine iminohyrolase (CI) and glutamate dehydrogenase (GDH) were used to assay creatinine in serum and urine. Optimum substrate concentrations for the assay were determined. The reactors were incorporated into a continuous flow system for creatinine analysis. The method was evaluated with respect to linearity, sample interaction, precision, accuracy, and analytical recovery. Comparison studies were carried out with a standard Jaffe method and the effect of interfering substances was investigated. From the results obtained, it was concluded that the assay was suitable as a simple, reliable, and specific method for serum and urine creatinine determinations. PMID- 6486779 TI - Effects of a fluoro substituent on the fungal metabolism of 1-fluoronaphthalene. AB - The metabolism of 1-fluoronaphthalene by Cunninghamella elegans ATCC 36112 was studied. The metabolites were isolated by reverse-phase high-pressure liquid chromatography and characterized by the application of UV absorption, 1H nuclear magnetic resonance, and mass spectral techniques. C. elegans oxidized 1 fluoronaphthalene predominantly at the 3,4- and 5,6-positions to form trans-3,4 dihydroxy-3,4-dihydro-1-fluoronaphthalene and trans-5,6-dihydroxy-5,6-dihydro-1 fluoronaphthalene. In addition, 1-fluoro-8-hydroxy-5-tetralone, 5-hydroxy-1 fluoronaphthalene, and 4-hydroxy-1-fluoronaphthalene as well as glucoside, sulfate, and glucuronic acid conjugates of these phenols were formed. Circular dichroism spectra of the trans-3,4- and trans-5,6-dihydrodiols formed from 1 fluoronaphthalene indicated that the major enantiomers of the dihydrodiols have S,S absolute stereochemistries. In contrast, the trans-5,6-dihydrodiol formed from 1-fluoronaphthalene from 3-methylcholanthrene-treated rats had Cotton effects that are opposite in sign (R,R) to those formed by C. elegans. The results indicate that the fungal monooxygenase-epoxide hydrolase systems are highly stereoselective in the metabolism of 1-fluoronaphthalene and that a fluoro substituent blocks epoxidation at the fluoro-substituted double bond, decreases oxidation at the aromatic double bond that is peri to the fluoro substituent, and enhances metabolism at the 3,4- and 5,6-positions of 1-fluoronaphthalene. PMID- 6486780 TI - Anaerobic incubation of membrane filter cultures for improved detection of fecal coliforms from recreational waters. AB - Anaerobic incubation of membrane filter cultures significantly enhanced detection of fecal coliforms in surface-water samples from recreational beaches. In contrast to standard aerobic incubation, anaerobic incubation suppressed overgrowth of masking, noncoliform bacteria but did not increase the frequency of fecal coliform recovery. PMID- 6486781 TI - Microbial models of mammalian metabolism: microbial reduction and oxidation of pentoxifylline. AB - Fourteen microorganisms, including fungi, yeasts, and bacteria, were screened for their ability to metabolize the xanthine drug pentoxifylline. Thirteen cultures either reduced the drug to the alcohol metabolite or oxidatively cleaved the ketonic side chain to homologous carboxylic acid metabolites. The alcohol metabolite was the predominant or sole metabolite in all organisms, with conversions ranging from 6 to 91%. Preparative-scale production of the alcohol metabolite with Rhodotorula rubra (ATCC 20129) allowed for the isolation of this product with a 40% yield. Two organisms also produced the carboxylic acid metabolites at low levels (2 to 10%). The routes of metabolism in microbial cultures are the same as those reported in mammalian systems. PMID- 6486782 TI - Microbial flora of in-use soap products. AB - A comparison has been made of the in-use bacterial load of two bar soaps with and without antibacterials and two liquid soaps in five different locations over a 1 week period. Of the 25 samples taken from each soap, 92 to 96% of samples from bar soaps were culture positive as compared to 8% of those from liquid soaps. Bacterial populations ranged from 0 to 3.8 log CFU per sample for bar soaps and from 0 to 2.0 log CFU per sample for liquid soaps. The mean bacterial populations per sample were 1.96 and 2.47 log CFU for the two bar soaps, and 0.08 and 0.12 log CFU for the two liquid soaps. The difference in bacterial population between bar soaps and liquid soaps was statistically significant (P = 0.005). Staphylococcus aureus was isolated on three occasions from bar soaps but not from liquid soaps. S. aureus was isolated twice from the exterior of the plastic dispensers of liquid soap but not from the soap itself. Gram-negative bacteria were cultured only from soaps containing antibacterials. Bacterial populations on bar soaps were not high compared with bacterial populations on hands, and the flora was continually changing without evidence of a carrier state. PMID- 6486783 TI - Isolation of Aeromonas spp. from an unchlorinated domestic water supply. AB - The recovery of Aeromonas spp. from the unchlorinated water supply for a Western Australian city of 21,000 people was monitored at several sampling points during a period of 1 year. Membrane filtration techniques were used to count colonies of Aeromonas spp., coliforms, and Escherichia coli in water sampled before entry to service reservoirs, during storage in service reservoirs, and in distribution systems. Aeromonas spp. were identified by subculture on blood agar with ampicillin, oxidase tests, and the use of Kaper medium and then were tested for production of enterotoxins and hemolysins. During the same period, two-thirds of all fecal specimens sent for microbiological examination were cultured on ampicillin-blood agar for Aeromonas spp. Recovery of Aeromonas spp. from water supplies at distribution points correlated with fecal isolations and continued during autumn and winter. Coliforms and E. coli were found most commonly in late summer to autumn. This pattern differs from the summer peak of Aeromonas isolations both from water and from patients with Aeromonas spp.-associated gastroenteritis in Perth, Western Australia, a city with a chlorinated domestic water supply. Of the Aeromonas strains from water, 61% were enterotoxigenic, and 64% produced hemolysins. PMID- 6486784 TI - Influence of water temperature, salinity, and pH on survival and growth of toxigenic Vibrio cholerae serovar 01 associated with live copepods in laboratory microcosms. AB - The influence of water temperature, salinity, and pH on the multiplication of toxigenic Vibrio cholerae serovar O1 cells and their attachment to live planktonic crustaceans, i.e., copepods, was investigated by using laboratory microcosms. By increasing water temperatures up to 30 degrees C, a pronounced effect on the multiplication of V. cholerae was demonstrated, as was attachment of the cells to live copepods. These were measured by culturable counts on agar plates and direct observation by scanning electron microscopy, respectively. Of the three salinities examined (5, 10, and 15%), maximum growth of V. cholerae and attachment to copepods occurred at 15%. An alkaline pH (8.5) was optimal both for attachment and multiplication of V. cholerae, as compared with pH 6.5 and 7.5. It is concluded that conditions affecting attachment of V. cholerae serovar O1 to live copepods observed under laboratory conditions may also occur in the natural estuarine environment and, thereby, are significant in the epidemiology of cholera. PMID- 6486785 TI - R-plasmid transfer in Salmonella spp. isolated from wastewater and sewage contaminated surface waters. AB - A total of 865 Salmonella isolates from wastewaters and sewage-contaminated natural waters were tested for antimicrobial resistance by using NR10 medium and incubation at 43 degrees C. Of the strains, 12.7% were resistant to one or more of the compounds tested, and 30% transferred resistance to an Escherichia coli recipient. The highest minimal inhibitory concentrations were ca. 1,000 micrograms/ml. Transfer frequencies ranged from 10(-3) to 10(-7). PMID- 6486786 TI - Isolation from haddock tissue of psychrophilic bacteria with maximum growth temperature below 20 degrees C. AB - A series of seven gram-negative obligately psychrophilic cultures were isolated from a fresh haddock fillet and constituted 8.8% of the total bacterial population on the tissue. All of these isolates are facultatively anaerobic, ferment dextrose without gas production, produce trimethylamine, are sensitive to the vibriostatic agent 0/129, and grow at temperatures from 0 to 15 degrees C but not at 20 degrees C. PMID- 6486788 TI - Methanogens and anaerobes in a colon segment isolated from the normal fecal stream. AB - Methanogens were in the isolated sigmoid colon but not in the colostomy bag of a woman with a left hemicolectomy with end colostomy and mucous fistula. The predominant methanogen was Methanobrevibacter smithii. An anaerobic bacterial community supported by nondietary substrates was present in the isolated sigmoid colon. PMID- 6486787 TI - Inhibitory effects of titanium (III) citrate on enumeration of bacteria from rumen contents. AB - Titanium citrate (TC) or L-cysteine-sodium sulfide was added as a reducing agent to buffers and agar media used for enumeration of bacteria from rumen contents of high-forage-fed steers. Approximately equal colony counts were found on TC and L cysteine-sodium sulfide-reduced media with rumen contents taken 8 h postfeeding, when active bacterial growth was occurring. The colony counts on TC medium were only 56% of those with L-cysteine-sodium sulfide medium with rumen contents taken 1 h prefeeding when bacterial growth was minimal. When colonies from L-cysteine sodium sulfide medium were transferred to TC medium and vice versa, almost all colonies grew. The data indicate that TC can be inhibitory to bacteria upon their initial isolation from natural habitats, particularly when growth rates are low in these habitats. PMID- 6486789 TI - 2-Chloro-4-amino-1,3,5-triazine-6(5H)-one: a new intermediate in the biodegradation of chlorinated s-triazines. AB - Pseudomonas sp. strain A grew with 2-chloro-1,3,5-triazine-4,6-diamine as the sole and growth-limiting source of nitrogen. The substrate was utilized quantitatively and concomitantly with growth and with excretion of a product which was identified as 2-chloro-4-amino-1,3,5-triazine-6(5H)-one. The reaction yielded 1 mol of organic product and 1 mol of NH4+ per mol of substrate. PMID- 6486790 TI - Purification of Giardia muris cysts by velocity sedimentation. AB - Giardia muris cysts were separated from fecal contaminants in primary isolates by unit gravity velocity sedimentation. Crude isolates obtained by centrifugation over 1.0 M sucrose were overlaid onto a Percoll density gradient, 1.01 to 1.03 g/ml. G. muris cysts were well separated from faster-sedimenting fecal debris and slower-sedimenting Spironucleus muris and bacteria in 1.5 h. PMID- 6486791 TI - Size, shape, and hydration of a self-associating human IgG myeloma protein: axial asymmetry as a contributing factor in serum hyperviscosity. AB - Studies of sedimentation, diffusion, viscosity, and buoyant density have been carried out on a human IgG1-lambda myeloma protein (IgG-MIT) isolated from the serum of a patient with multiple myeloma and the hyperviscosity syndrome. In comparison with pooled normal IgG, IgG-MIT exhibits smaller sedimentation and diffusion coefficients, a larger intrinsic viscosity, and a larger frictional ratio. The preferential hydration of IgG-MIT in cesium chloride was found to be within the range of values typically observed for globular proteins. The data are consistent with prolate ellipsoid geometry, and suggest that the axial ratio of the IgG-MIT monomer is approximately 50% greater than that typically observed for IgG. The concentration dependencies of the hydrodynamic data for IgG-MIT confirm the previous finding of reversible, concentration-dependent self-association for this protein. IgG-MIT thus represents the first reported instance of an IgG paraprotein for which in vivo hyperviscosity effects appear attributable to a twofold mechanism involving geometric asymmetry and concentration-dependent polymerization. The results are discussed in terms of the significant heterogeneity in molecular dimensions which may exist among normal IgG proteins. PMID- 6486792 TI - The proteinase inhibitors leupeptin, pepstatin A, and TLCK cause reduced collagen production in freshly isolated embryonic chick fibroblasts in suspension culture. AB - The production of [14C]proline-labeled collagen by embryonic chick tendon cells in suspension culture is reduced when the cells are incubated in the presence of lysosomotropic agents NH4Cl or chloroquine. Since these agents have multiple effects on fibroblasts, including inhibition of collagen secretion, specific proteinase inhibitors were tested for their effect on collagen production. Here the proteinase inhibitors N-p-tosyl-L-lysine chloromethylketone (TLCK) and leupeptin, specific for certain cysteine and serine proteinases, and pepstatin A, specific for aspartic proteinases, were tested for their effects on both the production and secretion of collagen. When treated with the proteinase inhibitor TLCK, the percentage of protein synthesis devoted to collagen decreased from control levels of 19.0 +/- 1.4% to 10.5 +/- 2.4% with 10 microM TLCK. Collagen synthesis was further reduced to only 1.2% of total protein synthesis with 100 microM TLCK. The incorporation of [14C]proline into collagenase-digestible peptides was only slightly decreased in the samples treated separately with 50 micrograms/ml leupeptin or 60 micrograms/ml pepstatin A. However, the production of collagen was reduced to 10.9 +/- 1.4% of total protein synthesis in samples treated with leupeptin and pepstatin A together. The basal intracellular degradation of newly synthesized, [14C]proline-labeled collagen was not significantly altered by any of the reagents tested, and secretion of the collagen which was produced was not impaired except in samples treated with 100 microM TLCK. The data presented are consistent with the hypothesis that a proteolytic mechanism utilizing some combination of cysteine, serine, and aspartic proteinases is necessary for continued collagen synthesis in freshly isolated embryonic chick tendon fibroblasts, and suggests that a heretofore unknown regulatory system may be operative in controlling the synthesis of collagen in fibroblasts. PMID- 6486793 TI - The regulation of hepatic gluconeogenesis using alpha-ketoisovalerate and propionate as precursors. AB - The regulation of gluconeogenesis from alpha-ketoisovalerate and propionate was investigated in perfused livers from fasted rats. With alpha-ketoisovalerate as the gluconeogenic precursor, infusion of beta-hydroxybutyrate and acetate stimulated the rate of alpha-ketoisovalerate decarboxylation, but inhibited the rate of glucose production. Oleate, on the other hand, inhibited both alpha ketoisovalerate decarboxylation and glucose production. When propionate was the primary gluconeogenic substrate, oleate, beta-hydroxybutyrate, and acetate infusion did not significantly alter hepatic glucose production. The present studies suggest that gluconeogenesis from alpha-ketoisovalerate is regulated at the level of various dehydrogenases prior to formation of propionyl-CoA, but subsequent to the branched-chain alpha-keto acid dehydrogenase reaction. PMID- 6486794 TI - Effects of dietary polyunsaturated fats and vitamin E on aging and peroxidative damage to DNA. AB - Peroxidative damage to DNA was studied in rats fed either a diet with 10% tocopherol-stripped corn oil and 30 IU DL-alpha-tocopherol acetate/kg (group A), the same diet without vitamin E (group B), a diet with 24% corn oil without vitamin E (group C), or the diet of group A for 10 months and then the diet of group C for 4 months (group D). After 3, 6, 9, and 14 months of feeding the diets, body weights, motoric activities, testicular weights, and lipid-soluble fluorophores in testes were measured. Groups A and B had higher hepatic DNA template activities at 9 and 14 months than group C, and group A had higher testicular DNA template activities than groups B and C at 6, 9, and 14 months. Hepatic DNA template activity of group C decreased from 6 to 9 and from 9 to 14 months. Group C hepatic DNA transcribed less long RNA than that of groups B and D, and more short RNA than groups B and D. Group A testicular DNA transcribed more medium-length RNA than that of groups B and D, and less short RNA than that of groups B, C, and D. DNA-bound tryptophan and DNA crosslinking were inversely related to DNA template activities. DNA damage correlated with other biochemical and physiological changes that are characteristic of cellular impairment in aging and disease. PMID- 6486795 TI - Covalent binding of folic acid to dimethylglycine dehydrogenase. AB - Dimethylglycine dehydrogenase (EC 1.5.99.2) carries out the oxidative demethylation of dimethylglycine to sarcosine in liver mitochondria. In vivo, the enzyme uses tightly bound tetrahydropteroyl pentaglutamate (H4PteGlu5) as an acceptor of the one-carbon group generated during the reaction. The purified enzyme can use, but does not require, H4PteGlu5 and under these conditions formaldehyde is the one-carbon unit produced. It is reported that folic acid may be covalently linked to dimethylglycine dehydrogenase in a specific and saturable manner so that only 1 mole of folic acid is bound per mole of enzyme. Covalently bound folic acid blocks the subsequent binding of H4PteGlu, and does not inhibit the rate of dimethylglycine dehydrogenase activity in vitro. PMID- 6486796 TI - Monoclonal antibodies PMN 6, PMN 29, and PM-81 bind differently to glycolipids containing a sugar sequence occurring in lacto-N-fucopentaose III. AB - Three monoclonal antibodies, PMN 6, PMN 29, and PM-81, bind myeloid cells. Antibodies PMN 6 and PMN 29 bind specifically to granulocytes but differ in their ability to bind some other cell lines [E. D. Ball, R. F. Graziano, L. Shen, and M. W. Fanger (1982) Proc. Natl. Acad. Sci. USA 79, 5374-5378]. Antibody PM-81, in addition to granulocytes, also binds to eosinophils, monocytes, and most acute myelocytic leukemia cells [E. D. Ball, R. F. Graziano, and M. W. Fanger (1983) J. Immunol. 130, 2937-2941]. Despite these differences, the binding of all three antibodies to cells was inhibited by the oligosaccharide, lacto-N-fucopentaose III [Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4Glc]. Solid-phase radioimmunoassays using purified glycolipids containing sugar sequences found in lacto-N-fucopentaose III demonstrated different binding characteristics for each antibody. PM-81 bound lower concentrations of glycolipids than PMN 29, while PMN 6 required the highest concentration of glycolipids for binding. Autoradiography of thin-layer chromatograms of glycolipid antigens supported these results. The binding of these monoclonal antibodies to cells probably depends on the density of antigens on the cell surface, each antibody requiring a different density. Thus, cells containing antigen below a certain threshold concentration may not bind low-affinity antibodies. PMID- 6486797 TI - Purine metabolism and urate biosynthesis in isolated chicken hepatocytes. AB - The metabolism of some purine compounds to urate and their effects on de novo urate synthesis in chicken hepatocytes were investigated. The purines, listed in descending order of rates of catabolism to urate, were hypoxanthine, xanthine, inosine, guanosine, guanine, IMP, GMP, adenosine, AMP, and adenine. During a 1-h incubation period, conversion to urate accounted for more than 80% of the total quantities of guanine, guanosine, and inosine metabolized, but only 42% of the adenosine and 23% of the adenine metabolism. Adenine, adenosine, and AMP inhibited de novo urate synthesis [( 14C]formate incorporation into urate), whereas the other purines, especially guanine, guanosine, and GMP, stimulated de novo urate synthesis. When hepatocytes were incubated with glutamine and adenosine, AMP, guanine, guanosine, or GMP, the rates of de novo urate synthesis were lower than the additive effects of glutamine and the purine in separate incubations. Increasing phosphate concentrations had no effect on urate synthesis in the absence of added purines but, in combination with adenosine, AMP, guanosine, or GMP, increased urate synthesis. These results indicate that the ratio of adenine to guanine nucleotides and the interaction between substrates and purine nucleotides are involved in the regulation of urate biosynthesis in chicken liver. PMID- 6486798 TI - Control of the purine nucleotide cycle in extracts of rat skeletal muscle: effects of energy state and concentrations of cycle intermediates. AB - The enzymes of the purine nucleotide cycle-AMP deaminase, adenylosuccinate synthetase, and adenylosuccinate lyase-were examined as a functional unit in an in vitro system which simulates the purine nucleotide composition of sarcoplasm. Activity of each cycle enzyme in extracts of rat skeletal muscle was observed to increase as ATP/ADP, reflecting the energy state of the system, was lowered from approximately 50 to 1. The increase in AMP deaminase activity could be attributed to effects of energy state and factors such as AMP concentration, which are obligatorily coupled to energy state. The increases in synthetase and lyase activities were accounted for by increases in the concentration of IMP and adenylosuccinate, respectively. The inhibitory influence of IMP concentration on synthetase activity reported in other systems was not observed in this system; synthetase activity progressively increased as IMP concentration was raised to approximately 4 mM, and apparent saturation occurred at concentrations above 4 mM. Also, adenylosuccinate was found to be an activator of AMP deaminase. The results of this study document that the activities of the enzymes of the purine nucleotide cycle increase in parallel at low energy states, and the components of the cycle function as a coordinated unit with individual enzyme activities linked via concentrations of cycle intermediates. PMID- 6486799 TI - Degradation of surface-labeled hepatoma membrane polypeptides: effect of inhibitors. AB - When their membrane proteins were labeled with 125I by lactoperoxidase, dividing hepatoma cells lost radioactivity to the medium in a biphasic manner (T1/2 = 16 26 h, greater than 40 h). Lysosomotropic weak bases, chloroquine, and NH4Cl inhibited the rapid phase by 59%. More than 50% of the radioactivity which accumulates in the media from dividing cells during the first 4 h after labeling was trichloroacetic acid-soluble, and was identified as iodotyrosine. Iodotyrosine release from labeled membrane proteins was 60-71% inhibited by lysosomotropic agents chloroquine and NH4Cl as well as the sodium-proton ionophore, monensin. The inhibitory effect of NH4Cl and monensin was reversible. Inhibitors of microtubule and microfilament function and transglutamination had no effect on release of iodotyrosine to the medium, but trypsin-like protease inhibitors, p-aminobenzamidine, tosyl-L-lysine/chloromethylketone, and phenylmethylsulfonyl fluoride, as well as the cathepsin B inhibitor, leupeptin, inhibited by 21-24%. Iodotyrosine release showed a biphasic Arrhenius plot with an activation energy of 17 kcal/mol above but 27 kcal/mol below 20 degrees C. These results indicate that cell membrane polypeptides require a temperature limiting event as well as passage through an ion-sensitive compartment prior to their complete degradation to constituent amino acids. In contrast to other lysosomal-mediated events, however, iodinated membrane proteins of dividing cells are degraded in a manner insensitive to agents which disrupt the cytoskeleton. PMID- 6486801 TI - Calorimetric study of carbohydrate binding to concanavalin A. AB - Flow microcalorimetry has been used to examine the delta H of binding of two types of saccharides, a series of simple monosaccharides and a series of alpha-(1 ---4)-linked glucosides, to the lectin Concanavalin A. It has been found that the delta H decreases with any change in the stereochemistry of a hydroxyl group relative to methyl alpha-D-mannopyranoside. The data have allowed the calculation of the relative contribution of two of the hydroxyl groups. The delta H's of binding for the alpha-(1----4)-linked glucosides are approximately 31 kJ/mol, and the apparent association constants vary insignificantly with increasing length. This result indicates that only one glucose residue binds to concanavalin A by hydrogen bonds, and that the additional glucose residues have no interaction either by hydrogen bonds or by nonspecific hydrophobic interactions. This result confirms the absence of an extended binding site for alpha-(1----4)-linked glucopyranosides, in contrast to that proposed for alpha-(1----2)-linked mannopyranosides which show an increase in apparent association constants with increasing length. PMID- 6486800 TI - Rate control of phosphorylation-coupled respiration by rat liver mitochondria. AB - Liver mitochondria provided with an oxidizable substrate, ATP, oxygen, and an ADP generating system (soluble F1-ATPase) were used to reevaluate the rate controlling step(s) intrinsic to all of the processes of mitochondrial oxidative phosphorylation. The quantity termed "control strength" (C), previously defined as the fractional change in flux through a (system) induced by a fractional change in the concentration of an individual enzyme in the system, has been used to evaluate rate-influencing steps in this overall process by carefully defining the dimensions of the "system" under analysis. If the system is defined by a suspension of mitochondria provided with substrates, plus an extrinsic ADP generating process (ATPase), the value of C of the latter for the overall process of phosphorylation-linked respiration is near 1.0 until the capacity of the mitochondria to phosphorylate ADP is approached, after which C for the soluble ATPase becomes zero as the maximum capacity for phosphorylation is attained. Carboxyatractyloside was found only marginally to inhibit respiration stimulated by ATPase, even when a large percentage of adenine nucleotide translocase molecules were immobilized. The relative lack of effect of carboxyatractyloside on phosphorylating respiration is explained by the readjustment of the concentration of one of the substrates (ADP) and an inhibitor (ATP), which results from inhibition of adenine nucleotide translocase. The residual blunted inhibition of respiration is explained by product inhibition of the ADP regenerating ATPase, and not necessarily to any intrinsically mitochondrial intermediate process. The system being evaluated can be redefined to include only the processes intrinsic to mitochondria. This can be achieved by providing exactly comparable substrate concentrations to the mitochondria under comparable incubation conditions. Under these conditions, the adenine nucleotide translocase is the principal, if not the only, rate-controlling step in the overall process of oxidative phosphorylation until a new rate-limitation is attained (ATP synthesis). These data are consistent with the conclusion that, at intermediate rates of phosphorylation-coupled respiration, the extramitochondrial ATP/ADP ratio regulates this process through its kinetic effects on the catalytic properties of the adenine nucleotide translocase. PMID- 6486802 TI - Ethanol increases calcium permeability of heavy sarcoplasmic reticulum of skeletal muscle. AB - The effects of ethanol on both Ca2+ pump activity and Ca2+-induced Ca2+ release in sarcoplasmic reticulum (SR) of rabbit skeletal muscle were studied. In concentrations of 0.1-1.0%, ethanol conspicuously enhanced Ca2+ release from the heavy fraction of SR, whereas a much smaller effect was noted in the light fraction. When Ca2+-induced Ca2+ release was inhibited by 10 mM Mg2+, the Ca2+ pump activities of both the heavy and light SR were the same; the activities were not significantly influenced by 1% ethanol. Ethanol itself did not release Ca2+ from the heavy SR. However, it appeared to render the heavy SR more permeable to Ca2+, thereby decreasing the amount of storable Ca2+. This action of ethanol may be related to the mechanism of its negative inotropic effect. PMID- 6486803 TI - Fructose-1,6-bisphosphate aldolase from rabbit muscle: different catalytic behavior of the dihydroxyacetone phosphate binding sites at low temperature. AB - The equivalence of the four dihydroxyacetone phosphate binding sites of aldolase was abolished by lowering the temperature. At pH 6.2 and -13 degrees C, four binding sites were detected by gel filtration; two sites with a Kdiss less than or equal to 0.1 microM, and a second set of sites with a Kdiss = 4 microM. The alteration of the binding was accompanied by the alteration of the catalytic activity. The low-affinity sites were incapable of catalyzing the cleavage of the (3S) C-H bond of dihydroxyacetone phosphate, and form only the ketimine phosphate intermediate. The high-affinity sites were still able to cleave the (3S) C-H bond of dihydroxyacetone phosphate; however, the eneamine phosphate intermediate formed was almost fully converted into the eneamine-aldehyde . . . phosphate intermediate, which was the prevailing species at the equilibrium. The mechanism of the half-of-the sites reactivity of aldolase at low temperature has been explained and the nonequivalence of sites in promoting catalysis has been utilized to dissect and characterize the individual partial reactions of the enzyme. In the course of these studies it has been shown that the rate of hydration-dehydration of dihydroxyacetone phosphate at -24 degrees C was too slow to measure. PMID- 6486804 TI - Oxime formation between alpha-keto acids and L-canaline. AB - Canaline reacts rapidly with glyoxylate, but more slowly with other alpha-keto acids, to form stable oximes. Oxidation of L-canaline with L-amino acid oxidase yields the cyclic, internal oxime, isoxazoline-3-carboxylate. L-Canaline-alpha keto acid oximes are also substrates of L-amino acid oxidase, yielding isoxazoline-3-carboxylate, alpha-keto acid, and ammonia. PMID- 6486805 TI - Rat hepatic cytochrome P-450 isozyme specificity for the metabolism of the steroid sulfate, 5 alpha-androstane-3 alpha, 17 beta-diol-3,17-disulfate. AB - Nine rat hepatic microsomal cytochromes P-450 (P-450a-P-450i) have been purified to electrophoretic homogeneity and assayed as potential catalysts of 15 beta hydroxylation of 5 alpha-androstane-3 alpha,17 beta-diol-3,17-disulfate in a reconstituted system containing NADPH-cytochrome c reductase and dilauroylphosphatidylcholine. Of the nine isozymes, only cytochrome P-450i, which is present in adult female but not adult male rats, catalyzes the hydroxylation of 5 alpha-androstane-3 alpha,17 beta-diol-3,17-disulfate. The reaction has an absolute requirement for cytochrome P-450i, NADPH-cytochrome c reductase, and NADPH, as well as a marked dependence on dilauroylphosphatidylcholine. Under optimal conditions, the Km,app was 69 microM, and the Vmax was 7.8 nmol min-1 nmol cytochrome P-450i-1. The affinity of cytochrome P-450i for the substrate, as expressed by the apparent spectral dissociation constant (Ks,app), was 20 microM. This female-specific isozyme had very low catalytic activity toward testosterone, and the metabolite profile from testosterone was distinct compared to the profiles obtained with the other eight isozymes. The results with androstane disulfate indicated that cytochrome P-450i is responsible for the sex-specific microsomal 15 beta-hydroxylase system in adult female rat liver, originally described by Gustafsson and Ingelman-Sundberg [(1974) J. Biol. Chem. 249: 1940 1945]. PMID- 6486806 TI - Enolase isozymes from Ricinus communis: partial purification and characterization of the isozymes. AB - The plastid and cytosolic isozymes of enolase from developing endosperm of castor oil seeds, Ricinus communis L. cv. Baker 296, were separated and partially purified. Each purified isozyme had a specific activity of approximately 200 mumol min-1 mg protein. The isozymes have similar pH optima for the forward reaction, but different optima for the reverse reaction. The divalent metal specificity is the same for both isozymes. In addition to differences in charge, the isozymes can be distinguished by their different kinetic constants, thermostability, and sensitivity to fluoride inhibition. Antibodies against yeast enolase isozyme I cross-react with Ricinus plastid enolase but not with the cytosolic isozyme. PMID- 6486807 TI - Monoclonal antibody A2B5 reacts with many gangliosides in neuronal tissue. AB - Monoclonal antibody A2B5, clone 105, obtained from a mouse immunized with 8-day chicken embryo retinas, reacts with most neuronal cells in chicken retina as revealed by immunofluorescence studies [G.S. Eisenbarth, F.S. Walsh, and M. Nirenberg (1979), Proc. Natl. Acad. Sci. USA 75: 4913-4917]. The antibody binds to many antigens, presumably gangliosides, present in ganglioside fractions from chicken brain, chicken retina, and human brain, as detected by autoradiography of thin-layer chromatograms. Most of the antigens, which are found in the mono-, di , tri-, and polysialoganglioside fractions, do not correspond in chromatographic mobility to any of the major gangliosides of these tissues, as revealed by orcinol reagent. Apart from the fact that only one neuraminidase-labile sialyl residue is required for binding, the carbohydrate sequence recognized by the antibody is not known. There is a qualitative and quantitative change in the ganglioside antigens in chicken brain and retina during development. The less sialylated antigens appear first, followed by the more sialylated ones. The adult tissues contain little ganglioside antigen. PMID- 6486808 TI - The role of tryptophan residues in heparin-antithrombin interactions. AB - A single tryptophan residue on antithrombin has been modified with dimethyl-(2 hydroxy-5-nitrobenzyl)sulfonium bromide. This alteration led to a 500-fold reduction in the heparin-dependent acceleration of thrombin-modified antithrombin interactions, as well as a 10-fold decrease in the avidity of the modified protease inhibitor for mucopolysaccharide. Preincubation of antithrombin with the octasaccharide binding domain of heparin prior to treatment with dimethyl-(2 hydroxy-5-nitrobenzyl) sulfonium bromide was able to suppress modification of the critical tryptophan and preserve the functional capacities of the protease inhibitor. Fluorescence quenching experiments indicated that the modifiable tryptophan groups of antithrombin were exposed to the solvent environment. Based upon these data, it was proposed that the loss of "heparin cofactor" activity of antithrombin must be predominantly due to an inability of the modified protease inhibitor to undergo a conformational transition required for mucopolysaccharide dependent "activation" of the macromolecule. PMID- 6486809 TI - Source of the oxygen atoms of nitrate in the oxidation of nitrite by Nitrobacter agilis and evidence against a P-O-N anhydride mechanism in oxidative phosphorylation. AB - 15N, 18O Tracer studies were applied to the aerobic oxidation of nitrite to nitrate by the chemolithotrophic bacterium, Nitrobacter agilis. It was established that, in conversion of nitrite to nitrate, one oxygen atom of nitrate arose from water and none from O2 or inorganic phosphate. This result confirms that of Kumar et al. [(1983) FEBS Lett. 152, 71-74]. Oxygen exchange between water and inorganic phosphate was small and that between water and nitrite or nitrate or any reaction intermediates between these two was not detected. Oxidation of nitrite was, therefore, effectively irreversible under the conditions employed. The uptake of extracellular phosphate was sufficient to allow significant transfer of 18O from phosphate to nitrate if oxidative phosphorylation had occurred by way of a P-O-N anhydride between phosphate (or ADP) and nitrate. The results are, therefore, inconsistent with the occurrence of a reaction of this type during nitrite oxidation. PMID- 6486810 TI - Release of ethane and pentane from rat tissue slices: effect of vitamin E, halogenated hydrocarbons, and iron overload. AB - The effects of in vitro addition of halogenated hydrocarbons on the susceptibility of various rat tissues to lipid peroxidation, and of iron overload and dietary vitamin E in the intact rat on subsequent lipid peroxidation in rat tissue slices were examined. The ease and speed of tissue slice preparation allowed testing of multiple tissues from the same animals. Total ethane and pentane (TEP) released from the slices was as reliable as and more sensitive than thiobarbituric acid-reactive substances as an index of lipid peroxidation. TEP was released by tissues from vitamin E-deficient rats in the following order of magnitude:intestine = brain = kidney greater than liver = lung greater than heart greater than testes = diaphragm greater than skeletal muscle. The potency of halogenated hydrocarbons for causing increased TEP release from vitamin E deficient rat liver slices was CBrCl3 greater than CCl4 = 1,1,2,2 tetrabromoethane = 1,1,2,2-tetrachloroethane greater than perchloroethylene. CBrCl3 also stimulated TEP release from kidney, intestine, and heart slices, thus identifying these as potential target organs for CBrCl3 toxicity. Dietary vitamin E decreased TEP release from liver and, to a lesser extent, from kidney. Iron overload in the rat increased TEP release by slices from all tissues tested except the brain. PMID- 6486811 TI - The dissociation of the extracellular hemoglobin of Tubifex tubifex at extremes of pH and its reassociation upon return to neutrality. AB - The dissociation of the extracellular hemoglobin of Tubifex tubifex at alkaline and acid pH, and its reassociation upon return to neutral pH, was investigated using gel filtration, ultracentrifugation, and polyacrylamide gel electrophoresis in sodium dodecyl sulfate (SDS-PAGE). Tubifex hemoglobin dissociated at pH above 8 and below 6; both dissociations appeared to be equilibrium processes. The extent of dissociation increased as the pH moved away from neutrality; although dissociation was virtually complete at pH 11, its extent at acid pH did not exceed 50-60% at pH 4. Ca(II), Mg(II), and Sr(II) cations over the range 1-100 mM decreased the extent of the dissociation only at alkaline pH. The visible absorption spectrum of the oxyhemoglobin remained unaltered in the pH range 4-9. At more extreme pH, it changed with time, altering irreversibly to that of the aquo ferri form. Gel filtration of the hemoglobin at both extremes of pH showed that it dissociated into two heme-containing fragments; one consisting of subunit 1 (Mr approximately 17,000) and the other containing subunits 2, 3, and 4 of the hemoglobin (Mr approximately 60,000). Upon return to neutral pH, the dissociated fragment reassociated to the extent of 50 to 80% to whole hemoglobin molecules. The reassociation decreased with increase in alkaline pH, and with decrease in acid pH to which the hemoglobin had been exposed; it increased in the presence of Ca(II), Sr(II), and Mg(II) only subsequent to dissociation at alkaline pH. The SDS-PAGE patterns, gel-filtration elution volumes, and alpha-helical contents, determined from circular dichroism at 222 nm, of the reassociated whole molecules were identical to those of the native hemoglobin. PMID- 6486812 TI - Cyclization of farnesyl pyrophosphate to the sesquiterpene olefins humulene and caryophyllene by an enzyme system from sage (Salvia officinalis). AB - A soluble enzyme preparation obtained from sage (Salvia officinalis) leaves was shown to catalyze the divalent metal-ion dependent cyclization of trans, trans farnesyl pyrophosphate to the macrocyclic sesquiterpene olefins humulene and caryophyllene. The identities of the biosynthetic products were confirmed by radiochromatographic analysis and by preparation of crystalline derivatives, and the specificity of labeling in the cyclization reaction was established by chemical degradation of the olefins derived enzymatically from [1-3H2]farnesyl pyrophosphate. These results constitute the first report on the cyclization of farnesyl pyrophosphate to humulene and caryophyllene, two of the most common sesquiterpenes in nature, and the first description of a soluble sesquiterpene cyclase to be isolated from leaves of a higher plant. PMID- 6486813 TI - Metabolism in vivo of furazolidone: evidence for formation of an open-chain carboxylic acid and alpha-ketoglutaric acid from the nitrofuran in rats. AB - The in vivo metabolism of an antibacterial nitrofuran, furazolidone [N-(5-nitro-2 furfurylidene)-3-amino-2-oxazolidone] was investigated. When the nitrofuran was administered orally to rats, two new-type nitrofuran metabolites, N-(4-carboxy-2 oxobutylideneamino)-2-oxazolidone and alpha-ketoglutaric acid, were isolated from the urine, together with 3-(4-cyano-2-oxobutylideneamino)-2-oxazolidone and N-(5 acetamido-2-furfurylidene)-3-amino-2-oxazolidone. In addition, the present study showed that the corresponding aminofuran was an intermediate in the conversion of furazolidone to these metabolites. PMID- 6486814 TI - Purification and properties of L-alanine:4,5-dioxovalerate aminotransferase from Chlorella regularis. AB - The enzyme L-alanine:4,5-dioxovalerate aminotransferase (EC 2.6.1.43), which catalyzes the synthesis of 5-aminolevulinic acid, was purified 161-fold from Chlorella regularis. The enzyme also showed L-alanine:glyoxylate aminotransferase activity (EC 2.6.1.44). The activity of glyoxylate aminotransferase was 56-fold greater than that of 4,5-dioxovalerate aminotransferase. The ratio of the two activities remained nearly constant during purification, and when the enzyme was subjected to a variety of treatments. 4,5-Dioxovalerate aminotransferase activity was competitively inhibited by glyoxylate, with a Ki value of 0.5 mM. Double reciprocal plots of velocity versus 4,5-dioxovalerate with varying L-alanine concentrations indicate a ping-pong reaction mechanism. The apparent Km values for 4,5-dioxovalerate and L-alanine were 0.12 and 3.5 mM, respectively. The enzyme is an acidic protein having an isoelectric point of 4.8. The molecular weight of the enzyme was estimated to be 126,000, with two identical subunits. These results suggest that, in Chlorella, as in bovine liver mitochondria and Euglena, both 4,5-dioxovalerate and glyoxylate aminotransferase activities are associated with the same protein. From the activity ratio of transamination and catalytic properties, it is concluded that this enzyme does not function primarily as a part of the 5-carbon pathway to 5-aminolevulinic acid synthesis. PMID- 6486815 TI - Self-association of sperm whale metmyoglobin. AB - The solution behavior of sperm whale metmyoglobin in 0.15 I phosphate-chloride buffer, pH 7.2, has been examined by sedimentation equilibrium, frontal gel chromatography, and sedimentation velocity. Results obtained from all three studies are shown to be consistent with a self-association model in which dimerization of the myoglobin is governed by an association equilibrium constant of 0.068 liter/g (580 M-1) at 20 degrees C. PMID- 6486816 TI - Purification and characterization of pregastric esterase from calf. AB - Calf pregastric esterase (PGE) was purified from calf gullet tissues. The tissue was excised and lyophilized, and lipid materials were extracted with acetone and n-butanol at -20 degrees C. Proteins were extracted from the delipidated tissue with a buffer containing a chaotropic salt (NaSCN) to solubilize hydrophobically bound protein aggregates. Calf PGE precipitated from the crude extract at pH 5.0. The precipitated, solubilized proteins were subjected to anion-exchange chromatography on DEAE-Sephacel, and the enzymatic activity was eluted using a linear gradient from 0.10 to 0.50 M NaCl at pH 8.0. Fractions with high specific activities were then chromatographed twice using gel filtration on Sephadex G 100. The resultant enzyme was shown to be pure upon discontinuous electrophoresis in 12% polyacrylamide containing 0.1% sodium dodecyl sulfate (SDS-PAGE). From SDS PAGE gel patterns, a molecular weight of 49,000 was determined. The amino acid composition of the enzyme allowed calculation of an "average hydrophobicity" (Bigelow index) of 1150 cal/residue. This indicates that calf PGE is relatively hydrophobic, being similar to proteins such as alpha-lactalbumin and bovine serum albumin in average hydrophobicity. PMID- 6486817 TI - Inhibition of the oxidation of acetaldehyde and formaldehyde by hepatocytes and mitochondria by crotonaldehyde. AB - Crotonaldehyde was oxidized by disrupted rat liver mitochondrial fractions or by intact mitochondria at rates that were only 10 to 15% that of acetaldehyde. Although a poor substrate for oxidation, crotonaldehyde is an effective inhibitor of the oxidation of acetaldehyde by mitochondrial aldehyde dehydrogenase, by intact mitochondria, and by isolated hepatocytes. Inhibition by crotonaldehyde was competitive with respect to acetaldehyde, and the Ki for crotonaldehyde was about 5 to 20 microM. Crotonaldehyde had no effect on the oxidation of glutamate or succinate. Very low levels of acetaldehyde were detected during the metabolism of ethanol. Crotonaldehyde increased the accumulation of acetaldehyde more than 10-fold, indicating that crotonaldehyde, besides inhibiting the oxidation of added acetaldehyde, also inhibited the oxidation of acetaldehyde generated by the metabolism of ethanol. Formaldehyde was a substrate for the low-Km mitochondrial aldehyde dehydrogenase, as well as for a cytosolic, glutathione-dependent formaldehyde dehydrogenase. Crotonaldehyde was a potent inhibitor of mitochondrial oxidation of formaldehyde, but had no effect on the activity of formaldehyde dehydrogenase. In hepatocytes, crotonaldehyde produced about 30 to 40% inhibition of formaldehyde oxidation, which was similar to the inhibition produced by cyanamide. This suggested that part of the formaldehyde oxidation occurred via the mitochondrial aldehyde dehydrogenase, and part via formaldehyde dehydrogenase. The fact that inhibition by crotonaldehyde is competitive may be of value since other commonly used inhibitors of aldehyde dehydrogenase are irreversible inhibitors of the enzyme. PMID- 6486818 TI - Anti-insulin-like (diabetogenic) peptides in pituitary extracts: role of oxytocin. AB - A peptide has been extracted and characterized from whole bovine pituitaries that has anti-insulin-like activities when assayed in rat adipocytes. This peptide has been purified approximately 100,000-fold, is homogeneous by thin-layer chromatography in three separate solvent systems, and shows a single peak by reverse-phase high-performance liquid chromatography. By these chemical criteria, as well as biological activity criteria (14CO2 production from D-[U-14C]glucose and D-[U-14C]glucose incorporation into glycogen in rat adipocytes], the peptide is indistinguishable from oxytocin. It reacts with anti-oxytocin antibody, and has an amino acid composition indistinguishable from purified oxytocin. The relationship between this material and other previously described anti-insulin or diabetogenic peptides is discussed, but it was not possible to conclude that this peptide, which has been purified to homogeneity and constant specific activity, is related to these previously described factors. PMID- 6486819 TI - Phospholipid asymmetry in the isolated sarcoplasmic reticulum membrane. AB - The total phospholipid content and distribution of phospholipid species between the outer and inner monolayers of the isolated sarcoplasmic reticulum membrane was measured by phospholipase A2 activities and neutron diffraction. Phospholipase measurements showed that specific phospholipid species were asymmetric in their distribution between the outer and inner monolayers of the sarcoplasmic reticulum lipid bilayer; phosphatidylcholine (PC) was distributed 48/52 +/- 2% between the outer and inner monolayer of the sarcoplasmic reticulum bilayer, 69% of the phosphatidyl-ethanolamine (PE) resided mainly in the outer monolayer of the bilayer, 85% of the phosphatidylserine (PS) and 88% of the phosphatidylinositol (PI) were localized predominantly in the inner monolayer. The total phospholipid distribution determined by these measurements was 48/52 +/ 2% for the outer/inner monolayer of the sarcoplasmic reticulum lipid bilayer. Sarcoplasmic reticulum phospholipids were biosynthetically deuterated and exchanged into isolated vesicles with both a specific lecithin and a general exchange protein. Neutron diffraction measurements directly provided lipid distribution profiles for both PC and the total lipid content in the intact sarcoplasmic reticulum membrane. The outer/inner monolayer distribution for PC was 47/53 +/- 1%, in agreement with phospholipase measurements, while that for the total lipid was 46/54 +/- 1%, similar to the phospholipase measurements. These neutron diffraction results regarding the sarcoplasmic reticulum membrane bilayer were used in model calculations for decomposing the electron-density profile structure (10 A resolution) of isolated sarcoplasmic reticulum previously determined by X-ray diffraction into structures for the separate membrane components. These structure studies showed that the protein profile structure within the membrane lipid bilayer was asymmetric, complementary to the asymmetric lipid structure. Thus, the total phospholipid asymmetry obtained by two independent methods was small but consistent with a complementary asymmetric protein structure, and may be related to the highly vectorial functional properties of the calcium pump ATPase protein in the sarcoplasmic reticulum membrane. PMID- 6486820 TI - Regulatory aspects of rat liver mitochondrial phospholipase A2: effects of calcium ions and calmodulin. AB - A comparative study was made of the metal ion requirement of rat liver mitochondrial phospholipase A2 in purified and membrane-associated forms. Membrane-bound enzyme was assayed using either exogenous or endogenous phosphatidylethanolamine. Although several divalent metal ions caused increased activity of the membrane-associated enzyme, only Ca2+ and Sr2+ activated the purified phospholipase A2. The activity in the presence of Sr2+ amounted to about 25% of that found with Ca2+. When the Ca2+ concentration was varied two activity plateaus were observed. The corresponding dissociation constants varied from 6 to 20 microM Ca2+ and from 1.4 to 12 mM Ca2+ for the high- and low-affinity binding sites, respectively, depending on the assay conditions and whether purified or membrane-bound enzyme was used. A kSr2+ of 60 microM was found for the high affinity binding site. The effect of calmodulin and its antagonist trifluoperazine was also investigated using purified and membrane-associated enzyme. When membrane-bound enzyme was measured with exogenous phosphatidylethanolamine, small stimulations by calmodulin were found. However, these were not believed to indicate a specific role for calmodulin in the Ca2+ dependency of the phospholipase A2, since trifluoperazine did not lower the activity of the membrane-bound enzyme to levels below those found in the presence of Ca2+ alone. Membrane-bound enzyme in its action toward endogenous phosphatidylethanolamine was neither stimulated by calmodulin nor inhibited by trifluoperazine. Purified enzyme was also not stimulated by calmodulin, while trifluoperazine caused small stimulations, presumably due to interactions at the substrate level. These results indicate that calmodulin involvement in phospholipase A2 activation should not be generalized. PMID- 6486821 TI - Turnover of proteoglycans in cultures of bovine articular cartilage. AB - Proteoglycans in cultures of adult bovine articular cartilage labeled with [35S]sulfate after 5 days in culture and maintained in medium containing 20% fetal calf X serum had longer half-lives (average 11 days) compared with those of the same tissue maintained in medium alone (average 6 days). The half-lives of proteoglycans in cultures of calf cartilage labeled after 5 days in culture and maintained in medium with serum were considerably longer (average 21 days) compared to adult cartilage. If 0.5 mM cycloheximide was added to the medium of cultures of adult cartilage, or the tissue was maintained at 4 degrees C after labeling, the half-lives of the proteoglycans were greater, 24 and greater than 300 days, respectively. Analyses of the radiolabeled proteoglycans remaining in the matrix of the tissue immediately after labeling the tissue and at various times in culture revealed two main populations of proteoglycans; a large species eluting with Kav of 0.21-0.24 on Sepharose CL-2B, of high bouyant density and able to form aggregates with hyaluronate, and a small species eluting with a Kav of 0.63-0.70 on Sepharose CL-2B, of low buoyant density, containing only chondroitin sulfate chains, and unable to form aggregates with hyaluronate. The larger proteoglycan had shorter half-lives than the smaller proteoglycan; in cartilage maintained with serum, the half-lives were 9.8 and 14.5 days, respectively. Labeling cartilage with both [3H]leucine and [35S]sulfate showed the small proteoglycan to be a separate synthetic product. The size distribution of 35S-labeled proteoglycans lost into the medium was shown to be polydisperse on Sepharose CL-2B, the majority eluting with a Kav of 0.27 to 0.35, of high buoyant density, and unable to aggregate with hyaluronate. The size distribution of glycosaminoglycans from 35S-labeled proteoglycans appearing in the medium did not differ from that associated with labeled proteoglycans remaining in the matrix. PMID- 6486822 TI - The primary structure of spinach acyl carrier protein. AB - Acyl carrier protein (ACP) from spinach leaves has been purified to homogeneity by high-performance liquid chromatography with an anion-exchange column. The amino acid sequence of one major ACP in spinach leaves, ACP-I, has been determined by automated Edman degradation. It consists of the following 82 amino acids: (sequence in text). Sequencing of the intact polypeptide provided data for the first 57 residues. Cleavage of the succinylated ACP with CNBr at Met-46, followed by sequencing of the fragment mixture, provided data for the final 36 residues. The C-terminal alanine was confirmed by carboxypeptidase Y digestion. The spinach ACP has 40, 70, and 25% homology with Escherichia coli, barley, and rabbit ACPs, respectively. The results not only provide the first complete sequence of a plant ACP, but also provide insight into the structural and evolutionary relationships among plant, animal, and bacterial ACPs. PMID- 6486823 TI - Retinoic acid metabolism by a system reconstituted with cytochrome P-450. AB - Feeding rats with a diet containing a hundred times the normal amount of vitamin A resulted, within 2 to 3 weeks, in an increase in total hepatic microsomal cytochrome P-450 content. This was associated, in isolated microsomes, with an enhanced conversion of all-trans-retinoic acid to polar metabolites, including a two- to threefold increased production of 4-hydroxy- and 4-oxo-retinoic acid, whether expressed per microsomal protein or per cytochrome P-450. Unlike effects of other inducers (e.g., phenobarbital or methylcholanthrene), activities of benzphetamine, aminopyrine, and ethylmorphine demethylases or benzopyrene hydroxylase were not increased. Furthermore, the CO-reduced difference spectral peak was shifted towards 449 nm. On sodium dodecyl sulfate-gel electrophoresis, one band was increased with electrophoretic mobility identical to that of cytochrome P-450f, a recently isolated new form which has a CO-reduced difference spectral peak at 448 nm. In a system reconstituted with NADPH-cytochrome P-450 reductase, NADPH, and phospholipid, purified cytochromes P-450f and b were discovered to promote conversion of retinoic acid to polar metabolites, including 4-hydroxy-retinoic acid. PMID- 6486824 TI - Differential effects of N-acetylglutamate on citrulline synthesis by coupled and uncoupled mitochondria. AB - When rats were placed on a low-protein (5%) diet for 24 h or less, liver mitochondrial acetylglutamate decreased rapidly, carbamyl phosphate synthetase (ammonia) and ornithine transcarbamylase decreased little, and carbamyl phosphate synthesis (measured as citrulline) by isolated mitochondria occurred at very low rates. The matrix acetylglutamate content of these mitochondria, whether coupled or uncoupled, was increased similarly by preincubating them with added acetylglutamate, but citrulline synthesis increased from less than 1 to 2.3 nmol min-1 mg-1 in the coupled state, and from less than 1 to 35 nmol min-1 mg-1 in the uncoupled state. However, when coupled mitochondria were incubated with the substrates required for the synthesis of acetylglutamate in the matrix, citrulline synthesis increased to 48 nmol min-1 mg-1; this rate was similar to that of mitochondria from control rats (fed a normal diet). When mitochondria from controls were incubated with up to 5mM acetylglutamate, citrulline synthesis by coupled mitochondria was increased by 10 to 40%, while synthesis by uncoupled mitochondria was 1.5 to 4 times higher than that observed with the coupled mitochondria; matrix acetylglutamate in both conditions rose to levels similar to those in the medium. The reason for the different behavior of carbamyl phosphate synthetase (ammonia) in coupled and uncoupled mitochondria was not apparent; neither oxidative phosphorylation nor ornithine transport were limiting in the coupled system. These observations are an example of the restrictions imposed upon enzymatic systems by the conditions existing in the mitochondrial matrix, and of the different behavior of carbamyl phosphate synthetase in situ and in solution. In addition, they show that conclusions about the characteristics of the enzyme in coupled mitochondria based on observations made in uncoupled mitochondria are not necessarily justified. PMID- 6486825 TI - Metabolism of 1-O-alkyl-2-acetyl-sn-glycerol by washed rabbit platelets: formation of platelet activating factor. AB - A new type of neutral lipid, 1-O-alkyl-2-acetyl-sn-glycerol (AAG), induced a delayed aggregation pattern on interaction with washed rabbit platelets. Although far less potent on a molar basis than platelet activating factor (1-O-alkyl-2 acetyl-sn-glycero-3-phosphocholine, AGEPC, nevertheless this compound caused an aggregation, albeit delayed in time, remarkably similar to that exhibited by AGEPC. In view of the possible formation of AGEPC in this reaction, AAG was incubated with washed rabbit platelets, and a lipid corresponding in chromatographic behavior to AGEPC was isolated and identified as such by a combined gas-liquid chromatography/mass spectrometry technique coupled with selected ion monitoring. PMID- 6486826 TI - The effect of hypolipidemic drugs on plant lipid metabolism. AB - The effect of hypolipidemic drugs, WY14643 and DH990, on plant lipid metabolism has been studied. The total incorporation of [14C]acetate into lipids was inhibited by addition of both drugs to aged potato (Solanum tuberosum) tuber discs, spinach (Spinacia oleracea) leaves, and spinach chloroplasts, while the incorporation in Chlorella vulgaris cells was affected only by DH990. Moreover, DH990 inhibited the incorporation of 14C-labeled fatty acids into phosphatidylcholine and phosphatidylethanolamine of potato discs, and decreased the incorporation into phosphatidylglycerol of Chlorella cells. DH990 inhibited the formation of polyunsaturated fatty acids in potato discs, Chlorella cells, and spinach leaves, whereas WY14643 had no effect on the formation of these fatty acids. Stearoyl-ACP desaturase from safflower (Carthamus tinctorius) seeds was very sensitive to both drugs, especially DH990, which completely blocked the activity at 2 mM levels. When safflower lysophospholipid acyltransferases were solubilized by detergent treatment, only DH990 inhibited the incorporation of [14C]oleoyl-CoA into lysophosphatidylcholine or lysophosphatidylethanolamine. Both drugs inhibited fatty acid synthesis from [14C]malonyl-CoA in the microsomal fraction from safflower seeds, but only DH990 inhibited FAS activity in the soluble fraction; both drugs inhibited severely the formation of stearic acid. Both acetyl-CoA carboxylase and acetyl-CoA synthetase were sensitive to both drugs. PMID- 6486827 TI - Quantitative affinity chromatography: further developments in the analysis of experimental results from column chromatography and partition equilibrium studies. AB - The problem of allowance for the effects of gel partitioning of the solute in quantitative affinity chromatography has been reexamined, and new expressions have been derived for the description of results obtained by frontal chromatography. In addition, the theoretical expressions have been rearranged into forms suitable for determination of the relevant interaction parameters by simple graphical analysis, a procedure illustrated with results obtained in a partition equilibrium study of the NADH-dependent elution of rabbit muscle lactate dehydrogenase from Blue Sepharose. PMID- 6486828 TI - Kinetics of hydrolysis of peptide thioester derivatives of arginine by human and bovine thrombins. AB - Several peptide thioester substrates have been synthesized and tested with human thrombins (alpha, gamma, and nitrated), bovine thrombin, trypsin, and Factor X alpha beta. The substrates include various thioalkyl esters, thiobenzyl esters with substitution in the 4-position, substrates containing additional residues on the amino-terminal side of the scissile bond (P extended substrates) and one substrate containing additional residues on the carboxyl-terminal side (P' extended substrate). Neither the P nor the P' extensions resulted in significantly increased specificity; however, with one P extended substrate, D Phe-Pro-Arg-SBzl, the KM with bovine thrombin (0.72 microM) was the second lowest KM yet reported. The results of this study underscore the importance of P vs. P' extension for thrombin substrates. The kinetic constants of the thiobenzyl esters were found to be little affected by the 4-position substitutions. A comparison of gamma-thrombin and nitrothrombin shows them to be quite similar kinetically, while both are significantly less reactive than alpha-thrombin. With these substrates, trypsin, bovine thrombin, and Factor X alpha beta have kcat/KM values in the approximate ratio of 35:10:1, respectively. The results presented here should be of value in the future design of reactive yet specific substrates for thrombin. The comparisons between the various enzymes could be helpful in clarifying the nature of their active sites. PMID- 6486829 TI - Calmodulin-dependent protein kinase (kinase II) which is involved in the activation of tryptophan 5-monooxygenase catalyzes phosphorylation of tubulin. AB - Tubulin was shown to be an endogenous substrate of the calmodulin-dependent protein kinase (kinase II), which is involved in the activation of tryptophan 5 monooxygenase [T. Yamauchi and H. Fujisawa (1983) Eur. J. Biochem. 132, 15-21]. Serine and threonine were identified as the phosphate acceptor amino acids of tubulin. The Vmax of the phosphorylation of tubulin and the apparent Km value for tubulin of calmodulin-dependent protein kinase II were 89 nmol phosphate transferred min-1 mg kinase II-1 and 1.7 microM, respectively. The maximum 32P incorporation into tubulin was 0.18 mol Pi/mol alpha-tubulin and 0.13 mol Pi/mol beta-tubulin. The phosphorylation of tubulin was decreased by the denaturation of tubulin. The phosphorylation of tubulin by kinase II did not affect the assembly of microtubules. PMID- 6486830 TI - [Estracyt (estradiol-nitrogen mustard complex)--estramustine binding protein and its specificity]. AB - Estracyt (estramustine phosphate) is a nitrogen mustard derivative of estradiol 17 beta which is rapidly dephosphorylated to yield estramustine. Estramustine is metabolized to estromustine mainly in the liver. Both estramustine and estromustine are retained in rat prostate with a high degree of specificity. This retention is due to the binding of estramustine and/or estromustine to a protein called EMBP (estramustine binding protein). When estimated by HPLC, the molecular weights of these estramustine binding components in rat prostate are 45,000 50,000 and 25,000-30,000, respectively. HPLC and glycerol density gradient analysis clearly demonstrated the occurrence of EMBP in a cytosol preparation from human prostatic cancer tissue. When estimated by HPLC, the molecular weights of estramustine binding components are 45,000 and 25,000 daltons, respectively. In addition, results of effectiveness of Estracyt studied under a cooperative research group in Japan, are reported in this paper. Effectiveness was evaluated at 3 months of the treatment on 121 patients with untreated prostatic cancer (Study I) and 95 patients with reactivated cancer (Study II), at 12 months of the treatment on 68 patients in Study I and 85 patients in Study II, and at 24 months on 37 patients in Study I and 23 patients in Study II. At 3 months of the treatment, Estracyt was effective in 89% of untreated prostatic cancers, and 38% of reactivated prostatic cancers. At 24 months of the treatment, this drug was effective in 65% of untreated prostatic cancers and 30% of reactivated ones. Estracyt is especially recommended as a first-choice drug for both the untreated patients with poorly differentiated adenocarcinoma and reactivated cancer. PMID- 6486831 TI - [Direct antitumor activity of biological response modifiers (B.R.M.) proven by an in vitro sensitivity test]. AB - Although the role of biological response modifiers in cancer therapy is well recognised, their mechanism of action remains unsettled. It is empirically considered that there may be some direct antitumor effects induced by some BRM. To analyse the mechanism of action, we evaluated the effects of BRM by using our in vitro sensitivity test, the principle of which was based on dynamic and morphological observation of target cells in vitro. Five kinds of BRM (OK-432, PSK, N-CWS, Bestatin, Lentinan) were tested and the target cell lines were L1210 and P388. The results showed that OK-432 and PSK were mildly cytotoxic, and that OK-432, PSK and Bestatin were effective for cell growth suppression. PMID- 6486832 TI - [Adjuvant immunochemotherapy with long-term OK-432 administration in colorectal cancer]. AB - A new clinical trial on immunochemotherapy as an adjuvant therapy of surgery for colorectal cancers was studied. Results were retrospectively evaluated against previous controls treated by chemotherapy alone. As an immunotherapeutic agent, a streptococcal preparation, OK-432 was used. The maintenance dosage of OK-432, was 5 KE once a week and was continued for at least 2 years after surgical resection. As chemotherapeutic agents, mitomycin C for 2 weeks postoperatively and tegafur for 1 year were administered. Delayed skin reactivity to SU-polysaccharide (SU PS) extracted from Streptococcus pyogenes SU-strain and lymphoproliferative response to phytohemagglutinins (PHA) were significantly enhanced in the OK-432, immunochemotherapy group. Disease-free interval in the immunochemotherapy group (n = 49) was prolonged compared to that in the control group (n = 129), especially in the curative resection cases of Duke's C stage. There was statistical significance between the two groups (p less than 0.05). These results suggested that long-term administration of OK-432 after surgical resection of colorectal cancer was effective on growth inhibition of micrometastasis and could increase the postoperative survival rate. PMID- 6486833 TI - [Effect of an anabolic steroid on the cellular immunity and postoperative evaluation of uterine cervical cancer]. AB - The effects of an anabolic steroid on the immune activity and clinical condition of patients with cancer of the uterine cervix were studied. The effects of the steroid on tumor growth were also studied in animals. The results obtained demonstrated that the anabolic steroid (1) enhanced the activity of macrophages and cell-mediated immune activity, (2) reduced the incidence of post-operative infection, (3) reduced pose-operative loss of weight of patients due to the intrinsic anabolic activity of the steroid, and (4) did not exert any influence on tumor growth. Judging from these results, administration of the anabolic steroid would appear to be effective for the improvement of the general condition of cancer patients following surgery or in terminal cases. PMID- 6486834 TI - [Fundamental studies on the introduction of chemotherapy of uterine cervical carcinoma--tissue level of 5-FU after oral administration]. AB - In Japan, oral 5-FU has been popularly used as an adjuvant chemotherapy to surgical operation mainly gastrointestinal carcinomas. This drug is generally administered consecutively at a low dose over a long term, because of its distribution at high levels in the upper gastrointestinal organs after oral administration. The authors have attempted to introduce the oral administration of 5-FU as an adjuvant chemotherapy in the treatment of uterine cervical carcinoma, and the results of a preliminary trial are reported in this paper; that is, the 5-FU level in target organs was measured after oral administration of 5-FU in 44 cases of uterine cervical carcinoma. Judging from the 5-FU level in organs removed about 2 hours after preoperative administration of 5-FU at 300 mg, the distribution of the drug to bilateral lymph nodes and the uterine cervix was good, and when calculated on the basis of the trace as 0, the average tissue level was 0.0432 microgram/g in the left lymph node, 0.0104 microgram/g in the right lymph node and 0.0190 microgram/g in the uterine cervix. From the above, it was concluded that, in the application of oral 5-FU as an adjuvant chemotherapy to treatment of uterine cervical carcinoma, a different manner application procedure should be established from that used to treat gastrointestinal carcinoma; that is, 5-FU should be administered intermittently at a moderate dose. PMID- 6486835 TI - [Effect of perfluorochemicals on tissue PO2 levels in a subcutaneous 9L rat glioma model]. AB - The purpose of this study was to investigate the effect of perfluorochemicals(Fluosol-43) and/or oxygen on tissue PO2 levels in a subcutaneous 9L rat glioma model. Thirty days after subcutaneous implantation of 9L cells in to the flank of Fisher 344 rats, tumors contained large central areas of necrosis and showed a heterogeneity in tissue PO2 levels. Tissue PO2 levels in the solid area, border area, and necrotic area were about 45 mmHg, 5 mmHg, and 0 mmHg respectively. More significant elevation of tissue PO2 levels of about 30 mmHg in hypoxic areas was found in the perfluorochemicals and oxygen group than in the oxygen group alone (p less than 0.001). It was suggested that perfluorochemicals with oxygen enhanced the oxygenation of hypoxic areas and might enhance the sensitivity of the hypoxic area of tumor tissue to anti-cancer drugs and radiation treatment. PMID- 6486836 TI - [Characteristics of lactate dehydrogenase (LDH) isozyme in human cancers transplanted into nude mice and its application to the evaluation of experimental chemotherapy]. AB - Human lactate dehydrogenase (LDH) was universally detected and quantified from sera of nude mice bearing human tumors. The patterns of LDH isozyme in sera reflected exactly those in each tumor extract, and remained unchanged over several generations. In 16 human cancers (7 gastric, 4 colorectal, 2 pancreatic and 3 breast) examined, human LDH levels in serum showed proportional increase as the transplanted tumors grew. Assessment of experimental chemotherapy by measuring the LDH levels of a treated group versus a control group was compared with that obtained by calculating the tumor weight during (14 tests) or after (61 tests) treatments. The percentage inhibition assessed by LDH level was strongly correlated to inhibition rate assessed by tumor weight. Moreover, LDH expressed more rapidly the inhibitory effect of an administered agent than tumor weight. If the drug was effective, serum LDH level in the treated group exhibited a temporary sharp rise within 2 days, thereafter decreasing to a lower level than that of the control. These results imply usefulness in further clinical application. PMID- 6486837 TI - [Tumor imaging with conventional X-ray using a new artificial blood substitute (perfluoroctylbromide emulsion, FOB)]. AB - A new artificial blood substitute, FOB, which has been shown to be a good solvent for oxygen, contains a Bromine atom within its molecule. FOB is taken up in tumor macrophages and the Bromine shows opacity on X-ray film by absorbance of X-rays. In this study, tumor imaging possibilities were studied using conventional roentgenograms, on mice bearing transplanted Ehrlich ascites tumors on the right leg and which were given a 1-ml injection of 50 w/v % FOB. The results obtained follows: Solid Ehrlich tumors were imaged clearly wih injected FOB. X-ray films showed persisting homogeneous tumor staining, and irregular linear and plaque opacities. Larger tumors (more than 5,000 mm3 in volume) were imaged less clearly than smaller ones (about 1,000 mm3 in volume), because of superimposition of X ray absorbance of the FOB taken up and of the larger tumor mass itself. The patterns of FOB taken up into the transplanted tumor were different according to various tumor growth time. Tumor imaging effect was enhanced by double time injection of 1 ml FOB. Histological features of Ehrlich tumors injected with FOB showed that FOB was phagocytosed by macrophages in the tumor tissue. The radiosensitization effect of FOB has already been reported by us. These results suggested that FOB acts not only as a sensitizer in radiation therapy, but also as a tumor imaging agent for diagnosis of the localization of malignancy in radiotherapeutic planning. PMID- 6486838 TI - [Domperidone suppositories treatment for nausea and vomiting during cancer chemotherapy]. PMID- 6486839 TI - Cosmetic (?) surgery. PMID- 6486840 TI - Raphe cyst or apocrine cystadenoma of the glans penis. PMID- 6486841 TI - Variations in plasma levels with 12 different forms of methoxsalen. PMID- 6486843 TI - A surplus of dermatologists. Wherefrom and whereto. PMID- 6486842 TI - Extramedullary hematopoiesis. PMID- 6486844 TI - Dermatology manpower projections. AB - Since an oversupply of physician specialists leads to a waste of professional resources, planning of the number of physicians may be desirable. A model projecting the future supply of dermatologists was formulated on the basis of current residency capacity, which produces about 270 dermatologists per year, and on experience regarding the average length of active clinical practice. How changes in the training capacity affect the future supply of dermatologists was also examined. The model projects an equilibrium supply of about 9,500 dermatologists, or 3.2 per 100,000 population early in the 21st century, provided the number of new graduates remains at its present level. Assuming no economic barriers to access, 2.8 to three dermatologists per 100,000 population should be adequate to meet demand. Because of many unpredictable factors, periodic reassessment of dermatology training capacity is necessary. PMID- 6486845 TI - Recreationally associated Pseudomonas aeruginosa folliculitis. Report of an epidemic. AB - An epidemic of Pseudomonas aeruginosa folliculitis occurred in 117 persons. An indoor swimming pool at a dude ranch was the source of the infection. Recognition of the epidemic occurred through four patients who reported to our clinic with a characteristic syndrome of follicular pustular eruptions and associated symptoms. Inadequate disinfection of the water was causative. Many affected persons had prolonged contact with the organism because swimsuits were worn for several hours after exposure. Early diagnosis and epidemiological investigation are important in treating this disorder. PMID- 6486846 TI - Management of leg ulcers with hydrocolloid occlusive dressing. AB - Twenty-two patients with 31 leg ulcers of various causes received local wound management consisting of the application of an adhesive hydrocolloid (HC) occlusive dressing (DuoDerm). Group 1 comprised 15 patients (11 outpatients) with 19 ulcers. Approximately two thirds (12/19) of the ulcers healed when treated solely with the HC dressing; mean treatment time was 57 days. Group 2 comprised seven hospitalized patients with at least two leg ulcers of similar size and distribution. The 20 ulcers in the seven patients were treated with either mild topical antimicrobial wet dressings (Sweitzer's 1:32 solution) or HC dressings, with each patient serving as his own "control." All 20 ulcers healed; the average time to healing was 44 days with HC dressing and 42 days with wet dressing management. Most of the patients reported convenience in management and substantial relief of pain with the use of HC dressings. PMID- 6486847 TI - Becker's nevus coexistent with connective-tissue nevus. AB - Becker's nevus (BN) has been reported in association with smooth-muscle hamartoma, and an acneiform eruption and underlying structural anomalies of bone and soft tissues. We report a case of BN coexistent with a large connective tissue nevus (CTN) on the right shoulder of a 74-year-old man. Whether this phenomenon represents the mere chance occurrence of two distinct cutaneous hamartomatous processes coexistent in the same anatomic site, an exaggerated manifestation of minor dermal changes previously described, or an association heretofore unrecognized due to the often subtle clinical and histologic features of both BN and CTN, is conjectural. PMID- 6486848 TI - Familial acanthosis nigricans. AB - A mother and daughter had benign familial acanthosis nigricans. Familial acanthosis nigricans begins in early childhood and may be accentuated at puberty. The eruption is not associated with underlying illness. Forms of acanthosis nigricans are associated with obesity, endocrinologic abnormalities, drug ingestion, and malignant neoplasms. PMID- 6486849 TI - Needle puncture scars from midtrimester amniocentesis. AB - A neonate was noted to have two depressed scars on the upper part of the back at birth that we believe resulted from midtrimester amniocentesis; no underlying injury was apparent. Scar formation from needle puncture occurs in an estimated 1% to 3% of the infants whose mothers have undergone midtrimester diagnostic amniocentesis. The scars most commonly are depressed, dimplelike, and measure 1 to 2 mm in diameter, although linear scarring may also occur. Single or multiple scars may be present, and, in seven of the 36 infants previously described in the literature, internal injuries also occurred as a result of the needle puncture. PMID- 6486850 TI - Oral ingestion of potassium permanganate or aluminum acetate in two patients. AB - Accidental ingestion of medication intended for topical use occurred in two patients. A patient hospitalized for psoriasis mistakenly swallowed potassium permanganate tablets intended for use in her bathwater. Another patient ingested tablets intended to prepare Burow's solution for topical treatment of his wound infection. These types of accidental ingestion of medicine intended for topical use are, fortunately, uncommon and do not usually lead to complications. However, the current trend to unit dosing, especially in tablet form, may result in the more frequent occurrence of such accidents. PMID- 6486851 TI - Pathology quiz case 2: staphylococcal scalded skin syndrome (SSSS). PMID- 6486852 TI - Pathology quiz case 1: eruptive xanthoma (associated with type 5 hyperlipoproteinemia). PMID- 6486853 TI - Verruciform xanthoma of the scrotum. PMID- 6486854 TI - Annular skin lesions induced by chope (candle suction). A Southeast Asian folk medicine practice. PMID- 6486855 TI - Dyskeratosis congenita with macular cutaneous amyloid deposits. PMID- 6486856 TI - Aluminum chloride hexahydrate treatment of localized epidermolysis bullosa. PMID- 6486857 TI - Diabetes. I. Measuring adequacy and lability of control. PMID- 6486858 TI - Early hospital admissions and subsequent behaviour problems in 6 year olds. AB - The relation between admission to hospital during the preschool years and teacher and maternal ratings of child behaviour problems at age 6 years was studied in a birth cohort of New Zealand children. There was a slight but consistent trend for reported behaviour problems to increase with increasing length of hospital stay, however, control for family and social factors suggested that this correlation was spurious. Children admitted to hospital tended to come from socially disadvantaged backgrounds and from families reporting large numbers of life events, and independently of this social background and life events were related to childhood behaviour problems. When the effects of family social background and life events were controlled for, there was no significant association between duration of hospital stay and reports of child behaviour problems. It is concluded that there is little evidence to suggest that in a modern paediatric setting, admission to hospital has any significant effect on the child's subsequent behavioural pattern. PMID- 6486859 TI - Usefulness of clinical features and liver biopsy in diagnosis of disseminated herpes simplex infection. AB - With the advent of effective antiviral treatment for disseminated herpes infection it has become important to be able to make a firm clinical diagnosis of this condition. We undertook a retrospective analysis of 20 patients with disseminated herpes simplex infection diagnosed at necropsy to derive useful clinical pointers to this severe form of the disease. The most useful clinical criteria were malnutrition, post measles state, and local herpes infection in addition to encephalopathy, enlarging hepatomegaly, and deteriorating pneumonia. The liver showed characteristic histological changes in 18 of 19 patients. These clinical criteria combined with liver biopsy were applied in a prospective pilot study of five patients at risk for disseminated herpes infection and the results were encouraging. PMID- 6486860 TI - Renal sodium handling in minimal change nephrotic syndrome. AB - Renal sodium handling was studied in 23 children at three different stages of the minimal change nephrotic syndrome--the oedema forming state, proteinuric steady state, and remission. Clearances of inulin and para-aminohippuric acid and urinary sodium excretion were determined basally, after intravenous infusion of isotonic saline and hyperoncotic albumin, and after furosemide injection. Absolute and fractional basal sodium excretion were significantly lower in oedema forming patients than in proteinuric patients in steady state, and non proteinuric patients. In contrast to proteinuric patients in steady state and non proteinuric patients, the oedema forming patients failed to respond to isotonic saline infusion with increased sodium excretion. After diuretic blockade with furosemide, the fractional sodium excretion of the oedema forming patients increased to values no different from those of the non-proteinuric patients, whereas the fractional sodium excretion of the steady state patients increased to significantly higher values. The plasma aldosterone concentration was within normal limits in 11 of 14 proteinuric patients, and did not correlate with the basal sodium excretion. Thus, sodium retention in the minimal change nephrotic syndrome was found only in oedema forming patients, and since this is not related to the plasma aldosterone concentration it may be caused by an intrarenal mechanism, probably sited in distal parts of the nephron. PMID- 6486861 TI - Transient riboflavin depletion in preterm infants. AB - Biochemical riboflavin status was measured in 68 preterm infants who were receiving either human milk or a preterm infant formula (containing riboflavin, 1.8 mg/l) during the first few weeks of life. The relation between riboflavin status, type of diet, and time of introduction of a multivitamin supplement containing riboflavin was analysed and the duration of phototherapy was recorded. Those who received the multivitamin supplement on or before day 7 of life seldom became deficient and no significant difference between diets was seen in this group. Of those who received the supplement after day 7, human milk fed infants commonly developed abnormal riboflavin status (18 out of 23 infants) compared with a small and significantly lower incidence in the formula fed group. Dietary effects on riboflavin status seemed to outweigh in importance those of phototherapy. It is concluded that the riboflavin content of human milk, which may be lowered by photodegradation, is not sufficient to ensure normal biochemical status in preterm infants. The larger amounts provided by a multivitamin supplement or by a preterm infant formula may, however, prevent biochemical deficiency. The desirability (and safety) of routine riboflavin supplementation of preterm infants is discussed. PMID- 6486862 TI - How long do we need to observe head injuries in hospital? AB - Between 1974 and 1981, 28 701 children in Wales were admitted to hospital for observation after an injury to the head. Only 22 of 35 who subsequently developed intracranial haemorrhage, presented for examination within 24 hours of the injury. All of these patients had symptoms or signs clearly needing continued observation or treatment six hours after the injury. Many children who are currently admitted to hospital could safely be discharged after a limited period of observation. PMID- 6486863 TI - Bleeding disorders and non-accidental injury. AB - Fifty children with suspected non-accidental injury, most of whom had bruising, were investigated to exclude a bleeding disorder. The following investigations were undertaken in each child: full blood count; platelet count, size, and shape; prothrombin time; partial thromboplastin time including mix with normal plasma; fibrinogen; and a bleeding time. The results of these initial investigations were abnormal in eight children (16%). One child had a severe coagulopathy secondary to spontaneously acquired inhibitory activity to coagulation factors which led to spontaneous bruising and noticeable signs of injury after a minor accident. The remaining children had several features supporting a diagnosis of non-accidental injury. Two had associated bleeding disorders in the form of von Willebrand's disease and a platelet aggregation abnormality and a baby had an acquired platelet disorder secondary to salicylates, provoking severe haemorrhage from a minor injury. The remaining four children initially had an abnormal laboratory finding--a prolonged partial thromboplastin time--which resulted in lengthy discussions during subsequent legal proceedings. Evidence of a bleeding disorder is not uncommon in non-accidental injury and the two conditions are not mutually exclusive. PMID- 6486864 TI - Therapeutic approach to sexual abuse. AB - An account is given of the development of a treatment project for sexually abused children and their families. We review incidence data which indicate that sexual abuse of children is likely to be a far more frequent problem than has been recognised and cause an appreciable degree of psychological damage. Professional responses to this are confused and treatment facilities limited. Sexual abuse is seen as an expression of severe relationship problems in the family and therapeutic provision is made, therefore, not only for the abused child but for other members of the family (including both parents). The method adopted is to offer group therapy to the child, mother, and father and regular family meetings with professionals in the community, concerned with care and protection of children. Clinical data on the first 56 children treated are discussed and our approach to treatment is evaluated. PMID- 6486865 TI - Bronchial lability and skin reactivity in siblings of asthmatic children. AB - Seventy five children with asthma (42 boys and 33 girls; age range 4 years 2 months to 15 years) and 75 of their siblings (37 boys and 38 girls; age range 4 years 3 months to 17 years 8 months) were studied to elucidate the mechanisms involved in the increased prevalence of asthma in boys, a prevalence that tends to disappear after puberty. Immediate cutaneous hypersensitivity to five allergens and maximum fall in peak expiratory flow rate after six minutes of treadmill running (bronchial lability) were determined in patients and siblings. There was no significant difference between boys and girls in skin test reactivity to single or multiple allergens in the sibling group. The percentage fall in peak expiratory flow rate after exercise was significantly greater in male than in female siblings and when a positive test was defined as a fall after exercise of either 10% or 15% of the rate before exercise the number of positive tests was significantly greater in boys. The results suggest that more boys than girls in this age group have asthma because their bronchial lability is greater, and not because more boys are atopic. PMID- 6486866 TI - Heat shield reduces water loss. AB - A heat shield covered by polyvinyl chloride film greatly reduced insensible water loss and radiant energy requirements in 12 preterm infants on a radiant cradle. Measured transmittance of radiant energy emitted by the radiant heater was impeded minimally by various thin film plastics but was blocked significantly by Perspex. PMID- 6486867 TI - Traumatic perforation of the hypopharynx--an unusual form of abuse. AB - Two infants presented with extensive interstitial emphysema of the neck as a result of non-accidental trauma to the pharynx. The clinical presentation, diagnosis, and management of this unusual form of child abuse is discussed. PMID- 6486868 TI - Selective bronchial intubation for pulmonary emphysema. AB - Two neonates with respiratory distress syndrome developed unilateral pulmonary interstitial emphysema causing mediastinal shift and compressive atelectasis. Treatment with contralateral bronchial intubation for five days proved to be life saving. PMID- 6486869 TI - Serum bilirubin kinetics in intermittent phototherapy of physiological jaundice. AB - Thirty four term babies with physiological jaundice were subjected to continuous phototherapy and to two regimens of intermittent phototherapy. The difference in serum bilirubin kinetics between the three groups of treated babies was insignificant; a schedule of one in four hours of irradiation achieved the same treatment effect as continuous phototherapy. PMID- 6486870 TI - Mebendazole in the treatment of hydatid cysts. AB - We report two children with ruptured, multiple hydatid cysts treated with mebendazole. Long term follow up has confirmed the success of this treatment. PMID- 6486871 TI - Phototherapy for neonatal hyperbilirubinaemia. PMID- 6486872 TI - Oral rehydration solutions and electrolyte content of water. PMID- 6486873 TI - Doxapram and neonatal apnoea. PMID- 6486874 TI - Pyridoxine dependent seizures. PMID- 6486875 TI - Metabolic acidosis in a neonate after frusemide. PMID- 6486876 TI - Are neck radiographs necessary in the management of croup syndrome? PMID- 6486877 TI - Danger of egg white treatment for nappy rash. PMID- 6486878 TI - A morphometric study of alterations in rough endoplasmic reticulum during differentiation in stratified squamous epithelium. AB - Stereological techniques were applied to investigate several structural parameters characterising the rough endoplasmic reticulum (RER) during differentiation in hamster cheek-pouch epithelium. Mucosal samples from five Syrian golden hamsters were obtained and processed for electron microscopy. Following a strict sampling regime, micrographs were obtained from defined basal, spinous and granular layers, and subjected to stereological point and intersection counting procedures. This enabled volume and surface densities, and volume-to-surface ratios of RER to be determined for each cellular layer. From previous estimates of the mean cytoplasmic volume of the "average" basal, spinous and granular cell in this tissue, it was possible to calculate the absolute volume and surface area of RER present in these average cells. Both volume and surface densities of RER decreased between basal and granular layers, whereas the total volume and surface area present in the average spinous and granular cell were both higher than in the average basal cell. These data suggest that RER is being synthesised during epithelial differentiation. In view of the role of the RER in the production of exportable proteins, it is possible that increased amounts of this organelle are required to synthesise the enzymes and glycoproteins found in membrane-coating granules, since these are also seen with increasing frequency in successively higher strata. PMID- 6486879 TI - Protective enzymes in human epidermal carcinomas and psoriasis. PMID- 6486880 TI - Immunoelectron microscopic demonstration of D 47 antigen on isolated human eccrine sweat glands. PMID- 6486881 TI - Comparison of serum levels and clinical results of PUVA therapy with three different dosage forms of 8-methoxypsoralen. PMID- 6486882 TI - The lack of effect of 11 alpha-hydroxyprogesterone on the flank-organ and ear sebaceous glands of adult male Syrian golden hamsters. PMID- 6486883 TI - Occupational exposure and drift hazard during aerial application of paraquat to cotton. PMID- 6486884 TI - Metabolism of toxaphene by the isolated perfused bovine liver. PMID- 6486885 TI - Acute effects of 1,1,1-trichloroethane, trichloroethylene, and toluene on the hematologic parameters in dogs. PMID- 6486886 TI - Effect of diet on tissue retention of cadmium heavily preaccumulated in rats. PMID- 6486887 TI - Effect of diet on urinary and fecal excretion of cadmium, copper, and zinc from rats preaccumulated heavily with cadmium. PMID- 6486888 TI - Toxicologic studies with pregnant goats fed grass-legume silage grown on municipal sludge-amended subsoil. PMID- 6486889 TI - [Classification of breast cancers. Comparative review apropos of a series of 876 cancers classified according to WHO in 1981. Discussion of problems of terminology and criteria for definition of histological types]. PMID- 6486891 TI - [Comparative morphology of the endometrium and foci of endometriosis. Histogenetic deductions]. PMID- 6486890 TI - [Interstitial cystitis. Anatomoclinical study of 55 cases]. PMID- 6486892 TI - [Forum on the immunohistochemistry of the extracellular matrix. 3d pathology symposium, Anatomical Society of Paris (Paris, 30 November-3 December 1983)]. PMID- 6486893 TI - [Recurrent mesenchymoma of the peritoneum with hepatic metastasis in an 8-year old child]. PMID- 6486894 TI - [Primary spontaneous hematomas of the cerebellum]. PMID- 6486895 TI - [Fluorinated osteosis of water and soil origin in a renal insufficiency patient. Apropos of a case with histomorphometric analysis]. PMID- 6486896 TI - [Buccopharyngeal localizations of carcinoma cuniculatum. Apropos of 5 cases]. PMID- 6486898 TI - [Measles: only vaccinate or vaccinate too?]. PMID- 6486897 TI - [Tuberculosis of the uterine cervix. Apropos of a case]. PMID- 6486899 TI - [Epidemiology of malaria in the plain of Ruzizi, Burundi]. PMID- 6486900 TI - [Relations among 3 antigen repertoires of Trypanosoma brucei brucei]. PMID- 6486901 TI - [A case of human dirofilariasis caused by Dirofilaria (Nochtiella) conjunctivae (Addario, 1885) in Belgium]. PMID- 6486902 TI - [Immune response of children homozygous for sickle cell anemia to vaccination against pneumococcus]. PMID- 6486903 TI - Cholera in Gaza strip. PMID- 6486904 TI - Technique of hearing preservation in small acoustic neuromas. AB - The ideal operation for acoustic neurinoma would not only provide total excision without injury to the brain stem and with preservation of facial nerve function, but would also allow retention of useful hearing in those patients who come to operation with intact hearing function. Documented preservation of useful hearing in the rather extensive literature concerning acoustic neurinomas is rare. An operative technique has been developed utilizing a retromastoid approach, brain stem auditory-evoked potentials and direct auditory monitoring, facial nerve electromyography, and microsurgical techniques that have enabled us to preserve useful hearing in three and some hearing in two of six consecutive patients who had preoperative hearing. Rules regarding preservation and criteria regarding documentation of hearing preservation are outlined. PMID- 6486905 TI - Radiation to the breast. Complications amenable to surgical treatment. AB - Major complications of radiation directed to the breast, axilla, and mediastinum were treated in 54 patients from 1974 to 1983. A classification of these complications facilitates both an understanding of the pattern of injury and the development of a treatment plan. CLASSIFICATION: I. Breast necrosis; II. Radionecrosis and Chest Wall Ulceration; III. Accelerated Coronary Atherosclerosis with Median Sternotomy Wound Failure After Coronary Revascularization; IV. Brachial Plexus Pain and Paresis; V. Lymphedema and Axillary Cicatrix; VI. Radiation-induced Neoplasia. The treatment has evolved during the 10-year study period to excision of the necrotic wound, including any tumor, and closure with a transposed muscle or musculocutaneous flap of latissimus dorsi (II, III, V) or rectus abdominis (I, II, VI). This strategy reflects a change from primary use of the omentum during the first years of the study. The vascularity, oxygen and antibiotic delivery of these muscle and musculocutaneous flaps promote wound healing, usually with one operation. The transfer of these muscles has not caused significant functional deficits. PMID- 6486906 TI - The bacteriology and septic complication of patients with appendicitis. AB - A detailed bacteriologic study was done on 161 patients operated for appendicitis. Aerobic and anaerobic cultures were taken from the blood, the appendicular lumen, mucosa, serosa, fossa, and from the wound after closure of the peritoneum. There is no correlation between the degree of appendicitis and the incidence of positive blood culture. The infection spread through the appendicular wall as the disease progressed. Aerobic infection was common in early appendicitis but a mixed aerobic and anaerobic infection was predominant in late cases. Late appendicitis, a positive wound culture at the end of the operation, the duration of symptoms of over 36 hours before operation and the age of the patient over 50 years were all associated with an increased incidence of septic complication. From the antibiotic sensitivity on the bacteria isolated, the most effective agent against anaerobes was metronidazole. Effective agents against the aerobes were aminoglycosides and cephalosporins. The best single agent against both anaerobes and aerobes was moxalactum. PMID- 6486907 TI - Endoscopy of the partitioned stomach. AB - Fiberoptic endoscopy is an important diagnostic modality for evaluation of the patient with upper gastrointestinal (GI) tract symptoms following gastric bypass and gastroplasty. During a 3-year period, 182 patients underwent gastric partitioning procedures and 22 patients (12%) developed upper GI symptoms requiring endoscopic evaluation. Eight patients had undergone Mason vertical banded gastroplasty, 12 patients had undergone Gomez gastroplasty, and two patients had undergone Roux-en-Y gastric bypass. In four of five patients with abdominal pain, gastritis of the proximal pouch was observed. Of the two patients with symptoms of obstruction of the proximal gastric outlet, one patient was found to have a cherry pit occluding the channel. Intraoperative endoscopy was performed in one patient who developed upper GI bleeding after Roux-en-Y gastric bypass, the pylorus was scarred and stenotic and multiple superficial ulcerations were seen in the excluded distal stomach. In eight patients with symptoms suggestive of channel stenosis, four were found to have a stenotic channel and underwent endoscopic dilation of the channel. Upper GI endoscopy was performed in eight patients with Gomez gastroplasty to confirm suspected dilatation of the channel between the upper and lower gastric pouches. Upper GI contrast studies did not estimate accurately the diameter of the channel as determined during endoscopy. No complications were observed following any of the endoscopic procedures. As the collective experience with gastric partitioning procedures increases, the need for endoscopic examinations of the upper GI tract will also increase. Endoscopists should be familiar with the altered gastric anatomy and with the spectrum of upper GI lesions that develop following these operations. PMID- 6486908 TI - Resection of terminal vagal branches to parietal cell mass in the treatment of duodenal ulcer. AB - In order to completely denervate the parietal cell mass and to prevent the undesirable side effects of highly selective vagotomy, the authors devised a new and simpler modified operative procedure. First, the anterior and posterior leaves of the lesser omentum are divided from the stomach at their attachment 6 cm proximal to the pylorus to the level 2 to 2.5 cm below the esophagogastric junction. Second, a circular seromuscular incision is made at the anterior and posterior wall of the stomach from the lesser curve 2 to 2.5 cm below the cardia to the highest short gastric artery at the greater curve. Forty cases followed for an average period of 21.8 months with satisfactory postoperative results reported. PMID- 6486909 TI - False pancreas divisum. Acquired pancreatic duct obstruction simulating the congenital anomaly. AB - Eight patients with recurrent acute pancreatitis were found by ERCP to have foreshortening of the duct of Wirsung simulating the radiographic appearance of the congenital anomaly pancreas divisum. In contrast to 44 patients with true pancreas divisum, who were predominantly young (mean 32 years), nonalcoholic (42/44), and female (34/44), patients with false pancreas divisum were older (mean 48 years), male (7/8), and alcoholic (5/8). False pancreas divisum is most often an acquired obstructing lesion resulting from irremediable injury to the pancreatic duct during acute pancreatitis, often associated with pseudocyst formation and subsequent healing by scar at the site of duct injury. Appreciation of the radiographic differences between pancreatograms in true and false pancreas divisum and the different findings at operation allow for proper selection of therapy. Whereas accessory papilla sphincteroplasty appears to be effective for recurrent pancreatitis associated with true pancreas divisum, false pancreas divisum requires distal pancreatectomy or pancreaticojejunostomy to overcome the irreversible obstruction of the main pancreatic duct. PMID- 6486910 TI - Physiologic role of cholecystokinin in the intestinal phase of pancreatic polypeptide release. AB - Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous administration of pure cholecystokinin-33 (CCK-33, 0.1 micrograms/kg/hr) in five dogs. Radioimmunoassay measurements of plasma concentrations of PP and CCK-33 were compared by linear regression analysis before and after vagotomy. Correlations between plasma concentrations of PP and CCK-33 before vagotomy (r = 0.83 [oleate], r = 0.97 [IV-CCK-33]) and after vagotomy (r = 0.92 [oleate], r = 0.92 [IV-CCK-33]) were highly significant. Changes in plasma concentrations of PP relative to a particular increment in plasma CCK-33 (before vagotomy) were similar, whether stimulated by oleate or by exogenous CCK-33. After vagotomy, less PP was released relative to a change in plasma CCK-33 (stimulated by oleate or by exogenous CCK-33), but the PP response relative to a change in plasma CCK 33 induced by the two stimuli remained remarkably similar. These results provide evidence that the intestinal phase of physiologic release of PP is mediated to a large extent through release of CCK. PMID- 6486911 TI - Does surgery attract students who are more resistant to stress? AB - This article examines perceptions of stress and career choice. One hundred sixty nine junior students specified what they thought were the two most and two least stressful careers, as well as their own career preferences before and after a 12 week surgical clerkship. The class was divided for analysis into three groups: those who selected careers that they said were A) most stressful (42%), B) least stressful (10%), and C) neither most nor least stressful (48%). Surgery was cited as one of the two most stressful choices by 99% of the class before and 93% after the clerkship. The next most stressful career was internal medicine, cited by 43% before and 35% after the clerkship. The two least stressful careers were dermatology and radiology, cited by approximately 50% of the class before and after the clerkship. Those who chose careers that they said were most stressful had significantly higher self-esteem (p less than 0.05), experienced less unfavorable stress themselves as measured by a 31-item stress scale before and after the clerkship (p less than 0.01), and experienced more favorable (in their view) stress (p less than 0.05) than did the other two groups. Reanalysis of data comparing those who selected surgery with those who did not confirmed findings similar to that of the matched high-stress career group. The study suggests that some students may be able to tolerate stress better and in fact, tend to thrive in an environment that they perceive as stressful, and that such students are more likely to go into a surgical career, which they foresee as one of the most stressful that they can enter. PMID- 6486912 TI - Parathyroid surgery in patients with renal failure. AB - A subtotal parathyroidectomy was performed in 32 patients with hyperparathyroidism and renal dysfunction. Minimal long-term sequelae were observed [two patients with recurrent hyperparathyroidism (6.2%), one patient with persistent hypoparathyroidism (3.1%)]. This experience is compared with reports in the literature advocating total parathyroidectomy and autotransplantation. A subtotal parathyroidectomy remains the preferred approach at this institution. Patients with elevated alkaline phosphatase levels before surgery should be monitored carefully for early postoperative hypocalcemia. The low incidence (3.2%) of hyperparathyroidism observed in patients following successful renal transplantation indicates that hypercalcemic allograft recipients should be observed for at least 4 months before contemplating surgical intervention. PMID- 6486913 TI - Value of the preoperative history as an indicator of hemostatic disorders. AB - Eighty-three general surgical patients completed the standardized bleeding history questionnaire, and screening tests of platelet counts, prothrombin times, partial thromboplastin times, and Ivy bleeding times were done on these patients. Fifty-two per cent had undergone previous operation; 25% described symptoms of potential hemostatic disorders and seven per cent had positive family histories. Laboratory results indicated abnormalities in five patients (6%). The bleeding history is an important part of the preoperative evaluation of a patient, but it can have serious false-negative results. This history should guide the selection of laboratory tests. Such testing can yield an unexpectedly high rate of abnormalities. When identified, these abnormalities require further investigation. PMID- 6486914 TI - Surgical therapy for necrotizing enterocolitis. AB - Fifty-one infants were treated surgically for necrotizing enterocolitis utilizing a uniform protocol from July 1980 through July 1983. The indications for surgery were pneumoperitoneum or a paracentesis indicative of bowel infarction. Segmental intestinal resection and exteriorization of the bowel ends through the upper abdominal transverse incision was the usual procedure. Intestinal continuity was reestablished when the patient reached 10 pounds, or sooner if he was failing to thrive with his ileostomy. The overall survival was 72.5%, and it was 82% for those patients have a definitive surgical procedure. This survival rate was not adversely affected by the patient's weight or age at the time of operation, nor by the presence of bowel perforation. The 37 survivors endured multiple postoperative complications. The most significant long-term sequela was short-gut syndrome, which occurred in 11% of survivors. PMID- 6486915 TI - A multiple regression equation for prediction of posthepatectomy liver failure. AB - This article reports a multiple regression equation for prediction of posthepatectomy liver failure. In phase I, using the correlations between 17 preoperative parameters (Xi) and the postoperative course scored (Y) of the past 36 hepatectomized patients, we proposed the following multiple regression equation: Y = -110 + 0.942 X resection rate (%) + 1.36 X ICG retention rate (%) + 1.17 X patient's age + 5.94 X ICG maximal removal rate (mg/kg/min). With the equation, the calculated Y value (prediction score) of these patients revealed that prediction scores of the eight nonsurvivors with liver failure were more than 50 points while those of the 28 survivors were 50 points or less. In phase II, the relationships between early prognosis and a precalculated prediction score were prospectively found the same as that seen in phase I. These findings indicate that our formula is a useful prognostic index for prediction of posthepatectomy liver failure. PMID- 6486917 TI - Pancreas divisum: is it a surgical disease? PMID- 6486916 TI - The diagnosis and treatment of the acute scrotum in children and adolescents. AB - Diagnosing acute scrotal pain and swelling in children and adolescents is urgent and often difficult. A review of 395 boys hospitalized with acute scrotal pain and/or swelling shows that a useful approach is to divide these patients into four groups--those with intermittent but recurrent episodes of pain, those with pathognomonic physical findings, those with definite epididymitis, and a remaining group with nonspecific swelling and tenderness. Five per cent of boys in this series presented with recurring episodes of scrotal pain; these boys should undergo a simple scrotal operation that yields excellent results. Eight per cent had pathognomonic physical findings; treatment in these boys is straightforward. Eighteen per cent had a definite diagnosis of acute epididymitis (i.e., three nonpathognomonic but suggestive findings of acute epididymitis or two suggestive findings plus a radionuclide scan showing bilateral perfusion); nonoperative therapy is indicated in this group. In the remaining boys, scrotal exploration is the diagnostic (and usually therapeutic) procedure of choice. PMID- 6486918 TI - Late cardiac tamponade can be a lethal complication. PMID- 6486919 TI - Problem of identifying patients with gallstone-induced pancreatitis based on biochemical and/or clinical criteria. PMID- 6486920 TI - Postfundoplication symptoms: do they restrict the success of the Nissen fundoplication? PMID- 6486921 TI - Significance of postcholecystectomy subhepatic fluid collections. PMID- 6486922 TI - Complication rate associated with central venous catheters. PMID- 6486923 TI - Trends in research on cestode infections. A symposium held at the Liverpool School of Tropical Medicine, 22-23 November 1983. PMID- 6486924 TI - Hydatid control scheme in South Powys, Wales, UK. PMID- 6486925 TI - An Echinococcus pilot control programme for north-west Turkana, Kenya. PMID- 6486926 TI - Strain characterization in the hydatid organism, Echinococcus granulosus: current status and new perspectives. PMID- 6486927 TI - Immune response to Echinococcus granulosus: histological and immunocytochemical observations. PMID- 6486928 TI - Hydatid disease in the Turkana District of Kenya. V. Problems of interpretation of data from a mass serological survey. PMID- 6486929 TI - The detection of circulating antigen in human hydatid disease. PMID- 6486930 TI - Some host factors which influence the epidemiology of Taenia multiceps infections in sheep. PMID- 6486931 TI - The transmission of Taenia saginata in Britain. PMID- 6486932 TI - Malumfashi Endemic Diseases Research Project, XXI. Pointers to causes of death in the Malumfashi area, northern Nigeria. AB - For 228 of 425 deaths (54%) occurring among 26 100 people of known age in the Malumfashi area of northern Nigeria, data were collected on symptoms present prior to death. Information was obtained on monthly registration visits, as part of demographic investigations, and data for the period November 1977-October 1978 have been analysed. Enumerators used a carefully prepared list of 25 symptoms to elicit information from relatives of the deceased. Pyrexia, diarrhoea and measles accounted for 77% of all deaths. Epidemiological determinants were responsible for all cases of meningococcal infections in the dry season and most cases of diarrhoea in the wet season. Most deaths attributed to measles occurred in the late dry season and early wet season. Epidemics of measles seemed to be localized at any one time in certain villages and the micro-epidemiology of this feature is considered. Malaria does not appear to be responsible for all deaths from pyrexia in the nought to four age group. PMID- 6486933 TI - Liposomes in leishmaniasis: effects of parasite virulence on treatment of experimental leishmaniasis in hamsters. AB - During studies on the use of liposomes as drug carriers in experimental leishmaniasis in hamsters, we noted incidentally that the apparent virulence of the infection often varied widely between different large groups of animals. When the death rates among control animals (injected only with saline) were compared with hepatic parasite counts of survivors in the same group, three distinctive types of infection were observed: type I, low death rate, low parasite count in survivors; type II, high death rate, low parasite count in survivors; type III, high death rate, high parasite count in survivors. The apparent virulence, based on death rates both at early and late stages of infection, was in the order I less than II less than III. Therapeutic efficacy of a drug (meglumine antimoniate) or liposome-encapsulated drug against each type of infection was in the order I greater than II greater than III. Liposomes reduced the drug dose required for each infection type many hundred-fold and reduced the death rate for type I to zero. However, among animals with type III (or even type II) infection certain individuals were completely refractory to treatment, even when liposome encapsulated drug was employed, and the lowest mortality rate achieved was approximately 30%. This latter resistance to treatment may have been due to irreversible tissue damage caused by advanced disease, or it may have reflected resistance of certain virulent infections to treatment. PMID- 6486934 TI - Glomerular disease in adults in the Savannah region of Nigeria--clinical and pathological features. AB - In a consecutive series of 134 adult patients with glomerular disease, 82.7% showed proliferative glomerulonephritis on renal biopsy; 45% of the cases were asymptomatic. Nephrotic syndrome in adults in northern Nigeria should respond to immunosuppressive therapy only rarely. There was no evidence to implicate Plasmodium malariae as the cause of glomerular disease in adults in the savannah belt in Nigeria. The roles of hepatitis B virus and Yersinia enterocolitica were discussed and require further serological investigations. O-serotype 8 yersiniosis is reported outside the USA for the first time and is possibly nephritogenic. Hepatosplenomegalic schistosomiasis is also reported for the first time in Africa south of the Sahara. The role of the eradication of infections due to the Streptococcus, hepatitis B virus, P. malariae, schistosomes and Y. enterocolitica in the reduction of glomerular disease is discussed. PMID- 6486935 TI - Immunodiagnosis of giardiasis by ELISA and studies on cross-reactivity between the anti-Giardia lamblia antibodies and some heterologous parasitic antigens and fractions. AB - Specific antibodies against Giardia lamblia in 92 sera from asymptomatic carriers were investigated by ELISA. Using cyst antigen, antibodies were detected in 91 of the sera, by means of alkaline phosphatase-labelled antispecies immunoglobulin. The E/405nm values of the positive sera ranged between 0.350 and 1.700, whereas in the 78 control sera they were 0.270 +/- 0.220. Cross-reactivity between the anti-G. lamblia antibodies and 18 heterologous parasitic antigens and fractions was also studied. Cross-reactions were observed with antigens of Toxoplasma gondii, Sarcocystis spp., Leishmania donovani, Fasciola hepatica Y, F. hepatica I, Echinococcus granulosus AM, Cysticercus tenuicollis, Taenia saginata, Dipylidium caninum Y, D. caninum I, Trichuris suis Y, T. suis I, Trichinella spiralis and Litomosoides carinii. No cross-reactions were observed with the antigens and fractions of Entamoeba histolytica, Dicrocoelium dendriticum, Schistosoma mansoni and Echinococcus granulosus Y. The results show that the ELISA could be easily and very successfully applied for routine diagnosis of giardiasis. PMID- 6486936 TI - Tsetse fly feeding preference as determined by vehicular trapping in Tanzania. AB - In eastern Tanzania an electric grid trap carried in the back of a moving pick-up truck was used to capture engorged Glossina morsitans morsitans and G. pallidipes for an analysis of their food sources. Although 12 000 head of domestic cattle represented c. 75% of the animal biomass in the survey area, they provided only 5.6% of the total blood meals, while 74.8% were from warthogs and bushpigs. The percentage of females among the captured flies was 12 and 47 for G. m. morsitans and G. pallidipes, respectively. The incidence of engorged flies captured by this method ranged from 15 to 20% in males and 26 to 42% in females. PMID- 6486937 TI - Oviposition by African malaria vector mosquitoes. II. Effects of site tone, water type and conspecific immatures on target selection by freshwater Anopheles gambiae Giles, sensu lato. AB - Females of Anopheles gambiae s. lat., most of which would have been A. gambiae s. str., were collected from houses in coastal Kenya and tested for their oviposition preferences using Petri dishes in large laboratory cages with lighting equivalent to weak moonlight. Significantly more eggs were laid overnight in water over black than over paler tones, and this difference increased as contrast with the surrounding floor was increased. Direct observation revealed that over white targets, females oviposited from a settled posture, whereas over black targets they did so from flight. The influence on this behaviour of target darkness (tone) overrode that of cage size or target size. In tests which yielded markedly fewer eggs in sea water than in tap water, no significant difference was detected when cage floors were either black or white, although a black floor might have resulted in significantly greater discrimination against sea water had more tests been conducted. All further testing was done over black cage floors. Turbid water from a natural development site received more eggs than distilled, tap or swamp water, even though the turbid water appeared paler than the others. The females did not discriminate between rearing water and tap water, or tap water with and without pupae, but the presence of larvae was repellent. Turbid water from a development site thus seemed to possess an arrestant property which overrode selection favouring darker targets, and which was not derived from prior presence of conspecific immatures. It is suggested that for A. gambiae, oviposition from a settled posture is a response to sub-optimal stimuli, possibly indicating conditions under which oviposition would not occur in nature, and hence why cage experiments using white targets have in the past yielded confusing results. PMID- 6486938 TI - A new technique for the isolation of Demodex bovis from preserved infected material. AB - A technique for the preservation of infected material from lesions of bovine demodicosis is described, together with a simple method for the isolation and permanent mounting of individual Demodex bovis mites. The technique is based on the fact that the mites float up from pus and cell debris, from which they can easily be collected. PMID- 6486939 TI - Continuous cultivation of animal-infective bloodstream forms of an East African Trypanosoma congolense stock. PMID- 6486940 TI - Lymphadenopathy in Indian kala-azar. PMID- 6486941 TI - Prevalence and pattern of intestinal infestations in an African university community. PMID- 6486942 TI - Notes on the molluscan intermediate hosts of Paragonimus spp. and their possible role in biological control. PMID- 6486943 TI - Bulinus tropicus (Krauss, 1848) from Kenya found naturally infected with Schistosoma bovis. PMID- 6486944 TI - The role of the thoracic surgeon in the intensive care unit. PMID- 6486945 TI - Decision making at the time of exploratory thoracotomy. PMID- 6486946 TI - Postoperative ventricular arrhythmia. PMID- 6486947 TI - Major pulmonary resection for suspected but unconfirmed malignancy. AB - Thoracotomy is not infrequently performed in patients with suspected pulmonary carcinoma but with no histological or cytological confirmation of malignancy. The intraoperative decision to proceed with major pulmonary resection (lobectomy or pneumonectomy) is difficult if a large or central lesion precludes total excisional biopsy. Incisional or needle biopsies violate the principles of good cancer surgery, and the results may be inconclusive if the tumor is missed and areas of associated inflammation or necrosis are sampled. Between January 1, 1970, and December 31, 1980, 303 patients underwent thoracotomy for suspected but unconfirmed malignancy. One hundred twenty-two had a minor resection only, 79 had a major resection (lobectomy or pneumonectomy) after a diagnosis was established by frozen section, and 102 had a major resection without a definitive diagnosis of cancer. Carcinoma subsequently was found in 68% (69) of this group of 102 patients, and benign lesions were identified in the remaining 32% (33), all of whom underwent lobectomy. The diagnoses in these 33 patients included seven granulomas, three hamartomas, nine instances of tuberculosis, and fourteen instances of fibrosis, inflammation, or cystic degeneration. The 2 thirty-day operative deaths in this group of 102 patients occurred among the 69 with malignant disease; 1 died of hemorrhage following pneumonectomy and 1, of respiratory insufficiency after lobectomy. In all 303 patients, there was no difference in operative mortality (p less than 0.01) between lobectomy (2%) and a lesser resection (1.6%). In a patient with a suspicious but inaccessible pulmonary lesion, lobectomy can be performed safely without violating the principles of cancer surgery. This recommendation should probably not be extended to lesions requiring pneumonectomy, because of the increased rates of morbidity and mortality associated with that procedure. PMID- 6486948 TI - Unanticipated postoperative ventricular tachyarrhythmias. AB - Eighteen (1.4%) of 1,251 patients who underwent cardiac operations during a three year period had new sustained ventricular tachycardia (12 patients) or ventricular fibrillation (6 patients) not caused by but resulting in hemodynamic compromise. In 13 patients, the initial arrhythmia occurred in the first 48 hours postoperatively. Lidocaine was being administered to 10 of these patients for suppression of previously noted ventricular ectopy, but it did not prevent the occurrence of the arrhythmia. The initial episode was fatal for 5 patients. Two of these deaths were directly related to the adverse effects of the antiarrhythmic agents used to suppress ventricular tachycardia or fibrillation. Five of 10 survivors underwent electrophysiological studies after initial resuscitation. In all 5, programmed ventricular stimulation reproduced the clinical arrhythmia. There have been 2 late sudden deaths in patients who either did not undergo or remained uncontrolled at electrophysiological study during serial drug trials. Our experience suggests that a cardiac operation may unmask or induce potentially lethal arrhythmias that previously had not been apparent. Pharmacological suppression of ventricular ectopy does not necessarily prevent ventricular tachycardia or ventricular fibrillation in the early postoperative period. Electrophysiological study may be helpful in determining the appropriate prophylactic therapy in such patients. PMID- 6486949 TI - Surgery for pulmonary metastasis: a 20-year experience. AB - During a recent 20-year period, 556 patients underwent operation for pulmonary metastasis at the University of Texas M.D. Anderson Hospital and Tumor Institute at Houston. The surgical mortality was 1.5% for 772 resections. A selection of 443 patients was made to evaluate the contribution of operative intervention as a primary treatment, with selective adjunctive therapy when applicable. The success of a surgical approach is dependent primarily on adherence to selection criteria; it is important that only patients in whom all known disease can be completely removed with the planned resection and who have full control of the primary site are treated. The overall survival for the group was 35%. For patients with carcinoma, survival ranged from 24% for those with primary uterine cervix tumors to approximately 54% for urinary tract, male genital tract, and corpus of uterus primary tumors. In the group with sarcoma, patients with skeletal tumors had a 46.4% survival rate (50.7% for those with osteogenic sarcoma), and 33% of the patients with soft tissue tumors had long-term survival. The outcome for patients with melanoma was poor; only 12.1% survived 5 years. If the original criteria apply, multiple and bilateral lesions can be successfully managed. Patients undergoing planned adjuvant treatment had a superior outcome compared with those not so treated. However, a significant survival advantage was shown only for patients with sarcoma. The failure to control all disease in patients in whom pulmonary metastasis is controlled surgically can only be improved on through the use of systemically active adjuvant treatment. PMID- 6486951 TI - Repair of pectus excavatum by sternal eversion. AB - Pectus excavatum was repaired by the sternal eversion (turnover) technique in 26 patients over a 7-year period. Vascular supply to the sternal graft was maintained by preservation of one internal mammary vascular pedicle. Good results were obtained in 21 (81%) patients followed for periods ranging from 2 to 76 months (mean, 32 months) postoperatively. Four patients (15%) had fair results; 2 patients with Marfan's syndrome had partial recurrence, as did 1 patient with skin necrosis and 1 with hypertrophic scar. One patient (4%) had a poor early result due to wound infection and distal sternal necrosis requiring reoperation. Other complications were minor: superficial wound seroma in 2 patients and pneumothorax in 1. The sternal eversion technique for repair of pectus excavatum utilizes the concave shape of the sternum when turned over to create a cosmetically acceptable convex anterior chest wall contour. Judicious tailoring of the costal cartilages and shaping of the anterior sternum corrects asymmetrical deformities. The chest wall is very stable after repair. Since no prosthetic struts or pins are used, a second operation for removal is avoided. Preservation of the vascular supply to the sternum should allow normal growth of the anterior chest wall. The results have been sufficiently encouraging for us to recommend sternal eversion as the primary method for repair of pectus excavatum. PMID- 6486950 TI - Extracardiac atrial pedicle conduit repair of partial anomalous pulmonary venous connection to the superior vena cava in children. AB - Between June, 1982, and July, 1983, 6 children with partial anomalous pulmonary venous connection to the middle or high segment of the superior vena cava (SVC) underwent repair of the anomaly by division of the SVC proximal to the site of entry of the anomalous pulmonary veins. Continuity between the cephalad end of the SVC and the right atrium was established by direct anastomosis to the right atrial (RA) appendage or by creation of a pedicle conduit of RA appendage, RA free wall, and pericardium. The anomalous pulmonary veins remained in situ on the lower segment of SVC, blood being directed to the left atrium through an atrial septal defect by a pericardial patch placed within the right atrium well away from the sinoatrial node, anomalous pulmonary veins, and cavoatrial junction. All children have survived, remain in normal sinus rhythm, and have no evidence of vena caval or pulmonary venous obstruction. Follow-up cardiac catheterizations, angiocardiograms, and Holter recordings support the efficacy of this technique as an alternative in the management of anomalous pulmonary veins joining the SVC well above the cavoatrial junction. PMID- 6486952 TI - One hundred neodymium-YAG laser ablations of obstructing tracheal neoplasms. AB - Forty patients with obstructing, nonresectable tracheal neoplasms underwent 100 ablations with the neodymium-yttrium-aluminum garnet (YAG) laser. The laser allows bloodless resection and vaporization of tumors. Unlike the carbon dioxide laser, the neodymium-YAG laser can be used with the flexible bronchoscope and has an excellent effect on coagulation. Thirty-four patients had primary lung malignancies (epidermoid in 24); 4 had metastatic malignancies; and 2 had benign lesions. Results have been excellent in 22, fair in 10, and poor in 8. No patient has died or had a deleterious result. Complications have occurred in only 1 of 89 ablations done with the flexible bronchoscope. We believe that the neodymium-YAG laser is effective in opening major tracheal or bronchial obstructions and offers substantial symptomatic improvement in patients who are short of breath. Although this treatment is only palliative, the results have been excellent in more than half of the patients. PMID- 6486953 TI - Tracheoesophageal fistula from carcinoma of the esophagus. AB - The records of the patients with tracheoesophageal fistula from carcinoma of the esophagus treated from 1970 to 1983 were reviewed to assess the length and quality of their survival. Twenty-four patients with malignant tracheoesophageal fistula were treated during this period. The site of the carcinoma was the middle third of the esophagus in 18 patients, the lower third in 5, and the upper third in 1. Three patients received only supportive treatment, and 1 had only radiation therapy. Nine patients underwent insertion of a Mousseau-Barbin or Celestin tube with or without gastrostomy, and 7 patients had gastrostomy alone. Four patients had exclusion of the tracheoesophageal fistula, 3 with esophagogastrostomy and 1 with colon interposition. The 3 patients who received only supportive treatment survived 5 days, 1 week, and 2 weeks. The 7 patients who had gastrostomy lived 3 days to 18 weeks (mean, 6 weeks). The 9 patients with a Mousseau-Barbin or Celestin tube lived 1 week to 6 months (mean, 8 weeks). The 4 patients who had exclusion of the tracheoesophageal fistula survived 5 weeks, 4 months, 7 months, and 26 months following operation. This study suggests that the treatment for patients with tracheoesophageal fistula from carcinoma of the esophagus should be individualized and that in selected patients, exclusion of the fistula with esophagogastrostomy improves the quality of life and prolongs survival. PMID- 6486954 TI - Reflux control by fundoplication: a clinical and manometric assessment of the Nissen operation. AB - Ninety-two Nissen fundoplications were performed for relief of symptoms of reflux in patients without stricture and in whom the wrap was left in the abdomen. Of these, 25 were reoperations. Reflux secondary to a hypotensive lower esophageal sphincter was associated with a sliding esophageal hiatus hernia in 61 patients, and surgical or other manipulative maneuvers were responsible for a hypotensive lower esophageal sphincter in 5 patients. No obvious cause could be determined in the remaining patients. The operation was transabdominal in 74 patients and by thoracotomy in 18 patients. Fifteen patients required ancillary operative procedures. Follow-up studies averaged 5 3/4 years in 82 patients and revealed permanent control of reflux in 74 of them (90.2%). Eighty percent of the patients were able to belch after operation. Overall patient satisfaction was achieved in 67 patients (81.7%). Among those who underwent operation for the first time, 84.5% achieved satisfactory results, whereas only 75% of those who underwent reoperation were benefited. Poorest results were caused by too tight a wrap, a complication that became rare after the size of the indwelling stent was increased to 42F. Esophageal manometry documented effective and significant augmentation of the amplitude and length of the lower esophageal sphincter from preoperative values of 7.2 +/- 0.5 mm Hg and 2.4 +/- 0.1 cm to postoperative values of 15.6 +/- 0.6 mm Hg and 4.1 +/- 0.1 cm (p less than 0.001). We conclude that if patients are properly selected and the wrap loosely fashioned, permanent control of reflux can be achieved by the classic Nissen fundoplication in 90% of patients with relatively few complications and a high degree of patient satisfaction. PMID- 6486955 TI - Tetralogy of Fallot and coarctation of the aorta: successful repair in an infant. AB - A 4 1/2-month-old infant was referred to our center with the rare combination of tetralogy of Fallot and coarctation of the aorta. Despite the presence of severe right ventricular outflow obstruction, the infant was virtually acyanotic because of the systemic afterload associated with the coarctation. She had marked systemic hypertension. The embryological and therapeutic implications of this child's defects are discussed. PMID- 6486956 TI - Aortobronchial fistula: a late complication of division of the persistent ductus arteriosus. AB - An 11-year-old girl had nearly fatal hemoptysis due to false aneurysm and aortobronchial fistula following ductus division 9 years previously. Silk suture material was implicated as a causative agent in association with dilation of the aortic isthmus. To our knowledge, no previous report of this complication exists in the literature. Twenty-two cases of false aneurysm have been described, 86.3% following ligation. The use of elective hypotension during ligation and monofilament suture during division may prevent this serious late complication in the future. PMID- 6486957 TI - Curvilinear paramedian sternotomy. AB - A modification of the classic straight midline sternotomy incision is described. The technique involves performing the sternotomy in a curvilinear manner along both sides of the midline to create two sternal halves that interdigitate with one another. With such a configuration, malalignment is virtually impossible. PMID- 6486958 TI - Radiographic diagnosis of aortic injury. PMID- 6486959 TI - Reversed subclavian flap repair. PMID- 6486960 TI - Valve complication rates. PMID- 6486961 TI - [Summary of consultations in a medical practice. Methods, results and problems in the interpretation of a survey carried out in Switzerland]. PMID- 6486962 TI - [Participation of personnel at basic health centers in epidemiologic surveillance programs. Realization of a survey on "Evaluation of Community health"]. PMID- 6486963 TI - [A medico-environmental system of health surveillance of workers]. PMID- 6486964 TI - [Education in epidemiology]. PMID- 6486965 TI - [Training of field personnel in epidemiology. Round table synopsis]. PMID- 6486966 TI - [Participation of medical practitioners of a French region in an epidemiologic survey of morbidity]. PMID- 6486967 TI - [Registration of morbidity data by a network of "spotter" general physicians]. PMID- 6486968 TI - [Participation of pediatric practitioners in field research. Possibilities, problems, perspectives. Swiss experience of the Roman Group for Studies of Ambulatory Pediatrics]. PMID- 6486969 TI - [Role of midwives in field epidemiology]. PMID- 6486970 TI - [Collection of data concerning child health services. Experience of the Pediatric Division of the University Health Section of Cheraga]. PMID- 6486971 TI - The actions of the hydroxamic acid of gamma amino butyric acid on the isolated rabbit atria and jejunum. AB - The hydroxamic acid of gamma amino butyric acid (HAGABA) has been prepared and was studied in the isolated rabbit atria and jejunum. HAGABA did not interfere with the spontaneous contractile rhythm and frequency of the isolated atria except in large mM concentrations in the bath. HAGABA displayed a biphasic effect in the isolated jejunum, which manifested itself first as stimulation followed by inhibition with an increasing concentration in the bath. Bicuculline and HAGABA did not antagonize each other in the enteric nervous system, but rather an augmentation was observed. PMID- 6486972 TI - Effect of lidocaine on membrane currents in rabbit sino-atrial node cells. AB - The ionic mechanism of effect of lidocaine (50-500 micrograms/ml) on the rabbit sino-atrial node was investigated by recording transmembrane potentials and by voltage clamping by means of a two microelectrode technique. Small sino-atrial (SA) node preparations (0.2 X 0.2 mm) were used. At doses larger than 50 micrograms/ml, lidocaine reduced the amplitude of the action potential, the maximum diastolic potential and the maximum rate of depolarization in a dose dependent manner. At the same time, lidocaine prolonged the action potential duration and the cycle length. At a higher dose, lidocaine induced sinus arrest (in 3 of 17 specimens at 300 micrograms/ml and in 15 of 17 specimens at 500 micrograms/ml). In voltage clamp experiments, lidocaine (50 micrograms/ml) reduced the time-dependent outward current (Ik) but did not affect the slow inward current (Is). At doses larger than 100 micrograms/ml, lidocaine reduced both currents in a dose-dependent manner. The inward current activated by hyperpolarization (Ih) was also reduced. Inactivation of Is (f infinity) and steady-state activation of Ik (p infinity) were unchanged. Lidocaine did not affect the decay time course of Is and Ik. These results suggest that lidocaine decreases Is and Ik and that this decrease is due to a reduction in conductance of these current systems. PMID- 6486973 TI - Restoration of post-thrombotic peripheral collateral circulation in the cat by ketanserin, a selective 5-HT2-receptor antagonist. AB - In cats, an acute thrombotic obstruction of the aorta inducing continuous platelet activation, was produced by permanent ligation above the trifurcation, temporary ligation below the caudal mesenteric artery and production of a stasis thrombus in the segment. Before, 5 min, 24 hr and 48 hr after surgery, plethysmographic systolic blood pressure in fore- and hindlegs, and clinical scoring of the hindleg function were performed; at 72 hr, venous occlusion plethysmography for quantification of blood flow was performed and collateral vascular resistance was calculated. Thrombotic occlusion resulted in a loss of adequately functioning collateral circulation as evidence by the changes in both the objective and the clinical parameters. Pre-treatment with ketanserin (1.25 mg/kg i.p. daily) significantly improved the objective circulation parameters blood pressure ratio, blood flow and collateral vascular resistance and restored the clinically scored function of post-thrombotic collateral function. Provided platelet activation contributes to human vascular pathology, a similar mechanism may be involved in the potential effect of ketanserin in man. PMID- 6486974 TI - Serotonin-induced blood flow changes in the rat hindlegs after unilateral ligation of the femoral artery. Inhibition by the S2 receptor antagonist ketanserin. AB - Collateral arteries can clearly be visualized in corrosion cast material after ligation of the femoral artery in rats. To characterize the influence of serotonin on the blood circulation under the experimental condition of unilateral ligation, we performed intermuscular thermoflow measurements. The data showed that intraperitoneal serotonin (8.7 and 20 mg.kg-1) injection markedly reduced the muscle temperature in both hindlegs. However, the effect was significantly more pronounced on the ligated side, where the blood was supplied through a collateral circulation, than on the non-ligated side with its normal arterial vasculature. Almost identical changes were obtained in rats with an early as well as in animals with a more advanced stage of collateral development (challenge with 8.7 mg.kg-1 serotonin). Evans blue dye experiments and angiographic data further revealed that, after challenge with 20 mg.kg-1 serotonin, the severe temperature decrease at the ligated side probably reflected a nearly complete blockage of blood supply. Pretreatment with the S2 receptor antagonist ketanserin (2.5 mg.kg-1) resulted in a significant reduction in the extent and duration of the serotonin-induced temperature decrease as revealed by the temperature measurements; such a treatment inhibited also the blockage in blood flow as seen with the other techniques. This study shows that serotonin, through its vasoconstrictive properties, can restrict the blood flow to the lower extremities of the rat, particularly when the blood is supplied through collateral circulation. This probably results in moderate to severe skeletal muscle ischaemia. It also suggests that the vasoconstriction is not only important in the inhibition of collateral blood flow in recently established collaterals but also in collateral vessels in a more advanced stage of development. The in vivo vasoconstriction and subsequent reduction of the blood supply caused by serotonin can be effectively counteracted by pretreatment with ketanserin. PMID- 6486976 TI - Variations of the jaw opening reflex observed in awake, freely moving rats. AB - Long term variations of the jaw opening reflex (J.O.R.) induced by tooth pulp stimulation (T.P.S.) have been investigated in the awake, freely moving rat. This study was specially centered on variations which could occur during the utilization of the J.O.R. as a test for analgesic drugs. Bipolar electrodes were implanted in the inferior incisor tooth pulp for stimulation and in digastric muscle for recording. J.O.R. recordings were subsequently integrated. Long term variations of J.O.R. were then observed during uninterrupted T.P.S. (1 Hz) alone or during subcutaneous (s.c.) injection, gavage or foot shock in addition to T.P.S.: --8 out of a total of 24 rats, observed during long uninterrupted T.P.S., showed a decrease of the J.O.R. The mean of reflex values, 15 min later, was 74 +/- 6% (n = 8) of the prestimulation level; --s.c. injection of saline, light handling, experimentator's brisk irruption, or sudden noise evoked a total disappearance of the reflex which completely returned within 30 sec; --gavage of arabic gum syrup gave either: . the same transient disappearance as for the s.c. injection in 6 rats; . a progressive, 28 min +/- 11 (n = 6), return to the initial value; . a progressive return to a subcontrol value of 52 +/- 4% (n = 7); --a 30 min foot shock delivered for 10 sec twice a minute at the infra vocalization threshold evoked a marked decrease of the reflex reaching to 68 +/- 6% (n = 10) of the control (prestimulation level). PMID- 6486975 TI - The role of adrenal medulla and neurohypophysis in the central and peripheral cardiovascular effects of neurohypophysial peptides. AB - The cardiovascular effects of intravenous and intracisternal administration of neurohypophysial peptides were compared in normal, diabetes insipidus and adrenal demedullated chloralose anaesthetized dogs. In normal dogs, intravenous lysine vasopressin (0.1 to 100 mU/kg) induced a dose-dependent increase in blood pressure with bradycardia whereas intracisternal injection (0.01 to 10 mU/kg) elicited a dose-related decrease in blood pressure but no change in heart rate. Intracisternally injected oxytocin (1 and 10 mU/kg) increased blood pressure. The central hypotensive effects of vasopressin were not observed in diabetes insipidus or adrenal demedullated dogs. In contrast, the central pressor properties of oxytocin were still observed in these two groups of animals. These results show that the central cardiovascular properties of vasopressin (but not those of oxytocin) may vary according to the hormonal state of the animals. Intracisternal vasopressin induces an hypotensive response due to a decrease in sympathetic tone and dependent on the integrity of the neurohypophysial tractus. PMID- 6486977 TI - Renal dysfunction from nonsteroidal anti-inflammatory drugs. PMID- 6486978 TI - Recognizing lead poisoning in adults. PMID- 6486979 TI - Mass hysteria. Diagnosis and treatment in the emergency room. PMID- 6486980 TI - Outbreak of itching and rash. Epidemic hysteria in an elementary school. AB - Fifty-seven of 159 rural elementary school students had an explosive spread of pruritus and rash--a rarely described manifestation of epidemic hysteria. In a sample of 13 children (23%), each child examined had irregular, macular, erythematous lesions that were excoriated and actively changed during examination. Rash occurred only at sites readily accessible to hands. The symptoms disappeared promptly when the children left school and recurred each morning when they returned. There were no secondary family cases in sample children. School-wide attack rates were higher in girls and younger children. The outbreak resolved after two to three weeks, with identification of its nature and resumption of normal activities. Academic stresses were circumstantially linked to the outbreak. PMID- 6486981 TI - The acquired cutaneous mucinoses. AB - Glycosaminoglycan (GAG) infiltration of the skin is a feature of hyperthyroidism, hypothyroidism, pretibial myxedema, scleromyxedema, and scleredema. We investigated the pathogenesis of the GAG deposits using light microscopy, histochemical digestion with a series of GAG-specific enzymes, and electron microscopy. Hyaluronic acid was the main GAG in all the conditions and in normal skin. Furthermore, there was minimal histologic variability of GAG dermal distribution. A striking distinguishing feature involved dermal fibroblast activity, which appeared normal or inactive in thyroid disorders and hypertrophic and/or hyperplastic in scleromyxedema and scleredema. Thus, the acquired cutaneous mucinoses exhibit similar skin GAG distribution and biochemical composition. The morphologic differences in fibroblastic activity suggest that the mucinoses of scleredema and scleromyxedema represent a local process, whereas the GAG infiltration of thyroid diseases may have a systemic origin. PMID- 6486982 TI - Head trauma in hemophilia. A prospective study. AB - Intracranial hemorrhage (ICH) remains a serious problem in hemophilia. Consecutive episodes of ICH or reports of head trauma were prospectively recorded in 140 patients with hemophilia seen during a two-year period. Forty of 48 consecutive episodes of ICH or trauma occurred in 37 patients with severe disease (less than 1% factor VIII or IX). Five injured patients had inhibitors to factor VIII. Two fatalities occurred following injury and one patient died following a spontaneous bleed. Injury in 40 instances warranted replacement therapy. No patient given coagulation factor within six hours of injury experienced ICH. The risk of ICH following head trauma (13% in this series) warrants aggressive use of coagulation factor replacement. Watchfulness in dealing with such patients and early therapy may be more necessary than often realized. PMID- 6486984 TI - Finally, her own child! PMID- 6486983 TI - Nonseptic cerebral emboli of cardiac origin. AB - There is considerable debate regarding immediate anticoagulation with heparin sodium for patients suspected of having acute cerebral embolism from a cardiac source. We studied 60 consecutive hospitalized patients suspected of having a nonseptic cardiogenic cerebral embolism who, with one exception, were treated with immediate full-dose anticoagulation. None of the patients had progression of their neurologic deficits secondary to intracranial hemorrhage or recurrent embolism, and there were no deaths secondary to anticoagulant therapy. One patient had punctate hemorrhages in the area of infarction, but remained clinically stable. In light of our experience and a review of the literature, we conclude that immediate anticoagulation is judiciously safe in selected patients after nonseptic embolic stroke of cardiac origin, provided early cranial computed tomography fails to demonstrate hemorrhagic infarction. PMID- 6486985 TI - Wives know. PMID- 6486986 TI - The creative clinician. PMID- 6486987 TI - Histiocytic hemophagocytosis in miliary tuberculosis. AB - The signs, symptoms, and bone marrow findings of the recently described virus associated hemophagocytic syndrome was seen in a patient we treated. The manifestations of this syndrome may not be specific to viral infections and may possibly occur in other infectious processes. Autopsy findings in the present case showed it to be associated with disseminated miliary tuberculosis. Concomitant viral infection was excluded. To our knowledge, only one similar patient has previously been described. PMID- 6486988 TI - Chest wall tenderness as a pitfall in the diagnosis of pulmonary embolism. A report of two cases. AB - Chest wall tenderness is commonly indicative of chest wall disease. Two patients with angiographically proved pulmonary emboli had clinical presentations dominated by chest wall tenderness. Clinicians should be alert to this mode of presentation and not exclude pulmonary embolism on the basis of such findings. PMID- 6486989 TI - Recurrent cardiac constriction after pericardiectomy. AB - Dependent edema, ascites, and exertional dyspnea developed in a patient seven months after pericardiectomy for constrictive pericarditis. Cardiac catheterization documented constrictive physiology. At the second operation, he was found to have extensive mediastinal fibrosis that encased the heart. Postmortem examination showed a fibrocartilagenous exoskeleton that encased both ventricles. Possible etiologies for this unusual reconstriction are discussed. PMID- 6486990 TI - Disseminated disease due to Mycobacterium chelonei treated with amikacin and cefoxitin. Absence of killing with either agent and possible role of granulocytes in clinical response. AB - Disseminated disease due to rapidly growing mycobacteria is manifested by positive blood cultures and multiple skin and subcutaneous abscesses. A patient had T-cell lymphoma and disseminated disease; he also had neutropenia intermittently. Single-agent therapy with amikacin sulfate or cefoxitin sodium was not adequate during periods of neutropenia, and combination therapy was necessary to control the infection. Clinical response correlated with detectable serum inhibitory levels of the antimicrobial agents. Surprisingly, the organism was not killed by either amikacin or cefoxitin, a finding that correlated with the absence of serum bactericidal levels. This case suggests that granulocytes may play a role in the host's response to this organism, and determination of serum inhibitory and possible bactericidal levels may be useful in monitoring therapy. PMID- 6486991 TI - Primary hyperparathyroidism complicated by multiple myeloma. AB - A patient with primary hyperparathyroidism and multiple myeloma did not have roentgenographic evidence of either disease, yet there was biochemical evidence for both diseases. Hyperparathyroidism was diagnosed by hypercalcemia and increased parathyroid hormone values. Multiple myeloma was diagnosed by serum gamma-globulin component of 2.74 g/dL with a monoclonal spike and bone marrow plasmacytosis of 31%. The serum IgA level was 2.22 g/dL and the IgG and IgM levels were normal. Serum and urine immunoelectrophoresis showed abnormal IgA and lambda arcs. Computed tomography of the neck localized a parathyroid adenoma that was found and removed at surgery. PMID- 6486992 TI - 'Culture-negative' prosthetic valve endocarditis. Hazards of postoperative steroid therapy for unexplained fever. AB - Two patients had prolonged unexplained fever along with multiple negative blood cultures after cardiac valve replacement surgery. Following the administration of corticosteroids for presumed postpericardiotomy syndrome, both patients improved symptomatically and defervesced, only to have positive blood cultures for Staphylococcus epidermidis shortly thereafter. The theoretical and practical risks of the empiric use of anti-inflammatory agents for unexplained post operative fever are reviewed. "Culture-negative" prosthetic valvular infection due to prior antibiotic prophylaxis or therapy must be strongly considered in the evaluation of such unexplained fever. PMID- 6486993 TI - Streptokinase-induced subcapsular hematoma of the liver. AB - Complications with thrombolytic therapy have been shown to occur no more frequently than with conventional anticoagulant therapy. Hemorrhagic complications and allergic skin reactions are the most frequently encountered adverse effects. The vast majority of the associated bleeding complications have been related to invasive procedure and monitoring techniques. The administration of systemic streptokinase was complicated in one case by development of progressive abdominal pain and hypotension necessitating an emergency exploratory laparotomy. A ruptured subcapsular hematoma of the left lobe of the liver was found and successfully repaired. This case of visceral hemorrhage complicating streptokinase therapy was not related to previous abdominal trauma or invasive procedure. PMID- 6486994 TI - Myocardial infarction after diet-induced warfarin resistance. AB - A 35-year-old woman was receiving warfarin sodium therapy for a prosthetic aortic valve. She sustained a myocardial infarction five weeks after beginning a diet of lettuce, broccoli, and turnip greens to lose weight. Excess dietary vitamin K can cause life-threatening consequences in patients on warfarin treatment. PMID- 6486995 TI - Recurrent acute appendicitis with erythema annulare centrifugum. AB - Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation. PMID- 6486996 TI - Erythromycin-warfarin interaction. PMID- 6486997 TI - Chronic fascicular block. PMID- 6486999 TI - Internal medicine and primary care. PMID- 6487000 TI - Correction. Propylthiouracil and hepatitis. PMID- 6486998 TI - Disopyramide-induced urinary retention. PMID- 6487001 TI - Terminoterminal microanastomosis. A scanning electron microscopy study. PMID- 6487002 TI - Major histocompatibility system and complotype in sarcoidosis. PMID- 6487003 TI - Immune response to hepatitis B vaccine in the staff of a hemodialysis unit. PMID- 6487004 TI - Episodic secretion of human chorionic gonadotropin. PMID- 6487005 TI - Lecithin: cholesterol acyltransferase levels in plasma of patients with hepatobiliary disease. PMID- 6487006 TI - Statistical correlation between delta-aminolevulinic acid dehydratase activity and blood lead in exposed and non-exposed human populations. A tentative model. PMID- 6487007 TI - [A spectacular sailing accident. A contribution to the problem of combined/concurrent causes of death in high-voltage injuries]. AB - During a sailing maneuvre the mast of the boat was brought into contact with a high-voltage transmission line; the metal parts of the boat caused a ground connection into the water. At first, the four men on board the boat attempted to interrupt the flow of electric current. In doing so, one of them got into the electric circuit and became unconscious. A second sailer jumped into the water, in order to save his unconscious colleague by pulling him ashore. This attempt, however, was not successful. Only the bodies of the two sailors could be recovered by divers. The forensic findings concerning each of the two bodies, as well as the results of an on-the-spot examination done with the help of the two survivors of the accident, are discussed with emphasis on the electrophysical laws related to the causes of death. PMID- 6487009 TI - [Hydrolysis of lorazepam with hydrochloric acid. Qualitative and quantitative analysis of byproducts of hydrolysis]. AB - Results of the identification of some additional products in the hydrochloric acid hydrolysis of lorazepam are reported, together with some quantitative results about the hydrolysis products under varying circumstances. It appeared that the amount of byproducts was reduced by applying hydrochloric acid of good quality and further on hydrolysis time had to be short. PMID- 6487008 TI - [Evaluation of fatal gunshot injuries (the weapon in the hand)]. AB - The evidential value of the finding "gun in the hand" has been rated differently in the course of time. While Casper (1857) considered it to be infallible proof of suicide, investigators in later years tended to see it more as a manipulation for the purpose of faking a suicide. In 71 cases of proven suicide by a shot in the head on which autopsies were performed by the Institute of Forensic Medicine (1956-1983), 20 (= 28%) were found with the gun in their hands according to police reports. No case was reported in which the gun was placed in the hand after the fact. The problem is discussed from various points of view (decerebrate rigidity, cataleptic rigidity, multiple shots, capacity to act). In the literature, on the other hand, there were 3 cases in which a gun was placed in the hand of a dead person to provide substantiation of a suicide; three more cases were found in a poll. PMID- 6487010 TI - [A simple procedure for characterizing the properties of biomechanical material in situ, especially human skin]. PMID- 6487011 TI - [Internal laryngeal hematoma. A contribution to death following blow to the neck]. AB - An 86-year old woman suffered blows with a forearm in a cast against the face and the neck. She was found dead some days later in a sitting position with heap of vomit beneath the corps. Autopsy showed extended haematoma and excoriations of the left side of the face and the neck. The mandibula and the left zygomatic arc were broken, just as the greater horns of the hyoid and the left upper and lower horne of thyroid cartilage. The main finding was a massive haematoma of the inner soft tissues of the larynx with a severe stenosis of the lumen. The haematoma was demonstrated by frontal section of the larynx, an unusual method in routine examination. Since this section was used in the autopsy especially of persons that died by strangulation, little bleedings in the false and true vocal cords were found in some cases. PMID- 6487012 TI - Performance, food intake and thermal environment in piglets and chickens. PMID- 6487013 TI - [Malignant hyperthermia in halothane-sensitive swine following maximal neuromotor stress]. PMID- 6487014 TI - [Radiative heat loss in swine]. PMID- 6487015 TI - [Changing the optimal biological temperature of laying hybrids by air movement velocity]. PMID- 6487016 TI - Natural brain cooling and temperature regulation. PMID- 6487017 TI - [Modulation of postural muscle tonus by thermoreceptive afferents]. PMID- 6487018 TI - Thermoregulation--an optimal control-loop? PMID- 6487019 TI - Thermoregulatory responses to cold stress of various intensity. PMID- 6487021 TI - [Optimal biological temperature in turkeys]. PMID- 6487020 TI - Optimum ambient and body temperature: can preferred temperature be regarded as a reliable index of the optimum? PMID- 6487022 TI - Effects of late prenatal temperatures on some thermoregulatory aspects in young chickens. PMID- 6487023 TI - Physiological responses of poultry to ambient temperature. PMID- 6487024 TI - Some responses of the domestic fowl to environmental temperature. PMID- 6487025 TI - Effect of cold thermal environment on feed requirements, growth rate and slaughter quality in pigs. PMID- 6487026 TI - Incubation temperature in relation to postnatal performance in chickens. PMID- 6487027 TI - Temperature requirement of does for optimal performance. PMID- 6487028 TI - Influence of environmental temperature on nitrogen and energy metabolism in growing chickens. PMID- 6487029 TI - Optimum temperature and performance (general discussion). PMID- 6487030 TI - [Light and electron microscopic findings in intramural coronary arteries of swine for slaughter]. PMID- 6487031 TI - [Electron microscopy studies of the fetal thyroid gland following treatment of the pregnant mother with maneb]. PMID- 6487032 TI - [Iron requirements of swine in the 1st 2 months of life]. PMID- 6487033 TI - [Anaphylactic shock in swine. 1. Induction of experimental anaphylactic shock reactions]. PMID- 6487034 TI - [Anaphylactic shock in swine. 2. Protective effect of acetylsalicylic acid premedication in experimental anaphylaxis]. PMID- 6487036 TI - [Levels of fatty acids, glucose, fructose, lactate and total alpha-amino N in blood plasma of sows and piglets prior to colostrum uptake]. PMID- 6487035 TI - [Anaphylactic shock in swine. 4. Pathologicoanatomic changes in experimental anaphylaxis]. PMID- 6487037 TI - [Biochemical follow-up studies of amniotic and allantoic fluid of sows in early pregnancy]. PMID- 6487038 TI - [Pyruvate kinase activity in organs of swine of different ages]. PMID- 6487039 TI - [Growth of the head in humans]. PMID- 6487040 TI - [Primary amenorrhea in adolescent girls. Incidence of isolated delayed menarche]. AB - In its strict meaning, primary amenorrhea is defined as the absence of any menstruation in a young girl without genital malformations who has reached her complete morphological development. Twenty-four cases corresponding to this definition, with bone ages of at least 15 years, breasts for at least 2 years, and adult type pubic hair were examined. In only 10 could a cause be found: anorexia nervosa, slight hyperandrogenism, acquired intracranial lesion. The other 14 girls, mean age of 16.2 +/- 1.4 years, were considered as presenting with simple delayed menarche. They were not given treatment, although 4 of them had been given steroids in artificial cyclical form previously. The 8 who were followed finally spontaneously developed normal cycles at a mean age of 17.6 +/- 2.8 years, one not until 24 years. Such data should lead to avoiding unnecessary treatments. PMID- 6487041 TI - [Unusual cause of intestinal invagination: congenital polypoid-form gastric heterotopia. Study of a case and review of the literature]. AB - The authors report a case of polypoid heterotopic gastric mucosa in the ileum presenting as intussusception with hypochromic anemia in a 6 year-old boy. Tumorous heterotopic gastric mucosa in the small bowel is very uncommon. So far 22 similar cases have been published in the literature. This congenital intestinal anomaly is discovered in one third of the cases during the first decade. In 9 of 23 cases gastric heterotopia was diagnosed after an ileal resection for intussusception induced by the heterotopia presenting as a pedunculated or sessile polyp. In our case the great number of the polypoid formations is exceptional and has not been previously described. PMID- 6487042 TI - [Value of prealbumin in the 1st and after the 12th day of life]. AB - From a series of 129 neonates, well defined with regard to weight and gestational age, the authors established that serum concentration of prealbumin (PA) in an aseptic neonate depends on its gestational age on the first day of extrauterine life (p less than 0.001). Serum concentrations of PA are significantly different in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates; this may be the consequence of insufficient materno-foetal transfers in the majority of SGA children. The study of the ratio maternal PA/neonatal PA at the time of delivery helps to establish the cause of SGA. On and after the 12th day of life, serum concentrations of PA are closely correlated with the usual data of anthropometry (weight, height, skull circumference) (p less than 0.001), when correlation is less close with gestational age at the time of sample taking: it may be used as a marker of the appropriateness of gestational age rather than of maturity. However, the ratio PA/weight varies from one child to another and from one week to another for a same child, giving PA a value different from ordinary anthropometry for the evaluation of the appropriateness of gestational size in neonates. PMID- 6487043 TI - [Comparative study of 4 groups of gastroduodenal ulcers in children]. AB - A retrospective cooperative survey allowed analysis of 151 cases of ulcers diagnosed by endoscopy (106), surgery (40), or autopsy (5). There were 58 primary ulcers, 21 aspirin-induced ulcers, 23 steroid-induced ulcers, and 49 stress ulcers. Up to the age of 7, the majority of ulcers (80%) were secondary; after 7 years, only 47.6%. The higher incidence was found in boys of all groups, especially after 7 years of age. Only aspirin-induced ulcers were located more often in the stomach (52.3%). A family history was present in parents and siblings of children with primary ulcers (31%) and aspirin-induced ulcers (23.8%). The secondary ulcers were often complicated: hemorrhage was nearly always present with aspirin induced ulcers (95.2%); perforation occurred principally in steroid-induced ulcers (30.4%), and stress ulcers (42.8%). Death occurred only in steroid-induced ulcers (8) and stress ulcers (21). Secondary ulcers rarely became chronic. PMID- 6487044 TI - [Association of early-onset nephrotic syndrome and microcephaly. Apropos of 4 cases in 2 families]. AB - The authors report 4 cases in 2 different families of a syndrome characterized by nephrotic syndrome of early onset (during the first 2 years of life) and microcephaly. Such an association was previously reported in 5 cases. In 4 it was familial. The study of families suggests an autosomal recessive transmission. Microcephaly was associated with psychomotor retardation, sometimes dysmorphic facies and various neurologic abnormalities. The nephrotic syndrome was characterized by its early onset and prognostic severity. However, the renal histologic lesions were heterogeneous: either minimal glomerular changes with focal and segmental hyalinosis or mesangial sclerosis, or, so-called "microcystic dysplasia". This heterogeneity does not suggest a single genetically determined disorder. PMID- 6487045 TI - [Antiprothrombinase anticoagulant and acquired prothrombin deficiency in childhood viral pathology. Spontaneous recovery]. AB - A 2 year-old female developed an acute bleeding diathesis related to a profound, isolated and acquired prothrombin deficiency; evidence for a "lupus anticoagulant" was also demonstrated. This association of hypoprothrombinemia and "lupus anticoagulant", rarely reported, was previously considered to be rather specific for SLE. This case report demonstrates that these coagulation disorders may present as an acute form, in viral diseases of the child, with spontaneous and quick recovery. Specific characteristics of the biological coagulation defects, namely those related to the low factor II, are discussed. PMID- 6487046 TI - [African histoplasmosis. A case]. AB - The case reported concerns a 12 year-old girl, native of the Cameroons, hospitalized in France for the treatment of the most severe disseminated type of African histoplasmosis (Histoplasma duboisii). In addition to a severe infectious syndrome, the child presented with 3 associated typical involvements: diffuse lymphadenopathy, skin lesions consisting of nodules of the face and trunk and suppurative osteo-articular lesions with an impressive radiological appearance: extensive bone lysis and metaphyseal fractures, without any sign of bone reconstruction, even after several months of treatment. This is rare a disease, but one that should be recognized, especially in its onset localized form, in a patient presenting with infectious osteoarthritis with a torpid evolution leading to the diagnosis of tuberculous or pyogenic infection, or even of osteosarcoma. The disseminated lesions may be difficult to distinguish from the multifocal bone lesions of sickle-cell disease osteomyelitis. PMID- 6487047 TI - [Consanguinity and public health. Algerian study]. AB - The frequency of consanguinity in Algeria and its impact on the national health were computed through several studies: demographic inquiries (national census) and inquiries in local hospitals, either in maternity services, where congenital malformations were recorded, or in pediatric services, consisting of hospitalized children or children seen in general or specialized consultation. The results demonstrated that consanguinity is very frequent (22 to 25%) predominantly "first cousin marriages". It has adverse consequences on infant mortality, with unexpected polymalformations or neural tube malformations, hematologic diseases, juvenile diabetes and recessively inherited diseases (neurological diseases were not studied here). The social causes of such a high incidence of consanguinity in Algeria are discussed. Measures to put into action in order to rapidly change the customs of the country are suggested. PMID- 6487048 TI - [Wolfram's syndrome]. PMID- 6487049 TI - [Plea for the combination of ampicillin and kanamycin in materno-fetal infection]. PMID- 6487050 TI - Parallel examination of receptors of malignant lymphoma cells using combined tests with mouse erythrocytes and monoclonal VIB-C5 antibody or polyvalent serum against human immunoglobulins. AB - This report presents the results of studies on two membrane markers of lymphocytes isolated from patients with non-Hodgkin's lymphoma. The combined methods were applied allowing for a simultaneous testing of: a) presence of the membrane receptor for mouse erythrocytes (Em) and membrane immunoglobulins (SmIg) or b) presence of the receptor for mouse erythrocytes and antigen binding monoclonal VIB-C5 antibody (VIB). In 12 patients with the low grade malignant lymphoma, up to 50% of lymphocytes possessed both receptor for mouse erythrocytes as well as membrane immunoglobulins and higher frequency of occurrence of Em+ cells were associated mainly with a high percentage of SmIg-- cells. In 9 patients with low grade malignant lymphoma, 24% of cells were observed to possess Em receptor and antigen detectable with VIB antibody, 34-70% of cells were Em-VIB lymphocytes and 13-54% were Em-VIB+ cells. The results obtained have revealed that the application of monoclonal antibody renders possible the diagnosis of lymphoma and may be of particular value in the cases with weak expression of receptor for mouse erythrocytes. PMID- 6487051 TI - Changes in natural killer cells activity in mice bearing subcutaneously implanted Lewis lung carcinoma. AB - Natural killer (NK) cytotoxic activity was measured against the standard target cell line YAC-1 in a four-hour chromium release assay. Effector cells were taken from spleen and bone marrow of BDF1 mice inoculated 3, 7, 14 or 21 days earlier with 2 X 10(6) Lewis lung carcinoma (LL) cells. The peak of cytotoxic activity both in spleen and bone marrow appeared in mice 3 days after tumor inoculation. There were no differences in cytotoxic effect between tumor bearing and normal mice on day 7. The significant decrease was observed in tumor bearing mice on day 14 and 21. However, at that time the spleen cellularity increased 2.7 and 3.8 times, respectively suggesting a possible dilution effect of NK cells in mice with splenomegaly. Bone marrow cellularity remained unchanged as compared to control. The possible mechanisms of decrease in NK cytotoxic activity and its implications for progression of tumor growth are considered. PMID- 6487052 TI - Effect of pregnancy on the activity of hematopoietic stem cells. AB - Effect of allogenic and syngenic pregnancy on the activity of multifunctional hematopoietic stem cells of bone marrow and spleen was studied. It was observed that bone marrow of mice mated syngenically and allogenically was more capable of restoring hematopoiesis in lethally irradiated recipients as compared to the bone marrow of nonpregnant mice. Increased number of colony forming hematopoietic cells (CFU-S) was recorded also in the spleen of female mice with syngenic pregnancy. When the spleen of pregnant mice mated allogenically, was the source of the multifunctional hematopoietic spleen cells, the animals displayed suppressed capability to restore hematopoiesis which manifested by a decreased number of CFU-S. Splenectomy appeared to have no influence upon the number of CFU S in the bone marrow of pregnant mice mated allogenically. PMID- 6487053 TI - [Synthesis of glycosides and sugar orthoesters of 9,10-dihydrolysergol]. PMID- 6487054 TI - Potential antitumor agents, XII. Alkylating agents from p-hydroxypropiophenone and p-hydroxyacetophenone. PMID- 6487055 TI - Antiinflammatory activities of compounds derived from salicylic and benzoic acids. PMID- 6487056 TI - Piperidinediones, III. Structure-activity relationships of the enantiomers of a series of 2,6-piperidinedione derivatives. PMID- 6487057 TI - Synthesis of leukotriene analogs. PMID- 6487058 TI - Syntheses of 7Z, 9E, 11E, 14Z-leukotrienes. PMID- 6487059 TI - Fast walking velocity in health and Duchenne muscular dystrophy: a statistical analysis. AB - Fast walking velocity was measured in 335 apparently healthy subjects, 180 males and 155 females, whose ages ranged from 3.5 to 24 years. These velocities increased with age and approached an asymptote of 3.44m/sec in males and 3.17 m/sec in females, a statistically significant difference (p less than 0.001). This parameter was also measured serially over periods of 18 to 132 months in 15 patients with Duchenne muscular dystrophy. A decrease in walking rate began between ages four and six. This decline was found to fit linear and monoexponential decay mode models equally. Average linear decay for all 15 patients was 0.0308 m/sec/month; and the average fractional decay was 0.0349/month. On average, by 10 years, the fast walking rate was reduced to about 29% of normal. This measure of disease progression followed a unique course in each subject, which could be mathematically characterized by a unique decay rate, and a unique walking velocity at age 10 years. Thus, in contrast to natural speed walking, the measurement of fast walking velocity has proved to be a simple and useful index for characterizing disease progression in Duchenne muscular dystrophy, and for evaluating therapeutic interventions. PMID- 6487060 TI - Wheelchair cushion modification and its effect on pressure. AB - Prevention of pressure sores is a major objective in the rehabilitation of individuals with paraplegia and quadriplegia. Wheelchair cushions made of polyurethane foam are frequently prescribed to relieve pressure and reduce the risk of ulceration for persons seated in wheelchairs. Because no cushion uniformly distributes pressure for all diagnostic groups, it may become necessary to modify a commercial cushion to provide protection against the effects of pressure. In this study, foam wheelchair cushions were geometrically modified by removing wedges from their wheelchair contacting side to reduce ischial pressure. Ischial pressures of 30 subjects on one unmodified and five geometrically modified cushions were determined using the Pressure Evaluation Pad. No significant differences were determined in the pressure measured for one modified cushion compared to the other modified cushions or for the control cushion. Independent effects of subject sex, diagnosis, and body build could not be identified so that no optimal modification was noted for any subpopulation of the total patient group. Marked individual variation and responsiveness were noted between cushions for any given patients. These data demonstrate that individualization of the prescription of a wheelchair cushion is essential for optimal pressure relief, and that no cushion appears to be universally superior for all patients or for any subgroup of patients requiring pressure relief devices. PMID- 6487061 TI - Arc-aggregation: a new method of range of motion analysis in hemophilia. AB - Arc-aggregation is a new graphic method of analysis of progressive loss of range of motion that can be applied to any diarthrodial joint undergoing a specific degenerative process. It is based on the premise that loss of motion (LOM) for a specific condition occurs in a predictable way or pattern. Using this method to analyze a population of 48 hemophilic patients with various stages of joint involvement, we studied 95 knees, 93 ankles, and 83 elbows for a total of 271 joints. We found a predictable pattern of progressive loss of range of motion for each joint. To detect the early onset of joint involvement, the first LOM is important. The early loss with the knee was in flexion, which gravitated toward fusion at 40 degrees. For the elbow, the early LOM was extension with fixation, occurring at 90 degrees of flexion, the preferred position for fusion. For the ankle, the early LOM was dorsiflexion with final ankylosis in slight equinus. PMID- 6487062 TI - Platform training and postural stability in hemiplegia. AB - Thirteen hemiplegic patients who had a cerebrovascular accident (CVA) in the anterior cerebral circulation were subjected to training on a moving platform. Each session consisted of a 5 min stance on the platform while they moved along an anteroposterior axis, and a 5min stance during transverse movement. Movement amplitude of the platform was adjusted once every three training sessions to the largest that the patients could sustain without using their hands for support. An electromyogram (EMG) was recorded from the tibialis anterior (TA) muscles of each patient during training and at stance on the floor. In addition, the distribution of body weight on the feet was measured in each case before the training program began and at its termination after three weeks (15 training sessions). A matched group of 11 hemiplegic patients served as controls. The maximal movement amplitude that each patient in the control group could sustain was determined twice, once at the beginning of the study and again after three weeks. Ten patients in the experimental group showed more than a two-fold increase in the maximal movement amplitude (MMA) that they could sustain. The patients most impaired initially showed the greatest increase in MMA--five- to seven-fold. In the control group, only one patient had an MMA increase greater than two-fold. A significant improvement in weight distribution on the feet during stance on the floor was found in the experimental patients, but not in the controls. EMG records indicated that improvement in stance did not result from increased TA activation in the hindered leg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487063 TI - Postmenopausal spinal osteoporosis: flexion versus extension exercises. AB - Fifty-nine women with postmenopausal spinal osteoporosis and back pain were instructed in a treatment program that included extension exercises (E) for 25 patients, flexion exercises (F) for 9, combined (E + F) exercises for 19, or no therapeutic exercises (N) for 6. Ages ranged from 49 to 60 years (mean, 56 years). Follow-up ranged from one to six years (means for the groups, 1.4 to 2 years). All patients had spine x-ray studies before treatment and at follow-up, at which time any further wedging and compression fractures were recorded. Additional fractures occurred as follows: group E, 16%; F, 89%; E + F, 53%; and N, 67%. In comparison with group E, the occurrence of wedging or compression fractures was significantly higher in group F (p less than 0.001) and group E + F (p less than 0.01). This study suggests that a significantly higher number of vertebral compression fractures occur in patients with postmenopausal osteoporosis who followed a flexion exercise program compared with those using extension exercises. Extension or isometric exercises seem to be more appropriate for patients with postmenopausal osteoporosis. PMID- 6487064 TI - Pressure sore management: efficacy of a moisture reactive occlusive dressing. AB - Twenty-five pressure sores occurring in a total of 21 patients were evaluated for their response to an adhesive hydrocolloid occlusive dressing (HCD). All ulcers had been treated previously. Response to the occlusive dressing was compared with previous clinical response. Due to the discharge or transfer of patients, evaluation of HCD therapy was usually made after a relatively short period of treatment, average treatment length being 27 +/- 3 days. Fourteen of the 25 decubitus ulcers (56%) demonstrated marked improvement or complete healing with HCD therapy. In contrast, only two of the 25 ulcers (8%) had demonstrated marked improvement under previous treatment. Of 16 ulcers which had failed to improve previously, seven (44%) had either healed or showed marked improvement with the use of the occlusive dressing. For ulcers which had healed, average healing time with HCD was 37 +/- 7 days. PMID- 6487065 TI - Football shoulder and neck injury: a study of the "stinger". AB - Twenty football players with preliminary diagnosis of "stinger" were examined and treated. Of the 12 on whom EMGs were performed, all but one were proven to have C6 radiculopathy rather than lateral stretch of brachial plexus. Most frequent mode of injury was neck flexion during tackling by a linebacker. Athletes should not return to competition until abnormal neurologic signs disappear. PMID- 6487066 TI - Callosal syndrome: implications for understanding the neuropsychology of stroke. AB - A case is presented of callosal syndrome following cerebral hemorrhage and amphetamine abuse in a 26-year-old right-handed man. There were few hemispheric findings but a full callosal syndrome including left apraxia to verbal commands, left tactile anomia, left agraphia, right constructional apraxia, failure of blindfolded side-to-side hand replication and form-board testing showing loss of interhemispheric transmission including intermanual interference. The "draw-a clock" test showed left inattention when drawn with the right hand but not the left, and perseveration was noted for spatial tasks done with the right hand and symbolic tasks done with the left. The patient recovered functionally almost completely but testing demonstrated continued loss of interhemispheric transmission. The case is considered of most interest for its potential in explaining phenomena observed in severe unilateral hemispheric lesions. Our findings suggest that perseveration is not a dysfunction of the damaged portion of the brain, but a phenomenon associated with intact brain attempting unfamiliar tasks. The persistence of left hemi-inattention is attributed to the inability of the left hemisphere to utilize spatial information to compensate for the phenomenon of inattention. Left-sided dyskinesia following left hemisphere lesions was attributed to the lack of symbolic information necessary to perform some movements. Dysprosody was attributed to lack of tonal information to the left hemisphere. Recovery of function following severe unilateral lesions may be largely due to compensatory learning by the intact hemisphere and assertion of ipsilateral control. As our patient originally assumed an inverted left-handed writing posture, we assume the posture is controlled by the right hemisphere.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487067 TI - Self-medication on a rehabilitation unit. AB - A self-medication program (SMP) has been designed and implemented as part of a multidisciplinary approach to rehabilitation. The four stages of the program, coordinated by a pharmacist, are: (1) patient assessment and introduction, (2) self-medication (SM) at the bedside, (3) SM at the nursing station, and (4) discharge assessment. Twenty-four patients, representing 52% of the patients introduced into the program, have successfully completed all stages. Severe physical impairment was not usually a deterrent to the completion of the program. All patients benefitted from the program by acquiring some skills in SM and by receiving additional motivation for improvement. The rehabilitation team received assurance that some patients could comply with their medication regimen after discharge. PMID- 6487068 TI - [Relations between subjective experience and physiologic reactions in an emotional stress test]. PMID- 6487069 TI - [Conditioning of acoustic evoked potentials and unconscious stimulus processing in repressors, non-defensives and sensitizers]. PMID- 6487070 TI - The effect of perceived physical symptoms on emotion. PMID- 6487071 TI - [Where is "fast" processed faster than "slow"? On the localization of the effect of semantic markedness in information processing]. PMID- 6487072 TI - [Extraction of significance from stories: a production system for the generation of macro- from microstructures]. PMID- 6487073 TI - [Differential controlling functions of motivation and prior experience in the acquisition of psychomotor skills]. PMID- 6487074 TI - Transsexual prostitution in New Zealand: predominance of persons of Maori extraction. AB - Information concerning the racial distribution, family background, sexual history, education, and employment status of 27 New Zealand, male-to-female preoperative transsexual prostitutes was obtained by interview and questionnaire. Subjects lived in Wellington, New Zealand, and Sydney, Australia. Subjects recalled childhoods with maternal dominance, paternal absence, being youngest sons, and being dressed in girls' clothes by female relatives. Further, an early history of homosexual intercourse and cross-dressing behavior occurred significantly often. Moreover, it was apparent that the Maori race, which forms 9.0% of the total New Zealand population, was disproportionately represented; approximately 90% of the transsexual prostitute population in Wellington is Maori. Various explanations are offered for the racial inequality. It is concluded that cultural influences have an effect on the number of transsexual prostitutes in New Zealand. Further research is needed to assess whether these factors also influence the etiology and development of transsexualism. PMID- 6487075 TI - Cognitive characteristics and homosexuality. AB - There have been many studies of psychological characteristics of homosexuals, but cognitive characteristics have been relatively neglected. This study investigated the verbal intelligence of 20 homosexual males, 20 heterosexual males, and 20 females, taking into account variables likely to affect verbal ability such as social class and handedness. There were no differences in overall IQ, but group differences in verbal and nonverbal ability were marked. No other differences between the groups were found. The implications are briefly discussed. PMID- 6487076 TI - An analysis of the effectiveness of two components in the treatment of erectile dysfunction. AB - This study compared the effectiveness of two components, a ban on sexual intercourse and communication of sexual preferences, in the treatment of couples in which the male was experiencing erectile dysfunction. Sixteen couples were randomly assigned to one of two treatment conditions. In one condition spouses were asked to refrain from intercourse and to make an effort to communicate sexual tastes and preferences during noncoital erotic interaction. Couples in the second condition were assigned only the communication portion of the therapeutic instructions given to the first group. The treatment consisted of written instructions concerning tasks to be carried out at home. Therapist contact was minimal. Following a 1-month baseline period of self-monitoring using a daily record-keeping form, couples underwent a 1-month treatment period and follow-up testing after another month. Male subjects also underwent an endocrinological examination to ascertain testosterone and related hormone levels prior to participating in the treatment. Both treatment groups reported significant improvement in several measures of erectile functioning, general sexual functioning, and marital adjustment. However, the ban on intercourse did not add to the effectiveness of encouraging sexual communication, indicating that the former component probably did not contribute to change. Two pretreatment measures, the Sexual Interaction Inventory and testosterone level, were found to predict treatment outcome with sufficient accuracy to permit selection of future patients who might benefit from this type of treatment format. The effectiveness of a treatment consisting of written instructions with minimal therapist contact for males with erectile dysfunction have important cost-benefit implications. PMID- 6487077 TI - The sexual development and life of female schizophrenic patients. AB - The sexual development of 51 female schizophrenics, their attitudes toward sex, and their sexual activity and arousability were investigated. The control group consisted of 101 gynecological patients. The sexual development of the female schizophrenics was significantly retarded, and their sexual activity and arousability significantly lowered in adult life compared with the control group. The hypothesis is advanced that the retarded development may be caused by some biological factor, while sexuality in adult life is negatively affected primarily by social isolation. PMID- 6487078 TI - The influence of parents, church, and peers on the sexual attitudes and behaviors of college students. AB - Male and female undergraduate students were surveyed concerning their sexual attitudes, sexual behaviors, and contraceptive behavior. In addition, the general attitudes about sexuality the students perceived as communicated to them by their parents, their church, and their peers were assessed. It was found for female students that general attitudes about sexuality, as defined on an erotophilia erotophobia dimension, and sexual behaviors were correlated with the perceived attitudes of peers, rather than those of parents and church. However, male students' attitudes and some sexual behaviors were correlated with the perceived attitudes of their parents, rather than the views of their peers and church. Church attitudes were not found to be related to any of the measures. None of the sources of influence, parents, peers, or church attitudes, or erotophilia erotophobia was related to contraceptive behavior. PMID- 6487079 TI - A comparison of structural patterns of sexual arousal in male and female homosexuals. AB - Patterns of sexual arousal were examined for eight male and eight female homosexuals. Comparisons were made in terms of physiological and subjective arousal. The results indicate that for each group there exists very distinct arousal responses, with each group showing the greatest response to same-gender homosexual activity. Results are discussed in relationship to establishing normative data for assessment and clinical function. PMID- 6487080 TI - Black female transsexuals and schizophrenia: a serendipitous finding? AB - While increasing numbers of individuals have identified themselves as transsexuals and requested sex reassignment surgery, the number of black female applicants is grossly underrepresented. Indeed, only 3% of the patients applying to the Case Western Reserve University (CWRU) Gender Identity Clinic (5 of 174 patients) were black females; and in one survey of nine gender identity clinics, only 1.1% of the applicants were black females. In this study, all five black female applicants who applied for transsexual evaluation to the CWRU Gender Identity Clinic served as subjects. The patients' characteristics, their psychological test results, clinical interview material, and psychological and psychiatric diagnoses are presented. All patients had severe psychopathology; three were schizophrenic, one was a schizophrenic character, and the last diagnosed as either a psychotic character or borderline personality. Among the hypotheses, it was suggested that black women may be "inoculated" against severe gender identity pathology and only exhibit such pathology as a consequence of a schizophrenic illness or severe borderline schizophrenic state. The data also suggest that more attention should be placed on investigating the family and cultural dynamics related to transsexualism. The implications of these findings for developing a comprehensive theory of transsexualism are presented. PMID- 6487081 TI - [Endogenous nitrogen metabolism in 15N-labeled swine. 1. Course of 15N-labeling and 15N excretion in urine and feces under 4 different diets]. AB - Four male castrated pigs (55-65 kg) either received a wheat--fish meal diet (1 and 2) or a wheat--horse bean diet (3 and 4) without straw meal supplement (1 and 3) or with a supplement of 20% DM partly hydrolysed straw meal to the DM of the ration (2 and 4). In order to investigate whether a 15N-labelling of the pigs is also possible with a protein excess in the ration, the animals 1 and 2 received 24.8 g and the animals 3 and 4 = 11.6 g crude protein/kg0,75 live weight. During a 10-day 15N-labelling 385 mg 15N-excess (15N') per kg0,75 were applied in a mixture of ammonia acetate and ammonia chloride in the feed. During the period of 15N-labelling the following quotas of the applied 15N-amount were incorporated: 1 = 10.2%, 2 = 7.2%, 3 = 18.7%, 4 = 14.4%. 15N-excretion in both TCA fractions of faeces showed a highly significant positive correlation to the increasing content of crude fibre in the 4 diets. The immediate 15N-incorporation into the TCA precipitable fraction of faeces (from the 2nd of the beginning of the 15N application onwards) proves that 15N enters the large intestine endogenously (probably as 15N-urea) and serves bacterial protein synthesis. Three days after the last 15N-application the pigs were killed. The following values of atom-% 15N' could be determined in the TCA-precipitable blood plasma and in the TCA precipitable fraction of the liver: 1 = 0.18 and 0.19 resp., 2 = 0.22 and 0.27 resp., 3 = 0.22 and 0.23 resp. and 4 = 0.24 and 0.26 resp. The other examined organs and tissues showed smaller differences between the test animals. The following atom-% 15N' were measured in the TCA-precipitable fractions on an average of the 4 test pigs: kidney = 0.20, pancreas = 0.18, intestinal wall tissue, duodenum = 0.18, jejunum (beginning) = 0.17, jejunum (end) = 0.15, ileum = 0.15, caecum = 0.16, colon (beginning) = 0.15, colon (middle) = 0.14, colon (end) = 0.13, stomach (cardia) = 0.11, stomach (fundus) = 0.12, spleen = 0.13, heart = 0.12, skin = 0.07 and skeleton muscles = 0.06. The results show that the 15N-labelling of tissues and organs of pigs is also possible at a high level of protein supply by means of an oral application of 15N ammonia salts. PMID- 6487082 TI - [Effect of protein restriction and refeeding on the nitrogen balance in piglets]. AB - In balance trials the effect of a 50% protein restriction with subsequent realimentation on N balance, endogenous N excretion, digestible and metabolisable energy was tested using 36 piglets. The dietary protein content during the restriction period from 5-12 kg live weight was 22.9 (control) and 12.4% of the dry matter and during the realimentation period from 12-18 kg live weight in both groups 17.2%. Protein quality and energy supply were not changed between the groups. Restricted protein supply proportionally reduced N retention with slightly improved efficiency of digestible N from 67 to 70%. During realimentation the previously reduced N supply did not influence N retention but increased the apparent N digestibility by 2% units. The endogenous N losses as well as digestible and metabolisable energy were not different between the groups. It was concluded that compensatory responses of the N metabolism might require a stronger dietary restriction and respectively or a longer restriction period. PMID- 6487083 TI - [Effect of the content of crude plant protein in feed on the utilization of urea in dairy cattle. 4. Passage of amino acids through the duodenum]. AB - Model investigations carried out by means of a re-entrant method at the duodenum with dairy cows and with energy-equivalent rations (600 EFU cattle/kg DM), which after the supplementation of 11 g urea/kg DM (150 g/animal and day) contained 13.8 (I), 16.7 (II) and 20.2 (III)% crude protein, had the following results: The amino acid profile of the duodenal protein differed from that of the applied rations and was similar to the microbial protein in the rumen. It only changed inconsiderably with the protein level of the ration. There were differences between the amino acids of the feed as to their apparent rate of fermentation in the rumen. Ser, tyr, lys, and leu apparently proved to be most resistent whereas arg, asp, met, ile and phe were apparently fermented for the most part or completely. The passage rate of amino acids at the duodenum related to intake were, from I ... III 126, 102 and 87%. With all rations there were always net losses of some amino acids (his, arg) and net gains (lys, thr, ser, gly, val, met and tyr) at the duodenum in comparison intake. 15N from urea was incorporated into all the amino acids determined in the duodenal protein, most intensively into glu, ser, asp, ile, gly, his and leu. The apparent digestibility of the total amino acids in the intestines was independent of the crude protein level of the rations and reached 69 ... 71% with a deviation range of 59 ... 81% for the individual amino acids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487084 TI - [Ultrastructure of cells of the human intraspinal organ]. AB - In the intraspinal organ at the level of the IV--V lumbar segments of the spinal cord, in 7 women and 8 men (30-45 years of age) certain cells have been studied electron microscopically. According to their ultrastructure, they are divided into ectogliocytes without processes, plasmic and fibrillar astrocytes, mesogliocytes, tissue basophils and cells with signs of secretion. Variability of organells of the secretory cells and their inclusions is connected with production and exocytosis of the secrete. PMID- 6487085 TI - [Development of nerves plexuses in the pelvis of the prenatal rabbit]. AB - By means of neurohistological and histochemical methods using serial sections of the embryos at the age of 12-30 days of development, the premediatory and beginning of the mediatory stages in development of cholinergic and adrenergic neural plexuses have been studied in rabbit small pelvis. Appearance of catecholamine-containing cells at early mediatory stages and a gradual development and complication of the cholinergic and adrenergic neural plexuses structure are demonstrated. By birth in the rabbit small pelvis area, some elements of cholinergic and adrenergic structures begin to form. PMID- 6487086 TI - [Spatial organization of the microcirculatory bed and organ-tissue functional elements of the myocardium]. AB - Angioarchitectonics of the microhemocirculatory bed (MHCB) of the myocardium have been studied by means of injection techniques and an original method for elective revealing (silver impregnation). Hearts of healthy persons died accidental deaths, those of intact dogs and rabbits have been investigated. The MHCB structure of the left ventrical myocardium has been followed in details; certain peculiarities on distribution of microvessels have been revealed. They secure principally equal conditions for transport-trophic supply for all cardiomyocytes. The data obtained make it possible to outline a principle structural scheme for the organ-tissue functional elements of the myocardium. PMID- 6487087 TI - [Intraorgan vascular bed of the transplanted small intestine after spontaneous and surgical restoration of lymph drainage from the transplant]. AB - The model of heterotopic autotransplantation of the small intestine has been made in 83 dogs. In two experimental groups the state of the intraorganic vascular bed of the intestine transplant has been studied at a spontaneous and surgical restoration of the lymph outflow ways from it. The reconstruction of the lymph outflow ways is performed by means of lymphonodulo-noduloanastomoses formed between the mesenteric and iliac lymphatic nodes. The intraorganic vascular bed is studied during 1 day - 1 year by means of polichromic injection of Gerota mass with a subsequent clearance of the preparations after Spaltecholts--Zhdanov. The autotransplantation of the small intestine results in a morphological rearrangement of the intraorganic blood and lymphatic bed of the transplant. In both experimental groups it is unityped and characterized with a dilatation of venous and lymphatic vessels in all layers of the intestine, with a twisted course of the vessels, with destruction of some lymphatic vessels and networks of the lymphatic capillaries. At the spontaneous regeneration of the lymphatic pathways, a longer time is necessary to correct these disturbances (up to 6 months). The surgical restoration of the lymph outflow ways from the intestine accelerates normalization of the vascular bed architectonics in the transplant. The morphological rearrangement of the intraorganic vascular bed of the small intestine is mainly completed in 1 month after autotransplantation. PMID- 6487088 TI - [Morphofunctional features of lymphoid tissue in the normal duck and after antigenic stimulation]. AB - Formation of lymphoid tissue in the spleen and lymphatic nodes has been studied in ducks after hatching. Its reaction in the course of immune response has been revealed in intact birds after removal of one of the central organs of immunity (the thymus and bursa of Fabricius). Participation of the lymphatic nodes in immunological reactions is revealed in Lamellirostris. Certain data have been obtained on thymus- and bursa-depending zones in the duck lymphatic nodes and spleen. Dynamics of cytological composition and histochemical reactions have been studied in various zones of the duck lymphoid organs at different age and in the course of immune response in intact ducks and after thymectomy and bursaectomy. The peculiarities in the lymphoid tissue formation in Lamellirostris, in comparison to Mammalia and lower poikilothermal animals, have been discussed, as well as certain regularities in influence of the central immune organs on this process. The data obtained can be used in immunological investigations widely performed in birds, and they are also of some interest to understand the mechanisms of ontogenesis of the lymphoid tissue in the mammalian and human organisms and their disturbances taking place at selective insufficiency of T- and B-parts of the immune system. PMID- 6487089 TI - [Age and changes in succinate dehydrogenase activity in functionally different muscles of the young rat]. AB - The antigravitational m. triceps brachii, its antagonist m. brachialis and the muscle having a universal functional specialization--m. serratus ventralis--have been studied in 35 male rats of Wistar strain, 60-105-day-old. Succinate dehydrogenase activity is determined in muscle fibers. Changes in the muscle fibers continue after the rats reach their sex maturation. Certain stageness of the process is observed, but the division of the period into separate steps either is absent (m. brachials), or their number is not great as compared to those during the 1st--60th days after birth. The borders of the periods in the muscles studied coinside (the 70th--74th day). Although it is possible to reveal the periods and separate steps in the changes occurring in the muscle fibers and in the muscles of the animals having reached their sex maturation, nevertheless, the borders between them are not distinct, the reconstruction during this age proceeds slower and more smoothely than before the sex maturation. It is possible that in young rats after sex maturation differentiation of the muscle fibers continues and that, in its turn, stimulates further specialization of the muscles as organs. The changes in the muscle fibers revealed histochemically occur most slowly under a low static loading, and when loading of various modality (kinetic and static) are combined, they are mostly pronounced. PMID- 6487090 TI - Chewing oscillopsia. PMID- 6487091 TI - Myelopathy after scorpion sting. PMID- 6487092 TI - Pure alexia without hemianopia. PMID- 6487093 TI - Transient global amnesia. PMID- 6487094 TI - And all the daughters of musick shall be brought low. Language function in the elderly. AB - Language, including articulated speech and also, communication of ideas in writing, is liable to progressive alteration with advancing years. This process may appear early or late and may advance throughout the presenescent-senescent senility continuum. An attempt is made to discuss these changes objectively, and from the standpoint of linguistics, their possible bearing upon the more fundamental problem as to the nature of the aging process is mentioned. PMID- 6487095 TI - Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long term prognostic study. I. Introduction. PMID- 6487096 TI - Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long term prognostic study. II. Ruptured intracranial aneurysms managed conservatively. AB - The late natural history of ruptured intracranial aneurysms was studied in 568 cases reported to the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage from 1958 to 1965. The patients had been selected for conservative management of their aneurysms at the time of diagnosis. A follow-up search in 1981 and 1982 revealed 378 known deaths; 40% had occurred within six months of hemorrhage. During the next two decades, the patients' survival probabilities were significantly worse than those of a matched US population. Multiple aneurysms did not differ prognostically from single aneurysms, but posterior circle aneurysms carried a better prognosis after ten-year survival. The rate of probable recurrent bleeding after six months was 2.2% per year for the first 9 1/2 years and 0.86% per year for the second decade. Reported rebleeding episodes were fatal in 78%. PMID- 6487097 TI - Cooperative study of intracranial aneurysms and subarachnoid hemorrhage: a long term prognostic study. III. Subarachnoid hemorrhage of undetermined etiology. AB - Among 6,638 cases reported to the Cooperative Study of Intracranial Aneurysms and Subarachnoid Hemorrhage were 477 cases in which the cause of hemorrhage could not be determined after carotid and vertebral angiography. These patients were followed up for up to 24 years after hemorrhage. Twenty patients were subsequently found to have an aneurysm or arteriovenous malformation missed by the first angiographic survey. After six-month survival, the rate of recurrent hemorrhage was a maximum 0.86% per year. Survival was significantly better than that of patients with verified ruptured aneurysms managed conservatively in this cooperative study. For normotensive patients who survived the first six months, the life expectancy for the next 20 years equaled that of an age- and sex-matched US population. Hypertensive patients had a higher mortality than normotensive patients. PMID- 6487098 TI - Thymectomy and chronic relapsing experimental allergic encephalomyelitis in guinea pigs. AB - Chronic relapsing experimental allergic encephalomyelitis (EAE) was induced in young Dunkin Hartley guinea pigs by a single sensitization with guinea pig spinal cord homogenate. The effect of either newborn thymectomy or young adult thymectomy on the clinical course of chronic and relapsing EAE was studied and evaluated statistically by Student's t test. All the animals that underwent thymectomy showed a significant delay in the onset of the disease compared with control groups. In addition, in the young adult guinea pigs in which thymectomy was done, the incidence of clinical disease was decreased. No substantial differences, however, were observed in the severity of the disease and number of remissions or relapses between guinea pigs in which thymectomy was done and in which clinical symptoms developed and controls. PMID- 6487099 TI - Mature oligodendrocytes. Division following experimental demyelination in adult animals. AB - Primary demyelination can be caused by injury to oligodendrocytes or to the myelin sheaths that these cells maintain. Although remyelination does take place in multiple sclerosis (MS), its possible role in the recovery from MS attacks has been inadequately considered, partly because of the belief that oligodendrocytes, once destroyed, cannot be replaced in the adult. The injection of lysolecithin into the mouse spinal cord causes primary demyelination, followed by the generation of new oligodendrocytes and remyelination. By using a pulse label of tritiated thymidine, this electron-microscopic autoradiographic study demonstrated a source of these regenerated oligodendrocytes. The replacement of oligodendrocytes can occur through the division of preexisting oligodendrocytes. This is the first demonstration that mature oligodendrocytes are capable of dividing in older animals. These results lend support to recent observations of an apparent proliferation of these cells in an active MS lesion. We believe that the ability of mature oligodendrocytes to divide and to remyelinate axons in the adult may play an important role in the recovery from MS attacks. PMID- 6487100 TI - CNS involvement by non-Hodgkin's lymphoma. Response to a standard therapeutic protocol. AB - Treatment results of 31 episodes of CNS involvement by malignant lymphoma diagnosed in 24 patients were studied. Leptomeningeal involvement occurred in 16 patients, intracerebral invasion in eight patients, and epidural cord compression in seven patients. Twelve patients with leptomeningeal involvement treated with intraventricular methotrexate sodium achieved complete CSF remission and ten patients' conditions improved neurologically. Five of the patients with epidural cord compression were ambulatory following treatment. Complete resolution of intracerebral lymphoma was documented by computed tomographic scan in four patients. The overall median survival was nine months, eight months for leptomeningeal involvement, five months for intracerebral lymphoma, and 12 months for patients with cord compression. Our results suggest that all forms of CNS lymphoma usually respond well to therapy, life span is prolonged, and is free of CNS disease until patients die of uncontrolled systemic lymphoma. PMID- 6487101 TI - Serum creatine kinase B concentrations in acute cerebrovascular diseases. AB - Serum creatine kinase B (CKB) concentrations were measured every 12 hours for five days in 38 patients during acute cerebrovascular diseases and in nine controls. Mean CKB concentration was 6.2 +/- 0.8 ng/mL. The fluctuation of the CKB concentration following ischemic stroke was as notable as the elevation immediately after the ischemic event. The two abnormalities were observed in 13 of 17 patients with acute cerebral infarction, and the extent of abnormalities roughly correlated with the volume of tissue damage. The profiles were normal for patients with transient vascular events. Patients with subarachnoid hemorrhage demonstrated wide fluctuation along with high CKB concentration. Although transient elevation of the CKB concentration in some patients with subarachnoid hemorrhage was observed after angiography or clinical worsening, the fluctuation in patients with ischemic stroke was not associated with worsening of neurologic conditions or recurrence of ischemic events. PMID- 6487102 TI - Plasma prolactin and cortisol concentrations in epileptic patients during the night. AB - Plasma cortisol and prolactin concentrations were determined every four hours, from 8 PM to 8 AM, in 19 epileptic patients during EEG recording of sleep. Data were compared with those obtained from 12 healthy young male volunteers studied under similar conditions. Patients had normal cortisol rhythm, with peak levels at 4 AM or 8 AM and trough at midnight. A sleep-related increase in prolactin concentration was observed in all patients. The range of prolactin concentrations in the patients was also normal. Treatment with valproic acid (ten patients) and frequent abnormal EEG discharges (five patients) did not affect cortisol and prolactin secretion. PMID- 6487103 TI - Lipofuscin in amyotrophic lateral sclerosis. AB - Lipofuscin has been reported to accumulate in abnormal amounts in motor neurons of patients with amyotrophic lateral sclerosis (ALS). Microdensitometry was used to quantitate such lipid masses in spinal motor neurons in normal subjects compared with spinal motor neurons in ALS cases. No overall difference in lipofuscin level was found between the normal and the ALS material. Some neurons of intermediate size did show increased amounts of lipofuscin, which is attributed to shrinkage during degeneration by larger cells having proportionately more lipofuscin originally. PMID- 6487104 TI - Serial evoked potential studies in patients with definite multiple sclerosis. Clinical relevance. AB - Twelve patients with clinically definite multiple sclerosis were examined both clinically and electrophysiologically at repeated intervals over one year to determine the clinical relevance of data obtained by serial multimodality evoked potential studies. We frequently found a disparity between the clinical and electrophysiologic changes, and also an excessive variability between test sessions of the responses to stimulation of a clinically involved afferent pathway even when the clinical deficit was stable. Our findings indicate that though evoked potential studies may provide information of diagnostic relevance, their role in monitoring disease progression has not been established. PMID- 6487105 TI - Trigeminal neuralgia. Current concepts regarding etiology and pathogenesis. AB - There has long been a controversy over the cause of trigeminal neuralgia. Most clinical data favor a peripheral cause. However, most of the experimental data tend to favor a central mechanism. Drugs that are effective in the treatment of trigeminal neuralgia facilitate segmental inhibition in the trigeminal nucleus, as well as depressing excitatory transmission. The most plausible hypothesis to reconcile all of these observations is that trigeminal neuralgia has a peripheral cause and a central pathogenesis. Chronic irritation of the trigeminal nerve apparently leads to both a failure of segmental inhibition in the trigeminal nucleus, and ectopic action potentials in the trigeminal nerve. This combination of increased firing and impaired efficiency of inhibitory mechanisms leads to paroxysmal discharges in the trigeminal nucleus, which are perceived as attacks of trigeminal neuralgia when they involve nociceptive trigeminothalamic-relay neurons. PMID- 6487106 TI - Clonidine treatment in paroxysmal localized hyperhidrosis. AB - We report two cases of paroxysmal localized hyperhidrosis (PLH), a rare disorder usually of undetermined origin. The patients were treated with clonidine hydrochloride on the assumption that this paroxysmal phenomenon is of CNS origin, probably hypothalamic. Both patients responded favorably to treatment. In treating PLH, clonidine may serve as an alternative approach to local or surgical treatment. PMID- 6487107 TI - Hyperammonemic encephalopathy related to ureterosigmoidostomy. AB - Urinary diversion to the colon may produce a metabolic encephalopathy with elevated blood ammonia levels. The condition resembles hepatic encephalopathy but can occur without obvious liver disease. The patient described herein also had a computed tomographic scan showing diffuse brain swelling and superficial contrast enhancement. The condition responds rapidly to lowering of the blood ammonia level and requires a high level of suspicion for diagnosis in the patient who has undergone urinary diversion and has an unexplained metabolic encephalopathy. PMID- 6487108 TI - Strongyloides stercoralis hyperinfection masquerading as cerebral vasculitis. AB - Strongyloides stercoralis hyperinfection is a unique opportunistic infection in which the nematode disseminates widely to cause a multisystem illness. We treated a patient with systemic lupus erythematosus in whom ileus and fever developed and who later lapsed into coma. A xenon Xe 133 cerebral blood flow study showed a global reduction in flow, compatible with CNS vasculitis. The patient's condition failed to improve with high-dose steroid therapy, but he recovered rapidly after Strongyloides larvae were found in stool and sputum and treatment with thiabendazole was begun. We believe that hyperinfection explained the patient's symptoms and should be considered as a cause of diminished cerebral perfusion and mentation in immunosuppressed patients. PMID- 6487109 TI - Arthrogryposis multiplex congenita occurring with maternal multiple sclerosis. AB - All children of a mother with multiple sclerosis (MS) had increasing grades of congenital joint contractures without demonstrable neuromuscular disease. Two had talipes equinovarus, one had congenital hip subluxation, and the youngest had arthrogryposis multiplex congenita. Maternal MS may be causally related to the development of congenital joint contractures. PMID- 6487110 TI - Isolated, reversible, hypoglossal nerve palsy. PMID- 6487111 TI - Hematoporphyrin derivative photoradiation therapy. PMID- 6487112 TI - The management of choroidal melanoma. PMID- 6487114 TI - Hyperthermic treatment of intraocular tumors. AB - A 5.8-gigahertz (GHz) ophthalmic microwave applicator was used to treat choroidal melanoma (Green strain) in rabbits. High-frequency electromagnetic radiation provides a favorable dose distribution to induce local hyperthermia in the treatment of intraocular tumors. Heating of the neoplasm, while sparing normal ocular structures, is best accomplished by a transscleral approach. A hyperthermia plaque is placed on the sclera at the base of the intraocular tumor. Contact (resistive) heating and electromagnetic radiation (radiofrequency and microwave) are best suited to a plaque technique. The advantages of electromagnetic heat induction, as compared with contact heating, are twofold: the depth of hyperthermic penetration can be modulated by frequency selection, and the tissues with low water content (sclera) remain relatively unaffected by microwaves. The 5.8-GHz ophthalmic microwave applicator satisfies the requirements for local hyperthermic treatment of intraocular tumors. PMID- 6487113 TI - Iris retraction associated with rhegmatogenous retinal detachment syndrome and hypotony. A new explanation. AB - Eyes with rhegmatogenous retinal detachment can occasionally be seen with hypotony and a peculiar retraction of the peripheral iris. Herein I report the following new observations in this syndrome: (1) seclusion of the pupil, (2) resolution of the retraction configuration after disruption of the seclusion, (3) the initial manifestation as angle closure secondary to iris bombe interchangeable with the iris retraction configuration with the addition (to bombe) and the withdrawal (from retraction) of pharmacologic aqueous suppressants, and (4) the rapid cataract formation. The theory that vitreous traction or retraction is the cause of the retrodisplacement of the iris was disproved. A hydrodynamic theory is presented. A lowering of pressure behind the iris, at least partially, due to posterior removal of fluid, presumably from the subretinal space, was shown to be the cause of the iris retraction. The iris retrodisplacement occurred when posterior aqueous removal exceeded aqueous formation. This removal of fluid may be an important factor in the understanding of proliferative vitreoretinopathy as the fluid flow involved may draw cells posteriorly. PMID- 6487115 TI - Static and kinetic visual field testing. Reproducibility in normal volunteers. AB - The SD of static visual threshold ranges from 0.12 log units near fixation to 0.41 log units 30 degrees from fixation. Among 60 points tested, most persons have at least one point that tests 0.5 log units less sensitive than the adjacent points, simulating a scotoma 0.5 log units deep. With automated kinetic perimetry, the SD of isopter position is 2.6 degrees to 5.5 degrees, with the greatest variation appearing in the temporal field where the slope is flatter and the isopters are more peripheral. More than 10% of the points show an inward deviation of 5 degrees or more compared with their neighboring points. Retesting of the deviant points is required to distinguish an artifact caused by variable responsiveness from true localized defects. Judgments about progression also require that the accuracy of the isopter position or threshold determination be taken into account. PMID- 6487116 TI - Congenital superior oblique palsy in infants. AB - A retrospective review of 20 cases of infants with congenital superior oblique palsy showed that all cases had been diagnosed and treated surgically before the patient was 2 years old. Single inferior oblique weakening procedures, single superior oblique tucks, and combined inferior oblique weakening procedures and superior oblique tucks were performed as the initial surgical procedures. Best results were obtained with the two-muscle procedure. The presence of preoperative primary position hypertropia correlated significantly with failure of single inferior oblique weakening to eliminate the signs of superior oblique palsy. PMID- 6487117 TI - Solar retinopathy. A biophysical analysis. AB - Funduscopic examination of two young adults complaining of blurred vision revealed small symmetrical macular lesions suggestive of solar retinopathy. Although both patients had recently looked at the sun for less than one minute, it is common to look at the sun for longer periods (ie, sunsets) without incurring visual symptoms of retinal lesions. Our biophysical analysis revealed the important parameters of solar retinopathy and the minimum exposure to the sun that would produce such lesions. Under ideal optical conditions, solar retinopathy can occur following extremely short observations of the sun. PMID- 6487118 TI - Criswick-Schepens syndrome (familial exudative vitreoretinopathy). Study of a Colombian kindred. AB - Ophthalmoscopic evidence of Criswick-Schepens syndrome was found in nine of 22 members of a Colombian family. Histopathologic study of an affected eye enucleated because of neovascular glaucoma showed a focal, nodular zone of fibrovascular proliferation, necrosis, and acute inflammation within the temporal preequatorial retina associated with dense preretinal fibrous organization. Although the cause of the inflammation and cicatrization is unknown, such a nidus may explain some of the advanced clinical manifestations of the syndrome, including temporal dragging of the retina and falciform retinal fold. PMID- 6487120 TI - Orbital Burkitt's lymphoma in a homosexual man with acquired immune deficiency. AB - A 22-year-old homosexual man had persistent systemic lymphadenopathy and a three week history of rapid swelling and induration of his right upper eyelid. Acquired immune deficiency leading to the development of lymphoma was suspected. A biopsy specimen of the mass revealed Burkitt's lymphoma and treatment with systemic chemotherapy and radiation therapy resulted in remission. A significant number of patients with acquired immune deficiency are developing Burkitt's lymphoma. The three separate syndromes of acquired immune deficiency and their associated ophthalmic manifestations are discussed. PMID- 6487119 TI - Malignant teratoid medulloepithelioma manifesting as a black epibulbar mass with expulsive hemorrhage. AB - An 18-year-old woman with malignant teratoid medulloepithelioma had an epibulbar, brown-black mass associated with expulsive hemorrhage and a limboscleral perforation. Histopathologically, a prominent pigmented neuroepithelial component was present and correlated to the black color of the mass. The massive hemorrhage is apparently related to rupture of necrotic and abnormal vascular channels within the angiomatous component of the neoplasm. Other mesenchymal elements included spindle-shaped cells, rhabdomyoblasts, and islands of hyaline cartilage. PMID- 6487121 TI - Vascular endothelial cell growth inhibitor of normal and pathologic human vitreous. AB - Normal and pathologic human vitreous have been analyzed for the presence of a low molecular weight inhibitor of aortic endothelial cell proliferation. Vitreous was subjected to gel chromatography and the material appearing in the retarded volume (less than 13,000 daltons) was tested for its ability to inhibit tritiated thymidine incorporation into DNA by calf aortic endothelial cells. Depending on the sample of vitreous analyzed, one or more fractions showing inhibitory activity were identified in each case. PMID- 6487122 TI - Alteration of acetylcholine synthesis by pilocarpine. In vivo and in vitro studies. AB - Imidazole activates synthesis of acetylcholine by choline acetyltransferase. Pilocarpine hydrochloride, an imidazole derivative, was investigated for its activation effect. In vitro, millimolar concentrations of pilocarpine significantly activated human ciliary body and retinal and rabbit corneal epithelial, iris-ciliary body, and retinal choline acetyltransferases. Concentrations greater than 100mM pilocarpine inhibited acetylcholine synthesis. In vivo, 1% or 4% pilocarpine eyedrops given every 30 minutes for four applications failed to significantly alter rabbit ocular acetylcholine levels. There was a tendency for pilocarpine-treated eyes to have lower levels of acetylcholine. Although pilocarpine altered acetylcholine synthesis by human and rabbit ocular tissues in vitro, this phenomenon could not be demonstrated in rabbits in vivo. However, because tissues of intact rabbit eyes degrade pilocarpine, the possibility remains that this drug can alter acetylcholine synthesis when applied to the intact human eye. PMID- 6487123 TI - Merkel cell carcinoma (endocrine carcinoma of the skin) of the head and neck. AB - Merkel cell carcinoma, also known as endocrine carcinoma of the skin, is a recently recognized and particularly aggressive form of skin cancer that exhibits histologic features similar to those of endocrine malignant neoplasms arising from other tissues. Forty-one patients with Merkel cell carcinoma arising from the cutaneous surfaces of the head and neck were seen at the University of Texas M. D. Anderson Hospital, Houston, between 1966 and 1983. Regional lymph node metastasis occur early and frequently, with a 79% overall incidence observed during the course of the disease. Treatment should consist of a wide resection of the primary tumor. A regional lymphadenectomy, when feasible, is successful in controlling nodal metastases. Postoperative radiation is recommended as an important adjuvant. PMID- 6487124 TI - Combined surgery and postoperative irradiation in the treatment of cervical lymph nodes. AB - One hundred seventy-three patients with squamous carcinomas of the laryngopharynx, oral cavity, and oropharynx received planned, combined resection of the primary neoplasm and radical neck dissection (when N1, N2, or N3 lymphadenopathy was present) followed by megavoltage irradiation to the primary sites and bilateral cervical regions between 1975 and 1982. Radical neck dissections were performed in all patients with N2 and N3 cervical lymphadenopathy, in 90% of those with N1 necks, but in only 4% whose necks were staged NO. Neck failures occurred in 10%, 22%, 19%, and 38% of patients with stages N0, N1, N2, and N3 necks, respectively. The most ominous pathologic feature was soft-tissue extension in the radical neck dissection specimen. Initially clinically benign contralateral lymph nodes became involved in only 9% of these patients. PMID- 6487125 TI - Parotid gland surgery using the Shaw Hemostatic Scalpel. AB - Twenty-five patients who underwent parotid gland surgery using the Shaw Hemostatic Scalpel (group 1) were compared with 25 patients who had similar surgery using conventional techniques (group 2). Overall, the patients in group 1 had less blood loss and shorter operative times. In patients who underwent superficial parotidectomy, the incidence of temporary partial facial nerve paralysis was 31% in the experimental group v 43% in the conventional group. The mean number of branch paralyses per patient was one in group 1 v 1.9 in group 2, and time to recovery of full function was 50% less in group 1. The Shaw Hemostatic Scalpel is a safe, efficacious instrument for use in parotid gland surgery. PMID- 6487126 TI - Antibody-dependent cellular cytotoxicity. Relation to stage and disease course in North American patients with nasopharyngeal carcinoma. AB - A prospective study of North American patients, mostly white, with different histopathologic types of nasopharyngeal carcinoma was initiated approximately five years ago. Several anti-Epstein-Barr virus (EBV) serologic tests are being evaluated; one is the antibody-dependent cellular cytotoxicity (ADCC) assay, which measures antibodies to an EBV-induced membrane antigen component. A low ADCC titer at diagnosis reflects a poor prognosis, and the determination of antibody titers by this assay identifies patients in whom recurrent disease is likely to develop after conventional radiation therapy for World Health Organization types 2 and 3 carcinomas. Of the patients who had high ADCC titers at diagnosis, 80% survived three years or longer, whereas 50% of the patients with low titers survived three years, and only 35% survived five years. High and low ADCC titers were seen in all stages (except in Ho stage V), and the distribution of patients by high and low ADCC titers was similar in each of the stage groupings. We conclude that the ADCC titer at the time of diagnosis is generally predictive of the prognosis. Clinical staging is the traditional approach for predicting prognosis, but determination of the ADCC titer can be used to segregate patients within the stage groups into those with "good" and "poor" prognoses. Serologic testing may eventually become one of the methods for staging patients with WHO types 2 and 3 nasopharyngeal carcinoma. PMID- 6487127 TI - Carcinoma of the nasal septum. AB - Twenty-two patients with nasal septal carcinoma have been treated at the University of Texas Medical Branch, Galveston, during the 18-year period from 1961 to 1979. Squamous cell carcinoma of the nasal septum was found in 18 patients (82%), with single instances of reticulum cell sarcoma, basal cell carcinoma, histiocytic lymphoma, and transitional cell carcinoma. One of the squamous cell carcinoma group had palpable cervical metastasis at diagnosis, with metastatic neck disease developing in eight patients from three to 25 months after treatment. Squamous cell carcinoma of the nasal septum is aggressive and often undertreated. Our experience suggests that patients with septal carcinoma of any size should be treated by wide surgical excision (via lateral rhinotomy) and irradiation to the primary site and neck. Control of the primary tumor was achieved in 17 of 18 patients, with neck control in ten patients. The five-year absolute survival rate for squamous cell carcinoma of the nasal septum was 66%. PMID- 6487128 TI - A new complication of prosthetic ossicular reconstruction. AB - The use of synthetic partial ossicular replacement prostheses (PORPs) and total ossicular replacement prostheses (TORPs) in ossicular reconstruction surgery has gained growing acceptance but is not without complication. Dysgeusia, resulting from tension or stretching of the chorda tympani, was noted in two patients who had undergone such reconstruction. The symptoms resolved following resolution of the tension on the chorda tympani. PMID- 6487129 TI - Duane's syndrome associated with crocodile tear and ear malformation. A case of stapes anomaly and its reconstruction. AB - Duane's syndrome is a congenital eye movement disorder characterized by marked limitation or absence of abduction, variable limitation of adduction, and narrowing of the palpebral fissure with retraction of the globe on attempted adduction. We treated a patient with bilateral Duane's syndrome associated with crocodile tear and external, middle, and inner ear anomalies. Exploratory tympanotomy showed an absence of the oval window and a rudimentary superior structure of the stapes that was connected to the abbreviated incudal lenticular process with connective tissue. A small hole was drilled into the vestibulum and the ossicular chain was reconstructed by inserting a Teflon wire piston to minimize the air-bone gap. Pertinent literature is reviewed, and the pathogenesis of Duane's syndrome and the aspect of concomitant anomalies are discussed. PMID- 6487131 TI - Kaposi's sarcoma of the soft and hard palates. PMID- 6487130 TI - Facial palsy in lymphocytic meningoradiculitis (Bannwarth's syndrome). AB - Four patients had unilateral or bilateral facial palsy associated with lymphocytic meningoradiculitis (Bannwarth's syndrome). Diagnosis depends on a lumbar puncture, and if the characteristic CSF changes, ie, pleocytosis and elevated protein level, are found, more comprehensive investigations can be restricted in view of the favorable prognosis. PMID- 6487132 TI - Spindle cell lipoma. PMID- 6487133 TI - Immunoblastic sarcoma of the nasal cavity. AB - Malignant lymphoma is primarily a disease of interest to haematologists, but it occasionally presents a problem for otorhinolaryngologists. Sinonasal lymphomas are rare and potentially radiocurable malignant neoplasms. At initial presentation, the disease is most often localized in the sinonasal region and, with rare exceptions, the dominating cytohistological type is the immunoblastic sarcoma (B-cell type), previously termed reticulum cell sarcoma. The clinical manifestations may mimic more common and benign conditions and the diagnosis may be difficult. The present paper, emphasizes the need for biopsy to be performed early and carefully even in the case of apparently benign lesions. PMID- 6487134 TI - Cervical intervertebral disc calcification in childhood. AB - A case of cervical intervertebral disc calcification in a child is presented. The condition is rare, the aetiology unknown and the prognosis good. Possibility for differential diagnosis are discussed and the importance of the otolaryngologist having a knowledge of the condition is emphasized. PMID- 6487135 TI - Some morphological features of neurons in the rat spinal ganglion. AB - By means of serial sections in different planes, the perikarya in the rat spinal ganglion were found to be of an irregular spherical shape, with the largest maximal diameter and perimeter in tangential sections. Type-I and type-II neurons have a mean size of about 18 micrometers and 13 micrometers, respectively. Since some type-I perikarya are in the range of type-II cells, it is not possible to distinguish them from type-II cells in unstained thick sections. Some type-I cell perikarya exhibit areas with a reduced number of organelles. These cells are considered as being in a generating state, a fact finally leading to an age dependent loss of neurons. PMID- 6487136 TI - Serum antibody response and germinal centre reaction in the upper respiratory tract after antigen challenge in mice. AB - In order to establish an experimental model for the study of immunological reactions to exogenic immunogens in the upper and lower respiratory system NMRI mice were subjected to inhalation of the mitogenic and inflammatory response inducing lectin concanavalin A (Con A) and bovine serum albumin (BSA). Immunological reactions were induced in the upper respiratory tract and in the lungs. Serologically, the course of the antibody titre was measured by radio immunoassay over several weeks. Germinal centre reactions in the nose and paranasal sinus equivalents were the morphological correlate. The lungs showed an increase in the number of macrophages and a thickening of the alveolocapillary membrane, but no germinal centre reactions were observed. These morphological and serological results may indicate a priming of the immune response in the upper respiratory tract leading to a subsequent production of antibodies in the lung. PMID- 6487137 TI - Blast injury to sensory hairs: a study in the guinea pig using scanning electron microscopy. AB - Guinea pigs were exposed to a blast (maximum 1.0 kg/cm2) of nitrous gas for 0.2 s through the external auditory canal. Then, they were either killed immediately, 1 day, 3 days, 1 week, 2 weeks, or 4 weeks after exposure to the blast. The morphological changes of the cochlear sensory hairs were examined by means of a scanning electron microscope. Changes in the sensory hairs of the animals exposed to the blast for 1 s were examined in the same manner. The results of these experiments show that sensory hairs of the basal and the second turns were damaged more markedly than those of the third and subsequent turns. Outer sensory hairs were damaged more than inner ones. PMID- 6487138 TI - Some otological differences between pigmented and albino-type guinea pigs. AB - Cochlear action potential thresholds across frequency (AP audiograms) and AP tuning curves were compared in albino (Dunkin-Hartley) guinea pigs and normal pigmented animals. AP audiograms were very similar; on average the albinos had AP thresholds 2-3 dB lower at 2 kHz and below compared with the pigmented guinea pig. AP tuning curves at 16 kHz were, on average, significantly less sharply tuned in the albino, but similar at 8, 4, and 2 kHz. Although we find only small differences in these measures of normal cochlear function, other evidence in the literature suggests that in auditory research the use of "albino" guinea pigs is best avoided. PMID- 6487139 TI - Light and electron microscopical studies of the anatomical and functional distribution of glands in human vocal cords. AB - The human vocal cord was studied by light and electron microscopy. Serial histological sections showed that a great number of mixed glands with mucous and serous acini were localized in the submucosa. Their ducts leave the deep surface of the gland and some open at the vocal cord surface near the free edge. The margin of the vocal cord does not have glandular ducts; however, its stratified squamous epithelium is furnished with microvilli and microridges of various patterns. The observed location of the glandular ducts is described and the possible function of the microridges in relation to distribution and retention of mucous on the vocal cord is discussed. PMID- 6487140 TI - Strip kymography of the glottis. AB - In this paper, a new photokymographical method of recording vocal cord vibrations is described, which has considerable advantages over the hitherto known method of larynx photokymography. Its temporal dissolving power is increased and the registration time can be prolonged to any extent. For one registration a series of so-called strip kymograms has to be made, where each single photo shows vibration-dependent, wave-formed distortions of the vocal cord margins of a selected section of the glottis. The possibilities of measurement are indicated. In some examples of strip kymograms the diagnostic efficiency of this method is demonstrated. PMID- 6487142 TI - Factors affecting the prevalence of tinnitus. AB - The prevalence of tinnitus was studied in a large population of noise-exposed workers. It was found that 6.6% had tinnitus which was more than momentary. Results of two other studies were compared. Factors possibly relating to the prevalence of tinnitus were studied. The single most important factor found to be related to tinnitus is hearing level. The higher the hearing level, the faster the rate of increase in the prevalence of tinnitus. Other factors such as sex, age, laterality, smoking and shooting do not seem to have a significant, direct relationship with tinnitus, but they are related to the prevalence of tinnitus indirectly through the influence they have on hearing loss. PMID- 6487141 TI - Hydrogen clearance and cochlear microcirculation at different levels of blood pressure. AB - To study the autoregulative capabilities of the cochlear vessels, hydrogen clearance (HC) measurements were carried out by means of various blood pressure levels in hemorrhagic hypotension. H2-sensitive platinum--needle electrode were applied and a polarographic microanalysis method was used. The measurements were performed in the scala media of anesthetized cats during measuring of blood pressure and blood gases. The statistical analysis of the experimental data shows that the relationship between the HC and aortic blood pressure represents a regression line. According to the regression line the half-life time of HC was delayed for 0.7 min, when the blood pressure was reduced by 10 mm Hg (40-150 mm Hg blood pressure range). This corresponds to a cochlea flow rate of 0.3 ml/100 g/min. By mean aortic blood pressure of 40 mm Hg, the speed of H2 exchange still remains about 50% of the initial clearance. This indicates that the cochlear vessels have autoregulative capability. This autoregulative capability differs from the saturation curves of most autoregulated blood flow in the brain, heart and kidney vessels. These findings are in accordance with the observations of other authors. As our experimental data show, and as long as an analogy can be drawn between man and cat, it is hardly possible to explain that the fall of the blood pressure alone could lead to a disturbance of the oxygen supply to the inner ear, as often discussed in certain inner-ear dysfunctions. PMID- 6487143 TI - Reliability of auditory function tests in severely hearing-impaired and deaf subjects. AB - The test-retest variability of a series of auditory functions has been investigated in a group of severely hearing-impaired and deaf subjects (64 ears, median Fletcher index: 80 dB) and in a group of 10 controls with normal hearing. An adaptive forced-choice procedure was used for both groups. The functions were: tone audiogram, difference limen for intensity, difference limen for frequency, modulation transfer function and critical ratio. In spite of sometimes strongly deviating function values within the hearing-impaired group, the test-retest variability of the two groups was found to be of the same order of magnitude, except for the tone audiogram where the variability in the hearing-impaired group was twice that for the control group. PMID- 6487144 TI - Extended high-frequency hearing loss in children with cleft palate. AB - Hearing sensitivity for frequencies 250 through 20 000 Hz was compared between children with repaired cleft palate and a history of otitis media, and children without cleft palate or middle ear disease. All subjects were clear of middle ear effusion during the evaluation. Although children in the cleft palate group had consistently poorer hearing throughout the auditory range, statistical analysis demonstrated significant differences in hearing levels above 9 000 Hz only. No statistical difference was observed for the standard clinical audiometric frequencies. Extra-high-frequency hearing loss appears to be associated with cleft palate and its sequelae. PMID- 6487145 TI - Ultrahigh-frequency auditory thresholds in young adults: reliable responses up to 24 kHz with a quasi-free-field technique. AB - A quasi-free-field technique was used to assess detection thresholds to pure tones, at frequencies ranging from 2 to 24 kHz. The sound delivery system of Osterhammel et al. [Scand. Audiol. 6:91-95, 1977] was modified in order to deliver constant stimuli at SPLs of at least 117 dB over the entire frequency range. A modified form of the method of adjustment maintained the subjects' interest, and a double-blind procedure minimized experimenter and subject bias. In the first experiment, 78 university subjects from Northern California (18-24 years old) were exposed to tones in 2-kHz increments. All but 12 of these persons could reliably detect the highest frequency, with females being slightly more sensitive. But from 10 to 20 kHz, there were no differences between the sexes. In a second group of 20 students, tested in 1-kHz increments from 8 to 16 kHz, the previously observed 10- to 14-kHz threshold plateau was revealed as a pronounced 13-kHz low-threshold region. The threshold at this frequency was approximately 14 dB lower than the 11-kHz threshold. These data were compared with those obtained in a similar fashion from other cultures. PMID- 6487146 TI - [Auditory-evoked brainstem potentials and stapedius muscle reflex: intersubject variability]. AB - Like other workers, we found gender differences in auditory-evoked brainstem response latencies. For the time being, this intersubject variability remains unexplained. This difference was observed only for wave V latency, and delta I-V is longer in men than in women, whereas delta I-III is identical. The absence of functional differences in the lower portion of the auditory tract is confirmed by both auditory-evoked brainstem potentials and stapedius reflex latency. Wave V latency and the influence of technical and anatomical factors are discussed as well. PMID- 6487147 TI - Auditory evoked potentials and audiological follow-up of subjects developing noise-induced permanent threshold shift. AB - Three examinations, including cochlear microphonics (CM) to 99/s 1-kHz tones and auditory brainstem evoked potentials (ABEP) to 10/s and 55/s clicks, as well as psychoacoustical tests, were performed on 31 normally hearing subjects, exposed to occupational noise for over a year. The results showed prolongation of the absolute latency of peaks I, III and V, without significant changes in interpeak latency differences (IPLD) or CM latency. The site affected by increasing stimulus rate, giving rise to increased IPLD, appears to be central rather than cochlear. The efficacy of increased stimulus rate in detecting noise-induced auditory changes was higher than achieved applying the 10/s click rate. PMID- 6487148 TI - A study of auditory middle latency responses in relation to electrode combinations and stimulus conditions. AB - Auditory middle latency responses were recorded from healthy right-handed subjects. Acoustic clicks at a rate of 10/s were presented to the subjects via headphones. Using the electrode combination unilateral mastoid-nose tip, responses characterized by two early negative waves (about 11.5 and 18 ms peak latencies), followed by a late positive one (about 30 ms peak latency), were elicited by binaural stimulation (50-dB SL clicks). The waveform of responses from the unilateral mastoid-nose tip combination was similar to that recorded from a combination of the same side mastoid and a balanced noncephalic reference electrode, although the phase was opposite to that recorded from the Cz unilateral mastoid combination. Auditory middle latency responses were recorded simultaneously from right mastoid and left mastoid and referenced to the nose tip; interaural differences in amplitude were found in most subjects. The amplitudes of the early components for binaural stimulation were larger than those for monaural stimulation. PMID- 6487150 TI - Peer review and the law. PMID- 6487149 TI - Medical records in a private hospital. PMID- 6487152 TI - Quality of care index. PMID- 6487151 TI - A review of early medical readmissions at the Flinders Medical Centre. PMID- 6487153 TI - A medical view of the role of the medical profession. PMID- 6487154 TI - An anacampsis: Love is not enough. Professional roles in mental health care. PMID- 6487155 TI - More about natural family planning. PMID- 6487156 TI - DHE and infectious mononucleosis. PMID- 6487157 TI - Renal colic. AB - The most common and overt manifestation of a ureteric calculus is renal colic. This paper discusses its clinical presentation and diagnostic difficulties and follows the management of the patient until the stone is passed or retrieved surgically; it does not address the overall picture of renal calculous disease. The role of subsequent metabolic investigation is outlined. PMID- 6487158 TI - Abdominal pain in the elderly. AB - This article deals with the difficulties of diagnosing the cause of abdominal pain in the elderly and indicates a general approach to management of such patients. It does not specify diagnostic and treatment criteria for the numerous causes of pain nor the management in difficult cases (which should be resolved in consultation with a specialist). PMID- 6487159 TI - Hepatobiliary scintigraphy. AB - The recently acquired ability to tag 99mTc to a number of chemicals which are excreted avidly by the liver and concentrated in the gallbladder has enabled improved diagnosis of acute cholecystitis. This article gives a brief overview of the imaging technique. PMID- 6487160 TI - Ulcerative colitis and Crohn's disease. What your patient wants to know. AB - The chronic nature of non specific inflammatory bowel disease causes anxiety for the patients who confront the doctor with concern about their future outlook. This paper addresses the questions a doctor is most likely to be asked and provides answers based on the most recent information. PMID- 6487161 TI - Recurrent abdominal pain in children. AB - Recurrent abdominal pain in the child is a common and difficult problem for practitioners. To resolve whether its origin is organic or psychogenic takes time and patience. Investigation is made more difficult by the fact that parents and doctors are happier if the pain has an organic basis; in the great majority of children it is caused by stress. PMID- 6487162 TI - Interpretation and presentation of results. Chickens will come home to roost. AB - Collecting information is an obsessional activity which can become an end in itself. Interpreting and presenting results in a way that others can learn from them requires reflection, selectivity and ability to accept criticism. In selecting the journal to which the article will be submitted, consider which has the most appropriate readership and ensure the article conforms to the requirements and style of that journal. PMID- 6487163 TI - Drug treatment of epilepsy. AB - The most important factors in drug management of epilepsy are an accurate diagnosis of the type of seizures; the use of a first line drug as sole therapy for some weeks; and adjustment of the dose, according to plasma levels, to give maximum benefit. PMID- 6487164 TI - Routine examination of the abdomen. PMID- 6487165 TI - An exotic reaction to tubal ligation. PMID- 6487166 TI - Aerobic exercise. PMID- 6487167 TI - Musculotendinous leg injuries. PMID- 6487168 TI - Evaluating runners' injuries. AB - Running is a simple and convenient form of exercise but is associated with a high risk of injury to the lower limbs and feet. Attention to the training programme, the footwear and anatomy will assist the management and prevention of many injuries. Overtraining is a special problem and the physician should be alert for its physical markers. PMID- 6487169 TI - Gymnastic injuries. PMID- 6487170 TI - Exercise haematuria. AB - Exercise haematuria is common, usually microscopic and glomerular in origin and possibly related to renal ischaemia. Less common, lower urinary tract bleeding is associated with higher counts of urinary red cells. It usually occurs after longer distance runs and probably is due to traumatic lesions of the bladder. Studies have indicated that exercise associated urinary abnormalities resolve in 24 to 48 hours. If any remain, urinary tract investigations should be performed, guided by interpretation of urinary red cell morphology. PMID- 6487171 TI - Abnormalities of the breast. PMID- 6487173 TI - The language of doctor and patient communication. A study of commands and requests. PMID- 6487172 TI - A clinical trial in general practice. Part 1: Report and comments. AB - Clinical trials are used to test drug therapy but the principles of a trial may be applied to the assessment of any treatment (although the essential formality of a trial might confuse and irritate a general practitioner involved as a participant or reader of results). This is the first of two articles which aim to reconcile the theory of formal clinical trials and the practice of medicine. PMID- 6487174 TI - Sylvian aqueduct syndrome. Chronology of tumors in the pineal region in view of ocular movement. AB - We experienced 21 cases of tumors (13 of pinealoma of the two-cell pattern and eight of tumors originating from the posterior part of the third ventricle). We carefully observed the eye movements of these patients during their respective clinical courses and found changes in abnormal eye movements along with remission following cobalt irradiation therapy or ventriculo-peritoneal shunt as well as with relapse on recurrence of tumors. From the neurotological viewpoint, we divided the development of these abnormal eye movements into four chronological stages. We emphasized the importance of the early diagnosis of tumors manifesting Sylvian aqueduct syndrome. Careful observation and analysis of eye movement will be a great help in making diagnoses as well as decisions for further examination and treatment. PMID- 6487175 TI - Transtympanic neurectomies for control of drooling. AB - Twenty patients of drooling were studied. Of the 20 patients studied, 8 patients underwent bilateral chorda tympani nerve section, and 12 patients underwent bilateral chorda tympani nerve along with bilateral tympanic nerve sections. Bilateral chorda tympani nerve section in combination with bilateral tympanic nerve section is a better and more effective procedure for control of drooling than bilateral tympanic nerve section alone. In both these methods there is immediate stoppage of drooling i.e. on 2nd postoperative day but chances of recurrence of drooling are less in chorda tympani nerve section in combination with tympanic nerve section (17%) than chorda tympani nerve section alone (38%). PMID- 6487176 TI - Relationship between ototoxicity of aminoglycoside antibiotics and their transferability into inner ear fluids. AB - The purpose of this study is to clarify the question whether the difference of severity of ototoxicity induced by the aminoglycoside antibiotics depends on the difference of quantity of transferability into inner ear. Aminoglycoside antibiotics (tobramycin, kanamycin, netilmicin and ribostamycin) were injected for 30 consecutive days to rabbits. The relationship between the severity of hair cell damage and concentration of antibiotics in perilymph was investigated. The drug concentration in the perilymph was determined by the bioassay method, and using the surface preparation technique the hair cell damage was observed under a phase contrast microscope. It was concluded that the difference of severity of ototoxicity induced by the aminoglycoside antibiotics is due to the difference of their own toxicity to hair cells but not to the difference of their transferability into the perilymph. PMID- 6487177 TI - Freeze-replica observations of guinea pig middle ear muscles. AB - The histological characteristics of the middle ear muscles, Musculus tensor tympani and M. Stapedius, of the guinea pig were studied using freeze-fracturing technique. No gap junction was observed but the tight junction was found in the tensor tympani muscle, possibly between muscle cells. No distinct difference was found between the size distributions of the apertures and caveolae on the fracture face of the sarcolemma of the two kinds of muscles. PMID- 6487178 TI - Pathophysiology of positional vertigo of the malignant paroxysmal type. AB - It is well known that paroxysmal positional vertigo is induced by change of head position and subsides immediately when the head is returned to the original position. There are two types of paroxysmal positional vertigo. One is what DIX and HALLPIKE (1952) call the benign type which is thought to be caused by otolith lesions. Another is a malignant type, in contrast to the former and is related to a lesion in the central nervous system. Otologists are usually familiar with the former, but the latter is not known among neurologists and neurosurgeons. We experienced 37 cases of the malignant type and found that this type of paroxysmal vertigo is induced by various diseases. Furthermore, we believe that the mechanism of this paroxysmal vertigo is the lack of inhibitory function of the vestibular cerebellum, and not abrupt malfunction of communication of the cerebrospinal fluid in the ventricular system. We also believe that this symptom is a very useful sign for diagnosing lesions of the cerebellar vermis. PMID- 6487179 TI - Vertical ocular dysmetria--vertical rebound nystagmus and optokinetic vertical ocular dysmetria. AB - Ocular dysmetria in vertical eye movement was confirmed by electronystagmographic recording in 100 cases. Ocular dysmetria in spontaneous vertical ocular movement was reported in seven cases. It can be called vertical rebound nystagmus. This phenomenon was more prominent in vertical movement of the eyes returning from upward gazing to mid-position than in the movements of downward gazing. Optokinetic vertical ocular dysmetria induced by vertical optokinetic stimulation was observed in 93 cases. This phenomenon was far more prominent in upward optokinetic nystagmus than in downward optokinetic nystagmus. The pattern of optokinetic vertical ocular dysmetria was classified into the following four types: the dysrhythmic type, the overshoot type, the ataxic type and the saccadic (semi-inversive) type. The pathophysiological mechanism of horizontal ocular dysmetria should be different from the mechanism of vertical ocular dysmetria. PMID- 6487180 TI - Clinical management in the face of the uveal melanoma controversy. AB - The modalities used to diagnose choroidal melanoma are described. The use of these procedures has reduced the misdiagnosis rate from 20% in the 1960s to less than 5% today. Observation and reinvestigation of small tumours is recommended. Surgery may cause dissemination of tumour emboli, which may be prevented by gentle handling of tissue, use of intravenous mannitol and hypotensive anaesthesia. Measures other than enucleation are available to treat choroidal melanoma, but few tumours meet the criteria for their use. PMID- 6487181 TI - A ten-year hospital survey of eyelid cancer. AB - Two hundred and four cases of malignant eyelid tumours, managed at the Concord Hospital, were reviewed. These cases spanned a ten-year period between 1973 and 1982 and all were treated surgically. The nature of each tumour was confirmed by histopathological examination. Included in this review were the site of the tumour, the tumour pathology, the surgical management, the type of surgeon involved, the ocular complications, the management of recurrences and any mortality. The importance of preventing recurrences by adequate initial surgery with frozen section control is emphasized. PMID- 6487182 TI - The national registry of drug-induced ocular side effects. AB - The National Registry of Drug-induced Ocular Side Effects is an international information centre for ocular toxicology. The Registry collects case reports of drug-induced ocular side effects from physicians and other national registries, and surveys the world literature for drug-related ocular events. Possible adverse drug associations can be identified in this system, and cause-and-effect relationships may on occasion be proven. Functions of this Registry include increasing ophthalmic awareness of human ocular toxicology, and promoting continuation of contributions to decrease the delay between recognition of a possible adverse drug reaction and the actual reporting of it in the literature. PMID- 6487183 TI - Combined vitrectomy, intraocular microsurgery and liquid silicone in the treatment of proliferative vitreoretinopathy. AB - This study investigates the effectiveness of combining vitrectomy, scleral buckling, intraocular microsurgery and liquid silicone injection for the treatment of retinal detachment complicated by proliferative vitreoretinopathy: 48 eyes were treated using these techniques combined. Complete attachment was achieved in 16 eyes (33%), partial attachment in 20 eyes (42%), and 12 eyes (25%) remained detached. Vision was improved in 17 eyes (35%), unchanged in 17 eyes (35%), and worse in 14 eyes (30%). Complications included emulsification of the silicone, glaucoma, cataract, band degeneration of the cornea, reproliferation of membranes and passage of silicone into the subretinal space. Significant preservation of mobility vision was achieved. A larger series of patients with longer follow-up will ultimately determine the place of this technique in the management of this complicated problem. PMID- 6487184 TI - Bardet-Biedl syndrome. AB - The Bardet-Biedl syndrome is characterized by five main features: obesity, polydactyly, pigmentary retinopathy, mental deficiency and hypogonadism; recently a sixth feature, renal disease, has been described. It was formerly known as the Laurence-Moon-Biedl syndrome, but Laurence and Moon described a different entity in which the main feature was paraplegia. Fourteen cases have been seen: all had pigmentary retinopathy which, in most cases, was severe and tended to affect central vision early in life. All had subnormal intelligence, twelve were obese, ten had polydactyly, eight hypogonadism, and two had renal disease. The condition was thought to be rare, but this may have been due to the failure to diagnose incomplete or partial cases. It is suggested that the prevalence is 1:160 000 of the population. PMID- 6487185 TI - Do any factors predict a favourable response to laser trabeculoplasty? AB - One hundred and thirty-three eyes with raised intraocular pressure treated by argon laser trabeculoplasty were studied to determine the factors predicting a fall in pressure with treatment. The two main predictive factors were: (i) initial pressure--a higher initial pressure was associated with a greater fall in pressure (p less than 0.001); and (ii) diagnosis (type of glaucoma)- pseudoexfoliative glaucoma (PXFG) and chronic open-angle glaucoma (COAG) had the greatest fall (p less than 0.05). Aphakic glaucoma was associated with the worst results. Of the other factors studied, only the degree of pigmentation of the angle was a significant predictor: the greatest fall in pressure occurred in eyes with moderately pigmented angles (p = 0.05). Complications of treatment were pigment scatter in the angle with depigmentation (41% of eyes), peripheral anterior synechiae (7.5%), immediate postoperative rise in pressure of 10 mmHg or more (7%), moderately severe iritis (3%) and hyphaema (2%). Medication was able to be ceased in only five patients after laser trabeculoplasty; even if a small fall in pressure is achieved, a large fall to the bottom of the normal range is unlikely. PMID- 6487186 TI - A simplified cryotherapy technique for trichiasis and distichiasis. AB - A simplified cryotherapy technique for the treatment of trichiasis and distichiasis is described. The success rate of aberrant lash ablation with one treatment was 82%; this was increased to 95% with a repeat treatment. There have been minimal long-term side effects. This paper shows that a simplified time based technique without the use of a thermocouple has produced results similar to other series using thermocouple control. A nitrous oxide cryo unit was used in a double freeze-thaw cycle to treat the area of aberrant lash growth. The times in the double freeze-thaw cycle found to be effective were 45 seconds freezing with a four-minute thaw in the first cycle and a repeat freezing cycle of 45 seconds' duration. PMID- 6487187 TI - A clinician's guide to electrophysiology of the retina. PMID- 6487188 TI - Observations on distichiasis, telecanthus, ectropion and blow-out orbital fracture. PMID- 6487189 TI - Immediate hypersensitivity (anaphylaxis) response in uninfected and Alcaligenes faecalis-infected turkey poults. AB - The immediate hypersensitivity (anaphylaxis) response in uninfected and Alcaligenes faecalis-infected turkey poults was studied. The optimum challenge dose of bovine serum albumin (BSA) to elicit an anaphylactic response was 40 mg/kg body weight, and the optimum poult age was 4 to 5 weeks. The response latency time was 7 days. The anaphylactic response was specific for the sensitizing antigen used. No differences were observed between A. faecalis infected and uninfected poults in the immediate hypersensitivity response to BSA. PMID- 6487190 TI - Use of amprolium for the control of coccidiosis in pheasants. AB - Amprolium administered in feed during the first 4 weeks of life at a level of 0.0175% protected pheasants against three major pathogenic species of coccidia (Eimeria colchici, E. duodenalis, and E. phasiani) when they were exposed at 2 weeks of age. The difference was significant when mortalities were compared between medicated infected (3%) and unmedicated infected (35%) pheasants. The manufacturer's proposed level (0.0175%) and twice the proposed level (0.0350%) of amprolium had no significant effect on weight gains or mortality in the safety trial. Amprolium residues found in the muscles and livers of pheasants that received either level of amprolium did not exceed the tolerance levels for chickens and turkeys permitted by the U.S. Food and Drug Administration. PMID- 6487191 TI - Comparison of strains of Mycoplasma iowae. AB - Comparison of biochemical test results and protein electrophoretic patterns of 21 strains of Mycoplasma iowae indicated that all were similar. Comparison of agglutination test results indicated marked within-species antigenic variation. None of 21 antigens prepared from different strains were effective in demonstrating turkey antibody against five reference strains. Examination of sera from turkeys exposed by intra-air-sac inoculation to two pathogenic strains also indicated antigenic variation. Neither the M. iowae type-strain, Iowa 695, nor the other reference strains were effective in demonstrating antibody against both strains used to expose the turkeys. These findings suggest that antigenic variation may be a major problem in effective serodiagnosis of M. iowae infections. PMID- 6487192 TI - Protection of ducklings with a broth-grown Pasteurella anatipestifer bacterin. AB - Pasteurella anatipestifer (PA) serotypes 1, 2, and 5 grew to high densities in tryptic soy broth and tryptose broth (TB) when the media were continuously shaken or aerated. Growth in 100 ml to 15 liters of TB exceeded an absorbance of 1.0 at a wavelength of 525 nm (about 0.7 for a 1/3 dilution) and contained more than 10(10) colony-forming units per ml. A bacterin was prepared from the three serotypes of PA grown in aerated TB. Two subcutaneous injections of this bacterin protected 70% to 85% of ducklings against experimental challenge with each of the three PA serotypes, which killed 90% to 100% of unimmunized controls. The bacterin could be diluted 1/5 without decreasing protection below 80%. Field studies on Long Island duck farms in 1980 and 1981 demonstrated significant reductions in mortality with the use of the broth-grown PA bacterin. PMID- 6487193 TI - Infectious sinusitis in turkeys at Ibadan, Nigeria. AB - Thirty out of 70 imported broad-breasted white turkeys with severe sinusitis were both culturally and serologically positive for Mycoplasma gallisepticum. Infectious sinusitis due to M. gallisepticum was therefore diagnosed. A low mortality of 5.7% of the total flock was recorded. This appears to be the first published report on M. gallisepticum isolation in turkeys in Nigeria. PMID- 6487194 TI - Favus in a fighting cock caused by Microsporum gallinae. AB - The first diagnosis of favus in chickens in Costa Rica was made in a 1-year-old fighting cock that had lesions surrounding the comb. The etiologic agent was isolated and identified as Microsporum gallinae. The rooster recovered during topical treatment with tolnaftate and oral treatment with griseofulvin. PMID- 6487195 TI - An epornitic of Mycoplasma gallisepticum in turkeys. AB - A major epornitic of Mycoplasma gallisepticum occurred in the Monroe, North Carolina, area between January and June of 1983. The outbreak involved 304,000 turkeys of various ages, which were slaughtered in the eradication program at a cost of more than $550,000 to growers and poultry companies. An infected peafowl was the likely source of infection on the first farm. Traffic between farms by growers and company personnel was theorized to be the means of further spread. PMID- 6487196 TI - Polycystic kidneys in a pigeon. PMID- 6487197 TI - Possible genetic variation in resistance of turkeys to erysipelas and fowl cholera. AB - Natural disease outbreaks of erysipelas and fowl cholera occurred in several lines of turkeys maintained for genetic studies. There were line differences in mortality during both outbreaks, suggesting that there is genetic variation in resistance to these diseases. A line developed by selection for increased egg production had a higher mortality rate from fowl cholera than did the randombred control line from which it was developed. Both the egg line and its control line had a lower mortality rate in the erysipelas outbreak than did a line selected for increased growth rate. Both diseases induced high mortality in a line selected for increased growth. PMID- 6487198 TI - Sinusitis in turkeys associated with respiratory cryptosporidiosis. AB - An outbreak of sinusitis due to cryptosporidial infection is described in 7-week old turkeys. Infection of 3-week-old turkeys subsequently placed in the same environment is documented. PMID- 6487199 TI - Detection of genomic differences between the avian reovirus isolate S1133 and its high-passage derivative P100. AB - Previous studies have shown that the S1133 and P100 strains of avian reovirus are identical by electropherotype analysis of their genomic RNA despite demonstrating differences in their protein composition. By using the more sensitive technique of liquid nucleic acid hybridization for comparing the genomes of these two viruses, differences among several homologous RNA genome segments have been detected. The implication of the use of these techniques for characterization and analysis of recently introduced and mutant strains of reoviruses is discussed. PMID- 6487200 TI - The occurrence of Aeromonas hydrophila in avian diagnostic submissions. AB - Twenty isolations of Aeromonas hydrophila were made from 15 species of free living, commercial, and companion birds submitted for routine diagnostic postmortem examination. Seventy percent of the isolations were made from November through March during the 25-month survey period. PMID- 6487201 TI - A model of spinal cord dysbarism to study delayed treatment: II. Effects of treatment. AB - Using the spinal cord decompression sickness model described in Part I, we explored the effects of delay to treatment on the recovery of spinal evoked potentials (SEP). The primary treatments of oxygen at 60 fsw (2.8 bar) and air at 165 fsw (6.0 bar) were studied. In this exploratory study the results were surprisingly poor in all treatments applied. There is evidence that in this model a delay of 15-18 min between diagnosis and start of therapy would generally allow some recovery of SEP, which would rarely be complete. Supporting experiments involving cord ischemia are described. The results from this study enabled us to design a set of practicable experimental criteria for the purpose of discovering the optimal combinations of oxygen and pressure for the treatment of spinal cord decompression sickness. PMID- 6487202 TI - Fluid-electrolyte metabolism and renal function of white rats in experiments aboard Cosmos biosatellites. AB - Rat experiments on the Cosmos biosatellites demonstrated that the percentage of renal excretion of consumed water after flight was lower than after synchronous experiment. This can be attributed not only to water retention but also to a different level of extrarenal losses postflight. Weightless rats showed increased sodium excretion after water load tests and increased potassium excretion after potassium load tests. The sodium, potassium, and calcium balance was positive after weightlessness. Analysis of the electrolyte composition of different kidney zones revealed a decreased potassium content in the medulla, which is considered to be one of the causes of changed renal iono- and osmoregulatory function in weightlessness. The normalizing effect of artificial gravity on the natri- and kaliuretic renal function was demonstrated. PMID- 6487204 TI - Relationship between the value of the Wenckebach point and +Gz tolerance. AB - The +Gz acceleration tolerance in a homogeneous group of 21 male clinically healthy pilots or candidates to airservice was evaluated. The +Gz acceleration tolerance was compared with the Wenckebach point, i.e., the lowest rate of atrial stimulation needed to produce constant Wenckebach or Mobitz II atrio-ventricular (AV) block. The Wenckebach point was used as an autonomic nervous system activity index. It was demonstrated that the degree of +Gz acceleration tolerance depends greatly upon autonomic nervous system activity, and is lower in people with enhanced parasympathetic tone. The possibility of pharmacological correction of +Gz acceleration tolerance was discussed. PMID- 6487203 TI - A cholinomimetic model of motion sickness and space adaptation syndrome. AB - The space adaptation syndrome is one of the more vexing problems confronted by our nation's astronauts during their journeys. This syndrome may be a variant of motion sickness, although this possibility has been questioned. Physostigmine, a centrally active cholinesterase inhibitor which increases brain acetylcholine, was found to cause a motion sickness-like syndrome--in psychiatric patients and normals--including nausea, emesis, malaise, dysphoria, increases in serum ACTH, beta-endorphin, cortisol, and prolactin, Neostigmine, a non-centrally acting cholinesterase inhibitor, and saline placebo caused no such effects. The above effects closely parallel those of motion sickness. Thus, the effects of physostigmine may be a convenient model for screening for treatments for motion sickness or space adaptation syndrome, or for predicting who will develop these syndromes. PMID- 6487205 TI - Cardiovascular responses during orthostasis: effect of an increase in VO2max. AB - Cardiovascular responses to orthostasis were assessed in eight men (18-29 years old) before and after an 8-d cycle ergometer exercise training (E) regimen for 2 h . d-1 at 65% maximal O2 uptake (VO2 max). Each subject underwent 60 degrees head-up tilt (60 min max) before (T1) and after (T2) E. Heart rate (HR), systolic (SBP), and diastolic (DBP) pressures were measured each min before, during, and after tilt; pulse pressure (PP), mean arterial pressure (MAP), and rate-pressure product (RPP) were calculated. Changes in plasma renin activity (PRA), vasopressin (pVP), hematocrit, hemoglobin, and plasma volume (PV, T-1824) were measured from venous blood samples taken pre- and immediately post-tilt. Following E, VO2 max increased by 8.3% (p less than 0.05), resting HR decreased by 8.1% (p less than 0.05), and PV increased by 430 ml (12.2%, p less than 0.05). Mean (+/- S.E.) tilt duration went from 40.0 +/- 5.1 min during T1 to 46.7 +/- 3.4 min during T2 (NS); mean tilt HR decreased from 86 +/- 4 bpm to 77 +/- 3 bpm (p less than 0.05), RPP decreased from 10,320 +/- 390 to 9,317 +/- 310 mm Hg . bpm (p less than 0.05), while mean SBP, DBP, PP, and MAP were unchanged. Plasma volume decreased during tilt by 479 ml in T1 compared to 544 ml in T2 (p less than 0.05), while % delta PV were similar: -13.6% and -13.9%, respectively. Peak fluid-accumulation in the calf and total leg during tilt increased (p less than 0.05) following E.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487206 TI - The endotoxin-pretreated, oxygen-adapted rat model in hyperbaric hyperoxia. AB - Rats pretreated with 500 micrograms X kg-1 endotoxin are resistant to the pulmonary toxic effects of normobaric hyperoxia (greater than 95% O2). After endotoxin-pretreatment and exposure to 1.0 ATA O2 for 72 h, such rats are found to have elevated total superoxide dismutase, glutathione peroxidase, and catalase activities in homogenates of whole lungs. Despite increases in these protective antioxidant enzymes which persist in 2.0 ATA O2 (4 h) and 4.0 ATA O2 (1.0 h), such rats do not have improved survival in hyperbaric hyperoxia. Likewise, endotoxin-pretreatment immediately prior to 2.0 or 4.0 ATA O2 exposure does not prolong survival compared to controls. It is likely that lung injury during the normobaric oxygen preexposure and the central nervous system toxicity of hyperbaric oxygen interact to limit survival. PMID- 6487208 TI - Commercial diving fatalities. AB - The distributions of fatal diving accidents in commercial diver populations were examined in the Gulf of Mexico from 1968 to 1975 and in the British sector of the North Sea from 1971 to 1978. Influences and causes of death were analyzed by examining the interaction between host, environmental and agent factors. The interaction of host and environmental factors appeared to be the greatest contributing factor to diving fatalities among the estimated 900 commercial divers in the Gulf of Mexico and the 700 in the North Sea. The most significant host factors were level of experience and behavioral dysfunction. They are also the host characteristics most amenable to change through improved and more thorough training. The most significant environmental factors were equipment failure and supervisor/tender errors. These factors would be minimized by improved selection, maintenance and operation of equipment, together with improved operating and emergency diving procedures. In recent years there has been a significant downward trend in mortality rates in the commercial diver populations of this study due to improved diving techniques and operations. Further research is needed, however, on the cause(s) of diver unconsciousness and inexplicable actions that occur at depths below 91.44m (300 ft.). PMID- 6487207 TI - Effects of endurance fitness on responses to cold water immersion. AB - The purpose of this study was to determine if the changes in selected blood hormones and substrates, metabolic rate, and rectal temperature (Tre) in nine males after immersion in 10 degrees C water, while clad in standard flight suits, were related to the level of aerobic fitness. Fitness was evaluated by the blood lactate response to submaximal exercise. Immersion time (IT) was defined as the time required for a 1 degrees C decrease in Tre and averaged 38.5 (range: 21-62) min. Metabolic rate increased 3.4 times the resting rate. Lactate, free fatty acids, triiodothyronine and thyroxine increased by 81%, 38%, 11%, and 8%, respectively, in contrast to insulin which decreased by 32%, with all changes being statistically significant (p less than 0.05). Glucagon increased slightly but not significantly (p = 0.11) while glucose levels did not change. The IT was correlated directly with a measure of aerobic fitness, with relative body fat, and with the T3 levels postimmersion (p less than 0.05). The results suggest that the aerobic fitness level can significantly influence the cooling rate during water immersion. PMID- 6487209 TI - Effects of constant magnetic fields on rats and mice: a study of weight. AB - Variations in the growth of animals from exposure to a magnetic field have been reported by several authors. In this study, young rats and mice were exposed daily to constant uniform magnetic fields. The strength of the field was 400, 600 or 800 mT. Rats were exposed for 4 weeks and mice for 250 d or more. Some mice were exposed in a permanent way to a non-uniform magnetic field of 4.6 mT. No significant effect on the growth was observed. PMID- 6487210 TI - Negative air ion effects on human performance and physiological condition. AB - Beneficial effects of exposure to negative air ions have been suggested, to include improved performance, mood, attention, and physiological condition. Existing support is clouded by methodological problems of control and standardization in treatment and equipment. This study investigated effects of negative ions produced by a commercially marketed air purification device on grip magnitude, coding, motor dexterity, reaction time, tracking, pulse, blood pressure, and temperature. Two groups of 12 males were exposed to 6 continuous h of either negative or "normal" ion environments under a double blind condition. Repeated measures (0,3,6 h) on each variable were obtained. MANOVA applied to change scores revealed no differences between groups, and 0 vs. 3 and 0 vs. 6-h group differences showed no significant alteration in any measure. Negative ions generated by an air purification device were concluded to produce no general or specific alteration of cognitive or psychomotor performance or physiological condition. PMID- 6487211 TI - Audio-ocular response: saccadic programming. AB - The eye movements elicited by auditory stimuli--the audio-ocular response (AOR)- differ from those made in response to a visual target. The movements consist of both monosaccadic and multiple saccadic refixations (MSR). In visual refixation, monosaccadic refixations are always accurate; in AOR, they rarely are. In MSR, many strategies were used in the attempt to find the target but they were not always successful. However, final amplitudes of the total refixation were quite accurate in both MSR and monosaccadic refixations. Velocity profiles of the AOR showed such anomalies as discrete decelerations and multiple, closely-spaced saccades. These data suggest that, without visual feedback, the location of acoustic targets is difficult. In the absence of visual afference, when vigilance may be decreased by the lack of arousal, the velocity profiles also became abnormal, even at small amplitudes. Thus, for cockpit warning devices, a combination of auditory and visual indicators should be used. PMID- 6487212 TI - Cardiovascular responses to isometric neck muscle contractions: results after dynamic exercise with various headgear loading configurations. AB - Experiments were conducted to quantify the cardiovascular response (blood pressure and heart rate) elicited by sustained isometric contractions of the neck muscles. The response was secondary to dynamic exercise with various headgear loading combinations. The neck muscles were loaded by the head itself (CON), the standard U.S. Army SPH-4 helmet (HEL), and a combination of the SPH-4 helmet with Night Vision Goggles (H/NVG). During two exercise periods of 5 min and 35 min, each of the five subjects would rotate the head from side-to-side in the CON, HEL, or H/NVG configuration. Immediately thereafter, the subject would position his head in an isometric head dynamometer and exert a sustained right lateral (LAT) neck contraction or forward (FOR) neck contraction at 70% of a maximal voluntary contraction (MVC). During this isometric neck muscle contraction, the subject's endurance time to fatigue was recorded, the blood pressure was manually recorded, and the heart rate was continuously recorded. Characteristic increases in the systolic and diastolic blood pressure and heart rate occurred with sustained isometric neck muscle contractions. There was an average 40% increase in the systolic blood pressure, an average 50% increase in the diastolic blood pressure, and an average 45% increase in the heart rate from resting to the end of a fatiguing 70% MVC (p less than 0.05). These responses appear to be relatively independent of the duration of the exercise period, the loading during the exercise period, and the specific muscle mass involved. The mechanisms for the pressor response and the heart rate response are reviewed. PMID- 6487213 TI - The energy expenditure of helicopter pilots. AB - The energy expenditure of Army Air Corps and Royal Air Force pilots has been measured during flight in Gazelle and Puma helicopters respectively. Heart rates were also recorded. The results were compared with resting values obtained in the crewroom before flight, and confirmed the findings of other authors that the energy cost of flying helicopters in level flight is about 50% higher than that of sitting at rest. PMID- 6487214 TI - Sphere and cylinder distribution among the USAF rated population requiring spectacles. PMID- 6487215 TI - Ethical dilemmas and nursing. AB - Professional responsibilities, tradition, and personal conscience along with legal, philosophical, and religious convictions dictate nursing interventions. Inevitably, these factors embrace life-sustaining therapies; however, in view of complications, prognosis, pain and suffering, and their own views of quality of life, some patients express wishes inconsistent with life-sustaining measures. In other situations, the health care provider as well as the patient may view heroic efforts as more debilitating than resortative. Resolving the conflict while preserving the patient's best interests requires a confrontation with the status of "do-not resuscitate" policies within th e nurse's institution, informed consent, refusal, and competency as the necessary underpinnings for the development of an ethical and legal posture within the profession, with which to approach significant decisions regarding life-sustaining therapies. Literally every hour of every day nurses are immediately and directly involved with resolving ethical dilemmas based upon judgements and interpretations of oral or written orders, patient and family wishes, professional training, and an infinite number of other factors. When clear policies or orders are lacking, the nurse is left with the burden of making a life or death decision. It is imperative that professional nurses assess the administrative, legal, and ethical ramifications of their actions in terms of ethical codes of practice, patients' rights, institutional and personal liability, civil and criminal laws, and private conscience. An understanding of these issues, passive and active euthansia, state and national trends, and uniform legislation can assist in resolutions of the no code dilemma. Nursing as a profession must strive to develop sound and consistent guidelines and rationale for the scope of practice in ethical dilemmas. PMID- 6487216 TI - Paternal behavior in the spiny mouse (Acomys cahirinus). AB - The responsiveness of adult male spiny mice (Acomys cahirinus) to both their own and alien precocial young was investigated. Paternal behavior was manifested primarily by the males huddling with their offspring and the coordination of pup attendance between adult males and females. With less than 2 days exposure to their own neonates, males were found to discriminate between their own and alien young. Experience plays an important role in the development of paternal behavior in spiny mice. Males who have never had pups of their own sniff and attack unfamiliar neonates more than males who have fathered pups. The adaptive significance of paternal investment in this uniquely precocial murid rodent was discussed. PMID- 6487217 TI - Discrimination between aversive brain stimulations: effect of stimulation parameters. AB - Rats placed in a T maze were shown to be able to discriminate between two stimulations applied to one and the same brain site and inducing aversive effects of different magnitude. Discrimination occurred irrespective of whether the two stimulations differed in either intensity or frequency, and irrespective of whether they were applied to a medial hypothalamic or to a mesencephalic central gray site. Generalization experiments were performed in which either the stimulation parameter used to establish the discrimination or another parameter was varied. The results show that the animal's choice cannot be predicted on the sole basis of either the electrical charge/second applied or the escape latency induced. PMID- 6487218 TI - Behavioral conditioned responses across multiple conditioning/testing trials elicited by lithium- and amphetamine-paired flavors. AB - The present experiment measured the pattern of conditioned responses across 10 conditioning/testing trials which were elicited by an intraoral presentation of either a lithium- or an amphetamine-paired flavor. A nonspecific conditioned response pattern of suppressed limb flicking after five conditioning trials and of suppressed scratching after six conditioning trials was supported by both drugs. Lithium-specific increased activity level after one conditioning trial and chin rubbing after two conditioning trials were observed across conditioning/testing days. The lithium-specific conditioned responses were not the result of a stronger flavor aversion, because both lithium and amphetamine produced equivalent flavor avoidance responses across the 10 conditioning/testing trials. The results support previous research which suggests that flavor aversions produced by lithium and amphetamine are produced by different unconditioned response mechanisms. PMID- 6487219 TI - Effects of protein synthesis inhibitors on sleep and amygdala-kindled seizure thresholds in cats. AB - This study examined the effects of protein synthesis inhibitors on sleep and seizure susceptibility in amygdala-kindled cats. Six cats with stable seizure thresholds were treated with 150 mg/kg of chloramphenicol or its cogener, thiamphenicol, at 12-h intervals over a 30-h period. State pattern variables were monitored continuously during the first 18 h. At 30 h, kindled seizure thresholds were measured in terms of minimum stimulus intensities (microA) required to elicit generalized tonic clonic convulsions. All cats were exposed to both drugs, with a 1-week intertrial interval and the order of drug treatment counterbalanced. Rapid eye movement (REM) sleep was significantly attenuated after chloramphenicol but was unaffected by thiamphenicol, as previously shown. Seizure thresholds were unaltered regardless of changes in sleep state physiology. The results extend previous work showing that protein synthesis inhibitors which suppress REM sleep increase seizure susceptibility only in animals that are either highly predisposed to seizures or that display REM sleep disruption as the sole sleep deficit associated with their seizure condition. PMID- 6487220 TI - Chlordiazepoxide impairs the performance of a learned discrimination. AB - Chlordiazepoxide (CDP) (5 mg/kg) administered on four of eight sessions significantly impaired the performance of a previously learned, reinforcement cued discrimination in male Sprague-Dawley rats. On four interspersed vehicle injection sessions, the performance of subjects demonstrated immediate recovery and was indistinguishable from that of controls (0 mg/kg). An analysis of response components indicated that the impairment in discrimination performance was due to a "disinhibitory" effect of the drug on responding during "no-go" phases of the task. The results are discussed in the context of similarities and differences in the effect of CDP on performance and acquisition. PMID- 6487221 TI - Hemispheric differences in split-brain monkeys viewing and responding to videotape recordings. AB - Eight split-brain monkeys were tested for hemispheric differences in their viewing of and responses to colored videotape recordings of monkeys, people, animals, and scenery. The number of facial expressions elicited from the right hemisphere was significantly greater than the number made when using the left hemisphere. Monkeys also tended to look longer when viewing with their right hemispheres than when viewing with the left. PMID- 6487222 TI - Effects of serotonergic and cholinergic antagonists on suckling behavior of neonatal, infant, and weanling rat pups. AB - In Experiment 1, Sprague-Dawley rat pups at postnatal days 3-4, 7-8, 10-11, 15 16, and 23-24 were tested for suckling behavior on their anesthesized multiparous dams following administration of metergoline or scopolamine. The serotonergic antagonist, metergoline, inhibited suckling in 3- to 4- and 7- to 8-day-old rat pups, but was not found to influence suckling in older pups. Scopolamine, a cholinergic antagonist, reduced suckling primarily in 3- to 4-day-old pups. In Experiment 2, parity of the maternal female was manipulated to assess whether this variable would influence suckling behavior and the effects of metergoline on suckling of weanlings. Baseline levels of suckling were reduced in 23- to 24-day old pups of primiparous dams when compared with multiparous-derived offspring. Administration of metergoline increased the amount of time that these primiparous derived pups spent attached to nipples, but did not influence suckling of offspring of multiparous dams, perhaps as a result of a ceiling effect on suckling behavior in these animals. PMID- 6487223 TI - Virus and autoimmunity in diabetes mellitus. PMID- 6487224 TI - Mechanisms in virus-induced cell injury. PMID- 6487225 TI - A viral etiology for type I diabetes mellitus? PMID- 6487226 TI - Familial mental retardation. PMID- 6487227 TI - Further investigation of racial/ethnic differences and of familial resemblances in flushing in response to alcohol. PMID- 6487228 TI - Genetic similarity theory: beyond kin selection. PMID- 6487229 TI - Residual latency (delay at the neuromuscular junction): normative values and heritability in mice. PMID- 6487230 TI - Inheritance of water-escape performance and water-escape learning in mice. PMID- 6487231 TI - Genetic control of the difference in male courtship sound between Drosophila virilis and D. lummei. PMID- 6487232 TI - A note on barometric pressure and behavior in Drosophila pseudoobscura. PMID- 6487233 TI - Comparison of heart function in male and female rats. AB - The objective of this investigation was to compare intrinsic cardiac function in male and female rats. The first series of experiments (Series I) compared hearts from age-matched males and females at 18 weeks of age. Since body and heart weight were 65 and 51 per cent greater respectively in male rats in this study, a second series of experiments was performed (Series II) where heart mass was matched in males and females by studying males at 10 weeks of age and females at 18 weeks of age. Cardiac function was studied in an isolated working heart apparatus at similar heart rates and at controlled levels of end-diastolic pressure and aortic diastolic pressure (ADP). In Series I coronary flow and end diastolic volume (both per g LV) were the same in male and female hearts, while stroke work (per g LV), ejection fraction and fractional shortening were significantly greater in male hearts but only as the ADP was increased. In Series II all of these measurements were significantly greater in male hearts at all loading conditions. The magnitude of the differences between male and female hearts was greater in Series II than in Series I which may have been due to a Frank-Starling effect in male hearts from Series II. The results indicate that intrinsic cardiac function is moderately greater in male rats compared to female rats. Studies employing similar size male and female hearts suggest that differences in heart mass may have accounted for the differential response to ADP in Series I. PMID- 6487234 TI - Late systolic stress-diameter relation in patients with aortic valve disease before and after valve replacement. AB - The end-systolic pressure-diameter ratio (Ees) and the maximal pressure-diameter ratio (Emax) during systolic ejection were determined in 10 control patients and 25 patients with aortic valve disease before and 18 months after successful valve replacement. The pressure-diameter ratio was determined from simultaneous M-mode echocardiograms and high-fidelity pressure measurements. A new index of myocardial contractility, as proposed by Pouleur and co-workers, was assessed from the late systolic stress-diameter relationship during one single heart cycle. The slope of this stress-diameter relationship was used for determination of myocardial contractility. Meridional wall stress was calculated from echo pressure measurements at time intervals of 5 to 10 msec. The aortic valve patients were divided into two groups according to the preoperative angiographic ejection fraction: group 1 (ejection fraction greater than or equal to 57%) consisted of 16 patients and group 2 (ejection fraction less than 57%) of 9 patients. Standard hemodynamics showed a significant decrease in left ventricular end-diastolic pressure from 18 to 11 mm Hg in group 1 (P less than 0.01) and from 16 to 12 mm Hg (NS) in group 2. Peak systolic pressure decreased from 186 to 135 mm Hg (P less than 0.01) in group 1 and from 155 to 140 mm Hg (NS) in group 2. Left ventricular end-diastolic volume decreased from 137 to 105 ml/m2 in group 1 and from 225 to 150 ml/m2 in group 2 (P less than 0.05) whereas left ventricular ejection fraction remained unchanged in group 1 (67 versus 65%) and increased slightly in group 2 (45 versus 51%) following surgery. Emax and Ees were preoperatively significantly decreased in group 2 when compared to group 1. Postoperatively, Emax and Ees were no longer significantly different between the two groups although left ventricular ejection fraction remained significantly depressed in group 2 after surgery when compared to group 1. The slope of the late systolic stress-diameter relationship (beta) and the diameter at zero stress (D0) did not show any difference between the two groups pre- as well as postoperatively. Thus it is concluded that Ees and Emax might help to identify myocardial dysfunction in preoperative patients with aortic valve disease. However, in the presence of persistent myocardial dysfunction, as evaluated from systolic ejection fraction, following successful valve replacement, both Ees and Emax do not allow to identify patients with postoperative depressed myocardial function.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6487235 TI - Assessment of left ventricular function by a power index: an intraoperative study. AB - To investigate whether left ventricular performance can be described independent of loading conditions, twelve patients underwent intraoperatively two cineangiographies of the left ventricle with simultaneous pressure recordings. The first ventriculography was performed with ejecting left ventricle without assistance by the extracorporeal circulation. The second one was performed with ejecting left ventricle partially unloaded by the extracorporeal circulation. Myocardial perfusion pressure (mean aortic pressure) was held constant. Due to this procedure marked decreases in preload (end-diastolic wall stress: -54%) and modest changes in afterload (mean systolic wall stress: -23%) were achieved. End diastolic volume index was reduced from 84 ml/m2 to 57 ml/m2, whereas end systolic volume index decreased slightly from 33 ml/m2 to 29 ml/m2. Left ventricular end-diastolic pressure decreased from 12 mm Hg to 7 mm Hg, while peak pressure remained nearly unchanged. Usual parameters of ejection phase (EF, Vmw) as well as power per wall volume (PW) were markedly affected by unloading. In contrast to these parameters, the power index (PI), i.e., the ratio of power per wall volume and end-diastolic wall stress, remained unchanged when left ventricular preload was reduced: PI under control: 5.2 +/- 1.8 sec-1; PI under unloading: 5.2 +/- 1.5 sec-1. This power index can easily be determined from routine angiographies. It may provide a new approach to the assessment of left ventricular function in man. PMID- 6487236 TI - Temporal and spatial development of infarcts in porcine hearts. AB - We investigated the temporal and spatial development of infarcts in porcine hearts to evaluate the time-dependent beneficial effect of reperfusion on infarct size. The left anterior descending coronary artery (LAD) was occluded in 17 pigs for different periods of time followed by 4 hours of reperfusion. Transmural needle biopsies subdivided into subendocardial and subepicardial halves were taken from the ischemic apex after 60 min of ischemia to determine the tissue concentrations of ATP and NAD. The myocardium-at-risk was assessed with a fluorescent dye injected into the right atrium at the end of the experiments, just after the LAD had been reoccluded. The excised hearts were cut into slices parallel to the heart basis. The ischemic myocardium was measured by planimetry of the non-fluorescent areas whereas the infarcted tissue was determined with the NBT stain and related to the area-at-risk. Ischemic cell death started in the jeopardized left ventricular subendocardial septum after about 30 min of ischemia. The further progress involved the right subendocardial septum and the subendocardium of the left anterior free wall. Already after 75 min of ischemia most of the myocytes-at-risk were irreversibly injured. Infarctions reached their final extent after 90-120 min of ischemia. These results indicate that in hearts without a significant collateral blood flow reperfusion can only reduce infarct size if its initiated within 60-75 min of ischemia. Like in canine hearts infarctions progress from the ischemic subendocardium towards the outer layers. PMID- 6487237 TI - Increase in myocardial collateral blood flow during repeated brief episodes of ischemia in the awake dog. AB - The purpose of this study was to determine whether coronary collateral blood flow changes in response to repeated brief periods of ischemia in dogs in which no attempt has been made to stimulate collateral vessel development. The dogs were instrumented with aortic and left atrial catheters and a balloon occluder on the left circumflex coronary artery and were studied in the awake state the following day. Blood flow to the collateral dependent myocardium was measured using 9 mu radioactive microspheres during four coronary occlusions of two minutes duration, each separated by one hour of reperfusion. A small but statistically significant increase in mean collateral blood flow was noted between the first and fourth occlusions; .03 to .05 ml/min/g. These data suggest that transient periods of brief ischemia may result in increases in collateral blood flow. PMID- 6487238 TI - Different respiratory activities of mitochondria isolated from the subendocardium and subepicardium of the canine heart. AB - Mitochondria were prepared from the subendocardial and subepicardial layers of the canine left ventricle. The oxidation rates of palmitate, palmitoyl carnitine and pyruvate of the mitochondria obtained from the two cardiac layers were measured. The cytochrome content and the specific activities of different beta oxidation and Krebs cycle enzymes were also measured in the two mitochondrial populations. Mitochondria isolated from the ENDO layer showed significantly higher oxidation rates than mitochondria from the EPI layer for all the three substrates. No statistically significant differences in cytochrome c+c1 and a+a3 content were found in mitochondria isolated from the two regions. No significant transmural differences were found in fatty acyl CoA, L-3-hydroxy fatty acyl CoA, succinic and malic dehydrogenase specific activities, whilst isocitric dehydrogenase (NADP) specific activity was significantly higher in mitochondria isolated from the inner layer. In conclusion, the mitochondria isolated from the inner left ventricular layer of the canine heart show a higher oxidative capacity than subepicardial mitochondria. This difference could partly be explained by the higher specific activity of isocitric dehydrogenase in this layer. These properties of subendocardial mitochondria could represent a metabolic support for the greater contractile performance of this layer. PMID- 6487239 TI - Effects of dihydroergotamine (DHE) on blood flow and metabolism in the underperfused myocardium in anaesthetized dogs. AB - The study was carried out in 13 mongrel dogs. Regional myocardial blood flow was measured using radiolabelled microspheres. Lactate, H+-ions, and O2 content were measured in arterial and local venous blood. Partial occlusion of the ramus circumflexus (LCX) led to a decrease in left ventricular dp/dt max, systemic arterial pressure, and a marked release of lactate from the underperfused myocardium. With DHE (2 micrograms/kg infused within 5 min, 8 dogs), a slight decrease in heart rate, left ventricular dp/dt max, LCX-resistance and a small increase in femoral and total peripheral resistance as well as in arterial and left and right atrial pressure was observed. In the normally perfused and in the underperfused part of the left ventricle microsphere assessed blood flow was unchanged or slightly elevated with DHE. Lactate release from the underperfused myocardium was markedly reduced. None of the DHE-induced effects on hemodynamic and metabolic parameters were observed in control experiments with infusion of 0.9% NaCl (5 ml). The results indicate that DHE leads to an amelioration of impaired metabolism in the underperfused myocardium and exerts no vasoconstriction in this area. PMID- 6487240 TI - Effects of recurrent ischemia on myocardial high energy phosphate content in canine hearts. AB - Successive ischemic episodes are commonly seen in clinical and experimental cardiology. Although prolonged abnormalities of the canine myocardium have been described following a single ischemic episode, it is not known whether myocardial injury is cumulative following multiple ischemic episodes. Dogs were subjected to three 15-min left anterior descending coronary artery occlusions, each followed by 30 min of reperfusion. In vivo biopsies were obtained for biochemical analysis before and during the first occlusion and 30 min into each reperfusion period. ATP and creatine phosphate (CP) fell in the endocardium during occlusion by 24% and by 69% respectively (both p less than .0001). While CP recovered during each reperfusion period, ATP remained significantly depressed. Loss of membrane permeable purine nucleotide synthesis precursors occurred with the first reperfusion period but not with the second and third reperfusion periods. Therefore, reperfusion following one 15-min coronary occlusion is associated with severe depression of myocardial high energy phosphates; however, two additional occlusions do not cause a further decrease of these substances when intermittent reperfusion is allowed for 30 min. PMID- 6487241 TI - Hypopotassemia-induced U wave in electrocardiogram (an experimental study for possible mechanism). AB - To define the mechanism of hypopotassemia-induced U wave change, we performed open-chest experiments in 20 dogs and obtained following results: (1) During hemodialysis U wave amplitude of epicardial electrogram increased significantly (p less than 0.05) from 0.4 +/- 0.3 (mean +/- SD) to 1.2 +/- 0.5 mV with lowering serum potassium (K) concentrations from 3.4 +/- 0.4 to 2.2 +/- 0.2 mEq/l (p less than 0.001) in 6 dogs. (2) These hypopotassemia-induced U waves disappeared after instillation of high K+ solution into the regional coronary artery, without detectable increase in systemic plasma K+ concentration. (3) In 10 dogs, huge (0.5-1.0 mV), delayed (corrected Q-U apex = 0.66 +/- 0.16) positive U waves were induced at the epicardial surface by infusion of K+-free, Ca++-rich Tyrode solution into the regional coronary artery, whereas no appearance of negative U waves was shown at the endocardial surface. (4) In all of 6 dogs with infusion of K+-free, Ca++-rich solution, monophasic action potential registered with suction electrode showed early afterhyperpolarization, which corresponded to appearance of huge positive U waves. These data indicate that hypopotassemia-induced U wave may reflect early afterhyperpolarization developed in the ventricular muscle. PMID- 6487242 TI - [Proliferative capacity of chondrocytes in chondral and subchondral articular cartilage lesions]. PMID- 6487243 TI - [Transplantation of the posterior tibial muscle in peripheral paralysis of the peroneal nerve]. PMID- 6487244 TI - [A new method for the replacement of the anterior cruciate ligament]. PMID- 6487245 TI - [Pericapsular ilium osteotomy using the Pemberton method]. PMID- 6487246 TI - [Punctures of the joint and intra-articular injections in orthopedic ambulatory care facilities]. PMID- 6487247 TI - [A cartilage-protective wound hook for knee arthrotomy]. PMID- 6487249 TI - [Concepts for increased cooperation of practicing veterinarians in the monitoring of udder health in dairy animal stocks]. PMID- 6487248 TI - [Juvenile rheumatoid arthritis (juvenile chronic arthritis--Still's disease)]. PMID- 6487250 TI - [Problems in the construction of cattle stalls from the orthopedic viewpoint]. PMID- 6487251 TI - [Feeding of rumen contents from slaughter cattle. 3. Use of rumen contents in the feeding of swine]. PMID- 6487252 TI - [Nomenclature and classification of animal tumors based on currently recognized classification systems exemplified by mammary tumors. A contribution to comparative oncology]. PMID- 6487253 TI - [Effect of arprinocid on the growth of young ducks (Anas platyrhynchos)]. PMID- 6487254 TI - [Demonstrability and survival of Mycoplasma bovis in milk]. PMID- 6487255 TI - [Use of liquid animal carcass homogenates. 1. Composition and digestibility for swine]. PMID- 6487256 TI - [Determination and occurrence of ochratoxin A in slaughtered swine]. PMID- 6487257 TI - [Development and testing of a pelleted feed for cats]. PMID- 6487258 TI - [Proliferative kidney disease in salmonid fish]. PMID- 6487259 TI - [Prevalence of oribatid mites on sheep pastures and their role as intermediate host for the sheep tapeworm Moniezia expansa]. PMID- 6487260 TI - [Occurrence of Mycoplasma bovis in milk samples from cows from the northern part of Germany]. PMID- 6487261 TI - [Use of the creatine kinase test in young swine]. PMID- 6487262 TI - [Use of fluid animal carcass homogenates. 2. Use of animal carcass homogenate in the fattening of swine]. PMID- 6487263 TI - [Insight into the physiologic fluctuations of marker values in comparison to average values of selected groups exemplified by the hematologic study of a group of dogs]. PMID- 6487264 TI - [Histologic and chemical studies of residues in chickens following the administration of an oil emulsion vaccine against Newcastle disease]. PMID- 6487265 TI - Specificity of the effects of leucine and its metabolites on protein degradation in skeletal muscle. AB - The effects of leucine, its metabolites, and the 2-oxo acids of valine and isoleucine on protein synthesis and degradation in incubated limb muscles of immature and adult rats were tested. Leucine stimulated protein synthesis but did not reduce proteolysis when leucine transamination was inhibited. 4-Methyl-2 oxopentanoate at concentrations as low as 0.25 mM inhibited protein degradation but did not change protein synthesis. The 2-oxo acids of valine and isoleucine did not change protein synthesis or degradation even at concentrations as high as 5 mM. 3-Methylvalerate, the irreversibly decarboxylated product of 4-methyl-2 oxopentanoate, decreased protein degradation at concentrations greater than or equal to 1 mM. This was not due to inhibition of 4-methyl-2-oxopentanoate catabolism, because 0.5 mM-3-methylvalerate did not suppress proteolysis, even though it inhibited leucine decarboxylation by 30%; higher concentrations of 3 methylvalerate decreased proteolysis progressively without inhibiting leucine decarboxylation further. During incubation with [1-14C]- and [U-14C]-leucine, it was found that products of leucine catabolism formed subsequent to the decarboxylation of 4-methyl-2-oxopentanoate accumulated intracellularly. This pattern was not seen during incubation with radiolabelled valine. Thus, the effect of leucine on muscle proteolysis requires transamination to 4-methyl-2 oxopentanoate. The inhibition of muscle protein degradation by leucine is most sensitive to, but not specific for, its 2-oxo acid, 4-methyl-2-oxopentanoate. PMID- 6487266 TI - Effect of lead ions on chick-embryo liver mitochondrial delta-aminolaevulinate synthase. AB - Pb2+ activated native chick-embryo liver mitochondrial delta-aminoaevulinate synthase (EC 2.3.1.37). This result contradicted with the inhibitory effect observed by earlier workers who used degraded enzyme preparations. Enzyme activation was biphasic. An initial activation phase was observed with Pb2+ concentrations up to 200 microM, and a secondary phase with concentrations from 200 microM to at least 2mM. Maximum primary activation was 2.5-fold at 200 microM Pb2+, with a further 2-fold activation observed at 2mM-Pb2+. Primary activation was not affected by a 10-fold molar excess of dithioerythritol, but the secondary activation was abolished by dithioerythritol. Secondary-phase activation was lost upon increasing time of incubation of the enzyme with Pb2+. The implications of these findings are discussed with reference to lead poisoning and the mechanism of delta-aminolaevulinate synthase. PMID- 6487267 TI - Binding of malonyl-CoA to isolated mitochondria. Evidence for high- and low affinity sites in liver and heart and relationship to inhibition of carnitine palmitoyltransferase activity. AB - [14C]Malonyl-CoA bound to intact mitochondria isolated from rat liver and heart in a manner consistent with the presence of two independent classes of binding sites in each tissue. The binding characteristics for mitochondria obtained from fed male rats were: for heart, KD(1) = 11-18nM, KD(2) = 30 microM, N1 = 7pmol/mg of protein, N2 = approx. 660pmol/mg of protein; for liver, KD(1) = 0.1 microM, KD(2) = 5.6 microM, N1 = 11pmol/mg of protein, N2 = 165pmol/mg of protein. In the presence of 40 microM-palmitoyl-CoA the characteristics of binding at the high affinity sites were changed, so that for heart KD(1) = 0.26 microM, with no change in N1 and for liver KD(1) = approx. 2 microM, with N1 increased to approx. 40pmol/mg of protein. Differences between the two tissues in tightness of malonyl CoA binding at the high-affinity sites explains the considerably greater sensitivity of heart CPT1 (overt form of carnitine palmitoyltransferase) to inhibition by malonyl-CoA [Saggerson & Carpenter, (1981) FEBS Lett. 129, 229-232; McGarry, Mills, Long & Foster (1983) Biochem. J. 214, 21-28]. Starvation (24h) did not change the characteristics of [14C]malonyl-CoA binding to liver mitochondria and did not alter the I50 (concentration giving 50% inhibition) for displacement of [14C]malonyl-CoA by palmitoyl-CoA. Therefore the decreased sensitivity of liver CPT1 to inhibition by malonyl-CoA in starvation [Saggerson & Carpenter (1981) FEBS Lett. 129, 225-228; Bremer (1981) Biochim. Biophys. Acta 665, 628-631] is not explained by differences in malonyl-CoA binding. Percentage occupancy of the high-affinity sites in heart mitochondria by malonyl-CoA correlated closely with percentage inhibition of CPT1 measured under similar conditions. This finding supports the proposal that the high-affinity binding sites are the functional sites mediating inhibition of CPT1 by malonyl-CoA. Similar experiments with liver mitochondria also suggested that the occupancy of high-affinity sites by malonyl-CoA regulates CPT1 activity. 5,5'-Dithiobis-(2 nitrobenzoic acid), which decreased the sensitivity of heart or liver CPT1 to inhibition by malonyl-CoA [Saggerson & Carpenter (1982) FEBS Lett. 137, 124-128], also decreased [14C]malonyl-CoA binding to the high-affinity sites of heart mitochondria. N1 values for [14C]malonyl-CoA binding to high-affinity sites in liver mitochondria were determined in various physiological states which encompassed a 7-fold range of CPT1 maximal activity (fed, starved, pregnant, hypothyroid, foetal). The N1 value did not change in these states.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6487268 TI - Extracellular superoxide dismutase and other superoxide dismutase isoenzymes in tissues from nine mammalian species. AB - The contents of extracellular superoxide dismutase, CuZn superoxide dismutase and Mn superoxide dismutase were determined in tissues from nine mammalian species. The pattern of CuZn superoxide dismutase distribution was similar in all species, with high activity in metabolically active organs such as liver and kidney and low activity in, for example, skeletal muscle. Mn superoxide dismutase activity was high in organs with high respiration, such as liver, kidney, and myocardium. Overall the Mn superoxide dismutase activity in organs was almost as high as the CuZn superoxide dismutase activity. The content of extracellular superoxide dismutase was, almost without exception, lower than the content of the other isoenzymes. The pattern of tissue distribution was distinctly different from those of CuZn superoxide dismutase and Mn superoxide dismutase. The tissue distribution of extracellular superoxide dismutase differed among species, but in general there was much in lungs and kidneys and little in skeletal muscle. In man, pig, sheep, cow, rabbit and mouse the overall tissue extracellular superoxide dismutase activities were similar to each other, whereas dog, cat and rat tissues contained distinctly less. There was no general correlation between the tissue extracellular superoxide dismutase activity of any of the various species and the variable plasma activity. The ratio between the plasma and the overall tissue activities was high, for some species over unity, providing further evidence for the notion that one role of extracellular superoxide dismutase is as a plasma protein. PMID- 6487269 TI - The molecular characteristics of a human pancreatic acidic phosphoprotein that inhibits calcium carbonate crystal growth. AB - A CaCO3-crystal-growth inhibitor was isolated from human pancreatic stones by using EDTA demineralization, followed by DEAE-Trisacryl chromatography. The isolated inhibitor was found to be a phosphoglycoprotein with Mr 14017 and having an unusual chemical composition. It is characterized by a high (42%) acidic amino acid content, but lacks methionine and gamma-carboxyglutamic acid. The protein contains 2.65 mol of P/mol of protein, as phosphoserine (2 mol) and phosphothreonine (0.5 mol). Isoelectric focusing of the protein yields one major band corresponding to an isoelectric point of 4.2. Immunochemical quantification of the crystal-growth inhibitor in pure pancreatic juice reveals that it constitutes 14% of the normal exocrine secretion. Our findings demonstrate that this is a novel secretory protein, which has no enzymic activity and which maintains pancreatic juice in a supersaturated state with respect to CaCO3. PMID- 6487270 TI - Purification and characterization of chicken erythrocyte ferrochelatase. AB - Ferrochelatase (EC 4.99.1.1) was purified 2000-fold to apparent homogeneity from isolated chicken erythrocyte mitochondria. The purified enzyme yields a single band on sodium dodecyl sulphate/polyacrylamide-gel electrophoresis with an apparent Mr of 42 000. The enzyme utilizes proto-, meso- and deutero-porphyrin with Km values of 37, 51 and 80 microM respectively. The disubstituted porphyrins 2,4-bisglycol deutero-porphyrin and 2,4-disulphonic deuteroporphyrin were not substrates. Mn2+, Hg2+, Pb2+ and Co2+ were strong inhibitors of the purified enzyme. Palmitic acid and oleic acid stimulated activity, whereas linoleic acid inhibited and phospholipids had variable effects. Chicken ferrochelatase was inhibited by N-ethylmaleimide and iodoacetamide. Inhibition by iodoacetamide was pseudo-first-order, but inhibition by N-ethylmaleimide appeared to be biphasic in nature with an initial high rate followed by a much lower rate of inactivation. The characteristics of the chicken erythrocyte enzyme are compared with those previously reported for mammalian liver ferrochelatase. PMID- 6487271 TI - Effects of diet and of alloxan-diabetes on the activity of branched-chain 2-oxo acid dehydrogenase complex and of activator protein in rat tissues. AB - The total activities (sum of active and inactive forms) of branched-chain 2-oxo acid dehydrogenase complex in tissues of normal rats fed on a standard diet were (unit/g wet wt.): liver, 0.82; kidney, 0.77; heart, 0.57; hindlimb skeletal muscles, 0.034. Total activity was decreased in liver by 9%- or 0%-casein diets and by 48 h starvation, but not by alloxan-diabetes. Total activities were unchanged in kidney and heart. The amount of active form of the complex (in unit/g wet wt. and as % of total) in tissues of normal rats fed on standard diet was: liver, 0.45, 55%; kidney, 0.55, 71%; heart, 0.03, 5%; skeletal muscle less than 0.007, less than 20% (below lower limit of assay). The concentration of the active form of the complex was decreased in liver and kidney, but not in heart, by low-protein diets, 48 h starvation and alloxan-diabetes. In heart muscle alloxan-diabetes increased the concentration of active complex. The concentration of activator protein (which activates phosphorylated complex without dephosphorylation) in liver and kidney was decreased by 70-90% by low-protein diets and 48 h starvation. Alloxan-diabetes decreased activator protein in liver, but not in kidney. Evidence is given that in tissues of rats fed on a normal diet approx. 70% of whole-body active branched chain complex is in the liver and that the major change in activity occasioned by low-protein diets is also in the liver. PMID- 6487272 TI - Involvement of oxidoreductive reactions of intracellular haemoglobin in the metabolism of 3-hydroxyanthranilic acid in human erythrocytes. AB - 3-Hydroxyanthranilic acid, a metabolite of tryptophan, was rapidly metabolized by human erythrocytes. The final product was determined to be cinnabarinic acid as detected by spectrophotometry, paper chromatography and t.l.c. The formation of cinnabarinic acid from 3-hydroxyanthranilic acid in the cells was markedly inhibited by CO when intracellular haemoglobin was in a ferrous state, and by cyanide when it was in a ferric state. Ferrous haemoglobin in erythrocytes was oxidized to (alpha 3+ beta 2+)2, (alpha 2+ beta 3+)2 and (alpha 3+ beta 3+)2 by 3 hydroxyanthranilic acid, and the oxidation rates were very high, like those of cinnabarinic acid formation, suggesting that the metabolism of 3 hydroxyanthranilic acid is coupled with oxidoreductive reactions of intracellular haemoglobin. This view was further confirmed by the findings that 3 hydroxyanthranilic acid was metabolized by ferrous or ferric haemoglobin and that ferrous and ferric haemoglobins were oxidized and reduced by the compound respectively. The significance of the metabolism of 3-hydroxyanthranilic acid and the oxidoreductive reactions of haemoglobin with this compound may be associated with the pathological conditions with increased 3-hydroxyanthranilic acid levels in the blood of diabetic subjects. PMID- 6487273 TI - Uptake and esterification of exogenous cholesterol by low-density-lipoprotein receptor-negative human fibroblasts in culture. AB - The incorporation and metabolism of both vesicle- and LDL (low-density lipoprotein)- derived [3H]cholesterol by LDL-receptor-negative fibroblasts were studied. Independent of the cholesterol source, free [3H]cholesterol was readily incorporated into the cells and was available for esterification. 7 Oxocholesterol stimulated both [3H]cholesterol incorporation, by increasing the exchange rate, and the subsequent esterification of it irrespective of the source of exogenous [3H]cholesterol. The 7-oxocholesterol-stimulated esterification of exogenously derived LDL free [3H]cholesterol was progesterone-sensitive and energy-requiring. PMID- 6487274 TI - Temperature effect of cholesterol association with synaptosomal plasma membranes of rabbit brain. AB - Association of exogenous cholesterol with rabbit brain synaptosomal plasma membranes follows an exponential path described by the general formula y = a X ebx. The co-operative nature of this association was shown when increasing amounts of unlabelled cholesterol glucoside (up to 0.5 mM) were added to a fixed amount (5 microM) of [14C]cholesterol, when a biphasic curve of the binding of [14C]cholesterol into the membranes was obtained. Arrhenius plots of this association revealed two break points which occur at 25 degrees C and 42 degrees C. The first break apparently corresponds to the transition from the crystalline to the gel phase. The second break may be due to the (continuously) increasing entropy of the system which creates at a certain point difficulties in the binding of cholesterol into the lipid bilayer. PMID- 6487275 TI - N-Acetylglutamate in rat liver during foetal development. AB - N-Acetylglutamate is present in foetal rat liver at 17 days' gestation. The tissue content (approx. 50 nmol/g wet wt.) remains constant during later foetal life. The appearance of N-acetylglutamate does not parallel the developmental pattern of the urea cycle. PMID- 6487276 TI - Rate law of mitochondrial respiration versus extramitochondrial ATP/ADP ratio. AB - Rate equations describing the dependence of mitochondrial respiration or ATP formation on the extramitochondrial ATP/ADP ratio were derived from a simplified reaction scheme of oxidative phosphorylation. The equations include maximum velocities of (1) respiration, (2) ATP formation, and (3) other energy utilizing side reactions; apparent Michaelis constants for ATP and ADP; an apparent cooperativity coefficient; and in addition an apparent equilibrium constant which is equal to the ATP/ADP ratio at zero net formation of ATP in the resting state of mitochondria. The control characteristics described by the rate equation are in close agreement with curves that can be obtained from a much more complex mathematical model of phosphorylating mitochondria. The kinetic parameters of the equation can be estimated from experimental data by a nonlinear regression procedure. The results demonstrate a weak apparent cooperativity and a strong shift of the apparent affinity ratio for ATP and ADP towards ADP. PMID- 6487278 TI - Rabbit atrial myocardium in hypoxic conditions: rate dependent variation of contraction. AB - The dependence of contraction in the atrial myocardium on the stimulation pattern was studied in normoxic and hypoxic conditions. Isotonic contractions were measured from left atrial muscle strips of the rabbit. At rapid stimulation hypoxia produced a negative inotropic effect which disappeared at slower stimulation and became a positive inotropic one. The potentiation of a first beat after a pause in stimulation was enhanced by hypoxia because the contractions were stronger depressed at steady state than after a pause. At all pacing patterns the relative maximum rate of shortening and re-lengthening were independent of the oxygen-supply. After application of epinephrine in hypoxia they were enhanced and so was peak shortening. The findings suggest an impaired or altered function of the sarcolemma only under the degrees of hypoxia chosen. PMID- 6487277 TI - [Motivation and biological significance of photically evoked potentials of the visual cortex of rats]. AB - In 4 rats the photically evoked potential of the visual cortex was recorded during a conditioned reflex. As compared with the evoked potentials following flashes without biological meaning fullness significant differences occur in all rats at the same time intervals during the performance of the conditioned reflex. These differences remain unaltered when motivation increases an dare independent of the configuration of the evoked potentials following flashes without biological significance. PMID- 6487279 TI - Automated rhythmic movements and their control under different experimental conditions. AB - Automated rhythmic movements (tapping) represent a facility for the examination of a motor control subsystem. The actual tapping frequency is influenced by variations of experimental conditions and related to EEG phenomena. The study deals with the effect of different instructions and additional mental load upon tapping and its relation to EEG rhythms. Depending on instruction, large differences occur between "maximum" and "convenient" rhythm, the latter being much slower. If maximum speed is required, the sub ect produces a higher frequency by its dominant hand; there is no difference between tapping without additional load (non-dominant hand) and with additional load (dominant hand). Previous results concerning the relationship between EEG rhythms and tapping movements could be confirmed. PMID- 6487280 TI - A qualitative model of the control of automated rhythmic movements: coupling between EEG and motor systems. AB - The aim of this study is to show a model of processing control of automated rhythmic movements. On the basis of different tapping tasks (real movements and ideomotor test situation) a scheme will be shown which describes the process control of different process levels with different feedback possibilities and with the influence of slow rhythms. Furthermore, a mathematical approach for the phenomena occurring during a tapping task in the EEG will be discussed. The model test and the scheme are the first attempts to describe the whole control system of automated rhythmic activity. In this first step the physiological substrate of the scheme elements was intentionally left out. PMID- 6487281 TI - [Dopaminergic sensitivity after ethanol pretreatment and its relation to alcohol preference]. AB - The interactions between ethanol and the central dopaminergic synaptic transmission also refer to the ethanol drinking behaviour. In mice the alteration of the locomotoric activity induced by apomorphine is influenced by ethanol pretreatment for 28 days in a different way referring to drinking behaviour. Ethanol preferent animals do not differ significantly from the ethanol untreated animals in respect to the apomorphine induced locomotion. The nonpreferent animals show, by comparison, a decrease of the sedative effect of low apomorphine doses (0.25 mg/kg; i.p.) and an increase of the stimulating effect of higher doses (1.0 mg/kg; i.p.). These behavioural alterations may be understood as an expression of dopaminergic presynaptic subsensitivity and of a postsynaptic supersensitivity in ethanol pretreated nonpreferent animals. PMID- 6487282 TI - [Learning behavior in rats after chronic haloperidol treatment]. AB - The effect of 3 week chronic haloperidol treatment has been investigated in rats by retention of active avoidance (pole jumping). In the period of dopaminergic supersensitivity, i.e. after withdrawal of haloperidol, pretreated rats showed a better retention of the learned reaction than controls. The results demonstrate that the neuroleptic-induced supersensitivity enhanced not only the spontaneous and stimulated locomotor activity, but also improved the retention of an active avoidance reaction. PMID- 6487283 TI - The red cell glutathione reductase in trisomy of the chromosome 8. AB - About one and a half-fold increase of the red cell glutathione reductase (GSR) activity was detected in two children with trisomy of the chromosome 8. In the third child with clinical suspicion of this trisomy, but with normal karyotype, the GSR activity was normal. Evaluation of the red cell GSR activity is of diagnostic value in this syndrome. PMID- 6487284 TI - Observations on the red cell ATP of surgical patients during premortal period. AB - In surgical septic patients a significant decrease of the red cell ATP concentration was observed in last two days before death. Only in renal failure (with high Pi serum level) this phenomenon was not observed. In malnourished patients with very low red cell ATP, administration of a high Pi dose resulted in some elevation of the ATP. PMID- 6487285 TI - Interaction of fusogen substances with the erythrocyte membrane. AB - The influence of the fusogen substances poly-(ethylene glycol) (PEG) and linoleic acid on the dynamics and structure of the erythrocyte membrane was studied. Linoleic acid disturbs the lipid matrix and nonlamellar structures were formed. PEG affects the stability of membranes by changing the polarity of the aqueous medium and the hydration state of membrane lipids and proteins. PMID- 6487286 TI - In vivo modulation of outward Na+, K+ cotransport by oestradiol and progesterone in rat red cells. AB - Outward Na+, K+-cotransport was 50% higher in female than in male rat red cells (50%). Ovariectomy induced a marked decrease in the activity of this system. Oestradiol increased and progesterone decreased Na+, K+-cotransport in ovariectomized rats. PMID- 6487287 TI - Generalized deficiency of the NADH-methemoglobin reductase in congenital methemoglobinemia with neurological symptoms. AB - Determination of the NADH-methemoglobin reductase (NADH-metHb-R) activity in red cells, lymphocytes and platelets of a two year old Polish girl with congenital methemoglobinemia and severe damage of the central nervous system, as well as in control subjects, was performed. The results permitted us to diagnose a rare case of the generalized deficiency of the NADH-metHb-R. PMID- 6487288 TI - Interaction between rat peritoneal macrophages and sialidase-treated erythrocytes: biochemical and morphological studies. AB - Rat peritoneal macrophages bind and phagocytose homologous, sialidase-treated erythrocytes at a rate depending on the number of red cells and the amount of sialic acids released. Vibrio cholerae sialidase only partially (75%) removes the sialic acid residues from rat erythrocytes, whereas with Arthrobacter ureafaciens sialidase complete desialylation is possible. Analysis of the sialic acids by capillary gas-liquid chromatography combined with mass spectrometry (GLC-MS) revealed the occurrence of N-acetylneuraminic acid (Neu5Ac), N-acetyl-9-O acetylneuraminic acid (Neu5,9Ac2), N-acetyl-7,9-di-O-acetylneuraminic acid (Neu5,7,9Ac3), N-acetyl-9-O-lactylneuraminic acid (Neu5Ac9Lt) and N glycolyneuraminic acid (Neu5Gc). Native rat serum enhances binding and phagocytosis, as has been observed by radioactive measurements and studies in a micro-scale by light and electron microscopy. The morphological experiments showed that maximum binding of sialidase-treated erythrocytes to macrophages occurs after 15-30 min, while for maximum phagocytosis at least 60 min are necessary. Striking alterations of the shape of erythrocytes during their interaction with macrophages were observed. PMID- 6487289 TI - Different behaviour of normotonous and spontaneously hypertensive rats with vitamin D intoxication. AB - Spontaneously hypertensive rats (SHR) were found to tolerate the consequences of vitamin D intoxication much better than Wistar Kyoto rats (WKY). This is obvious from the 10-fold higher death rate of WKY rats and from the considerable differences of the tissue reactions occurring in the aorta, the cardiac muscle and the arterial vessels between WKY rats and SHR. Thus, myocardial alterations are much rarer in SHR; this holds also for the aorta calcification which is less pronounced in SHR and which is age-dependent in so far as it is almost absent from one year onward. Giant granulomas as a result of vitamin D intoxication were found in juvenile SHR at a time where they would otherwise no yet have occurred at a frequency observed in old untreated SHR. Common to both WKY rats and SHR is the formation of vascular alterations (plasmatic vasculosis) which reveal--though less pronounced with SHR--the angiotoxic action of vitamin D. For these considerable differences in the behaviour of WKY and SHR in vitamin D intoxication the different Ca-binding and transport properties of the arterial plasma membranes should be responsible, which is likely to be due to a defect in the Ca-transport mechanism of the smooth vascular muscle. The importance of these findings for the use of vitamin D intoxication in arteriosclerosis research as well as for studies on the pathogenesis of permeability disorders and alterations of the arterial vascular system is pointed out. PMID- 6487290 TI - Salivary female sex hormone levels and gingivitis in pregnancy. AB - Salivary estradiol 17 beta (E2-17 beta) and progesterone (P) were determined by using radioimmunoassay techniques in 30 pregnant females in the first, second and third trimesters as well as in 10 non-pregnant controls during the luteal phase of the menstrual cycle. Plaque index (P.I.), gingival index (G.I.) and retention index (R.I.) were measured in all cases. The data obtained showed that the levels of the two hormones in saliva were significantly increasing during the 3 trimesters of pregnancy. P.I. and R.I. did not change, however, G.I. was significantly higher in the second and third trimesters when compared with controls. A correlation between both E2--17 beta and P during pregnancy and gingival changes is suggested. PMID- 6487291 TI - Psychometric intelligence correlates with interindividual different rates of lipid peroxidation. AB - The review outlines a theory concerning the neurochemical basis of interindividual differences in human intelligence. From the work of Lehrl and Frank it can be concluded that Spearman's general factor of intelligence is a phenomenon of short-term memory capacity, i.e. a phenomenon of reversible short term changes in synaptic membrane permeability. The empirical correlations between glutathione peroxidase activity, a genetically polymorphous enzyme, and IQ, and between the relative lipofuscin content of the brain and the ontogenetic development of fluid intelligence, have the background that peroxidation of phospholipids and its cleavage products are the regulating factors of membrane permeability. Furthermore, the glutathione status plays via lipid peroxidation, activating adenylate cyclase and inhibiting the sodium pump and acetylcholinesterase, an essential role in the regulation of energy supply and reducing power of cortical cells. In inbred strains of mice inherited learning speed, serum peroxide levels, and the parameters of the acetylcholine system are closely correlated. PMID- 6487293 TI - A new method of parameter estimation from progress curves. AB - A mathematical procedure is presented which permits kinetic parameters to be determined from progress curve data. The method is applicable to any kind of enzymatic reaction which can be described by a single rate equation. A general criterion is derived to check the accuracy of the method. An application to a simulated 2-substrate reaction is given. PMID- 6487292 TI - Effects of piracetam on brain development in newborn rats exposed to hypoxia. AB - Perinatal hypoxia is one of the main causes of disturbances of the function of the CNS during childhood. In this study the protective effect of the nootropic drug piracetam (oxo-2-pyrrolidinyl-1)-2-acetamide was tested. One-day-old Wistar rats were exposed together with their mothers to hypoxia up to the 10th day of life (11 h daily, pO2 = 9.86 kPa). On the 11th day a 48% decrease of body weight and a 30% decrease of brain weight was found in the hypoxic animals. The protein/DNA ratio and the AChE activity in the brain cortex were decreased indicating retarded brain development. Piracetam (daily 100 mg/kg, s. c., before hypoxic exposure) did not affect the mortality rate, the somatic development of the animals, or the estimated basic neurochemical markers in the cortex of the brain. At the age of 3 months the fractional efflux rate (FER) of dopamine (DA) evoked chemically or electrically as a characteristic functional feature of chemical synaptic transmission, was examined. It was found that postnatal hypoxia induces a long lasting increase of FER of DA of striatum slices. Animals exposed postnatally to hypoxia and treated with piracetam showed an increased FER of DA (potassium as stimulus) by comparison with those animals also exposed postnatally to hypoxia but left untreated with piracetam. PMID- 6487294 TI - Theoretical study of oscillatory and resonance phenomena in an open system with induction of enzyme by substrate. AB - A simple mathematical model of an open metabolic system is constructed in which the metabolism of a substrate is enhanced by induction of the catalyzing enzyme. It is demonstrated that the steady-state in such a system may be approached by damped oscillations of substrate and enzyme levels. If the input rate of substrate into the system has periodic fluctuations, the phenomenon of resonance is observed. Numerical analysis reveals the non-linear character of the resonance. PMID- 6487295 TI - [Changes in the cholinesterase activity and glucose concentration in the blood induced by paraoxon in rabbits immunized against paraoxon]. AB - The immunization of rabbits with a paraoxon-HSA-conjugate resulted in an antibody response with titres of 1:25000 to 1:100000 of antisera dilution and average affinity constants K0 of 10(6) M-1 and heterogeneity indices of 0.8 to 0.9 calculated by means of the Sips equation. The serum cholinesterases and the erythrocyte acetylcholinesterase in immunized rabbits were protected against a stronger inhibition by parenteral application of paraoxon. An increase of blood glucose after paraoxon application to immunized rabbits could not be observed but was detectable in unimmunized animals. PMID- 6487296 TI - IgG antibodies do not bind to band 3 in intact erythrocytes; enzymatic treatment of cells is required for IgG binding. AB - Naturally occurring autoantibodies to band 3 in normal human serum do not bind to red cells unless they are senescent, stored, or damaged. We suspected that IgG did not bind to native band 3 in intact red cells because of steric "shielding" of band 3 by adjacent molecules such as the glycophorins. In order to test this hypothesis, immunoelectron microscopy experiments were performed on intact red cells and red cells subjected to enzymatic treatment. Results revealed that antibodies to band 3 did not bind to untreated red cells, but did bind to red cells treated with trypsin, which spares band 3 but cleaves glycophorins A and C. Treatment with alpha-chymotrypsin did not significantly increase antiband 3 antibody binding. Binding of antibodies to the senescent cell antigen was not increased by either enzymatic treatment. It appears that binding of antibodies to the senescent cell antigen requires more than exposure of band 3 and proteolysis at a site other than the alpha-chymotrypsin sensitive site in intact red cells. PMID- 6487297 TI - Crown gall transformation of tobacco callus cells by cocultivation with Agrobacterium tumefaciens. AB - Incubation of cells from squashed tobacco callus tissue with virulent Agrobacterium tumefaciens leads to the production of cells displaying a crown gall phenotype. PMID- 6487298 TI - Uptake of free hemoglobin by rat liver parenchymal cells. AB - Parenchymal cells isolated from rat liver are capable of taking up free hemoglobin. Uptake was saturable with a concentration for half-maximal velocity of 1.35 mg/ml (1.99 X 10(-5) M) hemoglobin. At a concentration of 0.088 mg/ml, the endocytic index for hemoglobin uptake was 4.5 microliters/h per mg of cell protein. This may be compared with the rate of fluid pinocytosis by these cells of 0.025 microliter/h per mg of cell protein (determined with yeast invertase as the marker). Free beta globin chains were also taken up with an endocytic index of 26.7 microliters/h per mg of cell protein at a beta chain concentration of 0.075 mg/ml. Hemoglobin inhibited the uptake of labeled beta globin. Hemoglobin haptoglobin complex at a concentration of 0.12 mg/ml (as hemoglobin) was cleared at a rate of 0.89 microliter/h per mg cell protein and its uptake was also inhibited by free hemoglobin. We conclude that haptoglobin serves to conserve the iron of hemoglobin by preventing its renal clearance and not by promoting its hepatic uptake. PMID- 6487299 TI - 'Abnormality of 2-deoxyglucose uptake kinetics in fibroblasts at low concentrations. AB - 2-deoxyglucose uptake rates at low sugar concentrations (less than 500 microM) appeared to be lower than those predicted by the Michaelis-Menten model which correctly described higher concentrations. This phenomenon which we will call concentration-dependent transport lag, was also observed for L-glucose uptake which suggest that this phenomenon is carrier-independent. A model involving the perimembrane space is developed which, for L-glucose, gives k1 = 0.931 +/- 0.072 X 10(-6) l X mg protein-1 X minute-1, k2 = 2.97 +/- 0.19 X 10(-7) l X mg protein 1 X minute-1 and So = 88,8 +/- 4,3 microM; where k1 is the diffusion constant in the cell membrane, k2 is the diffusion constant in the perimembrane space and So the sugar concentration required in the external medium in order to provide an equivalent sugar concentration in the transport carrier area. PMID- 6487300 TI - Characterization of virtual coupling in the proton nuclear magnetic resonance spectrum of N,N'-diacetylchitobiose by two-dimensional J-resolved spectroscopy. AB - The anomeric proton of the reducing N-acetylglucosamine residue of beta-N,N' diacetylchitobiose exhibited an unusual lineshape indicative of virtual coupling in the 250 MHz proton NMR spectrum. The two-dimensional J-resolved spectrum contained four lines associated with this proton, and this pattern can be used to distinguish virtual coupling from other effects. Anomeric protons of previously studied asparagine-linked glycopeptides which exhibited unusual lineshapes in the conventional NMR spectra did not exhibit the four line patterns indicative of virtual coupling in the two-dimensional J-resolved spectra. Although virtual coupling may partially account for the unusual lineshapes observed in the normal proton NMR spectra, the anomalous behavior observed in the two-dimensional J resolved spectra of these glycopeptides cannot be explained solely by this phenomenon. PMID- 6487301 TI - Na+ transport by brush border membrane from rat kidney. AB - Na+ uptake was measured in brush border membrane isolated from rat kidney cortex. In the presence of 100 mM NaCl gradient, Na+ equilibrated across the membranes within 30 minutes, but uptake was linear only for the first 10 seconds. Total uptake could be analysed in terms of a diffusion component and a saturable component (Kt = 5 mM, Jmax = 0.62 pmol/microgram prot/s). Uptake at 1 mM NaCl was found to be inhibited at 60% by amiloride; stimulation of uptake by pH gradient (inside greater than outside) supports the functioning of a Na+-H+ antiport. Uptake at 100 mM NaCl was insensitive to amiloride in the absence of pH gradient. The influence of anions on Na+ uptake was in agreement with known permeabilities for generation of electrical potentials (Thiocyanate greater than chloride greater than gluconate) and was observed at 100 mM Na+ but not at 40 microM. These results suggest that rat renal brush border membrane vesicles are leaky towards Na+ and present a permeability coefficient for Na+ much higher than what is expected from the in vivo conditions. PMID- 6487302 TI - Phalloidin and tropomyosin do not prevent actin filament shortening by the 90 kD protein-actin complex from brain. AB - Previously we reported the purification from bovine brain of the 90 kD protein actin complex that shortens actin filaments. In the present work we study the effect of this complex on actin polymerized in the presence of phalloidin (PL) or tropomyosin (TM) which are known to stabilize actin filaments. The effect of the complex has been compared with that of cytochalasin D (CD), a fungal metabolite that also shortens actin filaments. Low shear viscosimetry and electron microscopy showed that PL or TM could not prevent the shortening of actin filaments in the presence of 90 kD protein-actin complex whereas they effectively protected actin filaments from shortening by CD. We conclude that the 90 kD protein-actin complex is a more potent filament-shortening factor than CD. PMID- 6487303 TI - Stopped-flow kinetics of the interaction of the fluorescent calcium indicator Quin 2 with calcium ions. AB - The kinetics of the Quin 2-Ca2+ interaction have been studied using stopped-flow fluorimetry. Mixing the Quin 2-Ca2+ complex with a large excess of EGTA, EDTA or MgCl2 resulted in first order dissociation kinetics. The observed dissociation rate increased slightly with increasing EGTA concentration yielding a limiting value of 83 +/- 4 s-1 for the dissociation rate constant (k-) at pH 7.2, 37 degrees C, +/- 3mM Mg2+. The temperature dependence of the dissociation was weak (activation energy = 22 +/- 1 kJ/mol) and around neutral pH the pH dependence was negligible. The association reaction was too fast to be monitored directly. From this and the instrument dead-time, the second order rate constant k+ was estimated to be greater than or equal to 10(9) M-1s-1, in agreement with the calculation from k+ = k-/K. These data should be useful in evaluating the potential of Quin 2 to measure fast intracellular Ca2+ transients. PMID- 6487304 TI - L1210(A) mouse lymphoma cells depleted of glutathione with L-buthionine-S-R sulfoximine proliferate in tissue culture. AB - L1210(A) mouse lymphoma cells have been adapted to long-term tissue culture in the presence of L-buthionine-S-R-sulfoximine in concentrations of 1-10 mM. As a result of the inhibitory action of this compound on the synthesis of gamma glutamylcysteine, the dipeptide precursor of glutathione, the cells are depleted of more than 90% of their normal cellular glutathione content. The residual 10% seems to resist depletion at high concentrations of buthionine sulfoximine. Glutathione depleted cells proliferate at a rate similar to that of non-depleted cells, and show full viability. Upon transfer of cells into inhibitor-free medium, they fully regain their original glutathione content. It is concluded that these cells contain at least two pools of glutathione: a large cytoplasmic pool and a smaller, possibly mitochondrial, pool. It is further concluded that the large pool of cytoplasmic glutathione is not obligatory for cell growth and mitosis. PMID- 6487305 TI - 3'-Deoxyinosine as an anti-leishmanial agent: the metabolism and cytotoxic effects of 3'-deoxyinosine in Leishmania tropica promastigotes. AB - 3'-Deoxyinosine is a potent inhibitor for growth of the promastigote form of Leishmania tropica. In culture, EC50 value is 4.43 X 10(-7) M for the promastigote. On the other hand, it is less toxic towards mouse mammary tumor FM3A cells: EC50 value is 1.25 X 10(-4) M. 3'-Deoxyinosine is metabolized by Leishmania promastigote to give 3'-deoxyinosine-5'-monophosphate and 3' deoxyadenosine(cordycepin)-5'-mono-, di-, and triphosphates. This metabolic conversion provides a mechanism for the parasite-selective toxicity of 3' deoxyinosine: Leishmania can aminate the 6-position of 3'-deoxyinosine residue, thereby converting a less toxic nucleoside into the cordycepin nucleotides that are known to be highly toxic to cells. PMID- 6487306 TI - PTH release stimulated by high extracellular potassium is associated with a decrease in cytosolic calcium in bovine parathyroid cells. AB - We employed the calcium (Ca++)-sensitive, intracellular dye QUIN-2 to examine the role of cytosolic Ca++ in the stimulation of PTH release by high extracellular potassium (K+) concentrations. Addition of 55 mM KC1 to cells incubated with 115 mM NaC1 and 5 mM KC1 lowered cytosolic Ca++ at either low (0.5 mM) extracellular Ca++ (from 194 +/- 14 to 159 +/- 9 nM, p less than .01, N = 6) or high (1.5 mM) extracellular calcium (from 465 +/- 38 to 293 +/- 20 nM, p less than .01, N = 10). This reduction in cytosolic Ca++ was due to high K+ per se and not to changes in tonicity since addition of 55 mM NaC1 was without effect while a similar decrease in cytosolic Ca++ occurred when cells were resuspended in 60 mM NaC1 and 60 mM KC1. PTH release was significantly (p less than .01) greater at 0.5 and 1.5 mM Ca++ in QUIN-2-loaded cells incubated with 60 mM NaC1 and 60 mM KC1 than in those exposed to 115 mM NaC1 and 5 mM KC1. In contrast to most secretory cells, therefore, stimulation of PTH release by high K+ is associated with a decrease rather than an increase in cytosolic Ca++. PMID- 6487307 TI - In vitro biosynthesis of isoprene from mevalonate utilizing a rat liver cytosolic fraction. AB - The in vitro biosynthesis of isoprene from DL-mevalonate in the cytosolic fraction of rat liver is described. Evidence is provided suggesting a non enzymatic formation of isoprene from isopentenyl pyrophosphate and/or dimethylallyl pyrophosphate. Furthermore, the data establish an alternate fate of the mevalonate carbon skeleton providing the first evidence that breath isoprene is linked to cholesterol biosynthesis. PMID- 6487308 TI - Differential kinetics of histone H1(0) accumulation in neuronal and glial cells from rat cerebral cortex during postnatal development. AB - The accumulation of histone H1(0) as been studied in neuronal and glial nuclei from rat cerebral cortex during postnatal development. In neurons H1 degrees represents approximately 2% of the H1 content at birth and remains unchanged until day 8. Beyond this point H1 accumulates rapidly until day 18, where it levels off at 16% of H1. The midpoint of the transition is at day 14. In glial cells H1 represents approximately 2.5% of the H1 at birth. It starts to accumulate between days 18 and 21; its concentration raises rapidly up to day 30 slowing down from then on. At day 300 (the farthest point examined) it represents 21% of H1. These results are discussed in relation to the events of the postnatal development of the cerebral cortex in the rat. It is concluded that H1 probably does not suppress cell proliferation. PMID- 6487309 TI - Iron depletion: possible cause of tumor cell cytotoxicity induced by activated macrophages. AB - The experiments reported here provide a possible molecular mechanism for the activated macrophage cytotoxic effect. Tumor cells that develop cytostasis and inhibition of mitochondrial respiration in response to cocultivation with activated macrophages release a significant fraction of their intracellular iron 59 content. Kinetic studies show that specific release of iron-59 from target cells begins 4-6 hours after initiating cocultivation which is the time point that inhibition of DNA synthesis is first detected. Treatment of tumor cells with metabolic inhibitors causing inhibition of respiration, protein synthesis, RNA synthesis, and DNA synthesis to a similar or greater extent than that caused by activated macrophages does not induce release of intracellular iron-59. It is significant that mitochondrial respiration and DNA replication, both strongly inhibited in target cells by activated macrophages, are metabolic pathways with enzymatic activity vulnerable to inhibition by depletion of intracellular iron. PMID- 6487310 TI - Deoxynucleoside triphosphate pool changes and UV-induced depression of DNA synthesis. AB - It has been reported that changes in deoxynucleotide pool levels following exposure to UV might lead to an overestimation of the UV-induced depression in DNA synthesis as analyzed by incorporation of 3H-thymidine (1). We attempted to determine the importance of such pool effects in two ways. First, we examined the grain density along DNA fiber autoradiographs obtained from CHO AA8, and CHO UV-5 cells exposed or sham exposed to UV. Exposure to UV did not alter the grain density immediately or 5 hours after exposure to UV in these cell lines. Second, we examined the kinetics of incorporation of 3H-dTTP in permeabilized AA8 cells under conditions of increased dCTP or increased exogenous dTTP levels. The extent of the depression of 3H-dTTP was identical under all incubation conditions. PMID- 6487311 TI - On the fundamental role of the Glu 2- ... Arg 10+ salt bridge in the folding of isolated ribonuclease A S-peptide. AB - The fundamental role of the Glu 2- ... Arg 10+ salt bridge in the folding of isolated S-peptide (1-19 N-terminal fragment of Ribonuclease A) is demonstrated from the comparison of the helix contents, at 0 degrees C, of S-peptide and related peptides. Helix contents have been determined from the analysis of proton chemical shift vs. temperature curves. The observed data can be accounted for by assuming that two side-chain interactions contribute to stabilize the 3-13 helix of S-peptide, the salt bridges Glu 2- ... Arg 10+ and Glu 9-... His 12+, the former being more effective. The salt bridge Glu 9- ... Arg 10+ turns to a weaker interaction, a hydrogen bond Glu 2 (C delta = 0) ... Arg 10+, on protonation or esterification of the Glu 2 carboxylate. PMID- 6487312 TI - Two kinetically distinguishable ATP sites in firefly luciferase. AB - Results are presented which indicate that firefly luciferase has two catalytically active sites. One site, Km of 1.1 X 10(-4) M ATP, is responsible for the initial flash and is apparently product inhibited for further light production. The second site, Km of 2 X 10(-5) M ATP, catalyzes the continuous low production of light. ATP or AMP is a potent inhibitor of the initial flash when LH2-AMP is used to initiate the light reaction but appears to have no affect on the second site low level light emission. Both sites must be occupied by ATP for the formation of one L-AMP. Thus, ATP appears to function both as a catalytically active substrate and a regulator for light emission. PMID- 6487313 TI - Oscillation of electrical potential in a porous-membrane doped with triolein induced by an Na+/K+ concentration gradient. AB - The electrical potential across a fine pore membrane doped with trioleoyl glyceride (triolein) and separating aqueous solutions of 0.5M NaCl and 0.5M KCl, respectively, was studied. It was found that this system showed rhythmic and sustained oscillations of electrical potential between the two aqueous solutions. These oscillations were attributed to the change of permeability of Na+ and K+ ions across the membrane, which originated from the phase-transition of triolein molecules within the fine pores. PMID- 6487314 TI - The effects of extracellular K+ and angiotensin II on cytosolic Ca++ and steroidogenesis in adrenal glomerulosa cells. AB - We evaluated changes in cytosolic calcium concentration (Ca++) and steroidogenesis in rat adrenal glomerulosa cells (GC) stimulated with potassium (K+) or angiotensin II (AII). Cytosolic Ca++ concentration was determined using the Ca++-sensitive, fluorescent dye QUIN 2. Raising extracellular K+ increased cytosolic Ca++ from 267 +/- 23 nM at 3.7 mM K+ to a maximum of 377 +/- 40 nM at 8.7 mM K+ (p less than 0.01, N = 23). AII also increased cytosolic Ca++ from 238 +/- 20 nM to a maximum of 427 +/- 42 nM at 10(-7) M (p less than 0.01, N = 16). In parallel studies, K+ and AII stimulated aldosterone secretion from QUIN 2 loaded GC at concentrations similar to those which raised cytosolic Ca++. QUIN 2 loaded cells were as responsive steroidogenically as unloaded cells and showed trypan blue exclusion of 98% suggesting that QUIN 2 did not compromise cellular viability. These results provide direct support for a role of cytosolic Ca++ as a second messenger during stimulation of aldosterone secretion by both K+ and AII. PMID- 6487315 TI - Studies on thiol proteinase inhibitors in rat peripheral blood cells. AB - The concentrations of two types of endogenous thiol proteinase inhibitors, TPI alpha and TPI-beta, in rat peripheral blood cells were determined by sensitive immunoassay methods. The concentration of TPI-alpha was highest in neutrophils among the peripheral blood cells tested. On the contrary, the concentration of TPI-beta was highest in macrophages followed in order by neutrophils, lymphocytes and erythrocytes. The serum level of TPI-beta was 47 times that of TPI-alpha. Immunohistochemical studies showed that in rat liver, TPI-beta was localized in Kupfer cells, and that only little TPI-alpha was present in liver tissue. PMID- 6487316 TI - Thermal melting of poly(dA-dT).poly(dA-dT) in methanol-water solutions. AB - Thermal melting of a synthetic DNA poly(dA-dT).poly(dA-dT) was investigated in methanol-water solutions. Methanol decreased melting temperature of the polynucleotide but the decrease was qualitatively different in the presence of milimolar concentrations of sodium and cesium cations. The difference is a consequence of the fact that poly(dA-dT).poly(dA-dT) undergoes a helix-helix conformational isomerization in methanol-water solutions which is cesium cation specific. The arising conformation is much more stable than the conformation which poly(dA-dT).poly(dA-dT) adopts in solutions with sodium cations at high methanol concentrations. The (A+T) rich DNA of Bacillus cereus displays a similar behaviour. PMID- 6487317 TI - The L-aspartate oxidase reported to be present in higher plants is actually glutamic oxaloacetic transaminase. AB - We previously reported (Biochem. Biophys. Res. Commun. (1983) 111, 188-193) that cotton callus cells contain an L-aspartate oxidase which requires an unidentified cofactor with an apparent molecular weight of 1,050. Further study has revealed that this report was in error. The enzyme is actually glutamic oxaloacetic transaminase and the "cofactor" has been identified as alpha-ketoglutarate. PMID- 6487318 TI - Irreversible inhibition of hepatic glutathione S-transferase by ciprofibrate, a peroxisome proliferator. AB - Ciprofibrate (2-[4-(2,2-dichlorocyclopropyl) phenoxy]2-methyl propionic acid) which is a hypolipidemic agent and has been shown to cause peroxisome proliferation, non-competitively inhibits glutathione S-transferase activity of rat liver, both in vivo and in vitro. Among all the glutathione S-transferases of rat liver, ligandin is maximally inhibited by ciprofibrate. Studies with the purified glutathione S-transferases of rat liver indicate that the affinities of different subunits of liver enzymes for ciprofibrate are in the order Ya greater than Yb, Yb' greater than Yc. PMID- 6487319 TI - Cartilage type IX collagen is cross-linked by hydroxypyridinium residues. AB - Type IX collagen, a recently discovered, unusual protein of cartilage, has a segmented triple-helical structure containing interchain disulfides. Its polymeric form and function are unknown. When prepared by pepsin from bovine articular cartilage, type IX collagen was found to contain a high concentration of hydroxypyridinium cross-links, similar to that in type II collagen. Fluorescence spectroscopy located the hydroxylysyl pyridinoline and lysyl pyridinoline cross-linking residues exclusively in the high-molecular-weight collagen fraction, from which they were recovered predominantly in a single CNBr derived peptide. The results point to a structural role for type IX collagen in cartilage matrix, possibly as an adhesion material to type II collagen fibrils. PMID- 6487320 TI - Simultaneous detection of native and luminol-dependent luminescence of stimulated human polymorphonuclear leukocytes. AB - A method for investigating the cellular response of polymorphonuclear leukocytes to various stimuli was introduced using simultaneously native (luminol independent) and luminol dependent luminescence as an indicator for myeloperoxidase (MPO)-H2O2-halide and O2- mediated reactions. In experimental systems containing low concentrations of luminol the total light emission was separated into contributions of native and luminol-dependent luminescence by making use of the different spectral behaviour of the two kinds of luminescence. Consequently the MPO-H2O2-halide system could be distinguished from the O2- dependent system by interpreting the recorded temporal traces of the emitted light. PMID- 6487321 TI - Extreme X-ray sensitive modification of type I aldolases by blue dye ligand chromatography. AB - Aldolases purified by Blue dye ligand chromatography from a variety of vertebrate sources crystallize at room temperature in a habit similar to the monoclinic form of rabbit skeletal muscle aldolase. Crystals of aldolases thus purified including rabbit muscle aldolase are extremely sensitive to X-ray (Cu K alpha) radiation and shatter after short exposure to X-ray radiation (less than 5 min.). Crystals of aldolases purified by other techniques possess demonstrable diffraction patterns and are stable in the X-ray beam with lifetimes of the order of days. No clear distinction could be made on the basis of different biochemical assays between aldolases purified by Blue dye chromatography and those purified by other techniques. PMID- 6487322 TI - The B4 lectin from Vicia villosa seeds interacts with N-acetylgalactosamine residues on erythrocytes with blood group Cad specificity. AB - We have previously shown that the B4 lectin from Vicia villosa seeds interacts with N-acetylgalactosamine alpha-linked to serine or threonine in cell surface glycoproteins. In the present study, we show that the lectin also binds to Cad erythrocytes (0.44-2.78 X 10(6) sites/cell) with an association constant of 0.61 0.84 X 10(7)M-1. Variability in the number of B4 lectin binding sites in Cad erythrocytes from different individuals parallels reactivity of these erythrocytes with other N-acetylgalactosamine-binding lectins. Agglutination of Cad erythrocytes with B4 lectin is inhibited by urinary Tamm-Horsfall Sda-active glycoprotein. Since the Cad and Sda determinants share the terminal GalNAc beta 1.4----Gal sequence, our results indicate that Vicia villosa B4 lectin can also interact with terminal beta-linked N-acetylgalactosamine in closely-spaced oligosaccharide units of cell surface glycoproteins. PMID- 6487323 TI - Subcellular glutathione contents in isolated hepatocytes treated with L buthionine sulfoximine. AB - The glutathione contents of the mitochondrial and cytosolic fractions and extracellular space of isolated hepatocytes decrease when glutathione synthesis is inhibited with L-buthionine sulfoximine. Mitochondrial glutathione is depleted to 50% of its initial value whereas the cytosolic pool is completely emptied after 2 h incubation in the presence of inhibitor. The mitochondrial glutathione content was only fully depleted when L-buthionine sulfoximine was added together with phorone (2,6-dimethyl-2,5-heptadiene-4-one), a substrate of the glutathione S-transferases (E.C. 2.5.1.18). PMID- 6487324 TI - Effect of unsaturated fatty acids on protoporphyrinogen oxidation, a step in heme and chlorophyll synthesis in plant organelles. AB - Oleic acid stimulates enzymatic protoporphyrinogen oxidation by extracts of barley mitochondria and etioplasts. Greater stimulation occurred with Triton X 100 extracts which had been passed over a Sephacryl S-200 column than with crude Triton extracts, suggesting that purification may have removed a lipid factor required for optimal enzymatic activity. Palmitic acid, various phospholipids and detergents, or esters and alcohols of oleic acid did not substitute for free oleic acid. Linoleic acid caused a greater stimulation of protoporphyrinogen oxidation in both crude and purified barley organelle extracts and also caused a slow chemical oxidation of protoporphyrinogen. The stimulating effect of unsaturated fatty acids on enzymatic protoporphyrinogen oxidation may indicate a lipid requirement for this membrane bound enzyme or may also indicate involvement of unsaturated lipid oxidation in plant protoporphyrinogen oxidation. PMID- 6487325 TI - Micro-analysis for coenzyme Q10 in endomyocardial biopsies of cardiac patients and data on bovine and canine hearts. AB - A micro-analysis was designed for determining the levels of coenzyme Q10 (CoQ10) in specimens of ca. 500 nanograms of myocardial tissues. The prime steps included acetone extraction, purification by thin-layer chromatography, and HPLC. CoQ11 was the internal standard. This methodology was successful for human endomyocardial biopsies from cardiac patients before and after therapy with CoQ10 and has now been used for canine and bovine tissues. The mean canine CoQ10 level from six specimens from the left ventricle (l.v.) of a single animal is 0.99 +/- 0.06 micrograms/mg/d.w. The mean levels of the tissues from nine animals is 1.04 +/- 0.17 (l.v.) and 1.11 +/- 0.16 (r.v.). The mean bovine level from seven animals was 0.48 +/- 0.12 (l.v.) and 0.68 +/- 0.06 (r.v.). PMID- 6487326 TI - Two forms of acid alpha-D-mannosidase in monkey brain: evidence for the co existence of high mannose and complex oligosaccharides in one form. AB - Lysosomal alpha-D-mannosidase of monkey brain existed in two forms. One form of mannosidase was bound to the Ricinus communis agglutinin120 (RCA1)-Sepharose and could be specifically eluted with lactose. The other form did not bind to the RCA1-Sepharose. Both forms of mannosidase could bind to a similar extent to the immobilized brain lysosomal receptor protein. Both the forms were purified to apparent homogeneity. Neutral sugar analysis by GLC showed the presence of glucose, mannose and galactose in the RCA1-Sepharose bindable mannosidase and glucose and mannose in the non-bindable mannosidase. Several other brain lysosomal hydrolases did not bind to the RCA1-Sepharose. The results suggested the existence of only high mannose oligosaccharides in the RCA1 non-bindable mannosidase and both high mannose and complex oligosaccharides in the bindable mannosidase. PMID- 6487327 TI - Amino-terminal sequence analysis of six cytochrome P-450 isozymes purified by monoclonal antibody directed immunopurification. AB - Six hepatic microsomal cytochromes P-450 were isolated from 3-methylcholanthrene induced animals by immunopurification using two monoclonal antibodies. Two forms of cytochromes P-450 (MW 56K and 57K) were from Sprague-Dawley rats, two from C57BL/6 mice (56K and 57K), one form from DBA/2 mice (56K) and one form from guinea pigs (53K). NH2-terminal sequences of the first ten amino acids of these cytochromes P-450 were determined by automated Edman degradation. The 56K polypeptides from rats, C57BL/6 mice, and DBA/2 mice were shown to have identical NH2-terminal sequences. The 57K polypeptides from rats and C57BL/6 mice are homologous to each other but exhibit no homology to 56K polypeptides. The 53K polypeptide from guinea pigs has a unique NH2-terminal sequence with no apparent homology to the other five cytochromes P-450. PMID- 6487328 TI - Inhibition of reconstituted vitamin D3 25-hydroxylase by a protein fraction from rat liver microsomes. AB - A cytochrome P-450 fraction, containing vitamin D3 25-hydroxylase activity after reconstitution, was prepared from rat liver microsomes. The 25-hydroxylase activity increased considerably upon purification. A protein fraction isolated from the microsomes during the preparation markedly inhibited the reconstituted vitamin D3 25-hydroxylase activity. The inhibition was dependent on the amount of protein and completely reversed by heat treatment. PMID- 6487329 TI - Photochemical cross-linking of beta-galactoside-binding lectin to polylactosamino proteoglycan of chick embryonic skin. AB - beta-Galactoside-binding lectin from chick embryonic skin was coupled with a new photoactivatable, radioactive cross-linking reagent, [35S]N-succinimidyl-3 [(2 nitro-4-azidophenyl)-2-aminoethyldithio] propionate, and was allowed to interact with an insoluble preparation from skin. After UV irradiation, the lectin was specifically cross-linked to a high-molecular-weight substance, which was degraded by endo-beta-galactosidase and pronase. This suggests that the endogenous receptor is polylactosamino-proteoglycan. The interaction between the lectin and polylactosaminoglycan has implications for the role of the lectin in embryonic differentiation. PMID- 6487330 TI - In vivo 13C nuclear magnetic resonance spectroscopy using a solenoid transmit/receiver coil. AB - Topical nuclear magnetic resonance spectroscopy (NMR) using a solenoid transmit/receiver coil has been used to monitor the kinetics of intragastric utilization of [1-13C] glucose in mice in vivo. Using a double-tuned solenoid coil, signal to noise response was excellent and the natural abundance in vivo 13C spectra obtained with acquisition times of 10-15 minutes compares more than favourably with comparable studies using surface or saddle coils. This study clearly shows the potential of solenoid coils to monitor the kinetics of 13C labelled metabolites in vivo. PMID- 6487331 TI - Glycosylation of lens proteins in senile cataract and diabetes mellitus. AB - We have investigated glycosylation of lens proteins in diabetic and non-diabetic senile cataract patients. Our study reveals that glycosylation of lens cortical proteins, but not of nuclear proteins, is significantly higher in diabetic patients with senile cataract. This finding serves to clarify the confusion over glycosylation of lens proteins as it relates to diabetes mellitus and further contributes to an understanding of glycosylation of lens tissues as a distinct posttranslational modification. PMID- 6487332 TI - Change in the protein tertiary structure with non-enzymatic glycosylation of calf alpha-crystallin. AB - Non-enzymatic glycosylation of calf alpha-crystallin was induced by incubation with glucose. Glycosylated and non-glycosylated proteins were separated by affinity chromatography on Glyco Gel B boronic acid and were studied by circular dichroism (CD) and fluorescence. CD indicated that the glycosylated protein secondary structure was not altered, but the tertiary structure did undergo some changes. The CD band of this protein between 290 and 310 nm decreased in intensity. Extrinsic fluorescence probes, TNS (6-(p-toluidinyl) naphthalene-2 sulfonate) and MIANS (6-(4'-maleimidyl-anilino) naphthalene-2-sulfonic acid), indicated changes in both TNS binding sites and the sulfhydryl groups to a less hydrophobic microenvironment. Our results suggest that the glycosylation of protein leads to partial unfolding, and facilitates the sulfhydryl to oxidation. PMID- 6487333 TI - Natural variation in the expression of cytochrome P-450 and dimethylnitrosamine demethylase in Drosophila. AB - Electrophoresis of Drosophila microsomes resolves two major heme-containing protein bands with apparent molecular weights of 59,290 (band a) and 55,750 (band b). The hemoproteins in these two bands can account for most of the cytochrome P 450 in the organism. Band a is present in all strains examined: band b is not. Dimethylnitrosamine demethylase, a P-450 enzyme, is a component of band b. PMID- 6487334 TI - On the inhibition of the RNA polymerase-catalysed synthesis of RNA by daunomycin. Interference of the inhibitor with elongation and pre-longation steps. AB - The inhibition of the RNA polymerase-catalyzed synthesis of RNA by daunomycin was examined. Saturation binding of daunomycin to the template leads, as expected, to complete inhibition of RNA synthesis as a result of daunomycin interference with enzyme-template interactions. However at concentrations of the inhibitor below saturation formation of the enzyme-template complex remains remarkably undisturbed, while both the transformation of this complex to an elongating complex and the elongation of the nacsent RNA chains are substantially inhibited. Clearly, daunomycin interferes with a number of different substeps of RNA synthesis and inhibits the synthesis by different mechanisms depending on the amount of inhibitor bound to the template. Elucidation of the mechanism of inhibition at low daunomycin concentrations may be a prerequisite for a better understanding of the mechanism of the pharmacological action of the drug. PMID- 6487335 TI - Revised analysis of amino acid replacement in a prealbumin variant (SKO-III) associated with familial amyloidotic polyneuropathy of Jewish origin. AB - Amyloid fibril protein (SKO-III) of 14K daltons associated with familial amyloidotic polyneuropathy of Jewish type was identified by Pras et al. as a prealbumin variant with a single amino acid substitution of a glycine for a threonine at position 49, mainly based on data obtained by automated sequence analyses. Structural re-investigation of SKO-III was performed by comparing tryptic peptide maps of SKO-III and normal human prealbumin. The present analysis reveals that the reported replacement at position 49 is not present in the molecule of SKO-III. SKO-III should be revised to be a prealbumin variant with one amino acid substitution of an isoleucine for a phenylalanine at position 33. PMID- 6487336 TI - Impaired plasma membrane glycoprotein assembly in the liver following acute ethanol administration. AB - The in vivo effects of acute ethanol administration on hepatic plasma membrane assembly were studied in the rat. When [14C]fucose and [3H]N-acetylmannosamine, a sialic acid precursor, were injected following an acute dose of ethanol, minimal effects on fucose and a slight reduction of sialic acid incorporation into the total pool of hepatic membrane glycoproteins were observed. However, the assembly of labeled fucoproteins and sialoproteins into the plasma membrane was markedly inhibited in the ethanol-treated animals. These results indicate that ethanol administration impairs the late stages of membrane assembly which include the transport of glycoproteins from the Golgi complex to the plasma membrane and/or the insertion of glycoproteins into the membrane. PMID- 6487337 TI - A subnanosecond-pulse fluorometric study of the CA2+ and MG2+ induced conformational changes on S-100a protein. AB - The fluorescence parameters of the single tryptophan residue (Trp 90 alpha) in S 100a (alpha beta) protein have been studied by steady state fluorimetry and by subnanosecond fluorescence decays excited by pulsed-picosecond laser system. At pHs 7.1 and 8.5, double exponential decays were consistently observed. At both pHs, Ca2+ and to a less extent Mg2+ ions proved to modify the percentage contribution of the two decaying species. The interest of the finding is discussed. PMID- 6487338 TI - Effect of heparin modification on its circular dichroism spectrum. AB - The effect of modification of the carboxyl groups of high affinity heparin was investigated. The binding affinity toward antithrombin III decreases in the following order: Heparin greater than heparin methyl ester greater than heparinylglycine greater than heparinylglycine methyl ester. This result agrees qualitatively with the previous studies using unfractionated heparin. Esterification of the carboxyl groups (i.e., HME) does not affect the CD profile of heparin at 210 nm but introduction of a bulkier glycine methyl ester (i.e., HGME) leads to formation of a very intense band at 235 nm. Based on reported CD analyses of uronic acid derivatives and our model building studies, it is concluded that the large difference in CD spectra of HGME as compared to unmodified heparin and HME is due to a change in ring conformation of the uronic acid moiety (i.e., 4C1 to 1C4 or vice versa). PMID- 6487339 TI - The major rat heart glutathione S-transferases are anionic isozymes composed of Yb size subunits. AB - The GSH S-transferases from rat heart cytosol has been purified by S hexylglutathione-linked Sepharose-6B affinity chromatography. The majority (approximately 80%) of these GSH S-transferases are anionic isozymes which can be resolved further by DEAE-cellulose column chromatography and isoelectric focusing. They are mainly composed of Yb size (Mr = 27,000) subunits with different substrate specificity patterns from the rat liver anionic GSH S transferases. The major cationic GSH S-transferases from liver are not expressed in rat heart. Although some cationic GSH S-transferases from rat heart can be purified by CM-cellulose column chromatography they are composed of major subunits of Yb electrophoretic mobility. PMID- 6487340 TI - Photochemical intermediate of third rhodopsin-like pigment in Halobacterium halobium by simultaneous illumination with red and blue light. AB - We found new photochemical intermediate of third rhodopsin-like pigment (tR) or slow cycling rhodopsin-like pigment (sR) in Halobacterium halobium, which was produced by simultaneous illumination with red and blue light. This illumination is employed for measurements of negative phototaxis. The formation of this intermediate is fast. (With the instrument used, it could not be measured.) The half-time of its decay is ca 150 msec in 4 M NaCl, pH 7.0 at 20 degrees C. The maximum of absorbance is located at 510-530 nm. PMID- 6487341 TI - Lithocholate detoxification and biliary secretion in the rat. AB - To define the efficiency of hepatic detoxification, 14C lithocholate in combination with taurocholate was continuously infused intravenously into rats until steady-state. Quantitation of hepatic radiolabelled bile acid under these conditions showed only 11% of total liver bile acid was unmetabolised, indicating very efficient detoxification of lithocholate, in its most hepatotoxic state. Interestingly we found the rate for each bile acid to reach steady-state differed. To test whether the difference was due to glutathione S-transferase binding, as proposed by Strange et al (8), glutathione S-transferase levels were induced by phenobarbitone treatment. An increase in cytosol glutathione S transferase levels had no effect on the time it took for each bile acid to reach steady-state. PMID- 6487342 TI - Rapid increase of profilin-like proteins during liver development. AB - Extraction of the cytoplasm of rat liver with 5% PCA and subsequent TCA (20%) treatment resulted in the recovery of only a few proteins, the predominant one having an apparent molecular weight of 12K. This 12K protein increased sharply (9 fold) between 2 weeks and 10-20 weeks and then decreased until at least 2 years after birth. 12K protein was separated into two components, 12K-1 (larger) and 12K-2 (smaller), by gel chromatography which had similar amino acid compositions to those of profilin (from Acanthamoeba and hog thyroid). Like profilin, 12K-1 protein inhibited the rate of actin polymerization, while 12K-2 protein did not. These findings suggest that liver profilin-like proteins increase sharply during development. PMID- 6487343 TI - D-amphetamine and DL-alpha-N-methyltryptamine eliminate the irreversible inhibition of mitochondrial monoamine oxidase, caused by clorgyline. The specific action on the tyramine oxidation. AB - A new hitherto unknown important property of D-amphetamine (but not L-isomer) and DL-alpha-N-methyltryptamine was discovered. These substances decrease the irreversible inhibition by clorgyline of tyramine deamination without affecting a sharply expressed inhibitory effect of clorgyline on serotonin oxidation. As a result of such a directed increase of selectivity, clorgyline became a still more highly specific inhibitor of serotonin oxidation without affecting, even at relatively high concentrations, tyramine deamination. PMID- 6487344 TI - Inactivation of toxin B from the Indian cobra by cleavage of a specific bond during limited hydrolysis with trypsin. AB - Two neurotoxins, "toxin B", a long neurotoxin from Naja naja, and "cobrotoxin", a short neurotoxin from Naja naja atra, were compared with respect to their limited hydrolysis by trypsin and chymotrypsin and its effect on their neurotoxicity. Limited hydrolysis of toxin B with trypsin cleaves peptide bonds at Arg68-Lys69 and Arg33-Gly34 in the toxin molecule and causes complete loss of the neurotoxicity yielding des-carboxyl terminal toxin B(1-68) nicked at Arg33-Gly34 in the molecule. On the other hand, the des-carboxyl terminal toxin B(1-67) shows 70% of the native toxin B neurotoxicity. These results indicated that the complete loss of the toxicity may be due to hydrolysis of a specific peptide bond, Arg33-Gly34, in the toxin B molecule. Limited trypsin digestion did not affect the toxicity of cobrotoxin and limited chymotrypsin digestion had no effect on either neurotoxin. PMID- 6487345 TI - Undermethylation of DNA in mononucleosomes solubilized by micrococcal nuclease digestion of HeLa cell nuclei. AB - To examine the distribution of 5-methylcytosine in chromatin DNA, DNA of HeLa cells was labeled with [3H-methyl]methionine and [14C] thymidine and analyzed after extensive digestion of the nuclei with micrococcal nuclease. When the chromatin solubilized with the nuclease was fractionated on a sucrose density gradient, DNA in mononucleosomes was considerably depleted in 5-methylcytosine, as compared with polynucleosomes. Electrophoretic separation of DNA from the chromatin also revealed the depletion of 5-methylcytosine in the mononucleosomal size of DNA. This was confirmed by the chromatographic analysis of 5 methyldeoxycytidine after enzymatic digestion of the DNA to nucleosides. Thus the DNA in mononucleosomes solubilized by extensive micrococcal nuclease digestion is depleted in 5-methylcytosine, suggesting that 5-methylcytosine is preferentially missing from the DNA in the nucleosome core particles. PMID- 6487346 TI - T-kinin and T-kininogen--children of new technology. PMID- 6487347 TI - The hemolytic activity of citral: evidence for free radical participation. AB - In the present investigation the hemolytic properties of citral were examined. Tests with different concentrations of citral showed that hemolysis of rat erythrocytes commenced after a lag period the length of which depended on the concentration of the hemolysin and tended to 100% hemolysis. Comparison of the characteristics of the hemolysis induced by high and low citral concentrations, indicated that two mechanisms are involved--a non specific steroid--terpenoid or glutathione depletion mechanism dominating at high citral concentrations and a free radical mechanism dominating at low citral concentrations. Experiments performed with various free radical scavengers indicate that 1O2 might be involved. PMID- 6487348 TI - Effects of an antimitotic agent (cyclophosphamide) on plasma lipoproteins. AB - A cyclophosphamide injection to male New Zealand white rabbits induced a pronounced hypertriglyceridemia and a hypercholesterolemia whose concentration was maximal at 16 hr. Different doses were studied. In this hyperlipemia significant changes in plasma lipoprotein fractions appeared: the very low density lipoproteins increased and the high density lipoproteins decreased. Lipid composition showed that HDL cholesterol was very low comparatively to a high VLDL cholesterol. The apoprotein composition of VLDL from treated rabbits was studied and compared to that of normal rabbits. After electrophoresis in urea/polyacrylamide gels, two new apoproteins which resembled those observed in irradiated rabbits appeared. The molecular weight of these proteins was about 10,000, and they focused into three bands with isoelectric points of 6.72, 6.42 and 6.10. Total lipoprotein lipase activity in treated rabbits decreased; it was very low with 32.5 mg/kg. This lipolytic activity remains to be studied after separation of hepatic triacylglycerol lipase and lipoprotein lipase activities by chromatography. PMID- 6487349 TI - Nonenzymatic glucosylation of human serum albumin and its influence on binding capacity of sulfonylureas. AB - To estimate the functional change occurring in human serum albumin by nonenzymatic glucosylation, glucosylated human serum albumin was prepared by in vitro incubation with glucose. The rate of glucosylation proceeded as a first order reaction. The binding of sulfonylureas to serum albumin was determined by equilibrium gel filtration. Through this method, it was possible to estimate the binding capacity of a low water solubility drug with a high affinity to protein. The amounts of the sulfonylureas bound to glucosylated HSA decreased by 44% with tolazamide and acetohexamide, 50% with glibenclamide, and 52% with tolbutamide, compared to human serum albumin (HSA). This suggests that a high concentration of glucosylated HSA in diabetic patients may possibly cause an increase in free drug concentration exceeding normal levels. This study shows that the decrease in the binding capacity of sulfonylureas with protein is due to the modification of albumin molecules by the covalent binding of glucose. PMID- 6487350 TI - Effects of gramine on energy metabolism of rat and bovine mitochondria. AB - The indole alkaloid gramine is found in several plant families. Its effects on mammalian mitochondria and submitochondrial particles were studied. Low concentrations of gramine slightly stimulated basal electron transport, totally inhibited the Ca2+-induced respiratory control and partially abolished the enhancement of 8-anilino-1-naphthalene sulfonate fluorescence induced by proton translocation coupled to ATP hydrolysis or to succinate oxidation. At higher concentrations gramine inhibited specifically the electron transport at the level of Complex I of the respiratory chain. The I50 values (2-6 mM) were dependent on the presence of uncouplers. Higher concentrations of the alkaloid also inhibited coupled succinate oxidation and ATP hydrolysis (I50 = 10 mM). Possible explanations for these effects are discussed. PMID- 6487351 TI - Agonist mediated conformational changes of solubilized calf forebrain muscarinic acetylcholine receptors. AB - Muscarinic receptors in calf forebrain membranes can be identified by the specific binding of the radiolabelled antagonist [3H]dexetimide. These receptors (2.8 pM/mg protein) comprise two non-interconvertible subpopulations with respectively high and low agonist affinity but with the same antagonist affinity. For all the agonists tested the low affinity sites represent 85 +/- 5% of the total receptor population. 0.5% Digitonin solubilized extracts contain 0.8 pM muscarinic receptor/mg protein. In contrast with the membranes, these extracts contain only sites with low agonist affinity. The alkylating reagent N ethylmaleimide causes an increase of the acetylcholine affinity for the low affinity sites in membranes as well as for the solubilized sites. This effect is time dependent until a maximal 3-fold increase in affinity is attained. The rate of N-ethylmaleimide action is enhanced by the concomitant presence of agonists. In contrast, N-ethylmaleimide does not affect antagonist binding. This suggests that agonists mediate a conformational change of both the membrane bound low affinity muscarinic sites and of the solubilized sites, resulting in their increased susceptibility towards NEM alkylation. PMID- 6487352 TI - Mechanism of action of paracetamol protective agents in mice in vivo. AB - The mechanism of action of cysteine, methionine, N-acetylcysteine (NAC) and cysteamine in protecting against paracetamol (APAP) induced hepatotoxicity in male C3H mice in vivo has been investigated by, characterising the effect of the individual protective agents on the metabolism of an hepatotoxic dose of APAP, and determining the efficacy of the protective agents in animals treated with buthionine sulphoximine (BSO), a specific inhibitor of glutathione (GSH) synthesis. Co-administration of cysteine, methionine or NAC increased, while co administration of cysteamine decreased, the proportion of GSH-derived conjugates of APAP excreted in the urine of mice administered APAP, 300 mg/kg. Pretreatment of animals with BSO abolished the protective effect of cysteine, methionine and NAC, whereas cysteamine still afforded protection against APAP after BSO treatment. In conjunction with other data, these results suggest the most likely mechanism for the protective effect of cysteine, methionine and NAC is by facilitating GSH synthesis, while the most likely mechanism for the protective effect of cysteamine is inhibition of cytochrome P-450 mediated formation of the reactive metabolite of APAP. PMID- 6487353 TI - A study of factors which determine the pharmacological response to vitamin K in coumarin anticoagulated rabbits. AB - The pharmacological response to vitamin K has been determined by measuring prothrombin complex activity (P.C.A.) in male New Zealand White rabbits anticoagulated (P.C.A. less than 20%) with the long acting 4-hydroxycoumarin brodifacoum, at a dose (10 mg/kg) which produces maximum antagonism of vitamin K1. Thus, according to current concepts, this animal model may be used to assess vitamin K requirements in the absence of a functional vitamin K-epoxide reductase. After intravenous administration of vitamin K1 (1 mg/kg) P.C.A. reached a maximum (64 +/- 19%) at 3 hr and then declined at a rate which corresponds to complete inhibition of clotting factor synthesis. Vitamin K2 (1 mg/kg) stimulated clotting factor synthesis for 2 hr, while cis-vitamin K1, vitamin K3, vitamin K1 2,3-epoxide and oral administration of vitamin K1 were ineffective. Plasma concentrations of vitamin K1 fell steeply during the 12 hr following administration of a pharmacological dose, and then declined with a terminal half-life of 18.9 +/- 9.0 hr. Comparison of the pharmacodynamic and pharmacokinetic data indicated that plasma concentrations in the range 0.4-1.0 microgram/ml are required for clotting factor synthesis in the limiting situation of maximum antagonism of vitamin K by coumarin anticoagulants. These findings explain why frequent and repeated administration of vitamin K1 may be necessary during coumarin poisoning. PMID- 6487354 TI - The binding and subsequent inhibition of tubulin polymerization in Ascaris suum (in vitro) by benzimidazole anthelmintics. AB - Benzimidazole anthelmintics may act by interfering with the microtubule system in Ascaris suum. Binding of benzimidazole anthelmintics, and their inactive metabolites, to A. suum tubulin was demonstrated by the inhibition of intestinal extracts of the nematode to bind [3H]colchicine. In addition, these compounds inhibited the polymerization of tubulin into microtubules in vitro. PMID- 6487355 TI - The effect of immunization with digoxin-specific antibodies on digoxin disposition in the mouse. AB - After intravenous dosing, digoxin was rapidly distributed to tissues, with a distribution half-life of 3.0 min. The highest digoxin concentrations at 1 hr post dosing were found in lymph nodes, adrenals, gallbladder (including contents), liver and kidney respectively. Digoxin concentrations in the heart, spleen, brain, lung, skeletal muscle and fat were similar to, or lower than, those in the plasma. The apparent volume of distribution (AVd) was 1 l/kg, and the plasma elimination half-life and clearance (Cl) 2.8 hr and 0.25 l/kg per hr respectively. When digoxin was given one day after passive immunization with digoxin-specific immunoglobulin G (IgG) or Fab fragments the respective plasma digoxin concentrations were elevated some 26- and 5-fold respectively compared with control values. Consequently there were reductions in AVd (93 and 32%) and Cl (94 and 50%). The effect of IgG treatment on clearance was still apparent when the hapten was given up to 14 days after immunization, while the weaker effect of Fab-treatment was less persistent. Although tissue digoxin concentrations were slightly lower in the immunised mice, it was only in the lymph nodes at 10 and 14 days after IgG treatment that the reduction in hapten concentration was statistically significant. PMID- 6487356 TI - Ethanol and isoniazid induce a hepatic microsomal cytochrome P-450-dependent activity with similar properties towards substrate and inhibitors and different properties from those induced by classical inducers. AB - Male Wistar rats were pretreated with chronic ethanol ingestion (3 weeks), phenobarbital in the drinking water (1 week), beta naphtoflavone or trans stilbene oxide (one daily i.p. injection for 3 days) or isoniazid (one daily i.p. injection for 7 days). All these treatments increased 4-nitroanisole O demethylase activity above the control level. Kinetic studies indicated that ethanol and isoniazid induction gave low apparent K0.5 (less than 0.1 mM), trans stilbene oxide and phenobarbital intermediate (0.1 mM less than K0.5 less than 0.5 mM) and beta naphtoflavone high K0.5 (greater than 0.5 mM) for the induced activities. Inhibition studies with 0.1 mM metyrapone, 0.1 mM imidazole or 5 mM 1,3-dioxolane provided further evidence that the induced activities had different properties. Differences were also observed in the subtypes of spectral type II interaction (IIa and IIb) with 0.1 mM imidazole or 0.1 mM metyrapone in the induced microsomes. The results indicate that demethylation of 4-nitroanisole is an effective reaction for distinguishing between three different types of cytochrome P-450 induction. The clinically important hepatotoxins ethanol and isoniazid appeared to induce the same type of cytochrome P-450 activity, and it is speculated that these toxins may predispose to hepatotoxicity by means of this common property. PMID- 6487357 TI - Characterization of soluble glutathione transferase activity in resting mononuclear leukocytes from human blood. AB - Glutathione transferase activity in the soluble fraction of resting human mononuclear leukocytes was measured and characterized using [3H] trans-stilbene oxide as a substrate. Because of the low activity of this enzyme in these cells, a published assay procedure developed for rodent liver was slightly modified to improve its sensitivity: the substrate was highly radiolabeled (2 Ci/mmole) and carefully purified, and the incubation time was extended to 30-60 min. The activity measured was linear with cell density up to at least 6 million cells. Soluble glutathione transferase activity measured in this manner has a pH optimum around 7.4 and an optimal temperature of 40 degrees. This activity could be measured in lymphocytes, monocytes, granulocytes, erythrocytes and platelets, but not in plasma. From these measurements it could be calculated that lymphocytes account for somewhat more than half of the total activity in the mononuclear leukocyte fraction and that monocytes account for the rest. The intraindividual variation in soluble glutathione transferase activity towards trans-stilbene oxide in the mononuclear leukocyte fraction from different subjects was only about 10%, whereas the interindividual variation in this same activity was 15 fold. An explanation for this relatively large interindividual variation is now being sought. PMID- 6487358 TI - Extrahepatic sulfation and glucuronidation in the rat in vivo. Determination of the hepatic extraction ratio of harmol and the extrahepatic contribution to harmol conjugation. AB - The phenolic compound, harmol, is metabolized by sulfation and glucuronidation in the rat in vivo. In the present study, various harmol infusion rates into the jugular vein were used to delineate first-order conditions whereby total body clearance was maximal and constant; at low infusion rates the steady state harmol concentration in blood varied proportionally with the infusion rate. At infusion rates of 167 nmole/min and below, the steady state clearance of harmol was 60 ml/min or 200 ml/min/kg. Because this value for total body clearance greatly exceeded the value for hepatic blood flow rate (20 ml/min for a 300 g rat), considerable extrahepatic conjugation of harmol was suggested. At higher harmol infusion rates the total clearance decreased. Since an intraportal infusion of 167 nmole/min to the rat yielded, during steady state, the same arterial harmol blood concentration as a 52 nmole/min jugular infusion, the hepatic extraction ratio of harmol in vivo was 0.7. Extrahepatic clearance, therefore, constituted about 77% of total body clearance (after taking the difference between total body clearance and hepatic clearance). Total sulfation clearance was 52 ml/min, and greatly exceed the value for hepatic clearance (14 ml/min). Extrahepatic clearance for sulfation (at least 38 ml/min) therefore accounted for a major proportion of the sulfation activity. Blood platelets did not seem to contribute to sulfation or glucuronidation in vivo. PMID- 6487359 TI - Difference in hepatic uptake kinetics of aspirin and salicylamide in rats. AB - Immediately after intraportal administration to rats, the ratio of liver to plasma concentrations for total aspirin was close to unity, whereas that for total salicylamide ranged from about 3 to 7. The hepatic accumulation of salicylamide appeared to be capacity-limited because the ratio decreased with increases in the dose. In vitro experiments with isolated hepatocytes indicated that aspirin was slowly transported into the hepatocytes by an apparently linear process only, while salicylamide was taken up very rapidly by both saturable and apparently linear transport processes. The cell to medium concentration ratio estimated for the initially net transported component of the unchanged drug was significantly larger with salicylamide, which give ratios from 3.5 to 19, than with aspirin which gave an almost constant value lower than 2 despite wide variations in the initial concentration. For the capacity-limited uptake process of salicylamide, the kinetic parameters were estimated as Vmax = 0.325 nmole X (mg cellular protein)-1 X sec-1 and Km = 201 microM. Among various metabolic inhibitors, 2,4-dinitrophenol (50 microM) inhibited the uptake of salicylamide most extensively. The present comparison of the in vivo and in vitro data for aspirin with those for salicylamide confirmed the previously reported difference in the hepatic first-pass effect of these two drugs. PMID- 6487360 TI - Effect of age upon the uptake and binding of calcium in rat aorta. PMID- 6487361 TI - The site of O-methylation by membrane-bound catechol-O-methyltransferase. PMID- 6487362 TI - Comparison of high affinity binding of calcium channel blocking drugs to vascular smooth muscle and cardiac sarcolemmal membranes. AB - The binding of the 1,4-dihydropyridine calcium channel blocker [3H]nitrendipine to canine cardiac sarcolemmal and bovine aortic membranes was found to be rapid, specific, saturable, and reversible. Dissociation constants (Kd) determined by Scatchard analysis were 0.14 and 0.16 nM and the maximal numbers of binding sites (Bmax) were 0.96 +/- 0.2 and 0.08 +/- 0.01 pmole/mg protein for cardiac and aortic membranes respectively. Values of Kd calculated from kinetic data were approximately 0.10 nM for both membrane preparations. Competition assays with the enantiomers of a nisoldipine derivative indicated that [3H]nitrendipine binds stereoselectively. The order of potency of several nifedipine analogs for inhibition of binding of [3H]nitrendipine to cardiac and aortic membranes paralleled their relative potencies for inhibition of contraction in smooth muscle. It is concluded that the high affinity binding sites for nitrendipine in bovine aortic smooth muscle membranes are similar to those of canine ventricular sarcolemma. PMID- 6487363 TI - Involvement of tryptophan residues of lysozyme in its binding with cytosine arabinoside. AB - Cytosine-1-beta-D-arabinofuronaside, an antileukemic drug and hen egg white lysozyme (E.C. 3.2.1.17) form a 1:1 complex with Ka 1.2 X 10(4) M-1 at low drug concentrations. However, association was cooperative in nature at high concentrations with values of Ka = 1.8 X 10(4) M-1 and N = 2. Involvement of tryptophan in the drug protein complex was evident from fluorescence quenching and from the association of the drug with free tryptophan with a Ka = 1.5 X 10(4) M-1. Modification of tryptophan 108 reduced the binding by 89% suggesting a major role for this residue in the binding process. Oxidation of tryptophan 62 and acetylation of lysine residues also decreased the affinity of the drug to the protein by 55 and 66% respectively. Binding improved with increase in temperature and positive values for change in enthalpy and entropy were obtained. Ara-C inhibited lysozyme activity noncompetitively. PMID- 6487364 TI - Two mechanisms of adriamycin-DNA interaction in L1210 cells. AB - Among the effects exerted by adriamycin (ADR), interaction with DNA is closely related to cytotoxicity. The interaction results in the formation of protein associated DNA single-strand breaks (PA-SSB) and, at drug levels greater than or equal to 2.8 X 10(-6) M, also in "direct" (nonenzymatic) DNA single-strand breaks (D-SSB). To characterize the two types of DNA lesions, euoxic mouse leukemia L1210 cells were treated with various antioxidant agents in the presence of 2.8 X 10(-6), X 10(-5), or X 10(-4) M concentrations of ADR. The enzymes superoxide dismutase (200 micrograms/ml) or catalase (250 micrograms/ml), the OH' scavengers dimethyl sulfoxide (70 mM) or ethanol (70 mM), and an inhibitor of superoxide production, 2-deoxy-glucose (1 and 10 mM), reduced the frequency of D-SSB to 18.3 to 68.2% of its level in ADR-treated controls, while the frequency of PA-SSB remained unchanged. These observations seem to indicate that ADR-mediated free radicals cause discernible DNA damage in euoxic cells only at very high drug concentrations, greater than the peak plasma level achievable clinically following i.v. bolus. At lower ADR levels, relevant to clinical use, another type of interaction between the drug and DNA prevails, which apparently does not involve a free-radical mechanism. PMID- 6487366 TI - Metabolic activation of 1-naphthol by rat liver microsomes to 1,4-naphthoquinone and covalent binding species. AB - 1-Naphthol was metabolized by rat liver microsomes, in the presence of an NADPH generating system, both to methanol-soluble metabolites including 1,4 naphthoquinone and an uncharacterized product(s) (X) and also to covalently bound products. NADH was much less effective as an electron donor than NADPH. Metyrapone, SKF 525-A and carbon monoxide all inhibited the metabolism of 1 naphthol to 1,4-naphthoquinone and to covalently bound products suggesting the involvement of cytochrome P-450 in at least one step in the metabolic activation of 1-naphthol to reactive products. Ethylene diamine, which reacts selectively with 1,2-naphthoquinone but not 1,4-naphthoquinone, did not affect the covalent binding whereas glutathione, which reacts with both naphthoquinones, caused an almost total inhibition of covalent binding. These and other results suggested that 1,4-naphthoquinone, or a metabolite derived from it, was responsible for most of the covalent binding observed and that little if any of the binding was due to 1,2-naphthoquinone. PMID- 6487365 TI - Antitumor activity of N-phosphonacetyl-L-aspartic acid in combination with nitrobenzylthioinosine. AB - N-Phosphonacetyl-L-aspartic acid (PALA) resistance may be due to the ability of tumor cells to utilize preformed circulating pyrimidine nucleosides, thereby overcoming the block of de novo pyrimidine biosynthesis which PALA causes. To test this hypothesis we examined the effects of PALA and nitrobenzylthioinosine (NBMPR) alone and in combination on B16 melanoma cells in vitro using a clonogenic assay and in vivo using growth delay. In medium containing purine and pyrimidine nucleosides at a final concentration of 28 microM, exposure to PALA (100 microM) alone or to NBMPR (10 microM) alone for periods up to 72 hr did not result in any cytotoxicity. However, exposures to PALA (100 microM) plus NBMPR (10 microM) resulted in a decrease in clonogenic survival to 0.011 at 72 hr. In medium without nucleosides, PALA (100 microM) exposure for 72 hr caused a similar decrease in survival to 0.015, whereas NBMPR (10 microM) had no effect on survival. The addition of uridine resulted in a concentration-dependent reversal of the cytotoxic effects of PALA. C57 Bl female mice bearing B16 melanoma were treated intraperitoneally daily for 4 days with PALA, the phosphate of NBMPR (NBMPR-P), or PALA plus NBMPR-P. PALA, 300 mg/kg daily X 4, resulted in a 6-day tumor growth delay but NBMPR-P, 100 mg/kg daily X 4, had no effect. PALA, 150 mg/kg daily X 4, plus NBMPR, 50 or 100 mg/kg daily X 4, resulted in a 6-day tumor growth delay also. These studies demonstrate that: (1) circulating pyrimidine nucleosides are determinants of the cytotoxic effects of PALA; (2) in vitro PALA and NBMPR combine to cause significant cytotoxicity whereas either agent alone has no effect; (3) in vivo the combination of PALA and NBMPR-P results in the same antitumor affect as PALA alone at twice the dose; and (4) due to an increase in animal toxicity, no therapeutic advantage could be demonstrated for the combination over PALA alone in vivo. We conclude that the cytotoxic effect of PALA is modulated by the levels of the preformed circulating nucleosides and that combining PALA with an inhibitor of salvage pyrimidine uptake would not increase the therapeutic efficacy of PALA because of an increase in toxicity. PMID- 6487367 TI - Current models of hepatic pharmacokinetics: flow effects on kinetic constants of ethanol elimination in perfused rat liver. AB - At present two different pharmacokinetic models of the enzymic elimination of substances from the blood flowing through the liver are used: the sinusoidal perfusion model assuming the elimination to take place at the local sinusoidal blood substrate concentration, falling continuously from the inlet to the outlet of the sinusoid, and the venous equilibration model assuming elimination at the hepatic outlet concentration. It is an ultimate requirement of such models that the estimates of the enzymic parameters Vmax and Km be independent of variations in hepatic blood flow rate. This was used to compare the two models experimentally. Ethanol was given at two successive constant infusion rates (7 and 10 mumol/min) to 11 livers from rats (200 g) perfused by a recirculating medium. In each of the infusion periods the hepatic blood flow rate was varied experimentally (10 and 17 ml/min, respectively). From the measured steady-state ethanol concentrations in the hepatic inlet and outlet, Km and Vmax were calculated from both models at both low and high blood flow rates. The Km calculated according to the venous equilibration model was significantly lower in the low-flow than in the high-flow periods (P less than 0.05); this model is thus not consistent with data. Vmax values were not influenced by hepatic blood flow. The Km calculated according to the sinusoidal perfusion model were not influenced by flow (P less than 0.5) and Vmax was also unchanged. The sinusoidal perfusion model is thus not inconsistent with data. PMID- 6487368 TI - Intra-arterial injection of diisopropylfluorophosphate or phenylmethanesulphonyl fluoride produces unilateral neuropathy or protection, respectively, in hens. AB - Hens injected in one sciatic artery with diisopropylfluorophosphate (DFP) (0.184 mg/kg) developed monolateral ataxia on the injected side 10-12 days later. The inhibition of neuropathy target esterase (NTE) was 85% in the sciatic nerve of the injected leg and less than 60% in the contralateral sciatic nerve, in spinal cord and in brain. Other hens injected in the wing vein with the same dose of DFP showed low inhibition of NTE in the nervous system and did not develop delayed neuropathy. Hens injected in one sciatic artery with phenylmethanesulphonyl fluoride (PMSF) (1 mg/kg) and 24 hr later with high subcutaneous dose of DFP (1.1 mg/kg) developed monolateral ataxia 10-12 days later on the side not injected with PMSF. The level of NTE inhibition after PMSF was greater than 40% in the sciatic nerve on the injected side compared with less than 20% in other parts of the nervous system. The same dose of PMSF injected in the wing vein produced low NTE inhibition in the nervous system and failed to protect the animals from the same high systemic dose of DFP. We conclude that both toxic and protective effects of NTE inhibitors for delayed neuropathy are better related to the level of NTE inhibition in the peripheral nerve on the site of injection than to NTE inhibition in other parts of the nervous system. Furthermore we suggest that NTE inhibition should also be measured in the peripheral nerve in the standard toxicity testing for organophosphate-induced delayed neurotoxicity. PMID- 6487369 TI - Hepatic extraction of chenodeoxycholic acid in dogs chronically intoxicated with dimethylnitrosamine. AB - The pharmacokinetics of chenodeoxycholic acid (CDCA) in hepatic dysfunction were evaluated by analyzing the plasma disappearance curves after simultaneous administration of [3H]- and [14C]-CDCA through the femoral and portal veins, respectively, in dogs chronically intoxicated with dimethylnitrosamine (DMN). The plasma concentration-time curve of intravenously administered [3H]-CDCA was best fitted to a three-exponential equation, while that of intraportally administered [14C]-CDCA was fitted to either a two- or a three-exponential equation. In the DMN-intoxicated dogs, significant decreases were observed in total body plasma clearance (CLp), hepatic extraction ratio (EH) and apparent intrinsic clearance (CLint) compared to those of the untreated (control) dogs. The hepatic blood flow (QH), calculated from CLp, CLint and blood-to-plasma concentration ratio (RB) according to the equation reported by Wilkinson and Shand [Clin. Pharmac. Ther. 18, 377 (1975)], was reduced to approximately 70% in the DMN-intoxicated dogs compared to the control dogs. The bindings of CDCA to plasma and liver cytosol fraction were determined by equilibrium dialysis; no significant difference was observed in the unbound fraction between the DMN-treated and control dogs. By comparing both pharmacokinetic parameters obtained from intravenous and intraportal administration, the usefulness of the oral bile acid tolerance test was examined. From these findings, it was suggested that the decrease in the CLp of the DMN-intoxicated dogs was due to both the decrease in QH and that in CLint, and that the decrease in CLint may be due not to an alteration of plasma or cytosol binding but to that of a carrier-mediated transport system. It is also suggested that the measurement of fasting plasma bile acid concentration or the oral bile acid tolerance test is more sensitive for the detection of hepatic dysfunction than the intravenous bile acid tolerance test. PMID- 6487370 TI - A novel biologically active seleno-organic compound--I. Glutathione peroxidase like activity in vitro and antioxidant capacity of PZ 51 (Ebselen). AB - a synthetic seleno-organic compound, 2-phenyl-1,2-benzoisoselenazol-3(2H)-one (PZ 51), exhibits GSH peroxidase-like activity in vitro, in contrast to its sulfur analog, PZ 25. In addition, PZ 51 behaves as an antioxidant shown by a temporary protection of rat liver microsomes against ascorbate/ADP-Fe-induced lipid peroxidation, an effect also elicited by PZ 25 but to a smaller extent. This protection against lipid peroxidation is independent of GSH and of P-450 monooxygenase activity. PMID- 6487371 TI - A novel biologically active seleno-organic compound--II. Activity of PZ 51 in relation to glutathione peroxidase. AB - The anti-inflammatory compound 2-phenyl-1,2-benzoisoselenazol-3(2H)-on (PZ 51) catalysed GSSG formation from GSH in the presence of hydroperoxides in an NADPH/GSSG reductase system with the following rates (delta log GSH/min per molar selenium): 1.1 X 10(6) with H2O2, 1.2 X 10(6) with butylhydroperoxide, 1.7 X 10(6) with cumenehydroperoxide. The reaction catalysed by the sulphur analogue of PZ 51 was negligible. Similar results were obtained in a direct assay of GSH-Px activity based on GSH estimation by dithionitrobenzoate. The activation energy of the reaction was determined as 55 kJ/mol . deg in the presence of 30 mumol/1 PZ 51 compared to 36.5 kJ/mol . deg obtained in the presence of 1 nmol/1 pure GSH-Px isolated from bovine red blood cells. In mouse liver microsomes, NADPH-dependent aminopyrine dealkylation was totally inhibited in the presence of 50 mumol/1 PZ 51. In vivo experiments with Se-deficient mice showed that the Se-moiety of PZ 51 is not available for the synthesis of the selenoenzyme GSH-Px after dietary treatment or i.p. doses up to 25 mg Se as PZ 51 per kg body wt. After oral administration of labelled PZ 51, unlike with selenite, no radioactivity was incorporated into GSH-Px within 48 hr. The data suggest that several similarities between PZ 51 and the active site of GSH-Px exist, resulting in the capability of the compound to catalyse the GSH-Px reaction. An extracellular pharmacodynamic action of the drug seems likely. PMID- 6487372 TI - Synthesis and evaluation of 2,4-diaminoquinazoline antifolates with activity against methotrexate-resistant human tumor cells. AB - In an attempt to find potent antifolates with selectivity against tumor cells with intrinsic or acquired resistance to methotrexate, eleven nonclassical 2,4 diaminoquinazoline antifolates were synthesized and tested as inhibitors of dihydrofolate reductase from L5178Y cells. Several compounds appeared to be good enzyme inhibitors, with I50 values around 1 nM. Two of the compounds were also good inhibitors of cell growth in vitro. One of these (PKC-32, 9-(2,4-diamino-5 methylquinazoline-6-methylene)aminophenanthren e) appeared to be 100-fold more potent than methotrexate as an inhibitor of growth of a methotrexate-resistant cell line with impaired transport for methotrexate. PKC-32 and PKC-155 were also tested against mouse tumors in vivo. PKC-32 was modestly active in vivo as compared with methotrexate. This drug may be a useful agent in the treatment of methotrexate-resistant tumors. PMID- 6487373 TI - Characterization of aminoglycoside-lipid interactions and development of a refined model for ototoxicity testing. AB - Aminoglycoside interactions with various phospholipids were measured in three model systems and compared with the ototoxicities of the drugs: (a) competition for [14C]neomycin binding; (b) competition for 45Ca2+ binding; and (c) effect on surface pressure of monomolecular lipid films. The efficacies of the antibiotics in displacing neomycin from phosphatidylserine, phosphatidylinositol or phosphatidylinositol bisphosphate were netilmicin greater than neomycin greater than or equal to gentamicin; the efficacies in displacing calcium from phosphatidylinositol, phosphatidylinositol phosphate or phosphatidylinositol bisphosphate were netilmicin greater than gentamicin greater than neomycin much greater than kanamycin greater than spectinomycin. Neither measure correlated well with the ototoxicities of the drugs which were quantitated at equimolar drug concentrations in cochlear perfusions: neomycin greater than gentamicin greater than or equal to tobramycin greater than netilmicin greater than or equal to amikacin. When monomolecular films of phosphatidylcholine with phosphatidylserine, cardiolipin, phosphatidylinositol, or phosphatidylinositol phosphate or bisphosphate were challenged with neomycin, the phosphatidylinositol bisphosphate film showed a unique dose-dependent increase in surface pressure while the others showed a decrease or no significant effect. The abilities of aminoglycosides to increase the surface pressure of a film of phosphatidylcholine:phosphatidylinositol bisphosphate (1:1 molar ratio) in the presence of 3 mM CaCl2 correlated well with their toxicities. Non-ototoxic cations increased the film pressure or left it unaffected. The results confirm the unique interactions between aminoglycosides and phosphatidylinositol bisphosphate as a possible basis of a mechanism of toxicity and development of a drug-screening system. PMID- 6487374 TI - Effect of retinoids on collagen production by chondrocytes in culture. AB - The effect of vitamin A and of some of its derivatives on chondrocytes in culture has been studied. In the presence of retinoids the proliferation of the cells decreased and they lost their characteristic polygonal shape and assumed a fibroblast-like morphology. All retinoids also caused dedifferentiation of chondrocytes as indicated by the induction of types I and III collagen. 13-cis retinoic acid (= isotretinoin) was the most active derivative in this aspect. Since appropriate control of the synthesis of extracellular matrix proteins is a prerequisite for their normal physiological function, alterations such as those observed here may be involved in the pathogenesis of side effects which are observed during the treatment of dermatological disorders with retinoic acid derivatives. PMID- 6487375 TI - Modulation of anti-metabolite effects. Effects of thymidine on the efficacy of the quinazoline-based thymidylate synthetase inhibitor, CB3717. AB - CB3717 (N-(4-(N-((2-amino-4- hydroxy-6-quinazolinyl)methyl)prop-2-ynylamino ) benzoyl)-L-glutamic acid) is an antitumour agent that inhibits thymidylate synthetase (TS). A dose-dependent fall in plasma thymidine (dThd) (1.43 microM to 0.47 microM) occurred in non-tumour-bearing mice following the administration of CB3717. Further, in mice carrying the L1210/CBRI tumour, the drug's antitumour properties were ablated by co-administration of dThd, an effect consistent with TS being the cytotoxic locus. In vitro studies of protection by dThd against CB3717 cytotoxicity were carried out in an attempt to quantify this reversal. The metabolism of [14C]-dThd was measured in cultures of L1210 cells (10(4)/ml) exposed to a completely cytotoxic dose of CB3717 (50 microM). The cytotoxicity of the drug was only expressed when the dThd concentration (0.5-2 microM) had fallen to less than 0.1 microM in the media. This reduction was due to: (1) dThd incorporation into DNA, (2) catabolism of dThd to thymine. By reducing the initial cell concentration to 10(3)/ml the depletion of dThd was substantially reduced and consequently cells continued to grow for a longer period. The critical concentration of dThd, below which growth in the presence of CB3717 could not be supported was estimated to be between 0.026 and 0.1 microM. Thus even the minimum level of dThd achieved in vivo was still in excess of that required for protection from CB3717 toxicity in vitro. There was a small accumulation of deoxyuridine (dUrd) (approximately 2-fold) in mouse plasma 24 hr after completion of a 5-day course of CB3717 (200 mg/kg) but in vitro studies demonstrated that this was unlikely to modulate CB3717 toxicity in the presence of dThd. We caution against the use of rodent tumour models (or human tumour xenografts) for antitumour or toxicity testing of compounds designed to inhibit the de novo synthesis of thymidylate; they may be misleading because the high dThd levels found in these animals compared with man may mask the cytotoxic effects of these drugs. PMID- 6487376 TI - In vitro effects of quinoline derivatives on cytochrome P-450 and aminopyrine N demethylase activity in rat hepatic microsomes. AB - A series of quinoline drugs was evaluated for the ability to inhibit rat liver microsomal aminopyrine N-demethylase (APDM) activity in vitro. Quinine was found to be a quite potent inhibitor of APDM from control rat liver (I50 = 0.061 mM) but was only approximately half as potent against APDM from phenobarbitone induced rat liver (I50 = 0.14 mM). Primaquine and amodiaquine were also relatively potent inhibitors of these activities, but quinidine and chloroquine were essentially non-inhibitory, especially against control-type APDM. Primaquine and quinine elicited characteristic type II optical difference spectra with oxidised cytochrome P-450 from both types of microsomes whereas chloroquine and quinidine were type IIb ligands for cytochrome P-450 in phenobarbitone-induced microsomal fractions. Good correlations were obtained for the logarithmic relationship between binding affinity (Ks) and inhibition potency (I50), as well as the logarithmic relationship between efficiency of binding (delta Amax/Ks) and inhibition. These findings suggest that the capacity of quinoline antimalarials, and similar drugs, to inhibit microsomal APDM activity is related to the affinity of the type II spectral binding interaction between the drug and oxidised cytochrome P-450. PMID- 6487377 TI - Effect of dietary fat upon ethanol metabolism in rats. AB - The effect of dietary fat upon ethanol metabolism was studied in rats. Wistar strain male rats were divided into four groups according to diet, namely alcohol high fat, alcohol-low fat, control-high fat, and control-low fat. After 4 weeks of feeding, blood ethanol levels following an intraperitoneal injection of 0.2 g ethanol/100 g of body weight were measured. The disappearance rate of blood ethanol was faster and the metabolic rate of ethanol was significantly greater in the alcohol-high fat group compared to the alcohol-low fat or non-alcoholic groups. Microsomal enzymes, such as the microsomal ethanol-oxidizing system, aniline hydroxylase, and glucose-6-phosphatase, were significantly higher in the alcohol-high fat group than in the alcohol-low fat or non-alcoholic groups. The ethanol uptake rate of the isolated perfused liver was increased significantly in the alcoholic groups. In the alcoholic rats, the high fat group showed significantly higher uptake than the low fat group. Although the ethanol uptake rate after 4-methylpyrazole treatment was not significantly different among the four groups, its fraction of the total ethanol uptake was increased significantly in the alcohol-high fat group. These results suggest that high fat diets accelerate ethanol metabolism through the microsomal ethanol-oxidizing system. PMID- 6487378 TI - Drug-protein conjugates--VII. Disposition of [3H]-ethinylestradiol-protein conjugates in the rat. AB - [3H]17 alpha-Ethinylestradiol [( 3H]EE2; 5 micrograms/kg, 98.5 muCi) was administered to a female rat. After 18 hr less than 0.02% of the dose was present per ml plasma. Approximately 60% of radioactivity present in plasma was irreversibly bound to proteins, as determined by exhaustive solvent extraction and by high performance ion exchange chromatography of proteins after removal of unbound metabolites with activated charcoal. After chronic administration of [3H]EE2 (5 micrograms/kg; 2 muCi per day) for 22 days, there was a three- to fourfold accumulation of radioactivity in the plasma, together with an accumulation of radioactivity in the lung, liver, kidney, spleen and brain, compared to animals receiving a single dose. The spleen showed the greatest (greater than tenfold) significant (P less than 0.001) accumulation of radioactivity. There was a greater increase in radioactivity irreversibly bound to the soluble fraction than to the microsomal fraction of the liver. [3H]EE2 was conjugated to rat serum proteins by incubation with rat microsomes in vitro. Upon administration to female rats, the [3H]EE2-rat serum protein conjugate had a small volume of distribution (12.5 +/- 0.5 ml), and its plasma concentration declined slowly (t 1/2 = 450 +/- 140 min). Immunization of male New Zealand White rabbits with a chemically synthesized conjugate of 2-hydroxyethinylestradiol (2 OH-EE2) and human serum albumin produced antibodies which bound EE2 and 2-OH-EE2 but not estrone. These data indicate that although reactive metabolite formation represents a minor biotransformation, drug protein conjugates may accumulate during chronic administration. PMID- 6487379 TI - Glutathione S-transferase activity during pregnancy in the mouse: effects of trans-stilbene oxide pretreatment. PMID- 6487380 TI - Internal field strength measurements in chick forebrains at 50, 147, and 450 MHz. AB - This report describes some experimental measurements of the internal field levels induced within isolated chick-forebrains irradiated at 50, 147, and 450 MHz, under essentially the same conditions as those used in the in vitro calcium-ion efflux experiments. Ratios of incident power at 50/147 MHz and 147/450 MHz that are needed to establish the same probe output are given and comparisons made with values predicted by different spherical models. Data predicted by the layered sphere model were found to be in close agreement with measured values for the 50/147-MHz ratio. Agreement for the 147/450-MHz ratio was poorer. PMID- 6487381 TI - Biological effects of a 765-kV, 60-Hz transmission line on honey bees (Apis mellifera L.): hemolymph as a possible stress indicator. AB - Number of circulating hemocytes and hemolymph protein patterns of adult worker honey bees were analyzed as possible indicators of stress resulting from colony placement under a 765-kV transmission line. Although exposure to 55, 80, and 95 microA total induced hive current (THC) produced colony behavioral disturbance, there were no consistent effects on mean hemocyte counts at 55- or 95-microA THC. Age-dependent declines in circulating hemocyte number were similar in all exposure groups. There were no consistent differences in tube-gel electropherograms. No consistent differences were found in two-density slab-gel electropherograms based on ultrasensitive silver stain. The 67 positively charged and four negatively charged protein fractions from overwintering bees are two- to threefold more than currently reported in the literature. PMID- 6487382 TI - In utero exposure to microwave radiation and rat brain development. AB - Timed-pregnancy rats were exposed in a circular waveguide system starting on day 2 of gestation. The system operated at 2,450 MHz (pulsed waves; 8 microseconds PW; 830 pps). Specific absorption rate (SAR) was maintained at 0.4 W/kg by increasing the input power as the animals grew in size. On day 18 of gestation the dams were removed from the waveguide cages and euthanized; the fetuses were removed and weighed. Fetal brains were excised and weighed, and brain RNA, DNA and protein were determined. Values for measured parameters of the radiated fetuses did not differ significantly from those of sham-exposed fetuses. A regression of brain weight on body weight showed no micrencephalous fetuses in the radiation group when using as a criterion a regression line based on two standard errors of the estimate of the sham-exposed group. In addition, metrics derived from brain DNA (ie, cell number and cell size) showed no significant differences when radiation was compared to sham exposure. We conclude that 2,450 MHz microwave radiation, at an SAR of 0.4 W/kg, did not produce significant alterations in brain organogenesis. PMID- 6487383 TI - Cerebrovascular permeability to 86Rb in the rat after exposure to pulsed microwaves. AB - Microwaves (pulsed, 2,450 MHz) at an average power density of 3 W/cm2 were applied directly to the head for 5, 10, or 20 min, producing a peak specific absorption rate of 240 W/kg in the brain, which, after a 10-min exposure, resulted in brain temperatures in excess of 43 degrees C. A bolus of 86Rb in isotonic saline was injected intravenously and an arterial sample was collected for 20 s to determine cardiac output. Compared with unexposed controls, uptake of 86Rb increased most in those regions directly in the path of the irradiation, namely, the occipital and parietal cortex, as well as the dorsal hippocampus, midbrain, and basal ganglia. In a separate group of animals, regional brain vascular spaces were found to increase with brain temperature. These results support previous observations indicating that reliably demonstrable increases of blood-brain barrier permeability are associated with intense, microwave-induced hyperthermia, and that the observed changes are not due to field-specific interaction. PMID- 6487384 TI - The effects of microwave radiation on avian dominance behavior. AB - Seventeen birds from 12 flocks were exposed to microwave radiation under various combinations of power density and duration; three birds from two additional flocks served as sham-exposed controls. Experiments were conducted outdoors at Manomet, Massachusetts (41 degrees 56'N, 70 degrees 35'W) under normal winter ambient temperatures. Although irradiated birds maintained their positions within a flock hierarchy with one exception, some appeared to have a change in their level of aggression after exposure. PMID- 6487385 TI - The membrane potential of characean cells exposed to amplitude-modulated, low power 147-MHz radiation. AB - The membrane potential of isolated cells of Chara braunii or Nitella flexilis was monitored while the cells were exposed, at nominal power densities from 2 to 1,000 W/m2, to 147-MHz radiation amplitude modulated at frequencies from 4 to 64 Hz. Phase-sensitive detection was used to seek radiation-correlated changes in the membrane potential, and none were apparent under any of the conditions used in this investigation. PMID- 6487386 TI - Vacuolar hyperpolarizing offsets in characean cells exposed to mono- and bichromatic CW and to squarewave-modulated electromagnetic radiation in the band 200-1,000 MHz. AB - Single giant cells of the algae Chara braunii and Nitella flexilis were exposed to bursts of electromagnetic radiation (monochromatic CW, bichromatic CW, or squarewave-modulated) in the band 200-1,000 MHz while their vacuolar potentials were monitored using micropipettes. The slow hyperpolarizing response that was observed seemed to be linear in the power deposited in the vicinity of the cell, to be otherwise indifferent to irradiation frequency or modulation, and therefore to be thermal in origin. PMID- 6487387 TI - Short-circuit currents, surface electric fields, and axial current densities for guinea pigs exposed to ELF electric fields. AB - Short-circuit currents, surface electric fields, and axial current densities were measured in electrically grounded guinea pigs exposed to a uniform, vertical, ELF electric field. These data are 70-110% of corresponding values obtained in grounded rats exposed to the same electric field. PMID- 6487388 TI - [Conformation of estrone and its derivatives from crystallographic data. Roentgenostructural analysis of 3-deoxyestrone]. AB - The conformational analysis of estrone and its derivatives has been performed using the crystallographic data. It is shown that the estrone backbone may have four different conformers due to the conformational flexibility of the B- and D rings. The correlation plots describing the conformations of the B- and D-rings are given. There is no apparent correlation between the nature of the substituent at C (3) and the overall conformation of the estrone backbone. An X-ray analysis of 3-deoxyestrone has also been undertaken. The crystal data are: space group P212121, Z = 4(C18H22O), a 25,240 (3), b 8,049 (2), c 7,002 (3) A, V 1423 A3, dcalc 1,19 g X cm.-3. The final reliability factors are: R 3,71% and Rw 4,23% for 1501 observed reflections measured on an automatic diffractometer. PMID- 6487389 TI - [Study of a lipid A-protein complex from Yersinia pseudotuberculosis endotoxin]. AB - Mild acid hydrolysis of endotoxin of Yersinia pseudotuberculosis afforded a lipid A--protein complex composed of amino acids and all characteristic components of lipid A: glucosamine, dodecanoic, 3-hydroxytetradecanoic acids and phosphorus in a molar ratio of 2 : 1,5 : 2,8 : 1,7, respectively. The protein component of the complex was shown by gel electrophoresis in the presence of sodium dodecylsulphate to consist of two polypeptides with apparent molecular weights of 12000 and 8000. The lipid A--protein complex cross-reacted with antiserum to endotoxin and lipid A antiserum. The components of the complex, namely lipid A and a protein, are associated tightly but noncovalently and can be separated by ultracentrifugation in the sucrose density gradient after treating the complex with sodium dodecylsulphate. The resultant lipid A and the protein manifest a serological activity. PMID- 6487390 TI - [Relative localization of the bound acetylcholine receptor subunits and neurotoxin]. AB - A series of neurotoxin II (Naja naja oxiana) derivatives, each containing one p azido-[14C]benzoyl group, have been prepared. Those labeled at Leu1, Lys15, Lys25, Lys26, or Lys46 associate specifically with the acetylcholine receptor from the Torpedo marmorata electric organs and form the crosslinks with it as a result of irradiation. Electrophoresis in polyacrylamide gel and gel chromatography revealed the contacts between the neurotoxins and alpha, beta, gamma and delta subunits of the receptor, modification of a particular subunit being governed by the photoactivable group position in the neurotoxin molecule. The differences of the two neurotoxin binding sites in the receptor were demonstrated by analysis of the photoinduced crosslinks under the conditions of one site being blocked by hexa (trifluoroacetyl) neurotoxin II. The mutual arrangement of the two bound neurotoxin molecules was established. On the basis of data obtained, two models for the acetylcholine receptor subunit topography were proposed. PMID- 6487392 TI - [Improved accuracy of a direct spectrophotometric method of determining iodotyrosines and thyroxine in iodinated proteins]. AB - The accuracy of spectrophotometric quantitation of iodinated amino acid residues in proteins was enhanced 2,6--7,0-fold by appropriate choice of wavelengths. PMID- 6487391 TI - [Neutral glycosphingolipids in Ehrlich ascites carcinoma cells]. AB - The structure of the neutral glycosphingolipids of the Ehrlich ascite carcinoma (EAC) cells was studied. The main four components were identified as glycosylceramide, lastosylceramide, N-acetylgalactosyllactosylceramide and galactosyl-N-acetyllactosylceramide (asialo-GM1). The neutral glycolipid pattern of the cells was found to depend on their density. Dilution of the cell suspension resulted in an increased content of asia-lo-GM1, whereas the content of the other neutral glycolipids remained unchanged. The possible connection between these changes and the earlier disclosed cell density dependence of the gangliosides in EAC cells is discussed. PMID- 6487393 TI - Erosive azotemic osteoarthropathy. AB - Fifty-nine patients with end-stage renal disease undergoing long-term dialysis were studied prospectively for joint disease. Radiographic assessment allowed division of patients into 3 groups: group 1 included 12 patients with renal osteodystrophy and erosions of the metacarpophalangeal, proximal interphalangeal, distal interphalangeal, shoulder, wrist, and knee joints; group 2 had 11 patients with renal osteodystrophy without articular erosions; group 3 included 36 patients without osteodystrophy or erosions. Clinical manifestations were frequent in patients of group 1 and included episodes of arthralgias of the metacarpophalangeal, wrist, proximal interphalangeal, and knee joints. Patients of groups 1 and 2, particularly those of group 1, had a longer mean duration of dialysis and a higher mean serum alkaline phosphatase level compared with group 3 patients. The study indicates that there is a relatively high incidence (20%) of erosive arthropathy in dialysis patients. Renal osteodystrophy, more specifically, secondary hyperparathyroidism, and duration of dialysis are important factors in the development of this articular disorder. PMID- 6487394 TI - Impaired release of a soluble natural killer cytotoxic factor in systemic lupus erythematosus. AB - Disease states characterized by abnormalities in immune regulation often demonstrate concomitant abnormalities in cytotoxicity mediated by natural killer (NK) cells. For example, some patients with systemic lupus erythematosus (SLE) have depressed NK activity despite the presence of normal numbers of effector cell:target cell conjugates. This study was designed to determine if defects in NK cell function were directly related to impaired release of a soluble cytotoxic factor. NK activity of peripheral blood mononuclear cells and large granular lymphocytes was measured using 51Cr-labeled K562 target cells in 4-hour release assays. The SLE patients had significantly decreased NK activity relative to normal controls. However, the number of effector cell:target cell conjugates was not different in SLE patients versus control subjects. The release of a soluble natural killer cytotoxic factor (NKCF) by peripheral blood mononuclear cells was measured by cytotoxicity induced in K562 cells. NKCF was released preferentially by suspensions enriched in NK cells (large granular lymphocytes). At a 1:1 dilution, NKCF release was significantly lower in SLE patients than in controls. The release of NKCF correlated well with NK activity. Thus, this study shows that the defect in NK cell activity in SLE patients may be related to an impairment in release of a soluble cytotoxic factor with specificity for NK cell-sensitive targets. PMID- 6487395 TI - Clinical and pathologic studies of synovitis in polymyalgia rheumatica. AB - Clinically detectable joint swelling was found in 10 of 13 fully evaluated patients considered to have polymyalgia rheumatica. Five patients had some joint findings at disease onset. Knees were most commonly affected. Sternoclavicular involvement was seen in 3 patients. Joint effusions in 8 patients had 300-5,700 leukocytes/mm3 with a mean of 2,900. Six synovial biopsy specimens studied by light microscopy revealed mild to moderate synovial proliferation and chronic inflammation that was generally less severe than in typical rheumatoid arthritis. Electron microscopy identified microvascular changes and large amounts of vesicular and granular debris in lining cells. In 1 patient, a "fingerprint" pattern in the granular material was suggestive of the findings in some immune complexes. This still unexplained synovitis may, as previously suggested, be important in the pathogenesis of the polymyalgia rheumatica syndrome. PMID- 6487396 TI - Arthritis confined to knee joints. Synovial lymphocyte responses to microbial antigens correlate with distribution of HLA. AB - The responses of synovial lymphocytes to Chlamydia/Ureaplasma and to enteric antigens were studied in 31 patients with arthritis confined to knee joints, 15 patients with sexually-transmitted Reiter's syndrome, 9 with enteric Reiter's syndrome, and 24 with rheumatoid arthritis. The frequency of HLA antigens was studied in 28 patients with knee joint arthritis; this group was characterized by elevated frequencies of HLA-A2 and DR1. A subgroup of 8 responders to Chlamydia/Ureaplasma was characterized by an increase of HLA-Bw44 and DR7 or 8, while a subgroup of 8 responders to enteric antigens was characterized by increases of HLA-A1 and DR5. The frequency of HLA-B27 in the groups responding to antigens was 25-30%, less than half the frequency in patients with Reiter's syndrome. PMID- 6487397 TI - Conjugal progressive systemic sclerosis (scleroderma): report of the disease in husband and wife. PMID- 6487398 TI - Reflex sympathetic dystrophy as a probable paraneoplastic syndrome: case report and literature review. PMID- 6487399 TI - Pneumatosis intestinalis in mixed connective tissue disease: two case reports and literature review. PMID- 6487400 TI - Toxic oil syndrome, scleroderma, and eosinophilic fasciitis. PMID- 6487401 TI - 1984 convention booklet. November 16-19, 1984, San Francisco. American Speech Language-Hearing Association. Abstracts. PMID- 6487402 TI - Hearing impairment, hearing aids and audiology. PMID- 6487403 TI - Behavior alters the uptake of [3H]choline into acetylcholinergic neurons of the nucleus basalis magnocellularis and medial septal area. AB - Behavioral experience changed sodium-dependent high affinity choline uptake (SDHACU) in the hippocampus and frontal cortex. Rats were trained on various behavioral tasks and sacrificed after testing. SDHACU was determined in frontal cortex and hippocampus, areas that receive cholinergic innervation from the nucleus basalis magnocellularis (NBM) and the medial septal area (MSA), respectively. Untrained rats taken directly from their home cages had fairly consistent levels of SDHACU in the hippocampus (1.76 +/- 0.45, X +/- S.E.) and frontal cortex (1.46 +/- 0.37). In the hippocampus of rats performing in a radial maze and T-maze and in rats that surpassed a criterion level in an active avoidance task, SDHACU increased significantly above Cage (untrained) group levels. In the cortex of rats performing the radial maze task, SDHACU decreased slightly. There were no other changes in frontal cortical SDHACU. After behavioral testing ceased, SDHACU in rats performing the radial maze task remained elevated above Control and Treadmill group levels for 20 days, but returned to near control levels 40 days later. Our data demonstrate that a functional differentiation exists between the MSA and NBM cholinergic systems, and that the measurement of SDHACU in central cholinergic neurons is a useful tool to identify the influences of behavior and environment upon changes in neurochemical events and neuronal activity. PMID- 6487404 TI - Long-term changes of orienting behavior in cats with artificial divergent strabismus. AB - Orienting behavior was measured in two monocular spatial localization tasks in normal cats and in cats with artificially induced monocular divergent strabismus. Immediately, and for several weeks after the operation, cats made large "past pointing errors" with the deviated eye in a direction opposite to the misalignment. These errors were replaced later by "over compensation errors" in the same direction as the strabismus deviation, which persisted for many months after the operation. Over-compensation did not occur when the non-deviated eye was sutured in early life. Electrophysiological measures like grating VEP and A17 single unit responses demonstrated the dominance of the non-deviated eye in the strabismic cats. It is suggested that long-term binocular exposure may lead to a reorganization of visual direction for the deviated eye in divergent strabismus. PMID- 6487405 TI - Long-term consequences of exposure to an imprinting stimulus on 'spontaneous' impulse activity in the chick brain. AB - Young chicks were exposed in a running wheel to an imprinting object, a rotating flashing red box (n = 36 chicks) or a rotating stuffed jungle fowl (n = 18). The net number of revolutions of the wheel toward the imprinting object provided a measure of approach activity during training. The chicks were subsequently anaesthetized and the 'spontaneous' firing rates of units were recorded simultaneously in two regions of the left forebrain hemisphere. One microelectrode penetration was made through a region, the intermediate and medial part of the hyperstriatum ventrale (IMHV) known to be critical for imprinting; simultaneously another microelectrode penetration was made through the visual Wulst. The electrodes were advanced in steps of 250 micron and the spontaneous discharge of multiple units at each site recorded. The mean firing rate from greater than or equal to 3 sites was calculated for IMHV and for the hyperstriatum accessorium of the Wulst. There was a negative correlation between mean firing rate of units in IMHV and approach activity for chicks trained on the box. The effect was: stimulus specific since it was not found in chicks trained on the jungle fowl; and regionally specific since approach activity, depending on conditions which are described, was either not correlated or positively correlated with mean firing rate for neurons in the hyperstriatum accessorium. The positive correlation was not dependent on the training stimulus but on the presence of a visually responsive lamina deep to the hyperstriatum accessorium. PMID- 6487406 TI - Modifiability of responsiveness in a visual projection area of the chick brain: visual experience is only one of several factors involved. AB - The effects of visual experience on neuronal responsiveness in the hyperstriatum accessorium, a visual projection area, were investigated in 4 groups of domestic chicks, each comprising dark-reared (total = 44) and visually experienced (total = 34) birds. Visually experienced birds were placed singly in running wheels facing a flashing red light for 3 h; wheel revolutions were used as a measure of the chicks' locomotor activity. At approximately equal to 48 h after hatching each chick was anaesthetized and a microelectrode advanced in 250 micron steps through the left Wulst. After each step the responsiveness of units to diffuse retinal illumination (light flashes) was tested. Each recording site at which responses greater than or equal to 5 successive flashes could be evoked was classified as a response site. In some chicks at least one site responding briskly to greater than or equal to 15 successive flashes was found deep to the hyperstriatum accessorium. The zone of markedly increased responsiveness is referred to as the visually responsive lamina. The effect of visual experience on the response of units in the hyperstriatum accessorium varied between the groups of chicks. Visual experience did not significantly effect neuronal responsiveness in this region for chicks without a visually responsive lamina. For chicks with a lamina there was an effect of visual experience, but the effect again varied between groups. When data from inactive, visually experienced chicks were excluded, the group-to-group variation ceased to be significant. Thus visual experience alone was not adequate consistently to bring about long-term changes in the responsiveness of neurones in the hyperstriatum accessorium. Such experience was likely to increase neuronal responsiveness provided the chicks: were behaviourally active; and possessed a visually responsive lamina. PMID- 6487407 TI - Comparing frontal and lateral viewing in the pigeon. III. Different patterns of eye movements for binocular and monocular fixation. AB - The presence in the pigeon's retina of two areas of higher cellular density which we have shown mediate different visual functions, suggests the existence of two modes of fixation: a lateral monocular and a frontal binocular one. The participation of eye movements in these modes of fixation remained unexplored. We analyzed oculomotor behaviour in awake head-restrained pigeons by means of EOG and video film. Orienting saccades attaining up to 17 degrees from the resting positions could be elicited by presenting stimuli in different parts of the visual field. Two typical ocular patterns were consistently observed to the sudden presentation of large and novel stimuli: coordinated vergence of both eyes (even with one eye occluded) to stimulation within the frontal binocular field, and uncoordinated ipsilateral saccades to stimuli moving in one lateral field. Results point towards two different and reciprocally exclusive mechanisms of oculomotor control in the pigeon. The relevance of a trident mode of vision correlated to retinal organization and living praxis of some lateral-eyed vertebrates is discussed. PMID- 6487408 TI - Binocularity in the visual cortex of the adult cat does not depend on the integrity of the corpus callosum. AB - The importance of the corpus callosum for binocular interaction in areas 17 and 18 of the adult cat is still a matter of controversy, since its specific role in integrating information from the two eyes has been suggested by some and questioned by others. We have reanalyzed the problem by assessing binocular interaction for single neurons in areas 17 and 18 of adult cats submitted to section of the posterior two-thirds of the corpus callosum. In 5 cats this interhemispheric disconnection was performed from 10 days to 7 weeks before the electrophysiological recordings; in another cat callosal afferents to the recording sites were at first partially eliminated by an acute lesion of corresponding cortical zones in the other hemisphere, and thereafter completely interrupted by a posterior callosal section performed in the same recording session. Recordings were mainly aimed at the callosal zone of areas 17 and 18, which coincides with the border between these two areas and corresponds to visual field regions bordering the vertical meridian. Electrophysiological recordings were carried out in awake, unanesthetized animals in which all nociceptive pathways were previously interrupted by a midpontine pretrigeminal transection. The results indicate that the interhemispheric disconnection, whether acute or chronic, does not disrupt binocularity in areas 17 and 18; moreover, the analysis of the ocular dominance for binocular neurons did not reveal any imbalance between the inputs from the two eyes, since at all levels of eccentricity the majority of binocular neurons was equally activated by both eyes. Since in previous experiments on anesthetized cats, section of the corpus callosum apparently reduced binocular interaction in areas 17 and 18, we suggest that such an effect, which was lacking in our unanesthetized cats, was probably due to an interaction or summation between callosotomy and anesthesia. PMID- 6487409 TI - Monocular pattern discrimination performance in rabbits with unilateral interruption of the middle cerebral artery. AB - Rabbits were tested binocularly and with each eye separately, in pattern discriminations sensitive to the removal of the visual cortex opposite the exposed eye before and after the middle cerebral artery was unilaterally coagulated. Following surgery, the rabbits were not impaired in performing the discriminations with either eye; nor were any pathological changes found in the hemisphere in which surgery was performed. These findings imply that deficits in performing tasks dependent on the integrity of the visual cortical areas in rabbits may require interruption of the posterior and middle cerebral arteries, both of which supply the visual cortical areas. PMID- 6487410 TI - The threshold for eliciting the jaw opening reflex in rats is not increased by neonatal capsaicin. AB - Neonatal capsaicin administration has previously been shown to increase the threshold for withdrawal and escape response to noxious thermal, chemical and mechanical stimuli. The reason for these effects is destruction of afferent C fibers and associated reduction in central substance P levels. In contrast, neonatal capsaicin treatment did not eliminate the "jaw opening reflex" (JOR) or even significantly increases its threshold when tested in rats 2-8 months of age. There was no significant difference in the voltage required to elicit the JOR nor was there any difference in its latency, in the animal that had received an intraperitoneal injection of 50 mg/kg capsaicin on the second day of life. A reduction of 85% unmyelinated fibers was found as compared with untreated animals. This data support earlier indications that upon incisor tooth pulp chamber stimulation in rats, the JOR is affectively activated by low-threshold myelinated fibers in the tooth pulp and surrounding periodontal ligament. Destruction of tooth pulp C-afferents, therefore, does not affect jaw opening reflex threshold. PMID- 6487411 TI - Implication of amygdaloid muscarinic cholinergic mechanisms in passive avoidance learning in the developing rat. AB - Young rats, 12-20 days of age, received bilateral microinjections of atropine sulfate (1, 5 and 20 micrograms) into the basolateral part of the amygdala, and were trained to learn a cool-draft-stimulus passive avoidance task 17 min later. Twelve-day rats did not perform differently from their controls. In contrast, rats 13-20 days of age exhibited significant age- and dose-related acquisition deficits. Sensitivity to atropine was high until day 17, and decreased progressively thereafter. These results demonstrate that muscarinic cholinergic synaptic elements located in the basolateral part of the amygdala are involved in passive avoidance learning in the young rat and begin to function on postnatal day 13. They also suggest that the number of functioning muscarinic receptor sites increase reliably after day 17. PMID- 6487412 TI - Monkeys with combined amygdalo-hippocampal lesions succeed in object discrimination learning despite 24-hour intertrial intervals. AB - Monkeys with combined amygdalo-hippocampal removal show severe impairments on visual memory tasks after delays of only a minute or two, yet they learn visual discrimination habits about as quickly as normal animals with intertrial intervals of the same duration. In an attempt to resolve this discrepancy between abnormally rapid forgetting and successful retention, tests were conducted to determine whether discrimination learning would be prevented in animals with limbic lesions if intertrial intervals lasted 24 hr. The results showed that as long as the lesion did not encroach on inferior temporal cortex, the operated animals could acquire concurrent sets of 20 object discrimination habits at the same rate as normal animals, in an average of about 10 trials per set. The findings suggest that learning and retention processes are divisible into a mechanism for memory formation that is dependent on the limbic system and a mechanism for habit formation that is not. PMID- 6487413 TI - Neural lateralization of vocalizations by Japanese macaques: communicative significance is more important than acoustic structure. AB - The study was designed to determine whether the neural lateralization of vocal perception in Japanese macaques depends on the acoustic properties of the calls used or their communicative significance. Four monkeys--two Japanese macaques and two comparison macaques--were trained to discriminate among monaurally presented exemplars of two classes of vocalizations from the Japanese macaque's repertoire. Once the subjects mastered the discrimination, they performed at equivalent accuracy levels for 150 sessions. However, during this time the Japanese monkeys showed a right ear performance advantage, whereas the comparison monkeys showed no ear advantage. In order to assess whether the comparison and Japanese monkeys were attending to the same acoustic cue when performing the discrimination, a generalization test was conducted with 27 novel vocalizations. The individual monkeys' generalization gradients were highly similar and revealed that all subjects were in fact listening to the same feature of the calls. These findings, coupled with the fact that the calls were of biological significance to the Japanese monkeys alone, suggest that the laterality effect is related, in some fashion, to the communicative valence of the signals rather than their purely physical characteristics. PMID- 6487414 TI - Neonatal ablations of the gustatory neocortex in the rat: taste aversion learning and taste reactivity. AB - Rats sustaining ablations of gustatory neocortex (GN) at 2, 10, 20, or 60 days of age were compared with control rats in the acquisition and extinction of a learned taste aversion; in addition, these rats were tested for taste preference across five concentrations of sodium chloride solution. Results indicated that GN ablation disrupted aversion acquisition and extinction regardless of age at surgery. Taste response functions for the sodium chloride solutions shown by all GN groups of rats mirrored those of control rats: preference (relative to water baseline) for middle concentrations and rejection of the strongest salt concentration. There was a suggestion that the 20- and 60-day-old GN rats were hyperresponsive to the suprathreshold concentrations of NaCl (except the strongest concentration). The increased response to salt solutions in the 20- and 60-day GN rats may have been related to the significant decreases in water consumption relative to that of normal rats. Water consumption of control rats and GN rats in the 2-day and 10-day groups was essentially equal. It is concluded that infant ablation of the GN does not spare normal taste aversion learning and that rats with GN ablations, regardless of age at surgery, respond in a normal manner to the hedonic aspects of sodium chloride solutions. PMID- 6487415 TI - Taste potentiation of poisoned odor by temporal contiguity. AB - The synergistic interaction between odor and taste in flavor-toxicosis conditioning was tested in two experiments. The temporal interval between a 2-min odor and a 2-min taste was varied for thirsty rats licking at a water spout. In the first experiment, taste was presented at time zero, and odor was presented at -10, -1, 0, 1 and 10 min to independent groups in a simple compartment. In the second experiment, taste was presented at 0, and odor was presented at -5, -2, and 0 min in a "wind tunnel" apparatus. The results indicated that odor alone is an ineffective conditioned stimulus for a toxic unconditioned stimulus under our conditions, simultaneous (0-min) presentation of odor with taste potentiates the odor component so that it becomes more effective than the taste component, a 2 min interval between odor and taste attenuates potentiation, and a 5-min interval disrupts the effect, and the interaction in asymmetrical, that is, odor has no such systematic effect on the conditioning of taste. PMID- 6487416 TI - Effects of drug-induced changes in resting blood pressure on classically conditioned heart rate and blood pressure in restrained rats. AB - Subsequent to receiving aversive classical conditioning, which led to a decelerative heart rate (HR) conditioned response (CR) and a pressor-depressor blood pressure (BP) CR, three separate groups of restrained rats received intravenous infusion of sodium nitroprusside (40 micrograms/mg/min) to lower baseline BP, phenylephrine (17 micrograms/mg/min) to raise baseline BP, or an equivalent volume of saline. Conditioning test trials during infusion revealed that hypotension produced by sodium nitroprusside eliminated the HR CR and transformed the BP CR into a pressor-only reaction. Hypertension produced by phenylephrine facilitated the HR CR and changed the BP CR to a pressor-only response on selected trials in which baseline BP increases and baseline HR decreases were within restricted limits. Following drug withdrawal, the HR CRs of both drug groups and the BP CR of the phenylephrine group were attenuated. The unconditioned responses to the shock unconditioned stimulus under phenylephrine were exaggerated and consisted of tachycardias and depressor BP changes, whereas under sodium nitroprusside reduced tachycardias and depressor activity occurred. The results suggested that the loss of the vagally mediated HR CR under sodium nitroprusside was due to baroreceptor-controlled inhibition of vagal discharge and that the enhancement of the HR CR under phenylephrine was due to baroreceptor influenced facilitation of vagal discharge. PMID- 6487417 TI - Seasonal weight gain is attenuated in food-restricted ground squirrels with lesions of the suprachiasmatic nuclei. AB - The role of seasonal hyperphagia in the genesis of prehibernation fattening was assessed in golden-mantled ground squirrels. One group of animals was fed ad lib throughout the weight gain phase of the annual body weight cycle (June-October); a group of neurologically intact animals and one of squirrels with brain lesions incorporating the suprachiasmatic nuclei (SCN) were fed amounts of food equivalent to quantities consumed prior to the body weight trough (May). Part of the seasonal increase of body mass is independent of increases in food consumption; intact animals fed ad lib or restricted to prefattening food intakes underwent similar increases in body mass and possessed equivalent amounts of abdominal white adipose tissue. Food restriction combined with SCN lesions attenuated seasonal weight gain and reduced abdominal fat mass. However, some of the brain-damaged squirrels still evidenced weight gain, a result supporting a previous conclusion that the SCN are involved in circannual body weight rhythm generation but their contribution to this process is not essential for continued rhythmicity in most individuals. PMID- 6487418 TI - Deficits in conditioned avoidance responding following adrenalectomy and central norepinephrine depletion are dependent on postsurgical recovery period and phase of the diurnal cycle. AB - Rats that had undergone combined dorsal noradrenergic bundle lesion (DNBL) and bilateral adrenalectomy were impaired in acquiring a conditioned avoidance response when tested 1 week following surgery. Normal acquisition was observed, however, when testing occurred 3 weeks or more after surgery despite low levels of both plasma corticosterone and brain norepinephrine at that time. Furthermore, neither neonatal systemic administration of 6-hydroxy-dopamine to deplete forebrain norepinephrine, combined with the corticosterone inhibitor metyrapone, nor the pharmacological blockade of noradrenergic receptors, combined with adrenalectomy, disrupted acquisition of the avoidance response. Thus, the combination of forebrain norepinephrine loss and low plasma corticosterone does not inevitably impair avoidance acquisition. Rather, the determining factor for such impairment seems to be the interval between surgery and testing. The impairment at 1 week following DNBL and adrenalectomy occurred only for rats tested during the dark phase of their light cycle. In addition, the DNBL abolished the effect of the light/dark cycle on posttraining plasma corticosterone. These results demonstrate the importance of the phase of the rat's diurnal rhythm on both the hormonal and the behavioral effects of altering the pituitary-adrenal axis and/or forebrain norepinephrine. Because adrenocorticotropin, corticosterone, and vasopressin all show diurnal patterns of release, it cannot be determined at this time which, if any, of these hormones is most important for the behavioral results reported here. PMID- 6487419 TI - Chemosensory and hormonal mediation of social memory in male rats. AB - The persistence with which adult male rats investigated a juvenile conspecific was significantly reduced following preexposure to either the juvenile or chemosensory stimuli (soiled bedding or urine) from that juvenile. The reduced persistence did not occur when the chemosensory stimulus came from a juvenile different from the one with which the subject was subsequently tested, which suggests the presence of a chemosensorily mediated social memory. It is suggested that any such memory may have adaptive value in that it permits a male rat to more readily identify a novel conspecific. Also, the lack of reduced persistence of social investigatory behavior in castrated subjects demonstrates the importance of male gonadal hormones in the formation, storage, and/or retrieval of the proposed chemosensorily mediated social memory. PMID- 6487420 TI - Cardiac startle and orienting responses in the great apes. AB - Cardiac patterns of startle and orienting in response to auditory and vibrotactile stimuli were investigated in the infant chimpanzee and gorilla. Results revealed a notable cardiac acceleration in response to the initial presentations of stimuli of either modality. This acceleratory response appeared to reflect the cardiac correlate of startle and was closely associated with the elicitation of somatic startle responses. This initial cardiac acceleration was subject to rapid habituation and was replaced on subsequent trials by cardiac deceleration, which appeared to reflect the orienting response. Results from the chimpanzees and the gorilla were similar, although a slower rate of habituation was apparent in the gorilla. Taken together, these results are highly consistent with those obtained from humans and monkeys, and they provide the first characterization of cardiac patterns associated with startle and orienting responses in the great apes. PMID- 6487421 TI - Effects of acute trimethyltin exposure on appetitive acquisition and extinction performance in the adult rat. AB - Adult male rats were given one intragastric infusion of either 7 mg/kg trimethyltin chloride (dose calculated as the base of trimethyltin [TMT]) or physiological saline. Twenty-one days after dosing, subjects from each condition were divided into two equal-sized groups and trained with either partial (PRF) or continuous (CRF) reinforcement in a straight alley maze. The acquisition phase of training, lasting 40 trials (4 trials/day), was followed by 20 trials of extinction training (4 trials/day). Analyses performed on total speed revealed that TMT-treated subjects performed at lower levels during acquisition than controls regardless of schedule condition. Also, the rate of resistance to extinction was significantly reduced for treated subjects compared with that of controls regardless of the training schedules used during acquisition. A partial reinforcement extinction effect was observed for both control and TMT-treated subjects, that is, independent of dose regimen; PRF training occasioned greater persistence during extinction than did CRF training. These findings are discussed in terms of their implications for contemporary empirical and theoretical issues relating to TMT-induced hippocampal lesions. PMID- 6487422 TI - Plasma cortisol and appetitively motivated arousal in monkeys. AB - A disagreement exists in the literature as to whether plasma glucocorticoids are a sensitive index of emotional arousal. In order to provide further data on this subject, arousal in adult male rhesus monkeys was produced by classical appetitive conditioning done once every 48 hr. Monkeys showed significantly more aroused behavior during CS+ sessions than during CS- sessions. Concurrent with these behavioral changes, appetitive conditioning suppressed the increase in plasma cortisol that took place in control conditions. This dissociation between cortisol and arousal provides additional data for the conclusion that plasma glucocorticoids are an insensitive index of arousal. The fact that glucocorticoids decrease dramatically under similar experimental conditions in rats suggests that hormonal regulatory mechanisms for this rodent species may differ from that for primates. PMID- 6487423 TI - [Possibilities and limitations for controlled-release transdermal preparations]. PMID- 6487424 TI - [The influence of various wet granulation procedures on the technological characteristics of powders and tablets]. PMID- 6487425 TI - Pharmacokinetic aspect of tritium-labeled glycosaminoglycans (mesoglycan). Their absorption in rat and monkey and tissue distribution in rat. PMID- 6487426 TI - [Simultaneous determination of nikethamide and guaiafenesin by derivative UV spectrophotometry]. PMID- 6487427 TI - [Ultrastructural study on the mitochondrial myopathy associated with lactic acidosis]. PMID- 6487428 TI - [Postnatal changes of brain stem auditory evoked responses in normal and high risk neonates]. PMID- 6487429 TI - [Familial macrocephaly]. PMID- 6487430 TI - [A case of spastic diplegia treated by the Vojta procedure in early infancy with a remarkable effect. A comparison with 66 spastic diplegia children]. PMID- 6487431 TI - [Bilateral facial palsy complicating infectious mononucleosis in infancy]. PMID- 6487432 TI - [A case of encephalitis probably due to herpes simplex virus, presenting psychiatric symptom (delirium) and catatonic stupor-like state]. PMID- 6487433 TI - [Visual disturbances following right cerebral lesion: a case report]. AB - A 49-year-old right handed male, who showed three types of visual disturbance, e. g. hemianopsia, obscuration phenomena and unilateral visuospatial agnosia at different times, was reported. At first, he had hemiparesis, hemisensory disturbance and homonymous hemianopsia on the left side because of multiple stenoses of posterior branches of the right middle cerebral artery. His motor and visual field disturbances improved for several days after onset, but there appeared transient obscuration phenomena on the left visual field. CT scan revealed an abnormal low density area in the right temporo-parietal region. At about 4.5 years after the first attack, he again had hemiparesis and homonymous hemianopsia on the left side. Cerebral angiography showed an occlusion of the right middle cerebral artery. Since his paresis was progressive, STA-MCA anastomoses was performed. Hemiparesis was improved, but homonymous hemianopsia remained. Moreover, at about one year after the second attack, left visuospatial agnosia participated in his hemianopsia. Cerebral angiography showed an additional occlusion in the crural segment of the right posterior cerebral artery. CT scan showed a lesion in the right basal ganglia and temporo-parietal lobe. In most cases, unilateral visuospatial agnosia occurs with hemianopsia. But, in this case, these symptoms occurred at different times. This may indicate the differentiation between unilateral visuospatial agnosia and hemianopsia. PMID- 6487434 TI - [Quantitative double tracer autoradiographic technique for the simultaneous measurement of local cerebral blood flow and local cerebral glucose utilization using 14C-IAP and 18F-FDG]. AB - We have reported a quantitative double tracer autoradiographic technique for the simultaneous measurement of local cerebral blood flow (LCBF) and local cerebral glucose utilization (LCGU) using 14C-IAP and 18F-FDG respectively. Six awake normal rats and 3 left middle cerebral artery (MCA) occluded rats were used for this experiments. A 50-hold greater radioactivity of 18F was administered and the first exposure was done for 2 hours to obtain a 18F image. Three days later (39 half-lives of 18F), a second exposure was done for 5 to 6 days to obtain the 14C image. Tissue concentration of 14C was measured relative to the commercially available 14C-methyl methacrylate standards. 18F standards were prepared in each experiment. Cross contamination of 14C in the first exposure was less than 2% in the normal state and less than 4% even in the uncoupling condition. The values obtained by this methods for LCBF and LCGU agreed closely with those obtained by a single tracer technique previously reported in the literature. The technique outlined in this paper also provided local glucose utilization flow ratio (LGFR) for the first time. LGFR was obtained by dividing the LCGU image by LCBF image and was expressed as percent mumol/ml. The mean LGFR of control rats was 76 +/- 8% mumol/ml. In a MCA occlusion group, LGFR of ischemic cortex increased until 2 to 3 times higher than that of contralateral non-ischemic cortex. Oxygen glucose index image which was obtained from the LCGU and A-V differences of O2 showed that approximately half of the glucose was metabolized anerobically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487435 TI - [Ultrastructural study of the neuronal lipofuscin--an autopsy case of familial Alzheimer's disease]. AB - This work is to study the ultrastructure of the neuronal lipofuscin that occurred in the brain and the spinal cord of an autopsy case of familial Alzheimer's disease and to compare with those in several other diseases. The patient was a 46 year-old male, whose father and elder brother were diagnosed as Alzheimer's disease and died at the age of 42, respectively. He became afflicted with forgetfulness and disorientation at the age of 36. He developed a grand mal seizure at the age of 39 and thereafter, his clinical course was characterized by pyramidal signs, dysarthria and the symptoms of Gerstmann's syndrome, visuo spatial agnosia, apraxia for dressing and constructive apraxia. He became bedridden at 45 years old and died of general prostration. The brain weighed 1,250 g, and the cerebral cortex showed mild atrophy. The neuronal loss, senile plaques and Alzheimer's neurofibrillary tangles were found throughout the cerebral cortex. The senile plaques were also found in the basal ganglia, the cerebellar medulla and cortex. There was severe amyloid angiopathy in the occipital and cerebellar cortices. The specimens for electron microscopy were taken from the cerebral cortex, the basal ganglia, the thalamus, the midbrain, the medulla oblongata, the cerebellum and the spinal cord. The ultrastructural study revealed three different types of the neuronal lipofuscin, though different stainability between these lipofuscin granules could not be manifested by several histochemical methods. Their morphological differences seemed to be based on the sites of the central nervous system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487436 TI - [Regional cerebral blood flow in limbic seizures induced by microinjection of kainic acid into amygdala in cats]. AB - The relationship between neuronal epileptic activity and regional cerebral blood flow was studied by means of hydrogen clearance method (rCBF). Measurements of rCBF in the limbic structure and cerebral cortex were performed during limbic seizures induced by a microinjection of kainic acid to the left amygdala under concurrent monitoring of polygraph. Pentobarbital (35 mg/kg, i.p.) anesthesia was induced and cats were artificially ventilated. Physiological parameters such as blood pressure, body temperature, PaO2, PaCO2 and HCO3 were kept stable. After fixation of the cat's head in a stereotaxic device, stainless screw electrodes were placed over bilateral anterior sigmoid gyrus so as to touch the dura mater for cortical EEG monitoring. Bipolar needle electrodes were stereotaxically placed to both amygdala and the left dorsal hippocampus. Platinum electrodes were stereotaxically placed to the left amygdala, dorsal hippocampus and sensorimotor cortex. After measurements of control rCBF, a microsyringe was stereotaxically inserted into the left amygdala and kainic acid solution (2 micrograms) was injected. Polygraphic monitoring followed. Five to 30 minuted after kainic acid injection, continuous multiple spikes appeared in the left amygdala. Forty to 120 minutes later, continuous multiple spikes transmitted to the left hippocampus. Two to five hours later, limbic seizure occurred. The limbic seizure lasted five to eight hours and interictal discharges appeared. Repeated measurements of rCBF were done. In the left amygdala, rCBF increased about two-fold of the control immediately after development of continuous multiple spikes and remained increased as long as the seizure persisted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487437 TI - [Origin of components P 11 and P 13 in short latency somato-sensory evoked potentials (SSEP): correlative study of SSEP and intraoperative evoked potentials]. AB - In 15 patients with cervical or posterior fossa lesion, SSEPs were recorded between the skull and the non-cephalic reference electrodes during the surgical operation and compared with the evoked potentials directly recorded at the same time from the surface of the cervical spinal cord and the brain stem. The directly recorded evoked potential consisted of three main components appeared within about 25 ms., they were a small negative spike wave, a large positive spike wave and a subsequent slow potential. The positive spike wave of the evoked potentials recorded from the surface of the dorsal column was not only coincided in latency with component P 11 of SSEP, but also showed the greatest amplitude at the lower cervical level. Moreover, the positive spike wave gradually delayed in latency and reduced in amplitude from lower to upper cervical segments. The amplitude of the positive spike wave was greater at the surface of the dorsal column ipsilateral to the stimulated median nerve than that of contra-lateral recording. No polarity change was observed between the anterior and posterior surface of the spinal cord. Similarly, the positive spike wave of the evoked potentials, recorded from the surface of the brain stem, showed fairly same latency with P 13 and a maximal amplitude at the surface of the cuneate tuberculum ipsilateral to the median nerve stimulated, and those positive spike wave traveled to contra-lateral ventral surface of the pons, presumably from ipsilateral cuneate nucleus to the contra-lateral medial lemniscus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487438 TI - [Significance of hematoma irrigation with trephination therapy (HITT) in the management of acute subdural hematoma]. AB - Decompressive craniectomy in the management of acute traumatic subdural hematoma (acute SDH) has been advocated as a treatment for the cerebral edema or swelling associated with it. The bony decompression with dural grafting seems successful in some patients, but surely enhances cerebral swelling and exacerbates edema in others. Whether the external or internal decompression could be justified is therefore a subject of controversy for the surgical treatment of choice. The authors, herein, proposed the new method with small craniectomy, 3 cm in diameter and irrigation with Nelaton's catheter for acute SDH with cerebral edema or swelling, that is the hematoma irrigation with trephination therapy (HITT) and performed it in 27 adult cases, 19 to 84 years of age (20 males and 7 females), who were transported within 24 hours after trauma and hospitalized in Department of Emergency Medicine, University of Tokyo Hospital during the period from January, 1982 to January, 1984, whose Glasgow coma scale points were 3 to 8 on admission, 16 cases (59%) of whom showed unilateral or bilateral absence of light reflex. The patients were all placed under the intensive care, using artificial ventilation (27 cases, 100%), hemodynamic management with Swan-Ganz catheter insertion (10 cases, 37%), continuous intracranial pressure monitoring (27 cases, 100%) and barbiturate therapy (13 cases, 48%). Ten cases (37%) recovered, 3 (11%) fell in vegetative state, 2 of whom died of medical complications afterwards and 14 (52%) could not avoid progressive deterioration to result in brain death.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487439 TI - European Malignant Hyperpyrexia Group. PMID- 6487440 TI - Investigation of malignant hyperthermia in Denmark and Sweden. AB - Units for the investigation of susceptibility to malignant hyperthermia (MH) were set up in Denmark in 1977 and in Sweden in 1981. Two hundred and ten patients from 76 families have been investigated. The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle from vastus medialis to halothane and to caffeine. MHS criteria for the patients in this paper were established from examination of 31 control biopsies, obtained from the same muscle and with the same anaesthesia as the MH patients. The criteria have since been changed to those presented elsewhere in this issue. In our laboratories the halothane test (exposure to 0.5-2% halothane) was the more sensitive: 88% of MHS patients reacted to it. The caffeine test was positive in 68% of MHS patients, 0.5-2.0 mmol litre-1 solutions being the most discriminating. Forty-two percent of MHS patients reacted to only one test. Fulminant MH was the most common reason for investigation; all these families contained MHS members. Masseter spasm occurred as sole sign in 21 families, of which 11 were MHS. Only 10% of MHS patients had other signs or symptoms of neuromuscular disease such as muscle cramps or muscular dystrophy. Three families had experienced sudden infant death syndrome (SIDS), and two teenage brothers in a MHS family died suddenly, but death was unrelated to anaesthesia. PMID- 6487441 TI - Subarachnoid anaesthesia with 0.5% bupivacaine: effects of density. AB - The effects of subarachnoid administration of 0.5% bupivacaine 4 ml in 8%, 5% or 0% glucose were investigated in a double-blind study in 30 women undergoing laparotomy through a lower abdominal incision. The onset time for maximum segmental spread of analgesia was 10-15 min for all solutions. Cephalad segmental spread of analgesia was three to four segments higher with the hyperbaric solutions (T4-5 v. T7-8). Time of onset of complete motor blockade of the lower limbs was 5-10 min for all solutions. The glucose-free solution did not produce sufficient surgical anaesthesia because of too low cephalad spread. Duration of motor blockade generally decreased with increasing glucose concentration, only the hyperbaric solutions providing useful for abdominal surgery, with a duration of 1-1.5 h. Anaesthesia (halothane) was required in seven of 10 patients in the glucose-free group and in five of 20 in the hyperbaric groups. No occurrence of "post-spinal headache" was recorded in the study. PMID- 6487442 TI - Effect of volatile anaesthetics and nitrous oxide-fentanyl anaesthesia on bleeding time. AB - Fifty-one patients were divided randomly into four groups: halothane in oxygen; fentanyl plus nitrous oxide in oxygen; enflurane in oxygen; or isoflurane in oxygen. Standardized bleeding time was measured using a Simplate II bleeding device before and at least 40 min after the induction of anaesthesia. Arterial pressure was maintained at +/- 20% of control values and temperature was kept at 35-37 degrees C. The bleeding time was prolonged by 33% in the halothane group (P less than 0.01) and by 20% in the nitrous oxide-fentanyl group (n.s.). There was essentially no change in bleeding time in the groups receiving enflurane or isoflurane, although there was considerable variability within each group, which did not seem to be related to differences in sex, age, type of surgery, concentration of agent used or surgical procedure. PMID- 6487443 TI - Blood glucose concentrations in children undergoing outpatient dental anaesthesia. AB - Fifty-six children, aged between 2 and 16 yr, undergoing dental extractions under general anaesthesia had their plasma glucose concentrations estimated before surgery. The mean concentration was 3.80 mmol litre-1. The lowest value was 2.2 mmol litre-1 in spite of starvation for 16.5 h. It is possible that outpatients are less susceptible to hypoglycaemia. PMID- 6487444 TI - Effect of premedication with diazepam, morphine or nalbuphine on gastrointestinal motility after surgery. AB - Premedication with nalbuphine and morphine delayed gastric emptying in the period after operation, but oral diazepam did not. All three drugs delayed co-ordinated intestinal motility, although nalbuphine did so for less than half as long as morphine. This property of nalbuphine, if confirmed, could make it a valuable analgesic drug in the period after operation. PMID- 6487445 TI - Droperidol inhibits cardiac vagal efferents in dogs. AB - The action of droperidol on cardiac vagal efferents was studied in anaesthetized dogs. Droperidol in cumulative doses (0.125, 0.25 and 0.5 mg kg-1 i.v.) inhibited cardiac vagal discharge, shifted pressure-response curves to lower activities, increased heart rate, and decreased arterial pressure slightly. The effects on vagal discharge and heart rate reached their maxima at 0.25 mg kg-1 as a further increase in the dose had no additional effect. The vagal inhibition and the tachycardia were independent of arterial pressure as indicated by the shift in the pressure-response curves and by the fact that they also occurred when the decrease in arterial pressure was prevented. After pretreatment with atropine, droperidol had no effect on heart rate. Thus, droperidol inhibits central vagal drive independently of arterial pressure. This central vagolytic action seems to be the main cause for the positive chronotropic effect of droperidol. PMID- 6487446 TI - A protocol for the investigation of malignant hyperpyrexia (MH) susceptibility. The European Malignant Hyperpyrexia Group. AB - A European Malignant Hyperpyrexia Group has been formed to facilitate exchange of information between centres performing in vitro muscle testing for malignant hyperpyrexia susceptibility. Data have been collected according to a protocol agreed by the Group. Based on these results, test criteria have been established to allow the following diagnoses to be made: MH susceptible (MHS); MH normal (MHN) or MH equivocal (MHE). It is accepted that MHE classified patients will be under permanent review, pending the collection of further data. PMID- 6487447 TI - A paediatric "cardiac arrest" survey. AB - In the calendar year 1981 a prospective survey was carried out at the Royal Alexandra Hospital for Children, Sydney, to investigate patients who sustained a cardiorespiratory arrest (CRA). Forty-one patients suffered CRA in the wards of the hospital and eight patients in the operating theatre or recovery ward. Thirty three patients (66%) responded to initial resuscitation and 21 patients (42%) survived to leave hospital. Of the 41 patients who sustained CRA in the wards of the hospital, 15 had neurological disease, 12 respiratory disease, four septicaemia and three complex congenital heart disease. PMID- 6487448 TI - Spinal anaesthesia for caesarean section. Management of a parturient with severe cardiovascular disease. AB - A parturient with severe mitral valve disease and pulmonary oedema was admitted to the labour ward. Fetal distress was also present. An emergency Caesarean section was undertaken under spinal blockade. The reasons for the choice of this technique are discussed. PMID- 6487449 TI - Tube-in-tube: a cause of acute airway obstruction. PMID- 6487450 TI - Viruses and endotracheal tubes. PMID- 6487451 TI - Intercostal nerve blockade. PMID- 6487452 TI - Nitrous oxide distends the bowel. PMID- 6487453 TI - Essentials of clinical pharmacology for education and research in developing countries. PMID- 6487454 TI - Measurement of specific [3H]-ouabain binding to different types of human leucocytes. AB - We have studied the specific binding of [3H]-ouabain to intact mononuclear leucocytes (82% lymphocytes) and polymorphonuclear leucocytes. In both types of cells [3H]-ouabain binding was saturable, confined to a single site of high affinity, slow to reach equilibrium, slow to reverse, temperature-dependent, competitively antagonized by potassium, and facilitated by the presence of divalent cations. The equilibrium dissociation constants were 2.4 +/- 0.7 nmol/l (polymorphs) and 2.4 +/- 0.4 nmol/l (mononuclear cells) (NS). The values of maximal specific ouabain binding, measured by Scatchard analysis of concentration vs binding curves (Bmax), were 33.9 +/- 6.0 fmol/10(6) cells (polymorphs) and 59.3 +/- 11.6 fmol/10(6) cells (mononuclear cells) (P less than 0.02). The corresponding numbers of sites per cell were 20415 +/- 3616 and 35712 +/- 6986 respectively (P less than 0.02). When the numbers of binding sites were expressed per square micron of cell surface area the difference between the two cell types was proportionately greater (83 and 186 sites per micron 2 respectively). We conclude that the [3H]-ouabain binding sites on mononuclear and polymorphonuclear leucocytes are similar in nature, but different in both number and density on the cell surface. Measurements of Bmax in mixed cell populations should therefore take account of cell type as well as cell size and number. PMID- 6487455 TI - The effect of chlormethiazole on the hypoxic drive to breathing in normal man. AB - We have studied the effects of chlormethiazole infusion on the ventilatory response to progressive isocapnic hypoxia in seven healthy volunteers, during both normocapnia and induced hypercapnia. The dose of chlormethiazole was such that it produced the same degree of hypnosis as would be expected from oral administration of two capsules each containing 192 mg of base in arachis oil. Ventilation did not change significantly during chlormethiazole administration. The ventilatory response to hypoxia was unaffected by chlormethiazole during normocapnia and was enhanced during hypercapnia. In these subjects, giving chlormethiazole intravenously was not associated with depression of the resting ventilation nor the hypoxia ventilatory response. PMID- 6487456 TI - Relative potency of prorenoate potassium and spironolactone in attenuating diuretic induced hypokalaemia. AB - The plasma potassium responses to the aldosterone antagonists prorenoate K (10 mg/day and 40 mg/day) and spironolactone (25 mg/day and 100 mg/day) were compared following treatment for 11 days in combination with the diuretic metolazone (2.5 mg/day) in a double-blind crossover study in twelve healthy men. The best estimate of the potency of prorenoate K relative to spironolactone in attenuating metolazone induced hypokalaemia was 5.6 with 95% confidence limits 2.4-35.2. The method employed allowed a statistically valid quantitative comparison of the potassium sparing properties of the mineralocorticoid antagonists after repeated doses and may be useful in the preclinical evaluation of these drugs. PMID- 6487457 TI - Omeprazole: effects on oxidative drug metabolism. AB - Omeprazole, a substituted benzimidazole, and a potent inhibitor of gastric parietal cell H+/K+ ATPase, was tested for drug interactions at two dose levels (30 mg and 60 mg/day) in man using the model drugs [14C]-aminopyrine and antipyrine. Elimination of both models was assessed before and after 15 days treatment with omeprazole. In addition [14C]-aminopyrine metabolism was assessed on day 2 of treatment to investigate the rapidity of onset of any effect. In 10 healthy male volunteers omeprazole 60 mg/day for 14 days prolonged aminopyrine 14CO2 half life (t1/2), measured on the 15th day, by 21% (P less than 0.05), and reduced percent dose demethylated in 2 h (ABT2) by 19% (P less than 0.005). No effect was seen on day 2 of therapy. After 14 days treatment antipyrine half-life was prolonged by 10% (P less than 0.025) and clearance was reduced by 14% (P = 0.063). In nine healthy male volunteers omeprazole 30 mg/day for 14 days prolonged aminopyrine 14CO2 by 13% and reduced ABT2 by 11%. Both changes just failed to reach statistical significance. At this dose antipyrine metabolism was unaltered. As the dose of omeprazole used in clinical practice may be less than 30 mg/day it is unlikely that metabolic inhibition will occur during routine use, although it will be necessary to test for interactions with therapeutically more important compounds. Interactions should be looked for when large doses of omeprazole are being used to treat hypersecretory states. PMID- 6487458 TI - Paracetamol metabolites in the neonate following maternal overdose. AB - A case of paracetamol overdose in a 36 week pregnant woman is described. The baby was delivered by Caesarian section 6 h after the overdose. The mother but not the baby was treated with N-acetylcysteine and neither suffered liver damage. The plasma paracetamol half-life was prolonged to 10 h in the neonate compared to 2.5 h in the mother and was unaffected by a two volume exchange transfusion. The pattern of urinary metabolites in the neonate was similar to that observed in the mother, but there was a marked delay in the time taken to reach peak plasma concentrations of metabolites. This is consistent with a very slow biotransformation of the drug and may explain the relative resistance of very young children to the hepatotoxicity of paracetamol. There was no evidence of limited or decreasing capacity in sulphate conjugation nor was sulphation the major metabolic pathway. In retrospect both the obstetrical intervention and the exchange transfusion were unnecessary. PMID- 6487459 TI - Naproxen pharmacokinetics in the elderly. AB - While naproxen pharmacokinetics appear to be altered in the presence of both diminished renal and hepatic function, the degree to which naproxen disposition might be influenced in the elderly by concurrent alteration in these functions is not obvious. Total plasma clearance/bioavailability (CL/F) of naproxen after a single 375 mg oral dose was found to be less in a group of 10 healthy men between 66 and 81 years of age than in 10 healthy men between 22 and 39 years (0.318 +/- 0.078, 0.416 +/- 0.061 l/h). At steady state (375 mg, 12 hourly), however, CL/F was statistically indistinguishable between the two groups. The fraction of naproxen unbound to plasma protein was doubled in elderly subjects, both at peak and trough drug concentrations. The lowered protein binding tended to obscure a 50% decrement in the intrinsic clearance of naproxen in the elderly as estimated by unbound clearance/bioavailability (213 +/- 64, 396 +/- 155 l/h). As a result, mean steady-state plasma concentrations of naproxen were indistinguishable between the elderly and young (64.2 +/- 8.5, 58.2 +/- 8.1 mg/l) but the elderly generated twice the mean steady-state unbound plasma drug concentration (0.157 +/ 0.039, 0.0859 +/- 0.0212 mg/l). Since it is the unbound drug concentration which appears in general to relate more closely to pharmacological and toxic effect, it may be advisable to reduce naproxen doses by half in the elderly, pending plasma drug concentration-response studies in this age group. If a similar perturbation with age occurs in benoxaprofen protein binding as was observed with naproxen, benoxaprofen intrinsic clearance in the elderly might be only one quarter of that in younger individuals; a factor which may contribute to the toxicity of this drug in the elderly. PMID- 6487460 TI - Pinacidil monotherapy for hypertension. AB - Ten patients with mild to moderate hypertension were treated for 9 weeks with a tablet formulation of pinacidil. Mean supine blood pressure fell from 174/100 to 148/84 mm Hg and mean supine pulse increased by 3 beats/min. Daily dosage was 40 100 mg, given in two or three divided doses. Plasma urea increased significantly and mean weight increased by 1.1 kg. Side effects were frequent but mild, in the main being those typically associated with potent vasodilator drugs. No patient withdrew from the study, and all achieved target blood pressure. PMID- 6487461 TI - Maintenance therapy after i.v. administration of disopyramide with an oral sustained release preparation, a pharmacokinetic study. AB - The blood levels in 20 patients were studied during the change from parenteral administration of disopyramide to an oral sustained release preparation containing the same active substance. From this study it is concluded that 100 mg i.v. bolus injection of disopyramide can safely be followed by the immediate administration of one sustained release tablet containing 250 mg disopyramide. In case of an i.v. infusion (0.4 mg kg-1h-1) it seems wise not to start earlier with the administration of the sustained release preparation than at the moment of stopping the infusion. PMID- 6487462 TI - The effects of cyclosidimine, a peripheral vasodilator drug, on blood pressure and heart rate in healthy subjects. AB - Cyclosidimine is a new vasodilator drug with a direct action on vascular smooth muscle. Oral administration of 2.5, 5.0 and 7.5 mg in five normal volunteers had no effect on blood pressure in the supine position but reduced systolic and diastolic pressure in the erect position. In both positions heart rate was significantly greater after cyclosidimine than after placebo. Propranolol prevented the increases in heart rate produced by cyclosidimine which then produced greater reductions in blood pressure. PMID- 6487463 TI - Gender and oral contraceptive steroids as determinants of drug glucuronidation: effects on clofibric acid elimination. AB - The disposition of clofibric acid, a drug metabolised largely by glucuronidation, was studied in eight males, eight females and eight females receiving oral contraceptive steroids (OCS). Clofibric acid plasma clearance was not significantly different in males compared to the control female group but was 48% greater (P less than 0.01) in women receiving OCS compared to non-pill using females. This difference was due to an alteration in clofibric acid metabolic clearance as there were no differences between the groups in clofibric acid free fraction. Along with previous data the results suggest that induction of drug glucuronidation by OCS may be of clinical importance, although any sex-related differences are unlikely to be of clinical significance. PMID- 6487464 TI - Stereoselective binding of propranolol enantiomers to human alpha 1-acid glycoprotein and human plasma. AB - The binding of propranolol enantiomers to human albumin (ALB), alpha 1-acid glycoprotein (alpha 1-AGP) and plasma was studied. (-) propranolol is more bound than (+)propranolol to alpha 1-AGP (P less than 0.001) and to plasma (P less than 0.05). In solutions containing ALB at a constant concentration (580 mumol/l) and alpha 1-AGP at increasing concentrations, the binding of both isomers increases but the stereo selectivity is evident throughout the alpha 1-AGP concentration range examined (25-100 mumol/l). PMID- 6487465 TI - The role of the intestinal microflora in the reductive metabolism of acenocoumarol in man. AB - Although the oral anticoagulant acenocoumarol (AC) is very effectively metabolized by the intestinal microflora to its amino metabolite, under clinical conditions this route of AC-disposition is of no importance because the compound is rapidly absorbed from its pharmaceutical application form. Only when the gastro-intestinal absorption is retarded, for instance by using a capsule as vehiculum, are appreciable amounts of reduced metabolites recovered in urine. PMID- 6487467 TI - Placental transfer of metronidazole and tinidazole in early human pregnancy after a single infusion. AB - Concentrations of metronidazole and tinidazole were analysed in mother's serum, placental tissue and foetal tissue after a single intravenous infusion of 500 mg of either drug in 21 patients who underwent a first trimester legal abortion. At the time of the evacuation (60 min from the start of the infusion) the concentrations of metronidazole and tinidazole in serum were 13.6 +/- 0.6 micrograms/ml and 13.2 +/- 0.4 micrograms/ml, respectively. In foetal tissue the concentrations of metronidazole and tinidazole reached 66% and 58%, and in placental tissue 26% and 37%, of the respective serum values. PMID- 6487466 TI - Antipyrine absorption after delayed oesophageal capsule transit. AB - Twenty fasted patients were given hard gelatin capsules containing antipyrine and barium, and in ten patients the capsule arrested and disintegrated in the oesophagus. Plasma antipyrine was assayed at 10 min intervals for 1 h, then 30 min intervals for a further 3 h. The plasma concentration-time curves for the patients in whom the capsule entered the stomach rapidly, and for those in whom the capsule lodged in the oesophagus, were compared. The absorption in the first hour was calculated from the area under the plasma concentration-time curve and found to be significantly lower if the capsule disintegrated in the oesophagus (P less than 0.0005). The time to peak plasma concentration was delayed by an average of 46 min (P less than 0.01) and the peak plasma concentration was significantly lower (P less than 0.05) if delayed capsule transit occurred. Delayed capsule transit through the oesophagus significantly changed the pharmacokinetic profile of antipyrine. PMID- 6487468 TI - Influence of amiodarone on antipyrine pharmacokinetics in three patients with ventricular tachycardia. PMID- 6487469 TI - Gastric aspiration by nasal intubation: an additional route of elimination for metronidazole. PMID- 6487470 TI - Vagal activity is increased during intravenous isoprenaline infusion in man. AB - Eight healthy normal subjects (19-23 years) received graded intravenous isoprenaline infusions PRE- and POST-atropine, 0.04 mg/kg i.v. The adequacy of atropinization was tested with bolus intravenous injections of phenylephrine. PRE atropine, isoprenaline caused an increase in heart rate and systolic pressure, but a decrease in diastolic pressure with little change in mean pressure (+32.8 +/- 3.0 beats/min, +18.9 +/- 3.0 mm Hg, -13.5 +/- 1.9 mm Hg, -2.7 +/- 1.9 mg Hg respectively at isoprenaline 2 micrograms/min). POST-atropine, the increase in heart rate was enhanced, the rise in systolic pressure abolished and the falls in diastolic and mean pressures exaggerated (+47.0 +/- 2.8 beats/min, -8.9 +/- 2.9 mm Hg, -27.3 +/- 2.1 mm Hg, -21.1 +/- 1.9 mm Hg, respectively at isoprenaline 2 micrograms/min). During an isoprenaline infusion, when the heart rate and blood pressure changes are stable, there is an increase rather than a decrease in cardiac vagal tone. PMID- 6487472 TI - Lack of a pharmacokinetic interaction between nifedipine and the beta adrenoceptor blockers metoprolol and atenolol. AB - Nifedipine, metoprolol and atenolol were administered orally to young, healthy volunteers. Each drug was given alone and nifedipine was also given with both beta-adrenoceptor blockers. Each drug was given for 3 days immediately before the study days. Plasma and urine drug concentrations were measured and the relevant pharmacokinetic parameters calculated. No pharmacokinetic interaction between nifedipine and the beta-adrenoceptor blockers was revealed. PMID- 6487471 TI - Effect on finger tremor of withdrawal of long-term treatment with propranolol or atenolol. AB - The effect of the withdrawal of long-term beta-adrenoceptor blockade on pulse rate and finger tremor was studied in 27 patients who had been treated for 2 years following an uncomplicated myocardial infarction with either atenolol, propranolol or placebo. During treatment, pulse rate was significantly lower in patients treated with propranolol or atenolol compared with placebo. Compared with the response in the placebo group the mean increase in tremor on withdrawal of propranolol was statistically significant for postural and for work tremor in both hands. A significant increase in tremor on withdrawal of atenolol occurred only in the postural position and in a narrow frequency band (left hand, 7-11 Hz; right hand, 7-9 Hz). The differences in the effect on tremor of withdrawal of treatment with propranolol or atenolol in doses which produced similar reductions in heart rate, emphasise the beta 2 classification of peripheral receptors associated with normal muscle tremor but do not exclude the involvement of beta 1 adrenoceptors. PMID- 6487474 TI - The action of prazosin and propylene glycol on methoxamine-induced bronchoconstriction in asthmatic subjects. AB - The effect of 1 mg inhaled prazosin on bronchoconstriction induced by methoxamine was investigated in seven asthmatic subjects. Prazosin caused significant inhibition of the methoxamine-induced bronchoconstriction in six of the seven patients. These findings suggest that methoxamine produces bronchoconstriction in asthmatic subjects via stimulation of alpha-adrenoceptors. In previous studies propylene glycol has been used as a vehicle for delivery of prazosin. This substance was found to cause significant inhibition of methoxamine effects and to shift the dose response curve to histamine to the right in four of seven patients. PMID- 6487473 TI - Effects of cholestyramine and colestipol on the plasma concentrations of propranolol. AB - The effect of equivalent hypolipidaemic doses of cholestyramine (8 g) or colestipol (10 g) on the plasma concentrations of propranolol and 4' hydroxypropranolol was studied in 12 normal volunteers following the oral administration of 120 mg of normal release propranolol tablets. When two doses of either cholestyramine or colestipol were administered prior to the propranolol, the peak plasma concentrations and area under the curve for both propranolol and the metabolite 4'-hydroxypropranolol were reduced significantly (P less than 0.05). We conclude that the drug interaction between cholestyramine or colestipol and propranolol leads to significant reductions in plasma concentrations of propranolol and 4'-hydroxypropranolol which may cause a clinically diminished effect for a given dosage. Therefore, patients should be observed when either of these resins are added to or deleted from a therapeutic regimen. PMID- 6487475 TI - The potentiation of acenocoumarol anticoagulant effect by amiodarone. AB - Out of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy, 80 (35 males and 45 females) were taking amiodarone. Forty patients had started amiodarone treatment while being treated with acenocoumarol. Of these, nine patients had begun amiodarone treatment while taking acenocoumarol. The relation between the daily dose of acenocoumarol and the prothrombin ratio (AC dose/PR ratio) has been considered a useful indicator to study the interaction between amiodarone and acenocoumarol. Differences of acenocoumarol daily dose between takers and non-takers of amiodarone were statistically significant (t = 5.35; P less than 0.001) for the whole population, for all the age groups, and also among males (t = 2.43; P less than 0.01) as well as among females (t = 5.38; P less than 0.001). Out of 40 patients chronically treated with acenocoumarol in whom amiodarone was instituted, 32 showed a decrease of the AC dose/PR ratio, while in eight patients no change was recorded (paired t-test, t = 5.82; P less than 0.001). In 15 patients who were being concomitantly treated with acenocoumarol and amiodarone, amiodarone was discontinued. An increase of the AC dose/PR ratio was recorded (paired t-test, t = 4.01; P less than 0.001). Nine patients had started treatment with amiodarone while receiving acenocoumarol and a decrease of the AC dose/PR ratio was documented; amiodarone was discontinued some months later, and an increase of the AC dose/PR ratio was seen. PMID- 6487476 TI - An electromyographic method of objectively assessing cough intensity and use of the method to assess effects of codeine on the dose-response curve to citric acid. AB - The integrated surface abdominal electromyogram (EMG) has been used as a simple measurement of cough intensity which correlates well with the volume, air flow and noise produced in different coughs. Using the integrated abdominal EMG as a measure of cough intensity, dose response curves to inhaled citric acid can be drawn which are highly reproducible. We have studied the effects of codeine (60 mg) on these curves, and have demonstrated a reduction in cough intensity. It is suggested that this method of testing the effects of an antitussive on such a dose-response curve may be a useful one. PMID- 6487477 TI - Disposition of betamethasone in parturient women after intramuscular administration. AB - When betamethasone phosphate equivalent to 8 mg betamethasone was administered intramuscularly in solution (Celestone Injection) to pregnant women, a large proportion of this ester was absorbed unchanged. Bioavailability of betamethasone from the phosphate ester was as high as after intravenous injection. When pregnant patients received the equivalent of either 6 or 12 mg betamethasone in a formulation containing 3.1 mg/ml betamethasone acetate suspended in a solution of 4 mg/ml betamethasone phosphate (Celestone Chronodose), much of the phosphate ester was absorbed intact but betamethasone acetate was not detected in plasma. Availability of betamethasone from Celestone Chronodose was much lower than from Celestone Injection. After administration of either formulation, maternal plasma cortisol concentrations fell towards a basal level but were rising again within 2 to 3 days of the last dose. We conclude that Celestone Chronodose does not provide prolonged release of betamethasone and offers no advantage over Celestone Injection. PMID- 6487478 TI - The effects of enzyme induction and enzyme inhibition on labetalol pharmacokinetics. AB - The oral and intravenous pharmacokinetics of labetalol were determined in five subjects before and after a 3 week course of glutethimide 500 mg/day. After glutethimide there was a significant reduction in the AUC after the oral dose of labetalol, from 40,596 +/- 11,534 (mean +/- s.e. mean) to 22,057 +/- 6,276 ng ml 1 min (2P less than 0.05), and systemic bioavailability was reduced from 30.3 +/- 2.8 to 17.0 +/- 3.5% (2P less than 0.001). There was no significant change in labetalol plasma concentration-time curve (AUC) following an intravenous dose, half-life, volume of distribution, and plasma clearance. The oral and intravenous pharmacokinetics of labetalol were determined in six subjects before and after a 3 day course of cimetidine 1.6 g/day. After cimetidine there was a significant reduction in the volume of distribution of labetalol, from 520 +/- 51 to 445 +/- 24 1 (2P less than 0.05). The AUC of labetalol after the oral dose increased by 66%, from 51,029 +/- 7,950 to 84,772 +/- 19,444 ng ml-1 min (2P = 0.06). The systemic bioavailability of labetalol increased from 25.1 +/- 2.4 to 39.0 +/- 7.6% (2P = 0.06). There was no significant change in labetalol AUC after the intravenous dose, half life, and plasma clearance. There were no significant changes in resting heart rate and supine systolic and diastolic blood pressure following labetalol plus glutethimide, or labetalol plus cimetidine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487479 TI - Effects of cimetidine on carbamazepine auto- and hetero-induction in man. AB - The effect of cimetidine (CMT; 400 mg twice daily) and matching placebo on the enzyme-inducing properties of carbamazepine (CBZ; 200 mg at night for 15 days) was studied in seven healthy male volunteers. CMT alone had no significant effect on antipyrine kinetics, urinary 6 beta-hydroxycortisol excretion or leucocyte delta-aminolaevulinic acid synthase (ALA.S) activity. CBZ increased leucocyte ALA.S activity by 204% following 1 week's treatment (P less than 0.001). Thereafter, ALA.S activity fell despite continued CBZ administration. Concomitant CMT did not influence this response. Antipyrine clearance and urinary 6 beta hydroxycortisol excretion were both increased by CBZ after 2 weeks' treatment (P less than 0.01). CMT blocked CBZ induction of antipyrine metabolism but the rise in urinary 6 beta-hydroxycortisol excretion was unaffected. Plasma CBZ concentrations 10, 14 and 18 h following the 8th and 15th doses were higher when CMT was taken concurrently (P less than 0.05). CBZ half-life fell by 36% and clearance rose by 29% (both P less than 0.001) with placebo and by 10% and 7% (both NS) when CMT was taken concurrently. CMT inhibits CBZ auto- and hetero induction in man. Epileptic patients receiving CBZ chronically may be at risk of toxicity if CMT is also prescribed. PMID- 6487480 TI - The influence of cimetidine on the pharmacokinetics of 5-fluorouracil. AB - The influence of cimetidine pretreatment on the pharmacokinetics of 5 fluorouracil (5FU) has been studied in 15 ambulant patients with carcinoma. Neither pretreatment with a single dose of cimetidine (400 mg) nor with daily treatment at 1000 mg for 1 week altered 5FU pharmacokinetics. Pretreatment with cimetidine for 4 weeks (1000 mg daily) led to increased peak plasma concentrations of 5FU and also area under the plasma concentration-time curve (AUC). The peak plasma concentration after oral 5FU was increased by 74% from 18.7 +/- 4.5 micrograms/ml (mean +/- s.e. mean) to 32.6 +/- 4.4 micrograms/ml (P less than 0.05) and AUC was increased by 72% from 528 +/- 133 micrograms/ml-1 min (mean +/- s.e. mean) to 911 +/- 152 micrograms ml-1 min (P less than 0.05). After intravenous 5FU, AUC was increased by 27% from 977 +/- 96 micrograms ml-1 min (mean +/- s.e. mean) to 1353 +/- 124 micrograms ml-1 min (P less than 0.01). Total body clearance for 5FU following intravenous administration was decreased by 28% from 987 +/- 116 ml/min (mean +/- s.e. mean) to 711 +/- 87 ml/min (P less than 0.01). The elimination half-life of 5FU was not altered by cimetidine. The basis of the interaction between 5FU and cimetidine is uncertain but probably a combination of inhibited drug metabolism and reduced liver blood flow. The therapeutic implications are considerable and additional care should be taken in patients receiving the two drugs concomitantly. PMID- 6487481 TI - Comparative bioavailability of trazodone formulations using stable isotope methodology. AB - The bioavailability of trazodone, a new antidepressant, from 50 mg dividose (A) or film-sealed (B) tablets relative to an oral solution was determined in six healthy male subjects using 50 mg of D4-trazodone as a stable isotope labelled standard. Concentrations of trazodone and D4-trazodone were measured by GCMS. The pharmacokinetics of trazodone and D4-trazodone were identical indicating no isotope effect. For formulation A, B and solution, the relative (trazodone/D4 trazodone) Cmax values were 0.84 +/- 0.09, 0.90 +/- 0.05 and 1.05 +/- 0.04. The relative bioequivalence of the dosage formed with a power of 85% (power by conventional ANOVA was 54%). Among subjects % relative standard deviations (RSD) for the D4-trazodone AUC values, a measure of intra-subject variability, were 6 to 38% while the % RSDs by period, a measure of inter-subject variability, were 26 to 55%. PMID- 6487482 TI - The uricosuric action of azapropazone: dose-response and comparison with probenecid. AB - Azapropazone is an anti-inflammatory agent with reported uricosuric properties. The aim of the present study was to extend these observations, by examining the dose-response and to compare the uricosuric effect of azapropazone with that of probenecid. Patients were given varying doses of azapropazone from 900-2400 mg daily for 4-day periods at separated intervals. Plasma uric acid levels were measured before and at the end of each treatment period. Three other patients maintained on low purine diets were given a 4-day course of 1200 mg azapropazone daily followed at an interval by a 4-day period of probenecid 1 g daily. Plasma uric acid levels and 24 h urinary uric acid excretion were compared. The mean fall in plasma uric acid level after four days of 900 mg azapropazone daily was 31.4% (n = 9) compared with 33.9% (n = 12) on 1200 mg daily; 42.3% (n = 10) on 1800 mg daily; and 46% (n = 6) on 2400 mg daily, indicating a graded dosage response. In the three patients on low purine diets the falls in plasma uric acid levels on probenecid 1 g daily were 50.5%, 46% and 29% compared with 33.5%, 32% and 20% respectively on azapropazone 1200 mg daily. Similarly the total amount of uric acid excreted in the urine by each patient during the 4-day period on probenecid 1 g daily was 14.01; 13.03 and 8.97 mmol compared with 23.53, 10.9 and 7.69 mmol on azapropazone 1200 mg daily.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487483 TI - Theophylline-rifampicin interaction: non-selective induction of theophylline metabolic pathways. AB - The effect of rifampicin pre-treatment (600 mg daily for 6 days) on theophylline disposition at steady state was investigated in six healthy males. Following rifampicin treatment total plasma clearance of theophylline increased by 82%. Theophylline clearance through each metabolic pathway was increased, 1 demethylation by (116 +/- 34%) (mean +/- s.e. mean), 3-demethylation by (91 +/- 16%) and 8-oxidation by (81 +/- 17%). Renal clearance of unchanged drug was not altered. Previous studies have suggested that two forms of cytochrome P-450 are involved in theophylline metabolism, one mediating the N-demethylations and the other 8-oxidation. Thus, unlike the selective inductive effect of rifampicin on antipyrine metabolic pathways, rifampicin does not differentially affect those forms of cytochrome P-450 involved in theophylline metabolism. The extent to which theophylline metabolism is induced by rifampicin is likely to have important clinical consequences. PMID- 6487484 TI - Thiazide-induced hypokalaemia; prevalence higher in women. AB - In 193 hypertensive patients taking bendrofluazide 5 mg daily, the mean serum potassium concentration was lower in women than in men (3.77 vs 3.99 mmol/l, P less than 0.001) and the prevalence of hypokalaemia (less than 3.5 mmol/l) was higher (25% vs 12%, P less than 0.05). This difference between the sexes was independent of age, body weight, renal function, the use of other antihypertensive drugs and compliance with treatment as judged by tablet counts. Severe hypokalaemia (less than 3.0 mmol/l) was uncommon and showed no difference between the sexes. PMID- 6487485 TI - Oxprenolol placental transfer, plasma concentrations in newborns and passage into breast milk. AB - Thirty-two pregnant hypertensive patients were treated with oxprenolol administered in combination with dihydralazine as Trasipressol tablets. Before delivery, oxprenolol was demonstrable in the maternal plasma and the amniotic fluid. The free fraction of oxprenolol in the maternal serum (15% +/- 7.8; mean +/- s.d.; n = 25) was similar to that in normal serum. At the end of delivery, oxprenolol was found in both the maternal and umbilical plasma in most cases. Measurable, but low oxprenolol concentrations were present in the newborn plasma. After delivery, oxprenolol was demonstrable in the maternal plasma and breast milk. An infant weighing 3 kg and consuming 500 ml of breast milk per day would receive a maximum dose 60 times less than the normal daily dose for a hypertensive adult (4 mg/kg). PMID- 6487486 TI - Atenolol pharmacokinetics in patients on continuous ambulatory peritoneal dialysis. AB - The elimination of atenolol (20 mg i.v.) has been studied in seven patients with renal failure on continuous ambulatory peritoneal dialysis (CAPD). Although atenolol was eliminated in the peritoneal fluid, the amount recovered in 24 h was relatively low (1.2 +/- 0.15 mg). The calculated urinary (n = 4) and peritoneal (n = 7) clearance was 0.289 +/- 0.058 l/h and 0.152 +/- 0.018 l/h respectively. This was considerably less than calculated total body clearance (1.21 +/- 0.086 l/h). The kinetics of atenolol in CAPD are worthy of further study. PMID- 6487487 TI - Information, compliance and side-effects in patients on dothiepin. PMID- 6487488 TI - Effect of age and sex on acenocoumarol requirements. AB - A group of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy was studied. 62.8% of the values of the prothrombin ratio were within the chosen therapeutic range (1.8 to 2.7), 21.9% were below 1.8 and 15.3% were above 2.7. The daily maintenance dose, expressed on a weight basis, was found to significantly decrease with increasing age. The daily maintenance dose taken by females was significantly higher than the dose taken by males (P less than 0.05); the differences between males and females were maximal among patients aged between 21 and 50 years, and disappeared at older ages. Two hundred and twenty eight haemorrhagic episodes in 160 patients were recorded during a total of 7797 months of follow-up. No lethal haemorrhages were observed. The overall incidence of bleeding episodes among females (3.6%) was higher than among males (2.2%) (P less than 0.001), even if menorrhagia was excluded (P less than 0.01). PMID- 6487489 TI - The role of sulphate conjugation in the metabolism and disposition of oral and intravenous paracetamol in man. AB - The effects of paracetamol dose (5 and 20 mg/kg) and route of administration (intravenous and oral) on the urinary excretion of paracetamol and its glucuronide, sulphate, cysteine and mercapturic acid conjugates were studied in five healthy subjects. The fractional urinary excretion of unchanged paracetamol and its conjugates was independent of the route of administration at both dose levels, suggesting that the gastrointestinal tract is not an important site for paracetamol metabolism. The percentage of the dose excreted as the sulphate conjugate was significantly higher after 5 than after 20 mg/kg (37.7% and 33.3% respectively) and this is consistent with saturation of sulphate conjugation. No significant effect of paracetamol dose upon the area under the plasma concentration-time curve (AUC), corrected for dose, was found for the sulphate or glucuronide conjugates. The total plasma clearance of paracetamol and the renal clearance of the sulphate conjugate were significantly higher after the 5 than the 20 mg/kg dose (331 +/- 42 ml/min and 295 +/- 48 ml/min; 273 +/- 74 ml/min and 205 +/- 46 ml/min respectively). The oral systemic availability of paracetamol was 80% and independent of dose. PMID- 6487490 TI - Determinants of carbamazepine and carbamazepine 10,11-epoxide binding to serum protein, albumin and alpha 1-acid glycoprotein. AB - The binding of carbamazepine and carbamazepine 10,11-epoxide to serum, albumin and alpha 1-acid glycoprotein (AAG) was determined and compared at drug concentrations ranging from 0.5 to 400 mg/l using equilibrium dialysis and liquid chromatography. The total binding of carbamazepine in serum was determined primarily by albumin and to a lesser extent (20-30%) by AAG. Modified Scatchard plots for carbamazepine binding in serum were biphasic, suggesting the presence of two binding sites on serum protein. Association constants characterizing the first (k1 = 2.4 X 10(4) l/mol) and second (k2 = 4.6 X 10(2) l/mol) binding sites agreed with those measured for AAG and albumin respectively. Modified Scatchard plots for carbamazepine 10,11-epoxide binding in serum were linear and serum binding was largely accounted for by binding to albumin. The epoxide metabolite did not bind to AAG. Carbamazepine binding to AAG was drug concentration dependent over the concentration range considered to be therapeutic, while the percent binding values for carbamazepine and epoxide binding to albumin and serum from a normal individual were constant over this range. Computer simulations showed that physiological extremes in AAG and albumin concentrations can result in a range of carbamazepine unbound fractions of 0.17 to 0.47. These data suggest that normal variations in concentrations of both proteins may be the principal cause of interpatient variability in serum protein binding of carbamazepine. PMID- 6487491 TI - The effect of acetylator phenotype on the disposition of aminoglutethimide. AB - Aminoglutethimide (AG) 500 mg was administered orally to four normal volunteers and eight patients undergoing treatment for metastatic breast cancer. In each subject the acetylator phenotype was established from the monoacetyldapsone (MADDS)/dapsone (DDS) ratio. Acetylaminoglutethimide (acetylAG) rapidly appeared in the plasma and its disposition paralleled that of AG. A close relationship (P less than 0.01) was observed between the acetyl AG/AG and MADDS/DDS ratio suggesting that AG may undergo polymorphic acetylation like DDS. AG half-life was 19.5 +/- 7.7 h in seven fast acetylators of DDS and 12.6 +/- 2.3 h in five slow acetylators and its apparent metabolic clearance was significantly (P less than 0.01) related to the acetylAG/AG ratio. Over 48 h the fast acetylators excreted 7.7 +/- 4.4% of the administered AG dose in the urine as unchanged AG as compared to 12.4 +/- 2.8% in slow acetylators. A much smaller fraction of the dose was excreted as acetylAG: 3.6 +/- 1.5% by fast and 1.9 +/- 1.0% by slow acetylators respectively. After 7 days treatment with AG at an accepted clinical dose regimen to the eight patients there were significant reductions in the half-lives of AG (P less than 0.01) and acetylAG (P less than 0.01) and a trend (0.1 greater than P greater than 0.05) towards reduction of the acetylAG/AG ratio which became significant (P less than 0.05) if the one patient on a known enzyme inducer was omitted. The mean apparent volume of distribution was not significantly (P greater than 0.1) altered but the mean apparent systemic clearance of AG was increased (P less than 0.05). These changes are attributed to auto-induction of oxidative enzymes involved in AG metabolism. PMID- 6487493 TI - Comparative bioavailability of tetracycline and lymecycline. AB - The relative bioavailability of lymecycline and tetracycline hydrochloride was compared in 12 healthy volunteers in a double-blind cross-over study using a high performance liquid chromatographic method for plasma and urine analyses. A statistical significant difference in favour of tetracycline hydrochloride was found concerning the mean AUC and the mean lag time. The relative bioavailability of lymecycline was only 70% compared with tetracycline in multiple dosing (19.13 +/- 5.39 micrograms ml-1 h and 27.22 +/- 6.26 micrograms ml-1 h respectively) and 80% in a single dose (21.88 +/- 4.23 micrograms ml-1 h and 26.91 +/- 6.01 respectively) and the mean lag time of tetracycline was only 60% compared with lymecycline. PMID- 6487492 TI - Genetic aspects of the polymodally distributed sulphoxidation of S-carboxymethyl L-cysteine in man. AB - Interindividual variation in the sulphoxidation of S-carboxymethyl-L-cysteine (750 mg p.o.) was investigated in 200 healthy volunteers. Nearly a 100-fold difference was observed between individuals with respect to the amount of sulphoxide metabolites detected in their 0-8 h urine (0.6 to 59.1% recovery). Such a difference was shown to be reproducible over several months in 40 subjects who spanned the entire range of capacities. Cumulative plots and maximum likelihood analysis of the distribution indicated that a bimodal model was most probable. Analysis of pedigree data obtained from 12 families suggested a genetic effect with overlying environmental influences. PMID- 6487494 TI - An evaluation of possible interactions between ethanol and trazodone or amitriptyline. AB - The pharmacodynamic effects of single doses of trazodone (100 mg), amitriptyline (50 mg) or placebo either alone or with ethanol (0.5 ml/kg) were investigated in six healthy volunteers in a double-blind crossover study. Plasma concentrations of the drugs and ethanol were also measured. Pharmacodynamic tests were critical flicker fusion frequency threshold (CFF), choice reaction time (CRT), manual dexterity, a digit span test and visual analogue scales. Blood ethanol concentrations were not influenced by the co-administration of either antidepressant. tmax for trazodone was prolonged by ethanol but the other pharmacokinetic parameters for trazodone and amitriptyline were not influenced by ethanol. Trazodone and amitriptyline caused the expected profound depressant effects on CFF, CRT, manual dexterity and on the rating scales for drowsiness, 'clear-headedness', aggression and disinhibition. Ethanol alone impaired manual dexterity, increased drowsiness, reduced 'clear headedness' and also tended to reduce feelings of aggression. In combination with either trazodone or amitriptyline, ethanol caused little additional effect except in the case of manual dexterity which was further impaired. This result may reflect the profound effects of the antidepressants alone and does not suggest that it is safe for patients receiving antidepressant medication to take ethanolic drinks. PMID- 6487495 TI - Accuracy and clinical utility of simplified tests of antipyrine metabolism. AB - High-performance liquid chromatography (h.p.l.c.) was used to measure plasma antipyrine concentrations in sixteen healthy subjects; five males, six females taking oral contraceptive steroids (OCS) and five age-matched females not taking OCS. Following oral administration of the drug, antipyrine clearance could be determined with similar precision and accuracy from plasma concentrations at two selected times (4 h and 24 h) ('two-sample antipyrine clearance test') as from six samples taken over two to three elimination half-lives (t1/2) of the drug ('conventional antipyrine clearance test'). Provided times for plasma sampling were modified appropriately, the two-sample antipyrine clearance test also gave reliable results in four patients taking phenytoin (sampling times 4 h and 8 h) who had significantly enhanced antipyrine clearance, and in nine patients with severe liver disease (using 4 h and 48 h) in whom antipyrine clearance was impaired. Urinary excretion of antipyrine metabolites (from 0-24 h) was determined in the above groups. Antipyrine systemic clearance correlated best with the percentage of administered dose excreted as 4-hydroxyantipyrine (r = 0.66, P less than 0.001) but also with 3-hydroxymethylantipyrine (r = 0.54, P less than 0.001) and with total metabolites excreted (r = 0.60, P less than 0.001). Total antipyrine metabolites excreted in urine in 24 h were significantly different from controls only in patients with liver disease (14 +/- 7.6% of administered dose vs 62 +/- 14%, P less than 0.001). The relative proportion of antipyrine metabolites did not appear to be altered when hepatic mixed function oxidation was induced by phenytoin or inhibited by OCS or by severe liver disease. PMID- 6487496 TI - Interaction of isoxicam with acetylsalicylic acid. AB - Ten healthy male volunteers were given 200 mg p.o. of isoxicam after an overnight fast and the plasma concentrations over time followed for 96 h by h.p.l.c. Five days later enteric coated acetylsalicylic acid (ASA) 650 mg four times daily was started and continued for 10 days producing steady state trough plasma salicylate of 83 mg/l (range 21-133). A second 200 mg isoxicam dose was given 5 days after starting ASA and the plasma concentration time-curve again followed. After ASA, there was no change in lag time (0.54 vs 0.51 h), time to peak concentration (10 vs 10 h), or disappearance t1/2 (28.7 vs 31.0 h) however the peak isoxicam concentration and AUC were reduced 18 and 22% respectively (P less than 0.01). Plasma protein binding of isoxicam studied by equilibrium dialysis was 96 +/- 1% in the absence and 86 +/- 5% in the presence of ASA. The reduction in binding was unrelated to plasma SA concentrations achieved or observed reductions in AUC for plasma isoxicam. ASA decreased plasma isoxicam binding, peak plasma isoxicam concentrations and AUC without altering the apparent disappearance half-life of total plasma isoxicam after a single oral dose. PMID- 6487497 TI - Unchanged peripheral sympathetic activity following withdrawal of chronic metoprolol treatment. A study of noradrenaline concentrations and kinetics in plasma. AB - Noradrenaline plasma kinetics were assessed in 17 male patients, who had been treated with metoprolol 100-200 mg daily (n = 8) or placebo for 3 years after an acute myocardial infarction, before and 1 week after gradual withdrawal (during 1 week) of the study treatment. Endogenous noradrenaline concentrations in plasma were measured by high performance liquid chromatography. Noradrenaline spillover rate, plasma clearance and the t1/2 for the rapid removal from plasma were determined by radio-tracer methodology. During treatment the plasma noradrenaline concentrations and noradrenaline plasma kinetic variables were similar in the two groups. Venous plasma noradrenaline concentrations were more closely correlated to the spillover rates of noradrenaline to plasma than to the clearance of noradrenaline from plasma, but the spillover rates were correlated to the clearance rates. Following the withdrawal of metoprolol noradrenaline clearance from plasma increased slightly (by 18 +/- 5%, P less than 0.05), but the plasma concentrations and spillover rates of noradrenaline were unchanged. In the placebo group withdrawal did not result in any significant changes. Our results indicate that a generalised increase in sympathetic nerve activity is not the cause of so-called rebound phenomena following withdrawal of chronic beta adrenoceptor blockade. PMID- 6487498 TI - Omeprazole inhibition of nocturnal gastric secretion in patients with duodenal ulcer. AB - We studied the effect of single 08.00 h doses of omeprazole or placebo on gastric acid secretion during the following night, 14 to 23 h after administration, in seven male subjects with duodenal ulcer. The drug was given orally, double-blind, in randomized order. Omeprazole 20 mg, 40 mg and 80 mg reduced mean total overnight acid output by 43%, 73% and 91% respectively and median pH increased from 1.4 with placebo to 1.6, 3.1 and 7.0 respectively. The inhibitory effect was maintained throughout the study period. No clinical side effects or abnormalities of laboratory screening tests were seen. Omeprazole is well tolerated and administration at 08.00 h produces prolonged dose related inhibition of acid output during the following night. PMID- 6487499 TI - Maximally effective plasma concentrations of enprofylline and theophylline during constant infusion. AB - Bronchodilating effects produced by increasing intravenously administered doses of enprofylline and theophylline compared to placebo were evaluated in 20 asthmatic outpatients. Three mean plasma plateaux of enprofylline of 1.5, 2.9 and 4.0 micrograms/ml produced a mean increase in forced expiratory volume in the first second (FEV1.0) as a percentage of baseline, of 12.8%, 18.8% and 30.1%, respectively. Comparable plasma plateaux of theophylline i.e. 5.5, 10.8 and 15.2 micrograms/ml produced a mean increase of FEV1.0 in percent of basal values of 12.4%, 21.6% and 28.2%, respectively. Enprofylline at plasma concentrations above 2.9 micrograms/ml induced more headache and slightly more nausea than theophylline and placebo. Theophylline infusion produced more tremor (finger oscillation) than enprofylline and placebo. Intravenously administered enprofylline produces bronchodilation comparable to theophylline in a mean dose ratio of 3.8. PMID- 6487500 TI - 2-Hydroxylation of ethinyloestradiol in relation to the oxidation of sparteine and antipyrine. AB - The metabolism of [3H]ethinyloestradiol (EE2) was investigated in six male subjects who had been phenotyped with respect to sparteine metabolism (three metabolizers and three non-metabolizers). Urinary metabolite profiles of EE2 were virtually identical. Following enzyme hydrolysis of sulphate and glucuronide conjugates the major urinary metabolite was 2-methoxyEE2. The ratio EE2:2 methoxyEE2 was taken as a measure of EE2 2-hydroxylation (metabolizers, 2.4 +/- 0.3; non-metabolizers, 2.5 +/- 0.4). Primaquine (45 mg), previously shown to inhibit antipyrine metabolism, had no effect on EE2 2-hydroxylation. Supporting studies in rats showed that acute administration of primaquine (50 mg/kg) and 1 methylimidazole (50 mg/kg) inhibited antipyrine but not EE2 metabolism. It is concluded that the cytochrome P-450 enzyme responsible for 2-hydroxylation of EE2 is distinct from the enzymes involved in the oxidation of sparteine and antipyrine. PMID- 6487501 TI - Is N-acetylation of 5-aminosalicylic acid reversible in man? AB - In two healthy male subjects the disposition of deuterated N-(2H3) acetyl-5 aminosalicylic acid (d3-ac-5-AS) was investigated after a single rectal dose of 500 mg d3-ac-5-AS. Urine and plasma were analysed by h.p.l.c. and gas chromatography mass-spectrometry. Peak concentrations of around 0.5 microgram/ml occurred within 6 h and plasma concentrations declined thereafter with a half life (t1/2) of about 6 h which was confirmed by urinary excretion data. Renal clearance of d3-ac-5-AS ranged between 200 and 300 ml/min and only 4.4-11.2% of the dose could be recovered in the 48 h urine. Since no undeuterated ac-5-AS could be detected in any of the plasma and urine samples an irreversible acetylation of 5-AS is assumed in man. PMID- 6487502 TI - Xipamide: no advantage over bendrofluazide in hypertension. AB - In patients with uncontrolled hypertension addition of xipamide 20 mg daily to bendrofluazide 5 mg daily produced no significant additive antihypertensive effect, and the 95% confidence limits excluded a clinically important response. Xipamide treatment worsened hypokalaemia and increased the blood urea concentration significantly. PMID- 6487503 TI - A study of the potential interactions between azapropazone and frusemide in man. AB - Ten healthy individuals received frusemide 40 mg orally for 7 days. Following a drug free period of 7 days they received azapropazone 600 mg twice daily for 7 days and then both treatments for a further 7 days. Sodium excretion fell from 141 +/- 16.8 mmol/day to 84.3 +/- 6.8 mmol/day (P less than 0.01) on initiation of azapropazone treatment. The natriuretic response to frusemide was unchanged by premedication with azapropazone. Urate excretion rose from 3.35 +/- 0.249 mmol/day to 4.98 +/- 0.365 mmol/day on initiation of azapropazone therapy but subsequently returned to baseline values. Plasma uric acid fell from 0.289 +/- 0.024 mmol/l to 0.167 +/- 0.0125 mmol/l (P less than 0.001) on azapropazone but rose to 0.186 +/- 0.0116 mmol/l (P less than 0.001) with the addition of frusemide. Azapropazone may cause sodium retention but after repeated administration frusemide still has a marked diuretic action. The hypouricaemic effect of azapropazone is only slightly antagonised by frusemide at the doses studied. PMID- 6487504 TI - Cimetidine does not alter ibuprofen kinetics after a single dose. AB - Cimetidine does not slow the disappearance of ibuprofen from the serum after a single dose in healthy male volunteers. This suggests that no change in ibuprofen dosing is necessary when cimetidine is co-administered. PMID- 6487505 TI - Pharmacokinetic study of cyclosporin A (Sandimmun) in patients with primary biliary cirrhosis. AB - The pharmacokinetics of cyclosporin A (CS-A) were studied in 10 patients with primary biliary cirrhosis (PBC) after oral administration in steady state. Mean values for area under the blood concentration-time curve (AUC), time to maximal blood concentration (tmax), maximal blood concentration (Cmax) and elimination half-life (t1/2,z) were similar to results of previous studies in transplant patients. The variation between patients was large. No significant correlations of pharmacokinetic data with biochemical or histological parameters were found. Because of the high variability of pharmacokinetic parameters, patients with PBC treated with CS-A need to be regularly controlled for nephrotoxicity by estimation of serum creatinine and bioavailability (trough blood levels). PMID- 6487506 TI - Study of the bioavailability of pindolol in malabsorption syndromes. AB - Pindolol kinetics and bioavailability were studied after a single dose (oral 5 mg; intravenous 3 mg) in nine patients with malabsorption (two with villous atrophies, seven with short bowel syndromes) and in six healthy volunteers. After oral administration no significant differences were observed in bioavailability (59.4 +/- 6.2% in patients vs 79.5 +/- 8.6% in controls) and for most plasma and urinary pharmacokinetic parameters between the experimental and control groups as a whole. However, detailed analysis revealed decreased absorption for pindolol in two out of nine patients. After i.v. administration, apparent distribution volume was smaller (V: 2.10 +/- 0.25 l kg-1 vs 3.05 +/- 0.31 l kg-1) and global elimination constant was larger (ke: 1.43 +/- 0.46 h-1 vs 0.56 +/- 0.10 h-1), in patients with malabsorption than in controls (P less than 0.05). The smaller weight of patients and pharmacokinetic modifications due to the pathology could account for this. PMID- 6487507 TI - Delayed release peppermint oil capsules (Colpermin) for the spastic colon syndrome: a pharmacokinetic study. AB - Excretion of menthol (as glucuronide) from orally ingested peppermint oil contained in Colpermin was compared with oil contained in two soft gelatine capsules. Total 24 h urinary excretion of menthol was similar in the two formulations in healthy volunteers, but peak menthol excretion levels were lower and excretion delayed with Colpermin. Menthol excretion was reduced in ileostomy patients who took Colpermin and moderate amounts of unmetabolised menthol were recovered from the ileostomy effluent. This is consistent with Colpermin being a delayed-release form of peppermint oil. PMID- 6487508 TI - Cardiovascular and biochemical responses to nebulised salbutamol in normal subjects. AB - When conventional therapeutic doses of nebulised salbutamol were given to normal volunteers, there was a significant rise in pulse rate, systolic blood pressure and plasma glucose and a significant fall in diastolic blood pressure and serum potassium in comparison with placebo. Such changes may be potentially hazardous in certain situations. Patients with airways obstruction due to chronic bronchitis who have coexistent ischaemic heart disease or diuretic induced hypokalaemia may be at particular risk from the unwanted cardiovascular and biochemical responses to nebulised salbutamol. PMID- 6487509 TI - Serum theophylline levels with oral sustained release theophylline after transfer from intravenous aminophylline in patients with chronic lung disease. PMID- 6487510 TI - Improved effect of tolbutamide when given before food in patients on long-term therapy. PMID- 6487511 TI - Nifedipine and endocrine status in diabetic patients. PMID- 6487512 TI - Measurement of antipyrine half-life from urinary drug concentrations. PMID- 6487513 TI - Decreased alpha 1-acid glycoprotein in liver cirrhosis: consequences for drug protein binding. PMID- 6487514 TI - Clinico-pathological features of prognostic significance in operable rectal cancer in 17 centres in the U.K. (Third report of the M.R.C. Trial, on behalf of the Working Party). AB - Clinico-pathological features of prognostic significance in rectal cancer are described in 824 patients who were treated at 17 centres in the Medical Research Council Trial of radiotherapy in operable cancer of the rectum. Among the pre operative assessments the mobility of the tumour was the one most strongly related to prognosis. Other variables predictive of outcome were the number of involved quadrants of the rectum, the distance of the tumour from the anal verge and the age of the patient. Of assessments made at surgery or immediately after, the report of a curative operation and the Dukes' classification most closely related to prognosis. The information presented supports the idea that a pre operative clinical staging system for rectal cancer would be feasible and useful. PMID- 6487515 TI - Adjuvant low dose radiation in childhood non-Hodgkin's lymphoma (report from the United Kingdom Childrens' Cancer Study Group--UKCCSG). AB - From July 1977 to July 1983, 120 children with non-Hodgkin's Lymphoma entered a randomised trial of combination chemotherapy and radiotherapy. The primary site was abdominal in 42 patients, mediastinal in 27 and in other sites in 51. Failure free survival (FFS) at 4 years was 74% for the 41 patients with localised disease (Stages I and II) and 51% for the 79 with generalised disease (Stages III and IV). Patients with mediastinal primaries continued to relapse after the completion of 2 years' treatment, but FFS at 4 years for the 93 patients with non mediastinal primaries was 65% for all stages combined. In the latter group, there was no benefit to patients randomised at the end of induction chemotherapy to receive adjuvant radiation 15 Grays in 10 fractions in 2 weeks to sites of previous bulky disease when compared to those not receiving such radiation (P = 0.6). PMID- 6487516 TI - Restoration of doxorubicin responsiveness in doxorubicin-resistant P388 murine leukaemia cells. AB - The effects of certain compounds on the in vitro growth rate and the sensitivity to doxorubicin of P388 murine leukaemia cell line and of a doxorubicin-resistant subline (P388/ADR) were studied. The calcium channel blocking activity of these compounds was evaluated by measuring their effects on the sodium-dependent and membrane potential-dependent calcium uptake in synaptic plasma membrane vesicles. At non-inhibitory concentrations, verapamil, dipyridamole, meclizine and nicardipine were highly active in restoring the sensitivity to doxorubicin of P388/ADR cells. Moderately active were propranolol, N-(beta-diethylaminoethyl)-N (beta-hydroxy-beta-phenylethyl)-2,5-dich loranaline (MDL-6792), thioridazine and chlorocyclizine, while nifedipine, guanethidine, phentolamine, chloroquine and papaverine had zero or only minimal synergistic activity to doxorubicin in this cell line. Doxorubicin synergistic activity could not be demonstrated in the parent drug-sensitive cell line. No sodium-dependent or membrane potential dependent calcium uptake could be demonstrated in vesicles prepared from plasma membranes of either cell line. There is no correlation between the ability of these compounds to inhibit calcium uptake in synaptic vesicles and their potency in restoring the sensitivity of P388/ADR cells to doxorubicin. PMID- 6487517 TI - Chemopotentiation in vivo: no loss of sensitization with fractionation. AB - The response of KHT sarcomas to one, two, five or ten daily fractions of 1-(2 chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), with and without misonidazole (MISO), was evaluated using delay of tumour regrowth as the measure of response. When CCNU was given as 2 dose fractions separated by 24 h rather than as a single treatment, no extra dose was necessary to achieve a particular level of damage, suggesting a lack of damage repair. With increasing fraction number, however, an increasing total dose of drug was required to achieve a given effect, presumably to compensate for proliferation. Increasing drug doses also were readily tolerated (almost twice the LD50/7 for a single dose of CCNU resulted in no deaths when given in a 10 fraction treatment) indicating a large sparing of normal tissue toxicity when CCNU treatments were fractionated. The addition of MISO enhanced the tumour response to CCNU in all treatment schemes. When single doses of CCNU were combined with 0.5 mg g-1 MISO, an enhancement ratio (ER) of approximately 1.5 was observed. This ER was maintained for all fractionated treatment schedules including the 10 daily fraction protocol. In addition, no loss of sensitization with increasing fractionation was observed when a lower dose of 0.2 mg g-1 MISO was combined with each of 5 or 10 daily fractions of CCNU. Similar experiments were performed to test the combination of cyclophosphamide (Cy) and MISO (0.5 mg g-1) in the RIF-1 tumour; again chemopotentiation was maintained with increasing fractionation. These results of combined MISO and fractionated chemotherapy are in contrast to the rapid loss of sensitization observed when MISO is used as a radiation sensitizer and combined with small doses of X-rays, thus providing in vivo evidence of the mechanistic difference between the effects of MISO used as a radiation sensitizer or chemopotentiator. Peripheral white blood cell counts performed on mice receiving 5 daily fractions of CCNU +/- MISO displayed no significant enhancement of normal tissue toxicity by MISO. Thus combining MISO with repeated low dose treatments of a chemotherapeutic agent results in a therapeutic gain. PMID- 6487518 TI - Comparison of tumour age response to radiation for cells derived from tissue culture or solid tumours. AB - Direct comparison of the cell age response of 9L and KHT tumour cells derived either from tissue culture or solid tumours was achieved. Cells from dissociated KHT and 9L tumours (the latter implanted either subcutaneously or intracerebrally) and cells from tissue culture were separated into homogeneous sized populations by centrifugal elutriation. In both tumour models these homogeneous sized populations correspond to populations enriched at different stages of the cell cycle. The survival of these elutriated cell populations was measured after a single dose of Cs-137 gamma rays. For cells isolated from 9L solid tumours, there was little variation in radiosensitivity throughout the cell cycle; however, a very small but significant increase in resistance was found in late G1 cells. This lack of a large variation in radiosensitivity through the cell cycle for 9L cells from solid tumours also was seen in 9L cells growing in monolayer tissue culture. When similar experiments were performed using the KHT sarcoma tumour model, the results showed that KHT cells in vitro exhibited a fairly conventional increase in radioresistance in both mid G1 and late S. However, the cell age response of KHT cells from solid tumours was different; particularly in the late S and G2 + M phases. These data demonstrate that direct extrapolation of in vitro cell age responses to the in situ situation may not always be valid. PMID- 6487520 TI - The association of condylomata acuminata and squamous carcinoma of the vulva. PMID- 6487519 TI - A study of dose-response relationship between tobacco habits and oral leukoplakia. AB - In a house-to-house survey in Ernakulam district, Kerala, India, 12,213 tobacco users were interviewed about the details of their tobacco usage and examined for the presence of leukoplakia. The frequency of tobacco habit was associated with the prevalence of leukoplakia indicating a positive dose-response relationship. The dose-response relationship remained significant, taking age, sex, and the type of tobacco habit into account. After adjusting for all these variables jointly the association still remained significant. The dose-response relationship was stronger for the smoking habit than for the chewing habit. A weaker relationship in the chewing habit was not due to the duration of chewing habit or the habit of retaining the betel quid in the mouth while sleeping. Thus the dose-response relationship, although significant, was different for tobacco smoking and chewing habits. PMID- 6487521 TI - Testicular cancer and social class in East Anglia. PMID- 6487522 TI - Enhancement by serotonin of intra-tumour penetration of spleen cells. PMID- 6487523 TI - Advances in the applications of monoclonal antibodies in clinical oncology. Abstracts. PMID- 6487524 TI - Recent experience of tuberculosis in junior hospital doctors in Leeds and Bradford. AB - Over a 2-year period, six cases of active tuberculosis were seen in doctors in two adjacent northern cities. Five patients were junior hospital doctors and three were in close contact with children. Pre-employment screening in four doctors did not take place. Despite screening, two subsequently developed active disease. The advisability and difficulties of screening junior hospital doctors are discussed. PMID- 6487525 TI - The value of contact procedures for tuberculosis in Edinburgh. AB - We have reviewed the value of routine contact procedures (CP) in screening for tuberculosis in the Edinburgh area. Nine hundred and forty-seven index cases were notified during the 5-year period 1977-81; of these, 131 (14%) were detected by CP, 78 had previously undetected tuberculous disease and a further 53 required chemoprophylaxis (CPX). None had presented with symptoms, and disease was consequently detected at an earlier stage with fewer being sputum smear positive (10% vs 29% P less than 0.01). The 131 cases were found by CP during the screening of 4445 contacts, an overall yield of 2.9%. The highest yield was 18% for close contacts of sputum smear positive index cases, the yield for the casual contact being only 3%. The overall yield for contacts of smear negative respiratory and non-respiratory index cases was less than 2% in each group. Young contacts were particularly vulnerable and the yield in Asian children was 10.2%, twice that of the 4.9% in non-Asian children (P less than 0.001). The incidence of new cases in contacts who had previous BCG vaccination was significantly lower than that in non-vaccinated contacts (1.15% vs 3.06% P less than 0.001) suggesting a protective effect of 62%. One hundred and twenty-five (95%) of the 131 new cases were diagnosed within 3 months of first attendance, the remaining 5% at 6 months. The workload involved in screening contacts in this series could have been halved by restricting CP to all contacts of sputum smear positive index cases and only the close contacts of all other index cases. This would have resulted in missing 18% of the new cases, or three cases of tuberculosis and two cases requiring CPX per year, in a population of 608 000. Seventy-two (7.6%) of the 947 index cases were of Asian origin. Their disease occurred more in young adults, especially women, and was more frequently extrapulmonary in site (25% vs 12% in non-Asians P less than 0.01). We conclude that contact procedures remain valuable in the detection of new, asymptomatic cases of tuberculosis in Edinburgh and, by implication, in other urban areas of the United Kingdom. Particular efforts should be directed towards children, Asians and those without BCG vaccination, especially if they have been in contact with sputum smear positive index cases. PMID- 6487526 TI - Pneumococcal pneumonia with bacteraemia. AB - Fourteen cases of pneumococcal pneumonia with bacteraemia have been studied. Thirteen of the patients were older than 50 years and in ten there was evidence of pre-existing disease. Pneumococci of six serotypes were responsible for these infections but type 3 was the commonest and was associated with three of the four fatal cases. The patients who died all had evidence of renal failure. Eight of the ten survivors had prerenal failure which responded to treatment. Hyponatraemia was a common finding. Despite prompt antibiotic treatment and intensive therapy there is still a high morbidity and mortality from this condition. PMID- 6487527 TI - Bronchial asthma in Malaysia. AB - Asthmatic patients constitute up to 5% of admissions to medical wards in our area. Analysis of 1099 adult asthmatic admissions over a 3-year period showed that Malays composed 31% of patients (expected 23%), Indians composed 36% (expected 31%) and Chinese only 32% (expected 46%). There was a reduced prevalence of asthma in the Chinese (P less than 0.001). Male asthmatic admissions showed a non-seasonal cyclic variation (P less than 0.01) with an increasing trend in the number of admissions (P less than 0.02). The proportion of male to female asthmatic admissions did not differ. In a sample of 50 asthmatic patients, studied in detail, the mean age of onset was 33.3 years (range 6-74) while only 14% of subjects had onset of asthma before the age of 10 years. Although the clinical features of these patients differ from those of Caucasian asthmatics, skin prick tests and other features suggest that the majority of our patients suffer from extrinsic atopic asthma. PMID- 6487528 TI - The efficacy of drug delivery by a pear-shaped spacer and metered dose inhaler. AB - The efficacy of terbutaline delivered via a 750 ml spacer device (Nebuhaler) compared with a metered dose inhaler alone was studied by means of an open cross over trial in eight patients with stable asthma. The FEV1 and FVC response curves with cumulative doses up to 8 mg were shifted significantly to the left using the device, whilst side effects were not significantly increased. These results indicate that the spacer significantly improves aerosol drug delivery from a pressurized inhaler, even in patients whose inhalation technique was considered adequate. PMID- 6487529 TI - Answering the relatives of lung cancer patients. AB - Of 230 bronchial carcinoma patients, 30 underwent resection and 13 (5.6%) survived 5 years. Some of the domestic implications of the diagnosis were sought through study of the 200 non-surgically treated patients and by interviews with 191 of their relatives. Seventy-eight per cent of the relatives said that the illness had not been as bad as they had anticipated. Fifty-five per cent of patients died within 4 months of their first examination and 28.5% of relatives were unprepared for the suddenness of the death. Five per cent of patients died of a massive haemoptysis. For two-thirds of a subgroup of 56 patients, inability to get to the lavatory with help from one person, was a herald of death within 10 days. Some findings offered comfort for relatives living with a lung cancer patient: 41% of patients had no pain at all, 23.5% needed no treatment and 9.5% weakened and died very peacefully. PMID- 6487530 TI - The 100 m walk: a simple and reproducible exercise test. AB - In a modification of conventional walking tests in respiratory disease patients were asked to walk successive 50 m lengths of a corridor and the time taken over the third 100 m was taken as the walking pace. This pace was highly correlated (r = 0.994) with the 12-minute distance and was highly reproducible (r = 0.98). PMID- 6487531 TI - Pulmonary tuberculosis complicated by haemophagocytic syndrome and rifampicin induced tubulointerstitial nephritis. AB - The benign, or infection-associated, haemophagocytic syndrome (IAHS) is a rare bone marrow disorder of macrophage cell proliferation diagnosed most commonly in immune compromised patients who develop herpes type viral infections (Risdall et al. 1979). It has also been reported in association with bacterial infections and rarely with mycobacterial infection (Chandra et al. 1975; Mamoharon & Catovsky 1981; Bultmann et al. 1982). Despite being potentially reversible it may produce a life-threatening pancytopenia (Seligman et al. 1972). We report a further case of the haemophagocytic syndrome associated with Mycobacterium tuberculosis in which thrombocytopenia was the predominant feature. There were unusual features in the clinical presentation and the patient's treatment and recovery were subsequently complicated by rifampicin-induced renal failure. PMID- 6487532 TI - 'Atypical pneumonia' due to parakeet sensitivity: bird fancier's lung in a 10 year-old girl. AB - p6trinsic allergic alveolitis is rare in childhood, with most of the cases reported due to exposure to avian precipitins (Stiem et al. 1966; Dinda et al. 1969; Chandra & Everly Jones 1972; El-Hefny et al. 1980). We report a 10-year-old girl with bird fancier's lung, and suggest that environmental antigens should be sought in children presenting with non-resolving chest disease. PMID- 6487533 TI - Effect of mica dust and choline on the lymph nodes of rats. AB - Male albino rats given choline alone by intraperitoneal injection (40 doses of 25 mg/5 days a week over a period of 10 weeks), developed atypical lymphadenopathy at the end of the experiment (330 days). In a second group, the intratracheal instillation of single dose of 25 mg of respirable mica provoked proliferation of reticular cells and macrophages in the tracheobronchial lymph nodes. However, in a third group, the combined action of choline and mica caused marked lymphadenopathy with abnormal cells. The role of choline, an essential component of cell membrane, in enhancing the reaction to mica in the lymph nodes, is discussed. PMID- 6487534 TI - The role of lung development in the age-related susceptibility of ferrets to influenza virus. AB - Newborn (I-day-old) ferrets died following intranasal inoculation of influenza virus (clone 7a) but suckling (15-day-old) ferrets were almost as resistant as adult ferrets. Many of the deaths in newborn ferrets were consequent upon an increased lower respiratory tract infection. One reason for the latter was an increase in susceptibility of both ciliated epithelium and alveolar cells in newborn ferret lungs when compared with the corresponding cells in adult and suckling ferrets (Coates et al. 1984). Work reported here shows that the lungs of newborn ferrets possess a greater proportion of ciliated epithelium-lined airway in comparison with the lungs of suckling and adult ferrets. This situation might also contribute to the increased susceptibility of the lower respiratory tract although the difficulties of assessing this influence precisely are discussed. In addition, the occlusion of the narrower airways of the immature lung in the infected newborn ferret contributes to the increased respiratory complications. PMID- 6487535 TI - Effect of prolonged saline loading on HgCl2-induced renal tubular damage. AB - Male Porton-Wistar rats, 32 weeks old, were given i.p. one of the following doses of HgCl2; 0.5, 1.0 or 1.5 mg Hg/kg. In the preceding 4-week period and throughout the experiment the animals had free access to either tap water or 1.0% saline. The urinary excretion of alkaline phosphatase measured in urine samples, collected during the first 24 h after treatment with mercury, indicated that chronic saline loading significantly attenuated tubular damage caused by 0.5 mg or 1.0 mg Hg/kg, but not by 1.5 mg Hg/kg. Tubular necrosis 12 and 24 h after mercury was also less severe and extensive in saline than in tap water-drinking rats. This difference was still noticeable 4 days after mercury treatment in rats dosed with 0.5 mg Hg/kg, but death in the two higher dose groups prevented further pair-to-pair histological comparison. At the selected dose levels chronic saline loading did not decrease renal mercury content at 12 or 24 h and therefore protection was not associated with decrease in renal mercury uptake. The experiment indicates that chronic saline drinking, which at higher doses attenuates HgCl2-induced acute renal failure but not tubular necrosis, is able to moderate the severity of tubular necrosis when the dose of HgCl2 is as low as 0.5 mg Hg/kg. This protective effect diminishes as the dose is increased. PMID- 6487536 TI - Comparative effects of cimetidine on biliary lipid secretion in fasted and fed rats. AB - The effect of cimetidine on biliary lipid secretion has been investigated in fasted and fed rats with biliary drainage for 4 h after a single intraperitoneal administration at a dose of 120 mg/kg body weight. Bile flow, bile acids, cholesterol and phospholipids in bile have been determined. In intact rats similarly treated, serum bile acids, cholesterol and phospholipids have been determined. Biochemical and morphological studies have been conducted on the liver tissue in both experiments. Bile flow and bile acid secretion were not affected by cimetidine in fasted rats, but, 15 min after administration of the drug, fed rats showed an increase of the molar percentage of cholic acid together with a decrease of deoxycholic acid, a decreased secretion of cholesterol and an increased secretion of phospholipids. The values of these biliary lipids were in the range observed in fasted animals, so that the drug appeared to 'mimic' the effect of fasting. These findings could be related to altered vascular properties of the gastro-intestinal wall induced by cimetidine, leading to interference with intestinal postprandial hyperaemia and capillary permeability, so that there appears to be a conversion of bile composition from a digestive to an interdigestive pattern. PMID- 6487538 TI - Ultrastructural changes in re-endothelialized and non-endothelialized rabbit aortic neo-intima following re-injury with a balloon catheter. AB - The response by normal rabbit aortas to the removal of the endothelium with a balloon catheter, was compared to the response to the removal of regenerated endothelium from rabbit aortas that had been previously de-endothelialized. De endothelialization results in the formation of a neo-intima. Thrombus formation following a second balloon catheter injury was compared among injured neo-intima that had been re-endothelialized, non-re-endothelialized neo-intima, and the subendothelium of normal vessels following a single injury. Rabbit aortas were examined by scanning electron microscopy of full circumference segments of the aorta and by transmission electron microscopy. Thirty minutes after a single de endothelialization injury with a balloon catheter the luminal surface is covered by a monolayer of platelets adhering to the subendothelial connective tissues. Two weeks later there is neo-intimal formation and endothelial regeneration around branch vessel orifices. The remainder of the luminal surface is composed of smooth muscle cells (SMC). A balloon catheter injury to a vessel injured 2 weeks previously results in fibrin formation and platelet-fibrin microthrombi on the aortic intimal surface. The response of the aortic wall to re-injury does not seem to be related to the prior existence of endothelium. Both single and repeated injuries result in a distribution of formed elements which may depend, in part, on haemodynamic factors. PMID- 6487537 TI - Ultrastructural characteristics of hyperplastic alterations in the liver of congenital portacaval-shunt rats. AB - A congenital portacaval shunt was discovered in five rats. In these animals the hepatic artery was the only blood vessel perfusing the liver; the portal vein was absent. The livers were small and mainly hypoplastic, but light microscopy revealed the occurrence of focal hyperplastic alterations and occasional hyperplastic nodules. TEM and SEM showed these areas to be composed of clustered hepatocytes, separated by widened intercellular spaces. The cell membranes carried numerous pleomorphic microvilli, and the cytoplasma contained densely packed mitochondria, some of which were giant sized. Liver cells in the centrilobular region were hypoplastic. Comparison with findings of experimental portacaval anastomosis suggest that in congenital-shunt animals, the overall hypoplasia of the liver with the formation of hyperplastic areas is a consequence of the lack of portal blood. PMID- 6487539 TI - Cardiac cell damage: a primary myocardial disease in streptozotocin-induced chronic diabetes. AB - Ultrastructural changes in heart muscle due to chronic diabetes subsequent to a single injection of streptozotocin (65 mg/kg body wt, i.v.) were studied in rats. Presence of diabetes was indicated by hyperglycaemia (plasma glucose, control, 120 +/- 7; diabetic, 448 +/- 21 mg/dl) as well as hypo-insulinaemia (plasma insulin, control, 25.6 +/- 5.2; diabetic, 11.2 +/- 0.5 microU/ml). After 8 weeks of diabetes, the hearts were processed for electron microscopic examination. Cardiac muscle cells in diabetic hearts showed condensation of nuclear chromatin and folding of nuclear membranes. Swelling of mitochondria, clearing of mitochondrial matrix and incorporation of lysosomal membranes into mitochondrial matrix was also noted. A marked increase in both lysosomes and lipid droplets was apparent. Focal areas in diabetic hearts showed contracted sarcomeres, myofibrillar degeneration and separation of the intercalated disc. Atherosclerotic plaque formation as well as structural changes in the smooth muscle or endothelial cells in the small arteries, arterioles or capillaries were not seen to accompany the structural changes in the cardiac muscle cells of the diabetic hearts. This study provides strong evidence for the occurrence of primary myocardial disease in streptozotocin-induced chronic diabetes. PMID- 6487540 TI - Abnormalities induced in cultured rat embryos by hyperglycaemia. AB - Rat embryos explanted at stages between primitive streak and head-fold were exposed in rotating bottle cultures to glucose levels raised by 3-15 mg/ml either throughout a 66-h culture period, or for shorter intervals near the start of culture (with the rest of the culture period at normal glucose levels). A high proportion of embryos explanted at 8 days 20 h or at 9 days and exposed to 12 mg/ml exogenous glucose for only the first or second 8-h periods of a 66-68-h culture were malformed, whereas embryos exposed for the third 8 h were relatively resistant, and embryos exposed later still were unaffected. There were indications that embryos at stages of development corresponding to the second 8-h periods in these cultures were particularly susceptible to hyperglycaemia. Embryos explanted at 9 days exhibited malformations when exposed to 6-9 mg/ml glucose throughout culture, compared with the 12-15 mg/ml shown previously to be necessary to induce anomalies in embryos explanted 12 h later. PMID- 6487541 TI - Biochemical changes in mouse brain myelin during experimental primary amoebic meningo-encephalitis. AB - Myelin membranes were purified from normal as well as experimental primary amoebic meningo-encephalitis-afflicted mouse brains. Infected myelin fractions were observed to form a floating fraction in 0.32 M sucrose. Total proteins, total lipids, phospholipids, cholesterol and galactolipids decreased markedly due to amoebic infection. Phosphatidyl choline, phosphatidyl ethanolamine plus phosphatidyl serine and sphingomyelin were decreased with a concomitant increase in lysophosphatidyl choline, lysophosphatidyl ethanolamine plus lysophosphatidyl serine and phosphatidic acid. SDS-polyacrylamide gel electrophoresis of myelin proteins exhibited six major protein fractions. Marked depletion in proteolipid protein was observed; 5'-nucleotidase activity increased while Na,K-ATPase and Mg ATPase activities decreased. Infected myelin Na,K-ATPase had lower Vmax and higher Km values than normal. Arrhenius plots of normal myelin Na,K-ATPase exhibited transition temperature at 22 degrees C while no transition temperature could be observed in case of infected myelin Na,K-ATPase. PMID- 6487542 TI - Evidence for a functional defect of the lamina lucida in recessive dystrophic epidermolysis bullosa demonstrated by suction blisters. AB - Suction blisters were raised in non-lesional skin of sixteen patients with various types of epidermolysis bullosa (EB). The ultrastructural level of separation was found in each type to be within the lamina lucida of the epidermal basement membrane zone. Suction blister times were normal in EB simplex, dominant dystrophic and localized recessive dystrophic EB, but were markedly reduced in both junctional EB and severe generalized recessive dystrophic EB. These data indicate an unpredicted abnormality of adhesion within the lamina lucida in severe recessive dystrophic EB, in addition to the well-recognized defect at a deeper level, beneath the lamina densa, in this condition. The use of suction blister times may prove valuable in the diagnosis of EB. PMID- 6487543 TI - Porphyria turcica due to hexachlorobenzene: a 20 to 30 year follow-up study on 204 patients. AB - During 1955-1961 in south-east Turkey, over 3000 patients developed porphyria due to ingestion of hexachlorobenzene, a fungicide added to wheat seedlings. Subsequently they developed pigmentation, hirsutism, weakness, porphyrinuria and bullae. The condition was called kara yara or 'black sore'. Many of the breast fed children under the age of 1 year died from a disease known as pembe yara or 'pink sore'. In this follow-up study of 204 patients, 20-30 years later, there were 132 males and 72 females, average age 32.1 years (at time of examination), with an average age of onset of 10.2 years, and duration of 2.4 years. Neurological, dermatological, and orthopaedic abnormalities still persisted. Neurological symptoms included weakness (66%), paraesthesiae (54%), neuritis (63%), myotonia (49%), and occasional 'cogwheeling' (29%). Some individuals affected before puberty had small stature (44%), small hands (64%) and painless arthritis (67%). Severe residual scarring was common (85%), and pinched facies (42%), hirsutism (47%) and hyperpigmentation (71%) were also observed. Enlarged thyroids were observed in 37% (59% in females), which was above average of 5% in this area of Turkey. Porphyrin excretion, particularly uroporphyrin in the urine and stools, was still significantly increased in seventeen patients. Hexachlorobenzene levels as high as 2.8 p.p.m. were detected in human milk, and the average level (0.29 p.p.m. +/- s.d. 0.06) was 140 times the level allowed in cow's milk. PMID- 6487544 TI - Transient and persistent photosensitivity due to musk ambrette. Clinical and photobiological studies. AB - Musk ambrette caused contact photosensitivity in five patients. One patient showed transient light reactivity and four showed persistent light reactivity. Tests with artificial radiation were performed on normal skin without musk ambrette being added. All patients reacted abnormally to UV-B and three to UV-A. In particular the patient with transient light reactivity showed abnormal responses to UV-B and UV-A. The patients were not always aware of the role of sunlight in the development of their eruption and the clinical features were not always typical of a photodermatitis. PMID- 6487545 TI - Primary management of melanoma. AB - A questionnaire was sent to all consultant dermatologists in The Netherlands, Belgium and Scotland regarding their management of suspected melanomas. The 343 evaluable responses showed that 29.7% of the dermatologists regularly prefer to 'wait and see' or carry out incisional biopsies in the early management of suspected melanoma, especially if the risk is thought low. The main arguments advanced by the proponents of incision were doubts about whether incisional biopsy provokes metastatic spread, and the belief that a pathologist can make reliable diagnosis on a partial specimen of the tumour. These arguments are questioned and excision biopsy, provided it is feasible without being disfiguring, is strongly recommended in the initial treatment of a suspected melanoma. PMID- 6487546 TI - Studies of the clinically uninvolved skin in patients with dermatitis. AB - We have studied the clinically normal skin of eighty-four patients with quiescent dermatitis of different types, and fifty normal subjects. Increased susceptibility to chemical irritation was demonstrated in patients with atopic and exogenous dermatitis. There was a reduction in mean corneocyte area and a thinner horny layer in all patients, and an increased epidermal thickness in atopic dermatitis patients only. In forced desquamation studies, patients released more corneocyte clumps from the skin surface, but there were no significant differences between patients and controls in sensitivity to UVR or electrical conductivity. PMID- 6487547 TI - Short-contact modification of the Ingram regime. AB - "Minutes' (30 minutes) and "short-contact' (2 hours) therapy with dithranol in Lassar's paste were compared (using a paired comparison method) with the Ingram regime in twenty-one and twelve patients respectively. Both "minutes' and "short contact' regimes were effective in clearing psoriasis; the latter was the more effective of the two and proved just as good as the standard Ingram regime of 24 hour application. "Short-contact' therapy with dithranol in Lassar's paste should therefore reduce out-patient attendance and time off work, save valuable nursing time and allow a more social life. PMID- 6487548 TI - Six cases of malignant atrophic papulosis (Degos' disease) occurring in one family. AB - A family is described in which a mother and five of her children were affected by malignant atrophic papulosis. This suggests that genetic factors might be involved in this condition. PMID- 6487549 TI - Lichen planus and liver disease. PMID- 6487550 TI - Proceedings of the 230th meeting of the Netherlands Society of Dermatology, Utrecht, 4 February 1984. Abstracts. PMID- 6487551 TI - Shame in relation to narcissistic disturbance. AB - For some patients, whose sense of self is fragile, shame may be a more important affect than guilt. It is suggested here that shame functions to enhance and preserve the sense of self, and that shame arises particularly in people whose early environment has impeded the emergence of a cohesive sense of self. Using a clinical illustration several features of shame are described, including its association with vision and with sexuality, and its role in certain kinds of depression; the early infantile precursors of shame are also discussed. The clinical implications are outlined. PMID- 6487552 TI - Dependence and its relationship to depression. AB - Evidence is provided that dependence, either as a trait or a state, is closely related to depression. Theories to explain this fall into two broad categories: that some individuals make excessive demands for affection and become depressed when these are not met; and that some have persistently negative attitudes to life and an inclination to self-blame. These correspond with Blatt's (1974) two sources of depression, the 'anaclitic' and the 'introjective'. Self-esteem forms a link in both theoretical approaches. It is proposed that there are three major components to dependence, which have been named affectional, ontological and differential. The first corresponds with Bowlby's concept of anxious attachment and the psychoanalytic concept of the oral personality. The last is closely related to Beck's (1967) depression-prone person. The second, originally described by Laing (1965), is concerned with a poorly established identity and causes the individual to relate to another by the imperfect process of fusion. Its part in predisposing the person to depression is less well recognized. Excessive independence, or detachment, may be as maladaptive as dependence and the opposite of both dependence and independence is autonomy. The autonomous person is truly separate and yet able to form intimate relationships. PMID- 6487553 TI - Some implications for psychology of formulating all illness as deviancy. AB - Formulating all illness as deviancy can be offered as a basis for reconciling the psychological characteristics of physical and mental illness. This paper considers the epistemological background to this reconciliation and discusses some of the theoretical, practical and methodological implications for clinical psychology. Particular attention is given to the role of values in psychological activity and the need to recognize the central legitimacy of subjectivity in research and applied psychology. PMID- 6487554 TI - Prediction versus reflection in therapist demonstrations of understanding: three analogue experiments. AB - Many forms of therapy deem it important for therapists to demonstrate to their clients that they understand the particular client's dilemma. The most common approach to therapists' demonstrations of understanding is the Rogerian method of reflection. Another approach to demonstrating understanding is to make accurate predictions of the client's behaviour. The purpose of the present experiments was to test the hypothesis that therapist predictions (predictive interactions) would be viewed by observers as more demonstrative of understanding the client than therapist reflections (reflective interactions) and therapist admissions of not understanding the client's problem (naive interactions). In each experiment, subjects were randomly assigned to conditions, read excerpts from an interview transcript, and then rated therapist understanding of the client's problems and therapist demonstrations of understanding. The results of all three experiments were consistent and indicated that: predictive interactions were judged as superior to reflective interactions and naive interactions on ratings of demonstrated understanding; reflective and naive interactions did not differ on any measure. These results question the utility of reflective interactions in clinical practice for communicating understanding to clients and support the notion that accurate therapist predictions of client behaviour may be more useful in demonstrating understanding. The results also indicate the need to study these phenomena more thoroughly in clinical settings. PMID- 6487555 TI - Personal assessments of life-event stress and the near future onset of psychological symptoms. AB - This report presents data on prospective associations of life-event measures with psychological symptoms. Two issues in particular are addressed, the one relating to the causal influence of life-events on symptom onset, and the other to the role of personal interpretations of life-event impact in this association. The latter issue derives from a consideration of the cognitive view of stress. Prospective associations did, indeed, emerge and were strongest where the individual was permitted to personally assess the impact of encountered life events. Temporal patterns of association varied with the kinds of symptoms (anxiety of depression) used as the dependent variable. PMID- 6487556 TI - Anger, neuroticism, type A behaviour and the experience of angina. AB - The relationship of personality factors to self-reported variations in symptoms of angina pectoris and their impact on functioning was examined in a sample of 50 cardiac patients. The frequency of anginal pains was significantly correlated with trait anger. The degree of perceived interference of angina with daily activities was related to Type A behaviour, anger and neuroticism. However, only neuroticism was related to the tendency to avoid activities because of the possibility of angina. Results are discussed in terms of the role of psychological factors in the manifestation and management of angina. PMID- 6487557 TI - Relationship between health beliefs and psychological variables in diabetic patients. AB - The present paper is focused on the relationship between psychological variables and health beliefs in 93 diabetic men. A Diabetes Health Belief Scale was used to assess general health motivation, treatment beneficial, severity, susceptibility, psychological barriers, cues to action, and structural elements. The psychological variables included two measures of locus of control, depression, somatization, interpersonal sensitivity, obsessive-compulsiveness, anxiety, self esteem, and attitudes toward diabetes, doctor, and medical care. Ten of the 11 psychological variables were correlated with various aspects of health beliefs. This indicates the extent to which the health beliefs are enmeshed with the psychological dynamics of the person. It would seem important to take such a psychological profile into consideration when attempting to understand and even alter the health beliefs. PMID- 6487558 TI - How can we compare different psychotherapies? Why are they all effective? AB - The relationship between different schools of psychotherapy can be defined by locating them in terms of a more general, cognitive, theory. They differ in respect (a) of the level in the patient's hierarchy of schemata that is considered and addressed, (b) of the stages in the procedural sequence organizing aim-directed action at which treatment is aimed, (c) as to whether or not attention is paid to structural and defensive aspects of cognitive organization, and (d) according to where intervention is aimed in terms of the cycle of cognitive reorganization. The equivalent effectiveness of different methods is explained as being the result of the patient's capacity to integrate differently located treatment-induced changes into similar revisions of his system. Some implications of this view are indicated. PMID- 6487559 TI - Existential-behaviour therapy: a possible paradigm? AB - A comparative discussion is presented of existential and behavioural psychotherapy, indicating where behavioural theory, empirical research and single case studies can be related to the existential emphasis on phenomenology and personal confrontation with death, freedom, isolation and meaninglessness. The conclusions are that: more recent emphasis on cognitive variables in behaviour therapy has brought the two conceptual systems closer together; and there is improvement in the understanding of aetiology and clinical effectiveness when the therapist incorporates existential-behavioural constructs and methods of working. PMID- 6487560 TI - Thought organization and primary process in the parents of schizophrenics. AB - The nature of the relationship between thought organization and primary process was explored by correlating clinical indicators of thought disorder on the Rorschach and formal primary process mechanisms in the dreams of 14 parents of schizophrenics recorded during a two-week period. The relationship between variability of primary process intensity and the Thought Disorder Index produced a negative correlation at the 0.05 level of significance. Variability of primary process intensity was not found to be significantly related to the length or frequency of the dreams. This inverse relationship between formal thought disorder and variability over time of primary process in the dreams of biological relatives of schizophrenics suggested that dream constriction could be a regressive marker in the heritability of schizophrenia. PMID- 6487561 TI - Short-term group therapy for stroke patients in a rehabilitation centre. AB - Three groups of eight patients who had suffered strokes participated in short term group therapy run by a psychiatrist and a social worker. A simple assessment was made by patients and therapists, further information being obtained by means of a follow-up questionnaire. The feasibility of this approach, and the indications that such groups might be beneficial, are discussed. Certain common themes emerged from all three groups, but it was interesting to note a different reaction was shown by men and women in response to their strokes. The provision of such groups for patients suffering from different illnesses and alternative ways of running these groups are suggested. PMID- 6487562 TI - Emotional distress in nurses at work. AB - A sample of 173 female nurses was studied to assess the amount of stress they experienced whilst at work. Psychological symptoms were found to be commoner in younger, less experienced nurses spending more time with patients. Suggestions are made to reduce distress in vulnerable nurses. PMID- 6487563 TI - Intrapartum infusion of aqueous glucose solution, transplacental hyponatraemia and risk of neonatal jaundice. AB - Cord serum sodium levels in three groups of 278 singleton infants, born vaginally at term, were correlated with the incidence of jaundice (serum bilirubin greater than or equal to 85 mumol/1) in the first 3 days of life. Of the 278 infants, 87 were born to mothers who were given infusions of 5% or 10% glucose in water during labour (group I), 90 were born to mothers who received glucose solution as a vehicle for oxytocin (group II), and 101 to mothers who did not receive any intravenous fluid therapy (control group). Jaundice was seen significantly more frequently in groups I (28/87, 32%) and II infants (30/90, 33%) than in the control group (12/101, 12%) (P less than 0.01), but when analysed in relation to cord serum sodium levels, the prevalence of jaundice in the normonatraemic infants (serum sodium greater than or equal to 131 mmol/1) was similar in the three groups. On the other hand, in groups I and II jaundice occurred about 3.5 times more frequently in the hyponatraemic infants [group I (17/32, 53%) and II (20/39, 51%)] than in the normonatraemic infants (P less than 0.01). The difference was not associated with any other perinatal or neonatal characteristic. PMID- 6487564 TI - Estimation of fertility and fecundity in women receiving artificial insemination by donor semen and in normal fertile women. AB - The pregnancy rates after artificial insemination by donor semen (AID) have been compared with pregnancy rates in normal fertile women to assess the efficiency of AID. To do this, the curve y = a(1-(1-b)x) was fitted to life-tabled cumulative pregnancy rates. The equation describes a model in which the parameter a is the proportion of women who are potentially fertile under the conditions of treatment, and in which the parameter b is the pregnancy rate per cycle (or fecundity) of these fertile women. For 259 AID patients with no previous pregnancy a was 65% while for 57 AID patients with a previous pregnancy after AID 'a' was 99.9%. The values of b were similar for the two groups of patients, being 20% and 22% respectively. Women without fertility problems who had become pregnant after discontinuing oral contraception provided the reference group. Since only pregnant women were selected, a was 100% by definition. The values of b for the reference group were 22% for 100 primigravid women and 20% for 100 multigravid women. Only 65% of the AID patients were potentially fertile with AID, but those that were fertile became pregnant at the same rate as normal women who discontinued oral contraception. PMID- 6487565 TI - Transmission of the maternal electrocardiograph via a fetal scalp electrode in the presence of intrauterine death. Case report. PMID- 6487566 TI - Pseudoxanthoma elasticum and pregnancy. Two case reports. PMID- 6487567 TI - Ovarian hyperstimulation syndrome with clomiphene citrate. Case report. PMID- 6487568 TI - Inhibition of lactation by cyclofenil and bromocriptine. PMID- 6487569 TI - Day care in gynaecology. PMID- 6487570 TI - Factors affecting birthweights in Hindus, Moslems and Europeans. AB - The birthweights of 664 Hindu and 132 Moslem babies were compared with those of 486 European babies born at the same hospital. The mean birthweight of the Europeans was 3362 g, compared with 3146 g for the Moslems and 2960 g for the Hindus. The Asian women were smaller than the European and tended to have a shorter length of gestation. Forty-four per cent of the Asians and 46% of the European mothers were of social classes I and II; 28% of the Europeans and 2% of the Asians smoked. There were no significant differences between Asians and Europeans in the effects of maternal size, parity, gestational age and fetal sex on birthweight. After adjustment for these variables and for cigarette smoking there was no significant difference in birthweight between the Moslems and the Europeans, but the mean birthweight of the Hindus was about 190 g lighter than that of the Europeans. Hindus from East Africa had lighter babies than those from India. PMID- 6487571 TI - The investigation of proteinuria in pregnancy using iso-dalt analysis. AB - Urinary protein excretion has been investigated using the iso-dalt technique in pregnant patients with hypertension and proteinuria, without hypertension but with proteinuria and without either hypertension or proteinuria. This high resolution electrophoretic technique has shown a great variation in the pattern of protein excreted by these patients, particularly those with hypertension. These showed an increased number of protein species in the urine, some of unknown identity. Two urines from this group appeared to contain no detectable albumin. Currently this technique is inappropriate for the routine analysis of urine proteins. However, further studies may determine the diagnostic value of these changes in urine excretion and allow the development of more specific assays. PMID- 6487572 TI - The identification of false-positive amniotic fluid acetylcholinesterase results due to fetal calf serum contamination. AB - All 103 amniotic fluids with positive gel-acetylcholinesterase (AChE) test results, obtained in Oxford between July 1980 and March 1983, were tested for the presence of fetal calf serum using a counter-immunoelectrophoresis test for bovine serum albumin. None of the samples from pregnancies associated with neural tube defect (85), exomphalos (nine) and intrauterine death (four) had a positive fetal calf serum test, suggesting little or no immunological cross-reaction between the antiserum used in the test and amniotic fluid proteins. Among the remaining five samples, from unaffected pregnancies (two bloodstained and three clear), two had positive fetal calf serum test results (both were clear samples). The fetal calf serum test is therefore a useful technique capable of identifying false-positive AChE test results, without mis-classifying true-positive results as false-positive. PMID- 6487573 TI - A 1-hour hCG radioimmunoassay detection kit for the management of suspected ectopic pregnancy. AB - The value of a rapid hCG kit was assessed in 60 patients undergoing laparoscopy or laparotomy for suspected ectopic pregnancy, of whom 30 were subsequently proven to be pregnant. A high degree of specificity (93%) and sensitivity (97%) was found, with one false-negative and three false-positive results. If the kit had been used as a routine on admission three patients would not have been inadvertently discharged before the diagnosis of tubal pregnancy and 27 could have avoided a laparoscopy to exclude tubal pregnancy. PMID- 6487574 TI - Distance relationships between the catalytic site labeled with 4 (iodoacetamido)salicylic acid and regulatory sites of glutamate dehydrogenase. AB - The distance between the catalytic site on bovine liver glutamate dehydrogenase labeled with 4-(iodoacetamido)salicylic acid (ISA) and the adenosine 5' diphosphate (ADP) activatory site occupied by the analogue 2',3'-O-(2,4,6 trinitrocyclohexadienylidene)adenosine 5'-diphosphate (TNP-ADP) was evaluated by energy transfer. Native enzyme and enzyme containing about 1 mol of acetamidosalicylate/mol of subunit bind about 0.5 mol of TNP-ADP/mol of subunit, and TNP-ADP competes for binding with ADP to native and modified enzyme, indicating that the analogue is a satisfactory probe of the ADP site. From the quenching of acetamidosalicylate donor fluorescence upon addition of TNP-ADP, an average distance of 33 A was determined between the catalytic and ADP sites. The fluorescent nucleotide analogue 5'-[p-(fluorosulfonyl)benzoyl]-2-aza-1,N6 ethenoadenosine (5'-FSBa epsilon A) reacts covalently with glutamate dehydrogenase to about 1 mol/peptide chain. As compared to native enzyme, the SBa epsilon A-enzyme exhibits decreased sensitivity to GTP inhibition but retains its catalytic activity as well as its ability to be activated by ADP and inhibited by high concentrations of NADH. Complete protection against decreased sensitivity to GTP inhibition is provided by GTP in the presence of NADH. It is concluded that 5'-FSBa epsilon A modifies a GTP site on glutamate dehydrogenase. The distance of 23 A between the catalytic site labeled with ISA and a GTP site labeled with 5' FSBa epsilon A was measured from the quenching of salicylate donor fluorescence in the presence of the SBa epsilon A acceptor on a doubly labeled enzyme. The average distance between the ADP and GTP sites was previously measured as 18 A [Jacobson, M. A., & Colman, R. F. (1983) Biochemistry 22, 4247-4257], indicating that the regulatory sites of glutamate dehydrogenase are closer to each other than to the catalytic site. PMID- 6487575 TI - Interference of active site specific reagents in plasminogen-streptokinase active site formation. AB - We have recently observed slow, non-Michaelis-Menten kinetics of activation of native cat plasminogen by catalytic concentrations of streptokinase. In order to understand the reasons for this phenomenon, we undertook to study the formation of the plasminogen-streptokinase activator complex under the same plasminogen activation conditions. The results obtained in this study show that the potential active site in both cat and human plasminogen is capable of binding strongly the specific substrates (S) p-nitrophenyl p-guanidinobenzoate (NPGB) and H-D-valyl-L leucyl-L-lysyl-p-nitroanilide, through the active site is incapable of hydrolyzing these substrates. Binding studies support these and the following conclusions. Streptokinase binds to this zymogen-substrate complex to create the ternary plasminogen-S-streptokinase complex, which then slowly converts to an acylated plasminogen-streptokinase form. This acylation reaction is 550 times slower than acylation of the preformed plasminogen-streptokinase complex by NPGB. The same reaction also occurs with human plasminogen, though the acylation reaction is 10 times faster than when the cat zymogen is used. NPGB binds specifically to plasminogen but not to streptokinase. These studies proved that inhibition of cat plasminogen activation by streptokinase occurs at the level of activator complex formation. We conclude from our studies that streptokinase binding to both cat and human plasminogen occurs at the potential active site of the zymogen. Consequently, it is probable that plasminogen activation in vivo is inhibited by binding of active site specific inhibitors to plasminogen. PMID- 6487576 TI - Thermodynamic linkages in rabbit muscle pyruvate kinase: kinetic, equilibrium, and structural studies. AB - The mechanism of allosteric regulation of rabbit muscle pyruvate kinase (PK) was examined in the presence of the allosteric inhibitor phenylalanine (Phe). Steady state kinetic, equilibrium binding, and structural studies were conducted to provide a broad data base to establish a reasonable model for the interactions. Phe was shown to induce apparent cooperativity in the steady-state kinetic measurements at pH 7.5 and 23 degrees C. The apparent Km for phosphoenolpyruvate was shown to increase with increasing Phe concentrations. These results imply that Phe reduces the affinity of PK for phosphoenolpyruvate. This conclusion was substantiated by equilibrium binding studies which yielded association constants of phosphoenolpyruvate as a function of Phe concentration. The binding constant of Phe was also determined at pH 7.0 and 23 degrees C. The effect of ligands on the hydrodynamic properties of PK was monitored by difference sedimentation velocity, sedimentation velocity, and equilibrium experiments. The results showed that PK remains tetrameric both in the presence and in the absence of Phe. However, Phe induces a small decrease in the sedimentation coefficient of the enzyme; hence, it suggests a loosening of the protein structure. The accessibility of the sulfhydryl residues of the enzyme also increases in the presence of Phe. Furthermore, the Phe-induced conformational change was approximately 90% complete when only 25% of the binding sites were saturated. This result suggested that the regulatory behavior of PK might satisfactorily be described by the two-state model of Monod-Wyman-Changeux [Monod, J., Wyman, J., & Changeux, J.-P. (1965) J. Mol. Biol. 12, 88-118]. PMID- 6487577 TI - Thermodynamic linkages in rabbit muscle pyruvate kinase: analysis of experimental data by a two-state model. AB - A concerted, allosteric model is developed, and equations are derived for quantitative interpretation of the kinetic and equilibrium binding data of rabbit muscle pyruvate kinase at pH 7.5 and 23 degrees C. The simplest model which seems likely to rationalize the experimental data involves two conformational states. In this model, two simplifying assumptions are made. First, the affinities of pyruvate kinase for both substrate and inhibitor are assumed to depend only upon the conformational state of the tetrameric enzyme. Second, the rate of product formation is also assumed to depend only upon the enzyme conformation. All types of experimental data are analyzed simultaneously to estimate the parameters which best predict the total body of experimental results. The fitted parameters indicate that the intrinsic allosteric equilibrium favors the active (R) state by 11 to 1. The substrate phosphoenolpyruvate binds preferentially, by a factor of 10, to the R state, whereas the inhibitor Phe has about 23 times higher affinity for the inactive (T) state. In all cases tested, the calculated values are in good agreement with the experimental data. PMID- 6487578 TI - 1-Ethynylpyrene, a suicide inhibitor of cytochrome P-450 dependent benzo[a]pyrene hydroxylase activity in liver microsomes. AB - The preparation of 1-ethynylpyrene (EP) is described. Incubation of EP with liver microsomes in the presence of NADPH yields fluorescent products, but the production of these products ceases after 15 min. Addition of fresh microsomes restores the original rate of EP metabolism. The metabolism of EP is initially more rapid in microsomes from 5,6-benzoflavone- (BF) pretreated rats than in microsomes from phenobarbital- (PB) pretreated rats or from untreated, control animals. EP strongly inhibits the hydroxylation of benzo[a]pyrene (BP) by liver microsomes; after 20 min in the presence of EP, BP metabolism nearly ceases. Addition of fresh microsomes restores the original rate of BP hydroxylation. EP more effectively inhibits the oxidation of BP in liver microsomes from rats pretreated with BF than from rats pretreated with PB or from untreated, control animals. The inhibition of BP hydroxylation activity due to EP is dependent upon NADPH and is apparently irreversible. Kinetic analyses demonstrate that the observed inhibition of BP hydroxylation is due to loss of the enzymatic activity by a process that is first order in EP and that reaches a limiting value at infinite EP concentrations. One such first-order process, with a t 1/2 of 3.5 min and a Ks for EP of 40 microM, is observed in microsomes from BF-pretreated rats. Two such first-order processes, one with t 1/2 of 6.9 min and Ks of 46 microM and one with t 1/2 of 12.7 min and Ks of 33 microM, are observed in microsomes from PB-pretreated rats. It is proposed that a self-catalyzed inhibition (suicide inhibition) of the cytochrome P-450 dependent BP hydroxylation occurs in the presence of EP. Incubation with EP under conditions that result in loss of about 90% of the BP hydroxylase activity in microsomes from BF-pretreated rats and about 66% of the activity in microsomes from PB-pretreated rats causes the loss of only 6 and 12% of the cytochrome P-450, respectively. It is concluded that loss of P-450 content is an insensitive measure of the effect of this inhibitor upon this cytochrome P-450 dependent enzyme activity. The selectivity of the loss of P-450 due to the incubation of the different microsomal preparations with EP is also observed to be different than the selectivity for loss of BP hydroxylase activity. It is proposed that the suicide inhibition of cytochrome P-450 dependent enzymes by alkynes need not involve heme alkylation and a resulting loss of P-450 content.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6487579 TI - Spectroscopic investigation of ligand interaction with hepatic phenylalanine hydroxylase: evidence for a conformational change associated with activation. AB - We have examined the interaction of phenylalanine hydroxylase with phenylalanine, tetrahydropterin cofactors, and an activating phospholipid, lysophosphatidylcholine. Incubation of native phenylalanine hydroxylase with phenylalanine or lysophosphatidylcholine results in an increase in the fluorescence emission of the enzyme at 360 nm, which closely parallels the increase in tetrahydrobiopterin-dependent activity observed under these conditions. The presence of tetrahydrobiopterin in the absence of phenylalanine results in quenching of the enzyme fluorescence emission; this quenching exhibits a sharp end point at about 1 mol of tetrahydrobiopterin bound/mol of enzyme subunit. The binding of tetrahydrobiopterin under these conditions is unexpectedly tight, with an estimated KD of 10-20 nM, while in the presence of lysophosphatidylcholine, the KD is increased to about 25 microM. Quenching experiments with sodium iodide indicate greater exposure of tryptophan residues in the phenylalanine-activated enzyme. The ultraviolet difference spectrum of phenylalanine hydroxylase in the presence of phenylalanine exhibits a peak at 238 nm, which correlates with the fluorescence increase and activation, as well as additional changes in the aromatic region, which do not correlate well with activation. Phenylalanine does not alter the far-ultraviolet circular dichroism spectrum of phenylalanine hydroxylase. In contrast, lysophosphatidylcholine appears to induce a dramatic change in enzyme secondary structure upon activation. These results suggest that activation of phenylalanine hydroxylase results in a conformation change and the exposure of buried tryptophan(s) and possibly a cysteine residue. PMID- 6487580 TI - Picosecond absorption studies on rhodopsin and isorhodopsin in detergent and native membrane. AB - Picosecond transient absorption spectra of rhodopsin and isorhodopsin were measured at room temperature with a double-beam laser spectrophotometer after excitation at 355 nm. Photolysis studies were performed on rhodopsin solubilized in two different detergents (digitonin and 3-[(3-cholamidopropyl)dimethylammonio] 1-propanesulfonate). The resulting rhodopsin/bathorhodopsin absorption difference spectra were measured at times from 35 ps to 250 ns following photoexcitation. Rhodopsin and isorhodopsin in native disk membrane were studied after suspension in 75% glycerol. Isorhodopsin was prepared by photoisomerizing rhodopsin in disk membrane at 77 K. Transient spectra obtained from the visual pigments in native membrane were of a quality approaching that obtained from detergent-solubilized rhodopsin. The batho intermediate derived from isorhodopsin was spectrally the same as that generated by rhodopsin photolysis and was produced with a quantum yield higher than had been predicted on the basis of other studies. PMID- 6487581 TI - Synthesis of undecagold cluster molecules as biochemical labeling reagents. 1. Monoacyl and mono[N-(succinimidooxy)succinyl] undecagold clusters. AB - This paper describes the synthesis and characterization of succinyl, phthalyl, and N-(succinimidooxy)-succinyl derivatives of the undecagold cluster complex tricyanoheptakis[4,4',4"-phosphinidynetris(benzenemethana mine)]undecagold, 1, molecular formula Au11(CN)3[P(C6-H4CH2NH2)3]7. These are useful as electron-dense reagents for labeling biological structures in preparation for electron microscopic analysis. Limited reaction of 1 with succinic or phthalic anhydrides produces a mixture of mono-, bis-, etc. (N-succinyl)-1 or (N-phthalyl)-1, which can be separated by anion-exchange chromatography at pH 11.5. Yields of monoacylated derivatives can be maximized by controlling the ratio of succinic or phthalic anhydride to 1. The remaining 20 primary amino groups can be dialkylated or acetylated, blocking their participation in further chemical modifications of the carboxylic functional group introduced in the succinylation or phthalylation of 1. These carboxyl groups can be activated as N-hydroxysuccinimido esters, which are acylating derivatives of 1. An example is mono[N-(succinimidooxy) succinyl]icosa(N,N-dimethyl)-1 whose synthesis is described. Bis- and tris(N succinyl) and -(N-phthalyl) derivatives of 1 are also produced and isolated in usable quantities. PMID- 6487582 TI - Synthesis of undecagold cluster molecules as biochemical labeling reagents. 2. Bromoacetyl and maleimido undecagold clusters. AB - Derivatives of heptakis[4,4',4"-phosphinidynetris(benzenemethanamine) ]undecagold, 1, molecular formula Au11(CN)3[P(C6H4CH2NH3)]7, are described. These include undecagold complexes with a single free primary amino group, a single bromoacetyl group, and a single maleimido group per molecule. Hydrolysis of mono(N-phthalyl)icosa(N-acetyl)-1 at pH 3.2 and 46 degrees C under anaerobic conditions and in the presence of NaBH3CN produces icosa(N-acetyl)-1. Partial acylation of 1 with 1.3 equiv of 2,3-dimethylmaleic anhydride followed by complete acetylation with acetic anhydride produces a mixture consisting largely of mono- and bis(dimethylmaleyl)peracetyl-1. Hydrolysis of 2,3-dimethylmaleimides at pH 3.2 for 1 at 25 degrees C produces a mixture of icosa(N-acetyl)-1, with a single free amino group, and nondea(N-acetyl)-1. This mixture can be quantitatively separated by cation-exchange chromatography at pH 7, giving homogeneous icosa(N-acetyl)-1 in an overall yield of 55%. Icosa(N-acetyl)-1 serves as the starting material for the synthesis of the alkylating derivatives mono(N-bromoacetyl)icosa(N-acetyl)-1 and mono[N-(p-maleimidobenzoyl)]icosa(N acetyl)-1. These derivatives can be used for alkylating proteins in preparation for electron microscopy. PMID- 6487583 TI - Synthesis of undecagold cluster molecules as biochemical labeling reagents. 3. Dimeric cluster with a single reactive amino group. AB - The synthesis and characterization of a dimeric derivative of the undecagold cluster complex Au11(CN)3[P-(C6H4CH2NH2)3]7, 1, are described. The dimer, 2, consists of cross-linked molecules of 1 in which 41 of the 42 amino groups are acylated, leaving a single free amino group per dimer. This amino group is reactive and can be used to prepare derivatives of 2 for use in labeling biological macromolecules in preparation for electron microscopic analysis. Limited acylation of 1 by 1.3 equiv of citraconic anhydride in aqueous solution, followed by extensive acylation with acetic anhydride at pH 7-7.5, leads to a mixture of monomeric and dimeric products. Hydrolytic removal of N-citraconyl groups at pH 3.2 unmasks a few amino groups. Cation-exchange chromatography at pH 7 separates the products into three main groups, species containing one, two, or three free amino groups, in overall yields of 33%, 28%, and 15%, respectively. The monoamino species consist mainly of 2 and a monomeric product, which are separated by gel exclusion chromatography. 2 migrates as a dimer upon polyacrylamide gel electrophoresis in sodium dodecyl sulfate, and it contains a single free amino group, detectable by its ion-exchange behavior as a monocation at pH 7 and by its reactivity with [14C]phthalic anhydride. PMID- 6487584 TI - Synthesis and biochemical evaluation of 2'-deoxy-lin-benzoadenosine phosphates. AB - 2'-Deoxy-lin-benzoadenosine has been synthesized via reductive deoxygenation of 2 (beta-D-ribofuranosyl)-8-(methylthio)imidazo[4,5-g]quinazoline. The 5'-mono-, 5' di-, and 5'-triphosphates have been prepared by chemical and/or enzymatic methods. The 5'-diphosphate was found to be a substrate for phosphorylation by pyruvate kinase and was compared with various natural and extended substrates in kinetic assays. When 2'-deoxy-lin-benzoadenosine 5'-triphosphate was tested in a nick-translation experiment with Escherichia coli DNA polymerase I, a very low level of 32P incorporation from [alpha-32P]TTP into poly[d(AT)] was observed. Nearest-neighbor analysis indicated that the analogue was not significantly incorporated into internal positions in the polymer. In DNA-sequencing reactions, the analogue caused chain termination at adensine residues, although termination was less uniform and less efficient than that with 2',3'-dideoxy-ATP. These experiments show that lin-benzoadenine can form a widened Watson-Crick base pair with thymine. They strongly suggest, though they do not prove, that the enzyme is able to attach the analogue to DNA. PMID- 6487585 TI - Cooperative association of plasminogen with fibrinogen. AB - We have examined the association of both Glu- and Lys-plasminogen to fibrinogen by ultracentrifugal sedimentation equilibrium in neutral isotonic buffer in the presence of aprotinin. The fibrinogen and plasminogens, which were homogenous, did not exhibit any self-association. In each association study, five different molar ratios of plasminogen to fibrinogen were examined. The data were analyzed by mathematical modeling using nonlinear least-squares curve fitting. Analyses of molecular species present showed that up to 4 mol of either Glu- or Lys plasminogen was associated with each mol of fibrinogen. For the binding of Glu plasminogen, the values of the successive changes of the standard free energy of association were found to be -5.48, -7.73, -8.88, and -11.41 kcal/mol (Ka = 2.16 X 10(4), 1.32 X 10(6), 1.06 X 10(7), and 1.08 X 10(9) M-1). For the experimental conditions used here, the association of Lys-plasminogen appears to be described by virtually the same fitting parameters. The very marked cooperativity of association found here would appear to imply that there are significant alterations of the structure of fibrinogen as a result of each successive molecule of plasminogen bound. PMID- 6487586 TI - Ca2+ binding to phosphatidylcholine bilayers as studied by deuterium magnetic resonance. Evidence for the formation of a Ca2+ complex with two phospholipid molecules. AB - The binding of Ca2+ to bilayer membranes composed of 1-palmitoyl-2-oleoyl-sn glycero-3-phosphocholine (POPC) was investigated with atomic absorption spectroscopy and deuterium magnetic resonance, leading to the following conclusions. Atomic absorption spectroscopy allowed the determination of the amount of Ca2+ bound to the membrane surface (Cb) at low Ca2+ concentrations (3 100 mM). Simultaneous measurements of the deuterium magnetic resonance spectra of POPC with specifically deuterated choline head groups revealed a linear relationship between the quadrupole splitting and the amount of bound Ca2+. With this calibration, the amount of bound Ca2+ could be determined from the deuterium spectra under conditions where atomic absorption spectroscopy was technically not feasible, i.e., in the concentration range of 0.1-5 M CaCl2. The Ca2+ binding isotherm exhibited saturation behavior. The quadrupole splitting at the saturation limit corresponded to a binding stoichiometry of one Ca2+ per two POPC molecules. The surface charge density (sigma) could be evaluated from the amount of bound Ca2+ and the surface area per POPC molecule. By employing the Gouy Chapman theory, it was then possible to determine the surface potential (psi 0) and the Ca2+ concentration immediately at the lipid-water interface (CI). With this set of experimental parameters, various models for the mode of Ca2+ binding were tested. A simple partition equilibrium or a Langmuir absorption model could be ruled out. However, a very good fit to the experimental data was obtained by applying the law of mass action in the form Cb/(1 - 2Cb)2 = KCI in which K is the only adjustable parameter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487587 TI - Spontaneous formation of stable unilamellar vesicles. AB - Stable unilamellar vesicles form spontaneously upon mixing aqueous suspensions of long-chain lecithins (fatty acid chain lengths 14 carbons or longer) with small amounts (20 mol %) of micellar synthetic short-chain lecithins (fatty acid chain lengths 6-8 carbons). These vesicles are potentially ideal for any experiment (i.e., membrane protein reconstitution, drug delivery, etc.) that requires an easily formed, nonleaky unilamellar structure. PMID- 6487588 TI - Measurement of the ratio of the eighth and ninth components of human complement on complement-lysed membranes. AB - The mole ratio of the eighth (C8) and ninth (C9) components of human complement on membranes carrying the cytolytic C5b-9 complex was measured by direct binding assays. Erythrocytes from two different species were used as the membrane system. Antibody-treated sheep erythrocytes carrying a relatively small number of precursive membrane-bound C5b-7 complexes were prepared by exposure to human C8 depleted serum. These complexes were subsequently converted to C5b-8 by addition of saturating amounts of C8. Parallel binding assays using 125I-C8 were used to determine the exact amount bound and thus the number of C5b-8 complexes per cell. These cells were subsequently incubated with excess 125I-C9 and the amount bound relative to C8 on the membrane was measured. Results indicated the C8:C9 ratio remained constant at approximately 1:4 as the number of complexes varied from 40 to 310 per cell. Similar results were obtained regardless of whether C8 and C9 were added sequentially or simultaneously to cells bearing C5b-7. For comparison, experiments were also performed using membranes that contained a high number of complexes. Here, rabbit erythrocytes which carried approximately 25 000 C5b-7 per cell were incubated with limited amounts of C8 to form C5b-8 complexes on the membrane surface, the exact number of which was measured by 125I-C8 binding assays. When erythrocytes prepared in this manner were incubated with excess 125I C9, the ratio of C8:C9 on the membrane was found to be essentially constant at approximately 1:3 as the number of these complexes varied from 50 to 4000 per cell.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487589 TI - New structural model for mixed-chain phosphatidylcholine bilayers. AB - Multilamellar suspensions of a mixed-chain saturated phosphatidylcholine with 18 carbon atoms in the sn-1 chain and 10 carbon atoms in the sn-2 chain have been analyzed by X-ray diffraction techniques. The structural parameters for this lipid in the gel state are quite different than usual phosphatidylcholine bilayer phases. A symmetric and sharp wide-angle reflection at 4.11 A indicates that the hydrocarbon chains in hydrated C(18):C(10)PC bilayers are more tightly packed than in usual gel-state phosphatidylcholine bilayers and that there is no hydrocarbon chain tilt. The lipid thickness is about 12 A smaller than would be expected in a normal bilayer phase, and the area per molecule is 3 times the area per hydrocarbon chain. In addition, the bilayer thickness increases upon melting to the liquid-crystalline state, whereas normal bilayer phases decrease in thickness upon melting. On the basis of these data, we propose a new lipid packing model for gel-state C(18):C(10)PC bilayers in which the long C(18) chain spans the entire width of the hydrocarbon region of the bilayer and the short C(10) chain aligns or abuts with the C(10) chain from the apposing molecule. This model is novel in that there are three hydrocarbon chains per head group at the lipid-water interface. Calculations show that this phase is energetically favorable for mixed-chain lipids provided the long acyl chain is nearly twice the length of the shorter chain. In the liquid-crystalline state C(18):C(10)PC forms a normal fluid bilayer, with two chains per head group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487590 TI - Kinetics of the subtransition of asymmetrically substituted phosphatidylcholines. AB - The thermodynamics and kinetics of the subtransition L epsilon----P beta of sonicated unilamellar vesicles of 1-myristoyl-2-stearoylphosphatidylcholine (1M 2S-PC) and of 1-stearoyl-2-myristoylphosphatidylcholine (1S-2M-PC) were studied by equilibrium cooling curves and temperature-jump relaxation spectrometry with an anthracenophane cryptand as a mobile fluorescent probe. The unilamellar vesicles exhibit the midpoint temperature TsII of the subtransition about 10 degrees C below the respective main transition. The kinetics of the subtransition in the time range between 10(-4) and 10(3) s is characterized by a cooperative relaxation process in the range of milliseconds and a further noncooperative process in the range of seconds. The slow process is assigned to the rearrangement of lattice defects. The fast process is evaluated in terms of a cyclic reaction scheme that consists of two pathways for the biomolecular association of probe and vesicle coupled with the conformational change of the lipid matrix during the subtransition. The analysis reveals that the fast process comprises the nucleation and growth of cluster. The cooperative lattice transformation of the subtransition follows a first-order rate law. The rate constants at TsII are 70 s-1 for 1S-2M-PC and 170 s-1 for 1M-2S-PC. Since the plots of the relaxation time vs. the degree of transition are in accordance with the predictions of the linear Ising model, it is concluded that clusters are propagated anisotropically in a linear fashion; e.g., fluidlike P beta conformations grow along the ripple. PMID- 6487591 TI - Nonoxidative ethanol metabolism in rabbit myocardium: purification to homogeneity of fatty acyl ethyl ester synthase. AB - Fatty acyl ethyl esters, previously identified in our laboratory as metabolites of ethanol in human and rabbit myocardium, arise from an esterification of free fatty acids with ethanol in the absence of ATP and coenzyme A. This study was designed to isolate and purify the enzyme(s) in rabbit myocardium that catalyze(s) this reaction. Enzyme activity in homogenates of rabbit myocardium, as assayed by the rate of synthesis of ethyl [14C]oleate from 0.4 mM [14C]oleic acid and 0.2 M ethanol, was 31 nmol/(g.h), and all of it was recovered in the 48400g supernatant. This soluble ethyl ester synthase activity bound to DEAE cellulose at pH 8, and elution with a NaCl gradient (0-0.25 M) separated two enzyme activities accounting for 13 and 87% of recovered synthase activity. The major enzyme activity was then purified over 5000-fold to homogeneity by sequential gel permeation, hydrophobic interaction, and anti-albumin affinity chromatographies with an overall yield of 40%. Up to 45 micrograms of enzyme was present per g of myocardium. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed a single polypeptide with Mr 26 000, and gel permeation chromatography under nondenaturing conditions indicated a Mr of 50 000 for the active enzyme. Kinetic analyses using the purified enzyme indicated that greatest rates of ethyl ester synthesis were observed with unsaturated octadecanoic fatty acid substrates [Vmax = 1.9 and 1.5 nmol/(mg.s) for linoleate and oleate, respectively], with lesser rates associated with palmitate, stearate, and arachidonate substrates [0.14, 0.03, and 0.35 nmol/(mg.s), respectively].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487592 TI - Thermodynamic bases for fatty acid ethyl ester synthase catalyzed esterification of free fatty acid with ethanol and accumulation of fatty acid ethyl esters. AB - Myocardial homogenates rapidly synthesize fatty acyl ethyl esters from nonesterified fatty acid and ethanol in the absence of coenzyme A or ATP, and the enzyme catalyzing this reaction, fatty acid ethyl ester synthase, has been purified 5400-fold to homogeneity [Mogelson, S., & Lange, L. G. (1984) Biochemistry (preceding paper in this issue)]. To define the factors permitting this de novo synthesis of ester bonds and the consequent accumulation of fatty acyl ethyl esters in myocardium, we determined thermodynamic parameters relevant to the kinetics and equilibria of this reaction and specifically characterized (1) the rates of synthesis of ethyl oleate, in both the presence and absence of purified enzyme catalyst, and (2) the physical properties of the product, ethyl oleate, in an aqueous milieu. Compared to the reaction of ethanol and oleate in the absence of catalyst, fatty acid ethyl ester synthase enhanced the rate of ethyl oleate synthesis by reducing the free energy of activation (delta G) from 32.5 to 19.9 kcal/mol, effected in large part by a positive entropy shift, delta Senz - delta S uncat = 23.9 cal/(mol.deg). Rate constants in the presence and absence of enzyme at 37 degrees C were 6 X 10(-2) s-1 and 7.8 X 10(-11) M-1 s-1, respectively, indicating a catalytic power of at least 10(8)M for this enzyme. Kinetic data indicated an enzymatic Vmax of 1.25 nmol/(mg.s) (37 degrees C). The equilibrium constant was calculated for the reaction oleate + ethanol in equilibrium ethyl oleate and was 0.095 M-1 at 37 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487593 TI - Kinetic mechanism of the interaction of D-cycloserine with serine hydroxymethyltransferase. AB - The kinetic mechanism for the interaction of D-cycloserine with serine hydroxymethyltransferase (EC 2.1.2.1) from sheep liver was established by measuring changes in the activity, absorbance, and circular dichoism (CD) of the enzyme. The irreversible inhibition of the enzyme was characterized by three detectable steps: an initial rapid step followed by two successive steps with rate constants of 5.4 X 10(-3) s-1 and 1.4 X 10(-4) s-1. The first step was distinguished by a rapid disappearance of the enzyme absorbance peak at 425 nm, a decrease in the enzyme activity to 25% of the uninhibited velocity, and a lowering of the CD intensity at 432 nm to about 65% of the original value. The second step of the interaction was accompanied by a complete loss of enzyme activity and a marginal increase in the CD intensity at 432 nm. The final step resulted in the complete loss of the enzyme absorbance at 425 nm and of the CD band at 432 nm. The products of the reaction were identified as (a) apoenzyme by absorbance measurements, CD spectra, and reconstitution with pyridoxal 5' phosphate and (b) a pyridoxal 5'-phosphate-D-cycloserine Schiff's base complex identified by its fluorescence and absorbance spectra. The Schiff base complex was expelled from the enzyme active site in the final step of the reaction. The proposed mechanism, which is different from those operative in other pyridoxal phosphate dependent enzymes, probably accounts for the selective inhibition of serine hydroxymethyltransferase by the drug in vivo. PMID- 6487594 TI - Comparison of effects of smooth and skeletal muscle tropomyosins on interactions of actin and myosin subfragment 1. AB - The ATPase activity of acto-myosin subfragment 1 (S-1) was measured in the presence of smooth and skeletal muscle tropomyosins over a wide range of ionic strengths (20-120 mM). In contrast to the 60% inhibitory effect caused by skeletal muscle tropomyosin at all ionic strengths, the effect of smooth muscle tropomyosin was found to be dependent on ionic strength. At low ionic strength (20 mM), smooth muscle tropomyosin inhibits the ATPase activity by 60%, while at high ionic strength (120 mM), it potentiates the ATPase activity 3-fold. All of these ATPase activities were measured at very low ratios of S-1 to actin, under conditions at which a 4-fold increase in S-1 concentration did not change the specific activity of the tropomyosin-acto.S-1 ATPase. Therefore, the potentiation of the ATPase activity by smooth muscle tropomyosin at high ionic strength cannot be explained by bound S-1 heads cooperatively turning on the tropomyosin-actin complex. To determine whether the fully potentiated rates are different in the presence of smooth muscle and skeletal muscle tropomyosins, S-1 which was extensively modified by N-ethylmaleimide was added to the ATPase assay to attain high ratios of S-1 to actin. The results showed that, under all conditions, the fully potentiated rates are the same for both tropomyosins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487595 TI - Fluorescence lifetime and acrylamide quenching studies of the interactions between troponin subunits. AB - Fluorescence lifetime and acrylamide quenching studies were carried out to characterize the interactions between the subunits of troponin under various conditions of metal ion binding. Troponin C was labeled at Cys-98 with N (iodoacetyl)-N'-(5-sulfo-1-naphthyl)ethylenediamine. In the presence of Ca2+, the fluorescence decay of labeled troponin C (TnC*) was monoexponential, lifetime tau = 15.5 ns and quenching rate constant kq = 2.97 X 10(8) M-1 s-1. In the absence of Ca2+, the decay was resolvable into a major component with tau = 11.9 ns and a minor component with tau = 20.5 ns, with corresponding values of kq = 4.80 X 10(8) and 0.66 X 10(8) M-1 s-1, respectively. Upon the binding of either troponin I (TnI) or troponin T (TnT) in the presence of Ca2+, tau increased to approximately 18 ns, and kq decreased to approximately 0.8 X 10(8) M-1 s-1. For the Ca2+ form of the TnC*-TnI-TnT ternary complex, values of tau = 17.6 ns and kq = 1.73 X 10(8) M-1 s-1 were obtained. These values did not vary significantly when Ca2+ was removed, or when Mg2+ replaced Ca2+. These findings were interpreted as follows: the region around Cys-98 of TnC* adopts a looser conformation upon the removal of Ca2+ from the high-affinity sites. Both TnI and TnT bind to TnC* in the region containing Cys-98. The probe is shielded from the solvent to a greater extent in the binary complexes than in the ternary complex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487596 TI - Separation of active tubulin and microtubule-associated proteins by ultracentrifugation and isolation of a component causing the formation of microtubule bundles. AB - A new method for separating microtubule-associated proteins (MAPs) and tubulin, appropriate for relatively large-scale preparations, was developed. Most of the active tubulin was separated from the MAPs by centrifugation after selective polymerization of the tubulin was induced with 1.6 M 2-(N morpholino)ethanesulfonate (Mes) and GTP. The MAPs-enriched supernatant was concentrated and subsequently clarified by prolonged centrifugation. The supernatant (total soluble MAPs) contained almost no tubulin, most of the nucleosidediphosphate kinase activity of the microtubule protein, good activity in promoting microtubule assembly in 0.1 M Mes, and proteins with the electrophoretic mobility of MAP-1, MAP-2, and tau factor. The pellet, inactive in supporting microtubule assembly, contained denatured tubulin, most of the ATPase activity of the microtubule protein, and significant amounts of protein with the electrophoretic mobility of MAP-2. Insoluble material at this and all previous stages, including the preparation of the microtubule protein, could be heat extracted to yield soluble protein active in promoting microtubule assembly and containing MAP-2 as a major constituent. The total soluble MAPs were further purified by DEAE-cellulose chromatography into bound and unbound components, both of which induced microtubule assembly. The bound component (DEAE-MAPs) contained proteins with the electrophoretic mobility of MAP-1, MAP-2, and tau factor. The polymerization reaction induced by the unbound component (flow-through MAPs) produced very high turbidity readings. This was caused by the formation of bundles of microtubules. Although the flow-through MAPs contained significantly more ATPase, tubulin-independent GTPase, and, especially, nucleosidediphosphate kinase activity than the DEAE-MAPs, preparation of a MAPs fraction without these enzymes required heat treatment. PMID- 6487597 TI - Amino acid sequence of the regulatory subunit of bovine type I adenosine cyclic 3',5'-phosphate dependent protein kinase. AB - The complete amino acid sequence of the regulatory subunit of type I cAMP dependent protein kinase from bovine skeletal muscle is presented. The S carboxymethylated protein was cleaved with cyanogen bromide to provide a complete set of nonoverlapping fragments. These fragments were overlapped and aligned by using peptides generated by proteolytic cleavage. The protein contains 379 amino acid residues corresponding to a molecular weight of 42 804. As in the type II regulatory subunit of cAMP-dependent protein kinase, a pattern of internal gene duplication is observed, which is consistent with two cAMP-binding domains. The two types of regulatory subunit from type I and type II kinase display similarities in domain substructure and in amino acid sequence, which provide a molecular basis for new insight into their regulatory roles. Detailed analyses of the homology of the regulatory subunits of type I and type II cAMP-dependent protein kinase and of similar relationships to cGMP-dependent protein kinase and Escherichia coli catabolite gene activator protein are presented in accompanying reports from this laboratory [Takio, K., Smith, S. B., Krebs, E. G., Walsh, K., & Titani, K. (1984) Biochemistry (second paper of three in this issue); Takio, K., Wade, R. D., Smith, S. B., Krebs, E. G., Walsh, K. A., & Titani, K. (1984) Biochemistry (third paper of three in this issue)]. PMID- 6487598 TI - Poly(8-bromodeoxyadenylic acid): properties of the polymer and contrast with the ribopolynucleotide analogue. AB - Introduction of the bulky 8-bromo substituent into adenine residues of polynucleotides has strikingly different consequences in the deoxy- and ribopolynucleotide series. Poly(r8BrA) was found in earlier studies to form a very stable double-helical self-structure but not to undergo interaction with potentially complementary polynucleotides. We find that poly(d8BrA), in contrast, does not form an ordered self-structure in 0.1 M Na+ but appears to exist as an electrostatically expanded rigid rod with unusual circular dichroism (CD) properties at very low ionic strength. The deoxy polymer, moreover, readily forms double helices with either deoxy or ribo pyrimidine polynucleotides, studied by UV, CD, and IR spectroscopy. These complexes are destabilized, relative to those formed by poly(dA), possibly because energy is needed to convert the purine residues from a more stable syn to an anti conformation, required for heteroduplex formation. The CD spectrum of (d8BrA)n X (dT)n is similar to that of B DNA. The deoxy-ribo hybrids (d8BrA)n X (rU)n and (d8BrA)n X (rBrU)n have CD spectra resembling those of A DNA or RNA. Unlike other deoxy-deoxy pairs (d8BrA)n X (dBrU)n, however, has a CD spectrum resembling RNA and other helices having the A form. PMID- 6487599 TI - Differential inhibition of histone and polyamine acetylases by multisubstrate analogues. AB - Mammalian cells contain a number of enzymes catalyzing the acetylation of polyamines and histones including an inducible spermidine/spermine N1 acetyltransferase which may play a key role in regulating the interconversion of polyamines [Matsui, I., Wiegand, L., & Pegg, A. E. (1981) J. Biol. Chem. 256, 2454-2459]. The present experiments were carried out in order to provide a method to distinguish this enzyme from other polyamine/histone acetylases and to test whether specific inhibitors of its activity could be obtained. Rabbit antiserum to homogeneous rat liver spermidine/spermine N1-acetyltransferase had no effect on the activity of a crude nuclear extract from rat liver, indicating that its spermidine acetylating capability is not related to the cytosolic spermidine/spermine N1-acetyltransferase induced by hepatotoxins. Potential multisubstrate analogues were prepared by attaching various polyamines to coenzyme A via an acetic acid linkage and tested as potential inhibitors of the acetylation of spermidine and histones. There was little difference in the potency of these polyamine derivatives as inhibitors of histone or spermidine acetylation by the crude nuclear extracts which appeared to contain at least two such activities, one inhibited completely by 20-30 microM and the other amounting to 50% of the total being unaffected by 100 microM. Spermidine/spermine N1 acetyltransferase was also inhibited by all the derivatives, but the potency toward this enzyme differed widely. The derivative from sym-norspermidine was a very strong inhibitor, giving 50% inhibition at 0.3 microM, and was more than 1 order of magnitude more active than the others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487600 TI - New synthetic cluster ligands for galactose/N-acetylgalactosamine-specific lectin of mammalian liver. AB - Synthetic ligands containing up to six residues of nonreducing terminal galactose were prepared. The synthesis involved coupling of carboxyl groups of N-benzyloxy carbonylaspartic acid or of N-benzyloxycarbonyltyrosyl-gamma-glutamylglutamic acid to the omega-amino group of the aglycon of a glycoside that contained up to three lactosyl residues. The benzyloxycarbonyl group was removed by hydrogenolysis before these ligands were tested as inhibitors to the binding of 125I-asialoorosomucoid to the galactose/N-acetylgalactosamine lectin, both soluble and on the surface of freshly isolated mammalian hepatocytes. Each addition of a galactosyl residue to an existing ligand structure invariably increased the binding affinity of such a ligand. However, at each level of galactose valency, the binding constant varied as much as 1000-fold depending on the structure of the ligand. At a given level of valency, the binding strength of a cluster ligand depended mainly on two factors: (1) the maximum spatial inter galactose distances and (2) the flexibility of the arm connecting galactosyl residues and the branch points. It has been postulated that the three galactose combining sites of the lectin are arranged in space at the vertexes of a triangle whose sides are 15, 22, and 25 A [Lee, Y. C., Townsend, R. R., Hardy, M. R., Lonngren, J., & Bock, K. (1984) in Biochemical and Biophysical Studies of Proteins and Nucleic Acids (Lo, T. B., Liu, T. Y., & Li, C. H., Eds.) pp 349-360, Elsevier, New York]. Ligands having inter-galactose distances shorter than these lengths were invariably poor ligands at their respective level of valency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487601 TI - Analysis of the mechanism of ATP stimulation of calf thymus DNA alpha-polymerase. AB - Biochemical kinetic analyses of the ATP stimulation of the A2 form of calf DNA alpha-polymerase show that when DNA or primer termini are the variable substrates, maximum reaction velocity is independent of ATP concentration. When dNTP concentration is the variable substrate, the apparent Km is invariant with ATP. Such results indicate that the increase in the synthetic rate caused by ATP results from an improvement in synthesis initiation at primer termini. The effect of ATP on the DNA binding affinity of alpha-A2-polymerase was examined by using column chromatography. Passage of the polymerase through native DNA-cellulose at 70 mM ionic strength resulted in 40% binding of the enzyme. In the presence of 4 mM ATP, binding increased to 80%. In both cases, the bound polymerase could be eluted by a 370 mM ionic strength wash. An elution profile similar to that observed in the absence of ATP was obtained with 0.1 mM ATP, 4 mM GTP, or 4 mM each of the nonhydrolyzable ATP analogues adenyl-5'-yl imidodiphosphate or adenosine 5'-O-(3-thiotriphosphate). These results suggest that hydrolysis of the gamma-phosphate occurs at millimolar levels of ATP and leads to a higher affinity of polymerase for DNA. To distinguish the effects of ATP on RNA priming from those on DNA synthesis, products synthesized processively by alpha-A2-polymerase were sized by gel filtration. Results indicate that essentially all products made on a gapped fd replicative form template in the presence of four dNTPs and 4 mM ATP result from the extension of preexisting DNA primers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487602 TI - RNA-protein interactions and secondary structures of cowpea chlorotic mottle virus for in vitro assembly. AB - Laser Raman spectroscopy of the cowpea chlorotic mottle virus (CCMV) in native (pH 5.0) and partially swollen (pH 7.5) states reveals the presence of small percentages of protonated adenine (less than 15%) and cytosine (less than 7%) bases in the encapsidated RNA molecule of the native virion. The protonated bases are titrated with pH-induced swelling of the virus. Titration of putative COOH groups of aspartic and glutamic side chains of the virion subunit cannot be detected over the same pH range, which suggests that carboxyl anions (CO-2) and protonated bases are both available at pH 5 to stabilize the ribonucleoprotein particles by electrostatic interactions. The highly (95%) ordered secondary structure of encapsidated RNA may undergo a small additional increase (less than 3%) in ordered structure with release from the virion, suggesting at most a marginal structure-distorting influence from protein contacts in the native particle. The Raman spectra of the virion are also compared by difference spectroscopy with spectra of capsids (empty shells devoid of RNA), subunit dimers, and protein-free RNA. The results indicate that the subunit structure is altered by the release of RNA from the virion, as well as by the swelling of the virion. Amino acid residues and protein secondary structures that are affected in these in vitro assembly and disassembly processes are identified from their characteristic Raman lines. Two classes of cysteinyl SH groups, solvent exposed and solvent protected, are revealed for the capsid and virion subunit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487603 TI - N-hydroxycarbamate is the substrate for the pyruvate kinase catalyzed phosphorylation of hydroxylamine. AB - The true substrate for the pyruvate kinase catalyzed phosphorylation of hydroxylamine at high pH which is activated by bicarbonate is shown to be N hydroxycarbamate, since a lag is seen when the reaction is started by the addition of bicarbonate or hydroxylamine but a burst appears when it is started with a mixture of the two. The lag can be diminished by addition of carbonic anhydrase but not eliminated, showing that CO2 is an intermediate in the formation of the carbamate and that both the formation of CO2 and the subsequent reaction of CO2 with hydroxylamine limit the rate of carbamate formation. The equilibrium constant for the reaction bicarbonate + hydroxylamine reversed N hydroxycarbamate is 1.33 M-1. The product of the phosphorylation decomposes by loss of CO2 to O-phosphorylhydroxylamine, which is stable at 25 degrees C between pH 3 and 11 and has pK2 = 5.63 for the phosphate and pK3 = 10.26 for the amino group. PMID- 6487604 TI - Adenosine cyclic 3',5'-monophosphate dependent protein kinase: nucleotide binding to the chemically modified catalytic subunit. AB - 5'-[p-(Fluorosulfonyl)benzoyl]adenosine (FSBA) inactivates the catalytic subunit of the adenosine cyclic 3',5'-monophosphate dependent protein kinase isolated from bovine cardiac muscle by covalent modification of lysine-71, whereas 7 chloro-4-nitro-2,1,3-benzoxadiazole (NBD-Cl) and 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB) react with cysteines-199 and -343 to inactivate the enzyme. All three of these reagents have been postulated to modify residues at or near the active site of the catalytic subunit. ATP (2 mM) in the presence of excess Mg2+ (10 mM) protects the enzyme against inactivation by these reagents. AMP did not afford any protection, but adenosine slightly decreased the rate of inactivation. The specific effects of covalent modification of lysine-71 and cysteines-199 and 343 on nucleotide binding were characterized by fluorescence-polarization titrations with lin-benzoadenine nucleotides as fluorescent ligands. lin Benzoadenosine is a competitive inhibitor of the catalytic subunit with respect to ATP with a Ki (38 microM) similar to the Ki for adenosine (35 microM). This value agrees well with the Kd (32 microM) for adenosine determined by fluorescence-polarization titrations. lin-Benzoadenosine 5'-diphosphate (lin benzo-ADP) has been shown to be a competitive inhibitor with respect to ATP [Hartl, F. T., Roskoski, R., Jr., Rosendahl, M. S., & Leonard, N. J. (1983) Biochemistry 22, 2347], and lin-benzoadenosine 5'-triphosphate (lin-benzo-ATP) is a substrate for the phosphotransferase activity of the protein kinase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487605 TI - 5'-[p-(Fluorosulfonyl)benzoyl]adenosine-mediated inactivation of S adenosylhomocysteinase. AB - Rat liver S-adenosylhomocysteinase (EC 3.3.1.1) is inactivated by 5'-[p (fluorosulfonyl)benzoyl]adenosine following pseudo-first-order kinetics. A plot of the apparent first-order rate constant for inactivation vs. the 5'-[p (fluorosulfonyl)benzoyl]adenosine concentration exhibits a hyperbolic curve indicative of the formation of a reversible enzyme-reagent complex prior to the inactivation. Values of 71.0 +/- 7.7 microM and 0.14 +/- 0.01 min-1 are estimated for Kd and k, respectively, at pH 8.25 and 25 degrees C. The substrate adenosine and a competitive inhibitor adenine completely protect the enzyme against inactivation. Values of dissociation constant for these ligands calculated from the protection experiments agree well with those obtained by other means, indicating that 5'-[p-(fluorosulfonyl)benzoyl]adenosine competes with these ligands for the same binding site. The inactivation is not reversed by dialysis against phosphate buffer or tris(hydroxymethyl)aminomethane hydrochloride buffer, but a full enzyme activity is regained by treatment with dithiothreitol. The inactivation is not accompanied by covalent attachment of the reagent but is correlated with the loss of two sulfhydryl groups per enzyme subunit. Thus, the inactivation appears to result from a reagent-mediated formation of a disulfide between two cysteine residues in close proximity. The 5'-[p (fluorosulfonyl)benzoyl]adenosine-modified enzyme which is not capable of catalyzing the overall reaction can still catalyze the partial reactions such as the oxidation of the 3'-hydroxyl and the abstraction of the 4'-proton of adenosine. PMID- 6487606 TI - Electron paramagnetic resonance of spin-labeled aequorin. AB - Aequorin is a Ca-activated bioluminescent protein from jellyfish. This protein contains two sulfhydryl groups, one of which is essential for its bioluminescence. Little information concerning the structure of and relationship between the metal binding sites of aequorin and the sulfhydryl group(s) is known. Aequorin was modified by attachment of either a maleimide spin-label [studied by electron paramagnetic resonance (EPR)] or the fluorescent label Acrylodan at the essential sulfhydryl in order to gain such information. These modifications caused destabilization of the chromophore of aequorin. Both of the attached labels showed considerable freedom of motion. The spin-label was quite accessible to the solvent, and the fluorescent label was less so. In addition the metal binding properties of the spin-labeled aequorin were studied by Mn(II) EPR. One tight Mn(II) binding site per spin-labeled aequorin was found. The distance between the Mn(II) binding site and the spin-label is at least 20 A. Furthermore, the relative affinity of spin-labeled aequorin for various metal ions was found to be in the order Pr(III) greater than Mn(II) greater than Ca(II) greater than Mg(II). PMID- 6487607 TI - 13C NMR studies of the molecular dynamics of selectively 13C-enriched ribonuclease complexes. AB - 13C spin-lattice (T1) relaxation times determined at four frequencies (25, 68, 100, and 125 MHz) have been used to probe the molecular dynamics of ribonuclease S' complexes prepared from synthetic amino-terminal peptides containing 13C enrichment (ca. 90%) at selected sites [Niu, C., Matsuura, S., Shindo, H., & Cohen, J. S. (1979) J. Biol. Chem. 254, 3788]. It was found that the motion of the C alpha-H bond of Ala-5 could not be determined by isotropic reorientation alone. The time scale and spatial restriction on the internal motion of this residue were determined by the model-free approach of Lipari and Sazbo [Lipari, G., & Szabo, A. (1982) J. Am. Chem. Soc. 104, 4546-4559]. It was found that the C alpha-H bond, in addition to an overall correlation time of 20 ns, underwent internal motion with a correlation time of 0.5 ns and a generalized order parameter S corresponding to a cone semiangle of 23 degrees C. The C beta-H bond had a correlation time of 37 ps, reflecting the fast rotation of the methyl group, and had an S value close to that expected if the C alpha-C beta and C alpha-H bonds have the same degree of spatial restriction. PMID- 6487608 TI - Hairpin configuration of H-2Kk in liposomes formed by detergent dialysis. AB - H-2Kk is a transmembrane glycoprotein having the N-terminal region of the heavy chain exposed at the cell surface and the C-terminal region exposed at the cytoplasmic face in its native configuration in the plasma membrane. The configuration of H-2Kk in liposomes formed by detergent dialysis was investigated by using fluorescently labeled H-2 and Co2+ ions to quench fluorescence. H-2Kk was incorporated into sealed lipid vesicles when deoxycholate was removed by dialysis from a mixture of protein and lipid. Including 20 mM carboxyfluorescein (CF) in the mixture prior to dialysis resulted in CF trapped inside the vesicles at concentrations where self-quenching occurred. Vesicles with CF trapped inside were shown to be osmotically active and impermeable to Na+ and Co2+ ions. In order to examine the configuration of H-2Kk in these liposomes, the heavy chain was covalently labeled by using the sulfhydryl reactive fluorescent reagents fluorescein-5-ylmaleimide (NFM) or 5-[[2-[(iodoacetyl)amino] ethyl]amino]naphthalene-1-sulfonic acid (IAEDANS). In both cases, approximately equal amounts of fluorescent label were incorporated into the N- and C-terminal regions of the protein. Incorporation of the labeled H-2 into liposomes and examination of the effect of Co2+ on the fluorescence showed that all of the label was accessible to quenching by Co2+ and thus exposed on the outside of the liposome. The results demonstrate that the H-2Kk is incorporated into these liposomes in a hairpin configuration, not in the transmembrane configuration found in native membranes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487609 TI - Polyhistidine mediates an acid-dependent fusion of negatively charged liposomes. AB - Polyhistidine facilities the fusion of negatively charged liposomes prepared by sonication. Liposome fusion was demonstrated by (a) negative-stain electron microscopy, (b) gel filtration, and (c) resonance energy transfer of the fluorescent phospholipids. Liposome fusion required the presence of polyhistidine, whereas histidine at equivalent concentrations had no effect. Little or no liposome fusion was detectable at pH 7.4, but it was greatly enhanced when the pH of the medium was reduced below 6.5. Although acidic phospholipid is necessary for fusion, liposomes made of acidic lipids alone showed only low levels of fusion activity. Liposomes composed of mixtures (1:1) of a negatively charged phospholipid and a neutral phospholipid such as phosphatidylcholine and phosphatidylethanolamine (PE), but not sphingomyelin, showed high levels (about 80%) of fusion competency. For liposomes made of PE/phosphatidylserine (PS) (1:1), fusion at pH 5.2 and 2.5 micrograms/mL polyhistidine resulted in an increase in the average liposome diameter from 296 to 2400 A, indicating multiple rounds of fusion had occurred. Liposome fusion was not very leaky as revealed by the lack of release of encapsulated calcein. For PE/PS (1:1) liposomes, about 10% of dye leakage was observed for up to about 30% liposome fusion and about 45% leakage at 80% liposome fusion. Since polyhistidine becomes a strong polycation at acidic pH, liposome fusion may be a direct result of the bilayer phase separation induced by the binding of polyhistidine with the negatively charged phospholipids. Therefore, this phenomenon is similar to the liposome fusion induced by other polycations such as polylysine at neutral pH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487610 TI - Analysis of the ternary interaction of the red cell membrane skeletal proteins spectrin, actin, and 4.1. AB - Spectrin dimers interact weakly with F-actin under physiological solvent conditions (with an association constant of about 5 X 10(3) M-1 at 20 degrees C). In the presence of the membrane skeletal constituent, protein 4.1, strong binding is observed; an analysis of the profiles for formation of a ternary complex leads to an association constant of about 1 X 10(12) M-2. This association becomes weaker at low ionic strength, whereas the opposite applies to the spectrin-actin interaction. The stability of the ternary complex is maximal at physiological ionic strength and somewhat above. The effect of temperature in the range 0-20 degrees C on the formation of the ternary complex is small, whereas the spectrin actin interaction almost vanishes at low temperature. There is no detectable calcium sensitivity in either the binary or the ternary system within the limits of precision of our assay. The ternary complex resembles the natural system in the membrane in that the actin is resistant to dissociation and unavailable in the deoxyribonuclease assay; after selective proteolytic destruction of spectrin and 4.1, all the actin becomes available. In the absence of 4.1, spectrin dimers do not measurably protect the actin against dissociation. PMID- 6487611 TI - Interaction of purified nicotinamidenucleotide transhydrogenase with dicyclohexylcarbodiimide. AB - The inhibition of the energy-linked nicotinamidenucleotide transhydrogenase (TH; EC 1.6.1.1) by dicyclohexylcarbodiimide (DCCD) has been further studied because of its important mechanistic implications. We had shown earlier that TH bound to submitochondrial particles from bovine heart is inhibited by DCCD and that NAD(H) protects the enzyme against this inhibition [Phelps, D.C., & Hatefi, Y. (1981) J. Biol. Chem. 256, 8217-8221]. By contrast, Pennington and Fisher [Pennington, R.M., & Fisher, R.R. (1981) J. Biol. Chem. 256, 8963-8969] working with purified TH concluded that NAD(H) does not protect against DCCD inhibition and that DCCD inhibition involves the TH proton channel rather than the nucleotide-binding active site. The present study shows that NAD(H) as well as AMP and ADP, which are known to bind to the NAD(H) binding site from competitive inhibition studies, protect the purified TH against inhibition by DCCD, whereas 2'-AMP and 3'-AMP, which bind to the NADP(H) site on TH, do not protect. In addition, it is shown that whereas the unmodified TH binds to NAD-agarose such that it is elutable by buffer containing NADH, the DCCD-modified enzyme does not bind to NAD-agarose. These results suggest strongly that DCCD binds at or near the NAD(H) binding site on TH. Another less likely possibility is that NAD(H) and DCCD bind to separate sites, but their bindings are mutually exclusive. With the use of [14C]DCCD, it has been shown that 100% activity inhibition corresponds to 0.5 mol of DCCD binding per mol of TH (Mr approximately 11 X 10(4].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487612 TI - Functional characterization of human erythrocyte spectrin alpha and beta chains: association with actin and erythrocyte protein 4.1. AB - Human erythrocyte spectrin alpha and beta chains were purified by preparative sodium dodecyl sulfate gel electrophoresis and also by DEAE-cellulose chromatography in the presence of urea. The purified chains behaved as individual monomers on sucrose gradients and did not form homodimers. Recombination of the chains led to the formation of alpha-beta heterodimers with sedimentation characteristics identical with native alpha-beta dimers. The binding of 125I labeled band 4.1 to alpha and beta chains was measured by sucrose gradient rate zonal sedimentation and by quantitative immunoassay. It was found that both alpha and beta chains associated with 125I-labeled band 4.1 in a nearly identical manner over the range of band 4.1 concentration studied. The association was abolished by heat denaturation of the spectrin chains or by denaturation of band 4.1 with a 40-fold molar excess of N-ethylmaleimide. As expected, purified beta chains but not alpha chains bound to 125I-labeled ankyrin as measured by a quantitative radioimmunoassay. The binding of purified alpha chains, beta chains, and recombinant alpha-beta heterodimers to F-actin was measured in the presence of band 4.1. We found that alpha or beta chains separately exhibited no band 4.1 dependent association with F-actin but that alpha-beta heterodimers formed by recombination of the chains did. We conclude that spectrin binding to F-actin in the presence of band 4.1 requires the participation of both of spectrin's polypeptide chains. PMID- 6487613 TI - NADH oxidation by quinone electron acceptors. AB - The rate constants of NADH oxidation by quinones are increased with the oxidation potential increase: log kox (M-1 X s-1) = -0.25 + 12.2 E0(7) (V) for o-quinones and log kox (M-1 X s-1) = -3.06 + 13.5 E0(7) (V) for p-quinones (pH 7.0, 25 degrees C). It is assumed that the oxidation proceeds via the hydride-ion transfer. The rate constants of NADH oxidation by single-electron quinone acceptors are also increased with the oxidizer potential increase; log kox (M-1 X s-1) = -0.64 + 9.34 E0(7) (V) and correlate with the constants of NADH oxidation by quinone radicals obtained earlier (Grodkowski, J., Neta, P., Carlson, B.W. and Miller, L. (1983) J. Phys. Chem. 87, 3135-3138). Single-electron transfer is the limiting stage of the process. PMID- 6487614 TI - A redox study of the electron transport pathway responsible for generation of the slow electrochromic phase in chloroplasts. AB - The amplitude of the slow phase of the electrochromic bandshift and the dark redox state of cytochrome b6, as well as its flash-induced turnover, have been measured as a function of ambient redox potential between +200 and -200 mV. Formation of a quinol-like donor with an Em,7 = +100 +/- 10 mV is required for generation of the slow phase. 80-100% of the amplitude of this signal with a t 1/2 = 3-4 ms is observed at -200 mV where cytochrome b6 was almost fully reduced (Em,7 of dark and flash-induced photoreduction was -30 mV and -75 mV, respectively). The change in the photoreduction of cytochrome b6 above 0 mV had an Em,7 of +50 mV, about 50 mV more negative than the midpoint at this pH for the onset of the slow electrochromic change. At potentials below -140 mV the amplitude of b6 photoreduction becomes small or negligible. The nature of the cytochrome b6 photoresponse is changed at potentials below -140 mV from a net photoreduction with a t1/2 = approximately less than 1 ms to a photooxidation with a t1/2 = 15-20 ms that is substantially slower than the electrochromic band shift with a t1/2 = 3-4 ms. It is concluded that the slow electrochromic phase probably does not arise from a mechanism involving a turnover of cytochrome b6. From consideration of the possible flash-induced electron-transfer steps and alternative mechanisms for generation of the slow phase, it is suggested that it may arise from a redox-linked H+ pump involving the high potential iron-sulfur protein. PMID- 6487615 TI - Effect of nucleotides on translocation of sugar nucleotides and adenosine 3' phosphate 5'-phosphosulfate into Golgi apparatus vesicles. AB - Recent studies from this laboratory have suggested that rat-liver Golgi apparatus derived membranes contain different proteins which can translocate in vitro CMP-N acetylneuraminic acid, GDP-fucose and adenosine 3'-phosphate 5'-phosphosulfate from an external compartment into a lumenal one. The aim of this study was to define the role of the nucleotide, sugar and sulfate moieties of sugar nucleotides and adenosine 3'-phosphate 5'-phosphosulfate in translocation of these latter compounds across Golgi vesicle membranes. Indirect evidence was obtained suggesting that the nucleotide (but not sugar or sulfate) is a necessary recognition feature for binding to the Golgi membrane (measured as inhibition of translocation) but is not sufficient for overall translocation; this latter event also depends on the type of sugar. Important recognition features for inhibition of translocation of the above sugar nucleotides and adenosine 3'-phosphate 5' phosphosulfate were found to be the type of nucleotide base (purine or pyrimidine) and the position of the phosphate group in the ribose. Thus, UMP and CMP were found to be competitive inhibitors of translocation of CMP-N acetylneuraminic acid, while AMP did not inhibit. Structural features of the nucleotides which were less important in inhibition of translocation (and thus presumably in binding) of the above sugar nucleotides and adenosine 3'-phosphate 5'-phosphosulfate were the number of phosphate groups in the nucleotide (CDP and CMP inhibited to a similar extent), the presence of ribose or deoxyribose in the nucleotide, a replacement of hydrogen in positions 5 of pyrimidines or 8 in purines by halogens or an azido group. The sugar or sulfate did not inhibit translocation of the above sugar nucleotides and adenosine 3'-phosphate 5' phosphosulfate into Golgi vesicles and therefore appear not to be involved in their binding to the Golgi membrane. PMID- 6487616 TI - An X-ray diffraction and electron microscopy study of the extraction of erythrocyte membranes with the bile salt, cholate. AB - Studies by X-ray diffraction and electron microscopy of slowly frozen samples of control and cholate-extracted preparations of erythrocyte membranes have demonstrated changes in structural parameters which can readily be related to the extraction of cytoskeletal proteins. In the frozen state, these components appear to be condensed to about 10% of the total membrane thickness. The observations illustrate some of the advantages and limitations in the use of slowly frozen membrane preparations in studies of membrane structure. PMID- 6487617 TI - Adsorption of local anesthetics on phospholipid membranes. AB - In order to elucidate various types of adsorption modes of local anesthetics in membranes, a study of local anesthetic adsorption on lipid membranes was made by measuring electrophoretic mobility of phospholipid vesicles in the presence of local anesthetics of various concentrations in the vesicle suspension solution. The amounts of local anesthetics to be adsorbed on the membrane surface were deduced from the electrophoretic mobility of a phosphatidylcholine vesicle at various concentrations of the cationic form of local anesthetics. The order of surface adsorption of local anesthetic was dibucaine greater than tetracaine greater than procaine. A surface partition coefficient, Ks = 1/ACs, was introduced, where A is the membrane surface area per local anesthetic molecule adsorbed and Cs the surface concentration of local anesthetics. The amounts of local anesthetic adsorbed on phosphatidylserine membrane were much greater than that of the phosphatidylcholine membrane. It was deduced that the major factor for this large adsorption was due to the enhancement of cationic forms of local anesthetic concentrations at the charged membrane surface. Divalent cations inhibited such surface adsorption of local anesthetics by reducing surface concentrations of local anesthetics where the surface potential of the negatively charged membrane surface was influenced by the presence of divalent cations in the solution as well as by the reduction of fixed surface charges due to divalent cation binding. Some association modes of local anesthetics on nerve membranes are discussed with the results obtained in the above adsorption study. PMID- 6487618 TI - Benzyl alcohol penetration into micelles, dielectric constant of the binding site, partition coefficient and high-pressure squeeze-out. AB - The absorbance maximum, lambda max, of a local anesthetic, benzyl alcohol, is shifted to longer wavelengths when solvent polarity is decreased. The shift was approximately a linear function of the dielectric constant of the solvent. This transition in electronic spectra according to the microenvironmental polarity is used to analyze benzyl alcohol binding to surfactant micelles. A facile method is devised to estimate the micelle/water partition coefficient from the dependence of lambda max of benzyl alcohol on surfactant concentrations. The effective dielectric constants of the sodium decyl sulfate, dodecyl sulfate and tetradecyl sulfate micelles were 29, 31 and 33, respectively. The partition coefficient of benzyl alcohol between the micelles and the aqueous phase was 417, 610 and 1089, respectively, in the mole fraction unit. The pressure dependence of the partition coefficient was estimated from the depression of the critical micelle concentration of sodium dodecyl sulfate by benzyl alcohol under high pressure up to 200 MPa. High pressure squeezed out benzyl alcohol molecules from the micelle until about 120 MPa, then started to squeeze in when the pressure was further increased. The volume change of benzyl alcohol by transfer from the aqueous to the micellar phase was calculated from the pressure dependence of the partition coefficient. The volume change, estimated from the thermodynamic argument, was 3.5 +/- 1.1 cm3.mol-1 at 298.15 K, which was in reasonable agreement with the partial molal volume change determined directly from the solution density measurements, 3.1 +/- 0.2 cm3.mol-1. Benzyl alcohol apparently solvates into the micelles close to surface without losing contact with the aqueous phase. PMID- 6487619 TI - Cl- transport in apical plasma membrane vesicles isolated from bovine tracheal epithelium. AB - The Cl- transport properties of the luminal border of bovine tracheal epithelium have been investigated using a highly purified preparation of apical plasma membrane vesicles. Transport of Cl- into an intravesicular space was demonstrated by (1) a linear inverse correlation between Cl- uptake and medium osmolarity and (2) complete release of accumulated Cl- by treatment with detergent. The rate of Cl- uptake was highly temperature-sensitive and was enhanced by exchange diffusion, providing evidence for a carrier-mediated transport mechanism. Transport of Cl- was not affected by the 'loop' diuretic bumetanide or by the stilbene-derivative anion-exchange inhibitors SITS (4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid) and DIDS (4,4'-diisothiocyanostilbene 2,2'-disulfonic acid). In the presence of the impermeant cation, tetramethylammonium (TMA+), uptake of Cl- was minimal; transport was stimulated equally by the substitution of either K+ or Na+ for TMA+. Valinomycin in the presence of K+ enhanced further Cl- uptake, while amiloride reduced Na+ stimulated Cl- uptake towards the minimal level observed with TMA+. These results suggest the following conclusions: (1) the tracheal vesicle membrane has a finite permeability to both Na+ and K+; (2) the membrane permeability to the medium counterion determines the rate of Cl- uptake; (3) Cl- transport is not specifically coupled with either Na+ or K+; and, finally (4) Cl- crosses the tracheal luminal membrane via an electrogenic transport mechanism. PMID- 6487620 TI - A 12 A resolution X-ray diffraction study of the profile structure of isolated bovine retinal rod outer segment disk membranes. AB - Electron density profiles of disk membranes isolated from bovine retinal rod outer segments have been determined to 12 A resolution by analysis of the X-ray diffraction from oriented multilayers, in the absence of lipid phase separation. Data were collected on both film and a two-dimensional TV-detector; both detectors yielded identical patterns consisting of relatively sharp lamellar reflections of small mosaic spread. The unit cell repeat was reversibly varied over the range of 143 to 183 A. The diffraction patterns changed dramatically at 150 A; consequently, the low (less than 150 A) and high (greater than 150 A) periodicity data were independently analyzed via a swelling algorithm. The high periodicity data yielded two statistically equivalent phase choices corresponding to two symmetric, but different membrane profiles. The low periodicity data yielded essentially one, characteristically asymmetric profile. These profiles have been modeled with regard to the separate profiles of rhodopsin, lipid and water, subject to the known composition of the isolated disk membranes. PMID- 6487621 TI - The C-terminus of bacteriorhodopsin is a random coil. AB - The 21 amino acids which can be selectively removed from the carboxyl terminus of bacteriorhodopsin by proteolytic treatment are disordered in 2-dimensional arrays of the protein present in purple membranes. This C-terminal portion of the molecule may be involved in the efficiency and rate of light-driven proton uptake, although its presence is not required for pumping activity. In this study, the secondary structure of the C-terminus of bacteriorhodopsin has been determined by examining circular dichroism (CD) difference spectra derived from native and digested samples. In low ionic strength media, this part of the molecule appears to form a random coil-like structure. To examine if this structure is related to the structure found under the high ionic strength condition present in halobacteria, the CD spectra of native purple membranes in water and in 4 M salt solutions were compared. They were found to be identical, suggesting the conformation of the C-terminus in vivo may also be a random coil. PMID- 6487622 TI - Osmotic stabilizers differentially inhibit permeability alterations induced in Vero cells by Clostridium perfringens enterotoxin. AB - Using a sensitive Vero (African green monkey kidney) cell model system, studies were performed to further investigate whether Clostridium perfringens enterotoxin acts via disruption of the colloid-osmotic equilibrium of sensitive cells. Enterotoxin was shown to cause a rapid loss of intracellular 86Rb+ (Mr approx. 100) with time- and dose-dependent kinetics. The enterotoxin-induced release of intracellular 86Rb+ preceded the loss of two larger labels, 51Cr label (Mr approx. 3500) and 3H-labeled nucleotides (Mr less than 1000). The osmotic stabilizers, sucrose and poly(ethylene glycol), differentially inhibited enterotoxin-induced larger label loss versus 86Rb+ loss. Further, enterotoxin was shown to cause a rapid influx of 24Na+ that was not significantly inhibited by osmotic stabilizers. Additional studies demonstrated that lysosomotropic agents were not protective against characteristic enterotoxin-induced membrane permeability alterations or morphological damage. Taken collectively, these results are consistent with an action for enterotoxin which involves a disruption of the osmotic equilibrium. PMID- 6487623 TI - Erythrocyte Lii-Nao countertransport system. Inhibition by N-ethylmaleimide probes for a conformational change of the transport system. AB - Human erythrocytes were treated by a series of SH-reagents, including maleimides, iodo compounds, mercurials and oxidizing agents. Rates of Li efflux into Na-rich medium, Li leak and Lii-Nao countertransport were then determined. Of the 13 different reagents studied, only N-ethylmaleimide, iodoacetamide and iodoacetate inhibited selectively the countertransport activity. The effect of the various reagents indicates that the sensitive SH-groups of the countertransport system are not externally exposed. N-Ethylmaleimide was used to probe for changes elicited by substrate cations in Lii-Nao countertransport. In Na- and Li-free medium, inhibition of Lii-Nao countertransport by N-ethylmaleimide of 35% was reached within 2 s. In Na or Li medium, maximal inhibition was twice as great, but was attained much more slowly, within 10 min. Kinetic data and Hill plot analysis indicate the involvement of two classes of SH-groups: one expressed in the various media with and without substrate cations, and an additional one, which becomes specifically available to N-ethylmaleimide in the presence of external Na or Li. The affinity of Na to the site promoting inhibition by N ethylmaleimide (apparent Km = 12 mM) is higher than the affinity of Na to its external countertransport site (apparent Km = 25 mM, as reported by Sarakadi, B., Alifimoff, J.K., Gunn, R.B. and Tosteson, D.C. (1978) J. Gen. Physiol. 72, 249 265). Reactivity of N-ethyl[14C]maleimide was not modified by the media tested. It is concluded that external Na and Li cause a conformational change in the protein(s) of the countertransport system in human erythrocytes. PMID- 6487624 TI - Large-ligand adsorption to membranes. III. Cooperativity and general ligand shapes. AB - In previous reports (Stankowski, S. (1983) Biochim. Biophys. Acta 735, 341-351 and 352-360) the ordinary Scatchard-type analysis has been shown to yield erroneous results when applied to the binding of large molecules to membranes or cells. Formulae have been given to treat the limiting cases of very thin and of very bulky ligands. These results are now extended to include ligands of any shape and cooperative interactions. As an example, data on the cooperative binding of polymyxin to charged lipid bilayers are reevaluated. Adsorption with concomitant incorporation of the large molecule into the membrane is also considered. PMID- 6487625 TI - Role of the plasma membrane in the mechanism of cholesterol efflux from cells. AB - In order to investigate the role of the plasma membrane in determining the kinetics of removal of cholesterol from cells, the efflux of [3H]cholesterol from intact cells and plasma membrane vesicles has been compared. The release of cholesterol from cultures of Fu5AH rat hepatoma and WIRL-3C rat liver cells to complexes of egg phosphatidylcholine (1 mg/ml) and human high-density apolipoprotein is first order with respect to concentration of cholesterol in the cells, with half-times (t 1/2) for at least one-third of the cell cholesterol of 3.2 +/- 0.6 and 14.3 +/- 1.5 h, respectively. Plasma membrane vesicles (0.5-5.0 micron diameter) were produced from both cell lines by incubating the cells with 50 mM formaldehyde and 2 mM dithiothreitol for 90 min. The efflux of cholesterol from the isolated vesicles follows the same kinetics as the intact, parent cells: the t 1/2 values for plasma membrane vesicles of Fu5AH and WIRL cells are 3.9 +/- 0.5 and 11.2 +/- 0.7 h, respectively. These t 1/2 values reflect the rate limiting step in the cholesterol efflux process, which is the desorption of cholesterol molecules from the plasma membrane into the extracellular aqueous phase. The fact that intact cells and isolated plasma membranes release cholesterol at the same rates indicates that variations in the plasma membrane structure account for differences in the kinetics of cholesterol release from different cell types. In order to investigate the role of plasma membrane lipids, the kinetics of cholesterol desorption from small unilamellar vesicles prepared from the total lipid isolated from plasma membrane vesicles of Fu5AH and WIRL cells were measured. Half-times of cholesterol release from plasma membrane lipid vesicles of Fu5AH and WIRL cells were the same, with values of 3.1 +/- 0.1 and 2.9 +/- 0.2 h, respectively. Since bilayers formed from isolated plasma membrane lipids do not reproduce the kinetics of cholesterol efflux observed with the intact plasma membranes, it is likely that the local domain structure, as influenced by membrane proteins, is responsible for the differences in t 1/2 values for cholesterol efflux from these cell lines. PMID- 6487626 TI - The influence of lipid composition on the barrier properties of band 3-containing lipid vesicles. AB - Band 3 protein has been incorporated into lipid vesicles consisting of 94:6 (molar ratio) egg phosphatidylcholine-bovine heart phosphatidylserine or total erythrocyte lipids by means of a Triton X-100 Bio-Beads method, with an additional sonication step prior to the removal of the detergent. This methods results, for both types of band 3 lipid vesicles, in rather homogeneous vesicles with comparable protein content and vesicle trap. Freeze-fracture electron microscopy revealed that band 3-egg phosphatidylcholine-bovine heart phosphatidylserine vesicles have considerably more intramembrane particles as compared to the band 3-erythrocyte lipid vesicles. The dimensions of the nonspecific permeation pathways present in the band 3-lipid vesicles were measured using an influx assay procedure for nonelectrolytes of different size, in which the vesicles were sampled and subsequently freed from nonenclosed labeled permeant by means of gel-filtration. The band 3-egg phosphatidylcholine bovine heart phosphatidylserine vesicles have nonspecific permeation pathways (pores), with diameters of up to 60 A. In contrast, the band 3-total erythrocyte lipid vesicles are more homogeneous and show much smaller nonspecific permeation pathways, having a diameter of about 12 A. These results suggest that the nonspecific permeability of the band 3-lipid vesicles is strongly lipid dependent. Increase in specific anion permeability expected as a consequence of the presence of band 3 in the erythrocyte lipid vesicles was found to be very limited. However, stereospecific, phloretin-inhibitable D-glucose permeability could clearly be demonstrated in these vesicles. The difference of the nonspecific permeability of the band 3-egg phosphatidylcholine-bovine heart phosphatidylserine vesicles and band 3-erythrocyte lipid vesicles, is discussed in the light of the presence of defects at the lipid/protein interface and protein aggregation, which may induce formation of pores. PMID- 6487627 TI - Organic phosphates modulate anion self-exchange across the human erythrocyte membrane. AB - Anion transport across the red cell membrane has been measured as sulfate self exchange flux (Ja) in fresh and metabolically depleted human red cells. Depletion of metabolic stores by a starvation of the cells decreases Ja by 50%. A similar effect was observed when ATP was acutely and selectively depleted by iodoacetamide. This inhibition was independent of the presence of calcium and reversible after metabolic rejuvenation of the cells. Ghosts prepared from fresh red cells exhibited the same value of Ja as fresh red cells. By contrast, ghosts prepared from depleted red cells exhibited a decrease in Ja which was reverted by a physiological concentration of ATP. The effect of ATP was dependent on its concentration (Km approximately 40 microM) and on the duration of the metabolic depletion: complete restoration of Ja was obtained only in ghosts prepared from red cells acutely depleted of ATP by a 2 h incubation with iodoacetamide. After a 20 h starvation, Ja restoration was never more than 80%. We postulate that ATP acts primarily through the phosphorylation of band 3 protein, the anion exchanger; it acts also through the stabilization of the normal organization of the membrane. This latter effect may involve the phosphorylation of membrane components, but also a direct interaction, as shown by the influence of other organic phosphates (2,3-diphosphoglycerate and inositol hexaphosphate) on Ja in the absence of ATP. PMID- 6487628 TI - The role of fatty acids in the regulation of brush-border Ca2+ transport. AB - The role of the fatty-acid composition of the intestinal brush-border membrane in the control of transmembrane Ca2+ transport was examined by in vitro acylation of endogenous phospholipids. The initial rate of Ca2+ uptake into brush-border membrane vesicles was stimulated 1.6-fold by incubation with 50 microM linoleoyl CoA, which was the most effective CoA ester examined. Oleoyl CoA was also active, but stearoyl CoA, palmitoyl CoA and arachidonyl CoA displayed no activity. The effect of linoleoyl CoA was specific for Ca2+ transport; sodium-dependent phosphate uptake was slightly inhibited and the activity of alkaline phosphatase, a brush-border enzyme, was unaffected. Incubation of brush-border vesicles with either stimulatory (oleate) or nonstimulatory (stearate) CoA esters resulted in the incorporation of fatty acid into the four major phospholipid classes, suggesting a fatty-acid specificity of the Ca2+ transport phenomenon. These results are consistent with the hypothesis that fatty acids are important elements in the control of brush-border Ca2+ transport. PMID- 6487629 TI - The effect of ions and ionophores on cystine egress from human leucocyte lysosome rich granular fraction. AB - This paper describes the stimulation of exodus of cystine from lysosome-rich granular fractions by potassium. Potassium permeability into lysosomes is low, but in the presence of an ionophore or permeable anion, the movement of K+ into lysosomes caused a large stimulation of cystine exodus. Lysosomal preparations from leucocytes of cystinotic patients, which lack carrier-mediated cystine transport, also manifested stimulation of cystine egress by valinomycin and K+. This suggests that potassium-dependent cystine egress involves a carrier different from that defective in cystinosis, or occurs through a non-carrier mediated mechanism. PMID- 6487630 TI - Anion transport in single erythrocyte ghosts measured by fluorescence microphotolysis. AB - Fluorescence microphotolysis was used to measure in single resealed human erythrocyte ghosts the band 3-mediated transport of the fluorescent anion N-(7 nitrobenzofurazan-4-yl)-taurine (NBD-taurine). Transport was reduced to less than 5% of the control by the specific inhibitor 4,4'-diisothiocyanostilbene-2,2' disulfonate (DIDS). The accuracy of the determination of the rate constant for NBD-taurine influx was approximately +/- 15% as calculated from repetitive measurements in individual ghosts. The sample population distribution of the rate constant was slightly skewed towards values larger than the mean. The rate of NBD taurine transport showed an optimum near pH 7. The Arrhenius plot was linear in the range from 28.5 degrees C to 51 degrees C with an apparent activation enthalpy of 21.4 kcal/mol. PMID- 6487631 TI - Growth mechanism of myelin figures of phosphatidylcholine. AB - The initial growth process of myelin figures, rod-like lyotropic liquid crystalline structures, formed by phosphatidylcholine in water, ethylene glycol or glycerin, is suggested to be diffusion-limited with an apparent diffusion coefficient D of approx. 10(-6) cm2/s. D can be expressed by the sum of two processes. One is considered to describe the diffusion of an aggregate of phosphatidylcholine molecules and the other mainly to describe a lateral diffusion in the bilayer membranes which constitute myelin figures. PMID- 6487632 TI - The prediction of protein domains. AB - The ab initio prediction of the domain boundaries and types remains one of the most important problems which makes a possible description of protein tertiary structure from its amino-acid sequence elusive. The present paper describes new methods to predict both of them. The predictions of domain boundaries and types in proteins of known X-ray structures are reported in order to check the efficiency of these new algorithms. PMID- 6487634 TI - Purification, characterization and ion binding properties of human brain S100b protein. AB - Human brain S100b (beta beta) protein was purified using zinc-dependent affinity chromatography on phenyl-Sepharose. The calcium- and zinc-binding properties of the protein were studied by flow dialysis technique and the protein conformation both in the metal-free form and in the presence of Ca2+ or Zn2+ was investigated with ultraviolet spectroscopy, sulfhydryl reactivity and interaction with a hydrophobic fluorescence probe 6-(p-toluidino)naphthalene-2-sulfonic acid (TNS). Flow dialysis measurements of Ca2+ binding to human brain S100b (beta beta) protein revealed six Ca2+-binding sites which we assumed to represent three for each beta monomer, characterized by the macroscopic association constants K1 = 0.44 X 10(5) M-1; K2 = 0.1 X 10(5) M-1 and K3 = 0.08 X 10(5) M-1. In the presence of 120 mM KCl, the affinity of the protein for calcium is drastically reduced. Zinc-binding studies on human S100b protein showed that the protein bound two zinc ions per beta monomer, with macroscopic constants K1 = 4.47 X 10(7) M-1 and K2 = 0.1 X 10(7) M-1. Most of the Zn2+-induced conformational changes occurred after the binding of two zinc ions per mole of S100b protein. These results differ significantly from those for bovine protein and cast doubt on the conservation of the S100 structure during evolution. When calcium binding was studied in the presence of zinc, we noted an increase in the affinity of the protein for calcium, K1 = 4.4 X 10(5) M-1; K2 = 0.57 X 10(5) M-1; K3 = 0.023 X 10(5) M-1. These results indicated that the Ca2+- and Zn2+-binding sites on S100b protein are different and suggest that Zn2+ may regulate Ca2+ binding by increasing the affinity of the protein for calcium. PMID- 6487633 TI - Relationship between tetramer-dimer assembly and the stability of Hb Malmo (alpha 2 beta 2 97Gln). AB - The effects of the mutation of the alpha 1 beta 2 contact in Hb Malmo (alpha 2 beta 2 97(FG4)His----Gln) on oxygen-binding properties, ease of dissociation into dimeric hemoglobin and stability were studied. The P50 value of Hb Malmo in the absence of organic phosphates was 1.9 mmHg, in contrast to 8.8 mmHg of Hb A. The n-value of Hb Malmo was 1.6. The overall free energy of interaction of oxygen with Hb Malmo was about 25% that of Hb A. The Adair constant, K1, of Hb Malmo was about 10-times larger than that of Hb A, but the K4 of Hb Malmo was similar to that of Hb A. The liganded form of Hb Malmo was found to dissociate into dimers more readily than Hb A by gel filtration on Sephadex G-100. Dissociation into dimeric hemoglobin was enhanced in dilute solutions. Increased instability during mechanical agitation of diluted samples was greater for Hb Malmo than for Hb A. The denaturation rate constants of tetramers of the oxyform of Hb A and Hb Malmo were about 20-times greater than those of dimers of these hemoglobins. The instability of Hb Malmo depends on a greater alpha 1 beta 2 dissociation constant compared with that of Hb A. These findings allow an examination of the role of the intersubunit contact in determining the functional properties and the stability of the hemoglobin molecule. PMID- 6487635 TI - Reactions of the aminoacyl-tRNA synthetase-aminoacyl adenylate complex and amino acid derivatives. A new approach to peptide synthesis. AB - Several kinds of dipeptide derivative were shown to be formed by the reactions of the aminoacyl adenylate-aminoacyl-tRNA synthetase complex and amino acid ester or amide. It was shown that the peptide bond could be formed by aminoacyl-tRNA synthetases even in the absence of the ribosome. PMID- 6487636 TI - Fluorescence energy transfer measurements between the nucleotide binding site and Cys-373 in actin and their application to the kinetics of actin polymerization. AB - Intramonomer fluorescence energy transfer between the donor epsilon-ATP bound to the nucleotide-binding site and the acceptor 7-chloro-4-nitrobenzo-2-oxa-1,3 diazole bound to Cys-373 in G-actin was measured by steady-state fluorimetry. Assuming for the orientation factor its dynamic limit K2 = 2/3, the donor and acceptor distance in a G-actin molecule was calculated to be about 3 nm. The intermonomer energy transfer in F-actin occurring between the donor bound to an actin monomer and the acceptor bound to the nearest-neighbour actin monomer was also measured and the distance was calculated to be about 4 nm. The kinetics of the actin polymerization process was studied by following the decrease in fluorescence intensity upon addition of salts to G-actin solution. The initial velocity of the fluorescence intensity change was proportional to the square of the initial G-actin concentration. The temperature dependence of the velocity was proportional to the square of the initial G-actin concentration. The temperature dependence of the velocity was proportional to exp(-10/RT). These results indicated that the initial fluorescence intensity change corresponds to monomer dimer transformation and its activation enthalpy was 10 kcal/mol. PMID- 6487637 TI - Changes in the Bohr effect due to pyridoxylation of the alpha-chain terminal amino groups of hemoglobin. AB - Deoxyhemoglobins substituted with pyridoxal 5'-phosphate or pyridoxal 5' deoxymethylenephosphonate at the N-terminal amino groups of the alpha-chains were investigated by 31P-NMR spectroscopy. Titration curves of the 5'-side-chains show a substantial increase in acid strength in alpha-pyridoxylated deoxyhemoglobins when compared to the corresponding CO-liganded hemoglobins. These derivatives therefore contain a new oxygenation-linked acid group which opposes the normal Bohr effect. The loss in stabilization of the monoanion of the phosphate or phosphonate group derived from the three-dimensional structure can account for the lower pK of this ionization in deoxyhemoglobin as compared to CO-liganded hemoglobin. The reduction in the Bohr effect caused by modification of the alpha chains with pyridoxal 5'-deoxymethyl-enephosphonate is quantitatively equal to the expected contribution of alpha-chain N-terminal amino groups. PMID- 6487638 TI - Purification of five creatine kinase-MM variants from human heart and skeletal muscle. AB - Variants of creatine kinase-MM (variant of ATP:creatine N-phosphotransferase, EC 2.7.3.2), present in human heart and skeletal muscle, have been purified to homogeneity using DEAE-Sepharose column chromatography and column chromatofocusing techniques. Creatine kinase-MM I-IV were present in both heart and skeletal muscle, while MM-V was found only in heart. The number, ratio and elution profile of the variants during chromatofocusing remained identical even when they were purified in the presence of proteinase inhibitors. MM-I-V, on chromatofocusing, were eluted at pH 8.3, 7.9, 7.6, 7.2 and 6.8, respectively. Isoelectric focusing revealed the pI of MM-I-V to be 7.2, 6.9, 6.7, 6.4 and 6.2. Sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis showed a doublet pattern for creatine kinase-MM variants III-V. However, polyacrylamide gel electrophoresis without SDS indicated homogeneity because each variant showed a single band. The doublet pattern observed in the presence of SDS may reflect the presence of two subunits of slightly different mass. PMID- 6487639 TI - Chemical modification of adrenocortical cytochrome P-450scc with tetranitromethane. AB - Selective chemical modification of adrenocortical cytochrome P-450scc, responsible for key stages of steroid biogenesis, with tetranitromethane has been carried out. Nitration of the cytochrome P-450scc tyrosine residues results in heme protein inactivation with syncatalytic loss of enzyme activity. Analysis of the cytochrome P-450scc inactivation kinetics indicates that there are several pools of tyrosine residues, differing in their accessibility to tetranitromethane. The modification of cytochrome P-450scc results in changes in the hemeprotein spectral properties and its conformation which indicates to the involvement of essential tyrosine residue(s) in the heme-protein interaction. Cholesterol and adrenodoxin (high-spin effectors) prevent the inactivation of cytochrome P-450scc with tetranitromethane, i.e., protect the essential tyrosine residue(s) from modification. Possible functions of the tyrosine residues in the cytochrome P-450scc molecule are discussed. PMID- 6487640 TI - Size and stability to sodium dodecyl sulfate of alkaline phosphatases from their three established human genes. AB - Subunit molecular weights of human alkaline phosphatases (orthophosphoric monoester phosphohydrolases (alkaline optimum), EC 3.1.3.1) determined by polyacrylamide gel electrophoresis in sodium dodecyl sulfate (SDS) were dependent upon acrylamide concentration, a reflection of their glycoprotein nature. Molecular weights at a concentration of 7% (w/w) or greater were 68300, 80800 and 79400 for the enzymes from placenta, liver and mucosa of small intestine, respectively. All enzymes were dimers, the respective native Mr values determined by gradient gel electrophoresis being 138000, 186000 and 180000. None of the molecular weights was altered by desialylation. Stability of the catalytic activity of the purified enzymes to SDS varied and was very dependent on pH. SDS at 1% (w/v) rapidly denatured both native and desialylated alkaline phosphatase from placenta at pH 7.5 but had little effect on these at pH 10.3. Compared with placenta, the native enzyme from liver had greater stability at pH 7.5 and both native and desialylated forms had lower stability at pH 10.3. The enzyme from intestinal mucosa was sharply different from the other two isoenzymes: SDS had little effect at pH 7.5 but very rapidly denatured the enzyme at pH 10.3. The size of alkaline phosphatases and their stability to SDS can be used to identify gene products and to recognize heterodimers formed between products of more than one gene. PMID- 6487641 TI - Fluorescence energy transfers between points in acto-subfragment-1 rigor complex. AB - Fluorescence energy transfer was measured by time-resolved and steady-state fluorimetry in order to investigate the spatial relationships between the nucleotide binding site of actin, the Cys-373 residue of actin, and the SH1 of myosin subfragment-1 in the rigor complex of acto-subfragment-1. N-Iodoacetyl-N' (5-sulfo-1-naphthyl)ethylenediamine (IAEDANS) bound to the Cys-373 of actin or the fluorescent ADP analogue 1-N6-ethenoadenosine-5'-diphosphate (epsilon-ADP) bound to F-actin was used as a donor and 4-(N-(iodoacetoxy)ethyl-N-methyl)amino-7 nitrobenz-2-oxa-1,3-diazo le (IANBD) or 5-iodoacetamidofluorescein (IAF) bound to SH1 of myosin subfragment-1 was used as an acceptor. Assuming the random orientation factor, K2, to be 2/3, the distance between Cys-373 residue of actin and SH1 of myosin subfragment-1 was calculated to be about 50 A, in agreement with the values previously reported, 60 A (Takashi, R. (1969) Biochemistry 18, 5164-69) and 50 A (Trayer, H.R. and Trayer, I.P. (1983) Eur. J. Biochem. 135, 47 59). The distance between the nucleotide binding site of actin and SH1 of myosin subfragment-1 was calculated to be about 70 A or greater. PMID- 6487642 TI - 13C-NMR spectral study of reductively [13C]methylated glycophorin B. AB - Glycophorin BN was reductively [13C]methylated and the 13C chemical shift of the N-terminal [13C]dimethyl-leucine residue was monitored as a function of pH. These results were compared to the pH-dependent chemical shift studies of the N terminal [13C]dimethylleucine residues of intact glycophorin AN and N-terminal glyco-octapeptide AN. The results indicate that the titration data for [13C]dimethylleucine of glycophorin BN more closely resembles the titration data observed for the [13C]dimethylleucine residue of the N-terminal glyco-octapeptide AN rather than for the [13C]dimethylleucine residue of intact glycophorin AN. Integration of the 13C resonances indicated that glycophorin BN contains 3-4 lysine residues. PMID- 6487643 TI - Acetoacetate and glucose as substrates for lipid synthesis by rat brain oligodendrocytes and astrocytes in serum-free culture. AB - We have compared glucose and acetoacetate as precursors for lipogenesis and cholesterogenesis by oligodendrocytes and astrocytes, using mixed glial cultures enriched in oligodendrocytes. In order to differentiate between metabolic processes in oligodendrocytes and those in astrocytes, the other major cell type present in the mixed culture, we carried out parallel incubations with cultures from which the oligodendrocytes had been removed by treatment with anti galactocerebroside serum and guinea-pig complement. The following results were obtained: 1. Both oligodendrocytes and astrocytes in culture actively utilize acetoacetate as a precursor for lipogenesis and cholesterogenesis. 2. In both cell types, the incorporation of acetoacetate into fatty acids and cholesterol exceeds that of glucose by a factor of 5-10 when the precursors are present at concentrations of 1 mM and higher. 3. Glucose stimulates acetoacetate incorporation into fatty acids and cholesterol, whereas acetoacetate reduces the entry of glucose into these lipids. This suggests that glucose is necessary for NADPH generation, but that otherwise the two precursors contribute to the same acetyl-CoA pool. 4. Both with acetoacetate and with glucose as precursor, oligodendrocytes are more active in cholesterol synthesis than astrocytes. 5. Using incorporation of 3H2O as an indicator for total lipid synthesis, we estimated that acetoacetate contributes one third of the acetyl groups and glucose one twentieth when saturating concentrations of both substrates are present. PMID- 6487644 TI - Effect of hyperoxia on phosphatidylcholine synthesis, secretion, uptake and stability in the newborn rabbit lung. AB - The effects of breathing greater than 95% oxygen from birth for 48 h of life on surfactant phosphatidylcholine synthesis and secretion, as well as uptake and stability of exogenous phosphatidylcholine were studied using rabbit lung tissue slices. Lung slices from animals breathing greater than 95% oxygen for 48 h exhibited a decreased rate of [14C]phosphatidylcholine release (30%) in comparison to lung slices from air-exposed controls. In vitro incorporation of [14C]choline into phosphatidylcholine was decreased by a similar amount in lung slices from pups exposed to greater than 95% oxygen. Uptake of exogenous [14C]phosphatidylcholine by lung slices from hyperoxic-exposed and control groups was not different, and the stability of extracellular phosphatidylcholine was likewise unaffected by hyperoxia. Turnover of labelled phosphatidylcholine taken up by tissue slices from medium was apparently decreased in association with hyperoxic exposure. These results are consistent with multiple sites of effect of hyperoxia on the pulmonary surfactant system in the newborn. These effects of hyperoxia on the lung surfactant system occur at a time of critical adaption to extrauterine life, and thus may have major consequences on lung function and ultimate survival of the premature infant with respiratory distress syndrome. PMID- 6487645 TI - Cholesterol homeostasis in the guinea pig. The importance of quantitating net tissue accumulation of cholesterol in sterol balance studies. AB - Sterol balance measurements of whole body cholesterol synthesis were performed in guinea pigs to determine the relative quantitative importance of dietary cholesterol intake, endogenous cholesterol synthesis, fecal steroid excretion and net tissue accumulation in cholesterol homeostasis of a rapidly growing animal. Sterol inputs were from diet (33%) and endogenous synthesis (67%); sterol outputs, as fecal neutral and acidic steroids, accounted for 60% of the total input, the remainder being used for the demands of tissue growth. The data demonstrate that the measurement of total body cholesterol synthesis can be grossly underestimated in this rapidly growing animal if net tissue accumulation of cholesterol is not considered in the balance measurement. PMID- 6487646 TI - Lipoprotein lipase-mediated sequestration of long-chain polyunsaturated triacylglycerols in serum LDL from normal and hypothyroid rats. AB - Rat serum VLDL, unlike human, contains significant proportions of triacylglycerols with polyunsaturated C20 and C22 fatty acids. Hypothyroidism in this species is characterized by low levels of serum VLDL, the accumulation of LDL, elevated levels of lipoprotein lipase and depressed hepatic lipase activity. The hypothyroid rat thus represents an interesting model in which to study hepatic VLDL metabolism and the substrate specificity of lipoprotein lipase. This report shows that serum IDL and LDL in both euthyroid and hypothyroid rats contain progressively enhanced proportions of triacylglycerols with polyunsaturated C20 and C22 fatty acids when compared to VLDL. Hypothyroidism resulted in a decrease in the proportion of 22:6 fatty acid within the serum VLDL triacylglycerols when compared to euthyroid VLDL. Lipolysis of VLDL from euthyroid rats in vitro using the perfused rat heart system resulted in increases or sequestration of triacylglycerols containing long-chain polyunsaturated fatty acids within the IDL fraction similar to those seen in vivo. It is concluded that lipoprotein lipase-mediated hydrolysis of VLDL triacylglycerols and the conversion of VLDL to IDL and LDL in the rat results in a progressive sequestration of the longer-chain polyunsaturated triacylglycerol molecular species with the IDL and LDL. PMID- 6487647 TI - Uptake of rat plasma HDL subfractions labeled with [3H]cholesteryl linoleyl ether or with 125I by cultured rat hepatocytes and adrenal cells. AB - Rat plasma low- and high-density lipoproteins were labeled with [3H]cholesteryl linoleyl ether and isolated by rate-zonal ultracentrifugation into apolipoprotein B-containing LDL, apolipoprotein E-containing HDL1 and apolipoprotein E-poor HDL2. These fractions were incubated with cultured rat hepatocytes and comparable amounts of all lipoproteins were taken up by the cells. Rat HDL was isolated at d 1.085-1.21 g/ml and apolipoprotein E-free HDL was prepared by heparin Sepharose chromatography. The original HDL and the apolipoprotein E-free HDL were labeled with 125I or with [3H]cholesteryl linoleyl ether and incubated with rat hepatocytes or adrenal cells in culture. The uptake of apolipoprotein E-free [3H]cholesterol linoleyl ether HDL by the cultured hepatocytes was 20-40% more than that of the original HDL. Comparison of uptake of cholesteryl ester moiety (represented by uptake of [3H]cholesteryl linoleyl ether) and of protein moiety (represented by metabolism of 125I-labeled protein) was carried out using both original and apolipoprotein E-free HDL. In experiments in which low concentrations of HDL were used, the ratio of 3H/125I exceeded 1.0. In cultured adrenal cells, the uptake of [3H]cholesteryl linoleyl ether-labeled HDL was stimulated 3-6-fold by 1 X 10(-7) M ACTH, while the uptake of 125I-labeled HDL increased about 2-fold. The ratio of 3H/125I representing cellular uptake was 2-3 and increased to 5 in ACTH-treated cells. The present results indicate that in cultured rat hepatocytes the uptake of homologous HDL does not depend on the presence of apolipoprotein E. Evidence was also presented for an uptake of cholesteryl ester independent of protein uptake in cultured rat adrenal cells and to a lesser extent in rat hepatocytes. PMID- 6487648 TI - The significance of the attachment of rat kidney glutaminase to the inner mitochondrial membrane. AB - The inner mitochondrial membrane of rat kidney mitochondria was altered by 0.03% Triton X-100 treatment in such a way as to render it permeable to NAD and CoA molecules without release of phosphate-dependent glutaminase. A break of linearity in the Arrhenius plot of the enzyme activity was characteristic for a conformational change of a membrane-bound enzyme. The activity of phosphate dependent glutaminase immobilized in the inner mitochondrial membrane, as studied in 0.03% Triton X-100-treated mitochondria, and solubilized, as in the supernatant of sonicated mitochondria, was hyperbolic with respect to glutamine concentration. Under optimal conditions (pH 8.6 and 100 mM phosphate) the Vmax and Km were 216 +/- 12 nmol/mg per min and 2.7 +/- 0.4 mM, respectively, for Triton X-100-treated mitochondria, and 121 +/- 8 nmol/mg per min and 15.9 +/- 1.8 mM for sonicated mitochondria. Under near physiological conditions (pH 7.8 and 20 mM phosphate), distinct differences in phosphate-dependent glutaminase kinetics were observed. The Vmax as 29.8 +/- 0.4 and 2.6 /- 0.3 nmol/mg per min and the apparent Km 1.55 +/- 0.06 and 24.5 +/- 6.6 mM for Triton X-100 and sonicated mitochondria, respectively. The sigmoidal activation by phosphate at pH 7.8 was significantly shifted to the left in Triton X-100-treated as compared to sonicated mitochondria. As opposed to the data obtained in sonicated mitochondria, the kinetics of phosphate-dependent glutaminase in 0.03% Triton X 100-treated mitochondria agreed quite well with those obtained in intact, rotenone-inhibited and metabolically active mitochondria. These results suggest that an attachment of phosphate-dependent glutaminase to the inner membrane of kidney mitochondria has a profound effect on its kinetics, particularly under near physiological conditions. PMID- 6487649 TI - Fatty acid incorporation increases the affinity of muscarinic cholinergic receptors for agonists. AB - Incorporation of unsaturated fatty acids into membrane fragments from rat brain cortex and medulla pons selectively increased the affinity of the muscarinic agonist, carbamylcholine. The affinity and number of binding sites for the labeled antagonist, N-[3H]methyl-4-piperidyl benzilate was unchanged. The effect on agonist binding was most prominent in the cortex, in which carbamylcholine IC50 values were decreased up to 5-fold. Selectivity of the effect was observed with fatty acids of chain length 18-20 carbons, unsaturation in position 11-12, and a cis conformation of the double bond being most effective. The effects of fatty acids on agonist binding were due primarily to alterations in the affinity constants for the binding reaction, with minor increases in the proportion of high-affinity sites. Transition metals selectively increased the percentage of high-affinity sites in the cortex, but in cis-vaccenic-acid-treated membranes more than additive effects of the metal were observed; both were reversed by GTP. GTP also reversed binding parameters in cis-vaccenic-acid-treated medulla membranes to control level. We conclude that the primary effect of the active fatty acids is to alter the thermodynamic properties of muscarinic agonist binding without markedly inducing interconversion. PMID- 6487650 TI - One- and two-electron reduction of hydroxy-1,4-naphthoquinones and hydroxy-9,10 anthraquinones. The role of internal hydrogen bonding and its bearing on the redox chemistry of the anthracycline antitumour quinones. AB - First and second half-wave reduction potentials of 11 1,4-naphthoquinones and 42 9,10-anthraquinones have been measured for solutions in dimethylformamide. The presence of hydroxy groups at the 5- and 8-positions of the 1,4-naphthoquinone nucleus, and at the 1-, 4-, 5- and 8-positions of the 9,10-anthraquinone (the alpha-positions) markedly raises both reduction potentials. Measurements on the corresponding methoxy- and acetoxyquinones indicate that internal hydrogen bonding in the alpha-hydroxyquinones makes a major contribution to stabilisation of the semiquinone, probably as a result of increased delocalisation due to exchange of the hydroxy hydrogen between the two neighbouring oxygen atoms. The bearing of this phenomenon on the mechanism of action of anthracycline antitumour quinones is discussed, and the stabilising effect on the semiquinone of hydroxy groups at the 1- and 5-positions of the 9,10-anthraquinone nucleus is highlighted. PMID- 6487651 TI - Ligandin concentrations in the steroidogenic tissues of the rat during development. AB - Ligandin, a ubiquitous multifunctional cytoplasmic protein which exhibits glutathione S-transferase, glutathione peroxidase and delta 5-3-ketosteroid isomerase activities and binds to cortisol metabolites, is present in relatively high concentrations in gonadal and adrenal tissue. In contrast to hepatic ligandin, little is known about the ontogeny of ligandin in steroid-synthesising tissues. We report here the intracellular concentrations of ligandin as well as the serum concentrations of testosterone and progesterone measured by radioimmunoassay at different stages of development in the rat. Ligandin levels in testis, ovary and adrenal tissue were relatively high soon after birth, decreased by day 9 and increased rapidly during puberty to reach adult levels. These changes appeared to be paralleled by changes in the circulating levels of testosterone and progesterone. In contrast, ligandin levels in non steroidogenically active tissues, such as liver and kidney, were low at birth and rose progressively to reach adult levels. Whereas hepatic ligandin concentration could be increased at all stages of development by phenobarbital induction, no induction occurred in the endocrine tissues. PMID- 6487653 TI - Regulation of protein phosphorylation by polyamines in hepatocytes. AB - The effects of natural aliphatic polyamines on basal and hormone-stimulated protein phosphorylations in hepatocytes were studied. Cells isolated from adult rats were incubated in suspension with [32P]orthophosphate, in the absence or presence of polyamines at varying concentrations and for different times; hepatocytes were then exposed to various hormones for 10 min. Phosphoproteins contained in total cell lysates were analyzed by one- and two-dimensional gel electrophoresis and autoradiography. Spermine, the most effective amine, decreased the basal level of phosphorylation of proteins with 46, 34 and 22 kDa, and increased that of a 18 kDa protein. These effects, maximal with an external concentration of 7.5-10 mM, were detectable after a lag period of about 10 min and reached a plateau after 45 min. Pretreatment of cells with the polyamine almost completely prevented stimulation of the phosphorylation of the 46 and 34 kDa proteins by insulin; in contrast, the effects of phenylephrine on the same proteins were only partly inhibited, whereas those of glucagon appeared largely unaffected. The major polyamine effect observed in intact cells (i.e., decreased phosphorylation) could be reproduced in a cell-free system where no kinase activity persisted. Indeed, spermine added directly to cell extracts strongly accelerated dephosphorylation of the 46 kDa protein and also of the 61 kDa protein identified as pyruvate kinase; furthermore, restoration of the activity of this enzyme occurred concomitantly with dephosphorylation of the 61 kDa protein in the presence of spermine. PMID- 6487652 TI - Effect of acetate and octanoate on tricarboxylic acid cycle metabolite disposal during propionate oxidation in the perfused rat heart. AB - Tricarboxylic acid cycle pool size is determined by anaplerosis and metabolite disposal. The regulation of the latter during propionate metabolism was studied in isolated perfused rat hearts in the light of the characteristics of NADP linked malic enzyme, which is inhibited by acetyl-CoA. The acetyl-CoA concentration was varied by infusions of acetate and octanoate, and the rate of metabolite disposal was calculated from a metabolic balance sheet compiled from the relevant metabolic fluxes. Propionate addition increased the tricarboxylic acid cycle pool size 4-fold and co-infusion of acetate or octanoate did not change it further. Propionate caused a decrease in the CoA-SH concentration and a 10-fold increase in the propionyl-CoA concentration. A paradoxical increase in the CoA-SH concentration was observed upon co-infusion of acetate in the presence of propionate, an effect probably caused by competitive inhibition of propionate activation. A more pronounced decline in the propionyl-CoA concentration was observed upon the co-infusion of octanoate. In a metabolic steady state, acetate and octanoate reduced propionate disposal only slightly, but did not increase the tricarboxylic acid cycle pool size. The results are in accord with the notion that the tricarboxylic acid pool size is mainly regulated by the anaplerotic mechanisms. PMID- 6487654 TI - Oxidation of lactaldehyde by cytosolic aldehyde dehydrogenase and inhibition of cytosolic and mitochondrial aldehyde dehydrogenase by metabolites. AB - An enzyme fraction which oxidizes lactaldehyde to lactic acid has been purified from goat liver. This enzyme was found to be identical with the cytosolic aldehyde dehydrogenase. Lactaldehyde was found to be primarily oxidized by this enzyme. Almost 90% of the total lactaldehyde-oxidizing activity is located in the cytosol. Methylglyoxal and glyceraldehyde 3-phosphate were found to be strong competitive inhibitors of this enzyme. Aldehyde dehydrogenase from goat liver mitochondria has also been partially purified and found to be strongly inhibited by these metabolites. The inhibitory effects of these metabolites on both these enzymes are highly pH dependent. The inhibitory effects of both the metabolites have been found to be stronger for the cytosolic enzyme at pH values higher than the physiological pH. For the mitochondrial enzyme, the inhibition with methylglyoxal was more pronounced at higher pH values, whereas stronger inhibition was observed with glyceraldehyde 3-phosphate at physiological pH. PMID- 6487655 TI - The combination of normal-phase and reverse-phase high-pressure liquid chromatography with NMR for the isolation and characterization of oligosaccharide alditols from ovarian cyst mucins. AB - Normal-phase high-pressure liquid chromatography (HPLC) on amino-bonded silica with elution by aqueous acetonitrile is shown to be an especially suitable complement to reverse-phase HPLC on octadecyl silica for the fractionation of oligosaccharide alditols produced by alkaline borohydride degradation of mucin glycoproteins. The former technique separates well on the basis of molecular size, while the latter method shows selectivity for stereoisomers. Stereoisomeric pairs of tetra-, penta- and hexasaccharide alditols show relative retention times ranging from 3 to 12, resulting in excellent preparative separations in reverse phase chromatography. From a single ovarian cyst glycoprotein, H and Lewis b active, 13 oligosaccharides, representing essentially the entire carbohydrate content, have been isolated. The structures of 12 of the oligosaccharides have been determined by 1H-NMR spectroscopy. For those oligosaccharides which have been isolated from other sources and whose NMR spectra have been previously reported, unambiguous structural identification follows directly. Structures of oligosaccharides differing by only one or two residues from those whose NMR spectra are known may be deduced by a simple algorithm utilizing chemical shift analogies. PMID- 6487656 TI - Evidence that the cytosolic activity of 3-hydroxybutyrate dehydrogenase in chicken liver is L-3-hydroxyacid dehydrogenase. AB - Classical fractionation studies showed that chicken liver contains two enzymes which can oxidize DL-3-hydroxybutyrate. The cytosolic enzyme is specific for the L-(+) isomer and accounts for 60% of the total activity. The mitochondrial activity is specific for the D-(-) isomer and accounts for 40% of the total activity. Kinetic studies showed that L-gulonic acid is a competitive inhibitor of the enzyme. We conclude that the cytosolic enzyme is the previously described L-3-hydroxyacid dehydrogenase. PMID- 6487657 TI - Polyphosphate-mediated protection from cellular intoxication with Clostridium difficile toxin B. AB - The influence of polyphosphorylated compounds on intoxication of human lung fibroblasts with Clostridium difficile toxin B was studied. ATP, as well as other nucleoside di-, tri-, and tetraphosphates, inorganic polyphosphates and polyphosphorylated sugars, caused a dose-dependent (1-5 mM range) delay in the appearance of the cytopathogenic effect. With a longer phosphate chain, the delay was more pronounced, although the cytopathogenic effect always developed finally, reaching the level of the control within 20 h. Toxin preparations contained one fraction of molecules able to bind ATP, besides one non-binding fraction. The protective effect of ATP did not depend on its energy producing ability. Neither was the protective effect due to an inactivation of the toxin per se, or to an interference with binding of the toxin to the cells. ATP was protective even upon addition 10 min after the toxin binding step. In the presence of ATP, the toxin remained accessible to neutralization with antitoxin. In analogy with the P-site on diphtheria toxin, we postulate that C. difficile toxin B contains a polyphosphate-binding site. This site is separate from the receptor-binding site, but involved in the interaction of toxin B with the cell surface shortly after the binding step. PMID- 6487658 TI - Compartmentation of ATP within renal proximal tubular cells. AB - Studies on the relations between active solute transport and cell metabolism require not only knowledge of the total cellular ATP, but also of the separate mitochondrial and cytosolic ATP levels. For this purpose, mitochondrial and cytosolic fractions were separated from isolated proximal tubular suspensions by the digitonin technique and the amount of ATP analyzed separately for each compartment. In a parallel series of experiments, the absolute volumes of mitochondrial and extramitochondrial spaces were determined in rat renal cortical tubular suspension utilizing electron microscopic morphometry. When referring ATP measurements to the morphometrically determined absolute volumes, the ATP concentrations were calculated to be 4.33 mmol/l for the cytosolic and 2.62 mmol/l for the mitochondrial space. The cytosolic and mitochondrial ATP, thus, represent 70 and 30% of the total cellular ATP, respectively. PMID- 6487659 TI - The relationship between glucose concentration and rate of lactate production by human erythrocytes in an open perfusion system. AB - A thermodynamically open system, based on an assembly of capillaries with semi permeable walls was constructed in order to study glycolysis in human erythrocytes in high haematocrit suspensions. A phenomenological expression for the rate of lactate production as a function of glucose concentration was obtained. The rate was measured under steady-state conditions with low substrate concentrations (approx. 50 mumol/l). In a corresponding closed system, this concentration of glucose would be exhausted within a few minutes. A mathematical model of the whole system consisted of five differential equations, and involved parameters relating to flow rates, volumes of reaction chambers, the rates of lactate efflux from erythrocytes and the expression for the rate of lactate production by red cells. The binding of [14C]pyruvate to haemoglobin and the rate of efflux of [14C]lactate from red cells were measured to yield additional information for the model. The concentrations of ATP and 2,3-bisphosphoglycerate were measured during the perfusion experiments, and a detailed analysis of a model of red cell hexokinase was carried out; the former two compounds inhibit hexokinase and alter the apparent Km and Vmax for glucose in vivo. These steady state parameters were similar to the glucose concentration at the half-maximal rate of lactate production and the maximal rate, respectively. These findings are consistent with the known high control-strength for hexokinase in glycolysis in human red cells. The practical and theoretical validation of this perfusion system indicates that it will be valuable for NMR-based studies of red cell metabolism using a flow-cell in the spectrometer. PMID- 6487660 TI - Heme inhibits transferrin endocytosis in immature erythroid cells. AB - The inhibitory effect of heme on iron uptake from transferrin by rat and rabbit reticulocytes and erythroid cells from the fetal rat liver was studied in vitro. Addition of hemin was shown to cause a decrease in the rate of transferrin endocytosis, the degree of inhibition being proportional to the reduction in iron uptake. The heme synthesis inhibitors, isoniazid and succinylacetone, stimulated the rate of transferrin endocytosis by 15-30% and caused a proportional increase in the rate of iron uptake, possibly by reducing the intracellular free heme concentration. It is concluded from these results that heme affects iron uptake by influencing the rate of transferrin endocytosis and recycling. PMID- 6487661 TI - Lectin-like molecules on the murine macrophage cell surface. AB - Lectin-like molecules on the surface of murine peritoneal exudate macrophages induced by thioglycolate or an anti-tumor streptococcal preparation, OK-432, were investigated and isolated. Furthermore, their sugar-binding specificities and their role in macrophage-mediated tumor cytotoxicity were examined. A neoglycoprotein, D-galactose (Gal)-bovine serum albumin, bound to these murine peritoneal macrophages. This binding of Gal-bovine serum albumin was inhibited by D-galactose, and by complex-type oligosaccharides (unit B) and high mannose-type oligosaccharides (unit A) prepared from porcine thyroglobulin. When thioglycolate elicited macrophages were activated by lipopolysaccharide and/or the culture supernatant of concanavalin A-activated mouse spleen cells, they became tumoricidal and the number of the lectin-like molecules on the macrophage surface was found to increase. Since the binding and cytotoxic activities of these tumoricidal macrophages toward tumor cells were partially inhibited by D galactose, the D-galactose-binding lectin-like molecules on the surface of tumoricidal macrophages might play an important role in macrophage-mediated cytotoxicity. These lectin-like molecules were then isolated from solubilized murine peritoneal exudate cells labeled with pyridoxal 5'-phosphate and sodium [3H]borohydride by affinity chromatography on columns of asialo unit B oligosaccharide-Sepharose 4B and/or beta-D-galactose-Bio-Gel P-100. The proteins bound to the asialo unit B oligosaccharide-Sepharose 4B column and eluted specifically were found to have approximate molecular weights of 79 000 and 18 000, and the protein bound to and eluted from the beta-D-galactose-Bio-Gel P-100 column had an approximate molecular weight of 77 000. These isolated proteins bound to the surface of glutaraldehyde-fixed tumor cells, and their binding was inhibited by D-galactose and also by D-mannose. Since most of the 77 kDa protein bound to the asialo unit B oligosaccharide-Sepharose 4B, this protein was assumed to be identical with the 79 kDa protein. These results suggest that the lectin like molecules on murine macrophages have wide specificity and that one lectin like molecule can bind both D-galactose and D-mannose. PMID- 6487662 TI - Regulation of human leukocyte microsomal hydroxymethylglutaryl-CoA reductase activity by a phosphorylation and dephosphorylation mechanism. AB - The activity of microsomal 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34), obtained from cultured human IM-9 lymphoid cells or freshly isolated human peripheral blood leukocytes, is modulated by a phosphorylation/dephosphorylation mechanism. Addition of MgATP + ADP to IM-9 cell microsomal reductase leads to a time-dependent loss of enzyme activity. Inactivated reductase is reactivated by rat liver reductase phosphatase. Kinase dependent IM-9 cell microsomal reductase, prepared by heating IM-9 microsomes for 15 min at 50 degrees C, is inactivated in the presence of MgATP and ADP only after addition of cytosolic reductase kinase from either IM-9 cells, freshly isolated leukocytes or rat liver. Inactivation is time-dependent and dependent on the cytosolic protein concentration. Inactivated reductase is reactivated by rat liver reductase phosphatase. For cultured IM-9 cells and freshly isolated leukocytes incubated with culture medium for 2 h, the ratios of active (unphosphorylated) to total (phosphorylated + unphosphorylated) reductase activity are 0.22 and 0.43, respectively. Thus, in addition to its regulation by changes in the amount of total enzyme protein, human leukocyte reductase activity is also modulated by a phosphorylation/dephosphorylation mechanism. PMID- 6487663 TI - Immunological evidence for phenobarbital-stimulated synthesis of cytochrome P-450 in primary cultures of chick embryo hepatocytes. AB - The induction of cytochrome P-450 by phenobarbital was studied in primary cultures of chick embryo hepatocytes. The rate of the de novo synthesis of the induced form of cytochrome P-450 was measured directly and specifically, using form-specific anti-cytochrome antibodies that quantitatively immunoprecipitated this form from the radiolabeled hepatocytes. Additionally, the steady-state levels of the cytochrome were estimated spectrophotometrically and electrophoretically. In the presence of phenobarbital the synthesis of cytochrome P-450PB by cultured hepatocytes was markedly accelerated. Furthermore, the same cytochrome P-450PB form was induced by phenobarbital in vivo in chicken liver and in the cultured chick embryo hepatocytes. Their identity was judged from immunological and electrophoretic properties of these induced cytochromes. Immunological cross-reactivity was also detected between the cytochrome P-450PB forms from chick embryo hepatocytes and from adult rat liver. The immunological cross-reactivity observed between the phenobarbital-induced cytochrome P-450 forms from different species was not observed between the different cytochrome forms with the same liver (Thomas, P.E., Reik, L.M., Ryan, D.E. and Levin, W. (1981) J. Biol. Chem. 256, 1044-1052). Implications as to the evolutionary origin of the different cytochrome forms are discussed. PMID- 6487664 TI - Fibronectin-induced protein carboxy-O-methylation in aortic endothelial cells. AB - In a previous report (Bowersox, J.C. and Sorgente, N. (1982) Cancer Res. 42, 2547 2551) we demonstrated that the glycoprotein fibronectin is a chemoattractant for vascular endothelial cells. In probing the mechanisms by which fibronectin induces endothelial cell chemotaxis, we have discovered that the carboxy-O methylation of cellular proteins is stimulated by fibronectin. By measuring the incorporation of L-[methyl-3H]methionine into alkali-labile, [3H]methyl ester linkages, we determined that fibronectin stimulated protein carboxy-O-methylation in aortic endothelial cells in a time- and concentration-dependent manner; the greatest stimulation occurred at 100 micrograms/ml fibronectin (approx. 35% above controls). When inhibitors of carboxymethylation were added, fibronectin-induced stimulation of protein methylation did not occur. Furthermore, inhibitors of methylation prevented the chemotaxis of endothelial cells in response to fibronectin. These data support our hypothesis that fibronectin mediates endothelial cell chemotaxis, such as that occurring during neovascularization. As carboxy-O-methylation of cell proteins is also effected by fibronectin, transmethylation reactions may be an important component of endothelial cell chemotaxis. PMID- 6487665 TI - [Electric conductivity changes in salt-free solutions in connection with the formation of polyriboadenylic and polyribouridylic acid complexes]. AB - Conductometric and spectrophotometric investigations of concentrated salt-free solutions of poly(A) -- poly(U) demonstrated the 1:1 complex formation. It was accomplished by the increase of solution conductivity in contrast to the situation when DNA redenaturation takes place. PMID- 6487666 TI - [Effect of dehydration on interdomain interactions in immunoglobulin G and its fragments]. AB - Influence of urea on the structure of human IgG and isolated Fab and Fc-fragments was investigated by temperature-perturbation difference spectroscopy and circular dichroism. It was shown that 2M urea caused non-denaturational changes of IgG quaternary structure, localized in Fab-fragments. The same changes occur in solutions with ethylene glycol and glycerine as well. Apparently the main cause of these changes is dehydration. It is possible that the investigated effects model the conformational changes which appear in immunoglobulins after antigen binding. PMID- 6487668 TI - [Nonmonotonous character of temperature changes in protein conformation in predenaturational regions of temperatures]. AB - Temperature changes of protein infrared spectra have a nonmonotonous pattern. On the curves of temperature relationships of spectral characteristics the regions of high frequency displacement have been observed, interrupted by sharp low frequency shifts, partly or entirely compensating the displacement of the bands in the preceding temperature interval. It has been shown that at temperatures corresponding to the high frequency displacement heat weakening of the strength of hydrogen bonds takes place. At the low frequency shifts the whole system of the hydrogen bonds has an opposite change of the state maintaining high stability level of protein macromolecules in the broad temperature range. PMID- 6487667 TI - [Calorimetric study of G-actin denaturation]. AB - The investigation of G-actin heat denaturation at various pH of the solution by scanning microcalorimetry has shown that unfolding of G-actin is not a two-state process. Since the protein structure does not behave as a single cooperative unit during heat denaturation, it is suggested that the G-actin globule consists, at least, of two interacting domains. PMID- 6487669 TI - [Effect of ionic strength of the medium on the structure and aggregation of histone H1 from the calf thymus]. AB - In the region of 50 mM NaCl histone HI has the structure with a great number of binding sites with fluorescent probe 1.8-ANS as compared to the structure formed in solution of 0.6-1.0 M NaCl. These sites, however, have a lower constant of binding with the probe and are characterized by a higher surrounding polarity. At local significant increase of the ionic strength histone HI molecules form stable oligomers having hydrophobic cavities. A conclusion is made about the importance of cationic envelope formed by N- and C-ends around the globular "head", for manifesting effective interactions between several molecules of histone HI. PMID- 6487670 TI - [Relation of K+-dependent cellular swelling to the state of cellular membranes]. AB - It has been shown that after heating of ACE cells for 15 min at temperature 46 degrees C inhibition of K+-dependent swelling and a sharp decrease of cell resistance and capacity are observed. Changes of the parameters studied were of a threshold pattern, the threshold temperature proved to be uniform and equaled 46 degrees C. It is believed that the temperature relationships obtained point to an important role of barrier functions of cellular membranes in K+-dependent cell swelling. PMID- 6487671 TI - Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting. AB - Six children were provided with long-term biofeedback and academic treatment for attention deficit disorders. Their symptoms were primarily specific learning disabilities, and, in some cases, there were varying degrees of hyperkinesis. The training consisted of two sessions per week for 10 to 27 months, with a gradual phase-out. Feedback was provided for either increasing 12- to 15-Hz SMR or 16- to 20-Hz beta activity. Inhibit circuits were employed for blocking the SMR or beta when either gross movement, excessive EMG, or theta (4-8 Hz) activity was present. Treatment also consisted of combining the biofeedback with academic training, including reading, arithmetic, and spatial tasks to improve their attention. All children increased SMR or beta and decreased slow EEG and EMG activity. Changes could be seen in their power spectra after training in terms of increased beta and decreased slow activity. All six children demonstrated considerable improvement in their schoolwork in terms of grades or achievement test scores. None of the children are currently on any medications for hyperkinetic behavior. The results indicate that EEG biofeedback training, if applied comprehensively, can be highly effective in helping to remediate children who are experiencing attention deficit disorders. PMID- 6487672 TI - Effects of noncontingent feedback on EMG training, EMG responses, and subjective experience. AB - Various types of noncontingent feedback have been used as control procedures in EMG training; however, their effects on such training have received little attention. Experiment 1 in the present study examined the effects of noncontingent feedback on EMG training, and Experiment 2 assessed the effects of feedback characteristics on EMG responses. In Experiment 1, three noncontingent feedback groups (yoked control, randomly fluctuating tones, and decreasing tones) and one contingent group underwent 20 minutes of training for frontal EMG decreases. Procedures in Experiment 2 were identical to those in Experiment 1 except that subjects were instructed merely to listen to the feedback tones. Results of Experiment 1 indicated that contingent and noncontingent fluctuating feedback groups achieved significantly lower EMG levels than noncontingent decreasing and yoked control groups. In Experiment 2, however, no differences in EMG activity were found among groups. In both experiments, groups did not differ in terms of subjective variables such as frustration, suspiciousness about the tone, or length of time attending to the tone. Results of these two experiments suggest that differences in EMG responses to various types of noncontingent feedback result from interactions between characteristics of the feedback stimulus and instructions to decrease the stimulus. PMID- 6487673 TI - Clinical and electromyographic effects of biofeedback training in mandibular dysfunction. AB - Twenty patients with mandibular dysfunction, 10 acute and 10 chronic, were trained with electromyographic biofeedback from either m. masseter or m. frontalis area. The electromyographic activity in both muscle areas were recorded during six training sessions. The mean electromyographic activity decreased significantly within the sessions for both muscle areas, progressively more often for the m. masseter area. The activity did not decrease significantly between sessions for any muscle area. The clinical and subjective symptoms of mandibular dysfunction improved significantly after the training. No differences, electromyographically or clinically, among acute, chronic, m. masseter area, or m. frontalis area feedback patients could be observed. No correlation between decrease in electromyographic activity and symptoms could be established. Since a simplistic neuromuscular learning model for biofeedback training gains little support from these results, alternative views are discussed. PMID- 6487674 TI - Blood glucose discrimination training with insulin-dependent diabetics: a clinical note. AB - Two insulin-dependent diabetic adults were exposed to a blood glucose discrimination training program. Following baseline, during which subjects estimated their blood glucose levels twice daily, subjects received immediate feedback regarding the accuracy of their estimates. The procedure resulted in a large increase in accuracy of blood glucose level estimation. The implications of the findings were discussed. PMID- 6487675 TI - Heart rate biofeedback and cold pressor pain: effects of expectancy. AB - The study investigated the effects of expectancy on the reduction of cold pressor test pain using heart rate biofeedback training. Thirty-six male subjects were given an initial 45-sec cold pressor test, 25 heart rate decrease feedback training trials, and a final cold pressor test in which they were told to decrease their heart rate, but without the aid of feedback. Two levels of outcome expectancy (increase pain, decrease pain) and two levels of cold pressor water temperature (0 degrees C, 5 degrees C), resulting in four groups (N = 9 per group), were used to assess the interaction between expectancy and aversive stimulus intensity. Immediately prior to the final cold pressor test, the increase pain expectancy subjects were told that decreasing their heart rate during the ice water immersion would cause more pain. Decrease pain subjects were told that decreasing their heart rate would cause less pain. Expectancy was found to be the major determinant of pain reports. The decrease pain subjects consistently reported less pain on the final cold pressor, whereas the increase pain subjects consistently reported more pain. Contrary to prediction, expectancy effects were greater for the colder water. The findings indicate the importance of expectancy in the clinical use of biofeedback to control pain. PMID- 6487676 TI - Superposition of impulse activity in a rapidly-adapting afferent unit model. AB - Mechanosensory afferent units consist of a parent axon, the peripheral axonal arborization, and the branch terminal mechanoreceptors. The present work uses a mathematical model to describe the contribution of a given number of rapidly adapting mechanoreceptors to the impulse pattern of their parent axon. In the model, impulses initiated by any driven mechanoreceptor instantaneously propagate orthodromically and antidromically. The model also incorporates the axonal absolute refractory period as well as ortho- and antidromically elicited recovery cycles. In separate computations, periodic or random (Poisson process) trains of short-duration stimuli at constant amplitude are delivered to a given number (N = 2-30) of co-innervated mechanoreceptors. The superposition of component impulse trains always departs from the theoretical ideal (Poisson process). Such departures are attributable to: (i) the number of driven mechanoreceptors, when N is small, (ii) axonal absolute refractory period, during maximal amplitude stimulation, and (iii) antidromic recovery cycles as well as absolute refractoriness, during submaximal-amplitude stimulation. Computations reveal that this "instantaneous reset" model results in the elimination of information extracted by driven mechanoreceptors. Model predictions with Poisson stimulation at varied amplitudes are compared to G-hair afferent unit responses to analogous stimulation. Qualitatively opposite results with respect to parent axonal impulse patterns imply that the axonal arborization is not simply a substrate for impulse propagation from branch terminals to parent axon. PMID- 6487677 TI - Intermodulation components of the visual evoked potential: responses to lateral and superimposed stimuli. AB - Nonlinear interactions in the human visual system were studied using visual evoked potentials (VEPs). In one experiment (superimposed condition), all segments of a dartboard pattern were contrast reversed in time by a sum of two sinusoidal signals. In a second experiment (lateral condition), segments in some regions of the dartboard pattern were contrast reversed by a single sinusoid of one frequency, while segments in other (contiguous) regions of the pattern were contrast reversed by a single sinusoid of another frequency. An identical set of ten frequency pairs was used in each experiment. The frequency pairs were chosen such that the difference between frequencies in each pair was 2Hz. Amplitudes and phases of the sum and difference frequency components of the VEP (intermodulation terms) were retrieved by Fourier analysis and served as measures of nonlinear interactions. The use of input pairs with a fixed separation in frequency enabled the estimation of the temporal characteristics of the visual pathways prior to a second linear stage. The use of superimposed and lateral conditions revealed antagonistic contributions to the VEP, possibly reflecting direct-through excitatory and lateral inhibitory pathways, respectively. PMID- 6487678 TI - Syntheses of spinal cord field potentials in the terrapin. AB - A compartmental model of a terrapin motoneuron has been set up to compute membrane potential variations associated with synaptic input at different locations or with antidromic invasion. Membrane potential distributions obtained in that way were used to compute field potentials by means of a volume conduction formalism. The model was used to simulate field potentials measured in the spinal cord in response to stimulation of a muscle nerve with the intention to discriminate between different activation hypothesis for the generation of the spinal cord potential. Extracellular potentials calculated with an excitatory input distributed over the whole dorsal dendritic tree were found to give better reconstruction when compared with excitation restricted to the distal part of the dorsal dendrites, or with somatic inhibition. PMID- 6487679 TI - A synaptic modification algorithm in consideration of the generation of rhythmic oscillation in a ring neural network. AB - In consideration of the generation of bursts of nerve impulses (that is, rhythmic oscillation in impulse density) in the ring neural network, a synaptic modification algorithm is newly proposed. Rhythmic oscillation generally occurs in the regular ring network with feedback inhibition and in fact such signals can be observed in the real nervous system. Since, however, various additional connections can cause a disturbance which easily extinguishes the rhythmic oscillation in the network, some function for maintaining the rhythmic oscillation is to be expected to exist in the synapses if such signals play an important part in the nervous system. Our preliminary investigation into the rhythmic oscillation in the regular ring network has led to the selection of the parameters, that is, the average membrane potential (AMP) and the average impulse density (AID) in the synaptic modification algorithm, where the decrease of synaptic strength is supposed to be essential. This synaptic modification algorithm using AMP and AID enables both the rhythmic oscillation and the nonoscillatory state to be dealt with in the algorithm without distinction. Simulation demonstrates cases in which the algorithm catches and holds the rhythmic oscillation in the disturbed ring network where the rhythmic oscillation was previously extinguished. PMID- 6487680 TI - A computational aspect of kinetic depth effect. AB - A method is proposed to determine the rigid structure as well as the three dimensional motion of an object from a sequence of orthographically projected images. It is assumed that the velocities as well as the positions of the points attached to the object are observable in the images. The "instantaneous rigidity condition" wich states that the relative position vector between any two points is orthogonal to the corresponding relative velocity vector is derived from the condition of rigidity. Assuming further that the rotational velocity component is constant throughout the period of observation, each of the projected relative velocity vectors is shown to move along one of the elliptical trajectories, all of which are similar to one another. The orientations of the longer axes are common to every trajectory. Then one can determine the equations of the ellipses by observing only two points in three views or three points in two views. The solution is obtained from a set of linear equations. The length of the longer axis enables one to determine the relative velocity. The instantaneous rigidity condition is then used to obtain the relative position. The special cases where the rotational axis is either perpendicular to or parallel with the image plane are discussed. The above results are discussed in relation to the relevant psychophysical observations as well as theoretical studies. PMID- 6487681 TI - Properties of central control of body temperature in the rabbit. AB - The structure of the central temperature controller in rabbits has been analysed. On the one hand, experiments were carried out to obtain the necessary data for system analysis; on the other hand, a mathematical model of the passive system was developed which describes the thermal characteristics of the body in accordance with the experimental results. In applying the model, different controller equations for the effector mechanisms involved were tested to fit the experimental data best. They are compared with already existing models of metabolic control. In addition, mechanisms of the effector coordination are discussed. It is shown that the three effectors make use of a similar controller structure that feeds core temperature as well as skin temperature back into the controller. The system is insensitive to variations of the controller gains, whereas a slight change in the controller reference temperature causes significant changes of the controlled core temperature. Furthermore it is shown that any mutual effector blockings are dispensible. PMID- 6487682 TI - [Compact micromanipulator for the chronic extracellular recording of neuronal activity in restrained and freely moving animals]. AB - A design of a compact micromanipulator giving possibility to introduce the microelectrode into unlimited depth of the brain and to realize the penetration of it into the narrow area of trepanized cranial of the animal several times has been worked out and described. Small size and mass of the design allow to set up several micromanipulators on the cranial of different experimental animals and to record the neuronal activity of the different brain structures simultaneously. PMID- 6487683 TI - [Spectrophotometric method of assessing molecular DNA-DNA hybridization applicable to bacteria of the genus Pseudomonas]. AB - A variant of unisotopic optical DNA-DNA molecular hybridization method basing on the study of reassociation rate of DNA renaturation fragments is described. The choice of working part of the renaturation curve has been standardized. Using the species of Pseudomonas genus it has been shown that this method permits to obtain reproductive results. PMID- 6487684 TI - [Effect of Staphylococcus aureus on the formation of hematopoietic colonies in the spleen and on erythropoietic regeneration in mice following irradiation]. AB - Strains Staphylococcus aureus Cowan-1 and Wood-46 after injection of a dose of 1.10(8) cells to mice stimulate the formation of endogenous colonies on the surface of the spleen on the 9th day after radiation of mice with sublethal dose. Both strains staphylococcus activate postradiational regeneration of erythropoiesis in the mice bone marrow and spleen defined according to 59Fe injection. There is no increase in the transitory endocolony formation. PMID- 6487685 TI - [Diabetogenic action of alloxan in short-term termination of the blood supply to the pancreas and spleen]. AB - It has been shown that the development of alloxan diabetes in rats and the appearance of diabetogenic factor in blood is caused by the direct alloxan action on pancreas and spleen--the organs supplying by blood through the spleen artery. The stopping of blood circulation in that artery preserves rat's organism from the development of general toxic effect of alloxan. The inactivation of alloxan as a diabetogenic agent has been shown after its 5-minute at 37 degrees C incubation with blood. It has been established that the half activity of intravenous injected alloxan disappears in rat's organism during 50 s. and does not depend on alloxan sensitivity of animals. PMID- 6487686 TI - [Action of ultraviolet radiation on the sorption properties of liver, kidney and heart tissues]. AB - The data on the ultra-violet (UV) rays effect on the sorptional properties of rats liver, kidneys and heart tissues showing the different functions of internals tissues in the animal's reactions to the UV-radiation are given. PMID- 6487687 TI - Development of suckling controls in the rat: independence from thyroxine. AB - Until 2 weeks of age, rat pups attach to the nipples of their dam with the same avidity regardless of whether they are fed or fasted. During the 3rd postnatal week, some mode of control of suckling appears such that fasted pups attach much more rapidly than fed pups. In this study we have investigated the effects of hyper- and hypothyroidism on the maturation of suckling controls. Surprisingly, the results indicate that this aspect of behavioral development is independent of the thyroxine status of the pup. We conclude that the maturation of suckling controls is not cued by the developmental rise of serum thyroxine that occurs during the 2nd postnatal week. PMID- 6487688 TI - Some aspects of renal energy and lipid metabolism in newborn rats. AB - Some aspects of renal energy and lipid metabolism were studied in the postnatal period of rats. Oxygen consumption, RQ values, stimulation of oxygen consumption by exogenous substrates (8 mM glucose, 8 mM acetate, 1 mM palmitate), and conversion of acetate or palmitate to CO2 were measured in slices of cortex and inner medulla. The results obtained in 5-day-old rats are not essentially different from those observed in adults. On the other hand, the phenomenon of triacylglycerol storage in kidney cortex during starvation (well known in adult animals) is absent in the newborn rat. It can be demonstrated first in 30-day-old rats. At the same age renal arteriovenous concentration differences for total glycerol indicate a significant uptake during starvation and a release in the fed state. PMID- 6487689 TI - Modulation of the blood-brain barrier permeability in neonatal cytotoxic brain edema: laboratory and morphological findings obtained on newborn piglets with experimental pneumothorax. AB - Acute, bilateral pneumothorax (PT) was produced in 14 newborn piglets. The clinical status of the operated and 14 control animals was monitored by measuring the arterial blood gases, acid-base balance and mean arterial blood pressure. Different brain regions were processed for electron microscopy and albumin immunohistochemistry; water and electrolyte contents were also determined at the end stage of experimental intervention. Electron microscopy showed more intense pinocytotic activity in the endothelium of brain capillaries from PT animals evaluated by morphometry. Statistically significant (p less than 0.01) differences were found in the distribution of pinocytotic vesicles in different brain areas of PT animals. The blood-brain barrier seemed to be impermeable to albumin in all brain regions both in the controls and in the PT group. Parallel with the changes observed in pinocytosis, the water and sodium contents were also increased in the PT group in the parietal cortex (water content 85.18 +/- SD 0.81% vs. 84.10 +/- SD 0.52%, p less than 0.01; sodium content in wet brain tissue 70.94 +/- SD 8.44 mmol/kg vs. 65.09 +/- SD 4.43 mmol/kg, p less than 0.05, in dry brain tissue 481.70 +/- 75.70 mmol/kg vs. 410.15 +/- SD 35.45 mmol/kg, p less than 0.05) and in the cerebellum (water content 83.95 +/- SD 1.08% vs. 83.02 +/- SD 0.89%, p less than 0.05; sodium content in wet brain tissue 60.67 +/- SD 3.16 mmol/kg vs. 55.90 +/- 6.26 mmol/kg, p less than 0.01). However, in other brain regions--especially in the water-shed area--there was no correlation between the changes of pinocytosis and water-electrolyte contents of the tissues. It is suggested that the type of edema developing in this severe cardiovascular/hypoxic collapse is cytotoxic of origin and this fact should be more seriously taken into account in the treatment of the disease. PMID- 6487690 TI - Effects of 1,2-dibromo-3-chloropropane on male reproductive function in the rat. AB - The pesticide 1,2-dibromo-3-chloropropane (DBCP) is a known male reproductive toxin. Previous studies employed production-grade DBCP containing allyl chloride and epichlorohydrin, both capable of producing effects similar to DBCP. The purpose of this study was to determine if purified DBCP caused the same effects as DBCP containing allyl chloride. Rats were injected for 6 mo with varying doses of pure or production-grade DBCP. Very few differences were observed in the parameters measured between pure and production-grade DBCP-treated animals at any one dose level. Treatment with 25 mg/kg DBCP, pure or production grade, reduced body weight as well as the weight of the testes, prostate glands and seminal vesicles, and elevated serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This dose of pure DBCP reduced serum testosterone. Treatment with 5 mg/kg of either grade DBCP caused decreases only in body and testis weights. Animals treated with 1 mg/kg did not show any major differences from controls. These results indicate that DBCP, and probably not a contaminant, is responsible for the effects observed on male reproduction. Furthermore, DBCP appears to affect either androgen action or production since multiple androgenic indices are affected by DBCP administration. PMID- 6487691 TI - Source and regulation of 17 alpha-hydroxyprogesterone during baboon pregnancy. AB - The present study determined the source and regulation of 17 alpha hydroxyprogesterone (17-OHP4) during mid-late baboon pregnancy. Serum 17-OHP4 (ng/ml) in 5 untreated baboons increased from low values at mid-late gestation to a mean (+/- SEM) of 0.49 +/- 0.02 during the final 20 days of gestation. Fetectomy of 5 baboons resulted in serum 17-OHP4 concentrations which declined to and remained at baseline. Serum 17-OHP4 concentrations were 5- to 10-fold greater (P less than 0.001) in the uterine, utero-ovarian, and umbilical veins than peripherally. Apparently the fetal adrenal provides precursors for placental 17 OHP4 formation because the fetal adrenal gland develops delta 5-3 beta hydroxysteroid dehydrogenase only late in gestation, and because the fetal adrenal and not the placenta has the capacity for 17-hydroxylation. Thus, at mid late gestation the placenta appears to supply a major, and at term the corpus luteum a minor portion of the total 17-OHP4. Administration of the estrogen antagonist ethamoxytriphetol (MER-25, 15 mg/kg BW) to 4 baboons did not affect 17 OHP4 during mid-late gestation, when the placenta was the only source of 17-OHP4. However, MER-25 resulted in serum 17-OHP4 concentrations (ng/ml) at term which were greater (1.08 +/- 0.10, P less than 0.001) than in untreated baboons (0.49 +/- 0.02). Prior removal of the corpus luteum of pregnancy in 4 animals subsequently given MER-25 prevented this rise in 17-OHP4. This suggests that the marked elevation in 17-OHP4 observed near term after MER-25 administration was of luteal origin and that antiestrogen enhanced 17-OHP4 secretion by the corpus luteum. PMID- 6487692 TI - Sexual deprivation and its influence on testosterone levels and sexual behavior of old and middle-aged rhesus males. AB - After approximately 6 mo without access to a receptive female, eight old (19 to 25 yr) and eight middle-aged (9 to 15 yr) males were given nine daily 10-min tests of sexual behavior with receptive females. Three ovariectomized, estrogen primed females served as partners. Blood samples were taken from the males at 0900 and 2100 h on 2 consecutive days before and after the series of nine behavioral tests. Serum levels of testosterone (T) were measured by means of radioimmunoassay. There were no significant differences between serum T levels after 6 mo of sexual deprivation and after the nine tests of sexual behavior, nor did serum T levels differ between middle-aged and old males. Serum T levels were significantly higher in the 2100-h samples than in the 0900-h samples for both groups. The nocturnal increases in serum T, both absolute amounts and percentages of increase, did not differ between middle-aged and old males. Repeated daily testing had little effect on the major components of male sexual behavior. Middle aged males outperformed old males; middle-aged males had higher rates of contracting the female, mounting and intromitting. They ejaculated earlier and had a greater percentage of tests with ejaculations than did old males. PMID- 6487693 TI - Maintenance of pregnancy and levels of progesterone and relaxin in the serum of gilts following a stepwise reduction in the number of corpora lutea. AB - The number of corpora lutea (CL) was reduced in pregnant gilts in a stepwise fashion. Eleven pregnant gilts were unilaterally ovariectomized at Day 30, leaving from 6 to 12 CL on the remaining ovary. At Day 40, the number of CL was again reduced by about half in each gilt and this was repeated on Day 50 until 1 to 3 CL remained. Blood was obtained to determine the level of progesterone in plasma on each day of surgery and 24 h later. Four gilts aborted; one had 1 CL and three had 2 CL. One gilt which had 1 CL resorbed the litter. The six gilts that maintained pregnancy from Day 50 to parturition had 1, 3, 2, 2, 2 and 2 CL, respectively. Gilts pregnant at Day 60 were also bled on that day and at 8-h intervals beginning 2 to 3 days prior to expected parturition at Day 114. At laparotomy on Day 50, gilts had from 3 to 20, nonluteinized follicles ranging from 12 to 20 mm in diameter. Hypertrophy of CL was not detected, nor were accessory CL formed. The level of progesterone in serum dropped significantly 24 h after surgery and rose to levels intermediate to pre- and postsurgery levels 10 days later. Parturition was uneventful and levels of relaxin and progesterone appeared normal. PMID- 6487694 TI - Effects of copper on cytoplasmic and nuclear binding of 17 beta-estradiol in the rat uterus. AB - Interference of Cu++ with the initial events in estrogen action was tested by determining Cu++ effects on estradiol-receptor interactions. When immature rat uteri were incubated in vitro with [3H] estradiol ([3H]E2), steroid was bound in cytoplasmic fractions and rapidly accumulated in the nuclear fraction in a manner which was dependent upon time and hormone concentration. Uteri which were preincubated with 2 X 10(-4) M CuCl2 for 40-60 min and then exposed to [3H]E2 were found to have a 30-50% decrease in the amount of steroid bound in the cytoplasmic and nuclear fractions. When copper-treated uteri were exposed to [3H]E2 for variable times, the quantity of steroid bound in the cytoplasmic fraction was markedly depressed and the rate of nuclear accumulation of [3H]E2 was significantly decreased. These results show that Cu++ can inhibit [3H]E2 binding to tissue cytoplasmic receptors in vitro and thereby interfere with hormone delivery to target cell nuclei. PMID- 6487695 TI - Relationship between luteinizing hormone and decidual luteotropin in the maintenance of luteal steroidogenesis. AB - Between Days 6-11 of pregnancy or pseudopregnancy, the decidual tissue of the rat produces a prolactin-like hormone, decidual luteotropin, which can sustain luteal progesterone production when prolactin is suppressed. However, this effect is dependent upon the presence of the pituitary. The present investigation was undertaken to determine whether decidual luteotropin and luteinizing hormone (LH) act together to sustain luteal steroidogenesis and if so, to find out whether the need for LH is due to the inability of the decidual tissue to produce LH-like material and/or whether LH affects decidual luteotropin production. Pseudopregnant rats with or without decidual tissue were hypophysectomized on Day 8 and treated with either 1.5 IU human chorionic gonadotropin (hCG)/day or with vehicle. Within 24 h, serum progesterone dropped in both vehicle-treated groups and decidual luteotropin levels declined by 80% in the decidual tissue. Human CG administration had no effect on progesterone production in the control group. Yet in rats with decidual tissue, hCG stimulated progesterone production for at least 48 h and maintained the decidual tissue content of decidual luteotropin. Progesterone, but not hCG treatment, maintained decidual luteotropin concentrations in ovariectomized rats. To compare the luteotropic activity of the decidual tissue with that of the placenta, pregnant or pseudopregnant rats with decidual tissue were hypophysectomized on Day 8 and treated with 1.5 IU hCG. Control groups had decidual tissue or placentas removed and were similarly treated. Human CG stimulated progesterone production only in rats with placental or decidual tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487696 TI - Sertoli cell development of pig testis in the fetal and neonatal period. AB - The Sertoli cells of pig fetuses from 35 days postcoitum until 1 mo after birth have been investigated by light and electron microscopy in decapitated animals and their control littermates, as well as in untreated animals. Until 52 days postcoitum, Sertoli cells change in form during the formation of sex cords but from then onwards they are rather uniform. They primarily display an elongated nonindented nucleus with one or more prominent nucleoli, a well-developed Golgi apparatus, and in the basal compartment below or beside the nucleus, a large lipid droplet. There are large quantities of rough endoplasmic reticulum (RER) from 52 days postcoitum onwards, often with complex whirl forms and a parallel arrangement of profiles with relatively few ribosomes. After birth their numbers seem to be somewhat less, and by 1 mo after birth the RER profiles are often shorter and almost free of ribosomes. Clustered ribosomes are found in large quantities throughout the period under investigation. Especially in the early fetal period, the endoplasmic reticulum (ER) profiles show prominently filled cisternae. Mitochondria are mostly long and slender, or small and ovoid. Most have lamellar cristae, but mixed lamellar-tubular cristae can also be seen. Between decapitated, control and untreated animals no obvious ultrastructural differences could be observed. The peritubular cell sheath surrounding the sex cords did not show signs of differentiation into a layer of myoid cells. PMID- 6487697 TI - Harderian gland: regulation of sexual "type" by gonads and pineal gland. AB - The sexual dimorphism of the Harderian glands of golden hamsters is regulated by a complex interaction of the gonads and pineal gland. Ovariectomy was shown to prevent the conversion to male-type gland which normally follows blinding. Testosterone administration in combination with blinding and ovariectomy promoted the male type. Ovariectomy after 8 wk of blinding was ineffective in reversing the effects of blinding on the Harderian glands, but ovariectomy and pinealectomy caused complete reconversion to the female type. To our knowledge, this is the first report to demonstrate an influence of the ovaries on the Harderian gland of the hamster. In males, administration of testosterone for 7 days after 8 wk of castration was shown to have little effect on the conversion to the female type which normally attends castration, whereas testosterone injection followed by a period of blinding completely reversed the effects of castration on the Harderian gland. These studies, along with previously published reports, strongly suggest that the male-type Harderian gland is expressed whenever significant androgen levels are present, or when the glands are exposed to androgen priming during or just prior to a period of blinding-induced pineal activation. The probable role of ovarian androgens in mediating conversion to the male-type gland is discussed. PMID- 6487698 TI - Effect of selective removal of the adrenal medulla on female sexual development. AB - The ovary and adenohypophysis of the rat contain beta-adrenergic receptors and respond to beta-adrenergic stimulation with hormone release. To determine the importance of the adrenal medulla as a source of adrenergic influences regulating prepubertal ovarian and pituitary function, a technique was developed to remove most of the adrenal medulla without compromising adrenocortical function. Medullectomy (MED) of 24-day-old female rats depressed both spontaneous diurnal changes in plasma epinephrine (EPI), and the EPI and norepinephrine (NE) response to decapitation, without affecting corticosterone (B) levels. Vaginal opening and first ovulation were delayed in MED rats. Serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were normal in MED rats, but those of growth hormone (GH) and prolactin (Prl) were depressed. MED reduced the ovarian weight response to pregnant mare's serum gonadotropin (PMSG) and the ovarian steroidal response to human chorionic gonadotropin (hCG) in vitro, but it did not affect ovarian beta-adrenergic receptors. Cultured granulosa cells, harvested from juvenile ovaries and primed in vitro with FSH, responded to nanomolar concentrations of EPI with progesterone (P) secretion. EPI also augmented hCG- and FSH-induced P secretion. The EPI effect was reproduced by Zinterol, a beta 2 adrenergic agonist and was prevented by propranolol, a beta-adrenergic antagonist. Blockade of alpha-adrenergic receptors with phentolamine was ineffective. It is suggested that EPI of adrenomedullary origin supports female prepubertal development by a) stimulating ovarian P secretion, b) favoring Prl and GH release and c) amplifying the stimulatory effect of low gonadotropin levels on ovarian steroidogenesis. The effects of EPI on ovarian function appear to be mediated by beta-adrenergic receptors of the beta 2 type. PMID- 6487699 TI - Surface analysis of biomedical polymers by attenuated total reflectance-fourier transform infra-red. AB - An infra- red approach has been developed to characterize hydrophilic biomaterials, particularly contact lenses. Water was utilized as the optical coupling agent between the sample and the ATR element. This method enables the study of hydrophilic polymers in their natural aqueous environment and simultaneously solves the optical contact problem that usually arises when the ATR technique is used. Some studies were made utilizing this approach: dry and hydrated samples were structurally compared; also, a depth profiling study and a surface comparison were made on soft contact lenses fabricated by different industrial processes. Finally, the three dimensional orientation of one hydrated structure was characterized. PMID- 6487700 TI - The effect of exposure conditions upon the release of soluble copper and tin from dental amalgams. AB - The concentrations of soluble copper and tin which were generated by the corrosion of a number of different amalgams in both an artificial saliva and Ringer's solution are reported. Besides variations in solution composition, the effects of solution agitation and abrasive particle wear upon the release of soluble species are studied. Immersion only, moderate solution agitation, vigorous solution agitation with abrasive particle wear, and accelerated corrosion by both constant currents and cyclic voltammetry are included. The results indicate that an artificial saliva but not Ringer's solution is capable of generating high levels of soluble tin. With artificial saliva, agitation increases the amalgam weight losses and increases soluble copper and tin concentrations, whereas agitation with Ringer's solution decreases sample weight losses and decreases levels of soluble copper and tin. This latter effect is believed to be due to the increased oxygen supply to the amalgam surfaces with agitation and the greater ability for producing protective passivating films of the basic hydroxide and copper chlorides in solutions of higher chloride ion concentrations e.g. Ringer's solution. Abrasive particle wear, including pumice, alumina, glass beads, and silica gel had varied effects upon the release of soluble species. Depending upon the amalgam, the solution, and the abrasive combination, either larger increases in copper or in tin occurred or reduced concentrations. PMID- 6487701 TI - Ductility and structure of some cobalt-base dental casting alloys. AB - The shape of the clasps on removable partial dentures often has to be adjusted by bending. Occasionally they fracture during the small plastic deformation that takes place during the adjustment. The tendency to brittle failure of three Co-Cr Mo alloys for prosthetic use with different carbon and chromium contents was investigated by tensile testing. The total elongation which can be used as a measure of the ductility was observed to vary from 4-17% for the investigated alloys. The reasons for these differences have been sought by studying the structures of the alloys and analysing the fracture mechanisms. The fractures are basically brittle and seem to be initiated during straining by cracking of particles. Microprobe analyses showed that many of the particles were agglomerations of constituents which in all cases were substantially enriched in C, Cr and Mo. Each of these constituents may contain phases too small to be resolved by SEM and by the electron beam in the microprobe. TEM investigations showed that many of the constituents were eutectic with alternating lamellae of Co-rich FCC structure and M23C6. The crack propagates rapidly either by following the interface between the matrix and the particles or by running inside the particles. Cleavage along stacking faults in FCC Co-rich grains in the matrix takes place when the distance between neighbouring particles increases. The ductility of the alloys is clearly improved by decreasing amounts of particles and thus by a reduction of the C content. PMID- 6487702 TI - Constructional peculiarities of the human tibia defined by reference to ultrasound measurement data. AB - The distribution of the acoustic properties of the human tibia was studied by the method of ultrasound probing. This enabled the determination of some constructional peculiarities of the tibia. A considerable non-uniformity of ultrasound propagation velocity has been revealed along the entire length of the bone. The uniform velocity fields were longitudinally orientated in the diaphysis whereas in the epiphyseal parts of the bone they had a cross-sectional orientation. Isorapid zones formed spiral structures positioned at an angle of 6.7 +/- 0.5 degrees to the bone axis. Moreover, right-wound spiral was characteristic of the left bone but left-wound spiral of the right. A new parameter--acoustic stiffness of the construction is suggested. In the proximal third of the bone its acoustic stiffness was more pronounced in the sagittal plane; in the middle part it was best defined in the direction of the angular zones of the bone, but in the distal part it had a clearly marked frontal orientation. A statistically valid distinction of ultrasound velocity in the cross-sectional and longitudinal zones of separate bones has been established in all the bones studied. PMID- 6487703 TI - Assessment of biomaterials as components of a reciprocating dialyser during canine dialysis. AB - A recently reported device, the sorbent suspension reciprocating dialyser (SSRD), was investigated for use as a test system for biocompatibility of dialyser components. The device is easy to assemble and operate, and allows minimal blood contact with foreign material outside of dialyser components. Its constant pressure/variable flow rate operation allows quantification of degree of clotting of dialyser versus time. The effect of heparinization of the blood distribution gaskets (BDG) of the device on performance and dialyser lifetime was investigated. Heparin was bound to the surface of polyethylene gaskets by immersion in a solution of tridodecylmethylammonium chloride (TDMAC)--heparin complex for several hours. Gaskets were then assembled in an SSRD which was then used for experimental dialysis in dogs with AV shunts. Dialysers assembled using non-heparinized gaskets were used as controls. Blood coagulation tendency was quantified by the activated clotting time (ACT) and partial thromboplastin time (PTT), and these values correlated with the rate of clotting of the device. Heparinization of the gaskets resulted in the prevention of clotting in the dialyser until the final minutes of dialysis in all cases, in contrast to the constant decay of blood fill volume and evidence of clotting in the non heparinized cases. However, dialyser lifetime was not significantly increased by gasket heparinization. At normal initial values of ACT (80-95 s) dialyser clotting occurred in 10-15 min. In tests with non-heparinized gaskets and systemically heparinized dogs, values obtained in the ACT test were observed to decrease during dialysis, indicating the disappearance of heparin from the blood. Both ACT and PTT tests show promise as predictors of dialyser lifetime. PMID- 6487704 TI - Heparinizable materials (III). Heparin retention power of a poly(amido-amine) either as crosslinked resin, or surface-grafted on PVC. AB - The retentive power of a poly(amido-amine), in the form of a highly hydrophilic crosslinked resin, has been evaluated at different pH's. The resin releases heparin quantitatively in a very narrow pH range (10.8-11.4). This poly(amido amine) has also been grafted on PVC tubes, and the heparin-adsorbing capacity of the materials so obtained has been tested biologically. In this case heparin is only released at pH greater than 10 so confirming the strong interaction between our polymer and heparin. PMID- 6487705 TI - Drug delivery from catalysed erodible polymeric matrices of poly(ortho ester)s. AB - The incorporation of small amounts of acid anhydrides into hydrophobic poly(ortho ester)s can facilitate the erosion and drug release from delivery systems. Since the reaction can be controlled by the amount of anhydride employed, the reaction is confined to a small reaction zone near the surface and constant delivery rates can be achieved. The catalytic activity is negatively correlated with the pKa of the corresponding acid of the anhydride. PMID- 6487706 TI - In vivo production of hexavalent chromium. PMID- 6487707 TI - Modelling of drug release kinetics from a laminated device having an erodible drug reservoir. AB - The purpose of this communication is to present a preliminary analysis to demonstrate the effect of laminating a drug-containing erodible polymer matrix with a second barrier membrane. A mathematical model for the diffusive release of the drug from an erodible polymer device undergoing surface erosion has been extended to similar devices with a secondary membrane to allow a comparison of the results. The results indicate that the constant rate of release characteristic of erodible devices is not sacrificed with the addition of the secondary membrane; moreover, the membrane provides additional controllable parameters at the disposal of the device designer. PMID- 6487708 TI - In vivo evaluation of a new polyurethane-coated catgut suture. AB - Plain catgut sutures were coated with different polyester-based polyurethanes. The sutures were implanted subcutaneously in rats and tested for tensile strength loss and tissue reactions. A polyurethane coating based on an oxalic acid polyester was hydrolysed too fast to protect the catgut against proteolysis. However, a 2-0 plain catgut having a 50 micron polyurethane coating based on glutaric acid polyester maintained its original tensile strength for 8 days. The tensile strength then decreased as for plain catgut. Histological examination of the surrounding tissues showed that the strong inflammatory reaction observed in the first three days with non-coated catguts is decreased, but occurs again later, although to a lesser extent. PMID- 6487709 TI - Interaction of antithrombin III with preadsorbed albumin-heparin conjugates. AB - The adsorption of antithrombin III (AT III) onto polystyrene surfaces preadsorbed with albumin or albumin-heparin conjugates was studied using a two step enzyme immuno assay. When AT III-buffer solutions were used, the highest adsorption values were measured on high affinity albumin-heparin conjugate pretreated surfaces. Less AT III adsorption was found on nonfractionated albumin-heparin conjugate preadsorbed surfaces. AT III adsorption could also be detected on low affinity conjugate and albumin coated surfaces. When AT III was adsorbed from plasma or plasma dilutions with buffer, only AT III on surfaces preadsorbed with high affinity or nonfractionated albumin-heparin conjugate was found. These results demonstrate that the heparin moiety of the conjugate is directed to the solution phase whereas the albumin moiety contacts the polystyrene surface. PMID- 6487710 TI - Tear and rupture of elastomeric dental impression materials. AB - The curing time dependence of the tear energy, tensile strength and ultimate extension ratio of a range of characterized elastomeric impression materials was investigated. This variation of tensile strength and ultimate extension ratio was correlated with the development of the network structure. The tear energy showed only minor changes as the curing proceeded. PMID- 6487711 TI - Comparison of surface layer properties of composite resins by ESCA, SEM and X-ray diffractometry. AB - Hyperfine surface layer properties of three types of dental composite resins, highly-filled, conventional, and micro-filled resins, were studied using X-ray photoelectron spectroscopy (ESCA) by a combination of X-ray diffractometry and scanning electron microscopy (SEM). X-ray diffraction and SEM analysis showed clearly that each resin has different characteristics of SiO2 particle size and distribution. ESCA depth resolution with argon ion etching indicated that, in contrast to conventional and microfilled resins, carbon due to polymers of highly filled resin decreases dramatically with increasing depth in the nanometer range of the resin-rich surface layer. PMID- 6487712 TI - The effect of zinc on the biocompatibility of dental amalgams in vitro. AB - When freshly triturated, two zinc-containing amalgams, Velvalloy and Dispersalloy, were more cytotoxic in vitro than two zinc-free amalgams Amalcap and Sybraloy. The high copper amalgam, Sybraloy, was only slightly irritant: similarly the presence of copper in Dispersalloy did not increase its toxicity over Velvalloy. All four amalgams retained some degree of toxicity up to one month after setting which is in marked contrast to most other dental materials investigated previously. This was greatest with the zinc-containing amalgams and was accompanied by the continued release of zinc over this period. PMID- 6487713 TI - The chemistry of silicone materials for biomedical devices and contact lenses. AB - The mechanical, physical and physiological requirements for biomedical and, more specifically, contact lens materials are outlined. The synthesis and properties of a wide range of silicones is reviewed with reference to typical materials and end uses. The advantages and limitations of presently available silicones are compared with those of conventional lens materials. The effect on such materials of emerging and future advances in silicone chemistry are briefly discussed. PMID- 6487715 TI - [Passive telemetry system for monitoring heart pacemaker electrodes]. PMID- 6487714 TI - Effect of anionic polymeric hydrogels on spermatozoa motility. AB - The effects of a few synthetic polymers on the motility of human spermatozoa in vitro have been studied. An alternate copolymer of styrene and maleic anhydride, poly(S-MA), poly (styrene-maleic acid), poly(S-MC), poly(hydroxy-ethyl methacrylate-methacrylic acid) copolymer, poly(HEMA-MAC), poly(HEMA) homopolymer and poly(MAC) homopolymer were chosen for this purpose. It was found that all the carboxylic acid containing polymers are strong inhibitors of the motility of spermatozoa. Poly(HEMA) did not have any inhibitory effect on the motility of spermatozoa. PMID- 6487716 TI - [An electronic device for conversion of low-frequency biosignals to auditory frequency range]. PMID- 6487717 TI - [Biodegradation of polyethylene and polyether-polyurethane]. PMID- 6487718 TI - Important principles in the development, manufacture and maintenance of anaesthesia equipment. PMID- 6487719 TI - Fitting a sinusoid to biological rhythm data using ranks. AB - Biological data are frequently collected with small numbers of observations from several subjects. Often a linear model is fitted to the data by averaging over subjects. Frequently there are considerable between-subject differences, and due allowance should be made for these when the model is fitted by parametric techniques. In this paper it is proposed that the model should be fitted by using the within-subject ranks of the observations. The technique is applied to the problem of estimating the 'cosinor' diagram for biological rhythm data. An example involving melatonin levels, in which there are considerable between subject differences, is considered. The results obtained by use of the ranks are compared with those of a parametric analysis which makes allowance for the between-subject differences. The results are very similar, but the rank analysis requires much less computation. PMID- 6487720 TI - A method for estimating incidence rates of onchocerciasis from skin-snip biopsies with consideration of false negatives. AB - The aim of this study is to estimate incidence rates of onchocerciasis from skin snip biopsies, based on incomplete data obtained in field surveys, with consideration of false negatives. The method of maximum likelihood is employed and the effect of false negatives on the incidence rates is discussed. PMID- 6487721 TI - Modelling the migration of Onchocerca volvulus in simuliids, using a simple compartmental process. AB - A simple compartmental process, which is time-homogeneous and has differing transition rates between compartments, is discussed. When such a process is hierarchical, with all individuals released into the first compartment, the resulting distribution of individuals over the various compartments is multinomial. This process is applied to the migration of Onchocerca volvulus in simuliids and appears to represent successfully the early migration from the stomach through the abdomen to the thorax, provided that allowances are made for the engorgement period and the encapsulation of the blood meal by a peritrophic membrane. PMID- 6487722 TI - The distributions of N and F: measures of HLA haplotype concordance. AB - Nonrandom inheritance of the two HLA haplotypes of Chromosome 6, available from each parent among siblings affected by certain diseases, has afforded evidence of HLA-linked disease-susceptibility genes. Two algebraically equivalent measures of HLA haplotype concordance (that is, the excessive sharing of certain haplotypes among affected siblings) are used for family studies designed to test whether or not there is significant evidence of the existence of an HLA-linked disease susceptibility gene or for inferring the mode of inheritance when this is already believed to apply. The distributions of these measures are derived under the null hypothesis of random inheritance of HLA haplotypes, and there is a short discussion of the case in which inheritance of a diseased gene causes a change, from the purely random case, in the distribution of haplotype concordance among affected siblings. PMID- 6487723 TI - Testing the effect of sex differences on sib-sib correlations. AB - Procedures for testing the effect of sex differences on sib-sib correlations are studied. It is demonstrated that a simple procedure for testing the equality of a pair of brother-brother and sister-sister correlations (the modified Z test) is comparable in power to the likelihood ratio test in moderately large samples drawn from sibship-size distributions that are likely to occur in practice. In small samples, the modified Z test is preferable to the likelihood ratio test, since the latter tends to be anti-conservative. PMID- 6487724 TI - Estimating parameters of the family-size distribution in ascertainment sampling schemes: numerical results. AB - It is argued that, in any ascertainment sampling scheme using data from families of various sizes, there is never any need to assume a particular form for the (unknown) family-size distribution. There exists a simple conditional method, making no assumptions about the family-size distribution, that is always preferable to the assumption of any particular distributional form. Furthermore, the simplicity of the conditional method gives insights into properties of estimates of genetic and ascertainment parameters, which are not available when a particular form for the family-size distribution is assumed. PMID- 6487725 TI - Treatment allocation for nonlinear models in clinical trials: the logistic model. AB - Many clinical trials have a binary outcome variable. If covariate adjustment is necessary in the analysis, the logistic-regression model is frequently used. Optimal designs for allocating treatments for this model, or for any nonlinear or heteroscedastic model, are generally unbalanced with regard to overall treatment totals and totals within strata. However, all treatment-allocation methods that have been recommended for clinical trials in the literature are designed to balance treatments within strata, either directly or asymptotically. In this paper, the efficiencies of balanced sequential allocation schemes are measured relative to sequential Ds-optimal designs for the logistic model, using as examples completed trials conducted by the Eastern Cooperative Oncology Group and systematic simulations. The results demonstrate that stratified, balanced designs are quite efficient, in general. However, complete randomization is frequently inefficient, and will occasionally result in a trial that is very inefficient. PMID- 6487726 TI - Small-sample bias of point estimators of the odds ratio from matched sets. AB - The bias of several point estimators of the odds ratio arising from matched-pair data is investigated for small samples. Simple alternatives to the traditional maximum likelihood estimator are suggested, on both the original scale and the logarithm scale. In each case the suggested estimators possess a superior performance in terms of mean square error. Generalizations are given for 1:R matched data sets. PMID- 6487727 TI - Difficulties with regression analyses of age-adjusted rates. AB - A common type of observational study compares population rates in several regions having differing policies in an effort to assess the effects of those policies. In many studies, particularly in public health and epidemiology, age-adjusted rates are regressed on predictor variables to give a covariance-adjusted estimate of effect; this estimate is shown to be generally biased for the appropriate regression coefficient. For familiar models, the analysis of crude rates with age as a covariate can lead to unbiased estimates, and therefore can be preferable. Several other regression methods are also considered. PMID- 6487728 TI - On the use of case series to identify disease risk factors. AB - Methods to identify disease risk factors from a series of cases are considered. These include methods that compare risk factor levels among diagnostic categories and methods that relate risk factor levels to age at diagnosis, with a single diagnostic category. Statistical aspects considered include modelling assumptions, parameter identifiability, hypothesis-testing efficiency, assumptions concerning unsampled diagnostic categories and requirements for risk factor data and confounding factor data. It is argued that methods to identify risk factors using data on a single diagnostic category involve such strong assumptions that they have limited usefulness. Analyses that compare risk factor levels among diagnostic categories, on the other hand, should continue to play an important role in epidemiologic research, though there are important limitations in relation to analyses involving disease-free controls. PMID- 6487729 TI - Covariate analysis of competing-risks data with log-linear models. AB - A general system of log-linear modeling is proposed for analysis of competing risks data with discrete covariates. The instantaneous cause-specific failure rates, approximated by step-functions, are analyzed by techniques for multidimensional contingency tables. Censored observations are accommodated. Counts of failures of each type, and the amount of follow-up, are summarized in two arrays in which each cell denotes a distinct combination of failure type, time interval and covariate value. Maximum likelihood estimators for the parameters of the model are derived by iterative proportional fitting; the resulting estimates of the number of failures in each cell are used for goodness of-fit tests. The principal advantages of this approach are its simple display of data, its computational ease for the fitting and comparison of models and its provision of explicit goodness-of-fit tests. Interpretation of the models is facilitated by reference to several alternative models for survivorship and competing risks. The basic model is extended to incorporate stochastic covariates whose values change during follow-up, and to accommodate quantitative covariates. PMID- 6487730 TI - Some statistical methodology for the analysis of HLA data. AB - The estimation of gene frequencies, linkage disequilibrium and disease associations for the human leukocyte antigen (HLA) system is considered. Comprehensive models for HLA data are introduced and contrasted with simpler approaches to the analysis of such data. PMID- 6487731 TI - X-ray diffraction evidence for cross-bridge formation in relaxed muscle fibers at various ionic strengths. AB - Equatorial x-ray diffraction patterns from single skinned rabbit psoas fibers were studied at various ionic strengths to obtain structural information regarding cross-bridge formation in relaxed muscle fibers. At ionic strengths between 20 and 50 mM, the intensity of the 11 reflection, I11, of the relaxed state was close to that of the rigor state, whereas the intensity of the 10 reflection, I10, was approximately twice that of rigor reflection. Calculations by two-dimensional Fourier synthesis indicated that substantial extra mass was associated with the thin filaments under these conditions. With increasing ionic strength between 20 and 100 mM, I10 increased and I11 decreased in an approximately linear way, indicating net transfer of mass away from the thin filaments towards the thick filaments. These results provided evidence that cross bridges were formed in a relaxed fiber at low ionic strengths, and that the number of cross-bridges decreased as ionic strength was raised. Above mu = 100 mM, I10 and I11 both decreased, indicating the onset of increasing disorder within the filament lattice. PMID- 6487732 TI - A method for testing an extended poisson hypothesis of spontaneous quantal transmitter release at neuromuscular junctions. AB - A statistical method for testing the Poisson hypothesis of spontaneous quantal transmitter release at neuromuscular junctions has been proposed. The notion of the Poisson hypothesis is extended so as to allow for nonstationarity in the data, since nonstationarity is commonly seen in the occurrence of spontaneous miniature potentials. Special emphasis has been put on the nonstationary analysis of the quantal release. A time scaling technique has been introduced and is discussed for the analysis. Artificially generated data, which simulate three types of nonstationary spontaneous quantal release, i.e., Poisson, non-Poisson clustered, and non-Poisson-ordered types, were analyzed to demonstrate the effectiveness of the method. Some sets of miniature endplate potentials, intracellularly recorded at frog sartorius neuromuscular junctions in low Ca++ and high Mg++ solutions showing apparent nonstationarities, were analyzed as illustrative examples. The proposed method will extend the range of applicable data for the statistical analysis of spontaneous quantal transmitter release. PMID- 6487733 TI - Self-exchange of sodium in human lymphocytes. AB - Self-exchanges of Na and K in human lymphocytes were measured by isotopic efflux techniques. In washed cells, K exchanged in a single slow exponential fraction, but the Na exchange had a marked curvature. It was shown that the curvature was not caused by simple bulk-phase diffusion, and it was resolved into three major fractions: fast (F) (half-time, t1/2 = 2-4 min), intermediate (I) (t1/2 = 12 min), and slow (S) (t1/2 = 125 min). Each of these appeared to follow an exponential function. The I fraction contained approximately 10 mmol Na/kg cells (25-30% of normal cellular Na), was not affected by manipulations that cause lymphocytes to gain Na, and had little or no temperature dependence. The S fraction of Na in normal cells (S1) contained approximately 10 mmol Na/kg cells, had only a slight temperature dependence, and the amount and rate of S1 were independent of external K concentration (Kex). Another slow fraction (S2) appeared when the cells underwent a net gain of Na in exchange for K, and was characterized by a steep temperature dependence and a peak rate around the transition point (the point at which half of cellular K is replaced by Na) at 0.4 mM Kex. The results are discussed within context of a theory that assigns the exchange of the major part of K in its slow exponential fraction and the Na exchange in S2 to interactions of these ions with fixed anionic sites, on intracellular macromolecules, which have been shown previously to interact cooperatively in their association with K and Na. PMID- 6487734 TI - Method for the determination of oxygen consumption rates and diffusion coefficients in multicellular spheroids. AB - A method has been developed for the quantitative evaluation of oxygen tension (PO2) distributions in multicellular spheroids measured with O2-sensitive microelectrodes. The experimental data showed that multicellular tumor spheroids in stirred growth media were characterized by a diffusion-depleted zone surrounding the spheroids. This zone was elicited by an unstirred layer of medium next to the spheroid leading to a continuous decrease in the PO2 values from the bulk medium towards the spheroid surface. Theoretical considerations demonstrate that the volume-related O2 consumption rate, Q, in the spheroids can be assessed by measuring the PO2 gradient in the diffusion-depleted zone outside the spheroids. Accordingly, Krogh's diffusion constant, KS, in the spheroids can be determined through measuring the PO2 gradient within the spheroids. The results obtained suggest that multicellular spheroids represent useful in vitro tumor models for the experimental and theoretical analysis of the interrelationship among O2 supply to tumor cells, O2 metabolism in tumors tissue, and the responsiveness of cancer cells to treatment. PMID- 6487735 TI - Topological analysis of wall mass transport using a luminescent immobilized enzymatic system. AB - A new technique of visualization of diffusion-convection phenomena at a solid liquid interface using the luminol chemiluminescent reaction catalyzed by immobilized peroxidase has been previously described (Dimicoli, J.L., M. Nakache, and P. Peronneau, 1982, Biorheology, 19:281-300). We propose now a theoretical model that predicts quantitatively the light fluxes, JL, corresponding to the transfer J of the hydrogen peroxide substrate at the liquid-solid interface in a cylindrical tube for continuous flow experiments. A simple phenomenological relation, J alpha J1/mL (1 less than m less than 3) was first established for each point of the wall. Then, numerical integration showed that, independent of the laminar or turbulent character of the flow, J1/mL was proportional to (S1 Kideal)/(1 + Kideal/ET), where S1 is the bulk substrate concentration, Kideal is the ideal transport coefficient, and ET (in cm.S-1) a phenomenological first order enzymatic rate constant per unit of wall surface. This relation proved to be satisfactory for all experimental conditions since a single mean value of ET takes into account the experimental data collected for a given enzymated tube in a large range of Reynolds number values (Re) (500 less than Re less than 9,000) and of distances from the entrance of the tube (chi greater than 0.3 cm). This quantitative analysis using a pseudo-first-order approximation interprets the observed great dependence of JL on Re(JL alpha Ren', with n' usually greater than 1/3 for laminar flows) and on S1 (JL alpha S1m). It predicts also that the laminar-to-turbulent transition can be evidenced for interfacial enzymatic activity, ET greater than 2.10(-4) cm.S-1, as observed with most of the tubes prepared by covalent binding of peroxidase on the acrylamide gel wall. The experiment had to be carried out at a pH value of 8, which corresponds to the fastest rate of the chemiluminescent reaction. The predicted entrance effects were also observed experimentally for the first time in an immobilized enzyme system. This technique appears therefore to be a valuable tool for the quantitative analysis of diffusion-convection phenomena at a liquid-solid interface with a good spatial resolution with a great range of flow rate. PMID- 6487736 TI - A self-consistent chain model for the phase transitions in lipid bilayer membranes. AB - We presented a mechanical model of a lipid bilayer membrane. The internal conformations of a polar head group and double hydrocarbon chains in a lipid molecule were described on the basis of the isomeric bond-rotation scheme. The thermodynamic properties of the lipid membranes were represented by a density matrix that described the rotational isomeric states of the head groups and chains. The parameters that determined the density matrix were obtained in the presence of the intermolecular interactions, which depend on the conformation of the molecules. The interchain interaction was given by the Kihara potential, which depends on the shape of the chains. The Coulomb interaction between the polar head groups and the lateral pressure were considered. The calculation was made for the three lipid molecules corresponding to DMPC, DPPC, and DSPC. The model agreed well with the following experimental results: the temperature, the latent heat of the gel-to-liquid crystalline phase transition, the temperature dependencies of (a) the intermolecular distance, (b) the number of gauche bonds in a hydrocarbon chain, (c) the order parameter for the bond orientation, (d) the volume of the membrane, (e) the thermal expansion coefficients, and (f) the birefringence. PMID- 6487737 TI - Effect of colchicine on viscoelastic properties of neutrophils. AB - The effect of colchicine (15-60 micrograms/ml) on the viscoelastic properties of human neutrophils was studied by the micropipette technique. The small deformation of the neutrophil in response to a step aspiration pressure was analyzed by using a three-element model in which an elastic element, K1, is in parallel with a Maxwell element composed of another elastic element, K2, in series with a viscous element, mu. Colchicine treatment of neutrophils caused decreases in K2 and mu without affecting K1. The results indicate that the integrity of the microtubules plays a significant role in providing the viscoelastic resistance (as represented by the Maxwell element in the model) of neutrophils to deforming stress. PMID- 6487738 TI - The Smoluchowski-Poisson-Boltzmann description of ion diffusion at charged interfaces. AB - A theoretical description of ion diffusion in the electric field set up by the double layer in the neighborhood of a charged interface is presented. Such a description is needed for the understanding of diffusion-controlled chemical kinetics and transport of ionic species in a variety of systems of interest in biophysics, electrochemistry, and colloid science. The ion dynamics are taken to be governed by the Smoluchowski diffusion equation and the average electrostatic field is obtained from the nonlinear Poisson-Boltzmann equation. Diffusion in finite regions with partially absorbing boundaries of planar, cylindrical, or spherical geometry is considered. The complete analytical solution of the Smoluchowski-Poisson-Boltzmann equation for counterions between two planar charged interfaces is given. Simple expressions are derived for certain useful integral quantities, viz., mean absorption times and absorption probabilities, in all geometries considered. Finally, lateral counterion diffusion and its consequences for surface re-encounter-enhanced chemoreception is considered. PMID- 6487739 TI - A low voltage-activated calcium conductance in embryonic chick sensory neurons. AB - Isolated Ca currents in cultured dorsal root ganglion (DRG) cells were studied using the patch clamp technique. The currents persisted in the presence of 30 microM tetrodotoxin (TTX) or when external Na was replaced by choline. They were fully blocked by millimolar additions of Cd2+ and Ni2+ to the bath. Two components of an inward-going Ca current were observed. In 5 mM external Ca, a current of small amplitude, turned on already during steps changes to -60 mV membrane potential, leveled off at -30 mV to a value of approximately 0.2 nA. A second, larger current component, which resembled the previously described Ca current in other cells, appeared at more positive voltages (-20 to -10 mV) and had a maximum approximately 0 mV. The current component activated at the more negative membrane potentials showed the stronger dependence on external Ca. The presence of a time- and a voltage-dependent activation was indicated by the current's sigmoidal rise, which became faster with increased depolarization. Its tail currents were generally slower than those associated with the Ca currents of larger amplitude. From -60 mV holding potential, the maximum obtainable amplitude of the low depolarization-activated current was only one-tenth of that achieved from a holding potential of -90 mV. Voltage-dependent inactivation of this current component was fast compared with that of the other component. The properties of this low voltage-activated and fully inactivating Ca current suggest it is the same as the inward current that has been postulated in several central neurons (Llinas, R., and Y. Yarom, 1981, J. Physiol. (Lond.), 315:569 584), which produce depolarizing potential waves and burst-firing only when membrane hyperpolarization precedes. PMID- 6487741 TI - Dynamic light scattering study of muscle F-actin. AB - By use of digital autocorrelation and fast Fourier methods, dynamic light scattering studies of in vitro reconstituted muscle F-actin were made over a wide range of concentrations, 0.01-2 mg/ml F-actin. Measurements of correlation function [g1(t)]2 showed that a transition from a dilute to a semidilute regime for the Brownian motions of filaments occurred at around 0.3 mg/ml F-actin. Beyond this concentration, profiles of successively measured [g1(t)]2 showed very poor reproducibility. This resulted from the existence of very slow components, which could not be measured with a high statistical accuracy even for a measuring time of 3600 s/run. On the other hand, subtraction of these components automatically by an electronic circuit, [g-1(t)]2, or by computer processing, [g1(t)]2, resulted in a fairly good reproducibility of the profiles. The decay characteristics of [g1(t)]2 (and [g-1(t)]2) were very similar to those of [g1(t)]2 for dilute solutions. A theoretical model will be discussed which could account for the above situation. The time sequence [n(t,T)] of photoelectron counts at a sampling time T of light scattered from semidilute solutions of F actin was stored on magnetic tapes, and both power spectra S(f) and correlation functions [g-1(t)]2 were computed by taking the ensemble average over many short records with duration 1024T. Since both S(f) and [g-1(t)]2 lacked frequency components lower than 1/(2048T) Hz, their profiles were highly reproducible. An analysis of S(f) confirmed our earlier results which had shown an apparent contradiction to later results by a correlation method. A comparison of S(f) and [g-1(t)]2 based on the same [n(t,T)] clarified the reasons why the bandwidth gamma of S(f) largely differed from the bandwidth gamma of [g1(t)]2 and [g 1(t)]2. The temperature dependence of gamma suggested that F-actin would be flexible and that the flexibility parameter would change with temperature. PMID- 6487740 TI - Free energy potential for aggregation of giant, neutral lipid bilayer vesicles by Van der Waals attraction. AB - Here, we report the first direct observation of Van der Waals' attraction between biomembrane capsules using measurements of the free energy reduction per unit area of membrane-membrane contact formation. In these studies, the membrane capsules were reconstituted neutral (egg phosphatidylcholine) lipid bilayers of giant (greater than 10(-3) cm diam) vesicles. Micromanipulation methods were used to select and maneuver two vesicles into proximity for contact; after adhesion was allowed to occur, the extent of contact formation was regulated through the vesicle membrane tensions that were controlled by micropipette suction. The free energy reduction per unit area of contact formation was proportional to the membrane tension multiplied by a simple function of the pipette and vesicle dimensions. The free energy potential for Van der Waals attraction between the neutral bilayers in 120 mM NaCl solutions was 1.5 X 10(-2) ergs/cm2. Also, when human serum albumin was added to the medium in the range of 0-1 mg/ml, the free energy potential for bilayer-bilayer adhesion was not affected. Using published values for equilibrium spacing between lipid bilayers in multilamellar lipid water dispersions and the theoretical equation for van der Waals attraction between continuous dielectric layers, we calculated the value for the Hamaker coefficient of the Van der Waals attraction to be 5.8 X 10(-14) ergs. PMID- 6487742 TI - Oscillation of electrical potential in a porous membrane doped with glycerol alpha-monooleate induced by an Na+/K+ concentration gradient. AB - The electrical potential across a fine-pore membrane doped with glycerol alpha monooleate and separating aqueous solutions of 0.5 M NaCl and 0.5 M KCl was studied. It was found that this system showed rhythmic and sustained oscillations of electrical potential. These oscillations may be due to the phase transition of glycerol alpha-monooleate molecules within the fine pores. In relation to this, it is shown here that Na+ and K+ have different effects on the aggregation of glycerol alpha-monooleate. This oscillatory phenomenon is very interesting because in biological nervous membrane an Na+/K+ concentration difference across the membrane is essential for excitability. PMID- 6487743 TI - Buffer catalysis of amino proton exchange in compounds of adenosine, cytidine and their endocyclic N-methylated derivatives. AB - The use of buffer catalysts having a wide range of pK (dissociation) values (4 12) provides the first estimates of two generally useful empirical parameters of amino proton exchange in compounds of adenine and cytosine. These are a nucleobase amino group dissociation constant (pKD) and the 'encounter frequency' for proton transfer (kD), which can be used to predict amino proton exchange rates. Values of amino pKD fall in the range 8.6-9.4 for the unsubstituted nucleobases and their endocyclic N-methylated derivatives. Similar values of kD are obtained for all nucleobases (1 X 10(8) M-1 s-1). These constants were obtained from a statistical fit of second-order catalytic rate constants for amino proton exchange, measured by amino 1H-NMR lineshape at varying field frequencies (100, 300 and 360 MHz). These results confirm the requirement for buffer conjugate base formation and nucleobase protonation, but point to a different mechanism of exchange at low pH; most probably direct amino protonation for adenine, but not for cytosine compounds. Anionic buffer conjugate bases (phosphate and acetate) show a greater catalytic effect than neutral (nitrogen) bases, especially with cytosine compounds. The use of high concentrations of sodium perchlorate to sharpen amino 1H resonances of 1-methyladenosine is examined, with respect to chemical and rotational exchange and NMR line broadening. PMID- 6487744 TI - Nucleotide-induced changes in the heat capacity of beef cardiac myosin. AB - The heat of reaction of ATP with beef cardiac myosin has been determined in a flow microcalorimeter at two different temperatures. The reaction heat obtained by extrapolation to infinite flow rate is interpreted to be the heat of formation of the steady-state set of myosin-nucleotide complexes. The large temperature dependence of this heat, an apparent change in heat capacity, could be caused by an isomerization between two myosin conformations. The enthalpies and heat capacities of binding of ADP, AMP, and pyrophosphate have also been measured and are discussed in terms of this model. PMID- 6487745 TI - The biological functions of low-frequency vibrations (phonons). 4. Resonance effects and allosteric transition. AB - Based on the internal structure of oligoprotein as well as the basic physical characteristics+ of vibrations, it is deduced that the low-frequency vibrations possess some exceptional functions in transmitting biological information at the molecular level. In particular, according to the viewpoint of energy exchange and intramolecular displacement, it is demonstrated that the low-frequency resonance plays a very significant role during the dynamic process of allosterism of an oligomeric protein molecule. Furthermore, the cooperative reaction between hemoglobins and ligands is taken as an example, through which it is seen that some observed phenomena, whose dynamic principle has thus far been unclear, can be explicitly interpreted in terms of the concept of low-frequency resonance. PMID- 6487746 TI - Analysis of self-associations from partition isotherms. AB - Self-associations can be studied from the measurements of the partition of the self-associating solute between two immiscible liquids. The apparent partition coefficient, Kapp, is proportional to the ratio of the apparent weight fraction of monomer, fa, in each phase. If one assumes that the Adams-Fujita convention for the activity coefficients of the self-associating species applies, then fa is related to Mna and Mwa, the apparent values of the number and weight average molecular weights, respectively; and one can use previously developed methods to analyze the self-association. In order to use the method, one must make an independent study at the same temperature of one of the phases by an appropriate thermodynamic method, such as vapor pressure osmometry or sedimentation equilibrium. Then one can test the other phase for the type of self-association present and evaluate the equilibrium constant or constants (ki) and the nonideal term (BM1) from the partition data. One can also evaluate the partition coefficient (Kpar). From these measurements, one can obtain the free energy (delta G0) for the association in each phase and for the transfer between phases. Temperature-dependence studies will provide the enthalpy (delta H0) or entropy (delta S0) of self-association or transfer. This method should be quite useful for studying small molecules of biological importance. PMID- 6487747 TI - A micelle model for the sedimentation behavior of bovine beta-casein. AB - The monomer-single polymer model of G.A. Gilbert (Disc. Faraday Soc. 20 (1955) 68) for moving boundary sedimentation has been used by Payens and colleagues to explain the observed results for bovine caseins, and by Harrington and colleagues to explain the observed results for myosin fibrils. Electron microscope pictures of Buchheim and Schmidt have subsequently revealed micellar beta-casein in the form of slightly elongated or spherical particles having a bimodal size distribution, but with a broad range of particle sizes, at concentrations not too far above the critical micelle concentration. The equilibrium properties of a broadly distributed micellar system can be fitted by the shell model developed by one of us, and in the present article, the shell model is extended to predict the moving boundary sedimentation behavior of such a system. The observed sedimentation patterns, as well as the critical concentration predictions of the monomer-single polymer Gilbert sedimentation model, are satisfactorily described with the present model, based on a continuous distribution of intermediates between monomers and the largest possible spherical micelles. For one example considered, the predicted frequency distribution of molecular weight is in qualitative agreement with the frequency distribution of particle volume found by Buchheim and Schmidt. PMID- 6487748 TI - Pressure-jump kinetics of bovine beta-casein micellization. AB - Two samples of highly purified bovine beta-casein supplied to us by Dr. T.A.J. Payens of the National Institute for Dairy Research, Ede, The Netherlands, were studied over a range of concentration from just below the critical micelle concentration (CMC) to 0.46%, in 0.2 ionic strength phosphate buffer (pH 7.0), at 20 and 25 degrees C. The relaxation process studied by pressure jump using a 90 degree scattered light detector was also confirmed by the temperature-jump method. In the pressure-jump experiments, the process could be separated into two general time domains, with an approximate ratio of 10-25:1, a behavior reminiscent of that found for synthetic micellar systems. The faster relaxation process was still exhibited below the CMC, however. The concentration dependence of the faster relaxation time agreed very satisfactorily with predictions from the micelle model described in the companion paper. PMID- 6487750 TI - Pharmacokinetics of nalidixic acid associated with sodium citrate. AB - A pharmacokinetic study of sachets containing nalidixic acid (0.66 g) associated with sodium citrate (3.75 g)--NSC--was carried out in 10 healthy volunteers in order to determine the influence of the urine alcalinization due to sodium citrate on the elimination of nalidixic acid (NA) and its 7-hydroxy (HNA) and 7 carboxy (CNA) derivatives. Urine alcalinization enhanced markedly the urinary excretion of HNA, but not of NA and CNA. The urinary concentrations of bacteriologically active compounds--NA + HNA--remained above five times their minimum inhibitory concentration for 10 h following each dose. After a 3-day treatment using NSC three times daily there was no significant accumulation of NA and derivatives in the plasma and no significant change in their kinetics. Finally, from a pharmacokinetic viewpoint, the daily administration of 3 sachets of NSC each containing 0.66 g of NA seems valuable in the treatment of urinary tract infections. PMID- 6487749 TI - Comparative pharmacokinetics of ketoprofen derived from single oral doses of ketoprofen capsules or a novel sustained-release pellet formulation. AB - Nine healthy male volunteers took part in a crossover study to compare the pharmacokinetics of ketoprofen after administration of a single oral dose (200 mg) of ketoprofen as 'Orudis' capsules or encapsulated sustained-release pellets, 'Oruvail'. The mean +/- standard deviation values for highest observed plasma ketoprofen concentrations were determined by high performance liquid chromatography to be 23 +/- 11 micrograms ml-1 at 0.82 +/- 0.18 h after dosing with ketoprofen capsules and 3.5 +/- 1.0 micrograms ml-1 at 4.9 +/- 1.0 h after dosing with sustained-release pellets. The apparent ketoprofen elimination half lives after these treatments were 3.3 +/- 1.2 h and 8.4 +/- 3.4 h, respectively. The systemic availability of ketoprofen was essentially the same after each treatment. Administration of sustained-release pellets (containing 200 mg ketoprofen) once every 24 h is predicted to produce similar average and markedly higher minimum plasma ketoprofen concentrations than are produced by ketoprofen capsules (100 mg) every 12 h, and similar minimum plasma ketoprofen concentrations to those achieved by dosing ketoprofen capsules (50 mg) every 6 h. Once-daily administration of a non-steroidal anti-inflammatory agent has an obvious therapeutic advantage over more frequent dosing. This study suggests that the sustained-release pellet formulation described herein is a suitable formulation for once-daily administration of ketoprofen. PMID- 6487751 TI - Effects of penicillins on binding of phenytoin to plasma proteins in vitro and in vivo. AB - Effects of penicillins on the binding of phenytoin to plasma proteins were examined in vitro and in vivo. The results from in vitro studies showed that the penicillins including oxacillin and dicloxacillin were effective in displacing phenytoin from its binding sites. In vivo, the total phenytoin concentration in serum decreased during penicillin administration, while the free phenytoin concentration increased. As a result, penicillins caused a significant increase in the apparent volume of distribution and in the total body clearance of phenytoin. These results can be explained on the basis of the displacement of phenytoin from its plasma protein binding site by penicillins. PMID- 6487752 TI - Pharmacokinetics of diazepam from a controlled release capsule in healthy elderly volunteers. AB - A single dose open labelled two-way randomized crossover study was used to assess the pharmacokinetics of diazepam from a controlled release capsule relative to standard release tablets in elderly volunteers. Eighteen volunteers received a single 15 mg controlled release capsule or a 5 mg tablet t.i.d. on one day. Diazepam plasma concentrations were determined at specific times over a 96-h interval by an electron capture-gas chromatographic method. Mean plateau plasma concentrations endured from 2 to 24 h avoiding the peak to trough fluctuations associated with conventional t.i.d. dosing. Similar areas under the plasma concentration-time curve (AUC) values indicated equal extent of absorption between formulations and regimens. Comparing parameters in this same elderly population to a young adult population, previously administered the controlled release capsule, shows lower maximum concentrations and a longer plateau duration in the elderly volunteers. Although there is a twofold increase in the mean diazepam half-life in the elderly when compared to young adults, the estimated apparent volume of distribution increased proportionately with half-life to maintain a constant clearance. Thus, the total body clearance of diazepam appears to be age independent. The age-dependent pharmacokinetics observed in this study are consistent with previously reported data involving diazepam. Overall, the controlled release capsule administered once daily mimics a t.i.d. regimen in elderly volunteers. PMID- 6487753 TI - In vitro and in vivo evaluation of controlled-release and enteric-coated formulations of sodium salicylate. AB - The bioavailability and pharmacokinetics of salicylic acid (SA) were studied after single and multiple doses of a new slow-release formulation, based on porous membrane diffusion of sodium salicylate (NaSA). A solution of NaSA and an enteric-coated tablet of NaSA were used for comparison. Dissolution rate studies were carried out at various pH values, and both solid formulations showed pH dependent release rates. The enteric-coated tablet released its content rapidly at intestinal pH but slowly and irregularly at gastric pH. The dissolution from the controlled-release formulation at intestinal pH was completed after 6h and the drug was delivered at a constant rate. At gastric pH the release rate was lower but complete release was obtained within 24h. The novel formulation appeared to offer complete bioavailability of SA and an even and sustained release of SA, allowing twice-daily medication without increased fluctuations in SA concentrations. PMID- 6487754 TI - Comparison of the erythrocyte partitioning method with two classical methods for estimating free drug fraction in plasma. AB - A modification of the erythrocyte partitioning method for the rapid estimation of plasma-free drug fractions (fu) is described and applied to five basic drugs. In the procedure, which uses readily available clinical laboratory equipment, fu is calculated from measurements of drug partitioning between plasma and erythrocytes, and between buffer and erythrocytes. Results obtained are compared with those from equilibrium dialysis or ultrafiltration techniques for amitriptyline, imipramine, quinidine, lidocaine, and propranolol. For each drug, the mean value of fu obtained with the erythrocyte partitioning procedure was not found to be significantly different from that determined by one of the two other classical techniques. The erythrocyte partitioning method lead to reproducible (mean C.V. = 6.25) and precise values of fu when compared to the other methods; its clinical application to lidocaine gave results which agreed with those obtained by equilibrium dialysis. PMID- 6487756 TI - Proceedings of the Fifth International Congress of Biorheology. Part II. Baden Baden, F. R. Germany, 20-24 August 1983. PMID- 6487757 TI - Towards a unified model of elasto-thixotropy of biofluids. AB - Biofluids as concentrated suspensions exibit (at fixed shear rate gamma) a steady shear viscosity eta which critically depends on (i) the volume fraction of particles phi, and (ii) the ability the particles have to form more or less loose structural units (flocs, aggregates or parts of network). The latter can be quantified by some effective packing volume fraction phi p which reflects the actual compacity of structural units. A special eta-phi relationships which involves such a packing fraction will be discussed. Changes of structural units as shear rate gamma (or shear stress sigma) varies lead to phi p = phi p (gamma) i.e. to non-newtonian viscosity. This shear-thinning behaviour is believed to result from some dynamical equilibrium between formation and destruction of structural units, in the presence of both brownian motions of particles and the shear stresses the suspending fluid exerts on them. A (simple) rate equation (from reaction kinetics) gives a quantitative description of phi p-dependences in gamma and time t. Under steady conditions, the present approach is capable not only to model shear-thinning behaviour but also plastic and shear thickening (dilatant) ones. Time variations under transient shear rate (i.e. thixotropy) can be described with phi p(t) deduced from the same rate equation. Extension to visco-elastic behaviour has been obtained using a Maxwell-model with instantaneous values of viscosity and elasticity which both are functionals of the structural variable phi p(t, gamma). PMID- 6487755 TI - Plasma theophylline concentrations in healthy volunteers after multiple dosing of two sustained-release preparations taken after food. PMID- 6487758 TI - Kinetorheological aspects of biorheology. AB - The relationship between stress and strain is the rheological equation of state. In the case of sophisticated systems such as biological tissue, this is rarely a simple relationship. The relationship is seen to be even more complex when it is recalled that in most living tissues, the tissue is not in chemical equilibrium, but is at best in some controlled steady state. At worst, it is undergoing major fluctuations or transitions because the chemical reactions or fluxes are altering the system. It is shown, in particular, that in addition to the changes in composition, the effective rheological relaxation times of the system are shortened due to contributions deriving from the reaction rate constants. These and other points are illustrated by considering a process of irreversible monomolecular degradation of a large macromolecular species. PMID- 6487759 TI - Hemorheological approach to oxygen transport between blood and tissue. AB - A mathematical model is developed to elucidate micro-hemorheological factors of the oxygen transport between blood and tissue. A two-fluids model is introduced for capillary blood flow, including the non-equilibrium and relative motion between red blood cell (RBC) and plasma. A capillary-tissue unit is devised to describe the oxygen supply to tissue from a couple of capillaries with symmetric antiparallel input and output. Non-equilibrium flows are examined numerically on the basis of the model for various geometrical and dynamical parameters such capillary hematocrit, RBC velocity and flux. It is found that both RBC flux and capillary hematocrit have important influences on the oxygen transfer to tissue. Especially under low capillary hematocrit flow, the lowest oxygen pressure within tissue may appear at the maximal diffusional distance from the capillary between arterial and venous side. PMID- 6487760 TI - Aggregation and disaggregation of red blood cells. AB - The aggregation of red blood cells may be analyzed as an interaction of an adhesive surface energy and the elastic stored energy which results from deformation of the cell. The adhesive surface energy is the work required to separate a unit adhered area and is the resultant of adhesive forces due to the bridging molecules that bind the cells together and the electrostatic repulsion due to surface charge. The elastic strain energy in the case of the red blood is associated with the membrane elasticity only since the interior of the cell is liquid. The membrane elasticity is due both to bending stiffness and shear. The area expansion is small and may be neglected. These assumptions allow realistic computation of red cell shapes in rouleaux. The disaggregation of rouleaux requires an external force which must overcome the adhesive energy and also supply additional elastic energy of deformation. Depending on the geometry, the initial effect of elastic energy may tend to aid disaggregation. In a shear flow, the stresses on a suspended rouleau alternately tend to compress and to disaggregate the cells if they are free to rotate. This introduces a time dependence so that viscous effects due to the viscosity of the cell membrane, the cell cytoplasm and the external fluid may play a role in determining whether disaggregation proceeds to completion or not. PMID- 6487761 TI - Electrostatic fixed charge distribution in the RBC-glycocalyx and their influence upon the total free interaction energy. AB - On the basis of a recently developed biophysical model of cell-cell interaction, including electrostatic, electrodynamic, steric and bonding/bridging interaction energies the influence of different fixed charge (dissociated groups of the glycocalyx) density distributions in red blood cell (RBC) glycocalyces on the total free interaction energy was investigated. An analytical equation of electrostatic free energy on the basis of the linear Poisson-Boltzmann approach taking into account arbitrary distributions of fixed glycocalyx charges was obtained and corresponding free electrostatic energies of three example distributions were calculated. The electrodynamic, steric and bonding/bridging energies were computed as usual. It was shown that the free energy as a function of interaction distances strongly depends on the charge distribution and, correspondingly, the "weight" of this energy term in the total free interaction energy balance equation. Generally, it can be stated that as more charges are assumed to be fixed in the outer layer of RBC glycocalyx as more important becomes the electrostatic energy in contrast to the remaining three terms. PMID- 6487762 TI - Vasoactive drugs and tumor blood flow. AB - Different observations on the reactivity of tumor vessels to vasoactive drugs have suggested a decreased, a similar or an increased reactivity to vasoactive stimuli in the vascular bed of tumors as compared to normal tissues. No adrenergic innervation of newly developed tumor vessels has been found, while preexisting normal vessels incorporated during tumor growth may retain some innervation. In transplantable rat tumors, contractile cells, including smooth muscle cells, have been seen in tumor vessels. From recent experimental studies, it was concluded that the tumor's vascular bed is probably in a state of maximal dilatation and therefore sensitive to vasoconstriction, but less sensitive to pharmacological dilatation. These observations may correspond to regional tumor hypoxia and progressive development of tumor necrosis during tumor growth. The results of experimental tumor studies might question the reliability of diagnostic and therapeutic procedures in clinical oncology, which are based on differences in the reactivity to vasoactive drugs between normal and malignant tissues. PMID- 6487763 TI - Capillary blood flow in the amelanotic melanoma of the hamster after isovolemic hemodilution. AB - In malignant tumors, spontaneous arteriolar vasomotion disappeared already during earliest tumor growth (tumor weight less than 200 mg) suggesting that arterioles supplying a malignant tumor with blood are maximally dilated from the very beginning of tumor growth. As a result, the viscosity of blood becomes a limiting factor of tissue perfusion. To evaluate the effects of isovolemic hemodilution in a malignant tumor, a transparent chamber model was used in conjunction with a subcutaneously growing amelanotic melanoma of the hamster. Quantitative intravital microscopy (video image analysis) and a platinum multiwire electrode were utilized to study the tumor microcirculation. Isovolemic hemodilution was performed by exchange of blood vs. Dextran 60 to lower the systemic hematocrit to 30% in 21 animals. Capillary flow increased significantly and improved tissue pO2 on the tumor's surface without any change in capillary density. Since tumor growth was accelerated after hemodilution, these data suggest to combine with hemodilution other treatment modalities to improve blood-mediated tumor therapy. PMID- 6487764 TI - Hemodilution in isolated tumor perfusion. AB - Experiments are performed to study the influence of local hemodilution on tumor blood flow, oxygen availability in tumor tissue and O2 consumption of cancer cells. The results obtained clearly show that hemodilution in isolated tumor perfusion can distinctly improve nutritive blood flow through solid tumors. This can be utilized to enhance pharmacokinetics of antitumor drugs. Due to the improved metabolic status, the pharmacodynamics of some antitumor drugs should also be enhanced. To achieve a maximum improvement of the O2 supply to the tumor, hematocrit values should not be decreased below 0.20. PMID- 6487765 TI - Effect of hyperthermia on tumor blood flow. AB - Differences in blood perfusion rates between tumors and normal tissue can be utilized to selectively heat many solid tumors. Blood flow in normal tissues is considerably increased at temperatures commonly applied during localized hyperthermia. In contrast, tumor blood flow may respond to localized heat typically in two different blood flow patterns: Flow may either decrease continuously with increasing exposure time and/or temperature or flow may exhibit a transient increase followed by a decline. A decrease in blood flow at high thermal doses can be observed in most of the tumors, whereas an increase in flow at low thermal doses seems to occur less frequently. The inhibition of blood flow at high thermal doses may lead to physiological changes in the microenvironment of the cancer cells that increase the cell killing effect of hyperthermia. Flow increases at low thermal doses can enhance the efficiency of other treatment modalities, such as irradiation or the administration of antiproliferate drugs. PMID- 6487766 TI - The effect of rate of heating or cooling prior to heating on tumor and normal tissue microcirculatory blood flow. AB - Single vessel responses to hyperthermia were studied in tumor and normal tissues using a transparent access window chamber. Rates of heating less than or equal to .68 degrees C/minute preserved relatively better vascular function in normal than tumor tissue. A rate of heating of 1.0 degrees C/minute lowered normal tissue statis temperatures so they were no different from tumor. Cooling to 30 degrees C prior to heating slowed normal arteriolar flows to less than 5% of 38 degrees C controls. Heating resulted in increased flow in those vessels, but maximum flows never exceeded 5% of flows achieved in similar vessels which were not cooled first. The implications of this work are that rate of heating and cooling prior to heating can alter normal tissue vascular response to heat in a way that could prove deleterious to maintaining efficient vascular function in that tissue relative to tumor. PMID- 6487767 TI - Atherogenesis: hemodynamics, vascular geometry, and the endothelium. AB - The evidence for a hemodynamic involvement and possible mechanisms by which hemodynamic-related events could influence the arterial wall, and in particular the vascular endothelium, are reviewed and used to speculate on the role of fluid mechanics in atherogenesis and specifically in lesion localization. The evidence presented suggests that it is vascular geometry, and the way it influences the local detailed flow properties, which is the primary determinant of a hemodynamic effect on the arterial wall and in the initiation of atherosclerosis. PMID- 6487768 TI - Pulsatile flow of non-Newtonian fluid in distensible models of human arteries. AB - In addition to biochemical factors, hydromechanical influences are responsible for atherogenesis and deposits of blood platelets at bends and bifurcations of human arteries. Hence the flow patterns were simulated in a true-to-scale three dimensional bifurcation of a human renal artery model and of an arterial femoralis with Newtonian and non-Newtonian blood like fluid. Investigations were made with steady and pulsatile flow. The velocity profiles (at physiological Re numbers) were measured after the bifurcations with a laser-Doppler-anemometer. In previous works Newtonian fluids were used to investigate the flow in bends and bifurcations of rigid and elastic simplified models. In this paper, emphasis is placed on the difference between rigid and elastic models and also Newtonian and non Newtonian flow behavior. Differences between Newtonian and non Newtonian fluids may especially be expected to occur after branches where the flow has local strong convective elements such as in reverse zones and flow separation points. PMID- 6487770 TI - Structure of blood flow through a curved vessel with an aneurysm. AB - A fine structure of blood flow through a curved vessel with an aneurysm was studied in in vitro experiments in relation to rheological factors of arterial diseases such as arteriosclerosis or thrombosis. On the basis of the in vivo data related to cerebral circulation, red blood cell suspension was flowed through curved vessel models with an asymmetrical aneurysm. Flow visualization was made with a microscope 16 mm cinecamera-TV monitor system, and the velocity profile was measured using the laser Doppler velocimeter. Vortices induced in aneurysm influenced flow structure and velocity at the presence of the secondary flow due to the vessel curvature. This suggests strongly that blood flow in curved arteries with an aneurysm must be understood under the influence of the secondary flow. PMID- 6487769 TI - Role of blood cell-wall interactions in thrombogenesis and atherogenesis: a microrheological study. AB - The relationship between blood flow and the localization of thrombosis and atherosclerosis in vivo was investigated using the approach and techniques of microrheology. The flow patterns and wall-adhesion of platelets were studied in the captive annular vortex formed at a sudden tubular expansion at various hematocrits in steady and pulsatile flow. The adhesion density exhibited a peak within the vortex and just downstream of the reattachment point, which is also a stagnation point. The peaks flattened out with increasing Reynolds number in steady flow and also in pulsatile flow. Platelet adhesion increased markedly with increasing hematocrit. The localization of adhesion peaks was explained by curvature of the streamlines carrying platelets to the wall on either side of the reattachment point. The relevance of these results to the circulation is that stagnation points are found in regions of disturbed flow at various sites in the arterial and venous circulations. This was shown in experiments using a technique whereby flow was visualized in isolated transparent natural blood vessels prepared from dogs and humans postmortem. In dog saphenous vein bileaflet valves, there was a large primary spiral vortex as well as a smaller secondary vortex, the latter acting as a trap and generator of thrombi. Recirculation zones also existed in the dog aorta at T-junctions of the celiac, cranial mesenteric and renal arteries. Finally, in the human carotid bifurcation, a large standing recirculation zone consisting of spiral secondary flows formed in the carotid sinus at physiological flow conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6487771 TI - Orientation of endothelial cells in shear fields in vitro. AB - Vascular endothelial cells subjected to fluid shear stress change their shape from polygonal to ellipsoidal and become uniformly oriented with the flow. In order to study the mechanisms of this response, we have measured the relaxation of bovine aortic endothelial cells that were grown on glass coverslips and exposed to fluid shear stress for 72 hours. An image analysis system was developed to quantify the cell shape relaxation that occurs following the cessation of shear stress. This method provides two different quantitative measures of relaxation: the loss of elongated shape by the cells and the change in cell direction with time. After equilibration to a fluid shear stress level of 8 dynes/cm2, cells immersed in static medium relax their shape in about 20 hours. After 72 hours in this static condition, the cell elongation is comparable to that of unstressed control cells but vestiges remain of the original orientation in the flow direction. This relaxation process contributes to our understanding of the response of vascular endothelium to fluid shear stress. PMID- 6487772 TI - Effects of arterial pressure on endothelial transport of macromolecules. AB - The effects of variations in transmural pressure over a range of 0 to 200 mmHg on transendothelial transport of macromolecules were studied in the canine common carotid artery. The uptake of 125I-albumin per unit artery weight increased with rising pressure. There was no significant difference in albumin permeability per unit luminal surface area between 0 and 100 mmHg, but permeability nearly doubled when pressure was raised to 200 mmHg. The contribution of an increased rate of transendothelial vesicle diffusion, as evaluated from the experimental determination of the ratio of attached-to-free vesicles and theoretical modeling, was found to be negligible. The reduction in transendothelial vesicle diffusion distance due to pressure-induced thinning of the peripheral zone contributes to a 25% increase in permeability. With the use of colloidal Ag and Au of various sizes, vesicle loading of particles with diameters greater than or equal to 15 nm was found to be severely restricted at transmural pressure less than or equal to 100 mmHg, but it was significantly enhanced at 200 mmHg, when particles as large as 25 nm became detectable in endothelial vesicles and subendothelial space. This hypertension-induced increase in macromolecular transport across the endothelium may cause an overloading of the arterial wall with low-density lipoproteins and play a significant role in atherogenesis. PMID- 6487773 TI - The possible role of intimal convective transport in atherogenesis. AB - The possibility of fluid flux within the thickened subendothelial intima is considered. Both the media and the endothelium were already shown to be major hydraulic barriers. It is hypothesized that if the hydraulic conductivity of the inbetween layer of the subendothelial intima is considerably higher, then fluid flux in the downstream (axial) direction is likely to occur within the intima as a result of the luminal blood pressure wave. Macromolecular species (as lipoproteins) would then be transported axially by the fluid. This convective transport may give rise to the formation of early atheromas. The proposed mechanism is in accord with several clinical and experimental observations. PMID- 6487774 TI - Model experiments on platelet adhesion in stagnation point flow. AB - Experiments with glass models of arterial branchings and bends, perfused with bovine platelet rich plasma (PRP), revealed platelet deposition being strongly dependent on fluid dynamic factors. Predilection sites of platelet deposits are characterized by flow vectors directed against the wall, so-called stagnation point flow. Thus collision of suspended particles with the wall, an absolute prerequisite for adhesion of platelets to surfaces even as thrombogenic as glass, appears mediated by convective forces. The extent of platelet deposition is correlated to the magnitude of flow components normal to the surface as well as to the state of biological activation of the platelets. The latter could be effective by an increase in hydrodynamically effective volume, invariably associated with the platelet shape change reaction to biochemical stimulants like ADP. The effect of altered rheological properties of platelets upon their deposition and of mechanical properties of surfaces was examined in a stagnation point flow chamber. Roughnesses in the order of 5 microns, probably by creating local flow disturbances, significantly enhance platelet adhesion, as compared to a smooth surface of identical chemical composition. PMID- 6487775 TI - [Adrenergic mechanisms regulating the motor reactions of rats in the early postnatal period]. AB - In 12-day-old rats, L-DOPA, a precursor of catecholamine synthesis, provokes an increase in the rate of the motor reactions (MR) of the shudder type. Reserpine which promotes catecholamine release from the tissues, leads to the diminution of the rate of the MR of the shudder type in rats of the same age. Aminazine, an alpha-adrenoblocker and antagonist of dopamine receptors, decreases the rate of the MR of the shudder type. Administration of aminazine in a dose of 10 mg/kg at different age periods produces inconclusive changes in the diminution of the rate of the MR of the shudder type. During sudden changes in the growth, the rate of the above-described modulations substantially decreases. The high rate of the MR of the shudder type seen in rats in the early postnatal period is a consequence of the marked activity of the catecholaminergic (dopaminergic) systems during that period. Reduction in the effect of the decreased MR rate produced by the same dose of aminazine during the critical periods of the growth also attests to the high activity of the catecholaminergic (dopaminergic) system in rats at that period. PMID- 6487776 TI - [Antidiuretic hormone content in the neurohypophysis of adult white rats after hydrocortisone administration in the early postnatal period]. AB - The age-related time-course of changes in arginine-vasopressin (AVP) content in the pituitary gland was studied in adult intact Wistar rats. In 60-day-old rats, the hormone content was measured before and after 24 h of water deprivation. In adult rats treated with a single injection of hydrocortisone at different times after birth, the content of AVP remained high in rats injected with hydrocortisone on day 2 or day 5 after birth, exceeding significantly the content of AVP in intact rats. The animals injected with hydrocortisone on day 9 or 15 manifested a more noticeable reduction in the hormone content, as was the case in intact rats. It is suggested that the first five days after birth is a critical period in the formation of the central regulation of AVP secretion with high sensitivity to short-term changes in corticosteroid balance. PMID- 6487777 TI - [Compensation of anisocoria in cats following transection of the optic tract: the role of subcortical commissures]. AB - Experiments were carried out on cats with unilateral optic tract transection and cerebral commissures. The data obtained indicate that destruction of the afferent part of the pupillary reflex by optic transection led to reversible anisocoria. In cats with combined transection of the optic tract and teleencephalic, diencephalic and mesencephalic commissures, such a rehabilitation did not occur. In contrast, section of telencephalic commissures alone was immaterial for the processes of compensation of papillary system function. The data obtained attest to an important role of subcortical commissures in compensation of anisocoria after destruction of the afferent arc of the papillary reflex to light. PMID- 6487778 TI - [Changes in the activity of antioxidant enzymes in ischemia and subsequent reperfusion of the myocardium]. AB - Transitory coronary failure of the myocardium was accompanied by a considerable reduction in the activity of superoxide dismutase, glutathione peroxidase and glutathione transferase, with the activity of the enzymes under study being not different in the ischemized and distant from ischemia zones of the myocardium. Reperfusion did influence the activity of superoxide dismutase and glutathione peroxidase after 10 and 40 minutes of ischemia, whereas following 120 minutes of ischemia the activity of superoxide dismutase ascended after 10 and 40 minutes of reperfusion while the activity of glutathione peroxidase remained unchanged. PMID- 6487779 TI - [Interrelation of cardiodynamics and pulmonary gas exchange in an experimental model of the acute respiratory failure syndrome]. AB - Experiments were made on 30 dogs with lung contusion or injury to the chest wall. Eighteen animals demonstrated acute progressive arterial hypoxemia which proved to be fatal. Apart from the symptoms pointing to the development of gas exchange abnormalities, one could observe progressive impairment of myocardial function. A close correlation was established between pulmonary gas exchange and myocardial contractility. Myocardial dysfunction is regarded as one of the leading components in the pathogenesis of acute respiratory insufficiency in chest injury. PMID- 6487780 TI - [Effect of posttraumatic fluctuations in the oxygen tension value in the arterial blood on the intensity of lipid peroxidation in the lungs, liver and myocardium of rats with a lung contusion]. AB - It has been demonstrated in rat experiments that accumulation of lipid peroxidation products in the lungs, liver and myocardium in the early posttraumatic period of pulmonary contusion (the first week after trauma) is observed during the recovery of oxygen tension is the arterial blood (PaO2) rather than during the period of the appearance of arterial hypoxemia. In the lungs, accumulation of malonic dialdehyde (MDA) occurred together with PaO2 recovery in the myocardium and liver, MDA was recorded to accumulate in the initial period of PaO2 recovery, whereupon the MDA content in the myocardium dropped to the MDA content in the myocardium of intact rats, while that in the liver returned to normal only partially. PMID- 6487781 TI - [Dynamics of the activity of the postural asymmetry factor after unilateral damage to the motor area of the cortex]. AB - The authors studied the time-course of functional rearrangements of the segmental apparatus after unilateral injury of the rat motor cortex. It was found that one day after injury the postural asymmetry of the hind limbs was fixed by the lumbal region of the spinal cord. This functional state of the segmental apparatus lasted 10 days after injury in the presence of the maximal activity of postural asymmetry factor (PAF) in the CSF and increasing activity of the factor in the brain tissue. Recovery of the segmental apparatus to symmetrical function by the end of the third week following injury was accompanied by PAF inactivation. PMID- 6487782 TI - [High adrenaline sensitivity of the mitochondrial processes in the mucosa of the small intestine in rats]. AB - Higher adrenalin sensitivity of mitochondrial processes in the small intestinal mucosa compared to that in liver mitochondria, was revealed under specially devised conditions of work with isolated mitochondria retaining their natural properties. Fifteen minutes after intraperitoneal injection of adrenalin into rats in a dose of 5 micrograms/100 bw an increase in Ca2+ capacity was seen only in intestinal mucosa mitochondria. The adrenalin-induced activation of oxidative phosphorylation was more remarkable in intestinal than in liver mitochondria at the initial stages of adrenalin action. The effect of adrenalin was completely reversed by the beta-blocker propranolol only in liver mitochondria. After 3 hours the adrenalin-induced activation of phosphorylation in the mitochondria ceases, whereas in the small intestinal mucosa it still persists. PMID- 6487783 TI - [Phospholipids of the subcellular fractions of brain and liver tissues in rats in total oxygen starvation of the body]. AB - The rate of phospholipid turnover in brain subcellular fractions differ from that in the liver tissue. Hypoxia of medium severity (pressure chamber 240 mm Hg) influences neither the content nor the turnover rate of phospholipids in liver subcellular fractions. Meanwhile in brain subcellular fractions, it results in a decreased phospholipid turnover rate. Severe hypoxia (less than 200 mm Hg) leads only to the suppression of the phospholipid turnover rate in the liver, whereas in the brain, it results in the decline of the phospholipid turnover rate as well as in the reduction of phospholipid content. Thus, the well-known concept of the higher brain sensitivity to oxygen deficiency as compared to the liver is exemplified by phospholipid turnover in subcellular fractions. PMID- 6487784 TI - [Effect of antigenic stimulation and fasting on liver lysosomes in rats]. AB - Study of the interrelationship between immune responsiveness of the body and structural and functional status of the rat liver lysosomal apparatus under different alimentary conditions allowed one to establish that immune response during antigenic stimulation and complete fasting was considerably reduced. At the same time a dramatic rise in the total and non-sedimentable activities of some lysosomal hydrolases was recorded under the above conditions. The data obtained suggest that during acute malnutrition and antigenic stimulation, the rate of antibody synthesis is considerably decreased whereas activation of the lysosomal apparatus affected by both factors plays a compensatory role and is directed toward the most complete realization of the protective function of lysosomes. PMID- 6487785 TI - [Hydroxylation products of hydrophobic xenobiotics--stabilizers of cytochrome P 450 in the hepatocytes]. AB - The effects of the hydroxylation product 3,4-benzo(a)pyrene and the free radical scavenger 1,2,3-trioxybenzene on cytochrome P-450 degradation in isolated rat hepatocytes induced by the Fe2+-ADP + NADPH system activating lipid peroxidation (LPO) were investigated. During incubation of hepatocytes, cytochrome P-450 is destroyed due to accumulation of LPO products. Addition of the free radical scavenger 1,2,3-trioxybenzene and the monoxygenase substrate 3,4-benzo(a)pyrene to the incubation medium induces inhibition of LPO and simultaneous stabilization of cytochrome P-450. Deceleration of malonic dialdehyde production by the free radical scavenger of the monoxygenase substrate suggests that both the compounds stabilize cytochrome P-450. It is assumed that in liver hepatocytes, exogenous free radical scavengers of the phenolic type and the products of their decarboxylation protect cytochrome P-450 against the LPO-induced destruction via oxidative metabolism of hydrophobic substrates. PMID- 6487786 TI - [Trace effects of short-term temperature action in monoamine oxidase activity]. AB - The influence of short-term hypothermia and hyperthermia on the activity and catalytic properties of rat brain MAO was studied. It was found that short-term action of low and high environmental temperatures had considerable trace effects which differed in direction and duration. MAO activity increased after hypothermia and was maintained at a high level during 4 days. The lowering of serotonin deamination after hyperthermia was observed for 7 days. PMID- 6487787 TI - [Regulation of the excisional repair system in in vitro-cultured human cells by measles viruses depending on their attenuation]. AB - The effect of measles viruses (attenuated strain L-16 and virulent strain Edmonston) was studied in human cells (line L-41) according to the criteria of repair: excision of thymine dimers, repair replication of DNA and resynthesis of DNA breaks induced by UV-irradiation. Reproduction of attenuated measles virus in cells was accompanied with stimulation of excision of thymine dimers and repair replication of DNA in contradistinction to mild virus. This phenomenon depended on multiplicity of infection. PMID- 6487788 TI - [Effect of 1,2:5,6-dianhydrogalactitol and 1,2:5,6-dianhydro-3,4 diacetylgalactitol on DNA synthesis in the cells of melanoma B16, bone marrow, small intestine epithelium, spleen and liver of mice]. AB - Alterations in DNA synthesis induced by 1,2:5,6-dianhydrogalactitol (DAG) and 1,2:5,6-dianhydro-3,4-diacetyldianhydrocalactitol (Diac-DAG) were studied in host normal cells and tumor cells. After administration of these antitumor drugs to melanoma B16-bearing mice, DNA synthesis in host tissues (bone marrow, gastrointestinal mucosa, spleen, liver) got recovered more rapidly than DNA synthesis in melanoma B16. Diac-DAG differed from DAG from the standpoint of damage to DNA synthesis in normal cells. Only DAG inhibited the DNA synthesis in liver cells. Inhibition of DNA synthesis in the bone marrow and spleen with Diac DAG was less remarkable than with DAG. PMID- 6487789 TI - [Effect of tropane on the cholinoreceptors of the cerebral cortex]. AB - Spontaneous electric activity of single neurons of the sensorimotor cortex was recorded extracellularly in experiments on unanesthetized rabbits. During microiontophoretic application of tropane and acetylcholine to the neurons, the response to both the agents was the same. The cells excitable by acetylcholine are also excitable by tropane, while those inhibited by acetylcholine are also inhibited by tropane. The cells that do not respond to acetylcholine are also irresponsive to tropane. The excitatory response pattern to tropane is similar to that of acetylcholine. Under the same conditions of microiontophoretic application, tropane causes less excitation as compared with acetylcholine. Tropane preliminarily applied to the neuron reduces the excitatory effect of acetylcholine. The possible role of agonist-antagonist relations between tropane and acetylcholine in the mechanism of the pharmacological effects of tropane and its derivatives is discussed. PMID- 6487790 TI - [Mechanism of action of the stem-cell inhibition factor on the formation of exogenous hemopoietic colonies in the spleen of mice]. AB - It was established by previous works that thymocytes treated with antilymphocyte serum secrete soluble factor capable of inhibiting exogenous colony formation in the spleen of lethally irradiated mice injected with bone marrow cells treated with the stem cell inhibition factor (SCIF). The purpose of the present investigation was to explore possible mechanisms of SCIF action. Regeneration of erythropoiesis (measured by 59Fe incorporation) in the spleen and bone marrow of mice injected with SCIF-treated bone marrow cells was inhibited as compared with control, while CFUs started proliferating with a 3-day delay. Two hours after SCIF treatment 60% of CFUs entered S phase as judged by hydroxyurea cell kill. The CFUs fraction treated with the SCIF was found to be diminished 3-4-fold as compared with control. The data obtained suggest that SCIF treatment makes CFUs enter 3 phase, which may account for the reduced capacity of CFUs to populate the spleen and to proliferate with a 3-day delay. PMID- 6487791 TI - [Relationship of spontaneous chromosome instability and sister chromatid exchanges in Fanconi's anemia]. AB - The frequency of spontaneous instability of lymphocyte chromosomes of the first 2 mitoses, the rate of sister chromatid exchanges (SCEs), and the proliferative kinetics of lymphocytes were studied in a 6-year-old girl with Fanconi's anemia (FA) and in 4 healthy donors. The frequencies of aberrant cells and the total number of chromosome breaks in the FA patient decreased with cell transition from the first to the second mitosis. The FA lymphocytes had a slower proliferative kinetics and the level of SCEs was higher as compared with control. The probability of chromatid deletions at the sites of SCEs localization and in the dark and light stained chromatids was unequal. 33.8% of chromatid breaks were associated with SCEs. The data point to the relationship between SCEs and spontaneous chromosome instability in AF cells. PMID- 6487792 TI - [Lipid peroxidation in experimental allergic encephalomyelitis]. AB - Lipid peroxidation (LPO) in the brain and blood of guinea-pigs was studied during experimental allergic encephalomyelitis. The most pronounced activation of LPO in the brain occurred at the 7th day of sensitization with encephalolitogenic emulsion. It manifested by an increase in the content of diene conjugates and malonic dialdehyde, activation of catalase and reduction of superoxide dismutase activity. LPO activation in the blood occurred at the 3th-5th day of sensitization. It is assumed that LPO activation is caused by antigen-antibody reaction that occurs in the blood at the 3d day and in the brain at the 7th day of sensitization. PMID- 6487793 TI - [Capacity of intact and regenerating liver to trap CFUs]. AB - The normal and regenerating mouse liver is capable of trapping transplanted bone marrow CFUs, with this capability being increased in the regenerating liver. Inactivation of macrophages (Kupffer cells) by silica particles sharply reduces this ability, thus pointing to direct or indirect involvement of macrophages into the trapping of exogenous CFUs. PMID- 6487794 TI - [Circadian rhythms of the sex steroids of female Papio hamadryas in long-term hypokinesia]. AB - Radioimmunoassay was used to study the effect of restricted motor activity on circadian rhythms of blood plasma sexual steroids and cortisol in female Papio hamadryas during different phases of the menstrual cycle. Instact animals manifested clear-cut circadian rhythms of the testosterone and cortisol content during both the phases and those of estradiol and progesterone during the follicular phase of the cycle. Two-week immobilization did not produce any changes in the general pattern of circadian rhythms of cortisol and testosterone but led to a decrease in their mean daily concentrations, with that decrease being more pronounced for testosterone of females immobilized during the luteal phase. The authors established unbalance of sexual steroids with a dramatic fall of the mean daily concentrations of estradiol and progesterone and desynchronism of their circadian rhythms regardless of the cycle phase at the moment of immobilization. The mechanisms responsible for alterations in circadian rhythms of sexual steroids in hypokinetic females are discussed. PMID- 6487795 TI - [Structural changes in the testis in complete removal of the pancreas and its resection]. AB - The dog pancreas was resected completely or partially. The morphofunctional status of the testicle was examined at varying times after operation with the use of histological, histochemical and morphometric tests. The alterations discovered attest to the dependence of the structural shifts in the testicle on the type of surgery on the pancreas. Resection of the end parts caused temporary and insignificant changes in the testis. Resection of the central part with ligation and intersection of the main excretory ducts gave rise to dystrophic changes in the spermatogenic epithelium, disorders in the structural elements responsible for hormonal activity. Complete resection of the pancreas was early in affecting the morphofunctional status of the testicle. Ten to 15 days after operation profound dystrophic and atrophic changes were detectable in all the cells of the testicle. Injection of insulin postponed the animal's death, decelerated but not prevented the development of regressive changes in the testis. PMID- 6487796 TI - [Thermoregulation characteristics of rats exposed to cold in the early postnatal period]. AB - Cold adaptation of adult rats (at 4-5 degrees C for 7 weeks) increased their ability to respond to noradrenaline by the rise of body temperature and heat radiation, led to an almost 2-fold increase in the relative brown fat mass (BFM). Adult rats which experienced "cold imprinting" (from the first to the seventh day after birth, 15 min at 4-5 degrees C) showed a far less increment of the BFM on cold adaptation, no additional rise of body temperature and heat radiation in response to noradrenaline. In cold-imprinted rats, the relative surface of the tail and the body surface heat radiation transfer conefficient were found to be reduced. This attests to stable adaptive changes in physical thermoregulation, directed toward increase in animals' heat insulation. PMID- 6487797 TI - [Thrombocyte adhesion and aggregation on surfaces coated with human type-I, -III, -IV and -V collagens]. AB - Human collagens of type I, III, IV, and V (CI, CIII, CIV, and CV) can be localized in different anatomic structures of the vessel wall. To investigate the role of vascular collagenous components in mural thrombus formation, the authors studied platelet adhesion to the wells of Falcon culture plates coated with: a) monomeric CI, CIII, CIV, and CV; b) fibrillar CI and CIII, and c) amorphous CIV and CV. On monomeric and amorphous CV, only initial attachment takes place, i.e. platelets bind to the surface without subsequent spreading. Platelet adhesion on monomeric and amorphous CIV proceeds more actively: the total level of adhesion is substantially higher than on CV, with up to 75% of adherent platelets spread out and single unspread platelets from suspension attached to the upper surface of spread platelets. On monomeric and fibrillar CI/CIII, formation of large multi layer (thrombi-like) aggregates, with spread platelets at the basis, takes place along with processes characteristic for adhesion on CIV/CV. On the contrary, only fibrillar but not monomeric CI and CIII induce platelet aggregation in suspension. The data suggest that the ability of CI and CIII to induce platelet aggregation is fully conditioned by the genetic type of collagen and requires a simultaneous multivalent platelet-collagen interaction, which can be achieved by surface immobilization of collagen or formation of fibrillar structures in suspension. PMID- 6487798 TI - [Changes in the protein mass and ploidy level of the myocytes in the mouse heart]. AB - Neonatal mice were grown until 3 weeks of age at a rate of four or sixteen per litter (groups I and II, respectively). The group I animals were characterized by accelerated growth. At day 21 of postnatal development their body and heart weights were three times greater than those of the group II animals. The mean protein content in cardiomyocytes of the group I animals increased faster, correlating with the increase of the heart weight. The fast-growing mice showed an increase in the number of polyploid cardiomyocytes (polynucleate cells mainly), amounting to 15-16% as compared with 2-4% seen in normal and slow growing animals. PMID- 6487799 TI - [Changes in the morphometric indices of the microvascular bed of the brain in experimental hypertension]. AB - Brain stem microvessels up to 15 microns in diameter of spontaneously hypertensive rats and rats with experimental renal hypertension were investigated in histological sections with the aid of a texture analysis system. Hypertensive animals showed a reduction in the vascular diameter per unit volume of cerebral tissue, in the mean vascular diameter as well as in the area occupied by the vessels, thus attesting to the lessened density of brain vascularization. The proportion of the vessels measuring from 6 to 15 microns in diameter per unit volume of cerebral tissue decreased whereas the proportion of the vessels measuring up to 5 microns in diameter remained unchanged. The characteristics under study demonstrated the same line of changes in both spontaneous and experimental renal hypertension. PMID- 6487800 TI - [Microvascular changes in the lungs of rats with bronchiolo-alveolar fibrosis caused by the intrabronchial administration of trypsin]. AB - Rats were injected intrabronchially with trypsin solution. During the first 3 days, the animals developed acute desquamative alveolitis and at the second week bronchioloalveolar fibrosis. As for the capillaries of the alveolar walls, some of the capillary loops manifested obliteration, whereas other ones ectasia to the alveolar lumen. Deposition of immunoglobulins in the walls of pulmonary vessels was not revealed. PMID- 6487801 TI - [Use of a colorimetric method employing rhodamine 6G for determining the free fatty acid content in biological membranes]. AB - An improved modification of the Anderson-Chakrabarty method for demonstration of free fatty acids in the membranes of enterocytes, erythrocytes and mitochondrial fractions is described. The method includes the use of rhodamine 6G as a stain. PMID- 6487802 TI - [Purification of a special estrogen-binding protein from the liver of rats by affinity chromatography on estradiol sepharose]. AB - A procedure has been developed for purification of a special rat liver estrogen binding protein. It includes protein precipitation by ammonium sulfate, gel filtration, ion exchange chromatography, and affinity chromatography on estradiol sepharose. The protein is purified 2260-fold with a 27% yield. Upon electrophoresis in 10% PAG in the presence of sodium dodecylsulfate the protein gives one polypeptide strip with a molecular weight of 31.200 +/- 400 dalton. PMID- 6487803 TI - A variant of erythrocyte membrane skeletal protein band 4.1 associated with hereditary elliptocytosis. AB - A family comprising three patients (a mother and two children) with mild hereditary elliptocytosis was studied. Each patient had prominent elliptocytosis, reduced red cell deformability, and normal erythrocyte thermal sensitivity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of the erythrocyte membranes in each patient showed decreased levels of band 4.1 (approximately half of the normal value) and the presence of an additional band migrating below protein band 4.2. This additional band was shown to derive from protein 4.1. Comparative partial proteolytic mapping of protein 4.1 and the additional band revealed a number of common peptides. Enzyme-linked immunoelectrotransfer blots of the patients' erythrocyte membranes using a monoclonal antibody to protein 4.1 revealed that, in addition to protein 4.1, two other bands below protein 4.2 were stained; one of these bands migrated in the same position as the additional band detected in the Coomassie Blue-stained gels. Immunoblotting of the patients' whole cells using the antibody to protein 4.1 revealed that this altered band 4.1 occurred as such in the intact red cell. SDS PAGE of protein 4.1 purified from one patient showed the presence of two lower molecular weight bands below protein 4.1; the lower band migrated in the same position as the additional band found on SDS-PAGE of the patients' erythrocyte membranes. The patient's purified protein 4.1 displayed a decrease of about 40% in the binding activity with crude spectrin extracted from normal controls. Spectrin-spectrin interactions were normal in the three patients. The additional band present in the patients' red cell membranes probably represents a proteolytic degradation product. This alteration, present both in whole cells and isolated membranes, might affect the intact cells in vivo. We suggest that the patients' erythrocyte membrane instability may be related to the presence of an abnormal protein 4.1 whose modulatory influence on the spectrin-actin interaction in the skeleton is defective. PMID- 6487804 TI - Passive material behavior of granulocytes based on large deformation and recovery after deformation tests. AB - In order to better understand the in vivo rheologic behavior of white cells, we have studied the time-dependent deformability, recovery, and mechanical activation of blood granulocytes. We have used micropipette aspiration methods to measure the large deformation response and recovery after deformation characteristics of neutrophils as functions of time, temperature, and collecting media. The cell response in the pipette experiment was characterized by three time domains: the first phase was the passive deformation response to the fixed suction pressure; the second phase was an obvious transition from the passive to active motile cellular state where the cell exhibited erratic length changes in the pipette; and the third phase was the steady recovery after the suction pressure had been zeroed. Tests on white cells were carried out with three different anticoagulants to evaluate the effect of calcium on deformation and recovery behavior; also, cells were separated by centrifugation in high molecular weight dextran to determine whether or not collection and separation procedures affected the cell properties. Our results have shown that the passive deformation of granulocytes into the pipette was a continuous flow process with no approach to a static deformation limit. In addition, there was an obvious threshold pressure below which the cell would not deform and enter the micropipette. For suction pressures significantly above the threshold, granulocytes were continuously deformed with a similar functional dependence on time. The coefficient of proportionality between aspiration length and time, as well as the exponent, depended on suction pressure, pipette dimension, and temperature. It was observed that the granulocytes always recovered to the spherical state after deformation, independent of the extent of deformation or location where the cell was aspirated. Based on the recovery behavior, plus the dependence of the pressure threshold on pipette size, we propose the concept that the granulocyte membrane and cortical shell behave like a "contractile surface carpet" under tension, where the cell interior responds passively like a highly viscous liquid. The membrane cortex appears to be subject to a persistent stress (tension) of about 10(-2) dyne/cm. Our observations of passive to active transition in the pipette suction experiment indicated that granulocytes may be stimulated by deformation at room temperature. This study represents the first detailed investigation of the large deformation behavior of granulocytes, and the results indicate a simple structural model to represent the passive rheologic behavior of the granulocyte. PMID- 6487805 TI - Busulfan-induced chronic bone marrow failure: changes in cortical bone, marrow stromal cells, and adherent cell colonies. AB - This study represented an effort to determine if there were quantitative or morphological changes in marrow stromal cells in busulfan-induced marrow failure and to relate these changes to other disturbances in blood and bone marrow. Mice received four busulfan (BU) injections at two-week intervals and were killed at various time points up to 40 weeks after the first injection. Evaluation techniques included complete blood counts, in vitro assay of short-term adherent cell colonies per femur (STACC per femur) and colony-forming unit-culture (CFU-C) per femur, light microscopy of sternebral marrow and spleen, and electron microscopy (EM) of sternebral marrow taken at 40 weeks. STACC per femur were acutely reduced to 25% of control, but recovered to 76% by 40 weeks. CFU-C per femur dropped to below 10% of control and never recovered. Histologically, we found that hypoplasia of acutely affected marrow was associated with heightened endosteum and cortical bone thickening. In the chronic phase of BU injury, bones became osteoporotic, and the frequency of adipocytes and mast cells rose. BU affected spleens generally had enhanced erythropoiesis. No stromal cell changes in 40-week marrow were discernible by EM. We concluded that there were morphological changes in BU marrow stroma specifically involving endosteum, bone, adipocytes, and mast cells. Also, there was quantitative depression in stromal cells measured by the STACC assay, but this improved substantially with time, unlike damage to hematopoietic stem cells measured by the CFU-C. PMID- 6487806 TI - Neutrophils mediate lipid peroxidation in human red cells. AB - Activated neutrophils (ANs) are known to release reactive oxygen species that may cause oxidative damage to surrounding tissues. We determined if ANs could induce lipid peroxidation (LP) in human red cells and investigated the mechanism involved in this interaction. We studied neonatal glucose-6-phosphate dehydrogenase (G6PD) deficient, and sickle red cells, since each of these are known to be susceptible to oxidant injury. Neutrophils were isolated from whole blood and activated by incubation with opsonized zymosan. Mixtures of such neutrophils and red cells at a ratio of 1:100 were incubated for two hours at 37 degrees C, after which the malonyldialdehyde content in red cells was measured as an index of LP. All red cells underwent LP after AN treatment, and the degree of LP was proportional to the amount of AN in the mixture. Superoxide dismutase and catalase partially inhibited LP. When compared to normal red cells, only sickle cells demonstrated a significant increase in AN-mediated LP. Conversion of hemoglobin to carboxy-hemoglobin increased AN-mediated LP, whereas conversion to met-hemoglobin decreased AN-mediated LP. The protective effect of met-hemoglobin on LP was less in sickle cells than in normal cells. We conclude that AN can induce LP in red cells in vitro and that sickle cells are more susceptible to this process than normal cells. Hemoglobin can serve as an electron trap and protect the cell against peroxidative damage, but this mechanism is impaired in sickle cells. We speculate that the pathogenesis of hemolysis associated with infectious disease may include AN-induced red cell LP. PMID- 6487807 TI - Two-cycle timed-sequential chemotherapy for adult acute nonlymphocytic leukemia. AB - Based on a series of clinical and laboratory studies of leukemia cell kinetics and responses to chemotherapy, we have developed an intensive timed-sequential regimen of daunorubicin and high-dose infusion 1-beta-D-arabinofuranosyl cytosine for the treatment of adult acute nonlymphocytic leukemia. Of the first 34 patients achieving complete remission (CR) with a single cycle of this therapy, four (12%) remain in complete remission without further therapy after a minimum of five years of follow-up. Treatment of relapsed patients with a second course of the same regimen at relapse and no chemotherapy in second remission increased to seven (21%) the number of patients expected to remain in remission for four years or more from their last chemotherapy. Beginning in 1980, however, we gave all consenting adults a second cycle of this chemotherapy in early first remission. Of the first 25 patients treated with a second cycle of this chemotherapy in early first remission, there was one toxic death, but 11 patients (44%) remain in CR with a median follow-up of almost three years. PMID- 6487808 TI - A reassessment of the energy requirements for neutrophil migration: adenosine triphosphate depletion enhances chemotaxis. AB - In view of previous studies demonstrating a significant correlation between adenosine triphosphate (ATP) depletion and impairment of chemotaxis (CTX) during granulocyte (PMN) storage, we sought to quantitate the relationship between CTX and PMN energy metabolism. We incubated PMNs at 37 degrees C with 2-deoxyglucose (2-dg) in the presence of 5 mmol/L glucose. As expected, ATP inhibition by 2-dg was time-dependent (T 1/2, 18 minutes) and dose-dependent, with half-maximal inhibition of ATP (ID50) with 1.3 +/- .3 mmol/L 2-dg. Similar concentrations of 2 dg inhibited lactate generation, phagocytosis, superoxide anion generation, and degranulation. The random migration of PMNs was inhibited by somewhat higher concentrations of 2-dg (ID50, 12 mmol/L). In contrast, up to 40 mmol/L 2-dg did not inhibit CTX toward synthetic peptides or activated serum. In fact, 2-dg consistently increased the CTX of PMNs toward 10(-8) mol/L f-Met-Leu-Phe (fMLP), to a maximum of 450% of control CTX using 15 mmol/L 2-dg. Half-maximal stimulation (ED50) of CTX occurred at 6.3 +/- 1.0 mmol/L 2-dg. Although maximal CTX toward optimal concentrations of fMLP was consistently increased with 2-dg, the ED50 of CTX to fMLP was unchanged (ED50 with glucose, 2.0 +/- 0.6 nmol/L fMLP; ED50 with 2-dg 2.2 +/- 0.7 nmol/L fMLP), and 2-dg did not increase fMLP receptors. In the absence of glucose, 2-dg exerted similar effects on ATP and CTX, but at doses 30- to 50-fold lower than in the presence of glucose. Other glycolytic inhibitors (iodoacetamide and sodium fluoride) exerted similar effects. Additional studies indicated that CTX enhancement by 2-dg (a) required Mg++ but not Ca++, (b) occurred with PMNs from a patient with chronic granulomatous disease, (c) was unaltered in the presence of inhibitors of proteolysis, (d) was not due to generation of a soluble agent, (e) was not due to alterations in PMN adherence, and (f) was not due to inhibition of glycosylation. We conclude that the chemotaxis, but not the random migration, of PMNs is surprisingly resistant to inhibition of energy metabolism and depletion of ATP, since concentrations of 2-dg that decreased ATP and other cell functions by more than 50% not only did not inhibit, but actually stimulated, CTX. These studies also indicate that the previously reported correlation between ATP depletion and CTX impairment observed in stored PMNs are not causally related. PMID- 6487809 TI - Cell movement analysis in a necrotactic assay. AB - The methods of statistical physics have been applied to analysis of cell movement. Human leukocytes (granulocytes) were observed using time-lapse photography. The paths of the migrating cells were determined. The chemokinetic response at 35 degrees C is described by the diffusion constant (D = 233 micron2/min) and the track velocity (25 micron/min). A time-dependent chemotactic gradient is created by killing an erythrocyte by an intense laser flash. The chemotactic response at 35 degrees C is described by the degree of polar orientation (P1 = 0.85), the track velocity 24 micron/min, and the drift velocity towards the necrotactic source (v parallel = 20 micron/min). The track velocity as well the drift velocity show a broad distribution. The half-width of the velocity distribution. The half-width of the velocity distribution is approximately 5 micron/min. Cell movement can be described by elementary moving states. The characteristic time of the internal clock of the migrating cell is approximately 0.5 min. We found that the information transfer from the necrotactic gradient to the migrating cell is 1 bit per change in directed movement. A migrating cell cannot be stimulated within a period of approximately 10 s after the last decision to adapt a new moving direction. PMID- 6487810 TI - Physical bases for defining terms used to describe cell movement phenomena. PMID- 6487812 TI - Morphologic aspects of the leading lamella in locomotive normal and neoplastic blood cells. A study by scanning electron microscopy (SEM). AB - A leading lamella is part of every translocative cell, irrespective of nature and origin. The morphological aspect of this cytoplasmic extension, however, varies and, among the different cell types, locomotive blood cells show the greatest diversity with regard to position, size and shape. In this communication, SE micrographs of benign and malignant blood cells of different classes are presented. The dynamic interpretation attempted for the description of the static photographs is based on analyses of time-lapse films which show the activities of the live cells. PMID- 6487811 TI - A visual technique for the study of the pharmacological modification of polymorphonuclear chemotaxis. AB - The authors have shown the advantages of the necrotactic assay for the study of polymorphonuclear chemotactic responsiveness: observation of cellular behaviour during all the experiments, observation of a true chemotaxis and constant measure of cellular speed. Some examples of pharmacological treatment of the cells demonstrated the use of this technique for the study of modification of neutrophil chemotaxis by drugs. PMID- 6487813 TI - Impaired neutrophil locomotion associated with hyperadhesiveness in a patient with Chediak-Higashi syndrome. AB - Neutrophils from a patient with Chediak-Higashi (CH) syndrome exhibited defective directional locomotion in a gradient of activated plasma. Further analysis of the nature of this defect showed that CH neutrophils could respond normally to stimulation with f-Met-Leu-Phe, by increasing both their motility and polarization, provided the cells were kept in suspension. Contact with the substratum resulted in the loss of both motility and polarity in the majority of cells. CH neutrophils, in contrast to normal cells, did not respond chemokinetically to f-Met-Leu-Phe. Unstimulated random locomotion of CH neutrophils was also depressed, and this correlated with increased spreading on the substratum. Our results indicate that motility, locomotion and polarisation of CH neutrophils on the substratum are depressed because of excessive adhesion. PMID- 6487814 TI - Comparison of locomotion, chemotaxis and adhesiveness of rabbit neutrophils from blood and peritoneal exudates. AB - We compared the spontaneous behaviour (motility, adhesiveness, locomotion) and the chemotactic responses of exudate and blood-borne neutrophils. Directional locomotion of exudate neutrophils in 2% HSA-Gey's towards exudate fluid was not significantly changed, the response to activated autologous plasma diminished, and that to f-Met-Leu-Phe (10(-9) M) increased in comparison with blood-borne cells. The spontaneous behaviour of exudate cells in 2% HSA-Gey's (no gradient) differed markedly from that of blood-borne cells. In tissue culture medium (2% HSA-Gey's) exudate cells showed heightened motility in suspension and greater adhesiveness to glass substrata. These differences were eliminated by culturing the cells in their physiological media (i.e. plasma or exudate fluid). In contrast to blood-borne cells, exudate neutrophils tended to aggregate spontaneously. There was no correlation between neutrophil aggregation and adhesion to glass substrata of exudate cells in exudate fluid. PMID- 6487815 TI - Facts and speculation about necrotaxis (chemotaxis toward a dying cell). AB - The name "necrotaxis" has been given to a special type of chemotaxis in which granulocytes and monocytes are attracted to cells in the process of dying. Microirradiation devices (conventional UV and laser) have been used to destroy a target cell. Immediately, leukocytes (neutrophils and monocytes) can be seen to advance towards the damaged cell and to engulf it. Hemoglobin and albumin coagulated in the microbeam are equally necrotactic. The presence of plasma does not seem necessary, as the phenomenon also occurs in a saline environment. The neutrophil nucleus is not necessary for necrotaxis, anucleated cytoplasmic fragments are capable of directionality, rosette formation around the dead cell and phagocytosis. Three specific points are briefly discussed: -- the nature of necrotactic substances -- the recognition mechanism of damaged cells and molecules -- the eventual role of necrotaxis in vivo. PMID- 6487816 TI - Analysis of cell movement. AB - The methods of statistical physics have been applied to the analysis of cell movement. Human leukocytes (granulocytes) were observed using time-lapse photography. The center of gravity of a cell, variations of cell shape, and cell orientation were investigated. This analytical description leads to a better understanding of cell movement. Stationary motion of a cell is described by the anisotropy of the cell shape. The cell displacement can be characterized by three different types of movement: The persistent mode where the cell moves away from an arbitrary chosen origin with its track velocity. The diffusion mode where the cells become dispersed in space by a random walk process. The drift mode where the cell moves with a drift velocity, v parallel, in a concentration gradient of chemoattractant molecules. The chemokinetic response is described by the diffusion constant D (= 240 microns2/min) and the track velocity vc (= 30 microns/min). The chemotactic response is described by the degree of orientation P1 (= 0.8), which is identical with the McCutcheon index and the chemotropism index. Cell movement can be described by elementary moving states, and the life time of such a moving state is 0.5 min. The survival probability of the moving state is determined by an internal program. It is not described by a stochastic process. The angular change in moving direction is also programmed, as the square root of the mean square angular change is +/- 50 degrees. The plus and minus direction are equally probable in a chemokinetic response. However, in a chemotactic assay the plus and minus directions are not equally probably. We found that the information transfer from the chemotactic gradient to the migrating cell is 1 bit per change in moving direction. A disturbance in this information transfer leads to an order-disorder transition. Furthermore, we found that the migrating cell exhibits a directional memory of 75 s. PMID- 6487817 TI - Echo 9 virus-induced order-disorder transition of chemotactic response of human polymorphonuclear leucocytes: phenomenology and molecular biology. AB - By means of functional, morphological, and biophysical methods the in vitro interaction of Echo virus, type 9, strain A. Barty with human polymorphonuclear leucocytes (PMNs) was investigated and analyzed by statistical methods. Control cells and virus-treated PMNs (15 min, 37 degrees C; PMN: virus (pfu)-ratio ranging from 1:1 to 1:50) were exposed to a chemotactic gradient (N formylmethionyl-leucylphenylalanine = f-Met-Leu-Phe, 10(-8) M/mm) in a Zigmond chamber. Whereas the track velocity of the moving PMNs was not affected by the virus, the degree of orientation of virus-treated PMNs declined in a way dependent on the viral dose and on the time of PMN:virus interaction, resulting in a shift from chemotactic to chemokinetic response. This virus-induced order disorder transition of chemotactic response can be described by a logarithmic law in analogy to the Weber-Fechner law. Parallel to the functional disturbances, virus-induced changes of cell shape, which could be confirmed by additional light and electron microscopy techniques, were also detected using statistical analysis of cytological data (median cell size, anisotropy of cell shape) by means of two dimensional histograms. To investigate f-Met-Leu-Phe- or/and Echo 9 virus-induced PMN-cell membrane changes, the monomer-excimer technique with pyrenedecanoic acid as fluorescent probe was applied, which gives information about structural changes of the cell membrane. Addition of the chemotactic peptide (10(-8) M) to control PMNs resulted in a higher rate of excimer formation obviously due to the formation of new functional (receptor) units (= activated cell membrane). Echo 9 virus exhibited an opposite effect. Quantitative analysis of these results revealed that the f-Met-Leu-Phe-induced cell membrane changes were extinguished by the addition of 2 pfu Echo 9 virus. So far, we have additional indicators of a virus-induced order-disorder transition of chemotactic response of human PMNs on a molecular biological level. PMID- 6487819 TI - Causes of iron deficiency anemia in an adult inpatient population. Effect of diagnostic workup on etiologic distribution. AB - The causes of iron deficiency anemia in a population of adults admitted to two Jerusalem hospitals within a period of 7 years were examined. About one half of the 262 patients with iron deficiency anemia were over 70 years old. The ratio of males to females exclusive of young females with menorrhagia was 1:1.8. Despite the combined use of various diagnostic procedures, no definite cause of iron deficiency anemia could be established in 34% of patients. Benign gastrointestinal lesions were found in about one half of the cases in both hospitals. The prevalence of GI neoplasms in hospital B with a more intensive use of endoscopic procedures was significantly higher than in hospital A (18% vs 5%, p less than 0.001). The relative usefulness of barium contrast vs endoscopic studies is illustrated by the fact that 22 diagnoses established by endoscopy were missed by barium studies, whereas only 2 of those established by barium studies were not visualized by endoscopy. A particularly high risk group were anemic males aged 50 to 69 years in whom the prevalence of GI neoplasms was 30%. These data indicate that reliance on traditional contrast radioscopy may result in misdiagnosis of a high proportion of gastrointestinal neoplasms. PMID- 6487818 TI - Studies on Mv red cells. II. Immunochemical investigations. AB - The properties of the Mv antigen, a low incidence receptor of the MNSs blood group system, were investigated by serological tests with protease treated red cells and inhibition assays with glycoproteins or peptides from normal and Mv erythrocytes. Our data demonstrate that the Mv receptor represents an allelomorphic form of the 'N' antigen on the Ss sialoglycoprotein, rather than variant of the M receptor on the MN sialoglycoprotein. Anti-Mv plus -N (serum Arm.) reacts with the N, 'N' and Mv antigens, whereas anti-Mv (serum Arch.) is specifically directed against the latter receptor. PMID- 6487820 TI - Binding of lectins to human mammary tumors: ultrastructural study. AB - The site of several lectin receptors in human mammary tumors and stroma was studied with the electron microscope. The advantage of the ultrastructural over light microscopic study was that lectin receptors could be localized with precision on the different cell types of the tumor and stroma. Eighteen human mammary carcinomas were incubated with three peroxidase-labeled lectins: peanut agglutinin (PNA), Helix pomatia, and Ulex europaeus I (UEA). These lectins reacted in a selective way; some tumors were negative and others showed reaction in some areas of the tumor and/or the stroma. No correlation was found, however, between the presence of these lectin receptors on the tumor cells and either hormone receptors or histological type of the tumors. These results show that the value of the presence of lectin receptors in human mammary tumors as markers for evaluation of mammary lesions is more complex than thought up to now. The most relevant observations on the stroma cells and inflammatory infiltrates were: (A) Some lymphocytes were positive with PNA, probably representing sessile T cells. In two carcinomas, abundant plasma cells were present in the infiltrates, always with PNA receptors. (B) In all mammary tumors where blood vessels were present in the sections, these were always stained with UEA. This supports the use of UEA as a marker for human endothelial cells even in pathologically altered tissues. PMID- 6487822 TI - Stimulation by neonatal treatment with vitamin A of spontaneous mammary tumor development in GRS/A mice. AB - Daily subcutaneous injections of 100 micrograms (290.4 IU) vitamin A for the first 5 days of postnatal life to highly inbred GRS/A female mice resulted in a substantial increase in the incidence of both pregnancy-dependent and autonomous mammary tumors. The incidences of pregnancy-dependent mammary tumors in the experimental and control mice were 35.7% and 8.7% (p less than 0.05) in the first litter and 89.3% and 65.2% in the second litter, respectively, whereas neonatal treatments had no effects on reproduction. The incidence of autonomous mammary tumors was significantly higher in the experimental mice than in the control after 9 months of age. All experimental mice developed autonomous mammary tumors by 13 months of age, at which time the incidence in the control group was 57.9%. A significant stimulation by neonatal vitamin A treatment of murine mammary tumorigenesis has not heretofore been reported. PMID- 6487821 TI - Fluorescent ligands, used in histocytochemistry, do not discriminate between estrogen receptor-positive and receptor-negative human tumor cell lines. AB - A cell line containing estrogen receptors (MCF-7) and a cell line lacking estrogen receptors (PC-93) were used for a comparison of biochemical and histochemical procedures to detect estrogen receptors. We evaluated three different fluorescent estrogen derivatives: 17 beta-estradiol-6 carboxymethyloxime-bovine serum albumin-fluorescein isothiocyanate, 17 beta estradiol-17-hemisuccinate-fluoresceinamine, and coumestrol. The main results were: The relative binding affinities of these ligands for the estrogen receptor were between 0.1 and 2% of the affinity of estradiol. Fluorescent staining of the cells showed no relation to the presence of estrogen receptors. Staining was not suppressed with excess estradiol-17 beta, which is known to prevent binding of low affinity ligands to estrogen receptors. Cells with intact membranes were not stained after treatment with the albumin-linked estrogen derivative; only cells with damaged cell membranes were stained. Treatment of cells with 17 beta estradiol-17-hemisuccinate-fluoresceinamine resulted in a fluorescent labeling of the cytoplasm in intact and artificially damaged cells. Coumestrol caused only fluorescence of the cytoplasm in intact cells. It is concluded that estrogen receptors cannot be detected with these low affinity ligands. Fluorescence of these cells is probably due to binding of the ligands to low affinity binding sites. The presence of these low affinity binding sites appears not to be related to the presence or absence of estrogen receptors and can therefore not be used to discriminate between estrogen receptor-positive and receptor-negative tumor cells. PMID- 6487823 TI - Thymidine kinase as a predictor of response to chemotherapy in advanced breast cancer. AB - Cytosols from breast cancers were measured for estrogen receptor (ER) and thymidine kinase (TK) activity. There was no correlation between ER and TK in 137 primary breast cancers studied. The results of TK from 57 metastatic breast cancers were correlated with the response or failure to subsequent hormonal therapy or chemotherapy. TK did not predict the responses to hormonal therapy in 12 patients. Of the 45 patients treated with chemotherapies, 13 of 15 tumors with TK over 80 pmol/mg/min responded (86%), while only 4 of the 30 tumors (13%) with TK below 80 pmol/mg/min responded (p less than 0.001). TK appears to be useful in predicting the responses to chemotherapy. PMID- 6487824 TI - Comparison of muscle and fat wasting in patients suffering from breast and other cancers: an anthropometric study. AB - An anthropometric study was undertaken to determine muscle and fat areas in 50 cancer patients and 258 control patients suffering from minor conditions, to assess the degree of cachexia in patients with breast cancer, and in patients with other types of cancer. Patients suffering from cancers other than those of the breast showed muscle and fat wasting when compared with matched standard values and when the muscle and fat area measurements were expressed as a percentage of the appropriate mean standard value. Breast cancer patients showed increased muscle and fat area values, irrespective of whether they were in remission, or had progressive disease. This is interesting in view of the strong association between dietary fat intake and breast cancer incidence, and correlates well with present ideas on nutrition and the incidence of breast cancer. PMID- 6487826 TI - [Medullary cancers of the thyroid]. PMID- 6487825 TI - Increasing incidence and constant mortality rates of breast cancer: time trends in Stockholm County 1961-1973. AB - This study describes trends in breast cancer incidence and survival in Stockholm County during 1961-1973. A discrepancy between increasing incidence and constant mortality rates was reflected in a significantly improved survival of the more recently treated patients. However, no change in survival was found when the patients were classified by axillary node status. The improvement thus seemed entirely the result of a more favorable stage distribution. The shift towards less advanced tumors was mainly caused by an increased age-standardized incidence of node-negative tumors, whereas the incidence of more advanced tumors seemed relatively unchanged. The survival from first distant metastasis was significantly increased; the use of combination chemotherapy might have contributed to this. The increase, however, was only moderate and did not seem to have contributed much to the improved overall survival. It is concluded that several confounding factors must be recognized when time trends in breast cancer are analyzed. A straightforward interpretation of observed changes is therefore not always possible. An increasing detection of tumors with relatively benign biological properties or lead time bias may well contribute to seemingly improved results. PMID- 6487827 TI - [Medullary thyroid cancers. Prognostic factors of nonassociated sporadic forms. Therapeutic implications]. PMID- 6487828 TI - [Surgical treatment of medullary thyroid cancer]. PMID- 6487829 TI - [Role of radiotherapy in the treatment of medullary cancer of the thyroid]. AB - Medullary thyroid carcinoma (MTC) is a rare tumor for which the main treatment is surgery. However, external radiation therapy (RT) plays an important part in well defined patients. Out of the 115 patients with MTC treated at the Institute Gustave Roussy: Thirty-five MTC patients with residual cervical disease and without distant metastases had their thyroid region irradiated (60Co, 45 to 50 Gy in 5 weeks). The overall survival of these patients is similar to that of patients with limited cervical extension (n = 57) treated by surgery alone. The results of this study show the effectiveness of cervico-mediastinal irradiation treatment for MTC with extensive local tumor after incomplete surgery. Eight MTCs with inoperable cervical tumor were treated only by external RT. Median survival was 44 months. In six of them, long-term local control was observed: three are alive at 52, 62 and 70 months and 3 died from distant metastases at 36, 36, and 117 months after treatment. Sixteen MTCs with distant metastases were treated with RT on bone metastases (n = 10) or compressive lymph node metastases (n = 6) with good palliative effect. This study shows the efficacy of post-operative external RT in MTCs with extensive cervical tumors, as a curative treatment in non-surgically eradicable cervical tumors and as a palliative treatment for metastatic localisations. The technique of cervico-mediastinal RT is discussed. PMID- 6487830 TI - [Importance of the determination of serum thyroglobulin in the preoperative diagnosis of cold thyroid nodules]. PMID- 6487831 TI - Renal papillary necrosis in equines. PMID- 6487832 TI - Mercury content of head hair from residents on the coast of Jakarta Bay. PMID- 6487833 TI - Antidotes and neuropathic potential of isofenphos. PMID- 6487834 TI - Brominated phenol production from the chlorination of wastewater containing bromide ions. PMID- 6487835 TI - Multivariate statistical analyses of 96-hour sediment bioassay and chemistry data. PMID- 6487836 TI - Toxicity of the herbicides endothall and diquat to benthic crustacea. PMID- 6487837 TI - Influence of five phenylurea herbicides on the diatom Hantzschia in a sandy loam soil. PMID- 6487838 TI - Influence of anionic surface-active agents on the uptake of heavy metals by water hyacinth (Eichhornia crassipes). PMID- 6487839 TI - Effects of Puget Sound sediments and their elutriates on the life cycle of Capitella capitata. PMID- 6487840 TI - Differential response of marine organisms to certain metal and agrichemical pollutants. PMID- 6487841 TI - Distribution of fenitrothion residues in brook trout (Salvelinus fontinalis) and lake trout (Salvelinus namaycush) tissues following aerial applications to Lac Ste-Anne, Quebec. PMID- 6487842 TI - Sampling efficiency of five solid sorbents for trapping airborne pesticides. PMID- 6487843 TI - Parathion effects on reproductive characteristics and vital organ weights of female cottontail rabbits (Sylvilagus floridanus). PMID- 6487844 TI - Organochlorine residues in three heron species as related to diet and age. PMID- 6487846 TI - Comparison of live and video presentation of a speechreading test with children. AB - This paper compares the speechreading scores given by a group of normally hearing children aged 9 years using live and video presentation of the Manchester Speechreading (Lipreading) Test. Twenty children (10 boys and 10 girls) took part in the investigation. The same speaker was involved in the two modes of presentation which were given at a distance of 6 feet in the same room and against the same background. To simulate normal classroom and clinic situations the live mode was presented by uttering test stimuli without giving acoustic clues. Although there was a preference for the live mode, there was no significant difference between the scores obtained. The scores of the boys and girls are compared and discussed. A test re-rest involving 5 boys and 5 girls from the original sample substantially corroborated the original finding with high correlations for word and sentence tests. Consistency of presentation and reliability of the test were also supported by high correlations. These findings are discussed in the light of possible standardisation of test material. PMID- 6487845 TI - Nest defense behavior and reproductive success of laughing gulls sublethally dosed with parathion. PMID- 6487847 TI - Some aspects of the auditory nerve responses evoked by tone bursts. AB - Short latency (10 ms post-stimulus-time) auditory evoked potentials are a useful tool for assessing the hearing integrity at different frequency bands, especially if frequency-specific stimuli, like tone bursts, are used. However, a proper interpretation of the evoked potentials should rely upon the understanding of the single auditory nerve units activity patterns and their relations with the gross potentials, under the same stimulating conditions. In this paper, the basic properties of the burst evoked PST histograms of single units are explained with the aid of a model for the cochlear events. The relationships between single units activity and the gross potentials are then analysed on this ground, in particular for what concerns the Action Potential input-output latency curve, the off-response rising at the burst offset and the growth of N2. PMID- 6487848 TI - Speech, admittance and tone tests in school screening. Reconciling economics with pathology and disability perspectives. AB - In theory a criterion can be set on any test score to 'pass' or 'fail' a desired percentage of any population; but in practice, particular measures used in screening can have both intrinsically appropriate criteria and zones of great uncertainty in relation to the condition being screened. For example, the criteria for possible abnormality on oto-admittance measures in single-test screening for middle ear disease are intrinsically rather too sensitive, as potentially pathological signs are displayed by a high proportion of the population. In contrast, criteria on pure tone measures are intrinsically insensitive. One solution to such dilemmas and to other deficiencies of screening lies in a two-test approach. In two investigations we have examined these accepted screening tests in relation to a proposal to introduce also a disability measure as a means of broadening the information available from school screening systems and reducing over-referral from oto-admittance screening. A minimal-pair monosyllable 2-alternative forced-choice speech-in-noise test with a picture pointing identification response was developed and refined. The results obtained usefully complement existing screening methods and we examine ways of combining them with either pure tone threshold of oto-admittance measures. A sequential set of criteria for passing, referral or continuation of testing allows the test to be applied in short form for those children failing a pre-screen at a stringent level. In this way a reduction of approximately 10% of the total screened sample is obtained in the number of children needing referral or re-testing; the total testing time need not increase substantially; and more precise disability information is obtained on the marginal cases, where it is needed. Multiple regression enables a severity index (on the same scale as the widely appreciated pure-tone threshold scale) to be derived from speech and oto-admittance measures jointly. An adequate basis of referral for medical assessment and treatment of pathology would still require admittance methods at some stage, whatever the drawbacks may be in their sole use as a screen. The two-test sequential approach reconciles the pathology perspective and the disability perspective. PMID- 6487850 TI - Detecting hearing-impairment in neonates--the statistical decision criterion for the Auditory Response Cradle. AB - The Auditory Response Cradle (ARC) has great potential for detecting severe hearing impairments in neonates. This article reviews the ARC's statistical decision algorithm and presents data that show its present efficiency is below the proposed criterion (Bennett and Wade, 1980) in a high proportion of cases. Two alternative decision rules are proposed for use in screening neonates with the ARC. The first uses a test of fixed length and the second uses a statistically more controlled method based on the sequential probability ratio test of Wald. PMID- 6487849 TI - Effects of high-pass filtering on the detection of the auditory brainstem response. AB - The effects of high-pass filtering on the slow components of the click-evoked auditory brainstem response (ABR) have been assessed in eight normally hearing adults. Eight high-pass Butterworth-type filters (36 dB/octave) were investigated with cut-off frequencies at 10, 20, 30, 40, 50, 60, 80 and 100 Hz (-3 dB points). The low-pass filter was kept constant at 1 kHz. A 20 dB nHL stimulus was presented to the subjects at a rate of 26/s. Two averaged ABR waveforms, each consisting of 2048 individual sweeps, were recorded for each filter setting with a post-stimulus sweep time of 19.2 ms. In the visual interpretation of the recordings the correlation between each waveform, and the amplitude of the response relative to the noise, strongly affects the decision as to whether a response is present. A mathematical analysis of these parameters, using a scanning correlation window technique, showed that a 20 Hz filter is optimum for the best detection of the ABR close to hearing threshold. PMID- 6487851 TI - Use and non-use of hearing aids. AB - A hundred and fifty hearing-handicapped were interviewed at home two years after their hearing aids had been fitted. The aim was to find out how many of the delivered aids were in use, and if not, why. A remarkable percentage of the hearing aids were very seldom, if ever, in use (23%), 57% of them were used regularly every day and 19% of the hearing-handicapped used their aids occasionally. The hearing aids were less used if the hearing loss was mild or sensorineural. Behind-the-ear aids were used more regularly than the body-worn aids. The time needed for learning to handle the aid did not affect the amount of use. Very often, despite being satisfied with the instruction, the non-users were not skilled in handling the aid. They also often complained about having little opportunity to converse with others; however, no difference in the amount of social contacts could be shown between the users and non-users. On the basis of the results of this study the policy of our hearing-aid fitting has been revised. PMID- 6487852 TI - Speech discrimination in bilateral and unilateral hearing loss due to Meniere's disease. AB - A comparison of the speech audiograms of patients with bilateral and unilateral hearing loss due to Meniere's disease has shown that when matched in respect of pure-tone hearing levels, speech discrimination at the better ear of the former is appreciably better than that at the impaired ear of the latter. In addition, while roll-over is a characteristic feature of the unilateral group it is conspicuously absent in the bilateral group. More surprisingly, in the bilateral group, despite relatively small differences in the pure-tone hearing levels at the two ears, speech discrimination at the better ear is strikingly superior to that at the poorer ear. It is concluded that patients with bilateral hearing loss selectively make use of the better ear to the neglect of the poorer ear. This could have important implications in the prescription of binaural hearing aids. PMID- 6487853 TI - Vancomycin ototoxicity in patients with normal renal function. AB - Three patients with normal renal function developed ototoxicity during vancomycin therapy. This is an uncommon occurrence and the literature is reviewed. Assumptions on "safe' levels of vancomycin are questioned. PMID- 6487854 TI - The development and evaluation of a structured learning format introduction to behaviour therapy for psychiatric nurses. AB - A five-day in-service course in behaviour therapy for psychiatric nurses is described. The course utilized a structured learning format and systematized the progression from classroom to ward by introducing supervised single-case studies, although these were carried out by only a minority of trainees. This paper describes the comprehensive evaluation of a large-scale training programme, incorporating a control group design and 10 'outcome' measures. The evidence obtained from these measures indicated that the structured learning was effective in promoting knowledge and skills with behavioural techniques in the experimental group nurses (n = 41). There were no significant improvements in the scores obtained by the matched control group of nurses (n = 18). These results were maintained at a one-year follow-up assessment and indicated that psychiatric nurses can acquire and maintain behavioural techniques, and that they can apply them successfully with their long-stay patients. However, the proportion of nurses actually conducting the single-case study 'projects' was low. The implications of this are discussed in terms of the 'setting events' for projects in the ward. PMID- 6487855 TI - A classroom rating scale for use with mentally retarded children. AB - A behaviour rating scale intended primarily for use with mentally retarded children is described that is based on the behavioural descriptions of such children given by Pevsner (1963). A factor analysis showed that these descriptions could be viewed as being representable by two independent factors. The first of these factors, the AD factor may be seen to relate to attention/distractibility aspects of behaviour and shows a reliable correlation with verbal age and verbal quotient as assessed by the English Picture Vocabulary Test (EPVT), such that low EPVT scores predict greater distractibility. The second factor, the inhibition/excitation (IE) factor, did not correlate significantly with verbal age or verbal quotient but has, in other studies, shown relationships with style of social interaction and may be interpreted as relating to aspects of temperament. It is concluded that individual differences in the classroom behaviour of mentally retarded children may not be qualitatively different from those in non-retarded children and that the scale described is a useful instrument for measuring these individual differences. PMID- 6487856 TI - Selective memory effects in agoraphobic patients. AB - Two experiments tested the view that agoraphobic patients would show superior recall for phobic-related material relative to neutral material. In Expt 1, subjects were required to recall a series of five passages; three contained potentially phobic information and two contained neutral information. The results showed that phobic patients recalled more propositions from the phobic passages than did controls. In Expt 2, subjects completed four study-test trials with a list of 20 words: 10 phobic words and 10 neutral words. The results showed that the patients recalled more phobic than neutral words while the reverse was the case for controls. The results are discussed in terms of the cognitive organization of phobic patients and are related to Beck & Rush's proposal that phobics have a cognitive organization of situations labelled as dangerous. The possible sources of these selective memory effects are also considered. PMID- 6487857 TI - The Stress Response Rating Scale: a clinician's measure for rating the response to serious life-events. AB - The impact of a serious life-event on an individual's psychological well-being has long been appreciated, but not until recently has it become the subject of more thorough and careful research. Clinical, field, and experimental studies of the effects of potentially distressing life-events have suggested the presence of two primary modes of response: episodes of denial and numbing, oscillating with periods of intrusive thoughts, images, and pangs of emotion. Although self-report measures are available for determining the degree of distress experienced in each of these modes of response, there is no measure that can be used by a clinical observer to assess these same phenomena. We offer the Stress Response Rating Scale (SRRS) as such a measure, and present empirical data to support its reliability and validity. In addition, we present some initial normative data, a discussion of issues encountered in developing the scale, and potential difficulties that may be encountered in its use. PMID- 6487859 TI - Illusory correlations in paranoid and non-paranoid schizophrenia. AB - Paranoid schizophrenics, non-paranoid schizophrenics and normals were assessed on tasks designed to demonstrate their tendency to perceive illusory correlations. It was hypothesized that paranoids would show stronger illusory correlations than normals due to the predominance of their schemata when processing information, and that non-paranoids would show weaker correlations than normals because of their impaired ability to establish conceptual categories. Results were broadly consistent with predictions. PMID- 6487858 TI - Hyperactivity, drugs and attention deficit. AB - Thirty-two hyperactive children who were under imipramine or methylphenidate medication took part in the experiment. The children were asked to learn a set of paired associate pictures containing a salient, central, figure and a secondary figure below. Free recall of all pictures was scored both immediately and seven days later. The children were subdivided into four groups according to the classical state-dependent learning paradigm. Group 1 was withdrawn from medication on both trials, groups 2 and 3 were withdrawn from medication on the first or second trial and group 4 received medication on both trials. No drug effects were found in immediate total recall. Delayed free recall was improved when original learning was under the drug state. This result was related to the proposal that arousing words are better remembered in delayed recall. Delayed recall of the secondary stimuli was particularly improved by the drugs during learning. Drug state dependency of the children's memory was also shown. PMID- 6487860 TI - Inter-hemispheric transmission times in schizophrenics. AB - Using the subtraction method described by Bashore (1981), inter-hemispheric transfer times were calculated from the RTs of 12 schizophrenic and 12 matched hospitalized control patients to stimuli presented tachistoscopically to their left or right visual hemifields. No evidence was found for inefficient transfer of information between the hemispheres of the schizophrenics. PMID- 6487861 TI - Autonomic arousal in an antenatal clinic and its association with recall of information about pregnancy. AB - Pulse rates of 30 women attending an antenatal clinic were measured near the beginning and end of their visit. Mean pulse rate declined during the visit, and the difference was used as an index of autonomic arousal. Higher arousal was associated with poorer recall of information and advice about pregnancy. PMID- 6487862 TI - [European Research Organization on the Treatment of Cancer. Collaborative research and the Data Analysis Center]. PMID- 6487863 TI - Scales to assess the therapeutic alliance from a psychoanalytic perspective. PMID- 6487864 TI - Psychic seizures. A diagnostic challenge. PMID- 6487866 TI - Clinical notes on anorexia nervosa. A grand rounds consultation. PMID- 6487865 TI - Deanimated transitional phenomena in paranoid conditions. The "influencing machine" revisited. PMID- 6487867 TI - Pain and potential space. Toward a clinical theory of meaning. PMID- 6487868 TI - Primary health care in marginal urban areas: the Costa Rican model. PMID- 6487869 TI - Primary care and the pattern of disease in a rural area of the Argentine Chaco. PMID- 6487870 TI - Prevalence and geographic distribution of abnormal hemoglobins in the state of Sao Paulo, Brazil. PMID- 6487871 TI - The uses of modern technologies: problems and perspectives for industrialized and developing countries. PMID- 6487872 TI - Breast-feeding, weight gains, diarrhea, and malnutrition in the first year of life. PMID- 6487873 TI - A continuing focus of yellow fever in the Apurimac River Valley, Ayacucho, Peru, and the first isolation of yellow fever virus in that country. PMID- 6487874 TI - Vaccines used in the expanded program on immunization (EPI): indications and contradictions. PMID- 6487875 TI - Vascular access. How to set up a drip and keep it going. AB - No amount of helpful hints can replace experience when it comes to successful venous cannulation. Although the number of serious problems following intravenous infusions is small, we should still be critical of the standards employed. PMID- 6487876 TI - Vascular access. Haemodialysis in infants. AB - Access to the circulation in infants is a major problem because of the small size of the access sites. However, the increasing sophistication of dialysis means that more infants needing long-term access will be presenting for prolonged treatment in the future. PMID- 6487877 TI - Digital subtraction angiography in ischaemic cerebrovascular disease. AB - Digital subtraction angiography is a safe relatively noninvasive way of directly visualizing the major head and neck arteries, particularly by the venous route. It is the method of choice for investigating ischaemic cerebrovascular disease, and it may also be performed on an outpatient basis. PMID- 6487878 TI - The use and abuse of drugs in pregnancy. PMID- 6487879 TI - Anaemia in old age. AB - Because accurate diagnosis largely depends on the results of laboratory investigations, clinicians may undervalue their role in asking the right questions, in assessing the patient as a whole, and in consulting with colleagues in haematology. It is this that leads to most errors in diagnosis and treatment. PMID- 6487880 TI - Pulmonary manifestations of rheumatoid arthritis. AB - The catalogue of respiratory complications of rheumatoid arthritis has grown steadily in recent years. Physiological testing has highlighted surprisingly frequent asymptomatic disease while other respiratory problems are still rare. These and other pulmonary manifestations are discussed. PMID- 6487881 TI - Fibrescopes in urology. AB - Innovations in fibrescope design have coincided with a renewed interest in endoscopy of the upper reaches of the urinary tract. This may result in changes in the investigation and treatment of some renal diseases. PMID- 6487882 TI - Clinical aspects of hyperlipidaemia. PMID- 6487883 TI - Management of hypercalcaemia. PMID- 6487884 TI - Vulval dysplasia. PMID- 6487886 TI - Pharmacological analysis of the responsiveness of guinea-pig lung parenchymal strip to dopamine. AB - Responses to dopamine were examined in the guinea-pig isolated lung parenchymal strip. Complete cumulative concentration-response curves to dopamine exhibited a biphasic pattern with a small initial contraction at concentrations below 10(-5) M followed by a dose-dependent relaxation at higher concentrations. Phentolamine (10(-5) M) completely abolished the contractile component and enhanced sensitivity and maximal relaxation to dopamine. In the presence of phentolamine, propranolol antagonized the dopamine-induced relaxation (pA2 = 8.54 +/- 0.07). In the presence of propranolol (10(-6) M), dopamine produced a dose-related contraction displaced to the right by phentolamine. Incubation with haloperidol (10(-5) M) did not modify the characteristics of the concentration-response curve to dopamine. Pretreatment with reserpine abolished the contraction to dopamine without affecting its relaxant response. Cocaine significantly increased the pD2 value of dopamine in the presence of propranolol. It is concluded that dopamine produced both relaxation of lung parenchymal strip due to direct activation of beta-adrenoceptors and contraction mediated through direct and indirect (catecholamine release) actions at alpha-adrenoceptors. There is no evidence in favour of the existence of specific dopamine-receptors in this preparation. PMID- 6487887 TI - Evidence that ethylenediamine acts in the isolated ileum of the guinea-pig by releasing endogenous GABA. AB - Ethylenediamine (EDA) released [3H]-gamma-aminobutyric acid ([3H]-GABA) in a dose dependent manner from the isolated preloaded ileum of the guinea-pig maintained in Krebs-bicarbonate solution (pH 7.4, 37 degrees C), in the presence of beta alanine and amino-oxyacetic acid (AOAA) to prevent GABA uptake into glial cells and catabolism. This release was reversibly prevented by 3-mercaptopropionic acid (3-MPA), also in a dose-dependent manner. In the isolated ileal preparations of the guinea-pig maintained in Krebs-bicarbonate solution, EDA induced a dose dependent transient, cholinergic contractile response (GABAA-receptor-mediated effect), followed by an 'after-relaxation' (GABAB-receptor-mediated effect). EDA also induced a transient contraction superimposed on repetitive twitch responses to electrical transmural stimulation of the cholinergic neurones, followed by a depression of the twitch contractions. This GABAA-receptor-mediated contraction was antagonized by bicuculline methochloride and picrotoxinin, whilst the GABAB receptor-mediated 'after-relaxation', and depression of cholinergic twitch contractions, was susceptible to antagonism by delta-aminovaleric acid. The pA2 value for bicuculline methochloride antagonism of EDA was estimated to be 5.8, identical with that for GABA. 3-Mercaptopropionic acid also prevented these pharmacological actions induced by EDA without affecting responses to GABA, 3 aminopropranesulphonic acid, muscimol, baclofen or the twitch responses to transmural stimulation. It is concluded that EDA releases both [3H]-GABA and endogenous GABA in the guinea-pig ileum, thus providing further evidence that GABA is a transmitter in the enteric nervous system. PMID- 6487885 TI - The effect of gallamine, gallopamil and nifedipine on responses to acetylcholine and carbachol in the taenia of the guinea-pig caecum. AB - The effects of gallamine, gallopamil and nifedipine on isotonic contractions of the isolated taenia of the guinea-pig caecum produced by acetylcholine (ACh) or carbachol (CCh) were investigated. Gallamine (0.1 to 0.3 mM) inhibited contractions produced by CCh more than those produced by ACh. The difference was still present after pretreatment of the tissue with paraoxon (10 microM for 20 min) to inhibit cholinesterases or in experiments carried out in the presence of tetrodotoxin (0.3 microM) to exclude possible ganglionic stimulation by the agonists. Gallopamil or nifedipine selectively inhibited the tonic response to ACh in the absence or presence of paraoxon. The phasic response to ACh or the tonic response to CCh (0.1 or 1 microM) was much less affected. Reduction of the Ca2+ content of the bath medium reduced phasic and tonic responses to ACh more than the tonic response to CCh. These results suggest that there are differences in the interaction of ACh and CCh with muscarinic receptors in this muscle. PMID- 6487888 TI - Potassium induces relaxation and hyperpolarization of circular muscles but contraction of longitudinal muscles of pig duodenum. AB - The mechanisms by which K+ relaxes circular muscles of pig duodenum were investigated, and compared with the response of the longitudinal muscles to K+. Circular muscles were concentration-dependently relaxed by 8.3-23.6 mM K+, but contracted by 47.2-143.4 mM K+. Longitudinal muscles were contracted by 11.8-94.4 mM K+. The relaxation of circular muscles was correlated with hyperpolarization (4 mV), but evoked Ca2+ spikes were not suppressed. Neither ouabain (0.14 microM) nor phentolamine (10 microM) blocked the relaxation, but tetrodotoxin (TTX, 0.63 microM) blocked both the relaxation and hyperpolarization. Mesaconitine (0.16 microM) increased the relaxation. Inhibitory junction potentials and concomitant relaxations were also blocked by TTX. The results suggest that K+-induced relaxation is caused by the release of a non-adrenergic inhibitory transmitter. PMID- 6487889 TI - Changing surface charge with salicylate differentiates between subgroups of calcium-antagonists. AB - Sodium salicylate (5-10 mM) has been used to distinguish the effects of the three calcium-antagonist subgroups which had been previously differentiated in functional studies. Sodium salicylate (10 mM) reduced the antagonistic effects of verapamil and diltiazem on Ca2+-induced contractions of K+ (40 mM)-depolarized taenia preparations from the guinea-pig caecum. In contrast, salicylate had no effect on the potency of nifedipine and increased the inhibitory effects of cinnarizine and flunarizine. Sodium salicylate (10 mM) had little effect on Ca2+ induced contractions per se. In preparations pretreated with calcium-antagonists and recontracted with high concentrations of Ca2+, salicylate (5 mM) caused an additional contraction when the preparations had been pretreated with verapamil or diltiazem but had no effect in control or nifedipine-treated preparations. In contrast, salicylate relaxed Ca2+-induced contractions in tissues which had been pretreated with cinnarizine, flunarizine, pimozide, bepridil, fendiline, perhexiline and with the calmodulin antagonist W-7. The mechanism of action of salicylate was investigated. Inhibition of prostaglandin biosynthesis or of oxidative phosphorylation by salicylate was not responsible for these effects because indomethacin (28 microM) and 2,4-dinitrophenol (20 microM) did not differentiate between calcium antagonists. The effects of salicylate are ascribed to an increase in negative surface charge on the membrane because other agents changing surface charge (3,5-dichlorosalicylate, 0.3 mM; benzoate, 20 mM) have similar effects and their potency is dependent on their affinity for lipid membranes. Furthermore, salicylate increased the effectiveness of the cationic local anaesthetic, (+)-propranolol (100 microM), but did not change the effects of the neutral local anesthetic, benzocaine (1 mM). It is argued that salicylate increases the effectiveness of cinnarizine by increasing accumulation of this drug in the cell membrane or at intracellular sites whereas the reduced effectiveness of verapamil and diltiazem is secondary to a change in the state of the Ca2+ channel. PMID- 6487890 TI - A direct protective effect of sulphinpyrazone on ischaemic and reperfused rat hearts. AB - Initiation of 60 min ischaemia to rat isolated hearts produced a depression in developed tension and heart rate. Subsequent reperfusion caused a greatly exacerbated creatine phosphokinase (CPK) efflux and limited functional recovery. Sulphinpyrazone (100 ng ml-1 and 1 microgram ml-1) significantly reduced CPK release, particularly after reperfusion, the lower concentration being more effective. A reduction in the mechanical depression during ischaemia and enhanced recovery after reperfusion were seen only with 100 ng ml-1 sulphinpyrazone. Heart rate and coronary perfusion pressure were unaffected by drug treatment. The reduction in reperfusion-induced CPK efflux by 100 ng ml-1 sulphinpyrazone was maximal when the drug was present throughout the perfusion period although some protection was evident when sulphinpyrazone was present either during ischaemia or reperfusion only. An enhanced recovery in contractility was seen only when the drug was present throughout all phases of perfusion. It is suggested that sulphinpyrazone exerts a direct protective effect on the heart particularly during reperfusion. The degree of protection is critically dependent on the concentration of sulphinpyrazone. PMID- 6487891 TI - Some features of the spasmogenic actions of acetylcholine and histamine in guinea pig isolated trachealis. AB - Intracellular electrophysiological recording showed that acetylcholine (1 mumol l 1) and histamine (2 mumol l-1) depolarized trachealis cells and often increased the frequency of slow waves. Higher concentrations of these agents caused greater depolarization and abolition of slow waves. Marked depolarization was often associated with the appearance of electrical 'noise'. These electrical phenomena were accompanied by tonic tension development in a contiguous segment of trachea. Electrical 'noise' and tension evoked by high concentrations of acetylcholine or histamine could be dissipated by washing the agonist from the tissue. Acetylcholine-induced 'noise' was resistant to tetrodotoxin (3 mumol l-1) and to hexamethonium (1 mmol l-1). Neither acetylcholine (10-1,000 mumol l-1) nor histamine (2-200 mumol l-1) increased the lanthanum-resistant calcium fraction of muscle-containing strips of trachea. It is concluded that, while developing tension under the influence of acetylcholine or histamine, trachealis cells depolarize markedly but there is relatively little cellular influx of Ca2+. PMID- 6487892 TI - Nisoldipine-induced relaxation in intact and skinned smooth muscles of rabbit coronary arteries. AB - In smooth muscles of the rabbit coronary artery, nisoldipine inhibited the phasic and tonic responses of the contraction induced by 128 mM K (the IC50 values were 4 X 10(-8) M and 1 X 10(-13) M, respectively). This agent also inhibited the tonic response of the acetylcholine (ACh) (10(-5) M)-induced contraction (the IC50 value was 3 X 10(-10) M), but only slightly inhibited the phasic response (in 10(-7) M, 0.86 times the control). Nisoldipine (less than 10(-7) M) had no effect on the K-induced depolarization of the membrane at any given concentration. This drug (5 X 10(-8) M) did inhibit the oscillatory potential changes and spike potential evoked on the ACh-induced slow depolarization. After depletion of stored Ca from the polarized muscles (5.9 mM K), muscle cells accumulated Ca by application of 2.6 mM Ca without generation of contraction, i.e. a subsequently applied 20 mM caffeine produced the contraction in Ca-free solution. Nisoldipine (less than 10(-7) M) had little effect on this accumulation of Ca. The rate of rise and time to reach the maximum amplitude of the 128 mM K- or ACh-induced contraction (in 2.6 mM Ca) depended on the amount of stored Ca in cells. Nisoldipine (10(-8) M) consistently inhibited the Ca-induced contraction evoked in depolarized muscles (128 mM K), regardless of the amount of stored Ca. However, this agent (10(-8) M) did not inhibit the Ca release from storage sites evoked by activation of the muscarinic receptor. After prolonged superfusion (over 120 min) with Na- and Ca-free solution (guanethidine and atropine were present), application of 2.6 mM Ca produced contraction which was inhibited by 10(-8) M nisoldipine, while the depolarization induced by application of these solutions was not inhibited by nisoldipine. In saponin-skinned muscles, nisoldipine had no effect on the contractile proteins, as estimated from the pCa tension relationship, or on the Ca accumulation into the Ca release from the Ca storage sites, as estimated from the caffeine-induced contraction. It is concluded that nisoldipine possesses a selective inhibitory action on voltage dependent Ca influx, when the Ca channel is activated by depolarization. PMID- 6487893 TI - Effects of the antagonists MDL 72222 and ketanserin on responses of cat carotid body chemoreceptors to 5-hydroxytryptamine. AB - The effects of intracarotid (i.c.) injections of 5-hydroxytryptamine (5-HT; 1-50 micrograms) on carotid chemoreceptor activity recorded from the carotid sinus nerve have been studied in anaesthetized cats. Three separate components in the complex response of the chemoreceptors to injected 5-HT were identified. Firstly, a transient burst of activity was obtained during the injection period in 56% of the recordings. Secondly, in all the recordings a period of chemodepression commenced a few seconds after completing the injection and was usually dose related. Thirdly, a delayed longer-lasting chemoexcitation occurred in many experiments, concomitant with a fall in systemic blood pressure. The neuronal 5 HT receptor antagonist MDL 72222 (10-100 micrograms kg-1, i.c.) virtually abolished the transient chemoexcitation evoked during 5-HT injections and also significantly increased the mean ID50 for 5-HT-induced chemodepression; in 37% of recordings 5-HT caused a dose-related chemoexcitation after the high dose of MDL 72222. Neither the delayed chemoexcitation nor the hypotension caused by 5-HT were much affected by the antagonist. MDL 72222 itself had a biphasic effect on chemosensory discharge, causing depression followed by a delayed excitation. The 5-HT2-receptor antagonist ketanserin (100 micrograms kg-1, i.c.) had no appreciable effect on the transient chemoexcitation evoked during 5-HT injections and caused a slight but significant increase in the mean ID50 for 5-HT-induced chemodepression. The delayed chemoexcitation and accompanying hypotension associated with 5-HT were both substantially reduced or abolished by the antagonist. Ketanserin itself caused a short-lasting period of chemoexcitation. All the effects of injected 5-HT on chemosensory discharge could be abolished by the combination of MDL 72222 and ketanserin (100 micrograms kg-1, i.c.). Neither MDL 72222 nor ketanserin had any significant effect upon the response of the carotid chemoreceptors to hypoxia. The rate at which discharge increased, and also the steady-state discharge before and during hypoxia, were unaffected by the antagonists, alone or in combination. At least two types of 5-HT receptor appeared to be involved in the response of carotid body chemoreceptors to 5-HT. Transient excitation and chemodepression were mediated via MDL 72222-sensitive (peripheral neuronal) receptors whereas the delayed chemoexcitation and associated hypotension involved a ketanserin-sensitive, presumably 5-HT2-, receptor. It appears unlikely that 5-HT plays a crucial role in chemoreception. PMID- 6487894 TI - The effects of verapamil, prenylamine, flunarizine and cinnarizine on coronary artery occlusion-induced arrhythmias in anaesthetized rats. AB - In male rats, anaesthetized with pentobarbitone, ligation of the main left coronary artery causes an early phase of ventricular arrhythmias which last about 30 min. In approximately 60% of control animals, ventricular fibrillation occurs but since spontaneous reversion to sinus rhythm may occur, mortality is of the order of 30%. When administered intravenously 15 min prior to ligation, verapamil (0.01 and 0.05 mg kg-1), prenylamine (0.5 mg kg-1), flunarizine (0.1, 0.25, 0.5 and 1.0 mg kg-1) and cinnarizine (0.25, 0.5 and 1.0 mg kg-1) protected against these arrhythmias. Higher doses of verapamil (0.1 and 0.5 mg kg-1), prenylamine (5 mg kg-1) and flunarizine (2.5 mg kg-1) did not afford a similar protection and mortality was increased to or above control values. Death was due in prenylamine treated rats to atrioventricular block leading to asystole whereas in those administered verapamil or flunarizine it was a consequence of persistent ventricular fibrillation. Prior to ligation, a sustained fall in mean arterial blood pressure was observed only following the administration of the highest doses of prenylamine, flunarizine and cinnarizine. Heart rate was reduced by administration of only the highest dose of prenylamine. These studies show that although the four calcium antagonists studied, i.e. verapamil, prenylamine, flunarizine and cinnarizine do suppress ischaemia-induced arrhythmias, this protective effect may be limited to a narrow concentration range. PMID- 6487895 TI - Pressure reversal of the action of octanol on postsynaptic membranes from Torpedo. AB - Octanol increases the binding of [3H]-acetylcholine to the desensitized state of the nicotinic receptor in postsynaptic membranes prepared from Torpedo californica. This increase in binding results from an increase in the affinity of [3H]-acetylcholine for its receptor without any change in the number of sites or the shape of the acetylcholine binding curve. High pressures of helium (300 atm) decrease [3H]-acetylcholine binding by a mechanism that changes only the affinity of acetylcholine binding. Helium pressure reverses the effect of octanol on the affinity of [3H]-acetylcholine for its receptor. This pressure reversal of the action of octanol at a postsynaptic membrane is consistent either with pressure counteracting an octanol-induced membrane expansion or with independent mechanisms for the actions of octanol and pressure. The data do not conform with a mechanism in which pressure displaces octanol from a binding site on the receptor protein. PMID- 6487896 TI - Nicotine self-administration in rats. AB - Female Wistar rats were allowed to self-administer nicotine solutions through indwelling jugular vein cannulae for 23 h per day for periods from three to five weeks. Two response levers were available to the rats; responding on one lever, designated the active lever, produced an immediate infusion of nicotine solution or saline. A second lever for which responding had no programmed consequences was introduced as a control for the locomotor stimulant action of low doses of nicotine. Baseline lever response rates were determined over a period of one week, in which active lever responding produced an infusion of saline. Rats were then allowed access to varying doses of nicotine or saline for a further two or three weeks. Response rates on the active lever increased significantly in rats with access to nicotine at a dose of 30 micrograms kg-1 per response. However, control lever response rates were also significantly elevated. The role of nicotine-induced locomotor stimulation in the self-administration behaviour was further evaluated in a dose-reduction experiment, in which the dose of nicotine available to rats responding for 30 micrograms kg-1 per response was reduced to 3 micrograms kg-1 per response. This resulted in a significant differential increase in active lever responding relative to control lever responding. The results suggest that nicotine is positively reinforcing in rats which had not previously been deprived of food or water or received prior drug treatment, but also indicate that nicotine induced locomotor stimulation may contribute to the observed increases in lever response rates when rats self-administer nicotine. PMID- 6487897 TI - Biphasic effect of methylxanthines on acetylcholine release from electrically stimulated brain slices. AB - The effect of caffeine and aminophylline on the release of acetylcholine (ACh) was investigated in slices of rat cortex perfused with Krebs solution at rest and during electrical stimulation at frequencies of 0.2, 1 and 5 Hz. Both methylxanthines added to the superfusing Krebs solution at a concentration of 50 microM enhanced ACh release. Conversely, at a concentration of 0.5 mM both caffeine and aminophylline decreased ACh release. Neither caffeine nor aminophylline affected the unstimulated ACh release. Dipyridamole 10 microM potentiated the inhibitory effect of adenosine 30 microM on ACh release and antagonized both the stimulatory and inhibitory effects of caffeine on ACh release. The inhibitory effect of caffeine was antagonized by cyclohexyladenosine (CHA) 0.5 microM and N-ethylcarboxamideadenosine (NECA) 5 microM. The results indicate that methylxanthines exert both stimulatory and inhibitory effects on ACh release by acting on adenosine receptors. Methylxanthines may enhance the electrically-evoked ACh release by antagonizing the effect of endogenous adenosine on inhibitory adenosine receptors. On the other hand the mechanism through which methylxanthines decrease ACh release remains obscure. PMID- 6487898 TI - Development of markers for cholinergic neurones in re-aggregate cultures of foetal rat whole brain in serum-containing and serum-free media: effects of triiodothyronine (T3). AB - Development has been studied in re-aggregate cultures derived from the 16 day foetal rat brain and the effects of triiodothyronine (T3) investigated. Cultures were maintained in either a medium containing 10% serum (S+), or in serum-free culture medium (S-) or in serum-free medium containing 30nM T3. The muscarinic cholinoceptor, measured by specific binding of [3H]-quinuclidinyl benzitate ([3H] QNB) at 9 and 14 days in vitro, was at a lower level in the serum-free cultured cells compared with those in serum-containing culture medium (S+). In cultures in the latter medium, receptor concentration at day 14 was of a similar magnitude to that in rat brain at an equivalent postnatal age. Binding increased with development from 9 to 14 days in vitro in the S+ medium but not in the S- medium. T3 treatment caused an 85% increase in [3H]-QNB binding compared with the cultures in S- medium at day 14 to a level equivalent to that found in the cells grown in S+ medium. This increase was reflected in the Bmax but not in the KD (approx. 0.1nM). Choline acetyltransferase (ChAT) activity developed more slowly in the S- medium than in the S+ medium where the specific activity approximated values obtained in vivo. T3 treatment of cultures grow in S- medium significantly enhanced the developmental rate of increase of ChAT activity. The characteristics of [3H]-choline uptake and metabolism in the cultures was examined. Uptake was strictly Na+-independent but was energy-dependent, and inhibited by 2, 4' dinitrophenol (2, 4'-DNP) and cooling (0-4 degrees C). Neither iodoacetate nor ouabain had any effect on the amount of uptake. Hemicholinium (HC3) was a potent inhibitor of uptake (70% inhibition at 10 microM HC3). Metabolism studies showed virtually no conversion to [3H]-acetylcholine ([3H]-ACH) in reaggregates grown in either the S+, S- or T3 containing media. However, a small amount of [3H]-choline was incorporated into phosphorylcholine. T3 treatment had no effect on this metabolic profile. The kinetics of [3H]-choline uptake by the re-aggregates was also studied in the re-aggregate cultures (after 12 and 22 days in vitro) using [3H]-choline at 0.05-100 microM. Both Eadie-Hofstee transformation and least squares analysis of the data showed that the uptake comprised only a single low affinity component with an apparent Kt = approx. 50 microM. Unlike ChAT and [3H] QNB binding, there appeared to be no difference between the uptake in the different culture conditions. 6 It is concluded that the differentiation of cholinergic neurones and muscarinic receptors in serum-free cultured re aggregates from foetal rat brain is enhanced by thyroid hormone treatment. The development of [3H]-choline uptake does not seem to be associated with cholinergic cells under these culture conditions, and is unaffected by thyroid hormone treatment. PMID- 6487899 TI - Adenosine deaminase antagonizes inhibitory responses to adenosine and non adrenergic, non-cholinergic inhibitory nerve stimulation in isolated preparations of guinea-pig trachea. AB - In guinea-pig isolated tracheal tube preparations treated with dipyridamole, adenosine deaminase antagonized inhibitory responses to adenosine and non adrenergic, non-cholinergic nerve stimulation. Inhibitory responses to vasoactive intestinal peptide (VIP) were unaffected and hyoscine-sensitive excitatory responses to field stimulation were not reduced. The evidence supports a role of adenosine as an inhibitory neurotransmitter in non-adrenergic, non-cholinergic nerves in trachea. PMID- 6487901 TI - Inhibition of vasoconstriction by frusemide in the rat. AB - Mesenteric blood flow was measured in anaesthetized rats with a non-cannulating electromagnetic flow probe around the superior mesenteric artery. Reductions in blood flow were produced by intravenous bolus injections of angiotensin II (1-300 ng) and noradrenaline (3-300 ng) before and after the administration of frusemide (5 mg kg-1, i.v.). Loss of volume after frusemide was prevented by either a urinary bladder-intravenous shunt or replacement of urinary output by intravenous saline. Frusemide administration caused a small increase in baseline blood pressure of 3.2 +/- 1.3 mmHg (P less than 0.05) but did not change mesenteric blood flow. This dose of frusemide inhibited the vasoconstrictor responses to both angiotensin II and noradrenaline (P less than 0.01, two way analysis of variance). Responses to angiotensin II were inhibited to a greater extent. Acute bilateral nephrectomy or treatment with indomethacin (2 mg kg-1, i.v.) completely prevented the inhibitory effect of frusemide on the responses to angiotensin II and noradrenaline. To test whether frusemide-induced increased endogenous levels of angiotensin II may be responsible for the effects of frusemide on the vasoconstrictor responses, a separate group of rats were not given frusemide but were infused with exogenous angiotensin II (12.5-25 ng kg-1 min-1). This produced a small increase in mean blood pressure (4.0 +/- 1.4 mmHg, P less than 0.05) but did not change baseline mesenteric blood flow. Unlike frusemide, the responses to bolus injections of angiotensin II and noradrenaline were not changed by the infusion of angiotensin II. 5 It is suggested that frusemide may release directly or indirectly a prostanoid from the kidney (or a substance from the kidney which leads to the formation of a prostanoid) which inhibits constrictor responses in the peripheral vasculature. PMID- 6487900 TI - The effects of nicotine on spontaneous contractions of cat urinary bladder in situ. AB - Nicotine and dimethyl-phenylpiperazinium (DMPP) increased intravesicular pressure and then transiently depressed the spontaneous activity of the urinary bladder in chloralose anaesthetized cats. Adrenaline (5-10 micrograms kg-1), noradrenaline (5-20 micrograms kg-1) and isoprenaline (40-50 micrograms kg-1) which depressed spontaneous urinary bladder activity, were antagonized by the beta-receptor blocking agent propranolol (1 mg kg-1). Phenylephrine (10-30 micrograms kg-1) was ineffective on the urinary bladder though it increased the systemic blood pressure. This latter effect was blocked by the alpha-receptor blocking agent phentolamine (2 mg kg-1). Acetylcholine (2-8 micrograms kg-1) caused a marked fall in systemic blood pressure, which was potentiated by physostigmine, but failed to produce any response on the intravesicular pressure even after physostigmine (50-100 micrograms kg-1) treatment. ATP (2 mg kg-1) produced an increase in intravesicular pressure accompanied by a fall in systemic blood pressure. The increased intravesicular pressure was antagonized by quinidine (20 mg kg-1); however, the fall in blood pressure remained unaltered. The increased intravesicular pressure induced by nicotine (20-40 micrograms kg-1) or DMPP (50 100 micrograms kg-1) was not affected by phentolamine (2 mg kg-1), propranolol (1 mg kg-1) or guanethidine (15-20 mg kg-1). Physostigmine (50-100 micrograms kg-1), hemicholinium 3 (2 mg kg-1) or atropine (1 mg kg-1) were also unable to affect the response to nicotine. Hexamethonium (1 mg kg-1), reduced the amplitude of spontaneous bladder contractions and quinidine (20 mg kg-1) abolished the effect of nicotine. 7 Bilateral sectioning of the cervical sympathetic or hypogastric nerves did not alter the effect of nicotine or DMPP. Higher spinal cord transection (Cl-C2) blocked the spontaneous, as well as the nicotine- and DMPP induced, contractions of the bladder. 8 It is concluded that the increase in intravesicular pressure induced by nicotine is atropineresistant and is not mediated either through adrenergic or cholinergic mechanisms. It is probable that a purinergic mechanism is involved, via the activation of P2-receptors present in the urinary bladder. PMID- 6487902 TI - Antiarrhythmic actions of verapamil against ischaemic arrhythmias in the rat. AB - The actions of intravenous verapamil against arrhythmias induced by occlusion of a coronary artery were investigated in conscious rats. Verapamil (2-20 mg kg-1, i.v. given pre-occlusion) dose-dependently reduced arrhythmias in rats with either large or small occluded zones at an ED50 of 6 mg kg-1. This dose was effective when given immediately post-occlusion. Severe arrhythmias, as opposed to PVC, were preferentially reduced. In conscious, and pentobarbitone anaesthetized rats, verapamil (6 mg kg-1) had different effects on electrically induced arrhythmias, and the ECG, from an equi-effective anti-arrhythmic dose of quinidine (20 mg kg-1, i.v.). Quinidine decreased following frequency, but increased threshold current and pulse width, whereas verapamil did not. Both drugs increased P-R interval, but only quinidine increased QRS and Q-T intervals. Thirty minutes post-occlusion, the verapamil content of tissue and blood was determined after a 6 mg kg-1 dose given pre- or post-occlusion. Measurable levels of verapamil were found in both normal and ischaemic myocardium. Plasma and plasma water concentrations were 3.6 +/- 0.8 mumol l-1 and 0.6 +/- 0.1 mumol l-1 (mean +/- s.e. mean), respectively following post-occlusion administration vs. 2.7 +/- 1.2 and 0.24 +/- 0.04 for pre-occlusion administration. Plasma water concentrations were close to IC50 values for inhibition of contractility in rat atria and ventricles. Similar concentrations depressed slow action potentials induced in rat ventricles by raised K+ We suggest that the ability of verapamil to prevent severe ventricular arrhythmias following myocardial ischaemia in the conscious rat is largely due to the calcium antagonist effects of the drug. PMID- 6487903 TI - Effects of intravascular volume expansion on the cardiovascular response to naloxone in a canine model of severe endotoxin shock. AB - The specific opiate receptor antagonist, naloxone, can produce haemodynamic improvement and increased survival in experimental shock. The efficacy of naloxone therapy in a canine model of endotoxin shock has been evaluated both with and without intravascular volume replacement. Animals were anaesthetized with alpha-chloralose and allowed to breathe spontaneously. A large bolus dose of endotoxin was followed by a continuous infusion and treatment was instituted one hour after the endotoxin bolus. In the absence of volume replacement, naloxone caused only limited and transient increases in mean arterial pressure (MAP) and left ventricular (LV) dp/dt max, with little effect on cardiac index (CI). Total peripheral resistance index (TPRI) tended to rise in both control and naloxone treated dogs. In volume-replaced animals, naloxone produced substantial and sustained increases in the MAP and LV dp/dt max with an associated rise in the CI. TPRI rose initially in this series and then fell progressively. Further analysis of the improvements in the CI showed an increase in stroke index with a tendency for heart rate to fall. These findings suggest a myocardial action of naloxone in endotoxin shock, which is augmented by volume replacement. An initial, transient vasoconstrictor effect cannot, however, be excluded. Further work is required to determine the mechanism of the effects described. PMID- 6487904 TI - The periaqueductal gray is the site of the antinociceptive action of carbamazepine as related to bradykinin-induced trigeminal pain. AB - Using freely moving and conscious rats, the antinociceptive effects of microinjections of carbamazepine, into the periaqueductal gray (PAG), nucleus reticularis paragigantocellularis (NRPG) and nucleus raphe magnus (NRM) on the biting-like responses induced by bradykinin applied to the tooth pulp, were investigated to determine the primary site of action of this drug. Microinjections of carbamazepine into the PAG ipsi- and contralateral to the stimulated tooth pulp produced dose-dependent suppressive effects on the biting like responses within 1 min. The ED50 was 1.57 micrograms per rat, that is about 1,500 times less than that for carbamazepine administered systemically. The antinociceptive effect of carbamazepine administered into the PAG was inhibited by pretreatment with bicuculline but not by phentolamine, propranolol and haloperidol. Microinjections of carbamazepine into the NRPG and NRM were rarely effective in the production of antinociception at doses used (up to 3 micrograms per rat). These results suggest that the PAG is one of the primary target sites for the antinociceptive activity of carbamazepine, and that GABAergic systems are involved this action of carbamazepine. PMID- 6487905 TI - Lack of effect of leukotriene D4 on Ca-uptake in airway smooth muscle. AB - The effects of verapamil on leukotriene D4 (LTD4)- and KCl-induced contractions and 45Ca-uptake were examined in guinea-pig isolated tracheal smooth muscle. Both LTD4 (0.1 to 200 nmol l-1) and KCl (8 to 125 mmol l-1) produced concentration dependent increases in tension in the tracheal preparations. Verapamil (1 mumol l 1) inhibited the tension responses induced by both LTD4 and KCl. LTD4 failed to increase the lanthanum-resistant Ca content of tracheal smooth muscle at either low (EC25; 3 nmol l-1) or high (EC90; 50 nmol l-1) concentrations. Verapamil did not modify this result. KCl (90 mmol l-1) increased the lanthanum-resistant Ca content of the smooth muscle by approximately 60% over basal levels. This effect was completely inhibited by verapamil (1 mumol l-1). It is concluded that in this tissue, LTD4 utilizes principally an intracellular source of Ca2+ to initiate contraction whereas KCl is dependent upon the uptake of Ca2+ from the extracellular compartment. It is suggested that the inhibitory effects of verapamil may reflect an intracellular mechanism of action directed against Ca2+ release initiated by LTD4. PMID- 6487907 TI - Classification and diagnosis of depression in school phobia. AB - Fifty-one school phobic children, aged nine to fourteen years, were assessed for psychiatric diagnosis; this revealed the presence of two clinically meaningful sub-groups--depressed and residual school phobic. A wide range of symptoms were studied to identify those which might prove useful in diagnosing adult-type depression in childhood and early adolescence, both in terms of frequency of symptoms in the depressed group and the extent of the distinction between the two groups. Eleven such key symptoms were identified and based on these, a formula for diagnosing adult-type depression was evolved. The validity of several different ways of classifying the above cases were explored; these covered: kind of disorder; type of onset; adolescence versus pre-adolescence; and sex of the child. However, on only one dichotomy--depression versus absence of depression- were there many significant discriminants. Affective symptomatology of more recent onset was contrasted with pre-morbid personality traits, usually associated with school phobia. There was no evidence to support the concept of 'masked depression' in childhood. PMID- 6487906 TI - Potentiation of the action of adenosine on cerebral cortical neurones by the tricyclic antidepressants. AB - The effects of four tricyclic antidepressants, nortriptyline, iprindole, chlorimipramine and desipramine on adenosine-evoked depressions of the firings of rat cerebral cortical neurones has been studied. When applied iontophoretically, all four substances enhanced the depressant actions of iontophoretically applied adenosine but did not affect the depressant actions of the uptake-resistant analogue, adenosine 5'-N-ethylcarboxamide (NECA). Nortriptyline and iprindole administered intravenously (1 mg kg-1) enhanced the depressant actions of iontophoretically applied adenosine. When applied by larger iontophoretic currents, all four antidepressants inhibited the firing of cerebral cortical neurones. Chlorimipramine- and desimipramine-elicited depressions were antagonized by intravenously administered caffeine, an adenosine antagonist. Earlier studies showed the tricyclic antidepressants inhibit the uptake of adenosine by rat brain cerebral cortical synaptosomes. The present results demonstrate that four antidepressants are able to potentiate the action of adenosine and that this occurs when these compounds are given in behaviourally meaningful doses. The specificity of the potentiation is demonstrated by the failure of these compounds to potentiate the depressant actions of an uptake resistant analogue of adenosine, NECA. Antagonism of the inhibitory effects of the antidepressants on neuronal firings by caffeine, indicates that these compounds can enhance the extracellular levels of endogenously released adenosine sufficiently to depress cell firing. PMID- 6487908 TI - Depression: a breakdown of perceptual defence? AB - The effect of depressed mood on the tachistoscopic recognition of neutral/unpleasant words was investigated in a group of 18 depressed inpatients and in 17 normal controls. A 50% recognition threshold for 30 neutral words was calculated for each subject, in order to exclude the effects of depressive slowness on the experimental task. Each subject was tachistoscopically presented with a series of experimental words (30 neutral/30 unpleasant) at his 50% level, and the ratio of neutral to unpleasant words recognised calculated. Depressed subjects tended to recognise a higher ratio of unpleasant to neutral words. PMID- 6487909 TI - An evaluation of cognitive-behaviour therapy for depression in patients with multiple sclerosis. AB - Twenty depressed multiple sclerotic patients were randomly allocated either to cognitive-behaviour therapy or to a waiting list control condition. Assessment of depressive symptoms was conducted at pre-treatment, post-treatment, and a four week follow-up. In comparison to the waiting list condition, cognitive-behaviour therapy was found to result in clinically and statistically significant improvement on most measures. Although the mechanism by which such treatment achieves its effects is unclear, these results clearly support the use of cognitive-behavioural treatments for depression in this population. PMID- 6487910 TI - The limited utility of the dexamethasone suppression test for the diagnostic process in psychiatry. AB - In 231 psychiatric in-patients, the 1 mg or 1.5 mg DST with blood samples at 0900 h, 1600 h and 2300 h and a post-dexamethasone plasma cortisol threshold of greater than or equal to 5 micrograms/dl were tested for their differential diagnostic utility in clinical psychiatry. Neither test significantly separated endogenous depressed patients from patients with other depressive or non depressive psychiatric disorders. Studies of the 1 mg or 1.5 mg DST in 75 healthy subjects revealed about 12% of cortisol non-suppressors, when a post dexamethasone cortisol threshold of greater than or equal to 5 micrograms/dl was used. This seemed to be an unacceptably low specificity of the test in normal subjects. A threshold criterion of greater than or equal to 8 micrograms/dl, however, yielded only 2.7% of non-suppressed normal subjects. Analyses of the DST data of the psychiatric patients, using a cortisol threshold of greater than or equal to 8 micrograms/dl, also failed to reveal a significantly higher specificity of the DST for endogenous depression. However, it was demonstrated that intervening variables such as stress due to hospital admission, drug withdrawal, suicidal turmoil, weight loss, as well as a low dexamethasone plasma level, enhance the rate of abnormal DST results in psychiatric in-patients, regardless of their diagnostic classification. PMID- 6487911 TI - Dexamethasone suppression test and REM sleep in patients with major depressive disorder. AB - Dexamethasone suppression Test (DST) and sleep electroencephalogram (EEG) recordings were carried out during three consecutive nights in 39 depressed patients who met Research Diagnostic Criteria (RDC) for major depressive disorder and in nine normal controls. Cortisol response to DST was abnormal in 26 patients and normal in all controls. REM latency and REM density were compared in patients with abnormal DST (n = 26) to values obtained in patients with normal DST (n = 13) and in normal controls (n = 9). Rapid Eye Movement (REM) latencies were significantly lower in depressed patients showing cortisol non-suppression after dexamethasone than in patients with a normal DST or in controls. REM densities were significantly higher in depressed patients than in normal controls (P less than 0.025), but there was no significant difference between DST suppressors and non-suppressors. The DST provided high specificity (100%) and a sensitivity of 67%, while REM latency showed a lower specificity (78%), but a higher sensitivity (85%). PMID- 6487912 TI - Clinical use of the DST in a psychogeriatric population. AB - The dexamethasone suppression test (DST) was administered to 95 patients referred to a psychogeriatric assessment service. Non-suppression of plasma cortisol was found in 28 out of 48 patients (58%) with senile dementia and all patients with arteriosclerotic dementia or acute confusional states. Non-suppression could not be explained by associated depressive symptoms. The DST was confirmed as a valid diagnostic test for endogenous depression in the elderly, but its value in distinguishing true dementing illnesses from depressive pseudodementia was not supported. The clinical implications of these findings for interpreting DST results in the elderly are discussed. PMID- 6487913 TI - Perceptual learning with right unilateral versus bilateral electroconvulsive therapy. AB - Perceptual learning was examined with respect to variations in ECT electrode placement (bilateral versus right unilateral) and ECT stimulus waveform (sinusoidal versus brief-pulse). While patients receiving right unilateral ECT demonstrated more perceptual learning than did those receiving bilateral ECT, no difference in perceptual learning resulted from the variation in electrical stimulus waveform. Furthermore, the amount of perceptual learning was unaffected by EEG seizure duration and by the total amount of electrical stimulus energy delivered. The theoretical issue of whether an electrical or a seizure difference between bilateral and right unilateral ECT is responsible for inter-group learning or memory differences is discussed, as well as practical issues related to the choice of electrode placement. PMID- 6487914 TI - Motor and sighting dominance in chronic schizophrenics. Relationship to social competence, age at first admission, and clinical course. AB - The relationship was examined between sinistral eye and hand preference and age at first hospitalisation, clinical course and social competence in chronic schizophrenics. Motor and sighting dominance were assessed in 52 newly admitted chronic schizophrenic males. Left-handedness in this study was associated with inferior social competence, but left-eyedness with later age of first hospitalisation and proportionally less time spent in hospitals. These findings were only true for paranoid schizophrenics. PMID- 6487915 TI - Long-term outcome of bereavement. AB - With the aid of the Texas Inventory of Grief, 130 first-degree relatives were studied eight years after bereavement. It was found that relatives of persons who had died suddenly and unexpectedly had more pronounced grief reactions than those of persons whose deaths were more expected. The same was observed concerning parents as a group, compared with widows and widowers. The inventory was found to be of value for assessing whether the outcome was good or poor, but it was not possible to identify risk groups with this method. PMID- 6487916 TI - Smoking and malignancy in schizophrenia. AB - It has been suggested that schizophrenic patients have a lower risk of cancer than the general population. We therefore investigated the smoking patterns of 100 current chronic schizophrenic in-patients, and the causes of death in 122 recently deceased schizophrenics. We found that schizophrenics are heavy smokers, and that schizophrenics do die from carcinoma of the bronchus. Proportional mortality rates for all malignancies were not significantly lower in schizophrenics than in the general population but there was a significant absence of cancer of the gastro-intestinal tract. Proportional mortality rates for female mammary carcinoma, pneumonia, and suicide were raised, and that for cerebrovascular disease was low. These differences between schizophrenics and the general population warrant further investigation. PMID- 6487917 TI - Suicide in Fiji: a preliminary study. AB - A survey of police and medical records in a province of Fiji indicated high rates of suicide for Indian women under 30 and for Indian men over that age, especially amongst families engaged in sugar-cane farming. Indian suicide rates were high during the Indenture period (1879-1920), and are still higher amongst Indians than amongst native Fijians: almost 90% of all suicides are Indian, though this group comprises only 50% of Fiji's total population. Age/sex/ethnic distribution, methods, and precipitating factors of recorded suicides were examined for one province of Vanua Levu during the period 1979-82. The increasing use of toxic herbicides, especially paraquat, as a vehicle for suicide is discussed. PMID- 6487918 TI - Co-existence of the Capgras and Ekbom syndromes. AB - A case is described in which a diagnosis of paranoid schizophrenia was made using the criteria of Schneiderian first-rank symptoms. The patient showed the Capgras syndrome, with delusional misidentification of her son and other people in her environment, and also Ekbom's syndrome, with the delusion that she was infested with parasitic worms which migrated between various parts of her body. In this case, the two syndromes are descriptions of a specific delusional content, and occur as part of the psychopathology within a schizophrenic disorder, rather than as distinct disease entities. PMID- 6487919 TI - Doctors and nurses use of the word confused. AB - A questionnaire was sent to 274 doctors and nurses. The first section was to see if certain symptoms and signs elicited the description of patients as 'confused', and the second to discover the respondents' definitions. The results showed a marked discordance in health workers' understanding of this word 'confused' in reference to patients, and it is suggested that it should only be used if it is clearly defined. PMID- 6487920 TI - Depressive symptoms in pregnancy. PMID- 6487921 TI - Mitral valve prolapse and anxiety disorders: no longer an enigma. PMID- 6487922 TI - Dreams after amputation. PMID- 6487923 TI - Neuroleptic malignant syndrome. PMID- 6487924 TI - Evidence of unconscious semantic processing from a forced error situation. AB - A study was carried out to determine whether subjects extracted information from words presented below their recognition and awareness thresholds. A series of target words was used to generate the word matrix, which was a set of 24 words related to the target in specified ways. Following subthreshold exposure of a target word, subjects chose the word they thought had been shown from the word matrix for that particular target. It was held that the alternative chosen was a function of the type of processing the target was receiving. Results showed that structural analysis of the target predominated below recognition threshold, whereas semantic analysis predominated below awareness threshold. PMID- 6487925 TI - Continuity between childhood dyslexia and adult reading. AB - If reading disabilities were the result of developmental lags, disabled readers should catch up to their peers in proficiency at maturity. As a test of this hypothesis, current literacy skills were assessed for adults who did, and did not, have childhood reading disabilities. Contrary to the developmental lag hypothesis, most of the former group remained poor readers in adulthood, in many cases reading more than two standard deviations below levels predicted by IQ. Both within and between groups, very similar relationships were observed between reading level and: word recognition; phonic analysis; prose comprehension; reading speed; spelling ability and error types; and tolerance for visual and semantic text transformations. Other purported characteristics of dyslexia differentiated disabled from normal adult readers with only limited success. The results have implications for theoretical, methodological, and practical issues in the study of dyslexia in childhood as well as adulthood. PMID- 6487926 TI - On choosing to make aversive events predictable or unpredictable: some behavioural and psychophysiological findings. AB - Choice and psychophysiological correlates of choice were examined for 36 subjects in a laboratory paradigm where one of two visual display channels could be selected. The first gave warning of an aversive event (shock or noise). The second channel provided an interesting distraction but gave no warning of an aversive event. The subjects were led to believe that aversive events were either avoidable, possibly avoidable or unavoidable. The events were also described as differing in likelihood from trial to trial. Results suggested that threat of unexperienced events produced more monitoring for warning. Controllability and likelihood enhanced choice of monitoring though male subjects showed some anomalous results. There was some tentative evidence to suggest that subjects scoring internally on the locus of control dimension may show more definite preference for one or other channel. Monitoring was associated with greater subjective tension, tonic heart-rate and skin conductance fluctuations. The pattern of correlations among arousal and choice indices across trials suggested that the cardiovascular measure reflected the vigilant aspect of active coping whilst the subjective tension and electrodermal measures reflected affective aspects of arousal. Results are discussed in terms of the literature on coping strategies and stress, and possible applications of experimental work on controllability. PMID- 6487927 TI - Phonological confusability in short-term memory for sentences as a predictor of reading ability. AB - Upon entry to kindergarten, a group of 477 children was given sentence memory tasks involving rhyming and non-rhyming sentences. These tasks were readministered to the children at the end of Grade 1 when the children were also tested for reading ability. Short-term memory for sentences was found to correlate with Grade 1 reading ability on both occasions when it was tested. Furthermore, at both ages the children found rhyming sentences harder to recall than non-rhyming sentences. However, contrary to some previous research, the study failed to find that poor readers were less severely penalized when the short-term memory sentence stimuli rhymed. The possible role of scaling artifacts in producing inconsistent results between studies is discussed. PMID- 6487928 TI - Real and laboratory gambling, sensation-seeking and arousal. AB - The existence and importance of excitement in gambling, the effects of runs of wins and losses on gambling behaviour and the relationships of both with sensation-seeking were investigated using samples of students and experienced gamblers in real and artificial gambling situations. Heart-rate increases, gambling behaviour and events such as 'stake decision time' were recorded as subjects played blackjack. Significant differences between real and artificial casinos were found for mean heart-rate increases over base-lines, for gambling behaviour and in the relationships between sensation-seeking, arousal and gambling in the two conditions. Doubt is cast on laboratory gambling as a valid analogue of the real gambling situation. Sensation-seeking and arousal are discussed briefly in relation to explanations of gambling. PMID- 6487929 TI - Psoriatic arthritis in psoriatic patients. AB - One hundred and eighty patients with psoriasis have been studied in the Neapolitan area to find the prevalence of arthritis in psoriasis. Wright and Moll's criteria for the diagnosis of arthritis were applied. Of 180 psoriatic patients, 62 exhibited arthritis (34.4% of total cases) According to Moll and Wright's five broad clinical forms of arthritis, the following distribution was found: polyarticular in 38.7% of arthritic patients, mono-oligoarticular in 16.1%, distal interphalangeal in 7.5%, deforming or mutilans in 2.3% and spondylitic and/or sacro-iliitic in 20.9%. In 14.5% of arthritic patients an overlap of the spondylitic form and peripheral involvement was also found. Stratification by age of patient populations shows that cutaneous pathology has a homogeneous distribution in the various age decades, while joint symptoms are seen maximally in the sixth decade and are absent in the first two decades. The relationship between the onset of skin lesions and joint pathology demonstrates that skin lesions preceded arthritis in 64.5% of the cases, whilst arthritis antedated psoriasis in only 19.35%. In 16.1% of cases psoriasis and arthritis began almost simultaneously. Nail changes were present in 63% of arthritic patients and in 37% of psoriatic subjects without arthritis. Furthermore, in 88% of arthritic patients in whom arthritis preceded skin lesions, nail changes antedated the onset of clinically apparent psoriasis. Extra-articular features were not found. This absence might be associated with the usual seronegativity for rheumatoid factor in psoriatic arthritis, also confirmed in this survey. PMID- 6487930 TI - Metabolic bone disease among in-patients with rheumatoid arthritis. AB - Twenty-five consecutive in-patients who had suffered from rheumatoid arthritis for at least five years were investigated radiologically, histologically and biochemically for evidence of metabolic bone disease. Dietary intake of vitamin D was universally well below recommended levels. Serum 25-hydroxycholecalciferol (25-OHD) concentrations did not correlate with dietary intake of vitamin D but correlated significantly with a sunlight exposure score (p less than 0.01). Despite seven patients having 25-OHD levels below the normal reference range, no cases of osteomalacia were found. Pathological fractures, often initially unrecognized, had occurred in the lower limb bones of seven patients in the previous five years. Those with fractures of the leg bones had evidence of more pronounced osteoporosis of the axial skeleton radiologically and histologically and five of the seven had been taking oral corticosteroids. There was close agreement between qualitative histological assessment of osteoporosis and radiographic evidence of vertebral collapse and those with the severest osteoporosis had lower serum levels of 25-OHD than the rest (p less than 0.02). Ten subjects had reduced xylose absorption tests, although frank malabsorption was not found, and in five patients studied the jejunal mucosa was normal. PMID- 6487931 TI - Computerized tomography of the sacro-iliac joints in the diagnosis of sacro iliitis. AB - The radiological confirmation of sacro-iliitis is essential for the early diagnosis of ankylosing spondylitis. Conventional radiography is too insensitive to detect early changes in these joints, and radionuclide scintigraphy is a non specific, though highly sensitive, technique. This study describes a preliminary survey of the use of computed tomography (CT) of the sacro-iliac joints in the diagnosis of early sacro-iliitis. Patients were selected for study from a routine rheumatology clinic. Entry criteria included a clinical suspicion of sacro iliitis and normal or equivocal findings on conventional radiography. Twenty-two patients were selected for study. Nine had normal plain films and normal CT; four had equivocal plain films with conclusive evidence of sacro-iliitis on CT; in two cases, conventional radiographs were normal but CT showed clear evidence of sacro iliitis; two other patients had equivocal findings on straight X-ray examination but normal CT. Computerized tomography of the sacro-iliac joints can be useful in the early diagnosis of sacro-iliitis if conventional radiography is equivocal or normal. Further controlled studies are necessary to establish the sensitivity and specificity of the technique. PMID- 6487932 TI - The efficacy of local steroid injections in idiopathic carpal tunnel syndrome: a double-blind study. AB - In order to investigate the superiority of local steroid injection over the intramuscular route, 37 patients with idiopathic carpal tunnel syndrome were treated with local or systemic steroid injections in a double-blind study. The first group received steroid injections into the carpal tunnel of the more severely affected hand and placebo into the deltoid muscle of the same side. The second group received steroid injections intramuscularly, and placebo into the carpal tunnel. The only significant improvement observed at the end of one month was in the steroid-injected hands of the first group. At 10-12 months follow-up only four (22%) of the 18 patients from this Group were symptom free. PMID- 6487933 TI - Hyperuricaemia, gout and kidney function in New Zealand Maori men. AB - Several previous studies have demonstrated an increased prevalence of gout in New Zealand Maoris. The aetiology of the hyperuricaemia and its effect on morbidity, apart from gout, are unknown. A survey of 115 Maori men of working age revealed a history of gout in 10 (8%) and asymptomatic hyperuricaemia in 26 (23%). The relationship of hyperuricaemia with obesity was confirmed. Alcohol did not make an obvious contribution to the prevalence of hyperuricaemia. Hypertension was more common and creatinine clearance lower amongst those with gout, but not significantly so. The frequency of hypertension and mean creatinine clearance were similar to that seen in asymptomatic hyperuricaemia and normouricaemia. Urate clearance was lower in the gouty and hyperuricaemic subjects. The normouricaemic Maoris had a reduced fractional urate clearance compared with normal men elsewhere. They also excreted a relatively small proportion of hydrogen as ammonium. Both these features are characteristic of gout, and suggest that the Maoris' susceptibility to hyperuricaemia has a renal mechanism. Obesity is common amongst the Maoris and accentuates their natural tendency to hyperuricaemia. PMID- 6487935 TI - Acute colchicine poisoning presenting as symptomatic hypocalcaemia. AB - Symptomatic hypocalcaemia was the dominant feature of acute colchicine poisoning in a young female with periodic polyserositis. Experimental data suggest that colchicine-induced hypocalcaemia is secondary to colchicine inhibition of bone resorption. PMID- 6487934 TI - A pharmacokinetic comparison of choline magnesium trisalicylate and soluble aspirin. AB - Claims that twice-daily dosage of choline magnesium trisalicylate (CMT) may alter salicylate disposal kinetics and result in sustained plasma levels were examined. Plasma levels, urine excretion and pharmacokinetics of salicylate were estimated in six men following the recommended twice-daily dose of CMT and a smaller dose of soluble aspirin. The plasma salicylate levels achieved with CMT were lower than those seen in previous studies but this probably reflected differences of methodology. Salicylate levels were not sustained between doses and elimination rates and half-life were similar for both preparations. No major alteration of disposal kinetics could be demonstrated for CMT with the dose used in the present study. PMID- 6487936 TI - Plant-thorn synovitis occurring in a child with psoriatic arthritis. AB - In psoriatic arthritis, trauma to joints may be important in determining the site of joint involvement. We describe a child with a psoriatic arthritis in whom penetrating injury with a rose thorn led to a localized chronic synovitis which could not be distinguished clinically from psoriatic arthritis but which was effectively treated by synovectomy and removal of the remaining thorn. PMID- 6487937 TI - Thrombocytopenia in a case of systemic lupus erythematosus: repeated administration of 'pulse' methyl prednisolone. AB - The case of a young woman with systemic lupus erythematosus (SLE) is reported in whom thrombocytopenia was a major feature of her disease. She was given three courses of 'pulse' intravenous methyl prednisolone (IVMP) on separate occasions as treatment for profound thrombocytopenia. A diminishing response in platelet count was obtained following each course. She received a further course of IVMP for treatment of a nephritis, with a moderate platelet response; this may have been related in part to concomitant oral cyclophosphamide. IVMP may be an effective treatment for SLE-associated thrombocytopenia but repeated courses may result in a reduced platelet response. PMID- 6487938 TI - Rheumatoid arthritis and social class. PMID- 6487939 TI - Grip strength in tennis elbow. PMID- 6487940 TI - Reliability of rheumatoid factor tests. PMID- 6487941 TI - Muscle strength and cross-sectional area in man: a comparison of strength-trained and untrained subjects. AB - This study has examined muscle strength and cross-sectional area in a group of 35 healthy untrained male subjects and 8 subjects who had been engaged in a strenuous weight-training programme. The maximum voluntary knee extension force which could be produced by the untrained subjects was 742 +/- 100 N (mean +/- SD). The trained subjects could produce a significantly (p less than 0.001) greater force (992 +/- 162 N). Cross-sectional area of the knee-extensor muscle group was 81.6 +/- 11.8 cm2 in the untrained subjects and 104.1 +/- 12.3 cm2 in the trained subjects (p less than 0.001). In the untrained subjects, a significant correlation existed between strength and muscle cross-sectional area (r = 0.56, p less than 0.001). In the same group of subjects, there was a significant inverse relationship between muscle cross-sectional area and the ratio of strength to cross-sectional area (r = 0.55, p less than 0.001). The mean ratio of strength to cross-sectional area was 9.20 +/- 1.29 for the untrained group whereas for the trained group this ratio was 9.53 +/- 1.01. It is suggested that the inverse relationship between strength per unit cross-sectional area and cross-sectional area results in part from an increased angle of pennation in the larger muscles. PMID- 6487942 TI - Ergogenic demands of a 24 hour cycling event. AB - The maximal aerobic performance (VO2 max) and energy costs of cycling at various power outputs and equivalent road speeds of a highly trained endurance cyclist (age 23.4 yrs, height 1.95 m, weight 73.1 kg), were measured in the laboratory on an eddy-current cycle ergometer, and the physiological responses related to determinations made during a 24 h cycling time trial event, using continuous ECG recording from which estimates of ergogenic demands were obtained. The cyclist covered a distance of 694 km during the event at an average speed of 28.9 km.h-1 which corresponded to an equivalent oxygen cost of 38.5 ml.kg-1 min-1 and represented approximately 55% of his VO2 max. During the event, the cyclist expended an estimated 82,680 kJ of energy, of which approximately 44,278 kJ (54%) were supplied by repeated feedings of liquids, solids and semi-solids and some 38,402 kJ (46%) came from the stored energy reserves which resulted in a 1.19 kg loss of body weight during the event. The energy demands of the activity were more than three times greater than the highest recorded values of severe industrial work, and similar to the hourly rates of expenditure of shorter duration competitive events, but above the highest values reported over other extreme endurance events over the same period of time. The results thus represent near maximal levels of sustainable ergogenic effort by man over a complete 24 h cycle. PMID- 6487943 TI - Physiological changes and sleep responses during and following a world record continuous walking record. AB - Physiological changes, and subsequent sleep responses, were recorded in a male subject during and following 338 miles of continuous walking and consequent sleep deprivation. One hundred and thirty hours of walking and a seventy-two hours post walk recovery period were monitored. The subject walked at approximately 55% of maximum oxygen uptake (VO2 max), heart rate ranged between 102-106 b/min, and blood lactate (LA) remained below the 2 mmol/l level. No electrocardiograph abnormalities were observed either during the walk or pre- and post-functional diagnostic graded exercise test (FDGXT). Creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) levels rose throughout the walk but exhibited differing depletion patterns. The ratio of CK-MB to CK (MB/CK%) did not exceed levels which are suggestive of myocardial ischaemia. Haematological variables demonstrated signs of anaemia towards the end of the walk. Catecholamine levels rose throughout the walk, with greater rises being observed in nor-adrenaline and dopamine. During the post-walk recovery phase, adrenaline concentration remained elevated. Following this extreme period of exertion, the subject demonstrated very short sleep latency and rapid entry into slow wave sleep (SWS). These sleep patterns were compared to sleep recordings made over a similar period (72 h) six months post-walk, when the subject was not exercising. Nocturnal growth hormone (GH) levels were significantly raised on the post-walk nights. PMID- 6487944 TI - Football injuries in Oslo: a one-year study. AB - All football injuries treated at the Emergency Department, Oslo City Hospital, 1329 patients, 1167 males and 162 females, were recorded for one year, accounting for 28.4% of all sports injuries. Most injuries seen were in the 15-19 years age group in females and 20-24 years age group in males; 68% of the females and 42% of the males (p less than 0.001) were below 20 years of age, and 87% of the injuries occurred in competitive football. During matches, 695 players were injured giving an incidence of 34.5 injuries/10,000 player matches. The injuries occurred all year with a peak in June. Sprains accounted for 41% of the injuries, 23% were contusions and 19% fractures. Most injuries (59%) affected the legs. Hospital admission was required for three females and 57 males. The football injuries required 1966 consultations and necessitated that 349 patients had to stay away from work for a total of 6137 days. PMID- 6487945 TI - Maximal oxygen intake estimated from submaximal heart rate. AB - This study investigated the predictability of maximal oxygen intake from three different submaximal heart rates assessed during an initial and follow-up ride on a cycle ergometer. Twenty-four healthy male subjects performed workloads of 600, 750, and 900 kpm's for six minutes on each of two visits to the laboratory. Analysis of variance for a randomised complete blocks design, with subjects constituting blocks, was used to analyse heart rate, estimated maximal oxygen intake, and residual estimated maximal oxygen intake variations among the experimental conditions. Relationships between the actual and estimated maximal oxygen intakes were determined using the Pearson Product-Moment formula of correlation. The average estimated maximal oxygen intake was significantly increased from the first testing occasion to the second. Although errors of estimation decreased significantly (450 ml to 366 ml) in favour of the second testing condition, the decrease was neither consistent with workloads nor subjects. The correlation coefficients were consistently low at 600 kpm for both testing occasions (0.68 and 0.73, respectively), consistently high at 750 kpm (0.82 and 0.84, respectively), and quite variable at 900 kpm (0.71 and 0.84, respectively), indicated that the validity of the nomogram was not consistent with all workloads or testing occasions. Despite these inconsistencies, the nomogram is, for practical purposes, a valid predictor of maximal oxygen consumption. PMID- 6487946 TI - Sports injuries survey on university students in Hong Kong. AB - A sports injuries survey was conducted among 1714 students of the Chinese University of Hong Kong. The common sports involved in injuries were Soccer (26%), Basketball (18%), Cycling (11%), Track and field athletics (11%) and Swimming (10%). The lower limb usually took the brunt of the injuries (67%) followed by the upper limb (28%) and spinal injuries were relatively uncommon (3%). The majority of the injuries were mild to moderate and the commonest ones were abrasion (37%), contusion (21%), cramp (20%), sprains (9%), and strains (7%). Of the injuries 80% recovered in less than 10 days and 50% of them were self-treated. However, a significant group of more severe injuries was recorded: fracture, concussion and heat stroke which demanded special medical attention and longer period for recovery. The pattern of treatment was also unique in that traditional Chinese methods of treatment were sought more frequently than special orthopaedic advice. The preventive aspects of sports injuries was not well recognised with only 40% of the students regularly practising warm-up exercises, 18% stretching exercises and 4% using protective aids. More educational programmes and studies were indicated. The set up of a sports injury clinic is recommended with the utilisation of a sports injury reporting system. PMID- 6487947 TI - Alcohol, cardiorespiratory function and work performance. AB - Twelve males (six moderate drinkers and six abstainers) were studied for the influence of varying dosages of alcohol on cardiorespiratory function and work performance. The subjects underwent three separate maximal exercise tests which consisted of progressive workloads on the bicycle ergometer. Prior to each work bout the subject consumed either a placebo (0.0 ml.kg-1), small (0.44 ml.kg-1), or a moderate (0.88 ml.kg-1) dose of a 95 per cent ethanol solution. Analysis of the results indicated that the ingestion of a small or moderate amount of alcohol had no significant effect on heart rate, blood pressure, ventilation, oxygen uptake or work performance. PMID- 6487948 TI - Ice-skating and roller disco injuries in Dublin. AB - A comparative study was carried out on a series of 72 ice-skating and 57 roller skating injuries over a sixteen month period. The average patient age was 20.5 years in the ice-skating group and 16.5 years in the roller skating group. Females predominated in both groups accounting for 72% of ice-skaters injured and 77% of roller skaters injured. Ice-skaters sustained more serious injuries than roller skaters as was evident from the significant difference in fracture numbers in the two groups. Ice-skating fractures accounted for 40% of all injuries while roller skating fractures were only 14% of their total injuries. The majority of ice-skating fractures occurred in females. As a result of our study we recommended several preventative measures. PMID- 6487950 TI - Death of a fencer. AB - The first fatal accident to a fencer in the United Kingdom is described. Several factors contributed to the accident but there appears to be no simple way of preventing a recurrence, but some additional precautions are discussed. PMID- 6487949 TI - Simultaneous dorsal dislocation of both interphalangeal joints in a finger. AB - Following simultaneous dorsal dislocation of both interphalangeal joints of a finger, attention must be paid to the risk of a long period of recovery because of the severity of the lesion. Approximately one year after such an accident to a footballer arthrodesis was performed on the proximal interphalangeal joint, as the patient was still suffering from constant pain in the finger. PMID- 6487951 TI - An open-air running and circuit exercising track in France. PMID- 6487952 TI - Predicting mothers' choice of infant feeding method. AB - There is relatively little published research concerning the relationship between mothers' attitudes towards methods of feeding infants and their choice of breast feeding or bottle-feeding as methods of feeding their own babies. The present study used Fishbein & Ajzen's theory of reasoned action to analyse the impact of the attitudes, perceived norms and beliefs of 50 primiparous mothers on (i) their intentions to breast-feed or bottle-feed, assessed antenatally; and (ii) their self-reported use of breast-feeding and bottle-feeding during the first six weeks of the baby's life. The findings were generally consistent with the theory of reasoned action. Attitudes to the infant feeding methods accounted for a large and significant amount of variation in infant feeding behaviour. However, there were some aspects of the findings that were not entirely consistent with the theory. Attitudes to behaviour contributed significantly and independently to the prediction of behaviour, and beliefs about the consequences of behaviour explained a near-significant amount of variation in intentions, beyond that already accounted for by attitudes and normative beliefs. Theoretical and practical implications of these findings are discussed. PMID- 6487953 TI - Cynical boys, determined girls? Success and failure anxiety in British adolescents. AB - Fifteen-year-old British adolescents of both sexes were presented with success or failure story cues, in sex-appropriate and sex-inappropriate fields of endeavour. Responses were analysed to establish the extent and nature of 'motive to avoid success'. The effects of cue variables (sex appropriateness, success versus failure), sex-role attitude, locus of control, social class and maternal employment were explored. It was found that boys were generally more negative, predicting failure and demonstrating anxiety in various ways. Girls were generally more positive, more likely to predict success outcomes, and tended to treat the obstacles to girls' achievement as challenges to be overcome. They tended to show a realistic appreciation of the problems likely to be encountered rather than anxiety or a motive to avoid success. PMID- 6487954 TI - Body-image consciousness and self-reference effects in face recognition. AB - Subjects differing in body consciousness were compared on face memory. Compared to subjects low in body awareness, subjects with a highly developed body image showed enhanced retention of faces judged for similarity to self-appearance. Although the imaginal component of the self-concept may not be effective in general, subjects who are schematic on that dimension can effectively encode experiences in this way. PMID- 6487955 TI - Moral reasoning and delinquent behaviour among students. AB - In a sample of students, relationships between delinquency and moral reasoning scores--on Rest's (1975) DIT--were consistent with the view that these scores reflect political orientation rather than developmental differences. More serious delinquency was positively correlated with principled reasoning for females (P less than 0.05), and negatively with Stage 4 reasoning for males (P less than 0.02). PMID- 6487956 TI - Perceived controllability of life-events and willingness to prescribe psychotropic drugs. AB - To test an attributional model of psychotropic drug prescription, medical students rated the controllability of life-events along with prescription probability. As predicted, students were more willing to prescribe for more uncontrollable events. This relationship could not be explained by differences in the amount of readjustment required by events. PMID- 6487957 TI - Medical imaging and its technological development in relation to the treatment of cancer. The first Mayneord lecture, April 1984. PMID- 6487958 TI - The radiological evaluation of multiple pin fixation of the femoral head. AB - Following pin fixation of the femoral neck, extrusion of a pin tip into the joint space cannot be excluded with conventional bi-plane radiography. A per-cervical pin was allowed to extrude from the head of a dried femur. Anteroposterior and lateral photographs and roentgenograms of this preparation, simulating corresponding intra-operative radiology, demonstrated misleadingly that the pin tip was wholly within the head. Careful intra-operative and post-operative screening is considered important to detect unwanted joint penetration and so avoid avascular necrosis and late degenerative change. PMID- 6487959 TI - The changing place of radiology in obstetrics. AB - In 1970 42% of antenatal patients had an X-ray examination (88.6% involving abdominal exposure) but with the introduction of an ultrasound service in 1976 this figure had dropped to 3% by 1980. Looking at the indications for these it can be seen that X rays were still commonly performed for the detection of fetal abnormality and a further reduction in X-ray exposure of pregnant women could be achieved by using ultrasound in this situation. There was a dramatic decline in the use of erect lateral pelvimetry when the fetal presentation was known to be cephalic, especially when the head was engaged, reflecting an increasing awareness by obstetricians that this investigation is unrewarding in clinical practice. PMID- 6487960 TI - Experimental evaluation of various available contrast agents for use in the upper gastrointestinal tract in case of suspected leakage. Effects on lungs. AB - The reactions of seven contrast agents--pure barium sulphate, Micropaque, Gastrografin, Dionosil, Hytrast, Amipaque and Hexabrix--on the bronchi and lungs of rats were studied. This work was undertaken to find a safe gastrointestinal contrast agent for use in post-operative patients where aspiration may be an accompanying risk. Amipaque and Hexabrix produced no significant histological reaction in the lungs and would, therefore, appear to be suitable for use in such cases. PMID- 6487961 TI - The relation of weight of haematopoietic marrow to body weight. AB - Adequate evaluation of the effects of external radiation fields on the haematopoietic system often requires knowledge of the number of grams of active marrow which received specific radiation doses rather than the average dose to the entire active marrow. There are several published reports of the amount of active marrow in different bones expressed as fractions of the total active marrow in the body, but none in which the actual number of grams can be computed for the individual patient. In the present study the number of grams of active marrow in the individual bones of the head and torso of adults has been computed and expressed as percent of body weight. Differences between males and females are not significant. For the major bones of caucasians the standard deviations are less than 25%. Very limited data indicate that there may be a similar range for Japanese adults. Similar computations for children have not been attempted here because of the uncertainties in the necessary data on body proportions. PMID- 6487962 TI - Correlation of the dose-response relationships for epidermal colony-forming units, skin reactions, and healing, in the X-irradiated mouse tail. AB - The sensitivity of epidermal colony-forming units (CFU) in the mouse tail has been compared with the sensitivity of target units responsible for healing the epidermis (EHU). The value of D0 for epidermal CFU was 3.45 +/- 0.36 Gy, much higher than most earlier reports for CFU in dorsal epidermis. The reason for the high D0 is unknown, but it is considered unlikely to be due to marked hypoxia. The value of D0 for EHU was 2.78 +/- 0.51 Gy, which was deduced from the steepness of the dose-incidence curve for the healing of tails. A comparison of the two values of D0 indicates that the inactivation rate of CFU can account for the steepness of the dose-response curve for survival of the tissue. The dose which allowed 50% of tails to heal well corresponded to 3-4 colonies per cm2 of epidermis, to a median peak skin reaction of about 2 (moist desquamation) on an arbitrary scoring scale, and to a slightly lower median skin reaction of 1.7 when the reaction scores were averaged over the period 3 to 6 weeks after irradiation. PMID- 6487963 TI - A useful device for radiology of the female urinary outflow tract. PMID- 6487964 TI - Extensive subcutaneous calcification following injections of pitressin tannate. PMID- 6487965 TI - Repositioning of percutaneous biliary endoprosthesis with transendoscopic balloon catheters. PMID- 6487966 TI - Communication between a continuous ambulatory peritoneal dialysis cannula and right fallopian tube demonstrated radiographically. PMID- 6487967 TI - Relationship of clonogenic cells and "tumour-rescuing cells", modelled in irradiated spheroids in vitro. PMID- 6487968 TI - The diagnosis of alcoholic liver disease. PMID- 6487970 TI - Specification of brachytherapy sources. Memorandum from the British Committee on Radiation Units and Measurements. PMID- 6487969 TI - Badly designed couch braking system. PMID- 6487971 TI - Surgical treatment of squamous cell carcinoma of the oesophagus. AB - During the period 1976-1983, a total of 72 patients with squamous cell carcinoma of the oesophagus were seen. Exploration was undertaken in 62 patients and all those explored had their tumours resected. The overall operative mortality rate was 12.9 per cent. Overall survival rates were 49 per cent at 1 year, 31 per cent at 2 years and 11.5 per cent at 5 years. PMID- 6487972 TI - Dilatation of benign oesophageal strictures in the outpatient department. AB - Maloney's mercury weighted dilators have been used to dilate benign oesophageal strictures in 109 patients in the outpatient department. A total of 524 dilatations have been performed. Following dilatation two patients had a small haematemesis but there have been no oesophageal perforations. Maloney's dilators can be used in the outpatient department effectively to dilate benign oesophageal strictures and the risk of complications is low. PMID- 6487973 TI - Long saphenous incompetence as a cause of venous ulceration. AB - Four hundred and seventeen consecutive patients referred with significant chronic venous disorders of the lower limb have been studied. Two hundred and ninety-nine were considered to have uncomplicated primary varicose veins, with saphenous incompetence. The remaining 118 presented with past or current skin ulceration, prominent pain and swelling, or both. Ascending and descending venography and further Doppler studies revealed only 18 patients (17 with ulceration) with an incompetent long saphenous system and ankle perforators as the only identifiable abnormalities. In 12 of these, patients' dorsal foot vein pressures were measured at rest and the maximum fall demonstrable after exercise expressed as a percentage of this (12.9 per cent +/- 6.0). This test was repeated with a narrow tourniquet inflated to 160 mmHg, applied to the mid-thigh (35.6 per cent +/- 7.4) (P less than 0.05), and again after accurate groin ligation and stripping of the long saphenous vein to the knee (31.9 per cent +/- 10.7) (P less than 0.05). These results seem to validate the use of the foot pressure/tourniquet test in assessing the relevance of saphenofemoral incompetence, and suggest in a proportion of venous ulcers this is a princical factor. PMID- 6487974 TI - Drainage operations in chronic pancreatitis. AB - If pancreatic ductal hypertension explained the pain of chronic pancreatitis, adequate decompression of ectatic ducts should provide lasting relief. We have analysed a personal series of 20 patients (14 men and 6 women) with chronic pancreatitis undergoing one or more drainage procedures. Alcohol was the main aetiological factor, and symptoms had been present for a median of 2.5 years. Pancreatic ductal decompression was achieved by pancreatic sphincteroplasty (n = 4) or longitudinal pancreaticojejunostomy (11). Thirteen patients underwent incidental or additional procedures to decompress the biliary tree: sphincteroplasty (5), choledochal bypass (7) and T-tube drainage (1). Cysts were either drained (7) or resected (3). Two patients required re-operation for subphrenic abscess. Some pancreatic insufficiency was detected preoperatively in 11 patients (exocrine 10, endocrine 4) and was essentially unchanged in all but one patient who came to total pancreatectomy. Two other patients required a coeliac plexus block, but the remaining 17 patients had good pain relief at a median follow-up of 30 months. Ductal drainage procedures effectively relieve the pain of chronic pancreatitis without further compromising pancreatic function. PMID- 6487975 TI - The surgical factors influencing duodenogastric reflux. AB - The surgical factors influencing duodenogastric reflux have been assessed in dog and man using the biliary radiopharmaceutical 99mTc-EHIDA. Cholecystectomy led to a significant increase in the amount of reflux (P less than 0.01), but the combination of truncal vagotomy and pyloroplasty in addition to cholecystectomy produced a greater amount of reflux (P less than 0.01). In man, cholecystectomy also resulted in a significant increase in the amount of reflux (P less than 0.01). In ten control subjects reflux occurred but the amount was small and was not significantly different from the modified highly selective vagotomy group (n = 20). Symptomatic patients after truncal vagotomy and pyloroplasty (n = 16) showed a significant increase in the amount of reflux (P less than 0.002) but the combination of vagotomy and pyloroplasty in addition to cholecystectomy (n = 15) demonstrated the greatest amount of reflux (P less than 0.002). Similarly the addition of cholecystectomy to highly selective vagotomy (n = 9) showed a significant increase in the amount of reflux (P less than 0.02). Reconstruction of the pylorus (n = 8) was not a satisfactory procedure for the prevention of reflux but antrectomy and Roux-en-Y biliary diversion (n = 8) resulted in a significant reduction in the amount of reflux (P less than 0.001) and this was associated with clinical improvement. PMID- 6487976 TI - What has happened to perforated peptic ulcer? AB - The number of elective operations for chronic peptic ulceration has decreased substantially with the widespread use of H2-receptor antagonists. We have reviewed all cases of perforated peptic ulcer in Oxford over the last 18 years (1965-82) to see if a similar change in the incidence of this major complication of peptic ulceration has occurred. Since 1976 there has been a fall in the incidence of perforated peptic ulcer from 8.7 to 6.9 cases per 100 000 population per year. The male to female ratio decreased over the review period from 4.9:1 to 1.9:1 owing to a reduced incidence of perforation in men and an increased incidence in women. The mean age of men with perforated duodenal ulcer increased from 52.3 years in 1965-70 to 59.0 years in 1977-82. One hundred and sixty-six patients treated between 1977 and 1982 have been reviewed in detail. The overall mortality in this 6 year period was 12.7 per cent with an operative mortality rate of 8.9 per cent. The majority of perforations (65 per cent) are now of acute ulcers and therefore are unlikely to be prevented by improved therapy for chronic peptic ulceration. PMID- 6487977 TI - Transurethral ureteroscopic stone extraction. AB - Transurethral ureteroscopy has now been used for stone retrieval in 31 patients with ureteric calculi. Four stones were located in the upper third, nine in the middle third and eighteen in the lower third of the ureter. The stones varied in size from 4 to 10 mm in diameter. Successful retrieval of the stones was achieved at the first attempt in 17 and at a second attempt in 3. Of the 11 failures (due to impaction, dislodgement into the pelvis or failed instrumentation), 4 have required open ureterolithotomy, 2 percutaneous nephroscopy and 2 ureteric meatotomies; 3 have been successfully disintegrated in situ. There have been no significant complications to date. Transurethral ureteroscopy appears to offer an alternative to existing therapeutic options. PMID- 6487978 TI - Surgery for acute Crohn's colitis: results and long term follow-up. AB - Acute Crohn's disease of the colon requiring emergency surgery is uncommon, but may be increasing in frequency. Between 1954 and 1981, 215 patients had surgery for acute inflammatory bowel disease at St. Mark's Hospital, and of these 18 had acute Crohn's colitis. There was one postoperative death, and the remaining patients were followed up for an average of 8 years. Ten patients had toxic dilation, two a toxic dilation with free perforation, three had perforation without dilatation and in three surgery was required for an acute deterioration. Surgical treatment included proctocolectomy (one), colectomy and ileostomy (fourteen), colectomy and ileorectal anastomosis (two) and defunctioning ileostomy alone (one). Subsequent rectal excision was necessary in ten of sixteen patients. Acute colonic Crohn's disease requiring surgery is less likely than ulcerative colitis to be amenable to restorative surgery despite a policy of rectal conservation. PMID- 6487979 TI - Faecal occult blood testing in the detection of colorectal cancer. AB - 5012 asymptomatic patients over the age of 40 years were asked by their general practitioners to perform a Hemoccult faecal blood test over 3 days. 3422 patients on a normal diet completed the test (a compliance rate of 67 per cent). Ninety nine patients (3 per cent) had a positive result. Those patients with a positive result then underwent a second Hemoccult test over 6 days on a restricted diet. Thirty-two patients had a positive result on repeat testing (1 per cent). Only those patients who were positive on the second testing were fully investigated (including double contrast barium enema and colonoscopy). Twenty-seven patients on investigation were found to have neoplastic disease (84 per cent). Twelve had invasive carcinomas (nine Dukes' A, two Dukes' B, one Dukes' C) and thirty-seven adenomas were identified and removed at colonoscopy (barium enema missed three carcinomas--all dukes' A and only identified sixteen of the thirty-seven adenomas, 43 per cent). Those patients found to be negative after the second Hemoccult test are being followed up. PMID- 6487980 TI - The effect of malignant and inflammatory fixation of rectal carcinoma on prognosis after rectal excision. AB - Fixity of colorectal carcinoma at operation seems an important prognostic indicator, perhaps equally as significant as lymph node invasion. A proportion of tumours are, however, tethered by inflammatory adhesions only and, although patients with these tumours should fare better than those with tumours fixed by extramural malignant spread, available data is contradictory. With the recent interest in pre-operative radiotherapy for patients with fixed rectal tumours an in order to clarify the above points we studied 625 patients who had undergone rectal excision a minimum of 10 years previously. Excluding those with disseminated disease, 169 (27 per cent) were fixed, 124 (20 per cent) by direct malignant spread, 45 (7 per cent) by inflammatory tissue. Survival and recurrence rates in these patients were compared with an equivalent number who had mobile lesions. The groups were matched for age, sex and Dukes' stage. The degree of differentiation and height of the lesion above the anal margin were similar. Corrected 5 year survival rates were 28.5 per cent in patients with malignant fixation, 68.9 per cent (P less than 0.01) in those with mobile tumours and 64.6 per cent (P less than 0.01) where the lesion was tethered by inflammation. The incidence of local recurrence in the three groups was 41.3, 15.1 and 20.0 per cent respectively. Five year survival rate in patients with fixed Dukes' B lesions was 43.5 per cent and in patients with mobile C lesions was 62.9 per cent (P less than 0.01). Thus, patients with fixed carcinomas of the rectum have a poor prognosis but only if contiguous spread of the tumour has occurred. These findings have important implications for patients in whom fixity is used as an indication for adjuvant therapy. PMID- 6487981 TI - Polyamines in colorectal cancer. AB - Polyamine levels (putrescine, spermidine and spermine) in colorectal cancers (n = 25) were measured in order to assess their importance as markers of cellular proliferation. Colonic mucosa from healthy resection margins of patients with diverticular disease (n = 5) was used as control material. Polyamine levels (expressed as nanomoles per 100 mg tumour) in cancers ranged from 0.8 to 7.9 for putrescine (mean: 2.3 +/- 0.7), from 6.5 to 22.8 for spermidine (mean: 13.9 +/- 0.9) and from 13.0 to 37.5 for spermine (mean: 22.1 +/- 1.3). Mean spermidine and spermine content of cancers was more than three times mean spermidine (3.92 +/- 0.8), and more than four times mean spermine (5.0 +/- 1.2), content of normal colonic mucosa (P less than 0.01). Polyamine content of colorectal cancers was independent of tumour site, Dukes' stage, histological grade and the presence of palpable liver metastases at laparotomy. Because colorectal cancers contain such high levels of spermidine and spermine, polyamines may play an essential role in the regulation of their growth. PMID- 6487983 TI - Postmastectomy breast reconstruction with an inflatable prosthesis. AB - Breast reconstruction was carried out in 38 patients after modified radical mastectomy, using a saline-filled inflatable prosthesis placed in a submuscular pocket. In 79 per cent the reconstructed breast had normal texture without complications. One patient was dissatisfied with the cosmetic result. Marked capsular contraction occurred in two cases (6 per cent) and late deflation in five (14 per cent). PMID- 6487982 TI - Changes in intestinal blood flow during the development of chronic large bowel obstruction. AB - The effect of chronic progressive distal large bowel obstruction on intestinal blood flow was studied in 12 mini-pigs. Blood flow was measured by the techniques of xenon133 clearance and intracardiac injections of radiolabelled microspheres. Intestinal blood flow was increased in the left colon and ileum but decreased in the caecum. Blood was shunted from the mucosa to the muscle layers. The results suggest that primary anastomosis of the obstructed left colon is not contraindicated by haemodynamic considerations. PMID- 6487984 TI - Ureteric injury following chemical sympathectomy. PMID- 6487985 TI - Endemic non-venereal syphilis (bejel) in Saudi Arabia. AB - A total of 2515 people attending a large military hospital in Saudi Arabia was studied clinically, serologically, and (when appropriate) radiologically for evidence of treponematosis. The indications are that non-venereal endemic syphilis (bejel) is prevalent among the nomadic communities living in rural areas. In contrast, venereal syphilis is much less common, and is found almost exclusively in urban populations. Some of the high risk regions for bejel have been identified, and many people from these locations complained of persistent pain in the legs, which was often associated with radiological evidence of osteoperiostitis of the long bones. Bejel also seems to have become clinically "attenuated" within the last 30 years, with the majority of seroreactors having latent disease. A hypothesis suggesting a reason for this change is put forward, and ways of controlling the infection are outlined. PMID- 6487986 TI - Treatment of uncomplicated gonorrhoea in women with a combination of rifampicin and erythromycin. AB - One hundred women with uncomplicated gonorrhoea (in five cases due to penicillinase producing strains of Neisseria gonorrhoeae (PPNG)) were treated with a single oral dose of rifampicin 900 mg and erythromycin stearate 1 g. N gonorrhoeae was reisolated from the oropharynx of one patient, who was infected with a PPNG strain, but was eradicated from the genital tract in 100% of cases. The combination eradicated Chlamydia trachomatis from only 10 (28%) of the 36 patients infected. Side effects were predominantly mild and consisted of transient nausea. The treatment merits evaluation in areas with a high incidence of PPNG strains. PMID- 6487987 TI - Effect of epidemiological treatment of contacts in preventing recurrences of non gonococcal urethritis. AB - Clinical investigations of the usefulness of routine epidemiological treatment of sexual contacts of men with non-gonococcal urethritis (NGU) have produced conflicting results that could have been due to the selection of patients. In this study, which was undertaken in a provincial city, 100 men with untreated sexual partners and 100 demographically similar men with treated sexual partners were reviewed for recurrences of NGU over 12 months. Prolonged courses of tetracyclines were found to be beneficial particularly when the sexual partner gave positive results to tests for chlamydiae. There was, however, no clinical evidence that the men benefited from routine epidemiological treatment of their sexual partners. PMID- 6487988 TI - Hepatitis B antigen and antibody in the blood of prostitutes visiting an outpatient venereology department in Rotterdam. AB - We took blood samples from 128 prostitutes visiting the outpatient venereology department of the University Hospital, Rotterdam-Dijkzigt to test for the presence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis B surface antigen (anti-HBs). The prevalence of anti-HBs was found to be significantly higher in the group of prostitutes than in "normal populations", and we concluded that more of the former had been in contact with the hepatitis B virus (HBV). We recommend that the advice on vaccination of the hepatitis B committee of the Health Council of The Netherlands should be followed by screening prostitutes for the presence of HBsAg and anti-HBs in the blood, and vaccinating those who have no anti-HBs. PMID- 6487989 TI - Activity of the newer quinolones against Chlamydia trachomatis. PMID- 6487990 TI - Use of air dried vaginal specimens in the diagnosis of candidiasis and anaerobic vaginosis (non-specific vaginitis): effects of storage at room temperature. PMID- 6487991 TI - Treatment of anogenital warts with trichloroacetic acid and podophyllin. PMID- 6487992 TI - Teat skin lesions and mastitis. PMID- 6487993 TI - Effects of chronic chloramphenicol administration on weight gains and serum cortisol levels in calves. PMID- 6487994 TI - An investigation of the causes and of the financial loss of rejection of pig carcasses and viscera unfit for human consumption. I. Studies at one abattoir. PMID- 6487995 TI - Concentrations of oestradiol-17 beta and progesterone in bovine plasma and defatted milk during the post-partum anovulatory period, during oestrous cycles and following ovariectomy. PMID- 6487996 TI - Observations on a skin sensitivity test for ovine enzootic abortion. PMID- 6487997 TI - Snout impression prints: a technique for recording lesions in porcine atrophic rhinitis. PMID- 6487998 TI - The camel in health and disease. Introduction. PMID- 6487999 TI - A guide to the clinical examination, chemical restraint and medication of the camel. PMID- 6488000 TI - Recommended techniques in small animal anaesthesia: an update. PMID- 6488001 TI - Neurite-promoting factors and extracellular matrix components accumulating in vivo within nerve regeneration chambers. AB - The outgrowth of neurites from cultured neurons can be induced by the extracellular matrix glycoproteins, fibronectin and laminin, and by polyornithine binding neurite-promoting factors (NPFs) derived from culture media conditioned by Schwann, or other cultured cells. We have examined the occurrence of fibronectin, laminin and NPFs during peripheral nerve regeneration in vivo. A previously established model of peripheral nerve regeneration was used in which a transected rat sciatic nerve regenerates through a silicone chamber bridging a 10 mm interstump gap. The distribution of fibronectin and laminin during regeneration was assessed by indirect immunofluorescence. Seven days after nerve transection the regenerating structure within the chamber consisted primarily of a fibrous matrix which stained with anti-fibronectin but not anti-laminin. At 14 days, cellular outgrowths from the proximal and distal stumps (along which neurites grow) had entered the fibronectin-containing matrix, consistent with a role of fibronectin in promoting cell migration. Within these outgrowths non vascular as well as vascular cells stained with anti-fibronectin and anti laminin. Within the degenerated distal nerve segment, cell characteristic of Bungner bands (rows of Schwann cells along which regenerating neurites extend) stained with anti-fibronectin and laminin. The fluid surrounding the regenerating nerve was found to contain NPF activity for cultured ciliary ganglia neurons which markedly increased during the period of neurite growth into the chamber. In previous studies using this particular neurite-promoting assay, laminin but to a much lesser extent fibronectin also promoted neurite outgrowth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488002 TI - Biochemical characterization of the central nervous system myelin proteins of the rainbow trout, Salmo gairdneri. AB - Central nervous system myelin isolated from the rainbow trout (Salmo gairdneri) displays a very low median density on zonal gradient centrifugation, banding at approximately 0.32 M sucrose. Its proteins consist of a 36 K (36,000 mol.wt.) component, two Concanavalin A-reactive intermediate proteins IP1 (23,000 mol.wt.) and IP2 (26,200 mol.wt.), and two basic proteins BP1 and BP2, of which the latter co-migrates with rat SBP while BP1 is of slightly smaller size. The trout myelin proteins electrofocus at pH positions similar to those of their mammalian counterparts. Immunoblotting shows that antibodies against rat PNS myelin P0 glycoprotein are bound by IP1 and IP2, but not by 36K. None of the trout myelin proteins react with anti-rat CNS myelin proteolipid protein (PLP) antiserum. The basic proteins BP1 and BP2 bind strongly to antibodies directed against human myelin basic protein. In vivo injection of tritiated fucose or palmitate leads to radiolabeling of IP1 and IP2. Under autolytic in situ conditions the appearance of a glycosylated 20,000 mol.wt. component (IP0) is noted, with parallel reduction of both IP1 and IP2, indicating sequence homologies between IP1 and IP2. The 36K protein is not affected by autolysis. PMID- 6488003 TI - In vitro and in vivo evidence for the existence of presynaptic muscarinic cholinergic receptors in the rat hippocampus. AB - The intrahippocampal injection of kainic acid cleared 50% of muscarinic receptors and favored the detection of a further 20% loss in hippocampal presynaptic muscarinic receptors produced by electrolytic lesion of the medial septal nucleus as determined by Scatchard analysis of the saturation isotherms of [3H]dexetimide binding. In accordance, a decrease of about 20% in the in vivo accumulation of [3H]dexetimide in the hippocampus was found in animals lesioned in the medial septal nucleus. This effect occurred at both the dose of 5 micrograms/kg and at the saturating dose of 100 micrograms/kg of [3H]dexetimide. The results suggest that the loss was due to decreased receptor number rather than decreased receptor affinity. PMID- 6488004 TI - Release of pentobarbital-induced depression of metabolic rate during bilateral ischemia in the gerbil brain. AB - Treatment of gerbils with 40 mg/kg of pentobarbital (i.p.) reduced the metabolic rate in the hippocampus and cerebral cortex by approximately 60%. However, the depression of metabolic rate was lost within 40 s of ischemia and further, pentobarbital delayed but did not prevent the depletion of energy metabolites observed in the ischemic brain. PMID- 6488005 TI - The effect of 5,7-dihydroxytryptamine on the serum corticosterone resistance to suppression by dexamethasone. AB - The effect of serotonin (5-HT) deficiency on hypothalamic-pituitary-adrenal (HPA) activity was investigated by using 5,7-dihydroxytryptamine (5,7-DHT) for the selective destruction of central 5-HT neurons, and corticosterone response to suppression by dexamethasone as the index of HPA activity. Dexamethasone was shown to significantly suppress serum corticosterone levels in sham-treated rats, but did not suppress corticosterone in the 5,7-DHT-lesioned animals. This finding supports the conclusion that 5-HT is involved in the negative feedback mechanism of HPA regulation. PMID- 6488006 TI - Changes in frequency representation in the auditory system of mice with age related hearing impairment. AB - Aging C57BL/6 mice show a progressive decline in sensitivity to sound, beginning with high frequencies. In the inferior colliculus (IC), tonotopic organization- the orderly representation of frequency from low to high along the dorsoventral dimension--shows marked changes. No neurons respond to high frequencies, most respond best to a restricted range of frequencies, and ventral neurons become responsive to low frequencies. These age-related response alterations have implications for hearing problems of aging humans. PMID- 6488007 TI - Microiontophoretic bicuculline restores binocular responses to visual cortical neurons in strabismic cats. AB - Rearing cats with surgically induced strabismus resulted in an abnormally high percentage (80%) of monocularly driven neurons in visual cortex. Microiontophoretic application of the GABA antagonist bicuculline restored binocular responses to over 50% of these monocular cells. Elevation of spontaneous rate by glutamate failed to produce binocularity. These results indicate that intracortical inhibition plays a role in the abnormal ocular dominance distribution of strabismic cats. PMID- 6488008 TI - Changes in the thermal characteristics of hypothalamic neurons during sleep and wakefulness. AB - The characteristics of the mammalian thermoregulatory system are dependent upon arousal state. During NREM sleep thermoregulatory mechanisms are intact but body temperature is regulated at a lower level than during wakefulness. In REM sleep thermoregulatory effector mechanisms are inhibited and thermal homeostasis is severely disrupted. Thermosensitivity of neurons in the preoptic/anterior hypothalamus (POAH) was determined for behaving kangaroo rats (Dipodomys deserti) during electrophysiologically defined wakefulness, NREM sleep and REM sleep to elucidate possible neural mechanisms for previous findings of state-dependent changes in thermoregulation. Thirty cells were tested during at least two arousal states. During wakefulness, 70% of the recorded cells were sensitive to changes in local temperature, with the number of warm-sensitive (W) cells outnumbering cold-sensitive (C) cells by 1.6:1. In NREM sleep, 43% of the cells were thermally sensitive, with the ratio of W:C remaining the same as in wakefulness. In REM sleep only two cells were thermosensitive (both W). The decrease in neuronal thermosensitivity of POAH cells during REM sleep parallels findings of inhibition of thermoregulatory effector responses during REM, although further work is necessary to determine the source and nature of the inhibition. PMID- 6488010 TI - Climbing fiber action on the responsiveness of Purkinje cells to parallel fiber inputs. AB - Recent work in our laboratory has demonstrated that spontaneous or evoked climbing fiber inputs are associated with an increased responsiveness of Purkinje cells to mossy fiber inputs activated by natural peripheral stimuli. These experiments were designed to test the hypothesis that this increased responsiveness occurs in the cerebellar cortex. In decerebrate, unanesthetized cats Purkinje cells in the surface folium were isolated and their simple and complex spikes discriminated. A bipolar concentric stimulating electrode was placed on the surface of the folium to activate the parallel fiber volley and modulate the Purkinje cell's simple spike discharge. The cell's simple spike discharge was evaluated when the surface stimulus was presented randomly and when this stimulus was timed to occur at a fixed interval after the spontaneous complex spike activity. When the surface stimulus was timed to occur at short intervals after the spontaneous complex spike, the response to the surface stimulus was accentuated. This increase in simple spike modulation occurred independent of whether the simple spike discharge increased or decreased in response to the surface stimulus. These results support the hypothesis that the climbing fiber input changes the gain of Purkinje cells' simple spike responses to mossy fiber inputs due to interactions occurring in the cerebellar cortex. PMID- 6488009 TI - Effects of low pH on synthesis and release of catecholamines in the cat carotid body in vitro. AB - The rates of dopamine and noradrenaline synthesis in the cat carotid body (c.b.) are 5.9 +/- 0.58 pmol/c.b./2 h and 0.3 +/- 0.02 pmol/c.b./2 h, respectively. The synthesis is doubled when the organs are incubated at pH 7. Similarly, low pH induces a release of dopamine from the c.b. which is proportional to increased activity in the carotid sinus nerve. PMID- 6488011 TI - Hypothalamic knife cuts attenuate maintenance of deoxycorticosterone acetate-salt induced hypertension. AB - These experiments tested the effects of knife cuts transecting neural pathways associated with the anteroventral third ventricle (AV3V) region on deoxycorticosterone acetate (DOCA)-salt induced hypertension. Coronal knife cuts of the descending medial neural pathway from the AV3V region between the medial preoptic area and anterior hypothalamus did not significantly alter DOCA-salt hypertension. However, parasagittal cuts which separated the AV3V region from the medial forebrain bundle attenuated the hypertension following 5 weeks of DOCA salt treatment. PMID- 6488012 TI - Recovery functions of spinal cord and subcortical somatosensory evoked potentials to posterior tibial nerve stimulation: intrasurgical recordings. AB - The recovery function of evoked potentials to posterior tibial nerve stimulation was studied. Intrasurgical recordings were made from interspinous ligaments at lumbar levels and from high thoracic-low cervical level. In addition, surface recordings were obtained from neck-scalp derivations. The recovery function of the potentials recorded from lumbar and from high thoracic-low cervical spinal cord were very similar, showing an early period of supernormality (5-20 ms) followed by a period of subnormality which reached its lowest point at 40-60 ms. Assuming that the potentials recorded at the lumbar level reflect activity in the cauda equina, we conclude that the results support the hypothesis that the potentials recorded from the thoraco-cervical level reflect activity in the dorsal columns. The recovery curve of the amplitude between the far field potentials P27 (which most probably reflects activity of the afferent volley at the level of foramen magnum) and N30 (which, by latency criteria, would reflect lemniscal or thalamic activity) showed a similar shape but with a shorter duration of the periods of super- and subnormality. It is likely that this modification was due to the synapse at the gracilis nucleus. The first cortical component (P32) recorded in the neck-scalp derivation was totally abolished within the recovery period studied (50 ms interval). PMID- 6488013 TI - Transient and enduring morphological correlates of synaptic activity and efficacy change in the rat hippocampal slice. AB - This study examined anatomical correlates of: (1) long-term potentiation (LTP); (2) equivalent low frequency synaptic activity; (3) continuous high frequency synaptic activation which did not produce LTP; and (4) synaptic inactivation by high Mg2+/low Ca2+ incubation in hippocampal subfield CA1 in the in vitro slice, and examined the persistence of changes at 10-15 min, 2 h and 8 h after stimulation. After potentiating stimulation (6 trains at 100 Hz for 1 s or 200 Hz for 0.5 s), compared to an equivalent number of low frequency stimuli (1 Hz for 600 s), there were increases in numbers of shaft and sessile spine synapses (synapses on stubby, headless spines). This suggested an increase in the number of shaft synapses onto inhibitory interneurons and/or an enhancement of synapse formation on pyramidal neurons possibly involving initial formation of shaft synapses and a transition from shaft, to sessile spine, to full grown spine synapses. Postsynaptic spine heads also assumed a rounder shape, as indicated by decreases in spine perimeter to area ratios, contact lengths, and the percentage of 'cup' shaped spines. There was no effect of potentiating stimulation on bouton or spine areas. After continuous high frequency synaptic activation (40 Hz or 100 Hz for 10 min), which produced no apparent LTP, there were no changes in synapse numbers or spine head shape parameters. However, in contrast to effects of LTP, there was an increase in bouton mitochondrial area and a marginal increase in bouton area compared to the low frequency condition. Inactivation did not affect any of these measures. LTP-associated increases in numbers of shaft and sessile spine synapses persisted over an 8 h incubation period, while the effect on spine shape disappeared after 2 h. Physiologically-demonstrable LTP persisted over the 8 h period. Effects of continuous high level activation on mitochondrial and bouton areas were even more transient, disappearing 2 h after stimulation. These findings: (1) confirm previously reported effects of potentiating stimulation on synapse numbers and spine shape; (2) indicate that spine shape changes are not necessary for the maintenance of LTP; and (3) indicate that continuous high frequency activation which does not produce potentiation has different and non persisting effects from potentiating stimulation. PMID- 6488014 TI - Discharge properties of area 5 neurones during arm movements triggered by sensory stimuli in the monkey. AB - Unitary discharge was recorded from 157 cells in area 5 of 2 monkeys trained to perform rapid movements of the contralateral arm. Ninety-six cells were task related. The earliest movement-related modulation in discharge for the large majority of cells (92%) followed the onset of electromyographic (EMG) activity. The discharge pattern of almost all units for which discharge was recorded during movements in opposite directions varied with direction, most often in a nonreciprocal manner. Discharge was correlated with peak velocity in 23% of the excited cells (n = 52). Almost the entire population of cells correlated with velocity were located in the upper part of the anterior bank of the intraparietal sulcus, suggesting that there may be at least two different functional subregions within the arm representation of area 5. Forty percent of the movement-related units had a short latency response to a small, brief perturbation of the elbow which served as one of the movement cues. These sensory responses were labile, not being present in every trial for a large number of cells. Thirty-six percent of the perturbation-sensitive cells were classified as reaction time (RT) dependent on the basis of a correlation between RT and either the magnitude or the frequency of occurrence of the response. The response was clearly dependent on the subsequent motor response being absent when movement was extinguished. This dependence of the sensory response on the subsequent movement is a property which might represent a neural substrate for somatic sensory attention. The results also support the idea that the RT-dependent cells may be involved in the initiation of the shortest RT movements in response to the somaesthetic cue. PMID- 6488015 TI - Clonidine-induced feeding: analysis of central sites of action and fiber projections mediating this response. AB - Clonidine (CLON), an alpha-adrenergic agonist, was used in conjunction with norepinephrine (NE) to elicit feeding in satiated rats that had sustained hypothalamic electrolytic lesions, or coronal knife cuts at the hypothalamic, midbrain or pontine level of the brainstem. Electrolytic lesions of the paraventricular nucleus (PVN) of the hypothalamus significantly attenuated feeding normally stimulated by intraperitoneal injection of CLON. This contrasts with lesions in the dorsomedial or perifornical hypothalamic regions which had no effect on CLON-elicited eating. Knife cuts placed in the posterior hypothalamus and throughout the midbrain tegmentum also left intact the CLON eating response, in contrast to specific cuts in the dorsal pontine tegmentum which disrupted feeding elicited by PVN injections of NE and CLON, as well as by peripheral administration of CLON. Analyzed together, these results with effective and ineffective cuts relative to CLON and NE feeding provide evidence for an alpha adrenergic feeding circuit which originates in the PVN and descends from this nucleus, via a dorsal periventricular course, through the diencephalon and midbrain. Further caudally, these fibers mediating NE and CLON feeding then appear to traverse ventrolaterally into the dorsolateral pontine tegmentum on their way to the dorsal medulla. PMID- 6488016 TI - Influence of morphine and cyclazocine on the cortical epileptic foci in rabbits. AB - The effects of morphine, cyclazocine and naloxone on penicillin- and strychnine induced epileptic foci were studied in rabbits. The intracortical injection of penicillin (75, 150 and 300 units) elicited isolated spikes followed by repeated ictal events. The application of strychnine (0.062 and 0.125%) over the cortical surface of one side induced appearance of ipsilateral spiking spreading to the contralateral cortex. Administration of morphine (0.25-0.75 mg/kg i.v.) or cyclazocine (0.05-3.0 mg/kg i.v.) inhibited the occurrence or the duration of the EEG and motor manifestations induced by penicillin (75 and 150 units) and strychnine (0.062 and 0.125%), while it did not influence the effect of 300 units of penicillin. High doses of morphine (up to 10 mg/kg i.v.) failed to affect the epileptic responses to penicillin and strychnine and at the same time significantly reduced the pO2 in arterial blood. Naloxone per se potentiated the effects of the lower doses of penicillin and strychnine. Only at very high doses (20 mg/kg i.v.) displayed a weak antagonism towards the anticonvulsant effect of the two opiates. A full antagonism is only observed towards the effect of cyclazocine (2 mg/kg i.v.) administered after penicillin. Present data provide additional evidence of the heterogeneity of regulation by opioids of convulsive phenomena. One can hypothesize that the anticonvulsant effect of the two opiate agonists is mediated by naloxone-insensitive opiate receptors, while the proconvulsant-convulsant effect of naloxone might be related to an inhibition of GABA and glycine-mediated transmission. PMID- 6488017 TI - Interocular transfer of pattern discrimination learning in chicks. AB - A previous study found that chicks pecking a key for heat did not show interocular transfer of a pattern discrimination, indicating that the monocularly acquired discrimination was stored as a unilateral engram which was not available to the untrained eye/hemisphere system. In the present study, chicks were trained monocularly on a pattern discrimination and tested for interocular transfer exactly as in the previous experiment, except that a correct pecking response was reinforced by presentation of food. There was good interocular transfer of the discrimination under these conditions. These results are interpreted as indicating that the biological relevance of a learning situation influences the extent of interocular/interhemispheric communication of information. In addition to the findings with respect to transfer, the present study revealed some unexpected laterality effects. Chicks trained first through the right eye (left hemisphere) learned the pattern discrimination faster and showed more savings during the interocular transfer test than chicks trained first through the left eye (right hemisphere). These findings are discussed in terms of possible hemispheric specialization and asymmetry of interhemispheric communication in the avian brain. PMID- 6488018 TI - Endocytosis of nerve growth factor by 'differentiated' PC12 cells studied by quantitative ultrastructural autoradiography. AB - The endocytosis of [125I]nerve growth factor (NGF) by rat pheochromocytoma cells (PC12 line), previously exposed to the growth factor ('differentiated' or 'primed' cells), was studied by ultrastructural quantitative autoradiography. Cells previously grown in the presence of NGF were incubated at 37 degrees C with [125I]NGF for periods of up to 24 h. Under these culture conditions, PC12 cells have a rich network of neurites. At the commencement of the experiment, after incubation of cells with [125I]NGF for 1 min at room temperature, the plasma membranes of perikarya and processes showed similar levels of labeling by [125I]NGF of 0.186 +/- 0.03 grains/micron and 0.152 +/- 0.013 grains/micron respectively. The density of grains per micron of plasma membrane of perikarya reached a plateau between 15 min to 2 h of incubation of cells at 37 degrees C with [125I]NGF (0.58 +/- 0.15 grains/micron and 0.65 +/- 0.18 grains/micron, respectively). The endocytosis of [125I]NGF in perikarya of cells incubated for 6 h at 37 degrees C was studied by the 'mask' analysis method of Salpeter et al.22. At this time, the greatest amount of endocytosis was observed, corresponding to 28.4% of total grain counts. The following optimized computed source densities, or relative specific activities +/- standard errors of measurement (S.E.M.), were obtained: plasma membrane, 16.52 +/- 0.86; multivesicular bodies, 9.58 +/- 2.84; endosomes, 5.00 +/- 0.97; smooth vesicles and tubules, 1.66 +/- 0.38; lysosomes, 1.13 +/- 0.20; mitochondria, 0.46 +/- 0.10; nuclear membranes or envelopes, 0.32 +/- 0.14; nuclei, 0.06 +/- 0.01; the Golgi apparatus, 0.08 +/- 0.06; and other cytoplasmic elements 0.07 +/- 0.03. Our findings indicate that smooth vesicles and tubules, endosomes, multivesicular bodies and lysosomes are part of the pathway(s) of endocytosis of NGF, while all other cytoplasmic and nuclear elements, including the nuclear membrane, are not. The heavy plasma membrane labeling of NGF and the relatively low degree of its endocytosis are consistent with the hypothesis that the NGF action is mediated through plasma membrane activated second messenger(s). PMID- 6488019 TI - A comparative investigation in the rat of the anesthetic effects of the isomers of two barbiturates. AB - The sensitivities in the brain of the barbiturates N-methyl-cyclobarbital (MCB) and hexobarbital (HEX) were determined by an anesthesia threshold in male rats. The criterion was a burst suppression in the EEG of 1 s or more (the 'silent second'). The dose needed to induce the criterion was used as the threshold. Available for testing were with MCB the isomers and the racemate and with HEX the isomers and various combinations of them. In experiment 1 the 4 isomers and the racemates were all tested in the same group of animals. In experiment 2 various combinations of HEX were tested. With HEX the (+)-S-isomer and with MCB the (-)-R isomer was the most potent one. The differences in anesthetic action between the isomers were largest with HEX. During induction of anesthesia no jerks were recorded with (-)-R-MCB. All the other isomers induced jerks. The only significant regression found, when all isomers were tested against each other, was a negative one between (-)-R-MCB and (-)-R-HEX (r = -0.79). No significant relations were found between the isomers and the corresponding racemate. Experiments with the racemate of MCB and with various combinations of the isomers of HEX indicated that a potentiation appeared when the isomers were used together. PMID- 6488020 TI - A [14C]2-deoxyglucose analysis of the functional neural pathways of the limbic forebrain in the rat. IV. A pathway from the prefrontal cortical-medial thalamic system to the hypothalamus. AB - The present study utilized the [14C]2-deoxyglucose (2-DG) cell labeling procedure to characterize a functional pathway from the prefrontal cortex (Pfc) and mediodorsal thalamic nucleus (MD) to the hypothalamus. Rats were injected with 2 DG prior to a 45 min experimental paradigm consisting of alternating 30 s on-off periods of electrical brain stimulation. Standard procedures were utilized for the removal and processing of brain tissue for X-ray autoradiography. In the first phase of this study, stimulation applied to the prefrontal cortex generally yielded a pattern of 2-DG distribution consistent with the findings of classical anatomical studies. Stimulation of the dorsomedial and ventromedial prefrontal cortex or the infralimbic cortex produced the most effective activation of the diencephalon. This activation was primarily limited to MD, with no involvement of any region of the hypothalamus. In the second phase of this study, brain regions activated following stimulation of sites along the rostro-caudal axis of MD were examined. Stimulation of MD resulted in the activation of the nucleus reuniens and other midline and non-specific thalamic nuclei. Stimulation of this nucleus also activated the ventromedial thalamic nucleus, medial aspects of the nucleus accumbens and the medial and sulcal prefrontal cortices. Again, in each of these cases, labeling within any region of the hypothalamus could not be detected. Since MD stimulation activated the midline thalamus, and the nucleus reuniens in particular, the last phase of this experiment involved stimulation of the nucleus reuniens in order to determine the source of medial thalamic inputs to the hypothalamus. Stimulation of the nucleus reuniens activated fibers which were distributed to both the medial and lateral hypothalamus. In addition, stimulation also activated the descending periventricular system, which could be followed to the level of the midbrain central gray and such limbic structures as the hippocampal formation, septal area, amygdala and prefrontal cortex. These findings indicate that Pfc-MD activation of the hypothalamus is achieved indirectly via interneurons within the nucleus reuniens. PMID- 6488021 TI - Regenerating nerve fibres do not displace the collateral reinnervation of cat teeth. AB - Experiments in adult cats have shown that when the inferior alveolar nerve is sectioned and regeneration blocked, there is extensive collateral reinnervation from neighbouring nerves which reinnervate the denervated teeth. In the present experiments the fate of collateral nerve fibres supplying the teeth has been investigated following regeneration of the inferior alveolar nerve. In some experiments the inferior alveolar nerve was sectioned and regeneration temporarily blocked whilst in others the nerve was frozen but not sectioned, to allow a more complete restoration of normal properties after regeneration. The jaw opening reflex evoked by electrical stimulation of the left canine and incisor teeth was abolished by left inferior alveolar nerve section or freeze but returned within 3-9 weeks due to reinnervation by collateral nerve fibres. Regenerating inferior alveolar nerve fibres were allowed to reinnervate the teeth 12-15 weeks after the initial nerve injury. Twenty seven weeks after the initial nerve injury, pulpal nerve fibres supplying the teeth which had been denervated were present in the regenerated inferior alveolar nerve as well as the ipsilateral lingual and mylohyoid nerves and the contralateral inferior alveolar, lingual and mylohyoid nerves. Except for the ipsilateral inferior alveolar and lingual nerves, these nerves do not normally include pulpal fibres from these teeth. In these experiments, therefore, after inferior alveolar nerve section or freeze, the collateral reinnervation of tooth pulps was not withdrawn following the return of regenerating nerve fibres. PMID- 6488022 TI - Organization of neurons forming the femoral, sciatic, common peroneal and tibial nerves in rats and monkeys. AB - Our study shows that, using Elliott's method, 6 major groups of neurons can be identified in the lumbosacral cord segments of both monkeys and rats. These are the medial (m), ventromedial (vm) anterolateral (al), central (c), posterolateral (pl) and post-posterolateral (ppl) groups; they are, except for minor differences, similarly arranged in neonatal, immature, and mature monkeys and rats. Localization of neurons by the horseradish peroxidase method reveals that the sciatic nerve (ScN) neurons are distributed to L4-L7 segments in all monkeys studied and also to the rostral part of S1 segment in some monkeys. They occur in the ppl, pl, c and al groups. Of the ScN neurons, the common peroneal nerve (CPN) neurons occur more peripherally and slightly more rostrally than the tibial nerve (TN) neurons. ScN neurons in rats extend between the caudal parts of L3 and L6 segments but may extend to the rostral part of S1 segment. Their distribution to the ppl, pl, c and al groups resembles that in the monkey except for minor differences. The distribution of CPN and TN neurons in the ScN neurons in the rat also resembles that in the monkey. The distribution of ScN neurons is similar in the neonatal, immature and mature rats and monkeys except for minor differences. Femoral nerve (FN) neurons in both monkeys and rats extend between L2 and L4 segments. However, in monkeys, FN neurons start to appear only in the caudal part of L2 segment and may extend to the rostral part of L5 segment. In rats, they appear in the rostral part of L2 segment and end about the middle of L4 segment. In both rats and monkeys, FN neurons occur in the al, pl and c groups; in in addition they also occur in the ppl group in the monkey. There is minor difference in the distribution of FN neurons in the al, pl and c groups in both rats and monkeys. There is postnatal growth in length of the spinal segments containing ScN neurons in both rats and monkeys, but no significant difference in the number of labeled ScN neurons in the neonatal, immature and mature rats and monkeys. There is also no significant difference in the counts of labeled right and left ScN neurons. The histograms showing the number of labeled ScN neurons against their diameters are very similar in both rats and monkeys. In both animals, the diameters of ScN neurons vary widely between 3 and 53 microns. PMID- 6488023 TI - Thalamocortical projections to layer I of the primary auditory cortex in the cat: a horseradish peroxidase study. AB - HRP injected into layer I of the primary auditory cortex (AI) in the cat labeled neuronal cell bodies ipsilaterally in the medial, dorsal and ventrolateral divisions of the medial geniculate nucleus (MGN), suprageniculate nucleus, and nucleus of the brachium of the inferior colliculus. MGN neurons labeled after HRP injected into layer I were statistically smaller than those labeled after HRP injected into layer IV. PMID- 6488024 TI - Chemical synapses between turtle photoreceptors. AB - Rod photoreceptors of the snapping turtle retina wer Golgi impregnated and studied in the electron microscope. Telodendria arising from the synaptic bases ended at rods and cones as lateral or central elements of the ribbon synaptic complex, thus providing clear evidence of chemical synapses between turtle photoreceptors. PMID- 6488025 TI - Lesions of the paraventricular nucleus alter the development of spontaneous hypertension in the rat. AB - The role of the paraventricular nucleus of the hypothalamus (PVH) in the development of hypertension was determined after bilateral electrolytic or sham lesions of this structure in 4-5-week-old male spontaneously hypertensive rats (SHR). The average arterial pressure in the PVH-lesioned group was significantly lower compared to sham-lesioned animals during the first 3 weeks after the PVH lesions. At 9 weeks of age the arterial pressures of the PVH-lesioned animals increased, but remained significantly lower than those of the sham-operated animals of the same age. This difference in arterial pressures was observed to 16 weeks of age. Heart rate was significantly reduced by PVH lesions up to 5 weeks after the lesions, at which point the heart rate tended towards the control values of the sham-lesioned animals. These data have demonstrated that the region of the PVH is important in the initial phase of the development of hypertension and in the full expression of the hypertension in the SHR, and provide evidence of a central mechanism in the hypertensive process in the SHR. PMID- 6488026 TI - Karyometric development of four topographic subdivisions of the paraventricular nucleus in normal and castrated mice. AB - A karyometric study of the spontaneous development of four topographic subdivisions in the paraventricular nucleus was made in male albino mice from the 5th to the 190th day of postnatal life. Another 25 animals were castrated at 20 days and examined at 25, 35, 45, 55 and 85 days of life. A comparison was established between both groups of mice. PMID- 6488027 TI - Afferent connections of the ventral lateral geniculate nucleus in the rat: an HRP study. AB - The afferent connections of the ventral lateral geniculate nucleus (VLGN) of the albino rat were studied using the HRP-retrograde transport method. Neurons projecting to the VLGN were found in 4 visual systems areas: layer V of the ipsilateral visual cortex (areas 17 and 18), the stratum griseum superficiale of the ipsilateral superior colliculus, the ipsilateral olivary, anterior and posterior pretectal nuclei and in the contralateral medial divisions of the VLGN. Labeled neurons were also found bilaterally in the nucleus raphe dorsalis and nucleus locus coeruleus. PMID- 6488028 TI - [3H]Kainic acid binding and choline acetyltransferase activity in Alzheimer's dementia. AB - The binding of [3H]kainic acid to caudate nucleus membranes prepared from brains of examples of Alzheimer's dementia and controls has been determined. No changes were detected in either the affinity or the number of kainate binding sites in the Alzheimer samples compared to control, although there was a large decrease in choline acetyltransferase activity. PMID- 6488029 TI - Time course of the changes in striatal acetylcholine levels induced by pergolide and haloperidol after lesion of the nigrostriatal dopaminergic pathways in the rat. AB - Lesion of the nigrostriatal dopaminergic pathway in the rat by 6-hydroxydopamine enhances the ability of pergolide to increase striatal acetylcholine levels and prevents the haloperidol-induced decrease in acetylcholine concentrations. This supersensitive response of striatal cholinergic cells is already maximal 6 days after lesion but tends to decrease thereafter. As the time course of the development of the supersensitivity of cholinergic cells differs from that of increased dopamine binding site density, the two are probably not causally related, the former reflecting rather a change occurring beyond the dopamine recognition site. PMID- 6488030 TI - Selective impairment of declarative memory following stimulation of dentate gyrus granule cells: a naloxone-sensitive effect. AB - Albino rats received 10 s of sub-seizure electrical stimulation applied to the dentate gyrus granule cells immediately after acquisition of information on trial 1 of a 2-trial radial maze spatial memory task. Granule cell stimulation selectively reduced the probability of accessing information held in declarative memory ('knowing that' a particular maze location contains food) while leaving procedural memory intact ('knowing how' to search for food in the maze). This specific memory impairment was prevented by pretreatment with the opiate antagonist naloxone. Naloxone also improved memory performance when given to non stimulated subjects. PMID- 6488031 TI - Interconnections within the postarcuate cortex (area 6) of the macaque monkey. AB - Small amounts of horseradish peroxidase conjugated with wheat germ were injected in restricted parts of the postarcuate premotor area of the macaque monkey. It was found that regions of this area having different somatotopic representations are richly interconnected among them. This pattern of intra-areal connectivity was not observed in the precentral motor area. It appears therefore that the postarcuate area is organized according to anatomical principles which are different from those of the primary motor cortex. PMID- 6488032 TI - Structural asymmetries in brains of mice selected for strong lateralization. AB - The brains of 18 female mice from two lines selectively bred for lateralization of paw preference were investigated for morphological asymmetries in 5 horizontal sections from mid-dorsoventral planes. Cortical thickness was measured at orbitofrontal, somatosensory and lateral entorhinal regions; volume measures included the hippocampal formation and the striatum. Mice of the strongly lateralized line had stronger asymmetries in 4 of the 5 variables. Discriminant analysis showed that the two mouse lines could be differentiated best by their asymmetries in orbitofrontal cortex and hippocampus (P less than 0.02). PMID- 6488033 TI - Coexistence of dopamine and serotonin in an identified neuron of the lobster nervous system. AB - The combination of several analytical methods, i.e. chemical analysis (high performance liquid chromatography), biochemical analysis (radioimmunoassay) and immunohistochemistry, has shown that a single neuron can contain two 'classical' neurotransmitters. PMID- 6488034 TI - Intrinsic regulation of locus coeruleus neurons: electrophysiological evidence indicating a predominant role for autoinhibition. AB - Locus coeruleus neurons were antidromically activated and the resulting post stimulation inhibition was compared to the interspike interval and examined for its dependency on antidromic invasion and stimulus intensity. The post stimulation inhibition seen in these cells following antidromic activation approximated the interspike interval, was critically dependent on the antidromic invasion of the cell under study and was only weakly dependent on stimulus intensity. These results suggest that the post-stimulation inhibition following antidromic activation in the locus coeruleus is mediated principally by autoinhibition and not by hypothesized local inhibitory interactions between locus coeruleus neurons. PMID- 6488035 TI - Evidence for a serotonergically mediated sympathoexcitatory response to stimulation of medullary raphe nuclei. AB - The cardiovascular role of serotonin (5-HT) containing neurons in the midline medullary raphe nuclei was studied in anesthetized cats. High frequency electrical stimulation of nucleus (n.) raphe (r.) pallidus, n.r. obscurus and n.r. magnus produced both pressor and depressor responses. Single shock stimulation of pressor sites produced an excitatory evoked potential of sympathetic nervous discharge (SND) recorded from the inferior cardiac nerve. Conversely, single shock stimulation of vasodepressor sites resulted in a computer-summed inhibition of SND. The mean conduction velocity in the sympathoexcitatory medullo-spinal pathway to sympathetic preganglionic neurons was calculated to be 1.24 m/s. The 5-HT antagonists methysergide and metergoline blocked the excitation of sympathetic activity evoked from medullary raphe nuclei. In contrast, these agents failed to alter the sympathoexcitatory response to electrical stimulation of lateral medulla pressor sites or the sympathoinhibitory response elicited by raphe stimulation. The 5-HT uptake inhibitor chlorimipramine increased the duration of the sympathoexcitatory response evoked from the raphe but not from the lateral medulla. Finally, mid collicular transection did not effect the excitation of sympathetic activity elicited by stimulation of medullary raphe nuclei. These data suggest that serotonergic neurons in the midline medullary raphe nuclei provide an excitatory input to sympathetic neurons in the spinal cord. PMID- 6488036 TI - Membrane potential of cultured carotid body glomus cells under normoxia and hypoxia. AB - Type I cells of embryonic rabbit carotid bodies were cultured under normoxic (21% O2, 10% CO2, 69% N2) and hypoxic (5% O2, 10% CO2, 85% N2) conditions for two days. The mean membrane potential in the hypoxic cultivated type I cells (-27 mV) was significantly higher than in normoxic cultivated cells (-10 mV). The mean input resistance also had the tendency to increase under hypoxic conditions, from 19 m omega to 48 M omega. Results suggest that variations in membrane potential of type I cells due to oxygen pressure changes are an expression of the important role of these cells in oxygen sensing by the carotid body. PMID- 6488037 TI - Striatal dopamine release stimulated by amphetamine or potassium: influence of ovarian hormones and the light-dark cycle. AB - The release of endogenous dopamine (DA) from rat striatal tissue was studied in an in vitro superfusion system following hormonal manipulations in vivo. Progesterone treatment in estrogen-primed ovariectomized female rats potentiated DA release stimulated either by amphetamine or potassium (K+). In addition, the amount of striatal DA released in response to K+-stimulation was influenced by the light-dark cycle. We conclude that striatal DA release is modulated by ovarian hormones, and suggest that ovarian hormone modulation of presynaptic striatal DA activity may contribute to well-known estrous cycle dependent variations in some non-reproductive behaviors. PMID- 6488038 TI - Behavior of the stretch reflex in a multi-jointed limb. AB - When an external perturbation acts on a segment of a multi-jointed limb, angular motion results in all limb segments which are inertially linked to the one which is perturbed. In such a situation, different hypotheses on the functional role of the stretch reflex lead to different predictions on reflex responses by the stretched muscles. These predictions were examined experimentally and it was found that the EMG responses of elbow muscles evoked by forces applied to either the upper arm or the forearm were not uniquely related to changes in elbow angular position. They were instead correlated with the direction of changes in the net elbow torque resulting from the perturbation. PMID- 6488039 TI - Kinetic analysis of L-leucine transport across the blood-brain barrier. AB - Unidirectional L-leucine influx across cerebral capillaries was measured at different concentrations with an in situ rat brain perfusion technique, which has several advantages over presently-used methods such as the Brain Uptake Index (BUI) technique. The maximal influx rate (Vmax) and half-saturation concentration (Km) equaled 1.07 +/- 0.02 X 10(-3) mumol X s-1 X g-1 and 0.026 +/- 0.002 mumol X ml-1, respectively, for the saturable component, and the constant for non saturable influx equaled 6.8 +/- 1.4 X 10(-5) s-1. These values differ by 3-4 fold from respective values obtained with the BUI technique. PMID- 6488040 TI - Red nucleus modulation of somatosensory responses of cat spinal cord dorsal horn neurons. AB - Single unit extracellular recordings were obtained from cat lumbar spinal cord dorsal horn neurons activated by cutaneous inputs. The effect of electrical conditioning stimuli applied to the red nucleus (RN) was predominantly that of inhibition although in some cases excitation was seen. All the neurons that projected to the lateral cervical nucleus were inhibited; none of these were excited. These findings suggest that the RN may exert a dynamic modulatory action on the transmission of cutaneous information during the execution of a motor program. PMID- 6488041 TI - Acidification of interstitial fluid in hippocampal formation caused by seizures and by spreading depression. AB - Changes in the pH of interstitial fluid were measured with H+-selective double barreled micropipette electrodes in fascia dentata of urethane-anesthetized rats. Paroxysmal afterdischarges provoked by repetitive stimulation of an afferent fiber tract brought in their wake acidification by 0.07 to 0.2 pH units. Spreading depression caused acidification by 0.2-0.5 pH units. Acid shifts were often preceded by transient alkalinization. Acidification is attributed to the production of CO2 and of other acid metabolites. PMID- 6488043 TI - Investigations into a bioelectric component of synaptogenesis. AB - Synaptogenesis has been investigated in the electric organ of Torpedo marmorata with the objective of determining whether a bioelectric effect could be demonstrated. Answers to 3 questions were sought. (1) Are currents and/or fields present within the organ? (2) Can they be localized? (3) Are they involved with the synaptogenic process? Voltage measurements across pieces of electric organ revealed the presence of a dorsal positive potential in the low millivolt range. Injection of DC current against this dorsal positive dipole had the effect of reducing the percent of neuritic coverage on the ventral surface as measured by quantitative electron microscopy. These results indicate the presence of a field potential, dorsal positive which, when reversed, causes a retardation in the synaptogenic rate. They are consistent with published reports of neurites growing preferentially towards cathodal sources and implicate that bioelectric forces may be one component of the synaptogenesis process. PMID- 6488042 TI - Hypertrophy of immunohistochemically identified cholinergic neurons of the basal nucleus of Meynert following ablation of the contralateral cortex in the rat. AB - The effects of unilateral damage of the cortex on cholinergic neurons identified by immunohistochemical demonstration of choline acetyltransferase, were examined in the basal nucleus of the rat. Those cells contralateral to the lesion showed significant hypertrophy as compared with cells in the same nucleus in age- and sex-matched control animals. This enlargement was present by 7 days and persisted after 300 days postoperatively, the longest survival time examined. The age of the animal at operation and the extent of the damage may influence the magnitude of the enlargement. Similar changes were seen in the cholinergic cells of the medial septal nucleus after removal of the contralateral hippocampus. PMID- 6488044 TI - Serotonin-2 binding sites in human frontal cortex and hippocampus. Selective loss of S-2A sites with age. AB - Serotonin (S-2) binding sites were characterized in human frontal cortex and hippocampus throughout the lifespan. We found that the S-2 binding sites (labeled by [3H]spiperone and displaced by ketanserin) consisted of two subtypes (S-2A and S-2B) which are discriminated by competition with methysergide. The total S-2 sites in frontal cortex had a Bmax of 360 fmol/mg protein, which is approximately twice that of the hippocampus (160 fmol/mg protein). The density of total S-2 sites decreased with age in the frontal cortex of normal adults (17-100 years, n = 24). The receptor loss was primarily in the S-2A subclass. This loss of S-2A sites occurred primarily after 60 years and decreased to 50% of young adult values by the 10th decade. In the hippocampus, S-2A binding sites decreased with age, but no effects on total S-2 or S-2B sites were detected. A study of infant brains suggested the S-2A subtype in frontal cortex increases postnatally. However, in the infant hippocampus the S-2 binding approximated adult levels. PMID- 6488045 TI - Postsynaptic potentials in neurons of the pigeon's optic tectum in response to afferent stimulation from the retina and other visual structures: an intracellular study. AB - The responses of the cells in the pigeon's optic tectum to electrical stimulation of the contralateral optic nerve, the ipsilateral visual Wulst and the opposite optic tectum were intracellularly recorded. Optic nerve or visual Wulst stimulation elicited 3 types of responses: (1) a pure EPSP which gave rise to one or two action potentials; (2) an EPSP which sometimes gave rise to a spike, followed by an IPSP; and (3) a pure IPSP. Opposite tectum stimulation evoked in the tectal cells either a pure IPSP or a pure EPSP. The mono- or polysynaptic nature of the pathways involved in the excitatory and inhibitory responses of the tectal cells was assessed by increasing the frequency of the optic nerve stimulation. At low stimulus rates (2-6 Hz), all the excitatory events showing latencies longer than 5 ms were blocked suggesting that they were polysynaptic. Excitatory events having latencies shorter than 5 ms were generally able to follow high rate frequencies of optic nerve stimulation (40, 50 or 90 Hz) and we considered them to be monosynaptic. All but 3 IPSPs evoked by optic nerve stimulation, were blocked by stimulus rates beyond 5 Hz. Thus, although most IPSPs are generated through polysynaptic paths, direct retino-tectal inhibitory paths may also exist. The latency of the responses of individual cells to optic nerve, visual Wulst and opposite tectum stimulation show that the polysynaptic IPSPs to optic nerve stimulation did not involve relays in the visual Wulst or the opposite tectum. PMID- 6488046 TI - Electrophysiological properties of dentate granule cells in mouse hippocampal slices maintained in vitro. AB - Intracellular recordings were obtained from granule cells of the dentate gyrus in mouse hippocampal slices maintained in vitro. All the spikes observed in standard Krebs solution had a short duration and were tetrodotoxin (TTX)-sensitive. When elicited by synaptic activation or by direct electrical stimulation of the cells, these fast sodium spikes were followed by a brief spike afterhyperpolarization. In contrast, antidromic spikes elicited by electrical stimulation of the hilum as well as spikes arising at the end of hyperpolarizing current pulses passed through the recording microelectrode were followed by depolarizing afterpotentials (DAPs). These DAPs were reversed into brief spike afterhyperpolarizations by depolarization of the cells. After substitution of calcium (Ca) by barium (Ba) or after introduction of tetraethylammonium (TEA) in the bath, the fast spike repolarization became slower and the brief spike afterhyperpolarizations were abolished, suggesting that they involved fast K conductances. Slow spikes and long-lasting depolarizations were also elicited in granule cells in the presence of Ba or TEA. Since these slow events were left unaffected by TTX and were selectively abolished by the Ca channel blockers cobalt or cadmium, they are likely to be mediated by voltage-dependent Ca conductances, unmasked by the reduction of the fast K conductances. PMID- 6488047 TI - Electrophysiological properties of in vitro hippocampal pyramidal cells from normal and staggerer mutant mice. AB - Electrophysiological properties of intracellularly recorded CA1 pyramidal cells from normal and staggerer mice were compared by using hippocampal slices maintained in vitro. In staggerer mice, the passive membrane properties of these neurons as well as their synaptic potentials elicited by stratum radiatum stimulation were very similar to those observed in normal mice. In control and mutant mice and in standard Krebs solution, CA1 pyramidal cells mainly fired tetrodoxin (TTX)-sensitive fast spikes but could also generate slow spikes. In both groups, replacement of calcium (Ca) by barium (Ba) or introduction of TEA in the bathing medium prolonged the repolarization of the fast spikes and suppressed the brief spike afterhyperpolarization which normally followed them, thus suggesting that both events involve fast potassium conductances. Furthermore, in both groups of animals, TEA and Ba enhanced the slow spikes and induced the appearance of prolonged depolarizations. These slow events were TTX-resistant and were abolished by the Ca channel blockers cadmium or cobalt, thus suggesting that they are Ca-dependent. On the whole, the present results indicate that the staggerer mutation which yields marked abnormalities in the bioelectrical properties of cerebellar Purkinje cells has no such effect on CA1 pyramidal cells. PMID- 6488048 TI - Development of tactile discrimination capacity in Macaca mulatta. III. Effects of total removal of primary somatic sensory cortex (SmI) in infants and juveniles. AB - Four infant macaques between the ages of 3.0 and 5.1 weeks and three juvenile macaques between the ages of 79.9 and 109.3 weeks received unilateral lesions of all cytoarchitectural fields (Brodmann's areas 3, 1 and 2) in the hand area of the postcentral gyrus. These total SmI-lesioned infants acquired the size and texture tasks within the same time period and with the same efficiency as normal infants. On some size- and texture-ALL tasks they actually performed significantly better than partial SmI-lesioned or normal infants. The normal acquisition and ALL performance of the infants with total SmI lesions contrasts with that of the juveniles with comparable lesions. On size acquisition and ALL tasks, with the contralateral hand, total SmI-lesioned juveniles were significantly inferior to normal and total SmI-lesioned infants and to partial SmI-lesioned juveniles. During texture acquisition with the contralateral hand, the total SmI-lesioned juveniles made significantly more errors than normal and total SmI-lesioned infants. The capacity to recover from partial SmI lesions extends into the second year of life and is a gradual process which may be mediated by remaining SmI subdivisions. By contrast, the capacity to recover from total SmI lesions is restricted to infants and is a rapid process which must depend on other areas within the damaged, or possibly the intact, hemisphere. PMID- 6488049 TI - Alterations in the postnatal development of the cerebellar cortex due to zinc deficiency. II. Impaired maturation of Purkinje cells. AB - Zinc deficiency during the first 3 postnatal weeks retarded the maturation of Purkinje cells. The dendrites of the Purkinje cells of 21-day-old zinc-deficient (ZD) rats were reduced in size and had fewer branches. Somatic processes were found in 24% of the Purkinje cells of ZD animals. Only 3% of the Purkinje cells of normal animals had somatic processes. A basal polysomal mass in the Purkinje cells of 21-day-old ZD rats indicated that zinc deficiency impaired the cytoplasmic maturation of Purkinje cells. The development of the glial envestment of the dendrites and the maturation of climbing fibers also were retarded. Pair fed controls were studied to control for the effects of inanition in the ZD dams. In the pups of pair-fed dams, undernutrition slightly impaired the growth of the dendrites but produced few qualitative changes in the maturation of the soma and climbing fibers. Somatic processes were found on 10% of the Purkinje cells of pair-fed animals. Thus, the findings in the ZD animals were not only caused by the decreased maternal food consumption but by zinc deficiency. The retarded maturation of Purkinje cells was related to the altered metabolism of Purkinje cells and to effects secondary to decreased numbers of parallel fibers. PMID- 6488050 TI - Specificity of histiotypic organization and synaptogenesis in reaggregating cell cultures of mouse cerebellum. AB - The fine structure of reaggregating cultures of cells from 6- to 7-day-old mouse cerebellum was studied at intervals between 3 and 21 days in vitro (DIV). The resulting aggregates consisted mainly of small neurons (granule, stellate and basket cells), neuroglial cells and their processes. Large neurons were rarely present. By 7 DIV the previously loosely packed components had tightened into a more compact mass. A peripheral plexiform layer had formed which had many fine axons arranged into fascicles of parallel fibers. Deep to this zone was a cellular region containing clusters of neurons interspersed with small areas of neuropil. Axosomatic synapses appeared on neurons which resembled stellate or basket cells but not on granule cells. Axo-dendritic synapses formed in the neuropil of the cellular zone and, less frequently, in the outer plexiform layer. After 3 weeks glial cell processes had increased in volume at the expense of neurons. When cerebellar cells were cultured with cells from pons and medulla, which are normal sources of mossy fiber input, aggregates formed in which synaptic glomeruli were found. They were not seen in aggregates containing cells from retina and olfactory bulb cultured with cerebellum. Our observations suggest: that natural histogenetic mechanisms persist after dissociation and reaggregation of cerebellar cells resulting in a separation of an outer, 'molecular'-like layer from an inner granule cell layer and that neurons retain specificity of their synaptogenic capabilities both with regard to appropriate cell types and the morphological form that the synapses take. PMID- 6488051 TI - Survival of early monocular deprivation effects in cortical cells of kittens following prolonged dark rearing. AB - To study whether early visual experience survives the absence of consequent visual stimulation during development, experimental kittens were reared in the dark for 5-13.5 months following monocular deprivation (MD) periods of 2-11 weeks which were initiated at the time of natural eye opening (MD-dark). For comparison, experimental kittens, normally reared after equivalent MD periods (MD bino.), were also studied. Cats raised with permanent MD, dark-reared cats and normal cats, served as controls. The proportion of responsive cells was considerably reduced by the dark-rearing. It was especially reduced for the MD dark kittens following monocular deprivation limited to the first postnatal month (58.3% responsive cells) in comparison to the equivalent group of MD-bino. kittens (80.5%). This is also in keeping with the diminution in cortical responsiveness obtained in the kittens which were dark-reared from birth (55.5%). The responsiveness level found in the normal control cats was 87.3%. It was found that the duration of the MD period prior to the dark-rearing period was directly related to the ocular dominance (OD) distribution of cortical cells. The susceptibility period to MD in both MD-dark and MD-bino. groups ends at approximately 3 months of age; the lower limit for the susceptibility period is at approximately 1-2 weeks after natural eye opening. The main period of sensitivity within this period of time is the first 4 postnatal weeks following natural eye opening. It is concluded that once the effect of monocular deprivation has been established, it will survive for the rest of the cat's life, even under conditions of complete absence of consequent visual stimulation. Furthermore, a certain degree of consolidation of the MD effect takes place in the light (i.e. in MD-bino. cats) despite their return to normal binocular vision. A somewhat opposite occurrence takes place in the dark (in MD-dark cats) with a tendency for masking of the MD effect previously induced in the light to be found. PMID- 6488052 TI - Alterations in the postnatal development of the cerebellar cortex due to zinc deficiency. III. Impaired dendritic differentiation of basket and stellate cells. AB - The effects of zinc deficiency and undernutrition on the dendritic differentiation of basket and stellate cells were studied in 21-day-old rats. A morphometric analysis of the dendritic branching of basket and stellate neurons was used that took into account the cell's position in the molecular layer. Zinc deficiency and undernutrition during the suckling period impaired the dendritic differentiation of cerebellar basket and stellate cells. The effects of zinc deficiency were not due totally to the reduced food intake of lactating dams. In the lower 65-75% of the molecular layer of zinc-deficient (ZD) pups, the dendritic field area, the total dendritic length and the number of branches per interneuron were reduced by 45-61%. In the lower 50-60% of the molecular layer, undernutrition reduced the dendritic field area, the total dendritic length and the number of branches per neuron by 32-44%. A comparison of ZD and undernourished (pair-fed) pups indicated that the dendritic field area and total dendritic length of neurons of ZD animals were 43% and 30% smaller in the lower half of the molecular layer. The number of branches per neuron was not significantly different between ZD and undernourished animals. The area of the soma was unaffected by dietary treatment. A delay in the onset of dendritic differentiation and a retarded rate of dendritic growth were considered possible mechanisms for the impaired dendritic differentiation. PMID- 6488053 TI - The effect of progesterone on kindling: a developmental study. AB - Clinical epileptologists since Gowers have known that hormones may affect central nervous system excitability. Progesterone has been noted to have anticonvulsant properties in both clinical and animal studies. The effect of progesterone on central nervous excitability in the immature animal, however, has not been studied. This study evaluated the effects of progesterone on the rate of kindling in adult and immature animals. While progesterone has no effect on kindling in the adult animal, in the immature animal progesterone markedly inhibited kindling, preventing generalization of seizures. This study demonstrates that progesterone has a marked age-dependent effect on neuronal excitability. PMID- 6488054 TI - Relationship of endocrine function to inhibition of kindling. AB - Both animal and clinical studies have demonstrated that progesterone has antiepileptic properties. Progesterone in the immature, but not mature brain, markedly inhibits kindling. The purpose of this study was to determine if the kindling inhibition effect of progesterone is related to systemic endocrine properties. The effect of alphaxalone and alphadalone acetate, two progesterone like compounds devoid of significant endocrine effect, were administered to both immature and mature male rats during kindling. Alphaxalone and alphadalone acetate markedly inhibited kindling in the immature rat, but had minimal effects in the mature animal. This study demonstrates that the kindling inhibition effects of progesterone are not dependent on systemic endocrine properties. PMID- 6488055 TI - A comparison of the postnatal development of post-activation potentiation in the neocortex and dentate gyrus of the rat. AB - The postnatal development of short-term potentiation (STP) and long-term potentiation (LTP) was examined in the neocortex and dentate gyrus of rats aged 7 days to adult. STP and LTP of the transcallosal response in the neocortex could not be demonstrated until the third postnatal week. STP and LTP of the perforant path-dentate response could not be demonstrated until the second postnatal week. In both cases, STP appeared several days before LTP. Structural and neurochemical correlates of STP/LTP development, and their implications for possible STP/LTP mechanisms, are discussed. PMID- 6488056 TI - Development of tactile discrimination capacity in Macaca mulatta. I. Normal infants. AB - Infant macaques between the ages of 7 and 25 weeks of age were trained on a series of manual tactile discrimination tasks. Tactile discrimination capacity, as measured by the most difficult level of size and texture discrimination tasks mastered, was the same for all ages of infants and did not differ from that of adults. Infants as young as 10 weeks of age were found to have a discrimination capacity similar to that of adult macaques, although an adult level of manual motor control had not been achieved by this early age. During the acquisition of size tasks, older animals made fewer errors than did younger animals, suggesting an improved efficiency in size discrimination capacity over the first 6 months of life. By contrast, the efficiency with which the younger animals mastered texture discrimination was superior to that of the older infants. The possible contributions of sensory experience or manual motor control to the maturation of sensory capacity were examined by applying 16 weeks of sensory restriction in one infant and a unilateral motor cortex lesion in another infant, respectively. Only transient impairment was found in either case suggesting that neither tactile experience nor motor control contribute significantly to the maturation of tactile discrimination capacity in infant macaques. PMID- 6488058 TI - [Transplacental transfer of chemical substances in man]. PMID- 6488057 TI - Development of tactile discrimination capacity in Macaca mulatta. II. Effects of partial removal of primary somatic sensory cortex (SmI) in infants and juveniles. AB - Four infant macaques between the ages of 2.7 and 6.7 weeks and 5 juvenile macaques between the ages of 78.6 and 108.3 weeks received partial, unilateral lesions of the hand projection in primary somatic sensory cortex (SmI) (either Brodmann's area 3 or areas 1 and 2 combined). Following these partial SmI lesions, both infants and juveniles showed some initial impairment on acquisition and slightly inferior performance on the size-ALL task. Both infants and juveniles were able to discriminate smaller size differences with the contralateral hand than partial SmI-lesioned adult macaques with similar SmI lesions in previous studies. After partial SmI lesions, infants and juveniles were markedly retarded in the acquisition of texture discriminations indicating that, as in adult macaques, these separate SmI areas contribute jointly to texture discrimination capacity. However, in contrast to adult animals, all infants and most juveniles were able to master all levels of texture tasks after 2-4 months of training. On the texture-ALL task, the performance of partial SmI lesioned infants was slightly inferior to that of normal infants with the contralateral hand but significantly better than normal infants on the ipsilateral hand. Lesioned juveniles showed impairment on both contralateral and ipsilateral hands. Recovery of near-normal tactile function in both partial SmI lesioned infants and juveniles is seen although mature levels of function are typical of normal infants over this same age range. PMID- 6488059 TI - [Findings from our clinico-epidemiologic survey for the prevention of nosocomial infections]. PMID- 6488060 TI - [Histomorphology of the human ovary in postmenopause]. PMID- 6488061 TI - [Diagnosis and treatment of developmental defects of the uterus]. PMID- 6488062 TI - [Our views on the indications for vacuum extraction]. PMID- 6488063 TI - [Utilization of proteins in rats of various ages during high fat intake]. PMID- 6488064 TI - [Changes in circulation during autonomic tests in children with bronchial asthma]. PMID- 6488065 TI - [Diagnostic problems in extrauterine pregnancies in a 5-year clinical study]. PMID- 6488066 TI - [Immunologic indicators in acute and chronic tonsillitis]. PMID- 6488067 TI - [Function of the ciliary apparatus of the respiratory tract and diseases due to its structural abnormalities]. PMID- 6488068 TI - [The painful heel--calcar calcanei]. PMID- 6488069 TI - [Preventive mycological examination of women in a textile mill]. PMID- 6488071 TI - [Limits of fusion of visual stimuli moving at high rates]. PMID- 6488072 TI - [The effect of psychopharmacologic agents on potassium efflux induced by an increase in intracellular calcium in human erythrocytes]. PMID- 6488070 TI - [Correlation of electrocardiographic findings with the degree of hemodynamic severity in pulmonary artery stenosis and an intact ventricular septum]. PMID- 6488073 TI - [Study of central fatigue using electronystagmography]. PMID- 6488074 TI - [Results of an intelligence test (HAWIE) and a test of organicity (MPDT) in a 400 member group of a psychiatric population]. PMID- 6488075 TI - [Early morphological findings in the wall of the stomach after proximal selective vagotomy in an experiment]. PMID- 6488076 TI - [A partial ileal bypass in an experiment]. PMID- 6488077 TI - [Recording of surface isopotential mapping in rabbits]. PMID- 6488078 TI - [Results of tussiphonographic evaluation of probands during an 8-week period]. PMID- 6488079 TI - [The role of the psychiatrist as an expert in legal proceedings]. PMID- 6488080 TI - Some observations on vinca alkaloid and ethanol neurotoxicity using dissociated neuronal cultures. AB - Dissociated neuronal cultures have become a popular tool to address a number of questions in neurobiology. These culture systems may provide useful paradigms to approach problems related to in vivo neurotoxicity of xenobiotics. The clinical spectra of vinca neurotoxicity and alcohol teratogenesis is reviewed, and some observations on the use of dissociated cultures to study neuronal toxicity of vinca alkaloids and alcohol are presented. PMID- 6488081 TI - Estimation of dermal exposure to pesticides and its use in risk assessment. AB - The potential risks to humans resulting from the usage of a pesticide must be carefully assessed before the product is registered. One of the components in the risk assessment is the determination of the amount of pesticide to which the applicator is exposed. Traditional methods estimated dermal exposure by measuring the amount of pesticide deposited on absorbent patches worn on the applicator's body. A more recent approach consists of measuring urinary metabolite levels. A review of data obtained in humans and in rats suggests that the urinary concentration of dimethyl thiophosphate is a good indicator of dermal exposure to azinphos-methyl. PMID- 6488082 TI - Assessing safety of agricultural chemicals. AB - The objective of occupational health and safety programs in the chemical industry is to protect human health and the environment. Through studies in laboratory animals, bacteria, insects, and cultured cells, toxicologists collect data which allow them to predict which chemicals are likely to be hazardous to humans. The effects of acute (single high level exposures), subchronic (up to 6 months duration to sublethal levels), and chronic (lifetime to low level) exposures are studied. Toxicity involving all organ systems is evaluated. Specific end points such as skin sensitization, birth defects, mutations, accumulation in tissues, carcinogenesis, and other toxic effects are evaluated. The data collected are used to provide information for forming guidelines regarding the safe manufacture, handling, use, and disposal of agricultural and other chemicals. The results of toxicology studies are also used to support the registration of products with government agencies in Canada and other countries. PMID- 6488083 TI - The use of antimicrobial drugs in agriculture. AB - Antibacterial drugs have been used widely in animal production for treatment and prevention of disease and for growth promotion. Concern has been expressed about possible harm to humans, through the use of drugs, in the following ways: increased microbial drug resistance; drug residues in food; allergic reactions and sensitization to antimicrobials; and drug toxicity. Research has shown that microbial resistance in people can develop from drugs used in animals. Farmers, butchers, etc., have been shown to have an increased incidence of drug-resistant organisms. Resistance to antibiotics can develop in two ways; genetic mutation and natural selection, and through R-factor plasmid transfer. Allergic reactions have been reported following the ingestion of penicillin-containing milk; however, residues in other foods have not caused allergic reactions. Sensitization of humans to antimicrobials through the consumption of drug residues in foods has never been documented. Evidence suggests that the residue levels in food are too low to cause sensitization. Drug toxicity, other than allergic reactions, appears not to result from residues of antimicrobial drugs in food. While it has been studied many times, monitoring programs have failed to find any evidence of a problem. This appears to reflect the low toxicity of these agents and the small amounts obtained in the food, however, it could also reflect failure of the monitoring systems. PMID- 6488084 TI - Succinic dehydrogenase activity of forelimb and hindlimb muscles of the dystrophic mouse. AB - The activity of succinic dehydrogenase (SDH) was determined in muscles of normal and dystrophic mice. In contradistinction to reports based solely upon histochemical examination, we were unable to observe increased activity in fast twitch muscles of dystrophic mice. Because dystrophic muscles contain large amounts of connective tissue, two reference bases for expression of enzyme activity were compared. SDH activity was expressed either per micromole of creatine or per milligram of "true muscle fibre weight." The latter was obtained by determining the proportion of the whole muscle occupied by muscle fibres using an image analyzer with photographs of muscle cross section. It appears that the use of creatine content as an index of muscle mass may not be valid for pathological tissue, as the concentration of creatine in some dystrophic muscles differed from that of control muscles. Hindlimb muscles of dystrophic mice exhibit continuous spontaneous activity. To determine the effects of this on oxidative enzyme activity two fast-twitch muscles from the forelimb were also examined. Although they showed histochemical changes comparable to those seen in hindlimb muscles, there was no increase in SDH activity. The only dystrophic muscle examined which showed a change in SDH activity was the soleus in which a decrease was observed. PMID- 6488085 TI - Tissue blood flow in control and cold-adapted hyperthyroid rats. AB - Chronic injections (once daily for 10-14 days) of triiodothyronine (T3) stimulated oxygen consumption by 50 and 15% in anaesthetized, control (24 degrees C), and cold-adapted (5 degrees C) rats, respectively, compared with euthyroid controls. Tissue blood flow, determined from the distribution of radioactive microspheres, was unaffected by T3 treatment in skeletal muscle, scrotum, brain, bone, skin, diaphragm, and brown adipose tissue (BAT) of rats housed at 24 degrees C, but was decreased in spleen (53% of control) and significantly increased in three white adipose tissue depots (average 267% increase) and liver (56%). Blood flow to epididymal fat and leg muscle of cold-adapted rats was increased by T3 treatment (100 and 138% increases, respectively), but other tissues were unaffected. Blood oxygen extraction and oxygen consumption in vivo by interscapular BAT was increased in hyperthyroid rats compared with euthyroid controls, but was reduced by T3 treatment in cold-adapted animals. These data show that BAT makes only a minor contribution (7%) to thyroid thermogenesis, but suggest that kidney, liver, gut, and particularly white adipose tissue may be involved. PMID- 6488086 TI - Redox state of brown adipose tissue as a possible determinant of its blood flow. AB - During norepinephrine (NE) induced thermogenesis in the adipocytes of brown adipose tissue (BAT), the blood flow of the tissue, and thus its oxygen supply, seems to be controlled by the adipocytes, possibly through their production of a vasodilator. This study sought to discover a metabolic parameter of the adipocytes that might account for modulation of vasodilator production and BAT blood flow. The blood flow of the interscapular BAT (IBAT) of anesthetized, cold acclimated rats was varied by infusing NE and by altering the concentration of oxygen in arterial blood (AO2). Flow was measured with radiolabeled microspheres. IBAT was freeze fixed in situ for determination of its levels of adenine nucleotides and its cytosolic redox state; the latter was measured in terms of the concentration ratios, lactate/pyruvate (L/P) and glycerol-3 phosphate/dihydroxyacetone phosphate (GP/DHAP) in the tissue. The increase in IBAT blood flow with dose of NE was associated with a progressive decline in tissue ATP, increases in ADP and AMP at high doses of NE, and progressive increases in L/P and GP/DHAP, the latter increases indicating increased reduction of the cytosolic NAD+-NADH system. Reducing AO2 by hemodilution raised the blood flow, L/P, and GP/DHAP of IBAT to values significantly above those measured in rats of normal AO2 given the same doses of NE; whereas, elevating AO2 by hemoconcentration had the opposite effects on these values. For rats of normal or altered AO2 together, a correlation coefficient of 0.94 was obtained for the relation between IBAT blood flow and L/P and one of 0.85 for that between flow and GP/DHAP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488087 TI - Heterogeneity of high affinity nitrobenzylthioinosine binding sites in mammalian cortical membranes: multiple forms of central nervous system nucleoside transporters? AB - Specific binding of [3H]nitrobenzylthioinosine to cortical membranes from several mammalian species was investigated. Rat, mouse, guinea pig, and dog membranes contained an apparent single class of binding sites; there was, however, a marked species-dependent variation in their affinity for [3H]nitrobenzylthioinosine. Rabbit cortical membranes contained two classes of binding sites and the high and low affinity components were similar to those found in guinea pig and dog cortical membranes, respectively. The [3H]nitrobenzylthioinosine binding sites in rat and the low affinity sites in rabbit were atypical in that they exhibited a low affinity for dipyridamole. It is proposed that these latter sites may represent a form of the central nervous system nucleoside transport system which is less susceptible to inhibition by dipyridamole. PMID- 6488088 TI - Disappearance kinetics of 2,4- and 3,4-dichlorophenol in a fluvial system. AB - The disappearance rates of 2,4- and 3,4-dichlorophenol in a small stream were studied and were shown to be first order with respect to either distance or time of flow. Both chlorophenols disappeared at approximately the same rate with average half-lives in the stream of about 4 h. The absence of seasonal variability in the rate constants along with the observance of first order kinetics over several ecological zones of the stream led to the conclusion that the rate controlling factor was not biological. It is suggested that the disappearance was due to degradation within the biofilm covering the stream bed and that the rate is controlled by diffusion of the chlorophenols across the water-biofilm interface. PMID- 6488089 TI - Immobilization and geological disposal of nuclear fuel waste. AB - The Canadian Nuclear Fuel Waste Management Program is developing methods for the safe disposal of both used nuclear fuel and fuel recycle waste. The disposal strategy is based on interim storage of the used fuel, immobilization of either used fuel or recycle waste, and disposal, deep in a stable geological formation in the Canadian Shield. The disposal concept proposes a multibarrier system to inhibit the release of the radioactive waste from the disposal vault. The principal components of the multibarrier system are (i) the waste form in which the radionuclides are immobilized, (ii) engineered barriers including high integrity containers, buffers and backfills designed to retard the movement of groundwaters in the disposal vault, and (iii) the natural barrier provided by the massive geological formation itself. The research programs to investigate this concept are discussed briefly. Several different waste forms are being developed for the immobilization of high-level fuel recycle waste, including glass, glass ceramics and crystalline materials. Dissolution of these materials in groundwater is the only likely scenario that could lead to radionuclide release. The factors that influence the aqueous dissolution behaviour of these materials are reviewed. PMID- 6488090 TI - Toxic effects of acid rain on aquatic and terrestrial ecosystems. AB - The historical perspective as well as the nature and causes of acid precipitation are presented. The toxicological effects of acid precipitation on lakes, other water bodies, fish, and invertebrate fauna are reviewed. In addition, the effects of this phenomenon on soil productivity and forest growth are examined. It appears that grave toxic effects have been and are being experienced by aquatic systems, but there is little reliable evidence of economic damage to crops, natural vegetation, and soil and biological processes. There may be insidious long-term effects on terrestrial ecosystems, particularly in the more susceptible areas. PMID- 6488091 TI - Acid rain and soil. AB - A summary of important chemical properties of soil is given and the way in which acid rain may affect these properties is discussed. Acid rain may suppress microbiological decomposition and nitrification processes, thus influencing the nutrient status of soils. It has also been found that soil organic matter is less soluble in more acid solutions. Changed nutrient availability patterns are predicted in a low pH environment and enhanced leaching of essential elements from the soil exchange complex has been observed. Increased solubility of potentially toxic elements such as aluminium may also occur from soils which have been exposed to acidified rainfall. PMID- 6488092 TI - The 2-deoxyglucose uptake method as a first screen for neurotoxic compounds. AB - Our primary goal is to develop a screening procedure to detect and partially characterize neurotoxic compounds. There is a great need for a new approach to screening for neurotoxicants because our industrialized world abounds with untested and potentially neurotoxic compounds. A large number of new compounds are introduced each year. Although a number of testing approaches to the screening for neurotoxicants have been proposed in the recent years, a consensus on the most adequate approach is yet to emerge. The existing methods share a number of shortcomings. Thus, most methods only detect a fraction of the tested neurotoxicants. Other methods lack the necessary resolution to detect the neurotoxic damage reproducibly and reliably. Furthermore, many screening approaches are too time consuming and costly to be used for the large-scale screening of neurotoxicants. It is, therefore, imperative to develop reliable and efficient screening methods applicable in regulatory toxicology. In this report, we describe two versions of the same method that we feel may be very beneficial for the large-scale screening of neurotoxicants. The 2-deoxyglucose (2-DG) uptake method provides an indirect measure of neuronal activity in different areas of the brain. The ability of the method to detect most, if not all, neuroactive substances is reviewed in this report. In the context of this report, a neuroactive substance is defined as a substance acting directly on the central or peripheral nervous system neurons and (or) glia. The 2-DG method equals the sensitivity of the most sensitive alternative methods which were selectively designed to detect the effects of specific groups of compounds. The generality and sensitivity of the 2-DG method are of major importance. Thus, if a tested compound does not affect the uptake of 2-DG into the brain, it is not likely to be neuroactive. Since neurotoxic compounds are a subset of neuroactive compounds, a compound that is not neuroactive is also not neurotoxic. Thus, a single test may, in some instances, determine if a tested compound is nontoxic. In addition, it appears that each compound or, at least, each family of compounds produces a characteristic profile ("pattern") of the sites of altered 2-DG uptake. This pattern can be exploited to characterize the tested compound and help us decide whether it is neurotoxic or neuroactive. Preliminary results from our laboratory indicate classical neurotoxic agents such as acrylamide, triethyltin, and 2,5 hexanedione induce a generalized depression of the 2-DG uptake throughout the brain.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6488093 TI - Metacontrast masking in amblyopia. PMID- 6488094 TI - [Effect of the structure of space in the identification of a sense of movement in stroboscopic light]. PMID- 6488095 TI - Verbal and spatial interference effects in congenitally blind and sighted subjects. PMID- 6488096 TI - [Localization of form/color interference in perception in a Stroop task with drawn stimuli]. PMID- 6488097 TI - Does part-set cuing test for memory organization? Evidence from reconstructions of chess positions. PMID- 6488098 TI - Verbal responses to human figure paintings: a test of the uncertainty hypothesis. PMID- 6488099 TI - Studies on antibiotic biosynthesis by protoplasts and resting cells of Streptomyces echinatus. Part I. The synthesis of echinomycin. AB - Washed suspensions of Streptomyces echinatus, and protoplasts derived from them, have been shown to synthesise echinomycin in the absence of growth. Protoplast suspensions free from significant contamination with unlysed mycelia are obtained by incubation with lysozyme followed by filtration through layers of tightly packed glass wool. Although physiologically young cells produce a better yield of protoplasts, optimal antibiotic biosynthesis is achieved with protoplasts prepared from mycelia about to enter the stationary phase of growth i.e., approximately 24 h after inoculation into a nutrient broth--salts seed medium. As judged by the incorporation of label from L-[methyl-14C]methionine, echinomycin synthesis proceeds for about 1 h after preparation of washed suspensions, but the kinetics of incorporation by intact cells and protoplasts are different. Uptake of labelled methionine by protoplasts is critically dependent upon the presence of sucrose as osmotic stabiliser and is drastically reduced if galactose, calcium, or magnesium is omitted from the suspending buffer. Uptake by intact, washed cells is essentially independent of nutrients in the medium. Small quantities of 11 materials other than echinomycin are detectable in chloroform extracts after labelling with L-[methyl-14C]methionine; some of these may represent precursors in the biosynthesis of the antibiotic. All amino acid constituents of echinomycin as well as tryptophan, a putative precursor of the quinoxaline chromophores, are actively incorporated into echinomycin by protoplasts and resting cells, but not with equal efficiency. PMID- 6488100 TI - Directed biosynthesis of novel derivatives of echinomycin. II. Purification and structure elucidation. AB - New antibiotics produced by Streptomyces echinatus A8331 cultured in the presence of heterocyclic aromatic acids can be separated and purified by high-performance liquid chromatography using reversed phase columns. Natural quinoxaline antibiotics and certain quinoline derivatives can also be efficiently separated in normal phase systems. Details of purification procedures are described together with experiments to characterise the new antibiotics by field desorption mass spectrometry and proton magnetic resonance. Mono- and bis-substituted derivatives of echinomycin containing the following replacement chromophores have been isolated: 7-chloroquinoxaline-2-carbonyl, thieno[3,2-b]pyridine-5-carbonyl, and 6-methylquinoline-2-carbonyl. With a 6-methylquinoline-2-carboxylic acid precursor the analogues containing one or two replacement chromophores are each separable into two distinct components. One of the bis-substituted 6 methylquinoline products appears inactive in an antibacterial assay and behaves as a triostin analogue, presumably an immediate precursor of the corresponding echinomycin derivative. PMID- 6488101 TI - The cytochrome complement of Haemophilus parasuis. AB - Spectral analyses with subcellular fractions derived from Haemophilus parasuis demonstrated that this organism could synthesize membrane-bound and soluble CO- and NO-binding c-type cytochromes in addition to the membrane-bound cytochromes d, a1, b, and c; cytochromes d, a1, and o were identified as potential oxidases. The membrane-bound and soluble CO- and NO-binding cytochromes c were not spectrally variant cytochromes c, and the redox properties of the soluble cytochrome (reducible by NADH but not by succinate or ascorbate plus N,N,N',N' tetramethyl-p-phenylenediamine) suggested that it, at least, was a low-potential cytochrome; up to 68% of the soluble cytochrome c could be released from the organisms by osmotic-shock treatment, demonstrating its extracytoplasmic location. The cytochrome content of H. parasuis was influenced by both the composition of the growth medium and the phase of growth; it is suggested that the bacterial concentration and growth rate, and therefore the availability of oxygen, regulated cytochrome synthesis. PMID- 6488102 TI - Impact of an oil field effluent on microbial activities in a Wyoming river. AB - The survival, functions, and physiological diversity of autochthonous sediment microbiota were examined in situ at five stations along the Little Popo Agie River, WY; one station above, one at, and three below a discharge point for oil wastewater from Union Oil Company's Dallas Field. Below the oil wastewater discharge point there were increases in electron-transport activity, carbon dioxide production, and microbial populations of heterotrophs, ammonifiers, hexadecane degraders, starch hydrolyzers, protein hydrolyzers, and sulfate reducers. At a station 1420 m below the discharge point, however, overall sediment microbial activities and all of the physiological groups of bacteria, except hexadecane-degrading microbiota, were at levels comparable with those at the control station above the discharge point. Similarly, mineralization of glucose, amino acids, hexanoic acid, and hexadecane was elevated at stations directly below the discharge point, but appeared to subside rapidly. Xenobiotic biodegradation potential of the sediments varied with the chemical and the sample location and was not directly related to oil residue levels in the sediment. Microorganisms thus appeared to maintain physiological diversity and increased in numbers and activity in a riverine environment that contained petroleum hydrocarbon concentrations known to be deleterious to freshwater fish and macrobenthic communities. PMID- 6488103 TI - Suppression of nitrate utilization by ammonium and its relationship to chloramphenicol production in Streptomyces venezuelae. AB - Cultures of Streptomyces venezuelae grown in a medium containing glucose with mixtures of ammonium and nitrate as the nitrogen source produced chloramphenicol in a distinct idiophase that followed biomass accumulation. Analysis of fermentation broths showed that ammonium and nitrate were taken up consecutively by the organism. Measurements of nitrate reductase in the mycelium established that the enzyme was constitutive and that its specific activity did not increase during the period when ammonium was exhausted from the medium and nitrate was assimilated. The enzyme was neither repressed nor inhibited by ammonium. Production of chloramphenicol was also delayed until ammonium had been consumed and remained slow until subsequent depletion of nitrate. Arylamine synthetase, the initial enzyme in the pathway of antibiotic biosynthesis, showed no marked change in specific activity during utilization of the two nitrogen sources. The result suggests that the mechanism causing preferential utilization of ammonium does not simultaneously control the onset of chloramphenicol biosynthesis. PMID- 6488104 TI - Seasonal study of a freshwater lake and migratory waterfowl for Campylobacter jejuni. AB - In the summer and fall of 1981, water and sediment samples from Lake Onalaska, a Mississippi River navigation pool near La Crosse, Wisconsin, were quantitatively examined for Campylobacter jejuni and for standard bacterial indicators of fecal pollution. Fifty cecal content samples, representing seven species of transient waterfowl captured during fall migration, were also assayed for C. jejuni. Fecal coliform and fecal streptococcus counts from the water and sediment samples agreed with previously established values for the pool and accurately reflected the influx of approximately 619 000 ducks and geese during fall migration. Campylobacter jejuni was not recovered from water, sediment, or cecal samples. This conflicts with previous reports which implied a cosmopolitan distribution of C. jejuni among waterfowl. Reasons for the absence of C. jejuni from the pool and from waterfowl in and around that pool were discussed, with special reference to method of recovery and sporadic distribution of other pathogenic microorganisms among migratory waterfowl. PMID- 6488105 TI - The derivation and use of mice which do not harbour lactobacilli in the gastrointestinal tract. AB - Penicillin treatment used in conjunction with germfree technology has allowed the derivation of a colony of BALB/c mice which do not harbour lactobacilli in the gastrointestinal tract. The animals continue to harbour Gram-negative anaerobes and coliforms, but not enterococci or filamentous segmented ileal microbes. Isolates of lactobacilli from rodents were able to colonize the gastrointestinal tract of the mice; and isolate from a fowl could not establish in these animals. PMID- 6488106 TI - Polyacrylamide gel electrophoresis of Bacteroides succinogens. AB - Polyacrylamide gel electrophoresis (PAGE) of sodium dodecyl sulphate (SDS) extracts of bacterial cells was used to assess the similarity of polypeptide patterns in 15 isolates of the rumen cellulolytic bacterium Bacteroides succinogens. Analysis of densitometer traces of the polypeptide band patterns suggested that the majority of the isolates tested were closely related to the type strain S85. Representatives of other species of Gram-negative rumen bacteria had distinct SDS-PAGE patterns, and it is concluded that SDS-PAGE is a useful aid to the identification of B. succinogenes. PMID- 6488108 TI - An experiment in patient-physician communication. PMID- 6488107 TI - Immunization of children in Calgary. PMID- 6488110 TI - Investigation of extrahepatic bile duct obstruction. PMID- 6488109 TI - Cervical spine injuries in rugby players. PMID- 6488112 TI - Spontaneous dissolution of gallstones? PMID- 6488111 TI - Excellent response of pathologic jealousy to pimozide. PMID- 6488113 TI - The patient as the focus of teaching. PMID- 6488114 TI - Combining NSAIDs with anticoagulants: yes and no. PMID- 6488115 TI - A computerized database-management system for curriculum analysis. AB - This report describes a computerized database-management system designed to allow users to retrieve and report information on the curriculum of an undergraduate pathophysiology course. With the system the user can locate where and in what context a topic is covered in the course and can answer queries and prepare reports concerning, for example, format and duration of sessions, teaching aids used and instructors. The system is a unique tool that can be used to optimize course structure and content. It can easily be expanded to include other undergraduate medical courses, and the techniques can be applied to other disciplines. PMID- 6488116 TI - The menopause: stressors and facilitators. AB - Between about ages 40 and 55 years, women experience a transition known as the menopause, which marks the end of their childbearing years. Although the most striking feature of the menopause is the cessation of menstruation, other biologic and psychosocial events occur and can be classified as stressors and "facilitators". For a predisposed group of women the stressors are likely to cause psychiatric disorders. At the same time, the facilitators are opportunities for personal growth and development. Physicians who understand both types of events during this phase of life and who are sensitive to the overall effects of ageing on marital partners can provide comprehensive care to the menopausal patient rather than automatically pursuing drug therapy (substitution hormonal therapy) alone. PMID- 6488117 TI - Moderate drinking: an alternative treatment goal for early-stage problem drinking. AB - Family physicians are in a particularly good position to identify problem drinking in its early stages through the recognition of various psychosocial and medical indicators. Thorough history-taking or the use of a specific questionnaire should provide confirmation. Patients so identified can then be offered treatment designed to help them moderate their drinking, if not to achieve abstinence. The treatment strategy described in this paper involves specifying a safe drinking pattern, instructing the patient in the use of aids to appropriate drinking and seeing the patient at 1- to 2-month intervals for follow up assessment. In a pilot study of this strategy 16 of 17 patients reduced their drinking substantially, and 8 were abstinent at the last follow-up visit. Only 1 of the 17 dropped out of treatment; the high rate of compliance may have been primarily due to the patient's need to see the family physician for other problems. Visits to the family physician for other medical problems provide an opportunity to motivate patients to continue monitoring their drinking. PMID- 6488118 TI - Cefuroxime in pediatric practice. Committee on Infectious Diseases and Immunization, Canadian Paediatric Society. PMID- 6488119 TI - Evaluation of primary care in a community clinic by means of explicit process criteria. AB - This study reports an evaluation of care given at an urban multidisciplinary community family practice clinic. By means of an "indicator-condition" approach, the criteria and rating system developed for the Burlington Randomized Controlled Trial (BRCT) were applied to 103 randomly selected charts demonstrating 124 episodes of care given for seven specific "conditions": otitis media, hypertension, prenatal care, care of the newborn up to the age of 12 months, immunization up to the age of 24 months, depression and urinary tract infection. Overall, 83 (67%) of the episodes of care studied were rated adequate or superior. The proportion of such episodes varied from 33% for hypertension to 81% for care of the newborn. No statistically significant differences were found between these results and those of the BRCT. A total of 48 instances of inadequate care were noted, of which 21 (44%) were omissions in patient management. Inadequate preventive care and care of chronic diseases was more common than inadequate care of acute infectious diseases. The method of primary care assessment used was found to be both practical and inexpensive. PMID- 6488120 TI - Complications of cardiac catheterization: one centre's experience. AB - Data on complication rates in a cardiac catheterization laboratory were prospectively gathered over a 6-year period. During this time 7960 catheterizations were performed. Death occurred in seven (0.1%) of the cases. The difference between the mortality rates for procedures performed with and without systemically administered heparin (0.04% and 0.2% respectively) was barely statistically significant (p less than 0.05). A significant complication occurred in 1.5% of the cases; however, most did not have long-term sequelae. No significant change in the annual rate of such complications was seen during the study period. Such a tabulation permits audit of quality of care, points out changing trends in morbidity and offers meaningful information on the safety of cardiac catheterization to referring physicians and their patients. PMID- 6488121 TI - Polyarthritis associated with gastric carcinoma. AB - In a 68-year-old man who had polyarthritis associated with gastric carcinoma surgical resection of the tumour was accompanied by prompt resolution of the arthritic syndrome. In 11 years of follow-up the arthritis has remained in complete remission and there has been no recurrence of the carcinoma. An awareness that polyarthritis may be a presenting manifestation of an underlying carcinoma may, especially in an elderly person, lead to early recognition and treatment of the malignant disease. PMID- 6488122 TI - Human experimentation and informed consent. PMID- 6488124 TI - Obstacles to the treatment of psychiatric patients. PMID- 6488123 TI - The doctor goes to summer camp. PMID- 6488125 TI - The psychopharmacological treatment of depression in the medically ill patient. AB - With the introduction of effective antidepressants, pharmacotherapy has not been limited exclusively to the psychiatrically ill, but has been expanded to include medically ill patients exhibiting depressive symptomatology as well. This has led to problems in diagnostic differentiation and, just as important, problems with interactions resulting from multiple medications. By describing the coexistence of depressive symptomatology in a large variety of physical illness, the physician is alerted to the complexities of psychiatric illness in the medically ill patient as well as the caution necessitated by the poly-pharmacotherapy required in this population. PMID- 6488126 TI - Leonhard's classification of the chronic schizophrenias. AB - The conceptual development of Leonhard's classification of the chronic schizophrenias is outlined. The recognition within that classification of the importance of the polarity dimension has led to the identification of two distinct populations--atypical nonsystematic and typical systematic schizophrenia -each with a variety of different subtypes. It is hoped that recognition and validation of this group of illnesses which, for three-quarters of a century, have been called "schizophrenia" will provide a basis for meaningful biological research. Increasing interest in the system has already produced an awareness that future progress in the understanding of mental illness will greatly depend upon re-establishing the central place of psychopathology in psychiatric research. PMID- 6488127 TI - The management of children admitted to child welfare services in Ontario: a review and discussion of current problems and practices. AB - Children coming into the care of the Ontario Child Welfare System are generally older and more seriously disturbed. Foster parents and Children's Aid Societies have had to change in order to meet the needs of these troubled children. While the efficacy of foster care continues to be debated, there are ways to improve in care management including: ways of preventing drift, appropriate assessment of parenting capacity, minimizing emergency placements, and more energetic and focused casework which deals appropriately both with the deficits and distortions internalized in the child as a result of previous damage and with the ongoing interactional stresses operative within the foster family system. The advantages of planned over emergency placements are discussed. The child separated from natural parents will mourn. Foster parents' and workers' roles in assisting the work of mourning in foster children are discussed. Soon after admission to care, the practicality of restoration to the natural family must be assessed, and management should then aim towards restoration or towards freeing the child for adoption or planned permanent foster care, should that represent the least detrimental available alternative. The family court system as presently constituted frequently and unnecessarily undermines rather than protects the adjustment and development of vulnerable children. Mechanisms by which this occurs and some proposed solutions are suggested. The paper concludes by suggesting that the traditional low priority given to child welfare services by governments is unlikely to be altered unless mental health professionals succeed in eliciting considerably more community support for adequate social services than is currently available. PMID- 6488128 TI - [Toward a redefinition of community psychiatry in Quebec]. AB - Community Psychiatry is in troubled waters in Quebec. Overwhelmed by their caseloads, community clinics do not see the end of the tunnel with their new long term mentally-ill patients. The painful reality of the new asylum in the community raises questions about Community Psychiatry despite its remarkable progress. The authors analyze the state of the art about schizophrenia, which is mainly related to chronic mental patients and point out the discrepancy between the original ideals of Community Psychiatry and the clinical reality. They develop the four following propositions to redefine Community Psychiatry in the actual context: recognize the need for the asylum as a process; tolerate the paradox of the multidisciplinary work; narrow the target population and the type of therapy offered; and secure continuity with the community. PMID- 6488129 TI - Treatment of immigrant Indian patients. AB - When immigrant Indian patients develop psychiatric illness, they face many disadvantages such as the lack of family support and shame for becoming sick. In treating them, a knowledge of their cultural values and communication, is necessary. While taking history, reluctance of these patients to discuss sexual and aggressive feelings should be respected. Patients' harmony with the family and significant others is the goal of treatment rather than the patients' growth; interdependence and not independence is favored. Free expression of emotions create a dysphoric milieu. A careful assessment of psychopathology and dynamics and psychotherapy integrating these cultural factors is important to promote changes that are therapeutic. PMID- 6488131 TI - The prescription of psychotherapy. AB - This paper outlines a format for the evaluation of patients for whom intensive dynamic psychotherapy is being considered as a treatment modality. Such an evaluation includes a traditional descriptive diagnostic assessment leading to the establishment of a conventional nosological diagnosis. This is followed by a descriptive, developmental evaluation which pays close attention to the levels of ego development, at the same time attempting to assess the mutual influences between it and several other important lines of development which may not all have reached similar phases of maturation. The assessment is completed by the psychodynamic evaluation of the patient and a table is presented outlining a series of contrasting clinical findings which either favour the use of intensive, uncovering psychotherapy or mitigate against it. It is proposed that these factors, when taken into account with the degree and the duration of the presenting problems, provide useful guidelines for the prescription not only of intensive psychodynamic psychotherapy, but also of a whole variety of psychotherapeutic approaches. A second table illustrates how this integration assists in the prescription of the appropriate psychotherapeutic approach. PMID- 6488130 TI - Abortion and subsequent pregnancy. AB - Two hundred and fifty-four women were followed from the second trimester of pregnancy until twelve months postpartum. Of these women, twenty-eight had had a prior therapeutic abortion and 216 women had no previous abortion. During their pregnancy and the postpartum period, the women completed a series of psychological and attitudinal measures. Analysis revealed that there were no significant differences between the two groups in terms of their demographic status, their obstetric experience or attitudes towards labour and birth. The study failed to demonstrate a relationship between anxiety during pregnancy and a prior abortion, nor were there any indications of inadequate maternal functioning. Women who had a prior abortion scored higher on the autonomy and nurturance subscales of the Personality Research Form, and had higher levels of depressive affect in the third trimester of pregnancy and in the postpartum period. PMID- 6488132 TI - Clinical utility of dexamethasone suppression testing in the elderly depressive: a case report. AB - The dexamethasone suppression test may be a valuable tool in the assessment, treatment evaluation and maintenance management of depressive illness in old age. A case is presented illustrating these uses of the DST. PMID- 6488133 TI - Countertransference and supervision: a discussion of some dynamics from the point of view of the supervisee. AB - Although the important role of supervision in the training of psychotherapists is generally well recognized, it does remain a neglected topic in daily psychiatric practice. An overview of the abundant literature written on the subject shows the paucity of papers that take the perspective of the supervisee and subjectively describe the experience. A common difficulty of the supervisory process appears to be the management of the therapist's feelings both in his relationship with the patient and with the supervisor. This problem is approached from the point of view of the supervisee, using a group perspective. A clinical vignette, from a supervised individual psychotherapy process illustrates how supervision is a mourning process where frustrations and losses abound. The difficult task of working through these conflictual feelings is fundamental for the supervisee if he wants to learn from the experience. Within this painful process (and to avoid it) many defensive mechanisms are often used and are described by the author along with some of their possible psychodynamics. PMID- 6488134 TI - ECT as a form of restraint. PMID- 6488135 TI - Radiation therapy in the treatment of aggressive fibromatoses (desmoid tumors). AB - Twenty-five patients with aggressive fibromatoses (desmoid tumors) have been treated or followed in the Department of Radiation Medicine at the Massachusetts General Hospital between 1972 and 1982. Seventeen patients were treated by radiation, 4 for primary and 13 for recurrent disease. Seven patients were treated in conjunction with surgery. Partial or complete regression was achieved in 76%, and 59% are without evidence of disease (NED) at 9 to 94 months follow up. Eight of ten patients treated primarily with radiation have achieved complete response without an attempt at resection (five) or have achieved stabilization (three) of their disease after some regression. Consistent complete control was seen with doses above 60 Gy. Periods to 27 months were required to observe complete responses. Only three failures within the radiation field were observed, two after low doses (22 and 24 Gy, respectively). Eight patients were seen after resection but with uncertain or histologically minimum positive margins, and were followed regularly and not treated. One patient has failed to date and is NED after resection. Radiation therapy is recommended in those situations where wide field resection without significant morbidity is not possible for gross local disease. If minimally positive margins exist after resection in a patient who may be followed carefully, frequent follow-up and prompt treatment at recurrence may be an effective alternative to immediate radiation therapy. PMID- 6488136 TI - Preoperative radiation therapy for locally advanced vulvar cancer. AB - Eight patients with locally advanced vulvar cancer that would have necessitated pelvic exenteration to encompass the primary tumor were given preoperative radiation therapy in an attempt to shrink the primary tumor and allow more conservative surgery. From 4400 to 5400 rad of external radiation were delivered to the primary tumor, and one patient received an additional 2400 rad from intracavitary therapy. Satisfactory shrinkage of tumor occurred in seven of the eight patients (87.5%), thus allowing conservative surgical excision. In four patients (50%), there was no viable tumor in the surgical specimen. Moist desquamation of the vulva occurred in all patients and was of sufficient severity to require temporary cessation of radiation in four patients (50%). Five received groin radiation, and one (20%) subsequently developed bilateral hip fractures. No other major morbidity occurred. Five of the eight patients (62.5%) are alive without evidence of disease at intervals ranging from 15 months to 10 years. Preoperative radiation in this group obviated the need for pelvic exenteration, resulting in significantly less morbidity without compromising survival. PMID- 6488137 TI - Familial hemophagocytic lymphohistiocytosis (FHLH) in Israel. I. Description of 11 patients of Iranian-Iraqi origin and review of the literature. AB - Eleven patients with familial hemophagocytic lymphohistiocytosis (FHLH) are described. They all belonged to four Jewish families of Iranian and Iraqi origin. Parental consanguinity was found in three families. The age of onset of disease ranged from 6 weeks to 36 months. All patients had fever, wasting, and enlargement of the liver and spleen. In addition, lymph-node enlargement and neurologic complications were common. The most consistent laboratory findings were pancytopenia, atypical lymphomonocytoid cells in the peripheral blood, abnormal liver function test results, and increased cerebrospinal fluid protein. The course was fatal in all patients. Nine of the 11 patients died within 2 weeks to 3 months of presentation, and 2 patients achieved temporary remissions but died of disease within 8 and 24 months, respectively. Response to antibiotic therapy or to the administration of corticosteroids and cytotoxic drugs was unimpressive. Pancytopenia complicated by sepsis or bleeding, hepatic failure, or encephalopathy were the terminal events. This report draws attention to the existence of FHLH in Jews of Iranian-Iraqi origin in whom parental consanguinity is very common. PMID- 6488138 TI - Leiomyosarcomas of venous origin in the extremities. A correlated clinical, roentgenologic, and morphologic study with diagnostic and surgical implications. AB - This article presents a correlated clinical, roentgenologic, and morphologic study of six cases of leiomyosarcoma of large veins in the extremities. Growth of the tumor within the lumen of the affected vein was demonstrated by phlebography in one case and by angiography and computed tomography in one case. In all six cases, such growth was demonstrated by dissection of the surgical specimen. In four cases, arteriography showed both neovascularity at the site of the lesion and compression of the artery accompanying the affected vein. The compression apparently was caused by entrapment of the artery within the same preformed fibrous sheath (conjunctiva vasorum) that enclosed the tumor and the vein from which it had arisen. The histologic diagnosis was based on the light microscopic appearance in all cases and was supported by electron microscopic findings in three cases by the demonstration of ultrastructural features of leiomyoblasts. All six tumors were light microscopically of high-grade malignancy. Five of the patients died of metastatic tumor disease and one is alive with lung metastases. The information obtained by a careful physical examination combined with phlebography, arteriography, and computed tomography may be helpful in the clinical diagnosis and the planning of adequate surgical treatment. PMID- 6488139 TI - Prophylactic diazepam in prevention of contrast media-associated seizures in glioma patients undergoing cerebral computed tomography. AB - Five milligrams of intravenous diazepam given prior to contrast media injection statistically significantly reduced the incidence of contrast media-associated seizures from 16% to 2% in a prospective, randomized series of glioma patients. Factors related to increased risk of contrast media-associated seizures are (1) prior seizure history due to glioma and/or prior contrast media and (2) prior or concurrent brain antineoplastic therapy. Factors not related to an increased risk of contrast media-associated seizures are (1) contrast media dosage, (2) type or grade of glioma, and (3) computerized tomographic appearance of the glioma. Theories regarding the etiology of contrast media-associated seizures are discussed. PMID- 6488140 TI - The value of complete lymphadenectomy in radical treatment of cancer of the cervix, Stage IB. AB - Two hundred ninety-three patients with Stage IB carcinoma of the uterine cervix were treated by intracavitary irradiation followed by radical hysterectomy and pelvic lymph node dissection in the 3-year period 1970 to 1972, inclusive. Preoperative lymphography was performed and intraoperative films were taken to obtain a lymphadenectomy that was as complete as possible. The number and location of remaining nodes were determined by postoperative films. No patients were lost to follow-up. The 5- and 10-year survival and recurrence rates were correlated to the number of remaining nodes. It is concluded that patients with four or more remaining nodes have a possible inferior prognosis compared with the rest of the patients. Meticulous and time-consuming search for a few remaining nodes was, however, not found to be justified. PMID- 6488141 TI - Breast cancer developing in four women cured of Hodgkin's disease. AB - Four patients developed breast cancer 11 to 17 years after treatment for Hodgkin's disease. Three patients received radiotherapy only, and one received radiation plus chemotherapy. This study is in keeping with the report by Nelson and associates that with duration of follow-up exceeding 10 years, there is an increase of breast cancer in women treated for Hodgkin's disease that is similar to or greater than the risk of breast cancer in women treated with radiation for benign breast disease and is probably independent of chemotherapy. PMID- 6488142 TI - Prognostic significance of estrogen receptor status in breast cancer in relation to tumor stage, axillary node metastasis, and histopathologic grading. AB - The value of estrogen receptor (ER) measurements for predicting recurrence and survival rates in primary breast cancer was examined in 121 women who were followed from 5 to 12 years after mastectomy with a median follow-up of 64 months. The prognostic significance of the ER status was evaluated independently and in association with tumor stage, axillary node metastasis, and histopathologic grade. The independent evaluation demonstrated no statistically significant difference in prognosis between women with ER-negative and ER positive cancers, although the latter group tended to have a longer time to recurrence and longer survival. Multivariate analysis of the data by Cox's proportional hazard regression techniques revealed a synergistic effect of ER status on the risk associated with axillary node metastasis. Patients with nodal metastasis were at 2.8 times the risk of recurrence compared to patients without metastasis. For women with nodal metastasis whose primary cancer was ER-negative, this risk increased to 4.6 times compared to women without metastasis and ER positive tumors (P = 0.0003). The risk of cancer-related death was 5.6 times more likely for poorly differentiated tumors than for highly differentiated tumors. Patients with poorly differentiated ER-negative tumors were at an even higher risk (7.0) of dying than women with highly differentiated ER-positive carcinomas (P = 0.009). In conjunction with tumor stage, axillary node metastasis and histopathologic grade ER determination is useful for identifying subpopulations at increased risk of tumor recurrence or mortality. PMID- 6488143 TI - Efficacy of bone and liver scanning in breast cancer patients treated with adjuvant chemotherapy. AB - One hundred nineteen patients who underwent mastectomy and received adjuvant chemotherapy for breast carcinoma were studied retrospectively. Of these, 102 patients had serial bone scans and 101 patients serial liver scans during a mean follow-up of 59 months. All had negative scans prior to chemotherapy. Twenty three of 102 patients converted to positive bone scans during follow-up. These 23 patients converted a mean of 29.5 months after surgery. At conversion, 5 of 21 patients had bone pain, and none had elevated alkaline phosphatase. Thirteen of 101 patients developed positive liver scans a mean of 31.5 months after surgery. The liver scan was the first indicator of liver involvement in only 3 of 13 converters. In no case was the liver scan the first indication of metastatic disease. The incidence of bone scan conversion (22%) did not differ significantly from previously reported series of patients not receiving adjuvant therapy, but the mean time to conversion was prolonged (29.5 versus 18.0 months). In addition, none (0/21) of the bone scan converters had elevated alkaline phosphatase at the time of conversion. It is concluded that the interval from initial evaluation to bone scan conversion may be prolonged by adjuvant chemotherapy of breast cancer. It is recommended that patients have bone scans twice yearly for at least 3 to 4 years after surgery. This study emphasizes the singular importance of bone scanning in breast cancer patients who have adjuvant chemotherapy, as the scan may be the only indicator of bone involvement. Liver scans do not appear useful for screening patients without other evidence for metastatic liver involvement. PMID- 6488145 TI - A Phase II trial of high-dose intravenous interferon alpha-2 in advanced colorectal cancer. AB - Twenty-one patients with metastatic colorectal cancer were treated with high-dose intravenous interferon alpha-2 (30-50 X 10(6) units/m2) administered daily for 5 consecutive days. Courses of therapy were repeated every 2 to 3 weeks. No tumor responses were seen among 15 evaluable patients. In two subjects, disease remained stable for 3 and 7 months, respectively. Toxicity was substantial and a de-escalation of dose was frequently required. Fevers, gastrointestinal symptoms, fatigue, leukopenia, and elevated serum transaminases were common. High-dose interferon was found to be ineffective in the treatment of metastatic colorectal cancer. A daily dose of 50 X 10(6) units/m2 was greater than the maximum tolerated dose in this group of patients. PMID- 6488144 TI - Combined modality therapy for first recurrence of breast cancer. A Southwest Oncology Group study. AB - The Southwest Oncology Group has completed a study of 213 women with the first recurrence of breast cancer. Eligibility included a radical or modified radical mastectomy for cure and recurrence which had received no other form of therapy. Patients were started on tamoxifen (TAM) 20 mg daily (Phase I). Failures, or responders who subsequently failed, had an oophorectomy if the ovaries were intact, and TAM was continued (Phase II). During Phase III, eligible patients underwent an adrenalectomy, and lastly, in Phase IV, patients received chemotherapy. Responses to TAM were seen in 40% of 56 premenopausal patients, 46% of 95 postmenopausal women, and 44% of 62 patients without intact ovaries. Oophorectomy plus TAM gave responses only in premenopausal women who failed to respond on TAM or in postmenopausal patients who had a prior response to TAM. Adrenalectomy was successful in 7 of 21 patients. Chemotherapy resulted in 13% complete and 47% partial responses. Median overall survival was 108, 155, and 115 weeks, respectively, for the three patient groups. The authors believe that until results with chemotherapy improve significantly, hormonal therapy is the preferred first-line management of recurrent breast cancer. PMID- 6488146 TI - Effects of nutritional depletion and repletion on plasma methotrexate pharmacokinetics. AB - Clinically, a relationship exists among nutritional status, drug responsiveness, and host toxicity, but the effects of nutrition on chemotherapy drug metabolism are relatively unknown. This article evaluates the effect of malnutrition and nutritional repletion on plasma methotrexate (MTX) pharmacokinetics. In Study I, 55 non-tumor-bearing rats were fed regular diet (RD) (N = 27) or protein-free diet (PFD) (N = 28) for 10 days. On day 10, MTX 20 mg/kg was injected intraperitoneally and four to six animals in each group were killed at 30 minutes, 1, 2, 6, 24, and 48 hours following MTX administration. Plasma MTX was measured by dihydrofolate reductase enzyme inhibition assay and was found to be significantly elevated (P less than 0.01) in PFD animals as compared with RD animals at 1 and 2 hours following MTX injection. In Study II, 87 tumor-bearing rats were fed RD (N = 29) or PFD (N = 58) for 10 days. At this time, 27 PFD rats were switched to RD (PFD----RD), while 31 rats remained on PFD. MTX 20 mg/kg was injected intraperitoneally and six to eight rats in each group were killed at 1, 2, 6, and 24 hours post-MTX injection. Mean levels were found to be significantly elevated at 2, 6, and 24 hours in PFD (P less than 0.01) and PFD----RD (P less than 0.05) compared with RD rats. Several investigators have shown that increased plasma MTX levels at 24 and 48 hours after drug administration correlates with host toxicity in patients receiving chemotherapy. In this experimental study, malnutrition delayed plasma MTX clearance, and nutritional repletion for 2 days was insufficient to return MTX pharmacokinetics to normal. These results in experimental animals suggest an explanation for increased MTX toxicity in malnourished individuals. PMID- 6488147 TI - Screening for occult blood in selected patients. The potential for false negatives. AB - Seventy-one patients presenting for elective hernia repair without gastrointestinal symptoms were screened for occult blood in their stools. All patients had stools negative for occult blood and were studied with proctosigmoidoscopy and barium enema. Polyps were found in 10% of the study population. The potential for missing polyps definitely exists if patients are selected for further studies only on the basis of tests for occult stool blood. PMID- 6488148 TI - Significance of intestinal metaplasia for the evolution of cancer in the biliary tract. AB - Of 25 cases of cancer in the intrahepatic bile ducts, 44 cases of cancer in the extrahepatic bile ducts, 30 cases of adenoma in the gallbladder, and 100 cases of infiltrating carcinoma in the gallbladder, several to about 20% of the cases showed Paneth's cell metaplasia and/or enterochromaffin cell metaplasia within the tumor mass or in its surrounding mucosa. These metaplasia were not found in small adenomata of the gallbladder, but they were frequently seen in large adenomata. Goblet cell metaplasia and marked hyperplasia of mucous glands were seen more frequently in the mucosa surrounding cancer than in the mucosa of 500 non-neoplastic gallbladders. Although cancer in the gallbladder occasionally developed on the basis of intestinal metaplasia alone, intestinal metaplasia was not likely to be related to induction of most adenomata, but it was likely to be associated with growth and cancerous change of adenoma. PMID- 6488149 TI - Pseudomalignant erosion in hyperplastic gastric polyps. AB - Six cases of hyperplastic gastric polyps are described that, in the region of the eroded head, revealed strikingly atypical mesenchymal cells. These disseminated cells with marked nuclear pleomorphism and also atypical mitotic figures, undergoing direct transition to typical granulation tissue, are considered to be particularly activated mesenchymal cells. In a single case in which only excisional biopsy was performed, these cells were found to persist over a lengthy period, while in endoscopic-biopsy follow-ups of the polypectomized cases, these cells were subsequently no longer detectable. In four of the cases, the polyp was located in the region of the cardia, so that a traumatic factor may possibly be considered as having some causal relevance. In particular when biopsy excisions are performed, the differential diagnosis of this polyp with its endoscopic and histologic appearance of a tumor-like lesion, from epithelial and mesenchymal malignancies, as also from neural tumors, can be difficult. PMID- 6488150 TI - Hemangioendothelioma with intravascular coagulation and ischemic colitis. AB - An infant who presented with a thigh mass and coagulopathy was found to have a hemangioendothelioma. The tumor rapidly enlarged despite accepted therapeutic modalities, and the child died after a sudden cardiac arrest. Postmortem examination revealed a highly invasive tumor mass that had infiltrated the bowel and involved the inferior mesenteric artery, resulting in ischemic colitis of the left colon. A discussion regarding the pathophysiology with respect to endothelial cell properties and other microscopic features of the tumor is presented. PMID- 6488151 TI - Intraglomerular metastases. Report of two cases. AB - Glomerular metastases are rarely observed. Two cases of such metastases are reported. In one patient, proteinuria was detected and the diagnosis was made by kidney needle biopsy; light microscopy, immunofluorescence, and electron microscopy studies were performed. The second case was an autopsy finding. The histologic patterns were, respectively, an intracapillary metastasis and associated intra- and extracapillary metastases. These findings raise a number of questions concerning the early detection of such neoplastic diseases, the nature of primary tumors, and the mechanisms of malignant dissemination and glomerular localization. PMID- 6488152 TI - Binding of benzo(a)pyrene with peroxidase and its oxidation by peroxidase-H2O2 intermediate. AB - The oxidation of benzo(a)pyrene (BP) by horseradish peroxidase (HRP) (EC 1.11.1.7) was examined spectrophotometrically by the decomposition of peroxidase H2O2 intermediate "compound II." The rate constant of the oxidation of BP was 9.5 X 10(4) M-1 sec-1. The oxidation of BP by HRP was inhibited at high BP concentrations, and the hydrogen donor (BP) inhibition constant, KA', was 1.48 microM. The association constant, Kassoc, of the formation of a complex of BP and HRP at 403 nm was 4.37 X 10(4) M-1. The oxidation products of BP have been identified as 1,6-, 3,6- and 6,12-quinone BP. These products showed no mutagenicity in the mutagenicity assay. PMID- 6488153 TI - Cancer therapy with chemically modified enzymes. II. The therapeutic effectiveness of arginase, and arginase modified by the covalent attachment of polyethylene glycol, on the taper liver tumor and the L5178Y murine leukemia. AB - Monomethoxypolyethylene glycol (PEG) was attached covalently to arginase. PEG arginase was effective in prolonging the survival times of mice injected with the Taper liver tumor, whereas unmodified arginase was ineffective. PEG-arginase was more effective than arginase in the in vitro destruction of L5178Y mouse leukemia. However, neither PEG-arginase nor arginase inhibited the in vivo growth of this tumor. PMID- 6488154 TI - In vivo stimulation of DNA synthesis and induction of ornithine decarboxylase in rat colon by fatty acid hydroperoxides, autoxidation products of unsaturated fatty acids. AB - The effect of intrarectal instillation of hydroperoxy and hydroxy fatty acids on colonic DNA synthesis and ornithine decarboxylase activity in male Sprague-Dawley rats was examined. A mixture of hydroperoxy-arachidonic acid isomers was prepared by methylene blue-sensitized photooxygenation. Pure 13-hydroperoxy-9,11 octadecadienoic acid was prepared by the action of soybean lipoxygenase on linoleic acid. Sodium borohydride reduction yielded the respective hydroxy fatty acids. Twelve hr after instillation of solutions of either hydroperoxy or hydroxy fatty acids, at concentrations up to 10 mM, DNA synthesis was increased in a dose dependent fashion up to 240% above control values. The induction of ornithine decarboxylase occurred over a similar concentration range 3 hr after instillation of oxidized linoleic acid. In this case, the hydroxy acids (49-fold increase at 10 mM), were more stimulatory than the hydroperoxy derivatives (23-fold at 10 mM). Highly purified linoleic and arachidonic acids did not stimulate either activity at concentrations up to 50 mM. These data indicate that autoxidation products of unsaturated fatty acids, likely components of high-fat diets, can evoke proliferative responses in colonic mucosa. These responses may be relevant to the promotional effect of high dietary fat on colon carcinogenesis. PMID- 6488155 TI - Effect of intravenous dose and schedule on cerebrospinal fluid pharmacokinetics of 5-fluorouracil in the monkey. AB - There is little information regarding the pharmacology of 5-fluorouracil (5-FUra) in the central nervous system (CNS), despite its role in the treatment of diseases with CNS metastases and recent reports of neurotoxicity. In this study, the plasma and cerebrospinal fluid (CSF) pharmacokinetics of 5-FUra were examined in a primate model. Following a bolus dose, the area under the concentration versus time curves for 5-FUra in CSF was 48% of the plasma area under the concentration versus time curves. For continuous infusion of 5-FUra, the area under the concentration versus time curves ratio for CSF:plasma was 20 or 11%, depending upon the infusion rate. The mechanism for variations in CSF exposure based upon the pattern of plasma delivery is consistent with local metabolism of 5-FUra in the CNS. These findings should be considered in the evaluation of delivery schedules which are intended to maximize drug delivery to the CNS and/or minimize neurotoxicity. PMID- 6488156 TI - Synthesis of S-adenosylethionine by the gamma isozyme of methionine adenosyltransferase from Friend erythroleukemic cells. AB - Methionine adenosyltransferase (adenosine 5'-triphosphate-L-methionine S adenosyltransferase, EC 2.5.1.6) was found to occur only as the gamma isozyme in Friend erythroleukemic cells. Enzyme activity in a dialyzed 105,000 X g supernatant was linear for at least 30 min and dependent on the amount of protein added. The Km for methionine was 10.6 microM. In the presence of 10% dimethyl sulfoxide, the enzyme activity was slightly inhibited and dithiothreitol was not required for maximum activity. These properties identify the methionine adenosyltransferase in Friend erythroleukemic cells as the gamma isozyme. L Ethionine served as a substrate with a Km of 30 microM, and competitively inhibited the enzyme activity with a Ki of 150 microM. Friend erythroleukemic cells grown in the presence of ethionine accumulated S-adenosylethionine, which was dose and time dependent. Therefore, the gamma isozyme of methionine adenosyltransferase from Friend erythroleukemic cells utilize L-ethionine as substrate, resulting in an accumulation of S-adenosylethionine. These studies provide a mechanism by which ethionine through S-adenosylethionine may alter the methylation of DNA in Friend erythroleukemic cells. PMID- 6488157 TI - Enhancement by N-methylformamide of the effect of ionizing radiation on a human colon tumor xenografted in nude mice. AB - Polar solvents, which induce differentiation in murine and human tumor cells, enhance the effect of ionizing radiation on cultured mouse mammary and human colon cancer cells. To determine whether this enhancement occurs in vivo, DLD-2 human colon carcinoma xenografts in nude mice were treated with combinations of 6 MV photon irradiation, the polar solvent N-methylformamide (NMF), or combinations of the two agents. Nude mice bearing 300-mg s.c. implants of DLD-2 tumors were treated i.p. with 150 mg NMF/kg daily for 19 days. Local tumor irradiations were administered as graded single doses or as fractionated doses, daily for 4 days, following the third NMF injection. The growth-inhibiting effect of the radiation treatment for both single dose and fractionation protocols was enhanced by the polar solvent. NMF alone increased the time required for a doubling of initial tumor volume by 1.7 days, compared to control tumors. Initial tumor volume doubling times compared to untreated controls were increased by 3.6 and 7.6 days by photon doses of 10.0 and 13.75 Gy, respectively, whereas NMF plus 10.0 or 13.75 Gy increased the DLD-2 regrowth delay time by 7.5 or 12.9 days. NMF caused essentially equivalent enhancements, whether split-dose schedules of 2.5 Gy daily for 4 days, and 3.44 Gy daily for 4 days, or single doses of 10.0 and 13.75 Gy were used; therefore, radiation enhancement was not due to effects on sublethal damage repair. The results support the use of NMF, currently in Phase 1-Phase 2 clinical trials, with radiation in the therapy of selected human neoplasms. PMID- 6488158 TI - Selective inhibition of prostatic tumor 5 alpha-reductase by a 4-methyl-4 azasteroid. AB - The effect of sodium 4-methyl-3-oxo-4-aza-5 alpha-pregnane-20(s)-carboxylate (4 MAPC) on testosterone metabolism was investigated in rat and human prostates in organ culture. The general properties of the test system for androgen metabolism and response to inhibitors were in close agreement with in vivo observations. As an inhibitor of prostatic tumor 5 alpha-reductase, 4-MAPC was equally as effective as 17 beta-N,N-diethylcarbamoyl-4-methyl-4-aza-5 alpha-androstan-3-one, reported to be a potent 5 alpha-reductase inhibitor. Inhibition of 5 alpha reductase activity by 4-MAPC, but not by 17 beta-N,N-diethylcarbamoyl-4-methyl-4 aza-5 alpha-androstan-3-one, was accompanied by concomitant stimulation of 17 beta-oxidation of testosterone. This differential effect was observed in explants of human prostatic carcinoma and benign prostatic hypertrophy containing a relatively high degree of glandular hyperplasia. It was also seen in explants of dorsolateral rat prostate but not in the ventral prostate. 4-MAPC exhibited low affinity for rat prostatic cytosol 8S androgen receptor. Steroid extraction of purified nuclei from inhibited rat tissues revealed substantial amounts of radioactivity derived from [3H]testosterone cochromatographed with other metabolites in addition to dihydrotestosterone. The endocrine changes produced by this inhibitor of 5 alpha-reductase are reconcilable with the responsiveness of androgen-sensitive malignant prostatic cells to hormonal therapy. PMID- 6488159 TI - Catabolism of exogenously supplied thymidine to thymine and dihydrothymine by platelets in human peripheral blood. AB - The interference of platelets with the estimation of unscheduled DNA synthesis in human peripheral mononuclear leukocytes following genotoxic exposure was studied. A 96% reduction in the unscheduled DNA synthesis value was achieved by incubating [3H]thymidine with platelet-rich plasma for 5 hr at 37 degrees. Using radioactive thymine-containing compounds, together with quantitative analyses based on thin layer and ion-exchange chromatographies, we have shown that thymidine was converted to thymine which, in turn, was converted to dihydrothymine in platelet rich plasma. The enzymes responsible were separated from platelet lysates by gel filtration and were identified as thymidine phosphorylase and dihydrothymine dehydrogenase. The phosphorylase reversibly catalyzed the formation of thymine from thymidine and converted bromodeoxyuridine to bromouracil. The dehydrogenase reversibly catalyzed the interconversion of thymine and dihydrothymine in a reaction dependent on NADP(H), and it was inhibited by diazouracil and by thymine. Nearly all the thymidine-catabolizing activity found in whole blood samples supplied exogenously with thymidine was accounted for by the platelets. Since most genetic toxicological tests that use blood samples do not involve removing platelets from the blood cell cultures, then it is concluded that precautions should be taken in the future to determine the influence of platelets on these test systems. This is particularly true for methods dependent on thymidine pulses such as unscheduled DNA synthesis, or those dependent on bromodeoxyuridine, such as sister chromatid exchanges, since this nucleoside is also a substrate for thymidine phosphorylase. PMID- 6488160 TI - Involvement of plasma membrane lipid structural order in adriamycin resistance in Chinese hamster lung cells. AB - Plasma membrane preparations from Chinese hamster lung cells, which are resistant to the antitumor agent Adriamycin, were analyzed using fluorescence polarization of the membrane lipid probe trans-parinaric acid. The results of these studies reveal that membranes from several drug-resistant isolates have a substantial decrease in lipid structural order relative to membranes from drug-sensitive cells. Additional studies have shown that certain isolates are unstable and undergo a sequential phenotypic reversion after continuous passage in culture. Thus, we have identified cells which have reverted for membrane lipid physical changes but which still remain highly resistant to Adriamycin. At later passages, these cells are found to revert to drug sensitivity. These results indicate that an alteration of plasma membrane lipid structural order is not an essential component of the Adriamycin-resistant phenotype. However, in certain isolates, drug resistance and changes in membrane physical properties are both associated with an unstable genetic element. PMID- 6488161 TI - Influence of dietary medium-chain triglycerides on the development of N methylnitrosourea-induced rat mammary tumors. AB - The mammary tumor-promoting effects of a high-fat (HF) diet (23%, w/w) containing a 3:1 mixture of medium-chain triglycerides (MCT) and corn oil were compared with those of a low-fat (LF) corn oil diet (5%) and a HF: corn oil diet (23%, w/w). It was found that the ingestion of MCT in a HF diet resulted in no detectable tumor promoting effects in animals initiated with the potent mammary carcinogen N nitrosomethylurea. Total palpable mammary tumor incidence was 60% in the HF:corn oil plus MCT group, 66% in the LF:corn oil group, and 87% in the HF:corn oil group (p less than 0.03 and p less than 0.06, respectively). However, when palpable adenocarcinomas only were counted, differences in incidence between groups were not statistically significant, HF:MCT (57%) versus HF:corn oil (77%), p less than 0.08. Mean time to first tumor (days) was 122 +/- 40 (S.D.) in the MCT, 117 +/- 36 in the LF:corn oil groups, and 86 +/- 23 in the HF:corn oil group. The cumulative tumor incidence curves were similar for the MCT and LF:corn oil groups (p less than 0.9); however, both curves were significantly different from that of the HF:corn oil group (p less than 0.0099). No differences were found in tumor multiplicity, tumor size, or body weight gain in any of the treatment groups. Assay of serum total cholesterol and triglycerides showed that consumption of 23% corn oil diet significantly depressed serum cholesterol (but not triglyceride) levels compared to the LF:5% corn oil- and the HF:MCT containing diets. Analysis of serum fatty acid profiles indicated that animals fed 23% corn oil exhibited twice the amount of linoleic acid (C18:2) as did those fed either 5% corn oil or MCT. Differences in other fatty acids were of a much lesser magnitude. These results indicate that the mammary tumor-promoting effect of a HF diet can be diminished by substituting saturated MCT for the more common longer-unsaturated-chain triglycerides. In addition, they suggest an association between promotion of mammary cancer and elevated levels of linoleic acid in serum lipids. PMID- 6488162 TI - Antiestrogen binding in antiestrogen growth-resistant estrogen-responsive clonal variants of MCF-7 human breast cancer cells. AB - Although antiestrogen therapy is effective in the treatment of hormone-responsive breast tumors, approximately 40% of the patients with estrogen receptor-positive tumors fail to respond to antiestrogens. To better understand the mechanisms by which antiestrogens inhibit the growth of hormone-dependent breast cancers, we have investigated the physicochemical properties and binding characteristics of the estrogen receptors with estradiol and antiestrogens and the occurrence of estrogen-noncompetible antiestrogen binding sites in two estrogen-sensitive but tamoxifen-growth-resistant estrogen receptor-positive MCF-7 cell variant clones, R3-98 and R27. In the variant cells, estradiol (10(-8) M) significantly stimulates cell proliferation as in the parent MCF-7 cells, but the antiestrogen tamoxifen (10(-6) M) has no significant effect on growth of the variant cells, whereas antiestrogen strongly inhibits proliferation of the parent MCF-7 cells. All three cell types contain high concentrations of estrogen receptor (150 to 250 fmol/mg protein), and competition binding analysis shows that the relative binding affinity of a series of compounds for estrogen receptor is similar among the three cell types with the affinity of trans-hydroxytamoxifen greater than estradiol greater than alpha-[4-pyrrolidinoethoxy]phenyl-4-hydroxy-alpha' nitrostilben e greater than tamoxifen. Salt-extracted nuclear receptor complexes prepared from the three cell types showed similar sedimentation behavior on 0.4 M KCl-containing sucrose gradients with [3H]estradiol-labeled receptor complexes sedimenting at 4.2S, whereas receptors complexed with either of the antiestrogens trans-[3H]-hydroxytamoxifen or [3H]alpha-[4-pyrrolidinoethoxy]phenyl-4-hydroxy alpha'-nitrosti lbene sediment at 5.5S. In all 3 cell types, the nuclear receptor forms react with an estrogen receptor monoclonal antibody, D547Sp gamma, to form complexes which sediment at 8.5S. The nuclear estrogen receptors from the parental MCF-7 and the two variant cells, when covalently labeled with [3H] tamoxifen aziridine in intact cells and then salt extracted have identical molecular weights of approximately 62,000, as determined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The covalently labeled nuclear and cytosol receptors in these 3 cell lines also show identical migration in 8 M urea polyacrylamide isoelectric focusing gels consistent with a predominant receptor species of isoelectric point approximately 5.7.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6488163 TI - Direct relationship of marrow cell growth and 1-beta-D-arabinofuranosylcytosine metabolism. AB - To define the relationship between perturbed cell growth and intracellular metabolism of 1-beta-D-arabinofuranosylcytosine (ara-C) in sensitive human cells, growth kinetic, and biochemical pharmacological determinants were examined in normal human bone marrow populations in vitro in normal serum and in the presence of drug-induced humoral stimulatory activity (HSA). Cells cultured in HSA demonstrated both increased proliferation and greater ara-C-related inhibition of DNA synthesis than did cells maintained in normal serum, as measured by [3H]thymidine incorporation into DNA and [3H]thymidine granulocyte precursor labeling index. Parallel measurements of [3H]ara-C incorporation into DNA demonstrated similar behavior in HSA-perturbed cells. When these cultured cells were exposed to 1 and 10 microM ara-C, intracellular formation of 1-beta-D arabinofuranosylcytosine 5'-triphosphate over 3 hr and retention of this active form during 1 subsequent hr in drug-free medium were both increased in HSA stimulated cells relative to cells cultured in normal serum. These studies demonstrate coupling of induced cell growth kinetics with enhanced intracellular metabolism of the S-phase-specific antimetabolite ara-C in normal human marrow cells. The close direct relationship between growth kinetic perturbation and augmentation of intracellular ara-C activation in this normal hematopoietic model provides a basis for comparison with leukemic cell populations, in which uncoupling of growth kinetics and pharmacokinetics may signify divergence from normal drug-sensitive cell behavior and, thus, resistance to ara-C cytotoxicity. PMID- 6488164 TI - Inhibition of in vivo growth of murine plasmacytoma MOPC-460 by monoclonal anti idiotypic antibodies directed at distinct idiotypes of the immunoglobulin on the surface of MOPC-460. AB - The effect of several well-characterized monoclonal anti-idiotypic antibodies on the in vivo growth of idiotype-bearing murine plasmacytoma cells was examined. They were chosen from a group of immunoglobulin G1 antibodies which react with the binding site determinants of M460, the immunoglobulin A dinitrophenyl-binding myeloma protein secreted by and present on the surface of MOPC-460, and included representatives of two families which recognize different determinants in the M460 variable region. The antibodies were administered daily, beginning 2 hr before i.v. tumor cell inoculation, and the effect on the appearance of tumor colony formation in the spleen was judged after 14 days. All four antibodies tested were inhibitory. At the highest doses used, the number of splenic tumor foci was reduced by up to 97%. The effect was highly specific since the growth of MOPC-315, which also produces an immunoglobulin A dinitrophenyl-binding myeloma protein, was unaffected by the antibodies, and a similarly prepared immunoglobulin G1 monoclonal antibody against an unrelated idiotype did not affect the growth of MOPC-460. The inhibition of tumor growth appears to be independent of complement and antibody-dependent cellular cytotoxicity mechanisms. A small fraction of clones escaping the antitumor effect of anti idiotypic antibodies has stopped expressing the idiotype. PMID- 6488165 TI - Differential effect of the calmodulin inhibitor trifluoperazine on cellular accumulation, retention, and cytotoxicity of anthracyclines in doxorubicin (adriamycin)-resistant P388 mouse leukemia cells. AB - Calmodulin inhibitors enhance cytotoxic effects of doxorubicin (DOX) in DOX resistant (P388/DOX) P388 mouse leukemia cells by increasing cellular accumulation and retention of drug. In P388/DOX cells treated for 3 hr, cytotoxic effects (based on colony formation in soft agar) of daunorubicin (DAU) in the presence of trifluoperazine (TFP) were DAU concentration-dependent and enhanced 2 to 100-fold. Additionally, in the presence of TFP, on a molar basis, equitoxic doses of DAU were 4-fold lower than DOX for P388/DOX cells. However, in P388/DOX cells treated for 3 hr with other anthracyclines, except for a slight enhancement in the cytotoxic effects of aclacinomycin A (ACM) with TFP, colony formation in soft agar of cells treated with N-trifluoroacetyladriamycin-14-valerate (AD32) and N-trifluoroacetyladriamycin were similar in the absence and presence of TFP. In DOX-sensitive (P388/S) P388 mouse leukemia cells treated for 3 hr, some enhancement in the cytotoxic effects due to TFP were observed with DAU and DOX but not with ACM, AD32, or N-trifluoroacetyladriamycin. Although accumulation of ACM and AD32 in P388/S and P388/DOX cells was similar and unaffected by TFP, the retention of ACM but not AD32 was enhanced 1.5-fold only in TFP-treated P388/DOX cells. In contrast, DAU accumulation in P388/S cells was 4-fold higher than in similarly treated P388/DOX cells, and the 2- and 4-fold increase due to TFP in the accumulation and retention, respectively, of DAU in P388/DOX cells was not observed in P388/S cells. Results from this study indicate that in P388/DOX cells, the calmodulin inhibitor TFP is more effective with DAU than DOX, significantly less effective with ACM, and ineffective with AD32 and N trifluoroacetyladriamycin. PMID- 6488166 TI - Enhanced induction of the anchorage-independent phenotype in initiated rat tracheal epithelial cell cultures by the tumor promoter 12-O-tetradecanoylphorbol 13-acetate. AB - The purpose of the studies reported here was to compare the response of noninitiated and initiated primary rat tracheal epithelial (RTE) cell cultures to the mouse skin tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). The endpoints measured were number of cells per culture, colony-forming efficiency, subculturability, and colony formation in soft agarose. Primary RTE cell cultures were exposed on Day 1 to either 0.2% dimethyl sulfoxide, or to 0.1 micrograms per ml of N-methyl-N'-nitro-N-nitroso-guanidine (MNNG). Thereafter, the same cultures were exposed twice weekly from Days 6 to 30 to either 0.2% dimethyl sulfoxide or to TPA (10 pg/ml). Sequential exposure to MNNG and TPA did not increase the number of viable cells per culture beyond that seen in MNNG-exposed cultures. Determination of the frequency of colony-forming cells 10 days after the end of the initiation-promotion treatment (Day 40 of culture) revealed a marked enhancement in colony-forming efficiency of treated cultures compared to dimethyl sulfoxide-exposed control cultures. However, sequential exposure to MNNG and TPA had an additive or slightly more than additive effect on the colony-forming efficiency of RTE cells exposed to MNNG or TPA only. Treatment of the primary cultures with MNNG alone or TPA alone increased the subculturability of RTE cells to a similar extent. The sequential exposure to MNNG followed by TPA appeared to have an additive effect on the frequency of subculturability. The most pronounced effect of the sequential MNNG-TPA exposure as compared to single-agent exposure was a marked enhancement of the anchorage-independent (ag+) phenotype. Of the cultures treated with MNNG followed by TPA, over 50% were ag+ at 60 days. In contrast, of the cultures treated either with MNNG alone or with TPA alone, only 3% were ag+ on Day 60. (All control cultures were ag-.) Colony-forming efficiency in soft agarose also increased disproportionately between 60 and 120 days in initiated-promoted cultures. These experiments indicate that the major effect of the tumor promoter TPA on initiated RTE cell cultures is to enhance the appearance of the late ag+-phenotype. PMID- 6488167 TI - Characterization of mutagenic glucuronide formation from benzo(a)pyrene in the nonrecirculating perfused rat liver. AB - Excretion of mutagenic metabolites of benzo(a)pyrene into bile from livers of corn oil- or 3-methylcholanthrene-treated Sprague-Dawley rats perfused with a nonrecirculating perfusion system was quantitated. Mutagenic benzo(a)pyrene metabolites were detected using Salmonella typhimurium (strain TA 98) grown in the presence of limiting amounts of histidine. Microsomes were not included in the bacterial assay since metabolic activation was carried out by the perfused liver. Mutagenic activity was detected only if beta-glucuronidase was added to the assay mixture or if bile was treated with acid to hydrolyze glucuronides prior to assay. When livers were perfused with 20 microM benzo(a)pyrene, stable, mutagenic glucuronides were exported from corn oil-treated livers at maximal rates of 149 +/- 24 (S.E.) revertants/g/hr and at rates of 225 +/- 22 revertants/g/hr in livers from 3-methylcholanthrene-treated rats. Chromatography of bile by high-performance liquid chromatography demonstrated that two peak areas contained phenolic glucuronides which were hydrolyzed by beta glucuronidase. These two peaks, one which cochromatographed with authentic 3 benzo(a)pyrenyl-beta-D-glucuronide, accounted for all of the mutagenic activity in bile from livers perfused with benzo(a)pyrene. A good correlation (r = 0.86) between rates of mutagen production and rates of formation of phenolic glucuronides was observed under a variety of experimental conditions. The mutagenic activity observed with pure 3-benzo(a)pyrenyl-beta-D-glucuronide exposed to beta-glucuronidase was 4 revertants/nmol. When the rate of mutagen production was divided by the rate of production of 3-benzo(a)pyrenyl-beta-D glucuronide by the perfused liver, a value of 4 revertants/nmol was also obtained. Therefore, it is concluded that mutagens exported in bile from livers perfused with benzo(a)pyrene can be accounted for predominantly by hydrolysis products of phenolic glucuronides. PMID- 6488168 TI - Antigenic variants isolated from a mutagen-treated guinea pig fibrosarcoma. AB - Antigenic variants were derived from a mutagen-treated, apparently nonimmunogenic fibrosarcoma of strain 2 guinea pigs. Fibrosarcoma line 107C3, originally induced by exposure of fetal cells to a chemical mutagen, was treated in vitro with the same mutagen. Cells that survived mutagen treatment were cloned, and the clones were tested for growth in soft agar, in conventional and immunosuppressed syngeneic guinea pigs, and in nude mice. At early passages after treatment, all clones tested in conventional syngeneic guinea pigs either failed to grow intradermally or grew temporarily and then regressed. At later passages after treatment, five of eight evaluable clones grew progressively; the characteristic of intradermal tumor growth followed by tumor regression (tum- or regressor) was a stable property of three of eight evaluable clones. The number of tumor cells required to produce progressively growing intradermal tumors in 50% of the animals (TD50) of the three tum- clones was at least 4 orders of magnitude greater than the TD50 of the parent fibrosarcoma. Tum- clones were not detected among 10 clones derived from the untreated parent tumor. Regressor clones formed colonies in soft agar and grew progressively in immunosuppressed syngeneic guinea pigs and nude mice. Regressor clones contained tumor transplantation antigens. Guinea pigs immunized with clones that grew and regressed rejected a challenge with the parent tumor when the dose of parent tumor cells was 1 to 3 times the TD50. Guinea pigs immunized by temporary growth of the parent tumor followed by excision of the local tumor and the regional lymph node did not reject a challenge with the parent tumor. These results confirm the results of experiments with murine tumors and extend the observations on tum- clones to the guinea pig. The results indicate that in guinea pigs it is possible by immunization with tumor cell variants derived from the mutagen-treated parent tumor to produce transplantation immunity to an apparently nonimmunogenic tumor. PMID- 6488169 TI - Effects of single-dose and fractionated cranial irradiation on rat brain accumulation of methotrexate. AB - The effects of single-dose and fractionated whole-brain irradiation on brain methotrexate (MTX) has been studied in a rat model. The amount of MTX present in the brain 24 hr after a single i.p. dose (100 mg/kg) was the same wether animals were sham irradiated or given a single dose of 2000 rads 6 or 48 hr prior to the drug (6.9, 8.3, and 6.8 pmol MTX/g, wet weight, respectively). Animals sham irradiated or given 2000 rads in 10 fractions over 11 days and treated with an average dose of 1.2 mg MTX/kg i.p. twice a week for 24 weeks did not differ significantly in their brain MTX concentration (7.9 and 8.3 pmol MTX/g, wet weight, respectively). Chronically MTX-treated animals became folate deficient whether they were irradiated or not (450 and 670 pmol folate/g, wet weight, brain in MTX-treated and control animals). Thus, MTX accumulates in the brain with acute or chronic administration, and this accumulation is not altered by this amount of brain irradiation. PMID- 6488170 TI - Pharmacokinetics of 5-fluorouracil following different routes of intrahepatic administration in the canine model. AB - In an effort to achieve high concentrations of 5-fluorouracil (5-FUra) in the hepatic circulation while minimizing systemic exposure, several routes of intrahepatic administration were compared in the canine model. To ascertain these data, 5-FUra (30 mg/kg) was given as a bolus into either a systemic vein (femoral vein), hepatic artery, hepatic artery distal to its ligation after hepatic dearterialization, or through the portal vein. Three dogs were studied for each route with concomitant blood samples taken from the inferior vena cava and hepatic vein at 1, 2, 3, 5, 10, 15, 30, and 60 min after injection. 5-FUra levels were determined in plasma by high-pressure liquid chromatography. Blood flow in the portal vein and hepatic artery was measured by an electromagnetic flowmeter. The data were best described by a multicompartmental model including the measured flows. Hepatic components of the model were separate arterial and portal compartments, with elimination from each described by linear kinetics. Analysis of the results indicated that the highest hepatic levels with the least systemic exposure, as indicated by drug levels in hepatic and peripheral vein, were realized following hepatic artery administration distal to its ligation after hepatic dearterialization. PMID- 6488171 TI - Role of inflammatory neutrophils in antitumor effects induced by intraperitoneal administration of Corynebacterium parvum in mice. AB - We studied the role of inflammatory neutrophils in the antitumor effects that follow i.p. injection of Corynebacterium parvum (1400 micrograms) into C3HeB/FeJ mice challenged with the murine ovarian teratocarcinoma. Peritoneal neutrophils, obtained from mice 6 hr after injection of C. parvum, exerted significant antitumor effects when injected admixed with murine ovarian terato-carcinoma cells into the peritoneal cavities of normal mice. Treatment of recipient mice with whole-body irradiation or repeated injections of silica prevented the antitumor effects, indicating that neutrophils were activating a second effector mechanism in recipient mice. Peritoneal cells obtained at 24 or 72 hr or at 7 or 11 days following C. parvum injection were considerably less effective in activation of this effector mechanism. Heat-killed C. parvum (6 hr)-induced neutrophils activated antitumor responses, but thioglycolate-induced cells were without effect. Antitumor responses in mice receiving peritoneal neutrophils were not due to simple transfer of C. parvum organisms in the inocula. These results indicate that inflammatory neutrophils, elicited into the peritoneal cavity by injection of C. parvum, play an important role in the activation of subsequent antitumor effects. PMID- 6488172 TI - Differential effects of 12-O-tetradecanoylphorbol-13-acetate on cultured normal and neoplastic human bronchial epithelial cells. AB - The effects of the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA) on 10 human lung carcinoma cell lines were compared to those seen on normal human bronchial epithelial (NHBE) cells. TPA (0.1 to 100 nM) did not enhance the clonal growth rate for any of the cell lines. As little as 3 nM TPA induced the NHBE cells to undergo terminal squamous differentiation and thus completely inhibited their proliferation; in contrast, none of the carcinoma cell lines was significantly inhibited at this concentration, and they all continued to proliferate in as much as 100 nM TPA. To determine if this lack of TPA inhibition of clonal growth reflected resistance to TPA induction of terminal squamous differentiation, we measured the ability of TPA to induce cross-linked envelope formation and to increase plasminogen activator activity in four carcinoma cell lines. Cross-linked envelopes were not induced in two lines, and only a small number were induced in the other two lines relative to NHBE cells; plasminogen activator activity was induced in NHBE cells but not in any of the cell lines. PMID- 6488173 TI - Antitumor activity of lentinan in murine syngeneic and autochthonous hosts and its suppressive effect on 3-methylcholanthrene-induced carcinogenesis. AB - The antitumor effect of lentinan in syngeneic and autochthonous tumor-host systems and its suppressive effect on 3-methylcholanthrene (MC)-induced carcinogenesis were confirmed using DBA/2 and SWM/Ms hosts. The regressive activity of lentinan against the solid form of Sarcoma 180 was the most effective in DBA/2, SWM/Ms, or A/J mice and less effective in C3H/He or C57BL/6 mice. The growth of a syngeneic MC-induced DBA/2.MC.CS-1 fibrosarcoma (native and trypsinized) was markedly inhibited, and the regression of tumors was detected by the i.p. injection of minute amounts of lentinan into DBA/2 mice, which were the most suitable host in lentinan treatment. When DBA/2 mice were used, lentinan was also effective for even autochthonous primary tumors induced within 15 weeks after MC inoculation, but less effective for tumors induced during the 16 to 36 weeks after MC treatment. Lentinan showed a prominent suppressive effect in MC induced carcinogenesis using DBA/2 and SWM/Ms mice but not effect when BALB/c, C57BL/6, or C3H/He mice were used. The timing of lentinan administration in the latter result was examined using SWM/Ms mice, and lentinan, when it was given daily for 10 days after the third week of MC inoculation, was strikingly effective (33%), but not so effective (63%) when lentinan was given after the sixth week of MC treatment, compared with tumor-occurrence rate in the control group (88%). The reason why DBA/2, SWM/Ms, or A/J mice were suitable hosts for lentinan treatment is not clear, but the natural killer capability or phagocytic macrophage function in these strains seems to have no relation to lentinan action, because A/J mice are deficient in natural killer function, and in these strains of mice the phagocytic function of macrophages is weak. It may be quite possible that these strains of mice are most sensitive to delayed-type hypersensitivity and/or cytotoxic T-cell response in which T-cells and lentinan play important roles. The tumor-host systems presented here provide a good model in which lentinan retains an inhibitory capacity in syngeneic and autochthonous hosts, and such a model offers the possibility for further study of the host defense mechanism against cancer. PMID- 6488174 TI - In vitro versus in vivo correlations of chemosensitivity of human medulloblastoma. AB - An in vitro clonogenic assay was used to test the chemosensitivity of the human medulloblastoma cell line TE-671. Dose-response relationships for reduction in colony formation were generated for cyclophosphamide, vincristine, Adriamycin, 1,3-bis(2-chloroethyl)-1-nitrosourea (NSC 409962), and 1,4-cyclohexadiene-1,4 dicarbamic acid, 2,5-bis(1-aziridinyl)-3,6-dioxo-diethylester (NSC 182986); and the in vitro drug dose at which there is a 75% reduction in the number of colonies in comparison to controls (ID75S) were derived from these data. Methotrexate produced no colony reduction at any dose tested up to 1000 micrograms/ml. The in vitro results were compared to growth delays in s.c. TE-671 xenografts in athymic mice treated with the same agents. Agents with an ID75 less than assumed in vivo plasma drug concentrations were all active in vivo, whereas two of the three agents with an ID75 greater than assumed in vivo plasma drug concentrations demonstrated no in vivo activity. These results suggest that for these agents, the relationship between the ID75 of the drug and its in vivo concentration allows in vitro clonogenic assay results to agree with in vivo growth delay responses. PMID- 6488175 TI - Role of aldehyde dehydrogenase in cyclophosphamide-resistant L1210 leukemia. AB - A cyclophosphamide-resistant L1210 cell line has been shown to have unusually high aldehyde dehydrogenase activity. The sensitivity of this cell line to 4 methylcyclophosphamide and phosphoramide mustard in vivo and corresponding sensitivities in vitro indicate that 4-hydroxycyclophosphamide and/or aldophosphamide is the form in which cyclophosphamide reaches these tumor cells in mice and that intracellular aldehyde dehydrogenase activity is an important determinant of cyclophosphamide sensitivity in these leukemia cell lines. PMID- 6488176 TI - Tumorigenicity of dihydrodiols and diol-epoxides of benz[c]acridine in newborn mice. AB - The tumorigenicity of benz[c]acridine (B[c]ACR) and a number of its derivatives, including the five metabolically possible transdihydrodiols, the diastereomeric bay-region diol-epoxides, two non-bay-region diol-epoxides, and the K-region 5,6 oxide, were assessed in newborn mice. A total dose of 0.50 or 1.05 mumol of compound was administered i.p. to preweanling mice, and tumorigenic activity was determined when the mice were 33 to 37 weeks old. B[c]ACR was a weak carcinogen producing an average of 2.5 lung tumors/mouse and 0.15 liver tumor/male mouse at the 1.05-mumol dose. Of the five metabolically possible trans-dihydrodiols of B[c]ACR, only trans-3,4-dihydroxy-3,4-dihydro-B[c] ACR (B[c]ACR (B[c]ACR 3,4 dihydrodiol) had high tumorigenic activity. B[c]ACR 3,4-dihydrodiol induced 2- and 10-fold more pulmonary and hepatic tumors, respectively, than did the parent compound while the trans-1,2-, 5,6-, 8,9-, and 10,11-dihydrodiols had very little or no tumorigenic activity. Both of the diastereomeric bay-region 3,4-diol-1,2 epoxides, in which the epoxide oxygen is either cis (isomer 1) or trans (isomer 2) to the benzylic hydroxyl group, had tumorigenic activity. Isomer 2 was the most tumorigenic derivative tested, inducing at least 60, 7, and 12 times more lung tumors per mouse than did isomer 1, B[c]ACR 3,4-dihydrodiol and B[c]ACR, respectively. The K-region 5,6-oxide and two non-bay-region diol-epoxides (isomer 2 of B[c]ACR 8,9-diol-10,11-epoxide and B[c]ACR 10,11-diol-8,9-epoxide) were weakly active or inactive at the dose tested. The demonstration that B[c]ACR 3,4 diol-1,2-epoxide-2 is exceptionally tumorigenic and that its metabolic precursor, B[c]ACR 3,4-dihydrodiol, is more active than the parent hydrocarbon, B[c]ACR, support the concept that isomer 2 of the bay-region diol-epoxide may be an ultimate carcinogenic metabolite of B[c]ACR. PMID- 6488177 TI - Fractionation of skin tumor-initiating activity in coal liquids. AB - Narrow temperature range distillates from biologically active solvent refined coal-I and -II heavy-end coal liquids were fractionated according to chemical class and assayed for initiation of skin carcinogenesis in CD-1 mice. In addition, instrumental chemical analyses were performed on the distillates and their chemical fractions. Results showed that initiation activity in these complex fuel mixtures could be segregated both by boiling point and chemical class. Neutral polycyclic aromatic hydrocarbon fractions were the most active of the chemical classes, with some initiating activity being shown by nitrogen containing polycyclic aromatic hydrocarbon. Aliphatic and hydroxylated polycyclic aromatic hydrocarbon fractions showed little or no initiating activity. For the two solvent refined coal-II distillates studied, initiating activity was substantially higher in the material boiling above 850 degrees F than in that boiling 800-850 degrees F, although both contained essentially the same concentrations of benzo[a]pyrene. These data indicate that the overall initiating activity of these complex mixtures is highly dependent on interactions of the many chemical carcinogens and that relative concentrations of known carcinogenic polycyclic aromatic hydrocarbons, such as benzo[a]pyrene and dimethylbenz[a]anthracene, are not the sole determinants of initiating activity. PMID- 6488178 TI - Heat shock proteins and protection of proliferation and translation in mammalian cells. AB - The characteristics of heat shock protein(s) (HSP) and thermotolerance induction were examined in Chinese hamster ovary cells following two diverse nonlethal heat shocks: a continuous 41 degree exposure and a 45 degree, 5-min exposure. While induction of both HSP and thermotolerance were observed to initially develop simultaneously, a significant period was observed during which HSP induction was not accompanied by any further increase in the cells' ability to survive a thermal stress. Conversely, the achievement of the full tolerant state, as measured by colony survival, correlates in these instances with the moment at which development of the induction of HSP either ceased or began to be repressed. When a 99% lethal 45 degree, 22-min heat shock was examined, HSP and a thermal resistance were again observed to develop synchronously, despite the fact that the tolerance was measured in only 1% of the cell population. In this instance, a new protein of molecular weight 66,000 was observed which was not visibly induced by either of the two nonlethal treatments. Finally, the ability of heat-shocked thermotolerant cells to translate proteins following a second heat challenge (protection of translation) was investigated as an alternative measure of thermotolerance. While a protection of translation which encompassed several normal cellular proteins was observed, the phenomenon paralleled the induction and repression phases of HSP synthesis and was therefore not related to thermotolerance. PMID- 6488179 TI - Photoprotective role of epidermal melanin granules against ultraviolet damage and DNA repair in guinea pig skin. AB - We previously developed a quantitative autoradiographic technique with special forceps for measuring unscheduled DNA synthesis (UDS) in mouse skin after treatment with ultraviolet light in vivo. By this method, we investigated the relationship between the protective role of melanin and UV-induced DNA repair in black-and-white guinea pigs. Flat areas containing a sharp border between pigmented and unpigmented skin were selected. The skin of the selected areas was shaved and irradiated with short-wave UV (254 nm) or UV-AB (270 to 440 nm, emission peak at 312 nm) at various doses. Immediately after irradiation, the skin was clamped off with forceps, and an isotonic aqueous solution of [methyl 3H]thymidine was injected s.c. into the clamped off portion. UDS was clearly demonstrated as silver grains in this portion of the skin after irradiation with 254 nm UV or UV-AB. Errors due to individual differences were avoided by comparing the intensities of UDS in basal cells from pigmented skin and unpigmented skin of the same animals. Unexpectedly, in groups of animals treated with 254 nm UV or UV-AB, no difference in UDS in pigmented and unpigmented skin was seen at any UV dose. These results suggested that epidermal melanin granules do not significantly protect DNA of basal cells against 254 nm UV or UV-AB irradiation. Results of a study on the effect of the wavelength of irradiation on the UDS response of albino guinea pigs are also reported. PMID- 6488180 TI - Lack of intercellular communication between chemically transformed and surrounding nontransformed BALB/c 3T3 cells. AB - In order to study the possible role of intercellular communication in the process of in vitro cell transformation, the communicating capacity of BALB/c 3T3 cells transformed by 20-methylcholanthrene was investigated using a dye transfer method. Morphologically transformed foci, detectable 4 to 5 weeks after treatment with 20-methylcholanthrene (1.0 microgram/ml), are clearly distinguishable under the phase-contrast microscope from surrounding nontransformed monolayer cells; therefore, a tracer dye can be injected into individual cells, and gap-junctional communication between and among transformed and nontransformed can be studied directly. When fluorescent Lucifer Yellow CH was microinjected into a cell within the transformed focus, the dye was transferred to other transformed cells but not to cells in the adjacent nontransformed area, although they were in physical contact. Similarly, dye injected into a nontransformed cell was transferred to neighboring nontransformed cells but not to cells in an adjacent transformed focus. These results indicate that when BALB/c 3T3 cells are transformed by 20 methylcholanthrene they can no longer communicate with surrounding normal cells, although they maintain the ability to communicate with other transformed cells in the focus. These results suggest that loss of the ability to communicate with surrounding nontransformed cells may be one of the important determinants of induction and expression of the final malignant transformation. PMID- 6488181 TI - Similar characteristics of folate analogue transport in vitro in contrast to varying dihydrofolate reductase levels in epithelial cells at different stages of maturation in mouse small intestine. AB - We describe studies of folate analogue transport in purified epithelial cell fractions isolated from mouse small intestine. Fractionation of these cells into immature proliferative and mature absorptive components and two components representative of intermediate stages of maturation was carried out by stepwise, nonenzymatic stripping of the everted organ. In contrast to the proliferative specific enzyme markers, thymidine kinase and dihydrofolate reductase, folate analogue transport did not vary with the alteration in proliferative potential of these cells during maturation. The brush-border enzyme, alkaline phosphatase, was used as a positive marker for maturation. Initial influx of [3H]-aminopterin into both mature and immature cell fractions showed the same kinetics and did not exhibit pH dependence within the range of 6.0 to 7.8. A single saturable component (Km = 16 +/- 3 microM; V37 = 57 +/- 8 pmol/min/10(7) cells) was delineated, with the same temperature dependence (Q10 27-37 degrees = 3.2 +/- 0.4; Arrenhius constant = 11.1 +/- 3 kcal/mol) and same specificity for various folate compounds. Initial efflux of [3H]aminopterin was also similar in both cell types. Efflux was first-order (t1/2 37 degrees = 1.1 to 1.3 min; K37 = 0.53 +/- 0.04 min-1) and equal to the decay-time constant for approach to steady-state during accumulation of [3H]aminopterin, but showed higher-temperature dependence (Q10 27-37 degrees = 6.7 +/- 0.8; Arrenhius constant = 25.3 +/- 4 kcal/mol). Under the conditions used which do not allow polyglutamylation of [3H]aminopterin, steady-state levels of accumulation of exchangeable drug at 37 degrees in each cell fraction were accounted for by the various kinetic parameters for each flux. At all concentrations of [3H]aminopterin examined, both types of epithelial cells appeared to maintain a negative electrochemical gradient under physiological conditions. Overall, the data conform to a two carrier model for folate analogue transport in which each flux is mediated by a separate system. However, specificity and saturability of influx for folate compounds, and inhibition of this flux by various agents was markedly different from that reported for various tumor cells. PMID- 6488182 TI - Regulation of aldehyde dehydrogenase activity in five rat hepatoma cell lines. AB - Significant changes in aldehyde dehydrogenase (ALDH) activity occur during rat hepatocarcinogenesis in vivo. An NADP-dependent tumor ALDH isozyme has been studied extensively. To better understand the nature, origin, and importance of this tumor-associated phenotypic change, we have examined the ALDH activity of five well-established rat hepatoma cell lines, H4-II-EC3, HTC, McA-RH7777, JM1, and JM2. HTC, JM1, and JM2 express the tumor ALDH phenotype, as indicated by elevated NADP-dependent, benzaldehyde-oxidizing activity, the appearance of new isozymes by electrophoresis, and characteristic histochemical localization of ALDH activity in situ. The tumor ALDH phenotype is not detected in McA-RH7777 cells. H4-II-EC3 has intermediate tumor ALDH activity. Thus, the 5 cell lines provide a spectrum of tumor ALDH activities representative of the range of activities seen in vivo. Benzo(a)pyrene, 3-methylcholanthrene, and phenobarbital induce hepatic ALDH activity after treatment in vivo. The ability of these compounds to induce ALDH in vitro was assessed in H4-II-EC3, McA-RH7777, HTC, JM1, and JM2. Treatment of cell cultures for 72 hr with 3-methylcholanthrene (1.0 mM) increases the NADP-dependent ALDH activity in H4-II-EC3 and McA-RH7777 cell lines up to 34- and 11-fold, respectively. Treatment with benzo(a)pyrene (1.0 mM) also increases the NADP-dependent ALDH activity in both lines up to 17- and 48 fold, respectively. Treatment with 3-methylcholanthrene or benzo(a)pyrene increases ALDH activity 2-fold in HTC and JM2 but does not increase NADP dependent ALDH activity in JM1. Only marginal increases in NADP-dependent ALDH are observed after phenobarbital treatment in 4 of 5 cell lines. The induction of ALDH is blocked by actinomycin D, alpha-amanitin, and cycloheximide. These studies support our hypothesis that changes in ALDH activity observed in vivo are due to mutational events occurring in initiated cells. It appears that rat hepatoma cell lines will provide an in vitro model for studying genetic regulation of the tumor ALDH. PMID- 6488183 TI - High-frequency variation and population drift in a newly transformed clone of BALB/3T3 cells. AB - During repeated passage of BALB/3T3 cells and testing for anchorage-independent growth, a single transformed clone was isolated from agar, and five subclones were derived from it. These subclones differed from one another in morphology on a solid substratum, efficiency and size of colony formation in agar, and rate of tumor formation in nude mice. With weekly passage over a period of 6 months, the differences in morphology and growth in agar gradually decreased. The subclone which produced the fastest-growing tumors in nude mice after 4 weeks of culture produced the slowest-growing tumors after 18 weeks, and a change in the opposite direction was made by another subclone. There was no difference among the subclones in growth rate on plastic. The distribution of chromosome numbers was heterogeneous but overlapping in all the primary subclones at 16 and 24 weeks, with no statistically significant difference in the mean number of chromosomes per subclone. An extremely high degree of variation must have occurred to produce the multiple differences between the subclones, and the same type of variation could have been responsible for the subsequent changes with repeated passage. The high frequency and graded nature of the changes and the concurrent involvement of several traits suggest an epigenetic basis for the variation. PMID- 6488184 TI - Differential expression of ganglioside GD3 by human leukocytes and leukemia cells. AB - Gangliosides from normal leukocytes and the cells of 25 patients with acute and chronic leukemia were tested for the presence of the disialoganglioside II3-alpha N-acetylneuraminosyl-alpha 2----8-N-acetylneuraminosyllactosylceramide (GD3). GD3 was detected by immunostaining thin-layer chromatographs with an anti-GD3 monoclonal antibody (AbR24). Among the myeloid cells tested, acute leukemia cells were positive for GD3, whereas chronic leukemia cells and normal neutrophils did not have detectable GD3. A range of GD3 reactivity was apparent within the acute myeloid leukemia cells; gangliosides from pure myeloid leukemia cells stained more intensely than those from leukemia cells with monocytic characteristics. All lymphocytic leukemia cells (chronic and acute) contained GD3, but this ganglioside could not be detected in extracts from normal lymphocytes. A ganglioside extract from the cells of a patient with hairy cell leukemia was also positive for GD3 immunostaining. These results demonstrate that normal leukocytes and chronic myelogenous leukemia cells are distinguished from other lymphoid and nonlymphoid leukemia cells on the basis of GD3 ganglioside expression. PMID- 6488185 TI - Cell proliferation and growth of gastric carcinoma induced in inbred Wistar rats by N-methyl-N'-nitro-N-nitrosoguanidine. AB - Gastric carcinoma was induced in inbred Wistar rats by p.o. administration of N methyl-N'-nitro-N-nitrosoguanidine for 25 weeks, and cell proliferation and growth of the gastric carcinoma in an incipient stage were studied. A microscopic cancer was found by 24 weeks, and macroscopic cancers were found after 27 weeks. All the cancers were a single lesion located at the midpoint of the lesser curvature of the stomach. Histologically, they were tubular adenocarcinomas. The mucosal changes predisposing to the development of carcinomas were focal erosions and dysplasias confined to the midpoint of the lesser curvature. The malignant transformation appeared to occur in the dysplastic cells of the eroded mucosa by 17 to 18 weeks after N-methyl-N'-nitro-N-nitrosoguanidine treatment. Following the malignant change, the labeling indices of the tissues with [3H]thymidine decreased, suggesting an elongation of cell cycle time. By repeated injections of [3H]thymidine, a time required for all the cancer cells to enter S phase (reflecting the maximum cell cycle time) was estimated to be about 3.5 days. This gave a theoretical doubling time for the gastric cancers. On the other hand, from the temporal observations of tumor volumes, it was shown that the gastric cancers in an incipient stage underwent exponential growth with a doubling time of 14 days. The difference between the theoretical and actual doubling time might reflect a cell loss rate in the cancer tissue. PMID- 6488186 TI - Nuclear matrix antigens in azo dye-induced primary rat hepatomas. AB - Polyvalent antisera, monoclonal antibodies, and immunotransfer methodology have been used to identify and characterize a group of chromosomal protein antigens which appear during azo dye hepatocarcinogenesis. Experiments were designed to probe for the location and placement of antigens in chromatin according to solubility and possible DNA-binding properties. The majority of nuclear antigens were associated with high-speed DNA-containing pellets after ultracentrifugation of chromatin solubilized with denaturing buffers containing 6 M guanidine-HCl:2% sodium dodecyl sulfate, or 2 M NaCl:5 M urea. The addition of 2-mercaptoethanol or dithiothreitol to guanidine-HCl or sodium dodecyl sulfate solutions resulted in solubilization of nearly all antigens from the DNA pellets, suggesting the presence of complexes (protein:protein and/or DNA:protein) cross-linked with sulfhydryl linkages. Preparation of nuclear matrix from the primary hepatomas under several kinds of conditions indicated these antigens to be components of the residual nuclear matrix, envelope, and/or associated structures. Two dimensional gel analysis showed most antigens to exist in a range of isoelectric forms, suggesting posttranslational modifications. Studies with monoclonal antibodies prepared to these proteins revealed extensive antigenic homology among the members comprising these fractions. Our results document antigenic differences in the nuclear matrix proteins of primary tumors and their normal tissue counterparts. PMID- 6488187 TI - Comparison of specificity of inhibition of polyamine synthesis in bovine lymphocytes by ethylglyoxal bis(guanylhydrazone) and methylglyoxal bis(guanylhydrazone). AB - Ethylglyoxal bis(guanylhydrazone) (EGBG) was compared as an inhibitor of polyamine biosynthesis with methylglyoxal bis(guanylhydrazone) (MGBG) in bovine small lymphocytes stimulated by concanavalin A. EGBG brought about a decrease in spermidine and spermine levels equal to that found with MGBG, but at a 5-fold lower intracellular drug concentration. Despite identical polyamine levels, the degree of inhibition of DNA and protein synthesis by EGBG was smaller than that observed with MGBG, in either the presence or absence of the ornithine decarboxylase inhibitor, alpha-difluoromethylornithine. It was found that in vitro protein synthesis and in vivo mitochondrial function were inhibited by concentrations of MGBG necessary to inhibit polyamine synthesis in cells (1 to 3 mM), but not by efficacious levels of EGBG (0.2 to 0.6 mM). These results suggest that EGBG is more suitable as a specific inhibitor of polyamine biosynthesis and that use of this drug, rather than MGBG, in combination with alpha difluoromethylornithine may be useful for studying the physiological functions of polyamines in animal cells. PMID- 6488188 TI - Lack of production of myoepithelial variants by cloned epithelial cell lines derived from the TMT-081 metastasizing rat mammary tumor. AB - A series of cell lines was isolated from the metastasizing rat mammary tumor cell strain TMT-081. MS by single-cell cloning. Feeder cells were required for development of single tumor cells into clonal colonies. The rate, pattern, and incidence of metastases following injection of cells into the mammary fat pads of syngeneic rats were relatively similar for the various cell lines, with dissemination to the lungs and axillary and paraaortic lymph nodes. When a representative cell line termed Rama 800 was subcloned, one subline was nontumorigenic, and another gave a lower incidence of lung metastases, but the remainder had similar in vivo properties to the parental Rama 800 cells. The metastatic properties of Rama 800 cells were not affected by passage in vitro through 60 cell generations. No production of myoepithelial-like variants from Rama 800 cells was observed at the ultrastructural level. Antisera to keratin, actin, laminin, and fibronectin, which normally stain myoepithelial cells and basement membrane, failed to stain Rama 800 cells, either in cultures or in tumor sections. Heterogeneous staining of Rama 800 tumor cells with antiserum to epithelial cell-specific milk fat globule membrane antigens was seen in tumor sections but not in culture. Abundant microvilli and membrane blebs were observed on the surface of cultured Rama 800 cells, but no lumen formation, desmosomes, or tonofilaments were seen, either in vivo or in vitro. The results suggest that the metastatic epithelial-derived cell lines lack the ability to express features of myoepithelial cells, in contrast to cell lines isolated previously from nonmetastasizing rat mammary tumors. PMID- 6488189 TI - Incorporation of [35S]sulfate in normal and neoplastic rat pancreatic acinar cells in relationship to cytodifferentiation. AB - The rates of [35S]sulfate incorporation in highly differentiated acinar cells from normal pancreas, moderately differentiated cells of nafenopin-induced transplantable pancreatic carcinoma, and poorly differentiated cells from azaserine-induced transplantable pancreatic carcinoma were examined in an attempt to determine if sulfation is a property of acinar cells with well-developed secretory granules. The cells were dissociated, pulsed with [35S]sulfate (specific activity, approximately 1000 Ci/mmol) for 10 and 60 min, and chased with medium containing 100 X excess of cold inorganic sulfate for 0, 15, 60, and 120 min. The cells were then processed for determining their pool size and light and electron microscopic autoradiography. No significant differences among their pool sizes were observed. However, the light microscopic autoradiograms revealed the [35S]sulfate incorporation as follows: azaserine-induced transplantable pancreatic carcinoma greater than nafenopin-induced transplantable pancreatic carcinoma greater than normal pancreas. Electron microscopic autoradiograms revealed similar trends. The grain densities (concentration of radiation) were highest in the Golgi regions immediately postpulse (0 min) and gradually shifted toward the secretory granules over a 120-min period. In addition, the grain density values of the secretory granule-rich cells of nafenopin-induced transplantable pancreatic carcinoma were relatively similar to the cells of normal pancreas, whereas the grain density values of secretory granule-deficient cells from this tumor were similar to those of poorly differentiated neoplastic cells of azaserine-induced transplantable pancreatic carcinoma. These results show that poorly differentiated neoplastic cells incorporate more [35S]sulfate than do the well-differentiated cells, but the reasons for this unexpected differential incorporation are at present unknown. PMID- 6488190 TI - Differentiation of pancreatic acinar carcinoma cells cultured on rat testicular seminiferous tubular basement membranes. AB - The use of rat testicular seminiferous tubular basement membrane (STBM) segments as a model substratum for the in vitro maintenance of tumor cells dissociated from a transplantable pancreatic acinar rat carcinoma (J. K. Reddy and M. S. Rao, Science (Wash. DC), 198: 78-80, 1977) is described. Ultrastructurally pure, hollow tubular segments of STBM were prepared by mechanical disaggregation, DNase digestion, and deoxycholate treatment. Dissociated pancreatic acinar carcinoma cells adhered readily to STBM segments within 1 to 6 hr, and these STBM-tumor cell aggregates were maintained for up to 7 days in serum-free chemically defined medium supplemented with hydrocortisone, insulin, vitamin C, and soybean trypsin inhibitor. The tumor cells formed acinar-like clusters and displayed intercellular junctions and polarization of secretory granules toward the center of these clusters. By 4 days, virtually all cells of this acinar carcinoma maintained on STBM in supplemented chemically defined medium contained numerous secretory granules. Cell replication, as determined by [3H]thymidine autoradiography, ceased within 18 hr of attachment of neoplastic cells to STBM; however, all cells incorporated [3H]leucine as evidenced by light and electron microscopic autoradiography. In addition, two-dimensional analysis and fluorography of newly synthesized secretory proteins discharged by these cells in response to carbamylcholine revealed the presence of Mr 24,000 protein and 19 other secretory proteins characteristic of this tumor (L. J. Hansen, M. K. Reddy, and J. K. Reddy, Proc. Natl. Acad. Sci. USA, 80: 4379-4383, 1983). The culture system utilizing STBM and supplemented chemically defined medium should allow investigation of the effects of a variety of factors on morphogenesis, cytodifferentiation, and gene expression in pancreatic acinar tumors. PMID- 6488191 TI - Cytotoxicity of adriamycin in MGH-U1 cells grown as monolayer cultures, spheroids, and xenografts in immune-deprived mice. AB - The cytotoxic activity of Adriamycin was examined in the MGH-U1 human bladder carcinoma line, grown as monolayer culture, as spheroids, and as xenografts in immune-deprived mice. The MGH-U1 cells grown as spheroids were much more resistant to Adriamycin (concentration of drug resulting in 37% cell survival, 4.5 micrograms/ml) than when treated as monolayer cultures (concentration of drug resulting in 37% cell survival, 0.9 microgram/ml). Adriamycin fluorescence was demonstrated only in the outer two layers of cells forming the spheroids, suggesting that limited drug penetration is an important factor in the resistance of spheroids to Adriamycin. Sequential trypsinization of spheroids 750 micron in diameter allowed us to determine the cytotoxic effects of Adriamycin in MGH-U1 cells derived from different depths of the spheroid. We found that cells near the surface of the spheroid had a survival similar to those of exponentially growing monolayer cells treated with Adriamycin. Cells located in the middle of the viable rim were more resistant to Adriamycin, and those found near the necrotic center were most resistant to Adriamycin. The effects of Adriamycin treatment on spheroid growth delay were determined also. In spite of a small cytotoxic effect on the clonogenic fraction of cells in MGH-U1 spheroids, the growth delay effect of Adriamycin in intact spheroids was marked. This observation is consistent with Adriamycin killing primarily the cells in the outer layers of the spheroid, where most of the proliferation in the spheroid occurs. In vivo treatment of MGH-U1 xenografts with Adriamycin followed by assessment of cell survival in vitro showed minimal evidence of cytotoxicity, consistent with the poor drug penetration observed in the spheroid model. These studies suggest that: (a) Adriamycin penetrates poorly into solid tissues; (b) in vitro clonogenic survival following Adriamycin exposure of a cell suspension may predict falsely for drug sensitivity to chemotherapy; (c) a small decrease in clonogenic survival can be translated into a long growth delay but, ultimately, the tumor regrows because some clonogenic cells are spared; and (d) for Adriamycin, the spheroid model more closely parallels the in vivo effects than does monolayer culture. The use of the spheroid model for the study of Adriamycin cytotoxicity gives further insight into the action of this drug in solid tumors. PMID- 6488192 TI - Comparison between concentrations of trace elements in normal and neoplastic human breast tissue. AB - Histologically normal and neoplastic human breast tissues obtained from 25 patients at the time of mastectomy were homogenized (200 mg/ml) in distilled water and 5-microliter aliquots dried on Formvar films for trace element analysis by energy-dispersive X-ray fluorescence. The elements measured were calcium, vanadium, copper, zinc, iron, chromium, manganese, nickel, selenium, molybdenum, bromine, rubidium, strontium, mercury, arsenic, and lead. In general, significantly large increases (p less than 0.001) in calcium, vanadium, copper, zinc, selenium, and rubidium were found in breast tumors, with a less significant increase (p less than 0.05) for nickel. When a comparison was made between histologically normal and neoplastic tissues from the same individual, zinc and rubidium were found to be consistently higher in the tumor, whereas calcium, copper, and vanadium levels varied from normal to high. In no instance were the tissue changes in calcium, copper, zinc, or rubidium reflected in the blood levels, which were within normal limits. The distribution of calcium, copper, and zinc in urine varied among individuals with primary tumors; however, rubidium levels tended to be consistently elevated. An attempt is being made to correlate these various differences with the extent of the primary disease at the time of surgery, the postoperative tumor-free interval, and subsequent therapy. PMID- 6488193 TI - Influence of cellular DNA content on disease-free survival of Stage II breast cancer patients. AB - Using a novel flow cytometric method to analyze paraffin-embedded archival material, cellular DNA content of the primary tumor was measured in 165 patients with Stage II breast cancer who had been entered onto a large, multicenter trial of adjuvant chemotherapy. Fifty-three (32%) of the tumors examined were diploid, and the remainder contained one or more aneuploid clones. Aneuploid tumors had more extensive axillary lymph node involvement (p less than 0.05 using chi 2 analysis), but there were no significant correlations between cellular DNA content and either menopausal or estrogen receptor status. Forty-nine of 112 (44%) patients with aneuploid tumors have relapsed, compared to 12 of 53 (23%) with diploid tumors, and relapse-free survival curves show that beyond 2 years the diploid group reaches an apparent plateau, with a projected 4-year relapse free survival of 72%, whereas the aneuploid group shows a continuing risk of relapse with only 43% remaining relapse free at 4 years. This correlation was most pronounced in the premenopausal patients; only 5 of 36 (14%) of those with diploid tumors have relapsed compared to 23 of 63 (37%) in the aneuploid group. However, multivariate analysis using a stepwise Cox model does not thus far confirm an independent prognostic significance of cellular DNA content on disease free survival compared to node status. The cellular DNA content of the primary tumor did not appear to influence the patients' survival following relapse. These results indicate that compared to aneuploid tumors either diploid tumors have a different natural history or they are more responsive to adjuvant chemotherapy, possibly due to a lower probability of their developing drug resistance. PMID- 6488194 TI - Potentiation of melphalan cytotoxicity in human ovarian cancer cell lines by glutathione depletion. AB - The effectiveness of alkylating agents in the treatment of ovarian cancer is limited by the frequent development of drug resistance. In order to examine the mechanisms of resistance and potential ways in which this resistance could be overcome, we have developed a human ovarian cancer cell line, 1847ME, resistant to the bifunctional amino acid nitrogen mustard, melphalan. A 4-fold higher concentration of melphalan was required to produce an equivalent reduction in tumor colony formation in 1847ME cells as compared to the parent melphalan sensitive line A1847. The magnitude of resistance in 1847ME was similar to that observed in the cell lines NIH:OVCAR-2, NIH:OVCAR-3, and NIH:OVCAR-4 which were derived from ovarian cancer patients clinically resistant to alkylating agents. There was no detectable difference in melphalan uptake between A1847 and 1847ME. The cellular content of the inactive dihydroxy melphalan metabolite, however, was two times greater in 1847ME compared to A1847. Levels of the principal intracellular thiol, glutathione, were found to be 2-fold greater in 1847ME than in A1847, and to be similarly elevated in the OVCAR lines. Depletion of glutathione by incubation of the cells in cystine-free medium or in the presence of the specific inhibitor of glutathione synthesis, DL-buthionine-S,R sulfoximine, was accompanied by a marked increase in melphalan cytotoxicity. Doses of DL-buthionine-S,R-sulfoximine which were only minimally cytotoxic were associated with complete reversal of the induced resistance to melphalan in 1847ME. Synergism between melphalan and DL-buthionine-S,R-sulfoximine was also demonstrated in the OVCAR cell lines derived from previously treated ovarian cancer patients. The reversal of induced resistance to melphalan by modulation of glutathione levels is of potential clinical relevance. In addition, these cell lines provide a useful model system in which to study further the mechanisms of alkylating agent resistance in human tumors. PMID- 6488195 TI - Potentiation of human cell-mediated and humoral immunity by low-dose cyclophosphamide. AB - Although cyclophosphamide (CY) is a potent immunosuppressive drug, under the proper conditions, it can potentiate immune responses as well. In past work, we have shown that administration of a commonly used oncostatic dose of CY (1000 mg/sq m) to patients with advanced cancer 3 days before sensitization with the primary antigen, keyhole limpet hemocyanin (KLH), resulted in augmentation of delayed-type hypersensitivity (DTH) but not antibody response to that antigen. The present study was performed to test the immunopotentiation of a lower dose of CY (300 mg/sq m); animal studies and studies of human lymphocytes in vitro suggested that the lower dose might be more effective. Eighteen patients with advanced metastatic cancer were alternately assigned to one of two groups. Sixteen days before CY, one group received KLH and the other group received 1 chloro-2,4-dinitrobenzene (DNCB). CY 300 mg/sq m was given as an i.v. bolus on Day 0. Three days after CY, the patients received KLH or DNCB, whichever they had not received initially. Blood was drawn for antibody titer, and skin testing was performed 14 days after administration of KLH or DNCB. In addition, skin tests to microbial recall antigens were made 2 days before and 17 days after CY. Pretreatment with low-dose CY resulted in significant augmentation of DTH to KLH; thus, the median DTH responses were: KLH alone, 10 mm; and KLH after CY, 27 mm (p less than 0.01). CY pretreatment also resulted in augmentation of the antibody response to KLH. The median total antibody titers (log2 of reciprocal of dilution) were as follows: KLH alone, less than 1; and KLH after CY, 3 (p less than 0.01). All nine CY-pretreated subjects but only 4 of 9 controls developed measurable anti-KLH antibody titers. CY pretreatment neither augmented nor suppressed the 48-hr challenge reaction to DNCB. Moreover, CY had no effect on DTH responses to the recall antigens, dermatophytin, Candida, and mumps. PMID- 6488196 TI - Human neuroblastomas and abnormalities of chromosomes 1 and 17. AB - Structural rearrangements of chromosome 1p have been reported previously as a frequent finding in human neuroblastomas. In a review of karyotypes from 35 neuroblastomas (including 29 published cases and 6 unpublished tumors and cell lines), it was found that, in addition to the abnormalities of chromosome 1p (found in approximately 70% of cases), abnormalities involving only 2 other chromosome segments occurred with significant frequency (in 20% or more of cases) in this cancer. These abnormalities involved trisomies for the long arms of chromosomes 1 and 17. In addition, two novel cytogenetic aberrations, homogeneously staining regions and double minutes, were identified in two-thirds of the cases. It is postulated that the gene change(s) produced by the abnormalities of chromosome 1p in neuroblastoma play a primary role in the development of this cancer. The gene changes produced by the abnormalities of chromosomes 1q and 17q and by the homogeneously staining regions and double minutes are presumed to contribute to tumor progression. PMID- 6488198 TI - Clonidine therapy for tardive dyskinesia and related syndromes. AB - Twenty-nine patients with tardive dyskinesia (n = 20) or related syndromes [spontaneous dyskinesia (n = 3), levodopa-induced dyskinesia (n = 3), tardive dystonia (n = 3)] were treated with clonidine. Clinical effects of this drug were observed for up to 4 years. Seventy-five percent of patients showed at least moderate improvement, and in 50% of patients, full resolution occurred. In most cases, patients received concomitant medications, including neuroleptics and benzodiazepines. Two patients received clonidine alone, and dyskinesia was only minimally improved; however, when bromocriptine was added, prompt improvement occurred on this combined regimen. On the basis of these findings, we suggest that not only receptor supersensitivity of dopaminergic neurons but also involvement of noradrenergic neurons is important in the pathophysiology of tardive dyskinesia and related syndromes. PMID- 6488197 TI - Proliferative and antigenic properties of rectal cells in patients with chronic ulcerative colitis. AB - Two markers related to preneoplasia were studied simultaneously in ulcerative colitis (UC). The renewal of the rectal epithelial cells together with expression of second-trimester fetal antigen (STFA) were evaluated in nine patients with UC and four healthy subjects. Endoscopic biopsies were incubated with tritiated thymidine. Cell renewal was studied with microautoradiography, and the antigenic properties of the cells were evaluated by indirect immunofluorescence. At the time of the study, all the UC patients were in a mildly active or in a quiescent stage of the disease; their biopsies did not show dysplastic or neoplastic changes in epithelial cells. STFA was expressed in five UC patients. The analysis of cell renewal in this group revealed a shift of the proliferative compartment towards the luminal surface of the colonic crypts. By contrast, the patient group with STFA-negative reactions showed a pattern of cell proliferation similar to that observed in the controls. These results suggest that the expression of STFA in colonic mucosa is associated with an expansion of the epithelial stem cell population or with arrested cell differentiation, and it may represent a phenotypic marker of proneness of the mucosa toward neoplastic development. PMID- 6488199 TI - Structural determination of the capsular polysaccharide of Streptococcus pneumoniae type 18C (56). AB - The specific capsular polysaccharide of Streptococcus pneumoniae type 18C (56) contains D-glucose, D-galactose, L-rhamnose, and glycerol residues, and phosphate and O-acetyl groups in the molar ratios of 3:1:1:1:1:1. Accumulated data from methylation analyses of the native and the specifically degraded, native polysaccharide indicated that it is composed of the repeating unit shown; it also contains O-acetyl groups, of undetermined location, in the molar ratio to L rhamnose of 1:1. (formula; see text). PMID- 6488200 TI - Application of molecular-mechanics calculations to D-glucal and its acetate; a comparison of X-ray and n.m.r. results. PMID- 6488201 TI - Analysis of the linkage positions in D-fructofuranosyl residues by the reductive cleavage method. AB - The suitability of the reductive-cleavage method for analysis of the linkage positions in D-fructofuranosyl residues of D-fructans was examined by using sucrose, chicory-root inulin, and Aerobacter levanicum levan as models. Permethylation, and reductive cleavage with triethylsilane in the presence of either boron trifluoride etherate or trimethylsilyl trifluoromethanesulfonate, gave the expected methylated derivatives of 2,5-anhydro-D-mannitol and 2,5 anhydro-D-glucitol. With either catalyst, nonreducing (terminal) D fructofuranosyl groups and D-fructofuranosyl residues linked at O-1 gave derivatives having the manno configuration as the major product, whereas D fructofuranosyl residues linked at O-6, and at both O-1 and O-6, gave derivatives having the gluco configuration as the major product. The independent synthesis, and n.m.r.- and mass-spectral characterization, of the methylated 2,5-anhydro-D mannitol and 2,5-anhydro-D-glucitol derivatives formed from these residues by reductive cleavage are reported. PMID- 6488202 TI - Synthesis and biological activity of some lipophilic derivatives of 1-thio muramoyl-L-alanyl-D-isoglutamine. AB - 2-N-Octadecanoyl derivatives of 1-S-acetyl-, 1-S-octadecanoyl-, and of 6-O octadecanoyl-1-S-octadecanoyl-1-thiomuramoyl-L-ala nyl-D-isoglutamine were synthesized from benzyl 3,4,6-tri-O-acetyl-2-deoxy-2-(octadecanoylamino)-beta-D glucopy ran oside. Their immunoadjuvant activities were examined in guinea-pigs. PMID- 6488203 TI - Preliminary investigation of the structure of the carbohydrate component of Vicia graminea lectin, a plant glycoprotein. AB - Purified Vicia graminea lectin, isolated from seeds, was found to contain D mannose, 2-acetamido-2-deoxy-D-glucose, L-fucose, D-galactose, and D-xylose in the molar ratios approximately 3.9:1.5:1.2:1.1:1.0. The oligosaccharides, obtained after hydrazinolysis of Vg-lectin, were N-reacetylated, reduced with sodium borohydride, and fractionated into two peaks. The first peak contained D galactose, D-mannose, 2-acetamido-2-deoxy-D-glucose, and 2-acetamido-2-deoxy-D glucitol in the molar ratios 6:3:2:0.7. After h.p.l.c. fractionation into five oligosaccharides, the second peak contained D-mannose, D-xylose, L-fucose, 2 acetamido-2-deoxy-D-glucose, and 2-acetamido-2-deoxy-D-glucitol. Methylation analysis suggested the following general structure for these oligosaccharides: (formula; see text). PMID- 6488204 TI - Synthesis of some oligosaccharides containing the O-alpha-L-fucopyranosyl-(1--- 2)-D-galactopyranosyl unit. AB - A practical approach for the synthesis of oligosaccharides containing the O-alpha L-fucopyranosyl-(1----2)-D-galactopyranosyl unit has been developed by utilizing the readily accessible 3,4,6-tri-O-acetyl-2-O-(2,3,4-tri-O-acetyl-alpha-L- fucopyranosyl)-alpha-D-galactopyranosyl bromide (1). Thus, condensation of bromide 1 with 8-(methoxycarbonyl)octanol in benzene, in the presence of mercuric cyanide, afforded, after column-chromatographic separation, the anomers (3 and 4) of 8-(methoxycarbonyl)octyl 3,4,6-tri-O-acetyl-2-O-(2,3,4-tri-O-acetyl-alpha-L fucopyranosyl)-D- galactopyranoside in the ratio of 13:4. On the basis of their specific rotations, compounds 3 and 4 were tentatively assigned the alpha and beta configuration, respectively. Similarly, bromide 1 was allowed to react with some other, appropriately protected sugars having a free alcohol group, to afford the corresponding alpha and beta anomers of a galactopyranosyl residue having an alpha-L-fucopyranosyl substituent at O-2. Column-chromatographic separation of the anomeric mixtures, followed by systematic removal of the protecting groups, then provided the final oligosaccharides desired. In this manner, the synthesis of the following oligosaccharides has been accomplished: alpha-L-Fuc-(1----2) alpha-D-Gal-1----O(CH2)8CO2Me (5), alpha-L-Fuc-(1----2)-beta-D-Gal-1--- O(CH2)8CO2Me (6), alpha-L-Fuc-(1----2)-alpha-D-Gal-(1----3)-beta-D-GlcNAc-1--- OC6H4NO2 -p (11), alpha-L-Fuc-(1----2)-beta-D-Gal-(1----3)-beta-D-GlcNAc-1--- OC6H4NO2+ ++-p (13), alpha-L-Fuc-(1----2)-alpha-D-Gal-(1----3)-alpha-D-GalNAc-1-- -OC6H4NO 2-o, and alpha-L-Fuc-(1----2)-beta-D-Gal-(1----3)-alpha-D-GalNAc-1--- OC6H4NO2 -o (18).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488205 TI - Aromatic and heterocyclic 1-C-substituted derivatives of 1,5-anhydro-D-glucitol. AB - Reaction of anomeric 1-O-acyl and 1-halide derivatives of 2,3,4,6-tetra-O-benzyl D-glucose with anisole, ferrocene, thiophene, furan, and 1,3,5-trimethoxybenzene in the presence of a Lewis acid gives the corresponding C-beta-D-glucopyranosyl derivatives. PMID- 6488206 TI - Synthesis of 2-acetamido-2-deoxy-4-O-beta-D-galactopyranosyl-3-O-methyl -D glucopyranose (N-acetyl-3-O-methyllactosamine) and its benzyl alpha-glycoside. AB - Benzyl 2-acetamido-2-deoxy-3-O-methyl-alpha-D-glucopyranoside (3) was obtained by deacetalation of its 4,6-O-benzylidene derivative (2). Compound 2 was prepared by methylation of benzyl 2-acetamido-4,6-O-benzylidene-2-deoxy-alpha-D glucopyranoside with methyl iodide-silver oxide in N,N-dimethylformamide. Diol 3 was selectively benzoylated and p-toluenesulfonylated, to give the 6-benzoic and 6-p-toluenesulfonic esters (4 and 5, respectively). Displacement of the sulfonyl group of 5 with sodium benzoxide in benzyl alcohol afforded the 6-O-benzyl derivative (6). Glycosylation of 4 with 2,3,4,6-tetra-O-acetyl-alpha-D galactopyranosyl bromide (7) in dichloromethane, in the presence of 1,1,3,3 tetramethylurea, furnished the disaccharide derivative 8. Similar glycosylation of compound 6 with bromide 7 gave the disaccharide derivative 10. O-Deacetylation of 8 and 10 afforded disaccharides 9 and 11. The structure of compound 9 was established by 13C-n.m.r. spectroscopy. Hydrogenolysis of the benzyl groups of 11 furnished the disaccharide 2-acetamido-2-deoxy-4-O-beta-D-galactopyranosyl-3-O methyl-D-glucopyr ano se (N-acetyl-3-O-methyllactosamine). PMID- 6488207 TI - Synthetic mucin fragments: benzyl 2-acetamido-3-O-[3-O-(2-acetamido-2-deoxy-beta D-glucopyranosyl) -beta-D-galactopyranosyl]-2-deoxy-alpha-D-galactopyranoside. PMID- 6488208 TI - A convenient preparation of 3-deoxy-1,2-O-isopropylidene-5-O-p-tolysulfonyl-beta L-threo- pentofuranose. PMID- 6488209 TI - Synthesis of 6-thiosucrose, and an improved route to 6-deoxysucrose. PMID- 6488210 TI - Synthesis and characterization of some anomeric pairs of per-O-acetylated aldohexopyranosyl cyanides (per-O-acetylated 2,6-anhydroheptononitriles). On the reaction of per-O-acetylaldohexopyranosyl bromides with mercuric cyanide in nitromethane. AB - The synthesis and characterization of the anomeric pairs of the per-O acetylaldohexopyranosyl cyanides of D-galactose, L-fucose, D-glucose, and D mannose, as well as of 3,4,6-tri-O-acetyl-2-deoxy-2-phthalimido-beta-D glucopyranosyl cyanide, are described. Cyanation of the readily available, per-O acetylaldohexopyranosyl bromides with mercuric cyanide in nitromethane, and subsequent purification, gave the corresponding, crystalline glycosyl cyanides with a high degree of 1,2-trans stereoselectivity. Thus, per-O-acetylated aldohexopyranosyl cyanides of the 1,2-trans configuration were obtained in yields ranging from 20 to 79%, whereas the corresponding 1,2-cis anomers were obtained in yields of less than or equal to 8.4%, the ratios of the 1,2-trans:1,2-cis anomers so prepared being greater than or equal to 8.5:1. The principal by products of these irreversible, cyanation reactions were the per-O-acetylated 1,2 O-[1-(exo- and endo-cyano)ethylidene]aldohexopyranoses, obtained in yields of up to 40%. The structural assignments of the per-O-acetylaldohexopyranosyl cyanides were unequivocally established by elemental analysis, chemical transformation, vibrational spectroscopy, and 13C- and 1H-nuclear magnetic resonance spectroscopy. Correlations between the physical properties and the anomeric configurations of these C-aldohexopyranosyl compounds are described. PMID- 6488211 TI - Synthesis and fast-atom-bombardment-mass spectrometry of N-acetylmuramoyl-L alanyl-D-isoglutamine (MDP). AB - N-Acetylmuramoyl-L-alanyl-D-isoglutamine (MDP) was synthesized by a series of condensations of appropriate reagents, followed by hydrogenolysis. Each intermediate step resulted in a stable, crystalline product. D-Isoglutamine 4 benzyl ester was condensed with N-(tert-butoxycarbonyl)-L-alanine N hydroxysuccinimide ester, to give N-(tert-butoxycarbonyl)-L-alanyl-D-isoglutamine benzyl ester. Condensation of L-alanyl-D-isoglutamine benzyl ester with N-acetyl 1-O-benzyl-4,6-O-benzylidenemuramic acid, followed by hydrogenolysis, gave MDP. The synthetic scheme was shown to be capable of producing gram quantities of highly pure MDP, as well as a few of its analogs. The synthetic MDP was characterized by analytical and biological methods, and it was found that the use of fast-atom-bombardment-mass spectrometry may greatly simplify the characterization process. PMID- 6488212 TI - Structural analysis of 3-deoxy-D-arabino-heptulosonate 7-phosphate by 1H- and natural-abundance 13C-n.m.r. spectroscopy. PMID- 6488214 TI - Occult blood testing in asymptomatic patients previously resected for colorectal cancer. AB - Hemoccult testing was carried out in 100 patients who had previously undergone surgical resection for colorectal cancer. Of the 15 Hemoccult-positive patients detected, endoscopic examination revealed polypoid formations in six (one with invasive carcinoma) and local recurrent tumors in three. Eighteen polypoid lesions were endoscopically detected in 10 Hemoccult-negative patients. Patient acceptance was good (above 90%) for Hemoccult testing especially when compared to the significantly lower compliance to endoscopic examination (66% in Hemoccult negative patients). The results suggest that a significant number of lesions may be missed if the Hemoccult test is heavily relied upon exclusively for follow-up of patients previously resected for colorectal cancer. PMID- 6488213 TI - The organization of community disease prevention services: approaches to preventing lung cancer in the Los Angeles Basin. AB - The UCLA Jonsson Comprehensive Cancer Center initiated a broadly based community program with the goal to reduce lung cancer incidence and mortality in the Los Angeles Basin (LAB). Representatives from the medical and science communities participated with representatives from the business, legal, and legislative sectors of LAB in a number of workshops over an 18-month period. The objectives of the workshops were to involve as many community interests as feasible to identify the issues related to the lung cancer problem and to mount a strategic and broadly based plan to achieve the stated goal. More than 70 individuals participated in this effort. The principal topics identified and developed related to "Smoking and Youth," "Smoking in High Risk Adults," "Smoking in the Workplace," and "Occupational Exposures." The results of this protracted interaction and planning effort are now in evidence in a variety of action programs and intervention research across this large geographic region. PMID- 6488215 TI - The effect of tubal ligation on the incidence of epithelial cancer of the ovary. AB - A retrospective review of 666 women who underwent tubal ligation between 1930 and 1969 in Alberta, Canada, was undertaken to assess the effect of tubal ligation on the incidence of ovarian cancer. Tubal ligation did not affect the risk of ulterior ovarian cancer except in women who underwent tubal ligation between the ages of 20 and 29. These women showed a slight but statistically significant (p = 0.03) increase in observed versus expected cases of ovarian cancer. PMID- 6488216 TI - Transfer RNA breakdown products in the urine of asbestos workers. AB - Patients with malignant mesothelioma, a neoplasia strongly associated with previous asbestos exposure, excrete in the urine high levels of modified purines, pyrimidines, and their ribosides, breakdown products of transfer RNA. The urinary excretion levels of modified nucleosides were measured in 47 male insulation workers with long term exposure to asbestos and, therefore, at high neoplastic risk. The nucleoside levels of 44 male control subjects were used for comparison. Asbestos-related radiographic changes were found in 70% of the exposed individuals. An increasing severity of radiographic alterations was associated with a greater frequency of elevated nucleoside clusters, especially in m'A, m'I, m'G, and m2(2)G. Duration since onset of exposure was directly related to pseudouridine, m'I, and m2(2)G. Though cigarette smoking contributes to the development of asbestos-related lung cancer, data are presented that support the hypothesis that asbestos exposure is the more important factor related to the elevated values of nucleosides. It was concluded, therefore, that measuring nucleoside levels in populations at high risk of developing certain kinds of cancer may provide a useful diagnostic tool for detecting "preclinical" biochemical changes that may be predictive of future neoplastic manifestations. PMID- 6488217 TI - Contribution of aspirative cytology to the diagnosis of thyroidal tumoral disorders. AB - Four initially misdiagnosed cases of thyroid cancer or purported thyroideal malignancy are described. In each, aspirative cytology was instrumental in establishing the true nature of the lesion. PMID- 6488218 TI - Parametrial needle biopsy: follow-up of pelvic malignancies. AB - A total of 95 patients had 150 parametrial biopsies with all patients receiving follow-up for a period of 2-10 yr. The analysis of these patients revealed that needle biopsy was successful in differentiating between recurrent, persistent, and/or radiation changes in 97% of the patients. The biopsy was helpful in planning definitive treatment and follow-up in 93% of the patients with minimal complications. This study suggests that parametrial needle biopsy is very useful for diagnosis of persistent and/or recurrent carcinoma of the pelvis and carries minimal complications. PMID- 6488219 TI - Photometric studies on nuclear DNA content and area in different laryngeal epithelia. AB - A photometric study of different laryngeal epithelia was performed. The nuclear DNA content and area for epithelia with keratosis, hyperplasia, and moderate dysplasia were comparable to normal. These lesions cannot therefore be considered to be premalignant photometrically. The photometric values for carcinoma in situ and severe dysplasia were comparable to that for invasive carcinoma. Long-term follow-up has to be performed to evaluate the biological significance of these different lesions. PMID- 6488220 TI - Immunoperoxidase in lymphomas induced by host-versus-graft (HVG) reaction. AB - It appears that the development and type of lymphoid neoplasm in mice depends on the ratio of T cell subsets and the repeated stimulation of the lymphoid systems as well as a genetic predisposition. Mice with HVG disease developed lymphomas in an average of 462 days versus 567 days for normal mice. Murine leukemia virus was detected in the HVG mice perinatally at 3 weeks of age and three months earlier in the noninjected mice. The immunoglobulins were IgA and IgM or IgM alone and IgG in three cases. No IgA was detected. PMID- 6488222 TI - Prevention and detection of cancer. 6th international symposium. Vienna, Austria. 26 to 29 November, 1984. Abstracts. PMID- 6488221 TI - Chemically induced rat odontomas: morphogenetic considerations. AB - Three complex odontomas were found in 30 castrated male rats injected with N methyl-nitrosourea (MNU) and fed a high-fat diet. Histological studies were performed and the related literature was reviewed. The morphogenesis of the tumors is discussed in the light of the bibliographic data and personal findings. PMID- 6488225 TI - Diastolic time during exercise in normal subjects and in patients with coronary artery disease. A plethysmographic study. AB - Percent diastole (%D) was evaluated at rest and during effort (submaximal upright exercise) in 13 normal subjects and in 14 age-matched patients with coronary artery disease (CAD). Systolic time intervals were also simultaneously recorded by using the thermistor pulse transducer. At rest, in both groups, a positive linear regression was found between %D and cycle length (RR) (%D = 19.1 + 0.044RR, r = 0.83 in normals; %D = 21.2 + 0.044RR, r = 0.88 in CAD). During effort, while in normals no correlation was found between %D and RR values, in CAD patients %D and RR were linearly related (%D = -12.81 + 0.087RR, r = 0.67). These results prove that diastolic time is differently affected by the exercise in the two examined groups and that in CAD patients an abnormal reduction of %D occurs during stress test. PMID- 6488223 TI - Intramyocardial coronary arterial changes in rheumatic mitral valve disease. Relation to left ventricular function. AB - A retrospective analysis of intramyocardial coronary arterial changes was done in excised papillary muscles obtained at surgery in 46 cases with rheumatic mitral valve disease (RMVD). The findings were correlated with left ventricular function. Vessel wall thickening with obliteration of the lumen was found in 15 patients (32.6%) while adventitial and perivascular fibrosis was found in 12 cases (26%). Patients with microarteriopathy had significantly higher left ventricular and diastolic pressure (p less than 0.05), lower ejection fraction (p less than 0.001), and lower cardiac index (p less than 0.01), as compared to patients with no microarteriopathy. The incidence of left ventricular dysfunction and surgical mortality was higher in patients with microarteriopathy (80 and 47%, respectively) than in those with normal microvasculature (26 and 13%, respectively). As a test for predicting left ventricular dysfunction and surgical mortality a positive biopsy was moderately sensitive (sensitivity 60 and 64%, respectively) and highly specific (specificity 88 and 77%, respectively). Successful outcome after mitral valve replacement was correctly predicted by a negative biopsy result in 87% cases. We conclude that in RMVD, microarteriopathy is associated with left ventricular dysfunction and poor postoperative prognosis. PMID- 6488224 TI - Individual variability of radionuclide ventriculography in stable coronary artery disease patients over one year. AB - To determine the individual reproducibility of radionuclide ventriculography over an extended period of time, 33 patients with stable coronary artery disease were studied at rest and during three stages of exercise on two occasions separated by 1 year. The individual interstudy variability of ejection fraction (EF), end diastolic volume (EDV), end-systolic volume, and cardiac output was determined by calculating the mean and standard deviation of the difference between the individual studies (initial - 1 year). Despite high correlations between an EF measured at study 1 and study 2 of 0.96 at rest and 0.87 during maximal exercise, the individual interstudy difference was 0.01 +/- 0.04 and -0.02 +/- 0.09, respectively. The correlation of percent change in EF from rest to maximal exercise was 0.49 and the individual interstudy differences was -1.2 +/- 19%. Correlations of the EDV were 0.81 at rest and 0.72 during maximal exercise while the individual difference was 0.7 +/- 38 and -0.8 +/- 49 ml, respectively. Considering two standard deviations as the confidence limits for a true change, an EF change of 8 EF units (0.08) at rest and 18 (0.18) during exercise, and EDV changes of approximately 100 ml are needed in an individual to state with confidence that the observed difference between the two studies are true changes and not the result of technologic variability. Because of the large individual interstudy variability in EF and volume measurement, caution must be taken in assuming that any change over a year is due to more than technique variability. PMID- 6488226 TI - Isolated right ventricular infarction: a diagnostic challenge. AB - Right ventricular involvement during myocardial infarction of the diaphragmatic and posterior wall of the left ventricle is not an infrequent complication, but isolated right ventricular infarction is rare. We report a case of rupture of the anterior wall of right ventricle and tamponade due to infarction at this site. The lack of characteristic clinical and electrocardiographic findings made the isolated right ventricular infarction a diagnostic challenge. PMID- 6488227 TI - Usefulness of stress testing for the evaluation of hypertensive heart disease in young hypertensive subjects. AB - To investigate the usefulness of stress testing for the evaluation of hypertensive heart disease, 40 subjects, 28 men and 12 women (mean age 30.8 +/- 6.2 years), with mild or moderate hypertension, without ST segment or T wave abnormalities in their resting ECG, were examined. 13 patients (32.5%) showed exercise-induced ST segment depression. The heart rate at rest was significantly higher in the patients with a positive response; 6 of the 7 subjects with electrocardiographic signs of left ventricular hypertrophy (summed SV1 + maximum R V5/V6 voltage of 45 mm or more) had a positive exercise electrocardiographic test. There were no significant differences between positive and negative cases in age, sex, systolic and diastolic blood pressure, or the double product (heart rate X systolic pressure) at rest or during exercise. After resting blood pressure values had been significantly decreased by giving methyldopa with or without diuretics for at least 6 months, there were a regression of left ventricular hypertrophy in the resting ECG and an impressive reduction in the prevalence of exercise-positive responses (to 17.5%). In the 7 patients with positive exercise electrocardiographic tests even after antihypertensive treatment, no significant reduction in blood pressure values during exercise was obtained. PMID- 6488228 TI - Incidence and prognostic significance of symptomatic and asymptomatic exercise induced ischemia in patients with recent myocardial infarction. AB - To determine the incidence and the significance of anginal chest pain during abnormal exercise testing (S-T greater than or equal to 0.1 mV) in patients with recent myocardial infarction we reviewed a series of 353 patients who underwent maximal bicycle exercise stress 4-8 weeks following acute myocardial infarction. Of the 353 patients, 26 had ischemic ECG changes and chest pain (group A); 85 patients had ischemic ECG changes but no chest pain (group B). The two groups differ significantly only in the frequency of a history of typical angina pectoris more than 6 months prior to acute myocardial infarction (group A 42.3% vs. group B 15.2%, p less than 0.01). Typical chest pain is more frequent in anterior versus inferior myocardial infarction (50 vs. 14.4%, p less than 0.001). The patients were followed up for 28.8 +/- 8.7 months with clinical and exercise testing controls. The incidence of exertional angina during the follow-up was significantly more frequent in group A patients than in group B patients (80.7 vs. 24.7%, p less than 0.001). Unstable angina pectoris was more frequent in group A (34.6 vs. 11.8%, p less than 0.01). There was no statistically significant difference in mortality (group A 3.8% vs. group B 5.9%) and cardiac events (group A 3.8% vs. group B 5.9%) between the two groups. Thus, we concluded that the occurrence of anginal pain associated with S-T segment depression during exercise testing does not increase the prognostic risk. PMID- 6488229 TI - Inter-institutional variation of systolic time intervals in normal subjects. PMID- 6488230 TI - Comparison of left atrial and left ventricular performance in conscious dogs. AB - The velocity of contraction has been reported to be more rapid in left atrium (LA) than left ventricle (LV), but the mechanics of contraction in these two chambers have not been compared under physiological conditions. Accordingly, sonomicrometer crystals and solid state pressure transducers were used to measure LV and LA systolic function simultaneously in seven conscious dogs. Two sets of crystals (LA-1, LA-2) were placed perpendicularly across the LA. Phenylephrine was infused at increasing doses from 0.4 to 1.2 microgram . kg-1 . min-1 to increase LV and LA afterloads. Constant heart rates were maintained by atrial pacing. The results indicated that LA motion was virtually identical in both diameters. LA fractional shortening (0.07 +/- 0.01) and ejection time (0.057 +/- 0.002 s) were much smaller than the ventricular values (0.21 +/- 0.01 and 0.18 +/ 0.01 s, respectively). The velocity of circumferential fibre shortening (Vcf) for the LV (1.16 +/- 0.05 cir . s-1) was not significantly different from LA-1 Vcf (1.19 +/- 0.09 cir . s-1) or LA-2 Vcf (1.22 +/- 0.08 cir . s-1). During phenylephrine infusions, LV systolic pressure increased from 120.0 +/- 3.4 to 190.8 +/- 15.5 mmHg and LV end-diastolic pressure increased from 3.6 +/- 0.3 to 27.7 +/- 2.7 mmHg. When Vcf for each chamber was plotted against the peak systolic pressure in that chamber, the curve of the LA was located upward and to the right of the LV curve.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488231 TI - Restoration of normal reflex responses to orthostatic stress during felodipine therapy in congestive heart failure. AB - The mechanisms underlying the abnormal responses to orthostatic stress in congestive heart failure are ill defined and little is known about the effects of specific therapy. In the present study intravascular pressures and plasma noradrenaline levels were measured in nine patients with heart failure subjected to 45 degrees and 90 degrees upright tilt. Studies were repeated during 4 weeks of vasodilator therapy with felodipine and again after felodipine withdrawal. Before the introduction of vasodilator therapy, tilt did not activate orthostatic reflexes despite significant reductions in left ventricular filling pressure and cardiac output. Thus, plasma noradrenaline, heart rate and systemic vascular resistance were unaffected and blood pressure fell. Felodipine resulted in a rapid and sustained improvement in left ventricular function but restoration of orthostatic reflexes was delayed and could be detected only after 48 h therapy. At this time, and during the subsequent 4 weeks, tilt-induced reductions in ventricular filling and cardiac output produced a normal rise in plasma noradrenaline and heart rate. A postural drop in blood pressure, however, was not averted because the direct action of felodipine on vascular smooth muscle prevented adrenergically-mediated increments in systemic vascular resistance. Felodipine withdrawal led to a prompt deterioration in left ventricular function. Orthostatic reflexes, however, were still intact 48 h later when tilt elicited a completely normal pattern of responses. These observations confirm that the abnormal responses to orthostatic stress in congestive heart failure are due principally to impairment of autonomic control mechanisms and are not related to the absence of venous pooling. Importantly the autonomic dysfunction is reversible with felodipine therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488232 TI - Common carotid haemodynamic and metabolic effects of acutely administered nifedipine in human subarachnoid haemorrhage. AB - Although the drugs known as "calcium antagonists" exert inhibitory actions on vascular smooth muscle, there are no quantitative data concerning the clinical use of these vasodilator agents in human subarachnoid haemorrhage. In the present clinical study, we have measured the effects of nifedipine (20 mg tablet) on common carotid artery diameter (D) blood flow velocity (V) common carotid blood flow (CCBF) as an index of cerebral blood flow, systolic (Qs) and diastolic (Qd) blood flow fractions using a pulsed Doppler apparatus and on carotid arterial pressure (CAP), heart rate (HR) and oxygen consumption (VO2). Eight patients with subarachnoid haemorrhage were studied during anaesthesia for cerebral angiography. Thirty minutes after sublingual nifedipine, diameter (P less than 0.05), blood flow velocity (P less than 0.001), CCBF (P less than 0.001), Qs (P less than 0.05), and Qd (P less than 0.05) increased with a decrease in Qs/Qd ratio (P less than 0.05). carotid vascular resistance (CVR) fell (P less than 0.02) and oxygen consumption of the brain increased (P less than 0.01). Systolic, diastolic, and mean carotid blood pressure, heart rate, and arteriovenous difference in oxygen were unchanged. The increase in CCBF was closely correlated with the vascular resistance in the control state (r = 0.928, P less than 0.001) and with oxygen consumption (r = 0.869, P less than 0.001). We conclude that in vivo, nifedipine exerts a preferential action on cerebral vessels, vasodilating large arteries and arterioles. This action is more powerful if the vessels are already vasoconstricted. Thus, the use of nifedipine could be fruitful in cerebral ischaemia that is secondary to subarachnoid haemorrhage. PMID- 6488233 TI - Accentuated negative inotropism of verapamil after ischaemic intervention in isolated working rat heart. AB - We examined the effects of a clinically relevant concentration (2 X 10(-7) mol . litre-1) of verapamil on the cardiac functions of isolated working rat hearts during global ischaemia (15 min) and reperfusion (30 min). The aorta and the left atrium of each heart of male Sprague-Dawley rats were cannulated for perfusion with Krebs-Henseleit solution, and a soft elastic catheter was introduced into the left ventricle through the left atrial cannula. Verapamil slightly increased the left ventricular end-diastolic pressure, and slightly decreased the left ventricular dP/dt, but did not reduce the left ventricular peak systolic pressure before ischaemia. During the early phase of ischaemia and reperfusion, verapamil (n = 6) lowered the left ventricular peak systolic pressure and the left ventricular dP/dt in comparison with the controls (n = 6) (left ventricular peak systolic pressure 45.4 +/- 16.9 versus 60.9 +/- 15.2 mmHg: p less than 0.05; left ventricular dP/dt 1256 +/- 484 versus 2108 +/- 829 mmHg . s-1: p less than 0.05, after 30 min of reperfusion). Fifteen min of ischaemia resulted in no increase in the creatine kinase release during reperfusion. The creatine kinase release was not different in the two groups during the experiment. Thus, the negative inotropic effect of verapamil was accentuated by the ischaemic intervention. Myocardial protection may be achieved by reducing the left ventricular peak systolic pressure and thereby the oxygen consumption. On the other hand, in clinical application to patients with extensive myocardial ischaemia, verapamil may cause untoward deterioration in cardiac functions. PMID- 6488234 TI - Inducible ventricular arrhythmias in a naturally occurring model of cardiomyopathy. AB - This study examined inducibility of ventricular tachyarrhythmias in turkeys with and without naturally occurring dilated cardiomyopathy. Using a transvenously positioned electrode catheter, 32 cardiomyopathy and 12 control unsedated turkeys aged 2 to 4 months were studied by right ventricular endocardial extrastimulus testing at basic pacing cycle lengths of 200 and 170 ms with both 1 and 2 extrastimuli and burst pacing at progressively shorter cycle lengths (200 to 100 ms). Following study, a dilatation index (determined as the ratio of left ventricular endocardial and epicardial diameter at level of the apex-base midpoint) was utilized to assess the functional severity of cardiomyopathy. All control turkeys had a dilatation index less than 0.3. In cardiomyopathic turkeys, dilatation index was normal (less than 0.3) in 3/32, showed mild to moderate dilatation in 25/32 (0.3 to 0.6), and severe dilatation in 4/32 (greater than 0.6). Results showed no difference in right ventricular effective or functional refractory periods between control and cardiomyopathic turkeys. Control turkeys had no inducible ventricular tachyarrhythmias, but 16/32 cardiomyopathic turkeys (p less than 0.005) had inducible ventricular tachyarrhythmias, consisting most frequently of two beats of rapid ventricular tachycardia supervened by ventricular fibrillation. In the cardiomyopathic turkeys, inducible tachyarrhythmias occurred in 1/3 with normal dilatation index, in 11/25 with mild to moderate dilatation, and in 4/4 with severe dilatation. Thus, inducibility of ventricular tachyarrhythmias in cardiomyopathic turkeys is closely associated with increasing ventricular dilatation, but does not correlate with altered right ventricular refractoriness. This model may be suitable for studying the relationship between ventricular tachyarrhythmias and cardiomyopathy. PMID- 6488235 TI - Lipid peroxidation in red blood cell membranes. PMID- 6488236 TI - Synaptic membrane fractions from muscles: biochemical and morphological characteristics. PMID- 6488237 TI - Extracellular organization of an insect mucus elaborated by Malpighian tubules. PMID- 6488239 TI - Induction of differentiation in mouse embryonal carcinoma cell lines by coculture with rat glioma cells. PMID- 6488238 TI - Distributive pattern on butyrylcholinesterase in the fore- and mid-brain of the mouse. PMID- 6488240 TI - Effect of substrates on the oxygen uptake of bovine semen preserved in egg yolk citrate. PMID- 6488241 TI - Acetylcholinesterase and nerve axon formation during muscle regeneration in rats. PMID- 6488242 TI - The electric organ of Discopyge tschudii: its innervated face and the biology of acetylcholinesterase. AB - An ultrastructural, histochemical, and biochemical study of the electric organ of the South American Torpedinid ray, Discopyge tschudii, was carried out. Fine structural cytochemical localization of acetylcholinesterase (AChE) indicated that most of the esterase was associated with the basal lamina. Electron microscopy indicated no marked differences in the electrocyte ultrastructure between Discopyge and Torpedo californica. Discopyge electric organ possessed three molecular forms, two asymmetric forms (16 S and 13 S) and one globular hydrophobic form (6.5 S). The asymmetric 16 S AChE form was solubilized by heparin, a sulfated glycosaminoglycan, suggesting that heparin-like macromolecules are involved in the binding of the enzyme to the basal lamina. Our results show that cell-free translated AChE peptides, synthesized using Discopyge electric organ poly(A+) RNA, correspond to a main band of 62,000 daltons which probably represents the catalytic subunit of the asymmetric AChE. PMID- 6488243 TI - Alterations in high-affinity binding characteristics and levels of opioids in invertebrate ganglia during aging: evidence for an opioid compensatory mechanism. AB - In Mytilus and Leucophaea the high-affinity binding site density is significantly lower in old animals than in young animals, whereas the low-affinity site density remains unchanged. In Mytilus the estimated met-enkephalin and met-enkephalin Arg6-Phe7 levels are significantly higher in old than in young animals. In Leucophaea only the met-enkephalin level can be determined, and it is also higher in old animals. The decrease in the high-affinity binding site density and the corresponding increase in endogenous enkephalin levels suggest the existence of an opioid compensatory mechanism associated with the aging process. In Mytilus there is a demonstrated decrease with age in intraganglionic dopamine levels in response to applied opiates. In addition, the inhibition of dopamine-stimulated adenylate cyclase activity by opiates also decreases in older animals. In Leucophaea the sex difference in opioid binding densities diminishes with age. PMID- 6488245 TI - [New therapeutic approaches in endocrinology]. PMID- 6488246 TI - [The diabetic regimen in the light of new findings in the therapy of diabetes]. PMID- 6488244 TI - Modulatory effects of different temperatures and Ca2+ concentrations on gangliosides and phospholipids in monolayers at air/water interfaces and their possible functional role. AB - Gangliosides are neuraminic acid-containing glycolipids preferently localized in nervous membranes and showing physicochemical peculiarities, e.g., drastically changing amphiphilic properties by Ca2+ binding. On account of this they are favorite compounds to act as modulators of membraneous organization and functions during synaptic transmission. Lipid monolayers are suitable experimental systems for the study of the surface behavior of amphipatic molecules and therefore are useful to interpret membraneous organization. The surface pressure/area isotherms of monolayers of different individual gangliosides (GM1, GD1a, GD1b, GT1b) of an artificial reconstituted and a natural ganglioside mixture from bovine brain and of ganglioside mixtures from different brain parts of summer- and winter-adapted dsungarian hamsters were compared at three temperatures (11, 20, and 37 degrees C) with egg phosphatidylcholine (PC) and phosphatidylserine (PS) monolayers. The monolayers were formed in a Teflon trough on a triethanolamine/HCl-buffered (pH 7.4) subphase, in some cases containing different amounts of CaCl2. The surface pressure/area isotherms of ganglioside monolayers, in contrast to phospholipids, generally showed slowly rising slopes, with transitions from the liquid-expanded to the liquid-condensed state at a surface pressure of 20-30 mN/m. Ganglioside monolayers, in particular from GD1a or GT1b versus GD1b or from mixtures from summer- versus winter-adapted hamster brain, were differently affected by temperature and/or by Ca2+. PS monolayers were slightly condensed only by Ca2+. PC monolayers, however, were influenced neither by temperature nor by Ca2+. In mixed monolayers of the unpolar natural lipid cholesterol (Ch) and the disialoganglioside GD1a, intermolecular interactions were indicated. Ganglioside monolayers, in contrast to phospholipids, were shown to be easily modulated by temperature and/or Ca2+ ions, thus enabling gangliosides to act as possible membrane modulators, e.g., during synaptic transmission. In particular, the differences concerning the influences of temperature and/or Ca2+ on the surface behavior of ganglioside mixtures from the brain of summer- compared with winter adapted hamsters are correlated with other physiologically relevant data. PMID- 6488247 TI - [Determination of bone mineral levels: long-term reproducibility and results in pathological conditions]. PMID- 6488248 TI - [Diagnostic use of the determination of the spectrum of 17-oxosteroids during dynamic testing of adrenal and gonadal functions]. PMID- 6488249 TI - [Enlargement of the prostate after reserpine in an experimental animal]. PMID- 6488250 TI - [Present knowledge about the content and importance of hormones in milk]. PMID- 6488251 TI - [Histological changes in hypophyseal lactotrophs in rats after administration of metoclopramide]. PMID- 6488252 TI - [Levels of hormonal substances in the serum (plasma) and urine of old people. II. Tests with LHRH, TRH, ACTH, metyrapone, TSH and HCG]. PMID- 6488254 TI - [The Marxist-Leninist concept of the relation between life and death]. PMID- 6488253 TI - [Thyroid hormones and lipid peroxidation]. PMID- 6488255 TI - [Truth at the hospital bed]. PMID- 6488256 TI - [Psychosomatic aspects of malignant tumors]. PMID- 6488257 TI - [Observations on the psychosocial aspects of cancer patients]. PMID- 6488258 TI - [Negative reaction of monoclonal antibody W 6/32 with the lymphocytes of 6 individuals]. PMID- 6488259 TI - [The significance of author abstracts in medical journals]. PMID- 6488261 TI - [Apartheid and health]. PMID- 6488260 TI - [Use of mitoxantrone in the treatment of tumors]. PMID- 6488262 TI - [Sudden cardiac death]. PMID- 6488263 TI - [Prevention and rehabilitation in modern cardiology]. PMID- 6488264 TI - [Medicine--prevention--exercise]. PMID- 6488265 TI - [Isopotential ECG mapping at rest and after loading in a control group, in leading runners and in patients with ischemic heart disease]. PMID- 6488266 TI - [Determination of the anaerobic threshold with regard to the individual functional state using changes within the parameters of the acid-base equilibrium]. PMID- 6488267 TI - [High doses of cytosine arabinoside--a new use for an old drug]. PMID- 6488268 TI - [Clinical forms of aluminum poisoning]. PMID- 6488269 TI - [Primary prevention of hypertension]. PMID- 6488270 TI - [The effect of primary prevention on the 10-year incidence of ischemic heart disease in the male population of an industrial area]. PMID- 6488271 TI - [Prevention of atherosclerosis begins in childhood]. PMID- 6488272 TI - [Results of pharmcoethnographic research in the Champa national group of Southern Vietnam]. PMID- 6488274 TI - Alkalinization stimulates Ca2+-dependent spreading during the activation of resting lens epithelial cells in primary culture. AB - Lens epithelium, when attached to its natural substratum, the lens capsule, can be maintained in culture for more than 2 weeks in a simple HEPES- and EDTA buffered salt solution (HBS). In HBS, the epithelium shows the same characteristic phenomena of locomotion, initial retraction and respreading which in MEM plus serum precedes the inception of DNA synthesis. These phenomena have been shown to be dependent on extracellular Ca2+. 0.05 mM Ca2+ is necessary for maintaining cell-to-cell contacts of the in vivo epithelium. Higher concentrations of Ca2+ cause the epithelium to retract initially. In contrast, Mg2+ greatly favours cell-substratum interactions leading to the formation of lamellopodia and an initial spreading of the epithelium. After some hours in culture the epithelium changes markedly in response to extracellular Ca2+ and Mg2+; it respreads and flattens in the presence of Ca2+, while Mg2+ becomes less effective in maintaining cell-to-substratum contacts. Mg2+-dependent initial spreading is promoted at pH values near 7.0 but the Ca2+-dependent respreading requires an alkalinization of the salt solution. PMID- 6488273 TI - Different epidermal cell kinetic effects of hydroxyurea when injected at two different times of the day. AB - Circadian rhythms in epidermal basal cell-cycle progression in hairless mouse skin have been repeatedly demonstrated. A dose of 10 mg/animal hydroxyurea (HU), given to inhibit DNA synthesis was injected intraperitoneally to two groups of hairless mice. One group was injected at 10.00 hours MET, when the cell-cycle progression and cell division rate are relatively high, and another group was injected at 20.00 hours, when the same variables are at minimum values. Various cell kinetic methods--[3H]TdR autoradiography, DNA flow cytometry and the stathmokinetic method (Colcemid)--were used to study HU-induced alterations in cell kinetics. Hydroxyurea (HU) immediately reduced the labelling index (LI) to less than 10% of controls when injected at both times of the day, and higher then normal values were observed 8 hr later. A subsequent decrease towards normal values was steeper in the 20.00 hours injected group. The proportion of cells with S-phase DNA content was transiently reduced in both series, but the reduction was less pronounced and control values were reached earlier in the series injected at 10.00 hours. The observed alterations in LI and fraction of cells in S phase were followed by comparable alterations in the fraction of cells in G2 and in the mitotic rate. Hence the changes in G2 and mitotic rate are easily explained as consequences of the previous perturbations in the S phase. The time-dependent differences in the cell kinetic perturbations caused by HU in the S phase may be explained by a circadian-phase-dependent action of HU on the influx and efflux of cells to and from the S phase, respectively. At 10.00 hours the efflux of cells from S is most heavily inhibited; at 20.00 hours the influx is predominantly blocked. Hence, when physiological flux is high HU mainly blocks the efflux from S, but when flux normally is low, HU mainly blocks the entrance to S. Within 20 hours after the HU injection, the cell kinetic variables had approached the unperturbed circadian pattern. PMID- 6488275 TI - Endogenous regulation of endothelial cell proliferation. AB - Bovine aortic endothelial cells (BAEC) in culture have the ability to regulate their own proliferation. We have found that a fraction below 100,000 daltons obtained from the media of confluent cultures of BAEC inhibits tritiated thymidine [3H]TdR incorporation as well as their proliferation. The inhibition is dose- and time-dependent; maximum inhibition of [3H]TdR incorporation occurs 8 hr after cells are released from synchronization and the inhibitory fraction is added. Inhibition is evident at concentrations as low as 50 micrograms/ml and reaches a maximum at 600 micrograms/ml. The blockage of [3H]TdR incorporation is reflected in the inhibition of cell proliferation. In the presence of 400 micrograms of endogenous inhibitor per ml of media, added at the time of plating, the average population doubling time increases from 19 to 41 hr. These findings indicate that, in culture, BAEC can regulate their own proliferation by synthesizing an endogenous inhibitor(s) of proliferation. PMID- 6488276 TI - Comparative investigations on the effect of different dose schedules of the phase specific drug vincristine (VCR) on the proliferation kinetics of a solid experimental tumour. AB - The aim of the present investigation was to study the effect of a high bolus injection (1 X 2.1 mg) of vincristine (VCR) during the phase of tumour growth retardation at the 14th day after transplantation and to compare the findings with the results of single (1 X 0.35 mg) and repeated (6 X 0.35 mg) applications of this cytostatic drug. Furthermore, an attempt was made to induce a synchronization of tumour cell proliferation. It was found that the effect on the volume growth was very pronounced after the high bolus injection and the repeated application of vincristine compared with the single low dose of the cytostatic drug. A synchronization of the tumour cell proliferation by flow out of the mitotic block could not be demonstrated. On the other hand a modest simultaneous recruitment of previously non-cycling tumour cells into the cell cycle occurred in the periphery of the tumour after the high bolus injection. The repeated application and the high bolus injection of VCR increased the cytostatic effect, especially in the tumour centre, related to the more slowly proliferating tumour cell compartment. PMID- 6488278 TI - On the equivalence of mathematical models for cell proliferation kinetics. AB - Various types of mathematical models, such as partial differential equations, ordinary differential equations and difference equations, are available in the literature to describe the kinetics of cell proliferation, and different studies of cell kinetic phenomena have been conducted using these models. This paper discusses the equivalence between the different models identifying the conditions and approximations under which one type of models may be derived from another. Such an equivalence study is highly useful for an integration of the diverse results that have been obtained using different models in order to gain a more complete understanding of cell kinetic phenomena. PMID- 6488277 TI - Different sensitivities of granulocyte-macrophage and erythroid progenitor cells of normal human bone marrow to S-phase-specific agents. AB - The extraordinary sensitivity of early erythroid progenitor cells (BFU-e) of normal human bone marrow to tritiated thymidine ([3H]TdR) was studied. While exposure of bone-marrow cells to [3H]TdR for 1 hr resulted in the death of only 40% of the granulocyte-macrophage progenitor cells (CFU-c), 90% of BFU-e were killed. Experiments in which normal bone-marrow cells were mixed with bone-marrow cells which had been exposed to [3H]TdR demonstrated that the excessive killing of BFU-e by [3H]TdR reflected carry-over of the [3H]TdR by the exposed cells. A carry-over effect was not observed for CFU-c, suggesting the presence of a fundamental difference in the metabolism of TdR between CFU-c and BFU-e. There was a suggestion of a carry-over effect regarding two other S-phase-specific agents, hydroxyurea and 1-beta-D-arabinofuranosylcytosine. PMID- 6488279 TI - Cell-cycle-dependent and -independent damage to rat haemopoiesis by hydroxyurea. AB - The generally accepted cell-killing effect of hydroxyurea (HU) on S-phase cells, as well as its potential to arrest cells at the G1/S boundary, hardly explain its benefit for application in human chronic myelogenous leukaemia. Studies were therefore performed in rat haemopoiesis in order to quantify the cell-killing effect on various phases of the cell cycle. For this purpose, the [3H]thymidine [( 3H]TdR) labelling index and the specific activity of [3H]TdR in the DNA synthesizing fraction of cells were determined after a non-cytoreductive dose of 25 mg/kg HU, as well as a medium cytoreductive dose of 100 mg/kg. Furthermore, flow cytometric DNA histograms and absolute as well as differential cell counts of femoral bone marrow were performed after 100 mg/kg HU. The results indicate a predominant cell kill in G1 encompassing almost all 2c cells in the proliferative pool, while the S-phase fraction is not even reduced to half its initial value. The specific activity of [3H]TdR in cells synthesizing DNA, as well as the labelling index after HU show an initial dip and a tendency to recovery, as has been observed in many other cell systems. Instead of a complete restoration, however, there is a second depression of these parameters lasting for at least one cell cycle. The results are interpreted as a partly cell-cycle-dependent and partly independent action of HU in this cell system. The independent component may be attributed to the repeatedly described direct interference of HU with DNA. In rat haemopoiesis, therefore, this direct effect of HU on the DNA strands appears to be much more pronounced than in cell-culture systems and other mammalian tissues. In view of these findings, some caution should be taken in using HU for the determination of the S-phase fraction by way of a suicide experiment. PMID- 6488280 TI - Cell kinetic behaviour of a synchronized population of erythroid precursor cells in vitro. AB - Erythropoiesis in vitro was studied with practically pure erythroid progenitor cells: CFU-E (colony-forming-units-erythroid). The isolation of CFU-e from spleens of thiamphenicol pretreated anaemic mice with the combined methods of centrifugal elutriation and Percoll density gradient centrifugation was monitored by flow cytometry. The ultimate CFU-e preparation with a density of 1.070 g/ml contained a high percentage of cells in the S phase of the cell cycle (80%). CFU e occasionally found at a lower density of 1.065 g/ml were predominantly in the G2 + M and G1 phases. When CFU-e were cultured, the number of cells in the distinctive phases of the cell cycle changed periodically, so the cells were partly synchronized. Four periods up to 27 hr were observed by flow cytometrical screening of the cultured cells at hourly intervals. Cell-cycle times between 6 and 7 hr were found for all erythroid cell divisions. This was in agreement with results obtained from colony growth curves. Without the addition of erythropoietin cells start to degenerate after the second cell division. This experimental approach can be used for the cell kinetic modelling of erythropoiesis. PMID- 6488281 TI - Effects of [3H]UdR on the cell-cycle progression of L1210 cells. AB - Tritium-labelled uridine [( 3H]UdR) perturbs progression of L1210 cells through the mitotic cycle. The main effect manifests as a slowdown or arrest of a portion of cells in G2 and is already observed 2 hr after addition of 0.5-5.0 microCi/ml of [3H]UdR into cultures. At 2.5-5.0 microCi/ml of [3H]UdR a slowdown of cell progression through S is also apparent. Additionally, there is an increase in the number of cells with DNA values higher than 4C in cultures growing in the presence of [3H]UdR for 8-24 hr. A pulse of [3H]UdR of 2 hr duration labels predominantly (95%) cellular RNA. The first cell-cycle effects (G2 slowdown) are observed when the amount of the incorporated [3H]UdR is such that, on average there are fewer than thirty-six [3H] decays per cell which corresponds to approximately 12-19 rads of radiation. The S-phase slowdown is seen at a dose of incorporated [3H]UdR twice as high as that inducing G2 effects. The specific localization of [3H]UdR in nucleoli, peripheral nucleoplasm and in cytoplasm, as well as differences in the kinetics of the incorporation in relation to phases of the cell cycle are discussed in the light of the differences between the effects of [3H]UdR and [3H]thymidine. Mathematical modelling of the cell-cycle effects of [3H]UdR is provided. PMID- 6488282 TI - Aspects of statistics in studies of cell proliferation. II. Standard errors of estimated parameters. AB - Statistical methods such as regression analysis are often used to estimate cell kinetic parameters, such as cell birth rate or tumour growth rate. The standard errors which the statistical procedures provide may be considerable underestimates of the true uncertainty surrounding the parameter of interest. PMID- 6488283 TI - Organization and morphogenesis of the human seminiferous epithelium. AB - The various types of human primary spermatocytes were classified by means of morphological and morphometrical studies. Based on this classification, the topographic arrangement of the spermatocyte populations in the longitudinal course of seminiferous tubules was determined. This analysis revealed human spermatogenesis be to subjected to a complex local plan of organization, which is based upon the geometry of spirals. The centers of gravity of spermatocyte populations of subsequent degrees of differentiation are arranged on helices that are contracted conically to the lumen of the seminiferous tubule. On these helices the centers of gravity of the populations diverge continuously 173.8 degrees +/- 32.4 degrees. Populations of the same degrees of development are arranged on helices with constant diameters. On these helices the centers of gravity of the populations diverge continuously 142.6 degrees +/- 14.2 degrees. The present results lead to new aspects of the kinetics and morphogenesis of the seminiferous epithelium, which can be integrated into a comprehensive biological concept. PMID- 6488284 TI - Cell surface changes during mitosis and cytokinesis of epithelial cells. AB - PtK2 cells were studied with scanning electron microscopy to record changes on the cell surface during mitosis and cytokinesis. During prophase, prometaphase and metaphase, the cells remain very flat with few microvilli on their surfaces. In anaphase cells, there is a marked increase in the number of microvilli, most of which are clumped over the separating chromosomes and polar regions of the mitotic spindle leaving the surface of the interzonal spindle region relatively smooth. Microvilli appear over the interzonal spindle region in telophase and the cells also increase in height. At the beginning of cleavage, the distribution of microvilli is roughly uniform over the surface but it becomes asymmetric at the completion of cleavage when the daughter cells begin to spread. At this time most microvilli are over the daughter nuclei and the surfaces that border the former cleavage furrow. The regions of the daughter cells distal to the furrow are the first to spread and their surfaces have very few microvilli. When chromosome movement is inhibited by either Nocodazole or Taxol, microvilli formation is inhibited on the arrested cells. Nevertheless cell rounding still takes place in the normal time period. It is concluded from these observations that the signal for the onset of chromosome movement in anaphase is accompanied by a signal for the formation of microvilli. It is suggested that there is also a separate signal for the cell-rounding event in mitosis and that microvilli do not play a role in this contractile process. PMID- 6488285 TI - Ultrastructure and adrenergic innervation of preglomerular arterioles in the euryhaline teleost, Salmo gairdneri. AB - The opisthonephric kidney of the rainbow trout was investigated by light- and electron microscopy and a fluorescent-histochemical technique for biogenic amines was used. Preglomerular sphincters at the origin of afferent arterioles are present in this euryhaline teleost. The branching point of the afferent arteriole is characterized by (i) the formation of a right angle with the parent vessel, (ii) circularly arranged smooth muscle cells of the tunica media, (iii) additional circularly arranged smooth muscle cells intercalated between endothelium and tunica media, and (iv) a collar-like arrangement of several large endothelial cells with elaborate marginal folds and abundant myoendothelial junctions. A dense adrenergic innervation displaying specific fluorescence was found along the terminal arterioles and afferent arterioles, and conspicuously at the preglomerular sphincters. These results are suggestive of a neural participation in kidney function. They are discussed on the basis of recent evidence from pharmacological and physiological experiments for neural involvement in glomerular intermittency. PMID- 6488286 TI - The influence of differing connective tissue substrates on the maintenance of adult stratified squamous epithelia. AB - The interaction between adult stratified squamous epithelium and its supporting connective tissue possibly involves both permissive and directive influences. To examine the effect of vitality and specificity of connective tissue on the maintenance of epithelial structure and histodifferentiation, specimens of skin and oral mucosa from various regions of adult mice were separated using either EDTA or trypsin. Prior to transplantation, the epithelium was recombined with either inverted homologous connective tissue or with connective tissue that had been killed either by heating or repeated freeze-thawing. Epithelial sheets were also transplanted onto the graft bed alone or in combination with striated muscle or tendon. Normal patterns of cytodifferentiation were maintained when the epithelium was recombined with inverted or frozen-thawed subepithelial connective tissue but there was a loss of spatial organization on the frozen-thawed connective tissue. In contrast, heat-killed or trypsin-treated frozen-thawed subepithelial connective tissue and non-dermal connective tissue failed to maintain a viable epithelium. These observations suggest that subepithelial connective tissues (dermis, lamina propria) but not deep connective tissues facilitate epithelial proliferation and histodifferentiation. PMID- 6488287 TI - Ultrastructure of the epididymis of the tammar, Macropus eugenii, and its relationship to sperm maturation. AB - The ductus epididymidis of the tammar is lined by an epithelium composed of principal, mitochondria-rich, apical and basal cells, and intraepithelial leucocytes. The epithelium is structurally differentiated into 6 zones referred to as the initial segment, middle segment (3 subdivisions) and terminal segment (2 subdivisions). The occurrence of the initial, middle and terminal segments corresponds quite closely to the anatomical differentiation of the epididymis into a head, body and tail. The initial segment epithelium in the tammar is lower and has shorter and more slender stereocilia than in other mammals which have been described. Otherwise, the structure of the epithelium has similar characteristics in the tammar to that described in other mammals. Spermatozoa begin to develop the capacity for motility within the initial segment, but only show structural signs of maturation in the middle segment. The sperm head rotates through 90 degrees in the proximal subdivision of the middle segment. The cytoplasmic droplet is detached and spermatozoa develop the capacity for motility in the middle subdivision of the middle segment. The cytoplasmic droplets are phagocytosed by the epididymal epithelium of the middle segment. Sperm storage appears to be the main function of the terminal segment. PMID- 6488288 TI - Mapping of neurons in the central nervous system of the guinea pig by use of antisera specific to the molluscan neuropeptide FMRFamide. AB - Immunoreactive neurons were mapped in the central nervous system of colchicine treated and untreated guinea pigs with the use of two antisera to the molluscan neuropeptide FMRFamide. These antisera were especially selected for their incapability to react with peptides of the pancreatic polypeptide family. Only one group of perikarya was stained by both antisera; this group was mainly located in the nucleus dorsomedialis hypothalami and extended to the nucleus paraventricularis and nucleus periventricularis hypothalami. The perikarya were found to project fibers to all regions of the hypothalamus, to the septum, nucleus proprius striae terminalis, nucleus paraventricularis thalami, nucleus centralis thalami, nucleus reuniens, medial, central and basal amygdala, area praetectalis, area tegmentalis ventralis of Tsai, substantia grisea centralis mesencephali, formatio reticularis mesencephali, nucleus centralis superior, locus coeruleus, nuclei parabrachiales, nucleus raphe magnus, A 5-region, vagus solitarius complex, ventral medulla, nucleus spinalis nervi trigemini, and substantia gelatinosa of the spinal cord. In many brain regions FMRFamide immunoreactive processes were found in close contact with blood vessels. PMID- 6488289 TI - Vascularization and glomerular ultrastructure in the pig mesonephros. AB - Vascularization of the pig mesonephros was investigated in embryos 5-8 cm in length. Vascular injections with microfil were cleared and dissected; corrosion casts were studied under the scanning electron microscope (SEM). Perfusion-fixed tissue was used for SEM and transmission electron microscope (TEM) studies, including freeze-fracture specimens. The branches of one mesonephric artery carry up to 15 glomeruli. Several glomeruli occupy the same arterial branch, with very short afferent arterioles proper. The efferent vessels, frequently 2-5, leave the extensive vascular pole opposite the entering arteriole and split into peritubular capillaries radiating towards the superficial veins. These capillaries form vascular regions in the shape of flattened pyramids. Along its course, one nephron is supplied by vessels derived from 4-7 glomeruli. The nephrons have less vascular contact than in the definitive kidney. The ultrastructure of the single mesonephric vessels matches the metanephric counterparts. Epithelioid cells with renin granules are common in afferent arterioles, larger arteries, and efferent vessels. The lobulated glomeruli are up to 750 micron long and flattened, showing the usual features of podocytes, mesangial cells, and an attenuated endothelium with fenestrations between 50 and 250 nm. It partially retains its own basement membrane. There is no proximal mesangium. PMID- 6488290 TI - Homing of germinal-center cells into germinal centers of lymph node via afferent lymphatics. An autoradiographic study in rabbits. AB - Affinity of lymphoid cells for the microenvironment of germinal centers (GC), as detectable in transfer experiments by rapid homing in spleen GC from the blood, is a capacity expressed by only a subset of lymphoid cells, in particular by those constituting a GC. However, when introduced into the blood stream, these cells do not home into GC of lymph nodes and gut-associated lymphoid tissues. To investigate further this homing inability for high endothelial venule (HEV) containing lymphoid tissues, GC cells isolated from donor rabbit appendix were labeled in vitro with 3H-leucine and injected into an afferent lymph vessel of recipient popliteal lymph nodes. Draining lymph nodes were removed 15 min to 24 h after cell administration and prepared for radioautography. For reference, the migration of cells isolated from Peyer's patches and thoracic duct lymph was also studied. By use of appendix GC cells, large numbers of labeled cells were found to migrate into GCs of the outer cortex centripetally, i.e., from the subcapsular sinus through the lymphocyte corona into the GC proper. The same was observed for cells from Peyer's patches, although in smaller numbers. Thoracic duct lymphocytes were only localized in the lymphocyte corona and the deep cortex. Thus, appendix GC cells and a subpopulation of cells from Peyer's patches can reach lymph node GC, but only when administered intralymphatically.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488291 TI - Localization of zinc in the thymic reticulum of mice by electron-probe microanalysis. AB - Thymulin, a thymic hormone, is a nonapeptide requiring zinc for biological activity. It has been shown that epithelial cells, forming part of the thymic reticulum, secrete this hormone and/or store it within cytoplasmic vacuoles. X ray electron-probe microanalysis (EPMA) has been used to detect zinc in the thymus. Low concentrations of zinc have been demonstrated in the dense granules contained in clear vacuoles of some epithelial cells in normal and ZnCl2-injected mouse thymuses, thus suggesting that the metal may be coupled to the peptide before the secretion of the hormone from the cells. PMID- 6488292 TI - Influence of photoperiod on the ultrastructure of the hypophysial pars tuberalis of the Djungarian hamster, Phodopus sungorus. AB - Conspicuous cytological differences are found between specific secretory cells of the hypophysial pars tuberalis of Djungarian hamsters exposed to long and short photoperiods. The cells differ with respect to the shapes of perikarya and nuclei and show diverse amounts of secretory granules, lysosome-like bodies and glycogen. PMID- 6488293 TI - Nucleolus and large nucleolar aggregates of condensed chromatin in interphase nuclei of L 929 cells. AB - Three-dimensional reconstructions show that the nucleoli from L 929 cells are associated with one or several large aggregates of chromatin displaying a honeycomb-like structure. The form and the number of both nucleoli and honeycomb structures vary as the cells emerge from the resting state and enter exponential growth. Quantitative data show that the number of honeycomb structures decreases as the number of nucleoli diminishes; both numerical regressions are significant. In addition, the nucleoli and the honeycomb structures enlarge when the cells enter the exponential growth phase. In resting cells the number of honeycomb structures is correlated to the number of nucleoli. Therefore we conclude that the large nucleolar mass of condensed chromatin, which in L 929 cells displays a honeycomb structure, contains a portion of the nucleolar organizing region. PMID- 6488295 TI - Histological study of ibotenic acid-induced modifications of rat retina and their attenuation by diazepam. AB - After 2 h intraocular injections of 19 and 190 nmoles ibotenic acid in the rat retina produced an intensive vacuolization of the inner plexiform layer and cellular alterations, in the inner nuclear layer and ganglion cell layer. These alterations consisted of either cytoplasmic swelling accompanied by clumping of the nuclear chromatin or darkening of the cytoplasm along with nuclear condensation. A week later the retinas were thinner than the controls due to the disappearance of the affected cells. Pre-treatment with diazepam prevents the morphological alterations induced by 19 nmoles ibotenic acid; mainly the swelling, which was completely prevented, while the darkening was reduced drastically, although some vacuolization of the inner plexiform layer is still present. PMID- 6488296 TI - The prevalence of rubella haemagglutination inhibition antibodies in non immunized individuals. PMID- 6488294 TI - The innervation of the trachea and extrapulmonary bronchi of the mouse. AB - In the mouse, nerves were located throughout the trachea and extrapulmonary bronchi in both the smooth muscle and the connective tissue. However, no nerves were found within the epithelium. In the smooth muscle there were large numbers of nonmyelinated nerves. These were usually 'en passant' elements but varicosities containing small mitochondria and vesicles were also seen; these axons sometimes appeared to be efferent to the muscle. Unilateral cervical vagotomy reduced the numbers of nerves in the muscle of the trachea and ipsilateral primary bronchus, suggesting that they were afferent. The intramuscular nerves were characterized in terms of their complement of cytoplasmic organelles; in particular nerves containing many mitochondria disappeared following vagotomy. Pretreatment of mice with 5-hydroxydopamine to accentuate the electron-opacity of catecholamine-containing granules resulted in 3.5% of the nerves within tracheal muscle showing such granules. The afferent nerves of the smooth muscle may be complex branching structures with many varicosities. The absence of epithelial nerves may be related to the absence of the cough reflex in the mouse. PMID- 6488297 TI - A case of disseminated cryptococcosis. PMID- 6488298 TI - Aetiology of neonatal conjunctivitis in Harare. PMID- 6488299 TI - A case study of post traumatic neurosis. PMID- 6488300 TI - The threat of coronary heart disease. PMID- 6488301 TI - General practice and the general practitioner in Zimbabwe today. PMID- 6488302 TI - Brain-failure. PMID- 6488303 TI - Evaluation of patients with coronary artery disease during exercise: the relation between extent of disease and perfusion deficit. AB - The purpose of this study was to assess the relation between the extent of coronary artery disease (CAD) and size of exercise-induced myocardial hypoperfusion in 79 patients with angiographically documented CAD. None of the patients had Q-wave myocardial infarction. Fifty patients had one-vessel disease, ten had two-vessel disease, and 19 patients had three-vessel or left main disease. From a scintigraphic functional standpoint, patients were classified into two groups: 28 patients (35%) had large perfusion defects and 51 patients (65%) had small defects. The size of the thallium-201 perfusion defect during exercise was assessed as the perimeter of the defect in each projection expressed as a percentage abnormality of the total left ventricular perimeter in that projection. The average abnormality from the three projections was used in the final analysis. Eleven patients with large defects (39%) had one-vessel disease and 12 patients with small defects (24%) had multivessel disease. Stepwise multivariate discriminate analysis identified the number of diseased vessels (F = 13.9), the change in systolic blood pressure from rest to exercise (F = 10.8), the exercise heart rate (F = 9.1), and exercise electrocardiographic response (F = 7.8) as significant associates of the size of the perfusion defect (predictive accuracy = 70%). We conclude that the size of hypoperfused myocardium during exercise is variable in patients with CAD. Discriminate analysis identified the extent of CAD, exercise heart rate, change in systolic pressure from rest to exercise, and exercise electrocardiographic response as significant associates of the size of the defect. PMID- 6488304 TI - Intravenous versus intracoronary streptokinase for acute transmural myocardial infarction. AB - In order to compare the thrombolytic efficacy of selective versus systemic administration of streptokinase, we gave this drug by either the intracoronary or intravenous routes to 25 patients during the first 6 hours of acute myocardial infarction. All patients had total occlusion of the infarct-related vessel, unresponsive to intracoronary nitroglycerin. Twelve patients received intravenous streptokinase and 13 received intracoronary administration of the drug. Angiograms were taken prior to and during streptokinase administration. Reopening was achieved in 11 of 13 intracoronary patients and 8 of 12 intravenous patients (P = Ns). Time to reopening was longer (54 minutes) in the intravenous patients than in the intracoronary patients (26 minutes) (P less than 0.05). In this study, intravenous streptokinase reopened infarct-related vessels nearly as often as intracoronary streptokinase, but it took longer. Given the limited access and time to prepare for intracoronary infusion and the ease of intravenous administration, further study of intravenous streptokinase is justified. PMID- 6488305 TI - Myocardial perforation due to temporary transvenous pacing catheters in pediatric patients. AB - Over a 13-year period, 18 pediatric patients received temporary transvenous pacing catheters for symptomatic bradycardia due to complete atrioventricular block or sinoatrial node dysfunction. Right ventricular wall perforation occurred in two patients. The utility of two-dimensional echocardiography in the detection and assessment of myocardial perforation by temporary pacing catheters is discussed. PMID- 6488307 TI - Aberrant origin of the right ventricular coronary artery: a report of two cases. AB - Aberrant origin of coronary arteries is a not uncommon entity found on cardiac catheterization, at the time of surgery, and on post mortem examination. We present two cases of origin of a right ventricular (or atypical large conus) branch of the right coronary artery originating from a separate ostium in the right coronary cusp, which to our knowledge has been only rarely previously described. We feel that this may be a relatively frequent coronary varient that has important implications regarding patient assessment and care. PMID- 6488306 TI - Clinical and angiographic findings in a patient with vasospasm in an anomalous coronary artery. AB - We report the case of a 58-year-old man with coronary vasospasm that occurred within an anomalous coronary artery. The rapidly progressive clinical course and the dramatic treadmill test result preceeded the diagnostic cardiac catheterization. Combination therapy with isosorbide, beta blocker, and nifedipine resulted in complete resolution of symptoms. PMID- 6488308 TI - Anomalous separate origin of the septal perforator coronary artery from the left sinus of valsalva. AB - The anomalous separate origin of the first septal perforator from the left sinus of Valsalva is described. Previously documented anomalous origins of the septal perforator include the left main coronary artery, the right coronary artery, the right sinus of Valsalva, a diagonal coronary artery, the circumflex coronary artery, and its obtuse marginal branch. We could not find any previous description of the septal perforator originating from a separate ostium in the left sinus of Valsalva. PMID- 6488309 TI - Pigtail catheters in pulmonary angiography. PMID- 6488310 TI - Selective coronary arteriography by percutaneous transaxillary approach. AB - Coronary angiography by the percutaneous femoral approach is widely used. This technique is potentially dangerous or impossible in patients with advanced arterial disease of the lower limbs, whether or not surgically treated. In these cases, percutaneous left or right axillary approach is an alternative to brachial approach. In this article, we report our multicenter experience involving 120 patients. The left axillary artery was used in 94 cases (78%) and the right in 26 cases (22%). We used performed coronary catheters usually associated with the femoral approach. The left axillary artery was used preferentially since this avoids catheterization of the innominated trunk and allows easier catheterization of the coronary ostia and aortic ends of aorto-coronary bypass grafts. The routine use of a sheath (arterial introducer) avoided arterial compression during catheterization, prevented hemorrhagic suffusion when the catheters were exchanged, and reduced the risk of thrombosis or laceration of the axillary artery. There were no failures in the catheterization of the axillary artery and no complication was observed during or after the procedure. Axillary percutaneous technique appears to have the following advantages over the brachial arteriotomy: 1) Investigation time is equivalent to the time needed for the femoral percutaneous approach. 2) There is the possibility of lateral and simultaneous bi plane angiograms. 3) Arterial puncture is preferable to arteriotomy. The axillary approach could also be used for percutaneous transluminal coronary angioplasty. PMID- 6488311 TI - Left ventricular endomyocardial biopsy in children with the transseptal long sheath technique. AB - Left ventricular endomyocardial biopsies were obtained in 19 infants and children using a long sheath as an introducer after transseptal puncture of the atrial septum. From July 1982 to August 1983, 19 patients, ages 7 months to 12 years (mean = 4.6 years), underwent both right and left ventricular biopsies with only one failure. The long sheath technique allows positioning of the bioptome in different areas of the left ventricular chamber. Right ventricular biopsies were also obtained with the long sheath technique in 11 other patients. PMID- 6488312 TI - Contrast agents for selective coronary arteriography. PMID- 6488313 TI - Molecular coevolution: DNA divergence and the maintenance of function. PMID- 6488314 TI - Spontaneous mammary adenocarcinomas in transgenic mice that carry and express MTV/myc fusion genes. AB - We have produced 13 strains of transgenic mice that carry an otherwise normal mouse myc gene in which increasingly larger portions of the myc promoter region have been replaced by a hormonally inducible mouse mammary tumor virus promoter. Although expression of the fusion genes varies among these animals, the female founders of two of these transgenic strains spontaneously developed mammary adenocarcinomas during one of their early pregnancies. Both the tumors and the breast tissue of these founder animals expressed RNA transcripts corresponding to the fusion gene. Furthermore, in the best studied strain, all the available F1 female progeny that inherited the MTV/myc gene also developed mammary adenocarcinomas during their second or third pregnancies. Thus, although it has no obvious effect on the early development of these mice, the constitutionally deregulated myc gene appears to act as a heritable, predisposing factor favoring the accelerated development of a tissue-specific adenocarcinoma. PMID- 6488315 TI - Biosynthesis and processing of murine T-cell antigen receptor. AB - The antigen-specific receptor of C6VL T-lymphoma cells is a disulfide-linked heterodimer composed of 39 kd alpha chain and a 41 kd beta chain, both of which exhibit charge microheterogeneity. Pulse-chase labeling experiments indicate that epitopes reactive with the anti-receptor xenoantiserum #8177 were detectable by 2 min, while the clonotypic epitope reactive with monoclonal antibody 124-40 was not detectable until 10 min. Digestion with endoglycosidases H and F revealed that both subunits have at least three N-linked oligosaccharide side chains. The deglycosylated alpha and beta subunits were 27 and 32 kd, respectively. These data suggest that the dimeric receptor is formed shortly after translation, followed by extensive glycosylation. Emergence of the C6VL clonotypic epitope, and perhaps the antigen binding site, may therefore be dependent on post-assembly events. PMID- 6488316 TI - Transcription of muscle-specific actin genes in early Xenopus development: nuclear transplantation and cell dissociation. AB - Cloned cDNA probes that recognize muscle-specific alpha-actin gene transcripts have been used to analyze two kinds of experimental embryos in Xenopus. In one, genetically marked nuclei of larval muscle cells were transplanted to wild-type enucleated eggs; alpha-actin genes became transcriptionally inactive in the resulting blastulae but were reactivated when these embryos reached the normal stage of alpha-actin expression (late gastrula). In the other, blastula embryos reared from fertilized eggs were separated into animal, vegetal, and equatorial regions, and their cells dissociated and reaggregated. alpha-Actin RNA was synthesized at the normal time in development, but only by equatorial cells. We conclude that alpha-actin gene transcription is normally regulated in nuclear transplant embryos and is undisturbed by the absence of cell contacts during cleavage. PMID- 6488317 TI - A nonsense mutation within the act88F actin gene disrupts myofibril formation in Drosophila indirect flight muscles. AB - We have investigated the molecular basis of muscle abnormalities in the flightless Drosophila mutant lfm(3)7. This EMS-induced, semi-dominant allele was isolated by Mogami and Hotta (1981) and was shown to disrupt the organization of myofibrils in indirect flight muscles. Here we demonstrate that lfm(3)7 contains a nonsense mutation within codon 355 of the act88F actin gene. A single G greater than A transition converts a tryptophan (TGG) codon to an opal (TGA) terminator, thus deleting the carboxy-terminal 20 amino acids of an actin isoform that accumulates only in thoracic flight muscles. The truncated actin polypeptide is stable, and retains antigenicity to at least two anti-Drosophila actin monoclonal antibodies. We suggest that abnormalities in lfm(3)7 flight muscles result from incorporation of the mutant actin isoform into assembling myofibrils. PMID- 6488318 TI - The use of double mutants to detect structural changes in the active site of the tyrosyl-tRNA synthetase (Bacillus stearothermophilus). AB - In a previous study, a mutant of tyrosyl-tRNA synthetase in which a threonine residue (Thr51) was converted to proline dramatically improved the affinity of the enzyme for its ATP substrate. How does Pro51 improve the enzyme's affinity for ATP? A priori, Pro51 might interact directly with the ATP, or it might distort the polypeptide backbone and thereby force new or improved contacts elsewhere from the enzyme to ATP. By making mutants of the Pro51 enzyme at two residues that make hydrogen bonds to the ATP substrate, we show that Pro51 greatly improves the strength of one of these contacts. Thus the propagation of a structural change in an enzyme induced by mutation may be detected by the introduction of further mutations. PMID- 6488319 TI - Chromosome rearrangements in Trypanosoma brucei. AB - We have studied chromosome rearrangements in T. brucei using pulsed field gradient gel electrophoresis to separate chromosome-sized DNA molecules. We detect size changes in a set of small chromosomes (200-700 kb) at a frequency of 10(-5) to 10(-6) per trypanosome division; this results in a radical difference in the size distribution of these chromosomes in different T. brucei isolates. Several of these chromosome rearrangements can be related to a change in the expression of surface antigen genes. Such rearrangements may be undetectable by standard gel electrophoresis and Southern blot analysis because the DNA segment transferred is too large to detect the breakpoint with the antigen gene probe. We also provide additional evidence for the notion that transcription of protein coding genes in T. brucei and related flagellates is discontinuous. The possibility that gene rearrangements are essential for all changes in variant surface gene expression remains open. PMID- 6488320 TI - Concepts of target cells in plant differentiation. AB - The regeneration of whole plants from fragments of mature organs is compelling evidence that plant cells retain genetic totipotency throughout differentiation. Within the intact plant, however, strict regulatory controls operate to maintain a co-ordinated pattern of growth. Not every cell differentiates along the same developmental pathway. Cell performance is determined by mechanisms that permit subtle discriminations in recognition of and response to an array of environmental and hormonal cues. Much effort is currently directed to understanding these control systems in plants. Certain positionally differentiated cells and tissues have been characterized by their specific signal recognition and their precise responses in gene expression. In a few, the competence to respond to particular signals has been distinguished by the presence of cell-specific protein markers. This article discusses some recent studies that help towards an understanding of the target nature of cells in plant development. PMID- 6488321 TI - Fibronectin synthesis during oogenesis and early development of the amphibian Pleurodeles waltlii. AB - Fibronectin (FN) synthesis during oogenesis and early embryogenesis of the amphibian Pleurodeles waltlii was investigated. The isotopically labelled amino acids [3H]leucine and [35S]methionine were incubated with oocytes or microinjected into embryos. Newly synthesized FN was analysed by polyacrylamide gel electrophoresis, using the high resolution two-dimensional gel system described by O'Farrell. With this method and fluorography we demonstrate that FN synthesis begins during oogenesis. De novo synthesized FN appears during cleavage and gastrulation. Using actinomycin D we show the presence of maternal messenger RNA coding for FN. It is translated during the cleavage and gastrulation stages. PMID- 6488322 TI - In vitro inhibition of tubulin assembly by a ribonucleoprotein complex associated with the free ribosome fraction isolated from Xenopus laevis oocytes: effect at the level of microtubule-associated proteins. AB - The 100 000 X g supernatant prepared from defolliculated Xenopus laevis oocytes inhibits, in a dose-dependent manner, the in vitro polymerization of rat brain neurotubulin. The oocyte inhibitory factor is thermolabile, totally inactivated by RNAse and partially by trypsin. A preliminary purification of the inhibitor showed that it is associated with the free oocyte ribosomes (80 S). The saturable binding of microtubule-associated proteins, essentially MAP2, to this 80 S ribonucleoprotein fraction is responsible for the inhibition of the in vitro tubulin assembly. PMID- 6488323 TI - Incomplete fusion of the epithelial and endothelial basement membranes in interspecies hybrid glomeruli. AB - Avascular, undifferentiated mouse kidneys transplanted onto quail chorioallantoic membrane differentiate and become vascularized by quail vessels. The glomeruli which form under these conditions consist of mouse podocytes and quail endothelial cells. Immunohistochemistry has shown that the glomerular basement membrane (GBM) has a dual origin, as integral basement membrane components are produced by both podocytes and endothelial cells. In electron microscopy this GBM is composed of two partially separated layers, an epithelial and an endothelial basal lamina which both have a lamina densa and a lamina rara. These two basal laminas are partially fused, but there are large areas where this fusion does not occur. In some places of incomplete fusion, fibrillar extracellular material is seen between and beneath the GBM. It is concluded that basement membrane components derived from the different species can interact partially, but the fusion is incomplete. The abnormal assembly of the epithelial and the endothelial basal laminas might be due to molecular differences between the components produced by the two cell lineages. In spite of the incomplete fusion, the system used serves as a good model-system to study basement membrane formation, since the cells organize in a histiotypic fashion and form true vascularized glomeruli. PMID- 6488324 TI - Cytoskeleton and differentiation: effects of cytochalasin B and colchicine on expression of the differentiated phenotype of rabbit costal chondrocytes in culture. AB - Cytochalasin B changed the shape of cultured rabbit costal chondrocytes from polygonal to nearly spherical and stimulated glycosaminoglycan synthesis, which is a differentiated phenotype of chondrocytes, whereas colchicine changed them from polygonal to flattened and inhibited glycosaminoglycan synthesis. These morphological changes occurred parallel with the changes in glycosaminoglycan synthesis. Induction of ornithine decarboxylase by parathyroid hormone, which is a good marker of differentiated chondrocytes, was markedly potentiated in the spherical cells which had been pretreated with cytochalasin B, whereas pretreatment with colchicine inhibited the induction of the enzyme. Both cytochalasin B and colchicine inhibited DNA synthesis. The inhibitions were observed after the appearance of changes in the morphology of the cells and glycosaminoglycan synthesis. These findings suggest that intactness of microtubules and disruption of microfilaments are involved in regulating the expression of the differentiated phenotype of chondrocytes in culture. PMID- 6488325 TI - Monoclonal antibodies specific for stalk differentiation in Dictyostelium discoideum. AB - We have produced two monoclonal antibodies specific to the stalk cells of Dictyostelium discoideum fruiting bodies. Both monoclonal antibodies react with high molecular weight proteins previously found to be stalk-specific by two dimensional gel analysis. One antibody (JAb 1) is specific for a single protein of apparent molecular weight 310 000 which first appears when overt stalk differentiation begins at 20 h. The other monoclonal antibody (JAb 2) is also stalk-specific, though earlier in development it binds to proteins extracted from both prestalk and prespore cells of the migrating slug. It reacts with two proteins in stalks, one of apparent molecular weight 430 000 which is first detected during tip formation at 12 h and a lower molecular weight protein (310 000) detected from 20 h. Although several markers are available for the investigation of prespore/spore differentiation there is a distinct lack of suitable prestalk/stalk markers. The monoclonal antibodies described here are highly specific stalk markers and should prove useful in the study of cell proportioning and terminal differentiation. PMID- 6488326 TI - Retinoic acid enhances the displacement of newly synthesized hyaluronate from cell layer to culture medium during early phases of chondrogenesis. AB - Chondrogenic differentiation in mouse limb bud mesenchymal cells cultured at high density was suppressed by supplementation of the medium with retinoic acid (1 microgram/ml or 3.3 X 10(-6) M). Since in control medium overt chondrogenesis begins on day 3, retinoic acid was introduced on day 2 so that the relationship between initial biosynthetic changes and inhibition of chondrogenesis could be studied. During the first 24 h of exposure the treated cells remained viable but suffered 10% inhibition in growth and synthesized [3H]glucosamine-labeled glycosaminoglycan at a level 24% below untreated cells. The amount of labeled hyaluronic acid released into the culture medium by the treated cells was, however, 2-fold greater, on a per cell basis, than that in the untreated cultures. It is suggested that the displacement of hyaluronate may play a role in the disruption of mesenchymal cell differentiation and of limb morphogenesis as observed in other systems. PMID- 6488327 TI - Antigen transport II. The significance of the localization of antigen-laden cells in the spleen. AB - Previous studies have demonstrated that macrophage-like cells transporting antigen, e.g., human serum albumin (HSA) appear in thoracic duct lymph and blood shortly after antigen injection. The in vivo migration of these antigen-laden (Ag L) cells from the blood stream was examined systematically by transferring Ag-L cells bearing 125I-labelled HSA into syngeneic rats. There was no evidence autoradiographically that Ag-L cells migrated into lymph nodes, but the localization in the spleen followed a defined pattern: within the first hours after transfer, a majority of radiolabelled cells were identified in the marginal zone; by 3 hr and up to 4 days later, 60-80% of labelled cells were resident in the red pulp; Ag-L cells failed to migrate into the white pulp in significant numbers. Ag-L cells which had localized to the spleen, when examined 3 and 18 hr after transfer using combined autoradiography and immunoperoxidase staining, did not express Ia determinants in situ. The ability of Ag-L cells to stimulate an adoptive secondary response was tested in splenectomized, irradiated recipients receiving HSA-specific memory cells. Removal of the spleen before transfer severely reduced the antibody response evoked by Ag-L cells transporting HSA, thus indicating the functional importance of antigen transport to the spleen. Since Ag-L cell migration was primarily into the red pulp, we have considered whether the red pulp may provide a relevant microenvironment for lymphocyte/antigen interaction. PMID- 6488328 TI - Virus-mediated induction in human lymphocytes of antibody-independent cytotoxicity (VDCC) and enhancement of antibody-dependent cytotoxicity (ADCC) against natural killer-resistant tumor target cells. AB - The effect of Parotis virus on the in vitro cytotoxicity of human lymphocytes against NK-resistant mouse mastocytoma cells was studied. In the 51Cr-release assay, treatment of lymphocytes with virus induced a rapid cytotoxicity in the absence of anti-P815 antibody (virus-dependent cellular cytotoxicity, VDCC) and strongly enhanced antibody-dependent cytotoxicity (ADCC). At the effector cell level, virus treatment was found to increase the frequency of target-binding cells (TBC) as well as the proportion thereof mediating VDCC and/or ADCC, indicating recruitment of active effector cells. The recruited cells were heterogeneous but contained a major fraction bearing the T-cell-associated antigen T3. Virus was found to decrease rather than to increase the recycling capacity of the cytotoxic lymphocytes, suggesting that VDCC induction and ADCC enhancement were due to a virus-mediated improvement of effector cell-target cell interactions. VDCC and ADCC enhancement may be of protective importance in early phases of virus infection as well as for the production of nonspecific tissue injuries associated with viral disease. PMID- 6488329 TI - Post-natal ontogenesis of graft-versus-host reactivity of peanut agglutinin lectin-negative thymocytes in the chicken. AB - Chicken thymocyte fractionation by peanut agglutinin lectin yields two cell subpopulations which differ in their GvH competence when injected into major histocompatibility complex (MHC)-(B locus) incompatible embryos. The nonagglutinated PNA- fraction displayed a degree of alloreactivity similar to that of peripheral blood lymphocytes while the PNA+ cells were nonreactive. Analysis of chickens at the age of 4 to 24 weeks showed that the development of GvH-reactive PBL preceded by 12 weeks the maturation of GvH-reactive PNA- thymocytes. Possible interpretations for this difference between the time of appearance of GvH reactivity of PNA- thymocytes and PBL are discussed. PMID- 6488330 TI - The appearance of eosinophil-directed chemotactic inhibitory factor in the serum of complete Freund's adjuvant-treated guinea pigs. AB - When guinea pigs were treated by complete Freund's adjuvant (CFA), eosinophil directed chemotactic inhibitory factor (ECIF) appeared in the serum of the treated animals. The inhibition of the response of eosinophils by ECIF was selective for the T cell-derived chemotactic factor, which has been isolated from DNP-ascaris extract-induced skin lesions (termed delayed ECF-a) but not for another ECF (termed delayed ECF-b), which was also isolated from the same skin lesions. ECIF was detected in the serum after a single CFA injection, and no significant increase of ECIF activity was observed in the serum of animals injected with CFA twice. The ECIF activity in the serum was associated with fractions of MW 70,000 and 12,500, and failed to bind to Con A-Sepharose. Furthermore, ECIF was absorbed by eosinophils but not by macrophages suggesting that eosinophils have receptor sites for ECIF. On the other hand, chemotactic inhibitor against delayed ECF-b was not detected in the serum. It was thus suggested that inhibition of eosinophil reaction by CFA treatment is related to ECIF, inhibition being selective for the eosinophil response to delayed ECF-a. PMID- 6488331 TI - Induction of delayed-type hypersensitivity to measles virus in mice. AB - Intracutaneous injection of inactivated measles virus (MV) into hind footpads of BALB/c mice infected 5 to 11 days previously with MV produces a strong delayed type hypersensitivity (DTH) response. Pretreatment of mice with cyclophosphamide (CP) results in a significantly stronger response. In CP-pretreated mice, the optimal infecting dose of live MV and the restimulating amount of inactivated MV are approximately 10(7) plaque-forming units and 2 micrograms/mouse, respectively. The optimal time after infection for measuring DTH to MV is 7 days, while the optimal CP-pretreatment concentration is 200 mg/kg. The DTH response generated by MV is specific and not caused by fetal calf serum or Vero cell antigens. MV DTH is transferable to uninfected mice with lymph node cells. Transfer of DTH is sensitive to treatment with anti-Thy 1.2 serum plus complement, indicating the response is T cell dependent. With this sensitive assay for measuring cell-mediated immunity to MV, it will now be possible to analyze T cell cross-reactivity among paramyxoviruses and assess viral cell mediated immunity in mice infected with neuroadapted MV. PMID- 6488332 TI - Protein phosphorylation in anti-actin IgG and [(IgG)2protein A]2 complex stimulated L cells. AB - Phosphorylation of cellular proteins was stimulated in a dose-dependent manner by the surface binding of IgG antibodies to antigens on L cells. Most prominent among the phosphorylated cellular proteins were Mr = 115,000, 93,000, 58,000, 38,000, and 33,000 proteins. Stimulation of protein phosphorylation was maximal at 48 hr of incubation and was preceeded by maximal stimulated uridine incorporation into RNA (0-24 hr) and thymidine incorporation into DNA (24-48 hr), and followed by maximal stimulated cell proliferation occurring at 72 hr (P less than 0.001 for all differences). Modification of the ligand IgG molecule by formation of complexes with protein A (PA) altered the stimulation patterns of protein phosphorylation: [(IgG)2(PA)]2, Mr = 716,000, enhanced and (IgG)(PA), Mr = 200,000, inhibited phosphorylation. The nature of the cell surface antigen(s) was partially clarified by the demonstration that affinity-purified antibodies to cytoskeletal proteins (principally a surface actin molecule) accounted for a significant part of the stimulation effect. Thus, perturbation of the L-cell membrane by certain molecular forms of anti-actin IgG antibody produces a transmembrane signal resulting in an orderly series of metabolic events including enhanced protein phosphorylation at 48 hr occurring just prior to enhanced cell growth. PMID- 6488333 TI - [Are we fulfilling the general health care program for women?]. PMID- 6488334 TI - [Effective new oxytocin inhibitors in tests on strips of the human uterus in vitro]. PMID- 6488335 TI - [Rapid RIA of LH for the prediction of ovulation]. PMID- 6488336 TI - [Treatment and care of patients with malignant and semi-malignant forms of trophoblastic disease in the National Center in Prague]. PMID- 6488337 TI - [Treatment and results of treatment in patients with vulvar carcinoma at the Research Institute for Clinical and Experimental Oncology in Brno during the past 40 years]. PMID- 6488338 TI - [Volvulus in pregnancy]. PMID- 6488340 TI - [Use of prostaglandins in the interruption of pregnancy]. PMID- 6488339 TI - [Immunology of nonteratogenic choriocarcinomas]. PMID- 6488341 TI - [Bromocryptine in the treatment of carcinoma of the uterine cervix and its immunomodulating effect]. PMID- 6488342 TI - [Hot flushes in men]. PMID- 6488343 TI - [Differences in mathematical thinking ability in men and women and mathematics in the biological sciences]. PMID- 6488344 TI - [For increased effectiveness in scientific research activity]. PMID- 6488345 TI - [Radioimmunologic determination of HCG in the diagnosis of extrauterine pregnancy in our case material]. PMID- 6488346 TI - [Bacteriologic study of umbilical blood and its clinical significance]. PMID- 6488347 TI - [Diagnosis of extrauterine pregnancy in mini-abortions]. PMID- 6488349 TI - [Hysterectomy in obstetrical practice]. PMID- 6488348 TI - [Classification of operations for tuboperitoneal factors in female sterility]. PMID- 6488350 TI - [Initial clinical experience with the BMT 9141 cardiotocograph]. PMID- 6488351 TI - [Monogest in gynecologic practice]. PMID- 6488352 TI - [An unusual complication after cesarean section]. PMID- 6488353 TI - [Immunologic properties of cervical mucus]. PMID- 6488354 TI - [Measurement of blood circulation in the fetus]. PMID- 6488355 TI - [Present knowledge of the regulation of fetal erythropoiesis]. PMID- 6488356 TI - [Transdermal therapeutic systems and steroids]. PMID- 6488357 TI - [Placebo technics in obstetrical psychoprophylaxis]. PMID- 6488358 TI - [Experience of social welfare evaluating committees with visually handicapped adolescents]. PMID- 6488359 TI - [Lenster--a portable sterilizer for soft contact lenses]. PMID- 6488360 TI - [Personal experience with the treatment of amblyopia using the modified visual stimulator (CAM)]. PMID- 6488361 TI - [CT anatomy of the orbit]. PMID- 6488362 TI - [Computerized perimetry in glaucoma]. PMID- 6488364 TI - [Monitoring intraocular fluid hydrodynamics in retinal detachment using radioactive 22NaCl]. PMID- 6488363 TI - [Determination of glucose in human tears]. PMID- 6488365 TI - [Pachometry--measurement of corneal thickness]. PMID- 6488366 TI - [Collagen architecture of the lamina cribrosa of the human eye in glaucoma and severe myopia]. PMID- 6488367 TI - [Fluorescence angiography of the iris in open-angle glaucoma]. PMID- 6488368 TI - [Changes in the corneal surface after the application of chromatography paper]. PMID- 6488369 TI - [The "osteoporosis-pseudoglioma" syndrome]. PMID- 6488370 TI - [Possible uses of computer technology in the inpatient ophthalmology department]. PMID- 6488371 TI - [The effect of experimental inflammation on the ear drum in guinea pigs]. PMID- 6488372 TI - [Experience with the surgical treatment of congenital anomalies of the ear in adults]. PMID- 6488373 TI - [Recurrent aphthous stomatitis]. PMID- 6488374 TI - [Sinoscopy in injuries of the paranasal sinuses]. PMID- 6488375 TI - [Study of the humidifying and warming capacity of the nasal mucosa in patients with tracheostomies]. PMID- 6488376 TI - [Diagnosis and treatment of Meniere's disease at the Otorhinolaryngology Clinic in the Department of General Medicine of Charles University in Prague 1976-1981]. PMID- 6488377 TI - [Treatment of nasal polyps with ultrasound]. PMID- 6488378 TI - [Cervicofacial schwannomas]. PMID- 6488379 TI - [A successful autotransplant substitution of the facial nerve after parotidectomy followed by actinotherapy]. PMID- 6488380 TI - [Myiasis in the field of otorhinolaryngology]. PMID- 6488381 TI - [Incidence of double malignant tumors in the Otorhinolaryngology Clinic of the Medical School Hospital and Polyclinic in Brno over the past 15 years]. PMID- 6488382 TI - [Computer tomography of mediastinal lesions]. PMID- 6488383 TI - [Differential diagnosis of cystic formations in the abdomen using computer tomography]. PMID- 6488385 TI - [Radiation burden in the CT examination]. PMID- 6488384 TI - [Evaluation of changes in the density of the vertebral body after intravenous administration of contrast medium during routine CT examination]. PMID- 6488386 TI - [Angiographically silent aneurysm of the abdominal aorta]. PMID- 6488387 TI - [Hemispherical spondylosclerosis]. PMID- 6488388 TI - [Solitary benign bone lesions]. PMID- 6488389 TI - Photoaddition of chlorpromazine to DNA. AB - Chlorpromazine, 2-chloro-N-(3-dimethylaminopropyl)phenothiazine (CPZ), is a frequently prescribed antipsychotic drug that causes cutaneous photosensitivity in man. CPZ is also phototoxic and photomutagenic in vitro. We have investigated the photoaddition of CPZ to DNA as a possible mechanism for these photobiologic effects. Prior to irradiation, CPZ binds non-covalently to double-stranded calf thymus DNA. At high nucleotide to CPZ ratios, the CPZ absorption maximum shifts from 305 nm to 340 nm with an isosbestic point at 323 nm and 90% of the CPZ fluorescence at 455 nm is quenched. The excitation and emission spectra for the unquenchable fluorescence are the same as those for unbound CPZ. The absorption and fluorescence spectra of unbound CPZ are restored at 0.1 mM magnesium acetate or 100 mM sodium acetate. Non-covalent binding of CPZ to heat-denatured DNA does not shift the CPZ absorption spectrum but quenches 65% of the CPZ fluorescence. Photolytic decomposition of CPZ was inhibited by binding to DNA. In the presence of high concentrations of double-stranded DNA or denatured DNA the photolysis rates were reduced by greater than 98% and 65%, respectively, compared to free CPZ. Formation of covalent photoadducts between CPZ and denatured DNA was 10-fold more efficient than photoadduct formation with double-stranded DNA. Approximately 10% of the CPZ which photodecomposed upon irradiation at 323 nm photoadded to denatured DNA. These results indicate that formation of a complex between CPZ and double-stranded DNA absorbing at 340 nm protects CPZ from photodecomposition and inhibits covalent photoadduct formation. PMID- 6488390 TI - Inhibition of rat hepatic mixed function oxidases by antimalarial drugs: selectivity for cytochromes P-450 and P-448. AB - Intraperitoneal administration of chloroquine, primaquine and quinacrine to rats resulted in inhibition of the hepatic microsomal mixed-function oxidases. The N demethylation of benzphetamine (cytochrome P-450) was inhibited by chloroquine only while the O-deethylation of ethoxyresorufin (cytochrome P-448) was inhibited by primaquine and quinacrine. When incubated with hepatic microsomes from phenobarbital-pretreated rats, chloroquine and primaquine, but not quinacrine, caused a concentration-dependent inhibition of benzphetamine N-demethylase activity. Incubation of hepatic microsomes from beta-naphthoflavone rats with primaquine and quinacrine, but not chloroquine, resulted in a concentration dependent inhibition of the O-deethylation of ethoxyresorufin. These observations demonstrate that chloroquine and quinacrine are specific inhibitors of cytochromes P-450 and P-448, respectively. PMID- 6488391 TI - Metabolism of methyl n-amyl ketone (2-heptanone) and its binding to DNA of rat liver in vivo and in vitro. AB - Methyl n-amyl ketone (2-heptanone), a reported metabolite of 2-ethylhexanol which in turn is a primary metabolite of plasticizers such as di-(2-ethylhexyl) phthalate, is metabolized in male Fischer 344 rats to CO2, acetate and a variety of compounds that could be either anabolic or catabolic or a combination of the two. A significant percentage of the radioactivity given orally (gavage) as [2 14C]-2 heptanone, at least 10%, was not excreted from the body in 48 h. Radioactivity was incorporated into liver protein in the form of three unidentified products as well as [14C]arginine, and into DNA both as 14C-labeled normal nucleosides (50-75%) and as presently unidentified hydrophobic materials (25-50%). Urea and cholesterol were significantly labeled, indicative of anabolic reutilization of [2-14C]-2-heptanone breakdown products. The 2-heptanone also bound to DNA spontaneously in vitro, to the extent of 400 pmol/mg DNA. PMID- 6488392 TI - Isolation of a cigarette smoke fraction responsible for the inhibition of benzo[a]pyrene metabolism in the isolated perfused rabbit lung. AB - Among the several thousand components of cigarette smoke is a substance or substances capable of inhibiting pulmonary metabolism of nicotine and altering the metabolite profile of procarcinogens such as benzo[a]pyrene (BP). This substance(s) inhibits BP metabolism in the lung in amounts present in a few puffs of cigarette smoke. By a series of extractions and chromatographic methods an active subfraction containing only 1% of the total cigarette smoke condensate (CSC), was isolated. This fraction demonstrated the same inhibition of BP metabolism in the isolate perfused lung (IPL) as the whole smoke. The inhibitor(s) present in this fraction possess amphoteric characteristics. The acidic function is believed to be a phenolic one. PMID- 6488393 TI - Reductive metabolism of 1,1,1,2-tetrachloroethane and related chloroethanes by rat liver microsomes. AB - The susceptibility of polychlorinated ethanes to reductive metabolism was evaluated by measuring the amount of each compound consumed during anaerobic incubations with rat live microsomes; 1,1,1,2-tetrachloroethane, pentachloroethane and hexachloroethane were metabolized extensively, 1,1,1,2 tetrachloroethane and the trichloroethanes were metabolized very slowly and the dichloroethanes were not metabolized at a detectable rate. The electron affinity of the chloroethanes was determined by measuring electrochemical half-wave reduction potentials. Chloroethanes with an E1/2 of - 1.35 V or less negative were reduced readily in microsomes while those with an E1/2 equal to or more negative than -1.90 V were not good substrates for enzymatic reduction. Metabolites produced from 1,1,1,2-tetrachloroethane in vitro were 1,1 dichloroethylene (DCE) and 1,1,2-trichloroethane (TCEA) and the ratio DCE/TCEA was about 25:1. These conversions were NADPH-dependent and were inhibited by air, CO and metyrapone. In the presence of SKF 525-A, DCE formation was inhibited by 47%. Microsomes from untreated or beta-naphthoflavone-treated rats were 70-90% less active than microsomes from phenobarbital-treated rats. The Km was 0.50 mM and the Vmax was 66 nmol min-1 mg-1 protein for DCE formation. The results are consistent with the proposal that 1,1,1,2-tetrachloroethane is reduced by hepatic cytochrome(s) P-450 to a free radical intermediate which, for the most part, remains closely associated with the enzyme, is reduced further and undergoes beta elimination of a chloride ion to form DCE. The occurrence of this reductive pathway in vivo was demonstrated by the quantitation of DCE and TCEA in blood from rats treated with 1,1,1,2-tetrachloroethane. PMID- 6488394 TI - Interaction of the photosensitization products of oestrone with DNA: comparison with the horseradish peroxidase catalyzed reaction. AB - The interaction with DNA of [4-14C]oestrone upon photosensitization with hematoporphyrin (HP) as a photosensitizer has been investigated. By means of Sephadex LH-20 gel filtration and extraction with dichloromethane it was found that, after irradiation (lambda greater than 425 nm) of a solution of HP, DNA and [4-14C]oestrone 21% of the radiolabel was associated with DNA. If DNA was added after irradiation 23% was bound to DNA, whereas 25% of the oestrone remained after photoreaction under the conditions applied. The binding occurs via the reactive 10 beta-hydroperoxy-1,4-estradien-3,17-dione, which is the only product after photosensitization of oestrone. The hydroperoxide has a strong interaction with DNA compared with that of other steroids. By repeated precipitation with 5 M NaCl and ethanol the association can be broken. It is reported, that binding of oestrone to protein induced by both photosensitization and horseradish peroxidase (HRPO)/H2O2 is irreversible, but that the amount of binding to DNA is dependent on the method of determination. However, neither the hydroperoxide nor its reduced product, a p-quinol, is intermediate or product in the HRPO catalyzed reaction of oestrogens. The tight association of the hydroperoxide product of oestrone with DNA, which may proceed via hydrogen bonding between the -OOH group and oxygen atoms of the backbone phosphate groups or of the furanose ring, might be a cause of chemical modification of DNA and of mutagenic effects. PMID- 6488395 TI - Saturation of repair system for O6-methylguanine in rat liver DNA by pretreatment with cyclic nitrosamines. PMID- 6488396 TI - Studies on positive inotropic agents. I. Synthesis of 3,4-dihydro-6-[4-(3,4 dimethoxybenzoyl)-1-piperazinyl]-2(1H)- quinolinone and related compounds. PMID- 6488397 TI - Studies on prodrugs. II. Preparation and characterization of (5-substituted 2-oxo 1,3-dioxolen-4-yl)methyl esters of ampicillin. PMID- 6488398 TI - Syntheses and anti-histaminic and anti-allergic activities of hexahydro-4-hydroxy 1-benzofuran-2-ones. PMID- 6488399 TI - Evaluation of 99mTc-labeled amino acids as radiopharmaceuticals. VI. N pyridoxylidenehydrazine-N',N'-diacetic acid. PMID- 6488401 TI - Synthesis and analgesic activity of cyclohexenylmethylamines and related compounds. PMID- 6488400 TI - Studies on antidiabetic agents. IV. Synthesis and activity of the metabolites of 5-[4-(1-methylcyclohexylmethoxy)benzyl]-2,4-thiazolidinedione (ciglitazone). PMID- 6488402 TI - Preparation of specific antisera to digoxin using hapten-[C-17]- and [C-12] bovine serum albumin conjugates. PMID- 6488403 TI - Protective effect of molybdenum on the acute toxicity of mercuric chloride. III. PMID- 6488404 TI - Peroxisomes in the liver of frog, Bombina orientalis. PMID- 6488405 TI - Changes in histone H1 phosphorylation during differentiation of mouse myeloid leukemia cells. PMID- 6488406 TI - Studies on acidic arginine esterase excreted in urine. I. Purification and characterization of dog urinary arginine esterase. PMID- 6488407 TI - Biopharmaceutical studies of thiazide diuretics. II. High-performance liquid chromatographic method for determination of hydrochlorothiazide in plasma, urine, blood cells and bile. PMID- 6488408 TI - Study of protein adsorption on glass surfaces with a hydrophobic fluorescent probe. PMID- 6488409 TI - Effects of beta- and gamma-cyclodextrins on release of betamethasone from ointment bases. PMID- 6488410 TI - Classification of drugs on the basis of bilirubin-displacing effect on human serum albumin. PMID- 6488412 TI - The formation of m-tyrosine and o-tyrosine in rats. PMID- 6488411 TI - Enhancement of rectal absorption of ampicillin by sodium salicylate in rabbits. PMID- 6488413 TI - A novel method for preparing liposome with a high capacity to encapsulate proteinous drugs: freeze-drying method. PMID- 6488415 TI - Effect of experimental acute renal failure on intestinal barriers to drug absorption. PMID- 6488414 TI - Synthesis and biological activities of bioisosteric O-carba-analogues of platelet activating factor (PAF). PMID- 6488416 TI - Phosphatidylcholine bilayers: subtransitions in pure and in mixed lipids. AB - Aqueous dispersions of C14, C16, C17 and C18 phosphatidylcholines (PC, where Cn denotes di-acyl of n carbons per chain), and mixtures of C14/C16PC and C16/C17PC were prepared and their thermal properties studied by differential scanning calorimetry (d.s.c.) after sample storage at 2-6 degrees C for up to 22 days. C16PC and C18PC display subtransitions at 22 degrees C and 29 degrees C, respectively, as previously reported by Chen et al. (Proc. Natl. Acad. Sci. U.S.A. 77 (1980) 5060-5063). C17PC shows two subtransitions at 21 degrees C and 26 degrees C, respectively, which are independent of each other. Although C16PC and C17PC individually develop subtransitions, an equimolar mixture does not. However, mixtures of C14/C16PC containing 10 or more mol% of C14PC do display a subtransition. These results underscore the primary dependence of subtransition formation in phosphatidylcholine dispersions on acyl chain structure. PMID- 6488417 TI - [Prevalence of hepatitis B surface antigen and determination of its subtypes in the Central African Republic]. AB - To contribute to the epidemiology of hepatitis B, the authors report the results of a survey made in Bangui. This survey was performed on patients hospitalized in the department of medicine of the University Hospital. Some of the patients had a clinically typical hepatitis. HBsAg prevalence was 15.4%. The subtypes detected were: ay (8%), ayw2 (4%), ayw4 (88%). Those data are compared with other data obtained through medical publications in Central Africa. PMID- 6488418 TI - [Arboviruses and lemurs in Madagascar: experimental infection of Lemur fulvus with attenuated strains of yellow fever virus]. AB - Experimental infections of the malagasy Lemur fulvus have been carried out with two yellow fever virus attenuated strains (17D and FNV vaccine strains). A viremia is detected, with FNV virus only, between the 1rst and 11th day after inoculation. Haemagglutination inhibiting, complement fixing and neutralizing antibodies appear around the 10th day; the study of their dynamics shows their persistence through less than 6 months. These preliminary experiments are the first of a series of infections of malagasy lemurs by several Flaviviruses. The results might allow to evaluate the epidemiological role played by these prosimian primates in the arbovirus cycles in Madagascar. PMID- 6488419 TI - [Efficacy of measles vaccination in young malnourished African children]. AB - A survey aiming at assessing the anti-measles vaccination efficiency among malnourished children, 1-3 years old, has been conducted in rural Upper-Volta. The haemagglutination inhibition technique has been used and antibodies titers higher or equal to 20 were considered as markers of protective immunity. Malnutrition does not seem to be a factor that decreases the anti-measles antibodies production, because there is no significative difference between seroconversion percentages of well and malnourished children. It is proposed that a new serological technique would be useful in the assessment of actual post vaccinal immunity, mainly in children with ages ranging from 6 to 12 months old. PMID- 6488420 TI - [A case of laryngeal leishmaniasis with a long course]. AB - The authors report a case of leishmaniasis of the larynx in the adult contracted in Algeria. The diagnosis was made by histopathology and the disease was surely present during a period of 2 years and perhaps for 23 years (beginning of the laryngeal infiltration). Once again, the problem of unicity of leishmaniasis is discussed. PMID- 6488421 TI - Urban cutaneous leishmaniasis in Kerman, Southeast Iran. AB - To determine the prevalence and the trend of urban cutaneous leishmaniasis in the city of Kerman, Southeast Iran, a survey was made in more than 35,000 children in 77 elementary schools and 36 junior high schools. The overall prevalence of the active lesion was 0.8% and the scar rate 4.4%, cases had been few before 1970, then started to increase and reached a maximum in 1977. Most probably, P. sergenti, is the vector because more than 95% of indoor sandflies were of this species. Active season of Sandflies was from late April to late October. PMID- 6488422 TI - [Ancylostomiasis in Congo children among the population of Brazzaville]. AB - The prevalence of hookworm infection was measured by means of stool examinations including direct examination and the Willis technique in 230 children between the ages of 2-14 years living in Brazzaville, People's Republic of the Congo. 120 of them were seen in a hospital. The overall prevalence was 24.3%. The prevalence increased with age until 6-8 years. A highest prevalence was found in male and, whatever the sex, in children in hospital for digestive disorders, anemia malnutrition and also febrile syndromes-malaria. Coproculture were used to settle the species of hookworm. In 37 positives cases, the proportions of Necator americanus and Ancylostoma duodenale were respectively 91.6% (34/37) and 16.2% (6/37). PMID- 6488423 TI - Autochthonous strongyloidiasis in Italy: an epidemiological and clinical review of 150 cases. AB - The Pavia District, Northern Italy, is an endemic area of strongyloidiasis. This study reviews the epidemiology and clinics of 150 cases. For this purpose, subjects were categorized for sex, age, origin, profession, acute and chronic disease, symptoms due to larval migration, immunodepression (if present). The incidence, with male predominance (74.7%), peaked among adults (94.6%), and in rural areas (69.3%). Patients experienced digestive (58.6%), cutaneous (34.6%) and respiratory complaints (16.7%). Thiabendazole was successful in most cases, except for 6 gastroresected subjects. Mebendazole at high doses (1 g t. i. d. X 10 days), was no valid alternative drug for 12 patients. PMID- 6488424 TI - [Report on intestinal parasitosis in adults in an urban population of the Central African Republic]. AB - The authors point out the frequency of intestinal parasitism in Bangui, biggest town and capital of the CAR. Out of 3,352 samples, 1,570 were found positive. The main parasites found were: Ankylostoma duodenale, 26,7%; Schistosoma mansoni, 20,8%; Entamoeba histolytica, 18,2%. The authors underline the polyparasitism. They also emphazide the differences with another study carried out in Algiers and surrounding areas. PMID- 6488425 TI - [Value of the string test in the diagnosis of duodenal parasitosis]. AB - Diagnosis of small intestine parasitosis can be realized by string-test. This examination, easily performed, does not produce side-effects in ninety percent of cases. The main problems are: good string unrollment and duodenal passing over. When Necator ova or gardia cysts are found in the stools by the Junod's technic, string-test is always positive. In one case, this latter even showed Schistosoma mansoni ova. Among 18 patients with unexplained hypereosinophilia, in spite of a parasitologic check up involving three stools examinations, the string-test showed Necator ova. With regard to strongyloidiasis, when properly performed, string-test is positive in seventy percent of cases. Therefore, this technic seems very useful on the field or in laboratories which do not usually realize the Junod's technic. PMID- 6488426 TI - [Human basophil degranulation test in the diagnosis of anguilluliasis. Preliminary results]. AB - The human basophil degranulation test was applied to the diagnosis of strongyloidiasis. The preliminary results show an excellent response. 33 of the 35 cases give a definite positive result and in the 15 control cases, with no parasitosis or an other helminthiasis, the test was negative. If these results are confirmed by a more important study of sensitivity and specificity, the test would be of interest when the parasitosis is of difficult evidence and especially by patients needing immunodepressive therapy. PMID- 6488427 TI - [Evaluation of the activity of mebendazole in taeniasis caused by Hymenolepis nana in Tunisia]. AB - Forty-two Tunisian patients suffering from Hymenolepis nana infection, were treated with 500 mg tablets of mebendazole, 3 times a day, 3 consecutive days for 5 patients (group I) and 4 consecutive days for 37 patients (group II). The faeces were examined during the third and fifth week, after treatment. 18 (42.8%) patients, 2 from group I and 16 from group II, were cured. The tolerance of the product was excellent and there were no adverse side-effects. PMID- 6488429 TI - [Between Yucatan, Florida and French Guiana does lobomycosis exist in the Antilles?]. AB - Lobomycosis, or Blastomicose queloidiforme de Jorge Lobo, has been described in men around the North of South America, Central America, and the case reported in Yucatan, Mexico, is the northest. The same disease has been seen in Dolphins in Florida, where the humans cases are unknown. Epidemiology, pathogenic curiosities, and diagnosis are presented for all practicians in the geographic area. PMID- 6488430 TI - Management of exercise in the elderly. AB - The principles of exercise management in the elderly are reviewed from the standpoint of the practising physician. The fitness needs of the older individual are defined, and practical methods of assessment are suggested for both the healthy and the partially disabled senior citizen. Attention should be directed to clinical status, aerobic power, body composition, muscular strength, flexibility, and the electrocardiographic response to vigorous exercise. Fitness standards for the elderly are discussed, and arguments are advanced for improving their personal fitness. Greater activity should prolong independence, improve lifestyle, upgrade moodstate, and help in the prevention of many medical disorders. The exercise prescription must include an adequate warm up and warm down. As condition permits, the aerobic component should be extended to 30 minutes of activity at 60% or more of maximum oxygen intake. Reasons for strengthening specific muscle groups, and methods of reducing the percentage of body fat are considered. Techniques of developing flexibility are presented, and adapted prescriptions are suggested for those with various disabilities. Methods of sustaining motivation are reviewed, and the need for immediate medical supervision of programmes is discussed. Finally, the gains from a training programme are evaluated. Although absolute physiological responses are less than in a younger individual, a suitably graded exercise prescription does much to improve both the physical ability and the mood state of a senior citizen. PMID- 6488428 TI - [First case of rhinoentomophthoromycosis observed in the People's Republic of the Congo (Congo Brazzaville)]. AB - The first case of rhinoentomophthoromycosis to be recognised in the People's Republic of the Congo (Congo Brazzaville) is reported. The patients was a 55 years old congolese male. The early symptoms consist of a progressive nasal obstruction with a massa inside of the nostril, initially diagnosed as a rhinoscleroma. One year later the patient had a prominent distorsion of the face and the histological lesions were characteristic of an entomophthoromycose. Cultures were positive for Conidiobolus coronatus. PMID- 6488431 TI - A test of aerobic capacity: description and reliability. AB - The purposes of this study were 1) to describe a maximal aerobic capacity (MAC) test and 2) to report on its reliability. Thirty subjects (16 males and 14 females) were tested for maximal aerobic power (MAP) with a progressive bicycle ergometer test and the ventilatory anaerobic threshold (VANT) was determined. MAC was measured as the amount of work that could be performed in 90 min on a bicycle ergometer at an intensity set individually from VANT. Subjects were asked to perform as much work as possible during this non-stop 90 min period. For females and males respectively, MAP reached 42.9 +/- 5.9 (mean +/- SD) and 56.0 +/- 4.7 ml O2/kg X min-1 (p less than .01), VANT 36.3 +/- 6.1 and 46.0 +/- 5.2 ml O2/kg X min-1 (p less than .01), max HR 198 +/- 8 and 195 +/- 9 (p greater than .05) and HR at VANT 187 +/- 9 and 180 +/- 10 (p greater than .05). The same subjects were tested twice for MAC within 7 days. Results expressed in kJ/kg reached 10.6 +/- 2.1 and 10.8 +/- 2.4 for females, 14.7 +/- 2.1 and 14.9 +/- 2.2 for males. Mean HR maintained during MAC were 174 +/- 11 and 174 +/- 9 for females and 169 +/- 10 and 170 +/- 10 for males. There was a non significant difference between means (p greater than .05) of the first and second test in total work performed in kJ/kg. This difference reached about 2% of the first test score, 32.7% of this difference occurring in the first 10 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488432 TI - Isokinetic strength and endurance and muscle fiber type of elite oarswomen. AB - Knee extension (KE) and elbow flexion (EF) isokinetic strength (at angular velocities of 0, 1.05, 2.09, 3.14 and 4.19 rad sec-1) and fatigue (strength loss over 50 isokinetic contractions) were examined in ten elite oarswomen and ten untrained subjects. Muscle fiber types of the corresponding muscles were determined for the oarswomen. The oarswomen had a lower slow twitch percentage than previously reported values for oarsmen, which is consistent with the shorter duration of the women's competitive race. A marked similarity was found between untrained subjects and oarswomen in 1) the patterns of the torque velocity curves of the strength measurements and 2) the patterns of the fatigue curves of the isokinetic endurance measurements. Although the patterns were similar, the entire curves for the oarswomen were displaced upward. For each group, however, the patterns of both the KE torque velocity and the isokinetic fatigue curves differed from the patterns of the corresponding curves for EF. These differences are likely due to inherent morphological or physiological characteristics of the two muscle groups. PMID- 6488433 TI - [Ventricular function in the normal subject and the coronary patient following exercise]. AB - The effect of acute exercise stress on cardiac function varies between individuals. This variation can be attributed to differences in the degree of physical fitness, quality of coronary circulation and myocardial oxygenation and contractility. Extended long term physical training regimes can induce chronic modifications of cardiac function in both healthy individuals and subjects with coronary artery disease. These modifications are evident at rest and during submaximal and maximal work levels. It is not yet clear however, that exercise training induces a hypertrophic response of the ventricular walls in either healthy subjects or coronary patients although it is generally accepted that the functional capacity of the myocardial tissue is improved in both cases. The present report reviews recent data regarding the modifications of cardiac function in both normal healthy subjects and cardiac patients following exercise training. PMID- 6488434 TI - Metabolic, hemodynamic, and respiratory responses to performing cardiopulmonary resuscitation. AB - The purpose of this study was to evaluate the cardiorespiratory demands inherent to the maintenance of continuous one- and two-man cardiopulmonary resuscitation (CPR) for 10 min. Ten male paramedics (X age = 26 yrs) certified to perform CPR participated. Each subject assumed the three possible roles for administering CPR: ventilator, compressor, and one-man technique. Cardiorespiratory responses were determined by impedance cardiography and open-circuit spirometry at 2 min intervals while performing CPR with a resuscitation manikin. Left ventricular performance was evaluated by impedance ventricular function indices (VFI) and systolic time intervals (STI). All three roles elicited an increase in oxygen uptake compared to kneeling rest, with the roles of one-man and compressor being the most demanding. There were moderate increases in cardiac output and heart rate during the exercise roles, but stroke volume remained similar to resting values. Pulmonary ventilation increased during exercise, with the greatest increase occurring for the one-man role. STI and impedance VFI reflected an enhanced ventricular performance while performing the roles of one-man and compressor. These findings suggest that the energetic demands placed on the rescuer depend upon the specific role assumed. Properly trained and experienced individuals can perform CPR efficiently for at least 10 min while eliciting only moderate physiological stress. PMID- 6488435 TI - Mechanical energy in sculling and in rowing an ergometer. AB - The purpose of this study was to quantify and contrast the instantaneous segmental and total body energy patterns of rowing a single scull racing shell with rowing a Gjessing (Norway) rowing ergometer (RE), and to contrast energy savings through exchanges of mechanical energy among segments and conversions of energy within segments. Four scullers, two male and two female, were filmed at three stroke rates while rowing on a stationary and a wheeled RE, and rowing in single sculls racing shells. Coordinates of joint markers were digitized, digitally filtered, and combined with estimated body segment parameters using link-segment mechanics to obtain segmental centre of gravity kinematics. Mechanical energy and internal work analyses were conducted to compute the energy savings due to exchange and interconversion of segmental energy. The internal work was least in the wheeled RE and greatest in the boat. Savings of energy through exchanges were greatest in the boat, and least in the stationary RE. Savings of energy through interconversion were greatest in the wheeled RE. The interconversions (expressed as a percentage of total work) were quite similar for both the boat and the stationary RE. The additional energy savings with the wheeled RE allow the conclusion that wheeled RE testing will permit athletes to work at stroke rates similar to racing levels. PMID- 6488436 TI - The natural isotope tracing with 13C: a non-invasive method for studying the metabolism during exercise. PMID- 6488438 TI - Synergistic antitumor activity of vincristine and VP-16-213. AB - The potential interaction of the antitumor agents vincristine and VP-16-213 was investigated in vivo. DBA/2 mice were inoculated with 10(6) P388 murine leukemia cells, after which single IP injections of saline only, vincristine only, VP-16 213 only, or a combination of vincristine and VP-16-213 were administered. Long term survival (greater than 60 days) was observed in 0/45, 1/45 (2%), 9/135 (7%), and 44/135 (33%) mice, respectively (P less than 0.001). Treatment was most effective when VP-16-213 was administered 0-72 h after vincristine. A similar trend was observed in mice bearing P1534 murine leukemia. These data demonstrate synergistic antitumor activity between vincristine and VP-16-213 in a murine model. PMID- 6488437 TI - Pharmacological studies of ricin in mice and humans. AB - A highly sensitive enzyme-linked immunosorbent assay (ELISA) for determination of ricin in serum is presented. Using this method it was found that IV-injected ricin disappeared from the plasma of mice and cancer patients according to first order kinetics. DBA mice were found to be more sensitive to ricin than C3H and B6D2 mice. When mice of the different strains were given the same dose of ricin, the concentrations found in liver, spleen, and kidneys were highest in the most sensitive mice. Ricin disappeared most rapidly from serum of the mice with the highest sensitivity. The inverse correlation between the rate of disappearance of ricin from serum and the tissue concentrations reached may be due to the fact that ricin is rapidly and firmly bound to cell surface receptors. Whole-body autoradiography after IV injection of 125I-labeled ricin showed the highest amount of radioactivity in liver, spleen, and adrenal cortex. Considerable amounts of radioactivity were also present in bone marrow, showing that the lack of myelosuppressive activity of ricin previously found in mice and dogs cannot be accounted for by the failure of ricin to reach the bone marrow. Part of the ricin in the tissues was present in the form of free chains, the highest fraction being present in the liver. In this tissue both the free A-chains and those present in whole ricin were found to be modified. However, the modified A-chains had retained their full capacity to inhibit protein synthesis in vitro. In cancer patients, toxicity appeared at about the same initial serum levels as in the mice, supporting the view that mouse data have a good predictive value for man. At each dose level the individual variations were modest, a finding that is important for eventual clinical use of this potent drug. PMID- 6488439 TI - Structure-intestinal transport and structure-metabolism correlations of some potential cancerostatic pyrimidine nucleosides in isolated rat jejunum. AB - Both transport and biotransformation processes for a series of pyrimidine nucleobases, ribonucleosides, 2'-deoxyribonucleosides, and acetyl and 5' substituted derivatives of the cancerostatic agent araC were studied in the isolated everted rat jejunum with a continuous perfusion technique. Metabolic alterations during penetration were assessed by HPLC. 5'-Halogeno and 5'-deoxy derivatives of cytosine nucleosides exhibited higher transport rates and higher stability towards the deamination reaction than did unsubstituted derivatives. Octanol-buffer partition coefficients were estimated for the study compounds, and fragmental constants for the sugar moieties of nucleosides were assessed. With the present study compounds there was no correlation between lipophilicity and transport rate, as previously reported, but there was a correlation between lipophilicity and metabolic alteration of araC derivatives (r = 0.99, n = 5). PMID- 6488440 TI - Potential limitations of in vitro clonogenic drug sensitivity assays. AB - P388 murine leukemic cells lines which were resistant (P388R) or sensitive (P388S) to adriamycin (adr) were used to evaluate the potential utility of in vitro clonogenic assays for detecting and quantitating the number of adr resistant cells present in a cell mixture. The progeny of P388S cells that had been exposed for 1 h or continuously to adr were as sensitive to the drug as the original P388S cells. Serial passages in the presence of adr, however, resulted in the selection of adr-resistant cells, but even these cells varied in their level of resistance. When P388S and P388R cells were mixed together and exposed to adr, the clonogenic assay consistently overestimated the proportion of P388S cells present. These studies demonstrate some of the inherent limitations of clonogenic drug sensitivity assays and may provide an explanation for the reported discrepancies between in vitro drug sensitivity and clinical responses to therapy reported in the literature. PMID- 6488441 TI - Pharmacokinetic study of VM26 given as a prolonged IV infusion to ovarian cancer patients. AB - Plasma levels of VM26 were assayed by HPLC in six ovarian cancer patients with normal renal and liver function who received the drugs as an initial 1-h IV infusion of 80 mg/m2 followed by a 24-h IV infusion of 120 mg/m2. These doses and infusion rates were chosen on the basis of mean VM26 clearance values found in a previous study, with the aim of reaching plasma steady-state levels of approximately 6 micrograms/ml in a short time. Plasma steady-state levels of 4-10 micrograms/ml, close to those predicted theoretically, were in fact attained at 4 9 h during the second, slower infusion. Mean half-lives and clearance values were 8.6 +/- 1.1 h and 0.78 +/- 0.08 l/h/m2. Six percent of the VM26 dose was recovered as unchanged drug in the urines collected up to 24 h after the end of infusion. The glucuronide of VM26 aglycone (4'-demethylepipodophyllotoxin) was identified in the urine of all patients, in amounts corresponding to about 8% of the drug dose. PMID- 6488442 TI - A combination of 5-fluorouracil and thymidine in advanced colorectal carcinoma. AB - Concurrent administration of thymidine (TdR) has been shown to increase the antitumor activity of 5-fluorouracil (5-FU) in various experimental models. The clinical response rate, side-effects, and toxicity of 5-FU and TdR were evaluated in 27 patients with advanced colorectal carcinomas. Each 6-day treatment course consisted of an IV loading dose of TdR (405 mg/kg, over 30 min), followed by continuous IV infusions of 5-FU (7.5 mg/kg per day for 5 days), and TdR (216 mg/kg per day for 6 days); courses were repeated every 4 weeks. The overall partial response rate was 4.5%, or 16.7% in patients with no prior 5-FU chemotherapy. Short-lived stable disease was seen at an overall rate of 27.3%, half of these patients with prior 5-FU chemotherapy. Myelotoxicity occurred in 64% of the patients, but this was dose-limiting in only 20%. Gastrointestinal and neurological symptoms were mild and infrequent. There was one case of treatment related death due to sepsis secondary to leukopenia. It is concluded that the concurrent IV administration of 5-FU and TdR does not improve the response rate over that obtained with 5-FU alone. PMID- 6488443 TI - Bisantrene (NSC 337766) (CL 216,942) in advanced breast cancer. A cancer and leukemia group B study. AB - Bisantrene (NSC 337766) is an anthracenedicarboxaldehyde hydrazone demonstrating a wide spectrum of activity in animal tumor model systems with no evidence of cardiotoxicity or alopecia, in contrast to doxorubicin. Thirty-three women with advanced adenocarcinoma of the breast were treated with 260 mg/m2 IV every 3 weeks. All patients had received at least one prior combination chemotherapy regimen for metastatic disease and 32/33 were refractory to doxorubicin. Of 28 patients evaluable for response one had a partial response lasting 10 weeks and three patients had stable disease for 22, 22, and 9 weeks. The most significant toxicities were nonhematologic: nausea and vomiting (41%), phlebitic reactions (38%), hypotension, one fatal anaphylactic reaction, and the development of a 7th cranial nerve palsy during drug infusion. Hematologic toxicity, leukopenia, was dose-limiting but manageable without associated infections or bleeding. These results indicate that bisantrene in this dose and schedule is not a useful drug in heavily pretreated breast cancer patients. The incidence and severity of phlebitic reactions limited venous access and adversely affected patient compliance. Preliminary results of other phase II breast cancer trials indicate a similar spectrum of toxicity but suggest more significant antitumor activity even in patients previously treated with doxorubicin. Trials conducted in patients with minimal prior treatment and with bisantrene administered via central line appear warranted for definitive assessment of the activity of this agent in breast cancer. PMID- 6488444 TI - Kinetics and sensitivity of daunorubicin in patients with acute leukemia. AB - Leukemia cells isolated from eight patients with acute leukemia before treatment were examined for in vitro uptake of daunorubicin (DNR) and inhibition of DNA synthesis. In addition, plasma and cellular levels of DNR and daunorubicinol (DOL) were examined in six of the eight patients. Inhibition of DNA synthesis was determined with a 3H-thymidine incorporation assay. In vitro cellular 14C-DNR was quantified by means of liquid scintillation spectrometry, whereas in vivo DNR and DOL concentrations were determined by high-performance liquid chromatography. In vitro intracellular plateau concentrations of DNR were achieved within 1-2 h after continuous exposure to 0.01, 0.1, and 1.0 microgram/ml in the majority of cases. Based on our in vitro studies, a dose-response curve was found between increasing intracellular DNR and incorporation of 3H-thymidine. Peak intracellular levels of DNR after treatment occurred immediately after administration of the drug, whereas intracellular DOL levels accumulated over several hours. Plasma concentrations of DNR and DOL were not useful in estimating target tissue concentrations or inhibition of 3H-thymidine incorporation. Extrapolation of in vivo cellular DNR concentrations to the in vitro dose response curve allows an estimate of DNR sensitivity. PMID- 6488445 TI - Bronchopulmonary effects of elliptinium in anesthetized dogs. AB - The bronchoconstrictor effect of elliptinium already demonstrated in the guinea pig is shown in the dog. It is less intense and its onset is prompter. Successive administration of identical doses of elliptinium attenuates the bronchospasm induced, suggesting tachyphylaxis. The previously described indirect bronchoconstrictor effect involving endogenous mediators seems also to be active in these circumstances. PMID- 6488446 TI - Role of free radicals in the initiation and promotion of radiation transformation in vitro. AB - We have studied the effects of superoxide dismutase (SOD), catalase, Cu(II) (3,5 diisopropylsalicylate)2 (CuDIPS) and other copper compounds on radiation transformation in vitro using C3H 10T1/2 cells. When present only during irradiation, high concentrations of SOD in the medium enhanced transformation, while catalase, inactivated SOD (autoclaved), CuDIPS, cupric chloride and cuprous chloride inhibited the initiation phase of radiation transformation. SOD, catalase and CuDIPS did not affect the expression phase of radiation transformation. Suppression of the TPA enhancement of transformation by catalase was a highly significant effect, while the suppression by SOD was not of statistical significance. Our results suggest that hydrogen peroxide (H2O2) may be important in the cellular damage leading to malignant transformation. PMID- 6488447 TI - On mechanisms of sex differences in chemical carcinogenesis: effects of implantation of ectopic pituitary grafts on the early stages of liver carcinogenesis in the rat. AB - The resistant hepatocyte model was used to investigate the influence of pituitary factors on the early events of chemical carcinogenesis in rat liver. Diethylnitrosamine (DEN), 200 mg/kg body weight, was used as an initiator of enzyme altered foci. Two weeks after initiation the rats were placed on a 0.02% (w/w) 2-acetylaminofluorene (2-AAF) diet for two weeks. Partial hepatectomy (70%) was performed three weeks after initiation. The rats were killed four to six weeks after DEN initiation. Sex differences in area/foci as well as in area ratio (mm2 foci/cm2 liver section) were found in liver sections from sexually mature male and female rats (male greater than female) of both the Sprague-Dawley and Wistar strains. Ectopic pituitary grafts (PG:s) implanted under the kidney capsule of male Wistar rats one week before DEN initiation and removed by unilateral nephrectomy one week after initiation did not influence the number or area of enzyme altered foci as compared with sham operated male rats. On the other hand, PG:s implanted one week before 2-AAF selection in male Wistar rats and allowed to remain until the rats were killed two weeks after the 2-AAF selection period, decreased the area ratio to a level close to that of sham operated female rats, whereas no effect on the number of enzyme altered foci was found. The results suggest that the hypothalamo-pituitary axis may be involved in the regulation of early stages of liver carcinogenesis. PMID- 6488448 TI - Visualization of chromatin events associated with repair of ultraviolet light induced damage by premature chromosome condensation. AB - The purpose of this study was to characterize a system with which to study chromatin events associated with the repair of u.v. light-induced damage. Quiescent normal human fibroblasts were irradiated with u.v. and the ensuing chromatin events were visualized by inducing premature chromosome condensation in the treated cells. Treatment with u.v. induced the following two types of chromatin changes reflected in the morphology of G1 premature condensed chromosomes (PCC): (i) a generalized elongation of the G1 PCC and (ii) regions of localized elongation or gaps. The degree of chromatin change was dose dependent and could be seen immediately after irradiation. The generalized elongation process continued to increase for 24 h after irradiation, suggesting it represented a cellular reaction to the u.v.-induced damage, rather than a direct physical distortion. The localized decondensation reaction was associated with the site of unscheduled DNA synthesis. Posttreatment incubation of cells in the presence of cytosine arabinoside and hydroxyurea resulted in an accumulation of gaps. The inhibitor novobiocin predominantly inhibited the formation of gap regions, suggesting that a topoisomerase-like reaction might be important in their formation. The presence of cycloheximide after u.v. irradiation had no effect on the chromatin changes, suggesting that no new protein synthesis is required for these chromatin processes associated with repair. These results suggest that the PCC technique is useful in elucidating chromatin changes associated with DNA repair after u.v. treatment and can be used to elucidate chromatin events associated with the repair of other DNA-damaging agents. PMID- 6488449 TI - Metabolism and DNA adduct formation of 2-acetylaminofluorene by bladder explants from human, dog, monkey, hamster and rat. AB - Cultured bladder explants from human, dog, monkey, hamster and rat were used to study the metabolism, and DNA-adduct formation of [3H]2-acetylaminofluorene (AAF). After 24 h of incubation with 1 microM [3H]AAF, the organic-soluble and glucuronide fractions represented 29.0-58.4% and 0.7-10.8%, respectively, of the total amount of radioactive material in the medium. In the organic-soluble fraction of all species, the presence of both ring-hydroxylated (at the 7-, 9-, 5 , 3- and 1-carbons) metabolites and N-hydroxy-AAF could be demonstrated, with 7 hydroxy-AAF and 9-hydroxy-AAF being the most ubiquitous metabolic products. In addition, 2-aminofluorene could be detected in all cases with the highest amounts formed by dog bladder explants. Species susceptible to aromatic amine-induced bladder carcinogenesis (human and dog) showed widely varying DNA binding (0.23 +/ 0.20 and 1.95 +/- 1.2 mumol AAF/mol deoxyribonucleotide, respectively), and in explants of the less susceptible species (monkey, hamster and rat) DNA binding was comparable (0.46 +/- 0.21, 0.37 +/- 0.07 and 0.34 +/- 0.27, respectively). Enzymatic hydrolysis of the [3H]AAF--DNA to the nucleoside level revealed that N (deoxyguanosine-8-yl)-2-aminofluorene, together with small amounts (5.9-15.4% of the total) of its imidazole ring-opened derivative, was the most ubiquitous adduct formed (17.8-47.2% of the total) in all species, except the dog. In dog bladder DNA, N-(deoxyguanosine-8-yl)-2-acetylaminofluorene was the principal DNA adduct (39.0-46.5% of the total) with smaller amounts (15.5-22.2% of the total) in the other species. In addition, small amounts (3.5-8.6% of the total) of another adduct, 3-(deoxygaunosin-N2-yl)-2-acetylaminofluorene, could be detected in all cases. It is concluded that bladder explants of the human, dog, monkey, hamster and rat metabolize AAF mainly to ring-hydroxylated products, but also form small amounts of the proximate carcinogenic metabolite N-hydroxy-AAF. Neither the overall binding of AAF to bladder DNA, nor the formation of specific AAF--DNA adducts is correlated with the relative susceptibilities of these five species to aromatic amine-induced urinary bladder carcinogenesis. PMID- 6488450 TI - Repair of lethal, mutagenic and transforming damage induced by X-rays in golden hamster embryo cells. AB - We compared the frequencies of mutation and morphological transformation in relation to the repair of potentially lethal damage (PLD) and sublethal damage (SLD) in X-irradiated golden hamster embryo (GHE) cells. The repair of PLD induced in GHE cells by X-rays was shown to be an error-free process which reduced the frequency of mutation and morphological transformation. However, if cells were irradiated with doses divided into two halves separated by various time intervals to study repair of SLD, the frequency of mutants and morphological transformants depended upon the length of the interval between the doses. If the interval was 2 h, the frequency of mutants and transformants was lower than if the total dose were delivered in a single exposure. If the interval was 4 h, these frequencies were higher than the latter. The transformation frequencies remained high even if this interval was increased to 12 h, but the frequency of mutants decreased again. Thus, enhancement of mutant or transformant frequency by a second exposure to X-rays, 4 h after the first irradiation, correlated with recovery of DNA synthesis in the X-irradiated cell populations. Studies with synchronized cells also showed that induction of mutants and transformants was highest in cells irradiated at the DNA synthesis (S) phase. These results suggest that DNA synthesis plays a critical role in the process of X-ray-induced morphological transformation and mutagenesis. PMID- 6488451 TI - Low dose rate ionizing radiation induces increased growth capacities of d deletion retinoblastoma skin fibroblasts. AB - Skin fibroblasts from normal children and three children with a 13q deletion retinoblastoma (Rb) were exposed to cumulative low doses of gamma rays. The typical response of normal donors was a reduction in the lifespan of irradiated fibroblasts, the precocity of the decline being inversely related to the dose received. In contrast, the lifespan of one Rb cell line (Rb1) was prolonged; irradiated cells with an increased growth potential showed a higher number of cells at confluency and more cells were entering DNA synthesis phase than in non irradiated cells. Another Rb cell line (Rb2) demonstrated a normal lifespan following irradiation but foci were observed in irradiated cultures. Cytogenetic analysis revealed no selection of abnormal clones in these cell populations. The third Rb line examined (Rb3) responded like a normal cell line. We suggest that irradiated skin fibroblasts derived from some patients with Rb are in certain cases able to express abnormal growth capacities which may be one of the manifestations of the high susceptibility of the individual's stromal cells to carcinogenic agents. PMID- 6488452 TI - Tumorigenicity of fluoranthene in a newborn mouse lung adenoma bioassay. AB - A 24 week lung adenoma bioassay using newborn mice was employed to determine the tumorigenicity of fluoranthene, a common environmental polynuclear aromatic hydrocarbon. A 6.5-fold elevation of lung tumor incidence (58%) and a 12-fold increase in numbers (1.08 tumors/mouse) was observed in animals treated with the highest dose (3.5 mg/mouse), but no increase in tumor incidence was induced by 700 micrograms/mouse. Benzo[a]pyrene, used as a positive control at a comparatively low dose (280 micrograms/mouse), was highly potent, inducing lung tumors in 94% of the animals and elevating their number by 44-fold (4.0 tumors/mouse). Most of the mice treated with the highest dose of benzo[a]pyrene (1.4 mg/mouse) died with massive injection site sarcomas. Male mice, surviving for 24 weeks in fluoranthene and benzo[a]pyrene treatment groups that developed lung tumors, had 2- to 3-fold more tumors than comparably treated females. This is the first reported evidence of tumorigenicity of fluoranthene. The significance of these findings in terms of bioassay sensitivity and the implications regarding human health have been discussed. PMID- 6488453 TI - An alternative assay system for the detection of transforming genes. AB - We have developed an alternative assay system based on DNA mediated gene transfer (DMGT) for the detection of functional transforming genes which we find more sensitive and reliable than other assay systems. This approach involves selecting in tissue culture for cells which are expressing a drug-resistance marker co transferred with the tumour DNA thus isolating the small number of cells which have taken up and are expressing exogenously added DNA. The ability of transformed cells present in this drug-resistant cell population to form tumours in athymic (nu/nu) nude mice was then used to assay for transforming genes. Using NIH3T3 and Rat 2 cells as recipients, tumours produced after DMGT with DNA from non-tumorgenic cells were only very rarely observed. Tumour induction was observed using DNA from a biopsy of a human ovary carcinoma and a spontaneous murine lung carcinoma. Two human retinoblastoma cell lines were negative for tumour induction. The transforming gene from the ovarian carcinoma was identified as c-K-ras2. PMID- 6488454 TI - Lack of genotoxic activity of di(2-ethylhexyl)phthalate (DEHP) in rat and human hepatocytes. AB - Di(2-ethylhexyl)phthalate (DEHP) is a widely used plasticizer which has been reported to induce a statistically significant increase in the incidence of hepatocellular carcinomas in female Fischer-344 rats (8/50) when administered in the diet at 12 000 p.p.m. for two years. Numerous studies with cells in culture have failed to show any genotoxic activity associated with DEHP. Because DEHP induces multiple changes in the liver, such as peroxisomal proliferation, it was possible that these alterations could result in genotoxic effects in the treated whole animal that would not be seen in cells in culture. Accordingly, the ability of DEHP to induce DNA damage or repair was examined in rat hepatocytes in vivo and in vitro and in human hepatocytes in vitro. Unscheduled DNA synthesis was measured by incorporation of [3H]thymidine into primary hepatocyte cultures immediately isolated from treated animals or hepatocyte cultures incubated directly with DEHP. DNA damage was measured by alkaline elution of cellular DNA from the same cultures. In vivo-in vitro treatment regimens were: (i) female rats, 12 000 p.p.m. DEHP in the diet for 30 days; (ii) female rats, 12 000 p.p.m. in the diet for 30 days, followed by 500 mg/kg DEHP by gavage 2 h before sacrifice; (iii) male rats, 500 mg/kg DEHP by gavage 2, 12, 24, or 48 h before sacrifice; and (iv) male rats, 150 mg/kg/day by gavage for 14 days. In vitro conditions were 0.1, 1.0 and 10.0 mM DEHP in the cultures for 18 h. Primary cultures of human hepatocytes were prepared from freshly discarded surgical material and exposed to the same concentration of DEHP. Concentrations up to 0.5 mM mono(2-ethylhexyl)phthalate, a principal metabolite of DEHP, were also examined in the human hepatocyte assay. No chemically induced DNA damage or repair was observed in vivo or in vitro in rat or human hepatocytes under any of the conditions employed. However, an increase in the percentage of cells in S phase in the animals given DEHP was observed. These data indicate that DEHP does not exhibit direct genotoxic activity in the animals even with a treatment regimen which eventually produced tumors in a long term bioassay, and that both rat and human hepatocytes are similar in their lack of a genotoxic response to DEHP exposure in culture. PMID- 6488455 TI - Relationship between a chromatin anomaly in ataxia-telangiectasia cells and enhanced sensitivity to DNA damage. AB - The cellular basis for the enhanced sensitivity to ionising radiation and some DNA damaging chemicals in ataxia-telangiectasia (AT) cells is not clearly understood. Abnormalities in cell-cycle traverse, chromosome stability and DNA synthesis patterns have suggested that a chromatin associated defect may be the primary lesion in AT. This study involves an attempt to define such an anomaly by the use of a vital DNA specific bis-benzimidazole dye (Hoechst 33342) and deoxyribonuclease II as probes for chromatin organisation in intact and permeabilised human cells respectively. Despite similar DNA binding characteristics (determined by flow cytometry) of Ho33342 in normal and AT transformed fibroblasts, the AT cells show: (i) enhanced cell killing and increased accumulation of cells in G2 phase of the cell-cycle [both biological responses being relatively resistant in AT cells to modification by an inhibitor of poly (ADP ribosyl)ation], (ii) no resistance of de novo DNA synthesis to Ho33342-induced inhibition, (iii) elevated levels of slow-rejoining ligand induced DNA strand-breaks, and (iv) enhanced expression of chromatin regions accessible to an exogenously supplied endonuclease. The results are interpreted on the basis that a chromatin anomaly of enhanced nuclease susceptibility, involving a minor fraction of the genome, may be a controlling factor in the expression of the various in vivo and in vitro characteristics of AT cells. PMID- 6488456 TI - The effect of 3-methyl substitution on the carcinogenicity of nitroso-4 piperidone. AB - The carcinogenic activity of the 3-methyl derivative of nitroso-4-piperidone was compared with that of the compound without the methyl group, by chronic administration to rats at equimolar doses in drinking water. Nitrosopiperidone induced both liver and esophageal tumors, whereas the 3-methyl derivative induced only tumors of the esophagus in a much shorter time. PMID- 6488457 TI - Protease inhibitor antipain reduces nuclear binding of estrogen-receptor complex in MCF-7 breast tumor cells. AB - We have initiated studies to ascertain the effects of protease inhibitors on specific steroid hormonal-related events as they occur in cultured cells, in an attempt to identify hormone-related processes perturbed by these inhibitors. We report here that the presence of antipain during incubation of cultured MCF-7 breast tumor cells with estradiol-containing medium considerably reduces the extent of nuclear binding of the estradiol-receptor complex. PMID- 6488458 TI - The induction of liver cancer by dietary deficiency of choline and methionine without added carcinogens. AB - Fischer 344 male rats fed a choline-methionine deficient diet for from 13 to 24 months developed a 100% incidence of putative preneoplastic hepatocyte nodules and a 51% incidence of hepatocellular carcinoma. The addition of 0.8% choline chloride completely prevented the development of both the nodules and the cancer. The diet contained no added known carcinogen. Analysis of the deficient and supplemented diets revealed no detectable volatile nitrosamines or nitrosamides, nitrite, nitrate or malonaldehyde, less than 0.9 p.p.b. aflatoxin B1 and barely detectable levels of Ames positive material with one strain of Salmonella typhimurium. These findings indicate that a dietary deficiency of choline and methionine can be a major rate limiting factor in the development of liver cancer. PMID- 6488459 TI - Identification of ring oxidized metabolites of 1-nitropyrene in the feces and urine of germfree F344 rats. AB - 1-Nitro[U-4,5,9,10-14C]pyrene in trioctanoin was administered by gavage to male germfree F344 rats. Extracts of the 120 h feces and urine were analyzed by h.p.l.c., with or without acetylation. 4,5-Dihydro-4,5-dihydroxy-1-nitropyrene, 1 nitro-3-hydroxypyrene, 1-nitro-6-hydroxypyrene and 1-nitro-8-hydroxypyrene but not 1-aminopyrene, 1-amino-6-hydroxypyrene or 1-amino-8-hydroxypyrene were identified by co-chromatography with standards. These results are in contrast to those obtained in the conventional F344 rat in which 1-aminopyrene, 1-amino-6 hydroxypyrene, and 1-amino-8-hydroxypyrene were fecal and urinary metabolites, indicating that intestinal microflora are involved in their formation. PMID- 6488460 TI - Absence of DNA breaks during repair of DNA-protein cross-links induced by the mycotoxin botryodiplodin in mammalian cells. AB - Botryodiplodin induces DNA-protein cross-links (DPC) in mammalian cells in culture. Removal of the mycotoxin followed by incubation of cells in fresh medium leads to the gradual disappearance of DPC. The present experiments attempted to determine to what extent the repair mechanism acts through a system involving transient formation of single-strand breaks (SSB). The data reported here show that no SSB were detected in DNA of various strains of cells, even in the presence of inhibitors (hydroxyurea and 1-beta-D-arabinofuranosyl cytosine). These data demonstrate that neither the base excision, nor the excision repair process was involved in the repair of DPC or of any other lesions induced by botryodiplodin in mammalian cells. PMID- 6488461 TI - The effect of methyl substituents on the in vitro metabolism of cyclopenta[a]phenanthren-17-ones: implications for biological activity. AB - The in vitro metabolism of 15,16-dihydrocyclopenta[a]phenanthren-17-one and its 11- and 12-methyl derivatives has been compared. All three compounds form trans 3,4-dihydrodiols having quasi-diequatorial conformations and 3R,4R configurations. The trans-3,4-dihydrodiol of the mutagenic, but non-tumorigenic 15,16-dihydrocyclopenta[a]phenanthren-17-one appears to undergo stereospecific epoxidation to a syn-diol epoxide. By contrast the 3,4-dihydrodiol of the nontumorigenic 15,16-dihydro-12-methylcyclopenta[a]phenanthren-17-one appears to undergo stereospecific epoxidation to an anti diol-epoxide equivalent to that generated from 15,16-dihydro-11-methylcyclopenta[a]phenanthren-17-one which is a strong carcinogen. These results are discussed with reference to the biological activities of the parent compounds. PMID- 6488462 TI - Asbestos and benzo[a]pyrene act synergistically to induce squamous metaplasia and incorporation of [3H]thymidine in hamster tracheal epithelium. AB - When exposed to either crocidolite asbestos (single 1-h exposure to 0.4 mg/ml medium) or the polycyclic aromatic hydrocarbon, benzo[a]pyrene (BaP) (less than or equal to 2.5 micrograms/ml medium, 1x weekly for 4 weeks), the epithelium of hamster tracheal explants exhibits insignificant amounts of squamous metaplasia, an atypical lesion, in comparison to amounts observed in untreated tissues. Incorporation of [3H]thymidine, an indication of DNA synthesis by epithelial cells, likewise is unchanged. However, the extent of squamous metaplasia and numbers of labeled basal and suprabasal cells are increased substantially when BaP and asbestos are added in combination. These results suggest an important mechanism of co-carcinogenesis involving chemical and physical carcinogens and support epidemiologic observations documenting an increased risk of bronchogenic carcinoma in asbestos workers who smoke. PMID- 6488463 TI - The metabolism of 9,10-dimethylanthracene by rat liver microsomal preparations. AB - The metabolism of the weakly-carcinogenic hydrocarbon, 9,10-dimethylanthracene (DMA) by rat-liver microsomal preparations has been examined. 9-Hydroxymethyl-10 methylanthracene (9-OHMeMA) and 9,10-dihydroxymethyl-anthracene (9,10-DiOHMeA) were identified as metabolites by comparing their chromatographic and spectral properties with those of the authentic compounds. The trans-1,2-dihydro-1,2 dihydroxy derivative of DMA (DMA 1,2-diol) was the major metabolite formed which was identified by its chromatographic, u.v., n.m.r. and mass spectral properties. The dihydrodiol was also formed in the oxidation of DMA in an ascorbic acid ferrous sulphate-EDTA system. Two other dihydrodiols that were formed from DMA by metabolism appeared to be the trans-1,2- and 3,4-dihydrodiols of 9-OHMeMA (9 OHMeMA 1,2-diol and 9-OHMeMA 3,4-diol) and the further metabolism of DMA 1,2-diol yielded both of these dihydrodiols. When 9-OHMeMA was further metabolized, two main metabolites were formed; one was identified as 9,10-DiOHMeA and the other appeared to be 9-OHMeMA 3,4-diol. No metabolites were detected when 9,10-DiOHMeA was incubated with rat-liver microsomal fractions. PMID- 6488464 TI - Carcinogenicity of dichloroacetylene: an inhalation study. AB - Dichloroacetylene (DCA) is a by-product of the synthesis of certain chlorinated, aliphatic hydrocarbons (e.g., vinylidene chloride). In a long-term carcinogenicity inhalation study, groups of 30 male and 30 female rats and mice were exposed to DCA vapour under the following conditions: mice, group I: 9 p.p.m. 6 h/day, 1 day/week for 12 months; group II: 2 p.p.m. 6 h/day, 1 day/week for 18 months; group III: 2 p.p.m. 6 h/day, 2 days/week for 18 months; rats: 14 p.p.m. 6 h/day, 2 days/week for 18 months; controls: under identical conditions except for addition of DCA to breathing air. The most important result is a striking increase in the formation of kidney cystadenomas of the proximal tubuli in all DCA exposed animals. The median latency time of this tumor varied widely in both mice and rats. Renal cystic adenocarcinomas were found in statistically significant numbers in male mice. In addition to kidney tumors, the development of cystadenomas of the Harderian gland in mice and of liver cholangiomas in rats were highly significant findings. DCA failed to induce liver tumors in mice. Our results confirm that DCA possesses a high carcinogenic potential, pronounced organotropic properties and distinct species differences referring to the number and nature of the induced tumors. The risk associated with handling chlorinated aliphatic hydrocarbons is essentially increased by the decomposition product DCA. PMID- 6488465 TI - The bay-region geometry of some 5-methylchrysenes: steric effects in 5,6- and 5,12-dimethylchrysenes. AB - The presence of a bay-region methyl group in carcinogenic polycyclic aromatic hydrocarbons leads to considerable distortion in the molecule. This is illustrated in the structures, obtained by X-ray diffraction techniques, of 5,12- and 5,6-dimethylchrysene. The molecular distortions result from steric requirements, such as that the minimum H...H distance is 1.8 A and the minimum C...C distance is 2.90 A; distortions to accommodate these requirements may be both in-plane (by increasing the angles at carbon atoms in the bay-region from 120 degrees to approximately 124 degrees) and out-of-plane by torsion about certain bonds in the bay-region. It is shown that more in-plane distortions are found for 5-methylchrysene derivatives than for methylbenz[a]anthracene derivatives and this, it is suggested, results from the nature of the flexibility of the chrysene compared with the benz[a]anthracene fragment at the bay-region. PMID- 6488466 TI - Comparison of primary hepatocytes and S9 metabolic activation systems for the C3H 10T 1/2 cell transformation assay. AB - Three metabolic activation systems, primary rat hepatocytes, primary mouse hepatocytes and Aroclor 1254-induced rat liver S9 fraction were examined as exogenous activation systems for the C3H-10T 1/2 cell transformation assay. Under the conditions of the assay the primary mouse hepatocytes were more effective than the rat S9 fraction in mediating the transformation of C3H-10T 1/2 cells by the antineoplastic drug cyclophosphamide. However, the S9 fraction was more consistent than the mouse hepatocytes in the activation of dimethylnitrosamine. The primary rat hepatocytes were ineffective for activating either cyclophosphamide or dimethylnitrosamine in the transformation of C3H-10T 1/2 cells. The presence of mouse hepatocytes, but not the S9 fraction, inhibited transformation of C3H-10T 1/2 cells by 3-methylcholanthrene. These results demonstrate that the three systems were differentially effective in the activation of procarcinogens. PMID- 6488467 TI - Reproductive toxicity associated with endometrial cell mediated metabolism of benzo[a]pyrene: a combined in vitro, in vivo approach. AB - We have demonstrated the effect of a highly mutagenic metabolite of benzo[a]pyrene (BP) on postimplantation development of mouse blastocysts exposed in vitro. The full spectrum of metabolism of BP from microsomes of a nontumorigenic, estradiol responsive, mouse endometrial cell strain was established. The mouse endometrial cell microsomes showed inducible cytochrome P 450 mediated oxidation of BP(-)-trans 7,8-dihydrodiol to BP 7,8-dihydrodiol 9,10 epoxides which affect implantation and subsequent development of preimplantation embryos. Embryos obtained from pregnant mice on day 3 post-coitum were incubated with endometrial cell microsomes and BP(-)-trans-7,8-dihydrodiol at various concentrations from 0 to 1.0 microM. Following the incubation, the embryos were transferred to pseudopregnant surrogate mothers which were sacrificed 7 days later. The number of surrogate mothers remaining pregnant following transfer was reduced significantly at the highest concentration of BP(-)-trans-7,8 dihydrodiol. The 50% effective concentration (EC50) of this compound for blastocyst implantation rate was 0.33 microM and the EC50 for decidual swelling volume was 0.57 microM. Blastocyst implantation and decidual swelling volume was reduced in a concentration dependent manner. These data indicate that metabolites of BP formed in the presence of endometrial cell microsomes were capable of disrupting normal blastocyst development. PMID- 6488468 TI - Distribution, metabolism and excretion of N-nitrosobis(2-hydroxypropyl)amine in Wistar rats. AB - The metabolic fate of the carcinogen N-nitrosobis(2-hydroxypropyl)amine (BHP) in male Wistar rats was studied. The blood level of [1-14C]BHP after a single intraperitoneal injection, administered at a carcinogenic dose of 3 g/kg body weight, reached a maximum within 1 h. Whereas a relatively high concentration of 14C was found in the blood and target organs, such as the lung, liver, thyroid gland and kidney 1 h after the treatment, most of the radioactive labelling had disappeared from the tissues by 24 h after injection. Most of the administered 14C was eliminated via the urine; 90.8% was excreted in the urine within the 24 h period, 5.5% in the feces and 3.2% by way of expired air. Studies in rats with exteriorized bile flow demonstrated that about 11% of the intraperitoneally administered 14C was excreted via the bile in 24 h. Analysis by h.p.l.c. detected BHP (78.1% of the dose), HPOP (1.5%), glucuronides of BHP (4.3%) and HPOP (0.16%), MHP (0.03%) and unknown metabolites (6.0%) in the urine 24 h after the treatment. Besides these metabolites, BOP and two unidentified metabolites were also detected in the blood, lung, liver or kidney of rats 3 h after the treatment. These results suggest the involvement of BHP metabolites, HPOP, MHP and BOP, in carcinogenesis and in particular lung carcinogenesis induced by BHP in rats. PMID- 6488469 TI - Tumorigenicity and metabolism of 1-nitropyrene in A/J mice. AB - Four groups of 28-32 male and female A/J mice were given i.p. injections of either trioctanoin or 1-nitropyrene in trioctanoin such that the total doses of 1 nitropyrene were 0.71 mmol/kg, 2.14 mmol/kg, or 6.44 mmol/kg. The mean number of lung tumors/mouse was 1.3 +/- 1.0 in the group treated with 6.44 mmol/kg of 1 nitropyrene compared with 0.3 +/- 0.6 in the trioctanoin group (p less than 0.001). Combined tumor incidence was not significant compared with controls in the two lower dose groups. Cultured explants of A/J mouse lung, and 9000 g supernatant of A/J mouse lung and liver, metabolized [14C]1-nitropyrene to 4,5 dihydro-4,5-dihydroxy-1-nitropyrene and 1-nitrohydroxypyrenes. Substantial amounts of unknown polar metabolites were also produced by cultured lung. Nitro reduction to 1-aminopyrene was minimal in mouse lung and liver, even under oxygen deficient conditions. PMID- 6488470 TI - The assessment of DNA damage and repair in rat nasal epithelial cells. AB - A methodology for the isolation and culture of rat nasal turbinates was developed with the aim of studying chemically-induced genotoxic effects in the nasal epithelium. DNA damage, as assessed by alkaline elution, and unscheduled DNA synthesis, as measured by quantitative autoradiography, were observed in the cells of the respiratory and olfactory epithelium as a result of in vitro treatment with methyl methanesulfonate. The capacity of nasal epithelium to metabolize the promutagen dimethylnitrosamine (DMN) was demonstrated by the induction of both DNA strand breakage and the induction of unscheduled DNA synthesis. Although a response was observed in all of the epithelia examined, differences in response to DMN were observed that were not attributable to the differences in the cell types present (e.g., respiratory versus olfactory epithelium). The respiratory epithelial cells of the maxilloturbinate were found to be resistant to the induction of DNA damage at concentrations of 0.5 and 1.0 mM DMN, whereas the respiratory epithelial cells of the nasoturbinates were susceptible. In contrast, the response of the olfactory epithelium was similar to the response observed in the cells of the nasoturbinates. These techniques should prove valuable in assessing chemically-induced DNA damage and repair in this target tissue. PMID- 6488471 TI - Keratinocyte damage produced by 12-O-tetradecanoylphorbol-13-acetate in rodent epidermis. AB - Cell damage produced by 12-O-tetradecanoylphorbol-13-acetate (TPA) was evaluated in keratinocyte suspensions obtained from TPA treated mouse epidermis using a dye exclusion technique, and in tissue sections studied by light microscopy and quantitative enzyme histochemistry. TPA induced a maximum of approximately 25% of trypan blue stained basal keratinocytes using topical doses of 2, 20 and 200 micrograms. With the first two doses this effect was detectable at 12-24 h and disappeared 48-96 h after TPA treatment, whereas with 200 micrograms TPA the cell damage persisted for a longer time. Oxidative enzyme changes were moderate, and no changes in acid phosphatase levels could be detected. The facts that no signs of cell necrosis could be seen in tissue sections from epidermis treated with 2 and 20 micrograms TPA; that only a moderate change in oxidative enzyme pattern, without statistically significant variations in succinic dehydrogenase and cytochrome oxidase, could be detected, and that no shift of the damaged basal keratinocytes into the suprabasal compartment was evident, are indicative of moderate, probably sublethal damage induced by TPA. Although eventually committed to terminal differentiation, the epidermal cells do not show the cytologic and metabolic features of lethally damaged cells, suggesting that the membrane damage detected by the dye exclusion technique may be sublethal. Thus, it is possible that TPA can induce a reactive or regenerative type of epidermal hyperplasia without the prerequisite of extensive keratinocyte necrosis. PMID- 6488472 TI - A methodology for the analysis of the preneoplastic antigen. AB - A highly sensitive assay for the epoxide hydrolase activity associated with the preneoplastic antigen (PNA) has been developed based on the synthesis of cis stilbene oxide labeled with tritium at approximately 15 Ci/mmol. This assay allows the detection of elevated epoxide hydrolase activity in the serum of humans and rodents as well as in the culture medium bathing isolated hepatocytes. The integrity of the enzymatic assay was confirmed in rodents by precipitating the serum PNA activity using an antibody raised against the rat microsomal epoxide hydrolase. Methodology for the detection of PNA in serum will facilitate evaluation of this antigen as a marker for hepatic neoplasia in man and in experimental animals. PMID- 6488473 TI - The biological activity and activation of 15,16-dihydro-1,11 methanocyclopenta[a]phenanthren-17-one, a carcinogen with an obstructed bay region. AB - The proposal that an unobstructed bay region is a prerequisite for tumorigenic activity in cyclopenta[a]phenanthrene-17-ones is not supported by the observation of the tumorigenicity of 15,16-dihydro-1,11-methanocyclopenta[a]phenanthrene-17 one towards the skin of T.O. mice. The title compound is oxidised in vitro by a mixed function oxidase to produce, inter alia, a trans-3,4-dihydrodiol, postulated as the proximate tumorigen. Unequivocal identification of a second metabolite as a trans-1,2-dihydrodiol derivative demonstrates the potential for enzymatic oxidation within the obstructed bay region and supports the proposal that the ultimate tumorigen is a trans-3,4-dihydrodiol-anti-1,2-oxide. This is further substantiated by the chromatographic behaviour of the major hydrocarbon nucleoside adduct derived from mouse skin treated with the parent compound in vivo. The structures of certain others of the metabolites produced in vitro are also considered. PMID- 6488474 TI - Characterization of benzidinediimine: a product of peroxidase metabolism of benzidine. AB - [U-14C]Benzidine and unlabeled benzidine were used to synthesize benzidinediimine for which n.m.r., i.r. and u.v./visible spectra were obtained. Examination of benzidinediimine in acetate pH 4 buffer by electron spin resonance spectroscopy revealed that a free radical cation of benzidine was produced with maximum radical concentration occurring in 3-4 min. In contrast, u.v./visible spectroscopy revealed the production of a charge-transfer complex with maximum concentration occurring in 6-7 min. Liquid chromatography with electrical and radiochemical detection indicated that benzidine was the final product of benzidinediimine reduction in acetate buffer. The rate of reduction was greater at higher pH's and the time course for production of the free radical and charge transfer complex did not coincide at any pH examined. Addition of DNA to [14C]benzidinediimine resulted in DNA labeling which was completely inhibited by glutathione. These data suggest that charge-transfer complex formation neither precedes nor coincides with free radical formation. They are consistent with the hypothesis that the free radical cation observed during peroxidatic oxidation of benzidine is derived from one-electron oxidation. PMID- 6488475 TI - Association between erythrocytosis and renal cancers in rats following intrarenal injection of nickel compounds. AB - Seventeen nickel compounds were administered to Fischer-344 rats (N = 270) by intrarenal injection (7 mg Ni/rat); the compounds included nickel sulfides, selenides, arsenides, oxide, antimonide, telluride, titanate, ferronickel alloy and metallic nickel dust. Erythrocytosis, as defined by peak hematocrit values that averaged greater than 55% during 1-4 months post-injection, occurred in nine of 17 Ni-treated groups (NiS2, beta NiS, alpha Ni3S2, Ni4FeS4, NiSe, Ni3Se2, NiAsS, NiO, Ni dust). Renal cancers (N = 23) developed within 2 years post injection in nine of 17 Ni-treated groups (NiS2, beta NiS, alpha Ni3S2, Ni4FeS4, NiSe, Ni3Se2, NiAsS, NiAs, NiFe alloy). The renal cancers included eight fibrosarcomas, five mesangial cell sarcomas, two renal cell carcinomas, two carcinosarcomas, two leiomyosarcomas, two undifferentiated sarcomas, one rhabdomyosarcoma and one nephroblastoma. No erythrocytosis or renal cancers occurred in control rats (N = 97) in three groups treated with the vehicles or metallic iron dust. Rank correlation (p less than 0.0001) was observed between the incidences of erythrocytosis and renal cancers in the 17 Ni-treated groups. Rank correlation (p less than 0.001) was observed between the present incidences of renal cancers and the sarcoma incidences previously reported following intramuscular administration of the 17 nickel compounds to Fischer-344 rats (14 mg Ni/rat). The incidences of renal cancer were not correlated with the mass fractions of nickel in the 17 compounds, the dissolution half-times of the compounds in rat serum or renal cytosol, or the phagocytic indices of the compounds in rat peritoneal macrophages. PMID- 6488476 TI - Mutagenicity of urine of bidi and cigarette smokers and tobacco chewers. AB - Mutagenicity of urine concentrates from smokers, chewers and non-smokers prepared by the XAD-2 method were first tested in the Ames Salmonella assay with TA 1538 as the indicator organism. Aroclor 1254 induced rat liver supernatant (S9 mix) was used for metabolic activation. Those samples which were positive in Ames test were pooled and were tested in two other test systems, namely, the micronucleus test in mouse bone marrow cells and the induction of 8-azaguanine resistance in V79 Chinese hamster cells. The data presented here show that cigarette and bidi smokers' urine is mutagenic while non-smokers' urine is devoid of mutagenic effects. Urine of tobacco chewers showed variation in its mutagenic potential. Amongst the three tobacco habits bidi smokers' urine showed maximum activity. PMID- 6488477 TI - Increased incidence of chromosomal aberrations in peripheral lymphocytes of retired nickel workers. AB - Chromosomal aberrations and sister chromatid exchanges were analysed in the peripheral lymphocytes of nine retired nickel refinery workers 4-15 years after the retirement and compared with 11 matched non-nickel exposed controls. None of the controls had previous occupations with known relation to induction of chromosomal aberrations nor sister chromatid exchanges. The groups were equal as to socioeconomic status and environmental factors other than the occupational ones, which could influence the chromosome parameters, were to the largest possible extent excluded. The nickel workers' previous occupational employment involved exposure to inhalation of furnace dust of Ni3S2 and NiO or aerosols of NiCl2 and NiSO4. The concentration of nickel in the working atmospheres has been higher than 1.0 mg/m3 air and the exposure time more than 25 years. The retired nickel workers showed an increased incidence of breaks (p less than 0.001) and gaps (p less than 0.05) but no difference in the incidence of sister chromatid exchanges when compared with the controls. PMID- 6488478 TI - Use of a reversion assay HGPRT- to HGPRT+ to demonstrate mutagenic adaptation in V79 Chinese hamster cells. AB - A reverse mutation assay HGPRT- to HGPRT+ has been used to demonstrate adaptation to the mutagenic effects of monofunctional alkylating agents. HGPRT- cells exposed to single doses of methylating or ethylating agents show maximum revertant frequencies immediately after treatment and these subsequently decline exponentially. Cells pre-treated with MNNG (1.0 microM) or MMS (0.27 mM) then challenged 6-168 h later with MNNG or EMS showed a consistent reduction in revertant frequencies. Pretreatment with EMS did not result in any reduction in EMS-induced reversion frequency. In parallel experiments no modifications in survival kinetics were observed. V79 cells do not remove O6-methylguanine and totally lack O6-methylguanine transferase activity, therefore other lesions and repair enzymes must be involved in the mutagenic adaptation observed. PMID- 6488479 TI - The effects of phentolamine and isoproterenol in experimental hemorrhagic shock in the dog. AB - The effects of phentolamine and isoproterenol were investigated in eight dogs versus eight control dogs. The dogs were placed into simulated hemorrhagic shock using a reservoir to maintain arterial pressure at 40 mmHg until the level of the reservoir decreased to 20% of the maximum shed volume, or for 2 hr in the isoproterenol groups. After 30 min, during which phentolamine, isoproterenol, or saline was infused, the remaining blood was reinfused. Phentolamine was given as a 5-mg intravenous bolus. Isoproterenol was infused at 2.0 micrograms/kg/min. The dogs were monitored until their arterial pressure declined to 70 mmHg (50 mm for isoproterenol) or death ensued. Phentolamine lowered peripheral resistance and the size of the vascular space increased as shown by the rapid uptake of blood, 214.0 +/- 12.5 ml, during the 30 min after injection. The control group took back only 72.5 +/- 7.5 ml. Although reinfusion of the shed blood restored blood pressure to near normal for a short period, all groups showed a progressive decline in arterial pressure. There was no evidence that phentolamine or isoproterenol significantly decreased capillary permeability or that renal or pulmonary function were significantly altered by treatment. A large increase in venous oxygen content occurred following phentolamine, and a mild inotropic and vasodilator action lasted for about 30 min. Isoproterenol also decreased postinfusion arterial pressure. Neither drug influenced the hypoglycemia seen after reinfusion. PMID- 6488480 TI - Reduced venoconstrictor reserve in spontaneously hypertensive rats subjected to hemorrhagic stress. AB - Anesthetized spontaneously hypertensive rats (SHR) and normotensive WKY controls were subjected to either a constant pressure (CPH) (constant mean arterial pressure of 35 mmHg) or an incremental volume (IVH) hemorrhage protocol (successive 1-ml blood withdrawals separated by 20 minute compensatory periods). Diameters and pressures were measured in small (400-600 micron) intestinal mesenteric veins before and during hemorrhage. Before hemorrhage, vasodilator suffusion produced a significant venodilation in SHR but not in WKY. During hemorrhage, an active compensatory venoconstriction occurred in WKY but not in SHR. SHR were also less tolerant of hemorrhage than WKY. During CPH, venous pressures in WKY were significantly higher than those in SHR. However, venous pressures in SHR and WKY were not significantly different during CPH with vasodilator suffusion. This study indicates that a decreased reserve capacity for compensatory venoconstriction may contribute to the reduced ability of SHR to tolerate hypotensive stress. PMID- 6488481 TI - Effect of red blood cell stroma on the reticuloendothelial system clearance and killing of Streptococcus pneumoniae. AB - Previous studies from this laboratory have shown that thermal injury can cause sufficient intravascular hemolysis to depress reticuloendothelial system (RES) phagocytic function and that the injection of red blood cell (RBC) stroma depresses RES function and increases susceptibility to experimental shock. The present study evaluated the effect of thermal injury and RBC stroma on susceptibility to infection with Streptococcus pneumoniae as well as the effect of RBC stroma on the RES clearance and killing of the bacteria. The mortality rate following pneumococcal infection was increased after thermal injury from 0% to 100% (P less than .01), and with the injection of RBC stroma (0.5 ml/100 g) mortality increased from 20% to 80% (P less than .01). Hepatic uptake of heat killed S. pneumoniae was depressed from 64% to 44% of the injected dose following the injection of RBC stroma. RBC stroma depressed complement CH50 levels by 31%. The reduction in the number of viable S. pneumoniae present in the liver between 30 min and 4 hr following bacterial challenge was decreased in animals receiving RBC stroma. This was interpreted as an indication of impaired hepatic bactericidal function and was associated with an increase in the number of circulating viable S. pneumoniae. It is concluded that the increased susceptibility to pneumococcal infection induced by RBC stroma was probably due to an impairment in hepatic clearance and killing of the bacteria. The depressed bacterial clearance could have been contributed to by the stroma-induced decrease in complement levels. This study further supports the hypothesis that the intravascular hemolysis caused by thermal injury contributes to the increased susceptibility to infection following this form of injury. PMID- 6488482 TI - Vasopressin causes endothelium-dependent relaxations of the canine basilar artery. AB - The effect of synthetic 8-arginine vasopressin (vasopressin) was studied in isolated canine basilar, left circumflex coronary, and femoral arteries of the dog. Vascular rings with and without endothelium were suspended for isometric tension recording in physiological salt solution. The removal of the endothelium was confirmed by the absence of relaxations induced by either thrombin (basilar arteries) or acetylcholine (coronary and femoral arteries). In the basilar artery, vasopressin induced concentration-dependent inhibition of myogenic tone. In basilar and coronary arteries, the hormone caused concentration-dependent relaxations during contractions evoked by prostaglandin F2 alpha. In femoral arteries, vasopressin caused contraction. After removal of the endothelium, the inhibitory responses to vasopressin were abolished in basilar arteries and significantly reduced in left circumflex coronary arteries. The contractions of femoral arteries were not affected by endothelium removal. The V1 vasopressinergic antagonist d(CH2)5Tyr(Me)AVP prevented the inhibitory response to vasopressin, but did not alter endothelium-dependent relaxations of basilar arteries caused by adenosine diphosphate. These results demonstrate that the endothelial cells mediate relaxation induced by vasopressin via specific V1 vasopressinergic receptors. PMID- 6488483 TI - Hemodynamic and microvascular responses in the hindquarters during the development of renal hypertension in rats. Evidence for the involvement of an autoregulatory component. AB - Microvascular responses in the cremaster muscle were compared with changes in mean arterial pressure and hindquarters vascular resistance during the development (initial 3 hours) of two-kidney one-clip renal hypertension in rats, to examine the possibility that an autoregulatory mechanism may contribute to the development of hypertension. Rats were anesthetized with urethane and chloralose and implanted with Doppler flow probes on the renal artery and abdominal aorta. Acute hypertension was produced by inflation of a balloon occluder on the renal artery to reduce renal flow by 50%. The cremaster muscle was isolated with intact innervation and circulation for measurement of microvessel diameters. To determine whether increased pressure contributed to the changes in hindquarters vascular resistance or in microvascular diameters during acute hypertension, arterial pressure was prevented from increasing in the hindquarters region after renal artery stenosis by servo-controlled inflation of a balloon occluder around the sacral aorta to maintain hindquarters pressure at normotensive levels. In hypertensive rats with unprotected hindquarters, mean arterial pressure and hindquarters vascular resistance increased 26% and 20%, respectively, after renal artery stenosis. In comparison, hypertensive rats with protected hindquarters exhibited a similar increase in mean arterial pressure, but hindquarters vascular resistance was significantly reduced compared to that in hypertensive rats with unprotected hindquarters. In the cremaster microcirculation, vasoconstriction was observed only in the small third- (mean +/- SEM: 29 +/- 4 micron) and fourth- (12 +/- 2 micron) order arterioles in rats with unprotected hindquarters. In general, microvessel diameters in rats with protected hindquarters that had lower hindquarters vascular resistance than those with unprotected hindquarters were larger for the second- (82 +/- 5 micron), third-, and fourth-order arterioles, suggesting less vasoconstrictor tone. Our data indicate that the increase in hindquarters resistance during the development of renal hypertension is, in part, dependent on the presence of a pressure-dependent autoregulatory process. PMID- 6488484 TI - Development of collateral function with repetitive coronary occlusion in a canine model reduces myocardial reactive hyperemia in the absence of significant coronary stenosis. AB - The present study was designed to elucidate the role of collateral development, per se, on reactive hyperemia without persistent coronary stenosis in instrumented conscious dogs. Functional states of coronary collaterals were augmented by repetitive 2 minutes of coronary occlusion every 30 minutes for 2-9 days. Regional shortening measured sonomicrometrically recovered from -1.2 +/- 6.5% of the preocclusive state at the end of the first coronary occlusion to 100.5 +/- 1.2% (n = 8, P less than 0.01) after repeated coronary occlusions. Before and after collateral development, transient coronary occlusions of 5, 10, 20, 30, 60, 90, and 120 seconds were randomly performed. The degree of regional dysfunction and the following reactive hyperemic response were measured. Up to 20 seconds of coronary occlusion, the flow ratio and duration of coronary reactive hyperemia increased similarly, both before and after collateral development. However, when the duration of coronary occlusion was over 30 seconds, flow ratio and debt repayment ratio were reduced progressively after the collateral development. Among the indices exhibiting reactive hyperemia, debt repayment ratio decreased initially and correlated well with the recovery of regional dysfunction during coronary occlusion. Thus, the augmentation of collateral function after repetitive coronary occlusion reduces reactive hyperemia even in the absence of significant coronary stenosis. PMID- 6488485 TI - Developmental changes in the effects of lidocaine on the electrophysiological properties of canine Purkinje fibers. AB - Developmental changes in the cardiac effects of antiarrhythmic drugs have been noted in the clinical setting. To study whether these might in part be based on developmental differences in drug effects on the transmembrane potential, we used standard microelectrode techniques to study the effects of lidocaine on the transmembrane potentials of Purkinje fibers from adult and young dogs. Control studies of membrane responsiveness and steady state recovery kinetics of Vmax showed no age-related differences in these variables. Lidocaine reduced Vmax of adult fibers to a greater extent than that of young fibers at basic drive cycle lengths of 1000 and 400 msec. The number of beats to reach steady state Vmax at basic drive cycle length of 400 msec was smaller in adult than in young fibers. Both tonic and use-dependent block appeared to be greater and to develop more rapidly in the adult than the young fibers. Moreover, fibers from young dogs recovered more rapidly from the effects of lidocaine than did adult fibers. These data suggest there are developmental changes in the tonic and use-dependent effects of lidocaine that may contribute to age-related differences in drug effect. PMID- 6488486 TI - The effects of alpha 2-adrenergic and serotonergic receptor antagonists on cyclic blood flow alterations in stenosed canine coronary arteries. AB - Platelets possess alpha 2-adrenergic and serotonergic (5-hydroxytryptamine) receptors which are thought to mediate the in vitro proaggregatory effects of epinephrine and serotonin, respectively. However, their importance in platelet aggregation in vivo is uncertain. In the present study, we evaluate the ability of yohimbine and ketanserin, relatively selective alpha 2-adrenergic and serotonin antagonists, respectively, to alter cyclic flow reductions in stenosed coronary arteries in open-chest, anesthetized dogs. These cyclic flow reductions, characterized by progressive declines in coronary blood flow interrupted by abrupt and, often spontaneous, restorations of flow, were produced by cylindrical constrictors placed on the left anterior descending coronary artery. A pulsed Doppler flow probe, placed proximal to the constrictor, was used to measure coronary blood flow. Regional myocardial blood flow was measured with 15-micron radiolabeled microspheres before coronary constriction and when coronary blood flow appeared to be at its nadir and zenith during cyclic flow reductions. After the cyclic flow reductions had been observed for 1 hour, yohimbine (1-2 mg/kg), ketanserin (0.25 or 0.5 mg/kg), or saline was given, and coronary blood flow and hemodynamics were monitored for another hour. The frequency of cyclic flow reductions and the mean of the three lowest nadirs of coronary blood flow (mean +/- SE) were compared between the first and second hours. Ketanserin, at doses of 0.25 and 0.50 mg/kg, virtually abolished cyclic flow reductions in all dogs tested. Yohimbine [1 mg/kg ( n = 14)] was partially effective in reducing the frequency (9.6 vs. 5.5 cyclic flow reductions/hr) and severity of cyclic flow reductions (nadirs of coronary blood flow = 6.2 +/- 2.4 vs. 20.9 +/- 6.1% of control). A higher dose of yohimbine [2 mg/kg (n = 7)] was no more effective. The frequency (9.3 +/- 0.9 vs. 9.3 +/- 1.0 CFR/hr) and severity (17.4 +/- 5.4 vs. 12.4 +/- 3.9% of control coronary blood flow) of cyclic flow reductions were not changed by saline. The relatively selective alpha 1-adrenergic antagonist, prazosin (0.01 mg/kg, iv), and the beta-adrenergic antagonist, propranolol (1-2 mg/kg, iv), did not affect the frequency or severity of cyclic flow reductions. Thus, the abilities of yohimbine to inhibit and ketanserin to abolish cyclic flow reductions in stenosed canine coronary arteries suggest that serotonin and, possibly, alpha 2-adrenergic agonists may influence cyclic flow alterations importantly in this model. PMID- 6488487 TI - Interaction of bretylium tosylate with rat cardiac muscarinic receptors. Possible pharmacological relevance to antiarrhythmic action. AB - The interaction of the antifibrillatory antiarrhythmic drug, bretylium tosylate, with the muscarinic receptor in tissue homogenates from regions of rat brain and heart was investigated. Competition-binding experiments were carried out with the highly specific tritiated antagonist N-methyl-4-piperidyl benzilate. Bretylium tosylate competitively displaced the labeled antagonist from the muscarinic receptor. The binding of the drug to the two brain preparations was found to be best fitted by a one-site model in each case. On the other hand, in the case of both heart preparations, a two-site model yielded a significantly better fit for the binding data than that given by a single-site model. The low affinity-binding constants in the atrium and the ventricle were similar (approximately 10 microM) to those in the brain regions examined, namely, the cortex and the medullapons. Sites with relatively higher affinity for the drug were detected in the heart only, with equilibrium-binding constants of 0.24 +/- 0.12 microM and 0.97 +/- 0.27 microM for the atrium and the ventricle, respectively. The drug also exerted anti-acetylcholine activity (K1 = 14 +/- 2 microM) measured physiologically in the guinea pig atrium, which correlated well with the concentration of the drug observed to be efficacious clinically (approximately 10 microM). PMID- 6488488 TI - Dynamic discharge characteristics of low pressure receptors in the rat. AB - An in vitro preparation was used to examine the discharge of low pressure receptors in response to a pulsatile pressure stimulus. Both slowly adapting and rapidly adapting receptors were examined. After an increase in the mean level and/or dP/dt of a pulsatile pressure input, the discharge of slowly adapting receptors reached a steady state level within 2 minutes. An increase in mean pressure, with constant pulsatile amplitude and dP/dt, produced a sustained increase in the number of spikes/cycle, in the average number of spikes/second, and in the average frequency during the burst within the cycle. In slowly adapting receptors, an increase in dP/dt at a constant mean pressure and pulsatile amplitude produced a decrease in the number of spikes/cycle and an increase in both the average number of spikes/second and the frequency during the burst. Rapidly adapting receptors showed very different characteristics, responding to a pulsatile pressure input above threshold with an irregular discharge which averages approximately 1 spike/cycle at all mean pressure levels. Although rapidly adapting receptors transiently increased their discharge in response to an increase in mean pressure, within 60 seconds discharge returned to the pre-increase level. Rapidly adapting receptors continued to discharge with an average of 1 spike/cycle as dP/dt was increased. Since dP/dt was raised by increasing the frequency of the pulsatile input, the number of spikes/second increased. In the steady state, slowly adapting receptors transmit information reflecting mean pressure levels. They are also sensitive to the rate of change of pressure. Rapidly adapting receptors, on the other hand, are insensitive to mean pressure but do respond to the frequency of the stimulus. PMID- 6488489 TI - Release of endogenous catecholamines in the ischemic myocardium of the rat. Part A: Locally mediated release. AB - The accumulation of endogenous catecholamines within the extracellular space of the ischemic myocardium has been studied in the isolated perfused (Langendorff) heart of the rat subjected to various periods of complete ischemia, with subsequent collection of the reperfusate. Catecholamines and deaminated metabolites were measured by radioenzymatic methods, or high pressure liquid chromatography. Ischemic periods of less than 10 minutes are not associated with an increased overflow of catecholamines or metabolites. Longer periods of ischemia are accompanied by the overflow of noradrenaline and its deaminated metabolite 3,4-dihydroxyphenylglycol. This overflow increases with lengthening of the preceding ischemic period (10 minutes: 2.5 +/- 0.6, 20 minutes: 209.8 +/- 17.2, 60 minutes: 1270.5 +/- 148.1 pmol noradrenaline/g heart). Noradrenaline concentration is highest during the first minute of reperfusion, suggesting that the noradrenaline detected during reperfusion is released into the extracellular space of the myocardium during ischemia and is subsequently eluted. Experiments with variation of extracellular calcium concentration and with neuronal uptake (uptake1) blocking agents suggest that different mechanisms of catecholamine release are acting during the course of ischemia. A calcium-independent carrier mediated efflux of noradrenaline from the nerve terminals is of major importance, using the same carrier as is normally responsible for transporting noradrenaline from the synaptic clefts into the neuronal varicosities. Thus, various uptake1 blocking agents diminish the noradrenaline overflow following ischemic periods of between 10 and 40 minutes. The noradrenaline overflow following longer periods of ischemia is unaffected by uptake1-blocking agents, and additional noradrenaline release at this time is probably consequent upon dissolution of cell membranes. Overflow of adrenaline and dopamine occurs to a minor degree (less than 5% of the corresponding noradrenaline overflow), and only after ischemic periods of more than 15 minutes. PMID- 6488490 TI - Release of endogenous catecholamines in the ischemic myocardium of the rat. Part B: Effect of sympathetic nerve stimulation. AB - The contribution of centrally originating sympathetic activity to the myocardial extracellular accumulation of noradrenaline during the early phase of ischemia has been assessed in a perfused (Langendorff) rat heart preparation isolated except for its sympathetic innervation. A 10-minute electrical stimulation (4 Hz, 5 V) of the left cervicothoracic ganglion during normal perfusion causes the overflow of 177.5 +/- 13.7 pmol noradrenaline/g heart, whereas such stimulation during ischemia liberates only 21.5 +/- 3.6 pmol/g (collected during reperfusion). When neuronal reuptake is blocked by desipramine, corresponding values are 321.5 +/- 22.5 pmol/g (normal flow) and 151.8 +/- 22.4 pmol/g (ischemia). After combined blockade of neuronal uptake, extraneuronal uptake, and alpha 2-receptors, nerve stimulation liberates 674 +/- 22 pmol/g during normal flow and 206 +/- 24.3 pmol/g during ischemia. These results suggest that, in vivo, centrally originating neural activity would not lead to substantial accumulation of noradrenaline within the extracellular space of the ischemic myocardium. This failure of accumulation is due to both a functioning neuronal uptake of noradrenaline and a failure of neurotransmission. PMID- 6488491 TI - Current problems and future challenges in randomized clinical trials. PMID- 6488492 TI - Sources of the diet-heart controversy: confusion over population versus individual correlations. PMID- 6488493 TI - Increased risk of severe protamine reactions in NPH insulin-dependent diabetics undergoing cardiac catheterization. AB - Protamine is widely used for reversing systemic heparinization after cardiac catheterization. Although rare, major reactions to protamine that simulate anaphylaxis occasionally occur and have previously been associated only with an allergic reaction to fish. Because neutral protamine Hagedorn (NPH) insulin includes protamine, it might be anticipated that NPH insulin-dependent diabetic patients would develop sensitivity to protamine. Of 866 consecutive patients undergoing cardiac catheterization over a 20 month period, 651 received protamine for reversal of heparinization. Of these, 8.5% (56/651) were diabetics and 2.3% (15/651) were NPH insulin-dependent diabetics. During this period seven patients were observed immediately after administration of protamine to have major adverse reactions that required the administration of catecholamines. One death ensued. Of the seven major reactions, four occurred in NPH insulin-dependent diabetics and one occurred in a patient with an allergy to fish. The incidence of major protamine reactions was 27% (4/15) in the NPH insulin-dependent diabetics vs 0.5% (3/636) in those with no history of NPH insulin use (p less than .001). This represents a 50-fold increased risk of a major reaction to protamine if the patient was receiving NPH insulin. Accordingly, we recommend that diabetics on NPH insulin and patients with allergies to fish undergo cardiac catheterization without the use of protamine or, when necessary, that protamine be administered cautiously in anticipation of a major adverse reaction. PMID- 6488494 TI - Relationships between beat-to-beat interval and the strength of contraction in the healthy and diseased human heart. AB - Twenty-six adult patients, classified by clinical and catheter criteria into groups of those with normal and abnormal left ventricular function, were studied during cardiac catheterization. Right heart pacing was established, and left ventricular dP/dt was measured with end-catheter manometers. By varying the interval preceding a test beat after periods of steady pacing it was confirmed that recovery of left ventricular mechanical function (maximum dP/dt) occurs approximately 800 msec (optimum interval) after a beat. The augmentation of maximum dP/dt of the first 2 beats after an extrasystole, each spaced at the optimum interval, was also studied; the amount of potentiation was varied by alterations in extrasystolic interval. Potentiation decayed from the first to the second postextrasystolic beat with a ratio that was fixed in each individual patient. The ratio (recirculation fraction) was higher in patients with normal than in those with abnormal left ventricular function (mean +/- SD 0.52 +/- 0.10 vs 0.37 +/- 0.11, p less than .005). There was an inverse relationship between this ratio and the degree of potentiation of the first postextrasystolic beat (r = .80, p less than .001). We postulate a disturbance of excitation-contraction coupling mechanisms to explain these effects. PMID- 6488495 TI - Transcutaneous oxygen tension and capillary morphologic characteristics and density in patients with chronic venous incompetence. AB - The transparent oxygen electrode, recently developed by Huch and his co-workers, permits monitoring of transcutaneous oxygen tension (tcPO2) at defined sites on the capillaroscopic image obtained by videomicroscopy. This combined system has been applied to study the nutritional skin capillaries of patients with chronic venous incompetence (CVI). The results of 44 studies in 17 patients with CVI demonstrated a direct correlation between tcPO2 and density and morphologic characteristics of the superficial capillaries. The mean tcPO2 was 47.7 +/- 14.4 mm Hg at the site of incompetent perforating veins of the ankle without major trophic changes. There was no statistically significant difference between the mean values obtained in patients and control subjects (56.8 +/- 9.9 mm Hg). Videomicroscopic examination revealed dilated and tortuous capillaries surrounded by halo formations. In areas of hyperpigmentation, induration, and hyperkeratosis, significantly decreased mean tcPO2 (22.5 +/- 7.0 mm Hg; p less than .001) corresponded to reduced capillary density (less than 10 capillaries/mm2). In avascular skin areas (scar tissue, white atrophy) tcPO2 was measured at 0 mm Hg. No capillaries, or a greatly reduced number, were visible at such sites, resulting in a distance between capillary and cathode tip of the oxygen sensor of greater than 100 micron. The combined system of tcPO2 measurement and simultaneous videomicroscopy gives new pathophysiologic information on the development of skin ulcers and may be useful for the objective comparison of different therapeutic modalities at the microcirculatory level. PMID- 6488496 TI - Comparison of enzymatic and anatomic estimates of myocardial infarct size in man. AB - Enzymatic estimates of myocardial infarct size based on plasma levels of MB creatine kinase (MB-CK) were compared with anatomic infarct size in 49 human hearts obtained at autopsy. The patients studied had been enrolled in the Multicenter Investigation of Limitation of Infarct Size (MILIS) study program within 18 hr of the onset of acute infarction and were treated at one of five participating hospitals. Infarct size was estimated from serial measurements of plasma MB-CK made at the core laboratory for CK analysis. Hearts obtained at autopsy were studied independently by the core pathology laboratory without knowledge of the MB-CK levels or clinical results. Data from the two laboratories were compared at the data coordinating center. Of 49 hearts, 12 were excluded either because anatomic infarct size could not be established or because the infarct occurring at the time of enrollment in the MILIS study could not be distinguished with certainty from other infarcts. Of the remaining 37 hearts, peak MB-CK level was available in 36, but samples sufficient for estimation of infarct size were available in only 25. The overall correlation coefficient (Spearman) was .87 for these 25 hearts, indicating that enzymatic estimates of infarct size correlate closely with anatomic measurements. The results indicate that CK estimates of myocardial infarct size represent a valid clinical end point for assessing myocardial infarct size, and the effect of therapy thereon, in groups of treated and control patients. PMID- 6488497 TI - Echocardiographic recognition and implications of ventricular hypertrophic trabeculations and aberrant bands. AB - The accuracy of two-dimensional echocardiography in the recognition of aberrant ventricular bands and pathologic trabeculations (hypertrophic, fibrotic, or both) was assessed in 35 patients who underwent cardiac transplantation and pathologic examination. At pathologic study the prevalence of specific intracavitary structures ranged from 28% to 43%. Left ventricular thrombi were found in 12 patients (34%) and right ventricular thrombi in three (9%). Echocardiography accurately defined left ventricular aberrant bands and left ventricular thickened or fibrotic trabeculations. Bands, trabeculations, and thrombi each showed characteristic echocardiographic patterns. In the right ventricle, these structures were recognized, but accurate discrimination among them was not possible by echocardiography. Aberrant bands and pathologic trabeculations mimicked or obscured fresh or organized thrombi in three patients on two dimensional echocardiography. Left ventricular longitudinal bands and pathologic right ventricular trabeculations obscured the interventricular septal border in four patients; the presence of these abnormalities could lead to the erroneous diagnosis of asymmetric septal hypertrophy on M mode echocardiography. By expressing the accuracy of two-dimensional echocardiography in the recognition of left ventricular anomalous bands, our results support the feasibility of prospective studies to clarify their clinical significance. PMID- 6488498 TI - Magnetic resonance imaging in patients with congenital heart disease. AB - Magnetic resonance imaging (MRI) was conducted with use of the spin-echo technique (0.35 Tesla) in 22 patients with a variety of congenital and cardiovascular anomalies and in 16 normal volunteers. Electrocardiographic (ECG) synchronization of the data acquisition produced transverse, parasagittal, and coronal tomograms that were used to define size and relationship of the great vessels and internal cardiac structures. MRI findings were corroborated by angiography and sector-scan echocardiography. In most patients the diagnosis had been established before the MRI study. MRI detected all of 11 abnormalities at the level of the great vessels, all of six atrial septal abnormalities, and 10 of 11 ventricular septal defects. Images of poor quality resulting from patient motion were obtained in the one instance in which a small ventricular septal defect was not imaged. Of two patients with Ebstein's anomaly, the displacement of the tricuspid leaflets was shown in one patient but was not evident in another. Complex anomalies such as double-outlet right ventricle, uncorrected L transposition, single atrioventricular valve, single ventricle, and common ventricle were clearly shown by MRI. Initial experience with MRI has indicated the effectiveness of this technique for defining great vessel and internal cardiac anatomy in patients with congenital heart disease. This is accomplished without the use of contrast media and is thus a completely noninvasive technique for cardiovascular diagnosis. PMID- 6488499 TI - Effects of a single bolus of urokinase in patients with life-threatening pulmonary emboli: a descriptive trial. AB - To evaluate hemodynamic, angiographic, and biological effects of a single bolus of urokinase, an open descriptive trial was conducted in a homogeneous group of 14 patients with acute life-threatening pulmonary emboli and without prior cardiopulmonary disease. For every patient the efficacy of the treatment was evaluated by comparing control and posttherapeutic values after the bolus injection of 15,000 IU/kg body weight urokinase (urinary source) administered in 10 min in the right atrium, followed by continuous intravenous full-dose heparin therapy. In two patients clinical status, hemodynamics, vascular obstruction, and biological (fibrinogen and plasminogen levels) parameters remained unchanged. One of these two patients died, making the mortality rate for the whole group 7%. Twelve of 14 patients showed rapid clinical improvement. Evaluation at 12 hr demonstrated significant decreases in pulmonary vascular obstruction (Miller index, 34%), total pulmonary vascular resistances (37%), and fibrinogen and plasminogen levels (41% and 40%, respectively), without any significant change in cardiac index. The hemodynamic sequential measurements performed (1,3, 6, and 12 hr) in seven of the 12 improved patients showed that the greatest percentage of the total hemodynamic improvement occurred within the first 3 hr after bolus administration of urokinase. No severe hemorrhagic complications were observed. Because of its rapid efficacy and its low cost, the bolus technique appeared particularly useful in the treatment of patients with acute life-threatening pulmonary emboli. PMID- 6488500 TI - Salutary effects of intravenous ajmaline in patients with paroxysmal supraventricular tachycardia mediated by dual atrioventricular nodal pathways: blockade of the retrograde fast pathway. AB - Electrophysiologic effects of 50 mg iv ajmaline were evaluated in 10 patients with atrioventricular nodal reentrant paroxysmal supraventricular tachycardia (PSVT) utilizing the slow pathway for antegrade and the fast pathway for retrograde conduction. Ajmaline terminated the PSVT in all 10 patients in 17 to 165 sec (mean 94 +/- 49 sec): by ventriculoatrial block in eight, AH block in one, and intra-atrial reentry in one patient. The predrug mean PSVT cycle length of 289 +/- 44 msec (range 240 to 350) increased significantly to 373.5 +/- 60 msec (range 263 to 464; p less than .01) before the tachycardia was terminated. The increase in cycle length was a function of both AH and HA prolongation. In all 10 patients ajmaline depressed conduction through the retrograde fast pathway, as evidenced by the increase in mean ventricular paced cycle length producing ventriculoatrial block from less than or equal to 280 +/- 40 to 438 +/- 93 msec (p less than .001), and the increase in the effective refractory period of the ventriculoatrial conduction system from less than or equal to 241 +/- 42 to less than or equal to 298 +/- 62 msec (p less than .05); the drug abolished ventriculoatrial conduction in four cases. The effective refractory period of the antegrade fast pathway was unchanged after ajmaline (less than or equal to 281 +/ 31 vs less than or equal to 275 +/- 38 msec; p = NS), but conduction through the antegrade slow pathway was depressed (atrial paced cycle length producing AH block 269 +/- 30 msec before and 312 +/- 44 msec after drug; p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488501 TI - Beneficial effects of nifedipine on rest and exercise myocardial energetics in patients with congestive heart failure. AB - Rest and exercise systemic hemodynamic parameters, coronary blood flow, and myocardial energetics were assessed before and 15 min after the sublingual administration of 20 mg of nifedipine in 10 patients with idiopathic congestive cardiomyopathy. When compared with control, nifedipine increased rest and exercise cardiac index by 37% and 28%, respectively (p less than .001). Peripheral vasodilation was demonstrated with a drop in systemic arterial pressure, exercise pulmonary capillary wedge pressure, and systemic vascular resistance (p less than .05). The calcium-channel blocker did not alter myocardial oxygen consumption; however, coronary blood flow increased by 32% at rest (p less than .01) while coronary vascular resistance diminished both at rest and after exercise compared with control (p less than .05). Nifedipine elicited a decrease in the rest and exercise aortocoronary sinus oxygen difference while the coronary sinus oxygen saturation increased (p less than .01). In this group of patients with idiopathic congestive cardiomyopathy, nifedipine enhanced myocardial performance while increasing coronary blood flow and favorably altering the myocardial oxygen supply-demand balance. PMID- 6488502 TI - Anatomic correction of transposition of the great arteries associated with ventricular septal defect: midterm results in 50 patients. AB - From May 1977 to August 1982 50 patients who were 1.5 to 44 months old underwent anatomic correction of transposition of the great arteries (TGA) and closure of ventricular septal defect (VSD) at our institution. Thirty-nine patients underwent preliminary pulmonary arterial banding. Hospital mortality was 32%: four patients died as a result of technical problems, seven as a result of associated lesions, three of pulmonary hypertension, and two of left ventricular failure. Three other patients died after the first postoperative month (one of mediastinitis, one at reoperation for a residual VSD, and one of pulmonary hypertension). All 31 survivors are in excellent clinical condition and are in sinus rhythm after a mean follow-up period of 31 +/- 14 months. Twenty-five patients were reinvestigated by echocardiography (M mode and two-dimensional) and/or catheterization. Parameters of left ventricular contractility were within normal limits, but systolic aortic diameter was larger than normal (p less than .01). Seven patients had stenosis of the right ventricular outflow tract and five of these required reoperation. The two persistent problems with the anatomic correction of TGA associated with VSD are a relatively high operative mortality and secondary right outflow tract stenosis. However, use of this procedure results in better left ventricular function and fewer arrhythmias than does use of atrial repair techniques and also results in the use of the anatomically left ventricle as the systemic ventricle. PMID- 6488503 TI - Systemic venous and pulmonary arterial flow patterns after Fontan's procedure for tricuspid atresia or single ventricle. AB - Despite increasing use of Fontan or modified Fontan repairs, the comparative hemodynamic efficacy of different types of connections are unresolved. Accordingly, we undertook a prospective study designed to determine postoperative flow patterns after Fontan's operation. Seven subjects had tricuspid atresia and eight had single ventricle. Ages ranged from 5 to 38 years (mean 16.4). Ten subjects had nonvalved right atrial-to-pulmonary arterial connection, and four had nonvalved right atrial-to-right ventricular communication. A valved conduit established continuity between the right atrium and right ventricle in one subject. Doppler flow profiles were recorded in the pulmonary artery and in the superior and inferior venae cavae of each. A reference electrocardiogram was used for timing purposes. In 14 patients, forward flow in the pulmonary artery was biphasic. Flow began at the end of the T wave (early ventricular diastole), peaked at or before the P wave (atrial systole), and returned to baseline by the peak of the R wave. Forward flow recommenced at the peak of the R wave (ventricular systole) and returned to baseline at the end of the T wave. Flow in the superior vena cava varied, and could not be recorded in three subjects. Between the end of the P wave and peak of the R wave (atrial systole) flow was reversed in eight, absent in three, and forward in one patient. Forward flow occurred between the peak of the R wave and the end of the T wave and was either continuous or biphasic. Fourteen patients had adequate studies of inferior vena cava flow; reversed flow during atrial systole occurred in 10 subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488504 TI - Vasodilative effect of hydralazine in awake dogs: the roles of prostaglandins and the sympathetic nervous system. AB - The relative roles of prostaglandins and the sympathetic nervous system in mediating the hypotensive effects of hydralazine were studied in awake dogs with and without pretreatment with indomethacin, propranolol, and phentolamine. In normal dogs, mean aortic pressure decreased 23 +/- 4 mm Hg after administration of hydralazine (cumulative dose of 0.8 mg/kg). This hypotensive effect of hydralazine was potentiated by phentolamine but was abolished by propranolol. Indomethacin caused a paradoxic pressor response (11 +/- 3 mm Hg) to hydralazine, which also was abolished by addition of phentolamine. Hydralazine produced vasodilation in the coronary, skeletal muscle (quadriceps), splanchnic, and renal circulations in normal dogs. The increase in coronary blood flow was associated with increased cardiac oxygen consumption and narrowed arteriovenous oxygen difference across the heart. Propranolol reduced the increases in cardiac oxygen consumption and coronary blood flow, but only indomethacin abolished the narrowed arteriovenous oxygen difference, suggesting that the increase in coronary blood flow was related to both the increased cardiac oxygen demand and prostaglandin mediated active coronary vasodilation. The decrease in skeletal muscle vascular resistance after hydralazine was abolished by propranolol. Skeletal muscle vascular resistance actually increased after administration of hydralazine in dogs pretreated with both propranolol and indomethacin. These effects were blocked by the addition of phentolamine. Unlike the normal response, renal and splanchnic vascular resistances increased after administration of hydralazine in dogs pretreated with indomethacin. The splanchnic vasoconstriction was abolished by phentolamine, but the renal vascular change was affected by neither phentolamine nor propranolol. The results indicate that hydralazine does not produce uniform vasodilation in all organs and that the cardiovascular actions of hydralazine involve both prostaglandins and the sympathetic nervous system. PMID- 6488505 TI - New frontiers in biology related to heart, lung, and blood diseases. PMID- 6488506 TI - Thrombosis and the hypercoagulable state. AB - Our understanding of thrombosis remains anchored to Virchow's view that the evolution of a thrombus is fostered by vascular damage, by retarded blood flow, and by alterations in the blood itself that increases its likelihood to clot. The last of these forces, the so-called hypercoagulable state, has been defined in many ways. For example, some evidence exists that increased titers of clotting factors or increased numbers of circulating platelets may be correlated with a thrombotic tendency. A more exciting way that clotting factors might contribute to thrombosis is that under certain conditions the titer of their activated forms might reach critical levels in the circulation. Another possibility is that a thrombotic tendency may be caused by qualitative alterations in clotting factors or platelets. The firmest evidence that alterations in blood clotting may be related to thrombosis is the undoubted high incidence of recurrent thromboembolism in patients with familial deficiencies of antithrombin III or protein C, an inhibitor of antihemophilic factor (factor VIII) and proaccelerin (factor V). Impaired fibrinolytic mechanisms may also predispose to thrombosis. Not yet explained is the fact that patients with lifelong hemostatic alterations in peripheral blood sustain only a handful of thrombotic episodes. PMID- 6488508 TI - Heart, lungs, and blood as an integrated system: the alveolar-capillary barrier and the cardiorespiratory apparatus. AB - The living organism is complex and depends on information transfer for its effective operation. One way to regard the organism is as a biological hierarchy in which each level not only serves a particular, circumscribed function but also contributes in an important way to the integrated performance of the organism as a whole. Two levels in the organization of biological functions are discussed to illustrate the principle of biological hierarchy: a subsidiary role, as exemplified by the role of the lungs in water and macromolecular exchange, and a primary function, as typified by the integrated performance of the cardiorespiratory apparatus in accord with the metabolic needs of the whole body. This hierarchical approach not only preserves the perspective for appreciating the coordinated behavior of the normal individual but also provides a vantage for assessing derangements produced by disease at any level in the biological hierarchy. PMID- 6488507 TI - The role of endothelial injury and platelet and macrophage interactions in atherosclerosis. AB - Atherosclerotic lesions take two forms, the fatty streak and the fibrous plaque or complicated lesion. The former is a flat, lipid-rich lesion containing variable numbers of foam cells in the form of macrophages and/or smooth muscle. In contrast, the fibrous plaque is a proliferative lesion of smooth muscle containing variable numbers of macrophages. Associated with the smooth muscle proliferative response is the formation of connective tissue matrix and the accumulation of intracellular and extracellular lipid. The response to injury hypothesis of atherogenesis provides and approach to exploring the interactions among substances that alter endothelial function and/or structure and to investigating the relationships among endothelium, smooth muscle, platelets, macrophages, and plasma constituents. Studies of molecules potentially important in lesion development, such as mitogens derived from platelets, macrophages, and endothelium, and of the potential roles of lipids in generating these lesions and in inducing injury to the overlying endothelial cells, have begun to shed light on how these processes may occur and on approaches that may be taken to better understand and possibly prevent them. We still lack an understanding of one of the key events, endothelial injury. The many ways by which endothelial cells may be altered in relation to the hypercholesterolemic environment and to the underlying macrophages in the fatty streaks remain to be explored. Nevertheless, these approaches point the way to the development of new means for prevention, intervention, and diagnosis of atherosclerosis. PMID- 6488509 TI - Directions of atherosclerosis research in the 1980s and 1990s. AB - Several major achievements in cardiovascular research are likely to occur in the 1980s and 1990s. The lipid hypothesis should be settled once and for all: Does lowering levels of low-density lipoproteins prevent coronary artery disease? A new hypothesis will be tested and tried: Does increasing levels of high-density lipoproteins prevent coronary artery disease? We are likely to know the importance of modulations of the pathways of prostaglandin metabolism, of cyclooxygenase and thromboxane inhibitors, and of prostacyclin agonists. We should know the significance of vascular growth factors in promoting arteriosclerosis. Perhaps we will even learn the cause of arteriosclerosis. Sophisticated noninvasive methods will be able to detect arteriosclerosis early and to follow its progression. Therapy will be aimed at correcting the risk factors and at protecting the arterial wall despite the presence of risk factors. The use of laser beams or the injection of synthetic substances may dissolve atherosclerotic plaque. Replacement of damaged hearts with transplanted ones will be commonplace but limited to availability; a completely implantable artificial heart may be a reality. PMID- 6488510 TI - Immediate hypersensitivity, IgE and asthma. AB - Twenty-one asthmatic and twenty-two non-asthmatic children and nine asthmatic adults from two different rural areas of Tanzania, and eight asthmatic children from Dar-es-Salaam were surveyed by questionnaires, skin testing and the measurement of serum IgE. Asthma was significantly commoner in female rural children (four males, fifteen females). The rural asthmatic children apparently had less skin reactivity (in seven of nine tests) and lower specific (in two of four tests) and total serum IgE than age-, sex- and village-matched controls. This pattern of asthma in rural children in the tropics represents a different type of asthma from that found in temperate zones. In contrast, the adult rural asthmatics and the urban children seemed to have the pattern of increased skin reactivity and serum IgE found in asthmatic patients from temperate climates. PMID- 6488511 TI - Skin and radioallergosorbent tests in patients with sensitivity to bee and wasp venom. AB - Intradermal (ID) and prick tests with bee or wasp venom (Pharmalgen) have been performed on 102 subjects with a history of adverse reactions to stings and forty six control subjects giving no such history. Venom was diluted 100, 10 and 1 microgram/ml for prick testing and 10(-2), 10(-2), 10(-3) and 10(-4) micrograms/ml for ID injections. In forty-six control subjects all were tested with the highest concentration of prick testing solution (100 micrograms/ml), eight (17%) had positive reactions, a similar reaction rate to that reported in control subjects using 10(-1) micrograms/ml ID. In our 102 test subjects skin tests were therefore regarded as positive only if the reaction was elicited by 10 micrograms/ml or less by prick test of 10(-2) micrograms/ml or less ID. In general the results with skin prick tests and ID tests were comparable when the prick solution was 1000 times the concentration of that used for ID testing. ID tests were positive in thirteen with negative skin prick, seven of whom had detectable antibodies when tested by RAST. Conversely four with a positive skin prick test (two of whom were RAST positive) were considered negative on ID testing. As judged either by RAST or skin tests it appeared that sensitivity diminished with the time interval from the last sting (P less than 0.001). PMID- 6488512 TI - Antibodies to hen and duck antigens in poultry workers. AB - Serum antibodies to avian and Aspergillus antigens were detected by enzyme-linked immunosorbent assays (ELISA) in forty-two workers from a poultry abattoir and in twenty healthy blood donors. The levels of IgG and IgA antibodies to hen and duck serum were significantly higher in poultry workers than in blood donors (P less than 0.01). In workers employed for less than 1 year the antibody levels were lower than in those who had been employed for a longer period of time (P less than 0.05). The IgA antibody level to a high molecular weight Aspergillus antigen was higher in poultry workers than blood donors (P less than 0.05), whereas the level of other Aspergillus antibodies were similar in the two groups. The level of IgG antibodies to hen antigen was higher in non-smokers than in smokers (P less than 0.02). A correlation between the antibody levels to hen and duck antigens and to pigeon antigen was found (P less than 0.05), indicating cross reactivity between these antibodies. No cases of allergic alveolitis were found, and no correlation between antibody levels and respiratory symptoms could be demonstrated. PMID- 6488513 TI - Canary fancier's lung. AB - A 54-year-old man presented with features consistent with extrinsic allergic alveolitis occurring after contact with his pet birds. Screening of the serum for avian precipitating antibody was negative but canary precipitins were present. Extrinsic allergic alveolitis to his pet canaries was confirmed by inhalation challenge. PMID- 6488514 TI - Natural-killer-cell activity in atopic dermatitis. AB - Natural-killer (NK)-cell activity was measured in the peripheral blood of twenty patients with atopic dermatitis and in a group of thirteen age-matched non-atopic controls (nine subjects on thirteen occasions). The method uses a chromium release assay with the human leukaemia cell line, K562, labelled with 51Cr as the target cell. A highly significant reduction in NK-cell activity was found in the patients with atopic dermatitis. PMID- 6488515 TI - Abdominal migraine and food sensitivity in children. PMID- 6488516 TI - Biological variance of total lactate dehydrogenase and its isoenzymes in human serum. AB - We measured the variance components of total lactate dehydrogenase (LD; EC 1.1.1.27) activity and isoenzymes in sera of 24 healthy laboratory staff, ages 23 50 years, over a 12-month period. We used the first six weeks' results to establish baseline values for each analyte in each individual. These values were "normally" distributed for total LD and isoenzymes 1 through 4, but values for isoenzyme-5 were skewed slightly to the left. The overall means and variances determined for the remaining 10 months were not significantly (p greater than 0.05) different from the corresponding baseline values. Average variances (SD2) for the longer-term (10-month) study were: intra-individual, 732, 1.92, 2.25, 1.09, 1.11, and 2.25, and inter-individual, 1988, 5.03, 1.76, 1.57, 1.21, and 2.01 for total LD (U/L) and LD-1 through LD-5 (% of total), respectively. Average long-term analytical variability was less than 35% of the total variance for the five isoenzymes and 6% for total LD, and was characteristic of the individual. There were no significant differences in mean activities with respect to age or sex. All six analytes exhibited slight seasonal variations. PMID- 6488518 TI - Operational research and cost containment: a general mathematical model of a workstation. AB - To facilitate planning and management, I have derived a mathematical model describing the dynamics of a workstation that receives a mixture of routine and emergency specimens. The model parameters include the maximal specimen-processing rate (to be defined by personnel representatives) and the longest delay allowed for emergency specimens at the workstation. Based on the model, a computer simulation technique has been developed to maximize the length of time (planned pauses) during which the workstation could be closed without causing undue delay of routine and emergency specimen results. The application of this technique is illustrated with real data, in which more than 50% of the specimens were emergency specimens. Three pauses, constituting 35% of working hours, could be introduced with a negligible impact on the turnaround time of emergency specimens (mean increase = 8 min). The model may also be used to derive, as a function of time of day, the largest extra workload that may be presented to a workstation without creating overwork. The workload could be increased by 45%, provided that all additional specimens arrived before noon. PMID- 6488517 TI - An automated "high-pressure" liquid-chromatographic assay for hemoglobin A1c. AB - An automated "high-pressure" liquid-chromatographic assay for hemoglobin A1c is described. We use a 45-min incubation in acetate buffer (pH 5.5) to eliminate labile glycated hemoglobins. In this automated system conventional modules are used but it incorporates a solvent-switching valve to select either of two buffers, which differ in pH and NaCl concentration. The chromatographic column contains "polyCAT" (a weak cation-exchanger, polyaspartic acid linked to silica). Run time is 14 min per sample. The method is precise and results correlate well with those by other ion-exchange procedures. PMID- 6488519 TI - Determination of free thyroxin in serum by ultrafiltration: validation of a method and preliminary results. AB - We describe the determination of concentrations of free thyroxin in serum by ultrafiltration based on the Amicon micropartition system. The assay is straightforward and requires about 4 h for 25 samples. Our results demonstrate a correlation coefficient of 0.81 compared with equilibrium dialysis, and of 0.88 compared with radioimmunoassay. For sera from 49 normal, 25 hyperthyroid, 24 hypothyroid, 50 euthyroid sick, and 13 pregnant subjects, the means (and SD) were respectively: 19.3 (4.9), 40.1 (13.6), 5.0 (2.9), 25.9 (10.5), and 16.1 (3.2) ng/L. The interassay CV was 9.9% and the intra-assay CV 7.2%. We conclude that this procedure is useful in the diagnosis of thyroid disease and offers advantages of simplicity, rapidity, and economy. PMID- 6488520 TI - Stabilized analysis of antidepressant drugs by solvent-recycled liquid chromatography: procedure and proposed resolution mechanisms for chromatography. AB - In this efficient extraction and isocratic liquid-chromatographic procedure for measuring eight antidepressant drugs in serum (amoxapine, 8-hydroxyamoxapine, doxepin, desmethyldoxepin, imipramine, desipramine, amitriptyline, and nortriptyline), they are extracted from serum as a group by use of disposable solid-phase cyanopropyl columns; the eluate is injected directly onto a Zorbax cyanopropyl analytical column. This sample preparation circumvents potential problems of drug instability associated with the usual evaporating/concentrating techniques. Recycling the acetic acid/acetonitrile/n-butylamine mobile phase not only maintains a stable, cost-effective system, it also prolongs column life. Standard curves for all eight drugs are linear to 1000 micrograms/L; the detection limit is 8-10 micrograms/L. For all drugs and metabolites, within-run CVs were 0.9 to 2.2%, between-run CVs 2.1 to 3.8%. Analytical recovery of the solid-phase extraction step was 85 to 100% (mean = 94.5%) for all analytes. Standards and controls, stored frozen in drug-free serum, are stable for at least six months. We also report a study of separation mechanisms. PMID- 6488521 TI - Determination of enzyme activity in biological fluids by means of electrochemical oxidation of NADH at a modified glassy carbon electrode. AB - This amperometric technique for the determination of enzyme activity is based on detecting a decrease in the concentration of the NADH co-factor of the enzyme reaction. A glassy carbon electrode, modified by adsorption of Mg2+ and NADH, is used to measure the anodic peak current that corresponds to the oxidation of NADH. We found no significant difference between the enzyme activity of lactate dehydrogenase (E.C.1.1.1.27) preparations as measured by the above amperometric technique and by a spectrophotometric method. PMID- 6488522 TI - Measurement of gliclazide in plasma by radial compression reversed-phase liquid chromatography. AB - We describe a rapid, specific, and precise analysis for gliclazide in plasma by radial compression, reversed-phase, "high-performance" liquid chromatography. Gliclazide and the internal standard, 3-chlorogliclazide, are eluted after 4.4 and 6.8 min, respectively. Only 100 microL of plasma and minimal sample workup are required. The limit of detection for gliclazide in plasma is 0.5 mg/L (1.55 mumol/L) at 229 nm. Precision (CV) of the assay for 10 and 1 mg of gliclazide per litre is 2.1% and 6.4%, respectively. PMID- 6488523 TI - Kinetic approach for the enzymic determination of creatinine. AB - By exploiting the kinetics of NADH consumption in the enzyme system creatinine amidohydrolase + creatine kinase + pyruvate kinase + lactate dehydrogenase, one can determine creatinine in serum in the range of 1 to 90 mg/L. By using the conditions defined here, this determination can be made with a single measurement of the rate of disappearance of NADH. The analytical rate measurement is made at a fixed time (2 min) after the sample is introduced into the enzyme solution. For this fixed time, the interferences of creatine and pyruvate are eliminated. Results so obtained for creatinine in human blood serum samples correlated well (r = 0.98) with those obtained by the classical Jaffe-reaction method. Run-to-run reproducibility (CV) was 3%, and the limit of detection was 1 mg/L. PMID- 6488525 TI - Unreliability of immunochemical determination of lactate dehydrogenase isoenzyme 1 in heparinized plasma. AB - Paired serum and heparinized plasma samples were assayed simultaneously for lactate dehydrogenase (EC 1.1.1.27) isoenzyme 1 (LD1) activity by a commercially available immunochemical procedure. For all sera specimens tested, only LD1 activity was detected. For heparinized plasma, random discrepancies in LD1 activity were noted at normal (Group I), borderline (Group II), and increased (Group III) total LD activity. Incomplete precipitation of LD-M subunits was confirmed by electrophoresis and occurred in eight of 15, four of 13, and eight of 22 instances (total: 20/50, or 40%) with a mean difference of 13, 10.6, and 18.2 U/L (8.3, 4.0, and 4.4%) in Groups I, II, and III, respectively. We conclude that heparinized plasma is an unsuitable sample for the immunochemical determination of LD1. PMID- 6488524 TI - Creatine kinase isoenzymes in human cerebrospinal fluid and brain. AB - Extracts of normal brains obtained at autopsy and cerebrospinal fluid (CSF) from patients with global brain ischemia were analyzed for creatine kinase (CK; EC 2.7.3.2) isoenzymes. We used both qualitative and quantitative assays (electrophoresis and immunoinhibition). Brain extracts contained CK-BB isoenzyme and mitochondrial CK. In 54 CSF samples free of blood contamination and with total activities ranging from 7 to 2010 U/L (mean 202 U/L), virtually all of the CK activity was due to CK-BB, and none to CK-MM or CK-MB. We conclude that brain contains CK-BB and mitochondrial CK, but lacks CK-MM and CK-MB. After cardiac arrest, CK-BB is released into the CSF. Any CK-MM in the CSF is probably from blood contamination, in which case immunoinhibition with anti-CK-M antibodies accurately quantifies CK-BB. PMID- 6488526 TI - Effects of sample preparation on concentrations of cyclosporin A measured in plasma. AB - Because cyclosporin A rapidly changes its distribution in blood with changes in temperature, sample preparation affects results for it as measured in plasma. If whole blood is stored at either 4 degrees C or room temperature, results for cyclosporin A in the plasma are lower than in whole blood stored at 37 degrees C and centrifuged at this temperature. Re-equilibration of the former to 37 degrees C before cells are removed increases the analytical recovery of cyclosporin A in plasma; the optimal equilibration interval is 30 min. Use of such re equilibration, followed by immediate centrifugation at room temperature, increases values obtained for cyclosporin in plasma by 60 to 65% over those determined after non-temperature-standardized collection procedures, but does not significantly improve the correlation between values for plasma and whole blood. Hematocrit and concentrations of cyclosporin A in plasma are inversely related. Correction for hematocrit improves the correlation between results for plasma and whole blood. PMID- 6488527 TI - Automated kinetic assay for lactate dehydrogenase isoenzyme 1 by centrifugal analysis after alkaline inactivation. AB - Lactate dehydrogenase isoenzyme 1 (LD1, EC 1.1.1.27) has been used widely as a marker for myocardial infarction, and many analytical methods for it have been developed, most of which are relatively labor intensive. On the basis of a recent report by Takizawa et al. (Clin Chem 29: 1941-1945, 1983) describing the marked stability of LD1 in buffered alkaline solutions, and with use of a centrifugal analyzer, we have developed a fully automated assay for LD1. Results with this method are precise (between-day SD = 2.1 U/L), vary linearly with LD1 activity to 600 U/L, and correlate well with LD1 as determined by immunological (Roche Isomune-LD) and agarose electrophoretic methods (r = 0.985 and 0.986, respectively). Furthermore, the method is easy and convenient, and should provide a substantial savings in labor and reagent costs to laboratories currently determining LD1 by electrophoretic or immunologic methods. PMID- 6488528 TI - Performance of the ASTRA enzyme systems evaluated. AB - We evaluated the ASTRA enzyme systems for the kinetic measurement of some commonly measured enzymes. The comparison studies with the SMAC and the LKB 8600 show that results by the ASTRA enzyme systems correlate well with those by our routine methods. Studies with several control sera yielded excellent results for both within-run and between-day variation. The response of the photometer is linear up to 3.0 A. For three enzymes the range of linearity exceeded the limits proposed by the supplier, but for lactate dehydrogenase it did not extend as far as proposed. Reagents are stable for at least one week at 16-24 degrees C. PMID- 6488529 TI - Chromatograph with external column evaluated for determining breath hydrogen in clinical studies. AB - A novel breath-hydrogen analyzer involving an external chromatographic column in the form of a cartridge packed with molecular-sieve material and dessicant is described. The instrument incorporates a sintered SnO2 solid-state sensor into the detector, which registers a change in electrical potential in response to the adsorption of reducing gases; ambient room air is drawn through an activated charcoal filter by a small, internal pump and used as the carrier gas. Once calibrated with a gas of known H2 concentration, a digital meter registers the concentration of H2 in an unknown sample of breath air. The response is linear with concentration up to 160 microL/L. The external column is both necessary and effective for screening out contaminating reducing gases. The correlation coefficient for 250 gas samples measured simultaneously with an external cartridge instrument and with an internal column chromatography is greater than 0.99. Results by the new analyzer corresponded 100% with those by the conventional machine for detecting carbohydrate malabsorption; for diagnosing efficient carbohydrate absorption, results by the two instruments agreed for 96% of the tests. PMID- 6488530 TI - Inadequate hemolysis of erythrocytes on reagent strips at low pH causes false negative readings. AB - Patients' urines gave an unexpectedly high percentage of false-negative results for erythrocytes on a reagent strip, even when the test field for ascorbic acid indicated that none of this substance was present to inhibit the test reaction. By adding known amounts of erythrocytes to normal urines, we found that this phenomenon was time-dependent and occurred with three different brands of reagent strips in urines having a pH below 6.0. Hemolysis of erythrocytes was totally inhibited below pH 5.1 after 4 h of incubation with 50 X 10(6) erythrocytes per liter. The inhibition is apparently caused by shrinkage of the erythrocytes, rending them insensitive to the hemolytic agents in the different reagent strips tested. PMID- 6488531 TI - An evaluation of kits for measuring thyrotropin in newborns. AB - Several commercial radioimmunoassay kits are now marketed specifically for determination of thyrotropin (TSH) from whole-blood specimens collected on filter paper in neonatal screening programs. We have compared five kits in use in such screening programs in the United States. The reagent kits from Becton Dickinson, Neometrics, and Nuclear Medical Systems gave similar satisfactory results. That from Pharmacia was somewhat more difficult to use and gave greater coefficients of variation. Diagnostic Products' kit appeared to perform satisfactorily, but the analytical values obtained were significantly low, which may suggest erroneous calibrator values within the kit. PMID- 6488532 TI - The distribution of chymotrypsin within the feces and description of a new device for the preparation of stool samples. AB - We measured the distribution of chymotrypsin within feces by comparing duplicate 100-mg stool aliquots from 48 stool specimens. For practical purposes, the distribution of the enzyme in stool appears sufficiently homogeneous to assure representative results even from 100-mg stool aliquots. Given this likelihood, we have developed a new disposable device that measures 100-mg stool aliquots hygienically, prepares this material for shipping by mail, homogenizes and suspends the stool sample, and facilitates centrifugation of the fecal suspension, all within the same instrument. Performance studies with this new device revealed that stools of different consistency can be measured out precisely and conveniently by volume. The difference in the specific weight of different stools appears to be so low that for practical purposes a 100-mg mass of stool can be weighed out by volume. PMID- 6488533 TI - Lactate production by aerobic bacteria grown in cerebrospinal fluid. AB - The source of the abnormally high concentration of lactate in the cerebrospinal fluid in patients with bacterial meningitis is not known. It may represent a bacterial metabolite. To determine whether cerebrospinal fluid possesses appropriate substrates to support the growth of pathogenic aerobic bacteria, three Gram-positive and nine Gram-negative bacteria were separately inoculated in pooled normal cerebrospinal fluid. After incubation for 24 h, all Gram-positive bacteria increased lactate, eight Gram-negative bacteria decreased lactate, and one Gram-negative bacteria failed to significantly change the lactate concentration. We conclude that lactate produced in cerebrospinal fluid in patients with aerobic bacterial meningitis is not necessarily a bacterial metabolite. PMID- 6488535 TI - Improved dye-binding procedure for determining microgram quantities of protein in cerebrospinal fluid--once again. PMID- 6488534 TI - Condensation of isoniazid and acetaldehyde. PMID- 6488536 TI - Affinity chromatography of urinary brush-border enzymes on concanavalin Sepharose. PMID- 6488537 TI - Serum procollagen-III as indicator of therapeutic effect in children treated for somatotropin deficiency. PMID- 6488538 TI - More on "flipped" lactate dehydrogenase patterns in myocardial infarction. PMID- 6488539 TI - Activated polyamide tubes for radioimmunoassay. PMID- 6488540 TI - Ammonia results increased by bacteria in aca needle tubing. PMID- 6488541 TI - Pyruvate interference in RA 1000 single-reagent AST method. PMID- 6488542 TI - Negative interference with the Ektachem (Kodak) enzymic assay for creatinine by high serum glucose. PMID- 6488543 TI - In acetaminophen assay, only unconjugated drug should be measured. PMID- 6488544 TI - Colorimetric calibration of multichannel pipettes. PMID- 6488545 TI - Bichromatic blanking in the bromcresol purple method for albumin in serum and plasma. PMID- 6488546 TI - "Interferovalue" indicates the interference of substances with creatinine determination. PMID- 6488547 TI - Optimizing a liquid chromatographic mobile phase for simultaneous analysis of eight antiepileptic drugs. PMID- 6488548 TI - Enzyme activities and hypothyroidism. PMID- 6488549 TI - Urinary oxalate by rate analysis compared with gas-chromatographic and centrifugal analyzer methods. PMID- 6488550 TI - Astra creatinine reagent stable. PMID- 6488551 TI - Cystine accumulation and clearance in normal and cystinotic fibroblasts exposed to cystine dimethyl ester. AB - Exposure of cultured skin fibroblasts of normals and cystinotic patients to 0.5 mmol/l[35S]cystine dimethyl ester for 30 min resulted in an accumulation of cystine in excess to that naturally occurring in cystinotic skin fibroblasts. These equal levels of cystine accumulation achieved in both cystinotic and normal cells, permitted comparative experiments to look for differences in cystine disposal between normal and cystinotic cells. Cystinotic fibroblasts demonstrated very low cystine clearance with a lower ratio of cysteine-N-ethylmaleimide to cystine than normal. The results on cystinotic fibroblasts are consistent with those observed in leucocytes, suggesting that fibroblasts can be useful in further studies to elucidate the clearance defect of cystine in cystinosis as well as its potential in antenatal diagnosis. PMID- 6488552 TI - beta-N-acetyl-D-glucosaminidase isoenzymes by chromatofocusing from serum and skin in diabetes. AB - beta-N-Acetyl-D-glucosaminidase and its kinetic characteristics were determined in serum and skin from both diabetes mellitus and impaired glucose tolerance patients and controls. Mean total activity was reduced (p less than 0.05) in the skin of both patient groups. beta-N-Acetyl-D-glucosaminidase isoenzyme expression was investigated using chromatofocusing on PBE-94 coupled with automated enzyme assay. The isoenzyme profiles from serum showed two major forms (A and B) whose ratio varied from 2:1 in controls to 3:1 in diabetics. Moreover, diabetes mellitus and impaired glucose tolerance subjects displayed an intermediate (I) form. The A/B isoenzyme ratio was completely reversed in skin. PMID- 6488553 TI - Radioimmunoassays of 7-hydroxymethotrexate and methotrexate. AB - Antisera against 7-hydroxymethotrexate were raised in rabbits by injection of 7 hydroxymethotrexate coupled to bovine serum albumin. A 125I-radiolabelled probe was synthesised by radioiodination of 7-hydroxymethotrexate conjugated to tyrosine methyl ester. We developed with these reagents a liquid phase radioimmunoassay for 7-hydroxymethotrexate in which methotrexate did not interfere significantly (cross-reactivity factor = 2.5 X 10(-4]. Similar techniques were used also for the development of a specific radioimmunoassay for methotrexate, which minimally cross-reacted with 7-hydroxymethotrexate. The assessment of the specificity of these assays showed that parallel monitoring of methotrexate and 7-hydroxymethotrexate in human plasma was possible. Coefficients of variation for duplicate determinations were less than 15% between 0.06 and 1.2 nmol/l for methotrexate and between 0.08 and 9 nmol/l for 7-hydroxymethotrexate. Methotrexate and its oxidative metabolite, 7-hydroxymethotrexate, were quantified in plasma of patients following high-dose infusion (2 g over 24 h) by radioimmunoassay and high performance liquid chromatography. The agreement between the two techniques was found satisfactory, as evaluated by least square regression analysis (slopes 1.007 +/- 0.046 for 7-hydroxymethotrexate and 0.937 +/- 0.046 for methotrexate with y-axis intercept not significantly different from zero). These radioimmunoassays permitted also the evaluation of the concentrations of methotrexate and 7-hydroxymethotrexate in plasma after intravenous bolus injection (50 mg/m2), and large inter-individual difference in both methotrexate and 7-hydroxymethotrexate kinetic behaviour could be observed. PMID- 6488554 TI - Fecal lipid chromatography--identification of an unusual fraction in relation to colon cancer. AB - The thin-layer chromatography of fecal lipids with revelation by phosphomolybdic reagent indicates the presence of an unusual fraction only in colon cancer patients. After isolation and identification, this fraction appears to be composed of coprostanol and its derivatives. The quantitative analysis of fecal neutral steroids in colon cancer patients compared to controls, patients with other digestive diseases and polypi shows a positive relationship between this fraction and colon cancer. PMID- 6488555 TI - The relationship between urinary inhibitory activity and endogenous concentrations of glycosaminoglycans and uric acid: comparison of urines from stone-formers and normal subjects. AB - The inhibitory effect of urine from 64 male stone-formers and from 42 normal men on the growth and aggregation of calcium oxalate crystals was measured. The degree of inhibition of each urine specimen was related to the endogenous concentrations of glycosaminoglycans, uric acid, and creatinine, and to the ratio of glycosaminoglycan to uric acid concentrations. No significant difference between the two groups of subjects with regard to the effect of urine on crystal growth or aggregation was found. Inhibitory activity was found to be significantly correlated with the urinary concentration of glycosaminoglycans, creatinine and uric acid, but not to the ratio of glycosaminoglycan/uric acid concentrations. It was concluded that urinary inhibitory activity depends only partly on the endogenous concentration of glycosaminoglycans and that the inhibitory activity of these compounds in vitro does not depend on the associated level of uric acid in the urine. PMID- 6488556 TI - Dihydropyrimidine dehydrogenase deficiency leading to thymine-uraciluria. An inborn error of pyrimidine metabolism. AB - Three unrelated patients with excessive thymine-uraciluria due to dihydropyrimidine dehydrogenase deficiency are described. Excretory values (mmol/g creatinine) were: uracil 2.0-10.5, thymine 2.3-7.5, 5-hydroxymethyluracil 0.2-0.9. Orally administered (index patient) uracil and thymine were excreted for the greater part whilst dihydrouracil and S-dihydrothymine were mainly metabolised. Dihydropyrimidine dehydrogenase activities (nmol X h-1 X mg-1 protein) in leucocytes were 0.04, 0.01 and less than 0.01 in the patients, 0.31 1.66 in their parents, and 1.01-4.46 in controls (n = 4). The patients presented with a non-specific clinical picture of cerebral dysfunction. PMID- 6488558 TI - Determination of aluminium in body fluids by solvent extraction and atomic absorption spectroscopy with electrothermal atomization. PMID- 6488557 TI - Comparison of three methods for investigating placental protein 12(PP12)-like immunoreactive substance from preovulatory follicular fluid and purified PP12 from human placenta. AB - Placental protein 12(PP12)-like immunoreactive fraction of preovulatory follicular fluid from Sephadex G-100 and purified placental PP12 were subjected to reverse phase high performance liquid chromatography (HPLC). The elution was carried out with acetonitrile gradient. PP12-like immunoreactivity of both samples had the same retention time. This fraction of follicular fluid from HPLC and placental PP12 were then run on a sodium dodecyl sulfate-polyacrylamide gel and transferred electrophoretically to a nitrocellulose (NC) sheet. Protein bands on the NC sheet were then detected immunologically with anti-PP12 antisera. After visualising the bands which had reacted with antisera it was obvious that PP12 like immunoreactive substance from follicular fluid and from placenta had an electrophoretic mobility corresponding to the same molecular mass. PMID- 6488559 TI - Development of specific radioimmunoassays for the measurement of human hepatic basic and N/A2b glutathione S-transferases. PMID- 6488561 TI - On the specificity of assays for lipases in postheparin plasma. PMID- 6488560 TI - Two-site immunochemiluminometric assay for serum ferritin. PMID- 6488562 TI - Jamaican vomiting sickness: a study of two adult cases. AB - An acute illness (Jamaican vomiting sickness) which affected two adults after eating unripe ackee fruit was investigated. Analyses of serum and urine samples were performed to compare the patterns of organic acidaemia and aciduria with those reported from childhood cases. The main conclusion from the comparison is that the toxic ackee constitutent, hypoglycin, produces essentially the same metabolic effects in adults as in children. PMID- 6488563 TI - Plasma EC-superoxide dismutase activity in insulin-dependent diabetic children. AB - Toxic oxygen-centered radicals have been linked to beta-cell damage brought about by some chemicals and might conceivably also be of importance in the pathogenesis of spontaneous insulin-dependent diabetes mellitus (IDDM). In several model systems, superoxide dismutase has been protective. The major protector against superoxide radicals in the extracellular space appears to be a recently discovered superoxide dismutase, EC-superoxide dismutase. This enzyme was analysed in plasma from children with insulin-dependent diabetes mellitus. The specimens were obtained from 8 patients with disease of recent onset and from 15 patients with disease of longer duration. There was no significant difference in EC-superoxide dismutase between the patients and controls. PMID- 6488565 TI - The cholesterol content of HDL2 and HDL3 subfractions of high density lipoproteins in different normocholesterolemic populations. AB - Two normocholesterolemic populations, selected for either high triglyceridemia or low HDL cholesterol content, both known to have increased artery disease risks, were studied for their cholesterol content in HDL2 and HDL3 subfractions. These subfractions were isolated by a precipitation method. The results showed that, in both populations, total HDL cholesterol values were similar and HDL2 and HDL3 cholesterol content were decreased when compared with a control population. In percentage of total HDL cholesterol, the HDL2 cholesterol subfraction appeared significantly diminished only in female subjects for both populations studied. PMID- 6488564 TI - Prenatal diagnosis of Krabbe disease using a fluorescent derivative of galactosylceramide. AB - A fluorescent substrate 12-(N-methyl-N(7-nitro-2-oxa-1,3-diazol-4-yl) aminododecanoyl sphingosyl beta-D-galactoside ('NBD galactocerebroside') was synthesized and used for the detection of galactocerebrosidase activity. The enzyme determinations using this substrate were found to be extremely sensitive yielding unambiguous results. This substrate was used for the prenatal diagnosis of a fetus affected with Krabbe disease; the diagnosis was later confirmed in the aborted fetus. PMID- 6488566 TI - A sensitive and simplified radioimmunoassay for 1,25-dihydroxyvitamin D3. AB - A sensitive radioimmunoassay system for 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3] with an improved extraction procedure has been developed. Following one-step extraction and prepurification of 1,25(OH)2D3 by 'Extrelut-1' minicolumns final purification was achieved by high-performance liquid chromatography (HPLC) using a radial compression separation system equipped with a mu Porasil cartridge. The HPLC method applied allows the purification of 4 extracts/h. Recovery of 1,25(OH)2[3H]D3 after HPLC was 77 +/- 2.6% (mean +/- SD, n = 51). Since the recovery of 1,25(OH)2[3H]D3 was very reproducible, addition of labelled steroid to each single serum sample for monitoring recovery was omitted. The sensitivity of the assay was 0.8 pg/tube resulting in a detection limit of 3 ng/l, when 1 ml of serum was extracted. Intra-assay and inter-assay coefficients of variation were 12% and 16.8%, respectively. Serum 1,25(OH)2D3 concentration in 30 normal subjects (mean age: 25 yr) was 55 +/- 12 ng/l (mean +/- SD). In 55 elderly patients (mean age: 77 yr) the 1,25(OH)2D3 serum level was 32 +/- 12 ng/l (mean +/- SD) and in three patients with chronic renal failure on 1,25(OH)2D3 therapy 146 +/- 67 ng/l (mean +/- SD). Patients with chronic renal failure had reduced 1,25(OH)2D3 serum levels (mean 5.4 ng/l, range less than 3-11 ng/l, n = 10). In one patient with renal failure, following kidney transplantation the serum 1,25(OH)2D3 and creatinine levels were monitored from the 4th to the 12th post-surgical day: a highly significant negative correlation (r = 0.85) was found. PMID- 6488567 TI - Squamous epithelium in the subglottic region of paediatric larynges. AB - A macroscopic staining method was used to display and measure the extent of squamous epithelium in the subglottis of stillborn babies and of babies less than 3 months old. Squamous epithelium was found to be present in some babies without a previous history of intubation (3 of 8) and in some stillborn babies (3 of 11). Squamous epithelium in the subglottic space of the human is thus present at birth. PMID- 6488568 TI - Auditory brain stem responses in patients with vertigo. AB - Sixty-two patients with vertigo were examined with ABR. Eight of the 30 patients with vestibular neuronitis had abnormal ABR indicating brain stem dysfunction. Most of the patients with abnormal ABR showed continued ABR abnormality after recovery from the disease. Only one patient with epidemic vertigo had abnormal ABR, the remaining 15 patients had no signs of brain stem involvement. All 16 patients with benign positional vertigo had normal ABR. PMID- 6488569 TI - Pitfalls in the diagnosis of acoustic neuroma. AB - The patient with an acoustic neuroma may present to the otologist with a variety of clinical features. Classically these include a retrocochlear pattern of sensorineural hearing loss, reduced vestibular response on caloric testing and radiological asymmetry of the internal auditory canals (IAC). The absence of any or all of these features, however, does not exclude the presence of tumour. Five cases are presented to illustrate the potential for diagnostic delay unless a routine battery of investigations is undertaken in patients with neuro-otological disorders. All patterns of subjective audiometry are encountered, auditory brain stem response testing may be unreliable where hearing loss is profound, vestibular testing is normal in half of small tumours and the intracanalicular tumour may be radiologically undetectable unless IAC meatography is employed. PMID- 6488570 TI - Quality of life in treated head and neck cancer patients: a preliminary report. AB - A psychological study of 48 elderly men after treatment for buccopharyngeal cancers was carried out to see whether treatment type (surgery alone, irradiation alone or salvage surgery after failed radiotherapy) was associated with differences in quality of life. Eight measures were used, covering functional disability, appearance, pain, depression, psychological well being and life satisfaction. Functional disability was lower and performance status high in those treated by irradiation alone. There was greater dissatisfaction with appearance in patients treated by surgery. Levels of depression were high in all groups. There were no significant differences between treatment groups however for depression, present pain, psychological well being or life satisfaction. PMID- 6488571 TI - Basal cell carcinoma of the external auditory meatus. AB - Five of a personal series of 47 patients with carcinoma of the middle and external ear had basal cell carcinoma. Two patients had extensive disease, one having petrosectomy and the other refusing. All treated patients did well. PMID- 6488573 TI - Electrolyte disorders. PMID- 6488572 TI - Computerized study of the velocity of the rapid eye movements. AB - The average velocity-amplitude characteristics of rapid eye movements (voluntary saccades, and fast phases of caloric and optokinetic [OKN] nystagmus) in normal humans were analyzed with an analogue-digital computer and compared among them. For the same amplitude of movement the velocity of the saccades is considerably greater than that of the fast phases of the OKN, and these in turn are greater than those of their vestibular counterparts. The complexity in oculomotor neurophysiology makes this observation difficult to explain. PMID- 6488574 TI - Central nervous system manifestations of disordered sodium metabolism. PMID- 6488575 TI - The investigation of polyuria. PMID- 6488576 TI - Saline depletion, pre-renal failure and acute renal failure. AB - The wide range of diseases that can influence the kidney, either directly or indirectly, all influence water and electrolyte balances according to established 'rules'. There is great scope for helping patients by understanding these rules, and also a great potential to do harm by ignoring them. Careful consideration of simple routine data, and an awareness of the limitations of some indexes and ratios in common use, will usually result in an adequate provisional classification of the patient. This can be used to plan therapeutic trials designed to correct metabolic and electrolytic disturbances, and to organize diagnostic procedures that will establish the cause of any intrinsic renal diseases or the cause of obstructions. Earlier and more frequent use of dialysis and related techniques in management is recommended, as is greater attention to the control of blood glucose, nutrition and electrolyte balance. A general recommendation is that corrections of many deficits should not be excessively rapid. PMID- 6488577 TI - The role of the anion gap in detecting and managing mixed metabolic acid-base disorders. AB - Mixed metabolic-respiratory acid-base disorders may be diagnosed when the respiratory compensation for a primary metabolic acidosis or alkalosis is inappropriate or when there is inappropriate metabolic compensation for a primary respiratory disorder. The magnitude of the primary change in HCO3 concentration (in metabolic disorders) defines the limits of compensation. We emphasized the importance of the equality of the increment in the anion gap (delta AG) and the decrement in the serum bicarbonate concentration (delta HCO3) in diagnosing a simple high AG metabolic acidosis. The close relationship between these two changes in simple high AG acidoses is reviewed. When the delta HCO3 is greater than the delta AG, we suggest that a mixed high AG and hyperchloraemic acidosis is present. Other possible interpretations of these chemical changes are discussed. When the delta HCO3 is less than the delta AG, a mixed metabolic alkalosis and metabolic acidosis is likely to be present, but other additional explanations of this combination are also reviewed. Thus, guidelines are presented as a basis for the use of the delta AG and delta HCO3 for diagnosing and managing mixed metabolic acid-base disorders. PMID- 6488578 TI - Electrolyte disorders in the surgical patient. PMID- 6488579 TI - Plasma urea and electrolytes: the clinical need. PMID- 6488580 TI - The exocrine pancreas. PMID- 6488581 TI - Sebaceous carcinoma. PMID- 6488583 TI - Immune findings in staphylococcal bullae--cross-reactivity between epidermal and staphylococcal antigens. PMID- 6488582 TI - Hyperkeratotic porokeratosis (Mibelli) with psoriasis--response to an aromatic retinoid. PMID- 6488584 TI - Infantile gluteal granulomata--case report. PMID- 6488585 TI - The syndrome of acanthosis nigricans, hyperandrogenism and insulin resistance. PMID- 6488586 TI - Scar sarcoidosis. PMID- 6488587 TI - Natural killer (NK) cell activity in murine muscular dystrophy. II. Age-related tissue distribution and enhanced NK activity in the thymus of dystrophic mice. AB - The age-related tissue distribution of natural killer (NK) cell activity in murine muscular dystrophy was investigated. Lymphoid tissues including the spleen, thymus, mediastinal (or bronchial) lymph nodes (BLN), mesenteric lymph nodes (MLN), inguinal/popliteal lymph nodes (PLN1), and axillary/brachial lymph nodes (PLN2) were obtained from various aged normal (+/+) and dystrophic (dy2J/dy2J) C57BL/6J mice. Cell suspensions were incubated with 51Cr-labeled YAC 1 lymphoma target cells in a 4-hr 51Cr-release assay. The data indicated that dystrophic mice, at all ages studied, had elevated levels of NK activity in the spleen, BLN, MLN, PLN1, and PLN2 as compared with the normal age- and sex-matched control group. The NK activity in the thymocyte population from dystrophic mice at 2 weeks of age was found to be negligible, while at 8 weeks of age it was two fold higher than that for the normal control group. In addition, dystrophic mice had an age-related decline in NK activity in all tissues after 10 weeks of age but the activity was still elevated at 40 weeks of age as compared with the normal control group. Target cell binding studies revealed that the number of conjugate-forming cells in thymocytes from 8-week-old dystrophic mice were found to be significantly higher than that found in normal mouse thymocytes using NK sensitive YAC-1 tumor target cells. The number of cells bound per YAC-1 target cell ranged from 1 to 3 for dystrophic mouse thymocytes as compared with 1 to 2 for the normal control group. Thus, the data indicate an elevated NK activity in all lymphoid tissues studied from dystrophic mice of different ages. In addition, the thymus from dystrophic mice at 8 weeks of age contains an enhanced number of conjugate-forming NK cells and NK activity. PMID- 6488588 TI - Lymphocyte locomotion in experimental allergic thyroiditis. AB - Experimental allergic thyroiditis was produced in rats by immunization with homologous thyroglobulin (Tg). The mechanisms of lymphocyte accumulation of the thyroid lesion were analyzed by using this experimental model. The sensitized lymph node cells were cultured with Tg. After 72 hr, the cell-free supernatant was found to contain a chemotactic factor for sensitized lymphocytes. Lymph node lymphocytes from animals immunized 3 weeks previously were the best source of such sensitized lymphocytes while the cells at the latter stage could not produce the factor. The culture supernatant was applied to a Sephadex G-100 gel filtration column. The results indicate that the molecular weight of the factor is around 12,400. Among lymph node lymphocytes, nylon-wool column nonadherent lymphocytes were the most responsive; adherent lymphocytes were not responsive. Thyroglobulin itself did not chemoattract lymphocytes obtained from rats immunized with Tg. This phenomenon was in contrast to macrophage chemotaxis in the same model in which macrophage itself can move toward Tg. In any event, these results seem to indicate that a chemotactic lymphokine may be playing an important role in the pathogenesis of lymphocyte accumulation of the thyroid lesion. PMID- 6488589 TI - The effect of NPT 15392, 9-(erythro-2-hydroxy-3-nonyl)-6-hydroxypurine, on the phytohemagglutinin of OKT3+, OKT4+, OKT8+, and OKM1+ cell-depleted and undepleted peripheral blood mononuclear cells. AB - NPT 15392, 9-(erythro-2-hydroxy-3-nonyl)-6-hydroxypurine, has been reported to influence immunological responses involving different cell types. Herein data are obtained by studying the influence of NPT 15392 on the phytohemagglutinin (PHA) induced proliferative responses of unfractionated peripheral blood lymphocytes (PBLs) and of cell suspensions, which have been depleted of the cell subsets recognized by the monoclonal antibodies OKT3, OKT4, OKT8, and OKM1, in an attempt to identify which cell types respond to NPT 15392 in the PHA-driven blast transformation assay. The proliferative responses of unfractionated peripheral blood lymphocytes are potentiated when the drug is employed at the concentration of 0.1 microgram/ml and inhibited when NPT 15392 is added to the cell suspensions at concentrations over 5 micrograms/ml. The data reported here suggest that this phenomenon is a composite effect, made up of a combination of the counteracting effects caused by the OKT4+ cells on the one hand, and the OKT8+ and OKM1+ cells on the other. PMID- 6488590 TI - Suramin inhibits the binding of complement-fixing antibody/double-stranded DNA immune complexes to CR1. AB - The effects of varying concentrations of heparin and suramin on the complement mediated binding of antibody/double-stranded DNA immune complexes to red blood cells (RBCs) and Raji cells have been investigated. If the immune complexes are briefly opsonized with complement, suramin can block binding to both cell types, and heparin can block binding to RBCs. In addition, if these complexes are first allowed to bind to RBCs or Raji cells, relatively brief incubations in suramin are sufficient to cause release of the complexes from the cells' C3b receptors. The potential clinical and diagnostic implications of these findings are discussed. PMID- 6488591 TI - Inhibition of in vitro lymphocyte proliferation by serum from acquired immune deficiency syndrome patients depends on the ratio of cells to serum in culture. AB - The effect of serum from patients with acquired immune deficiency syndrome (AIDS) on cultures of normal human peripheral blood mononuclear cells stimulated with phytohemagglutinin (PHA) has been studied. It has been found that AIDS sera are inhibitory when compared with control sera from healthy individuals. The inhibitory activity in the AIDS patients' sera is dilutable with normal serum, is dependent on the number of cells present in culture and the amount of serum added, and cannot be attributed to a deficiency of nutrients in these sera. Inhibition of proliferation occurs even when AIDS serum is added to cultures of normal cells several hours after stimulation with PHA. In one patient who was being treated with plasmapheresis, decreases in serum inhibitory activity were found after pheresis procedures and were coincident with increases in the number of circulating T4-positive lymphocytes. PMID- 6488592 TI - Monoclonal antibodies to tissue-specific cell surface antigens. I. Characterization of an antibody to a prostate tissue antigen. AB - Monoclonal antibodies were raised to PC-3 human prostate adenocarcinoma cells, and one hybridoma, designated F77-129, was extensively purified and used to characterize a PC-3 antigen. The F77-129 antibody also showed serological reactivity with the Du-145 prostate cancer line and with three of four breast carcinoma lines tested; it showed variable binding to a colon carcinoma line. Several other lines tested, including melanomas, fibrosarcomas, and leukemias, were completely negative. Immunoperoxidase staining of frozen surgical specimens showed binding to both normal and malignant prostate and breast tissue. Injection of radioiodinated F77-129 into tumor-bearing nude mice showed specific in vivo targeting to prostatic cancer implants. The antigen also showed surface modulation by bound antibody, suggesting possible clinical utility of this antibody in delivering immunotoxins to tumors. PMID- 6488593 TI - Human umbilical cord vein smooth muscle cells lack receptors for C3b and the Fc portion of immunoglobulin G. AB - Under apparently normal conditions, the smooth muscle cells obtained from veins of human umbilical cord do not possess receptors for C3b or the Fc portion of IgG. These receptors were not expressed even after exposure to neutrophil lysate or a superoxide-generating system. The lack of these receptors argues against the possibility that smooth muscle cells participate in the pathogenesis of immune complex diseases through binding of C3b or Fc fragments. PMID- 6488594 TI - Response to cyclophosphamide in steroid-resistant focal segmental glomerulosclerosis: a reappraisal. AB - The response to and clinical outcome of cyclophosphamide therapy were retrospectively assessed in 29 steroid-resistant patients with idiopathic nephrotic syndrome and focal segmental glomerulosclerosis (FSGS) to determine whether a partial response to this drug was associated with long-term clinical benefits. Twenty of the patients were nephrotic when cyclophosphamide was started and 9 were not. Three of the nephrotic patients had a complete response (i.e., sustained remission of disease) to cyclophosphamide. Nine nephrotic patients had partial responses. Of these, 8 have residual proteinuria and one has progressed to end-stage renal disease (ESRD). In contrast, of the 8 nephrotic patients who were resistant to cyclophosphamide, only one has residual proteinuria, while 7 have chronic renal failure (CRF) or ESRD. The incidence of CRF or ESRD in patients with a partial response to cyclophosphamide (1 of 9) was significantly lower (p = 0.004) than that in patients who were resistant to cyclophosphamide (7 of 8). The benefit of cyclophosphamide in patients who were not overtly nephrotic was less certain. This study indicates that a partial response to cyclophosphamide leads to improvement in the clinical outcome of many steroid resistant nephrotic patients with FSGS. PMID- 6488595 TI - Carpal tunnel syndrome: a major complication in long-term hemodialysis patients. AB - One hundred and forty-five patients on hemodialysis for periods of 1 month to 16 years were examined clinically for carpal tunnel syndrome (CTS). Typical symptoms and clinical manifestations of symptomatic CTS, either unilaterally or in both hands, were detected in 21 of these patients (15%). In contrast to the classic form of CTS, hemodialysis CTS in our patients was frequently accompanied by Raynaud's phenomenon of those digits supplied by the median nerve. A highly significant correlation was established between the incidence of CTS and the duration of dialysis (p less than 0.001). The association of CTS with analgesic nephropathy was significantly higher (52%) than with other kidney diseases (p less than 0.034). Immediate relief of pain was achieved after carpal tunnel release (11 releases) in 8 of the 21 patients. Sensory and motor function was gradually, but often only partially, restored. Unoperated CTS progressed to loss of sensory and motor function within 1 to 4 years after the onset of symptoms. CTS should be considered a major late complication in patients on chronic hemodialysis. PMID- 6488596 TI - Idiopathic de Toni-Debre-Fanconi syndrome with absence of proximal tubular brush border. AB - In a girl with idiopathic de Toni-Debre-Fanconi syndrome associated with psychomotor retardation, severe renal tubular dysfunction was observed from the first day of life. At the age of 21/2 and 4 years the glomerular filtration rate (GFR) was only 60 ml/min/1.73 m2. No tubular transport of glucose, phosphate, paraaminohippurate and amino acids could be demonstrated. The tubular handling of uric acid, potassium and calcium, was also disturbed. Renal net acid excretion was zero at a plasma bicarbonate level of 14 mmol/l. Urinary osmolality ranged between 88 and 680 mosmol/kg. During hypotonic saline diuresis GFR decreased further; a GFR of 19 ml/min/1.73 m2 was accompanied by a fractional distal sodium delivery of 96.5% and a fractional free water clearance of 73%. In a renal biopsy specimen the proximal tubular cells showed variations in height with dedifferentiation and a widespread absence of brush border on electron microscopy. This formerly undescribed tubulopathy offers a unique chance to investigate glomerulo-tubular balance, adaptive mechanisms of distal tubular transport and renal metabolism under conditions where an apparently unchanged ultrafiltrate is offered by the proximal tubule to the loop of Henle and to a primarily intact distal tubule. PMID- 6488597 TI - Sclerosing peritonitis with mural bowel fibrosis in a patient on long-term CAPD. AB - A 66 year old white woman developed an incomplete small-bowel obstruction after 3 years of CAPD with lactate containing solutions. There were six episodes of peritonitis. The bowel obstruction was not due to a "sclerosing obstructive" (encapsulating) peritonitis but to a diffuse sclerosis of the serosal membranes extending into the muscle layers of the small and large bowels ("mural fibrosis"). This picture may be just one other expression of a spectrum of structural changes resulting from long-term chronic irritation of the abdominal cavity. PMID- 6488598 TI - Sudden cardiac death recorded during ambulatory electrocardiographic monitoring. AB - Two case reports of sudden cardiac death are detailed here. Holter monitoring plays an important role in documenting arrhythmias leading to sudden cardiac death. In addition, the importance of the Lown grading concept should not be underestimated. Our two case reports and a subsequent review of the literature demonstrate both points. PMID- 6488599 TI - Superiority of supine bicycle over isometric handgrip exercise in the assessment of ischemic heart disease: an evaluation of left ventricular ejection fraction response using radionuclide angiography. AB - Left ventricular ejection fraction (LVEF) response to supine bicycle and isometric handgrip exercise was evaluated in 15 patients with documented coronary artery disease (CAD) and stress-induced ischemia using radionuclide angiography. For purposes of analysis, the patients were divided into two groups: group I (n = 7) with single-vessel disease and group II (n = 8) with multiple-vessel disease including 3 with left main artery disease. The studies were repeated 18 days later at similar external workloads to assess reproducibility of both tests. LVEF response to bicycle exercise was different for the two groups. The change in LVEF from rest to peak exercise was +0.04 +/- 0.02 for group I and -0.07 +/- 0.04 for group II (p less than .001). LVEP response to isometric handgrip exercise was not different between the two groups. The change from rest to end of handgrip exercise was -0.02 + 0.02 for group I and -0.05 +/- 0.02 for group II. The reproducibility of LVEF response to bicycle exercise at similar workloads on day 1 and day 19 was good (r = 0.85) while it was poor for isometric handgrip testing (r = 0.67). Our data demonstrate that radionuclide angiographic measurement of LVEF response to supine bicycle exercise testing is superior to LVEF response to isometric handgrip testing in the evaluation of patients with CAD. PMID- 6488600 TI - Prolonged survival in tricuspid atresia with Eisenmenger's physiology. AB - Survival to adulthood is very rare in tricuspid atresia, particularly in certain subtypes and in the presence of Eisenmenger's physiology. We report a 32-year-old woman who has the type IC variant of tricuspid atresia and who has had documented Eisenmenger's physiology for over 10 years. PMID- 6488601 TI - Campylobacter jejuni myocarditis. AB - A case of Campylobacter jejuni (C. jejuni) myocarditis in a young man is described. C. jejuni was isolated from the patient's stools and he developed specific antibodies to this organism. Tests for other etiological agents (Salmonella, Shigella, Brucella abortus, beta-hemolytic streptococcus Group A, Treponema pallidum and coxsackievirus B) proved negative. PMID- 6488602 TI - Left ventriculography induced coronary artery spasm. AB - Angiographic contrast material is generally considered a vasodilator, although in vitro experiments have documented a spasmogenic effect. In this report we describe a patient with exercise and rest angina who developed spasm of the right coronary artery immediately following left ventricular angiography. The patient was treated successfully with calcium channel blockers. This is the first reported case of left ventricular angiography-induced coronary artery spasm. PMID- 6488603 TI - Amrinone: a weaning agent in catecholamine dependence. AB - Amrinone, a new inotropic agent, has been used successfully in refractory chronic congestive heart failure. Intravenous and subsequently oral amrinone administered in a setting of acute myocardial infarction and dopamine dependence allowed the catecholamine to be successfully weaned after volume loading, digitalization and vasoconstrictors failed to terminate dopamine dependence. There was the expected fall in filling pressure and increase in cardiac index and ejection fraction. Intravenous amrinone may be tried in refractory catecholamine dependence after conventional weaning methods have failed. PMID- 6488604 TI - Maternal nutrition and duration of gestation: a review. PMID- 6488605 TI - Endocrinology of preterm birth. PMID- 6488606 TI - Control of myometrial function in preterm versus term labor. AB - In this review I have attempted to briefly describe myogenic, neurogenic, and hormonal mechanisms which control myometrial function during term and preterm labor. The synthesis of myometrial gap junctions and receptors in response to hormonal changes appears to be a key element in the gradual evolution of contractility leading to labor. I suggest that the development of myometrial gap junctions is physiologically regulated and can be manipulated pharmacologically. Thus, this system provides a means of regulating myogenic control of smooth muscle. I have proposed a model, or working hypothesis, which may explain the indirect and direct interactions of various substances involved in the control of synthetic processes and stimulating or inhibiting myometrial contractility. The model predicts that term or preterm labor can be initiated at various steps. A more complete understanding of these interactions is necessary for a rational approach to the control of term or preterm labor. PMID- 6488607 TI - The importance of clinical trials in preterm labor. PMID- 6488608 TI - Proposals for a programmed prevention policy of preterm birth. PMID- 6488609 TI - The outcome of growth failure associated with preterm birth. PMID- 6488610 TI - Perinatal variables and neurodevelopmental outcomes with preterm births. PMID- 6488611 TI - A biosocial systems perspective on environmental interventions for low birth weight infants. PMID- 6488612 TI - Physiology of female sexual function. PMID- 6488613 TI - Sexuality during pregnancy. PMID- 6488614 TI - Screening for sexual dysfunction. PMID- 6488615 TI - Inhibited sexual desire and orgasmic dysfunction in women. AB - Desire phase dysfunction and orgasmic dysfunction are frequently brought to the attention of the gynecologist. While a variety of psychosocial and organic factors may be involved, the clinician can be helpful in a number of ways. Specific techniques of sexual counsel for both ISD and orgasmic dysfunction have been presented. Recognition and treatment of sexual dysfunction can be a somewhat time-consuming but rewarding aspect of comprehensive women's health care. PMID- 6488616 TI - Dyspareunia and vaginismus. AB - The understanding and treatment of vaginismus and dyspareunia have been greatly advanced by discoveries in sexual physiology and by the integration of the psychological sciences into clinical medicine. Historical evaluation of these problems should attend to their chronology, the impact on the individual and her relationships, and prior attempts at solution; and one should keep in mind common theories of etiology of sexual dysfunction. Physical examination, both as an educational instrument for the patient and as a means of localizing pain, can be most informative when undertaken with a thorough knowledge of the physiology of sexual response. Particular foci of dyspareunia may be amenable to various combinations of physical and psychological treatment. PMID- 6488617 TI - Psychosexual responses to infertility. AB - Clearly, infertility is one of several gynecologic conditions that may have a profound effect on the psychological and sexual status of its victim. It is obvious from indepth discussions with many infertile couples that they want their physician to help them recognize and deal with these problems. Unfortunately, we are often ill-prepared to meet such a request. Hopefully, however, the next several years will see an increase in the systematic and scientific study of such problems and their solutions, thus providing us with a rational and proven method of dealing with these problems. PMID- 6488618 TI - Physiologic assessment of sexual response in women: the unfulfilled promise. AB - With the exception of work by Semmens (1979), the clinical value of physiologic measures of female sexual response has not been demonstrated; it almost seems that controlled attempts to apply measures of vaginal muscular tone or blood flow to clinical settings has been jinxed. Hence, this author takes issue with Hatch (1980), who gives the impression that physiologic measures can now be used in clinical applications. The reasons for failure in sex therapy or biofeedback are uncertain, but it may be useful to speculate briefly. Sexual arousal in women is too personal a phenomenon to be objectively assessed during waking states in an "artificial" laboratory context. Orgasmic response is not related to genital muscle tone, but to other unknown anatomic, learning-history, and psychological components. The circumstances under which there is agreement between physiologic and either psychometric or self-reports of arousal or pleasure are complex and interactive. Therefore, physiologic measures of female sexual response may not reflect the subjective experience of women and, taken alone, may be misleading. This conclusion should not surprise anyone, for human beings are truly a "cognitive" species with representational imagery and language. Sexuality is very much "in the frontal lobes," and what we perceive eroticism to mean in a given context is probably much more important than the physiologic and behavioral aspects of actual sexual expression. Despite these problems of employing physiologic measures of female response in clinical settings, research into more basic issues has been quite profitable and heuristic. For example, several common assumptions about female sexuality are now open to question: women are more arousable just prior to menses; Kegel exercises improve orgasm consistency; sex therapy for inhibited arousal and desire is efficacious; there is usually agreement between the physiologic intensity of sexual response and a patient's subjective estimate of that intensity. On the other hand, there is evidence that vaginal engorgement in women remains at a high level after an initial orgasm, thus setting the physiologic stage for consecutive orgasmic responses; sexual arousal can be measured physiologically with acceptable degrees of reliability and specificity; muscle contractions in women during orgasm can be measured with high levels of precision; women respond to direct representations of erotic activity much the way men do; there are cortical "physiologic" signatures of orgasmic response in men and women. Obviously, a number of clinical research issues in female sexuality can now be investigated with physiologic measures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6488619 TI - Sexual counseling for the nontherapist. AB - Sexual health is a part of total health. Sexual problems can cause marital dissolution and emotional impoverishment. The physician is seen as a wise authority figure often and one who can provide sexual guidance and counsel. To be an effective counselor, an obstetrician/gynecologist must acquire sexual knowledge, comfort, and counseling skills. A sexual history is a recommended routine--as part of the new workup, when management of organic problems and treatment (mastectomy, hysterectomy, radical vulvectomy) necessitate inquiry into the patient's sexual practices and sexual value system, and when the patient presents with suspected "functional" or obscure complaints (hyperventilation, palpitations, chronic pelvic pain, recurrent vaginal discharge without obvious pathogens, chronic concerns that everything is all right "down there", cancerphobia). The sexual problem history is readily applicable, especially when a patient presents with an explicit sexual concern. The PLISSIT method is a paradigm that can be utilized effectively with usual referral for intensive therapy (sex therapy) if sexual counseling is ineffectual. The obstetrician/gynecologist can play an important role in facilitating healthful sexual changes in women and couples, enhancing intimacy, and enriching the marital bond. PMID- 6488620 TI - Surgical wound environment. AB - People are the major source of bacterial contamination in the hospital environment, and to control environmental bacteria, the shedding potential of people must be controlled. In a conventional operating room, the more complete the surgical attire worn by everyone in the room, the better the control; i.e., body exhaust equipment for the anesthesiologist and the scrub nurse is essential. The laminar airflow filter system and ultraviolet light are effective environmental controls for preventing wound contamination. PMID- 6488621 TI - Two-level thoracic disc herniation. AB - Herniation of thoracic discs at T6-7 and T7-8 occurred in a 41-year-old man. Thoracic disc disease is rare and the present case could be the first two-level herniation reported in the literature. The diagnosis was established by a myelogram (metrizamide) and computed tomographic (CT) scanning. The herniated discs were excised through a posterolateral approach. The preferred exposure is either translateral or transthoracic. Laminectomy is contraindicated, as it fails to correct spinal cord hemodynamics or relieve axial tension in the presence of an anterior epidural obstruction. PMID- 6488622 TI - Acquired spondylolisthesis following scoliosis surgery. A case report. AB - The association between scoliosis and spondylolisthesis is well documented; however, spondylolisthesis following a posterior spinal fusion with Harrington rod instrumentation for idiopathic scoliosis has not been previously reported. Internal fixation of the spine with metal rods and fusion for scoliosis produces a stress concentration at the immediately adjacent levels. This, combined with other factors that may cause failure of the neural arch, can lead to a traumatic spondylolisthesis. In an 11-year-old boy, localized pain and impending listhesis indicated that the instrumentation should be removed and an arthrodesis completed. PMID- 6488623 TI - Failure of the femoral component in the Howse total hip arthroplasty. AB - Fatigue failure of the femoral stem is reported in ten cases of the Howse modification of the Charnley total hip arthroplasty. The overall incidence is comparable to the Charnley original design. Torsional forces are important in the mechanism of failure. Medical cracking (not previously described) was discovered leading to stepped fracture surfaces. Multiple medial cracking has long-term implications for the Howse design. Torsional forces result in oblique fracture lines that are not always visible before surgery. Weight-bearing roentgenograms are advised prior to revision surgery. PMID- 6488624 TI - Stem fractures of extra-heavy Cobra femoral hip prostheses. Report of two cases. AB - Stem fractures of three extra-heavy, large Charnley serrated Cobra femoral components were observed in two young, heavy, and active male patients. The average time from implantation to stem failure was 68 months (43, 76, and 86 months). Two fractures extended from the lateral surface toward the lowest serration, which apparently acted as a stress-riser despite the caliber of the stem. Making a prosthesis thicker by using the same material does not solve the problem of fatigue fracture if the material, design, or cement interface is at fault. PMID- 6488625 TI - A natural course of a dislocated healed tuberculous hip in a child. A case report. AB - Subluxation was once a common complication of the tuberculous hip, even when properly treated. A review of the English literature failed to disclose the corrective process of development of the hip joint following a debridement operation. A three-year-old boy having a proven tuberculous hip had his hip dislocated after joint debridement. In the ensuing ten years, the luxated head spontaneously reduced to nearly normal position. Transitory capsular laxity was believed to cause the dislocation in this case, while growth and development led to spontaneous reduction. A decade may elapse before relocation is complete. PMID- 6488626 TI - Treatment of femoral neck fractures with a sliding compression screw and two Knowles pins. AB - Twenty-one patients with an average age of 65 years had displaced femoral neck fractures treated by a sliding compression screw and two Knowles pins. All patients had either Garden III or Garden IV fractures. One patient healed with a malunion and five developed symptomatic avascular necrosis; all of these patients required reconstructive surgery. There were no nonunions. The sliding compression screw with two Knowles pins gave a 100% rate of union, which was superior to most fixation methods. The incidence of avascular necrosis was 24%, the expected range for displaced femoral neck fractures. PMID- 6488627 TI - Percutaneous epiphysiodesis. AB - Percutaneous epiphysiodesis has the advantages of relatively little postoperative pain and excellent cosmesis. With the aid of image-intensification fluoroscopy, it is safe, effective, relatively easy to perform, and compares favorably with the traditional alternative procedures. No complications were encountered in 12 patients. PMID- 6488628 TI - An anteromedial approach to the posterior cruciate ligament. AB - A straight anteromedial incision for the exposure of the medial, posteromedial, and posterior ligaments of the knee provides favorable exposure of the distal attachment site of the posterior cruciate ligament. This approach enables a medial parapatellar arthrotomy to be performed through the same incision. The key elements of the exposure are the reflection of the semimembranosus tendon and detachment of the posterior capsule from the medial meniscus. PMID- 6488629 TI - Unicompartmental knee arthroplasty. AB - This is a review of the results of 17 knees treated by modular-type (Marmor) unicompartmental knee prostheses. The average age at the time of the operation was 62 years with an average follow-up period of 59 months. All the patients improved and were satisfied with the operation. There were no cases of revision or degenerative changes in the opposite compartment. It seems clear that the indications for this procedure should be an elderly person with severe pain and single-compartment disease. The knee should have a correctable deformity with good range of motion, minimal flexion contracture, and good quadriceps strength. PMID- 6488630 TI - Combined Coventry-Maquet procedure for two-compartment degenerative arthritis. AB - The combined Coventry-Maquet procedure has been proposed as a means of treating dual-compartment degenerative arthritis of the knee. The procedure was investigated in a prospective study of 14 patients treated by combined high tibial osteotomy and tibial tubercle elevation. Preoperative scores averaged 50 points and scores at follow-up evaluation averaged 57 points with a modified 100 point total knee grading system. There were no excellent results, one good result, and 13 poor results. Five patients whose results were poor have since had total knee arthroplasty. The combined Coventry-Maquet procedure required too much dissection, had too high a complication rate, and yielded a minimal improvement in knee function and pain. Two-compartment degenerative arthritis should be treated by an alternative method, such as total knee arthroplasty, when surgical intervention is indicated. PMID- 6488631 TI - Monitoring acute compartment pressures with the S.T.I.C. catheter. AB - A new solid-state transducer intracompartment (S.T.I.C.) catheter, combining a multiperforated polyethylene tip with a solid-state transducer, was developed to measure intracompartmental pressures. Its performance characteristics were compared with those of a conventional pressure-monitoring system. In animal and human studies, comparison of the S.T.I.C. catheter with a conventional pressure monitoring system demonstrated satisfactory correspondence over a wide pressure range (0-100 mm Hg) and a prolonged monitoring period (12-16 hours). As well as being functionally superior to the conventional systems (wick, continuous infusion, slit), the S.T.I.C. catheter is easier to assemble, calibrate, maintain, and interpret. The S.T.I.C. is recommended as a diagnostic aid in both acute and chronic compartment syndromes. PMID- 6488632 TI - Lead intoxication 18 months after a gunshot wound. AB - Lead poisoning can result from a retained intra-articular bullet. A 30-year-old man who was shot with a .38-caliber pistol illustrates the symptoms, signs, and differential diagnosis of lead intoxication. PMID- 6488633 TI - External fixation for the uninfected angulated nonunion of the tibia. AB - External skeletal fixation is an effective method of stabilizing angulated ununited fractures of the tibia. In 14 patients who were not infected, realignment was accomplished by: closed-fracture-site manipulation (five cases); fibular osteotomy and closed manipulation (six cases); or fibular osteotomy and open reduction (three cases). External fixation was selected instead of internal fixation for patients in whom there was: risk of reactivating quiescent sepsis; thin secondary epithelium adherent to bone that might slough after surgical dissection; a very proximal or a very distal nonunion, where internal fixation is technically difficult; or a bulky, angulated delayed union or nonunion or one in bayonet apposition that would require excessive plate contouring. On the average, patients were corrected from 17.3 degrees (either varus or valgus) to 2.3 degrees. Two patients did not unite with the fixator/orthosis treatment plan, but neither one lost correction during subsequent management. The technique is not suitable for atrophic nonunions. PMID- 6488634 TI - The posterior mechanism of acute anterior shoulder dislocations. AB - A tear of the rotator cuff often accompanies primary acute anterior dislocations of the shoulder in older patients. These structures, weakened by wear or degeneration, tear when the shoulder dislocates, permitting the humerus to hinge on intact anterior structures. Three typical cases illustrate the posterior structural reactions to acute anterior dislocation. PMID- 6488635 TI - Abductor digiti minimi muscle flap after tumor resection in the hand. AB - Extensive resection of aggressive nonmalignant tumors in the hand not only produces large tissue defects but also leaves important vital structures unprotected. The following case of a 25-year-old woman illustrates the successful use of an abductor digiti minimi muscle flap to provide adequate protective coverage. PMID- 6488636 TI - Stenosing tenosynovitis of the fingers and thumb. Results of a prospective trial of steroid injection and splinting. AB - In a prospective study of conservative treatment of stenosing tenosynovitis of the fingers and thumb, 53 fingers and thumbs were injected with 1 cm3 of methylprednisolone and 1 cm3 of 1% lidocaine and immobilized for three weeks. Thirty-eight (72%) of the 53 digits had a successful outcome (mean follow-up period, 25 months). Fifteen (29%) digits in ten patients were only temporarily improved. Treatment was successful in most patients with symptoms and signs of less than four months' duration. Only 41% of the digits causing symptoms for greater than four months had a successful outcome. Patients with multiple-digit involvement did not respond as well (12 satisfactory and ten failed) as those with single-digit involvement (39 satisfactory and two unsatisfactory). The patient with stenosing tenosynovitis in a single digit with less than four months of symptoms responded most favorably to the conservative regimen. PMID- 6488637 TI - Osteomyelitis of the great toe secondary to phlebotomy. AB - A premature infant developed Staphylococcus osteomyelitis secondary to multiple punctures of the great toe for drawing blood. The infection responded well to antibiotic therapy. PMID- 6488638 TI - The effect of steam sterilization on plaster casting material. AB - Plaster-impregnated gauze was autoclaved as a preventative measure against infection. The mechanical properties and the hardening time of casts made with autoclaved plaster were investigated by measuring flexural yield stress and flexural modulus of elasticity. A cantilever bending test was used to determine the time required to harden. The average yield stress in bending was reduced by an average of 8% and the modulus of elasticity was unchanged by the steam sterilization. The time required for the plaster splint to harden was increased by a factor of 5.6 after steam sterilization. Although the reduction in the yield strength was not prohibitive, the increase in hardening time was unacceptable. The use of gas sterilization is recommended when a sterile cast is necessary because gas sterilization does not increase hardening time. PMID- 6488639 TI - Fusion of the first metatarsophalangeal joint in forefoot arthroplasty. AB - Forefoot arthroplasty is often recommended for the management of metatarsalgia secondary to rheumatoid arthritis. Concurrently, the first metatarsophalangeal (MP) joint can be fused rather than excised. The results in 37 patients with 64 arthroplasty operations (34 with fusion and 30 with excision of the first joint) show that fusion produced a better cosmetic appearance of the foot, facilitated fitting with normal shoes, and improved overall balance. Pedobarograph measurements during gait indicated that relatively more weight was transmitted through the medial ray when the first metatarsophalangeal joint was fused. Residual pain in the foot was often caused by irregular trimming of the metatarsals. There was no difference in relief of pain between fused and unfused patients. Failure of fusion at the first metatarsophalangeal joint generally was painless. Radiologic degeneration of the interphalangeal (IP) joint of the great toe was relatively common following fusion. MP joint fusion is inadvisable if there is already disease in the IP joint. PMID- 6488640 TI - Posterior dislocation of the elbow. A simplified method of closed reduction. AB - Reduction of a posterior elbow dislocation can be accomplished by many methods and can require special positioning of the patient, trained assistants, and special equipment. A method that provides a simplified alternative is described. Leverage rather than forceful strength is the prerequisite. The maneuver is performed with the patient in the supine position, without any skilled assistant or special equipment. In the author's patient group the leverage technique has provided prompt and effective reduction without compromise to the neurovascular status of the limb. PMID- 6488641 TI - Juvenile nodular aponeurotic fibroma in the area of the knee joint. AB - A case of calcifying aponeurotic fibroma of the knee occurred in a 14-year-old boy. Review of the literature reveals that calcifying aponeurotic fibroma is an uncommon benign tumor with a tendency for local recurrence. It is manifested by a progressively growing mass involving fat, fascia, and aponeurosis. Chondroid tissue and calcification within the areas of proliferated spindle cells are the characteristic features of this lesion and differentiate it from the other forms of fibromatosis. PMID- 6488642 TI - Results of pulsed electromagnetic fields (PEMFs) in ununited fractures after external skeletal fixation. AB - Of 147 patients with fractures of the tibia, femur and humerus, in whom an average of 3.3 operations had failed to produce union, all were treated with external skeletal fixation in situ and pulsed electromagnetic fields (PEMFs). Of the 147, 107 patients united for an overall success rate of 73%. Union of the femur occurred in 81% and the tibia in 75%. Only five of 13 humeri united. Failure to achieve union with PEMFs was most closely associated with very wide fracture gaps and insecure skeletal fixation devices. PMID- 6488643 TI - The influence of etiology on the results of coccygectomy. AB - The results of coccygectomy for coccygodynia seem not to have been correlated with etiologic factors and were investigated in 48 cases (10 men and 38 women) with an average follow-up period of seven years. The following four etiologic groups were designated: I, direct trauma; II, spontaneous in origin; III, coccygodynia associated with spinal surgery; and IV, postpartum. Groups I and IV had a 75% recovery rate from pain and Group II had a 58% recovery rate. No satisfactory results were obtained in Group III. The incidence of infection was 16.6%. Few satisfactory results were obtained in cases of deep infection. While this operation is effective in many cases, it is seldom successful for pain associated with lumbar disc disease requiring lumbar laminectomy and spine fusion. Prophylactic antibiotic therapy is clearly indicated. PMID- 6488644 TI - Ununited fractures of the femur stabilized with the fluted rod. AB - Sixteen patients with ununited fractures of the femoral shaft were treated by the fluted intramedullary rod. Five cases were considered delayed unions and eleven nonunions. Fourteen fractures were managed by an open technique and two by a closed technique. Three of four cases treated open without a bone graft failed to unite after the initial nailing. These three fractures subsequently united following bone grafting. Two were renailed with a larger rod. Eventually, all 14 fractures united. The fluted rod appears to be an effective device for treating a variety of ununited fractures of the femur. Bone grafting in association with an open technique is advisable and is especially recommended when interposed connective tissue and bone have had to be excised from the fracture site. PMID- 6488645 TI - The accessory soleus muscle. AB - The accessory soleus muscle, as a clinically significant finding, has been infrequently reported in the English literature. Prior to the advent of the computerized tomography (CT) scanner, the diagnosis could only be suspected and was confirmed only at surgery. The CT scanner assists in differential diagnosis of a painful ankle mass and reveals the size and extent of the mass as well as its density. The density determinations in this case were most consistent with a muscle mass and led to the preoperative diagnosis of an accessory soleus muscle. PMID- 6488646 TI - Lipid composition of the tissues of human knee joints. II. Synovial fluid in trauma. AB - Synovial fluid was aspirated from the knees of 125 patients and lipid profiles were determined. The patients had knee injuries with or without fracture of bone; these lipid profiles were compared with "controls" (synovial fluid obtained at surgery from patients that did not have a knee injury). Floating lipid droplets were observed in some of the synovial fluid from patients with fractures. These lipid droplets could be separated as a well-defined supernatant layer after a few minutes of centrifugation (100 X g). This layer was found to consist mostly of triglycerides. The synovial fluid from patients with fracture and those with only soft-tissue trauma showed increases in total lipids and triglyceride content but had lower phospholipids when compared with nontraumatized knees. Phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol, sphingomyelin, cholesterol, monoglycerides, diglycerides, triglycerides, and free fatty acids were present in all synovial fluids assayed. The large amount of triglycerides in the synovial fluid in many cases may be a good indicator of marrow leakage. Because the soft tissue surrounding the knee is also rich in triglycerides, a low phospholipid level in some cases may be an even better indicator of marrow leakage. PMID- 6488647 TI - Principles of antibiotic usage. AB - New antibiotics must demonstrate an advantage over older agents with respect to therapeutic efficacy, protection against infection, toxicity, cost, and pharmacokinetic properties before they can be approved for public consumption. In order to use antibiotics properly, we must know more about whether certain organisms are resistant or sensitive to the drug; it must also be determined how sensitive or resistant the bacterium is to the drug and how long serum and tissue levels remain above inhibitory or bactericidal concentrations of the drug for the suspected or proven pathogen. Cost issues and potential for adverse reactions must also be considered. In brief, to prevent or treat infections the clinician must be familiar with the microbiology, pharmacology, toxicology, and cost of antibiotics. PMID- 6488648 TI - Subcalcaneal pain. PMID- 6488649 TI - The use of penicillins in orthopaedic surgery. AB - The main use of the penicillins in orthopedic surgery is in the treatment of infections due to Hemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, Neisseria gonorrhoeae, Escherichia coli, Proteus mirabilis, Streptococcus pneumoniae, and Group D streptococci (enterococci). Penicillins have antimicrobial activity and have a characteristic pharmacodynamic action, including side effects. The tissue penetration characteristics of the penicillins into synovial fluid and human bone are significant. Semisynthetic penicillins, antistaphylococcal penicillins, and the antipseudomonal penicillins are used for treatment of septic arthritis and osteomyelitis. Oral penicillin therapy can be useful in treatment of osteomyelitis. PMID- 6488650 TI - The principles of the use of preventive antibiotics. AB - Antibiotic prophylaxis is indicated only under specific surgical settings. Appropriate antibiotic prophylaxis must take into account the type of surgery, the competence of the host, and the pharmacologic properties of the antibiotic(s). The antibiotic should be given before the surgical procedure and have an antibacterial spectrum that covers the majority of the bacterial organisms anticipated at surgery. If there is doubt about the efficacy, antibiotic prophylaxis should not be initiated. PMID- 6488651 TI - Use of antibiotic-containing bone cement. AB - Erythromycin and colistin (or other thermostable antibiotics) may legally be added to polymethylmethacrylate (PMMA) for use in the fixation of prostheses to bone. The antibiotics are leached or rapidly released from the combination in bactericidal concentrations. They do not reduce the strength characteristics of the cement below acceptable standards, nor do they change its handling characteristics. Erythromycin alone was used in 1112 total hip arthroplasties between 1971 and 1976, with an infection rate of 0.98%. Erythromycin-colistin bone cement was used in 786 total hip arthroplasties from July 1976 to December 1980, with a deep-wound infection rate of 0.4%. Erythromycin-colistin-containing bone cement is safe and effective in treatment of and prophylaxis against deep wound infection in total joint arthroplasty. PMID- 6488652 TI - Tc-99m red blood cells for the study of rapid hemolytic processes associated with heterologous blood transfusions. AB - Chromium-51 labeled erythrocytes (Cr-51 RBC) are suitable for the study of hematologic disorders which involve relatively slow destruction of circulating erythrocytes, taking several days to several weeks. However, Cr-51 RBC are not suitable for investigating rapid hemolytic processes which occur within a matter of a few hours due to the variable and unpredictable elution of Cr-51 from the erythrocytes during the first 24 hours or so. Imaging, which could be useful in identifying organ systems involved in the hemolytic process, cannot be performed with Cr-51 RBC because of the high dose commitment caused by the low yield of gamma rays from Cr-51 (2). A method of labeling RBC with Tc-99m, which results in a radiopharmaceutical that combines the excellent dosimetric and imaging qualities of Tc-99m with an extremely stable bond between the Tc-99m and the RBC, is reported. The successful application of this technique in providing red cell support for a cancer patient with an unusual history of intravascular hemolytic transfusion reactions is also reported. PMID- 6488653 TI - Hepatic anomalous lobulation demonstrated by liver and hepatobiliary scintigraphy. AB - The use of liver and hepatobiliary scintigraphy for evaluation of the hepatobiliary system in patients with hepatic disease is now widespread. In the present case, the usefulness of liver and hepatobiliary scintigraphy for the diagnosis of liver malformation is described. PMID- 6488654 TI - Increased renal parenchymal accumulation of Tc-99m HDP in kidney contusion. AB - Unilateral focal areas of intense, increased renal uptake of Tc-99m oxidronate sodium (technetium-99m HDP) were incidentally detected in the bone scan of a female patient who subsequently gave a history of recent trauma to her flank. Increased renal parenchymal uptake of Tc-99m HDP in this patient was thought to be due to kidney contusion. The case is interesting in itself and for its possible implications regarding the use of radio-labeled phosphate compounds for detection of renal contusion. PMID- 6488655 TI - Gallium scintigraphy in cerebral toxoplasmosis. PMID- 6488656 TI - The case of the disappearing bladder. PMID- 6488657 TI - The "mucous plug syndrome". A pulmonary embolism mimic. AB - Reported are ten instances of major bronchial obstruction by mucous plugs in eight patients during which the clinical features resembled pulmonary embolism. Perfusion lung studies showed significantly diminished perfusion of the involved portions of the lungs. The chest radiographs generally did not, however, reflect the severity of the airway obstruction and in some instances were completely normal. The ventilation studies indicated the extent and severity of the obstruction and matched with the perfusion scans. Pulmonary arteriograms were performed in three patients and gave direct evidence of focally diminished lung perfusion without embolism. The physiologic mechanisms underlying the condition are discussed. PMID- 6488658 TI - Ruptured Baker cyst diagnosed by scintiarthrography. PMID- 6488659 TI - Evaluation of a paper-patch test for sweat chloride determination. AB - This article evaluates a recently developed qualitative sweat patch test (SPT). A battery-powered stimulator with polymer pad electrodes is used to stimulate sweating, followed by the application of a paper patch which collects the sweat and shows color change on sweat chloride levels above 40 to 50 mEq/l. Our data consist of 66 patients with cystic fibrosis, 75 control subjects, and 37 relatives of patients with cystic fibrosis, excluding 22 subjects (11%) with insufficient sweat. There were no false-negative results among 66 patients with cystic fibrosis, and in the control group, 71 of 75 subjects gave negative results and the other four gave positive results. Of the 37 relatives, eight gave positive results; all of the eight subjects are parents of patients with cystic fibrosis. Our results indicate that SPT is useful and reliable when there is sufficient sweat. This portable and simple patch test may serve as an excellent screening test for cystic fibrosis. PMID- 6488660 TI - Theoretical growth evaluation (TGE). A computerized screening system for growth disorders. AB - A computerized screening system for growth disorders is presented. Its aim is to save time and to facilitate the decision of whether a patient with a suspected growth problem should be referred for specialized evaluation. It uses accepted methods and common sense, and has been shown to be effective. A radiography of the hand and wrist, and a completed data sheet (birth date, date of x-ray, height and weight, parental height, and in girls, whether menarche has occurred) are mailed for analysis. Bone age is rated according to Greulich and Pyle, and Tanner et al. by trained technicians, and the results are supervised by a consultant pediatric endocrinologist. The supplied data and bone age values are then processed by a computer, which compares them with normal values, calculates three different height predictions (Bayley and Pinneau, Roche et al., Tanner et al.), as well as "target height" (estimation of genetic potential), and prints an easy to-read growth curve. Depending on the constellations of height (normal, below 3rd, above 97th percentile), bone age (normal, retarded, advanced in comparison with chronologic age), and height predictions vs. target height (predictions within, below, above target height range), different messages suggesting the most likely diagnostic possibilities are listed on a computer printout. PMID- 6488661 TI - Growth and tolerance studies of a new infant formula. AB - A new routine infant formula has been developed and clinically tested. The clinical study reported here involved 337 normal newborns cared for by six private pediatric group practices. Infants were examined regularly by the investigators until six months of age. Serum biochemistries, hematology, and growth and tolerance variables were compared to infants fed control formulas and to reported values for breast-fed infants. This new formulation compared favorably, in all areas studied here, to controls and previously reported values. PMID- 6488662 TI - The endocrine spectrum of septo-optic dysplasia. AB - Six children with septo-optic dysplasia were evaluated at the Children's Hospital of Philadelphia. There was a common history of young, nulliparous mothers. The clinical presentation of these children differed according to age of presentation and was a function of the degree and type of hypothalamic-pituitary and ophthalmologic impairment. Endocrine evaluation revealed four of six children to be growth hormone deficient, four of six to have hypothalamic hypothyroidism, and two of four to have elevated prolactin levels. One of the patients demonstrated adrenocorticotropic hormone deficiency, and one had diabetes insipidus. Neuroanatomic findings in the children were variable, but, in general, the rare syndrome did not carry as grave a morbidity as had been reported previously. Our data support a high degree of hypothalamic impairment in septo-optic dysplasia. PMID- 6488663 TI - Fatal fulminant hepatitis with hemolysis in Wilson's disease. Criteria for diagnosis. AB - We report a child with the presentation of Wilson's disease as acute fulminant hepatic failure and severe hemolysis. Our review of the literature suggests the following criteria for considering this diagnosis in the child with acute liver failure: discordance between mildly elevated serum transaminases and extremely elevated bilirubin levels; anemia associated with hemolysis (increased reticulocytes in the absence of bleeding); elevated hepatic copper; and other copper metabolic abnormalities (elevated serum copper, excessive 24-hour urine copper excretion, and reduced serum ceruloplasmin). Establishing the correct diagnosis enhances the possibility of detecting asymptomatic siblings or other family members in whom early inauguration preventive therapy should be successful. PMID- 6488664 TI - Abnormal hematologic findings in triploidy. PMID- 6488665 TI - Atelencephalic microcephaly. Counseling severe cerebral dysmorphogenesis. PMID- 6488667 TI - Mitral valve prolapse: clinical spectrum of 125 patients referred to a cardiac center. PMID- 6488666 TI - The association of spinal and gastroesophageal anomalies. Case report and review. AB - Severe cervical radiculopathy occurred in a child with gastroesophageal duplication who had a previously unrecognized vertebral malformation. We review the literature on the association of vertebral and gastroesophageal anomalies and discuss the recent studies in human embryology which detail the relations of notochord to endoderm and neural ectoderm at about 3 weeks of gestation. This case illustrates the opportunity of preventing nerve root or spinal cord compromise due to such vertebral anomalies when the possibility of their association with gastroesophageal duplication is considered. PMID- 6488668 TI - Temporal trends in reported malformation incidence--comments from Tasmania. PMID- 6488669 TI - Symposium on neonatal pulmonary hypertension. PMID- 6488670 TI - Neonatal pulmonary hypertension: pathophysiology, classification, and etiology. AB - Pulmonary hypertension in the newborn infant has many potential causes, and multiple etiologies are common. In this article, the author outlines the basic principles in pathophysiology, classification, and etiology that should be well understood by those who care for neonates with disease processes in which pulmonary hypertension is an important feature. PMID- 6488671 TI - Prostaglandin synthesis inhibition in persistent pulmonary hypertension of the newborn. AB - The data implicating prostaglandin synthesis inhibitors as an etiology for PPHN are reviewed. Consideration is given to the pharmacology of prostaglandin synthesis inhibitors in the fetus and newborn, the role of prostaglandins in the fetal and neonatal circulation, and the effect of closure of the ductus arteriosus on the fetal pulmonary vasculature. PMID- 6488672 TI - Noninvasive assessment of cardiac function and pulmonary hypertension in persistent pulmonary hypertension of the newborn. AB - This article describes the application and limitations of noninvasive techniques to assess cardiac function and to diagnose pulmonary hypertension in newborn infants in whom PPHN is suspected. PMID- 6488673 TI - Pulmonary vasodilator therapy in persistent pulmonary hypertension of the newborn. AB - A review of the physiology of persistent pulmonary hypertension of the newborn is provided, followed by a critical review of many of the agents that have been employed to treat this condition. In addition, the authors speculate on what type of pharmacologic therapy may prove useful in the future. PMID- 6488674 TI - Use of cardiotonic therapy in the management of infants with PPHN. AB - The author describes the rational use of cardiotonic agents in those infants with PPHN in whom myocardial dysfunction and/or extremely abnormal systemic vascular resistance have been completely documented. PMID- 6488675 TI - Use of extracorporeal membrane oxygenators in persistent pulmonary hypertension of the newborn. AB - Extracorporeal membrane oxygenators (ECMO) can give total respiratory support for neonates with PPHN without the barotrauma of hyperventilation. ECMO has resulted in survival of infants with PPHN who had been unresponsive to maximal ventilatory and medical support. PMID- 6488676 TI - Developmental follow-up of infants with persistent pulmonary hypertension of the newborn. AB - The authors review the relatively little follow-up of infants with PPHN, finding that a small number of studies found motor deficits and cognitive deficits in hyperventilated survivors, and that hearing loss has also been reported. Not enough data are available to separate the effects of various treatment modalities from the effect of the initial insult; however, no specific negative effects of hyperventilation have been found. PMID- 6488677 TI - Success rates in the United States drug development system. PMID- 6488678 TI - Effects of nadolol and propranolol on plasma lidocaine clearance. AB - Nadolol and propranolol effects on lidocaine elimination were followed in six healthy men and women. Each received three separate 30-hr infusions of lidocaine (2 mg/min): one alone, one after 3 days pretreatment with nadolol (160 mg daily), and one after 3 days pretreatment with propranolol (80 mg every 8 hr). Liver blood flow was determined by the systemic clearance of indocyanine green. Steady state plasma lidocaine levels were increased by nadolol (2.1 +/- 0.2 to 2.7 +/- 0.3 micrograms/ml) and by propranolol (2.1 +/- 0.2 to 2.5 +/- 0.3 micrograms/ml). Lidocaine plasma clearance was decreased by nadolol (1030 +/- 81 to 850 +/- 82 ml/min) and by propranolol (1030 +/- 81 to 866 +/- 75 ml/min). Hepatic blood flow was decreased by nadolol (1275 +/- 77 to 902 +/- 102 ml/min) and propranolol (1275 +/- 77 to 957 +/- 119 ml/min). The hepatic extraction ratio for lidocaine was increased by nadolol (0.86 +/- 0.06 to 0.91 +/- 0.05) and by propranolol (0.86 +/- 0.06 to 0.90 +/- 0.06). Lidocaine intrinsic clearance was not changed by nadolol (8.19 +/- 1.87 to 9.52 +/- 2.36 l/min) or propranolol (8.19 +/- 1.87 to 9.50 +/- 3.13 l/min). Our data indicate that both nadolol and propranolol reduce lidocaine clearance by their effects on hepatic blood flow and not by inhibition of lidocaine metabolism. PMID- 6488679 TI - Effect of oral dose size on hydralazine kinetics and vasodepressor response. AB - Levels of hydralazine in blood are log-linearly related to its vasodepressor effect. We examined the effect of oral dose size on the proportion of hydralazine that reaches systemic circulation. Nine subjects with hypertension were given hydralazine in oral doses in the therapeutic range. Blood hydralazine levels, effective liver blood flow, blood pressure, and heart rate were measured. As the hydralazine dose increased, the ratios of the AUC of hydralazine to hydralazine dose and of peak blood hydralazine concentration to hydralazine dose increased, indicating an increase in the proportion of the dose in blood. Liver blood flow tended to increase (maximum 40%) as dose increased above 0.5 mg/kg. Vasodepressor response and degree of tachycardia increased disproportionately with increasing hydralazine dose. There were strong log-linear relationships between peak hydralazine levels and both vasodepressor response and tachycardia that did not change with increasing hydralazine dose. Thus blood hydralazine and vasodepressor response increase disproportionately with increasing hydralazine doses in hypertension. PMID- 6488680 TI - Kinetics of digitoxin and the bis- and monodigitoxosides of digitoxigenin in normal subjects. AB - The kinetics of digitoxin and two of its metabolites, the bis- and monodigitoxosides of digitoxigenin, were determined in six normal subjects. Mean t 1/2s and total body clearances were 134.4, 15.4, and 0.59 hr and 2.66, 27.3, and 1071 ml/min. Mean renal clearance of the monodigitoxoside was more rapid (7.24 ml/min) than those of digitoxin (0.81 ml/min) or the bisdigitoxoside (0.94 ml/min). The volumes of distribution were of the same order, 0.45 l/kg for digitoxin, 0.57 l/kg for the bisdigitoxoside, and 0.83 l/kg for the monodigitoxoside. The short t 1/2 of monodigitoxoside would make it unsuitable for clinical use, but the bisdigitoxoside of digitoxigenin has a t 1/2 of an intermediate length and may have significant therapeutic advantages. PMID- 6488681 TI - Kinetics of digitoxin and the bis- and monodigitoxosides of digitoxigenin in renal insufficiency. AB - The kinetics of digitoxin and two of its major metabolites, the bis- and monodigitoxosides of digitoxigenin, were determined in six subjects with renal insufficiency and compared to those in six age- and sex-matched normal control subjects. No significant differences between the two groups were found in elimination t 1/2, total body clearance, or volume of distribution. Average renal clearances of all three drugs were reduced in subjects with renal failure, but the differences were significant only in the case of digitoxin. The bis digitoxoside of digitoxigenin has kinetic properties that offer clinical advantages. PMID- 6488682 TI - Age and cibenzoline disposition. AB - Oral cibenzoline kinetics were followed in 36 healthy subjects aged from 22 to 78 yr divided into groups of six subjects per decade between 20 and 80 yr. Each received a single, oral, 160-mg dose of cibenzoline. Blood and urine samples were collected for 72 hr. Cibenzoline plasma and urine concentrations were measured by HPLC. Maximum plasma cibenzoline concentrations (Cmax) ranged from 283 to 1100 ng/ml and occurred 1 to 2.5 hr after dosing. Apparent oral clearance (ClT) ranged from 401 to 1677 ml/min and the t 1/2 ranged from 5.9 to 13.4 hr. Nonrenal clearance (ClNR) ranged from 65 to 1113 ml/min, renal clearance (ClR) ranged from 165 to 645 ml/min, and 31% to 86% of the dose was recovered unchanged in urine (Xu). The volume of distribution (Vd) was large, ranging from 236 to 948 l. There was a significant relationship between age and the following kinetic parameters: Cmax, Xu, t 1/2 (all of which increased with age), ClT, ClR, ClNR, the terminal elimination rate constant beta, and Vd (which decreased with age). Mean ClT was 999 +/- 371 ml/min in the 20- to 30-yr age group and was 465 +/- 78 ml/min in the 70- to 80-yr age group. The change in ClT with age resulted from a decreased in both ClR and ClNR. Mean t 1/2 varied from 7 hr in the youngest group to 10.5 hr in the oldest group. The age-related changes in cibenzoline kinetics occurred over the entire age range studied and the relationship between age and these kinetic parameters appeared to be linear.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6488683 TI - Mechanism of action and tolerance of mesulergine. AB - The tolerance and prolactin (PRL) release-inhibiting action of the 8 alpha aminoergoline, mesurlergine, were investigated. In a blind crossover study in six subjects with hyperprolactinemia, 0.5 mg mesulergine induced fewer side effects than did 2.5 mg bromocriptine, while the PRL release-inhibiting effect of the two was of the same order. Six different subjects with suspected PRL-secreting pituitary adenomas who (repeatedly) had to discontinue bromocriptine because of nausea, vomiting, or symptoms of orthostatic hypotension were treated for 20 mo with mesulergine (1 to 2 mg/day). Mesulergine did not induce side effects and its actions resembled those of bromocriptine. Mesulergine induced cessation of galactorrhea and resumption of normal menstrual cycles in five subjects, while in one subject an insufficient luteal phase persisted. No abnormalities in routine blood parameter estimations were observed. In two of three subjects there was shrinkage of a pituitary tumor after 12 to 15 mo on mesulergine. Mesulergine did not directly inhibit PRL release by cultured normal rat pituitary cells and human prolactinoma cells and it antagonized the action of dopamine in a dose-dependent manner. This suggests that the dopaminergic action is carried out by a metabolite of mesulergine, while the parent drug probably prevents the well-known side effects of dopamine-agonistic drugs by its dopamine receptor blocking activity. Because of its acceptability, mesulergine might be important in the treatment of hyperprolactinemia and perhaps also of acromegaly and Parkinson's disease. PMID- 6488684 TI - Withdrawal phenomena in subjects with essential hypertension on clonidine or tiamenidine. AB - The incidence and pathogenesis of withdrawal phenomena with the centrally acting drugs clonidine (CLON) and tiamenidine (TIAM) were evaluated. Thirty subjects with hypertension on hydrochlorothiazide (HCTZ) were randomized to TIAM or CLON. Blood pressure and integrated plasma catecholamine levels fell equally in response to both drugs. On withdrawal, blood pressure and pulse rose in both groups with no difference between them. Three subjects had symptoms of withdrawal, four had blood pressure overshoot above pretreatment levels of 10 mm Hg or more, and eight had a rise in blood pressure of 30 mm Hg systolic or 20 mm Hg diastolic. There was no difference between TIAM and CLON in these effects. There was a direct correlation between blood pressure rise and increase in integrated plasma norepinephrine levels. We conclude that the incidence of withdrawal phenomena in subjects on TIAM or CLON is infrequent and that there is a direct relationship between the rise in blood pressure and the loss of suppression of catecholamines by these drugs. PMID- 6488685 TI - Influence of thyroid function on theophylline kinetics. AB - Theophylline kinetics were examined in five patients with hyperthyroidism before and after treatment with carbimazole. Theophylline clearance fell after carbimazole, but the apparent volume of distribution did not change. There was a correlation between reduction in theophylline clearance and decreased thyroxine serum concentration. Data suggest that maximum induction is reached at a specific level of thyroxine beyond which no further increase in drug metabolizing activity takes place. In 15 subjects treated with aminophylline for acute bronchial obstruction, there was a positive correlation between thyroxine concentration and total body theophylline clearance (r = 0.72 for nonsmokers; r = 0.44 for smokers and nonsmokers). PMID- 6488686 TI - Ketamine kinetics in unmedicated and diazepam-premedicated subjects. AB - Plasma ketamine concentrations after diazepam and placebo pretreatment were examined in a double-blind, randomized, cross-over study. Eight healthy male subjects received either diazepam or a 0.9% NaCl placebo before ketamine and received the alternate combination 5 to 24 days later. Ten minutes before ketamine dosing, diazepam, 0.3 mg/kg, or placebo in equal volume was injected intravenously at a rate not exceeding 5 mg/min. Ketamine, 2.2 mg/kg iv, was injected over 1 min. For the clinically relevant period for anesthesia (1 to 30 min), diazepam-ketamine treatment resulted in higher plasma levels at most time points, but diazepam pretreatment did not alter plasma levels of metabolite KI and pseudometabolite KII nor the 24-hr urinary excretion of ketamine, KI, and KII. Ketamine kinetics followed a three-term exponential decline under both treatment conditions. After placebo-ketamine dosing, plasma t 1/2s were as follows: distribution (pi t 1/2) = 24.1 sec, redistribution (alpha t 1/2) = 4.68 min, and elimination (beta t 1/2) = 2.17 hr. After diazepam-ketamine dosing, t 1/2s were: pi t 1/2 = 25.0 sec, alpha t 1/2 6.37 min, and beta t 1/2 = 2.32 hr. PMID- 6488687 TI - Stiripentol kinetics in epilepsy: nonlinearity and interactions. AB - Stiripentol kinetics during oral therapy were assessed in six patients with epilepsy who were receiving other antiepileptic drugs. Steady-state levels at 600, 1200, and 2400 mg/day increased in a nonlinear fashion, indicating Michaelis Menten kinetics. Oral clearance of stiripentol at 600 mg/day was 41.5 +/- 23.4 l/day/kg (mean +/- SD), greater than that at 1200 mg/day (20.3 +/- 8.8 l/day/kg; P less than 0.05) or 2400 mg/day (8.5 +/- 3.8 l/day/kg; P less than 0.01). The apparent in vivo Michaelis-Menten parameters were determined from three mean steady-state concentrations. The average velocity of conversion of stiripentol to its metabolites (Vm), Michaelis constant (Km), and the ratio Vm/Km were 49.3 +/- 13.1 mg/day/kg, 1.35 +/- 1.08 mg/l, and 50.2 +/- 27.5 l/day/kg. Stiripentol reduced the elimination clearances of concomitant antiepileptic drugs. Phenytoin clearance was reduced in all five subjects who received this drug, from a mean control of 29.5 +/- 13.4 l/day to 18.5 +/- 4.6 l/day at a stiripentol dose of 1200 mg/day (P = 0.05) and to 6.48 +/- 2.59 l/day at 2400 mg/day (P less than 0.01). Stiripentol reduced the clearance of carbamazepine in one subject from a control value of 209 l/day to 128 l/day (1200 mg/day) and 61 l/day (2400 mg/day). Stiripentol reduced phenobarbital clearance in two subjects from 3.8 and 5.1 l/day to 2.3 and 3.4 l/day (2400 mg/day). The Michaelis-Menten kinetics of stiripentol, as well as its interactions with other antiepileptic drugs, have important implications in the designing of controlled clinical trials. PMID- 6488688 TI - Mephenytoin and sparteine pharmacogenetics in Canadian Caucasians. AB - The frequency of genetically deficient hydroxylation of mephenytoin (M-defect) was studied in 83 healthy Caucasians living in Toronto. The M-defect was compared with the widely studied genetic polymorphism of sparteine/debrisoquine oxidations (S-defect). After ingestion of mephenytoin and sparteine, urine samples (0 to 24 hr) were analyzed for p(4')-hydroxymephenytoin and urine samples over 0 to 12 hr were analyzed for sparteine and 2-and 5-dehydrosparteine by gas chromatographic methods. Nirvanol, the N-demethylation product of mephenytoin, was determined by a newly developed gas chromatographic/mass spectrometric method. Frequency distributions of both p-hydroxymephenytoin and dehydrosparteine excreted in urine were discontinuous (bimodal), while nirvanol and sparteine data were normally distributed. Two poor metabolizers of mephenytoin excreted 2% to 3% of the dose as p-hydroxymephenytoin and excreted normal amounts of nirvanol, but they were extensive metabolizers of sparteine. Six poor metabolizers of sparteine were found to be extensive metabolizers of mephenytoin (34% to 42% excreted in urine as p-hydroxyme-phenytoin). Thus the M-defect occurs among Canadian Caucasians with a frequency of 2% (0.0% to 7.5% with a confidence limit of 99%) and is independent of the S-defect. PMID- 6488689 TI - Phenotypic consistency in hydroxylation of desmethylimipramine and debrisoquine in healthy subjects and in human liver microsomes. AB - The 2-hydroxylation of desmethylimipramine (DMI) and the 4-hydroxylation of debrisoquine (D) were studied in healthy subjects and in human liver microsomes. A single oral dose of DMI (25 mg) was given to 18 healthy subjects previously phenotyped with D (13 rapid and five slow hydroxylators). Urine was collected for 24 hr and DMI and total 2-hydroxydesmethylimipramine (2-OH-DMI) levels were determined by HPLC. The urinary ratio DMI/2-OH-DMI correlated strongly (r = 0.92) with the urinary ratio of D to 4-hydroxydebrisoquine (D/4-OH-D). The two hydroxylations were also studied in human liver microsomes from 10 different subjects. Formation rates of the hydroxylated metabolites correlated strongly (r = 0.869). Moreover, D competitively inhibited the 2-hydroxylation of DMI. These findings suggest that both are hydroxylated by the same cytochrome P-450 isozyme. PMID- 6488690 TI - Abnormal serum protein binding of acidic drugs in diabetes mellitus. AB - Nonenzymatic glycosylation of proteins is common in diabetes mellitus and glycosylation of serum albumin in this condition has been described. To evaluate whether glycosylation of albumin affects acidic drug binding, sulfisoxazole and diazepam binding was examined in samples of normal serum incubated with glucose and in samples of serum from 42 patients with diabetes mellitus. Incubation of normal serum with 20mM glucose for several days resulted in progressive glycosylation of proteins, with decreased binding of sulfisoxazole (100 micrograms/ml) but not of diazepam (3 micrograms/ml). Free fractions of sulfisoxazole and diazepam were higher in serum from patients with diabetes. The percentage of free sulfisoxazole in serum from 10 normal subjects was 5.1% +/- 0.2%, whereas it was 16.0% +/- 1.3% in serum from 42 patients with diabetes with varying degrees of carbohydrate control. The percentage of free diazepam in plasma was 2.6% +/- 0.1% in the normal group and 3.6% +/- 0.4% in patients with diabetes. Decreased serum albumin levels, increased levels of free fatty acids, and glycosylation of plasma proteins seem to play a role in the defective acidic drug binding in diabetes. Elevated free fatty acid levels explain the abnormal binding of diazepam and the increased free fraction of sulfisoxazole is directly related to glycosylation of plasma proteins. PMID- 6488691 TI - Kinetics of a naltrexone sustained-release preparation. AB - A biodegradable sustained-release naltrexone bead preparation containing 70% naltrexone in a physical mixture with a copolymer of 90% lactic acid and 10% glycolic acid was evaluated in three male subjects. Each subject received a 10-mg iv dose of naltrexone HCl and a 63-mg dose by subcutaneous implantation of naltrexone beads. Kinetics of naltrexone estimated from the intravenous dose indicated a plasma clearance range of 3.1 to 3.4 l/min and a t 1/2 range of 1.7 to 3.7 hr. After bead implantation, average plasma naltrexone levels were maintained at 0.3 to 0.4 ng/ml and naltrexol levels were at 0.4 to 1.0 ng/ml for a period of approximately 1 mo, during which urine naltrexone and naltrexol levels were about 20 to 30 and 70 to 200 ng/ml. It was estimated that approximately 70% to 77% of the dose was absorbed after bead implantation. There were no serious adverse effects other than tissue irritation in two of the three subjects. PMID- 6488692 TI - Separation, isolation and amino acid composition of uremic peptides. AB - Gel filtration and thin layer chromatography were conducted on sera from uremic patients and normal subjects for the isolation of nitrogenous substances unique to uremia. Many ninhydrin-positive substances were found in greater amounts in uremic patients compared to normal subjects. Some of these ninhydrin-positive substances were also detected by staining with chlorine-tolidine. Amino acid analysis of these substances showed considerable qualitative and quantitative differences, perhaps reflecting interference with enzymatic activity by the uremic environment. PMID- 6488694 TI - Comparison of serum total calcium, dialyzable calcium, and dialyzable magnesium in well and sick neonates. AB - We studied the relation of serum total calcium, dialyzable calcium, and dialyzable magnesium in 61 well and sick newborn infants aged 7-76 h. The infants' serum total calcium, dialyzable calcium and magnesium concentrations (ion chromatography method) were studied in comparison with the infant's history and sickness scale. We found that serum total calcium and dialyzable magnesium were lower in sick infants compared to well infants. Both serum total and dialyzable calcium concentrations initially decreased and then increased by about 30 h of age. Serum dialyzable magnesium concentrations increased with our infants' age. Serum total calcium values correlated significantly with the infant's birth weight, gestational age, 1-min Apgar score, respiratory distress, severity of sickness, serum bilirubin and sodium concentrations. PMID- 6488693 TI - Aortic stiffness in the DOCA-hypertensive pig. AB - Pulsatile changes in aortic diameter and pressure were monitored in order to obtain an index of aortic stiffness in the conscious pig during the development of mineralocorticoid hypertension. The aortic stiffness index increased but to a much lesser extent than it did in response to a similar pressure elevation produced by phenylephrine infusion. This observation suggests that chronic exposure to an elevated pulsatile pressure reduces the stiffness index at the elevated pressure. PMID- 6488696 TI - Infrared analysis of lecithin/sphingomyelin ratios. AB - A clinical evaluation of a quantitative infrared method for lecithin and sphingomyelin is described. The method incorporates techniques of computer assisted infrared spectroscopy for both control of the microprocessor-based infrared spectrophotometer and for evaluation of the data. An advanced software package for quantitative infrared analysis, which can operate on a microcomputer, provides the possibility of complete automation of the analysis. Results of the analyses of amniotic fluids from 20 patients are presented. In general, the results of the analysis of the lecithin/sphingomyelin ratio by the infrared method correspond closely to those obtained by two-dimensional thin-layer chromatography on the same respective samples. PMID- 6488695 TI - Chronic propranolol treatment decreases pulmonary artery pressure in conscious dogs. AB - Daily administration of propranolol to 9 chronically instrumented, trained dogs for 2 weeks caused significant (p less than 0.05) decreases in heart rate (70 +/- 8 to 57 +/- 6 beats/min), cardiac output (3.6 +/- 0.3 to 2.9 +/- 0.2 liters/min), pulmonary arterial pressure (15.7 +/- 0.5 to 10.0 +/- 0.5 mm Hg) and total pulmonary vascular resistance (4.6 +/- 0.6 to 3.3 +/- 0.4 units). Nadolol, a structurally dissimilar beta-adrenergic receptor antagonist, caused a similar decrease in total pulmonary resistance. Acute meclofenamate administration did not return to normal pulmonary arterial pressure and resistance in the dogs chronically treated with beta-adrenergic receptor blockers. We therefore conclude that chronic beta-adrenergic receptor blockade lowered pulmonary arterial pressure and resistance by a mechanism independent of cyclooxygenase. In addition, chronic beta-adrenergic receptor blockade did not affect the potential for hypoxic vasoconstriction. PMID- 6488697 TI - Relationship between uphill running performance at altitude and blood metabolite levels. AB - Venous blood samples were obtained from 18 marathon runners before and after the 27 km uphill portion of a 46 km transmountain race at altitudes of 1,950-3,400 m. There was an inverse correlation between blood lactate levels and running time (r = -0.83), with the runners with higher lactate levels completing the race in less time. The faster half of the group had higher blood levels of glucose and lactate and lower free fatty acid levels at 26 km distance and 3,400 m elevation. The elevated lactate concentrations in the blood of the faster runners suggest that anaerobic metabolism can contribute significantly to total energy production during prolonged exercise at high altitude. PMID- 6488698 TI - Neutrophil specific granules: a fuse that ignites the inflammatory response. PMID- 6488699 TI - Molecular analysis of human disease: dissection of beta-thalassemia. PMID- 6488700 TI - Protect the shifting paradigm: biomedical research and evolution. PMID- 6488701 TI - Testimony of the American Federation for Clinical Research before the US Senate Labor-HHS-Education Appropriations Subcommittee and the US House of Representatives Appropriations Subcommittee concerning NIH support in FY 1985. PMID- 6488702 TI - Comparison of atrial pacing and the cold pressor test in patients with angina pectoris. AB - A haemodynamic and myocardial metabolic study was performed to compare effects of maximal atrial pacing and the cold pressor test (CPT) in patients with angina pectoris. Twelve patients (group I) had angiographically severe coronary artery disease, while 16 patients (group II) had normal coronary angiograms. At maximal pacing, angina developed in all patients in group I, and myocardial lactate production was found in eight of 12 patients. In group II, 12 out of 16 patients experienced chest pain, but only two patients had myocardial lactate production. Neither angina nor myocardial lactate production was present in any patient in either group during CPT. Coronary sinus flow increased and coronary vascular resistance decreased significantly in both groups at maximal pacing (P less than 0.001). At CPT, coronary flow decreased (P less than 0.05) and coronary resistance increased (P less than 0.001) in group I, while individual response was more variable in group II. In conclusion, maximal pacing was a more effective method of provocation of angina pectoris than CPT. The reactions of coronary sinus flow and coronary vascular resistance were different in group I than in group II. However, because of the variability of response in patients with normal coronary arteries, CPT cannot be used to distinguish patients with coronary artery disease from patients with no such disease. PMID- 6488703 TI - Effect of small increments in plasma calcium concentration on the responsiveness of forearm resistance vessels to verapamil in normal subjects. AB - The effect of a small increase in local plasma calcium concentration on the responsiveness of the forearm resistance vessels to verapamil has been examined in normal subjects, by using a plethysmographic method with infusion of calcium and other agents into the brachial artery. Infusion of calcium at a rate which increased the concentration in forearm venous blood by about 0.5 mmol/l caused basal blood flow to fall by 19% and the dilator response to verapamil to fall by 35% (n = 8; P less than 0.02). When, after 46 min, the infusion of calcium was discontinued, the dilator response to verapamil increased to reach a level 53% higher than the initial control (n = 8; P less than 0.02). Infusion of calcium had no effect on the dilator response to sodium nitroprusside. Infusion of noradrenaline at a rate which caused a greater reduction in basal flow than that induced by calcium had no effect on the response to verapamil. It is concluded that the dilator response to verapamil, which is thought to reflect activity of the potential operated system for calcium entry, is selectively depressed by a small elevation of plasma calcium concentration, but subsequently becomes elevated. These findings point to an important role for calcium in the regulation of membrane function in the resistance vessels and support the view that altered calcium handling may contribute to the development of primary hypertension. PMID- 6488704 TI - Assessment of smoking behaviour and ventilation with cigarettes of differing nicotine yields. AB - Nine established cigarette smokers were each studied four times, smoking two identical cigarettes on each occasion. After an acclimatization study, they smoked one of three types of cigarettes, either their usual brand or one of two types of special low tar cigarettes. These latter both had tar yields of about 8 mg with nicotine yields of 0.55 (LN) and 0.90 (MN) mg respectively. The test order was randomized between individuals and before using the special cigarettes the subjects were given a pack to accustomize themselves. While smoking each cigarette, magnetic tape recordings were made of puff rate, ventilation measured by respiratory inductive plethysmography (RIP) and nasal airflow measured with a modified oxygen cannula. The data were then processed digitally off-line. Salivary nicotine and alveolar carbon monoxide levels were measured before and after smoking each cigarette, and the cigarette butt was analysed for nicotine. While smoking behaviour varied considerably between the various subjects only small differences were seen between the different cigarette types in puff volume and duration and shape of the puff profile. Some changes in smoking behaviour occurred during the course of smoking a single cigarette. Ventilatory patterns showed consistent inter-subject differences but there were no apparent variations due to the various cigarettes. Most subjects puffed during an expiration with the buccal cavity closed off, and then took a slower, deeper inspiration breathing through the mouth. Others, however, took puffs at any point in the respiratory cycle. The different nicotine yields of the cigarettes produced marked changes in the butt and salivary nicotine measurements, but neither these, nor the changes in alveolar carbon monoxide, were closely related to ventilatory measurements. Possible explanations for these discrepancies are discussed. PMID- 6488705 TI - Resistance to methylprednisolone in cultures of blood mononuclear cells from glucocorticoid-resistant asthmatic patients. AB - In order to investigate the cellular mechanism of glucocorticoid resistance in chronic asthma, peripheral blood mononuclear cells (MNC) from asthmatic patients were cultured in soft agar. Cells from patients known to be clinically sensitive to glucocorticoid therapy did not differ significantly from those of clinically resistant patients in terms of their immunophenotype or the number of colonies generated by culture in the presence of phytohaemagglutinin. The glucocorticoid methylprednisolone (MP) at low concentration (10 nmol/l) inhibited colony growth from cells of glucocorticoid-sensitive patients, whereas there was much less inhibition of colony growth from resistant patients' cells. In a small prospective study inhibition of colony growth by methylprednisolone in vitro correlated with the subsequently determined sensitivity of the patients' asthma to glucocorticoid therapy. Assessment in vitro of glucocorticoid sensitivity may help to predict which patients may be spared ineffectual glucocorticoid medication. The results raise the possibility that peripheral blood mononuclear cells may respond to glucocorticoid in a similar manner to cells involved in the pathogenesis of asthma. PMID- 6488706 TI - Diffuse fasciitis. PMID- 6488709 TI - Methods of assessing the synovial fluid cell count. AB - We have compared a rapid side-room testing strip and an automated cell counter with the conventional haemocytometer counting chamber as methods for assessing the synovial fluid cell count. The testing strip was shown to be very sensitive in detecting esterases derived from granulocytes, but to the experienced clinician it offered little clinical advantage over naked-eye judgement. The automated counter provides a fast and reliable alternative to the haemocytometer and in situations where an accurate cell count is required it could replace the haemocytometer. PMID- 6488708 TI - Measurement of disability in Dutch rheumatoid arthritis patients. AB - A self-administered health-assessment questionnaire (HAQ) was completed by 38 Dutch rheumatoid arthritis (RA) patients and the results compared to those obtained objectively when the same subjects were interviewed and asked to perform standardised tasks included in the HAQ. The results of the interview and the questionnaire showed a high degree of overall correlation and inter-component correlation. The correlation was comparable in outpatients with milder disease and in patients with more severe disease and was not influenced by age. The questionnaire offers a valid approach to the assessment of the functional disability of RA patients. PMID- 6488707 TI - Outcome measurement in osteoarthritis clinical trials: the case for standardisation. AB - Outcome measures for clinical trials to be valid and reliable should also be responsive to change. There are currently no standardised methods of measuring the outcome in osteoarthritis clinical trials. A review of 63 trials of nonsteroidal anti-inflammatory drugs revealed a large degree of variability in the items, instruments and scales employed. The implications of this variability are discussed and methods proposed for rationalising outcome measurement in this area of clinical research. PMID- 6488710 TI - Unusual articular abnormalities in scleroderma. AB - Articular involvement is described in a 58-year-old female patient with scleroderma. Radiological findings included intra-articular calcification, destructive osteoarthritis and selective involvement of the first metacarpal base. The discussion attempts to explain the way in which intra-articular calcification and osteolytic lesions may appear, citing various hypotheses put forward concerning such involvement in scleroderma. PMID- 6488711 TI - Postoperative wound infection in rheumatoid arthritis surgery. AB - The purpose of this study was to determine whether any of a number of factors studied correlated with the incidence of postoperative infection in rheumatoid patients, which is regarded as high. Data relating to all early postoperative infections between 1975 and 1978, 136 cases in all, were analysed together with data relating to two control series, one matched for sex, age and operation type, the other randomly chosen. The infection rate overall was 1.7%. The type of antirheumatic medication used did not influence the incidence of infection. Unrelated post-operative infections in the past correlated with risk of infection. Highly significant differences in the incidence of infection between the various types of operation were demonstrated. PMID- 6488713 TI - Localization of transferrin in the labial salivary glands of patients with rheumatoid arthritis. AB - A biopsy of the labial salivary glands of 57 patients with rheumatoid arthritis (RA) and those of 43 control subjects (CO) was made. Transferrin (TF) reactivity was demonstrated by using indirect immunoperoxidase technique. Salivary glands were also morphologically evaluated for presence of inflammation, fibrosis, fatty changes and ductal metaplasia. The salivary glands of RA patients showed significantly more pronounced fibrosis and inflammation than those of CO group. TF was found localized within the cells of striated ducts, in some intercalated ducts as well as in serous acinar cells. In all locations, the TF-positive findings were significantly (P less than 0.005) more frequent in RA than in CO series. No correlations between TF localization and the morphological parameters recorded could be established. The results are discussed in terms of the mechanisms of iron transport in RA, as well as of the possible relationships of TF to immunological mechanisms in RA. PMID- 6488712 TI - Lack of hormonal changes in postmenopausal women of equal weight with and without osteoporosis, including relation to time of menopause. AB - The hormonal variations in postmenopausal osteoporosis are not precisely defined. The duration of the menopause and other factors, such as the weight of the patients, may be of significance. Having a basic criterion of uniformity in weight, sixty postmenopausal women were studied in regard to the following aspects: urinary hydroxyproline, estrone, estradiol, parathyroid hormone, thyroxine, triiodothyronine, thyroid stimulating hormone, cortisol and metacarpal cortical area/total area. They were divided into: Group A: 15 patients with osteoporosis and five years since menopause; Group B: 15 patients without osteoporosis (age-matched with group A); Group C: 15 patients with osteoporosis and more than ten years since menopause; and Group D: 15 patients without osteoporosis (age-matched with Group C). In the group with postmenopausal osteoporosis (A and C) there is a significant increase in urinary hydroxyproline/creatinine and a significant decrease of the cortical area/total area when we compared them with age-matched groups. The hormonal values do not vary significantly among the four groups. Ours results indicate an increase of bone resorption as a cause of postmenopausal osteoporosis. The hormonal variations, if any, cannot be related to basal values. PMID- 6488714 TI - Clinical characteristics in male and female uro-arthritis or Reiter's syndrome. AB - To investigate the clinical characteristics of Reiter's syndrome (RS) or uro arthritis in females, 73 consecutive patients were studied. The findings were compared to those in 72 consecutive males with RS. The mean ages and the clinical picture of musculoskeletal findings, including frequency of mono- or oligoarthritis (68-69%), polyarthritis (26%) and back complaints (76-71%), were similar in both sexes. Inflammation of the knee, sterno-clavicular joint and "sausage" toe occurred predominantly in males and finger involvements in females. Anamnestic gonorrhoea occurred in 17 males (24%) and in 9 females (12%) (p less than 0.05) and verified aseptic pyuria in 34 males (47%) and in 19 females (26%) (p less than 0.01). Clinical findings of urogenital abnormalities (61 and 51%) and evidence of chlamydial infection (61 and 58%) occurred equally frequently in both sexes, as did the less commonly observed gastrointestinal involvements as triggering infection. The males had high ESR (greater than or equal to 50 mm/h) and HLA-B27 antigen more often than females (p less than 0.005 and p less than 0.025 respectively). Pyuria and elevated ESR (greater than or equal to 20 mm/h) were associated with HLA-B27 in males (p less than 0.02) but not in females. The occurrence of sacroiliitis was not associated with HLA-B27 and was not sex related. The many similarities in the clinical picture speak in favour of the same disease in both sexes. Though the "complete" form of RS with high ESR seems to be more rare in females than in males, the results of the present study emphasize that uro-arthritis is not a rare disease in females as compared to males. PMID- 6488715 TI - Diffuse (eosinophilic) fasciitis. A series of six cases. AB - Six patients with diffuse fasciitis are described. Their ages range from 12 to 45 years. Five had a typical clinical illness which responded well to corticosteroid therapy but one patient relapsed a year after discontinuation of corticosteroids. One patient had severe skin ulceration resistant to corticosteroids, cytotoxics and plasma exchange and was further complicated by the development of life threatening local and generalised sepsis. Eosinophilia of the blood was not present in any of the cases and not unduly prominent in biopsies of the affected tissue, but characteristic fascial thickening and infiltration by chronic inflammatory cells was diagnostic when a full-thickness biopsy was examined. The natural history and optimal treatment of this condition remain unclear. PMID- 6488716 TI - A case of scleroderma with Sjogren's syndrome developed after mammoplasty. AB - A case of scleroderma and Sjogren's syndrome, which occurred 9 years after mammoplasty, was reported. The association between mammoplasty and connective tissue disorders was considered to be more than coincidental. The prolonged hypersensitization by injected material may be responsible for the development of connective tissue disorders, that is, a human adjuvant disease. PMID- 6488717 TI - Septic polyarthritis due to bacteroides fragilis in a patient with rheumatoid arthritis. AB - A case of septic polyarthritis is described in a patient with severe RA who had not received steroid therapy. The organism involved, Bacteroides fragilis, was sensitive to metronidazole. PMID- 6488718 TI - Reactive arthritis due to Yersinia enterocolitica. AB - Two cases are reported of a reactive arthritis due to infection with Yersinia enterocolitica. These are the fifth and sixth cases reported in the United Kingdom. This interesting cause of arthritis may be more common than previously thought and should be considered even in the United Kingdom, although the practical implications are limited. PMID- 6488719 TI - Polymyalgia rheumatica/giant cell arteritis in husband and wife. AB - We present the first report of PMR/GCA occurring in husband and wife in Great Britain. The aetiology of the condition remains unclear but recent reports suggesting case clustering and 3 other reports of spouses developing PMR/GCA support the hypothesis that an infective agent may be implicated. PMID- 6488720 TI - Efficacy of oxaprozin in the treatment of articular symptoms of Behcet's disease. PMID- 6488721 TI - Prognosis of functional capacity in rheumatoid arthritis by chirophotogrammetry. PMID- 6488722 TI - The origin of platelet count and volume. AB - Platelet count and volume were measured in man (n = 51) and rat (n = 9). Bone marrow megakaryocyte nuclear and megakaryocyte planimetric areas were measured in man (n = 11) and rat (n = 9). Megakaryocyte cytoplasmic volumes were computed from the planimetric areas. Rat had a significantly higher (p less than 0.001) mean megakaryocyte cytoplasmic volume than man and a significantly wider range (p less than 0.01). Rat mean platelet volume was significantly lower (p less than 0.001) than man while the rat platelet count was significantly higher (p less than 0.001) than man. A computer simulation of the random binary sequential division of megakaryocyte cytoplasm was used to explain these observations. Transmission electron microscopy shows that the site of this binary sequential division is probably the pulmonary circulation. The number of circulating megakaryocytes ml-1 of blood which would maintain the observed platelet counts was computed. The ellipses of constant density associated with the bivariate Gaussian distribution of platelet count and mean volume were computed. Platelet volume distributions of 13 men within two standard deviations of the composite mean of platelet count and mean volume were used to construct the platelet volume distribution signature in normal man. A similar platelet volume distribution signature for rat was constructed. The two distributions were significantly different. Neither rat nor man had a log Gaussian platelet volume distribution, however the measured volume distributions tended towards a log Gaussian curve. PMID- 6488723 TI - Real-time beat-to-beat measurement of conduction intervals during cardiac electrophysiological studies. AB - The conduction times through different myocardial structures have been measured in real-time during clinical intracardiac investigations by means of a low-cost microprocessor-based system. Two endocavitary electrograms, a surface ECG and a pacemaker stimulus are analysed to detect the stimulus as well as atrial, His and ventricular waves and to measure, beat to beat, the time intervals between them. Measurements have been made in the course of 40 clinical studies, randomly chosen from about 500, and including different conditions such as sinus rhythm, acute drug tests and programmed atrial pacing. Our results show that the real-time measurement of the conduction intervals is feasible and may offer several advantages: it allows immediate data analysis which enables the investigator to better make decisions during the study; it reduces the time and effort required to perform and analyse the study; and it increases the quantity and quality of information gained on the cardiac status of the patient. PMID- 6488724 TI - Oesophageal manometry. A comparison of hydraulic and syringe catheter infusion systems using a simple hydrostatic bench model. AB - A simple hydrostatic bench model is described which can be used to validate oesophageal intraluminal manometry measurements. Conventional syringe pump infusion was compared with the hydraulic capillary infusion system using this model. Accurate recording of pressure changes was achieved on the low compliance hydraulic system at infusion rates of 1 X 10(-8) m3 s-1 (0.6 ml min-1). To achieve comparable accuracy with syringe pump infusion, undesirably rapid infusion rates of 10.35 X 10(-8) m3 s-1 (6.2 ml min-1) were required. We believe that the hydrostatic bench model is a useful tool for checking the accuracy of infused catheter systems. PMID- 6488725 TI - Photon scattering measurements of calcaneal bone density: results of in vivo longitudinal studies. AB - Sequential measurements of the density of calcaneal trabecular bone were made in normal postmenopausal women and in patients treated for osteoporosis. Cross sectional measurements of density were made in previously normal patients who had been without ovarian function for a known length of time of at least one year. There was a significant reduction in calcaneal density associated with aging in normal postmenopausal women. Estrogen lack was also associated with density reductions and the reduction was related to the length of time of estrogen deprivation. When osteoporotic patients were treated with combination therapy, density rose in females while in males the expected age dependent reduction was prevented. It is concluded that photon scattering measurements of calcaneal density can be used to monitor changes in the mineral status of the skeleton. PMID- 6488726 TI - An electronic peak flow meter with optional coded display. AB - A portable electronic spirometer giving peak expiratory flow rate has been developed and used successfully in studies of asthma. A turbine flow transducer produces a pulsed output whose frequency is proportional to flow. The output was coded to keep the results 'blind' to the patient. The code is suitable for use on other electronic instruments employing a similar display. It has been successfully used to investigate patients' perception of their asthma. PMID- 6488727 TI - Stress relaxation of the human cervix: a new tool for diagnosis of cervical incompetence. AB - A method is described for determination of the stress-relaxation characteristics of the cervix uteri of non-gravid women after almost stepwise dilatation of the cervical canal by a water-filled balloon. The stress relaxation is followed by measurement of the pressure decay in the same balloon. Application of this atraumatic technique to women with a normal cervix and women known to have an incompetent cervix yields diagnostic ranges of various parameters, in particular a time constant and the elastic ratio. The technique seems promising for easy detection of cervical incompetence, allowing suitable measures to be taken for prevention of immature deliveries. A mechanical model of the tissue of the ostium internum has further been developed on the basis of the measured characteristics. PMID- 6488728 TI - An automated microcomputer based electric response audiometry system for machine scoring of auditory evoked potentials. PMID- 6488729 TI - Possibility of Mallory-Weiss syndrome in cancer patients. PMID- 6488730 TI - Increased serum phenytoin concentration following influenza vaccination. AB - The effect of influenza vaccination on serum phenytoin concentration was studied in a group of long-term care patients with epilepsy. The subjects in this study were 15 men and 1 woman with a mean age of 76.7 years. All were white, receiving long-term phenytoin therapy for seizure disorders, on stable antiepileptic regimens for a minimum of eight weeks, and scheduled to receive an influenza vaccination. Baseline phenytoin concentrations were determined one or two days before vaccination. Subjects were vaccinated subcutaneously with 0.5 ml of an inactivated whole-virion trivalent influenza vaccine. Phenytoin therapy was maintained, and serum concentrations were determined on days 7 and 14 following the vaccination. Assays were performed with a standard enzyme immunoassay technique. No significant increases in mean serum phenytoin concentrations were observed on days 7 or 14 following vaccination. However, temporary increases of 46-170% occurred in four subjects, and in two of these subjects, the increases in serum phenytoin concentration could best be attributed to the influenza vaccination. Serum phenytoin concentrations may be temporarily increased in some individuals after influenza vaccination. PMID- 6488731 TI - Small-volume infusion of multiple vitamins. PMID- 6488732 TI - Evaluation of a device for delayed cutaneous hypersensitivity testing. PMID- 6488733 TI - Judging risks versus benefits of oral contraceptives. PMID- 6488734 TI - Unintentional overdose of theophylline: challenge to the pharmaceutical industry. PMID- 6488735 TI - Bayesian approaches in pharmacokinetic decision making. AB - The theory of Bayesian analysis and its application to therapeutic and pharmacokinetic decision making are discussed. Diagnostic and therapeutic decisions are commonly based on institution, experience, and laboratory information; these decisions reflect varying degrees of uncertainty. Bayesian analysis quantifies the decision process by attaching probabilities to the likelihood of accuracy of each of these decision-making factors to achieve an overall estimate of decision quality. Using Bayesian principles to quantify the probability of efficacy and toxicity associated with serum drug concentrations represents one application of Bayesian theory to enhance therapeutic decisions. The Bayesian approach in pharmacokinetics involves the prediction of pharmacokinetic values, dosage regimens, and serum concentrations for drugs. Beginning with mean population pharmacokinetic parameters, one uses observed serum concentrations in individual patients to modify these parameters through Bayesian analysis to improve the accuracy of future serum concentration predictions. As more clinical pharmacokinetic laboratories and consultation services become familiar with the procedure, Bayesian forecasting promises to expand markedly the sophistication of therapeutic drug monitoring. PMID- 6488736 TI - Extended verapamil infusion for recurrent atrial tachyarrhythmias complicating acute myocardial infarction. PMID- 6488737 TI - Lack of serious toxicity following carbamazepine overdosage. PMID- 6488738 TI - Haemoglobin GPhiladelphia and its interaction with haemoglobin S and alpha thalassaemia in Nigerians. AB - The diagnosis of Hb SS/GPhiladelphia disease was made in four young Nigerians from separate families. Their Hb electrophoretic patterns on cellulose acetate membrane at alkaline pH were similar to those obtained in sickle-cell haemoglobin C (HbSC) disease, but their clinical features and haematological data were consistent with the diagnosis of homozygous sickle-cell disease. Family studies also revealed that they had inherited an additional alpha-chain mutant haemoglobin. In one of the families, fingerprints of the globin peptides and amino acid analysis confirmed that the mutant haemoglobin was Hb GPhiladelphia (alpha 2 68 Asn----Lys beta 2 A). The results of the whole blood solubility test for sickle-haemoglobin provided firm support for the diagnosis of homozygous sickle-cell disease and distinguished clearly Hb SS/GPhiladelphia disease from Hb SC disease and Hb AS from Hb AGPhiladelphia heterozygotes. Restriction endonuclease mapping of the globin genes of the propositus and some relatives of one of the families revealed also that they were carriers of the alpha thalassaemia-2 gene (deletion-type). The globin gene-analysis data indicate also that the alpha GPhiladelphia and alpha-thalassaemia genes are linked closely in Nigerians. PMID- 6488739 TI - Ferrokinetic and erythrokinetic studies in alpha and beta thalassaemia. AB - Ferrokinetic and erythrokinetic studies were performed in 25 non-splenectomized patients with alpha or beta thalassaemia. Nine of these had HbH disease and six had HbE/beta thalassaemia or homozygous beta thalassaemia. In HbH disease, a mild anaemia was associated with severe peripheral haemolysis, increased splenic sequestration and only a moderate degree of ineffective erythropoiesis. By contrast, in the beta thalassaemia syndromes, a more marked anaemia was associated with prominent ineffective erythropoiesis and mild peripheral haemolysis. These findings indicate that the pathogenesis of anaemia in alpha and beta thalassaemia is different, haemolysis dominating in HbH disease and ineffective erythropoiesis in HbE/beta thalassaemia and homozygous beta thalassaemia. PMID- 6488740 TI - Preparation, characterization and storage of human ferritin for use as a standard for the assay of serum ferritin. International Committee for Standardization in Haematology (Expert Panel on Iron). AB - This paper describes studies on the source, preparation, characterization and storage of human ferritin for use as a standard for the immunoassay of serum ferritin. Ferritin was prepared from the liver or spleen by methods including either ultracentrifugation or cadmium sulphate crystallization. Preparations were characterized by polyacrylamide gel electrophoresis in dissociating and non dissociating buffers, iso-electric focusing, analysis of amino acid composition and measurement of protein content. The protein content of solutions of liver or spleen ferritin may be determined by the method of Lowry with bovine serum albumin as standard. Lyophilization under carefully controlled conditions in buffer containing high concentrations of albumin provides a stable preparation of ferritin. Accelerated degradation and collaborative immunological studies of two lyophilized preparations of ferritin, one from liver and one from spleen, indicate that either is an acceptable reference material. PMID- 6488742 TI - Symposium on pulmonary embolism and hypertension. PMID- 6488741 TI - Cross-immunoelectrophoretic analysis of heparin and gelatin binding capacity of fibronectin. PMID- 6488743 TI - New challenges in venous thromboembolic disease. AB - During the last 25 years, there has been much progress in the diagnosis, treatment, and prevention of venous thromboembolic disease. The guest editor believes that a great deal remains to be done and attempts, in this article, to outline some of the challenges remaining by developing themes put forth by the various authors of this issue. PMID- 6488744 TI - The natural history of pulmonary embolism. AB - It has been found that the proper management of pulmonary embolism improves survival. This article reviews the natural history of pulmonary embolism as it relates to the appropriateness of several alternative therapeutic strategies. PMID- 6488745 TI - Evaluation of latex agglutination and microtube coagulase tests for detection of Staphylococcus aureus. AB - In a blind study, a latex agglutination test (Serostat Staphylococcus, Scott Laboratories) and a microtube coagulase test (Staphase, API) were evaluated for their ability to detect Staphylococcus aureus. Of 289 isolates of catalase positive, gram-positive cocci, 122 were identified as S. aureus based on positive reactions in at least three of the following tests: tube coagulase, slide coagulase, DNase production, or anaerobic fermentation of mannitol. The latex agglutination test gave positive reactions for all S. aureus isolates and 10 (6%) non-S. aureus isolates. The slide coagulase test was positive for 121 S. aureus isolates and three (2%) non-S. aureus isolates. The microtube coagulase test detected 53, 90, and 98% of the S. aureus isolates after 2, 4, and 24 hr, respectively. In contrast, the conventional tube coagulase test detected 97% of the S. aureus isolates after 2 hr, and 98% after 4 and 24 hr. Two isolates of S. aureus gave negative tube coagulase reactions at 37 degrees C, but positive reactions at room temperature after 24 hr. The combination of tube and slide coagulase tests provided the most reliable results. The slide and tube coagulase tests gave more reliable results than the latex agglutination and microtube coagulase tests, respectively. PMID- 6488746 TI - Incidence, adherence, and antibiotic resistance of coagulase-negative Staphylococcus species causing human disease. AB - Fifty-two isolates of coagulase-negative Staphylococcus species recovered from the blood or intravenous catheters of patients with clinically significant disease were compared to 60 similar isolates from patients who were presumably colonized. All isolates were identified and evaluated for ability to adhere to smooth surfaces, and resistance to anti-staphylococcal penicillins. S. epidermidis, S. hominis, and S. haemolyticus were the most frequently occurring species, representing 65%, 15%, and 10%, respectively, of disease isolates and 57%, 25%, and 8% of colonizers. The seven other species recovered accounted for only 10% of the total in both groups. Differences in isolation rates of each species within the two groups were not significant and were reflective of their reported incidence in the normal flora. All species of coagulase-negative Staphylococcus (except S. capitis and S. cohnii, which were isolated in very small numbers) were capable of adhering to smooth surfaces. S. hominis disease isolates were all capable of adherence, and the difference between the disease isolates and colonizers was statistically significant (p less than 0.02). This was not true for any other species that was analyzed nor for all isolates considered as a whole. Resistance to anti-staphylococcal penicillins was documented for all coagulase-negative Staphylococcus species, and was more frequent in S. epidermidis disease isolates than colonizers (p less than 0.05). No correlation was found between resistance to antistaphylococcal penicillins and ability to adhere. PMID- 6488747 TI - An analysis of Streptococcus pneumoniae identification using biochemical and serological procedures. AB - Five methods for identification of Streptococcus pneumoniae were evaluated with stock strains representing all 83 capsular types and 130 fresh clinical isolates of alpha-hemolytic streptococci. The identification methods included bile solubility, optochin sensitivity, countercurrent-immunoelectrophoresis (CIEP), and coagglutination (CoA) using laboratory-prepared reagents (LPR) and the Phadebact Pneumococcus Test (Phadebact). The Quellung reaction was performed on the 83 capsular types of S. pneumoniae and on the clinical isolates that produced serological cross reactions with the three serological tests and those that were bile-soluble and optochin-sensitive. All 83 pneumococcal types were in complete agreement with each of the different test methods. Of the 130 alpha-hemolytic streptococci, 26 were identified as S. pneumoniae, and 104 isolates were identified as viridans streptococci using biochemical, physiologic, Quellung, or mouse virulence tests. All 104 viridans streptococci were bile-insoluble and optochin-resistant; however, 63 reacted with either one, both, or all three serological methods. Our data suggest that bile solubility and optochin tests are more reliable for pneumococcal identification than serological methods currently available. PMID- 6488748 TI - Effects of dressing type and change interval on intravenous therapy complication rates. AB - Using a prospective study design, we compared the incidence rates in 807 patients of phlebitis, malfunction, cellulitis, and septicemia for short-term Teflon catheters with dressings changed every 24 or 48 hr, or using a polyurethane dressing changed every 48 hr. The study utilized either a standard dressing, which consisted of a small piece of dry sterile gauze, or a polyurethane dressing. The risk of phlebitis at 48 hr was significantly greater in the daily dressing change group as compared with the group that had dressings changed every 48 hr or with those using the polyurethane dressing (p less than 0.05). At 72 hr, there was also significantly less phlebitis using the standard dressing changed every 48 hr (p less than 0.05). The risk of malfunction was significantly greater at 24 hr for the polyurethane dressing compared with the other two groups (p less than 0.05). These findings indicate that adoption of a 48-hr dressing change interval using a standard dressing could result in less phlebitis and significant cost savings to a university-based institution. PMID- 6488749 TI - Consultation on alcoholism. PMID- 6488750 TI - The occurrence and treatment of poststroke mood disorders. PMID- 6488751 TI - Prognostic contributions of exercise testing to the evaluation of myocardial infarction patients. PMID- 6488752 TI - Congestive heart failure. PMID- 6488753 TI - Sodium restriction in hypertension. AB - Hypertensive patients, treated or untreated, benefit from sodium restriction. Need for fewer drugs, less hypokalemia if thiazide-diuretic treated, and lower blood pressures should result from successful reduction of sodium intake. A planned program using behavior modification principles can help patients make the necessary changes in their eating habits. Monitoring blood pressure and urinary sodium excretion will give evidence of adherence to the diet. PMID- 6488754 TI - A microcomputer-controlled system for stimulation and acquisition of evoked potentials. AB - A system, controlled by a microcomputer (LSI-11/23 with appropriate peripherals) for conducting evoked potential (EP) experiments, is described. In each experimental trial, a stimulus is applied and multichannel EEG is sampled, displayed, and stored in an output file. Any required length of pre- and poststimulus sampling periods is available. Stimuli are triggered by a human operator, aided by an on-line graphic display of sampled data. Automatic artifact monitoring is used for rejecting bad trials. Various stimulators may be used (simultaneously) and stimulus features (duration, power, number of pulses) may be changed in each trial. Lists of trial parameters, such as stimulus features and subject's response, are incorporated in the output file to facilitate cross section analysis. The system was designed for the needs of pain EP research, but its flexibility and modularity make it useful in other areas of EP research. PMID- 6488755 TI - Computerized direct mail to treat smokers who avoid treatment. AB - Smoke, a computer program written in BASIC, uses interactive direct mail to assist smokers who do not wish to attend formal face-to-face smoking cessation therapy. The effectiveness of the program was evaluated in a yearlong study. Of 1044 smokers who expressed interest in smoking treatment, only 11.2% wished to participate in formal therapy. The rest received mail-based treatment. A total of 21.2% of the subjects who were assigned to the computerized direct mail group participated in this treatment. The abstinence rates of the participants in the computerized direct mail and face-to-face groups were similar. The results suggest that computerized direct mail could be a useful addition to smoking cessation campaigns. PMID- 6488756 TI - Evaluation of a computerized drug review system: impact, attitudes, and interactions. AB - A study was carried out across 11 psychiatric and mental retardation, and developmental disabilities facilities to investigate the impact of a computerized drug prescription monitoring system on clinicians' prescribing behavior, knowledge of pharmacotherapy, attitudes toward computers, and the relationships between their attitudes and changes in their prescribing practices. The results document that surveillance systems can improve prescribing practices. The tangible feedback provided by the exception report, although in the form of a surveillance mechanism, also increased user acceptance to computer technology. However, the findings also suggest that user acceptance is not necessarily required to see positive effects, which in environments where clinical and fiscal accountability are paramount, may override some clinicians' concerns. Attention to human factors components may help to alleviate some negativism. PMID- 6488758 TI - The implications of OX3. PMID- 6488757 TI - A model of the mechanics of binocular alignment. AB - A computer model (SQUINT) of the static mechanics of human eyes is developed and applied to the diagnosis and treatment of defects of binocular alignment (strabismus). Brief discussions of ocular anatomy, binocular vision, strabismus and its surgical correction, and early strabismus modeling are provided for nonspecialists in these areas. Models of muscle force, muscle path, globe translation, and binocularity are developed. To illustrate the use of the model in clinical cases, it is applied to the diagnosis and surgical treatment of a case of superior oblique palsy. The model's implementation under the UNIX operating system is described. PMID- 6488759 TI - A model of communication for the study of psychotic phenomena. PMID- 6488760 TI - Nonverbal disturbances attributed to the schizophrenic psychoses. PMID- 6488762 TI - Electroconvulsive therapy for schizophrenia in Ontario: a report on therapeutic polymorphism. PMID- 6488761 TI - Relationship of depression to clonidine detoxification of opiate addicts. PMID- 6488763 TI - Holocaust survivors and their children: comments on psychiatric consequences and psychiatric terminology. PMID- 6488764 TI - The relationship of panic disorder to agoraphobia. PMID- 6488765 TI - Vasoconstrictor and the anti-inflammatory effects of 7 corticosteroids. AB - The vasoconstrictor effect of 7 proprietary corticosteroid creams was compared with their effect on patches of allergic contact dermatitis provoked by patch testing in 20 subjects. A parallel between the blanching effect on the normal skin and the anti-inflammatory effect on the eczematous skin was generally found. A modified patch test method using the Finn chamber technique is described, which (with certain restrictions) offers an opportunity of studying the anti inflammatory effect of corticosteroids on allergic dermatitis under standard conditions. PMID- 6488766 TI - Ethylenediamine contact dermatitis. AB - A retrospective study of 50 patients with ethylenediamine allergy revealed that 2 topical products containing ethylenediamine as a stabiliser are the main sources of sensitization in Italy. Some of these patients cross-reacted to piperazine and diethylenetriamine, but none to ethylenediamine tetracetic acid. PMID- 6488767 TI - Sensitizing potential of urethane (meth)acrylates in the guinea pig. AB - Urethane (meth)acrylates are used as prepolymers in ultraviolet-curable inks, varnishes and coating formulations for industrial purposes as well as resins for dental applications. The sensitizing capacity of 3 commonly used urethane (meth)acrylates was investigated using the guinea pig maximization test. The study shows that an aliphatic urethane acrylate is not only a more potent sensitizer than an aromatic one, but also more sensitizing than a (meth)acrylated aliphatic urethane. PMID- 6488768 TI - Allergic contact dermatitis to zinc pyrithione. PMID- 6488769 TI - Laboratory animal allergy. PMID- 6488771 TI - Allergy to cetylalcohol. PMID- 6488770 TI - Benzaron allergy. PMID- 6488772 TI - Contact plantar pustulosis. PMID- 6488773 TI - Contact allergy to an olive oil containing ointment. PMID- 6488775 TI - Allergic contact dermatitis due to epoxy resin in textile labels. PMID- 6488774 TI - Contact dermatitis to trilaureth phosphate. PMID- 6488777 TI - Patch test reactions to Flamazine. PMID- 6488776 TI - Contact urticaria to etofenamate. PMID- 6488778 TI - Recovery of nickel sulphate from a standard patch test. PMID- 6488779 TI - Contact sensitivity to aluminum. PMID- 6488780 TI - Toxic epidermal necrolysis from oil lamp fuel. PMID- 6488781 TI - True cross-sensitization, false cross-sensitization and otherwise. PMID- 6488782 TI - Hand dermatoses and sick-leave: relationship between educational level, physical activity at work and housework as main occupation. AB - In parallel with a coronary risk factor survey in northern Norway, 14,667 men and women answered questions concerning health, life style, and social background. The occurrence of hand dermatoses varied only slightly within groups with different educational level and groups with different physical activity at work. Women with housework as their main occupation had a somewhat higher frequency of hand dermatoses than employed women. Sick leave due to hand dermatoses was 4-5 times more frequent in both sexes in less educated compared to highly educated individuals, and more frequent in men and women with physically active jobs. These differences may partly reflect differences in the over-all frequency of sick leave. PMID- 6488783 TI - Contact dermatitis from Frullania, Compositae and other plants. AB - 28 patients with dermatitis from plants were seen over the last 10 years. This was 1.45% of all patients with contact dermatitis. 7 reacted to Frullania, 4 to Compositae, and 1 to helenin. Patch tests with Frullanaceae, Lauraceae, Magnoliaceae, Compositae and helenin, showed no dominant allergen in the plant families with sesquiterpene lactone sensitivity. The positive reactions with feverfew (Chrysanthemum parthenium) in nearly all patients is probably due to the high content of the sesqueterpene lactone parthenolide; it is a better screening allergen for Compositae sensitivity than alantolactone (helenin). PMID- 6488784 TI - Allergy to 2 new corticoid molecules. AB - 6 cases of hypersensitivity to Tixocortol pivalate and 3 to Amcinonide are reported. The 9 female patients all presented with features of contact dermatitis. PMID- 6488785 TI - Patch testing in Japanese subjects. AB - Experience with various patch tests, usage tests, and other studies on Japanese and Caucasian subjects is presented. Differences between the races are noted by their responses. PMID- 6488786 TI - Contact and photocontact allergy in persistent light reactivity. AB - The patient group consisted of 18 elderly male patients with persistent light reactivity who were subjected to extensive phototesting with different wavelengths, including patch and photopatch testing. All reacted adversely to ultraviolet light and some also to longer wavelengths when tested on normal appearing skin. 17 patients showed contact or photocontact reactions, of which 12 were positive photopatch test reactions and 11 were plain contact reactions. Contact allergy to constituents of oak moss and different lichen compounds was twice as common as allergy to Compositae oleoresins. 72 patients with chronic polymorphic light eruption were used as a control group. 10 of these patients had either a positive photopatch test reaction or a plain contact allergy. Patients with persistent light reactivity are characterized by a particular susceptibility to develop a delayed-type hypersensitivity. They frequently have both photo and plain contact allergy, often to substances used in cosmetics. In 13 of 16 patients in whom a biopsy was carried out, the histology supported the clinical diagnosis. In none of the biopsies was the picture diagnostic in itself. This underlines the inadequacy of light microscopy as the only diagnostic procedure. PMID- 6488787 TI - New Britain cardiac rehabilitation: thirteen years' experience. PMID- 6488788 TI - The heart patient after hospitalization: social and psychological factors in life after a heart attack. PMID- 6488789 TI - Getting well in the 1980's: the second generation of cardiac rehabilitation. PMID- 6488790 TI - Osteoporosis. National Institutes of Health. PMID- 6488791 TI - Freestanding emergency medical care centers. AMA Board of Trustees. PMID- 6488792 TI - Needed: a new way to train doctors (1). PMID- 6488793 TI - Legal aspects of peer review. PMID- 6488794 TI - Profit in medicine: the impact on hospital staffing patterns and physician practice behavior. AMA Center for Health Policy Research. PMID- 6488795 TI - Magnetic resonance imaging. Where did it come from? What is it? Where is it going? Part II. Clinical applications. PMID- 6488796 TI - Measuring economic damages in wrongful death: the case of a physician. PMID- 6488797 TI - Choking: the Heimlich maneuver (abdominal thrust) vs. back blows. AMA Council on Scientific Affairs. PMID- 6488798 TI - Issues in glomerulonephritis and renin system. PMID- 6488799 TI - Evaluation of the effect of nifedipine in men after myocardial infarction. AB - The acute effect of nifedipine (Adalat, Bayer) was evaluated in 54 men with a history of transmural myocardial infarction. Haemodynamic changes (in 20 patients) and/or changes in left ventricular radionuclide ejection fraction (LVREF) (41 patients) were studied. 20 to 30 min after sublingual administration of 1 Adalat capsule (10 mg nifedipine) a decrease in arterial pressure and systemic resistance, and an increase in heart rate and cardiac output were observed already at rest. During exercise (50 W) there moreover occurred a decrease in pulmonary artery pressure and in arterial oxygen tension. LVREF was pathologically reduced already at rest, and in most patients exercise led to its further decrease. LVEF increased after Adalat administration only during exercise. In men with a history of myocardial infarction without clinical manifestations of heart failure, Adalat acted predominantly as a peripheral vasodilator; a negative inotropic effect was not demonstrable. The decrease in arterial oxygen tension, observed during exercise, was not clinically important. PMID- 6488800 TI - Early haemodynamic effects of mitral valve prosthesis in patients with acquired heart disease. AB - 42 patients with isolated mitral valve defect were divided into two groups: without cardiac complications -- and with acute myogenic heart failure, after implantation of a mitral valve prosthesis. In the first postoperative hours, a decrease in cardiac output and pulmonary hypertension were observed in both groups. By the end of the 1st postoperative day, cardiac output reached in both groups the initial level, but in patients of group 2 only thanks to catecholamine administration. The poor functional state of the heart before surgery is consequently the main cause of the fact that surgical intervention is not immediately followed by normalization of haemodynamics. Acute heart failure occurs in the early postoperative period in patients with an extremely impaired left ventricular pump function and with depleted myocardial reserves. In these patients, special attention must be given during surgery to myocardial protection. PMID- 6488801 TI - Provocation of higher-degree atrioventricular blocks by ajmaline and rapid ventricular pacing in patients with fascicular block. AB - In order to induce higher-degree AV block, ventricular pacing at a rate of 150/min after ajmaline administration (max. doses 100 mg) was performed in patients with fascicular block. Out of 109 patients with clinically and electrocardiographically documented intermittent complete AV block (group A) and 61 patients with a typical history without ECG manifestations of higher-degree AV block (group B), a total of 145 patients (85.3%) showed 2nd or 3rd degree AV block after pacing. In contrast to this, only 3 out of 38 patients with bifascicular block without syncope (group C) presented positive results. The method is regarded as being suitable for detecting latent trifascicular blocks. PMID- 6488802 TI - Examination and comparative study of a simple method to determine the left ventricular ejection fraction. AB - The authors developed a simple radioisotopic method for determining the left ventricular ejection fraction with 99mTc-labelled red blood cells. The semi quantitative data is acquired at the equilibrium stage and gated to the ECG. The results of this atraumatic and reproducible isotopic determination of LVEF correlate statistically well those of echocardiography and left ventricular angiography. PMID- 6488803 TI - The effect of adenosine on impulse formation and propagation in the heart. Electrophysiologic studies and clinical implications. AB - The effect of adenosine on impulse formation and conduction in the heart was studied in 20 dogs by the sinus node artery perfusion technique. Electrophysiologic studies were performed by using His electrograms and epicardial electrograms of the atria and left ventricle. This action potential was recorded in the hearts of 10 dogs. After adenosine administration, there first developed bradycardia, then sinus arrest. Instead of sinus rhythm, there appeared a junctional escape rhythm. Atrial extrasystoles could be also regularly detected. Impulse conduction slowed down in the AV node. Similar changes could be observed after local administration of verapamil. Adenosine decreased the resting membrane potential and the maximum rate of depolarisation in atrial tissue preparations. Experimental data support the assumption that slow Ca++ channels are involved in the bradycardiac effect of adenosine. PMID- 6488804 TI - [Clofibrate and phosphate metabolism]. AB - Experiments on rabbits with clofibrate and phosphate added to cholesterol-rich (2%) diet showed similar effects of both substances. During the first month of the experiment, total plasma lipid and total cholesterol level remained within normal range, thereafter up to the third month their level increased. The phosphataemia and phosphaturia showed similar dynamics. The results suggest a similar mechanism of action of both studied substances. PMID- 6488805 TI - Changing the protocol: a case report from the Macular Photocoagulation Study. Macular Photocoagulation Study Group. AB - The first report of findings from the Senile Macular Degeneration Study (SMDS), one of several clinical trials carried out by the Macular Photocoagulation Study (MPS) Group, appeared in June 1982. Although the SMDS did not terminate with the change of protocol that precipitated release of the initial findings of the trial, activities prior to and immediately following the decision to halt recruitment and publish findings were disruptive to the operations of all centers and to the professional and personal lives of the individuals with greatest responsibility for implementing the change. The purpose of this report is to describe the experiences of the MPS investigators in the hope that others may learn from them. The issues that confronted the investigators are discussed. The decisions they made, a chronology of events, and activities leading to the decision to terminate patient enrollment in the SMDS and to release findings from the trial are described. PMID- 6488806 TI - A note on data monitoring, incomplete data and curtailed testing. AB - A question often asked in a fixed sample size clinical trial is whether the final outcome has been determined before the data has been completely collected. Recent papers in this journal and elsewhere have considered this question from the viewpoint of curtailed testing. In this paper, a related concept, "the probability of reversal" of a test procedure, is described and associated least upper bounds are given that are pertinent to the issue. The results are also of relevance in assessing, at the end of the trial, whether missing data are of consequence in the test of significance. PMID- 6488807 TI - Measuring functional outcomes in therapeutic trials for chronic disease. AB - For clinical trials of many chronic diseases, the outcome of greatest interest may be patient function. Unfortunately, most scales for measuring functional status are crude and rarely consider important psychosocial impacts of disease. This paper briefly considers the pressures for improving functional status measurement, proposes six criteria for assessing functional or "health status" scales, and selectively reviews representative instruments using these criteria. Older functional classifications and many scales used for quality-of-care assessment are narrowly focussed on physical function. Their reliability, validity, and sensitivity to clinical changes are generally unknown. Traditional scales of "Activities of Daily Living" are similarly focussed on physical function, and are most appropriate for severely disabled inpatients. A new generation of "health status" instruments offers wider applicability, more comprehensiveness, and feasibility for clinical applications. Their validity and reliability are generally quite good. None of the instruments reviewed, however, has yet demonstrated convincing success as a "transition" variable (sensitivity to small but clinically important changes). Based on this analysis, future investigation should seek to (1) define the optimal balance between brevity on the one hand, and comprehensiveness and reliability on the other, (2) describe the sensitivity of scales to clinically important changes, and (3) directly compare existing instruments to aid selection by investigators who are considering their use in clinical trials. PMID- 6488808 TI - Who should code cause of death in a clinical trial? AB - Clinical trials of intervention in chronic disease often use cause-specific mortality as a principal outcome variable. Surprisingly, there has been little standardization of the approach to determining cause of death. Some studies use standard nosological coding based on the International Statistical Classification of Diseases while others rely on panels of physicians. Some studies utilize autopsy findings; others do not. There is a clear need for standardization, and a unified approach is suggested. In this approach, panels of physicians prepare death certificates and are trained and standardized to generate reproducible information. A system for adjudication of differences is a part of the trial's design. Death certificates are then transmitted to panels of nosologists who assign cause of death. Again, the nosologists are standardized, and an adjudication system for resolving differences is developed. This two-stage system takes advantage of strengths of the two types of cause of death coding now in use in clinical trials and should produce results permitting cross-trial and cross time comparisons. PMID- 6488809 TI - Bias, maximum likelihood estimators, and sequential clinical trials. PMID- 6488810 TI - Two brains, one child: interhemispheric information transfer deficits and confabulatory responding in children aged 4, 7, 10. AB - In an investigation of developmental trends in the ability to transfer information between the cerebral hemispheres, 138 children, ages 4, 7, and 10, viewed pictures presented to either the right or left hemisphere and were asked to describe what was viewed. Responses were socored for the number of accurate pictorial features reported (inclusion score), confabulation (erroneous embellishment), perceptual, semantic, and syntactic errors. Misses (failure to provide a response) were also noted. A preponderance of errors were found, such that 4-year olds engaged in a significant degree of confabulatory responding following right vs. left presentation. A significant inverse relationship was found between inclusion and confabulation such that the larger the gap in information reported the greater was the tendency to insert (confabulate) erroneous material. In addition, all children were given a tactile-shape recognition task employing both transfer and non-transfer conditions and requiring tactile exploration and visual recognition. Significantly more errors were found on the transfer vs. non transfer task among the 4-year olds only. In that deficits in information transfer were not complete but only partial, and given that significant intra-hemispheric (non-transfer) errors were also discovered, it was concluded that the hemispheres of children age 4 are not completely but only partially disconnected, and that intra-hemispheric (cortical) immaturity plays a significant role in the production of processing deficits. PMID- 6488811 TI - Investigation of everyday memory in normal subjects using the Subjective Memory Questionnaire (SMQ). AB - This study examined memory for everyday events by method of self-report using the Subjective Memory Questionnaire (SMQ). The purpose of the study was to repeat and extend existing normative data. The SMQ was found to be adequately reliable, but this finding needs to be replicated in a large sample of subjects. Data from 170 224 control subjects revealed no effects of age or sex on total SMQ scores. However, sex differences occurred in 50% of individual questions, possibly reflecting cultural stereotypes. Higher social classes rated their memory more optimistically than lower classes. Overall subjects estimated their memory as being above "average". Principal Component Analysis revealed 10 factors with eigen-values greater than 1.0. These included factors for "male" and "female" memory that have not been found previously in studies using subjective measures of everyday memory. Factors identified as "absentmindedness", "names" and "how to get somewhere" were similar to those reported elsewhere. PMID- 6488812 TI - Everyday forgetting experiences: real-time investigations with implications for the study of memory management in brain-damaged patients. AB - In order to attempt to measure everyday forgetting experiences outside the laboratory, groups of undergraduates, healthy old people, and neuropathological patients with memory complaints were asked to use portable memory diaries. For a period of 7 days, they were immediately to write down every instance of noticing that they had forgotten anything. Types of forgetting, their frequency, and types of cues in the world that served as reminders that forgetting had occurred are discussed. PMID- 6488813 TI - Verbal memory disturbances in left temporal lobe epileptics. AB - The relationship between laterality of paroxysmal discharges and characteristics of disturbances in memory functioning was investigated in temporal lobe epileptics. Subjects consisted of 22 temporal lobe epileptic patients, in whom the foci of the paroxysmal discharges were localized to one side of the temporal regions. The left focus group consisted of 10 patients; the right focus group, 12. Subjects were required to recognize verbal material presented to one hemisphere by means of a tachistoscope. The left focus group alone failed to demonstrate a right visual field superiority in these tasks. It was concluded that the left focus group specifically demonstrate disturbances in verbal memory functioning, particularly when stimuli were presented to the left hemisphere. Paroxysmal discharges seemed to interfere with normal memory functioning in the region where the foci of these discharges were found. PMID- 6488814 TI - Lateral differences in face processing: task and modality effects. AB - According to Sergent and Bindra (1981), the literature suggests that faces are better processed in the right visual field for identification tasks and in the left field for discriminative tasks. We have tried to test this hypothesis directly along with the degree of generalization in tactile modality. A sample of 16 young normal subjects were given a face identification task in the visual and tactile modalities. The faces were first associated with names and then laterally displayed for 180 msec. in the visual hemifield or haptically explored. The subjects were asked to depress one button for two stimuli and another button for the other two. Another group of 16 subjects was similarly given a discriminative task: same-different judgments were required on successive pairs of stimuli (central stimulus first and then lateral stimulus). The results agreed well with the hypothesis as regards the visual modality. The lack of laterality effects in the tactile tests could be due to procedural defects. It also appeared that the degree of familiarization with stimuli was an important variable, at least in the visual modality. PMID- 6488815 TI - On block design constructional disability in right and left hemisphere brain damaged patients. AB - Block design tasks without or with special visual cues, tests of reasoning abilities and tests of spatial abilities were administered to 20 right and 20 left hemisphere damaged patients and 20 controls. Hecaen and Assal's (1970) hypothesis was not confirmed for block design constructional performance. Results of multiple linear regression analysis suggest that left hemisphere damaged patients adopt different strategies for the two different task situations. PMID- 6488816 TI - Neuropsychological impairment after carotid endarterectomy correlates with intraoperative ischemia. AB - Detailed neuropsychological assessments were performed before and shortly after carotid endarterectomy in thirty-four patients. The degree of intraoperative ischemia was assessed by monitoring the somatosensory evoked cortical potential change upon carotid clamping. Changed neuropsychological performance was found to be related to intraoperative ischemia most clearly in patients with a history of previous stroke and in those with more severe vascular disease. In such patients greater SSEP change was correlated with greater neuropsychological change postoperatively. PMID- 6488817 TI - The effects of closed head injury upon intrusions and confusions in free recall. AB - Previous research suggests that closed head injury impairs the use of semantic encoding in human memory, and especially the use of mental imagery. An analysis of intrusion and confusion errors in immediate free recall was carried out to provide further evidence on the effects on head injury upon different categories of encoding operation. There was no sign of any effect of closed head injury upon the incidence of either phonemically related or semantically related confusion errors, nor upon the overall incidence of intrusion errors from previous lists. However, the control subjects demonstrated a strong tendency to produce intrusion errors of similar concreteness to the current list, a tendency which was totally absent in the case of the head-injured subjects. It is suggested that the persistent effects of closed head injury upon human memory may be attributable to a failure to attend to the image-evoking quality of the stimulus material. PMID- 6488818 TI - The power of a procedure for detecting mixture distributions in laterality data. AB - The results of a Monte Carlo simulation of the power of an iterative version of a Maximum Likelihood procedure for the detection of mixture distributions are described. In general the power of such techniques is low, and for mixtures typical of those found in laterality research a sample size of about 150 or 300 is required to have a 50% or 90% probability of detecting the presence of a mixture. PMID- 6488819 TI - The P3 potential and its clinical usefulness in the objective classification of dementia. AB - Two groups of normal subjects and three groups of demented subjects of specific etiology and severity (mild and moderate arteriosclerotic; moderate Alzheimer's) were compared on the basis of P3 latency and amplitude. P3 latency was found to be a useful parameter for the demonstration of cognitive dysfunction in patients with dementia, which supports the findings of Goodin et al. (1978). Clinically, the efficacy of using P3 latency as an objective test in determining the severity of dementia, can be questioned by two results of this study. First, P3 latency could not separate mildly demented patients from normals. Second, no significant difference was found for counts to the infrequent stimulus between the normal subjects, neurologically-impaired patients and patients with mildly arteriosclerotic dementia. However, P3 latency did enable separation of patients with a moderate classification of dementia from normal subjects. More importantly, P3 latency separated patients with mild and moderate arteriosclerotic dementia. This result indicated that P3 latency was sensitive enough to separate patients with dementia of the same etiology at different stages of the disease. PMID- 6488820 TI - Hand posture in writing: possible artifacts from self report. AB - Seven hundred forty undergraduate students were asked to report the hand posture they used during writing and the presence or absence of left-handedness in the immediate family. Drawings were provided of prototypical "normal" and "inverted" posture and subjects were also given the option of reporting that their hand posture was somewhere between the two illustrated positions. The incidence of reporting "between" was 17% for left-handers and 46% for right-handers. These results suggest that experimenters should exercise caution when categorizing subjects on the basis of self-report forms that include only two choices: normal posture and inverted posture. PMID- 6488821 TI - Hand and eye preference patterns in elementary and junior high school students. AB - There has been some controversy concerning the relationship between eye preference and hand preference. Another controversy involves age differences in eye preference patterns. These two issues were investigated in 725 elementary and junior high school students employing various tests. It was found that a sex difference exists in hand preference patterns. Males seem to display less right hand preference as compared to females; on the contrary, these was no sex difference in eye preference patterns. Hand preference was found to be negligibly correlated with eye preference. The distribution patterns of eye preference were reversed between right handers and left handers. Age difference were not observed in eye preference patterns. PMID- 6488822 TI - Handedness, sex and intelligence. AB - On the basis of data from a large and representative population (N = 1880), we have now had the opportunity to examine the relationships that have been claimed to exist between handedness, sex, and the patterning of intellectual abilities, as these are reflected in performance on the Wechsler Adult Intelligence Scale- Revised (Wechsler, 1981). Such relationships had previously been studied using rather small samples of men and women. Our analyses show a reliable, if negligible, effect of sex on these test results, but no effect of handedness. PMID- 6488823 TI - Amelioration of brain damage by lidoflazine after prolonged ventricular fibrillation cardiac arrest in dogs. AB - Calcium entry blockers can ameliorate postischemic cerebral hypoperfusion, protect the myocardium against ischemia, and may protect against early postischemic neurologic deficit. This study documents that a calcium entry blocker, given after cardiac arrest, can ameliorate late postischemic neurologic deficit (ND). Thirty-four dogs received 10 min of ventricular fibrillation, restoration of spontaneous circulation by external cardiopulmonary resuscitation, and standard postarrest intensive care. Eleven of these dogs were given lidoflazine, 1 mg/kg body weight, within 10 min postarrest and again at 8 h and 16 h. Pupillary light reflexes, EEG activity, arterial-cerebrovenous oxygen gradients (O2 demand/supply ratios) and intracranial pressure were the same in both groups. After weaning from controlled ventilation at 24 h, ND scores improved consistently through the 96-h observation period in the lidoflazine treated dogs. In the control group, ND scores were significantly higher than in the lidoflazine-treated dogs. In the lidoflazine-treated group, 5/11 dogs achieved normal overall performance and none remained comatose, whereas all control dogs had some deficit and 4/11 remained comatose. Delayed neurologic deterioration occurred in 6/11 control and 0/11 lidoflazine-treated dogs. Total mean cerebral histopathologic damage (HD) scores at 96 h were not significantly different between the two groups; however, individual HD scores and maximum cerebro-spinal fluid (brain-specific) creatine-phosphokinase activity--which increases after brain insults--correlated well with 96-h ND scores. In the lidoflazine group, life-threatening dysrhythmias were less frequent and the norepinephrine requirement for blood pressure maintenance was the same as in the control group. Cardiac output remained at prearrest levels in the lidoflazine treated dogs, but decreased in the control group, particularly during the first 4 h postarrest. PMID- 6488824 TI - Polymicrobial bloodstream infections related to prolonged vascular catheterization. AB - Between June 15 and August 7, 1982, six patients in a medical ICU developed primary nosocomial bloodstream infections. Nine different organisms were isolated during this epidemic. In three patients, contamination of intravascular lines was documented; and in the other three, the relationship was strongly suggested. The infected patients were compared to three groups of randomly selected controls: group A from the epidemic period; group B from the pre-epidemic period; and group C from both periods and matched for underlying disease. The infected patients had indwelling arterial and pulmonary artery catheters in place almost twice as long (6.3 +/- 2.8 days and 6.8 +/- 3.9 days, respectively) as most controls. Our evidence suggests that the guideline for changing catheters may have been ignored when the resident house staff changed. This is the first outbreak related to vascular catheters in which several different organisms were involved; it represents a new type of epidemic related to a common technique problem rather than a common source reservoir. PMID- 6488825 TI - A prospective comparison of arterial catheter blood and catheter-tip cultures in critically ill patients. AB - To determine if a culture of blood obtained through an arterial catheter reflects culture of the catheter's tip, we studied 68 arterial catheters removed from 65 patients with and without suspected catheter infections. Cultures of blood obtained before catheter removal were compared to catheter-tip cultures. The arterial catheter blood culture was neither sensitive nor highly predictive of positive catheter-tip cultures. Suspicion of catheter infection was not associated with a significantly higher rate of positive catheter-tip or blood cultures. PMID- 6488826 TI - Blind use of the double-lumen plugged catheter for diagnosis of respiratory tract infections in critically ill children. AB - Transtracheal aspiration, percutaneous lung biopsy, and tracheal aspiration can be dangerous and/or unreliable methods for obtaining specimens of pulmonary secretions for culture. Using a blind technique, we evaluated the efficacy of a double-lumen catheter (DLC) with a polyethylene glycol plug in obtaining specimens of respiratory tract secretions for culture, and compared these results with simultaneously obtained cultures of tracheal aspirates. Twenty-seven intubated children already receiving antibiotic therapy were studied. Sixteen (59%) DLC specimens were sterile, as opposed to only 6 (22%) tracheal aspirates. Only 2 (8%) of the DLC specimens were contaminated. Two DLC specimens yielded significant bacterial growth (at least 10(5) colony-forming units/ml). Using DLC culture data, there was an 81% success rate in making decisions concerning antibiotic selection. We conclude that blind use of the DLC is a safe and reliable method of obtaining pulmonary secretion specimens for culture. PMID- 6488827 TI - Prognostic and therapeutic importance of the aortic diastolic pressure in resuscitation from cardiac arrest. AB - A study was done to determine if 12 dogs could be resuscitated from 30 min of ventricular fibrillation if aortic diastolic blood pressure was maintained above 30 mm Hg by administration of epinephrine and, in 6 cases, saline solution during cardiopulmonary resuscitation (CPR). Of the 12 dogs seven were resuscitated successfully. The survivors received 3.4 +/- 1.7 mg of epinephrine, whereas the nonsurvivors received 11.1 +/- 2.1 mg of epinephrine. The aortic diastolic blood pressure was significantly higher (p less than .05) in the survivors at 12, 18, 24, and 30 min of ventricular fibrillation. In all nonsurvivors, it was impossible to maintain diastolic pressure above 30 mm Hg even with large doses of epinephrine and saline. Maintenance of an adequate diastolic blood pressure during CPR appears important for survival. PMID- 6488828 TI - Regional blood flow during cardiopulmonary resuscitation in dogs. AB - We studied regional blood flow (QR) using radiolabeled microspheres in 12 anesthetized dogs during cardiopulmonary resuscitation (CPR). A circumferential vest and abdominal binder were used with a mechanical ventilator to deliver 30 simultaneous chest compressions and ventilations per minute. When this device was modified to increase aortic pressure (Pao) during compression and the aortic-to right atrial pressure gradient (Pao-Pra) during relaxation, cerebral and myocardial QR increased significantly. These findings suggest that QR during CPR can be improved by augmenting perfusion-pressure gradients across the cerebral and coronary circulations. PMID- 6488829 TI - Some treatment-withholding implications of no-code orders in an academic hospital. AB - To identify treatment-withholding intentions for 56 VA medicine inpatients who received a no-code order, 31 resident physicians who wrote the orders completed a checklist on which they indicated the interventions they intended to withhold from each patient. Review of patients' charts indicated that 24 (43%) contained no documentation of treatment limitation plans beyond the no-code order. To identify the general interpretations of no-code orders, "cross-covering" physicians indicated on a questionnaire the likelihood that they would withhold specific interventions from patients they were covering who had received a no code order. Both the intention and interpretation of no-code orders were characterized by variability, and interpretation of the orders was characterized by uncertainty as well. Because of these discrepancies, we suggest a no-code order which provides greater specificity for individual patients. PMID- 6488830 TI - Early cerebral prognosis of anoxic encephalopathy using brain energy metabolism. AB - Cerebral arteriovenous differences in oxygen content [C(a-v)O2] and glucose content [C(a-v)gluc] were used to predict outcome in 20 patients who remained comatose after resuscitation for cardiopulmonary arrest. Cerebral prognosis was good when C(a-v)O2 values were greater than 1.8 mMol/L and the oxygen glucose index (OGI) was greater than 85%. Our results suggest that cerebral recovery is linked with increased oxidation associated with the beginning of nonglycolytic metabolism. PMID- 6488831 TI - Effect of nursing-staff support groups on the quality of newborn intensive care. AB - ICU support groups are widely recommended to mitigate the effects of stress on staff performance, thereby improving patient care. The usefulness of a nursing staff support group was assessed in the neonatal ICUs of both a city/county hospital (10,000 births/yr) and a private hospital (3200 births/yr). Support group meetings focused on communication and patient care and were conducted every 1 to 2 wk by psychiatrists experienced in intensive care support groups. Nevertheless, attendance diminished and the groups lasted only 6 to 7 months. Moreover, the quality of routine, emergency, and overall care did not differ significantly during intervention vs. control months. Our findings suggest that sources of ICU stress may be best addressed by methods other than nursing-staff support groups. Under the conditions of the study, we found little evidence to justify the expense and effort required to conduct ICU support groups. PMID- 6488832 TI - Effect of Intralipid on measurements of total hemoglobin and oxyhemoglobin in whole blood. AB - A co-oximeter study of whole blood samples containing Intralipid concentrations of 100 to 2000 mg/dl found that the light-scattering effect was greater at lower hematocrits. The methemoglobin reading was affected the most, and led to erroneous displays of total hemoglobin and percent oxyhemoglobin. The O2-content value, however, was accurate over the entire hematocrit and Intralipid concentration range tested. We suggest that an unexplained high methemoglobin value in whole blood samples from patients receiving Intralipid may reflect a light-scattering problem in the instrument. PMID- 6488833 TI - Clinical evaluation of a new finger oximeter. AB - Noninvasive measurements of oxygen saturation are used in ICUs, during exercise and sleep studies, and in the operating room. Traditionally, ear oximetry has been used to assess oxygen saturation during a variety of clinical situations. This study evaluates a new oximeter which takes its signal from the finger bed. It was tested in normal volunteers during rapid depletion of inspired oxygen, and in critically ill ICU patients requiring oxygen by nasal cannulas or masks or by mechanical ventilation. The new oximeter possessed accuracy equivalent to a standard ear oximeter and to oxygen saturation determined from direct blood measurements. PMID- 6488834 TI - Pressure measurement error with disposable domes for transducers: brief report. PMID- 6488835 TI - Hypotension secondary to balloon inflation of a pulmonary artery catheter. AB - Inflation of a balloon-tipped catheter for measurement of pulmonary artery wedge pressure caused a decrease in systemic arterial blood pressure in a mechanically ventilated patient after pneumonectomy. Obstruction by the balloon of a significant proportion of the cross-sectional area of the pulmonary circulation results in increased right ventricular afterload with subsequent decreased cardiac output and left atrial pressure. This decreased left atrial pressure can be measured accurately by the inflated balloon-tipped catheter but may be falsely low. PMID- 6488836 TI - Use of high-frequency jet ventilation to prevent aspiration in a patient with an uncuffed tracheostomy tube. AB - We report the use of high-frequency jet ventilation (HFJV) in a patient with an uncuffed tracheostomy tube who had significant pulmonary aspiration of upper airway secretions. Respiratory secretions decreased during HFJV, indicating that the patient was no longer aspirating. Despite a continuous flow of gas out of the patient's nose and mouth, arterial blood gases remained within acceptable limits. We conclude that HFJV can prevent aspiration and maintain adequate ventilation when used with an uncuffed tracheostomy tube. PMID- 6488837 TI - Morphologic effects of defibrillation: a preliminary report. AB - A 72-yr-old man receiving more than 300 separate DC countershocks in 2 wk exhibited morphologic heart changes, including areas of coagulation necrosis in the subepicardium and areas of frank hemorrhage. In other sites the myocytes were pathologically contracted, a finding previously demonstrated in experimental animals as a result of defibrillation but not seen in man. We suggest that these changes may occur more often than has been previously supposed and thus may be of clinical importance. PMID- 6488838 TI - Orders not to resuscitate: the DNR patient. PMID- 6488839 TI - Cricothyroid puncture of an undeflatable endotracheal tube cuff. PMID- 6488840 TI - Sympathetic nervous system activity during hypothermia. PMID- 6488841 TI - Cyclic variations in blood pressure. PMID- 6488842 TI - Fluctuations in resting energy expenditure. PMID- 6488843 TI - Increased intracranial pressure associated with N-acetylcysteine inhalation therapy. PMID- 6488844 TI - Paths to psychiatric care in Hong Kong. AB - The pattern of psychiatric consultation in Hong Kong is examined among 226 patients at a public outpatient clinic and 56 patients at a private psychiatric clinic. The approach to psychiatric services is marked by lengthy delay during which patients get help from their family members or close friends. Arrival at the present psychiatric clinic was diverted through other medical resources, primarily Western-style medical services, and to some extent, traditional Chinese medicine. Individual routes were diverse, characterized by frequent switches among resources especially in the private sector. The nature of the patients' presenting complaints as well as the conceptualization of their initial complaints were multi-faceted, including both psychological and somatic factors. The overall consultation pattern of patients in Hong Kong is compared with other studies on Chinese and Western patients. Questions are raised for further analysis. PMID- 6488845 TI - The effect of cultural conceptions on therapy: a comparative study of patients in Israeli psychiatric clinics. AB - This article explores the relationships between culture and therapy among patients from three contrasting Israeli groups: Persian, Ashkenazi and Moroccan Jews. The population studied is composed of persons who came to Jerusalem mental health clinics for consultation and treatment. Emphasis is placed upon the patients' conceptions and beliefs regarding health and illness as well as their actual behavior in this sphere. Systematic contrasts among the three groups are analyzed, and the ways these differences influence the treatment process are also discussed. PMID- 6488846 TI - Family therapy and anthropology. AB - There has been among family therapists a widespread belief that anthropology is at least useful if not kindred to their field. The belief springs from the assumption that families in different cultural milieus have different ways of expressing their experience of intimacy in everyday life. If this is true, family organization transcends culture, and the latter is a mere language or mode of expression of the more basic pillar of family organization. However, the assumption is also strong that different cultural contexts produce different types of families, and the natural consequence of this hypothesis is that family therapy as developed in the United States would be restricted to dealing with American families, while the problems of family life elsewhere should be meted by the local cultural ways. These two hypotheses, namely that of family universality and that of cultural relativism, are far ends of a continuum. The more interesting and real cases lie somewhere in the middle. In the following argument I will discuss this subject by presenting a brief overview of family therapy's theories and practices for those readers who know nothing about it, by reviewing a recent book that makes the claim that therapists will benefit from some kind of anthropological knowledge, and finally by turning the question on its head and addressing the interest family therapy may have for anthropologists. PMID- 6488847 TI - Cross-cultural aspects of bereavement. I: A conceptual framework for comparative analysis. AB - This paper reviews some key conceptual questions in the study of cross-cultural aspects of bereavement. Six questions are reviewed in cross-cultural perspective: whether individuals in all societies share the same private experience and public expression of grief; whether the stages of grief occur in the same sequence and at the same rate in all cultures; the nature of the relationship between the individual's private grief and his public mourning; the reactions of children to death, and the reactions of adults to the death of children; the role of religious belief; and the possibility that an ethnic group can experience collective grief in response to uprooting. PMID- 6488848 TI - An immunological study of papillary conjunctivitis due to contact lenses. AB - Serum and tear levels of IgE were compared in patients with contact lens papillary conjunctivitis (CLPC), vernal keratoconjunctivitis (VC), healthy contact lens wearers (CLW), and healthy controls without lenses. The mean of serum IgE was elevated only in the VC group. Tear IgE levels were significantly higher for CLPC and VC than for CLW and healthy controls. Tear IgG levels were also increased in CLPC patients. With serum albumin (HSA) as a marker for leakage of proteins from the circulation to the tear fluid, the data indicated, that tear IgG was blood-borne whereas tear IgE was essentially a product of local synthesis. In one of the 10 CLPC patients, high titers of IgE type antibodies to housedust mites and cat epithelium were demonstrated in both serum and tears. We conclude that CLPC is usually an IgE mediated reaction to the lens material or to contaminations of allergenic material that sticks to the lenses. PMID- 6488849 TI - Culture of adult rabbit retinal glial cells: methods and cellular origin of explant outgrowth. AB - Culture methods to propagate glial cells from the avascular adult rabbit neural retina are described. To determine the site(s) in the retina from which the cells originated, retina fragments were retrieved from culture at intervals after explanation and processed for light microscopy to localize surviving cells. Tritiated-thymidine radioautography was used to determine the time of onset and the localization of proliferating cells in the isolated retina and in the early culture outgrowth. Although some glial cells located just subjacent to the inner limiting membrane and at the interface between the ganglion cell and inner plexiform layers were activated to DNA synthesis in three to five days after explanation of the retina, the dominant cell type in the cultures derived from the retina appeared to be the Muller cell. Regionally, in isolated retina fragments, Muller cells became hyperplastic and formed tissue masses of proliferating cells surrounding photoreceptor remnants. These proliferating clusters could be retrieved from the culture medium after about 10 days in vitro and replated whereupon they attached to the culture substrate and gave rise to cellular outgrowths. The cells in the early explant outgrowth were heteromorphic, but passaged cultures contained a relatively homogeneous population of cells that exhibited a low maximal growth rate and senesced quickly in vitro. PMID- 6488851 TI - The effect of diet on inherited retinal dystrophy in the rat. AB - The rate of photoreceptor cell degeneration was significantly retarded in albino rats afflicted with inherited retinal dystrophy by merely changing the food supply from a commercial lab chow to a well defined diet. The data suggest that female dystrophic rats may benefit somewhat more from this dietary manipulation than the males. A well defined fat-free diet was less successful than a standard defined diet in retarding the rate of retinal degeneration. PMID- 6488850 TI - Effect of topical epinephrine and timolol on ocular and optic nerve blood flow in phakic and aphakic rabbit eyes. AB - The effects of 4% epinephrine bitartrate and 0.5% timolol on ocular and optic nerve blood flow were studied in phakic and aphakic rabbit eyes using a radioactive microsphere (85Sr) technique. Either epinephrine or timolol was given topically as eight drops in the hour immediately preceding blood flow measurements (one drop every 7.5 minutes). Epinephrine decreased anterior uveal blood flow in both phakic and aphakic eyes, whereas timolol exhibited no effect. Retinal and choroidal blood flow were not affected by either timolol or epinephrine in phakic eyes. In aphakic eyes, epinephrine increased choroidal blood flow without altering retinal blood flow, whereas timolol increased both retinal and choroidal blood flow. Optic nerve blood flow was increased in epinephrine treated phakic and aphakic eyes and also in timolol treated aphakic eyes. PMID- 6488852 TI - Distribution of freezable and non-freezable water in bovine vitreous. AB - The viscoelastic behavior of and the transport of molecules in the vitreous is influenced by the binding of water to the macromolecular components. The macromolecular components are unevenly distributed in the vitreous. Therefore, it is of interest if the bound water, which can be identified with the non-freezable water content, is also unevenly distributed in the vitreous. Differential scanning calorimetric measurements between -30 degrees C and 15 degrees C were performed on samples from different regions of bovine vitreous body. From the endotherms the amount of freezable water content was calculated. The total water content of the vitreous was measured by vacuum dehydration. There is a slight increase in the non-freezable water content when one proceeds from the lens to the retina along the optic axis. The average amount of non-freezable (bound) water content of the vitreous is high, approximately 20% of the total water content. PMID- 6488853 TI - Ocular melanin pigmentation anomalies in cats, cattle, mink, and mice with Chediak-Higashi syndrome: histologic observations. AB - The Chediak-Higashi syndrome (CHS) is a hereditary disorder of man, with the homologous condition reported in five animal species. Multiple defects, including oculocutaneous hypopigmentation, are present in individuals with this syndrome. Giant cytoplasmic granules, including melanosomes and lysosomes, are characteristic. In this study, eyes from CHS affected and control cats, cattle, mink, and mice were examined histologically to determine: 1) degree of pigmentation; 2) structure and distribution of melanin granules; and 3) morphology of cells and tissues containing melanin. The CHS cattle were found to be the most ocularly hypopigmented species, whereas CHS mouse eyes contained considerably more melanin than those of the other species. Melanin granules of abnormal sizes and shapes were present in neuroepithelial and uveal tissues of CHS animals of all four species. Depigmentation apparently had occurred in the CHS eyes, since less melanin was present in eyes of old CHS animals of each species than was present in eyes of young animals. In addition, melanin containing macrophages were common in CHS eyes, and the numbers of melanocytes and pigmented epithelial cells were decreased in older CHS eyes. PMID- 6488854 TI - Keratocyte attachment to hydrogel materials. AB - We have developed an in-vitro model for keratocyte interactions with hydrogel materials. With the aid of inverted phase contrast microscopy and scanning electron microscopy, we observed the growth of baboon stromal keratocytes on the surface of various hydrogel materials. In this study, the Bioflex lens (0.5% hydration) surface was extensively covered with keratocytes, whereas 1% to 25% of the surfaces of Crofilcon A (40% hydration) and Perfilcon A (70% hydration) lenses were covered with keratocytes. The Bufilcon A (55% hydration) lens was free of keratocyte attachment. Keratocytes attached to the surfaces of the lenses produced extracellular collagenous material as evidenced by positive staining with alcian green-metanil yellow. These in-vitro results correlate with our non human primate studies using Bioflex, Crofilcon A and Bufilcon A lenses as intracorneal implants. PMID- 6488855 TI - Acetylcholine can exert two opposite effects on uveal flow in isolated arterially perfused eyes of cats and rabbits. AB - Acetylcholine (Ach) has an effect on IOP and uveal flow. It elevates IOP in cats but not in rabbits in eserinized preparations. A fall in IOP induced by epinephrine (epi) or norepinephrine (nor-epi) is partly reversed by the addition of Ach. Ach has a dual effect on uveal flow in both cats and rabbits. It causes vasoconstriction in high concentrations or in the presence of eserine (Es). The constriction is presumably maximal in the choroidal (efferent) part of the ciliary processes. Ach may also cause vasodilatation after preconstriction of uveal with adrenergic agents. The dilatation is probably located in the afferent vessels of the ciliary processes. The dose of Ach required for dilating preconstricted uveal vessels is at least 3 magnitudes lower than the dose for constricting the uveal vasculature. We propose that uveal vessels contain two kinds of muscarinic receptors, one inhibitory and another excitatory. PMID- 6488856 TI - Inhibition of oxidative degradation of hyaluronic acid by uric acid. AB - It has been postulated that glycosaminoglycans in the trabeculum have an influence on aqueous humor drainage. Ascorbate reduces the viscosity of hyaluronic acid, and also increases outflow facility. Our recent observation of high urate concentrations in some glaucomatous eyes led us to study the influence of urate on oxidative degradation of hyaluronic acid by ascorbate. The viscosity of rooster comb hyaluronic acid was reduced slowly by ascorbate. Cupric sulfate accelerated ascorbate oxidation and also enhanced hyaluronic acid degradation. Urate inhibited ascorbate oxidation and prevented the copper catalyzed oxidative degradation of rooster comb hyaluronic acid. The range of urate concentrations used in this study was within the range of urate concentrations observed in glaucomatous eyes. The partially purified umbilical cord hyaluronic acid had lower viscosity than rooster comb hyaluronic acid, and rapidly degraded in the presence of ascorbate. The ascorbate effect on umbilical cord hyaluronic acid was partially prevented by urate. PMID- 6488857 TI - Acid proteases of vitreal macrophages. AB - Macrophage invasion in rabbits was elicited by intravitreal injection of trypan blue or latex particles; as after hemorrhage, there are two periods of macrophage invasion with elevated numbers of intravitreal cells at three and 21 days. Release of acid proteolytic activity by macrophages from both time periods was assayed by analysis of the cell-free vitreal supernate and of the medium of cultured cells. Lysates of freshly-isolated macrophages and of adjacent ocular tissues were also analyzed. Although some quantitative differences were observed, a similar profile of acid proteolytic activity toward hemoglobin at pH 2.0 to 6.5 was found in the vitreal supernate and in the cells from both periods. Most macrophages invade via the ciliary processes and during invasion elevated levels of acid proteolytic activity were found in this tissue. Although some macrophages transmigrate the retina, normal acid protease levels were low in sensory retina and essentially unchanged during macrophage invasion. Protease inhibitor studies indicated the presence of carboxyl, cysteinyl, serine and metallo proteases in macrophages and in macrophage-containing tissues. The inhibitor data also suggested qualitative differences in acid protease activities in macrophages from the two invasive periods. During macrophage invasion vitreal pH was reduced from 7.4 to 6.2 suggesting that some macrophage-derived acid proteases may be active in that compartment. Thus, although the phagocytic activity of macrophages aids vitreal clearing, action of macrophage proteases may also contribute to vitreal pathology by cleavage of vitreal proteins. PMID- 6488858 TI - Biochemical studies on the use of sodium hyaluronate in the anterior eye segment. IV. The protective efficacy of the corneal endothelium. AB - We devised an apparatus to add constant mechanical force to the corneal endothelium, and the protective efficacy of sodium hyaluronate to the corneal endothelium was determined quantitatively using an image analyzer. When the corneal endothelium was coated with a 1% solution of 800K or 2150K sodium hyaluronate, the damaged area was significantly less than cases having a coating with a 1% solution of 200K sodium hyaluronate or phosphate buffered saline which was the solvent of sodium hyaluronate. The water uptake of damaged cornea was also investigated using tritiated water. The cornea coated with 800K or 2150K sodium hyaluronate showed the same water uptake as the normal cornea, but the cornea coated with 200K sodium hyaluronate or phosphate buffered saline showed a significantly higher uptake. These results suggest that a 1% solution of 800K or 2150K sodium hyaluronate protects the corneal endothelium from mechanical damages. PMID- 6488860 TI - Photoreceptoral basis for altered dark-adaptation in retinal degeneration (RCS) rats. AB - The 'fast PIII' rod mediated photoreceptor response to flashes of monochromatic light has been investigated in isolated retinae of the RCS rat at age 30 days. A loss of both sensitivity and maximum response amplitude were found, with a concurrent slowing of the response kinetics. These observations indicate a rod abnormality which may underly the altered adaptational properties in these retinae. PMID- 6488859 TI - Gentamicin diffusion across hydrogel bandage lenses and its kinetic distribution on the eye. AB - Soft contact lenses have been used as therapeutic bandages to aid epithelial healing following pentrating keratoplasty. Often the hydrogel lenses are used in conjunction with topical medications such as gentamicin. A reported complication is the persistence of infectious ulcers even though the eye is being treated with topical antibiotics. The purpose of this study was to measure the gentamicin diffusion coefficients for some hydrogel bandage lenses and to design a kinetic model to estimate the drug distribution on an eye covered with a hydrogel contact lens. The model includes the hydrogel diffusion coefficients and literature values for tear production, tear exchange per blink around the edge of a lens, fit, etc. From the computer generated data, it can be shown that the permeability of gentamicin sulfate through the Saulfon-80 hydrogel lens on a normal eye was only 0.002% of the amount of the drug under the contact lens after 10 minute intervals of topical drug application. The important drug distribution pathway was around the edge of the lens. PMID- 6488861 TI - Trabeculoplasty and visual field decay: a follow-up study using computerized perimetry. AB - 15 eyes with glaucomatous visual field defects were followed with computerized perimetry before and nearly one year after Argon Laser Trabeculoplasty. An expected reduction of the IOP was achieved, the pressure being on an average 25.7 mm Hg before and 17.7 after the treatment. Performance values obtained at computerized perimetry were used to trace the trend of visual field development. There was a visual field decay during the period preceding the intervention. This trend did not change after trabeculoplasty. PMID- 6488862 TI - Effects of timolol on intraocular pressure following ocular adrenergic denervation. AB - The effects of timolol on the elevation of intraocular pressure induced by orogastric water-loading were studied in conscious pigmented rabbits which had undergone unilateral, superior cervical ganglionectomy. Each rabbit was studied without timolol treatment and with unilateral 2% timolol treatment, either to the innervated eye or to the denervated eye, 90 min before water-loading. Timolol, applied to the innervated eye, significantly reduced the elevation of intraocular pressure in that eye, but not in the fellow eye. Timolol, applied to the denervated eye, did not affect the elevated intraocular pressure in either the denervated or the fellow eye. These results demonstrate that ocular adrenergic innervation participates in the mechanism of ocular hypotensive action of timolol in water-loaded pigmented rabbits. PMID- 6488863 TI - The effect of age on corneal and lens superoxide dismutase. AB - The enzymatic activity of copper-zinc superoxide dismutase within the cornea and lens of the juvenile (1 week) and adult (26 week) rat has been measured relative to both total soluble protein and immunoreactive protein. Enzymatic activity of corneal superoxide dismutase, localized in the epithelium and endothelium, remains constant with age relative to total soluble protein and the ratio of catalytically active enzyme to immunoreactive enzyme is near unity indicating that the superoxide dismutase present is enzymatically active. Likewise, in the juvenile rat, the majority of lens superoxide dismutase, which is located in the capsule epithelium, is enzymatically active. However, in the adult rat a large portion of the enzyme present is catalytically inactive. The enzymatic activity also decreases relative to total soluble protein with age in both the rat and the rabbit lens. This decrease in protection against toxic radicals and/or the accumulation of enzymatically defective enzyme may be contributing factors to age related lens disorders. PMID- 6488864 TI - Acid phosphatase localization in the equatorial region of human lenses. AB - Localization of acid phosphatase activity is described in equatorial segments of four human cataractous lenses, including one lens with equatorial cortical cataract, and three lenses with no significant equatorial opacities. The lenses were removed surgically with a cryoprobe. Enzyme reaction product was confined mostly to epithelial and cortical Golgi complexes and dense bodies, and to cortical smooth endoplasmic reticulum (SER). It also was located in small cortical vacuolar cysts in the lens with equatorial cataract, and intercellularly in a single lens which was devoid of equatorial opacity. In the latter case, intercellular activity was confined mostly to areas showing minimal pathological modification. Evidence is presented that the cortical SER represented GERL. The hypothesis is made that intercellular acid hydrolase activity might play a role in the early stages of human senile cortical cataract development. However, it is recognized that confirmation of this hypothesis will require additional studies involving comparison of both cataractous and normal lenses of various ages, which have been removed by a careful procedure which minimizes the lysis of lens cells. PMID- 6488865 TI - Proliferation of lens epithelial explants in culture increases with age of donor rat. AB - Lens epithelial cells explanted together with their capsule into serum-free medium underwent cell division. The extent of cell division depended on the age of the donor rat. After explantation, lens epithelia from newborn and 5 day rats showed decreased mitotic activity from day 0 to day 3 whereas epithelia from 15 day rats showed a marked increase in mitotic activity which peaked at day 3. To determine the age when mitosis is first stimulated by explantation, explants were prepared from 10 day and 13 day rats. Explants from 10 day rats showed a slight increase in cell division and explants from 13 day rats showed a substantial increase in cell division. Therefore about 10 days of post-natal development, mitosis is stimulated by explantation and the magnitude of stimulation increased up to 15 days of age. We also found that in 7 week old rats the central epithelium, where most cells are blocked in Go-1 in vivo, showed a similar high level of cell division after 3 days. Moreover, the peripheral epithelium, which includes the zone of highest mitotic activity in vivo, had a significantly lower mitotic response to explantation than the central epithelium. Thus, explantation into serum-free medium must in some way stimulate cells blocked in Go-1 to re enter the cell cycle. Furthermore, it is suggested that the increased mitotic response of rat lens epithelial cells with post-natal age indicates that the proportion of cells blocked in Go-1 increases substantially from 10-15 days of age. PMID- 6488866 TI - Calibration of the Alcon applanation pneumatonograph and Perkins tonometer for use in rabbits and cats. AB - The Alcon pneumatonograph (PTG) and Perkins tonometer were calibrated for use on rabbits and cats by connecting the eyes of the anaesthetised animal to a pressure manometer and performing tonometry at varying known pressures. The slope of the calibration graph obtained for the PTG was steeper when the stopcock was closed just before tonometry, whereas open and closed stopcock curves were identical using the Perkins tonometer. When using the PTG on rabbits it was found that tonometer readings could exaggerate changes in intraocular pressure unless converted to mmHg using a relevant calibration curve. PMID- 6488867 TI - A clinical epidemiologic study of thyroid carcinoma in Malmo, Sweden. AB - The annual incidence of clinically diagnosed TC in Malmo was, on an average, 2.4 per 100,000 population during the years 1960-1977. This was 1.2 per 100,000 population lower than the corresponding incidence in the whole of Sweden as reported by the National Cancer Registry. The main reason for the difference was suggested to be inclusion in the official figures of autopsy cases and of cases with a benign diagnosis, rather than a true difference in the prevalence of TC. During the later part of the study an increase in the incidence of differentiated TC of approximately 70% was noted. This was considered to be due to increased health awareness and the availability of medical care, because only the number of tumors with less advanced growth increased. The average annual mortality from TC in Malmo was 0.9 per 100,000, which was 0.4 per 100,000 lower than the corresponding official rate in all of Sweden. The difference was suggested to be mainly due to inclusion in the official figures of persons not dying of TC. The mortality did not change significantly during the period of investigation. The percentage distribution by histologic type of tumors clinically diagnosed (N = 104) was as follows: papillary cancer, 65%; follicular, 21%; medullary, 4%; and anaplastic, 12%. The prognosis as estimated by the life table method was worst for patients with anaplastic TC, followed by those with follicular, papillary, and medullary TC. The validity of using the relationship of the tumor to the thyroid capsule (i.e., intrathyroidal and extrathyroidal growth) as a basis for classification into tumor stages was supported in the present study: the mortality in patients with intrathyroidal tumors was lower than in those with extrathyroidal tumors. The definition of occult TC--TC not larger than 1.5 cm, without regard to the relation to the thyroid capsule--was considered inappropriate and a change in the conception of occult TC was proposed. The presence or absence of node metastases in TC did not seem to have major significance for the prognosis. The significance of age for survival was strongly supported in our study. Deaths from TC clinically diagnosed before the age of 60 were infrequent, whereas the disease after this age increasingly often was fatal. This was partly due to a late onset of anaplastic TC and partly to a higher mortality in older than in younger patients with papillary or follicular TC.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6488868 TI - Morphological aspects of valvular heart disease: Part I. PMID- 6488870 TI - How to assess quality in a residency. PMID- 6488869 TI - ABSITE: uses and abuses. PMID- 6488871 TI - Small intestinal obstruction after appendectomy: an avoidable complication? PMID- 6488872 TI - Pulmonary physiologic response to central venous administration of hemorrhagic pancreatic ascitic fluid in a porcine model. PMID- 6488873 TI - Subpopulations of cardiac mitochondria. PMID- 6488875 TI - Colonic mucosal lesions: evaluation of monopolar electrocautery, argon laser, and neodymium: YAG laser. PMID- 6488874 TI - Effects of carbon monoxide on pulmonary fluid accumulation. PMID- 6488877 TI - The molecular biology of adenoviruses 3. 30 Years of adenovirus research 1953 1983. PMID- 6488876 TI - Phase I treatment of women with metastatic breast cancer with baboon anti-gross cystic disease fluid protein. PMID- 6488879 TI - Adenovirus DNA replication. PMID- 6488878 TI - Genetic analysis of adenoviruses. PMID- 6488880 TI - A study of viral genomes in cells transformed by the nononcogenic human adenovirus type 5 and highly oncogenic bovine adenovirus type 3. PMID- 6488882 TI - Cosmetic dermatitis of the eyelids. PMID- 6488881 TI - Early and late proteins of adenovirus type 12: translation mapping with RNA isolated from infected and transformed cells. PMID- 6488883 TI - Insect sting allergy. PMID- 6488884 TI - Hydrofluoric acid burns. AB - Contact with hydrofluoric acid may produce extensive tissue necrosis. This can be prevented by prompt recognition and specific treatment. Unfortunately, symptoms and therefore treatment are often delayed. Education of employees and physicians should result in the prevention of unnecessary tissue destruction and pain for those inadvertently exposed to hydrofluoric acid. PMID- 6488886 TI - The vasculitis of atrophie blanche (livedoid vasculitis) and abdominal aortic pathology. AB - Seven of forty-two patients with livedoid vasculitis whose cases were reviewed at the Mayo Clinic were found to have abdominal aortic disease, in the form of aortic calcification and atherosclerosis or aneurysm. None of these patients had any associated systemic mesenchymal disease (lupus erythematosus, periarteritis nodosa, rheumatoid arthritis, Sjogren's syndrome, or carcinomatous diseases). Three patients received graft replacements for aneurysm or vascular occlusive disease. Removal of the aneurysm in one case was associated with resolution of the livedoid vasculitis. Abdominal aortic changes should be considered in patients with diagnosed livedoid vasculitis. PMID- 6488885 TI - Secondary and tertiary syphilis presenting as sarcoidal reactions of the skin. AB - Secondary and tertiary skin lesions of syphilis are infrequently biopsied and studied histologically. Examination of biopsy specimens from two patients, one with secondary and one with tertiary syphilis, revealed sarcoidal reactions, which caused confusion in the patients' diagnoses. The response to penicillin therapy in each patient was dramatic and contrary to the response anticipated in sarcoidosis. The histologic changes of secondary and tertiary syphilis are discussed. PMID- 6488887 TI - Exercise-induced immunological responses. Part I: Exercise-induced asthma. PMID- 6488888 TI - Self-help clinic for psoriasis. PMID- 6488890 TI - Teething ring cheilitis. PMID- 6488889 TI - Erythema gyratum repens with associated squamous cell carcinoma of the lung. AB - A 63-year-old man with erythema gyratum repens (EGR) was found to have an underlying squamous cell carcinoma of the lung. Neither radiation nor chemotherapy had any effect on the extensive eruption. EGR is the most distinctive of the figurate erythemas, and continues to be one of the most consistent cutaneous signs of an associated visceral malignancy. PMID- 6488891 TI - Sympathomimetic amines in the treatment of chronic urticaria: two case reports. AB - Two patients are presented whose chronic urticaria had previously failed to improve with antihistamine therapy or glucocorticoids. Both demonstrated marked improvement with dextroamphetamine sulfate. Both patients also had idiopathic orthostatic edema for which the treatment of choice is amphetamines. When treatment was discontinued the urticarial lesions returned, only to decrease significantly again when therapy was resumed. Whether the response to amphetamines in chronic urticaria is unique to patients with idiopathic orthostatic edema or will also prove to be effective in treating typical idiopathic urticaria will be determined by future research. PMID- 6488892 TI - Refining the hair-bearing flap. AB - The availability of hair-bearing flaps offers patients a more extensive choice of corrective procedures for baldness. The hair-bearing axial temporoparietal occipital (TPO) flap which we prefer is based on the superficial temporal artery and extends well past the posterior midline. The procedure is performed in the office. The "instant" and exceptionally dense hair which grows in patients with sparse, limited, and finely textured hair is a distinct advantage over the hair transplanted by punch autograft technique. Since the surgery involved is formidable, the patient must be highly motivated, well-informed and advised realistically about the results available with this procedure. A well-planned and properly executed TPO flap procedure is the best method for obtaining the density of hair and the appearance desired within the shortest time. PMID- 6488893 TI - Pemphigus vulgaris localized to the nose. AB - Pemphigus often begins with localized oral lesions. Initial localized pemphigus lesions elsewhere are less common. A 65-year-old man who presented with one crusted erosion on his nose was diagnosed as having pemphigus and was treated with local and intralesional steroids. Seven months after the onset of the first lesion, others occurred elsewhere on his skin. PMID- 6488894 TI - Histoplasmosis presenting as erythema multiforme and polyarthritis. AB - Erythema multiforme and polyarthritis occurred in association with serologic evidence of primary histoplasmosis. Although such occurrences have been noted in epidemics, recognition of this triad outside of the epidemic setting has been described only once before. PMID- 6488895 TI - Atypical fibroxanthomas of the skin: multiple primaries. AB - An 83-year-old man experienced, within a four-year span, two separate atypical fibroxanthomas occurring on the right ear and right forehead without any satellite lesions or obvious lymph node metastases. Such an occurrence has not been reported before. PMID- 6488896 TI - Bart's syndrome: report of a case. AB - The fifth reported case of Bart's syndrome, a congenital mechanobullous disorder with an excellent prognosis, is presented, with therapeutic considerations and a review of the literature. PMID- 6488897 TI - Analysis of three whole-arm translocations in a mouse sarcoma cell line. AB - Three apparently whole-arm translocation chromosomes in the mouse sarcoma 180 ascites cell line have been studied by G- and C-banding and by Hoechst staining. All three chromosomes appear to have two centromeres. Both centromeres of one, which are very close together, are likely to be active and to produce parallel separation of the chromatids. The centromeres of the other two chromosomes are well separated. One of these two centromeres may be inactive either because the kinetochore organizer has been inactivated or because the kinetochore plate has been deleted, leaving the AT-rich centromeric constituative heterochromatin intact. The possibility that these whole arm translocations arose by telomeric fusion and the molecular basis of such fusions are discussed. PMID- 6488898 TI - NOR associations with heterochromatin. AB - Associations between nucleolus organizer regions (NORs) and non-acrocentric chromosomes were scored in 2,800 metaphase spreads from PHA-stimulated lymphocyte cultures (48 h) from 14 individuals. The preparations were both silver stained and C-banded. In order to calculate the expected values for associations, the ratio of heterochromatin length to euchromatin length was established for each subject. Individual C-band lengths and centromeric lengths were also determined. When silver connective (SC) associations with heterochromatin were compared to SC associations with euchromatin, the number of associations with heterochromatin was significantly greater than expected (P less than 0.000001) for each subject. The SC associations were not distributed randomly over the heterochromatin of the non-acrocentrics. Chromosomes 1 and 2 had significantly more than expected. Chromosomes 17, 18, 19, 20, and the Y had fewer than expected. NOR associations with euchromatic segments also showed a nonrandom pattern of distribution. PMID- 6488899 TI - Intermittent flow oxygen devices; technically feasible, but rarely used. PMID- 6488900 TI - Transient pulmonary hypertension associated with esophageal sclerotherapy. PMID- 6488901 TI - A demand valve conserves oxygen in subjects with chronic obstructive pulmonary disease. AB - Demand valves conserve oxygen by limiting delivery to the inspiratory phase of respiration and reducing the waste which occurs during expiration with conventional, constant flow therapy. However, arterial oxygen tensions (PaO2) achieved in past evaluations were frequently higher than recommended for treating chronic hypoxemia. We wondered if excessive amounts of oxygen were used which would exaggerate waste with conventional therapy, and, in turn, apparent savings with demand valves. Oxygen savings were evaluated with a demand valve in ten stable COPD patients who had recommended levels of PaO2 (55 to 65 mm Hg, SaO2 90 percent to 92 percent). The valve reduced oxygen use significantly compared to conventional therapy (average savings 28 percent, range 14 percent to 49 percent). The greatest savings were found in subjects who used the highest conventional flows. PMID- 6488903 TI - Epidemic of pulmonary blastomycosis (Namekagon fever) in Wisconsin canoeists. AB - Epidemics of pulmonary blastomycosis have rarely been reported. The following epidemic occurred in a Minnesota family and several of their acquaintances after a canoeing trip in northwestern Wisconsin. The common exposure area was most likely a campsite, located along the upper reaches of the Namekagon River. The Namekagon River Valley is a known endemic area of Namekagon fever (blastomycosis) in dogs. Approximately one month after returning home, five of the eight members of the group had positive direct microscopic examinations and cultures of Blastomyces dermatitidis from their sputa, as well as abnormalities on their chest roentgenograms. Among these five patients, four were symptomatic, with fever, cough, and pleuritic chest pain. Of the three others, one had pleuritic chest pain with a transient lung infiltrate, the second was asymptomatic with a transient lung infiltrate, and the third was asymptomatic with a normal chest roentgenogram. Results of acute serologic tests (complement fixation and immunodiffusion) were negative in all five patients evaluated. None of the patients received antifungal therapy. Follow-up five years after the epidemic revealed that all eight were in excellent health, and none had evidence of continuing pulmonary or extrapulmonary disease. PMID- 6488902 TI - Open lung biopsy in immunocompromised patients. AB - Increased use of open lung biopsy in the search for a treatable etiology of acute interstitial pneumonitis (AIP) in immunocompromised patients is based on the assumption that examination and cultures from biopsy specimens will yield significant information leading to beneficial treatment of the condition. To assess the true impact of the results of open lung biopsy on the subsequent treatment and outcome in such patients, a retrospective study was done of 64 consecutive patients undergoing the procedure in a recent five-year period. When open lung biopsy was performed for the diagnosis of AIP in immunocompromised patients after empiric broad spectrum treatment failed, it rarely missed a specific, treatable etiology, if present. However, the results from open lung biopsy infrequently lead to a change in the treatment that improves the patient's clinical course. PMID- 6488904 TI - The role of transcarinal needle aspiration in the staging of bronchogenic carcinoma. AB - Transcarinal needle aspiration for staging subcarinal nodes was performed in 134 consecutive patients with suspected bronchogenic carcinoma at the time of diagnostic fiberoptic bronchoscopy using a prototype 20-gauge by 1-cm needle. The aspiration was performed before examination of the lower airways to avoid cellular contamination. Twenty-four patients had benign primary disease and negative needle aspirates. The transcarinal needle aspirate was positive in 15 percent of the 110 patients with bronchogenic carcinoma. There were no false positives, and the transcarinal needle aspirate was the only evidence of unresectability in 69 percent (11/16) of those in whom it was positive. In addition, two subgroups of patients were identified in whom the aspirate is most likely to be positive--patients with endobronchial tumors (24 percent; 15/63) and those with an abnormal carina at bronchoscopy (38 percent; 8/21). No complication occurred. We conclude that transcarinal needle aspiration is a low-risk procedure that can save a significant number of patients the morbidity and cost of surgical staging and that it should be performed at the time of diagnostic bronchoscopy in all patients with an endobronchial lesion or a visually abnormal carina. PMID- 6488905 TI - Tuberculous and posttuberculous bronchopleural fistula. Ten year clinical experience. AB - Between 1972 and 1982, 15 episodes of tuberculosis-related bronchopleural fistula (BPF) were observed in 13 patients at a municipal hospital in New York City. All 13 had a history of inadequate treatment for pulmonary tuberculosis, and seven had one or more associated chronic debilitating conditions. Past pleural inflammation with resultant fibrothorax appeared to be the source of the late BPF formation in at least seven patients, while rupture of a cavity during active disease was likely in four. Clinical presentation ranged from life-threatening tension-pneumothorax to incidental discovery, a long-term wasting illness being the most common form. Diagnosis was not difficult. Antituberculosis chemotherapy and tube suction were generally employed in treatment, with further surgical drainage procedures done when necessary and possible; open window thoracostomy was usually successful (four of seven BPFs closed, one stable for years), as were one case each of pleuropneumonectomy and decortication. When surgery was not feasible, long-term tube drainage was a useful alternative. PMID- 6488906 TI - Enlarged pulmonary arteriovenous vessels in COPD. Another possible mechanism of hypoxemia. AB - Among 27 patients with moderate-to-severe chronic obstructive lung disease, 22 had anatomic intrapulmonary shunting greater than that seen in normal subjects. The shunted blood passed through enlarged pulmonary vessels, as demonstrated with particles 10-90 microns in diameter. The shunt magnitude was correlated with the decrement in lung diffusing capacity. It did not correlate well with pulmonary mechanical abnormalities such as air flows and volumes or resting blood gas data. Nevertheless, shunting through enlarged pulmonary vessels may play a role in the hypoxemia seen in COPD patients, especially at exercise. PMID- 6488907 TI - Parietal pleural plaques, asbestos bodies, and neoplasia. A clinical, pathologic, and roentgenographic correlation of 25 consecutive cases. AB - An investigation was made to correlate autopsy and roentgenographic findings of pleural plaques with occupational exposure to asbestos and occurrence of respiratory tract tumors. Of the 434 autopsies performed over a 2 1/2 year period, 25 (5.8 percent) had pleural plaques but no gross evidence of parenchymal fibrosis. Review of the posterior-anterior chest roentgenograms using the International Labor Office criteria for classification of pneumoconiosis (1980) revealed that only seven of the 25 cases had detectable pleural thickening or calcification, which demonstrates the poor sensitivity of standard x-ray films. There was no detectable difference in frequency of known or presumed exposure to asbestos between the pleural plaque cases and controls as determined by occupational information obtained from chart review. Asbestos bodies were identified in lung tissue digests from all 25 cases with pleural plaques, and exceeded the normal range for our laboratory in 14 cases (56 percent). Of the 25 cases with pleural plaques, four also had bronchogenic and three had laryngeal carcinoma. The prevalence of bronchogenic carcinoma in patients with plaques was not different from those without plaques (p greater than 0.50). However, the association between plaques and laryngeal carcinoma was highly significant (p = 0.004). PMID- 6488908 TI - Clinical evaluation of a percutaneous pneumothorax catheter. AB - This study prospectively evaluates the efficacy and complications of the percutaneous pneumothorax catheter. Twenty-five patients were treated with the percutaneous catheter for 19 episodes of spontaneous or iatrogenic pneumothorax, six malignant effusions, and one infected bulla. The catheter was effective in all but a single episode of spontaneous or iatrogenic pneumothorax and was especially useful in three patients with tension pneumothorax. Further experience is required to define fully its feasibility in the treatment of malignant effusions or infected bullae. The ease of insertion, good response, and low incidence of complications suggest that this catheter may be a useful alternative to tube thoracostomy in selected situations. PMID- 6488909 TI - Quantitation of wheezing in acute asthma. AB - Pulmonary sounds were recorded before and after bronchodilator treatment in 20 patients with acute attacks of asthma. Analysis of the sounds showed that improvement in the forced expiratory volume in one second was associated with the following two changes in the sound signal: (1) the proportion of the respiratory cycle occupied by wheeze (Tw/Ttot ratio) was reduced from 86 percent to 31 percent on average; and (2) the sound frequency of the highest pitched wheeze was also reduced, from a mean of 440 Hz to 298 Hz. PMID- 6488910 TI - Cocaine and acute myocardial infarction. A probable connection. AB - Six young cocaine users, median age 35.5 years (range 27 to 44 years) experienced acute myocardial infarction. The close temporal correlation in two cases between cocaine use and clinical infarction and the relative paucity of atherosclerotic blockage of the coronary arteries in the others, as demonstrated by autopsy or angiography, suggest that cocaine, either by a mechanism of coronary artery spasm or by increased myocardial oxygen demand consequent to hypertension and tachycardia, is implicated in the precipitation of these infarctions. PMID- 6488911 TI - Arterial-esophageal fistulae developing in patients with anomalies of the aortic arch system. AB - Two cases are presented in which anomalies of the aortic arch system were associated with development of an arterial-esophageal fistula. The fistula resulted in massive upper gastrointestinal hemorrhage and death. In each malformation, part of the anomalous aortic arch system lay against the esophagus and thereby provided the anatomic substrate for an arterial-esophageal fistula. In both cases, nonmassive ("sentinel") hemorrhage occurred prior to the massive fatal hemorrhage. Recognition of the significance of the "sentinel" hemorrhage may allow surgical correction of the problem avoiding uncontrolled massive hemorrhage. PMID- 6488912 TI - Hemodynamic effects of isoxsuprine in cardiac failure. AB - Isoxsuprine, a peripheral arteriolar vasodilator, was given to 12 patients with congestive heart failure. Cardiac index increased up to 31 percent; pulmonary artery wedge pressure fell by as much as 33 percent; mean arterial pressure fell by 17 percent; mean pulmonary artery pressure fell by 29 percent; systemic pulmonary vascular resistance fell by 37 percent; and pulmonary vascular resistance fell by 33 percent. All patients showed clinical improvement in the signs and symptoms of congestive heart failure during the three-hour observation period. This initial report documents the short-term salutary effects of isoxsuprine in congestive heart failure. The long-term efficacy of the drug remains to be evaluated. PMID- 6488913 TI - Peripheral pulmonary infiltrates in sarcoidosis. AB - The chest roentgenograms are described in eight patients with sarcoidosis who demonstrated a peripheral distribution of pulmonary infiltrates quite similar in appearance to that classically observed in eosinophilic pneumonia. The presence of mediastinal/hilar lymph node enlargement (eight patients), a nodular component to the infiltrate (four patients), an often asymptomatic presentation (four patients), and absence of blood eosinophilia (eight patients) should suggest the correct diagnosis. PMID- 6488914 TI - Clinical experience with continuous monitoring of mixed venous oxygen saturation in respiratory failure. AB - The amount of oxygen in mixed venous blood (SvO2) is a reliable indicator of the status of oxygenation of tissue in most clinical settings. Monitoring levels of SvO2 might, therefore, aid in managing critically ill patients. A recently developed adult pulmonary arterial catheter provides continuous measurement of SvO2 via fiberoptic bundles incorporated into the catheter, in addition to measuring hemodynamic pressures and cardiac output by thermodilution. We evaluated 100 consecutive fiberoptic catheters for accuracy and reliability of the system in 86 critically ill adult patients and determined the clinical usefulness that knowledge of SvO2 provided. Over a range of hemoglobin saturations from 24 to 85 percent, the correlation coefficient between in vivo SvO2 vs photometrically measured samples for 199 paired measurements was 0.95. Mean duration of usage for 33 catheters in the medical intensive care unit was 6.1 days; all catheters functioned normally until clinical conditions permitted removal. Continuous measurements of SvO2 detected unsuspected increases in tissue oxygen consumption during coughing spasms and positioning of the patient. In nine of 13 patients with hypoxemic respiratory failure requiring positive end expiratory pressure (PEEP), we found a strong correlation (r = 0.88) between oxygen delivery and SvO2. Of the four patients not showing correlation, two had sepsis, and two had nearly normal values of SvO2 and oxygen delivery at all levels of PEEP studied. Continuous measurement of SvO2 improves monitoring of patients, facilitates titration of respiratory therapies, detects abrupt changes in tissue oxygen consumption, and identifies levels of PEEP associated with greatest oxygen delivery. PMID- 6488915 TI - Continuous monitoring of mixed venous oxygen saturation in hemodynamically unstable patients. AB - A balloon-tipped catheter has recently become available which, when placed in the pulmonary artery, in addition to enabling the usual measurements of pulmonary arterial pressure, pulmonary capillary wedge pressure, and cardiac output by thermodilution, measures mixed venous oxygen saturation (SvO2) by spectrophotometry. Unlike the measurement of cardiac output by thermodilution, which is done intermittently, the continuous measurement of SvO2 is an effective method of monitoring hemodynamically unstable patients, since changes in cardiac output will immediately become apparent via a corresponding change in SvO2. This is of particular benefit in patients in whom knowledge of the immediate effects of therapy is important. It is also of value in assessing the time of onset of action and duration of action when a cardioactive drug is given to increase cardiac output. We suggest that monitoring SvO2 will provide an earlier indication of the effect of both diagnostic and therapeutic interventions and, therefore, will improve our management in such patients. PMID- 6488916 TI - Use of continuous monitoring of mixed venous saturation in the coronary care unit. AB - Recent advances in catheter technology that enable continuous measurement of mixed venous oxygen saturation (SvO2) have improved diagnostic and therapeutic capabilities in the critical care setting. The utilization of the Opticath has provided valuable information in the diagnosis and treatment of many critically ill patients in our coronary care unit. In many instances, a change in SvO2 supplied the first indication of a hemodynamic change in the patient. Specific clinical situations in which the Opticath was used are reviewed. PMID- 6488917 TI - Effects of verapamil on histamine-and carbachol-induced contraction of pulmonary tissues in vitro. AB - It has been hypothesized that calcium antagonists may be useful in the management of airway hyperreactivity. In these studies, we evaluated the effects of verapamil on guinea pig tracheal spirals and parenchymal lung strips in vitro. Preincubation of both tissues with verapamil caused concentration-dependent inhibition of contraction with significant effects noted at a 10 micromolar concentration. At this concentration of verapamil, approximately fivefold greater concentrations of either histamine or carbachol were required to produce contraction of tracheal spirals; and 21-fold greater concentrations of histamine and 630-fold greater concentrations of carbachol were required to contract parenchymal strips. We also assessed the ability of verapamil to reverse contraction. Significant reversal of both histamine- and carbachol induced contraction was observed with concentrations of 3 micromolar verapamil and contraction was nearly abolished with a 100 micromolar concentration. These data demonstrate that verapamil can both inhibit airway contraction and reverse contraction once it is present and further suggest that verapamil or other calcium antagonists may prove useful in the management of airway hyperreactivity. PMID- 6488918 TI - Hypercalcemia and rapidly progressive respiratory failure. PMID- 6488919 TI - Functional classification of bronchial carinae. AB - Extensive classifications have been in use to describe the bronchial tree; however, the lack of uniform nomenclature to describe the carinae which separate the various bronchi has led to the use of lengthy and often confusing terminologies in reporting and understanding bronchoscopic findings. We have developed a practical classification of main bronchial carinae and suggest the use of abbreviations to describe them. The newer nomenclature is designed to help improve clinical communication, especially with regard to bronchoscopic findings and their clinical implications, among physicians who specialize in pulmonary diseases. PMID- 6488920 TI - ECG changes in global LV ischemia simulating wide complex tachycardia. PMID- 6488921 TI - Adult epiglottitis. Is there a role for the fiberoptic bronchoscope? AB - The "cherry red" laryngoscopic appearance of adult epiglottitis, as visualized through a fiberscope, is reproduced. The possible role of the fiberoptic bronchoscope, both as a diagnostic aid and as a means of facilitating endotracheal intubation, in this condition, is discussed. PMID- 6488922 TI - Recurrent re-expansion pulmonary edema. AB - A unique patient is described who experienced two episodes of pulmonary edema following re-expansion of two left pneumothoraces occurring months apart. Successful surgical treatment was carried out at thoracotomy. Factors regarding pathogenesis are discussed. PMID- 6488923 TI - Two-dimensional echocardiographic detection of pericardiocentesis-induced intrapericardial thrombus. AB - Heart puncture-induced hemopericardium is a serious complication of the pericardiocentesis. Two-dimensional echocardiographic examination performed in two patients just before and after the development of hemopericardium revealed a unique image in which pericardial bleeding manifested itself by an echodensity thrombus appearance adjacent to the cardiac chambers. With appropriate differentiation to some other intrapericardial echodensity masses, such distinctive images can be highly specific for active bleeding into the pericardial sac. PMID- 6488924 TI - Cadmium chemical pneumonitis. AB - Metal fume exposures are common to a number of trades and may result in the self limited acute toxic syndrome of metal fume fever. Acute inhalational cadmium toxicity may mimic metal fume fever on initial presentation, but may have a markedly different clinical course. We report a case of cadmium-induced chemical pneumonitis in a welder who, over four years, has shown persistent pulmonary function abnormalities. The potential for acute cadmium toxicity needs to be considered in any patient suspected of having metal fume fever. PMID- 6488925 TI - Systolic anterior motion of the mitral valve. An unusual echocardiographic feature of mitral valve endocarditis. AB - An unusual M-mode echocardiographic feature of mitral valve endocarditis is described: systolic anterior motion of the mitral valve, likely due to mitral valve vegetations, protruding during systole into the left ventricular outflow tract. The presence of mitral valve vegetation was confirmed at operation. PMID- 6488926 TI - Obstructive sleep apnea and abnormal cephalometric measurements. Implications for treatment. AB - The position of the hyoid bone, which anchors much of the tongue musculature, is often abnormally low in patients with obstructive sleep apnea syndrome (OSAS). Cephalometric measurements, frequently used to measure SNA and SNB angles, can also provide information on the posterior airway space (PAS), the mandibular plane, and the hyoid bone. This information is useful in determining the appropriate surgical treatment for OSAS patients. PMID- 6488927 TI - Acute pneumonitis with bilateral pleural effusion after talc pleurodesis. AB - We describe a patient who developed acute pulmonary distress with bilateral interstitial infiltrates and pleural effusion following talc pleurodesis. Talc particles, obtained by bronchoalveolar lavage, were identified by transmission electron microscopy and chemical analysis. The patient improved with corticosteroid therapy. Acute respiratory failure can be a potential hazard of talc pleurodesis. PMID- 6488928 TI - Tachyarrhythmia provoked by coughing and other stimuli. AB - A rare case of cough-induced tachyarrhythmia is described. The effectiveness of atropine sulfate, and worsening of the arrhythmia resulting from administration of digitalis, suggests that vagal reflex might be the mechanism responsible for the tachyarrhythmia. PMID- 6488929 TI - Acute esophageal obstruction by a psyllium-based bulk laxative. PMID- 6488930 TI - Right and left ventricular function in sarcoidosis. PMID- 6488931 TI - Nicotine overdose from a single piece of nicotine gum. PMID- 6488933 TI - Alcohol consumption and emphysema. PMID- 6488932 TI - Serious hazards of tracheal intubation. PMID- 6488934 TI - Difference in trimethoprim pharmacokinetics between children and adults. AB - We used a new micromethod, an application of a previously published high performance liquid chromatography assay, to investigate trimethoprim (TMP) pharmacokinetics in children. The subjects were 5 girls who were treated for urinary tract infection with a TMP suspension, 6 mg/kg/day, twice daily for 10 days. Elimination studies were done after the last dose. The girls were 1.08-9.71 years old. 3 healthy adult males, aged 26.35-37.31 served as controls. The half life (t 1/2) of TMP in the children was 3.0-5.5 versus 9.3-13.6 h in the adults. The volume of distribution (Vd) was 0.7-1.1 1/kg in the children and 0.5-0.9 1/kg in the adults. Plasma clearance (Clp) was 2.1-2.8 ml/min/kg for the children. The adults had a smaller Clp of 0.4-1.2 ml/min/kg. From this and previous studies we conclude that the t 1/2 of TMP is much shorter in children than in adults. PMID- 6488935 TI - Diffusion of metioprim, tetroxoprim and sulphadiazine in the cerebrospinal fluid of dogs with healthy meninges and dogs with experimental meningitis. AB - The diffusion of metioprim (MTP), tetroxoprim (TXP) and sulphadiazine (SDZ) in cerebrospinal fluid (CSF), following single intravenous doses and continuous infusions, was studied in dogs. The drugs penetrated well into the CSF of animals with and without experimental Staphylococcus aureus meningitis. In dogs with healthy meninges, the CSF bioavailability - expressed as the ratio of CSF/plasma area under the curve 0-5-hour values - following continuous infusion was determined to be 86.7% for MTP, 58.2% for TXP and 38.8% for SDZ. In infected animals, CSF availability following continuous infusion increases slightly to ratios of 96% (MTP), 70% (TXP) and 50% (SDZ). For all drugs, the concentrations reached in CSF were above the minimum inhibition concentrations for the majority of Enterobacteriaceae, indicating their potential value in treatment of gram negative bacillary meningitis. PMID- 6488936 TI - Comparative efficacy of four antibiotics in anaerobic pulmonary infection. An experimental model in rabbits. AB - The efficacy of cefoxitin, mezlocillin, latamoxef and metronidazole in anaerobic lung infection was studied using a rabbit model. A mixture of Bacteroides fragilis, Peptococcus morbillorum, Eubacterium lentum and Fusobacterium nucleatum was inoculated transtracheally to produce infection within the lung. Mezlocillin was most effective, achieving bacteriologic cure in 5 out of 8 animals. With cefoxitin therapy, 4 out of 8 became bacteriologically sterile. Severe diarrhea with elevated titers of Clostridium difficile toxin was noted in most cefoxitin treated animals. Latamoxef- and metronidazole-treated animals had apparently healed lesions, but cultures were positive in 6 and 7 out of 8 in each group, respectively. The commonest pathogen isolated in the last two groups was P. morbillorum. The therapeutic superiority of mezlocillin over metronidazole and latamoxef was statistically significant (p less than or equal to 0.05). PMID- 6488937 TI - Childhood play as an analog to adult capacity to work. PMID- 6488938 TI - Developmental and psychodynamic aspects of childhood depression. PMID- 6488940 TI - Treat mother too--"failed" psychotherapy of an adolescent with school refusal. PMID- 6488939 TI - Clinical approaches to traumatized parents: psychotherapy in the intensive-care nursery. PMID- 6488941 TI - Conjoint mother-child admission in-patient management of crises in mother-infant relationships. PMID- 6488942 TI - Children's activities and their behavior: are activities worth manipulating? PMID- 6488943 TI - Facts about childhood. Hyperactivity. PMID- 6488944 TI - Workers are parents, too. AB - The nuclear family, whose structure was supposed to permit the separation of work and family, is still the model for employers' social policies toward workers. The efficiency of this model is even less evident today, as the author points out, and she argues that it is in the best interests of industry to support the needs of the changing family, whose adult members, now both mothers and fathers, make up the workforce, and their children, who will be the workforce. PMID- 6488945 TI - The case conference revisited: a systems view. AB - To disentangle clients from a social service network that has turned into a web, the author suggests a method: case conferences that include staff members of involved services, and a role: the systems-oriented case manager. As the coordinator of the client's social service network, the case manager would mediate the overt and convert conflicts that often exist among the professionals who are involved simultaneously with the client. PMID- 6488946 TI - Implementation dilemmas in North Carolina's Willie M. program. AB - The state of North Carolina entered into a consent agreement in response to a class-action lawsuit initiated by a class of emotionally or neurologically impaired children who had exhibited assaultive or violent behavior and who had been denied appropriate care and education. The consent agreement stipulates in detail a full range of services appropriate to each child's ability. The Willie M. program represents a dramatic shift in state-level child welfare services, but dilemmas deter the full realization of its potential. These dilemmas are discussed and illustrated. PMID- 6488947 TI - Preventing rural child abuse: progress in spite of cutbacks. AB - Professionals in a rural community started a service delivery program not in spite of, but because of, economic distress, to counteract the increase in child abuse caused by economic depression. Public education is shown to be a necessary tool in the establishment of new services. PMID- 6488948 TI - A vocational exploration program for residential youths. AB - Children who "grow out" of group care into independent living without the structure of a family to support their efforts toward self-sufficiency can find support in a vocational program, as described by the authors. PMID- 6488949 TI - Dyads at risk: methadone-maintained women and their four-month-old infants. AB - As part of a longitudinal study of offspring born to substance abusers, we videotaped 17 methadone-exposed and 23 comparison 4-month-old infants interacting with their mothers. Using a scale we developed, we rated communicative functioning in dyadic interaction and related mothers' interactive performance to their psychological and psychosocial resources and infants' interactive performance to their motor functioning as assessed on the Bayley Infant Behavior Record. We found, cutting across drug groups, that mothers who performed poorly on interaction were likely to have poor maternal resources and that infants showing poor communicative functioning were likely to show problematic motor functioning--namely, greater tension and poorer coordination relative to activity level; it was the opposite for mothers or infants who communicated well. Methadone was only one among several risk factors affecting interaction. PMID- 6488950 TI - Factors affecting neurobehavioral responses of preterm infants at term conceptional age. AB - A revised Prechtl Neurological Examination was administered to 510 singleton infants at term conceptional age to assess the influence of gestational age, race, and sex on neurobehavioral responses in a "typical" newborn population. The infants were born at 1 of 5 centers and were subjects of the NIH Collaborative Study on Antenatal Steroid Therapy. Of these babies, 392 were born at less than 37 weeks gestational age, whereas 118 infants were born at greater than or equal to 37 weeks. Of a total of 50 items of interest, 12 differed significantly based on race, 14 items differed in terms of gestational age at birth, and 5 items were influenced by the sex of the baby. These data suggest that singleton preterm infants born at differing gestational ages should not be considered to comprise a homogeneous sample. Further, caution should be exercised when considering babies of heterogeneous race groupings, and the babies' sex has minimal impact on neurobehavioral responses at term conceptional age. PMID- 6488952 TI - Child health and maltreatment. AB - Children who are abused have been said to have more illnesses than children who are not maltreated. The relationship between abuse and illness has been hypothesized to function in 2 ways: (1) that abuse precedes the illnesses and children from abusive homes become ill because of the damaging environment they endure, or, conversely, (2) that the illnesses precede the abuse, with the fussy behavior of ill children eliciting abuse. This study was intended to clarify the temporal relationship between illnesses and maltreatment. Health data were collected on a sample of 80 children: 11 from abusive families, 31 with nonorganic failure to thrive (NOFT), 14 from neglectful families, and 24 from control families. Hospital records (both inpatient and outpatient) for these children from the time of birth until they were 3 years old were searched by data collectors unaware of the child's classification. Children from abusive families or with NOFT appeared to be ill more often than control children, particularly during the first few months after birth, before abuse had been reported, but not necessarily before NOFT had been discovered. Health records of neglected children were not significantly different from those of controls. In addition to the abused. These 6 children also had more illnesses than control children, again particularly during the first few months after birth. Having ill children is described as a source of stress that may trigger abuse in an already stressed family. PMID- 6488951 TI - Preterm infants' manipulative exploration of objects. AB - Because manipulative exploration of objects may be important to the infant's perception and conceptualization of objects, this study compared full-term infants with preterm infants who are considered to be at risk for cognitive deficits. 30 preterms at 9 months, with age corrected for prematurity, and 20 9 month-old full-terms were videotaped while they explored novel objects; the videotapes were scored for behaviors such as looking, handling, mouthing, turning the object around, fingering, transferring from hand to hand, and banging. There were no differences between the preterms and the full-terms. A "low-risk" subgroup and a "high-risk" subgroup of preterms were then compared with each other as well as to the full-terms. The low-risk subgroup was essentially the same as the full-terms. The high-risk preterms, however, fingered, rotated, and transferred the objects less than either the full-terms or the low-risk preterms. There was a relationship between manipulative exploration at 9 months and later cognitive functioning, suggesting that lower levels of manipulation may be one way in which cognitive deficits originate or are maintained. PMID- 6488953 TI - Correlates of difficult temperament in infancy. AB - Despite interest in the construct of "difficult temperament" in infancy, little is known about its correlates within the first 2 years of life. In a study of 272 families consisting of 152 adopted and 120 nonadopted infants tested in their homes at 12 and 24 months of age, a parental report of difficult temperament was related to 3 major areas of correlates: (1) infant functioning (parental ratings of temperament, tester ratings using Bayley's Infant Behavior Record, and Bayley Mental Index scores); (2) parental personality (Cattell's 16PF test and a self report temperament inventory); and (3) measures of the home environment (Home Observation for Measurement of the Environment and the Family Environment Scales). No systematic significant relationships were found between difficult temperament and other aspects of infant development, parental characteristics, or the home environment for the entire sample or for a subsample consisting of the 10% most difficult infants. In addition, we found no evidence for significant interactions between parental personality and home environment as they affect difficult temperament nor did interactions of any type emerge as significant. Taken together with other evidence indicating that difficult temperament in infancy fails to predict concurrent or later behavioral problems, these data add to growing doubts about the utility of the construct of difficult temperament and suggest the need to consider specific infant temperaments that parents find difficult. PMID- 6488954 TI - Early mother-infant interaction and infant cognitive status as predictors of school performance and cognitive behavior in six-year-olds. AB - This study examines the predictive validity of early mother-infant interaction for development in early childhood. Observations of the interaction between 40 mothers and their 3-month-old infants were used in multiple regression analyses to predict math and reading achievement, conversation, and WISC Vocabulary and Block Design performance at 6 years of age. Frequency and proportion of interaction measures were derived that represent types of maternal stimulation and responsivity. Frequency measures are counts of the occurrence of a given behavior, while proportion measures are the proportion of the mother's total behavior that occurred as a specific behavior. Percentage responsivity measures are the best predictors of child performance. However, type of responsivity is differentially related to cognitive performance. Proximal and vocal responsivity are related to reading and conservation, while distal responsivity to infant distress is related to math achievement. Results suggest that maternal behavior can be characterized along several different and conceptually relevant dimensions as these dimensions differentially account for aspects of early development. PMID- 6488955 TI - Bridging the gap: parent-child play interaction and peer interactive competence. AB - A multimeasure, multicontext study of the relationship between father-child and mother-child play and children's competence with preschool peers was conducted. 13 boys and 14 girls, ages 3-4 years, and their parents participated. Children were videotaped while playing with each parent separately for 20 min in their homes. Children's social competence with their peers was independently evaluated by 3 measures: (1) rankings of preschool teachers of popularity with peers, (2) Q sort ratings of children's competence by their teachers, and (3) assessments of social interaction with 3 different preschool peers on separate occasions. Differential patterns of maternal and paternal behavior were associated with the social competence of boys and girls. Paternal physical play, engagement, and maternal verbal behavior were positively related to children's peer relations, especially for boys. Paternal directiveness was negatively related to popularity for boys and girls, while maternal directiveness was positively linked with popularity for girls. Opportunities for learning to regulate affect are hypothesized to contribute to these relationships. The study illustrates the linkages between family and peer social systems. PMID- 6488956 TI - Coordinating attention to people and objects in mother-infant and peer-infant interaction. AB - In a longitudinal study, infants 6-18 months of age were observed in their homes playing with their mothers and with peers. Of primary concern was how they coordinated their attention to people and objects. Observations were coded using a state-based scheme that included a state of coordinated joint engagement as well as states of person engagement, object engagement, onlooking, and passive joint engagement. All developmental trends observed were similar regardless of partner: person engagement declined with age, while coordinated joint engagement increased. Passive joint engagement, object engagement, and onlooking did not change with age. However, the absolute amount of some engagement states was affected by partner: both passive and coordinated joint engagement were much more likely when infants played with mothers. We conclude that mothers may indeed support or "scaffold" their infants' early attempts to embed objects in social interaction, but that as attentional capabilities develop even quite unskilled peers may be appropriate partners for the exercise of these capacities. PMID- 6488957 TI - Verbal rationales and modeling as adjuncts to a parenting technique for child compliance. AB - The purpose of this study was to examine whether the effectiveness of a behavioral parenting technique with children in 2 age groups (3-4 1/2 or 5 1/2-7 1/2 years) is facilitated by introducing the procedure to the child by verbal rationales and/or modeling adjuncts. Mothers were taught to implement a procedure in which they ignored their children following child noncompliance to a maternal command. 80 mother-child pairs were assigned to 1 of 4 conditions: ignoring training, ignoring plus verbal rationale, ignoring plus verbal rationale and modeling, or control. Each mother issued a set of 20 standard commands to her child in a laboratory playroom. Dependent measures included observations of child compliance and inappropriate behavior and self-report of parental satisfaction and child comprehension. Children in the rationale and rationale-plus-modeling conditions were more compliant and less inappropriate than children in either of the other 2 conditions, and their mothers reported greater satisfaction than mothers in the ignoring condition. Older children were more compliant, were quicker to comply, and demonstrated a greater comprehension of the contingencies than younger children. There was no differential responsivity in either age group between the rationale and rationale-plus-modeling adjuncts. PMID- 6488958 TI - The correlation of family management practices and delinquency. AB - Family-management skills of parents of seventh- and tenth-grade boys were related to each of 2 criterion measures of delinquency: police contacts and self-reported delinquency. The measures of family-management skills were monitoring, discipline, problem solving, and reinforcement. The measures of parent monitoring and discipline were shown to correlate significantly with both criterion measures. The monitoring score accounted for the most variance in both criterion measures of delinquency, and the problem solving and reinforcement measures accounted for the least. The monitoring score also differentiated moderate offenders from persistent offenders. PMID- 6488959 TI - Children's responses to separation from mother during the birth of another child. AB - Preschool children's behavioral and physiological responses to separation were monitored before, during, and after their mothers' hospitalization for the birth of a sibling. During these 3 periods, play sessions were videotaped simultaneous with activity level and heart rate monitoring, nighttime sleep was time-lapse videotaped, and the parents were administered questionnaires on changes in their child's behaviors. Increases in fantasy play across these periods were interpreted as active coping both with the stress of separation and the altered interactions following the arrival of a new sibling. Increases in negative affect, activity level, heart rate, night wakings, and crying characterized the hospital period as one of agitation. Longer periods of deep sleep at this stage were interpreted as conservation withdrawal. Following the mother's return, decreases were noted in positive affect, activity level, heart rate, and active sleep suggestive of depression. These changes are discussed in the context of parallel data on agitation/depression during young primate separations. PMID- 6488960 TI - Employed mothers and family day-care substitute caregivers: a comparative analysis of infant care. AB - Despite dramatic increases in recent decades in the number of employed mothers with children under 3 years of age and the greater utilization of nonmaternal child-care services (particularly unregulated family day care), little is known about the nature and quality of care provided to these infants by their employed mothers and substitute caregivers. This study was conducted to provide a comparative assessment of maternal and nonmaternal infant caregiving practices in own-home and unregulated family day-care homes, respectively. 30 caregivers (10 employed mothers, 10 substitute caregivers, and 10 nonemployed mothers) were observed in interaction with 5-6-month-old infants using Yarrow, Rubenstein, and Pedersen's Home Environment and Mother-Infant Interaction scales. While no differences were observed in the caregiving of employed and nonemployed mothers, both of these groups exceeded the sitters in socially mediated stimulation, contingent responsiveness, positive affect, and overall level and variety of social stimulation. In addition, employed mothers provided more tactile kinesthetic, visual, and auditory stimulation to their infants than did the substitute caregivers. However, no differences were found between the infants reared in the home and day-care settings in Bayley Mental and Psychomotor developmental abilities. Evidence implicated group size (total number of children) in the quality of caregiving in family day-care homes. The impact of daily separations and qualitatively different caregiving experiences on infants is discussed. PMID- 6488961 TI - Men and women as parents: sex role orientations, employment, and parental roles with infants. AB - Mothers' and fathers' sex role orientations and employment situations were examined in connection with their involvement in child-oriented activities using a longitudinal research design. During interviews that took place within 3 months of their wedding dates, 34 couples completed questionnaires that measured their sex role attitudes, masculinity-femininity, and their skills and role preferences for performing a number of child-oriented activities. Approximately 1 year later, after the couples had become parents, they were interviewed about their employment situations and again about their child-care skills and role preferences for performing certain child-care tasks. During the 2- to 3-week period following the second interview, the couples were telephoned on 9 occasions and asked to report on the household tasks, leisure activities, and child oriented activities they had performed during the 24-hour period that preceded each call. The findings showed that mothers' sex role attitudes before their infants' births predicted their role preferences after their babies were born, and these two factors, as well as mothers' involvement in the paid labor force, were related to the extent of their involvement in child-oriented activities. Mothers' masculinity and femininity, however, were unrelated to their parenting behavior. In contrast, fathers' work involvement was related only to the extent of their leisure activities with children. In addition, fathers' role preferences for performing child-care tasks and their perceived skill at such tasks (as measured both before and after their children's births) were related to the overall extent and the nature of their involvement in child-oriented activities. Fathers' role preferences were somewhat stable from before to after children's births, and fathers' preferences before their children were born predicted the mothers' preferences afterward. Neither fathers' sex-role attitudes nor their masculinity or femininity, however, predicted their activities with infants. PMID- 6488962 TI - The development of sex role stereotypes in the third year: relationships to gender labeling, gender identity, sex-typed toy preference, and family characteristics. AB - The onset and development of preschoolers' awareness of sex role stereotypes, gender labeling, gender identity, and sex-typed toy preference were explored in 26-, 31-, and 36-month-old children. Gender labeling, gender identity, sex-typed toy preferences, and awareness of adult sex role differences were observed in significantly more 26-month-old children than would have been expected by chance. Verbal gender labeling was observed in a majority of 26-month-olds, while verbal and nonverbal gender identity were observed in a majority of 31-month-olds. Nonverbal gender labeling and awareness of adult sex role differences were observed in a majority of children by 36 months. No evidence of awareness of sex differences in children's toys was found in the majority of children at any age. Awareness of sex role differences in children's toys was not related to awareness of adult sex role differences. Brighter children were more aware of adult sex role differences. Sex-typed toy preference was not related to awareness of sex role differences but was related to gender identity. Predictors of sex role development included the mothers' employment, and the father's personality traits, attitudes toward women, and sex-typed activities in the home. Implications for theories of early sex role development are discussed. PMID- 6488963 TI - How two-year-old children interpret proper and common names for unfamiliar objects. AB - The linguistic form class of a word and the kind of object the word refers to both provide information for discovering whether a new noun refers to an object as a category member (e.g., a dog) or as an individual (e.g., Lassie). This study investigated children's use of both syntactic (i.e., form class) and semantic (i.e., type of referent) information, clarifying and extending work summarized by Macnamara. Although widely accepted, past results were inconclusive because (1) children were taught new words for objects they could already name, and (2) the earlier procedure lacked appropriate distractor items. This work eliminated these problems by using unfamiliar objects and a revised testing procedure. 32 2-year olds were each taught 1 new noun. Linguistic form class (presence or absence of an article) and type of referent (animal-like or blocklike toy) were varied between groups. Children's interpretations of the new nouns were assessed by asking the subjects to select the named toy from an array of 4 toys (e.g., "Point to Zav"). With animal-like toys, Macnamara's claim that children interpret common nouns as category names, and proper nouns as individual names, was supported. With blocklike toys, children in our study interpreted a common noun as a category name, but there was a tendency for children in the proper noun condition to choose a particular stuffed animal as the new noun's referent rather than the named blocklike toy. These results show that 2-year-old children use both linguistic form class and their knowledge about real-world objects to interpret new words. PMID- 6488964 TI - Long-term effects of four preschool programs: ninth- and tenth-grade results. AB - Follow-up of achievement test and IQ data on low-income black youths who had participated for 1 year in Bereiter-Engelmann, DARCEE, Montessori, or Traditional prekindergarten was continued through ninth and tenth grades. Stable trends persisted. Montessori males and DARCEE females were high; Montessori males were performing at about grade level on reading and math; IQs parallelled achievement test results. Additional tests of fluid intelligence, task persistence, self esteem, divergent thinking, task approach, and aspirations and expectations were administered in ninth and tenth grades. Results from program comparisons and factor analyses were consistent with those on IQ and school achievement. The possibility of relationships between techniques used in the different preschool programs and sex differences in children's developmental level was discussed. PMID- 6488965 TI - The development of sensitivity to causally relevant dynamic information. AB - The present study examined whether younger observers (kindergartners, second graders, and fourth graders) could extract relative weight information from collisions and also lifting events, and if they could judge whether collisions were natural (i.e., momentum conserving) or anomalous (non-momentum conserving). 20 children at each age and 20 adults viewed videotapes of 8 collisions (4 natural, 4 anomalous) and 6 sequences of lifting events. Observers also viewed sequences of static images taken from these events. Observers at all grade levels were able to reliably judge relative weight in both collisions and lifting events, and could differentiate between natural and anomalous collisions. Performance was much poorer when static sequences of the events were viewed, especially for the young children. A consistent age trend was noted across tasks: adults performed better than second and fourth graders who, in turn, performed better than kindergartners. In addition, there was evidence that younger children were differentially aided when the kinematics of the event made the kinetics more pronounced. PMID- 6488966 TI - The perception of stimulus shape: the influence of velocity of stimulus movement. AB - 46 3-month-old infants were presented with geometric stimuli moving laterally at two different velocities (34.8 degrees/sec; 103.3 degrees/sec). The results were interpreted as evidence that 3-month-old infants could discriminate between geometric forms moving at velocities that, according to previous findings, might interfere with shape discrimination. The findings are discussed in relation to the possible interactive effect of type and velocity of movement on geometric form discrimination. PMID- 6488967 TI - Infants' sensitivity to accretion and deletion of texture as information for depth at an edge. AB - Based on Gibson's hypothesis that accretion and deletion of texture in the optic array provides unambiguous information for the spatial layout of surfaces, we sought evidence of early responsiveness to this information with infant subjects. 5- and 7-month-olds viewed computer-generated random-dot displays in which accretion and deletion of texture provided the only information for contours, specifying either a foreground surface moving in front of and occluding a moving background surface or 2 partially overlapping surfaces. The infants in both age groups showed significant preferences to reach for the apparently nearer regions in the displays. Since previous research has shown that infants reach more frequently for the nearer of 2 surfaces, these results indicate that 5- and 7 month-olds are sensitive to accretion and deletion of texture as information for the spatial layout of surfaces. PMID- 6488968 TI - Fetal cardiac responding: a correlate of birth weight and neonatal behavior. AB - Certain intrapartum fetal heart-rate (FHR) patterns are associated with low Apgar scores and other neonatal risks. Intrapartum FHR has been the subject of extensive clinical investigation, but only occasional reference is made to the possible behavioral correlates of this phenomenon. The current investigation found that neonates classified as FHR decelerators had lower birth weights and shorter gestational ages than FHR accelerators. Decelerators exhibited higher baseline heart rate and experienced more frequent uterine contractions than accelerators. Neurobehavioral assessment of these neonates indicated that decelerators had more abnormal reflex ratings and were less behaviorally organized than heart-rate accelerators. The results indicate that FHR responses are associated with prenatal growth, maturity, and possibly stress tolerance, and that intrapartum FHR responses be related to nonoptimal neonatal behavior. PMID- 6488969 TI - The effects of within-group and between-group methodologies in the study of perceptions of infant crying. AB - Recent studies have indicated that various infant cry patterns can be reliably distinguished when directly compared with other infant cry patterns. The purpose of this study was to compare the effects of this within-group method of cry presentation (in which listeners are exposed to 2 types of cry patterns) with the effects of a between-group methodology (in which listeners are exposed to only 1 type of infant cry pattern). 4 groups of adult listeners rated the tape-recorded cries of low- and high-risk infants on 4 Likert-type scale items during experimental phases. In phase 1, subjects were exposed to either the cries of low risk or high-risk infants but not both. In phase 2, subjects were exposed to both low-risk and high-risk infant cries. In phase 3, subjects were exposed to the cries they heard in phase 1. Whereas all scale items differentiated the low- and high-risk infant cries during the within-group analyses of phase 2, all scale items did not differentiate low- and high-risk infant cries during the between group phase of the experiment. The specific pattern of results indicate that within-group methods of cry presentation accentuate the perceptual distance among cry types and may actually create many reliable differences that would not be found in between-group comparisons. PMID- 6488971 TI - [Thoracic spine injury after a plunge into water]. PMID- 6488970 TI - [Injuries of the upper segment of the cervical spine]. PMID- 6488972 TI - [Brown-Sequard's syndrome after spinal injury]. PMID- 6488973 TI - [Extension fracture of the lumbar spine in a patient with Bechterew's disease]. PMID- 6488974 TI - [Fractures of the pelvis with urologic injuries]. PMID- 6488975 TI - [Conservative treatment of oblique-spiral tibial fractures]. PMID- 6488976 TI - [Treatment of inveterate injuries of the anterior cruciate ligament]. PMID- 6488977 TI - [Value of decortication in osteotomies of the long bones]. PMID- 6488978 TI - [Various possibilities of the clinical use of atypical total hip endoprostheses]. PMID- 6488980 TI - [Principles of scientific medical writing]. PMID- 6488979 TI - [A device for intramedullary infusion of fluids]. PMID- 6488981 TI - [Clinical evaluation of results obtained in 582 cases of osteosynthesis using Ender nails]. PMID- 6488982 TI - [Pertrochanteric fractures in the aged: emergency or elective surgery?]. PMID- 6488983 TI - [Elbow hanging cast in the treatment of fractures of the proximal humerus. Review of 614 cases]. PMID- 6488984 TI - [Supracondylar fractures of the humerus in children]. PMID- 6488985 TI - [Treatment of inter-supracondylar fractures of the femur using the Judet bone plate]. PMID- 6488986 TI - [The Augustine operation in the treatment of chronic, isolated or combined, injuries of the posterior cruciate ligament]. PMID- 6488987 TI - [Antibiotic prophylaxis in common wounds of the limbs]. PMID- 6488988 TI - [Experimental study on osteonecrosis of the femur head: methods]. PMID- 6488989 TI - [Osteoid osteoma: diagnostic errors]. PMID- 6488991 TI - [Osteochondritis dissecans of the humeral head]. PMID- 6488990 TI - [Diabetic neuroarthropathy of the knee: clinical case]. PMID- 6488992 TI - [Habitual voluntary and atraumatic posterior dislocation of the shoulder. Description of a case]. PMID- 6488993 TI - [Posterior diaphyso-metaphyseal hemiresection of the femur]. PMID- 6488994 TI - [Hyperthermic isolation perfusion of the extremities in malignant melanomas and soft tissue sarcomas]. PMID- 6488996 TI - [Surgical treatment of malignant melanoma of the skin with special reference to the vertical tumor diameter]. AB - The level of invasion of the primary tumor is a reliable criterion of prognosis for cutaneous melanoma. Hence it follows that a differential surgical treatment is possible especially in the clinical stage I. Primary treatment of malignant melanoma consists of three-dimensional excision. The width of excision is determinated by the microstage. The elective regional lymphadenectomy shows an apparant benefit for stage I melanoma with a level between 1.5 and 4.0 mm. The value of added treatments (radiotherapy, systemic, and local chemotherapy, immuntherapy) is still controversial, but should be considered in the future clinical and therapeutical research. PMID- 6488995 TI - [Regional hyperthermic cytostatic perfusion as an alternative in the treatment of malignant soft tissue tumors of the extremities]. AB - From March 1979 through December 1983, 15 patients with soft-tissue sarcomas of the extremities were treated by a local excision and an adjuvant regional hyperthermic cytostatic perfusion. Reversible edema in two patients was the only post-operative complication. 14 patients were disease-free after a median follow up period of 24.2 months. One female patient developed a local recurrence 10 months following surgery. Based on our results and long-term studies of several authors, the adjuvant regional perfusion appears capable of successfully treating patients with soft-tissue sarcomas of the extremities. PMID- 6488997 TI - [Experimental and clinical studies of the efficacy of an antimicrobial incision drape]. AB - The antibacterial activity of an antimicrobial incise drape containing povidone iodine was compared to a normal drape by experimental and clinical investigations. In vitro, no difference in the survival rate of six bacterial species depending on the kind of the drape, could be demonstrated. Clinical studies by contact cultures, postoperatively taken from the skin after removal of the drape, yielded no significant difference in the recolonisation of the skin during the operations. The importance of the preoperative, antimicrobial preparations of the skin is discussed. PMID- 6488998 TI - [Importance of postoperative endotoxin determination. A pilot study]. AB - In a prospective pilot study a daily test for the presence of endotoxin was performed on the blood of 145 patients that were admitted to the intensive care unit for at least 3 days. Endotoxin positive patients showed a significantly higher mortality rate and the period of admittance to the intensive care unit and the period of ventilation were prolonged. PMID- 6488999 TI - [Cervical achalasia]. PMID- 6489000 TI - [Parathyrotoxic crisis in solitary mediastinal parathyroid adenoma]. PMID- 6489001 TI - [Cystic adventitial degeneration of the popliteal artery. Clinical case and review of the literature]. PMID- 6489002 TI - [Current status of the physician's responsibility for patients information]. PMID- 6489003 TI - [Freedom of therapy: choice of methods and quality of treatment]. PMID- 6489004 TI - [Clinical and pathological analysis of 40 cases of IgA nephropathy]. PMID- 6489005 TI - [Mesangial IgM nephropathy]. PMID- 6489006 TI - [Membranous glomerulonephritis--analysis of 21 cases]. PMID- 6489007 TI - [Acute drug-induced tubulointerstitial nephritis--analysis of 5 cases]. PMID- 6489008 TI - [The diagnostic value of touch smear cytology, brush cytology and gastric mucosal biopsies combined or alone for gastric cancer--analysis of 200 cases]. PMID- 6489009 TI - [A clinicopathologic study on 245 cases of colonic adenomas detected by colonoscopy]. PMID- 6489010 TI - [Clinical significance of serum transferrin determination in viral hepatitis]. PMID- 6489011 TI - [Chromosome study of 20 cases of acute nonlymphocytic leukemia]. PMID- 6489012 TI - [Antral G cell distribution and its relationship with pathogenesis of peptic ulcer]. PMID- 6489013 TI - [Significance of apparent S-T segment depression in precordial leads in acute inferior myocardial infarction]. PMID- 6489014 TI - [Clinical observation on 56 cases of thyrotoxic heart diseases]. PMID- 6489015 TI - [Glomerulonephritis, interstitial nephritis and renal tubular acidosis in Sjogren's syndrome--report of 2 cases]. PMID- 6489016 TI - [Mass investigation of serum ferritin]. PMID- 6489017 TI - [Application of direct spot hybridization to hepatitis B virus DNA in the serum of patients with liver diseases]. PMID- 6489018 TI - [Pulmonary embolism--report of 100 cases]. PMID- 6489019 TI - [Relationship between left ventricular function and microangiopathy in diabetic patients]. PMID- 6489020 TI - [Cyclic nucleotides and cell-mediated immunity in chronic cor pulmonale]. PMID- 6489021 TI - [Differential diagnosis of primary dilated cardiomyopathy and chronic cor pulmonale complicated with coronary heart disease]. PMID- 6489022 TI - [Thyroid function in chronic cor pulmonale]. PMID- 6489023 TI - [Clinical analysis of 1544 cases of acute myocardial infarction in Shanghai in 1970-1979]. PMID- 6489024 TI - [Radioimmunoassay of phenithionate (7720) and its clinical application]. PMID- 6489025 TI - [Factors affecting the healing rate of duodenal ulcer]. PMID- 6489026 TI - [Advances in the research of atherosclerosis and coronary artery disease]. PMID- 6489027 TI - [Prevention and treatment of viral hepatitis]. PMID- 6489028 TI - [Classification of gallstone based on cross-sectional surface structures and chemical compositions]. PMID- 6489029 TI - ["Bilirubin-calcium compound" precipitation and the effect of bile salts on its process]. PMID- 6489030 TI - [The change in ultrastructure of dissolved gallstones]. PMID- 6489031 TI - [The relation between infrared spectrum classification and chemical compositions of gallstones]. PMID- 6489032 TI - [A structural and chemical study of gallstones]. PMID- 6489033 TI - [Characteristics of cholelithiasis in Beijing: infrared spectrum analysis of 772 cases of cholelithiasis]. PMID- 6489034 TI - [Treatment of causalgia by decompression of peripheral nerves and experimental study of its mechanism]. PMID- 6489035 TI - [Surgical treatment of acute arterial embolism]. PMID- 6489036 TI - [Diagnosis and surgical treatment of intracranial venous sinus injury: experiences in 21 cases]. PMID- 6489037 TI - [Treatment of severe lung abscess by drainage of the abscess cavity]. PMID- 6489038 TI - [Use of sheep and goat skin as biological dressing in the treatment of burns]. PMID- 6489039 TI - [Use of free skin flap graft for acute injuries of extremities in emergency surgery]. PMID- 6489040 TI - [Open pelvic fracture: report of 86 cases]. PMID- 6489041 TI - [Pathological study of 22 cases of primary squamous cell carcinoma of the urinary bladder]. PMID- 6489042 TI - [Seminal vesicle cysts: report of 5 cases]. PMID- 6489043 TI - [Hyperoxaluria and hyperuricosuria following large doses of vitamin C]. PMID- 6489044 TI - [Intra-abdominal hemorrhage, a complication after resection of cancer of the cardia and esophagus: report of 4 cases]. PMID- 6489045 TI - [Advances in cryopreservation of organs]. PMID- 6489046 TI - [Desquamative interstitial pneumonia]. PMID- 6489047 TI - [Evaluation on the prevention and treatment of tuberculosis]. PMID- 6489048 TI - [A clinical analysis of 212 cases of tuberculous meningitis with a disorder of consciousness]. PMID- 6489049 TI - [Misdiagnosis of tuberculous meningitis in adults: an analysis of 26 cases]. PMID- 6489050 TI - [Mediastinoscopy for the diagnosis of tuberculosis of mediastinal lymph nodes]. PMID- 6489051 TI - [Discussion on the misdiagnosis of 102 cases of diffuse, miliary and mottled lesions of the lung]. PMID- 6489052 TI - [Pulmonary thrombosis and embolism in cor pulmonale caused by chronic obstructive pulmonary disease]. PMID- 6489053 TI - [Clinical application of prolonged nasotracheal intubation for the management of acute respiratory failure]. PMID- 6489054 TI - [Study on etiology and pathogenesis of acute respiratory alkalosis]. PMID- 6489055 TI - [Comparative study on bronchial reactivity between normal subjects and asymptomatic asthmatics]. PMID- 6489056 TI - [Observation on airway responsiveness following methacholine inhalation]. PMID- 6489057 TI - [The diagnostic value of transbronchial lung biopsy via bronchofiberscope in the peripheral solitary pulmonary lesion with emphasis on its pathological basis]. PMID- 6489058 TI - [A report on 21 cases of mediastinal emphysema]. PMID- 6489059 TI - Morphologic changes in rat urothelial cells during carcinogenesis: I. Histologic and cytologic changes. AB - The methods of either image or flow cytometry applied to developing bladder tumors in rats requires satisfactory cell samples and a system for cell classification that is related to the lesions from which the cells are derived. Seven- to eight-week-old male Fisher 344 rats were fed 0.05% of the carcinogen N butyl-4-N-hydroxybutylnitrosamine (BBN) in drinking water for 10 wk and then returned to tap water. Animals were killed at 14, 26, 34, 45 and 62 wk after the start of carcinogen feeding. Age-matched untreated animals were controls. Bladders were fixed, embedded, sectioned, and histologically evaluated, or were dissociated with a trypsin/EDTA solution into single cells that were Papanicolaou stained and evaluated for cytopathologic changes. Overnight urines were collected before killing; urine sediments were Papanicolaou stained and evaluated. Histologic features were hyperplasia at 14 wk, followed by slowly progressing papillary transitional cell tumors that eventually led to invasive carcinoma and were similar to those reported for this animal model. Treated animals had cytologic features of repair at 14 and 26 wk and neoplastic features at 45 and 62 wk. Both reparative and neoplastic changes were found at 34 wk. Cells were much more numerous in urines from treated rats (greater than 1,000 per sample) than in urines from controls (less than 1,000 per sample). Although exfoliated cells in urine samples were generally of poor quality, as many as 11% of cells were adequately preserved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489060 TI - Classifying breast carcinomas with DNA measurements and morphometry. AB - The relation between the DNA distribution pattern and the variables DNA content and nuclear area was investigated in 73 breast carcinomas. According to the DNA patterns, the tumors were subclassified into groups I, II, III, and IV (Auer's classification). The Auer's classes correlate with prognosis. In this investigation it was shown that Auer's classes strongly correlate with the standard deviation of DNA content and mean nuclear area. The carcinomas were subclassified using data of DNA content and nuclear area. For the establishment of this subclassification, multivariate analysis was applied. It was evident that Auer's group III was a hybrid group. Therefore a second classification rule was calculated without the data of Auer's group III. This second classification rule was even more successful in determining the Auer's group of each individual case. Our investigation shows that it is possible to subclassify breast carcinomas objectively using DNA content and nuclear area of the tumor cells. PMID- 6489061 TI - Quantitation of cell kinetic responses using simultaneous flow cytometric measurements of DNA and nuclear protein. AB - A rapid procedure was developed for the simultaneous flow cytometric analysis of nuclear protein using fluorescein isothiocyanate, and DNA using propidium iodide in isolated nuclei. The staining procedure did not involve centrifugation and was easily adapted to the staining of human peripheral blood lymphocytes stimulated with phytohemagglutinin, EL4 murine lymphoid tumor cells in suspension culture, and R3327-G rat prostatic adenocarcinoma solid tumor specimens. Histograms of unstimulated and PHA-stimulated HPBL perturbed by actinomycin D, hydroxyurea, 3H TdR, colcemid, or hydroxyurea + colcemid showed that 1) resting, noncycling G1 (G1Q) cells are distinguished from late G1 (G1AB) cells, 2) early G2 (G2A) cells are distinguished from late G2 (G2B) cells, and 3) mitotic cells are distinguished from G2 cells. Treatment with hydroxyurea resulted in a build-up of cells having high nuclear protein content and 2C DNA content (G1AB), while incubation with 3H-TdR caused an increase in the number of cells with high nuclear protein content and 4C DNA content (G2B). Colcemid-blocked mitotic cells were identified as having low nuclear protein content (lower than G2A nuclei) and 4C DNA content. The nuclear DNA/protein histograms of untreated and colcemid treated log-phase EL4 cells provided information concerning G1A, G1B, S, G2A, G2B, and M. The method was also used to quantitate the response of androgen sensitive rat prostatic R3327-G tumors to androgen deprivation following castration. Sample preparation and staining for correlated nuclear DNA/protein measurements takes approximately the same amount of time as for single parameter nuclear DNA measurements. PMID- 6489063 TI - Calculation of S-phase numbers of four major cell categories in human bone marrow from DNA-flow cytometry and counterflow centrifugation data. AB - Fractionation of heterogeneous cell populations into a number of fractions differing in cell size and composition, followed by measurement of DNA profiles and differential morphology of the samples allows the calculation, using a mathematical deconvolution procedure, of the cell proliferation of the individual categories. The method was applied to human bone marrow, fractionated by counterflow centrifugation into 10 to 15 fractions. Calculated percentage of S phase cells in four major categories, including myeloid, erythroid, monocytic, and lymphoid cells, were in good agreement with data obtained by tritiated thymidine autoradiography. PMID- 6489062 TI - Concentration-dependent effects of potassium dichromate on the cell cycle. AB - Hexavalent chromium is found to be a strong mutagen, and it also is a potential carcinogen in man. DNA flow cytometry, growth measurements, and determinations of mitotic index show that 1-2 microM K2Cr2O7 produces a prolongation of the G2 phase of the cell cycle in NHIK 3025 cells. By increasing the chromate concentrations (greater than 2 microM K2Cr2O7) the cells are also arrested in G2 phase. We have found, using synchronized cells and measuring cell cycle time, that the most chromate-sensitive part of the cell cycle is S phase. This phase is also somewhat prolonged, and the cells became arrested in early S phase at high toxic K2Cr2O7 concentrations (8 microM). Our results thus indicate that K2Cr2O7 has an effect within S phase--maybe on DNA/RNA synthesis--and also interferes with processes necessary for progression through the G2 phase. PMID- 6489064 TI - A new disaggregation device for cytology specimens. AB - A new means of disaggregating cytology specimens in suspension using an immersible rotor device is described. The new rotor is compared to an automated syringing apparatus using cervical samples. Similar results using both devices are obtained for both normal and abnormal specimens. PMID- 6489065 TI - The application of perpendicular and forward light scatter to assess nuclear and cellular morphology. AB - Perpendicular and forward light scatter have been employed in a multiparametric approach to distinguish the various lines of the transplantable Dunning R3327 rat prostatic adenocarcinoma. Perpendicular light scatter has been shown to correlate with nuclear size and shape. The average intensity of forward light scatter and perpendicular light scatter signals was demonstrated to increase as cells became less well-differentiated. The combination of perpendicular and forward light scatter allows for the discrimination of histologically indistinguishable tumors and may therefore be useful to establish a system of grading cancer. PMID- 6489066 TI - Flow karyology of serially cultured Chinese hamster cell lineages. AB - Flow karyology of serially cultured Chinese hamster cell lineages has been observed to be influenced by the degree of cellular heterogeneity in culture. The minimum coefficient of variation (CV) and debris fraction obtainable vary as a cell lineage evolves from a primary cell culture to an established cell line. The cell lineages pass through a stage of decreased cellular heterogeneity from which flow karyotypes can be obtained with lower CV and debris fraction. The influence of cellular heterogeneity on flow karyology is observed with constant preparative protocol and constant instrument performance, and can be an additional source of variability. PMID- 6489067 TI - Preparation of chromosome suspensions from cells of a solid experimental tumour for measurement by flow cytometry. AB - A method is described by which metaphase chromosomes are isolated from cells of a transplantable rat sarcoma. The chromosomes are derived from cells in a suspension prepared by trypsinisation of tumours from rats that have been treated with vindesine 24 h before excision in order to accumulate cells in mitosis. Histograms obtained for the chromosomes of the solid tumour are compared with flow karyotypes of cells cultured for 20 h or for several generations in vitro. PMID- 6489069 TI - A proposal for a flow cytometric data file standard. AB - The increasing complexity of multiparameter data collection and analysis in flow cytometry and the development of relatively inexpensive arc-lamp-based flow cytometers, which increases the probability that laboratories or institutions may have more than one type of instrument, creates a need for shareable analysis programs and for the transport of flow cytometric data files within an installation or from one institution to another. To address this need, we propose a standard file format to be used for all flow cytometric data. The general principles of this proposal are: (1) The data file will contain a minimum of three segments, TEXT, DATA, and ANALYSIS; (2) The TEXT and ANALYSIS segments consist of KEYWORDS, which are the names of data fields, and their values; (3) All TEXT is encoded in ASCII; (4) KEYWORDS and their values may be of any length; (5) Certain KEYWORDS will be standard, i.e., having specified formats to be recognized by all programs. The structure of the DATA segment will be uniquely defined by the values of KEYWORDS in the TEXT area. It may be in any bit resolution, facilitating compatibility between machines with different word length and/or allowing bit compression of the data. The structured nature of the TEXT area should facilitate management of flow cytometric data using existing data base management systems. The proposed file format has been implemented on VAX, PDP-11, and HP9920 based flow cytometry data acquisition systems. PMID- 6489068 TI - A simple device to obtain high local concentrations of material sorted by flow cytometry for biochemical or morphological analysis. AB - A system is described which allows us to collect flow cytometry sorted objects onto a very small area, thus obtaining very concentrated particles. For that purpose, collection is made directly on a nitrocellulose filter while a vacuum is established below the filter. By comparison with collection onto a microscope slide, the local concentration is increased about 1,000-fold. This efficient and simple system allows us to concentrate cell or cellular organelle populations for observation by microscopy of many objects in a single field, or to study the biological or biochemical properties of a small number of sorted particles. PMID- 6489070 TI - Influence of sigmoid resection on progression of diverticular disease of the colon. AB - The surgeon is frequently confronted with the problem of how much colon to resect when operating on patients with colonic diverticulosis or diverticulitis. Two questions arise: will diverticulosis progress in the proximal colon if only the sigmoid is removed, and will diverticulitis recur in the more proximal diverticula? To evaluate these potential problems, the histories were reviewed of 61 patients who had elective sigmoid resection for diverticular disease and who had barium enema examinations before operation, early during the postoperative period, and at least five years later. Progression of diverticulosis was noted in only nine (14.7 per cent) patients on repeat barium-enema examination five to nine years after resection; the progression was noted to be minimal in all nine. Seven patients (11.4 per cent) had signs and symptoms of recurrent diverticulitis. Only three patients demonstrated progression of diverticulosis and recurrent diverticulitis. We see no benefit in resecting all of the diverticula-bearing colon after adequate sigmoid resection, as there is minimal progression in the diverticular process and the risk of recurrence is low. PMID- 6489071 TI - Angiography in colonic carcinoma. AB - Angiography of the mesenteric arteries was performed in 17 patients with adenocarcinoma of the colon and rectum. At angiography, the marginal artery was encased in 13 patients and 10 of these were surgically unresectable while three could be resected radically. Encasement of the mesenteric arterial branches was found in seven of 11 unresectable tumors and in two of five resectable tumors. The resectability of colonic carcinoma cannot be established by means of angiography but in two patients with recurrent colonic carcinoma, barium-enema examinations were negative, while infiltrated vessels were demonstrated by angiography and the carcinomas were verified at surgery. Four patients received intra-arterial chemotherapy with mitomycin C. In one of these, a slight decrease in tumor size was noted, while in the others no change was noted. PMID- 6489072 TI - Diagnosis of disturbances of continence and defecation. AB - Defecography was performed in 60 patients with disorders of continence or defecation in whom previous investigative procedures had not revealed any abnormality that could explain the disorder. A correct diagnosis was made in 47 patients (78%). Defecography appears to be a suitable procedure to detect functional disturbances of defecation. Since anterior rectal wall abnormalities such as colitis cystica profunda and solitary rectal ulcer were seen in eight patients, it is suggested that these abnormalities are a result of functional disorders of defecation. Furthermore, the function of the pelvic floor musculature can be assessed by defecography in order to determine the cause of fecal incontinence. PMID- 6489073 TI - Radiotherapy and resection for apparently inoperable rectal adenocarcinoma. AB - Sixty-seven patients with primary, apparently inoperable rectal adenocarcinomas were referred for radiotherapy from a defined geographic region in Norway during the period from 1976 to 1981. Fifty-five were without detectable metastasis at referral and were potentially resectable. Patients were given high energy radiation towards abdominal chimney or pelvic fields to a dose of 3150 rads. Resection was attempted after three weeks. Additional radiotherapy was given to both resected and nonresected patients to a NSD (nominal standard dose) of 1400 to 1560 ret (rad equivalent therapy). At full radiation dose, nonresected patients were reexamined, and in some explorative laparotomy with resection was attempted. Twenty patients had radical resections in the pelvis, but five of them had moderately advanced distant metastasis. Nine patients are disease-free at 12+ to 76+ months. Although the overall prognosis for the patients with apparently inoperable rectal adenocarcinomas remains poor (median survival 12 months), some patients can achieve long-term disease-free survival after combined radiotherapy and surgery. Patients with moderately advanced metastasis can enjoy a better of quality of life without local symptoms following the combined treatment. PMID- 6489074 TI - An assessment of nutritional depletion following major colonic surgery. AB - This study was undertaken to determine the changes in basic nutritional indices associated with major colonic surgery accompanied by periods of semi-starvation. Changes in weight, serum albumin, nitrogen balance, and maximum exercise capacity were studied. Weight loss was 5.5 +/- 1 per cent, serum albumin decreased 0.20 +/ 0.15 gm per cent. Nitrogen loss was 5.9 +/- 0.9 gm per day and maximum exercise capacity decreased by 13.5 +/- 1.8 per cent. Nitrogen balance improved when amino acids were substituted for glucose as the maintenance regimen, but no corresponding improvement in exercise performance could be demonstrated. It is concluded that major colonic surgery associated with moderate periods of semi starvation is associated with an average nitrogen loss of 5.9 +/- 0.9 gm per day and a 13.5 +/- 1.8 per cent loss in maximum exercise capacity or effective muscle mass. PMID- 6489075 TI - Collagenous colitis: a transient condition? Report of two cases. AB - We have seen two patients with watery diarrhea whose work-up revealed a collagenous infiltration beneath the rectal epithelium. Within a year, symptoms disappeared in both. Repeated rectal biopsy revealed the disappearance of the collagen layer. Collagenous colitis may thus present as a transient condition. PMID- 6489076 TI - Perianal abscess due to Enterobius vermicularis. Report of a case. AB - A case of recurrent perianal abscess caused by Enterobius vermicularis infestation of the anal canal and glands in an 11-year-old boy is reported. PMID- 6489077 TI - Cystic lymphangioma of the colon. Report of a case and review of the literature. AB - A rare case of cystic lymphangioma of the colon is reported. The lobulated and fluctuant lesion was located in the splenic flexure and was associated with multiple adenomas in the entire colon. Well differentiated adenocarcinomas restricted to the mucosal layer were also demonstrated in two of the adenomas of the colon. Clinical features, appropriate treatment, and possible pathogenesis of colonic lymphangioma are discussed. PMID- 6489078 TI - A simple device to facilitate the "double stapling technique" for low anterior resection. PMID- 6489079 TI - Comparison of fecal granulocyte excretion in ulcerative colitis and Crohn's colitis. AB - Impaired granulocyte migration has been suggested to be present in Crohn's disease on the basis of in vitro granulocyte function tests and in vivo skin window studies. This idea is supported by the impression histologically that the acute inflammatory infiltrate in diseased bowel is less in Crohn's disease than ulcerative colitis. We have developed a method of quantitating the acute inflammatory infiltrate in inflamed bowel by measuring fecal indium-111 granulocyte excretion and have compared this assessment in patients with ulcerative colitis and Crohn's colitis matched for disease activity. For equivalent disease groups in ulcerative colitis and Crohn's colitis, there was no significant difference between fecal granulocyte excretion. These findings provide no support for the contention that there is a reduced granulocyte infiltration in Crohn's disease. PMID- 6489080 TI - Induced mucosal penetration and transfer to portal blood of luminal horseradish peroxidase after exposure of mucosa of guinea pig small intestine to ethanol and lysolecithin. AB - The effect of luminal 150 mmol saline, 0.05-0.2% (w/v) lysolecithin, and 5-20% (v/v) ethanol was studied on the mucosal morphology of the proximal small intestine in conscious guinea pigs as well as on the mucosal penetration and transfer to portal venous blood of luminal horseradish peroxidase (HRP). No ultrastructural evidence of mucosal damage was identified in any of the lysolecithin-perfused animals compared with saline controls. Ten and 20% ethanol (v/v) resulted in the appearance of fluid-filled spaces between enterocytes and in cytoplasmic lipid deposits and an increased number of autophagic vesicles within the cells themselves. Tight junctions remained intact. These changes after luminal 5% ethanol (v/v) were much less conspicuous. In the presence of saline, luminal HRP was largely confined to the brush border. Both lysolecithin and ethanol (5% v/v) rapidly induced mucosal penetration of HRP which was seen in cytoplasmic vesicles within enterocytes, between enterocytes, and in the lamina propria. Peak portal venous blood levels of HRP studied in multiple samples over 3 hr were one log unit greater than saline controls. Absorption of HRP was proportional to the luminal concentration of lysolecithin in the range tested. These studies show that mucosal penetration and absorption of functional exogenous macromolecules may be induced, in the absence of morphological evidence of mucosal damage, by luminal constituents which may perturb the structure of enterocyte membranes. PMID- 6489081 TI - Effects of central and peripheral administration of dopamine on pattern of intestinal motility in dogs. AB - The central vs peripheral effects of dopamine on the motility pattern of the small intestine were investigated by electromyography in four conscious dogs, chronically fitted with transparietal duodenal and jejunal electrodes. In the fasted dog intracerebroventricular administration of dopamine (10 micrograms/kg) increased the duration of the interval between two consecutive migrating myoelectric complexes (MMC) while the intravenous administration at a 10-fold higher dose induced in 37.5% of trials a phase of regular spiking activity propagated over the duodenum and the jejunum. When dopamine was centrally administered 1 hr before a daily meal, the duration of the postprandial disruption of the MMC pattern was significantly (P less than 0.01) reduced from 9.4 +/- 1.8 to 3.2 +/- 1.3 hr at the level of the duodenum. Peripheral administration of dopamine did not modify the duration of the postprandial disruption. All of the central and peripheral effects persisted after vagotomy. It is concluded that in the dog dopamine acts centrally to modify the food induced disruption of the MMC pattern and the frequency of the interdigestive myoelectric complexes. PMID- 6489082 TI - Pathogenesis of rotavirus-induced diarrhea. Preliminary studies in miniature swine piglet. AB - The pathogenesis of diarrhea caused by rotavirus infection was studied in miniature swine piglets. The animals were inoculated orally with 2 X 10(7) plaque forming units of porcine rotavirus (OSU strain). During the height of diarrhea, intestinal function was investigated by in vivo perfusion of a 30-cm segment of proximal jejunum and a 30-cm segment of distal ileum. Absorption of Na+ and water decreased and 3-O-methylglucose transport was markedly reduced, P less than 0.01 compared to control animals. Mucosal lactase and sucrase levels were depressed in both the jejunum and ileum, P less than 0.001. Na+,K+-ATPase activity was significantly depressed only in the ileum, P less than 0.001. These changes were associated with a marked reduction in villous height, suggesting that the diarrhea could be an osmotic diarrhea due to nutrient (carbohydrate) malabsorption. Fresh stool samples were obtained and analyzed immediately for NA+,K+, osmolarity, glucose, and lactose; the osmotic gap was also determined. Stool osmolarity continually increased from 248 +/- 20 mosm/liter prior to inoculation to 348 +/- 20 mosm/liter at 75 +/- 1 hr postinoculation (P less than 0.005); the majority of the fecal osmotic gap could be accounted for by the amount of lactose present in the stools. Stool sodium increased from 34 +/- 6 mM prior to inoculation to a maximum of 65 +/- 4 mM at 53 +/- 1 hr postinoculation, P less than 0.001. There was no significant change in potassium concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489083 TI - Comparative effects of bombesin and porcine gastrin-releasing peptide in the dog. AB - Bombesin and porcine gastrin-releasing peptide (GRP) share a common C-terminal decapeptide fragment and are known to have similar bioactivity. The potencies of parenterally administered GRP and bombesin have been compared in their effects on gastric acid output, serum gastrin, and serum pancreatic polypeptide. In the dose range 0-720 pmol/kg/hr, infusions of both peptides resulted in dose-related increases of gastric acid output and corresponding elevations of serum gastrin and pancreatic polypeptide. At the dose of 1440 pmol/kg/hr, both bombesin and GRP resulted in a decrease in gastric acid output and serum gastrin. The mechanism of this inhibition is unknown. No significant difference in potency between the two peptides in changing gastric acid output, serum gastrin, and pancreatic polypeptide was observed. The demonstration of equimolar potency of porcine GRP and bombesin support the concept that GRP is mammalian bombesin. PMID- 6489084 TI - Plasma enteroglucagon and CCK levels and cell proliferation in defunctioned small bowel in the rat. AB - Luminal nutrients exert a powerful trophic effect on small bowel mucosa. Recent evidence suggests that a circulating factor, possibly enteroglucagon, is also growth-promoting. In order to study the isolated effect of nonluminal influences on bowel mucosa, Thiry-Vella fistulae (TVF) were constructed in rats. Circulating enteric hormone concentrations were manipulated by resecting different lengths of remaining gut. Thirty-two male Wistar rats had either 25%, 50%, 75%, or 90% proximal small bowel resection. In each animal the first 25% of resected bowel was exteriorized as a Thiry-Vella fistula. Seven control rats underwent jejunal transection. Twelve days postoperatively the fasted animals were killed, and circulating and tissue concentrations of enteroglucagon and CCK were estimated by radioimmunoassay. Crypt-cell production rate was used as an index of cellular proliferation in the Thiry-Vella fistulae. Proximal small bowel defunctioned in the Thirty-Vella fistulae had a significantly lower crypt-cell production rate and enteroglucagon and CCK content than the equivalent segment in transected rats. Further small bowel resection produced a subsequent increase in circulating enteroglucagon and CCK concentrations, an increase in the Thiry-Vella fistula content of these hormones, and a doubling of the crypt-cell production rate in the Thiry-Vella fistulae. These results show that circulating enteroglucagon and CCK concentrations match closely with enterocyte production even when luminal influences are excluded. It is suggested that circulating factors may play a major role in postresectional ileal hyperplasia. This hyperplasia apparently affects endocrine cells as well as enterocytes. PMID- 6489086 TI - Small bowel radiography. An overview. PMID- 6489085 TI - Effect of dietary cholesterol and indomethacin on cholelithiasis and gallbladder motility in guinea pig. AB - This study examines the effects of dietary cholesterol and subcutaneous indomethacin on gallstone formation, gallbladder motility, and bile composition in guinea pigs. Guinea pigs on cholesterol diets developed gallstones which were not primarily composed of cholesterol and were not prevented by indomethacin. Animals receiving cholesterol diets showed significant gallbladder enlargement which was inhibited by indomethacin. Cholesterol did not alter gallbladder pressure-volume relationships or the response to CCK, while indomethacin diminished gallbladder tone. Although cholesterol feeding did not appear to alter smooth muscle contractility in the guinea pig gallbladder, it caused significant gallbladder enlargement by a mechanism which may be dependent on prostaglandins. PMID- 6489087 TI - Methodological problems in measuring gastrointestinal blood flow. PMID- 6489088 TI - Alkaline gastritis following antrectomy--an elusive syndrome. PMID- 6489089 TI - Carcinoma associated with achalasia. Occurrence 23 years after esophagomyotomy. AB - Carcinoma developed in a 67-year-old woman with achalasia of the esophagus 23 years after esophagomyotomy. Postoperative manometric and radiologic studies showed satisfactory relief of esophageal obstruction. The development of carcinoma after an unusually long interval after adequate surgical treatment emphasizes the need for lifelong surveillance for this complication. PMID- 6489090 TI - Measurement of esophageal reflux by scintigraphy. AB - Gastroesophageal reflux and clearance of the refluxed material can be measured by plotting a time-activity curve from an esophageal area of interest after 1 mCi of 99mTc sulfur colloid is placed in the stomach. Control subjects do not have peaks exceeding a value twice that of the baseline count levels. Reflux patients exceed this value, either spontaneously or after Valsalva maneuvers. This technique has a sensitivity which is greater than that of barium and equal to the sensitivity of a pH probe in patients with both moderate and severe reflux. Scintigraphic reflux was shown in 62% of moderate refluxes and 85% of those with severe reflux as defined clinically. Clearing of the refluxed material occurs rapidly in most patients if measured by this scintigraphic technique. This test can be performed rapidly with minimal radiation exposure and is noninvasive. PMID- 6489091 TI - Monthly fluctuations of active duodenal ulcers. AB - In an attempt to verify whether the periodicity of ulcer-related symptoms would be confirmed by a spring and fall exacerbation of peptic ulcers, we have analyzed the monthly variation of active duodenal ulcers found at endoscopy of the upper gastrointestinal tract in the years 1979-1981. Control diagnoses were active gastric ulcers, gastric and rectal adenocarcinomas, and rheumatoid arthritis. Data were also available on hospital admission for perforated ulcers. The calendar fluctuation of active duodenal ulcer is characterized by a significant fall in August which is associated with July and fall peaks. This pattern of variation for duodenal ulcer was evident in both sexes and across the different decades of age. Duodenal ulcer diagnosis and hospitalization for perforated ulcer fluctuated in a similar way. The shape of monthly variation for active duodenal ulcer was not paralleled by similar changes in gastric ulcers and in the control diagnoses, gastric and rectal carcinomas, and rheumatoid arthritis. PMID- 6489092 TI - Serum trypsinogen in diagnosis of chronic pancreatitis. AB - A new radioimmunoassay to serum trypsinogen (Cis Trypsik) was tested in several patient populations. A low serum trypsinogen level (less than 10 ng/ml) was found in 69.2% of 13 patients with chronic pancreatic insufficiency (CPI), in 100% of 10 patients with 95-100% pancreatectomy but only in 14% of 14 patients with cancer of the pancreas. A low trypsinogen level was not found in any of 68 control subjects or 10 patients with nonpancreatic steatorrhea. Nine patients with CPI or 95% pancreatectomy were retested a mean of six months after initial testing. Four of these nine (44.4%) had a significant variation in serum trypsinogen which would have led to a different diagnostic interpretation (two went from low to normal levels and two from normal to low levels). A mixed meal had little effect on serum trypsinogen levels in five of six patients with CPI, and pancreatic enzyme replacement therapy had no consistent effect on the serum trypsinogen level in seven patients with CPI or 95% pancreatectomy. It is speculated that minor subclinical episodes of focal pancreatitis may effect the serum trypsinogen level. Although there can be considerable variability using this assay, it still offers important clinical utility. A low trypsinogen level points to a chronic pancreatic process with excellent specificity. A normal trypsinogen level is of no help and should be repeated if clinical suspicion of chronic pancreatitis remains high. PMID- 6489093 TI - Effects of dietary butter fat on fecal bile acid excretion in patients with Crohn's disease on elemental diet. AB - The excretion rate of fecal bile acids was determined by gas-liquid chromatography in nine patients with Crohn's disease and six healthy volunteers under two dietary conditions with different amounts of fat: during nasoduodenal tube feeding with a fat-restricted elemental diet containing approximately 1.5 g/day of fat, and during the addition of 50 g/day of butterfat by peroral administration. The fecal bile acid excretion rate on the elemental diet was significantly greater in the patients with Crohn's disease than in the healthy controls. With ingestion of the additional fat, the excretion rate was significantly increased in the patients with Crohn's disease, but not significantly changed in the healthy controls. The bile acid excretion rate in Crohn's disease correlated with fecal fat excretion, but not with either fecal weight or disease activity. These studies show that the amount of dietary fat represents an important consideration in the evaluation of bile acid malabsorption in Crohn's disease. PMID- 6489094 TI - Nucleotide sequence requirements for transient expression of human metallothionein-IIA-thymidine kinase fusion genes. AB - The transient expression of the human metallothionein-IIA (hMT-IIA) gene was examined after introduction into NIH-3T3 cells. A series of deletion mutants within the 5' flanking region of the hMT-IIA gene was constructed and fused to the structural sequences of the Herpes simplex thymidine kinase (TK) gene to generate hMTK chimeric genes. During transient expression, the hMTK gene is responsive to both ligands. In addition we find at least 92 bp of 5' flanking DNA are required for both transient expression and induction by Cd2+, in contrast to only 50 bp required for induction by the heavy metal ions of the same gene in stable transformants. This difference is due to a deletion of a regulatory element, located between nucleotides -70 to -90 of the hMT-IIA gene, which functions to maintain basal expression in the absence of inducers. This element is absolutely required for transient expression of the hMT-IIA gene. PMID- 6489095 TI - Use of unpurified synthetic deoxynucleotide primers for rapid dideoxynucleotide chain termination sequencing. AB - Synthetic oligodeoxyribonucleotides were used as primers for sequencing DNA by the dideoxy chain termination method. We report that the use of unpurified preparations of such oligonucleotides decreases the time involved in preparing the primers and yields a sequencing reaction of comparable quality to that obtained with pure preparations. It is possible to use unpurified primers if the yield per coupling step during manual or machine synthesis of oligonucleotides is greater than 98%. Also, a method for the rapid purification and desalting of synthetic DNAs is presented for cases in which the coupling is less efficient. Unpurified primers have been used to determine the sequence of a 1987-bp fragment with a single M13 recombinant clone. This DNA was first sequenced using the universal M13 primer. Subsequently, a primer homologous to the 3' end of the newly obtained sequence was synthesized and used to extend the sequence. New primers were synthesized until the sequence of the whole fragment was determined. Because only one clone is necessary, this method can be used to obtain the nucleotide sequence of large DNA fragments in a relatively short time and in an orderly fashion, simplifying analysis of the data. PMID- 6489096 TI - Sensory evaluation of strabismus and amblyopia in natural environment. In honour of Professor Bruno Bagolini on occasion of his 60th birthday. PMID- 6489097 TI - Afferent trigeminal fibres in the oculomotor nerve and their physiological role. PMID- 6489098 TI - Congenital esotropia with a bifixation result. Report of a case. AB - Surgical alignment of the eyes in congenital esotropia within the first two years of age can result in the development of binocular vision. With one exception, reported here, the binocular vision has been extramacular and never macular. In this one case the patient was proven to be a bifixator. This is such an unusual outcome that the diagnosis of congenital esotropia must be questioned. Moreover, dissociated double hypertropia was not found in this case. PMID- 6489099 TI - Sidedness, writing and art. Significance in some problems related to oculomotricy. AB - Direction in drawing depends mainly on handedness. In certain cases writing habit also has an influence, yet curiously it is less common in Western culture. Knowledge of sidedness may be important in certain squint and nystagmus cases. Kinsbourne's test is easy, innocuous and, in the author's opinion, highly reliable. PMID- 6489100 TI - Disturbances of ocular motility after retinal detachment surgery. AB - In a series of 562 patients who underwent surgery for retinal detachment, 17 (3.02%) had significant post-operative muscle imbalance. On the basis of the patients histories and clinical examinations, it is possible to classify the disturbances of ocular motility according to the symptoms (type, time of onset) and the pathogenesis (lesion of muscular sheats or bodies, capsulo-conjunctival cicatricial retractions, prolonged muscular compression, decompensation of pre existing squints). If diplopia does not cease spontaneously, treatment consists of use of temporary prisms, but in some cases surgery is required. PMID- 6489101 TI - Suppression associated with esotropia with convergence excess (high AC/A ratio). AB - With binocular perimetry suppression was found for near vision in patients with esotropia with convergence excess, whereas fusion was present for distance. If a bitenuporal stimulation was obtained by means of base-out prisms, diplopia was elicited instead. PMID- 6489102 TI - Nystagmus blockage syndrome in the unilaterally blind patient. AB - Those patients who have reduced vision in one eye and a variable esotropia should be suspected of having the nystagmus blockage syndrome. Typically such patients will have a head turn in the direction of the good eye with a preferred medial fixation point. Careful examination will reveal a nystagmus with the preferred position as the null point. Also, any patient who repeatedly has a recurrent esotropia after surgery should be suspected of having the nystagmus blockage syndrome. It is important to perform a posterior fixation suture with a recession on the medial recti of both eyes and to alter the null point by recessing the medial rectus more than 3 mm and resecting the lateral rectus appropriately for the head turn at the same surgical procedure. The eye with poor vision also should have the lateral rectus resected. PMID- 6489103 TI - The Bagolini striated lens test for cyclotropia. AB - Measurements of cyclotropia obtained by two different techniques were compared in ten patients with superior oblique palsies. These techniques were the Maddox double rod test and a new test for cyclotropia using the Bagolini striated lenses. In contrast to the Maddox rods, the Bagolini lenses permit a nearly normal view of the visual environment; in addition with the Bagolini striated lens test, the patient's eyes were not prismatically dissociated as in the Maddox double rod test, but instead prisms were used when necessary to eliminate horizontal and vertical image disparities prior to measuring cyclotropia. The Bagolini striated lens test thereby permitted cyclotropia adaptive mechanisms to function under nearly normal viewing conditions. The two tests yielded similar measurements of cyclotropia under dissociated binocular conditions, but in several patients different results were found with the Bagolini striated lenses when associated vertical and horizontal heterotropias were eliminated spontaneously or prismatically. Three cases are reported in whom the Bagolini striated lens test provided important clinical information not revealed by the Maddox double rod test. PMID- 6489104 TI - Injection treatment of endocrine orbital myopathy. AB - Eight patients with endocrine orbital myopathy received botulinum toxin injection of extraocular muscles for strabismus or injections of the levator for lid retraction. Strabismus of 25 prism diopters or less, especially during early stages of eye muscle involvement, responded well to injection with realignment and, probably, with avoidance of fixed muscle shortening. Long-standing strabismus, large angles, and lid retraction responded less well. PMID- 6489105 TI - Ophthalmological features of pseudo-tumor cerebri. Report on 18 cases. AB - The aim of this paper is to point the attention of the ophthalmologist to the ophthalmic symptoms of pseudo-tumor cerebri. The ophthalmologist needs to control periodically patients with this condition in order to decide for an urgent necessary operative decompression in case of initial visual deficits. PMID- 6489106 TI - Treatment of heterophorias. AB - It is well known that the treatment of heterophorias is first of all medical (optical and orthoptic). In some cases surgery is required. The surgical indications are stressed by the authors. PMID- 6489108 TI - Binocular visual perception in strabismics studied by means of visual evoked responses. AB - Ten normal subjects and 14 patients with comitant esotropia were examined by means of pattern visual evoked responses (VER) under monocular and binocular viewing conditions. When both eyes were stimulated together a VER summation was noted both in normals and in strabismics with small-angle deviation and anomalous retinal correspondence (ARC). This is considered as an objective proof of binocularity. Patients with large-angle strabismus and/or suppression of the image of the deviated eye did not show summation. The significance of summation and its relationship with binocular vision was analyzed by recording binocular VER in normals in which diplopia was artificially induced and in strabismics who spontaneously exhibited double vision. A simple way for differentiating normals from strabismics by means of VERs is presented, considering that the presence or absence of summation per se does not achieve this result. This method is based on the anteposition in front of the fixing eye of neutral filters of increasing density. Summation disappears in strabismics with much weaker filters than in normals (0.5 versus 1.6 log. unit). PMID- 6489107 TI - Contrast sensitivity differences between strabismic and anisometropic amblyopia: objective correlate by means of visual evoked responses. AB - The visual evoked response transfer function of amblyopic subjects was studied. Strabismic amblyopes showed abnormalities only in the high spatial frequency range. Anisometropic amblyopes on the contrary, showed an abnormal function both in the low and high spatial frequency range. This is an objective correlate of functional differences between strabismic and anisometropic amblyopes. PMID- 6489109 TI - The accuracy of fixation in lateral gaze and the problem of retinal slip. AB - The mean accuracy of foveal fixation in lateral gaze was measured by means of an after-image method used previously in the study of autokinesis. During physiological excursions of gaze a lag between target image and foveal image could not be demonstrated. It must be smaller than 1/1000 of the excursion. Thus there is a striking difference between the mechanism of voluntary gaze on the one hand and the mechanism of vergence on the other hand. During sustained divergence the eyes lag almost 1/10 in respect to the required vergence. PMID- 6489110 TI - Relating vernier acuity and Snellen acuity in specific clinical populations. AB - The relationship between vernier acuity and Snellen acuity in a group of cataract patients was examined. The vernier stimulus consisted of two small spots of light, vertically separated by a variable-sized gap. The Snellen stimulus was a standard projected Snellen chart. The form of the relation between vernier and Snellen acuity was found to depend upon the vernier gap size used. Specifically, when the smaller gaps of 4 or 8 min of arc are used, the two types of acuity are linearly related. When the gap is 16 or 32 min of arc, (or if best vernier performance irrespective of gap is considered) vernier acuity is related to Snellen acuity by a power function with an exponent less than one, within this clinical population. Thus, with increasing degrees of retinal image degradation caused by cataract, optimum vernier acuity is impaired at a slower rate than Snellen acuity. Our results in cataract patients are compared to results obtained by others within a population of strabismic and anisometropic amblyopes. PMID- 6489111 TI - Improvements in clinical electronystagmogram analysis. AB - The authors apply the technique of amplitude histogram analysis to the clinical electronystagmogram (ENG). After a brief survey of the underlying concepts, some typical normal and pathological ENG records are discussed. Comparison of advantages and disadvantages reveals that the quoted technique may be suitable to be profitably introduced in clinical practice. PMID- 6489112 TI - Objective and subjective evaluation of cyclovergence and cyclofusion. AB - There is a marked dispersion in the measured results of the angle formed by the intersection of the optic disc-center-meridian with the horizontal meridian, when the cycloposition of the eyes is determined through evaluation of the position of the optic disc (with fundus photographs or indirectly with perimetry). Values of the angle ranging from 0 degree at 12 degrees are still physiological. Inside this dispersion, individual right-left asymmetries of less than 4 degrees with photography and of less than 7 degrees with monocular perimetry are still normal as well. Positional differences of less than 4 degrees in sequential testings are also in a physiological range. The motor behaviour of both eyes during cyclofusion is evaluated by means of a perimetrical analysis of the blind spot at the phase-difference haploscope. Various sensory and motor adaptation phenomena are detected by comparing objective and subjective findings in patients with cyclotropia. These phenomena are discussed in detail. PMID- 6489113 TI - The fourth image of Purkinje: a diagnostic tool in microtropia. AB - The displacement of the fourth Purkinje image, obtained photographically, is used to assess the presence of small angles of deviation (microtropia). PMID- 6489114 TI - Electrophysiological and behavioural evidence for the role of oculomotor proprioception on visual functions of the cat. AB - Review of a series of experiments which demonstrate that surgical deafferentation of proprioceptive fibers of the Vth cranial nerve affects various visual performances of cats. PMID- 6489115 TI - [Antibody-stimulating and protective effect of a conjugate of the influenza virus M protein with a synthetic polymer]. PMID- 6489116 TI - [Electrochromic reactions of rhodopsin]. PMID- 6489117 TI - [Biochemical bases of the thermal insulation of homoiotherms]. PMID- 6489118 TI - [Quaternary phosphonic salts as reversible cholinesterase inhibitors]. PMID- 6489119 TI - [Effect of opioid peptides and morphine on 3H-dopamine uptake and release in the neostriatum of the rat brain]. PMID- 6489121 TI - [Possibilities of the remote functional diagnosis of biological objects by their infrared radiation]. PMID- 6489120 TI - [Vaccinating effect of conjugates of influenza virus surface antigens with a synthetic polymer carrier]. PMID- 6489122 TI - [3-dimensional structure of lectin studied by using the ARGUS multichannel diffractometer]. PMID- 6489123 TI - [Neuronal uptake of 3H-noradrenaline by isolated organs of rats under hyperthermia]. PMID- 6489125 TI - [Effect of mutations of chromosome 17 on homolog segregation in the progeny of mice heterozygous for Robertsonian translocation]. PMID- 6489124 TI - [Interneuronal connections in the transplantation of embryonic brain tissue into the brain of normal adult mammals and in pathology]. PMID- 6489126 TI - [Repetitive sequences of the A2 genome family in mice: size and transcription characteristics]. PMID- 6489127 TI - [Immobilization of microsomal fraction in the rat liver]. PMID- 6489128 TI - [Distribution of teichoic acids in representatives of the order Actinomycetales]. PMID- 6489129 TI - [Chemical modification of proteins (enzymes) by water-insoluble reagents]. PMID- 6489130 TI - [Study of body temperature fields in relation to excitation of the cerebral cortex in the rat]. PMID- 6489131 TI - [Closure of patent ductus arteriosus without thoracotomy]. PMID- 6489132 TI - [Surgical treatment of total anomalous pulmonary venous drainage]. PMID- 6489133 TI - [Diagnosis of rupture of Valsalva's sinus--report of 12 cases]. PMID- 6489134 TI - [Embolectomy of arterial embolism of the lower extremities by balloon catheters]. PMID- 6489135 TI - [Study on the cardiac function of normal residents at an altitude of 2,300 m by impedance plethysmocardiography]. PMID- 6489136 TI - [Non-invasive diagnosis of dual pathways and reentrant tachycardia]. PMID- 6489137 TI - [Treatment of arrhythmia by trans-esophageal incremental atrial pacing]. PMID- 6489138 TI - [A preliminary study on low-threshold electrodes for esophageal pacing]. PMID- 6489139 TI - [Inhibition of collagen-induced platelet aggregation and release function by aspirin and dipyridamole in cynomolgus monkey]. PMID- 6489140 TI - [An ultrastructural observation on the effect of L-thyroxin on rabbit myocardium]. PMID- 6489141 TI - [Morphology and arterial supply of the left ventricle papillary muscles in human]. PMID- 6489142 TI - [Activities of 2 plasma lipases and serum high density lipoprotein after heparin injection]. PMID- 6489143 TI - [Histological and ultrastructural observation on atrial myxomatous sarcoma- report of 1 case]. PMID- 6489144 TI - [Trends in coronary disease mortality in industrialized countries since 1960]. PMID- 6489145 TI - [Hypercoagulation in fishermen with hypertension, hyperlipidemia and coronary heart disease]. PMID- 6489147 TI - [An experimental and clinical study on the effect of magnesium during cardiopulmonary bypass]. PMID- 6489146 TI - [The role of His bundle electrogram in heart block]. PMID- 6489148 TI - [Clinical application of endomyocardial biopsy--report of 36 cases]. PMID- 6489149 TI - Tobacco use by narcoleptics and daytime sleep tendency. AB - The nocturnal sleep and daytime sleep tendency were assessed in 10 narcoleptics who regularly smoked cigarettes and 10 narcoleptics who did not use tobacco. Standard sleep-wake polygraphic measures were recorded during the 24-h study. There were no statistical differences between groups in terms of nighttime sleep structure, although tobacco use resulted in a decreased sleep duration. Smokers tended to fall asleep more rapidly than non-smokers throughout daytime multiple sleep latency testing. The data failed to demonstrate a daytime arousal effect of tobacco for patients with narcolepsy. PMID- 6489150 TI - Alcohol abuse in a rural community in India. Part I: Epidemiological study. AB - By systematic sampling of households after two stage proportionate random sampling of villages, a total of 4670 persons above 15 years of age were selected from the rural areas of Ajmer district in Rajasthan, India, to estimate the prevalence rate of alcohol abuse and to study its socio-demographic correlates (Part I) and the pattern and characteristics of use (Part II, submitted). The data on these aspects were collected through pre-tested questionnaires. The results showed that prevalence of alcohol abuse in the sample was 24.7% (36.1% for males and 13.4% for females) and the percentage of dependents was 3%. Relative risk of alcohol abuse in males was 3.64 with respect to females. Alcohol abuse was found to be significantly associated with religion (higher in Hindus with a relative risk of 8.65 in males and 5.21 in females), marital status (higher in married with a relative risk of 2.51 in males), age (higher in age group more than 20 years with a relative risk of 2.50 in males and 1.63 in females), family structure (higher in nuclear or joint families with a relative risk of 2.88 in males), educational status (higher in illiterates with a relative risk of 1.53 in males) and occupational status (higher in those engaged in agriculture with a relative risk of 1.43 in males and 1.80 in females). It was not significantly associated with per-capita income. These results have been compared with those in similar studies in the country and the possible reasons for differences, if any, have been discussed. PMID- 6489151 TI - Chronic opiate use during methadone detoxification: effects of a dose increase treatment. AB - The effects of administering high methadone doses during detoxification treatment were examined on illicit opiate use and treatment retention in chronic opiate supplementors. Twenty-six applicants to a 90-day outpatient detoxification program who delivered 50% or more opiate-positive urine samples during treatment weeks 2 and 3 were randomly assigned to receive a constant 30-mg dose through treatment week 10 or an increase to 60 mg in week 4 with gradual reduction to 30 mg by week 10. Dosage for both groups was reduced to 0 mg during weeks 11-13. Treatment retention was better for experimental (median = 86 days) than for control (median = 41 days) subjects, but the difference was not statistically significant. In the dose increase group, percent opiate-positive urines decreased from 80% to 62% during the first two weeks of dose increase (t = 2.39, P less than 0.05); opiate positive rates for the control group remained above 80%. A 20% between group difference in percent of opiate positive urine tests persisted through study week 10 in subjects (N = 5 control, 7 experimental) who remained in treatment this long. Although the blind dose increase did improve treatment outcome, we concluded that the magnitude of the effect in this population of chronic opiate supplementors was insufficient to judge the procedure clinically useful. PMID- 6489152 TI - Development of sexual behavior in prenatally ethanol-exposed rats. AB - Female rats were given 16% ethanol solution as the sole liquid during the entire period of gestation. At birth the offspring was removed and reared by foster dams consuming normal drinking water. When tested for feminine sexual behavior in adulthood, the males showed marked signs of feminization as evidenced by an increased amount of lordosis responses. No changes were seen in the masculine sexual behavior. No deviations were seen in the female estrous cycles or in onset of vaginal estrus, whereas the onset of behavioral estrus was delayed. It is suggested that prenatal ethanol exposure may lower the fetal testosterone production and thereby interfere with the normal course of sexual differentiation in the male. PMID- 6489153 TI - Parenteral abuse of diazepam: a case report. AB - A 26-year-old male was admitted to the emergency ward, presenting what seemed to be an acute dystonic crisis. The patient was found to be an oral and parenteral abuser of Valium (diazepam). He used to feign the dystonic syndrome in order to get an i.v. shot of the drug. PMID- 6489154 TI - Multivariate analysis of familial and non-familial influences for commonality in drug use. AB - A multivariate behavioral genetic analysis of common legal drug usage was performed on data from 238 Swedish families. By calculating cross-covariances between parents and offspring for pairs of traits, familial and non-familial correlations were computed to determine the extent to which pairs of measures share the same familial and non-familial influences. Factor analyses resulted in a 3- and a 2-factor solution for the familial and non-familial correlations, respectively. This suggests that familial and non-familial influences for drug usage are structured differently. If replicable, these results also suggest that the phenotypic structure reflects familial factors more than non-familial influences. PMID- 6489155 TI - A comparison of disulfiram acceptors and refusers on selected demographic and clinical characteristics. AB - Male problem drinkers who accepted a treatment recommendation to take disulfiram were compared to those who refused the drug therapy. Subjects were drawn from a clinical population presenting to an outpatient alcoholism assessment service over a 3-year period. Both univariate and multivariate analyses were employed to investigate which client variables were associated with compliance to the disulfiram recommendation. The most important variable that distinguished the two groups was the percentage of other treatment recommendations adhered to by the client with the disulfiram acceptors being more likely to accept the other treatment recommendations. In addition, clients agreeing to take disulfiram were slightly younger and had higher scores on the Michigan Alcoholism Screening Test (MAST). Variables such as socio-economic status, previous treatment history, other drug use and drinking pattern were not associated with agreement to take disulfiram. The implications of these findings are discussed, particularly their relevance to research on the therapeutic effectiveness of disulfiram. PMID- 6489156 TI - Drug addicts seeking treatment after the Iranian Revolution: a clinic-based study. AB - A sample survey of 200 addicts attending the Rehabilitation Centre at Shiraz was conducted after the 1979 Iranian Revolution had disrupted both drug supply and addict treatment programmes. The study showed that clinics were, after the revolution, seeing a broader social range of addicts than before; and that action by the authorities was bringing many recently-addicted individuals to clinics. Heroin use predominated among those who were urban residents, whilst villagers were more likely to be opium users. The survey also sought the addicts' perceptions of the reasons for their initiation and addiction. PMID- 6489157 TI - Increased mortality associated with dependence on legal drugs? PMID- 6489158 TI - Carcinogenesis bioassay data: correlation by species and sex. PMID- 6489159 TI - Design of safer chemicals: an EPA goal. PMID- 6489160 TI - Theoretical and quantum prediction of toxic effects. PMID- 6489161 TI - Baclofen toxicity associated with declining renal clearance after ibuprofen. AB - A 64-year-old male with an incomplete spinal cord injury had been taking baclofen 20 mg tid for 2 1/2 months without side effects. His blood urea nitrogen and serum creatinine rose from 13 and 0.9 mg%, respectively, to 59 and 2.8 mg% after ibuprofen 600 mg tid was begun. The patient displayed baclofen toxicity, developing confusion, disorientation, bradycardia, and hypothermia. His blood pressure dropped and he complained of blurred vision. Ibuprofen discontinuation and fluid repletion corrected the renal indices. Rapid tapering of baclofen was accompanied by reversal of baclofen toxicity. Patients taking baclofen must be monitored closely for toxicity when declining renal function is present. Clinicians should be alert to the possibility of renal insufficiency developing when ibuprofen is initiated. This case demonstrates the potential for ibuprofen induced renal insufficiency to reduce baclofen clearance, thereby leading to baclofen toxicity. Published reports of ibuprofen-induced renal insufficiency are reviewed and pertinent pharmacokinetics of baclofen discussed. PMID- 6489162 TI - Once-daily propranolol for hypertension. AB - Twenty patients with essential hypertension, who were receiving a diuretic plus propranolol qid, were instructed to take their entire daily requirement of propranolol as a single morning dose. Blood pressure was measured in standing and supine positions at the end of a dosing interval. Patients were questioned about the occurrence of specific propranolol side effects during each of four bi-weekly evaluations. Mean blood pressure on once-daily propranolol did not differ significantly from that observed on propranolol qid. Daily doses of propranolol ranged from 80-320 mg. Side effects were infrequent and mild. We conclude that propranolol may be administered as a single daily dose to patients with hypertension whose blood pressure already has been controlled on a qid regimen. PMID- 6489163 TI - Tobramycin blood levels from an indwelling right atrial catheter. AB - Indwelling right atrial catheters provide continuous access to the venous circulation for the purpose of long-term alimentation and blood collection. Two types of central venous systems are the Broviac and Hickman catheters. In general, the Hickman is more versatile, allowing easy blood sample collection, in addition to continuous intravenous fluid and drug administration. Two cases are presented where apparent erroneous tobramycin blood samples were collected through one of these catheter systems. One case compares Hickman tobramycin blood levels with standard peripheral venicollection. Possible ramifications and solutions to the problem are discussed. PMID- 6489164 TI - Evaluation of family physician prescribing: influence of the clinical pharmacist. AB - This study was designed to determine whether prescribing patterns in family practice residency training offices were more favorable in offices with clinical pharmacists. Two family practice residency training offices with clinical pharmacists and two offices without clinical pharmacists served as study sites. At each office, 100 prescription copies were selected by stratified random sampling, and a case abstract was constructed from the medical record. An additional 38 prescriptions that resulted from clinical pharmacist consultation were studied. A blinded review panel evaluated the cases for appropriateness of drug choice and dose and anticipated benefit of the prescription. Prescriptions from offices with clinical pharmacists and consult prescriptions were rated significantly more favorably both for drug choice and drug dose (p less than 0.02). These data suggest that clinical pharmacists involved in family practice residency programs may refine and improve otherwise acceptable prescribing. PMID- 6489165 TI - Propoxyphene and warfarin interaction. PMID- 6489166 TI - Should pulmonary exacerbations in cystic fibrosis be treated with antibiotics? PMID- 6489167 TI - Pharmaceutical education and the practice of pharmacy. AB - Community pharmacy has undergone a process of relative deprofessionalization; most community pharmacists are now and will continue to function primarily as drug distributors. More sophisticated professional services can and will be offered mainly in hospitals and clinics. There is need for a rigorous and objective assessment of future needs and career opportunities in pharmacy. Many of the expanded roles for pharmacists have not yet been justified by proper functional and economic evaluation. The acceptance of those who fill these new and nontraditional roles cannot be ascertained adequately as long as they are supported extensively by schools of pharmacy rather than by professional fees or by salaries from the institutions in which they practice. There has been an unwillingness or inability on the part of academic pharmacy to make objective and rigorous assessments of the career potential of the various new roles envisaged for pharmacists. Other important issues that have not been explored objectively include drug information leaflets for patients and the single professional degree (Pharm.D.). A good case can be made for having physicians rather than community pharmacists provide drug information literature to patients. There must be pharmacists with one of three different levels of training: the B.S., the Pharm.D., and the Ph.D. Of these, the most critically needed at the present time are Ph.D. pharmacists qualified for positions in drug discovery, formulation, pharmacokinetics and pharmacodynamics, and in the development and evaluation of new drug delivery systems. PMID- 6489168 TI - Surgery and long-term medication. PMID- 6489169 TI - Nitrates in heart disease. PMID- 6489170 TI - Reye's syndrome and aspirin. PMID- 6489171 TI - Idiopathic hypercalciuria: can we reduce stone formation? PMID- 6489172 TI - [Abuse of laxatives as a cause of chronic, therapy-refractory diarrhea]. PMID- 6489173 TI - [Continuing medical education is based on the guidance of an authorized physician]. PMID- 6489174 TI - [Herpes simplex encephalitis]. PMID- 6489175 TI - [Duodenogastric reflux]. PMID- 6489176 TI - [Clinical aspects and fine structure of papillary cancer. With special reference to morphological carcinogenesis]. AB - Course of the disease and microscopic work-up of the operative specimens with special consideration of morphological carcinogenesis were analysed in 72 patients with tumour of the ampulla of Vater. Mean duration since onset of symptoms was 6.6 weeks. Cardinal symptoms were jaundice, loss of weight and abdominal pain. Endoscopic-retrograde cholangio-pancreatography, computed tomography and percutaneous transhepatic cholangiography had the highest diagnostic accuracy. Resection rate of the carcinoma was 55%, hospital mortality was 6.7% for partial duodenopancreatectomy and 15.4% for palliative surgery. The mean survival rate was 20 months after partial duodenopancreatectomy and 5 months after palliative surgery. The survival rate was significantly decreased if tumour size was above 2 cm and lymph nodes were positive for tumour. In 82.8% of the examined operative specimens moderate to high-grade epithelial dysplasias were found in carcinoma-free portions of the ampulla, and in 91.4% there were adenomatous structures. It is to be assumed that carcinoma of the ampulla develops via dysplastic epithelial changes or from adenoma of the ampulla. PMID- 6489177 TI - [Polymyalgia rheumatica and giant cell arteritis]. AB - Among 47 patients with polymyalgia rheumatica there were 30 (63.8%) with temporal giant-cell arteritis. Rapidly progressing visual reduction occurred in 2, acute blindness in 10. Four forms of polymyalgia rheumatica were identified by their different clinical courses, with differing risk of blindness. Those patients with polymyalgia rheumatica and giant-cell arteritis are most endangered who have headaches and neck and shoulder pains, but no or only mild general symptoms. PMID- 6489178 TI - [Hyperviscosity syndrome with pseudopapilledema and cerebral ischemia]. AB - Papilloedema and fundal haemorrhages in a 46-year-old man were diagnosed to be due to polycythaemia and resultant abnormal blood viscosity. Viscosity was normalized by isovolemic haemodilution: papilloedema and fundal haemorrhages disappeared. Reduction in blood viscosity up to hyperfluidity increased mean regional cerebral blood flow, particularly in those areas of the brain in which initial blood flow was reduced. The effectiveness of isovolemic haemodilution was demonstrated in the patient by fluorescence angiography for the fundus, and by 133Xenon inhalation for cerebral blood flow. PMID- 6489179 TI - [Therapy of hemosiderosis with deferoxamine]. PMID- 6489180 TI - [Testosterone and estradiol levels in male gynecomastia. Clinical and endocrine findings during treatment with tamoxifen]. AB - Oestradiol-(E2) levels in serum were significantly higher in a group of 91 males with gynaecomastia than in a control group. The levels were highest in patients with testicular tumour, hyperprolactinaemia and idiopathic gynaecomastia. In gynaecomastia of puberty and primary or secondary hypogonadism, the E2 level was within normal limits, but the testosterone/oestradiol ratio was significantly reduced. Tamoxifen, at a daily dose of 20 mg, was administered over 2-4 months to 16 patients with gynaecomastia. Of twelve patients with painful gynaecomastia ten became painfree. Gynaecomastia regressed partially or completely in 14 patients, in only 2 was it unchanged. There was no recurrence of gynaecomastia after discontinuing tamoxifen. Side-effects did not occur. It is concluded that tamoxifen is a promising alternative to the surgical treatment of gynaecomastia. PMID- 6489181 TI - [Deferoxamine in hemosiderosis. Fecal iron excretion during continuous subcutaneous infusion]. AB - Faecal iron excretion during continuous subcutaneous deferoxamine infusion was measured by flameless atom-absorption spectral photometry in 21 patients with homozygous ss-thalassaemia and one patient with Blackfan-Diamond anaemia. Taking into account faecal and urinary iron excretion, more iron was eliminated than was taken up during transfusion and by intestinal absorption. Urine contained 37.9%, faeces 62.1% of the amount of iron eliminated. PMID- 6489182 TI - [The motor intention potential. The brain's electric concomitant effect of motor intention in autocorrelated electroencephalography]. PMID- 6489183 TI - [Old and new problems in surface disinfection in hospitals]. PMID- 6489185 TI - [Cholelithiasis and acute pancreatitis]. PMID- 6489184 TI - [Recompensation of decompensated liver cirrhosis by a peritoneo-pleural shunt?]. PMID- 6489186 TI - [Puncture and drainage of the pericardium using pigtail catheters]. PMID- 6489187 TI - The effect of diethylhydroxylamine on the incidence of tumors induced by benzo(a)pyrene in the mouse. AB - Groups of 20 male and 20 female CD-1(ICR)Br mice were treated either with 0, 3, 30, or 300 mg diethylhydroxylamine (DEHA)/kg-day (administered via the drinking water) from 57-112 days of age. For the four week period between 70 to 98 days of age, all animals received (via gavage) eight 1 mg doses of benzo(a)pyrene at 4 day intervals. One hundred thirty-seven animals survived the dosing period. Of these, 132 survived to 211 days of age at which time they were euthanized and necropsied. Gross lesions were observed only in the lungs and squamous portion of the stomach. Treatment with DEHA produced no significant effect on the lung tumor incidence of either sex. However, a significant increase in stomach tumors was observed in the females. PMID- 6489188 TI - The lack of effect of tertiary butylhydroquinone on prothrombin time in male rats. AB - The potential for tertiary butylhydroquinone (TBHQ) to produce hemorrhagic death similar to that seen after butylated hydroxytoluene (BHT) treatment was tested in male rats. Groups of male rats were given three consecutive daily doses of 380, 760 or 1520 mg/kg/day BHT or 50, 100 or 150 mg/kg TBHQ. Twenty-four hours following the last dose, the rats were killed, blood was taken for prothrombin determinations and gross autopsies were performed. No evidence of hemorrhage was found in any of the animals. BHT caused a significant dose-dependent increase in prothrombin times, while the prothrombin times of the TBHQ rats were comparable to the controls. Since hypoprothrombinemia plays a major role in producing hemorrhagic death, these data indicate that the potential for THBQ to have such an effect is low. PMID- 6489189 TI - Lack of lung damage in mice following administration of tertiary butylhydroquinone. AB - Tertiary butylhydroquinone (TBHQ), a phenolic antioxidant used in foods, was tested for its potential to produce lung damage in mice similar to that seen following administration of butylated hydroxytoluene (BHT). Male mice (CRL:CD-1) were given single intraperitoneal injections of 62.5, 125, 250 or 500 mg/kg TBHQ or 300, 625 or 1230 mg/kg BHT in corn oil. Survivors were killed five days after treatment and the lungs were removed, weighed, and processed for histologic examination. Lung weights of the TBHQ treated animals were comparable to the controls, while BHT produced a statistically significant increase in lung weight. Histologically, BHT produced hyperplasia of pulmonary pneumocytes as previously reported. No treatment-related lung lesions were seen in the TBHQ mice. The results of this study indicate that TBHQ does not produce pulmonary lesions in mice. PMID- 6489190 TI - Glutathione depletion and resynthesis in laboratory animals. AB - The availability of tissue glutathione (GSH) appears to depend upon a balance between tissue concentrations, the rate of reactive metabolite formation and the re-synthesis of GSH. To test this hypothesis, diethyl maleate (DEM, 5.8 mmol/kg bw) was administered intraperitoneally to male and female mice, hamsters, rats and guinea pigs. The regeneration of hepatic and renal GSH was examined at 0.5, 1, 2, 4, 8 and 24 hr post-treatment. DEM caused a rapid and marked depletion of tissue GSH but re-synthesis began to occur by 4 hr post-treatment in all species with the exception of the guinea pig. By 24 hr after treatment, the mouse, hamster and rat had tissue levels of GSH in excess of usual values but, in the guinea pig, recovery of hepatic GSH was still significantly reduced. Considering the reported species differences in S-alkenetransferases which detoxify DEM, the present results revealed that the conjugation of DEM proceeded rapidly in all four species but that the toxicity elicited in the guinea pig may have arisen from the unavailability of GSH during the slow re-synthesis stage following maximal depletion of this agent. PMID- 6489191 TI - Teratological evaluation of a novel antiabortifacient, dibenzyloxyindanpropionic acid. II. Postnatal morphological and behavioral development. AB - Dibenzyloxyindanpropionic acid (DIPA) is an antiabortifacient prostaglandin F2 alpha antagonist. Significant protection against prostaglandin F2 alpha-induced abortion in Charles River CD-1 mice is afforded by 50 mg/kg DIPA, administered intramuscularly twice daily from day-15 of gestation, two days prior to prostaglandin F2 alpha challenge. Furthermore, treatment of CD-1 mice with 50 mg/kg DIPA intramuscularly daily throughout gestation or with 50 or 200 mg/kg twice daily only on day-15 of pregnancy, revealed no structural teratological effects nor histopathological anomalies in the offspring. The present behavioral teratological investigation demonstrates that prenatal treatment of CD-1 mice with 50 mg/kg DIPA intramuscularly daily throughout gestation does not adversely affect postnatal morphological development (offspring viability; weight gain; timing of bilateral pinna detachment, eye opening, eruption of mandibular and maxillary incisors, appearance of mamillary ridges, vaginal opening, testicular descent, and appearance of downy fur), postnatal behavioral development (vocalization; auditory startle reflex; corneal reflex; righting reflex and subsequent air righting; cliff avoidance; limb placing response and grip strength; motor coordination; olfactory orientation; locomotion; motor activity; homing instinct; and acquisition and retention of an active avoidance task), or fertility of the progeny. It is concluded that DIPA is an effective and safe antiabortifacient in mice at the doses tested. PMID- 6489193 TI - Teratological assessment of the oxidative dye 4-methyl-N-ethylamino phenol sulfate. AB - The oxidative dye 4-methyl-N-ethylamino phenol sulfate was evaluated for teratogenic potential. The dye was administered by gavage to pregnant Sprague Dawley rats at dose levels of 300, 600, and 1200 mg/kg on gestation days six through fifteen. No signs of toxicity were observed during the treatment period. A significant reduction in mean maternal weight gain was noted during treatment at the high dose level of 1200 mg/kg. The test material did not produce embryotoxic nor fetal toxic effects at dose levels utilized. Evaluation of fetal external, visceral, and skeletal anomalies revealed no statistically significant differences between dye treated and control groups. Oral exposure of dams to the positive control, Vitamin A, resulted in a significant increase in the number of litters with abnormal fetuses. PMID- 6489192 TI - Cocaine-induced hepatotoxicity: lipid peroxidation as a possible mechanism. AB - In vitro experiments with hepatic washed microsomal preparations showed that malondialdehyde (MDA) formation was increased in a time- and concentration dependent manner using COC or NC as the substrate. Though 1 mM COC or NC inhibited MDA formation, significant elevations were observed for 100, 10 or 1 microM concentrations. NC at 10 microM after a 30 minute incubation produced a 34% decrease in hepatic microsomal cytochrome P450 whereas 1 mM NC had no such effect. MDA formation in vivo, measured as total absorbance at 535 nm per gram liver, was found to be maximal 4 hours after 40 mg/kg NC ip. Elevations of serum transaminase (SGPT) however were not found until 6 hours after NC. We conclude from these studies that COC and NC induce lipid peroxidation in the liver of PB pretreated Swiss-origin mice and that peroxidative attack may be a mechanism for hepatotoxicity of these compounds. PMID- 6489194 TI - Effects of verapamil on doxorubicin-induced mortality and electrolyte changes in the mouse heart. AB - The effects of verapamil on doxorubicin-induced mortality and electrolyte changes were investigated in mice using either 0, 8, 16, or 32 mg/kg verapamil. The verapamil doses were injected by subcutaneous route 24 and 3 hr prior to administration of a single dose of doxorubicin (20 mg/kg, IP), followed by daily treatment with verapamil for 20 subsequent days. Using total deaths or changes in ventricular electrolyte levels as indices of toxicity, there was no evidence that verapamil decreased doxorubicin toxicity. At this dose, doxorubicin increased myocardial calcium and sodium, and decreased magnesium and potassium. Verapamil alone was shown to significantly reduce total ventricular calcium and increase magnesium in a dose-dependent manner. The ventricular sodium and potassium levels were not affected by verapamil treatment. Neither the increase in calcium nor the decrease in heart magnesium content of the ventricles in response to doxorubicin, was lessened by verapamil treatment. Doxorubicin-associated sodium increase in ventricular tissue was greater in groups receiving higher doses of verapamil but decrease of potassium in the ventricles of these animals remained unaffected. We conclude from the findings of the present study that verapamil is inappropriate as an antagonist of the cardiac toxicity resulting from treatment with doxorubicin. PMID- 6489196 TI - [Diagnosis and localization of pheochromocytoma]. PMID- 6489197 TI - [Meconium aspiration syndrome]. PMID- 6489198 TI - [Thyrotoxic chorea]. PMID- 6489200 TI - [Elevated blood sedimentation rate]. PMID- 6489199 TI - [Bronchiolitis in rheumatoid arthritis]. PMID- 6489201 TI - [Weight loss, diarrhea and abdominal cramps in a previously healthy young man]. PMID- 6489195 TI - Indapamide. A review of its pharmacodynamic properties and therapeutic efficacy in hypertension. AB - Indapamide is an orally active sulphonamide diuretic agent. Although some evidence appears to indicate that the antihypertensive action of indapamide is primarily a result of its diuretic activity, only a limited diuresis occurs with the usual antihypertensive doses of 2.5 mg daily, and in vitro and in vivo data suggest that it may also reduce blood pressure by decreasing vascular reactivity and peripheral vascular resistance. In mild to moderate hypertension it is as effective as thiazide diuretics and beta-adrenergic blocking agents in lowering blood pressure when used as the sole treatment. Indapamide has been successfully combined with beta-adrenergic blocking agents, methyldopa, and other anti hypertensive agents. While such findings need confirmation, it appears that indapamide shares the potential with other diuretic agents to induce electrolyte and other metabolic abnormalities, although it may do so with less frequency or severity. Thus, indapamide appears to offer a suitable alternative to more established drugs as a 'first-line' treatment in patients with mild to moderate hypertension. Whether it differs significantly from other diuretics when used as antihypertensive therapy, either in its mode of action or its side effect profile, needs further clarification. PMID- 6489202 TI - [Weight, height and age at menarche of Finnish children in 1980]. PMID- 6489203 TI - [Detection of inflammatory processes using indium 111-labeled granulocytes]. PMID- 6489204 TI - [Renal angiomyolipoma]. PMID- 6489205 TI - Torticollis in infancy and adolescence. PMID- 6489206 TI - Treatment of recurrent respiratory papillomatosis with interferon. PMID- 6489207 TI - Toxic shock syndrome from staphylococcal pharyngitis. PMID- 6489208 TI - Interactions of nutrition and temporomandibular joint dysfunction. PMID- 6489209 TI - Malignant melanoma of the nasal cavity and maxillary sinus. PMID- 6489210 TI - Inverted sinonasal papillomas. PMID- 6489211 TI - False vocal cord nodules: an unusual case of hoarseness. PMID- 6489212 TI - Dermoid sinus of the nose with intracranial extension. PMID- 6489213 TI - Basal cell carcinoma. PMID- 6489214 TI - On the cutting edge. PMID- 6489215 TI - Distention of the stylomandibular ligament as a cause of styloid pain syndrome. PMID- 6489216 TI - Amalgam tattoos of the oral soft tissue. PMID- 6489217 TI - Effect of argon laser radiation on vascular blemishes of the face. PMID- 6489218 TI - A physiologic assessment of upper airway function following hemilaryngectomy. PMID- 6489219 TI - Cosmetic considerations of dental arch form and function in managing the aging face. PMID- 6489220 TI - Pneumocephalus. PMID- 6489221 TI - Otolaryngic manifestations of mycoplasma pneumonia infections. PMID- 6489222 TI - Comparative nasopharyngeal analysis. PMID- 6489223 TI - Ewing's sarcoma: report of a case in the nasopharynx. PMID- 6489224 TI - Rhinocerebral mycosis. PMID- 6489225 TI - Fluorides and dental health revisited. PMID- 6489226 TI - The discriminatory value of the various parts of the University of Nairobi qualifying examination in internal medicine (final MB). PMID- 6489228 TI - Weight, height, weight-for-height and Quetelet's Index of Akamba schoolchildren and adults. PMID- 6489227 TI - Opinions about breastfeeding amongst middle-income African and Indian women in Nairobi. PMID- 6489229 TI - Ascorbic acid deficiency in pulmonary tuberculosis. PMID- 6489230 TI - Experience in the management of sinus histiocytosis with massive lymphadenopathy. PMID- 6489231 TI - Neonatal necrotizing enterocolitis at Kenyatta National Hospital. PMID- 6489232 TI - A tool at hand for the screening of Schistosoma haematobium infections. PMID- 6489233 TI - Clinical malaria in Nairobi. PMID- 6489234 TI - The clinical spectrum of hypertensive heart failure: a point-score system for solving an old problem. PMID- 6489235 TI - Chlormethiazole in the management of eclampsia. PMID- 6489236 TI - Single dose pharmacokinetics of a controlled release lithium preparation "Liskonum" in African patients suffering from manic depressive psychosis. PMID- 6489237 TI - Salmonella endocarditis in a Nigerian child. PMID- 6489238 TI - Practical therapeutics: first aid and therapy of poisoning from agricultural insecticides and herbicides. PMID- 6489239 TI - Biochemical and morphological comparison of microsomal preparations from rat, quail, trout, mussel, and water flea. AB - Differential centrifugation methods already in use were applied to purify rat, quail, and trout liver microsomes and modified as necessary to purify microsomes from mussel digestive gland and whole water flea. All these microsomal preparations were comparatively characterized with respect to protein and RNA content, levels of markers of subcellular contaminants, ultrastructural morphology, differential spectra of cytochromes P-450 and b5, monoxygenase activity, and in vitro metabolism of p-dichlorobenzene. Yields of microsomal proteins of the tested organisms differed widely, with mussel showing the lowest yield. Very low levels of nuclear and mitochondrial contaminants were detected in all microsomal preparations, but cell membrane contaminants were clearly present in most preparations. Daphnia microsomes were significantly contaminated by plasma membranes, and hepatopancreas microsomes contained significant amounts of partially disrupted secretory granules and plasma membrane. From a qualitative standpoint differential spectra of cytochrome b5 were very similar for all the preparations, whereas cytochrome P-450 spectra were largely dependent on the microsomal preparation as well as on the assay method used. The content of cytochrome P-450 was highest for rat liver microsomes and very low or absent in Daphnia and mussel preparations; the range of cytochrome b5 contents was much narrower. Significant differences were observed among monoxygenase activities of the different preparations. In Daphnia and mussel microsomes, aniline hydroxylase was absent and benzo[a]pyrene hydroxylase activity was much lower than in rat and quail microsomes. Benzo[a]pyrene hydroxylase activity of trout liver microsomes was similar to that of rat and quail microsomes, whereas hydroxylation of substrates which in rat liver are preferentially metabolized by phenobarbital inducible forms of cytochrome P-450 was much lower in trout microsomes. PMID- 6489240 TI - The water flea (Daphnia magna) as a sensitive indicator for the assessment of toxicity of synthetic detergents. AB - The water flea (Daphnia magna) was used as a sensitive indicator for assessing the toxicity due to synthetic detergents. Acute and chronic toxicity of detergents to the water flea was studied under laboratory conditions by following the median tolerance limit (TLM) at 48 hr and the rate of survival. A significant decrease in the rate of reproduction (number of hatching and neonates produced) were found at 21 days. During acute toxicity studies behavioural changes were also noticed. PMID- 6489241 TI - Biodegradation of 4-nitrophenol in standardized aquatic degradation tests. AB - During the years 1978-1981 both the European Economic Community (the EEC) and the Organization for Economic Cooperation and Development (the OECD) organized various interlaboratory comparison programs on standardized screening methods to study the biodegradability of chemicals in water. While the ring test results were generally rather heterogenous, one of the compounds studied, 4-nitrophenol, turned out to be particularly problematic as the compound was found either easily biodegradable or not biodegradable by various laboratories in various tests. This paper describes some more detailed studies on 4-nitrophenol degradation in two different tests, the modified OECD screening test (MOST test) and the Zahn Wellens test, respectively. The test variables investigated include inoculum characteristics and pretreatment, test duration, and 4-nitrophenol concentration. The results are discussed in relation to toxicity and degradation pathways of 4 nitrophenol. It is concluded that in order to improve the comparability of results from standardized aquatic biodegradation tests, test strategies should allow the option of performing a test with a preadapted inoculum in the event of negative test results with freshly collected inocula. Increasing the inoculated concentration of microorganisms in some tests may also contribute to the attainment of more consistent test results. PMID- 6489242 TI - Fate and biological effects of methyl parathion in outdoor ponds and laboratory aquaria. I. Fate. AB - Three outdoor ponds were treated with methyl parathion (MEP) applied beneath the water surface at a concentration of 100 micrograms liter-1. Laboratory aquaria containing either tap water, pond water, tap water plus plants, tap water plus sediment, or tap water plus sediment and plants were similarly treated. Samples of water, sediment, and fish were analyzed for residues of MEP. The rate of loss from water and concentrations found in sediment were compared with predictions based on a calculated rate of biodegradation and a sediment:water partition coefficient. The rate of loss of MEP from pond water isolated in an aquarium was similar to the predicted rate. However, the rate of loss from outdoor ponds, or from aquaria containing plants and sediment, was greater than predicted. MEP was not detected in sediment even though predicted concentrations far exceeded the limit of detection. These results are discussed and it is suggested that the rate of biodegradation in shallow bodies of water may be determined predominantly by bacteria attached to sediments and plants, rather than by planktonic bacteria. Bioaccumulation in fish was predicted from empirical equations based on the octanol:water partition coefficient. Observed values were in good agreement with predictions. PMID- 6489243 TI - Fate and biological effects of methyl parathion in outdoor ponds and laboratory aquaria. II. Effects. AB - Methyl parathion (MEP) applied to three outdoor ponds at a nominal concentration of 100 micrograms liter-1 was toxic to some species of aquatic insects and crustaceans but not to fish. The spectrum of toxicity was similar to predictions based on a literature survey of data obtained from laboratory tests. Various secondary effects occurred that could not be predicted from laboratory toxicity tests. An increase in populations of Diaptomus in treated ponds was probably caused by mortality of predators and competitors. A bloom of filamentous algae which then collapsed, leading to severe depletion of dissolved oxygen and fish deaths, may have been triggered by mortality of herbivorous mayflies and daphnids. The growth of juvenile rainbow trout in treated ponds was significantly less than in untreated ponds. On the other hand their growth in laboratory aquaria was not affected when rainbow trout were exposed to higher concentrations of MEP than occurred in the outdoor ponds. It was concluded that growth of rainbow trout in the ponds was probably affected by mortality among aquatic insects and crustaceans on which they feed. PMID- 6489244 TI - [Uses and perspectives of epidemiology]. PMID- 6489245 TI - [New directions in epidemiology]. AB - The article presents a panoramic view of the outlook for epidemiology and its future applications under the new orientations. It is based on the documents presented to the Seminar on the uses and prospects of epidemiology, held in Buenos Aires in November 1983. It reviews the uses of epidemiology in health services, the integration of epidemiology and health administration, epidemiology applied to evaluation and to the control and surveillance of diseases, epidemiological research, and manpower training in epidemiology. The article stress throughout the need for a reorientation of activities in epidemiology so that it may become an ideal instrument for the improvement of health services and the attainment of health for all. PMID- 6489246 TI - [A simple method for reviewing the curriculum of the Nutrition Program of the University of Costa Rica]. AB - The article explains that, in drawing up and reviewing the Nutrition Program of the University of Costa Rica, it was viewed as important to determine the kind of professional to be produced. To find the answer, the methodology proposed in 1974 by Segall and associates for systematic course design was adopted. Based on the country's needs, two specific posts were described that should be filled with priority: Chief of a food service, and chief of the nutrition program in a health region. Professionals in each of those fields collaborated in defining the duties of each post and the skills, knowledge and attitudes required to enable a nutritionist to perform them well. The resulting list is distributed for each course and used as a basis for defining the aims of the Program and its courses. PMID- 6489247 TI - [Research on models of surgical care: the "Simplified Surgery System" program]. AB - The article describes the models of surgical care designed and tested at Valle University Hospital in Cali, Colombia, for the provision of more coverage of patients without detriment to the quality of their care. The program was based on an analysis of preliminary studies done on operations performed in the department of Valle del Cauca. The surgical problems were analyzed by the systems approach, and taking account of the physical, educational and administrative resources and the evaluation of those components. Finally, prototype models have been designed that have been successfully used to demonstrate the feasibility of increasing the coverage of patients by 80% and attaining 90% satisfaction of the patients themselves. Later, one of the models was put into practice at San Cristobal, Venezuela, with similar results. PMID- 6489248 TI - [Medical residency in hospital administration]. AB - The increasing complexity of organized medical care requires that the field of hospital and health systems administration be included in medical curricula as a means of training professionals to do research, analyze and determine the community's health needs, obtain and efficiently use resources for meeting them, and promote activities that contribute to the community's wellbeing. With this end in view, the Polyclinic Hospital of the School of Medicine, University of Sao Paulo (Brasil) has instituted the Program of Advanced Studies in Hospital and Health Systems Administration (PROAHSA) which endeavors, during the medical residency, to complement the training of recently graduated physicians by providing the conditions they need to develop into health service administrators. In this two-year program, the resident physician acquires direct knowledge of the services rendered by the health organization, familiarizes himself with its purposes and problems, gains insight into its dynamics, and exercises his own initiative in establishing programs. The first level of the program is designed to give the resident a solid basic training; the second enables him to acquire specialized knowledge through in-depth study of the concepts, methods, and techniques of health services, administration and organization. Applying the concept of health services research, the program requires that the resident complement his biomedical and clinical research by studying different methods for the delivery of services, use of resources, and mobilization and use of manpower to organize hospital medical care. PMID- 6489249 TI - [Compulsory internship in diagnostic radiology in the 5th year of medicine at the University of Montreal]. AB - Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students. PMID- 6489250 TI - Analysis of F wave parameters in median and ulnar nerves in healthy infants and children. Age related changes. PMID- 6489251 TI - F wave study in children with birth brachial plexus paralysis. PMID- 6489252 TI - Electrophysiological features in patients with non-progressive and late progressive weakness after paralytic poliomyelittis. Conventional E.M.G. automatic analysis of the electromyogram and single fiber electromyography study. PMID- 6489253 TI - The electromyographic prognosis of traumatic paralysis of radial nerve. Study of its myelinic and axonal damage. PMID- 6489254 TI - Diaphragmatic contraction following phrenic nerve stimulation evaluated by cine fluoroscopy. PMID- 6489255 TI - Electromyographic study of the rectus abdominis and external oblique muscles during exercises. PMID- 6489256 TI - Electromyographic study of the trapezius (pars superior) and levator scapulae muscles in circumduction and pendular oscilation of the arm. PMID- 6489257 TI - The nonluteal porcine ovary as a source of angiogenic activity. AB - Nonluteal ovarian tissue extracts were tested for their ability to stimulate migration and proliferation of cultured bovine capillary endothelial cells. Stimulation of migratory and proliferative activity was found in the 105,000 X g supernatant of homogenates of either whole nonluteal porcine ovaries or isolated theca (follicular walls). Maximal proliferative and migratory activity was obtained with 1-10 micrograms homogenate protein. Neither follicular fluid nor extracts of granulosa cells showed significant activity when tested over a broad concentration range. The proliferative and migratory activities were associated with a heat-labile, nondialyzable, protease-sensitive fraction that was soluble in 40%, but not 60% (NH4)2SO4. The tissue extracts that effectively stimulated growth and migration of capillary endothelial cells in vitro also stimulated the formation of new capillary blood vessels in an angiogenesis assay performed on chick chorioallantoic membranes. PMID- 6489258 TI - Correlation between in vitro growth and regulation of estrogen and progesterone receptors in rat mammary epithelial cells. AB - The present studies examine 1) the effect of enzymatic cell dissociation on the level of cytosolic estrogen receptor (ER) and progesterone receptor (PR) for normal rat mammary tissue, 2) the concentrations of ER and PR in rat mammary epithelial (RME) cells cultured within collagen gel, and 3) correlations that may exist between receptor concentration and cultured RME cell proliferation after hormonal stimulation in vitro. After cell dissociation, ER was present in mammary cells at higher concentrations than those found in the whole gland, whereas PR concentrations were similar to those in the whole gland. As characterized by Scatchard analysis, PR and, to a lesser extent, ER can be maintained in cells cultured in serum-free medium within a collagen gel matrix. ER is apparently functional at relatively low levels, since estradiol did induce PR synthesis, and cytosolic ER was reduced by estrogen administration. However, estradiol had no mitogenic effect on RME cells in this system, supporting the hypothesis that there may be a dichotomy between estrogen's effect on growth and progesterone receptor synthesis. PRL plus progesterone act synergistically to induce cell proliferation in our system, and this correlates with increased concentrations of progesterone receptors. Thus, the collagen gel system appears to provide a useful in vitro model for the study of receptor regulation and cell proliferation. PMID- 6489259 TI - Effects of chronic administration of amiodarone on kinetics of metabolism of iodothyronines. AB - Treatment with amiodarone, an iodinated anti-arrhythmic drug, is associated with increases in serum rT3 and serum L-T4 with a mild variable decrease in T3. We have examined the metabolic basis for these changes by studying the kinetics of metabolism of 125I-labeled iodothyronines in rabbits given amiodarone (20 mg/kg BW) for 3 weeks. The mean +/- SE MCR of rT3 was significantly (P less than 0.05) lower in amiodarone-treated rabbits (1.88 +/- 0.14 liters/day) than that in the control animals (2.72 +/- 0.25 liters/day), with no appreciable changes in the MCR of T3. The mean MCR of T4 was also significantly lower in amiodarone-treated animals than in controls (0.23 +/- 0.03 vs. 0.37 +/- 0.04 liters/day; P less than 0.05). Amiodarone had no significant effect on daily production rates (PRs) of rT3 or T3, but the PR of T4 showed an increase which was significant (P less than 0.05) when expressed per unit BW. The mean +/- SE molar ratio of daily PRs of T3 and T4 was reduced significantly (P less than 0.05) from 0.75 +/- 0.12 in controls to 0.35 +/- 0.06 in drug-treated rabbits. Amiodarone treatment was also associated with a moderate reduction in the ratio of the PRs of rT3 and T4, but the change was not statistically significant. The overall data suggest that amiodarone administration is associated with a reduction in the MCRs of rT3 and T4 and a reduction in monodeiodination of T4 in the outer ring; monodeiodination of T4 in the inner ring either remains unaffected or decreases moderately. PMID- 6489260 TI - Effect of the antiestrogen ethamoxytriphetol (MER-25) and luteectomy on serum progesterone concentrations in pregnant baboons. AB - The present study determined whether the reduction in serum progesterone (P4) concentrations which follows the administration of the antiestrogen ethamoxytriphetol [1-(rho-2-diethylaminoethoxyphenyl)1-phenyl-2-rho-methoxyphenyl ethanol (MER-25)] to pregnant baboons reflects a decline in placental and/or luteal function. Maternal saphenous venous blood was collected at 1- to 4-day intervals between day 70 of gestation and term in pregnant baboons. Four females received no other treatment, and eight females received MER-25 (15 mg/kg BW, orally) daily between day 130 of gestation and term. Four of the MER-25-treated baboons received no other treatment, and four had the corpus luteum of pregnancy surgically excised between days 104 and 118 of gestation. Serum P4 concentrations in the untreated baboons fluctuated, but no significant progressive rise or fall in P4 occurred. Administration of antiestrogen to intact pregnant baboons resulted in a 50% decline (P less than 0.001) in serum P4 concentrations from mean pretreatment values of 7.0-25.1 to 4.2-10.8 ng/ml thereafter. Although removal of the corpus luteum alone had no effect on serum P4, administration of MER-25 to luteectomized females resulted in an 80% decrease (P less than 0.001) in serum P4 concentrations from pretreatment means of 10.6-16.6 to 2.5-3.2 ng/ml thereafter. The results indicate that most or all of the P4 that remained in the peripheral circulation after MER-25 administration to intact pregnant baboons originated from the ovary, primarily the corpus luteum. Thus, the major site of action of antiestrogen in reducing P4 production during baboon pregnancy is on the placenta. PMID- 6489261 TI - Production of a macromolecular bone-resorbing factor by the hypercalcemic variant of the walker rat carcinosarcoma. AB - The Walker rat 256 carcinosarcoma is a spontaneous rat breast tumor which has two unique variants, one of which is always associated with severe hypercalcemia and one which is not associated with hypercalcemia when the tumor is carried im. To determine the factor responsible for hypercalcemia, we established tumor cells derived from both variants in culture and found that the tumor cells from the hypercalcemic variant release an acid-soluble and acid-stable bone-resorbing factor of approximately 25,000 mol wt. Cells from the normocalcemic variant produce no bone-resorbing activity. These data are consistent with the notion that hypercalcemia in this animal model of the humoral hypercalcemia of malignancy is due to a macromolecular bone-resorbing factor which is acid and heat stable and requires disulfide bonds for biological activity. PMID- 6489262 TI - Potassium regulates angiotensin II-induced aldosterone biosynthesis in acutely nephrectomized rats. AB - The studies described herein were designed to determine whether serum potassium modulates the aldosterone secretory response to angiotensin II (Ang II) after nephrectomy. We used isolated adrenal glomerulosa cells harvested from rats maintained with either normal (5.2 meq/liter) or high (6.8 meq/liter) serum potassium for 48 h after bilateral nephrectomy for determining Ang II-aldosterone dose-response relationships. Kayexalate, which exchanges sodium for potassium in the gastrointestinal tract, was used to achieve the desired level of serum potassium. Both groups of cells were responsive to low concentrations of Ang II (10-100 pM). Cells from rats with lower serum potassium levels had lower basal and maximum Ang II-stimulated aldosterone and ED50 values. The importance of variables as contributors to differences between the groups were ranked from most to least important by two group discriminant function analysis and revealed: serum potassium greater than maximum Ang II-stimulated aldosterone greater than ED50 greater than basal aldosterone greater than serum sodium. Stepwise multivariate discriminant analysis demonstrated that all variables except the level of serum sodium contributed to the groups being significantly different at P less than 0.05. These studies demonstrate that adrenal glomerulosa cells obtained from nephrectomized rats maintain sensitive secretory responses to Ang II. Additionally, the level of serum potassium of rats before death directly regulates both the sensitivity and magnitude of the aldosterone secretory response to Ang II in vitro. PMID- 6489263 TI - Mullerian duct maintenance in heterotypic organ culture after in vivo exposure to diethylstilbestrol. AB - Prenatal exposure to diethylstilbestrol (DES) results in the persistence of Mullerian ducts in male offspring. The influence of DES on Mullerian duct regression was studied using an organ culture system in which DES-treated or control indifferent ducts (embryonic reproductive tracts) were cocultured along with treated or control embryonic testes. Prenatal DES exposure was by sc injection of the mother (100 micrograms/kg BW) on days 9 through 12 of gestation. Embryonic tissues were removed on day 13 of gestation and cultured for 72 h. In organ culture, Mullerian duct regression, comparable to that seen in vivo, occurred when control reproductive tracts were associated with control testes. However, maintenance of the Mullerian duct was observed in 100% of the tissues when DES-treated testes and DES-treated reproductive tracts were cultured together. When recombinations were formed by the association of control reproductive tracts and DES-treated testes, there was regression of the Mullerian duct (87%). However, in the combinations of DES-treated reproductive tracts and control testes, 41% of the cultured tissue demonstrated partial regression of the Mullerian duct, and 59% showed no regression. These data support previous in vivo results that prenatal exposure to DES has an inhibitory effect on Mullerian duct regression and further suggest that this inhibitory effect is mainly due to a decrease in responsiveness of the treated embryonic Mullerian duct. PMID- 6489264 TI - Parathyroid hormone responses to calcium stress during eggshell calcification. AB - PTH bioactivity during the egg-laying cycle of the chicken has been measured by the cytochemical bioassay for PTH. During the period of eggshell calcification, PTH bioactivity is elevated. After completion of the shell the plasma PTH falls to a low level but is slightly raised again 2 h after ovulation. These results indicate that changes in bioactive PTH play an important role in the calcium metabolism of the chicken during this physiological calcium stress. PMID- 6489265 TI - Transuteroplacental metabolism of cortisol and cortisone during mid- and late gestation in the baboon. AB - We measured uterine extraction (i.e. metabolism) and transuteroplacental interconversion of cortisol (F) and cortisone (E) to determine whether metabolism across the uterus changes during pregnancy and contributes to the MCR of these corticosteroids. On day 100 (n = 4) or 170 (n = 3) of pregnancy (term = day 184), baboons (Papio anubis; 14-18 kg) were sedated with ketamine, and a constant infusion (0.38 ml/min) of 8-12 microCi [3H]F and 9-15 microCi [14C]E in 80 ml 0.9% NaCl-1% ethanol was initiated (time zero) via a maternal antecubital vein. At 60 min, animals were laparotomized, and at 70, 80, and 90 min, blood samples were obtained from right and left uterine veins and from a maternal saphenous vein. At 95 min, a transverse incision was made in the uterus, the fetus was isolated, and blood samples were obtained from the umbilical vein and artery. The cord was then clamped, and the fetus was delivered. Radio-labeled F and E were extracted from serum and purified by sequential paper chromatography, and metabolic parameters were calculated. Endogenous F and E levels were determined by RIA. In the mother, the percent conversions of E to F at midgestation (mean +/ SE; 72 +/- 4) and late gestation (65 +/- 3) were similar and exceeded (P less than 0.01) respective values for oxidation of F to E (51 +/- 7 and 46 +/- 7, respectively), indicating that maternal corticosteroid metabolism favors F formation and is unchanged during the second half of gestation. In contrast, corticosteroid metabolism across the uterus and placenta (transuteroplacental) was altered during pregnancy. At midgestation, transuteroplacental conversion of E to F (37 +/- 9) exceeded (P less than 0.05) the reverse reaction (18 +/- 3), whereas oxidation of F to E at term (28 +/- 4) was 7-fold greater (P less than 0.05) than reduction of E to F (4 +/- 1). At midgestation, essentially all of the F and E in umbilical vein was derived from maternal F. This contrasts with that observed in near-term baboons in which only 41 +/- 9% of the F and 64 +/- 8% of the E entering the fetal circulation was of maternal origin. As a result of uterine, placental, and fetal metabolism, 30% of the F and 15% of the E in maternal circulation were extracted by the uterus at both mid- and late gestation. We conclude that transuteroplacental corticosteroid metabolism changes from reduction at midgestation to oxidation at term.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489266 TI - Membrane-associated vitamin D-induced calcium-binding protein (CaBP): quantification by a radioimmunoassay and evidence for a specific CaBP in purified intestinal brush borders. AB - The vitamin D-induced intestinal calcium-binding protein (CaBP) was quantitated in membranous components of the intestinal mucosa by a specific and sensitive RIA. Inclusion of detergent (Triton X-100) in extraction buffer and in the RIA system was required to release and measure membrane-associated CaBP. Purified brush borders were shown to contain CaBP with a specific activity (micrograms per mg protein) about 12% of that in the total homogenate. By transferring proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis to nitrocellulose blots electrophoretically, CaBP was immunologically detected in brush borders from vitamin D3-treated chicks, but not in those from vitamin D3 deficient chicks. CaBP was also detected in isolated brush border membrane vesicles by the gel electrophoresis-blot transfer technique. Brush border CaBP was inaccessible to proteolytic hydrolysis by trypsin unless trypsinized in the presence of detergent. CaBP-binding substances were found to be present in purified brush borders, using the gel overlay technique. A specific binding protein with a mol wt in the range of 50,000-70,000 daltons was identified, as well as an avid CaBP binder at less than 14,000 mol wt. These observations provide evidence for the association of a significant fraction of total intestinal CaBP with brush borders in vivo, which might have physiological relevance. PMID- 6489267 TI - Progesterone production by ectopic corpora lutea is independent of luteinizing hormone-stimulated adenylyl cyclase during early luteal development in the rabbit. AB - Although estradiol is luteotropic in rabbits, corpora lutea develop and secrete progesterone in the absence of estradiol for 4-5 days. This period of estradiol independence is associated with high levels of LH-activated adenylyl cyclase and low levels of estradiol receptor. To determine if progesterone secretion is dependent on LH-stimulated adenylyl cyclase during this period of development, ectopic corpora lutea were established in ovariectomized rabbits. Rabbits were injected daily or twice daily with saline or 50, 100, or 150 IU hCG to desensitize LH-responsive adenylyl cyclase. On day 3, 4, 5, or 7, adenylyl cyclase activity was measured in luteal homogenates, and serum progesterone levels were determined by RIA. Basal and LH-stimulated adenylyl cyclase levels rose through day 5 of pseudopregnancy. Daily treatment with 50 or 100 IU hCG did not alter basal activity, but decreased LH-stimulated adenylyl cyclase activity by approximately 50% on day 3, by 80-90% on day 4, and by 90-95% on days 5 and 7. Serum progesterone levels were not different in hCG- and saline-treated rabbits. When LH-stimulated adenylyl cyclase was completely desensitized on days 3 and 4 of pseudopregnancy with twice daily injections of 150 IU hCG, serum progesterone levels were again, not different in saline- and hCG-treated rabbits. These results demonstrate that progesterone production by ectopic corpora lutea is not altered when LH-stimulatable adenylyl cyclase is desensitized and suggest that this early period of luteal development is independent of LH as well as estradiol. PMID- 6489268 TI - Control of fibronectin synthesis by rat granulosa cells in culture. AB - The secreted and cellular [35S]methionine-radiolabeled proteins of cultured rat granulosa cells were separated by electrophoresis on sodium dodecylsulfate (SDS) polyacrylamide gradient slab gels. From 24 to 72 h of culture FSH increased the intensity of labeling of most of the secreted proteins. A 220,000-dalton protein, however, increased in intensity only in control cultures and became the major secreted protein after 72 h, comprising 20% of the total radiolabeled proteins. This protein was identified as fibronectin by immunoprecipitation. There was no increase in the secreted or cellular fibronectin in FSH- or testosterone- and insulin-treated cultures. These studies indicate that a component of extracellular matrix is a major secretory product of unstimulated immature granulosa cells. As hormones induce the differentiated functions of granulosa cells in culture, the secretion of fibronectin is inhibited. PMID- 6489269 TI - Blind pan-esophageal brush cytology. Diagnostic accuracy. AB - A non-endoscopic abrasive panesophageal method of detecting malignant cells is described. This method showed a high specificity and an acceptable sensitivity as compared with endoscopic abrasive guided cytology, and is suitable for screening patients at risk of developing esophageal malignancy, and in the follow-up of patients who have undergone radical surgery. PMID- 6489270 TI - Endoscopic treatment of scar stenosis in the upper GI tract. AB - Short cicatricial stenoses following surgery of the upper gastrointestinal tract are difficult to treat and have a high recurrence rate. A method of eliminating stenoses endoscopically with the aid of diathermy is described. This method has, to date, been employed in 51 patients, and only a single serious complication has been observed. The procedure can thus be recommended, since reoperation with resection of the anastomosis is associated with a very high rate of complications. A new method of treating scar stenosis in the upper GI tract, which develops in particular after surgical anastomosis of the esophagus, is described, in 51 patients this method helped replace bougienage. This method obviates the need for life-long, unpleasant dilatation with the bougie in the mostly elderly patients. PMID- 6489271 TI - Gastric stump carcinoma following Billroth II resection for peptic ulcer disease. Comparison with cancer in non-operated stomach. AB - 40 gastric stump carcinomas have been investigated. The results are compared with 72 gastric carcinomas without preceding Billroth II resection. The aim of this study was to contribute to our knowledge about the pathogenesis of gastric stump carcinoma. The mean age of patients with gastric stump carcinoma and with carcinoma without preceding Billroth II resection is identical. The age distribution, too, is similar in both groups. Furthermore the time of the Billroth II resection for benign peptic ulcer shows no correlation with the appearance of the gastric stump carcinoma, which suggests that there is no constant time lag between Billroth II resection and stump carcinoma. The histological investigation of the tumor-free gastric mucosa shows similar alterations in the two groups compared. Intestinal metaplasia and cystic dilatation seems to be more common in the gastric mucosa after Billroth II resection as compared with the non-tumorous mucosa of patients without preceding Billroth II resection. But the grade of nuclear atypia in non-tumorous mucosa is identical in both groups. Interestingly enough, the frequency of the main types of gastric cancer, intestinal carcinoma and diffusely infiltrating carcinoma is very similar. Thus, both the epidemiological and histological data seem to indicate that the pathogenesis of gastric carcinoma is very similar to that of gastric carcinoma without preceding gastric surgery. The Billroth II resection does not seem to be a main factor in pathogenesis, but may have co-factorial significance. PMID- 6489272 TI - Trans-FBS-channel ventilation during the flexible bronchoscope (FBS) examination in infant. AB - The most important problem during FBS examination in infants is respiratory care. A new ventilation method using the channel of the FBS is proposed for respiratory care during FBS examination in infants. An FBS with a channel of more than 1.2 mm in diameter was directly inserted into the trachea under general anaesthesia without an orotracheal tube. The first step of this ventilation is the flushing of pure O2 into the lung as inspiration through the channel of the FBS. The second step is the aspiration of expiratory gas through the channel by a vacuum pump. Ventilation during the FBS examination is maintained by the repetition of these two steps by the operation of a stop-cock. Experiments in dogs, and clinical use showed that this method of respiratory care is effective and safe with certain limitations. Clinically, inspection with the FBS could be performed continuously for five minutes in most cases. PMID- 6489273 TI - Endoscopic microscopy of the colon. AB - The authors analyse the results of endoscopic colonomicroscopy at various magnifications in 250 patients. A study of dye absorption in different histological types of colonic tumor made it possible to establish that chromocolonoscopy is an effective method in diagnosing and differentiating some types of tumors and hyperplastic changes in the mucosa of the colon. Adenomas with severe dysplasia of the glandular epithelium, and tumors with a structure of an adenocarcinoma do not readily accept vital staining. PMID- 6489274 TI - Easier elective injection of oesophageal varices. PMID- 6489275 TI - A high-pressure injector for sclerotherapy of oesophageal varices. AB - In the intravascular sclerotherapy of oesophageal varices, the success of the procedure depends upon the precision and rapidity of injection of the sclerosant. With the aid of a high-pressure injector, which has been tested in a total of 174 sclerotherapeutic procedures, 10 ml of the sclerosant can be injected within 7 seconds, without any particular manual effort being required. PMID- 6489276 TI - Rapid test for determination of disaccharidase activities in endoscopic biopsy specimens from the small intestine. AB - We have developed a new and rapid semiquantitative method of demonstrating disaccharidase activities in biopsy specimens obtained endoscopically from the jejunum. Biopsy samples are placed in sucrose or lactose solutions. Sucrase and lactase activities are detected by testing glucose in the solutions using commercial urine glucose detection strips. PMID- 6489277 TI - Primary malignant melanoma of the oesophagus. AB - Primary malignant melanoma of the oesophagus is a rare tumour, whereas metastatic disease originating from melanomas is occasionally encountered in the upper GI tract. Two cases of endoscopically diagnosed primary esophageal melanomas are presented which were treated by surgery and radiotherapy combined with immunostimulation, respectively. PMID- 6489278 TI - Primary malignant lymphoma of the esophagus. A case report. AB - We report a rare case of primary malignant lymphoma of the esophagus. The 45-year old patient was followed up radiologically and endoscopically for 3 months prior to operation. PMID- 6489279 TI - To see or not to see, a difficult question in the ileocaecal region. AB - A case is reported in which two diagnostic procedures were used to visualize colonic pathology, i.e. radiography and endoscopy. Neither of these methods led to the correct diagnosis. This case illustrates the need to combine and integrate the information obtained with the two methods, with respect to both the localization and the nature of the pathological process. PMID- 6489280 TI - Heterotopic gastric mucosa in the rectum. AB - A case of an ulcer of the rectum in a 20-year-old patient with rectal pain and rectal bleeding is reported. Histological examination of the endoscopic biopsy showed the presence of gastric or fundic mucosa. The patient was treated with Cimetidine and alkaline drugs, with positive results. Ulcer cicatrization was verified at subsequent endoscopic examinations, and biopsies obtained at different levels of the colon revealed a normal histological picture. PMID- 6489281 TI - Epidemiological-environmental study of lead acid battery workers. I. Environmental study of five lead acid battery plants. AB - Industrial hygiene measurements were taken at five lead acid battery plants. The average of all personal samples for H2SO4 was 0.18 mg/m3 with a range of "nondetectable" to 1.7 mg/m3. Highest levels of acid were found in the charging and forming areas of the plants. Stibine and arsine were also detected in the charging and forming areas (means = 0.44 and 0.042 mg/m3, respectively). Arsenic in particulate form was also detected, but levels were low (means = 0.00083 mg/m3). The average mass median aerodynamic diameter of the acid mist as measured by cascade impactors was approximately 5 micron. Air lead results were variable with an overall average of 0.072 mg/m3 and a standard deviation of 0.11 mg/m3. PMID- 6489282 TI - Asbestos-activated peritoneal macrophages release a factor(s) which inhibits lymphocyte mitogenesis. AB - Intraperitoneal asbestos injection in mice has previously been reported to elicit an activated macrophage population. In the present study supernatants from such macrophages were tested for their effect on thymocyte mitogenesis in response to concanavalin A; control supernatants were obtained from saline- and latex elicited macrophages. Supernatants from asbestos-elicited macrophages were significantly inhibitory to thymocyte mitogenesis while saline- and latex elicited macrophages did not release significant amounts of such activity. Asbestos-activated macrophage supernatants were inhibitory in a dose-dependent way and the activity was not secreted by macrophages from mice which had received asbestos in the long term. The inhibitory activity was partially dialysable. Supernatants prepared by treating macrophages in vitro with a lethal dose of asbestos were not inhibitory suggesting that the inhibitory activity in the supernatants of asbestos-activated macrophages did not leak from dead or dying cells. The asbestos macrophage supernatant was also significantly inhibitory to mature T-cell-enriched spleen cells but had no effect on fibroblasts, suggesting that the inhibitory effect could be lymphoid cell specific. PMID- 6489283 TI - Increased hair cadmium in newborns of women occupationally exposed to heavy metals. AB - Newborn and maternal hair samples were obtained from subjects occupationally exposed to heavy metals and from matched controls. The geometric means of levels of cadmium and lead in hair from exposed mothers and of cadmium in hair from transplacentally exposed newborns were twice as high as levels present in samples from controls. There was a positive correlation between levels of cadmium in maternal and newborn's hair, but no such correlation for lead. Despite statistically significant evidence of increased exposure to cadmium, no adverse health effects were documented in the small group of exposed newborns included in this study. Problems associated with exogenous contamination of hair by heavy metals and potential advantages of hair sampling for measuring fetal exposures to heavy metals are discussed. PMID- 6489284 TI - Lack of bronchomotor response to up to 3 ppm formaldehyde in subjects with asthma. AB - A study was undertaken to determine whether exposure to concentrations of formaldehyde occasionally encountered in polluted indoor air would cause bronchoconstriction in subjects with mild asthma. In seven subjects the increase in specific airways resistance (SRaw) caused by inhalation of 1 ppm formaldehyde for 10 min was compared with the response caused by inhalation of formaldehyde free air. Also, the increase in SRaw caused by inhalation of 1 and 3 ppm formaldehyde during moderate exercise for 10 min was compared with the response caused by inhalation of formaldehyde-free air during exercise for 10 min. Inhalation of formaldehyde at rest and during exercise did not cause a significant increase in SRaw in the subjects. It is concluded that brief exposure to these concentrations of formaldehyde, even in association with moderate exercise, is unlikely by itself to cause significant bronchoconstriction in most subjects with mild asthma. PMID- 6489285 TI - Omaha childhood blood lead and environmental lead: a linear total exposure model. AB - The majority of experimental and population studies of blood lead (PbB) and environmental lead, including the Omaha study, have utilized the Goldsmith-Hexter log-log or power function model. Comparison was made of the log-log model and a linear model of total exposure to describe the Omaha Study of 1074 PbBs from children ages 1-18 years as related to air (PbA), soil (PbS), and housedust (PbHD) lead. The data fit of the linear model was statistically equivalent to the power model and the predicted curves were biologically more plausible. The linear model avoids the mathematical limitations of the power model which predicts PbB zero at PbA zero. From the Omaha data, this model, ln PbB = ln (beta 0 + B1 PbA + B2 PbS + beta 3 PbHD) predicts that PbB increases 1.92 micrograms/dl as PbA increases 1.0 microgram/m3. Since PbS and PbHD increase with PbA, however, the increases in total exposure predict a PbB increase of 4-5 micrograms/dl as PbA increases 1.0 microgram/m3. PMID- 6489286 TI - Genotoxic activity of nitrosated coal dust extract in mammalian systems. AB - The genotoxicity of coal dust extract nitrosated by NaNO2 was investigated because of an elevated incidence of gastric cancer in coal miners. Human peripheral lymphocytes were used to determine the frequency of sister chromatic exchanges (SCE) and chromosome aberrations. Chinese Hamster Ovary (CHO) cells were also used to measure SCEs. The mouse lymphoma forward mutation assay comprised the final in vitro system, while the micronucleus test on mouse bone marrow cells was used as an in vivo assay. The SCE frequency in human lymphocytes increased from 9.2 per cell in untreated cultures to 31.6 per cell in cultures treated with 10.0 microliter/ml of nitrosated coal dust extract (NCDE) (P less than .0001). Chromosome aberrations were tested during two phases of the cell cycle; the results indicate that NCDE causes an increase in aberrations in each cell phase tested. The SCE frequency in the CHO system increased from 9.0 per cell in untreated cultures to 18.0 per cell in cultures treated with 3.3 microliter NCDE per ml of medium (P less than .001). In the mouse lymphoma system, the background mutation frequency was tripled at 2.0 microliter NCDE per ml of medium. NCDE was not found to be active in the murine micronucleus assay. No consistent increase in genetic activity was observed with nonnitrosated coal dust extract alone or with NaNO2 alone. Metabolic activation greatly reduced or eliminated genetic activity. These results indicate that nitrosated coal dust extract is genetically active in in vitro mammalian systems without metabolic activation. These findings suggest that the nitrosation of ingested coal dust may be responsible for the elevated incidence of gastric cancer in coal miners. PMID- 6489287 TI - Subcellular distribution of lead in cultured rat hepatocytes. AB - A clear understanding of the sequence and molecular mechanism of the events involved in lead toxicity is hampered by a lack of information about lead compartmentation within the cell. As part of a continuing effort to identify the mechanism by which lead affects cellular functions, we examined the subcellular distribution of 210Pb in cultured hepatocytes. The cells were isolated, labeled, homogenized in sucrose-N-[(2-hydroxyethyl)piperazine]-N'-2-ethanesulfonic acid buffer, and fractionated into mitochondrial, microsomal, and cytosolic components by differential centrifugation. Complete fractionation of the cells revealed that 71% of the cellular 210Pb was associated with the mitochondria, 5% with the microsomes, and 24% with the cytosol. A modified, rapid fractionation procedure indicated that 45% of the cellular lead was associated with both the mitochondria and the cytosol and 10% with the microsomes. When the cells were separated into total particulates and cytosol with a single centrifugation, 22% of the 210Pb was associated with the soluble fraction. The process of homogenization and fractionation of the isolated hepatocytes altered the intracellular distribution of 210Pb. This experimental approach to studying the localization of lead may be compromised by the redistribution of 210Pb during the extensive centrifugations and resuspensions required for subcellular fractionation and suggests that the subcellular distribution patterns of 210Pb obtained by the fractionation of cells reflects the distribution of lead in the homogenate rather than the distribution of 210Pb in the intact cell. PMID- 6489288 TI - Changes of cardiac and respiratory rhythm in non- and tracheostomized rats exposed to nitrogen dioxide. AB - Cardiac and respiratory changes in non- and tracheostomized rats were examined during exposure to 20 ppm of NO2 for 150 min. The abnormal respiratory pattern consisted of rapid shallow breathing, deep breathing, and apnea, and the bradyarrhythmias were observed in the tracheostomized rats during exposure. Also, similar changes were seen in the nontracheostomized rats. A decrease in the heart rate (HR) was observed in both non- and tracheostomized rats. The decrease in HR was depressed by atropine injection, and the abnormal respiratory patterns were almost abolished by this drug. It was suggested, from these results, that the cardiac and respiratory abnormalities could be induced without the irritation to upper respiratory tracts, and that the vagal efferent pathway had an important role in the appearance of the abnormalities during exposure. PMID- 6489289 TI - Prenatal chlordane exposure: effects on plasma corticosterone concentrations over the lifespan of mice. AB - Developmental exposure to nonteratogenic doses of the organochlorine pesticide Chlordane has been reported to alter endocrine function of apparently normal offspring evaluated at 101 days of age (J.S. Cranmer, D.L. Avery, R.R. Grady, and J.S. Kitay, 1978, J. Environ. Pathol. Toxicol. 2, 357-369). The long-term study reported here was conducted in cohort groups of identically treated mice to determine if prenatal exposure to Chlordane had a persistent effect on endocrine function over the lifespan of the exposed offspring as determined by alterations in plasma concentrations of corticosterone at 400 and 800 days of age. Dihybrid female mice were exposed throughout gestation to 0.16 or 8.00 mg/kg/day Chlordane and endocrine function of offspring was evaluated at three timepoints in their lifespan. Adrenal production and liver reduction capacity for corticosterone (the primary glucocorticoid in rodents) and plasma concentration of corticosterone were measured at 101 days. In this and three previous studies, changes in plasma levels of corticosterone proved to be a reliable indicator of changes in adrenal and/or liver function, thus, only plasma concentrations of corticosterone were determined at 400 and 800 days of age. Plasma corticosterone concentrations of male mice prenatally exposed to the lower Chlordane dose were significantly (P less than 0.01) elevated when measured at 101 days of age. This abnormal elevation (P less than 0.05) was recorded in both dose groups when male mice were examined at 400 days of age. At 800 days of age, no differences from control were found for male offspring in the lower dose group; insufficient numbers of offspring in the higher dose group survived to be evaluated. An effect of Chlordane on corticosterone metabolism in female offspring was observed only in the 0.16 mg/kg dose group at 400 days of age when plasma concentrations of corticosterone were significantly (P less than 0.05) increased. Results suggest that prenatal exposure to nonteratogenic doses of Chlordane (1) had a significant effect on endocrine function (corticosterone control), (2) affected males more than females, and (3) produced changes (increased plasma corticosterone levels) which were detectable at adulthood and persisted into middle age. The mechanisms responsible for these persistent changes in corticosterone metabolism remain to be elucidated. PMID- 6489291 TI - Estimation of personal exposure to tobacco smoke with a newly developed nicotine personal monitor. AB - To evaluate the actual level of exposure of nonsmokers to tobacco smoke in their living environments, a convenient personal monitor of nicotine specific for tobacco smoke has been developed. The nicotine personal monitor consists of a sampler tube containing 450 mg of Uniport-S coated with silicon OV-17 and a portable sampling pump with a mechanical counter for obtaining total sampling volume. Using the personal monitor attached to a nonsmoker, ambient nicotine was collected in the sampler tube by drawing environmental air at a constant flow rate for a maximum period of 8 hr. The collected nicotine was desorbed by heating and directly transferred onto a GC column with a carrier gas. The amounts of nicotine inhaled by passive smoking in various living environments were estimated to be in the range of 0.9-40 micrograms/hr. These levels are equivalent to those from the active smoking of about 0.001-0.044 ordinary cigarettes in 1 hr. PMID- 6489290 TI - Lung clearance of neutron-activated Mount St. Helens volcanic ash in the rat. AB - To determine pulmonary deposition and clearance of inhaled volcanic ash, rats received a single 60-min, nose-only exposure to neutron-activated ash. Over a period of 128 days after exposure, the rats were sacrificed in groups of five animals. Lungs were analyzed for the radionuclide tracers 46Sc, 59Fe, and 60Co by gamma-ray spectrometry. The alveolar ash burdens, determined by the radionuclides 46Sc and 59Fe, are in good agreement for the majority of samples analyzed, indicating ash particulate levels in the lungs, rather than leached radionuclides. The ash deposition estimates based on 60Co were appreciably lower for the lungs, indicating that 60Co leached from the ash. Approximately 110 micrograms ash, or 6% of the inhaled ash, was initially retained in the deep lung. The biological half-time of the alveolar ash burden was 39 days. After 90 days, the mean lung burden had decreased to about 20% of its initial value; 128 days after exposure, about 10% remained. PMID- 6489292 TI - Growth rate of the bacterium Sphaerotilus natans in lead-containing medium and the effect of calcium ions. AB - Growth rate of bacteria Sphaerotilus natans in lead-containing medium (1 X 10(-4) M Pb2+) and bioaccumulation of lead in the bacterial cells were investigated together with the effect of calcium ions on these processes. A rapid increase in biomass was observed in the presence of calcium and lead whereas calcium alone had no visible effect on the bacterial growth. The increase in biomass in the presence of lead and calcium was accompanied by a pronounced drop in lead content in the bacterial cells. This suggests that calcium ions protect the bacterial cells against lead poisoning. PMID- 6489293 TI - Lower efficiency of DTPA in reducing cadmium retention in suckling rats. AB - The influence of age on the effectiveness of chelation therapy in enhancing cadmium elimination was studied in 1-, 2-, 8-, and 26-week-old rats. 115mCd was administered intraperitoneally, followed immediately and after 24 hr by an intraperitoneal injection of trisodium calcium diethylenetriaminepentaacetate (DTPA) (600 mumole/kg body wt). The whole body retention determined on the second, fourth, and sixth days of the experiment showed that DTPA greatly decreased cadmium retention in all age groups being about four times more effective in older than younger animals. Determination of 115mCd retention in the gut and organs also revealed that effectiveness of DTPA was lowest for the youngest age group and increased with increasing age. This effect of DTPA was more pronounced in the liver than in the kidney and brain in all age groups. These results indicate that age greatly influences chelation of cadmium and that age might be an important factor in chelation therapy in general. PMID- 6489294 TI - Differential viability of phosphoglucose isomerase allozyme genotypes of marine snails in nonionic detergent and crude oil-surfactant mixtures. AB - The effects of a nonionic detergent and of crude oil-detergent mixtures in aqueous solutions on the allozyme frequencies of phosphoglucose isomerase (Pgi) genotypes were tested in the Mediterranean marine gastropods Monodonta turbinata and M. turbiformis. Our results indicate differential survivorship of electrophoretical Pgi allozyme genotypes for both detergent alone and for crude oil-detergent mixtures. These results reflect the adaptive nature of some Pgi genotypes in these marine gastropods and seem inconsistent with the neutral theory of allozyme polymorphisms. Furthermore, these findings suggest that allozyme variants demonstrate a differential tolerance to these organic pollutants and can, therefore, be used as detectors of organic pollutants in the sea. PMID- 6489295 TI - Personal exposure to volatile organic compounds. I. Direct measurements in breathing-zone air, drinking water, food, and exhaled breath. AB - A pilot study to test methods of estimating personal exposures to toxic substances and corresponding body burdens was carried out between July and December 1980. Individual exposures to about a dozen volatile organic compounds in air and drinking water were measured for nine volunteers in Bayonne and Elizabeth, New Jersey, and for three volunteers in Research Triangle Park, North Carolina during three 3-day visits over the 6-month period. Breath samples were also collected from all subjects on each visit. Composite food samples were collected in each locality. Sampling and analytical methods for air, water, food, and breath were evaluated and found generally capable of detecting concentrations as low as 1 microgram/m3 in air and breath, and 1 ng/g in water and food. About 230 personal air samples, 170 drinking water samples, 66 breath samples, and 4 food samples (16 composites) were analyzed for the target chemicals. Ten compounds were present in air and eight were transmitted mainly through that medium. The two target trihalomethanes (chloroform and bromodichloromethane) were predominantly transmitted through water and beverages. Food appeared to be a minor route of exposure, except possibly for trichloroethylene in margarine. Seven compounds were present in more than half of the breath samples. Diurnal and seasonal variations were noted in air and water concentrations of some compounds, with summer levels generally higher. For some chemicals, weekday air exposures were significantly higher than weekend exposures. Some, but not all, of the potentially occupationally exposed individuals had significantly higher workplace exposures to several chemicals. Distributions of air exposures were closer to log normal than normal for most chemicals. Several chemicals were highly correlated with each other in personal air samples, indicating possible common sources of exposure. PMID- 6489296 TI - Metabolic changes induced by organophosphates in the piscine organs. AB - Two common fish of commercial importance viz., Channa punctatus and Heteropneustes fossilis were exposed to sublethal concentrations of malathion and dimethoate (rogor). The exposure to malathion showed a gradual decrease in glycogen content in the liver and kidney of C. punctatus whereas the cholesterol level was increased. The protein content decreased initially, but thereafter a gradual increase was observed. However, in the exposure of H. fossilis to dimethoate, there was an increase in the glycogen content both in the liver and kidney during the second week. Thereafter a decrease was noted. The protein content showed insignificant changes. The specific activity of SDH showed a sharp rise initially for 2 weeks followed by a steep decline in both the tissues. The significance of these results are discussed in light of piscine metabolism. PMID- 6489297 TI - Augmented hepatic susceptibility to malathion toxicity in rats on low-protein diets. AB - With an increasing world population, use of pesticides is unavoidable. However, indiscriminate use of these chemical agents has resulted in several incidents of human intoxication. Toxic effects of human exposure may be influenced by their nutritional status. Effects of malathion, an organophosphorus insecticide, on the hepatic lipid and protein levels and GOT, GPT, and beta-glucuronidase activities in rats maintained on 16, 6, and 1% protein diets for a period of 3 weeks is reported. The doses of malathion used were 5, 50, 250, and 500 mg/kg body wt, administered 24 hr prior to decapitation. The results obtained indicated that malathion induced alterations in enzyme activity; lipid and protein levels were further perturbed by the dietary protein deficiency. PMID- 6489298 TI - The toxic effects of heavy metals on rat bone marrow in vitro erythropoiesis: protective role of hemin and zinc. AB - The effects of gold (Au), lead (Pb), and cadmium (Cd) on rat bone marrow in vitro erythropoiesis (CFUE) were studied. Au was found to be significantly toxic to CFUE growth at concentrations as low as 10(-9) M whereas Pb and Cd displayed toxicity at 10(-7) M. Addition of Pb plus Cd in combination had a greater toxic effect on CFUE growth than when the metals were added singly, and the toxic effect of Cd was reduced when Zinc (Zn) was added in combination to the cultures. When hemin (10(-6) M) was added to cultures containing 10(-6) M Au, Pb, or Cd, CFUE numbers were obtained that were equivalent to control cultures without hemin. Thus, hemin exerted a protective effect on erythropoiesis in the presence of otherwise toxic amounts of Au, Pb, and Cd. It is concluded that Au, Pb, and Cd have toxic effects on in vitro erythropoiesis and that this toxicity may be overcome in part by Zn or hemin. The possible involvement of the heme biosynthetic and degradative pathways is discussed with respect to these results. PMID- 6489299 TI - Congenital malformations: genetic versus mechanistic factors. PMID- 6489300 TI - The relevance of red cell potassium in diagnosis. PMID- 6489301 TI - Aetiology and pathogenesis of congenital torticollis and head scoliosis in the equine foetus. AB - In 214 cases of severe dystocia in mares, of which 141 (66 per cent) were Draught horses, deviation of the head and neck, with or without torticollis, malformed head and limbs were found to be the cause of dystocia. No evidence of a genetic lethal factor was found and torticollis was often combined with scoliosis of the head and, frequently, with malformation of one or more limbs. This is considered evidence of a common aetiology and pathogenesis of the syndrome of malformation. The malformations were found to be associated with an increased incidence of caudal and, particularly, transverse presentations. These findings are presented as evidence to support the hypothesis that, during the second half of pregnancy, the narrow tip of the uterine horns provides only limited space for the developing cranial half of the foetus. The surprisingly rapid and complete anatomical and functional recovery of severe malformations of the bones of the neck, head and limbs of surviving foals, born by caesarian section, is taken as further evidence that these malformations have no genetic basis, but originate from unfavourable intrauterine conditions. PMID- 6489302 TI - Radiological investigations of osteochondrosis dissecans in Standardbred Trotters and Swedish Warmblood horses. AB - A total of 106 Standardbred Trotters and 27 Swedish Warmblood horses, with a radiological diagnosis of osteochondrosis dissecans, were studied over a six year period. The majority were young horses. No statistical difference in frequency between the sexes was demonstrated. In both breeds osteochondrosis was most common in the hock joints, the site of predilection being the distal dorsal tip of the intermediate tibial ridge. On radiographs the lesions of the hock joints were graded on a scale from 0 to 5 according to size, number and localisation of defects and visible loose bodies. The sizes of the loose bodies estimated radiologically were fairly closely correlated with those found at surgery or autopsy. PMID- 6489303 TI - Contagious equine metritis--use of gas liquid chromatography in identifying the causal agent. AB - Cellular fatty acid compositions of contagious equine metritis isolates and three reference Haemophilus equigenitalis cultures were determined by gas chromatography. The chromatographic data were standardised and normalised fatty acid methyl ester (FAME) profiles were produced. The profiles were compared visually and similarity indices were determined using a computer peak matching method. There was little difference between the profiles of the three reference strains, each strain being characterised by three major fatty acids; C 18:1, C 16:0 and 30H-C 14:0. Variations in cultural conditions had no significant effect on the FAME profiles. The identification of laboratory isolates using the technique was in agreement with the presumptive identification based on the currently recommended tests and an improvement on the confirmatory serological identification. The FAME profiles provided confirmation of identity where it was not possible to use the presently recommended serological procedures. The authors recommend the gas chromatography technique for use in the diagnostic laboratory as an adjunct to the presently accepted identification methods. PMID- 6489304 TI - Ulcerative colitis and protein losing enteropathy associated with intestinal salmonellosis and histoplasmosis in a horse. AB - Ulcerative colitis, protein losing enteropathy and intestinal histoplasmosis salmonellosis were diagnosed in a six-year-old Quarterhorse stallion. For six months before examination, the horse experienced a slow continual loss of weight. During the 17 day period of hospitalisation the horse developed progressive generalised oedema. On the 12th day of hospitalisation a severe profuse watery diarrhoea began; the horse was killed five days later. PMID- 6489305 TI - Clinicopathological studies on neurectomy in equids. AB - Clinical and pathological changes following neurectomy were studied experimentally in 46 male and female equids. Sixty-three operations were performed using either the traditional or the Fackelman and Clodius methods of neurectomy. The effect of arteriovenous ligation was studied in 12 animals and 20 angiograms were performed post mortem to study the arterial pattern of the extremities of the operated limb. Neuroma formation (31 cases) and sloughing of the hoof (five cases) were the two main untoward sequelae. Neurectomy by the technique of Fackelman and Clodius proved superior to the traditional method. No essential changes were observed after ligation of the blood vessels, except in one case where collateral circulation was established. PMID- 6489306 TI - Potassium concentration in equine red blood cells: normal values and correlation with potassium levels in plasma. AB - The concentration of potassium in plasma and in red blood cells was determined in 948 horses. The coefficient of correlation between the two parameters was low. In 436 of these horses, which were clinically healthy, the red blood cell potassium (RBCK+) levels did not fit within a normal distribution curve, but a bimodal distribution was observed with a section point at 90 mmol/litre. In 90 per cent of these normal horses, mean RBCK+ content was 97.5 mmol/litre. In the remaining 10 per cent, mean RBCK+ concentration was 93.8 mmol/litre. A subdivision into a 'low potassium group' and a 'high potassium group' was made. In 10 out of 15 horses in the 'low potassium group', bimonthly sampling over a period of one year showed that RBCK+ content remained low. In the remaining five horses an increase was observed. PMID- 6489307 TI - Relationship between potassium administration, hyperkalaemia and the electrocardiogram: an experimental study. AB - Hyperkalaemia affected the equine myocardium. The minimum plasma potassium concentration required to induce electrocardiographic changes was 6.2 mmol/litre and severe cardiotoxic effects were observed at levels of 8.0 to 10.1 mmol/litre in this experimental situation. The most consistent sign of hyperkalaemia was broadening and flattening of the P wave, which was generally associated with a change in T waves in the chest lead from negative to positive. The more pronounced the hyperkalaemia, the less pronounced the P wave and the more peaked positive the T wave. Severe hyperkalaemia was associated with various arrhythmias invariably associated with the presence of broad flat or absent P waves and upright T waves in chest leads. Caution against extrapolation from the experimental to the clinical situation must be exercised because of many complex interacting factors. Hyperkalaemia is difficult to induce experimentally and, unless associated with disease, is unlikely to occur in the horse. PMID- 6489308 TI - Observations on structure and function of the equine mitral valve. AB - The anatomy of the equine mitral valve and certain variations observed in 60 adult horses are described. The functional role of this valve, sited between the left atrium and the high pressure-generating left ventricle, is discussed in relation to its anatomical structure. A method of examining the left side of the heart post mortem is described. PMID- 6489309 TI - Relationship between intervertebral joint morphology and mobility in the equine thoracolumbar spine. AB - The anatomical features of 21 equine thoracolumbar spines, obtained from horses with clinically normal backs, were examined and the results compared with recent data on the mobility of the joint complexes of the horse's spine. The thoracolumbar spine can be divided into four regions based upon the morphology of the joint complexes: the first thoracic intervertebral joint (T1-2), the cranial and mid thoracic region (T2-T16), the caudal thoracic and lumbar region (T16-L6) and the lumbosacral joint. The mobility of the intervertebral joints in each of these regions can be related to their morphology, particularly the shape, size and orientation of the articular facets and the presence and frequent fusion of the lateral joints of the lumbar spine. The shape and thickness of the intervertebral discs also appear to be of importance. PMID- 6489310 TI - A disease resembling sweet itch in Hong Kong. PMID- 6489311 TI - Equine electrocardiography: some practical hints on technique. PMID- 6489312 TI - Metabolic costs of load carriage with different container sizes. PMID- 6489313 TI - Effects of loud noise and signal probability on visual vigilance. PMID- 6489314 TI - Trunk posture and load on the trapezius muscle whilst sitting at sloping desks. PMID- 6489315 TI - Relation between intra-abdominal pressure and lumbar moments when lifting weights in the erect posture. PMID- 6489316 TI - The energy cost and heart-rate response of trained and untrained subjects walking and running in shoes and boots. PMID- 6489317 TI - Accumulation of the isolated carboxy-terminal domain of histone H1 in the Xenopus oocyte nucleus. AB - Histone H1 accumulates in the nucleus after injection into the cytoplasm of Xenopus oocytes. A proteolytic fragment of 89 amino acids encompassing the carboxy-terminal domain also accumulates in the nucleus. Lysine, alanine and proline compose 84% of this domain. Accumulation is not due solely to the high lysine content since poly-L-lysine does not accumulate in the nucleus when injected into the cytoplasm of Xenopus oocytes. Proteolytic fragments encompassing other domains of the molecule are degraded in the oocyte after injection. In these instances degradation is more rapid in the cytoplasm than in the nucleus giving the false impression of accumulation in the nucleus, an artefact which is likely to confuse other studies of protein migration. Susceptibility to rapid degradation is a dominant feature, thus the globular domain destabilises the contiguous carboxy-terminal domain. The properties of the carboxy-terminal domain of H1 and the possible involvement of the amino acids lysine, proline and alanine in migration are discussed and compared with those of a domain that specifies migration of nucleoplasmin into the oocyte nucleus. PMID- 6489318 TI - Association of transcriptionally active vitellogenin II gene with the nuclear matrix of chicken liver. AB - Supercoiled DNA loops linked to the nuclear matrix can be progressively cleaved with deoxyribonuclease I. The DNA which remains associated with the nuclear matrix can be purified and analysed for vitellogenin II sequence content by dot blot hybridization. Using this technique we show that vitellogenin II gene sequences are selectively associated with the nuclear matrix of liver but not with oviduct of laying hens. Following primary stimulation in immature chicks of vitellogenin synthesis with estradiol, the association of the gene with the nuclear matrix precedes vitellogenin mRNA synthesis. After 15 days when the level of vitellogenin mRNA has returned to zero, the gene is no longer preferentially associated with the nuclear matrix. At this time a second stimulation with estradiol results in a reassociation of the vitellogenin II gene with the nuclear matrix. In addition to the structural gene, both the 3' and 5' end flanking regions (1.5-2 kb) also bind to the nuclear matrix. However, beyond the limit of 1.5-2 kb upstream from the 5' end of the gene, there is no preferential binding of DNA to the nuclear matrix. PMID- 6489319 TI - Synthetic donor and acceptor splice sites function in an RNA polymerase B (II) transcription unit. AB - We have synthesised a 32-bp oligonucleotide containing sequences conforming to the consensus sequences for donor and acceptor splice sites. The oligonucleotide has been inserted into an RNA polymerase B (II) transcription unit and the resulting recombinant used to study the splicing mechanism. Our findings are as follows: (i) the synthetic sites function when separated by several different prokaryotic or eukaryotic DNA fragments providing bulk intron sequence, (ii) intron size need not be greater than 29 bp, (iii) an AG dinucleotide 11 bp upstream from the invariant AG of an acceptor splice site renders the latter non functional, and (iv) sequence changes distant from splice sites can affect the efficiency of their utilisation. PMID- 6489320 TI - Host defence mechanisms, antibiotics and immunosuppressive agents--a complex relationship. PMID- 6489321 TI - Modified microdilution susceptibility test for staphylococci, streptococci and Haemophilus spp. PMID- 6489322 TI - In vitro susceptibility of Mycobacterium fortuitum and Mycobacterium chelonei to sulfadiazine, sulfisoxazole and sulfathiazole. PMID- 6489323 TI - A latex agglutination technique for rapid, direct identification of pneumococci in blood cultures. PMID- 6489324 TI - Susceptibility of Campylobacter fetus subsp. jejuni to paromomycin. PMID- 6489325 TI - Antibacterial activity of ciprofloxacin in conventional tests and in a model of bacterial cystitis. AB - In conventional in vitro tests and an experimental bladder model ciprofloxacin proved very active against 103 strains of enterobacteria isolated from infected urine. Nalidixic acid-resistant strains were less susceptible to ciprofloxacin than nalidixic acid-sensitive strains, and the activity of the drug was reduced under acid conditions. Nevertheless, all strains were inhibited by 4 mg/l of ciprofloxacin at pH 5.5. Streptococcus spp., Staphylococcus aureus, Pseudomonas aeruginosa and Bacteroides spp. were less susceptible than enterobacteria, although most strains were inhibited by a therapeutically achievable concentration of 2 mg/l. Under conditions simulating the treatment of bacterial cystitis, changing concentrations of ciprofloxacin well within levels achievable in urine inhibited dense bacterial cultures for periods exceeding 24 hours, and surviving bacteria did not exhibit any reduction in susceptibility. PMID- 6489326 TI - Pharmacokinetics of ciprofloxacin after oral and intravenous administration in healthy volunteers. AB - The pharmacokinetics of ciprofloxacin (Bay o 9867) was examined after a single oral dose of 250 mg and a single intravenous dose of 100 mg respectively in six healthy male volunteers in an open, randomized crossover study. Although ciprofloxacin concentrations were measured in serum, plasma and urine by HPLC with fluorimetric detection and by microbiological assay, all pharmacokinetic calculations are based on the highly sensitive HPLC method only. The mean serum concentration of ciprofloxacin peaked approximately 1 h after the oral dose (0.94 mg/l). The elimination half-life was about 4 h and the renal clearance was 4.75 ml/min . kg; both were independent of the route of administration. The total clearance (9.62 ml/min . kg) was about twofold higher than the renal clearance. The volume of distribution of the central compartment was calculated to be 0.161 l/kg and the total volume at steady state was 2.0 l/kg. About 27% of the oral dose was excreted in urine, whereas the urinary recovery of the i.v. dose was 46%. The absolute bioavailability of ciprofloxacin was found to be approximately 60%. Ciprofloxacin appears to follow first-order, three compartment model kinetics. PMID- 6489327 TI - Diffusion of ciprofloxacin into prostatic fluid. AB - To determine whether ciprofloxacin might be efficacious in therapy for chronic bacterial prostatitis, its diffusion into prostatic fluid was studied in ten healthy volunteers. One hour after administering 500 mg ciprofloxacin, the concentration of ciprofloxacin was measured by the agar diffusion method and bioassay. Serum levels were twice as high as in seminal fluid; however, 12 and 24 hours later concentration in seminal fluid was tenfold higher than in serum. Split ejaculates were examined to determine the secretory pattern of ciprofloxacin into seminal fluid. The two fractions also showed tenfold concentration. Ciprofloxacin concentration in expressed prostatic secretion ranged from 15 to 0.9 mg/l, thus indicating pronounced diffusion of ciprofloxacin into the prostatic fluid. PMID- 6489328 TI - Dose- and sex-independent disposition of ciprofloxacin. AB - Serum concentrations and urinary excretion of ciprofloxacin were studied in female and male volunteers following a single oral administration of 100 mg, 250 mg, 500 mg or 1000 mg. Serum and urine concentrations increased proportionally to the increasing dose administered but independently of sex. Twenty-five percent of the administered dose was excreted in the urine as unmetabolized ciprofloxacin within the first 24 hours after oral administration. Renal clearance averaged 5 ml/min X kg. PMID- 6489329 TI - In vitro activity of ciprofloxacin against Brucella melitensis. PMID- 6489330 TI - Susceptibility of Legionella spp. to quinolone derivatives and related organic acids. PMID- 6489331 TI - Purification and characterization of tomato polygalacturonase converter. AB - Extracts of ripe tomatoes contain two forms of polygalacturonase (PG I and PG II). A heat-stable component that binds PG II to produce PG I has been isolated from tomato fruit. This component has been named polygalacturonase converter (PG converter). The PG converter has been purified by gel filtration, ion-exchange chromatography and chromatofocusing. It appears to be a protein with a relative molecular mass of 102000. It was readily inactivated by papain and pronase. The converter was labile at alkaline conditions, and treatment of PG I at pH 11 released free PG II. A similar factor with a lower molecular mass was extracted from tomato foliage. PMID- 6489332 TI - Apolipoprotein A-IGiessen (Pro143----Arg). A mutant that is defective in activating lecithin:cholesterol acyltransferase. AB - Apolipoprotein A-IGiessen is a variant form of apo A-I that is displaced from the corresponding normal A-I isoforms on isoelectric focusing gels by a single charge unit towards the cathode [Utermann et al. (1982) J. Biol. Chem. 257, 501-507]. Three subjects heterozygous for the variant were detected in one family. The percentage of the total A-I in plasma represented by the A-IGiessen in these subjects ranged over 25-30%. The variant and normal major A-I isoforms from the proband (Y.J.) were purified by preparative isoelectric focusing and cleaved with CNBr. Analytical focusing of CNBr fragments demonstrated a charge difference between CB3Giessen and normal CB3. Sequence analysis of CB3Giessen revealed that a proline existing in normal A-I was replaced by an arginine in the variant A-I at residue 143. The ability of the mutant A-I to activate purified lecithin:cholesterol acyltransferase was determined in vitro. The cofactor activity of [Arg143]apolipoprotein A-I was about 60-70% of that demonstrated by control A-I. Residue 143 is in a putative beta-turn between two of the repeating amphiphilic helices in apolipoprotein A-I and may be a critical determinant of the protein's structure and function. PMID- 6489333 TI - Low pH induces a hydrophobic domain in the tetanus toxin molecule. AB - Binding of the non-ionic detergent [3H]Triton X-100 by tetanus toxin, by its fragment C and by its alpha chain has been studied. At pH 4.00 or above, tetanus toxin does not bind Triton X-100. At pH lower than 4.00, binding of detergent to the toxin occurs. At pH 3.00, a maximum of 100 mol bound/mol of protein is reached only when the detergent concentration exceeds its critical micelle concentration. No measurable amount of Triton X-100 is bound by the toxin C fragment at pH 3.00. Most of the tetanus toxin alpha chain precipitates out in Triton X-100 at pH 3.00. Leakage of K+ from single-walled asolectin vesicles loaded with potassium was observed with tetanus toxin at pH lower than 4.00. When ganglioside GDlb was present on the asolectin vesicles, release of K+ was obtained with tetanus toxin between pH 4.00 to 5.00. We suggest that, as for diphtheria toxin, entry of tetanus toxin into an acidic compartment of target cells might be required for the expression of its biological activity. PMID- 6489334 TI - Neuronal nuclei and glial nuclei from mammalian cerebral cortex. Nucleosome repeat lengths, DNA contents and H1 contents. AB - We have characterised the histone and DNA contents of neuronal and glial nuclei from ox cerebral cortex which have, respectively, repeat lengths of 162 base pairs and 201 base pairs. Although the neuronal population cannot be obtained completely free of glial nuclear contamination, the degree of contamination is easily determined by counting, and has been allowed for in all the methods used here. By diphenylamine assay and flow cytofluorometry we find that the DNA contents of both nuclear types are essentially equal, and equivalent to the diploid value, contrary to some reports. By quantification of the core histones in known numbers of nuclei with respect to an added external standard, we have shown that the ratio of core histone octamers in the two nuclear types, neuronal and glial, is the inverse of the ratio of repeat lengths. Thus the same proportion of DNA is associated with core histone octamers in the two nuclear types, most simply all of the DNA. By complete radiolabelling of the lysine side chains of the histones with methyl [1-3H]acetimidate we have determined the stoichiometry of H1 relative to the core histones. Neuronal nuclei have a low H1 content of 0.45 molecule H1/nucleosome on average; glial nuclei have the 'normal' 1 H1 molecule/nucleosome. In neuronal nuclei about half of the nucleosomes therefore probably lack H1. Whether there is any relation between the low H1 content and the short DNA repeat length of neuronal nuclei, on the one hand, and their high transcriptional capacity (at least when assayed in vitro), on the other, remains to be established. PMID- 6489335 TI - The amino acid sequence of sarcoplasmic calcium-binding protein obtained from sandworm, Perinereis vancaurica tetradentata. AB - The amino acid sequence of sarcoplasmic calcium-binding protein obtained from sandworm (Perinereis vancaurica tetradentata) has been determined. It is composed of 174 amino acid residues, its N-terminus is blocked by an acetyl group and the relative molecular mass is calculated to be 19556. From the results of amino acid sequence, it has three EF-hand-type calcium-binding sites. The positions of calcium-binding sites could be easily predicted by its hydropathy profile. Amino acid sequence homology between sarcoplasmic calcium-binding protein from different species is between 14-20%, thus it is not such a conservative protein. PMID- 6489336 TI - Gluconeogenesis predominates in periportal regions of the liver lobule. AB - Rates of gluconeogenesis from lactate were calculated in periportal and pericentral regions of the liver lobule in perfused rat livers from increases in O2 uptake due to lactate. When lactate (0.1-2.0 mM) was infused into livers from fasted rats perfused in either anterograde or the retrograde direction, a good correlation (r = 0.97) between rates of glucose production and extra O2 uptake by the liver was observed as expected. Rates of oxygen uptake were determined subsequently in periportal and pericentral regions of the liver lobule by placing miniature oxygen electrodes on the liver surface and measuring the local change in oxygen concentration when the flow was stopped. Basal rates of oxygen uptake of 142 +/- 11 and 60 +/- 4 mumol X g-1 X h-1 were calculated for periportal and pericentral regions, respectively. Infusion of 2 mM lactate increased oxygen uptake by 71 mumol X g-1 X h-1 in periportal regions and by 29 mumol X g-1 X h-1 in pericentral areas of the liver lobule. Since the stoichiometry between glucose production and extra oxygen uptake is well-established, rates of glucose production in periportal and pericentral regions of the liver lobule were calculated from local changes in rates of oxygen uptake for the first time. Maximal rates of glucose production from lactate (2 mM) were 60 +/- 7 and 25 +/- 4 mumol X g-1 X h-1 in periportal and pericentral zones of the liver lobule, respectively. The lactate concentrations required for half-maximal glucose synthesis were similar (0.4-0.5 mM) in both regions of the liver lobule in the presence or absence of epinephrine (0.1 microM). In the presence of epinephrine, maximal rates of glucose production from lactate were 79 +/- 5 and 59 +/- 3 mumol X g-1 X h-1 in periportal and pericentral regions, respectively. Thus, gluconeogenesis from lactate predominates in periportal areas of the liver lobule during perfusion in the anterograde direction; however, the stimulation by added epinephrine was greatest in pericentral areas. Differences in local rates of glucose synthesis may be due to ATP availability, as a good correlation between basal rates of O2 uptake and rates of gluconeogenesis were observed in both regions of the liver lobule in the presence and absence of epinephrine. In marked contrast, when livers were perfused in the retrograde direction, glucose production was 28 +/- 5 mumol X g-1 X h-1 in periportal areas and 74 +/- 6 mumol X g-1 X h-1 in pericentral regions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489337 TI - Biosynthesis of enzymes of rat-liver mitochondrial beta-oxidation. AB - The biogenesis of seven enzymes involved in the mitochondrial fatty acid beta oxidation of rat liver was studied. Hepatic RNA was translated in vitro in a rabbit reticulocyte lysate cell-free system and the translation products were immunoprecipitated, subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and visualized by fluorography. The translation products obtained in vitro of medium-chain and/or long-chain acyl-CoA dehydrogenase (these enzymes were immunochemically cross-reactive), enoyl-CoA hydratase, 3-hydroxyacyl-CoA dehydrogenase, and acetoacetyl-CoA thiolase and probably also short-chain acyl CoA dehydrogenase were larger than the subunits of the corresponding mature enzymes by 2-4.5 kDa, whereas the 3-oxoacyl-CoA thiolase obtained in vitro was approximately the same size as the mature subunit. The free polysome fraction of rat liver was 4.3-9.0-times more active than the membrane-bound polysome fraction in the synthesis of these seven enzymes. The enzyme activities were increased after administration of di(2-ethylhexyl)phthalate; the extent of the increase varied from one enzyme to another. The increase in the cell-free translation activity of total hepatic RNA for these enzymes after administration of the chemical was markedly different among individual enzymes and higher than that in the rates of synthesis of the corresponding enzymes which were determined by the experiment in vivo. PMID- 6489338 TI - Simultaneous purification of hexokinase, class-I fructose-bisphosphate aldolase, triosephosphate isomerase and phosphoglycerate kinase from Trypanosoma brucei. AB - A method is presented for the simultaneous purification of hexokinase, fructose bisphosphate aldolase, triosephosphate isomerase and phosphoglycerate kinase, and the partial purification of glycerol-3-phosphate dehydrogenase (NAD+), 6 phosphofructokinase, glucosephosphate isomerase, and glycerol kinase from Trypanosoma brucei. As a first step, the glycosomes, microbody-like organelles of Trypanosomatidae, containing almost exclusively enzymes involved in glucose and glycerol metabolism [Opperdoes, F. R. and Borst, P. (1977) FEBS Lett. 80, 360 364], were purified eightfold from homogenates with an average yield of 38%. Subsequently, the glycosomal content was subjected to hydrophobic interaction chromatography on phenyl-Sepharose. This step results in pure hexokinase (15% final yield) and almost pure triosephosphate isomerase, while the other glycosomal enzymes elute as mixtures of two or three enzymes. Triosephosphate isomerase was further purified to homogeneity on CM-cellulose (33% final yield), while phosphoglycerate kinase and fructose-bisphosphate aldolase were separated from each other and purified to homogeneity by affinity chromatography using ATP Sepharose (25% and 30% final yields, respectively). Fructose-bisphosphate aldolase was further characterized as a typical class I enzyme. PMID- 6489339 TI - Mechanism of rate control of the NADPH-dependent reduction of cytochrome P-450 by lipids in reconstituted phospholipid vesicles. AB - The NADPH-supported reduction of cytochrome P-450 LM2 (liver microsomal isozyme 2) in reconstituted phospholipid vesicles in general exhibits two-exponential kinetics. The physiologically relevant rapid partial reaction is favoured in amount with increasing reductase/P-450 ratio. A lipid specificity was observed in that negatively charged lipids favour that process, too. The rate constant increases concomitantly. The data are consistent with the formation of a reactive 1:1 complex the amount of which determines the rate constant. The dissociation constants amount to 0.048 microM for a microsomal lipid extract, 0.051 microM for a 3:1 (w/w) mixture of dioleoylglycerophosphoethanolamine and phosphatidylserine, and 0.47 microM for dioleoylglycerophosphocholine, respectively, in the respective reconstituted systems. At low reductase/P-450 ratio the amount of the rapidly reduced P-450 exceeds the equilibrium concentration of a 1:1 complex. Preformed 1:1 associates, therefore, cannot fit the derived mechanism. Instead, a cluster model based on P-450 association does correspond to the data. PMID- 6489340 TI - Comparison of spectrin isolated from erythroid and non-erythroid sources. AB - Spectrin from erythrocytes and two other tissues (brain and intestine) were isolated from two distant species, pig and chicken; some structural and functional properties were compared. A quantitative antibody inhibition assay was used to determine that antibodies to mammalian red cell spectrin cross-react very poorly, if at all, with their non-erythroid (brain) counterpart and similarly antibodies to pig brain spectrin (fodrin) cross-react very weakly with erythroid spectrin. By contrast, antibodies which were directed against the 240000-Mr subunit of avian fodrin were completely inhibited with avian spectrin and vice versa. To analyze the structural relatedness of these molecules further we compared the chymotryptic iodinated peptide maps generated from each individual subunit. Consistent with the antibody results, we find little (less than 10%) homology between peptides derived from mammalian fodrin and spectrin, but complete homology (100%) of the peptides derived from the 240000-Mr subunits of chicken fodrin, spectrin and another related molecule from intestine, TW260/240. Whereas the peptide maps of fodrin (brain spectrin) revealed striking similarity between divergent species, suggesting a high degree of structural conservation, the peptide maps of erythrocyte spectrin was highly variable between species, indicating that it has diverged considerably in mammalian evolution. In addition we have compared a functional activity of mammalian spectrins, the ability to bind calmodulin, using two different assays. Both results show that, whereas fodrin-calmodulin interaction can be readily demonstrated, the binding to mammalian erythroid spectrin is negligible. This suggests that the high-affinity calmodulin site present on fodrin has been lost from spectrin in mammalian evolution. PMID- 6489341 TI - Influence of cyanogen-bromide-digested fibrinogen on the kinetics of plasminogen activation by urokinase. AB - The catalytic efficiency (kcat/Km) of high-molecular-mass urokinase for the activation of Glu-plasminogen is increased about 10-fold in the presence of CNBr digested fibrinogen. This stimulation is similar to that observed with 6 aminohexanoic acid, and yields kinetic parameters comparable to those for the activation of Lys-plasminogen by urokinase. The increase of the activation rate of Glu-plasminogen by urokinase in the presence of CNBr-Fg can thus be explained by a conformational change in the plasminogen molecule similar to that observed upon conversion of Glu-plasminogen to Lys-plasminogen and upon binding of 6 aminohexanoic acid to Glu-plasminogen. Stabilization of the Michaelis complex between urokinase and plasminogen by formation of a cyclic ternary complex with CNBr-Fg, which has been invoked to explain the dramatic stimulatory effect of CNBr-Fg on the activation of plasminogen by tissue-type plasminogen activator, does not appear to play a significant role in the increased activation rate. PMID- 6489342 TI - Electron microscopic studies on liver 5-aminolaevulinate synthase. AB - The structure of chick embryo liver 5-aminolaevulinate synthase has been examined by electron microscopic studies using negative staining. From the different projections of the enzyme particles observed in electron micrographs, a model for the enzyme molecule has been proposed. In this model, an enzyme molecule consists of two curved and identical subunits associated in opposite polarities. From the dimensions of an enzyme molecule subunit measured from electron micrographs, the relative molecular mass of each subunit is estimated to be 70 000. PMID- 6489343 TI - Muscarinic cholinergic receptor of rat brain. Factors influencing migration in electrophoresis and gel filtration in sodium dodecyl sulphate. AB - The muscarinic cholinergic receptor present in synaptosomal membranes of rat brain was covalently labelled with the alkylating muscarinic antagonist, tritiated propylbenzilylcholine mustard. The labelled receptor was then solubilized in sodium deoxycholate and sodium dodecyl sulphate, and its migration in polyacrylamide gel electrophoresis and gel filtration in the presence of sodium dodecyl sulphate analysed. Provided both proteolysis and inter-chain disulphide bond formation were vigorously prevented, the receptor from rat forebrain (cerebral cortex plus caudate putamen) migrated, in sodium dodecyl sulphate/polyacrylamide gel electrophoresis, as a broad band of apparent Mr 66000 76000. Two dominantly labelled polypeptides, of apparent Mr 68000 and 73000, could be distinguished as the major components of this band. These multiple species seen in electrophoresis may reflect a structural diversity related to the different binding properties, and modes of action, of this receptor. In electrophoresis using discontinuous buffer systems the labelled receptor readily formed intermolecular disulphide bonds and so aggregated. In particular, if solubilized membranes were reduced with 2-mercaptoethanol, and reformation of disulphide bonds during electrophoresis not prevented, then formation of a dimeric species (apparent Mr 119000-128000) occurred. This probably explains previous reports in the literature of larger-Mr species seen in electrophoresis. During gel filtration, the receptor formed intra-chain disulphide bonds which produced conformational heterogeneity, leading to polydisperse migration. In addition, extensive proteolytic degradation of the receptor occurred due to a protease migrating slightly ahead of the receptor. Both effects were eliminated by alkylation of the solubilized membranes with iodoacetamide before gel filtration. Alkylated receptor migrated on Sephacryl S-300 in 0.5% sodium dodecyl sulphate with an equivalent Stokes' radius of 6.1 nm. This is identical to that of reduced ovalbumin, a molecule with an apparent Mr in gel electrophoresis of 43000. On a different gel matrix, TSK HW 55(S), the receptor migrated with a somewhat larger Stokes' radius, eluting just behind reduced bovine serum albumin (Stokes' radius 8.5 nm; apparent Mr in electrophoresis 67000). Thus the receptor appears to adsorb to the Sephacryl matrix, although even on the TSK gel the receptor eluted as a somewhat smaller protein than expected from its behaviour in gel electrophoresis. Solubilized, alkylated receptor, partly purified by gel filtration so that it was not degraded by endogenous proteases, was not cleaved by mild hydroxylamine treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489344 TI - Requirement of the 20-kDa light chain for the papain-resistant conformation of gizzard myosin. AB - The limited chymotryptic digestion of unphosphorylated gizzard myosin in 0.15 M NaCl converted a papain-insensitive myosin in ATP to a papain-sensitive one. This conversion without phosphorylation of its 20-kDa light chain was accompanied with truncation of a 200-kDa heavy chain to a 195-kDa fragment and with the degradation of a 20-kDa light chain. Papain also yielded the 195-kDa fragment from the heavy chain, irrespective of the presence or absence of ATP. However, the ATP-induced protection of unphosphorylated myosin from the papain-digestion disappeared concurrently with degradation of the 20-kDa light chain by papain rather than the truncation of heavy chain. Papers from two laboratories [Onishi, H. & Watanabe, S. (1984) J. Biochem. (Tokyo) 95, 903-905; Kumon, A., Yasuda, S., Murakami, N., and Matsumura, S. (1984) Eur. J. Biochem. 140, 265-271] have reported that the ATP-protection of unphosphorylated myosin against papain is not observed after the 20-kDa light chain has been phosphorylated. The present results might indicate that the ATP-induced protection is also abolished through the chymotryptic degradation of the 20-kDa light chain. PMID- 6489345 TI - Penicillin-binding proteins of Streptococcus pneumoniae: characterization of tryptic peptides containing the beta-lactam-binding site. AB - Penicillin-binding proteins of Streptococcus pneumoniae were labeled with [3H] propionyl-ampicillin and treated with trypsin. The fragments were separated on sodium dodecyl sulfate/polyacrylamide gels, and peptides containing the beta lactam-binding site visualized by fluorography. From native penicillin-binding proteins (PBP), either membrane-bound or solubilized with Triton X-100, relatively stable end products of proteolysis were obtained. The smallest radioactive peptides from PBP 1a (92 kDa), PBP 2b (77 kDa), and PBP 3 (43 kDa ) had sizes of 36.5 kDa, 26 kDa, and 29 kDa, respectively. When the PBP were trypsin treated prior to labeling with the radioactive beta-lactam, these small peptides were still able to bind the antibiotic. Under conditions of limited proteolysis, membrane-bound PBP 2b and PBP 3 were converted into soluble, hydrophilic derivatives after loss of a peptide of only 2 kDa and 1.5 kDa, respectively. These two PBP are therefore anchored in the membrane by a small terminal peptide. In contrast, PBP 1a could be digested to a Mr of 48000 without becoming water-soluble; the only hydrophilic tryptic peptide that could be found was the 36.5 kDa fragment. Therefore, large domains of this PBP seem to be embedded in the membrane. PMID- 6489346 TI - Activation of potassium ion transport in mitochondria by cadmium ion. AB - Low levels of Cd2+ (1-5 microM) produce rapid swelling of mitochondria, which is respiration-dependent and uncoupler-sensitive. No cation requirement is apparent, since the swelling occurs in a medium containing only sucrose and the respiratory substrate. The swelling is inhibited by ruthenium red, suggesting that this effect of Cd2+ requires its entry into mitochondria. In medium containing 9 mM K+, addition of Cd2+ along with ruthenium red increases the rate of K+ influx threefold. In the presence of K+, Rb+ or Li+, but not of Na+, addition of Cd2+ produces first efflux of H+ into the medium followed by discharge of the pH gradient or uncoupling. Only the latter effect is inhibited by ruthenium red, showing that the efflux and influx of H+ are independent reactions. The H+ efflux appears to be an antiport response to the induced K+ entry. Its activation by Cd2+ is similar to the known effect of p-chloromercuriphenyl sulfonate. The H+ influx or uncoupling appears to result from binding of Cd2+ to some matrix-facing membrane site, perhaps the dithiol group on coupling factor B, and may relate to apparent permeability changes associated Cd2+-induced swelling. PMID- 6489347 TI - Structure of the lipopolysaccharide core isolated from a human strain of Aeromonas hydrophila. AB - Lipopolysaccharide was isolated from the cell-walls of a human strain of Aeromonas hydrophila by the aqueous phenol method in 0.58% yield (based on dry weight of bacteria). The lipopolysaccharide consisted of SR-polysaccharide, core oligosaccharide and lipid A; there was no O-specific polysaccharide. The core had the composition D-galactose, D-glucose, D-glycero-D-manno-heptose, L-glycero-D manno-heptose and D-glucosamine in a molar ratio of 1:1:2:4:1. Glucosamine was linked to an L-glycero-D-manno-heptose residue by a bond which was resistant to hydrolysis. The D-glucosamine-(1----7)-LD-heptose disaccharide was isolated and identified by the mass spectrum of its methylated alditol and the heptose residue not observed under normal hydrolysis conditions was easily determined after deamination of the complete core. Methylation analysis, chemical degradation, periodate and chromium trioxide oxidations and nuclear magnetic resonance (13C and 1H NMR) spectroscopy were used to identify the structure of the core oligosaccharide as: (formula: see text) PMID- 6489348 TI - Characterization of ATP-dependent Ca2+ uptake by canine brain microsomes with saponin. AB - ATP-dependent Ca2+ uptake by brain microsomes was classified into two fractions according to the sensitivity to saponin. Properties of each fraction of Ca2+ uptake were examined and compared with those of inside-out membrane vesicles of erythrocyte and cardiac sarcoplasmic reticulum. The concentration of saponin for 50% inhibition (IC50) of major saponin-sensitive Ca2+ uptake was 11 micrograms/ml, and this uptake was enhanced by calmodulin. The minor saponin insensitive Ca2+ uptake fraction (IC50; 90 micrograms/ml) was not affected by calmodulin but was enhanced by oxalate or 0.1 M KCl. The IC 50 of saponin for inside-out membrane vesicles of erythrocyte and cardiac sarcoplasmic reticulum was 11.3 and 114.8 micrograms/ml, respectively. A characteristic ring-like saponin-cholesterol micellar structure was observed electron microscopically in most membrane vesicles of brain microsomes and erythrocyte membrane vesicles but not in the cardiac sarcoplasmic reticulum. These observations indicate that saponin-sensitive and insensitive Ca2+ uptake was derived from plasma membranes and endoplasmic reticulum, respectively. Saponin proved useful for distinguishing the Ca2+ transport activity of plasma membrane from the Ca2+ uptake of other cellular organelles in the membrane preparations. PMID- 6489349 TI - Thrombospondin interactions with fibronectin and fibrinogen. Mutual inhibition in binding. AB - Thrombospondin synthesized and secreted by human endothelial cells in culture binds specifically to fibronectin immobilized on Sepharose beads. It can also bind to immobilized platelet-derived thrombospondin but not to immobilized gelatin or albumin. These interactions are not dependent on the presence of divalent cations or of other secreted materials. Purified platelet thrombospondin binds to fibronectin and fibrinogen immobilized on plastic surfaces with dissociation constants of 1.12 +/- 0.37 X 10(-7) M and 1.27 +/- 0.41 X 10(-7) M respectively, and to thrombospondin immobilized on plastic with dissociation constant of 4.82 +/- 1.01 X 10(-7) M. The affinities of interaction are not significantly affected by removal of divalent cations. Soluble fibrinogen inhibits binding of thrombospondin to fibronectin regardless of which of the latter two is surface-bound. Thrombospondin-fibronectin interaction is also inhibited by soluble thrombospondin. The binding of soluble thrombospondin to surface-bound fibrinogen is inhibited both by soluble fibronectin and soluble fibrinogen. These results suggest that thrombospondin plays a role both in platelet-platelet aggregation and in platelet-substratum adhesion, and that it may also take part in the construction of the extracellular matrix. PMID- 6489350 TI - Suppression of kinetic cooperativity of hexokinase D (glucokinase) by competitive inhibitors. A slow transition model. AB - Hexokinase D ('glucokinase') displays positive cooperativity with mannose with the same h values (1.5-1.6) as with glucose but with higher K0.5 values (8 mM at pH 8.0 and 12 mM at pH 7.5). In contrast, fructose and 2-deoxyglucose exhibit Michaelian kinetics [Cardenas, M. L., Rabajille, E., and Niemeyer, H. (1979) Arch. Biol. Med. Exp. 12, 571-580; Cardenas, M. L., Rabajille, E., and Niemeyer, H. (1984) Biochem. J. 222, 363-370]. Mannose, fructose, 2-deoxyglucose and N acetylglucosamine acted as competitive inhibitors of glucose phosphorylation and decreased the cooperativity with glucose. Their relative efficiency for reducing the value of h to 1.0 was: fructose greater than mannose greater than 2 deoxyglucose greater than N-acetylglucosamine. Galactose, which is not a substrate nor an inhibitor, was unable to change the cooperativity. The competitive inhibition of glucose phosphorylation by N-acetylglucosamine or mannose was cooperative at very low glucose concentrations (less than 0.5 K0.5), suggesting the interaction of the inhibitors with more than one enzyme form. These and previously reported results are discussed on the basis of a slow transition model, which assumes that hexokinase D exists mainly in one conformation state (E1) in the absence of ligands and that the binding of glucose (or mannose) induces a conformational transition to EII. This new conformation would have a higher affinity for the sugar substrates and a higher catalytic activity than EI. Cooperativity would emerge from shifts of the steady-state distribution between the two enzyme forms as the sugar concentration increase. The inhibitors would suppress cooperativity with glucose by inducing or trapping the EII conformation. In addition, the model postulates that the different kinetic behaviour of hexokinase D with the different sugar substrates, cooperative with glucose and mannose and Michaelian with 2-deoxyglucose and fructose, is the consequence of differences in the velocities of the conformational transitions induced by the sugar substrates. PMID- 6489351 TI - The structure of a novel polysaccharide isolated from Zymomonas mobilis determined by nuclear magnetic resonance spectroscopy. AB - A novel polysaccharide has been observed in vivo by 13C nuclear magnetic resonance (NMR) spectroscopy of the gram-negative bacterium, Zymomonas mobilis. The polysaccharide, which was not removed from the Z. mobilis cell by washing with 0.86% saline, was extracted by mild acid treatment. The structure was elucidated by a combination of NMR techniques, including proton and proton-carbon two-dimensional methods. The structure was determined to be -alpha fructofuranosyl-(2-1)-beta-fructofuranosyl-(2-6)-. The polysaccharide is unlike levan, a beta-(2-6)-fructose polymer which is produced by many bacteria, including Z.mobilis, when grown on sucrose. The polysaccharide isolated here is produced by cells cultured on glucose, fructose or sucrose. PMID- 6489352 TI - Induction of chalcone isomerase in elicitor-treated bean cells. Comparison of rates of synthesis and appearance of immunodetectable enzyme. AB - Chalcone isomerase, an enzyme involved in the formation of flavonoid-derived compounds in plants, has been purified nearly 600-fold from cell suspension cultures of dwarf French bean (Phaseolus vulgaris L.). Chromatofocussing yielded a single form of the enzyme of apparent pI 5.0. This preparation was used to raise rabbit anti-(chalcone isomerase) serum. Changes in the rate of synthesis of chalcone isomerase have been investigated by indirect immunoprecipitation of enzyme labelled in vivo with [35S]methionine in elicitor-treated cultures of P. vulgaris. Elicitor, heat-released from cell walls of the phytopathogenic fungus Colletotrichum lindemuthianum, the causal agent of anthracnose disease of bean, causes increased synthesis of the isomerase, with maximum synthetic rate occurring 11-12 h after exposure to elicitor. Immune blotting studies indicate that the elicitor-mediated increase in extractable activity of the isomerase is associated with increased appearance of immunodetactable isomerase protein of Mr 27 000. However, the maximum level of immunodetectable isomerase was attained approximately 6 h earlier than maximum extractable activity. Furthermore, a 2.8 fold increase in enzyme activity above basal levels at 12 h after elicitor treatment was associated with a corresponding 5.8-fold increase in immunodetectable enzyme. It is concluded that elicitor induces the synthesis of both active and inactive chalcone isomerase of Mr 27 000, and that some activation of inactive enzyme occurs during the elicitor-mediated increase in isomerase activity. The presence of a pool of inactive chalcone isomerase in bean cell cultures has recently been suggested on the basis of density labelling experiments utilising 2H from 2H2O [Dixon et al. (1983) Planta (Berl.) 159, 561 569]. PMID- 6489353 TI - Some aspects of the phosphorylation of phenylalanine 4-monooxygenase by a calcium dependent and calmodulin-dependent protein kinase. AB - A calmodulin-dependent protein kinase purified from liver catalyzed the incorporation of up to 0.7 mol of phosphate per mol subunit of phenylalanine 4 monooxygenase. The phosphorylation was accompanied by a proportional increase in the hydroxylase activity. The reaction was Ca2+-dependent and was inhibited by physiological concentrations of phenylalanine. Phenylalanine 4-monooxygenase was also a substrate for the cGMP-dependent protein kinase, but in this system phenylalanine stimulated the rate of phosphorylation to a similar extent as that observed in the reaction catalyzed by cAMP-dependent protein kinase. The hydroxylase was not a substrate for phosphorylase kinase. The calmodulin dependent reversal of the kinase reaction in the presence of MgADP, was also inhibited by phenylalanine. Since the kinetics of the reverse reaction was the same using 32P-hydroxylase phosphorylated by calmodulin-dependent and cAMP dependent kinases, it is likely that both kinases phosphorylate the same site on the enzyme. This conclusion was further supported by peptide mapping of tryptic and peptic digests of 32P-hydroxylase, which revealed one major phosphopeptide with enzyme phosphorylated by either kinase. The Ca2+-dependent and calmodulin dependent phosphorylation described above may mediate the increased phosphorylation of the hydroxylase [Garrison, J. C., Johnsen, D. E., and Campanile, C. P. (1984) J. Biol. Chem. 259, 3283-3292] and its increased activity [Fisher, M. J., Santana, M. A., and Pogson, C. I. (1984) Biochem. J. 219, 87-90] recently observed in hepatocytes exposed to Ca2+-elevating agents. PMID- 6489354 TI - Exposure of the major human red-cell glycolipid, globoside, to galactose oxidase. AB - Plasma membrane glycolipids are localized at the outer leaflet of the lipid bilayer, and their carbohydrate portions are exposed to the environment. The efficiency of exposure has, however, not been known. We have been able to determine the availability of the major red cell glycolipid, globoside, to externally added galactose oxidase. Red cells were extensively treated with the enzyme and the oxidized cells reduced with NaBD4. After isolation the extent of exposed globoside was estimated by mass spectrometry. The results show that the exposure of globoside varies in red cells of different individuals from 37-66%. The fatty acid composition of externally available globoside was the same as that of non-oxidized globoside. The exposure was not influenced by protease treatment of intact cells and no correlation was found with different ABO blood groups. PMID- 6489355 TI - Effects of cell sap, ATP, and RNA synthesis on the transfer of ribosomal proteins into nuclei and nucleoli in a rat liver cell-free system. AB - To investigate the mechanism for the transfer of ribosomal proteins from cytoplasm into nuclei and nucleoli, the uptake of 3H-labelled ribosomal proteins by the isolated rat liver nuclei was investigated in the system containing ATP, GTP, CTP, UTP, and an energy-regenerating system. In the presences of cell sap, the transfer became temperature-dependent. The concentration of ribosomal proteins was also very important for their specific transfer and 10-15 micrograms of ribosomal proteins/ml were suitable in the presence of 10(7) nuclei. Removal of one of the four nucleoside triphosphates from the complete system containing cell sap, especially that of CTP or UTP, resulted in a marked decrease of the uptake. A low concentration of actinomycin D inhibited significantly the transfer of ribosomal proteins, while alpha-amanitin to a less extent. The results indicate that the uptake of ribosomal proteins by liver nuclei is largely dependent on RNA synthesis especially rRNA synthesis. The transfer was enhanced to some extent by ATP alone. Other nucleoside triphosphates were less effective. Non-hydrolyzable ATP analogues, adenosine 5'-[beta, gamma-methylene]triphosphate and adenosine 5'-[alpha, beta-methylene]-triphosphate were only slightly stimulative. Although ATP enhanced the transfer into the extranucleolar fraction to some extent, the maximal transfer not only into nucleoli but also into the extranucleolar fraction was dependent on the rRNA synthesis. Sedimentation analyses of the nucleolar fraction of rat liver nuclei incubated with [3H]GTP or 3H-labelled ribosomal proteins, showed that small but distinct amounts of the both labelled compounds were incorporated into 60S preribosomal particles although most of them were found in ribonucleoprotein particles below 30S which were previously shown to be degraded products containing larger rRNA precursors [Tsurugi, K., Morita, T., and Ogata, K. (1972) Eur. J. Biochem. 25, 117-128]. PMID- 6489356 TI - Interaction of filamentous actin with isolated liver plasma membranes. AB - Actin-membrane interactions have been studied using purified liver plasma membranes and muscular filamentous actin. Despite the large quantity of endogenous actin present in membranes, exogenous muscular filamentous actin cosediments with membranes after a 30 min centrifugation at 30 000 g. The cosedimentation process is time-dependent and exhibits a complex relationship with actin concentration. The cosedimentation of actin with membranes can be partly explained by gelation as shown by low-shear viscosity and electron microscopy. The characterization of the gelation phenomenon as a function of time, actin and membrane concentrations, ionic strength, temperature and Ca2+ concentration is also presented. Gelation alone cannot however account for the overall cosedimentation data, and a more direct mode of association between actin and the membrane must be envisaged. The analogy that exists between the results obtained with liver plasma membranes and those obtained with other membrane systems suggests that a general mechanism may be involved in the interaction of actin with plasma membranes. PMID- 6489357 TI - Modeling Balbiani Ring gene transcription with electron microscope tomography. AB - Cross-sectional views of mature regions of Balbiani Ring (BR) transcription loops were reconstructed by electron microscope tomography. Balsa wood models were built based upon the resulting tomograms. Coordinates of the centers of the ribonucleoprotein BR granules were estimated and employed to calculate the approximate orientation of the BR transcription unit axis in the plastic section. The density of BR granules per micron of transcription unit axis was estimated. Employing structural parameters for mature regions of BR transcription loops derived from present and previous studies, theoretical calculations were performed to examine potential steric restrictions around the central chromatin axis. Tomograms were also observed and photographed on a varifocal (vibrating) mirror to illustrate the utility of a rapid user-interactive 3-D display. PMID- 6489358 TI - Macrophages of athymic nude mice: Fc receptors, C receptors, phagocytic and pinocytic activities. AB - Expression of Fc receptors (FcR) for IgG1, IgG2A, IgG2B, IgM, IgA and IgE, binding of C3 and C5 complement components and phagocytic and pinocytic activities were determined in peritoneal and omental macrophages of nu/nu, nu/+ and +/+ Balb/c mice. nu/nu mice showed a higher proportion of FcR and complement receptor-bearing peritoneal macrophages along with a significantly higher phagocytic activity of peritoneal macrophages both in vitro and in vivo. Tests of pinocytic activity in these cells and phagocytic activity in omental phagocytes yielded similar results. We conclude that athymic mice compensate their immune defects by a higher phagocytic activity of their professional phagocytes and a higher expression of receptors mediating this process. PMID- 6489359 TI - A freeze-fracture and thin section study of the interaction of blood platelets with native type I collagen fibrils. AB - The membranes of non-activated and activated human blood platelets have been studied with freeze-fracture and conventional electron microscopy. Aggregated platelets activated by ADP or by native collagen fibrils did not show any intramembrane particle clustering. No intramembrane modification is detectable at the contact regions with collagen fibrils. However, a local densification of the cortical cytoplasm is noted in thin sections where platelets make contact with collagen fibrils. These results suggest that either the membrane receptor for collagen is not visualized by freeze-fracturing or that, as suggested previously, the binding site on collagen may not have a specificity and affinity as high as expected from a conventional receptor-ligand interaction. PMID- 6489360 TI - Neurite outgrowth of neuroblastoma cells induced by proteins covalently coupled to glass coverslips. AB - A method using proteins covalently coupled to glass surfaces has been applied to studies on the differentiation of neuroblasts. Neuroblastoma cells from clones N 18 and NIE 115 adhere to surfaces coated with fibronectin or laminin and extend rapidly growth cone-containing neurites. Some lectin-coated surfaces are also able to support neurite outgrowth, although the activities are lower than those of fibronectin and laminin. We discuss the biochemical requirements of the surface structures capable of inducing a differentiated neuronal morphology to neuroblastoma cells, and also consider the possible relationship of the results to physiological differentiation phenomena. PMID- 6489361 TI - Sucrose-induced spindle elongation in mitotic PtK-1 cells. AB - Brief treatment of mitotic metaphase and anaphase PtK-1 cells with tissue culture medium containing 0.5 M sucrose resulted in spindle elongation without chromosome motion. Spindle birefringence also changed from a uniform appearance to one of highly birefringent bundles. Electron microscopic analysis indicated these birefringent bundles were composed of tightly packed arrays of spindle microtubules. No kinetochores could be seen following a 10 min sucrose treatment. Upon removal of sucrose, metaphase spindles returned to pretreatment lengths and the normal birefringence pattern returned. Reduction in spindle length could be temporally coupled with the reappearance of kinetochores and the reassociation of microtubules with these structures. In contrast to treated and released metaphase cells, anaphase spindles did not return to pretreatment lengths. Replacement of sucrose with medium showed the resumption of chromosome-to-pole motion within 2 min of sucrose removal. Chromosome motion could be correlated with the reappearance of kinetochores and kinetochore microtubules. These data have led us to postulate the existence of two microtubule continuums in the spindle and to discuss their roles in spindle organization and chromosome motion. PMID- 6489362 TI - Polyploid cells in ageing hamster fibroblasts in vitro: possible implication of the centrosome. AB - Fibroblasts from hamster embryos cultivated in vitro present the typical ageing process of other fibroblastic lines, but they also suddenly give rise to giant non dividing cells which could be considered to represent terminally differentiated cells [36]. We investigated the latter mechanism, first by showing that microtubules in these cells depolymerized from the centrosome and not from the cell periphery as in other cells; secondly we analysed the structure of the centrosome on serial sections and found a diminished pericentriolar material; finally time lapse sequence studies of cell division confirmed that this process sometimes aborts giving rise to these giant polyploid cells. As a consequence, what first appeared as a differentiation process is in fact the result of an environmental deterioration which probably reaches a critical level thus creating a catastrophic consequence for the cell. PMID- 6489363 TI - Flow kinetics of fibronectin secretion by livers of young preweanling rats. AB - Fibronectin is a high molecular weight adhesive glycoprotein present both on the cell surface (cellular fibronectin) and circulating free in the plasma (plasma fibronectin). To investigate the cellular origins of plasma fibronectin, monoclonal antibodies prepared against purified plasma fibronectin of the rat were used in both in vivo and in vitro pulse-chase experiments comparing livers of animals of different ages. For in vitro analyses, slices were pulsed with 3H leucine and purified fractions of endoplasmic reticulum, Golgi apparatus and plasma membrane were prepared at various times post-chase and characterized morphologically. The total protein was solubilized with NP-40, and incorporation into fibronectin was determined from PAGE analysis of immunoprecipitates. Incorporation was greatest in 5-day-old animals, representing greater than 0.3% of the total radioactivity and was least in adults animals. Label appeared in fibronectin associated with the plasma membrane within 60 min. At earlier times, labeled fibronectin appeared first in the endoplasmic reticulum (30 min) and then in the Golgi apparatus (45 min). The findings demonstrate synthesis of fibronectin by rat liver and evidence for participation of liver endomembranes in its secretion. PMID- 6489364 TI - Morphological and biochemical characterization of possible intracellular precursors of milk lipid globules. AB - Within milk secreting mammary epithelial cells, immediate precursors of milk lipid globules existed as relatively large (diameter greater than 1 micron) cytoplasmic lipid droplets. The periphery of these lipid droplets was characterized by an electron-dense, granular material which lacked unit membrane character. Cytoplasmic lipid droplets which retained surface coat material were isolated from lactating cow and rat mammary glands. Surface coat material on isolated droplets was composed of polar lipids and proteins. In enzyme activities, this surface material was distinct from plasma membrane and endomembranes. In polar lipid composition, surface material on cytoplasmic lipid droplets was similar to milk lipid globule membrane or was intermediate between endoplasmic reticulum and milk lipid globule membranes. A previously unrecognized group of small structures (diameter less than 0.5 micron), which resembled cytoplasmic lipid droplets in matrix and surface coat appearance, was observed and characterized. These structures were isolated and found to contain large amounts of triacylglycerols, which closely resembled triacyl/glycerols of cytoplasmic lipid droplets in fatty acid composition. Surface coat materials of these small structures and of cytoplasmic lipid droplets were similar in enzymatic, polypeptide and polar lipid composition. Morphological evidence that these small structures may fuse with cytoplasmic lipid droplets was obtained. These small structures, for which we propose- the name micro lipid droplets, may provide triacylglycerols to support growth of cytoplasmic lipid droplets. PMID- 6489365 TI - A simple radio-isotopic method for the detection of bronchial inhalation during intensive care. AB - The high incidence of pneumopathy in intensive care units might be due to the pulmonary aspiration of gastric juice following gastro-oesophageal reflux. The paper describes a radio-isotopic method using material easy to install at the patient's bedside. This technique demonstrated aspiration of gastric juice in the lungs of 8 of 25 intensive care patients investigated. Such a method might be useful later to demonstrate that silent bronchial aspirations of gastric juice are responsible for pulmonary complications. PMID- 6489366 TI - 81mKr gas and 99mTc-MAA V/Q ratio images for detection of V/Q mismatches. AB - Methods for creating ventilation/perfusion ratio images have been reported previously using radioxenon. With the availability of 81mKr gas, corresponding ventilation and perfusion views in multiple projections to evaluate for V/Q mismatch may be performed more readily. A technique for the creation of a functional V/Q ratio image to highlight V/Q mismatches to aid in the evaluation of pulmonary embolism is described. By removing nonpertinent and distracting information and by converting a 'cold spot' imaging modality to a 'hot spot' modality, these functional images aid in the synthesis of the information provided by the ventilation and perfusion images. The limitations due to technical artifacts and the advantages of using these functional images are described. PMID- 6489367 TI - First-pass left ventricular ejection fraction with 95mAu on a 1/4 in. crystal gamma camera. AB - First-pass left ventricular ejection fraction was determined in 21 patients using 195mAu. The technical aspects of the application are discussed with particular reference to the thin crystal (1/4 in.) gamma camera. The use of diverse catheter types and combinations were also investigated so that optimal administration of the radionuclide could be achieved. PMID- 6489368 TI - Quantitation of esophageal transit by means of 81mKr. AB - A method for quantifying esophageal transit by means of 81mKr is described. The principal advantage of 81mKr compared with 99mTc is its ultra-short half-life with its consequences on radiation dose and counting statistics. Factors which may influence the esophageal transit time such as body posture, volume of the tracer, and the nature of the tracer were studied. The reproducibility of the technique is quite good and its capacity to detect minor esophageal transit disorders is demonstrated. PMID- 6489369 TI - In vitro labeling of human polymorphonuclear leukocytes with 99mTc. AB - Preliminary experience with 99mTc labeling of isolated polymorphonuclear leukocytes is reported. Leukocytes efficiently purified from 100 ml peripheral blood were labeled in vitro with 99mTc after pretreatment with small amounts of a stannous agent to reduce pertechnetate. A labeling yield of 1.3 mCi equivalent to 12.5% of the added dose of 99mTc and a cell binding efficiency of more than 90% was achieved under sterile conditions. Viability assays showed no influence of the labeling procedure on cell function. The technique may prove a valuable alternative for assessment of local leukocyte accumulation by scintigraphy. PMID- 6489370 TI - Measurement of regional lower limb blood flow in normal humans by inhalation of 133Xe. AB - A non-invasive method of measuring regional calf blood flow after inhalation of 133Xe has been investigated. The mean blood flow at rest was 3.3 ml X min-1 X 100 g tissue-1 by the 133Xe method and 3.5 ml X min-1 X 100 g tissue-1 by plethysmography. There was a significant correlation r = 0.88, P less than 0.001. During exercise the mean blood flow in the anterior tibial compartment increased from 3.4 to 10.9 ml X min-1 X 100 g tissue-1 in ten cases and in the posterior compartment from 3.3 to 7.1 ml X min-1 X 100 g tissue-1 in seven cases as measured by the 133Xe technique. The inhalation method seems to be an accurate, reliable and non-invasive method for measuring tissue blood flow in the human calf at rest and during exercise. PMID- 6489371 TI - The effect of specimen processing on radiolabeled monoclonal antibody biodistribution. AB - Monoclonal antibodies are assuming increasing importance in experimental and clinical medicine. Generally, tissue biodistribution studies in animals precede human studies. To investigate a concern of ours that varying methods of sample handling in these studies could result in apparent alterations in tissue-binding levels, we compared two methods of tissue processing after the administration of labeled antibodies: one including only blotting away of blood, the other involving several washing steps. The unwashed, blotted specimens were found to have significantly more radioactivity per gram of tissue than the washed, ranging from 22% more in the spleen to 52% more in the lungs and left ventricle. Since in vivo imaging is dependent on the total mount of radioactivity in an organ, we believe the most meaningful determination of tissue radioactivity should be based on unwashed samples. Awareness of this problem is suggested to allow meaningful extrapolations from measured tissue localization data to imaging and therapy. PMID- 6489372 TI - Phase quadrature shift between left and right ventricles during a ventricular tachycardia attack. AB - Equilibrium gated nuclear angiography was performed on a patient during an attack of ventricular tachycardia and then after conversion to sinus rhythm. Global and regional wall motion was assessed by means of isocontours, Fourier phase analysis and factor analysis. Ventricular phase histograms showed a 100 degrees difference between ventricles: left ventricular filling time occurred during right ventricular contraction. The earliest phase was located in the septum and the sequence of activation showed a large delay of left ventricular activation. After conversion to sinus rhythm, a right bundle branch block was observed, being almost the inverse of the latter situation. PMID- 6489373 TI - European system for reporting of adverse reactions and drug defects: second report 1982-1983. PMID- 6489374 TI - Serum zinc concentration in exclusively breast-fed infants and in infants fed an adapted formula. AB - Serum zinc concentrations have been determined in 28 healthy full-term Italian infants of both sexes at birth, as well as at 3 and at 5 months of age. Fourteen exclusively breast-fed infants who served as a control group were compared with 14 infants fed a cow's milk based adapted infant formula. No significant differences in serum zinc concentration between the breast-fed and the bottle-fed group became apparent during the study. The results of this study suggest a similar zinc nutriture in both groups. The availability of zinc from the adapted infant formula was not significantly different from that of human milk. These findings may be explained by the composition of the adapted formula tested, e.g. by a protein composition fairly close to that of human milk, by the presence of zinc derived from the natural ingredients only, by the low Fe/Zn ratio and by the elevated citrate content. PMID- 6489375 TI - Genetic analysis of familial erythrophagocytic lymphohistiocytosis. AB - A family with two patients suffering from familial erythrophagocytic lymphohistiocytosis (FEL) is described. Reports on FEL found in the literature were collected and the family trees reconstructed. Genetic analysis of this material indicated that FEL is an autosomal recessive hereditary disease. This conclusion is supported by the following evidence: considerably increased consanguinity rate; complete concordance in monozygotic twins; more frequent occurrence in inbred populations and in cousins; limitation of cases to one generation, and results of segregation analysis. PMID- 6489376 TI - Circulating thyroid antibodies and thyroid function studies in children and adolescents with insulin-dependent diabetes mellitus. AB - Significant high titres (1:400-1:25,600) of circulating thyroid microsomal antibodies (MCHA) were found in the sera of 5 out of 59 non-ketoacidotic, insulin dependent diabetic (IDDM) patients (mean age 14.5 years). Among these five patients (four females, one male), all of whom were over 11 years, two also had thyroglobulin antibodies. Increased thyrotropin (TSH) response to TRH was found in 3/5 MCHA positive patients and in 3/54 without circulating MCHA. Serum thyroxine (T4) and free T4 (FT4) average values were significantly lower (P less than 0.01 and P less than 0.001) in diabetics (7.1 +/- 1.8 micrograms/dl and 10.2 +/- 3.1 pg/ml, means +/- SD) as compared to normal sex and age matched controls (8.9 +/- 1.9 micrograms/dl and 12.2 +/- 2.2 pg/ml, respectively). T4 and FT4 values were inversely related to the duration of the disease. Subnormal T4 values were found in six (five females and one male) patients, four of whom had subnormal FT4 values. No patient had low triiodothyronine (T3) and high reverse T3 (rT3) values, i.e. none displayed the biochemical pattern of the 'low T3 syndrome' described with ketoacidotic status. This indicates also a satisfactory compensation of IDDM in all the patients. At the time of study no patient (including also those with circulating MCHA and TGHA and with TSH hyper-response to TRH) showed either thyroid size enlargement or clinical features of thyroid dysfunction including impaired growth and bone age retardation. PMID- 6489377 TI - Defective succinic semialdehyde dehydrogenase activity in 4-hydroxybutyric aciduria. AB - Succinic semialdehyde dehydrogenase deficiency has been demonstrated in a fourth patient with 4-hydroxybutyric aciduria. Lysates of freshly isolated lymphocytes and cultured lymphoblasts of the patient had much lower than control activity in the conversion of U-14C-4-aminobutyric acid to 14C-succinic acid in an assay designed to estimate succinic semialdehyde dehydrogenase utilizing endogenous 4 aminobutyrate transaminase. Lymphocyte and lymphoblast lysates of the patient accumulated U-14C-succinic semialdehyde when incubated with U-14C-4-aminobutyric acid and NAD+ whereas none could be detected in controls. Assays using U-14C succinic semialdehyde as substrate for succinic semialdehyde dehydrogenase in lysates of cultured lymphoblasts characterized the patient as having a severe deficiency of succinic semialdehyde dehydrogenase. The data indicate that defective activity of succinic semialdehyde dehydrogenase is responsible for 4 hydroxybutyric aciduria. PMID- 6489378 TI - Congenital anomalies in patients with choanal atresia: CHARGE-association. AB - Six patients with both choanal atresia (ChA) and additional malformations are described and another 110 cases with this combination reviewed from the literature. Our study of these cases supports the existence of the CHARGE association (Coloboma, Heart Disease, Atresia of choanae, Retarded mental development and growth, Genital hypoplasia, Ear anomalies and deafness). Our findings suggest the inclusion of orofacial clefts and oesophageal atresia among the main symptoms of this association. A certain degree of facial dysmorphism (low set, dysplastic ears, retrogenia, antimongoloid slant of palpebral fissures and anteverted nares) was observed in each of our cases. Infants with the bilateral type of ChA plus cardiac defects and those with ChA plus renal malformations have a high mortality rate. The aetiology of the association is not clear. The recurrence risk may be low. PMID- 6489379 TI - Enteric infections, cow's milk intolerance and parenteral infections in 118 consecutive cases of acute diarrhoea in children. AB - One hundred and eighteen consecutive cases of childhood acute diarrhoea (mean age: 10.5 months) were studied after admission to our Pediatric Unit in Naples over a 13-month period. A diagnosis was established in 92 patients (78%): 55% of patients were found to have an infectious enteritis (among them, 5 had ETEC infections and 1 had an ST-producing Klebsiella infection), 12% a parenteral infection, 11% cow's milk intolerance. The occurrence of gross blood (P less than 0.01), leukocytes, and reducing substances in the stools was more commonly associated with infectious enteritis than with diarrhoea due to all other causes. In 14 patients (8 of whom were malnourished), diarrhoea ran a prolonged course. In all, the eventual outcome was favourable. Our findings, while confirming that infectious enteritides account for most of acute diarrhoeas in children, stress the importance of parenteral infections and cow's milk intolerance in this condition. Also, the need for an accurate search for enterotoxigenicity of enterobacteria before ruling out their pathogenetic role is stressed. PMID- 6489380 TI - A child with acute pancreatitis and recurrent hypoglycemia due to 3-hydroxy-3 methylglutaryl-CoA lyase deficiency. AB - A five-year-old-girl with a history of recurrent hypoglycemia presented with acidosis, intractable vomiting, and abdominal tenderness; the diagnosis of acute pancreatitis was made by abdominal ultrasonography and supportive biochemical studies. Urinary organic acid analysis revealed metabolites suggestive of HMG-CoA lyase deficiency, and subsequent enzyme assays of lymphocytes and fibroblasts confirmed this diagnosis. Acute pancreatitis, an uncommon condition in childhood, is seen with increased frequency in patients with Reye syndrome, a metabolic disorder with which HMG-CoA lyase deficiency may be confused. The pathogenesis of pancreatitis in Reye syndrome or in HMG-CoA lyase deficiency has not been determined. PMID- 6489381 TI - Ruvalcaba syndrome: a case report. AB - An 11-year-old child with mental retardation and short stature was examined and found to be affected with some skeletal malformations. The clinical and radiological pattern of limb alterations was particularly suggestive of the features of Ruvalcaba syndrome. A complete examination confirmed the diagnosis and showed ocular involvement. To the best of our knowledge this is first published confirmation of Ruvalcaba syndrome. PMID- 6489382 TI - Steroid sulphatase deficiency and hypogonadism. PMID- 6489383 TI - Fatty acid pattern of platelet phospholipids in cystic fibrosis. PMID- 6489384 TI - Familial haemophagocytic lymphohistiocytosis in two brothers: possible relationship between impaired immune function and clinical picture of graft versus-host disease. PMID- 6489385 TI - Cerebral schistosomiasis presenting as a brain tumor. AB - A patient with cerebral Schistosoma mansoni schistosomiasis is described. The infection presented as a cerebral tumor, and the patient did not have the usual hepatic or intestinal symptoms of this disease. The computed tomography (CT) findings in histologically proven cerebral schistosomiasis are reported. The pathological CT findings developed at a late stage of the disease, and the CT scans were normal at a time when the EEG recordings were pathological. PMID- 6489386 TI - Brain stem vascular malformation simulating a hemorrhagic metastasis: report of a case with pathologic correlation. AB - A 65-year-old woman with known breast carcinoma developed headaches, followed shortly by disequilibrium, vertical diplopia and dysarthria. Cranial computerized tomography (CCT) demonstrated a dense, irregularly enhancing pontine lesion with associated mass effect. She received dexamethasone (Decadron) and radiotherapy and subsequently expired. Postmortem examination disclosed a ruptured brain stem arteriovenous malformation within a massive hemorrhage along with necrotic atypical cells suggestive of metastatic disease. PMID- 6489387 TI - Electrophysiological studies in primary biliary cirrhosis. AB - In 11 female patients with primary biliary cirrhosis, clinical and or electrophysiological signs of a polyneuropathy were found in 9 cases. 8 patients had clinical and 7 patients electrophysiological signs of a polyneuropathy. We derive from the significant correlations between neurographic and metabolic parameters that a hepatic disorder, a disorder of lipid and protein metabolism strongly contribute to the development of polyneuropathy in primary biliary cirrhosis. PMID- 6489388 TI - Fahr's disease associated with cystic astrocytoma. PMID- 6489389 TI - Hemangiopericytic meningioma of the pineal region. Case report. AB - A case of hemangiopericytic meningioma of the pineal region is reported. We discuss the origin of meningiomas in this region and their histological nature. The rapid recurrence in situ of the tumor in this particular case seems to confirm the need to complement surgery with radiation therapy. PMID- 6489390 TI - Chorea and systemic lupus erythematosus. A critical review. AB - A critical analysis of cases of systemic lupus erythematosus (SLE) and chorea is presented. Choreatic movements occurred early in the course of the disease in most cases; the duration varied from several days to 3 years. No sex predominance was found and no relationship could be demonstrated between chorea and other neurological signs, or between chorea and other SLE manifestations. Also, the neuropathological findings offered no simple explanation for the emergence of chorea. Immunological pathomechanisms might be present. PMID- 6489391 TI - Cimetidine neurotoxicity. EEG and behaviour aspects. AB - Cimetidine-related neurotoxicity may be characterized by signs of affective dysfunction, toxic delusional state and/or delirium, confusion and/or amnestic signs, coma, epileptic phenomena and focal neurological signs. EEG features are rarely mentioned in the literature. They are discussed here in a patient presenting with cimetidine-related mental impairment and epileptic seizures. Some of the clinical signs are related to our incomplete understanding of the neurotransmitter function of histamine in the brain. It is suggested that transient functional deafferentiation of the cortex may occur with chemical histamine receptor blockade at brain stem level. EEG monitoring may be helpful in patients at risk. PMID- 6489392 TI - Plasma haloperidol levels and therapeutic response in acute mania and schizophrenia. AB - In an open study, 18 patients suffering from an acute episode of schizophrenia and 18 patients with severe mania were given haloperidol at different dosage levels. Haloperidol plasma concentrations were measured and the status of the patients was evaluated at intervals using the Brief Psychiatric Rating Scale (BPRS). No correlation was found between the oral dose and the plasma concentrations in the schizophrenic group, but there was a low correlation for manic patients. In both groups, however, there was a correlation between these two parameters when the drug was given intramuscularly. There was no correlation between haloperidol plasma concentrations and the BPRS scores. Of the 36 patients 28 responded well to the treatment and were discharged from hospital. A good relationship between the clinical status as observed by the clinicians and the BPRS score was found. Plasma haloperidol concentration measurement was found to be a useful tool for the detection of non-compliance or excessive plasma levels. Accordingly, the present study indicates the value of drug level monitoring as a means to improve therapy. PMID- 6489393 TI - The psychiatric significance of dermatitis artefacta. AB - A total of 71 patients (12 males and 59 females) who attended the University Skin Clinic of Basle in the years 1956-1982, have been investigated by a dermatologist, a psychiatrist and a psychologist. Among 55 female patients (group I and II) 14 had a suicide attempt in their history. Of the 39 female patients of group I 25 (64%) had suffered from a stressful childhood event. Of group I (39 female patients) 19 (48.7%) had had psychiatric therapy in the past or at the time of investigation; 23 patients (59%) had suffered from depressions either in the past or at the time of investigation. Among group II (16 patients) 11 (68.7%) had had psychiatric therapy in the past or at the time of investigation. The psychological test investigation (Colour Pyramid Test and Rosenzweig Picture Frustration Test) revealed artefact patients to be in a state of considerable depressive-aggressive tension without being able to handle their emotions and impulses in an adequate manner. PMID- 6489394 TI - [Results of 110 microsurgical acoustic neuroma operations]. AB - We report our experiences in 110 cases of microsurgical removal of acoustic neurinomas. The historic development, the chances of preservation of the facial nerve and hearing function and the mortality risks are described in detail, hereby stressing the advantages of the lateral suboccipital approach in microneurosurgery. PMID- 6489395 TI - Relationship between subjective self-report of cognitive dysfunction and objective information-processing performance in a group of hospitalized schizophrenic patients. AB - This study examines the relationships between subjective self-report of cognitive difficulties associated with schizophrenia and performance parameters of an objective choice reaction time task. The predicted relationships did not emerge and the results are discussed with regard to the methodological difficulties of measuring self-report and the features of the CRT task used. One positive finding was the significant relationship between chronicity of illness and the CRT measures. PMID- 6489396 TI - Family studies in multiple sclerosis: HLA haplotypes of affected sib-pairs. AB - The occurrence of multiple sclerosis (MS) in several members of families has been observed in 4.8% of 105 MS patients from a limited epidemiological area of Rostock. Typing of the HLA antigens in 4 affected sib-pairs showed two identical HLA haplotypes in 3 of the pairs: 1 pair shared one haplotype. These findings point to a dominant mode of inheritance of the disease susceptibility gene together with the HLA haplotype. The assessment of family studies in MS is discussed. PMID- 6489397 TI - On the nosology of severe psychiatric post-partum disorders. Results of a catamnestic investigation. AB - A group of 57 women, who had been hospitalised for puerperal psychiatric disorders from 1958 to 1977, were reexamined in 1982. The aim of the study was to determine the proportion of patients who had suffered from nonpuerperal psychotic relapses or other subsequent psychopathology, to define the sample diagnostically, taking into account progress in classification, to characterize the so far relatively neglected later course of illness, and to establish criteria related to relapse and global clinical outcome. Of these patients 65% had at least one nonpuerperal relapse, only 25% remained free of later psychopathology, but the global outcome was favorable or relatively favorable in many cases. Of the patients who had had nonpuerperal relapses 43% were classified as suffering from affective psychosis, as many as 38% from schizoaffective psychosis, and only 19% from schizophrenia. Schizoaffective psychosis seems to be particularly liable to be provoked by childbirth. No major evidence was found that endogenous psychoses with puerperal onset and nonpuerperal relapses have a course of illness different from that of the corresponding diagnostic category in general. Cases with exclusively puerperal decompensations seem to be nosologically independent from the traditionally recognized endogenous psychoses. Characteristics strongly related to nonpuerperal relapses were a family history of psychosis and the occurrence of psychotic episodes before the index episode. Puerperal relapses occurred at a much higher rate in patients who also had nonpuerperal relapses than in patients without. PMID- 6489398 TI - Neuropsychological changes associated with stenoses or occlusions of the carotid arteries. A comparative psychometric study. AB - A total of 33 patients with a relevant stenosis or occlusion of extracranial arteries were tested for a number of neuropsychological functions. Most of them [22] suffered from transient ischemic attacks, 6 from strokes, 5 were asymptomatic. Compared to an age-matched population of normals, patients showed an impairment in their mnemic functions, and attention under stress as well as in their psychomotor function. The degree of neuropsychological impairment was independent of the unilaterality or bilaterality of carotid stenoses. The results illustrate the neuropsychological deficit even in asymptomatic patients and those with complete recovery from transient neurological deficits. PMID- 6489399 TI - Neuropsychological functions after carotid endarterectomy. AB - Psychological testing was performed on 23 patients (mean age 60.7 years) with unilateral or bilateral stenoses of the carotid arteries prior to and 10 months after carotid endarterectomy. Intellectual functions were slightly improved, mnemic functions impaired, psychomotor functions and dimension of personality remained unchanged. Carotid endarterectomy, although improving neuropsychological functions in a few cases, on average does not cause a significant improvement. This underscores the preventive character of the surgical intervention. PMID- 6489400 TI - Frequency of occurrence of Schneider's first rank symptoms in Schizophrenia. AB - We investigated the frequency of first rank symptoms (FRS) among patients hospitalised for schizophrenia for the first time in their life. The diagnosis was made in a Schneider oriented psychiatric hospital; 47% of the patients showed FRS. The frequency of FRS depends on the age and sex of the patient and on the existence of somatic findings but is independent of the level of their intellectual capacity or of the duration of the observation time. PMID- 6489401 TI - Altered interrelationship of dopamine, prolactin, thyrotropin and thyroid hormone in schizophrenic patients. AB - Increased dopaminergic activity has been postulated to be one of the main causes of schizophrenia. To evaluate this hypothesis further, the interrelation between dopamine, prolactin, thyrotropin (TSH) and L-thyroxine was studied by determining their concentrations in the serum of ten acutely ill schizophrenic patients exhibiting distinct stages of process activity and ten healthy subjects. The level of dopamine was elevated in the sera of schizophrenic patients, whereas the levels of prolactin, TSH and L-thyroxine were decreased. On the basis of these results we hypothesize that 1. increased dopaminergic activity affects pituitary secretory function, and 2. decreased beta-adrenergic activity may be a consequence of decreased thyroid hormone concentration in plasma. PMID- 6489402 TI - Electrocardiographic changes following electroconvulsive therapy. AB - This paper reports a study of the effects of ECT (electroconvulsive therapy) upon cardiac function (as judged by electrocardiographic changes) in 24 patients who were given 139 treatments in all. Of the 24 patients 13 were studied over a 24-h period using monitoring equipment. No potentially dangerous arrhythmias were encountered. Modified ECT was found to give rise to sinus tachycardia, which was considerably more prolonged than previously reported. The tachycardia was shown in some cases to be accompanied by a depression of the ST segment and may hence be potentially harmful to those with pre-existing ischaemic heart disease. In such patients consideration should be given to the prior administration of beta adrenergic blocking drugs and/or oxygen. PMID- 6489403 TI - Cerebrospinal fluid neurophysins in affective illness and in schizophrenia. AB - We studied the concentration of neurophysin I (hNPI) and II (hNPII), the hypothalamo-pituitary carriers of vasopressin and oxytocin, in CSF of depressed and schizophrenic patients and age matched controls. Mean hNPI values were lower and mean hNPII values greater in schizophrenics than in controls. Lower hNPI values were observed in unipolar patients than in controls. In bipolar patients however, higher hNPI values were present. Significantly higher hNPII values were observed in bipolar patients than in controls; no difference was present between unipolars and controls. A positive correlation was observed with age in controls and bipolars for hNPII. These data emphasize the interest of studying the neurohypophysal function in affective illness and in schizophrenia. PMID- 6489404 TI - Patterns of mental health care for the elderly. A cohort study in a Dutch register area. AB - Four cohorts of patients of 65 years or more who had contact with a mental health service in the first 3 months of 1975, 1977, 1979 and 1981 were followed for 1 year to study their pattern of care. Data were collected in a psychiatric case register covering a town of approximately 45,000 inhabitants in the north of the Netherlands. Patterns of care were analysed for various diagnostic groups. Findings suggest that the socially determined age of retirement of 65 years, makes less sense from a psychiatric point of view. Typical disorders of the aged, such as dementia manifest themselves in significant numbers at a much older age. PMID- 6489405 TI - Tetrabenazine (Nitoman) therapy of chronic spontaneous oral dyskinesia. A video- and EMG-controlled study. AB - Therapeutic results achieved with tetrabenazine in six patients with spontaneous oral dyskinesia were evaluated by clinical rating as well as time-blind video and EMG assessment. Dramatic improvement of symptoms was observed in five of our six patients and good to satisfactory improvement in the remaining patient. The correspondence among clinical findings, EMG data, and video analysis was good. Medication was started at low doses and slowly increased. Adverse reactions (i.e., rigidity, akinesia, vasodepression) were minimal. PMID- 6489406 TI - Prognosis of the course of schizophrenic psychoses compared to other psychiatric illnesses. Catamnestic treatment and outcome 1 year after discharge. AB - In a prospectively designed study of the course of illness of 161 hospitalized psychiatric patients, data regarding outcome could be obtained for 93% 1 year after clinic discharge. It was possible to reexamine 67% of the patients by means of direct interviews. No significant differences appeared in the comparison of the course of illness outcomes (symptoms, rehospitalization, occupation and social contacts) of patients with schizophrenic psychoses, affective psychoses, neuroses or a group of mixed other diagnoses (predominantly alcohol dependency). For the group of neuroses there was a particularly striking discrepancy between the self- and the observer-ratings at the time of discharge from inpatient index treatment. From this finding and from the comparatively more intense prominence of depressive symptoms at the time of follow-up, one can presume that there has been insufficient after-care treatment of this patient group considering the recorded treatment data. This seems to hold true for the group of alcohol dependents as well. In contrast, the after-care treatment of patients with affective and schizophrenic psychoses seems more likely to be ensured today. Despite this, however, for the latter the close link between the rate of relapse and the rate of rehospitalization can apparently scarcely be influenced. PMID- 6489407 TI - Transcultural comparison of eating attitudes in young females and anorectic patients. AB - Eating attitudes were assessed by use of the Eating Attitude Test (EAT) in two samples of normal German female adolescents and young adults. In addition scores from clinical samples of anorectic patients were available. The EAT contributed to an adequate differentiation between normal controls and clinical patients. There were marked transcultural differences with regard to mean and cut-off scores obtained in Anglo-Saxon studies where the present samples scored lowest. Reliability in terms of internal consistency and stability was more satisfactory. Neither age nor SES were significantly related to the total score. Subjects with extreme obesity had significantly increased scores on the EAT. PMID- 6489408 TI - Discrimination of former depressed patients from healthy volunteers on the basis of stable personality traits assessed by means of KSP. AB - A total of 208 former depressed patients were investigated by means of the personality inventory KSP and compared to 75 healthy volunteers who had never had an affective episode. By means of discriminant analysis 81.3% of the subjects could be correctly classified as former depressed patients or healthy volunteers. When patients in the diagnostic subgroups, unipolars, bipolars, patients with neurotic-reactive depressions and patients with unspecified depressions were compared to healthy volunteers, 85.4%, 83.0%, 84.2% and 86.4% respectively could be correctly classified. The main personality traits differentiating former depressed patients from healthy volunteers were high scores on subscales measuring psychasthenia, impulsivity, guilt and inhibition of aggression and low scores on subscales measuring indirect aggression, hostility, socialization and verbal aggression. PMID- 6489410 TI - Comparison of oral enprofylline and theophylline in asthmatic patients. AB - The bronchodilator effect and side-effects of a single oral dose of enprofylline were compared with the corresponding actions of a therapeutic dose of theophylline in 20 asthmatic patients, in a randomized cross-over clinical trial. Enprofylline 4 mg/kg and theophylline 8 mg/kg produced mean maximum plasma levels of 4.40 +/- 0.91 micrograms/ml and 16.5 +/- 2.58 micrograms/ml and mean maximum increases in FEV1.0 of 38.5% and 34.8%, respectively. The degree of headache and nausea was estimated by a scoring system. Enprofylline produced significantly higher scores for headache than theophylline, and both drugs produced s light nausea. No other side-effects were seen. Enprofylline seems to have bronchodilating properties comparable to those of theophylline without producing severe side-effects. PMID- 6489409 TI - Pharmacological actions of the main metabolites of dihydroergotamine. AB - Dihydroergotamine (DHE) and 5 of its main metabolites, namely 8'-hydroxy dihydroergotamine (8'-OH-DHE), 8',10'-dihydroxy-dihydroergotamine (8',10'-OH DHE), 2,3seco,N(1)formyl,3-keto,8'-hydroxy-dihydroergotamine (8'-OH,N(1)formyl DHE), dihydrolysergic acid amide (DH-LSA) and dihydrolysergic acid (DH-LS) were investigated on human and canine veins in vitro, on canine veins in situ, and in the ganglion-blocked rat in vivo. Like DHE, the metabolites 8'-OH-DHE, 8', 10'-OH DHE and DH-LSA caused constriction of human varicose veins and only weak alpha adrenoceptor blockade. On canine femoral vein strips the same compounds produced predominantly alpha-adrenoceptor blockade and only negligible stimulation. 8' OH,N(1)formyl-DHE and DH-LS were largely inactive. The same compounds, which were agonists on human vein strips in vitro, induced dose-dependent reduction of venous compliance when infused locally into the dog saphenous vein in situ. In the ganglion-blocked rat, only 8'-OH-DHE and 8',10'-OH-DHE besides the parent drug produced an increase in diastolic blood pressure when injected intravenously. It is concluded that DHE metabolites with considerable venoconstrictor activity may contribute to the selective therapeutic action of DHE. PMID- 6489411 TI - Effects of long-term carbamazepine treatment on water metabolism and plasma vasopressin concentration. AB - Plasma osmolality, sodium and vasopressin were measured in 7 patients before and during long-term treatment with carbamazepine, under resting conditions, and following an oral water load of 20 ml/kg body weight. During carbamazepine treatment, the ability to excrete the oral water load was decreased, the urine/plasma osmolality ratio was higher, and the free water clearance was lower. In two patients, the ability to excrete the oral water load was severely impaired, and the free water clearance remained negative following water loading. Plasma osmolality and sodium concentration were significantly lower during carbamazepine administration, but despite this the plasma vasopressin concentration remained unchanged or was even slightly increased. Four patients showed inappropriately high vasopressin concentrations in relation to the corresponding plasma osmolality when taking carbamazepine. The findings suggest a decrease in plasma osmolality during carbamazepine treatment, which might account for the inappropriate secretion of vasopressin. The latter might cause clinical symptoms of water intoxication, as has previously been reported in a few patients on carbamazepine therapy. PMID- 6489412 TI - Chlorpropamide-alcohol flush: significance of body weight, sex and serum chlorpropamide level. AB - Chlorpropamide-alcohol flush (CPAF) tests were carried out in 15 male and 15 female Type 2 diabetics. Twelve subjects were CPAF-positive and 18 were negative. The two groups did not differ in age or duration of diabetes, but the CPAF-positive subjects weighed less (mean difference 13 kg) and had higher plasma chlorpropamide levels. There was a negative correlation between plasma chlorpropamide and body weight, and a positive correlation between plasma chlorpropamide and the increase in facial skin temperature. Females had higher plasma chlorpropamide, a greater skin temperature increase and lower body weight than males; there were 11 females and only 1 male amongst the 12 CPAF-positive subjects. The findings confirm that plasma chlorpropamide is a major determinant of the CPAF reaction and also show that body weight strongly influences the chlorpropamide level and, consequently, the outcome of the CPAF test. The sex difference in body weight probably accounts for most, if not all, of the sex difference in the incidence of the CPAF. PMID- 6489413 TI - Fenofibrate therapy of hypertriglyceridaemia. Differential effects on LDL cholesterol level in type IV and in type IIb primary hyperlipoproteinaemia. AB - Twenty five hypertriglyceridaemic patients (16 Type IV and 9 Type IIb) were treated with fenofibrate 300 mg/d. In Type IV patients serum triglycerides and VLDL cholesterol decreased, while LDL and HDL cholesterol rose significantly. In Type IIb patients, triglycerides and total, VLDL, IDL and LDL cholesterol were significantly reduced by the treatment. The correction of hypertriglyceridaemia by fenofibrate seems, therefore, to induce different changes in lipoproteins in Type IIb and in Type IV hyperlipoproteinaemic patients. The practical implications of these results are discussed. PMID- 6489414 TI - Colon motility and colo-anal reflexes in chronic idiopathic constipation. Effects of a novel enterokinetic agent cisapride. AB - Motor activity of the colon and reflex behaviour of the anal sphincters in normal subjects and in patients with idiopathic constipation were studied using a novel probe with 5 open-end tips to measure pressures, and 3 balloons for stimulation of the distal colon. Constipation appeared to be associated with an increased threshold of the inhibitory relaxation reflex of the internal anal sphincter (41.7 in normals and 65.7 in patients), and in particular with a blunted sensation of the defaecation urge (51.0 in normals and 112.8 in patients). Single blind comparison with a placebo showed that cisapride, a new gastrointestinal prokinetic substance, had a significant effect on the sensation threshold, which normalized or improved in 15 out of the 16 patients studied. PMID- 6489415 TI - D-propoxyphene kinetics in man: significance of a deep third compartment. AB - Data from a previously published single dose study of d-propoxyphene 65 mg given i.v. to 8 healthy subjects have been subjected to non linear regression analysis by a curve-fitting program to test the applicability of a 2- and a 3-compartment open model. Analysis of residuals (difference between observed and computed concentrations) revealed similar systematic deviations in all 8 subjects when the 2-compartment model was used (5-10 h negative residuals, after 13 h positive residuals). In contrast, curve-fit by a 3-compartment model (with two parallel peripheral compartments) was good with no systematic deviations. The data show that a terminal monoexponential decline in d-propoxyphene concentrations cannot be expected until 15-30 h after single dose administration, and that the determination of the corresponding half-life is rather inaccurate. Accordingly, precise steady state level predictions may be difficult to obtain from conventional single dose studies with d-propoxyphene. PMID- 6489416 TI - Pharmacogenetics of mephenytoin: a new drug hydroxylation polymorphism in man. AB - Inherited deficiency in mephenytoin hydroxylation was observed in a family study. It is important that the propositus was of the extensive metabolizer phenotype for the genetically controlled hydroxylation of debrisoquine. Thus, a genetic polymorphism of drug hydroxylation was suspected for mephenytoin. A population study of mephenytoin hydroxylation, combined with identification of extensive and poor debrisoquine hydroxylation phenotypes, was carried out in 221 unrelated normal volunteers. Twelve of them (5%) exhibited defective aromatic hydroxylation of mephenytoin, and 23 (10%) could be identified as poor metabolizers of debrisoquine. Amongst these 35 subjects with a drug hydroxylation deficiency, 3 (or 0.5%; 1 female, 2 males) displayed both defects simultaneously. A panel study of 10 extensive and 10 poor metabolizers of mephenytoin showed that the ability to perform aromatic hydroxylation of the demethylated mephenytoin metabolite nirvanol (5-phenyl-5-ethylhydantoin) was co-inherited with the mephenytoin hydroxylation polymorphism. Family studies suggested that poor metabolizer phenotypes of nirvanol and mephenytoin were most likely to have the homozygous genotype for an autosomal recessive allele of deficient aromatic drug hydroxylation. Intra-subject comparison of the debrisoquine and mephenytoin hydroxylation phenotypes in these subjects indicated that deficiency in the two drug hydroxylations occurred independently. Consequently, the co-inheritance of extensive and poor hydroxylation of mephenytoin and nirvanol, respectively, represents a new drug hydroxylation polymorphism in man. PMID- 6489417 TI - Effect of dose of charcoal on the absorption of disopyramide, indomethacin and trimethoprim by man. AB - The efficacy of various charcoal-to-drug ratios for the absorption of drugs was studied in 6 healthy volunteers and in vitro at two pHs. Disopyramide 200 mg, indomethacin 50 mg and trimethoprim 200 mg were ingested on an empty stomach with 100 ml water. After 5 min the subjects ingested a charcoal suspension in 300 ml- 2.5 g, 10 g, 25 g or 50 g of Norit A, or 10 g of PX-21, or water 300 ml only. Increasing the dose of activated charcoal from 2.5 g to 50 g reduced the gastrointestinal absorption of disopyramide and indomethacin from 30-40% to 3-5%, and that of trimethoprim from 10% to 1% of the respective controls. Disopyramide and trimethoprim were best adsorbed by charcoal in vitro at neutral and indomethacin at acid pH, but saturation of the adsorption capacity was apparent at charcoal-to-drug ratios less than 7.5. Combining the in vitro and in vivo results it can be concluded that the dose of activated charcoal to be given in acute intoxication should be as large as possible, because the drug history is often unknown. PMID- 6489418 TI - Systematic within-person variation in the bioavailability of various drugs in healthy volunteers. AB - The relative bioavailability of 22 registered pharmaceutical specialities compared to one or more generic equivalents was investigated in 50 human volunteers using randomized cross-over trials. The data were reassessed with regard to individual behaviour in different experiments and with different drugs. The pharmacokinetic behaviour (Cmax, Tmax, and AUCo-t) of the volunteers exhibited consistent patterns, which were not attributable to chance. It is concluded that the cross-over design is necessary in conducting relative bioavailability studies. PMID- 6489419 TI - Effect of histamine and cimetidine on cholesterol synthesis in human mononuclear leukocytes. PMID- 6489420 TI - Bioavailability and pharmacokinetics of phenytoin during pregnancy. AB - Five epileptic women needing to commence phenytoin therapy during pregnancy received a single intravenous and a single oral dose of phenytoin several days apart before starting regular intake of the drug. Plasma phenytoin concentration time data were analysed by three different pharmacokinetic techniques. However assessed, the mean oral bioavailability of the drug proved to be about 90% of the intravenous bioavailability. This finding makes it unlikely that impaired bioavailability accounts for the increase in oral phenytoin dosage necessary in pregnancy to maintain plasma phenytoin concentrations at pre-pregnancy values. Phenytoin clearance in the pregnant subjects was approximately double the published values for phenytoin clearance in non-pregnant persons. This suggests that increased (metabolic) clearance accounts for the increased phenytoin dosage requirement of pregnancy. PMID- 6489421 TI - Effect of food on pharmacokinetics of chlorambucil and its main metabolite, phenylacetic acid mustard. AB - The influence of food intake on the pharmacokinetics of chlorambucil (C) and its cytotoxic metabolite, phenylacetic acid mustard (PAM), has been studied in man after oral doses of chlorambucil. The administration of chlorambucil with food resulted in slower absorption than when fasting. However, the area under the plasma concentration-time curve (AUC) was unaffected. The mean ratio AUCPAM/AUCC was 2.8 (range 1.4-7.1) under fasting and 3.3 (range 1.3-7.4) under nonfasting conditions. The metabolite very probably plays an important role in the cytotoxic effects observed after administration of C, since calculations show that a major fraction of the metabolite is eliminated by alkylation reactions. PMID- 6489422 TI - Pharmacokinetics of S-adenosyl-L-methionine in healthy volunteers. AB - S-Adenosyl-L-methionine (AdoMet) kinetics was studied in 6 male subjects given 100 and 500 mg i.v. Drug concentrations in plasma and urine were assayed using a radioenzymatic method. Pharmacokinetic parameters were estimated according to an open two-compartment model. The apparent volumes of distribution after the 100 and 500 mg doses were 407 +/- 27 and 443 +/- 36 ml/kg (mean +/- SEM), terminal half-lives 81 +/- 8 and 101 +/- 7 min and body clearances 3.7 +/- 0.5 and 3.1 +/- 0.2 ml/min per kg. Urinary excretion was 34 +/- 3 and 40 +/- 2% of the administered dose. The results demonstrate that drug disposition occurs more via metabolism than via renal excretion, and it is not dependent on the administered dose. Binding of AdoMet to serum proteins is negligible. PMID- 6489423 TI - Amphetamine secretion in breast milk. AB - The excretion of amphetamine in human breast milk was studied in a nursing mother with narcolepsy, who was treated with 20 mg daily of a racemic preparation of amphetamine. The concentration of amphetamine was 3 and 7 times higher in breast milk than in maternal plasma on the 10th and 42nd days after delivery. Small amounts of amphetamine were found in urine samples from the infant. PMID- 6489424 TI - Serum digoxin measurements during pregnancy. PMID- 6489425 TI - Effect of adrenaline on myocardial oxygen consumption during selective and non selective beta-adrenoceptor blockade comparison of atenolol and pindolol. AB - The effect of adrenaline on myocardial oxygen consumption (MVO2) during selective and non-selective beta-adrenoceptor blockade was examined in 26 patients with angina pectoris. Cardiac venous flow was measured by thermodilution and blood was sampled for metabolic studies. Thirteen patients were given atenolol 62.5 micrograms/kg i.v. and the other 13 patients pindolol 7.5 micrograms/kg i.v. Measurements were repeated before and during infusion of adrenaline 0.1 microgram/kg/min. Compared to the control situation, adrenaline increased MVO2 more in atenolol-treated (39%) than in pindolol-treated patients (11%). This was partly due to augmented external cardiac work. Arterial FFA was considerably increased in the atenolol group (105%), but was unchanged in the pindolol group, suggesting an additional metabolic mechanism. Thus, adrenaline stimulation, which is comparable to that found in acute myocardial infarction, increases MVO2 more during selective than non-selective beta-blockade. PMID- 6489427 TI - Sequestration of fentanyl by the cardiopulmonary bypass (CPBP). AB - Immediately following the connection of pediatric patients to cardiopulmonary bypass we have consistently observed a steep decrease in fentanyl plasma concentration (74 +/- 8.7%) (mean +/- SD), much greater than would have been expected from hemodilution alone (50.6% +/- 12.0%) (p less than 0.0001). Priming of the pump with 20 ng/ml of fentanyl before connection to the patients did not prevent this phenomenon. In order to study the possibility that fentanyl is sequestered by the bypass, levels of the primed drug in the bypass were assessed before connecting the pump to the children and a steep fall from 20 ng/ml to zero was shown before initiation of bypass. Pharmacokinetic assessment of fentanyl in a closed pump circuit showed that levels of 120 ng/ml fall to 2 ng/ml within 3 min and remain stable at the lower concentration for at least 30 min. Further studies have identified the membrane oxygenator as the major site of fentanyl sequestration. Concentrations across the membrane fall from 120 ng/ml to 10 ng/ml. The attached siliconized tubing is associated with a minor binding effect sufficient to reduce concentrations from 110 to 84 ng/ml. The pvc tubing, aluminium heat exchanger and plastic reservoir had no binding effect on fentanyl. The possibility that a decrease in fentanyl protein binding caused the fall in serum concentration was checked in 5 patients undergoing open heart surgery. After initiation of the cardiopulmonary bypass, there was a significant decrease in albumin serum concentrations from 32.0 +/- 2.3 mM to 15.0 +/- 1.6 mM (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489426 TI - Effect of bendrofluazide on calcium reabsorption in hypoparathyroidism. AB - In hypoparathyroidism the absence of parathyroid hormone leads to a reduction in the absorption of calcium by renal tubular cells. In spite of treatment with vitamin D, hypercalciuria persists and normocalcaemia can only be maintained by providing the kidney with a large load of calcium. Thiazide diuretics enhance tubular calcium reabsorption and it has been suggested that they can be used as an alternative to vitamin D. Bendrofluazide in a dose of 10 mg daily was given to 9 patients with severe hypoparathyroidism in addition to their usual treatment with calcium and vitamin D. Following the introduction of Bendrofluazide the calculated renal threshold for calcium reabsorption (TmCa/GFR) increased by a mean value of 0.14 mmol/l, and the mean rise in serum calcium was 0.13 mmol/l. This increase was due to a direct effect of the drug and was not caused by salt restriction or changes in glomerular filtration rate. The rise in serum calcium is modest compared to the rise following the introduction of vitamin D and except for patients with mild hypoparathyroidism, thiazides are not an alternative to vitamin D. They may however reduce the oral calcium load required to maintain normocalcaemia. PMID- 6489428 TI - Acetaminophen accumulation in pediatric patients after repeated therapeutic doses. AB - Acetaminophen serum concentrations were studied in 21 infants and children with fever. The maximum serum concentrations ranged from 9.96 to 19.6 micrograms/ml after a single dose of 12-14 mg/kg and 13.9 to 40.1 micrograms/ml after a single dose of 22-27 mg/kg. Ten patients were restudied at steady-state after repeat doses had been given every 4 or 8 h for 1 to 3 days. Total area under the acetaminophen serum concentration-time curve normalized for dose averaged 0.181 (ml/min/kg)-1 after the first dose and 0.202 (ml/min/kg)-1 at steady-state (p less than 0.05). Five patients showed a 13 to 44% increase in the AUC; one had a 10% decrease in the AUC; and four had less than 6% change in the AUC. There was no evidence of hepatotoxicity. These data suggest that acetaminophen may accumulate after repeated therapeutic doses in children with fever. PMID- 6489429 TI - The IgA immune system in epileptics on anticonvulsant therapy. AB - Disturbances in IgA have often been reported in white epileptics on anticonvulsant therapy. The clinical significance of these disorders is of interest as this aspect does not appear to have been sufficiently explored. In a previous study neither African nor Caucasian epileptics on treatment showed a deficiency of serum IgA. Since secretory IgA is the main defence factor in protecting mucosal surfaces, the object of the present study was simultaneously to determine serum and salivary IgA in suitable subjects and to monitor related clinical events. A similar elevation of salivary IgA level was found in Black and White epileptics on treatment. Clinical events were rare and were not related either to serum or secretory IgA concentrations. It is concluded that at present epileptics do not seem to require special immunological or clinical monitoring. PMID- 6489430 TI - Pharmacokinetics and bioavailability of digitoxin by a specific assay. AB - The pharmacokinetics and bioavailability of digitoxin were examined in six normal human subjects using an assay that separates digitoxin from its metabolites. After intravenous administration, the mean systemic clearance was 2.44 ml/min; the volume of distribution was 0.47 l/kg; and the elimination half-life was 6.5 days. After oral administration, the elimination half-life was 5.8 days. The bioavailability was 81.5% using the specific assay. Using a non-specific, direct serum digitoxin radioimmunoassay the bioavailability was 98.0%. Assay of aqueous fractions from extracted serum samples indicated higher levels of water-soluble metabolites following oral compared to intravenous digitoxin administration. These findings suggest that previously reported values for digitoxin bioavailability using non-specific methods may be falsely elevated due to the presence of digitoxin metabolites in serum. PMID- 6489432 TI - Influence of mild thyroid dysfunction on antipyrine clearance and metabolite formation in man. AB - The salivary kinetics and rates of metabolite formation of antipyrine were studied in 6 hyperthyroid and 6 hypothyroid out-patients on 2 occasions, on admission and when T3 and T4 levels had returned to normal after treatment with carbimazole (hyperthyroidism) or l-thyroxine (hyperthyroidism). In hyperthyroidism the half-life of antipyrine was significantly shorter (p less than 0.05) than after recovery (9.3 +/- 1.0 versus 10.6 +/- 0.9 h). Hypothyroid patients showed a significantly longer elimination half-life before treatment than after recovery (12.7 +/- 2.6 versus 10.3 +/- 2.6 h). Antipyrine clearance in hyperthyroid patients was decreased after treatment from 2.7 +/- 0.3 to 2.4 +/- 0.3 l/h, and it was increased in hypothyroid patients from 2.1 +/- 0.4 to 2.5 +/- 0.5 l/h (p less than 0.05). The changes in clearances for the production of the antipyrine metabolites 4-hydroxyantipyrine (OHA), norantipyrine (NORA) and 3 hydroxymethylantipyrine (HMA) were of the same order of magnitude as total antipyrine clearance, and no selectivity towards any of the metabolic pathways of antipyrine was apparent. Mild thyroid dysfunction seems to affect oxidative drug metabolizing enzyme activity in a non-selective manner and only to a small extent (10-30%). It is suggested that adjustment of the therapeutic regimens of various drugs in mild thyroid disease will only rarely by required on the basis of pharmacokinetic considerations. PMID- 6489431 TI - Effect of age and sex on the plasma binding of acidic and basic drugs. AB - Protein binding of chlorpromazine, propranolol, meperidine, desipramine, salicylic acid and phenytoin was determined in plasma of 64 healthy volunteers (35 males and 29 females). An attempt was made to identify factors affecting the plasma protein binding of these drugs. Whereas plasma albumin levels decreased as a function of age in both sexes, alpha 1-acid glycoprotein levels increased with age, but the increase was more pronounced in males. The free plasma fraction of the acidic drugs (salicylic acid, phenytoin) and desipramine (a base) showed a significant (p less than 0.005) negative correlation with plasma albumin levels. The free fractions of the other three basic drugs (chlorpromazine, propranolol, meperidine) in plasma showed a significant (p less than 0.005) negative correlation with alpha 1-acid glycoprotein plasma levels. Plasma protein binding of salicylic acid, phenytoin and desipramine decreased as a function of age. Plasma protein binding of chlorpromazine, propranolol and meperidine was virtually unaffected by age or was slightly increased (chlorpromazine). Only in the case of salicylic acid could a statistically significant difference be demonstrated between males and females in the free fraction-age relationship. Stepwise multiple linear regression analysis, including age and blood chemistry values such as hematocrit, bilirubin, cholesterol, triglycerides, creatinine, BUN, albumin and alpha 1-acid glycoprotein as independent variables, identified age as the variable explaining most of the variability in plasma binding of salicylic acid, phenytoin and desipramine. For chlorpromazine, propranolol and meperidine alpha 1-acid glycoprotein was the most important determinant of plasma protein binding. PMID- 6489433 TI - A comparative study on possible calcium antagonistic properties of indapamide and other drugs potentially interfering with calcium transport in isolated vascular smooth muscle. AB - In the present study the effects of indapamide (IN) were compared with those of chlorthalidone (C) and of drugs potentially interfering with calcium transport, e.g. verapamil (V), papaverine (P), phentolamine (PH) and diazoxide (D) using isolated rabbit aorta in order to detect calcium antagonistic properties. IN and C failed to show any relaxation effect towards either noradrenaline (NA)- or high K+-precontracted aorta strips, whereas V and P reduced the K+ contraction dose dependently and PH, V, P and D induced a significant relaxation of the NA contraction. Preincubation with IN or C did not affect the dose-response curve of NA-induced contractions. PH antagonized the NA contraction strongly whereas V and P shifted the dose-response curve to the right only at the highest concentration. In a Ca2+-depleted and high K+-depolarized aorta preincubation with V was able to antagonize Ca2+-induced contraction effectively in a dose-dependent fashion whereas P only showed partial inhibition at the highest concentration. The effects of the drugs on responses to NA in a Ca2+-free medium were also investigated. This type of contraction is likely to be due to mobilization of internally located Ca2+. The results demonstrate that PH was able to counteract this type of contraction effectively whereas only a high concentration of V, P and D was effective in reducing the Na contraction in Ca2+-free medium. Both IN and C failed to affect this type of contraction. In conclusion, the present results indicate that neither IN nor C possess calcium entry and or intracellular calcium antagonistic properties under different conditions as measured in a conduit vessel of rabbits. Moreover, the results point to an additional site of calcium antagonistic action for V, P and D, especially at higher concentrations. PMID- 6489435 TI - Tetrabenazine-induced depletion of brain monoamines: characterization and interaction with selected antidepressants. AB - The peripheral administration of tetrabenazine (TBZ) induces rapid depletion of brain regional concentrations of norepinephrine (NE), dopamine (DA) and serotonin (5-HT). With respect to both dosage and time, striatal DA was most sensitive to the effects of TBZ while hypothalamic NE was least affected. Pretreatment with the monoamine oxidase (MAO)-inhibitor, clorgyline (1-6 mg/kg) dose-dependently prevented the reduction of all three monoamines for up to 60 min after TBZ (3 mg/kg). The TBZ-induced depletion of cortical NE was also significantly antagonized by desmethylimipramine (DMI) but was of shorter duration (up to 30 min after TBZ). DMI, however, did not influence the effect of TBZ on striatal DA or hypothalamic 5-HT. The protective effects of both clorgyline and DMI were also evident under the conditions of the behavioral TBZ test utilizing high doses of TBZ (20 mg/kg). PMID- 6489434 TI - Effects of felodipine, nitrendipine and W-7 on arterial myosin phosphorylation, actin-myosin interactions and contraction. AB - The relative effects of felodipine, a dihydropyridine with purported calmodulin antagonistic properties, have been compared with the calmodulin inhibitor, W-7, for inhibition of Ca2+-dependent force development and direct inhibition of Ca2+ calmodulin mediated arterial myosin light chain phosphorylation and actin-myosin interactions. Felodipine (IC50 3 X 10(-9) M) was approximately 30 000 X more potent than W-7 (IC50 10(-4) M) and equipotent with another dihydropyridine, nitrendipine, in inhibiting isometric force development in K+-depolarized aortic smooth muscle strips. In contrast, W-7 (IC50 4 X 10(-5) M) was approximately 5 X more potent than felodipine (IC50 2 X 10(-4) M) in inhibiting Ca2+-dependent myosin light chain phosphorylation or superprecipitation of arterial actomyosin. Concentration-related inhibition of both parameters by W-7 was tightly coupled to concomitant inhibition of force development in intact smooth muscle. In contrast, inhibition of myosin light chain phosphorylation and superprecipitation by felodipine was only apparent at concentrations greater than or equal to 10(-5) M while maximal inhibition of force development occurred at a concentration as low as 10(-7) M. Inhibition of contractility by W-7 was minimal in paced rabbit atria, whereas inhibition by felodipine was similar to that seen with nitrendipine. These results suggest that the pharmacologically-relevant mechanism of Ca2+ antagonism in smooth muscle by felodipine is similar to nitrendipine (blockade of the Ca2+ entry channel) and does not involve direct inhibition of Ca2+-calmodulin stimulated myosin light chain phosphorylation and subsequent actin-myosin interactions. PMID- 6489436 TI - The contractile effect of bombesin, gastrin releasing peptide and various fragments in the rat stomach strip. AB - The contractile activity of bombesin (BB) and related peptides including the gastrin releasing peptide (GRP) was evaluated in the rat stomach strip. BB and GRP were found to elicit concentration-dependent contractile effects in concentrations varying between 5.0 X 10(-10) and 5.0 X 10(-7) M. EC50 values of BB and GRP were 6.5 X 10(-9) and 10(-8) M, respectively. The contractile effect of BB (1.5 X 10(-8) M) was not modified by a mixture of antagonists containing atropine (1.7 X 10(-6) M), mepyramine (1.2 X 10(-6) M), methysergide (1.4 X 10( 6) M), phentolamine (1.8 X 10(-6) M), propranolol (1.9 X 10(-6) M) and indomethacin (7.0 X 10(-6) M), nor by the nerve paralyzing drug tetrodotoxin (1.6 X 10(-6) M). These results suggest the existence of BB receptors in the rat stomach strip. The results also suggest that the contractile effects of BB in this tissue result from a direct effect on the smooth muscle cell. The data derived from our structure-activity study indicate that deletion of the N terminal sequence pGlu1-Gln2-Arg3-Leu4-Gly5- from the BB molecule causes practically no loss of affinity and intrinsic activity. Further shortening of BB gives rise to a gradual reduction of both parameters. Residual contractile activity could still be observed with the tetra- and pentapeptide BB-(11-14) and BB-(10-14) at 10(-5) M.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489437 TI - Inotropic effect of taurine in guinea-pig ventricular strips. AB - At 0.9 mM CaCl2 taurine prevented the negative inotropic effect due to low calcium concentration in guinea-pig ventricular strips but not in rat strips. This taurine effect was dose-dependent. The presence (in the perfusion medium) of beta-alanine, an inhibitor of taurine transport, antagonized the effect of taurine suggesting that the action of taurine was correlated to its transport. Neither propranolol, cimetidine nor indomethacin affected the response to taurine in guinea-pig ventricular strips. PMID- 6489438 TI - Acute cardiovascular effects of two central phenylethanolamine-N-methyl transferase inhibitors in unanesthetized desoxycorticosterone-salt hypertensive rats. AB - SKF 64139, an inhibitor of phenylethanolamine-N-methyltransferase (PNMT), has a marked hypotensive effect in models of sodium-dependent hypertension. The mechanism of this effect is obscure, the compound having in addition alpha adrenoceptor blocking properties. We compared the acute effects of SKF 64139 with those of LY 134046, another PNMT inhibitor with minimal alpha-blocking capacity, in desoxycorticosterone-salt hypertensive rats. The former agent produced profound hypotension whereas the latter caused only bradycardia. Both induced a similar pronounced suppression of PNMT activity in the C1 and C2 region of the medulla oblongata. These results suggest that the alpha-adrenergic effect rather than PNMT inhibition accounts for the acute lowering of blood pressure in this model. PMID- 6489439 TI - Cross generalization with LSD and yohimbine in the rat. AB - Rats trained to discriminate intraperitoneal injections of 0.16 mg/kg LSD from saline injections were found to show stimulus generalization with 0.31-5 mg/kg of yohimbine. Partial generalization also occurred with clonidine and xylazine. Rats discriminating intraperitoneal injections of 5 mg/kg of yohimbine from saline generalized LSD at doses of 0.08-0.63 mg/kg. The data establish an equivalence between LSD and yohimbine as to discriminative effects in rats. This equivalence is consistent with LSD and yohimbine producing at least partly similar subjective effects in humans. PMID- 6489440 TI - Differential relaxant effects of isoproterenol on methacholine- versus leukotriene D4-induced contraction in the guinea-pig trachea. AB - The ability of isoproterenol to relax guinea-pig trachea was examined in tissues precontracted with three concentrations of methacholine or three corresponding equieffective concentrations of leukotriene D4. Although increasing the concentration of either contractile agent progressively shifted isoproterenol concentration-response curves to the right, the shifts produced by methacholine were greater than those produced by leukotriene D4. Thus, the sensitivity of tracheal smooth muscle to beta-agonists depends upon the initial contractile state of the tissue, and the type of agent used to induce tone. PMID- 6489441 TI - Naloxone inhibits both glucocorticoid and [D-Ala2,Met5]enkephalinamide reversal of behavioural effect of adrenalectomy. AB - Intact rats treated immediately after a 15-min swimming exposure with i.m. 1 or 10 mg/kg naloxone (but not with 10 mg/kg of MRZ2593, a quaternary analogue) showed significant reduction in immobility (55, 30%) compared with controls (70%) during a 5-min retest 24 h later. This effect of naloxone was seen when administered 1 h prior to retest. Adrenalectomized rats, as previously shown, are only approximately 30% immobile on retest; administration of [D Ala2,Met5]enkephalinamide (50 micrograms i.m.) or dexamethasome (6 micrograms i.m.) elevated immobility to 66 and 69% respectively. Administration of naloxone (0.1-10 mg/kg) progressively antagonized the effect of both [D Ala2,Met5]enkephalinamide and dexamethasone, to 36 and 41% immobility on retest at 10 mg/kg. We conclude that the incorporation of information post-stress normally involves at least two opioidergic pathways, and that the integrity of one of these pathways is an absolute requirement for such incorporation to occur, based on the naloxone studies. In contrast, either glucocorticoids or enkephalin analogues are sufficient to restore behaviour post-adrenalectomy, suggesting that corticosteroid-dependent neural mechanisms may substitute for this second opioidergic pathway. PMID- 6489442 TI - GABA agonists inhibit central sodium-induced vasopressin-dependent increases in arterial pressure. AB - Previous studies have demonstrated that intraventricular (i.v.t.) administration of low doses of GABA agonists reduced the central pressor effects of cerebrospinal fluid (CSF) made hypertonic with sodium (Na). The following studies were designed to determine if GABA agonists acted to decrease the pressor response of Na through inhibition of the vasopressin-dependent pressor component. Following pretreatment with vascular vasopressin antagonist, the pressor response of i.v.t. administered Na was reduced approximately 60%. Hypophysectomy produced a similar reduction in the pressor response elicited by hypertonic CSF. These results indicate that vasopressin contributed to approximately 60% of the pressor response of Na. In order to generate a vasopressin-dependent pressor response, the sympathetic nervous system was eliminated with ganglionic blockade by chlorisondamine. The increase in arterial pressure produced by i.v.t. injection of hypertonic CSF was augmented after ganglionic blockade compared to untreated rats. The augmented pressor effect of i.v.t. administered Na was markedly reduced by the vascular vasopressin antagonist or by hypophysectomy. Therefore, the pressor effect of Na after ganglionic blockade was caused almost entirely by the pressor actions of arginine-vasopressin (AVP). This AVP-dependent pressor effect of i.v.t. injected Na in rats subjected to ganglionic blockade was reduced by pretreatment with 100 micrograms of GABA or 50 ng of the GABA agonist muscimol. These doses of GABA and muscimol have previously been shown to reduce the pressor response of i.v.t. administered Na in untreated rats. Thus, pretreatment with low doses of GABA agonists reduced the pressor effect of Na in part through inhibition of the vasopressin component of the pressor response. GABA pretreatment also antagonized the increase in plasma AVP levels produced by i.v.t. administered hypertonic CSF. PMID- 6489443 TI - Corticosterone prevents the increase in noradrenaline-stimulated adenyl cyclase activity in rat hippocampus following adrenalectomy or metopirone. AB - Corticosterone modulation of the noradrenaline-responsive cyclic AMP generating system was examined in rat hippocampus. Adrenalectomy was found to produce a small but significant elevation in the rate of cyclic AMP formation in response to noradrenaline. Implantation of corticosterone pellets 5 days prior to sacrifice prevented this adrenalectomy-induced increase. Metopirone, an inhibitor of corticosterone synthesis, was also observed to increase cyclic AMP formation. This elevation was seen 2 h following a 50 mg/kg i.p. injection and was completely prevented by corticosterone pellet implantation. Metopirone had no significant effect on cyclic AMP production after 1 h, while a slight but statistically non-significant elevation remained at 4 h. These observations parallel the inhibitory effect of Metopirone on corticosterone synthesis as determined by serum corticosterone levels. PMID- 6489444 TI - Comparison of affinities of muscarinic antagonists to pre- and postjunctional receptors in the guinea-pig ileum. AB - The myenteric plexus-longitudinal muscle preparation of the guinea-pig ileum was preincubated with [3H]choline, then superfused and stimulated electrically (1 Hz 120 pulses). Oxotremorine reduced the evoked outflow of [3H]acetylcholine in a concentration-dependent manner. Each of the six antagonists (scopolamine, methylatropine, trihexyphenidyl, 4-DAMP, clozapine, pirenzipine) produced parallel shifts of the concentration-response curves for the prejunctional effects of oxotremorine. Similarly, in contraction experiments, the antagonists competitively antagonized the postjunctional responses to oxotremorine. The pre- and postjunctional pA2 values did not differ significantly for any of the antagonists. It is concluded that pre- and postjunctional muscarinic receptors in the guinea-pig ileum are pharmacologically similar. PMID- 6489445 TI - An evaluation of tamoxifen as a partial agonist by classical receptor theory--an explanation of the dual action of tamoxifen. AB - Tamoxifen is known to have both agonist and antagonist properties. Classical receptor theory predicts that given the relative concentrations of a partial agonist and full agonist acting on the same receptor, the partial agonist may reduce the effect of the full agonist. The immature rat uterine model is an excellent system to evaluate the interactions of estradiol and tamoxifen by application of receptor theory. Using this model, tamoxifen demonstrates both additive and antagonistic effects to estradiol in the fashion predicted by theory. The effects of tamoxifen are additive at low doses of estradiol and antagonistic over higher estradiol doses. It is possible that the dualism of agonism and antagonism seen in other target organs and species is a function of these basic characteristics of a partial agonist. PMID- 6489446 TI - Proconvulsant effect of morphine on seizures induced by pentylenetetrazol in the rat. AB - The chemoconvulsant pentylenetetrazol (PTZ) was administered by a variety of routes to rats pretreated with morphine (10-50 mg/kg s.c.). In a naloxone reversible, dose-dependent manner, morphine decreased the threshold for seizures induced by the slow intravenous infusion of PTZ. In addition, morphine increased the severity of seizures induced by the intravenous, intraperitoneal, and subcutaneous routes of administration of PTZ. Morphine also caused an increased incidence of multiple seizures following subcutaneous administration of PTZ. These results demonstrate that morphine has a proconvulsant effect on PTZ-induced seizures in the rat. PMID- 6489447 TI - [Leu5]enkephalin inhibits norepinephrine-induced contraction of rat aorta. AB - Leucine-enkephalin produces a dose related decrease in the contractile response of spirally cut strips of rat aorta to norepinephrine (NE). The maximal effect (55.0 +/- 1.0 percent reduction in developed tension) occurs at a leucine enkephalin concentration of 10(-10) M. The attenuation of contractile response is reversed by naloxone. PMID- 6489448 TI - N-Acetyltryptamine antagonizes the melatonin-induced inhibition of [3H]dopamine release from retina. PMID- 6489449 TI - Alkyl-substituted gamma-butyrolactones inhibit [35S]TBPS binding to a GABA linked chloride ionophore. PMID- 6489451 TI - The microtubular cytoskeleton and the initiation of DNA synthesis. AB - Depending on cell type and mode of growth stimulation, an intact cytoplasmic microtubule system may either support or suppress passage through the prereplicative G1 phase (growth and maturation) and entrance into the S phase (DNA synthesis) of the cell cycle. In peripheral blood lymphocytes exposed to mitogenic lectins, colchicine and other antimicrotubular drugs inhibit blast transformation and initiation of DNA synthesis. The inhibitory effect is not due to decreased cellular binding of lectin or lack of generation of a stimulatory signal. Rather, it can be explained by an inability of the cells to pass through the G1 phase at a normal rate in the absence of cytoplasmic microtubules. The formation of new organelles and the growth in cell size that occur during this phase is markedly delayed by the drugs. For example, the Golgi complex, an organelle system that participates in membrane biogenesis and other basic cellular functions, is reduced in size and structurally disorganized. In cells with a shorter prereplicative phase, such as fibroblasts and smooth muscle cells, antimicrotubular drugs inhibit DNA synthesis in growth-arrested cultures exposed to optimal concentrations of serum, thrombin or platelet-derived growth factor (PDGF). On the other hand, antimicrotubular drugs stimulate DNA replication in serum-free cultures and enhance the stimulatory effect of insulin, epidermal growth factor (EGF), fibroblast growth factor (FGF), and prostaglandin F2 alpha on entrance into S phase. Moreover, stabilization of cytoplasmic microtubules with taxol has been found to block microtubule disassembly and initiation of DNA synthesis by colchicine and to inhibit thrombin- and EGF-stimulated DNA synthesis under serum-free conditions. These findings suggest that partial microtubule disassembly is an inherent step in the reactions that precede DNA replication and mitosis. However, the cell biological and molecular details of these reactions and the exact role of microtubules remain enigmatic. PMID- 6489450 TI - Effects of the calmodulin inhibitor, trifluoperazine, on membrane potentials and slow action potentials of cultured heart cells. AB - The effects of an inhibitor of calmodulin, trifluoperazine (TFP), were determined on the electrical activity of cultured cell reaggregates derived from chick embryonic hearts (15-day-old). The cells exhibited naturally occurring slowly rising action potentials (APs) having a maximum rate of rise (+Vmax) of less than 35 V/s. After superfusion with 100 microM TFP, the maximal diastolic potential (MDP) decreased, within 30 min, from -66.0 to -55.5 mV. The frequency of discharge decreased, and there was also a decrease in AP amplitude and in +Vmax (from 10.0 to 4.9 V/s). By 90 min, all spontaneous activity had stopped, and the resting potential was about -10 mV. Input resistance increased, consistent with a decrease in K+ conductance. Hyperpolarization by current pulses did not allow the production of APs upon electrical stimulation, suggesting that the TFP blocks slow inward current (Isi). No recovery occurred upon washout (up to 48 h). Higher concentrations of TFP (200-500 microM), or injection of the inhibitor intracellularly be means of phosphatidylcholine liposomes, accelerated the time course of the blockade (e.g. within 15 min). In fresh (non-cultured) chick ventricle with fast-rising APs, TFP (400 microM) caused excitation-contraction uncoupling within 10 min, presumably by blocking the slow Ca2+ channels; the the fast APs were depressed (+Vmax) within 45 min, before any depolarization occurred. The cells became completely depolarized (Em congruent to -4 mV) by 195 min; hyperpolarization by current pulses did not allow the production of APs, suggesting that the fast Na+ channels were blocked.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489452 TI - Changes in inducibility of ornithine decarboxylase activity in differentiating human neuroblastoma cells. AB - Human SH-SY5Y neuroblastoma cells could be induced to differentiate morphologically and biochemically in the presence of 12-O-tetradecanoylphorbol-13 acetate (TPA), retinoic acid (RA), or a combination of these two substances. The phenotypical changes induced by these substances differed, but one effect of both was an inhibition of the cell growth. Addition of TPA or RA to non-treated cells had no effect on the activation of ornithine decarboxylase (ODC, EC 4.1.1.17.), while a change to fresh medium stimulated the ODC to maximum activity after 4-6 h. The activity was not altered by the presence of RA in the fresh medium, but TPA partially inhibited the medium-stimulated ODC activity. Cells treated for 4 or 8 days with TPA or a combination of TPA and RA had a low ODC activity which could not be induced by fresh medium. However, RA-treated (and thus growth inhibited) cells still responded to a change of medium by exhibiting an ODC activity of the same magnitude and duration as in medium-stimulated control cells. The results seem to suggest that the growth inhibition induced by TPA and RA, respectively, is mediated by different mechanisms. PMID- 6489453 TI - Cardiomyocytes cultured in serum-free medium. Growth and creatine kinase activity. AB - Primary cultures of newborn rat heart cells were grown for up to 3 weeks in serum free medium supplemented by insulin, hydrocortisone, transferrin and fetuin. The cells resumed spontaneous beating at 20 h post plating. Mean rates of beating on the second and third day were 79.5 and 94 beats per min, respectively. Cell proliferation occurred during the first 3 days of culture with maximal rates of DNA and protein synthesis on the second day. The highest values of creatine kinase activity were observed on days 2-5 and the three cytoplasmic isozymes, MM, MB and BB, were present in the cultures in proportions similar to those of the newborn heart, indicating stability of the differentiated state of the cells. The relative amount of each isozyme remained unchanged throughout the experiments, MM constituted 70-90% of enzyme activity, MB contributed up to 30% and BB did not exceed 15% of activity. The very low proportion of BB and the lack of increase in this isozyme with age of culture support our earlier morphological observations that non-myocytes do not overgrow the culture. PMID- 6489454 TI - Amino acid control of protein degradation in normal and leukemic human lymphocytes. AB - Lymphocytes from normal human subjects and from patients with chronic lymphocytic leukemia were found to degrade their endogenous protein at similar rates (2.5 3.0%/h) when incubated in an amino acid-free buffer. Protein degradation was inhibited 20-35% by inhibitors of autophagic sequestration (amino acids, 3 methyladenine) and by inhibitors of intra-lysosomal proteolysis (leupeptin, propylamine), the extent of inhibition being similar in normal and leukemic lymphocytes. The inhibitor effects, together with the electronmicroscopic demonstration of autophagosomes in the lymphocyte cytoplasm, is taken as evidence for the existence of an autophagic-lysosomal pathway in human lymphocytes, potentially responsible for as much as one-third of their overall protein degradation. PMID- 6489455 TI - Deoxyribonucleoside triphosphate metabolism and the mammalian cell cycle. Effects of thymidine on wild-type and dCMP deaminase-deficient mouse S49 T-lymphoma cells. AB - The size of the dCTP pool has been implicated as a possible regulator of DNA synthesis. In this investigation we correlate large intracellular variations in deoxyribonucleoside triphosphate levels to the growth rates and cell-cycle kinetics of mouse S49 T-lymphoma cells. Wild-type and a mutant line AzidoC-100-5, lacking dCMP-deaminase activity resulting in a 10-fold expanded dCTP pool were studied and compared using flow cytometry, centrifugal elutriation and nucleoside triphosphate determinations. An increase in the dCTP pool was closely correlated to the passage of cells from G1 to S phase in both cell types. Addition of thymidine to wild-type and mutant cells resulted in an accumulation of cells in early S phase, concomitant with a decreased dCTP level. Mutant cells excreted large amounts of deoxycytidine into the medium which partially protected the cells from thymidine inhibition. The doubling times for the mutant and wild-type cells were very similar but the mutant had a somewhat prolonged S phase and shortened G1 phase compared with the wild-type cells. Large changes in the DNA precursor levels were produced by addition of thymidine to mutant cultures. This gave no change in the growth rate but a somewhat shortened S phase and prolonged G1. The biochemical background for these effects is discussed. PMID- 6489456 TI - Phosphorylation of chromosomal proteins during the transition of a normal plant cell to a crown gall tumor cell. AB - The transition of a wounded plant cell to a crown gall tumor cell, which is induced by infection with virulent Agrobacterium tumefaciens cells, is accompanied by enhancement of chromatin-bound protein phosphokinase activity. Various protein kinases with different substrate specificity (viz. histone, phosvitin, casein phosphokinases) are distinctly more active in tumor cells. The phosphate is introduced into seryl and threonyl residues of proteins and is stable under standard assay conditions, thus indicating the absence of protein phosphatases. Acyl or histidyl phosphates are not involved. The properties of protein phosphokinases change during tumor induction, giving rise to kinases which are sensitive to spermine or spermidine. The pattern of chromatin proteins is tissue-specific and consequently different in wounded and tumorous plant cells, as is the phosphorylation pattern of these proteins. PMID- 6489457 TI - High diadenosine tetraphosphate (Ap4A) level at initiation of S phase in the naturally synchronous mitotic cycle of Physarum polycephalum. AB - Levels of the diadenosine tetraphosphate Ap4A are high during exponential growth of Physarum, decrease during encystment (spherulation) and increase again during excystment. Consistently, a rapid 8-30-fold increase in Ap4A level occurs at entry into S phase of the mitotic cycle and is maintained during the first half of genome replication. The elevated Ap4A level depends significantly on ongoing DNA replication and is completely sensitive to the protein synthesis inhibitor cycloheximide administered either before or after initiation of S phase. PMID- 6489458 TI - Control in previous and present generations of preparation for entry into S phase and the relationship to resting state in 3Y1 rat fibroblastic cells. AB - In both the presence and absence of serum, 3Y1 rat fibroblastic cells synchronized at early S phase by aphidicolin entered M phase 6 h after removal of aphidicolin. However, in the second generation their entry into S phase in the presence of serum was delayed due to the deprivation of serum in the first generation. A similar delaying effect in the second generation was observed when the resting cells were stimulated by serum and then deprived of serum during a period of 8 h preceding mitosis. In both cases, the interval between mitosis and entry into S phase in the second generation was almost equal to that required for the resting cells to enter S phase when stimulated by serum. A similar delaying effect was also observed when the cells, synchronized at early S phase, were kept in suspension culture in the presence of serum for a period in the first generation. Results of a similar type of experiments using various combinations of growth factors showed that, when the G1 period in the second generation was shortened by exposure to growth factors in the first generation, and when the resting cells were stimulated to enter S phase, the same combination of growth factors was required. These and previous results suggest that the preparation for entry into S phase is controlled in both previous and present generations of 3Y1 cells. PMID- 6489459 TI - The chick oviduct in tissue culture. II. Estrogen affects ovalbumin synthesis differently than oviduct cell proliferation. AB - The addition of estradiol alone to oviduct cell cultures was sufficient to induce ovalbumin synthesis, detectable both by immunofluorescence and immunoprecipitation of newly synthesized protein. Most cells stained positively for ovalbumin indicating that the culture conditions promoted the growth of the ovalbumin synthesizing tubular gland cells relative to other cell types. The rate of ovalbumin synthesis was lower than that expected in vivo but as high as or higher than that found in organ culture. In tissue culture ovalbumin gene expression was under the direct influence of estrogen. Previous work showed that estrogen did not stimulate rapid proliferation of oviduct cell cultures (S. S. Seaver, J. van der Bosch & G. Sato, Exp cell res 155 (1984) 241) [5]. Therefore further experiments were done in vivo to correlate the effects of different hormonal regimes on oviduct growth and ovalbumin synthesis. In several instances the hormones affected oviduct growth differently than they affected ovalbumin synthesis. However, there was a strong correlation between the ability of a hormonal regime to stimulate oviduct growth in vivo and the ability of the serum from those chicks to stimulate oviduct cellular proliferation in culture. In vivo estrogen also stimulates oviduct growth by very different mechanisms than it stimulates the expression of the egg white protein genes. PMID- 6489460 TI - Doubling of cell mass is not necessary in order to achieve cell division in cultured human cells. AB - When exponentially growing NHIK 3025 cells were shifted from medium containing 30% serum to medium containing 0.03% serum the rate of net protein accumulation was reduced due to both a reduction in the rate of protein synthesis and an increase in the rate of protein degradation. This change in growth conditions increased the protein doubling time from 18 to 140 h. The cell cycle duration of cells synchronized by mitotic selection was, however, only increased from 17 to 26 h by this treatment. Therefore, when the cells divide by the end of the first cell cycle following synchronization, the cells shifted to 0.03% serum contained far less protein than those growing continuously in 30% serum. Hence, the attainment of a critical cell mass is probably not controlling cell division for cells growing in a balanced state. PMID- 6489461 TI - Inducibility of heat shock polypeptides in cells containing hyperacetylated histones. AB - We have examined the effect of sodium butyrate on the levels of histone acetylation, the pattern of protein synthesis and the inducibility of heat shock polypeptides (hsps) in cultured trout fibroblasts. Maximal levels of histone acetylation are achieved upon treatment of these cells with 5 mM butyrate for 24 h. No significant changes in the pattern of protein synthesis, as detected by two dimensional gel electrophoresis, are apparent under these conditions, although changes in the levels of three polypeptides are seen at shorter times of exposure to butyrate. Heat shock polypeptides are inducible at normal levels in butyrate treated cells. This is in contrast to the ability of butyrate to inhibit the activation of steroid-inducible genes in some systems. PMID- 6489462 TI - Microinjection in the chick blastoderm. An improved method to study the extracellular matrix in the living organism. AB - A microinjection technique for the chick blastoderm is described. With a micropipette attached to a de Fonbrune micromanipulator, 25-45 nl of a reagent was injected into the entophyllic crescent of a chick blastoderm explanted in vitro according to New [7]. This procedure offers the advantage of eliminating the concentration variability which was observed after subblastodisc injection, and in contrast to the in ovo techniques, it allows one to stage the blastoderms properly. To check its applicability, testicular hyaluronidase was injected. On the basis of morphological and histochemical observations we ascertained that the experimental procedure itself did not interfere with the results. This method may provide a reliable experimental procedure with which to study the interactions between several macromolecules and the tissues during morphogenesis. PMID- 6489463 TI - Ultrastructural evidence of progesterone receptor by immunochemistry. AB - Antiserum against purified chick oviduct non-transformed "8S"-progesterone receptor has been used for detecting progesterone receptor in rat pituitary cells at the ultrastructural level after immunochemical reaction according to Sternberger. In prepubertal (21-day-old) and adult (diestrus) female rats, the gonadotropic, lactotropic and somatotropic cells were positive, but not the corticotropic and thyreotropic cells. In all positive cases, the progesterone receptor-like antigen was found in both the cytoplasm and the nucleus. Two hours after progesterone administration to immature rats, there was an increase of receptor-like antigen in nuclei of gonadotropic cells. These results and the immunological controls related to antibody specificity give the first evidence of progesterone receptor at the ultrastructural level. They remarkably show that its distribution in pituitary cells parallels the distribution of the estradiol receptor. PMID- 6489464 TI - Correction of sister chromatid exchanges in Bloom's syndrome fibroblasts after fusion with cytoplasts from a Chinese hamster cell line. AB - Cytoplasmic hybrids (cybrids) were prepared by fusion of Bloom's syndrome (BS) fibroblasts with cytoplasts derived from a chloramphenicol (CAP)-resistant cell line of hypoxanthine phosphoribosyl transferase (HPRT)-deficient Chinese hamster wg3h cells to study the role of cytoplasmic and nuclear factors which may involve corrective factor(s) of sister chromatid exchanges (SCEs) of the BS cells. The high rate of SCEs characteristic of the cultured BS fibroblasts was found to be fully corrected in cybrids. This result suggests the existence of a transmissible corrective factor(s) in the cytoplasm of the Chinese hamster cells. Long-term cultures of such cybrids after 3 and 5 weeks of fusion, however, showed a reversion to a high SCE level similar to the parental BS cells, indicating that the corrective factors have not been stable in the cybrid cells. PMID- 6489465 TI - A calmodulin antagonist increases the apparent rate of endocytosis of liposomes bound to MHC molecules via monoclonal antibodies. AB - We have investigated the molecular mechanisms required for endocytosis of MHC encoded proteins by a cell line, TRH 42, that expresses endogenous murine and introduced human class I molecules. As probes we have used protein A-bearing liposomes which bind to cell surface determinants via monoclonal antibodies. The technique of fluorescence quenching release was used with liposome encapsulated quenched carboxyfluorescein as the marker for endocytosis. We demonstrate that the calmodulin antagonist trifluoperazine (TFP) enhances the apparent rate of endocytosis of liposomes bound to MHC class I molecules. Drugs that interfere with energy metabolism, microfilament organization, or phospholipase A2 activity all block endocytosis both in the presence and absence of TFP. The requirement of extracellular Ca2+ for endocytosis was found to be partial. The implications for the structural and enzymatic requirements of endocytosis of MHC class I molecules are discussed. PMID- 6489466 TI - Increased survival of rat hepatocytes in serum-free medium by inhibition of a trypsin-like protease associated with their plasma membranes. AB - Bovine pancreatic trypsin-inhibitor (bPTI) is required for survival of adult rat hepatocytes for more than 2 days in primary cultures in serum-free medium. Of the various protease inhibitors tested, all trypsin inhibitors increased the survival of rat hepatocytes in serum-free medium, their potencies being in the order bPTI greater than alpha 2-plasmin inhibitor greater than leupeptin greater than soybean trypsin inhibitor greater than alpha 1-antitrypsin = alpha 2 macroglobulin. Elastatinal, a specific inhibitor of elastase, was also effective. bPTI did not inhibit the degradation of proteins with short or long lives, suggesting that it did not increase the survival of hepatocytes by inhibiting cellular protein degradation. alpha 2-Plasmin inhibitor immobilized on Sepharose 4B caused dose-dependent increase in survival. Plasma membranes purified from adult rat liver had significant protease activity, about 80% of which was sensitive to bPTI, alpha 2-plasmin inhibitor and leupeptin. From its specificity for substrates and sensitivity to inhibitors, the membrane-bound protease was characterized as a trypsin-like protease. The effects of various inhibitors on the membrane-bound protease correlated well with their abilities to increase survival of rat hepatocytes. Therefore, it seems that bPTI acts on the cell surface and increases hepatocyte survival in serum-free cultures by inhibiting a trypsin-like protease associated with the plasma membranes. PMID- 6489467 TI - Hereditary retinal degeneration in the Rhode Island Red chicken. I. Histology and ERG. AB - Hereditary blindness in Rhode Island Red chickens was analyzed at various post hatching stages by light microscopy and electrophysiological recordings. At the time of hatching the retina of affected chicks appeared morphologically normal and identical to that of control, non-affected chicks. Whereas the electroretinographic (ERG) response to light stimulus in normal chicks was near the adult level at the time of hatching, no ERG either under light- or dark adapted conditions was measurable in affected chicks at any stage examined. Photoreceptor cells of affected animals were seen to undergo degenerative changes after about one week post-hatching. Decrease in number of outer segments, spaces between inner segments and large spaces in the outer nuclear layer were apparent by Day 10. By Day 21, most of the photoreceptor inner segments appeared swollen, and the decrease in number of outer segments and photoreceptor nuclei was noteworthy. By the end of the second month no outer segments were seen and the majority of identifiable inner segments were from cones, a larger proportion than normally present being double cones. By six months, very few photoreceptor inner segments and nuclei remained; most inner segments were deformed and diminutive but usually contained a clearstaining oil droplet characteristic of the principal member of the double cone. In all stages after one week of age, pycnotic nuclei and thinning of inner retinal layers accompanied photoreceptor degeneration. In all specimens examined, degeneration of retinal cells was more pronounced in the superior central retina than in the periphery. Pathological changes were frequently also noted in the pigment epithelium overlying degenerating retina. Because the chick retina is well developed at birth, contains a fovea and a significant cone population and because cones (particularly one specific type) survive rods, we believe that this congenitally-blind chicken may be a useful model for studies on human hereditary retinal degenerations. PMID- 6489468 TI - Exogenous Na-hyaluronate in the anterior chamber of the owl monkey and its effect on the intraocular pressure. AB - Exogenous, ultrapure (sterile, pyrogen-free), non-inflammatory fraction of Na hyaluronate (NIF-NaHA) was introduced into the anterior chamber of owl monkeys (Aotus trivirgatus), replacing approximately 48% or 77% of the aqueous humor and creating post-injection intraocular pressures (IOPs) below normal (5-10 mmHg) or above normal (40-60 mmHg), respectively. Five different molecular weight samples (MW 1.7, 3.4, 3.7, 4.5 and 4.9 X 10(6)) were used. All solutions contained 1% NIF NaHA and, because of the varying molecular weights, the viscosities of the solutions ranged between 10 000 and 930 000 cSt. The IOP and the rate of export of the exogenous NIF-NaHA from the anterior chamber were measured. All solutions caused an increase in the IOP, and the maximum level occurred at 4 hr after injection. In all cases, the IOP returned to normal 24 hr after injection. The highest and most persistent increase in IOP was observed after the injection of the solution with the lowest viscosity (10 000 cSt). The smallest increases in IOP over the post-operative value were observed after replacement of the aqueous humor using those samples with viscosities of 10 0000 to 300 000 cSt. The turnover (export rate) of injected NIF-NaHA depends for the most part on the viscosity of the injected solution. With increasing viscosity the rate constant, and therefore the half-life, of the injected NIF-NaHA decreases. The volume fraction of the viscous solution replacing the aqueous humor is also a determining factor in establishing the turnover rate. The molecular weight of the injected NIF-NaHA did not change during that time (48 hr) in which a sufficient amount of sample for analysis could be obtained. No evidence was found for the presence of any kind of hyaluronic acid-degrading agent in the anterior chamber. PMID- 6489469 TI - Glycoprotein synthesis in the human retina: localization of the lipid intermediate pathway. AB - Retinal tissue from human eye donors was incubated with [3H]-labeled mannose, glucosamine, fucose, and leucine in the presence and absence of tunicamycin, a selective inhibitor of dolichol-dependent glycoprotein biosynthesis. The incorporation of labeled substrates was examined by quantitative light microscopic autoradiography and biochemical methods. [3H]-Mannose and [3H]-fucose were predominantly incorporated into the photoreceptor layer, while [3H] glucosamine and [3H]-leucine labeled the entire retinal expanse. Tunicamycin caused a marked and selective reduction in the incorporation of [3H]-mannose and [3H]-glucosamine in the photoreceptor layer (especially the inner segments) without affecting the relative distribution of labeled products derived from [3H] fucose or [3H]-leucine. All three [3H]-labeled sugars were incorporated preferentially into rod inner segments, relative to cones. Dual-label experiments with [3H]-sugars and [14C]-leucine revealed that tunicamycin selectively inhibited the incorporation of [3H]-mannose, but not the other substrates, into total retinal TCA-precipitable material. This inhibition was not due to decreased mannose uptake by retinal cells. Detergent-solubilized retinas were analyzed by polyacrylamide gel electrophoresis and fluorography. The results indicated that each labeled substrate was incorporated into a variety of glyoproteins, including a component having the electrophoretic mobility of opsin. These results suggest that the lipid intermediate pathway of glycoprotein synthesis is localized preferentially to the photoreceptor layer of the retina, and may subserve the biosynthesis of rod cell glycoproteins (e.g. opsin). PMID- 6489470 TI - Lens deviations in rabbit offspring after short-term prenatal exposure to dexamethasone: a light-microscopic study. AB - Female New Zealand White rabbits were treated subcutaneously with 0.0375 or 0.15 mg kg-1 dexamethasone or physiological saline solution from the 8th through to the 11th day of gestation. Short-term administration of 0.15 mg kg-1 dexamethasone induced two types of morphological lens deviations in the offspring (lenses were studied by means of sagittal serial sections). In the first type of deviation a progressive series of changes in the lens bow region was observed. Early changes consisted of an enlargement of some lens bow nuclei, an increase in the number of lens bow nuclei and a disturbance in the shape of the lens bow. Later changes consisted of the degeneration and vacuolization of a peripheral zone of cortex fibre cells. The overall picture showed that the size of up to 8% of the nuclei in the deviating lens bows was enlarged and that the average number of lens bow nuclei in the deviating lenses was 28% higher (P less than 0.01) than in the lens bows without deviations. The second type of lens deviation consisted of isolated bundles of disintegrated cortex fibre cells, which extend downwards (anterior-posterior) from subepithelial vesicles. In these bundles all nuclei were smaller and more basophilic than normally. Both types of lens deviations occurred independently in the superficial cortex. Control offspring treated with physiological saline solution showed neither the first nor the second type of lens deviation. Of the offspring exposed to 0.0375 mg kg-1 dexamethasone one animal (8%) showed lens changes of the first type only, whereas 59% of the offspring exposed to 0.15 mg kg-1 dexamethasone displayed either one or both types of lens deviations. PMID- 6489471 TI - Sequential structural response of lens epithelium to retina-conditioned medium. AB - When lens epithelium is cultured with retina-conditioned medium, many of the cells undergo fibre differentiation within 6-10 days. Here we report the temporal sequence of structural events that characterize this change in an organ culture model system. Within an hour of exposure to conditioned medium, some cells withdrew from the epithelial monolayer and began migrating over stationary cells still attached to the capsule. By 24 hr, migratory activity was largely responsible for causing the explant to become multilayered, increasing its thickness while at the same time reducing its surface area. Control cells attached to each other along their lateral boundaries through interdigitations of microvilli. After BRCM treatment, microvilli flattened out and the membranes had a crinkled appearance. Eventually, as the cultured cells developed into fibres, membranes straightened and developed knob and socket junctions and large numbers of their organelles underwent degradation within autophagic vacuoles. Nucleoli began to enlarge by 16 hr and by the time cells had been exposed for 24 hr, some nucleoli were enlarged to seven-fold their original area, as measured on electron micrographs. This nucleolar change was followed over the next few days by a gradual increase in cytoplasmic protein, and cells became plump or elongated. The ultrastructural changes that we observed in culture are similar to those that can be seen in the intact lens. Such fidelity of change indicates that this cultured lens explant system is an excellent model for experimental intervention and analysis of the processes involved in terminal lens fibre differentiation. PMID- 6489472 TI - Development and degeneration of retina in rds mutant mice: light and electron microscopic observations in experimental chimaeras. AB - Mice, homozygous for the rds gene, fail to develop the receptor outer segments and show a slow reduction of the outer nuclear layer. A series of 13 chimaeric mice was produced by combining morulae from albino rds/rds and pigmented normal (+/+) mice. At 3-4 weeks, variable stretches of visual cells without outer segments were observed together with stretches of visual cells with normal outer segments. The location of these areas was unrelated to the genotype of the overlying pigment epithelium. Phagosomes containing outer segment debris were present in albino pigment epithelial cells, located over normal outer segments, indicating normal functional properties of rds/rds pigment epithelial cells. At 9 months, regions with visual cell loss were observed underlying both types of pigment epithelial cells. Regions showing normal and intermediate thicknesses of the outer nuclear layer were seen more often than regions showing rds/rds type distribution. In another series of eight chimaeras, consisting of albino rds/rds and pigmented rd/rd genotypes, the eyes examined at 22 days showed more pronounced visual cell loss than in the rds----normal retinas at 9 months. Regions of the outer nuclear layer, containing a single row of cone perikarya, were similar to the rd/rd phenotype and differed from the phenotype of the double homozygous rd/rd rds/rds retina, which has a slower rate of degeneration than in rd/rd mice. Visual cell loss in these chimaeras at 9 months was similar to that in the rds/rds retina of the same age. The findings show that the expression of the rds gene, resulting in failure of outer segment development and eventual death of visual cells is unrelated to the genotype of the overlying pigment epithelial cells and suggest that the gene acts within the neural retina and possibly intracellularly in the visual cells. PMID- 6489474 TI - Low natural killer cell activity in the bone marrow of healthy donors with normal killer cell activity in the peripheral blood. AB - We have investigated the natural killer (NK) cell activity in peripheral blood and in bone marrow of nine normal donors. It was found that Ficoll-Hypaque (FH) separated cells from the bone marrow collected in small (1 ml) aliquots had very low NK activity compared with normal activity in the peripheral blood of the same donor (mean +/- SD: 4.2% +/- 2.5% vs 25.1% +/- 15%, P less than 0.01). This difference was maintained for cells bearing receptors for sheep erythrocytes (E+) in both tissues (4.3% +/- 2.37% vs 15%+/-12.6%, P less than 0.01) or E- cells (2.5% +/- 2.86% vs 20.4% +/- 19.5%, P less than 0.01). Also, in bone marrow cells with Fc receptors for IgG (Fc gamma+) neither E+ nor E- had significant NK activity, in contrast to the peripheral blood, where significant NK cell activity was detectable in the Fc gamma + cells, either E+ or E- (1.9% +/- 1.2% and 1.3% +/- 1.4% vs 16.1% +/- 10.3% and 12.8% +/- 7.4%, respectively, P less than 0.01 for both). Our data indicate that bone marrow obtained with a low degree of blood contamination from normal donors has very low NK activity with no significant increase in any of the several fractions tested. PMID- 6489473 TI - Increased synthesis of mouse minor hemoglobin in erythroid colonies: a cellular model for hemoglobin regulation. AB - Globin synthesis was examined in mouse erythroid colonies. Bone marrow cells from DBA/2J adults were cultured in methylcellulose and labeled with 3H-leucine; globin synthesis ratios were determined following electrophoresis of lysates on polyacrylamide gels containing urea, acid, and Triton X-100. Colonies derived from the immature progenitor cells, BFU-E and CFU-E, produced close to 40% beta mi of total beta, while cluster-forming units, erythroblasts, and reticulocytes synthesized approximately 30% beta mi. Thus, beta mi synthesis decreased with increasing maturity of the erythroid compartment being examined, qualitatively resembling the decrease in fetal hemoglobin between BFU-E and erythrocytes in human adults. The mouse system described here thus provides a small animal model for studies of changes in hemoglobin expression during erythroid development. PMID- 6489475 TI - Natural killer cell profile of two random-bred strains of athymic rats. AB - We have demonstrated that Rowett and NIH strains of random-bred athymic and euthymic rats exhibited significant levels of natural killer (NK) cell cytotoxicity against various murine and human tumor cell lines. Rats of both strains displayed high NK cell cytotoxicity in peritoneal exudate, peripheral blood and spleen, and lower activities in lung and liver. No activity was detected in bone marrow. In general, athymic rats manifested higher levels of NK cell cytotoxicity and higher tumor-binding potential than euthymic animals. NK cell cytotoxicity was subject to late maturation and did not decline with age. Cytotoxic cells were not removed by carbonyl iron treatment and resided in both adherent and nonadherent fraction after nylon-wool filtration, with the majority of the cytotoxicity in the latter fraction. Percoll gradient separation studies indicated that, in general, the cytotoxic cells were of large granular lymphocyte morphology and of low density. Evaluation of tumor-binding capacity and cytotoxic profile of large granular lymphocytes has shown that the majority of these cells exhibited cytotoxic potential, but only a minority of them displayed tumor binding capacity. PMID- 6489476 TI - Inhibition of erythroid colony growth in vitro by serum from patients with disseminated bronchial cancer. AB - The anemia of malignancy is characterized by a reduced output of erythroid cells but with a normal red cell survival. In this study, clonal assays of normal human marrows in the presence of serum from 13 patients with bronchial cancer gave significantly reduced yields of erythroid colonies compared with control cultures with normal serum. More than half the cultures showed no growth of either CFU-E or BFU-E. Four sera producing marked depression of erythroid colony growth had no effect on CFU-GM. The evidence suggests the presence of a circulating inhibitor that may be found in either anemic or nonanemic patients. PMID- 6489477 TI - Chromosomal assignment of two murine genes controlling susceptibility to spleen focus formation by Rauscher leukemia virus. AB - Two murine genes affecting susceptibility to spleen focus formation by RLV were assigned to chromosomes. The gene Rv-2, which controls susceptibility to spleen focus formation, was assigned to chromosome 9, and closely linked to the Fv-2 gene, by using the two congenic strains B10.C(47N)/Sn and B6.C-H-7b/By. These congenic strains, which were previously shown to carry the BALB/cJ allele for susceptibility to FLV on chromosome 9, were also susceptible to RLV, as determined by number of foci on the spleens of infected mice. A second gene which contributes to the susceptibility to spleen focus formation by RLV was assigned to the X chromosome because hemizygous male offspring of crosses between resistant-strain females and susceptible-strain males (C57BL/6J X CBA/Lac) showed significantly lower numbers of foci/spleen than the female littermates and than the offsprings, males and females, of the reciprocal cross (CBA/Lac X C57BL/6J). We suggest this gene be called Rv-3. PMID- 6489478 TI - The proliferative state of early erythropoietic progenitor cells (BFU-E) in human umbilical cord blood: low probability of finding BFU-E in DNA synthesis. AB - We have investigated the proliferative behavior of early erythropoietic progenitor cells (BFU-E) in human umbilical cord blood with hydroxyurea and tritiated-thymidine suicide experiments. Our results indicate that the great majority of these progenitors are normally either in a quiescent state with respect to DNA synthesis or in a prolonged cell cycle experimentally indistinguishable from this state. In this regard, neonatal BFU-E resemble adult circulating BFU-E. PMID- 6489479 TI - Serotonin uptake by progeny of murine megakaryocyte precursors (CFU-M) in vitro. AB - Normal megakaryocytes take up and store serotonin (5-hydroxytryptamine) (5-HT). Murine megakaryocyte colonies were grown in plasma clot cultures, labeled autoradiographically with 3H-5-HT-creatinine sulfate, and stained for acetylcholinesterase. Silver granules representing serotonin uptake were present over almost all acetylcholinesterase-positive cells, including both mature megakaryocytes and smaller mononuclear cells. There was no evidence of serotonin accumulation in non-acetylcholinesterase staining granulocytic, monocytic, or erythroid cells. The results of this study provide: (a) a new label to identify murine megakaryocytes and smaller mononuclear megakaryocyte precursors (progeny of CFU-M) in plasma clot cultures, (b) further evidence that immature acetylcholinesterase-positive megakaryocyte precursor cells possess the ability to take up and store serotonin, and (c) evidence that this function of megakaryocytes and megakaryocyte precursors is preserved in the artificial environment of plasma clot cultures. PMID- 6489480 TI - In vivo kinetic status of hematopoietic stem and progenitor cells as inferred from labeling with bromodeoxyuridine. AB - The extent of incorporation of bromodeoxyuridine (BrdUrd) into DNA of different types of hematopoietic stem cells assayed in vivo and of progenitor cells assayed in vitro was determined after continuous infusion of BrdUrd into mice for either four or seven days. Cells surviving subsequent exposure to 320 nm ultraviolet light (UV320) were considered not to have incorporated BrdUrd. Assays of stem cells were carried out in 8-Gy-irradiated Balb/c-specific pathogen-free (SPF) mice by measuring the ability of injected marrow: (a) to form spleen colonies at either seven, ten, or 13 days (the units giving rise to such colonies were named CFU-S-7, CFU-S-10, and CFU-S-13), (b) to increase the marrow content at 13 days of colony-forming cells (CFC) responsive in vitro to pregnant-mouse-uterus extract (P) (this ability was named marrow-repopulating ability P-CFC [MRA-P CFC]) and, (c) to increase blood platelet counts at day 13 (this was named platelet-repopulating ability [PRA]). The in vitro assays carried out on marrow from BrdUrd-infused mice were measurements of the content of CFC responsive to P and to P plus human spleen-conditioned medium (H). The percentage survival after exposure to UV320 in marrows obtained after four and seven days of infusion of BrdUrd, respectively, was: MRA-P-CFC, 100% and 100%; PRA, 80% and 50%; CFU-S-13, 65% and 25%; CFU-S-10, 11% and 3%; CFU-S-7, 8% and 2%; P + H CFC, 20% and 12%; and P-CFC, 6% and 6%. These results are in agreement with predictions from previous experiments that studied the effects of 5-fluorouracil (5-FU) on bone marrow using the same assays and are compatible with a model that considers marrow to be organized as a concatenated series of compartments in which turnover rate increases as maturity increases. PMID- 6489481 TI - Regulation of the plasma erythropoietin level in hypoxic rats. AB - Exposure to hypoxia results in an increase in the plasma erythropoietin (Ep) content to a peak level in 10-12 h. If hypoxia is discontinued before maximum plasma Ep concentrations are reached, then the plasma Ep level continues to rise before it declines toward normal. To clarify this phenomenon, we determined the Ep level in the plasma and kidneys at various times after rats that had been exposed to 0.42 atm returned to ambient pressure. The plasma Ep level 2 h after hypoxia was 4-5 times as high as it was immediately after hypoxia and then gradually declined. The Ep content of the kidneys rose for only 1 h after which it rapidly fell to an undetectable level. The most plausible interpretation of this data is that renal Ep production decelerates rapidly within 1 h after return to ambient pressure, but plasma Ep levels continue to rise because of the release of preformed Ep into the plasma. Experiments were also performed to determine whether an increased plasma Ep level inhibits the production or secretion of Ep. Three different types of experiments were performed in which the plasma Ep level was increased by intravenously injecting a large amount of Ep prior to, during, or after exposure to hypoxia and determining its effect on the plasma Ep activity from 15 min to 4 h after injection. In all experiments the plasma and renal Ep levels rose comparably in Ep-treated and control rats during exposure to hypoxia. The data do not support the hypothesis that a rise in the plasma Ep level inhibits Ep production or secretion into the plasma. PMID- 6489482 TI - Growth kinetics of CFU-GEMM, BFU-E, and CFU-C in diffusion-chamber cultures of normal human bone marrow cells. AB - The proliferation and differentiation of human pluripotent hemopoietic precursor cells CFU-GEMM as well as of the committed precursors BFU-E and CFU-C within conventional diffusion chambers (DC) was studied. Low-density human bone marrow cells from eight normal donors were cultured in DC implanted into 750-rad preirradiated mice. Cells harvested from DC after 1-14 days were assayed for the content of CFU-GEMM, BFU-E, and CFU-C. The mean number of progenitor cells inoculated per DC on day 0 was 59 (range 12-144) for CFU-GEMM, 367 (range 165 878) for BFU-E, and 632 (range 122-1168) for CFU-C. After an initial decrease in the number of all progenitors, an increase of CFU-GEMM was observed in five out of eight experiments and in the number of BFU-E and CFU-C in seven and five experiments, respectively. The assessment of the percentage of precursor cells sensitive to ara-C demonstrated a rise in the proportion of cells in S phase after implantation into DC consistent with reentry into active proliferation. From the observed behavior of the CFU-GEMM it is concluded that the earliest detectable human precursor cells do proliferate within DC. PMID- 6489483 TI - Serum lysozyme concentration in silicosis patients and workers exposed to silica dust. AB - Lysozyme in serum (LZM, EC 3.2.1.17) was assayed in 135 male patients with silicosis. Twenty-eight of the patients had controls matched for exposure to silica dust, age and sex but with no radiographical signs of silicosis. A reference group without exposure to silica dust was composed of 34 lumberjacks. The mean concentration of serum LZM was higher in silicosis patients (7.8 +/- 2.8 mg/l, n = 28) than in the controls exposed to silica (6.0 +/- 1.7 mg/l, p less than 0.05), or in the lumberjacks (5.7 +/- 2.1 mg/l, p less than 0.01). There was an association between serum LZM concentration and radiographic severity of silicosis, and on a group basis an association of serum LZM concentration with the progression of silicosis. In the multivariate regression analysis the highest regression coefficients were found for progression of small opacities as well as patient age. The results suggest that the elevation of LZM concentration is associated with the progression of the disease. PMID- 6489484 TI - Forced oscillation technique and maximum expiratory flows in bronchial provocation tests in children. AB - Variables obtained with the forced oscillation technique (total respiratory resistance and impedance at 2, 4 and 12 Hz) and with the forced vital capacity manoeuvre (FVC, FEV1, MMEF, MEF75, MEF50, MEF25) were used in the evaluation of the bronchial allergen challenge test in 2 groups of asthmatic children. Each method was applied in 15 provocation tests and the changes of the different variables, allowing for their respective variations, were compared with the clinical assessment. Agreement with the clinical evaluation was found in 15 of 15 occasions with the forced oscillation technique and in 12 of 15 occasions with the forced vital capacity manoeuvre. With the forced oscillation technique a bronchial reaction was detected in 6 of 10 patients at 1/10 of the allergen concentration that gave positive clinical signs and the single most sensitive variable was resistance determination at 4 Hz, with significant change in 5 of 10 cases. The forced vital capacity manoeuvre allowed detection of a bronchial reaction preceding clinical signs at a tenfold lower allergen concentration in 2 of 9 cases and the most sensitive variables were FEV1 and MEF25. PMID- 6489485 TI - Impairment of ventilatory function by supine posture in asthma. AB - Forced expiratory volumes were recorded in the upright position in 10 asthmatics before and after lying supine. On consecutive days were investigated, in random order, the effect of being supine for 0.5 h, 2 h, 4 h, and of being upright as a control experiment. Peak expiratory flow (PEF) was similarly recorded in the upright position, and, in addition, at every 0.5 h in the supine position. PEF decreased progressively in the supine position, but not in the control experiment. The decrease averaged 24% when supine for 4 h. After return to the upright position, it increased rapidly but incompletely. Forced expiratory volumes tended to decrease after being supine. Thus, the supine position may induce airflow obstruction in asthmatics, and posture may be a major factor behind nocturnal asthma. This protocol may be used as a bronchial challenge test in order to study possible influences on posture-induced obstruction in asthma. PMID- 6489486 TI - Lysozyme and lactoferrin in sputum from patients with chronic obstructive lung disease. AB - The two basic proteins lysozyme and lactoferrin have been isolated from solubilized mucoid sputum from patients with chronic bronchitis in one step by cation exchange chromatography. In sputa from 13 patients with chronic bronchitis their mean concentrations were 0.4 g/l and 0.7 g/l, respectively, representing 6.6% and 11.5% of the total amount of solubilized protein. Lysozyme and the acid mucin glycoproteins of sputum formed aggregates at low ionic strength, probably as a result of electrostatic interactions between the two. Although only aggregates were formed and not a viscoelastic fluid or a gel, these interactions may contribute to the viscoelastic properties of native sputum. PMID- 6489488 TI - Activation of lymphocytes by PPD and PHA is promoted by exudate from BCG-induced pleurisy. AB - Cell-free pleural exudate (PE) obtained from guinea pigs with BCG-induced pleurisy was tested for influence on in vitro activation of lymphocytes by PHA and PPD. A previous study has shown poor activation of lymphocytes derived from pleural exudate and this was thought possibly to depend on inhibitory activity of the exudate. Instead of the expected suppressive effect, however, PE in the present study promoted activation of lymphocytes from most sample sites in healthy and pleuritic guinea pigs. Thus, in the presence of PE, lymphocytes derived from the pleural exudate were always activated in vitro by PHA and PPD. PMID- 6489487 TI - Primary hypogammaglobulinaemia: impaired lung function and body growth with delayed diagnosis and inadequate treatment. AB - The prevalence of primary hypogammaglobulinaemia in Sweden was found to be at least 2.0/100,000, notwithstanding the average diagnostic delay of 12 years found in the 26 patients studied in detail in this report. Height and weight were reduced significantly in patients affected before 15 years of age, particularly in those inadequately treated. Lung function was affected in 19 patients, in 18 demonstrated by the single breath nitrogen test. According to dynamic spirometry and static lung volume measurements 8 were obstructive, 2 were restrictive and 2 had a combined impairment. Furthermore patients who had had inadequate immunoglobulin prophylaxis (less than 25 mg/kg per week) showed significantly worse lung function compared to those adequately treated. We conclude that efficient immunoglobulin prophylaxis supported by antibiotics when required, seems to promote normal growth and to inhibit development of disabling lung disease. PMID- 6489489 TI - Spontaneous pneumothorax related to falls in atmospheric pressure. AB - The relation of changes in atmospheric pressure to admissions due to radiologically verified spontaneous pneumothorax, was studied in 282 consecutive patients. A fall in atmospheric pressure of at least 10 mbar within 24 h was followed by a statistically significant increase in the number of admissions 2 days later. PMID- 6489490 TI - Induction of pneumothorax by means of the Veress cannula. AB - The Veress cannula was used in 20 patients to induce a closed pneumothorax preceding diagnostic thoracoscopy. The Veress cannula appears to be simple, safe and precise in use. PMID- 6489491 TI - Selective IgA deficiency associated with recurrent sinopulmonary infections in sarcoidosis. AB - We present a case of pulmonary sarcoidosis associated with serum and secretory IgA deficiency. This association has only previously been reported in 6 patients and may be coincidental. However, in light of current knowledge of the immunoregulatory defects postulated for sarcoidosis and for patients with selective IgA deficiency, 2 other possible explanations for the association of sarcoidosis and selective IgA deficiency are presented. PMID- 6489492 TI - Phagocytic and metabolic reactions to chronically implanted metal brain electrodes. AB - In order to study the biocompatibility of metal electrodes and insulations in the rat brain, eight different metal electrode types and two different insulations were implanted for 11, 35, 36, 37, or 63 days. Stainless steel and Nichrome were nontoxic metals, silver was toxic, and copper extremely toxic with phagocytosis active to 37 days of implantation. Active phagocytosis was easily detected by high glucose demand using 2-deoxy[14C]glucose (2-DG) autoradiography contrasted with normal 2-DG autoradiographs where phagocytes were present but not ingesting. Epoxylite, an epoxy-polyester varnish, was slightly more reactive in brain than polyimide but not statistically significant. In general, larger electrodes created more tissue reaction per se for as long as 37 days. These results suggested that a thin stainless-steel bipolar electrode will provide safe recording electrodes in either animal or human brain. The importance of these findings is that certain metals (silver, copper) cannot be used in the brain without producing necrosis and phagocytosis, whereas other metals (stainless steel, Nichrome) with varnish insulators (Epoxylite, polyimide) can be implanted without producing any detectable damage beyond that of the initial trauma and brief phagocytosis limited to the edge of the electrode track. Finally, the glucose metabolism autoradiographs differentiated active phagocytosis (copper) from inactive phagocytes (silver) when using long implants (37 days) of toxic metals. PMID- 6489493 TI - Phagocytic and metabolic reactions to intracerebral electrical stimulation of rat brain. AB - Electrical stimulation of the brain has been used with a variety of different electrode types and different stimulating intensities. Few studies have explored neural damage resulting from electrical stimulation that may render the experiment unreliable. The present study used conventional intracerebral bipolar metal stimulating electrodes, delivered a range of defined charge levels, and systematically measured "acute" metabolic effects on glucose (2 deoxy[14C]glucose) metabolism as well as "chronic" (96 h poststimulation) neuronal death and phagocytosis at the electrode surfaces. Neither charge density per phase (QD) nor total charge density per phase (TQD) were independent predictors of "safe" or damaging stimulation; however, together they provided ranges of clearly safe or damaging stimulating conditions that lasted 1 to 2 h. The lowest QD (11.11 microC/cm2/ph) was safe even at 9.1 TQD but not when the pulses totaled 9.6 TQD in 4 h. The middle QD (22.22) was safe even at 9.3 TQD but not when the 2-h pulsing totaled 11.0 TQD. The highest QD (44.44) was safe at 0.4 and 0.8 TQD but irreversibly damaging at 1.6 and 9.6 TQD. These comparisons demonstrated conditions suitable for 1 to 2 h of safe stimulation, but did not provide evidence on the cumulative effects of longer periods or higher frequencies. PMID- 6489494 TI - Irreversible inhibition of phospholipid methylation and protein carboxymethylation does not alter acetylcholine receptor function in muscle cells. AB - The role of methyltransferase (MT) reactions in acetylcholine (ACh)-evoked depolarization and contraction in primary chick myotubes was determined by using a mixture of erythro-9-(2-hydroxy-3-nonyl) adenine, homocysteine thiolactone, and adenosine which together inhibit the activity of MT. Carboxy-MT and lipid-MT activities were inhibited irreversibly by 91 and 100%, respectively. ACh-induced muscle contraction was also inhibited within 10 min after application of the inhibitor mixture. However, in contrast to permanent inhibition of MT activities, inhibition of acetylcholine receptor (AChR)-dependent muscle contraction was reversible. Moreover, physiological studies showed that the inhibitor mixture had no effect on resting membrane potential or ACh-induced depolarization or desensitization. These results suggest that AChR function is not altered by methylation inhibitors and that changes in AChR-mediated contraction are not due to inhibition of MT activities. PMID- 6489495 TI - Conduction velocity changes along lumbar primary afferent fibers in cats. AB - Though peripheral conduction velocity is widely used to characterize afferent fibers according to somatosensory modality, disagreement exists as to whether or not conduction velocity varies along such an axon's length. Therefore, in this experiment, conduction velocities were measured over very short axonal segments (7.5 to 15 mm) within the posterior tibial nerve, sciatic nerve, and L7 dorsal root, using the method of spike-triggered averaging of neurograms recorded from tripolar electrodes. The conduction velocities for several units were also determined using electrical stimulation, so that the accuracy of the two techniques could be compared. For most units, dorsal root and sciatic nerve conduction velocities were not significantly different; however, they were not tightly correlated. Tibial nerve conduction velocity averaged 86% of that within the sciatic nerve. Variations in sciatic nerve conduction velocity within adjacent axonal segments (9 mm in length) rarely exceeded experimental error. It appears that spike-triggered averaging of signals from tripolar electrodes separated 15 mm or more apart is a more accurate method for measuring conduction velocity than electrical stimulation, which was subject to several large errors. PMID- 6489496 TI - Effects of claustrum stimulation on spontaneous bioelectrical activity of motor cortex neurons in the cat. AB - Electrophysiologic interactions between claustrum and motor cortex neurons were investigated in the cat. A total of 136 neurons was recorded from the motor cortex in area 4 (90 cells) and in area 6 (46 cells). Ninety-eight of the total neurons were identified as pyramidal tract neurons (PTNs). Stimulation of the claustrum by single shocks or by trains of stimuli imposed on the tested PTNs a pure long-lasting inhibition, or a long-lasting inhibition preceded by a short early activation, or no effect. No functional localization of the effects of claustrum activation were found within the motor areas. The observed results are consistent with the hypothesis that the claustrum may play a role in movement organization. PMID- 6489497 TI - The effects of disconnection on two phases of kindled frontal-cingulate motor seizures. AB - The effects of various central nervous system cuts on different aspects of behavioral convulsions were observed in separate groups of rats after kindling in the frontal-cingulate area. Cuts in the corpus callosum lateralized the main aspects of the convulsions whereas coronal and sagittal cuts had little effect. Horizontal cuts beneath the electrode eliminated the phase of the convulsions attributable to the neocortex, even at high-intensity stimulation, but permitted the phase attributable to subcortical seizures. Placement of DC lesions in the lateral thalamus or the red nucleus and brachium conjunctivum abolished the tonic component of the neocortical phase, indicating possible involvement of cerebellar circuitry. PMID- 6489498 TI - 2-Deoxyglucose uptake in the thalamus of awake rats after neocortical ablations. AB - Local, temporary or permanent depressions and elevations in 2-deoxy[14C]glucose (2-DG) uptake were observed in the brains of unanesthetized, freely moving rats that 3 days to 1 year earlier had sustained large unilateral posterior neocortical ablations. Some of the differences in metabolic activity between the normal and damaged hemispheres, in both cortical and subcortical regions, were attributed to cell death and gliosis, and surgical trauma. In addition, it appeared that certain metabolic changes provided a physiologic correlate of diaschisis, a temporary impairment in function which von Monakow hypothesized to occur in neurons denervated by a lesion. We concluded that the 2-DG technique is a useful tool for examining the widespread effects of brain damage, and that when employed in the manner exemplified by this and a previous study, the technique can disentangle the changes in neural activity which occur after brain damage from the changes in glial activity which accompany them. PMID- 6489499 TI - Somatotopic relations between the motor nucleus and its innervated muscle fibers in the cat tibialis anterior. AB - The normal development of the anatomic relationships between the motoneurons of the tibialis anterior (TA) muscle and their innervated muscle fibers was studied in 1-, 6-, and 12-week-old and adult cats. The motoneurons of the anterior branch and the contralateral posterior branch of the TA nerve were retrogradely labeled with horseradish peroxidase. Within the TA motor nucleus, anterior branch motoneurons (63% of total) were located rostrally and posterior branch motoneurons (37% of total) were located more caudally. The distributions of soma diameters of labeled motoneurons were bimodal in all age groups, allowing a presumptive division into gamma (small) and alpha (large) motoneurons. The posterior branch contained 52% of the total gamma motoneurons but only 28% of the total alpha motoneurons. Within the TA muscle, the regions innervated by the anterior and posterior branches were clearly segregated as determined by glycogen depletion. Myofibrillar ATPase staining at pH 4.4 demonstrated that the posterior branch innervated a higher proportion (56%) of types I and IIA fibers than the anterior. Our results support the hypothesis that a topographic relationship exists between the locus of a motoneuron within its motor nucleus and the position of its innervated muscle fibers within the muscle. Since these topographic relationships apply to all age groups studied, the muscle volume innervated by each muscle nerve branch appears to represent a reproducible developmental unit with distinct anatomic, physiologic and possibly functional properties. This unit may be termed a muscle "compartment." PMID- 6489500 TI - The rat amygdaloid nucleus: a morphometric right-left study. AB - Our results indicate that Long-Evans male rats housed in standard conditions show no significant difference between the areas of sections of their left and right amygdalas. In contrast, the S1 strain maze-bright animals have a significantly greater right amygdala than left. Furthermore, the data indicate an overall increase in mean (R + L)/2 amygdala area from 6 to 400 days, except for a significant decrease in area from 26 to 90 days. PMID- 6489502 TI - Retrograde and transganglionic degeneration of sensory neurons after a peripheral nerve lesion at birth. AB - The sciatic nerve of newborn rats (less than or equal to 16 h old) was crushed with a watchmaker forceps. During the first 4 weeks after the injury, examination of ipsilateral L4 through L6 dorsal root ganglia, their dorsal nerve roots, and the dorsal funiculus revealed the presence of degenerating myelin and axons. Chromatolysis was not observed. In the spinal cord, the degenerating argyrophilia was restricted to the medial part of the dorsal funiculus (fasciculus gracilis). This is interpreted as transganglionic degeneration of the central processes of the pseudounipolar cells. Twelve weeks after nerve crush, there was a noticeable reduction in the size of the leg, foot, and muscles innervated by the sciatic nerve as well as a substantial loss (P less than 0.001) of neurons and myelinated axons in ipsilateral spinal ganglia and their dorsal nerve roots. The reduction was most prominent among the larger sensory neurons (greater than 40 microns) and the larger myelinated axons. A total loss of about 60% of sensory neurons was found in the L4 through L6 spinal ganglia. About 58 and 64% of the myelinated axons were lost in L4 and L5 dorsal roots, respectively. The remaining perikarya and dorsal root axons were hypoplastic. PMID- 6489501 TI - Electroencephalographic, behavioral, and histopathologic features of seizures induced by intra-amygdala application of folic acid in cats. AB - The effects of intracerebral injection of folic acid are still controversial. We studied the electroencephalographic, behavioral, and histopathologic consequences of the seizures induced by intra-amygdala administration of various doses of FA in freely moving cats. The severity of the seizures was dose-dependant. For doses of 25 and 50 nmol, single low-amplitude spikes appeared in the amygdala 15 to 20 min after injection and a typical amygdala symptomatology was observed. From doses of 100 nmol recurrent limbic seizures occurred 40 to 80 min after injection. Finally, from doses of 150 nmol secondarily generalized seizures were induced, which could be followed by death 4 to 6 h after injection. The severity of the cerebral lesions was related to both the dose and the paroxysmal manifestations. In cases with short survival time (6 h) and few seizures the pathology was restricted to a lymphocytic and glial reaction with some ischemic cells at the injected site. In cases with status epilepticus, edema and neuronal degeneration was observed in the hippocampus, amygdala, thalamic nuclei of the midline, entorhinal cortex, and cerebellum. No neuronal alteration at the injected site was observed. For longer survival times (8 days) edema was less severe, but hyperchromatic cells were still numerous. These results, compared with those of intra-amygdala administration of kainic acid, suggest that pathologic lesions induced in cats by folic acid more closely resemble those described in man after some status epilepticus. PMID- 6489503 TI - Quantitative ultrastructural stereology of synapses in nucleus dorsalis after a peripheral nerve injury at birth. AB - Utilizing recent techniques in quantitative stereology, this investigation studied the synaptology of nucleus dorsalis (Clarke's column) in 12-week-old rats whose sciatic nerves were crushed in the 1st postnatal day. Four morphometric variables were analyzed at the levels of L1 and L3 spinal cord segments: total surface area of synaptic contact zones per unit volume (SV), total length of synaptic contact zones per unit area (LA), average length of synaptic membrane (L), and numerical density of synapses per unit volume (NV). The original raw data were corrected for Holmes's effect. The results indicated that peripheral nerve crush at birth induced a transganglionic change in central sensory terminals with a loss of numerous synapses. A significant loss (P less than 0.001) of about 32% in the SV and LA and a significant loss (P less than 0.001) of about 36% in the NV were observed on the experimental side. There was no preferential loss of synapses in either segment. The mean synaptic membrane length showed no significant difference between the control and experimental sides. The control values of the four morphometric variables calculated for L3 were lower than those calculated for L1. The loss of synapses after a peripheral nerve lesion was probably due to the loss of sensory neurons and their central processes, but there were other possibilities. PMID- 6489504 TI - Unit activity related to head and eye movements in central thalamus of cats. AB - Single-unit activity was recorded with stereotaxically guided microelectrodes in the central thalamus of five alert cats. The animals were studied with the head either fixed or free to move in a horizontal plane. They were trained to make eye and/or head movements toward discrete visual targets presented on a screen. Unit activity was analyzed in relation to triggered and spontaneous gaze displacements with head fixed and free successively. Four groups of cells were found, all within the thalamic internal medullary lamina: 20 cells were active with eye but not head movements, 49 with head but not eye movements, 36 with head or eye movements, and 17 responding to visual stimuli in the absence of movement. The patterns of firing during gaze shifts are described. It is hypothesized that eye- or head-related units carry a signal representing gaze driving. PMID- 6489505 TI - Axon growth in tendon organs of botulinum-paralyzed neonatal mouse muscles. AB - Paralysis of neonatal mouse gluteus muscles with botulinum toxin stimulated the growth not only of motor nerve terminals but also of the terminals of the sensory axons innervating the tendon organs. However, the adult mouse tendon organ axons, unlike motor nerve terminals, did not sprout in response to paralysis. PMID- 6489506 TI - Isoelectrically focused carboxyesterases as a biological marker in chimeras. AB - Species-specific multiple forms of carboxyesterases (CE) were determined in zymograms obtained by isoelectric focusing (IEF) using homogenized wing zeugopodal tissues of chick, quail and quail-chick chimeras. The validity of the CE pattern of chimeric tissues was verified by the nuclear marker technique. Analytical IEF of CE was found to be useful for investigation of the origin of tissues in chimeras. PMID- 6489507 TI - Dense core vesicles during photoreceptor development. AB - The presence of dense core vesicles in the terminal expansions of photoreceptors in development is described in the chick embryo retina, from the 16th to the 18th day of incubation. PMID- 6489508 TI - Evidence for no relationship of the pineal activity with the neonatal shrinkage of Leydig cells in the rat. AB - The collective volume of Leydig cells in prenatally pinealectomized newborn rats declined as sharply as in intact newborn rats. Also, the collective volume in pups born in the dark declined in a fashion similar to that in pups born in the light. The results indicate that neither the pineal gland nor the light is responsible for the neonatal shrinkage of Leydig cells. PMID- 6489509 TI - Out-of-wedlock births, premarital pregnancies and their effect on family formation and dissolution. AB - The persistent rise in the proportion of firstborn babies conceived out of wedlock, which characterized the period from the 1950s to the early 1970s, has apparently abated, according to data analyzed from the June 1980 and June 1982 Current Population Surveys (CPS). Although the proportion increased from 16 percent of firstborn children among women 15 years and older in the 1950-1954 period to 34 percent in the 1970-1974 period, it subsequently declined to 31 percent in 1975-1979, and has remained at that level. Since 1970, approximately 68 percent of firstborn children among teenage women have been conceived outside of marriage, four times the level recorded during the same period among women aged 20 and older. In addition, more than 90 percent of firstborn babies among black teenagers have been conceived out of wedlock, compared with about 60 percent among white teenagers. Among women aged 20 and older, about 50 percent of firstborn babies of black mothers and approximately 13 percent of firstborn babies of white mothers have been conceived outside of marriage. Despite the recent overall stability in the proportion of first babies conceived out of wedlock, a notable decline has occurred in the likelihood of mothers to marry before the birth of the child. Between the 1950-1954 and the 1970-1974 periods, about 50 percent of all women who had an out-of-wedlock pregnancy married before the birth; this proportion has since fallen below 40 percent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489510 TI - Family communication and teenagers' contraceptive use. AB - Improving communication about sex and birth control between parents and their children has often been cited as a means to encourage young people to use contraceptives more effectively. In an attempt to test this hypothesis, we interviewed 290 adolescents at family planning clinics in southeastern Pennsylvania three times in the course of 15 months about their communication with their families and their use of contraceptives. At the time of their first clinic visit, two-fifths of the teenagers said that their mothers knew that they had gone to the clinic; this proportion rose to almost three-fifths six months later and to about three-quarters at the end of 15 months. However, the proportion of teenagers who said that they had discussed sex or birth control with their mothers remained almost the same; the proportion who said that they would never discuss such topics with their mothers also remained fairly constant. The teenagers whose mothers knew of their clinic attendance at the time of their first visit were no more likely to have had extensive conversations with their mothers about sex or contraception than were the teenagers whose mothers found out afterwards. Among a subsample of the mothers of these young women, fewer than one-third said that they had ever discussed their daughters' sexual activity with them. There was only a modest level of correspondence between the mothers' responses and their daughters' replies; for the most part, the mothers thought that they were much more communicative about sex and birth control than their daughters perceived them to be.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489511 TI - Adolescent sexual attitudes and behavior: are they consistent? AB - Relationships between sexual attitudes and behavior among adolescents were studied in data collected by self-administered questionnaires from approximately 3,500 junior and senior high school students attending four inner-city schools during 1981-1982. An analysis of the results by sex, race and age found that 83 percent of sexually experienced adolescents cite a best age for first intercourse that is older than the age at which they themselves experienced that event, and 43 percent of them report a best age for first coitus older than their current age. In addition, 88 percent of young women who have had a baby say the best age at which to have a first birth is older than the age at which they first became mothers. Thirty-nine percent of the women and 32 percent of the men say that they believe premarital sex is wrong. Among those who are virgins, the proportions are much higher. However, even among those who have had intercourse, approximately 25 percent of both sexes say they believe sex before marriage is wrong. Women desire stronger relationships before having intercourse than do men, and women claim to have had a stronger relationship with their last sexual partner. Very few teenagers believe neither partner is responsible for pregnancy prevention, which tends to be viewed as a joint responsibility. Those who see it as a shared responsibility are slightly more likely than those who assign the responsibility to one or the other partner to have used a method at last intercourse, and they are considerably more likely to have used a method than are those who believe contraception is neither partner's responsibility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489512 TI - A new strategy for preventing unintended teenage childbearing. PMID- 6489513 TI - The roles of intrinsic kinase and of kinase/activator protein in the enhanced phosphorylation of pyruvate dehydrogenase complex in starvation. AB - Extracts of heart mitochondria from fed and from 48 h starved rats subjected to gel filtration on Sephacryl S-300 gave 4 major protein peaks. Pyruvate dehydrogenase complex eluted in the void volume and was assayed for intrinsic pyruvate dehydrogenase kinase activity which was increased approximately 3-fold by 48 h starvation of the rat. A second fraction, containing peaks 2 and 3 which overlapped, enhanced the activity of the intrinsic kinase and corresponds to kinase/activator protein described previously. Its activity was increased 1.5 fold by starvation. PMID- 6489514 TI - The competitive equilibrium between aluminium and ferric ions for the binding sites of transferrin. AB - Human transferrin is shown to bind 2 mol of aluminium per mol of protein using spectrophotometric titration. Competitive equilibrium between aluminium and ferric ions for transferrin binding sites is observed, and a value of 2.5 (+/- 0.4) X 10(15) M-1 is found for the apparent binding constant under physiological conditions. PMID- 6489515 TI - Fluorescence changes from single striated muscle fibres injected with labelled troponin C (TnCDANZ). AB - A fluorescently labelled derivative of the calcium binding subunit of troponin, TnC, has been injected into isolated striated muscle fibres from the barnacle Balanus nubilus. The Ca2+ affinity of isolated TnC is close to that of intact troponin when located in the thin filament. Excitation of the TnCDANZ within the muscle cell (325nm) revealed a marked fluorescence at 510 nm and was similar to that observed in vitro, which was absent at 400 or 600 nm after subtraction of the fibre autofluorescence. High Ca2+ salines increased the fluorescence at 510 nm by roughly 2 times. Single voltage clamp pulses produced a rapid rise in fluorescence at 510 nm after allowing for any non-specific changes at 400 nm, and this signal preceded force development by approx. 55 ms at 22 degrees C. It reached a maximum at the same time as force and subsequently decayed more slowly. The fluorescence signal increased in magnitude with increase in stimulus intensity. These results suggest that Ca2+ attaches rapidly to the contractile filament, but is lost relatively slowly and imply a slow decay of the activation process. PMID- 6489516 TI - Mare lactotransferrin: purification, analysis and N-terminal sequence determination. AB - Mare lactotransferrin has been purified and analyzed. Its molecular mass is 81 kDa. A 28 amino acid long N-terminal sequence was established and a first series of comparisons with other transferrins was performed. PMID- 6489517 TI - Does microsomal glycerophosphate acyltransferase also catalyze the acylation of dihydroxyacetone phosphate? AB - Rat liver microsomal dihydroxyacetone phosphate acyltransferase, in contrast to the glycerophosphate acyltransferase, was found to be active at low pH (5.5), stable towards heat (55 degrees C, 15 min) and trypsin (in the absence of detergents) and was not inhibited by high concentrations of N-ethyl maleimide. Dihydroxyacetone phosphate acyltransferase is only slightly and non-competitively inhibited by sn-glycerol-3-phosphate whereas glycerophosphate acyltransferase is strongly inhibited by dihydroxyacetone phosphate in a competitive manner. Kinetic analysis indicates that this competitive inhibition is not due to the competition of two common substrates for the same active center of one enzyme. These results demonstrate that microsomal glycerophosphate acyltransferase and dihydroxyacetone phosphate acyltransferase are two distinct and separate enzymes. PMID- 6489518 TI - New fluorescence of nonenzymatically glucosylated human serum albumin. AB - Glucosylated human serum albumin (G-HSA) obtained under incubation with glucose at 37 degrees C for 8 days showed a new fluorescence with a maximum at 430 nm, resulting in quenching of the fluorescence of only one tryptophan residue on HSA. The quantum yield of new fluorescence is 0.024 at 25 degrees C. The analysis of the excitation spectra allowed us to conclude the absence of energy transfer. In G-HSA, non-disulfide cross-linking hexamer was confirmed by SDS-PAGE. PMID- 6489519 TI - Sequence data concerning the protein core of the cartilage proteoglycan monomers. Characterization of a sequence allowing the synthesis of an oligonucleotide probe. AB - The present report develops our previous structural data concerning the cyanogen bromide fragments from the bovine nasal cartilage proteoglycan monomers. Among the reported sequences a Met-Ile-Trp-His sequence was characterized, useful for future studies devoted to the molecular cloning of the proteoglycan monomers. PMID- 6489520 TI - Specific inhibition of human beta-D-glucuronidase and alpha-L-iduronidase by a trihydroxy pipecolic acid of plant origin. AB - The glucuronic acid analogue of 1-deoxynojirimycin, 2(S)-carboxy-3(R), 4(R), 5(S) trihydroxypiperidine, recently isolated from seeds of Baphia racemosa, is a novel specific inhibitor of human liver beta-D-glucuronidase and alpha-L-iduronidase. No other glycosidases are inhibited. The inhibition of beta-D-glucuronidase is competitive, with a Ki of 8 X 10(-5) M and is pH-dependent. This inhibitor may be useful to induce a mucopolysaccharidosis or to investigate the function of microsomal beta-D-glucuronidase. PMID- 6489521 TI - Transfer of ferritin-bound iron to adriamycin. AB - Interactions of adriamycin with ferritin-bound iron have been investigated. It is demonstrated (i) that adriamycin stimulates an iron-dependent lipid peroxidation in submitochondrial particles in the presence of ferritin, and (ii) that incubation of adriamycin with ferritin results in a slow transfer of iron to adriamycin with formation of an adriamycin-iron complex. The results are discussed in relation to the possible role for intracellular iron in adriamycin toxicity. PMID- 6489522 TI - The decarboxylation of 3-mercaptopyruvate to 2-mercaptoacetate. AB - Rat brain mitochondria were found to convert 3-mercaptopyruvate to 2 mercaptoacetate in the presence of NAD+, coenzyme A and thiamin pyrophosphate. The overall reaction probably consists of an oxidative decarboxylation of 3 mercaptopyruvate with 2-mercaptoacetyl CoA as a product which is then hydrolyzed to 2-mercaptoacetate by acyl CoA hydrolase. PMID- 6489523 TI - Functional reconstitution of the partially purified aspartate-glutamate carrier from mitochondria. AB - The aspartate/glutamate carrier from beef heart mitochondria has been solubilized with detergent. The transport protein was partially purified by chromatography on hydroxyapatite in the presence of dodecyl octaoxyethylene ether and high concentrations of ammonium acetate. During purification, the aspartate/glutamate carrier was identified by functional reconstitution into egg yolk phospholipid liposomes. After hydroxyapatite chromatography the protein is 30 fold enriched in aspartate/glutamate transport activity but still contains ADP/ATP-carrier and phosphate carrier. The reconstituted activity is specific for exchange of L aspartate and L-glutamate and is similar to intact mitochondria with respect to substrate affinity and inhibitor sensitivity. PMID- 6489524 TI - Malonyl CoA inhibition of carnitine palmityltransferase in rat heart mitochondria. AB - The effects of malonyl CoA on carnitine palmityltransferase I (CPT-I), fatty acid supported state 3 respiration, and carnitine reversal of palmityl CoA inhibition of state 3 respiration and of the adenine nucleotide translocator, were studied in isolated rat heart mitochondria. Malonyl CoA was a potent competitive inhibitor of CPT-I with an I50 of 0.8 microM. Fasting did not affect CPT-I activity or the I50 value of malonyl CoA. Malonyl CoA inhibited fatty acid supported respiration and prevented carnitine from reversing the inhibition of the adenine nucleotide translocator by palmityl CoA. These findings suggest that malonyl CoA may affect fatty acid oxidation in the heart. PMID- 6489525 TI - Phosphorylation of elongation factor 1 in polyribosome fraction of rabbit reticulocytes. AB - A single protein, Mr approximately 50000, is shown to be phosphorylated during incubation of a mono- and polyribosome fraction of rabbit reticulocytes with [gamma-32P]ATP at a low ionic strength. This protein has been identified as the elongation factor 1 alpha (EF-1 alpha). The phosphorylated EF-1 alpha, in contrast to the unmodified factor, is not detected in complexes with mono- and polyribosomes. It is suggested that the phosphorylation of EF-1 alpha can result in its decompartmentation from polyribosomes and thus affect the rate of protein synthesis. PMID- 6489526 TI - Inhibition of protein A24 lyase by nitrosoureas. AB - The protein A24 content of Ehrlich ascites tumor cells increased several-fold following treatment of cell cultures with nitrosoureas, but did not increase when other alkylating agents not containing carbamoyl moieties were tested. The same nitrosoureas and, in addition, 2-chloroethyl isocyanate inhibited an A24 lyase containing cytoplasmic extract in cleaving protein A24 into histone H2A and ubiquitin. It appears that carbamoylation of A24 lyase by nitrosoureas inhibits the enzyme and is responsible for the measured increases in cellular protein A24 content due to reduced turnover of this protein. PMID- 6489527 TI - The effect of phallotoxins on the structure of F-actin in myosin-free ghost muscle fibres of rabbit. AB - Using polarized UV fluorescent microscopy it has been shown that phallotoxins (phalloidin-sulfone, phalloidin-sulfoxide-B, phalloidin-sulfoxide-A and dithio phalloidin) cause an increase in tryptophan fluorescence anisotropy of F-actin myofilaments in myosin-free ghost muscle fibres of rabbit. The results obtained are considered to be evidence of conformational changes in F-actin, induced by phallotoxins. These changes are irreversible to a significant extent, which points to a high degree of actin binding to both toxic and nontoxic phallotoxins. PMID- 6489528 TI - Photoaffinity labelling of the nucleoside transporter of cultured mouse lymphoma cells. AB - Nitrobenzylthioniosine (NBMPR), a potent and specific inhibitor of nucleoside transport, is bound reversibly by high affinity sites on nucleoside transporter proteins of erythrocyte membranes and, upon photoactivation, NBMPR molecules become covalently bonded to the sites. This study showed that [3H]NBMPR molecules reversibly bound to intact S49 and L5178Y mouse lymphoma cells became covalently bound upon exposure to UV light. Electrophoretic analysis of plasma membrane fractions from the labelled cells showed that 3H was present in polypeptides which migrated as a major band with an apparent Mr of 45000-65000. PMID- 6489529 TI - Why nerves to coronary vessels? PMID- 6489530 TI - Effects of acetylcholine on the coronary artery. AB - Acetylcholine acts on the different components of the coronary arterial wall by 1) initiating endothelium-dependent relaxation of the smooth muscle cells; 2) inhibiting the exocytotic release of norepinephrine (NE), which could result in either vasodilator or vasoconstrictor effects depending on whether the main action of NE is alpha- or beta-adrenergic, respectively; and 3) activating the contractile process of the smooth muscle cells. These different effects of the cholinergic transmitter are muscarinic in nature. Their relative importance varies among species, or when acetylcholine is given exogenously rather than released from cholinergic nerves. PMID- 6489531 TI - Parasympathetic control of coronary blood flow. AB - Active parasympathetic coronary vasodilation in excess of any changes in myocardial metabolism has been observed in a number of circumstances. Electrical stimulation of the cardiac end of the cut vagus nerve produces a cholinergic coronary vasodilation that is blocked by atropine. Activation of carotid body chemoreceptors, carotid sinus baroreceptors, or left ventricular receptors elicits reflex parasympathetic coronary vasodilation. The coronary vasodilation produced by these reflexes can be prevented by vagotomy or atropine. The relative importance of parasympathetic coronary control in relation to sympathetic and local metabolic coronary control awaits further research. PMID- 6489532 TI - Neuropeptidergic regulation of food intake. Introduction. PMID- 6489533 TI - Neuromodulation of intestinal ion transport. Symposium summary. PMID- 6489534 TI - Preservation of the ovary: a reevaluation. AB - The incidence of routine ovariectomy approximates 20% to 30% of all women at hysterectomy. The propriety of this practice is evaluated from three perspectives: the review of the longevity of ovarian hormonal function throughout life, the review of the low risk of subsequent disease in the retained ovary, and the review of epidemiologic considerations. Because oophorectomy and the loss of its steroid contribution has such a profound influence on many body functions, with the most devastating relation to osteoporosis, and because there are no meaningful data in the literature to support the value of routine oophorectomy, removal of ovaries should only be performed when the ovaries are diseased. PMID- 6489535 TI - Wedge metroplasty for the septate uterus: an update. AB - Twenty-one patients with septate uteri and 2 patients with a T-shaped uterine anomaly and recurrent abortions underwent wedge metroplasty during the period from September 1978 to August 1983. Thirteen patients had a characteristic history of one or more abortions associated with the septate uterus and absence of other metabolic and endocrine abnormalities. Ten other patients, including the two with a T-shaped uterine anomaly, either had one or more abortions of an uncharacteristic nature with absence of other abnormalities or had one or more characteristic abortions in addition to the presence of other metabolic, endocrine, or surgically correctable disease. The application of wedge metroplasty for the surgical reconstruction of the uterus yielded equally gratifying results in both groups with approximately two thirds of the patients having a term delivery or carrying a pregnancy in the third trimester. PMID- 6489536 TI - Microsurgery of endometriosis in infertile patients. AB - From January 1973 to December 1980, 176 infertile women with endometriosis were treated with atraumatic and microsurgical techniques. None of these patients received preoperative or postoperative antigonadotropin therapy. The degree of endometriosis in these patients was classified according to the scaling point system of The American Fertility Society. After 2 years the cumulative pregnancy rate of the severe group (40%) was not different from that of the mild (43%) or moderate group (45%). It is therefore suggested that the use of microsurgical techniques can improve the pregnancy outcome in patients with severe endometriosis. PMID- 6489537 TI - Sterilization failures with bipolar tubal cautery. AB - From a consecutive series of 105 patients undergoing bipolar tubal sterilization (BPS), ten pregnancies were reported, and a tubal patency rate of 16% was found at hysterosalpingography. There were no significant clinical variables separating the BPS failure patients from those with successful sterilization. Ninety percent of the BPS failures were intrauterine, and 90% occurred within three cycles of BPS. The results of this investigation suggest that (1) BPS tubal occlusion may be associated with an increased failure (pregnancy and tubal patency) rate; (2) the majority of BPS failures are intrauterine gestations; (3) delayed fibrosis, rather than immediate tubal destruction, may be the mechanism of BPS tubal occlusion; (4) for maximum effectiveness, patients undergoing BPS should use alternative contraception for two to three cycles; and (5) surgeons employing BPS require precise training in the application of this modality of female sterilization. PMID- 6489538 TI - Progressive dosages of clomiphene in hypothalamic anovulation. AB - A group of 89 sterile patients with hypothalamic anovulation were subjected to progressive dosages of clomiphene citrate according to a predesigned program. In order to analyze our results, we divided our patients into seven groups, according to the largest dosage of clomiphene citrate received. Clinical features were revised in relation to the ovulatory dose of clomiphene. Significant differences between groups regarding weight, menstrual pattern, age at menarche, and hirsutism were not found. Obesity increased the dose required for ovulation when it was less than 900 mg/cycle, but had no effect at higher doses. The ovulation rate, pregnancies, prenatal wastage, and side effects of treatment were analyzed; and it was found that the scheme for ovulation induction used, without expensive and sophisticated ovarian monitoring resources, improved ovulation and pregnancy rates with few and unimportant deleterious side effects. PMID- 6489539 TI - Consequences of intrauterine contraception in diabetic women. AB - A study has been performed covering the clinical consequences of copper intrauterine device insertion in 103 insulin-dependent women and in 119 nondiabetic control subjects. Furthermore, the progress of corrosion has been measured in 15 intrauterine devices removed from diabetic women, and the results were compared with data obtained from nondiabetic women. The clinical data did not reveal any differences in the total continuation rates or in the removal rates because of accidental pregnancy or pelvic inflammation between the diabetic and the nondiabetic women after 3 and 12 months. Also, the maximal depth of corrosion as well as the distribution and the biochemical constitution of the corrosion products deposited on the copper wires were found identical in the two groups studied. PMID- 6489540 TI - Identification of antibody-laden sperm by cytofluorometry. AB - A direct assay for measuring sperm-associated immunoglobulin G (IgG) and an indirect assay for measuring IgG plasma antisperm antibodies were devised utilizing fluorescein-labeled antihuman IgG and a fluorescein-activated flow cytometer. The method singularly analyzed Ig attached to the surface of sperm because sperm and nonsperm cells were separately assessed. The direct assay technique results correlated with results from a previously reported direct radiolabeled antiglobulin assay. As few as 100,000 sperm are required in the indirect method; the sensitivity of the indirect technique corresponded with that of a previously reported indirect radiolabeled antiglobulin assay. PMID- 6489541 TI - Contralateral tubal-ovarian apposition and fertility in hemiovariectomized primates. AB - Here, we examined longitudinally (1) the incidence of pregnancy in hemiovariectomized macaques possessing only one ovary contralateral to a single fallopian tube, i.e., pregnancy after transabdominal ovum migration; (2) the pregnancy rate after surgically achieving contralateral apposition of the ovary and fallopian tube; and (3) the frequency of ovulatory menstrual cycles, patterns of menstruation, and steroid profiles in serum of intact versus hemiovariectomized monkeys to determine whether the ovarian cycle is altered by constraining recurrent follicular maturation and corpus luteum function to one ovary. Despite matings during 28 ovulatory menstrual cycles, none of the five primates possessing only one ovary contralateral to a single fallopian tube became pregnant. In contrast, following contralateral tubal-ovarian apposition, three of these five monkeys conceived after only nine ovulatory menstrual cycles. Hemiovariectomy of monkeys did not compromise the regularity of menstrual cycles or frequency of ovulation, compared with intact control females over the 13-month interval of study (P greater than 0.01). Thus, tubal-ovarian apposition is required in these primates for efficient ovum pickup and fertilization and deserves further clinical scrutiny for women having one functional ovary and one healthy fallopian tube, albeit contralateral. PMID- 6489542 TI - Menses induction in rhesus monkeys using a controlled-release vaginal delivery system containing (15S) 15-methyl prostaglandin F2 alpha methyl ester. AB - Polymeric controlled-release vaginal delivery systems were designed for (15S)15 methyl prostaglandin (PG)F2 alpha methyl ester (carboprost methyl). The drug was incorporated into a highly permeable reservoir membrane that was bound to a relatively nonpermeable support membrane. The rate of drug release was controlled by coating the reservoir membrane with a less permeable rate-controlling membrane. Vaginal devices were prepared with in vitro steady-state release rates from 5 to 180 microgram/hour. The release curves were characterized by an initial, transient rapid release of the drug, followed by a linear zero-order release phase. Pregnancy was terminated in rhesus monkeys following a 24-hour treatment with vaginal devices having release rates of carboprost methyl of 45 microgram/hour or greater. Successful menses induction was associated with peripheral plasma concentrations of (15S)15-methyl PGF2 alpha between 2000 and 3000 pg/ml. Peripheral plasma concentrations of progesterone declined very rapidly to less than 1.0 ng/ml in monkeys in which pregnancy was terminated. These studies demonstrate the feasibility of manufacturing controlled-release vaginal delivery systems containing carboprost methyl for use in early pregnancy termination. PMID- 6489543 TI - Repeat ipsilateral tubal pregnancy following partial salpingectomy: a case report. PMID- 6489544 TI - Characteristics of the menstrual cycle. PMID- 6489545 TI - Serum estradiol and danazol. I. Endometriosis response, side effects, administration interval, concurrent spironolactone and dexamethasone. AB - Serum estradiol (E2) levels and resolution of endometriosis were evaluated in 42 women after 75 days of danazol treatment. Complete or almost complete remission occurred when radioimmunoassay E2 levels were less than 15 pg/ml in extensive, less than 22 pg/ml in severe, and less than 41 pg/ml in moderate endometriosis. E2 less than or equal to 20 pg/ml occurred in 23% of 104 patients given 400 mg every 12 hours but in none weighing over 150 pounds (68 kg). E2 greater than 100 pg/ml occurred in 7%. The mean E2 levels were identical with 400 mg every 12 hours and 200 mg every 8 hours. The E2 level was 40% lower with 200 mg every 6 hours than with 400 mg every 12 hours (P less than 0.001). Dexamethasone further decreased E2 levels by 61% (P less than 0.001). Spironolactone decreased androgen symptoms but increased E2 levels by 49% (P less than 0.01). PMID- 6489546 TI - Hormonal monitoring of early pregnancy by a direct radioimmunoassay of steroid glucuronides in first morning urine. AB - The usefulness of the direct 4-hour radioimmunoassay of estriol-16-glucuronide (E3G) and pregnanediol-3-glucuronide (P2G) in first morning urine (FMU) for establishing a prognosis of the early pregnancy outcome was evaluated in 106 patients that became pregnant. Microaliquots of FMU were serially assayed from day 3 of the conception cycle until day 80 of pregnancy. The E3G and P2G profiles of 19 pregnancies which terminated in spontaneous abortion with either a diagnosis of the blighted ovum syndrome (n = 11) or presumption of a corpus luteum/trophoblast failure (n = 8) have been compared with those of clinically normal pregnancies (n = 87). Normal pregnancies displayed typical patterns of E3G and P2G development, while variations were observed in abortive events that reflected changes of the fetoplacental unit. PMID- 6489547 TI - Serum is not necessary in human in vitro fertilization, early embryo culture, and transfer. AB - Human in vitro fertilization (IVF), embryo culture (EC), and embryo transfer (ET) are commonly performed in various media supplemented with blood serum. To determine whether serum is really necessary, the results of IVF, EC, and ET were compared by using two types of media: B2 medium supplemented with human cord serum and B3 medium without any serum. B3 medium is similar to B2, except that it contains 1% pure controlled human serum albumin in place of 1% bovine serum albumin. We did not observe any difference between the results obtained by using B2 or B3 at any phase of IVF, EC, and ET processes. Both media give an overall evolutive pregnancy rate of about 16%. B3 medium with serum seems to increase slightly the cleavage speed. Our results indicate that there are no positive effects when serum is used for human IVF-ET. To avoid serum supplementation is of evident interest for the homogeneity of the results. This will also lead to a better understanding of human early development and control of the egg quality by metabolic analysis of the media following in vitro EC. PMID- 6489548 TI - Successful pregnancy following clomiphene citrate therapy in Sheehan's syndrome. PMID- 6489550 TI - Transmission of Ureaplasma urealyticum by AID. PMID- 6489549 TI - Communicating uteri. PMID- 6489551 TI - Cardiac output and gonadal steroids. PMID- 6489552 TI - [Neuronal mechanisms and the functional importance of inhibition in the auditory cortex neurons]. PMID- 6489553 TI - [Neurophysiological analysis of internal inhibition]. PMID- 6489554 TI - [Neuronal mechanisms of the tonic activity of the peripheral section of the autonomic nervous system]. PMID- 6489555 TI - [Slow surface-negative potentials and the concentration of extracellular potassium in the cerebral cortex under different parameters of electrical stimulation]. PMID- 6489556 TI - [Electrophysiological study of the hypothalamic projection of nociceptive afferents of the dental pulp]. PMID- 6489557 TI - [Effect of the deprivation of paradoxical sleep on learning an active avoidance reaction]. PMID- 6489558 TI - [Neuronal inhibition reactions of an isolated strip of the associative cerebral cortex in the cat (field 5) to intracortical stimulation]. PMID- 6489559 TI - [Effect of the midbrain reticular formation on the neuronal activity of the associative cortex evoked by transcallosal stimulation]. PMID- 6489560 TI - [Dominant and reciprocal relationships in the organization of the spatial structure of the biopotential correlations of the brain]. AB - The factor analysis of correlation coefficients of brain potentials spatial temporal structure revealed the "leading constellations" of neural centers in the coordination system for activity of the human brain hemispheres in resting as well as in functional loads; the reciprocity in organization of potential oscillations in the frontal and occipital brain areas, the reciprocal interrelationships being more obvious in the dominant hemisphere. This factor was shown to depend on the level of activation of the subjects even in a functional state unaltered in respect to other EEG indices. When expecting stimuli demanding a left-hand response, a rearrangement of spontaneous dominant interrelationships to the advantage of the right hemisphere occurs in the EEG. PMID- 6489561 TI - [Neurofunctional programs of brain activity and their structural characteristics in different psychopathological states and during treatment]. AB - EEG patterns (neurofunctional systems) characteristic of certain mental states are presented from the standpoint of theoretic ideas of these patterns as neurofunctional programs of brain activity. Approaches for studying the structure of these programs are discussed. PMID- 6489562 TI - [Stable motor states in embryogenesis and their physiological analysis]. AB - The experimental data obtained showed the reasonableness of N. P. Bechtereva's concepts in elucidation of regularities of ontogenesis of the nervous activity. The possibility of formation of new stable motor states was shown for the terminal period of embryogenesis (starting from the 18th day), the states being actualized by a forming long-term memory matrix. Rigid and versatile ("flexible") links were revealed in coordinated rearrangements of the biorhythmological structure of movements on the basis of the principle of minimization of maintaining cerebral area in the process of formation of new stable motor states. PMID- 6489563 TI - [The polyelectroneurograph--a modular amplifying system for the complex study of the bioelectrical activity of the brain]. PMID- 6489564 TI - [A method for the multiparameter evaluation of the functioning of surviving rat brain slices]. PMID- 6489565 TI - [Relationships of distantly located neuronal populations in the human brain in the realization of the thinking process]. AB - The time characteristics of the interneuronal connections as well as interrelationships among distant neuronal populations of the human brain deep structures were studied during monotonous mental activity. It was shown that stable interrelationships could be considered as a correlate of mental activity though the connections themselves were not of the correlative nature. These connections, being the elements of the activity--maintaining system, could be of various degree of rigidity. PMID- 6489566 TI - [Component analysis of the reactions of neuronal populations in the human brain during the memorizing of visual stimuli]. AB - The components of the evoked impulse activity of neurons and neuronal populations were studied in different nuclei of the thalamus and strio-pallidar system of the human brain, in patients treated with indwelled electrodes. The impulse activity was recorded during recognition of polygonal shapes with and without semantic meaning, during memorizing of visual stimuli without meaning. Peri-stimulus-time histograms for the cases of presentations of familiar and unfamiliar patterns, for the cases of stimulus presentation in the initial and terminal parts of the memorizing were computed and compared with each other. In some neuronal populations, a group of late components was revealed, altering during learning and depending upon subject evaluation of the meaning of the stimulus. PMID- 6489567 TI - [Ultraslow processes of the brain and liver in studying normal intersystem interactions and in terminal states]. AB - Steady potential (omega-potential) and infraslow oscillations of potentials within the 0.2-0.5 Hz range (zeta-waves) were simultaneously recorded in the hypothalamus, caudate nucleus, hippocampus, RF and cortex of the brain as well as in liver in chronic experiments on rabbits in resting, terminal state and in posthumous period. A compatibility of amplitude--temporal parameters of the processes under study was revealed in subcortical brain structures and in liver in resting state as well as their stability in repeated recordings at the same time on different days. Types of transitory processes were differentiated in the systems under study in crucial stages of terminal state. omega-potential and zeta waves are shown as indices of state of cerebral structures and liver. PMID- 6489568 TI - [Systems approach to the stability and plasticity of neurophysiological processes during the adaptive activity of the brain]. AB - The problem of stability and plasticity of regulatory processes is presented from the standpoint of N. P. Bechtereva's theory of stable pathological state, rigid and versatile links in regulating systems, and the necessity of probabilistic approach is emphasized. Data on connection among separate components of biorhythms in physiological systems and on stability of their frequency-amplitude parameters, are reviewed. The data obtained reveal advantages of using functional bioregulatory feedback methods in clinic. PMID- 6489569 TI - [Characteristics of the formation of reinforcing brain systems in rats under the limitation of individual experience]. AB - Emotiogenic (reinforcing) abilities of the hypothalamic lateral nucleus and cortico-medial part of the amygdala were studied with locomotor and lever self stimulation techniques in normal rats and in those which had been kept under partial sensory and intraspecies deprivation during early postnatal development. A noticeable increase in size and excitability of negative reinforcing areas occurred in the latter rats. The data obtained suggest that limitation of early individual experience results in including of polyfunctional emotiogenic structures into the systems of negative emotion regulation. PMID- 6489570 TI - [Effect of vasopressin on long-term memory (psychophysiological and clinical aspects)]. AB - In chronic alcoholic patients with reduced ability for memorizing, lysin vasopressin (LVP) exerts an obvious positive effect upon the involuntary long term memory. The effect is more obvious in tests demanding a semantic processing of information rather than the automatic memorizing. Under the LVP effect, an enhancement of the alpha-rhythm synchronization occurs in the EEG. The maximal "inhibitory" effect of the LVP occurs against background of desynchronization with an initial increased level of unspecific ascending influences. The LVP rises the upper limit of the response in the form of the EEG rhythms rearrangement, i. e. it increases the lability of cerebral structures. In conditioning therapy of chronic alcoholism the LVP increases the negative reflex to ethanol formed on the basis of apomorphine. The data obtained reveal an essential acceleration and increased durability of conditioning to ethanol as the result of the LVP use. PMID- 6489571 TI - [A simple radioimmunoassay determination of urinary aldosterone using 125I labeled ligand [ALDOCTK-125KIT] and its clinical application]. AB - A method of radioimmunoassay for urinary aldosterone excretion (AER) using 125I labeled ligand [ALDOCTK-125KIT] is described. The sensitivity, specificity, reproducibility and accuracy of this method were compared with the 3H-RIA method previously reported. Since the extraction method using ALDOCTK-125KIT was considered to be preferable to the direct method, the former method was applied to the present study. An excellent correlation was found between the values determined by the 3H-RIA method and the extraction method (r = 0.935, p less than 0.001, Y = 0.89X + 0.80, n = 146). The within-assay and the between-assay coefficient of variation was 7.7--15.0% and 9.7--12.2%, respectively. As a clinical application, the circadian variation of AER was investigated in 5 control subjects and groups of essential hypertension (EHT), primary aldosteronism (PA), chronic glomerulonephritis (CGN) and Cushing's syndrome, each of which consisted of 5 patients, all of which had serum creatinine concentrations of less than 1.2 mg/dl. Under a control diet containing 10 g of salt per day, urine was collected in 4-hour pools starting at 8:00 for the ensuing 24 hours, and AER was determined by means of both 3H-RIA and the extraction method. The difference of the values between the peak and the nadir in each subject was statistically significant, and marked and identical circadian variations of AER with the peak and the nadir at the period of 4:00 to 12:00 and 20:00 to 4:00 were observed in the control, EHT, PA and CGN groups. In the Cushing group, however, the circadian variation of AER was different from the other 4 groups: the peak and the nadir of AER occurred at the period of 20:00 to 24:00 and 4:00 to 8:00, respectively. The circadian variation of AER became more obvious in all groups including the Cushing, when each value was expressed in the percentage of the mean. AER under the control diet was 9.38 +/- 2.04 micrograms/day in the control subjects. In PA and CGN, AER was significantly higher, and in the Cushing group, it was significantly lower than that observed in the control. However, no difference was found in AER between the control and EHT. AERs in both 4-hour and 24-hour urine specimens measured by ALDOCTK-125KIT were consistent with those by the 3H-RIA method. PMID- 6489572 TI - [An extrarenal role of aldosterone on the regulation of blood pressure]. AB - This study was designed to examine the effects of aldosterone on the distribution of extracellular fluid between the intra- and extra-vascular compartments, and to relate the changes in the fluid distribution to blood pressure in nephrectomized and nephrectomized-adrenalectomized male Wistar rats. Polyethylene catheters were inserted into the right common carotid artery and the right jugular vein, and bilateral nephrectomy with or without adrenalectomy was performed. The animals were divided into three groups: 10 nephrectomized rats (NX), 10 nephrectomized adrenalectomized rats (NX-AX), and 10 nephrectomized-adrenalectomized and aldosterone treated rats (NX-AX-A). Aldosterone (250 micrograms/rat: Aldocorten, Ciba), mixed with sesame oil, was given subcutaneously in the NX-AX-A. After these procedures, food and water were withheld. Twenty four hours later, blood pressure and body fluid volumes were measured in the unanesthetized unrestricted condition. Mean arterial pressure (MAP) was directly recorded through the carotid catheter using electric manomater. Plasma volume (PV) and extracellular fluid volume (ECFV) were measured according to the dilution principle using 131I-RISA and 35S-Na2SO4, respectively. Interstitial fluid volume (IF) defined as ECFV minus PV and PV/IF ratio was also calculated. In NX, NX-AX and NX-AX-A, the transcapillary escape rate of albumin (TER) was determined after 6 hours. TER was obtained by measuring the disappearance of intravenously injected 131I-RISA for 2 hours after injection. The initial body weight and the changes in body weight were similar among the three groups. MAP was definitely higher in the NX than in the NX-AX and the NX-AX-A. Moreover, it was significantly higher in the NX-AX-A than in the NX-AX (p less than 0.001). Although ECFV and IF were equally and significantly reduced in the NX-AX-A and the NX-AX as compared to the NX, PV was significantly higher in the NX-AX-A than in the NX-AX (p less than 0.01), leading to a significantly lower PV/IF ratio in the latter than in the former (p less than 0.02). When a relationship between MAP and PV was examined in the rats as a whole, a significant positive correlation was found between the two parameters (r = 0.69, p less than 0.001). This relationship still held in the NX-AX and the NX AX-A in combination (r = 0.69, p less than 0.001). TER was significantly higher in the NX-AX than in the others (p less than 0.001 vs NX, and p less than 0.02 vs NX-AX-A).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489573 TI - Medical grand rounds: aspergillus pulmonary disease. PMID- 6489574 TI - Repair of pectus excavatum with subcutaneous silastic implant. PMID- 6489575 TI - Current concepts in diagnosis and management of prostate carcinoma. PMID- 6489576 TI - Distribution of Iranian and Filipino physicians in the United States by region of residence and medical specialty. PMID- 6489577 TI - Male sex hormone and nephropathy in Cohen diabetic rat. (Genetically selected sucrose fed). AB - In the Cohen diabetic rat (genetically-selected sucrose fed) ovariectomy caused a significant decrease in the incidence of nephropathy, from 52% in the unovariectomized, to 16% in the ovariectomized rat, [X2 (d.f. = 1) = 7.21905 P/0.01]. Testosterone administration to the ovariectomized diabetic animal resulted in a significantly increased incidence of nephropathy, from 16 to 92% [X2 (d.f. = 1) = 28.04427 P/0.01]. This change in incidence of nephropathy was directly correlated with a corresponding decrease or increase in the plasma oestradiol levels (in the ovariectomized and in the ovariectomized-testosterone treated diabetic animals, respectively). No such correlation was found with carbohydrate metabolism disturbances (as demonstrated by spontaneous blood glucose and spontaneous insulin) or with plasma testosterone levels. PMID- 6489578 TI - [Plasma glucose and C-peptide after ingestion of sucrose and starch in controlled insulin-dependent diabetics. Importance of glucose availability]. AB - Oral tests using 50 g of sucrose and 100 g of white bread were carried out in ten insulin-dependent diabetics (four with signs of residual B-cell function and in six without). Plasma glucose and C-peptide (CPR) were estimated during the 180 minutes after ingestion. After bread intake, plasma glucose increase was significantly delayed (30 min.). Hyperglycemia (greater than 2.5 g/l) lasted significantly longer after bread then after sucrose ingestion. Blood glucose decreased more quickly in subjects with residual B-cell function than in subjects without. CPR was not significantly modified by either of the carbohydrate loads. In the controlled insulin-dependent diabetic the hyperglycemia observed results from the ease of carbohydrates hydrolysis and from the amount of available glucose. The role of fructose seems weak in the case of sucrose because its conversion to glucose would be minimized in the presence of metabolic normalization as indicated by a well controlled blood glucose. PMID- 6489579 TI - [What is the future of continuous insulin infusion by peritoneal route?]. PMID- 6489580 TI - [Choice of an insulin pump]. PMID- 6489581 TI - [Familial survey on a patient with idiopathic hemochromatosis. Therapeutic implications]. PMID- 6489582 TI - An explanation of the low lecithin/sphingomyelin ratio of amniotic fluid in early pregnancy. AB - We have attempted to determine why the lecithin/sphingomyelin (L/S) ratio of amniotic fluid is lower than 2 during an early stage of pregnancy. We found that, at 16 wk of gestation, long before the fetal lung secretes lecithin into the amniotic fluid, the L/S ratio was about 1. High-density lipoprotein isolated from the amniotic fluid also had such a low L/S ratio. The L/S ratios of the high density lipoprotein from umbilical cord blood and maternal blood, however, were much higher, viz. 3.7 (+/- 0.25) and 6.4 (+/- 0.33), respectively. The increase coincided with a decrease in their fluorescence polarization. We suggest that the low L/S ratio of 16 wk amniotic fluid is caused by lipolysis of its lecithin, which is derived from fetal or maternal high-density lipoproteins. PMID- 6489583 TI - Twin pregnancy: report of a case with 35 days between deliveries. AB - A prolonged interval between the births of the first and second of twins is rare and only a few reports are found in the literature. This paper reports a patient with twins with an interval of 35 days between the births of the 2 infants, who, due to prematurity and complications, were both stillborn. Three months later the patient became pregnant again and after an uneventful pregnancy gave birth to a healthy baby. However, due to breech presentation an abdominal delivery was undertaken. PMID- 6489584 TI - The effect of methadone and naloxone on cultured rat liver cells. AB - Opioids modify hepatic function in vivo, however, a direct effect of this class of drugs on liver cells has not been demonstrated. The potential effect of opioids on liver parenchymal-type cells, therefore, was studied using cultured albumin-secreting rat hepatoma cells. Liver cells were incubated with methadone or naloxone individually or in combination. Dose-response analysis indicated that concentrations of either or both drugs in excess of 2.5 X 10(-5) M were clearly cytotoxic to cultured hepatoma cells. At a concentration (2.5 X 10(-7) M) at which no adverse effect on hepatoma cell viability or growth rate was observed, naloxone, methadone, or naloxone plus methadone produced a 26, 41, and 63% decrease in trichloroacetic acid-precipitable protein (per 10(6) cells), respectively, when compared to control. The inhibitory effect of naloxone, methadone, or naloxone plus methadone on albumin accumulation in the culture medium was greater than the drug-induced reduction of protein synthesis. These studies demonstrate that opioids have several direct effects on cultured hepatoma cells and, therefore, raise the question of whether clinically significant hepatic dysfunction may be produced by the direct action of opioids on the liver. PMID- 6489585 TI - Detection of primary antimitochondrial activity of drugs in cultured mammalian cells utilizing glutamine as the carbon source. AB - Growth of guinea-pig keratocytes (GPK) proceeded normally in standard medium in which glutamine (mitochondrial substrate) replaced glucose as the carbon and energy source. Cells in the glucose-free glutamine cultures were much more sensitive to the toxic and growth-inhibiting effects of the antimitochondrial drugs ethidium bromide, chloramphenicol and oligomycin than cells in glucose containing cultures. In the latter, cells continued to proliferate in the presence of these drugs after 2-3 days incubation, but in the non-fermenting cells growth was arrested within 24 h and there was more than 95% cell death after 2 days. Cycloheximide, a general inhibitor of protein synthesis in eukaryotic cells, showed no selective inhibition of growth and glutamine and glucose cultures were equally affected. The system appears to be useful for the detection of primary antimitochondrial activity of drugs in general. PMID- 6489586 TI - A test for the effects of low-temporal-average-intensity pulsed ultrasound on the rat fetus. AB - In 1978, Pizzarello and co-workers reported that exposure of rat fetuses to diagnostic levels of ultrasound caused marked reduction in fetal weight. Replicates of these experiments have been conducted and, in addition, exposures at 10 times the peak and average intensity were used. No effect on fetal weight, numbers of living fetuses or resorptions could be attributed to ultrasound at either exposure level. PMID- 6489587 TI - Dissecting the Streptomyces genome. PMID- 6489588 TI - Optimization of streptomycete strains producing polyether and macrolide antibiotics. PMID- 6489589 TI - Carbohydrate chains from human bronchial mucus glycoproteins: a wide spectrum of oligosaccharide structures. PMID- 6489590 TI - Mucin sialidase in the rat large intestine. PMID- 6489591 TI - Effect of alkalis on N-glycosidic linkages of glycoproteins. PMID- 6489592 TI - Is the macromolecular architecture of cervical, respiratory and gastric mucins the same? PMID- 6489593 TI - Conformation of human mucus glycoproteins observed by electron microscopy. PMID- 6489594 TI - Studies on the molecular weight distributions of two mucins. PMID- 6489595 TI - Light scattering and correlation measurement. PMID- 6489596 TI - Low-angle laser light scattering from surfactant solubilized biological macromolecules. PMID- 6489597 TI - The measurement of motility in micro-organisms and its biochemical significance. PMID- 6489598 TI - Picosecond spectroscopy: applications in biochemistry. Part I: Techniques. AB - A number of sources of picosecond optical pulses and the means by which they may be used to investigate fast molecular processes have been described. In addition, it should be pointed out that most of these techniques can be extended to take advantage of other properties of the laser pulses; in particular, the polarization is of use in measuring time-dependent antisotropy. The state of the art is now the generation of 30fs pulses; it seems likely that this is all the time resolution that one is likely to need for investigating biological and other molecular processes as at such short times the uncertainty principle leads to a considerable loss of spectral resolution. PMID- 6489599 TI - Picosecond spectroscopy: applications in biochemistry. Part II: Applications. PMID- 6489600 TI - Laser Doppler microscopy. PMID- 6489601 TI - Anti-androgens do not alter androgen-dependent characteristics of acid phosphatase in the rat ventral prostate. AB - When administered to intact adult male rats, cyproterone acetate (10 mg/day), flutamide (15 mg/day), or Compound I (1 mg/day) caused a significant decrease in the organ weight to body weight ratios, with a concomitant rise in the specific activity of prostatic acid phosphatase. These compounds do not affect two other markers of androgen activity in the prostate. Neither the percentage inhibition of acid phosphatase activity by tartrate nor the appearance of the secretory band of acid phosphatase on polyacrylamide gels was altered by the administration of anti-androgens. When administered to castrated rats given doses of 5 alpha dihydrotestosterone (250-750 micrograms/day), flutamide (15 mg/day) was unable to alter the percentage inhibition of acid phosphatase activity by tartrate, or the pattern of activity on polyacrylamide gels. These results suggest that these anti androgens affect only some of the androgen-dependent functions of the prostate. PMID- 6489602 TI - Intratesticular secretion of a factor(s) with major stimulatory effects on Leydig cell testosterone secretion in vitro. AB - As intratesticular communication between the Sertoli and Leydig cells must take place via testicular interstitial fluid (IF), we have tested whether this fluid contains a factor(s) which has effect on testosterone secretion by Percoll purified Leydig cells in vitro. Addition of increasing concentrations of charcoal stripped IF to Leydig cells caused dose-dependent stimulation of basal testosterone secretion and greatly enhanced the response to a maximally stimulating dose of hCG. These effects were first evident after 2 h of incubation and were progressive up to 24 h. Charcoal-stripped serum from the same donor animals also had some stimulatory effect on basal and, occasionally, on hCG stimulated testosterone secretion, but the magnitude and pattern of this effect and its limited dose-dependence were very different from the effects seen with IF. The effects of IF and serum were not altered by the addition of an antiserum to LH. It is therefore concluded that testicular IF contains a factor(s), not derived from serum, which can alter Leydig cell testosterone responsiveness. This factor(s) was heat-sensitive with a MW of greater than 10 000 daltons. IF from the abdominal testes of adult rats which had been made unilaterally cryptorchid contained much higher levels of the stimulatory factor(s) compared to the contralateral scrotal testes, and this is of interest because of the well documented alteration in Sertoli-Leydig cell interaction that occurs in this situation. These results provide the first direct evidence that one or more factors capable of altering testosterone secretion are produced within the testis of the normal adult rat, and raises the possibility that this factors(s) may be involved in the local regulation of the intratesticular testosterone levels. PMID- 6489603 TI - A common 43 K protein induced by glucocorticoids in a variety of cells and tissues. AB - We have investigated the domain of adrenal steroid action in a variety of mammalian cells and tissue by high resolution two-dimensional gel electrophoresis and autoradiography. Following in vivo or in vitro treatment with steroids, minced tissue or cells were pulsed with [35S]methionine, and they newly synthesized polypeptides compared with controls by visual inspection of partial protein maps. We have found a similar protein (Mr approximately 41-44K, pI approximately 6.3-6.5) to be consistently increased by dexamethasone in 3 rat tissues and 9 human, bovine and rat cell lines. The protein was constitutively synthesized in all targets; quantitative measurements on the magnitude of response show a 2-fold induction by dexamethasone in all systems, in vivo and in vitro. Glucocorticoid-specific hormones but not sex steroids increase the rate of synthesis; deoxycorticosterone has agonist or antagonist effects on 43K synthesis in different systems studied. Co-electrophoresis experiments indicated that 43K proteins co-migrate in at least 3 rat cell lines from tissues with diverse functions. The functional significance of this common glucocorticoid-induced protein is unknown; its ubiquity and electrophoretic properties suggest a highly conserved, common indicator of glucocorticoid action in diverse target cells and tissues, rather than a tissue-specific response. PMID- 6489604 TI - Comparative effects of thyroid hormone analogs on the activities of brain and liver mitochondria and nuclei in thyroidectomized rats. AB - Several thyroid hormone analogs have been tested for thyromimetic activity on rat brain and liver subcellular organelles. The compounds were administered immediately after thyroidectomy to 90 g male S-D rats for 10 days, by daily s.c. injection. In cerebral cortex and liver we measured the activities of mitochondrial succinate cytochrome c reductase and alpha-GPD, and nuclear RNA polymerase I. Brain mitochondrial enzymes were unchanged in thyroidectomized (Tx) and in Tx-treated rats, whereas the activities of these enzymes in liver mitochondria were partially restored by the treatments. RNA polymerase I activity in brain and liver dropped significantly 10 days after thyroidectomy and daily injection of thyroid hormones or analogs maintained the nuclear activity at a normal level. Correlation between the structure of thyroid hormone analogs and their subcellular effects is in good agreement with previous binding and in vivo studies. Enzyme activities stimulated by T3 were lowered by replacing the T3 side chain by an acetic acid group or by substituting the bridged oxygen atom by atom by CO. In contrast, the activity was enhanced by substituting iodine with a 3' isopropyl group. Although less active than iodine, the 3,5-dimethyl substituents may be introduced without a complete loss of nuclear activity. PMID- 6489605 TI - Translocation of latex beads after laser ablation of the avian neural crest. AB - Previous studies from this laboratory (M.E. Bronner-Fraser, 1982, Dev. Biol. 91, 50-63) have demonstrated that latex beads translocate ventrally after injection into avian embryos during the phase of neural crest migration, to settle in the vicinity of neural-crest-derived structures. In order to examine the role of host neural crest cells in the ventral translocation of implanted beads, latex beads have been injected into regions of embryos from which the neural crest cells have been ablated using a laser microbeam. Prior to their migratory phase, neural crest cells reside in the dorsal portion of the neural tube. Laser irradiation of the dorsal neural tube was used to reproducibly achieve either partial or complete ablation of neural crest cells from the irradiated regions. The effectiveness of the ablation was assessed by the degree of reduction in dorsal root ganglia, a neural crest derivative. Because of the rapidity and precision of this technique, it was possible to selectively remove neural crest cells without significantly altering other embryonic structures. The results indicate that, after injection of latex beads into the somites of embryos whose neural crest cells were removed by laser irradiation, the beads translocate ventrally in the absence of the endogenous neural crest. PMID- 6489606 TI - Morphogenesis of the head of a newt: mesodermal segments, neuromeres, and distribution of neural crest. AB - Segmentation of the mesoderm in the head of a newt embryo is revealed by scanning electron microscopy. By the end of gastrulation, the newt embryo is already segmented from one end to the other, with additional segments added later by the tail bud. This metameric segmentation appears long before the first "somite" can be seen in the late neurula by light microscopy. The six segments found in the newt head look much like the six most-cranial segments described decades ago in shark embryos. Mesodermal segments in the newt head are similar to somitomeres in amniote embryos, but in amniote embryos, the numbers and relationships of head segments are quite different from those of the newt. In both amniote and newt, the first segment abuts the prosencephalon, but for each more caudal head segment, where the newt embryo has one segment, the amniote has two. Although the pattern and distribution of cranial neural crest is quite similar in newt and amniote embryos, there are different relationships between migrating crest masses and mesodermal segments due to the doubling of most of the cranial segments in amniotes. It now appears that all vertebrate embryos, regardless of their mode of gastrulation, form similar mesodermal segments from one end of the embryo to the other, and this metameric pattern is established during gastrulation. PMID- 6489607 TI - Motoneurons purified by cell sorting respond to two distinct activities in myotube-conditioned medium. AB - Spinal motoneurons from chick embryos were purified by retrograde transport and fluorescence-activated cell sorting. Growth conditions for motoneurons were studied, with experiments focused on the effects of conditioned media from chick myotubes, fibroblasts, and spinal cord dividing cells. Motoneurons rapidly extended neurites when plated onto polylysine-coated dishes that had been exposed to these conditioned media. Enzymatic analysis of the substratum-binding, neurite outgrowth-promoting activity from myotube-conditioned medium indicated that it contained heparan sulfate and protein. The neurite outgrowth-promoting activity sedimented as a peak centered at a density of 1.34 in associative cesium chloride gradients, and eluted near the void volume of a Sepharose CL-6B column. Inclusion of myotube conditioned medium in the culture medium of motoneurons also enhanced their survival over periods greater than 2 days in culture. This enhancement of survival could not be explained by myotube-conditioned medium providing motoneurons with a continuous supply of the neurite outgrowth-promoting activity. Media conditioned by spinal cord dividing cells and fibroblasts supported motoneuron survival to some extent, but this effect was not as great as that of myotube-conditioned medium. PMID- 6489608 TI - Morphological and functional development of plasma membranes of mouse hepatocytes: an autoradiographic study of asialoglycoprotein uptake during the postnatal period. AB - The morphological development of the postnatal mouse liver was studied with reference to the specialization of sinusoidal plasma membranes of hepatocytes. Numerous hemopoietic islands were distributed at random among hepatocytes at neonatal stages. The hemopoietic fronts of hepatocytes were flat and showed few structures indicating endocytotic and exocytotic activities. They gradually acquired structural characteristics of the sinusoidal region as the processes of the endothelial cells extended in the space between hemopoietic cells and hepatocytes. The degree of attenuation and fenestration of the sinusoidal endothelial cells increased as the postnatal day advanced. In the course of these changes, microvilli, pinocytotic pits, and vesicles of sinusoidal regions of hepatocytes increased as well. The functional development of sinusoidal regions of hepatocytes was investigated by the quantitative analysis of autoradiograms of [3H]asialoorosomucoid (ASOR). Silver grains were distributed only in the regions where the structural specializations of the sinusoidal region were observed. They increased as the maturation of sinusoidal structure advanced. These results suggest that the sinusoidal regions of hepatocytes specialize structurally and functionally, as regards ASOR-uptake capability, in correlation with the structural establishment of sinusoids. PMID- 6489609 TI - Developmental time, cell lineage, and environment regulate the newly synthesized proteins in sea urchin embryos. AB - Strongylocentrotus purpuratus embryos were fractionated into two cell populations of defined lineages at times corresponding to two critical developmental events: determination (16-cell stage) and early differentiation (mesenchyme blastula). The 16-cell stage blastomeres, labeled with [35S]methionine, exhibited identical protein synthesis patterns by fluorography, and this pattern was not significantly altered by cell separation. In comparing the proteins of the mesenchyme blastula to the 16-cell stage, differences (increases and decreases) were seen by fluorography of newly synthesized proteins. The synthesis of 2.9% of the mesenchyme blastula proteins is specific to or enriched in primary mesenchyme cells and 8.2% is specific to or enriched in endoderm/ectoderm cells. Additionally, in contrast to the earlier stage, the pattern of protein synthesis in the mesenchyme blastula embryos is substantially altered by cell separation. The ability to alter protein synthesis in response to environmental factors may be a further demonstration of the differentiation of these cells. PMID- 6489610 TI - Changes in myofibrillar gene expression during fiber-type transformation in the claw closer muscles of the snapping shrimp, Alpheus heterochelis. AB - Isotopes of a number of crustacean myofibrillar proteins have been identified with sodium dodecyl sulfate-polyacrylamide electrophoresis, and their distribution in muscles of the snapping shrimp has been examined. Fast-slow differences in distribution have been observed for myosin light chains and tropomyosin. In contrast, three troponin T subunits have been resolved, each specific to one of the three muscles examined. This result suggests that expression of crustacean contractile proteins is not accomplished by a simple coexpression of a battery of slow or fast isotopes. In addition, the expression of these proteins was examined during the quasi-developmental fiber-type transition of the main claw closer muscle during the reversal of claw asymmetry in response to the loss of the large snapper appendage. The changes observed appear similar to the cross-innervation induced changes in gene expression of vertebrate muscle. PMID- 6489612 TI - Subpopulations of cells in immature mouse mammary gland as detected by proliferative responses to hormones in organ culture. AB - Organ culture of immature mouse mammary gland was used to demonstrate the presence of different epithelial cell types in this tissue. Whole glands were cultivated for 10 days in various hormone combinations, and the proliferative responses of the epithelium were evaluated by [3H]thymidine autoradiography. It was found that different regions of the gland responded to hormones dissimilarly. The large, primary duct required no added hormones for either maintenance (viability according to histological criteria) or proliferation. Secondary and tertiary ducts required insulin for maintenance and proliferation and exhibited hyperplasia when a mineralocorticoid plus either growth hormone, prolactin, or placental lactogen were also present. End buds required the most complex hormone environment for maintenance in culture, and did not exhibit proliferative activity as intense as that which occurs in vivo, even in the optimum hormone combinations used. PMID- 6489611 TI - Two glial cell lineages diverge prenatally in rat optic nerve. AB - Three types of glial cells have been previously described in cultures of neonatal rat optic nerve--oligodendrocytes, type 1 astrocytes, and type 2 astrocytes- which can be distinguished using three different antibodies: antigalactocerebroside antibodies recognize oligodendrocytes; antibodies against glial fibrillary acidic protein recognize both types of astrocytes, while the A2B5 monoclonal antibody distinguishes between the two, binding to type 2 but not type 1 astrocytes. It was subsequently shown that oligodendrocytes and type 2 astrocytes, but not type 1 astrocytes, develop in cultures of 7 day optic nerve from a common, A2B5+ progenitor cell. In the present study, the distribution of rat neural antigen-2 (Ran-2), a cell-surface antigen defined by a monoclonal antibody, has been examined on optic nerve cells. It is demonstrated that, in contrast to A2B5, Ran-2 is present on type 1 but not type 2 astrocytes in optic nerve cultures. More importantly, it is shown that Ran-2 and A2B5 antibodies react with largely nonoverlapping populations of cells in cell suspensions of embryonic Day 17 (E17) and postnatal Day 1 (P1) optic nerve, and that the Ran-2+, A2B5- population contains type 1 astrocytes and their precursors while the A2B5+,Ran-2- population contains the progenitor cells for oligodendrocytes and type 2 astrocytes. These findings provide strong evidence that the glial cells of the rat optic nerve develop as two distinct lineages--one giving rise to type 1 astrocytes and the other to oligodendrocytes and type 2 astrocytes--and that the two lineages diverge as early as E17. PMID- 6489613 TI - SEM localization of laminin on the basement membrane of the chick corneal epithelium with immunolatex microspheres. AB - Embryonic chick corneal explants were soaked in mild detergent and the anterior corneal epithelium was peeled from its basement membrane, leaving the lamina lucida surface exposed and supported on the subjacent primary stroma. Explants were treated with rabbit anti-laminin IgG, followed by sheep anti-rabbit IgG linked microspheres, and processed for SEM. The lucida surface was heavily decorated with microspheres, whereas controls treated with preimmune rabbit IgG were essentially beadless. Laminin distribution was not regular, appearing denser in some regions than others. However, the connective tissue surface of the basement membrane was never laminin-positive, even after treatment with hyaluronidase. These results suggest the basal lamina of the corneal epithelium is asymmetric, with preferential location of laminin to the lucida surface of the basement membrane. PMID- 6489614 TI - Immunogenic properties on mice of cell-wall-deficient Brucella (L-forms). PMID- 6489615 TI - [Contribution of the OIE to controlling animal brucellosis on a world-wide scale. Office International des Epizooties]. PMID- 6489616 TI - [Proposed general method of controlling the activity of brucella vaccines]. PMID- 6489617 TI - Theoretical, practical and statistical basis for a general control method of activity for anti-Brucella vaccines. AB - Lots of five weeks old female CD-1 mice were vaccinated at several doses with living (B. abortus 19), killed whole cells or purified fractions vaccines. The doses were the number of bacterial cells injected per mouse, either viable (living vaccines), total (killed) or number calculated from the yield of extraction. The mice were intraperitoneally injected with a lyophilized standard challenge, 2 X 10(5) Brucella abortus 544, thirty days after vaccination. In two assays, B. melitensis H.38 was used as challenge at several doses. Responses to a good live vaccine were dose independent. Responses to killed whole cell and purified fractions were usually dose dependent. A reference lyophilized vaccine previously prepared and titrated would give the reference response to one unit. These data can be used to devise a general control method of activity for anti Brucella vaccines. This was proposed and discussed in the preceding paper. PMID- 6489618 TI - [Effect of immune sera on the evolution of experimental brucellosis in mice]. PMID- 6489619 TI - Brucellosis as a world problem. PMID- 6489620 TI - Observations on serological cross-reactions between smooth Brucella species and organisms of other genera. AB - Serological cross-reactions have been demonstrated between smooth Brucella species and Escherichia coli 0:116 and 0:157, Salmonella serotypes of Kauffmann White group N, Pseudomonas maltophilia and Yersinia enterocolitica 0:9 and 0:16. All of these organisms may evoke significant titres of cross-reacting antibodies in cattle and pigs inoculated by parenteral routes. E. coli 0:157, Salmonella urbana and Y. enterocolitica 0:9 evoked substantial titres of cross-reacting antibodies in cattle inoculated by the oral route with live organisms. Only Y. enterocolitica 0:9 was effective in evoking cross-reacting antibodies to Brucella in pigs inoculated by the same route. Differentiation of cross-reacting and homologous antibodies to Brucella was difficult and was not accomplished consistently by any single test. PMID- 6489621 TI - Problems in the serodiagnosis of canine brucellosis: dog responses to cell wall and internal antigens of Brucella canis. AB - Three procedures are commonly used for the serodiagnosis of B. canis infection: 1) The rapid slide agglutination test (RSAT), 2) the tube agglutination test (TAT), and 3) the modified 2-mercaptoethanol tube agglutination test (2ME-TAT). Hemocultures are always essential for diagnosis. The RSAT was developed to provide a presumptive diagnosis rapidly. It has been found accurate in identifying non-infected dogs; however false positive reactions are common due to shared determinants between the surface antigens of B. canis and certain other gram-negative bacteria. The RSAT has recently been modified to include brief reaction of test sera with 2ME (0.2M) prior to adding test antigen. The modification has improved specificity, but it has not eliminated false positive reactions. The TAT and 2ME-TAT are widely used. Although there is good agreement between tests, both suffer from lack of specificity but are valuable in kennels where B. canis has been identified by blood cultures. Agarose gel immunodiffusion (AGID) tests using extracted (SDC or hot PBS) cell wall antigenic complexes reveal precipitins in the sera of infected dogs usually 8 to 12 weeks postinfection (PI) that may persist 5 years. The antigenic complexes consist of at least 3 antigens; one (antigen '2R') appears to possess high B. canis specificity. Sera from noninfected dogs also may react nonspecifically in AGID tests that employ crude SDC or PBS antigenic extracts leading to 'false positive' interpretations. Cytoplasmic antigens gave up to four precipitin lines with sera from B. canis infected dogs. The antigens (protein or glycoprotein) were present in both S and R Brucella cells, but not in other gram-negative organisms examined. AGID tests that employed cytoplasmic antigens revealed precipitins against one or more (usually 2-3) antigens from PI months 4 through 64. In some dogs, precipitins were present 12 months after the bacteremia had ceased, a time when other tests were diagnostically insignificant, or equivocal. No 'false positive' field sera reached with the cytoplasmic antigens. PMID- 6489622 TI - Evaluation of the allergic test in diagnosis of brucellosis in sheep. AB - In this investigation the Brucellizate was used as an allergen at a dose of 0.25 ml, injected into the lower eyelid, intrapalpebral for the detection of sheep brucellosis in Iran. Four hundred and thirty sheep were tested by the intrapalpebral allergic test (IPAT). In addition to this test, serum samples from the sheep were subjected to Rose Bengal Plate Test (RBPT), serum agglutination test (SAT), complement fixation test (CFT) and mercaptoethanol test (MET). Sixty five sheep giving reactions to the IPAT and serological tests were selected for slaughter and subsequent culture of lymph nodes. The results of IPAT and of the serological tests were compared with each other and that of Brucella organism isolated in culture. According to this study, the IPAT is more sensitive than the serological tests in the detection of infected sheep, but CFT is more specific than other tests. It is concluded that IPAT is a reliable screening test, provided that the test is periodically repeated. PMID- 6489623 TI - [Clinical applications of a delayed hypersensitivity skin test for detecting brucellosis in sheep and goats using a commercial allergen]. PMID- 6489624 TI - [Brucellin in the diagnosis of human brucellosis]. PMID- 6489625 TI - [Typological analysis of serological test responses and brucellosis hypersensitivity]. PMID- 6489626 TI - [Value of I.N.R.A. brucellin for the diagnosis of human brucellosis. Institut National de la Recherche Agronomique]. PMID- 6489627 TI - Two sensitive assays for the detection of anti-Brucella antibodies. AB - A laser-nephelometric assay (LNA), applied to an adapted Wright's agglutination technique and an immunoenzymatic assay (ELISA) on tyndallised and sonicated Brucella are described. Both lead to an increased sensitivity of previous techniques for the detection of anti-Brucella antibodies. This was assessed in a) Brucellosis patients with either Wright and/or IF positive reactions (sero positive) or Wright and IF negative reactions (sero-negative, ancient brucellosis). Positive results were obtained in all cases with a highly significant increase of the titers observed in "sero-positive" patients. b) Normal subjects with no previous history and no biological stigmata of brucellosis: most sera gave negative results - a very low incidence of weakly positive results were however evidenced. c) Subjects vaccinated with fraction PI: positive results were observed in all cases. They were much earlier detected with LNA or ELISA than with Wright's or IF tests and the ELISA or LNA titers of late "sero-positive" sera were 3 to 36 times higher than Wright's titers. d) Supernatants of anti-Brucella hydridomas: LNA and ELISA were both successfully applied to the screening of such supernatants. PMID- 6489628 TI - [Counterimmunoelectrophoresis of the brucellin antigen in the serological diagnosis of brucellosis]. PMID- 6489629 TI - [Value of the ELISA test for detecting human brucellosis during epidemiological investigations]. PMID- 6489630 TI - [Practical value of examining cellular immunity in human brucellosis]. PMID- 6489631 TI - [Rapid antibiogram and MIC (minimal inhibitory concentration) for Brucella (Autobac)]. PMID- 6489632 TI - Brucellosis in man--II. Isolation of the causative organisms with special reference to blood picture and urine constituents. AB - Blood and urine samples were collected from 50 patients with febrile splenomegaly suspected to be Malta fever in Sharkia fever hospitals, Egypt. Blood samples were subjected to isolation of Brucellae; blood counts and erythrocyte sedimentation rate. Urine analysis. Four strains of brucella were isolated. Two of these isolated first from the 50 patients and typed as Br. melitensis Biotype I and the others were recovered secondly and thirdly from serologically positive patients and typed as Br. abortus Biotype I. All the strains from positive serology, titre ranging from 1/160-1/640. Br. melitensis is more readily isolated from the blood than Br. abortus. Blood picture of serologically positive Malta fever showed three patients with mild leukopenia; two with relative lymphocytosis; two with secondary anaemia and three with accelerated erythrocyte sedimentation rate. Urine analysis revealed five patients with albuminuria. PMID- 6489634 TI - [Epidemiological elements of human brucellosis in Upper Corsica]. PMID- 6489633 TI - [Evaluation of the treatment of human brucellosis]. PMID- 6489635 TI - [Let us vanquish brucellosis]. PMID- 6489636 TI - The epidemiology of brucellosis in animals. AB - The Brucella spp. may infect a wide variety of both domesticated and feral animals. However, classic symptoms are usually limited to hosts typically associated with singular bacterial species. The host-parasite relationship is influenced by many factors such as age, gestation, virulence and number of bacteria. Environmental conditions such as animal density affect exposure to infection. A diagnosis of herd infection is usually simple, but individual diagnoses can be complicated. Influences such as incubation period, vaccine titers, and heterospecific antigenic stimuli must be considered. A wide variety of test methods is available. The control of animal brucellosis is affected by many factors and is made difficult by modern agricultural practices such as increases in herd size and commerce. These and ancient practices such as nomadism may limit the effectiveness of organized programs. The use of vaccines will continue to play a major role in control in most countries. Research will hopefully lead to the development of more accurate and simple diagnostic methods, improved vaccines, and a better understanding of the host-parasite compatibility. New delivery mechanisms may prove beneficial in chemotherapy. PMID- 6489637 TI - [Immunization of ewes and she-goats against experimental Brucella melitensis infection. A comparison of REV 1 and H 38 vaccines]. PMID- 6489638 TI - Vaccination against bovine brucellosis. AB - Four experiments are summarized. Initially an attempt was made to modify strain 19 calfhood vaccination so as to eliminate the persistent serological reactions which interfere with eradication programmes. Later the project broadened into a search for an effective method of vaccination that could be applied when required, to all ages of cattle, thus allowing calfhood vaccination to be safely stopped. In the first experiment, reducing the age at vaccination with strain 19 to 1 month practically eliminated the serological response to vaccination, but the resulting immunity was not satisfactory. However, vaccination at 1 month followed by a booster consisting of a reduced dose of strain 19, given conjunctivally 1 year later, stimulated an immunity at least equal to that given by conventional calfhood vaccination. The vaccination of pregnant cows with either of 2 reduced dose levels of strain 19 gave better immunity than calfhood vaccination with the full dose. Uterine strain 19 infections were unacceptably frequent in cows given 6 X 10(9) c.f.u. of strain 19 in early pregnancy, but no such infections were found in 9 cows given 3 X 10(8) c.f.u. Vaccinal antibody titres declined rapidly in the latter group. Vaccination of mature, non-pregnant heifers with 3 X 10(8) c.f.u. of strain 19 produced immunity at least as good as that produced by calfhood vaccination, with a serological response greatly reduced in the majority of cattle. However, a small proportion of vaccination cattle developed high titres persisting for at least 7 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489639 TI - Biological properties and dog response to a variant (M-) strain of Brucella canis. AB - Wild type (virulent) B. canis organisms are always rough and growth becomes extremely mucoid (M+) after several days of incubation, especially on media pH 7.2. The mucoid growth of virulent (M+) B. canis and the marked tendency for M+ bacteria, and extracted cell wall antigens, to aggregate at acid pH (pH less than 6.5) are markedly diminished in a less mucoid (M-) variant. The M+ and M- Brucella, and their extracted cell wall antigens, also differ in hydrophobic properties; the M+ organisms (and antigens) being the more hydrophobic. Immunoelectrophoresis and immunodiffusion analysis also revealed differences between the two strains. Prolonged survival (greater than 1 year) of B. canis in host tissues, with the production of abortions or epididymitis/orchitis is a principal expression of B. canis virulence. Pathogenicity studies in Beagles have indicated that the M- variant is reduced in virulence, since dogs given high doses of the M- strain by the subcutaneous or conjunctival/oral routes remained asymptomatic. Abortions did not occur in experimentally infected pregnant bitches and there was no epididymitis/orchitis in inoculated males. Nevertheless, M- bacteria persisted in the spleen, prostate tissue of some males, and in the lymph nodes for 3 to 9 postinoculation months. Serological responses of dogs to the M organisms were generally weaker and less enduring than in dogs infected with the M+ Brucella. Sera from dogs infected with the M- strain generally reacted weakly in agglutination tests, especially when the antigen was B. ovis. The minimum infectious dose of M + B. canis was at least five times less than that of the M - Brucella (conjunctival or subcutaneous routes).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489640 TI - [Brucella vaccination administered via the conjunctiva]. PMID- 6489641 TI - [Control of animal brucellosis in France]. PMID- 6489642 TI - [Prevention of bovine brucellosis on socialist breeding farms of the Wilaya of Annaba from 1976 to 1982. The control plan, results and recommendations]. PMID- 6489643 TI - Epidemiological situation of brucellosis in the Mediterranean countries. PMID- 6489644 TI - Pancreatic polypeptide and gastrin release during sham feeding in man. AB - During modified sham feeding (MSF) the role of endogenous gastric acid secretion and the influences of the autonomic nervous system on the release of pancreatic polypeptide (PP) and gastrin have been studied in 12 healthy subjects (aged 24-38 years). Sham feeding was performed without pretreatment (control) and after pretreatment with 400 mg cimetidine, 80 mg propranolol (both given orally) or 1 mg atropine administered subcutaneously 60 min prior to sham feeding. MSF induced a significant increase (about 100%) in PP release. Its early peak was reduced by pretreatment with propranolol whereas cimetidine had no effect. Atropine completely abolished the PP response. Gastrin release was stimulated by MSF only after prior administration of cimetidine and, to a lesser extent, after atropine pretreatment. It is concluded that: (1) the PP release after stimulation is under strong cholinergic control but is also mediated--particularly in the early phase- by adrenergic mechanisms; (2) endogenously released acid during vagal stimulation plays a minor role in the modulation of PP secretion, but (3) masks gastrin response to MSF. PMID- 6489645 TI - Sulfated glycoprotein biosynthesis in human gastric mucosal biopsies. AB - Sulfated mucus glycoprotein biosynthesis by human gastric mucosal biopsies was studied. Human gastric healthy specimens and cancer specimens were obtained from antral and corpus normal mucosal areas by biopsy. A comparison was made of the biosynthesized sulfated mucus glycoproteins assessed by the incorporation of 35S sulfate and 14C-glucosamine into the specimens using an organ culture technique. A significant uptake of 35S-sulfate or 14C-glucosamine into the mucus glycoproteins was demonstrated in all specimens. 14C-glucosamine incorporation into the glycoproteins was almost the same for all biopsies. The synthesis of sulfated glycoprotein in healthy antral mucosa was about four times that in corpus mucosa. Significantly raised levels in sulfated glycoprotein biosynthesis were found in cancer specimens, being about 30 and 13 times higher in antrum and corpus mucosa than that of healthy specimens, respectively. PMID- 6489647 TI - Patient restraints. PMID- 6489646 TI - Faecal weight, constituents, colonic motility, and lactose tolerance in the irritable bowel syndrome. AB - Lactose intolerance and faecal characteristics were compared in 16 patients with symptomatic irritable bowel syndrome and in age- and sex-matched controls. Faecal stool weight was increased in the irritable bowel syndrome patients, whereas faecal bile acids, fat, volatile fatty acids, and neutral sterols were not significantly different. No lactose intolerance was found in irritable bowel syndrome subjects. Measurements of colonic motility showed only modest activity for both basal and food-stimulated activity. There was a weak correlation between the concentration of total bile acids, deoxycholic acid, lithocholic acid and the motility index. PMID- 6489648 TI - Coping with AIDS: crucial considerations. PMID- 6489649 TI - Manitoba's rural hospitals curtail nosocomial infections. PMID- 6489650 TI - Sick Children's surveys viral nosocomial infections. PMID- 6489651 TI - Medical ethics committees--the decision is yours. PMID- 6489652 TI - Preparing for accreditation: how to minimize the pain. PMID- 6489653 TI - Educating patients: a headache for administration. PMID- 6489654 TI - Proximal glomerulo-tubular balance in patients with type 1 (insulin-dependent) diabetes mellitus. AB - To evaluate the glomerulo-tubular balance of sodium and water in the proximal tubules of diabetic patients with elevated glomerular filtration rate, the renal plasma clearance of lithium and the glomerular filtration rate (51Cr-EDTA plasma clearance) were determined simultaneously in 11 ambulatory Type 1 (insulin dependent) diabetic patients (aged 25-35 years) with no evidence of diabetic nephropathy and in 10 age-matched healthy subjects. The renal plasma clearance of lithium, which is a measure of flow from the proximal tubule into the thin descending limb of the loop of Henle, did not differ between diabetic and control subjects (28.9 +/- 4.0 versus 28.3 +/- 5.1 ml/min per 1.73 m2 surface area, mean +/- SD), whereas the glomerular filtration rate in the diabetic patients was significantly higher than in the control subjects (136 +/- 10.2 versus 108 +/- 13.6 ml/min per 1.73 m2, p less than 0.001). The same held true for the fractional reabsorption rate in the proximal tubules (78.7 +/- 3.2 versus 73.6 +/ 4.9%, p less than 0.02). The results indicate that the elevation of the glomerular filtration rate in diabetic patients is associated with a parallel increase in the proximal reabsorption rate. This type of glomerulo-tubular balance implies that the flow of water and flux of sodium to the segments distal to the proximal tubule are kept constant during variations in the glomerular filtration rate. PMID- 6489655 TI - Incidence of childhood diabetes in The Netherlands: a decrease from north to south over north-western Europe? AB - The incidence of childhood diabetes (0-19 years of age) in The Netherlands, where there is no nationalized health-care system, was investigated retrospectively in the years 1978 to 1980 inclusive. The method chosen was a questionnaire among all Dutch paediatricians and internal physicians acting as consultants. Ascertainment was by the same questionnaire held separately among the large Dutch membership of the Dutch Diabetes Association, employing the capture-recapture census method for calculation. For paediatricians the ascertainment was 94%, for specialists in internal medicine 75%. Before correction for ascertainment 1271 children were registered in the two surveys. The ascertainment-corrected annual incidence was 10.95/100000 for 0-19-year-old children, lower than in any other ascertained survey in north-western Europe published so far. The male:female ratio was the same as in other studies and no local geographical differences were found. Seasonal variation was absent in children 0-10 years old in the month the first insulin injection was administered. The data support the influence of unknown exogenous factors associated with the clinical onset of childhood diabetes. PMID- 6489656 TI - The fast acetylator phenotype in diabetes mellitus: abnormal prevalence and association with the ABO blood groups. AB - The acetylator phenotype and ABO blood groups were evaluated in 55 normal subjects and in 156 diabetic patients [61 with Type 1 (insulin-dependent) diabetes and 95 with Type 2 (non-insulin-dependent) diabetes]. The prevalence of fast acetylators was significantly higher in the Type 1 diabetic patients (53%) than in the control subjects (29%). In the Type 2 diabetic patients the prevalence was 39%, and thus not significantly different from the control or Type 1 diabetic groups. In the Type 2 diabetic patients, but not in the control or in the Type 1 diabetic subjects, an association between the fast acetylator phenotype and the B blood group was found. PMID- 6489657 TI - Increased arachidonic acid incorporation into platelet phospholipids in type 2 (non-insulin-dependent) diabetes. PMID- 6489658 TI - In vivo and in vitro evaluation of left ventricular thrombi by two-dimensional echocardiography. Comparison with cineventriculography. AB - The purpose of this study was to assess the capability of two-dimensional echocardiography to identify left ventricular thrombi as compared to standard single plane cineventriculography in 284 patients, who underwent both procedures within 24 hours for diagnostic purposes. In order to obtain informations about the degree of thrombus organization and diagnostic accuracy of the echocardiographic technique, two-dimensional echocardiographic examinations were also performed in 31 thrombi from 16 autopsy specimens. In 249 cases the results were negative and in 14 cases positive by both techniques. Seven cases were positive by cineventriculography but negative by 2D-echocardiography. In seven cases the findings were equivocal by two-dimensional echocardiography; three of them were negative, two positive, and two equivocal by cineventriculography. In two cases the results were negative by two-dimensional echocardiography but equivocal by cineventriculography. Finally five cases were diagnosed to have a thrombus but two-dimensional echocardiography but not by cineventriculography. In two patients, positive by two-dimensional echocardiography, who were on anticoagulant therapy, follow-up studies showed the disappearance of left ventricular thrombi. In all of them the thrombi showed tissue characteristics similar to those of fresh thrombi examined in vitro. Two-dimensional echocardiography seems to be more reliable than cineventriculography for assessing the presence, extension, number, and morphology of left ventricular thrombi. In vitro studies suggest that two-dimensional echocardiography cannot visualize small thrombi, that fibrotic areas may simulate a thrombus and that in some cases under or overestimation is possible. PMID- 6489659 TI - [Diagnostic value of echocardiographic examinations in the evaluation of patients with infectious endocarditis of aortic and/or mitral valve localization]. AB - We estimated sensitivity, specificity, predictive value and efficiency of echocardiography in detecting vegetations and ruptured valves in patients with aortic and/or mitral valves infective endocarditis. We studied two groups of patients, in whom both high quality echocardiography examination and surgical inspection of heart valves were available. Group I: 16 patients (32 valves) with aortic and/or mitral valves endocarditis and surgical demonstration of vegetations and/or ruptured valves. In this group the prevalence of vegetations was 65.6%, the prevalence of ruptured valves was 43.7%. Group II was composed of the 16 patients of group I with endocarditis and of 93 other patients without endocarditis. In this group (139 valves) the prevalence of vegetations was 15%, the prevalence of ruptured valves was 13.6%. Echocardiographic detection of valve vegetations. Sensitivity (71.4%) was the same in group I and II. Specificity was 91% in group I and 91.5% in group II. The positive predictive value was 93.7% in group I and 60% in group II. The negative predictive value was 62.5% and 94.7% respectively. Echocardiographic detection of ruptured valves: sensitivity was 50% in I and 42% in group II. Specificity was 94.4% in group I and 99% in group II. The positive predictive value was 87.5% in group I and 89% in group II. The negative predictive value was 70.8% in group I and 91.5% in group II. The echocardiographic efficiency was higher in group II: 88.4% for vegetations and 91.3% for ruptured valves. This reflects the high specificity and the high definition of normal valves in this unselected low-risk group. The efficiency was lower in group I: 78% for vegetations and 75% for ruptured valves. This reflects the poor sensitivity and the failure of the test to identify all the vegetations or the ruptured valves in this selected high-risk group. PMID- 6489660 TI - Dilated (congestive) cardiomyopathy. Follow-up study of 137 patients. AB - The purpose of this study was to examine the clinical course of dilated (congestive) cardiomyopathy (DCM) and to identify the factors of prognostic significance. Between January 1969 and April 1982, 137 patients with a diagnosis of dilated cardiomyopathy were followed-up for a mean period of 48,7 +/- 40 months. Mean duration of illness before the first study was 15,5 months. A history of excessive alcohol intake was present in 22% of the patients and an influenza like syndrome in 9%. At diagnosis most of the patients were in NYHA functional class IV (43,5%) and III (35%). The 5-year survival rate was 45%, the mean annual mortality rate 10,2% and the highest mortality rate 14% in the second and third year. One hundred and seven patients (78%) progressed to major complications (worsening heart failure and death), while thirty patients (22%) showed stable or even improved conditions. Systemic or pulmonary emboli occurred in 18% of the patients, with a significant prevalence in patients with atrial fibrillation (p less than 0,05). Prognosis was unfavorably affected by the following factors: bi-ventricular heart failure as first clinical manifestation (p less than 0,01), intraventricular conduction delay (LBBB, LAHB) (p less than 0,05), significant cardiomegaly (cardiothoracic ratio greater than 0,53, p less than 0,001), left ventricular dysfunction (left ventricular fractional shortening less than 14%, p less than 0,005, left ventricular end-diastolic pressure greater than 17 mmHg, p less than 0,05, left ventricular end diastolic volume greater than 185 ml/m2, p less than 0,001, cardiac index less than 2,2/min/m2, p less than 0,001). PMID- 6489661 TI - [Sexual dysfunction in infarct patients and their partner: repercussions on the couple's relations]. AB - We have studied the sexual dysfunction in 115 couples under 60 years a member of whom had overcome a myocardial infarction (M.I.) not less than 6 months and no more than 2 years. We used two distinct questionnaires filled in anonymously one by the patients, the other by their partners. 70 (60,8%) patients have sexual dysfunction in post infarction as: partner's lack of co-operation 34 (48,6%), premature ejaculation 12 (17,1%), erectile failure 7 (10%), frigidity 6 (8,6%), sexual dissatisfaction 4 (5,7%), retarded ejaculation 2 (2,9%), various disorders 5 (7,1%), 58 (50,4%) partners have sexual dysfunction as: frigidity 22 (37,9%), sexual dissatisfaction 19 (32,8%), partners lack of co-operation 7 (12,1%), erectile failure 3 (5,2%), retarded ejaculation 2 (3,5%), various disorders 5 (8,6%). An important factor in sexual dysfunction is the partner's fear concerning the coitus which could provoke another heart attack due to stress and consequently the consort's death. We emphasize the importance acquired by the physician's tasks in favouring a complete psychophysical recovery in patients with previous M.I. whenever there are no rehabilitation institutes. PMID- 6489662 TI - [Catheterization of the left heart by trans-septal approach]. PMID- 6489663 TI - Diagnosis of cardiac amyloidosis made by ultrastructural examination of endomyocardial biopsy. A case report. AB - A case of cardiac amyloidosis is described in which clinical and scintigraphic findings were those of ischemic heart disease. Electrocardiogram disclosed low voltages in the peripheral leads and a pattern of anterior pseudo-myocardial infarction. 2D-echocardiography showed thickened cardiac walls and a "granular sparkling" appearance of the septum. The curve of the left ventricular diastolic pressure suggested impaired ventricular relaxation without a true dip-plateau morphology. Stains for amyloid of rectal biopsy specimens were negative. Histological study of left ventricular endomyocardial biopsy indicated the presence of basophilic material among the myocytes; at ultrastructural examination this infiltrating substance resulted to be amyloid. This case stresses the effectiveness of ultrastructural investigation of left ventricular endomyocardial biopsy in the diagnosis of infiltrative and/or metabolic cardiac disorders. PMID- 6489664 TI - [Fetal echocardiography. Prenatal diagnosis of hypoplastic left heart syndrome]. AB - The authors report of a prenatal ultrasound diagnosis of hypoplastic left heart syndrome (HLHS) in a fetus at 36 weeks' gestation. The diagnosis-was substantiated by a postnatal two dimensional and M-mode echocardiogram and confirmed at postmortem examination. Pertinent findings were the morphology of ventricular cavities and of the mitral valve, and the abnormally increased ratio of right ventricular to left ventricular dimensions (approximately 2) as well as the pulmonary-to-aorta diameter ratio of 1,7. We stress the need of an accurate measurement of ventricular cavities to avoid a falsely positive diagnosis and the importance of a prenatal ultrasound diagnosis of congenital heart anomalies for a correct perinatal management. PMID- 6489665 TI - [Echocardiographic documentation of fibrocalcific degenerative changes of a lascia lata valvular prosthesis at the aortic valve]. AB - The echocardiographic features of fibrocalcific degeneration of fascia lata aortic bioprosthesis are presented in two cases. M-Mode and 2D echocardiograms showed increased density and reduced motion of the bioprosthetic leaflets, suggestive of fibrocalcific degeneration. These features were confirmed at surgery. Two-dimensional echocardiography was mostly useful (in one case) in the assessment of morphology and motion of the diseased prosthetic valve. PMID- 6489666 TI - [Polygraphic study of left ventricular function in severe hepatitis cirrhosis]. AB - Systolic time intervals have been investigated in 26 subjects with severe liver cirrhosis. The patients were subdivided as follows: 15 with alcoholic cirrhosis; 11 with post-necrotic cirrhosis. Systolic time intervals were recorded and measured according to the Weissler's method. The left ventricular ejection time was significantly shortened due to the low systemic vascular resistance, while the pre-ejection period was unchanged, denoting preserved myocardial contractility. The isometric contraction time was also significantly shortened, thus confirming a good myocardial response to increased pre-load due to hyperdynamic state. The cardiac performance as assessed by systolic time intervals, is unchanged in hepatic cirrhosis. PMID- 6489668 TI - [Apex cardiography calibrated by an infinite-time constant. Technic and methodology]. AB - A new apexcardiographic transducer system is presented. The device features infinite time constant, absolute pressure calibration and measurement of thorax coupling pressure (PO). The sensing element is an estensimetric bridge, mounted on the internal surface of a rigid membrane, coupled to the chest by a 4 x 7 mm plastic cylinder. The system is linear within the range of 0 to 1350 mmHg; the frequency response of the transducer is linear between 0 and 3500 Hz. The electronic filtering circuits allow simultaneous output of apexcardiogram, first apexcardiographic derivative and three phonocardiographic bands. Measurements carried out on 6 volunteers using the new apparatus and a traditional transducer system demonstrate that control of the coupling pressure is necessary not only for absolute amplitude, but also for accurate amplitude ratio measurements because the transmission of pressure signal across the thorax changes with different coupling pressures. PMID- 6489667 TI - [Effects of delayed-action metoprolol evaluated in hypertensive patients responsive to therapy subdivided in 2 different age groups]. AB - Thirty patients with essential hypertension, whose blood pressure was controlled by metoprolol, were divided according to age in two groups. All the patients were treated with long-acting metoprolol given as simple daily dose at 08.00 h. Blood pressure and heart rate were recorded before and at the 7th, 15th, 30th, 45th, 60th days of treatment. No significant difference in the antihypertensive effects of metoprolol was detected between the two groups of patients. A significantly higher reduction of the heart rate was observed in the older patients. PMID- 6489669 TI - Training the disabled for income generating activities. AB - The main aim of the paper is to look at the general situation in which many handicapped persons find themselves and to suggest ways in which trainers can help by training the handicapped without thinking in terms of attending "traditional" training courses. The ultimate aim of the trainer is to help handicapped persons to stand on their own, be productive within society and be engaged in gainful activities, even though this may not necessarily involve them working formally in a factory or similar enterprise. PMID- 6489670 TI - [Rehabilitation of workers with amputated limbs]. AB - New technologies such as modular prostheses and prostheses fitted with a myoelectrical control mechanism have made it possible for individuals who have suffered amputation of the lower or upper limbs to be reinstated in work. Many examples of artificial limbs are illustrated that have given excellent cosmetic and functional results. Obviously, good functional recovery depends on the facilities, the environment, the cooperation experts engaged in rehabilitation, on retraining and reinstatement at work, and only the combined efforts of all sectors can ensure that the many obstacles can be overcome, as the author's twenty-year experience has shown. PMID- 6489671 TI - [Importance of rehabilitation in the evaluation of personal injury]. AB - The paper distinguishes between rehabilitation and the conferring of ability, limiting the application of rehabilitation methods to recovery of disablement due to trauma or disease. This can be achieved with the collaboration of specialists in the various branches of medicine; microsurgery, orthopaedics, physiotherapy, together with socio-psycho-biological aids. The Artificial Limb Center of the National Institute for Insurance against Occupational Diseases (INAIL) located at Vigorso di Budrio (Bologna) has been particularly successful in designing myoelectric and modular prostheses for patients who have undergone amputation of limbs, thus achieving functional, social and occupational rehabilitation. The concept of functional and anatomical disablement and personal injury on a forensic medicine basis is illustrated, as applicable in criminal and civil law, insurance and social security. Rehabilitation plays an important role since it reduces personal injury on a social and occupational level. PMID- 6489672 TI - [Rehabilitation of the worker with heart disease]. AB - The physical, metabolic and psychological advantages of cardiac rehabilitation and its effects on secondary prevention and mortality are discussed. The importance of functional assessment of the patient with postacute myocardial infarction (MI) is emphasized in order to define the prognostic and therapeutic approaches. The methods of assessment are described, ith particular regard to Echocardiography, ambulatory ECG and exercise test. The echocardiographic location and extension of left ventricular asynergy, which are often unpredictable with conventional ECG, have important functional implications. In our experience, on the basis of these data, subsets of patients with different degrees of left ventricular dysfunction, both at rest and during exercise, can be identified. The ambulatory ECG can reveal ventricular arrhythmias in 60% of infarcted patients, while during exercise test the incidence of ventricular premature beats (VPB) is 20%. Both in post-acute evaluations and in evaluations performed 1 year later, poor correlations were found between VPB and ECGraphic and hemodynamic parameters either at rest or during exercise; however during the first postinfarction year ventricular arrhythmias tend to decrease. Hemodynamic and ECGraphic patterns during exercise were analyzed in about 600 patients with recent MI: the left ventricular filling pressure (PWP) was greater than 20 mm Hg in 54% of the patients and greater than 30 mm Hg in 28%. The MI site is predictive of hemodynamic left ventricular dysfunction both at rest and during exercise: anterior MIs are more impaired than inferior MIs. Good correlations were found between the ST-segment elevation (increased ST) during exercise and left ventricular function; in particular, in anterior MI the ventricular function is generally normal in patients without increased ST, abnormal in those with increased ST (the increased ST increment during exercise, if present at rest, has no hemodynamic implications). In inferior MI the increased ST does not seem to have nay hemodynamic significance. The ST-segment depression (decreased ST) too, is of important functional significance: in anterior MI it is usually associated with increased ST and a more evident left ventricular dysfunction. In inferior MI, ventricular function is generally better in patients without decreased ST than in those with increased ST.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489673 TI - [Rehabilitation of the worker with bronchopneumopathy]. AB - Epidemiological data show that chronic diseases of the respiratory apparatus have constantly increased over the last 20 years or so, often involving relatively young age classes. The increased survival rates due to chemotherapy also increase the importance of rehabilitation in such diseases. The officially accepted concept of a "global" rehabilitation is particularly significant in the case of patients of working age. The main rehabilitation procedures include chest physiotherapy, aerosol therapy, oxygen therapy (where selection criteria have been established and where there are new prospects related to long-term oxygen therapy), intermittent positive pressure breathing and physical retraining. Details on the methods of assessment and training and data concerning three groups of patients suffering from respectively chronic obstructive lung disease, silicosis and asbestosis, are given. The data show a general pattern of a decrease in ventilation (for an unchanged level of O2 uptake and CO2 output) and reflect a rise in muscular efficiency (exercising and respiratory) enabling the body to perform the same work load at a lower energy cost. The authors discuss the vocational rehabilitation of the patient with lung disease and illustrate the most useful procedures in the assessment of the subject, the environment and the place of work, including guidelines to achieve this. Rehabilitation treatment is also summarized into a number of stages, with the goals at different therapeutic levels and the ways to reach them. PMID- 6489674 TI - [Determination of anticonvulsant drugs in the saliva. Correlation with plasma concentrations]. PMID- 6489675 TI - Enhancing effect of sodium taurocholate on N-methyl-N'-nitro-N-nitrosoguanidine induced stomach tumorigenesis in rats. AB - Male Wistar rats that had received a low dose of N-methyl-N'-nitro-N nitrosoguanidine (MNNG) and sodium taurocholate showed a significantly higher incidence of hyperplastic and neoplastic lesions in the stomach mucosa than did the MNNG-treated controls. The result suggested an enhancing effect of taurocholate in stomach tumorigenesis. PMID- 6489676 TI - Establishment of human KB cells resistant to 1-beta-D-arabinofuranosylcytosine, and mechanisms of cellular resistance in isolated clones. AB - A subline of human KB cells that was resistant to 1-beta-D arabinofuranosylcytosine (ara-C) was established by continuous exposure of the cells to increasing concentrations of ara-C. Thirteen resistant clones were isolated from the resistant subline (KB/ara-C). KB/ara-C showed 1,300-fold higher resistance than the parent KB cells to ara-C; the most resistant clones, clones 7 and 10, showed 1,330-fold higher resistance. In the absence of ara-C, the resistance of the parent KB/ara-C cells was stable for at least 14 weeks, whereas that of clone 7 was stable for 10 weeks, but was slightly less after 14 weeks. The ara-C kinase and ara-C deaminase activities of the 13 clones and the cellular uptake of ara-C by several clones were measured. In general the clones showed decreased deoxycytidine kinase activity and decreased cellular uptake of ara-C. Most clones had higher cytidine deaminase activity than KB cells, but some had activity similar to that of the KB cells. A clear inverse relationship was found between the ara-C sensitivity of the clones and their kinase activity, but not their deaminase activity or their ara-C uptake. These results clearly demonstrate that a major mechanism of ara-C resistance of these human KB cells was a decrease in the activity of the ara-C activating enzyme deoxycytidine kinase. The parent KB/ara-C cells showed no clear cross-resistance to various antitumor agents other than an ara-C derivative, including metabolic inhibitors, alkylating agents, DNA binders and mitotic spindle poisons. PMID- 6489677 TI - Correlations between iron content and isoferritin profiles of normal and malignant tissues. AB - Isoelectric focusing profiles of ferritins isolated from livers of anemic rats and 3'-methyl-4-dimethylaminoazobenzene-induced hepatomas were more acidic than their normal counterparts, and exhibited patterns similar to those of heart ferritin. Iron administration induced a shift to more basic components for the normal and tumor ferritins. The isoferritin patterns reflected the subunit populations of the protein, as the more acidic components had greater proportions of H-type subunits and iron induced an increase in L subunits with concomitant increases in more basic isoferritins. For both normal and malignant tissues there was a direct correlation between iron content of the tissue and subunit composition. The apparently unique isoferritin patterns in the tumor tissue may, therefore, be ascribed primarily to the lower iron contents. PMID- 6489678 TI - Anti-tumor effects of radiolabeled syngeneic monoclonal anti-melanoma antibodies. AB - The effect of 131I-labeled syngeneic mouse monoclonal anti-melanoma antibodies on tumor growth in vivo were investigated. The injection of unlabeled antibody had little effect on tumor growth, whereas the anti-tumor activity was considerably increased when the antibody was conjugated with 131I and also when a mixture of two different radiolabeled monoclonal antibodies with distinct specificities was used. The anti-tumor effects of the radiolabeled antibody were transient but significant under the present experimental conditions: melanoma growth was completely inhibited for about 10 days or more after the antibody treatment, but resumed thereafter. Possible mechanisms of escape of the tumor from the therapy with radiolabeled monoclonal anti-tumor antibody are discussed. PMID- 6489679 TI - Activation of murine macrophage-like cell line J774.1 by Sarcophaga peregrina lectin. AB - The effect of Sarcophaga lectin on mouse macrophage-like cell line J774.1 was studied. It was found that this lectin induced significant morphological changes and stimulated glucose consumption of J774.1 cells. A similar effect was observed when bacterial lipopolysaccharide was added to the culture medium. However, although cells treated with lipopolysaccharide were not cytotoxic to allogeneic tumor cells, those treated with Sarcophaga lectin were found to acquire cytotoxicity. The physiological significance of Sarcophaga lectin is discussed from the viewpoint of comparative immunology. PMID- 6489680 TI - Clonogenic assay for urologic malignancies. AB - An in vitro double soft agar technique was used to culture 91 human urologic tumors including 37 renal cell, 40 uroepithelial, 7 prostatic and 7 testicular cancers. Cells from 31 of 37 renal, 32 of 40 uroepithelial, 3 of 7 prostatic and 4 of 7 testicular cancer specimens grew to the extent that they could be used in chemosensitivity testing in soft agar (greater than or equal to 30 colonies per control plate). With this assay system, a very high growth rate (70/91; 77%) was obtained. The in vitro response rates of greater than or equal to 10% were noted with mitomycin C, 5-fluorouracil, cisplatin, bleomycin and vincristine in renal cell cancers, and with vincristine and cisplatin in uroepithelial cancers. Drug sensitivity studies showed that the rates of in vitro sensitivity of uroepithelial cancers were close to those obtained in general clinical experience, while the rates of the vitro sensitivity of renal cell cancers were considerably higher than the rates found clinically. It is concluded from this study that in vitro chemosensitivity testing by clonogenic assay is likely to be a useful tool in the treatment of urologic cancers, but that a simple definition of sensitivity cannot be applied for all types of tumors. PMID- 6489681 TI - [Comparison of 3 methods of recording esophageal pH in the diagnosis of gastroesophageal acid reflux]. AB - The aim of this prospective work was to analyze the results of 3 methods of esophageal pH recording (i. e. short-term pH test, 3-hr postprandial recordings, and 12-hr nocturnal pH recording) in 47 patients with suspected gastroesophageal reflux. Nocturnal pH recording was used as a reference for evaluation of the diagnostic value of the 2 other pH tests. Normal ranges were established from 20 control subjects. Esophageal endoscopy with biopsies were performed systematically in order to evaluate the relationship between pH results and the grades of esophagitis. According to the results of nocturnal pH recordings, 32 patients were considered to suffer from acid gastroesophageal reflux and 15 patients as being free of reflux. The sensitivity and specificity of the pH measurements were 0.94 and 0.13 for the short-term pH test and 0.91 and 0.80 for 3-hr postprandial recordings respectively. The total duration of reflux (expressed as a percentage of total duration of the test) was the most discriminative parameter for the diagnosis of reflux and was simpler to determine than previously described pH scores. Because of the absence of lamina propria in the biopsy specimens obtained at endoscopy, histological diagnosis of esophagitis was possible in only 35 patients (74 p. 100). No relationship was found between the grade of esophagitis and the results of short-term pH tests. On the other hand, the mean duration of reflux episodes, the duration of the longest episode, the total duration of reflux measured by 12-hr nocturnal pH recording, and the number of low pH reflux episodes determined by postprandial tests were significantly higher in patients with macroscopic lesions than in those with normal endoscopic aspect or mild (histological) lesions of esophagitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489682 TI - [Instrumental dilatation of esophageal and gastric stenoses using Gruntzig's catheter and Celestin's dilator. Preliminary results]. AB - The aim of this study was to present the technique of endoscopic dilatation and the preliminary results obtained with 2 new instruments, the Gruntzig balloon catheter, and the Celestin dilator, in patients with esophageal or gastric strictures. The Gruntzig balloon catheter was used 11 times in 7 patients (6 adults and one child aged 1 1/2 year), for the dilatation of severe or irregular strictures of the esophagus (5 cases), the stomach (1 case) and the pylorus (1 case). Partial (4 cases) or complete relief (2) were observed and allowed subsequent use of the Celestin bougies (2 cases), or the introduction of an esophageal prosthesis (1 case). In the child with caustic stricture of the esophagus, dilatation with the Gruntzig balloon-catheter was complicated twice by perforation. In the second case, the perforation was related to the technique used in dilatation and was treated by conservation measures. Endoscopic dilatations with the Celestin bougies were performed in 27 patients with benign (including 9 peptic strictures) or malignant strictures (14 cases, 7 related to esophageal cancer, and 7 to cancer of the cardia). A total of 74 dilatations were performed, attaining a maximum diameter of 16 or 18 mm in one session, in 21 patients (78 p. 100 of the cases). In the case of peptic stricture, the anatomical result was excellent in 8 patients and the functional result good in 7 of 9 cases. In case of malignant stricture, the result was conditioned by the evolution of the tumor; recurrence of dysphagia called for either repeated dilatations (8 cases) or the introduction of an esophageal prosthesis (5 cases).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489683 TI - [Complex recto-colic adenomatous and hamartomatous polyposis with hyperplastic gastric polyps in a 13-year-old girl]. AB - We report the case of a 13-year-old girl who presented mixed polyposis coli and gastric polyps. The rectal and colonic polyps were of the adenomatous and hamartomatous type (i. e. juvenile and Peutz-Jeghers polyps) without any intermediate features; in the stomach, the polyps were of the hyperplastic type. Microadenomas of the appendix and lymphoid hyperplasia of the ileum were also found. The karyotype was normal and the HLA group was A2 B12. No family history of polyps was discovered. To our knowledge no such case (complex polyposis) has been previously described. The present findings suggest that the usual pathological classification of polyposis may be arbitrary and that various pathological types may represent different aspects of the same spectrum of disease. Absence of "intermediate" polyps rule out the hypothesis of the sequence "hyperplastic polyp-juvenile polyp-adenoma". PMID- 6489684 TI - Role of delta infection in the progression to chronicity of acute HBsAg positive hepatitis. AB - A previous study of 159 consecutive cases of HBsAg+ acute viral hepatitis, observed from the onset of disease and seen between May 1977 and May 1980, revealed a higher frequency of evolution to chronicity in the region of Naples than that reported for other areas. This suggested that environmental factors might influence the chronically rate. We investigated 125 HBsAg+ acute hepatitis cases for whom sera were available: 35 patients who remained HBsAg+ at the two year control (28 chronic hepatitis and 7 healthy carriers) and 90 who recovered and seroconverted HBsAg---- anti-HBs during follow-up. At the onset of disease, all patients who cleared HBsAg showed IgM anti-HBc positivity and 48 were also HBeAg positive; no patient was anti-delta positive. On the contrary of the 28 chronic cases only 7 were IgM anti-HBc+ (6 under 13 years old), while 21 were IgM anti-HBc- but anti-delta+. This study demonstrates that not all HBsAg+ acute hepatitis cases are due to HBV and that in our area, superinfection by the delta agent is responsible for most cases of chronic HBsAg positive hepatitis. PMID- 6489685 TI - [Anti-HBc IgM antibodies: prevalence during HB virus infection and value of studying titers]. AB - IgM antibody to hepatitis B core antigen (IgM anti-HBc) was determined in acute and chronic hepatitis B by the immunocapture method. To avoid interference with the rheumatoid factor, F (ab')2 antibodies were used; non-specific reaction of IgG anti-HBc with anti-mu usually observed with 1/100 dilution of the serum was avoided by 1/1,000 dilution. IgM anti-HBc was positive in 100 p. 100 of the patients with acute hepatitis B (n = 32), in respectively 100 p. 100 and 70 p. 100 of the patients with complete recovery 6 and 12 months after acute illness (n = 10 and n = 10), 20.8 p. 100 of the healthy chronic HBs Ag carriers (n = 48), 80 and 85.7 p. 100 of the patients with chronic persistent and chronic active hepatitis (n = 40 and n = 14). S/N ratios (S = sample, N = negative controls) were above 5 in all patients with acute hepatitis. In patients with complete recovery, 6 to 12 months after acute illness, and in healthy chronic HBs Ag carriers, S/N ratios were above 5 in only 5 and 2 p. 100 of cases respectively whereas in patients with chronic hepatitis, the S/N values were dispersed. The main interest of the IgM anti-HBc test is to allow for the diagnosis between acute hepatitis B and acute hepatitis non B in healthy chronic HBs Ag carriers. In our patients, a S/N ratio above 5 discriminated between an acute hepatitis B and a healthy chronic HBs Ag carrier with a specificity of 98 p. 100. PMID- 6489686 TI - [Perfusion-fixation of liver needle biopsy: technic]. AB - Technical details concerning the perfusion-fixation of liver needle biopsies are described. The biopsy (less than or equal to 0,5 cm length) migrated in a Pasteur pipette filled with heparinized Ringer solution and stopped when its diameter corresponded to the internal diameter of the pipette. The pipette was cut above the upper part of the biopsy. The biopsy was perfused with a thin needle (external diameter 0.2 mm) struck in the upper part of the biopsy under binocular microscopy control. Fixation medium, 2.5 p. 100 glutaraldehyde, was aspirated at the inferior extremity of the pipette. The aspiration speed was equal to the perfusion speed (0.15 ml/min). The biopsy was perfused for 5-8 min. This simple technique allows for detailed electron microscopic examination of sinusoids, sinusoidal and perisinusoidal cells as well as of the spaces of Disse. PMID- 6489687 TI - [Hepatitis secondary to a gold salt overdose]. AB - The authors report the case of a 51-year-old woman who developed cholestatic and cytolytic hepatitis after an overdose of sodium aurothiopropanol sulfonate 1.1 g, namely 300 mg gold metal. Liver biopsy demonstrated cholestasis, centrolobular steatosis and portal fibrosis. Electron microscopy showed abundant lipo-pigments in the hepatic and cellular cells, as well as myelinic bodies. Gold analysis by atomic absorption spectroscopy showed a level of 22.76 micrograms per ml in the plasma and a level of 2.16 micrograms per g in the liver. Chelating agents increased the urinary gold excretion, but were without effect on the course of hepatitis. Dimercaptopropanol seemed to favor the occurrence of other gold salt side-effects and penicillamine increased the hepatic cytolysis. The patient recovered without sequelae. PMID- 6489688 TI - [Gastritis varioliformis with human basophil degranulation test positive for an herbal tea mixture]. PMID- 6489689 TI - [Sensitivity and specificity of the Hemoccult test compared with fibrosigmoidoscopy in the detection of colorectal polyps]. PMID- 6489690 TI - [Myelolipoma of the liver]. PMID- 6489691 TI - Manometric study and prolonged pH monitoring of esophagus in patients with hiatus hernia before and after operation. AB - The pathophysiology of the lower esophagus in 18 patients with hiatus hernia and 15 normal controls was investigated by esophageal manometry and prolonged pH monitoring. Thirteen patients with symptoms of severe gastroesophageal reflux had lower than normal pressures at the gastroesophageal junction. In 5 patients without symptoms, the pressure was normal. Nine of the 13 patients were inadequately controlled by conservative measures and underwent Nissen or Dor Nissen fundoplication. All were free of esophageal symptoms postoperatively. Fundoplication resulted in a significant increase in the lower esophageal pressure. Prolonged esophageal pH monitoring showed significant improvement in all indices. Hiatus hernia and gastroesophageal reflux are related etiologically. However, further observations are needed to explain the association between reflux esophagitis and hiatus hernia. Nissen and Dor-Nissen fundoplications restored competence to the gastroesophageal junction as judged by esophageal manometry and prolonged pH monitoring. PMID- 6489692 TI - Bile secretion in regenerating liver--a comparison of hepatic resection and ligation of the portal vein branch in dogs. AB - To elucidate the mechanism of bile secretion in the regenerating liver, changes of bile secretion were investigated in dogs during 12 weeks or more after 70% hepatectomy and after ligation of the portal vein branch supplying 70% of the area of the liver. The remnant liver weight increased remarkably and reached a normal level at 2 weeks after 70% hepatectomy. Liver weight increased in the nonligated lobes and decreased in the ligated lobes after ligation of the portal vein branch, but the whole liver weight was unchanged. Bile flow increased and continued for 12 weeks or more in the remnant liver except for a period of 2 weeks in the nonligated lobes. It decreased markedly in the ligated lobes. The taurocholic acid-independent bile flow was higher in the remnant liver than in nonligated lobes in both of which it was higher than normal liver. In the ligated lobes, taurocholic acid-independent bile flow was lower and taurocholic acid dependent bile flow was higher than normal liver. When gallbladder bile was infused into the terminal ileum, bile flow increased in both the remnant liver and the nonligated lobes, except for 2 weeks in the remnant liver. Therefore it is suggested that in the regenerating liver enterohepatic circulation of bile acid and the new balance of the bile acid pool size participates in not only in bile flow but also in liver regeneration. PMID- 6489693 TI - Hepatitis B virus infection and its sequelae in Taiwan. PMID- 6489694 TI - Development and prognosis of histologic cirrhosis in corticosteroid-treated hepatitis B surface antigen-negative chronic active hepatitis. AB - To determine the frequency and prognosis of histologic cirrhosis developing during or after corticosteroid therapy of hepatitis B surface antigen-negative chronic active hepatitis, we followed 83 patients for 90 +/- 5 mo after administration of corticosteroids. Thirty-three patients satisfied histologic criteria for cirrhosis after 30 +/- 5 mo. In 25 patients, cirrhosis developed during treatment; in 8 patients, cirrhosis eventuated after remission and cessation of therapy. The probability of developing histologic findings of cirrhosis was 59% if remission had not been achieved after 3 yr of continuous therapy. Longer requirements for treatment and deterioration during therapy characterized these patients. Once remission was achieved, the mean annual incidence of cirrhosis was only 2.6%. Patients who manifested evidence of cirrhosis in their biopsy specimens could not be distinguished by initial clinical, biochemical, or histologic findings. Ascites, encephalopathy, and esophageal varices developed infrequently; 5-yr survival after documentation of cirrhosis was 93%. We conclude that histologic features of cirrhosis develop commonly during therapy, especially if remission is not achieved quickly. After remission, cirrhosis develops infrequently. The development of histologic cirrhosis does not influence immediate morbidity and 5-yr life expectancy. PMID- 6489695 TI - Dual mechanism of inhibition of rat liver uroporphyrinogen decarboxylase activity by ferrous iron: its potential role in the genesis of porphyria cutanea tarda. AB - Hepatic iron overload amplifies the uroporphyrinogen decarboxylase enzyme defect in human porphyria cutanea tarda. To understand its mechanism, we studied the effects of iron on the enzyme activity from rat liver cytosol. Enzyme activity was inhibited about 50% by 0.10 mM Fe2+ or by 0.16 mM Zn2+ directly regardless of whether the cations were added immediately, or were first preincubated for 2 h at 37 degrees C in the absence or presence of oxygen. Cysteine (6.7 mM) protected the enzyme from inhibition by Fe2+ under strictly anaerobic preincubation conditions; cysteine also protected enzyme inhibition by Zn2+ even in the presence of oxygen. Under aerobic conditions, cysteine enhanced the inhibition by Fe2+ to about 70%. This additional 20% inhibition was reversed by vitamin E, an antioxidant. The results suggest dual inhibitory effects of iron (a) by direct interaction of Fe2+, as well as Zn2+, with the essential sulfhydryl group(s) of the enzyme and (b), indirectly, due to generation of free radicals in the presence of oxygen and an electron donor such as cysteine. These radicals might interact directly with the enzyme and/or oxidize the porphyrinogen substrates to nonmetabolizable porphyrins, which accumulate in porphyric patients. PMID- 6489696 TI - Gastric emptying and sieving of solid food and pancreatic and biliary secretions after solid meals in patients with nonresective ulcer surgery. AB - This study was undertaken to compare with previously published findings in normal subjects and subjects after truncal vagotomy and antrectomy the effects of nonresective ulcer surgery on (a) gastric emptying, grinding, and sieving of solid food and on (b) pancreatic and biliary secretions. Six subjects with proximal gastric vagotomy and 7 subjects with truncal vagotomy with pyloroplasty were studied using a previously validated indicator perfusion system with its aspiration port placed in the proximal jejunum. All subjects were given a meal of 30 g of 99mTc-liver, 60 g of beefsteak, and 100 ml of H2O. In conjunction with a gamma-camera to measure total gastric emptying of 99mTc-liver, this method allowed us to estimate the fraction of 99mTc-liver emptied from the stomach as particles of less than 1-mm diameter; in addition, we were able to measure jejunal concentrations and outputs of bile salts and pancreatic enzymes. In subjects with proximal gastric vagotomy, all parameters studied were indistinguishable from normal. Subjects with truncal vagotomy and pyloroplasty behaved similarly to subjects with vagotomy and antrectomy, showing (a) early precipitous emptying of food, (b) heterogeneous distribution of half-emptying times, (c) near normal concentration of biliary and pancreatic secretions, (d) markedly reduced jejunal flow rates, and (e) a reduction in postcibal trypsin secretion. In contrast to subjects after truncal vagotomy and antrectomy, however, the majority of subjects with vagotomy and pyloroplasty did not show a persistent defect in grinding and sieving of solid food. PMID- 6489697 TI - Effect of sodium taurocholate on the human gastric mucosa at acid and neutral pH's. AB - This study was conducted to determine whether taurocholate alters human gastric function and structure at a neutral pH, when ionized, and to contrast this with its effect at an acid intraluminal pH, when pronated. Five fasted healthy subjects were studied on 4 days in random order. Net ion fluxes, mucosal damage (as quantitated endoscopically), and potential difference were measured. The control solution instilled into the stomach in the first, third, and fourth 15 min periods contained 200 ml of 100 mM HCl, 54 mM mannitol, and [14C]polyethylene glycol. Taurocholate (10 mM) was added to the control solution (pH 1.1) or citrate buffer (pH 7.0) during the second 15-min period. The effect of citrate buffer alone or control solution alone was also tested. Because hydrogen and sodium fluxes could not be quantitated at pH 7 in the presence of citrate buffer, the net ion fluxes during the 15 min immediately after exposure to the test agent were measured. At both pH 1.1 and 7.0 taurocholate produced similar and significant increases in net hydrogen ion flux (-1.7 +/- 0.4 and -1.8 +/- 0.3 mmol/15 min, respectively), net sodium ion flux (1.8 +/- 0.4 and 1.7 +/- 0.2 mmol/15 min, respectively), decreases in potential difference, and mucosal erosions. The net hydrogen ion fluxes were significantly greater than occurred after citrate buffer alone or the HCl control. The net sodium fluxes after taurocholate in citrate were significantly greater than the pH 1.1 acid control, but not citrate buffer alone. These findings indicate that pronated (pH 1.1) or ionized (pH 7.0) taurocholate significantly damaged the in vivo human gastric mucosa. Taurocholate at pH 7 could in part be responsible for the gastric mucosal injury that occurs in patients with bile reflux gastritis. PMID- 6489698 TI - Hyposplenism and gluten-sensitive enteropathy. Natural history, incidence, and relationship to diet and small bowel morphology. AB - Splenic function was quantitatively assessed using "pitted" erythrocyte counts in 177 patients with gluten-sensitive enteropathy. Hyposplenism was found to be a common, but not inevitable, complication of gluten-sensitive enteropathy that fluctuated with disease activity. Splenic function improved after withdrawal of gluten from the diet and a close relationship was demonstrated between hyposplenism and the morphology of the small intestine. The severity of the hyposplenism increased with advancing age and prolongation of exposure to dietary gluten. Splenic function did not vary with the HLA-A, -B, and -DR antigens, but, due to the presence of HLA-B8 and -DR3 in the vast majority of patients, a role for this haplotype in the causation of the hyposplenism cannot be excluded. PMID- 6489699 TI - Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study. AB - Rectoanal manometry and a rectometrographic study were carried out on 31 control subjects and 63 constipated children. A single contrast barium enema was performed on all constipated children and on 20 children for whom this x-ray study (made for a reason other than constipation) was considered normal. This study allowed the determining of four manometric parameters (rectoanal inhibitory reflex threshold, rectorectal reflex threshold, conscious rectal sensitivity threshold, maximal anal resting closure pressure), of three rectometrographic parameters (maximal rectal tolerable pressure, maximal rectal tolerable volume, maximal rectal compliance), and of one radiologic parameter (rectopelvic ratio). It appeared that the barium enema study was not meaningful. The threshold of the inhibitory reflex and of the rectoanal reflex did not allow for a specific definition of abnormality in constipation. Anal closure pressure was higher in 38% of the constipated patients. The sensitivity threshold was significantly higher in the constipated group. In 79% of the patients an increase in rectal compliance was observed. Finally, in this series of constipated patients who did not have Hirschsprung's disease, organic abnormalities were demonstrated in 97% of the children. PMID- 6489700 TI - Fasting breath hydrogen concentration: normal values and clinical application. AB - Excretion of hydrogen in breath commonly persists despite an overnight fast. Although elevation of hydrogen concentration above the fasting value after administration of a test sugar is evidence of malabsorption, the significance of the fasting value itself is unknown. We determined the normal limits of fasting breath hydrogen in healthy children and adults, and in patients with chronic diarrhea or recurrent abdominal pain. Fasting breath hydrogen in 221 healthy children and 9 healthy adults averaged 7.1 +/- 5.0 parts per million (mean +/- SD), exceeding 30 parts per million in less than 1%. No value exceed 42 parts per million. In 73 patients with recurrent abdominal pain and 76 patients with chronic diarrhea, fasting breath hydrogen was less than 42 parts per million in 97% and 83%, respectively. History and laboratory data were reviewed in the 15 patients where fasting breath hydrogen exceeded 42 parts per million. Seven had documented small bowel bacterial overgrowth and an additional 3 patients had radiographic evidence of intestinal stasis. Using test dinner meals, we prospectively evaluated the effect of previously ingested foods containing complex carbohydrates on fasting breath hydrogen. Dinner meals consisting of rice, wheat, or beans influenced fasting breath hydrogen values, but did not result in elevated fasting breath hydrogen in healthy individuals. Rice bread resulted in uniformly low fasting breath hydrogen values in healthy subjects (2.0 +/- 2.5 parts per million), but fasting breath hydrogen remained elevated in patients with bacterial overgrowth. Our studies indicate that conditions for measurement of the fasting breath hydrogen value may be standardized to improve discrimination between normal and abnormal values. PMID- 6489701 TI - Total colonic aganglionosis initially diagnosed in an adolescent. AB - A 12-yr-old girl was admitted for evaluation of a 5-wk history of increasing abdominal pain. She also reported a history of constipation since birth requiring chronic laxative use. Occasional bouts of abdominal distention and vomiting resulted in dehydration necessitating hospitalization. Two previous laparotomies had identified an apparent obstructing angulation of the ascending colon. Rectal biopsy specimens obtained on this admission failed to reveal any ganglion cells. Sequential biopsy specimens of the entire colon obtained at laparotomy also failed to reveal any ganglion cells. Ganglion cells were found in the distal ileum. A total colectomy was performed. Three previously reported cases of total colonic aganglionosis initially diagnosed in older patients are reviewed. Similarities included nonspecific radiographic findings, a history of constipation since birth, and initial laparotomies revealing spurious causes of bowel obstruction. PMID- 6489702 TI - Marked hepatic congestion caused by a thoracoabdominal aneurysm. AB - A 70-yr-old man with a large thoracoabdominal aortic aneurysm developed marked congestive hepatomegaly. Evaluation by arteriography, venography, and computed tomography revealed compression and venous obstruction at the confluence of the hepatic veins and inferior vena cava. Although obstruction of the inferior vena cava caused by rupture of an abdominal aortic aneurysm is known to occur, obstruction without rupture and involving the hepatic veins has not been previously reported. PMID- 6489703 TI - Spontaneous Yersinia enterocolitica peritonitis in idiopathic hemochromatosis. AB - We report a case of spontaneous Yersinia enterocolitica peritonitis revealing idiopathic hemochromatosis in a 62-yr-old man with fever and diarrhea. Blood and stool cultures were repeatedly negative, but Yersinia enterocolitica serotype 9 was isolated from ascitic fluid and serum agglutinins against this organism were positive at a dilution of 1:2560. Moreover, a serum Brucella agglutination test was positive at a dilution of 1:320. Antibiotic therapy with doxycycline led to a rapid clinical improvement, with disappearance of the organism in the ascitic fluid. This case suggests that Yersinia enterocolitica infection must be suspected in any febrile abdominal syndrome occurring in patients with iron overload, such as thalassemia major or idiopathic hemochromatosis. PMID- 6489704 TI - Gastric mucosa in portal hypertension. PMID- 6489705 TI - Hepatitis B and alcoholic liver disease. PMID- 6489706 TI - Diuretic treatment and renin-aldosterone axis in liver cirrhosis. PMID- 6489707 TI - Determinants of ulcer healing. PMID- 6489708 TI - Candidal infection of benign gastric ulcer. PMID- 6489709 TI - An experimental endoscopic technique for reversing gastroesophageal reflux in dogs by injecting inert material in the distal esophagus. AB - After the lower esophageal sphincters of large mongrel dogs had been made surgically incompetent, the degree of sphincter incompetency was determined by the grade of esophagitis present and the reflux volume. Five dogs were endoscopically injected in the distal esophagus with 5 to 30 ml of Teflon paste during four to six injection sessions, and all five dogs developed transient increases in the reflux volumes. Each of the five dogs sloughed a portion of injected Teflon during the 4-month study. Four additional dogs received between 5 and 105 ml of bovine dermal collagen injected in the distal esophagus. All have reversed their esophagitis and have retained a reflux volume at least 5 times the preinjection value without evidence of slough. PMID- 6489710 TI - The effect of upper gastrointestinal endoscopy on arterial O2 tension in smokers and nonsmokers with and without premedication. AB - Fiberoptic upper gastrointestinal endoscopy has become an accepted procedure with recognized and acceptable complication rates. Recently, significant hypoxemia during upper gastrointestinal endoscopy has been identified. This report evaluates changes in arterial blood gases and investigates the effects of drugs, smoking, and length of procedure. Upper gastrointestinal endoscopy was performed on 60 patients--15 patients in four different groups. Group I and II were smokers and nonsmokers who received sedation; groups III and IV were smokers and nonsmokers who received no sedation. A significant drop in PaO2 was noted in each group. Sedation, length of procedure, or smoking did not affect the PaO2 levels significantly. No significant change in PaCO2 was noted in any of the four groups. A V/Q mismatch related to vasospasm and/or bronchospasm is proposed as the main reason for the hypoxemia. PMID- 6489711 TI - Endoscopic biliary lavage in a case of Clonorchis sinensis. PMID- 6489712 TI - Adenocarcinoma and Barrett's esophagus following surgically treated achalasia. PMID- 6489713 TI - Percutaneous endoscopic gastrostomy: another cause of "benign" pneumoperitoneum. PMID- 6489714 TI - Apthous ulcers of the esophagus in a patient with ulcerative colitis. PMID- 6489715 TI - Endoscopic sphincterotomy in patients with Billroth II partial gastrectomy: comparison of three different techniques. PMID- 6489716 TI - Percutaneous endoscopic gastrostomy and jejunostomy: endoscopic highlights. PMID- 6489717 TI - An approach to malignant polyps. PMID- 6489718 TI - The sentinel clot and invisible vessel: pathologic anatomy of bleeding peptic ulcer. PMID- 6489719 TI - Demonstration of a traumatic biliary fistula by ERCP. PMID- 6489720 TI - Emergency ERCP for the diagnosis of complications after cholecystectomy. PMID- 6489721 TI - Necrosis of the uvula after endoscopy. PMID- 6489722 TI - Bezoar of the esophagus occurring in achalasia. PMID- 6489723 TI - Safe extraction of a hatpin from the stomach. PMID- 6489724 TI - Ectopic gastric mucosa. PMID- 6489725 TI - [Effect of secular acceleration on the human brain weight and its changes during aging]. AB - The presented examinations on humans are based on 26 publications regarding the secular acceleration and 16 regarding the brain weight (each of the latter containing at least 500 values). The secular acceleration of the body length was only insignificant up to 1800 AD (about 1 mm per 100). From 1800 to 1900, the size of the length increased steadily and reached finally a size of 1 to 1.2 mm/a which is probably unchanged at present. This behaviour can be observed in every country in which such data were sampled. A positive correlation between brain size and body length can be found in a sample of about 11,000 values. An increase of 10 cm body-length corresponds to an increase of 59 g in brain weight, respectively 10 g brain weight are equal to 1.7 cm body-length. 21,300 values of 15 transversal examinations regarding brain weight and age compare the brains of the older and smaller generation having primarily smaller brains with those of the younger generation having primarily larger brains. Therefore the observed diminution of the brain weight during ageing is partly fictitious. With the help of correlation between brain weight and body length on the one hand and the secular acceleration of the body length on the other hand it is possible to correct the fictitious part of this diminishing. The result can state that the real diminution of the brain begins around the 60th year of age. However, it is probable that a high individual variability concerning time and speed exists. At present, the ideas regarding the sources of the secular acceleration are highly speculative. PMID- 6489726 TI - [Comparative anatomical studies of the vomeronasal complex and the rostral palate of various mammals. I]. AB - The anatomy of the vomeronasal complex and, in connection with this, the structures of the rostral palate were studied in different species of mammals, namely members of the order Marsupialia, Scandentia, Insectivora, Primates, Rodentia, and Lagomorpha. The following results were obtained: The organs of Jacobson of all forms studied are well-developed. The organ of Jacobson is situated at the base of the nasal septum and opens rostrally, always closely connected to the nasopalatine duct. Even in rodents, lagomorphs and Solenodon, where the openings of the organs are positioned rostral to the ductus, both systems are nevertheless connected by means of special furrows. Accordingly the organs of Jacobson are functionally much more closely related to the oral cavity than to the nasal cavity, which they actually belong to. This can be emphasized by the peculiar structures of the rostral palate inclosing the papilla palatina and with it the oral openings of the nasopalatine ducts. In all species studied, the anterior part of the upper jaw presents a very interesting situation because the median furrow of the rhinarium communicates directly or indirectly with the sulcus papillae palatinae, thus forming a very distinct system of grooves which preserves a connection between the nasopalatine ducts and the preoral surroundings. In rodents, lagomorphs, and Solenodon, we find in this part of the palate a special situation because of their unusually arranged incisors, which are not separated by a diastema. However, also in these cases, there are distinct connecting passages between the papilla palatina and the extraoral surroundings. The conditions found in Ratufa bicolor and in early stages of the rat demonstrate that the extraordinary topography of the rostral palate in rodents is a secondary formation by means of ontogeny and phylogeny. Cebus apella, a platyrrhine simian, shows already a clear reduction of palatal structures compared to those found in prosimians. In Setifer setosus and Echinops telfairi, we find the papilla palatina and with it the oral openings of the nasopalatine ducts overgrown by a bipartite caudal branch of the rhinarium. The neonate Setifer allows us to reconstruct the mechanism of this overgrowing procedure. We find a similar situation in Erinaceus, where the papilla palatina remains uncovered, however. Because of contradictory bibliographical data, some elements of the vomeronasal complex in mammals needed to be carefully analysed in regard to structure and nomenclature: in many species the paraseptal cartilage bifurcates rostrally into a dorsal and a ventral branch.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489727 TI - [Methodological aspects of the preparation of measurements in animal experiment studies of metabolism]. AB - Methodical aspects are discussed concerning an analysis of time series which result from experimental investigations of metabolic parameters in rats. Especially there are 2 questions. Should the measured temporal variations of the metabolic parameters be recorded model-free by empirical regression or by functional expression? Before treatment, a time-period was designed in which the rats could become a stable group. Should be chosen a steady description of the temporal parameter changes for the whole time-period of the experiment or should they be described separately for the periods of acclimating and of treatment? Especially due to the discrete time points of measurements, the 1st approach also allows the description of possible jumps in the parameter changing at the begin of the treatment. As consequence of the 2nd mode of description always a jump results. Further parametric and non-parametric statistical procedures are used for analysis of the time series and for comparisons of the time courses. In detail following statistical problems are discussed: Homogeneity of dispersion along a single-measurements course or along a mean value course, equality resp. parallelism of 2 courses, and local or global level differences between 2 courses. Finally it is pointed out that besides the characterization of the mean temporal variations of a parameter also the description of correlation between 2 parameters by empirical regression curve may give information on the mechanisms which give rise to the observed phenomena. PMID- 6489728 TI - Sex differences in adrenocortical structure and function. XVII. Analysis of adrenal growth rate in maturing male and female rats and hamsters. AB - The aim of the study was to analyse the rate of adrenal growth of maturing rat and hamster of both sexes in relation to age, body weight and body surface. In the course of postnatal onto-genesis--days 21 to 77 in rats and 21 to 96 in hamsters--all of the estimated relations between body weight and body surface on adrenal size in both sexes of rat and hamster were almost linear. The values of all analysed regression line slopes are higher in female rats when compared to male animals. Male hamsters had higher values of regression line slopes than females. The results of the study suggest higher activity of the adrenal gland in female rat and male hamster when compared with the animals of opposite sex. PMID- 6489729 TI - Experimental calcipenic osteopathy. AB - Calcipenic osteopathy was used as a model, in order to reveal the diagnostic value and capacity of the noninvasive radiological methods (microradioscopy, densitometry, and Roentgen-morphometry), in comparison with the results of histological, histomorphometrical, and atomic absorption methods. The study proved that calcipenic diet causes an osteoporosis in the experimental animals. The alterations observed meet both the histological and radiological criteria. PMID- 6489730 TI - Fibronectin mediated human gingival fibroblasts attachment to bone. AB - Experiments were undertaken to examine the effects of acid and fibronectin treatments on the human gingival fibroblast attachment to bone in vitro. The binding of [125I]fibronectin to bone powders was dependent on concentration of fibronectin and incubation time. The optimum pH of [125I]fibronectin attachment to bone powders was 6.0 using phosphate buffer. Acid treatment on bone powders in low concentration such as 10 mM of citric acid enhanced [125I]fibronectin binding. The attachment of [3H]thymidine labelled human gingival fibroblasts to bone was enhanced 1.5, 2.0 and 2.5-fold by citric acid, fibronectin and citric acid + fibronectin treatment, respectively. Scanning electron microscopic observations confirm that citric acid and/or fibronectin treatment enhanced the cell number and rapidity of fibroblast attachment to bone surfaces. PMID- 6489731 TI - Action of nicotine on guinea-pig isolated bronchial smooth muscle preparation. AB - In the isolated bronchial preparation of the guinea-pig, nicotine induced a contraction but not a relaxation. The contractile response of the bronchial preparation to nicotine was inhibited by hexamethonium and d-tubocurarine but not influenced by atropine and tetrodotoxin. In the isolated tracheal preparation of the guinea-pig where nicotine stimulated nicotinic receptor in nervous tissues, the contractile response to nicotine as considerably accelerated by the treatment of the guinea-pig with egg-albumin, while the contractile response of the bronchial preparation to nicotine was not influenced by the same treatment. These results suggest that a possible site of action of nicotine in the isolated bronchial preparation is not on the nervous cells but on the smooth muscle cells. However, we could not rule out a contribution by chemical mediators released by nicotine in the contractile mechanisms in the bronchial preparation. PMID- 6489732 TI - Synergistic anticonvulsant effects of a GABA agonist and glycine. AB - Administration of muscimol to mice in subcutaneous doses between 0.34 and 1.25 mg/kg produced partial protection against 3-mercaptopropionic acid (MPA)-induced seizures. Glycine at a dose of 750 mg/kg (10 mmol/kg) protected 20% of the animals 45 min after its administration. Combined treatment with the two compounds gave a near to complete protection against MPA-induced seizures. These observations suggest that the concomitant enhancement of glycinergic and GABAergic activities amplify the anticonvulsant effect of these neuronal systems against seizures induced by impairment of GABA-mediated transmission. PMID- 6489733 TI - Effect of short exposure to cold on plasma thyroxine in Coturnix quail: role of the infundibular complex and its neural afferents. AB - Exposure of control quail to low ambient temperature (4 degrees) for a short duration (15 min) led to a rapid increase in plasma thyroxine (T4) levels. A peak appeared 40 min after the cold began and was followed by a progressive and slow decline. T4 levels were elevated in birds maintained for up to 3 hr at 4 degrees. Restraint stress could be accompanied by a slight and late decrease in thyroxine concentration, indicating that glucocorticoids could partly inhibit thyroid function. Both cold and restraint stresses elicited sustained adrenocortical activation. No thyroid response to cold appeared after complete or partial neural deafferentation of the hypothalamus, indicating that cold signals were conveyed to the thyrotropic centers from peripheral and/or deep thermoreceptors through neural posterior-lateral afferents to the hypothalamus. No thalamic relay appeared to be necessary since normal thyroidal stimulation was observed after thalamic-hypothalamic disconnection. Such a response persisted in hemispherectomized quail. PMID- 6489734 TI - Metabolism of ecdysteroids during the vitellogenesis of the tick Ornithodoros moubata (Ixodoidea, Argasidae): accumulation of apolar metabolites in the eggs. AB - The fate of injected [3H]ecdysone [( 3H]E) and 20-hydroxy-[3H]ecdysone [( 3H]20E) has been investigated in the female tick Ornithodoros moubata (Murray, 1877; sensu Walton, 1962). When injected into fed mated vitellogenic females, [3H]E is converted into [3H]20E and two apolar classes of metabolites, AP1 and AP2. Injected [3H]20E is directly converted into AP1 and AP2. AP2 is incorporated into the ovaries in a high proportion and at the end of the vitellogenic cycle represents about 25% of the total label recovered from the animal. The fate of labeled hormones injected into virgin females which perform an abortive vitellogenic cycle is quite similar. However, the ovaries incorporated less of the AP2 products. Ovaries of mated females cultured in vitro in the presence of [3H]E are able to produce [3H]20E and AP2. AP2 is incorporated, while [3H]20E is mainly found in the medium. Ovaries of virgin females presented a slower rate of transformation and of incorporation of the label. Labeled AP2 is recovered in freshly laid eggs and AP1 in the females after oviposition. AP1 and AP2 can produce [3H]20E, [3H]E, and other minor polar peaks when submitted to hydrolysis by esterase. It is concluded that the female O. moubata possesses a special enzymatic mechanism for transformation of ecdysteroids into apolar products and for selective incorporation of AP2 into the ovaries. These products are present in the freshly laid eggs and could play a role during embryogenesis. PMID- 6489735 TI - Serum levels of 11-oxotestosterone in male and 17 beta-estradiol in female rainbow trout (Salmo gairdneri) during the first reproductive cycle. AB - From September 1980 to August 1981 the serum levels of 11-oxotestosterone (11-O T) in 231 male and of 17 beta-estradiol (E2) in 207 female rainbow trout were measured radioimmunologically, and compared with the development stages of the gonads. Using histological criteria, testicular development was divided into seven stages, and ovarian development into four stages. In males, 11-O-T levels remained below 6 ng/ml until the appearance of spermatozoa. Maximum values (126 ng/ml) were observed in spermiating males. In females, E2 levels were below 2 ng/ml during the period of slow oocyte growth. Maximum values (average of 31 ng/ml) were observed during exogenous vitellogenesis. PMID- 6489736 TI - Brain testosterone metabolism in thyroidectomized and thyroxine-treated chickens. AB - The metabolism of testosterone to reduced derivatives was studied in the pituitary gland, the hypothalamus, and the hyperstriatum dorsale of thyroidectomized, sham-operated, and thyroxine (T4)-injected immature cockerels. The levels of plasma thyroid hormones were markedly reduced (P less than 0.001) in thyroidectomized cockerels whereas thyroidectomized or sham-operated birds injected daily with 100 micrograms/kg thyroxine had significantly elevated (P less than 0.001) levels in comparison with sham-operated control birds. Each tissue was found to produce significant amounts of 5 beta-androstane-17 beta-ol-3 one (5 beta-DHT), 5 beta-androstane-3 alpha, 17 beta-diol (5 beta-3 alpha-diol), and androstenedione. Irrespective of thyroid state 5 beta-DHT and 5 beta-3 alpha diol were produced to the greatest extent by the hyperstriatum dorsale whereas androstenedione was maximally produced in the pituitary gland. In comparison with the hyperstriatum dorsale and the hypothalamus only small quantities of 5 beta DHT were produced in the pituitary gland. In the hyperstriatum dorsale of thyroidectomized birds both 5 beta-DHT (P less than 0.05) and 5 beta-3 alpha-diol (P less than 0.1) were formed to a greater extent than in sham-operated birds. This effect was reversed by administration of T4 to the operated birds which reduced the levels to those measured in the sham-operated controls. Similarly, injection of T4 into sham-operated birds decreased (P less than 0.05) the production of 5 beta-DHT in the hypothalamus while in the pituitary gland injection of T4 into thyroidectomized birds reduced the production of androstenedione (P less than 0.05). It was concluded that in the cockerel thyroid hormone is likely to play a role in the metabolism of testosterone. The physiological significance of 5 beta-reductase activity in the neuroendocrine tissues is discussed. PMID- 6489737 TI - Stimulation of crop sac and pituitary lactotrophs after intraventricular administration of dermorphin in pigeons. AB - The effects of dermorphin, a new potent opioid peptide, on structural and ultrastructural changes in the crop sac and in pituitary lactotrophs were assessed in pigeons (Columba livia). A single administration of dermorphin into the third cerebral ventricle (1 microgram) and the same dose repeated for 3 consecutive days both produced maximal crop sac stimulation, as documented by the presence of milk-like material as well as by scanning and transmission electron microscopy of crop sac mucosa. In addition, marked stimulatory effects were also observed in pituitary lactotrophs, as shown by stimulation of Golgi apparatus, enlargement of rough endoplasmic reticulum, increase in mitochondria size, and the presence of lysosomes and electron-opaque granules. The stimulatory effects of dermorphin on the crop sac and lactotrophs were completely prevented by naloxone, an antagonist at opiate receptors. Since dermorphin is a natural constituent of the avian brain, it has been suggested that this peptide may represent the still-obscure hypothalamic prolactin stimulatory factor. PMID- 6489738 TI - Light, thyroid, gonad, and photorefractory state in the migratory redheaded bunting, Emberiza bruniceps. AB - When exposed to constant long photoperiods the redheaded bunting, Emberiza bruniceps, was shown to become absolutely photorefractory and the condition was observed to be accelerated by thyroidectomy. Photoinduced gonadal growth was inhibited partially and the photoinduced increase in body weight was inhibited completely by thyroidectomy. Injection of thyroxine reversed the effects of thyroidectomy if administered during the nonbreeding photosensitive or breeding states, but had no effect in birds which had entered the photorefractory state. Gonadal growth was stimulated by pregnant mare serum gonadotrophin in intact and thyroidectomized photorefractory birds, suggesting that thyroidectomy does not lead to loss of response of the gonads to gonadotrophins but directly affects the secretion of gonadotrophins. Injection of prolactin increased the body weight of intact but not of thyroidectomized photorefractory birds, suggesting that metabolic photorefractoriness is due to a decreased secretion of prolactin and that the effects of T4 on body weight depend on its synergism with prolactin. It is suggested that thyroid hormone(s) may be part of the coupling mechanism(s) for body weight and gonad development cycles and that the beneficial role of thyroid hormones may consist in an increased threshold of the central nervous system control of neuroendocrine functions towards the negative feedback regulation of increased sex steroid levels. PMID- 6489739 TI - Variations in aldosterone and corticosterone plasma levels during metamorphosis in Xenopus laevis tadpoles. AB - Aldosterone and corticosterone plasma levels have been determined by radioimmunoassay at various stages (St) of metamorphosis in Xenopus laevis tadpoles. The aldo level first showed a significant peak at the beginning of the climax (St 58), and again at the middle of the climax (St 61-62); B level increased slightly but significantly at St 59, then showed an important peak at St 62-63. The high levels of these hormones at these stages seem to be associated with the concomitant surge of interrenal synthesis. At this stage, the plasma level of thyroid hormones is maximal, and the main morphological changes occur. Therefore, corticosteroids and thyroid hormones could have synergistic effects on morphogenesis. A relationship is assumed between the surge of corticosterone at the middle of the climax, and the glucocorticoid function of this hormone. Aldosterone could play a part in the differentiation of adult skin. PMID- 6489740 TI - Role of thyroid and testicular hormones in the regulation of basal metabolic rate, gonad development, and body weight of spotted munia, Lonchura punctulata. AB - Normal saline, L-thyroxine (L-T4, 0.5 micrograms/bird/day), and testosterone (100 micrograms/bird/day) were administered separately to intact, thyroidectomized, and castrated spotted munia over a 30-day period and the effects on basal metabolic rate (BMR), gonads, and body weight were recorded. Thyroidectomy and castration decreased the BMR. L-Thyroxine increased the BMR of intact and thyroidectomized but not of the castrated birds. Testosterone had no effect on BMR of either the intact or of the operated birds. L-Thyroxine and testosterone both had no effect on regressing gonads but inhibited thyroidectomy-induced testicular development. Body weight increased in intact, testosterone-treated birds, and in thyroidectomized and castrated spotted munia. L-Thyroxine inhibited body weight gain only in thyroidectomized birds. It is suggested that the physiological actions of L-T4 and testosterone depend on the gonadal status, thyroid activity, and nature of the thyroid-gonad relationship. PMID- 6489741 TI - Melatonin rhythms in the eyes, pineal bodies, and blood of Japanese quail (Coturnix coturnix japonica). AB - Melatonin levels in the eyes, pineal bodies, and blood of Japanese quail exposed to 12L:12D show robust daily rhythms with high levels occurring in the night and low levels occurring during the day. Since melatonin is synthesized in both the eyes and pineal bodies of birds, the relative contribution of these structures to the blood melatonin levels was determined. A rhythm of blood melatonin persisted in 12L:12D in birds blinded by complete orbital enucleation and in pinealectomized birds but the nighttime levels were reduced by 33 and 54%, respectively, as compared to melatonin levels in control quail. Only a small melatonin rhythm (13% of control levels) was detected in the blood of pinealectomized, blinded quail. This "residual" rhythm could indicate either the contribution of extrapineal, extraocular sources of melatonin or melatonin secretion from remnants (if any) of pineal body tissue remaining after pinealectomy. Blinding did not obviously affect pineal melatonin levels nor did pinealectomy affect ocular melatonin levels. It was concluded that (1) daily rhythms in melatonin content occur in the pineal bodies, the eyes, and the blood of quail; (2) the blood rhythm is the result of melatonin secretion from both the pineal body and the eyes; (3) extraretinal photoreceptors can mediate entrainment of the pineal melatonin rhythm; and (4) obvious compensatory changes in melatonin levels do not occur in the eye following pinealectomy or in the pineal body following blinding. PMID- 6489742 TI - Preventive psychosocial intervention with newly diagnosed cancer patients. AB - To study the effectiveness of preventive intervention in lowering emotional distress and improving coping, 381 newly diagnosed cancer patients were assessed shortly after the time of initial diagnosis. Subjects predicted by a screening instrument to be at risk for high levels of emotional distress and poor coping during the second through sixth months of their illness were randomly allocated to one of two short-term intervention programs (N = 59). Specific techniques to lower distress and improve coping were given during the four weeks following diagnosis. A control group (N = 58) received no intervention. All were followed at two-month to 6-month intervals by interview and testing. There was a significant lowering of emotional distress in the intervention group as compared to the control group (p less than 0.05). There was also a significant increase in the level of problem resolution in the intervention groups (p less than 0.01), although the numbers of problems experienced by both groups were no different. PMID- 6489743 TI - Psychotherapeutic intervention in angina: I. A critical review. AB - This paper considers the literature on factors found to be associated with angina and pseudoangina, and attempts to delineate those psychosocial characteristics that might distinguish angina patients from either nonanginal CAD patients or from non-CAD normals. A cluster of characteristics emerges from both retrospective and prospective studies suggesting greater affective lability, "neuroticism," and perhaps physiologic reactivity than in either comparison group. The literature also suggests that learning and suggestion may play important roles in generating specific precipitants for anginal attacks. The literature on psychosocial intervention in anginal syndromes is almost entirely anecdotal, allowing few firm conclusions to be drawn, but suggesting the possible efficacy of certain behavioral, didactic, and supportive-psychodynamic interventions. PMID- 6489744 TI - A comprehensive psychiatric service. AB - A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service, and an outpatient service. The number of chronic patients has not decreased, due to an influx of unruly senile patients. The close proximity of the service to the community has increased the pressure with regard to the care of such patients. Other services, such as outpatient treatment of alcoholics and neurotics, have suffered, due to the increased workload caused by these senile patients. PMID- 6489745 TI - General hospital psychiatry in Italy: on the hospitalization of psychiatric patients and consultation-liaison psychiatry after Law 180, 1978. AB - The type of psychiatric assistance carried out in Italy before Basaglia's views gained ground--that is, before 1968, when his book L'Istituzione Negata was published--is first described. The "Democratic Psychiatry" movement he launched was the mainspring of Law 180 (1978), known to have led to the closing of asylums. This law has brought about moves to create new mental health community services covering wide areas, the setting up of special diagnosis and care sections in general hospitals responsible for compulsory admissions--and overcrowding in private clinics and University clinics within general hospitals. The role of the psychiatric ward (opposed by the supporters of "Democratic Psychiatry") and of consultation-liaison psychiatry within the ambit of the general hospital is then discussed in the light of our experience. PMID- 6489746 TI - Liaison psychiatry in an Indian general hospital. AB - Patterns and the "dynamics" of the psychiatric referral process in a postgraduate teaching general hospital in India have been studied and compared with the trends in the West. The overall referral rate was 1.48%. On the whole, it is not simply the problem of "organic" versus "functional" diagnosis or abnormal behavior that are referred for psychiatric opinion. A large variety of other clinical problems are referred as well. Most of these problems could be tackled by simple measures like advice to the treating team, use of drugs, and supportive psychotherapy in the respective wards. PMID- 6489747 TI - Psychiatric consultations in a Dutch university hospital: a report on 1814 referrals, compared with a literature review. AB - A report is presented of four years of psychiatric consultations with inpatients in the University Hospital Leyden, The Netherlands. The characteristics of these 1814 consultations are compared with a comprehensive review of 42 publications (mostly from the United States) on psychiatric referral patterns in general hospitals. Compared to the literature, the present study covers a long period of investigation and a high number of consultations in quite a large hospital. Yet, the figures in this report are surprisingly similar to the median numbers that can be compiled from the literature. There is, however, a striking lack of conformity in the classifications used by authors in reporting reasons for referral, psychiatric diagnoses, and the actions of psychiatric consultants. A plea is made, therefore, for better definition and classification of patients seen by consultation-liaison services. PMID- 6489748 TI - Role adoption in residency training. AB - Two hundred residents in training in Wisconsin during 1982 responded to a survey that assessed attitudes, stressors, and coping strategies in each of three areas: work environment, role adoption, and personal life. Results indicate that successful role adoption (making difficult decisions, displaying leadership, dealing with uncertainty, being personally responsible for patients' care) is the primary task of residency, balanced by increasing stress in maintaining social support systems in family and peer groups. Coping strategies are directed at promoting role adoption and preserving personal ties. Work factors that accentuate the tension between these two aspects create the most distress. The degree to which role adoption is accomplished, the stress imposed, and coping strategies employed differed significantly with gender, specialty, and program type. PMID- 6489749 TI - Anorexia nervosa masking the diagnosis of spinal meningioma: a case report. AB - A case report of an adolescent female with signs and symptoms of both anorexia nervosa and high thoracic spinal cord meningioma is presented. Similarities in the presentation of both conditions are discussed, with emphasis on the early diagnosis of anorexia nervosa masking and delaying diagnosis of the thoracic meningioma. The contribution of the family and doctor-patient relationship in delaying the diagnosis are discussed. Pertinent literature is also reviewed. PMID- 6489750 TI - Children coping with impaired appearance: social and psychologic influences. AB - Coping with impaired appearance presents difficulties for children. This study is based on interviews of children with vitiligo, a disfiguring disorder that involves depigmentation of the skin, and focuses on social and psychologic factors that predict effectiveness of coping. Age plays an extremely important part in adjustment, with the junior high school years especially traumatic. Change of location or situation also is a predictor of stress. Children who develop other competencies that build self-esteem cope well with the disorder. These and other factors are explored in depth, and strategies for helping child patients with disfiguring disorders are suggested. PMID- 6489751 TI - Double jeopardy: suicide and malpractice. AB - Psychiatric malpractice is not a common occurrence. However, the suicide of a patient under treatment is an event that may lead to legal action. The author details the basic facts and ideas necessary to an understanding of this phenomenon. The plaintiff must ultimately prove that there was a dereliction of professional duty that led directly to the death. Several cases from the legal literature are presented to illustrate how judges evaluate this type of claim. Recommendations designed to minimize the risk of being found negligent are offered, and include detailing the specifics of suicide precautions, careful documentation of decisions to grant patients increased freedom, consultation from supervisors or colleagues, and outreach to survivors. Suicide is not always preventable, but following appropriate standards of care is likely to convince the court that no liability need be attached to the patient's demise. PMID- 6489752 TI - Characterization of an antibiotic resistance plasmid pAV5 and its constituent replicons in Acinetobacter calcoaceticus. PMID- 6489753 TI - Protein and amino acid composition of hair from mice carrying the naked (N) gene. PMID- 6489754 TI - Weight and age at puberty in female and male mice of strains selected for large and small body size. PMID- 6489755 TI - Effects of selection on growth, body composition and food intake in mice. II. Correlated responses in reproduction. PMID- 6489756 TI - Multilocus recombination frequencies. PMID- 6489757 TI - Cloning and expression of an extracellular-agarase from Streptomyces coelicolor A3(2) in Streptomyces lividans 66. AB - An extracellular agarase gene was cloned from Streptomyces coelicolor A3(2) strain M130 into S. lividans 66 using the multicopy plasmid vector pIJ702. Various deletion derivatives of the initial clone (pMT605) were obtained by in vitro and in vivo methods. This allowed the gene to be localised to a 1.9-kb segment of DNA. The agarase enzyme was overproduced (up to 500 times) and exported efficiently into the medium. The agarase protein was identified as a 28 kDal band after sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE); in the case of one derivative, pMT608, this band accounted for nearly 50% of the total extracellular protein. Differences in agarase production between the deletion derivatives correlated well with plasmid stability. PMID- 6489758 TI - Bradyarrhythmias: sinus node dysfunction. AB - In the elderly, short asymptomatic episodes of syncope may be caused by many disorders. Therefore, it is essential to obtain ECG evidence of sinus node dysfunction before beginning treatment. Treatment of extrinsic causes of sinus node dysfunction may require removal of a suppressive agent. Medications to suspect include beta blockers, antiarrhythmic drugs, and eyedrops used in the treatment of glaucoma. PMID- 6489759 TI - Dyspnea in the elderly: old age or disease? AB - Suspect pulmonary or cardiac disease when dyspnea occurs with moderate exercise. Age-related reductions in pulmonary function almost never result in dyspnea at rest--or with such exercise as walking at a normal pace. Cardiac origin of pulmonary changes can often be recognized by the presence of cardiac abnormalities such as gallop rhythms, ECG changes, and concomitant signs of right ventricular failure. In some cases, the cardiac origin of the abnormality can only be established by right heart catheterization. PMID- 6489760 TI - Ischemic bowel disease: diagnosis and prognosis. AB - Ischemic colitis is most often a self-limited disease lasting a few days and requiring only supportive treatment, but some patients will have persistent disease or develop infarctions or perforations that require surgery. The prognosis of patients with acute superior mesenteric arterial ischemia is poor, partly because of their advanced age and associated cardiovascular abnormalities. PMID- 6489761 TI - Congestive heart failure: Dx and Rx in the elderly. AB - Ventricular gallop is a reliable indicator of poor ventricular compliance and heart failure in the elderly. Late diastolic atrial gallop, however, has very little use in the diagnosis of heart disease in the elderly. M-mode and 2 dimensional echocardiography are the most expeditious and least costly of the non invasive means of identifying the cause of heart failure in the elderly. They enable rapid assessment of cardiac chamber size, wall thickness and contractility, valve morphology and motion, and easy evaluation of the pericardium. PMID- 6489762 TI - An approach to hyperuricemia and gout. AB - Arthrocentesis and patient and family histories make gout relatively easy to diagnose. The next step is to distinguish between primary and secondary hyperuricemia. Hyperuricemia results from either impaired renal excretion or excessive production of uric acid--or both. Determining the cause guides the choice of therapy. PMID- 6489763 TI - Aging and infectious diseases: state of the art. AB - Infectious diseases are major causes for morbidity and mortality in the elderly population. A variety of factors contribute to the elderly person's increased susceptibility to infection. Diagnosis of infections in the old individual is often difficult, and antimicrobial strategies may have to be altered in this patient population. Newer and innovative strategies in management are needed in the field of aging and infections. PMID- 6489764 TI - A long-term study with co-dergocrine mesylate (Hydergine) in healthy pensioners. Results after 3 years. AB - Started in 1976, a long-term study in healthy pensioners is now in progress in Basel, Switzerland, to investigate medical, psychological, and electrophysiological aspects of the normal aging process and to establish whether these can be influenced by drug treatment. The subjects are receiving co dergocrine mesylate (Hydergine) 1.5 three times daily or placebo orally under double-blind conditions. At 1-year intervals each subject's case history is reviewed, a clinical examination and laboratory tests are carried out, an ECG and an EEG are recorded, and a shortened form of the Hamburg-Wechsler Intelligence Test for Adults (German version of the WAIS, i.e., the Wechsler Adult Intelligence Scale), the Raven Coloured Progressive Matrices Test, and the Maudsley Personality Inventory are administered. Treatment compliance is being monitored by pill counting and determination of drug plasma levels. The results after 3 years of the study are presented. The subjects included in this evaluation are those who have undergone all examinations under double-blind conditions (n = 99). During the 3-year period, 27 of the 148 subjects (64 women and 84 men, mean age 63 years) initially recruited for the study have withdrawn, mainly because serious illness has supervened. Three subjects in the placebo group and 1 in the co-dergocrine mesylate group have died. The double-blind code has been broken for medical reasons in 18 cases; these subjects have continued to participate under open conditions. During this 3-year period, the following changes have been observed: A slight but statistically significant rise in systolic and diastolic blood pressure in the sample as a whole (mean increase 12 mm Hg). A decrease in systolic blood pressure in subjects with high initial values (mean decrease 6 mm Hg in the placebo group, and 18 mm Hg in the co dergocrine mesylate group). An increase in systolic blood pressure in subjects with low initial values (mean increase 17 mm Hg in the placebo group and 16 mm Hg in the co-dergocrine mesylate group). A significant decrease in pulse rate in all subjects (mean decrease 7 beats/min). An increase in the number of subjects with pathological ECGs. A significant decrease in mean serum creatinine and lipid levels (all subjects) and a decrease of about 70% in the number of subjects with pathologically raised values. A decrease in the number of subjects from both groups with pathological signs in the EEG.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6489765 TI - Hereditary ocular dysproteinhydria of the aqueous humour with crystalline deposits. AB - We describe a family with coloured crystalline deposits on the corneal endothelium and on the lens surface. A protein with a molecular weight of about 110,000 and an isoelectric point of 7-8 could be demonstrated in the aqueous humour, which was not found in the controls or in the serum of the family members. The pedigree is suggestive of autosomal dominant inheritance. To our knowledge this is the first report of this entity. PMID- 6489766 TI - Gas-mediated vitreous compression: an experimental alternative to mechanized vitrectomy. AB - We have developed a simple technique in rabbit and baboon eyes that utilizes intravitreally injected perfluoropropane gas, which expands slowly to efficiently compress and displace nearly completely the vitreous body. There is cataract formation after extended contact of the gas bubble with the lens. However, it is rapidly reversible by reducing the duration of lens contact (gas-fluid exchange) and by using young animals. No long-term alterations in intraocular pressure or retinal function were observed, as determined by electroretinography, during the 4-month test period. Gross examination and scanning electron microscopy revealed that the vitreous cavity, shortly after full expansion of the gas bubble, was practically free of collagen. The vitreous body had been detached from most of the retina and compressed into a collagenous strand between the optic nerve head and lens in the rabbit eyes, and there was also a dense collagen accumulation on the inferior retinal surface and anterior vitreous base in the rabbits and the baboon. Large areas of the retina and medullary wings were stripped of overlying collagen. By the end of 4 months, the compressed vitreous body had expanded to become an irregular structure that remained separated from the retina in areas of previous detachment. Mechanized vitrectomy is a difficult procedure often needed in experimental work. We believe that the vitreous compression and gas-fluid exchange technique is a valid alterative to a mechanical approach. We also believe that we have a model that simulates the human situation of posterior vitreous detachment and vitreous syneresis. PMID- 6489767 TI - Histoautoradiographic and biochemical studies on human and monkey trabecular meshwork and ciliary body in short-term explant culture. AB - Explants of two types of chamber angle tissue derived from five human autopsy eyes and five freshly enucleated monkey eyes were kept under tissue culture conditions for 1-3 days and then incubated with labelled 14C-glucosamine for 40 48 h. In all specimens an intense labelling was seen histoautoradiographically within the area of the trabecular meshwork, especially in the cribriform layer and the outer wall of Schlemm's canal. Large quantities of silver grains were also found at the tips of the ciliary processes where the nonpigmented epithelium showed the most intense labelling. Measuring the total radioactivity of the two types of specimens in the tissue-localized and the medium-released glycosaminoglycans (GAGs), we found that the type 1 specimens containing only trabecular meshwork work and corneosclera "excrete" relatively more GAGs into the medium than the type 2 specimens consisting of corneosclera, trabecular meshwork and ciliary body. Biochemical analysis of these GAGs revealed that 57%-70% of the tissue GAGs were hyaluronic acid, 16%-33% heparan sulphate and 12%-22% various types of chondroitin sulphate. The findings show that both the ciliary epithelium and the trabecular meshwork possesses the ability to synthesize large amounts of GAGs, probably in the form of proteoglycans. The differences between the in vitro behaviour of type 1 and type 2 specimens indicate a functional interrelationship between the ciliary body and the trabecular meshwork, at least with regard to the GAG metabolism. PMID- 6489768 TI - Daunomycin in the treatment of experimental proliferative vitreoretinopathy: retinal toxicity of intravitreal daunomycin in the rabbit. AB - The retinal toxicity of daunomycin, a drug that effectively suppresses experimental proliferative vitreoretinopathy (PVR), was studied in the rabbit by clinical examination, electroretinography (ERG), light microscopy, and electron microscopy. Although no toxicity was observed at the therapeutically effective dose of 10 nmol per eye, the safety margin is too small to recommend this drug for therapy of proliferative vitreoretinopathy in man. PMID- 6489770 TI - Alteration of oscillatory potentials in diabetics induced by photocoagulation of the retina. AB - Oscillatory potentials (OP) of the electroretinogram (ERG) were recorded and normalized with respect to the overall amplitude of the ERG in normal and diabetic subjects. Normalized OP decrease with increasing diabetic retinopathy, exhibiting a strict bilateral symmetry in normal individuals but an extremely wide scatter (of asymmetry between both eyes) in diabetics. It can be demonstrated that after successful (?) photocoagulation (partial or panretinal), the amplitude of the OP can sometimes increase, possibly indicating improved retinal function in the noncoagulated area. PMID- 6489771 TI - Healon in retinal detachment with proliferative vitreoretinopathy. AB - In 73 eyes, retinal detachments complicated by proliferative vitreoretinopathy (PVR) were treated by intravitreal injections of Healon, in addition to scleral buckling procedures. The number of completely reattached retinas three months postoperatively was dependent upon the grade of PVR: 50% were reattached when PVR comprised only one quadrant (Grade C-1); 30% when two to four quadrants were involved (Grade C-2, C-3 and D-1). Reattachment was not achieved in two cases of PVR with funnel-like configurations (D-2). Major complications that could be attributed to Healon did not occur. The results indicate that Healon injections, combined with scleral buckling procedures, are an encouraging approach to retinal detachments with PVR Grades C-2 through D-1. PMID- 6489772 TI - [Hygienic aspects of the current use of sewage waters for agricultural purposes]. PMID- 6489773 TI - [Dose-bioeffect relationship in long-term exposure to occupational noise]. PMID- 6489769 TI - Retinitis pigmentosa: a quantitative study of the apical membrane of normal and dystrophic human retinal pigment epithelial cells in tissue culture in relation to phagocytosis. AB - The phagocytic capabilities of both normal and dystrophic human retinal pigment epithelial cells were assessed by challenging cultures with both non-biological and biological particles. Cells from either source ingested both carbon particles and latex microspheres. Quantification of the phagocytic process in relation to microspheres showed that uptake was linear over an 8 h period and the rate was dose-dependent. All cultures phagocytosed rod outer segments from a variety of species, but excluded bacteria. By using bovine rod outer segments labelled with [H3] choline both normal and dystrophic cells were still accumulating label 24 h subsequent to challenge; however, this technique had significant problems. The introduction of any particulate matter into the culture medium resulted in changes in the apical membrane of the recipient cells. Such responses were quantified in terms of apical projections per unit area. Counts were always greater in cells challenged with biological material even if the material was not engulfed. PMID- 6489774 TI - [Experimental studies on the embryotoxic, gonadotoxic and mutagenic effects of hexachlorophene]. PMID- 6489775 TI - [Effect of a dynamic microclimate on the functional state of senior schoolchildren]. PMID- 6489776 TI - [Effect of motor activity on the physical work capacity of schoolchildren with excessive body weight]. PMID- 6489777 TI - [Methodological approach to the hygienic evaluation of toys made of polymer materials]. PMID- 6489778 TI - [Formation of practical skills in the learning process; a major stage in the training of a physician-hygienist]. PMID- 6489779 TI - [State and perspectives of developing environmental health research in the Ukraine]. PMID- 6489780 TI - [Method of evaluating musculoskeletal function in sportsmen]. PMID- 6489781 TI - [Gas-chromatographic determination of pesticides in the air]. PMID- 6489782 TI - [Quantitative analysis of nicotine in the plasma of pregnant and non-pregnant animals by gas chromatography]. PMID- 6489783 TI - [Methodological approaches to the determination of the size of health protective areas in the vicinity of television centers and television retransmitters]. PMID- 6489784 TI - [The probability method of evaluating the concentration-time relationship in toxicological studies]. PMID- 6489785 TI - [Potentiometric method of determining plasma and serum concentrations of potassium and sodium using ion-selective electrodes]. PMID- 6489786 TI - [Effect of various meteorological factors on changes in the level of radon degradation products]. PMID- 6489787 TI - [Toxicological evaluation of products of the photolytic destruction of pesticides]. PMID- 6489788 TI - [Use of various indicators of the state of immunological reactivity and physiological functions for the evaluation of the health status of the population]. PMID- 6489789 TI - [Hygienic evaluation of tea-bag paper]. PMID- 6489790 TI - [Effect of phytoncides on air ionization]. PMID- 6489791 TI - [Embryotoxic effect of diuron in animal experiments]. PMID- 6489792 TI - [Skin-irritating and sensitizing effects of the pesticide acetochlor]. PMID- 6489793 TI - [Determination of concentration of Mn-54 in plant and soil samples]. PMID- 6489794 TI - [Polycythemia in the newborn infant]. PMID- 6489795 TI - [Viral condylomata of the cervix]. PMID- 6489796 TI - [Evidence of biorhythmic organization of the fetal heart rate. Technic of prolonged electrocardiographic recording]. PMID- 6489797 TI - [Production of placental protein hormones during hemodynamic changes induced in normal pregnancy]. PMID- 6489798 TI - [Comparative study of the intrauterine devices TCu 380 Ag and the Multiload Cu 375 in Panama]. PMID- 6489799 TI - [Clinical use of phospholipid determination in amniotic fluid]. PMID- 6489800 TI - [Immediate materno-fetal morbidity in the use of forceps. Comparative study of divergent and crossed forceps]. PMID- 6489801 TI - [Biosocial analysis of the patients entering a prenatal clinic]. PMID- 6489802 TI - [Polyamine metabolism in different physiological states in women]. PMID- 6489803 TI - [Tubal recanalization. Psychosocial profile of 10 patients]. PMID- 6489804 TI - [Principal findings in 1000 placentas of the Instituto Nacional de Perinatologia, Desarrollo Integral de la Familia. Preliminary communication]. PMID- 6489805 TI - [Endometriosis and sterility. Difference between disease endometriosis and implantation endometriosis]. PMID- 6489806 TI - [Prognostic value of C-reactive protein in premature rupture of membranes. Prospective study]. PMID- 6489807 TI - [Current achievements and problems of occupational hygiene and occupational pathology]. PMID- 6489808 TI - [Various regular features in the clinical course of dust-induced bronchitis]. PMID- 6489809 TI - [Clinical forms of chronic dust-induced bronchitis]. PMID- 6489810 TI - [The course of intrathoracic adenopathy in silicosis and silicotuberculosis]. PMID- 6489811 TI - [Clinical characteristics of pneumoconiosis and chronic bronchitis in electric welders]. PMID- 6489812 TI - [Use of the spirographic method for early diagnosis of obstruction of the small bronchi in workers exposed to dust]. PMID- 6489813 TI - [Respiratory function in workers engaged in the manufacture of graphite articles]. PMID- 6489814 TI - [Comparative evaluation of the toxic and fibrogenic properties of sylvinite dust after inhalation]. PMID- 6489815 TI - [Body function and the work quality of operators of power-generating units during work of varying intensity]. PMID- 6489816 TI - [Occupational stress in operators of energy-generating units in present-day thermal power plants]. PMID- 6489817 TI - [Complex measures for improving working conditions in the foundry of the Moscow "Vodopribor" plant]. PMID- 6489818 TI - [The state and relation between various indicators of the body's natural resistance in patients with silicosis and silicotuberculosis]. PMID- 6489819 TI - [Achievements and perspectives of occupational hygiene in the railroad transport industry]. PMID- 6489820 TI - [Vegetative and psychoemotional disorders in occupational dust-induced pathology]. PMID- 6489821 TI - [Determination of maximum permissible exposure levels for polyvinyl chloride combustion products]. PMID- 6489822 TI - [Experimental data on the carcinogenic effect of fibrogenic petroleum pitch]. PMID- 6489823 TI - [Prevention of dust-induced occupational diseases in the coal industry]. PMID- 6489824 TI - Presidential panel. The gynecologic oncologist in academic departments. AB - Now that the subspecialty of gynecologic oncology is well established within the specialty of obstetrics and gynecology, it seems timely to evaluate the pros and cons, the strengths and weaknesses of such a program as it interrelates with other programs in an academic department. A survey is presented which reflects the beliefs of both members and candidate members of the Society of Gynecologic Oncologists on such issues as gynecologic oncologists as chairmen of departments; teaching demands; time commitments to patient care and research in an academic institution; and surgical privileges for gastro-intestinal and urologic procedures in various hospitals. Financial and budgetary items are also discussed. Perspectives from three different points of view are presented as a discussion of the report of the survey. PMID- 6489825 TI - Therapeutic results using high-dose-rate intracavitary irradiation in cases of cervical cancer. AB - A comparison of the 5-year relative survival rates has been made between cases of cancer of the uterine cervix treated with 226Ra low-dose-rate intracavitary irradiation and those treated with 60Co high-dose-rate intracavitary irradiation (using the remote afterloading system, RALS). External irradiation using LINAC was also administered in both groups. The 5-year relative survival rates of the low-dose-rate cases were 82.6, 55.4, 49.0, and 18.2% in stage I, II, III, and IV cases, respectively, whereas they were 97.4, 55.1, 56.8, and 29.0% in the respective high-dose-rate cases. The differences between the two groups were not statistically significant. Delayed radiation complications of the rectum were frequent in both groups (approximately 14%) and those of the urinary bladder were somewhat less frequent (approximately 8%). The incidence of such complications did not differ significantly between the two groups. PMID- 6489826 TI - The second-look surgical reassessment for epithelial ovarian carcinoma. AB - The second-look surgical reassessment is currently being performed on most patients with epithelial ovarian carcinoma after first-line chemotherapy if they are clinically free of disease. Ninety-six patients who underwent such procedures at Walter Reed Army Medical Center and the Naval Hospital, Bethesda, from January 1974 through May 1982 are reviewed. The grade of tumor, stage of disease, and amount of residual tumor remaining after initial surgery are predictive of the findings of the surgical reassessment. While a surgical reassessment is beneficial in evaluating response to therapeutic modalities under protocol investigation, its use should be individualized. PMID- 6489827 TI - Sister Joseph's nodule: seven cases of umbilical metastases from gynecologic malignancies. AB - Seven cases of patients with gynecologic cancer and Sister Joseph's nodule, umbilical metastases from intraabdominal malignancy, are presented, making a total of 44 such cases in the literature. One such case, uterine leiomyosarcoma with umbilical metastases, is the first such lesion reported. Although the prognosis is generally poor, a few long-term survivors have been reported, and aggressive therapy may be warranted, particularly in patients with ovarian malignancy. PMID- 6489828 TI - Autopsy findings in patients with uterine sarcoma. AB - Autopsy findings were reviewed in 22 patients treated for uterine sarcoma at the University of Michigan Hospitals. Included are 11 mixed mesodermal tumors, 6 endometrial stromal sarcomas, and 5 leiomyosarcomas. Only one patient died with disease limited to the pelvis. Forty-five percent of the patients died with disease limited to the pelvis and abdomen. The most common site of the disease above the diaphragm was the lung. Lymph nodes were involved in 59% of our patients. There were no obvious differences in the patterns of spread between the tumor types. PMID- 6489829 TI - Second-look laparotomy in fallopian tube carcinoma. AB - From August 1974 through August 1980, eight patients with primary fallopian tube carcinoma underwent second-look laparotomies at The University of Texas M.D. Anderson Hospital and Tumor Institute. Prior to the second-look laparotomies all patients were clinically free of disease. Initial treatment consisted of surgery and chemotherapy for four of these patients, surgery and radiation therapy for two patients, and surgery, radiation therapy, and chemotherapy for two patients. The second-look laparotomies showed five patients were free of disease, one patient had microscopic residual disease, and two patients had persistent macroscopic disease. Recurrences following negative second-look laparotomies developed in two patients. One recurrence occurred at 41 months after the procedure and the other 69 months afterward. Both patients lived more than 5 years after the second-look laparotomies were performed. Three patients with negative findings at second-look procedures and the patient with microscopic residual disease remain clinically free of disease 34, 53, 74, and 50 months after the laparotomies, respectively. Following additional chemotherapy, the two patients who evidenced macroscopic disease at the second-look procedure died 16 and 32 months following the second-look laparotomies. The second-look findings can be used to predict disease behavior and may have a role in the management of patients with fallopian tube carcinoma. PMID- 6489830 TI - The prognostic significance of the size of the largest nodes in metastatic carcinoma from the uterine cervix. AB - Sizes of the largest metastatic nodes were evaluated as a prognostic factor in 152 patients with Stage IB to IIB cervical carcinomas treated by radical hysterectomy and postoperative irradiation. Of the 152 cases, the largest positive nodes were less than 10 mm in 24 (16%), 10-20 mm in 74 (49%), greater than or equal to 20 mm in 37 (24%), and unresectable in 17 (11%). The frequency of patients with one positive node decreased, and those patients with greater than or equal to 4 positive nodes increased along with an increase in the size of the largest nodes (P less than 0.05). Disease-free periods for 58 patients with recurrent cancer were less than 1 year in 26 (45%), 1-2 years in 18 (31%), 2-3 years in 9 (15%), and greater than or equal to 3 years in 5 (9%). There was a significant increase in cases with node sizes of greater than or equal to 20 mm with recurrence within 1 year after surgery over those with less than 20 mm (P less than 0.001). Incidence rates of 3-year recurrence were significantly different between cases with sizes of less than 10 mm and those with greater than or equal to 10 mm (P less than 0.05), as well as between cases with resectable and unresectable positive nodes (P less than 0.001). These results indicate that the size of the largest positive nodes is a good indicator of the number of positive nodes and the patient's prognosis. PMID- 6489831 TI - Verrucous carcinoma of the uterine cervix: report of a case with follow-up of 6 1/2 years. AB - A case of verrucous carcinoma of the uterine cervix was reported with a long-term follow-up and close observation. The patient was a 73-year-old, Japanese female, who had a suspicious Papanicolaou smear on routine examination. The cervix was replaced by a papillary mass, which was diagnosed as benign papilloma. The patient was followed every 6 months with cytology, colposcopy, and punch biopsy. No cytologic or microscopic diagnosis of invasive squamous cell carcinoma was made during the entire follow-up period. Total abdominal hysterectomy and partial vaginectomy were performed after 6 1/2 years' follow-up, and the tumor was finally diagnosed as verrucous carcinoma. The patient is alive and well 4 years after the operation. PMID- 6489832 TI - Papillary adenofibroma of the endometrium: case report and review of the literature. AB - A case of papillary adenofibroma of the endometrium is reported in a 78-year-old parous woman. Diagnosis was made by curettage. The patient was treated by total abdominal hysterectomy with bilateral salpingo-oophorectomy. This is the eighth case known in the literature. Clinical and pathological aspects of this relatively new pathological entity are reviewed. PMID- 6489833 TI - Atypical melanocytic hyperplasia of the vagina. AB - A case of extensive pigmentation of the vagina is reported. Microscopic sections showed a resemblance to atypical melanocytic hyperplasia, which has been described as a possible precursor of malignant melanoma of the skin including the acral lentiginous form. PMID- 6489834 TI - Chondrosarcoma of the uterus. AB - Chondrosarcoma of the uterus is a rare tumor. The clinical and pathological features of a recent case are presented and the histogenesis, treatment, and prognosis of the heterologous sarcomas are discussed. The authors favor the theory of totipotential endometrial stromal cells for the histogenesis, and suggest that radiotherapy and/or chemotherapy continue to be used in addition to total abdominal hysterectomy with bilateral salpingo-oophorectomy. PMID- 6489835 TI - Malignant melanoma of the vagina: a case report of progression from preexisting melanosis. PMID- 6489836 TI - Granular cell tumor of the clitoris in pregnancy. AB - Granular cell tumors of the female genital organs represent 7-15% of all granular cell tumors reported in the literature. The majority of these genital lesions are located on the vulva. Granular cell tumor involving the clitoris is extremely rare and should be considered in the differential diagnosis of clitoral masses. PMID- 6489837 TI - Appendicitis masking as recurrent squamous cell carcinoma of the cervix. AB - The diagnosis of pelvic recurrent squamous cell carcinoma of the cervix is made on the basis of clinical assessment and radiologic confirmation. Occasionally the diagnosis is confused with sequelae of radiation therapy. The authors describe the symptoms and signs of appendicitis mimicking recurrent squamous cell carcinoma in a 43-year-old female. A 10-year search of the literature has failed to detect another case report or review. The authors believe that, if there is ever any doubt as to the diagnosis of pelvic recurrent squamous cell cancer, exploratory laparotomy and biopsies are warranted for confirmation. PMID- 6489838 TI - [Pathogenesis and therapy of dysmenorrhea]. PMID- 6489839 TI - [Basic considerations in the choice of contraceptive methods for male and female]. PMID- 6489840 TI - [Hormonal contraception]. PMID- 6489841 TI - [Intrauterine contraception]. PMID- 6489842 TI - [Classic methods of contraception]. PMID- 6489843 TI - [Postcoital contraception (without prostaglandins)]. PMID- 6489844 TI - [Sterilization of women]. PMID- 6489845 TI - [Sterilization of men]. PMID- 6489846 TI - Do aspirin and acetaminophen affect total menstrual loss? AB - Two commonly taken over-the-counter analgesics, aspirin and acetaminophen, were compared for: effect on total menstrual loss, effect on total days of menstruation, and effect in reduction of pain due to headaches and/or menstrual cramps. Drugs were administered during a 4-month study according to a double blind format. During the first 2 months, subjects ingested no drugs whatsoever during their menstrual periods. During the second 2 months, subjects ingested aspirin, acetaminophen, or placebo at the rate of two 325-mg tablets every 4 h to total 8 tablets per day during the first 3 days of their menstrual periods. Statistical analysis of the first 2 periods compared to the last 2 showed no differences in total menstrual weights. The number of days of menstruation in the placebo group was significantly lower (p = 0.0137) than in its own control or in the other groups. Neither analgesic showed a significant reduction in pain due to headache or cramps, although acetaminophen appeared to be slightly more effective than aspirin in reducing menstrual cramps. PMID- 6489847 TI - Obtained pregnancies by AID using frozen semen in relation to specific qualities of the semen. AB - The results obtained by insemination with 3,418 frozen donor ejaculates with known semen characteristics were analyzed. The concentrations of motile spermatozoa before and after thawing were significantly higher in samples from donors producing pregnancies compared to samples from donors not causing pregnancies. In ejaculates known specifically to have caused a pregnancy even higher concentrations were found. It was assumed that the concentration of motile spermatozoa after thawing was the most important parameter, and by dividing the material into fractions it could be demonstrated that a spermatozoa concentration of more than 20 million/ml is essential for reasonable results. PMID- 6489848 TI - Zinc concentration of amniotic fluid in the course of pregnancy and its relationship to fetal weight and length. AB - The interest of the zinc content of amniotic fluid and its relationship to different maternal and fetal parameters is recent. It was reported that the zinc content of amniotic fluid increases in the course of pregnancy probably as an indirect indicator of an increased rate of protein synthesis. These considerations and the known important metabolic role of zinc led us to study the zinc content of amniotic fluid and its importance in the growth and development of the fetus. Amniotic fluid samples of 24 women with normal pregnancies and normal term deliveries were studied. The samples were obtained between weeks 29 and 42 of gestation by transabdominal amniocentesis and the zinc content was determined by means of atomic absorption spectrophotometry. The zinc content of amniotic fluid increases significantly during the third trimester. A positive linear correlation was found between the zinc concentration of amniotic fluid and fetal weight and length. Fetal growth and development would depend on the zinc available due to its biological functions and thus the increase of zinc concentration of amniotic fluid in the last weeks of gestation and its correlation with fetal weight and length. These results suggest that the determination of zinc content of amniotic fluid can be useful in the assessment of fetal development and well-being, and of course of pregnancy. PMID- 6489850 TI - [Indications and significance of esthetic plastic surgery]. AB - The motivations of aesthetic operations for achievement of a more harmonious appearance or for treatment of the external signs of aging are, besides purely aesthetic reasons, the desire to increase professional opportunities, to better adapt to the social environment or to improve affective relations. Aesthetic surgery has therefore a mainly psychic indication: the aim is to improve the self esteem, which, on the other hand facilitates the social integration. A responsible execution of aesthetic surgery requires, besides a basic knowledge of psychology and sensitivity for aesthetics, a complete training in general surgery and in reconstructive plastic surgery as well as a continuing education in the aesthetic field. It is therefore not advisable to divide the specialty of plastic surgery. The advancements in both fields have a mutual positive influence and both have to consider function as well as appearance, although with different emphasis. The adequate treatment of eventual complications also requires a basic knowledge in both fields. The intensive advertising made by commercial, so-called "cosmetic clinics" is in contrast to the plastic surgeon's possibilities of public relations, restricted for ethical considerations. Undoubtedly it is not sufficient, at least on a medium-term basis, to achieve better results--in benefit of the patient--unless this is also made known to the public. The necessary information of the public should therefore be taken over or be directed by the National Societies of Plastic Surgery, on an anonymous basis. PMID- 6489849 TI - Calcium, parathyroid hormone and calcitonin in normal pregnancy and preeclampsia. AB - Calcium, parathyroid hormone (PTH) and calcitonin (CT) in serum, and the fractional renal excretion of calcium (FECa) were determined in (1) normal pregnant women, (2) patients with preeclampsia, and (3) normal nonpregnant control subjects. Serum calcium, corrected for individual variation in serum protein, was reduced and FECa increased in the normal pregnant group when compared to the nonpregnant control group. In preeclampsia serum calcium did not differ significantly from the normal pregnant group, but FECa was considerably lower and also reduced below the level in the nonpregnant control group. PTH was slightly lower during normal pregnancy than after delivery, but did not deviate significantly from the nonpregnant control group; in preeclampsia PTH did not deviate significantly from the levels in normal pregnancy. CT was the same in the third trimester of pregnancy in both groups. Changes in serum calcium and FECa were not correlated to PTH or CT. It is concluded that both normal pregnancy and preeclampsia are accompanied by considerable alterations in calcium metabolism, that PTH and CT in both groups are mainly unchanged and at nonpregnant level, and that the increase and decrease in renal calcium excretion in normal pregnancy and preeclampsia, respectively, may be attributed to changes in kidney function. PMID- 6489851 TI - [Formation of a microvascular, multilayer constructed transplant using the greater omentum]. AB - The high potential for vascularisation of the greater omentum, described in the literature and in our own investigations was used to build microsurgical compound island flaps containing hard tissue grafts like Proplast. In the first operative procedure Proplast was inserted into the omentum and a flap was formed pedicled on the right gastro-epiploic vessels and transposed into the subcutaneous layer. Two to three weeks later the vascularized Proplast could be removed together with the overlying skin and fat. In another experiment Proplast was inserted into the pedicled omentum and put back into the belly. A second laparotomy was performed 14 days later to cover the omentum-Proplast sandwich with a split skin allograft. In both experiments the total compound sandwich flap was supplied only by the right gastro-epiploic vessels, which allowed a microsurgical transplantation. PMID- 6489852 TI - [Glycosaminoglycans in Dupuytren contracture]. AB - Connective tissue from specimens of Dupuytren's disease showed higher contents and altered distribution patterns of glycosaminoglycans. Increasing chondroitin sulphate concentrations as well as increasing proportions of 6-sulphated galactosamines were found to be the characteristic changes. PMID- 6489853 TI - [Hand injury from a spindle conveyor]. AB - A case report is presented of a left hand injury in a four-year-old girl with a bone defect of the mid hand caused by a spindle conveyor. The technical problems both of age and bone reconstruction where the epiphysis is missing, are discussed. PMID- 6489854 TI - [The burned hand]. AB - The treatment of the burned hand is part of the care of the burned patient and is not an isolated problem. Second degree injuries present no difficulties because any therapy will be successful. The deep dermal burn is treated in different ways, some authors preferring early tangential necrectomy, while others had good results with secondary reconstructions. In the case of the third degree burn, necrectomy will in any case be mandatory. The preservation of the scar with Betadine gives the opportunity to choose the best timing for the operation in relation to the general condition of the patient. Skin grafting can be performed without any dressing by using the "hayrake" splint. Postoperative treatment is important, splints and pressure dressings are successful. In electrical burns, early necretomy is mandatory. Defects should be closed with flaps. In the area of the secondary reconstruction, the treatment of functional disability has priority over aesthetic corrections. PMID- 6489855 TI - [Apert syndrome--case report]. AB - The Apert syndrome is a complex deformity. Blauth distinguishes three degrees of deformity in the hand; these are demonstrated in our patients. The functional results after operative treatment were satisfying. PMID- 6489856 TI - [Functional treatment of palmar edge fractures of the middle phalanx and palmar capsule ruptures of the interphalangeal joint]. AB - Rupture of the palmar plate of the PIP joint is frequently followed by flexion contracture. The results of operative or immobilizing treatment are disappointing and therefore 46 patients have been treated by a Capener splint. 35 of these joints could be reviewed for the functional result. Only in five cases was extension reduced by five to ten degrees, the remaining being normal in this respect. By contrast flexion was limited in 27 patients, in 19 of them by between five to ten degrees, in the remaining eight by not more than 35 degrees. PMID- 6489857 TI - [Possibility of the para-articular finger fractures with external minifixation]. AB - Use of external minifixation is shown for the stabilization of finger fractures in more then one hundred cases. The author shows that this technique is applicable in intra-articular fractures. PMID- 6489858 TI - [Incidence and significance of epiphyseal and para-epiphyseal injuries in replantations in the area of the upper extremity in children]. AB - A series of 15 cases of replantation in children is reviewed with special attention to the frequency and the implications of epiphyseal lesions. Definite conclusions, however, will only be possible after these patients reach maturity. PMID- 6489860 TI - [Proceedings of the 34th meeting of the Japanese Society of Pharmacology, Northern Division. Abstracts]. PMID- 6489859 TI - [Forearm flap with its various possibilities of application]. AB - The authors describe the different possibilities of the forearm flap as a free and pedicle flap. The forearm flap is arterialized by the A. radialis, the venous outflow goes through the Venae comitantes of the A. radialis or the big veins of the forearm (V. cephalica and basilica). Sensation can be preserved through the three cutaneous forearm nerves. The advantage of the flap is based on the constant anatomy, the big vessels and nerves, the quality and quantity of the forearm skin as well as the relatively thin layer of subcutaneous fat. PMID- 6489861 TI - [A quantitative analyzing method for drug-induced tremor]. AB - A method for analyzing drug-induced tremor in mice was developed using a power spectral analysis of the random current induced by the movement of a magnet attached to a mouse on a wire coil. The power spectral density function defined the frequency composition of the drug-induced tremor, and the mean square value of the data in any frequency range of concern was determined. PMID- 6489862 TI - [Effect of nizofenone (Y-9179) on experimental cerebral ischemia in Mongolian gerbils]. AB - The cerebral protective action of nizofenone was compared with that of pentobarbital (PBT) in Mongolian gerbils in which an incomplete circle of Willis causes the development of ischemic damage in the cerebral hemispheres following common carotid arteries occlusion. The mean survival time following occlusion of both common carotid arteries which induced a mortality rate of 100% was 2.3 hr for the control group and 3.3 hr (P less than 0.05) and 4.1 hr (P less than 0.01) for the animals pretreated with nizofenone (10 mg/kg) and PBT (60 mg/kg), respectively. The mortality rate during a 1 month period following transient bilateral occlusion of the carotid arteries for 30 min was 100% for the control group and 41% (P less than 0.01) and 40% (P less than 0.01) for the animals pretreated with nizofenone (30 mg/kg) and PBT (60 mg/kg), respectively. No significant protective action was observed when administration of the drugs was carried out immediately after the onset of recirculation. These results suggest that nizofenone may be an effective cerebral protective agent. PMID- 6489863 TI - [Proceedings of the 69th meeting of the Japanese Society of Pharmacology, Kanto Division. Abstracts]. PMID- 6489864 TI - [Pharmacodynamic effects of d-nicotine--Comparison with l-nicotine]. AB - The acute toxicity and pharmacological effects of d-nicotine were examined in several species of animals and compared with those of l-nicotine. The LD50s for intravenous administration of d- and l-nicotine were 6.15 and 0.33 mg/kg, respectively. In unanesthetized rhesus monkeys, EEG activity was not influenced by d-nicotine, 64 micrograms/kg, i.v., while the same dose of l-nicotine produced seizure-like waves with some spindles. In rats, d-nicotine increased spontaneous motor activity, and in the experiment under a DRL 20-sec schedule, it increased lever press responding, decreased the number of reinforcements and shortened interresponse time. Similar effects were also observed by administration of l nicotine at lower doses than for the d-isomer. In anesthetized rats, d-nicotine elevated the blood pressure and increased the heart rate with a potency of about one-eighth that of the l-isomer. Further, tachyphylaxis and cross tachyphylaxis were developed to the blood pressure-raising effect in rats after repeated administration of both isomers. d-Nicotine elicited contraction of isolated rat ileum preparations, but with a potency of about one-tenth that of the l-isomer. Both isomers at the same concentration blocked transmission at the neuromuscular junction in isolated rat phrenic nerve-diaphragm muscle preparations. These results indicate that the pharmacological effects of d-nicotine are qualitatively similar to but quantitatively less potent than those of l-nicotine. PMID- 6489865 TI - [Effects of 3,4,5-trimethoxy-N-(3-piperidyl) benzamide (KU-54) on the incorporation (excretion) of 14C-glucosamine in the gastric mucosa and the liver of rats]. AB - Effects of KU-54 on the biosynthesis of glycoprotein in the gastric mucosa and the liver, as measured by the rate of incorporation of 14C-glucosamine, were investigated in rats under various conditions after a single administration of 14C-glucosamine of (9.88 microCi/animal, ip). 14C-glucosamine was incorporated with relative ease in the acid-insoluble fraction of the gastric mucosa. KU-54 at 100 mg/kg was orally administered twice daily for 5 days in rats (though it was given once on the 5th day) before injection of 14C-glucosamine. The rate of 14C glucosamine incorporation into the acid-insoluble fraction of the gastric mucosa was significantly increased by KU-54, but that of the hepatic tissue was not increased. In addition, hydrocortisone (20 mg/kg) also produced a drop of incorporation of 14C-glucosamine in the gastric mucosa, but oral KU-54 at 100 mg/kg twice daily for 5 days (though it was given once on the 5th day) significantly inhibited the drop of incorporation of 14C-glucosamine in the gastric mucosa, but that in the hepatic tissue was not inhibited. Therefore, the effects of KU-54 were greater in the gastric mucosa than in the hepatic tissue. On the 5th day of the ulcer produced by acetic acid in rats, the specific radioactivity in the mucosa of the margin of the ulcer increased significantly compared with that in the normal (non-ulcerative) mucosa, but this phenomenon was not affected by KU-54.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489866 TI - [Effect of elcatonin on experimental osteoporosis induced by ovariectomy and low calcium diet in beagles]. AB - Effect of elcatonin, a synthesized analogue of eel calcitonin, on experimental osteoporosis in beagles induced by ovariectomy and a low calcium diet was studied. Twelve female beagles, 15-18 months old, were divided equally into 3 groups. The first group of beagles were ovariectomized and then fed a low calcium diet, Ca: 0.08%, (ovariectomy plus low Ca diet group); the second group was subjected to the same procedure and diet plus daily injection of elcatonin, 1.0 u/kg, i.m., (elcatonin group); and the third group was fed a standard diet, Ca: 1.36%, (control group) for 6 months. The undecalcified bone sections from the iliac crest were analyzed using histomorphometric methods following in vivo double labeling with Calcein. In the ovariectomy plus low Ca diet group, there were a decrease in trabecular bone volume and an increase in both resorption and formation surface of the trabeculae compared with the control group. These changes of trabecular bone volume and resorption surface were significantly prevented by daily injection of elcatonin. The increase of formation surface of trabeculae and mineral appositional rate was noted in the elcatonin group in comparison with the ovariectomy plus low Ca diet group. These results suggested that elcatonin could prevent bone loss caused by deficiency of sex hormone and dietary calcium. PMID- 6489867 TI - [An electroencephalographical study on timiperone, a new antipsychotic drug]. AB - This investigation was undertaken to analyze the EEG synchronizing effects of timiperone in cats. The effects of timiperone on the brain-stem reticular and hypothalamic activating system, diffuse and specific thalamic projection system, and caudate spindle were investigated by the electroencephalographic method. Timiperone produced a weak inhibition of EEG arousal response induced by electrical stimulation of the sciatic nerve almost without affecting that which was induced by stimulation of the mesencephalic reticular formation. Furthermore, timiperone suppressed the activation of neocortical EEG in response to stimulation of the posterior hypothalamus more selectively than that of limbic EEG. Neither the recruiting response to stimulation of the centro-median nucleus of the thalamus nor the augmenting response to stimulation of the ventro-postero lateral nucleus of the thalamus was modified by timiperone. In addition, timiperone significantly potentiated the caudate spindle. The EEG effects of haloperidol were qualitatively similar to those of timiperone. These results indicate that the synchronizing effect of timiperone may be mediated by a suppression of an ascending reticular activating system and may influence the conscious levels and sleep-wakefulness cycle in cats. PMID- 6489868 TI - [Study on the functional development of the sympathetic nervous system of fetal heart in rats]. AB - The drugs acting on the autonomic nervous system were administered intravenously to dams or intraperitoneally to the 20-day-old fetuses maintained by umbilical and placental circulation. The fetal heart rates were accelerated by the administration of isoproterenol, epinephrine, norepinephrine, tyramine and dopamine to fetuses, and they were decelecated by the injection of propranolol and methacholine to fetuses. However, the tachycardia caused by the fetal injection of isoproterenol and the bradycardia by methacholine were inhibited by the pretreatment of propranolol and atropine. The fetal bradycardia and hypoxia caused by the administration of epinephrine under the pretreatment of propranolol to fetuses were inhibited by the injection of alpha-adrenergic receptor blockers such as phentolamine and yohimbine. Furthermore, the tyramine treatment to fetuses produced significant acceleration of the fetal heart rate on day 19-20 of gestation, but not on day 18. These findings suggest that fetal cardiac beta adrenergic, muscarine-cholinergic receptors and vascular postsynaptic alpha adrenergic receptor may be sensitive enough to respond to sympathomimetic and sympatholytic drugs, and the fetal cardiac sympathetic innervation between the adrenergic nerve terminal and synapse effector cells may be developed on day 18 19 of gestation. PMID- 6489869 TI - [Effects of anti-inflammatory drugs on the lame walking reaction in adjuvant induced edematous rats]. AB - Acute inflammatory paw edema of rats was formed by the injection of 0.5% Mycobacterium tuberculosis-liquid parraffin suspension into the hind paw, and then the pain threshold of the inflamed paw decreased. At that time, the rats showed a three-legged gait, namely, the lame walking reaction. The reaction was inhibited by acidic nonsteroidal anti-inflammatory drugs, e.g., indomethacin, ibuprofen and aspirin, inhibitors of prostaglandins biosynthesis, at a lower dose level than those in the Randall-Selitto test using yeast edematous rats and in the flection tests using adjuvant arthritic or silver nitrate arthritic rats. On the other hand, basic nonsteroidal anti-inflammatory drugs, e.g., tiaramide HC1, mepirizole and perisoxal citrate, not inhibitors of prostaglandins biosynthesis, were less potent than the acidic nonsteroidal anti-inflammatory drugs in the inhibition of the lame walking reaction. When prostaglandin E2 was injected into the inflamed paw, the inhibitory effects of acidic non-steroidal anti inflammatory drugs on the reaction disappeared, but those of the basic nonsteroidal anti-inflammatory drugs didn't disappear. Bradykinin had no influence on the effects of both acidic and basic nonsteroidal anti-inflammatory drugs in the inhibition of the reaction. Analgesic evaluation with the lame walking reaction is more sensitive than with the Randall-Selitto or the flection methods. Morphine, pentazocine and acetaminophen inhibited the reaction, and these effects didn't disappear by the injection of prostaglandin E2 into the inflamed paw. These results suggest that prostaglandins play important roles in inflammatory pain, and the lameness test can serve as a new method for evaluating analgesics such as anti-inflammatory drugs and for investigating the mechanism of inflammatory pain. PMID- 6489871 TI - SIF cell--neuron contacts in sympathetic ganglia. PMID- 6489870 TI - [Changes in secretory activity of tracheal submucosal glands by repeated treatment with brovanexine and BR-227 in rats]. AB - The effects of brovanexine (BvX) and BR-227 on sectetory activities of tracheal submucosal glands (SG) including behavior of mucus glycoproteins in the cells were investigated. BvX, BR-227 or bromhexine (BH) was given repeatedly at a dose of 10 or 20 mg/kg p.o. a day, to rats for 1, 3, 7 or 14 days. Then, the trachea was excised and drug effects were determined according to our histological/histochemical technique. The outer diameter of the acini of SG did not change, but the inner diameter markedly increased by the drug given for 3-14 days. The ratio of the acinar inner diameter to the tracheal wall thickness (AIWR) was increased with the 3, 7, and 14 day treatments with BvX or BR-227 at a dose of 10 mg/kg a day. On the other hand, these drugs at a dose of 20 mg/kg a day caused an increase in AIWR when drug was given for 1-14 days. BH (10 mg/kg a day)-induced increase in AIWR was shown when drug was administered for 7 and 14 days. The number of SG cells stained blue with alcian blue (pH 2.5)/periodic acid Schiff decreased with the 1, 3, 7 and 14 day treatments, and a part of SG cells became red with the 7- and 14-day treatments. There was no significant difference in the effects among the three drugs both qualitatively and quantitatively. These findings indicate that repeated treatments with BvX and BR-227 have an effective secretagogic action on SG, and in addition, a mucolytic action toward acid glycoprotein in granules of the cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6489872 TI - The rat superior cervical ganglion during prenatal development. PMID- 6489873 TI - Morphogenesis of the nasal apparatus in a member of the genus Chamaeleon L. (morphogenesis of the nasal capsule, the epithelial nasal tube and the organ of Jacobson in Sauropsida. VIII). PMID- 6489874 TI - On the origin of the upper mandible in the chick embryo. PMID- 6489875 TI - A short mandible as a cause of cleft palate in a human embryo--an embryological casuistic. PMID- 6489876 TI - Innervation of the capsules of the large limb joints of the hedgehog (Erinaceus europaeus). PMID- 6489878 TI - Adenohypophyseal cell types in the pituitary gland of Osteobrama cotio (Ham.). PMID- 6489877 TI - Functional morphology and histology of the olfactory organs of the hill stream carp Crossocheilus latius latius (Hamilton). PMID- 6489879 TI - Kidney patterns in some teleostean fishes--a morphological study. PMID- 6489881 TI - A comparative study of two reptilian muscles. II. Histology of cardiac muscles. PMID- 6489880 TI - A comparative study of two reptilian muscles. I. Histology of striated muscles. PMID- 6489882 TI - Paraquat poisoning. AB - A fatal case of paraquat poisoning is described. Postmortem concentration of paraquat in different tissues reveals that treatment in this case could not prevent lethal tissue accumulation. Although accumulation was more pronounced in renal tissue, lung toxicity caused death. The formation of enormous fecaliths and the appearance of hypercalcemia are reported. Both were most likely connected with Fullers earth therapy. In spite of the fact that the exact nature of the equilibrium between plasma levels and tissue accumulation of paraquat (static or dynamic) is not understood, aggressive treatment must be recommended, even after the distribution phase and despite likely "fatal" plasma levels. PMID- 6489883 TI - Experiments using high pressure fluid jets on human tissues. AB - The object of the experiments was to observe the effects of small jets of high pressure fluid on skin and subcutaneous tissues. This was to simulate a situation which might occur following minor failures in the pressure hulls of submersibles. It was found that the dissipation of Kinetic Energy on a small experimental scale resulted in considerable tissue damage. Preliminary tests interspersing fabric between the jet and skin did not show a great reduction in potential damage. An important aspect considered is the possible introduction of pathogens into tissues when sea water is the fluid. PMID- 6489884 TI - Analytical pyrolysis of Streptococcus salivarius as an aid to identification in bite-mark investigation. AB - The use of pyrolysis mass spectrometry (Py-MS) and statistical analysis of mass spectra is introduced as a method for "finger-printing" strains of Streptococcus salivarius. The objective is to provide correlative evidence regarding the identity of suspects in cases of assault or rape involving bite-marks. The results of the analysis of isolates from two individuals are presented, illustrating the differentiation of S. salivarius at strain level according to the origin of the isolate. PMID- 6489885 TI - The biochemistry of vitreous humour. A comparative study of the potassium, sodium and urate concentrations in the eyes at identical time intervals after death. AB - Analysis of the vitreous humour from an individual's eyes collected at the same time since death showed variation between the eyes in the concentration of potassium, sodium and/or urate. This previously unreported finding would limit the use of measuring these electrolytes in determining the time of death. PMID- 6489886 TI - The biochemical changes in pericardial fluid after death. An investigation of the relationship between the time since death and the rise or fall in electrolyte and enzyme concentrations and their possible usefulness in determining the time of death. AB - This paper reports the biochemical changes that occur in pericardial fluid after death. Significant changes in relation to the time since death occurred in potassium, sodium, phosphate, protein and several commonly measured enzymes. The variation in individual results at similar times since death would limit the use of pericardial fluid biochemistry in determining the time of death. PMID- 6489887 TI - [When can exact information on treatment risk be dispensable? The federal court has further differentiated its legal stand on risk information]. PMID- 6489888 TI - [Body plethysmography in infants and small children. Respiratory function diagnosis using a special baby plethysmograph]. AB - Successful body plethysmographic examination of infants and toddlers can now be performed by means of a special baby plethysmograph which is commercially available (Fa. Jaeger, Wurzburg, Fed. Rep. of Germany). The apparatus is equipped with a heated rebreathing system and manipulation ports. Examinations require paying attention to certain potential sources of error: the consequences of necessary sedation; possible undefined leaks due to non-airtight manipulation ports; the influence of irregular breathing or increasing hyperventilation; the effect of nasal resistance; the large variation in total airway resistance; problems in the quantitative evaluation of box pressure/flow curves and curve form analysis. Careful handling can overcome all these difficulties. From the clinical point of view, body plethysmographic examination is just as important for infants and toddlers as for schoolchildren and adults. PMID- 6489889 TI - [Allergic dermatoses. 7: Allergic contact eczema]. PMID- 6489890 TI - [Differential use of sex hormones during the perimenopause]. AB - Various regimens are available for hormone replacement in perimenopausal patients. Their pharmacodynamic effects differ e.g. in respect to the relief of subjective climacteric symptoms, the risk of endometrial cancer, the prevention of osteoporosis and the alterations of lipid metabolism. In view of the conflicting epidemiologic data general long-term prophylaxis in all climacteric women cannot be recommended at present. The institution of therapy requires valid indications and careful assessment of relative risks. Today, the cyclic administration of oral estrogen-progestin combinations may be regarded as the method of choice. However, treatment can and should be individualized. The practical aspects of a differential management are discussed. With prudent use, the benefits of perimenopausal hormone replacement clearly outweigh their potential disadvantages. PMID- 6489891 TI - [Radioactive labeling of cytoplasmic hormone receptors. Determination and clinical significance of estrogen and progesterone receptors]. AB - Neither autoradiography nor in vitro labeling of thin sections of tumor tissue can be used for the quantitative determination of radioactive labeled cytoplasmic hormone receptor. The acknowledged method for his purpose is the DCC (Dextran Coated Charcoal) method. Hormone receptor estimations are routinely used to predict those patients with hormone-dependent tumors who will respond to endocrine therapy. Some 80% of patients with positive estrogen and progesterone receptor show objective remissions after endocrine therapy. Receptor determinations are carried out routinely in patients with mammary, uterine or ovarian carcinoma to identify those subjects who would benefit most from endocrine therapy. PMID- 6489892 TI - [Extended indication for hysterectomy. Changes in the incidence and indications in hysterectomy within 2 decades]. AB - At the Gynaecological Department of the Medical Hospital of the University of Hannover, the medical reports of two periods (1960 to 1963 and 1978 to 1980) were employed to investigate hysterectomies and a number of uterus-preserving procedures, the indications for which could also have served as an indication for hysterectomy. As compared with the first period, the average hysterectomy rate per age group was almost twice as high in the second period, while uterus preserving surgery was virtually insignificant in the later period. In the second period, patients were younger and had less severe complaints. In the second period, sterilization and carcinoma prophylaxis represented major secondary indications for the operation. Overall, the result point to a considerable expansion of indications in the second period. However, owing to the fact that the operation carries a risk that cannot be neglected, sterilization of carcinoma prophylaxis alone cannot be considered a sufficient reason for hysterectomy. PMID- 6489893 TI - [Exfoliative cytology of the vulva. Histological and clinical aspects]. AB - Special criteria of malignancy are evident in vulvar cytology which are completely different from the well-known features of cervical cytology. These criteria are well suited to improve the efficiency of vulvar cytology. Cytology and the full utilization of all other diagnostic procedures should lead to the early detection of precancerous and cancerous lesions of the vulva. PMID- 6489894 TI - [Drug therapy of functional disorders of the lower urinary tract in women. 1: Functional anatomy, clinical course and therapy of stress incontinence]. PMID- 6489895 TI - [Weight reduction on a commercially available minimal diet. Results of replacing 1 meal per day]. AB - Over a period of 14 days eight female outpatients ingested a new low-calorie formula diet (Enerday Protein) as a substitute for either dinner or lunch. This formula diet contains fructose as carbohydrate. In the two weeks of treatment an average reduction in weight of 2.7 kg (range: 2.0-3.4 kg) was observed, which means a daily weight loss of 193 g. Gastrointestinal disturbances or metabolic changes were not observed. This form of weight reduction was well accepted by the patients. Living and eating habits were not altered, since only one daily meal was replaced. PMID- 6489896 TI - [Effect of a betamethasone-dimethidine-maleate combination on dermatologic diseases. Determination of plasma cortisol levels before, during and after several days' therapy]. AB - The combination of betamethasone and dimetindene maleate (Fenistil Plus) is a new combination of a corticosteroid and an antihistaminic agent. According to the pharmaceutical formula, patients must take three capsules daily, whereby only the morning dose contains betamethasone as well as the antihistaminic. The aim of the study, which was performed on dermatological cases, was to examine the restitution of plasma cortisol concentrations following circadian betamethasone therapy of several days duration, as well as to confirm the clinical effectiveness of the drug combination. The results obtained in the study, carried out in a total of nine Patients suffering from various types of dermatitis, showed that the desired therapeutic effects were achieved. In three patients, plasma cortisol concentrations were found to have returned to normal values within four days after cessation of a ten days treatment. From the above results it may be concluded that permanent adrenocortical suppression is not to be expected in patients treated with betamethasone (0,75 mg) in the morning, for a period of ten days. Furthermore, it may be stated that dimetindene maleate (3 mg/day) in combination with the morning dose of betamethasone proved to be therapeutically effective. PMID- 6489897 TI - [The biological ego--life as an immunologic phenomenon]. PMID- 6489898 TI - [Improvement of walking disability and conservative treatment. Guiding principles for drug treatment of chronic arterial occlusive disease (stage I and IIb)]. PMID- 6489899 TI - [Pregnancy termination: not for family planning. The legal difference between sterilization and pregnancy termination is decisive]. PMID- 6489900 TI - [Non-operative treatment of ureteral calculi using ureterorenoscopy]. AB - Rigid transurethral ureteroscopy was used in the treatment of 31 patients with 32 ureteral calculi. The stones could be visualized in 90% of cases. The aim of treatment was immediate extraction under visual control for smaller calculi and retrograde advancement into the renal pelvis with subsequent extracorporeal shock wave lithotripsy for larger calculi. The aim of treatment was reached in 92% (11/12) of stones in the lower third of the ureter, in 67% (4/6) in the middle third and in 64% (9/14) in the upper third of the ureter leaving 12 calculi extracted and 12 pushed up into the renal pelvis. Electrohydraulic lithotripsy in the ureter was used in 3 cases before extraction. Ureterolithotomy had to be carried out in 3 patients only (9%) following the endoscopic procedure. PMID- 6489901 TI - [Percutaneous nephrolithotomy and litholapaxy. Endoscopic destruction and removal of kidney calculi]. AB - With the development of the ultrasonically guided punction of the kidney it has become possible nowadays to achieve direct access to the kidney without much difficulty. The puncture tract can be widened and used for the entrance of the so called nephroscope, which enables the sitting and extraction of renal calculi, which are not able to drain away by themselves. The calculi are removed through the shaft by small forceps. Larger calculi are chiefly removed by means of ultrasonic probes or electro-hydraulic shock waves. This method of percutaneous lithotripsy or litholapaxy is also suitable for the extraction of calculi from kidneys with impaired drainage. Since the procedure can be carried out in a large proportion of patients with local anaesthesia, there are hardly any contraindications--except in cases of complete staghorn calculi. In contrast to the extracorporeal shock wave lithotripsy little apparatus is needed and it is not too expensive; therefore, it is also suitable for smaller hospitals and departments. The percutaneous lithotripsy represents a safe method of renal calculus extraction with little stress for the patients. PMID- 6489903 TI - [Pharmacotherapy of functional disorders of the lower urinary tract in the female. 2: Drug therapy of stress incontinence, bladder muscle weakness and increased bladder outflow resistance]. PMID- 6489902 TI - [Mononuclear phagocytes in the cerebrospinal fluid. Studies on the clinical significance and factors of activation]. AB - Examination of 1050 cerebrospinal fluid samples showed, that mononuclear phagocytes contribute only slightly to the explanation of affections of the CNS except they are containing specific particles e.g. iron. Further investigations on patients with concussion, herniation of the intervertebral disk and cerebral infarction turned out, that the relative proportion of mononuclear phagocytes and qualitative cytological changes correlate with the extent of the CNS lesion. Phagocytosis of India ink was studied dependent on milieu and different mediators. Phagocytosis correlates with alpha-1-glycoproteid and the relative part of mononuclear phagocytes in cerebrospinal fluid. It depends on pH, various ions and mediators (adrenalin, histamine, prostaglandines, cAMP, cGMP). DNA contents of the nucleus was measured by cytophotometria. No signs of proliferation (tetraploidia) were found. The slightly increased contents of nuclear DNA of some phagocytes was interpreted as a metabolically active DNA. PMID- 6489904 TI - [Adjuvant topical doxorubicin therapy in bladder cancer]. AB - Thirty-four patients with tumors of the bladder were, after prior tumor surgery, treated with topical doxorubicin. Owing to undesired side effects, it was possible to adhere to the treatment regime in only 30 of the patients. Over an average observation period of 18 months, the number of recurrent lesions had diminished; the number of tumor-free patients at the time of evaluation was high. In view of these results, the question may be asked: could this form of treatment possibly be a suitable alternative to cystectomy, which has such a negative effect on the patient's quality of life? The answer can be given only on the basis of further prospective studies. PMID- 6489905 TI - [Studies on the relation between seasons and mental disorders]. AB - Studies published in literature have claimed that there are interconnections between seasons and mental diseases. However, such conclusions are unacceptable, since they have no methodological foundation: whatever was claimed to have been measured, was actually not measured at all. This makes any discussions on the causes of such interconnections redundant. What was actually found, were certain connections between rates of hospitalisation and certain seasons. In our study, such relationships were also measured, but partly we also found other seasonal variations in hospital admission rates. The only conclusion that can be drawn from these observations is that, while there are certain connections between seasons and hospitalisation, the reasons for such variations are rules and conditions governing the admission to hospitals which do not bear any relation to the season at a particular time. Such relations, if any, are probably so highly complex that it will be necessary for establishing any causal relationship to gradually eliminate any possible disturbing factors by examining their impact and importance in each case. This requires a stepwise and extremely cautious approach. PMID- 6489906 TI - [Pathogenesis of primary open angle glaucoma]. PMID- 6489907 TI - [Clinico-epidemiological study on obesity in relation to mortality figures. Twenty years follow-up results in Hisayama study]. PMID- 6489908 TI - [A combination of glycosylated hemoglobin and fasting plasma glucose testing facilitate screening of diabetes mellitus]. PMID- 6489909 TI - [A combination of glycosylated hemoglobin and fasting blood glucose testing is necessary for the management of diabetics]. PMID- 6489910 TI - [A clinicopathological study of IgA nephropathy; analysis of 100 cases and follow up study of 49 cases]. PMID- 6489911 TI - Effects of intravenous administration of iron preparations on the metabolism of phosphorus. Comparative study on 3 iron preparations. PMID- 6489912 TI - [An electron microscopic study on the cells in the lumen of the ligated artery]. PMID- 6489913 TI - [Effects of sequential autonomic blockade on blood pressure and vascular resistance in patients with borderline hypertension]. PMID- 6489915 TI - [Control of cancer mortality]. PMID- 6489914 TI - [Operative intestinal fiberscopic findings and recurrences following surgery in Crohn's disease]. PMID- 6489916 TI - [Studies on the local immunity of the gastrointestinal tract]. PMID- 6489917 TI - [A study on relation between premotor cortex and forelimb movement: analysis of neuronal activity]. AB - The aim of this study is, first, to examine the existence of topographical organizations in the premotor cortex in monkeys trained rigorously to move his proximal and distal forelimb separately. The second aim is to observe premotor cortex neuronal activity in association with simple movement triggered by sensory signals of three different modalities (visual, auditory, and somatosensory). Premotor cortex was defined as the lateral part of frontal agranular cortex where intracortical microstimulation could not evoke muscle contraction at intensity below 50 microA. Neurons related to the distal forelimb movement formed three foci in the premotor cortex. Neurons related to the proximal forelimb movement distributed widely in the premotor cortex without forming any distinct focus. Movement-related premotor neurons showed less modulation of discharge frequency in association to the movement than motor cortex neurons, and some of them responded selectively to one or two sensory signals triggering the movement. These results suggests that premotor cortex contributes less directly to the execution of simple movements, but may play an important role in controlling or organizing complex movements. PMID- 6489918 TI - [Partial purification and characterization of delta 7-sterol 5-desaturase from rat liver microsomes]. AB - The terminal oxygenase of the NADH-depending lathosterol (cholest-7-en-3 beta-ol) 5-desaturase system was partially purified from rat liver microsomes, by Triton X 100 solubilization, DEAE-cellulose column chromatography, and hydrophobic affinity chromatography with Aminohexyl-Sepharose. The terminal oxygenase activity was approximately 18 fold greater than the starting microsome, and the yield was 18.4%, nevertheless, the terminal enzyme activity was almost free from other electron transfer components in microsomes. It was demonstrated that NADH, molecular oxygen, phospholipid, and three enzymes: NADH-cytochrome b5 reductase, cytochrome b5, and the terminal oxygenase, were absolutely essential for lathosterol 5-desaturation in the reconstituted system. Furthermore, the rate of the NADH-depending lathosterol 5-desaturation in the reconstitution system, was proportional to the concentration either of the terminal desaturase, cytochrome b5, or NADH-cytochrome b5 reductase, under conditions in which other enzymes were present in excess. PMID- 6489919 TI - [Effect of metoprolol on water drinking activity in Wistar Kyoto rats]. AB - The study was undertaken to elucidate the effect of beta 1 adrenoceptor blocking agent, metoprolol, on water drinking activity in Wistar Kyoto rats (WKY). Both 7 day (10mg/kg/day) oral administration of metoprolol and propranolol did not produce any changes in the systolic blood pressure of WKY. However, metoprolol produced a significant decrease in heart rate in WKY. Neither the propranolol treated rats nor the control (non-drug group) rats showed any significant changes in heart rate. Heart rates were significantly changed in the metoprolol group as compared with the other two groups. This finding reconfirms that metoprolol has beta 1 selectivity. Drinking activity, an indicator of central nervous function, did not change after metoprolol administration. Power spectral analysis of water drinking activity did not reveal any changes in rhythm in respect to periodicity in the metoprolol group. Although water drinking activity is synchronized with urinary catecholamine and aldosterone excretion rates, urinary catecholamine and aldosterone excretion rates did not change after metoprolol administration. These findings suggest that it is the beta 1 adrenergic blocking action of a bradycardia-producing dose of metoprolol that prevented any change in water drinking behavior in WKY. PMID- 6489920 TI - [Clinical application of immuno-precipitation inhibition technique for determination of disopyramide in human plasma]. AB - Immuno-precipitation Inhibition Technique (IPIT) method of determining disopyramide levels in human plasma was reevaluated in respect to factors affecting assay procedure, specificity and recovery. With this method only 20 microliters of plasma is required to obtain a rapid, sensitive and specific determination. Due to little intra-assay and inter-assay variation, the IPIT method is suitable for clinical determinations for disopyramide. Furthermore pharmacokinetic parameters calculated from the disopyramide concentrations coincided with the reported data determined by other methods. It was demonstrated, however, that precise temperature control and sample mixture are essential for accurate plasma disopyramide determination using this method. PMID- 6489921 TI - Renal ammoniagenesis in rats made acutely acidotic by swimming. AB - Rats develop metabolic acidosis acutely after exercise by swimming. Renal cortical slices from exercised rats show an increase in both ammoniagenesis and gluconeogenesis from glutamine. In addition, plasma from the exercised rats also stimulates ammoniagenesis in renal cortical slices from normal rats. In exercised rats renal phosphate dependent glutaminase shows a 200% activation when the enzyme activity is measured at subsaturating concentration of glutamine (1 mM) while only an increase of 12% in Vmax is observed. When kidney slices from normal rats are incubated in plasma from exercised rats an activation of phosphate dependent glutaminase is obtained with a 1.0 mM (100%) but not with 20 mM glutamine as substrate. This activation of phosphate dependent glutaminase at subsaturating levels of substrate may indicate a conformational change in PDG effected by a factor present in the plasma of exercised acidotic rats. PMID- 6489922 TI - Treatment of primary hyperparathyroidism with cyclofenil--a synthetic stilbestrol derivative with minimal feminizing effects. AB - In eight patients with primary hyperparathyroidism (HPT) the laboratory effects of cyclofenil, which is a synthetic stilbestrol derivative with weak feminizing effects, were studied over a period of 5-13 weeks. In all the patients there were during treatment clear reductions of the serum calcium levels as well as the urinary excretions of calcium and hydroxyproline. These findings are in accordance with earlier reports that oestrogens reduce bone resorption mediated by parathyroid hormone. It has previously been demonstrated that cyclofenil can be given, on other indications, for several years to both male and female patients without oestrogenic side-effects. This pilot study, therefore, indicates that treatment with cyclofenil might be of value in some cases of primary HPT where surgery is not considered. PMID- 6489923 TI - Evidence for insulin resistance in Indian patients with non-insulin dependent diabetes in the young. PMID- 6489924 TI - Effect of adrenalectomy on brown adipose tissue of obese (ob/ob) mice. PMID- 6489925 TI - Effects of testosterone and estrogens on deltoid and trochanter adipocytes in two cases of transsexualism. PMID- 6489926 TI - Adrenocortical function in the course of long-term verapamil treatment. PMID- 6489927 TI - Absence of sex differences in urinary prostaglandin E2 excretion in the rat under basal conditions or following acetazolamide. PMID- 6489928 TI - A radioimmunoassay method for measurement of urinary kinins. AB - A sensitive and specific radioimmunoassay for measuring urinary kinins was developed. Antibodies against bradykinin were induced in rabbits by injecting bradykinin coupled to bovine albumin. One of the antisera generated was used at a final dilution of 1:18,000 to obtain a 30% total binding of bradykinin-(8 tyrosine)-[125I]-triacetate. Synthetic bradykinin (5-1,000 pg) was used as standard in the curves. The sensitivity of the assay was 5 pg. The recovery of bradykinin added to urinary samples was 86.85 +/- 6%. The intraassay and interassay coefficients of variation were 3.3% (n = 12) and 4.4% (n = 5), respectively. The antiserum showed no cross-reactivity with oxytocin or low molecular weight kininogen and cross-reacted with kallidin (lys-bradykinin), met kallidin, and angiotensin I, but cross-reaction with angiotensin I (2.5%) was low enough to be disregarded. The mean urinary levels of total kinins in 12 normal subjects were 23.2 +/- (SEM) 2.2 micrograms/day. PMID- 6489929 TI - High-performance liquid chromatographic (HPLC) separation and quantitation of endogenous glucocorticoids after solid-phase extraction from plasma. AB - This study describes a method for the extraction and simultaneous measurement of cortisone, cortisol and corticosterone using dexamethasone as an internal standard. Solid-phase extraction of plasma steroids with C18 columns allows the samples to be extracted, washed and concentrated in a single step with minimal sample handling and without the use of large volumes of organic solvents. HPLC separation of the steroids is accomplished within 10 min and the individual steroid peaks are quantitated by UV detection at 239 nm. This assay was examined for linearity, extraction efficiency, precision and potential interference by commonly used drugs. Plasma values of glucocorticoids are reported for samples obtained from human subjects as well as from rats. HPLC was also compared to RIA for the determination of plasma levels of corticosterone in the rat. Solid-phase extraction and assay by HPLC provides a rapid and specific method for the simultaneous determination of plasma glucocorticoids. PMID- 6489930 TI - Insulin-specific binding to erythrocytes in 6 girls with acanthosis nigricans. AB - 6 girls, aged 4-16 years, with acanthosis nigricans and hirsutism were studied. Fasting and postglucose hyperinsulinism was present in the 5 older girls. In the youngest, a transitory diabetes with hyperinsulinism was induced by a cortisone therapy for hepatitis. Insulin resistance, suggested by the failure to significantly decrease blood glucose after insulin injection (0.1 U/kg), was demonstrated in three steps: (1) Patient plasma failed to bind 125I-insulin after a 5-day incubation followed by precipitation by antihuman globulin serum. (2) Specific 125I-insulin binding to rat liver membranes was identical in the presence of patient plasma and control plasma. (3) Specific 125I-insulin binding to the erythrocytes of the 6 patients (3.5-7.0%) was significantly lower (p less than 0.01) than in controls (4.5-19.5%). Moreover, the significant correlation present in controls between total binding and reticulocyte counts (r = 0.824, p less than 0.001) was absent in the patients. These data demonstrate further that, in the juvenile type of acanthosis nigricans, insulin resistance which may precede hyperinsulinism is not related to anti-insulin antibodies nor to antireceptor antibodies, but results from a primary defect of insulin receptors. PMID- 6489932 TI - On the synthesis of a 32P-labelled Edman reagent for the sensitive identification of amino-acid derivatives. AB - A phosphorus-32 containing derivative of phenylisothiocyanate was prepared to increase the sensitivity of amino-acid sequence determination. The respective compound 2-(4-isothiocyanatophenoxy)-1,3,2-dioxaphosphinane 2-oxide showed about the same reactivity, stability, and polarity as the Edman reagent itself. A repetitive yield of 94% was obtained in the stepwise degradation of insulin B chain using a solid phase sequencer. The synthesis of this radioactive reagent was achieved within 5 h but with a specific activity of 1 Ci/mol. Eight amino acids were reacted with the 32P-labelled reagent and identified by autoradiography after two dimensional thin-layer chromatography. PMID- 6489931 TI - Effect of aldosterone on the serum zinc, copper, and magnesium concentrations in the rat. AB - Possible regulation of trace metal metabolism by various steroid hormones has been reported by a number of investigators. The purpose of the present study was to determine the effect of aldosterone on the serum copper, zinc, and magnesium concentrations in the rat. Male and female rats were infused with aldosterone for up to 72 h and the serum copper, zinc, and magnesium concentrations were determined. The serum zinc concentration exhibited a transient decrease with a nadir at 24 h. No significant change was observed in serum magnesium or copper that was directly attributable to aldosterone. The mechanism by which aldosterone affects the transient serum zinc decrease was not demonstrated, but several possibilities were discussed. PMID- 6489933 TI - Nicotinic acid metabolism. Dimethylmaleate hydratase. AB - The partial enrichment of a new enzyme, dimethylmaleate hydratase from Clostridium barkeri and some of its characteristics are described. The unstable and oxygen-sensitive hydratase depends on ferrous ions and is induced during growth of C. barkeri on nicotinic acid. The enzyme uses both dimethylmaleate and the hydration product, 2,3-dimethylmalate, as substrates to establish an equilibrium that is 70% in favour of the latter acid; dimethylfumarate is not attacked. A 2,3-dimethyl[3-3H]malate specimen was prepared from dimethylmaleate with the hydratase in tritiated water. Based on proton attack at the re-face of the double bond, experimental results indicate the (2R,3S)-configuration for this malate. The hydration reaction takes an anti-course. The tritium label was lost in the sequence (2R,3S)-2,3-dimethyl[3-3H]malate----(R)-[2-3H1]-propionate--- (2R) - [2-3H1]propionyl-CoA----(2S)-methylmalonyl-CoA. This result confirms the stereochemical course of the 2,3-dimethylmalate lyase reaction, inversion of configuration, by an independent approach. The hydratase reaction completes the degradation scheme of nicotinic acid by C. barkeri. The pathway is briefly reviewed. PMID- 6489934 TI - Tilorone acts as a lysosomotropic agent in fibroblasts. AB - Tilorone, an amphiphilic cationic compound with antiviral activity perturbed the lysosomal system. In cultured fibroblasts tilorone induced storage of sulfated glycosaminoglycans, enhanced secretion of precursor forms of lysosomal enzymes, inhibited intracellular proteolytic maturation of lysosomal enzymes, and inhibited receptor-mediated endocytosis of lysosomal enzymes. In isolated lysosomes tilorone was found to increase pH and to abolish the ATP-dependent acidification. These effects suggest that tilorone acts like a weak base that accumulates in acid compartments of the cells, raises the pH therein and interferes with lysosomal catabolic activity and with receptor-mediated transport of lysosomal enzymes. PMID- 6489935 TI - Intramolecular hydride transfer of a combined coenzyme-substrate analog by D- and L-lactate dehydrogenases. AB - The synthesis of 3-[(3-carboxy-3-oxopropyl)aminocarbonyl]pyridine adenine dinucleotide, a new combined analog of NADH and pyruvate with pyruvate covalently attached to the amide nitrogen atom of the dihydronicotinamide ring via an additional methylene group, is described. In the presence of D-lactate dehydrogenase from Limulus polyphemus, from Lactobacillus leichmannii, and L lactate dehydrogenase from pig skeletal muscle a redox reaction takes place between the pyruvate moiety and the dihydropyridine ring of the analog. This reaction is shown to be intramolecular by competition experiments with pyruvate. Degradation of the reaction products reveals that the carbon-2 atom of the formed lactate side chain exhibits D configuration in each of these cases studied. PMID- 6489936 TI - Sequence homology between phospholipase and its inhibitor in snake venom. The primary structure of the inhibitor of vipoxin from the venom of the Bulgarian viper (Vipera ammodytes ammodytes, Serpentes). AB - We are presenting the first primary structure of a snake venom inhibitor. It was isolated from the neurotoxin vipoxin of the Bulgarian Viper (Vipera ammodytes ammodytes, Serpentes) which represents a complex of a strong toxic basic protein with phospholipase A2 activity (2 isoenzymes) and the nontoxic acidic component functioning as its inhibitor. The sequence was established by automatic degradation in a liquid phase sequenator on the S-carboxymethylated chain and on the peptides obtained by tryptic hydrolysis of the oxidized chain. A limited tryptic digestion of the oxidized chain provided the necessary overlapping peptides. The inhibitor consists of 122 amino-acid residues including 14 cysteine and 10 tyrosine residues and is thus similar to the phospholipases from snake venoms. A comparison of the inhibitor sequence with the primary structure of the phospholipase A2 (CM-II) from the Horned Adder (Bitis nasicornis) venom shows a surprising homology of 52%. The identical amino acids include the cysteine and tyrosine residues and are generally accumulated in the surroundings of cysteine residues. The histidine (pos. 47) in the active center of the phospholipase A2 is substituted by glutamine in the inhibitor, but the tryptophan (pos. 30) which is essential for the enzymatic activity is present. The significant homology between enzyme and inhibitor in the vipoxin complex is believed to originate from a gene duplication. The relatively late development of the reptiles and the snake venom complex explains the highly preserved structure compared to other enzyme inhibitor systems. PMID- 6489937 TI - Measurement of urinary 7,8-dihydro-6-hydroxylumazine in healthy and in Ehrlich ascites tumour-bearing mice. AB - An estimation of 7,8-dihydro-6-hydroxylumazine in urinary samples of mice by high performance liquid chromatography on reversed phase material is presented. Urinary samples are diluted with water and oxidized by iodine. Chromatographic elution is done isocratically using aqueous buffer containing methanol. Effluent 6-hydroxylumazine is monitored by its fluorescence (382 nm excitation, 449 nm emission). The described method can be performed rapidly with satisfactory accuracy and precision. The electrochemical detection of 7,8-dihydro-6 hydroxylumazine was studied additionally. Total values of daily excreted 7,8 dihydro-6-hydroxylumazine of healthy and of Ehrlich ascites tumour-bearing mice were measured. PMID- 6489938 TI - Sexual dimorphism in the motor mounting pattern of the New Zealand white rabbit: steroid regulation of vigor and rhythmicity of pelvic thrusting. AB - The motor mounting patterns of male and female New Zealand white rabbits were analyzed by means of an accelerometric technique and frequency analysis. Clear behavioral dimorphism was noted in the motor mounting pattern. Pelvic thrusting by males was periodic while that performed by females lacked rhythmicity. Thrusting in males was more vigorous than in females. Ovariectomy markedly decreased the incidence of mounting behavior. Testosterone propionate (TP, 5 mg daily for 1 month), restored mounting in all ovariectomized rabbits. TP stimulated the vigor of thrusting and induced a rhythmic mounting pattern in many cases similar to that displayed by intact male rabbits, i.e., thrusting frequency 13-16 per second. Estradiol benzoate (10 micrograms daily for 1 month), elicited mounting in three of the seven rabbits tested. Pelvic thrusting in these rabbits was often highly synchronous showing a frequency higher (18 to 21 thrusts per second) than that displayed by male rabbits. The results suggest the following conclusions: (a) the behavioral dimorphism in mounting observed in rabbits is due to variations in the secretion of sex steroids by the adult gonads rather than to differences in the organization of the neural substrate of mounting; (b) gonadal steroids influence directly or indirectly the neural structures involved in some characteristics of pelvic thrusting, i.e., rhythmicity and vigor. PMID- 6489940 TI - Increased sexual activity during the midcycle portion of the human menstrual cycle. AB - Daily sexual activity of sexually active lesbian couples was recorded over a 14 week period. Significant peaks in sexual encounters and orgasms were found during the midcycle portion of the menstrual cycle. These results demonstrate a pattern of increased midcycle sexual activity independent of interactions with males, type of contraceptive method, or fear of pregnancy. PMID- 6489939 TI - Prostaglandin induction of spawning behavior in Cichlasoma bimaculatum (Pisces cichlidae). AB - Prostaglandin (PG) stimulates female spawning behavior in goldfish and in some other teleosts in which female reproductive behaviors consist of postovulatory oviposition acts. This study examined the effects of PG on female sexual behavior in a teleost fish, Cichlasoma bimaculatum, in which female reproductive behaviors involve both preovulatory courtship and substrate cleaning behaviors, and post ovulatory oviposition behavior. In females of established pairs, PGF2 alpha injection (5 micrograms, im) at any stage of the spawning cycle, or in the parental phase, rapidly induced substrate cleaning which soon merged into oviposition behavior (without egg release). These results support a role for PG in oviposition behavior of Cichlasoma. However, indomethacin (1 mg, ip), a PG synthesis inhibitor, did not block oviposition in ovulated females which had begun to spawn. Indomethacin may not have lowered PG levels sufficiently. Alternatively, as shown by J.J. Polder (1971, Neth. J. Zool. 21, 265), oviposition behavior may be induced or maintained by other factors associated with the spawning situation. PMID- 6489941 TI - Antagonism of central estrogen action by intracerebral implants of tamoxifen. AB - In order to determine the neural site(s) of estradiol (E2) priming of receptive behavior in female Long-Evans rats, we attempted to inhibit the behavioral effects of peripheral injections of E2 by administering the E2 antagonist tamoxifen (TX) to particular brain regions. Crystalline TX was administered unilaterally or bilaterally via 28-gauge cannulae into the ventromedial hypothalamic nucleus (VMN), the preoptic area (POA), or the interpeduncular region (IP) 1 hr prior to the first of three daily E2 benzoate injections. Subjects were tested for the presence or absence of behavioral estrus 5 hr after a 200-micrograms progesterone injection given 4 days after the initial hormone treatment. Results of this experiment showed that TX inhibits lordosis when directed toward the VMN, but not when directed toward the POA or IP. The quality of the lordosis response and the proportion of subjects showing solicitation behavior were both lower in VMN subjects treated with TX than in POA or IP subjects given the same treatment. Unilateral implants were as effective as bilateral implants in inhibiting the behavior of VMN subjects. A second experiment measured uptake of radiolabeled E2 by nuclei of hypothalamic (HYP) and POA tissue following bilateral TX administration to the VMN or POA. TX was capable of inhibiting uptake of [3H]E2 into nuclei of cells located near the implant site. Most subjects which showed behavioral inhibition also showed a reduction in uptake of [3H]E2 by HYP tissue. These data support the hypothesis that exposure of the VMN to E2 is necessary for the priming of estrous behavior in the female rat. PMID- 6489942 TI - Oxytocin induction of short-latency maternal behavior in nulliparous, estrogen primed female rats. AB - This study was designed to test whether intracerebroventricular (icv) administration of oxytocin can shorten the latency of estrogen-treated virgin rats to respond to foster pups with maternal care. A secondary goal was a description of the behavioral effects of icv oxytocin in rats. Forty-eight hours before pup presentation female rats (Sprague-Dawley strain, obtained from Zivic Miller Laboratories, Inc.) with chronic lateral ventricle cannulae were ovariectomized and treated with 100 micrograms/kg body wt estradiol benzoate (EB). Immediately before pup presentation either 400 ng oxytocin or the normal saline vehicle was infused. A second control group of noncannulated animals received the same surgery, EB treatment, and behavior tests without any icv infusion. Maternal behavior was scored on a scale from 0 to 5, one point each being given for licking pups, carrying pups, grouping pups, crouching over pups, and nest building. At the end of 1 hr of pup exposure 65% of the oxytocin-infused animals received scores of 4 or 5, while only 25% of the control animals attained these scores. Maternal behavior appeared as a unit in both spontaneously maternal and oxytocin-treated animals, with fewer than 10% in either group receiving scores of 1, 2, or 3. The oxytocin group also spent significantly more time grooming. In a second experiment in which oxytocin or normal saline was administered icv to oil-treated animals, this grooming effect was shown to be estrogen independent while the induction of maternal behavior required prior treatment with estrogen. Finally, a slight, transient hyperthermic effect of oxytocin on body temperature was observed in this test paradigm. These data suggest a role for oxytocin, acting with estrogen, in the onset of maternal behavior in rats. PMID- 6489943 TI - Estradiol contributes to the postnatal demasculinization of female Japanese quail (Coturnix coturnix japonica). AB - Two experiments were performed to characterize the process of postnatal demasculinization in Japanese quail. In the first experiment, it was shown that estradiol (E2) can complete female demasculinization during the first 4 weeks of life. By contrast, E2 did not demasculinize sexual behavior and cloacal gland in neonatally castrated males. Neonatally gonadectomized females preferentially performed mount attempts when tested in their home cage by comparison to a test arena. In Experiment 2, E2 Silastic implants (40-mm) maintained full copulatory behavior in castrated males but not in females. This large dose of E2 did not demasculinize adult sexually active birds (males or females) even if treatment lasted for 1 month. It is concluded that E2 can demasculinize sexual behavior only in females and only if treatment is performed in very young birds. PMID- 6489944 TI - Lesions confined to the ventromedial hypothalamus decrease the frequency of coital contacts in female rats. AB - Ovariectomized female rats received either bilateral radiofrequency lesions of the ventromedial nucleus of the hypothalamus (VMH) or control treatments and were tested for copulatory activity following either estrogen (E) alone, or E plus progesterone (P) administration. In separate experiments the females were tested in two testing apparatuses both of which allowed the test females to control their contacts with sexually active males. One of the testing apparatuses also allowed the females to control their contacts with sexually inactive males and ovariectomized females. Females receiving VMH lesions engaged in fewer coital contacts with sexually active males than sham-operated females in the E plus P condition. Lesioned females also tended to spend less time with sexually active males than did sham operates in both the E and E plus P hormonal conditions. The VMH-lesioned females did not differ from the sham-operated females in the ability to display lordosis during the coital contacts or the frequency and duration of visits to the inactive males or ovariectomized females. The sham-operated females did have some transitory alterations in copulatory behavior in comparison to unoperated control females. PMID- 6489945 TI - Effects of long-term grouping on serum cortisol levels in Microcebus murinus (Prosimii). AB - The influence of social interactions on plasma cortisol was studied in captive Microcebus murinus, a prosimian primate. Regardless the group composition, there is an annual variation in cortisol levels characterized by an autumn peak that coincides with the fattening and sexual resting period. The beginning of activity, early in January, is accompanied by a fall in cortisol levels. Cortisol levels are higher in females than in males both in pairs and in heterosexual groups. In paired animals, mean cortisol levels vary around 140 ng/ml in males and 230 ng/ml in females. In all grouped animals, a persistent adrenocortical activation was found and represents a 75 to 120% increase compared to paired animals. Due to the fact that M. murinus, the mouse lemur, is a solitary species with a primitive social structure, the high concentrations of cortisol found in grouped mouse lemurs could be a reaction to persistent social stress. Such high concentrations of cortisol may be related to poor reproductive success of grouped females and could play a major part in the pathological lesions found in males that die while maintained in social groups. PMID- 6489946 TI - Psychosexual milestones in women prenatally exposed to diethylstilbestrol. AB - Thirty women aged 17 to 30 years with a record-confirmed history of prenatal exposure to diethylstilbestrol (DES) were compared to 30 women of similar age and demographic background with a history of abnormal Pap smear findings. Heterosocial and heterosexual histories were assessed by systematic semistructured interviews. The groups differed neither in the age at menarche nor in the age at attainment of various psychosexual milestones. PMID- 6489947 TI - The case for investor-owned hospitals. AB - The author presents the case for investor-owned hospitals based on his work experience in both nonprofit and for-profit hospitals. Viewing investor-owned hospitals as a natural development within a capitalistic democracy, he discusses the origins of the moral, ethical, and political arguments used against for profit hospital care, as well as the increasing necessity for all hospitals to follow the laws of sound economic practice. Finally, having seen good and bad hospitals in every ownership category, the author believes that issues of cost and quality depend not on type of ownership, but on a complex set of variables including goals, management, personnel, and fiscal and physical resources. PMID- 6489948 TI - Integrating psychosocial rehabilitation into the hospital psychiatric service. AB - Psychosocial rehabilitation services, while sorely needed by patients with prolonged mental illness, are not usually offered as part of hospital psychiatry. The authors describe the Veterans Resource Program (VRP), a hospital-based psychosocial rehabilitation program, as a model for introducing rehabilitation services into a hospital psychiatry system. Its perceived residential treatment environment was found to be more practically oriented and to provide more autonomy for patients than did an intensive treatment unit, while still possessing many supportive relationship characteristics. The authors found that the VRP patients had very low dropout and relapse rates; VRP patients also had better recidivism and employment rates compared with baseline rates and with patients in two comparison programs. These results suggest that integrating rehabilitation into hospital psychiatry improves patient care. PMID- 6489949 TI - An examination of the efficacy of social skills training for chronic schizophrenic patients. AB - To study the efficacy of social skills training and day hospital treatment for schizophrenic patients, the authors treated 20 chronic schizophrenic patients in a 12-week day hospital program and 44 patients in the same program supplemented by comprehensive social skills training. While both groups of patients who completed treatment showed improvement immediately following treatment, during the six-month posttreatment period patients who had received social skills training either continued to improve or maintained their gains on most measures, while the patients receiving day hospital treatment alone either maintained gains or lost them. The authors discuss the implications of these findings as well as the finding that almost half of the patients in both groups were hospitalized at least once in the year following treatment. PMID- 6489950 TI - A senior citizens center and a geriatric transitional house at a state psychiatric hospital. AB - Many older, severely dependent patients in large psychiatric hospitals, who are often inadequately treated with traditional psychiatric approaches, have no realistic chance of improving or of returning to the community. At Marlboro (N.J.) Psychiatric Hospital, two programs--a senior citizens center and a transitional house--were founded in 1979 and 1981, respectively, to maximize productive life roles for clients. After discussing the goals, admission criteria, and activities of each program, the authors present a profile of a patient who had shown little progress during 15 years of hospitalization but whose participation in the programs facilitated her return to the community. PMID- 6489951 TI - Staff responses to the pregnancy of a therapist on an inpatient unit. AB - The author interviewed staff on three psychiatric wards to elicit their response to pregnant colleagues. Staff expressed particular concern about protecting the pregnant women from possible patient assaults. Some staff members were overprotective or unwilling to express anger directly toward the pregnant staff members. Staff also reported increases in jealousy, maternal transference and countertransference, anxiety about the impending separation, flirting with the pregnant women, and joking about sex. The author compares these findings with reports from outpatient settings and discusses potential implications. PMID- 6489952 TI - Compliance and outcome of patients accompanied by relatives to evaluations. PMID- 6489953 TI - When and where should we hospitalize alcoholics? PMID- 6489955 TI - Recidivism. PMID- 6489954 TI - Schizophrenia and work. PMID- 6489956 TI - Disability status. PMID- 6489957 TI - Chronic pain management: science and art. PMID- 6489958 TI - Day care for demented clients. PMID- 6489959 TI - Legal liability for tardive dyskinesia. PMID- 6489960 TI - Chronic pain management. AB - In the past ten years developments in social psychology, neurochemistry, learning theory, and psychophysiology have expanded the concept of chronic pain into a biopsychosocial model, in which pain is viewed as a form of abnormal illness behavior influenced by a wide range of biological, social, and psychological factors. Using the literature on chronic pain, the authors discuss the evolution of the chronic pain concept into the multidisciplinary multimodal approach used by pain clinics today, and the factors identified in the literature that influence a patient's perception of pain. Finally, based on their experiences in setting up a pain clinic and on the literature on leading pain management programs, they discuss in detail the evaluation, treatment, and management strategies of a comprehensive chronic pain management program. PMID- 6489961 TI - Can 'essential services' be defined? PMID- 6489962 TI - Computer hardware in the hospital industry. PMID- 6489963 TI - Cost hike causes cuts in stay, beds, FTEs. PMID- 6489965 TI - AHA cites leaders in patient education. PMID- 6489964 TI - Terminations require thoughtful handling. PMID- 6489966 TI - A survey of hospital salaries. PMID- 6489967 TI - Four WI hospitals share mobile CT scanner. PMID- 6489968 TI - Bar codes increase efficiency, cut costs. PMID- 6489969 TI - Atriums highlight nursing complex design. PMID- 6489970 TI - Productivity efforts on the rise. PMID- 6489971 TI - Erie, PA, hospital achieves 'productivity without trauma'. PMID- 6489972 TI - Housekeeping directors see growth in college-educated workers: survey. PMID- 6489973 TI - How do joint ventures affect relations with physicians? PMID- 6489974 TI - NJ hospital profits from better relations with medical staff. PMID- 6489975 TI - Roles of CEOs, boards are changing in not-for-profits. PMID- 6489976 TI - Obstacles and opportunities for the teaching hospital. PMID- 6489977 TI - What compensation for an unwanted life? PMID- 6489978 TI - Measurement of physical activity in population studies: a review. PMID- 6489979 TI - Genetic differentiation and population structure in Kinnaur District, Himachal Pradesh, India. PMID- 6489980 TI - Measures of lateral functional dominance: hand dominance. PMID- 6489981 TI - Ethnic, familial, and environmental influences on lactose tolerance. PMID- 6489982 TI - Biosocial aspects of high blood pressure in people of the Bahamas. PMID- 6489983 TI - Replicability for anthropometry in the elderly. PMID- 6489984 TI - Morbidity and mortality rates in Okinawan Japanese vs. mainland Japanese: the Honolulu Heart Program. PMID- 6489986 TI - Evaluating lung function and anthropometric growth data in a longitudinal study on adolescents. PMID- 6489985 TI - Ethnic differences in adulthood growth attainment of first generation Israelis and in their babies' birth weights. PMID- 6489987 TI - Menstrual status and validation of body fat prediction in athletes. PMID- 6489988 TI - Secular trend in milk consumption and growth in Japan. PMID- 6489989 TI - Estimation of body density in adolescent athletes. PMID- 6489990 TI - Diabetes mortality among Chinese migrants to New York City. PMID- 6489992 TI - Human body surface area: validation of formulae based on a cadaver study. PMID- 6489991 TI - Gross tissue weights in the human body by cadaver dissection. PMID- 6489993 TI - Estimating mortality from two censuses: an application to the Trio of Surinam. PMID- 6489994 TI - Age overstatement and Puerto Rican longevity. PMID- 6489995 TI - Growth status of non-agrarian, semi-urban living Indians in Guatemala. PMID- 6489996 TI - A longitudinal study of growth and maturation in rural Thailand. PMID- 6489998 TI - Crossroads of the basic sciences--the cell membrane. PMID- 6489997 TI - Role of gynecological age and growth maturity status in fetal maturation and prenatal growth of infants born to young still-growing adolescent mothers. PMID- 6489999 TI - Tetralogy of Fallot after surgery: autopsy review of 14 cases. AB - The possible determinants of a fatal outcome following surgical repair of the tetralogy of Fallot were analyzed by postmortem examination in 14 cases. Only one patient died late in the postoperative period, due to patch detachment; the others died shortly after undergoing surgery. Death could not be explained in three cases. In three patients with perimembranous ventricular septal defects, complete atrioventricular block occurred as a consequence of traumatic disruption of the branching bundle. In four cases residual stenosis of the pulmonary outflow tract was shown; in one of these cases adequate relief of obstruction had been prevented by a large conal coronary artery. A residual mitral cleft was found in one patient. Death was not related to the cardiac conditions in two cases; one of these patients died of brain apoplexy and the other of tracheal hemorrhage. These findings stress the need for accurate preoperative diagnosis and precise knowledge of the surgical anatomy of this malformation. PMID- 6490000 TI - Bone marrow biopsies in patients with the acquired immunodeficiency syndrome. AB - Bone marrow biopsy findings in 32 homosexual patients with the acquired immunodeficiency syndrome (AIDS) or prodromal AIDS are described. A high incidence (38 per cent) of nonparatrabecular lymphohistiocytic infiltrations containing irregular small lymphocytes was observed, as well as the presence of diffuse bone marrow damage with plasmacytosis (22 per cent), decreased or absent stainable iron (50 per cent), and histologically identifiable pathogenic organisms (6 per cent). Morphologically, the lymphohistiocytic infiltrations are indistinguishable from bone marrow involvement by peripheral T-cell lymphoma, which may cause confusion, especially when a concurrent lymph node biopsy is difficult to interpret. On deeper sectioning, a specimen from one patient assumed a more granulomatous appearance. Specimens from two patients with small, poorly formed noncaseating granulomas contained demonstrable organisms. PMID- 6490001 TI - Morphologic features of renal oncocytoma: a light and electron microscopic study. AB - Five renal oncocytomas were studied by light and electron microscopy. Five glutaraldehyde-fixed blocks from each tumor were examined. Scarce short, blunt microvilli, plasmalemmal interdigitations, basement membrane protuberances, and round or oval mitochondrial profiles were found, suggesting that these neoplasms arise from the epithelium of the distal tubule. Morphologic criteria for the diagnosis of renal oncocytoma, including ultrastructural demonstration of cytoplasmic filling by mitochondria, are presented. PMID- 6490002 TI - Clinicopathologic and dysmorphic findings in recombinant chromosome 8 syndrome. AB - Clinical records, autopsy reports, and microscopic slides from 11 infants with the recombinant 8 syndrome, an inherited abnormality of chromosome 8 affecting Hispanics from New Mexico and Colorado, were evaluated. A prevalence of cardiac and genitourinary anomalies was found, while few central nervous system abnormalities were observed. Dysmorphic features associated with recombinant 8 syndrome are presented, with descriptions of the inheritance pattern and recurrence risk. Because recombinant 8 syndrome is a chromosomal disorder that will appear more and more frequently as kindreds enlarge, pathologists must be alert to its diagnostic characteristics and genetic implications. PMID- 6490003 TI - Malignant giant cell tumor of bone: ultrastructural and immunohistologic evidence of histiocytic origin. AB - A malignant giant cell tumor of the carpal bones metastatic to the lung in a 23 year-old woman is described. Findings from ultrastructural and cell marker studies support the concept that this tumor is of histiocytic origin. PMID- 6490004 TI - Three new phenotypes of human red cell acid phosphatase: ACP1FA, ACP1GA, and ACP1GB. AB - Three new phenotypes of human erythrocyte acid phosphatase (ACP1) have been detected and found to be unique by direct comparison with previously identified ACP1 variants. One of these new electrophoretic variants, labeled as ACP1FA, has been detected in the Hispanic population of California. The electrophoretic variants identified as ACP1GA and ACP1GB have been detected in a black family in North Carolina. A family study has shown that ACP1G is transmitted as an allele of ACP1. PMID- 6490005 TI - A re-examination of the case for homology between the X and Y chromosomes of mouse and man. AB - Evidence is presented from the literature which suggests that in mouse and man, (1) synapsis between the X and Y is nonhomologous, (2) crossing over does not regularly occur between the X and Y, but is prevented by "precocious" desynapsis, and (3) normal disjunction of the X and Y is assured by an achiasmatic end association. PMID- 6490006 TI - Heterochromatin and nucleolus organizer regions in cells of patients with malignant and premalignant lymphatic diseases. AB - Peripheral blood lymphocytes (short-term cultures) and permanent lymphoid cell lines (long-term cultures) of patients with Hodgkin disease (5), lymphoma (1), plasma cell leukemia (1), angioimmunoblastic lymphadenopathy (1), and infectious mononucleosis (3) were investigated for C-band variants and nucleolus organizer region (NOR)-activities by C-banding and silver-staining, and compared to those of healthy adults (5) and newborn children (3). Heterochromatin polymorphisms were found in malignant diseases (33%) as well as in controls (29%). In the lymphoma patients, heterochromatin of class 3 (Patil and Lubs 1977) was seen more frequently than in the controls (83%:57%). No marker C-band variants could be detected in any of the lymphatic diseases. There was no difference in the heterochromatin polymorphism between short-term cultures (predominantly T-cells) and long-term cultures (B-cells), and there was little but inconsistant difference in the NOR-activities. Silver-staining showed differences between healthy adults (8.8 AgNORs; SD:0.5) and newborn children (6.9; SD:0.4). In the lymphoma patients we found 8.3 (SD:0.7) AgNORs. Thus, using silver staining there was no detectable increase in the number of active NORs in cells of patients with malignant diseases as an expression of increased nucleolus activation in malignancies. The remarkably low NOR-activity in infectious mononucleosis (6.7; SD:1.0) may reflect an influence of acute virus infection (Epstein-Barr virus) on NOR-activity. PMID- 6490007 TI - A gene regulating the time dependence of alpha-L-fucosidase concentration is closely linked with the structural gene in man. AB - The dependence of the specific activities of human alpha-L-fucosidase and four other lysosomal glycosidases on cell growth was determined in long-term lymphoid cell lines in which the polymorphic forms of alpha-L-fucosidase were identified by isoelectric focusing. In cultured lymphoblasts of Fu-1 phenotype the alpha-L fucosidase synthesis during cell growth was found to be proportional to the general amount of protein. However, in cells derived from individuals possessing at least one FUCA*2 allele, the amount of enzyme increased progressively during the log-phase of growth, reaching a maximum at the transition to the stationary phase. The maximum increase of enzyme concentration was observed in the mid-log phase of exponential growth. The results may be explained by the existence of a regulatory locus FUCT which maps in close proximity to the structural gene. The FUCT locus which controls the amount of enzyme in the cell appears to be specific for alpha-L-fucosidase. PMID- 6490008 TI - A new X-linked dysplasia gigantism syndrome: identical with the Simpson dysplasia syndrome? AB - Thirteen male newborns of a family spanning five generations revealed a syndrome consisting in elevated birth weight and length, a disproportionately large head with coarse, distinctive facies, short neck, slight obesity, and broad, short hands and feet. The affected who reached adulthood attained heights of about 2 m; their unusual facial and general appearance and the clumsiness of all their motions, remarkable during infancy and childhood, had become somewhat less conspicuous. In all but one affected individual, intellectual development was normal. In two index cases neither clinical nor laboratory evaluations revealed a basic defect. X-linked recessive inheritance is most probable. PMID- 6490009 TI - C3 polymorphism, HLA and chronic renal failure in Spaniards. AB - C3 allele frequencies were studied in 196 unrelated normal Spaniards. The results fit the Hardy-Weinberg equilibrium. No rare variants were detected. The C3 frequency was close but slightly higher than that found in other Caucasoid populations, and higher than that found in Negroids and Orientals. Spanish Basques also showed a high C3F frequency. A North-South decreasing C3F gradient was recorded and compared to other gradients (HLA-D/DR, height, etc.) thought to be due to natural selection. Lod scores in 28 Spanish families excluded C3 gene assignment at less than 45 cM of HLA/GLO linkage group; no significant linkage disequilibrium was found between C3 and HLA. C3F was also significantly increased in 20 chronic renal failure (CRF) patients as compared to 196 controls; this would support the existence of functional differences between C3F and C3S alleles. PMID- 6490010 TI - Techniques for estimating genetic admixture and applications to the problem of the origin of the Icelanders and the Ashkenazi Jews. AB - A method is introduced for simultaneously using multiple loci to estimate admixture and test goodness of fit of the model of admixture. Deviation of observed frequencies from expectation caused by sources of error such as sampling and/or drift is allowed for all loci in all populations. This allows investigation of the effects of different assumptions about sources of error on the estimates. Admixture is then investigated for Icelanders and Ashkenazi Jews. Results indicate that the Icelanders have a large Norse contribution, and that the Jews may have a small to moderate contribution from the European gene pool. There are some indications that AB0 and G6PD give abnormal estimates of admixture compared to other loci, and that the Jewish gene pool may be derived from additional populations in addition to the populations considered. PMID- 6490011 TI - X-Y translocation. A case report. AB - A translocation of genetic material involving the long arm of the X chromosome and the heterochromatic portion of the Y chromosome is reported in a young woman. The phenotypic effect of this translocation and loss of almost half of the long arm of the X chromosome is described. PMID- 6490013 TI - The Shramadana camps of Sri Lanka. Health education and traditional values. PMID- 6490012 TI - X-linked Duchenne muscular dystrophy in an unusual family with manifesting carriers. AB - We report a unique case of a 46-year-old female who had signs of Duchenne-like muscular dystrophy on clinical, electromyographic, and laboratory investigation. A brother, sister, maternal uncle, and her own son also had Duchenne type muscular dystrophy. Karyotype analysis in the proband showed both the X chromosomes to be morphologically normal. We discuss different hypothetical mechanisms to account for the family pedigree. PMID- 6490014 TI - Public education in primary and secondary cancer prevention. PMID- 6490016 TI - Cancer, a universal scourge. PMID- 6490015 TI - Factors affecting promptness of reporting in breast cancer patients. PMID- 6490017 TI - The psychological needs of the cancer patient and the help nurses can provide. PMID- 6490018 TI - The Brigantia smoking survey. Smoking-related habits and preferences of 9 to 19 year-olds in northern England. PMID- 6490019 TI - Impact of community need differentials on health education planning. PMID- 6490020 TI - [Apropos of drug addicts. Challenges of participation and education for public health]. AB - Community participation to improve the health of the population and to control disease is nowadays strongly recommended by the World Health Organization. How should such participation be implemented? Certain important conditions for its implementation have been underrated. Among them, self confidence is of great importance. Experts are sometimes too specialized and cannot grasp the various implications of certain activities. In health education the need to maintain and reinforce the self-esteem of those concerned has been repeatedly stressed recently. When one deals with drug addicts the difficulty of obtaining their participation is compounded. Many drug addicts often claim that they are bored, that the life they lead is dull. The author indicates that he has no miraculous recipe to offer but he believes it is extremely important that drug addicts be helped to recover their self-esteem since most of them have lost confidence in themselves, a factor which explains failures. PMID- 6490021 TI - How to mobilize a rural community for a health programme. PMID- 6490022 TI - Reduction in exposure to lead from drinking water and its effect on blood lead concentrations. AB - The water supply in Ayr (Scotland, UK) was plumbosolvent and many dwellings in Ayr contained lead pipes. In 1981 treatment of the water supply to reduce its plumbosolvency was initiated. Measurements of water and blood lead concentrations were made before and subsequent to the treatment. Most of the measurements made before and after water treatment began were made on water samples from the same dwellings and blood samples from the same women. Water treatment produced a sharp fall in water lead concentrations and a decrease in the median blood lead concentration from 21 to 13 micrograms/100 ml. Two women had higher than expected blood lead concentrations, both these women had been removing old paint. Women who had lead pipes removed from their dwellings all showed substantial decreases in their blood lead concentrations. The curvilinearity of the relation between blood lead and water lead concentrations is confirmed. Even relatively low (less than 40 micrograms/l) water lead concentrations may make a substantial contribution to blood lead concentrations. PMID- 6490023 TI - Measurement and prediction of thermal injury in the retina of the rhesus monkey. PMID- 6490024 TI - Impedence method for calculation of power deposition patterns in magnetically induced hyperthermia. PMID- 6490025 TI - Model studies with the inversely calculated isochrones of ventricular depolarization. PMID- 6490026 TI - A rule-based microcomputer system for electroencephalogram evaluation. PMID- 6490027 TI - Application of the positive reality principle to metal electrode linear polarization phenomena. PMID- 6490028 TI - Polarity correlator for conduction velocity measurement. PMID- 6490029 TI - Diffraction effects in reflected ultrasound spectral estimates. PMID- 6490030 TI - Finding the site of origin and velocity of propagation in a short one-dimensional strand from two extracellular waveforms. PMID- 6490031 TI - A comparison between Walsh and Fourier analysis of the electroencephalogram for tracking the effects of anesthesia. PMID- 6490033 TI - Psychophysical response to electrocutaneous stimulation. PMID- 6490032 TI - Ceramic electrodes for ELF bioeffects studies. PMID- 6490034 TI - An optoelectronic device to read and spell braille--braillect. PMID- 6490035 TI - Heart-sound processing by average and variance calculation--physiologic basic and clinical implications. PMID- 6490036 TI - On surface EMG spectral characterization and its application to diagnostic classification. PMID- 6490037 TI - An approach to control laws for arm motion. PMID- 6490038 TI - Use of the finite element method to determine epicardial from body surface potentials under a realistic torso model. PMID- 6490039 TI - Airflow perturbation device for measuring airways resistance of humans and animals. PMID- 6490040 TI - Frequency-dependent attenuation effects in pulsed Doppler ultrasound: experimental results. PMID- 6490041 TI - Management of tachyarrhythmias. PMID- 6490042 TI - Computer analysis of left ventricular ejection fraction and segmental wall motion -a preliminary study. PMID- 6490043 TI - Mexiletine in ventricular arrhythmias--an assessment by 24 hours holter monitoring. PMID- 6490044 TI - Acute effect of nifedipine on left and right ventricular functions in patients with ischaemic heart disease--a radionuclide ventriculography study. PMID- 6490045 TI - Age and coronary artery disease. PMID- 6490046 TI - Assessment of left ventricular changes in systemic hypertension--before and after therapy. PMID- 6490047 TI - Oxyfedrine and cardiac inotropism in coronary artery disease. PMID- 6490048 TI - Corrected QT interval (QTc) and its relationship with fatal ventricular tachyarrhythmias and sudden death in acute myocardial infarction. PMID- 6490049 TI - Reactive mesothelial nodule of the pericardium. PMID- 6490050 TI - Effect on pulmonary function of propranolol and hydralazine in hypertension. PMID- 6490051 TI - Hyperkalaemia induced pacemaker exit block. PMID- 6490052 TI - Acute myocardial infarction: contusion due to blunt and blast injury to chest. PMID- 6490053 TI - Cardiac arrhythmias and prostaglandins revisited. PMID- 6490054 TI - Solubility of cholesterol & cholesteryl benzoate in some polar & nonpolar organic solvents. PMID- 6490055 TI - Solubility of cholesterol in bile salt-synthetic detergent mixed micelles & that of cholesteryl benzoate in synthetic detergent mixed micelles. PMID- 6490057 TI - Characteristics of phosphatidylcholine/peptidylglycolipid liposomes. PMID- 6490056 TI - Fe2+-dependent modulation of 3-hydroxy-3-methylglutaryl CoA reductase by a cytosolic protein, fermodulin. PMID- 6490058 TI - Synthesis of LDL-apoproteins in D-galactosamine-induced hepatitis in rats. PMID- 6490059 TI - Effect of acetaldehyde on hepatic glucose metabolism. PMID- 6490060 TI - Formation of an enzyme-bound carbanion in the reaction catalysed by isocitrate lyase. PMID- 6490061 TI - Threonine (serine) dehydratase in mouse liver as a function of age. PMID- 6490062 TI - Furazolidone-induced inter-strand cross-linking of Vibrio cholerae DNA: a quantitative study by thermal chromatography through hydroxyapatite column. PMID- 6490063 TI - Effects of transient high electric fields on rat thymocytes. PMID- 6490064 TI - Lectin-glycolipid interaction. PMID- 6490065 TI - Dielectric properties of normal & malignant human breast tissues at radiowave & microwave frequencies. PMID- 6490066 TI - Carboxypeptidases from buffalo pancreas: purification and characterisation of two forms of carboxypeptidase A. PMID- 6490067 TI - Partial purification and properties of diaminopimelate decarboxylase from gamma irradiated potatoes. PMID- 6490068 TI - Binding of benzo(a)pyrene to DNA in normal and vitamin A deficient rats. PMID- 6490069 TI - Effect of acetaldehyde on carbohydrate metabolism in rat brain. PMID- 6490070 TI - A simple and direct method for synthesis of S-mercuric-N-dansylcysteine. PMID- 6490071 TI - An in vitro assay of erythropoietin at milliunit level. PMID- 6490072 TI - A modified spectrophotometric assay of superoxide dismutase. PMID- 6490073 TI - Chemical method for identification of N-blocked group in pyroglutamic acid peptides. PMID- 6490074 TI - Effect of physical and chemical modifications on molecular and agglutinating properties of rice lectin. PMID- 6490075 TI - Effect of asymmetrical diaryl and arylalkyl ketones on uteroglobin progesterone interaction. PMID- 6490076 TI - Wide-line NMR studies on organic and biomolecules: Part VIII--PMR study of some sugars. PMID- 6490077 TI - Joint action of membrane-active components from central Asian cobra (Naja naja oxiana Eichwald) venom on rat liver mitochondrial functions. PMID- 6490078 TI - Effect of central Asian cobra (Naja naja oxiana Eichwald) venom cytotoxin on enzymatic hydrolysis of phospholipids. PMID- 6490079 TI - Molecular analysis of cucurbitaceae genomes: II--comparison of high resolution thermal denaturation profiles of DNAs in seven plant species. PMID- 6490080 TI - Effect of gonadotropins and gonadal hormones on female fish thyroid peroxidase activity. PMID- 6490081 TI - Isolation and purification of prolactin from human amniotic fluid by a combination of affinity chromatography and chromatofocusing. PMID- 6490082 TI - Functional properties of divalent derivatives of concanavalin A. PMID- 6490083 TI - Steady state kinetics and negative cooperativity in the action of isocitrate lyase. PMID- 6490084 TI - Phenotype of cytotoxic effector cells infiltrating a transplanted, chemically induced rat sarcoma. AB - Previous work from this laboratory indicated that methylcholanthrene-induced sarcomas in the rat are infiltrated by cells with the cytotoxic properties of natural killer (NK) cells. Using a combination of velocity sedimentation and analysis and separation in the fluorescence-activated cell sorter, it has been possible to isolate and characterize these putative NK cells. The present results confirm that cytotoxicity is restricted to NK-sensitive targets (syngeneic, allogeneic and xenogeneic) and no evidence was found for cytotoxic T lymphocytes (CTL). In addition, effector cells have the morphology of large granular lymphocytes, and the pattern of expression of five monoclonal antibody-defined surface markers is identical with that of normal splenic NK cells. PMID- 6490085 TI - Generation of slow-reacting substance (leukotrienes) by endotoxin and lipid A from human polymorphonuclear granulocytes. AB - Leukotrienes were released from human polymorphonuclear granulocytes on incubation with endotoxins and lipid A. The analysis was performed by their smooth muscle contracting properties, reversed phase high-pressure liquid chromatography and radioimmunoassay for leukotrienes C4 and D4. The active component of the lipopolysaccharides seems to be the lipid A portion. PMID- 6490086 TI - Isolation and characterization of C-reactive protein from the dog. AB - Using calcium-dependent affinity chromatography on Sepharose-bearing, covalently coupled pneumococcal C-polysaccharide, a protein was isolated from the serum of dogs that had undergone general anaesthesia and major surgery. This protein was confirmed as the canine analogue of C-reactive protein (CRP) in other species by virtue of its electron microscopic appearance, subunit composition and behaviour as an acute phase reactant. Dog CRP had an apparent molecular weight of approximately 100,000 and was composed of five subunits of approximately 20,000 MW each. Two of the five subunits in each molecule were glycosylated. Negatively stained preparations had the typical cyclic pentameric disc-like structure of proteins of the pentraxin family, and in some preparations had a tendency to form stacks. Serum from normal healthy dogs of various strains usually contained less than 5 mg/l of CRP but, following the stimulus of major surgery, an increase in the CRP concentration was first detected at 4 hr. PMID- 6490088 TI - Immune responsiveness in mice heavily infected with Mycobacterium kansasii. AB - Growth of Mycobacterium kansasii TMC 1203 in B6D2 F1 hybrid mice was associated with increased splenic cellular proliferation, hyperplasia and the generation of non-specific antibacterial resistance. Both responses were dose dependent; the larger the inoculum, the more rapid and extensive the cellular response. However, such mice were still unable to reduce the mycobacterial load within the tissues, apparently because of their inherent resistance to inactivation by immunologically activated macrophages. On the other hand, mice infected with the non-persistent strain of M. kansasii 1214 exhibited only a transient increase in non-specific (anti-listeria) resistance which rapidly declined as the number of viable mycobacteria within the spleen fell below an arbitrary threshold level. Mice infected with either M. kansasii 1203 or 1214 could be immunized with sheep red blood cells (SRBCs), an unrelated T cell-dependent antigen. The humoral (PFC) response was not affected by the mycobacterial load within the spleen. However, the delayed footpad swelling reaction was severely depressed. The latter could be restored merely by increasing the size of the intravenous sensitizing inoculum 100-fold. The present study indicates that mice chronically infected with M. kansasii are not severely immunosuppressed (as had been inferred from earlier in vitro lymphoproliferation studies) but are fully capable of responding to appropriate in vivo stimuli. PMID- 6490087 TI - A study of the differential respiratory burst activity elicited by promastigotes and amastigotes of Leishmania donovani in murine resident peritoneal macrophages. AB - Acridine orange and ethidium bromide and a combination of fluorescent and transmitted light microscopy used in conjunction with the qualitative nitroblue tetrazolium assay for superoxide anion (O2-) release demonstrated dramatic differences in the binding of and respiratory burst (RB) activity elicited by promastigotes and amastigotes of Leishmania donovani in resident peritoneal macrophages (M phi) from C57BL/10ScSn mice. When amastigotes were incubated with M phi for 30 min the number of parasites per 100 M phi was 2-4-fold higher, a higher proportion of M phi became infected and the mean number of parasites per infected M phi was higher than in promastigote infections. RB activity was higher for promastigotes than amastigotes both in terms of the percentage of infected M phi containing formazan positive parasites and the percentage of individual formazan positive parasites. In an attempt to explain the differential response to promastigotes and amastigotes, RB activity was examined for sodium azide treated, glutaraldehyde-fixed and heat-killed parasites and for various transformation intermediates between amastigotes and promastigotes. Binding and RB activity were also examined in conjunction with competitive binding assays designed to determine the specific receptors involved in ligand binding of both forms of the parasite to the M phi. The results indicate that, while amastigotes may possess an azide-sensitive mechanism which either competes for O2- produced or causes localized inactivation of RB activity, this cannot account for the full magnitude of the difference between the two forms of the parasite. The transformation and competitive binding studies suggest that the more likely explanation lies in both qualitative and quantitative differences in the distribution of surface ligands involved in binding the parasite to the M phi plasma membrane and that the well characterized mannose/fucose receptor may be important in promastigote, but not amastigote, binding and RB activity. PMID- 6490089 TI - The development of IgE-suppressive immunocompetence in young animals: influence of exposure to antigen in the presence or absence of maternal immunity. AB - Previous studies recognized a prolonged suppression of egg-albumin (EA)-specific IgE responsiveness in the progeny of immunized female rats, and showed that an identical effect was produced by the administration of small amounts of specific IgG during the first few days of life. Both manipulations also elevated the primary IgG response to a subsequent immunization but with less consistency. We have now investigated the effects on the progeny of varying the type of maternal response by immunizing with antigen given with or without adjuvant. Mothers immunized with EA without adjuvant (by mouth or parenterally) in whom both IgE and IgG responses are thereby suppressed do not influence the antibody responsiveness of their progeny. By contrast, mothers immunized with EA in adjuvant, a procedure which suppresses IgE but enhances IgG responsiveness to the antigen, transfer both effects to their offspring. In this way, both IgE suppression and IgG-enhancement are seen to correlate with the transmission of maternal IgG. EA administered either by mouth or parenterally in the period up to 6 weeks after birth, suppresses both IgE and IgG responses to subsequent specific challenges in a dose-dependent manner. The results of feeding antigen to the progeny of (IgG-transmitting) immune mothers indicated that passive and active immunity in the young rat, although both suppressing IgE-responsiveness, do not have additive depressive effects. PMID- 6490092 TI - Brugia pahangi: serum-dependent cell-mediated reactions to sheathed and exsheathed microfilariae. AB - The immune mechanisms operating on the sheath and the cuticle of the Brugia pahangi microfilariae have been studied in vitro. The intact and exsheathed parasites were used for this purpose with serum from albino rats immunized with sonicated homogenates of the parasites as the source of antibodies. The IgG component of the serum was found to promote adherence of rat leucocytes and death of the sheathed and exsheathed parasites in presence of fresh normal serum. EDTA and EGTA abolished the adherence activity suggesting the involvement of complement components via the classical pathway. Both macrophages and neutrophils participate in this reaction. Eosinophils exhibit marginal activity only on exsheathed parasites. The intensity of adherence and killing by neutrophils in the presence of immune serum was greater with the exsheathed microfilariae than with the sheathed ones. PMID- 6490091 TI - The transfer of immune complexes from the lumen of the small intestine to the bloodstream in sucking rats. AB - The epithelial cells along the small intestine of the sucking rat display specific receptors for IgG. These permit the uptake and transcellular transport of IgG, usually presented in milk, from the gut to the bloodstream. Antigen already combined with IgG may also gain access to the bloodstream by this route, but no data exists to show whether this could be sufficient to immunize or to induce tolerance in the young rat to a future exposure to antigen. Monoclonal IgG1 antibody to horseradish peroxidase was used in order to quantitate such a transfer of antigen, using the electron microscope and also studies with radiolabelled antigen and/or antibody. It was found that much less intact antigen was transferred to the bloodstream than would have been calculated from the quantity of antibody transported. Also, IgG1 combined with antigen was more likely to be broken down intracellularly than free IgG1. This was compared with the transport across rat hepatocytes of monoclonal polymeric IgA anti-horseradish peroxidase. The transfer of polymeric IgA from blood to bile was the same whether or not the IgA was complexed with antigen. However, as for the IgG system, less antigen was transported intact into bile than might have been expected theoretically. PMID- 6490090 TI - Contribution of intraperitoneal immunization to the local immune response in the respiratory tract of sheep. AB - The contribution of gut-associated lymphoid tissue (GALT) to the local immune response in the respiratory mucosa of sheep has been investigated. Sheep were primed intraperitoneally (i.p.) with antigen in Freund's complete adjuvant, a procedure known to produce a large IgA-specific antibody-containing cell (ACC) response in intestinal lymph. ACC and their class specificity were then enumerated by double fluorochrome immunofluorescence in respiratory tissues after intratracheal (i.t.) antigen administration. This immunization procedure produced an enhanced IgA-specific ACC response in the upper respiratory tract mucosa compared with either i.t. or i.p. immunization alone and this was not reflected in the regional lymph nodes. Furthermore, chronic drainage of the intestinal efferent lymphatic duct for the duration of the immunization period abrogated the enhanced response in the respiratory mucosa. These data are consistent with the concept of an intermucosal cell circuit with respect to IgA cell precursors, and provide indirect evidence that IgA responses in the respiratory tract can be enhanced by harnessing the immune potential of GALT as a source of IgA precursors by appropriate immunization strategies. PMID- 6490093 TI - Lack of IgA subclass restriction in antibody response to phosphorylcholine, beta lactoglobulin and tetanus toxoid. AB - Although there is IgG subclass restriction in the antibody responses to most antigens, our data indicate that the human IgA subclasses, IgA, and IgA2, do not demonstrate a similar antigen specific restriction. We did not find evidence for IgA subclass restriction in the antibody responses to phosphorylcholine (PC), beta lactoglobulin or tetanus toxoid. These antigens were chosen to represent carbohydrate-like versus protein antigens and antigens presented through the mucosal route versus the humoral route. For each of these antigens the proportion of antigen specific IgA that was IgA1 and IgA2 was similar to that of total serum IgA. IgA anti-PC, which is thought to be directed against the phosphorylcholine moieties found on certain bacterial polysaccharides, could be found in the serum of all individuals tested and constituted 0.063-0.088% of the total serum IgA. IgA anti-beta lactoglobulin and anti-tetanus toxoid could be measured only in the serum of selected individuals, usually those with known milk protein sensitivity, or those recently immunized with tetanus toxoid. The lack of marked subclass restriction of IgA responses to these antigens stands in contrast to results obtained by others for IgG antibodies, in which carbohydrates and proteins preferentially stimulate antibodies in different IgG subclasses. PMID- 6490094 TI - Antisera specificities to 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide adducts of proteins. AB - Animals were immunized with either 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDCI)-coupled peptide hapten-protein carrier conjugates or with N-acylurea EDCI derived protein carrier. Sera from all animals demonstrated antibody to N acylurea EDCI when tested by double immunodiffusion using N-acylurea EDCI coupled to a heterologous carrier. Two rabbit antisera, one produced to EDCI-coupled peptide-24-thyroglobulin and another produced to N-acylurea EDCI derived thyroglobulin were further characterized using an enzyme-linked immunosorbent assay (ELISA). Competitive binding assays using either EDCI-coupled peptide protein conjugates or N-acylurea EDCI derived proteins demonstrated the presence of N-acylurea EDCI reactive antibodies. Such antibodies were also shown to react with the EDCI isourea employed as inhibitor. The specificity of the anti-EDCI antibodies to portions of the EDCI molecule was demonstrated using structural analogues of EDCI. Both 3-dimethylaminopropylamine and 2-dimethylaminoethanol effectively inhibited anti-N-acylurea EDCI reactivity. These results show that when EDCI is used as a coupling agent, antibody is produced to N-acylurea EDCI carrier, the antibody being primarily directed to the 3-dimethylaminopropyl end of the EDCI molecule. PMID- 6490095 TI - Anti-tumour cytotoxin from macrophages: no correlation between cytotoxin adsorption by tumour cell lines and their cytotoxin susceptibility. AB - Mononuclear phagocytes can synthesize a cytotoxin, similar to that in tumour necrosis serum, which is cytotoxic to certain tumour cell lines in vitro. This study has investigated whether susceptibility and resistance to the cytotoxin can be explained in terms of the amount of cytotoxin receptor expressed on the tumour cell surface. Binding of cytotoxin has been quantitated both by direct adsorption and competitive inhibition assays with cytotoxin-resistant or -susceptible tumour lines and with sublines of susceptible lines, selected for resistance to the cytotoxin. For both rabbit and human cytotoxin, there was no correlation between cytotoxin adsorption by tumour cell lines and their cytotoxin susceptibility, suggesting that resistance to the cytotoxin is expressed at a post-receptor stage. Preliminary studies on the cytotoxin receptor of K562 cells have shown that it is probably not the transferrin receptor, and that protein but not carbohydrate is essential for its function. PMID- 6490096 TI - Antibody-dependent cellular cytotoxicity and chemiluminescence as a tool for studying the mechanism of anti-glomerular basement membrane nephritis. The role of the cytotoxic potential of polymorphonuclear granulocytes and monocytes. AB - An in vitro system was elaborated to study the mechanisms inducing tissue injury in anti-glomerular basement membrane (GBM) nephritis. Collagenase-digested GBM (CGBM) was covalently attached to Fab' specific for chicken red blood cells (CRBC). The preparation of the CGBM-Fab' conjugate was effected by using iodoacetyl chloride coupling in analogy to a procedure described by Chiang & Koshland (1979). This conjugate was used for coating CRBC (CGBM-CRBC). In this system the antibody-dependent cellular cytotoxicity (ADCC) and the chemiluminescence mediated by purified bovine polymorphonuclear (PMN) and mononuclear cells (MNC) as well as rabbit MNC against CGBM-CRBC were compared in the presence of sheep anti-GBM IgG. All three cell populations were potent effectors in ADCC and chemiluminescence and evidence was obtained that the cytotoxic potential of MNC has to be attributed to monocytes. If compared at low effector target cell ratios in a 2 hr assay bovine PMN, however, were significantly more efficient than bovine MNC. The extent of both ADCC and chemiluminescence was directly related to the amount of anti-GBM IgG present in the system. Based on the inhibition experiments with oxygen intermediate scavengers, both ADCC and chemiluminescence by bovine PMN is dependent on generation of reactive oxygen species indicating that such radicals could play a role in vascular (endothelial) injury as documented in the loss of structural integrity of GBM. PMID- 6490097 TI - Complement-induced granulocyte adhesion and aggregation are mediated by different factors: evidence for non-equivalence of the two cell functions. AB - Cell-cell aggregation and cell-substratum adherence, two functional manifestations of granulocytes of potential clinical relevance, are widely considered to result from identical cell membrane alterations. Our study casts doubt on this assumption and defines the complement-derived adhesion-inducing (pectic)/enzyme releasing activity as an entity that is clearly separable from the chemotactic/aggregating activity (C5adesArg). Using selective activators of the alternative and the classical pathway of the complement system, unexpected dissimilarities were observed. Adhesion inducing potency that went in parallel with secondary granule content liberation, and respiratory burst activation (hexose monophosphate shunt activation), was confined to alternate pathway activators, was heat-labile (50 degrees) and could be inhibited by the protease inhibitor di-isopropylfluorophosphate. In contrast, plasma activated with aggregated gamma-globulin or cobra venom factor had no pectic/burst activating capacity but was equally potent in inducing heat- and DFP-resistant chemotactic aggregating activity. It was further shown that, even in the presence of cytochalasin B, C5adesArg (evoked in whole plasma) does not liberate secondary granule constituents. These findings were corroborated by using highly purified C5adesArg. Our data suggest that the complement system plays a dual role in PMN accumulation at the inflammatory focus: whereas C5adesArg orientates cellular movement toward the site of bacterial invasion, the complement-dependent pexin(s) is mainly involved in confining infections localized by the adhesion-induced trapping of highly reactive cells. PMID- 6490098 TI - [Round table: Scleroderma and esophageal changes]. PMID- 6490100 TI - [The sclerodermatous esophagus: clinical and radiologic aspects]. PMID- 6490099 TI - [Scleroderma and esophageal changes: treatment and instrumental control]. PMID- 6490101 TI - [Diagnosis and follow-up of sclerodermatous esophagopathy by electromanometry]. PMID- 6490102 TI - [Various visceral changes in scleroderma]. PMID- 6490103 TI - [Dyskinetic pathology of the esophagus in progressive systemic sclerosis]. PMID- 6490104 TI - [Esophageal changes in scleroderma]. PMID- 6490105 TI - [Dermatogenic enteropathy]. PMID- 6490106 TI - [Peristomal dermatitis]. PMID- 6490107 TI - [Peristomal dermatitis. Our experience at the Stoma Rehabilitation Center of the M. Bufalini Hospital of Cesena]. PMID- 6490108 TI - Analysis of the B-G antigens of the chicken MHC by two-dimensional gel electrophoresis. AB - The B-G antigens of the chicken major histocompatibility complex (MHC) have been analyzed by high resolution two-dimensional (2-D) gel electrophoresis. Monoclonal antibodies recognizing a widely shared B-G determinant were used for immunoprecipitating the B-G antigens from radioiodinated, detergent-solubilized erythrocyte membrane preparations. The B-G antigens produce a variety of patterns on 2-D gels. The number of polypeptides within a B-G pattern varies among haplotypes from single polypeptide arrays showing slight microheterogeneity to complex patterns which contain as many as four or five polypeptide arrays differing in relative mobility and isoelectric point. Many of the patterns, but not all, include a polypeptide of Mr = 48 kd focusing near pH 6.9. At present it is not understood whether the multiple polypeptides within some B-G patterns represent the expression of multiple B-G genes or whether they are the result of modifications of single gene products during biosynthetic processing. 2-D gel analyses were also used to confirm the assignment of the same B-G haplotype in several different inbred flocks and the fate of the B-G antigens in two B system recombinant haplotypes. The 2-D gel patterns of these highly polymorphic antigens provide evidence for a complexity of the B-G locus not previously demonstrated. This technique may serve to define more objectively the diverse chicken MHC haplotypes which are now recognized and characterized only by serological techniques using alloantisera and monoclonal antibodies with varying cross reactivities. PMID- 6490109 TI - Partial C4 deficiency in subacute sclerosing panencephalitis. AB - In an immunogenetic study, 23 subacute sclerosing panencephalitis (SSPE) patients and their families were studied for the HLA region markers HLA-A, B, C, DR, BF, C2, C4A, C4B, GLO I, and PGM3. In addition, C3, C4, and factor B serum levels were determined. A highly significant association of C4A QO with SSPE was found. Furthermore, two rare haplotypes, C4A QOB QO, two C4ACh+ allotypes, and four Ch partial inhibitors were detected, which possibly impair the function of the C4 molecules. HLA-DR5 was increased. In addition, a number of rare HLA-A, C, B, DR haplotypes were observed. It is postulated that rare C4 molecular deficiency might be a predisposing factor in the pathogenesis of SSPE. PMID- 6490110 TI - Identification of class I major histocompatibility complex encoded molecules in the amphibian Xenopus. AB - Class I-like molecules have been immunoprecipitated from Xenopus leukocytes and erythrocytes with alloantisera directed against major histocompatibility complex (MHC)-linked antigens. The heavy chains, depending on the allele examined, have molecular weights of 40 000-44 000 of which 3000 daltons are asparagine-linked carbohydrates, probably present as one N-linked glycan. The presumed analogue of beta 2-microglobulin has a molecular weight of 13 000 and bears no asparagine linked glycans. Family studies show that the heavy chains are encoded by genes residing in or closely linked to the MHC. PMID- 6490111 TI - Complement fixing antibodies in patients of suspected subacute sclerosing panencephalitis in Delhi. PMID- 6490112 TI - Granulocyte adherence in leprosy. PMID- 6490113 TI - Campylobacter fetus ssp jejuni as seen in Bangalore. PMID- 6490114 TI - Action of bioflavonoids on lipid peroxidation & glutathione redox system in hypercholesterolemic rats. PMID- 6490115 TI - Lithium-induced changes in brain amino acids, alpha-ketoacids & transaminases. PMID- 6490116 TI - Tensile properties of human umbilical cord. PMID- 6490117 TI - Different types of massive small bowel resection & hyperchlorhydria. PMID- 6490118 TI - Use of low ionic strength solution in blood group serology. PMID- 6490119 TI - Effect of quinine on phagocytic functions of normal rhesus monkey (Macaca mulatta) monocytes. PMID- 6490120 TI - Connective tissue necrosis after cold injury. PMID- 6490121 TI - A preliminary aero-biological survey in a Virginia tobacco farm during harvesting. PMID- 6490122 TI - Hypocholesteremic activity of different fractions of garlic. PMID- 6490123 TI - Angularis oculi vein temperature variations related to man's mental activity- preliminary studies. AB - This preliminary study describes a noninvasive, inexpensive approach to the study of lateralization as related to mental activity. It supports the concept of a thermoregulatory role of blood in cerebral temperature control. Right and left angularis oculi vein temperatures were measured during periods of mental activity and mental rest and both temperature changes were asymmetrical. There was a consistent temperature drop during thinking, with a consistent rise after thinking ceased. Heat loss from superficial vessels of the buccal region and nasal mucosa to the ambient air was evident which caused lowering of the venous blood temperature flowing towards the cavernous sinus. This drop in blood temperature of angularis oculi veins coincided with increased brain metabolism and heat production occasioned by an increase in the level of mental activity and oxygen utilization. PMID- 6490124 TI - Evidence for the presence of osmoreceptors in medulla of the dog. AB - Hypertonic solutions of different substances were injected into the vertebral artery of dogs anesthetized with chloralose, preventing their access to the hypothalamic osmoreceptors by ligating the basilar artery and both the external carotid arteries. The hypertonic solution of sodium chloride produced graded inhibition of water diuresis and a concomitant rise in plasma antidiuretic hormone (ADH) level; hypertonic solution of glucose produced lesser effect. Hypertonic urea solution, on the other hand, did not alter the course of water diuresis. It was concluded that osmoreceptors are also present in the medulla which sense the changes in blood osmolarity and accordingly modify the ADH release. PMID- 6490125 TI - The reversal by metoclopramide of apomorphine-induced inhibition of responses to stimulation of the cardioaccelerator nerves in the cat. AB - The effect of metoclopramide on presynaptic dopamine receptors was investigated in the cat cardioaccelerator nerve preparation. Metoclopramide, a substituted benzamide derivative, antagonized inhibitory action of apomorphine on positive chronotropic responses induced by sympathetic nerve stimulation in cat hearts, in vivo. Neither phentolamine, an alpha-adrenergic blocking agent, nor indomethacin a prostaglandin synthesis inhibitor, antagonized the effect of apomorphine. Apomorphine did not alter the positive chronotropic effects of intravenously administered noradrenaline. Metoclopramide potentiated stimulation-induced positive chronotropic responses. These results suggest that metoclopramide blocks the presynaptic dopamine receptors at the cat heart. PMID- 6490126 TI - Inability of amphotericin B(Fungizone) or of sodium deoxycholate to alter natural drug resistance or sensitivity of transplanted murine leukemias. AB - The ability of Amphotericin B ('Fungizone') to alter the natural resistance of leukemia L1210 to vincristine was studied in BDF1 mice Neither Fungizone nor the "solubilizing agent" sodium deoxycholate, when used in combination with vincristine potentiated the activity of the drug against L1210. There was no change in the activity pattern of 5-fluorouracil against L1210 or vincristine against P388 lymphocytic leukemia respectively, which are sensitive to these drugs. Thus, both Fungizone and sodium deoxycholate failed to improve the activity of the drugs in either a naturally resistant or sensitive murine leukemia in vivo. PMID- 6490127 TI - Effect of change in limb position on mean electrical axis and amplitudes of QRS complex of rat electrocardiogram. AB - The effect of altered fore limb alignment to trunk on mean electrical axis (MEA) and on amplitude of the QRS complex of frontal plane leads was studied in both prone and supine postures in 32 albino rats. It was found that in both postures bilateral extension of fore limbs caused a significant change in MEA to right. Unilateral change in the fore limb alignment caused a shift in MEA to right only in supine position, but was ineffective in prone position. The amplitudes of QRS complexes also changed with change in MEA. The changes in MEA with change in limb alignment and subsequent alteration in amplitude of QRS complexes can be attributed to the alteration in anatomical orientation of the heart in the chest cavity. PMID- 6490128 TI - The effect of malathion dust on certain tissues of male rats fed varying levels of dietary protein. AB - The effect of malathion, an organophosphorus insecticide on tissue levels of acetylcholinesterase (Ache), phosphomonoesterases and transaminases have been studied in presence of different levels of dietary proteins. Adult male albino rats weighing 150-200 gms were given 5%, 10% and 20% protein diets containing 400 mg malathion (dust) 5% conc./kg feed for 30 days. Its effect was evaluated in liver, kidney, brain, lungs and spleen and results were compared with their respective malathion dust, pair-fed animals (5%, 10% and 20% protein groups without malathion). Animals kept on low protein diets (5% and 10%) when exposed to malathion dust showed significant increase in the activities of GOT and alkaline phosphatase in liver, kidney, brain, lungs and spleen, while a marked inhibition in the activity of Ache was observed under similar treatment. GPT was decreased in kidney and lungs, in the low protein groups (5% and 10%, whereas its activity was increased in liver, brain and spleen of animals receiving 5% protein, when exposed to compared to their respective pair-fed animals. Thus, although the degree of alteration in the enzyme profile is less severe, these changes show that high protein diet has a protective role against pesticide hazards, whereas low protein diet provides less stability to the structural integrity of the tissues. PMID- 6490129 TI - Correlation of blood groups with congenital disorders and gastro intestinal diseases. AB - Blood group studies were conducted in 330 patients suffering from gastro intestinal disorders and 180 patients with congenital malformations and compared with normal subjects. Statistical analysis has shown that (a) there is significant correlation between B group and thalassaemia, (b) congenital malformations show higher incidence in B and O groups. It would be pertinent to draw attention to the fact that B group was found to be significantly correlated to duodenal ulcer from the present study contrary to the early reports. In addition, these observations show that blood groups are linked with diseases. PMID- 6490130 TI - Impact of scorpion Heterometrus fulvipes venom on cholinesterase rhythmicity in the tropical mouse Mus booduga. AB - Rhythmicities of acetylcholine (ACh) and acetylcholinesterase (AChE) were studied in the mouse, Mus booduga (Gray), following intramuscular injection of scorpion, Heterometrus fulvipes (C. Koch) venom. Envenomation inhibited the activity levels of ACh and AChE in all the tissues selected for experimentation. Control animals exhibited diel rhythmicity in ACh and AChE while envenomated animals showed fluctuation in the Phase (delta phi), amplitude (A), Acrophase (phi) and the extreme activity hours (X and X1). PMID- 6490132 TI - Spirometric data in South Indian subjects 60-80 years of age. AB - Forced expiratory and inspiratory vital capacities and the timed expiratory and inspiratory volumes and forced expiratory and inspiratory flow rates were determined in 50 old men and women between 60-80 years of age. Some of the ratios between expiratory and inspiratory volumes and flow-rates that have been found to be useful for detecting some forms of ventilatory defects are also given. PMID- 6490131 TI - Effects of body weight on taste of male and female rats. AB - Single-choice taste (solution and mixed-diet) tests revealed that ad lib fed male rats with increasing body weight showed increased intake on sweet taste as compared to intake of identically aged ad lib fed female rats with static body weight. On meal-time (3 hr) and meal-size (50% diet) restrictions though rats of either sex increased on intake of sweet taste, the increment shown by female was higher and it was correlated with their greater % loss in bw. Hence it appears that the basis for sweet taste preference is the mismatch between actual and target body weight irrespective of sex of animal. PMID- 6490133 TI - Purgative and anthelmintic effects of Mallotus philippinensis in rats against tape worm. AB - A resin isolated from Mallotus philippinensis (Kamala) caused a significant purgative effect after an oral dose (120 mg/kg) in rats as assessed from the weight of faeces as well as from the surface area of blotting paper soaked by liquid faeces. The anthelmintic effect of the resin was evaluated in albino rats found to be infested with tape worms. The resin in 60 and 120 mg/kg dose had a lethal effect on 35.69% and 78.21% population of tape worms respectively, in small intestine. PMID- 6490134 TI - Activity of some anti-inflammatory agents against carrageenin-induced pedal oedema in mice. PMID- 6490135 TI - Amphetamine anorexia and metoclopramide. PMID- 6490136 TI - Effects of high-dose methotrexate on rat alveolar and inflammatory macrophage populations. AB - Methotrexate (MTX) is used clinically in high doses to treat a variety of neoplastic diseases. Although it has been recognized that such aggressive chemotherapy can result in suppression of cellular host defense mechanisms, phagocytic cell function during MTX therapy remains poorly understood. The present study was designed to examine the effects of a single high dose of MTX on alveolar and inflammatory peritoneal cell populations in the rat. Male Sprague Dawley rats were treated with a single intraperitoneal injection of MTX (25 or 50 mg/kg) and subsequent alterations in the composition of peripheral blood white cells (WBC), a peritoneal inflammatory exudate, and the resident alveolar macrophage (AM) were measured 1-4 days after MTX treatment. A severe depression in the polymorphonuclear leukocyte (PMNL) and monocyte populations in the peripheral blood was observed 72 and 96 h after either dose of MTX. Similarly, the total number of peritoneal exudate cells, collected 72 h after a caseinate inflammatory stimulus, was reduced by 50% after MTX treatment. When the cellular composition of the peritoneal exudate was examined, it was observed that macrophage and lymphocyte numbers were selectively depressed. In addition, the number of AM obtained by lung lavage was significantly reduced 72 and 96 h after MTX injection. Although both peritoneal and alveolar macrophage numbers were diminished, in vitro phagocytic activity was not impaired 72 h after MTX injection. These studies demonstrate that a single, clinically relevant dose of MTX, in addition to depressing PMNL and monocyte levels in the peripheral blood, can also impair the accumulation of macrophages at a site of tissue injury and the influx of macrophages into lung alveoli. These findings suggest that the capacity of the mononuclear phagocyte system to respond to an infectious or tumor cell challenge may be severely compromised during MTX treatment. PMID- 6490139 TI - Pediatricians and the Indian National Code for Protection and Promotion of Breast feeding. PMID- 6490137 TI - Degranulation of polymorphonuclear leukocytes is induced by multivalent cross linking of wheat germ agglutinin binding site(s) on cell membrane. AB - Polymorphonuclear leukocyte (PMN) surface membrane glycoproteins very likely are involved in the phenomenon of stimulus-response coupling. Previously, we have shown that subagglutinating concentrations of the plant lectin, wheat germ agglutinin (WGA) specifically and irreversibly inhibited N-formyl-methionyl leucyl-phenyl-alanine (FMLP)-mediated PMN chemotaxis. WGA did not affect the binding of [3H]FMLP to its receptor on the PMN plasma membrane. We have examined the possibility that cross-linking of WGA binding sites may elicit PMN degranulation. We have found that multivalent, but not bivalent, cross-linking of WGA bound to PMNs elicits release of lysosomal constituents. This phenomenon was specific for WGA since it did not occur when concanavalin A (Con A), instead of WGA, was used. It is intriguing to speculate that WGA may attach to a "physiologic" receptor for FMLP on the PMN membrane and that redistribution (cross-linking) of this receptor might be an early event in the activation of PMNs by FMLP. PMID- 6490138 TI - Experimental monoarthritis. Modulatory effect of injected eosinophils on influx of various types of inflammatory cells. AB - Bovine serum albumin (BSA) in complete Freund's adjuvant (CFA) was injected into the knee joints of previously BSA-sensitized guinea pigs and rabbits. The primary immune reaction to BSA prevented secondary immune response to Trichinella larvae infection. We were unable to produce either eosinophilia in the peripheral blood or antibodies against Trichinella antigen (shown by complement fixation test). The additional injection of mediators of the inflammatory reaction or their precursors, e.g., complement component C5 and arachidonic acid, caused different histological pictures. C5 produced a prolonged acute inflammatory phase with abundant neutrophils, whereas arachidonic acid did not significantly change the inflammatory response as compared to controls. The additional application of eosinophil-enriched preparation (EEP) caused a conspicuously reduced influx of monocytes/macrophages, a reduction of lymphocyte numbers, a prolonged influx of neutrophils, increased arylsulfatase activity, earlier reduction of the inflammatory process, and earlier onset of synoviocyte regeneration as compared to controls. PMID- 6490140 TI - Fecal leucocytes in acute diarrhea. PMID- 6490141 TI - Low birth weight infants--study of mortality. PMID- 6490142 TI - A community survey of infant feeding practices in Berhampur, South Orissa. PMID- 6490143 TI - Haptoglobin status in thalassemia. PMID- 6490144 TI - Cockington nomogram as a guide to phototherapy in the management of neonatal hyperbilirubinemia: evaluation in Indian neonates. PMID- 6490145 TI - Serum lipids and lipoprotein values in children of coronary artery disease parents. PMID- 6490147 TI - Behcet syndrome. PMID- 6490146 TI - Epidemic dropsy in Delhi. PMID- 6490148 TI - Lesch Nyhan syndrome. PMID- 6490149 TI - Round pneumonia in a young infant. PMID- 6490150 TI - BCG vaccination. PMID- 6490151 TI - Indian National Code for Protection and Promotion of Breast-feeding. PMID- 6490152 TI - Myocardial contusion associated with fracture of the sternum: important features of the seat belt syndrome. AB - Recent legislation has led to increasing numbers of car occupants wearing seat belts and presumably the number of injuries attributable to seat belts will also increase. The commonest such injury is a fracture of the sternum, and blunt myocardial damage is a logical sequel although often unsuspected and therefore unsought. Confirmation is difficult and ECG changes are usually absent or not specific. In three consecutive patients admitted with a fractured sternum we found raised blood levels of CK-MB (creatine kinase-myocardial band) and believe these indicate myocardial contusion. We therefore feel that an isolated fracture of the sternum should be considered a more serious injury than is initially apparent, as these patients are at risk of developing cardiac complications. PMID- 6490153 TI - The management of type III open tibial fractures. AB - In extensive type III open tibial fractures, limb salvage is considered worthwhile when there is good distal circulation and nerve function. The use of the external fixator has revolutionized the management of skin and soft tissues. However, the subsequent morbidity is still high. A retrospective study of 17 cases is analysed: the amputation rate was 6 per cent, delayed union 60 per cent, infected non-union 30 per cent and mal-union 40 per cent. The final functional result was good in 13 per cent of cases, satisfactory in 30 per cent, fair in 30 per cent and poor in 27 per cent. All patients preferred a functional limb to a prosthesis. The technique of using external fixation and the subsequent management are discussed. To improve the result, we recommend perfect alignment, fixation of the fracture with semi-rigid external fixation and early cancellous bone grafting for comminuted fractures and bone loss. Secondary internal fixation using implants is not advisable. A radical approach is necessary in infected ununited fractures. This includes excision of dead and contaminated tissue and the insertion of gentamicin methyl methacrylate bead implants. Although the complication rate is high and the rehabilitation period is prolonged, the main aims of limb salvage, viz. to retain a functional leg, are largely fulfilled. PMID- 6490154 TI - Irreducible displacement of the distal radial epiphysis complicating a fracture of the lower radius and ulna. AB - Open reduction of complete displacement of the distal radial epiphysis in an 11 year-old boy is reported. Difficulty was encountered in dealing with an associated radial diaphyseal fracture at a higher level, an open fracture of the distal ulna and an ulnar nerve injury. The rarity of this combination is discussed. PMID- 6490155 TI - Subtrochanteric fracture after Garden screw fixation: a review of predisposing factors and management in nine cases. AB - Nine cases of subtrochanteric fracture are reviewed following 300 fixations of subcapital fractures with Garden screws. In six cases technical operative errors were considered to contribute to the fracture. It is stressed that adequate reduction and suitably placed crossed Garden screws are demanding requirements and that every attempt should be made to avoid making extra holes with guidewires. In two technically satisfactory cases the low position of the lower Garden screw-hole in the femur probably predisposed to the subtrochanteric fracture. A computerized two-dimensional finite analysis confirmed smaller magnitudes of stress at a more proximally positioned lower Garden screw, and in patients at risk, particularly those with a valgus femoral neck or valgus reduction, it is suggested that if this method of internal fixation is to be used, the screws should be crossed less obliquely, with the lower screw more proximally positioned in the femur. PMID- 6490156 TI - Closed Rush pinning of fractures of the humeral shaft. AB - Twenty-three simple and pathological fractures of the shaft of the humerus were treated by insertion of a Rush pin through the greater tuberosity, without exposing the fracture site. An image intensifier was used during the insertion of the pins. This technique results in few complications with simple fractures, and in pathological fractures relief of pain can be achieved without exposing the fracture site or surrounding soft tissues, which are often diseased. PMID- 6490157 TI - Elbow function following tension band fixation of displaced fractures of the olecranon. AB - Fifty-two patients were reviewed following displaced fractures of the olecranon fixed by the tension band technique. Symptoms, range of movement and strength in flexion and extension were assessed, together with the accuracy of reduction. Eighty-five per cent of patients regained very good function. The results confirm that tension band fixation can yield excellent functional results whatever the degree and severity of fracture of the olecranon. The wires must be totally buried to allow full excursion of the triceps tendon. PMID- 6490158 TI - Functional index: a numerical expression of post-traumatic wrist function. AB - Accurate functional assessment is an essential part of the analysis of managing fractures. A new technique for the measurement of the wrist's function is described. Observations of a wrist's performance are made using three devices. A dynanometer records movement while acting against a resistive torque. Angular and rotational movement at the wrist is measured using a three-dimensional goniometer. A vigorometer is used to assess the strength of grip. The three derived measurements give a functional index for each patient. Eighty-nine patients sustaining fractures at the wrist were seen at the time of trauma and at an assessment clinic 6 months later. Statistical analysis has shown that all three measurements are necessary to assess function. A functional index has applications in clinical work and research. PMID- 6490159 TI - Irrigation drainage with intracatheter in severe infections of the hand. AB - Severe infections of the hand and fingers still challenge the surgeon's skill in spite of modern antibiotics. Very often patients are referred too late, with inadequate incisions and insufficient drainage. In addition, wound edges tend to seal up rapidly, even if no sutures are inserted. In the management of such infections we have successfully introduced an irrigation drainage system, using a common intracather (I-Cath). The method described here is simple, atraumatic and shortens the time of treatment. PMID- 6490160 TI - Secondary carcinoma simulating a pulp infection. AB - Pulp infections are second in frequency to paronychia among infections of the hand (Hamilton Bailey, 1977) Metastatic carcinoma involving the fingers, however, is very rare (Norman and Leventhal, 1966; Martin and Dove, 1983; Schulz and Kearns, 1983). A case is reported to illustrate that a secondary carcinoma from a lung primary can present itself as a pulp infection, with a poor prognosis. PMID- 6490161 TI - Acute carpal tunnel syndrome caused by fracture of the scaphoid and the 5th metacarpal bones. AB - A case of acute carpal tunnel syndrome in a 19-year-old girl is described. She sustained undisplaced fractures of the right scaphoid and 5th metacarpal bones during a motorcycle collision with a deer. The carpal tunnel syndrome developed within 3 hours of the accident and the diagnosis was easily established since she developed intense pain in her wrist, together with paraesthesiae in the distribution of the median nerve. The carpal tunnel was decompressed within 1 hour of the onset of the symptoms, revealing a fracture haematoma under pressure. The pain disappeared immediately and the sensation was next to normal within 12 hours and completely normal within 3 weeks. PMID- 6490162 TI - A colocutaneous fistula occurring 50 years after a shotgun injury. AB - Traumatic fistulae of the gastrointestinal tract are usually acute processes which occur at the time of, or shortly after, the injury. Because of its rarity, we report here a case of a colocutaneous fistula that developed 50 years after a shotgun wound of the abdomen. PMID- 6490163 TI - Fracture and herniation of bowel at bone graft donor site in the iliac crest. AB - Fracture at a bone graft donor site in the iliac crest is an uncommon but documented occurrence. Herniation at this site requires a deep dehiscence of the wound, and is rare. A patient is reported with complete wound dehiscence in association with a fracture at a bone graft donor site in the iliac crest. PMID- 6490164 TI - Pathological fracture of the humerus in a young adult with Paget's disease of bone. PMID- 6490165 TI - Fatal complications of the surgical treatment of distal fractures of the femur. AB - Two deaths following the insertion of a Kuntscher nail and cement fixation of distal femoral fractures of the femur are described and the possible aetiology is discussed. PMID- 6490166 TI - [Pathogenesis of staphylococcal infections of implanted plastics and intravascular catheters]. AB - Coagulase-negative staphylococci are the predominant organisms causing infection of intravasal catheters and implanted plastic material. They are able to adhere to and grow on polymer surfaces. During the course of colonization they produce large amounts of an extracellular slime substance by which they are finally covered completely. It is supposed that this matrix of slime protects the embedded staphylococci against antibacterial substances and natural host defenses. The slime substance is not a true capsule but is loosely bound to the staphylococcal cells. It seems to have interesting biological properties such as an adhesin-like function and the ability to inhibit the lymphoproliferative response of mononuclear cells. PMID- 6490167 TI - Clinicopathological response of HBsAg-positive chronic active hepatitis to adenine arabinoside: lack of correlation with DNA polymerase response. AB - Fifteen patients with HBsAg-positive, severe chronic active hepatitis, nine DNA polymerase (DNAP)-positive and six negative were treated with intravenous adenine arabinoside (Ara-A) in a dose of 10 mg/kg/day for five consecutive days during each of two consecutive weeks. Of the DNAP-positive patients, two responded with histological and clinical remission as well as permanent loss of DNAP. However, histological and clinical remission were also observed in patients with unsatisfactory DNAP response and even in DNAP-negative patients. It is suggested that, in addition to its antiviral effect, Ara-A might have another mechanism, such as immunosuppression, that induced histological and clinical remission. Alternatively, the discrepancy of response might relate to the natural course of chronic type B hepatitis. Accordingly, controlled trial is mandatory for assessing the effect of Ara-A or any other agent in the treatment of chronic type B hepatitis. PMID- 6490169 TI - Spinal epidural abscess: an unusual complication of bacterial endocarditis. AB - We are reporting a case of epidural abscess complicating bacterial endocarditis. To the best of our knowledge, this association has not been reported before. Streptococcus sanguis was isolated from the blood. A full recovery followed surgery and antibiotic therapy. The relevant characteristics of both diseases are reviewed. No explanation for this rare association is available as yet. PMID- 6490168 TI - Bacterial-mycotic liver abscess in a non-immunocompromised host. AB - We are presenting the case of a 70-year-old, formerly healthy patient. Seven weeks after abdominal surgery, a liver abscess was diagnosed by sonography and aspiration. Cultures revealed a mixed bacterial-fungal etiology. Treatment with irrigation (povidone iodine) and parenteral mezlocillin failed. Final cure was only achieved when long-term treatment with piperacillin and miconazole was initiated and abscess drainage removed. PMID- 6490170 TI - Actinobacillus actinomycetem-comitans endocarditis in a child with a prosthetic heart valve. AB - The first case of Actinobacillus actinomycetem-comitans endocarditis in a child with a prosthetic cardiac valve is reported. Endocarditis was possibly caused by dental work done without antibiotic prophylaxis four weeks prior to admission. PMID- 6490171 TI - Brain abscess due to Streptobacillus moniliformis and Actinobacterium meyerii. AB - This paper deals with a case of brain abscess due to Streptobacillus moniliformis (the cause of the streptobacillary type of rat-bite fever) and Actinobacterium meyerii. Brain abscesses due to these micro-organisms are rare. The possible causative mechanisms in this particular case and the diagnostic and therapeutic management of brain abscesses in general are discussed. PMID- 6490172 TI - Serratia rubidaea isolated from a silastic foam dressing. AB - A pigment-producing strain of Serratia rubidaea was isolated from two consecutive cultures from a sponge of silastic foam used as a dressing for chronic crural ulcers. The bacterium caused a red discolouration of the sponge and the surrounding part of the leg. The silastic sponge creates a new type of environment for microorganisms. The growth of previously rare bacteria such as S. rubidaea may be favoured by conditions within the sponge. PMID- 6490173 TI - Fusidic acid for the treatment of antibiotic-associated colitis induced by Clostridium difficile. AB - Twenty courses of fusidic acid were given to 16 patients with antibiotic associated colitis caused by Clostridium difficile. Fusidic acid was given in a dose of 0.5-1.5 g daily for seven to 21 days. Diarrhoea disappeared rapidly. Clinical relapse occurred after five courses and once when the patient was still on treatment. Clinical cure with persistence or reappearance of toxin occurred in four further patients. Nineteen courses of metronidazole were given to 19 patients who experienced six failures or relapses. Seven courses of vancomycin were given to five patients, three of whom had had relapse. Five patients healed without treatment. The relapses occurred only in old and prostrated patients. They often recurred several times in the same patient. 0.5 g of fusidic acid daily appears to be as effective as vancomycin and metronidazole for the treatment of C. difficile-induced colitis. PMID- 6490174 TI - [Antibacterial activity of clindamycin and lincomycin in broth, serum, and in combination with polymorphonuclear leukocytes against Staphylococcus aureus and Staphylococcus epidermidis]. AB - We investigated the antibacterial activity of clindamycin and lincomycin at 1/4 X minimum inhibitory concentration (MIC), 1 X MIC and 4 X MIC against a serum resistant Staphylococcus aureus and a serum-resistant Staphylococcus epidermidis strain in broth, in serum with and without the presence of leukocytes and in Hank's medium in combination with leukocytes alone. Against both test strains, lincomycin in broth and serum was similarly effective, whereas against S. aureus clindamycin in broth was somewhat more active. In the combined test mixture of serum with leukocytes, even a 1/4 X MIC of clindamycin or lincomycin markedly improved leukocyte killing of S. aureus, whereas both compounds could not further enhance the marked leukocyte killing of S. epidermidis, even at inhibitory concentrations. In Hank's medium with leukocytes alone, clindamycin and lincomycin had at the most only a bacteriostatic effect against both test strains. PMID- 6490175 TI - Rotavirus infection and otitis media. PMID- 6490176 TI - Aspects of male endocrinology. PMID- 6490177 TI - Practical fluid therapy for small animals. PMID- 6490178 TI - Radiography: problems and reasons for poor quality. PMID- 6490179 TI - Parathyroid hormone concentration in the serum of people with cadmium-induced renal damage. AB - Serum parathyroid hormone (PTH) and renal functions were measured in thirty subjects with cadmium-induced renal damage and in the same number of control subjects. The negative correlations between PTH and creatinine clearance (Ccr) and between PTH and percentage renal phosphorus reabsorption (% TRP) were significant in the cadmium (Cd)-exposed group. Serum PTH concentrations were clearly high in two cases of the cadmium-exposed group. Their renal functions decreased severely compared with those of the other Cd-exposed people. The present study indicates that chronic cadmium intoxication could cause increased secretions of PTH, which may be related to cadmium-induced bone damage. PMID- 6490180 TI - Preliminary evaluation of dose-effect relationships for vibration induced white finger in Japan. AB - Habitual use of many vibrating tools has been found to be connected with the appearance of various disorders affecting the blood vessels, nerves, bones, joints, muscles or connective tissues of the hand and forearm. The vibration exposures required to cause these diseases are not known exactly, either with respect to vibration intensity and the vibration frequency spectrum, or with respect to daily exposure time and total exposure period. The purpose of this study is to investigate available data on the physical conditions in Japan that have caused vibration induced white finger (VWF) and attempt to establish approximate relationships between vibration conditions and prevalence of VWF. The vibration conditions were evaluated using the method of vibration assessment recommended by the International Standardized Organization, which uses the weighted vibration level of the frequency weighted, dominant, single axis component of vibration directed into the hand. A clear correlation between level, prevalence of VWF and exposure period can be found. The results also suggest the relationship between the weighted levels and latent intervals. These dose-effect relationships enable the prediction of the average latent interval for a population group and the range of progression of the disorders--all from a measurement of the vibration entering the hands. In Japanese cases, 4, 8, and 15% of VWF prevalence correspond with 10, 20, and 40% of VWF prevalence in the Draft International Standard ISO/DIS 5349 (1982) within the weighted vibration level range of 2 to 50m X s-2. PMID- 6490181 TI - 2,4-Difluoroaniline and 4-fluoroaniline exposure: monitoring by methaemoglobin and urine analyses. AB - Two possible methods for monitoring exposure to 2,4-difluoroaniline and 4 fluoroaniline have been investigated: measurement of methaemoglobin content in blood and measurement of urinary metabolites. Experiments using rats dosed by the oral route as a model system show that measurement of methaemoglobin content provides a very rapid and simple monitoring method, but is not very sensitive. Measurement of the ortho-hydroxy metabolites of the two compounds, as their benzoxazole derivatives, provides a much more sensitive, but complicated technique. Details of both methods are presented. PMID- 6490182 TI - Measurement of nitrosodimethylamine by capillary gas chromatography-mass spectrometry with the 15N-labelled compound as an internal standard. AB - Artifactual formation of N-nitrosodimethylamine during the extraction procedure from aminopyrine and nitrite was examined. The use of the basic pH condition was the most effective in preventing artifactual formation. Sulfamic acid or ascorbic acid was partially effective in preventing artifactual formation. Since significant losses of volatile N-nitrosodimethylamine occur during the extraction and concentration steps, we analyzed N-nitrosodimethylamine by combined gas chromatography mass spectrometry with 15N-nitrosodimethylamine as an internal standard. The use of a fused silica capillary column enabled us to obtain a fine separation of the chromatogram. This methodology was applied to our model experiment, which was performed to locate the formation of N-nitrosodimethylamine when a rabbit was exposed to NO2 after the administration of aminopyrine. SO3 inhaled together with NO2 was found to increase the nitrosation. PMID- 6490184 TI - Epidemiological studies of vibration disease due to brush saw operation. AB - A longitudinal study was performed to evaluate the risk for vibration disease during the period 1961-1980 among a given population of forest workers using brush saws in Japan. The vibration levels in the measurements occasionally exceeded the 60-min line proposed by the ISO/DIS 5349 in 1/3 octave bands mainly centered on 125 Hz in vertical during the sawing operations. The peak prevalence rate was 12.0% found in the cohort group beginning in 1961-1962. Thereafter, it decreased significantly and no patients with VWF were found in the cohort group beginning in 1969-1970. In the study periods, the prevalence rate was around 2, 4, 6 and 7% after 3, 7, 11 and 13 years of exposure time respectively. The incidence rate had two peaks of 2.2% in 1965 and in 1973. Among workers using brush saws, the prevalence rate and incidence rate were smaller than those of workers using various other kinds of vibrating tools. The workers used brush saws for 4 to 5 months a year during the warmer season for grass trimming and limbing. This is the main reason why the prevalence rate was so low in spite of the high acceleration levels of the brush saw. On the other hand, the latency period (6.4 +/- 3.5 years) was rather shorter than that of the chain saw. This result suggests that the individual susceptibility of workers to contract VWF may play a more important role in the case. PMID- 6490183 TI - Urinary excretion of chromium as an indicator of exposure to trivalent chromium sulphate in leather tanning. AB - Two workers exposed to trivalent chromium sulphate in a leather tannery had high concentrations of chromium in the urine. The concentration of chromium showed a workshift-related diurnal fluctuation, but it was remarkably high even after a vacation, indicating accumulation of chromium in the body. The concentrations of chromium in the workplace air, as collected on filters using standard techniques, were below 30 micrograms/m3. The chromium in the air was present in the form of large droplets not collected by the standard techniques. In the blood stream, chromium was transported exclusively in the plasma. No absorption of chromium through the skin could be detected. Absorption from the gastrointestinal tract was calculated to explain the findings. PMID- 6490185 TI - Cardiorespiratory and thermal effects of wearing gas protective clothing. AB - Six healthy men aged 25 to 37 walked on a treadmill at work levels of 21 and 41% of their VO2max for 25 to 30 min wearing gas protective clothing (GPC) consisting of an impermeable suit with a self-contained breathing apparatus (total weight 25 kg) or shorts (control tests, CT) in a temperate environment (ta 24.3 degrees C +/- 1.0 degrees C, rh 30-50%). When the GPC was worn at 21 and 41% VO2max, the most prominent increases, compared with the CT, were noted in the heart rate (means +/- SE, 120 +/- 5 vs 76 +/- 3 beats min-1 and 171 +/- 5 vs 103 +/- 3 beats min-1), mean skin temperature (36.1 +/- 0.2 vs 31.3 degrees C +/- 0.1 degree C and 36.9 +/- 0.3 vs 30.9 degrees C +/- 0.4 degrees C) and sweat rate (473 +/- 51 vs 70 +/- 23 g m-2 h-1 and 766 +/- 81 vs 135 +/- 18 g m-2 h-1) indicating a high cardiovascular and thermoregulatory strain, which was not decreased by ventilating the suit with an air flow of 281 min-1 at 41% VO2max. The ventilation, oxygen consumption and production of carbon dioxide increased in relation to the extra weight of the GPC, partly dependent on the dynamic work level. It was concluded that the increase in the physiological load caused by the GPC was so high that the work-rest regimens, workers' level of physical fitness, cardiovascular health and heat tolerance should be considered whenever gas protective clothing is used. PMID- 6490186 TI - Continuous renal prosthetic therapy in acute renal failure. PMID- 6490187 TI - Controlled versus non-controlled drug release systems: facts or fancy. PMID- 6490188 TI - Acid-base homeostasis in peritoneal dialysis patients. PMID- 6490189 TI - Active carbon and its controversial ability to adsorb uremic toxins. PMID- 6490190 TI - A new operational principle for blood treatment with highly permeable membranes. AB - Conventional membrane devices for blood treatment have traditionally been operated either as hemofilters or as dialyzers. This article discusses the possibility of combining both aspects in one single device, using a single membrane with a high hydraulic permeability. In fact, the combined function is found to be the only possible mode of operation, using very permeable membranes, but this apparently has so far not been recognized in actual application. PMID- 6490192 TI - Effect of charcoal hemoperfusion on amino acid disturbance in experimental hepatic coma. AB - Using the galactosamine induced hepatic coma rat model, we studied the effects of coated charcoal hemoperfusion on amino acids in plasma and CSF in grade III hepatic coma. We found that 1 hour of hemoperfusion significantly reduced AAAs and BCAAs in plasma and increased the molar ratio of BCAA:AAA. When rats in grade III coma were treated with 2 consecutive 1-hour hemoperfusions, the substantial reduction of plasma AAAs resulted in a significant decrease of AAA levels in CSF. PMID- 6490191 TI - Amino acid disturbances in experimental hepatic coma rats. AB - In our previous paper (1), we discussed the in-vitro adsorption spectrum of plasma amino acids by coated charcoal hemoperfusion. We now describe the general amino acid disturbances in plasma, CSF and cerebrum in the galactosamine induced hepatic coma model in rats. All aromatic amino acids (AAA) increased significantly in the three compartments studied. Branched chain amino acids (BCAA) were either elevated to a much lesser extent or remained unchanged. The molar ratio of BCAA:AAA was consequently reduced. This is similar to findings in fulminant hepatic failure in human and other animal models. Most of the 20 amino acids analyzed were increased significantly in the plasma. Increases of amino acids were minimal in the brain tissue studied, i.e. the cerebrum. PMID- 6490194 TI - Sedimentation theory and practical considerations for the design of centrifugal blood cell processes. AB - This is the first of a five-part series discussing the basic conceptualization and evaluation of techniques for centrifugal separation of blood cells. In this paper, the basic concepts of sedimentation theory will be discussed. The next two papers will discuss the effects of plasma recycle and stagewise separations, respectively, as applied to continuous-flow and semicontinuous-flow processing systems. The subsequent paper will underline the differences between the theoretical approach and our experimental efforts, and the final paper will consider potential future process configurations and areas of expected improvement. A series of calculations is presented for the prediction of sedimentation velocities for red and white cells. The equations are simplified to investigate the regions of high red cell concentration, and are not valid for regions of concentrated platelets or white cells. The intent is to present a sample calculational design approach. PMID- 6490193 TI - Polymer resins with amino acid containing pendants for sorption of bilirubin. I. Comparison of Merrifield and polyamide resins. AB - Merrifield resins with various amino acid containing pendants and a water swellable polyamide resin with the peptide alanine-alanine-alanine-arginine as the pendant group have been prepared by solid phase peptide synthesis. Merrifield resins with either arginine or lysine pendants are capable of sorbing bilirubin from aqueous solution (pH = 7.8) but those with other amino acid pendants gave no indication of sorption. The polyamide-arginine resin showed, on a functional group basis, a higher capacity for bilirubin than does cholestyramine. It is proposed that the formation of salt linkages causes a strong interaction of bilirubin with arginine and lysine. PMID- 6490195 TI - Preliminary study on plateletpheresis with the CS-3000 blood cell separator using a single phlebotomy technique. AB - A coaxial dual flow catheter has been tested for thrombapheresis with a continuous flow blood cell separator in order to render the procedure as comfortable as possible for our donors. Therefore, two groups of five donors underwent a standard plateletpheresis: 3500 ml of blood were withdrawn at a speed of 35-45 ml per minute and were anticoagulated with ACD-A in a 1/9 ratio to whole blood. In the first group one vein puncture was effectuated with the coaxial catheter after local anesthesia. Two 14G catheters were used in the second group. In both groups the platelet yield was studied as well as the half life of 111 Indium-oxinate labeled platelets after autologous transfusion. Although the comfort of the donors was greatly improved, the one needle procedure resulted in a mean platelet yield of 1,28.10 while the two needle procedure yielded 3,46.10 platelets. In contrast, the survival of the platelets after autologous transfusion did not differ significantly in the two groups: t 1/2 in group I was 3,94 d, in group II 3,66 d. It is advocated that the poor efficacy of the single needle procedure might be due to recirculation. PMID- 6490196 TI - Plasma protein-binding of amantadine in maintenance hemodialysis patients. PMID- 6490197 TI - Membrane plasma exchange by single-needle hemofiltration device. A technical note. PMID- 6490198 TI - A parametric algorithm for computing model period and cohort human survival functions. AB - A parametric algorithm was developed for computing model cohort and period survival functions used in making projections of human populations. Two levels of parameters were used in developing the algorithm. The algorithm provides a method for calculating model period survival functions as a function of an expectation of life at birth; model cohort survival functions are calculated as a function of a time series of period expectations of life at birth. Expectations of life at birth ranging from about 35 to 110 years in both sexes may be accommodated by the algorithm. PMID- 6490199 TI - Orthogonal polynomials used as soft tissue energy density functions. AB - A mathematical method is developed for computing the coefficients of soft tissue energy density polynomials, satisfying certain constraints. The polynomial coefficients are computed in the least squares sense. It is demonstrated that this method: (a) determines up to 30 polynomial coefficients whereas the unmodified least squares method based on Maclaurin power series determines up to nine coefficients; and (b) increases numerical stability and accuracy by several orders of magnitude. All computations are carried out in single precision on a LSI-11/23 laboratory minicomputer. The algorithm is particularly useful for on line data analysis using small laboratory computers. PMID- 6490200 TI - Seasonal variation in the junctional component of pigmented naevi. PMID- 6490201 TI - Exogenous hormone use and fibrocystic breast disease by histopathologic component. AB - In a hospital-based case-control study of 590 women with biopsy-proven fibrocystic breast disease and 1,018 control women with other surgical conditions, no linear relationship was evident between the use of oral contraceptives or of estrogen replacement therapy and the degree of epithelial atypia of the fibrocystic lesions. Case-control and intracase comparisons suggested that oral contraceptive use might be associated with an increased occurrence of sclerosing adenosis among the premenopausal women and of gross cysts among the postmenopausal women. Estrogen replacement therapy, which was positively associated with fibrocystic breast disease as a whole among the post menopausal women, was most frequently used among the cases whose biopsy specimens exhibited gross cysts, papillomatosis or papillary hyperplasia. PMID- 6490202 TI - Correlation between tumorigenicity and altered glycosylation of a "leukocyte common" antigen in human lymphoid cell lines. AB - Five human lymphoblastoid cell lines which have become tumorigenic, as judged by transplantability into immunosuppressed mice, have been compared with earlier, non-tumorigenic stocks of the same cultures, recovered from liquid nitrogen. Analysis of the cell surface glycoproteins by SDS-PAGE, electro-transfer to cellulose nitrate and "blotting" with radioiodinated lectins, reveals an increase in the molecular weight of one band from around 190 kd to 220 kd, in each case coinciding with the acquisition of the tumorigenic phenotype. Probing the electrotransfers with a monoclonal antibody demonstrates that the altered glycoprotein is a member of the "leukocyte common antigen" family. The increase in molecular weight is due to the addition of carbohydrate residues which are removed by treatment with neuraminidase and endoglycosidase. Screening a larger number of lymphoid cell lines, including those derived from Burkitt's lymphoma, shows an excellent correlation between tumorigenicity and altered molecular weight of a leukocyte common antigen. PMID- 6490203 TI - Tumorigenicity of human lymphoblastoid cell lines, acquired during in vitro culture and associated with chromosome gains. AB - Tumorigenicity of human lymphoma and lymphoblastoid B-cell lines was assessed by their ability to form growing and transplantable masses on subcutaneous inoculation into neonatally thymectomized, Ara-C-protected, total-body-irradiated mice. By these criteria, 12 lines of known malignant origin were tumorigenic, 11 lymphoblastoid lines, tested after less than one year of in vitro growth, were non-tumorigenic and 8/18 long-established lymphoblastoid lines produced transplantable tumours. All of the long-established lines had acquired karyotypic changes on prolonged culture, the predominant characteristic being a gain of whole chromosomes or of major chromosome segments. None showed the classical 8:14 translocation associated with Burkitt's lymphoma. Comparisons with nontumorigenic precursors (recovered from liquid nitrogen storage) and with other non tumorigenic but chromosomally abnormal, lymphoblastoid lines suggest that imbalance of the dosage of genes carried on chromosomes 7,8 and 9 may be important in determining the tumorigenic phenotype. PMID- 6490204 TI - Effect of dietary stearic acid on the genesis of spontaneous mammary adenocarcinomas in strain A/ST mice. AB - Strain A/ST female mice maintained on a high fat (15%) diet in which stearic acid was the major lipid component developed initial spontaneous mammary adenocarcinomas at an older age than mice fed a low fat (4.5%) stock diet. Mice placed on the SA diet at weaning developed tumors at 15.7 +/- 0.87 months compared to 12.7 +/- 0.43 months for those retained on the stock diet (p less than .05). Placing mice on the SA diet at 11.5 months resulted in a smaller but significant increase in the latency period (5.0 +/- 0.86 vs 3.0 +/- 0.57 months +/- 0.57 mo), (p less than .05). Fatty acid analyses of non-tumorous mammary tissue from mid-pregnant mice and of tumor tissues showed that feeding large amounts of 18:0 did not result in increases in the proportion of 18:0. Significant reductions in the percentages of polyunsaturated fatty acids (PUFA) was found in tissues on mice fed the SA diet. The percentage of 18:2 was reduced in both types of tissues; 20:3 and 20:4 was reduced in tumor tissues. Distribution of C18 fatty acids in plasma membranes of tumors of mice fed the two diets were similar; percentages 18:2 was higher in plasma membranes of non tumorous tissues of mice fed the SA diet. These results suggest that dietary stearic acid interferes with the availability of certain PUFA required for tumor production. PMID- 6490205 TI - Influence of migratory blood cells on the attachment of tumor cells to vascular endothelium. AB - The purpose of this study was to determine whether the presence of migratory blood cells in association with tumor emboli had the capacity to alter the attachment of tumor cells to vascular endothelium. Highly metastatic RT7-4bs rat hepatocarcinoma cells were labelled with [125I]UdR before being allowed to form mixed cellular spheroids incorporating resident peritoneal macrophages, activated peritoneal macrophages, polymorphonuclear leukocytes, splenic T lymphocytes, or splenic B lymphocytes derived from both normal and tumor-bearing animals. The presence of polymorphonuclear leukocytes or activated macrophages led to a considerable increase in the number of tumor cells attaching to endothelial cell monolayers in vitro. The presence of T or B lymphocytes from either normal or tumor-bearing rats was without effect on tumor attachment to endothelium. Increased tumor cell retention in the lungs was evident for mixed spheroids containing tumor cells and polymorphonuclear leukocytes compared to homotypic tumor spheroids composed of tumor cells alone. Furthermore, preinjection of polymorphonuclear leukocytes intravascularly or inoculation of tumor cells as heterotypic spheroids containing polymorphonuclear leukocytes increased lung colony formation over that obtained after inoculation of tumor cells alone. Several simple sugars were tested for their ability to block tumor cell, polymorphonuclear leukocyte or activated macrophage binding to endothelium in vitro. The results indicate that the glycosylated cell surface components mediating tumor cell attachment to endothelium are not identical with those mediating attachment of either polymorphonuclear leukocytes or activated macrophages. Medium conditioned during mixed spheroid formation was without effect on tumor cell attachment to endothelium. We conclude that the presence of some, but not all classes of leukocytes can modulate tumor cell attachment to vascular endothelium, an effect most likely mediated by a mechanism involving direct contact between the leukocytes and the endothelial cell monolayer. PMID- 6490206 TI - Morphology of peritumoral proteoglycan alterations in the rabbit mesentery invaded by V2 carcinoma cells. AB - After intraperitoneal implantation into Swiss Silver rabbits, V2 rabbit carcinoma cells invade the mesentery where they form nodules of different size and texture: compact (less than 120 microns in diameter), loose (120-250 microns) and mixed (above 200 microns). Together with tumor development, certain changes take place in the loose connective tissue of the mesentery. Application of TEM, together with use of safranin O, has shown that, in areas free of tumor growth, collagen bundles become thick and heavy and proteoglycan density is increased. Concurrently, the number of fibrocytes, now transformed to fibroblasts, increases. Small, compact nodules are surrounded by a concentrically arranged extracellular matrix. Its overall density is similar to that of nodule-free areas. In the immediate vicinity of large, loose nodules, all constituents of the extracellular matrix disappear. Adjacent connective tissue is partly destroyed but still contains collagen fibers and proteoglycans. These findings suggest the following: The presence of V2 carcinoma cells induces marked alterations in the structured and non-structured components of the extracellular matrix. These changes are, at the same time, progressive and regressive and the occurrence of one or the other depends on local tumor progression. Progressive alterations may result from an increased activity of fibroblasts. Since degradative effects, on the other hand, are only seen in the immediate vicinity of larger tumor aggregates, it is assumed that a minimal number of tumor cells is essential for destruction of extracellular matrix. PMID- 6490207 TI - The differential expression of H-2K versus H-2D antigens, distinguishing high metastatic from low-metastatic clones, is correlated with the immunogenic properties of the tumor cells. AB - Two clones of the 3LL Lewis lung carcinoma, a low-metastatic clone A9 and a high metastatic clone D122, were studied for MHC expression and immunogenic properties. Using monoclonal antibodies, we demonstrated that the A9 clone expresses both the H-2Kb and the H-2Db, whereas the D122 expresses only the H 2Db, and lacks the expression of the H-2Kb encoded molecules. Cells of the low metastatic clone A9 grew progressively in syngeneic (C57BL/6J) or in F1 mice, but were rejected in allogeneic recipients. The high-metastatic D122 grew progressively in all mouse strains tested, yet metastases were formed only in syngeneic recipients. When H-2 recombinant mice were used, the A9 again manifested a significantly greater immunogenic potency than the metastatic D122, which grew in all 4 recombinants tested. Metastases, however, were formed in B10HTG and to a lesser extent in B10A(4R), thus indicating that metastasis formation is restricted by both C57BL background and H-2Db sub region. We subsequently tested whether the higher immunogenicity of the H-2Kb-positive A9 cells is expressed also in syngeneic mice, to examine whether this could account for its low metastatic phenotype. We found that immunization by A9 cells significantly inhibited the growth of a subsequent A9 graft and even of D122, yet D122 did not retard the growth of secondary D122 or A9 cells. The increased immunogenic effect was expressed also in the generation of syngeneic cytotoxic lymphocytes by A9 but not by D122 cells. We suggest that expression of H-2K molecules on the 3LL clones, immunogenicity and the metastatic phenotype are causally related in this system. PMID- 6490208 TI - Distribution of tumor-sensitized cells during the induction of permanent tumor regression by chemoimmunotherapy: the use of glucose phosphate isomerase as a marker. AB - Using a previously described tumor model system, in which permanent tumor eradication was induced by treatment with cyclophosphamide (CY) and adoptively transferred tumor-sensitized (immune) spleen cells, we determined the distribution of the transferred cells in recipient mice. The experiments were carried out using the C57BL/6J (B6) sarcoma, MCA/76-9, and B6 and congeneic B6.CAST.Gpi-Ia strains, which are homozygous for the glucose phosphate isomerase (Gpi) alleles Ib and Ia respectively. Thus, tumor-bearing mice of the one strain were injected with CY (200 mg/kg) 10 days after implantation of tumor cells and 4 h later with an intravenous injection of 50 X 10(6) immune cells from presensitized mice of the other strain. It was observed that the donor-type isozyme was expressed in the tumor within 24 h of injection and continuously up to the time at which the tumor mass had totally regressed (11 days). The tumor associated macrophage and neutrophil fractions were shown to express host-type isozyme, while the lymphocyte fraction expressed isozyme of both host and donor type. The donor-type isozyme did not appear in the blood until day 4 but persisted thereafter for long periods. The spleen and lymph nodes expressed donor type isozyme by 1 day after chemoimmunotherapy and remained positive for the duration of the experiments. The adoptive transfer of normal (non-immune) spleen cells gave similar results, except that donor-type isozyme did not persist at the tumor site. The conclusion reached was that the injection of either normal or immune donor spleen cells after CY treatment of B6 mice gave rise to chimeric mice, in which the distribution of normal and immune donor cells was basically similar in terms of overall isozyme expression. However, only immune donor cells resulted in the appearance of both donor and host T cells at the tumor site, suggesting amplification of both donor and host lymphocyte function either at the tumor site or in the lymphoid tissues. PMID- 6490209 TI - Coronary microangiography in the guinea pig, rabbit and ferret. AB - Using improved methods, we have developed a microangiographic technique for studying the coronary circulation in Langendorff perfused guinea pig, rabbit and ferret hearts. Striking anatomical differences were observed between these species. In the guinea pig, the interventricular septum was supplied by a large septal artery which always arose from the right coronary artery, whereas in the rabbit and ferret, the septal artery was smaller and originated from the left coronary artery. The circumflex artery was more prominent than the right coronary artery in the ferret and guinea pig, whereas the reverse pertained in the rabbit. Extensive apical collateral connections were observed between terminal branches of the left anterior descending, left ventricular branches and the septal artery in the guinea pig, while collaterals were usually absent in the rabbit and ferret. These species differences in the myocardial blood supply have wide ranging implications regarding the choice of small animals for cardiac research. PMID- 6490210 TI - Incidence and clinical significance of repetitive ventricular response in patients without identifiable organic heart disease. AB - We determined the incidence of repetitive ventricular response (RVR) after programmed electrical stimulation and the incidence of spontaneous ventricular arrhythmias during 24 hr Holter monitoring in 38 patients in whom extensive non invasive and invasive diagnostic tests had excluded abnormalities suggestive of organic heart disease. A standardized stimulation protocol with single (S1S2) and double (S1S2S3) extrastimuli during ventricular drive at cycle lengths of 600, 500 and 430 msec with a current strength below 5 mA at the right ventricular apex was employed. RVR occurred in 20 patients (58%) after S1S2 and in 30 patients (79%) after S1S2S3 stimulation. Eighteen patients (47%) showed RVR with 2 echo beats and 1 patient had 3 echo beats. RVR was due to bundle branch reentry (BBR) in 20 patients independent of the mode of stimulation. RVR due to intraventricular reentry (IVR) was found in 17 patients (47%) only after S1S2S3 stimulation. The incidence of both BBR and IVR was influenced by the basic ventricular driving rate, decreasing with shorter basic cycle lengths. 17 patients had no ventricular premature depolarizations (VPDs), 12 patients had uniform, 4 multiform (Lown III), 2 consecutive (Lown IVA) VPDs, and 1 patient had parasystolic rhythm. There was no relation to the incidence of repetitive ventricular response. We conclude that in patients without identifiable organic heart disease RVR with more than 2 consecutive beats is rarely found if single and double extrastimuli are employed during ventricular drive. Both bundle branch and intraventricular reentry with one or two echo beats are a common finding in this population without relation to the incidence of spontaneous ventricular arrhythmias. PMID- 6490211 TI - Accuracy of absolute left ventricular volumes and cardiac output determined by radionuclide cardiography. AB - We determined left ventricular (LV) volumes and derived variables by gated equilibrium radionuclide imaging at rest and during exercise in 12 patients without valve disease or intracardiac shunts. LV volume was determined as the product of the background-corrected LV count rate and an individual attenuation correction factor divided by the count rate in peripheral blood. Attenuation correction was based on measurement of LV depth within the chest from an initial first pass study in the left lateral view and a linear attenuation coefficient of 0.156 cm-1 determined in phantom studies. The average LV depth was 8.0 cm (range 6.9-9.1) in agreement with an average depth measured by echocardiography of 8.2 cm (6.3-9.4), P much greater than 0.05. The correlation between radionuclide (RC) and simultaneous thermodilution (TD) measurements was for cardiac output (CO): r = 0.95; CO (RC) = 1.00 X CO (TD) + 0.10 1/min with a standard error of the estimate (SEE) of 0.79 1/min; for stroke volume (SV): r = 0.90; SV(RC) = 0.93 X SV (TD) + 5 ml; SEE = 8 ml; for end-diastolic volume (EDV): r = 0.96; EDV(RC) = 1.06 X EDV(TD) -14 ml; SEE = 27 ml; and for end-systolic volume (ESV): r = 0.98; ESV(RC) = 1.05 X ESV (TD) -6 ml; SEE = 20 ml. The interobserver variation, expressed as the coefficient of variation, was for cardiac output 6%, for stroke volume 6%, for end-diastolic volume 4%, and for end-systolic volume 5%. This method permits non-invasive determination of LV volume and total LV output per beat based exclusively on data obtained during radionuclide imaging. PMID- 6490212 TI - The circulatory response to lifting and carrying and its modification by beta adrenoceptor blockade. AB - The circulatory effects of lifting and holding weighted suitcases of 5, 10 and 15 kg, and carrying the same suitcases at two different walking speeds were evaluated in 6 normal subjects before and after beta-adrenoceptor blockade with 160 mg oxprenolol. Lifting and holding induced significant weight-induced increments in systolic and diastolic blood pressure which were not attenuated by beta-blockade. There was a significant increase in heart rate only on lifting the 15 kg weight which was attenuated by oxprenolol. Dynamic exercise (walking) with the same weighted suitcases resulted in rate and speed related increase in systolic pressure and heart rate, the magnitude of which was greater than that of lifting alone. The isometric pressor response was attenuated when walking and carrying at 2 mph, but completely abolished by the metabolic and heat induced vasodilatation when walking at 4 mph. Following beta-blockade both the absolute blood pressure and the systolic pressor and heart rate responses to combined lifting and carrying were attenuated. The diastolic pressor response induced by lifting, which was offset in the control period by the vasodilation induced by dynamic exercise was progressively attenuated proportionate to the load carried following beta-blockade; presumably this reflected systemic vasoconstriction to maintain mean perfusion pressure in the presence of central beta-blockade. These observations suggest that the isometric component which predominates at slow walking speeds when carrying weights between 5 and 15 kg is completely suppressed by the vasodilatation at fast walking speeds. Beta-blockade, while reducing heart rate and systolic pressor response to the same stimuli, leads to an augmented systemic vascular resistance which is particularly evident at high metabolic workloads. PMID- 6490213 TI - Anomalous muscle bundle of the sub-pulmonary outflow in tetralogy of Fallot. AB - This case report deals with the clinicopathologic correlations in a 50-year-old man with tetralogy of Fallot, in whom the classical pulmonary stenosis by deviated infundibular septum was intensified by an anomalous muscle bundle located in the sub-pulmonary infundibulum. PMID- 6490215 TI - Automated external defibrillator-pacemaker. PMID- 6490214 TI - Myocardial involvement in acromegaly. AB - We recently encountered a case of an acromegalic patient with congestive heart failure and secondary cardiomyopathy. Cardiac biopsies were available in addition to autopsy material. This enabled us to perform electron microscopical studies which have hitherto not been reported. This may help to clarify the relationship between these two conditions and reveal specific characteristics. PMID- 6490216 TI - Research on hypnosis in hemophilia--preliminary success and problems: a brief communication. PMID- 6490217 TI - Antarctic isolation and imaginative involvement--preliminary findings: a brief communication. PMID- 6490218 TI - Hypnotic stimulation of antisocial behavior: a case report. PMID- 6490219 TI - The impact of an indirect suggestion. PMID- 6490220 TI - Society for Clinical and Experimental Hypnosis. Annual scientific program. San Antonio, Texas, October 25-27, 1984. Abstracts. PMID- 6490221 TI - Activated charcoal adsorption of diphenhydramine. AB - The adsorption of the antihistamine diphenhydramine (D) by activated charcoal (AC) was assessed in vitro and in vivo in six healthy volunteers in order to assess the utility of AC as an adjunct in the treatment of antihistamine overdose. Results of greater than 85% adsorption with AC:D weight ratios of 10:1 or greater in the in vitro studies led to a three-way crossover trial in six volunteers. Fifty mg D was administered alone (control), with 50 g AC within 5 minutes of D (D + C5) and with 50 g AC 60 minutes after D (D + C60). Mean reductions in peak serum D concentrations of 94.8% (D + C5) and 12.3% (D + C60), AUC 0-24 h of 96.9% (D + C5) and 20.4% (D + C60), and AUC 0-omega of greater than 90% (D + C5) and 24.0% (D + C60) were noted, although only the comparison of D with D + C5 reached statistical significance due to wide interpatient variation. A positive correlation of time to peak concentration of drug in serum in the control group with percentage reduction in AUC in the D + C60 group further indicate the potential for positive therapeutic benefit of AC in antihistamine overdose. This is because lag time and time to peak concentration may be excessively prolonged in overdose due to anticholinergic-induced alterations in G.I. motility. Maximal and multiple doses of AC are recommended for adjunctive treatment of antihistamine overdose. PMID- 6490223 TI - The relationship between pharmacodynamics and pharmacokinetics in asthmatic children receiving a sustained-release formulation of theophylline. AB - Pharmacodynamic response as well as serum and saliva concentrations of theophylline were monitored in 15 children under a long term theophylline treatment. Respiratory parameters, such as vital capacity and total bronchial resistance all related to bronchodilatation, were measured by use of a bodyplethysmograph. Measurements were performed before treatment and during the steady state with respect to serum levels. Due to small differences between peak and trough concentrations, no correlations between serum concentrations and respiratory parameters were found during the steady state. However, some important respiratory parameters exhibit considerable differences with respect to pretreatment values. In conclusion, one can state that during the steady state, theophylline exerts a constant influence on bronchodilatation which depends only slightly on the concentration range achieved. PMID- 6490222 TI - Influence of acute diuresis on calcium balance--a comparative study of furosemide and azosemide. AB - The influence of acute diuresis on calcium balance induced by furosemide (FM) and azosemide (AM) was observed and compared in the human body. The treatment resulted in significant diuresis (FM: 2488 +/- 163 ml; AM: 2930 +/- 109 ml for 6 hours) and calciuresis (FM: 132.0 +/- 15.2 mg; AM: 181.0 +/- 16.6 mg for 6 hours). In spite of the urinary calcium loss, the serum calcium concentrations were elevated by both drugs. The elevation was also found even when the correction to serum protein concentrations was performed, and the magnitude of this change was less by AM than by FM. Plasma parathyroid hormone (PTH) concentrations were slightly elevated by AM only at 6 hours, but they remained unchanged by FM. This mild elevation of PTH could not be explained sufficiently by the concentration changes of serum calcium as noted above, and might be caused by factors other than serum calcium. The alkaline phosphatase concentrations corrected by means of serum protein concentrations were unchanged in both drugs, and it was suggested that the calciuresis may not extend to bone calcium remodeling at least in such a short-term experiment. PMID- 6490224 TI - Pharmacokinetics and pharmacodynamics of three sustained-release theophylline preparations (350 mg Theograd, 350 mg Theolair Retard and 300 mg Theodur) in steady state in healthy volunteers and asthmatics--Part I: Theophylline plasma levels. AB - The pharmacokinetic profiles of three oral sustained-release theophylline preparations in steady state (350 mg Theograd, 350 mg Theolair Retard [= Nuelin Retard], and 300 mg Theolin Retard [= Theodur]) were compared in a group of six normal subjects and six patients with moderately severe asthmatic bronchitis. All preparations were given twice daily for 7 days. Before this study, an intravenous infusion of aminophylline had been administered (5.6 mg theophylline per kg body wt.). The plasma theophylline levels after oral administration were rather low from a clinical point of view (below 55 mumol/l = 10 mg/l). The mean plasma theophylline level of the three different oral preparations in steady state did not show a statistically significant difference. The group of six healthy volunteers reached higher mean theophylline levels than the group of six patients, possibly due to differences in mean weight and smoking habits. This difference was only statistically significant (p = 0.001) for Theograd. Between Theograd, Theolair (Nuelin) Retard, and Theolin (Theodur) Retard no statistically significant difference in absolute bioavailability was observed, and virtually no side effects were reported. PMID- 6490225 TI - Parenteral augmentin: pharmacokinetics. AB - The pharmacokinetics of intravenous Augmentin have been investigated and the data found to fit a two compartment model. In the first study, to a crossover design, a bolus injection of 1.2 g Augmentin was given to 8 healthy volunteers with and without probenecid. It was found that the serum concentrations of amoxycillin were increased in the presence of probenecid, but those of clavulanic acid were unaffected. In a second study a further 8 volunteers received an infusion over 30 min of 2.2 g Augmentin. At the end of the infusion, peak concentrations in excess of 100 micrograms/ml were recorded for amoxycillin and 14 micrograms/ml for clavulanic acid. In both studies the serum and urinary concentrations of amoxycillin and clavulanic acid obtained were well above those considered necessary to achieve a therapeutic effect. PMID- 6490226 TI - Long term follow-up of mild chronic active hepatitis. AB - A group of 41 patients (25 males and 16 females) with mild chronic active hepatitis was studied for a mean follow-up period of 6.5 years. All patients had liver biopsy on admission and a second biopsy during the follow-up period. All but 7 patients were treated with prednisolone. Most of the patients were asymptomatic. There was no history of alcohol abuse or chronic administration of drugs. Fourteen patients were HBsAg positive and 27 HBsAg negative. Circulating autoantibodies were absent. Thirty-three patients did not demonstrate any change in disease activity. Four developed liver cirrhosis and four were apparently cured. PMID- 6490227 TI - Effects of acebutolol combined with mefruside on total-body and serum potassium in essential hypertensive patients. AB - Fifteen essentially hypertensive patients were treated with a fixed combination of the beta-adrenoceptor antagonist acebutolol and the diuretic substance mefruside for 6 weeks. The systolic and diastolic blood pressure as well as the heart rate were significantly reduced. Before and after the treatment period, total-body and serum potassium were examined. Both parameters were not significantly changed. Diuretic therapy causes hypokalemia by increased potassium excretion in the distal tubulus, whereas beta-adrenoceptor antagonists could compensate this effect by a mechanism which is not yet clarified. PMID- 6490228 TI - Effects of moderate salt restriction in hypertensive patients treated with oxprenolol or chlorthalidone. AB - Ninety-five hypertensive out-patients, whose lying diastolic blood pressure was still greater than or equal to 95 mm Hg after a 4-week treatment with oxprenolol slow release 160 mg/day or chlorthalidone 25 mg/day, restricted their daily sodium intake for a 4-week period, while continuing to receive the previous pharmacological therapy. The dietary intervention, appositely formulated to moderately restrict sodium intake, resulted in a high patient compliance as assessed by the significant (p less than 0.01) reduction in the 24-hour urinary sodium excretion. At the end of the 4-week dietary period, a significant (p less than 0.01) decrease in lying and standing systolic and diastolic blood pressure was observed in both the oxprenolol and chlorthalidone treated groups. These results suggest that a moderate reduction in sodium intake, obtained from a low sodium diet characterized by high patient compliance and easily followed in everyday life, is effective in lowering blood pressure in hypertensive patients who don't respond satisfactorily to pharmacological therapy alone. PMID- 6490229 TI - Acute and chronic effects of the beta-receptor blocker mepindolol on hemodynamics and the portal circulation. AB - After administration of mepindolol, a reduction of the portal pressure was demonstrated in an acute study in six patients with varying degrees of cirrhosis of the liver and in a chronic study in 5 patients. The reduction of the portal pressure did not correlate very closely with the decrease in the cardiac output. It is therefore assumed that a beta 2-receptor effect with dilatation of the splanchnic vessels is the main mechanism. However, further studies are required to clarify the situation unequivocally. The properties of mepindolol (intrinsic sympathomimetic activity, slight negatively inotropic effect, non-selective action, primarily renal elimination) appear to be advantageous in this respect. PMID- 6490230 TI - Outcome evaluations in substance abuse: a comparison of alcoholism, drug abuse, and other mental health interventions. AB - Outcome evaluation studies in the areas of alcohol and drug abuse have suffered from design problems. The lack of control groups, prospective designs, adequate outcome measures, and sufficient follow-up has presented the major difficulties. This study reviews all such studies reported in 50 major journals between 1969 and 1979 and compares them to outcome evaluations on other mental health topics reported in the same journals. We find that significant problems remain in each of these areas. In general, drug abuse studies employ the least adequate methodologies. Alcohol evaluations are approximately as rigorous as other mental health evaluations. A major finding is the lack of rigor found in all types of outcome evaluations. Attention must be paid to these issues if outcome evaluations are to remain credible and able to secure continued support. PMID- 6490231 TI - Predictors of adolescents' intentions to smoke: age, sex, race, and regional differences. AB - The present study investigated the predictors of smoking intentions among subgroups of adolescent nonsmokers, examining age, sex, ethnic, and regional differences. Both proximal factors specific to smoking and more general, distal factors were successful predictors of intentions to smoke. The similarities in prediction outweighed the differences between demographic subgroups. There were three demographic differences: (1) peer and family smoking levels were more important in predicting intentions for girls than boys; (2) smoking initiation was more of a way of adopting deviant or problem behavior for midwestern than for southwestern subjects; (3) familial smoking models were more related to the intentions of midwestern than southwestern subjects. The theoretical significance of these results and their practical implications for smoking prevention are discussed. PMID- 6490232 TI - Professional psychotherapy and its relationship to compliance in treatment. AB - Compliance rates over a 21-month period for 57 drug-abusing patients receiving individual professional psychotherapy in addition to paraprofessional counseling were compared to compliance rates for patients not receiving individual professional psychotherapy. Compliance was defined as remaining in the treatment environment for an agreed upon time and neither leaving the hospital against medical advice nor being given a disciplinary discharge for illegal drug use, stealing, or fighting. Patients receiving professional psychotherapy had been assessed as having either higher levels of psychiatric symptoms or a history of a psychiatric diagnosis, or being potential management problems. Patients who received psychotherapy more likely remained stabilized in the treatment environment and in their role as patient. An additional finding was that clarity of the therapist's role in the ward environment affected the patient's stabilization. This study supports recent findings that professional psychotherapy can be effective for drug abusers. It suggests that individual psychotherapy/consultation with distressed and difficult patients experiencing disequilibrium in the hospital milieu can be an effective means of restoring that equilibrium. PMID- 6490233 TI - Alcohol use by juvenile offenders. AB - Reasons for alcohol use were examined in a sample of detained and adjudicated juveniles at a state residential facility. By means of factor analysis, patterns of self-reported reasons for using alcohol were identified. The findings suggest that alcohol appears to have become primarily associated with coping and/or altering mood. The implications of this finding are briefly discussed with respect to treatment and prevention. PMID- 6490234 TI - Defining alcohol problems as a repressive mechanism: its formative phase in imperial Germany and its strength today. AB - In Germany, in the takeoff years of industrialization, judgments about drinking, drunkenness, and drunken comportment changed drastically. While for centuries drunkenness had been seen as the transitory effect of too much drinking, it now was perceived as a sign of moral weakness which afflicted most strongly the working class. Naming someone a drunkard, then, was as much a label for denouncement as for a sickness, which since then has been called alcoholism. It can be shown that structurally similar processes are in use in today's debate over the changing drinking habits of women in West Germany. PMID- 6490235 TI - Prediction of readmission in a cohort of alcoholics: a 2-year follow-up. AB - A cohort of 1,192 first admissions to metropolitan public alcohol treatment programs was examined after 2 years. With the sample sub-divided by number of readmissions, discriminant analysis based on demographic data, social history, and current drinking behavior provided only modest prediction of group membership (k = .46), but may be sufficient to provide an alerting function for recidivism. PMID- 6490236 TI - A task approach to drug use intervention. AB - A schema is presented to help intervention agents and agencies plan and carry out programs which focus upon a number of tasks which need to be adequately fulfilled by the individuals and/or systems in order to facilitate healthy growth, maturation, and functioning. PMID- 6490237 TI - A functional approach to drug use intervention. AB - A schema is presented designed to help intervention agents and agencies plan and carry out programs which relate to a variety of human functions which historically have been associated with a broad range of chemical substances: drugs, medicines, social substances, sacramental substances, etc. PMID- 6490238 TI - A rapid and sensitive high-pressure liquid chromatographic method for monitoring josamycin levels in plasma. AB - In this study a new high-pressure liquid chromatographic method for monitoring plasma levels of josamycin is described. Josamycin propionate was used as the internal standard. After being extracted from plasma by chloroform at an alkaline pH, the compounds were easily separated on a reversed-phase column C8. The mobile phase was methanol: citrate-phosphate buffer 0.01 M pH 2.8 (85:15 v/v); and the wavelength 232 nm. The retention time was 2.2 min for josamycin and 2.7 min for josamycin propionate; the chromatogram lasted about 3.5 min. Using this method, concentrations of josamycin up to 0.3 microgram/ml were determined. PMID- 6490239 TI - Human intravenous and intramuscular pharmacokinetics of amoxicillin. AB - Amoxicillin was administered at doses of 500 mg and 1000 mg, intravenously and intramuscularly to normal volunteers in a parallel study. Intramuscular amoxicillin was 100% bioavailable at both dose levels. Mean peak serum levels observed for the 500 mg and 1000 mg doses, respectively, were: i.v. (5 min after dosing) 46 and 74 micrograms/ml; i.m. (30 min after dosing) 14 and 21 micrograms/ml. Six hour trough levels ranged between 0.5 and 0.9 micrograms/ml. Between 50% and 60% of the doses were excreted in urine as intact amoxicillin in the 24 h after dosing. Almost 90% of this excretion occurred in the first 3 h after dosing. There was a statistically significant increase in mean clearance, after i.v. dosing, from the 500 mg level (14.8 l/h) to the 1000 mg level (20.7 l/h) implying that amoxicillin pharmacokinetics are non-linear over this range. Since there was very little difference between mean renal clearances at these dose levels (9.2 and 11.7 l/h, respectively) this clearance change might be due to enhancement of non-renal clearance. It would not be expected that this non linearity would have any therapeutic influence. PMID- 6490240 TI - Effect of diltiazem on pentagastrin-induced gastric secretion in man. AB - The effects of diltiazem on pentagastrin-induced gastric secretion were studied in 11 normal volunteers. Diltiazem 60 mg thrice daily for 10 doses did not produce any clear-cut effect on the increase in gastric acidity induced by either standard or low doses of pentagastrin. Despite the role of calcium on gastric secretion, diltiazem does not show promise as an agent capable of reducing gastric acidity. PMID- 6490241 TI - Pharmacokinetics of the enantiomers of indoprofen in man. AB - Indoprofen, a non-steroidal analgesic and antiinflammatory drug whose activity and safety in man have been established in a large number of studies, has an asymmetric carbon atom and can therefore occur as either the (+) or the (-) enantiomer. As it has been shown that its pharmacological effects are almost entirely due to the (+) isomer (d-indoprofen), some pharmacokinetic properties of the latter have been studied in man in comparison with the racemic mixture given by oral administration, d-indoprofen is cleared from plasma and excreted in urine (as unchanged plus conjugated drug) at a slower rate than l-indoprofen. Moreover, no stereospecific inversion of d-indoprofen to the inactive enantiomer occurs after either single or repeated (one week) administration. The pharmacokinetic behaviour of d-indoprofen in the human organism appears to be the same after administration of the racemic form or of the dextro-enantiomer, when the latter is given at half the dose. PMID- 6490242 TI - Flunarizine: a wide spectrum prophylactic for migraine headache. AB - The effects of flunarizine in migraine headache were investigated in 40 patients treated with single 10 mg evening doses for 16 weeks. Standard criteria were adopted for patient admission and for the monitoring of clinical (headache index, consumption of analgesics, side-effects) and laboratory variables (platelet aggregation and red cells filterability). Significant positive effects were found in 31/40 cases irrespective of the clinical course of the disease (i.e., recurrent attacks or more or less chronic forms). Some baseline characteristics of the patients are discussed on the basis of the therapeutic response. PMID- 6490243 TI - Asymmetric mydriatic response to topical tyramine in cluster headache relatives. AB - A pupillometric study was performed to evaluate the mydriatic response to tyramine, a noradrenaline releaser. There were three groups of subjects: (a) 10 cluster headache patients, in an asymptomatic period; (b) 20 of their close relatives, exempt from this disease; (c) 10 healthy controls. The tyramine was instilled into both eyes of each subject. The controls displayed an isocoric tyramine-induced mydriasis but the cluster headache sufferers and their relatives showed an anisocoric mydriasis. This anisocoric mydriasis was caused by a deficient mydriatic response on one side, which in the cluster patients corresponded to the symptomatic side. The sympathetic abnormality of the iris may be the expression of a functional asymmetry in the hypothalamus. Central sympathetic asymmetry could thus represent a dysgenetic family predisposition to lateralized headache attacks. PMID- 6490244 TI - Operative arthroscopy. AB - With appropriate instrumentation it is now possible to follow a diagnostic arthroscopy with a definitive surgical procedure. Arthroscopic surgery has become an established technique in many centres of the world and in most instances, is done on an out-patient basis. Partial meniscectomy and other operative procedures involve either two or three portals of entry into the joint, with visual triangulation of instruments to the area of the pathology. PMID- 6490245 TI - Amputations and prostheses for the lower limb. AB - Amputations in the lower limb are now carried out principally in the elderly because of vascular disease. The management and rehabilitation of the amputee is best achieved by a team approach with the close cooperation of the different disciplines. Attention should be paid to the psychological state of the patient who should be encouraged to mobilise as soon as possible. Prosthesis design and manufacture has changed greatly in recent years. Widespread use is now made of lightweight plastic materials. Modern technology is being applied to the design and manufacture of prostheses, with increasing use of modular systems of components. PMID- 6490246 TI - [Spinal injuries without neurologic complications]. AB - Instability of the injured spine may be bony, which allows only limited displacement, or osteo-disco-ligamentous where the potentiality for displacement is unlimited. A reasonable degree of purely bony displacement can be accepted in the spine, and only when the deformity is considerable is closed or open reduction necessary. However, osteo-disco-ligamentous instability requires operative stabilisation. There is a risk of post operative medullary complications, which can be lessened by sound surgical technique, but this has to be judged against the possibility of secondary cord damage in an unstable injury. Properly performed operations should allow the same degree of correction to be obtained in the spine as is customary in long bones. This will lessen the aesthetic and functional problems which occur secondary to the spinal deformity, and lessen the risk of onset of neurological damage arising as a result of acquired spinal stenosis. PMID- 6490247 TI - Current trends in revision of total hip arthroplasty. AB - Total hip arthroplasty has brought pain relief and mobility to many patients, but load bearing implants may fail and the resulting problems must be tackled early and with vigour. The primary operation offers the best chance of success, and revision may only ever be considered a salvage procedure. Patients with total hip arthroplasty must be offered facilities for an indefinite follow-up. Revision surgery is not to be undertaken lightly or on an occasional basis, and the lessons learned from such procedures must be used for the benefit of the patients undergoing primary operation. PMID- 6490248 TI - A group dynamic-peer interaction approach to group psychotherapy. PMID- 6490249 TI - Symposium: contrasting techniques of short-term inpatient group psychotherapy. Introduction. PMID- 6490250 TI - Group psychotherapy on a short-term treatment unit: an application of object relations theory. PMID- 6490251 TI - Helping patients survive theories: the practice of an educative model. PMID- 6490252 TI - The words of the therapist: errors of commission and omission. PMID- 6490253 TI - On group therapy developments in context: a Hellenic view. PMID- 6490254 TI - Effectiveness of different group structures for schizophrenic, character disordered, and normal groups. PMID- 6490255 TI - Intensive gestalt group therapy with schizophrenics. PMID- 6490256 TI - Group psychotherapy with schizophrenic patients: an example of the oneness group. PMID- 6490257 TI - Recent developments in gestalt group therapy. PMID- 6490258 TI - Group therapy with Chinese schoolchildren. PMID- 6490259 TI - Bean bag chairs as versatile play objects in boys' latency groups. PMID- 6490260 TI - The micropolitics of medicine: a contextual analysis. AB - Certain features of the doctor-patient encounter "medicalize," and thereby depoliticize, the social structural roots of personal suffering. The critique of medicalization holds that medicine has become an institution of social control, that the health care system helps promulgate the dominant ideologies of a society, and that the doctor-patient relationship is a major site where these developments occur. This paper presents a contextual analysis of medical encounters, drawn from a sample of tape-recorded doctor-patient interaction in medical practice. The doctor-patient relationship manifests problems that arise despite the best conscious intents of well-motivated participants. Conveying the symbolism of scientific medicine, messages of ideology and social control reinforce current relations of economic production and reproduction in work, the family, leisure, pleasure, sexuality, and other areas of social life. Ambiguities within the doctor-patient relationship both reflect and help reproduce broader social contradictions and structures of oppression. The medical encounter is one arena where the dominant ideologies of a society are reinforced and where individuals' acquiescence is sought. A vision of a progressive doctor-patient relationship must include a conception of how that relationship contributes to fundamental social change. PMID- 6490261 TI - Playing doctor, seriously: graduation follies at an American medical school. AB - In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self congratulation. PMID- 6490262 TI - Survival of the fittest? The democratization of hospital administration in Quebec. AB - In 1973 the Canadian Province of Quebec "democratized" its hospital boards of directors by replacing their traditional lay community or religious members with individuals more representative of the hospitals' major interest groups. In the province's English-speaking hospitals, patients, community organizations, physicians and nonprofessional hospital employees elected representatives to boards that were formerly comprised mostly of business executives. After a brief description of the social organization of the former "elite" boards and their role in the distribution of power within hospitals, the paper demonstrates how the "elite" board members and hospital administrators retained control despite "democratization." Several theoretical explanations for this outcome are critically examined in the light of these empirical findings. One suggestion is that the "elite" administration survived democratization because it was "fitter" in terms of ability to influence the hospitals' major economic and political constraints. PMID- 6490263 TI - Productivity and safety in worker cooperatives and conventional firms. AB - This paper examines the relationship between productivity and workers' safety in firms characterized by very different types of relations in production. Arguments are developed to explain why worker cooperatives are expected to have higher productivity and lower accident rates than conventional capitalist firms. Workers who own and control their firms are expected to have a greater incentive to be efficient and a greater ability to safeguard their health than workers employed under hierarchical and alienating conditions. The hypotheses are tested by comparing carefully matched conventional and cooperative plywood companies. Preliminary results suggest that while cooperatives may be more productive they are not safer, indicating the limits of the isolated cooperative form in capitalist market economies. PMID- 6490264 TI - A decade of genetic struggle. PMID- 6490265 TI - Medical care and health under state socialism. AB - This paper derives a conception of ideal socialist and communist medical care and health policy. This model is based on a review of Marxist and allied critiques of capitalist medical care policy and on theoretical work on socialist social policy. The ideal conception, operationalized in terms of 16 criteria, is then applied to a review of medical care and health policy in the Soviet Union. Hungary, and Poland. It is concluded that medical care policy in all three countries exhibits very few characteristics of socialist medical care. The possibility (for the moment repressed) provided by the Solidarity movement in Poland of a new development toward a more genuine socialist medical care and health policy is also described. PMID- 6490266 TI - Public policy and the nursing home industry. AB - The nursing home industry is a multibillion dollar business in the United States, characterized by rapid growth in profits and large chain-owned corporations. The industry, while private in nature, is effectively a public program defined by public policies, particularly by the Medicaid program. Demand for services is artificially inflated because of the absence of community-based alternatives and favorable nursing home reimbursement policies. The effectiveness of regulatory activities in protecting consumers is questionable, where poor quality is commonly found. Although the structure of the nursing home industry requires radical change, the politics and economics of the current situation reinforce continued expansion of the industry and the use of institutionalization as the primary modality of treatment for the frail aged. PMID- 6490267 TI - More schools of public health: a worldwide need. AB - This article asserts an urgent need for more schools of public health to produce an adequate supply of personnel capable of dealing with the health problems of the world population. Although there is a need for 450 schools of public health worldwide (1 for every 10 million population), there are currently fewer than 100 independent schools, with 23 concentrated in the United States alone. The benefits of independence from medical schools are stressed. The academic environment of patient-oriented clinical medicine is posited not to be conducive to the growth of the community-oriented public health discipline. The need for expansion exists in both developing and industrialized countries, although shortages are greater in less developed areas. Effective schools of public health should welcome students from a variety of backgrounds and serve as centers for the research and evaluation of national health systems. PMID- 6490268 TI - Principles of medical ethics relevant to the protection of prisoners against torture. Council for International Organizations of Medical Sciences. PMID- 6490269 TI - The coping process with illness in patients with cardiovascular or cerebrovascular diseases: a new survey: EKV. AB - The EKV is a survey constructed by the authors to get detailed information about the patient's feelings, thoughts, attitudes, and plans when confronted with a severe organic (chronic) disease, especially with cardiovascular or cerebrovascular diseases. Starting from the actual situation the focus lies on the patient's realization of consequences resulting from the illness-event for the organic, emotional-cognitive, familial, occupational and social aspects of life. Further topics are early and previous events or thoughts and the development of symptoms associated with the later outbreak of functional disorders or organic lesions which are treated now. Attention is also paid for the treatment situation in the past and at time and for the patient's projections to future life: thoughts about the progress of his disease, expected physical and psychical potency, occupational and leisure plans, partnership, familial and social life, illness-related changes in the style of life, expected satisfaction with life etc. The survey is to be used as a half-structured interview that takes 2 to 3 hours. It has already been tested, modified and now used on ca. 150 patients with different vascular diseases (pts. with myocardial infarction, coronary heart disease (angina pectoris), functional heart and circulatory disorders; completed stroke, prolonged ischaemic neurological defect, or transitoric investigation with the EKV are in preparation. Within a psychosomatic framework the survey gives a relevant overview and useful insight in the patient's reality, his adapting and coping reactions, the meaning of the chronic disease for his self-conception and way of life, as well as possibilities or necessities for psychological interventions and other treatment aspects. PMID- 6490270 TI - The relationship of rehabilitation center staff and client endorsement of appropriate client behaviors to outcome. AB - Clients who enroll in comprehensive rehabilitation centers but fail to complete their planned programs tend to be, at follow-up, less well adjusted than clients who do complete their planned program. Consequently, much research has been directed at understanding why clients fail and at identifying those clients most likely to fail. This study analyzed the relationship of client and staff expectations toward important client behaviors to outcome. Using a two dimensional scaling technique, staff (n = 74) and clients (n = 268), at a large comprehensive rehabilitation center were asked to judge their acceptance of clients exhibiting either independent or dependent behaviors. Results indicated that both clients and staff approved of independence over dependence, that there was no difference between types of staff in their perceptions of appropriate client behaviors, that there were no significant differences between client program completers and noncompleters in perceptions toward appropriate behaviors, but that there were significant differences between clients and staff in the degree of approval of select client behaviors. Implications for rehabilitation practice and future research are discussed. PMID- 6490271 TI - Impact of an engineered physical therapy program for the elderly. AB - An eight week pilot study was conducted at McDonald Army Hospital, Physical Therapy Clinic, Fort Eustis, Virginia to evaluate the effectiveness of an engineered pool therapy program for resolving the inadequacies of providing the elderly with care which incorporated a total concept of health when staffing was a constraint. It was designed to change misconceptions about aging, create a viable social network through group instructional strategy and improve physical fitness. A small, intact, non-random sample of ten participants was selected for the pilot program. The Palmore "Facts on Aging Quiz" (1977) was administered as pre- and posttests to assess attitudinal changes. Physical measurements of strength, range of motion, flexibility and/or endurance, as applicable, were documented. Calculated pairing of participants based on similar disability but dissimilar age category constituted the key difference between this pool program and a traditional pool program. Results for the original group of participants were analyzed and residual findings were discussed. Statistical analysis revealed significant impact of this program on endurance performance but no difference for attitudinal changes. However, attributing this significant improvement of physical fitness exclusively to the engineered pool program design would be premature. Further investigations using randomized sampling and a control group were recommended. PMID- 6490272 TI - Grading of muscle power: comparison of MRC and analogue scales by physiotherapists. Medical Research Council. AB - The M.R.C. scale for grading muscle power in stages from 0 to 5 has been compared with an analogue scale in which power is expressed as a percentage of the maximum expected for that muscle. Twenty therapists examined many patients in a series of comparative tests. The M.R.C. grade is more reliable and accurate for this type of clinical assessment in weak muscles, that is grades 0-3 on the M.R.C. scale or 0-62% on the analogue scale. The analogue scale is more reliable and accurate for the assessment of stronger muscles, that is grades 4 and 5 of the M.R.C. scale or 62-100% on the analogue scale. Therefore, analogue scales could be usefully adopted when testing bulky muscles operating at 50% or more of their normal power. PMID- 6490273 TI - A description of independent living projects in the United States: various programmatic strategies for fiscal coping. AB - Independent living facilities in the United States provide numerous services to a large number of residential clients using a diversity of human service personnel. The facilities are often homogeneous in the range of services offered, the large nature of the facility, client population, staff, and sometimes budget. Most facilities feel that various styles of residential programs should be researched. A clearly defined service delivery model and fiscal models for prudent operations appears to be lacking in most agencies. Almost all the programs rent part of their building space to outside business interests. An absence of Federal money would eliminate or vastly reduce the services of most of the surveyed programs. PMID- 6490274 TI - Epidemiology of cerebrovascular and ischaemic heart disease. PMID- 6490275 TI - A microprocessor based control system for multifunctional hand prostheses. PMID- 6490276 TI - Psychological adjustment to aphasia. PMID- 6490277 TI - Evaluation of a new frequency transposing hearing aid and/or speech training aid for the sensory neural deaf. PMID- 6490278 TI - Short review of psycho-physiological studies into visual perception in normal and impaired vision. PMID- 6490279 TI - Longitudinal study of teacher language interacting with their mentally retarded students. PMID- 6490280 TI - Identifying and meeting the needs of profoundly mentally handicapped children, 1980-83. PMID- 6490281 TI - Body image and motor skills in normal and subnormal subjects. PMID- 6490282 TI - Preston Skreens: a family support unit for mentally handicapped children in the Medway Health District. PMID- 6490283 TI - The utility of routine blood pressure assessments at outpatient alcohol treatment clinics. PMID- 6490284 TI - Factors relating to under-use of hearing aids. PMID- 6490285 TI - Social aspects of acquired hearing loss in adults. PMID- 6490286 TI - The vocational development of mentally handicapped young people. PMID- 6490287 TI - The interaction of parents and their mentally handicapped pre-school-children. PMID- 6490288 TI - Experimental research with families of mentally handicapped children and young adults. PMID- 6490289 TI - A follow-up study of young mentally handicapped people. PMID- 6490290 TI - Cytotoxicity of sera from patients with scleroderma--effects on human endothelial cells and fibroblasts in culture. PMID- 6490291 TI - Cowden's disease with associated malignant melanoma. AB - Cowden's disease (multiple hamartoma syndrome), a rare genodermatosis, is inherited in an autosomal-dominant genetic pattern. It is characterized by mesodermal and epithelial hamartomas appearing as verrucous papules occurring predominantly over the central portion of the face, with perioral and acral papular lesions and papillomatosis of the lips, gingiva, and tongue extending through the entire length of the gastrointestinal tract. These skin lesions have been found to be associated with a number of benign and malignant tumors involving the breast, thyroid, skin, ovaries, adipose tissue, and gastrointestinal tract. The authors report the second case of Cowden's disease associated with malignant melanoma and emphasize the need for a high index of suspicion for related benign or malignant tumors in these cases. PMID- 6490292 TI - Hereditary polymorphic light eruption in Canadian Inuit. AB - Twelve Canadian Inuit patients from the Keewatin District of the Northwest Territories were found to have hereditary polymorphic light eruption. The clinical manifestations were similar to those described in the North American Indian, with a photodermatitis occurring in the sunlight-exposed area. The onset occurred prior to the age of 15 years in 70% of subjects, and the condition was seasonally recurrent, starting in February and lasting until September. Patients demonstrated improvement on a combined regime of local therapy and oral trioxalen. Seventy-five percent of patients had a family history of photosensitivity, suggesting an autosomal dominant trait with incomplete penetrance. Indian ancestry was not demonstrated in these patients. PMID- 6490293 TI - Juvenile plantar dermatosis in Singapore. AB - Juvenile plantar dermatosis (JPD) is the most common form of foot dermatitis in children in Singapore. Sixty-four patients (29 boys) with an age range of 2-25 years were studied. The Chinese have a greater predisposition for JPD compared with the Malays and Indians. The mean age of onset was 8 years, but onset in adulthood is not uncommon. Friction and closed shoes are the main aggravating factors. Association with an atopic history (42%) and ichthyosis vulgaris (19%) is reported. Patch testing was not rewarding. The histology was essentially a subacute dermatitis. Women with no atopic background, in whom the type of shoes made no difference and had a family member with a similar dermatosis, tend to have a more prolonged course of disease. PMID- 6490294 TI - Malignant melanoma in Jordan. AB - Seventy-four patients with primary cutaneous malignant melanoma were diagnosed in Jordan from June 1969 until April 1983. The percentage of melanomas to the total number of biopsied tumors was 4.1, and the prevalence of melanoma in the population of Jordan was 2.1 in 100,000. This is the first study of its kind on melanoma in Jordan and is based mainly on cases seen at three major referral centers. PMID- 6490295 TI - The infra-red coagulator and its role in dermatology. PMID- 6490296 TI - Improving data bases for international studies. PMID- 6490297 TI - The gathering smoke clouds: a worldwide challenge. AB - Based on the 1983 WHO Expert Report, Smoking control strategies in developing countries, the problem in these countries is briefly reviewed. Many countries are well on the way to adding a formidable epidemic of smoking related diseases to their already overwhelming health problems. Rational policies of prevention are reasonably well understood. But, just as in developed countries, the difficulty is to get them applied. Doctors in the industrialized world could do much to support their colleagues in the threatened countries. All of us should feel a responsibility towards helping to prevent the tragedy. PMID- 6490298 TI - Bladder cancer mortality in New Jersey counties, and relationship with selected environmental variables. AB - Age-adjusted mortality rates for bladder cancer were calculated for the 21 New Jersey (NJ) counties (USA) during the period 1968-1977, and compared with the period 1950-1969, with the Surveillance, Epidemiology and End Results (SEER) survey and with cancer mortality in the US 1973-1977. The county rates were also correlated with: the rates of low birth weight, birth defects, infant mortality; chemical waste disposal sites; annual per capital income; per cent of the population working in the chemical industries; density of population and urbanization indices of 21 NJ counties. Age-adjusted bladder cancer mortality rates in 95% of NJ counties were higher than national and SEER area rates. The overall NJ State rates for four subgroup populations were highly significantly (p less than 0.001) greater than the national rates. There was a statistically significant correlation between bladder and lung cancer mortality among females in 21 NJ counties which may suggest a common risk factor--namely cigarette smoking. There was no such correlation between bladder and lung cancer mortality among males. There was a statistically significant association between bladder cancer mortality in individual counties and the percentage of the adult population working in the chemical industries. PMID- 6490299 TI - Mortality due to all causes and to cardiovascular diseases among seven race ethnic populations in Los Angeles County, 1980. AB - Mortality rates during 1980 in Los Angeles County are presented for Whites, Blacks, Hispanics, and Americans of Japanese, Chinese, Philippine, and Korean descent, seven groups with varying patterns of migration during the prior decade. For all causes of death, age- and sex-adjusted rates were highest among Blacks, intermediate among Whites and Hispanics, and substantially lower among Asians and Pacific Islanders. A similar observation was made for the major cardiovascular diseases and for diseases of the heart. In contrast, the mortality rates for cerebrovascular diseases exhibited a slightly different pattern, with Blacks again highest, Whites and Japanese being intermediate, and Hispanics, Filipinos, Chinese, and Koreans being lowest. The descriptive information suggests several areas for further research into the effect of various cultural or lifestyle patterns on the occurrence of cardiovascular disease. PMID- 6490300 TI - Late mortality after partial gastrectomy. AB - A 10-year prospective study of Hawaii Japanese males with partial gastrectomy shows that the age-adjusted mortality rates in men with partial gastrectomy were slightly higher than in those with an intact stomach, but the difference failed to achieve statistical significance. This excess of mortality is due, in part, to excess smoking by men who had ulcers of the stomach. Although death due to stroke and lung cancer showed the most substantial deviations from the base population, this can be attributed only in part to the tendency of men with these diseases to be smokers. Other factors, possibly related to nutrition, also contribute to the increased risk of mortality from these diseases. Death from coronary heart disease, an illness with a substantial association with smoking in men with an intact stomach was less frequent in men with gastrectomy but the difference was not statistically significant. It would appear that men with partial gastrectomy had other characteristics that weakened the impact of smoking upon coronary disease risk--low blood pressure, low serum cholesterol, low body weight and increased alcohol consumption. PMID- 6490301 TI - Repeatability of infant deaths in Korea. AB - Using data from the world fertility survey for Korea, repeatability of infant death in the family was investigated applying the log-linear model. There is a strong association in survivorship between any two consecutive births. No such association is observed in nonconsecutive birth orders. There is a suggestion however, that the survival of the first birth is related to that of the third or even the fourth birth order. PMID- 6490302 TI - Adolescent idiopathic scoliosis: epidemiology and treatment outcome in a large cohort of children six years after screening. AB - A prospective study was carried out in a cohort of 6873 children to determine diagnosis and treatment rates for adolescent idiopathic scoliosis (AIS) and to establish the distribution of parameters related to bracing. The follow-up completion rate was 85%, and prevalence rates were adjusted accordingly. The prevalence of AIS of 6 degrees or more at time of diagnosis was 8.1%. The female to male ratio for curves of 6 degrees or more was 1.07:1 with an increase to 6:1 for curves greater than 21 degrees. The rate of brace treatment was 2.8 per 1000. Deterioration, defined as progression of a scoliosis curve to the point where a brace was prescribed, was found in 3.7% of the scoliosis group. Fifteen children were prescribed braces: eight did not follow the treatment plan adequately (non compliers), and five among these abandoned the follow-up programme. However, none of the non-compliers deteriorated to the point where spinal fusion was required. PMID- 6490303 TI - A survey of dietary nitrate in well-water users. AB - The hypothesis that high nitrate ingestion may increase the risk of stomach cancer has led to concern over rising levels of nitrate in drinking water, but with little consideration as to whether nitrate from water makes a major contribution to total nitrate intake. In order to investigate the relative importance of water and food as sources of nitrate, 404 adult well-water users completed a diet diary over a 48-hour period and provided a 24-hour urine specimen and a sample of their drinking water. Where the waterborne nitrate level is less than 50 mg/I, as recommended by the World Health Organization (WHO), 30% of ingested nitrate is from water. As the well-water nitrate concentration rises the contribution of water to daily intake increases; at levels between 50 and 100 mg/I, on average, nearly 70% of daily intake is from water, and above 100 mg/I over 80% of daily intake is waterborne. Thus it is only at levels above those currently recommended by the WHO that waterborne nitrate appears to be the major contributor to total nitrate intake. PMID- 6490305 TI - Calculating risk ratios for spontaneous abortions: the problem of induced abortions. AB - The frequency of induced abortions varies greatly between and within populations, and the currently employed measures of the ratio of spontaneous abortions are distorted proportionally to the number of induced abortions. Corrections are therefore often necessary to avoid bias when risk ratios for spontaneous abortions are estimated. The potential magnitudes and direction of the bias associated with such risk ratios (under the null hypothesis) are given under certain model assumptions. Adjustment of the estimated risk ratios using an appropriate model for the given data is proposed, rather than using a fixed correction factor. PMID- 6490304 TI - Transmission of non O group 1 Vibrio cholerae by raw oyster consumption. AB - After having eaten dinner many customers of a restaurant in Dolo (Venice) developed gastroenteritis with diarrhoea and vomiting. Strains of non O group 1 Vibrio cholerae were isolated from rectal swabs of four customers. Epidemiological investigations revealed an association between the illness and raw oyster consumption (p = 0.008). Also, an association was found between age and illness among males (p = 0.034). As a consequence of this outbreak, a gastroenteritis surveillance programme was run for three months by health authorities in the Regione Veneto. The results indicate that, although non 0-1 V. cholerae does not account for severe pathology, it causes mild gastroenteritis and asymptomatic infections in developed countries. PMID- 6490306 TI - The development of matching criteria for epidemiological studies using record linkage techniques. AB - The hypothesis that pairs of records with identical surnames, given names and birth dates represent the same person was tested by compiling a frequency distribution of the number of birth date digits in common when the names contained in two registers were matched. This distribution was compared with a computer simulation of the distribution which would be expected if the paired records represented different people. The divergence of the two distributions in the region of five and six birth date digits in common confirmed the hypothesis. Where surname, two given names and at least four date of birth digits matched, only 0.012% of the matching records represented different people. Where surname, two given initials and six date of birth digits matched, 0.1% of the matched records represented different people. PMID- 6490307 TI - Methodological issues in case-control studies. III--The effect of joint misclassification of risk factors and confounding factors upon estimation and power. AB - The effect of joint misclassification of polytomous risk factors and polytomous covariates in case-control studies upon estimation and power has been examined using computer simulation and mathematical models. It is concluded that non differential misclassification of covariates may be as important as non differential misclassification of exposure variables, and that the resultant bias of the relative risk estimate may be either toward or away from the null. It is pointed out that when a confounding variable is misclassified the calculated p value from the particular study will be incorrect and may either be too large or too small depending on the nature of the confounding. PMID- 6490308 TI - Regional differences in dietary habits, coronary risk factors and mortality rates in Belgium. An interuniversity study. PMID- 6490309 TI - Anencephaly in Belgium, 1969-1982. PMID- 6490310 TI - Birthweight and perinatal mortality. PMID- 6490311 TI - Measuring the impact of water supply and sanitation on diarrhoeal diseases: problems of methodology. PMID- 6490312 TI - Human endometrium and endometriotic tissue obtained simultaneously: a comparative histological study. AB - A comparative study on the histological appearance of endometrium and endometriotic tissue obtained simultaneously has been performed. In all, 47 endometriotic samples from 28 patients were examined. In 15 cases, samples from more than one endometriotic lesion were included. The endometriotic tissue had developed a distinctive menstrual phase pattern in 23 patients (82%). In 16 of these patients (70%), the phase pattern was found to be synchronous (+/- 3 days) in the two tissue types. In seven cases (30%), it varied inconsistently as compared with the endometrial phase. In the remaining five cases (18%), no menstrual phase pattern was found in the endometriotic specimens in spite of a well-defined phase in the endometrium. When biopsy specimens from different endometriotic lesions in the same patient showed a menstrual phase pattern, the phase did not differ significantly among the specimens. Although a menstrual phase pattern could be recognized in the endometriotic tissue samples in most cases, a considerable variability in glandular and epithelial cell morphology was frequently found. PMID- 6490313 TI - Fibromatosis and massive edema of the ovary, possibly related entities: a report of 14 cases of fibromatosis and 11 cases of massive edema. AB - Twenty-five cases of ovarian enlargement secondary to massive edema, to a hitherto undescribed lesion that we have designated fibromatosis, or to both processes were reviewed to explore the possibility of a relation between them. The patients ranged in age from 13 to 39 years. The 14 patients with pure or predominant fibromatosis usually presented because of menstrual abnormalities; two had evidence of androgen excess and three had abdominal pain. At laparotomy two involved ovaries were observed to have twisted on their pedicles. There was definite bilateral ovarian involvement in two cases and probable bilateral involvement in two others. The excised specimens measured up to 12 cm in diameter and typically had firm, white sectioned surfaces. Microscopic examination showed a proliferation of spindle cells usually separated by dense collagen, which surrounded normal follicular structures. Lutein cells were present in the fibromatous areas in one patient, who was masculinized, and in the adjacent ovarian stroma in another patient, who was hirsute; a proliferation of cells of sex cord type was observed in the fibromatous areas in three cases. Six of the specimens contained focal areas of edema similar in appearance to that seen in cases of massive edema. The features of the 11 cases of massive edema were, in general, similar to those of the 40 examples of this entity reported in the literature. Six of the 11 patients had menstrual abnormalities and/or evidence of androgen excess, but most of them presented because of abdominal pain. At operation an involved ovary was observed to have undergone torsion in five of the cases; bilateral ovarian enlargement due to massive edema was present in two cases. The excised specimens, which measured up to 15 cm in diameter, typically had a watery appearance on sectioning. Microscopic examination showed edematous stroma surrounding residual normal ovarian structures. Lutein cells were identified in the edematous stroma in four cases and in the adjacent ovarian stroma in three of these cases. One of these patients was masculinized and another was hirsute. Small foci of fibromatosis similar to that seen in cases of pure fibromatosis were present in eight cases. The similar age range and clinical manifestations of these two processes and the overlap in their histologic features suggest that they are closely related and may reflect differing morphologic expressions of the same underlying disorder. Some of the cases of massive edema, however, may result from the development of stromal edema in ovaries involved by hyperthecosis. PMID- 6490314 TI - Adenocarcinoma in situ of the cervix. AB - Adenocarcinoma in situ (ACIS) of the cervix is rare and is frequently overlooked. To characterize this disease more fully, 21 cases were studied. All except two patients presented with abnormal smears. The distribution of ACIS was focal in two cases, multicentric in three, and diffuse and continuous in 15 (in one case it was unknown). The depth of crypt involvement varied from 0.5 to 4 mm and the volume was estimated to range from 0.25 to 1,500 mm3. ACIS should and can be distinguished from early ("microinvasive") adenocarcinoma in most cases by its limitation to the glandular field, by the constant admixture of neoplastic and normal glands, and by the lack of stromal response. Invasive adenocarcinoma cannot be excluded by target biopsy, the diagnosis of ACIS requiring conization. If the surgical margins are disease free, conization alone may be adequate therapy. PMID- 6490315 TI - The clinical and histologic spectrum of endometrial stromal neoplasms: a report of 41 cases. AB - Clinical and pathological features of 41 homologous uterine stromal tumors classified by the criteria of Norris and Taylor were reviewed. These included stromal nodules (12 cases), endolymphatic stromal myosis (20 cases), and stromal sarcoma (nine cases). Patients ranged in age from 18 to 79 with a median of 45 years. Symptoms were similar in all three forms and included vaginal bleeding (63%), pelvic pain (11%), or an abdominal mass (6%), while 26% of patients were asymptomatic. Tumors characteristically resembled endometrial stroma histologically, but variations included hemangiopericytoma and "sex-cord-like" patterns, hyalinization, and foam cells. A sex-cord-like pattern was seen only with stromal nodules and endolymphatic stromal myosis. Necrosis was seen in all three lesions, whereas nuclear anaplasia was seen only with stromal sarcoma. Follow-up ranging from 2 months to 12 years (median interval: 5 years) was obtained in 23 cases. No recurrences were recorded among six stromal nodules. Endolymphatic stromal myosis behaved as an indolent low grade malignancy, with three recurrences but no deaths among 13 patients; these occurred at 3 to 7 years after initial diagnosis. Stromal sarcoma behaved as a high grade malignancy, with two deaths among five patients with follow-up, both occurring within 8 months of diagnosis. PMID- 6490316 TI - Synthetic gestagens and endocervical adenocarcinoma. PMID- 6490318 TI - Abstracts: XVIII annual meeting of the European Society for Pediatric Nephrology. Dubrovnik, Yugoslavia, September 17-20, 1984. PMID- 6490317 TI - Marfan syndrome and medullary sponge kidney: case report and speculation on pathogenesis. AB - The case of a 16 year old boy with Marfan syndrome, recurrent nephrolithiasis, and bilateral Medullary Sponge Kidney (MSKD) is described. This association was not previously described. PMID- 6490319 TI - The significance of focal segmental glomerulosclerosis in oligomeganephronia. AB - Oligomeganephronia (OMN) is characterized by a reduced number of nephrons, with compensatory hypertrophy of the remaining glomeruli and tubules. The clinico pathological features of six cases seen at The Hospital for Sick Children, Toronto were reviewed. One patient presented in infancy (10 days of age), the others between 12.8 and 14.5 years (mean 13.7 years), with long-standing polydipsia and polyuria, enuresis, and growth retardation. All patients had proteinuria which tended to increase as the disease progressed. At renal biopsy, four patients showed significant proteinuria (greater than 1.3 g/24 hr). Biopsies from these patients showed focal segmental glomerulosclerosis (FSGS) and all have rapidly progressed to dialysis/transplantation. The two remaining patients had lesser degrees of proteinuria (less than 0.3 g/24 hr) and no evidence of FSGS on biopsy; however, they are currently in chronic renal failure (mean serum creatinine 2.8 mg/dl). We conclude that increasing proteinuria in patients with OMN heralds the development of FSGS, presumably due to functional overload of the reduced nephron number. This is associated with a rapid decline in renal function. PMID- 6490320 TI - Evaluation of total protein excretion as a predictor of increased hemoglobin A1C levels in children with type 1 diabetes. AB - The purpose of this study was to investigate the use of the readily available and frequently used clinical test of total protein excretion as a correlative of hemoglobin A1C concentration and thus, as an indicator of strictness of control of type 1 diabetes. Subjects were 211 diabetic children being followed in a private practice. Twenty-four hour urine protein excretion and hemoglobin A1C were measured and data were compared using Pearson correlation procedures. The relationship between these two variables was not significant (p = .88). These findings indicate that total urinary protein does not correlate with hemoglobin A1C and is therefore not a useful clinical test to evaluate strictness of control in type 1 diabetes in children. PMID- 6490321 TI - Evaluation of kidney growth in vesico-ureteral reflux. AB - The parenchymal growth of 80 kidneys with vesicoureteral reflux (VUR), 50 of them surgically corrected, has been evaluated by calculating the ratio between bipolar thickness (BT) and the kidney length (KL), as measured radiographically. We consider this ratio provides a more precise evaluation of the morphologic and functional state of the refluxing kidney as it corresponded closely with the planimetric measurement of the area of renal parenchyma (ARP) in the 12 kidneys where this has also been calculated. Eighteen out of 30 medically treated refluxing kidneys showed a BT/KL ratio inferior to the 2 SD value for age at the time of diagnosis. A worsening BT/KL ratio has been observed in 6 out of 30 kidneys in which reflux ceased spontaneously and in 11 out of 50 which have been corrected surgically. The unfavourable outcome, as far as this parameter is concerned, in the medically treated cases seems to be due to the recurrence of urinary tract infection (UTI); while there is non so clear explanation for it in cases which have been surgically corrected. PMID- 6490322 TI - Anion gap in nephrotic syndrome. AB - Low anion gap occurs in a variety of disorders including hypoproteinemia. We evaluated anion gap in 28 children - 18 boys and 10 girls with minimal change nephrotic syndrome during 55 separate episodes of exacerbations. To assess the contribution of serum total proteins, albumin, cholesterol and immunoglobulin levels to low anion gap, a coefficient of correlation was calculated. Anion gap was significantly low (p less than 0.01) during exacerbations in nephrotic. The low anion gap correlated with low serum total proteins (less than 4 g/dl) and serum albumin levels (less than 1.5 g/dl) but not to serum cholesterol or immunoglobulin levels. Low total serum protein at patients blood pH, contributed fewer negative charges to anion gap thereby lowering the anion gap. The major cause of low anion gap in nephrotic syndrome is hypoproteinemia especially hypoalbuminemia. PMID- 6490323 TI - Renal water handling in minimal change nephrotic syndrome. AB - Renal water handling was studied in proteinuric and non-proteinuric phase in 25 children with minimal change nephrotic syndrome. Clearance of inulin was determined during water diuresis and in hypodropenia followed by intravenous saline infusion. The diluting capacity, evaluated both as minimal urinary osmolality and as free water clearance did not differ from that in controls. An inverse correlation was found between distal tubular sodium delivery and serum albumin concentration during proteinuric phase. The concentrating capacity, evaluated as maximal urinary osmolality did not differ in proteinuric and non proteinuric phase. Free water reabsorption, however, was significantly lower in proteinuric phase than in remission. The correlation of severe hypoalbuminemia with high distal tubular sodium delivery indicates a decrease in proximal sodium reabsorption in proteinuric phase, and the normal diluting capacity supports an intact, probably increased, distal tubular sodium reabsorption. The normal ability to excrete a water load suggests that the water retention in the nephrotic syndrome is secondary to sodium retention. PMID- 6490324 TI - Nephropathy associated with Charcot-Marie-Tooth disease. AB - In this report, we describe a case of 14-year-old girl with Charcot-Marie-Tooth (CMT) disease and the nephropathy which was characterized by heavy proteinuria and microscopic hematuria. She progressed to renal failure with clinical duration of 4 years from the onset of disease. Renal biopsy specimens revealed the features of focal segmental glomerulosclerosis (FSGS). The patient has also a bilateral sensorineural deafness. Although the clinical features show similarities to those of the Alport syndrome, electron microscopic examination did not disclose the glomerular basement membrane changes which were characteristic of the Alport syndrome. The association of nephropathy with CMT disease is discussed, as compared with previous report. PMID- 6490325 TI - Regulation of erythropoiesis. AB - The regulation of erythropoiesis is an important factor in maintaining normal blood viscosity. In this short summary the three erythroid compartments in the bone marrow are described: the stem cells, the committed cells and the morphologically recognisable cells. The stimulating factors burst forming activity (BFA) and erythropoietin (Ep) act on the committed cells. The production of Ep is regulated through tissue oxygenation while BFA seems to be unrelated to this. Under normal conditions erythropoiesis is a well regulated system, while under pathological conditions it may escape control and thus give rise to very high haematocrits and increased blood viscosity. PMID- 6490326 TI - 'Regulation' of capillary haematocrit. AB - The nature of blood as a suspension with characteristic flow properties is the basis of the uneven distribution of total red cell mass and plasma volume in the cardiovascular system. On one hand the fraction of blood volume occupied by red cells is reduced in the small blood vessels due to axial accumulation of erythrocytes in flow. On the other hand, the fraction of blood flow occupied by red cells is affected by hydrodynamic separation effects at microvascular bifurcations. The combination of these phenomena results in inhomogeneous haematocrit distribution even within the network of capillaries. Both effects are, for different reasons, affected by changes in vascular smooth muscle activity; as a consequence, haematocrit distribution is coupled to the mechanisms regulating vascular resistance. PMID- 6490327 TI - Flow behaviour of rigid red blood cells in the microcirculation. AB - Flow behaviour of rigid (diamide treated) red blood cells (RBC) was investigated in anaesthetised rats and isolated rat mesentery, supplemented by pressure-flow curves in small bore glass tubes. It was shown that (1) Diamide treated cells, the shear modulus of which is increased, were not eliminated from the circulation of rats within an experimental time of 4 h. (2) At normal arterial pressure, an exchange of native for diamide treated red blood cells only slightly reduced RBC flow velocity in capillaries of the mesentery of anaesthetised rats. (3) Flow velocity of stiffened red blood cells was drastically reduced at low driving pressure (hypotension). Many capillaries became irreversibly clogged and flow did not resume with normalisation of the arterial blood pressure. (4) In the capillaries of the isolated mesentery, no difference in resistance to flow was observed between treated and control cells as long as steady state velocities were compared. This is in accordance with results obtained in glass tubes above wall shear stresses of 0.05 Pa. At stenoses, however, where RBC's undergo transient deformations, the passage times of treated cells were longer than those of untreated cells. From this it is concluded that not only the elastic properties but also the viscous properties of the red cell membrane are changed by diamide treatment and that the dynamic response of the red cell during transient deformations may limit the ability of the cell to negotiate the microcirculation. PMID- 6490328 TI - Contracted plasma volume syndromes. AB - There is a wide range of disorders in which plasma volume may be contracted. This may either be due to a primary reduction in plasma volume, or secondary to a reduction in the volume of the vascular compartment. In the former there may be a salt and water deficit as the cause or a loss of plasma volume due to a capillary leak. Reduction of the vascular compartment is usually due to increased adrenergic activity reducing the circulatory capacitance volume. Plasma volume is reduced to compensate for the overfilling of the central circulation. The causes and clinical significance of plasma volume contraction are discussed, with particular emphasis on the pathophysiology and implications for therapy. The controversial subject of stress polycythaemia is addressed and a theoretical analysis of its pathophysiology presented. PMID- 6490329 TI - In vitro incorporation of proline into keratoconic human corneas. AB - Corneal buttons were obtained from four young adults with advanced keratoconus following perforating keratoplasty. The corneal buttons were incubated in organ culture media containing 3H-proline. Autoradiographs of corneal sections showed that the incorporation of the radioisotope was significantly higher in all layers of the kerotoconic corneas than that found in the normal controls, indicating an increased protein biosynthesis in the former. It is suggested that in spite of the found increased synthetic activity, slow destruction and thinning of the cornea in keratoconus might occur as the result of inadequate compensation for tissue loss due to increased collagenolytic activity in the disease. PMID- 6490330 TI - Hexokinase of calf trabecular meshwork. AB - Although aqueous outflow is most likely a passive, nonenergy-dependent process, alterations in cellular function in the trabecular meshwork presumably are involved in the development of some types of glaucoma. Accordingly, it seems important to define both the normal and abnormal biochemistry of this tissue. The authors have chosen glycolysis as their starting point, concentrating on the regulatory enzymes, hexokinase, and, in a companion paper, phosphofructokinase. Hexokinase activity has been measured in the 100,000 X g supernatant of homogenates prepared from excised calf trabecular meshwork. Treatment of the homogenate with Triton X-100 before centrifuging caused a twofold increase in measurable activity. Electrophoresis on cellulose acetate revealed types I and II isoenzymes. Electrophoresis on starch gel further resolved type 1 into the adult and fetal subtypes. The principal isoenzyme type released into solution by Triton X-100 was type 1. The kinetic behavior of hexokinase was measured by varying the concentrations of glucose at saturating levels of ATP. Kms calculated from these plots were 7.15 X 10(-2) M, 1.78 X 10(-3) M, and 1.19 X 10(-4) M. Apart from the fetal form of type I hexokinase, the isoenzymes from trabecular meshwork resemble those of other ocular tissues and most extraocular tissues. The special role, if any, of the fetal isoenzyme in regulating glycolysis is not known. Possibly, it is a "kinetically adaptable" isoenzyme. PMID- 6490331 TI - Photobinding of 3H 8-methoxypsoralen to monkey intraocular tissues. AB - Young (less than 1 year) and old (greater than 15 years) Rhesus monkeys were utilized in this study in order to determine whether ultraviolet (UV) radiation at ambient levels induces psoralen photobinding in primate eyes (in particular the lens and retina). Unilateral aphakia or pseudophakia was induced surgically and the eyes were allowed to heal. The animals then were given a single intraperitoneal injection of 3H 8-methoxypsoralen (8-MOP) and immediately exposed to BLB lights (of measured radiation intensity at the corneal surface). The animals were killed at varying time periods (2-6 weeks), and the eyes were removed immediately. One-half of each cornea and lens was frozen for subsequent optical spectroscopy and the remaining ocular tissues were fixed for histopathologic studies and autoradiography. These data demonstrate that low level UV radiation (less than 0.4 mW/cm2) can cause 8-MOP photobinding to lens proteins and DNA and to aphakic, pseudophakic, and young phakic primate retinas. The older phakic primate lens serves as a protective UV filter and prevents psoralen photobinding within the retina. These data suggest that older aphakes and pseudophakes may require UV radiation protection to prevent direct as well as photosensitized retinal photodamage. PMID- 6490332 TI - Rocket-ship psychophysics. Assessing visual functioning in young children. AB - A set of psychophysical procedures is described for rapidly measuring visual functions such as spatial contrast sensitivity, flicker fusion, and rod and cone two-color increment thresholds in young children. The psychophysical procedures, disguised as electronic space games, use a forced-choice paradigm combined with the method of descending limits. Because children enjoy the tasks and are highly motivated, the tests yield good sensory thresholds in a short period of time. However, when thresholds from 6-8-year-old children are compared with those of adults, the children have slightly higher thresholds for all of the functions tested. The differences are ascribed to the tendency of children to adopt a guessing strategy when stimuli are close to threshold. PMID- 6490333 TI - Stereo-discrimination between diplopic images in clinically normal observers. AB - When retinal disparity exceeds the limits for fusion, the resulting images are perceived as diplopic. In a stereo test that allowed comparison of crossed and uncrossed disparity sensitivities, 74% of the subjects perceived convergent disparities more readily than divergent disparities. This asymmetric sensitivity to disparity did not appear to be related to measurements of phoria, vergence amplitudes, or clinical measurements of stereo acuity. PMID- 6490334 TI - Neuron-specific enolase-containing cells in the rhesus monkey trabecular meshwork. AB - Neuron-specific enolase (NSE) localizes immunohistochemically to a discontinuous band of cell clusters in the trabecular meshwork of the anterior segment of the rhesus monkey eye. To date, this enolase isomer has been found exclusively in neurons or in cells of the diffuse neuroendocrine system. On this basis, its presence provides presumptive evidence for neuroregulatory cells in the primate trabecular meshwork. PMID- 6490335 TI - Sialic acid on the surface of photoreceptors and pigment epithelium in RCS rats. AB - Incubation of isolated retinas and pigment epithelium (PE) from normal and dystrophic RCS rats with colloidal iron (CI) at pH 1.8 resulted in dense labeling of rod outer segments (ROS) and PE surfaces. Pretreatment with neuraminidase reduced subsequent binding of CI. The authors conclude, therefore, that sialic acid residues are localized on the ROS and PE surfaces. In dystrophic rats, uningested ROS tips, which accumulate in the subretinal space, did not bind CI. PMID- 6490336 TI - Bladder cancer in Iowa. PMID- 6490337 TI - Splenic abscess in a patient with sickle trait. PMID- 6490338 TI - Oral contraceptives in 1984. PMID- 6490339 TI - Congenital heart disease in the adolescent: an Iowa perspective. PMID- 6490340 TI - Artificial urinary sphincter and penile prosthesis surgery: current status. PMID- 6490341 TI - Prediction of steady state theophylline concentration during drug infusion. PMID- 6490342 TI - Quality of care in Iowa nursing homes. PMID- 6490343 TI - Effect of loss of the atrial contribution to ventricular filling on left ventricular function in patients requiring intermittent pacing with ventricular demand pacemakers. PMID- 6490344 TI - The complications of isolated tibial fractures. A review of thirty-six patients. PMID- 6490345 TI - Studies with modern hypnotics. PMID- 6490346 TI - Subjective aspects of the effects of benzodiazepines on sleep and early morning behaviour. PMID- 6490347 TI - Colorectal cancer in a rural population. PMID- 6490348 TI - Acute synovial rupture in Behcet's syndrome. PMID- 6490349 TI - Smoking-related cancers and potential years of life lost attributable to cigarette smoking, Ireland, 1968 to 1978. PMID- 6490350 TI - Life events and psychiatric referral in children: comparison with a general population. PMID- 6490351 TI - Late referral of patients with rheumatoid arthritis to rheumatologists. PMID- 6490352 TI - The effect of a peripheral vasconstrictor drug on the systemic arterial oxygen saturation in Eisenmenger's syndrome. PMID- 6490353 TI - Familial temporal arteritis. PMID- 6490354 TI - Localised amyloid tumour of breast--a case report. PMID- 6490355 TI - Echocardiogram processing and classification using data-dependent systems analysis. AB - This paper presents results of a study on M-mode echocardiogram analysis and classification using the recently developed data-dependent system (DDS) methodology along with clustering techniques. Results of thirty clinically obtained waveforms yielded a correct classification rate of between 83% and 90%, depending on the features used for clustering. The choice of features was facilitated, in part, by a study of six hypothetical waveforms representing an echocardiogram in transition from normal to stenosed. The DDS approach offers potential in the identification and recognition of various cardiac abnormalities, based on echocardiographic data. A comparison with Fourier analysis confirmed the results and points to the advantages of DDS in (a) minimizing false negatives and (b) providing additional features for improved discrimination. PMID- 6490356 TI - The inhibitory effect of phenothiazines on NK-mediated cytolysis of tumor cells. AB - Non-toxic concentrations of fluphenazine caused a marked (90%) inhibition of NK mediated cytolysis of YAC-1 tumor cells. The biologically inactive sulphoxide derivative was not inhibitory and the efficacy of inhibition of other compounds was directly correlated (r = -0.96, p less than 0.02) with their reported affinities for calmodulin. Fluphenazine may act on the earliest stages of the target-effector interaction since conjugate formation between CBA effectors and YAC target cells decreased from 20% to 6% (p less than 0.02) upon pre-treatment with fluphenazine. However, fluphenazine was not selective for NK cells since cytotoxic T lymphocytes, derived from both mixed lymphocyte culture and by concanavalin A stimulation, revealed depressed cytolytic activity against P815 tumor targets after fluphenazine treatment. Tumoricidal activity by activated macrophages and effectors of antibody-dependent cell-mediated cytotoxicity was also blocked. Fluphenazine inhibition was reversible, since addition of 1.25-5 micrograms/ml of the calcium ionophore A23187 to fluphenazine-treated effectors restored NK binding and cytolytic functions to normal levels. Calmodulin was isolated from NK-enriched populations by affinity chromatography on sepharose fluphenazine columns. Pre-treatment of effector cells with [3H]fluphenazine and isolation of calmodulin by immunoprecipitation and SDS-polyacrylamide gel electrophoresis showed that fluphenazine entered the cells and bound a calmodulin like molecule. These data are compatible with the suggestion that fluphenazine inhibits NK function by inactivating the calcium-calmodulin complex and thereby altering binding events in the target-effector interaction. Other actions of the phenothiazines are also possible. PMID- 6490357 TI - Prevention of cardiac damage induced by formyl-leurosine, a potent cytostatic agent, by radio-detoxified endotoxin (Tolerin) in dogs. AB - Radio-detoxified endotoxin (Tolerin), produced by 60Co-gamma irradiation of Escherichia coli 089 endotoxin, can protect dogs against the acute cardiotoxic side-effects of formyl-leurosine, a semi-synthetic Vinca derivative with promising antineoplastic potency. Formyl-leurosine induces a rapid decrease in arterial blood pressure and diminishes the contractile force of the myocardium in the anaesthetized dog. These responses indicate a direct pharmacologic relaxant effect of the drug on the heart and vasculature smooth muscle. The early cardiovascular depression is of short duration and is unaffected by Tolerin. Tolerin can prevent, however, the secondary, more dangerous phase of circulatory depression that is associated with the severe cardiotoxic manifestations of the drug, as demonstrated by hemodynamic and morphologic (light and electronmicroscopic) patterns. PMID- 6490358 TI - Ammonia toxicity for mammalian and avian lymphocytes from blood. AB - The effect of addition of ammonia to cultures of avian, bovine, cavian, equine, human, leporinae, murine, ovine and porcine blood lymphocytes was studied. The concentrations of ammonia in the lymphocyte cultures represented normal (0.01-0.5 mg/dl), subtoxic (0.5-1 mg/dl), and toxic (1-10 mg/dl) concentrations of ammonia in blood. Viability of the lymphocytes and their mitogenic reactivity were measured. In general, 1.0 and 10 mg/dl of ammonia (toxic concentrations) affected viability and mitogenic responsiveness of all lymphocytes from tested species. The lower concentrations of ammonia affected only avian, bovine and equine lymphocytes. PMID- 6490359 TI - Personality factors in classical migraine and tension headache. PMID- 6490360 TI - Bilateral cervical carotid and intracranial vasospasm causing cerebral ischemia in a migrainous patient: a case of "diplegic migraine". PMID- 6490361 TI - Raynaud's phenomenon complicated by recurrent brain infarction. PMID- 6490362 TI - Absolute and proportional resting EMG levels in chronic headache patients in relation to the state of headache. PMID- 6490363 TI - Delayed onset dystonia following hemiplegic migraine. PMID- 6490364 TI - Patient motivation in the treatment of migraine. A non-medicinal study. PMID- 6490365 TI - Migraine due to hydrocephalus. PMID- 6490366 TI - Attacks of trigeminal pain associated with buccolingual dyskinesias. PMID- 6490367 TI - An assessment of the elderly patients in a New Town general practice. PMID- 6490368 TI - Parenteral drug misuse and the accident and emergency department. PMID- 6490369 TI - Alcohol intake of patients with psoriasis and dermatitis. PMID- 6490370 TI - Changing patterns of gastric surgery in a district general hospital. PMID- 6490371 TI - A dental emergency service in a rural area. PMID- 6490372 TI - Abortion statistics 1983. PMID- 6490373 TI - Ambulatory visit groups: a framework for measuring productivity in ambulatory care. AB - This article describes Ambulatory Visit Groups (AVGs) and the process by which they were defined. An approach to the analysis of physician productivity in the ambulatory setting is then demonstrated, with data derived from the National Ambulatory Medical Care Survey [1]. Finally, recommendations for future work are presented to make this approach more effective in designing and managing ambulatory care delivery organizations. PMID- 6490374 TI - The research program and priorities of the Robert Wood Johnson Foundation. AB - Since its establishment as a national philanthropy in 1972, The Robert Wood Johnson Foundation has appropriated almost $560 million in grants directed toward improvement of health in the United States. Grants are made primarily to develop innovative methods of providing health services, for research and evaluation, and for education and training of health professionals. Since 1972, more than $100 million has been appropriated for research and evaluation projects. The research supported by the Foundation is applied rather than basic, and, like all of the Foundation's programs, must be responsive to the institution's mission. In the 1980s, this mission comprises three objectives: improving access to health care for the most vulnerable underserved population groups, containing increases in health care costs, and improving functional outcomes for patients. In this article, we provide details on the Foundation's research program and priorities, including evolution of the mission, the role of research in the Foundation's overall programs, the purposes for which the Foundation supports research and evaluation activities, and the types of grants available for health services researchers. PMID- 6490375 TI - Hospital contract management. Organizational and public policy issues. PMID- 6490376 TI - Hospital contract management: a descriptive profile. AB - Despite the dramatic growth in hospital contract management in the last decade, research only recently has begun to provide insights into the structure, operation, and effectiveness of these arrangements. Two descriptive questions regarding hospital contract management are addressed in an effort to increase correspondence between theoretical and evaluative research in this area: (1) how do contract-managed hospitals differ from traditionally managed hospitals? and (2) how do contract-managed hospitals differ from each other? Principal discriminating variables in the analyses are hospital size, control, urban-rural location, region, management organization control, and management organization size. Results of the analysis on a sample of 406 contract-managed hospitals and 401 unaffiliated hospitals reveal important differences between contract-managed and traditionally managed hospitals as well as among contract management organizations. These findings are discussed in terms of their implications for future research and performance evaluations on contract management arrangements. PMID- 6490377 TI - Effects of contract management on hospital performance. AB - The performance of contract-managed (CM) hospitals is compared to that of a set of internally managed hospitals matched on a variety of hospital and market area characteristics. The performance of the study hospitals was similar to that of the matches in the years before the onset of contract management. Among 12 performance indicators, only occupancy rates differed significantly in the two samples in the years before contract management. Occupancy rates were lower on average in the hospitals which later became contract managed. During the 3 years following the onset of contract management, the CM hospitals showed no improvement in productive efficiency but did show changes in the way services were priced. The ratio of gross patient revenue to total expense increased significantly in the CM hospitals relative to their matches. This increase also appears to be associated with an increase in net profits in the CM hospitals relative to their matches. PMID- 6490378 TI - Hospital management contracts: institutional and community perspectives. AB - Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for profit hospital systems, are described. Finally, the effects of these management changes over time on hospital and community objectives are presented. These effects suggest progressive stages in the development of management contracts. The first stage focuses on stabilizing hospital financial performance. Stage two involves recruitment and retention efforts to secure necessary personnel. In the third stage, attention shifts to strategic planning and marketing. PMID- 6490379 TI - The private management of public hospitals. AB - Since the public sector traditionally has provided the public goods viewed as unprofitable by the private sector, the growing trend to manage public hospitals under outside private contract raises some fundamental issues of concern. It is hypothesized here that the system maintenance and output goals of privately managed public hospitals become increasingly similar to those of investor-owned hospitals. The thesis is empirically tested using documented effects of private contract management on the operative goals of short-term, general hospitals owned by local governmental bodies. Traditionally managed public hospitals matched with the study hospitals on important characteristics serve as the control group. Costs do appear to be reduced under private contract management, but the service structure becomes somewhat altered. It is the task of public health policymakers to reconcile the cost-control and efficiency mechanisms brought about by private management with the community's right of access to comprehensive medical care. Carefully structured regionalization plans--a possible means of providing both- will require the stimulation of more government involvement during an era of cutbacks. PMID- 6490380 TI - The incidence of occult metastases for cancer of the oral tongue and floor of the mouth: treatment rationale. AB - One hundred thirty-six surgical cases of squamous cell carcinoma of the oral tongue and floor of the mouth at the Emory University Hospitals were reviewed for the incidence of occult metastases. Thirty-five percent of the T1 T2 lesions of the anterior tongue had occult metastases. The figure was 31.5% for similarly staged lesions of the floor of the mouth. The presence of regional metastases resulted in a 2-year determinate survival rate of 37% and 32% for patients with oral tongue and floor of the mouth lesions, respectively. The poor prognosis in the study for delayed cervical metastases and the high incidence of occult cervical metastases have led the authors to propose a more aggressive therapy for the clinically negative necks in these two sites of squamous cell carcinoma of the oral cavity. PMID- 6490381 TI - A study of whole organ cancerous larynges to determine resectability by conservation surgery. AB - Sixty-two extirpated whole larynges containing squamous cell carcinoma were examined by a transverse slicing method to determine whether a partial laryngeal resection would have been feasible. The epithelial origin and sites of invasion of each tumor were recorded. The observations suggested that in one third of the specimens conservation laryngeal surgery could have achieved complete removal of the cancer. PMID- 6490383 TI - Carcinoma in situ of the larynx. AB - A series of 28 cases of carcinoma in situ of the larynx treated over the last 16 years is reviewed. The majority of the patients were treated with endolaryngeal stripping of the cords. In the few cases in which the treatment failed, early detection of disease was made and radiotherapy was successful in controlling the carcinoma. The use of radiotherapy is only advocated for selected cases because there is often difficulty in assessing a radiated larynx; radiotherapy may induce field changes, and if treatment fails, laryngectomy may have to be carried out as a salvage procedure. PMID- 6490382 TI - Advanced supraglottic carcinoma: a comparative study of sequential treatment policies. AB - Data from 131 consecutive patients with operable stage III or IV (American Joint Committee) supraglottic carcinoma were analyzed. Based on existing treatment policies at the time of presentation, patients received either preoperative radiation therapy (RT) (48 patients), surgery alone (42 patients), or postoperative RT (41 patients). Preoperative RT dose levels were either 2,000 rad in five fractions (33 patients) or 5,000 rad in 25 fractions (15 patients). Postoperative RT dosages were 5,000 to 6,000 rad in 6 to 6 1/2 weeks. Surgical procedures included either subtotal or total laryngectomy and radical neck dissection. Tumor control was achieved in 21 of 42 patients (50%) treated with surgery alone, 23 of 48 patients (48%) treated with preoperative RT, and 29 of 41 patients (71%) treated with postoperative RT (P = 0.005). The actuarial, recurrence-free survival at 5 years was 36% and 35%, respectively, in the surgery alone or preoperative RT groups as compared to 55% in postoperatively irradiated patients. The authors conclude that advanced but resectable supraglottic carcinomas may be best treated with surgery followed by RT, rather than with surgery alone or with combined preoperative RT and surgery. PMID- 6490384 TI - Clinical evaluation and surgical treatment of hemangiomata. AB - We report on the histologic and anatomopathologic aspects of cutaneous hemangiomas, stressing the involutive and noninvolutive aspects of these malformations. We analyze its clinical evolution, approaching the propedeutic and therapeutic methods, and present a detailed commentary on the conservative methodology of a series of 473 consecutive patients, encompassing a follow-up of 1 to 18 years. PMID- 6490385 TI - Surgical pathology of olfactory neuroblastoma. AB - The natural history of a personal group of eight patients with olfactory neuroblastoma is reviewed with particular reference to surgical pathology as revealed by a study of the operative specimens in seven of these patients. This reveals that spread to the cranial surface of the overlying dura must be considered to be present in all patients irrespective of the radiologic findings. Craniofacial resection is therefore considered to be an essential part of any treatment regimen. PMID- 6490386 TI - High resolution computed tomography, Part 1: Soft tissues of the neck. AB - Normal and pathologic anatomy of the soft tissues of the neck is clearly delineated with high resolution computed tomography (CT). The CT densities of soft tissues, fat, and enhanced blood vessels are strikingly different from each other and, therefore, mass lesions are clearly discernable. Often, a histologic diagnosis may be suggested with a high level of confidence based on the location and tissue characteristics. PMID- 6490387 TI - Arterial blood supply to the infrahyoid muscles: an anatomical study. AB - The arterial supply to the infrahyoid strap muscles originating from the superior thyroid artery (STA), the inferior thyroid artery (ITA), and the internal mammary artery (IMA), also called the internal thoracic artery, were investigated. Intraarterial silicone dye was injected into eight fresh cadavers followed by dissections. The blood supply to the infrahyoid muscles was found to be segmented in nature with the dividing line at the level of the cricoid ring. No axial pattern of vascularization could be demonstrated within the strap muscles. The skin overlying these muscles is supplied by tributaries arising from the above described arteries. Application of the information gathered is discussed in consideration of local myocutaneous and myoosseous flaps for reconstructive surgery, particularly of the larynx and trachea. PMID- 6490388 TI - Pilomatrixoma of the head and neck. AB - Pilomatrixoma is an uncommon neoplasm which occurs most frequently in the head and neck region. It usually presents as a slowly growing dermal or subcutaneous mass. Unfamiliarity with this lesion may lead the physician to mistake it for more common infectious or neoplastic processes. Most pilomatrixomas are benign and are adequately treated by local excision. Since a spectrum of clinical and histologic aggressiveness (pilomatrixoma carcinoma) has been noted in some lesions, a more aggressive surgical approach for such tumors is recommended. Two patients with pilomatrixoma are presented to emphasize the diagnostic confusion that can occur. PMID- 6490389 TI - Patterns of the early, gross chromosomal changes in malignant human gliomas. PMID- 6490390 TI - Chromosome instability is associated with hypodiploid clones in myelodysplastic syndromes. PMID- 6490391 TI - The effects of linked loci on estimates of relative viability derived from pedigree analysis. AB - The effect of viability selection at linked loci on segregation ratios at a specified studied locus is analysed in this paper for the crosses of a heterozygote to a homozygote and of two heterozygotes. Both autosomal and sex linked loci are treated. The analysis indicates that it would be unusual for the change in frequency of a given allele at the studied locus to be distorted by as much as one per cent by the combined effects (assumed to be additive) of selection at all linked loci. This result encourages the use of pedigree analysis in tests of the null hypothesis of selective neutrality of the genotypes at a particular locus since the inevitable cases where selection at linked loci does lead to incorrect rejection of the null hypothesis should be relatively few. PMID- 6490392 TI - Dietary intake of weaned infants in a Swedish community. AB - The energy and nutrient intake of 6 and 12-month-old weaned Swedish infants was studied by means of 24-h recalls. Milk-cereal follow-up formulas played a dominating role in the diet, contributing 57 per cent of the total energy intake at 6 months and 26 per cent at 12 months. The ratio between the macronutrients was characterized by a high-protein and low-fat intake; 16-17 per cent of energy derived from protein and 29-33 per cent from fat at 6 and 12 months respectively. The protein intake was also high in absolute figures: 3.3 g per kg body-weight at 6 months and 4.2 g per kg at 12 months. The mean daily energy intake for these normally growing infants was 75 per cent of the recommended daily allowance (RDA) at 6 months, and the need for a revision of the energy allowances in infancy is discussed. The estimated daily intake of iron was equal to the RDA at 6 months and 80 per cent of the allowance at 12 months. The daily intake of vitamin D exceeded the RDA to such a degree, that the present level of vitamin D supplementation through oral drops is questioned. PMID- 6490393 TI - Dietary patterns of elderly people living in inner Sydney. AB - The dietary intakes of an elderly non-institutionalized population in inner metropolitan Sydney were collected and analysed. Participants in the study (n = 124) had their midday meal at either an Activity Centre or at home (Meals-on Wheels Organization). The dietary data was collected over 4 days. Heights and weights and some sociological data were also obtained. The study indicated that a significant proportion of this population may be at nutritional risk, and that this was particularly so for males receiving Meals-on-Wheels. PMID- 6490394 TI - Dietary intake and sources of selenium in young Finnish women. AB - Dietary intake of selenium by 29 young Finnish women was estimated using the 7 day record method. The mean daily selenium intake was 31 micrograms by calculation. The main dietary sources of selenium were fish and eggs (29.5 per cent of the total intake), cereals (28.1 per cent) and milk (18.7 per cent). Using multiple regression analysis, it was shown that selenium intake cannot be explained by the consumption of nine main food groups because of the large variation in selenium content of different foods in each of the food groups. The 95 per cent confidence limits for an individual's selenium intake showed that the 7-day record method gave an estimate within 35 per cent of the long-term selenium intake. The high intra-individual variation in the selenium intake found in the present study warrants particular attention when dietary data on selenium intake are considered in relation to health parameters. PMID- 6490395 TI - A weighed dietary survey of men in Caerphilly, South Wales. AB - Four hundred and ninety-three men aged 45-59 years, selected from the general population of Caerphilly, South Wales completed a 7-day weighed dietary record. Calculation of nutrient intakes revealed that the mean energy intake was 2412 kcal, (10.1 MJ), 37 per cent of which came from fat, 43 per cent from carbohydrate, 14 per cent from protein and 5 per cent from alcohol. The polyunsaturated : saturated fat ratio was 0.28, polyunsaturated fat contributing 5 per cent of the total energy intake. Seasonal variation in nutrient intakes was minimal, being statistically significant only for dietary fibre and beta carotene, both being lower in summer. Nutrient intakes were compared with data from Cambridgeshire and Edinburgh. PMID- 6490396 TI - Food and nutrient intakes of vegetarians in Britain. AB - The food purchase and meal records of 120 households which took part in the National Food Survey between 1979 and 1982 indicated that they were vegetarian. In 83 households containing 158 individuals there were no indications from the menu lists that families were eating an Asian type of diet. Among these vegetarians the levels of most nutrients available from the household food were lower than the national average for the same years but calcium, vitamin C and folic acid intakes were above the national average. Intakes of fat were substantially lower than the national average and the ratio of polyunsaturated to saturated fatty acids was over 40 per cent higher among vegetarians than the national average. In 37 households containing 146 individuals an Asian type of diet was consumed. Only limited conclusions can be drawn from their food acquisitions as a result of large purchases in certain categories of food. For these households the nutrients available from a week's record of food brought into the home do not appear to be a useful reflection of the consumption of food in that household during the survey week. PMID- 6490397 TI - What do patients eat in hospital? AB - A study was made of the food chosen and eaten by patients on a surgical, a medical, an accident service and an elective orthopaedic ward. Patients were studied over 5 consecutive days. Daily energy intake was less than the predicted basal metabolic rate in 13 (24 per cent) of the 55 patients studied. Daily protein intake was less than 0.8 g/kg ideal body weight in nine (16 per cent) patients. Many of the patients had daily intakes of iron and of vitamins less than those recommended for healthy adults. There were no differences in food intake between the patients on the different wards. This study indicates the neglect of nutrient intake of many hospital patients. PMID- 6490398 TI - The transmission of ultra-violet light through fabrics and its potential role in the cutaneous synthesis of vitamin D. AB - The transmission of ultra-violet radiation (UVR) through various samples of fabrics was estimated using polysulphone film, the spectroscopic properties of which change with exposure. Significant amounts of UVR were transmitted through fabrics indicating that clothed skin may contribute to the cutaneous synthesis of the vitamin D precursor, cholecalciferol. PMID- 6490399 TI - The nutrition and growth over a 10 month period of an infant with the Prader Willi syndrome. AB - The nutritional status and growth of infants in the pre-obese phase of the Prader Willi Syndrome has not previously been investigated. In this study the daily energy and protein intake of a male infant with this syndrome was measured from the 21st to the 330th day of life, together with weekly weight and monthly height measurements. The primary source of food was expressed breast milk. Daily energy intake was 29-66 per cent below recommended amounts. Protein intake did not exceed 12 g per day. Body weight remained at or below the third centile with a marked downward trend at 6 months. The symptoms associated with the Prader-Willi Syndrome result in a lack of physical maturity; poor feeding exacerbates this situation. PMID- 6490400 TI - Growth of the foetus and infant following maternal jejuno-ileal bypass for obesity: a case report. AB - We describe detailed anthropometry in an infant born to a mother who had a jejuno ileal bypass for obesity. He was average in all dimensions at birth but showed excessive weight gain in his first 3 years, partly due to obesity and partly to an unusually muscular build. More postnatal growth data are needed on such infants. PMID- 6490401 TI - Koelle's copper thiocholine method performed with a low-pH phosphate buffer, followed by osmification of the precipitate: revival of two abandoned procedures. AB - Using a glutaraldehyde-fixed mouse neuromuscular junction, a fine precipitate of copper thiocholine was obtained with Koelle's medium prepared by a mixture of phosphate buffer (pH 5.6-5.9) and copper glycine solution (strongly acidic). The final pHs of these incubation media were very low, being situated between 3.8 and 4.2, respectively. It is well known that phosphate buffer, at such a low pH value, has no buffering effect on the acetic acid of enzymatic hydrolysis. This probably caused a sharp drop of the pH value in the vicinity of the enzymatic site and allowed a fine localization of copper thiocholine, the precipitation of which is pH dependent. Furthermore, the osmification of copper thiocholine in the same phosphate buffer provided a finely localized electron dense product. The chemical nature of the osmified copper thiocholine is discussed. PMID- 6490403 TI - Preparation and characterization of methyl green tetrafluoroborate. AB - Commercial methyl green dyes were converted to tetrafluoroborate by means of NaBF4-solution, the compounds thus obtained were analytically pure. It was shown to be possible to distinguish between a "methyl" and an "ethyl" compound by means of NMR spectroscopy. The dyes are stable in buffered aqueous solution, and in crystalline form. A spectrophotometric assay is proposed. PMID- 6490402 TI - Differential distribution of dihydrotestosterone and estradiol binding sites in the epididymis of the mouse. An autoradiographic study. AB - The distribution of androgen and estrogen binding sites in the mouse epididymis was assessed by autoradiography with 3H dihydrotestosterone (3H DHT) and 3H estradiol (3H E2). Nuclear labeling with 3H DHT in principal cells of the epithelium is high in the caput, low in the corpus, and high again in the cauda. 3H E2 also binds to the nuclei of principal cells. The pattern is distinct from 3H DHT: nuclear labeling is highest in the ductulus efferens and high in the caput, but low or absent in corpus and cauda. Apical cells in caput and clear cells in corpus and cauda are moderately labeled with 3H DHT but heavily labeled with 3H E2. Connective tissue cells show variable labeling with both hormones, being more pronounced with 3H E2. Smooth muscle cells are also labeled to varying degrees with both hormones. The different binding patterns of 3H DHT and 3H E2 and the results of the competition studies with unlabeled compounds demonstrate that in the epididymis besides the specific nuclear receptors for androgen also estrogen receptors are present. PMID- 6490404 TI - Topo-optical investigations of the human erythrocyte glycocalyx-age related changes. AB - The conformational state of the glycocalyx of the intact and altered erythrocyte membrane was studied by means of the topo-optical toluidine blue reaction, i.e. induced membrane birefringence. High membrane anisotropy represents the normal glycocalyx structure and its decline represents their perturbation. The results show that the glycocalyx structure is changed during ageing of the erythrocytes in vivo as well as in vitro. During fluid preservation, in vitro ageing and vesiculation of cells in vitro, a subpopulation of cells showed a decline of membrane anisotropy, but other cells demonstrated abnormally high values. In the latter cases, there is usually a correlation to spherocytes. From this point of view, it is to be assumed that spherogenesis during cell ageing is induced by cell vesiculation. This leads to a remodelling of an intact plasmalemma. In contrast, the cell fractions which are probably non-vesiculating seem to be more or less damaged by membrane and/or plasmic hydrolases. This can be mimicked by neuraminidase and protease treatment of erythrocytes in vitro. Membrane lesions caused by freeze preservation of red blood cells are rare. The topo-optical results are interpreted according to the assumptions of the theory of membrane anisotropy, i.e. the formation of dye-stuff micelles at distinct, clustered, sialylated carbohydrate chains of the glycophorin A. PMID- 6490405 TI - Cholinesterases and choline acetyltransferase in the ductus deferens of the guinea-pig. AB - Several authors have reported that longitudinal and circular muscle layers of the guinea-pig ductus deferens possess a rich adrenergic innervation. Cholinergic innervation has been doubted by several authors, especially its presence in the longitudinal muscle layer. Acetylcholinesterase and butyrylcholinesterase were demonstrated, by electron-microscopic examination of both muscle layers of the guinea-pig ductus deferens, to be localized on the axolemma of the nerve endings and in smooth-muscle fibres, on sarcolemma, in the intracellular caveolae and in the intercellular space. Activity of cholinesterases and choline acetyltransferase was measured by the radiometric method and was found in both muscle layers. The activity of butyrylcholinesterase was higher than that of acetylcholinesterases in the homogenates of the whole ductus deferens and in the longitudinal muscle layer. In the circular muscle layer, the activity of acetylcholinesterase was higher than the activity of butyrylcholinesterase. In both muscle layers, we also found choline acetyltransferase, the activity being stronger in the circular layer. The localization of cholinesterases in smooth muscles in the same places as the calcium and muscarinic acetylcholine receptors is discussed, together with the possibility that the enzyme is in some way involved in the excitation-contraction mechanism of smooth muscle. PMID- 6490406 TI - Correlation between potassium and phosphorus content and their nonuniform distribution in Acanthamoeba castellanii. AB - Biologically important elements: K, Na, Mg, Ca, Cl, P, and S were analyzed in Acanthamoeba castellanii. A higher potassium content, as compared with other cations, was detected. Total content of the cation-forming elements: K, Na, Mg, and Ca was ca. 360 mmoles/kg dry weight of the cells. Phosphorus content was estimated as 492 mmoles/kg dry weight. Content of chlorine, a basic cellular anion, was 173 mmoles/kg dry weight. The low level of chlorine appears not the be sufficient to balance all the cations in Acanthamoeba. Distribution of potassium in Acanthamoeba cells was nonuniform and similar to that of phosphorus as shown by X-ray microanalysis technique. Quantitative correlation between phosphorus and potassium as well as the similar distribution of these elements suggests that in Acanthamoeba phosphorus is an essential anion which, being nonuniformly distributed in the cell, determines also a nonuniform distribution of potassium. PMID- 6490407 TI - Digital subtraction angiography of the head and neck: experience in a community hospital over a 9-month period. PMID- 6490408 TI - Update on article on Lyme disease. PMID- 6490409 TI - Sequential multisystem failure: a retrospective study. PMID- 6490410 TI - Primary obstructive megaureter: report of a case. PMID- 6490411 TI - Obturator hernia: report of a case. PMID- 6490412 TI - Epidural narcotic analgesia. PMID- 6490413 TI - Lancefield group G streptococcus septic arthritis in a heroin user: report of a case. PMID- 6490414 TI - A comparison of the response of specific sensory and noradrenergic afferents to enucleation-induced deafferentation of the mammalian superior colliculus. PMID- 6490415 TI - Dietary supplements of phenylalanine and other amino acid precursors of brain neuroamines in the treatment of depressive disorders. PMID- 6490416 TI - Thioridazine pharmacodynamics: clinical effects may depend upon drug metabolism. PMID- 6490417 TI - A favorable subset of AJCC stage IV squamous cell carcinoma of the head and neck. PMID- 6490418 TI - Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979). AB - From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (N0), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4T3) developed local recurrences; 10 of these 11 patients underwent penile amputation which controlled the tumor in 7 of the patients. One patient refused amputation. Three patients developed post therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Overall, at their last follow-up examinations, 74% of the patients were free of disease with conservation of penile morphology and function. Most patients without metastatic nodes (37/45) at diagnosis did not receive prophylatic treatment of the groin. Two of these patients developed delayed metastatic nodes; one was successfully salvaged. All 5 patients presenting with metastatic nodes at diagnosis died, four with uncontrolled regional disease. Twenty-one percent of the patients died of their disease. We advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does not exceed 4 cm. Pre-implant circumcision and regular long-term follow-up are necessary. More extensive tumors are better managed surgically. When regular follow-up can be assured, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis. PMID- 6490419 TI - The radiation response of human bladder cancer assessed in vitro or as xenografts in immune-deprived mice. AB - We have studied the response to radiation of cells derived from transitional cell carcinoma (TCC) of the human bladder. In vitro radiation survival curves for two established cell lines, RT-4 and MGH-U1, and for a cell line HB-10 derived recently from biopsy of a metastatic lymph node were characterized by values of D0 and n in the range of 1.1-1.5 Gy and 2-7 respectively. The oxygen enhancement ratio of HB-10 cells was 2.8. Xenografts derived from the line HB-10 were irradiated in vivo under both aerobic and hypoxic conditions and cell survival was assessed in agar. Both aerobic and hypoxic survival curves were similar to that obtained for irradiation of hypoxic HB-10 cells in culture. Another tumor line, HB-15, derived from a cystoscopic biopsy of primary TCC, was maintained by transplantation of xenografts. Regrowth curves for HB-15 xenografts after radiation doses of 10 or 20 Gy were parallel to the growth curve for untreated controls but with volume reduced by factors of about 5 and 20 respectively. Irradiation of HB-15 xenografts under hypoxic conditions conveyed minimal protection as compared to irradiation in air. We conclude that cells derived from TCC of the human bladder exhibit parameters of radiation survival similar to those of other mammalian cells, and that xenografts derived from such cells contain a high proportion of hypoxic cells. PMID- 6490420 TI - Radiation sensitivity of cultured rabbit aortic endothelial cells. AB - The radiation response of cultured rabbit aortic endothelial cells was measured using colony formation to determine survival. The dose survival curve was qualitatively similar to those reported for other cell types. At doses of 400 rad and greater, the curve was an exponential function of dose with a D0 of 120 rad and an n of 7. Exponentially growing endothelial cell cultures recovered from sublethal damage between two doses of radiation. Plateau phase cultures recovered from potentially lethal damage when incubated for 6 hr between irradiation and assay. PMID- 6490421 TI - Numerical calculations of the temperature distribution in realistic cross sections of the human body. AB - Numerical calculations of the temperature distribution in detailed cross sections of the human body are presented. The solution procedure uses a finite-difference representation of the bioheat transfer equation, and thus it routinely considers the various heat exchange mechanisms including the blood flow rate, heat conduction and the metabolic heat generation. The new feature of the presented solution, however, is related to the utilization of the detailed electromagnetic power deposition patterns obtained numerically using the method of moment. In the present calculations, therefore, the temperature distribution is based on a realistic description of the various tissue distributions in the cross section of the human body and the radiation characteristics of the electromagnetic source. The obtained results clearly showed a significant dependence of the temperature distribution on the values of the blood flow rates used in the modeling. Present efforts which include the use of the developed computer program in the planning of the hyperthermia treatments, as well as its use as a study tool for investigating the effect of the variation of the various radiation and thermal parameters on the desired temperature distributions, are described. PMID- 6490422 TI - Versatility of distributed focus ultrasound in treatment of superficial lesions. AB - In order to study the efficacy of hyperthermia as a cancer treatment modality, it is important to be able to define the specific volume being raised to hyperthermic temperatures corresponding to the selected method of heating. Measurements have been made of temperature distributions in rat mammary tumors during steady state heating with annular focused ultrasound (2.0 MHz). Biological response in terms of growth inhibition is compared with uniformity of induced temperature throughout the tumors as a function of annular focusing dimensions. PMID- 6490423 TI - Tests for the fit of the linear-quadratic model to radiation isoeffect data. AB - The linear-quadratic (LQ) model for cell survival is frequently extended to describe multifraction isoeffect data via the formula: ln(response) = -n(alpha d + beta d2), where d is the dose per fraction and n is the number of fractions. However, estimates of the quantity "alpha/beta" derived from such data are meaningless unless the use of the model is justified. Two methods are proposed for testing the fit of the multifraction LQ model to isoeffect data. If the use of the model cannot be rejected, each method also provides a new technique for estimating alpha/beta. The two methods are applied to published data from spleen, kidney, and colon. In each case, consistent results are obtained from the two methods concerning the quality of the fit. PMID- 6490424 TI - The treatment of cancer of the uvula and soft palate with interstitial radioactive wire implants. AB - A new method of implantation of the soft palate with radioactive wires is described. Experience with 25 patients is reported and the results analyzed. This method of treatment appears to be highly effective and avoids radiation complications. PMID- 6490425 TI - Orthovoltage intraoperative radiotherapy: a new look at an old idea. AB - A 300 kvp orthovoltage machine has been permanently installed in an operating room for delivering intraoperative radiation therapy (IORT). A historical review of orthovoltage IORT and our present approach are described. The preliminary experience with 38 patients treated with orthovoltage IORT indicates that this technique is feasible, has low acute morbidity, and can be useful for palliation. "Radical" radiation therapy consisting of IORT "boost" treatment combined with external beam was used in 24 patients with primary or recurrent cancer. Local failure in 27 patients treated with IORT +/- external beam radiation therapy was 56%, but varied from 11% (1/9) for patients with resected disease to 78% (14/18) for patients with unresected disease. Complications occurred in nine patients (24%) and have been acceptable. There are 17 patients alive and six are NED, with follow-up of 4-18 months. There appears to be a role for orthovoltage IORT especially when combined with surgical resection for local control of advanced cancer arising in the abdomen where the use of high doses of external radiation therapy are hazardous. PMID- 6490426 TI - A computerized record and verify system for radiation treatments. AB - We have developed a general purpose, comprehensive, and highly reliable computerized Record and Verify System to detect and prevent mistakes in the delivery of external beam radiation therapy. This system helps prevent accidental delivery of dangerous dose, improves quality control, and provides invaluable record keeping and report generating capabilities. Currently, treatment machine and couch parameter settings of four different machines are monitored by the system and compared with prescribed values. The system inhibits a machine from being turned on if the settings do not agree with the prescribed values to within specified maximum permissible deviations. The system is user-friendly and provides useful, complete, and easily accessible data. We describe many aspects of the system including hardware, software, data, and operation, and we conclude with a brief discussion of clinical experience and preliminary data. PMID- 6490427 TI - Intraoperative radiotherapy--past, present and future. PMID- 6490428 TI - Extended field irradiation in the treatment of patients with cervical carcinoma involving biopsy proven para-aortic nodes. PMID- 6490429 TI - A technique to avoid unnecessary perineal reaction. PMID- 6490430 TI - Double and multiple primary cancers in an adult head and neck radiation therapy clinic. AB - The records of 321 consecutive patients referred to the Radiation Oncology Center between January 1, 1980, and December 30, 1982, for head and neck cancers were reviewed to determine the incidence of other cancers. Two hundred sixty-two patients have had a single primary cancer in the head and neck region. Fifty-nine patients (18%) have had more than one cancer. These 59 patients have had 68 other cancers. While other head and neck cancers lead the list of second primaries, second cancers also occurred in the esophagus, lung, genitourinary system and elsewhere. Twenty cancers had occurred prior to the patient developing head and neck cancer. Thirty-two cancers were synchronous with the head and neck cancer; 16 have been metachronous. These numbers emphasize that patients with head and neck cancers are in a cancer-prone group that develops a variety of other cancers. These findings have important implications in work-up, radiation treatment planning, treatment goals and follow-up programs. PMID- 6490431 TI - Results of twice-a-day irradiation of squamous cell carcinomas of the head and neck. AB - The results of twice-a-day irradiation for moderately advanced and advanced squamous cell carcinomas of the head and neck in 57 patients, treated at the University of Florida between March 1978 and July 1981, are reviewed. Fifty patients received irradiation alone to the primary site with or without neck dissection; 7 patients received preoperative irradiation (5040-6000 rad) followed in 4-6 weeks by resection of the primary tumor and neck dissection(s). Two 120 rad treatments were administered daily, with a 4-6 hour interval between fractions. External beam tumor doses were usually 7440-7680 rad when irradiation alone was used for the primary lesion; 2 of 3 T2 and 11 of 13 (85%) T3 lesions that received greater than or equal to 7440 rad remain locally controlled at 2-5 years' follow-up. External beam doses of 7440 rad controlled only 1 of 10 T4 cancers; higher doses controlled 3 of 8 T4 lesions. One severe complication of irradiation and 2 severe complications of salvage surgery have occurred in the group that received irradiation alone to the primary lesion. Five of the 7 patients who received planned combined preoperative irradiation plus surgery to the primary tumor were alive and free of disease at 2 years. Absolute disease free survival at 2 years for the entire patient group was 23/57 (40%). PMID- 6490432 TI - Disappearance of local tumor of esophageal carcinoma after irradiation. AB - The range of doses which may lead to disappearance of local tumor after radiation treatment of esophageal carcinoma is extensive. Its possibility may reach 33% if the dose exceeds 5000 rad. However, the sensitivity of this cancer varies greatly in different patients. In clinical practice, the total dose should be decided according to the response of the tumor. Disappearance of local tumor signified better prognosis than otherwise. Radiation ulcer can be easily mistaken as local recurrence. Based upon clinical symptoms and X ray film, the possibility of misdiagnosing ulceration as local recurrence after radiotherapy of more than 6000 rad was as high as 29% (12/42) in our experience. The pathogenesis and management of radiation ulcer in the esophagus are discussed. PMID- 6490433 TI - Prognostic factors and changing trends in the treatment of Stage I endometrial cancer: a clinical and histopathological study of 182 patients. AB - Changing trends in treatment of Stage I endometrial carcinoma are reflected in the modalities used in the University Hospital in Groningen. From 1969 to 1979, three treatment regimes have been used in 182 patients with Stage I disease: Group A (50 patients): preoperative uterine radium packing followed by surgery six weeks later; Group B (94 patients): preoperative low dose external irradiation (14 Gray) immediately followed by surgery and an additional 40 Gray in patients who had invasion of the myometrium beyond the inner one-third; Group C (38 patients): primary surgery with post-operative radiation therapy. No significant differences were found in the 5-year actuarial survivals of 92, 90 and 88% in Groups A, B and C respectively. Most recurrences were seen in Group B (16%) as compared to 10% in Group A and 8% in Group C. Poor prognostic factors were found to be myometrial infiltration beyond the inner one-third, dedifferentiation of the tumor (Grade 2 and 3), vascular invasion, age over 60 years, and uterine length over 8 cm. The advantages of primary surgery, allowing for accurate surgical-pathological examination and individualization of postoperative irradiation, are stressed. PMID- 6490434 TI - Dose-rate effects in mammalian cells: V. Dose fractionation effects in noncycling C3H 10T 1/2 cells. AB - Multiple gamma ray dose fractionation effects were studied using contact inhibited C3H 10T 1/2 murine fibroblast cultures in an attempt to simulate conditions in tissues with low rates of cell turnover. Multifraction survival curves were determined for different doses per fraction using 12 hour interfraction intervals 7 days per week. Isoeffect curves were generated from the multifraction survival curves. For doses per fraction greater than approximately 1.0 Gy, these isoeffect curves were similar to those derived from tissue reactions in humans and experimental animals published previously. For doses per fraction below 1.0 Gy, the isoeffect curves became essentially flat, thus deviating appreciably from the total dose which would be predicted by extrapolating the NSD equation to achieve an isoeffect. The existence of a non repairable component of gamma ray damage can be inferred from this finding, which has implications both for basic radiobiology, and radiotherapy. PMID- 6490435 TI - Relative biological effectiveness of 125I sources in a murine brachytherapy model. AB - The relative biological effectiveness of 125I and 192Ir has been determined in a murine brachytherapy model that uses a clonogenic cell assay as the end point. Removable 125I or 192Ir sources were implanted at right angles to the surface of RIF-1 tumors grown in the flanks of C3H/He mice. After irradiation for 1-5 days, mice were sacrificed and isodosed annuli of irradiated tumor tissue were sampled for the clonogenic cell assay. The slopes and intercepts of the two radiation survival curves for implanted sources with activities of 10 to 50 Gy for 125I (dose rate = 39.8 +/- 4.3 cGy/hr) and 192Ir (dose rate = 42.3 +/- 2.7 cGy/hr) were identical; the relative biological effectiveness was 1. PMID- 6490436 TI - Modification by dexamethasone of radiation response of in vitro cultured cells. AB - Because of the potential clinical significance of the report that dexamethasone is a radioprotector of Chinese hamster V-79 cells, the effect of dexamethasone treatment on the radiosensitivity of five other cultured mammalian cell lines (including two human cell lines) was tested and preliminary investigations into the mechanism of protection of V-79 cells were undertaken. In agreement with the published results of others, we found that treatment of V-79 cells with dexamethasone results in a 1.3-fold increase in D0. Conversely, dexamethasone had no effect on the radiosensitivity of Chinese hamster ovary cells, murine fibrosarcoma, rat glioma cells, human diploid fibroblasts, or human mammary carcinoma cells. To study the mechanism of the radioprotective effect of dexamethasone on V-79 cells, the cell cycle was examined. Dexamethasone treatment causes a change in cell cycle distribution in V-79 cells, resulting in a dose dependent reduced fraction of S-phase and an increased fraction of G1- and G2 + M phase cells. However, these kinetic changes cannot explain the observed radioprotection of asynchronous populations, since purified G1 cells are more radiosensitive. Furthermore, cells synchronized in G1 by centrifugal elutriation were shown to be protected by dexamethasone to the same extent as was the unsorted population, thereby ruling out the mechanism of protection being a redistribution in the cell cycle. PMID- 6490437 TI - Local hyperthermia in combination with definitive radiotherapy: increased tumor clearance, reduced recurrence rate in extended follow-up. AB - Fifty-nine patients with superficial malignancies appropriate for treatment with definitive radiotherapy and technically suitable for application of local microwave hyperthermia were available for at least 6 months follow-up. Thirty-one of these patients presented with two lesions, only one of which was heated, the other serving as internal control. The responses of the lesions which were heated were compared with those receiving only radiation. The heated lesions responded more quickly, reconfirming observations previously made. However, at subsequent 6 months, 1 year, 18 months and 2 years follow-ups, tumor clearance was shown to be significantly more complete as compared with the internal controls. At 6 months follow-up complete response with combined therapy was observed in 27 of 31 lesions (87%) in contrast to complete response in 12 of 31 (39%) lesions treated with radiotherapy alone. At one year combined modality treatment produced complete response in 19 of 19 lesions (100%) while radiotherapy alone yielded complete response in 10 of 19 lesions (53%). At 18 months, 8 of 9 lesions (89%) treated with combined therapy remained controlled, 1 having recurred. Seven of 9 (78%) treated by radiotherapy alone were controlled, 2 having recurred. At 2 years, 6 patients were available for follow-up and 6 of 6 (100%) of lesions treated with combined modality remained controlled. Among those treated by radiotherapy alone, 5 of 6 (83%) remained controlled, while 1 recurred. The rate of tumor recurrence among the heated lesions was significantly lower than was found among the controls. The recurrence rate among the controls was similar to that expected in a similar group of patients treated with definitive radiotherapy. Therefore, in addition to its established capability to shrink tumors, hyperthermia in combination with radiotherapy has been shown to increase the rate of overall tumor clearance and reduce recurrences compared with that obtained from radiotherapy alone. PMID- 6490438 TI - Development of a rat lung cancer model. AB - A rat lung cancer model based on intrabronchial instillation of a tumor cell suspension has been developed for use in therapy and toxicity testing. Two tumors were used in this study, a sarcoma and an adenocarcinoma, both of which were of spontaneous origin in the strain of rats used. The inoculated tumor cells implant on the bronchiolar mucosa, forming a detectable single "primary" tumor resembling the spontaneous lung cancers arising in humans. The tumor growth is detectable by use of diagnostic radiographs, weight loss and other "clinical" signs. The tumors appear on chest radiographs 3 to 5 weeks after inoculation, and the implant rate is proportional to the number of tumor cells inoculated. Untreated animals have a median survival (after radiographic detection of the tumor) of 8 days, and die of local complications of tumor growth. When a slow growing transplantable tumor line of lung origin is developed, this model will be used to evaluate radiotherapy and chemotherapy schedules. PMID- 6490439 TI - The effect of adjuvant chemotherapy on the cosmetic results after primary radiation treatment for early stage breast cancer. AB - Breast cancer patients treated by primary radiation therapy who have positive axillary lymph nodes now typically receive adjuvant chemotherapy. In order to evaluate the effect of adjuvant chemotherapy on the response of the breast to radiation treatment, we compared the cosmetic results of 49 patients treated with adjuvant chemotherapy and 206 patients not treated with adjuvant chemotherapy. A variety of chemotherapy regimens were employed, most commonly a combination of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). The median follow-up time for all patients was 33 months. Cosmetic results were scored by the physician at each follow-up evaluation as excellent, good, and fair or poor, depending on the presence and extent of radiation-related changes in the treated breast. Patients who received adjuvant chemotherapy were less likely to have an excellent overall cosmetic result than patients who did not receive adjuvant chemotherapy. At 24 months 24% of these patients had an excellent cosmetic result compared with 64% of patients who did not receive adjuvant chemotherapy (p = 0.0002). This difference was due primarily to a shift in chemotherapy-treated patients from an excellent to a good overall cosmetic result. Breast retraction was noted to be the most frequent determinant of a fair or poor cosmetic result and was more common in patients treated with adjuvant chemotherapy. At 24 months, 62% of these patients had evidence of breast retraction compared with 44% of patients who did not receive adjuvant chemotherapy (p = 0.06). We conclude from this preliminary analysis that adjuvant chemotherapy modifies the response of the breast to radiation, most notably by increasing the development of retraction. PMID- 6490440 TI - Improved response of a murine fibrosarcoma (Meth-A) to interstitial radiation when combined with hyperthermia. AB - Removable Iridium-192 implants provided a dose of 10 Gy/day or 41.5 cGy/hr at 0.5 cm from the center of 1.0 cm diameter tumors. The total radiation (x) alone was 20, 40 or 60 Gy, representing 2, 4, or 6 days of continuous radiation. The doses used for the combined treatments at elevated temperatures were 10, 20 or 30 Gy. The local tumor hyperthermia (LTH) treatment (43.6 for 35 min, water bath) was administered once for each 10 Gy of dose. The combined radiation + LTH was clearly superior to that achieved with radiation or LTH alone and yielded Thermal Enhancement Ratios (TER) of 3.4-3.9. Local tumor control rate was 67% and 89% for the 20 and 30 Gy x + LTH groups, respectively. A comparison of the results obtained in this study with those of earlier studies on the same tumor system indicate that the effects of Iridium-192 alone on this rapidly proliferating tumor were comparable to similar total doses of fractionated external beam radiation. Iridium + LTH produced a tumor response comparable to that achieved with external fractionated radiation + LTH. Combined treatment effect of elevated temperature appears to be less dose rate dependent in the range of 40 cGy/hr to 100 cGy/min and more dependent upon total dose accumulation. PMID- 6490441 TI - Design and thermometry of an intracavitary microwave applicator suitable for treatment of some vaginal and rectal cancers. AB - The construction of a modified coaxial cable as an intracavitary microwave applicator suitable for use in some vaginal and rectal cancers is presented. Thermometry was performed for microwave frequencies of 300, 400, 650, and 915 MHz. Temperature profiles in tissue phantoms were obtained with non-perturbing temperature probes and thermography, and the data were compared with those obtained in dogs. The temperature profiles were dependent on the frequency of the microwaves and the insertion depth of the applicator. In addition, an acrylic cylindrical spacer external to the applicator also altered the heating pattern. Therefore, with proper combinations of frequency, insertion depth and spacer, the applicator can be used for heating tumors in some clinical situations. PMID- 6490442 TI - Synchronous and metachronous carcinomas in patients with head and neck cancer. PMID- 6490443 TI - Alterations of fractionation. PMID- 6490444 TI - Which patients can have their para-aortic node metastases controlled by para aortic radiation. PMID- 6490445 TI - 1984, utopias, dystopias and psychiatry. PMID- 6490446 TI - Some remarks on the Oedipus complex from an ethological point of view. AB - Starting from the classical psychoanalytic view that, in human evolution, an overlap of sexual maturation and dependency occurred, the oedipal situation is regarded as an innate behavioral sequence that also includes appropriate parental responses. An integration between this level of development and the earlier sequence of symbiosis and separation is attempted. In this connection, Bowlby's concept of the subsidiary attachment figure plays a central role. The links between pathological developments at the oedipal level and those at the earlier level are investigated, and clinical examples are provided. In many cases, the Oedipus complex is considered to be the culmination of a bad symbiosis. The hypothesis is then put forth that the Oedipus complex, as a pathological structure, is an historical phenomenon which arose when cultural developments interfered with the appropriate parental responses. It is suggested that these developments were the changes which took place after the advent of agriculture, in particular the changes in family and character structure connected with the peasant adaptation. Finally, the relevance of these problems to training analysis is discussed. PMID- 6490447 TI - The impact of psychoanalytic theories of conflict upon treatment. PMID- 6490448 TI - The role of the mirror in human suffering and in intimacy. PMID- 6490449 TI - Intimacy, autonomy and gender: developmental differences and their reflection in adult relationships. PMID- 6490450 TI - Sociocultural considerations in the emergence of sexual feelings in male patients seeing female therapists. PMID- 6490451 TI - Psychoanalysis and contextual analysis of phobias. AB - When phobic behavior is studied and analyzed as it changes in its natural contexts during treatment, new information develops about social, environmental, psychological, personality and bodily factors and their relationships in causing these changes. Contextual analysis, basing its approach on such studies, has conceptualized pathogenic (i.e., phobogenic) and therapeutic processes that have led to new approaches to treatment and a new understanding of familiar psychoanalytic phenomena. This effort to understand disturbed phobic behavior by analyses of innumerable samples of current change under varied conditions reverses the prevailing psychoanalytic approach of studying the reported past to understand the present, and makes possible the development of validatable concepts and more effective treatment, as well as setting the stage for more meaningful research and integration with other sciences. PMID- 6490452 TI - Psychoanalytic principles in psychosocial rehabilitation. AB - Major mental symptomology in schizophrenic patients is alleviated when isolation and withdrawal are replaced by improved object relationships. This can best be accomplished through the enhancement of social, emotional, and environmental support systems. Psychosocial rehabilitation, that is, the establishment of a corrective living situation for emotionally isolated individuals, is a dynamic process. Staff in psychosocial centers are presented with unusual challenges and opportunities for helping people. Freudian psychoanalytic theory helps explain the causation of major mental symptomatology in schizophrenics as well as the mechanisms for the alleviation of those symptoms. It is postulated that the basic defect is exaggerated narcissistic libido and deficient cathexis of libido onto objects, which is accompanied by dammed-up libido. Like a festering boil, the dammed-up libido continues to exert noxious and deleterious effects, ultimately by way of chemical and neuronal pathways presently not well understood. The release of the dammed-up libido through improved object relationships is accompanied by lessening symptomatology and improved functioning. Indiscriminate and prolonged utilization of psychotropic medication is antitherapeutic in that it prevents delabeling, interferes with the resocialization process, and inhibits ego growth and development. PMID- 6490453 TI - Marathon performance, anaerobic threshold, and onset of blood lactate accumulation. AB - The study tested the hypothesis that running velocity corresponding to the anaerobic threshold (VAT) would more accurately approximate the actually measured marathon race velocity (VM) than would running velocity corresponding to the so called onset of blood lactate (4 mM) accumulation (VOBLA). The VAT (4.57 m X s-1) well approximated the VM (4.49 m X s-1), whereas the VOBLA (5.30 m X s-1) differed significantly from the VM. In addition, the VAT (r = 0.781) correlated with VM to a greater extent than did the VOBLA (r = 0.682). When the VAT (X1) was combined with delta % maximum O2 consumption (VO2max) (%VO2max at the OBLA minus %VO2max at the AT; X2) and VO2max (ml X min-1 x kg-1; X3), variation in the VM accounted for increased profoundly from 61 to 88%. Thus one of the useful equations formulated with high predictive accuracy was VM (m X s-1) = 1.312X1 + 0.0346X2 - 0.00993X3 - 1.272. Our study demonstrates that the anaerobic threshold (AT) is more closely associated with marathon running performance and that the degree of the association is raised when delta %VO2max and/or VO2max are combined as additional information. PMID- 6490454 TI - Soft palate and oronasal breathing in humans. AB - In 20 naive patients without respiratory impairment, we investigated the ability of the soft palate to direct airflow during breathing. Patients were connected to a spirometer, without noseclip. No instructions were given on the breathing route. During quiet respiration, 15 patients breathed solely through the nose, despite an open mouth. During forced vital capacity (FVC) maneuvers, 19 patients expired exclusively through the mouth. When specifically asked to breathe quietly through the mouth, pure nasal breathing was no longer observed. Tidal volume (VT) or FVC were comparable when patients were asked to breathe through the mouth, with or without noseclip: 0.67 +/- 0.46 vs. 0.60 +/- 0.21 liter for VT (mean +/- SD); 4.05 +/- 0.65 vs. 4.18 +/- 0.70 liters for FVC. In eight separate healthy volunteers, the soft palate was shown by fluoroscopy to close the oropharyngeal isthmus during quiet breathing (resulting in pure nasal breathing) and to close the nasopharynx during FVC efforts (resulting in mouth breathing). During oronasal breathing, the soft palate lay in between the tongue and the posterior pharyngeal wall. These data suggest that when both mouth and nose are open, the soft palate is responsible for the partitioning of oronasal flow. PMID- 6490455 TI - Gross and subgross anatomy of bronchial circulation in sheep. AB - The anatomy of the bronchial artery in sheep has recently been described. However, the course of the bronchial veins has not been well established. It has been suggested that the bronchial veins are the major site of fluid leakage following histamine infusion, and it has been postulated that the bronchial circulation may play a role in fluid reabsorption. We studied the anatomy of the bronchial circulation in 18 sheep with emphasis on bronchial venous drainage and bronchopulmonary communications. Following anesthesia animals were heparinized and exsanguinated. Evans blue dye was infused into the bronchial artery in six sheep and the gross and subgross anatomy of the bronchial circulation studied. In six other sheep the bronchial artery, pulmonary artery, and tracheobronchial tree were filled with Batson's solution of varying colors. The subgross anatomy was studied under a dissecting microscope, and samples were taken for scanning electron microscopy. In six separate sheep we studied the anatomy of the proximal vein by infusing dye directly into the vein and found that the extrapulmonary bronchial blood drained into the left azygos vein via a single vessel. Intrapulmonary bronchi are surrounded by a dense bronchial microvascular plexus which drains into the pulmonary vessels at the precapillary level. PMID- 6490456 TI - Pressure excursions during oscillatory flow in a branching network of tubes. AB - The pressure difference across individual branches of a four-generation network of branching tubes was measured with the objective of obtaining general laws to describe the pressure drop in the airways under conditions of oscillatory flow. Fourier decomposition showed that the pressure signals consisted of a dominant component at the excitation frequency ("fundamental") and a "first harmonic" of smaller magnitude. For values of the ratio Re/alpha less than 200, the fundamental mainly represented fluid acceleration, whereas the first harmonic reflected the effects both of viscous dissipation and the change in total cross sectional area between parent and daughter generations. For values of Re/alpha greater than 200, the magnitude of the fundamental was considerably larger than that due to fluid acceleration alone, suggesting the possibility of onset of turbulence in the branching network. These pressure measurements were applied to a simple model of the dog lung to predict total airway resistance. The results are found to be in substantial agreement with physiological measurements. PMID- 6490457 TI - Effect of increased lung volume on perception of breathlessness, effort, and tension. AB - By the addition of externally added elastic loads at both functional residual capacity (FRC) and increased lung volume, increased respiratory muscle effort, tension, and breathlessness were induced in normal subjects. The magnitude of each of these sensations was estimated using the psychophysical technique of category scaling (Med. Sci. Sports Exercise 14: 377-381, 1982). The tidal volume, inspiratory time, and breathing frequency were kept constant to avoid variability in sensation due to these factors. The perceived magnitude of effort and breathlessness increased significantly as the inspiratory pressure and lung volume increased (P less than 0.05). The magnitude of perceived tension increased as the inspiratory pressure increased (P less than 0.05) but not as lung volume increased. To validate these results, the subjects estimated the perceived magnitude of a series of static inspiratory occlusion pressures at both lung volumes using open-magnitude scaling and sensory matching. The perceived magnitude of effort increased significantly as the pressure increased and as the lung volume increased (P less than 0.05). To match the perceived effort required to produce the target pressures at FRC, the subjects reproduced pressures. These were not significantly different. However, to match the effort required to produce the target pressures at increased lung volume, the pressures reproduced at FRC were significantly greater (P less than 0.05). The results suggest that the sensations of breathlessness and effort are psychophysically the same, whereas tension is perceived by a different sensory mechanism. PMID- 6490458 TI - Leukocyte kinetics in the human lung: role of exercise and catecholamines. AB - In six normal supine subjects epinephrine infusion produced a greater leukocytosis with smaller changes in heart rate and blood pressure than did norepinephrine or isoproterenol. Upright exercise in those subjects produced a greater leukocytosis than supine exercise at the same work load. To determine the lung's participation in these events, indium-labeled neutrophils (PMN) were given to four of the subjects. We found that 20-25% were retained in the first pass through the lung when compared with technetium-labeled erythrocytes. The number of labeled PMN in the lung gradually decreased and the number in the spleen and the liver increased. Exercise and catecholamine infusion caused an acceleration in the release of labeled cells from the lung, an increase in both labeled and unlabeled cells in the peripheral blood, and an increase in the number of labeled cells in the liver and spleen. This suggests that increased perfusion of low-flow areas in the lung may contribute to the increased leukocytosis seen in association with both exercise and catecholamine infusion. PMID- 6490459 TI - Renal clearance of urea, inulin, and p-aminohippurate in heat-acclimated rats. AB - Clearance values of urea, inulin, and p-aminohippurate (PAH) were measured in heat-acclimated (HA) rats exposed for 3 wk to 35 degrees C, in control rats (C) exposed to 23 degrees C, and in HA rats deacclimated (DA) for 3 wk. In HA rats, urea clearance was lower by 73%, inulin clearance by 61%, and PAH clearance by 56%, compared with C rats. The clearance values of these substances returned to the control values in DA rats. The data suggest that the low clearance values reflect both reduced renal blood flow and possible changes in the capacity of the glomeruli for filtration and the tubules for either reabsorption or secretion. PMID- 6490460 TI - O2 transport in ponies during treadmill exercise. AB - We assessed cardiovascular variables and blood O2 contents in order to characterize O2 transport in ponies during treadmill exercise. In normal ponies at 1.8, 3, and 6 mph, respectively, cardiac output (Qc) increased from 12 l/min at rest to maximum levels of 19.7, 28.7, and 39.9 l/min between 30 and 60 s. Qc then decreased to steady-state levels of 18.2, 24.6, and 32.7 l/min by 4 min. Heart rate (HR) showed a similar biphasic response in the 1st min of exercise. Systolic and diastolic arterial blood pressure (BP) decreased at the onset of exercise by 20-25 Torr (P less than 0.05) and then increased to a steady-state by 60 s. Mean right ventricular pressures (MRVBP) increased from approximately 9.7 Torr at rest to 15.9 (1.8 mph), 15.2 (3 mph), and 23.6 Torr (6 mph) by 1 min and then decreased throughout the remainder of the 8 min of exercise (P less than 0.05). At 3 and 6 mph, respectively, arterial O2 content (CaO2) increased from 11.6 vol% at rest to 12.7 and 15.0 vol% by 45 s and 13.1 and 16.6 vol% by 7 min. At 7 min of 9.3 mph exercise, it increased to 20.34 vol%. Hemoglobin (Hb) at 3 mph increased from 9.6 g/100 ml at rest to 10.5 g/100 ml by 45 s and 11.7 g/100 ml by 7 min. At 6 mph, Hb increased to 12 g/100 ml at 45 s and 13.0 g/100 ml by 7 min of exercise. These data demonstrate that the rapid, work load-dependent increase in CaO2 represents an important mechanism to increase O2 transport in exercising ponies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490461 TI - Temporal pattern of pulmonary gas exchange during exercise in ponies. AB - We characterized the temporal patterns of pulmonary O2 consumption (VO2) and CO2 excretion (VCO2) in exercising ponies. We also assessed the cardiac, ventilatory, and hematologic contributions to the VO2-VCO2 changes during exercise. At five moderate treadmill work loads in normal ponies, VO2 and VCO2 generally increased progressively throughout the 1st min reaching, respectively, approximately 95 and 80% of steady state by 45-60 s. Between 1 and 1.5 min, Vo2 and Vco2 were either stable or they decreased 300-500 ml, but then each increased slightly, reaching steady-state levels between 3 and 5 min. The increases to steady-state VO2 and VCO2 were clearly not monoexponential. Arterial O2 content (CaO2) increased during exercise, presumably because of mobilization of stored splenic erythrocytes. For example, after 1 and 6 min at 6 mph 3% grade, CaO2 had increased above rest by 3.2 and 4.9 vol%, respectively (P less than 0.05). Hyperventilation during exercise decreased arterial CO2 content (CaCO2) below rest. For example, after 1 and 6 min at 6 mph 3% grade, CaCO2 had decreased below rest by 2.8 and 1 vol%, respectively (P less than 0.05). At all work loads, heart rate (HR) and presumably cardiac output increased rapidly during the 1st min, reaching a maximum by approximately 45 s. HR then decreased (P less than 0.05), reaching a steady state by 3 min of exercise. During the first 1.5 min of exercise in carotid body-denervated (CBD) ponies, the changes in VO2, HR, and CaO2 were temporally delayed relative to the normals, whereas the changes in VCO2 and CaCO2 were relatively augmented.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490462 TI - Conservation of blood plasma fluids in hamadryas baboons after thermal dehydration. AB - After 2 days of water deprivation in a warm climate, Papio hamadryas baboons lost 10% of their body mass, 12.5% of their total body water (3H2O) space, but only 4% of their plasma volume [Evans blue (EB) space]. Hematocrit and hemoglobin concentration as well as blood viscosity and blood pressure were not affected by thermal dehydration. Plasma colloid osmotic pressure (COP) in the dehydrated animals was, however, 8 Torr higher than in fully hydrated baboons. Total mass and concentration of plasma albumin, and protein concentration increased after dehydration. Both half times (T 1/2) of EB and T 1/2 of 131I-serum albumin were twice as high as in the dehydrated animal than in the fully hydrated ones. Incorporation rate of L-[3H]leucine in the plasma proteins was similarly higher in the dehydrated animals. The capacity of the P. hamadryas baboon to maintain its plasma volume at the expense of losses from other body fluid compartments is related to an increase in the blood COP that is brought about by a more efficient retention of albumin and an increase in its rate of synthesis. PMID- 6490463 TI - Change in extra-alveolar perimicrovascular pressure with lung inflation. AB - In eight isolated dog lobes, we examined the change in extra-alveolar perimicrovascular hydrostatic pressure (Pis) due to lung inflation. The vasculature was filled with autologous plasma. Pulmonary arterial and venous lines were connected to a common plasma reservoir. Perimicrovascular volume change (delta Vis), compliance (Cis), and the microvascular filtration coefficient (Kf) were derived from the change in lobe mass over time following a step increase in vascular pressure (Piv). Initially, transpulmonary pressure (PL) was 5 cmH2O and Piv = 0 cmH2O. At constant Piv, two sequential 5-cmH2O increases in PL increased Vis; division of delta Vis by Cis yielded the change in Pis attributable to lung inflation. Cis was 0.035 +/- 0.018 g X cmH2O-1 X g dry mass 1 (mean +/- SD) at PL = 15 cmH2O. Kf was 0.019 +/- 0.023 g X min-1 X cmH2O-1 X g dry mass-1. With inflation from PL = 5 to PL = 10 cmH2O, Pis = -2.15 +/- 1.76 cmH2O; from PL = 10 to PL = 15 cmH2O, Pis = -2.25 +/- 1.50 cmH2O. This perimicrovascular pressure change is very close to the perihilar interstitial pressure change reported by others. Such near equality suggests that the stress of lung inflation is very uniformly applied to the interstitial continuum. PMID- 6490464 TI - Reproducibility and accuracy of airway area by acoustic reflection. AB - To determine the accuracy and reproducibility of measurements of airway area by acoustic reflection (AAAR) we made repeated measurements of tracheal areas in human volunteers, glass airway models, and excised canine tracheae. In 10 adult males, the mean ratio of tracheal AAAR to tracheal areas determined roentgenographically was not significantly different from one (1.06 +/- 0.13 SD). Within-run variability was 10 +/- 4% (CV), mean intrasubject day-to-day variability was 9 +/- 4% (CV). A custom-made mouthpiece is necessary for accurate measurements of AAAR. Mean variability related to differences in mouthpiece construction was 7 +/- 6% (CV). The effect of variations in upper airway and glottic sizes on tracheal AAAR measurements was investigated using glass airway models. In model studies, tracheal AAAR measurements were found to be independent of changes in proximal airway size for glottic apertures greater than or equal to 1 cm2 and upper airway areas less than or equal to 8 cm2. Tracheal area was, however, overestimated by 20% in the rigid-walled glass models. The effects of airway wall rigidity were qualitatively investigated by comparing acoustic and roentgenographic measurements of excised canine tracheae surrounded by either air or petroleum jelly. Differences in the accuracy of measurements of AAAR in vitro and in vivo are probably due to differences in airway wall inertance. These studies suggest that the measurement of AAAR yields an accurate and reproducible result that may be clinically useful for the noninvasive detection of changes in central airway geometry. PMID- 6490465 TI - Alveolar pressure nonhomogeneity during small-amplitude high-frequency oscillation. AB - In six excised canine lungs, regional alveolar pressures (PA) were measured during small-amplitude high-frequency oscillations applied at the airway opening. Both the regional distribution of PA's and their relationship to pressure excursions at the airway opening (Pao) were assessed in terms of amplitude and phase. PA was sampled in several capsules glued to the pleural surface and communicating with alveolar gas via pleural punctures. Pao and PA were measured over the frequency (f) range 1-60 Hz, at transpulmonary pressures (PL) of 5, 10, and 25 cmH2O. The amplitude of PA excursions substantially exceeded Pao excursions at frequencies near the resonant frequency. At resonance the ratio [PA/Pao] was 1.9, 2.9, and 4.8 at PL's of 5, 10, and 25 cmH2O, respectively. Both spatial homogeneity and temporal synchrony of PA's between sampled lung regions decreased with f and increased with PL. Interregional variability of airway impedance [(Pao - PA)/Vao] and tissue impedance (PA/Vao) tended to be larger than differences due to changing PL but not as large as between-dog variability. These data define the baseline nonhomogeneity of the normal canine lung and also suggest that there may be some advantage in applying high-frequency ventilation at frequencies at least as high as lung resonant frequency. PMID- 6490466 TI - Differential inhibitory effect of isoproterenol on contractions of canine airways. AB - We examined the inhibitory effect of isoproterenol on contractions of isolated canine airways induced by histamine, 5-hydroxytryptamine (5-HT), and acetylcholine. Airway contractions were matched by using agonist concentrations that produced approximately 60% of the contractile force generated during a previous exposure to 10(-4) M acetylcholine. Concentrations of isoproterenol causing 50% relaxations of histamine-, 5-HT-, and acetylcholine-induced contractions were 9.9 X 10(-9), 3.6 X 10(-8), and 9.0 X 10(-8) M, respectively. Total relaxation of histamine- and 5-HT-induced contractions occurred at 10(-7) and 10(-6) M isoproterenol, respectively, whereas isoproterenol concentrations greater than or equal to 10(-4) M never totally relaxed airways contracted by acetylcholine. We conclude that isoproterenol inhibits airway contractions induced by histamine and 5-HT much more effectively than those induced by acetylcholine. PMID- 6490467 TI - Plasma catecholamines in rats during rewarming from induced hypothermia. AB - The present study sought to quantitate the levels of plasma catecholamines [norepinephrine (NE), epinephrine (E), and dopamine (DA)] during induction and rewarming from hypothermia. Male rats (317 +/- 8 g) were made hypothermic by exposure to 0.9% halothane at -10 to -15 degrees C while blood pressure (carotid artery), heart rate, and colonic temperature (Tc) were monitored. Anesthesia was discontinued when Tc reached 28 degrees C. Tc continued to fall but was held at 20-20.5 degrees C for 30 min. Rewarming was then initiated by raising ambient temperature to 22 degrees C. Arterial blood samples were taken 1) before cooling, 2) just before rewarming, 3) when Tc reached 22 degrees C during rewarming, and 4) when Tc reached 27 degrees C during rewarming. Plasma was assayed radioenzymatically for catecholamines using both phenylethanolamine-N methyltransferase and catechol-O-methyltransferase procedures, and hypothermic induction resulted in significant increases in NE, E, and DA above control levels (P less than 0.01). With rewarming to Tc = 22 degrees C, all catecholamines increased above the level observed during hypothermia (P less than 0.01), and NE and DA increased still further (P less than 0.01) when Tc reached 27 degrees C. The levels of plasma catecholamines observed during hypothermia and during the rewarming phase indicate a role of the sympathoadrenal medullary system in the metabolic adjustments associated with hypothermia and recovery. During rewarming, the levels of E and NE attained exceed those at which both substances may be expected to act as circulating hormones. PMID- 6490468 TI - On the likelihood of decompression sickness. AB - The occurrence of decompression sickness in animals and humans is characterized by the extreme variability of individual response. Nevertheless, models and analyses of decompression results have generally used a critical value approach to separate safe and unsafe decompression procedures. Application of the principle of maximum likelihood provides a formal and consistent way to quantify decompression risk and to apply models to data on decompression outcome. By use of the maximum likelihood principle, a number of models were fit to data from dose-response and maximum pressure-reduction experiments with both rats and men. Several different formulations of two- and three-parameter models described the data well. In addition to summarizing data sets, the analyses provide a way to maximize the value of experimental observations, test theoretical predictions, estimate uncertainty in conclusions, and recommend safe practices. PMID- 6490469 TI - Effect of resistive loading on inspiratory work output in anesthetized cats. AB - In five spontaneously breathing anesthetized cats, we determined the inspiratory elastic (Wel), resistive (Wres), and total (WI) mechanical work rates (power) during control and first loaded inspirations through graded linear resistances (delta R) by "Campbell diagrams" based on measurement of esophageal pressure. WI did not change with delta R's up to 0.31 cmH2O X ml-1 X s, the concomitant decrease in Wel being balanced by an increase in Wres. The stability of WI in the face of delta R's was due to the vagally mediated prolongation of inspiration and the intrinsic properties of the respiratory system and of the contracting inspiratory muscles. To assess the separate contributions of volume-related and flow-related intrinsic mechanisms to the stability of WI, we made model predictions of the immediate effects of delta R's on inspiratory mechanical work output based on measurements of inspiratory driving pressure waves and passive and active respiratory resistance and elastance on the same five cats. The results suggest that the intrinsic stability of WI in the face of delta R's is provided primarily by the active elastance. PMID- 6490470 TI - Voluntary dehydration and alliesthesia for water. AB - The purpose of this experiment was to explore the complex relationship between fluid consumption and consumption factors (thirst, voluntary dehydration, water alliesthesia, palatability, work-rest cycle) during a simulated 14.5-km desert walk (treadmill, 1.34 m X s-1, 5% grade, 40 degrees C dry bulb/26 degrees C wet bulb, and wind speed of approximately 1.2 m X s-1). Twenty-nine subjects were tested (30 min X h-1, 6 h) on each of two nonconsecutive days. The subjects were randomly assigned to one of three groups: tap water (n = 8), iodine-treated tap water (n = 11), or iodine-treated flavored tap water (n = 10). The temperature of the water was 40 degrees C during one trial and 15 degrees C on the other. Mean sweat losses (6 h) varied between 1.4 kg (warm iodine-treated; 232 +/- 44 g X h 1) and 3.0 kg (cool iodine-treated flavored; 509 +/- 50 g X h-1). Warm drinks were consumed at a lower rate than cool drinks (negative and positive alliesthesia). This decreased consumption resulted in the highest percent body weight losses (2.8 and 3.2%). Cooling and flavoring effects on consumption were additive and increased the rate of intake by 120%. The apparent paradox between reduced consumption concomitant with severe dehydration and hyperthermia is attributed to negative alliesthesia for warm water rather than an apparent inadequacy of the thirst mechanism. The reluctance to drink warm iodine-treated water resulted in significant hyperthermia, dehydration, hypovolemia, and, in two cases, heat illness. PMID- 6490471 TI - Temporal delay of venous blood correlates with onset of exercise hyperpnea. AB - We tested the hypothesis that humoral factors contribute to the onset of exercise hyperpnea in an electrically induced model of isocapnic exercise in alpha chloralose-anesthetized dogs. A cannula placed in the inferior vena cava (IVC) permitted hindlimb venous blood to flow either directly to the lungs or through a variable-length extracorporeal circuit. Mean transit times (MTT) of blood from exercising hindlimbs were measured from the arrival at the pulmonary artery of green dye injected into the saphenous vein. Onset of hyperpnea was determined by the half time of the ventilatory response (T 1/2), the time required to reach 50% of the steady-state ventilation. In seven dogs, T 1/2 was directly related to MTT (P less than 0.001), suggesting that blood-borne substances released at the onset of exercise contribute to the hyperpneic response. The T 1/2-MTT relation persisted following L2 cord transection (n = 4), suggesting that intraspinal afferents are not required for this response. Chemoreceptor denervation (n = 4) slowed the onset of exercise hyperpnea but did not alter the T 1/2-MTT relation. In this model of electrically induced "exercise" in which neurogenic influences have been minimized, humoral factors alone may stimulate ventilation sufficiently to produce arterial isocapnia. PMID- 6490472 TI - Physiological dead space during high-frequency ventilation in dogs. AB - Tidal volumes used in high-frequency ventilation (HFV) may be smaller than anatomic dead space, but since gas exchange does take place, physiological dead space (VD) must be smaller than tidal volume (VT). We quantified changes in VD in three dogs at constant alveolar ventilation using the Bohr equation as VT was varied from 3 to 15 ml/kg and frequency (f) from 0.2 to 8 Hz, ranges that include normal as well as HFV. We found that VD was relatively constant at tidal volumes associated with normal ventilation (7-15 ml/kg) but fell sharply as VT was reduced further to tidal volumes associated with HFV (less than 7 ml/kg). The frequency required to maintain constant alveolar ventilation increased slowly as tidal volume was decreased from 15 to 7 ml/kg but rose sharply with attendant rapid increases in minute ventilation as tidal volumes were decreased to less than 7 ml/kg. At tidal volumes less than 7 ml/kg, the data deviated substantially from the conventional alveolar ventilation equation [f(VT - VD) = constant] but fit well a model derived previously for HFV. This model predicts that gas exchange with volumes smaller than dead space should vary approximately as the product of f and VT2. PMID- 6490473 TI - Scaling of added loads to breathing: magnitude estimation vs. handgrip matching. AB - Six healthy male adults were studied at five levels of suprathreshold added resistance (delta R) applied three times to inspiration in a random sequence. Subjects squeezed an isometric handgrip dynamometer coincident with the breath to express the perceived magnitude of the load and also gave a numerical estimate after completing the loaded inspiration. Peak mouth pressure, grip deflection, and numerical estimate were analyzed to derive the exponents for Stevens' power law. The mean exponent and correlation coefficient obtained from numerical estimates were 1.11 +/- 0.16 and 0.94 +/- 0.04, respectively, while the exponent and correlation coefficient simultaneously obtained from handgrip matching was 0.73 +/- 0.10 and 0.91 +/- 0.05, respectively. Multiplying each subject's exponent obtained from handgrip matching by 1.7 yields a mean equated exponent of 1.23 +/- 0.17. The equated exponents were not statistically different (P greater than 0.05) from the exponents derived from numerical estimates. These results suggest that the use of cross-modality (handgrip) matching provides a reliable method for obtaining psychophysical magnitude functions of respiratory sensations and that exponents obtained using either technique can be equated for comparison. PMID- 6490474 TI - Single-unit pH-sensitive double-barreled microelectrodes for extracellular use. AB - The purpose of this study is to systematically describe the construction of pH sensitive double-barreled microelectrodes for extracellular use. The most important advantages of these microelectrodes are as follows: the reference and the pH barrels are next to each other, and therefore the measured pH is not affected by asymmetric or slowly spreading direct current potential. The diameter of the tip of the microelectrodes is between 7 and 35 micron. These pH-sensitive microelectrodes are generally stable and Nernstian. They can be used repeatedly both in vivo and in vitro to measure tissue extracellular fluid pH. Some applications are described. PMID- 6490475 TI - Time domain analysis of diaphragmatic electromyogram during fatigue in men. AB - Diaphragmatic fatigue has been correlated with a change in the electromyogram recorded from the diaphragm (EMGdi), which suggests that the electromyogram is a potential clinical tool to detect respiratory muscle fatigue. Changes in the EMGdi have previously been quantified by using the power spectral parameters high low ratio or mean frequency. In this study, we developed an autoregressive model of the EMG in an attempt to improve the analysis of the EMGdi. This model was tested on recordings of the EMGdi that were obtained from an esophageal electrode in five normal subjects breathing to fatigue through an inspiratory resistor. The data obtained from the autoregressive model were directly compared with data from the high-low ratio and mean frequency techniques. The autoregressive model showed an excellent correlation with mean frequency. Both techniques were superior to the high-low ratio measurement. Because the autoregressive model requires much less computation than mean frequency and can be easily implemented in real time on a minicomputer, we propose this as a preferable approach. PMID- 6490476 TI - Measurement of fetal heat production using differential calorimetry. AB - These experiments were undertaken to measure heat production of fetal lambs in utero by using differential calorimetry. We used the principle that fetal heat production, H(fetus), can be calculated from measurements of base-line temperature difference between mother and fetus, delta T(fetus), heat introduced from an external source, H(heater), and the increase in body temperature, delta T(heater), that results, i.e., H(fetus) = H(heater) X delta T(fetus)/delta T(heater). We placed microheaters (1.8 mm diam) in the inferior vena cavae of eight near-term lambs and placed thermistors and catheters into maternal and fetal vessels and amniotic fluid. Five days later, fetal arterial temperature averaged 0.54 +/- 0.02 degrees C (SE) higher than maternal arterial temperature. When the heater was turned on to dissipate 29-103 cal/min, fetal temperature increased to approach 0.1-0.5 degrees C higher than control; the final temperature was estimated using the rate of increase during the first 20 min. Fetal heat production averaged 47.1 +/- 4.1 cal X min-1 X kg-1 during the warming phase in these lambs, which weighed 3.26 +/- 0.36 kg. This value would be 3-4% less if corrected for the increase in metabolic rate caused by heating, assuming a Q10 of 2.5. Fetal heating did not alter fetal heart rate, blood pressure, or blood gas values significantly, nor was hemolysis visible in plasma samples. When heat production was calculated from the decrease in fetal temperature after the heater was turned off, an average value of 41.2 +/- 2.5 cal X min-1 X kg-1 was found. Because this value is comparable to the heating phase, fetal metabolic rate and the insulating properties of the fetal shell are not likely to have been changed by the heating. PMID- 6490477 TI - Granulocyte depletion and histamine sensitivity. PMID- 6490478 TI - Psychosocial adaptation to wearing the Milwaukee brace for scoliosis. A pilot study of adolescent females and their mothers. AB - The psychological, social, and lifestyle effects of wearing the Milwaukee brace for scoliosis was examined in 16 mother-daughter pairs using a patient interview and a questionnaire of similar content for the mother. Results suggested that after the initial shock of learning about the condition and treatment, the effects of the brace-wearing experience were minimal. Positive aspects of brace wearing included better posture and a straighter back. The experience of "being different" was reported to be constructive by 12.5% of the patients. Negative aspects were related to buying clothing, limited movement, and the rudeness shown toward them by others. Participation in sports and extracurricular activities was maintained by the group. The responses of most mothers were similar to those of their daughter. PMID- 6490479 TI - Cervical intraepithelial neoplasia in adolescents. AB - Three hundred and eleven adolescent patients with abnormal Pap smears were referred for evaluation. Two hundred and ninety-three were evaluated with colposcopy and directed biopsies. Fourteen percent had normal findings, 42% CIN I, 22% CIN II, and 22% CIN III. The distribution of pathologic findings was similar to that in an adult population in the same clinic except that no invasive carcinomas were found in our adolescents. Since there was a predominance of exocervical lesions, only 3% of the patients required diagnostic conization. Ninety-four percent of the adolescents were treated by cryotherapy as compared to 68% of the adults. Since adolescents have significant cervical intraepithelial neoplasia, an abnormal Pap smear should be evaluated and a tissue diagnosis obtained. Outpatient therapy is well suited for the majority of teenagers because the lesions are commonly confined to the exocervix. PMID- 6490480 TI - Attitudes toward health and illness. A comparison of adolescent, physician, teacher, and school nurse views. AB - To assist physicians, teachers, and school nurses in meeting adolescent health needs, 240 members of these three professional groups and 600 middle school students answered a self-administered questionnaire to assess student attitudes towards health and illness. chi 2 Analyses were employed to determine if response patterns varied as a function of the group. Incongruencies (p less than 0.05) were noted between students' and professionals' responses to all questions. Adolescents attributed more importance to their health, showed a better personal health status, expressed more worry about personal health and becoming sick and more concern about being sick, showed more feelings of responsibility for their health, and exhibited less frequent practice of harmful behaviors than adults anticipated that the students would report. Adults differed in their perceptions of the students' reported health status and the frequency of student worry about personal health and being sick. Findings are discussed in relation to the provision of more meaningful, comprehensive, multidisciplinary approaches to meeting adolescent health care needs and concerns. PMID- 6490481 TI - Adolescent dentistry programs: a survey of United States dental schools. AB - The dental care needs of the adolescent have not been recognized as a distinct area of education and treatment. A survey was sent to United States dental schools to determine the number of schools with adolescent dentistry programs and how these programs are organized. The results suggest that dental schools are beginning to incorporate adolescent dentistry as a separate entity. Greater attention is required for teaching of this topic in the future. PMID- 6490482 TI - Abnormal cervical cytology in sexually active adolescents. AB - A routine Pap smear was performed on 1,207 sexually active adolescents seen in a public health department family planning clinic. One hundred and thirty-two (11%) had abnormal findings and were referred for evaluation to the gynecologist of their choice. Thirty-five patients (27%) failed to keep their initial referral appointment, and twenty-eight patients (21%) were inadequately evaluated. Therefore, only 69 patients (52%) were evaluated by colposcopy with directed biopsies. Fifty of the 69 patients (72%) had cervical intraepithelial neoplasia. Sexually active adolescents should be routinely screened with Pap smears and those with abnormal findings should be evaluated and a tissue diagnosis obtained. The primary care provider must reinforce the need for complete evaluation and therapy. Referral must be made to a gynecologist who is expert in the evaluation of abnormal Pap smears. PMID- 6490483 TI - An adolescent with vomiting and weight loss. AB - A 17-year-old female complained of difficulty swallowing and recurrent vomiting of one year duration. She stated that she was trying to gain weight. She felt that a weight at the 5th percentile for age was appropriate for her 70th percentile height. She denied binge eating, self-induced vomiting, concern over abnormal eating, or depressed mood. She had low normal intelligence, long standing problems with school and peer relationships, and was experiencing significant conflict with her stepfather. The mother noted that her daughter's symptoms had begun at the time her prized horse went lame. Physical examination was unremarkable except for thinness. At a two-week follow-up visit, all vomiting had ceased and the patient had gained 1.6 kg. Plans for a barium esophagogram were cancelled and psychiatric consultation was arranged. A six-week followup revealed no vomiting, although weight gain had not progressed. Six months later, the patient was seen with a two-month history of recurrent vomiting. A barium esophagogram revealed achalasia. Pneumatic dilation of the lower esophageal sphincter was successful. Seventeen months after the initial visit the patient was asymptomatic, happy, and seemingly well adjusted. PMID- 6490484 TI - Achalasia in an adolescent with behavioral features compatible with anorexia nervosa. AB - A case report of an adolescent female with esophageal achalasia and behavioral features of anorexia nervosa is presented. This unusual combination of problems may cause similar physical symptoms and thus create diagnostic confusion. PMID- 6490485 TI - On sex between adults and adolescents. PMID- 6490486 TI - Parent-child communication about sexuality. The physician as a community educator. PMID- 6490487 TI - Change of inhalation anesthetic agents for management of ventricular premature depolarizations in anesthetized cats and dogs. AB - Ventricular premature depolarizations (VPD) were found in 27 cats and 14 dogs during inhalation anesthesia. For animals receiving halothane, the anesthetic agent was changed to enflurane (n = 22) or isoflurane (n = 15). After the change to enflurane, the VPD reverted to normal sinus rhythm (n = 19) or decreased in frequency (n = 3). After the change to isoflurane, the VPD reverted to normal sinus rhythm (n = 14) or decreased in frequency (n = 1). For 4 cats receiving enflurane, the inhalant agent was changed to halothane, which caused an increased frequency of VPD (n = 3) or reversion to normal sinus rhythm (n = 1). It was concluded that cats and dogs with VPD during inhalation anesthesia with halothane would benefit from a change to enflurane or isoflurane. PMID- 6490488 TI - Cynoglossum officinale (hound's-tongue)--a cause of pyrrolizidine alkaloid poisoning in horses. AB - The death of 10 horses was attributed to feeding dried grass hay containing hound's-tongue, Cynoglossum officinale. Affected horses developed weight loss, icterus, photosensitization, and hepatic encephalopathy. Histologic examination of the liver of 3 of the horses revealed megalocytosis, biliary hyperplasia, and fibrosis characteristic of pyrrolizidine alkaloid poisoning. Hound's-tongue was found to contain large quantities (0.6% to 2.1%, dry matter basis) of toxic pyrrolizidine alkaloids, which, when fed to a pony for 20 days, caused liver fibrosis and biliary hyperplasia. PMID- 6490489 TI - Isolation of Streptococcus suis from swine in Nebraska. AB - Streptococcus suis was isolated from swine with localized and diffuse infections. The isolates (n = 121) were unable to grow in broth containing 6.5% NaCl. Their abilities to hydrolyze esculin were variable, as were their fermentative reactions in lactose, trehalose, raffinose, and inulin. Sorbitol was not attacked by any strain. Serologic reactions were obtained between the isolates and coagglutination reagents prepared from commercially available antisera to streptococcal groups D, R, or S. PMID- 6490491 TI - Lincomycin-associated enterocolitis in rabbits. PMID- 6490490 TI - Cystic and peritoneal giardiasis in a dog. PMID- 6490492 TI - Subcutaneous dermatophilosis in a cat. PMID- 6490493 TI - Laryngeal oncocytoma in two dogs. PMID- 6490494 TI - Egg retention in four snakes. PMID- 6490495 TI - Pet ownership by life group. PMID- 6490496 TI - What is your diagnosis? Dorsopalmar slab fracture of the medial aspect of the third carpal bone. PMID- 6490497 TI - Anaplasmosis in embryo transfer cattle. PMID- 6490498 TI - Controlling distribution of drugs. PMID- 6490500 TI - Licensing boards and approval of veterinary educational programs. PMID- 6490499 TI - Treatment of acute renal failure in horses. PMID- 6490501 TI - Storage considerations for thiacetarsamide sodium. PMID- 6490502 TI - Medial condylar fractures of the third metatarsal bone in horses. AB - Fifteen longitudinal fractures involving the medial condyle of the third metatarsal bone were diagnosed in racing Thoroughbreds and Standardbreds. Twelve were repaired surgically with lag screws placed through stab incisions. Two of the horses suffered catastrophic fracture of the third metatarsal bone during recovery from anesthesia, and 3 more sustained complete fractures within 4 days of the repair. Of 3 horses with fractures treated without surgery, 2 healed without complication. Preoperative radiography did not demonstrate a nonlongitudinal fracture component in any of the horses that sustained complete fractures. The complete fractures were uniformly "Y" shaped. Horses in which the fractures healed had a good prognosis for return to racing. PMID- 6490503 TI - Techniques and applications of transabdominal ultrasonography in the pregnant mare. AB - To establish the feasibility of utilizing high-frequency ultrasound to image equine fetal development transabdominally, in vitro and in vivo observations were made. Three fetuses retrieved from mares that died from various causes were scanned in vitro to establish fetal images from various orientations. A total of 50 mares ranging in age from 4 to 16 years and representing various breeds were scanned intermittently from 100 days of gestation to parturition. Fetal parts, amniotic fluid, placental membranes, and motion patterns could be reliably identified. Fetal heart rates decreased from 180 beats/min at 100 days' gestation to 60 to 80 beats/min from 2 weeks before parturition to term. Detection of fetal orientation, viability, and twin recognition represented practical applications of the technique. PMID- 6490504 TI - Equine plasma banking: collection by exsanguination. AB - A procedure was developed for the collection, preparation, storage, and administration of equine plasma. The technique involved exsanguination of anesthetized donor horses via carotid artery catheterization with a large-bore cannula. Blood was collected into plastic bags, allowed to settle by gravity, then transferred into storage bags and frozen. These were quickly thawed when needed. PMID- 6490505 TI - Medical management of esophageal stricture in seven horses. AB - Esophageal strictures developed in 7 horses that were treated for esophageal obstruction. A soft diet was fed to all horses, with intermittent nasogastric tube feeding in one, and medication included nonsteroidal anti-inflammatory drugs. Maximal reduction in esophageal lumen diameter was evident by 30 days following circumferential esophageal ulceration, after which lumen diameter increased rapidly. Five horses were clinically normal by 60 days after the esophageal injury. Two horses were euthanatized at the owner's request, 16 and 17 days after the original insult. PMID- 6490506 TI - Infertility due to foreign objects in the cervix of a cow. AB - Two fetal claws were removed from the cervix of a Holstein cow that had a chronic vulvar discharge. The cow had calved 1 year earlier. After removal of the claws, localized peritonitis developed and the cervix remained open and draining. PMID- 6490507 TI - External lipomas in three horses. AB - Lipomas involving the musculoskeletal system were seen in 3 horses. The lipomas were on the thorax of 2 horses and the stifle of the third horse. The thoracic lipomas were surgically removed. No recurrence has been noted by 8 months in either case. The lipoma on the stifle had invaded the surrounding tissue and the horse was euthanatized. Unlike mesenteric lipomas, which occur in older horses, these lipomas all occurred in horses less than 2 years of age. PMID- 6490508 TI - Isolation of Actinobacillus lignieresii from enlarged tongue of a horse. AB - In the horse described herein, Actinobacillus lignieresii was associated with a syndrome identical to wooden tongue in cattle. It responded rapidly to systemic sodium iodide and antibiotic therapy. The definitive diagnosis was based on cytologic examination and culture. If actinobacillosis is suspected, immediate treatment with sodium iodide should be instituted along with supportive therapy. PMID- 6490510 TI - Femoral fracture repair complicated by vascular injury in a foal. AB - A comminuted, mid-diaphyseal femoral fracture was diagnosed radiographically in a 4-month-old Quarter Horse colt. Disruption of the distal blood supply was suspected, as evidenced by coolness and diminished pulses of the distal portion of the limb. The fracture was repaired by compression plating but the foal's condition continued to deteriorate. A femoral arteriogram of the affected limb was obtained. Positive contrast agent was visible only as far as the mid-shaft of the femur. The foal was euthanatized and the postmortem examination revealed a transected popliteal artery accounting for ischemic necrosis of the distal limb. PMID- 6490511 TI - Catastrophic death losses in a dairy herd attributed to type D botulism. AB - Clostridium botulinum type D intoxication was diagnosed as the cause of death of 42 of 67 lactating cows in a southeast Texas dairy herd over an 11-day period. By necessity, the diagnosis was based on clinicopathologic findings, as the toxin could not, by standard laboratory tests, be demonstrated in affected cattle. The predominant clinical findings were hindlimb weakness/ataxia rapidly progressing to persistent recumbency. Affected cattle were alert until just before death, which occurred without notable agonal movements or respirations after 6 to 72 hours' recumbency. Abnormal laboratory findings included neutrophilic leukocytosis (all affected cattle), proteinuria (most affected cattle), slight elevations of serum aspartate transaminase and low serum inorganic phosphorus (some affected cattle), and patchy areas of hyperemia/congestion of the mucosa in the small intestine (postmortem examination of 3 affected cattle). This report confirms the findings of others with regard to the difficulty of demonstrating the causative toxin in C botulinum type D-intoxicated cattle and presents available information on the clinicopathologic features of this intoxication that may aid in the differentiation of this condition from other causes of down cows. PMID- 6490509 TI - Oxytetracycline-associated nephrotoxicosis in feedlot calves. AB - Renal nephrosis and increased mortality were investigated in feedlot calves that had received excessive doses of oxytetracycline for the treatment of bronchopneumonia. Histopathologic findings included moderate to severe, cortical tubular nephrosis, and suppurative bronchopneumonia. Results of serum and peritoneal fluid analysis were consistent with severe renal disease. Renal toxicosis from the administration of excessive oxytetracycline should be considered a possible side effect in stressed calves with concurrent respiratory disease. PMID- 6490512 TI - Transient Horner's syndrome following routine intravenous injections in two horses. AB - Horner's syndrome developed in 2 horses after routine jugular venipuncture. Signs included unilateral sweating of the face in both horses and ptosis in 1 horse. The signs resolved within 14 hours. Signs of a perivascular injection did not develop in either horse. Although Horner's syndrome has been reported after perivascular jugular injections these cases illustrate that the syndrome may develop following routine intravenous injections. PMID- 6490513 TI - Management of chronic colitis in the dog. PMID- 6490514 TI - The adrenal gland of Euproctus (Urodela, Salamandridae): comparison of three species and phylogenetic inferences. AB - Adrenal glands of three species of Euproctus (E. asper, E. montanus and E. platycephalus) were compared. Differences were observed as regards: (1) the distribution of the adrenal tissue, which is more sparse in E. asper than in the other two species; (2) the amount and size of the adrenal islets: in E. asper, they are numerous and small, in E. platycephalus, they are decreased in number and larger, in E. montanus they are few and very large; (3) the distance of the islets from the medial border of the kidney is variable in E. asper; in E. montanus they are mostly in contact with the medial edge, whereas in E. platycephalus they are distant from it. The adrenals of E. montanus and E. platycephalus are more similar to each other than to that of E. asper; the gland in this species may be considered a more primitive type. Such structural relationships are in agreement with phylogenetic inferences concerning the three species. PMID- 6490515 TI - The transitional node of Ranvier at the junction of the central and peripheral nervous systems: an ultrastructural study of its development and mature form. AB - When the central-peripheral transitional node first appears it lies immediately distal to the astrocyte processes delineating the cord surface. Its initial location may be influenced indirectly by the astrocytes, since they determine the position of the transitional Schwann cell by preventing it from invading the central nervous system. The central end of the Schwann cell becomes specialised to form a narrow cytoplasmic collar which closely envelopes, and so may influence, the developing nodal axon segment. The earliest nodal specializations include subaxolemmal undercoating which first appears as discrete plaques. These soon fuse to form a complete layer. The transitional node is closely related to the Schwann cell collar throughout its maturation. However, the presumptive oligodendrocyte paranode lies a considerable distance central to the node for some time. The intervening axon segment is enveloped by astrocyte processes. Terminal pockets of the oligodendrocyte gradually extend distally along this segment until they reach the node. Here the distal end of the oligodendrocyte is at first apposed to the Schwann cell collar. With maturation, astrocyte processes extend into the node gap, intervening between the two. The Schwann collar gradually becomes retracted distally as it gives rise to microvilli which project into the node gap space. With maturation, the astrocyte processes form a progressively more complete barrier between the oligodendrocyte and the node gap space. As the myelin sheaths on either side of the transitional node become thicker, the angles through which their turns incline inwards towards the axon progressively increase. The node gap thus tends to become deeper and to be bounded by steeper walls. However, in small fibres and in a proportion of large fibres, this angle remains relatively small and the node gap is therefore relatively open. Axonal protrusions commonly arise from the nodal and the paranodal segments of the axon. With maturation they become more frequent at the latter. Small recurrent collateral axon branches arise at transitional nodes of large fibres in increasing numbers with maturation. They possess thin myelin sheaths. Most run centrally in the intramedullary bundle towards the anterior horn grey matter. PMID- 6490516 TI - Development of smooth muscle in the human fetal uterus: an ultrastructural study. AB - Prenatal development of uterine smooth muscle was studied by light and electron microscopy in specimens obtained from ten human fetuses between 12 and 40 weeks gestation. Light microscopical observation of transverse sections of the body of the uterus revealed that the outer, subserosal layer of elongated cells was distinguishable from 14 weeks. This layer was more cellular than the inner layer and increased its thickness with advancing age. Ultrastructurally, the mesenchymal cells of the uterus did not contain myofilaments until 16 weeks. At 18 weeks, however, spindle shaped cells in the outer layer had a few filaments with dense bodies and well developed organelles and were identified as immature smooth muscle cells. By 31 weeks, the cells in this layer developed into almost mature smooth muscle cells, which contained abundant cytoplasmic filaments, dense plaques and surface vesicles along the cell membrane, and an external lamina. Therefore, in the human fetal uterus, smooth muscle differentiation begins at about 18 weeks and myometrium is formed in the outer layer of the wall by 31 weeks gestation. In the inner layer of the uterus that corresponds to the endometrial stroma, in addition to fibroblast-like cells, there were cells with plump cytoplasm which contained well developed granular endoplasmic reticulum and Golgi apparatus and which were identified around blood vessels by 26 weeks. These features resembled those of predecidual cells, and suggested the influence of sex steroids on the human fetal uterus. PMID- 6490517 TI - Influence of pulsed electromagnetic fields on regenerating rat liver after partial hepatectomy. AB - Partially hepatectomised rats have been exposed immediately after surgery and every 12 hours thereafter to pulsed extremely low frequency electromagnetic fields. Stereological analysis performed on electron micrographs has shown that the treatment limits the depletion of liver glycogen found in control untreated rats within the first post-operative day. The massive accumulation of lipid droplets found in control rats is also limited to about one half by exposing the animals to pulsed magnetic fields. The time taken for glycogen and lipid content to recover to values found at zero time decreases from seven to five days in animals undergoing treatment with pulsed electromagnetic fields. The liver wet weight and the total protein content show a pattern of changes which is consistent with the behaviour of glycogen and lipid content. Five days after operation the treated rats reach the values found at zero time, while control animals need seven days to reach the same values. PMID- 6490518 TI - A neutron diffraction study of the bones of the foot. AB - The preferential orientation of the apatite crystals in the lower tibia, talus and calcaneus, as determined by neutron diffraction, serves as an indicator of the lines of stress in the foot. The main stress flows down from the tibia to the heel and the ball of the foot and there is noteworthy orientation along the line of the plantar aponeurosis which acts as a tie. Orientation is particularly marked above the point of attachment of the Achilles tendon, where the edge of the calcaneus functions as a beam. The centre of the talus serves as a junctional region for forces and is relatively unoriented. PMID- 6490519 TI - Further insights into the structural principles governing the function of articular cartilage. AB - A new experimental technique involving the observation of an artificial notch propagating through articular cartilage has been used to examine the biomechanical properties of this tissue. By predetermining both the orientation of the notch and its location with respect to the primary functional zones a more rigorous description of the structure/function relationships in cartilage has been achieved. The principal findings are: A primary 'strain-locking' role for the superficial zone has been demonstrated experimentally in articular cartilage. Comparison of the behaviour of radial and transverse notches has revealed a primary structural anisotropy in the general matrix. This is strong evidence in support of the morphological model proposed in a recent paper by the present author. A range of mechanical responses is shown to be reflected consistently in structural features considered to arise principally from variations in the degree of crosslinking between the overall radial configuration of collagen fibres. It is possible to separate mechanically the collagen fibres from the general matrix and the bonding relationship between them is time-dependent. Measurement of loads required to propagate a radial notch suggest (a) that the strength of the fibres and/or that of the crosslinks between fibres increases with depth through the cartilage thickness, and (b) that the radial columns of chondrocytes typical of the deep zone do not represent planes of significantly reduced strength relative to the adjacent matrix. A major structural discontinuity exists in normal articular cartilage in a plane parallel to and below the articular surface. It is argued that this plane represents a major change in overall orientation of the collagen fibres. Finally, by applying the experimental techniques described in this paper both to degenerative articular cartilage and to healthy articular cartilage in which the primary components have been selectively degraded enzymatically it should be possible to gain a more precise picture of the structural origin of malfunction in this tissue. PMID- 6490520 TI - Development of structural heterogeneity of mitochondria in mouse hepatocytes. AB - The volume and shape (the axial ratio:length/diameter) of mitochondria in periportal and perihepatic hepatocytes from newborn, 5 days old, 10 days old and adult male ddY mice were analysed by quantitative electron microscopy. In newborn animals, the volume and relative histogram of the axial ratio were not significantly different between periportal and perihepatic cells. Thereafter, the volume did not change significantly in periportal cells, whereas it decreased between 5 days of age and the adult in perihepatic cells. In adult animals, the volume in perihepatic cells was 26% of that in periportal cells. The relative histogram of the axial ratio for periportal cells deviated significantly to smaller values than in that for perihepatic cells in 5 days old, 10 days old and adult animals. Thus, the structural heterogeneity of hepatocyte mitochondria, evident in adult animals, is not present in newborn animals but arises during postnatal development. PMID- 6490521 TI - Elastic and related fibres in the normal cornea and limbus of the domestic cat. AB - The presence of elastic and related fibres in the corneal and limbal tissue of the domestic cat is described. Various ages of animal from birth to maturity were studied by light and electron microscopy. Oxytalan fibres were present throughout the new-born kitten cornea. They were seen in greatest concentration both at the junction of the posterior limiting lamina with the inner substantia propria and beneath the peripheral anterior epithelium. With increasing maturity, oxytalan fibres disappeared from all but the most peripheral parts of the cornea where some of the, by now, thicker oxytalan fibres had matured into elaunin. All ages of animals studied showed an abrupt increase in fibre thickness and numbers at the corneal limbus. Oxytalan fibres predominated in the newborn kitten limbus but material from adult animals showed an increased proportion of elaunin fibres. Occasional elastic fibres were also seen in the more superficial region of the adult limbus. An overall decrease in elastic fibre types with increasing maturity was most obvious in the middle limbal layers. PMID- 6490522 TI - Observations on the relationship between nerve supply and hair positioning in the rat vibrissa follicle. AB - The present study has demonstrated an anatomical relationship between the position of the growing and non-growing hairs of the rat vibrissa follicle and the point where the follicular nerve supply penetrates the follicle capsule circumference. This finding may be significant in relation to the sensory function of the follicle, as physiological data have shown that the degree of stimulation of brain cells following mechanical displacement of the whisker is direction dependent. The observed relationship between the nerve entry point and the hairs, therefore, may reflect an uneven distribution of nerve endings around the upper follicle circumference. In relation to hair growth, the above observation requires that the non-growing club hair must consistently move up one side of the follicle at the end of each growth cycle. A possible clue as to the mechanism by which club hair movement is directed can be derived from observation of asymmetry, both at the base of the club hair, and in the epidermal matrix near the end of the growth cycle. PMID- 6490523 TI - The respiratory epithelium of the lung in the green turtle (Chelonia mydas L.). AB - The chelonian lung exhibits reptilian, mammalian and avian features. The respiratory epithelium is typically vertebrate, i.e. pseudostratified columnar with cilia; gaseous exchange areas appear at all levels from the respiratory bronchi down to the alveoli. The latter are invested with a capillary network and both type I and type II cells are present. The possible functional significance of the distribution of collagen, elastic tissue, cartilage and smooth muscle is discussed. PMID- 6490524 TI - Thalidomide deformities and their nerve supply. AB - The aim of this study was to test the hypothesis that thalidomide acts upon the embryonic peripheral nervous system rather than upon mesenchyme. Pregnant rabbits were given oral thalidomide (150 mg/kg/day) on Days 7-11 of gestation. Fetuses were removed at laparotomy, under anaesthesia, on Day 29 of gestation. Seven fetuses with partial or total absence of the tibia, five treated fetuses without deformities, and four untreated controls were photographed, radiographed, killed and fixed for histological examination. Sciatic nerves were dissected and transverse sections were taken from an identical site. Total fascicular area, myelinated fibre number, fibre density and diameter distribution were obtained. There was a significant reduction in total fascicular area, and in the number of large diameter fibres in all treated animals. There was a significant depletion of total fibre numbers in deformed fetuses compared with controls. These findings are similar to the quantitative changes described in human adult subjects with thalidomide polyneuropathy, and are consistent with primary axonal degeneration in both instances. It is concluded that thalidomide acts upon embryonic nerves rather than on mesenchyme, and that dysmelic deformities of the limbs are secondary to toxic embryonic neuropathy. It is suggested that skeletal defects result when irreversible damage to the nerves reduces the transverse fascicular area below a critical minimum threshold. PMID- 6490525 TI - Regeneration of the perineurium across a surgically induced gap in a nerve encased in a plastic tube. AB - Sciatic nerves of mice were cut and the early regenerative stages were studied after the stumps had been encased within plastic tubes and kept separate by a gap of 5 mm. Only isolated cells were seen inside the tube after 7 days; after 12 days active regeneration and myelination were seen proximally; more distally, cells with long processes formed large spaces filled with collagen and less numerous Schwann cells. Zonulae occludentes and segments of basal lamina became more evident at a later stage. One month after the operation an almost complete regeneration of the nerve had taken place and perineurial cells were lined by a continuous basal lamina. The regeneration of the perineurium seemed to take place from fibroblasts; their cytoplasm as well as that of Schwann cells contained fibrillary material at this stage, sometimes in relation to segments of basal lamina. The results of this study indicate that both types of cells take part in the formation of endoneurial structures and that the early arrangement of fibroblasts contributes to the orderly longitudinal alignment of collagen fibrils. PMID- 6490526 TI - Morphometric studies of the epidermal-dermal junction in the rat ear: some effects of experimental friction on epidermis and anchoring fibrils. AB - The aim of this investigation was to determine whether, following the application of experimental friction to the skin, qualitative an quantitative differences could be induced in the epidermis and in anchoring fibrils. The skin of rat ears was subjected to repeated mild fractional stimulation with a rotating bristle brush moistened with saline thrice weekly for three weeks, untreated ears being used as controls. A stratified random sampling design was followed for the morphometric analysis of interfollicular epidermis. With the light microscope, the lengths of the granular cell/keratin (BGK) and epithelial-connective tissue (BEC) junctions were measured using an image analyser, as was the epithelial thickness (T). The ratio BEC/BGK provides an index of the degree of irregularity of the epithelial-connective tissue junction. Using electron microscopy, the numbers of anchoring fibrils per unit length of lamina densa (NB) were determined using stereological intersection counting. There are no significant differences in BEC/BGK or T between control and experimental groups, but anchoring fibril frequency NB increased from 10.29 micrometers in control epidermis to 18.9 micrometers in friction-treated epidermis. It is concluded that a mild frictional stimulus which fails to produce significant alterations in epidermal thickness can produce a marked increase in anchoring fibril frequency. This response may reflect a functional alteration associated with increased mechanical loading, in which epidermal-dermal adherence is augmented by either synthesis of anchoring fibrils or their insertion into the lamina densa. PMID- 6490527 TI - The nerves of the accessory pancreatic ducts of the common starling (Sturnus vulgaris): an ultrastructural and light microscopic study. AB - An ultrastructural and light microscopic study was undertaken to examine the nerves of the accessory pancreatic ducts of the starling (Sturnus vulgaris), previously noted (Vinnicombe, 1982) to have a particularly dense innervation. Large numbers of nerves were found in the ducts, predominantly in the lamina propria, and all contained exclusively unmyelinated axons. Probable neuron cell bodies were observed in the smooth muscle layer, but not in the lamina propria. Schwann cells invested all the axons, and these displayed terminal swellings in a 'synapse en passage' arrangement. The nerves of the lamina propria were most numerous in the region immediately beneath the epithelium and were present in the epithelial folds. One axon was observed to have penetrated the epithelial basal lamina and to lie between two epithelial cells. Examination of the terminal profiles and their contained synaptic vesicles showed the innervation to have probable pain afferent, cholinergic, adrenergic and perhaps peptidergic components. The results of this study were compared with reports on pancreatic duct innervation in other species, mostly as parts of wider studies on pancreatic innervation. PMID- 6490528 TI - An ultrastructural study of the effects of right cervical sympathectomy on the sinuatrial and atrioventricular nodes in the heart of the monkey (Macaca fascicularis). AB - This study describes the ultrastructural changes in the sinuatrial and atrioventricular nodes of the heart of the monkey (Macaca fascicularis) after right cervical sympathectomy. Obvious changes in the nodal cells were seen one day after operation. Numerous glycogen particles grouped together to form electron-dense patches containing vacuoles in the cytoplasm. At three days after operation, intracellular organelles exhibited fragmentation and dissolution. By five and seven days after operation, the affected cells were vacuolated and some were swollen and appeared to have degenerated. Simultaneously, there was massive infiltration of macrophages were present nodal tissues. Axon profiles and terminals showing various degrees of degeneration were present in the vicinity of the nodal cells throughout the period of study. It is concluded that right cervical sympathectomy resulted in a rapid degeneration in some of the cells in the sinuatrial and atrioventricular nodes. PMID- 6490529 TI - Studies on the poll glands of the one-humped camel in relation to reproductive activity. II. Ultrastructural observations. AB - An alveolus of an active poll gland is lined with cells in various stages of secretory activity. The cells are generally tall and characterised by the presence of a spherical nucleus, a massive Golgi complex, numerous mitochondria, granular endoplasmic reticulum, many ribosomes and secretory granules; these are features which constitute evidence of high metabolic and secretory activities. An alveolus of a resting gland, on the other hand, is lined with low inactive cells possessing an infolded nucleus, an inconspicuous Golgi complex and a few other organelles; secretory granules are virtually absent. The alveolar cells undergo a cyclic merocrine secretory activity yielding a proteinaceous product. It is suggested also that the gland may be a steroid-dependent organ accumulating or possibly synthesising steroids and releasing them through a mechanism as yet unknown. PMID- 6490530 TI - Nerve degeneration study of the source of afferent axonal endings in the carotid baroreceptor zone of the domestic fowl. AB - Axonal elements of the carotid baroreceptor zone of nine domestic fowls were examined with the electron microscope after either distal vagal ganglionectomy or midcervical vagotomy. The bare baroreceptor endings and the central axon of the encapsulated baroreceptor endings degenerated within 5 to 15 days after ganglionectomy. This was interpreted as Wallerian degeneration and indicated that these two types of baroreceptor endings are derived from the vagus nerve. Similar degenerative changes were not seen after midcervical vagotomy, thus indicating that both types of endings are derived from nerve cell bodies located peripheral to the midcervical site of vagotomy, i.e. in the distal vagal ganglion. The accessory axon of the encapsulated endings and the presumptive aminergic/peptidergic endings of the baroreceptor zone were affected neither by distal vagal ganglionectomy nor by midcervical vagotomy, and therefore were considered not to be derived from the vagus nerve. PMID- 6490531 TI - Intramural granular cells in the arteries of the carotid body region of the domestic fowl. AB - The major blood vessels of the carotid body region of the domestic fowl were examined with both the light and electron microscope. With the light microscope, argyrophilic cells were found in the wall of the common carotid artery, carotid body artery, oesophagotracheobronchial artery, and the common trunk for the latter two arteries. With the electron microscope, cells containing granular vesicles were found in all the above mentioned arteries. In the wall of the common carotid artery two types of granular cell were found, one with small granular vesicles (60-140 nm) and the other with large granular vesicles (100-300 nm). Capillaries were not present amongst these cells, apposed axonal endings were infrequently seen, and there were no synapses. It is concluded that these cells do not have a chemoreceptor function but may secrete amines or peptides with a local action. Since the cells are located in the baroreceptor zone of the common carotid artery their secretions may modulate baroreceptor activity. In the other three arterial sites and on the distal vagal ganglion there were groups of granular cells characterised by small (60-140 nm) granular vesicles. These granular cells, together with their associated fenestrated capillaries, apposed axonal endings with synapses, and cells resembling carotid body Type II cells were interpreted as aberrant carotid body tissue, presumably with a chemoreceptor function. PMID- 6490532 TI - The effects of mesencephalic neural crest cell extirpation on the development of chicken embryos. AB - The mesencephalic neural crest cells of Hamburger-Hamilton Stage 9-Stage 11 chick embryos were surgically extirpated unilaterally in 148 embryos and bilaterally in 8 embryos. Sham operations were performed unilaterally on 16 control embryos and bilaterally on one control embryo. Embryos were fixed at various time intervals after operation, studied macroscopically, and by light and scanning electron microscopy, and their development compared with that of 47 normal embryos. The extirpated mesencephalic region was repopulated by crest cells within 6-8 hours after operation. These 'new' crest cells migrated from adjacent neuraxial levels (principally the metencephalon and prosencephalon) along the basement membrane of the neural tube and the regenerating ectoderm. At prosencephalic and metencephalic levels, both intrinsic hyperplasia of migrating cells and prolonged migration of crest cells from the dorsomedian part of the neural tube contributed the additional cells required to repopulate the mesencephalic region. Morphogenesis and differentiation of all crest cell derivatives were normal and craniofacial malformations were absent. Thus the neural crest and neural tube can compensate for an extensive regional loss, premigratory crest cells are neither regionally patterned nor determined (as prosencephalic and metencephalic cells give rise to normal mesencephalic derivatives) and regional failure of crest cell formation is an unlikely facial pathogenetic mechanism. Previous workers who observed facial malformations following crest cell extirpations performed the latter by removing the lips of the neural tube which not only removed the crest cells but also the compensatory mechanism. Cervical scoliosis was observed in extirpated embryos but not in controls. The pathogenesis of this scoliosis may be related to the process of compensation, which could disturb the sequential differentiation of the neural tube and so disorganise the mechanisms of normal axial flexion. These observations may be relevant to the pathogenesis of some forms of congenital and infantile idiopathic scoliosis; such scoliosis in man is frequently present in neurofibromatosis--a neural crest lesion. PMID- 6490533 TI - Sex differences in adrenocortical structure and function. XVI. Stereological and karyometric studies on the cortex of the suprarenal gland of intact adult male and female Mongolian gerbils (Meriones unguiculatus). AB - The histological structure of intact adult male and female Mongolian gerbil (Meriones unguiculatus) suprarenal cortex has been described, and quantitative stereological and karyometric studies were performed. The weight of the gland relative to body weight was higher in female than in male gerbils, but the volume of the gland was similar in both sexes. The relative volume of the zona reticularis was higher in the female, while no sex difference was observed in the absolute volume of all suprarenal components (expressed in mm3). In all cortical zones, average cell volume was higher in the female; the nuclear volume of the zona glomerulosa and zona reticularis were also higher in the female. In the zona fasciculata, some large cells with large nuclei (greater than 210 micrometers 3) were observed. These are probably polyploid cells and have not been described in other species. The suprarenal cortex of the male gerbil contained more parenchymal cells than that of the female, the difference being dependent upon variation in the number of cells in the zona fasciculata and zona reticularis. Despite these structural differences, gland homogenates from male and female animals secreted similar amounts of cortisol and the plasma levels in the two sexes were the same. PMID- 6490534 TI - Morphological and histometric study of human spermatogonia from birth to the onset of puberty. AB - Normal human testes obtained at autopsy from 99 male subjects whose ages ranged from a few days after birth to 13 years of age were studied by light and electron microscopy. Besides fetal and transitional spermatogonia, types Ap, Ad, and B spermatogonia, similar to those of the adult testis, are found. The number of spermatogonia per 10 cross sectioned tubules decreases slightly from birth (15.3 +/- 1.2) to 3 years of age (12.1 +/- 1.0), and increases afterwards until 8 years of age (28.2 +/- 2.6). After a brief decrease between the ages of 8 and 9, it increases markedly until 12-13 years of age (49.7 +/- 4.6). The number of fetal and transitional spermatogonia per 10 cross sectioned tubules is 5.3 +/- 0.5 at birth, and progressively decreases until they disappear at 6 years of age. The numbers of types Ap and Ad spermatogonia per 10 cross sectioned tubules are similar to one another from birth (about 5.2) to 12-13 years of age (about 21.5), except during the period between 4 and 10 years of age, when the number of type Ad spermatogonia slightly decreases with respect to that of type Ap. This period coincides with the appearance of type B spermatogonia, of which the number per 10 cross sectioned tubules progressively increases from 4 (0.2 +/- 0.02) to 12-13 years of age (6.7 +/- 0.5). All spermatogonial types are found either resting on the basal lamina or lying toward the lumen. Some of the basal spermatogonia, but mainly those occupying a more adluminal position, appear hypertrophic, bi- or trinucleated, or degenerated. These anomalous spermatogonia are more abundant at 3 and 8 years of age, prior to periods of spermatogonial proliferation. At these times spermatocytes and occasional spermatids are seen in some seminiferous tubules of some children. PMID- 6490535 TI - The structure and distribution of nasal glands in four marsupial species. AB - The structure and distribution of nasal glands in four marsupial species were studied by light and electron microscopy. The species studied were the honey possum (Tarsipes rostratus), the bandicoot (Isoodon macrourus), the koala (Phascolarctos cinereus) and the agile wallaby (Macropus agilis). Glands were grouped and described according to their location. Those of general distribution (goblet cells and olfactory glands) were similar in structures and distribution in all specimens. Glands of the lateral nasal wall include the lateral nasal, maxillary sinus and turbinate glands. The lateral nasal and maxillary sinus glands were absent in the adult koala but occupied large areas in the other species. Turbinate glands were best developed rostrally and ventrally in the nasal cavity. On the nasal septum, Tarsipes and Isoodon had well developed glands associated with vascular 'swell bodies'. These were poorly developed to Macropus though septal glands were abundant. 'Swell bodies' were absent in Phascolarctos and glands were sparse. Tubular vomeronasal glands were present in all species and most extensive in Tarsipes. In Isoodon, there was a posterior ventral septal gland associated with the septal olfactory organ. The fine structural features of secretory cells and ducts are described and their potential role discussed in terms of chemoreception and temperature and humidity control. PMID- 6490537 TI - Grooves on the occipital lobe of Indian brains. AB - The existence of a groove on the occipital lobe formed by the dural venous sinus or ridge has only rarely been described in the past. As observed in this study such grooves are either unilateral or bilateral and their incidence is very high in Indian brains. PMID- 6490536 TI - A correlative ultrastructural and histochemical study on the submandibular gland of the hare, Lepus europaeus. AB - A morphological and histochemical study was carried out on the submandibular gland of the hare (Lepus europaeus). The results indicated that it is a characteristic tubulo-acinar gland formed by terminal tracts, preterminal tracts and excretory ducts of various calibre. The striated ducts are formed by dark and pale cells with the pale cells predominating. The results of histochemical staining show that the preterminal tracts did not react to any of the methods used, while the terminal tracts reacted intensely to high or low iron diamine thiocarbohydrazide-silver proteinate and tannic acid-uranyl acetate, indicating the presence of sulphated, acidic and neutral glycoconjugates. In particular in the terminal tracts the different structural appearance of the electron-lucent granules corresponded to different reactivity. The morphological and histochemical data were compared to those of the rabbit submandibular gland and the functional significance of the cells in the terminal and preterminal tracts was discussed. PMID- 6490538 TI - Horseradish peroxidase injection of physiologically characterized afferent and efferent neurones in the guinea pig spiral ganglion. AB - Single afferent and efferent neurones in the guinea pig spiral ganglion were injected with horseradish peroxidase. They could be recovered in subsequent histological processing and traced from the injection site in the ganglion to their final termination in the organ of Corti. All responsive primary afferents innervated the inner hair cells (58 neurones). One outer spiral fibre innervating the outer hair cells was recovered. This cell was non-spiking and unresponsive to acoustic stimulation. Neurones having properties previously attributed to cochlear efferents, terminated on the outer hair cells in regions of the cochlea consistent with their characteristic frequencies. PMID- 6490539 TI - Growth of a fish ear: 1. Quantitative analysis of hair cell and ganglion cell proliferation. AB - Proliferation (or addition) of inner ear sensory hair cells continues for a long time postembryonically in cartilaginous and bony fishes, and in amphibians. In contrast, proliferation only occurs during embryonic development in birds and mammals. However, detailed quantitative data on hair cell addition are not available for bony fishes. In order to quantify the extent of proliferation, we determined the number of sensory hair cells on the saccular sensory epithelium in specimens of the cichlid fish Astronotus ocellatus (the oscar) ranging from 2.0 to 19.0 cm in standard length (0.9-343 g). Ganglion cells were counted using serial sections of the saccular branch of the eighth nerve in animals of the same size range. The saccular macula of a 2.0 cm long (0.9 g) Astronotus contains approximately 5500 sensory hair cells; fish from 16 to 19 cm long have over 170 000 hair cells. The increase in number of sensory cells and the increase in both length and weight of the animals studied were statistically correlated (r2 = 0.8). The relative densities of saccular sensory cells in different epithelial regions remained constant in animals from 2.0 to 17 cm; in larger animals the cell density decreased somewhat. Based upon very conservative estimates of the rate of growth of Astronotus, we calculate that an average of 167 hair cells/day are added during the time when the cell population of the saccule increases. Ganglion cell number also increased approximately 4.8 times in the range of fish studied. The smallest animals in our study had about 150 ganglion cells per saccular epithelium, while the largest fish had over 600 ganglion cells. We estimate that the average ratio of hair cells to afferent fibers increases from about 30:1 in the smallest fish to over 300:1 in the largest animals. PMID- 6490540 TI - Permeability to sodium ions of the endolymph-perilymph barrier. AB - The endocochlear potential and Na+ activity in the endolymph were simultaneously measured with a double-barreled Na+ selective liquid membrane electrode. The modified Na+ conductance and permeability coefficient of the endolymph-perilymph barrier were calculated from the rate of change in the endolymph Na+ concentration relative to the Na+ electrochemical gradient across the barrier during permanent anoxia. In normal guinea pigs the Na+ conductance of the endolymph-perilymph barrier is approximately 5 times less than its K+ conductance. Exposure to noise or treatment with kanamycin suppresses the cochlear microphonics but does not result in significant alterations in the Na+ permeability of the endolymph-perilymph barrier. It is likely that the Na+ permeability of the endolymph-perilymph barrier is not involved in the physiological processes which lead to the cochlear damage produced by noise or kanamycin. PMID- 6490541 TI - Theoretical and experimental analysis of a central optimal processor for pitch of multicomponent inharmonic tones. AB - This paper describes some experiments on the pitch produced by multicomponent tones. Stimuli used were the sum of a pure tone at frequency f = 1 kHz and of the first six successive subharmonics at frequencies psi i = f/i (i = 2, 3, 4, 5, 6, 7) or, in separate experiments, the sum of six (i = 2, 3, 4, 5, 6, 7), five (i = 3, 4, 5, 6, 7) or four (i = 4, 5, 6, 7) subharmonics, respectively. Pitch data produced by these stimuli have been compared with the predictions of the optimum processor theory developed by Goldstein and coworkers (Goldstein, J.L. (1973): J. Acoust. Soc. Am. 54, 1496-1516; Goldstein, J.L. et al. (1978): J. Acoust. Soc. Am. 63, 486-497; Gerson, A. and Goldstein, J.L. (1978): J. Acoust. Soc. Am. 63, 498-510). Model predictions are shown to deviate significantly from the experimental results. By assuming the existence of an additional transformation to be included into the original mathematical model, without any other modification, predictions are in complete agreement with pitch data. PMID- 6490542 TI - Relationship of gross cochlear potentials to hair cell pathology in the waltzing guinea pig. AB - Electrophysiological recordings were made from the hearing organs of young waltzing guinea pigs of different ages. Age-related morphological changes in the cochleas of the same animals were studied with scanning and transmission electron microscopy. Results were compared with the results of studying the cochleas of normal guinea pigs of the same age. Waltzing guinea pigs are born with a hearing loss, as can be concluded from the magnitude of the whole-nerve action potential and their lower than normal summating potentials. However, their cochlear microphonics are nearly normal until the time in the degeneration process when hair cells start to disappear. This degeneration process begins at the tops of the hair cells and is evident upon electron microscopical examination of these structures. PMID- 6490544 TI - Detection of interaural time differences for clicks and tone pips: effects of interaural signal disparity. AB - The ability to detect small interaural time differences (delta t) was determined in 4 subjects using clicks or long tone pips of various interaural signal disparities which are expressed as the extent of interaural spectral overlaps. The interaural signal disparity was varied by changing (a) the interaural pulse duration difference (delta d) for clicks, or (b) the interaural carrier frequency difference (delta f) for tone pips. In either case, the sensitivity to delta t was maximal under diotic presentations and declined with delta d or delta f. The overall sensitivity to delta t was remarkably higher for clicks than for long tone pips. The results indicate that both (a) the extent of binaural spectral overlaps and (b) the structure of acoustic stimuli are important in detecting small interaural time differences of binaural sounds. PMID- 6490543 TI - The potentiation of ototoxicity when aminooxyacetic acid and kanamycin are co administered. AB - Aminooxyacetic acid (AOAA) has been shown to confer protection against noise induced cochlear trauma [3]. We, therefore, decided to study the possible protective effect of AOAA against kanamycin (KM) ototoxicity and found, instead, that AOAA potentiated the toxicity. To produce ototoxicity in guinea pigs, KM is usually given in 10-14 daily doses of 400 mg/kg s.c. However, when combined with a single dose of AOAA (8, 11, 15, or 25 mg/kg) a single 400 mg/kg dose of KM is sufficient to cause cochlear damage. Such animals show a negative Preyer's reflex between 1 to 3 days post injection. 21 days later hearing thresholds as detected electrocochleographically at 2, 4, 8, 12 and 16 kHz have changed drastically sometimes to the point of being undetectable. The damage seen histologically at this time is destruction of both inner and outer hair cells. A pharmacokinetic analysis of this potentiation revealed a slight prolongation of KM's sojourn in the inner ear. The possible mechanisms of this unexpected, marked potentiation are discussed but remain unknown. PMID- 6490545 TI - The central auditory pathway of the gerbil Psammomys obesus: a deoxyglucose study. AB - The tonotopic organization of the central auditory pathway of the gerbil Psammomys obesus was mapped with deoxyglucose autoradiography under anesthesia. Animals, injected with tritiated deoxyglucose, were stimulated with 0.8, 2.5 and 17.0 kHz tone bursts monaurally in the free field and compared with non stimulated controls. Apart from the medial geniculate body, all auditory structures showed sound-specific uptake of tracer. Frequency selective tracer accumulation could not be discriminated in the auditory cortex, the nuclei of the lateral lemniscus or the superior olivary complex. Isofrequency laminae could be determined most precisely in the dorsal cochlear nucleus and the central nucleus of the inferior colliculus. About half the mass of each of these nuclei is devoted to the processing of sound below 2.5 kHz. This disproportionately large representation of low frequencies matches the very high sensitivity of the peripheral auditory system in that range. PMID- 6490546 TI - Computerized reconstruction of the regional blood flow in the rodent cochlea. AB - The regional blood flow in the cochlea has been studied by mapping the distribution of microspheres in 22 micron thick serial sections of plastic embedded rat and rabbit cochleas. Using a computer-assisted reconstruction technique, a graphic display of the microspheres in each cochlea is obtained. From this display, microspheres may be counted and their distribution may be observed both in relation to the different vascular areas and with respect to the length of the cochlea. This technique, coupled with quantitation of the microspheres in a reference blood sample, offers a method for calculating total and regional cochlear blood flow using non-radioactive microspheres. In addition, this technique allows analysis of blood flow patterns with respect to the different capillary beds along the length of the cochlea. Thus it may be possible to determine if regional blood flow displays a longitudinal gradient, as do other functional, morphologic and biochemical characteristics of the cochlea. PMID- 6490547 TI - Shipping suppresses lymphocyte blastogenic responses in Angus and Brahman X Angus feeder calves. AB - An experiment using 40 Angus or Brahman X Angus preconditioned feeder calves was conducted to evaluate the influence of shipping on cellular immune reactivity. Steers were allotted on the basis of weight and breed to a control or shipped group. Shipped steers were trucked 700 km to a feedlot; control steers remained at the ranch of origin. Total and differential leukocyte counts, phytohemagglutinin skin-test responses, lymphocyte blastogenic responses, monocyte phagocytic function, packed cell volumes and concentrations of plasma cortisol were determined before, immediately after and 1 wk after shipment. At unloading, total leukocytes were increased (P less than .05) in shipped Angus steers. Shipped steers also had higher (P less than .01) numbers of neutrophils. Skin-test responses to phytohemagglutinin were higher (P less than .05) in Angus than in Brahman X Angus steers, but shipping did not influence the reaction. Lymphocyte blastogenic responses were lower (P less than .05) in shipped steers; however, cortisol levels in plasma were not elevated (P greater than .10) in shipped calves. Monocyte phagocytosis and packed cell volume were not influenced by shipping. These data suggest that shipped steers have suppressed lymphocyte blastogenic responses. PMID- 6490548 TI - Breed and swine lymphocyte antigen haplotype differences in agglutination titers following vaccination with B. bronchiseptica. AB - Genetic differences in immune response to B. bronchiseptica after vaccination with a commercial B. bronchiseptica bacterin were investigated in 1,069 8-wk-old pigs. These pigs were from 65 litters born in the spring and 66 litters born in the fall of 1982 and were purebreds from the Chester White (n = 128), Duroc (n = 281), Hampshire (n = 143), Landrace (n = 309) and Yorkshire (n = 208) breeds. Each litter was raised separately. Individual pigs were vaccinated im at 4 and 6 wk of age with 2 ml of B. bronchiseptica bacterin. At 8 wk of age, 8 ml of blood were collected from each animal and serum prepared to determine agglutinating antibody titers against B. bronchiseptica bacterin by a bacterial agglutination method. In addition, lymphocytes were separated from 1 ml of heparinized blood and used to determine Swine Lymphocyte Antigen (SLA) haplotypes by using cytotoxic antibodies against the SLA complex. Antisera for 3 SLA haplotypes were made available by the National Institutes of Health. Results indicated that breed of pig (P less than .01) and dam of pig (P less than .01) affected the immune response of the pig after B. bronchiseptica vaccination. Higher immune response was also associated (P less than .05) with one of the SLA haplotypes tested. Heritability estimates for immune response following vaccination were .10 +/- .12 (half-sib) and .42 +/- .19 (full-sib). Results suggest that the relationship of the SLA complex to immune response in the pig and nonadditive genetic and maternal effects on immune response should be further investigated. PMID- 6490549 TI - Development of methods to measure activity of polysomes and cytoplasmic enzymes from bovine skeletal muscle in in vitro protein-synthesis assays. AB - A cell-free, protein-synthesis system containing components from bovine skeletal muscle was developed as prerequisite to attempts to learn whether polysomes or cytoplasmic enzymes limit rate of muscle protein synthesis in the current population of domestic animals. Amino acid incorporation into trichloroacetic acid-precipitable protein was optimal at pH 7.5 and, if Tris buffer was used, at K+ and Mg2+ concentrations of 40 mM and 4 mM, respectively. Optimal concentrations of compounds that provide energy for amino acid incorporation were 1 mM ATP, .2 mM GTP, 20 micrograms creatine phosphokinase/ml and 20 mM creatine phosphate; .03 mM of each of the 20 amino acids was required for assays lasting up to 60 min. Neither rate of tRNA acylation nor availability of aminoacyl-tRNA was rate-limiting in the cell-free system established; hence, the cytoplasmic enzyme fraction from bovine skeletal muscle contains ample tRNA and has aminoacyl tRNA synthases that are sufficiently active to form aminoacyl-tRNA faster than these compounds are used to form polypeptides in the cell-free system developed. Reinitiation of ribosomes onto new mRNA occurred very slowly, if at all, in the protein-synthesis system developed. Cytoplasmic enzymes were rate-limiting whenever cytoplasmic enzyme protein to polysomal protein ratios were 3.2:1 or lower in the cell-free system. Polysomes were rate-limiting whenever cytoplasmic enzyme protein to polysomal protein ratios were 400:1 or higher in the cell-free system. These ratios define the conditions needed to assay activity of cytoplasmic enzymes or polysomes from different animals quantitatively. PMID- 6490550 TI - Relative roles of polysomes and cytoplasmic enzymes in regulating bovine skeletal muscle protein synthesis. AB - Activities of cytoplasmic enzyme or polysomal fractions, both prepared from longissimus muscle of bovine animals differing markedly in muscle growth were measured in cell-free, protein synthesis assays. Two groups of animals were used: 1) eight animals comprising two "double-muscled" animals fed a high-energy diet, two "double-muscled" animals fed a low-energy diet, two "normal" animals fed a high-energy diet and two "normal" animals fed a low-energy diet and 2) six animals differing in age and sex and including two bull calves, 87 and 145 kg; two 18- to 24-mo-old animals, 411 and 596 kg and two cows, 594 and 681 kg. Ability of cell-free, protein-synthesis systems prepared from muscle of different animals to incorporate amino acids into TCA-precipitable protein differed significantly and was in direct correlation with phenotypic muscle growth. Mixing experiments using cytoplasmic enzymes from one set of animals with polysomes from another set showed that source of cytoplasmic enzymes had a greater effect on rate of in vitro protein synthesis than source of polysomes. Cytoplasmic enzymes and polysomes from double-muscled animals and animals fed a high-energy diet supported more rapid in vitro protein synthesis than the same components from normal animals or animals fed low-energy diets. The "double-muscling" characteristic had a greater effect on rate of in vitro protein synthesis than did high or low-energy diets. Cytoplasmic enzymes and polysomes from calves supported a greater rate of in vitro protein synthesis than the same components from 18- to 24-mo-old animals or cows. Based on these limited results in one species and with two groups of animals in that species, cytoplasmic enzymes may have a greater role in limiting rate of muscle protein synthesis in the current population of domestic animals than polysomes. Composition of the crude cytoplasmic enzyme fraction used in this study is unknown, but it likely contains elongation and termination factors in addition to aminoacyl-tRNA synthases and regulatory RNA. PMID- 6490551 TI - Effect of protein deficiency on growth and plasma zinc concentration in genetically lean and obese swine. AB - Thirty-two genetically lean and 32 genetically obese weanling (4 to 5 wk old) pigs from inter se matings of crossbreds produced by within-line matings of Duroc and Yorkshire breeds, selected for low or high backfat, were fed the following four diets for 8 wk (eight lean and eight obese pigs/diet): 10% protein -- 100 ppm Zn, 10% protein -- 200 ppm Zn, 18% protein -- 100 ppm Zn, 18% protein -- 200 ppm Zn. After 8 wk, all pigs were fed a standard 16% protein corn-soybean meal type growing diet to a slaughter weight of about 87 kg. Lean pigs were more severely affected than obese pigs by low protein diets as measured by weight gain, plasma total protein and plasma albumin. Plasma Zn concentration was reduced in lean and obese pigs fed low protein diets. Supplemental Zn failed to increase plasma Zn in protein-deficient pigs. During repletion, weight gain of lean and obese pigs previously fed the 10% protein -- 100 ppm Zn diet was less than that of pigs previously fed other diets. The lower level (100 ppm) of Zn fed during protein depletion appeared to be associated with a negative effect on repletion weight gain of lean and obese pigs. Lean and obese pigs responded similarly during the repletion phase to earlier protein restriction. We conclude that supplementary dietary Zn does not maintain plasma Zn concentration in growing pigs fed protein-deficient diets and that repletion from dietary protein restriction is not associated with compensatory growth in genetically lean pigs. PMID- 6490552 TI - Effects of level of feed intake on nitrogen, amino acid and energy digestibilities measured at the end of the small intestine and over the total digestive tract of growing pigs. AB - A replicated trial of 3 X 3 Latin square design was conducted with growing pigs (about 29 kg initially) to determine the effects of different levels of feed intake on nutrient digestibilities determined near the end of the small intestine and over the total digestive tract. Pigs were fiftted with simple T-cannula. Feeding levels were ad libitum (AL) and limit-fed (4.5 or 3% of body weight/d). A 16% sorghum-soybean diet was used. Limit-fed pigs were fed at 12-h intervals and water was limited to 2 liters/kg of diet; AL pigs received water ad libitum. Consumption by pigs fed ad libitum averaged 6% of body weight/d. Neither feeding method nor level greatly affected nutrient digestibility measured at the end of the small intestine, but values tended to decrease as feeding level decreased. Comparisons of nutrient digestibility between AL and limit-fed pigs ranged from 2.9 to .7 percentage units, with only N (P less than .10) and methionine (P less than .05) reaching significance. Differences between 4.5 and 3% were slightly larger, ranging from 4.3 to -.2 percentage units, with differences for dry matter, N, gross energy and several amino acids reaching significance (P less than .10 or P less than .05). Measured over the total tract, observed differences among feeding levels were again small, but the trend was reversed, with digestibilities increasing as feeding level decreased. The estimated percentage of ingested nutrients that disappeared in the large intestine increased as feeding level decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490553 TI - Effects of seleniferous grains and inorganic selenium on tissue and blood composition and growth performance of rats and swine. AB - Two experiments were conducted to determine the effect of varying dietary selenium (Se) levels and Se source on growing swine. In Exp. 1, seleniferous wheat and oats were used to formulate diets containing .47, 2.58, 5.60 or 8.40 micrograms/g organic Se. Dietary Se level had no effect on pig performance during the 6-wk experiment as measured by daily gain, daily feed intake or feed/gain. Blood composition and enzyme activity were not affected by dietary treatment. Selenium concentrations of blood, hair, liver, kidney, heart, spleen and diaphragm muscle were increased linearly (P less than .01) as dietary Se increased. In addition, liver weight as a percentage of body weight was increased linearly (P less than .01) as dietary Se level increased. No signs of chronic Se poisoning were observed. Dietary treatments in Exp. 2 were similar to Exp. 1 with the exception that sodium selenite was utilized as the Se source and the diets were fed for 17 wk. Inorganic Se levels of .54, 2.63, 5.69 or 8.33 micrograms/g had no effect on pig performance as measured by daily gain, daily feed intake or feed/gain. Selenium concentrations of blood, hair, liver, kidney, spleen and diaphragm muscle were significantly increased as dietary Se level increased. Liver weight as a percentage of body weight was increased at the two highest dietary Se levels. Blood glutathione peroxidase activity was significantly increased by dietary treatment, while other blood variables were not affected. No signs of chronic Se poisoning were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490554 TI - Energy utilization of weanling pigs raised under pen conditions. AB - Two comparative slaughter experiments were conducted to evaluate the energy utilization of weanling pigs raised in groups under pen conditions. In Trial 1, 64 weanling pigs were kept in groups of four and fed every 12 h. The pigs were fed either ad libitum during the two daily feedings or 80, 60 or 40% of the intake/kilogram body weight (BW) of the 100% intake group. The efficiency of dietary energy and N utilization for carcass energy and N gains increased quadratically (P less than .01) with increasing feed intake. The daily metabolizable energy (ME) requirement for maintenance (MEm) was calculated to be 115 kcal X d-1 (kg X 75)-1. Above maintenance, the ME of the diet was utilized for carcass energy gain with an efficiency of 50%. Trial 2 was conducted to examine the energy and N utilization of weanling pigs kept either individually in cages or in groups of four under pen conditions. Twelve pigs were allotted to each pen type and fed at levels of 2, 3.5 or 5% of their BW daily. Increasing the level of intake, quadratically increased (P less than .01) the efficiency of ME and digestible N (DN) utilization for carcass energy and N gains. The apparent digestibilities of energy and N decreased linearly (P less than .05) while rate of passage increased linearly (P less than .05) with increasing feed intake. When compared with the individually caged pigs, the grouped pigs showed lower apparent digestibility of energy (P less than .05) but improved efficiency (P less than .05) of ME and DN utilization for carcass energy and N gains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490555 TI - Influence of aluminum as sulfate, chloride and citrate on magnesium and calcium metabolism in sheep. AB - Three metabolism trials were conducted to determine the effects of Al as sulfate (SO4), chloride (Cl) and citrate on metabolism of Al, Mg, Ca and serum concentrations of Mg and Ca. Twelve wether lambs, equipped with rumen cannulas and blocked by breeding and weight, were allotted randomly to the following six treatments during each of three trials: 0, 1,000 and 2,000 pm Al as SO4 or Cl; or 2,000 ppm Al as citrate. Treatments were administered in 200 ml of deionized water twice daily in divided doses via rumen cannula. Lambs were fed 1,000 g/d of chopped tall fescue hay (Festuca arundinacea, Schreb. IFN 1-09-187). Aluminum, Mg and Ca in feces and urine, and Mg and Ca in blood serum were determined daily over the 10-d treatment period. Means were calculated for d 6 through d 10. By d 6, serum Mg was lowered (P less than .05) for lambs administered 2,000 ppm Al as citrate. Serum Ca was not affected by Al treatments. Neither Mg nor Ca absorption was significantly affected by Al treatment. Urinary excretion of Ca increased linearly (P less than .001) with all treatments. Absorption of Al occurred with all forms of the element and was highest for Al2(SO4)3, expressed as percentage of intake. PMID- 6490556 TI - Detection of post-pasteurization contamination of cream by impedimetric methods. AB - Impedimetric methods for evaluating post-pasteurization contamination and shelf life of cream were assessed. Over 94% of the samples tested were in agreement, using selected cut-offs of 20 h for detection time measured at 21 degrees C with creams containing inhibitors for the growth of Gram positive bacteria on standard plate count agar as growth media, and 3.2 X 10(7) cfu/g for plate counts obtained on cream which had been pre-incubated in the presence of inhibitors for the growth of Gram positive organisms, and on cream stored at 6 degrees C for 7 d. Agreement between the impedimetric method and plate count was not as good if either Brain Heart Infusion or Milk Agar was used in place of Plate Count Agar in the former technique. A poor correlation was obtained between plate count methods for enumerating post-pasteurization contamination and keeping quality with impedimetric measurements on cream alone. It was possible, with a reasonable degree of certainty, to determine if cream had suffered post-pasteurization contamination within 20 h of production. PMID- 6490557 TI - Scanning electron microscopy of dairy equipment surfaces contaminated by two milk borne micro-organisms. AB - Ethanol dehydration followed by argon replacement induced drying (ARID) was found to be a suitable method for the preparation of glass, stainless steel and rubber surfaces which had been in contact with inoculated milk and which were to be examined using scanning electron microscopy (SEM). This technique was used to examine samples of all three materials which had been subjected to both single and repeated inoculation with whole milk containing a Pseudomonas sp. or a Micrococcus sp. and incubated for various periods. Some samples were also prepared for SEM using a cryofixation technique. The Pseudomonas sp. was found to proliferate on glass and stainless steel surfaces but not on rubber. Due to the clumping tendency of the Micrococcus sp. proliferation of this organism was more difficult to assess accurately. In general there was no difference in results obtained between single and repeated inoculation. Various factors which may have aided attachment of micro-organisms to surfaces were identified viz., surface channels present in stainless steel, milk deposits and the production of extracellular material. The value of using both the cryofixation and chemical preparatory techniques for the identification of artifacts is discussed. PMID- 6490558 TI - A note on the survival of bacteria in cryoprotectant medium at temperatures above 0 degrees C. AB - Many bacteria can survive for days or weeks at temperatures of 4 degrees or 22 degrees C in medium containing 15% (v/v) glycerol as a cryoprotectant. This observation suggests that breakdown of refrigeration for a short time may not be a serious danger to survival of cultures stored frozen in such media. PMID- 6490559 TI - A note on catalase enhanced recovery of acid injured cells of gram negative bacteria and its consequences for the assessment of the lethality of L-lactic acid decontamination of raw meat surfaces. AB - Addition of catalase (150 units/ml) to a rich infusion agar used for solid medium repair of acid injured pathogenic Enterobacteriaceae increased the recovery of such populations by 1-2 log cycles entailing an equal size reduction in the true lethality of this mode of processing for safety. PMID- 6490560 TI - A note on the use of the non-central t-distribution in setting numerical microbiological specifications for foods. AB - An exact procedure is described and used to determine k values and probabilities of rejection used in the application of variables sampling plans to foods. Comparison of quantities so obtained to those calculated by Kilsby et al. (1979), who used an approximation procedure, reveals that for small samples the approximation can lead to probabilities of rejection which are larger than those obtained using the exact procedure. It is recommended that the exact procedure be used in the application of these plans. PMID- 6490562 TI - Psychrotrophic bacterial flora of raw ewes' milk, with particular reference to gram negative rods. AB - The microbial flora of 141 samples of raw ewes' milk was determined, before and after storage for 72 h at 4 degrees and 7 degrees C. Penicillin-resistant bacteria represented ca 61% of 1760 psychrotrophic isolates from refrigerated milk samples. Pseudomonas fluorescens and Pseudomonas fluorescent group-related strains predominated (ca 86%) in the Gram negative psychrotrophic microflora. Leuconostoc dextranicum was the most frequent Gram positive psychrotrophic species isolated. PMID- 6490561 TI - A note on the effect of dilution and temperature on the bactericidal activity of potassium sorbate. AB - The effect of dilution and temperature on the antibacterial properties of potassium sorbate was determined. The time taken to kill a standard inoculum of Escherichia coli was increased considerably after either dilution of the preservative or lowering of the temperature. The value for the concentration exponent, eta, was approximately 3 and that for the temperature coefficient, Q10, was 2.3. PMID- 6490563 TI - The rationale and a computer evaluation of a gamma irradiation sterilization dose determination method for medical devices using a substerilization incremental dose sterility test protocol. AB - The experimental procedure described is designed to allow calculation of the radiation sterilization dose for medical devices to any desired standard of sterility assurance. The procedure makes use of the results of a series of sterility tests on device samples exposed to doses of radiation from 0.2 to 1.8 Mrad in 0.2 Mrad increments. From the sterility test data a 10(-2) sterility level dose is determined. A formula is described that allows a value called DS Mrad to be calculated. This is an estimate of the effective radiation resistance of the heterogeneous microbial population remaining in the tail portion of the inactivation curve at the 10(-2) dose and above. DS Mrad is used as a D10 value and is applied, in conjunction with the 10(-2) sterility level dose, to an extrapolation factor to estimate a sufficient radiation sterilization dose. A computer simulation of the substerilization process has been carried out. This has allowed an extensive evaluation of the procedure, and the sterilization dose obtained from calculation to be compared with the actual dose required. Good agreement was obtained with most microbial populations examined, but examples of both overdosing and underdosing were found with microbial populations containing a proportion of organisms displaying pronounced shoulder inactivation kinetics. The method allows the radiation sterilization dose to be derived from the natural resistance of the microbial population to gamma sterilization. PMID- 6490564 TI - The modification and evaluation of some cytochemical techniques for the enumeration of metabolically active heterotrophic bacteria in the aquatic environment. AB - Variants of the tetrazolium-reduction, nalidixic acid-inhibition and fluorescein diacetate-hydrolysis techniques for enumeration of metabolically active bacteria were compared, using samples of planktonic, benthic, and epiphytic freshwater bacteria. Results obtained by these methods generally showed statistically significant differences. However, an INT reduction technique, without added substrate, and a slightly modified nalidixic acid procedure gave values which did not differ at the 5% level. The results indicated that from 10 to 40% of total bacteria in the samples examined were metabolically active. These values were up to two orders of magnitude higher than those obtained by conventional plate count techniques. PMID- 6490565 TI - A study of the relative incidence of different Pseudomonas groups on meat using a computer-assisted identification technique employing only carbon source tests. AB - A computer-assisted probabilistic identification technique employing 18 carbon source utilization tests has been developed and applied to 787 Pseudomonas strains isolated from beef, pork and lamb stored under aerobic conditions. Seven hundred and twelve (89.7%) were identified using these tests alone and a further six (0.8%) with extra tests. Taxa detected were Ps. fragi cluster 2, 390 strains (49.6% of all isolates); Ps. fragi cluster 1, 191 strains (24.9%); meat cluster 3, 87 strains (11.1%); Ps. fluorescens biotype I, 31 strains (3.9%); Ps. fluorescens biotype III, 7 strains (0.9%); and Ps. putida, 1 strain (0.1%). The relative incidence of members of the various taxa was similar on beef, pork and lamb, and was unaffected by storage temperature in the range 0 degrees-10 degrees C. Each taxon was also detected at similar rates before and after spoilage. Meat origin (abattoir) affected the frequency of detection of meat cluster 3 and Ps. fluorescens biotype I strains but did not affect the incidence of detection of either cluster of Ps. fragi. PMID- 6490566 TI - Volatile compounds associated with the aerobic growth of some Pseudomonas species on beef. AB - Five strains representing four clusters of meat spoilage pseudomonads were grown on sterile beef at 5 degrees C. After 7 days incubation sensory assessments were made and the chemical composition of the headspace gases determined by gas chromatography-mass spectrometry. There was good correlation between odour descriptions and chemical data for three of the strains. The most numerous types of product were esters and sulphur-containing compounds. Of 45 compounds identified only 1-undecene was common to all the tested strains. PMID- 6490567 TI - Anaerobic ureolytic bacteria from caecal content and soft faeces of rabbit. AB - Forty strains of ureolytic bacteria were isolated from the caecal content and soft faeces of seven rabbits by the anaerobic roll tube method and were characterized. The isolates were identified with Clostridium coccoides, Cl. innocuum, Peptostreptococcus productus, P. micros, Peptococcus magnus, Fusobacterium russii and Fusobacterium sp. Urease activity of representative strains of the various species was also determined. The study indicated that strongly-ureolytic anaerobic bacteria are present in the caecum of the rabbit. PMID- 6490568 TI - Quality of antibiotic clinical trials. PMID- 6490569 TI - Pharmacokinetics of the oral triazole antimycotic vibunazole in animals. AB - Methods of assay of the oral triazole antimycotic vibunazole (BAY n 7133) in body fluids by GLC, HPTLC and by a microbiological assay are described and compared. Bioassay data of vibunazole concentrations in mice and rats are lower than those of the chemical methods, probably due to a species-dependent difference in protein binding. The pharmacokinetics of vibunazole was studied after administration to mice, rats, rabbits, beagle dogs and rhesus monkeys. Peak concentrations of 14 to 16 mg/l were found in plasma of mice after oral administration of 25 mg/kg as an aqueous suspension. After the first oral dose the mean plasma half-life was 4.8 h. After the fifth dose, plasma levels were lower and declined with a half-life of 1.2 h which may indicate enzyme induction. Signs of enzyme induction after multiple oral doses were also seen in beagle dogs but not in rhesus monkeys. After intravenous administration to one beagle dog, vibunazole plasma half-life was 1.8 h. The absolute bioavailability of oral vibunazole in the dog was estimated to be about 70%. PMID- 6490570 TI - Renal tolerance and pharmacokinetics of vancomycin in rats. AB - The nephrotoxicity, as measured by urinary cell and enzyme excretion, of vancomycin was studied in rats. The lowest daily iv dose inducing significantly increased cell elimination was 25 mg/kg. Im administration caused less effects probably due to incomplete absorption from the im injection site, since im dosages of 100 mg/kg daily led to lower renal tissue concentrations than the same doses given iv. Nephrotoxicity of vancomycin increased when combined with tobramycin and was reduced when combined with D-glucaro-1.5-lactam, a beta glucuronidase inhibitor. Vancomycin accumulated in renal tissue during repeated administration. PMID- 6490571 TI - Comparative clinical study on the absorption of orally administered amoxycillin and bacampicillin. AB - In nine consecutive hospitalized patients treated with either ampicillin or amoxycillin, studies on the pharmacokinetics of orally administered amoxycillin and bacampicillin gave a mean absorption of 73% (+/- 15%) of the dose for amoxycillin and 65% (+/- 17%) for bacampicillin. An analysis of variance showed that the difference between the two drugs has only borderline significance (P less than 0.10). These mean values are lower than those reported in the literature for healthy volunteers, and the variation between patients is also larger. The mean absorption rates found for the two drugs did not differ from those found in healthy volunteers, amoxycillin being absorbed significantly more slowly than bacampicillin (P less than 0.02), but there were also large differences between patients. PMID- 6490572 TI - Metronidazole: pharmacokinetic observations in severely ill patients. AB - Single and multiple dose pharmacokinetics of metronidazole and its two major metabolites were studied in ten patients. Patients with hepatic insufficiency had longer average serum half-life of metronidazole (11.2 h) than individuals with normal liver and kidney function (5.9 h) or isolated moderate renal impairment (6.5 h). Patients with hepatic disorder presented larger areas under the serum concentration curve, lower serum clearances and a tendency to more rapidly rising trough values of metronidazole. In patients with renal insufficiency trough values of the hydroxy metabolite seemed to rise faster and serum half-life was prolonged. The acetic acid metabolite was detected in serum of all patients with renal dysfunction but only in half of those with normal renal function and then at lower levels. A reduced 24-h total urinary recovery of metronidazole among patients with renal disorder was explained by a decreased excretion of hydroxy metabolite. The kinetics of metronidazole itself seem not to be influenced by renal impairment while the elimination rate of metabolites is reduced. The decreased clearance of the drug in patients with hepatic dysfunction makes a dose reduction in this patient group advisable. PMID- 6490573 TI - Dissociation of maximum concentration of kanamycin in plasma and perilymph from ototoxic effect. AB - Kanamycin was administered in total daily doses of 0 (vehicle), 100, 200 or 300 mg/kg to different groups of guinea pigs for two weeks. These total daily doses were administered according to three different dosing schedules, either as a single injection given once a day, divided into two equal doses and given twice a day, or divided into four equal doses and administered four times a day. It was found that the magnitude of the ototoxicity resulting from kanamycin administration was related to the total daily dose alone and not the dosing schedule. This lack of relationship between the dosing schedule and the magnitude of the ototoxicity due to kanamycin is the reverse of that reported for the nephrotoxicity resulting from gentamicin, tobramycin and netilmicin. PMID- 6490574 TI - Effectiveness of intravenous Augmentin in the treatment of thalassaemic patients with Yersinia enterocolitica infection. AB - Four thalassaemic patients with severe Yersinia enterocolitica infection were treated effectively with Augmentin. In three patients initial treatment with ampicillin and gentamicin was not effective. Augmentin was well tolerated and no toxic effects were detected on biochemical and haematological follow-up. PMID- 6490576 TI - New laboratory and clinical aspects of antiviral compounds. PMID- 6490575 TI - Thiopronine and lung levels of erythromycin. PMID- 6490577 TI - New laboratory and clinical aspects of antiviral compounds. Introduction: a virological prescript. PMID- 6490578 TI - Prospects for the design of new antiviral molecules: a chemist's view. AB - Most antiviral agents have been discovered by chance. These discoveries and the rationalization of their mode of action in terms of their selective action in the viral replicative cycle has demonstrated that viral targets exist. It is unlikely that in the near future that rational design will result in the synthesis of new classes of antiviral agents. Progress is more likely from a combination of the continuing identification of potential targets and the design of screens to identify prototype compounds, the properties of which may then be improved by chemical synthesis of analogues. PMID- 6490579 TI - Construction of a system for the regeneration of adenosine 5'-triphosphate, which supplies energy to bioreactor. AB - An engineering model was successfully developed for an ATP regeneration system by using two enzymes, acetate kinase (AK) and adenylate kinase (AdK), both obtained from the thermophile Bacillus stearothermophilus. This model is composed of five units: a substrate unit consisting of substrate solutions--AMP, ATP, and acetyl phosphate (AcOP)--an enzymatic reactor unit consisting of AK and AdK immobilized to Sepharose 4B, an auto sampler unit, an analytical unit made up of high performance liquid chromatography, and a control unit made up of a microcomputer. Operation of the four units could be systematically controlled by the microcomputer. Fundamental, operational conditions were examined using this engineering model. The conversion of AMP to ATP concentration and space velocity (SV). The minimum amount of ATP, which is required to obtain the 100% conversion of AMP to ATP, was determined to be about 4% of AMP concentration. The conversion of AMP to ATP was controlled effectively by changing the SV value. Based on the above experimental data, the continuous operation of an ATP regeneration system was tested at pH 7.5 and 30 degrees C under the conditions of 1.59 mM AMP, 0.084 mM ATP, and 5.0 mM AcOP. It was found that the conversion of AMP to ATP was more than 99% over a period of 6 days without changing SV. PMID- 6490580 TI - Generation of monoclonal antibodies to human chorionic gonadotropin by a facile cloning procedure. AB - A facile hybridoma procedure has been used to generate monoclonal antibodies to alpha- and beta-subunits of human chorionic gonadotropin (HCG). The procedure is based on the method of Davis et al. (1982, J. Immunol. Methods 50, 161) and involves the use of a semisolid medium containing methylcellulose for the initial cloning of hybrid cells following immunization and cell fusion. Seven to ten days after cell fusion, viable hybrid clones were removed for subculture in a liquid medium containing RPMI 1640 and 15% fetal calf serum. Initial screening of hybrid cell lines that secrete antibodies to HCG was performed on microplate enzyme linked immunoassay (ELISA) using HCG-coated microtiter plates. The specificity of these antibodies to either alpha- or beta-subunits was determined by the sodium dodecyl sulfate-gel/protein blot radioimmunobinding method which separates alpha- and beta-subunits of HCG on nitrocellulose strips for radioimmunobinding assay. As a result of this study, it has been possible to generate about 272 hybrid cell lines that secrete antibodies reacting with either the alpha- or beta-subunit of HCG in about 5 weeks. The association constants and cross-reactivities to luteinizing hormone for some of the HCG monoclonal antibodies were determined. The high affinity and specificity of these monoclonal antibodies permit their clinical application in a sensitive sandwich solid-phase enzyme-linked and radioimmunoassay of HCG. PMID- 6490581 TI - More useful maleimide compounds for the conjugation of Fab' to horseradish peroxidase through thiol groups in the hinge. AB - Nine different maleimide compounds were evaluated for the conjugation of Fab' to horseradish peroxidase through thiol groups in the hinge. The compounds evaluated were succinimidyl maleimidoacetate (I), succinimidyl 4-maleimidobutyrate (II), succinimidyl 6-maleimidohexanoate (III), succinimidyl 4-(N maleimidomethyl)cyclohexane-1-carboxylate (IV), succinimidyl m-maleimidobenzoate (V), succinimidyl 4-(p-maleimidophenyl)butyrate (VI), sulfosuccinimidyl 4-(N maleimidomethyl)cyclohexane-1-carboxylate (VII), sulfosuccinimidyl m maleimidobenzoate (VIII), and sulfosuccinimidyl 4-(p-maleimidophenyl)butyrate (IX). Maleimide groups of I-IV and VII were fairly stable at pH 7.0 at 30 degrees C, while those of the other compounds were significantly decomposed. I-III and VII-IX were sufficiently soluble in the reaction mixture for the introduction of maleimide groups, while the others were more or less precipitated during the reaction. II and III were the most effective in the introduction of maleimide groups and gave the highest recovery of peroxidase in the conjugate, which reached 80%. From these results, II and III were judged to be the most useful, and IV and VII were judged to be fairly useful. PMID- 6490582 TI - Effects of gamma-ray irradiation on superoxide dismutase activity and lipid peroxide level in mouse salivary glands. AB - The effect of local gamma-ray irradiation on the enzymatic activity of superoxide dismutase in salivary glands was examined. Mice received a single dose of 60Co gamma-ray irradiation in the range of 3 to 24 Gy to their neck regions. The enzymatic activity in salivary glands was decreased significantly at the 7th day and almost recovered at the 14th day after irradiation with over 6 Gy. The elevation of the lipid peroxide levels in the submandibular gland followed by the leakage of superoxide dismutase from the glands into the blood plasma was observed after irradiation, indicating radiation-induced membrane damage of salivary glands. PMID- 6490583 TI - Effect of flow rate and blood cellular elements on the efficiency of red blood cell targeting to collagen-coated surfaces. AB - The effect of bloodstream factors (flow rate and blood cellular elements) on the behavior of an experimental system simulating drug targeting to injured sites of vessel walls was studied. The system consisted of red blood cells carrying antibody to type I human collagen (drug carrier) and plastic tube with a collagen coated inner surface (target). The tube was perfused with a 0.5% (v/v) suspension of 51Cr-labeled red blood cells at different linear flow rates and the red blood cell binding to the tube was determined by gamma-counting. It was demonstrated that an increase in the linear flow rate from 0 to 2 cm/s leads at first to increase of red blood cell binding from 2 X 10(5) to 7 X 10(5) cells/cm2 and then to the decrease of binding back to 2 X 10(5) cells/cm2. In the presence of 50% (v/v) of intact red blood cells the binding continuously increases from 2 X 10(5) to 2.5 X 10(6) cells/cm2 without a subsequent drop. On the basis of the obtained results it is concluded that the behavior of the systems for drug targeting in simple in vitro models can drastically differ from the conditions present in vivo. PMID- 6490585 TI - [Palpation of multinodular breasts indicates the presence of adipose lobules in 1 case out of 2]. PMID- 6490584 TI - Conversion of cassava starch to biomass, carbohydrates, and acids by Aspergillus niger. AB - The filamentous fungus, Aspergillus niger, efficiently converted cassava polysaccharides to mycelial mass, simple sugars, and acids during the course of its growth. A typical 70-ml culture broth containing 2% cassava polysaccharides yielded 0.38 g dry mycelial mass, 1.14 mmol reducing sugars, and 1.17 meq acids at the end of 42 h. About 70% of the initial total carbohydrate in the medium was degraded during the same period. The sugars and acids in the culture broths were analyzed by HPLC on a single Aminex HPX-87 column at 55 degrees C, using 0.013 N H2SO4 as the eluting solvent. Cassava polysaccharides were degraded to oligosaccharides, maltotriose, maltose, and glucose beyond the 20-h growth periods, with maltotriose emerging as the major simple sugar. The appearance of citric, malic, gluconic, succinic, and fumaric acids accounted mostly for the decreasing pH in the growth media. Formation of carbohydrate species in the culture broths was closely related to the biosynthesis and secretion of several carbohydrases by A. niger. The extracellular carbohydrases were separated and identified by chromatofocusing and polyacrylamide gel electrophoresis to be amyloglucosidase (EC 3.1.2.3), alpha-amylase (EC 3.2.1.1), and alpha-glucosidase (EC 3.2.1.20), respectively. PMID- 6490586 TI - [Tomodensitometry of the sellar region]. PMID- 6490588 TI - Renal oncocytoma: angiographic studies in three cases. PMID- 6490587 TI - Associated superior vena cava syndrome and pericardial effusion in bronchogenic carcinoma. Report of two cases. PMID- 6490589 TI - Fibroadenolipoma (hamartoma) of the breast: a case report. PMID- 6490590 TI - Radiological diagnosis of linear ulcer of the stomach and duodenum. PMID- 6490591 TI - The role of computed tomography in the diagnosis of polycystic ovarian syndrome. PMID- 6490592 TI - Defecographic and tonometric aspects in idiopathic anorectal constipation. PMID- 6490593 TI - The pharmacotherapy-psychotherapy triangle: psychiatrist, nonmedical psychotherapist, and patient. AB - Members of the Washington State Psychiatric Association (N = 387) were sent a questionnaire asking about their experience with providing adjunctive medicinal treatment to patients in psychotherapy with someone else. Of the 202 respondents, 63% acknowledged such "therapeutic triangles." Younger psychiatrists, psychiatrists working in clinic and/or public settings, and non-psychoanalytic psychiatrists were more likely to participate in such arrangements. It is estimated that between 7200 and 21,000 U.S. psychiatrists participate in such arrangements, with 72,000-210,000 patients seen each month. More extensive study of all aspects of this phenomenon is urged. PMID- 6490594 TI - Double suicides: four modal cases. AB - Double suicides, or suicide pacts, are relatively rare and usually involve older married couples. Histories of four such couples are reviewed. The participants were similar to other (nonpact) suicides with regard to recent visits to physicians, alcohol use, and communication of intent. They differ from other suicides in that they are more likely to have a first-degree relative who died by suicide. Similar DSM-III diagnoses were found in both members of each couple, and there was a complementary quality in their personal and family histories. PMID- 6490596 TI - Neurosyphilis and late onset mental changes in the elderly. PMID- 6490595 TI - Secondary agoraphobia: two case reports. AB - Two patients with agoraphobic symptoms and major depressive disorder exhibited dexamethasone nonsuppression. Antidepressant pharmacotherapy was associated with remission of depressive symptoms and DST normalization. This improvement predated remission of agoraphobic symptoms by 1-2 months. It is suggested that agoraphobia was secondary to the depression in both cases. PMID- 6490597 TI - Propranolol therapy in a patient with panic disorder, tardive dyskinesia, and essential tremor. PMID- 6490598 TI - Purification and characterization of an aminopeptidase from bovine leukocytes. AB - An aminopeptidase was purified about 4,000-fold from the clarified homogenate of bovine leukocytes by a series of column chromatographies on DEAE-cellulose, hydroxyapatite, Sephadex G-150, and DEAE-Toyopearl. The purified enzyme had a specific activity of 3.8 mumol X min-1 X mg-1 with arginine beta-naphthylamide (Arg-2-NNap) as substrate, and a minute amount of contaminating protein was found to be present by gel electrophoresis. The molecular weight of the enzyme was estimated to be 94,000 by gel filtration on Sephadex G-150. The enzyme had a broad substrate specificity and a pH optimum between 6.5 and 7.0 for the hydrolysis of alpha-aminoacyl beta-naphthylamides. It hydrolyzed beta naphthylamides of basic, aliphatic, and aromatic amino acids, and also catalyzed the liberation of amino-terminal phenylalanine from phenylalanyl peptides. The enzyme was inhibited by bestatin, puromycin, 1,10-phenanthroline, sulfhydryl reagents, and a variety of heavy metal ions. Only the cobaltous ion stimulated the enzyme and the values of both Km and Vmax for Arg-2-NNap increased. In gross properties the present enzyme resembles porcine liver aminopeptidase reported previously (Kawata, S., et al. (1982) J. Biochem. 92, 1093-1101) very closely. PMID- 6490599 TI - Characterization of three forms of cytochrome P-450 isolated from liver microsomes of rats treated with 3-methylcholanthrene. AB - Three forms of cytochrome P-450, designated as P-450MC-I, P-450MC-II, and P-450MC III, were isolated from liver microsomes of rats treated with 3 methylcholanthrene (MC) by using a high performance liquid chromatography (HPLC) technique. The major MC-inducible forms, P-450MC-I and P-450MC-II showed a single protein band on SDS-polyacrylamide gel electrophoresis giving a minimum molecular weight of 56,000 daltons. The oxidized absolute spectra of both cytochromes P-450 were of low spin type, having a Soret absorption peak at 417 nm. The CO-reduced difference spectra of these two cytochromes P-450 showed a peak at 447 nm. In a reconstituted system, both cytochromes P-450 exhibited similar high levels of catalytic activity for benzo(a)pyrene hydroxylation and 7-ethoxycoumarin O deethylation. Anti-P-450MC-I IG and anti-P-450MC-II IG, which were produced against the corresponding cytochromes P-450, each formed a single continuous precipitin line with both P-450MC-I and P-450MC-II in Ouchterlony double diffusion tests. Amino acid sequence analysis revealed that the sequence of the NH2-terminal 18 amino acids of both enzymes was the same. Therefore, the major MC inducible forms, P-450MC-I and P-450MC-II, were highly homologous, being indistinguishable from each other in terms of apparent molecular weight, spectral properties, substrate specificity and the NH2-terminal 18 amino acid residues, but clearly separable by HPLC. The characteristics of both P-450 forms appear to correspond to those of the previously reported P-450c (1). On the other hand, a minor form, P-450MC-III was different from P-450MC-I and P-450MC-II in chromatographic properties, apparent molecular weight, substrate specificity and immunochemical properties, and did not correspond to any P-450 species previously purified from MC-treated rat liver microsomes. PMID- 6490600 TI - A 13C-NMR study on the interaction of riboflavin with egg white riboflavin binding protein. AB - The interaction between riboflavin and riboflavin binding protein (RBP) was studied by 13C-NMR spectroscopy. The 13C-NMR spectra of riboflavin selectively enriched at the 2-, 4-, 4a-, and 10a-positions and of (3-[13C]methyl)riboflavin were measured both in the free and RBP-bound forms. The 13C signals of 13C enriched riboflavin or 3-methylriboflavin bound to RBP are broader than those of the free form, reflecting the restriction of flavin mobility. The 2-, 4-, and 10a 13C signals of riboflavin show no pH-dependent shift in the neutral to acidic pH region either in the bound or free form but the 4a-13C signal of bound riboflavin shifts to lower field in the acidic pH region while that of the free form remains unshifted. The 2-, 4-, 4a-, and 10a-13C signals of free riboflavin exhibited pH dependent change in the alkaline pH region with a pK value of about 10, in association with the N(3)-H deprotonation. The pH titration profile of the 2-, 4 , and 4a-13C signals of bound riboflavin indicates that the pK of N(3)-H is shifted substantially to the alkaline side when riboflavin is bound to RBP. The 3 methyl-13C signal of 3-methylriboflavin shows no pH-dependent shift whether the compound is free or bound to RBP. The binding of riboflavin and 3 methylriboflavin was also studied spectrofluorometrically. The analysis of the pH dependence of the association constant revealed that one ionizable group in RBP with pK of about 5 and N(3)-H of riboflavin play important roles in the binding. We conclude that RBP preferentially binds the neutral, i.e., N(3)-protonated, form of riboflavin and that the neutral form in turn is stabilized by the hydrophobic environment of RBP surrounding the N(3) region of the bound riboflavin molecule. PMID- 6490601 TI - Gangliosides and neutral glycolipids in guinea pig adrenal glands. AB - Glycolipids were isolated from the adrenal glands of seven strains of guinea pig by DEAE-Sephadex and Iatrobeads column chromatographies. The average lipid-bound sialic acid content of the adrenal glands was estimated to be 96.0 +/- 30.4 nmol/g fresh tissue. The ganglioside fraction contained two major gangliosides which accounted for 82% of the total lipid-bound sialic acid. They were identified as N-acetylneuraminylgalactosylceramide (GM4) and N acetylneuraminyllactosylceramide (GM3). The neutral glycolipid fraction contained one major and three minor glycolipids. The major glycolipid was identified as galactosylceramide, which accounted for 81% of the total glycolipid. The other three glycolipids were identified as Forssman glycolipid (7%), lactosylceramide (5%), and gangliotriaosylceramide (7%). In all strains examined, the glycolipid patterns were similar. PMID- 6490602 TI - Interaction of lysozyme with dyes. II. Binding of bromophenol blue. AB - The binding of lysozyme with bromophenol blue (BPB) at various dye concentrations and pH was carried out at 25 degrees C by equilibrium dialysis, ultraviolet (UV) difference and circular dichroism (CD) spectral techniques. Binding isotherms at pH 5.0 show non-cooperative binding at low dye concentrations, which change over to cooperative binding at higher concentrations indicating biphasic nature. However, binding isotherms at pH 7.0 and 9.0 show cooperative binding only, at all concentrations of the dye. The number of available binding sites decreases with the increase of pH. Gibbs free energy change, calculated on the basis of Wyman's binding potential concept, decreases with the increase of pH. Binding isotherms at pH 5.0 obtained at a lower temperature of 8 degrees C, also indicate the biphasic nature similar to those observed at 25 degrees C, but with a slight decreased strength of binding. The UV difference spectra of the complex do not show any distinct peaks in the 285 to 297 nm region eliminating any possible interaction of BPB with tryptophan and tyrosine residues of the lysozyme molecule. The CD spectra of lysozyme-BPB complex show a decrease in ellipticities with reference to native lysozyme in the near UV and far UV regions. This indicates that the lysozyme-BPB complex has a lower helical content probably due to the conformational changes induced into the native enzyme. The appearance of new positive peaks at 315 nm in the near UV region and at 592 nm in the visible region of the CD spectra may be due to the induced asymmetry into the BPB molecule as a result of its binding to a cationic residue (probably a lysine residue) of lysozyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490603 TI - Autoradiography of ganglioside antigens separated by high-performance thin-layer chromatography with their antibodies. AB - An improved method is described for the detection of ganglioside antigens with the antibodies on thin-layer chromatograms. The method involves the following steps: Separation of gangliosides on a high-performance thin-layer chromatographic plate, application of antibody solution, and detection of bound antibody with [125I]staphylococcal protein A. Using specific antibodies against gangliosides GM4, GM1, GD3, and asialo GM1 ganglioside, the method allowed positive identification of these antigens on thin-layer plates. It also provides a convenient means of assessing the specificity of an anti-glycolipid antibody. PMID- 6490604 TI - Spectral similarities between "H-450" and cytochrome P-450. AB - The absorption spectrum of reduced H-450 was reversibly affected by a pH change; the Soret peak of the alkaline form was at 448 nm, and that of the acidic form (H 420) at 425 nm. The same spectral change of conversion of reduced H-450 to H-420 was also produced by the action of n-butanol, urea and p-chloromercuribenzoate. These spectral properties of H-450 were similar to those of the conversion of cytochrome P-450 to cytochrome P-420, suggesting the similar heme environments of these two hemoproteins. Reduced H-450 bound carbon monoxide to be transformed into a new spectral species having a Soret peak at 420 nm. PMID- 6490605 TI - Direct cross-linking of three domains in the myosin head. AB - To obtain information about domain-domain contacts in the myosin head, trypsin split myosin subfragment-1 (S-1), which mainly consists of 50K, 26K, and 20K fragments, was cross-linked directly by the photodynamic technique under mild conditions (pH 7-8.5, 0 degrees C) using riboflavin 5'-phosphate, protoporphyrin, and methylene blue as sensitizers. Exposure of trypsin split-chymotryptic S-1 to visible light in the presence of the sensitizers resulted in formation of cross linked products of (20 + 26)K, (20 + 50)K, (26 + 50)K, and (20 + 26 + 50)K fragments. The results suggest that three domains in the myosin head are in contact with each other, at least partly, raising the possibility that the communication between the ATP- and actin-binding sites passes through a "short cut," i.e., the contact region between the domains. PMID- 6490606 TI - Ca-dependent regulation of the subunit exchange of F-actin under the influence of tropomyosin and troponin. AB - A quasi-steady state rate of actin subunit incorporation into a complex of F actin, tropomyosin, and troponin was studied in a solution containing MgCl2 0.5 mM, ATP 0.2 mM, Tris-HCl 5 mM (pH 8.0), and either CaCl2 64 muM or EGTA 644 muM at 33 degrees C by adding a small amount (less than 1 muM) of fluorescence labeled actin monomer. Incorporation of the labeled actin monomer was remarkably much slower in the presence of EGTA, but the rate recovered instantaneously upon addition of an excess amount of CaCl2. The rate was very much reduced by the presence of cytochalasin D (1 muM) and again showed Ca-dependence. PMID- 6490607 TI - Amino acid sequence of the beta chain of sarcoplasmic calcium binding protein (SCP) obtained from shrimp tail muscle. AB - The amino acid sequence of the beta chain of shrimp SCP has been determined. It is composed of 192 amino acid residues and is acetylated at the N-terminus. The molecular weight was determined to be 21,960. The sequence difference with the aB chain of the same shrimp, of which the sequence was determined previously (J Biochem. (1984) 95, 1603-1615), is 19% (37 non-identical residues out of 192 residues). The shrimp SCPs have three EF-hand type Ca2+ binding sites, however, from comparison with the amino acid sequences of SCPs of scallop (Takagi et al., Biochim. Biophys. Acta in press) and of sandworm (Kobayashi et al., manuscript in preparation), it is reasonable to think that SCP originally had four Ca2+ binding sites, and in the case of shrimp SCPs, one of them (site IV) may have lost the affinity to Ca2+ on amino acid replacements during evolution. PMID- 6490608 TI - Kinetic study of beta-cyclodextrin-dye system by high-pressure temperature-jump method. AB - The pressure dependence of the formation and dissociation rate constants of the inclusion reaction between beta-cyclodextrin and phenolphthalein was investigated with a newly constructed high-pressure temperature-jump apparatus. The jump height of temperature was 2.8 degrees C within 1 microsecond under pressure up to 2,000 kg/cm2. The reaction was analyzed as a simple reversible bimolecular reaction. The activation volume was 1.78 +/- 0.85 cm3/mol for the forward reaction and 10.65 +/- 1.40 cm3/mol for the backward reaction. The values of activation volumes suggest that desolvation from the phenolphthalein molecule and release of hydrating water molecules from the beta-cyclodextrin cavity occur at the transition state. PMID- 6490609 TI - Amino acid sequence around a cysteine residue in the active center of jack bean urease. AB - Cysteine residues in the active center of jack bean urease [EC 3.5.1.5] were modified with 14C-labeled diazonium-1H-tetrazole (DHT). The labeled enzyme was carboxymethylated with iodoacetic acid, and then hydrolyzed with trypsin. The tryptic digest was subjected to gel filtration on Sephadex G-50, yielding two radioactive fractions. The [14C]DHT-labeled peptide having a lower molecular weight, which was determined to be approximately 1,000 by the method of gel filtration, was further purified to homogeneity by ion-exchange chromatography on DEAE-Sephadex A-25. [14C]DHT-labeled cysteine was identified as cysteic acid after performic acid oxidation, and the amino acid sequence of the low-molecular weight [14C]DHT-labeled peptide was determined to be Phe-Glu-Pro-Gly-Asp-Cys-Asn Ser-Thr-Phe-Lys. PMID- 6490610 TI - Kinetic studies on the cleavage of oligouridylic acids and poly U by bovine pancreatic ribonuclease A. AB - Kinetic parameters, Km and Vmax for the transesterification of oligouridylic acid, (Up)nU greater than p (n=0-4), by RNase A were measured spectrophotometrically at pH 7.0 and 25 degrees C. The kinetic parameters, pKm and log Vmax increased with increase in the chain length (n), and seemed to be almost constant with substrates having n greater than or equal to 2. The contribution of each subsite to the binding was estimated according to Hiromi's theory. The subsite affinities for (B1, R1, P1)+(B2, R2, P2) and (B3, R3, P3) are 8.03 kcal and 0.72 kcal/mol, respectively, and those for (B4, R4, P4) and (B5, R5, P5) are less than 0.5 kcal/mol. Therefore, we postulate that the size of the RNase A active site is about 3 nucleotides in length. Transesterification of poly U by RNase A was followed spectrophotometrically. The reaction is markedly influenced by ionic strength. At lower ionic strength, the v0-S curve of poly U cleavage was sigmoidal and cooperative, and it became less cooperative at higher ionic strength. Since the estimated Vmax value for poly U cleavage at ionic strength of 0.1 was more than 20 times larger than that of oligouridylic acids cleavage, we propose a non-specific interaction of poly U anion with cationic groups on the surface of the enzyme, modulating the conformation of active site, and thus increasing the activity at low ionic strength. The interaction decreases at higher ionic strength due to the interaction of counter anions with the non specific sites. PMID- 6490611 TI - Changes of intracellular free Ca2+ in macrophages following N-formyl chemotactic peptide stimulation. Direct measurement by the loading of quin 2. AB - The changes in the intracellular free Ca2+ in guinea pig peritoneal macrophages induced by N-formyl chemotactic peptides were examined using a fluorescent Ca2+ indicator, quin 2. The ATP contents of quin 2-loaded macrophages were also examined. The intracellular free Ca2+ was immediately raised about 4-fold by the addition of chemotactic peptides both in the presence and absence of extracellular Ca2+, and returned to the basal level within 6 min. A mitochondrial uncoupler had no effect on basal free Ca2+ concentration and the increase in intracellular free Ca2+ induced by chemotactic peptides. A23187 increased the intracellular free Ca2+ concentration and minimized the increase by chemotactic peptides. Chlorpromazine also gradually increased the basal level, in agreement with our previous report that this drug induced Ca2+ release from the store sites. The results indicate that the increase in the intracellular free Ca2+ induced by chemotactic peptides is due to Ca2+ release from the membraneous store site(s), other than mitochondria. Extracellular Ca2+ was raised by the addition of a chemotactic peptide, when assayed in free Ca2+-free saline using quin 2. The second addition of the chemotactic peptide, after the intracellular free Ca2+ concentration had returned to the basal level, was ineffective. Recovery of the free Ca2+ change induced by chemotactic peptide was observed only when the macrophages were freshly incubated in Ca2+-containing saline for more than 20 min at 37 degrees C. These results suggest that the Ca2+ released from the store site(s) may be effluxed through the plasma membrane. Quin 2 loaded in macrophages may interfere with mitochondrial ATP synthesis. PMID- 6490612 TI - Initiation codon mutation as a cause of alpha thalassemia. AB - Cloning and sequence analysis of the alpha-globin genes from a Sardinian patient with the nondeletion type of hemoglobin-H disease revealed a new type of thalassemia lesion. A mutation in the alpha 2-globin gene changes the initiation codon ATG to ACG and abolishes the function of this gene. Globin mRNA output from the affected alpha 2 locus is decreased relative to the alpha 1 locus. The mutation is detectable in genomic DNA by restriction analysis with the enzyme NcoI. Of the seven Sardinian patients with nondeletion alpha thalassemia screened with this enzyme, six had the initiation codon lesion. PMID- 6490613 TI - Structure of the retinal chromophore in the hR578 form of halorhodopsin. AB - Halorhodopsin is a retinal-containing pigment that is thought to function as a light-driven chloride ion pump in the cell membrane of Halobacterium halobium. To address the role of the retinal chromophore in chloride ion transport, resonance Raman spectra have been obtained of the hR578 form of chromatographically purified halorhodopsin (hR). The close similarity of the frequencies and intensities of the hR578 Raman bands with those of light-adapted bacteriorhodopsin (bR568) shows that the chromophore in hR578 has an all-trans configuration and that the protein environment around the chromophore in these two pigments is very similar. In addition, hR578 exhibits a Raman line at 1633 cm 1 which is assigned as the stretching vibration of a protonated Schiff base linkage to the protein based on its shift to 1627 cm-1 in D2O. The reduced frequency of the Schiff base stretching vibration compared with bR568 (1640 cm-1) is shown to result from a reduction of its coupling with the NH in-plane rock. This may be due to a reduction in hydrogen-bonding between the Schiff base proton and an electronegative counterion in halorhodopsin. PMID- 6490614 TI - The mechanism of the adenylosuccinate synthetase reaction as studied by positional isotope exchange. AB - In an attempt to gain insight into the mechanism of the rat muscle adenylosuccinate synthetase reaction, experiments using the technique of positional isotope exchange (isotope scrambling) were undertaken. [gamma-18O]GTP was prepared and incubated with Mg2+ and the synthetase in the presence of various ligands. Positional isotope exchange occurred, as measured by nuclear magnetic resonance spectroscopy, when IMP was present. In the absence of IMP, with or without aspartate or succinate, the [gamma-18O]GTP did not exhibit scrambling. These results suggest that the adenylosuccinate synthetase reaction involves the participation of 6-phosphoryl-IMP as an obligatory intermediate. On the basis of experiments carried out in our laboratory as well as in others, we believe the GDP remains bound to the enzyme until the product, adenylosuccinate, is formed. All products may then dissociate randomly from the enzyme. The positional isotope exchange experiments, along with initial-rate experiments carried out in our laboratory, serve to explain the lack of partial exchange reactions associated with the synthetase (Fromm, H. J. (1958) Biochim. Biophys. Acta 29, 255-262), as well as the net inversion of configuration when chiral thio GTP is converted to thiophosphate (Webb, M. R., Reed, G. H., Cooper, B. F., and Rudolph, F. B. (1984) J. Biol. Chem. 259, 3044-3046). PMID- 6490615 TI - Leukotriene A4 hydrolase in human leukocytes. Purification and properties. AB - Leukotriene A4 hydrolase, a soluble enzyme catalyzing hydrolysis of the allylic epoxide leukotriene A4 to the dihydroxy acid leukotriene B4, was purified to apparent homogeneity from human leukocytes. The enzymatic reaction obeyed Michaelis-Menten saturation kinetics with respect to varying concentrations of leukotriene A4. An apparent KM value ranging between 20 and 30 microM was deduced from Eadie-Hofstee plots. Physical properties including molecular weight (68,000 70,000), amino acid composition, and aminoterminal sequence were determined. It was indicated that leukotriene A4 hydrolase is a monomeric protein, distinct from previously described epoxide hydrolases in liver. PMID- 6490616 TI - Biochemical and genetic analysis of variant mouse hepatoma cells which overtranscribe the cytochrome P1-450 gene in response to 2,3,7,8 tetrachlorodibenzo-p-dioxin. AB - Using the fluorescence-activated cell sorter, we have isolated a population of variant mouse hepatoma cells which have a markedly increased ability to metabolize benzo(a)pyrene. Compared with wild-type (Hepa 1c1c7) cells, the variant cells exhibit increased aryl hydrocarbon hydroxylase activity and increased responsiveness of the aryl hydrocarbon hydroxylase induction mechanism to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Cell fusion experiments indicate that the variant phenotype is co-dominant with respect to wild-type. Filter hybridization analyses indicate that increased accumulation of cytochrome P1-450 specific mRNA accounts for the overproduction of aryl hydrocarbon hydroxylase activity. Measurements of RNA synthesis in isolated nuclei reveal that the variants exhibit an increased rate of transcription of the cytochrome P1-450 gene in response to TCDD. The variant cells contain no detectable alteration in their TCDD receptors, nor is the cytochrome P1-450 gene amplified in the variants. Filter hybridization analyses of restriction endonuclease-digested DNA indicate that the variant cytochrome P1-450 gene is relatively undermethylated, compared with the wild-type gene. We conclude that the variant cells contain an altered cis-acting genomic element(s) which regulates the expression of the cytochrome P1 450 gene. PMID- 6490617 TI - Studies of the induction of spermidine/spermine N1-acetyltransferase using a specific antiserum. AB - A specific antiserum to rat liver spermidine/spermine N1-acetyltransferase was used to study the induction of this protein. The antiserum had no effect on the spermidine acetylating capacity of crude nuclear extracts and very little effect on the activity present in crude cytosolic extracts from control rat tissues indicating that most of this activity is not due to spermidine/spermine N1 acetyltransferase. Treatment of rats with carbon tetrachloride, spermidine, thioacetamide, or methylglyoxal bis(guanylhydrazone) produced a substantial increase in the spermidine acetylating capacity of rat liver cytosolic extracts which was exclusively due to an increase in the immunoprecipitable spermidine/spermine N1-acetyltransferase protein. Exact measurement of the extent of this increase was not possible because the basal amount was too low to determine precisely but the amount of this enzyme increased about 250-fold with 6 h of treatment with carbon tetrachloride, about 25-fold at 6 h after spermidine, about 23-fold at 24 h after thioacetamide and up to 300-fold at 24 h after methylglyoxal bis(guanylhydrazone). Treatment of rats with spermidine also increased spermidine/spermine N1-acetyltransferase in other tissues including lung, kidney, and pancreas. The spermidine/spermine N1-acetyltransferase protein was found to turn over very rapidly with a half-life of about 15 min in thioacetamide-treated rats and 180 min after carbon tetrachloride. PMID- 6490618 TI - Extension and structural variability of the antithrombin-binding sequence in heparin. AB - Oligosaccharides with different affinities for antithrombin were isolated following partial deaminative cleavage of pig mucosal heparin with nitrous acid. The smallest high-affinity component obtained was previously identified as an octasaccharide with the predominant structure: (Formula: see text). The interaction of this octasaccharide, and of deca- and dodecasaccharides containing the same octasaccharide sequence, with antithrombin was studied by spectroscopic techniques. The near-ultraviolet difference spectra, circular dichroism spectra, and fluorescence enhancements induced by adding these oligosaccharides to antithrombin differed only slightly from the corresponding parameters measured in the presence of undegraded high-affinity heparin. Moreover, the binding constants obtained for the oligosaccharides and for high-affinity heparin were similar (1.0 2.9 X 10(7) M-1 at I = 0.3). In contrast, two hexasaccharides corresponding to units 1-6 and 3-8, respectively, of the above sequence showed about a 1000-fold lower affinity for antithrombin, and also induced considerably different spectral perturbations in antithrombin. Since the 1-6 hexasaccharide contains a reducing terminal anhydromannose residue instead of the N-sulfated glucosamine unit 6 of the intact sequence, these results strongly support our previous conclusion that the N-sulfate group at position 6 is essential to the interaction with antithrombin. The low affinity of the hexasaccharide 3-8 provides further evidence that a pentasaccharide sequence 2-6 constitutes the actual antithrombin binding region in the heparin molecule. Structural analysis of the various oligosaccharides revealed natural variants with an N-sulfate group substituted for the N-acetyl group at position 2. The preponderance of N-acetyl over N sulfate groups at this position may be rationalized in terms of the mechanism of heparin biosynthesis, assuming that the D-gluco configuration of unit 3 is an essential feature of the antithrombin-binding region. PMID- 6490619 TI - Correlation between oxysterol binding to a cytosolic binding protein and potency in the repression of hydroxymethylglutaryl coenzyme A reductase. AB - Support for the role of a cytosolic oxysterol-binding protein in the regulation of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase was obtained by correlating the relative binding affinities of a wide range of oxysterols to their potency in suppressing HMG-CoA reductase activity in mouse fibroblast cell cultures. Forty-seven oxysterols encompassing a 100-fold range of activity in both assays were tested and the two parameters were closely correlated for 35 of the sterols. Twelve sterols showed poor binding when compared to their ability to suppress HMG-CoA reductase activity in cell cultures. Among these were seven sterols with a ketone function at C-3. For this group, the discrepancy could be explained by their rapid conversion within cells to the 3 beta-hydroxy derivatives which have a much higher affinity for the binding protein. One sterol with 3-keto-4-ene grouping was not reduced to its 3 beta-hydroxy derivative in cells and thereby showed no discrepancy in the two assays. The remaining five sterols exhibiting discordant activities in the two tests contained 4,4-dimethyl moieties and were relatively weak suppressors of HMG-CoA reductase activity. Cellular metabolism of these sterols was not detected. Possible reasons for their apparent inactivity in the binding assay are discussed. PMID- 6490620 TI - Different forms of the oxysterol-binding protein. Binding kinetics and stability. AB - Based upon measurements of the sedimentation coefficient and the Stokes radii, three forms of the oxysterol-binding protein were identified. The unliganded binding protein was the largest (7.7 S, Stokes radius = 71.6 A, Mr = 236,000) was relatively asymmetric (f/f0 = 1.7), and was composed of at least three subunits. Binding of 25-hydroxycholesterol was associated with a reduction in the size of the protein (7.5 S, Stokes radius = 50 A, Mr approximately 169,000) and an increase in symmetry (f/f0 = 1.4), due to the loss of a subunit of Mr approximately 67,000. At pH 6 or lower, the Mr = 169,000 sterol-protein complex was altered so that reversible dissociation to give a smaller (4.2 S, Stokes radius = 53 A, Mr = 97,000) more asymmetric (f/f0 = 1.8) sterol-protein complex occurred when it was sedimented in a sucrose gradient buffered at pH 7.4 containing 0.3 M KCl and 2.5 M urea. Irreversible dissociation of the 7.5 S, Mr = 169,000 form to a 4.2 S form occurred spontaneously when the complex in whole cytosol buffered at pH 7.8 was allowed to stand overnight at 0 degree C, or when the partially purified complex was incubated at pH 5.5 at 0 degree C for several days. The partially purified, unliganded binding protein was unstable at 0 degree C (approximately 75% loss of binding activity in 24 h) whereas the liganded protein was stable for 7 days at 0 degree C although irreversible conversion to a 4.2 S form occurred under some conditions. Rates of sterol binding and dissociation were increased in the presence of 2.5 M urea at pH 7.4 or when the pH was lowered to 5.5 Kd values were not greatly altered under the various incubation conditions. PMID- 6490621 TI - Partial functional reconstitution of the cardiac muscarinic cholinergic receptor. AB - Digitonin-solubilized cardiac muscarinic receptors were reconstituted by dialysis into human erythrocyte acceptor membranes which lack high-affinity muscarinic receptors. The number of receptors reconstituted was proportional to the quantity of soluble receptors added to the reconstitution system. Specific [3H](-) quinuclidinyl benzilate binding to the reconstituted receptor was found to be saturable with a Kd (dissociation constant) equal to 48 +/- 4 pM and a Bmax (maximal density of binding sites) equal to 50 +/- 5 fmol/mg of protein. Competitive binding studies indicated that the reconstituted receptors showed stereoselectivity and drug specificity consistent with a high-affinity muscarinic receptor. Agonist binding to the reconstituted receptor was decreased by the addition of guanyl-5'-yl imidodiphosphate. Sixty per cent of the reconstituted receptors were found to be integral membrane proteins. The molecular weight of the reconstituted receptor as determined by sodium dodecyl sulfate-gel electrophoresis was 76,000 +/- 2,000 and was identical to the molecular weight of the muscarinic receptor in the original cardiac membranes. The data indicate that a partially functional, intact muscarinic receptor was reconstituted into human erythrocyte acceptor membranes and that membrane constituents may be required to stabilize the receptor in a high-affinity state for antagonists. PMID- 6490622 TI - Glucocorticoids stimulate elastin production in differentiated bovine ligament fibroblasts but do not induce elastin synthesis in undifferentiated cells. AB - Glucocorticoid treatment of fibroblasts from late gestation fetal bovine ligamentum nuchae resulted in a time- and dose-dependent selective increase in elastin production. Tropoelastin levels increased 2-3-fold in the presence of 10 nM dexamethasone while total protein synthesis and the rate of cell division decreased with glucocorticoid exposure. Two tropoelastin bands of molecular weights 64,500 and 61,000 were identified by immunoprecipitation and sodium dodecyl sulfate gradient-gel electrophoresis and both bands increased to an equal extent in the presence of dexamethasone. Undifferentiated cells from early gestation animals did not synthesize elastin after hormone exposure, even though glucocorticoid receptors were demonstrated by nuclear-translocation experiments. These results indicate that glucocorticoids stimulate elastin production in elastin-producing ligament cells but do not induce elastin synthesis (differentiation) in undifferentiated cells. PMID- 6490623 TI - Isolation and partial characterization of high-buoyant-density proteoglycans synthesized in ovo by embryonic chick skeletal muscle and heart. AB - Proteoglycans, a major component of the extracellular matrix, are produced in many tissues. A report from this laboratory describes the proteoglycans synthesized in culture by chick embryonic skeletal muscle myotubes. To extend this study to in vivo conditions, chick embryos were radiolabeled in ovo and the newly synthesized high-buoyant-density proteoglycans from skeletal muscle analyzed. In both leg muscle and pectoral muscle, three major high-density proteoglycans are synthesized. One is small and is similar to the proteoglycans synthesized in culture by muscle fibroblasts. The other two proteoglycans are large. The larger of these shares structural features with the proteoglycan synthesized by skeletal muscle cells in culture. It has large chondroitin sulfate chains (estimated molecular weight of 70,000) with a high proportion of chondroitin 6-sulfate (approximately 90%). The smaller of the two large proteoglycans is distinct (chondroitin sulfate of estimated molecular weight 24,000 and approximately 60% 6-sulfated disaccharides) and is not detected in muscle cultures; evidence suggests it is not made by myoblasts. Whole hearts synthesize proteoglycans with some structural similarities, and also differences, to those made in skeletal muscle. These data indicate that the proteoglycans synthesized in muscle cultures are likewise made in developing muscle in ovo but that another distinct strictly in ovo proteoglycan is also produced. PMID- 6490624 TI - Distinctions between the multiple cationic forms of rat liver glutathione S transferase. AB - Three cationic glutathione S-transferase forms isolated from rat liver were characterized as dimers that originated from different combinations of two subunit types, Ya and Yc. The cationic forms were purified using lysyl glutathione affinity matrices and were chromatographically resolved from anionic glutathione S-transferases that contain Yb subunits. The three classes of cationic transferase exhibited similar specific activities with 1-chloro-2,4 dinitrobenzene as a substrate, all forms cross-reacted with antibodies to glutathione S-transferase B, and all had comparable secondary structures and tryptophan fluorescence properties. In spite of those similarities, the Yc containing forms were clearly distinguishable from Ya forms on the basis of characteristic differences in circular dichroic patterns associated with their aromatic side chains. All cationic transferases bound bilirubin with stoichiometric ratios of 1 mol/dimeric protein molecule, but discrete differences in mode of binding were ascribed to forms containing Ya subunits as compared to Yc dimers. Binding to Yc forms was of lower affinity and may be associated with the catalytic region of the protein since glutathione effectively displaced bilirubin from the Yc component. PMID- 6490625 TI - The use of antibodies to 5-bromo-2'-deoxyuridine for the isolation of DNA sequences containing excision-repair sites. AB - We have developed an immunological method for isolation and identification of DNA sequences containing 5-bromo-2'-deoxyuridine (BrdUrd) incorporated during UV induced excision-repair synthesis. DNA fragments containing BrdUrd incorporated during repair synthesis were incubated with goat anti-BrdUrd and rabbit anti-goat IgG, and the antibody-DNA complexes were separated from bulk DNA by nitrocellulose filter binding. With this method, 80% of DNA sequences containing BrdUrd-labeled excision-repair sites were recovered, contaminated with less than 1% of DNA fragments devoid of excision-repair sites. Recovery of DNA fragments containing repair sites was independent of size from 2 to 20 kilobases. We have used this method in conjunction with blot hybridization to demonstrate that repair synthesis occurs in human ribosomal gene sequences in cells treated with UV. PMID- 6490626 TI - The distribution of DNA excision-repair sites in human diploid fibroblasts following ultraviolet irradiation. AB - Using the technique for separating DNA fragments containing excision-repair sites from total genomic DNA as described in the previous paper (Cohn, S. M., and Lieberman, M. W. (1984) J. Biol. Chem. 259, 12456-12462), we have developed a method for directly determining the distribution of excision-repair sites in the genome. DNA was prepared from confluent, diploid human fibroblasts which had been irradiated with ultraviolet light and incubated in the presence of 5-bromo-2' deoxyuridine (BrdUrd), repaired fragments were isolated, and the dependence of the fraction of total DNA fragments containing excision-repair sites on DNA fragment length was determined by electrophoretic analysis. The observed dependence was compared to the relationship expected for a random distribution of repair sites. At 36 h following 3 J/m2 UV, the distribution of repair sites was indistinguishable from a random distribution; however, at doses of UV above 6 J/m2, the observed dependence indicated that the distribution of repair sites was nonrandom. A time course of the distribution of repair sites following 12 J/m2 UV was clearly nonrandom from 4 h after irradiation until at least 36 h following irradiation. By 72 h, however, the distribution had become random. In cells treated with hydroxyurea, a reduced number of excision-repair sites were present, but the distribution of repair sites was also nonrandom. Autoradiographic analysis of the amount of unscheduled DNA synthesis in individual nuclei suggested that the nonrandom distribution of repair sites did not result from variable extents of repair synthesis in different cell populations or from cell death. PMID- 6490627 TI - Identification of the covalently bound flavin of dimethylglycine dehydrogenase and sarcosine dehydrogenase from rat liver mitochondria. AB - Dimethylglycine dehydrogenase (EC 1.5.99.2) and sarcosine dehydrogenase (EC 1.5.99.1) are the folate binding proteins of rat liver mitochondria. These two enzymes contain covalently bound flavin and catalyze similar oxidative demethylation reactions (Wittwer, A. J., and Wagner, C. (1981) J. Biol. Chem. 256, 4102-4108). Flavin-peptides have been purified from these two enzymes after proteolytic digestion by trypsin and chymotrypsin. The spectral and chromatographic properties of these flavin peptides changed after treatment with nucleotide pyrophosphatase in a manner consistent with the conversion of an FAD peptide to an FMN-peptide. The pKa for pH-dependent fluorescence quenching of the purified flavin-peptides was not affected by borohydride reduction which, in conjunction with the pKa values, indicated that the flavin was covalently linked via the 8 alpha position of the isoalloxazine ring to an imidazole N(3) of a histidine residue. Peptides from both enzymes showed histidylflavin at the N terminus. Amino acid composition and sequence analysis showed that the flavin peptide from dimethylglycine dehydrogenase was His(flavin)-Ala-Ala-Gly-Leu. Amino acid composition and N-terminal analysis suggested the sequence of the flavin peptide of sarcosine dehydrogenase was His(flavin)-(Ala, Gly,Thr)-Leu. PMID- 6490628 TI - 3-O-methylation of mannose residues. A novel reaction in the processing of N linked oligosaccharides occurring in Mucor rouxii. AB - Yeast- and mycelial-form cells of the dimorphic fungus Mucor rouxii incubated with [U-14C]glucose were found to synthesize Man-P-dolichol, Glc-P-dolichol, and Glc3Man9GlcNAc2-P-P-dolichol. The structure of the oligosaccharide moiety of the latter was similar to that of the same compound isolated from other eucaryotic cells. Oligosaccharides that migrated on paper chromatography as Man6-30GlcNAc standards were obtained upon treatment of delipidated proteins with a protease and endo-beta-N-acetylglucosaminidase H. The oligosaccharides that migrated apparently as single substances on paper chromatography could be separated into three different populations by paper electrophoresis in sodium borate buffer. The fastest migrating substances contained only mannose and N-acetylglucosamine residues, whereas the other two contained, in addition, different proportions of 3-O-methylmannose units. The oligosaccharides with the highest content of 3-O methylmannose residues appeared to be completely resistant to alpha-mannosidase degradation; they were, however, cleaved by endo-beta-N-acetylglucosaminidase H. Mycelial cells synthesized a much higher proportion of 3-O-methylmannose containing oligosaccharides than yeast cells. Cells incubated with [methyl 14C]methionine were found to label only the N-linked oligosaccharides containing 3-O-methylmannose residues. It is concluded that transfer of Glc3Man9GlcNAc2 to protein is followed by excision of glucose and probably one or two mannose residues, followed by further mannosylation and in some cases also methylation of oligosaccharides. This represents a novel reaction in the processing of N-linked oligosaccharides. PMID- 6490629 TI - pH dependence of the reoxidation of p-hydroxybenzoate hydroxylase 2,4 dihydroxybenzoate complex. AB - Oxidation of reduced p-OH-benzoate hydroxylase . 2,4-diOH-benzoate complex by molecular oxygen occurs in four clearly defined steps. Inclusion of azide in the reaction medium slows the rate for each step. We have found that the rates for the last three steps as well as the UV/visible absorbance spectrum for the second intermediate are markedly dependent on pH. Formation of intermediate II is base catalyzed while its decay to intermediate III is acid-catalyzed. Formation of oxidized enzyme from intermediate III is base-catalyzed. The spectrum of intermediate II is shifted to longer wavelengths on raising the pH. A pKa of about 7.8 can be calculated for each of these pH-dependent transitions, except for the rate of formation of oxidized enzyme. This rate appears to be directly dependent on hydroxide ion concentration. The presence of azide does not change the observed pH dependence. These results are discussed in the context of a 4a,5 ring opened flavin structure for intermediate II. PMID- 6490630 TI - Ca2+ homeostasis in unstimulated platelets. AB - Unstimulated platelets maintain a low cytosolic free Ca2+ concentration and a steep plasma membrane Ca2+ gradient. The mechanisms that are required have not been completely defined. In the present studies, 45Ca2+ was used to examine the kinetics of Ca2+ exchange in intact unstimulated platelets. Quin2 was used to measure the cytosolic free Ca2+ concentration. Under steady-state conditions, the maximum rate of Ca2+ exchange across the platelet plasma membrane, 2 pmol/10(8) platelets/min, was observed at extracellular free Ca2+ concentrations 20-fold less than in plasma. Two intracellular exchangeable Ca2+ pools were identified. The size of the more rapidly exchanging pool (t 1/2, 17 min) and the cytosolic free Ca2+ concentration were relatively unaffected by large changes in the extracellular Ca2+ concentration. In contrast, the size of the more slowly exchanging Ca2+ pool (t 1/2, 300 min) varied with the extracellular Ca2+ concentration, which suggests that it is physically as well as kinetically distinct from the rapidly exchangeable Ca2+ pool. The locations of the Ca2+ pools were determined by differential permeabilization of 45Ca2+-loaded platelets with digitonin. 45Ca2+ in the rapidly exchanging pool was released with lactate dehydrogenase, which suggests that it is located in the cytosol. 45Ca2+ in the slowly exchanging pool was released with markers for both the dense tubular system and mitochondria, but inhibition of mitochondrial Ca2+ uptake with carbonyl cyanide m-chlorophenylhydrazone had no effect on the size of the slowly exchangeable Ca2+ pool or the cytosolic free Ca2+ concentration. In contrast, addition of metabolic inhibitors (KCN plus carbonyl cyanide m chlorophenylhydrazone plus deoxyglucose) or trifluoperazine caused a decrease in the size of the slowly exchangeable Ca2+ pool and an increase in the cytosolic free Ca2+ concentration. These observations suggest that Ca2+ homeostasis in unstimulated platelets is maintained by limiting Ca2+ influx from plasma, actively promoting Ca2+ efflux, and sequestering Ca2+ within an internal site, which is most likely the dense tubular system and not mitochondria. PMID- 6490631 TI - The effect of Na+ on Ca2+ homeostasis in unstimulated platelets. AB - Platelets maintain a low cytosolic free Ca2+ concentration by limiting Ca2+ influx from plasma and promoting Ca2+ efflux. The present studies examine the role of the plasma membrane Na+ gradient in these processes. The Na+ gradient in intact unstimulated platelets was altered by incubating the platelets with ouabain or by replacing extracellular Na+ with N-methyl-D-glucamine or choline. Ca2+ flux across the plasma membrane and the amount of exchangeable Ca2+ in the platelet cytosol were measured by observing 45Ca2+ influx and efflux under steady state conditions. The cytosolic free Ca2+ concentration was measured with the fluorescent probe quin2. At extracellular Na+ concentrations below 50 mM, the size of the cytosolic exchangeable Ca2+ pool increased by 48%. The size of the exchangeable Ca2+ pool sequestered in the dense tubular system increased by 356%. Ca2+ flux across the plasma membrane increased by 38%. There was, however, no change in total platelet Ca2+ and little, if any, change in the cytosolic free Ca2+ concentration. Similar effects were produced by incubating platelets with ouabain. These observations demonstrate a marked influence of the plasma membrane Na+ gradient on Ca2+ homeostasis in platelets. The nature of the changes, however, suggests that Na+/Ca2+ exchange cannot be sole basis for Ca2+ efflux from platelets. PMID- 6490632 TI - Ammonia/potassium exchange in methanogenic bacteria. AB - Methanospirillum hungatei exposed to ammonia in a K+-free buffer lost up to 98% of the cytoplasmic K+ through an ammonia/K+ exchange reaction. The exchange was immediate, and occurred in cells poisoned by air or by other metabolic inhibitors. Additions of NH4OH or various NH+4 salts (or methylamine) were most effective in causing K+ depletion in media of alkaline pH, suggesting that NH3 was the chemical species crossing the membrane. In alkaline media, the exchange reaction resulted in a dissipation of the transmembrane pH gradient (inside acidic), but had only small effects on the membrane potential until concentrations of ammonia were used above those required to abolish the K+ gradient. Through the use of NH4Cl to vary the cytoplasmic pH at a constant acidic external pH, and NH4OH to abolish the transmembrane pH gradient at various alkaline external pH values, we conclude that methanogenesis is sensitive to both the pH of the cytoplasm and the medium. Methanogenesis in Msp. hungatei and Methanosarcina barkeri was inhibited dramatically at external pH values more acidic than 6.5 or more alkaline than 7.5. Dramatic K+ depletion in response to ammonia additions at pH 8.0 occurred with Ms. barkeri, another strain of Msp. hungatei, Escherichia coli, and Bacillus polymyxa. In several other methanogens, ammonia/potassium exchange was hardly detected. PMID- 6490633 TI - The kinetics of O2 release by human red blood cells in the presence of external sodium dithionite. AB - Oxygen release by human erythrocytes in the presence of external sodium dithionite was examined by stopped-flow, rapid mixing techniques. The resultant time courses were analyzed quantitatively using a three-dimensional disc model which had been developed previously to describe oxygen uptake (Vandegriff, K. D., and Olson, J. S. (1984) Biophys. J. 45, 825-835). This scheme takes into account diffusion of oxygen through external unstirred solvent layers and intracellular oxygen diffusion and chemical reaction with hemoglobin. Application of this model to deoxygenation time courses required three additional considerations: the reaction of free oxygen with external sodium dithionite, cooperative oxygen binding to intracellular hemoglobin, and the alkaline Bohr effect. The resultant theoretical treatment described accurately both the observed dependence of the deoxygenation rate on dithionite concentration and pH and the exact shapes of the corresponding time courses. Membrane resistance to oxygen diffusion was not required to simulate the observed data as had been suggested previously (Lawson, W. H., Jr., Holland, R. A. B., and Forster, R. E. (1965). J. Appl. Physiol. 20, 912-918). The final, three-dimensional model is general and allows, for the first time, analysis of both oxygen uptake and release kinetics (Vandegriff, K. D., and Olson, J. S. (1984) J. Biol. Chem. 259, 12619-12627). PMID- 6490634 TI - Morphological and physiological factors affecting oxygen uptake and release by red blood cells. AB - The kinetics of oxygen uptake and release by human, salamander (Amphiuma means), and artificially constructed red cells were measured under a variety of physiological conditions using stopped-flow, rapid mixing techniques. The results were analyzed quantitatively using the generalized, three-dimensional disc model that was developed in two previous publications (Vandegriff, K. D., and Olson, J. S. (1984) Biophys. J. 45, 825-835 and Vandegriff, K. D., and Olson, J. S. (1984) J. Biol. Chem. 259, 12609-12618). The apparent rate of gas exchange is governed primarily by the oxygen flux at the red cell surface. In the case of uptake, this flux is roughly independent of intracellular chemical reaction parameters and inversely proportional to the thickness of the unstirred solvent layer which is adjacent to the red cell surface. For release experiments in the presence of high concentrations of sodium dithionite, the flux at the cell surface is inversely proportional to the oxygen affinity of the intracellular hemoglobin and roughly independent of the thickness of the external unstirred solvent layer. As a result, the effects of cell size, internal heme concentration, and pH are expressed differently in the two types of kinetic experiments. The rate of oxygen uptake depends on roughly the second power of the surface area to volume ratio of the erythrocyte, whereas the rate of release is much less dependent on the size and shape of the red cell. The half-time of oxygen uptake is directly proportional to intracellular heme concentration for cells of equivalent geometries; the half-time of oxygen release is linearly dependent on internal heme concentration but, at low heme concentrations, is determined primarily by the rate of oxygen dissociation from hemoglobin. The rate of cellular oxygenation is roughly independent of pH and internal 2,3-diphosphoglycerate concentration; in contrast, the rate of deoxygenation depends markedly on these conditions. As the pH is lowered or the internal diphosphoglycerate concentration is raised, the overall oxygen affinity of the cell suspension decreases severalfold, and the rate of oxygen release increases by roughly the same extent. PMID- 6490635 TI - Regulation of myosin isoenzyme composition in fetal and neonatal rat ventricle by endogenous thyroid hormones. AB - The effect of thyroid hormone on the expression of ventricular isomyosins V1, V2, and V3 was studied in fetal and neonatal rats. Between 15 and 21 days gestation, V3 accounts for 80-90% of fetal ventricular myosin. After birth, there is a rapid transition from the fetal V3 isotype to an equal mixture of V1 and V3 at 3 days, and to 100% V1 at 3 weeks of age. The endogenous serum levels of thyroxine (T4) and triiodothyronine (T3) increase from trace amounts in the fetus to adult levels at 2-3 weeks of age; this increase correlates with the maximal expression of V1 during the same period. Expression of the V1 isomyosin can be eliminated in the neonatal rat if endogenous thyroid hormone synthesis is suppressed by propylthiouracil (PTU) treatment. In the PTU-treated rats, V3 is the only isomyosin synthesized between 1 and 30 days of age. In fetal ventricle, the amount of V1 is also decreased but not completely eliminated by PTU treatment. Conversely, the relative amount of V1 can be increased in the fetal ventricle by increasing the fetal serum concentrations of T4 and T3 to adult physiological levels. In these fetal ventricles, V1 represents greater than 85% of the total myosin. Likewise, the expression and accumulation of V1 could be stimulated in ventricles of PTU-treated, 12-day-old rats by administration of pharmacological or physiological doses of T3. Within 4 to 8 h after an initial dose of T3, V1 accumulates to 5-10% of the ventricular myosin, and by 72 h comprises 60-80% of the myosin. These results indicate that endogenous thyroid hormone induces the synthesis of ventricular heavy chain alpha, which as a dimer forms the V1 isomyosin, or plays a permissive role for the continued synthesis of heavy chain alpha in ventricles of fetal and neonatal rats. PMID- 6490636 TI - Peptidoglycans as promoters of slow-wave sleep. I. Structure of the sleep promoting factor isolated from human urine. AB - Fast atom bombardment-mass spectrometry (FABMS) has been used to determine the structure of the urinary sleep-promoting factor (FSu), the nature of whose components had been reported earlier. Less than 1 nmol of the underivatized substance sufficed for the FABMS experiments. The major somnogenic constituent of the purified preparation was a peptidoglycan of Mr = 921 with the structure N acetylglucosaminyl-N -acetylanhydromuramylalanylglutamyldiaminopimelylalanine. The anhydro linkage is between C-1 and C-6 of the muramyl entity. Two additional substances accompanied the above compound. These were the hydrated form (i.e. in which the muramyl entity had a free reducing end, and a free hydroxyl on C-6), and an anhydro analogue lacking the terminal alanine. The Mr values were 939 and 850, respectively. Methyl esters were prepared, and these were also acetylated. The mass spectra of the methyl ester of Mr = 921 displayed an increase in Mr of 42 (i.e. 3 X 14), indicating the presence, originally, of three free carboxyls. Acetylation increased Mr by a further 168 units (i.e. 4 X 42), indicating 4 hydroxyl or amino groups. These data are consistent with the structure cited above for the main entity of FSu. Similar confirmatory results were obtained for the two minor constituents described above. These operations were worked out on natural muramyl peptides of known structure, obtained from other sources, and the data are given for comparison. PMID- 6490637 TI - Peptidoglycans as promoters of slow-wave sleep. II. Somnogenic and pyrogenic activities of some naturally occurring muramyl peptides; correlations with mass spectrometric structure determination. AB - The structures of components of the sleep-promoting material purified from human urine were established by fast atom bombardment-mass spectrometry, as reported in the accompanying paper (Martin, S. A., Karnovsky, M. L., Krueger, J. M., Pappenheimer, J. R., and Biemann, K. (1984) J. Biol. Chem. 259, 12652-12658). We report here that two substances isolated from that preparation, viz. N acetylglucosaminyl-1,6 -anhydro-N-acetylmuramyl-Ala-gamma-Glu-diaminopimelyl-Ala) and that compound lacking the terminal alanine, are active as somnogens. Cerebro intraventricular administration of 1 pmol of the glycotetrapeptide was sufficient to induce prolonged excess sleep in rabbits. A similar substance obtained from Brevibacterium divaricatum in which the free carboxyls of the glutamic and diaminopimelic moieties, indicated above, were amidated (N-acetylglucosaminyl-1,6 anhydro-N-anhydromura-myl-Ala-iso- Gln- epsilon-amido-diaminopimelyl -Ala-Ala) was not active as a promoter of slow-wave sleep. Deamidation of this peptide to a mixture of the free dicarboxylic forms produced a somnogenic substance. Our findings show that in addition to the muramyl form of peptidoglycan monomers, the anhydro muramyl form, with no reducing end, is compatible with somnogenic activity. Furthermore, the data obtained with a natural product amplify our earlier observations with smaller synthetic molecules of the importance of amidation/deamidation in the structure-activity relationships of muramyl peptides. PMID- 6490638 TI - Multiple forms of vitamin D-dependent calcium-binding protein in rat kidney. AB - The technique of two-dimensional electrophoresis was used in combination with a highly sensitive silver stain to study vitamin D-dependent calcium-binding protein (CaBP) in rat kidney. Rat renal CaBP was shown to co-migrate almost exactly with CaBP purified from chick intestine suggesting evolutionary conservation of this protein. In some cases rat renal CaBP appeared not as a single polypeptide, but rather as a cluster of 4 polypeptides. Formation of the satellite cluster of CaBP in response to high doses of 1,25-dihydroxyvitamin D3 occurred in young rats which had been maintained on a vitamin D-deficient diet for 2 weeks, as well as in older rats which had been maintained on the same diet for 5 months. The 4 forms of CaBP were not the result of various states of Ca2+ binding, but rather the result of an enzymatic reaction. This was shown by 3 experiments. 1) Adding excess EGTA to samples containing the 4 satellite forms did not change the two-dimensional electrophoretogram. 2) Incubation of purified chick intestinal CaBP with kidney cytosols from D-deficient rats brought about the formation of the satellite CaBP forms from the chick protein. However, purified chick CaBP was unchanged by incubation in buffer alone for up to 2 h at 37 degrees C. 3) Placing rat kidney cytosols in a boiling water bath for 10 min inactivated the factor which generated the satellite forms as would be expected for an enzyme. The physiological significance of these forms of CaBP is as yet unknown. PMID- 6490639 TI - Genetic and biochemical analysis of mutation(s) affecting ricin internalization in Chinese hamster ovary cells. AB - We have previously reported the isolation and characterization of Chinese hamster ovary (CHO) cell mutants defective in the internalization of ricin (Ray, B., and Wu, H.C. (1982) Mol. Cell. Biol. 2, 535-544). These mutants also do not exhibit the enhancement of ricin internalization by nigericin pretreatment at a low concentration, which is observed in the wild-type CHO cells. An analysis of somatic cell hybrids between the mutant and the toxin-sensitive wild-type CHO cell line shows that all of the phenotypes associated with the toxin resistance mutation are dominant in the hybrid cell lines. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of [3H]palmitic acid-labeled cell extracts from the mutant and toxin-resistant hybrid cell lines has revealed an increased incorporation of [3H] palmitic acid into two proteins with apparent molecular weights near 30,000 in the mutant and hybrid cells as compared to that in the wild-type cell line. Our studies indicate that these two fatty acyl proteins might be related to a dominant mutation(s) which results in a decreased uptake of ricin. PMID- 6490640 TI - Structures of the oligosaccharide chains in swine trachea mucin glycoproteins. AB - The structures of large O-glycosidically linked oligosaccharides derived from swine trachea mucin glycoprotein were established. Reduced oligosaccharides released by treatment with alkaline borohydride were separated by gel filtration on Bio-Gel P-6 and the neutral oligosaccharides were isolated by chromatography on DEAE-cellulose. Eight oligosaccharides (DIa to BII), ranging in length from 8 to 15 sugar units, were isolated. On the basis of carbohydrate composition and analytical data from sequential treatment with exoglycosidases and permethylation analysis, the following structures were assigned to these oligosaccharides: (Formula: see text). PMID- 6490641 TI - Characterization of the rat liver glucocorticoid receptor purified by DNA cellulose and ligand affinity chromatography. AB - Two rapid and high yield purification methods for the rat liver glucocorticoid receptor based on differential DNA affinity (method A) and ligand affinity (method B) chromatography are described. In method A, the amount of receptor in rat liver cytosol that can be activated and subsequently eluted from a DNA cellulose column has been increased to 80% by introducing a second heat activation step. Using this method, 1.5 nmol of 25% pure glucocorticoid receptor can be routinely obtained per day from 15-20 rat livers. Method B yields about 2.2 nmol of 60% pure receptor with an overall yield of congruent to 60%. The quality of these purifications has been controlled by affinity labeling. In each case, more than 95% of purified binding activity represented the intact 92,000 +/ 400-Da glucocorticoid receptor polypeptide as shown by sodium dodecyl sulfate gel electrophoresis and fluorography. No difference in the labeling pattern was observed using either [3H]triamcinolone acetonide (photoaffinity labeling) or [3H]dexamethasone 21-mesylate (electrophilic labeling). The electrophilic labeling step was performed in the cytosol prior to purification by method A to compare the labeled components thus purified with those obtained when the photoaffinity labeling was performed after the purification. Using this approach, distinct breakdown products of the glucocorticoid receptor were revealed, co purifying during DNA affinity chromatography. Cross-linked receptor obtained by method A has been further purified to homogeneity by preparative sodium dodecyl sulfate-gel electrophoresis and successfully used as immunogen to raise glucocorticoid receptor antibodies in rabbits. These antibodies raised against glucocorticoid receptor, as well as those previously obtained using affinity chromatography-purified receptor, react with the receptor molecules irrespective of their method of purification. Glucocorticoid receptors purified by methods A and B have been analyzed for specific DNA-binding properties by the nitrocellulose filter binding assay. PMID- 6490642 TI - Coagulation Factor V contains copper ion. AB - Preparations of bovine and human coagulation Factor V were analyzed for copper using both atomic absorption and atomic emission spectroscopy. All preparations of the bovine and human protein were found to contain copper ion at a ratio of 1 copper ion bound per mol (Mr = 330,000) of Factor V. As a result of copper binding and sequence homology between ceruloplasmin and Factor V, bovine Factor V and thrombin-activated Factor V (Va) were assessed with respect to their visible and near ultraviolet absorption spectra and to their ability to oxidize N,N dimethyl-p-phenylenediamine (a substrate for ceruloplasmin). Factor V and Factor Va exhibited absorption spectra with no maxima at either 310 or 610 nm, indicating that the copper is not bound in a site analogous to Type I or Type III copper sites in ceruloplasmin. Further, Factor V and Factor Va are not capable of serving as catalysts for the oxidation of N,N-dimethyl-p-phenylenediamine under solution conditions that are optimum for ceruloplasmin oxidase activity. These data suggest that the copper ion bound to Factor V may be functionally and structurally distinct from the Type I and Type III copper ion bound to ceruloplasmin. PMID- 6490643 TI - The stereochemical course of the ribulose-5-phosphate kinase-catalyzed reaction. AB - Spinach-leaf ribulose-5-phosphate kinase catalyzes the reaction of (Rp)-[beta, gamma-18O, gamma-18O]adenosine 5'-(3-thiotriphosphate) with ribulose 5-phosphate to form ribulose 1-[18O]phosphorothioate 5-phosphate. This product is incubated with CO2, Mg2+, and ribulose-bisphosphate carboxylase to form the [18O]phosphorothioate of D-glycerate. Reduction of this material using phosphoglycerate kinase/ATP, glyceraldehyde-3-phosphate dehydrogenase/NADH, triose-phosphate isomerase, and glycerol-phosphate dehydrogenase/NADH produces glycerol 3-[18O]phosphorothioate, which is subjected to ring closure using diethylphosphorochloridate. This in-line reaction produces a diastereoisomeric mixture of glycerol 2,3-cyclic phosphorothioates. 31P NMR spectroscopy was used to analyze the 18O content of the products. The anti-diastereoisomer, which is the major isomer formed and corresponds to the downfield 31P NMR signal (Pliura, D.H., Schomburg, D., Richard, J.P., Frey, P.A., and Knowles, J.R. (1980) Biochemistry 19, 325-329), retains the 18O label. This observation indicates that the ribulose-5-phosphate kinase reaction proceeds with inversion of configuration at phosphorus. The reaction is, therefore, unlikely to involve the participation of a covalent phosphoryl-enzyme intermediate. PMID- 6490644 TI - 18O studies of pyrogallol cleavage by catechol 1,2-dioxygenase. AB - 18O labeling studies on the catechol 1,2-dioxygenase-catalyzed oxidative cleavage of pyrogallol demonstrate that the enzyme functions both as a dioxygenase and a monooxygenase in this reaction. Two products are observed, 2-pyrone-6-carboxylic acid, 99% singly labeled at the carboxylate, and 2-hydroxy-cis,cis-muconic acid, 74% doubly labeled (one 18O at each carboxylate) and 24% single labeled (one 18O at either carboxylate). The labeling pattern observed shows that 2-pyrone-6 carboxylic acid cannot be derived enzymatically from the lactonization of the 2 hydroxy-cis,cis-muconic acid, thus eliminating the dioxetane as an intermediate in the dioxygenase mechanism. The observations are interpreted to indicate the intermediacy of 2-hydroxymuconic anhydride. This anhydride or the corresponding muconyl enzyme species must be sufficiently long-lived to allow the exchange of labeled hydroxide with solvent. Evidence for mechanism-based enzyme inactivation by a pyrogallol-derived intermediate is also presented. PMID- 6490645 TI - Preparation and polymerization of skeletal muscle ADP-actin. AB - Skeletal muscle ADP-G-actin was prepared from ADP-F-actin, which had been freed of residual ATP by repeated sonication, by depolymerization in 5 mM Tris-HCl, 0.2 mM ADP, 0.2 mM dithiothreitol, 0.1 mM CaCl2, 0.1 mM MgCl2, and 0.01% NaN3, pH 8.0. The ADP had been freed of traces of ATP by DEAE-chromatography, and 5 microM diadenosine pentaphosphate was added to inhibit myokinase activity. The kinetics of the spontaneous polymerization of ADP-actin in 1 mM MgCl2 + 0.1 M KCl were compatible with the simple nucleation-elongation model previously used to explain the polymerization of ATP-actin. The critical concentrations of ADP-actin were 8.0 and 2.0 microM in 1 mM MgCl2 and 1 mM MgCl2 + 0.1 M KCl, respectively. These values are 20-30-fold higher than the corresponding values in ATP. Using cross linked actin trimers to nucleate polymerization, the association rate constants were found to be 0.8 and 0.9 microM-1 S-1 in MgCl2 and MgCl2 + KCl, respectively, which are 0.4 and 0.2 times the values for ATP-actin. The dissociation rate constants, calculated from the critical concentrations and the association rate constants, were 6.4 and 1.8 S-1, respectively, which are 10 and 5 times the corresponding values for ATP-actin. PMID- 6490646 TI - Characterization of the reversible conformational equilibrium of the cytoplasmic domain of erythrocyte membrane band 3. AB - The cytoplasmic domain of the erythrocyte membrane protein, band 3, contains binding sites for hemoglobin, several glycolytic enzymes, and ankyrin, the linkage to the cytoskeleton. In an earlier study, we found evidence which suggested that band 3 might undergo a native conformational change. We demonstrate here that the cytoplasmic domain of band 3 does exist in a reversible, pH-dependent conformational equilibrium among 3 native states. At physiological salt concentrations this equilibrium is characterized by apparent pKa values of 7.2 and 9.2; however, these apparent pKa values change if the domain's sulfhydryl groups are modified. A major component of the structural change appears to involve the pivoting of two subdomains of the cytoplasmic domain at a central hinge, as evidenced by both hydrodynamic and fluorescence energy transfer measurements. The probable site of this hinge is between residues 176 and 191, a region highly accessible to proteases and also rich in proline. These structural rearrangements also apparently extend to the cluster of tryptophan residues near the N terminus, since the domain's intrinsic fluorescence more than doubles between pH 6.5 and 9.5. No measurable change in band 3 secondary or quaternary structure could be detected during the conformational transitions. A structural model of the cytoplasmic domain of band 3 is presented to show the possible spatial relationships between the regions of conformational change and the sites of peripheral protein binding. PMID- 6490647 TI - Sigmoid kinetics of purified beef heart mitochondrial carnitine palmitoyltransferase. Effect of pH and malonyl-CoA. AB - The kinetics of purified beef heart mitochondrial carnitine palmitoyltransferase have been extensively investigated with a semiautomated system and the computer program TANKIN and shown to be sigmoidal with both acyl-CoA and L-carnitine. In contrast, Michaelis-Menten kinetics were found with carnitine octanoyltransferase. The catalytic activity of carnitine palmitoyltransferase is strongly pH dependent. The K0.5 and Vmax are both greater at lower pH. The K0.5 for palmitoyl-CoA is 1.9 and 24.2 microM at pH 8 and 6, respectively. The K0.5 for L-carnitine is 0.2 and 2.9 mM at pH 8 and 6, respectively. Malonyl-CoA (20 600 microM) had no effect on the kinetic parameters for palmitoyl-CoA at both saturating and subsaturating levels of L-carnitine. We conclude that malonyl-CoA is not a competitive inhibitor of carnitine palmitoyltransferase. The purified enzyme contained 18.9 mol of bound phospholipid/mol of enzyme which were identified as cardiolipin, phosphatidylethanolamine, and phosphatidylcholine by thin-layer chromatography. The data are consistent with the conclusion that native carnitine palmitoyltransferase exhibits different catalytic properties on either side of the inner membrane of mitochondria due to its non-Michaelis-Menten kinetic behavior, which can be affected by pH differences and differences in membrane environment. PMID- 6490648 TI - Neurophysin heterogeneity. Difference between newly formed and aged neurosecretory granules. AB - Neurosecretory granules from bovine neurohypophyses were isolated on iso-osmotic gradients. The content of the granules was analyzed by analytical and two dimensional gel electrophoreses. The distributions in the gels of vasopressin precursor and neurophysins were detected by radioimmunoassays. Analytical gel electrophoresis of the content of a crude granule preparation showed the presence of different populations of neurophysin molecules. Further analysis demonstrated that vasopressin-neurophysin and oxytocin-neurophysin can be subdivided into molecules with different pI values. Whereas newly formed granules showed two main spots of neurophysin with pI of 5.0 and 5.6, aged granules contain in addition to these different populations of neurophysin-like material, some of which had a basic pI. Vasopressin precursor activity was detected in spots containing proteins with acidic pI and Mr approximately 18,000 and also in proteins of Mr = 8,000-10,000 migrating in the basic region of the gel. The results suggest that in the neural lobe there is an aging process which gives rise to several subpopulations of neurophysins. The different forms of vasopressin-associated bovine neurophysin and oxytocin-associated bovine neurophysin are only found in the granules which are not required for release. PMID- 6490649 TI - A novel class of genetic variants of the L1210 cell up-regulated for folate analogue transport inward. Isolation, characterization, and degree of metabolic instability of the system. AB - We have isolated stable variants of the L1210 cell exhibiting increased transport inward of the folate analog, methotrexate. These variants show 3- to 14-fold increases in [3H]methotrexate influx compared to parental cells but are unaltered for [3H]methotrexate efflux. This increased influx in each variant is quantitatively reflected in corresponding elevations in intracellular exchangeable levels of drug at steady state, but there is no alteration in membrane potential. The increases in influx are associated with increased values for influx Vmax for a system normally transporting reduced folates and the same increase in the amount of a specific binding component at the cell surface. Otherwise, values for influx Km and specificity for various folate structures are unchanged. This alteration in [3H]methotrexate influx is biochemically and genetically stable, since it is expressed in isolated plasma membrane vesicles and is retained during growth in non-selective medium. Following addition of cycloheximide, the same rate of decay of this transport activity (t 1/2 = 126 +/- 24 to 137 +/- 26 min) was shown for parental and variant cells. From these results we conclude that turnover of this transport property occurs in these cells which is genetically regulated. Also, the elevated transport activity inward for this folate analog in these variant cells is probably the result of a genetic alteration up-regulating the rate of synthesis of the "putative" carrier protein itself. The absence of any effect on efflux of [3H]methotrexate in these variants in the face of evidence for increased synthesis of the carrier protein for the system mediating influx of this folate analog is construed as further evidence for the nonidentity of systems mediating each flux that we proposed on the basis of earlier kinetic studies. PMID- 6490650 TI - Rapid calcium release from the isolated sarcoplasmic reticulum is triggered via the attached transverse tubular system. AB - Rapid replacement of 0.15 M K gluconate with 0.15 M choline Cl led to multiphasic Ca2+ release from a heavy fraction of rabbit skeletal muscle microsomes. Following the initial lag period (0-50 ms), about 15 nmol of Ca2+/mg of protein was rapidly released with first-order rate constants k = 60-140 s-1. Subsequently, a larger amount of Ca2+ (up to 56 nmol/mg) was released at a slower rate (k = 0.8-1.5 s-1). The Ca2+ released in both rapid and slow phases was reaccumulated within 60 s. In agreement with a previous report (Caswell, A. H., Lau, Y. H., Garcia, M., and Brunschwig, J-P. (1979) J. Biol. Chem. 254, 202-208), French press treatment of the tubule/sarcoplasmic reticulum (SR) complex results in dissociation of transverse tubular membrane (T-tubules) from SR. Subsequent incubation with 0.4 M potassium cacodylate results in the reassociation of the complex, as shown by sucrose density-gradient sedimentation. Upon T-tubule dissociation, both rapid and slow Ca2+ release was inhibited. Upon reassociation, the rapid Ca2+ release was completely restored and the slow phase partially restored. The results indicate that the T-tubule associated with SR plays a crucial role in triggering rapid Ca2+ release induced by ionic replacement. Other types of Ca2+ release, e.g. those induced by Ca2+ alone or with drugs such as caffeine and quercetin, are unaffected by T-tubule dissociation, and hence produced by direct stimulation of the SR membrane. PMID- 6490651 TI - Proton stoichiometry associated with human neutrophil respiratory-burst reactions. AB - Control of the intraphagosomal pH in neutrophils may be of importance in creating a microbicidal environment by regulating the activity of the O2-.-generating NADPH oxidase and the lysosomal enzymes discharged into this compartment. In this study, we examined the proton stoichiometry associated with the primary enzymatic reaction underlying the respiratory burst. A preparation of the neutrophil derived, membrane oxidase consumed NADPH and generated O2-. with a stoichiometry of 1 NADPH:2 O2-. When the enzymatically produced O2-. was prevented from undergoing dismutation, net protons were released in an approximate 1:2 stoichiometry with O2-. generated. In contrast, when O2-. was allowed to dismutate to H2O2, net protons were consumed in a 1:1 stoichiometry with the accumulated H2O2. Thus, the delta pH associated with the NADPH oxidase-dependent production of O2-. was dictated by the fate of the generated radical. The consumption of the oxidase-generated H2O2 by the lysosomal enzyme myeloperoxidase resulted in the formation of HOCl which was trapped in the presence of taurine as the N-chloro derivative. The ratio of chlorinated product formed to H+ consumed was 1:1. The implications of these results are discussed in terms of the known intraphagosomal pH changes that occur following neutrophil stimulation. We conclude that the O2-.-generating oxidase plays a dual role in the phagosome by simultaneously creating an oxidizing environment that optimizes pH-dependent microbicidal processes. PMID- 6490652 TI - Isolation and characterization of the proteinase inhibitor-inducing factor from tomato leaves. Identity and activity of poly- and oligogalacturonide fragments. AB - Mild acid hydrolysis of a small (Mr = 6 kDa) pectic polysaccharide isolated from tomato leaves, an inducer of the synthesis and accumulation of two proteinase inhibitors in excised tomato plants, yielded a alpha-D-polygalacturonic acid polymer with degree of polymerization = 20 that retained proteinase inhibitor inducing activity. Enzymic and acid hydrolysis of this polygalacturonan yielded a series of alpha-1,4-D-galacturonic acid oligomers with degrees of polymerization from 2 to 6 which were purified to homogeneity and assayed for proteinase inhibitor-inducing activity in young excised tomato plants. All of the oligomers exhibited activity. The hexagalacturonide possessed the highest activity and the trimer the lowest. The evidence supports a possible role for plant cell wall fragments as systemic messengers that regulate the expression of proteinase inhibitor genes in plant leaves in response to pest attacks. PMID- 6490653 TI - Detergent solubilization and affinity purification of a local anesthetic binding protein from mammalian axonal membranes. AB - Previously, we identified a local anesthetic receptor in the membranes of nerve cells, especially enriched in axonal membranes, by the binding assay of a fluorescence local anesthetic probe, quinacrine (Greenberg, M., and Tsong, T.Y. (1982) J. Biol. Chem. 257, 8964-8971). We report here affinity chromatography purification of the quinacrine binding protein from axonal membranes of bovine brain. One per cent sodium cholate solubilized more than 90% of the membrane proteins, and the quinacrine binding activity was preserved in the extract; KD remained at 1.0 microM. An affinity column of quinacrine mustard covalently linked to Affi-Gel 10 (Bio-Rad) retained about 5% of the total solubilized proteins, and the subsequent elution with 1.0 M lidocaine revealed a protein peak which coeluted with the lidocaine peak. After removal of lidocaine, the protein peak retained the high affinity to quinacrine (KD = 1.5 microM). Furthermore, bound quinacrine could be displaced with dibucaine in the range of its nerve blocking concentration, around 10 microM. Sodium dodecyl sulfate-gel electrophoresis of the peak protein fractions gave a predominant band of approximately 16 kDa. A major protein band with the same molecular weight was also seen in the sodium dodecyl sulfate gel of the total axonal membrane proteins. The receptor concentration in the axonal membranes was estimated to be 2-5 nmol/mg protein. With a molecular weight of 16 kDa, the receptor should constitute 3-8% of total proteins, consistent with the finding that it is a major protein constituent of the axonal membranes. The purity of the binding protein after the affinity chromatography step was about 90%. The purified protein contained roughly 60 nmol of quinacrine binding sites/mg. PMID- 6490654 TI - Biosynthesis of tyrosine O-sulfated gastrins in rat antral mucosa. AB - Biosynthetic incorporation of labeled amino acids into the major gastrins in rat antrum, Component I, gastrin 34 ("big" gastrin), and gastrin 17-like peptides ("little" gastrin) was demonstrated after in vitro incubation of antral mucosal slices. The antral gastrin synthesis was stimulated by fundectomy, which ablates gastric acid secretion and thereby increases the gastrin concentration in plasma 20-fold. Tyrosine O-sulfation of gastrin was also demonstrated by incorporation of [35S]sulfate. Sulfate-labeled peptides precipitated by gastrin antisera coeluted with sulfated gastrin immunoreactivity on ion-exchange chromatography. Aryl-sulfatase treatment removed the [35S]sulfate from labeled gastrin and resulted in a change in elution pattern of the immunoreactivity to that of the unsulfated gastrins. The presence of 35S-labeled tyrosine O-sulfate residues was directly demonstrated by two-dimensional thin-layer electrophoresis after alkaline hydrolysis of [35S]sulfate-labeled gastrin. All the antral gastrins incorporated [35S]sulfate. PMID- 6490655 TI - Synthesis of a model protein of defined secondary and quaternary structure. Effect of chain length on the stabilization and formation of two-stranded alpha helical coiled-coils. AB - Five polyheptapeptides (Ac-(Lys-Leu-Glu-Ala-Leu-Glu-Gly)n-Lys-amide, where n = 1 5) of 8, 15, 22, 29, and 36 residues were synthesized by the solid-phase method. The peptides were purified by reversed-phase high-performance liquid chromatography. The ability of these peptides to form two-stranded alpha-helical coiled-coils in benign medium (1.1 M KC1, 0.05 M PO4 buffer, pH 7.0) was monitored by molecular weight determinations and circular dichroism studies and their physical properties were compared to carboxamidomethylated alpha tropomyosin at cysteine 190 (CM-tropomyosin). The peptides TM-8, TM-15, and TM-22 were shown to be monomeric in both denaturant (8 M urea) and benign medium by gel filtration high-performance liquid chromatography on TSK G2000 SW while peptides TM-29 and TM-36 were shown to be dimeric in benign medium both by gel-filtration and sedimentation equilibrium experiments. The CD spectra of the polyheptapeptides TM-8, TM-15, and TM-22 show large increases in molar ellipticity at 220 nm on the addition of trifluoroethanol (helix-inducing solvent) to the benign buffer. By comparison, the two-stranded polyheptapeptides (TM-29 and TM-36) and CM-tropomyosin do not show any increase in molar ellipticity at 220 nm. The helicity of polyheptapeptides increases with increasing chain length, with TM-36 having a value comparable with CM-tropomyosin [( theta]220 = -31,800 degrees and -32,200 degrees, respectively) which is considered to be essentially 100% alpha-helical. These small two-stranded alpha helical coiled-coils are considerably more stable to temperature and urea denaturation than CM-tropomyosin. Whereas CM-tropomyosin is almost completely denatured in the presence of 6 M urea, TM-29 and TM-36 maintain 22 and 70% of their helicity, respectively. The 30% denaturation values (t30) are 74, 62, and 37 degrees C for TM-36, TM-29, and CM-tropomyosin, respectively, in benign medium (1.1 M KC1:PO4 buffer, pH 7.0). The t30 values can be substantially decreased in the presence of denaturant (3 M urea, 0.1 M KC1, PO4 buffer, pH 7.0) to 62 and 43 degrees C for TM-36 and TM-29, respectively.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6490656 TI - Characterization of mucus glycoprotein fatty acyltransferase from gastric mucosa. AB - A fatty acyltransferase activity which catalyzes the transfer of palmitic acid from palmitoyl coenzyme A to gastric mucus glycoprotein has been demonstrated in the rat gastric mucosa. Subcellular fractionation studies revealed that the enzyme activity was present in a Golgi-rich membrane fraction. Optimum enzymatic activity for acylation of mucus glycoprotein was obtained with 0.5% Triton X-100, 25 mM NaF, and 2 mM dithiothreitol at a pH of 7.4. The enzymatic activity increased proportionally, over a given range, with increased concentrations of both substrates and of enzyme. The apparent Km of the enzymes for the undegraded mucus glycoprotein was 4.5 X 10(-7) M and for palmitoyl-CoA, 3.8 X 10(-5) M. The 14C-labeled product of the reaction cochromatographed on Bio-Gel A-50 column and migrated on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with gastric mucus glycoprotein. Treatment of this 14C-labeled glycoprotein with mild alkali released hexane-extractable product which was identified as [14C]palmitate. The enzyme was also capable of fatty acylation of the deglycosylated glycoprotein, but did not catalyze the transfer of palmitic acid to the proteolytically degraded mucus glycoprotein. This indicates that the acceptor site for fatty acyltransferase is situated in the protease-susceptible nonglycosylated region of the mucus glycoprotein polymer. PMID- 6490658 TI - Biosynthesis of blood group I antigens. Identification of a UDP-GlcNAc:GlcNAc beta 1-3Gal(-R) beta 1-6(GlcNAc to Gal) N-acetylglucosaminyltransferase in hog gastric mucosa. AB - A beta 1-6N-acetylglucosaminyltransferase has been identified in microsomal preparations from hog gastric mucosa which is able to synthesize branch points in branched lactosaminoglycans (blood group I antigenic structures). The enzyme can be assayed specifically using the synthetic trisaccharide GlcNAc beta 1-3Gal beta 1-4Glc beta-OMe as acceptor. The product of the transferase reaction was isolated and identified by methylation analysis as, (Formula: see text) Into this tetrasaccharide two galactose residues were incorporated by the specific beta-N acetylglucosaminide beta 1-4-galactosyltransferase from bovine milk. Thus a hexasaccharide was formed which was shown to inhibit strongly a murine monoclonal and a human anti-I antibody. Using a variety of oligosaccharides and glycolipids, which correspond to structures found in linear lactosaminoglycan chains, the acceptor substrate specificity of the branching enzyme was determined. From these results it is concluded that branching occurs only during the elongation process at the nonreducing end and follows a well-defined order. N-Acetylglucosamine is first transferred to position 3 of a terminal galactose followed immediately by the addition of a second N-acetylglucosamine to position 6; only then the 1-3 and the 1-6 branches are further elongated by galactose residues. PMID- 6490657 TI - Binding of ATP citrate lyase to the microsomal fraction of rat liver. AB - Purified rat liver ATP citrate lyase is shown to bind to the microsomal fraction of rat liver. Under the same conditions the enzyme does not bind significantly to the mitochondrial fraction or to the outer membrane prepared from the mitochondrial fraction. The binding component of the microsomal fraction is further identified as the endoplasmic reticulum, and a protein component of the membrane is involved in binding. Binding decreases with increasing salt concentration. It requires more than 50 mM potassium phosphate or 60 mM potassium chloride to decrease binding significantly whereas complete inhibition of binding is observed in the presence of 0.01 mM CoA. The binding capacity of the microsomal fraction is shown to be high enough to allow most, if not all, the ATP citrate lyase present in rat liver to be bound to the microsomal fraction even when the enzyme has been induced over 10-fold by dietary manipulations. No significant difference has been found when comparing the binding of the phospho and dephospho forms of ATP citrate lyase. PMID- 6490659 TI - Fatty acid transfer between multilamellar liposomes and fatty acid-binding proteins. AB - A simple experimental system was developed for studying the movement of long chain fatty acids between multilamellar liposomes and soluble proteins capable of binding fatty acids. Oleic acid was incorporated into multilamellar liposomes containing cholesterol and egg yolk lecithin and incubated with albumin or hepatic fatty acid-binding protein. It was found that the fatty acid transferred from the liposomes to either protein rapidly and selectively under conditions where phospholipid and cholesterol transfer did not occur. More than 50% of the fatty acid contained within liposomes could become protein bound, suggesting that the fatty acid moved readily between and across phospholipid bilayers. Transfer was reduced at low pH, and this reduction appeared to result from decreased dissociation of the protonated fatty acid from the bilayer. Liposomes made with dimyristoyl or dipalmitoyl lecithin and containing 1 mol per cent palmitic acid were used to show the effect of temperature on fatty acid transfer. Transfer to either protein did not occur at temperatures where the liposomes were in a gel state but occurred rapidly at temperatures at or above the transition temperatures of the phospholipid used. PMID- 6490660 TI - Mechanism of interferon action. Increased phosphorylation of protein synthesis initiation factor eIF-2 alpha in interferon-treated, reovirus-infected mouse L929 fibroblasts in vitro and in vivo. AB - The effect of interferon (IFN) treatment and virus infection on the phosphorylation both in vitro and in vivo of the alpha subunit of protein synthesis initiation factor eIF-2 (eIF-2 alpha) was examined in mouse fibroblast L929 cells. The [gamma-32P]ATP-mediated in vitro phosphorylation of eIF-2 alpha catalyzed by cell-free extracts prepared from IFN-treated, uninfected cells was dependent upon exogenously added double-stranded RNA (dsRNA). However, the dsRNA requirement for eIF-2 alpha phosphorylation in vitro was eliminated by prior infection of cells with reovirus Dearing strain virions but not with defective top component particles. The enhanced phosphorylation in vitro of eIF-2 alpha and ribosome-associated protein P1 depended in a similar manner upon the multiplicity of virus infection. The extent of phosphorylation in vivo of eIF-2 alpha prepared from L929 cells was also examined by utilizing two-dimensional isoelectric focusing/sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting techniques. About 5-10% of the eIF-2 alpha was typically phosphorylated in vivo in untreated, mock-infected cells, whereas 25-30% was phosphorylated in IFN-treated, reovirus-infected cells. An intermediate extent of eIF-2 alpha phosphorylation, routinely between 15 and 20%, was observed with either IFN treatment or reovirus infection alone. The integrity of eIF-4A and eIF 4B was also examined by two-dimensional electrophoresis and immunoblotting, and no significant alterations in molecular size or charge heterogeneity were detected when these factors were prepared from IFN-treated, reovirus-infected cells as compared to untreated, uninfected cells. PMID- 6490661 TI - Levels of histone H4 diacetylation decrease dramatically during sea urchin embryonic development and correlate with cell doubling rate. AB - Basic proteins in nuclei and nucleosomes at different stages of development in Arbacia punctulata sea urchins were analyzed directly by in situ protamine release of chromosomal proteins into Triton/acid/urea-polyacrylamide gels. The predominant protein band in the H4 region of 2-cell through 64-cell stage embryos migrates with the mobility expected for diacetylated histone H4 (i.e. H4aa), whereas after blastulation (approximately 300 cells) the predominant H4 species is the unmodified form, H4O. In early embryos this H4aa band is highly labeled in vivo with [3H]acetic acid. The ratio of H4aa:H4O is more than 20-fold greater at the rapidly dividing 2-cell stage than at pluteus stage. This is true for both newly synthesized H4 labeled with [3H]lysine and total H4 (stained). Enhanced acetylation is also found in nucleosomes. The relative amount of this acetylated H4 species correlates roughly with the rate of cell doubling during early embryogenesis, and decreases as the average nucleosomal repeat increases. The results are indicative of a dynamically changing chromatin structure through development, as well as an intimate role of diacetylated histone H4 in the maturation of newly replicated chromatin. PMID- 6490662 TI - Multiple fibronectin subunits and their post-translational modifications. AB - We report analyses of fibronectin subunit diversity by high resolution one- and two-dimensional gel electrophoresis. We have studied plasma and cellular fibronectins of rats and hamsters. Each form of fibronectin comprises multiple distinguishable subunits and, within each rodent species, all subunits of plasma fibronectin are resolvable from those of cellular fibronectin. Some, but not all, of this heterogeneity is caused by differential glycosylation. Thus, while glycosylated plasma and cellular fibronectins share no common subunits, nonglycosylated forms of these proteins appear to share 2-3 subunits. In addition, there are subunits unique to plasma and to cellular fibronectins in both rats and hamsters, although the pattern of diversity differs slightly between species. All size variants of fibronectin are phosphorylated to varying degrees. However, only some subunits are sulfated, apparently on tyrosine residues in the C-terminal third of the molecule. Comparison of the distribution of sulfate on the various fibronectin subunits with recent results on generation of multiple mRNAs by alternative splicing suggests that tyrosine sulfate is located in a polypeptide segment present in only certain fibronectin subunits. The results reported here provide information on the likely contributions of primary sequence differences and post-translational modifications to the heterogeneity of fibronectin subunits. PMID- 6490663 TI - Purification and properties of ovoperoxidase, the enzyme responsible for hardening the fertilization membrane of the sea urchin egg. AB - The ovoperoxidase from the egg of the sea urchin, Strongylocentrotus purpuratus, has been purified to apparent homogeneity. Ovoperoxidase is secreted from the egg at fertilization and is responsible, in vivo, for hardening of the fertilization membrane by forming cross-links between protein tyrosyl residues. Purification was accomplished by activation of cortical granule exocytosis with acetic acid, followed by NH4SO4 precipitation, DEAE-Sephacel chromatography in the absence of divalent cations, and CM-Sephadex chromatography. The purified enzyme is a glycoprotein of Mr 70,000, based on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme exhibits a UV-visible spectrum typical of heme peroxidases (epsilon 412 = 1.19 X 10(5) M-1 cm-1). Ovoperoxidase catalyzes the oxidation of tyrosine, guaiacol, iodide, and bromide, but not chloride, and can employ either H2O2 or, with 8% relative efficiency, ethyl peroxide as an oxidative substrate. Phenylhydrazine, 3-amino-1,2,4-triazole, azide, and sulfite all inhibit purified ovoperoxidase at concentrations similar to those that inhibit hardening in vivo. Inhibition by 3-amino-1,2,4-triazole is reversible, requires H2O2, and is slow relative to substrate turnover. The purified enzyme is sensitive to protease cleavage in the native state, yielding an active product of Mr approximately 50,000 which varies slightly depending upon the protease employed. Ovoperoxidase should provide a useful tool for the study of fertilization membrane formation as a paradigm of macromolecular assembly and modification. PMID- 6490664 TI - Osmotic properties and internal pH of isolated rat parotid secretory granules. AB - Secretory granules of the rat parotid have been purified rapidly by differential centrifugation in iso-osmotic sucrose. Despite low-level contamination by other organelles, this fraction is predominantly secretory granules, based on biochemical and morphological characterization. Measurements of intragranular water space show that isolated granules swell in hypo-osmotic media, and begin to release alpha-amylase and other content proteins below 250 mosM. Exposure of granules to selected anions also causes lysis, increasing in the order sulfate less than phosphate less than or equal to gluconate less than or equal to isethionate less than or equal to acetate less than or equal to chloride much less than thiocyanate. The internal pH of isolated parotid granules is approximately 6.8 as measured by the distributions of either [3H]acetate or [14C]methylamine. Varying the external medium pH from 5.0 to 8.0 results in little change in the measured internal pH. Parotid granules have a substantial internal buffering capacity, i.e. a decrease of 85-140 mM intragranular H+ is needed to raise the internal pH by 1.0 unit. Finally, results obtained using acridine orange staining suggest that the secretory granule internal pH in situ is similar to that measured in isolated granules. PMID- 6490665 TI - Terminally directed hydrolysis of duplex ribonucleic acid catalyzed by a species of the BAL 31 nuclease from Alteromonas espejiana. AB - The extracellular nuclease activities of Alteromonas espejiana sp. BAL 31 are mediated by at least two distinct protein species that differ in molecular weights and catalytic properties. The two species that have been purified to homogeneity and characterized, the "fast" (F) and "slow" (S) enzymes, both possess an exonuclease activity that shortens both strands of duplex DNA, with the F nuclease displaying a much greater (approximately 19-fold) turnover number for this degradation than the S species. In the present article, it is shown that the F species also mediates the terminally directed hydrolysis of a linear duplex RNA, gradually shortening molecules of this substrate through a mechanism that results in the removal of nucleotides from both the 3' and the 5' ends. This degradation proceeds with very infrequent introduction of scissions away from the termini as demonstrated by gel electrophoretic examination of the products of partial degradation, both in duplex form and after denaturation by reaction with CH3HgOH, and by electron microscopic characterization of duplex partially degraded molecules. The apparent Michaelis constant and turnover number have been determined. At equimolar enzyme concentrations in the limit of high substrate concentration, the F nuclease will degrade duplex RNA at a rate 0.021 +/- 0.010 (S.D.) times that for a duplex DNA of comparable guanine + cytosine content. The S species, by contrast, shows very little activity against the duplex RNA substrate relative to that of the F enzyme. PMID- 6490666 TI - A non-linearly elastic, finite deformation analysis applicable to the static mechanics of excised lungs. AB - Continuum mechanical analyses of lung behavior require a constitutive relationship for the parenchyma. For a homogeneous, isotropic, elastic material this relationship is dependent upon the strain invariants. Furthermore, the sparse data available indicate that the relationship should be exponential in form. A suitable equation has previously appeared in the literature. In this paper it is developed for application to whole lung experiments. PMID- 6490667 TI - The pattern of hammer speed during a hammer throw and influence of gravity on its fluctuations. AB - Hammer speed at release is one of the most important factors contributing to the distance of a hammer throw. Hammer speed follows a generally increasing trend during the throw, with one fluctuation per turn. The purpose of the present paper was to quantify the influence of gravity on the speed fluctuations. Eight experienced hammer throwers were studied with three-dimensional filming methods. Instantaneous values of hammer velocity and speed were calculated from the film data. The rate of change of hammer speed due to the tangential component of gravity was computed, and integrated to calculate the accumulated contribution of gravity to hammer speed at all instants of the throw. These values were subtracted from the corresponding values of hammer speed. The amplitude of the fluctuations was reduced in the corrected speed functions, indicating a contribution of gravity to the original fluctuations. However, the fluctuations were still clearly present in the corrected speed functions, indicating the existence of other causal factors. PMID- 6490668 TI - Myocardial material mechanics: characteristic variation of the circumferential and longitudinal systolic moduli in left ventricular dysfunction. AB - Active systolic moduli for the circumferential (E theta) and longitudinal (E phi) axes of the left ventricle were determined along with circumferential and longitudinal contractile filament stress (sigma theta and sigma phi) and circumferential and longitudinal fiber strain (epsilon theta and epsilon phi). These material property parameters were determined at four points during cardiac systole. Thirty-nine patients comprising five clinical groups were evaluated using pressure and volume data acquired from single-plane cineangiography. The results indicate that the active moduli exponentially decrease during cardiac systole. Characteristic variations from normal differentiated the various pathological groups. With compensated volume overload, E theta was significantly reduced during the latter half of systole (p less than 0.25). With decompensated volume overload, both E theta and E phi were not significantly different from the normal group throughout cardiac systole. With compensated pressure overload, both E theta and E phi were significantly lower than the normal group at end-systole (p less than 0.005; p less than 0.005). With congestive cardiomyopathy, both E theta and E phi were significantly greater during the latter half of systole compared to the normal group (p less than 0.05 and p less than or equal to 0.025). PMID- 6490669 TI - A semi-empirical pressure analysis for anatomy constrained by elastic support. AB - A mathematical foundation is developed for the computation of pressures exerted on portions of the anatomy constrained by elastic fabric support. General formulae are derived for curvatures of an ellipsoidal model corresponding to orthogonal tension components at the point of measurement. It is found that the pressure contributions from both tension components are significant to first order in the longitudinal variation of circumference over an axial test zone, because while the transverse curvature approaches the zeroth order cylindrical approximation, its longitudinal counterpart does not. PMID- 6490670 TI - Study of cradle and pendulum motion for applications to health care. AB - Hammocks and cradles have long been appreciated, but in a very limited way. Aside from being emotionally soothing the devices affect the skin and all deep body components. While structurally simple they are functionally quite sophisticated and could very well affect the pattern of health care across the board--acute, rehabilitation and home care--because of potential physiologic, economic and logistic advantages. PMID- 6490671 TI - Effects of structure and strain measurement technique on the material properties of young human tendons and fascia. AB - It is generally recognized that the organization of collagen bundles in soft tissues strongly influences their material properties. To study this, sixty failure tests were conducted on double-layered fascia lata, 'isolated' parallel bundled tendons (gracilis and semitendinosus) and parallel-bundled bone-patellar tendon-bone units taken from about the knees of eighteen young human donors (mean age of 26 yr). Surprisingly, most material parameters for the two-layered fascia lata did not differ significantly from corresponding values for the isolated tendons and tendon-bone preparations, suggesting their longitudinal fibers predominated during loading. Differences were present however between the gracilis tendon and all other tissues for both modulus and maximum stress. The large variations in reported maximum and failure strains for tendons, fascia and other collagenous tissues prompted the other phase of the study. During 15 of the 60 failure tests, surface markers were simultaneously filmed to determine; differences between local surface strains and grip to grip values; the amount of tissue slippage and/or failure occurring in the grips; and the effect of strain measurement technique on tissue moduli and failure energy densities. Maximum local strains were found to be 25-30% of grip strains for all tissues tested. Some slippage and/or failure could be seen in all isolated tissues which were gripped directly although their maximum grip strains were similar to values for tendon-bone units. For all tissues, two to three fold differences were also found in moduli and failure energy densities between grip and midregion measurements. PMID- 6490672 TI - The elastic properties of a polyurethane arterial prosthesis. AB - The relationship between the mechanical properties of a fibrous polyurethane arterial prosthesis and the graft manufacturing process variables was studied from uniaxial tensile tests. A non-linear model was used to characterize the cylindrical elastic properties. Experiments on cylindrical segments were carried out to determine the constitutive constants and to assess the applicability of the model to the polyurethane graft. The compliance of 4 mm internal diameter grafts with various wall-thicknesses was predicted. The results were used to produce grafts with compliance matched to that of the carotid and femoral arteries. PMID- 6490673 TI - Pulsatile flow past aortic valve bioprostheses in a model human aorta. AB - Pulsatile flow development past tissue valve prostheses in a model human aorta has been studied using qualitative flow visualization and quantitative laser Doppler techniques. Experiments were conducted both in steady and physiological pulsatile flow situations and the measurements included the pressure drop across the valve, the instantaneous flow rate as well as the velocity profiles and turbulent stresses downstream to the valves. Our study shows that the velocity profiles with pericardial valves are closer to those measured past natural aortic valves. The porcine valves with a smaller valve opening area produce a narrower and stronger jet downstream from the valve with relatively larger turbulent axial stresses in the boundary of the jet. Our study suggests that the pericardial valves with turbulent stresses comparable to those of caged ball and tilting disc valves are preferable from a hemodynamic point of view. PMID- 6490674 TI - Incremental elastic modulus for ventricles in diastole. AB - Utilizing the formulation of so-called 'small deformations superimposed on a large initial deformation' the incremental pressure modulus of a ventricle in diastole is studied and the explicit expression of it is obtained as a function of intraventricular pressure. In the analysis the ventricular wall material is assumed to be homogeneous, incompressible, isotropic and the stress-strain relation is exponential. The numerical results for a dog left ventricle indicate that above a critical value of inner pressure the incremental pressure modulus increases with increasing intra-ventricular pressure. Furthermore, the relationship between the stiffness and pressure is seen to be curvilinear (particularly for low pressure level), but for large values of inner pressure the behavior of the curve may be approximated by a set of straight lines. PMID- 6490675 TI - An anatomical model for streaming potentials in osteons. AB - An anatomical model for streaming potentials in osteons is developed to characterize the electromechanical effect in bone. The model accounts for the microstructure of the osteon and is based upon first principles of electrochemistry, electrokinetics, continuum mechanics and fluid dynamics. Intra osteonal potentials and their relaxation times are numerically evaluated. Many of the previously reported observations of potentials in osteons and across macroscopic specimens are explained for the first time in terms of an electrokinetic model. The cusp-like behavior of intra-osteonal potentials is explained, the dependence of the potentials on solution viscosity and conductivity is demonstrated, and insight is gained relative to the time dependence of stress generated potentials. PMID- 6490676 TI - Changes in aortic bifurcation geometry during a cardiac cycle. AB - In vivo radial strain measurements at the rabbit aortic bifurcation were made at different times during the cardiac cycle. At the peak of the pressure pulse, the radial strain at the bifurcation is positive in the plane perpendicular to the bifurcation but negative in the plane of the bifurcation. Thus the cross sectional geometry at this location distorts from an elliptical shape in diastole toward a more circular shape in systole. PMID- 6490677 TI - A mathematical study of semilunar valve vibration. AB - A simple mathematical model to describe the valvular vibrations and their role in the production of the second heart sound is presented. The closed semilunar valve is considered as a vibrating stretched membrane secured around a circular edge. An exponential function is used to represent the actual pressure gradient across the closed valve, which is the force that drives the membrane to vibrate. The displacement and the rate of displacement of the centreline are calculated and are found to be similar to the experimental and numerical results given earlier in the literature by Stein and his co-workers. PMID- 6490678 TI - Wall distensibility effect on arterial flow distribution. PMID- 6490679 TI - The positive inotropic action of isoprenaline is associated with the release of noradrenaline from rabbit, guinea-pig and rat atria. AB - The actions of isoprenaline (1 microM) were investigated in spontaneously beating isolated paired atria from rabbits, guinea-pigs and rats and in paced left atria from rabbits and rats. Isoprenaline, when applied for a 10 min period to paired atrial from rabbits, guinea-pigs and rats, produced a short-lived release of noradrenaline which appeared to be associated with the positive inotropic actions, rather than with the positive chronotropic actions. Exposures of 3 min to isoprenaline in paired atria in the three species produced increases in force and release of noradrenaline (% of tissue content) in the order: rabbit greater than guinea-pig greater than rat. The increases in rate did not differ between species. Rat atria had the highest resting rates followed by guinea-pig and rabbit atria. In rabbit left atrial preparations which were electrically paced at resting rates of approximately 61, 158 and 334 beats per min there were progressive decreases in release of noradrenaline and positive inotropic actions produced by isoprenaline with increasing rates of pacing. In rat left atrial preparations which were electrically paced at a slower rate, which was similar to that of rabbit paired atria, a greater release of noradrenaline associated with a greater positive inotropic effect was induced by isoprenaline than in rat paired atria. In rabbit paced left atria, an increase in pacing frequency alone produced small increases in force and release of noradrenaline. Verapamil (1 microM) significantly reduced the positive inotropic effect and release of noradrenaline induced by isoprenaline without affecting the positive chronotropic effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490680 TI - Effects of aminotetralins on intraocular pressure and pupillary function in rabbits. AB - Aminotetralin compounds, A-6, 7-DTN and TL-99, produced bisphasic changes in intraocular pressure (IOP) and pupillary dilatation in rabbits. The rise in IOP appeared to result from an action on extraocular muscles because this effect was not produced by either compound in rabbits with transected extraocular muscles. The ocular hypotensive action of A-6, 7-DTN and TL-99 was markedly attenuated in sympathectomized rabbits indicating that this action resulted from suppression of sympathetic neuronal activity. Inhibition of ocular hypertension induced by waterloading by both compounds and suppression of the IOP recovery rate by A-6, 7 DTN suggested that the latter compound lowered IOP, in part, by inhibiting aqueous humor formation. The ocular hypotensive action of A-6, 7-DTN was antagonized by pretreatment with sulpiride, but not by yohimbine, indicating that dopamine receptors are involved in the response. These studies demonstrated that dopamine agonists can lower IOP and suggest that these types of drugs might prove useful in the therapy of open-angle glaucoma. PMID- 6490681 TI - Profile of contraceptive clients in Katsina, northern Nigeria. PMID- 6490682 TI - Male attitudes towards family planning in Khartoum, Sudan. PMID- 6490683 TI - Breast-feeding and sexual abstinence in Papua New Guinea. PMID- 6490684 TI - Analysis of demographic data collected in a rural area of Kenya. PMID- 6490685 TI - Birth interval, mortality and growth of children in a rural area in Kenya. PMID- 6490686 TI - Fertility, birth timing and marital breakdown: a reinterpretation of the evidence. PMID- 6490687 TI - Voluntary childlessness: early articulator and postponing couples. PMID- 6490688 TI - Menarcheal age in University of Warwick students. PMID- 6490689 TI - Social class and mobility in male adoptees and non-adoptees. PMID- 6490691 TI - Slipped capital femoral epiphysis. PMID- 6490690 TI - Housing quality and child mortality in the rural Philippines. PMID- 6490692 TI - Cuneiform osteotomy of the femoral neck in the treatment of slipped capital femoral epiphysis. AB - I reviewed the cases of eighty-two patients (106 hips) with slipped capital femoral epiphysis who were treated during a twenty-four-year period. Of these, forty-two hips had a sufficiently severe displacement to require surgical correction by means of a cuneiform osteotomy of the neck of the femur just distal to the physis. The purpose was to restore the normal anatomical relationship of the proximal capital femoral epiphysis to the neck of the femur. Follow-up of these patients ranged from two to twenty-two years, with an average of nine years and nine months. Aseptic necrosis developed in one femoral head and osteoarthritis developed in one hip. The remaining forty hips were graded as having an excellent result. PMID- 6490693 TI - The treatment of chronic slipped capital femoral epiphysis by biplane osteotomy. AB - Thirty-two biplane osteotomies in thirty patients were performed for the treatment of chronic slipped capital femoral epiphysis during a fourteen-year period at the Jersey City Medical Center. Twenty-seven patients (twenty-nine hips) were followed for two and a half to fourteen years. The correction obtained at surgery was maintained in all of the patients. Although two patients had had narrowing of the hip joint preoperatively and one had narrowing postoperatively, this had resolved at an average of three years postoperatively. Improvement in the range of motion was noted. In twenty patients the limb lengths were equal, in three the involved limb was longer, and in four patients the limb was shorter postoperatively. One patient had a slight subluxation of the femoral head due to an excessive valgus correction at the time of surgery, and one patient had delayed union of the osteotomy site which went on to satisfactory healing. No patients had avascular necrosis of the femoral head or symptoms of degenerative arthritis at follow-up. Preoperative joint-space narrowing did not appear to be a contraindication to this procedure. PMID- 6490694 TI - Postoperative neurological deficits in segmental spinal instrumentation. A study using spinal cord monitoring. AB - We retrospectively analyzed the postoperative neurological complications in 137 patients who underwent a posterior spine fusion for scoliosis and had concomitant somatosensory cortical evoked-potential spinal-cord monitoring. The patients were divided into three specific operative groups: group 1, forty-nine patients who had a Harrington rod with segmental wiring (segmental spinal instrumentation); group 2, twenty patients who had Luque segmental spinal instrumentation; and group 3, sixty-eight patients who had a Harrington rod without segmental spinal instrumentation. There were neurological complications in twelve (17 per cent) of the sixty-nine patients in groups 1 and 2. Three patients (4 per cent) had a major injury to the spinal cord and nine patients (13 per cent) had only transient sensory changes. No difference was apparent between group 1 and group 2 in the degree of operative correction of curves or in the incidence of neurological complications. The one neurological complication (1.5 per cent) that occurred in the sixty-eight patients in group 3 was a Brown-Sequard syndrome. The factors related to increased risk for spinal cord injury in groups 1 and 2 included: (1) the passage of sublaminar wires in the thoracic and thoracolumbar spine, (2) intraoperative correction exceeding the preoperative bending correction, and (3) the surgeon's lack of adequate experience with the technique. With spinal cord monitoring we were able to predict the impending major neurological deficits, but the transient (sensory) changes that may be associated with segmental wiring were less reliably predicted. PMID- 6490695 TI - Posterior spinal arthrodesis for congenital scoliosis. An analysis of the cases of two hundred and ninety patients, five to nineteen years old. AB - We analyzed the results of posterior arthrodesis of the spine for congenital scoliosis, with or without Harrington instrumentation, in 290 of 323 patients who were operated on between the ages of five and nineteen years and were followed for two years or more. The length of follow-up averaged six years and ranged from two to twenty-eight years. The average curve before surgery was 55 degrees (range, 13 to 155 degrees), the average curve at correction was 38 degrees (range, 5 to 102 degrees), and the average curve at final follow-up was 44 degrees (range, 5 to 103 degrees). Bending of the fusion mass of more than 10 degrees was seen in forty patients; pseudarthrosis, in twenty; and adding-on of vertebrae with an increase in the curve of more than 10 degrees, in seven patients. There were four deaths, only one of them in the last twenty-five years. One was due to intraoperative cardiac arrest; one, to intraoperative overtransfusion; one, to postoperative overtransfusion; and one, to gastrointestinal bleeding eight months postoperatively while the patient was in a Risser jacket. Two patients became paraplegic due to excessive distraction with the Harrington rod, and two others had a partial cranial-nerve lesion due to halo traction. Based on these results, we concluded that posterior arthrodesis of the spine is satisfactory for most patients with congenital scoliosis. The most common problem was bending of the fusion mass in growing children, which occurred in 14 per cent of the patients. Use of Harrington instruments allowed slightly better correction (36 per cent compared with 28 per cent) but was associated with the only cases of paraplegia and infection in the series. PMID- 6490696 TI - Polycentric total knee arthroplasty. A ten-year follow-up study. AB - After review of the first 209 polycentric total knee arthroplasties (in 159 patients) performed at the Mayo Clinic between July 1970 and November 1971, we found that the calculated probability of the arthroplasty remaining successful ten years postoperatively was 66 per cent. Actual results showed 42 per cent of the arthroplasties to be successful in patients who were still alive at review; another 24 per cent were successful but were in patients who had died or were lost to follow-up before ten years postoperatively. In 34 per cent failure occurred, which we defined as reoperation for any reason, unacceptable pain, or loss of function. The most common causes of failure were instability or ligament laxity (13 per cent), loosening of a component (7 per cent), infection (3 per cent), and patellofemoral joint pain (4 per cent). Prior knee surgery significantly decreased the probability of success, as did axial malalignment of the prosthetic components at operation. PMID- 6490697 TI - Comminuted femoral-shaft fractures: treatment by roller traction, cerclage wires and an intramedullary nail, or an interlocking intramedullary nail. AB - In a retrospective study, we attempted to assess progress in the treatment of comminuted fractures of the femoral shaft at Parkland Memorial Hospital from 1978 to 1983. Seventy-nine comminuted femoral-shaft fractures were available for follow-up: thirty-two treated by roller traction, twenty-three treated by cerclage wires and an intramedullary nail, and twenty-four treated by an interlocking intramedullary nail. Using the classification of Winquist and Hansen, Grade-III and IV comminuted fractures accounted for 69 per cent of those treated by roller traction, 68 per cent of those treated by nailing and cerclage wires, and 96 per cent of those treated by an interlocking nail. The frequency of multiple injuries was 38 per cent in the patients treated by roller traction, 39 per cent in those treated by nailing and cerclage wires, and 58 per cent in those treated by an interlocking nail. The average hospitalization times were thirty one days for roller traction, sixteen days for cerclage wires and an intramedullary nail, and 19.5 days for an interlocking nail. The average length of follow-up was 132 weeks after roller traction, 115 weeks after cerclage wiring and an intramedullary nail, and sixty weeks after insertion of an interlocking nail. All fractures were followed until after union; the average times to union were 18.4 weeks after roller traction, thirty-four weeks after open reduction and intramedullary nailing with cerclage wires, and 13.8 weeks after insertion of an interlocking nail. For the purposes of this study, treatment was assumed to have failed if a change in treatment was necessary, an unplanned reoperation was performed, femoral shortening exceeded 2.5 centimeters, angulation was more than 15 degrees, non-union or a deep infection developed, motion of the knee was less than 70 degrees of flexion, or a refracture occurred. By these criteria, the frequency of failure after roller traction was 66 per cent (secondary to malalignment and shortening); after insertion of an intramedullary nail with cerclage wires, 39 per cent (secondary to unplanned surgery, non-union, shortening, and infection); and after use of an interlocking nail, 4 per cent (secondary to shortening). Currently, at our institution, an interlocking intramedullary nail is the treatment of choice for comminuted femoral-shaft fractures because it encourages early union with maintenance of length and alignment and the results are predictable. PMID- 6490698 TI - Refracture of bones of the forearm after plate removal. AB - Thirty-two plates originally used for fracture fixation in the ulna and radius in twenty-three patients were removed at Hennepin County Medical Center in Minneapolis between 1977 and 1982. The plate was on the ulna in eighteen arms and on the radius in fourteen. Removal of twenty-one plates was elective, and eleven were removed because of slight pain or discomfort. The interval between plate application and plate removal ranged from eight to sixty-two months. The average duration of cast immobilization used for protection after removal of the plate was six weeks. There were seven refractures, which occurred between two and forty weeks after plate removal. Three refractures occurred at the former fracture site; three, through the fracture site, extending into an adjacent screw-hole; and one, at one screw-hole. No refracture occurred more than forty weeks after removal of the plate. PMID- 6490699 TI - The spread of tumor-cell-sized particles after bone biopsy. AB - For the purpose of determining possible passive dissemination of tumor cells from a bone biopsy site, we created an animal model. A cortical window was placed in the canine femur and a measured quantity of radioactive microspheres was placed in the medullary canal. Local and distant spread of the microspheres were measured four days after the simulated biopsy. In the animals in which the cortical window was left open, spread of the microspheres was limited to the adjacent tissue and the regional lymph nodes. In the animals in which the bone window was plugged with methylmethacrylate, there was little or no local spread of the microspheres; however, there was significant uptake of the microspheres in the lung. In a separate trial, significant microsphere activity was present in the lung within twenty minutes after placement of the methylmethacrylate plug. PMID- 6490700 TI - The induction of neochondrogenesis in free intra-articular periosteal autografts under the influence of continuous passive motion. An experimental investigation in the rabbit. AB - The purpose of this study was to determine the chondrogenic potential of free intra-articular autografts of periosteum under the influence of joint immobilization compared with continuous passive motion. A graft of periosteum (including the cambium layer) was taken from the medial aspect of the proximal end of the tibia and transplanted into each corresponding knee joint in thirty adolescent New Zealand rabbits. A cast was applied to the left hind limb to immobilize the knee joint in a position of 40 degrees of flexion; the animal was then placed on the continuous passive-motion apparatus so that the right knee joint could be moved continuously and passively from 40 to 110 degrees of flexion. Fifteen rabbits were killed at intervals from seven to twenty-eight days and fifteen rabbits were killed at twenty-one days. The grafts in the immobilized limbs were small and soft, and did not resemble cartilage, whereas the grafts in the limbs that had been treated with continuous passive motion had grown much larger and had taken on the gross appearance of articular cartilage. After one week the cells in the cambium layer were rapidly proliferating and by two weeks there was consistent evidence of differentiation along a chondroid line in the grafts that had been exposed to continuous passive motion. After three weeks bone formation was apparent in all of the grafts, which had become adherent to the synovial tissue and vascularized. Cartilage was the predominant tissue in only 8 per cent of the grafts in the immobilized limbs, compared with 59 per cent of the grafts (p less than 0.01) in the limbs exposed to continuous passive motion. This investigation demonstrated the chondrogenic potential of free periosteal grafts in a synovial fluid environment and also the stimulating effect of continuous passive motion on periosteal neochondrogenesis. PMID- 6490701 TI - Comparison of osteotomy healing under external fixation devices with different stiffness characteristics. AB - The aim of this study was to investigate the effect of the rigidity of external fixation on osteotomy healing based on radiographic, morphological, histological, and biomechanical analyses of canine tibial osteotomies treated with more rigid (six half-pins) and less rigid (four half-pins) unilateral external fixators. Successful healing was obtained in all tibiae, but the bone-healing mechanisms appeared to be different depending on the rigidity of the device used. On the side with more rigid fixation, early clinical union was observed thirty days after osteotomy. Periosteal callus formation was significantly increased on the less rigidly fixed side at both ninety and 120 days (p less than 0.05). Fixation stiffness was found to affect the incidence of pin loosening (p less than 0.01) and of bone porosity (p less than 0.05) at the osteotomy site. However, new-bone formation and the structural strength of the bone were not significantly different between the four-pin and six-pin sides. These results seem to indicate that a longer period is required for fracture repair and remodeling when external fixation with less rigidity is used. PMID- 6490702 TI - Centrifugation as a method of improving tensile and fatigue properties of acrylic bone cement. AB - In this study centrifugation dramatically reduced the porosity and substantially increased the mechanical properties of bone cement. Monotonic tensile tests to failure of centrifuged specimens of cement demonstrated an increase of 24 per cent in the mean ultimate tensile strength compared with the control value. Mean ultimate tensile strain was improved by 54 per cent. In fully reversed tension compression fatigue-testing, centrifugation resulted in a mean increase in fatigue life of 136 per cent. These strong advantages in mechanical properties were obtained without any detrimental changes. There was no change in elastic modulus, setting time, or peak temperature. Handling properties were improved. There was no increase in systemic toxicity as demonstrated in dogs by assessment of arterial blood-pressure response and peak levels of monomer in the serum during simulated total hip arthroplasty. We also present a practical system of cement centrifugation and delivery that is suitable for use in the operating room. PMID- 6490703 TI - Stereological studies on the epiphyseal growth plate in strontium-induced rickets. With special reference to the distribution of matrix vesicles. AB - Applying stereological principles, we recently demonstrated a matrix-vesicle distribution between the zones of the epiphyseal growth plate that is at variance with the generally accepted distribution. In the present study of strontium induced rickets we demonstrated a similar bimodal distribution, the highest matrix-vesicle volume fraction being found in the resting and hypertrophic zones and the lowest, in the proliferative zone. These volume-fraction differences are due to differences in the number of vesicles between zones, the variation in mean diameter being rather small. The disturbed mineralization in strontium-induced rickets is associated with a diminished reduction of the matrix-vesicle volume fraction in the lower part of the growth plate compared with normal animals. The findings may indicate that matrix-vesicle removal is a part of the mineralization process, but a causal connection cannot be proved on the basis of our results. Our findings are, however, compatible with the earlier-posed cell-debris theory for matrix-vesicle origin and distribution. PMID- 6490704 TI - A dynamic canine model of experimental hip dysplasia. Gross and histological pathology, and the effect of position of immobilization on capital femoral epiphyseal blood flow. AB - We produced a dynamic model of experimental hip dysplasia in growing puppies by cast immobilization of a single hind leg with the knee in extension. Serial roentgenographic studies demonstrated a progressive acetabular dysplasia with subluxation and eventually dislocation of the femoral head. A consistent finding in the dysplastic hip was significant hypertrophy of the ligamentum capitum femoris, both in length and in cross-sectional area. Quantitative studies of blood flow in the femoral head by the hydrogen-washout technique in normal and dysplastic hips demonstrated a significant decrease in blood flow to the dysplastic femoral heads. The dysplastic hips were then placed in various positions of immobilization and blood-flow determinations were repeated. The position of forced abduction significantly reduced circulation in the femoral head, whereas immobilization in flexion consistently resulted in the highest rate of blood flow in the femoral head. These experimental data indicate the potential ischemic hazards of immobilization in the forced abducted position in the treatment of congenital dislocation of the hip. Progressive degenerative changes developed in the articular cartilage of the dislocated joint, with severe reduction of safranin-O staining, fibrocartilaginous metaplasia, and hypocellularity. The degenerative changes in the acetabular cartilage were more severe than those in the femoral head. These findings further emphasize the importance of reducing the dislocated hip at the earliest opportunity in order to prevent irreversible degenerative changes. PMID- 6490705 TI - Mineral parameters in early fracture repair. AB - In an effort to define and characterize the initial mineralization product of fracture-healing, we studied the mineral components within a model of endochondral osseous repair. Fracture calluses from the tibiae of rats and rabbits undergoing endochondral fracture-healing were analyzed, in toto and following density fractionation, by physicochemical and crystallographic techniques. Significant changes in mineral composition, crystal size, and density occurred in the early phases of fracture repair. In the rat, two weeks after fracture, the calcium-to-phosphorus ratio was higher than that of the mineral component, possibly due to calcium-binding to some of the macromolecules known to be present. The earliest mineral was poorly crystallized hydroxyapatite with a high carbonate content. Crystal perfection improved rapidly and approached that of normal diaphyseal bone within eight weeks after endochondral fracture in both the rabbit and the rat. PMID- 6490706 TI - Rupture of the patellar ligament after use of its central third for anterior cruciate reconstruction. A report of two cases. PMID- 6490707 TI - Bilateral fracture-dislocation of the sacrum. A case report. PMID- 6490708 TI - Locking of the thumb at the interphalangeal joint by one of the sesamoid bones. A case report. PMID- 6490709 TI - Cervical myelopathy in pseudogout. Case report. PMID- 6490710 TI - Fracture of the coronoid process requiring open reduction with internal fixation. A case report. PMID- 6490711 TI - Occult intraspinal anomalies and congenital scoliosis. PMID- 6490712 TI - Instability of the distal tibiofibular syndesmosis after bimalleolar and trimalleolar ankle fractures. PMID- 6490713 TI - Rotator cuff tears associated with os acromiale. PMID- 6490714 TI - Toxic shock syndrome as a complication of orthopedic surgery. PMID- 6490715 TI - Temporal sequence and spatial distribution of early events of fertilization in single sea urchin eggs. AB - Measurements and observations of five early events of fertilization, singly and in pairs, from single sea urchin eggs have revealed the precise temporal sequence and spatial distribution of these events. In the Arbacia punctulata egg, a wave of surface contraction occurs coincident with membrane depolarization (t = 0). These two earliest events are followed by the onset of a rapid, propagated increase in cytoplasmic-free calcium at approximately 23 s as measured by calcium aequorin luminescence. The luminescence reaches its peak value by 40 s after the membrane depolarization. The luminescence remains uniformly elevated for some time before its decay over several minutes. The onset of an increase in the pyridine nucleotide (NAD(P)H) fluorescence follows the membrane depolarization at approximately 51 s. The fertilization membrane begins its elevation in a wave like fashion coincidentally with the increase in NAD(P)H fluorescence. Similar results are observed in the Lytechinus variegatus egg. The results suggest that while the increase in cytoplasmic-free calcium may be important for many changes occurring in the egg, the elevated-free calcium is not directly responsible for the propagated wave of cortical granule exocytosis. PMID- 6490716 TI - Heparin and related glycosaminoglycans modulate the secretory phenotype of vascular smooth muscle cells. AB - Previous studies have established a role for heparin-like molecules in the regulation of vascular smooth muscle cell growth and migration in vitro. We present data indicating that the secretory phenotype of cultured rat aortic smooth muscle cells can be modulated by exogenous soluble heparin, heparan sulfate, and dermatan sulfate glycosaminoglycans. In the presence of these molecules, smooth muscle cells secrete increased amounts of two noncollagenous proteins (Mr 37,000 and 39,000). This effect can be mimicked by iota carrageenan and dextran sulfate but not by hyaluronic acid, chondroitin-4-sulfate, or chondroitin-6-sulfate. The inductive effect of heparin was dose-dependent and occurred rapidly (within 1 h) with maximal induction (three- to fivefold over controls) occurring after 10-12 h of treatment. The effect was rapidly reversible (within 1 h) and was not altered in the presence of actinomycin D, suggesting regulation at a posttranscriptional level. These data indicate that the biosynthetic expression of specific smooth muscle cell proteins may be determined, at least in part, by components of the smooth muscle cell extracellular matrix. PMID- 6490717 TI - Axonal tubulin and axonal microtubules: biochemical evidence for cold stability. AB - Nerve extracts containing tubulin labeled by axonal transport were analyzed by electrophoresis and differential extraction. We found that a substantial fraction of the tubulin in the axons of the retinal ganglion cell of guinea pigs is not solubilized by conventional methods for preparation of microtubules from whole brain. In two-dimensional polyacrylamide gel electrophoresis this cold-insoluble tubulin was biochemically distinct from tubulin obtained from whole brain microtubules prepared by cold cycling. Cleveland peptide maps also indicated some differences between the cold-extractable and cold-insoluble tubulins. The demonstration of cold-insoluble tubulin that is specifically axonal in origin permits consideration of the physiological role of cold-insoluble tubulin in a specific cellular structure. It appears likely that much of this material is in the form of cold-stable microtubules. We propose that the physiological role of cold-insoluble tubulin in the axon may be associated with the regulation of the axonal microtubule complexes in neurons. PMID- 6490718 TI - Sequence of a highly divergent beta tubulin gene reveals regional heterogeneity in the beta tubulin polypeptide. AB - The nucleotide sequence of a chicken genomic DNA segment containing the chicken beta 4 tubulin gene has been determined. The predicted amino acid sequence of beta 4 is surprisingly divergent from that of the chicken beta 2 gene that encodes the dominant neural beta tubulin. beta 4 differs from beta 2 at 36 residue positions and encodes a polypeptide that is four amino acids longer, yielding a divergence of 8.9% between the two beta tubulin isotypes. While many of the amino acid substitutions are conservative, several involve significant alteration in the physiochemical properties of the residue. Furthermore, the amino acid substitution positions are not randomly located within the primary sequence but are distinctly clustered: major divergence occurs in the carboxy terminal region beyond residue 430 and within the second protein coding exon segments of the genes. In addition, large regions of absolute sequence conservation are also present. Certain sequences within the heterogeneous regions are conserved in other species, indicating that these regions are under positive evolutionary selection pressure and are therefore probably essential for some aspect of beta-tubulin function. These findings strongly suggest that regional amino acid sequence heterogeneity may play an important role in the establishment of functionally differentiated beta tubulin polypeptides. PMID- 6490719 TI - Chemokinetic accumulation of human neutrophils on immune complex-coated substrata: analysis at a boundary. AB - The locomotory behavior of human blood neutrophil leukocytes was studied at a boundary between two surfaces with different chemokinetic properties. This was achieved by time-lapse cinematography of neutrophils moving on coverslips coated with BSA, then part-coated with immune complexes by adding anti-BSA IgG with a straight-line boundary between the BSA and the immune complexes. Cell locomotion was filmed in microscopic fields bisected by the boundary, and kinetic behavior was assessed by comparing speed (orthokinesis), turning behavior (klinokinesis), and the rate of diffusion of the cells on each side of the boundary, using a recently described mathematical analysis of kinesis. In the absence of serum or complement, the proportion of motile cells and their speed and rate of diffusion were greater on BSA than on antiBSA, but there was no consistent difference in turning behavior between cells on the two surfaces. The immune complexes were therefore negatively chemokinetic in comparison with BSA, and this resulted from a negative orthokinesis with little or no contribution from klinokinesis. As would be predicted theoretically, this resulted in gradual accumulation of cells on the immune complexes even in the absence of a chemotactic factor. In further studies, a parallel plate flow chamber was used to show that, under conditions of flow, neutrophils accumulated much more rapidly on a surface coated with BSA-anti BSA than on BSA alone. Moreover, neutrophils on immune complex-coated surfaces lost their ability to form rosettes with IgG-coated erythrocytes. This suggests that neutrophils on immune complex-coated surfaces redistribute their Fc receptors (RFc gamma) to the under surface, and that the lowered speed of locomotion is due to tethering of neutrophils by substratum-bound IgG-Fc. PMID- 6490720 TI - Spatial distribution of DNA loop attachment and replicational sites in the nuclear matrix. AB - Biochemical fractionation was combined with high resolution electron microscopic autoradiography to study the localization in rat liver nuclear matrix of attached DNA fragments, in vivo replicated DNA, and in vitro synthesized DNA. In particular, we determined the distribution of these DNA components with the peripheral nuclear lamina versus more internally localized structural elements of isolated nuclear matrix. Autoradiography demonstrated that the bulk of in vivo newly replicated DNA associated with the nuclear matrix (71%) was found within internal matrix regions. A similar interior localization was observed in isolated nuclei and in situ in whole liver tissue. Likewise, isolated nuclear lamina contained only a small amount (12%) of the total matrix-bound, newly replicated DNA. The structural localization of matrix-bound DNA fragments was examined following long-term in vivo labeling of the DNA. The radioactive DNA fragments were found predominantly within interior regions of the matrix structure (77%), and isolated nuclear lamina contained less than 15% of the total nuclear matrix associated DNA. Most of the endogenous DNA template sites for the replicative enzyme DNA polymerase alpha (approximately 70%) were also sequestered within interior regions of the matrix. In contrast, a majority of the endogenous DNA template sites for DNA polymerase beta (a presumptive repair enzyme) were closely associated with the peripheral nuclear lamina. A similar spatial distribution for both polymerase activities was measured in isolated nuclei before matrix fractionation. Furthermore, isolated nuclear lamina contained only a small proportion of total matrix-bound DNA polymerase alpha endogenous and exogenous template activities (3-12%), but a considerable amount of the corresponding beta polymerase activities (47-52%). Our results support the hypothesis that DNA loops are both anchored and replicated at nuclear matrix-bound sites that are predominantly but not exclusively associated with interior components of the matrix structure. Our results also suggest that the sites of nuclear DNA polymerase beta-driven DNA synthesis are uniquely sequestered within the characteristic peripheral heterochromatin shell and associated nuclear envelope structure, where they may potentially participate in DNA repair and/or replicative functions. PMID- 6490721 TI - Early synthesis of specific cytoplasm proteins is correlated with the rate of exit of lymphocytes from the resting state. AB - We investigated the initiation of synthesis of proteins in human lymphocytes exposed to the mitogen phytohemagglutinin (PHA) for 6 h. Radiolabeled proteins in three subcellular fractions, cytoplasmic, nuclear salt wash, and nuclear, were separated on polyacrylamide gels. Compared with cells incubated for the same time in the absence of PHA only two cytoplasmic proteins of Mr 51 and 60 kd showed increased synthesis in a dose-dependent fashion. Synthesis of the 60-kd protein shows the strongest correlation with rate of entry into the first S phase and with rate of cellular aggregation. Thus, the 60-kd protein appears to be a major early response-associated protein for entry of lymphocytes into the first S phase after PHA stimulation. PMID- 6490722 TI - Biologically active synthetic peptides as probes of embryonic development: a competitive peptide inhibitor of fibronectin function inhibits gastrulation in amphibian embryos and neural crest cell migration in avian embryos. AB - We describe a new method for analyzing embryonic events dependent on a specific peptide recognition signal. A short, specific amino acid sequence in fibronectin has been implicated as a recognition site in fibronectin-mediated interactions. Fibroblast adhesion to fibronectin is competitively inhibited by certain synthetic peptides, including the decapeptide Arg-Gly-Asp-Ser-Pro-Ala-Ser-Ser-Lys Pro, which appears to contain the cell recognition sequence. We found that this peptide inhibited both amphibian gastrulation and avian neural crest cell migration in vivo, as well as the attachment and migration of neural crest cells in vitro. These processes are major cell migratory events previously suggested to involve fibronectin. Negative controls included another conserved fibronectin peptide from the collagen-binding region containing the sequence Cys-Gln-Asp-Ser Glu-Thr-Arg-Thr-Phe-Tyr and another peptide. Our results demonstrate the feasibility of using synthetic peptides directed at recognition sites in extracellular proteins as probes of morphogenetic processes, and they provide further support for the hypothesis that fibronectin is involved in gastrulation and neural crest cell migration. PMID- 6490723 TI - Normal basal laminas are realized on dystrophic Schwann cells in dystrophic in equilibrium shiverer chimera nerves. AB - Multiple discontinuities are observed in the basal laminas of Schwann cells in mature dystrophic mice. To explore the pathogenesis of this abnormality we have exploited a dystrophic in equilibrium shiverer mouse chimera preparation in which both the basal lamina phenotype and the genotype of myelin-forming Schwann cells can be determined. If the basal lamina abnormality were to arise from an intrinsic deficiency of the dystrophic Schwann cell itself, only those Schwann cells of dystrophic genotype could express the mutant phenotype, whereas the coexisting population of shiverer Schwann cells should express typically normal basal laminas. No such distinction was observed; rather both dystrophic and shiverer Schwann cells were found to express relatively normal basal laminas and two pathogenetic mechanisms remain theoretical possibilities. The dystrophic Schwann cell population may be intrinsically defective but also may be rescued by obtaining the normal product of the dy locus synthesized by the coexisting shiverer cells. Alternatively, an extra Schwann cell deficiency existing within dystrophic mice may be normalized by shiverer cells and the normal intrinsic potential of both dystrophic and shiverer Schwann cells can then be realized. Regardless of the exact mechanism underlying these findings, some extracellularly mediated influence, emanating in vivo from shiverer cells, is capable of ameliorating the basal lamina deficiency typically expressed by dystrophic Schwann cells. PMID- 6490725 TI - Calcium transients during early development in single starfish (Asterias forbesi) oocytes. AB - Maturation and fertilization of the starfish oocyte are putative calcium dependent events. We have investigated the spatial distribution and temporal dynamics of this calcium dependence in single oocytes of Asterias forbesi. We used the calcium photoprotein, aequorin, in conjunction with a microscope photomultiplier and microscope-image intensifier. Surprisingly, in contrast to earlier work with Marasthenias glacialis, there is no detectable increase in intracellular-free calcium in the oocyte of A. forbesi in response to the maturation hormone 1-methyl adenine. During fertilization of the same, matured, A. forbesi oocyte there is a large increase in intracellular-free calcium. The calcium concentration increases to approximately 1 microM at the point of insemination and the region of elevated free calcium expands across the oocyte in approximately 20 s (17-19 degrees C). After the entire oocyte reaches an elevated concentration of free calcium, the concentration decreases uniformly throughout the oocyte over the next several minutes. PMID- 6490726 TI - An in vitro clonal assay of adherent stem cells (ASC) in mouse marrow. AB - Hematopoietic stem cells with high proliferative capacity can be assayed when stromal bone marrow cultures are overlaid with limiting dilutions of marrow samples. This leads to hematopoietic growth after 4 weeks in a fraction of cultures, consistent with expectations based on Poisson statistics. It will be shown that monoclonal cultures are obtained that last from 2 to 15 weeks and that can generate up to several million mature granulocytes. The originating clone forming cell is named adherent stem cell (ASC) because of its adherence to plastic or stromal surfaces. The ASC is comparable to the CFU-S in frequency, proliferative capacity and in its ability to give rise to CFU-S. As an unexpected additional finding we report that a mode of "clonal succession" was apparent in cultures which expressed more than one clone. PMID- 6490727 TI - Pig reticulocytes. V. Development of Rb+ influx during in vitro maturation. AB - Influx of the K+ analogue Rb+ was measured through the ouabain-sensitive Na+/K+ pump and the ouabain-insensitive "leak" pathways in Cl- or NO3- in mature red cells from adult pigs and in reticulocytes naturally occurring in 7-day-old piglets. In reticulocytes, Rb+ influxes by the two pathways were of about equal magnitude in Cl- (13 and 10 mmoles/liter cells X hr) and at least 25-fold larger than in mature red cells (0.5 and 0.4 mmoles/liter cells X hr). In Na+ media, a portion of the ouabain-insensitive "leak" flux of Rb+ was Cl(-)-dependent (Rb+Cl- transport) as NO3- replacement reduced Rb+ influx by 90% in reticulocytes and by 40% in mature red cells. The sulfhydryl reagent N-ethylmaleimide (NEM) stimulated Rb+Cl- transport about twofold in reticulocytes and up to 13-fold in mature red cells. When reticulocytes matured to erythrocytes during in vitro incubation, about 90% of both ouabain-sensitive Rb+ pump and ouabain-insensitive Rb+Cl- influx were lost. In contrast, the NEM-stimulated Rb+Cl- transport changed much less throughout this period, suggesting an entity operationally but not necessarily structurally distinct from the basal Rb+Cl- transport. Although the experimental variability precluded a full assessment of significant changes in the small Na+/K+ (Rb+) pump and Rb+Cl- fluxes in mature pig red cells kept for the same time period in vitro, Rb+ flux changes in reticulocytes appear to be maturational in nature, reflecting parallel activity transitions of Na+/K+ pump and Cl(-)-dependent K+ fluxes in vivo. PMID- 6490724 TI - ATP-dependent movement of myosin in vitro: characterization of a quantitative assay. AB - Sheetz and Spudich (1983, Nature (Lond.), 303:31-35) showed that ATP-dependent movement of myosin along actin filaments can be measured in vitro using myosin coated beads and oriented actin cables from Nitella. To establish this in vitro movement as a quantitative assay and to understand better the basis for the movement, we have defined the factors that affect the myosin-bead velocity. Beads coated with skeletal muscle myosin move at a rate of 2-6 micron/s, depending on the myosin preparation. This velocity is independent of myosin concentration on the bead surface for concentrations above a critical value (approximately 20 micrograms myosin/2.5 X 10(9) beads of 1 micron in diameter). Movement is optimal between pH 6.8 and 7.5, at KCl concentrations less than 70 mM, at ATP concentrations greater than 0.1 mM, and at Mg2+ concentrations between 2 and 6 mM. From the temperature dependence of bead velocity, we calculate activation energies of 90 kJ/mol below 22 degrees C and 40 kJ/mol above 22 degrees C. Different myosin species move at their own characteristic velocities, and these velocities are proportional to their actin-activated ATPase activities. Further, the velocities of beads coated with smooth or skeletal muscle myosin correlate well with the known in vivo rates of myosin movement along actin filaments in these muscles. This in vitro assay, therefore, provides a rapid, reproducible method for quantitating the ATP-dependent movement of myosin molecules on actin. PMID- 6490728 TI - Flexible association of hemopoietic differentiation programs in multilineage colonies. AB - Pluripotent hemopoietic progenitors lose potentialities during the process of differentiation. We have examined events that lead to lineage restriction by determining the cellular composition of 785 multilineage colonies grown from peripheral blood samples of glucose-6-phosphate-dehydrogenase (G-6-PD) heterozygous volunteers. Of these colonies, 762 contained only one isoenzyme type and were considered to be of clonal origin. A considerable heterogeneity was observed. Some colonies were composed of cells belonging to two different lineages, while other colonies contained three or more different cell types. A small number of colonies consisted--in addition to myeloid cells--of T lymphocytes. The variable association within individual colonies of members belonging to different hemopoietic lineages suggests a flexible determination and expression of differentiation programs by early progenitors. PMID- 6490729 TI - Regulation of production of a platelet-derived growth factor-like protein by cultured bovine aortic endothelial cells. AB - Platelet-derived growth factor (PDGF) is a potent mitogen for cultured cells of mesenchymal origin. Known sources of PDGF or PDGF-like protein are blood platelets, several transformed cell lines, and cultured endothelial cells (EC). We have examined the regulation of production of a PDGF-like protein in cultures of bovine aortic EC using a specific radioreceptor assay for PDGF. EC constitutively secreted PDGF-like protein into serum-containing or serum-free medium. The rate of production of PDGF-like protein was constant for at least 3 weeks and was not due to release of an internal store, since cell lysis by repeated freeze/thaw cycles did not release significant amounts of the protein. Synthesis of PDGF-like protein was sensitive to changes in the pH of the media and was maximal at pH 8.5. Production of PDGF-like protein was independent of EC growth rate: rapidly dividing cells and confluent, quiescent cells produced equal amounts per cell. However, sparse, quiescent EC produced more PDGF-like protein per cell than did confluent, quiescent cells. Several phorbol esters stimulated production of PDGF-like protein. At a concentration of 10(-6) M, a twofold stimulation was observed upon addition of the tumor promoter 12-O tetradecanoylphorbol 13-acetate (TPA) and nearly a fourfold stimulation upon addition of the nonpromoting analog, methyl TPA. Incubation of EC with endotoxin (10 micrograms/ml) resulted in a twofold stimulation of PDGF-like protein production. In all experiments with endotoxin and phorbol esters, an increase in the production of PDGF-like protein was accompanied by morphological changes in the EC cultures. The cells appeared elongated and fibroblastic and exhibited low viability. A mathematical model was developed in which PDGF-like protein production was shown to consist of two separate components--production at a constant rate by healthy cells and a large burst of synthesis and secretion by dying cells. These results suggest that injurious agents may be capable of stimulating production of a growth factor by the endothelium. PMID- 6490730 TI - A cloning assay for 6-thioguanine resistance provides evidence against certain somatic mutational theories of aging. AB - The frequencies of 6-thioguanine-resistant primary clones from the kidneys and skeletal muscles of aging male cohorts of two F1 hybrid strains of Mus musculus varied from 0.59 to 10.96 X 10(-5) and did not increase as a function of donor age (up to 40 months). Resistant clones were shown to be severely deficient in the activity of hypoxanthine-guanine phosphoribosyltransferase (EC 2.4.2.8). These deficiencies presumably resulted from molecular alterations at this X linked locus, including point mutations. No alterations of the X-chromosome were observed at the level of the light microscope. These results are inconsistent with predictions of the intrinsic mutagenesis and protein synthesis error catastrophe theories of aging. They do not rule out, however, somatic mutational theories that invoke comparatively large-scale chromosomal lesions, many of which would be likely to be lethal at the cellular level. PMID- 6490731 TI - Control of DNA synthesis in polyploid mammalian cells. AB - To test the hypothesis that the duration of DNA synthesis is an inverse function of nuclear size or DNA content, the S phase was calculated from PLM analysis for pseudodiploid, tetraploid, and octaploid lines of Chinese hamster cells growing as a monolayer or in suspension. S phase times were found not to be significantly different between polyploid lines and the diploid lines from which they were derived, regardless of the conformation of the nucleus. There is no evidence, therefore, that would implicate the nuclear membrane, or nuclear surface area/volume relationships, in the control of DNA synthesis. PMID- 6490732 TI - Acetylcholine receptors in monkey and rabbit oocytes. AB - Membrane potential responses to acetylcholine (ACh, 10(-7)-10(-3 M) were investigated in monkey and rabbit ovarian oocytes. In monkey oocytes ACh most commonly elicited a short-latency hyperpolarization concomitant with a decreased membrane input resistance (Rin). Under voltage-clamp short-latency ACh currents had an equilibrium potential of approximately -40 mV. In rabbit oocytes responses to ACh consisted of an increase in Rin or of a depolarization with an equilibrium potential of approximately -15 mV. Curare, hexamethonium, and atropine (10(-5) 10(-3) M) did not block these ACh responses. Thus, the oocyte membrane in the rabbit contains ACh receptors that cannot be classified as either muscarinic or nicotinic. PMID- 6490733 TI - Interferon inhibition of thymidine incorporation into DNA through effects on thymidine transport and uptake. AB - Replenishment of medium after 72 hr of growth of HeLa-S3 cells in dense suspension cultures increased [3H]-thymidine uptake into cells and incorporation into DNA, with the levels reaching a peak approximately 12 hr following medium change; beta interferon inhibits the enhanced uptake of [3H]-thymidine and labeling of DNA in a dose-dependent manner. Some reduction in these processes is observed at a concentration as low as 1 u/ml, and approximately 75% inhibition at 640 u/ml. Kinetic analysis has revealed that the rate of labeling of the acid soluble pool with [3H]-thymidine, measured either at 22 degrees C or 37 degrees C, is reduced in interferon-treated (640 u/ml, 24 hr) HeLa-S3 cells. At 22 degrees C, the initial rate of thymidine transport at a high (500 microM) thymidine concentration, determined within the first 30 sec of [3H]-thymidine addition was depressed by 44% in interferon-treated HeLa cells. At 37 degrees C, labeled precursors accumulate in acid-soluble material for approximately 8 min after the addition of [3H]-thymidine, after which an apparent equilibrium level is attained. At this temperature, the rate of thymidine uptake and the apparent equilibrium level attained were depressed by 70% in interferon-treated HeLa cells. The reduced incorporation of [3H]-thymidine into DNA in interferon-treated HeLa-S3 cells can be largely explained by interferon inhibition of thymidine transport and phosphorylation. PMID- 6490734 TI - Self-inhibition of chloride transport in Ehrlich ascites tumor cells. AB - Previous studies have shown that mediated Cl- transport which occurs by at least two processes (Cl- -dependent cation cotransport and Cl- self-exchange) becomes progressively inhibited when extracellular Cl- exceeds about 60 mM (Hoffmann et al., 1979). To account for this type of kinetic behavior, that is, self inhibition, an anion transport system possessing two sites, a high affinity transport site and a lower affinity modifier site is suggested (Dalmark, 1976). In the present experiments we have attempted to determine which of the mediated transport pathways is susceptible to self-inhibition by studying the dependence of the steady state Cl- flux on the extracellular Cl- concentration and how DIDS, an inhibitor of Cl- self-exchange, and H + affect this relationship. Addition of DIDS to Ehrlich cells results in inhibition of Cl- transport at every Cl- concentration tested (40-150 mM). Moreover, the Cl- flux/Cl- concentration relationship no longer exhibits self-inhibition, suggesting that this phenomenon is a characteristic of the Cl- self-exchanger rather than of the Cl- -dependent cation cotransport system. Lowering the extracellular pH (pHo) from 7.35 to 5.30 stimulates Cl- transport by a process that saturates with respect to [H +]. Half maximal stimulation occurs at pHo 6.34. A comparison of the kinetic parameters, Ks and Jmax, calculated from the ascending limb of the Cl- flux/Cl- concentration curve at pHo 7.30 to those at pHo 5.50 show that the values for Ks are almost identical (23.6 mM and 21.3 mM, respectively), while the values for Jmax [22.2 mEq/Kg dry wt) X min] differ by only 15%. This finding along with the observation that DIDS completely blocks H + stimulation of Cl- transport is compatible with the suggestion that H + interact at the modifer site of the Cl- self-exchanger and thereby prevents self-inhibition. PMID- 6490735 TI - Loss of differentiating nematocytes induced by regeneration and wound healing in Hydra. AB - Cell death was observed in the nematocyte differentiation pathway in Hydra during head and foot regeneration. This death occurs throughout the regenerating piece, is transient in nature and is selective for committed stenotele and desmoneme precursors. Proliferating nematoblasts are unaffected. Cell death appears to be caused by release of a toxic factor rather than loss of a hormone required for differentiation, since regenerating pieces released a factor that inactivated differentiating nematocytes, and injured animals that had intact head and foot tissue also lost differentiating nematocytes. The inactivated nematocytes are removed by phagocytosis by epitheliomuscular cells. PMID- 6490736 TI - Alterations induced by glucose deprivation and tunicamycin in the kinetic parameters of hexose transport in hybrid cells. AB - Matched pairs of malignant and non-malignant hybrid cells were compared in their response to glucose deprivation and to tunicamycin. Glucose deprivation induced an increase in the maximum velocity in the malignant cells, but not in the non malignant cells. The Michaelis constant of hexose uptake was largely unchanged by glucose deprivation except in the case of one melanoma derivative, PG19 G-, which showed a large increase in Michaelis constant when deprived of glucose. Tunicamycin increased the Michaelis constant of hexose uptake in both malignant and non-malignant cell lines. It is therefore possible that the Michaelis constant of hexose uptake is affected by the extent of glycosylation of one or more of the cell membrane glycoproteins. PMID- 6490737 TI - The three-dimensional structure of the cell wall glycoprotein of Chlorogonium elongatum. AB - The green alga Chlorogonium elongatum, a member of the Volvocales, possesses a crystalline cell wall composed of hydroxyproline-rich glycoprotein similar to the primary cell wall glycoproteins of higher plants. Electron microscopy and computer image processing have been used to determine the crystal structure of the Chlorogonium cell wall in three dimensions to a resolution of 2.0 nm. The structure is composed of heterologous dimers. Each subunit of the dimer comprises a long, thin spacer domain and a large globular domain, which is the site of the intra- and inter-dimer interactions. There are also sites of intersubunit interactions at the opposite ends of the rod domains. We suggest that the rods are composed predominantly of glycosylated polyproline helix, as has been suggested for higher plant cell wall glycoproteins and has been shown for the cell wall glycoprotein of Chlamydomonas reinhardtii, which is closely related to Chlorogonium. PMID- 6490738 TI - Resistance of mouse lymphoma L5178YAII cells to alkylation with methylmethane sulphonate resides in a late step of excision repair. AB - The mutant mouse lymphoma cell line (L5178YAII), resistant to X-rays, ultraviolet light and alkylating agents, was reinvestigated in an attempt to establish the nature of the mutation. These cells were compared with P388 mouse lymphoma cells, which exhibit normal sensitivity to these mutagens. A series of studies was conducted to compare DNA alkylation and strand breakage with cell survival after exposure of the two cell lines to methylmethane sulphonate. It was found that neither the degree of alkylation nor the removal of the common alkylation products was correlated with the different sensitivities observed in these cell lines. A correlation was established between cell killing and the production of long-lived strand breaks. P388 cells were found to accumulate twice as many long lived strand breaks compared to L5178YAII cells, at equal levels of alkylation. This suggested that long-lived strand breaks were the major toxic lesions. Further experiments indicated that these long-lived strand breaks were produced by a process consistent with excision repair. Evidence is also presented that indicates that the mutation in L5178YAII cells that is responsible for their resistance may occur in ligase activity or its associated ADP-ribosyl transferase system. PMID- 6490740 TI - Altered labelling of the cell surface and intracellular organelles with [3H]mannose in enucleated amoebae. AB - The production, transport, and disposition of material labelled with [3H]mannose were studied in microsurgically enucleated and control amoebae. Cells were injected with the precursor and samples were prepared for electron-microscope radioautography at intervals, up to 24 h later. Control cells showed heavy labelling of the rough endoplasmic reticulum and the Golgi apparatus at early intervals after injection. Later, labelling of groups of small vesicles increased, and the percentage of grains over the cell surface peaked 12 h after administration of the precursor. Two major changes were detected in enucleate amoebae. First, the kinetics of labelling of cell organelles with [3H]mannose were altered in the absence of the nucleus. The Golgi apparatus and cell surface both displayed maximal labelling at later intervals in enucleates, and the percentage of grains over the rough endoplasmic reticulum varied less with time in enucleated than in control cells. Second, the distribution of radioactivity was altered. A greater percentage of grains was associated with lysosomes in enucleates than in control cells. The change in the kinetics of labelling of the endoplasmic reticulum, Golgi apparatus and cell surface indicates that intracellular transport of surface material was slower in the absence of the nucleus. It is suggested that this is related to the decreased motility of enucleate cells. PMID- 6490739 TI - Circus movements in dissociated cells from two new hybrid frog embryos. AB - Circus movements are a peculiar kind of cell movement, seen in many amphibian cells, that involve the formation of a hyaline protrusion from the cell surface and rotation of this blister around the circumference of the cell. Studies of cells from normal Rana pipiens embryos have shown a close correlation between circus movements in vitro and gastrulation related cell movements in vivo. Cells from two developmentally arrested hybrid embryos (R. pipiens female X R. sylvatica male and R. pipiens female X R. catesbiana male) are deficient in circus movements to an extent that corresponds to their gastrulation deficiencies. This study reports on the preparation of two new hybrids (R. pipiens female X R. temporaria male (temp) and R. pipiens female X R. clamitans male (clam)). Cells from temp embryos show some circus movements but the proportion of cells displaying such movements does not increase with increasing developmental age to the same extent as is seen in cells from normal embryos. Cells from clam embryos show very few circus movements at any developmental age. These aberrations in the onset and extent of circus movements are discussed in relation to characteristic morphogenetic events that occur in normal embryos and in these two new arrested hybrid embryos. PMID- 6490741 TI - A cell-cycle-phase-specific mutant of amoeba. AB - The treatment of Amoeba indica with ethylmethanesulphonate (EMS) at early S, late S and late G2 phases of the cell cycle leads to the production of mini amoeba cells in the G2 period. Among them, only a few of the mini cells that originated from EMS treatment at early S phase have been found to be viable and to give rise to stable clones. These mini amoebae show stable and altered characteristic features in cell size, structure, membrane properties, cell-cycle timing and the patterns of macromolecular syntheses as compared to the parental cells. It is suggested that the mini amoeba cell is a size mutant that has a cell-cycle-phase specific origin. The finding is discussed in relation to preferential mutagenic action involving the functional state of DNA leading to the production of viable mutant amoebae. PMID- 6490742 TI - In situ arrangement of nor-bearing chromosomes in the interphase nucleus of Aotus trivirgatus. AB - The spatial organization of the two nucleolus-organizing region (NOR)-bearing chromosomes during interphase was studied in Aotus trivirgatus fibroblasts, using nucleoli as ultrastructural markers. Their distribution was examined by measuring the distances between them in 30 reconstructed nuclei, and comparing these experimental values with the theoretical ones obtained by simulation. Results were as follows: (1) the nucleoli are arranged in a polarized manner inside the nucleus; (2) the nucleoli are tightly bound to the nuclear envelope at two opposites sites; (3) the distance between the two nucleoli is variable, and is shorter than it would be if the two nucleoli were distributed at random. These findings indicate that the NOR-bearing chromosomes are fixed at the nuclear envelope in two opposite areas. They are also consistent with the hypothesis that each chromosome occupies a separate domain inside the nucleus. They can be interpreted according to the model in which chromosome arrangement within the interphase nucleus is based on the separation of the diploid complement into two independent haploid sets. PMID- 6490743 TI - Membrane-substrate contact under the spermatozoon of Caenorhabditis elegans, a crawling cell that lacks filamentous actin. AB - Caenorhabditis elegans spermatozoa use a single, persistent pseudopod to crawl at about 20 micrometers/min but, unlike other types of crawling cells, sperm lack both filamentous actin and myosin. Interference reflection microscopy has revealed that sperm form broad grey areas of contact, analogous to the close contacts that have been described underneath other crawling eukaryotic cells, between their pseudopods and their substrate. Individual sperm change the size, shape and pattern of their substrate attachments as they crawl but we found no correlation between the extent of underside of the cell in contact with the substrate and the velocity of locomotion. Two predominant attachment patterns were observed: (1) a single broad contact extending from the front of the pseudopod nearly to the rear of the cell; and (2) two separate contact sites, one under the front of the pseudopod and one under the cell body. Occasionally, under cells exhibiting the second type of attachment pattern, portions of the anterior contact separated and remained stationary relative to the substrate while the cell moved forward. This observation, as well as the continuous change in shape of the contact areas, suggests that sperm continually form new contacts near the tip of the pseudopod and release these contacts backwards. In extreme cases, sperm were able to crawl with only the front of the pseudopod in contact with the substrate. Therefore, we propose that sperm locomotion depends on the interaction of several key events (traction, propulsion, membrane insertion) occurring at the leading edge of the pseudopod. PMID- 6490744 TI - Post-pollination callose development in ovules of Rhododendron and Ledum (Ericaceae): zygote special wall. AB - In Rhododendron spp. and Ledum groenlandicum a callose wall is laid down around the zygote in the first 2 days after fertilization. The periodic acid/Schiff positive, aniline blue-fluorescence-positive callosic wall is initiated adjacent to the degenerating synergid, extends to cover the entire zygote surface, and remains visible during the initiation of embryogeny as the zygote elongates before the first proembryonal division. Unfertilized ovules show eventual callose deposition in the ovule wall cells during senescence in undeveloped abscising pistils, but show no development of callose within the embryo sac. Possible roles of a zygote special callose wall are discussed. PMID- 6490745 TI - Division of peribacteroid membranes in root nodules of white clover. AB - Division of peribacteroid membranes in the cytoplasm of root nodules of white clover was found, from a study of serial thin sections prepared for electron microscopy, to accompany division of the bacteroids. It was also observed that the peribacteroid membranes appeared to have adhered to various sites on the surface of the bacteroid envelope outer membranes. Wherever peribacteroid membranes were constricted as though undergoing division in the region of the cleft formed by partial division of the bacteroids, these constrictions could be related to the point of adhesion of the peribacteroid membranes to the surface of the bacteroids within the cleft. It was concluded that adhesion of the peribacteroid membranes to the bacteroid envelope outer membranes is likely to be a critical element in the process of division of the peribacteroid membranes. Differences in the degree of adhesion between peribacteroid membranes and the bacteroid envelope outer membranes may explain variations in the number of bacteroids enclosed by peribacteroid membranes in nodules of different legumes. PMID- 6490746 TI - Control of cellular differentiation by temperature in the cellular slime mould Dictyostelium discoideum. AB - The effects of low temperature on morphogenesis and cellular differentiation of Dictyostelium discoideum were examined. During incubation at 5 degrees C, the vegetative and preaggregation cells never developed, but cell masses at the aggregation or slug stage developed to form hemispherical, or dumbbell-shaped multicellular structures. By staining with FITC-antispore IgG, the structures formed after 10 days of incubation of tipped aggregates at 5 degrees C were found to be composed of 90% spores, 5% prespore cells and 5% non-stained cells. Since only 20% of the total cells constituting the tipped aggregate had been prespore cells at the beginning of incubation, this showed that spore differentiation proceeded even at low temperature, while stalk differentiation was completely inhibited. Similar results were obtained when the cells were incubated at 3 degrees C. However, at 0 degree C, morphogenesis and cellular differentiation did not occur, although most of the prespore cells at the late culmination stage differentiated incompletely into spores. Possible reasons for the high proportion of spores being induced by low temperature are discussed. PMID- 6490747 TI - Protein synthesis and its relation to the DNA-division cycle in the fission yeast Schizosaccharomyces pombe. AB - The rate of protein synthesis has been measured with pulse labels of [3H]tryptophan in synchronous and asynchronous cultures of cdc mutants of Schizosaccharomyces pombe shifted up to the restrictive temperature. The cell cycle related fluctuations in rate that occur in normal synchronous cultures vanish when nuclear division is blocked in synchronous cultures of cdc2 and cdc10. But they persist in cdc11 where nuclear division continues and cleavage is stopped. We conclude that nuclear division affects the rate of synthesis and that this effect is inhibitory and probably persists for the last 40% of the cycle. When nuclear division has been blocked, the rate of synthesis continues to increase until a plateau is reached where the rate remains constant. Three size mutants of cdc2 reach the plateau at the same average protein content per cell although their initial protein contents vary over a threefold range. Comparison of these results with those from cdc10 leads to the tentative conclusion that the plateau starts when the cells reach a critical protein/DNA ratio. PMID- 6490748 TI - Mechanical stretching increases the number of epithelial cells synthesizing DNA in culture. AB - The influence of mechanical stretching on epithelial (E) cells was examined by culturing E cells derived from the epithelial cell rests of Malassez on a flexible plastic substrate and stretching the substrate by means of an orthodontic screw. A significant increase in the number of E cells synthesizing DNA was observed after just 30 min of stretching. In 17 experiments the ratio of cells labelled with tritiated thymidine in cultures stretched for 2 h to the number of labelled cells in unstretched controls was 1.92 +/- 0.34. An increase in labelling as a result of stretching was found for E cells cultured at either high or low cell-population densities but the effect was most pronounced for E cells cultured at higher concentrations of foetal bovine serum. Morphometric analysis of electron micrographs of stretched and unstretched cultures indicated that the stretched cultures had a higher volume fraction of filamentous structures and more desmosomes per unit length of cell membrane than unstretched cultures. The behaviour of E cells in response to stretching in vitro appears to be similar to the response of the epithelial rests in vivo when the latter are exposed to tension as a result of forces produced by orthodontic techniques. PMID- 6490749 TI - Septum pattern in ts mutants of Schizosaccharomyces pombe defective in genes cdc3, cdc4, cdc8 and cdc12. AB - Septum-defective mutants of Schizosaccharomyces pombe impaired in cdc genes 3, 4, 8 and 12 were compared by fluorescence microscopy, freeze-etching and ultrathin sectioning. This approach made it possible to recognize the internal organization of defective phenotypes under restrictive conditions. Of special interest in this study was the pattern of unusual septum malformations found to be regular features of the terminal phenotypes of the mutants. Their overall topology was visualized at the cellular level by primulin fluorescence. The subcellular location of septum defects was found to be identical in origin to the compartment where normal septum was assembled in the wild type. Delocalized septation involved both microfibrillar and matrix components, which participated in the final assembly of malformations. Unique contour views of delocalized septa were exposed by freeze-fracturing. Cytoplasmic microtubules and microfilaments were detected in ultrathin sections of the cytoplasm of mutant cells. The internal organization of malformation-accumulating phenotypes suggested a disruption of the directional mechanism that steers septum material to the periplasm at the cell equator. PMID- 6490750 TI - Ultrastructural morphometric of gap junctions during differentiation of stratified squamous epithelium. AB - The presence of gap junctions in stratified epithelia has now been extensively documented, but there have been few attempts to quantify them. In the present report, samples of hamster cheek pouch mucosa were processed for electron microscopy and electron micrographs from defined basal, spinous and granular layers were obtained. Using a combination of direct measurement and stereological intersection counting techniques, the relative surface areas of peripheral gap junctions (i.e. those in direct contact with the epithelial plasma membrane) and annular gap junctions (i.e. those present as complete, approximately circular profiles within the epithelial cell cytoplasm) were determined. Following estimation of the plasma membrane surface area of 'average' epithelial cells from each of the defined strata, relative values were transformed into absolute data. Data from peripheral and annular junctions were pooled to provide an estimate of total gap junctions area. Relative surface area estimates were similar for peripheral, annular and total gap junctions, in that values were invariably highest in the spinous layer and lowest in the granular layer. Absolute data indicate that there is more than a threefold increase in the area of membrane differentiated into gap junctions in the average spinous cell when compared with the average basal cell. Values for total gap-junctional areas in the average granular cell are reduced somewhat with respect to the average spinous cell and this is effected by a decrease in the area of peripheral gap junctions. We conclude that there is synthesis of gap junctions between basal and spinous cells, which is followed by evidence of degradation between spinous and granular cells. The magnitude of the estimates of area is comparable to those obtained from other stratified and non-stratified epithelia and it would thus appear that gap junctions may play a significant role in cellular control processes in all viable epithelial strata. PMID- 6490751 TI - Scintillation and autoradiographic studies on 63 nickel uptake in Pseudomonas tabaci. AB - Scintillation studies on the uptake of 63Ni2+ by Pseudomonas tabaci demonstrate an incorporation of approximately 2.5 nmol per 10(10) bacterial cells, in medium containing 12 nmol (8.3 microCi) per ml. Over 80% of the incorporated Ni2+ is lost from the cells during washing, fixation and dehydration with ethanol. The remaining insoluble (bound) 63Ni2+ has the highest level in cells fixed in acetic acid/ethanol (0.4 nmol/10(10) cells), with smarter amounts in paraformaldehyde- and glutaraldehyde-fixed cells. The radioactive level in aldehyde-fixed cells represents a total Ni2+ uptake of about 10(-18) g or 10(4) atoms per cell. Light- and electron-microscope autoradiography corroborated the scintillation studies in demonstrating a higher retention of label by cells fixed in acetic acid/ethanol, possibly reflecting a higher retention of medium Mr proteins with this type of fixation. High-resolution electron-microscope autoradiography involving gold latensification with physical development demonstrated a clear localization of silver grains to the central nucleoid region (seen most clearly over the discrete nucleoid of aldehyde-fixed cells) and within this to the chromatin (seen most clearly over the condensed chromatin of acetic acid/ethanol-fixed cells). It is suggested that the incorporated 63Ni2+ labels mainly central, genetically inactive DNA, while peripheral, actively transcribing DNA has little associated radioactivity. The pattern of cation association seen in this bacterium shows a number of close similarities to the situation seen in dinoflagellate cells. PMID- 6490753 TI - Use of high-performance liquid chromatography for preparing samples for microsequencing. AB - A method has been developed for the microsequencing of protein at subnanomole levels. The protein is carboxymethylated and freed of salts and reagents by reversed-phase chromatography prior to automated Edman degradation on a gas-phase sequencer. The carboxymethylated protein can also be fragmented chemically or enzymatically for further sequence analysis. The analytical techniques used to monitor the progress of the reactions all have picomole level sensitivity. PMID- 6490752 TI - Resolution of multiple forms of cytochrome P-450 by high-performance liquid chromatography. AB - The major forms of cytochrome P-450 in the hepatic microsomes of rats pretreated with phenobarbital (PB) or 3-methylcholanthrene (3MC) were isolated by sequential chromatography on n-octylamino-Sepharose 4B and DEAE-cellulose columns. These preparations exhibited single protein bands corresponding to cytochrome P-450s by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE). High performance liquid chromatography (HPLC) of these preparations on an anion exchange column yielded three peaks from the PB-induced major cytochrome P-450 and a single peak from the 3MC-induced major cytochrome P-450. That the HPLC isolated protein peaks were various forms of cytochrome P-450 was confirmed by spectral examination and sodium dodecyl sulphate-polyacrylamide gel electrophoresis. Examination of their absolute spectra revealed these cytochrome P-450s to be in a low-spin state. The lambda max of the reduced CO-complex spectra and molecular weights were found to be 450 nm and 53,000, respectively, for all the three HPLC-resolved cytochrome P-450s from PB-induced rats; and 448 nm and 56,000, respectively, for the HPLC-isolated cytochrome P-450 from 3MC induced rats. The results demonstrate the effectiveness of HPLC in the determination of cytochrome P-450 multiplicity and charge heterogeneity. PMID- 6490755 TI - Analysis and characterisation of aromatic amino acids, metabolites and peptides by rapid-scanning photodiode array detection in high-performance liquid chromatography. AB - The role of rapid-scanning UV detectors based on the linear photodiode array has been examined in studies on the chromatography of aromatic amino acids, some metabolites and peptides. Multichannel detectors can generate characteristic qualitative information presented as individual spectra, as three-dimensional spectrochromatograms or as contour maps in the (lambda, t) plane. The use of such contour plots for mapping amino acids and their metabolites, and for peptide mapping Tyr-Gly, Gly-Tyr, Phe-Gly, Tyr-Tyr and Phe-Val, is examined. The application of computer-aided methods for validating peak homogeneity by spectral suppression, second derivative in the time domain and by other methods is discussed with respect to Tyr and its metabolite dopamine, which are not resolved by the system described, and which have closely similar spectral characteristics. The use of colour graphics with the IBM Personal Computer is demonstrated for simplifying the presentation of contour maps of amino acids, metabolites and dipeptides. PMID- 6490754 TI - Partial purification of a membrane glycoprotein antigen by high-pressure size exclusion chromatography without loss of antigenicity. AB - A high-pressure size exclusion chromatography system eluted with phosphate saline buffer containing 0.25% sodium deoxycholate has been developed that fractionates both soluble and membrane glycoproteins with good resolution and molecular weight versus elution time relationship. Using this system we fractionated membrane glycoproteins from a mutagenized mastocytoma cell that carries a strong transplantation antigen. After dialysis to remove the detergent, the fractions were tested for biological activity by an in vitro assay involving T-lymphocyte cell culture. Antigenic activity was found between 43 and 85 kdaltons. This demonstrates the efficiency of the system to resolve complex membrane protein samples without destroying their biological activity. PMID- 6490756 TI - High-performance liquid chromatography of amino acids, peptides and proteins. LVIII. Application of reversed-phase high-performance liquid chromatography to the separation of tyrosine-specific phosphorylated polypeptides related to human growth hormone. AB - Procedures for the purification of native and phosphorylated human growth hormone (hGH), S-carboxymethylated hGH, and hGH tryptic peptides, based exclusively on reversed-phase chromatography have been developed. Combinations of several volatile ion-pairing systems with small- and large-pore n-alkylsilicas were exploited in a general strategy, which allowed high recoveries of various hGH related polypeptides from enzymatic incubations, as well as rapid desalting of samples following chemical modifications of the native protein, such as reductive alkylation in 6 M guanidine hydrochloride. The influence of the elution conditions on retention behaviour of phosphorylated hGH and its tryptic peptides in reversed-phase high-performance liquid chromatography is discussed. PMID- 6490757 TI - Determination of neuropeptides in discrete regions of the rat brain by high performance liquid chromatography with electrochemical detection. AB - High-performance liquid chromatography (HPLC) in combination with electrochemical detection (ED) is suitable for measuring accurately the levels of oxidizable neuropeptides in small samples of brain tissue. We have determined by HPLC-ED and a two-column-switching technique the levels of leucine- and methione-enkephalin in rat brain. By a sequential two-column HPLC-ED method we have also determined the levels of cholecystokinin tetrapeptide and octapeptide sulphate in various regions of the rat brain. The values found are in good agreement with those reported previously based on radioimmunoassay. We conclude that, due to its simplicity, HPLC-ED is an attractive alternative to existing methods for the determination of some neuropeptides in biological material. PMID- 6490758 TI - Cluster analysis of chromatographic profiles of urine proteins. AB - A method to examine and classify the chromatograms of urinary proteins, separated on a fast protein liquid chromatography system, is presented. For the analyses a measure of similarity between chromatogram profiles is defined and this is used to implement a statistical cluster analysis technique for the identification of a system of classification. The resulting classification can be related to a clinical assessment of the proteinuria of the sample urines, which are from patients with various renal disorders. PMID- 6490759 TI - Measurement of enkephalin peptides in canine brain regions, teeth, and cerebrospinal fluid with high-performance liquid chromatography and mass spectrometry. AB - Endogenous enkephalin pentapeptides are measured with unambiguous molecular specificity in canine and human tissue and fluid extracts. Both field desorption and fast atom bombardment mass spectrometry have been used to produce a protonated molecular ion of the peptide high-performance liquid chromatography fraction. The protonated molecular ion is subjected to collision-activated dissociation processes and a linked-field scan (B/E) selects a unique amino acid sequence-determining ion for monitoring and measurement. Stable isotope incorporated peptide internal standards are used for quantification. Endogenous enkephalins are measured in hypothalamus, cerebrospinal fluid, pituitary, caudate nucleus, and tooth pulp extracts. Part-per-billion levels of endogenous peptide are measured. PMID- 6490760 TI - Reaction detector system for the simultaneous monitoring of primary amino groups and sulfhydryl groups in peptides eluted by high-performance liquid chromatography. AB - A reaction detector system is described which can be used for simultaneous analysis of primary amino groups and sulfhydryl groups in peptides separated by high-performance liquid chromatography. By use of an automatic split valve system, well-defined portions of the effluent are diverted alternately into one of the two reaction detectors, based on the ninhydrin and Ellman assay, respectively. In the latter case the dithioerythritol included in the elution buffers for thiol preservation is eliminated with arsenite. For selective recovery of eluted peptides the amino/thiol group analyser can easily be converted into a high-yield monitoring system compatible with volatile, UV-opaque gradient buffers. In this version an automatic sample valve is used for the thiol assay, removing picomole amounts of material from the effluent destined for collection. In preparative applications there is a progressive net gain in sensitivity with increasing proportion of collected material. Under conditions of optimum recovery ca. 90% of the material could be recovered at a total consumption in the two detectors of less than 100 pmol. Experimental conditions are described which would allow for the additional identification of tryptophan, tyrosine and lysine-containing peptides. The monitoring system may also be used without modification for the assessment of key residues in polypeptides and proteins. PMID- 6490761 TI - Analytical methodology for assays of serum tryptophan metabolites in control subjects and newly abstinent alcoholics: preliminary investigation by liquid chromatography with amperometric detection. AB - A rapid, isocratic assay for the determination of all major tryptophan metabolites in serum samples from control non-alcoholic subjects, recovered alcoholics and newly abstinent alcoholics is described. The sample preparation involves only precipitation of protein with sulfosalicylic acid. The complete liquid chromatographic analysis is short (25 min) and the sensitivity of amperometric detection permits the routine assessment of catabolites at the picogram level. This preliminary longitudinal study of the basal and post tryptophan load serum metabolites revealed a considerable scatter of experimental results for kynurenine and serotonin in all groups examined, probably owing to the clinical heterogeneity of the sample populations. PMID- 6490762 TI - High-performance chromatofocusing and size-exclusion chromatography: separation of human uterine estrogen-binding proteins. AB - We have employed high-performance chromatofocusing (HPCF) and high-performance size exclusion chromatography (HPSEC) to separate and identify radiolabelled estrogen binding proteins present in human uterine cytosol. Results obtained using these high-performance methods are compared to results of similar analyses by conventional isoelectric focusing procedures and open-column size exclusion chromatography. By HPCF, descending pH gradients (pH 8-4) allow us to discern four to five estrogen binding proteins with elution pH values typically between pH 4.5 and 7.2. However, when using HPCF, significant quantities of estrogen binding proteins are rarely detected between pH 7.2 and 8.0. This observation has been confirmed by open-column chromatofocusing of these proteins on Polybuffer Exchanger 94. In contrast, preparative isoelectric focusing by electrophoresis in polyampholytes reveals substantial quantities of estrogen binding activity eluted between pH 7.5 and 8.0. Several possible explanations for this disparity are discussed. Apparent differences are also observed when the size heterogeneity of estrogen binding proteins is analyzed simultaneously by size exclusion chromatography in open-column (Sephacryl S-300) and high-performance (TSK-3000SW) modes. HPSEC of these estrogen binding proteins on TSK-3000SW columns demonstrates a predominant 80-85 A species, whereas size exclusion chromatography on conventional Sephacryl S-300 columns reveals two to three distinct regions of estrogen binding proteins with Stokes radii of ca. 85, 60 and 30 A (major species). The larger form of receptor, whether a non-specific aggregate or a multisubunit complex, is stable in unfractionated cytosol and becomes more labile only during size exclusion chromatography. PMID- 6490763 TI - Isoforms of estrogen receptors by high-performance ion-exchange chromatography. AB - SynChropak AX-300, AX-500 and AX-1000 columns were used to separate ionic forms of estrogen receptors by high-performance ion-exchange chromatography. Cytosols from hormone-responsive tissues were incubated for 4-10 h with 3-4 nM [16 alpha 125I]iodoestradiol-17 beta, cleared of unbound ligand and applied to an anion exchange column. Components were eluted at pH 7.4 using a gradient of phosphate buffer at 4-6 degrees C. Non-specific binding components were identified by chromatographing, the identical cytosol, incubated with [125I]iodoestradiol and a 500-fold excess of diethylstilbestrol, which blocks specific binding sites. [125I]Iodoestradiol was applied to the column in the absence of cytosol and eluted normally to determine the behavior of free ligand. Each column exhibited a different elution pattern for the estrogen receptor. The various isoforms of estrogen receptor were eluted differently from each column usually in the 15-120 mM and 180-250 mM region of the gradient. Often one non-specific binding component was not retained whereas other non-specific species were retained and eluted from the column in a salt-dependent manner; their position in the gradient varied from column to column. Similarly, free [125I]iodoestradiol was eluted at different positions in the gradients, dependent upon which column was employed. In general, the high flow-rates, reproducibility, good recovery and the apparent differential selectivity of each of the columns appear valuable in the investigation of the nature and subunit composition of the estrogen receptor molecule. PMID- 6490764 TI - Rapid chromatographic quantitation of glycosylated haemoglobins. AB - We have developed a rapid chromatographic method for determination of glycosylated haemoglobins by high-performance liquid chromatography with a new cation-exchange column. The haemoglobins are eluted with a three-step gradient in 7 min, and total assay time including re-equilibration of the column is 15 min. The method permits separation and quantitation of HbAlc, even in the presence of elevated levels of HbF. HbA1a, A1b and A2 can also be determined. The results correlate well (r = 0.94) with those obtained by the macro-column method of Trivelli et al. [New Engl. J. Med., 284 (1971) 353] for determination of HbA1c. The method has been fully automated by the use of an automatic injector. The within-assay and between-assay coefficient of variation of the method is 2-3%. PMID- 6490765 TI - Separation of haemoglobins using a monodisperse cation exchanger. AB - In order to separate haemoglobin variants in one step, a chromatographic method using Mono S (Pharmacia) monodisperse cation exchanger was developed The separation of haemoglobins (A, S, E, D, C and F) on a short analytical column (50 X 5 mm I.D.) was accomplished in 30 min, including the regeneration, using linear buffer gradient elution (lithium chloride in 0.01 M sodium malonate, 0 to 100%). For haemoglobin A, two peaks, probably corresponding to different molecular forms, were found. This systematic double peak affected the recognition and the measurement of haemoglobins. By filling the test-tube with carbon monoxide before injecting the haemolysate, we obtained reproducible results with regard to both retention times and peak shape, and also great stability. The long-term stability and the high speed of the separation seem to be adequate for automation, making the method suitable for routine clinical laboratory-use. PMID- 6490766 TI - Glycosylated haemoglobin: high-performance liquid chromatographic determination of 5-(hydroxymethyl)-2-furfuraldehyde after haemoglobin hydrolysis. AB - A specific and accurate method for the quantitation of the azomethine linkage present in non-enzymatically glycosylated haemoglobin is described. This protein is hydrolysed for 5 h in 1 M oxalic acid at 100 degrees C to yield 5 (hydroxymethyl)-2-furfur-aldehyde (5-HMF), known as a specific degradation product of hexoses linked to the protein. 5-HMF is then purified through a Sep Pak C18 cartridge and measured by its absorption at 280 nm after separation on a C18 reversed-phase silica column. Quantitation is made accurate by using 1 methylxanthine as internal standard throughout the whole procedure. The identity and the purity of the 5-HMF chromatographic peak was ascertained by UV spectroscopy, gas chromatography on a glass capillary column and mass spectrometry. The method has been successfully used for 5-HMF determinations in monitoring diabetes mellitus patients. The mean values, expressed as nmol of 5 HMF per mg of haemoglobin were 0.64 +/- 0.13 (S.D.) for 27 controls and 1.32 +/- 0.39 for 78 diabetic patients. Unlike the usually employed thiobarbituric acid assay, the present procedure is truly specific for the 5-HMF determination. PMID- 6490767 TI - High-pressure size-exclusion chromatography of anticoagulant materials. AB - A comparative determination of molecular weights of anticoagulant materials is made on different types of high-performance liquid chromatographic stationary phases in aqueous media. The influence of different elution parameters is reported. Narrow-molecular-weight-distribution polystyrenesulphonates are used as standards for the calibration curves. Slight retentions are observed on unmodified silica supports. The commercially available grafted silica columns give similar results for the molecular weight values of heparin. A retention of pentosan polysulphate is observed on a TSK column. However, the size of this anticoagulant polymer is determined on the other grafted silica columns. PMID- 6490768 TI - Determination of anti-protease homogeneity. AB - Virgin and modified [single peptide bond between arginine (63) and isoleucine (64) is cleaved] soybean anti-trypsin was separated by chromatofocusing using a narrow pH range. The separation on anion-exchange and reversed-phase chromatography was less satisfactory. Anti-proteases isolated by affinity chromatography from Boophilus decoloratus were monitored for the formation of any modified protein, with chromatofocusing. PMID- 6490769 TI - High-performance liquid chromatography in the quality control of immunoglobulin preparations during production and storage. AB - High-performance liquid chromatography (HPLC) has been used in the routine quality control of immunoglobulin preparations to measure the contents of aggregates, dimers, monomers and degradation products. The correlation coefficients between TSK 3000 SW, Ultrogel AcA 34 and Sephacryl S-300 chromatography were calculated and a reasonable correlation was found. The decrease in the potency of anti-tetanus immunoglobulin at room temperature was accompanied by an increase in degradation products. The speed and high sensitivity of HPLC make it suitable for the detection of aggregates in intravenous immunoglobulin preparations. PMID- 6490770 TI - Use of TSK-SW columns for the high-performance liquid chromatographic analysis of proteins, isolated from sympathetic nerves and fractionated by fractogel TSK-HW chromatography. Purification of L-DOPA decarboxylase. AB - The soluble proteins isolated from sympathetic nerves were separated on Fractogel TSK-HW columns. With a mobile phase of 0.1 M phosphate + 0.1 M K2SO4, pH 6.8, the main fractions I-VI were obtained. These fractions were analysed by high performance (HPLC) on TSK-SW columns. Fractogel fractions I-III showed peaks of molecular weights, Mr670,000, as estimated by HPLC. With sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) these fractions show no bands stainable with Coomassie Blue. The protein of fraction IV was L-DOPA decarboxylase (AADC E.C. 4.1.1.28) with Mr 150,000 existing of subunits with Mr 55,000, 45,000, 27,000 and purified according to Christenson et al. (Arch. Biochem. Biophys., 141 (1970) 356). The dopamine-beta-hydroxylase (E.C. 1.14.2.1) subunits with Mr 75,000 proteins were detected in Fractogel fraction V. Fraction VI was Mr 27,000 protein. Proteins with molecular weights Mr less than 5,000 were also detected. With Phenothiazine-Affigel the proteins of fraction V (mr 75,000) showed no affinity to the phenothiazine column equilibrated with application buffer containing Ca2+ X 50-70% fraction IV (Mr 150,000), eluted with Tris-EGTA buffer, and 100% fraction VI (Mr 27,000) showed affinity to the Phenothiazine Affigel column. PMID- 6490771 TI - High-performance liquid chromatographic separation of iodoamino acids for tracer turnover studies of thyroid hormones in vivo. AB - A reversed-phase high-performance liquid chromatographic technique was developed to separate radioiodinated thyroxine (T4), 3,5,3'-triiodothyronine (T3), 3,3',5' triiodothyronine (rT3) and two diiodothyronines (3,3'-T2 and 3',5'-T2), in extracts from either serum or urine. Chromatography was performed with 10-micron C18 silica gel, packed in a glass column (3 X 300 mm); the mobile phase was methanol-water (55:45) adjusted to pH 3 with H3PO4, at a flow-rate of 1.2 ml/min and a pressure of 2800 p.s.i. The results demonstrate the ability of the system to yield a clear-cut separation of the iodothyronines involved in in vivo turnover studies, i.e., T4, T3, rT3, and the two T2 compounds together. PMID- 6490772 TI - Combination of conventional and high-performance liquid chromatographic techniques for the isolation of so-called "uraemic toxins". AB - Using fluids from the artificial kidney as an example, a generally useful combination of separation techniques is described for the preparative isolation of biologically active subfractions from extremely heterogeneous and diluted biological fluids. Haemofiltrate (20 l) and dialysate (100 l), respectively, are desalted and concentrated in one step by reverse osmosis using membranes with a nominal cut-off of 500 Daltons. The retentate with high concentrations of "uraemic toxins" is fractionated by preparative ion-exchange chromatography (double column technique with detection at 206 nm) and size exclusion chromatography yielding large amounts of ninhydrin-positive subfractions which inhibit DNA synthesis of rat bone marrow and HeLa cells in vitro, respectively. These fractions were analyzed by reversed-phase and size exclusion high performance liquid chromatography. Many of the isolated fractions were shown to contain peptides. PMID- 6490773 TI - Measurement of free amino acids in human biological fluids by high-performance liquid chromatography. AB - Favourable analytical conditions allowing amino acid analysis in biological fluids, acquired from small human biopsy specimens, were achieved by considering various derivatization methods, the mode of detection and the column used. By using o-phthalaldehyde-3-mercaptopropionic acid as derivatization agent (high sensitivity and stability) and fluorescence detection (excitation at 330 nm, emission at 450 nm), excellent separation of 26 amino acids was obtained in the lower pmol range (1-10 pmol). The reproducibility of the retention times was better than 1.0% for the majority of amino acids and the results from high performance liquid chromatography (HPLC), compared favourably with those of conventional amino acid analysis (r = 0.97). HPLC technology facilitates amino acid analysis in biopsy specimens of less than 1 mg of tissue. PMID- 6490775 TI - Application of high-performance liquid chromatography to the determination of free amino acids in physiological fluids. AB - Multiple-step gradient systems were used for the analysis of free amino acids in physiological fluids by high-performance liquid chromatography with fluorescence detection on two reversed-phase C18 columns. Standard amino acids, plasma or urine samples were subjected to derivatization with ophthalaldehyde in the presence of mercaptoethanol before the separation was performed. More than 22 amino acids were separated in less than 1 h on either 5-micron Ultrasphere-ODS columns or 5-micron Resolve C18 columns by using a two-solvent system. The correlation of the integrated peak areas with the concentration of all amino acids showed a linear relationship between 10 and 150 pmol per 20-microliter injection for all The method has a lower detection limit of less than 1 pmol per 20-microliter injection for all amino acids. Quantitative analysis of micro amounts of amino acids in plasma and urine by the internal standard method gave highly reproducible results with a mean coefficient of variation of less than 3% and r2 = 0.999. Because of the simplicity of the method its application provides a better means for closely monitoring the patients undergoing dialysis and treatment for renal disorders. These results are compared with those from classical ion-exchange chromatography. PMID- 6490774 TI - Determination of histidine and 3-methylhistidine in physiological fluids by high performance liquid chromatography. AB - High-performance liquid chromatography based on pre-column derivatization of histidine and 3-methylhistidine with o-phthalaldehyde-mercaptoethanol has been used to determine these amino acids in small volumes of plasma and urine. The elution is performed in 45 min on a 5-micron Resolve C18 column by a multi-step gradient. The eluted analytes are measured with a fluorescence detector which provides detection limits of less than 1 pmol per 20-microliter injection. The correlation between concentration and the integrated area of amino acids gives a linear relationship between 10 and 150 pmol per injection. Some preliminary results from patients with chronic renal failure under variation of diet are presented. PMID- 6490776 TI - Improvement of chemical analysis of antibiotics. V. A simple method for the analysis of tetracyclines using reversed-phase high-performance liquid chromatography. AB - An isocratic high-performance liquid chromatographic method for the determination of tetracyclines is described using a mobile phase containing oxalic acid and C8- and C18-modified silica gel columns. For good separations of tetracyclines, oxalic acid concentrations of above 0.01 and 0.2 M respectively for parent tetracyclines (group I) and impurities in tetracycline (group II) are required. The optimum pH of the aqueous oxalic acids solution in the mobile phase is 2.0. The combinations of the C8-modified silica gel column with methanol-acetonitrile 0.01 M aqueous oxalic acid solution pH 2.0 (1:1.5:5) and the C18-modified silica gel column with methanol-acetonitrile-0.2 M aqueous oxalic acid solution pH 2.0(1:1:3.5) gave satisfactory results for groups I and II, respectively. PMID- 6490777 TI - Determination of the component ratio of commercial gentamicins by high performance liquid chromatography using pre-column derivatization. AB - Commercial samples of gentamicin from different origins were analyzed by paired ion high-performance liquid chromatography (HPLC) on a C18 bonded phase. The procedure uses pre-column derivatization with a omicron-phthalaldehyde mercaptoacetic acid reagent and UV detection (350 nm). The ratios of the four gentamicin components (C1, C1a, C2a and C2) were determined and compared with the compositions obtained by an independent method based on 13C NMR spectrometry. Quantitation by HPLC, based on peak heights and peak areas, was performed with the aid of an external standard, which was an artificial mixture of the four components. The latter were prepared by separation of the gentamicins C1, C2 + C2a and C1a by chromatography on silica gel, followed by chromatography of the C2 + C2a fraction on a cellulose phosphate column. PMID- 6490778 TI - High-performance gel permeation chromatography assay for endoglycanase activities. PMID- 6490779 TI - Reaction of vitamin K and dithiothreitol on reversed-phase C18 high-performance liquid chromatographic columns. AB - A non-enzymatically catalyzed side reaction between dithiothreitol and vitamin K occurs on reversed-phase C18 high-performance liquid chromatographic columns. Excess dithiothreitol may be effectively removed from enzymatic reaction mixtures with N-ethylmaleimide. A low polarity gradient elution system is reported which gives quantitative recoveries (greater than 95%) of the vitamins in a concentration range useful for analysis of enzymatically catalyzed reactions. PMID- 6490780 TI - Analysis of Cinchona alkaloids by high-performance liquid chromatography. Application to the analysis of quinidine gluconate and quinidine sulfate and their dosage forms. AB - The application of high-performance liquid chromatography to resolve the individual alkaloids present in marketed Cinchona alkaloids was investigated. Normal-phase and several reversed-phase systems were evaluated. The proposed procedure uses an alkylphenyl column; it adequately resolves quinidine, quinine, dihydroquinidine, dihydroquinine, cinchonine, cinchonidine, dihydrocinchonine and dihydrocinchonidine. Epiquinidine, epiquinine, quininone and quinitoxine are also resolved from quinidine and dihydroquinidine. This high degree of resolution enables the analysis of quinidine and its salts for their usual composition and establishes the absence of any cross-contamination or decomposition. The proposed procedure was applied to currently marketed samples of quinidine salts and their dosage forms. It was also applied to samples that were cross-contaminated or which contained decomposition products. PMID- 6490782 TI - Quantitative determination of ppb levels of carbamate pesticides in water by capillary gas chromatography. PMID- 6490781 TI - Determination of 2-ethylhexyl 2,4-dichlorophenoxyacetate in rat blood and urine by electron-capture gas chromatography and gas chromatography-mass spectrometry. PMID- 6490783 TI - Determination of aldicarb and its derivatives in groundwater by high-performance liquid chromatography with UV detection. PMID- 6490784 TI - Simultaneous determination of thiamine and riboflavin in enriched cereal based products by high-performance liquid chromatography using selective detection. PMID- 6490785 TI - Separation of myosin light chains by reversed-phase high-performance liquid chromatography on wide pore supports. PMID- 6490786 TI - Solubilization of plasma membranes in anionic, non-ionic and zwitterionic surfactants for iso-dalt analysis: a critical evaluation. AB - A critical study has been made of the solubilizing properties of anionic, nonionic and zwitterionic surfactants to be used in the first dimension of two dimensional isoelectric focusing-sodium dodecyl sulphate (IF-SDS) maps. Excess of SDS is a powerful solubilizing agent, but prevents proteins from entering the IF gel. Nonidet P-40 (NP-40)-urea mixtures are mediocre solubilizing agents, but are compatible with the IF dimension. Zwitterionic detergents (zwittergents) appear to exhibit a well balanced solubilizing power and are able to generate sharp two dimensional maps, with round spots and minimal vertical and horizontal streaking. SB3-12 and SB3-14 appear to have the best solubilizing properties; shorter surfactants (SB3-8) exhibit a poor solubilization efficiency, while longer detergents (SB3-16) bind too strongly to hydrophobic regions in proteins. The random performance of non-ionic detergents has been attributed to their ability to form mixed micelles with the carrier ampholytes used in the IF step: depending on the relative ratio of NP-40 to Ampholines, different types of micelles would be formed, which, when reaching appropriate stoichiometries and charge densities, would mimic the behaviour of natural zwittergents. Acceptable two-dimensional maps can be obtained when the sample is lysed in limiting amounts of SDS (SDS:protein = 1:3), suggesting that excess of free SDS in solution is deleterious to the IF process. PMID- 6490787 TI - High performance liquid chromatography as a source of structural information for medicinal chemistry. AB - The methods of generating physicochemical data related to the changes in structure of solutes by means of high performance liquid chromatography (HPLC) are reviewed from the point of view of quantitative relationships between chemical structure and biological activity. The information obtainable from retention data are discussed in categories of the specific molecular interactions involved and in thermodynamic terms. The advantages and limitations of the approaches directly relating bioactivity and capacity factors are also considered. The present and potential usefulness of HPLC for medicinal chemistry is demonstrated. PMID- 6490788 TI - Gradient LC separation of macromolecules: theory and mechanism. AB - The theory and mechanism for the reversed-phase liquid chromatographic separation of macromolecules was somewhat vague and controversial until recently when the Flory-Huggins theory of dilute polymer solutions was used to provide the technique with a firm theoretical foundation. As a result of this treatment, the concept of a critical mobile phase composition (Xc) has been introduced to liquid chromatography. Macromolecular solutes below Xc are completely retained, while above Xc they are rapidly eluted. Because the capacity factor of a solute is related to Xc, traditional chromatographic parameters such as theoretical plate number have little meaning. A brief summary of the history of chromatographic polymer separations that foreshadows the current theory is given. A review and an evaluation of the current mechanistic status of macromolecular chromatography are presented. Also considered is the use of adsorption theory, "small molecule" theory, and solvophobic chromatographic theory for macromolecular separations. The theory and separation mechanism are relatively straightforward for synthetic polymers but tend to be more complex and less clearcut for biological polymers. PMID- 6490789 TI - Polymeric columns for liquid chromatography. AB - Polymeric columns are becoming used more frequently in modern liquid chromatography applications as improvements in polymeric packing materials are realized and as more applications are developed for these materials. Modern polymers have overcome earlier problems associated with their use; higher rigidity now allows them to be used at normal eluent flow rates resulting in faster analyses, and improved synthesis techniques have resulted in efficiencies comparable to the best silica materials, sometimes exceeding 100,000 plates/m. In addition, polymers offer distinct advantages over silica packing for particular applications. Because silica packings are readily degraded by aqueous eluents, they are not always suitable for separations involving ionic species. Polymeric columns are particularly useful in determinations of amino acids, peptides, proteins, organic acids, carbohydrates, and inorganic cations and anions. Polymers are also characterized by exceptional lot-to-lot reproducibility. Reproducibility is often problematic with silica packings, particularly the bonded phases. PMID- 6490790 TI - Stereoselective analysis of D and L dansyl amino acids as the mixed chelate copper(II) complexes by HPLC. AB - This paper reviews the mixed chelation approach to resolution of the optical isomers of D and L dansyl amino acids by high performance liquid chromatography. The use of eluants containing Cu(II) complexes of L-proline, L-arginine, L histidine, and L-histidine methyl ester effected the separation of many D and L amino acids, including those with aliphatic, polar, and aromatic substituents. The mechanism of separation, which is based on the preferential ternary complex formation of the analyte amino acid and the chiral chelate with Cu(II) in the mobile phase, is discussed. The stereoselectivity depends mainly on the different steric interactions between the alkyl side chains of the amino acid analytes and the chiral ligands coordinating around Cu(II), although such parameters as pH, temperature, organic modifier, and concentration of the chiral additive also affect the chromatographic separation. Among the chiral ligands studied, L histidine methyl ester is unique in that it possesses both achiral selectivity for the dansyl amino acids and chiral selectivity for the respective D and L enantiomers. With a mobile phase gradient of acetonitrile in a buffer containing Cu(II) L-histidine methyl ester complex, a stereoselective procedure was devised for the analysis of D and L amino acid enantiomers, achieving the separation that the current amino acid analyzer could not perform. Finally, the use of the mixed chelation approach in two biomedical studies is described. In the first application, the histidine methyl ester gradient was adapted for analyzing amino acids in cerebrospinal fluid; in the second, an L-aspartame Cu(II) complex eluant was developed for measuring the urine concentration of D and L pipecolic acid (piperidine-2-carboxylic acid), a metabolite of lysine. PMID- 6490791 TI - Reduction in intestinal calcium absorption by hydrochlorothiazide in postmenopausal osteoporosis. AB - In six women with postmenopausal osteoporosis, most of whom responded to 50 micrograms/day 25-hydroxyvitamin D (25-OHD) therapy with a rise in intestinal calcium (Ca) absorption, 50 mg/day hydrochlorothiazide (TZ) were added to determine whether the resulting decline in urinary Ca would cause Ca retention in the skeleton. Urinary Ca decreased from 183 +/- 48 (SD) mg/day to 142 +/- 67 mg/day (P less than 0.05) when TZ was added. However, fractional Ca absorption also declined from 0.532 +/- 0.077 during 25-OHD treatment to 0.401 +/- 0.064 during combined 25-OHD and TZ therapy (P less than 0.0025). The above changes were accompanied by a significant decline in urinary cAMP from 4.29 +/- 1.64 to 3.19 +/- 1.44 mumol/g creatinine (P less than 0.05) and in serum 1,25 dihydroxyvitamin D from 41 +/- 14 to 22 +/- 11 pg/ml (P less than 0.01). The results suggest that TZ lowers urinary Ca, suppresses parathyroid function, inhibits 1,25-dihydroxyvitamin D synthesis, and thereby reduces intestinal Ca absorption. Thus, combined 25-OHD and TZ therapy probably does not improve Ca balance. PMID- 6490792 TI - Marked hypotonic polyuria resulting from nephrogenic diabetes insipidus with partial sensitivity to vasopressin. AB - We studied two women with severe hypotonic polyuria whose symptoms dated from infancy. We eliminated the possibility of central diabetes insipidus (DI) and primary polydipsia, and established the presence of nephrogenic DI on the basis of: 1) the interrelationships between plasma osmolality, urine osmolality, and urinary AVP; and 2) impaired antidiuretic responses to AVP and 1 deamino-8-D arginine vasopressin. Though 25-50 times as resistant to 1 deamino-8-D-arginine vasopressin nasal spray as patients with central DI, these patients could be treated effectively with large doses of the nasal spray. One patient has been so treated for more than a year with dramatic improvement in her polydipsia, polyuria, and sense of well-being. PMID- 6490793 TI - Vertebral body bone mineral content in hyperprolactinemic women. AB - Hyperprolactinemia with amenorrhea and galactorrhea generally has a benign clinical course without treatment. Prolonged amenorrhea due to early surgical castration or premature menopause is, however, associated with reduced bone mass and increased risk of fractures. Previous studies in hyperprolactinemic women suggested an association with decreased cortical bone density. To determine whether hyperprolactinemia is associated with reduced trabecular bone mineral, we studied 13 hyperprolactinemic women and matched normal women by quantitative computed tomographic scans of the vertebral bodies. No patient had taken bromocriptine and one patient had previously unsuccessful transsphenoidal surgery. Each patient was matched with a normal woman on the basis of race, age +/- 52 weeks, parity, exercise, tobacco use, oral contraceptive (OCP) use, and alcohol use. No subject was currently taking OCPs. Calcium, phosphorus, and protein intakes were estimated from a 3-day diet diary. The mean duration of amenorrhea was 98.9 +/- 79.7 (SD) months. The mean height, weight, serum 25 hydroxyvitamin D (25,OHD), serum 1,25 dihydroxyvitamin D [1,25(OH)2D] and daily intakes of calcium, phosphorus, and protein were not different. The bone mineral content for each patient fell within +/- SD of the mean of the normal subjects. The mean bone mineral content (mg K2HPO4 eq/ml) of the patients was 10% less than in the normal subjects (144.6 +/- 31.4 (SD) vs. 160.1 +/- 26.6, P less than 0.05). The slope of the regression of bone mineral content and age (mg K2HPO4 eq/ml X yr) was similar in patients (-2.4 +/- 1.1) and normal subjects (-2.3 +/- 1.0). We conclude that hyperprolactinemia is associated with reduced bone mineral content, but does not necessarily produce persistent acceleration of the age related decline in bone density. PMID- 6490794 TI - Effects of neutralization of luteinizing hormone on corpus luteum function and cyclicity in Macaca fascicularis. AB - The primate corpus luteum (including the human) is thought to require continuous exposure to LH for normal progesterone production and menstrual cyclicity. Recently, normal luteal function was reported in rhesus monkeys after postovulatory hypophysectomy or treatment with an antagonist to GnRH. We studied the effects of neutralization of LH by specific antiserum in the fascicularis monkey. A potent antiserum to ovine LH, which cross-reacted with monkey pituitary extract, was produced in rabbits; this antiserum was administered daily to cycling monkeys during the midluteal phase. The pretreatment cycle duration was 32.4 +/- 1.7 (+/- SE) days, and luteal length was 16.5 +/- 0.8 days, with a midluteal progestin peak of 15.28 +/- 2.23 ng/ml. LH antiserum treatment resulted in a precipitous fall in serum progestin within 24 h, which remained low for the remainder of the cycle. All treated monkeys had premature menstrual bleeding, with mean cycle length shortened to 22.8 +/- 1.6 days (P less than 0.0005). These results confirm that the continuous presence of LH is essential for maintenance of corpus luteum function in this species of primate. PMID- 6490795 TI - Site of insulin resistance in type 1 diabetes: insulin-mediated glucose disposal in vivo in relation to insulin binding and action in adipocytes in vitro. AB - To evaluate the mechanism of insulin resistance in type 1 diabetes mellitus, we measured insulin sensitivity in vivo and insulin action in adipocytes in vitro. The study groups consisted of 18 insulin-treated type 1 diabetic patients and 14 matched normal subjects. In each subject, insulin-mediated glucose disposal in vivo was measured by the euglycemic clamp technique. An open surgical biopsy was performed in 9 diabetic and 7 healthy subjects to obtain abdominal sc adipose tissue for the measurement of [125I]insulin binding, D-[14C]-glucose transport, oxidation, and lipogenesis. During the euglycemic clamp studies, similar steady state plasma glucose (4.8 mmol/liter) and insulin (80 mU/liter = 700 pM) levels were maintained in both groups. The rate of glucose metabolism (M) was 43% lower in the diabetic patients (4.75 +/- 0.34 mg/kg X min) than in the normal subjects (8.27 +/- 0.43 mg/kg X min; P less than 0.001). [125I]Insulin binding to adipocytes was reduced in the diabetic patients (26% reduction in tracer binding; P less than 0.05) due to a reduction in receptor number. Insulin binding was not related to the M value at any insulin concentration. Basal and insulin-stimulated rates of glucose transport were not significantly different in diabetic and normal subjects. The basal glucose oxidation rate was reduced by 50% (P less than 0.02), and maximal glucose oxidation was reduced by 49% (P less than 0.03) in the diabetic patients (237 +/- 30 vs. 359 +/- 49 pmol/30,000 cells X 90 min, basal vs. maximal glucose oxidation, respectively) compared to those in normal subjects (513 +/- 101 vs. 700 +/- 133 pmol/30,000 cells X 90 min). The percentage responses of glucose oxidation and glucose transport to insulin were similar in both groups. Glucose oxidation rates at basal (r = 0.68; P less than 0.01), half maximally (ED50; r = 0.70; P less than 0.01), and maximally (r = 0.64; P less than 0.05) effective insulin concentrations were positively related to the M value. Basal and insulin-stimulated rates of lipogenesis were comparable between the diabetic and normal subjects. In conclusion, insulin-mediated glucose disposal in vivo is reduced in conventionally treated type 1 diabetic patients. In vitro, adipocytes from diabetes bound slightly less insulin at tracer insulin concentrations, but the magnitude of this reduction was not related to impairment of glucose metabolism in vivo. Of the pathways of glucose metabolism studied, the rate of glucose oxidation was most affected. A significant relationship was found between the M value and the rate of in vitro glucose oxidation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6490796 TI - Rifampicin-induced adrenal crisis in addisonian patients receiving corticosteroid replacement therapy. AB - Rifampicin induced profound alterations in cortisol metabolism when administered to three patients with primary adrenal failure receiving adequate corticosteroid replacement therapy. In one patient, adrenal crisis was precipitated after the institution of rifampicin therapy for treatment of coexistent tuberculosis and in another, profound asthenia, decrease in blood pressure, hyperkalemia, and hyponatremia developed during the hydrocortisol kinetic study. The clinical symptoms subsided and the electrolyte abnormalities were corrected approximately 7 days after rifampicin withdrawal. The half-life of hydrocortisol and the area under the curve were decreased by 35% and 23%, respectively, whereas the systemic clearance was increased by 35% during rifampicin administration. It appears, that the effectiveness of glucocorticoids and mineralocorticoids were greatly impaired by rifampicin administration due to induction of liver steroid-metabolizing enzymes. It is strongly recommended that in patients with compromised adrenal function, treatment with rifampicin must be accompanied by doubling or tripling the dose of adrenal steroids to maintain adequate steroid replacement therapy. PMID- 6490797 TI - Free thyroid hormones in evaluating persistently elevated thyrotropin levels in children with congenital hypothyroidism on replacement therapy. AB - Some children with congenital hypothyroidism receiving L-T4 therapy have elevated serum TSH levels despite having normal serum T4 concentrations, suggesting that they have a higher threshold for the feedback regulation of TSH release. To further study this possibility, we determined serum free T4 (FT4) and T3 (FT3) concentrations in two groups of L-T4-treated hypothyroid children. Group A consisted of 10 patients with high serum TSH levels; group B consisted of 10 patients with normal TSH levels. All patients were clinically euthyroid, and serum total T4 and T3 concentrations were similar in the two groups. A third (control) group (C) consisted of randomly selected normal children. The three groups were age matched. Serum FT3 and FT4 were significantly lower in group A compared to group B. Serum FT4 and T4 were higher and TSH was lower in group B compared to group C. The T4/T3 ratio wash higher in both groups of children with hypothyroidism than in group C. We conclude that in most patients a high serum TSH was due to inadequate L-T4 therapy, as shown by free hormone concentrations (low) but not by total hormone levels (normal). This suggests that L-T4 therapy should be monitored by measurement of TSH and free hormone concentrations. The latter also can be used to indicate moderate overdosage, not clinically detectable, as shown by the comparison between groups B and C. Measurement of serum total T4, as indicated by the lack of difference between groups A and B and also by T4/T3 ratio, cannot be considered a reliable index of therapeutic adequacy in such children. PMID- 6490798 TI - Effect of desialylation of human chorionic gonadotropin on its metabolic clearance rate in humans. AB - We determined the MCR and other kinetic parameters of desialylated hCG (as-hCG) in eight subjects (four men and four women), aged 20-47, using a single injection of 1 mg of a highly purified preparation. The plasma disappearance curve was fitted to a single exponential equation, with a half-time of disappearance of 3.56 +/- 0.62 min (mean +/- SD) and an initial volume of distribution of 1790 +/- 582 ml/m2. The mean MCR of as-hCG was 349 +/- 96 ml/min X m2. The mean transit time of as-hCG was 373 times shorter than that of hCG. The rapid plasma disappearance of as-hCG could not be accounted for by renal clearance into urine, since less than 0.05% of the as-hCG injected was excreted in the urine, nor could it be explained by degradation by plasma proteases, since as-hCG was not appreciably degraded during incubation in human serum at 37 C for 3 h. These data show that desialylation markedly accelerates the MCR of hCG in the human in spite of reduced renal excretion and, therefore, indicate the presence of a highly active pathway for uptake of desialylated glycoproteins. PMID- 6490799 TI - A primate model of human postmenopausal hot flushes. AB - The hot flush is the only symptom specifically attributable to the menopause. Hot flushes appear to represent an episodic derangement of thermoregulation as a result of estrogen deficiency but the underlying physiological mechanisms are unknown. We have developed an animal model for the study of hot flushes. Two female monkeys (Macaca arctoides) were trained to accept monitoring of scalp cutaneous temperatures. After baseline temperature recordings were obtained both monkeys were ovariectomized. A few days after operation the previously stable scalp temperature changed to an undulating pattern with cycles lasting approximately 40-50 min. Ethinyl estradiol (20 micrograms orally or im) and (7 alpha,17 alpha)-17-hydroxy-7-methyl-19-nor-pregn-5(10)-en-20-yn-3-one (2.5 mg orally), a steroid with weak estrogenic, progestogenic, and androgenic properties, suppressed the characteristic undulating temperature pattern; this returned after withdrawal of replacement therapy. Clonidine (0.15 mg twice a day) suppressed the cyclic changes for 2 to 3 h. Domperidone and naloxone had no significant effect. This animal model may be useful for the investigation of alternative therapy for the management of menopausal flushes. PMID- 6490800 TI - [Group dynamics among long-term inpatients from the viewpoint of medical psychology]. PMID- 6490801 TI - [The isolation and characterization of human milk lactoferrin and the fluctuations of its concentration at different stages of lactation]. PMID- 6490802 TI - [Effects of voluntary running exercise during growing and post-growing periods on iron metabolism and body composition of the rats fed on normal and iron deficient diets]. PMID- 6490803 TI - [Estimation of cardiac index and pulmonary capillary wedge pressure using the theory of quantification]. PMID- 6490804 TI - [Histopathological studies on chronic gastritis: their fine mucosal patterns and histological changes]. PMID- 6490805 TI - [Effect of a single dose of iron on ferritin synthesis in isolated rat hepatocytes]. PMID- 6490807 TI - [Corticosteroid hormones for external use. Present status and problems]. PMID- 6490806 TI - [Characterization of rat monoamine oxidase and the alteration of their activities in iron deficiency]. PMID- 6490808 TI - [Indication for microcapsulated antineoplastic agents, with special reference to local therapy using magnetized powder]. PMID- 6490809 TI - Genomic analyses of influenza A (H3 N2) viruses from Japan and Thailand, in the period of 1979 to 1981. PMID- 6490810 TI - Detection of encapsulation in Staphylococcus aureus by use of antiserum agar. AB - We examined an antiserum agar method to study its reliability in screening Staphylococcus aureus strains for capsule production. The encapsulated S. aureus Smith diffuse strain was compared with its nonencapsulated variant, Smith compact, in CCY medium containing 0.5% NaCl and 5.0% Smith diffuse rabbit antiserum. A halo was visible surrounding colonies of the Smith diffuse strain but not the Smith compact strain. On this same medium, the protein A-producing Cowan I strain possessed a halo that was visible on photographs. Single high-salt medium is known to inhibit protein A production, halo formation by the strains was also compared in 7.5% NaCl medium. The halo surrounding the Cowan I strain was not present when the salt content of the medium was increased. In contrast, the halo surrounding the Smith diffuse strain persisted in the 7.5% NaCl medium. By use of this medium, the antiserum agar technique may be valuable for the identification of encapsulated staphylococci without appreciable interference from protein A. PMID- 6490811 TI - Genetic relationship of lyme disease spirochetes to Borrelia, Treponema, and Leptospira spp. AB - Genetic studies were performed on the following spirochetes: three Lyme disease spirochetes isolated from Ixodes ticks and from human spinal fluid; three species of North American borreliae; four species of Treponema; and two species of Leptospira. The mol% G+C values for Lyme disease spirochetes were 27.3 to 30.5%, similar to values of 28.0 to 30.5% for Borrelia species but different from the values of Leptospira or Treponema species which ranged from 35.3 to 53%. Lyme disease spirochetes represent a new species of Borrelia, with DNA homologies of 31 to 59% with the three North American strains of Borrelia studied. These studies also showed that Lyme disease spirochetes from three sources constituted a single species, with DNA homologies ranging from 76 to 100%. A high degree of relatedness was also seen between the three North American borreliae, with homology varying from 77 to 95%, indicating that these spirochetes represent a single species. Lyme disease spirochetes and Borrelia species exhibited almost no homology with Leptospira and Treponema species (0 to 2%). Plasmids were detected in the three Lyme disease spirochetes and in the three North American borreliae. PMID- 6490812 TI - DNA characterization of the spirochete that causes Lyme disease. AB - Lyme disease, a tick-borne disease long recognized in Europe but only recently recognized in the United States, was shown in 1982-1983 to be caused by a spirochete, the Lyme disease spirochete. Whether one or more species of the spirochete exists is unknown, as is its taxonomic status. To answer these questions, we determined (i) the DNA base (guanidine-plus-cytosine) content for five strains; (ii) the DNA relatedness of 10 strains from Europe or the United States (isolated from ticks, humans, and a mouse) by DNA hybridization (hydroxyapatite assay at 50 and 65 degrees C); and (iii) the DNA relatedness to other pathogenic spirochetes. The guanine-plus-cytosine content of the Lyme disease spirochete strains was 27.5 to 29.0 mol%, most similar to those of Borrelia hermsii (30.6 mol%) and Treponema hyodysenteriae (25.6 mol%) among the other spirochetes tested. DNA hybridization studies with 32P-labeled DNA from Lyme disease spirochete strain TLO-005, a human blood isolate, revealed divergence (unpaired bases) within related nucleotide sequences of only 0.0 to 1.0% for all nine Lyme disease spirochete strains tested for relatedness to TLO 005. Relatedness values of seven strains to TLO-005 were 58 to 98% (mean, 71%) in 50 degrees C reactions and 50 to 93% (mean, 69%) in 65 degrees C reactions. Two other strains, from which very low yields of DNA were obtained, showed less relatedness (36 to 50 degrees C, 38 to 47% at 65 degrees C). These were nonetheless considered to belong to the same species because of the low amount of divergence in the sequences related to TLO-005 and the absence of decreased relatedness in reactions done at 65 degrees Celsius compared with those done at 50 degrees Celsius. DNA from strain TLO-005 showed relatedness of 1% to DNAs of two leptospires and 16% relatedness to DNA from T. hyodysenteriae. B. hermsii DNA was 30 to 40% related to three Lyme disease spirochete strains in 50 degrees Celsius reactions. Divergence in these reactions was 16.5 to 18.5%, and relatedness in 65 degree Celsius reactions was 8 to 10%. On the bases of phenotypic similarity, guanine-plus-cytosine content, and DNA relatedness to B. hermsii, we conclude the Lyme disease spirochete is single previously undescribed species which belongs in the genus Borrelia. PMID- 6490813 TI - Vibrio vulnificus endometritis. AB - Vibrio vulnificus most frequently causes wound infections contracted after exposure to seawater or primary septicemias resulting from the consumption of raw oysters. We report a case of endometritis caused by V. vulnificus. The infection was apparently acquired during the act of sexual intercourse in seawater in an area in which V. vulnificus has been frequently isolated. The efficacy of treatment with an antimicrobial regimen which included tetracycline is discussed. PMID- 6490814 TI - Disseminated candidiasis caused by a sucrose-negative variant of Candida tropicalis. AB - A patient suffering from leukemic transformation of a non-Hodgkin's lymphoma developed fatal disseminated candidiasis caused by a sucrose-negative variant of Candida tropicalis. The results of histopathological tests showed massive tissue invasion in many organs. The course of infection and the tissue morphology of the etiological agent were indistinguishable from those of C. albicans and typical C. tropicalis strains. PMID- 6490815 TI - Monoclonal antibody that preferentially binds polylysine, polyarginine, and histones and selectively decorates nuclei and chromosomes. AB - A monoclonal antibody, designated J-57, selectively and uniformly decorates the interphase nuclei and mitotic chromosomes of a variety of eucaryotic cells as determined by indirect immunofluorescence. As determined by enzyme-linked immunosorbent assay, however, this monoclonal antibody is not monospecific. It reacts weakly with cytochrome c, RNase A, and brain tubulin. By these tests monoclonal antibody J-57 has broad cross-reactivity similar to that of antisera directed against polylysine. The differential reactions of this monoclonal antibody suggest that it may be a useful immunohistochemical probe for nuclei and chromosomes in whole cells. PMID- 6490816 TI - Identification of Streptococcus bovis and Streptococcus salivarius in clinical laboratories. AB - Streptococci identified as Streptococcus bovis, S. bovis variant, and Streptococcus salivarius were examined with respect to physiological and serological characteristics and cellular fatty acid content. Similarities in physiological reactions and problems encountered in serological analysis were noted, suggesting that an expanded battery of physiological tests is needed to definitively identify these streptococci. Cellular fatty acid analysis provided an accurate method for distinguishing S. salivarius from S. bovis and S. bovis variant. PMID- 6490817 TI - Pulmonary disease due to Mycobacterium malmoense. AB - A case of pulmonary disease due to Mycobacterium malmoense was recently diagnosed in a 43-year-old man from Virginia. This organism was isolated from sputum and bronchial washings. This is the first case of documented human infection due to this organism in the United States PMID- 6490818 TI - Prevalence of Clostridium difficile and its cytotoxin in infants in Mexico. AB - The incidence of Clostridium difficile and its cytotoxic activity were determined in the feces of 122 children under 1 year of age. Samples were obtained from children receiving antibiotics and with (52 cases) or without (26 cases) diarrhea, from children with diarrhea who did not receive antibiotics (22 cases), and from healthy children (22 cases). Isolation of C. difficile in feces from children in all groups was similar (mean 23.4%) except for the group with non antibiotic-associated diarrhea (4.5%). In both groups of children receiving antibiotics, with or without diarrhea, the cytotoxin was detected in 7.6% of the cases. In the group with non-antibiotic-associated diarrhea, none of the samples was positive for cytotoxicity. In healthy children, cytotoxin was positive in 4.5% of the cases. PMID- 6490819 TI - Evaluation of the API latex conjugate reagent for serological typing of Salmonella and Shigella species. AB - The serological types of Salmonella and Shigella isolates were determined by using the SerImm Sure latex conjugates (Analytab Products, Plainview, N.Y.) and the standard slide agglutination test. The Salmonella latex conjugates correctly typed 114 of the 115 Salmonella isolates found in serogroups A through F; 50% these isolates were from serogroups B. The Shigella latex conjugates correctly typed 87 of the 92 Shigella isolates; 87% of these isolates were from serogroups B and D. PMID- 6490820 TI - Pyomyositis caused by Yersinia enterocolitica. AB - Yersinia enterocolitica is known to be associated with gastroenteritis in children and Reiter's syndrome in adults, but it has only rarely been the cause of primary soft tissue infections. A patient with diabetes mellitus developed a calf abscess, from which Y. enterocolitica was isolated in pure culture. Incision, drainage, and intravenous gentamicin therapy resulted in cure. PMID- 6490821 TI - Recovery of Staphylococcus aureus from multiple body sites in menstruating women. AB - Because we suspected the number of women harboring Staphylococcus aureus perivaginally to be higher than previously reported, we undertook an examination of normal, healthy volunteers. Of 97 young women, 26% yielded S. aureus from the external labia at the time of menstruation. Toxin associated with toxic shock syndrome was recovered from 5 of 25 subjects with positive genital cultures. Approximately one-half of the women with positive genital cultures yielded positive cultures from the posterior cervical fornix. These 12 women with positive vaginal cultures formed a distinct subgroup that was characterized by positive labial and tampon cultures, higher incidence of previous streptococcal infections, and more frequent vaginal insertion of their own fingers or those of a partner. Tampons were used by all but one woman in the group with positive labial cultures and all but one woman in the group with positive vaginal cultures. We concluded that the presence of S. aureus in the vagina involves mechanisms other than the use of tampons. Insertion of fingers and perhaps some aspect of immunological status appear to play a role. PMID- 6490822 TI - C-reactive protein in patients with bacteremia. AB - Quantitative measurement of C-reactive protein (CRP) in serum has been proposed as a sensitive and, for some populations, a specific indicator of infection. To determine whether early measurement of CRP in serum could differentiate patients with bacteremia from a control group of patients whose blood cultures yielded contaminants, we measured CRP concentrations quantitatively by rate nephelometry in serum samples that had been obtained from patients on the same day as blood samples that yielded bacteria or fungi. Of the 36 episodes of bacteremia, 3 (8.5%) occurred in patients with normal concentrations of CRP in serum and 2 (5.5%) in patients with minimally elevated levels. Of the 21 episodes associated with contaminated blood cultures, only 2 (9.5%) occurred in patients with normal CRP levels. Of the patients with marked elevations of CRP (greater than 10 mg/dl), 18 (86%) had infection, although not all of these patients had bacteremia. We conclude that a normal concentration of CRP in serum does not eliminate the possibility of bacteremia. Moderate elevations (1 to 10 mg/dl) of CRP levels are common in both patients with contaminated blood cultures and in those with bacteremia. If the CRP concentration in serum is greater than 10 mg/dl and if other causes of marked elevations of CRP levels are eliminated, CRP concentration in serum may be a relatively specific indicator of infection. However, elevations of CRP concentrations are neither completely sensitive nor specific for detecting infection in patients with bacteremia. PMID- 6490823 TI - Diagnosis of fastidious enteric adenoviruses 40 and 41 in stool specimens. AB - Thirty-five stool specimens, collected over a 14-week period from pediatric gastroenteritis patients and shown to contain adenovirus by electron microscopy, were inoculated onto 293 and HeLa cells. Virus isolates were characterized by serum neutralization and restriction endonuclease cleavage analysis of viral DNA from infected cells. Adenovirus was isolated upon primary inoculation of 293 cells from all 35 specimens shown to contain adenovirus by electron microscopy. Fastidious adenoviruses 40 and 41 (Ad40 and Ad41) were found in 17 (49%) of the stool specimens, and 4 of these specimens contained a conventional species (Ad1, Ad1, Ad18, Ad31) as well as Ad40. This was first manifest by the observation that four of the isolates which initially grew only in 293 cells acquired the capacity to grow in HeLa cells upon subsequent passage. In each case, the conventional species was undetectable by DNA analysis in the original inoculum but was selected in 293 cells and became the only one detectable by the second passage. Four other specimens, containing Ad1 or Ad31 alone, failed to grow initially in HeLa cells but did grow in 293 cells. The results of this study demonstrate therefore that (i) 293 cells are more sensitive than HeLa cells for the isolation of conventional as well as fastidious enteric adenovirus species and (ii) identification of viruses from patient specimens should involve minimal passage of the virus in cell culture, as a single passage can result in misdiagnosis of the virus associated with the infection. PMID- 6490824 TI - Latex agglutination test for detection of Clostridium difficile toxin in stool samples. AB - A total of 163 stool specimens were tested for detection of Clostridium difficile and its toxin by cytotoxicity assay with tissue culture, latex agglutination test, and isolation of the organism. From 33 specimens which were positive for toxin by cytotoxicity, 30 were positive by the latex agglutination test; the organism was isolated from 21. The total number of samples which were positive with the latex agglutination test was 44. The predictive value of a positive latex agglutination result relative to the cytotoxicity test was 68%, and the predictive value of a negative result was 97.5%. The specificity and sensitivity of the latex agglutination test relative to the cytotoxicity assay and the low cost and simple facilities required indicate that the latex agglutination test is a useful procedure for screening for C. difficile toxins, provided that positive latex results are confirmed by cytotoxicity assay. PMID- 6490825 TI - Enzyme-linked immunosorbent assay for detection of Clostridium botulinum type A and type B toxins in stool samples of infants with botulism. AB - An enzyme-linked immunosorbent assay (ELISA) for Clostridium botulinum type A and type B toxins was assessed for diagnostic accuracy in cases of infant botulism. This test was positive in all 22 cases confirmed by the conventional tests, which included the mouse lethality assay and stool culture. Stool specimens from five cases were positive by culture, but the mouse lethality bioassay was either negative or toxicity was judged nonspecific since it could not be neutralized by specific antitoxin. The positive ELISA results in these specimens suggested that this assay may be more reliable, in some cases, than the mouse bioassay. Of the 21 fecal specimens from suspected foodborne cases, 2 contained botulinal toxin demonstrable by the mouse assay and the ELISA. With regard to specificity, 35 fecal specimens from infants and 19 from suspected foodborne cases which were negative in the bioassay for botulinal toxins A and B were also negative in the ELISA. Only two fecal specimens with negative bioassay gave positive ELISA readings, providing a specificity rate of 96%. These results suggest that the ELISA may serve as a useful screening test to detect C. botulinum toxin in clinical specimens. PMID- 6490826 TI - Disk diffusion testing, quality control guidelines, and antimicrobial spectrum of HR810, a fourth-generation cephalosporin, in clinical microbiology laboratories. AB - HR810 is a new, very broad-spectrum cephalosporin with significant activity against members of the family Enterobacteriaceae, pseudomonads, gram-positive cocci, and anaerobes that is generally greater than the third-generation cephalosporins (99.6% of 4,128 clinical facultative enteric isolates were inhibited by less than or equal to 8.0 micrograms of HR810 per ml). Tests and statistical methods to establish in vitro antimicrobial susceptibility test criteria favor tentative breakpoints of greater than or equal to 18 mm (less than or equal to 8.0 micrograms/ml) as susceptible and less than or equal to 14 mm (greater than or equal to 32 micrograms/ml) as resistant. This provides a 93.7 to 98.3% absolute interpretive accuracy. Several preliminary ranges for zone sizes obtained with quality control organisms are proposed for the 30-micrograms HR810 disk diffusion test used during the clinical trials. PMID- 6490827 TI - Selective medium for isolation of Clostridium butyricum from human feces. AB - A selective medium, Clostridium butyricum isolation medium (BIM), is described for the isolation of C. butyricum from human feces. The BIM is a synthetic minimal medium and contains trimethoprim (16 micrograms/ml), D-cycloserine (10 micrograms/ml), and polymyxin B sulfate (20 micrograms/ml) as selective inhibitory agents. Qualitative tests indicated that C. butyricum and other butyric acid-producing clostridia grew on BIM, Clostridium sphenoides and Bacillus cereus produced small colonies, and other clostridia and other obligate anaerobic or facultatively anerobic bacteria were inhibited. Quantitative recovery of C. butyricum from cultures or seeded fecal samples was comparable with BIM and with complex medium, but the quantitative recovery of the other butyric acid-producing clostridia tested (C. beijerinckii, C. acetobutylicum) was lower with BIM than with complex medium. The BIM should aid the rapid isolation of C. butyricum from fecal samples and should be useful for bacteriological investigation of neonatal necrotizing enterocolitis. PMID- 6490828 TI - Determination of catalase, peroxidase, and superoxide dismutase within the genus Legionella. AB - We examined 40 strains of Legionella for reduced-oxygen scavenging enzymes. Using a simple reaction chamber with a Swinney filter for the Beers and Sizer assay, we determined the catalase activity of live cells grown on buffered charcoal-yeast extract agar. For 29 strains of Legionella pneumophila, the apparent first-order rate constants for catalase ranged from 0.000 to 0.005. Similarly, low values ranging from 0.001 to 0.005 were observed for Legionella wadsworthii, Legionella oakridgensis, and Legionella gormanii. High catalase activities were found for Legionella jordanis, Legionella longbeachae, Legionella micdadei, and Legionella bozemanii, with first-order rate constant values of 0.010 to 0.035. Cell-free extracts were analyzed for catalase, peroxidase, and superoxide dismutase. Cell free extracts of all strains had superoxide dismutase levels ranging from 8.2 to 30.5 U per mg of protein. The species could be characterized by their catalase and peroxidase since L. pneumophila and L. gormanii had only peroxidase (relative molecular weight [Mr], 150,000); L. dumoffii had a peroxidase (Mr, 150,000) plus a catalase (Mr, 174,000); and all remaining species had catalase only (Mr, 300,000, 220,000, or 150,000). PMID- 6490829 TI - Differentiation of Campylobacter species by protein banding patterns in polyacrylamide slab gels. AB - Soluble protein extracts of 37 catalase-positive strains of Campylobacter species were examined by polyacrylamide slab gel electrophoresis (PAGE). Electrophoretic banding patterns showed good correlation with biochemical tests and with available DNA homology data in distinguishing species of Campylobacter but did not differentiate subspecies or biotypes. PAGE patterns indicated that Campylobacter coli is a distinct species. Furthermore, the PAGE patterns indicated that C. jejuni and nalidixic acid-resistant thermophilic Campylobacter species (C. laridis) are each distinct species. The protein banding patterns of C. fetus subsp. venerealis and C. fetus subsp. fetus strains were distinctly different from those of the three thermophilic species. PMID- 6490830 TI - Rapid antimicrobial susceptibility testing of isolates from blood cultures by direct inoculation and early reading of disk diffusion tests. AB - Disk diffusion tests, inoculated directly from positive blood cultures, were evaluated for accuracy of reading zone diameters after 4- and 6-h and overnight incubation. In comparisons with results from standard disk diffusion tests, the 4 h results were in agreement for 83% of tests with gram-positive organisms and 64% of tests with gram-negative organisms. When minor discrepancies were ignored, the 4-h readings were in agreement for 98% of the tests with gram-positive organisms and 95% of the tests with gram-negative organisms. After 6 h of incubation, 91% of the tests with gram-positive organisms and 86% of the tests with gram-negative organisms agreed with standard results. The agreement was 99% for tests with both gram-positive and gram-negative organisms when minor discrepancies were excluded. Very major discrepancies occurred in two tests (0.1%) with gram-positive organisms and were not observed in tests with gram-negative organisms. The frequencies of major discrepancies were 3.5% after 4 h, 0.6% after 6 h, and 0.7% after overnight incubation. Ampicillin and cephalothin tests with Escherichia coli and Klebsiella spp. accounted for 81% of the major discrepancies in tests with gram-negative organisms. Oxacillin tests accounted for more than half of the major discrepancies in tests with staphylococci. The results of this study, which did not include the newer antibiotics, indicate that direct susceptibility tests from blood cultures read after 6 h of incubation are more reliable than 4-h results and produce less than 1% major errors in comparisons with standard susceptibility tests. PMID- 6490831 TI - Detection of soluble Legionella pneumophila antigens in serum and urine specimens by enzyme-linked immunosorbent assay with monoclonal and polyclonal antibodies. AB - Urine and serum specimens from three patients with pneumonia caused by Legionella pneumophila serogroup 1 (Lp1) were tested by enzyme-linked immunosorbent assay (ELISA) for Lp1-soluble antigen. A three-layer direct ELISA with polyclonal antibodies and a four-layer indirect ELISA with both polyclonal and monoclonal antibodies were used. Lp1 antigen was detected in both urine and serum from the three patients. As determined by ELISA, the concentration of antigen was 30- to 100-fold less in serum than in urine collected on the same day. In some instances the indirect ELISA was more sensitive than the direct ELISA, but in others it was less sensitive, depending on the monoclonal antibody used. The subgroup of the infecting Lp1 organism was determined based on antigenic determinants expressed in the urine. This study illustrates the use of serum as well as urine as an antigen reservoir in the laboratory diagnosis of legionellosis by ELISA and the potential for developing more sensitive antigen detection systems by the judicious use of monoclonal antibodies. PMID- 6490832 TI - Physicochemical inactivation of Lassa, Ebola, and Marburg viruses and effect on clinical laboratory analyses. AB - Clinical specimens from patients infected with Lassa, Ebola, or Marburg virus may present a serious biohazard to laboratory workers. We have examined the effects of heat, alteration of pH, and gamma radiation on these viruses in human blood and on the electrolytes, enzymes, and coagulation factors measured in laboratory tests that are important in the care of an infected patient. Heating serum at 60 degrees C for 1 h reduced high titers of these viruses to noninfectious levels without altering the serum levels of glucose, blood urea nitrogen, and electrolytes. Dilution of blood in 3% acetic acid, diluent for a leukocyte count, inactivated all of these viruses. All of the methods tested for viral inactivation markedly altered certain serum proteins, making these methods unsuitable for samples that are to be tested for certain enzyme levels and coagulation factors. PMID- 6490833 TI - Variation in the abilities of automated, commercial, and reference methods to detect methicillin-resistant (heteroresistant) Staphylococcus aureus. AB - The abilities of commercial MIC, automated, and reference methods for in vitro detection of methicillin-resistant Staphylococcus aureus were determined on 49 strains from eight hospitals. Micro-Media, MicroScan, Sensititre, Sceptor, API Uniscept KB, Abbott MS-2, Vitek AMS, Autobac MTS, NCCLS disk diffusion, and broth microdilution antimicrobial susceptibility testing procedures were evaluated. All testing was performed by using manufacturers' or reference procedures, and results were determined at no later than 24 h of incubation at 35 degrees C. With NCCLS disk diffusion, all strains were resistant to oxacillin (1 microgram), 47 (96%) were resistant to methicillin (4 micrograms), and 48 (98%) were resistant to nafcillin (1 microgram). The percentages of strains resistant to methicillin (greater than 8 micrograms/ml) were 98% with API Uniscept KB, 86% with Sceptor, MicroScan, and Autobac MTS, 84% with Sensititre, 71% with Micro-Media, and 70% with NCCLS MIC. Abbott MS-2 detected 86% of strains resistant to methicillin (greater than 5 micrograms/ml). With oxacillin (greater than 2 micrograms/ml), 90% were detected with Vitek AMS and 70% were detected with NCCLS MIC. With nafcillin (greater than 2 micrograms), 82% were resistant with Micro-Media, 57% were resistant by NCCLS MIC, and 50% (three of six) were resistant by MicroScan. Two strains from one hospital and one strain from another gave susceptible results with all automated and commercial methods. All strains from three centers were detected by all methods. Variability also occurred among the systems with cephalothin, clindamycin, gentamicin, chloramphenicol, and trimethoprim sulfamethoxazole. PMID- 6490834 TI - Scanning electron microscopy of bacteria adherent to intravascular catheters. AB - Scanning electron microscopy was used to assess the morphological features of coagulase-negative staphylococci adherent to polyvinylchloride intravascular catheter specimens. Clinical specimens were obtained by using patient catheters from which coagulase-negative staphylococci (greater than or equal to 15 colonies per catheter) grew on semiquantitative blood agar roll cultures. In vitro specimens were prepared by a previously published technique in which sterile polyvinylchloride catheters were immersed in 10(6) CFU of coagulase-negative staphylococci per ml suspended in phosphate-buffered saline. Unused sterile polyvinylchloride catheters were also examined. Scanning electron microscopy of unused sterile polyvinylchloride catheters demonstrated multiple linear surface irregularities. Scanning electron microscopy of infected patient catheters showed a diffuse amorphous material covering the entire surface and the presence of bacteria which appeared anchored to that surface by several different means. These included a slime layer, "foot" processes, and lodgement in surface irregularities. Scanning electron microscopy of in vitro specimens demonstrated no background surface coating, but it did show attachment of cocci to the surface by the same mechanisms as described for clinical specimens. These observations of similar means of attachment in clinical and in vitro specimens suggest that intrinsic catheter surface properties, bacterial surface features, and perhaps coating with host substances may all play a role in bacterial attachment to intravascular catheters. More sophisticated analysis of these interactions may clarify mechanisms of pathogenesis. PMID- 6490835 TI - Frequency-pulsed electron capture gas-liquid chromatographic analysis of metabolites produced by Clostridium difficile in broth enriched with amino acids. AB - Clostridium difficile strain CDC A-567 was cultured in Trypticase (BBL Microbiology Systems)-yeast-salt broth supplemented with 0.2% L-leucine, L norleucine, L-isoleucine, L-tyrosine, or L-tryptophan. Four extractions were done on the spent medium, three at pH 2 and one at pH 10, using CHCL3 or ether. Derivatizations were done with trichloroethanol, heptafluorobutyric anhydride, and heptafluorobutyric anhydride-ethanol. All samples were analyzed with frequency-pulsed electron capture gas-liquid chromatography. A dedicated computer was used to assist in data analysis. C. difficile produced both short-chain and aromatic acids in Trypticase-yeast-salt broth; hydroxy acids were also detected. p-Cresol, indoleacetic acid, 4-methylthio-2-hydroxybutyric acid, and some unidentified alcohols were observed. The basic chloroform extraction contained cadaverine and putrescine. Leucine, norleucine, and isoleucine influenced the production of C5 and C6 acids and alcohols. L-Tyrosine underwent successive degradation to produce p-cresol and aromatic acids as final products. Tryptophan increased the production of indoleacetic, indolepropionic, and indolebutyric acids. Isocaproic acid was produced in relatively high concentrations regardless of medium substitution. The consistent production of iC6 under various substrate conditions indicates that the production of this compound might be consistent enough in vitro to form the basis of a rapid test for detection of C. difficile in stool specimens by frequency-pulsed electron capture gas-liquid chromatography. PMID- 6490836 TI - Studies of stools from pseudomembranous colitis, rotaviral, and other diarrheal syndromes by frequency-pulsed electron capture gas-liquid chromatography. AB - Thirty-five patients with various diarrheal syndromes and 22 controls were studied. All stool samples were carefully cultured for Clostridium difficile, using selective isolation media. Cytotoxin assays with proper antitoxin neutralization were done in MRC-5 cells. The stool samples were extracted four times, three times at pH 2 and once at pH 10, using CHCl3 or ether. Derivatizations of extracts were done with trichloroethanol, heptafluorobutyric anhydride, and heptafluorobutyric anhydride-ethanol, and all derivatives were analyzed by frequency-pulsed electron capture gas-liquid chromatography (FPEC GLC). A dedicated computer was used to assist in both qualitative and quantitative data analysis. Isocaproic acid (iC6) was always found in stool from which C. difficile was isolated and was absent in C. difficile-negative specimens. p-Cresol was found frequently in both persons with pseudomembranous colitis and controls. Tryptamine was found in stool containing C. bifermentans. The FPEC-GLC profiles of persons with acute diarrhea were very different from those of normal persons. Diarrhea associated with adenovirus and rotavirus, Klebsiella spp., and Escherichia spp. showed different FPEC-GLC patterns. Stools from well persons consistently contained full-scale peaks of pyruvic, acetic, propionic, isobutyric, butyric, isovaleric, and valeric acids. In rotavirus stools isobutyric, isovaleric, and valeric acids were reduced in quantity from those found in control stools, whereas propionic and butyric acids were increased. PMID- 6490837 TI - New biphasic culture system for isolation of mycobacteria from blood of patients with acquired immune deficiency syndrome. AB - A new biphasic medium consisting of a 7H11 agar slant and brain heart infusion broth liquid phase has been used for the past 10 months at the University of California at Los Angeles for isolation of Mycobacterium avium complex from blood. In 12 patients whose blood cultures were grown on this medium, the median time for isolation of M. avium complex was 7 days (range 6 to 15 days) compared with 21 to 27 days on a fungal medium and 28 to 38 days on routine blood culture medium. The system has provided a reliable and rapid way to obtain morphology and rapid identification of colonies produced from blood samples of patients with acquired immune deficiency syndrome, who are at high risk for M. avium complex mycobacteremia. PMID- 6490838 TI - Evaluation of a rapid latex agglutination test for identification of group D streptococci. AB - The SeroSTAT latex agglutination test (Scott Laboratories, Inc., Fiskesville, R.I.) for identification of group D streptococci was compared with bile-esculin agar and Lancefield grouping by using 110 clinical isolates of group D streptococci (S. faecalis, 74; S. bovis, 24; S. durans, 3; S. faecium, 9) and 65 viridans streptococci (S. anginosus-constellatus, 2; Streptococcus MG, 15; S. sanguis II, 14; S. mitis, 7; S. mutans, 5; S. salivarius, 8; S. sanguis I, 8; S. acidominimus, 1; S. morbillorum, 2; S. pneumoniae, 3). All strains of group D streptococci were bile-esculin positive. SeroSTAT reactions were falsely positive with 2 strains of S. sanguisII and 1 strain of Streptococcus MG (4.6% of all viridans streptococci tested) and falsely negative with 10 S. bovis, 8 S. faecalis, 1 S. durans, and 6 S. faecium strains (22.7% of all group D streptococci tested). When considered with colonial morphology and hemolytic reaction, SeroSTAT is a rapid (60-s) and useful test for recognition of group D streptococci. PMID- 6490839 TI - Endocarditis caused by Actinobacillus actinomycetemcomitans. AB - Actinobacillus actinomycetemcomitans is a gram-negative coccobacillus which is a very rare cause of bacterial endocarditis. Preexisting cardiac lesions are a main contributing factor, and antibiotic prophylaxis has long been felt necessary before dental or other manipulation to prevent endocarditis. Penicillin in combination with an aminoglycoside has been the most often used treatment regimen. We present a case of endocarditis caused by this organism which developed after antibiotic prophylaxis for dental cleaning. Streptomycin and rifampin therapy resulted in the cure of the infection. The treatment and epidemiology of Actinobacillus endocarditis are reviewed. PMID- 6490840 TI - Recovery of Salmonella group B from blood and Salmonella group C2 from feces and serological evidence of dual infection in one patient. AB - A patient with a dual Salmonella infection is described. Salmonella group B was recovered from three blood culture sets but was not detected in seven stool cultures. Salmonella group C2 was isolated from three of seven stool cultures but was not recovered from blood cultures. Specific, non-cross-reactive antibodies to Salmonella groups B and C2 were detected in the sera of the patient by passive hemagglutination assays. PMID- 6490842 TI - Evaluation of the Pneumoslide latex agglutination test for identification of Streptococcus pneumoniae. AB - The Pneumoslide latex agglutination tests was evaluated with 106 strains of Streptococcus pneumoniae and 56 strains representing seven species of viridans streptococci. The Pneumoslide test gave one false-positive and one false-negative reaction. Testing of isolated colonies for solubility in 10% sodium deoxycholate was as accurate but was simpler and less expensive to perform. PMID- 6490841 TI - Comparison of three tests for virulent Yersinia enterocolitica. AB - Magnesium oxalate agar was found to select against virulent types of Yersinia enterocolitica. Small colonies isolated from magnesium oxalate agar which were presumably virulent generally contained no detectable virulence-specific plasmids, did not agglutinate with virulence-specific antiserum, and exhibited various degrees of virulence in mice. Results indicate that the virulence potential of a Y. enterocolitica isolate cannot always be identified by these in vitro methods and suggest that virulence also involves other factors yet to be identified. PMID- 6490843 TI - Conversion of Blastomyces dermatitidis to the yeast form at 37 degrees C and 26 degrees C. AB - A partially defined agar medium, KT, has been developed and compared with brain heart infusion agar for the conversion of Blastomyces dermatitidis to the yeast form. On the KT medium, the mold form converted to a yeast form within 72 h of incubation at 37 degrees C or after 3 weeks at 26 degrees C. A nutritionally dependent dimorphism in B. dermatitidis was observed. PMID- 6490844 TI - Diarrhea due to Plesiomonas shigelloides in cancer patients. AB - Plesiomonas shigelloides was isolated from the stools of two patients with gastrointestinal malignancies and from one "healthy" patient with diarrhea. No other enteric pathogens were isolated. One patient was neutropenic after antineoplastic chemotherapy. The two cancer patients had crampy abdominal pain and severe diarrhea and required antibiotic therapy for resolution of symptoms. The third patient responded to symptomatic treatment. Patients with gastrointestinal malignancies may be more susceptible to gastroenteritis caused by P. shigelloides than normal individuals, and these infections may be more severe than those seen in normal individuals. PMID- 6490845 TI - Reexamination by bacteriophage typing of Clostridium difficile strains isolated during a nosocomial outbreak. PMID- 6490846 TI - Onset and duration of urinary antigen excretion in Legionnaires disease. AB - The purposes of this study were to determine whether antigen is excreted by patients with Legionnaires disease early enough after the onset of symptoms to be useful for making therapeutic decisions and whether antigen excretion ends when successful treatment is concluded. Specific antigen was detected in the urine of 14 (88%) of 16 patients with Legionnaires disease during days 1 to 3 of symptoms, 33 (80%) of 41 patients during days 4 to 7, 25 (89%) of 28 patients during days 8 to 14, and 11 of 11 patients after day 14, by solid-phase immunoassays for serogroup 1 Legionella pneumophila antigen. Antigen excretion persisted for 42 days or longer after the onset of treatment in at least 15 patients. The longest documented duration of excretion was 326 days. We conclude that antigen can be detected approximately as often early after symptoms begin as later, allowing meaningful therapeutic decisions to be made, but that prolonged antigen excretion may negate the diagnostic value of urinary antigen detection for relapsing or recurrent L. pneumophila pneumonia. PMID- 6490847 TI - Evaluation of three commercial agglutination tests for the identification of Staphylococcus aureus. AB - Three commercially available rapid slide agglutination tests for the identification of Staphylococcus aureus were evaluated with 354 recent clinical isolates (165 strains of S. aureus). The test results of two latex agglutination products, SeroSTAT Staph (Scott Laboratories, Inc.) and Staphylatex (American Micro Scan), and one hemagglutination product, Staphyloslide (BBL Microbiology Systems), were compared with the results of the tube coagulase test, which was read at 4 h (4-h tube coagulase test) and, if negative, again after overnight incubation at room temperature (24-h tube coagulase test). Discrepancies between agglutination and tube coagulase identifications were resolved by use of the thermonuclease, mannitol fermentation, and slide coagulase tests. All sensitivities, specificities, predictive values of a positive result, and predictive values of a negative result for the three agglutination tests were at least 98.8% and comparable with the 4-h tube coagulase test. Best results were obtained with the 24-h tube coagulase test, which yielded one false-negative and no false-positive tests. Agglutination identifications may be performed on organisms taken directly from a primary plate when sufficient growth is present. Kit agglutination procedures yield rapid and reliable identifications and are easy to perform. This study also demonstrates the usefulness of the 24-h tube coagulase test. PMID- 6490848 TI - Pseudomonas mesophilica and an unnamed taxon, clinical isolates of pink-pigmented oxidative bacteria. AB - Twenty-one strains of pink-pigmented bacteria, isolated from human clinical specimens and an environmental source, were compared with Pseudomonas mesophilica ATCC 29983 and Protaminobacter ruber ATCC 8457. These isolates were gram negative, oxidative rods which were motile by means of a single polar flagellum; gave positive catalase, indophenol oxidase, urease, and amylase reactions; and grew slowly at 30 degrees C. Fourteen isolates conformed to the designated type strains Pseudomonas mesophilica ATCC 29983 and Protaminobacter ruber ATCC 8457. The remaining seven strains represented an undescribed taxon. These pink bacteria appear to be invaders of debilitated patients with an underlying chronic disease. PMID- 6490849 TI - Evaluation of the AutoMicrobic system Gram-Negative General Susceptibility-Plus Card. AB - The MICs of 10 antimicrobial agents were determined for 1,000 clinical aerobic and facultatively anaerobic gram-negative bacilli by the 6-h AutoMicrobic system Gram-Negative General Susceptibility-Plus Card (GSC+) (Vitek Systems, Inc., Hazelwood, Mo.) and by an 18-h reference agar dilution method. Results obtained by both systems were evaluated for twofold dilution discrepancies and for interpretive category discrepancies. MICs that differed by more than one twofold dilution between the two test systems were considered to be discrepant. The overall twofold dilution agreement of the GSC+ MICs to agar dilution MICs was 94.0%. The agreement for each drug tested ranged from 91.7% (ampicillin and chloramphenicol) to 96.5% (carbenicillin). Interpretive categories were considered in agreement when the susceptibility interpretations obtained by the two systems were both very susceptible, moderately susceptible, or resistant. The overall interpretive category agreement was 80.5%. This agreement increased to 95.8% when all minor errors (moderately susceptible, one system; very susceptible, the other system) that would not affect therapy were omitted. The AutoMicrobic system GSC+ provides rapid and accurate susceptibility test results for clinical aerobic and facultatively anaerobic gram-negative bacilli. PMID- 6490850 TI - New, extended biotyping scheme for Campylobacter jejuni, Campylobacter coli, and "Campylobacter laridis". AB - A biotyping scheme using improved media and methods for the detection of hippurate hydrolysis, rapid H2S production, and DNA hydrolysis was applied to 1,826 cultures of Campylobacter jejuni, Campylobacter coli and "Campylobacter laridis" isolates from human and nonhuman sources. Four biotypes were identified among C. jejuni: 57.3% of the isolates belonged to biotype I; 36.0%, to biotype II; 4.0%, to biotype III; and 2.7%, to biotype IV. C. coli organisms were differentiated into biotype I (67.0% of the isolates) and biotype II (33.0%). All "C. laridis" isolates belonged to biotype I. The combination of the biotyping scheme with the serotyping of campylobacters provided additional epidemiological markers by further differentiating the serogroups by species and biotypes. PMID- 6490851 TI - Bacteriuria screening by direct bioluminescence assay of ATP. AB - A direct bioluminescence assay for bacteriuria screening is described and compared with the MS-2 system (Abbott Laboratories, Irvine, Tex.) and the chemical strip, Gram smear, and calibrated-loop methods. A total of 973 specimens were tested. Unlike previously described bioluminescence methods, this test measures total ATP in urine without pretreatment of samples to remove somatic ATP. The result was compared with an ATP standard (20 ng/ml). A low result (less than 3% of standard) was interpreted as negative and a high result (greater than 10% of standard) as positive. Samples with intermediate results (38% of total) were incubated at 35 degrees C in thioglycolate broth (1:10). A 2% increase in ATP concentration was interpreted as positive. The sensitivity of this method for detecting greater than 10(5) pathogens per ml was 92.3% and was comparable to those of the MS-2 system (92.7%) and the Gram smear method (90.5%). The chemical strip method was less sensitive (84.0%). The direct bioluminescence method was more sensitive than were the MS-2 system and the Gram smear method for detecting low-level bacteriuria (less than 10(3) to 10(5) organisms per ml), primarily because of associated pyuria. Thioglycolate broth provided a suitable medium for ATP production, and 5% CO2 decreased bacterial ATP synthesis during log-phase growth. The direct bioluminescence assay is rapid, simple, cost-effective, and reliable for bacteriuria screening. PMID- 6490853 TI - Comparison of indirect hemagglutination and rapid plate agglutination tests with counterimmunoelectrophoresis for typing Pasteurella haemolytica. AB - A rapid, simple, and accurate counterimmunoelectrophoresis (CIE) technique was developed and compared with the indirect hemagglutination and rapid plate agglutination techniques for serotyping cultures of Pasteurella haemolytica. The CIE test had 100% correlation with the conventional indirect hemagglutination test and, after serum absorption, correctly identified cultures representing the 12 established serotypes and 49 field isolates of P. haemolytica with reasonable rapidity. Cross-reactions were observed in the CIE and rapid plate agglutination tests but not in the indirect hemagglutination test with antisera prepared from the 12 established serotypes. These cross-reactions were eliminated from the CIE test but not from the rapid plate agglutination test by absorption of antisera with cells which possessed the cross-reacting antigens. Avian isolates of P. haemolytica did not type with antisera to the 12 established serotypes by any of the methods. Both homologous and heterologous reactions were observed with these strains in the rapid plate agglutination and CIE tests with antisera prepared from six selected cultures. These results support the previous finding that the taxonomic relationship of these avian strains to P. haemolytica is questionable. PMID- 6490852 TI - Glucose-sucrose-potassium tellurite-bacitracin agar, an alternative to mitis salivarius-bacitracin agar for enumeration of Streptococcus mutans. AB - An agar medium for selective recovery and enumeration of Streptococcus mutans was developed as an alternative to mitis salivarius-bacitracin (MSB) agar. Combinations of dyes, antibiotics, and tellurite were added to a nonselective medium which, because of its sucrose content, allowed easy recognition of S. mutans colonies. Candle jar incubation for 2 days, by comparison with anaerobic incubation, reduced background flora but did not diminish S. mutans recoveries from clinical samples. Quantitative comparisons were made of the simultaneous recoveries of a number of authentic S. mutans serotype representatives and fresh clinical isolates, using various glucose-sucrose-potassium tellurite-bacitracin (GSTB) formulations and mitis salivarius, MSB, and blood agars. Mitis salivarius counts were not detectably different from blood counts, but counts on MSB were distinctly lower. A formulation of the new medium containing 5% glucose 5% sucrose, 0.001% potassium tellurite, 0.3 U of bacitracin per ml (hence GSTB), and 2% agar gave recoveries nearly equal to those on mitis salivarius agar and much greater than those on MSB. The medium yielded readily recognized S. mutans colonies and facilitated detection of intracellular polysaccharide formers upon flooding with I2 reagent. Freshly isolated serotype c, E, and f colonies could often be distinguished from serotype d and g colonies, a distinction made reliable by testing for intracellular polysaccharide. A study of 300 salivary samples revealed GSTB to give significantly higher recoveries than MSB. About 72% of all samples were substantially underestimated for S. mutans with MSB, and 6.7% of samples were falsely negative for S. mutans with MSB. Recovery of background flora on GSTB was as low or lower than on MSB, and both types of agar could be stored for at least 9 weeks without notable change of selectivity. Thus, GSTB agar appears to be simple and reliable to use and requires no anaerobic incubation. Caution is voiced about interpretation of data previously reported which evaluated S. mutans on MSB agar. PMID- 6490854 TI - Laboratory experience with radiometric detection of bacteremia with three culture media. AB - In two long-term studies, the BACTEC radiometric system for detection of bacteremia was evaluated with three culture media each: (i) BACTEC media 6A (for aerobes) and 7B (for anaerobes) plus a thioglycolate medium and (ii) BACTEC media 6A, 7B, and 8A (hypertonic). In study 1, clinically significant isolates were identified in 1,873 (13.9%) of 13,432 blood cultures with all three media. The thioglycolate medium revealed 143 (1.1%) organisms not recovered from the 6A and 7B media. In study 2, isolates were identified in 1,135 (12.9%) of 8,759 cultures with all three media; 104 (1.2%) organisms were isolated only from the hypertonic medium. The increased yield of positive cultures in the three-medium system is likely due to the larger volume of blood cultured. PMID- 6490855 TI - Use of bone marrow fibroblasts to prepare targets for an HLA restricted cytotoxicity assay system. AB - Methods are described for obtaining and growing fibroblasts from bone marrow for use as virus-infected targets. Fibroblasts obtained at the time of routine marrow examination were maintained through 12 to 18 passages as confluent monolayers. Bone marrow fibroblasts could be infected with varicella-zoster virus, and these infected cells were suitable targets for a 51Cr-release cytotoxicity assay. Since these virus-infected cells retain their HLA-A and -B antigens, they are readily available to study the immune cells which mediate virus-specific cytotoxicity. PMID- 6490856 TI - Diagnostic probability matrix for identification of slowly growing mycobacteria in clinical laboratories. AB - A probability matrix is presented for identification of slowly growing mycobacteria that are likely to be encountered in clinical laboratories. The matrix includes 23 features that are useful for identifying members of 14 species or species complexes. The computer program identifies strains as a function of the ID (identification) score, which measures the discrimination among possible alternative identifications, and the R (ratio) score, which measures the degree of fit to the most likely taxa. It is not necessary to employ all 23 tests when initiating an identification; the program will suggest additional tests to perform when a partial data set fails to yield a definitive identification. Two independent sets of cultures comprising a total of 1,212 strains were used to test the matrix. Correct diagnoses were based on clustering behavior in numerical taxonomic analysis with larger numbers of features. The probable efficiencies with the two sets were 94.2 and 83.4%, respectively, and the accuracy of the definitive identifications for both sets exceeded 95%. A discussion is presented of situations when it may be appropriate to override an R score that has caused the rejection of an identification and to thereby enhance the efficiency. PMID- 6490857 TI - Evaluation of the rapid NFT system for identification of gram-negative, nonfermenting rods. AB - This study evaluated the ability of the Rapid NFT system (API System SA, Montalieu-Vercieu, France) to accurately identify 262 clinically isolated, gram negative, nonfermentative rods without additional tests. Identifications were classified as correct; low discrimination, with a spectrum of two or more possibilities (additional tests necessary for accurate identification); and incorrect. Correct identification rates were analyzed in two categories: (i) correct to species or biotype for all organism groups except Alcaligenes faecalis odorans, Moraxella, Pseudomonas testosteroni-alcaligenes-pseudoalcaligenes, and Acinetobacter calcoaceticus biotype haemolyticus-alcaligenes (in this category, the latter four genus-biotype group identifications were taken as correct) and (ii) correct to species or biotype in all cases, including the above four groups. In category i, 87.4% of the strains were correctly identified, with 4.2% low discrimination and 8.4% incorrect. When the criteria of category ii were used, 71.8% of the strains were correctly identified, with 19.9% low discrimination. The Rapid NFT system provided excellent species identification of Pseudomonas and Flavobacterium spp., Bordetella bronchiseptica, and Achromobacter xylosoxidans strains. Within Acinetobacter calcoaceticus, differentiation between biotypes anitratus and lwoffi was satisfactory, but the system did not differentiate between biotypes haemolyticus and alcaligenes. Species resolution within the genera Moraxella and Alcaligenes was incomplete. All Alcaligenes faecalis strains were misidentified and accounted for 50% of misidentifications with the Rapid NFT system; however, these results may reflect taxonomic differences rather than true misidentifications. The Rapid NFT system is easy to inoculate and interpret and represents a worthwhile advance in the identification of gram-negative, nonfermentative rods. PMID- 6490858 TI - Comparison of strains of gram-negative, anaerobic, agar-corroding rods isolated from soft tissue infections in cats and dogs with type strains of Bacteroides gracilis, Wolinella recta, Wolinella succinogenes, and Campylobacter concisus. AB - A total of 64 strains of gram-negative, asaccharolytic, anaerobic, agar corroding, rod-shaped bacteria from soft-tissue infections of cats and dogs were compared with other agar-corroding, anaerobic organisms isolated from human periodontal pockets (Wolinella recta ATCC 33238T), bovine rumens (Wolinella succinogenes ATCC 29543T), and gingival crevices of humans (Bacteroides gracilis ATCC 33236T and Bacteroides ureolyticus NCTC 10941T). Campylobacter concisus ATCC 33237T (from human gingival crevices) which did not corrode agar but which biochemically resembled organisms in this group was also included in this study. Although the type strains of W. recta, W. succinogenes, and B. gracilis resembled the animal strains phenotypically and in DNA base ratios, none had bacterial protein patterns (as indicated by isoelectric focusing) identical with the animal strains studied. The animal strains could be divided into motile and nonmotile groups. The motile animal strains were similar biochemically but could be divided into three groups by isoelectric focusing of bacterial proteins. Some had cell wall ultrastructural features identical with W. recta; others had the smooth walls of conventional gram-negative organisms. One group of nonmotile animal strains closely resembled B. gracilis phenotypically, and they had the cell wall ultrastructure of conventional gram-negative bacteria as described previously (4). The other nonmotile group had cell wall ultrastructure like that of W. recta. PMID- 6490859 TI - Evaluation of passive bacterial agglutination for the diagnosis of typhoid fever. AB - We evaluated the reliability of a passive bacterial agglutination test to detect Salmonella typhi somatic antigen(s) in the sera of patients with typhoid fever. It was positive in 32 of 33 bacteriologically proven typhoid fever cases. Among 13 patients with a presumptive diagnosis of typhoid fever, 11 were positive by passive bacterial agglutination. The serum of one patient with paratyphoid A was also positive. Among 50 febrile patients without typhoid fever, one was persistently positive during the course of illness; 49 were negative. The sensitivity, specificity, and accuracy indices of the passive bacterial agglutination test were over 95%. The positive and negative predictive values were 94 and 98%, respectively. PMID- 6490860 TI - Comparative evaluation of the Eiken and API 20E systems and conventional methods for identification of members of the family Enterobacteriaceae. AB - To evaluate the accuracy and utility of the Eiken Systek No. 1 (Eiken system; Eiken Chemical Co., Ltd., Tokyo, Japan), we conducted a clinical comparison, with 345 Enterobacteriaceae isolates, of the Eiken System with API 20E (Analytab Products, Inc., Plainview, N.Y.) and conventional methods. The Eiken system is a 21-biochemical-test battery tray stored at 25 degrees C and inoculated in one step. It is similar to the API 20E except that the Eiken system contains malonate, adonitol, and maltose; lacks gelatin, sucrose, melibiose, amygdalin, and arabinose; and uses reagent strips instead of liquid reagents. The API 20E and Eiken systems correctly identified 339 (97.7%) and 276 (79.5%), respectively, and misidentified 3 (0.9%) and 13 (3.7%), respectively, of the isolates. There were no identification codes for 5 (1.4%) organisms with the API 20E and 58 (16.7%) organisms with the Eiken system; of these latter unidentified organisms, 42 were identified as Proteus spp., Morganella sp., and Providencia rettgeri by conventional methods. There was no significant difference between the two rapid systems in total time required for inoculation and reading. Modifications for interpretation of decarboxylase and oxidase tests were needed for the Eiken system, and manipulation of reagent strips required considerable dexterity. However, the Eiken system was easier to inoculate than the API 20E, and, with minor increases in the data base to include more of the Proteus and Morganella spp. and P. rettgeri, the system should be reliable for identification of members of the family Enterobacteriaceae. PMID- 6490861 TI - Antimicrobial agent susceptibility patterns of bacteria in hospitals from 1971 to 1982. AB - Bacterial susceptibility to 16 commonly used antibiotics was analyzed for a 12 year period (from 1971 to 1982, inclusive). Susceptibilities of 5,828,243 strains isolated from a mean of 242 hospitals nationwide and of 194,575 strains isolated at the Massachusetts General Hospital, Boston, Mass., and the Bronx Lebanon Hospital Center, New York, N.Y., were compared. Strains of Escherichia coli, Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa showed virtually the same susceptibilities to antibiotics throughout the 12-year period, whereas Streptococcus faecalis and Staphylococcus epidermidis showed significant increases in resistance to most antibiotics. The close similarity between antibiotic susceptibilities shown at both the 242 hospitals and the 2 individual hospitals suggests that this analysis accurately reflects trends of bacterial resistance to antibiotics in U.S. hospitals. Since most of the species analyzed produce serious disease and high mortality, their susceptibility to antibiotics is relevant both to physicians treating infectious diseases and to epidemiologists. PMID- 6490862 TI - Comparison of the Lumac and Monolight systems for detection of bacteriuria by bioluminescence. AB - The development of practical and rapid methods for detection of infectious disease-producing agents in clinical specimens is the most important current goal of clinical microbiology. Bioluminescence is a technique which is rapid and potentially sensitive enough to detect significant numbers of bacteria in urine specimens. To determine whether bioluminescence is practical and cost effective for routine use, we compared two commercially available instruments and kits, Lumac and Monolight, to standard bacterial cultures on 986 urine specimens. Lumac had an overall 83.7% agreement with cultures, a sensitivity of 92.4%, and a specificity of 79.4%. Monolight had 83.5% agreement with cultures, a sensitivity of 89.1%, and a specificity of 81.8%. There were 13.8% false-positive results and 2.5% false-negative results with both systems. When only potentially significant organisms were included, the false-negative rate was reduced to ca. 1%. Both systems are sufficiently accurate to be recommended for routine use. The cost of bioluminescence is higher than that of bacterial cultures, and bioluminescence may not be cost effective in some laboratories. PMID- 6490863 TI - Patterns of antibodies to staphylococcal DNases in dog sera. AB - Sera from clinically healthy dogs and from dogs with a history of skin disease were examined for the presence of antibodies to the DNases of Staphylococcus aureus, Staphylococcus hyicus subsp. hyicus, and Staphylococcus intermedius. The antibodies found most frequently and in the largest amounts were those to the DNase of S. intermedius. PMID- 6490864 TI - Wound infection caused by Kanagawa-negative Vibrio parahaemolyticus. AB - Kanagawa-positive Vibrio parahaemolyticus strains are considered to be human pathogens and are most commonly associated with summer diarrhea. Kanagawa negative strains are most frequently isolated from the environment and are generally considered to be nonpathogens. We report a wound infection caused by a Kanagawa-negative V. parahaemolyticus strain. The infection occurred in October, an unusual time of the year for a V. parahaemolyticus infection to occur in the mid-Atlantic region of the United States. PMID- 6490865 TI - Evaluation of a leukocyte dip-stick test used for screening urine cultures. AB - A 2-min leukocyte esterase dip-stick test for pyuria was used to screen 409 consecutive clinical specimens received for culture. The leukocyte esterase dip stick test proved to be a sensitive and inexpensive means of screening urine specimens for the absence of leukocytes and, by inference, for the absence of significant bacteruria. PMID- 6490866 TI - Chocolate agar, a differential medium for gram-positive cocci. AB - Reactions incurred on chocolate agar by gram-positive cocci were correlated with species identity. Darkening and clearing of the medium was usually associated with the species Staphylococcus epidermidis, Staphylococcus aureus, Staphylococcus simulans, and Streptococcus faecalis. Yellowing of chocolate agar was associated with alpha-hemolytic species of Streptococcus. The study demonstrated that reactions occurring on chocolate agar are useful in identifying gram-positive cocci. PMID- 6490867 TI - Antigenic identity of Yersinia enterocolitica serotypes O:Tacoma and O21. AB - Yersinia enterocolitica serotypes O:Tacoma and O:21 are antigenically identical and include both pathogenic and nonpathogenic types. PMID- 6490868 TI - Congenital posteromedial bowing of the tibia and fibula. AB - Patterns of growth and development are presented for 33 patients with congenital posteromedial bowing of the tibia and fibula. The bowing is accompanied by shortening of the tibia and fibula, an initial calcaneovalgus deformity of the foot, and a decrease in ankle motion that does not improve with age. In general, the greater the initial bowing, the greater the ultimate extremity length discrepancy. The proportionate length differences between the normal and the bowed tibiae remained stable after the age of 12 months. This allowed a projection of anticipated extremity length discrepancy at maturity and a determination of the proper treatment. At birth the bowing varied from approximately 25 to 70 degrees, and at maturity the absolute tibial length discrepancies varied from 3.3 to 6.9 cm. Both the posterior and the medial components of the bow became markedly reduced with increasing age, but a mild residual medial portion of the bow remained. Soft tissue enlargement was observed in the posterior aspect of the affected legs in early life and developed to a relative muscle atrophy in later years. PMID- 6490869 TI - Advantage of early spinal stabilization and fusion in patients with Duchenne muscular dystrophy. AB - Segmental instrumentation and fusion of spinal deformity in patients with Duchenne muscular dystrophy yields good correction and provides firm internal stabilization that allows rapid mobilization of patients following surgery. When surgery to stabilize spinal deformity is done in younger patients in whom pulmonary function is better and curves are milder, complication rate and length of hospital stay are diminished, correction and balance are improved, and patients rapidly return to their normal life-style. We no longer routinely attempt orthotic treatment of these curvatures, but advise stabilization of the collapsing spine surgically with segmental instrumentation and fusion when scoliosis reaches 30-40 degrees. PMID- 6490870 TI - Acquired valgus deformity of the tibia in children. AB - Nine cases of acquired valgus deformity following injury to the proximal tibial metaphysis in children are presented. The deformity is of a dual nature, involving both angular deformity and longitudinal overgrowth. The angular component reaches a maximum within 2 years after the injury. There is some indication that the angular component will remain static or spontaneously correct if treated nonoperatively. Treatment intervention in the majority of the cases has precluded an analysis of the natural history of the longitudinal overgrowth. Early intervention in the form of corrective osteotomy during the growth years has resulted in an unacceptably high rate of recurrence of both components of the deformity. Nonoperative treatment seems to be the treatment of choice for the angular component of valgus deformity following proximal tibial fracture in children. Significant longitudinal overgrowth may be corrected with appropriately timed epiphysiodeses calculated from observed growth rates and skeletal maturational patterns. PMID- 6490871 TI - Arthroscopy of the knee in children. AB - A review was carried out of arthroscopy of the knee in children. During a 34 month period, 2,378 arthroscopies were performed, 80 of these on children less than 16 years of age. Seventy-one cases were reviewed, which is approximately 2% of all children seen at the clinic. Thirty procedures were carried out in patients with hemarthrosis. Eleven patients required operative repair or reconstruction. There were 13 ruptures of the anterior cruciate ligament (43%), 4 ruptures of the posterior cruciate ligament, 14 ruptures of the medial collateral or posterior oblique ligament, and 5 ruptures of the lateral meniscus. Forty-one arthroscopies were done in patients without hemarthrosis or history of acute trauma. A clinical diagnosis of meniscus tear was correct in only 20%. Only one meniscectomy was performed and another meniscus tear was repaired. The most common diagnostic finding was abnormality of the patellofemoral articulation, which was diagnosed in 31 patients. Arthroscopic shaving of the patella was rarely indicated. As in adults, hemarthrosis indicates significant injury to the knee. Meniscus lesions are rare. PMID- 6490872 TI - Experimental epiphyseal separation by torsional force. AB - Separation of the proximal tibial epiphysis from the metaphysis by torsional force was experimentally studied using cadaver bone preparations from 19 adolescent sheep. The energy needed to displace the epiphysis increased in correlation with an increase in the age of the animal. The separated epiphyseal and metaphyseal surfaces were examined using scanning electron microscopy. In the younger animals the separation line passed through the area of hypertrophied chondrocytes. In the animals more near skeletal maturity the separation occurred in a more sinuous fashion and also through spongious bone. PMID- 6490873 TI - Syme amputation in children: indications, results, and long-term follow-up. AB - Syme amputations are not always effective. Heel pad migration, skin sloughs, and problems with prosthetic fitting may complicate a seemingly simple procedure. We reviewed 69 Syme amputations performed in 62 children at the Los Angeles Shriners Hospital between 1956 and 1980. The major indication was leg length discrepancy, due to either paraxial fibula hemimelia (33 cases) or proximal focal femoral deficiency (19 cases). The average age at amputation was 5.6 years, with an average follow-up of 10.5 years (range 1-25 years). The results were assessed by a combination of chart review, patient recall examinations, and questionnaires. Satisfaction in adulthood was high. Early complications included three skin sloughs and one infection. Late complications included 2 retained os calcis apophyses, 1 exostosis, and 16 cases of heel pad migration. Only one of the heel pad group required revision; prosthetic adjustment resolved the others. Prosthetic knees were often too low because of failure to limit the length of the stump appropriately. Syme amputation should be considered a primary reconstructive procedure, rather than a last resort, in fibula hemimelia and proximal femoral focal deficiency. PMID- 6490874 TI - Extraarticular subtalar arthrodesis with internal fixation. AB - Forty extraarticular subtalar arthrodeses with internal fixation were performed in 26 patients with cerebral palsy who had a mobile, paralytic planovalgus deformity. We assessed the correction achieved and maintained by evaluating the clinical status, improvement in gait, correction of deformity, and foot stability. Union was achieved in a mean interval of 10 weeks with no instance of mechanical failure of the fixation screw. At a mean follow-up of 30 months, 38 feet (95%) were rated excellent or good and two were rated fair. The advantages of this technique of extraarticular subtalar arthrodesis warrant continued use of this procedure. PMID- 6490875 TI - Foot deformities secondary to gluteal injection in infancy. AB - We report six cases of foot deformities in children due to sciatic nerve dysfunction that appear to have been caused by gluteal intramuscular injection. Of four patients who developed cavovarus foot deformities, two also exhibited a component of ankle equinus. A fifth patient had a calcaneocavus foot deformity. In the sixth patient foot palsy resolved completely 1 year after injury, and no deformities developed. Identification of the muscle imbalance, as well as appropriate correction of the deformity before the implementation of muscle balancing procedures, led to the attainment of a satisfactory plantigrade gait in the first five patients with deformities. Bases on our experience with these six cases and reports in the literature, we recommend that the superolateral gluteal area between the crest of the ilium and the greater trochanter be properly defined as the preferred site for intramuscular injection. PMID- 6490876 TI - Ball-and-socket ankle joint: anatomical and kinematic analysis of the hindfoot. AB - Ten feet in eight children with ball-and-socket ankle joint (BSA-J) are reported with discussion of associated anomalies, kinematic analysis of the hindfoot motion, and talocalcaneal malalignment in the apparent valgus deformities. BSA-J is considered to be a common congenital condition associated with other anomalies in the foot or lower extremities. Even though BSA-J seems to have unusual side-to side motion at the ankle joint, it does not occur in patients without subtalar fusion. Moreover, apparently valgus feet are responsible for talocalcaneal malalignment, not for lateral unstable motion at the ankle. PMID- 6490877 TI - Slipped epiphysis associated with hypothyroidism. AB - Seven cases of slipped capital femoral epiphysis appearing concurrently with juvenile hypothyroidism are reported. This association seems to occur more commonly than the general incidence of slipped capital femoral epiphysis or of juvenile hypothyroidism would suggest, and the thyroid hormone deficiency and a diminished strength of the epiphyseal growth plate of the upper femur appear to be associated. Although concrete scientific data are as yet not available to define clearly the effect of thyroid hormone on the growth plate, the possible pathophysiology is discussed in light of available data. PMID- 6490878 TI - Pin placement in slipped capital femoral epiphysis. AB - Standard radiographs taken at right angles to each other during the pinning of a slipped capital femoral epiphysis may not demonstrate pins protruding into the joint. In this study roentgenograms of 110 patients (148 hips) with slipped capital femoral epiphyses were analysed by a three-dimensional mathematical model of the femoral head and pin position. A computer was used to determine the spatial distance between the tip of the pin and the subchondral bone of the femoral head. Pin protrusion was found in 41 hips. In 22, protrusion was sufficient to have transgressed the joint space. Pin protrusion did not, however, appear to increase the risk of chondrolysis. PMID- 6490879 TI - Use of pulsed electromagnetic fields in Perthes disease: report of a pilot study. AB - A pilot study of pulsed electromagnetic fields (PEMFs) in the treatment of 10 older children with unilateral Perthes disease of the hip is reported. Patients were allowed to walk using crutches, with the affected hip splinted by the Birmingham containment orthosis during the day. For 10 h during the night the affected hip was exposed to PEMFs delivered via a pair of coils, mounted anterior and posterior to the hip joint on a plastic abduction orthosis. Splintage time of this group was compared with that of 72 patients selected at random from a historical control group of 200 patients. The 72 patients and the 10 children were assigned to early or late groups depending on the radiologic evolution of the disease when treatment commenced. The group of 10 children showed an overall reduction of time in all splintage of 32% in early cases (to 12.8 months) and 18% in late cases (to 13.5 months). No untoward effects were detected during the 2 years that these children have been under observation. In view of the apparent safety of PEMFs and their effects in this limited population of older patients with advanced Perthes disease, a double-blind study in younger patients with earlier lesions seems to be justified. PMID- 6490880 TI - Hip disease in Hutchinson-Gilford progeria syndrome. AB - Two cases of Hutchinson-Gilford progeria syndrome are presented with a focus on hip disease. A severe coxa valga is the first abnormality. The femoral head becomes increasingly uncovered as the acetabulum becomes more dysplastic. The center edge angle decreases, the acetabular index increases, and the medial wall of the acetabulum widens. Hip pain, subluxation, and eventually dislocation are the sequelae of these changes. Late osteotomy is unpredictable; thus the best therapeutic regimen is early osteotomy (age 4-6 years) and a regular exercise program to maintain muscle strength and range of motion. PMID- 6490881 TI - Transient osteopaenia of the hip in children. AB - The syndrome of transient osteopaenia of the hip is described in children for the first time. Six children 6-12 years of age are presented with follow-up between 1 and 4 years. The presenting symptoms, clinical signs, investigations, and radiologic changes are described, together with the findings at arthrotomy of the affected joints. This syndrome in children closely parallels that described in adults, but, presumably because of growth potential, enlargement of the affected bones occurred in two patients. Management, with emphasis on excluding more sinister pathology and avoiding excessive treatment, is outlined. The fact that the syndrome is characterised by spontaneous resolution is stressed. PMID- 6490882 TI - Osteomalacia of very-low-birth-weight infants. AB - Neonatal osteomalacia has received scant attention in the orthopedic literature, despite a reported incidence of 13-32% in very-low-birth-weight infants. This retrospective study focused on the calcium, phosphorus, and vitamin D metabolism of 10 surviving infants up to 28 weeks old born over a 30-month period. Clinical and radiologic evidence of osteomalacia appeared to be related to the intake of calcium and phosphorus. The lower the amount of mineral intake, the more severe was the clinical appearance of rickets. The amount of vitamin D intake, although low, did not correlate with the degree of clinical or radiographic abnormalities noted in these infants. There was an orderly appearance of radiographic changes that were dependent on the amount of mineral depletion. Recognition and identification of the early radiographic findings may lead to the early diagnosis and treatment of osteomalacia in the very-low-birth-weight infant. Prevention of fractures resulting from calcium, phosphorus, or vitamin D deficiency is the goal of early therapy. PMID- 6490883 TI - Arthrogryposis of the hand. AB - Forty-five cases of arthrogryposis multiplex congenita were reviewed with respect to deformities and function of the hand. A distal predominance of the involvement and severity was apparent; hand deformity was a common manifestation in the arthrogrypotic patients. The majority of the hand deformities consisted of two types: one was a thumb-in-palm deformity with the fingers in intrinsic plus position, and another type was flexion contractures of the fingers at the interphalangeal joints. Regardless of type, hand function was impaired with severe or moderate deformity. Twenty-nine hands of 17 patients were successfully treated by surgery. Surgical methods are discussed based on an analysis of hand deformity and function. PMID- 6490884 TI - Pattern of forearm fractures in children. AB - Retrospective analysis of 500 consecutive fractures of the forearm in normal children was conducted. The fracture pattern secondary to fall on the out stretched arm in the pediatric age group is for the fracture line to progress from proximal to distal with advancing skeletal age. Fractures falling outside described norms for the age represent a different population. In the older child they are an increased indication for open reduction, and in the younger child indicate an increased possibility of child abuse. Changes in the radial shaft occurring with maturity place differing areas at risk and are offered as the major reason for the fracture pattern. Epiphyseal fractures of the forearm were primarily fractures of early adolescence rather than childhood. PMID- 6490885 TI - A postoperative long-term study of the deltoid contracture in children. AB - Sixty-eight children with contracture of the deltoid muscle (82 shoulders) were treated operatively. These cases showed a minimum angle of 25 degrees of abduction in the resting position. The postoperative course with a minimum follow up of 5 years was analyzed in 40 cases (49 shoulders). Abduction contracture of the shoulder joint completely disappeared after surgery in 23 shoulders (47%), and winging of the scapula disappeared in 39 shoulders (78%). The angle of horizontal adduction was restored in 14 shoulders (41%) postoperatively. Contracture recurred in only three shoulders (6%). PMID- 6490886 TI - Stress fracture of the femoral shaft in children: report of two cases and discussion. AB - Stress fractures of the femur in children are unusual. This report describes the findings of two recent cases in children. Because of the potential for confusion with malignant lesions, it is hoped that these two illustrative cases will encourage the inclusion of a stress fracture diagnosis in femoral lesions in children. Also described is a CT scan finding which may be unique to stress fractures. PMID- 6490887 TI - Fracture separation of the distal humeral physis in the newborn. AB - Fracture separation of the distal humeral physis in the newborn is a rare injury. Two case reports are presented, both with a history of traumatic delivery and a clinical examination revealing swelling, hypermobility, and muffled crepitance about the elbow. Radiographs demonstrated posteromedial displacement of the distal humeral epiphysis with respect to the shaft. Closed reduction with splint immobilization is the most common form of treatment. PMID- 6490888 TI - Articular cartilage sleeve fracture of the lateral humeral condyle capitellum: a previously undescribed entity. AB - Salter-Harris type IV fractures of the lateral humeral condyle are well recognized injuries that have been previously described and classified. The case of an 11-year-old boy who sustained an unusual fracture of the distal humerus with the free fragment composed of 75% of the articular cartilage of the capitellum is presented. The cartilage was attached to only a thin shell of subchondral capitellar bone in continuity with the lateral aspect of the distal humeral physis and metaphysis. Radiographs did not show the magnitude of the articular cartilage component of the fracture, although physical examination was significant for elbow crepitus through a limited range of motion. Open reduction and internal fixation were necessary to achieve a congruous joint and restore anatomic alignment. PMID- 6490889 TI - Persistent congenital isolation of the suprapatellar pouch mimicking patellofemoral disease. AB - A patient with congenital isolation of the suprapatellar bursa presented with pain suggestive of patellofemoral joint disease. At arthroscopy, injection filled only the bursa. The diagnosis of congenital isolation of the suprapatellar bursa was made by the injection of radiopaque material into the bursa. Excision of the bursa eliminated the symptoms. This case is instructive, as it documents an unusual congenital anomaly that can complicate arthroscopic technique and can be a rare cause of knee pain. PMID- 6490890 TI - Dysplasia epiphysealis hemimelica. AB - A new case of dysplasia epiphysealis hemimelica is reported. It is the third case reported in Spain and presents involvement of almost all the epiphyses of the left side of the body. The involvement of the left hip following surgery is hard to explain. The patient also presents lengthening of the left lower limb. Following a review of the world literature, it seems that this case demonstrates the greatest epiphyseal involvement to date. PMID- 6490891 TI - Vitamin K deficiency presenting with hemarthrosis. AB - A breast-fed 25-day-old infant was hospitalized because of swelling and tenderness of the left leg, developed after mild rotary motion of the leg by his brother. Radiographic examination showed widening of the left articular hip joint space. On the day of admission, a presumptive diagnosis of septic arthritis was entertained, and antibiotic therapy was instituted. Following profuse bleeding from sites of skin punctures, coagulation studies were performed. Prothrombin time and partial thromboplastin time were prolonged. Administration of phylloquinone (vitamin K1) resulted in rapid normalization of coagulation. Differential diagnosis between hemarthrosis resulting from vitamin K deficiency and septic arthritis with disseminated intravascular coagulation is a matter of great importance in such patients. PMID- 6490892 TI - Orthotic management of severe genu varum and tibia vara. AB - In two cases of severe genu varum and one case of infantile tibia vara, we employed double-upright knee-ankle-foot orthoses with free knee and ankle joints. The patients tolerated these orthoses well and were able to walk. The results were satisfactory. PMID- 6490893 TI - Slipped capital femoral epiphysis. AB - Slipped capital femoral epiphysis is a common malady which must be managed by virtually every orthopedic surgeon. While each of us has a "foolproof method" of managing the disease, we also have somewhere in our files a patient with a disastrous outcome. The next several instructional cases will focus on the trials and tribulations of this disorder. Each of the discussants has had to formulate his opinions regarding management at each step in the case presentation, without knowledge of the subsequent outcome. We hope through this process we all will learn from our own and others' mistakes. PMID- 6490894 TI - The public health effects of the death penalty. PMID- 6490895 TI - Cigarette taxation: doing good by doing well. PMID- 6490896 TI - Newer perspectives on the health of Canadians: beyond the Lalonde report. The Rosenstadt lecture. PMID- 6490897 TI - The prevention of dust diseases in coal miners. PMID- 6490898 TI - International trends in alcohol production, trade and consumption, and their relationship to alcohol-related problems, 1970 to 1977. PMID- 6490899 TI - A rebuttal to the tobacco industry's paper, "Cigarette Smoke and the Nonsmoker". PMID- 6490900 TI - Federal funds and state motor vehicle deaths. PMID- 6490901 TI - High school students' views of laws restricting teenage driving. PMID- 6490902 TI - San Diego county's community right-to-know ordinance: case study of a local approach to hazardous substances control. PMID- 6490903 TI - Reflections on an elusive vision: social work in health. PMID- 6490904 TI - The Yugoslav health system: public ownership and local control. PMID- 6490905 TI - Macrocephaly and minor congenital anomalies in children with learning problems. AB - To determine whether existing data which indicate a significant prevalence of abnormal head circumference and minor congenital anomalies in referred learning disabled populations could be replicated in a nonreferred population, 75 children enrolled in learning disabilities resource programs in an elementary school district were compared with a matched group of 73 children. Macrocephaly (occipitofrontal head circumference of 2 or more SD above the mean) was noted significantly more often in resource than in control children (12 versus 3) (p less than 0.05). Macrocephalic resource children had significantly lower achievement scores than either normocephalic resource or control children (p less than 0.05). There were no significant differences between resource and control children for mean number of anomalies per child, frequency of individual anomalies per group, or evidence of recurring anomaly patterns in the resource children. The macrocephalic resource children revealed the same prevalence of anomalies as normocephalic resource and control children, with no evidence of recurring anomaly patterns. Resource children with four or more anomalies did not differ from those with three or fewer anomalies on any psychometric parameters. Clinical, familial, radiological, and psychometric investigation of several macrocephalic resource children indicated similar patterns of learning deficits and documented evidence of familial macrocephaly but did not show any recognizable CNS abnormalities. This study confirms a significant prevalence of macrocephaly in children with learning problems. It indicates the need for further research into the prevalance and patterns of learning deficits in children with familial macrocephaly. The results add to recent concerns about the psychoeducational criteria of specific learning disabilities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490906 TI - Behavioral adjustment of children attending a residential school for the blind. AB - The behavioral adjustment of 23 children attending a residential school for the blind was examined using a well-standardized behavior rating scale. Ratings of internalizing, externalizing, and overall problem behaviors were obtained from either the dorm or natural parents, using Achenbach's Child Behavior Checklist (CBCL). Stepwise multiple regression analyses of demographic and intellectual variables indicated that WISCR Verbal IQ accounted for 50% of the variation in the adjustment ratings. Compared with the CBCL's sighted reference group, the blind children had a significantly greater number of internally directed problem behaviors, although the mean I score was still within the normal range. Implications for clinicians evaluating visually impaired children are discussed. PMID- 6490907 TI - Improving physician/teacher collaboration. AB - This paper describes a three-phase project designed to improve physician/teacher collaboration with exceptional school children. In phase 1, the school district's 54 special education personnel completed a 24-item questionnaire designed to identify communication and role-expectancy problems. Phase 2 consisted of a series of workshops in which physicians explained their evaluations and and treatments of exceptional children. In phase 3 a collaboration model linking the school district and a university-based medical center was developed and implemented. Questionnaire data, the collaboration model, and suggestions for other models are presented. PMID- 6490909 TI - Plasma progesterone concentrations and infant temperament. AB - Progesterone and its metabolites are potent depressors of the central nervous system. Plasma progesterone concentrations significantly correlated with temperament ratings for approach/withdrawal (r = -0.35, p = 0.01) and intensity (r = -0.28, p = 0.04) among 42 normal infants. The median age at the time of the progesterone sample was 36 days. Easier infants tended to have higher plasma progesterone concentrations compared with more difficult infants (mean +/- SEM: 25 +/- 4 ng/dl versus 17 +/- 3 ng/dl, p = 0.15). Results are consistent with the hypothesis that progesterone or its metabolites may exert a behavioral depressor effect in infancy. PMID- 6490908 TI - Behavioral effects of circumcision with and without anesthesia. AB - The behavior of full-term neonates undergoing circumcision with and without local anesthesia was examined using the Brazelton Neonatal Assessment Scale (BNAS). Evaluations were done blindly pre-and postcircumcision and on the day following the procedure. Infants receiving lidocaine in a dorsal penile nerve block (DPNB) remained more attentive to animate and inanimate stimuli following circumcision and demonstrated a greater ability to quiet themselves when disturbed. The smoothness and maturity of motor behaviors showed the expected rate of improvement or recovery curve in the anesthetized group, while the control group's behavior did not. Behavioral differences were still evident on the day following the procedure. This report adds to the growing body of data that indicate that circumcision is a painful procedure that disrupts the course of behavioral recovery following birth. These disruptions can be lessened by the use of local anesthesia to relieve pain and stress during the procedure without any additional morbidity. These data support the use of DPNB during anesthesia for routine neonatal circumcisions still requested by the majority of parents in the country. PMID- 6490910 TI - The forensic pediatrician as a child advocate. AB - This paper focuses on the medicolegal activities of a group of six pediatricians from the Winnipeg Children's Hospital. Increasing legal demands resulted in 93 court appearances for the group, during a 12-month period ending in December 1982. The educational processes and the individual court room issues confronted by both the courts and the six pediatricians, dealing with problems of child protection, are described. Major pediatric roles and principles of advocacy resulting from these experiences are delineated. Society's accountability is discussed with specific reference to the pediatrician's role. PMID- 6490911 TI - Examining the Chapman and Chapman theory of schizophrenia through continuous word association with two nosological systems. AB - Examined the Chapman and Chapman (1973) theory of excessive yielding to normal response biases in schizophrenia by using the technique of continuous word association. The word association stimulus list included items with single and multiple meanings (homographs) in order to investigate differential response characteristics between single- and multiple-meaning items and the relative neglect of nondominant meaning responses. Several word association variables were examined, including logical relatedness, reaction time, and response productivity. Further, two discrete samples were studied: A DSM-II-diagnosed sample of schizophrenic and non-schizophrenic Ss (N = 61) and a sample (N = 60) diagnosed according to the more contemporary Research Diagnostic Criteria of Spitzer, Endicott, and Robins (1978) with schizophrenic, manic, and schizoaffective disorder diagnoses. Results were not in accord with predictions derived from the Chapmans' theory using either diagnostic approach. PMID- 6490912 TI - The "winter born phenomenon" among schizophrenics: differences between blacks and whites. AB - Reviewed the literature on birth seasonality among schizophrenics and reported data on highly significant differences between the quarterly birth patterns of black and white schizophrenics (N = 724). The findings strongly indicate that specific subgroups of schizophrenics are especially likely to be winter-borns. Log-linear analyses uncovered a highly significant difference between the birth seasons of black and white patients. Black schizophrenics are especially likely to be winter-borns, while white schizophrenics had a birth peak in the fall. We speculate about the causes of this race-specific finding from a perspective that is sociological and neurophysiological. PMID- 6490913 TI - Older age research non-responders: an inpatient "profile". AB - Examined the differences between older research non-responders and older completers and between older research non-responders and younger ones. As part of a large cooperative Veterans Administration study, a sample of 619 older non responders were compared to 964 older completers and also to 4,731 younger non responders on basic demographic and treatment factors, as well as on self-rated adjustment dimensions. Among other factors, results show that older non responders tend to be substance abusers, to be "loners," but have equal or better adjustment ratings than older completers; and among other variables, older non responders tend to be "first timers" in psychiatric hospitals, to have greater treatment expectations, and to rate themselves with better adjustment in many areas relative to younger non-responders. PMID- 6490914 TI - Self-reported psychiatric symptoms among black, Hispanic, and white outpatients. AB - Examined ethnic differences among black, Hispanic, and white applicants for outpatient psychotherapy, using symptoms self-reported on the Symptom Checklist 90-Revised (SCL 90-R). The relationship between self-reported severity of symptoms and therapist-reported severity of psychiatric diagnoses also was examined in order to assess the utility of SCL 90-R as a predictor of diagnostic severity for these ethnic groups. One hundred sixty-five patients completed the SCL 90-R. The patients were predominantly in the low-income social classes. A significant ethnic effect was found on several symptom dimensions, with black patients less likely to report symptoms than Hispanic or white patients. Hispanic patients were found to report the highest symptom levels on 8 of 11 measures. While, overall, therapist diagnostic severity was related significantly to self reported symptomatology, the relationship was strongest for white patients, significant but less strong for Hispanic patients, and not significant for black patients. PMID- 6490915 TI - Motivation to obtain self-relevant feedback in depressed college students. AB - Thirty depressed and 30 nondepressed college students completed a social judgment task. Students initially received either positive, negative, or no preliminary feedback and were told that they could obtain more extended feedback about their performance at a cost of $.20 for each unit of feedback. As predicted, depressed students were willing to relinquish a greater amount of money to obtain self relevant feedback. Additionally, depressed and nondepressed Ss were more motivated to obtain additional feedback after they had received positive or no preliminary feedback than after they had received negative preliminary feedback. Results support Rehm's (1977) description of a heightened need for external reassurance among depressed persons. PMID- 6490916 TI - Parent MMPI critical item and clinical scale changes in the 1970s. AB - The Child and Adolescent Psychiatry Service of the William S. Hall Psychiatric Institute, Columbia, South Carolina, routinely administers the MMPI to the parents of children and adolescents in outpatient psychiatric treatment. The MMPI data obtained from parents during the (1970-74) and (1975-79) periods (N = 342) have been analyzed from two perspectives. MMPI critical item endorsement and MMPI clinical scale changes have been evaluated statistically through a comparison of parents in the two time periods. Both the increase in clinical scale elevations and shift in critical item endorsement suggest a parent population in which mothers are suffering considerably more psychological distress or psychopathology than fathers during the last 5 years. The findings indicate the need for cross clinic replications of the present investigation in order to establish the reliability of the current findings. PMID- 6490917 TI - Social support, personality and the prediction of psychological distress: an interactionist approach. AB - Theoretical considerations as well as recent research suggest that the concept of social support, instead of being viewed solely as a stress buffer, should be seen as an important etiological factor in symptom development in its own right. Consequently, the present study set out to examine the influence of six personality factors, derived by a principal component analysis of the 16PF, on the relationship between social support and symptoms of psychological distress in a student sample (N = 139). The results indicated a significant interaction between extraversion and social support; extraverts showed a substantially heightened sensitivity to social support variations. This finding appears to emphasize the usefulness of an interactionist approach that integrates person and context variables for the prediction of psychological distress. PMID- 6490918 TI - Clinical utility of the McVaugh and Grow rules for the detection of faking on the Personality Inventory for Children. AB - Investigated the clinical utility of the McVaugh and Grow (1983) suggestions that Adjustment Scale (ADJ) greater than or equal to 84T indicates faking bad and K greater than or equal to 59T or Social Desirability (SD) greater than or equal to 54T indicates faking good on the Personality Inventory for Children (PIC) in 100 children, aged 6-0 to 12-11, seen in a private, fee-for-service, practice of psychology. Profiles that exceeded the fake bad criterion were found in 35% of the cases, but only one profile met fake good criteria. In contrast to profiles below the faking bad criterion, those profiles with ADJ greater than or equal to 84 were associated with higher levels of family pathology, a higher incidence of learning disabilities, and a higher incidence of hyperactivity. It was concluded that profiles that meet the ADJ greater than or equal to 84T criterion reflect psychopathology, not faking. PMID- 6490919 TI - Measuring family functioning with the MMPI: a reliability and concurrent validity study of three MMPI family scales. AB - Examined the utility of three MMPI family scales. Three MMPI family scales and three criterion family scales were administered to 110 undergraduates. Internal consistency coefficients were calculated for each MMPI family scale. Relationships between the MMPI family scales and the criterion scales are examined by a correlational analysis. Findings suggest that the MMPI family scales are reliable and concurrently valid measures of an individual's perception of interpersonal family relationships. Procedures for scoring and interpreting the MMPI family scales are examined. The findings also indicate which MMPI family scale is the overall best scale. PMID- 6490920 TI - Correlates of death anxiety in elderly persons. AB - Studied the variables related to death anxiety in the elderly. The population consisted of 122 elderly persons who resided in the community and in institutions. Questionnaires that measured demographics, support systems, health, personality, and death anxiety were administered. Multiple regression analyses with death anxiety as the criterion were performed on five subsamples of the population. The results showed very little consistency in predictors of death anxiety among the subsamples. It was concluded that death anxiety response patterns are a function of the population examined, rather than existing as general characteristics of the elderly, which explains the inconsistency of previous literature on death anxiety in elderly persons. PMID- 6490921 TI - Reassessment of inferring personality traits from Bender-Gestalt drawing styles. AB - Fifty patients with closure difficulty on the Bender-Gestalt and 50 patients with edging tendencies on the Bender Gestalt were assessed for possible personality traits associated with those drawing styles. Patients with and without the drawing styles were compared using MMPI data. Patients who drew along the edge of the paper showed no significant difference in MMPI scores when compared to non edgers. Patients with closure difficulty were significantly higher on Scale O of the MMPI than were the non-closure difficulty patients. The difference was not considered to be interpretatively important. PMID- 6490922 TI - Age-related decrements in Stroop Color Test performance. AB - Administered a modified Stroop Color-Word Test to 80 healthy males aged 21-90 years as part of a study of neuropsychological functioning. No age differences were demonstrated on simple reading tasks; however, significant age effects were observed for the color naming and interference tasks (ps less than .001). Ss in the oldest age groups (61-70 and 71-90 years) performed more slowly than younger individuals on both of these. Of a variety of tests administered, performance on the Stroop Test was most affected by age. Because impairment on Stroop color naming and interference tests appears to be a concomitant of normal aging, caution should be exercised when one is interpreting Stroop test results from older patients with suspected cerebral dysfunction. PMID- 6490923 TI - Comparison of the Wisconsin Card Sorting Test and the Halstead Category Test. AB - Correlational comparisons of the Wisconsin Card Sorting Test and the Halstead Category Test (Pendleton & Heaton, 1982) are criticized as inadequate to assess the degree to which these two tests call upon the same cognitive processes. Asking patients to "think aloud" while performing on the tests is recommended as a more direct approach to understanding the cognitive components of the tests. Some results of analysis of such think-aloud protocols are presented that suggest the differences and areas of overlap of the two tests. PMID- 6490924 TI - The Slosson Intelligence Test and young learning-disabled children: a comparative study. AB - Evaluated 26 children independently diagnosed as learning disabled in a counterbalanced design with the deviation IQ form of the Slosson Intelligence Test and the Wechsler Intelligence Scale for Children-Revised (WISC-R). Moderate to good correlations were obtained between the Slosson and the WISC-R Full Scale (r = .91), Verbal (r = .94) and Performance (r = .60) IQ scores. The Slosson correctly predicted functioning level to within 10 IQ points of WISC-R Full Scale scores for 88% of the Ss. These data suggest that the recent revision of the Slosson has corrected the tendency of earlier versions of this instrument to inflate the estimated IQs of young learning-disabled children. PMID- 6490925 TI - Reliability and validity of the Primary/Secondary Alcoholism Classification Questionnaire and the Hk/MBD Childhood Symptoms Checklist. AB - Primary vs. Secondary Alcoholism and claimed childhood symptoms of hyperkinesis/minimal brain dysfunction (Hk/MBD) have been shown to predict cognitive differences in alcoholics. The reliability and validity of the methods used to measure these variables were investigated in three separate studies. High test-retest reliability of the Primary/Secondary Classification Questionnaire and the Hk/MBD Childhood Symptoms Checklist was found in the first study (N = 45). In the second, the validity of the Hk/MBD Checklist was investigated by comparing childhood symptoms claimed by the alcoholics with those ascribed by relatives to them (N = 53). A significant positive correlation was found. Finally, a satisfactory percent agreement between the Primary/Secondary Classification Questionnaire and a clinical interview to elicit the same information was obtained in two samples (N = 38). These self-administered instruments, the Primary/Secondary Classification Questionnaire and the Hk/MBD Childhood Symptoms Checklist, should prove useful in future research on diagnosis and treatment of alcoholism. PMID- 6490926 TI - Factor structure of the Profile of Mood States (POMS): two partial replications. AB - Examined the factor structure of the Profile of Mood States (POMS) in samples of psychiatric outpatients (N = 165) and adult smokers (N = 298). Principal component analyses (oblique rotation) yielded seven interpretable components in both cases, which accounted for 66% and 64% of the total variance, respectively. Coefficients of congruence indicated that the two component structures were quite similar. Three of the six POMS scales (Anger-Hostility, Vigor-Activity, Fatigue Inertia) were replicated successfully in both samples. The remaining three scales were factorally complex and tended to merge, partially attributable to social desirability, to high scale intercorrelations, and to the inherent confluence of psychopathology. The POMS appears to be an internally consistent, multidimensional instrument with a relatively stable factor structure. Caution is recommended in the separate scoring and interpretation of several POMS scales. PMID- 6490927 TI - The application of a model of psychotherapy to world problems. AB - This editorial uses a model of psychotherapy to respond to the question of why conservative attitudes seem to be gaining ground in our world. We assume that a patient who desires change also has a great need to resist it because he or she cannot tolerate uncertainty. The rapid changes in the world provide all of us with an increasing number of choices and consequently with existential anxiety. The return to yesterday's certainty, however, has significant dangers for the survival of the individual as well as mankind. Survival is a viable question when we consider that we play our war-games still by the rules of yesterday and thereby deny the fact that we are given the realistic choice of self-destruction. Such attitudes are very reminiscent of suicidal patients, who typically show a great deficit in information-gathering in the vulnerable areas of their lives. Resistance to change is at least one base to the understanding of a fundamentalist philosophy. Resistance can be defined as a wish to stay with the problems one knows rather than the ones dictated by existential demands: A reluctance to accept uncertainty. While the traditional values may in fact be "better" than new ones, the need on the part of either patient or society to act as though the traditional values were still intact denies reality. (The parent who does not want to see his offspring sexually active before marriage has to deal with the fact that presently available technology enhances sexual stimulation, lack of supervision, and privacy and opportunity).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490928 TI - Experimental studies in explicitly paradoxical interventions: results and implications. AB - A dozen experimental studies have assessed the effectiveness of paradoxical interventions with agoraphobia, depression, insomnia and procrastination. The studies suggest that paradoxical interventions are more effective than no treatment and placebo treatment and are as effective and, in some instances, more effective than other behavioral interventions. Several studies show that the wording of paradoxical interventions affects their impact. PMID- 6490929 TI - Paradoxical procedures and single-case methodology: review and recommendations. AB - Recently, paradoxical techniques have been increasingly employed by behavior therapists. The present paper: summarizes case study paradoxical investigations, reviews paradoxical procedures evaluated via intrasubject replication designs, and offers suggestions for continued use of single-case methodology in paradoxical research. Five major design strategies (reversal, time-series, multiple-baseline, simultaneous treatment and changing criterion) are discussed and examples provided within each area. Specific recommendations are made for a further merging of single-case experimental designs and paradoxical therapies. PMID- 6490930 TI - Paradoxical interventions in behavioral medicine. AB - This article discusses the current and potential use of paradoxical interventions in behavioral medicine. Paradoxical interventions are considered to be of two types: intra-individual and interpersonal. Treatment indications differ for the two types of interventions. Intraindividual paradoxical interventions have been successful in the treatment of insomnia, psychogenic urinary retention and constipation. Interpersonal paradoxical interventions have been subjected to less empirical research, but have been useful in the treatment of anorexia nervosa and in family based interventions where medical patients maladaptively cope with their rehabilitation. Paradoxical procedures are also used in the treatment of sexual dysfunction and may be of value in pain management. Further possible applications as well as limitations of paradoxical interventions in behavioral medicine are discussed. PMID- 6490931 TI - Paradoxical intention in the treatment of agoraphobia and other anxiety disorders. AB - Following a description of the paradoxical intention procedure and a brief review of the general behavioral literature relevant to this technique, the authors focus on the role of paradoxical treatment programs for agoraphobic clients. The cognitive and exposure components of paradoxical intention are discussed and the procedure is compared and contrasted with other cognitive behavioral methods on one hand, and with flooding on the other. Finally, the authors provide several ideas for future research. PMID- 6490932 TI - Paradoxical techniques in strategic family therapy: a behavioral analysis. AB - Accounts of paradoxical intervention with individuals are appearing increasingly in the behavior therapy literature. As yet little attention has been given to the use of such interventions with families. The present article examines their use in the context of strategic family therapy, the assumptions of which are briefly stated. The treatment of a case of family discord is described, and a behavioral analysis of its effects is provided. PMID- 6490933 TI - Paradoxical interventions in behavior therapy. AB - The use of paradoxical interventions in overcoming resistance to behavior therapy is discussed and a categorization and description of paradoxical interventions provided. Two factors are of primary importance in assessing the desirability of using paradoxical interventions: the individual's reactance potential and the perceived freedom of the problematic behavior. Paradoxical interventions themselves can be divided into two categories: compliance-based strategies and defiance-based strategies. Several types of paradoxical interventions are described and their use within therapy discussed, such as symptom prescription, restraining, reframing and utilization techniques. Preliminary research evidence attesting to the usefulness of some of these techniques is discussed. PMID- 6490934 TI - Paradox in psychotherapy: a cybernetic perspective. AB - Recent uses of the term "paradox" in the field of psychotherapy have distracted attention from the concept's broader implications. All therapy can be seen as paradoxical because of the recursive nature of self-evaluation. Using agoraphobic problems as illustrative, and starting from the notion that the core issue for the agoraphobic is a demand for absolute control of his environment, we argue that therapy requires the bonding of two observers--the therapist and the "client as-observer". Negotiations issuing from this bond are crucial to outcome, even when behavioral techniques, often considered to have automatic effects, are used. Behavior therapy, like all other psychotherapy, is not simply action--it is action contextualized by a specific, negotiated social contract. PMID- 6490935 TI - Expectancy effects on anxiety and self-generated cognitive strategies in high and low dental-anxious females. AB - Expectancy effects on self-reported anxiety and self-generated cognitive strategies were evaluated in a dental analogue by means of a film response questionnaire and an interview. Seventy-two female college subjects, half high and half low in self-reported dental fear were assigned to three levels of expectancy set (positive, fearful and neutral) induced by means of a slide presentation and verbal set. Although expectancy effects on post-film anxiety were not significant, differences due to dental fear level were found. Interview protocols were rated for general cognitive response style (coping, catastrophizing or no strategy), arousal and absorption. Discriminant function analysis between response styles indicated that arousal level provided a strong contribution to the discriminant functions differentiating between the general response styles, separating non-strategy users from catastrophizers. Specific ratings of reported absorption were related to whether or not cognitive coping strategies were used. Expectancy set was related to the direction of these cognitions. The findings validate the use of dental analogue studies for investigating dental fear. PMID- 6490936 TI - Assessment of change-agent expectations in reversal-to-baseline designs. AB - Questionnaires similar to those used in previous research to assess behavioral expectations produced by differing reversal-to-baseline rationales were presented to 160 male and female parents in rural South Dakota. Given two case histories, respondents were asked to predict, as simulated change agents, the frequency of problem behavior during reversal in an ABAB design intervention. The five rationales for reversal were: (a) withdrawal, (b) withdrawal and counter expectancy, (c) problem switch and counter-expectancy, (d) fade and counter expectancy and (e) inert treatment and counter-expectancy. While obtained means were close to those of a previous study, there were no significant sex or treatment effects. This fails to confirm the earlier results obtained from university undergraduates. Implications for internal validity of ABAB designs are discussed. PMID- 6490937 TI - Training parents of retarded children: program-specific outcomes. AB - This study examined the specificity of outcome in a group behavior modification training program for parents of developmentally disabled children. Fifteen families were randomly assigned to either a Parents as Teachers or Parents as Advocates course. Measures of behavior modification knowledge and skill, and advocacy knowledge and skill were administered to all subjects pre and post training. On three of the four outcome measures, subjects demonstrated gains that were specific to their training program. The effects of nonspecific factors appear to have been minimal. PMID- 6490938 TI - Use of nonexclusionary timeout for the elimination of a stereotyped behavior. AB - The purpose of the present study was to investigate the effectiveness of a nonexclusionary timeout procedure in reducing a high-frequency stereotyped behavior in a 28-year-old profoundly mentally retarded and autistic male. The experimental design consisted of baseline (A), treatment (B), and 1- and 6-month follow-up studies. After 2 weeks of treatment, the target behavior was reduced to a virtually zero rate of occurrence and the low rate of response was maintained throughout follow-up. Findings suggest that nonexclusionary timeout may prove to be a cost-effective intervention for reducing or eliminating disruptive stereotyped behaviors. The need for further research is indicated. PMID- 6490939 TI - A preliminary investigation of three issues pertaining to a common behavioral treatment for nocturnal enuresis. AB - Two adolescent brothers exhibiting nocturnal enuresis since birth participated in this multiple case study examining the successful application of a modified alarm and pad procedure with a deaf youth and the generalization of effects to an initially untreated, non-hearing impaired sibling. A description of the treatment program and the explicit statement of an avoidance contingency prior to intervention resulted in a rapid and marked increase in percentage of dry nights in both cases, with further increases observed following implementation of an alarm and pad plus accident correction procedure in conjunction with self monitoring. Treatment gains were maintained at a 10-month follow-up. PMID- 6490940 TI - Poor peer interactions and social isolation: a case report of successful in vivo social skills training on a child psychiatric inpatient unit. AB - The effects of social skills training comprising didactic instructions, coaching, modeling, feedback and reinforcement were examined in a child diagnosed Conduct Disorder and Attention Deficit Disorder in whom social isolation and poor peer interactions were prominent features. Treatment was implemented in the specific settings in which deficient social performance was noted using a multiple baseline design. Application of social skills training led to increased rates of appropriate interactions with peers and decreased rates of playing alone. In addition, pre- and posttreatment scores on the Child Behavior Checklist and School Behavior Checklist showed significantly decreased dysfunctional behaviors after training. Follow-up contact 1 and 12 months following discharge indicated that the child continued to socialize more with peers and to show improved adjustment. PMID- 6490941 TI - In vivo training of a fire emergency skill with a severely retarded adult. AB - A behavioral training program of shaping, stimulus control and contingent reinforcement (primary and social) procedures was utilized to teach required survival skills to a 43-year-old severely retarded man. All training was conducted in vivo with his residential living unit, initially by a psychologist and subsequently by residential staff personnel. Using an AB design, effects of intervention were immediate, with skill acquisition achieved in 2 weeks and maintained at a 1-year follow-up. PMID- 6490942 TI - Effect of sterilization by autoclaving on the stability of eye drops of pilocarpine hydrochloride and physostigmine sulphate. AB - A high-performance liquid chromatographic assay is described for the simultaneous assay of pilocarpine and physostigmine in the presence of their decomposition products. This assay method was used to quantitatively determine these medicaments in an eye drop formulation which had been sterilized by autoclaving at 115 degrees C for 30 min and at 121 degrees C for 15 min. There was no significant loss of pilocarpine whereas physostigmine was degraded. The major decomposition product is shown to be eseroline. PMID- 6490943 TI - Effect of stress on the gastric emptying of capsules. AB - During a series of experiments on the gastric emptying of capsules, certain subjects were exposed to stress in the form of high noise levels. In the non fasting condition, these subjects showed a significantly faster gastric emptying than those who were not exposed to the stress. PMID- 6490944 TI - Use of a warfarin dose prediction method. AB - Warfarin dose prediction methods developed in one hospital might not be valid elsewhere. Factors such as heparin co-administration, the use of various thromboplastin reagents and differences in technique in the haematology laboratory should all be considered before a warfarin dose prediction method is accepted for use in a hospital. PMID- 6490945 TI - Theoretical model of gastrointestinal absorption of lead. AB - A theoretical model is presented which is used to explain gastrointestinal absorption of ingested lead from use of traditional medicines. Dissolution processes are discussed and the relative contributions of pore and passive diffusion through the intestinal epithelium for the resulting species examined. The determination of the rate of absorption is described in terms of a mathematical three-compartment system and effects of particle size are considered by reference to the Noyes-Whitney dissolution rate law. PMID- 6490946 TI - Evaluation of a high pressure liquid chromatographic technique for metoclopramide analysis. AB - High-dose metoclopramide has found an established place in the prophylaxis of nausea and vomiting which may be induced by cancer chemotherapy. A simple reliable high pressure liquid chromatographic technique for the measurement of this drug in serum has been developed and evaluated. The methodology will find application in the study of metoclopramide pharmacokinetics and in the monitoring of high-dose metoclopramide therapy in individual patients with neoplastic disease. PMID- 6490948 TI - Primary brain trauma in non-accidental injury. AB - The brains from 12 babies up to 21/2 years of age, who died after repeated non accidental injury to the head, were subjected to detailed neuropathological examination. The nine brains from infants under 5 months showed contusional tears -slit like lesions in the white matter surrounded by astrocytes and associated with evidence of old and recent haemorrhage. The three brains from infants over 5 months showed white matter lesions similar to those seen in adults after closed head injury, including damage in the dorsolateral quadrant of the brain stem without axonal hemispheric damage, which may have been a result of whiplash injury after shaking. In addition, all the brains examined showed diffuse gliosis. This paper draws attention to contusional tears and other white matter lesions, which the authors believe are manifestations of mechanical damage produced by trauma. The long term neurological and intellectual defects observed in patients suffering non-accidental injury early in life are increasingly being recognised, although it is difficult to identify the extent to which these are due to social or neuropathological factors. We suggest that the white matter damage we describe has an important role. PMID- 6490947 TI - Iliac bone histomorphometry in adults and children with osteogenesis imperfecta. AB - Histomorphometric analysis was performed on transiliac undecalcified bone biopsies taken from eight adults and four children with osteogenesis imperfecta. Double tetracycline labelling done before the biopsy allowed measurement of the calcification rate in 11 patients. The adults, as well as the children, had thin iliac cortices and considerably decreased trabecular bone volume. In addition, the calcification rate was significantly reduced. Since the thickness index of osteoid seams was low or normal in all subjects, it indicated a reduced bone formation at the cellular level. In the adults, there was no significant increase in the parameters of bone resorption or in the bone formation rates at the basic multicellular unit and the tissue levels. Thus the histomorphometric profile of iliac bone in osteogenesis imperfecta is characterised by cortical and trabecular osteoporosis with decreased activity of the individual osteoblasts. These findings would suggest the use of therapeutic agents stimulating bone formation rather than agents inhibiting bone resorption in osteogenesis imperfecta. PMID- 6490949 TI - Histological appearances of intracranial biopsies obtained using the Cavitron ultrasonic surgical aspirator. AB - The Cavitron ultrasonic surgical aspirator causes localised ultrasonic tissue fragmentation and has recently been used to remove intracranial tumours. We have examined tissue fragments from 17 operations in which the apparatus was used: in all cases a definitive diagnosis could be made from the material aspirated. This finding has not been previously described. PMID- 6490950 TI - Borderline or malignant ovarian tumour? A case report of decision making with morphometry. AB - A young woman presented with bilateral ovarian tumours. Multiple sections of each tumour were shown to many pathologists for consultation; some considered the tumours to be borderline, whereas others thought that one or both of them was malignant. Morphometry showed that the numerical classification probabilities for borderline tumour were 0.78 for the left ovarian tumour and 0.85 in the right. The lesions were therefore regarded as borderline tumours and no additional chemotherapy was given. Three years after the second operation the patient is alive and well without clinical or biochemical evidence of recurrence. Most patients with borderline tumours who die from the disease do so in the first two years after the operation. This young patient was prevented from severe overtreatment by the application of morphometry, illustrating its use in this area of diagnostic gynaecopathology. PMID- 6490951 TI - Herpes simplex lymphadenitis: a case report and review of the published work. AB - Viral lymphadenitis may lead to a histological appearance that can simulate malignancy. The histological features of herpes simplex lymphadenitis have not previously been described in detail. We report a case of proved herpes simplex lymphadenitis in a 30 year old man which was characterised by a pronounced proliferation of immunoblasts. The microscopical findings are described and the published work is reviewed. PMID- 6490952 TI - Recommendation for a selected method for the measurement of plasma viscosity. International Committee for Standardization in Haematology. PMID- 6490953 TI - Hospital blood bank laboratory data processing system. AB - A data processing system designed to improve the management and usage of blood and blood products has been developed as a pilot for general application throughout the West Midlands Regional Health Authority. The package provides for the routine clerical, patient record, and stock management aspects of a hospital blood bank laboratory. It can be tailored to the individual requirements of different laboratories and may be implemented in a variety of ways on a family of computer systems of differing power and capacity, thus accommodating widely varying workloads and archiving requirements. Bar code readers are included in the system design, and may be used for data input where standard Codabar labels are affixed to blood products by blood transfusion centres. The system has been installed in one hospital laboratory and preliminary results indicate a high degree of acceptability at all levels. Further refinement of the software to meet minor deficiencies and the requirements of the recent DHSS Health Circular BLD/2/13 are currently being specified. PMID- 6490954 TI - Comparison of five commercial kits for the determination of glycosylated haemoglobin. AB - Five commercial chromatography kits for the measurement of glycosylated haemoglobin have been compared using blood specimens obtained from diabetic patients and from non-diabetic controls. Assessment was based on accuracy, general impressions of practicality, and overall performance. The precision of each technique was assessed by selecting five diabetic and five non-diabetic specimens and testing each one by each technique. All systems tested were of a high standard and the advantages and disadvantages of each system are discussed. PMID- 6490955 TI - Digitisers: their use in the entry of orders, urinalysis results, and isoenzyme interpretation in a clinical biochemistry computer system. AB - The processes of order entry, urinalysis result, and isoenzyme interpretation entry into a laboratory computer system is a time consuming activity. We have designed a series of forms for use with a digitising pad that allow us rapidly to enter orders, urinalysis results, and isoenzyme interpretative comments into our laboratory computer system. We have shown that digitiser entry is always significantly faster than manual entry. Although there are many devices available to facilitate computer entry, we believe that the digitiser technique is an attractive option because of its ease of use, speed, reliability, and low cost. PMID- 6490956 TI - Storage of skin biopsies at -70 degrees C for future fibroblast culture. PMID- 6490957 TI - False positive results with Pregnosticon pregnancy test. PMID- 6490958 TI - Small intestinal mucosal fat in childhood enteropathies. PMID- 6490960 TI - On the naming of dyes. PMID- 6490959 TI - Susceptibility of Campylobacter spp to inks. PMID- 6490961 TI - Prospective evaluation of two lithium maintenance dose schedules. AB - A prospective method for recommending lithium carbonate maintenance doses for patients requiring the drug either prophylactically or for acute mania has been previously described. Of 18 patients who required prophylactic lithium levels between 0.40 and 0.89 mEq/liter, the maintenance dose equation achieved the predefined therapeutic range in 15 (83%) cases. Of 20 patients requiring lithium concentrations between 0.90 and 1.30 mEq/liter for the treatment of acute mania, 17 (85%) attained the therapeutic range after receiving the recommended maintenance dose. The authors discuss the factors that limit the usefulness of this prospective dosing protocol. PMID- 6490962 TI - Nortriptyline pharmacokinetic parameters in depressed children and adolescents: preliminary data. AB - The pharmacokinetic parameters of nortriptyline in the pediatric age group following oral administration of a single dose of 25 or 50 mg were investigated from nortriptyline plasma level assays at 12, 18, 24, 36, and 48 hours postdose. Data were analyzed separately for the nine prepubertal and 11 postpubertal subjects, all of whom were diagnosed major depressive disorder. These data were compared with studies in the literature of nortriptyline pharmacokinetics from adult and geriatric normal and depressed populations. Similar to adults, the elimination of nortriptyline in children and adolescents is apparently first order kinetics with a logarithmically linear rate of disappearance. The prepubertals had a shorter mean half-life (17.6 +/- 3.7 hours) than some adult groups and twice a day dosage would, therefore, be more appropriate for many children. Although the mean half-life (27.1 +/- 17.1 hours) for the adolescent group suggested that once a day dosage would be sufficient, some adolescents would need twice a day dosage for optimum plasma level control because there was a wide range (14.1 to 76.2 hours). The almost twofold variation in half-life in prepubertals and fivefold variation in postpubertals were similar to differences in adult groups and emphasize the value of plasma level monitoring in the clinical use of nortriptyline. PMID- 6490963 TI - Ejaculatory inhibition with trazodone. AB - The case of a middle-aged depressed man who experienced ejaculatory inhibition after being treated with trazodone is presented. A discussion of the probable mechanism involved in causing this side effect is included, as well as a review of other side effects of trazodone on the genitourinary system. Other medications with genitourinary sequelae are reviewed. Such complications may deter patient compliance. It is recommended that clinicians carefully screen for iatrogenic disturbances in sexual function. PMID- 6490964 TI - Propranolol in the treatment of assaultive patients with organic brain disease. AB - Propranolol in doses up to 520 mg/day was administered to eight patients with organic brain disease characterized by violent and assaultive behavior refractory to conventional treatment. Improvement was demonstrated in the seven patients able to tolerate adequate drug dosages. Hypotension, bradycardia, and interactions with other medications constituted complications. PMID- 6490965 TI - Isofrequency labelling revealed by a combined [14C]-2-deoxyglucose, electrophysiological, and horseradish peroxidase study of the inferior colliculus of the cat. AB - Tonotopic sequences of single units were recorded in the central nucleus (ICC) of the inferior colliculus of cats. The sites of units with a particular characteristic frequency (CF) were marked histologically. After injection with [14C]-2-deoxyglucose (2-DG), each animal was stimulated with tone bursts, which corresponded to the CFs of the selected units. The position of a selected unit was found to correspond with the position of a band of discrete 2-DG labelling. In some animals, multiple penetrations revealed that more than one unit with the same CF was located on the same band, indicating that the 2-DG bands represent isofrequency contours. Single units were recorded in the pars lateralis (LV) of the medial geniculate body of cats and areas of consistent CF were found, which contained the same frequencies as some of those employed with 2-DG. Horseradish peroxidase (HRP) was ejected into these selected areas and labelled cells were identified in ICC after retrograde transport. The labelled cells were found to lie in a band which had a similar orientation to the 2-DG bands produced by the same frequencies. Both sets of data indicate that ICC is organized into three dimensional isofrequency sheets, the orientation of which do not match the concentric model of frequency organization inferred from some Golgi studies. The isofrequency sheets slope from medial to lateral throughout ICC with high frequency contours found more medially and caudally and low-frequency contours more laterally and rostrally. The organization of the isofrequency contours is largely in agreement with a recent Golgi model of the laminations in ICC put forward by Oliver and Morest ('84). The 2-DG contours do not agree with the orientation of laminae in the lateral part of ICC as described by this model. The 2-DG contours also extend further into the dorsal cortex than previous degeneration evidence would suggest. The functional isofrequency contours are often quite narrow and could represent two or three overlapping cellular laminae. The results show clearly that there is only one tonotopic organization extending throughout ICC and the dorsal cortex. PMID- 6490966 TI - The postnatal development of corticotrigeminal projections in the cat. AB - The postnatal development of corticotrigeminal projections was studied in kittens following 3H-amino acid injections into the face area of the primary somatosensory cortex. Corticofugal axons grow into the brainstem and form the pyramidal tract prenatally. Corticotrigeminal projections begin to develop at the end of the first postnatal week. The earliest corticotrigeminal axons grow out of the pyramidal tract caudally and project into laminae III-V of the spinal trigeminal (Vs) nucleus caudalis. During the second postnatal week, corticotrigeminal axons grow out of the pyramidal tract in a caudal to rostral sequence and project up to the ventromedial borders of Vs-interpolaris, Vs oralis, and to the principal trigeminal nucleus. Corticotrigeminal axons pause at the periphery of these nuclei for 1-2 days before penetrating the trigeminal neuropil and forming terminal arborizations in a centripetal direction. Coincident with the development of cortical projections to the principal trigeminal nucleus, some of the labeled axons which were in lamina III of Vs caudalis project into lamina I and terminate. This sequence of development of corticotrigeminal projections closely parallels, albeit at a later time, the sequence of formation of the trigeminal nuclei, suggesting that the temporal sequence of cytogenesis of trigeminal neurons may be a factor which regulates their order of innervation by afferents. Corticotrigeminal projections develop bilaterally and, during the second postnatal week, are relatively equal in density in the ipsilateral and contralateral nuclei. Many of the ipsilateral corticotrigeminal projections are lost, however, after the second postnatal week, so that by the fourth postnatal week, corticotrigeminal projections are mainly contralateral and adultlike in their distribution. It remains to be determined whether the transience of ipsilateral corticotrigeminal projections is due to selective elimination of axon collaterals or to neuronal death. PMID- 6490967 TI - Postnatal development of primary visual projections in the tammar wallaby (Macropus eugenii). AB - The time course and pattern of retinal innervation of primary visual areas was traced in pouch-young wallabies. Tritiated proline was injected into one eye of animals ranging in age from 1 to 72 days after birth. These results are compared to the 11 primary visual areas found in the adult wallaby, seven of which receive binocular input while four are monocular. At birth retinal ganglion cell axons have not reached any visual areas. Two to 4 days after birth, all of the axons are crossing to the contralateral optic tract. Nine to 12 days after birth axons begin to invade the contralateral lateral geniculate nucleus, the superior colliculus, and the medial terminal nucleus. Twenty to 21 days after birth, ipsilateral axons invade the lateral geniculate nucleus and superior colliculus. The contralateral projection precedes the ipsilateral projection in all binocular visual areas. By 25 days, ipsilateral and contralateral afferents share common territory in the lateral geniculate nucleus; however, afferents from each eye are initially concentrated in appropriate areas. Between 52 and 72 days, afferents to the dorsal lateral geniculate nucleus are gradually segregated into nine terminal bands. Four are contralateral while five are ipsilateral. By 72 days, the ipsilateral component to the superior colliculus is clustered beneath the contralateral projection a deeper layer. Projections to four monocular visual areas--lateral posterior nucleus, dorsal terminal nucleus, lateral terminal nucleus, and nucleus of the optic tract--are established later than binocular visual areas, except the suprachiasmatic nucleus. The suprachiasmatic nucleus is the last to be bilaterally innervated even though it is situated closest to the optic chiasm. At the light microscope level a mature pattern of visual development is emerging by 72 days, although the eyes do not open until 140 days. PMID- 6490968 TI - Thalamocortical connections in newborn mice. AB - Thalamocortical axons reach the developing neocortex and become distributed within the cortical subplate during the third week of gestation. The present study is an analysis of the organization of connections that link thalamus and cortical subplate (corresponding to future layers V and VI) at birth. This age antedates the ascent of thalamic axons to contact cells of the supragranular layers, their principal targets in the adult cortex. At birth thalamic nuclear subdivisions are explicit; field-characteristic cytoarchitectonic features, relating principally to the infragranular layers, delineate the majority of neocortical fields. The projection of principal relay nuclei upon the majority of fields of the cerebral convexity has been mapped by means of retrograde transport of HRP. Nucleus-to-field interrelationships as well as topologic order of the overall thalamic projection prove to be identical to that in the adult animal. The neonatal projection appears to be somewhat more divergent than that of the adult. PMID- 6490969 TI - Postembryonic changes in the peripheral electrosensory system of a weakly electric fish: addition of receptor organs with age. AB - The organization of the peripheral electrosensory system of the cheek was studied in an age-graded series of Sternopygus dariensis in Nissl-stained sections and silver-stained whole mounts of skin. As in other gymnotoids, both ampullary and tuberous electroreceptors are present. Small fish have only one ampullary organ or tuberous organ per axon, and the number of receptor organs per axon increases with age in both ampullary and tuberous systems. Large fish may have up to ten tuberous organs per axon, although the distribution of tuberous organs per axon is bimodal with one peak occurring at a single receptor organ per axon and the other peak shifting upward in relation to the age of the fish. The ampullary system adds receptor organs at a faster rate and a large fish may have 20 ampullary organs per axon. With increasing size, the number of sensory receptor cells in each organ remains constant for both types of electroreceptors. Evidence is presented for addition of new electroreceptor units by de novo production in small fish and increases in the number of organs in existing electroreceptor units by division of previously formed organs in medium-sized and large fish. As the surface area of the skin increases with growth, the density of electroreceptor units decreases and, although new receptor organs are still being added to existing receptor units, no generation of new receptor units occurs in medium-sized to large fish. PMID- 6490970 TI - Cell configurations in the olfactory tubercle of the rat. AB - The rat olfactory tubercle was studied with the rapid Golgi method. Several distinct cell types were identified mainly on the basis of the size of their somata and the structure of their dendrites. The commonest neuron type in the tubercle is the medium-sized densely spined cell. The somata of these neurons occur chiefly in the dense cell and multiform layers. They also form the cell bridges that directly link the olfactory tubercle with the nucleus accumbens and caudate-putamen. Their dendritic trees exhibit a variety of shapes; some of them are spherical, some are bipolar, and others are asymmetrical. The axons project dorsally, deep into the multiform layer. En route they give off numerous collaterals. A large version of this cell type is the crescent cell. Other medium sized neurons also have somata in the dense cell and multiform layers. They include the spindle cells, so named because of the shape of their cell bodies, and the medium-sized spine-poor neurons. Neither of these cell types has dendritic trees that are as highly branched as those of the medium-sized densely spined cells. There are three types of small cells; their somata occur primarily in the dense cell and molecular layers. The dwarf cells are near the pial surface, although their somata are included in the dense cell layer, and they have axons that resemble those of medium-sized densely spined cells. The radiate cells have numerous, relatively short, spine-free dendrites that extend out from the rounded somata in all directions. The small spine-rich cells look like miniature versions of the medium-sized densely spined neurons. They are frequently confined to the molecular layer. Large spine-poor neurons, with their cell bodies located in the dense cell and multiform layers, seem to be a heterogeneous cell group since there are subtle variations in the structure of their dendrites and the shape and extent of their dendritic trees. The large, moderately spined neurons are less common than the other large cells; their somata are found in all three layers. The granule cells of the islands of Calleja make up the most homogeneous cell group. They have only a few dendrites, and these are quite thin. Except for the medium-sized densely spined and dwarf cells, the axons of the different cell types were not very well impregnated. The different cell types in the tubercle are compared to cells in the nucleus accumbens, caudate-putamen, and globus pallidus.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6490971 TI - Non-uniform postnatal growth of the cat retina. AB - The distributions of alpha-type ganglion cells in 3-week-old and adult cats were used to measure the increase in the distances between existing cells and thus the amount of growth in various regions of the retina. Growth shows two major non uniformities. (1) The area centralis is at the point of minimum growth; its area increases by only about 3% while regions near the retinal margin increase in area by about 80%. (2) The retina grows about half as much in linear extent as does the radius of the eye and thus comes to occupy a smaller fraction of the globe. Measurements of retinal dimensions indicate that both non-uniformities also occur from birth to 3 weeks. These non-uniformities have the following implications. (1) They would tend to elongate dendritic fields radially, in the direction of the area centralis, in central retina but perpendicular to this direction in peripheral retina. However, these asymmetries are probably not the primary reason why ganglion cells throughout the retina tend to have radially oriented dendritic fields (Leventhal and Schall, '83). (2) Greater growth in the periphery could contribute to the gradient of increasing dendritic field size from central to peripheral retina if the dendritic fields of ganglion cells passively stretched as the retina expanded. Passive stretching is not the primary determinant of dendritic extent, however, because the dendritic fields of beta-type ganglion cells were found to grow 70% more from 3 weeks to adulthood than can be accounted for by passive stretching. (3) Greater peripheral growth steepens the central-to peripheral gradient of decreasing ganglion cell density; if this trend also occurs prenatally, it could be the major factor in producing the final adult gradient. PMID- 6490972 TI - Corticocortical connections among visual areas in the cat. AB - The cortical interconnections of 17 visual areas in the cat were studied by making single injections through recording micropipettes of the neuroanatomical tracers 3H-leucine and horseradish peroxidase (HRP) into the visual cortex of 40 adult animals. Coronal sections from each of the brains were analyzed for location of silver grains and HRP-filled neurons. There are five main results: (1) all corticocortical connections among visual areas are reciprocal. (2) Each cortical visual area has a unique set of cortical connections; the cortical targets of no two cortical visual areas are identical. (3) There is a vast and complicated pattern of connections among the visual areas which implies that there are numerous parallel circuits which run through any one visual area. (4) The connections among the cortical visual areas link retinotopically similar loci and are consistent with the visuotopic maps which microelectrode recording experiments have provided. (5) The connections among visual cortical areas often originate from, or terminate in, discontinuous patches within each area; this result obtains not only for areas 17, 18, 19, and posteromedial lateral suprasylvian area (PMLS), but for at least 13 other areas as well. The data reveal many parallel pathways and suggest multiple functional circuits interconnecting visual cortical areas. Since each visual area has multiple inputs and outputs it may have multiple functions, a different one for each of the circuits of which it is a part. PMID- 6490973 TI - The glial reaction in the course of axon regeneration: a stereological study of the rat hypoglossal nucleus. AB - Both hypoglossal nuclei were examined by electron microscope stereology after unilateral axotomy. The principal aim of this study was a quantitative assessment of the accompanying glial reaction. Volume densities (%) of neuronal and glial perikarya, as well as their processes, were evaluated in terms of volume plus surface densities (mm-1). In addition, specific surfaces (surface to volume ratio) of these neuronal and glial processes were assessed. First, a temporary decrease of dendritic volume density was detected on the ipsilateral side only. Further, the astrocytic reaction displayed differences between stem and lamellar processes. One day after axotomy, a bilateral decrease of volume density, as well as surface density of stem processes, was observed, yet their normal dimensions soon were reestablished. However, a more severe lamellar process reaction was evident. During the first 4 days, a significant increase of volume density and surface density was apparent. In the contralateral hypoglossal nucleus, this glial reaction also occurred but disappeared by day 14, whereas the ipsilateral nucleus continued to display a severe reaction of lamellar processes, only returning to normal status at day 77. In addition, a transient, severe reaction of presumptive microglia was established by employing the volume density and surface density quantitation procedure. Nevertheless, in comparison with the volume and surface contribution of astrocytic processes, the presumed microglial component was minimal. This study indicates a two-step involvement of astrocytes in regenerative repair. Namely, the first phase seems to result in an increase of lamellar processes through reshaping of the stem process.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6490974 TI - Central organization of eighth nerve and mechanosensory lateral line systems in the brainstem of ictalurid catfish. AB - The octavolateral sensory systems in teleost fish comprise at least four distinct hair-cell sensory modalities which are processed separately within the CNS. Two of these modalities, the mechanosensory lateral line system and the eighth nerve auditory system, have been implicated in the animal's ability to detect and localize underwater vibrations. Distinct mechanosensory lateral line and auditory nuclei are present within the torus semicircularis, the midbrain homologue of the inferior colliculus. The present study utilized horseradish peroxidase tracing techniques to delineate those areas of the lower brainstem which are involved in auditory as opposed to mechanosensory lateral line processes. The primary mechanosensory nucleus of the medulla, n. medialis, projects directly to the optic tectum and to the mechanosensory nucleus of the torus semicircularis. Nucleus medialis receives input from primary lateral line nerve fibers as well as from a number of sites within the CNS: n. praeeminentialis pars ventralis, and the eminentia granularis and lobus caudalis of the cerebellum. The n. praeeminentialis itself receives a descending input from the mechanosensory nucleus of the torus semicircularis. These mechanosensory lateral line pathways are parallel to, but distinct from, those of the electrosensory lateral line system. Auditory signals reach the midbrain via an entirely separate route. The octaval nerve terminates in a column of five medullary nuclei. Of these, only the anterior and descending octaval nuclei maintain a direct but sparse projection to the auditory nucleus of the midbrain. The bulk of the auditory input to the midbrain involves a newly described medullary nucleus, the medial auditory nucleus of the medulla. This nucleus receives input from the descending octaval nucleus and projects bilaterally to the auditory nucleus of the torus semicircularis. It is suggested that the medial auditory nucleus of the medulla is homologous to portions of the superior olivary complex of other vertebrates. PMID- 6490975 TI - Laminar origins of visual corticocortical connections in the cat. AB - The interconnections among visual areas in cat cortex were studied with respect to the specific laminae in which the cortically projecting neurons are located. Single injections of HRP were made through recording micropipettes into nine different visual areas. In 15 cortical areas the laminar distribution of neurons which were retrogradely filled with HRP was plotted. In this way we determined the laminar origins of the cortical projections to the nine separate cortical visual areas which were injected. There are three major observations. First, areas 17 and 18 are the only two visual areas in which layers II and III are the primary site of cortically projecting cells; in the other 13 areas the deeper layers of cortex provide a large percentage of such neurons. Second, within any one cortical area, cortically projecting neurons may be distributed among different layers; the specific layer depends upon the cortical target of those neurons. Third, any one cortical area receives projections from several different cortical layers, the specific layers being dependent upon the area from which the projection originates. An individual cortical area, therefore, contributes to several different cortical visual circuits, with each of these circuits defined by the laminar connections of its neurons. PMID- 6490976 TI - Afferent influences on brain stem auditory nuclei of the chicken: time course and specificity of dendritic atrophy following deafferentation. AB - The time course and specificity of the changes in dendritic morphology following deafferentation were examined in nucleus laminaris of young chickens. The dendrites of nucleus laminaris neurons are segregated into dorsal and ventral domains, which are innervated separately from the ipsilateral and contralateral nucleus magnocellularis, respectively. Transection of the crossed dorsal cochlear tract deafferents the ventral dendrites of nucleus laminaris bilaterally without interrupting the matching input to the dorsal dendrites. In 10-day-old chicks, atrophy of the ventral dendrites began immediately after transecting the tract; the ventral dendrites were 10% shorter by 1 hour and 16% shorter by 2 hours after deafferentation. The length of the ventral dendrites progressively decreased over the next 2 weeks, resulting in at least a 60% loss of ventral dendrite 16 days after surgery. The dorsal dendrites of the same cells, whose afferents remained intact, did not change in length during the time course of this study. However, 16 days after the lesion, spines appeared on the normally smooth dorsal and ventral dendrites. The time course of dendritic atrophy and its restriction to the deafferented postsynaptic surface are related to possible mechanisms by which afferents regulate and maintain their target neurons. PMID- 6490977 TI - Retinal ganglion cells in two teleost species, Sebastiscus marmoratus and Navodon modestus. AB - Distribution patterns of ganglion cells in the retina were examined in Nissl stained retinal whole mounts of Sebastiscus and Navodon. The existence of area centralis in the temporal retina in both species suggests binocular vision. In Navodon, another high density area was found in the nasal retina, and a dense band of ganglion cells was observed along the horizontal axis between the two high-density areas. There is an obvious trend for the ganglion cell size to increase as the density decreases. The total number of ganglion cells was estimated to be about 45 X 10(4) in Sebastiscus and 87 X 10(4) in Navodon, whereas the total number of optic nerve fibers was about 35 X 10(4) and 70 X 10(4), respectively. The retinal ganglion cells labeled with HRP were classified into six types according to such morphological characteristics as size, shape, and location of the soma as well as dendritic arborization pattern. Type I cells have a small round or oval soma in the ganglion cell layer and a small dendritic field in the inner plexiform layer. Type II cells are similar to type I cells, but the dendrites arborize more closely to the ganglion cell layer in the innermost region of the inner plexiform layer. Type III cells have a medium-sized round soma in the ganglion cell layer, and the dendrites extend in an extremely wide area in the inner plexiform layer with few branches. Type IV cells have a large soma which is located in the ganglion cell layer. Dendrites emanate from the soma in all directions, branching out several times within a rather small region in the innermost part of the inner plexiform layer. Type V cells have large somata of various shapes, usually dislocated to the inner plexiform or granular layer. The dendrites extend in every direction and occupy an extremely large area in the inner plexiform layer. Type VI cells have the largest somata, which are also dislocated to the inner plexiform or granular layer. Type VI cells have a characteristic triangular or fan-shaped dendritic field. Soma size and the axon diameter are intimately linked, that is, small somata of type I and II cells give off thin axons, and large somata of type V and VI give off thick axons.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6490978 TI - Extrinsic visual and auditory cortical connections in the 4-day-old kitten. AB - The major extrinsic projections to and from the visual and auditory cortical areas were examined in 4-day-old kittens using axonal transport of horseradish peroxidase (HRP) and/or tritiated proline. Six different afferent and seven different efferent systems were studied; all 13 were present by postnatal day 4 as revealed by either HRP, or autoradiography alone, or these two techniques combined. Topographical projections were found for the corticopetal pathways from the thalamus and claustrum and for the corticofugal pathways to the thalamus, claustrum, striatum, and tectum, as well as for the inter- and intrahemispheric pathways. No topographical relations were seen in projections to the cortex from the basal ganglia or the lower brainstem. The results of the present study indicate that most or all of the major extrinsic connections of the kitten's visual and auditory cortical areas are present neonatally, and that both the cells of origin and the axonal targets are arranged topographically much like those of adult cats. However, the origins of callosal projections from visual cortex are more widespread in newborn kittens than in adult cats. In addition, the laminar arrangements of the kitten's corticocortical connections differ from those of adult cats in a number of details. The results suggest that the sparing of some visual and auditory functions after neonatal lesions occurs despite the fact that the cortical areas removed have formed extrinsic connections. PMID- 6490980 TI - Cancer of the skin in blacks. IV. A review of nineteen black patients with Kaposi's sarcoma. AB - Kaposi's sarcoma in American blacks is relatively rare, according to the literature. Using information from the Tumor Registry of Charity Hospital of Louisiana in New Orleans, we discuss the available data on nineteen black patients (10 men, 9 women), with histologically diagnosed Kaposi's sarcoma between the years 1948 to 1983. The overall mortality rate directly attributable to their disease was 21%. The mean survival of patients dying from disease was 2.0 years from the time of diagnosis. The mean survival for the entire series was 6.1 years. No second primary lymphoreticular neoplasms were reported. PMID- 6490979 TI - Cancer of the skin in blacks. III. A review of nineteen black patients with Bowen's disease. AB - In a series of nineteen black patients with Bowen's disease of the skin diagnosed between 1948 and 1982, twenty-one lesions occurred. Involvement on non-sun exposed areas was three times more common than on sun-exposed areas. The most common location was the lower extremity. A history of arsenic ingestion could not be confirmed in any of the patients, but was suggested by histopathologic findings in at least one instance. Invasive lesions developed in five patients, three of whom subsequently died from metastatic disease. Five patients also had a second noncutaneous malignancy. PMID- 6490981 TI - Monoclonal gammopathy and mycosis fungoides. Report of four cases and review of the literature. AB - Of four patients with mycosis fungoides and monoclonal gammopathy, one died of multiple myeloma that developed 4 years after the mycosis fungoides. The other three had monoclonal gammopathy of undetermined significance. This association does not appear to occur with a high frequency in patients with mycosis fungoides than in the general population. However, it demonstrates that B cell proliferation can occur in patients with primary cutaneous T cell disease. PMID- 6490982 TI - Histologic changes in the liver during etretinate treatment. AB - Histologic changes in the liver were evaluated in thirty-two patients with different dyskeratotic dermatoses treated with etretinate (Tigason) during an average of 24.9 months. Fatty infiltration, nuclear variability, periportal inflammation, focal necrosis, fibrosis, and cholestasis were estimated. The usual dose was 50-75 mg/day, with reduction according to efficacy and side effects. No statistically significant differences were found between a control group of thirty-five liver biopsies from psoriasis patients who had not received systemic therapy and biopsies from the patients treated with etretinate. Among the thirty two etretinate-treated patients, six had two serial biopsies, and eight had pretreatment biopsies. No significant changes appeared during therapy. PMID- 6490983 TI - Different biologic effectiveness of blacklight fluorescent lamps available for therapy with psoralens plus ultraviolet A. AB - In 1976 we reported a change in spectral distribution of "blacklight" fluorescent lamps. It was not possible to determine the spectral composition of these lamps by any codes or packaging materials. Phototherapy booths utilizing standard BL-HO lamps will accept lamps of at least two spectral distributions; both types are commercially available. This study was conducted to determine the biologic efficacy of these two lamp types that we refer to as BL-O and BL-N. The BL-O spectrum had a peak emission at approximately 350 nm with 98% of the energy between 320 and 400 nm. The BL-N spectrum had its peak emission at 365 nm with a range from 340 to 400 nm. The BL-O spectrum was at least 2.5 to 4 times as effective as BL-N in causing minimally perceptible phototoxicity in albino hairless mice given oral doses of 8 mg/kg of 8-methoxypsoralen. Food and Drug Administration (FDA)-approved specifications imply that the BL-O spectrum is to be used for psoralens and ultraviolet A (PUVA) phototherapy. If lamps with the BL N spectrum are replaced by lamps with the BL-O spectrum, the metered dose must be reduced to no more than one-fourth of the previous dose or the patient may suffer serious phototoxic reactions. PMID- 6490984 TI - Hypersensitivity to rat saliva. AB - A patient who rapidly developed impressive local edema around a rat bite site is described. An interesting differential diagnosis was presented since the offending rat was experiencing an opiate withdrawal syndrome. A discussion of the possibilities of animal product allergy, local infection, and edema produced by opiate histamine releasers was considered. PMID- 6490985 TI - Liver abnormalities in patients with lichen planus. A retrospective case-control study. AB - A retrospective case-control study of 136 patients with lichen planus and 272 paired controls demonstrated a significantly higher occurrence of liver abnormalities in this dermatosis. There is currently no good explanation for the high occurrence rate of such abnormalities in lichen planus. Factors that alter epidermal cell antigenicity may induce reactions that can damage keratinocytes as well as hepatocytes. PMID- 6490986 TI - Fixed-tissue binding of fluorescein-conjugated concanavalin A to malignant melanomas versus nevi. AB - Concanavalin A (con A) is a plant-derived lectin that has the capability of agglutinating malignant cells in vitro. We studied the binding of fluorescein isothiocyanate-conjugated con A to formalin-fixed, paraffin-embedded malignant melanomas and nevocellular nevi. Both malignant melanoma cells and nevus cells emitted partial or circumferential, cytoplasmic rim, apple green fluorescence. There was no demonstrable difference between fluorescence distribution or intensity between the two groups. Control, unstained tissue specimens yielded a brilliant nuclear and nucleolar yellow-green autofluorescence, which is peculiar to melanoma cells and rare to absent in nevus cells. Fluorescein isothiocyanate conjugated con A provided no clear differentiation between malignant melanomas and nevocellular nevi in fixed tissue. However, characteristic melanoma cell autofluorescence may prove to be of benefit for differentiating malignant melanocytic from benign nevocytic lesions. PMID- 6490987 TI - Fibroma of tendon sheath. AB - This report describes four patients with fibroma of tendon sheath. The tumors were slowly enlarging, firm nodules that were adherent to tendon sheaths of the volar aspect of the fingers or palm. One lesion was recurrent. Microscopically, they consisted of lobulated, hyalinized, collagenous masses that contained spindled and stellate fibroblasts and an array of slitlike spaces. There were small pseudopods and separate foci of tumor in adjacent connective tissue. These may explain the propensity of fibroma of tendon sheath to recur. PMID- 6490988 TI - Management of congenital nevocytic nevi: a survey of current practices. AB - Questionnaires were sent to the chairmen of 105 dermatology training programs and to sixty practicing dermatologists (randomly chosen from the American Academy of Dermatology directory) in order to identify current practices regarding the management of congenital nevocytic nevi. The return rate was 45.7% and 43.3%, respectively. A clear majority of dermatologists both in private practice and in academia recommend the removal of giant- and medium-sized congenital nevocytic nevi. There is less agreement among dermatologists with regard to the treatment of smaller lesions. PMID- 6490989 TI - Lichenoid benign keratosis. AB - A histopathologic study of 108 lesions of lichenoid benign keratosis from 104 patients confirmed previously observed clinicopathologic features such as involvement of whites, age range of 35 to 65 years, female predominance, single keratosis, common location on the arm or presternal area, and failure of clinical recognition of the lesion. Histologically, lichenoid benign keratosis can be diagnosed by the characteristic lichenoid appearance, parakeratosis, an infiltrate occasionally containing plasma cells and eosinophils, and remnants of lentigo-like changes at the periphery of the lesion. The clinical information of a solitary lesion and suspicion of a premalignant or malignant diagnosis aids in establishing the pathologic diagnosis of the disease. Direct immunofluorescence studies of tissue from seven lesions of lichenoid benign keratosis resembled those seen in lichen planus. Features distinguishing lichenoid benign keratosis from lichenoid solar keratosis are discussed. PMID- 6490990 TI - Tubular apocrine adenoma with perineural invasion. AB - A tumor is reported that had remarkable pathologic changes showing with light microscopy a pattern in some portions consistent with tubular apocrine adenoma, while other areas were suggestive of syringoid eccrine carcinoma. Perineural invasion, commonly seen in syringoid eccrine carcinoma and never before reported in tubular apocrine adenoma, was found. Electron microscopy revealed the true apocrine nature of the tumor even though the tissue had been stored for 2 months in buffered formalin prior to processing. PMID- 6490991 TI - Collagen concentration in zyderm. PMID- 6490992 TI - Calcinosis cutis in a burn scar. PMID- 6490993 TI - Criteria for diagnosis in dermatology and dermatopathology: a critical evaluation. AB - The logical processes of application of criteria to make diagnoses in dermatology and dermatopathology are examined. The limitations of use of a single criterion are delineated, and the advantages and limitations of multiple criteria are defined. It is important that all diagnostic criteria be applied with careful attention to the frequency of the designated entity in the study population and the sensitivities and specificities of the criteria used. The exclusive use of single, "favorite" criteria should be avoided, and multiple criteria should be applied, whenever possible. PMID- 6490994 TI - Vitiligo and melanoma: can genetically abnormal melanocytes result in both vitiligo and melanoma within a single family? AB - We found twelve families with melanoma who had close family members with halo nevi, early graying of hair, a halo primary melanoma, or ordinary vitiligo. On the basis of these findings and the observation of others in fish, horses, and pigs with melanomas, we suggest that the melanocytes of people with vitiligo or with a genetic background for vitiligo are predisposed to undergo a malignant transformation. The presence of vitiligo appears as a manifestation of host suppression of malignant melanocytes. PMID- 6490995 TI - Congenital smooth muscle hamartoma. AB - Smooth muscle hamartoma is a rare congenital cutaneous hyperplasia of the arrectores pilorum muscles. Clinically it may mimic a solitary mastocytoma or congenital nevocellular nevus. The pattern histopathologically is distinct from all other benign muscle tumors of the skin and is mimicked only by the smooth muscle hyperplasia present in Becker's nevus. PMID- 6490996 TI - Disseminated superficial "actinic" porokeratosis. AB - The dramatic therapeutic response of disseminated superficial actinic porokeratosis (DSAP) to retinoid plus psoralens with ultraviolet A prompted a review of clinical, histologic, and etiologic data of all of the DSAP cases available in the English and German literature. The review showed that many case reports lack adequate documentation to confirm actinic induction. More than one third of the patients have observed no exacerbations during the summer. Histologic damage after long-term ultraviolet (UV) exposure could not be observed in every case. In addition, cases do exist in which lesions are distributed mainly in non-UV-exposed skin. These data cause doubt about the importance of actinic induction of DSAP. PMID- 6490997 TI - Dysplastic nevus syndrome with multiple primary amelanotic melanomas in oculocutaneous albinism. AB - Melanomas are rare in albinos, although the incidence of solar radiation-induced skin tumors is extremely high because of the absence of photoprotective melanin. This report describes a 40-year-old white woman with tyrosinase-negative oculocutaneous albinism who developed four primary amelanotic melanomas--three of the superficial spreading and one of the nodular type-and, in addition, displayed nevi that exhibited histologically the characteristic features of dysplastic nevi. The concomitant occurrence of multiple primary melanomas and several dysplastic nevi classifies the patient's condition as "dysplastic nevus syndrome," which to our knowledge has not been described in albinism so far. PMID- 6490998 TI - Subungual squamous cell carcinoma. AB - Subungual squamous cell carcinoma is a rare phenomenon. Diagnosis of this condition is often delayed because of a resemblance to a variety of benign inflammatory conditions. Metastases are unusual, but involvement of underlying bone is common. Curative treatment is achieved by amputation of the involved digit. The index of suspicion for malignancy in the face of an inflammatory nail condition unresponsive to standard treatment should be high, and a biopsy should be performed. PMID- 6490999 TI - Gnathostomiasis, or larva migrans profundus. AB - Gnathostomiasis, or larva migrans profundus, is a significant cause of morbidity in many parts of the world, especially the Far East. Over forty cases have recently been reported from South America, and some of those patients are seeking diagnostic evaluation and treatment in the United States. A clinical course of painless migratory recurrent urticarial skin lesions in a patient who has eaten raw or poorly cooked freshwater fish should alert a physician to the diagnosis of gnathostomiasis. PMID- 6491000 TI - Urticaria pigmentosa responsive to nifedipine. AB - A patient with symptomatic urticaria pigmentosa who responded to nifedipine therapy is reported. Relief from cold-induced urtication and flushing was obtained with 10 mg taken orally three times daily. Calcium influx is an early step in the degranulation of mast cells. We hypothesize that the beneficial effect of nifedipine was due to calcium-channel blockade causing elevation of the mast cell threshold for degranulation. PMID- 6491001 TI - Disseminated xanthosiderohistiocytosis, a variant of xanthoma disseminatum, in a patient with a plasma cell dyscrasia. AB - A 57-year-old man was evaluated for infiltrative sclerotic nodules and plaques of the skin, the oral cavity, and the eye. Skin biopsy revealed a proliferation of mature histiocytes and extensive hemosiderin deposition, findings most consistent with xanthoma disseminatum and its variant, disseminated xanthosiderohistiocytosis. The subsequent development of a plasma cell dyscrasia was consistent with previous reports and suggests that xanthoma disseminatum is a marker for plasma cell disorders. PMID- 6491002 TI - Acrodermatitis continua of Hallopeau: treatment with etretinate and review of relapsing pustular eruptions of the hands and feet. AB - Acrodermatitis continua of Hallopeau is considered by many to be a variant of pustular psoriasis because of similar histologic features. Its clinical picture is unique and helps to distinguish acrodermatitis from pustular psoriasis. We present a patient with acrodermatitis continua of Hallopeau resistant to conventional therapy. We describe the beneficial effect of etretinate in this patient. PMID- 6491003 TI - The diagnostic value of parakeratosis. AB - A study of dermatopathological specimens exhibiting parakeratosis has been made and the parakeratosis classified on morphological and topographical criteria. Twelve patterns of parakeratosis have been identified and their association with particular pathological conditions described. PMID- 6491004 TI - Ultrastructural studies of barrier restoration in epidermis of hairless mice following dimethyl sulfoxide application. AB - Sixteen hairless mice were studied by transmission electron microscopy to determine the ultrastructural changes in epidermal barrier restoration following topical applications of dimethyl sulfoxide (DMSO) to back skin. Samples of experimental skin were examined at 30 min, 1 h, 2 h and 3 h after the initial DMSO treatment and compared with that of control animals. At earlier time periods (30 min-1 h) the DMSO treated epidermis showed greatly expanded intercellular spaces, disrupted desmosomal attachments, and desmosomal remnants lying free within the intercellular space. Mitochondria contained droplets of lipoid material which reached maximum size in the spinous and granular layers. Cytoplasmic vacuoles were particularly prominent in the 30-min samples. Large numbers of membrane coating granules (MCG) emerged in the 1 h specimens. The MCG were laden with numerous electron-dense inner membranes which crisscrossed at various angles. Many of the MCG were observed in the process of fusion with plasma membranes of granular cells adjacent to the stratum corneum. At 2 h a process of recovery from the effects of DMSO was evident and at 3 h there was little or no difference between experimental and control epidermis. PMID- 6491005 TI - Why do melanomas ulcerate? AB - Ulceration is an indicator of unfavourable prognosis in malignant melanoma (MM). But why do melanomas ulcerate?. Possible causes of ulceration were investigated in a group of 69 ulcerated and 69 non-ulcerated malignant melanomas. A significant correlation (P less than 0.001) between ulceration and mitotic index was found. In a group of 69 ulcerated malignant melanomas, 49 had over 7, 15 had 4-6, and only 5 had 0-3 mitotic figures per 10 high-power fields. Among 69 non ulcerated melanomas, 28 had more than 7, 24 had 4-6, and 17 had 0-3 mitotic figures per 10 high-power fields. This study supports the hypothesis that ulceration of melanomas is usually the result of the destruction of the epidermis by the proliferating neoplastic cells or modification of blood supply due to the expansile activity of the tumor. The relationship between ulceration and mitotic activity helps clarify the prognostic significance of ulceration. PMID- 6491006 TI - Ultrastructural and histochemical analysis of thready material in Pseudoxanthoma elasticum. AB - The components of the thready material in skin lesions of pseudoxanthoma elasticum, recessive Type I, were analysed. Immunoelectron microscopic observation revealed the presence of fibrinogen in the thready material. Part of the fine fibrils in the thready material was sensitive to collagenase. The thready material was also stained by ruthenium red. These results suggest that the thready material is composed at least of fibrinogen, collagenous protein and glycoprotein. PMID- 6491007 TI - Large acquired nevocytic nevi induced by the Koebner phenomenon. AB - A patient with characteristic clinical, histopathological, ultrastructural and family history of epidermolysis bullosa simplex (EBS) developed large acquired nevocytic nevi at the sites of some healing blisters. An isomorphic reaction may have initiated the development of these nevi. Such large acquired nevi should be considered in the differential diagnosis of large and giant congenital nevi which have the potential to evolve into malignant melanoma. PMID- 6491008 TI - The surface structural alterations of elastic fibers and elastotic material in solar elastosis: a scanning electron microscopic study. AB - The surface structure of altered elastic fibers and elastotic material in solar elastosis has been described using a scanning electron microscope. There were 3 different areas in the dermis, depending on the degree of changes in elastic fibers: areas of (1) normal-looking fibers, (2) thick, cylindrical fibers, and (3) a large mass of markedly changed fibers. They were mainly located in the deep, middle, and upper dermis, respectively. The normal-looking fibers were the same as the normal elastic fiber. The thick, cylindrical fibers showed various findings ranging from relatively normal to heavily damaged surface. The large mass was composed of a cord-like element and a fine net-like one. There was a transition between the thick, cylindrical fibers and the large mass. It is suggested that the thick, cylindrical fiber is an early event and the mass is more damaged, as one of the elastotic changes in solar elastosis. It is also suggested that the thick, cylindrical fiber corresponds to the fibrous form and the mass to the amorphous form of the elastotic material. PMID- 6491009 TI - Large melanoacanthomas: a report of five cases. AB - Five patients with melanoacanthoma are reported. The skin lesions consisted of a single, round plaque measuring several centimeters in diameter. Histologic findings were characterized by formation within an acanthotic epidermis, of many islands of small basaloid cells and highly dendritic melanocytes. Electron microscopic examination of one lesion revealed a disturbance of melanin transfer from the highly dendritic melanocytes to the neighboring keratinocytes. PMID- 6491010 TI - Eosinophilic ulcers of the tongue. AB - A case of eosinophilic ulcer of the tongue is presented. Although the entity is rarely described, the distinctive histopathologic pattern featuring the remarkable presence of eosinophils in the superficial corium and in between muscle bundles, together with the benign clinical course, make a diagnosis possible. PMID- 6491012 TI - Relationship of milk intake by sucking and by drinking to reticular-groove reactions and ingestion behavior in calves. AB - Two pairs of rumen-fistulated calves in early development of the rumen were fed milk by sucking and by drinking in alternating sequences to compare effects on swallowing behavior, openings and closings of reticular groove, and leakage of fluids into reticulorumen. These responses, determined primarily by palpation of the groove throughout feeding, revealed that sucking in comparison with drinking effected: longer times to complete first swallows, smaller amounts of milk per swallow, slower rates of milk intake and of swallowing, fewer sequential openings and closings of groove, lower incidence and shorter duration of groove openings, less spillage into reticulorumen, and less variability of these reactions among calves. Alternation of feeding methods from meal to meal did not change groove responses, but sucking immediately prior to drinking reduced incidence of groove openings in the latter. Presence of milk in the reticulorumen was not a consistent indicator of states of groove during ingestion. Observations emphasize importance of monitoring throughout feeding to determine changes of groove reactions and of role of calf individuality in response to feeding treatments. PMID- 6491011 TI - Net absorption of glucose and nitrogenous compounds by lactating Holstein cows. AB - Net absorptions from portal-drained viscera of glucose, ammonia nitrogen, alpha amino nitrogen, and urea nitrogen were measured in four Holstein cows in first lactations. Cows were fed for ad libitum consumption a completely mixed, 60:40 corn silage:supplement diet (dry basis) in two equal feedings at 12-h intervals daily. Portal blood flow (dye dilution) and net absorption (portal-arterial difference times portal blood flow) were measured at hourly intervals for 12 h for all cows 4 and 8 wk postpartum and for two cows 4, 8, 12, 16, and 20 wk postpartum. Apparent digestibilities of dry matter and nitrogen were measured immediately after net absorption. Milk yield and composition were measured with absorption and digestion. Mean daily dry matter intake and milk yield were 14.1 +/- .6 and 23.8 +/- 1.8 kg. Portal blood flow was not affected by time of day or weeks postpartum; mean was 1371 +/- 123 liters/h. Net absorption of glucose was negative, indicating no uptake of glucose from dietary sources. Means (g/day) for nitrogenous sources were: nitrogen intake 387, fecal nitrogen 121, urinary nitrogen 146, milk nitrogen 116, net ammonia nitrogen absorption 149, net alpha amino nitrogen absorption 137, and net loss of urea nitrogen from blood to the gut 93. Net absorption of amino nitrogen and alpha-amino nitrogen in blood was greater than in plasma; corresponding losses of urea nitrogen and glucose to the gut were greater from blood than plasma. PMID- 6491013 TI - Prolactin in blood plasma and milk of buffalo during estrous cycle and early pregnancy. AB - Concentration of prolactin was measured by radioimmunoassay for 11 primiparous and 16 multiparous buffalo. Prolactin concentration of blood plasma on day of insemination was about 200 ng/ml for primiparous and about 315 ng/ml for multiparous animals and fluctuated between 130 and 200 ng/ml for primiparous and between 250 and 345 ng/ml for multiparous pregnant animals. For the nonpregnant group prolactin fluctuated between 145 and 240 ng/ml for primiparous and between 210 and 310 ng/ml for multiparous animals with minor elevations 1 to 2 days before estrus. Concentration of prolactin of milk was not significantly different from that of plasma and was positively correlated .68 for nonpregnant and .93 for pregnant animals. PMID- 6491014 TI - Effects of exogenous oxytocin on production and milking variables of cows. AB - Five doses of oxytocin (.5, 1.0, 1.5, 2.0, 3.0 IU) were injected through the subcutaneous abdominal vein (milk vein) of 15 Holstein Friesian cows 1 min before machine attachment. After teat cup removal, cows were given 10 IU of oxytocin via the milk vein for measurement of residual milk 1. An additional 10 IU of oxytocin was given 15 min later for estimating residual milk 2. Total milk yield was slightly higher for cows receiving 2.0 and 3.0 IU oxytocin. Milk fat yield was highest for cows receiving 2.0 and 3.0 IU oxytocin. Percent milk protein was less for cows receiving higher doses. Administration of 2.0 or 3.0 IU oxytocin significantly reduced total residual milk yield as compared with other doses. Fat percent in total residual milk was not affected by administration of oxytocin. Machine-on time, peak flow rate, and average milk flow rate did not differ with oxytocin treatment. A dose of either 2.0 or 3.0 IU oxytocin given via the milk vein will lead to slightly higher milk yields but will not affect milk flow dynamics as compared with lower doses. Moreover, milk fat yield is increased and total residual milk yield is decreased with either 2.0 or 3.0 IU oxytocin, suggesting that these doses result in more efficient extraction of milk. Administering more than 3.0 IU of oxytocin intravenously to promote milk ejection should be of no advantage. PMID- 6491016 TI - What's new in equipment for medical photography (1). PMID- 6491015 TI - Tumor conference #53. Necrotizing hemangioma. PMID- 6491017 TI - Aromatic retinoid in the chemoprevention of the progression of nevoid basal-cell carcinoma syndrome. AB - The management of nevoid basal-cell carcinomas in this syndrome is sometimes very difficult, because of the high number of tumors and of their particular localizations. The authors reviewed the literature and here report their experience in the treatment of nevoid basal-cell carcinoma syndrome with aromatic retinoid etretinate (RO 10-9359; Tigason). PMID- 6491018 TI - Hair transplantation--otic speculum as a grafting funnel. PMID- 6491019 TI - Evaluation of donor harvesting techniques in hair transplantation. AB - Ultra close-up photography shows that an ideal donor graft in hair transplantation is harvested using a sharp carbon steel punch driven at approximately 5000 rpm by an electrically powered hand engine. Skin distortion at the donor site is minimized by firm infiltration using physiologic saline. Dull punches, hand driven punches, or flaccid donor skin all increase distortion which is detrimental to the harvesting of superior quality donor grafts. Carbon steel punches attain and maintain a sharper cutting edge than stainless steel punches. PMID- 6491020 TI - Recurrent dysplastic nevus following shave excision. AB - Distinguishing benign from malignant melanocytic lesions is an on-going challenge for the clinician and the histopathologist. The regrowth of benign melanocytic nevi at the dermoepidermal junction following inadequate excision has been shown to be confused with superficial spreading melanoma. The dysplastic nevus has atypical features in and of itself, which become even more compounded when the lesion recurs in the dermoepidermal junction following inadequate resection by shave excision. The use of Monsel's solution to achieve hemostasis at the biopsy site can itself also produce a clinically irregular area of hyperpigmentation, accompanied by a pathologic pigmented and cellular dermal reaction. A case of a dysplastic nevus recurring after inadequate shave excision is reported here. The resultant atypia were further compounded by the use of Monsel's solution for hemostasis in the initial excision, which could have led to a mistaken diagnosis of malignant melanoma. The spectrum of dysplastic nevi is reviewed. PMID- 6491021 TI - Effect of freezing the helix and the rim or edge of the human and pig ear. AB - We have studied the effect of increasing freeze times on the normal pig's ear and on a variety of lesions of the human ear. The clinical and laboratory data suggest that cartilage necrosis secondary to cryosurgery is a dose-related phenomenon and is uncommon with the freeze times used in clinical practice. Cryosurgery is an effective and cosmetically acceptable treatment for superficial skin lesions of the ear. PMID- 6491022 TI - Bowenoid papulosis of the chin. PMID- 6491023 TI - Stellate subperichondrial repair of a double ear cancer. AB - Cancer disguised as dermatitis involved both the anterior and posterior auricular perichondrium, necessitating excision of the middle third of the ear. Closure of this larger defect was effected by a three-pronged subperichondrial wedge excision of cartilage, leaving overlying skin intact. The reconstructed ear, therefore, had fewer scar lines than would have resulted from open-wedge excisions. PMID- 6491024 TI - Epidermal cell outgrowth from CO2 laser- and scalpel-cut explants: implications for wound healing. AB - We set out to determine if the slow healing of CO2 laser-incised skin wounds compared with that of scalpel-incised wounds is the result of an inhibitory effect of the CO2 laser energy on the rate of epithelialization. We compared the rate of epidermal outgrowth from laser- and scalpel-cut explants in vitro. The onset of epidermal cell outgrowth (epiboly) from CO2 laser-incised skin was delayed, but there was no difference in the rate of epidermal cell outgrowth. These studies suggest that a delay in onset of epidermal migration, not a decreased rate of epidermal migration, contributes to the slower epithelialization of CO2 laser-incised skin wounds. PMID- 6491025 TI - Microcystic adnexal carcinoma treated by microscopically controlled excision. AB - Microcystic adnexal carcinoma is a distinct clinicopathologic entity with combined pilar and eccrine differentiation. Clinically it resembles other adnexal neoplasms, but it tends to be deeply invasive and locally aggressive. A 47-year old man with microcystic adnexal carcinoma of the left cheek with deep dermal and subcutaneous invasion was successfully treated by microscopically controlled excision. The possible etiologic association with teenage radiation therapy is discussed. PMID- 6491027 TI - Cutaneous candidosis as a complication of facial dermabrasion. AB - Cutaneous candidosis is a common skin condition. Facial candidosis is rare. Described herein are three cases of facial candidosis complicating dermabrasion, a previously undescribed condition. Why this may occur, why it is uncommon, and its differential diagnosis and therapy are discussed. The side effects and complications of dermabrasion in general are presented. PMID- 6491026 TI - Darkly pigmented lesions in dark-skinned patients. AB - It is well known that fair-haired, fair-complected individuals have an increased risk of skin malignancies. Current literature, however, gives no aid in evaluating darkly pigmented lesions in the dark-skinned patient. Blacks have an incidence of malignant melanoma from 5 to 18 times less than whites, while Hispanics have a higher incidence than blacks, but 3.5 to 4.5 times less than whites. Basal-cell epitheliomas are more likely to be darkly pigmented in both groups, leading to erroneous diagnosis and treatment as melanomas. PMID- 6491028 TI - Cutaneous meningioma. AB - A case of a subcutaneous meningioma is presented. It is uncommonly encountered but, because of its superficial location, is apt to present to a dermatologist. Meningioma should be included in the differential diagnosis of lesions of the scalp, especially the midline, face, and paraspinal areas. Biopsy, especially of type III, can be potentially complicated by infection or leakage of cerebrospinal fluid. Suspicion of the nature of the lesion and appropriate additional studies may avoid these complications. PMID- 6491029 TI - Embedded foreign bodies presenting as earlobe keloids. AB - We present a case report of a young woman who developed earlobe nodules subsequent to the piercing of her ears. Clinically the nodules appeared to be keloids. Surgical intervention demonstrated the nodules to consist of the embedded backings of her pierced earrings. PMID- 6491030 TI - CO2 laser treatment of trichoepithelioma with focused and defocused beam. AB - A patient with multiple trichoepithelioma was treated with the carbon dioxide (CO2) laser. The beam was utilized in a defocused mode for debulking and exposing the tumors. The focused mode was used for destruction of the dermal remnants of the tumors and in the sculpting of lesions to match the contour of the external ear. Examination of lesional tissue for the presence of estrogen or progesterone receptors revealed the absence of these receptors. PMID- 6491031 TI - Lipo-suction surgery. PMID- 6491032 TI - Skin refrigerants. PMID- 6491033 TI - Tattoo removal. PMID- 6491034 TI - Thermodilution in mechanically ventilated patients. PMID- 6491035 TI - Classifications of coma. AB - Coma classifications have been a matter of debate for over 35 years. The Glasgow Coma Scale is now widely accepted but its indiscriminate application has often led to misuse. The various methods that have been devised can be divided into two types, coma scales and coma scoring systems. In this critique the origins and values of these methods are analysed. PMID- 6491036 TI - Oropharyngeal flora as a source of bacteria colonizing the lower airways in patients on artificial ventilation. AB - During 1 year 27 patients admitted to the respiratory intensive care unit were monitored bacteriologically for a minimum of 10 days (mean: 26.7 days). Oropharyngeal swabs and tracheal aspirates were qualitatively and semi quantitatively cultured twice weekly. A correlation between oropharyngeal and tracheal flora was found: once a bacterial species colonized the oropharyngeal cavity in high numbers, the identical microorganism was frequently isolated (greater than 50%) from the lower respiratory tract. Six of the 27 patients acquired an infection of the lower airways in the respiratory intensive care unit. The bacteria involved belonged to the patients oropharyngeal flora: S. aureus, Enterobacteriaceae and Pseudomonadaceae. As a result of this study showing the oropharynx to be the source of lower airway colonization/infection, a policy for infection prevention has been outlined. This policy is based on the concept of source elimination by means of oropharyngeal decontamination. PMID- 6491037 TI - An extreme form of the hyperdynamic syndrome in septic shock. AB - We classified 41 patients in septic shock on the basis of cardiac index (CI) after volume expansion with plasma protein solution, in order to obtain adequate filling pressures. Five had decreased CI (less than 3.5 1/min per m2), 31 had moderately increased CI (3.5 - 7.0 1/min per m2) and 5 had extreme hyperdynamic shock with CI superior to 7.0 1/min per m2. Among the patients with increased CI, those with extreme hyperdynamic state (EHS) had lower total systemic and pulmonary arteriolar resistances (370 vs 658 and 52 vs 119 dynes X s X cm-5, respectively) and a higher stroke index (67 vs 46 ml/m2), in spite of similar right atrial pressures. In this latter group, blood lactate was higher (6.5 vs 2.1 mmol/l), acidosis was more severe and coagulation disorders more pronounced; all five patients maintained an extremely high CI until death, which supervened after a brief episode of sinus bradycardia. A similar clinical course was rarely observed in the remaining moderately hyperdynamic group, in which mortality rate was significantly lower (35%). Three of five patients with EHS (compared to 2 of 31 in the moderately hyperdynamic group) had liver cirrhosis, the fourth died of fulminant meningococcemia and the fifth had prolonged polymicrobial bacteremia before adequate treatment was begun. Thus, underlying liver disease or particularly severe and uncontrolled infection seems to predispose to EHS. It is concluded that septic shock with extremely high cardiac output and excessively low peripheral resistances represents a distinct subset with more severe metabolic and coagulation disorders, an unusual hemodynamic evolution and a particularly poor prognosis. PMID- 6491038 TI - Air embolism: a serious hazard of central venous catheter systems. AB - Central venous catheter systems are an important yet little recognised source of serious air embolism. Scrupulous care and vigilant observation of this equipment is necessary to prevent the severe cardio-respiratory and neurological sequelae which may occur. Air embolism following central venous catheterisation is one of the most serious complications of this procedure. We describe an unusual and hitherto unreported mechanism by which air accidentally entered the circulation; fortunately in this case there were no serious sequelae. PMID- 6491039 TI - Recurrent torsade de pointes type ventricular tachycardia in intracranial hemorrhage. AB - Two out of 72 cases of intracranial hemorrhage-induced polymorphous ventricular tachycardia with typical Torsade de Pointes morphology are presented. Both patients had marked QTc prolongation more than 550 ms. In one patient (QTc: 669 ms) Torsade de Pointes degenerated into fatal ventricular fibrillation. Even though polymorphous Torsade de Pointes type ventricular tachycardia is rare during the clinical course of intracranial hemorrhage, attention should be given to the QT interval. QTc prolongation more than 550 ms may carry a high risk of Torsade de Pointes type ventricular tachycardia and ventricular fibrillation. PMID- 6491040 TI - Dopamine administration. PMID- 6491041 TI - Etomidate and adrenocortical function. PMID- 6491042 TI - Speechreading supplemented with frequency-selective sound-pressure information. AB - The benefit of supplementing speechreading with frequency-selective sound pressure information was studied by auditorily presenting this information to normal-hearing listeners. The sound-pressure levels in one or two frequency bands of the speech signal with center frequencies of 500, 1600, and 3160 Hz, respectively, and with 1- or 1/3-oct bandwidth were used to amplitude-modulate pure-tone carriers with frequencies equal to the center frequencies of the filter bands. Short sentences were presented to 18 normal-hearing listeners under the conditions of speechreading-only and speechreading combined with the sound pressure information. The mean number of correctly perceived syllables increased from 22.8% for speechreading-only to 65.7% when sound-pressure information was supplied in a single 1-oct band at 500 Hz and to 86.7% with two 1-oct bands at 500 and 3160 Hz, respectively. The latter signal scored only 26.7% correct syllables without accompanying visual information. PMID- 6491043 TI - The detection of French accent by American listeners. AB - The five experiments presented here examine the ability of listeners to detect a foreign accent. Computer editing techniques were used to isolate progressively shorter excerpts of the English spoken by native speakers of American English and French. Native English-speaking listeners judged the speech samples in one- and two-interval forced-choiced tests. They were able to detect foreign accent equally well when presented with speech edited from phrases read in isolation and produced in a spontaneous story. The listeners accurately identified the French talkers (63%-95% of the time) no matter how short were the speech samples presented: entire phrases (e.g., "two little dogs"), syllables (/tu/ or /ti/), portions of syllables corresponding to the phonetic segments /t/,/i/,/u/, and even just the first 30 ms of "two" (roughly, the release burst of /t/). Both phonetically trained listeners familiar with French-accented English and unsophisticated listeners were able to accurately detect accent. These results suggest that listeners develop very detailed phonetic category prototypes against which to evaluate speech sounds occurring in their native language. PMID- 6491045 TI - Integration of spectral and temporal cues separated in time and frequency. AB - Subjects discriminated a "standard" pair of tone bursts (T1, T2) from a "comparison" pair (T1 + delta t, T2 + delta f), containing increments in the duration delta t of the first burst and/or the frequency delta f of the second burst. The threshold (d' = 2.0) for delta t was measured as a function of delta f, and the threshold for delta f as a function of delta t. The integration of increments in duration and frequency was studied as a function of the spectral and temporal separation between T1 and T2. A trade-off between the values of delta t and delta f required for d' = 2.0 performance was observed. This integration takes place when delta t, delta f occur simultaneously in the same spectral region, and when they occur separated by up to 120 ms, or by up to a full octave. The efficiency of integration was similar for all conditions of temporal and spectral separation studied, because the discriminability of delta t and of delta f is also nearly uniform across experimental conditions. The results from all experimental conditions are adequately described by a vector summation model derived from TSD. In a subsidiary experiment, subjects categorized pure tones varying in duration and frequency as "high" or "low" in pitch and "long" or "short" in duration. It was found that combined variations in duration and frequency result in essentially independent perceptual processes, although pitch has a small effect upon the perceived duration. It is concluded that spectral temporal integration is a general ability operating in a variety of stimulus conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491044 TI - Intensity perception. XIII. Perceptual anchor model of context-coding. AB - In our preliminary theory of intensity resolution [e.g., see N. I. Durlach and L. D. Braida, J. Acoust. Soc. Am. 46, 372-383 (1969)], two modes of memory operation are postulated: the trace mode and the context-coding mode. In this paper, we present a revised model of the context-coding mode which describes explicitly a process by which sensations are coded relative to the context and which predicts a resolution edge effect [L. D. Braida and N. I. Durlach, J. Acoust. Soc. Am. 51, 483-502 (1972); J. E. Berliner, L. D. Braida, and N. I. Durlach, J. Acoust. Soc. Am. 61, 1256-1267 (1977)]. The sensation arising from a given stimulus presentation is coded by determining its distance from internal references or perceptual anchors. The noise in this process, combined with the sensation noise, constitutes the limitation on resolution in the model. In the revised model the probability density functions of the decision variable are not precisely Gaussian (and cannot be expressed analytically in closed form). This paper outlines the predictions of the model for one-interval paradigms and for fixed-level two interval paradigms and derives estimates of the values of model parameters. PMID- 6491046 TI - On the growth of masking asymmetry with stimulus intensity. AB - Masking asymmetry was investigated over a wide range of stimulus intensities for two signal frequencies, fo = 1.0 and 4.0 kHz, using both fixed-masker and fixed signal paradigms. The masker was a notched noise with the upper and lower edges of the notch, fu and fl, respectively, placed asymmetrically about fo. For various notch widths, the asymmetry of masking was measured as the difference between the masked threshold obtained when fl was nearer fo and that obtained when fu was nearer fo. For maskers with wide notches, (fu - fl)/fo greater than 0.15, masking asymmetry changed with stimulus level; at the highest level, masked threshold was greatest when fl was nearer fo, and, at the lowest level the asymmetry reversed slightly for fo = 1.0 kHz so that masked threshold was actually greater when fu was nearer fo. Nonparallel growth of masking functions reveal changes in masking asymmetry with signal level as well as with masker level. It is concluded that the nonlinear growth of masking with level is due primarily to changes in the auditory filter, rather than changes in the detector following the filter. PMID- 6491047 TI - The effects of multichannel compression/expansion amplification on the intelligibility of nonsense syllables in noise. AB - The effects of six-channel compression and expansion amplification on the intelligibility of nonsense syllables embedded in speech spectrum noise were examined for four hearing-impaired subjects. For one condition (linear) the stimulus was given six-channel amplification with frequency shaping to suit the subject's hearing loss. The other condition (nonlinear) was the same except that low level inputs, to any given channel, received expansion amplification and high level inputs received compression. For each condition, each subject received the nonsense syllables at three different input levels, representing low, average, and high intensity speech. The results of this study, like those of most other studies of multichannel compression, are mainly negative. Nonlinear processing (mainly expansion) of low intensity speech resulted in a significant degradation of speech intelligibility for two subjects and in no improvement for the others. One subject showed a significant improvement in intelligibility for the nonlinearly processed average intensity speech and another subject showed significant improvement for the high intensity input (mainly compression). Clearly, nonlinear processing is beneficial for some subjects, under some listening conditions, but further research is needed to identify the relevent characteristics of such subjects. An acoustic analysis of selected items revealed that the failure of expansion to improve intelligibility was primarily due to the very low intensity consonants /e/ and /k/, in final position, being presented at an even lower intensity in the expansion condition than in the linear condition. Expansion may be worth further investigation with different parameters. Several other problems caused by the multichannel processing were also revealed. These included alteration of spectral shapes and band interaction effects. Ways of overcoming these problems, and of capitalizing on the likely advantages of multichannel amplification, are currently being investigated. PMID- 6491048 TI - Intelligibility ratings of continuous discourse: application to hearing aid selection. AB - Twelve normal-hearing subjects rated the intelligibility of 35-s, hearing-aid processed continuous discourse (CD) passages. Three talkers (two male, one female), four hearing aids, and two signal-to-babble (S/B) ratios were used in a completely crossed design. Research questions concerned: (1) ability of listeners to rate intelligibility, (2) sensitivity of hearing aid rankings were based on intelligibility ratings for three CD passages per instrument, and (3) dependence of hearing aid rankings on (a) S/B ratio, and (b) talker characteristics. Results were: (1) listeners were able to rate intelligibility, (2) rankings based on intelligibility ratings of three CD passages per hearing aid were capable of identifying two superior instruments within a group of four hearing aids that were similar in frequency/gain function, (3) listening in a more difficult S/B ratio substantially decreased the sensitivity of the hearing aid rankings for the female talker but had only minor effects on the rankings for the male talkers, and (4) hearing aid intelligibility rankings were found to be different for different talkers. Applications to hearing aid selection are discussed. PMID- 6491049 TI - Cochlear mechanics: analysis for a pure tone. AB - A three-dimensional hydroelastic model of the cochlea is analyzed, in which the fluid is viscous and the basilar membrane is an inhomogeneous orthotropic elastic plate. After the solution is obtained using a multiple-scale approximation, comparison is made with experiment for the human cochlea. PMID- 6491050 TI - High-frequency rolloff in a cochlear model without critical-layer resonance. AB - Zwislocki's original cochlear model, incorporating axial fluid inertia and shunt basilar-membrane stiffness and viscous resistance, possesses an operating regime not previously emphasized in the literature. Even in the absence of basilar membrane mass and the consequent critical-layer resonance, this regime provides extraordinarily steep high-frequency rolloff. That rolloff is not associated with a critical frequency at which energy flow velocity goes to zero, but is attributable instead to a combination of two effects; (1) frequency-dependent energy coupling to the basilar-membrane viscous resistance, leading to local attenuation of the traveling wave at a rate (Np/cycle) that is directly proportional to frequency, and (2) wavelength that decreases with increasing frequency, thus increasing the number of cycles per unit length of basilar membrane. This combination leads to local attenuation of the traveling-wave amplitude (hence energy absorption from the traveling wave) that is strongly dependent on frequency, the rate (Np/cm) being proportional to the square of frequency in the long-wave mode. In Ranke's (two-dimensional, short-wave mode) version of the model, the same operating regime leads to attenuation that is even more intensely dependent on frequency, the rate being proportional to the cube of frequency. PMID- 6491051 TI - Monaural and binaural auditory brainstem responses in relation to the psychophysical loudness growth function. AB - Electrophysiological measures of the brainstem response to auditory stimuli permit comparisons to be made between latency shifts across intensity increments and psychophysical measures of loudness growth. Monaural comparisons leave much room for uncertainty in the interpretation of the nature of the relationship between the two response modes. A more definitive method for examining this relationship is to compare the monaural and binaural data obtained from psychophysical and electrophysiological measures. It is shown here that, while the brainstem electrophysiological response to intensity changes can be described by a power function, the latency of the neural response does not provide a direct link to the process of loudness summation or to the psychophysical response to loudness growth. PMID- 6491052 TI - Noise levels and hearing thresholds in the drop forging industry. AB - A-weighted equivalent continuous noise levels for hammer and press operations in a drop-forging industry were determined using both tape recordings of the noise and personal noise dosimeters. The results indicated average A-weighted Leq values of 108 dB for hammer operators and 99 dB for press operators. Comparison of hearing level statistics for 716 hammer and press operators and 293 control subjects indicated the severe hazard to hearing of impact noise exposures. For mean exposure times of less than 10 years, hearing levels for the press (99 dB) and hammer (108 dB) operator age groups are nearly identical, and in the latter case are less than those predicted for exposure to equivalent continuous noise. For long-term exposures of 10 years or more, the results of this study indicate that hearing losses resulting from impact noise in the drop-forging industry are as great or greater than those resulting from continuous noise. PMID- 6491053 TI - Method of data reduction for accurate determination of acoustic backscatter coefficients. AB - In previous methods of data reduction used to determine ultrasonic backscatter coefficients, various approximations were made. One frequently used is that there is an abrupt cutoff in the lateral extent of the scattering volume interrogated. Another approximation in all previous methods is that the effect of time gating the received echo signals can be written as a function of the distance along the axis of the interrogating beam. In the present paper we show that the backscatter coefficient can be derived from experimental data without making such approximations. The cases of narrow-band and broadband pulses are treated, and the method is applicable whatever the distance between the interrogated volume of scatterers and the transducer face. It is shown that, for a given pulse form, the gate duration must be sufficiently long in order to attain a specified accuracy for the measured backscatter coefficient. A test of the method was done using a phantom with well-defined scattering properties. Very good agreement was found between measured values of backscatter coefficients and those calculated using a first-principles theory. PMID- 6491054 TI - Laryngeal muscles and articulatory control. AB - The present study continues earlier work on laryngeal control in speech with particular reference to adjustments in Swedish voiceless consonants and consonant cluster. Electromyographic recordings were obtained from four intrinsic laryngeal muscles together with simultaneous transillumination and acoustic signals. Results indicate that the vocalis and lateral cricoarytenoid muscles participate in the control of both articulation and phonation (F0). The interarytenoid muscle appeared to be involved only in articulatory adjustments. Activity in the cricothyroid was mostly related F0 change; however, this muscle also showed an increase in activity for voiceless sounds. In addition, the vocalis muscle appeared to participate in glottal adduction without complete closure in voiceless clusters with the lateral cricoarytenoid and the interarytenoid playing no particular roles. The results suggest the need of studying laryngeal behavior in speech within a general systems famework for movement control. PMID- 6491055 TI - A review of personal/portable monitors and samplers for airborne particles. PMID- 6491056 TI - Indoor-outdoor air pollution, allergen and meteorological monitoring in an arid Southwest area. PMID- 6491057 TI - The Hamilton study: distribution of factors confounding the relationship between air quality and respiratory health. PMID- 6491058 TI - Comprehension of nonverbal communication: a reexamination of the social competencies of learning-disabled children. AB - This study was designed to determine whether learning-disabled (LD) children differed from nondisabled (NLD) children in their ability to comprehend nonverbal communication when potential attentional differences between the groups were controlled. In addition, the relationship between nonverbal comprehension and social competence was assessed. Thirty LD and 30 NLD boys between 9 and 12 years of age were administered a short form of the Profile of Nonverbal Sensitivity (PONS) to assess nonverbal comprehension; social competence measures included teachers' ratings of aggressive and withdrawn behaviors using the Behavior Problem Checklist, and "blind" judges' ratings of performance on a role-play of friendship-making skills. Under attention-incentive conditions, no performance differences between LD and NLD children were found on the PONS; however, LD children were judged to be more withdrawn and less socially skilled. While PONS scores were not related to other social competence measures, they were associated with academic achievement and IQ. Results emphasize the importance of considering the presence of attentional problems in LD children that may interfere with an accurate assessment of their skills. PMID- 6491059 TI - Home environment questionnaire. AB - Psychometric and normative data are presented for two forms of the Home Environment Questionnaire (HEQ) that provide measures of 10 variables used to describe the psychosocial environments of children. One form, HEQ-2R, is suitable for use with families in which there are two parents; the other form, HEQ-1R, is for use with one-parent families. The HEQ scales are relatively independent and not significantly related to the age of the target child, and most of the scales are reasonably internally consistent. Previous research has found several of the HEQ scales to be significantly related to several dimensions of children's clinically important behavior. PMID- 6491060 TI - Attention styles of hyperactive and normal girls. AB - Behavioral characteristics and cognitive skills of teacher-identified hyperactive (n = 24) and normally active (n = 24) first- and second-grade girls were investigated. Teachers rated subjects on the Conners Teacher Rating Scale (TRS). Subjects were given several tasks measuring attentional styles and motor skills. Results suggested that hyperactive girls, like hyperactive boys, have short attention spans and poor concentration when compared with normals. Unlike hyperactive boys, hyperactive girls did not show an impulsive response style, and presented few conduct problems to their teachers. TRS profile patterns of the hyperactive girls were similar to those of hyperactive boys, but cutoff scores currently used for males may not be applicable to females. A direct comparison of hyperactive females and males is advocated. PMID- 6491061 TI - Interrelationships between temperament characteristics and first-grade teacher student interactions. AB - The relationships between temperament characteristics and first-grade teacher student interaction were investigated. It was hypothesized that the temperament characteristics of Adaptability and Approach/Withdrawal would be potent predictors of teacher-student interactions since they had been found previously to be strong predictors of children's emotional and behavioral adjustment to school. The teachers of 105 first-grade children completed temperament questionnaires during the early part of the academic year, and their interactions with the children were observed soon thereafter. The teacher temperament ratings were factor-analyzed, and regression models were generated to predict classroom interactions. The study's hypothesis was supported, and three separate temperament dimensions were found to be predictive of classroom interactions. Suggestions are made for future extensions of the findings. PMID- 6491062 TI - Performance of disturbed hyperactive and nonhyperactive children on an objective measure of hyperactivity. AB - Twenty hyperactive emotionally disturbed children (6-11 years) and a matched sample of nonhyperactive emotionally disturbed children were selected from the population of a therapeutic day treatment facility on the basis of teacher ratings. They were administered the Matching Familiar Figures Test-20 and were rated on several scales of impulsivity and/or hyperactivity. Each subject was required to perform on the Delay Task of the Gordon Diagnostic System, which required them to inhibit behavioral responding on a temporally based schedule (DRL-6) in order to win points. Children classified as hyperactive, whether by one or more criteria, were relatively unable to refrain from emitting a high number of nonreinforced responses. Moreover, these performance differences persisted regardless of age or IQ and were stable over the 8 minutes required to complete the test. PMID- 6491063 TI - A comparison of children who receive and who do not receive permission to participate in research. AB - In a study examining children's social competence in elementary school settings, the authors had the opportunity to compare children who received parental permission to participate to children who did not receive permission. Results indicated that children who were not involved in the study were more likely to be viewed by teachers as having unsatisfactory relationships with peers than children who were in the study. The present results suggest that investigators begin reporting the number of children who do not participate in a given study and begin examining whether minors who receive parental permission differ on important dimensions from minors who do not receive such permission. Ethical considerations of the present study are discussed. PMID- 6491064 TI - The importance of prudent negative consequences for maintaining the appropriate behavior of hyperactive students. AB - Teachers use both positive and negative consequences to influence classroom behaviors. Four experiments were conducted to examine the differential affects of these two types of consequences on the maintenance of appropriate behaviors of hyperactive children. Results of Experiment 1 showed that the use of both positive and negative consequences (combined) was associated with high levels of on-task behaviors. Withdrawal of negative consequences caused a significant and dramatic decrease in on-task performance. The withdrawal of positive consequences produced no change in the rate of on-task behaviors. In Experiments 2, 3, and 4, the on-task results of Experiment 1 were replicated using a different teacher, different children, a counterbalanced design, longer phases, and different types of negative consequences. The withdrawal of negative consequences led to decreases in productivity in Experiment 2. The results of Experiment 3 also suggested that a prudent (e.g., calm, concrete, and consistent) approach to discipline was more effective than an imprudent (e.g., loud, emotional, and inconsistent) approach. Some level of mild negative consequences for inappropriate behavior is an important ingredient in effective classroom management, and qualitatively different negative consequences may have drastically different effects on the behavior of hyperactive students. PMID- 6491065 TI - Social-cognitive and cognitive correlates of depression in children. AB - The present investigation examined depression and its social-cognitive and cognitive correlates in a sample of 108 elementary school children: 36 children in each of grades 1, 4, and 8. Children were classified as depressed and nondepressed according to their scores on the Children's Depression Inventory (CDI). Depression appeared stable over a 3-week time interval. Depressed children reported a higher number of "masking" symptoms, were rated as more depressed by their teachers, and perceived their family environment to be more distressed. As posited, when compared to nondepressed children, depressed children have lower self-esteem, a more depressive attributional style, and more self-control deficits. Further, they have impaired performance on some cognitive tasks (block design, coding digit span) but not all (vocabulary). The prediction that depression would be manifested differently in first-, fourth-, and eighth-graders was not supported. PMID- 6491066 TI - Extracardiac conduit obstruction: initial experience in the use of Doppler echocardiography for noninvasive estimation of pressure gradient. AB - Extracardiac valved conduits are often employed in the repair of certain complex congenital heart defects; late obstruction is a well recognized problem that usually requires catheterization for definitive diagnosis. A reliable noninvasive method for detecting conduit stenosis would be clinically useful in identifying the small proportion of patients who develop this problem. Continuous wave Doppler echocardiography has been used successfully to estimate cardiac valvular obstructive lesions noninvasively. Twenty-three patients with prior extracardiac conduit placement for complex congenital heart disease underwent echocardiographic and continuous wave Doppler echocardiographic examinations to determine the presence and severity of conduit stenosis. In 20 of the 23 patients, an adequate conduit flow velocity profile was obtained, and in 10 an abnormally increased conduit flow velocity was present. All but one patient had significant obstruction proven at surgery and in one patient, surgery was planned. In three patients, an adequate conduit flow velocity profile could not be obtained but obstruction was still suspected based on high velocity tricuspid regurgitant Doppler signals. In these three patients, subsequent surgery also proved that conduit stenosis was present. Doppler-predicted gradients and right ventricular pressures showed an overall good correlation (r = 0.90) with measurements at subsequent cardiac catheterization. Continuous wave Doppler echocardiography appears to be a useful noninvasive tool for the detection and semiquantitation of extracardiac conduit stenosis. PMID- 6491067 TI - Pulsed Doppler and two-dimensional echocardiographic findings in aortico-left ventricular tunnel. AB - Two-dimensional echocardiography was used to make the anatomic diagnosis of aortico-left ventricular tunnel in a 1 day old infant. Pulsed Doppler echocardiography allowed directional flow to be determined within the tunnel. The findings were confirmed by cardiac catheterization and by direct visualization at the time of surgical repair. Aortic valve insufficiency was excluded before and after surgery using pulsed Doppler echocardiography. The anatomy and physiology of aortico-left ventricular tunnel can thus be documented using noninvasive techniques. PMID- 6491068 TI - Left atrial isomerism associated with asplenia: prenatal echocardiographic detection of complex congenital cardiac malformations. AB - Complex congenital heart disease with suspected isomerism of the atria was diagnosed in two fetuses of 20 and 29 weeks' gestation using two-dimensional and M-mode scanning techniques. The first pregnancy was terminated at 21 weeks' gestation and stillbirth occurred at 31 weeks' gestation in the second pregnancy. At postmortem examination, a thoracoabdominal discordancy was found; the spleen was absent and the arrangement of the abdominal vessels was as anticipated for asplenia, but the thoracic situs revealed a bilateral right-sided arrangement with left isomerism of the atria. The heart, otherwise, showed complex abnormalities as anticipated for asplenia. PMID- 6491069 TI - Noninvasive estimation of peak pulmonary artery pressure by M-mode echocardiography. AB - In an attempt to predict peak pulmonary artery pressure from routine M-mode echocardiographic tracings, 95 infants and children with congenital heart disease were examined. Following the Burstin method for prediction of peak pulmonary artery pressure, which was originally based on the phonocardiogram and jugular phlebogram, M-mode echocardiography was used to measure the interval from pulmonary valve closure to tricuspid valve opening, namely, the period of isovolumic diastole. The measured interval was plotted on a modified table relating the interval, heart rate and predicted peak pulmonary artery pressure. The peak pulmonary artery pressure predicted by echocardiography was compared with that measured at cardiac catheterization. The correlation between predicted and actual peak pulmonary artery pressure was good (r = 0.86) for routine studies with the patient in the nonsedated state. All patients with a predicted peak pressure less than 40 mm Hg were found at catheterization to have a pressure less than 40 mm Hg. The correlation was better (r = 0.96) when comparing predictions made from the echocardiogram obtained while the patient was sedated for catheterization. Prediction of the magnitude of elevation of peak pressure was especially good when prediction and measurement were nearly simultaneous. Predictions were less accurate in the presence of tachycardia at rates of more than 155 beats/min. The method for estimating peak pulmonary artery pressure from M-mode echocardiographic tracings is reliable, relatively simple and clinically useful. PMID- 6491070 TI - Intraoperative contrast echocardiography to evaluate mitral valve operations. AB - Intraoperative two-dimensional contrast echocardiography was performed on 29 patients undergoing open heart surgery to determine the presence of mitral regurgitation before and immediately after the operative procedure: 14 patients had predominant mitral stenosis, 9 had severe mitral regurgitation and 6 had no mitral valve disease (control subjects). Two-dimensional echocardiography was performed by applying a 5 MHz transducer directly on the heart during injection of saline solution through an apical ventricular sump or transseptal needle, generating contrast microbubbles, with imaging in two planes. Baseline studies were performed after thoracotomy and pericardiotomy before cardiopulmonary bypass, and a second study was done after the operative procedure, with the patient off cardiopulmonary bypass with hemodynamic stabilization before chest closure. No control subject had contrast evidence of mitral regurgitation before or after cardiopulmonary bypass. Two of three patients with mitral valvuloplasty and two of five with commissurotomy required a second operative procedure before chest closure because of persistent mitral regurgitation detected by intraoperative two-dimensional contrast echocardiography. Thirteen of the 15 patients with valve replacement had no mitral regurgitation after cardiopulmonary bypass. Intraoperative two-dimensional echocardiographic findings correlated with data from postoperative clinical examinations and two-dimensional echocardiography-Doppler studies. It is concluded that two-dimensional echocardiography with contrast is an important intraoperative tool for assessing the presence and relative severity of mitral regurgitation after mitral commissurotomy, valvuloplasty or valve replacement. This technique may allow surgeons to be more aggressive in combining reparative operative procedures (that is, commissurotomy and valvuloplasty) in an attempt to retain native valves. PMID- 6491071 TI - Right atrial thromboemboli: clinical, echocardiographic and pathophysiologic manifestations. AB - In six patients with clinically unsuspected right atrial thromboemboli the diagnosis was made with two-dimensional echocardiography. Five patients had pulmonary emboli, and one had systemic embolization. Three patients had congestive cardiomyopathy, two with tricuspid regurgitation; of the remaining three, one had cor pulmonale complicated by tricuspid regurgitation, one had thrombophlebitis and one had no discernible cardiac illness. Four patients had dizziness or syncope, four had dyspnea, three had chest pain, three had hypotension and tow had cyanosis. Five patients were treated with thrombolytic or anticoagulant therapy, or a combination of the two. In three patients, surgical removal of the thrombus was undertaken because of recurrent pulmonary emboli or tricuspid regurgitation, or both, and progressive right heart failure. The thromboemboli were removed in all three, but one patient died. On two-dimensional echocardiography, four of the six patients' thromboemboli were snake-like, unattached to the right atrium and prolapsed freely across the tricuspid valve into the right ventricle in diastole and back into the right atrium in systole. The other two patients' thromboemboli were attached to the right atrium and did not prolapse across the tricuspid valve. Our cases, together with a review of other reports, suggest that right atrial thromboemboli: 1) can be accurately diagnosed by two-dimensional echocardiography; and 2) result from two different pathophysiologic mechanisms developing a) in situ, either on a foreign body or secondary to reduced cardiac output, or b) as a result of an embolus from systemic vein thromboses. PMID- 6491072 TI - Clinical significance of incomplete tricuspid valve closure seen on two dimensional echocardiography. AB - Incomplete closure of the tricuspid valve without apparent cusp disease was noted on two-dimensional echocardiography in 31 patients. This abnormality was defined as a failure of the tricuspid valve leaflet tips to reach the plane of the tricuspid valve anulus by at least 1 cm in the standard apical four chamber view at the point of maximal systolic closure. This resulted in a final systolic leaflet position deeper within the right ventricular cavity than is normally seen. The finding was present in the following diagnostic subgroups: Group A, pulmonary hypertension (11 patients); Group B, rheumatic heart disease (4 patients); Group C, dilated cardiomyopathy (9 patients) and Group D, previous myocardial infarction (7 patients). Right atrial, right ventricular and tricuspid anulus measurements were made and compared with those from a group of 67 normal subjects. The results were as follows: right atrial endsystolic area = 27.2 +/- 8.6 cm2 (normal = 13.4 +/- 2.0); right ventricular end-systolic area = 25.6 +/- 8.7 cm2 (normal = 10.9 +/- 2.9); right ventricular end-diastolic area = 31.5 +/- 9.1 cm2 (normal = 20.1 +/- 4.9) and tricuspid valve anular end-systolic dimension = 4.0 +/- 0.6 cm (normal = 2.2 +/- 0.3). The differences from the normal data were all statistically significant (p less than 0.001). Incomplete closure of the tricuspid valve, although a nonspecific diagnostic finding, is primarily associated with right-sided chamber enlargement. Tricuspid regurgitation may be present. The mechanism could be related to geometric changes in valve apparatus dynamics secondary to right-sided cardiac enlargement and tricuspid valve anular dilation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491073 TI - Surgical therapy of a dissecting aortic aneurysm involving a right-sided aortic arch. AB - Dissecting aortic aneurysm involving a right-sided aortic arch is apparently quite rare. A patient with this unusual entity is described. By performing an extraanatomic bypass, the aneurysm was excluded between stainless steel staples. The patient was discharged from the hospital 21 days postoperatively. Although the reasons for the extreme rarity of this entity are not clear, precise anatomic definition is required for successful surgical therapy. PMID- 6491074 TI - Pulsus alternans: a systolic phenomenon? PMID- 6491075 TI - Transient entrainment and interruption of ventricular tachycardia with rapid atrial pacing--I. PMID- 6491076 TI - Transient entrainment and interruption of ventricular tachycardia with rapid atrial pacing--II. PMID- 6491077 TI - Exercise-induced atrioventricular block. PMID- 6491078 TI - Idiopathic "myocarditis"? PMID- 6491079 TI - Diastolic atrial compression in a premature infant. PMID- 6491080 TI - Calculating pulmonary vascular resistance in children with congenital heart disease. PMID- 6491081 TI - Left ventricular dysfunction after acute myocardial infarction: results of a prospective multicenter study. AB - In a multicenter prospective study of 866 patients who survived the coronary care unit phase of an acute myocardial infarction, variables reflecting left ventricular function were examined to assess their impact on 2 year survival. Single variables that reflected left ventricular dysfunction before infarction and in the acute and recovery phases were, respectively, history of prior myocardial infarction, rales in the coronary care unit dichotomized at greater than bibasilar and predischarge radionuclide ejection fraction dichotomized at less than 0.40. When combined in a stepwise fashion, patients lacking these three risk characteristics had a 2 year 4.2% mortality rate, whereas patients possessing all three characteristics had a 45% mortality rate. Rales in the coronary care unit and predischarge ejection fraction act independently, and each contributes to mortality. Fifty-two patients with advanced rales but an ejection fraction of 0.40 or greater had a 21% mortality rate. Similarly, 208 patients with few rales but an ejection fraction of less than 0.40 had a 15% mortality rate. These data suggest that the mortality risk imposed by those factors that assess permanent left ventricular damage is independent of and additive to the mortality risk contributed by dynamic, acute phase dysfunction. These data fit the hypothesis that acute phase dysfunction is, in part, due to transient ischemia that, on reversal, can restore function toward normal. The results suggest 1) that assessment of left ventricular function during the acute and recovery phases of myocardial infarction is necessary to define prognostic characteristics of an individual patient, and 2) that of particular importance is the identification of patients whose postinfarction course is consistent with reversible ischemia. PMID- 6491082 TI - Adverse hemodynamic and clinical effects of calcium channel blockade in pulmonary hypertension secondary to obliterative pulmonary vascular disease. AB - The hemodynamic and clinical responses to calcium channel blockade with verapamil and nifedipine were compared with those of hydralazine in 12 patients with pulmonary hypertension secondary to obliterative pulmonary vascular disease. All three drugs produced a marked and similar decrease in pulmonary vascular resistance; however, this was accompanied by a significant increase in cardiac index with hydralazine (+0.71 liter/min per m2, p less than 0.01), no change in cardiac index with nifedipine and a significant decrease in cardiac index with verapamil (-0.25 liter/min per m2, p less than 0.05). Mean pulmonary artery pressure decreased markedly with both calcium channel blocking drugs (-16.0 mm Hg with verapamil and -14.5 mm Hg with nifedipine, both p less than 0.01), but this was associated with a concomitant increase in mean right atrial pressure (+6.2 mm Hg with verapamil and +4.4 mm Hg with nifedipine, both p less than 0.01); neither variable changed after hydralazine. Hence, right ventricular performance (as reflected by right ventricular stroke work index) deteriorated during treatment with both calcium channel blocking drugs, despite the decrease in resistance to right ventricular ejection; in contrast, right ventricular stroke work index increased after hydralazine. The unfavorable hemodynamic effects of calcium channel blockade were accompanied by severe adverse clinical events, including profound hypotension and cardiogenic shock during acute drug administration and the exacerbation of right heart failure during long-term treatment. These deleterious responses to verapamil and nifedipine are likely the result of a direct depressant effect exerted by these drugs on right ventricular function independent of their pulmonary vasodilatory actions. PMID- 6491083 TI - Noninvasive assessment of acute effects of nifedipine on rest and exercise hemodynamics and cardiac function in patients with aortic regurgitation. AB - The acute effects of nifedipine (20 mg sublingually) on hemodynamics and cardiac function were studied at rest and during supine bicycle exercise in 20 patients with aortic regurgitation. At rest, heart rate increased by 13%, systemic vascular resistance decreased by 34% and regurgitant index decreased by 17%. The change in systemic vascular resistance was related to its initial rest level (r = 0.82, p less than 0.001) and to the changes in forward cardiac output (r = 0.58, p less than 0.01) and regurgitant index (r = 0.60, p less than 0.01). Left ventricular end-diastolic and end-systolic volumes, stroke volume and ejection fraction were unchanged, whereas right ventricular ejection fraction increased. During exercise, nifedipine administration further increased heart rate by 8% and decreased systemic vascular resistance by 19%. Both forward stroke volume and forward cardiac output increased, but total left ventricular stroke volume was unchanged, resulting in a significant decrease in regurgitant index. Although left ventricular end-diastolic volume was slightly decreased, end-systolic volume did not increase; thus, ejection fraction was higher than that during control exercise (p less than 0.01). Right ventricular ejection fraction increased further. In aortic regurgitation, the acute administration of nifedipine improved cardiac performance and reduced regurgitation at rest and during exercise as a result of afterload reduction and increased heart rate. Whether these beneficial effects will occur during long-term therapy requires further investigation. PMID- 6491084 TI - First transit and equilibrium radionuclide angiography in patients with inferior transmural myocardial infarction: criteria for the diagnosis of associated hemodynamically significant right ventricular infarction. AB - To define radionuclide criteria for identifying hemodynamically significant right ventricular infarction, 33 consecutive men with inferior transmural infarction were evaluated prospectively by right heart catheterization and first transit and equilibrium radionuclide angiography within 36 hours of the onset of symptoms. Hemodynamically significant right ventricular infarction was present in 6 of the 33 patients (Group I); the remaining 27 patients did not demonstrate the hemodynamics characteristic of right ventricular infarction (Group II). A right ventricular ejection fraction of less than 40% separated Group I and Group II patients by equilibrium (p = 0.003) but not by first transit (p = NS) radionuclide angiography. However, a right ventricular ejection fraction of less than 35% separated Group I and II patients by both techniques (p = 0.02 and p = 0.005, respectively). The presence of a right ventricular regional wall motion abnormality on either first transit or equilibrium radionuclide angiograms separated Group I and II patients (p less than 0.001). The combination of both a right ventricular ejection fraction of less than 40% and a regional wall motion abnormality separated Group I and II patients using either equilibrium (p less than 0.001) or first transit (p = 0.02) radionuclide angiography. It is concluded that in patients with acute inferior transmural myocardial infarction, a right ventricular regional wall motion abnormality alone or in combination with a right ventricular ejection fraction of less than 40% by either first transit or equilibrium radionuclide angiography is a useful criterion for establishing the presence of hemodynamically significant right ventricular infarction, while its absence argues against the diagnosis of right ventricular infarction. PMID- 6491085 TI - Right and left ventricular ejection fraction in acute inferior wall infarction with or without ST segment elevation in lead V4R. AB - To detect right ventricular involvement, lead V4R was recorded within 10 hours of the onset of chest pain in 42 consecutive patients admitted with acute inferior wall myocardial infarction. One week after the acute infarction, multigated equilibrium radionuclide ventriculography was performed to assess right and left ventricular ejection fraction. Two weeks after the acute infarction, coronary angiography was performed to determine the site and location of the obstruction leading to the infarction. Seventeen patients had an obstruction in the right coronary artery proximal to the first branch to the right ventricular free wall (group 1); all of these had ST segment elevation in lead V4R. Fourteen patients had an obstruction in the right coronary artery distal to the first branch to the right ventricular free wall (group 2); only two of these patients had ST segment elevation in lead V4R. In 11 patients, the obstruction was located in the circumflex coronary artery (group 3); none of these had ST segment elevation in lead V4R. Nineteen patients had ST segment elevation of 1 mm or greater in lead V4R (group 4). Left ventricular ejection fraction was not different among the four groups of patients, although the right ventricular ejection fraction was significantly lower in group 1 and group 4 patients. It is concluded that ST segment elevation in lead V4R reliably identifies the group of patients with inferior wall myocardial infarction with depressed right ventricular function. This phenomenon persists for at least 1 week after infarction. PMID- 6491086 TI - Right ventricular performance in septic shock: a combined radionuclide and hemodynamic study. AB - Twenty-five patients with septic shock underwent simultaneous radionuclide ventriculography and right heart catheterization to clarify the role of the right ventricle in this syndrome. A depressed right ventricular ejection fraction (less than 38%) was present in 13 patients and was found in patients with elevated cardiac output (4 of 6 patients) and with normal or low cardiac output (9 of 19 patients). Right ventricular dysfunction was seen with or without acute respiratory failure. In eight patients, a depressed right ventricular ejection fraction was seen in combination with an abnormal left ventricular ejection fraction (less than 48%), but in five patients, right ventricular ejection fraction impairment occurred with normal left ventricular ejection fraction. There was no significant correlation between abnormal right ventricular afterload and depressed right ventricular ejection fraction. No clinical or hemodynamic finding could be used to identify patients with diminished right ventricular ejection fraction. On follow-up study in 17 surviving patients, right ventricular ejection fraction improved in 6 and was unchanged in 11. Improvement in right ventricular ejection fraction occurred more frequently in patients without pulmonary hypertension or respiratory distress. The results suggest that right ventricular dysfunction in septic shock may be more common than previously suspected. It may be caused by abnormalities in right ventricular afterload in some patients and depressed myocardial contractility in others. The findings are of therapeutic importance since interventions that diminish right ventricular afterload and increase right ventricular contractility would be appropriate in patients with septic shock and right ventricular dysfunction. PMID- 6491087 TI - Cardiac histologic findings in patients with life-threatening ventricular arrhythmias of unknown origin. AB - Percutaneous endomyocardial biopsy (right ventricle in 10, left ventricle in 2) was performed in 12 patients, aged 9 to 57 years, with serious ventricular arrhythmias occurring in the setting of normal cardiac anatomy and mechanical function. Light microscopic examination of tissue revealed histologic abnormalities in 11 patients, including myocardial cellular hypertrophy in 7, interstitial fibrosis in 5, endocardial fibrosis in 2, myocardial degenerative changes in 1 and increased interstitial cellularity in 1. One patient had histologic evidence of acute lymphocytic myocarditis. Thus, a majority of patients with serious ventricular arrhythmias and normal cardiac anatomy had histologic abnormalities, bringing into question the concept of primary electrical heart disease or idiopathic ventricular tachycardia. PMID- 6491088 TI - Effect of aerobic conditioning on the peripheral circulation during chronic beta adrenergic blockade. AB - The relation of peripheral circulatory adjustments to exercise training during long-term beta-adrenergic blockade has not been investigated. In 12 healthy men aged 22 to 34 years, blood flow in the calf was evaluated with submaximal exercise before and after a 6 week aerobic conditioning program. During conditioning, six subjects received no drug and six received propranolol, 80 to 120 mg/day in divided doses. Treated and control subjects were studied on entry and at the conclusion of a conditioning program, 72 hours after drug withdrawal in subjects given propranolol. The training was intensive and equivalent in both groups. Control subjects increased maximal oxygen uptake from 47.5 +/- 1.1 to 51.4 +/- 0.4 ml/kg per min (p less than 0.05), whereas those on propranolol did not improve. Immediately after exercise, blood flow in the calf was measured with strain gauge plethysmography after 3 minutes of supine exertion on a cycle ergometer. In control subjects, flow decreased from 15.7 +/- 1.6 to 14.0 +/- 1.4 ml/100 ml per min at 300 kg-m/min of exertion (p less than 0.05) and from 26.5 +/ 3.8 to 21.8 +/- 2.3 ml/100 ml per min at 700 kg-m/min (p less than 0.05). Vascular resistance was unchanged in these subjects at 300 kg-m/min (6.1 +/- 0.8 to 6.7 +/- 1.0 pru) (p = NS), but increased at 700 kg-m/min (4.2 +/- 0.8 to 4.8 +/- 0.7 pru) (p less than 0.05). In subjects given propranolol, no change in flow or resistance occurred after training at either work load.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491089 TI - Phase image characterization of localized and generalized left ventricular contraction abnormalities. AB - To evaluate their phase image characteristics, 61 patients with varying left ventricular contraction abnormalities were studied. In 16 normal patients, the left ventricular phase image revealed a homogeneous pattern, a narrow bell-shaped histogram and an orderly spatial progression of phase angle (phi). In 16 patients with segmental abnormalities, the left ventricular phase image showed a region of uniformly delayed phase angle corresponding to the site of segmental abnormality, a discrete secondary histogram peak and a discontinuous, but orderly, spatial progression of phase angle. The mean phase angle (phi) (23.6 +/- 15.7 degrees) and its standard deviation (17.6 +/- 7.2 degrees) differed from the normal group (7.6 +/- 11.1 degrees, p less than 0.002 and 8.9 +/- 2.8 degrees, p less than 0.001). The percent of end-diastolic volume involved in the segmental abnormality, calculated using phase data in 13 of these and in 11 additional patients with a left ventricular aneurysm on ventriculography, correlated well with the percent akinetic segment on scintigraphic (r = 0.78) and angiographic (r = 0.84) study. In 18 patients with generalized abnormalities, the left ventricular phase image revealed multiple regions of inhomogeneous phase angle, a grossly irregular histogram and a disorderly spatial progression of phase angle. The mean phase angle (56.4 +/- 23.9 degrees) and standard deviation (27.3 +/- 7.1 degrees) differed from values in the normal group and from patients with segmental contraction abnormalities (both p less than 0.001). The mean phase angle and its standard deviation in scattered regions with abnormally prolonged phase angle differed significantly from abnormal regions in patients with segmental abnormalities (both p less than 0.001). These patterns of left ventricular phase angle demonstrate characteristics that may help differentiate between ventricles with segmental and generalized contraction abnormalities. Their relation to underlying pathophysiology and potential clinical implications should be considered. PMID- 6491090 TI - Characterization of the human right ventricular pressure-volume relation: effect of dobutamine and right coronary artery stenosis. AB - Right ventricular function was assessed in 15 patients using right ventricular pressure-volume loops. Right ventricular pressure using a micromanometer-tipped catheter, thermodilution cardiac output and gated blood pool scintigrams were simultaneously obtained. To help isolate the right ventricle, a slant hole collimator was used. The measurements were repeated during dobutamine infusion, which was titrated so there was minimal change in systemic pressure and heart rate. The right ventricular pressure-volume loop resembles the usual left ventricular loop except that the isovolumic contraction phase is often not as distinct, and right-sided ejection may continue well beyond right ventricular peak systolic pressure. Systolic but not diastolic function improved with dobutamine administration. There was no significant difference in right ventricular systolic function (ejection fraction, stroke work index, stroke volume index and cardiac index) or in end-diastolic volume index between patients without (Group I) and with (Group II) significant right coronary artery stenosis. However, there was a small but significant difference in right ventricular end diastolic pressure (5.3 +/- 2.5 and 8.1 +/- 1.8 mm Hg [p less than 0.05]) for Group I and II, respectively. Thus, the right ventricular pressure-volume loop can be used to graphically display right ventricular function and improvement in contractility with dobutamine. The right ventricular isovolumic contraction phase and ejection phase differ from those in the usual left ventricular loop. Although there was a small difference in right ventricular end-diastolic pressure in patients with and without right coronary artery stenosis, the right ventricular pressure-volume loop did not provide additional discriminatory information between these two groups of patients. PMID- 6491091 TI - Aerobiology of pollinosis. PMID- 6491092 TI - Sulfites and asthma. PMID- 6491093 TI - Feeding of antigen reduces antigen-binding activity and blunts the secondary response of actively immunized rats. AB - Enteric administration of soluble or particulate antigens to unprimed animals has been repeatedly demonstrated to blunt or abrogate the cellular and humoral immune response to parenteral immunization. We tested the effect of administering bovine serum albumin by gavage or in the drinking water on the serum antigen-binding activity of rats primed by previous immunization with bovine serum albumin and alum. In some animals, this treatment served initially to boost the systemic humoral response; prolonged treatment led to a reduction in antigen-binding activity at a faster rate than was observed in sham-fed controls. In all rats treated with enteric antigen, the booster response to a second parenteral immunization was reduced or absent. Example of the use of enteric antigen in treatment of patients are cited. On the basis of our findings in rats and those of other investigators who studied mice, as well as the results obtained in patients, it is suggested that further exploration of the enteric approach to treating actively immunized subjects appears warranted. PMID- 6491094 TI - Allergic contact urticaria caused by raw prawns and shrimps: three cases. AB - Contact urticaria from raw prawns and shrimps was suspected in three housewives with hand eczema who visited our clinic. A practice skin test in which patients stripped the shells from raw prawns and shrimps was positive, but an intradermal skin test with an allergen extracted from a mixture of prawns and shrimps was negative. Results of skin tests with fresh extracts of raw prawns and shrimps were positive. The RAST with a paper disc method with use of a raw prawn and shrimp as antigens was also positive in these three patients. It is evident from the results obtained that some common substances causing a local urticaria exist in raw prawns and shrimps. PMID- 6491095 TI - Natural history of large local reactions from stinging insects. AB - In ongoing studies of the natural history of stinging-insect allergy, 133 patients with large local reactions have been evaluated over 8 yr; 79 patients returned for reevaluation. Based on RAST analysis with honeybee and vespid venoms, patients were divided into RAST-positive and RAST-negative groups. Sixty six patients were RAST-negative with positive venom skin tests in 58%. Seventy five testings in this group led to no systemic reactions and 74 large local reactions. At follow-up RASTs remained negative, and the incidence of positive skin tests was unchanged. Sixty-seven patients had detectable serum venom specific IgE covering a wide range in antibody titers, indistinguishable from patients with systemic reactions. Twenty-four of 67 patients received venom immunotherapy (VIT). RAST titers decreased similarly in the VIT and untreated groups. There were 55 testings resulting in 40 recurrent large local reactions occurring in equal incidence in treated and untreated patients. One systemic reaction occurred in an untreated patient. In reviewing 118 patients with sting anaphylaxis, a previous large local reaction occurred in five. These results suggest that after repeat stings, patients with large local reactions tend to have subsequent large local reactions, regardless of the presence of venom specific IgE or immunotherapy. There is small risk of anaphylaxis. Determination of serum venom-specific IgE by RAST or skin tests does not aid in treatment or in predicting prognosis. Thus skin tests are not necessary in patients who have had large local reactions, and venom immunotherapy is not indicated. PMID- 6491096 TI - Evaluation of a family asthma program. AB - This article presents the results of an evaluation of a 12-hour patient education program for children with asthma and their parents. Ninety-two of 147 participants (63%) completed the 1-year follow-up. The effectiveness of the family asthma program (FAP) was measured by a "knowledge of asthma" questionnaire administered before and at the last session; it demonstrated a significant improvement for parents (p less than 0.001) and children (p less than 0.01). The "multidimensional health locus of control scales" (administered to a subgroup of 42 adults and 29 children before and 3 mo after the FAP) demonstrated a significant change in attitude toward asthma for both parents (p less than 0.05) and children (p less than 0.005), indicating an interest to assume more responsibility for self-management. In addition, eight variables were measured in the children before the FAP was started and longitudinally on a monthly basis for 1 yr after completion of the FAP. Three of these variables demonstrated a significant change: total activities were increased (p less than 0.001), unscheduled health-care visits were decreased (p less than 0.005), and school absences were decreased (p less than 0.005). Four variables did not reach statistical significance but did change in the expected direction: medication score, 10% decrease; emergency treatments, 24% decrease; hospital admissions, 44% decrease; school activities, 5% increase. These results demonstrate that this FAP effectively complemented medical care and provided a useful preparation for self management. PMID- 6491097 TI - Bronchospastic responses to aerosolized metabisulfite in asthmatic subjects: potential mechanisms and clinical implications. AB - Eight asthmatic patients with a history suggestive of sulfite sensitivity were studied, six of whom had a positive oral challenge to doses from 10 mg to 50 mg. All eight patients had aerosol metabisulfite challenge; six positive tests were observed at doses of 0.5 mg/ml and 5.0 mg/ml. Aerosolizing solutions of metabisulfite at 5.0 mg/ml generated significant amounts of free sulfur dioxide. Implications of these findings are discussed. PMID- 6491098 TI - Serum-IgE levels in rural Namibian infants. AB - Serum IgE levels were examined in 237 infants ages 2 wk to 12 mo in a remote rural area of Namibia. There was a wide range of values (0.5 to 884 IU/ml). The highest value in the first month of life was 295 IU/ml. Median values for the age groups 2 wk to 3 mo, 3 to 6 mo, and 6 to 12 mo were higher than those reported from Western countries. Values in general increased with age, but only 4% of the variation is explicable on this basis. There were differences between median values for male and female infants, but they did not reach statistical significance at the 5% level. Levels between Baster and Nama infants, the main ethnic groups in the area, did not differ. The median IgE levels in breast-fed infants, although high, tended to be lower than those in weaned infants. The differences were not statistically significant (p greater than 0.05). Investigations did not suggest that parasitic infestations or atopy were of significant importance. It was not possible to identify the factor(s) responsible for the high IgE levels. They must have been operative from very early life. However, the basic immunologic mechanisms involved are presumably genetically determined and similar to those responsible for the corresponding high IgG, IgA, and IgM levels reported in infants from developing communities. PMID- 6491099 TI - Two pretreatment regimens for high-risk patients receiving radiographic contrast media. AB - The risk of anaphylactoid reaction (AR) developing from radiographic contrast media in patients who previously have had an AR to radiographic contrast media ranges from 17% to 60%. Pretreatment with prednisone plus diphenhydramine or prednisone and diphenhydramine plus ephedrine decreased the reaction rate to 9.0% and 3.1%, respectively, during 657 procedures in 563 patients. No deaths occurred, and only three episodes of transient hypotension developed, one of which was treated with epinephrine. Pretreatment consisted of prednisone, 50 mg, 13 hr, 7 hr, and 1 hr before the procedure and diphenhydramine, 50 mg, 1 hr and or ephedrine, 25 mg, 1 hr before the procedure. The addition of ephedrine provided a statistically significant reduction in reaction in 192 procedures (chi 2 = 5.4996, p = 0.019). In 138 procedures in patients whose initial AR was considered serious, pretreatment was as effective as for patients with histories of mild to moderate reactions. Emergency equipment should be available for all procedures. PMID- 6491100 TI - IgE against ethylene oxide-altered human serum albumin in patients who have had acute dialysis reactions. AB - Serum samples obtained from seven hemodialysis patients with immediate-type allergic reactions, from six hemodialysis patients without reactions, and from three nonatopic control subjects were analyzed for IgE against human serum albumin exposed to ethylene oxide (ETO-HSA). ETO is used to sterilize medical equipment like dialyzers that cannot withstand heat sterilization. IgE to ETO HSA, measured by a polystyrene tube technique was found in six of seven dialysis reactor patients but in only one of six nonreactor patients (p less than 0.05 two tailed Fisher's exact test). No control sera from three nonatopic individuals had antibody. The reactor patients had 2.0 +/- 8.0 ng (SD) of ETO-HSA bound per milliliter of serum, whereas nonreactor patients had 0.2 +/- 8.0 ng per milliliter bound (p less than 0.05 one-tailed Student's t test on log transformed values). We suggest that there is an association between the presence of IgE to ETO-HSA and immediate-type allergic reactions to dialysis in this group of patients. PMID- 6491101 TI - Symposium proceedings on drug allergy: prevention, diagnosis, treatment. December, 1983, Washington, D.C. Sponsored by the National Institute of Allergy and Infectious Diseases and National Center for Drugs and Biologics (FDA). PMID- 6491102 TI - Adverse drug reactions: the magnitude of the problem. AB - Much quantitative information on the clinical use and adverse effects of drugs has been accumulated in the past 15 years. These data provide a basis for substantial knowledge and perspective on the problem of drug toxicity, particularly for drugs that have been marketed for many years. We have also learned how to study adverse effects of newly marketed drugs in a cost-efficient and effective manner. Studies have shown that hospitalized adult patients in the United States receive on average about 10 drugs during hospitalization. Outpatient adults take on average about two drugs on a regular basis (i.e., at least once a week). Results from in-hospital studies indicate that some type of adverse reaction occurs about once in every 20 drug treatments. Most of these drug reactions are clinically minor and reversible, but about 10% of adverse reactions are regarded as life-threatening. Virtually all organ systems have been involved with adverse drug effects. Deaths in hospitalized patients that are attributable to drugs are rare and tend to occur in patients who are quite ill from their primary illness and receive potent drugs such as antitumor agents. However, some drug-induced illnesses appear to be preventable. Out-patient drug toxicity is the cause of about 3% of all hospitalizations. When considered with the enormous use of drugs in the outpatient population, however, this number of admissions secondary to drug toxicity seems to represent a small incidence. PMID- 6491103 TI - Risk factors for drug allergy. AB - Judging from available data on penicillin allergy there appear to be multiple definable risk factors for drug-induced immunopathology. The induction of a drug specific immune response can be influenced by the age of the patient; underlying genetic or metabolic factors, which may restrict ability to initiate a drug specific immune response; the chemical properties of the drug, largely its protein reactivity; and the dose and duration of treatment as well as the route of drug administration. The elicitation of drug-induced immunopathology is a function of the persistence of a drug-specific immune response; the frequency of drug treatment and its dose and duration; and probable constitutional factors that may determine in an important way the efficiency with which a drug-specific immune response can be translated into a systemic allergic reaction. PMID- 6491104 TI - Management of adverse drug reactions. AB - Successful management of adverse drug reactions requires early identification and prompt treatment of anaphylaxis, whether due to immunoglobulin (Ig) E- or non-IgE mediated mechanisms of mast cell mediator release. Acute therapy is directed toward enhancement of oxygenation and maintenance of normotension. Requisite measures include the use of epinephrine, oxygen, and adequate fluid replacement; in some instances, vasopressors or corticosteroid drug therapy may be warranted. Emergency measures may be needed to maintain the airway. Although the offending drug is usually discontinued, a necessary drug for which there is no satisfactory alternative occasionally may be continued without danger of further anaphylaxis as long as therapy is not interrupted. Other nonemergent adverse drug reactions requiring an early decision include accelerated urticarial and late maculopapular eruptions, in both of which the patient may tolerate a necessary drug with schedule manipulation. Differentiation of an adverse drug reaction from problems unrelated to the drug is essential so that needed medication is not inappropriately discontinued. Good management also requires anticipation of adverse reactions whenever a therapeutic program is instituted. Familiarity with the drug groups most commonly responsible for immunologic reactions is helpful, as is knowledge of satisfactory alternatives for these drugs in the presence of known hypersensitivity. An adverse reaction can often be minimized through use of established protocols for premedication. Desensitization, when essential, may be achieved for most drugs with graduated dosage schedules and maintained through continued administration of the drug. Identification to avoid inadvertent exposure to agents that have caused immunologic reactions in the past is essential. PMID- 6491105 TI - Penicillin allergy. AB - Although many new antibiotics are available, penicillin and its many semisynthetic derivatives are first-line drugs for many infections. These agents are relatively nontoxic even at high doses; however, their use frequently leads to allergic reactions. Withholding penicillin therapy from patients at high risk of allergic reaction to it is the most effective means of preventing such occurrences. Because immunoglobulin E-mediated reactions account for significant mortality and morbidity in association with penicillin use, the thrust of research on penicillin allergy has been to prevent such reactions. The many risk factors associated with subsequent immunoglobulin E-mediated penicillin allergy include history, timing and nature of previous penicillin exposure and/or allergy, age, route of administration, and response to skin testing with major and minor determinants of penicillin. The relative predictive values of each are discussed. Cross-reactivity between penicillin and its many analogs is reviewed and an approach to the patient who has a positive history for penicillin allergy and is in need of penicillin is offered. PMID- 6491106 TI - Allergic reactions to antimicrobial agents: a review of reactions to drugs not in the beta lactam antibiotic class. AB - Allergic reactions to antimicrobial drugs are common causes of morbidity but rarely of death. Despite the lack of proven immunodiagnostic tests for reactions to the non-beta-lactam drugs, the agents that cause reactions usually can be identified by analysis of their propensity to cause reactions, temporal relationships of exposure to reactions, and remission of reactions when the drugs are discontinued. Measurements of plasma histamine levels, high-molecular-weight neutrophil chemotactic factor, and heparin-like activity and of urinary histamine and prostaglandin D2 metabolites should help clarify the role of mast cell mediator release in the various forms of these reactions. Measurements of C3a, C4a, and C5a, in biologic fluids should facilitate analysis of the contributions of complement activation to the reactions observed. Assessment of these pathophysiologic parameters should provide a more rational basis for the selection of specific pharmacologic interventions to suppress allergic reactions. If no alternative drugs are available, infected patients who are allergic often can be gradually desensitized with the agents to which they are allergic. While much important work remains to be completed, current approaches can minimize the morbidity and mortality rates associated with allergic reactions to antimicrobial agents. PMID- 6491108 TI - Skin testing and incremental challenge in the evaluation of adverse reactions to local anesthetics. AB - True allergic reactions to local anesthetics (LAs) probably make up no more than 1% of all adverse LA reactions. A diagnosis of true potential allergic reactivity is made difficult because (1) the history of the prior reaction may be vague or equivocal and (2) the lack of identification of the actual specific LA hapten carrier complex limits the potential usefulness of immunologic tests. Nonetheless, since avoidance of LAs may be associated with substantial increased pain or increased risk and because true allergic reactions are rare, investigators and clinicians have used skin testing, incremental challenge, or both as a means of identifying a safe LA for a patient with a history of a prior adverse reaction. Review of the literature dealing with LA skin testing and incremental challenge suggests the following: (1) Skin testing with LAs may correlate with a history of an adverse reaction but may produce systemic adverse reactions, especially with undiluted drug. (2) Although false positive skin tests have been reported, most skin-tested patients who subsequently tolerate an LA have a negative skin test to that drug, and false negative skin tests have not been clearly documented. (3) Incremental challenge beginning with diluted LA is a safe and effective means of identifying a drug that a patient with a history of a prior adverse reaction can tolerate. (4) Current concepts of non-cross-reacting LA groups may be useful in the choice of a drug for use in skin testing and incremental challenge. (5) Preservatives in LAs may account for some but probably not the majority of adverse reactions to LAs. On the basis of this literature review, a practical protocol including dilutional skin testing and incremental challenge is presented for use in evaluating patients with prior adverse reactions to LAs. PMID- 6491107 TI - Contrast media reactions. AB - Contrast media reactions may be classified as anaphylactoid, vasomotor, severe or life threatening, and fatal. Anaphylactoid reactions mimic immunoglobulin E mediated hypersensitivity in that signs may consist of urticaria, angioedema, wheezing, dyspnea, hypotension, or shock. These reactions occur in 2% to 8% of all contrast media infusions. Vasomotor reactions occur in 5% to 8% of patients and consist of nausea, vomiting, flushing, and warmth. Severe reactions during which there is a concern for life occur about once per 1000 procedures. Fatalities have occurred in from 1:3000 procedures for intravenous cholangiography to between 1:10,000 to 1:100,000 procedures for intravenous urography. The pathogenesis of contrast media reactions is unknown, and various mechanisms may be associated with different clinical features. Radiocontrast media infusions can cause rises in plasma histamine and complement activation by either classic or alternate pathways or nonsequentially, yet adverse reactions may or may not occur. Abnormalities in the complement system or an increased conversion of prekallikrein to kallikrein has been demonstrated in some patients who have had anaphylactoid reactions. It is unknown if these mechanisms can explain the pathogenesis of anaphylactoid contrast media reactions. When patients who have had definite anaphylactoid reactions require a repeat procedure, the incidence of reactions ranges from 35% to 60% for intravascular infusion. Pretreatment with prednisone and diphenhydramine has been demonstrated to reduce this reaction rate to 9% in 465 procedures. Prednisone-diphenhydramine and ephedrine have further reduced the reaction rate to 3.1% in 192 procedures. These results are statistically significant (X2 = 5.4996, p = 0.019). Emergency equipment should be available should a severe reaction occur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491109 TI - Adverse reactions to drug additives. AB - There is a long list of additives used by the pharmaceutical industry. Most of the agents used have not been implicated in hypersensitivity reactions. Among those that have, only reactions to parabens and sulfites have been well established. Parabens have been shown to be responsible for rare immunoglobulin E mediated reactions that occur after the use of local anesthetics. Sulfites, which are present in many drugs, including agents commonly used to treat asthma, have been shown to provoke severe asthmatic attacks in sensitive individuals. Recent studies indicate that additives do not play a significant role in "hyperactivity." The role of additives in urticaria is not well established and therefore the incidence of adverse reactions in this patient population is simply not known. In double-blind, placebo-controlled studies, reactions to tartrazine or additives other than sulfites, if they occur at all, are indeed quite rare for the asthmatic population, even for the aspirin-sensitive subpopulation. PMID- 6491110 TI - Early recognition of allergic reactions to new drugs. PMID- 6491111 TI - Perceived control of nutrition behavior: a study of the locus of control theory among healthy subjects. AB - This study was conducted to gain insight into individuals' perceptions of their willingness and ability to change their nutrition behavior. As eating habits are primarily socially learned, the locus of control theory, a social learning theory, was applied to the understanding of nutrition behavior. Responses from 105 young male and female subjects to a questionnaire devised to examine individuals' beliefs about the internal and external factors which control, or determine, dietary habits and health were analyzed. Individual values and assessment of personal health and diet were measured, and demographic data were collected. Two major findings were obtained. First, the locus of control theory was too narrow a construct to explain the subjects' responses and beliefs. The data suggested six categories which differentiated between individuals' expectations about factors controlling outcomes of behavior and those controlling actual personal behaviors. Second, there were significant differences in responses to locus of control statements on the basis of certain demographic variables, especially religious affiliation. Religious/traditional Jewish subjects tended to be more internally oriented than nonreligious/nontraditional Jewish subjects, independent of other demographic variables. Subjects with greater willingness and perceived ability to change their nutrition behavior appeared to take responsibility for choosing what is "right" or "better" and had firmly established personal guidelines for what is, or is not, acceptable. PMID- 6491113 TI - Determination of nutritional status in critical care. AB - The application of the standard battery of nutritional assessment tests, measurements, and calculations is of limited value in the immediate nutritional diagnosis of the critically ill patient. Many of these tests are affected by stress, making it impossible to distinguish the etiology of abnormalities during the early postinjury period. Altered test results because of stress or injury include: increased excretion of creatinine; increased white blood cell (WBC) counts; increased anergy to skin tests; and decreased serum albumin, transferrin, thyroxin-binding prealbumin, and retinol-binding protein concentrations. Therefore, in assessing the nutritional status of the critically ill patient, it is important to focus on indexes that are realistic relative to the patient's metabolic status. Timing of data collection is of keen importance; data collected after fluid resuscitation and the peak metabolic response to injury on postinjury days 5 through 10 are usually more meaningful than those collected immediately after hospital admission. Admission assessment is necessary only to identify the high-risk patient in need of immediate nutrition intervention, to estimate energy/nutrition and fluid requirements, and to provide guidelines for planning nutrition care. This article presents recommendations for initial assessment, postcatabolism assessment, and serial assessment of the critically ill patient. Guidelines for estimating energy/nutrient requirements and timing data collection are also presented. PMID- 6491112 TI - Analyzed vitamin B-6 intakes of pregnant and postpartum lactating and nonlactating women. AB - Daily dietary food composites were collected for three consecutive days from 36 women (23 who planned to breast feed their infants and 13 who planned to formula feed their infants) at approximately the 37th week of pregnancy and at one, three, and six months postpartum. When the food composites were collected, each woman also kept detailed food intake records. Daily protein and energy intakes were calculated from the records. Representative aliquots of the homogenized food composites were analyzed microbiologically for total vitamin B-6. The data from the composite analyses indicate that the daily dietary intakes of vitamin B-6 for both groups of women in late pregnancy through six months postpartum were substantially less than the Recommended Dietary Allowances (RDAs). During pregnancy, the women who planned to breast feed their infants consumed diets which provided 54% of the RDA. The women who planned to formula feed their infants consumed diets which provided only 44% of the RDA for vitamin B-6 for pregnant women. At one, three, and six months postpartum, the diets of the lactating women provided 61% of their RDA for vitamin B-6, and the diets of the nonlactating women provided a mean of 46%. Of the 402 daily dietary composites analyzed, only 6% met or exceeded the RDA for vitamin B-6 for the women while they were pregnant or postpartum, either lactating or nonlactating. PMID- 6491114 TI - Leadership in clinical dietetics: meeting the challenge to roles in nutritional support. AB - The success of efforts to improve nutrition training of other health professionals poses a threat to the position of clinical dietitians as authorities in nutrition. In situations in which no dietitians are present or dietitians' skills are not recognized, pharmacists and nurses are especially likely to take over nutritional support roles traditionally assigned to the clinical dietitian. At the University of California, San Francisco, where dietitians are included in nutrition education and patient care programs and where understanding of the role of the dietitian is a stated educational goal, a preliminary survey suggests that conflicts occur in roles that are shared by members of nutritional support teams. Factors contributing to role conflicts include not only inadequate education of other health professionals but also problems of job expectations, education, training, and self-image among dietitians. Improved training in clinical nutrition, acquisition of better team and patient care skills, documentation of the effectiveness of dietetic services, and efforts to improve status and visibility would help alleviate role conflicts and ensure clinical dietitians a more rewarding place in the health care system. PMID- 6491115 TI - Geriatric team dynamics: the dietitian's role. AB - In 1980, a geriatric consultation team was formed at Massachusetts General Hospital to meet the complex medical, psychological, rehabilitative, nutritional, and social needs of geriatric patients. This team strives to provide elderly patients with the comprehensive care necessary to potentiate return to maximum independent functioning and to change attitudes of primary caretakers toward care of geriatric patients through increased recognition of the elderly as a heterogeneous group. The team consults on patients with changes in mental status, need for physical rehabilitation, "failure to thrive," or need for definitive planning for posthospital disposition. The dietitian conducts nutritional screening of each patient, is a nutrition resource for team members, and promotes collaboration in nutrition care planning. When the dietitian communicates nutrition concerns, goals, and care plans for patients to other health professionals, they use the information to reinforce her recommendations and integrate nutrition components into their care plans. A multidisciplinary approach has resulted in earlier identification and evaluation of functional ability, more comprehensive individualized care planning, and a reduced percentage of readmissions. PMID- 6491116 TI - Intervention specialist: new role for dietitians' counseling skills. AB - Dietitians who want to expand their clinical responsibilities beyond dietary counseling should consider the role of the intervention specialist. The role is a logical expansion of the duties of the dietitian who is already serving as a health behavior counselor. The concept of dietitians' functioning as intervention specialists originated in clinical trials, when they served as adherence counselors. The intervention specialists in the clinical trials used the health behavior counseling process to help research participants adhere to the trials' protocols. This counseling process uses a systematic, problem-solving approach to assess, diagnose, intervene, and follow up on a targeted behavioral problem. Dietitians can prepare for the expanded counseling role of intervention specialist through interviewing and counseling skill assessment and further training. They must take an active role in defining how the services of an intervention specialist can be beneficial to physicians as well as to their patients. They should address the cost-effectiveness of behavior counseling in order to justify the increased initial costs. Dietitians will need to actively promote the role of intervention specialist in the medical community if they want this opportunity for increased professional responsibility. PMID- 6491117 TI - The development of clinical psychiatric dietetic technicians. AB - Employing dietetic technicians to complement and enhance the roles and responsibilities of clinical dietitians is not a new practice. But tailoring the training of the dietetic technician to meet the needs of a specific psychiatric institution is unique. The successful clinical psychiatric dietetic technician training program also assisted the hospital in extending the nutrition care services offered to the patients. PMID- 6491119 TI - Pseudoscience--a critical look at iridology. PMID- 6491118 TI - Dietary status of elite female high school gymnasts: inadequacy of vitamin and mineral intake. AB - In general, the diets of these athletes appeared to be nutritionally inadequate. Diets were judged to be inadequate for vitamins B-6, folic acid, calcium, iron, zinc, and magnesium in 30% to 60% of gymnasts studied. Several reasons seem to make this population somewhat more vulnerable: (a) the desire to be light, lean, and aesthetically appealing; (b) the anaerobic nature of their sport, which does not lend itself to excessive levels of energy expenditure; and (c) the fact that these athletes are teenagers, subscribing all too often to typical teenage diets. It seems clear that this is a population which could benefit from nutrition counseling. PMID- 6491120 TI - The relationship of contrast sensitivity functions to sports vision. AB - Contrast sensitivity, a more recent test of visual function, has never been studied in its relationship to sports vision. The hypothesis that contrast sensitivity functions among college varsity level baseball players significantly differs from that of a random sample of optometry students was tested using Arden grating plates. A statistically significant difference was found at the 98 percent confidence level, demonstrating that in this study, a sample of college varsity level baseball players have higher level contrast sensitivity functions than those of a randomly selected sample of Southern California College of Optometry students. PMID- 6491121 TI - The effectiveness of multifocal correction upon presbyopic near and intermediate visual resolution performance. AB - The effectiveness of multifocal correction upon presbyopic near and intermediate visual resolution performance was measured using Landolt ring targets. Decimal resolution acuity was determined at eight viewing distances from 36.4 cm to 1 m for non-presbyopic controls, presbyopic subjects corrected for infinity, and for presbyopic subjects corrected by bifocals, trifocals and Varilux 2 multifocal lenses. Non-presbyopic subjects demonstrated a resolution ability of 1.9 decimal acuity or better at all viewing distances. Presbyopic subjects corrected for distance but without multifocal addition showed a precipitous decrease in visual acuity to less than .50 decimal acuity at distances closer than 58 cm. When corrected by conventional straight-top bifocal lenses, these individuals regained a maximum of 1.8 decimal acuity at 40 cm, but demonstrated a significant depression of intermediate visual acuity to about .90 between 44 and 58 cm. Correction with straight top trifocal lenses and Varilux 2 progressive addition lenses enabled presbyopic subjects to resolve acuity targets at the level of 1.6 decimal acuity at all test distances. PMID- 6491122 TI - Noncomitant strabismus: evaluation and management. AB - A model is presented for the functional evaluation and management of noncomitant strabismus. The model considers the identification of noncomitancy and the differences in approach to evaluation and management depending upon whether the involvement is recent or long-standing. PMID- 6491123 TI - Simplified fitting procedures for toric soft contact lenses. AB - This pilot study assessed a simplified procedure for fitting toric soft contact lenses without the use of a diagnostic fitting set. The sample consisted of 12 patients (21 eyes) who has astigmatic refractive effects of -0.75 D.C. to -2.50 D.C. and who ranged in age from 21-38 years. Patients were fit using a standard protocol. Using the criteria of success as defined in this paper, 17 of the 21 eyes were successfully fit with Hydromarc toric soft contact lenses. PMID- 6491124 TI - The office with the open concept. PMID- 6491125 TI - Assuring the continued competence of licensed optometrists: a modest proposal. PMID- 6491126 TI - Clinical investigation of the cup/disc ratios. PMID- 6491128 TI - Contact lens deposits. PMID- 6491127 TI - Eye care in China. PMID- 6491129 TI - International eye/vision care: the United States responsibility. PMID- 6491130 TI - Role of the international agency for the prevention of blindness. PMID- 6491132 TI - The legal diversification of optometry. PMID- 6491131 TI - The challenges of international optometry. PMID- 6491133 TI - VOSH revisited. PMID- 6491134 TI - Optometrists' registration in India. PMID- 6491135 TI - Optometry worldwide: an educator's perspective. PMID- 6491136 TI - The establishment of a school of optometry in Puerto Rico. PMID- 6491137 TI - A combination for success: the optometric partnership. AB - Mode of practice may be a critical factor in the success or failure of professional optometry. The advantages of partnerships competing with the corporate approach are numerous and hopefully clear to see. As optometric care becomes more complex and specialized, the maintenance or improvements in individual skills become more difficult. To attempt to maintain expertise in all areas has become nearly impossible and the group or partnership practice addresses this situation very well. Many methods of partnership formation have been described over the years, but the gradual buy-in, using earned profits, eases the financial burden, while reimbursing the seller in a very adequate manner. The methods as described make partnership affordable and practical, but the main ingredient of compatibility has to be present before any other consideration. PMID- 6491138 TI - Demographic and professional characteristics of Texas optometrists. AB - Texas optometrists must renew their license annually. From information obtained during the renewal process, demographic and professional characteristics of all active civilian optometrists in Texas as of June 1981 were studied. Population data from the 1980 U.S. census were used to calculate prevalence ratios. Data were examined for the state as a whole and for each health service area (HSA). PMID- 6491139 TI - Body temperature following podiatric surgery. PMID- 6491140 TI - Haglund's deformity. An electrodynographic approach to analysis. PMID- 6491141 TI - An investigation of Fowler-Philip's angle in diagnosing Haglund's deformity. PMID- 6491142 TI - Surgical considerations in the presence of Charcot-Marie-Tooth disease. PMID- 6491143 TI - Intramedullary foreign body. Operative considerations and a case report. PMID- 6491144 TI - The influence of the height of the heel on the first metatarsophalangeal joint. PMID- 6491145 TI - Rheumatoid vasculitis. A case report. PMID- 6491146 TI - Diabetic gangrenous ulcerative disease with an ectopic finding. A case report. PMID- 6491147 TI - The partial foot amputation. PMID- 6491148 TI - Mutagenicity and chemical characterization of two petroleum distillates. AB - To investigate if the Salmonella/microsome assay could reliably screen complex petroleum samples for their carcinogenic potential, two high boiling (700-1070 degrees F) petroleum distillates with known activity in a dermal carcinogenesis bioassay were fully characterized with respect to their hydrocarbon composition and polynuclear aromatic hydrocarbon (PNA) content and assayed for mutagenic activity. Mutagenicity assays were also carried out on the aromatic hydrocarbon aggregates separated from these oils by adsorption chromatography. The composition of the distillates differed substantially, and reflected the fact that they were derived from crude oils that were extremely divergent in hydrocarbon character. Both the distillate and aromatic samples consistently induced a very slight increase in revertant TA98 and TA100 colonies; however, an increase of 2-4-fold over background was observed when the S-9 concentration was increased 5-10 times that of the standard assay. The maximal response was less than that expected from the samples' known PNA content and observed potency in the dermal carcinogenesis bioassay. In the Salmonella/microsome assay, all samples inhibited the mutagenic activity of added benzo[a]pyrene. Discordance between the magnitude of the samples' mutagenic activity and their known PNA content may be related to direct or indirect inhibition of sample PNAs by other components of the complex petroleum fractions. Observed inhibitory effects support the use of elevated S-9 concentration in the in vitro assays assessing the carcinogenic potential of petroleum-derived materials. PMID- 6491149 TI - Respiratory responses of humans exposed to an aerosol-gas pollutant mixture: multivariate contrast of a complex atmosphere to clean air and sodium chloride aerosol controls. AB - Data from a group of 20 subjects with normal baseline pulmonary function, who were exposed for 2 h to a test atmosphere containing a complex mixture of pollutants, have been contrasted with data from two other groups exposed to presumably non-toxic control atmospheres. Group 1 was exposed to clean air, group 2 was exposed to clean air containing sodium chloride aerosol at 270 micrograms m 3, and group 3 was exposed to the complex atmosphere containing sodium chloride (332 micrograms m-3) and zinc ammonium sulfate (23 micrograms m-3) aerosols plus nitrogen dioxide (0.5 ppm) and sulfur dioxide (0.5 ppm). These atmospheres (ranked according to the presumed relative toxicities of the components; clean air = 0, sodium chloride = 1, complex mixture = 2) were contrasted using multiple regression and partial correlation analyses. The effects of exposure to the complex gas-aerosol mixture on forced expiratory performance were not significantly different from those observed in subjects exposed to clean air or to sodium chloride aerosol. PMID- 6491150 TI - The acute toxicity of coal liquefaction-derived materials. AB - The acute toxicity of a series of potential streams from the EDS coal liquefaction process have been assessed in animal bioassays. In general, the materials present minimal acute toxic hazards. However, there was some evidence of ocular and dermal irritation. These results indicate that eye and dermal contact should be minimized, particularly when the process streams contain high concentrations of phenolic materials. PMID- 6491151 TI - Quantitation of specific myeloid cells in rat bone marrow measured by in vitro 35S-sulphate incorporation. AB - A biochemical measurement which can be used for quantitation of specific early myeloid cells in rat bone marrow has been developed. This measurement consists of a rapid, simple assay for the in vitro quantitation of 35S-sulphate incorporation into rat bone marrow cells. Incubation of bone marrow cells with 35S-sulphate led to a time-dependent increase in radioactivity obtained in perchloric acid insoluble fractions of bone marrow cell suspensions. This incorporation was inhibited by cyanide and puromycin. Autoradiography has demonstrated the radiolabel to be specifically associated with immature cells of the myeloid series. The cells most active in this respect were eosinophils. When rats were treated with endotoxin, the rate of 35S-sulphate incorporation was increased. Cell number measurements, using conventional histopathology and a Coulter Counter, demonstrated that endotoxin caused an initial release of mature granulocytes from the bone marrow. The regeneration of this mature population in the marrow was rapid, and was characterized by an increase in the number of immature cells and a concomitant increase in the rate of 35S-sulphate incorporation measured in preparations of bone marrow cells in vitro. Furthermore, this response to endotoxin has demonstrated that Coulter Counting techniques can be used to distinguish specific populations of cells (e.g. mature granulocytes) within the bone marrow. PMID- 6491152 TI - A method for covalent insertion of mercury into the cysteine disulfide bridges of proteins. AB - A method is described by which atomic mercury can be taken up by thiol groups and inserted into the disulfide bridges of proteins which can be reversibly reduced and denatured. The method utilizes tandem columns of Sephadex G-10 and Biogel P2. Protein samples are separated from reducing and denaturing agent on the Sephadex column and then react with mercury, which is bound to the Biogel P2 column. Of eight proteins tested, all took up mercury using this method. The amount of mercury incorporated by this method differed from that found using other methods and was closer to the stoichiometry of the disulfide bridges of the protein than these methods. PMID- 6491153 TI - A radiochemical method for determination of ethanol oxidation. AB - A radiochemical method for the measurement of ethanol oxidation by tissue preparations is described. Ethanol oxidation is determined from the production of [14C]acetaldehyde, quantified as the semicarbazone derivative, from [1 14C]ethanol. The assay is quantitative, reproducible and highly correlated with the NADH-enzymic-spectrophotometric procedure. PMID- 6491154 TI - NMR methods for characterizing the state of the surfaces of complex mammalian cells. AB - It is shown that narrow 1H NMR resonances may be observed in cancer cells, and that these belong to fatty acyl chains of membrane lipids. A variety of NMR techniques such as Gaussian-Lorentzian deconvolution, and T1 and T2 measurements, may be used to subdivide these resonances further. The results of these various methods require that in the membrane structures the observed lipids tumble isotropically and sufficiently rapidly to give motionally narrowed 1H NMR lines. PMID- 6491155 TI - Isolation of a membrane protein by chromatofocusing: cytochrome b-561 of the adrenal chromaffin granule. AB - Chromatofocusing, a form of ion-exchange chromatography in which proteins are separated on the basis of their differing isoelectric points, has been adapted for use with membrane proteins, solubilized by the non-ionic detergent Nonidet P 40. Using a two-step detergent extraction followed by chromatofocusing under high pressure, the highly hydrophobic protein cytochrome b-561 was isolated from chromaffin granule membranes and purified to near homogeneity in a functionally active form, in less than 5 h. Chromatofocusing conditions were optimized empirically since the behaviour of the chromaffin granule membrane proteins conformed less to the theory than that of soluble proteins, and the various factors affecting yield and resolution are discussed. The speed, high resolution and focusing effect could make this method particularly suitable for rapid isolation in a functionally active form of the many membrane proteins that are unstable in dilute solution and when removed from their lipid environment. PMID- 6491156 TI - Monitoring protein conformational changes by quenching of intrinsic fluorescence. AB - The quenching of intrinsic fluorescence of human serum albumin and pigeon liver malic enzyme by acrylamide was studied after the proteins were denatured to different stages. The progress of protein denaturation induced by guanidine hydrochloride was accompanied by increasing of effective dynamic quenching constant which provides a convenient parameter for monitoring protein conformational change. PMID- 6491157 TI - Salivary secretion induced by L-DOPA in haloperidol-treated rats. AB - The effect of chronic haloperidol treatment on salivary secretion induced by L dopa, was studied in male Sprague-Dawley rats. Dose-response relationships for L dopa, obtained 24 h after haloperidol treatment, showed that salivary secretion was greater in rats that had been injected with haloperidol (2 mg/kg/day, i.p.) for 7 days than in controls. The threshold doses requirements were significantly reduced in that group. Pretreatment with carbidopa suppressed the salivary secretion produced by L-dopa in haloperidol-treated and control rats whose glands had been denervated. The secretory response in innervated glands was higher in haloperidol-treated animals than in controls. Haloperidol treatment also increased salivation induced by L-noradrenaline as determined by dose-response relationships. This was associated with a decrease in the threshold doses requirement. In controls and in rats chronically treated with haloperidol, the salivary responses to L-noradrenaline were temporarily depressed by 80-90% by a prior acute injection of haloperidol (2 mg/kg, i.v.) presumably acting as an alpha blocker. A similar reduction was observed after acute treatment with phentolamine (3 mg/kg, i.v.). The data obtained in this study, i.e. that chronic administration of haloperidol increases the salivary response to L-dopa and L noradrenaline, suggests that such an affect could be due to the development of supersensitivity of striatal dopamine receptors as well as of peripheral alpha adrenergic receptors. PMID- 6491158 TI - Impairment of cardiovascular autonomic reflexes in multiple symmetric lipomatosis. AB - Cardiovascular autonomic reflexes were evaluated in 13 male subjects affected by Multiple Symmetric Lipomatosis (MSL) and the results were compared with those obtained in 13 age-matched male controls and in 16 male heavy drinkers matched with the MSL group for age and alcohol intake. Valsalva Manoeuvre (VR), Heart Rate variations on Deep Breathing (DB) and R-R intervals 30/15 ratio during Lying to-Standing (LS) (tilting), were used as primarily parasympathetic tests. As primarily sympathetic tests, we assessed the increment of diastolic blood pressure in Sustained Handgrip (SHG) and the fall of systolic blood pressure on standing (Postural Hypotension = PH). Mean values of VR and DB were significantly (P less than 0.001) lower in MSL subjects than in controls and heavy drinkers. Mean LS values were significantly lower in MSL subjects (P less than 0.001) and in heavy drinkers (P less than 0.01) in relation to controls. No significant differences were observed in the 3 groups of subjects regarding the mean values of PH and SHG. The results suggest that MSL is characterized by an impairment of autonomic function. This impairment seems to be prevalently parasympathetic and not related to a high alcohol intake. PMID- 6491159 TI - Comparison of the distributions of renal and splenic neurons in sympathetic ganglia. AB - Postganglionic neurons in different sympathetic ganglia are innervated selectively by preganglionic neurons originating from different segments of the spinal cord. These selective connections between pre- and postganglionic neurons may determine the specificity with which postganglionic nerves participate in differential reflex reactions. Because specificity of renal and splenic nerve responses to stimulation of visceral afferent nerves may depend on the distribution of postganglionic neurons in sympathetic ganglia, retrograde axonal transport of horseradish peroxidase was employed in this study to identify the ganglionic distribution of cell bodies of postganglionic neurons supplying the kidney and spleen in cats. Superior mesenteric, left and right celiac ganglia usually are fused together into a complex ganglion (solar plexus) in the cat. Most labeled cell bodies of renal nerves were clustered in groups within the solar plexus, but some cell bodies of renal neurons were observed in upper lumbar (L1-L3) and lower thoracic (T12-T13) paravertebral sympathetic ganglia. In contrast, 90% of labeled splenic neurons were scattered randomly throughout the left and right celiac poles of the solar plexus. In conclusion, the disparate distribution of renal and splenic neurons in sympathetic ganglia provides an anatomical basis for differential reflex responses in the two populations of nerves. PMID- 6491160 TI - Effects of 4-aminopyridine on sympathetic preganglionic neuron activity. AB - Sympathetic preganglionic neuron (SPN) activity (mass or single unit discharge) was recorded extracellularly from axons of the cervical sympathetic trunk (CST) in unanaesthetized, midcollicular decerebrate or C1 spinal anemically decerebrate cats which were paralyzed and artificially ventilated. Phrenic motoneuron activity was also recorded in the midcollicular preparation. The drug 4 aminopyridine (4-AP) was administered intravenously. Doses of 0.5 to 1.0 mg/kg increased the background firing rate of SPNs in a dose-dependent manner. These doses increased the repetition rate of phrenic nerve bursts and, in a parallel fashion, that of the inspiration-synchronous activity of the CST. In contrast, the action of 4-AP on activity evoked by stimulation of high threshold myelinated afferents in the radial, femoral or pelvic nerve, or in the L7 dorsal root, was very variable. The evoked responses could be increased, decreased or not affected by the drug. Thus, treatment with 4-AP produces a graded increase in background firing of SPNs, but the drug is ineffective at reliably enhancing somato- or viscero-sympathetic reflexes. PMID- 6491161 TI - Clustering of intensely fluorescent sympathetic cells in embryonal and postnatal rats. AB - A fluorescence microscopic study has been performed on the ontogenetic appearance of clusters of small intensely fluorescent (SIF) cells in the superior cervical ganglion of the rat. Small SIF cell clusters were observed after the 13th embryonal day. Postnatally, the number of clusters first reversibly decreased, while after the 2nd week, the adult level was reached. Since the total number of SIF cells greatly increased after the 3rd week, the mean size of the clusters increased. From the 1st postnatal week, SIF cell clusters were present also in the external carotid nerve, and from the 2nd postnatal week in the internal carotid nerve. In adult rats, SIF cell clusters were constantly observed in the main postganglionic nerve trunks or near their outlet. The fine structure of the SIF cell clusters in the ganglion and in the nerve trunks was essentially similar. Widened intercellular spaces between adjoining SIF cells, sometimes closed by mutual membrane thickenings, were separated from the pericapillary space often only by a basal lamina. Opening of coated pits into the intercellular spaces was a common occurrence, suggesting that catecholamines may be secreted by the SIF cells into intercellular canaliculi, possibly then diffusing into the pericapillary space. Coated pits were occasionally observed also in the immediate vicinity of synapsing nerve endings that contained small agranular vesicles, suggesting a reciprocal synaptic mechanism. Occurrence of presumable postganglionic axons and SIF cell processes within the same sheath cell enwrapment provides indirect evidence for the idea that the SIF cells may affect the axon, in addition to the cell soma, of the postganglionic neuron. PMID- 6491163 TI - Video recording in paediatric medicine--technique and educational benefits. PMID- 6491162 TI - Vagal stimulation and cardiac slowing. PMID- 6491164 TI - Medical illustration and community health. PMID- 6491165 TI - A fast NiCd charger, a Wireless World design, capable of charging all common cell types in an hour or so, with a single switch to accommodate batteries of different sizes. PMID- 6491166 TI - The black-and-white positive line slide: a modern approach. PMID- 6491168 TI - [Use of silicone oil for temporary tamponade in the treatment of retinal detachment with vitreoretinal retraction. 2. Aspects, prevention and treatment of complications]. AB - A retrospective study of 36 cases of retinal detachment with vitreoretinal retraction, greatly improved immediately after intravitreal cavity injection of silicone was definitely responsible for two complications: cataract and chronic corneal edema. Their onset requires routine extraction of the silicone, recurrence of the retinal detachment developing in only 50% of cases. Used as a transient procedure, the injection of silicone into the vitreal cavity appears to be a relatively simple surgical procedure for detachments requiring prolonged internal tamponade. PMID- 6491167 TI - [Use of silicone oil for temporary tamponade in the treatment of retinal detachment with vitreoretinal retraction. 1. Short- and long-term anatomic and functional results in 110 cases]. AB - Vitreoretinal retraction treated by silicone oil injections to provide internal tamponade after vitrectomy showed total reapplication in 28.2%, persistent residual detachment with a flat posterior pole in 18.2%, and a measurable visual acuity in 40%, including 10% of patients in show it was superior to 2/10. When immediate postoperative visual acuity could be measured this good result remained stable. When relapse occurred in spite of the presence of the silicone, it involved patients with the lowest postoperative visual acuity due to progressive major retinal fibrosis. These findings suggest that silicone oil injection is a valid procedure for treatment of retinal detachment requiring internal tamponade, and that perhaps its earlier use is indicated. Part 2 discusses its tolerance of this material. PMID- 6491169 TI - [A clinical case of ocular onchocerciasis: clinical, angiofluorographic and developmental aspects]. AB - The authors discuss one case of ocular onchocerciasis. Not only corneal damage (punctate keratitis) is present, but also chorioretinal signs are seen: in the right eye at an advanced stage and in the left one provoked by the onset of the specific treatment using diethylcarbamazine citrate. During the 1 st year follow up, a further evolution of the chorioretinal lesion was noted in the right eye, while the left eye presented a partial regression of the above lesions. The characteristic angiographic findings, the particular site (temporal paramacular) and the arousal of the lesions provoked by the treatment are factors which denote the importance of choriocapillaritis, probably due to immunity reactions. PMID- 6491170 TI - [Microangiopathy and retinal dystrophy]. AB - Two cases are described of an association of retinal dystrophy and a vasculopathy similar to Coat's disease. The first case was a female adult in whom the two sets of symptoms appeared almost simultaneously. In the second case the disease appeared in infancy, evolved rapidly during adolescence and led to blindness. In both cases, the vasculopathy developed over several years and then stabilised; in contrast, the dystrophy, which was of the paucipigmentary type, continued to get worse. From these two cases, and others described in the literature, it appears that many causes can be involved in the association of the two syndromes. A genetic factor that has been demonstrated in several families was not present in these two patients; there appears to have been an immunological or inflammatory process, not yet identified, that became active at the time of the rapid evolution of the dystrophy. PMID- 6491171 TI - [Corneal cryopreservation in man: a proposal for an original technic]. AB - Using the method of Capella and Kaufman, the authors propose an original cryopreservation technique of human corneas. Sixty biomicroscopically normal corneas were obtained from cadavers (50-70 years) within six hours after death. Initial protocol involves four phases: 1) cryoprotection is carried out in three baths of three minutes each with human plasma and DMSO (dimethylsulfoxide) at 2-4 7%; 2) freezing is performed with 10 ml of the final cryoprotective fluid in a controlled rate freezer, the "Minicool" (CFPO). The cornea is cooled at a rate of 2 degrees C/min from + 6 degrees C down - 40 degrees C then at 5 degrees C/min down - 140 degrees C; 3) a tank containing liquid nitrogen at - 150 degrees C is used for a long term storage; 4) thawing is carried out in a water-bath at 37 degrees C for one minute, then in serum albumin 25% for three minutes and in M-K medium for thirty minutes. Effects of three cryobiological parameters are studied: cryoprotection: DMSO is diluted with human plasma at the following increasing concentrations: 2-4-7% or 4-6-10%; freezing medium: the cornea is frozen with or without the final cryoprotective bath. Thus freezing is carried out either in dry or liquid phase; thawing: initial temperature and the osmolar decrease of the dilution are modified in order to obtain four protocols: n degrees 1, initial protocol; n degree 2, an additional step using Hanks 5% - SA 25% for three minutes (1 000 mosm); n degree 3, after initial step reheating the cornea is directly placed in M-K medium; n degree 4, temperature of 50 degrees C for ten seconds precedes the initial protocol. For each protocol change, the endothelial viability is controlled by histological and/or SEM studies results: For each protocol change, the endothelial viability is controlled by histological and/or SEM studies results: cellular osmotic lesions are greater for DMSO concentrations of 10%; dry phase freezing induces more intense and more diffuse nuclear damage than in liquid phase; thawing under protocols 4 and 2 cause a high degree of nuclear damage associated with diffuse cytoplasmic vacuole formation. Histological and SEM studies clearly show endothelial cell lesions due to the cryoconservation. The human cornea endothelium is affected by any modification of the cryobiological parameters.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491172 TI - [Angle-closure glaucoma in 1984]. PMID- 6491173 TI - Hydrolytic and metabolic products of acephate in water and mouse liver. AB - Acephate was incubated in distilled water of three different pH's at 37 degrees C for 7 days. Three hydrolytic products were formed: methamidophos, O,S-dimethyl phosphorothiolate (DMPT), and O-methylacetyl phosphoramidothiolate (OMPT). A single dose of acephate was also fed to mice, and their livers were excised and analyzed for metabolic products up to 30 hours. Three products were detected: methamidophos, DMPT, and S-methylacetyl phosphoramidothiolate (SMPT). The anticholinesterase properties of acephate, methamidophos, DMPT, SMPT, and OMPT were determined. Only acephate and methamidophos had measurable inhibitory effects on the mouse erythrocyte enzyme, methamidophos being about ten times more effective than acephate. The amount of methamidophos formed in the water and mouse liver was too low to have any direct effect on the toxicity of acephate. Acephate toxicity to aquatic insects would depend on its persistence in water, its uptake by the insects, its conversion to methamidophos, and the combined inhibitory effect of acephate and methamidophos on the cholinesterase enzyme. The toxicity of acephate to mammals would depend on the direct anticholinesterase effect of the chemical and to a small extent on methamidophos. PMID- 6491174 TI - The fate of methoxychlor in soils and transformation by soil microorganisms. AB - Methoxychlor was found to be sufficiently persistent in soil and its residues were present even 18 months after the soil treatment. Saprophytes, fungi and actinomyces were unaffected by varying concentrations of methoxychlor, azotobacter however was susceptable. Soil strains isolated did not utilize methoxychlor as a sole carbon source except for 9 cultures belonging to the genera Bacillus, Acinetobacter and Rhodococcus which carried out the complete dechlorination, demethylation and splitting of one of methoxychlor aromatic rings. Anaerobic conditions were more favorable for methoxychlor biodegradation by soil and pure microbial cultures. PMID- 6491176 TI - Research workshop of the Thyroid Foundation-University of Arizona College of Medicine. Mechanisms of thyroid hormone action. October 15-16, 1983. Abstracts. PMID- 6491175 TI - Uptake, distribution and elimination of monosodium methanearsonate following long term oral administration of the herbicide to sheep and goats. AB - The rate and extent of accumulation and washout of arsenic, during daily oral administration of the herbicide monosodium methanearsonate (MSMA) were evaluated in Iranian dairy sheep and goats. Subjects received a dose of 10 mg of MSMA as arsenic per kg of body weight daily for 28 consecutive days. The total arsenic concentration in blood and milk was measured during and after the period of MSMA administration while arsenic in urine and feces was measured for 10 days following administration of last dosage of MSMA. Arsenic was accumulated slowly during 28 days of MSMA administration and steady states were essentially complete in sheep after 20 days and in goats following 25 days of MSMA administration. Blood arsenic concentration decreased rapidly after termination of MSMA administration. In both test animals, the half-lives of washout were smaller than accumulation. The concentration of arsenic in the urine and feces of both species did not increase significantly over controls and animals were free of arsenic relatively shortly after administration stopped. These data indicate that arsenic from MSMA is mainly absorbed from gastrointestinal tract and is not significantly accumulated in the body. Arsenic is eliminated from body by way of urine and feces with urinary excretion being the most important route. PMID- 6491177 TI - Effect of aging upon small intestinal structure in the Fischer rat. AB - The dimensions and composition of the small intestine were studied in fed aged (27 month) and young adult (4 to 5 months) male Fischer rats maintained under barrier-reared, controlled conditions. In the proximal intestine (duodenum and jejunum) of aged rats there was no reduction in mucosal mass, protein, or deoxyribose nucleic acid, and the villus epithelium had similar dimensions and cell number as in young rats. The ileum of old rats had a 20% larger villus epithelium than those of young rats, suggesting that the function of the proximal intestine in aged rats might be impaired. In the proximal intestine of old rats, the proliferative zone was expanded, crypt depth and cell number were approximately 20% greater than in young rats. Because previous studies have shown no effect of aging upon epithelial cell migration in proximal intestine and villus height in young and old animals was not different, decreased survival of newly formed crypt epithelial cells is likely. These observations must be taken into account in the analysis of nutritional requirements and intestinal function. PMID- 6491178 TI - Aging and sleep apnea: action of benzodiazepine, acetazolamide, alcohol, and sleep deprivation in a healthy elderly group. AB - Ten nonobese, healthy elderly adults (M = 73.3 years) were monitored polygraphically during sleep for sleep state changes, breathing, and the development of cardiac arrhythmias. All participated in 2 baseline nights and 1 night of flurazepam 30 mg ingestion; six underwent 1 night of sleep deprivation; four received ethyl alcohol (.6 mg/kg); and four whose apnea worsened significantly with flurazepam 30 mg were pretreated for 3 days with acetazolamide, taking acetazolamide and flurazepam 30 mg on the fourth night. Elderly adults with an Apnea Index (the number of apneas per sleep hour) between 5 and 7 at baseline experienced a worsening of their apnea with each manipulation. Acetazolamide did not protect individuals whose Apnea Index increased after flurazepam ingestion. One person developed premature ventricular contractions in conjunction with an increased Apnea Index after each manipulation. PMID- 6491179 TI - The effect of age on variability in gait. AB - The intercycle variability in gait of two temporal parameters (stride time and double-support time) and the step-to-step variability of two spatial parameters (step length and stride width) were assessed in 64 healthy adults, 32 aged 21 to 47 and 32 aged 66 to 84. For all parameters the median values of the coefficient of variation did not differ significantly between the two groups. They were below 6% for step length and stride time but much higher for stride width and double support time (between 17 and 27%). These differences in variability are discussed in relation to the control systems involved. Step length and stride time are thought to be determined predominantly by the gait-patterning mechanism, whereas stride width and double-support time may be determined predominantly by balance control mechanisms. The results suggest that, in both age groups, the gait patterning mechanisms are more consistent in their operation than are the balance control mechanisms and that increased variability in gait should not be regarded as a normal concomitant of old age. PMID- 6491180 TI - Autobiographical memory across the life-span. AB - The processes of autobiographical memory were studied in four groups with mean ages of 12.7, 19.1, 44.5 and 67.2 years. Participants provided memories of specific events in response to single-word prompts. Analyses of response time and age of memories indicated response time remains stable during adulthood, whereas average event age increases. Analyses of retention function, however, indicated little difference in the retrieval of memories from recent intervals. Imagery value and meaningfulness correlated with response time for all age groups but only correlated with age of memories for college students. The data suggest similarity of memory systems across age for the level of functioning associated with the encoding of daily events. PMID- 6491181 TI - Lateralization of peripherally and centrally masked words in young and elderly people. AB - Twenty three-letter, vertical words were presented to the right or left visual fields followed by either a flash, a visual noise, or a pattern mask at various stimulus onset asynchronies. For both young and elderly adults, target identification decreased from the flash to the pattern mask condition, whereas the magnitude of the right visual advantage increased. Although the elderly people identified fewer targets than the young, especially in the pattern mask condition, the magnitude of the right visual field advantage did not vary with age. The results argue against the hypothesis that the cerebral hemispheres deteriorate at different rates with age. PMID- 6491182 TI - A comparison of physical health and psychosocial variables as predictors of reaction time and serial learning performance in elderly men. AB - Choice reaction time and serial learning tasks were studied in three groups of elderly men (aged 65 to 85), including (a) hospitalized veterans, (b) veteran outpatients, and (c) nonhospitalized veteran volunteers. Demographic variables, life satisfaction, and attitudes toward aging, as well as objective and subjective measures of physical impairment, were assessed in each group. The three groups differed on both reaction time and serial learning measures. Multivariate analysis revealed that objective physical health assessments were the best predictors of reaction time performance, whereas subjective assessments best predicted serial learning performance. More negative attitudes and life satisfaction were associated with impaired physical health, but these psychosocial measures were poor predictors of behavioral performance. PMID- 6491183 TI - The relationship between cognitive status and visual information processing. AB - The present investigation involved an examination of susceptibility to visual masking of older adults displaying evidence of Alzheimer's disease and healthy, cognitively intact older adults. Results indicated that the cognitively impaired group was more susceptible to the perceptual interference of a visual mask than was the cognitively intact group. In addition, the impaired group was found to be particularly susceptible to masking by a visual pattern (which had similar figural characteristics to target stimuli) as compared to masking by random noise (which had figural characteristics unrelated to the target). Finally, susceptibility to masking was found to be negatively correlated with performance on the Information subtest of the Wechsler Adult Intelligence Scale-Revised and with rated level of cognitive functioning. It was concluded that this pattern of results represents an acceleration of changes in perceptual processing typically associated with normal human aging. PMID- 6491184 TI - Selective subject attrition in a longitudinal study of head-injured veterans. AB - Recent longitudinal studies of aging have suggested that intellectually inferior subjects selectively drop out during the course of the investigation. This issue of subject attrition was addressed in a neuropsychological study of 314 veterans who had sustained head or peripheral nerve injuries in World War II. These men were examined originally by Teuber and his colleagues at New York University in the 1940s and 1950s, and the veterans' participation was sought for a 40-year follow-up study at the Massachusetts Institute of Technology. In the current follow-up study, the veterans were subdivided according to their response to recent recruitment letters: those who agreed to be retested, those with whom recent contact was established but who declined to participate, those who did not reply to our correspondence, and those who were deceased. Those who agreed to be retested in the 1980s had significantly more education and achieved significantly higher Army General Classification Test scores both before and after injury than did the untested cohort. Even with the selective subject attrition, however, the remaining sample represented a broad range of intellectual competence. PMID- 6491185 TI - Aged metropolitan-nonmetropolitan migration streams over three census decades. AB - One type of population redistribution is discussed in this paper. It is the migration of older people between metropolitan and nonmetropolitan locations as it has occurred over three decades. Both net migration and stream migration studies documented the metropolitan-to-nonmetropolitan turnaround between 1960 and 1970, but no three-decade trends have been established and thus the trend remains in doubt. The data used in this analysis came from the census microdata files, using the 1-in-100 samples in 1960 and 1970 and the 1-in-40 sample in 1980. Only the records of persons age 60 and over were examined. This analysis documents the continuation of the turnaround in 1980 among older migrants and pictures them as forerunners of larger migration trends. It also discusses the dynamics of the trend and some of the processes that may have brought it about and maintain it. PMID- 6491186 TI - What should adult children do for elderly parents? Opinions and preferences of three generations of women. AB - Three generations of women (N = 403) were surveyed to discover their opinions about appropriate filial behavior toward elderly parents and their personal preferences among various providers of services that they might need in old age. Opinions were elicited by a vignette focused on what hypothetical adult children with differing situational characteristics should do to help meet the needs of their dependent widowed mother. Preferences were obtained from subjects' rankings of six potential providers (representing formal and informal support systems) for eight types of services. In the responses to the vignette, adjustment of family schedules and help with costs of professional health care were seen as appropriate for adult children, but adjustment of work schedules and sharing of households were not. For themselves, the women preferred adult children as providers of emotional support and financial management but not of income. The middle generation was least in favor of receiving financial support or instrumental help from children, preferring formal services for such assistance. PMID- 6491187 TI - Social resources and mental health: an empirical refinement. AB - A factor analysis of the social resources measures included in the Older Americans Resources and Services instrument (Blazer, 1978) yielded four factors. These factors were labeled attachments, social interaction, social support, and adequacy of social resources. Of these, attachments and social interaction measures were found to have a very limited degree of association with mental health measures (self- and interviewer-rated mental health and the Minnesota Multiphasic Personality Inventory). The overall rating of social resources and the perceived adequacy of social resources, however, had a higher degree of association with the mental health measures. PMID- 6491188 TI - The impact of forced residential relocation on the health of the elderly hotel dweller. AB - This paper reports on a prospective study designed to assess the impact of involuntary relocation from one community setting to another on the self perceived physical, functional, and emotional health status of older persons living in urban residential hotels. The research design was quasiexperimental and took advantage of a naturally occurring urban renewal project. Older persons (n = 38) living in five hotels marked for demolition and a randomly selected comparison group (n = 32) living in similar and contiguous hotels were interviewed 3 to 6 months prerelocation and again 3 to 6 months postrelocation. In general, there were few adverse changes in health associated with relocation as it was implemented with this population. PMID- 6491189 TI - Fear of personal aging and subjective well-being in later life. AB - This study examined the relationships among situational factors, fear of personal aging, and subjective well-being in a probability sample of 595 Alabamians, aged 55 and older, using regression analysis. Of the variables employed, fear of aging was found to be the best predictor of subjective well-being. PMID- 6491190 TI - [Toward a reduction of perinatal mortality]. AB - Having studied perinatal mortality in Ille-et-Vilaine from 1972 onwards, the authors have come to realise how out of date the present method of working out perinatal mortality is because it only takes account of late intra-uterine death and early neonatal mortality of infants weighing at least 1 kilogram. The old method does not take notice of the changes that have occurred because of the progress that has taken place in obstetrics and neonatology such as the survival of an increasing number of newborn that weigh less than 1,000 grams or of the fact that the distinction between early and late neonatal death seems to be less and less valid. It does not add up to the total of "lost pregnancies". Furthermore, it does not make it possible to compare our figures with those published in foreign countries. The authors therefore feel that a new definition of perinatal mortality should be made, and this should satisfy the four following requirements: It should include on the one hand all fetuses and newborn that weigh at least 500 grams and on the other hand it should include early and late mortality and even mortality that occurs after the neonatal period. It should take into account the problem of false still-births. It should take into account fetal malformations and abnormalities that have called for therapeutic abortions because they are among the principal causes of perinatal mortality. It should study all the statistics and publications on this subject. PMID- 6491191 TI - [Echocardiography study of hemodynamic changes in pregnancy]. AB - The purpose of this study is to monitor the haemodynamic changes that occur in pregnancy using ultrasound. Although all previous studies do demonstrate an increase in frequency and the volume of the cardiac output, the results seem to be different as far as variations in volume during systole occur and the mechanisms by which they occur. These differences can be explained by problems associated with the different methods used. Our study was carried out on ten pregnant women who were examined in each trimester (TM1, TM2, TM3) and post partum (TM4). The results confirm that cardiac frequency rises (TM3 92 +/- 5 VS TM4 73 +/- 3 cpm p less than 0,01) and cardiac output does (TM3 7,2 +/- 0,6 VS TM4 4,8 +/- 0,3 Umm p less than 0,01). The volume in systolic ejection (VES) rises throughout pregnancy when the patient is lying on her left side (TM3 81 +/- 4 VS TM4 69 +/- 2 ml p less than 0,01). The rise in VES could be put down to an increase to the veinous return which itself is reflected by the left auricle (TM3 33,7 +/- 1,1 mm VS TM4 29,9 +/- 0,7 mm p less than 0,05) and in the left ventricle (TM3 48,7 +/- 0,6 VS TM4 46,3 +/- 0,3 mm p less than 0,01) and the sudden drop in the total peripheral resistance (TM1 950 +/- 50 VS TM4 1 335 +/- 95 dynes/sec. X cm-5 p less than 0,01). It does not seem as though there is any change in myocardial contractility. PMID- 6491192 TI - [New data on the morphology of the allanto-chorion fetal membranes]. AB - The authors have carried out an electron microscopic study on the morphology of the allanto-chorial membranes of late pregnancy. The demonstration of these amniotic cells with their long pedicles which resemble those of renal podocytes, together with the presence of intercellular canals lined by long villi which themselves cross over with one another to make a grid, and the existence of intracellular canals that make transcytoplasmic tunnels, permit the authors to suggest that they are dealing with a morphological illustration of ultrafiltration processes. The authors suggest that the forces that bring about plasma filtration from the intervillous chamber towards the amniotic compartment crossing the allanto-chorial membranes are the same as those that cause glomerular filtration. These are hydrostatic pressure in the intervillous chamber and the oncotic pressure within the amniotic compartment. PMID- 6491193 TI - [The placenta of premature and hypotrophic Gabonese infants]. AB - 494 placentae coming from two different geographical parts of Gabon were studied. They were grouped into control, premature, small-for-dates and stillborn. The urban population gives rise to most mothers of about 26 years of age, who deliver normally at 38 weeks of babies weighing 3,300 g and 50 cm long, with placentae weighing 550 g, as well as premature babies and those in which there is white cell infiltration of the membranes, signs of toxaemia and normal placentae. On the eastern plateaux of Gabon there are more mothers around the age of 23, who deliver normally at 37 weeks of pregnancy of babies weighing 3,100 g and 48 cm long, with placentae weighing 450 g, with small-for-dates babies and inflammation of the placenta. Malaria is the cause of many premature deliveries and of small for-dates and stillborn, especially in the plateaux. PMID- 6491194 TI - [Distant metastases of cervical cancer. Apropos of an unusual case. Review of the literature]. AB - The authors present a single but unusual case of metastases from a squamous cell cancer of the cervix which had been treated radically 35 months previously; the metastases occurring in the digestive tract as well as the peritoneum. They try to explain the physiopathological mechanisms, which are probably not unequivocal, as to how theses metastases could have occurred. They point out that further studies should be carried out with a view to seeing whether prophylactic chemotherapy should be given even in very early cancers. PMID- 6491195 TI - [Multiple metastases of a benign leiomyoma. Apropos of a case. Review of the literature. Pathogenic concepts and therapeutic stance]. AB - The authors report a rare unusual case of fibroleiomyoma of the uterus which which recurred and which had metastases in the peritoneum, the abdominal wall and in the lungs. They review the international literature and the various hypotheses that have been mentioned in it to try to explain how fibroleiomyomata can metastasise. They suggest that aggressive therapy should be used in spite of the benign character of the fibroma and of the matastases. PMID- 6491196 TI - [Exstrophy of the bladder and pregnancy]. AB - Two patients with bladder extrophy who had been operated on during infancy (the one by reconstruction of the bladder and the other by Coffey's operation) had delivered by Caesarean section, in the one patient of one child and in the other of two normal children. They formed the basis of this study. Vesical extrophy or ectopia vesicae is a rare malformation (in 1/40 000 to 1/50 000 births). It occurs most often in male children. It can be associated with genital, urological and orthopaedic malformations. The principal complications that can occur in pregnancy are urinary tract infections, prematurity, malpresentations and genital prolapse. As far as the urological side is concerned the complications are of ureteric stones, metabolic troubles, stenosis or obstruction of the uretero sigmoid anastomosis following Coffey's operation, and ileal prolapse if Bricker's operation had been undertaken. The ways in which the babies should be delivered are discussed, as are the risks of this malformation recurring in children who are born to mothers with vesical extrophy. PMID- 6491197 TI - [Acute edema of the lung in eclampsia]. AB - In 6 cases of eclampsia in the course of pre and post-partum, we could observe neurological disorders associated with acute pulmonary oedema with acute respiratory distress occurring 5 to 72 hours after the first convulsive crisis. Hemodynamic check-up provided various results: 3 cases corresponded to A.P.O resulting from a lesion, with normal capillary pressure. In 3 other cases, there was hemodynamic oedema (overloading with high flow and hypervolemia in one case, myocardial incompetence with hypovolemia in an other case revealed by test filling in a third case). There were clinical signs of left ventricular failure in 4 case. Post-mortem investigations (5 cases) revealed unimportant ultrastructural alterations of myocardium only in 2 cases. Pulmonary histopathological investigations (5 cases) were the investigations carried out in case of oedema resulting from lesions with interstitial and alveolar oedema, hyaline membranes, alteration of pneumocytes, and intra-capillary thrombi. Mendelson's syndrome which was always discussed could be eliminated. The syndrome of respiratory distress was certainly connected with more or less generalized microcirculatory disorders (microembolism with hyperpermeability) connected with hemostasis disorders and cerebral manifestations. PMID- 6491198 TI - [A case of a well-tolerated spontaneous post partum uterine inversion]. AB - The authors report the unusual case of spontaneous inversion of the uterus that occurred three days after a normal delivery. Clinically this was very well tolerated. There did not seem to be a constriction ring which normally occurs in there cases. The authors were therefore able to wait until it was quite safe to give the patient an anaesthetic. Manual replacement was easy bu inversion recurred immediately. A pack was therefore put inside the uterus, and the uterus closed down satisfactorily on it in the right position. When the pack removed under anaesthesia 48 hours later inversion did not recur. PMID- 6491199 TI - [Prognostic factors in cancer of the endometrium and therapeutic indications]. AB - Between 1970 and 1979, 270 patients were treated at Fondation Bergonie for carcinoma of the endometrium (169, for the whole treatment). The cases were classified according to the FIGO staging system. The mean age of the patients was 62.2, with a range from 31 to 95. 62% of patients had stage I carcinoma, 16% stage II, 18% stage III and 4% stage IV. The operability rate, according to the patients ages was considered a main factor in the prognosis. The 5 years survival was 64% for stage I, 60% for stage II, 47% for stage III and 0% for stage IV. Histologic grade of the tumor and depth of myometrial invasion are also important prognosis factors; both influencing survival. This study compared with others, provides the main prognosis factors: age and operability, stage of the tumor, histologic grade, depth of myometrial invasion and pelvic and/or para-aortic lymph nodes involvement. The authors conclude by specifying the indications for treatment. PMID- 6491200 TI - [Estrogens or progestational agents?]. PMID- 6491201 TI - [Does a second pregnancy induced by artificial insemination occur more rapidly than the first?]. PMID- 6491202 TI - The late functional results of upper limb revascularization and replantation. AB - The functional results in 25 of 30 patients after successful upper limb revascularization or replantation were evaluated by subjective-patient surveying and objective measurements. Young patients with complete, sharply amputated extremities at the wrist level or those with incomplete injuries and uninjured peripheral nerves had the best functional results. Multiple-level, diffuse crush, or avulsion injuries, even if the injuries were incomplete, and patients with high-level nerve injury had less return of function. PMID- 6491204 TI - Free microvascular transfer of second toe ray and serratus anterior muscle for management of thumb loss at the carpometacarpal joint level. AB - A 50-year-old machine operator suffered traumatic amputation of the thumb, ring, and small fingers. The thumb had been amputated at the carpometacarpal joint and was reconstructed 6 months later by microneurovascular transplantation of the second toe including the second metatarsal. Opposition was provided and the first web space was released at a second stage by reconstruction with the lowest two digitations of the serratus anterior muscle covered with a split-thickness skin graft. PMID- 6491203 TI - Free vascularized small joint transfer to the hand. AB - Free vascularized digital joint transfers should provide joint stability, painless functional range of motion (ROM), tolerance of normal stresses without degeneration, and growth potential in children. In our department since 1977, seven transfers have been carried out in seven patients, including four children aged 4 to 11 years and three adults aged 19 to 46 years. Donor sites were the metatarsophalangeal joint of the second toe (four cases), the proximal interphalangeal (PIP) joint of the second toe (two cases), and the PIP joint of a useless amputated small finger (one case). Recipient sites were digital PIP and metacarpophalangeal (MP) joints (three cases each) and the MP joint of a thumb (one case). Six of the seven procedures were successful. There was retention of normal joint space and stable, painless functional ROM, while epiphyseal centers in the children remained open and showed normal growth. Follow-up ranged from 2 to 4.7 years, averaging 3.5 years. Some adherence of an associated extensor tendon has been observed. The feet have been asymptomatic. When digital joint replacement is required because of local causes of destruction, free toe joint transfer should certainly be considered in children and in young adults. PMID- 6491205 TI - The effect of redundancy and tension on microvascular vein grafts. AB - Variation in length and tension occurs with microvascular vein grafts in clinical practice. The length and tension of a vein-grafted segment was varied in 50 Sprague-Dawley rats. This enabled a full range of redundancy and tension across the 1 mm diameter vein grafts. The initial patency rate was 100%. Wounds were reexplored 2 weeks after operation. A linear increase in microaneurysm formation was found with increasing tension. There was a mild but not statistically significant observed effect on patency. Increasing tension in rat vein graft anastomosis has an adverse effect with an increased incidence of microaneurysm formation and should be avoided. PMID- 6491206 TI - Vascularized bone grafts in the treatment of infected forearm nonunions. AB - Infected nonunions of both-bone forearm fractures may not respond to conventional treatment. Four patients with infected nonunions were successfully treated with vascularized fibular grafts and conversion to a one-bone forearm after failure of as many as six procedures. The fibula was fixed to the ulna proximally and the radius distally with internal fixation, and this was supplemented with an external fixator in three of the four patients. All wounds healed and all bone junctures healed primarily with the exception of one that required supplemental cancellous grafting. Free vascularized fibular grafts should be considered for infected nonunions that are unresponsive to properly executed conventional surgical and antibiotic treatment. PMID- 6491207 TI - Ulnar ray deficiency: its various manifestations. AB - Eighty-eight upper extremities of 65 patients with ulnar ray deficiency were reviewed with regard to clinical manifestations. Based on the findings, a subclassification into four types was established: type I, hypoplasia or partial defect of the ulna; type II, total defect of the ulna; type III, total or partial defect of the ulna with humeroradial synostosis; and type IV, ulnar defect with congenital amputation at the wrist. Various manifestations of deficiency were evident not only within the ulnar ray but also in other rays. Hypoplasia of the shoulder and/or proximal part of the humerus was present in some cases of types III and IV. Elbow involvement varied from functioning (type I) to acute flexion contracture (type II) to fusion (type III). In 57 hands the digits and carpal bones in the radial ray showed hypoplasia and/or defect. Central digits and carpal bones were also influenced by ulnar ray deficiency, presenting carpal bone fusion, syndactyly, and delta phalanx. PMID- 6491208 TI - Congenital hypoplastic thumb with absent thenar muscles: anomalous digital neurovascular bundle. AB - Congenital hypoplastic thumb with absent thenar muscles and an associated single midline digital neurovascular bundle is reported in four patients. Several other anomalies localized to the hand were encountered in all patients, including instability of the metacarpophalangeal joint of the thumb and anomalous extrinsic tendons of the involved thumb. Multiple congenital abnormalities were also found in all patients, especially in relation to the spine. PMID- 6491209 TI - A gross anatomic and histologic study of the innervation of the proximal interphalangeal joint. AB - The innervation of the proximal interphalangeal joint was studied by gross dissection with magnification and histologic analysis. The joint is innervated by a constant articular branch arising from the palmar proper digital nerve at the level of the midproximal phalanx. This articular nerve bifurcates adjacent to the joint, and its terminal branches enter the joint in the midlateral plane at the junction of the palmar plate and lateral capsule. No contribution to the articular innervation was found to arise from the sensory radial, dorsoulnar cutaneous, and collateral branches of the proper digital nerve that cross the joint. The innervation of the proximal interphalangeal joint is congruent with the palmar sensory innervation and has no relation to the dorsal sensory innervation. PMID- 6491210 TI - Junctura tendinum between extensor digitorum communis and extensor pollicis longus. AB - A junctura tendinum was incidentally identified between the extensor digitorum communis of the index finger and the extensor pollicis longus in a 34-year-old woman. This tendinous interconnection did not represent a supernumerary muscle. Examination of the patient suggested that this anomaly was probably bilateral since she lacked independent extension of the thumb and fingers in both hands. This anatomic variant has not previously been reported. PMID- 6491211 TI - Relationship between ulnar variance and triangular fibrocartilage complex thickness. AB - The thickness of the thinnest aspect of the articular disc portion of the triangular fibrocartilage complex (TFCC) was experimentally measured and compared with ulnar variance. There is an inverse relationship between positive ulnar variance and TFCC thickness. PMID- 6491212 TI - Recovery of skeletal muscle after laceration and repair. AB - Few data are available regarding structural and functional recovery of lacerated skeletal muscle after repair. This study used the extensor digitorum longus muscle of rabbits to document recovery after laceration and repair and a healing period of 12 weeks. Completely lacerated muscles recovered approximately 50% of their ability to produce tension but were able to shorten to 80% of normal. Partially lacerated muscle bellies recovered approximately 60% of their ability to produce tension and normal ability to shorten. Histologic specimens revealed that the lacerations did not cause necrosis of either segment. After the recovery period, histologic and histochemical sections revealed that the distal segment initially isolated from the nerve supply showed histologic changes of fiber atrophy and size variability, increased fibrosis, and nuclear centralization suggestive of denervation. Dense scar separated the two fragments. Data show that skeletal muscle can recover useful but not normal function after laceration and repair. PMID- 6491213 TI - Ligament reconstruction for the painful thumb carpometacarpal joint: a long-term assessment. AB - An extra-articular ligament reconstruction to stabilize the thumb carpometacarpal (CMC) (basal) joint by routing a portion of the flexor carpi radialis (FCR) through the base of the thumb metacarpal has been performed on more than 100 patients since 1967. This study reviews the first 50 consecutive reconstructions with an average follow-up of 7 years. Intractable pain was the primary indication for surgery. Each joint was examined both pre and postoperatively and rated as a stage I through stage IV according to the radiographic appearance. Of the patients with zero or minimal articular changes (stages I and II), 95% achieved good or excellent results because of having little or no postoperative pain. Of the patients with moderate to advanced degenerative changes (stages III and IV), 74% achieved good or excellent results. All stage I cases and 82% of stage II cases were free of recognizable degeneration on follow-up radiographs up to 13 years postoperatively. These findings suggest that ligament reconstruction that is now recommended only for stage I or stage II disease will restore stability, reduce pain, and possibly even retard joint degeneration in a large proportion of patients with painful instability of the thumb CMC joint. PMID- 6491214 TI - Complications of opponensplasty with transfer of extensor carpi ulnaris to extensor pollicis brevis. AB - The extensor carpi ulnaris (ECU) was transferred to the extensor pollicis brevis, as described by Phalen and Miller, in 12 patients with hand deformities from high and low median and ulnar nerve injuries. Although no complications of this transfer have been reported by other surgeons, four of our 12 patients developed significant radial deviation and loss of power grip. This complication was corrected in two patients by transferring the extensor carpi radialis longus to the base of the fifth metacarpal to balance the wrist extensor forces. We believe that this complication may occur when the extensor carpi radialis inserts into the radial aspect of the second metacarpal and when the ECU inserts into the ulnar aspect of the base of the fifth metacarpal. The flexor carpi ulnaris must have normal strength if the wrist is to be balanced after the ECU is transferred. PMID- 6491215 TI - Symptomatic palmar tendon subluxation after surgical release for de Quervain's disease: a case report. AB - Palmar subluxation of the abductor pollicis longus and extensor pollicis brevis tendons developed in a 50-year-old woman after total excision of the first dorsal compartment sheath for de Quervain's disease. Conservative therapy did not improve her symptoms and surgical reconstruction of the first dorsal compartment from a slip of extensor retinaculum was performed. The patient was asymptomatic 1 year after surgery, with no evidence of subluxation or recurrence of de Quervain's disease. This complication can be avoided by leaving a palmarly based flap of extensor retinaculum to prevent palmar subluxation of the tendons with wrist flexion. PMID- 6491216 TI - Open radiocarpal fracture-dislocations. AB - Ten open radiocarpal fracture-dislocations in nine patients were treated by wound debridement, open reduction, and maintenance of reduction by casting supplemented with internal or external fixation. Eight patients had associated fractures or dislocations of the ipsilateral extremity: elbow fracture or dislocation (three patients), shoulder fracture (one patient), fractured humerus (two patients), and phalangeal fractures (three patients). In seven of ten cases the median and/or ulnar nerve was severely contused and required immediate decompression. Six patients were followed at least 15 months. All had mild asymptomatic sensory neurologic deficit, diminished range of motion of the wrist, and wrist pain with activity. The prognosis should be guarded. PMID- 6491217 TI - Entrapment of the median nerve and flexor pollicis longus tendon in an epiphyseal fracture-dislocation of the distal radioulnar joint: a case report. AB - A 10-year-old boy sustained a severe distal radius and ulna epiphyseal fracture dislocation, Salter type II, with entrapment of the median nerve and the flexor pollicis longus tendon. Nerve function was intact before reduction and is normal 1 year after open reduction. PMID- 6491218 TI - Dorsal dislocation of the fourth and fifth carpometacarpal joints and simultaneous dislocation of the metacarpophalangeal joint of the small finger: a case report. AB - A patient with dorsal dislocation of the fourth and fifth carpometacarpal (CMC) joints and dislocation of the metacarpophalangeal (MP) joint of the small finger was managed successfully by open reduction and transarticular fixation of the CMC joint dislocation and closed reduction of the MP joint dislocation. This rare combination of injuries has not been reported previously. PMID- 6491219 TI - Palmar dislocation of the proximal interphalangeal joint requiring open reduction: a case report. AB - A case is described of a palmar dislocation of the proximal interphalangeal joint that required open reduction because of interposition of the central extensor tendon. PMID- 6491220 TI - Stiffness of small-bone external fixation methods: an experimental study. AB - A variety of small-bone external fixation methods were evaluated to determine bending and torsional stiffness. Several methods of external pin stabilization with bone cement and with a commercial device were used. Among experimental variables examined were: the number of pins, pin diameter, pin length, pin spacing, and pin threading. The most rigid fixation was achieved with four pins held with a wire-reinforced bone cement fixator. Pin diameter was the most significant variable in the determination of stiffness with this configuration. PMID- 6491221 TI - Closed reduction and internal fixation of proximal phalangeal fractures. AB - Displaced fractures of the shaft of the proximal phalanx can lead to marked deformity and disability when poor results are obtained. Despite the attention popular concepts of open reduction and internal fixation have received, a less invasive technique has been our standard approach. A prospective study of closed reduction and percutaneous Kirschner wire fixation in 100 consecutive fractures yielded good or excellent results in 90% of cases when treated within 5 days of injury. PMID- 6491222 TI - Preiser's disease: a case report. AB - Preiser's disease, or avascular necrosis of the scaphoid, is an exceedingly rare although debilitating pathologic process. A case of progressive avascular necrosis of the carpal scaphoid is presented together with a review of the possible etiology of this rare syndrome. Histologic evaluations of resected specimens have demonstrated a localized sequestrum of necrotic bone, leading to the belief that disruption of blood supply is a major predisposing factor. The diagnosis of Preiser's disease or avascular necrosis of the carpal scaphoid should be exclusively reserved to those cases that demonstrate a progressive clinical and radiographic sequence of osteosclerosis and subsequent fragmentation of the scaphoid. PMID- 6491223 TI - Bilateral partial ruptures of the flexor carpi radialis tendon secondary to trapezial arthritis. AB - This is a report of bilateral partial ruptures of the flexor carpi radialis tendons associated with trapezial osteoarthritis. Splinting for 4 weeks was curative. One of the tendons was exposed 4 months after rupture in conjunction with carpal tunnel release and the abnormal healed tendon was revealed. PMID- 6491224 TI - Alumina ceramic finger implants: a preliminary biomaterial and clinical evaluation. AB - An alumina ceramic hinge-type finger prosthesis, composed of alumina ceramics and high-density polyethylene, is described. Biomaterial evaluations, including flexion-extension tolerance, stretching, twisting, extraction tests, and histologic examinations of affinity for bone, demonstrated that this implant has characteristics superior to those of previous finger implants. Eighteen proximal interphalangeal joints and 13 metacarpophalangeal joints have been replaced with this alumina ceramic finger implant. Follow-up studies (12 to 31 months) have been most encouraging with satisfactory functional recovery and no fracture or dislocation of the implants. PMID- 6491225 TI - Pachydermodactyly: a case report and discussion of the pathologic entity. AB - Numerous case reports have described idiopathic hypertrophy of the skin on the dorsum of the hands. Many different and confusing names have been assigned to these conditions. A case report of a patient with pachydermodactyly is presented, with a discussion of the literature, in an effort to clarify the identification, treatment, and nomenclature of idiopathic hyperkeratosis and acanthosis of the dorsum of the hands. PMID- 6491226 TI - Lateral antebrachial cutaneous nerve as as a graft for digital nerve. PMID- 6491227 TI - Total wrist arthroplasty. PMID- 6491228 TI - Elongation of the repair configuration after flexor tendon repair. PMID- 6491229 TI - Poor people and poor hospitals: implications for public policy. AB - In 1980, while most hospitals were in reasonably good financial health, hospitals heavily involved in serving the poor ran a considerable risk of financial trouble. Fewer than 9 percent of the nation's hospitals accounted for 40 percent of the nation's total care to the poor. These hospitals, almost half of which were in the 100 largest cities, not only devoted more of their care to the poor than other hospitals, they also served substantially smaller proportions of privately-insured patients. The result was that one-third of these hospitals--by themselves accounting for over 15 percent of all care to the poor--ran deficits in 1980. Using data from a 1980 survey of nonfederal, nonprofit hospitals, this paper examines the fiscal situation of hospitals heavily involved in serving the poor. The analysis shows that it is insufficient revenues, not inefficiency or underuse, that creates these hospitals' financial problems. The article concludes with an assessment of several policies that could be adopted to alleviate this financial pressure and sustain care to the poor. PMID- 6491230 TI - Restraint of trade through hospital exclusive contracts: an economic appraisal of the legal theory. AB - The growth of antitrust litigation in the health care area reflects the developing consensus that competition is as powerful a force in health care as it is elsewhere in the economy. Exclusive contracts between hospitals and hospital based physician specialists have been prominent among the contested practices. Challenges to these arrangements uniformly assert an injury to competition; for example, that the contracts are a means of gaining monopoly power in some market. But these claims have lacked a solid theoretical basis for general hostility to exclusive dealing of this sort. This article describes several economic considerations that are fundamental to an analysis of this contractual phenomenon. These considerations imply that there is no general economic basis for suspicion, and that the circumstances under which suspicion would be warranted are likely to be rare. PMID- 6491231 TI - The right to refuse treatment and the movement for mental health reform. AB - The right to refuse treatment is the most controversial of the rights of mental patients, and usually polarizes the movement for mental health reform between providers of care and external activist reformers. A broad alliance supported earlier struggles for recognition of patients' rights, but most professionals oppose recognizing this most extreme right of treatment refusal. Professional opposition to treatment refusal is not based on a wide extent of actual refusal; rather it derives from a defense against challenges to professional and institutional autonomy, an opposition to legal interference, and a belief that the community as well as the patient must be protected. These three reasons for opposition are examined by reviewing studies of attitudes toward patients' rights, knowledge about patients' rights, and implementation of patients' rights. Finally, the implications of these studies for future directions in the movement for patients' rights are examined. PMID- 6491232 TI - The conflict of patient privacy and the Freedom of Information Act. AB - The purpose behind the Freedom of Information Act was to permit greater access by the public to information held by the federal government. In promoting this democratic ideal, little attention was focused on a potential problem that this access to government-held information might cause: violation of another individual's right to privacy. This article examines a recent case in which these two goals came into conflict. PMID- 6491233 TI - On "Protecting the reproductive health of workers: problems in science and public policy". PMID- 6491234 TI - Special combined survey for poliomyelitis and neonatal tetanus as supplement to routine surveillance system in India. PMID- 6491235 TI - Prevalence of intestinal parasitic infection in some urban localities of Solan District, Himachal Pradesh. PMID- 6491236 TI - Isolation of Salmanella soahanina (6, 14, 24 : z: e, n, x) from a case of infantile diarrhoea. PMID- 6491237 TI - Viral hepatitis in Delhi during 1980 and 1981--an epidemiological evaluation. PMID- 6491238 TI - Neuroleptic malignant syndrome. AB - Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening complication of neuroleptic therapy. Its occurrence is not familiar to most emergency physicians. Early recognition and appropriate management of NMS may prevent significant morbidity and mortality. PMID- 6491239 TI - Free intraperitoneal cholelithiasis--a sign of traumatic perforation of the gallbladder. AB - Traumatic perforation of the gallbladder is relatively infrequent and is rare as an isolated lesion. The unique aspect of this case is the diagnosis of traumatic gallbladder perforation based on plain abdominal roentgenographic evidence of free intraperitoneal cholelithiasis. PMID- 6491240 TI - Pulmonary and aortic punctures--complications of an attempt at internal jugular venipuncture. AB - A case of pulmonary and aortic punctures occurred during an attempted internal jugular venipuncture in a patient with a dilated aortic arch. Procedural errors contributing to the complications included an inexperienced operator, inappropriate medial and caudal angulation of the needle, and failure to use a "finder" needle or Seldinger technique. Use of proper procedural technique will reduce the risk of complications in performing this procedure. PMID- 6491241 TI - Carbon monoxide poisoning: mechanisms, presentation, and controversies in management. AB - Carbon monoxide (CO) remains the leading cause of death due to poisoning in the United States. CO produces toxicity by binding to hemoglobin, thereby reducing oxygen-carrying capacity, and by binding to myoglobin, which may impair cardiac output and result in cerebral ischemia. Severe CO poisoning results in coma or encephalopathy, but milder intoxication may occur with nonspecific symptoms suggestive of hysteria, hyperventilation, psychosis, or viral syndrome. Survivors of severe CO poisoning may have permanent neurologic or neuropsychiatric sequelae. Subtle memory deficits or personality changes may not be readily apparent to the examining physician. Administration of 100% oxygen at ambient pressure remains convenient, safe, and inexpensive. Hyperbaric oxygen can shorten the half-life of carboxyhemoglobin and can carry oxygen independent of hemoglobin. However, it is not known if either 100% oxygen or hyperbaric oxygen can actually alter mortality or improve neurologic outcome in survivors. Carefully controlled prospective studies should be carried out to assess the potential value of hyperbaric oxygen in CO poisoning. PMID- 6491242 TI - Carbon monoxide poisoning. PMID- 6491243 TI - Diving injuries. AB - This is a collective review about the pathophysiology, diagnosis, and management of SCUBA and diving injuries by the emergency physician. These injuries can be classified into those resulting from the toxic effects of the inhaled gas, from the pressure changes in the water and gas mixture while diving, and from decompression sickness. With the increasing popularity of SCUBA diving, it is hoped that this discussion will enable a recognition of these injuries and therefore minimize the morbidity and mortality from them. PMID- 6491244 TI - Olly-olly in come free. PMID- 6491245 TI - Emergency department staffing by nonspecialists. PMID- 6491246 TI - Standards for attending staff in an emergency medicine residency program. AB - An academic emergency department established comprehensive standards for its attending staff. Extensive input from multiple levels of emergency department (ED) personnel were utilized. There was uniform agreement that written roles and responsibilities were needed for a more efficiently operating department. Written standards for attending staff represent a novel approach in ED administration. PMID- 6491247 TI - Cervical spine trauma in a pregnant patient. PMID- 6491248 TI - Child safety seats: proper use and selection. PMID- 6491249 TI - Peritoneal dialysis. PMID- 6491250 TI - Being sensible about salt. From the National Institute on Aging, Food and Drug Administration. PMID- 6491251 TI - TEFRA: how it will affect your retirement plan. PMID- 6491252 TI - PPO: opportunity over adversity. PMID- 6491253 TI - Bombesin/gastrin-releasing peptide (GRP)- and Met5-enkephalin-Arg6-Gly7-Leu8-like immunoreactivities in small intensely fluorescent (SIF) cells and nerve fibers of rat sympathetic ganglia. AB - Superior cervical and hypogastric ganglia were removed from rats that had been perfused with a mixture of 4% paraformaldehyde and 0.25% glutaraldehyde. Specific antisera against Met5-enkephalin-Arg6-Gly7-Leu8 (MEAGL) and bombesin/gastrin releasing peptide (BN/GRP) were used in the immunofluorescence procedure. In hypogastric ganglia, a subpopulation of small intensely fluorescent (SIF) cells, as identified by their aqueous aldehyde (Faglu)-induced fluorescence, showed MEAGL- and BN/GRP-like immunolabeling. SIF cells in the superior cervical ganglia were unlabeled. In both ganglia, varicose nerve fiber networks and nerve terminals surrounding principal ganglion cells showed MEAGL- and BN/GRP-like immunoreactivities. Unlabeled SIF cells often were in close contact with nerve fibers that had MEAGL-like immunolabeling. Immunoreactivities against MEAGL- and BN/GRP-like neuropeptides in nerve fibers and terminals suggest a neurotransmitter or neuromodulator role for these peptides. In addition, labeling in SIF cells implies their possible endocrine function. PMID- 6491254 TI - Scanning electron microscopy and X-ray microprobe analysis in detection of acetylcholinesterase in cultured embryonal carcinoma cells. AB - Mouse F9 cells, induced by retinoic acid and dibutyryl cyclic adenosine monophosphate (cAMP) to differentiate into neural-type cells, were incubated for localization of specific acetylcholinesterase (AChE) activity according to the Karnovsky-Roots method where the final enzymatic reaction product is crystalline cupric ferrocyanide and cuprous thiocholine iodide. By scanning electron microscopy (SEM) neural-type cells with long processes were seen. Most of these cells exhibited crystalline precipitates on their surface that in microprobe analysis contained copper, iron, and sulfur. These elements were also detected in some of the neural-type cells that had no visible surface precipitates. Thus, the X-ray analysis also revealed intracellular enzymatic activity. Undifferentiated rounded cells, devoid of AChE activity at the light microscope level, did not show any surface precipitates by SEM and lacked copper, iron, and sulfur emission peaks in the elementary analysis. These results demonstrate that elementary analysis of cytochemical enzymatic reaction products by SEM can be used in identifying cells. PMID- 6491255 TI - Myoglobin levels in individual human skeletal muscle fibers of different types. AB - An attempt was made to determine the relationship of myoglobin content to specific fiber types in human muscle. Biopsies were obtained from biceps brachii, vastus lateralis, and gastrocnemius muscles of untrained subjects and from the vastus lateralis muscle of a highly trained athlete at peak training and at intervals of no training (detraining). Individual muscle fibers were assayed, by quantitative microanalytical methods, for myoglobin, lactate dehydrogenase, malate dehydrogenase, citrate synthase, beta-hydroxyacyl-coenzyme A dehydrogenase, and adenylokinase activities all on the same fiber. The enzyme levels were used to classify the fibers into type I or II. The results show that the content of myoglobin in human muscle does not differ greatly between fiber types in contrast to other species. The type II fibers contained, on the average, at least two-thirds as much myoglobin as type I fibers. The concentration of myoglobin did not change in either fiber type during detraining (84 days), despite marked changes in lactate dehydrogenase, adenylokinase and the three oxidative enzymes. PMID- 6491256 TI - Distribution of calcium during interphase and mitosis as observed by ion microscopy. AB - The ion microscope, based on secondary ion mass spectrometry, has been used to demonstrate the distribution of calcium in the root tip cells of two plant species, Allium cepa and Vicia faba. Interphase nuclei showed higher intensities of calcium than cytoplasm, while nucleoli exhibited higher calcium intensities than the rest of the nucleoplasm. The chromosomes showed high intensities of calcium at all stages of mitosis. Calcium was also detected in the cell plate and phragmoplast region of dividing cells. It appears that during prophase calcium concentrates in the condensing chromosomes, and during telophase it is transferred to nucleoli. These observations suggest that chromosomes may serve as a reservoir of calcium during mitosis. PMID- 6491257 TI - Immunocytochemical localization of glucocorticoid receptors in midgestation murine embryos and human embryonic cultured cells. AB - Glucocorticoid receptors have been localized immunocytochemically in the developing mouse secondary palatal shelves and in cultured human embryonic palatal mesenchyme cells. In the midgestation embryo, receptors are found in the highest concentration in the palatal mesenchymal cells, suggesting that they play a major role in normal development as well as in glucocorticoid-induced cleft palate. The presence of these receptors in cultured human embryonic palatal cells also suggests that development of the human secondary palate may be dependent on glucocorticoids. PMID- 6491258 TI - Feulgen densitometry in image analysis. PMID- 6491259 TI - Towards a theory of homosexuality: socio-historical perspectives. PMID- 6491260 TI - The ethical and moral implications of sexual classification: a commentary. AB - This paper reviews the relationship between psychiatric diagnosis and morality, suggesting that moral reasoning has been the primary determinant in the diagnosis of sexual disorders. It suggests two hypotheses to explain why homosexuality was eliminated from DSM. One, that homosexuality is now viable as a lifestyle and therefore has become socially regulated; and two, that the normal is the intractible. It further suggests that there is no scientific reason to keep the paraphilias in DSM. PMID- 6491261 TI - Therapeutic implications of viewing sexual identity in terms of essentialist and constructionist theories. AB - One of the most challenging developments in recent historical studies and in empirical research in sociology has been constructionist theories relating to "sexual personalities." The "constructionist" view is that sexual identity is labile and can be therapeutically modified. In clinical work, this has presented an alternative view of the development of social sex-role and sexual orientation. Previously, views of sexual identity as a fixed personal characteristic (the "essentialist" view) provided clinicians with ways of treating psychologically distressed people either by transsexual conversion or aversion therapy. This article reviews some implications of "constructionist" and "essentialist" theory. It describes the author's clinical attempts to present constructionist views to clients who are in conflict about their sexual orientation and social sex-role. The article concludes that constructionist therapy has not taken into account clinical evidence that clients may adhere to "essentialist" beliefs. PMID- 6491262 TI - Conceptualizations of homosexual behavior which preclude homosexual self labeling. AB - Our culture presents people with a problematic pair of messages: engaging in homosexual behavior makes a person a homosexual, and homosexuality is bad. In this context, maintenance of self-esteem, sexual/affectional satisfaction, and coherent identity requires some intricate psychological footwork. This article describes a variety of common conceptualizations of "homosexual behavior" which permit the individual to avoid the stigma of homosexual self-labeling. It is suggested that the "accuracy" of these constructions is less important than the appropriate doubt they cast on our widely held, but psychologically inadequate, concepts of sexual orientation. PMID- 6491263 TI - Classifying sexual disorders: the Diagnostic and Statistical Manual of the American Psychiatric Association. AB - The objectivity of the classification of sexual disorders in the third edition of the Diagnostic and Statistical Manual (DSM-III) of the American Psychiatric Association is explored via a critical examination of the replacement of homosexuality per se by ego-dystonic homosexuality, DSM's working concept of a mental disorder, the notion of a paraphilia, components of sexual identity, and the literature on variant sexual behaviors. It is argued that the same criteria that led to the removal of homosexuality per se as a mental disorder require the removal of all the paraphilias per se, there is no empirical warrant to justify their continued inclusion, and while there is legitimacy for a generalized ego dystonic category, such ego-dystonias are only incidentally sexual. It is suggested that the present classification of sexual disorders is merely the codification of social mores. PMID- 6491264 TI - Psychological preparation as a method of reducing the stress of surgery. AB - Studies of the preparation of adult patients for surgery are reviewed. While many show that preparation reduces stress, the studies are criticized for methodological and conceptual inadequacies. In particular, studies often fail to measure a range of stress responses, and also fail to provide measures over a sufficient time span to fully assess the effect of preparation on stress responses which are known to have differing rates of responsiveness. The experimental study was specifically designed to overcome these problems. Eighty patients undergoing a minor gynecological operation (laparoscopy for sterilization or infertility investigation) were allocated to one of three groups: routine care only (Control 1); routine care plus a minimally informative preparatory booklet (Control 2); or routine care plus a maximally informative preparatory booklet (Experimental group). Patients in the special preparation condition showed lower stress responses on measures of preoperative anxiety. At both one- and six-week follow ups they showed reduced state anxiety and elevated postdischarge vigor scores. They also showed less pain after surgery and recovered faster in hospital and in the first six days after going home. They returned to normal activities faster than patients in the two control groups. There were no differences on measures of postoperative symptoms, medication use, or reported time to return to normal health. The results are discussed in terms of previous studies of psychological preparation, and current concepts of stress. Suggestions for the design of preparatory interventions are made which match the type and timing of the intervention to the target stress response. PMID- 6491265 TI - Professional burnout and its relation to job characteristics, satisfaction, and control. AB - Burnout scores for 104 professionals in the fields of college student personnel, health and mental health, administration and miscellaneous other professionals were correlated with ratings on 13 job characteristics, and ratings of satisfaction with, and control over, these characteristics. Results indicate significant positive correlations between the burnout scores and 10 of the 13 job characteristics. Significant positive correlations were found for burnout and all 13 items of job satisfaction. Significant negative correlations were found for 6 of the items where control was rated. Demographic variables of age, sex, marital status, employment status of spouse, dependents, number of hours worked, and being on call showed no significant correlations with burnout. Recommendations are made for continued research and theory building which take into account the concept of control over one's work environment. PMID- 6491266 TI - Sources of stress among nurses: an empirical investigation. AB - The effect of personality, demographic, and professional variables on nurses' experienced stress is examined through the use of the Nursing Stress Inventory in a midwestern Catholic hospital. Findings indicate that age, nursing role status, length of time since graduation, job tenure, area of nursing, and interpersonal needs are associated with various dimensions of stress. PMID- 6491267 TI - Urinary excretion of mandelic and phenylglyoxylic acids after human exposure to styrene vapour. AB - The kinetics of the urinary excretion of mandelic and phenylglyoxylic acids were studied in volunteers exposed to the known concentrations of styrene vapour. The level and the time of exposure were suitably changed to simulate situations in the industrial environment. The aim was to find out the reasons for the contradictory reports in the literature and to verify parameters characterizing the course of excretion of both metabolites. It was found that the course of mandelic acid excretion might be influenced by the length of styrene exposure. If exposure was longer than 4 hours the maximum of excretion was at the end of the exposure time; after short-term exposures (4 h or less) it was somewhat delayed. Maximum excretion of phenylglyoxylic acid was delayed both after short-term and 8 hour exposures. Excretion of the metabolites was diphasic (biexponential). The effective half-lives were found to be independent of the level of exposure. The apparent half-lives (determined in the post-exposure time of 0-16 hours) tended to become prolonged at daily repeated exposures. The ratio of mandelic to phenylglyoxylic acid changed considerably with the level of exposure. In biological monitoring it is advisable to determine both metabolites. PMID- 6491268 TI - The effect of static magnetic field on protein concentration in serum of guinea pigs. AB - The influence of the static magnetic field on magnetic induction 0.005 T--0.3 T on the protein concentration in serum of guinea-pigs with regard of twenty four hours rhythm was investigated. The range of occurrenced changes were determined by the duration of the static homogeneous magnetic field. PMID- 6491269 TI - Aerosol particle deposition in human lungs. AB - The pneumoconiosis developing after inhalation of air-borne dusts in the work place depends on the relation between the value of particle deposition in the respiratory tract and the rate of particle clearance from sites of their deposition. For testing the deposition in humans an aerosol of paraffin oil was given to a cohort of healthy persons. The characteristic parameters of the aerosol had been defined. The concentration of particles in 5 channels were measured in both the inhaled and exhaled air samples using the particle counter ROYCO 225. The deposition fraction was calculated from the relation of particle amount in expired air to the amount in inhaled air in each distribution class. In this preliminary report the results comparable with the prediction mathematical curve are discussed. PMID- 6491270 TI - Prevalence of viral hepatitis among the hospital staff in CSR between 1980 and 1982. AB - The hepatitis morbidity data were used to study prevalence rate of manifest viral hepatitis among the hospital staff members in CSR over a 3-year period between 1980 and 1982. This study showed that the overall hepatitis morbidity rate was 2.68 per 1,000 health personnel and was 3.6 times as high as that recorded in a normal population matched by age. The mean HBsAg positivity rate was 1.67 per 1,000 and was 5.8 times the rate in the control population group. The rate of HBsAg-negative cases of hepatitis was 1.01 per 1,000 health personnel and was higher than double the rate of morbidity encountered in an age-matched normal population. The highest morbidity rates were recorded in the lower-grade and auxiliary health personnel. When compared with an age-matched normal population the hospital staff members at all departments had distinctly higher morbidity rates than the general population, but the highest risk of acquiring viral hepatitis was evidently run by the personnel at departments of renal dialysis, biochemistry, hematology, infectious diseases, internal medicine, surgery, urology and TRD (tuberculosis and respiratory diseases). Of a total number of recorded cases of viral hepatitis those with HBsAg positivity predominated, especially at departments of urology, TRD, internal medicine, renal dialysis, psychiatry and hematology. Analyzed by specialty and professional status of personnel these viral hepatitis morbidity rates encountered among the hospital staff members seem to point to at least two conclusions: this infection in the health personnel is work-related and its transmission and spread is dependent on the frequency and intensity of contact with the blood and other secretions of infectious patients. PMID- 6491271 TI - Relation of enterotoxin production and lipolytic activity in Staphylococcus aureus strains isolated from acute diarrhoeal diseases to clinical course of illness. AB - Two sets of cases of acute diarrhoeal disease caused by plasma-coagulase-positive Staphylococcus aureus strains were studied. Testing the isolates for staphylococcal enterotoxin (SE) production and for lipolytic activity on egg-yolk agar in relation to the clinical course of the illness showed that only part of the cases could be attributed to the effect of SE and that lipolytic activity apparently also played some pathogenetic role. In one of the sets (205 cases) SE production was found in only 29% of the strains isolated; the clinical course in the corresponding patients was typical of staphylococcal enterotoxicosis. Pronounced lipolytic activity without SE production was demonstrated in 30% of strains; here the clinical course was much milder and protracted. Where both factors were produced (21% of cases), the clinical pattern of enterotoxicosis predominated but was somewhat modified. Two outbreaks in one of which SE production and in the other only clear-cut lipolytic activity were found also differed mutually in the clinical respect. The first displayed a picture of typical staphylococcal enterotoxicosis, the second comprised mild diarrhoeal cases with an incubation period of 6-9 hours, diffuse abdominal pain and no fever. Accordingly, the above observations showed a certain positive correlation between the presence of some staphylococcal exoproducts (SE, lipolytic-activity factor) and the clinical course of the disease. This was particularly striking in infants up to 2 years of age. Lipolytic activity seemed to be associated with mild diarrhoeal staphylococcal disease, although the co-participation of (an)other, so far undetermined factor(s), could not be precluded. PMID- 6491272 TI - Detection of staphylococcal enterotoxigenicity IV. Strains isolated in 1981 and 1982. AB - Enterotoxin A, B, C, D and E detection and typing was undertaken in 807 staphylococcal strains isolated from food, breast milk, clinical material, diarrhoeal stools and hospital-collected swabs in 1981 and 1982. One hundred and sixty-six of the strains produced enterotoxin, most frequently type A or C, less so type D or B. There were single instances of strains with double toxin production: AB, AC or AD. Nine hundred and ten supernatants collected in 1972 1973 were additionally tested (after a lapse of 8 years) for type D enterotoxin; there were 152 positive specimens, predominantly relating to strains isolated from tinned cocoa and delicatessen, with 26 of the supernatants containing AD and BD enterotoxin combinations. For the first time the authors' laboratory detected strains producing enterotoxin F and the combination. PMID- 6491273 TI - A rapid coagglutination test for the detection and serogrouping of Legionellae. AB - The applicability of coagglutination for the rapid detection and serogrouping of Legionellae has been investigated. The coagglutination reaction is carried out with the aid of self-made preparations of protein A containing staphylococci, sensitized with specific antibodies against the antigens of L. pneumophila (serogroups I to 6), L. bozemanii and L. micdadei. Preliminary heating of Legionella suspensions at 100% C for 15 min was used to prevent cross coagglutination reactions and ensure greater safety of laboratory personnel during the performance of the test. The results obtained demonstrate a high specificity of coagglutination. With the aid of the coagglutination reactions it has been shown that L. pneumophila strains isolated in Bulgaria belong to serogroup I. The coagglutination method is characterized by its rapidity, simplicity and feasibility. It is a useful and convenient means for the rapid detection and serogrouping of Legionellae. PMID- 6491274 TI - Yersinia enterocolitica 03 findings on porcine tongues in comparison with yersiniosis incidence in man in Czechoslovakia. AB - Positive isolations of Yersinia obtained in repeated bacteriological examinations of porcine tongues at three slaughter-houses in Prague and a single examination at the slaughter-house at Kladno were compared with notified yersiniosis morbidity. The incidence of illnesses caused by Y. enterocolitica 03 does not exceed values of 4.5/100,000 and 3.5/100,000 population in the Czech and Slovak Socialist Republics, respectively, and is equal to a sixtieth part of the notified shigellosis and salmonellosis morbidity. Cultivation of 334 pooled samples consisting of 1142 porcine tongues yielded 12 strains (1.05%) of Y. enterocolitica 03, five strains (0.44%) of Y. pseudotuberculosis and 55 strains (4.82%) of other Yersinia organisms (indole-positive serotypes). Because of the low isolation rates obtained for the individual Yersinia species, Y. enterocolitica 03 in particular, the isolation efficiency of different cultivation techniques and culture media was statistically evaluated for all Yersinia organisms jointly. Primary cultivation on deoxycholate-citrate medium yielded five of the 12 Y. enterocolitica 03 strains isolated. The other Yersinia strains grew only after preliminary propagation. Yersinia pseudotuberculosis grew almost exclusively (4 out of 5 strains) on McConkey's agar. PMID- 6491275 TI - Host immune response against homologous challenge infection of Ancylostoma caninum larvae after application of effective anthelmintics. AB - The development of immunity against Ancylostoma caninum larval reinfection has been investigated in mice after the primary infection has been treated with an effective anthelmintics. Experimentally A, caninum larvae infected mice treated with levamisole (5 x 40 mg/kg), thiabendazole (5 x 200 mg/kg), oxfendazole (5 x 100 mg/kg), or albendazole (5 x 100 mg/kg) when challenged with A. caninum larvae showed 47.77 to 55.81% larval reduction from the challenge dose indicating thereby the development of partial immunity. PMID- 6491276 TI - Change in immune response in children suffering from opisthorchosis and attempt at its correction using Levamisol. AB - The number of circulating T-, B- and O-lymphocytes, the activity of non-specific T-suppressors, the ability of lymphocytes to blasttransformation with PHA and the levels of M, G and A immunoglobulins in blood serum were studied in 40 children suffering from chronic opisthorchosis and in 18 virtually healthy children (mean age 9 years). The affected children were studied before and after treatment with Levamisol. It has been established that the number of T-lymphocytes is reduced and the activity of non-specific T-suppressors decreases considerably in children suffering from chronic opisthorchosis which by its nature is a heavy allergosis. Through a similar factor, the inhibition of the activity of T-helpers is reduced and conditions are created for increased antibody production in the organism of the patients without an increase in the level of B-lymphocytes. Consequently, manifestations of autoimmune and allergic reactions of the immediate and delayed type can be expected to occur in such patients. Treatment of the affected children with Levamisol (2 mg/l kg body mass every other day, 3 administrations of the preparation in one course) showed an immunoregulative effect characterized by intensification of the formerly reduced activity of T-suppressors (P less than 0.001), decrease in the number of B-lymphocytes in the peripheral blood and normalization of IgA concentration in blood serum. It is recommended to include Levamisol, together with anthelminthics, in complex opisthorchosis therapy so as to realize its immunoregulative effect because the antiparasitic therapy using Chloxil (anthelmithic), while showing good dehelminthizing results, failed to promote correction of immune disturbances observed during opisthorchis invasion and in opisthorchosis convalescents. PMID- 6491277 TI - Toxoplasma antigen isolated by affinity chromatography with monoclonal antibody protects mice against lethal infection with Toxoplasma gondii. PMID- 6491278 TI - Cholera toxin feeding did not induce oral tolerance in mice and abrogated oral tolerance to an unrelated protein antigen. AB - The feeding of protein antigens to mice results in a state of tolerance when feeding is followed by parenteral immunization. Cholera toxin (CT) is a protein that has been used extensively as a potent oral immunogen for mucosal IgA responses, but CT feeding also stimulates a substantial plasma IgG antibody response. This latter finding prompted us to study whether or not CT induces oral tolerance. Mice were fed 5 mg keyhole limpet hemocyanin (KLH) or 10 micrograms CT at least twice before parenteral immunization with 1 microgram KLH or CT in alum i.p. Plasma and intestinal secretions were collected at intervals. The specific IgG or IgA antibody in the samples was measured by ELISA. Although KLH feeding did induce oral tolerance, CT feeding did not induce oral tolerance in any of three mouse strains tested or at any dose of CT given orally. The feeding of the B subunit of CT did not result in oral tolerance either. When both CT and KLH were fed together, CT was able to abrogate oral tolerance to KLH, an antigenically unrelated protein. Moreover, feeding CT along with KLH stimulated secretory IgA anti-KLH responses, whereas no such IgA responses were found when KLH was given alone. Thus, in these experiments with protein antigens, IgA immunization and oral tolerance were reciprocally linked and did not occur simultaneously. CT appears to abrogate oral tolerance and to stimulate secretory IgA responses by altering the regulatory environment in gut-associated lymphoid tissue, shifting it toward responsiveness. PMID- 6491279 TI - Phylogeny of lymphocyte heterogeneity: the cellular requirements for in vitro mitogenic responses of channel catfish leukocytes. AB - Cell separation and enrichment techniques were employed to isolate three distinct leukocyte subpopulations present in channel catfish (Ictalurus punctatus) peripheral blood. Surface immunoglobulin-positive (sIg+) and sIg- lymphocytes were separated by an indirect "panning" technique employing monoclonal antibodies reactive with channel catfish Ig. A third cell population composed of macrophages was isolated by adherence to baby hamster kidney cell microexudate-coated surfaces. Functional features of these three subpopulations were assessed by in vitro mitogenic responses to lipopolysaccharide (LPS) and concanavalin A (Con A). The results that were obtained indicated that the sIg+ cells responded only to LPS stimulation regardless of the presence or absence of macrophages. The sIg- subpopulation, however, responded to neither LPS nor Con A unless macrophages were present, in which case responses were obtained to both mitogens. The accessory cell nature of the macrophages was shown by experiments utilizing fixed numbers of one cell type mixed with varying numbers of another cell type. Furthermore, the accessory cell function was abrogated by passage through Sephadex G-10 and preincubation with L-leucine methyl ester. These studies provide further evidence that teleosts not only contain B and T cells akin to those in mammalian systems, but contain accessory cells (macrophages) as well. PMID- 6491280 TI - Resistance to tolerance induction is not prerequisite to development of murine SLE. AB - Four different SLE-prone mice, NZB, (NZB x NZW)F1, MRL/MpJ-lpr/lpr, and male BXSB/MpJ, resisted the induction of tolerance to human IgG (HGG) at 5 wk, but not before 3 wk of age. However, female F1 hybrids between NZW and BXSB mice were easily made tolerant to HGG, although they develop an acute form of typical SLE similar to that seen in (NZB x NZW)F1 hybrid females. In addition, C57BL/6 mice bearing a mutant gene, lpr (lymphoproliferation), which produced significant amounts of various autoantibodies characteristic of murine SLE, were still as susceptible to tolerance induction as control C57BL/6 mice. In contrast, both (NZW x BXSB)F1 and (C3H x BXSB)F1 hybrid males carrying the abnormal Y chromosome of BXSB mice failed to become tolerant to HGG, although the extent of resistance to tolerance induction was less significant in (C3H x BXSB)F1 males than in (NZW x BXSB)F1 males. Our results suggest that 1) the defect in tolerance induction to heterologous IgG such as HGG is not necessarily required for the development of an SLE-like syndrome in mice; 2) the induction or enhanced production of autoantibodies by the lpr gene is not related to this cellular abnormality; but 3) a Y chromosome-associated factor from BXSB mice plays a significant role in the abnormality to resist tolerance induction as well as the acceleration of SLE. Our observations are consistent with the hypothesis that SLE may be based on highly specific abnormalities of immune responses to particular autoantigens, but not on a generalized breakdown of a tolerance mechanism. PMID- 6491281 TI - Monoclonal antibodies that distinguish between subspecies of human interferon alpha and that detect interferon oligomers. AB - Monoclonal antibodies to human interferons (HuIFN) of the alpha-class have been prepared by screening against 125I-labeled IFN in a rapid liquid-phase radioimmunoassay. All of the six antibodies produced react with HuIFN-alpha 2 and with some components of HuIFN-alpha N (Namalwa); three of the antibodies also bind HuIFN-alpha 1, and these either do not bind or bind very weakly the 25K component of Namalwa. Reaction of the antibodies with IFN components blotted onto nitrocellulose after separation on reducing gels suggests that two of the antibodies are against conformational determinants, whereas the epitopes recognized by the other antibodies are not destroyed by reduction or SDS treatment; these antibodies can be used to detect the presence of oligomers in IFN preparations. From the reaction of the antibodies with different alpha-IFN in immunoblots, in an antiviral assay, and in an ELISA, it was concluded that at least five different epitopes are recognized by the six antibodies, only one of which is non-neutralizing. PMID- 6491282 TI - Mechanism of inhibition of human natural killer activity by ultraviolet radiation. AB - Ultraviolet radiation (UVR) has been shown to inhibit various immune functions in vivo and in vitro. We have confirmed that UVR inhibits human natural killer (NK) activity in vitro and have shown that UVR inhibits human ADCC. In this report, the mechanism by which UVR inhibits NK function was investigated by analyzing the stage at which the inhibiting activity occurs and the ability of the NK cells to release cytotoxic factors previously shown to be involved in CMC. Single cell assays in Agarose revealed that inhibition of NK activity was localized at the postbinding lethal hit stage rather than the initial recognition or binding stage of lysis. We then examined whether UV-treated cells were able to release cytotoxic factors after stimulation with target cells. As expected, stimulated cells released cytotoxic factors, yet, surprisingly, these factors were also released in the absence of stimulator cells. The spontaneous release was detectable in the supernatants as early as 30 min after UV irradiation. The lytic material examined in 48- to 72-hr viability assays was not NK specific, because lysis was obtained with a wide range of NK sensitive and resistant target cells. These results demonstrate that UVR does not alter the capacity of the cells to secrete cytotoxic material, but in fact enhances its release. Several possible mechanisms are proposed to explain the UVR-induced NK inhibition. PMID- 6491283 TI - Binding specificities of eight monoclonal antibodies to human glycophorin A- studies with McM, and MkEn(UK) variant human erythrocytes and M- and MNV-type chimpanzee erythrocytes. AB - Four newly derived mouse monoclonal antibodies to human glycophorin A are described. Three of these antibodies bind preferentially to the N form of glycophorin A; the fourth recognizes a shared determinant of the M and N forms. All four antibodies are directed toward the 39 amino acid, amino-terminal portion of the protein, and the N-specific antibodies require for binding the presence of N-acetyl-neuraminic acid on the glycosidically linked oligosaccharides. Cross reaction of the N-specific antibodies to homozygous MM erythrocytes appears to result from binding to glycophorin B. In addition, these antibodies together with four previously reported glycophorin monoclonal antibodies, including two that specifically recognize the M form of glycophorin A, were tested for binding to McM and MkEn(UK) variant human erythrocytes and M- and MNV-type chimpanzee erythrocytes. Results obtained for five of the six M- or N-specific monoclonal antibodies point to the general immunodominance of the amino-terminal serine leucine polymorphism and the requirement for sialic acid. One of the two M specific monoclonal antibodies, 9A3, discriminates between the M, N, and Mc forms of glycophorin A solely on the basis of the amino-terminal serine-leucine polymorphism. The other M-specific antibody, 6A7, requires a more complex determinant involving the glycine-glutamic acid polymorphism at the fifth position in the sequence as well. The epitopes for all three N-specific monoclonal antibodies include the amino terminal leucine that occurs in the N form of glycophorin A and may also include the glutamic acid that occurs at position five. Our studies support the proposed Lepore-type glycophorin A-B hybrid gene rearrangement for the En(UK) allele found in the English En(a-) family. The data also confirm the expression of the M-like glycoprotein on chimpanzee erythrocytes and the presence of a human glycophorin B-like antigen on the MNV-type cells. PMID- 6491284 TI - The adjuvant activity of nonionic block polymer surfactants. II. Antibody formation and inflammation related to the structure of triblock and octablock copolymers. AB - We tested the ability of 17 surface-active agents to enhance antibody formation and inflammation. The surfactants were all block copolymers of hydrophilic polyoxyethylene (POE) and hydrophobic polyoxypropylene (POP), which differed in m.w. and mode of linkage of POP to POE. Mice were injected in each rear footpad with 1.25 mg of each surfactant with 25 micrograms of bovine serum albumin in an oil-in-water emulsion. Each agent produced a distinct pattern of immune response and inflammation. Preparations that are large and insoluble with the POE chains flanking the POP chains were very effective adjuvants for increasing antibody formation. They also activated complement and induced the release of chemotactic factors from serum. Increasing the percent of POE decreased adjuvant activity and inflammation. Decreasing the m.w. of the molecules while maintaining the proportions of POP and POE decreased the adjuvant activity and increased inflammation. Preparations synthesized in the reverse order, with the POP flanking POE, tended to induce granulomas instead of antibody. These data demonstrate that block copolymer surfactants have a spectrum of biologic activities that depend on the size and arrangement of their constituent parts. We suggest that much of the activity of these agents derives from their ability to form adsorptive surfaces similar to those of a mycobacterial glycolipid, quartz, and monosodium urate. PMID- 6491285 TI - Cobra venom factor: structural homology with the third component of human complement. AB - The functional analogy between cobra venom factor (CVF), the complement activating protein in cobra venom, and C3b, the activated form of the third complement component, prompted us to conduct a comparative analysis of structural properties of the two proteins derived from two phylogenetically distant species. We subjected CVF and human C3 and its physiologic cleavage products, C3b and C3c, to a variety of biochemical analyses. We report here structural similarities of these proteins, which include similarities in amino acid composition, far and near UV circular dichroism spectra, secondary structure, band patterns and pI values from isoelectric focusing, immunochemical cross-reactivity, ultrastructural morphology, and amino-terminal amino acid sequences. Analysis of these data reveals that, structurally, CVF resembles C3c more than C3b. We conclude that CVF is not the product of a convergent evolution, but is, in all likelihood, derived from a common C3 ancestor protein. PMID- 6491286 TI - Purification of a lamprey complement protein homologous to the third component of the mammalian complement system. AB - A lamprey protein homologous to the third component of mammalian complement was isolated from lamprey plasma and was tentatively designated lamprey C3. Lamprey C3 is a major protein in lamprey serum with electrophoretic mobility of beta globulin and with m.w. of 190,000. It consists of three polypeptide chains (84,000-alpha, 74,000-beta, and 32,000-gamma chains) linked by disulfide bonds. The protein retains a unique internal thiolester bond on the alpha-chain that is cleaved on methylamine treatment or on limited proteolysis with trypsin. Lamprey C3 by itself could not bind to zymosan or rabbit red cells, but it could covalently bind to these substances when activated by other factors present in lamprey serum. The binding of lamprey C3 to activating surfaces is mediated by covalent bonds and is accompanied by limited proteolysis of the alpha-chain. A fragment with an m.w. of 35,000 containing the internal thiolester site was isolated from methylamine-treated lamprey C3 bound to activated thiol-Sepharose by extensive tryptic digestion followed by dithiothreitol treatment. Lamprey C3 functions as the essential factor in phagocytosis of rabbit red cells by lamprey phagocytes. However, it is not involved in naturally occurring hemolytic activity in lamprey serum. PMID- 6491287 TI - Flow cytometric quantitation of oxidative product formation by polymorphonuclear leukocytes during phagocytosis. AB - Stimulation of the oxidative metabolic burst of human polymorphonuclear leukocytes (PMNL) may occur by an all-or-none trigger mechanism or by a graded response to increasing stimulation of an individual cell. If the proposed all-or none mechanism occurred during phagocytosis, a PMNL would expend all of its metabolic potential at once, yet PMNL can proceed to ingest multiple organisms. This study employed dual laser flow cytometry to correlate the number of cell associated organisms with oxidative product formation in individual PMNL. Intracellular oxidation of nonfluorescent 2',7'-dichlorofluorescein (DCFH) to highly fluorescent 2',7'-dichlorofluorescein (DCF) provided a quantitative assay of H2O2-dependent oxidative product formation generated by the cell's oxidative metabolic burst. Staphylococcus aureus were fixed and stained with Texas red to allow simultaneous monitoring of bacteria (red fluorescence, greater than 580 nm) and DCF (green fluorescence, 510 to 550 nm) content of each cell. Computer correlation of bacterial and DCF fluorescence allowed determination of the DCF formation by PMNL containing specific numbers (0 to 15) of bacteria. Oxidative product formation was directly related to the number of bacteria ingested in a time-dependent manner (mean per cell of 6.4, 12.8, 19.1, and 24.4 attomoles (amol) DCF formed per cell per bacterium after 15, 30, 45, and 60 min, respectively. Opsonization of bacteria with fresh normal serum (primarily C3b opsonization) or with specific IgG demonstrated qualitatively similar responses, except that the response per IgG-opsonized organism was, on the average, more than twice the response to bacteria opsonized with serum. Thus, sequential phagocytosis of multiple bacteria elicits an incremental oxidative response of human PMNL. PMID- 6491288 TI - Blood clearance by anti-phosphocholine antibodies as a mechanism of protection in experimental pneumococcal bacteremia. AB - Previous studies have demonstrated that monoclonal IgG and IgM antibodies to phosphocholine (PC), a determinant in the cell wall of Streptococcus pneumoniae, can protect mice from fatal infection with S. pneumoniae. In this study we demonstrate that both passive and naturally occurring anti-PC antibodies promote the clearance of S. pneumoniae from the blood. The bulk of the cleared pneumococci are apparently killed, because they fail to accumulate in reticuloendothelial tissues. These findings suggest that their protective effect is probably dependent on their ability to promote phagocytosis. We have found that on a weight basis IgG antibody is more effective at promoting blood clearance than IgM antibody. This observation fits with our earlier findings that IgG anti-PC antibody is more protective against i.v. infection than IgM anti-PC antibody. We have also demonstrated that anti-PC antibodies are protective against S. pneumoniae infection when given as late as 24 hr postinfection. This finding makes it unlikely that the ability to protect against pneumococcal infection with anti-PC antibody is dependent on an artifact associated with either their in vitro growth or the harvesting procedure. PMID- 6491289 TI - Characterization of tick antigens inducing host immune resistance. I. Immunization of guinea pigs with Amblyomma americanum-derived salivary gland extracts and identification of an important salivary gland protein antigen with guinea pig anti-tick antibodies. AB - Guinea pigs immunized by subcutaneous injection of an emulsion of incomplete Freund's adjuvant (IFA) containing tick salivary gland extract antigens (SGA) from partially fed female ticks expressed a significant level of tick rejection when challenged 17 days later. This level of tick rejection was similar to animals actively sensitized by tick feeding and challenged at the same time. SGA emulsified with complete Freund's adjuvant (CFA) or administered with saline was ineffective. However, ticks that fed on animals immunized with SGA+IFA or SGA+CFA expressed significant reductions in engorgement weight. SGA was active when prepared with or without protease inhibitors. The minimum effective immunizing dose of SGA was between 100 and 280 micrograms per animal. Extracts made from salivary gland-derived cement material (CA) from partially fed female ticks administered at 50 micrograms in IFA induced levels of tick rejection comparable to animals immunized with 280 micrograms of SGA+IFA. Sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS/PAGE) of 35S- and 125I-radiolabeled SGA and CA extracts immunoprecipitated by guinea pig anti-tick serum that transferred immune resistance demonstrated a unique protein of 20,000 m.w. Serum from animals immunized with SGA+IFA (successful immunization) recognized this same protein, whereas serum from animals immunized with SGA+CFA (unsuccessful immunization) did not. The results of this study suggest that a 20,000 m.w. protein derived from the tick salivary gland may be responsible for the induction and perhaps elicitation of host immune resistance responses to Amblyomma americanum ticks. PMID- 6491290 TI - Subclasses of rat IgG active in the killing of schistosomula of Schistosoma mansoni in vitro and in vivo. AB - Schistosomula of Schistosoma mansoni are known to be killed in vitro by complement and IgG (lethal antibody). To investigate whether this mechanism reflects the in vivo situation, we isolated IgG subclasses from sera of infected rats and assayed their ability to promote the complement-mediated killing of schistosomula in vitro as well as to protect normal recipients from a challenge infection. We found that a serum fraction containing only IgG2a + IgG2b has lethal activity to schistosomula in vitro, whereas a fraction containing only IgG1 + IgG2c fails to kill schistosomula in the presence of complement. The assay of protective activity has shown that the same fraction containing the lethal activity (IgG2a + IgG2b) was able to reduce the number of schistosomula recovered from lungs. These results provide evidence of the participation of IgG2a and/or IgG2b, but not IgG1 or IgG2c, in protective immunity to S. mansoni in rats, possibly through a complement-mediated mechanism. PMID- 6491291 TI - Macrophage activation to kill Leishmania tropica: characterization of P/J mouse macrophage defects for lymphokine-induced antimicrobial activities against Leishmania tropica amastigotes. AB - Macrophages from P/J mice demonstrated both quantitative and qualitative defects in lymphokine (LK)-induced activated macrophage antileishmanial effector reactions: a) these cells recognized the same LK signals that generated resistance to infection in responsive C3H/HeN macrophages, but more signal was required to observe maximal activity; b) LK-induced intracellular destruction of Leishmania tropica by P/J macrophages was minimal (less than 20%), and was induced by only one of three LK signals that regulate antimicrobial activities in C3H/HeN macrophages. The defective microbicidal activity of P/J macrophages observed with LK activation in vitro could also be demonstrated in vivo. Macrophages from P/J mice exposed to the macrophage-activating agent Mycobacterium bovis strain BCG in vivo were capable of restricting the intracellular replication of L. tropica but could not eliminate intracellular parasites, even with further incubation with LK during the 72-hr culture period. The defect of P/J macrophages for intracellular destruction of L. tropica, then, occurred in the activation sequence before the triggering stage that characterizes the macrophage defect of C3H/HeJ mice. Genetic regulation of the P/J macrophage defect appears to be by a single autosomal gene, with defective microbicidal activity as a recessive trait in these animals. PMID- 6491292 TI - Studies on the mechanism of natural killer cell-mediated cytotoxicity. V. Lack of NK specificity at the level of induction of natural killer cytotoxic factors in cultures of human, murine, or rat effector cells stimulated with mycoplasma-free cell lines. AB - We have proposed that lysis of target cells by NK cells is mediated by NK cytotoxic factors (NKCF). According to our model, for a target cell to be NK sensitive, it must be recognized by the NK cell, it must stimulate the release of NKCF, and it must be sensitive to lysis by these factors. This report examines whether the ability to stimulate release of NKCF is a characteristic restricted to NK-sensitive tumor cells or whether it is also a property of NK-resistant target cells. Many different types of cell lines were tested for their ability to stimulate release of NKCF in the human, rat, and murine systems. It was found that mycoplasma-free NK-sensitive cell lines, resistant cell lines, and Con A could stimulate the release of NKCF. Many different types of cell lines grown in suspension or in monolayers were found to be effective stimulators, including T or B lymphoid, myeloid, and those of histiocytic origin. Cells cultured in the absence of serum stimulated NKCF release, thus ruling out the possible involvement of serum components in stimulation. NKCF was also produced by xenogeneic combinations of effector and stimulator cells, demonstrating lack of species specificity in NKCF production. Factors stimulated by NK-resistant cell lines or by Con A exhibited the same NK target specificity as supernatants stimulated by NK-sensitive tumor cells. The finding that many different NK resistant cell lines can stimulate the release of NKCF indicates that there is no apparent NK specificity at the level of induction of NKCF release from human, rat, or murine effector cells. Therefore, the NK specificity of a target cell is determined ultimately by its sensitivity to lysis by NKCF. PMID- 6491293 TI - Differential antigen adhesivity used to select spleen cells for the production of monoclonal antibodies to embryonic neurons. AB - Monoclonal antibodies specific for cell surface antigens on embryonic chick ciliary ganglion neurons (CG) have been obtained at high frequencies by fractionating spleen cells from immunized mice according to their adhesiveness for cell surfaces of the cultured neurons. Spleen cells from mice that had been immunized with live or lightly fixed (0.125% glutaraldehyde) CG neurons were selected for subsequent hybridization with myeloma cells after fractionation on lawns of CG neurons in tissue culture. Immunized spleen cells were cultured with the neurons for 4-7 days prior to fractionation. Three groups of spleen cells were selected for fusion with a myeloma cell line: a non-adherent population of spleen cells, a population of spleen cells that could be removed from the neuronal cells by shaking on a vibratory shaker for 1 h, and a population that could be removed from the neuronal cells only by treatment with low concentrations of trypsin. Of the 3 groups of spleen cells, the population that required trypsin treatment produced the greatest number of hybridomas specific for neurons and for neuronal cell surfaces. Fewer neuron-specific hybridomas resulted from fusion of the group of spleen cells that could be removed from the antigen lawn by shaking. None of these was specific for the CG neurons. No neuron specific hybridomas resulted from the fusion of the cells that did not adhere to the neuronal cells, and at most only 1 neuron-specific hybridoma resulted from fusions of comparable groups of unselected spleen cells (spleen cells from immunized animals which were not selected on antigen lawns). PMID- 6491294 TI - Development of a radioimmunoassay for papain. AB - Various well-tried radioimmunoassay (RIA) techniques were compared for the quantitation of papain. The evaluation of individual assays was performed by logit-log analysis. The most compatible analytical steps were combined in order to obtain the optimal analytical conditions of the assay. The preferred RIA involves papain labelling with lactoperoxidase, a double antibody method as the separation step and a 24 h incubation period at 2 degrees C. It permits the detection of 16 ng of papain per tube. In contrast, a method using immobilized antibody was satisfactory for rapid quantitation of papain with quite acceptable accuracy. PMID- 6491295 TI - A method for the preparation of imprints from the nasal mucosa. AB - Important immunological reactions take place on the surface of mucosal membranes. Improved methods for the sampling and quantitative study of the cells taking part in these reactions are therefore desirable. We here describe a new technique for the preparation of imprints from the nasal mucosa. The method utilizes a plastic film coated with a thin layer of an albumin-glycerol mixture to improve cell adherence to the surface. The membrane is gently pressed onto a defined portion of the mucous membrane. Fixation and staining procedures are performed on the plastic film, which is then mounted on a slide and covered by a coverslip. The preparations have excellent optical properties and specific cell types can be easily studied, quantified and related to the specific area of the mucosa from which the imprint was taken. PMID- 6491296 TI - Allergen discs prepared from nitrocellulose: detection of IgE binding to soluble and insoluble allergens. AB - Nitrocellulose discs, 6 mm in diameter, are suggested as an alternative to cyanogen bromide-activated paper for the coupling of allergens in radio- or enzyme-linked assays to estimate allergen-specific IgE in serum. The preparation of allergen discs with nitrocellulose is simple, involving 3 steps: (a) drying allergen extract onto disc, (b) soaking discs in a 3% solution of bovine serum albumin, and (c) washing out the buffer. Very similar results (r = 0.94) were obtained using either paper or nitrocellulose discs for radioallergosorbent testing of sera from 15 bakers using allergens from mites, ryegrass pollen or wheat grain. The amount of protein (as radiolabelled albumin) actually bound to either type of disc or microtitre trays was similar, and low (5% of the protein applied for each media). However, when the protein was applied to nitrocellulose in 1% KOH up to 70% of it was bound. This solvent permitted better evaluation of IgE binding to insoluble allergens such as glutenin, which proved to be the most allergenic wheat-grain fraction tested by this method for a group of 9 bakers. PMID- 6491297 TI - An enzyme immunoassay for the detection of all Salmonella using a combination of a myeloma protein and a hybridoma antibody. AB - An enzyme immunoassay was developed for the detection of salmonellae in foods and stool samples. The test is sensitive and specific, showing virtually no cross reactivity to other enteric organisms. The sensitivity is such that less than 10(6) Salmonella organisms can be detected, and this is not influenced even by a 3 log10 overgrowth of other bacteria. This assay can be performed routinely in any laboratory, and can be automated as much as desired. It can be performed from growth in liquid or on solid media. A myeloma protein (M467) and a hybridoma antibody (6H4) were attached to a polycarbonate coated metal bead. The beads were then incubated in a heat extract of the organisms for 20 min. After thorough washing by a magnetic transfer device, the beads were then incubated in a mixture of the 2 antibodies which were labeled with horseradish peroxidase. After another thorough washing and incubation in substrate, the reactions were either read by the naked eye or by spectrophotometry. The entire process following the culture takes less than 2 h. PMID- 6491298 TI - Efficient selection of human tumor growth-inhibiting monoclonal antibodies. AB - A method is described for selection early after fusion for hybridomas that secrete IgG2a monoclonal antibodies (MAbs) with binding specificity for antigens on the human tumor cells used to immunize mice. By combining this preselection method with antibody-dependent macrophage-mediated cytotoxicity assays, it was possible to select those MAbs mediating a tumoricidal effect against tumor cells in culture and inhibiting the growth of tumor xenografts in nude mice. Two such MAbs, GA733 and CO441, inhibited the growth of colorectal carcinoma cells, and one of them (GA733) was effective even when administered 6 days after implantation of tumor cells. These results suggest the potential usefulness of the 2 MAbs in immunodiagnosis and immunotherapy of human tumors. PMID- 6491299 TI - Red cell-labelled monoclonal antibodies for assay of human chorionic gonadotropin and luteinising hormone by reverse passive haemagglutination. AB - The assay of human chorionic gonadotropin and luteinising hormone by reverse passive haemagglutination reaction, using monoclonal antibodies coupled to red cells, is described. Quantitation is achieved by end-point determination for serial dilutions of standard or sample, the haemagglutination reaction being observed after settling under gravity for 90 min. Red cell-labelled antibodies were stabilised with glutaraldehyde without loss of sensitivity and allowing long term storage. Various antibody combinations were assessed, and the best combination under optimum conditions gave a positive haemagglutination reaction down to 0.2 ng/ml with HCG. PMID- 6491301 TI - Determination of blood volume in the mouse with 51chromium-labelled erythrocytes. AB - The present report concerns the use of 51chromium-labelled erythrocytes to measure the blood volume of mice. Statistical analysis showed a linear correlation between blood volume and body weight for male and female Swiss mice and female B10 mice; for female CBA mice the relation was curvilinear. The mean blood volumes of these mice, expressed per 100 g body weight, amounted to 7.14 ml for male Swiss mice, 7.17 ml for Swiss females, 6.96 ml for B10 females, and 6.29 ml for CBA females. The difference in blood volume between the CBA strain and the other mouse strains is statistically significant. PMID- 6491300 TI - Cobra venom factor: improved method for purification and biochemical characterization. AB - A method to purify cobra venom factor (CVF) from cobra venom by sequential column chromatography is described which yields a product virtually free of phospholipase A2, a common contaminant of CVF preparations. The separation of phospholipase A2 from CVF was achieved by chromatography on Cibacron blue agarose, a resin that tightly binds cobra venom phospholipase A2. A rapid and simple hemolytic assay for the qualitative and quantitative determination of CVF based on its ability to induce bystander lysis of erythrocytes has been devised. CVF was isolated from the venom of the Naja naja kaouthia subspecies and some of its biochemical properties and physicochemical parameters were delineated. PMID- 6491302 TI - Comparison between enzyme-linked immunosorbent assay (ELISA) and diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) for detection of antibodies to pneumococcal polysaccharides. PMID- 6491303 TI - Magnetic labeling and cell sorting. AB - Magnetic labeling by a magnetite-antibody conjugate has been combined with magnetic filtration (high gradient magnetic separation) to effect a rapid and efficient separation of a selected cell population from a suspension of single cells. Samples of more than 10(8) cells could be fractionated in about 5 min with complete recovery. The system has been applied to a model system using red blood cells (sheep or chicken) and commercial antibodies against species-determined cell surface antigens. Enrichments of labeled cells by factors of up to 37-fold were observed. The approach was relatively insensitive to details in the experimental protocol and to the number of unlabeled cells which were in the sample. Thus, the method was easy to use and can readily be scaled up to handle large samples containing 10(8) labeled cells in a total of 10(11) or more. It should be useful as a pre-enrichment scheme for suspensions in which cells of interest are rare and, consequently, very inefficiently sorted by fluorescence activated instruments. PMID- 6491304 TI - A new enzyme-linked immunosorbent assay (ELISA) for measuring immunoconglutinins directed against the third component of human complement. Findings in systemic lupus erythematosus. AB - A new enzyme-linked immunosorbent assay, using purified activation product of the third component of human complement (C3b), detects immunoglobulins of the IgG isotype which demonstrate affinity for C3b (C3b-immunoconglutinins; C3b-IK). This assay offers significantly improved specificity compared to previous immunoconglutinin (IK) assays in that it not only defines the isotype and antigenic specificity of the IK but also eliminates false positive results associated with immune complexes or aggregated human gamma globulin, or with natural antibodies directed at heterologous reagents. Using this assay, we observed elevated C3b-IK levels in serum of 34 systemic lupus erythematosus (SLE) patients when compared to serum of 13 healthy controls. Comparing sera from patients with clinically active and clinically inactive lupus showed greater immunoconglutinin levels in the active group. Immunoconglutinin levels did not correlate with the erythrocyte sedimentation rate, total hemolytic complement, or with circulating immune complex levels by the Raji cell and C1q-binding assays. PMID- 6491305 TI - Dot-based ELISA and RIA: two rapid assays that screen hybridoma supernatants against whole live cells. AB - Two assays are described that are suitable for the screening of large numbers of hybridoma supernatants as well as for the screening of a wide range of tissues for the distribution of a given cell surface antigen. These assays use whole live cells as targets, avoiding fixation or extraction, which could alter the antigenic structural profile. The assays are rapid, simple and inexpensive. Their advantages and applications are discussed. PMID- 6491307 TI - A colorimetric assay for serial determination of adenosine deaminase activity in small lymphocyte populations. AB - We describe here an easy, sensitive and quantitative assay for the determination of adenosine deaminase activity in small populations of lymphoid cells. Determinations of enzyme activity and protein concentration are based on colorimetric reactions. All steps are directly performed in 96-well flat-bottom microtiter plates: growth of lymphoid cells (1-2 X 10(5) cells needed), detergent mediated lysis, incubations for enzymatic assay, and reading of colorimetric reactions with an automatic multiscan spectrophotometer. Thus, screening of several hundred independent cell cultures is easily done within a day. Applications to the detection of rare adenosine deaminase variants from large cell populations and to routine medical assays are considered. PMID- 6491306 TI - Serological detection of H-Y antigen in humans with a cellular radioimmunobinding assay and monoclonal antibody. AB - A sensitive and reliable serological assay for the detection of H-Y antigen is described which uses monoclonal H-Y antibody and a cellular radioimmunobinding assay on cultured human fibroblasts. Cell lines from 2 normal human females, 2 normal human males and one XX human male were tested in 3 separate assays. Cells from XY and XX males were found to contain H-Y antigen; however, the reaction against the XX male cells was found to be intermediate between the XY male and normal XX female cells. PMID- 6491308 TI - Size, adherence, and phagocytic characteristics of alveolar macrophages harvested 'early' and 'later' during bronchoalveolar lavage. AB - Alveolar macrophages (AM) harvested by sequential lung lavage procedures are physically, biochemically, and functionally heterogeneous. The present studies were undertaken in order to determine if such AM heterogeneity is a function of their sequential removal from the lung during episodic bronchoalveolar lavage. Our results demonstrate that AM harvested during 'early' lung wash cycles and during 'later' sequential lung wash cycles are essentially identical in terms of their: (1) abilities to exclude a vital dye; (2) volume distributions; (3) plastic substrate adherence characteristics; and (4) Fc gamma receptor-mediated phagocytic activities. PMID- 6491309 TI - A simple enzyme-linked immunosorbent assay for detection of anti-mitochondrial antibodies. AB - An enzyme-linked immunosorbent assay (ELISA) has been developed for detection of anti-mitochondrial antibodies (AMA) in patients' sera. Results are expressed as a mitochondrial binding index, calculated from binding of patients' antibodies to rabbit liver mitochondrial fraction and total liver homogenate. The incidence of AMA detectable by this method in 22 sera from patients with primary biliary cirrhosis was identical with that obtained by conventional immunofluorescence testing (86%), and there was a highly significant correlation between titres determined by the two methods (r = 0.828; P less than 0.01) although ELISA titres were far higher. AMA were also detectable by ELISA in sera from 9/22 patients with chronic active hepatitis, 1/38 patients with other liver diseases, 3/16 patients with syphilis, 2/16 patients with non-hepatic autoimmune diseases and 0/29 normal blood donors; of these, only 2 chronic active hepatitis sera were positive for AMA by immunofluorescence. The ELISA titre was significantly correlated with the mitochondrial binding index determined at a serum dilution of 1:200 (r = 0.793; P less than 0.01), allowing an estimate of antibody titre to be made from ELISA screening at this single serum dilution. This assay, which is simple and reproducible, may be of value as an objective method of screening for AMA. PMID- 6491310 TI - Centrifugation of normal and rheumatoid arthritis blood on Ficoll-Hypaque and Ficoll-Nycodenz solutions. AB - Attempts to use the rapid single-step Ficoll-Hypaque centrifugation procedure for the purification of mononuclear and polymorphonuclear leucocytes from the blood of normal individuals and rheumatoid arthritis patients have sometimes been unsuccessful, largely because the erythrocytes would not sediment through the centrifugation medium. Re-evaluation of the factors (e.g. Ficoll concentration, temperature, and ratio of the diatrizoate salts) which affect these separations showed that under our conditions it was advantageous to use a medium with a lower viscosity (Ficoll concentration) and/or a higher osmotic strength (increased sodium diatrizoate: meglumine diatrizoate) than had been recommended previously (Ferrante and Thong, 1978; 1980; Ferrante et al., 1982). Higher osmotic strength media must be used for separating the components of blood from rheumatoid arthritis patients than from normal individuals because rheumatoid arthritis erythrocytes have a lower buoyant density than normal erythrocytes. PMID- 6491311 TI - Complement and its fractions (C3-C4) pattern in subjects with neoplasia. AB - The total complement (CH50) and its fractions C3 and C4 have been assayed for up to two years after surgery in subjects with breast, gastric and colon-rectum carcinomas. In all three types of pathology a constant pattern has been observed. Before surgery the CH50 stayed below the normal range but was increased following surgery. After a month it was again within the normal range and subsequently, according to the clinical evolution of the disease, it remained normal in those patients without relapse or any apparent metastasis, whereas in those patients who displayed metastasis and/or approached the terminal phase it fell below the normal range. The C3 fraction followed the CH50 pattern whereas the C4 did not show any variation correlated with the stages of the disease. PMID- 6491312 TI - Effects of cytochalasins on lymphocytes: some distinctive features of cytochalasin-E. AB - Cytochalasin-E (CE) has specific properties that distinguishes it from other cytochalasin congeners. We have taken advantage of these in investigating the mechanisms operative in the effects of cytochalasins on lymphocyte proliferative responses to phytomitogens. Like the other cytochalasins, CE inhibits these responses only when present during the early phases of exposure of lymphocytes to mitogens, but not when added later on. The effects of CE are irreversible since prior incubation of lymphocyte in CE renders them incapable of response. Unlike the effects of cytochalasin A, the only other irreversibly active congener, lymphocytes preincubated in CE completely recover the ability to respond if they are cultured in cytochalasin-free medium for 48 hours. Unlike cytochalasins A and B, cytochalasin-E does not inhibit glucose transport into lymphocytes and all. We have shown that human lymphocytes bind cytochalasins at 3 distinct classes of sites named L, M, and H (J. Biol. Chem. 256:1290-1300, 1981). CE binds irreversibly to the L and H-sites on the short to medium term but does not bind to the glucose displaceable M-site at all. CE may have potential usefulness as affinity label towards isolation of specific binding sites since the chemical structure offers feasible approaches towards isotopic labelling. PMID- 6491313 TI - Plasma lipoprotein lipase activity in ganja smokers. PMID- 6491314 TI - Clinical and radiological aspects of chronic diarrhoeas. PMID- 6491315 TI - Early and delayed cholecystectomies in acute cholecystitis. PMID- 6491316 TI - Silicosis in stone-cutters in Kashmir. PMID- 6491317 TI - A suggested method of fixation in supracondylar fracture. PMID- 6491318 TI - Carcinoma of rectosigmoid junction in a young child. PMID- 6491319 TI - Supernumerary testis with torsion. PMID- 6491320 TI - Pancoast's tumour. PMID- 6491322 TI - Amelia with exomphalos major. PMID- 6491321 TI - Lymphocytoma cutis with meningeal involvement. PMID- 6491323 TI - Embryonal rhabdomyosarcoma of the face. PMID- 6491324 TI - Transient paraplegia following sudden lowering of blood pressure. PMID- 6491325 TI - Carcinoma of ovary. PMID- 6491326 TI - Short term chemotherapy of tuberculosis. PMID- 6491327 TI - Cimetidine in gastric ulcer: a note of caution. PMID- 6491328 TI - Parsplana vitrectomy. PMID- 6491329 TI - Medical education in India in a mess. PMID- 6491330 TI - Prognostic evaluation of CSF lactic acid in cases of meningitis. PMID- 6491331 TI - A study of seropositive syphilitic cases during pregnancy. PMID- 6491332 TI - A study of second malignant neoplasm. PMID- 6491333 TI - Caesarean section (present and past). PMID- 6491334 TI - Incidence of shigellosis among paediatric diarrhoeal disorders (a bacteriological study). PMID- 6491335 TI - Immunological status in acute viral hepatitis and fulminant hepatic failure. PMID- 6491336 TI - Ganglion: a critical review of management. PMID- 6491337 TI - An unusual presentation of osteoid osteoma. PMID- 6491338 TI - Renal glycosuria (a family study). PMID- 6491339 TI - Tolbutamide photosensitivity. PMID- 6491340 TI - Cerebral cysticercosis. PMID- 6491341 TI - Psychiatric symptoms in carcinoid syndrome. PMID- 6491343 TI - General surgery--a shrinking specialty. PMID- 6491342 TI - Choledochoascariasis causing radiological fallacy. PMID- 6491344 TI - [Tumors of the upper urinary tract. Analysis of a series of 85 cases]. AB - Case-reports of 85 patients with upper urinary tract tumors were reviewed. Mainly affected were males (87% of cases), particularly over 60 years of age, the principal presenting sign being hematuria. Other signs such as renal colic, lumbago or infections were observed more rarely. The renal pelvis was affected in 52 of the 85 patients (two of these were bilateral), multiple tumor foci being present in only 6 cases. Most tumors were epitheliomas (62 papillary and 13 non papillary), with 52 of these at the superficial stage (0 or A), 21 at stage B 1 and 5 at stage B II or C. Based on Broders' classification, 48 were grade II and 16 grade III tumors. Prognosis was routinely poor in 5 patients with a stage B or C tumor and lymph node extension. Diagnosis is by intravenous urography, although retrograde ureteropyelography has its place, with increasing interest being given to ultrasound and computed tomography examinations combined with routine cystoscopy. If no particular contraindications exist, the preferred treatment is a total one-stage nephro-ureterectomy without curettage (52 cases), although curettage was performed at the same time in 9 other patients. Conservative surgery has only a limited application: 6 patients had segmental resections of the ureter and 2 patients underwent tumorectomy. Postoperative mortality was particularly loco: 4 patients (4,7%), mainly from vascular or respiratory diseases. (4,7%), mainly from vascular or respiratory diseases. Bone (5 cases), pulmonary (3 cases) and medullary (1 case) metastases represented the main cause of death during the year following surgery, all these patients having infiltrating tumors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491345 TI - [Medical treatment of cystine lithiasis in children]. AB - Prophylactic measures or dissolution by medical therapy was used to treat bladder cystine stones in 14 children over about a 10-year period. All patients received alpha-MPG (alpha-mercaptopropionylglycine) except one child allergic to alpha-MPG who was treated with DNP (D-penicillamine). In 10 patients the treatment was administered 11 times to dissolve the stones, with resulting total dissolution in 6 cases, partial removal in one case. Two patients are still under treatment and 2 cases failed to respond. Among the 12 patients receiving preventive therapy, only 2 cases were reported as developing recurrences, due in fact to irregular taking of medication. Lytic treatment proceeded without any particular problems, and results were more than satisfactory, but for preventive therapy the difficulty resides in its application and duration when confronted with the serious and frequent danger of a relapse. PMID- 6491346 TI - [Treatment of urinary stress incontinence by transvaginal suspension of the bladder neck. Peyreyra-Raz technic]. AB - Results are reported of the use of the technique of suspension of paravaginal tissue from either side of the neck of the bladder to treat female stress incontinence. Conducted almost exclusively through the vaginal route, an inversed incision in U allows dissection of the total retropubic space and pre-urethral bladder neck adhesions from any previous surgery, and the passage of a solidly implanted non-absorbable thread from one side of the suprapubic incision involving skin and subcutaneous tissue is made down to the aponeurosis alone. A special long needle is then passed from above downwards from the lateral extremity of the suprapubic incision to the vaginal incision and the two ends of the non-absorbable thread clamped. One of the advantages of the retropubic dissection is the guidance of this needle without the risk of perforation of the bladder or urethra. The ends of the thread are brought from the vaginal incision to the lateral angles of the hypogastric wound and tied together or over a small square of Teflon. The tension of the thread is such that it will just allow ascension of the posterior lip of the neck. This ascension, as well as the absence of any vesico-urethral perforation, and the permeability of the ureteral meatuses is verified by endoscopy. The very wide safety margin inherent in this procedure is shown by the 96% of perfect results in patients not previously operated upon, and the 94% of successes in those operated upon previously on one or several occasions without practically any complications. These findings suggest that this technique should occupy a place of choice in the treatment of urinary stress incontinence in women. PMID- 6491347 TI - [Surgical treatment of total urinary incontinence based on Leadbetter's technic]. AB - Ten patients (4 boys and 1 girl, 4 adult women and 1 man) were operated upon for incontinence due to epispadias (5 children and 2 women), or the result of multiple operations for stress incontinence (2 women), or of a transurethral bladder neck resection (the adult man), using Leadbetter's technique, which is described. In 4 patients with a sufficiently long trigonum, it was not considered necessary to perform ureterovesical reimplantation. Interesting results were obtained as they were assessed as very good in 4 and good in 2 of the 7 cases of epispadias, good in 1 of the 2 cases of sphincter lesions following surgery, and poor after endoscopic resection of the bladder neck in the man. All patients retained a normal upper urinary tract. In those patients who became continent, the new urethra measured 3.3 to 5 cm in length, whereas it was too short and dilated in cases remaining incontinent. Initial pollakiuria improved in the children after several months. These findings suggest that the ureter should be reimplanted in all cases, to allow the formation of a muscular, newly formed urethra of sufficient length. This operation appears to be effective for treating incontinence due to epispadias and traumatic sphincter lesions in women. It gives poor results in incontinence after prostate surgery and from neurological bladder. Reeducation of the child is as important as selection of patients for operation and a strict operative technique. PMID- 6491348 TI - [Cystic form of kidney cancer. Apropos of a case]. AB - The authors report a case of cystic form of carcinoma of the kidney in a patient who also had a bladder tumour which could have explained the presenting symptom of haematuria. It was the discordance between echotomography and CT scan findings which led the authors to explore the patient surgically. A reassuring result of a frozen section biopsy led to partial nephrectomy even though the cystic mass had thick walls and serosanguinous contents. The actual diagnosis was corrected within 24 hours by the histopathologists who reported a clear cell renal carcinoma. The authors performed an extended nephrectomy which revealed the presence of some malignant cells in the remaining renal fragment. They take this opportunity to review the general problem of the association of carcinoma of the kidney and renal cyst. This case shows how hazardous may be the answer given from frozen section biopsy of a cystic mass in the kidney and how dangerous it is to perform a partial nephrectomy which may leave tumour tissue in place. PMID- 6491349 TI - [A case of pseudopriapism: pericavernous hematoma of the penis]. AB - A case is reported of a hematoma developing between the tunica albuginea of the cavernous bodies and the deep fascia of the penis, following traumatic avulsion of the region of insertion of the adductor muscles of the right lower limb. The interesting feature of this case, a type apparently not reported previously, was the suggested differential diagnosis of early priapism. PMID- 6491350 TI - Ileal conduit urinary diversion in children. A long term follow-up. AB - In recent years ileal conduit diversion for children with neuropathic bladders secondary to myelomeningocele has been performed less frequently than previously, mainly because of reports of long term upper tract deterioration in these patients. The results of this series of 144 ileal conduit urinary diversions show that in the 85 children diverted for more than ten years, there has been improvement or preservation of their upper tracts in 80%. This compares favourably with the results of a recently reported series of colonic conduit diversions and consequently we feel that there is still a place for ileal conduit diversion in this group of patients. The early and late complications are described and means of minimising these are discussed. PMID- 6491351 TI - [Bladder wall urethroplasty in the treatment of urinary incontinence caused by congenital cervico-urethral malformations]. AB - Twelve patients with urinary incontinence from congenital cervico-urethral malformations were treated by bladder wall urethroplasty. Operation was that of Leadbetter (16 times) or Tanagho (twice) type. Results were satisfactory in 5 patients, poor in the other 7 cases: 6 children required endoscopic resection of the neck malformation to improve bladder retention, but this failed to provoke deterioration of the acquired continence. The relevant literature is reviewed, the commonest techniques mentioned, and factors affecting results analyzed. Essential factors appear to be the state of the bladder, the contractility of the bladder tissue used for urethroplasty, and residual bladder capacity which depends on initial capacity. Final evaluation of efficacy of treatment requires long-term follow up, continence sometimes improving at puberty. PMID- 6491352 TI - Urethral carcinoma after cystectomy: the case for routine urethrectomy. AB - Eight out of 73 men developed urethral carcinoma after cystectomy and died within 26 months. Of the patients at risk, the calculated incidence of urethral tumour was 2.7 per cent per annum. Prophylactic urethrectomy is recommended for all patients having cystectomy for carcinoma, whatever type of tumour they have. In men without urethral involvement it may be delayed until they have recovered fully from cystectomy. The whole length of the urethra should always be removed, including the fossa navicularis. PMID- 6491353 TI - [Diagnosis and emergency treatment of traumatic rupture of the male urethra in pelvic fractures. Apropos of 14 cases]. AB - Fourteen of 400 cases of fractured pelvis had rupture of the urethra and, unfortunately, an exploratory catheter was introduced in nearly all these patients. Routine radiological investigations were not conducted, and true emergency surgical repair was performed in only 3 cases, all of these three patients obtaining good urethral permeability. Analysis of data on recently published cases and from the present series shows that opposing views are still held by those who support immediate, emergency (true or deferred) end-to-end suture of the urethra, and those who advocate simple suprapubic drainage of the bladder or "realignment" of the urethra over an indwelling catheter with or without a direct approach to the site of rupture. However, carefully executed immediate end-to-end suture gives better results than other methods, and also considerably reduces duration of hospital stay and incapacity for work. PMID- 6491354 TI - [Recent urethral rupture. From diagnosis to treatment]. AB - A retrospective study of 30 cases of rupture of the urethra treated over a period of 12 years showed that the membranous urethra was involved in 25 patients. Cases of partial rupture of the anterior urethra treated by transient urine bypass were excluded from the study. As a result of the only moderate results obtained before 1977, the following therapy was instituted for ruptures of the posterior urethra after that date: immediate insertion of a suprapubic bladder drain (percutaneous or surgical); visualization of bladder and urethra on the 5th day using the bladder catheter and retrograde urethrography; deferred emergency repair operation towards the 8th or 10th day for cases with a stable pelvis and absent vital lesions; delayed repair during the 3rd month for the other cases. Results were evaluated as good with respect to urethral permeability in 3 of the 6 cases of emergency repair, 10 of 12 patients receiving deferred emergency surgery and 11 of 12 cases of delayed operation. Only two cases of sexual impotency were noted among the last ten cases treated. The obvious procedure to be adopted whenever possible is therefore an end-to-end urethrography as a deferred emergency operation. PMID- 6491355 TI - [Cutaneous transuretero-ureterostomy or cutaneous Y-ureterostomy. Apropos of 14 cases]. AB - Cutaneous transureterostomy was performed in 14 patients, this bypass procedure being necessary in 9 cases for neoplasm (7 after total cystectomy) and in 5 patients for non-neoplastic lesions. The simplicity of this method is emphasized, particularly when compared with Bricker's operation, beneficial effects with respect to the comfort of the patient being similar. However, at least one ureter must be dilated: one failure of treatment was due to narrow ureters and a repeat operation was necessary to exteriorize each ureter on to the skin. The essential problem concerns the skin stoma, if an apparatus is to be fitted without a catheter. In 8 of 12 patients the cutaneous ureterostomy remained patent without artificial assistance. Two operated cases required ureteral catheters, while two others had prosthetic replacement of the foot of the ureterostomy in Y. One patient died after cystectomy for cancer. A new cutaneous and aponeurotic reconstructive mode appears capable of guaranteeing more consistent results. PMID- 6491356 TI - [Is the improvement of survival in advanced bladder cancer possible?]. AB - A retrospective study included 41 cases of bladder cancer, with deep invasion of the muscles (C) or perivesicular cellular tissue (D), but without detectable metastases, treated curatively by total cystectomy. Comparison was made between a first group of 19 patients not treated by cellulolymphadenectomy and another group of 22 patients in whom curettage was performed to remove cells and nodes and who also received 2 concentrated radiations of 7-5 Gy of telecobalt to the bladder during the immediate pre-operative period. Only 10 patients in the latter group were given routine postoperative chemotherapy. Postoperative mortality was unaltered (10,5% in the first group and 9% in the second), but postoperative survival was markedly affected: 10,5% after 5 years in the first group as against 41% in the second. Five-year life expectancy was therefore increased by a factor of 4 in spite of 9 N+ cancers. In the 2nd group of 19 patients operated upon and regularly followed up 3 years and more 7 are alive. True 5 year survival rate in the 2nd group was therefore 35% as against 10% in the first group. Note that 2 of the 9 N+ patients are alive after 3 years. Aggressive therapy in the 2nd group also drastically reduced pelvic recurrence rate, which dropped from 8 (42,1%) in the first group to 1 (4,5%) in the second. In contrast, the major cause of death (7 cases = 31,8%) in the 2nd series was the development of metastases, without evidence of any pelvic recurrence. The effect of routine chemotherapy is being investigated. PMID- 6491357 TI - Emphysematous cystitis. AB - Emphysematous cystitis is a rare clinical entity. The most commonly afflicted patients are immunocompromised and have urinary retention. Most patients appear to have diabetes mellitus. Treatments consist of establishing bladder drainage and administering broad spectrum antibiotics. Successful treatment is based on early diagnosis and prompt treatment. PMID- 6491358 TI - [Value of Whitaker's test in children for the diagnosis of an upper urinary tract obstruction]. AB - Upper urinary tract pressure was measured during constant rate perfusion (10 ml/min in children and 5 ml/min in infants), and with the bladder maintained empty by an indwelling catheter. Pressure was measured simultaneously in the bladder and upper urinary tract when bladder hypertonia was suspected, determination of bladder pressure being of particular importance in patients with moderately elevated endopyelic pressure. The term differential pressure is used to denote the value obtained by subtracting endovesical from pyelic pressure. A value less than 12 cm of differential pressure is considered as being normal, one of 20 cm as markedly elevated, and those between 12 and 20 cm as of doubtful significance. Whitaker test was performed in 27 patients, with practically no complications. Differential pressure was normal in 21 cases. The short-term maximum 1 year follow-up course in the most chronic cases was radiologically and functionally stable, without signs of worsening of the disorder. Five of the 6 cases with elevated pressure readings were operated upon. The value of isotopic exploration in cases with unaltered renal function is unquestioned, but direct measurement of upper urinary tract pressure is a valid procedure in difficult cases. PMID- 6491359 TI - [Ultrastructural modifications of the tunica muscularis in congenital obstruction of the upper urinary tract. Physiopathological interpretations and anatomo clinical correlations]. AB - Upper excretory pathway musculature was studied by electron microscopy, both at the level of the obstruction and proximally. Two types of lesion were investigated: pyelo-ureteral junction anomalies and primary obstructive mega ureter. Two types of muscle cell are recognized in the excretory pathway walls, typical and atypical cells, the latter being considered as possessing pace-maker activity and constituting almost total population of muscles of calices and pelvis. However, they were few in number in the pyelo-ureteral region and were practically absent from the ureter. Various conclusions can be drawn from the findings in this study. Both typical and atypical cells are modified in the obstructed upper excretory pathways. Ultrastructural appearances of lesions are identical at the site of an proximal to the obstruction. Modifications in these cells were: a rich sarcoplasmic reticulum, an increase in number of mitochondria and glycogen particles, disorganized distribution of contractile or cytoskeletal filaments, altered contact zones between contiguous smooth muscle cells, increased richness of granular endoplasmic reticulum and excessive development of the Golgi apparatus. More chronic lesions show enhanced fibrosis with reduced muscle contractility, the fibrosis affecting mainly elastic fibers in young patients and collagen fibers in more elderly subjects. The development of fibrosis may be due to changes in the granular endoplasmic reticulum and the Golgi apparatus. From the practical point of view, increase in fibrosis with duration of course of obstruction is an argument for as early as possible surgical intervention. PMID- 6491360 TI - [Treatment of urinary incontinence of neurologic origin in children and adolescents]. AB - Recent advances in the treatment of urinary incontinence of neurological origin in children are discussed. The etiology of the neurological changes is mainly congenital (myelomeningocele, sacral agenesis and hidden dysraphism) other causes such as myelitis, radiculitis or cord injuries being very rarely observed. Two fundamental elements can be evaluated by radiologic and urodynamic investigations of the lower urinary tract: the capacity for compliance of the detrusor muscle and the degree of cervico-urethral resistance. The presence of a cervico-urethral obstruction is no longer an indication for its removal but, on the contrary, a factor that can be retained to assist continence. Intermittent use of self catheterization enables the obstruction to be used to obtain continence (dryness) and makes the obstruction innocuous, since it enables emptying of the bladder. Of 50 patients (26 girls and 24 boys) treated in this way, 11 were not seen again, but the other 39 are still being followed up after an average of 50 months. This method of bladder emptying maintains the integrity of the upper urinary tract when this was normal previously and improves uretero-pyelo-caliceal distension. Uretero-vesical reimplantation can prevent reflux. Of these 39 children, 23 are continent during the day and 13 among them during the night also. A colocystoplasty was performed in 3 cases to enlarge the bladder capacity. The use of a catheter is well accepted by the girls and young boys but less so by the male adolescents. In the absence of a cervico-urethral obstruction it is impossible to relieve incontinence by re-education, and only three solutions exist: high cutaneous diversion continent cystostomy and artificial sphincter. The high diversion operation should be used as a last resort only. The continent cystostomy uses an appendix isolated on its mesothelium an opening on the abdominal wall and into the bladder in a long anti-reflux tunnel. Catheterization is by a catheter which passes through the newly formed ureter and enables the bladder to be siphoned dry four times daily. This method was used in 25 patients but many complications developed, including febrile attacks with dilatation of the upper urinary tract due to too small a bladder under increased pressure (an enlarging colocystoplasty was required). Eight other children continued to have urine loss through the urethra and required repeated closure of the bladder neck, and one child developed a bladder stone.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491361 TI - Nitrogen mustard (mechlorethamine) and UVB photocarcinogenesis: a dose response effect. AB - The effects of UVB energy and nitrogen mustard (mechlorethamine, HN2) on tumor formation in the hairless mouse skin was examined. Twice weekly applications of HN2 produced tumors in 34% of the mice. In addition, the HN2 treatments plus UVB radiation resulted in a significant acceleration in tumor formation as compared to either carcinogenic stimulus alone. The twice weekly application of HN2 plus UVB exposure was more tumorigenic than UVB plus HN2 applied once a week. Thus a positive carcinogenic dose response was noted. No tumor-suppressing effects were detected in this study. PMID- 6491362 TI - Selective cultivation of human melanocytes from newborn and adult epidermis. AB - Development of adequate culture systems for the human epidermal melanocyte is critical to further advances in pigment cell biology. We now report selective growth and long-term maintenance of melanocytes derived from both newborn and adult skin specimens. Disaggregated epidermal cell suspensions were plated in a hormone-supplemented medium containing cholera toxin and a hypothalamic extract treated to remove keratinocyte growth-promoting activity. After 3-4 weeks, pure melanocyte populations could be harvested and serially passaged up to 6 times over several months for a total of 10 or more cumulative population doublings in vitro. Electron microscopic studies revealed metabolically active cells with abundant melanosomes in various stages of melanization throughout the culture lifespan. Differences in size and number of melanosomes attributable to race of the tissue donor were readily apparent, and pigment content of melanocytes from both black and Caucasian donors appeared to increase with time in culture. Newborn melanocytes proliferated more rapidly and survived longer than did adult melanocytes, but there were no consistent morphologic differences as a function of donor age. Comparison of growth potential for the 3 major skin-derived cell types in this hormone-supplemented medium revealed striking specificity for melanocytes, with total elimination of keratinocytes over 1-2 weeks, and no fibroblast proliferation whatever in the absence of serum supplementation. This system promises to facilitate in vitro investigation of epidermal melanocytes in normal and diseased human skin. PMID- 6491363 TI - Rocky Mountain spotted fever: epidemiological and early clinical signs are keys to treatment and reduced mortality. PMID- 6491364 TI - Epidemiology of Rocky Mountain spotted fever as determined by active surveillance. AB - Prospective, active surveillance for Rocky Mountain Spotted fever (RMSF) was undertaken in two North Carolina counties for the years 1979-1981. Appropriate age, sex, and geographically matched controls were compared with the serologically confirmed cases of disease. Patients who were suspected of having infection, but were shown not to have RMSF, were also compared with the serologically proven cases. Ninety-eight cases were identified, and three of these patients died. The mean annual incidence of RMSF in these two counties was 14.59 cases/100,000 population. Identified cases occurred between the months of March and September. The overall mean annual incidence for men was 19.65/100,000 and for women 10.3/100,000. The study suggests that persons contracting RMSF are exposed to the vectors at their residences, which tend to be detached dwellings in woody, brushy areas. Children are more likely than adults both to be seen by physicians early in the illness and to be checked for ticks. Eighty-four percent of patients with serologically confirmed cases developed a rash. The epidemiology of RMSF in these two endemic counties is described. PMID- 6491365 TI - Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases. AB - Most previous reports of Rocky Mountain spotted fever (RMSF) have included cases either not laboratory confirmed or confirmed by relatively weak diagnostic criteria. In the present study detailed epidemiological, clinical, and laboratory features of 262 confirmed or highly probable cases of RMSF reported from six states from 1977 to 1980 were analyzed. This analysis revealed that early clinical diagnosis of RMSF is difficult because the illness may have a gradual or an abrupt onset, the symptoms and signs may be unusual in timing or frequency, and the clinical appearance may vary depending on such factors as age and location of residence. RMSF was diagnosed later in those who died than in survivors, primarily because of atypical initial symptoms and the late onset of rash. RMSF should be considered in any individual who, during the spring and summer, has been in RMSF-endemic areas and develops a fever, regardless of the absence of rash or history of tick exposure. PMID- 6491366 TI - Plasmid transfer into members of the family Legionellaceae. AB - The plasmids RP4 and pPH1JI::Mu::Tn5 were transferred with moderate frequency from Escherichia coli to Legionella pneumophila (strain Bloomington 2) and Fluoribacter (Legionella) bozemanae (strain WIGA). The frequency of transfer to Tatlockia (Legionella) micdadei (strain Tatlock) was much lower. In these transconjugant strains the plasmids were maintained following at least 10 nonselective passages. However, the introduced plasmids could not be transferred from these strains to several other strains of Legionella or Tatlockia with a detectable frequency, yet they could be transferred to a restriction-modification deficient (rm-) E. coli strain with moderate frequency. This suggests not only that the expression of transfer genes may be repressed but that the legionellae are poorer recipients than are the rm- E. coli. PMID- 6491367 TI - Foreign body infection: role of fibronectin as a ligand for the adherence of Staphylococcus aureus. AB - Foreign bodies made of polymethylmethacrylate coverslips were implanted subcutaneously into guinea pigs, were explanted four weeks later, and were tested for in vitro adherence of Staphylococcus aureus strain Wood 46. In the presence of serum, the level of staphylococcal adherence to explanted coverslips was 20 times higher than that of adherence to unimplanted coverslips. Adherence to explanted coverslips was caused by fibronectin deposits on the foreign body surface and was inhibited in a dose-related fashion by specific antibodies to fibronectin. PMID- 6491368 TI - Demonstration of differences between strains of Staphylococcus aureus by peptidoglycan fingerprinting. AB - Lysis of peptidoglycans of Staphylococcus aureus yields products that exhibit strain-specific patterns on analysis by thin-layer chromatography and polyacrylamide gel electrophoresis. The patterns are demonstrated when products of the endogenous autolysins are examined and are enhanced and/or altered by the use of exogenous murolytic enzymes. These fingerprinting techniques were applied to the study of 55 strains of S. aureus. Twenty-six strains were from patients in five localized hospital outbreaks, and 29 were obtained randomly from individual patients. With only two exceptions all strains from a given outbreak had an identical murolytic pattern, whereas the random strains showed variable patterns. Peptidoglycan fingerprinting may be an adjunct tool for the hospital epidemiologist and may also be valuable for the study of certain biologic aspects of interstrain differences. PMID- 6491369 TI - Surveillance of Rocky Mountain spotted fever in the United States, 1981-1983. AB - Surveillance of Rocky Mountain spotted fever (RMSF) in the United States has revealed a stable incidence of the disease from 1981 to 1983, with a median of 0.48 cases/100,000 population per year (range, 0.42-0.52). During this three-year period an increase in both the number and the percentage of total cases reported from the West South Central states was observed when compared with previous three year periods. An expanded case report form, which was introduced in 1981 for use by state health departments, was received for 2,850 (87%) of the 3,294 cases reported in 1981-1983. Of these 2850 cases, 1375 (48%) were laboratory confirmed. Death from RMSF was more common in persons greater than or equal to 30 years of age (case-fatality ratio of 8.4%) than in persons less than 30 years (2.2%, P less than .001). Fatality was also associated with failure to obtain a history of a tick bite within 14 days before onset of illness (P less than .05) and with lack of treatment with tetracycline or chloramphenicol (P less than .01). PMID- 6491370 TI - Intralesional administration of large doses of human leukocyte interferon for the treatment of condylomata acuminata. PMID- 6491371 TI - Failure to detect endotoxin in sera from patients with Lyme disease. PMID- 6491372 TI - Possible prevention of tick-borne relapsing fever in patients infected with Borrelia recurrentis. PMID- 6491373 TI - Leukonychia partialis in Kawasaki disease. PMID- 6491374 TI - Antigenic relatedness of human enteric coronavirus strains to human coronavirus OC43: a preliminary report. PMID- 6491375 TI - The presence of curved anaerobic bacteria in nonspecific vaginosis. PMID- 6491376 TI - The biochemistry of opsonization: central role of the reactive thiolester of the third component of complement. AB - In these studies, we have defined the mechanism by which the opsonic fragment of the third component of complement (C3) binds to pathogenic bacteria. With use of purified human C3 to reconstitute the alternative pathway in human serum in which both C3 and C4 had been chemically inactivated, we showed that opsonization of pathogenic serotypes of Streptococcus pneumoniae (serotypes 3, 4, 6A, 14, and 18C) requires the reactive thiolester of native C3. When purified human C3 (thiolester intact) is added to serum deficient in C3 and C4, phagocytic uptake of 3H-labeled pneumococci by polymorphonuclear leukocytes from normal adults is fully reconstituted. However, hydrolysis of the thiolester or reaction of the thiolester with the inhibitor methylamine abolishes opsonization and phagocytosis. Finally, by characterizing those C3 fragments released from pneumococcal surfaces after treatment with 1.0 M hydroxylamine, we have defined a role for covalent-bond formation in the opsonic interaction. Therefore, the presence of the reactive thiolester of C3 is an absolute requirement for the opsonic and covalent binding of the C3b molecule to pathogenic bacteria. PMID- 6491378 TI - Occurrence of AUSAB test positivity unrelated to prior exposure to hepatitis B virus. AB - Positive AUSAB test results in the absence of all other serological markers for hepatitis B have been seen frequently in serial serum specimens from quarantined chimpanzees. In this study the responsible reactant was found to be similar to IgM in terms of both size and charge. After the inoculation of hepatitis B virus, AUSAB-positive and AUSAB-negative chimpanzees were found to be equally susceptible to hepatitis B infection. Thus, the presence of this reactant did not confer immunity to hepatitis B or modulate the course of the disease. At present, hepatitis B virus-seronegative chimpanzees are excluded from use in research on hepatitis B because of the occurrence of this "false-positive" AUSAB test result. It is likely that humans may be denied active or passive immunization for similar reasons. PMID- 6491377 TI - Antibody responses to toxic-shock-syndrome (TSS) toxin by patients with TSS and by healthy staphylococcal carriers. AB - Serum samples taken from women with toxic-shock syndrome (TSS) and from women without a history of TSS were examined for the presence of antibodies to toxic shock-syndrome toxin (TST). Serum samples from 38 women with TSS and from 70 women with no history of TSS were analyzed by radioimmunoassay (RIA) and by an enzyme-linked immunoadsorbent assay (ELISA). Antitoxin titers obtained by the assays were highly correlated. Antibody levels in sera of women with TSS, or a history of TSS, were significantly lower than levels in sera of women with no prior evidence of TSS. The mean level of antitoxin titers in the total sample of acute, convalescent, and recovered TSS groups was significantly lower than that of the control groups, which consisted of 31 carriers of genital Staphylococcus aureus and a similar number of age- and race-matched noncarriers. Although a trend toward elevated antitoxin titers was apparent after recovery, no vigorous immunologic response to TST was noted. In contrast, the majority of healthy women demonstrated measurable antitoxin titers, a finding indicative of current or prior colonization with TST-producing strains of S. aureus. The data suggest that absence of antibodies to the TSS toxin may be a predisposing factor in the development of clinical disease. PMID- 6491379 TI - Production of experimental endocarditis by coagulase-negative staphylococci: variability in species virulence. AB - The abilities of 11 coagulase-negative staphylococcal isolates of human origin to establish infective endocarditis in a rat model were compared. Seven of the strains were Staphylococcus epidermidis, the species most commonly causing endocarditis in humans. The other four strains were Staphylococcus hominis, an infrequent cause of endocarditis. Four of the seven strains of S. epidermidis and two of the four strains of S. hominis elaborated surface slime. With an inoculum of 10(7) colony-forming units, endocarditis was established in all of 77 rats injected with S. epidermidis but in only five (12.5%) of 40 animals injected with S. hominis (P less than .001). Strains of S. epidermidis were significantly more resistant to phagocytic killing in vitro than were strains of S. hominis. These data indicate that there are major differences in the virulence of various species of coagulase-negative staphylococci, both in vivo and in vitro, and that these differences are reflected in the observed incidence of disease caused in humans by the respective species. PMID- 6491380 TI - Enteric lesions and diarrhea in gnotobiotic calves monoinfected with Cryptosporidium species. AB - The pathogenicity of Cryptosporidium species was studied by inoculation of two gnotobiotic calves with cryptosporidial oocysts that had been decontaminated by treatment with peracetic acid. Two control calves were inoculated with similar material from which the oocysts had been removed by filtration. Oocyst-inoculated animals shed Cryptosporidium in their feces and developed depression, weakness, anorexia, and diarrhea. At necropsy five days after inoculation, endogeneous stages of Cryptosporidium were found in association with epithelial cells throughout the small and large intestines of these animals. The parasites were most numerous in the lower small intestine. Atrophic villi, disordered and degenerate villous epithelium, and hyperplastic crypt epithelium were associated with infection in the small intestine. Control animals remained normal. Extraneous agents were not detected in any of the calves. The results indicate that Cryptosporidium can destroy intestinal epithelial cells and cause diarrhea in monoinfected gnotobiotic calves. PMID- 6491381 TI - In vitro activity of various cephalosporins against Pseudomonas pseudomallei. PMID- 6491382 TI - Myositis and rhabdomyolysis due to Staphylococcus aureus septicemia. PMID- 6491383 TI - Rapidity of booster response to rabies vaccine produced in cell culture. PMID- 6491384 TI - Susceptibility of hospital personnel to varicella-zoster virus. PMID- 6491385 TI - Experimental transmission of the Lyme disease spirochete to rabbits. PMID- 6491386 TI - A comparison of neutralizing and antigen-binding assays for human antibodies against toxic-shock-syndrome toxin 1. PMID- 6491387 TI - Isolation of Campylobacter jejuni from milk during an outbreak of campylobacteriosis. PMID- 6491388 TI - Usefulness of serotyping in the epidemiology of family outbreaks of Campylobacter jejuni. PMID- 6491389 TI - Statement on ethical conduct in research by the Infectious Diseases Society of America. PMID- 6491390 TI - The effect of bone marrow stromal cells on the cloning of human leukemia/lymphoma cell lines. AB - The cloning of established human leukemia and lymphoma cell lines at limiting dilutions in microwells and soft agar is described. Growth of most cell lines was improved by the addition of human AB serum and irradiated human bone marrow stromal cells. In general, the cloning efficiency in microwells was greater than in soft agar. The effect of bone marrow stromal cells appeared to be caused by a diffusable factor(s), but close cellular interaction could not be excluded since cloning in microwells produced consistent and optimal cell growth compared to growth in soft agar. It was concluded that cloning of leukemia and lymphoma cell lines in microwells was the preferred method and that similar techniques could improve the cloning of fresh leukemia and lymphoma cells. PMID- 6491391 TI - Interference of a human leukocyte interferon preparation with stimulatory activities in leukocyte-conditioned medium for human hematopoietic stem cells. AB - Medium conditioned by leukocytes in the presence of phytohemagglutinin (PHA-LCM) promotes the growth of multilineage hemopoietic progenitors derived from human bone marrow. However, PHA-LCM prepared in the presence of a human leukocyte interferon preparation does not support mixed colony formation. Crude PHA-LCM preparations were characterized by gel filtration, affinity chromatography, and gel electrophoresis. The elution profile on Sephacryl S-300 of PHA-LCM prepared without interferon showed a distinct peak that stimulated the growth of pluripotent stem cells (CFU-gemm) and committed precursors (CFU-c, BFU-e). Gel filtration of PHA-LCM, prepared with 1000 U/ml of interferon, revealed a change in the elution profile. The eluted material demonstrated no growth-promoting activities. We conclude that the abolished stimulatory activity of PHA-LCM, prepared with human leukocyte interferon, might be due to a reduced production of stimulatory molecules, suggesting that interferon interferes with the molecular events required for colony formation of committed and noncommitted hemopoietic progenitors. PMID- 6491392 TI - Growth and morphological characteristics of vervet monkey bone marrow-derived adherent cells. AB - Monkey bone marrow-derived adherent cells were maintained in culture for six months. Phase contrast and scanning electron microscopy showed two cell shapes: fusiform and polygonal. No difference was observed in the cyto-chemical staining of the two shapes. Both stained positively for alpha-napthyl acetate esterase, acid phosphatase, collagens I and III, and lipids and negatively for peroxidase and factor VIII antigen. A small proportion (1.5%) were alkaline phosphatase positive. An average of 14% of the cells were phagocytic in the primary culture, but this proportion decreased progressively with passage. Fc receptors were not detected, while C3 receptors were detected in 1% of primary cultured cells in primary culture, but were not detected in subcultured cells. Adherent cells were not evident in cultures supplemented with 10 mM ammonium acetate. These findings indicate that monkey marrow-derived adherent cells are fibroblastoid in nature. PMID- 6491393 TI - Complement sensitivity of erythroid and myeloid precursors in paroxysmal in nocturnal hemoglobinuria. AB - To test the hypothesis that paroxysmal nocturnal hemoglobinuria (PNH) is a hematopoietic stem cell disorder, the growth of BFU-e and CFU-gm and the complement sensitivity of cultured cells from BFU-e and CFU-gm colonies, as well as of unipotential progenitor cells (CFU-gm and BFU-e), were examined in five PNH patients. BFU-e growth was reduced in the three patients examined, and poor CFU gm growth was noted in three of the five patients. Compared to normals, BFU-e and CFU-gm colonies in all patients demonstrated an increased susceptibility to the lytic action of complement when the release of 59Fe and myeloperoxidase was measured as specific markers for monitoring membrane damage. Compared to the growth of normal bone marrow cells, CFU-gm growth was significantly inhibited by pretreatment of bone marrow mononuclear cells with monoclonal OKIal antibody and complement. These findings support the proposition that a membrane defect predisposing blood cells to complement-mediated lysis may occur at the level of unipotential progenitor cells. PMID- 6491394 TI - Semisynthetic deoxyharringtonine for treating leukemia in mice and humans. AB - The effects of two varieties of semisynthetic deoxyharringtonine on the tumor mass and survival time of mice with murine leukemia were evaluated. Compared to untreated control mice, the survival time of those with murine leukemia increased by 146% (L7212) and 68% (L615) after treatment. The LD50 for deoxyharringtonine variants DH4.8 and DH was determined to be 322 +/- 9 mg/kg and 71 +/- 1 mg/kg, respectively. Seventeen patients were then treated with either DH or DH4.8; 11% achieved complete remission, 23% achieved partial remission, and an additional 35% had markedly lower leukocyte levels after treatment. Side effects were minimal. It was concluded that deoxyharringtonine is an effective anti-leukemic agent. PMID- 6491395 TI - Genetics of susceptibility of mice to inhibition of interferon induction by benzo (a)-pyrene. AB - Embryonic fibroblasts were prepared from four different strains of mice: DBA/2, noninducible at the Ah locus for aryl hydrocarbon hydroxylase for carcinogen activation and, therefore, relatively resistant to tumor induction; C57BL/6, normal at the Ah locus; SENCAR, mice innately highly sensitive to tumor induction; and ICR, normal controls for SENCAR mice. The fibroblasts were exposed to the carcinogen benzo-(a)-pyrene at varying dosages. Alpha/beta IFN was next induced with poly(I)(C). Interferon production by cells from C57BL/6 mice was severely inhibited. Interferon production by DBA/2 cells was equally susceptible to inhibition by BP as IFN production by C57BL/6 cells, perhaps because of alternative pathways of activation of BP. Interferon production by SENCAR mouse cells was, on the other hand, much more susceptible to inhibition by BP than was IFN production by ICR mouse cells. These results suggest parallels between genetically controlled sensitivity to tumor induction by BP and genetically controlled susceptibility to inhibition of IFN induction by BP. PMID- 6491396 TI - Antigenicity of mouse interferons induced in vitro and in vivo by poly(I).poly(C). AB - Various mouse IFNs induced by poly(I).poly(C) or poly(ICLC) were analyzed for the antigenic types by neutralization tests using anti-IFN-alpha and anti-IFN-beta antibodies. The IFN samples included IFNs produced by L cells, by spleen cells in vitro and ex vivo, and in plasma of mice injected with the inducers. L-cell IFN was estimated to consist of IFN-beta and IFN-alpha at a ratio of about 80:20. Spleen IFNs also consisted of both IFN species, but IFN-alpha was the major component. Blood IFN samples obtained 1-4 h after injection of poly(I).poly(C) or poly(ICLC) consisted of the two molecular species, whereas the samples 8 and 24 h after injection contained only IFN-alpha. High levels of IFN activity (IFN-alpha) persisted much longer in the circulation of mice injected with poly(ICLC) than in mice injected with poly(I).poly(C). PMID- 6491397 TI - Pharmacokinetics of recombinant alpha A interferon following I.V. infusion and bolus, I.M., and P.O. administrations to African green monkeys. AB - The pharmacokinetics of recombinant alpha A interferon (rIFN-alpha A) were studied following an intravenous (iv) bolus, 60 min infusion, intramuscular (im), and oral administrations to four African Green monkeys. Each monkey received 3 X 10(6) units/kg of rIFN-alpha A parenterally and 6 X 10(6) units/kg orally. Blood samples were collected and the serum was separated and analyzed for rIFN-alpha A concentrations by an enzyme immunoassay, ELISA. No significant changes in clinical chemistry values resulted from rIFN-alpha A administration. There were no measurable rIFN-alpha A concentrations (less than 20 pg/ml) following oral administration. Serum rIFN-alpha A concentrations declined rapidly in a biphasic manner following iv bolus and infusion doses and were described by a single pharmacokinetic model. The volume of distribution at steady state (Vdss) ranged from 0.034 to 0.31 l/kg after iv infusion. Total clearance ranged from 4.5 to 19 ml/min, which is about 75% the estimated inulin clearance in monkeys, suggesting glomerular filtration without reabsorption. The elimination half-life ranged from 1.8 to 4.8 h. A prolonged absorption profile was seen following im administration and the systemic bioavailability was 93% when compared with intravenous infusion. The overall disposition of rIFN-alpha A is comparable to the disposition of other interferons in both animals and humans. The monkey appears to be a suitable pharmacokinetic model for the testing of rIFN-alpha A and could be useful in conjunction with a viral efficacy model. PMID- 6491398 TI - Different pharmacokinetics between natural and recombinant human interferon beta in rabbits. AB - The pharmacokinetic behavior of recombinant (r) HuIFN-beta was compared with that of fibroblast-derived HuIFN-beta in rabbits using a pharmacokinetic model analysis with a computer curve-fitting. The observed data were in good agreement with a two-compartment open model in intravenous experiment, and with a one compartment open model in intramuscular and continuous infusion experiments. Although the parameters of elimination phase (beta, Kel or K10) were almost the same in both IFNs, there were significant differences for the parameters (alpha, K12, K21, V1, V2, Vdss) of distribution phase in intravenous experiment and for the parameter (Vd) of the steady-state level in continuous infusion experiment. These results indicate that rHuIFN-beta has a larger distribution volume and a higher distribution rate from the central compartment to the peripheral. The serum levels in intramuscular experiment represented so-called flip-flop type of kinetics. Although the absorption rate from the injection site to the blood circulation was similar in both IFNs, the availability of rHuIFN-beta was higher than that of fibroblast-derived HuIFN-beta. These results suggest that the deficiency of carbohydrate moiety conjugated with IFN molecule may influence the distribution property in vivo. PMID- 6491399 TI - [External conduit operation in infants]. PMID- 6491400 TI - [Surgical treatment of congenital aortic valve stenosis]. PMID- 6491401 TI - [Evaluation of the right ventricular function before and after cardiac surgery in patients with acquired valvular disease by radionuclide cardioangiography]. PMID- 6491402 TI - [Application of moire topography for the evaluation of anterior chest deformities]. PMID- 6491403 TI - [Surgical management of interruption of the aortic arch]. PMID- 6491404 TI - [Myocardial protective effect and negative inotropic effect of verapamil in potassium cardioplegia]. PMID- 6491405 TI - [Fontan procedure for complex heart diseases]. PMID- 6491406 TI - [Studies on plasma catecholamines during cardiopulmonary bypass --with special reference to the effects on children and adults]. PMID- 6491407 TI - [Screening of the donor's blood by measuring the serum guanase level for the prevention of posttransfusion hepatitis in cardiac surgery]. PMID- 6491408 TI - [A case of complete transection of intrathoracic trachea due to blunt chest trauma]. PMID- 6491409 TI - [A successful complete repair of pulmonary atresia with nonconfluent pulmonary arteries in 6-year-old boy]. PMID- 6491410 TI - [Successful surgical treatment of right atrial myxoma in infant]. PMID- 6491411 TI - [Successful repair of left ventricular rupture due to blunt trauma: a case report and review of the literature]. PMID- 6491412 TI - [Non-valved external conduit repair in corrected transposition of the great arteries associated with ventricular septal defect and pulmonary outflow tract obstruction]. PMID- 6491413 TI - [The graph of neonatal and infant mortality rates analyzed by gestational week and live birth weight]. PMID- 6491414 TI - [Fetal therapy]. PMID- 6491415 TI - [Recent trend in diagnosis and treatment of breast cancer]. PMID- 6491416 TI - [Mass population screening for endometrial cancer]. PMID- 6491417 TI - [Evaluation of biochemical tests during pregnancy]. PMID- 6491418 TI - [X-ray CT in the evaluation of gynecologic tumor]. PMID- 6491419 TI - [Surgical complication and its prevention]. PMID- 6491420 TI - [Proceedings of the 36th annual scientific meeting of the Japan Society of Obstetrics and Gynecology. 12-16 May 1984, Sendai, Japan. Abstracts]. PMID- 6491421 TI - [Pathological study of experimental osteoporosis]. AB - Effects of uni- or bi-lateral resection of the sciatic nerve followed by calcium deficiency on the bone structure of the adult male rat were studied and the mechanism of the development of osteoporosis was discussed. After the evaluation of the thickness of the cortex and trabecula of the lower leg bone by X-ray morphometry, the bone was excised, calcium and phosphate contents of the bone were analyzed and histopathological and ultrastructural examinations were made on the calcaneus and the lower leg bone. Reduction of the bone trabecular area and of the thickness of the cortex, a loss of dry weight and of calcium and phosphate contents and decrease in the number of osteoblasts and osteocytes were induced to the bone with sciatic denervation. The ultrastructural changes of the osteogenic cells were also observed. The osteoblasts turned to be smoothly surfaced showing only a few cytoplasmic projections were connected loosely each other. These changes were enhanced by calcium deficiency. We concluded from these results that the disturbance of nerve connection and the calcium deficiency contributed to the development of experimental osteoporosis of rats. PMID- 6491422 TI - [Experimental study of acrylic resin coated gentamicin tablets for local antibiotic therapy]. AB - Gentamicin tablets were prepared and evaluated for local antibiotic therapy. Two types of tablet were used. One, a slow release tablet, was coated with acrylic resin (Eudragit R.S.) and another was non-coated. The release of gentamicin from the coated tablets can be controlled by changing the thickness of the film coating. The thickness of the film coating was adjusted to release gentamicin within three weeks when placed in Ringer's solution. Coated tablets were inserted into the bone marrow of rabbits. Thereafter, daily excretion of gentamicin was measured in the urine for three weeks. Constant excretion of gentamicin was seen for ten to fourteen days, which suggests the release of gentamicin from the bone marrow. Plasma concentrations were very low, thus precluding side effects. Non coated tablets were inserted to the bone marrow by the same method as above. Plasma concentrations of gentamicin peaked in one hour and then rapidly decreased. This pattern is similar to that seen with intramuscular administration. As acrylic resin was non-absorbable material in vivo, the tissue reactions around coated tablets were examined. Histological findings at three weeks, six weeks and six months after insertion, respectively, did not show any severe tissue reactions. The possible use of local therapy by coated antibiotic tablets for bone infections is discussed. PMID- 6491423 TI - [Quantitative study of spinal bone atrophy by computed tomography]. AB - A method of quantitative measurement of vertebral bone mineral content using the computed tomography (CT) number as an index was deviced. Basic and clinical studies were performed and its clinical applicability was evaluated. The CT number of vertebrae was shown to be highly reproducible; thus, the variations of two measurements between 1 and 336 days observed on the same vertebral body of 13 cases were averaged 3.1. By immersing the isolated autopsy lumbar vertebral bodies in water and then removing the air by aspiration the comparison of CT number showed that in vivo condition could be stimulated. The CT number of the cancellous bone examined in this phantom model with such treatment was found to closely correlate with the Ca content. The CT numbers of the cancellous and cortical bone of lumbar vertebral bodies were investigated from 200 subjects and the CT numbers were decreased gradually with age. Furthermore the tendency of the decline in CT number of cancellous bone at ages over 50 was more distinct in females than males, and in the cortical bone the presence of bone spiculae tended to be associated with a higher CT number. The changes with age were noted in the distribution pattern of CT number in the cancellous bones from the same 200 subjects and the possibility that osteoporosis begins at the periphery of cancellous bone was suggested. This method was used clinically for sequential chronological evaluation of the mineralization status of lumbar vertebrae. The situations sometimes develop that it is impossible to continue the evaluation on the specific vertebral body. In such cases, an adjacent lumbar vertebral body could instead as the target. PMID- 6491424 TI - [Growth of the human acetabulum--with a comparison of cartilaginous proliferation in acetabular and triradiate physeal cartilages]. AB - For the purpose of investigation on the human acetabular growth, proliferation of cartilage cells as well as extent and degree of maturation of newly formed trabeculae in both acetabular and triradiate physeal plates were observed. The material consisted of 13 acetabula of the left hip joints from necropsies whose age distribution ranged from the period of neonate to adolescence. The acetabulum was divided into 5 parts by radial lines. Histological sections were then prepared from each of these parts. The growth of the acetabulum was mainly based on the development of the acetabular and triradiate physeal cartilages, and it seemed that the course of newly formed trabeculae from both physeal plates showed centripetally directed arrangement, with convergence upon a point. These trabecular arrangement was most conspicuous in the neonatal period in which active new bone formation progressed. Based on these findings it would be reasonable to consider that the acetabular physeal cartilage takes a large part of increase in depth of the acetabulum, while the triradiate one is mainly responsible for increase in its diameter. From neonatal period to about 1 year of age there was an active growth of both acetabular and triradiate cartilages. With age the growth rate of physeal plates showed a decrease, and there was a tendency to a predominance of triradiate cartilage proliferation over acetabular one. On reaching adolescence cessation of cartilage growth occurred in both physeal plates. PMID- 6491425 TI - [A study on the fatty acid composition of the plasma lipoprotein in patients with fractures]. AB - Although the etiology of post-traumatic fat embolization still remains obscure, various concepts as to the pathophysiology of the syndrome have emerged in recent years. Extensive studies have indicated that trauma and surgical stress cause remarkable alterations in lipid metabolism. In the following study designed to characterize this situation more fully, the author has analyzed the changes of fatty acid composition of triacylglycerol, phospholipid and cholesterol ester in the circulating plasma lipoprotein of the patient with fractures. MATERIALS AND METHODS: Ten patients who sustained one or more fractures without chest injury between age 9 and 79 years and seven healthy human subjects as control were selected for study. Blood samples were withdrawn into EDTA-treated syringes from patients after overnight fast at intervals of 2, 3, 4, 5 and 14 days after injury. Lipoprotein fractions (very low density lipoprotein: VLDL, low density lipoprotein: LDL, high density lipoprotein: HDL, and very high density lipoprotein: VHDL) were prepared by the method of ultracentrifugation. Lipids were extracted from the lipoprotein fractions according to the procedure of Folch. Lipids separation and purification were carried out by one-dimension thin layer chromatography. The purified lipids were methylated with BF3-methanol complex and the fatty acid composition of each lipid fraction was analyzed by gas liquid chromatography. RESULTS: In the blood samples of normal subjects and patients, myristic, palmitic, palmitoleic, stearic, oleic and linoleic acids (C14: 0, C16: 0, C16: 1, C18: 0, C18: 1 and C18: 2) were the principal fatty acids and these fatty acids were all altered after injury except C14: 0 and C18: 2. The distribution of fatty acids in VLDL-TL was especially altered from the 3rd to 5th hospital day. Stearic acid derived from VLDL-PL was decreased and C18: 1 derived from VLDL-TG was increased. Of the ten patients there were greater changes in those with the femoral fracture. In LDL-TL, the distribution of fatty acids was also altered, and C18:1 derived from LDL-TG was increased. In fatty acid composition of HDL-TL, C16: 0 derived from HDL-PL and C18: 1 derived from HDL-TG were increased and C18: 0 derived from HDL-PL was decreased. In fatty acid composition of VHDL-TL, C16: 1 derived from VHDL-TG was increased. PMID- 6491426 TI - [Results of radiation therapy for squamous cell carcinoma of the vulva]. PMID- 6491427 TI - [Increased effect of hypoxic cell radiation sensitizers in combination with BSO, a substance depleting the intracellular radioprotective thiols]. PMID- 6491428 TI - [Clinical studies on effective treatment for gastric cancer patients with synchronous hepatic metastasis]. PMID- 6491429 TI - [Analytical studies on the treatment of adenocarcinoma of the ovary]. PMID- 6491430 TI - [Experimental study of oral administration of streptococcal preparation "OK-432". The third report: its enhancing effects on natural killer activity and lymphoproliferative response to mitogens of mouse mesenteric lymph node]. PMID- 6491431 TI - [Clinical radio-protective anti-inflammatory effects by superoxide dismutase (orgotein)]. PMID- 6491432 TI - [Studies on a biochemical marker of malignant bladder tumors. Polyamine concentrations in tissues of bladder cancer]. PMID- 6491433 TI - Superficial views on treatment for cancer. PMID- 6491434 TI - [The 21st Congress of the Japan Society for Cancer Therapy. Panel discussion. Abstracts]. PMID- 6491435 TI - [Glomerular polyanion and beta-glucuronidase--histochemical studies of glomerular diseases]. PMID- 6491436 TI - [Clinical features in familial brady-arrhythmia of an adult onset]. PMID- 6491437 TI - [Clinical features and long-term immunosuppressant therapy of the SLE patients with nephrotic syndrome]. PMID- 6491438 TI - [Discriminant function analysis using treadmill exercise test variables to predict the presence and extent of coronary artery disease: a new diagnostic approach by a point score system]. PMID- 6491439 TI - [Familial amyloidosis with polyneuropathy presenting restrictive cardiomyopathy as its main manifestation]. PMID- 6491440 TI - [A case of allergic granulomatous angiitis (Churg & Strauss) complicated with temporal arteritis]. PMID- 6491441 TI - [Clinical study of transient thyrotoxicosis with low radioactive iodine uptake]. PMID- 6491442 TI - [A case of glycyrrhizin-induced pseudoaldosteronism with suppressed pituitary adrenocortical axis]. PMID- 6491443 TI - [A case of familial hypo-beta-lipoproteinemia with steatosis of the liver]. PMID- 6491444 TI - [The effect of gallstone-dissolving agents on lipid and bile acid metabolism]. PMID- 6491445 TI - [Alcoholic liver disease]. PMID- 6491446 TI - [Progress in the study of liver disease and immune abnormalities. b. Autoimmune liver diseases]. PMID- 6491447 TI - [Evaluation of hepatic reserve]. PMID- 6491448 TI - [Effect of high and low salt intakes on norepinephrine concentrations in cerebrospinal fluid in patients with essential hypertension]. PMID- 6491449 TI - [Periodic fever probably caused by dysfunction of the central thermoregulatory area. Report of a case]. PMID- 6491450 TI - [Bulbospinal muscular atrophy with endocrinological abnormalities (Kennedy-Alter Sung syndrome), with special reference to hypothalamo-pituitary dysfunction]. PMID- 6491451 TI - [Pathogenesis and pathophysiology of itai-itai disease in 2 cases, with special reference to vitamin D metabolism]. PMID- 6491452 TI - [A case of ulcerative colitis with amyloidosis initially presented as fever of unknown origin]. PMID- 6491453 TI - [A case of insulin-resistant diabetes caused by anti-insulin receptor autoantibodies, showing varied clinical course]. PMID- 6491454 TI - [Nephrogenic diabetes insipidus accompanied by bilateral hydronephrosis. Report of a case]. PMID- 6491455 TI - [A case of hypothyroid myopathy complicated with congestive heart failure simulating dilated cardiomyopathy]. PMID- 6491456 TI - [A case of Sjogren's syndrome associated with pulmonary embolism, monoclonal hypergammaglobulinemia, and thymoma]. PMID- 6491457 TI - [An autopsy case of mixed connective tissue disease associated with viral myocarditis]. PMID- 6491458 TI - [Two cases of idiopathic restrictive cardiomyopathy]. PMID- 6491459 TI - [Studies on human hepatic copper contents in Japanese patients with liver cirrhosis and biliary obstruction]. PMID- 6491460 TI - [Analysis of hospitalized patients with fever of unknown origin (FUO) during 11 years]. PMID- 6491461 TI - [A case of primary adult Fanconi syndrome with refractory anemia closely related to sideroblastic anemia]. PMID- 6491462 TI - [A case of coccidioidomycosis]. PMID- 6491463 TI - [The analysis of the blood flow pattern of the left ventricle during isovolumic relaxation period by the use of pulsed Doppler echocardiography]. PMID- 6491464 TI - [Clinical study of coagulopathy in renal failure. 1. Vitamin K-deficient hemorrhage]. PMID- 6491465 TI - [A young female case of myxedema associated with atrophic gastritis (type A) with remarkable hypergastrinemia]. PMID- 6491466 TI - Brain methanethiol and ammonia concentrations in experimental hepatic coma and coma induced by injections of various combinations of these substances. AB - In normal rats in a coma induced by NH+4 alone or by methanethiol alone, the brain and blood levels of ammonia or methanethiol are much higher than those observed in rats in experimental hepatic coma. When various smaller dosage combinations of NH+4, methanethiol, and octanoic acid were injected simultaneously, coma occurred at lower brain and blood concentrations of ammonia and methanethiol. Brain ammonia and methanethiol concentrations in normal rats receiving 0.75 mmol NH+4 plus 0.15 mmol octanoic acid plus 18 mumol methanethiol were comparable with those observed in 24 rats in hepatic coma after fulminant hepatic failure caused by acute massive ischemic liver necrosis. The normal rats became comatose. In these rats and in the rats in hepatic coma, the ammonia level in the brain was increased threefold and the methanethiol level in the brain was increased fivefold. Because these levels of ammonia and methanethiol were sufficient to induce coma in normal rats, they should also have been sufficient to induce coma in rats with damaged livers. Therefore, the accumulation of ammonia and methanethiol in the central nervous system after the acute massive ischemic necrosis may have been sufficient to account for the coma that ensued, without the involvement of other factors. PMID- 6491467 TI - Quantitative analysis of postmortem changes in myocardial norepinephrine using HPLC with electrochemical detection. AB - Myocardial adrenergic function may be important in the pathophysiology of many cardiac abnormalities, and quantitative analysis of catecholamines in cardiac tissue can provide insight in the role of adrenergic neurons in specific disorders. Our purpose was to determine the stability of myocardial catecholamines postmortem to assess the validity of using postmortem samples to represent premorbid conditions and to provide information applicable to proper handling of biopsy specimens. Serial myocardial samples were obtained postmortem in rats and dogs for which norepinephrine and dopamine levels were analyzed using high-pressure liquid chromatography with electrochemical detection. No significant differences in catecholamine content were found between samples taken immediately after death and those taken 15 minutes later. Thereafter, a progressive decline in catecholamines was observed. We conclude that biopsy or postmortem samples frozen within 15 minutes of death will accurately reflect premortem catecholamine values. PMID- 6491468 TI - Estimation of changes in alveolar-arterial oxygen gradient induced by hypoxia. AB - The alveolar-arterial oxygen tension difference provides a useful clinical indication of ventilation-blood flow mismatching in the lungs. In some clinical situations involving alveolar hypoxia (e.g., patients with chronic obstructive lung disease flying in commercial aircraft or normal humans at high altitudes) it would be useful to know this tension difference to predict the likely arterial PO2 under such potentially stressful conditions. Such estimates would require multiple arterial punctures performed under a variety of trying circumstances, conditions usually far distant from a suitable analytic facility. Consequently, we induced controlled hypoxia in 23 healthy humans and calculated changes in the alveolar-arterial oxygen tension difference during the hypoxic challenge test. We plotted this difference as a function of the alveolar oxygen tension over a range from 35 to 110 mm Hg. In addition to a series of control studies in which multiple arterial blood samples were obtained, we calculated arterial PO2 by converting the arterial oxyhemoglobin saturation (measured with an ear oximeter) into partial pressure of oxygen. During hypoxic procedures in which levels of oxygenation fell on the steep section of the oxyhemoglobin dissociation curve, fixing PCO2 at constant predetermined levels allowed accurate predictions of arterial PO2. We were able to demonstrate that the alveolar-arterial oxygen tension difference narrowed with decreasing alveolar oxygen tension, and that measurement with an ear oximeter provided data that allowed a reasonable estimate of the tension difference during hypoxic conditions. PMID- 6491469 TI - Influence of pH on the rheologic and antisickling effects of dimethyl adipimidate. AB - Dimethyl adipimidate, a bifunctional imidoester, is an effective inhibitor of sickling in vitro. We determined the reaction conditions necessary to inhibit sickling without impairing cell deformability. Although imidoesters are routinely used at alkaline pH, we found that reaction of red blood cells with dimethyl adipimidate at pH 8.4 shortened the survival of rat red blood cells and impaired the deformability of human red blood cells. These adverse effects were eliminated by changing the pH of the reaction from 8.4 to 7.4. Furthermore, treatment of sickle cells with dimethyl adipimidate at pH 7.4 inhibited sickling, as demonstrated by dose-dependent reductions in the percentage of sickle forms, viscosity, and potassium efflux. Dimethyl adipimidate appeared to inhibit sickling by several mechanisms: namely, it increased deoxygenated sickle hemoglobin solubility, oxygen affinity, and cell hydration. We conclude that dimethyl adipimidate at pH 7.4 can inhibit sickling without impairing the rheologic properties of the red blood cell. PMID- 6491470 TI - Structural features of the quinidine and quinine molecules necessary for binding of drug-induced antibodies to human platelets. AB - Although most quinidine- and quinine-induced platelet antibodies react only in the presence of the drug that provoked sensitization, some are active with either quinidine or its stereoisomer, quinine; that is, they are "cross-reactive." This suggests that the activity of drug-dependent antibodies is dependent on different structural features of the quinidine or quinine molecules. To investigate this possibility, we studied reactions of 16 quinidine- and quinine-induced antibodies with quinidine, quinine, and analogues of these drugs modified at the quinoline ring (desmethoxy-derivative), the quinuclidine ring (dihydro-derivative), or the asymmetric C(9)-hydroxyl position. It was found that the antibodies could be classified into three groups on the basis of their reactions with platelets in the presence of these compounds. Eight antibodies (group 1) reacted only in the presence of the sensitizing drug or its dihydro- or desmethoxy-derivative. Three antibodies (group 2) differed from those in group 1 only in that their reactions were markedly weakened when the primary desmethoxy-derivative was used. Five antibodies (group 3) reacted in the presence of the sensitizing drug, its stereoisomer, and one or more of the analogues tested, including at least one of the C(9)-derivatives. Antibodies in this group gave stronger reactions with the sensitizing drug than with its stereoisomer. These results provide further evidence for heterogeneity among drug-induced platelet antibodies by demonstrating that noncross-reactive antibodies (groups 1 and 2) are dependent for their activity on a specific configuration at the optically active C(9) hydroxyl position, and that some of these (group 2) also require the methoxy group for full reactivity. In contrast, cross-reactive antibodies (group 3) appear to be dependent on the quinoline ring common to all the analogues tested but also require a specific configuration at C(9) for full reactivity. PMID- 6491471 TI - The plasma lipoproteins in familial chylomicronemia. Analysis by zonal ultracentrifugation. AB - Familial chylomicronemia is a rare genetic disorder attributable to the absence of lipoprotein lipase activity or the absence of apo-CII, i.e., the cofactor for the same enzyme. Plasma lipoproteins were analyzed by zonal ultracentrifugation under rate flotation conditions in four patients with lipoprotein lipase deficiency and two patients with apo-CII deficiency. Lipoproteins of density less than 1.006 gm/ml, and particularly lipoproteins with Sf greater than 100, were present in very high concentrations. Low levels of density greater than 1.006 gm/ml lipoproteins were observed. This fraction was composed of some different and discrete lipoprotein populations: intermediate-density lipoproteins (in three of six patients, density = 1.006 to 1.019 gm/ml); low-density lipoprotein LDL2 (in all patients, density = 1.019 to 1.045 gm/ml); low-density lipoprotein LDL3 (in all patients, density = 1.045 to 1.063 gm/ml); high-density lipoprotein HDL2 (in four of six patients); and high-density lipoproteins HDL3 (in all patients). LDL3 was never observed in normal participants by means of zonal ultracentrifugation; this subclass of low-density lipoproteins seems to correspond to LDL particles of very low Sf (2 to 5) previously identified by analytical ultracentrifugation in patients with severe hypertriglyceridemia. LDL3 was isolated by means of zonal ultracentrifugation as a single and discrete peak in all patients. Lipoproteins of density greater than 1.006 gm/ml were rich in triglycerides and poor in cholesterol in comparison with normal lipoproteins. The heterogeneity of low-density lipoproteins (particularly the appearance of LDL3), low levels of total high-density lipoproteins, and lower HDL3 flotation rate than normal are typical aspects of serum lipoproteins in these patients. No significant differences in the lipoprotein profiles of the patients with lipoprotein lipase deficiency in comparison with patients with apo-CII deficiency were found. In both groups of patients, the plasma lipoproteins profile and the altered lipoprotein composition could be related to the impaired catabolism of triglyceride-rich lipoproteins caused by the absence of lipoprotein lipase activity. PMID- 6491472 TI - Highly sensitive microassay for aldosterone in unextracted plasma: comparison with two other methods. AB - A direct radioimmunoassay for aldosterone in unextracted plasma was developed using a highly sensitive and specific antiserum and 125I-labeled aldosterone. This new method was compared with the previously used assay based on methylene chloride extraction and column chromatography and with a micromethod utilizing methylene chloride extraction alone. Concentrations of 2 pg/ml aldosterone can be measured in 25 microliter plasma. The within-assay coefficient of variation ranged between 4.0% and 5.3% over a sixfold range of aldosterone concentrations, and the between-assay coefficient of variation ranged between 5.0% and 9.4% over a tenfold range. The correlation coefficients among the three methods varied between 0.97 and 0.99, and results were virtually identical between the new direct and the standard chromatography methods. Normal values on unrestricted salt intake were 68 +/- 28 pg/ml (n = 30, mean +/- SD) in seated humans. In conclusion, this is an extremely simple, truly direct microradioimmunoassay for plasma aldosterone that is accurate over a wide range of plasma concentrations, is exquisitely sensitive, and provides results identical to those obtained with established methods. PMID- 6491473 TI - Effect of acetazolamide on rat gastric mucosal protection and stimulated bicarbonate secretion with 16,16-dimethyl PGE2. AB - The effect of pretreatment with acetazolamide, a carbonic anhydrase inhibitor, was studied on the mucosal protection provided by and the gastric alkaline secretion stimulated by 16,16-dimethyl prostaglandin E2. Using a model employing a chamber of the rat whole stomach, 16,16-dimethyl prostaglandin E2 (1 microgram/ml) was found to significantly (p less than 0.05) increase the secretion of bicarbonate by 31.1 +/- 4.1 mu Eq/hr over basal values. This stimulated secretion was inhibited (to 18.0 +/- 2.2 mu Eq/hr) by pretreatment with acetazolamide (50 mg/kg body weight). In a separate series of experiments, the ability of this concentration of 16,16-dimethyl prostaglandin E2 to protect the rat stomach from necrosis caused by absolute ethanol was not impaired by prior exposure to the same dose of acetazolamide. PMID- 6491474 TI - Saliva lithium. Too variable for significant plasma level correlations. PMID- 6491475 TI - Tracheobronchomegaly (Mounier-Kuhn Syndrome). PMID- 6491476 TI - Staphylococcal pneumonia in pediatric practice. PMID- 6491477 TI - Fractures of the pelvis. New methods of diagnosis and treatment. PMID- 6491479 TI - Documenting tumours of the head and neck. PMID- 6491478 TI - Late effects of perivascular injection of Thorotrast in the neck. AB - Two cases of late sequelae of accidental perivascular injection of Thorotrast (thorium dioxide) during carotid arteriography are presented. The complaints of the patients and the clinical findings are due to topical granulomatous and fibrous reactions with compression of the carotid artery and cranial nerves, and influence upon larynx and trachea. For future decades it will still be necessary to be aware of this possible cause of neck tumours with oto-laryngeal and neurological symptoms. PMID- 6491480 TI - Cardiac depression on syringing the ear. A case report. AB - While syringing of the ear was being done to clean the ear canal, the heart stopped beating suddenly. This was presumed to be due to stimulation of the vagus nerve, which supplies both the external auditory meatus plus the tympanic membrane and the cardiac muscle. There were also other signs of cholingergic nerve stimulation. The patient recovered in less than a minute, after external cardiac massage. PMID- 6491481 TI - Voice changes following cricothyroidotomy. AB - Twenty-four patients underwent cricothyroidotomy at Guy's Hospital between 1977 and 1981. Of these, 13 died during admission or shortly after discharge as a result of their primary disease and three were unsuitable for further examination. The eight remaining patients were examined to assess the effect of cricothyroidotomy on the laryngeal function of voice production. Assessment was made both subjectively and objectively by laryngography. Objective findings were correlated with structural changes seen by indirect laryngoscopy. Six of the eight patients examined had both subjective and objective disturbance of voice production. We report our experience with the surgical procedure of cricothyroidotomy which, in addition to a high incidence of vocal disturbance, includes one case of subglottic stenosis secondary to granulation tissue. PMID- 6491482 TI - A case of carcinoid tumor of the middle ear. AB - A case of a primary carcinoid tumor of the middle ear is presented. This neoplasm superficially resembles a so-called 'adenomatous' middle ear tumor. The importance of transmission electron microscopy and histochemical staining (Grimelius technique) are discussed. PMID- 6491483 TI - Hydatid disease of the maxilla. PMID- 6491484 TI - Cervical lymph node biopsy--a study of its morbidity. PMID- 6491485 TI - Intraoral lipoma. A rare cause of dysphagia. AB - Lipomas of the oral cavity are rare and in most cases asymptomatic. A case of lipoma in the floor of the mouth in a 89-year-old man, causing severe dysphagia and difficulty with speech, is presented. After surgical excision of the lipoma, the symptoms disappeared. Histologically, lipomas are composed of mature fat cells. Their aetiology is uncertain. Recurrence after surgical excision is unusual. PMID- 6491486 TI - The s.c. 'hairy polyp' or 'dermoid' of the nasopharynx. (An unusual observation in older age). AB - A case of 'hairy polyp' or 'dermoid' of the nasopharynx in a 71-year-old man is described. This tumor-like condition is usually discovered at birth or during the first years of life. The oldest patient previously recorded in the literature was a 66-year-old man. The occurrence of such masses in older patients suggests that the condition is a malformation and not a neoplasm. PMID- 6491487 TI - Fractured genial tubercles. PMID- 6491488 TI - A case of hanging. AB - A case history of attempted hanging with pharyngeal and laryngeal injuries is described. The management of this problem is discussed to include not only treatment as for a more commonly occurring laryngeal injury, but also to be aware of pharyngeal tears and the possibility of the rarer post-suspension syndrome and neurogenic pulmonary oedema. PMID- 6491489 TI - A persistent parotid fistula following the extraction of mandibular teeth. AB - A case of a persistent parotid fistula in a middle-aged patient following dental extractions is described. The management is outlined, possible conservative and surgical options are discussed, and the literature is reviewed. PMID- 6491490 TI - An unusual tumour mistaken as a lingual thyroid (a case report). AB - A rare case of benign mass with hypertrophic sero-mucinous gland presenting as a tumour at the junction of the anterior two-thirds and the posterior third of the middle of the tongue is reported, which is found to be of great academic interest because of its unique situation of that of a lingual thyroid and its characteristic histological picture. The salient features of the lesion are discussed. PMID- 6491491 TI - Radiation-induced fibrosarcoma of the thyroid. AB - A rare thyroid tumour is described. It started as a papillary cytoadenoma 20 years ago, followed by the appearance of a papillary adenocarcinoma 6 years later. At that time most of the tumour was excised, except for a small portion which had invaded the trachea. Post-operatively 6,000 rads of Co60 was given to the neck; the tumour remained quiescent for 18 years until two years ago, when a recurring fibrosarcoma appeared in her neck. It is suggested that this tumour was a radiation-induced sarcoma. PMID- 6491492 TI - Middle-ear pressure changes during general N2O anaesthesia in adeno tonsillectomies due to post-nasal packing. PMID- 6491493 TI - Familial Bell's palsy. PMID- 6491494 TI - Electronystagmography and horizontal directionalization. AB - A series of 22 patients complaining of disorders of equilibrium or hearing thought to be due to Central Nervous System (CNS) dysfunction has been studied. Data were obtained for electronystagmography (ENG), horizontal directionalization (HD), the staggered spondee word test (SSW), brainstem auditory evoked responses (BSER) and the Chocholle test of binaural interaction of pure tones (CH). The central ENG abnormalities found were spontaneous central vestibular nystagmus, paroxysmal central positional nystagmus, gaze paretic nystagmus, impaired optokinetic nystagmus, impaired smooth pursuit eye movements and impaired fixation-suppression of caloric nystagmus. HD results showed a weak link with hearing loss (HL). The central ENG abnormality most closely associated with impairment of HD was abnormal smooth pursuit eye movements. No significant relationship could be established between any two of the tests studied. The limited localizing value of the tests is discussed together with the contribution they make towards the diagnosis of the patient complaining of dizziness. PMID- 6491495 TI - Aetiological evaluation of foreign bodies in the ear and nose. AB - A clinical study has revealed that irritation caused by pre-existing diseases of the ear (e.g. chronic otitis externa, wax with chronic otitis externa, C.S.O.M. with otitis externa or the presence of wax in the meatus) and by those of the nose (e.g. acute or chronic rhinitis, chronic vestibulitis or the presence of dried, thick sticky mucus in the vestibule of the nose in the resolving stage of a common cold) are the major aetiological factor in foreign bodies in the ear and nose. Boredom, curiosity, whims to explore the natural cavities of the body, habit, acts of imitation, fun-making and mental retardation are only minor aetiological factors. PMID- 6491496 TI - Post tonsillectomy haemorrhage in children: The value of routine monitoring of the pulse. AB - Twenty-one children with reactionary haemorrhage after tonsillectomy were returned to theatre for the control of this haemorrhage. This group was matched for age and weight with 21 patients who underwent an uncomplicated tonsillectomy. The maximum pulse rate, the mean pulse rate and the maximum rise in pulse rate were recorded during the post-operative period and were noted for each group. No statistical difference existed between the groups. The monitoring of children in the period following tonsillectomy may be inadequate if the pulse alone is measured. PMID- 6491497 TI - Necrotizing external otitis. The importance of prolonged drug therapy. PMID- 6491498 TI - Oral acetazolamide in Meniere's disease. AB - The therapeutic efficacy of oral acetazolamide has been evaluated in a small pilot study of 14 patients with Meniere's disease (23 hydropic ears). Symptomatic improvement was found in 4 cases. In 2 of these patients the improvement was not sustained, whilst another had to stop the drug due to the development of bilateral renal calculi. A deterioration in symptoms was seen in 3 cases. Significant adverse side-effects were encountered in 6 of the 13 patients (46.2 per cent) who complied with drug dosage instructions. It is suggested that this high incidence of side-effects may be consistent with a general metabolic difference between Meniere's patients and normal subjects. We conclude that oral acetazolamide has no place in the medical treatment of Meniere's disease. PMID- 6491499 TI - Hearing in acromegaly. AB - Fifty-six individuals with acromegaly referred for pituitary surgery were studied to determine any relationship between acromegaly and sensorineural or conductive hearing loss. Compared to a matched population control sample, no significant difference between the acromegalics and controls has been found, either for air conduction or for bone conduction. The differences between these findings and those published previously are discussed, and reasons proposed to explain the discrepancies. PMID- 6491501 TI - The role of chemotherapy in untreated squamous-cell carcinoma of the head and neck. PMID- 6491500 TI - Restricted mandibular opening (trismus). PMID- 6491502 TI - Topographic anatomy of the external branch of the superior laryngeal nerve. Its importance in head and neck surgery. AB - The authors have studied the anatomy of the external branch of the superior laryngeal nerve in its entirety on 40 fresh cadavers, and they have drawn the following conclusions: the nerve ramifies from the vagus immediately below the nodose ganglion or in the ganglion itself. The nerve splits into two branches approximately 1.5 cm below the ganglion nodosum. In four cases, both branches originated from the vagus itself. In one case, anastomosis of the external branch of the superior laryngeal nerve with the recurrent nerve was found. The external branch of the superior laryngeal nerve is not usually severed at supraglottic laryngectomy but the nerve is at risk during neck dissections, resection of Zenker's diverticula and thyroidectomy. An accurate knowledge of its course should reduce the incidence of injury to the branches of the superior laryngeal nerve during surgery. PMID- 6491503 TI - A microprocessor system for the storage and retrieval of otolaryngological data. PMID- 6491504 TI - Inner ear cholesteatoma with preserved hearing. PMID- 6491505 TI - A case of profound hearing impairment following the prolonged use of framycetin ear drops. PMID- 6491506 TI - Extracranial arteriovenous malformation presenting as objective tinnitus. PMID- 6491507 TI - Eosinophilic granuloma with bilateral maxillary and mandibular involvement. PMID- 6491508 TI - A small osteoma of the frontal sinus causing headaches. AB - Osteomas of the frontal sinus are usually symptomless. When they enlarge they may produce pressure symptoms such as headaches. Small osteomas developing near the fronto-ethmoidal duct may interfere with the patency of the duct and impair the aeration of the sinus. This is a report of a case in which a small osteoma was found to be the cause of severe chronic headaches. PMID- 6491509 TI - Pituitary abscess following asymptomatic sphenoid sinusitis. PMID- 6491510 TI - Gross facial bone destruction following trigeminal rhizotomy. PMID- 6491512 TI - A view of a viewpoint: nutritional considerations. PMID- 6491511 TI - Combined adenocarcinoma and squamous carcinoma of the hypopharynx. A case report. PMID- 6491513 TI - The training of psycho-educational technicians (para-professionals) to administer a screening battery which delineates dyslexia and hyperkinesis. PMID- 6491514 TI - Problem-solving instruction as an oral comprehension aid for reading disabled third graders. PMID- 6491515 TI - There's more to a reading problem than poor reading. PMID- 6491516 TI - The survival story of a non-reader: an interview. PMID- 6491517 TI - Investigating awareness of and teaching passage organization in learning disabled children. PMID- 6491518 TI - Verbal mediation in high-active and cognitively impulsive second graders. PMID- 6491519 TI - Social skills assessment and training for the learning disabled: who's on first and what's on second? Part II. PMID- 6491520 TI - How to change the world without ruining it or yourself. PMID- 6491521 TI - Structural studies on apolipoprotein B: controllable heterogeneity of the complex formed with the surfactant, Triton X-100. AB - Apolipoprotein B complexed with Triton X-100 (T-ApoB) has been isolated from human low density lipoprotein (LDL). Preparations are heterogeneous when analyzed by sedimentation velocity, with a major 12 S species and minor 17 S species present. The 12 S T-ApoB complex possesses a molecular weight of 880,000 containing 400,000 daltons of protein. Hydrodynamic measurements on this complex are consistent with a prolate ellipsoid model having an axial ratio of 13:1 and 0.22 g/g of bound water. Heterogeneity results from the irreversible aggregation of 12 S complexes into discrete 17 S and faster sedimenting components. A significant finding is that three determinants of this T-apoB heterogeneity could be elucidated and controlled. First, the initial state of aggregation is mainly influenced by the technique by which Triton and LDL are mixed. Second, once isolated, T-ApoB complexes slowly but spontaneously undergo further aggregation at 4 degrees C; the rate and extent of aggregation is enhanced remarkably with increasing temperature. Finally, reagents that unfold and expose protein structure (perchlorate, thiocyanate, and reducing reagents) lead to increased aggregation. The ability to control heterogeneity carries important implications for other studies concerning interactions of apoB with surfactants and lipids. PMID- 6491522 TI - In vitro effect of Triton WR-1339 on canine plasma high density lipoproteins. AB - We studied the effect in vitro of various concentrations of Triton WR-1339 on normolipidemic canine plasma and on the high density lipoproteins (HDL) isolated from this plasma by ultracentrifugation. As a preamble to this study, we established that Triton WR-1339 has a unimer molecular weight of 4,500, a micellar molecular weight of 180,000, and a critical micellar concentration (CMC) of 0.018 mM or 0.008 g/dl. Above its CMC, Triton WR-1339 in concentrations between 2 and 10 mg/ml induced concentration-dependent structural changes in HDL which were characterized by a progressive displacement of apoA-I from the HDL surface without loss of lipids. The addition of Triton WR-1339 to the HDL particles modified their electrophoresis mobility and caused an increase in size (95 +/- 5 A to 114 +/- 7 A). At the extreme Triton WR-1339 concentrations utilized in these studies (10 mg/ml) disruption of the HDL particles occurred; at this stage, the original, relatively homogeneous, spherical HDL particles were replaced by a heterogeneous population ranging in size between 50 and 250 A, representing complexes of Triton WR-1339 with lipids essentially free of apoA-I which could be sedimented by ultracentrifugation. The effects of Triton WR-1339 on whole plasma or isolated HDL were comparable. These studies indicate that Triton WR-1339 in vitro alters HDL in a concentration-dependent manner and that these changes vary from a displacement of apoA-I from the HDL surface to a state where all lipids are solubilized into the Triton WR-1339 micellar phase and are driven away from the protein moiety.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491524 TI - Aggregation patterns of bile salts: crystal structure of calcium cholate chloride heptahydrate. AB - Crystals of calcium cholate chloride heptahydrate, CaC24H39O7Cl . 7H2O, are monoclinic, space group P2(1), with a = 11.918(2), b = 8.636(1), c = 15.302(3) A, beta = 97.93(3) degrees, V = 1559.9(8) A3, and Z = 2. A trial structure was obtained by Patterson and Fourier techniques and was refined by full-matrix least squares calculations using absorption corrected CuK-alpha diffractometer data. The final R index is 0.047. The crystal structure contains bilayer-type arrangements, with hydrophobic portions of cholate rings sandwiched between layers of polar groups that are interacting with calcium ions and water molecules. The calcium ion is coordinated to five water molecules and to the two carboxylate oxygen atoms of the cholate residue. Two additional water molecules are involved only in crystal packing through the formation of hydrogen bonds. Cholate-cholate hydrophobic interactions involve contacts between the hydrocarbon portions of the carboxylate sidechains and the A and B rings. This results in a staggered packing pattern that is nearly identical to that found in crystals of sodium cholate and rubidium deoxycholate. Similar bilayer aggregation patterns may also be involved in the formation of bile salt micelles in aqueous media. The characteristic bilayer packing arrangement can accommodate a variety of cation binding patterns, as evidenced by the finding that calcium, sodium, and rubidium ions interact with the polar faces of the bilayers in different ways. The carboxylate sidechain displays two different conformations in the crystal structure of calcium cholate chloride heptahydrate. Variation in sidechain conformation may be of importance in the adjustment required to accommodate different cation coordination schemes. PMID- 6491523 TI - Influence of probucol on cholesterol and lipoprotein metabolism in man. AB - The mechanisms for the hypocholesterolemic action of probucol were examined in 17 patients with various levels of plasma cholesterol and triglycerides (TG). All the patients were studied on a metabolic ward. The first period of 6 weeks was for control. Thereafter, probucol was started, and after 2-6 months of drug treatment, the patients were readmitted for another 6-week period for a repeat study. During treatment with probucol, the cholesterol decreased in total plasma by an average of 12%, in low density lipoproteins (LDL) by 11%, and in high density lipoproteins (HDL) by 9%. The TG in total plasma and in very low density lipoproteins (VLDL) remained unchanged during probucol treatment. Turnover of low density lipoprotein apoprotein (apoLDL) was estimated following injection of 125I labeled apoLDL. Probucol increased the fractional catabolic rate (FCR) for apoLDL by an average of 23%, but did not change apoLDL synthesis. The drug produced no consistent changes in fecal excretion of cholesterol (neutral steroids) and bile acids, in cholesterol absorption, in lipid composition of gallbladder bile, in biliary secretion of cholesterol and bile acids, or in the activities of lipoprotein lipase and hepatic lipase. These data show that probucol lowers LDL by increasing its catabolism. This effect appears to be independent of any changes in metabolism of cholesterol or bile acids. PMID- 6491525 TI - Hepatic uptake of chylomicrons and triglyceride emulsions in rats fed diets of differing fat content. AB - The hepatic removal of plasma chylomicrons was determined for rats fed the following diets: a) containing no triglyceride, b) regular chow diet with 4.5% of its mass as lipid and, c) a corn oil-supplemented chow with triglyceride accounting for 20% of the mass. The fractional hepatic uptake of either radiolabeled chylomicrons or a triglyceride emulsion was reciprocally related to the amount of lipid in the diet. The animals receiving only carbohydrate and protein calories had the most active hepatic uptake of particulate triglyceride and were observed to have a significant decrease in the plasma concentration of the C apolipoproteins. The addition of either C-I, C-II, or C-III apoproteins to the triglyceride emulsion prior to intravenous injection produced a significantly lower hepatic triglyceride recovery of emulsions containing apoC-III. When the plasma of animals fed a fat-free diet was supplemented with human C-III-1 apolipoprotein, the distribution into the liver of either enterally administered fatty acid or parenteral triglyceride was diminished. The triglyceride content in the liver of the rats fed fat-free or corn oil-supplemented diets was significantly greater than that of the control rats and composition was somewhat similar to that of lymph triglyceride. The studies indicate an important influence of dietary lipid on both the partition of plasma triglyceride into the liver and the steady state hepatic triglyceride content. PMID- 6491526 TI - Plasma clearance of chylomicrons labeled with retinyl palmitate in healthy human subjects. AB - To estimate hepatic uptake of chylomicron remnants in humans, chylomicrons and intestinal very low density lipoproteins (VLDL) were endogenously labeled with retinyl esters, harvested by plasmapheresis, and pulse-injected into the donor 44 hr after plasmapheresis. Plasma decay of retinyl palmitate was measured in eight healthy volunteers. Retinyl palmitate plasma disappearance obeyed an apparent first order function in seven studies and, in one study, a biexponential function with the second, slow exponential accounting for only 13% of the retinyl palmitate plasma decay. The mean fractional removal of rate was 0.037 +/- 0.037 min-1 (mean +/- SD) in a one-compartment model. The apparent volume of distribution, Vd, was 109 +/- 25% of the estimated plasma volume. Plasma clearance of retinyl palmitate was 130 +/- 97 ml/min calculated as Vd x Ke. Mean T 1/2 was 29 +/- 16 min. Both in vitro and in vivo the retinyl palmitate remained largely within chylomicrons and intestinal VLDL. Only 4.3% was transferred from chylomicrons to other lipoprotein classes during in vitro incubation for 5 hr. After plasma was stored for 42 hr, 5% was transferred to higher density lipoproteins. During 12 hr after a test meal containing retinyl palmitate, only 6.4 +/- 1.5% of the retinyl palmitate absorbed was found in the LDL fraction and 3.1 +/- 3.8% in the d 1.063 g/ml lipoproteins. We conclude that retinyl palmitate is a useful marker for chylomicrons and their remnants in humans and that the plasma clearance of retinyl palmitate-labeled chylomicrons is probably an estimate of chylomicron remnant plasma clearance in man. PMID- 6491527 TI - Hepatic triacylglycerol synthesizing activity during progression of alcoholic liver injury in the baboon. AB - To study the effects of alcoholic liver injury on the ability of ethanol to promote hepatic fat accumulation and hyperlipemia, baboons were pair-fed liquid diets containing 50% of energy either as ethanol or as additional carbohydrate (controls) for 1 to 7 years. Alcohol consumption produced triacylglycerol accumulation in the liver, hypertriacylglyceridemia, and various degrees of liver injury, including cirrhosis. At the early stages of fatty liver (with or without perivenular fibrosis), there was increased activity of microsomal diacylglycerol acyltransferase and of both microsomal and cytosolic phosphatidate phosphohydrolase, with no changes in glycerol-3-phosphate acyltransferase. With progression of the liver injury and development of septal fibrosis and/or cirrhosis, the rate of hepatic triacylglycerol accumulation and the magnitude of the hyperlipemia decreased, despite continuous ethanol intake. These changes were associated with disappearance of the increases in microsomal diacylglycerol acyltransferase and cytosolic phosphatidate phosphohydrolase activities, whereas those of microsomal phosphatidate phosphohydrolase remained elevated and glycerol 3-phosphate acyltransferase was unaffected. Thus, changes in the activity of two enzymes of the triacylglycerol-synthesizing pathway, namely the microsomal diacylglycerol acyltransferase and the cytosolic phosphatidate phosphohydrolase, may contribute to the differences in the rate of hepatic triacylglycerol accumulation and the degree of hyperlipemia during progression of the alcoholic liver damage. PMID- 6491528 TI - Interactions between fatty acid synthesis, oxidation, and esterification in the production of triglyceride-rich lipoproteins by the liver. AB - In a series of experiments with male rat livers perfused with or without 5 tetradecyloxy-2-furoic acid (TOFA) in the presence and absence of oleate, the relationships between fatty acid synthesis, oxidation, and esterification from newly synthesized and exogenous fatty acid substrates have been examined. When livers from fed rats were perfused without exogenous fatty acid substrate, 20% of the triglyceride secreted was derived from de novo fatty acid synthesis. Addition of TOFA caused immediate and nearly complete inhibition of fatty acid synthesis, measured by incorporation of 3H2O into fatty acids. Concurrently, ketone body production increased 140% and triglyceride secretion decreased 84%. These marked reciprocal alterations in fatty acid synthesis and oxidation in the liver almost completely abolished the production of very low density lipoproteins (VLDL). Cholesterol synthesis was also depressed by TOFA, suggesting that this drug also inhibited lipid synthesis at a site other than acetyl-CoA carboxylase. When livers from fed rats were supplied with a continuous infusion of [1-14C]oleate as exogenous substrate, similar proportions, about 45-47%, of both ketone bodies and triglyceride in the perfusate were derived from the infused [1-14C]oleate. The production of ketone bodies was markedly increased by TOFA; the secretion of triglyceride and cholesterol were decreased. Altered conversion of [1-14C]oleate into these products occurred in parallel. While TOFA decreased esterification of oleate into triglyceride, incorporation of [1-14C]oleate into liver phospholipid was increased, indicating that TOFA also affected glycerolipid synthesis at the stage of diglyceride processing. The decreased secretion of triglyceride and cholesterol following TOFA treatment was localized almost exclusively in VLDL. The specific activities of 3H and of 14C fatty acids in triglyceride of the perfusate were greater than those of liver triglyceride, indicating preferential secretion of triglyceride produced from both de novo fatty acid synthesis and from infused free fatty acid substrate. These observations suggest the following chain of events in the liver following TOFA treatment: inhibition of fatty acid and cholesterol synthesis; increased fatty acid oxidation and ketogenesis; decreased triglyceride synthesis as a result of inhibition of fatty acid synthesis, stimulation of fatty acid oxidation, and altered partition of diglyceride between triglyceride and phospholipid synthesis; and decreased production of VLDL. These comparative rat liver perfusion experiments indicate that free fatty acids provide the major source of substrate for the hepatic production of triglyceri PMID- 6491529 TI - Properties of acyl-coenzyme A:1-acylglycerophosphate acyltransferase and lipases in porcine erythrocyte membranes. AB - Acyl-CoA:1-acylglycerophosphate acyltransferase activity was found in porcine erythrocyte membranes. However, the membrane preparations did not catalyze the acylation of either 2-acylglycerophosphate or 2-acylglycerophosphocholine. The 1 acylglycerophosphate acyltransferase and the known acyl-CoA:1 acylglycerophosphocholine acyltransferase systems differ in their specificities for acyl-CoAs and in their stabilities to detergents. Diacylglycerol lipase and monoacylglycerol lipase activities were also detected in porcine erythrocytes. These two activities appear to be catalyzed by different enzymes inasmuch as diacylglycerol lipase but not monoacylglycerol lipase was completely inhibited by divalent cations. The diacylglycerol lipase was relatively specific for the 1 position yielding 2-acylglycerol. The monoacylglycerol lipase hydrolyzed 1 acylglycerol and 2-acylglycerol at comparable rates. Phosphatidic acid was dephosphorylated to form 1,2-diacylglycerol but the acyl groups of phosphatidate were not hydrolyzed significantly by the erythrocyte membranes. Thus, the origin of 1-acylglycerophosphate, a substrate for the newly described enzyme, acyl-CoA:1 acylglycerophosphate acyltransferase, in mature erythrocyte could not be ascribed to action of diacylglycerol lipase, glycerophosphate acyltransferase, or phosphatidate-specific phospholipase A. 1-Acylglycerophosphate may be supplied extracellularly or the 1-acylglycerophosphate acyltransferase activity in erythrocytes may be a remnant of de novo phosphatidate synthesizing system of reticulocytes. PMID- 6491530 TI - Conformational changes of cholesteryl palmitoleate in the crystal structure at low temperature. AB - At 123 K, crystals of cholesteryl cis-9-hexadecenoate (cholesteryl palmitoleate, C45H74O2) are monoclinic, space group P2(1) with cell dimensions a = 12.917(7), b = 8.910(5), c = 34.04(1) A, beta = 94.95(7) degrees [lambda(CuK alpha) = 1.5424 A] having two independent molecules (A and B) per unit cell. The crystal structure has been determined from 6178 reflections with sin theta/lambda less than or equal to 0.56 A-1, of which 3406 gave [F] greater than 3 sigma. Structure refinement by alternating cycles of Fourier syntheses and block diagonal least squares gave R = 0.24 for all reflections, R = 0.13 for reflections [F] greater than 3 sigma. At 123 K, the crystal structure consists of closely packed layers very similar to those at 295 K. However, there are major conformational differences in the layer interface region, which affect the ester chain of molecule B and the C(17) tail of molecule A. Although the electron density is diffuse in this region, the B-chain, which is bent, appears to be ordered at 123 K and has a different conformation from the disordered B-chains at 295 K. The change in the A-tail, which is twisted at 123 K and extended at 295 K, is very similar to that which occurs in two of the molecules when anhydrous cholesterol undergoes phase transition. Measurements of the unit cell dimensions at twelve temperatures (295 K to 123 K) indicate that the major changes in the crystal structure of cholesteryl palmitoleate occur in a 10 K range near 173 K. PMID- 6491531 TI - Absolute configuration at carbon 23 of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,23,25-pentol excreted by patients with cerebrotendinous xanthomatosis. AB - Absolute configuration at C-23 of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,23,25-pentol, one of the bile alcohols isolated from the patients with cerebrotendinous xanthomatosis, was unequivocally determined as 23S by conversion of a key intermediate, (23S)-5 beta-cholest-25-ene-3 alpha,7 alpha,12 alpha,23 tetrol to either the bile alcohol of known absolute configuration, (23R)-5 beta cholestane-3 alpha,7 alpha,12 alpha,23-tetrol, or the naturally occurring 23,25 pentol. PMID- 6491532 TI - Isolation of human apolipoprotein E by high performance liquid chromatography. PMID- 6491533 TI - Analysis of galactosylsphingosine (psychosine) in the brain. AB - A sensitive and specific analytical procedure has been developed for determination of galactosylsphingosine (psychosine) in the brain. The method takes advantage of two unusual properties of psychosine--the strong positive charge and the reactivity of the free amino group. It involves lipid extraction, separation from other lipids on a cation-exchange column (AG-50W), elimination of the last trace of galactosylceramide by silicic acid chromatography, dansylation of psychosine, Florisil and DEAE-Sephadex chromatography, and finally, fluorescent densitometry of dansylated psychosine separated by thin-layer chromatography. The detection limit is 5-10 ng/100 mg brain tissue when the standard procedure is followed exactly. Reliable determination can be made for 50 ng/100 mg or higher in the presence of 200,000-fold excess of other lipids and in the presence of 40,000-fold excess of galactosylceramide. The sensitivity can be increased fivefold by using a larger aliquot for the final determination. This analytical procedure has been successfully applied to demonstrate abnormal accumulation of psychosine in the brain in human, canine, and murine genetic galactosylceramidase deficiencies (globoid cell leukodystrophy). PMID- 6491534 TI - Simplified fluorometric assay for sphingosine bases. AB - A simplified procedure for fluorometric determination of sphingosine bases is presented. Nitrogenous bases are reacted with fluorescamine and then extracted into a lower phase solvent, obviating the need to transfer the reaction products prior to quantitation. Consequently, the entire procedure may be carried out in a single set of screw-capped reaction tubes. Chloroform was found to be the best solvent of those tested for the maximal extraction of derivatized sphingosine bases with negligible extraction of nitrogenous contaminants derived from phospholipids and amino sugars. The simplified method retains excellent sensitivity and selectivity and allows for simultaneous processing of large numbers of samples. Furthermore, quantitation of glycolipid-derived hexosamine can be obtained by measuring the fluorescence of the aqueous phase after partitioning. PMID- 6491535 TI - Production of glycolipid affinity matrices by use of heterobifunctional crosslinking agents. AB - Photoactivatable heterobifunctional crosslinking agents have been used to prepare glycolipid affinity matrices by nitrene insertion into adsorbed ligand. High degrees of covalent coupling have been obtained and the method has been used to purify antisulfoglycolipid antibodies from immune serum. PMID- 6491536 TI - Pigeon aortic smooth muscle cells lack a functional low density lipoprotein receptor pathway. AB - The low density lipoprotein (LDL) receptor pathway was studied in aortic smooth muscle cells from atherosclerosis-susceptible White Carneau pigeons and compared with rhesus monkey cells whose LDL receptor pathway has been previously characterized. Pigeon LDL was bound with high affinity in a saturable manner to both pigeon and monkey aortic smooth muscle cells. The kinetics of binding were different, however. LDL binding to pigeon cells exhibited positive cooperativity at low LDL concentrations and at least two classes of binding sites. The same pigeon LDL bound to monkey cells in a manner consistent with a single class of binding sites. Thus, these differences were a property of the pigeon cells and not the result of differences in the LDL. On the average, pigeon cells bound less than 50% the amount of LDL as monkey cells. Despite the surface binding to pigeon cells, little of the LDL was internalized, whereas pigeon LDL was actively internalized by monkey cells. Consistent with this observation, chloroquine and leupeptin had no effect on accumulation of LDL or on LDL degradation by pigeon cells, and incubation of pigeon cells with LDL produced no increase in cellular cholesteryl ester content. Binding of LDL to pigeon cells also differed from that of monkey cells by being unaffected by pretreatment with the proteolytic enzyme pronase, and by not requiring calcium. Binding was not specific for LDL since acetyl-LDL, and to a lesser degree HDL, were able to compete for LDL binding. Incubation with lipoprotein-deficient serum decreased LDL binding in pigeon cells while 25-OH cholesterol caused an increase in binding; both effects are opposite of that seen with the same LDL in mammalian cells. Preincubation with LDL or cholesterol dissolved in ethanol were without effect on LDL binding in pigeon cells, even though they produced significant increases in cellular free cholesterol content. In spite of the failure to internalize LDL, there was considerable degradation of LDL. This apparently occurred on the cell surface rather than by internalization and degradation within the lysosomes as occurs in mammalian cells. The functional significance of LDL binding to pigeon smooth muscle cells is unclear. The characteristics of binding resemble that of a nonspecific lipoprotein receptor referred to by others as the "lipoprotein receptor" or the "EDTA-insensitive receptor." It is apparent, however, that White Carneau pigeon aortic smooth muscle cells lack a functional LDL receptor pathway and in this way resemble cells from human beings with homozygous familial hypercholesterolemia or from Watanabe rabbits. PMID- 6491537 TI - Cholesterol metabolism in pigeon aortic smooth muscle cells lacking a functional low density lipoprotein receptor pathway. AB - Cholesterol metabolism was examined in aortic smooth muscle cells from atherosclerosis-susceptible White Carneau pigeons that have been shown to lack a functional LDL receptor pathway. In cells incubated in the presence of whole serum or low density lipoprotein (LDL) the rate of cholesterol synthesis from [1 14C]acetate or of HMG-CoA reductase activity was 20-100 times greater than for mammalian cells incubated under the same conditions. Unexpectedly, cholesterol synthesis decreased by nearly 50% after preincubation for 24 hr with lipoprotein deficient serum (LPDS). This occurred without a change in cellular cholesterol content. Neither the high rate of cholesterol synthesis nor the effect of LPDS could be accounted for by differences in cell turnover or state of growth. Cholesterol added in ethanol was ineffective in altering cellular cholesterol synthesis or esterification even though a near doubling in cellular free cholesterol content occurred. Cholesterol synthesis and esterification were, however, able to be regulated with 25-OH cholesterol and mevalonolactone, as indicated by their ability to suppress cholesterol synthesis and to stimulate cholesterol esterification. In spite of the high rate of endogenous cholesterol synthesis, cellular cholesterol content was maintained at a constant level by the efficient efflux of the newly synthesized cholesterol from the cell. Unlike mammalian cells that require a cholesterol acceptor in the medium for efflux to occur, cholesterol efflux from pigeon cells occurred in the absence of a cholesterol acceptor. This suggests either that pigeon cells utilize a different mechanism for cholesterol efflux or that they produce their own cholesterol acceptor. As a result of a lack of a functional LDL receptor pathway, pigeon smooth muscle cells do not maintain cholesterol homeostasis through the controlled uptake of exogenous LDL cholesterol, as do mammalian cells. Rather, pigeon smooth muscle cells would appear to regulate cholesterol concentrations at the level of either cholesterol synthesis or efflux. PMID- 6491538 TI - Action of a microbial glycerophospholipid:cholesterol acyltransferase on plasma from normal and LCAT-deficient subjects. AB - The action of a bacterial acyltransferase similar in overall reaction mechanism to the plasma enzyme lecithin:cholesterol acyltransferase (LCAT) has been studied using normal plasma and lipoproteins and plasma from LCAT-deficient patients. The microbial enzyme (GCAT) catalyzed acyl transfer using phosphatidylcholine and cholesterol in all of the lipoprotein fractions, presumably because it has no apolipoprotein cofactor. In addition, the enzyme was capable of hydrolyzing cholesteryl ester in lipoproteins but not in small unilamellar vesicles nor in micellar dispersions containing low amounts of Triton X-100. This suggests that cholesteryl ester is exposed on the surface of lipoprotein particles or that it may be transferred there quickly from the interior. Although considerable interconversion of radiolabeled cholesterol and cholesteryl ester could be demonstrated upon treatment of normal plasma or lipoproteins with the enzyme, there was little change in the actual amount of either steroid. This indicates that the rate of cholesteryl ester formation is very similar to the rate of hydrolysis. The relative proportions of cholesterol and cholesteryl ester in normal plasma are therefore near the equilibrium ratio for the reaction carried out by GCAT, or the ratio is controlled by the properties of the lipoproteins themselves. During reaction with the microbial acyltransferase, the ratio of cholesterol to cholesteryl ester in plasma from LCAT-deficient patients was reduced substantially, suggesting that the enzyme may have some practical applications. PMID- 6491539 TI - Abnormal high density lipoproteins from patients with liver disease regulate cholesterol metabolism in cultured human skin fibroblasts. AB - Apolipoprotein B (apoB) of plasma low density lipoproteins (LDL) binds to high affinity receptors on many cell types. A minor subclass of high density lipoproteins (HDL), termed HDL1, which contains apoE but lacks apoB, binds to the same receptor. Bound lipoproteins are engulfed, degraded, and regulate intracellular cholesterol metabolism and receptor activity. The HDL of many patients with liver disease is rich in apoE. We tested the hypothesis that such patient HDL would reduce LDL binding and would themselves regulate cellular cholesterol metabolism. Normal HDL had little effect on binding, uptake, and degradation of 125I-labeled LDL by cultured human skin fibroblasts. Patient HDL (d 1.063-1.21 g/ml) inhibited these processes, and in 15 of the 25 samples studied there was more than 50% inhibition at 125I-labeled LDL and HDL protein concentrations of 10 micrograms/ml and 25 micrograms/ml, respectively. There was a significant negative correlation between the percentage of 125I-labeled LDL bound and the apoE content of the competing HDL (r = -0.54, P less than 0.01). Patient 125I-labeled HDL was also taken up and degraded by the fibroblasts, apparently through the LDL-receptor pathway, stimulated cellular cholesterol esterification, increased cell cholesteryl ester content, and suppressed cholesterol synthesis and receptor activity. We conclude that LDL catabolism by the receptor-mediated pathway may be impaired in liver disease and that patient HDL may deliver cholesterol to cells. PMID- 6491540 TI - Mathematical model of biliary lipid secretion: a quantitative analysis of physiological and biochemical data from man and other species. AB - We propose a simple mathematical model to account for the coupling of secretion rates of bile salts, lecithin, and cholesterol into bile. The model assumes that: 1) molecules of "biliary" lecithin and cholesterol enter a functional compartment located in the endoplasmic reticulum of the hepatocyte from which they are secreted into bile, and in the case of cholesterol, also catabolized to bile salts; 2) the rates at which lecithin and cholesterol enter the "secretory" compartment are regulated independently by feedback loops that control their synthesis and/or uptake; 3) lecithin secretion is coupled by an unknown transport mechanism, possibly micellar or vesicular, to the flux of bile salts passing through the compartment; 4) cholesterol secretion is coupled by a similar mechanism to lecithin secretion and not to bile salt secretion directly; and 5) bile salt synthesis is proportional to the cholesterol content of the compartment. The model predicts that in the steady state the dependences, lecithin secretion vs bile salt secretion; cholesterol secretion vs lecithin secretion; and cholesterol secretion vs bile salt secretion, will all have the form of rectangular hyperbolae. Four independent parameters related to the postulated mechanisms of biliary lipid synthesis, uptake, and transport determine the quantitative features of these hyperbolae. These four "secretion parameters" also determine how the biliary lipid composition of hepatic and "fasting" gallbladder bile varies with bile salt secretion rate. A quantitative analysis of biochemical and physiological data on biliary lipid secretion in rat, dog, and man confirms the general predictions of the model. Deductions of the secretion parameters are made for each species and are compared with other relevant data on biliary lipid metabolism. From this analysis, we offer new insights into: i) the species differences in biliary lipid secretion and bile composition; ii) the influence of obesity on biliary lipid secretion in man; and iii) the causes of cholesterol super-saturation in fasting gallbladder bile. PMID- 6491541 TI - Measurement of human leukocyte microsomal HMG-CoA reductase activity. AB - Methods were developed for determination of microsomal HMG-CoA reductase activity from freshly isolated human lymphocytes, monocytes, and granulocytes or cultured human lymphoid cells. Reductase activity in monocytes is approximately twice that in lymphocytes or granulocytes. The activity in cultured cells is approximately 34-fold greater than that in freshly isolated cells. Assay conditions were such as to preclude formation of HMG-CoA cleavage products. Leukocyte reductase activity was inhibited by dichloroacetate, a noncompetitive inhibitor of rat liver reductase and a serum cholesterol-lowering agent in man. Measurement of microsomal reductase activity from freshly isolated leukocytes may prove useful in assessing in vivo regulation of cholesterol synthesis in man. PMID- 6491542 TI - Regulation of cholesterol biosynthesis and esterification by 25 hydroxycholesterol in a macrophage-like cell line: uncoupling by progesterone. AB - The coordinated control of cholesterol biosynthesis and esterification by 25 hydroxycholesterol was studied in the macrophage-like cell line P388D1. Since 25 hydroxycholesterol rapidly stimulated incorporation of [3H]oleate into the cholesteryl ester fraction of these cells, we have tested the possibility that the well-known inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG CoA reductase) by 25-hydroxycholesterol might be the indirect consequence of an increased cholesterol esterification rather than a direct effect on HMG-CoA reductase. The experimental results show that progesterone, an inhibitor of acyl CoA:cholesterol acyltransferase (ACAT), when added together with 25 hydroxycholesterol, abolished the increased cholesterol esterification without affecting the inhibition of HMG-CoA reductase by 25-hydroxycholesterol. Thus, uncoupling cholesterol esterification had no effect on 25-hydroxycholesterol's ability to inhibit HMG-CoA reductase. Unexpectedly, pretreatment of P388D1 cells with 25-hydroxycholesterol resulted in no elevation of ACAT activity as measured in broken cell preparations. Therefore, the possibility that 25 hydroxycholesterol stimulated cholesteryl ester formation by increasing the amount of cholesterol available for esterification, rather than by acting directly on ACAT activity, was considered. Labeling experiments using [14C] cholesterol have provided evidence for this assumption. PMID- 6491543 TI - On the optimal sex-ratio: a stability analysis based on a characterization for one-locus multiallele viability models. AB - Theoretical one-locus multiallele sex-determination models are found to admit even sex ratio equilibrium surfaces besides the equilibria for corresponding one locus multiallele viability models. Both types of equilibria can be defined in terms of a single spectral radius function, the former corresponding to level surfaces and the latter to critical points. The stable equilibria in the corresponding viability models are associated with the local maxima, and the equilibrium structures for the sex-determination models can be fully described. Several optimality properties of the even-sex-ratio equilibrium surfaces can be deduced. PMID- 6491544 TI - Models of genetic control by repression with time delays and spatial effects. AB - Two models for cellular control by repression are developed in this paper. The models use standard theory from compartmental analysis and biochemical kinetics. The models include time delays to account for the processes of transcription and translation and diffusion to account for spatial effects in the cell. This consideration leads to a coupled system of reaction-diffusion equations with time delays. An analysis of the steady-state problem is given. Some results on the existence and uniqueness of a global solution and stability of the steady-state problem are summarized, and numerical simulations showing stability and periodicity are presented. A Hopf bifurcation result and a theorem on asymptotic stability are given for the limiting case of the models without diffusion. PMID- 6491545 TI - A note on the role of generalized inverse Gaussian distributions of circulatory transit times in pharmacokinetics. AB - Based on a stochastic pharmacokinetical model (which mirrors topological properties of the circulatory system) it is shown by reinterpreting results of Wise (1974) that if the transit times of circulating drug molecules have a generalized inverse Gaussian distribution the corresponding residence times are gamma distributed. The condition that the probability of elimination of a drug molecule in a single circulatory passage is sufficiently small appears to be valid for most drugs. Thus theoretical evidence is given for fitting blood concentration-time curves following bolus injection of a single dose by power functions of time. PMID- 6491546 TI - Ovulation control: the right number or nothing. PMID- 6491547 TI - Fibrillation of a cardiac region and the tachycardia mode of a two-oscillator system. AB - The interaction between two nonlinear oscillators is discussed, each one representing a region of the heart and characterized by a specific type of phase transition curve (PTC) which has been derived from human ECG-recordings. Besides the normal conduction a tachycardia mode is studied where the excitation is reflected by each oscillator (reentry). It turns out that under specific physiologically plausible conditions this tachycardia mode cannot be terminated by an external stimulus. Under periodic stimulation the response of the tachycardia mode is chaotic. Within a sheet of nonlinear oscillators the tachycardia mode serves as an ectopic focus or a region of reentry which induces fibrillation of the whole tissue. PMID- 6491548 TI - Sympathetic nervous system response to mechanical stress of the spinal column in rats. AB - The effects of mechanical stimulation of the spine on blood pressure, heart rate and the activity of selected sympathetic nerves (renal and adrenal) were examined in alpha-chloralose/urethane anesthetized rats. Spinal segments from T10 to T13 or from L4 to L7 were isolated from surrounding muscle and the upper and lower segments of the four segment units were fixed by means of spinal clamps. Forces from 0.5 to 3.0 kg were applied to the lateral aspect of the two mobile segments. Stimulations of the thoracic or the lumbar region produced large decreases in blood pressure (-29.8 +/- 3.1 mmHg) along with small decreases in heart rate (6.1 +/- 1.6 beats/min). Additionally, large and immediate decreases were observed in renal nerve activity. While responses attenuated during the course of stimulation, they generally outlasted the stimulus. The adrenal nerve, after an initial decline in activity, showed subsequent increases which were attributed to baroreceptor effects, since bilateral lesion of the vagi and carotid sinus nerves abolished them. After baroreceptor denervations only initial decreases in activity were observed by mechanical stimulation of the spine. The observed responses were found not to be due to spinal cord compression, but rather were ascribed to afferent fiber mediated reflexes. Cutting dorsal (sensory) roots T10 to L2, bilaterally, abolished the response to lower lumbar stimulation. Additionally, in recording from the peripheral end of the severed dorsal roots, large increases in afferent activity were observed by spine stimulation. The present study has demonstrated potent somatovisceral reflexes from mechanical stimulation of the spinal column. These results are discussed in relation to other studies of somatovisceral responses and with regard to various clinical reports. PMID- 6491549 TI - Vascular ischemia of the cervical spine: a review of relationship to therapeutic manipulation. AB - Techniques employed by chiropractors in adjusting fixations of the cervical spine have often been a subject of criticism by other health care professionals. A primary concern is the potential risk of vascular occlusion in this region, subsequent to manipulative therapy. Although rare when compared to the millions of such manipulations given over a corresponding period of years, several reports exist to support the possibility of such an occurrence. Recent evidence, however, suggests that manipulation alone may not be solely contributory. Other extrinsic and intrinsic factors may play important roles in predisposing individuals who seek chiropractic intervention. Such factors are reviewed with the intention of establishing chiropractic professional awareness to such entities and to illustrate the need for a greater corroboration among health care professionals. PMID- 6491550 TI - Attitudes of chiropractic patients: a preliminary survey of patients receiving care in a chiropractic teaching clinic. AB - A survey of 390 patients receiving care in the teaching clinics of the Northwestern College of Chiropractic (NWCC) was conducted to obtain information about patient satisfaction with their chiropractic care and about their prior or subsequent utilization of other types of health care services. Patients were contacted by telephone after a period of at least one month had passed since discharge or discontinuance of care. Of patients surveyed, 92.1% responded that there was improvement in their condition ranging from "slight" to "complete" while 7.9% stated that there was no improvement in their complaint after receiving care. When asked about receiving treatment for their complaint prior to admittance, 58.0% stated that they had not sought previous care while 42.0% received treatment from another doctor first. These data are discussed and compared to other recently published investigations regarding utilization of chiropractic health care services and patient attitudes concerning chiropractic. PMID- 6491551 TI - The four quadrant weight scale: a technical and procedural review. AB - A discussion is presented of the four-quadrant weight scale; a postural analysis unit developed by the chiropractic profession to evaluate weight-bearing in the sagittal and frontal body planes. This report summarizes the technical description of the apparatus and attempts to establish a standardized procedural protocol. The normal and several aberrant weight-bearing patterns, and their clinical implications are discussed. Possible research applications for the future are suggested. PMID- 6491552 TI - Sacroiliac syndrome associated with lumbosacral anomalies: a case report. AB - A successfully treated case of sacroiliac syndrome coexisting with lumbosacral anomalies is presented. Spinal manipulative therapy is not contraindicated if properly modified to account for the anomalous anatomical orientation. PMID- 6491554 TI - Osseous configurations of the axial skeleton: Specific application to spatial relationship of vertebrae. PMID- 6491553 TI - Research and responsibility. PMID- 6491555 TI - Liberty, beneficence, and involuntary confinement. AB - My purpose in this paper is to show that current legal criteria for paternalistic involuntary psychiatric confinement of the mentally ill are both too narrow and too broad. I do this by first developing a principle of justified paternalistic interference with adults, which I take to be acceptably protective of individual liberty, but which does not require unnecessary sacrifices of individual welfare. After offering an analysis of current legal criteria for involuntary confinement, I argue that an acceptable theory of paternalistic interference reveals that those criteria (1) exclude some cases where confinement would be morally permissible, and (2) allow paternalistic confinement of many whose detention is not morally justifiable. PMID- 6491556 TI - Involuntary confinement: legal and psychiatric perspectives. PMID- 6491557 TI - The 'right' not to know. AB - There is a common view in medical ethics that the patient's right to be informed entails, as well, a correlative right not to be informed, i.e., to waive one's right to information. This paper argues, from a consideration of the concept of autonomy as the foundation for rights, that there can be no such 'right' to refuse relevant information, and that the claims for such a right are inconsistent with both deontological and utilitarian ethics. Further, the right to be informed is shown to be a mandatory right (though not a welfare right); persons are thus seen to have both a right and a duty to be informed. Finally, the consequences of this view are addressed: since the way in which we conceptualize our problems tends to determine the actions we take to resolve them, it is important properly to conceptualize patients' requests not to be informed. There may be many reasons for acting in accord with such a request, but it is a mistake to conceptualize one's act as 'respecting a right possessed by persons'. PMID- 6491558 TI - Rejoinder to 'medicine as patriarchal religion'. PMID- 6491559 TI - Women, medicine and religion: a response to Raymond and Abrams. PMID- 6491560 TI - The causes of neonatal mortality: an analysis of 760 autopsies on newborn infants. PMID- 6491561 TI - The effect of buprenorphine and morphine on intraluminal pressure of the common bile duct. PMID- 6491562 TI - Endomyocardial fibrosis in Thai children. PMID- 6491563 TI - Endoscopic study of X-rays negative dyspepsia. PMID- 6491564 TI - Duplication of the stomach. PMID- 6491565 TI - Malignant ectomesenchymoma (neoplasm of mixed mesenchymal and neuroepithelial origin) of wrist joint. PMID- 6491566 TI - Jaw metastasis from follicular carcinoma of thyroid gland simulating ameloblastoma. PMID- 6491567 TI - Conjugation in Tetrahymena: formation of a special junction area for conjugation during the co-stimulation period. PMID- 6491568 TI - Morphological analysis of the Golgi apparatus in rat amelogenesis as revealed by the Ur-Pb-Cu block staining method and freeze-fracture replication. PMID- 6491569 TI - Cell membrane-associated microtubules in secretory ameloblasts of rat incisor. PMID- 6491570 TI - Intercellular junctions between visual cells in the snake retina. PMID- 6491571 TI - Ultrastructure of glia-like cells contacting cerebrospinal fluid of pigeon third ventricle. PMID- 6491572 TI - A method for estimation of the total number of parenchymal cells of the anterior pituitary gland in the mouse and rat studied by electron microscopy. PMID- 6491574 TI - The twenty-ninth symposium of the Japanese Society of Electron Microscopy. Matsumoto, Japan, October 7-8, 1983. 200kV transmission electron microscopy. Abstracts. PMID- 6491573 TI - Vacuum grid box for TEM samples. PMID- 6491575 TI - Comparative rates of formation, in vivo, of 16-androstenes, testosterone and androstenedione in boar testis. AB - Three mature Large White boars were anaesthetized and received [7(n) 3H]pregnenolone by continuous infusion into right and left spermatic arteries for up to 180 min. Spermatic venous blood flow was measured by separate timed collections of completely diverted outflow from each testis and blood not sampled was returned to the peripheral circulation. The total radioactivity in plasma from each testis increased markedly during the first 60 min of infusion to reach a plateau from 80 to 180 min. Radiolabelling of 5 alpha-androst-16-en-3-one, 5 alpha-androst-16-en-3 beta-ol and -3 alpha-ol showed similar patterns with ratios of mean radioactivity of 5:3:1 respectively between 80 and 180 min. In comparison, the amounts of tritiated 4,16-androstadien-3-one formed were very small. The radiolabelling of testosterone and 4-androstenedione occurred more rapidly than that of the 16-androstenes and reached maxima by 30 min. However the amounts were only one-fifth (testosterone) and one-tenth (4-androstenedione) those of the combined quantities of tritiated 16-androstenes. Addition of human chorionic gonadotrophin (hCG) to the infusate to one testis in each animal (so that 5000 i.u. hCG were delivered in 15-20 min) produced no change in the outputs of radiolabelled steroids although radioimmunoassay of spermatic venous plasma in samples from the third experiment showed a transient increase in the concentration of 4-androstene-3,17-dione during the hCG infusion. It is suggested the lack of response to hCG could be produced by saturation and down regulation of binding sites by the very high local concentrations of hCG. PMID- 6491576 TI - Corticosterone availability in male rats at rest and during shock avoidance: differences among individuals, temporal patterns and effects of dexamethasone. AB - Repeated measurement of the time-integral of interstitial fluid free corticosterone concentration (corticosterone availability) under home-cage conditions, during exposure to recently unfamiliar apparatus, and during active shock avoidance over 3 days, demonstrated extreme stability within individuals, and consistent differences among individuals, in corticosterone availability under home-cage conditions. These consistent differences among individuals were preserved, while mean levels were doubled, during exposure to apparatus and during shock avoidance after treatment with dexamethasone. However, this persistent pattern of differences among individuals was not apparent during shock avoidance in the absence of dexamethasone. Shock avoidance provoked up to fourfold increases in corticosterone availability. Repeated measurements over 3 days showed consistent hour-to-hour increases within days and a gradual decline over days. Dexamethasone given 4 h before shock avoidance resulted in corticosterone availability intermediate between that in home-cage and that in the previous shock-avoidance session. The situation-dependent loss of consistent interindividual differences is proposed to signal a qualitative change in regulation of corticosterone availability within individuals, and a tactic for using inter-individual differences to study some aspects of complex regulatory systems is suggested. The hour-to-hour increase in corticosterone availability during shock avoidance may be attributable to slow achievement of full adrenal output; the decline over days may be due to behavioural factors. PMID- 6491577 TI - Secretory dynamics of 1 alpha-hydroxycorticosterone in the elasmobranch fish, Scyliorhinus canicula. AB - Peripheral plasma concentrations, metabolic clearance rates (MCR) and blood production rates (BPR) of 1 alpha-hydroxycorticosterone (1-OH-B) were determined in female dogfish (Scyliorhinus canicula) under varying environmental conditions. The constant-infusion technique, using high specific activity tritiated 1-OH-B, was applied to measure the MCR, and BPR were derived from the product of plasma concentration and MCR at equilibrium. Urea plasma clearances and apparent BPR were assessed in a similar manner. Fish were adapted stepwise to 140, 120, 90, 80, 70, 60 and 50% normal sea water (about 1000 mosmol/l). In all cases 1-OH-B was the major corticosteroid, cortisol and corticosterone were sought but never detected. In environments of reduced osmolarity, plasma osmolarity, sodium, chloride and urea concentrations all declined, alongside increases in plasma concentrations, MCR and BPR of 1-OH-B. In fish held in environments at concentrations greater than normal sea water, plasma osmolarity, sodium, chloride and urea concentrations all increased. Plasma clearance of urea increased in fish held in environments more dilute than sea water, while it decreased in the more hyperosmotic waters. It is tentatively concluded that homeostasis of plasma composition, with particular respect to urea, is in part regulated by 1-OH-B in the dogfish. PMID- 6491578 TI - Stimulation of milk secretion with inhibition of milk ejection by corticosteroids during extended lactation in the rat. AB - Milk yield declined significantly between days 22 and 28 of lactation in rats, when lactation was extended by frequent replacement of older litters with younger ones. Corticosterone implants but not cortisol injections or implants prevented this decline. Cortisol, however, appeared to inhibit milk ejection since the mammary glands became engorged with milk and milk yield was improved dramatically by oxytocin injections. In both cases corticosteroid concentrations increased approximately threefold above basal concentrations. Both corticosteroids increased total mammary gland RNA content and lipoprotein lipase (LPL) activity of the mammary gland but were without effect on insulin binding. They also decreased LPL activity, lipogenesis and the number of insulin receptors on adipose tissue. Serum prolactin and insulin concentrations were unaffected by any of the treatments. The results suggest that corticosteroids inhibit milk ejection under certain conditions, may be circulating in lower concentrations, which thereby limit milk production, during prolonged lactation and may improve milk yield during extended lactation in part by suppressing anabolic activity in adipose tissue. PMID- 6491579 TI - Inverse changes in plasma prolactin and LH concentrations in female canaries after disruption and reinitiation of incubation. AB - Prolactin and LH concentrations were measured in the plasma of female canaries sampled during the breeding cycle and after disruption and reinitiation of incubation behaviour. The late incubation period was characterized by low LH and high prolactin concentrations, and canaries separated from their nests at this stage showed an increased in LH and a decline in prolactin within 3 h. In one experiment mean (+/- S.E.M.) concentrations before and 24 h after nest deprivation were: prolactin 397 +/- 86 and 18 +/- 5 micrograms/l; LH 1.04 +/- 0.21 and 2.03 +/- 0.17 micrograms/l. Female canaries which abandoned their nests after the eggs had been removed also showed an increase in LH together with a fall in prolactin 24 h after egg removal. When nest-deprived canaries were allowed to resume incubation, plasma prolactin increased again within 5 h and after 2 days had reached levels normal for incubating birds (398 +/- 46 micrograms/l). Concentrations of LH changes more gradually but had decreased 2 days after the resumption of incubation. Thus prolactin and LH show inverse changes after the disruption and reinitiation of incubation behaviour; it is not clear, however, if the change in one is dependent on the other or if both hormones are responding to the same external stimulus. PMID- 6491580 TI - Do larval epidermal cells possess the blueprint for adult pattern in Drosophila? AB - When the diploid histoblasts, the precursors of adult abdominal epidermal cells, of the larva of Drosophila are deleted by gamma-radiation, the polytene larval epidermal cells survive metamorphosis and secrete cuticle and cuticular outgrowths. A comparison of the morphology of the cuticle secreted by the larval epidermal cells in the different regions of the abdominal segments to that secreted by the histoblasts of the unirradiated animal suggests that the former contain the blueprint for the pattern of landscape of the adult abdominal cuticle and possibly could provide this information to the dividing and spreading histoblasts during the normal ontogeny of the fly. PMID- 6491581 TI - Role of transferrin in branching morphogenesis, growth and differentiation of the embryonic kidney. AB - Our previous work has suggested that transferrin is an important serum component for differentiation of the kidney. In this study we have analysed more closely the response of cultured mouse embryonic kidney to exogenous transferrin and the dependence of kidney tubule induction on transferrin. Our results show that transferrin causes a dose-dependent increase in cell proliferation in the differentiating kidney mesenchyme, but no stimulation of cell proliferation in the inductor tissue used, the embryonic spinal cord. In cultures of whole kidney rudiments a remarkable increase in the amounts of DNA and protein are caused by transferrin but not by other serum components present in a transferrin-depleted serum. The morphology of the explants was similar when cultured in the presence of human serum and in the transferrin-depleted serum supplemented with transferrin. In transferrin-containing chemically-defined medium the explants flattened and spread out, but the morphology of the kidney tubules was similar as in explants cultured in the presence of serum. Examination of the cultured explants by electron microscopy showed that in all transferrin-containing culture media the mesenchymal cells had differentiated into kidney tubules consisting of epithelial cells lined by a basement membrane. The experiments with the transferrin-depleted serum demonstrate that the main mitogen for kidney development is transferrin, and that other serum factors are mainly required for maintenance of tissue compactness. Our earlier studies have shown that exogenous transferrin is not needed for certain changes preceding overt tubule formation in the kidney mesenchyme, and we suggested that transferrin responsiveness is acquired during the induction of kidney mesenchyme. Our present results do not contradict the postulate, although they demonstrate that the acquisition of the responsiveness is more complicated than previously thought. When the mesenchyme is exposed to inductor tissue for 24 h without transferrin, and then subcultured without the inductor in the presence of transferrin, morphogenesis fails and there is no proliferation of the mesenchyme. The experiment shows that the inductor, the mesenchyme and transferrin must all three be simultaneously present for the acquisition of the transferrin responsiveness. Other experiments show that the induced mesenchyme can be a direct target tissue, since it can proliferate in response to transferrin also in the absence of the inductor. It is evident that the inductor is required for the acquisition of the responsiveness, as suggested.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491582 TI - Regeneration of surgically created mixed-handed axolotl forelimbs: pattern formation in the dorsal-ventral axis. AB - The regeneration of surgically created mixed-handed limb stumps is examined in the axolotl. Operations were performed in the lower arm and upper arm regions and grafts were allowed to heal for approximately one month prior to amputation or were amputated immediately. In the lower arm group both anterior and posterior limb halves were inverted, whereas only posterior halves were inverted in the upper arm group. Almost all the limbs regenerated were normal in the anterior posterior axis, whereas a range of limb types were found when the dorsal-ventral axis was analysed using the metacarpal muscle pattern and epidermal Leydig cell number as positional markers. The carpal and forearm muscle patterns were also analysed in order to assess whether the pattern determined from analysis at the metacarpal level reflected that seen at more proximal levels. The results are discussed in terms of the possible role of cell contribution from the stump to the blastema and the relevance of the study to models of pattern regulation. PMID- 6491584 TI - The histogenetic capacity of tissues in the caudal end of the embryonic axis of the mouse. AB - The caudal end of the embryonic axis consists of the primitive streak and the tail bud. Small fragments of this caudal tissue were transplanted from mouse embryos of various developmental stages to the kidney capsule in order to test their histogenetic capacity. The variety of mature tissues obtained from these small fragments was similar to that obtained by grafting a larger caudal portion of the embryo. Initially, the grafted tissue broke up into loose masses of embryonic mesenchyme and this was later re-organized into more compact tissues and into cysts that were lined with various types of epithelia. After 14 days in the ectopic site, grafted tissues coming from embryos of the primitive-streak, the early-somite and the forelimb-bud stages differentiated into structures that has presumably originated from the three embryonic germ layers. Many of these structures were related to the caudal region of the adult body, such as the mid- and hindgut segments and urogenital derivatives. The histogenetic capacity for endodermal tissues and urogenital organs was lost when the grafted tissue consisted entirely of the tail bud of the hindlimb-bud-stage embryos. The behaviour of the caudal tissues suggested that (1) the primordia for the various parts of embryonic body were derived from a small progenitor population in the primitive streak and the tail bud, and (2) the histogenetic capacity of this population changed during development. PMID- 6491583 TI - The pattern of alkaline phosphatase activity in the developing mouse spinal cord. AB - The localization of alkaline phosphatase activity in the lumbosacral region of the developing spinal cord was studied in 9.5- to 17.5-day mouse embryos. The activity was uniformly distributed in the pseudostratified neuroepithelium of the 9.5-day cord. In the 11.5-day cord in which the lateral motor columns were being formed, the enzymatic activity was localized in the ventrolateral sector of the cord. The enzyme-positive ventricular cells tended to be located medially whereas radially oriented enzyme-positive processes extended into the marginal layer. The 13.5-day cord displayed a similar distribution pattern, but there were many more radial processes and the enzyme-positive cells had spread laterally. Close apposition between the processes and the ventricular cells was observed. By 15.5 and 17.5 days, when the intermediate layer was fully developed and the ventricular layer had regressed to a thin ependyma, the activity had become diffusely located in the ventral half of the cord. The enzyme-positive cells and processes became less conspicuous. The silver-stained processes in the cord were found to be organized in an entirely different pattern from that of the enzyme positive processes, suggesting that the enzyme-positive processes were not neuronal processes. The enzymatic activity found in the developing spinal cord may be associated with the migration of neuroblasts along the radially aligned processes. PMID- 6491585 TI - Mutational analysis of patterning of oral structures in Tetrahymena. I. Effects of increased size on organization. AB - The oral apparatus (OA) of the ciliated protozoan Tetrahymena thermophila consists of four ordered arrays of ciliary units. In wild-type cells, these arrays are constant in spatial organization and vary little in size except during extreme starvation. Recessive mutations at five gene loci are known to increase the size of the OA. They do this by increasing the length of the ciliary arrays, without affecting their width and often without increasing their number beyond the usual four. Comparison of the oral arrays over a large range of sizes has revealed: (1) that the lengths of the anterior two of three parallel arrays (membranelles) are rather tightly coordinated; (2) that the specific basal body configurations resulting from remodelling of the membranelles are only slightly affected by large changes in lengths of membranelles; and (3) that the third membranelle is restricted to a nearly constant length, except in the very largest OAs in which the structure is lengthened but interrupted by a gap in the middle. This gap may reveal the spatial extent of a putative zone of basal body regression. These phenomena are not specific to any of the genotypes utilized in this investigation; the effect of the mutations is to loosen quantitative restrictions and thus reveal underlying associations and constraints. PMID- 6491586 TI - Mutational analysis of patterning of oral structures in Tetrahymena. II. A graded basis for the individuality of intracellular structural arrays. AB - The ciliary arrays of the oral apparatus of the ciliated protozoan Tetrahymena thermophila each have their own unique 'pattern signature', which varies little so long as the number of arrays remains the same. In this study, we analyse the consequence of increases in the number of these arrays (membranelles) brought about by certain mutations. In oral apparatuses of mutant cells, the addition of a membranelle is associated with specific alterations in at least one of the other membranelles. The features that are altered include the relative lengths of membranelles, the state of ciliation of basal bodies located at specific positions within these membranelles, and the spatial configurations resulting from displacement of ciliary units during late oral development. The final organization of each membranelle depends upon its relative position along the length of the oral apparatus. This indicates that the membranelles are not individually 'named' by the organism, and suggests that the unit of pattern organization is the membranelle field as a whole. In the Discussion, we consider means for testing whether the same underlying idea might also apply to multicellular systems, such as the vertebrate limb, in which spatially ordered differences appear to be superimposed upon a fundamental repeating pattern. PMID- 6491587 TI - Effects of radius--ulna removal on forelimb regeneration in Xenopus laevis froglets. AB - Regeneration of boneless amputated forearms of adult newts was found to progress at a rate and to a degree comparable to amputated control limbs in which stump bones were not removed. In contrast, regeneration of boneless amputated Xenopus froglet forearms was significantly delayed and did not occur until two to three weeks following amputation. This is in comparison with the initiation of distal cartilage formation observed one week postamputation in control forelimbs of Xenopus froglets. The regeneration of cartilage in boneless forearms of adult newts was found to occur distal to the amputation level. In contrast, distal as well as proximal (centripetal) regeneration of cartilage was observed in the amputated boneless forearms of Xenopus. In froglets and newts, unamputated forelimbs in which forearm bones were extirpated did not initiate cartilage regeneration. Our findings support the hypothesis that forelimb regeneration in Xenopus froglets is primarily a tissue response. In comparison, limb regeneration in the adult newt is predominantly an epimorphic response. PMID- 6491588 TI - Hormonal control of muscle atrophy and degeneration in the moth Antheraea polyphemus. AB - The intersegmental muscles of the giant silkmoth Antheraea polyphemus (Cramer) can undergo two forms of degenerative changes: a wasting atrophy that lasts about 6 days or rapid dissolution that is completed within 30 h. Muscle atrophy is induced by a dramatic decline in the endogenous titres of the steroid moulting hormone 20-hydroxyecdysone. 20-Hydroxyecdysone appears to act as a trophic factor for the muscles as infusion or injection of this steroid blocks further atrophy of the muscle. The normal decline of 20-hydroxyecdysone also allows the muscles to become competent to respond to the peptide eclosion hormone. Eclosion hormone is then released and acts directly on these muscles to induce rapid cell death which is morphologically and physiologically distinct from steroid-regulated atrophy. PMID- 6491589 TI - Power output and force-velocity relationship of red and white muscle fibres from the Pacific blue marlin (Makaira nigricans). AB - Single white fibres and small bundles (two to three) of red fibres were isolated from the trunk muscle of Pacific Blue Marlin (50-121 kg body weight). Fibres were chemically skinned with 1% Brij. Maximum Ca2+-activated force production (Po) was 57 kN m-2 for red fibres and 176 kN m-2 for white fibres at 25 degrees C. The force-velocity (P-V) characteristics of these fibres were determined at 15 and 25 degrees C. Points below 0.6 Po on the P-V curve could be fitted to a linear form of Hill's equation. The degree of curvature of the P-V curve was similar at 15 and 25 degrees C (Hill's constant a/Po = 0.24 and 0.12 for red and white fibres respectively). Extrapolated maximum contraction velocities (Vmax) were 2.5 muscle lengths s-1 (Lo S-1) (red fibres) and 5.3 Lo S-1 (white fibres) at 25 degrees C. Q10(15-25 degrees C) values for Vmax were 1.4 and 1.3 for red and white fibres respectively. Maximum power output had a similar low temperature dependence and amounted to 13 W kg-1 for red and 57 W kg-1 for white muscle at 25 degrees C. The results are briefly discussed in relation to the locomotion and ecology of marlin. PMID- 6491591 TI - Lithium attenuates the active transport of calcium in the larva of Aedes aegypti. PMID- 6491590 TI - Electrolyte composition of parotid saliva from sodium-replete red kangaroos (Macropus rufus). AB - Saliva was collected from the parotid salivary gland of anaesthetized sodium replete red kangaroos (Macropus rufus) by catheterization of the parotid duct through its opening in the mouth. Salivary secretion was stimulated by ipsilateral intracarotid infusion of acetylcholine at varying rates to produce salivary flow rates ranging from 0.056 +/- 0.0042 (S.E. of mean) to 4.509 +/- 0.1136 ml min-1. The concentrations of sodium (142.2 +/- 1.93 to 157.0 +/- 1.17 mmol l-1), calcium (40.1 +/- 7.08 to 72.8 +/- 8.0 mumol l-1) and bicarbonate (68.6 +/- 3.48 to 143.3 +/- 0.67 mmol l-1) and the osmolality (270.1 +/- 2.98 to 291.7 +/- 2.10 mosmol kg-1) were positively correlated with salivary flow rate, whereas the concentrations of potassium (11.4 +/- 0.57 to 6.92 +/- 0.19 mmol l 1), magnesium (206.0 +/- 34.1 to 9.3 +/- 0.78 mumol l-1), hydrogen ion (17.0 +/- 1.89 to 6.82 +/- 0.49 nmol l-1), chloride (30.7 +/- 2.41 to 4.11 +/- 0.23 mmol l 1) and phosphate (47.6 +/- 2.65 to 14.9 +/- 0.81 mmol l-1) were negatively correlated with flow rate. The relationships between flow rate and concentration were curvilinear for all the inorganic solutes. The rates of secretion for each ion and for total solute were positively correlated with salivary flow rate. These regressions for sodium, potassium, calcium, hydrogen ion, bicarbonate and osmolality were always linear, with highly significant correlation coefficients and variance ratios, which indicated that the changes in concentration of these ions were related solely to flow rate and were not due to any other factor modifying glandular function. Spontaneous secretion was not observed during anaesthesia. PMID- 6491592 TI - Effects of in vivo and in vitro changes in PO2 on the deformability of red blood cells of rainbow trout (Salmo gairdneri R.). PMID- 6491593 TI - Correlations between structure and function in the design of the bat lung: a morphometric study. AB - The lungs of five species of bat Pipistrellus pipistrellus, Miniopterus minor (Peters), Tadarida mops (De Blainville), Cynopterus brachyotis (Muller) and Cheiromeles torquatus (Horstield) have been analysed by morphometric techniques. The mean body weight (W) ranged from 5 g in Pipistrellus pipistrellus to 173 g in Cheiromeles torquatus; the lung volume (VL) ranged from 0.3 cm3 in Pipistrellus to 10 cm3 in Cheiromeles. The volume densities or the main components of the bat lung, namely the parenchyma [VV(p,L)] (the gas exchange region) and the non parenchyma [VV(np,L)], were closely similar, the VV(p,L) constituting a mean value of 84.2% and the VV(np,L) 15.8% in the five species. The VL, the surface area of the blood--gas (tissue) barrier (St), the pulmonary capillary blood volume (Vc), and the total morphometric pulmonary diffusing capacity (DLO2) were all strongly correlated with body weight. The harmonic mean thickness of the blood--gas (tissue) barrier (tau ht) and the surface density of the blood--gas (tissue) barrier [SV(t,p)] were poorly correlated with W. The bats had a remarkably higher VL than either birds or terrestrial mammals. The Vc in the bat lung was similar to that in the bird lung but higher than that of the terrestrial mammals. The bats had a more extensive St than either the birds or the terrestrial mammals. In the bats the tau ht was thicker than in the birds but thinner than that of the terrestrial mammals. These pulmonary structural adaptations culminated in a higher DLO2 in the bat than either in the birds or in the terrestrial mammals. The superior morphometric properties of the bat lung coupled with the established physiological adaptations may help to explain how the bat lung is capable of providing the immense amount of oxygen demanded by flight. PMID- 6491594 TI - Analysis of contact-rehydration in terrestrial gastropods: osmotic control of drinking behaviour. AB - Contact-rehydration in slugs is mediated by a specific behavioural pattern in which dehydrated slugs move onto a moist surface, assume a flattened posture while water is absorbed through the surface of the foot and move off once they are rehydrated. 'Drinking behaviour' is initiated when slugs have been dehydrated to the threshold level of 60-70% of initial body weight (IBW). Drinking behaviour is terminated once slugs have rehydrated to their individual rehydration set points. The mean 'rehydration set-point' for Limax is 93.6 +/- 12.2% IBW (+/- S.D.). Slugs can achieve their individual set-point regardless of the extent of initial dehydration. Drinking behaviour can be initiated by injections of hyperosmotic mannitol solution and terminated by injections of dilute saline. This indicates that variation in the osmolality of the haemolymph is involved in the control of the behavioural sequence. PMID- 6491595 TI - Analysis of contact-rehydration in terrestrial gastropods: absorption of 14C inulin through the epithelium of the foot. AB - Contact-rehydration in terrestrial slugs involves a specific drinking behaviour during which water is rapidly absorbed through the integument of the foot. When dehydrated slugs were placed on wet filter paper containing 14C-inulin, they displayed the characteristic drinking posture and absorbed both water and 14C inulin. Samples of haemolymph from dehydrated slugs after 12 min of contact rehydration contained about 6 micrograms of 14C-inulin 100 mg-1 of haemolymph (0.24 mmol l-1 14C-inulin in the substrate). The haemolymph of hydrated slugs however contained no detectable radioactivity after 12 min on the filter paper. Electron microscopy revealed that the intercellular spaces between the epithelial cells of the foot were reduced in dehydrated slugs, but were rapidly enlarged during contact-rehydration. It is concluded that contact-rehydration in terrestrial slugs is mediated by bulk flow of water through an epithelial paracellular pathway in the integument of the foot. PMID- 6491596 TI - Development of visually guided hand orientation in reaching. AB - The development of an ability to use vision in adjusting the hand and the fingers to the orientation of an object to be grasped was studied in a group of 15 infants. They were 18 weeks at the first session and were seen at 4-week intervals until 34 weeks old. At each session they were presented with horizontal and vertical rods. The orientation of the hand of the infant when reaching for these rods was measured at each 60-msec interval during the last 540 msec of the approach. It was found that even at the youngest age there were signs of adjustment of the hand to the orientation of the object. However, at that age the adjustments were rather incomplete. During the months that followed there was a rapid improvement in the skill studied. The findings were in accordance with the idea that information about object orientation is accessible to the manual system when infants start reaching for objects but that the system has yet to be tuned and calibrated before functioning adequately. PMID- 6491597 TI - Word recognition under spatial transformation in retarded and normal readers. AB - The recognition of words in normal, reversed, and inverted orientation was compared in a group of 9- to 11-year-old retarded readers and a matched group of normal readers. Using the ratio of reading times as an index of reading difficulty under spatial transformation, the results confirmed those of earlier studies which have shown that retarded readers' performance is less affected by spatial transformation than is normal readers'. However, an analysis in terms of the ratio of numbers of words read correctly pointed to just the opposite conclusion. The two sets of findings were reconciled by showing that they follow from the form of the function relating reading time to number correct, and by demonstrating that when word lists are equated for orthographic familiarity the performances of retarded and normal readers are equally affected by spatial transformation, whether the time or number ratio is used as an index. PMID- 6491598 TI - The role of self-produced movement and visual tracking in infant spatial orientation. AB - In two longitudinal studies, infants were trained at 12 and 18 months to find an object hidden in one of two identical wells in a Plexiglas box. On the test trial, normal access was blocked and infants were either guided by their mother or allowed to move on their own to another opening on the opposite side. In Experiment 1 significantly more correct responding occurred after active movement than after passive at 12 months, with correct responding related to high visual tracking. In contrast, at 18 months correct search without tracking predominated among both movement conditions. A difference between the conditions in the position of the mother on the test trial was ruled out as a contributor to performance on the basis of data from Experiment 2. When opaque sides were inserted to prevent tracking in Experiment 3, active movement no longer facilitated correct search at 12 months, thus indicating that the tracking and not the active movement per se was the critical factor. PMID- 6491599 TI - A developmental study of learning disabilities and memory. AB - Seven-, ten-, and thirteen-year-old learning-disabled (LD) and non-learning disabled (NORM) children were presented specially structured lists of 38 words each and tested for free recall. Each list contained only four semantically related words. Two of the four related words were presented contiguously (serial positions 9 and 10) and the other two words were spaced (serial positions 20 and 30). All children recalled disproportionately more adjacent words (item 9 or 10) than any other words. Spaced words (items 20 and 30) were less likely to be recalled by the younger children than by the older children and by the LDs than by the NORMs. These findings provided support for the distinction between automatic and purposive semantic processing. NORMs' recall was governed by purposive semantic processing to a greater extent than was LDs' recall. However, no group or age differences were observed in automatic semantic processing. PMID- 6491600 TI - Dual origin of mouse spleen macrophages. AB - The present study concerns the isolation, characterization, origin, and kinetics of spleen macrophages. The spleen was first perfused in situ to remove monocytes from the vascular bed and then dissected and treated with collagenase. The macrophages in the cell suspension thus obtained were characterized morphologically and cytochemically and then quantitated. The spleen cell suspension was incubated for 24 h in Leighton tubes to obtain an enriched glass adherent population of macrophages for characterization and [3H]thymidine labeling studies. Almost all of the adhering macrophages were esterase positive, had Fc and C3b receptors, and ingested EIgG and opsonized bacteria. In vitro labeling with [3H]thymidine showed that approximately 5% of the mononuclear phagocytes in the spleen synthesize DNA and must be considered to be dividing cells. The course of the number of labeled monocytes and macrophages after a single injection of [3H]thymidine indicates migration of monocytes into the spleen, where they become macrophages. Calculation of the influx of monocytes into the spleen and of the local production of macrophages by DNA-synthesizing mononuclear phagocytes showed that under steady-state conditions, 55% of the population of spleen macrophages is supplied by monocyte influx and 45% by local production. This means that there is a dual origin of spleen macrophages. The mean turnover time calculated with the value for the efflux of spleen macrophages is 6.0 d. PMID- 6491602 TI - Human autoantibodies against a desmosomal core protein in pemphigus foliaceus. AB - Pemphigus foliaceus (PF) is a human autoimmune disease in which antibodies are directed against the cell surface of epidermal cells with resultant blister formation. The histopathology of these blisters indicates that cells have detached from each other, and electron microscopy of early blisters shows diminished numbers, to complete loss, of desmosomes as well as abnormalities of the tonofilament-desmosome complex. In this study we demonstrate that autoantibodies from certain PF patients bind to a desmosomal core glycoprotein called desmoglein (DG) I. Proteins in extracts of normal human epidermis were separated by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE), then transferred to nitrocellulose or 2-aminophenylthioether paper for immunoperoxidase staining. Results of these immunoblots indicated that sera from 6 of 13 PF patients specifically and intensely stained an approximately 160,000 mol wt polypeptide, "PF antigen". Such staining was not seen with normal human sera or sera from patients with pemphigus vulgaris or bullous pemphigoid, two autoimmune blistering skin diseases that are clinically, histologically, and immunochemically distinct from PF. However, rabbit antiserum directed against DGI, that was isolated from bovine muzzle desmosomes, stained a polypeptide band which co-migrated with PF antigen. Furthermore, when proteins from extracts of normal human epidermis were electrophoresed in two dimensions (isoelectric focusing, then SDS-PAGE) before transfer to nitrocellulose for immunoperoxidase staining, PF antibodies and antibodies to DGI stained identical spots. Finally, PF sera as well as PF IgG that was affinity purified with PF antigen from normal human epidermis, both selectively bound to DGI extracted from bovine muzzle desmosomes. These studies demonstrate that the human autoantibodies from certain patients with PF, a disease of epidermal cell adhesion, are directed against a desmosomal core protein. PMID- 6491601 TI - Augmentation of organ-associated natural killer activity by biological response modifiers. Isolation and characterization of large granular lymphocytes from the liver. AB - Natural killer (NK) activity in the rat and human has been attributed to cells having the morphology of large granular lymphocytes (LGL). However, this association has been less clear in the mouse, largely because of difficulties in obtaining highly enriched populations of LGL from normal spleen and blood. We have previously observed that the administration of the biological response modifier (BRM) maleic anhydride divinyl ether (MVE-2) strongly augmented NK activity in lung and liver, and the augmented NK activity coincided with increased resistance to the formation of experimental metastases in these organs. The degree of NK augmentation was most striking in the liver, an unexpected and previously unreported observation. In the present study, both MVE-2 or Corynebacterium parvum induced a dramatic augmentation of liver NK activity, which reached maximum levels 3-5 d after treatment. This augmentation of NK activity in the liver coincided with a large increase in the number of lymphoid cells with the morphological characteristics of LGL that could be isolated from enzymatically digested suspensions of perfused liver. The yield of LGL per liver following BRM treatment corresponded to a 10-50-fold increase as compared to normal mice. LGL were purified from these enzymatically digested suspensions of perfused liver by depletion of adherent cells on nylon wool columns and subsequent enrichment for low-density lymphoid cells by fractionation on Percoll density gradients. The enrichment of LGL correlated with greatly increased NK activity against YAC-1. Conversely, the higher-density fractions were depleted of both LGL and NK activity. This increase in NK activity in the liver was suppressed by in vivo treatment with anti-asialo GM1 (asGM1) serum. This treatment also resulted in a corresponding reduction in both the total number and percentage of LGL. By flow cytometry analysis, the phenotype of the majority of these highly cytolytic LGL isolated from the livers of BRM-treated mice were asGM1+, Thy-1+, Ly-5+, Qa-5+, Mac-1+, and Gma-1+, whereas these LGL were Ly-1-, Lyt-2-, L3T4-, and surface Ig-. We conclude that the livers of BRM-treated mice can provide a rich source of highly active mouse LGL that could be used for further characterization of this lymphocyte subset. Further, these studies imply a potential for BRM therapy of neoplastic or viral diseases through augmentation of organ-associated immune responses. PMID- 6491603 TI - A unique natural human IgG antibody with anti-alpha-galactosyl specificity. AB - A new natural anti-alpha-galactosyl IgG antibody (anti-Gal) was found to be present in high titer in the serum of every normal individual studied. The antibody was isolated by affinity chromatography on a melibiose-Sepharose column. The reactivity of the antibody was assessed by its interaction with alpha galactosyl residues on rabbit erythrocytes (RabRBC). The specificity was determined by inhibition experiments with various carbohydrates. The anti-Gal interacts with alpha-galactosyl residues, possibly on glycolipids of human RBC (HuRBC), after removal of membrane proteins by treatment with pronase. In addition, the anti-Gal bind specifically to normal and pathologically senescent HuRBC, suggesting a physiological role for this natural antibody in the aging of RBC. The ubiquitous presence of anti-Gal in high titers throughout life implies a constant antigenic stimulation. In addition to the theoretical interest in the antibody, the study of the anti-Gal reactivity seems to bear immunodiagnostic significance. Decrease in the antibody titer was found to reflect humoral immunodeficiency disorders. PMID- 6491604 TI - Possible role for a human adenovirus in the pathogenesis of celiac disease. AB - Celiac disease in humans is activated by the dietary ingestion of wheat, rye, triticale, barley, and possibly oats. Gliadins in wheat and similar proteins in the other grains are known to activate disease in susceptible individuals. There is a striking association between celiac disease and HLA-B8, -DR3 and/or -DR7, and -DC3. Nonetheless, less than 0.2% of individuals with those serologic HLA specificities develop celiac disease and disease is not always concordant among monozygotic twins. We propose that additional environmental factors may be important in the pathogenesis of celiac disease. To investigate that possibility, we examined a data bank of protein sequences for other proteins that might share amino acid sequence homologies with A-gliadin, an alpha-gliadin component known to activate celiac disease and whose complete primary amino acid sequence is known. These studies demonstrate that A-gliadin shares a region of amino acid sequence homology with the 54-kD E1b protein of human adenovirus type 12 (Ad12), an adenovirus usually isolated from the intestinal tract. The region spans 12 amino acid residues, includes 8 residue identities and an identical pentapeptide, and is hydrophilic in both proteins. Antibody reactive with the 54-kD Ad12 E1b protein cross-reacts with A-gliadin, a 119 amino acid cyanogen bromide peptide of A-gliadin that spans the region of homology and a synthetic heptapeptide of A gliadin from within the region of homology. We suggest that an encounter of the immune system with antigenic determinants produced during intestinal viral infection may be important in the pathogenesis of celiac disease. PMID- 6491605 TI - Acquisition of high metastatic capacity after in vitro fusion of a nonmetastatic tumor line with a bone marrow-derived macrophage. AB - A low metastatic, thioguanine-resistant murine T lymphoma line (EbTGR) was hybridized in vitro, with the help of polyethylene glycol, with syngeneic bone marrow-derived macrophages. Two HAT-resistant hybrid lines (Eb-F1 and Eb-F2) were obtained from independent fusion cultures. A cytogenetic analysis revealed that most of the macrophage chromosomes except No. 12 had segregated or become rearranged 60 d after fusion, a time at which the cell lines had become stabilized in culture. Syngeneic mice inoculated subcutaneously with the tumor macrophage hybrid lines developed, very quickly, visceral metastases and died after less than 2 wk, while those inoculated with the parental line lived for greater than 6 wk and developed only localized, large primary tumors. The metastatic hybridomas expressed a similar tumor antigen as a spontaneous, in vivo derived, high metastatic variant (ESb) of the same tumor. This suggests that ESb cells might have arisen from a spontaneous fusion with a host macrophage. PMID- 6491606 TI - A multivalent lacto-N-fucopentaose III-lysyllysine conjugate decompacts preimplantation mouse embryos, while the free oligosaccharide is ineffective. AB - A multivalent lacto-N-fucopentaose (LNFP) III-lysyllysine conjugate was observed to decompact preimplantation mouse embryos. Decompaction was not obtained with free oligosaccharides (LNFP II and III), nor with multivalent LNFP II-lysyllysine or chitotriose-lysyllysine conjugates. These results suggest a role for X hapten recognition during compaction and suggest further that X hapten valency may play a key role in modulating this developmental process. PMID- 6491607 TI - Differential effects of reinforcement of an inhibitory feature after serial and simultaneous feature negative discrimination training. AB - Two experiments using a conditioned suppression procedure with rat subjects found that postconditioning reinforcement of an inhibitory feature stimulus (X) had substantially different effects depending on whether a serial (A+, X----A-) or a simultaneous (A+, AX-) feature negative discrimination procedure was used to establish the inhibition. With the simultaneous procedure, acquisition of excitation to the previously inhibitory X was retarded when X was paired with shock. Subsequent summation tests showed no evidence of inhibition to X after reinforced X presentations. However, acquisition of excitation to X was unaffected by prior serial feature negative training, and X-shock pairings had relatively little effect on X's inhibitory power in summation tests. These data suggest that the nature of inhibition established in feature negative discriminations differs substantially depending on the temporal arrangement of stimuli. One possibility is that inhibitors established using simultaneous stimulus arrangements modulate behavior by acting on a representation of the unconditioned stimulus, but inhibitors established with serial procedures act on particular conditioned stimulus-unconditioned stimulus associations. PMID- 6491608 TI - Unblocking in Pavlovian appetitive conditioning. AB - Two experiments demonstrated unblocking in an appetitive conditioning preparation with rat subjects. One stimulus, A, was first paired with either a low-value reinforcer (one food pellet) or a high-value reinforcer (one food pellet followed by two more food pellets). A second stimulus, X, was then added to A, and the compound was reinforced with either the high- or low-value reinforcer. Conditioning to X was blocked if the same reinforcer was used in both phases of the experiment, but there was substantial conditioning to X when the reinforcer value was shifted either up or down when X was introduced. Experiment 1 demonstrated this unblocking phenomenon using a design that minimized the potential contribution of generalization decrement. Experiment 2 examined the effects of a variety of posttraining manipulations on conditioned responding to the added X cue after unblocking procedures. Responding of subjects that received downshifts in reinforcer value when X was introduced was affected by several posttraining manipulations, including changes in context value. Those manipulations had smaller effects on the responding of subjects that received upshifts in reinforcer value and no effects on responding in control conditions. PMID- 6491609 TI - Pigeon memory: same/different concept learning, serial probe recognition acquisition, and probe delay effects on the serial-position function. AB - Two pigeons were trained with sets of 70 pairs of color-slide stimuli in a same/different task to perform at least 88% correct; six different sets were used in successive acquisitions. The subjects transferred same/different performance to novel stimuli with 60% accuracy following their six acquisitions; further training and daily changes in the training stimuli revealed 71% transfer to novel stimuli. Four pigeons were trained (88% criterion) in a serial-probe-recognition task with three list items, and the list length was increased with successive acquisitions to four, five, and six list items. Their serial-position functions changed for different delays between the last list item and the test item revealing a recency effect (last items remembered well) for 0-s delay, recency and primacy effects (first items remembered well) for 1- and 2-s delays, and only a primacy effect for a 10-s delay. These results are discussed in relation to human memory performance and theories of memory processing generally. PMID- 6491610 TI - Monkey memory: same/different concept learning, serial probe acquisition, and probe delay effects. AB - Three rhesus monkeys were trained and tested in a same/different task with six successive sets of 70 item pairs to an 88% accuracy on each set. Their poor initial transfer performance (55% correct) with novel stimuli improved dramatically to 85% correct following daily item changes in the training stimuli. They acquired a serial-probe-recognition (SPR) task with variable (1-6) item list lengths. This SPR acquisition, although gradual, was more rapid for the monkeys than for pigeons similarly trained. Testing with a fixed list length of four items at different delays between the last list item and the probe test item revealed changes in the serial-position function: a recency effect (last items remembered well) for 0-s delay, recency and primacy effects (first and last list items remembered well) for 1-, 2-, and 10-s delays, and only a primacy effect for the longest 30-s delay. These results are compared with similar ones from pigeons and are discussed in relation to theories of memory processing. PMID- 6491611 TI - Forgetting of visual discriminations by pigeons. AB - A series of three experiments examined the forgetting of visual discriminations by pigeons. The problems consisted of feature discriminations, with dot displays as the discriminative stimuli, and involved a successive go-no-go pecking response. It was found, in all three experiments, that pigeons trained to refrain from pecking an S- display resumed pecking at this display after retention intervals. It was argued that these data represent the first direct demonstration of forgetting of a discrimination by pigeons. In addition to the simple demonstration of forgetting, it was found in Experiment 1 that the amount of forgetting progressively increased, in a negatively accelerated fashion, over intervals of 1, 10, and 20 days. Also, more S- responses occurred during relearning a reverse discrimination than after relearning a nonreverse discrimination. In Experiment 2, acquisition was retarded and more forgetting occurred for discriminations that involved more highly similar stimuli. In Experiment 3, a change in contextual cues between acquisition and retention testing enhanced forgetting when the contextual cues present during original acquisition were conspicuous; when these cues were relatively inconspicuous, a change in context had no effect on forgetting. PMID- 6491612 TI - Effects of task-irrelevant cues and reinforcement delay on choice-escape learning following inescapable shock: evidence for a deficit in selective attention. AB - Prior exposure to inescapable shock has been reported to interfere with choice escape learning, but several investigators have failed to obtain this effect. A series of five experiments examined the conditions under which choice-escape learning in an automated Y-maze is impaired by pretreatment with inescapable shock. Inescapably shocked rats made more errors and responded more slowly than did controls only when shock termination was delayed and task-irrelevant cues were present during choice-escape training. These findings are discussed in terms of information processing and neurochemical consequences of exposure to inescapable shock. PMID- 6491613 TI - Serial position curves in rats: automatic versus effortful information processing. AB - Rats were trained to remember lists of five arms on an Olton eight-arm radial maze. A forced-choice memory recognition test procedure was used which required the animal to choose between an arm previously visited during the study phase of a trial and an arm not visited. To receive additional food reinforcement, 10 animals were required to return to the previously visited arm (win-stay) and 10 animals were required to choose the novel, unvisited arm (win-shift). In this way, a direct comparison was made between the serial position curves (SPCs) generated by win-stay trained and win-shift trained animals. The results indicated that only win-stay trained animals produced the classical U-shaped SPC, which included significant primacy and recency effects. Win-shift subjects showed only recency effects. These findings are discussed in terms of differential processing requirements for the two procedures. It is suggested that the win-stay rule necessitates relatively more effortful, elaborative processing than does the win-shift rule, which is used automatically. PMID- 6491614 TI - HDL phosphatidyl choline and risk-factors of coronary heart disease. AB - As part of our epidemiological study of employees in Westphalia, the concentration of HDL phosphatidyl choline was measured in 1546 men and 778 women. The results were analysed in relation to the corresponding HDL cholesterol values, as well as the various risk factors for coronary heart disease. HDL phosphatidyl choline values were found to be age independent, higher in women than in men (p les than 0.001), and lognormally distributed in both sexes (men: mean 1.162 mmol/l, median 1.13 mmol/l, minimum 0.60 mmol/l, maximum 2.46 mmol/l; women: mean 1.370 mmol/l, median 1.34 mmol/l, minimum 0.55 mmol/l, maximum 2.46 mmol/l). A positive correlation (p less than 0.001) was found in both sexes between HDL phosphatidyl choline and HDL cholesterol (men: r = 0.588; women r = 0.605). A negative correlation was found in both sexes between HDL phosphatidyl choline values and body weight (men: r = -0.102 (p less than 0.001) women: r = 0.129 (p less than 0.001); and in men, but not in women, there was a negative correlation between HDL phosphatidyl choline values and triglycerides (men: r = 0.190 (p less than 0.001) women: r = -0.042). A negative correlation between HDL phosphatidyl choline and cigarette smoking was found only in female smokers (r = 0.121 (p less than 0.05). The correlation coefficients between HDL cholesterol and triglycerides as well as HDL cholesterol and relative body weight in both sexes were clearly higher than the corresponding correlation coefficient of HDL phosphatidyl choline. In men as well as in women the HDL phosphatidyl choline/HDL cholesterol ratio decreased with increasing HDL cholesterol values or decreasing triglyceride values in blood serum. PMID- 6491615 TI - Biochemical observations on a non-elite marathon runner. AB - Biochemical observations made on a 30 year old male marathon runner before, during and following the race are described. The prolonged exercise appears to result in gluconeogenesis using non-essential amino acids as substrates while essential amino acids except lysine are spared. PMID- 6491616 TI - Plasma catecholamines assay: comparison between fluorimetric and radioenzymatic methods. AB - Plasma catecholamines were simultaneously measured in duplicate plasma samples by the fluorimetric method of Renzini et al. (1970) Clin. Chim. Acta 39, 587-594) and by the radioenzymatic method of Da Prada & Zurcher ((1976) Life Sci. 19, 1161 1174). The correlation of noradrenaline and adrenaline plasma concentrations determined by the two methods were, respectively, r = 0.95 (p less than 0.001) and r = 0.75 (p less than 0.01). The fluorimetric method was less sensitive, but more economical and less time-consuming than the radioenzymatic method. The fluorimetric method is still of value for measuring plasma catecholamines in man. PMID- 6491617 TI - Effects on analgesic and antirheumatic drugs on the assay of serum enzymes. AB - Interference by some commonly used analgesic and antirheumatic drugs in the spectrophotometric and colorimetric assays of serum enzymes was examined. None of the investigated methods was significantly influenced by caffeine, phenacetin, ibuprofen or indomethacin. Acetylsalicylic acid affected the continuous assays of creatine kinase and lactate dehydrogenase (with pyruvate as substrate), and the colorimetric assay of alanine aminotransferase. Aminophenazone interfered with the colorimetric method for determination of aspartate aminotransferase and alanine aminotransferase, while phenobarbital interfered only with the continuous method for lactate dehydrogenase (with L-lactate as substrate). Ketoprofen interfered with the colorimetric assays of lactate dehydrogenase and aspartate aminotransferase, while diclofenac affected the continuous assay of aspartate aminotransferase. None of the tested drugs interfered with the continuous methods for the determination of alkaline phosphatase and alpha-hydroxybutyrate dehydrogenase. PMID- 6491618 TI - International Federation of Clinical Chemistry (IFCC). Scientific Committee, Analytical Section. Guidelines (1984) for listing specification spectrometers in clinical chemistry. PMID- 6491619 TI - International Federation of Clinical Chemistry (IFCC). Scientific Committee, Analytical Section. IFCC/WHO principles and recommendations on evaluation of diagnostic reagent sets used in health laboratories with limited resources. Part 3. Selection and evaluation using reference materials. General considerations. AB - The purpose of this document is to provide general considerations for the selection and evaluation of clinical chemistry kits in laboratories with limited resources. Separate documents have been developed to provide guidance on experimental procedure, the statistical treatment and interpretation of the data and criteria for acceptable performance of diagnostic kits designed to measure specific analytes. PMID- 6491620 TI - The relationship of lipoprotein (a) (Lp(a)) to risk factors of coronary heart disease: initial results of the prospective epidemiological study on company employees in Westfalia. AB - Lp(a) concentrations were determined in 987 male and 477 female company employees in Westfalia, in the age range 17-70 years. These values were then related to age and to the following risk factors: obesity, smoking, hypertension, hypertriglyceridaemia, hypercholesterolaemia, hyperbetalipoproteinaemia, hypoalphalipoproteinaemia, hyperglycaemia and hyperuricaemia. The Lp(a) values showed a similar markedly skewed distribution for both men and women. The median for men was 0.039 g/l, for women 0.050 g/l. In both sexes only about 25% of all Lp(a) values were above 0.10 g/l. Raised Lp(a) values (greater than 0.30 g/l) were found in 6.5% of males and in 6.1% of females. A significantly higher frequency of raised Lp(a) values (greater than 0.30 g/l) was found in: post menopausal women (11.3% as against 4.1%, p less than 0.01); females with hypercholesterolaemia (19.0% when cholesterol values were greater than or equal to 6.73 mmol/l, 10.8% when cholesterol values were between 5.70-6.72 mmol/l, 3.0% when cholesterol values were less than 5.70 mmol/l, p less than 0.001); and females with hyperbetalipoproteinaemia (22.6% when LDL cholesterol values were greater than or equal to 4.92 mmol/l, 5.0% when LDL cholesterol values were less than 4.92 mmol/l, p less than 0.001). 12.0% of men with hypoalphalipoproteinaemia (HDL cholesterol values less than 0.907 mmol/l) had Lp(a) values greater than 0.30 g/l, as against 5.5% of men with HDL cholesterol values greater than or equal to 0.907 mmol/l (p less than 0.01). This percentage rate increased to 16.9% when hypertriglyceridaemia (greater than or equal to 2.28 mmol/l triglycerides) was also present. All other risk factors which were examined and their combinations had no significant influence on the prevalence of raised Lp(a) concentrations. PMID- 6491621 TI - Influence of food intake on concentrations of plasma catecholamines and cortisol. AB - Plasma concentrations of epinephrine, norepinephrine, dopamine and cortisol were determined in four healthy volunteers--resting completely in bed--before and after food intake. Meals were provided at 17.00 h on the first day and at 12.00 h on the second day of the test. Blood samples were drawn every 15 minutes. Epinephrine, norepinephrine, dopamine, and cortisol showed a clear dependence on food intake. After the meals plasma concentrations of the four analytes showed rises, which were more pronounced after lunch at 12.00 h than after dinner at 17.00 h. An increase of epinephrine was observed shortly before meal-times; this could be caused by physiological adaptation to the usual rhythm of food intake and reflex response to expectation of the meal. PMID- 6491622 TI - Evaluation of three current methods for the determination of creatine kinase-MB catalytic activity. AB - Three current methods for the determination of the creatine kinase-MB activity were evaluated: electrophoresis (Beckman Inst.), ion-exchange MB-Zyme (J.T. Baker) and ion-exchange on aca (Du Pont). Eighty patients were selected out of three groups: acute myocardial infarction, heart and vascular surgery patients and a number of noncardiac cases. The precision of the ion-exchange methods was comparable; CV 5.7% (aca) and CV 5.2% (MB-Zyme) for a high creatine kinase-MB pool. Electrophoresis overestimated the creatine/kinase-MB/activity and was less precise (CV 9.6%) and less sensitive than the ion-exchange methods. The aca (Du Pont) method was less specific than the MB-Zyme. The main source of discrepancy was samples from certain patients in the surgery unit, which gave falsely high value by the aca method, and showed altered mobility in electrophoresis, suggesting an atypical creatine kinase. Three macro creatine kinase type I included in this study were erroneously determined as creatine kinase-MB by both the ion-exchange methods. PMID- 6491623 TI - Surveys of neonatal bilirubin. An evaluation. AB - Experience in surveying the neonatal bilirubin determination in the Netherlands is described. Initially it was organized as a local activity (the Rotterdam area), then later enlarged to a national scale (some 150 participants). A number of items is discussed i.e. the initial improvements, which stabilized at an interlaboratory imprecision of about 8%, and further changes that could improve this rather high imprecision. PMID- 6491624 TI - Effects of biological and analytical variations on the appropriate use of "reference intervals" in clinical chemistry. Proposal of a scheme for longitudinal assessment of laboratory values. AB - For twenty one different laboratory parameters the separate contributions of both biological (age, sex, hospitalisation) and analytical variations to the total variation have been examined. For each of the different laboratory parameters the reference interval and critical difference are given for the longitudinal evaluation of analysis results. These critical differences are not only calculated on the basis of the analytical imprecision from day to day, as has been usual until now, but the mean individual deviations of the reference samples have also been included. The critical differences given in this paper are therefore essentially higher for some parameters compared with the critical differences on the basis of the analytical deviation, and are therefore much more realistic quantities to be used for longitudinal evaluation. Finally for practical purposes a scheme is presented for use with longitudinal assessment of laboratory values, in order to enable the practising physician to consider these data in daily decision making. PMID- 6491625 TI - [Isolation and quantification of nonsulfated and sulfated bile acids in the feces]. AB - A method is described for the qualitative and quantitative analysis of non sulphated and sulphated bile acids in faeces. After extraction and preliminary purification, the faecal bile acids are separated by liquid-gel-chromatography (DEAP-Sephadex LH20) into free, conjugated and sulphated bile acids; these are quantitated separately (after solvolysis and hydrolysis), and the individual bile acids are analysed by gas-liquid-chromatography. The validation both of the individual analysis steps and the overall procedure by adding bile acid standards to the faecal homogenates showed a good reproducibility and a reliable separation of non-sulphated and sulphated bile acids. Using the described method, the excretion of total faecal bile acids in 15 control subjects was 3.85 mg/g dry stool, consisting of 10.4% primary bile acids and 89.6% secondary bile acids. 92.9% of faecal bile acids were in the free form, only 2.7% in the conjugated form, and 4.4% as sulphated bile acids. PMID- 6491626 TI - Cost efficiency: a new dimension of emphasis for family practice. PMID- 6491627 TI - Six years of psychosis. PMID- 6491628 TI - Compliance with acute otitis media treatment. AB - A total of 295 patients at four offices were studied to determine whether the type of medical office or population serviced, written instructions given to the patient, or patient familiarity with the prescribing physician influenced compliance with a 10-day course of antibiotics prescribed for acute otitis media. The relationship between compliance with the recommended treatment and outcome was subsequently determined. The study population included all patients with a new case of acute otitis media who presented to any of four different types of family practice centers involved in the study. Results indicated that compliance, as measured by follow-up rates in less than 11 days and urine antibiotic assays, varied significantly between different office types and patient populations. Written instructions did not improve compliance. In the low socioeconomic group, compliance was improved when the patients were diagnosed and treated by their own physicians. Neither the study factors nor compliance was related to outcome. PMID- 6491629 TI - Evaluation of fatigue in a family practice. AB - A retrospective chart review describing the rates of occurrence, methods of evaluation, and diagnoses of patients complaining of fatigue in a university family medicine teaching practice was performed. After excluding patients in whom an unequivocal explanation for the fatigue was reached at the initial encounter, 118 patients aged 15 years and over were identified during a two-year study in a practice with about 6,000 active adult patients (9.9/1,000 patients per year). The age and sex distributions of the cases were identical to those of the active patient population. The average laboratory examination cost approximately $48. An average of 2.7 laboratory tests per patient were ordered. Although 12 percent of laboratory tests were abnormal, laboratory tests were important in securing a diagnosis in only 9 of the 118 patients. Clinical diagnoses were classified as either primarily biomedical or primarily psychosocial. Psychosocial diagnoses were identified in 50 percent of patients, while primarily biomedical diagnoses were found in 22 percent. No diagnosis was made in 28 percent of patients. Sixty eight percent of patients had at least one follow-up visit. Failure to follow up was uncommon in patients with depression or biomedical diagnoses other than viral syndromes but was common with other primarily psychosocial diagnoses. PMID- 6491630 TI - Resident and parental perceptions of adolescent problems and family communications in a low socioeconomic population. AB - This cross-sectional survey of a low socioeconomic patient group was designed to determine the prevalence and severity of parentally perceived behavioral problems in adolescents as well as to investigate the correlation between such problems and single parenting, family communications, and medical care delivered. The sample population consisted of 79 parents and 121 teenagers selected from a family practice center. The medical record and telephone interview were the sources of information. Results include a parental perception of a high prevalence of problems with school grades (48 percent), school attendance (38 percent), and household problems (chores and sibling rivalry). Of low prevalence but high severity were perceived problems related to suicidal ideation, running away, sexual activity, and gang membership. Single-parent homes had a threefold higher incidence of behavioral problems, a greater degree of communication, and a lower use of community resources than two-parent families. None of the approximately 400 perceived behavioral problems listed by parents was found in the family physicians' master problem list. The results indicate the need for physician education of low socioeconomic and single-parent patients with regard to communication and coping style. In addition, it appears that training programs should provide more education in the care of adolescents. PMID- 6491631 TI - Forensic training in family practice residencies. AB - Knowledge and skill in forensic medicine are important in primary care not only for defensive purposes but also because of potential therapeutic value in patient care. The major role in future mental health services envisioned for primary care physicians makes such training especially important. A national survey of family practice residency programs reveals that 47 percent of programs do not address forensic aspects of medical practice. A model forensic medicine curriculum is described that would require minimal adjustment of existing programs. The need for inclusion of forensically qualified clinicians in training programs for primary care physicians is evident. PMID- 6491632 TI - Depression and conversion hysteria in chronic inflammatory polyradiculoneuropathy. PMID- 6491633 TI - Physician education in human sexuality. PMID- 6491634 TI - Family physicians in an information society. PMID- 6491636 TI - Responsiveness of neurons in the hamster parabrachial nuclei to taste mixtures. AB - Responses from hamster parabrachial nuclei neurons to stimulation of the anterior tongue with sucrose, NaCl, HCl, quinine hydrochloride, and the six two-component mixtures of these stimuli were recorded. A cell's response to a mixture approached its response to the mixture's more effective component in the majority of cases, but was sometimes greater or smaller than this response. The best predictor of a neuron's response to a mixture, then, was its response to the mixture's more effective component. The single-component stimulus producing the maximum response was determined for each neuron and the response to this stimulus was compared with the responses evoked by the six mixtures. For 30% of the cells, a mixture elicited a response reliably, but only 1.1-2.1 times greater than the response to the best single-component stimulus. Thus, there were no neurons specialized to respond to these mixtures. The across-neuron patterns elicited by mixtures and the responses of best-stimulus classes to mixtures were studied for comparison with psychophysical data on taste mixtures. Mixtures were usually correlated with single-component stimuli in the mixture, but not with stimuli not in the mixture. In fact, five of the six mixtures fell directly between their components in a multidimensional scaling plot. In addition, a mixture was most effective in stimulating only those classes of neurons maximally stimulated by the mixture's components. These results correlate with psychophysical data suggesting that mixtures of taste stimuli evoke the same taste qualities as evoked by the mixture's components. PMID- 6491637 TI - [Medical ethics in genetic counseling]. AB - Genetic counselling gives the doctor a peculiar responsibility according to medical deontology and professional ethics rules. Originality and specificity of that kind of counselling requires intensive discussion of the geneticist's attitude in front of the diagnosis and specially prenatal diagnosis. PMID- 6491635 TI - Changes in external Na induce a membrane current related to the Na-Ca exchange in cesium-loaded frog heart cells. AB - The effects of transient alterations in Nao were investigated under voltage clamp conditions in frog heart cells previously loaded with Cs. Tetrodotoxin and Cs were used to inhibit Na and K currents. On applying a Na-poor solution (39.2 mM), an outward current was generated during both depolarizations and hyperpolarizations. The current amplitude described a U-shaped function of the membrane potential. On reapplying the standard solution after 15 min equilibration, an inward current was then induced that exhibited a bell-shaped function of the membrane potential. Current amplitude was sensitive to the external Ca concentration. Increasing pHi by 10 mM NH4Cl enhanced this current, while the internal acidification that occurred on switching back to the control solution greatly reduced it. Variations in the amplitude of this current during repetitive stimulations or long pauses are best explained by subsequent alterations in Nai and pHi; no evidence for a time dependence was found. This current was inhibited by La3+, Co2+, and D600, and was sensitive to adriamycin, quinidine, and disopyramide; lidocaine, another local anesthetic, and nifedipine had no effect. These observations extend previous work on intact heart cells and sarcolemmal vesicles. They suggest that the Na-Ca exchange may generate a current that is outward when Ca ions are moving into the cell. PMID- 6491638 TI - [Should we expand the indications for analysis of fetal chromosomes?]. AB - The usual indications of amniocentesis for prenatal diagnosis are briefly reviewed. Some situations which are note included in these usual indications are discussed: mothers of 34 years, young aunts of a trisomic child, patients with a previous aborted conceptus diagnosed as trisomic by histological examination of the placenta or tissue culture. It is anticipated that, if accepted, these "unusual" criteria would not overload a given laboratory with an excess of analysis, and would certainly relief anxiety of motivated couples. PMID- 6491639 TI - [Fertility and genetic counseling in Turner syndrome]. AB - We report three cases of Turner syndrome 45,X/46,XX with spontaneous menstruations. Two patients had together four pregnancies with a normal girl, a malformed boy and two miscarriages. The outcome of the pregnancy in such a women is discussed with a review of the literature. PMID- 6491640 TI - [The Antley-Bixler syndrome. Review of the literature. Apropos of a personal case]. AB - A female newborn presenting multiple congenital anomalies with acrocephalosynanky, external auditory canals atresia, vertebral anomalies, is described as being affected of an Antley-Bixler Syndrome. The authors compare this case with the eight others reported with this disorder, of whom two are sisters. PMID- 6491641 TI - [The 49,XYYYY syndrome: apropos of a case detected at birth and followed for 2 1/2 years]. AB - A male child, mentally and physically retarded shows a facial dysmorphy, fingers' abnormalities and a radio-ulnar synostosis. These features are common in the 49,XYYYY syndrom, in which external genitalia, normal at birth, remain undevelopped at the time of puberty. Four others publications through the literature report tetrasomic cells for Y chromosome, but only two of them are real 49,XYYYY (with 88% to 100% of affected cells). Our case has 96,7% tetrasomic cells. PMID- 6491642 TI - Acute type A hepatitis during chronic hepatitis B virus infection: association of depressed hepatitis B virus replication with appearance of endogenous alpha interferon. AB - Two patients with chronic type B hepatitis and intercurrent episodes of acute type A hepatitis are presented. Serological markers of hepatitis B virus replication decreased or became undetectable in both patients during the acute illness, while interferon activity was transiently detected in serum. The presence of serum leukocyte (alpha) interferon was confirmed by neutralization with specific antisera and tests of pH2 stability. These observations suggest a role for natural leukocyte (alpha) interferon in the modulation and control of hepatitis B virus infection and provide further evidence to support trials of exogenous leukocyte (alpha) interferon in the chronic infection. PMID- 6491643 TI - Immune response of adults to sequential influenza vaccination. AB - Annual immunization against influenza is recommended for numerous individuals, but the antibody response to sequential vaccination has not been well characterized. Levels of hemagglutination-inhibition antibody were measured in adults given either two or three doses of trivalent influenza vaccine at six month intervals. A significant rise in the number of individuals with antibody titers of greater than or equal to 40 was seen for all three antigens only after initial vaccination. Repeated vaccination was necessary to maintain adequate antibody levels only to the A/Brazil (H1N1) antigen; it did not significantly affect the proportions of individuals with protective levels of antibody to either the A/Bangkok (H3N2) or the B/Singapore 222/79 antigens. These findings do not support the current recommendation for annual immunization when the vaccine formulation has not changed. PMID- 6491644 TI - Dynamics of viral growth, viral enzymatic activity, and antigenicity in murine lungs during the course of influenza pneumonia. AB - Mice were infected by aerosol inhalation with influenza A/PR8/34 virus, and the kinetics of infection were monitored by the measurement of infectious virus, viral neuraminidase activity, and viral antigen as detected by enzyme immunoassay. Pulmonary levels of neuraminidase activity closely paralleled the infectious titers quantitated by standard egg inoculation techniques. Both viral neuraminidase activity and viral antigen increased in a dose-dependent manner during the early stages of the viral infection. After day 5, however, viral neuraminidase activity precipitously declined, whereas viral antigen levels remained elevated at high concentration for up to 60 days. Immunosuppressive treatment with cyclophosphamide resulted in the prolonged maintenance of peak virus titers without any additional increases in viral antigen. Previously infected mice were resistant to reinfection with homologous virus as evidenced by the lack of detectable viral neuraminidase activity and the lack of generation of additional viral antigen. These data define the temporal relationship between levels of infectious virus, neuraminidase activity, and viral antigen in an experimental model of influenza virus infection. PMID- 6491645 TI - EKG of the month. Prolonged QT interval and abnormal T waves. PMID- 6491646 TI - Pain and a radiation accident. PMID- 6491647 TI - Childhood lead poisoning. PMID- 6491648 TI - Occurrence of unilateral retinoblastoma in three generations of a Louisiana family. PMID- 6491649 TI - Dead or alive. PMID- 6491650 TI - Differences in the use of substances of abuse by psychiatric patients compared with medical and surgical patients. AB - This paper presents findings from a comparison between patterns of use of substances of abuse among a psychiatric population and among a similarly studied medical and surgical patient population. A self-assessment survey was carried out in an urban, university medical center population that included 300 psychiatric patients and close to 3000 medical and surgical patients. The psychiatric population was significantly higher than the demographically similar general medical and surgical population in quantity and frequency of use, problems associated with use, and composite categories of use of alcohol and other drugs of abuse. This was true in spite of the fact that the psychiatric service did not readily accept known substance-abusing patients at the time the study was conducted. PMID- 6491651 TI - The epidemiology of treatment for chronic and nonchronic mental disorders. AB - To estimate the annual treated incidence and prevalence of chronic and nonchronic mental disorders, data from the Monroe County Psychiatric Register were analyzed. Patients were classified as either chronic or nonchronic based upon their utilization of inpatient psychiatric treatment. A chronic illness was defined as one requiring at least three psychiatric hospitalizations or at least 365 inpatient days during a 5-year follow-up period. Based upon this definition, the annual treated incidence of chronic mental disorders did not change significantly between 1964-65 (.47/1000) and 1969-70 (.41/1000), unlike the annual treated incidence of nonchronic disorders, which rose by 37 per cent (p less than .001). The annual treated prevalence of chronic mental disorders also remained unchanged at approximately .6 per cent between 1965 and 1970, but the treated prevalence of nonchronic mental disorders rose by 43 per cent from 1.4 per cent in 1965 to 1.9 per cent in 1970 (p less than .01). These increases in treatment for nonchronic disorders coincided with the development of community mental health centers. The rates of chronicity and peak ages of treatment varied considerably across diagnostic groups. Approximately one fifth of new cases of organic brain disorders, schizophrenia, and alcohol disorders became chronic according to our definition during the first 5 years after illness onset, compared to only 9 to 11 per cent of cases of major affective disorders and less than 2 per cent of all other disorders.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491652 TI - An assessment of the schedule for schizotypal personalities and the DSM-III criteria for diagnosing schizotypal personality disorder. AB - The authors assessed the reliability and validity of the DSM-III criteria for schizotypal personality disorder (SPD) and their measurement by the Schedule for Schizotypal Personalities (SSP) developed by Baron. Additional criteria not in DSM-III were also explored. Consensual clinical ratings of videotaped interviews of subjects were used to validate item content of the SSP and the schizotypal diagnosis. The SSP assessments, with the exception of odd speech, were found to be reliable and valid. Higher cutoff scores than those recommended by Baron may be helpful in discriminating schizotypal from other psychiatric patients. Six of eight DSM-III criteria and all experimental criteria were highly specific for SPD cases but varied widely in their sensitivities. Based on these pilot data, the authors recommend combining all of the criteria into four conceptual categories: 1) self-report cognitive-perceptual disturbances, 2) observable disorders of thought and communication, 3) deficits in drive or affect, and 4) interpersonal difficulties. When three of these were required to make the SPD diagnosis, all of the subjects in the present data set were correctly identified. PMID- 6491653 TI - Impulsive nonconformity as a trait contributing to the prediction of psychotic like and schizotypal symptoms. AB - A 51-item true-false Impulsive Nonconformity Scale was constructed to measure impulsive antisocial behavior of the sort often reported in the premorbid adjustment of some psychotics. Schizophrenics and schizoaffective patients (N = 46) scored higher on the scale than control (N = 76). An experimental group of 120 aberrantly high-scoring (2 SDs above the mean) college students and 176 control subjects were interviewed using modified versions of Weissman and Paykel's Social Adjustment Scale interview and Spitzer and Endicott's Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L). The experimental subjects reported more antisocial and nonconforming behaviors than control subjects, supporting the construct validity of the scale as a measure of impulsive nonconformity, and reported more psychotic or psychotic-like experiences, more schizotypal experiences, and more depressive and manic or hypomanic symptoms, suggesting that a portion of the experimental subjects may be at elevated risk for psychosis and/or major affective disorder. Subjects who score aberrantly high on both the Impulsive Nonconformity Scale and our earlier Perceptual Aberration-Magical Ideation Scale are more aberrant on several other measures of schizophrenic-like cognitive slippage than are subjects who score high on only one of the two scales. PMID- 6491654 TI - Behavioral and biochemical effects of subchronic treatment with (-)3-(3 hydroxyphenyl)-N-n-propylpiperidine in the rat: dopamine receptor sensitivity and tolerance. AB - Male Sprague-Dawley rats were treated for 3 weeks with (-)3-(3-hydroxyphenyl)-N-n propylpiperidine (3-PPP). Twenty-four hours, but not 72 hours, after withdrawal of the treatment there was an increase in locomotor activity in comparison with saline treated controls. At the same time there was a decrease in striatal DOPAC and HVA and an increased locomotor activity response to apomorphine, indicating supersensitive dopamine receptors. There was no evidence for behavioral tolerance since the suppression of locomotor activity after an acute dose of (-)3-PPP was the same in (-)3-PPP-pretreated as in saline-treated controls. Plasma levels of ( )3-PPP in these animals were, however, slightly decreased. PMID- 6491655 TI - A multinuclear NMR relaxation study of the interaction of divalent metal ions with L-aspartic acid. AB - Carbon-13 spin-lattice relaxation times, T1, have been measured for aqueous solutions of L-aspartic acid, L-alanine, O-phospho-L-serine, and 2-mercapto-L succinic acid in the presence of the paramagnetic metal ions, Cu2+ and Mn2+, and Mg2+ as a diamagnetic control, at ambient temperature and neutral pH. Nitrogen 15, oxygen-17 and proton relaxation times were also obtained for L-aspartic acid and phosphorus-31 relaxation times for O-phospho-L-serine under similar conditions. The structures of these complexes in solution were determined from the various metal ion-nuclei distances calculated from the paramagnetically induced relaxation. These results indicate that the Cu2+ interaction with L aspartic acid is through alpha-amino and beta-carboxyl groups while Mn2+ coordinates most strongly through alpha- and beta-carboxyl groups, with the possibility of a weak interaction through the amino group. An examination of the coordination of these divalent metal ions to an analog of L-aspartic acid in which the beta-carboxyl group is replaced by a phosphate group (O-phospho-L serine) indicated that Cu2+ coordination is now probably through the alpha-amino and phosphate groups, while this analog is a monodentate ligand for Mn2+ coordinating through the phosphate group. Removal of the beta-carboxyl group (L alanine) also results in Cu2+ coordination through the alpha-carboxyl and alpha amino groups, and the same ligand interactions are observed with Mn2+. Replacement of the alpha-amino group of L-aspartic acid with an -SH group (2 mercapto-L-succinate) is sufficient to eliminate any specific coordination with either Cu2+ or Mn2+. PMID- 6491656 TI - Guanyl nucleotide and divalent cation regulation of cortical S2 serotonin receptors. AB - Computer-assisted quantitative analysis of radioligand binding to rat cortical S2 serotonin receptors indicates the existence of two affinity states of the same receptor population. Monophasic antagonist competition curves for [3H]ketanserin labelled sites suggest a uniform population of receptors with one affinity state for antagonists. Biphasic competition curves of agonists suggest that agonists discriminate high- and low-agonist-affinity forms of the S2 receptors. The affinities of agonists for the high- and low-affinity states, and the apparent percentages of high agonist-affinity forms varies with different agonists. The guanine nucleotides GTP and guanyl-5'-imido-diphosphate [Gpp(NH)p], as well as divalent cations, modulate the proportion of the sites with high affinity for agonists as evidenced by their ability to shift the agonist competition curves for [3H]ketanserin-labelled S2 receptors. GTP and Gpp(NH)p effects appear to be agonist-specific, as they do not affect antagonist competition for [3H]ketanserin labelled S2 receptors, or [3H]ketanserin binding to S2 receptors. ATP and ADP have little or no effect on the binding properties of S2 serotonin receptors, whereas GDP is less potent than GTP. The presence of these specific nucleotide effects are the first evidence suggesting involvement of a guanine nucleotide binding protein in the mechanism of agonist interaction with the S2 serotonin receptor. In general, the binding properties of [3H]ketanserin-labelled S2 serotonin receptors strongly resemble those of adenylate-cyclase coupled receptors such as the beta-adrenergic, the alpha 2-receptor, and the D-2 dopamine receptor. This may indicate the S2 serotonin receptor is coupled to adenylate cyclase activity, through a GTP binding protein. PMID- 6491657 TI - Study of the mechanism of release of [3H]GABA from a teleost retina in vitro. AB - gamma-Aminobutyric acid (GABA) is thought to be a neurotransmitter in the vetebrate retina. We studied the voltage and Ca2+ dependency of the process of release of [3H]GABA from the retina of the teleost Eugerres plumieri, using a microsuperfusion technique. Two depolarizing agents, veratridine and high potassium, produced a concentration-dependent release of [3H]GABA. The veratridine effect was inhibited in Na+-free solution, but was not affected by 1 microM tetrodotoxin. A substantial inhibition (about 75%) of the veratridine- and potassium-stimulated release of [3H]GABA occurred in Ca2+-free medium. Inhibitors of the Ca2+ channel, such as Mg2+ (20 mM), La3+ (0.1 mM), and methoxy-verapamil (4 microM-0.4 mM), inhibited the veratridine- and K+-stimulated release. However, Co2+ and Cd2+ caused a potentiation and no change of the K+- and veratridine stimulated release, respectively. This release process is apparently specific, since both depolarizing agents were unable to release [3H]methionine, a nontransmitter amino acid, under the same experimental conditions. Autoradiographic studies with [3H]GABA, using the same incubation conditions as for the release experiments, showed a high density of silver grains over the horizontal cells with almost no accumulation by amacrine cells and Muller cells. beta-Alanine and nipecotic acid were used as two relative specific inhibitors of the glial and neuronal GABA uptake mechanisms, respectively. Only a small heteroexchange with [3H]GABA was found with beta-alanine, and no inhibition of the subsequent veratridine-stimulated release. On the other hand, nipecotic acid produced a strong heteroexchange with [3H]GABA and lacked the capacity to induce the veratridine-stimulated release of [3H]GABA. These results suggest a voltage- and Ca2+-dependent neuronal release of [3H]GABA from retina. PMID- 6491658 TI - Immunoreactive Met-enkephalin Arg6 in rat brain, and bovine brain, gut, and adrenal. AB - Antibodies directed against the Met-enkephalin-related hexapeptide, Met-enk Arg6, have been used in radioimmunoassays in the characterization of material in rat brain, and bovine striatum, colon, and adrenal medulla. Met-enk Lys6 reacted 0.27 relative to Met-enk Arg6, but Leu-enk Arg6 and C-terminal extensions or deletions of Met-enk Arg6 showed less than 0.02 immunoreactivity. In rat brain, the concentration of Met-enk Arg6-like immunoreactivity was less than 20 pmol X g-1 in all regions, but after trypsinization of tissue extracts there were up to 80 fold increases in immunoreactivity as a result of cleavage of C-terminally extended forms. The tryptic product eluted as Met-enk Arg6 on gel filtration. In control extracts of rat brain there were at least three immunoreactive forms of Met-enk Arg6; one eluted in the position of the hexapeptide standard on gel filtration and HPLC while the others had properties of N-terminally extended forms. In bovine striatum and colon the hexapeptide-like material predominated; but in bovine adrenal extracts, there were relatively low concentrations of the hexapeptide and, instead, the dominant immunoreactive forms corresponded to two components that were probably N-terminally extended variants. Trypsin again produced marked increases in immunoreactivity. HPLC studies indicated that Met enk Arg6Phe7- and Met-enk Arg6Gly7Leu8-like immunoreactive peptides were important substrates in bovine brain for the production of hexapeptide immunoreactivity after trypsin. The differences in the patterns of immunoreactive forms in bovine adrenal, colon, and brain are consistent with tissue variations in the pathways of posttranslational processing of the precursor molecules. PMID- 6491659 TI - Identification of an acidic dipeptide, beta-aspartylglycine, in the CNS of Aplysia. AB - A novel dipeptide, beta-aspartylglycine (beta-DG), has been isolated from tissues of the marine gastropod mollusc Aplysia californica. This compound was detected only in Aplysia and not in other molluscs, such as Helix or Mercenaria, or in lobster or frog. Among the Aplysia tissues, the highest levels of beta-DG were in nervous tissue and in the reproductive tract. beta-DG was assayed by HPLC as the o-phthaldialdehyde derivative and found to be present in all individual, identified neurons at a concentration of approximately 40 pmol/microgram protein. The peptide was identified as beta-DG by gas chromatography-mass spectrometry (GCMS) using trimethylsilyl derivatives prepared before and after acid hydrolysis. It was further characterized as the beta-isomer by TLC, including Rf, atypical blue-gray color with ninhydrin, and a violet color with Cu2+-ninhydrin. A fractionation scheme is described whereby acid-soluble tissue constituents can be divided into acidic, neutral, and basic components using mini ion-exchange columns. This partial purification prior to TLC analysis was necessary to remove compounds that interfered with the isolation of beta-DG. PMID- 6491660 TI - Resistance to disruption of multilamellar fragments of central nervous system myelin. AB - Single-bilayer vesicles of myelin are desirable for studying myelin development and metabolism. Accordingly, our interest was drawn to a procedure for vesiculating myelin (Steck et al., Biochim, Biophys. Acta 509, 397-408, 1978). We used X-ray diffraction analysis to examine these putative vesicle preparations because much larger amounts of material can be surveyed by this method than by electron microscopy. The sharpness (width) of the rings in the X-ray diffraction pattern varies inversely with the number of bilayers per multilayer structure. We therefore expected to see the diffuse diffraction pattern characteristic of single bilayers. Diffraction patterns were recorded from isolated rat brain myelin before and after the vesiculation procedure. Both patterns showed sharp rings, indicating numerous multilayered structures. Average values ranging from 7 to 10 bilayers per multilayer were calculated in both cases. This procedure did produce a small fraction of single-bilayer structures, which were isolated by differential centrifugation; however, these accounted for only about 1% of the total myelin present. The diffraction pattern of this material showed the diffuse band typical of single-bilayer structures, and sodium dodecyl sulfate polyacrylamide gel electrophoresis indicated it had the same protein composition as in normal myelin. Similar results were also obtained using either fresh or frozen bovine brain myelin. Variations of the published vesiculation procedure (incubation in 0.1 M NaCl or in buffers containing glycerol; disruption by sonication or use of a Tissumizer) also were not effective in breaking down the multilamellar fragments into thinner structures. The conclude that the multilamellar fragments of isolated CNS myelin resist disruption into single bilayer structures. PMID- 6491661 TI - Formation and clearance of norepinephrine glycol metabolites in mouse brain. AB - To determine the degree of conversion of 3,4-dihydroxyphenylethyleneglycol (DHPG) to 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and the amount of DHPG eliminated unchanged from the brain, we have examined the kinetics of formation and disappearance of mouse brain MHPG and DHPG following clorgyline (10 mg/kg, i.p.) and/or tropolone (75 mg/kg, i.p.) treatment. During the first 10 min after tropolone, brain DHPG levels accumulated linearly at a rate of 1,300 pmol/g/h, whereas MHPG disappeared exponentially at a rate of 411 pmol/g/h. Following clorgyline administration, brain DHPG declined exponentially at a rate of 1,240 pmol/g/h. In contrast, the elimination of MHPG became a first-order process only when catechol-O-methyltransferase (COMT) was also inhibited in addition to monoamine oxidase. Thus, combined clorgyline and tropolone treatment resulted in an exponential decline of MHPG levels at a rate of 524 pmol/g/h, whereas DHPG levels were slightly but significantly elevated compared to control values. When the animals were treated with pargyline (75 mg/kg, i.p.) in combination with clorgyline and tropolone, brain DHPG and MHPG disappeared at rates of 40 and 660 pmol/g/h, respectively. The above observations suggest that mouse brain DHPG is cleared primarily through O-methylation with minimal direct elimination from brain. Assuming the disposition and clearance of norepinephrine metabolites are similar in mouse and human brain, peripherally measured DHPG in humans is likely derived principally from extracerebral sources and reflects peripheral sympathetic function. PMID- 6491662 TI - Purification of the chick eye ciliary neuronotrophic factor. AB - Dissociated 8-day chick embryo ciliary ganglionic neurons will not survive for even 24 h in culture without the addition of specific supplements. One such supplement is a protein termed the ciliary neuronotrophic factor (CNTF) which is present at very high concentrations within intraocular tissues that contain the same muscle cells innervated by ciliary ganglionic neurons in vivo. We describe here the purification of chick eye CNTF by a 2 1/2-day procedure involving the processing of intraocular tissue extract sequentially through DE52 ion-exchange chromatography, membrane ultrafiltration-concentration, sucrose density gradient ultracentrifugation, and preparative sodium dodecyl sulfate-polyacrylamide gradient electrophoresis. An aqueous extract of the tissue from 300 eyes will yield about 10-20 micrograms of biologically active, electrophoretically pure CNTF with a specific activity of 7.5 X 10(6) trophic units/mg protein. Purified CNTF has an Mr of 20,400 daltons and an isoelectric point of about 5, as determined by analytical gel electrophoresis. In addition to supporting the survival of ciliary ganglion neurons, purified CNTF also supports the 24-h survival of cultured neurons from certain chick and rodent sensory and sympathetic ganglia. CNTF differs from mouse submaxillary nerve growth factor (NGF) in molecular weight, isoelectric point, inability to be inactivated by antibodies to NGF, ability to support the in vitro survival of the ciliary ganglion neurons, and inability to support that of 8-day chick embryo dorsal root ganglionic neurons. Thus, CNTF represents the first purified neuronotrophic factor which addresses parasympathetic cholinergic neurons. PMID- 6491663 TI - Protein synthesis rates in rats with portacaval shunts. AB - Protein synthesis rates were measured (33 days postoperatively) in rats with portacaval shunts and in unoperated controls. In brain, no change in the rate of protein synthesis was evident in shunted rats. These data thus do not support the hypothesis that an inhibition of brain protein synthesis is a factor in the etiology of hepatic encephalopathy. The synthesis rate in forebrain at 82 days of age was 0.52%/h. Though brain wet weight was the same in both groups, rats with shunts grew relatively slowly, and their testicles probably decreased in weight. However, no inhibition of muscle, liver, or testicular protein synthesis could be detected. The mechanism of slower or negative growth in these tissues might thus involve an increase in the degradation rate, although a transient inhibition of synthesis at an earlier period is also possible. PMID- 6491664 TI - Dural mast cells: source of contaminating histamine in analyses of mouse brain histamine levels. AB - Histamine levels were determined in mouse brains from WBB6F1-+/+ (mast cell normal) and WBB6F1-W/Wv (mast cell-deficient) mice whose brains were dissected immediately after decapitation or after freezing the severed heads in liquid nitrogen for 10 s. In WBB6F1-+/+ mice, brains obtained from frozen heads contained significantly higher levels of histamine than those obtained from unfrozen heads. The converse was found in brains obtained from the WBB6F1-W/Wv mice. When CF-1 mice (which also contain brain-associated mast cells) were treated as described above, results very similar to those found with the WBB6F1 +/+ mice were obtained. Further, the high levels of histamine found in CF-1 mice whose brains had been frozen in situ were accompanied by an extensive degranulation of mast cells in the dura mater of these mice. Because of this degranulation of mast cells, and the fact that increased levels of brain histamine were not found in mast cell-deficient mice, it is concluded that dural mast cells are the likely source of the artifactually higher levels of histamine seen in brains frozen in situ. PMID- 6491665 TI - Extraction and partial characterization of enkephalin-like peptides from splanchnic nerve. AB - A method is described for the extraction of enkephalin-like peptides from peripheral nerve using chloroform and acidic methanol to facilitate a differential extraction of peptides and lipid. Porcine splanchnic nerve contains enkephalin-like peptides in low amounts compared to porcine adrenal medulla and striatum. Gel filtration chromatography reveals the presence of enkephalin-like peptides in both processed and cryptic forms. This is the first reported isolation and partial characterization of these peptides in splanchnic nerve. The presence of these peptides in this nerve provides support for the contention that the splanchnic nerve can modulate catecholamine release from the adrenal medulla through an effect on opiate receptors located on chromaffin cells. PMID- 6491666 TI - Use of [3H]triphenylmethylphosphonium cation for estimating membrane potential in neuroblastoma cells. AB - The lipophilic permeant cation [3H]triphenylmethylphosphonium (TPMP) was used to estimate membrane potential in neuroblastoma N1E 115 cells under carefully controlled conditions. The cation distributes into the cells only in the presence of a lipophilic anion, and tetraphenylboron and picrate have been used for this purpose. The potassium salt of tetraphenylboron is poorly soluble, so that studies in high [K+] media are difficult with this anion whereas picrate, at the concentrations required, hyperpolarises the cells. The effect of muscarinic receptor activation was investigated by treating cells with carbachol but no effect was seen either on [3H] TPMP distribution or electrophysiological parameters. The use of [3H]TPMP for qualitative and quantitative evaluation of membrane potential in these cells is discussed. PMID- 6491667 TI - Developmental regulation of phenylethanolamine N-methyl transferase in avian sympathetic nerves. AB - The presence of the catecholamine synthetic enzyme, phenylethanolamine N-methyl transferase (PNMT), has been detected in the expansor secundariorum, a smooth muscle of the avian wing. The concentration of the enzyme was estimated over a 10 week time course from 17 days incubation to 9 weeks posthatch and found to increase rapidly up until hatch in parallel with dopamine beta-hydroxylase activity, but then to fall precipitously to very low levels. The time course of the initial increase in activity corresponds to the presence of ingrowing sympathetic nerve fibres, and denervation of the expansor results in loss of greater than 80% of the PNMT activity. It is concluded that during the period of innervation the growing nerves contain the enzyme PNMT and therefore have the capacity to synthesize adrenaline, but that shortly after innervation is complete the capacity to synthesize adrenaline is lost. Several alternate mechanisms are proposed to explain the observations. PMID- 6491668 TI - Histamine turnover in the brain of different mammalian species: implications for neuronal histamine half-life. AB - The turnover of neuronal histamine (HA) in nine brain regions and the spinal cord of the guinea pig and the mouse was estimated and the values obtained were compared with data previously obtained in rats. The size of the neuronal HA pool was determined from the decrease in HA content, as induced by (S)-alpha-fluoro methylhistidine (alpha-FMH), a suicide inhibitor of histidine decarboxylase. The ratios of neuronal HA to the total differed with the brain region. Pargyline hydrochloride increased the tele-methylhistamine (t-MH) levels linearly up to 2 h after administration in both the guinea pig and the mouse whole brain. Regional differences in the turnover rate of neuronal HA, calculated from the pargyline induced accumulation of t-MH, as well as in the size of the neuronal HA pool, were more marked in the mouse than in the guinea pig brain. The hypothalamus showed the highest rate in both species. There was a good correlation between the steady-state t-MH levels and the turnover rate in different brain regions. Neither the elevation of the t-MH levels by pargyline nor the reduction of HA by alpha-FMH was observed in the spinal cord, thereby suggesting that the HA present in this region is of mast cell origin. The half-life of neuronal HA in different brain regions was in the range of 13-38 min for the mouse and 24-37 min for the guinea pig, except for HA from the guinea pig hypothalamus, which had an extraordinarily long value of 87 min. These results suggest that there are species differences in the function of the brain histaminergic system. PMID- 6491669 TI - [3H]nitrobenzylthioinosine binding to the guinea pig CNS nucleoside transport system: a pharmacological characterization. AB - The binding of [3H]nitrobenzylthioinosine (NBMPR) to specific membrane sites in guinea pig brain was rapid, reversible, and saturable, and was dependent upon protein concentration, pH, and temperature. Mass law analysis of the binding data for cortical membranes indicated that NBMPR bound with high affinity to a single class of sites at which the equilibrium dissociation constant (KD) for NBMPR was 0.10-0.25 nM and which possessed a maximum binding capacity (Bmax) per mg of protein of 300 fmol of NBMPR. Kinetic analysis of the site-specific binding of NBMPR yielded an independent estimate of the KD of 0.16 nM. A relatively homogeneous subcellular distribution of the sites for NBMPR was found in cortical tissue. Recognized inhibitors of nucleoside transport were potent, competitive inhibitors of the binding of NBMPR in guinea pig CNS membranes whereas benzodiazepines and phenothiazines have low affinity for the sites. NBMPR sites in guinea pig cortical membranes have characteristics similar to those for NBMPR in human erythrocytes, the occupation of which is associated with inhibition of nucleoside transport. The comparable affinities for a range of agents for sites in human erythrocytes and guinea pig CNS membranes suggest that NBMPR also binds to transport inhibitory elements of the guinea pig CNS nucleoside transport system. It is proposed that the study of the binding of NBMPR provides an effective method by which to examine drug interactions with the membrane-located nucleoside transport system in CNS membranes. PMID- 6491670 TI - Degradation of NAD by synaptosomes and its inhibition by nicotinamide mononucleotide: implications for the role of NAD as a synaptic modulator. AB - We have found NAD to be rapidly degraded by extracellular enzymes present on intact rat brain synaptosomes. The enzyme involved had the specificity of an NADase cleaving the molecule at the nicotinamide-glycoside linkage and was inhibited by nicotinamide mononucleotide (NMN). This inhibitor did not displace specific binding of NAD to rat brain membranes or affect electrical activity in the guinea pig hippocampus. Therefore, inclusion of NMN in binding assays allowed unambiguous demonstration of two specific NAD binding sites on rat brain synaptosomal membranes (KD1, 82 nM, KD2, 1.98 microM). The depressant action of NAD on the evoked synaptic activity of the guinea pig hippocampus was not blocked after inhibition of NAD degradation with NMN. The physiological implications of these results for the function of NAD as a neurotransmitter or neuromodulator in the CNS are discussed. PMID- 6491671 TI - Mass spectrometric analyses of brain synaptic peptides containing taurine. AB - The structure of a number of low-molecular-weight acidic peptides containing taurine prepared from calf brain synaptosomes and their subcellular vesicles was studied using electron impact mass spectrometry. At least seven sequences could be identified: N-acetylaspartyl-glutamyl-taurine, N-acetylaspartyl-taurine, N acetylglutamyl-taurine, glutamyl-taurine, aspartyl-taurine, seryl-glutamyl-seryl taurine, and seryl-taurine. PMID- 6491672 TI - Blood-brain transfer of galactose in experimental galactosemia, with special reference to the competitive interaction between galactose and glucose. AB - The interaction between glucose and galactose during transport across the cerebral capillary endothelium was studied in anesthetized rats. Although galactose is present in the diet of suckling mammals and is a potential substrate for brain metabolism in adult mammals, its effect on glucose transport in adult rats is unknown. A kinetic model was formulated to analyze the effect of chronically elevated galactose levels on glucose transport in adult rats. The analysis indicated that galactose and glucose compete for the same transport mechanism in the cerebral capillary endothelium. The Tmax of glucose and galactose were both about 380 mumol 100 g-1 min-1 and the Kt of galactose (30 mM) was about three times that of glucose (10 mM). During prolonged galactosemia in adult rats, neither the Tmax, nor the Kt of either competitor changed substantially when compared with rats subjected to acute galactosemia. At 10 mM galactose in plasma in rats with acute galactosemia, the inhibition of glucose transport, simulated a 25% reduction of plasma glucose, and in rats with chronic galactosemia a 20% reduction. This moderate effect is in contrast to the effect of galactose in suckling rats in which 10 mM galactose in plasma reduced the glucose transport to a level corresponding to a 50% reduction of the plasma glucose concentration. PMID- 6491673 TI - Interaction of N-(2-nitro-4-azidophenyl)-serotonin with two types of monoamine oxidase in rat brain. AB - The effects of N-(2-nitro-4-azidophenyl) serotonin (NAP-5-HT) on types A and B monoamine oxidase (MAO) in rat brain cortex were studied. In the dark this compound acted as a competitive inhibitor for both types A and B MAO (Ki values of 0.19 microM and 0.21 microM for types A and B MAO, respectively). Upon photolysis, NAP-5-HT became an irreversible inhibitor for only type B MAO. A 50% inhibition was obtained by irradiation of the enzyme in the presence of 35 nM NAP 5-HT. Furthermore the inhibition of type B MAO could be protected by including its substrate phenylethylamine during the irradiation. Under the same photolytic conditions photodependent inhibition of type A MAO by NAP-5-HT was not clearly observed. These results provide further evidence that there is a fundamental difference in the active site of the two types of MAO in brain. NAP-5-HT may be a useful photoaffinity probe for characterizing the active site of type B MAO. PMID- 6491675 TI - Regional distribution of homocysteine in the mammalian brain. AB - The regional distribution of L-homocysteine (Hcy) was determined in brains from mouse, rat, guinea pig, and rabbit, using a sensitive radioenzymatic assay. Large interspecies variations in the Hcy content in various parts of the brain were observed, but cerebellum contained the highest amount in all species investigated. In the rat the amount of Hcy in cerebellum (6.4 nmol/g) was about sixfold higher than in most other parts of the brain, whereas in the mouse and guinea pig the amount in cerebellum (about 1 nmol/g) was only twofold higher than in the other brain regions. There was a remarkably high level of Hcy in all regions of the rabbit brain (4-10 nmol/g); the highest concentration was found in the cerebellar white matter. In this species the amount of Hcy in all brain regions examined exceeded that in the liver. PMID- 6491674 TI - Effect of age on human brain serotonin (S-1) binding sites. AB - The effect of age on the binding of [3H]5-hydroxytryptamine [( 3H]5-HT, serotonin) to postmortem human frontal cortex, hippocampus, and putamen from individuals between the ages of 19 and 100 years was studied. One high-affinity binding site was observed in adult brains, with a mean KD of 3.7 nM and 3.2 nM for frontal cortex and hippocampus, respectively, and 9.2 nM for putamen. Decreased binding capacities (Bmax) with age were detected in frontal cortex and hippocampus. In putamen a decrease in affinity was noted. Postmortem storage did not significantly contribute to the age-related changes. No significant sex differences were detected. [3H]5-HT binding was also studied in brains from human neonates. The specific binding was 1.5-3 times lower than in adult frontal cortex and putamen, and Scatchard analysis suggested more than one binding site. In infant hippocampus a single binding site was observed and except for a premature individual, the binding capacity approximated adult values. PMID- 6491676 TI - Effects of chronic (dietary) choline availability on the transport of choline across the blood-brain barrier. AB - The effects of dietary choline availability on the transport of choline across the blood-brain barrier (BBB) were investigated using the intracarotid injection technique. Maintenance of rats on choline-deficient, basal choline, or choline supplemented diets for 28-32 days led to respective increases in blood levels of choline and correlative increases in the velocity of transport of choline measured using a buffer injectate. When serum from these rats was included in the injectate and transport determined in control animals, there was a marked inhibition of choline transport that was related to the concentration of choline in the diets. Results suggest that the activity of the choline carrier at the BBB is antagonized by an inhibitory substance in serum whose concentration or activity may be modified by chronic alterations in circulating levels of choline and whose presence may normally regulate the velocity of choline transport. PMID- 6491677 TI - Chemical constituents of Crotalaria madurensis. AB - Two new compounds, crotmadine (1) and crotmarine (3); a known pyrrolizidine alkaloid, fulvine (8), and three other known compounds, trans-3,4,3',5'-tetra methoxystilbene (5), dihydroalpinumisoflavone (6), and 4',5,7-trihydroxy-3 methoxyflavone (7), have been isolated from the leaves and stems of Crotalaria madurensis. Both crotmadine (1) and crotmarine (3) exhibit antifungal activity against Trichophyton mentagrophytes. PMID- 6491678 TI - Structure and conformation of two new dolabellane-based diterpenes from Dictyota sp. AB - Two new dolabellane derivatives (5 and 6) have been isolated from a Dictyota sp. and their structure, including absolute configuration, has been determined on the basis of spectral studies and chemical correlations. PMID- 6491679 TI - Reinvestigation of the conformations of a variety of hexahydrobenzo[c]phenanthridine alkaloids by 470 MHz PMR and 50 MHz CMR spectroscopy. AB - The high resolution pmr and cmr spectra of a variety of benzo[c]phenanthridine alkaloids and their CF3COOD salts were examined. The chemical shift of H-14 was found to be a reliable indicator of the orientation of the N-methyl group. The conformations of the C rings were assigned on the basis of the coupling constants between H-11 and the two H-12 protons. On the basis of the pmr spectra of (+)-14 epicorynoline (9) and (+/-)-14-epicorynoline-6,6,12 alpha-d3 (13), a revision of certain previous C ring conformations is indicated. PMID- 6491680 TI - Rollinone, a new cytotoxic acetogenin from Rollinia papilionella. AB - Rollinone, a new member of a series of cytotoxic, linear acetogenins bearing a bistetrahydrofuran moiety and a gamma-lactone, has been isolated from Rollinia papilionella. The structure elucidation of rollinone was achieved by interpretation of the pmr and cmr data and mass spectral fragmentation patterns. PMID- 6491681 TI - Oxidation of rotenone by Polyporus anceps laccase. AB - The extracellular laccase produced by Polyporus anceps transforms rotenone to a single, more polar product. This transformation occurs in incubation mixtures containing chlorpromazine, laccase, and rotenone where rotenone serves as a pseudosubstrate for the enzyme. Chlorpromazine, the true substrate, serves as a cycling redox component of the system forming a radical-cation species that abstracts an electron from rotenone in the oxidation process. Physicochemical properties of the product were determined on an analytically pure sample obtained by preparative hplc. High resolution ms, high-field pmr and cmr, uv, and optical rotation analyses indicated that rotenone had been transformed to 6a beta, 12a beta-rotenolone by P. anceps laccase. PMID- 6491682 TI - Antitumor agents from bohemic acid complex, VI. Schaunardimycin. PMID- 6491683 TI - Correlation of the anticholinesterase and molluscicidal activity of the latex of Euphorbia royleana on the snail Lymnaea acuminata. PMID- 6491684 TI - Constituents of Jasminum azoricum. PMID- 6491685 TI - Cinnamic acid esters from Meum athamanticum. PMID- 6491686 TI - Terpenoids of Monardella hypoleuca. PMID- 6491687 TI - Terpenoids of Hyptis emoryi. PMID- 6491688 TI - Chemical constituents of Lythospermum fruticosum. PMID- 6491689 TI - Sesquiterpene lactones of one chemical race of Helianthus maximiliani. PMID- 6491690 TI - Studies on Indian medicinal plants, 78. Chemical investigation of Malvaviscus conzattii. PMID- 6491691 TI - Role of complement in demyelination in vitro by multiple sclerosis serum and other neurological disease sera. AB - Multiple sclerosis (MS) sera can demyelinate and cause selective cellular changes to organ cultures of rodent CNS which suggests possible immunoglobulin involvement. The complement dependence of this serum action was investigated using complement-inactivating agents and radiolabelled rat cerebellar cultures. After heat inactivation at 56 degrees C, the in vitro effects of MS, chronic relapsing experimental allergic encephalomyelitis (cr-EAE) and Guillain-Barre syndrome (GBS) sera were severely reduced or eliminated as measured by radiolabel release. On introducing a source of fresh complement, the cr-EAE and GBS serum effects were largely restored whereas MS serum effects remained suppressed. Inactivation of serum complement with mercaptoethanol and Zymosan was associated with marked reduction in serum myelinotoxicity; some restoration of in vitro effects was possible on adding fresh complement although this occurred to a greater extent with cr-EAE and GBS than with MS sera. Inactivation of the alternative complement pathway brought a limited reduction in MS serum activity in vitro which was not restored with fresh complement. It is concluded that complement is involved only to a limited extent in MS serum myelinotoxic effects and that MS serum effects in vitro are due to several components of which thermolabile substances make a significant contribution and are as yet uncharacterised. PMID- 6491692 TI - Plasma pyruvate kinase and creatine kinase activity in Becker muscular dystrophy. AB - Plasma creatine kinase (CK) and pyruvate kinase (PK) were measured in 31 obligate carriers of Becker muscular dystrophy (BMD), 36 BMD patients and appropriate controls. Mean plasma CK was 108 U/l in obligate carriers and 62 U/l in 43 age- and sex-matched controls (P less than 0.001 carriers vs controls). Control CK reference range was 31-125 U/l (mean +/- 2 SD of log transformed values). Mean plasma PK was 40 U/l in obligate carriers and 34 U/l in 56 controls (P less than 0.02 carriers vs controls). Control PK reference range was 18-61 U/l. Values of CK above the reference range upper limit were found in 13 of 31 BMD obligate carriers but only 2 showed elevated PK values. The sensitivity of CK in determining BMD carrier status, although only 42%, was markedly better than PK at 6.5%. Mean plasma CK in BMD patients was 2366 U/l, a 19-fold increase over the control value of 127 U/l (P less than 0.001 patients vs controls). Control CK reference range was 40-316 U/l. In contrast, mean plasma PK in BMD patients was 353 U/l, only 7-fold higher than the mean control value of 57 U/l (P less than 0.001 patients vs controls). Control PK reference range was 22-126 U/l. Clearly, the estimation of plasma PK as a means of determining BMD carrier status is markedly inferior to CK. Previous reports of increased sensitivity of PK compared with CK may have been due to artefactually elevated PK levels produced during sample preparation. PMID- 6491693 TI - Concanavalin A binding to fibroblasts from Duchenne muscular dystrophy patients and age-matched controls. AB - An investigation of [125I]Con A binding to skin fibroblasts from Duchenne muscular dystrophy patients and age-matched controls was carried out. The age groups examined were 5-6 years, 11-12 years, and 15-17 years. Only small differences in binding abilities were observed between dystrophic cells and matched controls. When data was examined as micrograms Con A bound/micrograms protein, dystrophic fibroblasts bound slightly more lectin compared to controls with the 5-6 and 11-12 year age groups, whereas the 15-17 years age group bound slightly less Con A compared to normal controls. However, analysis of binding data as lectin bound/cell showed slightly reduced binding of Con A to dystrophic cells from all age groups when compared to matched controls. It was also found that the amount of Con A bound by both normal and dystrophic fibroblasts markedly increased with the age of the donor. Obviously several factors must be taken into account when analyzing lectin binding data obtained with human fibroblasts. Taken as a whole, our studies do not provide evidence for significant modification of cell surface Con A receptors on fibroblasts from Duchenne muscular dystrophy patients. PMID- 6491694 TI - Peripheral nerve morphometry in stroke patients. AB - Sural nerve biopsy specimens from affected and non-affected limbs of stroke patients were examined morphometrically. Two principle abnormalities of peripheral nerve were found in hemiparetic and hemiplegic limbs. First, the frequency of abnormal teased nerve fibers was significantly increased with abnormal internodes frequently "clustered" and showing a 50% or more reduction in myelin thickness. Second, the mean diameter of myelinated nerve fibers was reduced. These results suggest a primary atrophy of peripheral nerve fibers in the affected limbs of stroke patients with secondary demyelination. Possible aetiological factors include disuse, transynaptic degeneration, ischemia, pressure effect, and decreased axoplasmic flow. It would seem that the structural integrity of peripheral nerve is frequently compromised following a cerebral lesion. PMID- 6491695 TI - Therapy-related leukemia: a necessary complication of successful systemic chemotherapy? PMID- 6491696 TI - Correlations between estrogen receptor, progesterone receptor, and patient characteristics in human breast cancer. AB - The relationships between estrogen receptor, progesterone receptor, and a variety of patient characteristics are described for 2,977 women with primary breast cancer. Older women were more likely to be estrogen-receptor positive than younger women. When patient age and menopausal status were analyzed together, age was found to be the primary determinant of increased estrogen-receptor concentrations. There appeared to be no relationship with progesterone receptor for either age or menopausal status when these variables were analyzed separately. But premenopausal women had higher progesterone receptor concentrations than postmenopausal women when patients of the same age were compared, perhaps reflecting greater estrogen-mediated synthesis of progesterone receptor. Tumor size was negatively related to steroid receptor concentrations, but no relationships were observed between steroid receptors and either the number of positive axillary lymph nodes or the location of the primary tumor. PMID- 6491697 TI - Clinical trial of sequential N-phosphonacetyl-L-aspartate, thymidine, and 5 fluorouracil in advanced colorectal carcinoma. AB - Preclinical studies have demonstrated enhanced cytotoxic effects of 5 fluorouracil (5-FU) when given in conjunction with N-phosphonacetyl-L-aspartate (PALA) or thymidine in several murine systems. Early clinical studies have demonstrated significant delayed depletion of pyrimidine nucleotides in tumor biopsy specimens following systemic PALA administration and prolonged serum levels of 5-FU after thymidine administration. Each of these biochemical effects would be anticipated to augment the cytotoxic activity of 5-FU. A phase II trial of a timed sequential administration schedule of PALA, thymidine, and 5-FU was conducted in 37 patients with advanced measurable colorectal cancer. Ten of 37 patients (27%) experienced objective tumor responses with a median response duration of 22 weeks, and 18 patients (49%) had stable disease for a median duration of 20 weeks. Six of 13 patients (46%) with anaplastic histology and/or rapidly progressive tumors experienced high-quality tumor responses. Leukopenia and neurologic side effects were the primary toxicities, including one death caused by sepsis. This regimen has demonstrated striking alteration in the 5-FU dose-effect relationship and definite antitumor activity in patients with advanced colorectal cancer. Further trials in patients with anaplastic carcinomas of the colon or other anatomic sites should be considered. PMID- 6491698 TI - Radiation therapy in the treatment of meningioma: the Joint Center for Radiation Therapy experience 1970 to 1982. AB - The standard treatment for meningioma is complete resection. However, complete resection is often not possible because of tumor location and extent. To evaluate the usefulness of radiation therapy in patients with unresected or residual tumor, we reviewed the Joint Center for Radiation Therapy experience from 1970 to 1982 (n = 31). Histologic diagnosis was available in 27 patients. The patients were treated with megavoltage radiation to a mean dose of 5,280 rad (3,780 to 6,050 rad) in 180- to 200-rad daily fractions using multiple static or rotational fields. The median follow-up period was 45 months, with a range of four to 156 months. The overall four-year relapse-free survival (RFS) rate was 72%. All relapses occurred within the first 37 months; the mean time to relapse was 31 months. The four-year RFS was the same whether patients were treated at initial presentation or after recurrence (74% v 67%, respectively). There was no difference in RFS for patients treated after partial resection or those patients with no resection (76% v 64%). No patients with malignant meningioma were relapse free three years after radiation therapy. Complications included decreased auditory acuity in three patients and retinopathy in one patient. These data suggest that moderate dose radiation therapy can offer long-term symptom-free survival with few complications in patients having unresected or partially resected benign meningioma. PMID- 6491699 TI - Clinical characteristics associated with the development of anticipatory nausea and vomiting in cancer patients undergoing chemotherapy treatment. AB - Approximately one in four patients experiences nausea and/or vomiting in anticipation of a chemotherapy treatment by the time of their fourth treatment cycle. Anticipatory nausea and vomiting is a prevalent problem of clinical significance in the total management of chemotherapy side effects. While refractory to standard antiemetic treatment, anticipatory nausea and vomiting has been successfully treated with behavioral approaches such as systemic desensitization. The present study was designed to identify the characteristics of patients at high risk for developing anticipatory side effects. Early identification of cancer patients prone to developing anticipatory side effects could lead to preventive measures. One hundred seventy-six consecutive ambulatory patients with histologically confirmed cancer who were being treated at three geographically separate hospitals of the University of Rochester Cancer Center were studied at the time of their fourth chemotherapy treatment. Patients found to experience anticipatory nausea and vomiting were significantly more likely (P less than .001) to have four or more of the following characteristics than patients who did not report anticipatory side effects: (1) less than 50 years of age; (2) the experience of nausea and/or vomiting after their last chemotherapy treatment; (3) a description of nausea after the last treatment as "moderate, severe, or intolerable"; (4) a description of vomiting after the last treatment as "moderate, severe, or intolerable"; (5) the reporting of the side effect "warm or hot all over" after their last treatment; (6) a susceptibility to motion sickness; (7) the experience of "sweating after their last treatment"; (8) and the experience of "generalized weakness after their last chemotherapy treatment." Results support a view that anticipatory side effects are conditioned and point to practical interventions for their clinical control. PMID- 6491700 TI - The dangers of ad hoc protocols. PMID- 6491701 TI - The effect of specific and nonspecific immunotherapy on natural killer cell activity in patients with non-small-cell lung cancer. AB - Fourteen patients with stages I and II non-small-cell lung carcinoma receiving adjuvant immunotherapy after surgery were studied serially for natural killer (NK) cell cytotoxicity assays. Seven patients received active nonspecific immunotherapy with Freund's complete adjuvant alone and seven patients received active specific immunotherapy with tumor-associated antigen plus Freund's complete adjuvant. Both groups were analyzed as a single group in view of the lack of any difference in the results. The results indicated that NK-cell cytotoxicity v K562 was lower in untreated patients than in normal controls, but the difference was not significant. There was no evidence of specific cytotoxicity v the lung cell line A549 in untreated patients when compared with normal controls. Compared with pretreatment values, elevated cytotoxicity v both K562 and A549 was observed at every post-treatment time point tested, and this was statistically significant at several time points by a paired t test. No specific effect was noted after immunization with lung antigen on cytotoxicity against the lung cell line A549. Other correlations studied did not show any relationship between delayed hypersensitivity skin testing or serum carcinoembryonic antigen levels and NK-cell cytotoxicity. It is concluded that NK cell reactivity was increased nonspecifically by active specific and nonspecific immunotherapy. This increase seems to peak at the 12-month period and was significant when compared with pretreatment levels. PMID- 6491702 TI - Malignant melanoma in childhood: clinical course and response to chemotherapy. AB - Malignant melanoma is uncommon in patients less than 20 years of age, and little is known about the response to chemotherapy in this age group. We report here a series of 18 children, of whom ten with metastatic disease were treated with cyclophosphamide, vincristine, and dactinomycin. Only two of nine evaluable patients failed to show an objective response to therapy. Five of ten patients treated are alive and free of tumor 12 to 80 months from the start of chemotherapy. Three have been in remission for more than five years. Results suggest that melanoma in this age group may be more responsive to chemotherapy than melanoma in adult patients and that a trial of this therapy in a larger number of children with evaluable disease is warranted. PMID- 6491703 TI - Combined 5-fluorouracil and radiation therapy as a surgical adjuvant for poor prognosis gastric carcinoma. AB - Sixty-two patients with resectable but poor-prognosis gastric carcinoma were randomized to either no surgical adjuvant therapy or treatment with 5 fluorouracil (15 mg/kg by rapid intravenous injection X 3) plus radiation (3,750 rad in 24 fractions) initiated 3 1/2 to six weeks postoperatively. Informed consent was obtained after randomization and only from the 39 randomized to treatment. Ten patients refused their treatment assignment. The five-year survival rate for patients randomized to treatment was 23%, and for those randomized to no treatment, 4% (P less than .05). Both the survival distributions and the alive-without-recurrence distributions were significantly different for the two groups (P = .024) and favored treatment assignment. When the treatment assignment group was broken down to those patients actually receiving treatment and those refusing, five-year survival rates were: treated, 20%; treatment refusal, 30%; controls, 4%; the three survival distributions were not significantly different. Thirty-nine percent of patients actually treated had a local-regional component of first clinical recurrence compared with 54% of those who received no treatment. This study does not establish 5-fluorouracil plus radiation as effective surgical adjuvant therapy for gastric cancer but suggests this approach as a possible fruitful area for continued research. This study also illustrates the potential problems that may be encountered in interpreting results when patients are randomized to a study before consent is obtained. PMID- 6491704 TI - Pulmonary uptake of technetium 99m macroaggregated albumin: a predictor of gastrointestinal toxicity during hepatic artery perfusion. AB - Hepatic artery infusion of 5-fluoro-2-deoxyuridine (5-FUdR) provides high hepatic drug levels but little systemic toxicity, since, by this route of administration, the drug is detoxified by the hepatocytes. Slow infusion of technetium 99m- (99mTc) labeled macroaggregated albumin (MAA) through the hepatic artery is an aid in catheter placement, in predicting response of liver metastases to therapy, and in identifying extra-hepatic flow in the gastroduodenal or splenic arteries as an indicator of systemic toxicity. Marked pulmonary uptake of this tracer after slow radionuclide hepatic angiography was noted in four patients who showed major gastrointestinal (GI) toxicity. A retrospective examination of pulmonary accumulation of 99mTcMAA as a predictor of GI toxicity is the subject of this paper. Two groups of patients were evaluated. The first group consisted of 14 consecutive patients in whom continuous infusion of drug was administered by an external pump by way of a percutaneous catheter. Patients received baseline and follow-up (seven to 27 days) slow-infusion tracer studies (2 to 4 mCi 99mTcMAA at 10 to 21 mL/h). The second group included 14 consecutive patients who were receiving intraarterial chemotherapy by a totally implantable pump system. All received baseline slow-infusion studies (2 to 4 mCi 99mTcMAA at approximately 0.5 to 1.0 mL/min). The percentage of the injected dose in the lung was determined. Patients with greater than 20% of tracer in the lung after radionuclide hepatic angiography had significantly greater severe GI toxicity than patients with baseline values of less than 20%. Our findings support the existence of hepatic arteriovenous (A-V) communications in some patients and suggest that they are present pretherapy. Presence of these A-V communications, which can result in a vascular bypass of normal hepatic parenchyma and the subsequent decrease in hepatic detoxification of chemotherapeutic agents, is the likely cause of GI toxicity. Pulmonary uptake of tracer injected in the hepatic artery may be useful in quantifying the degree of shunting and facilitate the monitoring of potential systemic toxicity. PMID- 6491705 TI - Totally implantable system for peritoneal access. AB - A totally implantable system for providing access to the peritoneal cavity was evaluated. Fifty-six Port-A-Cath (Pharmacia Nu Tech, Piscataway, NJ) peritoneal access systems were implanted in 54 cancer patients receiving intraperitoneal chemotherapy. The catheters are accessed by transcutaneous placement of a Huber point needle through a silicone septum at the top of the portal. A total of 32 patient years of experience are reported. The Port-A-Caths have been in place for a median of 22 weeks (range, one to 85). A total of 401 entries have been made for paracentesis, chemotherapy administration, antibiotic administration, peritoneal lavage for cytology, and catheter flushing. There have been six episodes of peritonitis (five Staphylococcus epidermidis, one S aureus) in three patients. There have been no mechanical failures of the Port-A-Caths. Loss of bidirectional flow through the catheter due to fibrin deposition about the catheter has been the major cause of catheter failure. Patient acceptance of the Port-A-Cath has been excellent. PMID- 6491706 TI - Multiple primary malignancies. PMID- 6491707 TI - Electrophysiological characteristics of lumbar spinal cord neurons backfired from lateral reticular nucleus in the rat. AB - Spinal neurons antidromically activated from either the lateral reticular nucleus (LRN) or immediately adjacent areas were identified in the rat lumbar spinal cord. In agreement with previous anatomical work (60), these neurons were widely distributed in both the dorsal and ventral horns of the spinal cord and could be subdivided into three main groups according to their location: a) deep ventromedial (DVM) cells, which project more substantially to the LRN than to other supraspinal targets; b) cells of the median portion of the neck of the dorsal horn (mNDH), which project exclusively to the LRN; c) cells lying in other parts of the dorsal horn (superficial layers, nucleus proprius, reticular extension of the neck), by their location, they are indistinguishable from cells projecting to other supraspinal targets. The probability is high that the DVM and mNDH cells contribute exclusively, or at least preferentially, to the lateral component of the spinoreticular tract (lSRT), defined as the direct spinal pathway to the LRN. Although electrophysiological properties of cells were clearly related to their spinal location, several subpopulations could be recognized in each of the three main groups. The majority of DVM neurons were in lamina VII, with some in laminae VI, VIII, and X. With the exception of a few lamina X cells, the DVM neurons had high conduction velocities. Four subpopulations of these neurons were recognized. a) Innocuous proprioceptive cells responded to small changes in joint position, some showing convergence of nonnoxious cutaneous inputs. b) High-threshold cells (approximately 50% of DVM cells). Seventy-five percent of these cells were excited from bilateral receptive fields (mostly symmetric) with noxious cutaneous pinching that extended to subcutaneous tissues. Their evoked responses had long-lasting postdischarges that continued up to several minutes after cessation of the stimulus. c) Inhibited cells had no demonstrable excitatory receptive fields and a high ongoing activity that was tonically depressed by pressure or pinch; poststimulus effects of long duration were observed. d) Cells with no resting discharge and demonstrable excitatory peripheral receptive fields. mNDH cells had recording sites at the medial border of the internal portion of the reticular area of the neck of the dorsal horn.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491708 TI - Properties of deep spinothalamic tract cells in the rat, with special reference to ventromedial zone of lumbar dorsal horn. AB - Spinothalamic tract cells lying at the base of the dorsal horn or in deeper areas were identified in the rat at the lumbar spinal cord level by injecting horseradish peroxidase or stimulating posterior thalamic areas. Two groups of neurons were delineated; each constituted a homogeneous population of cells in terms of electrophysiological properties. Ventromedial dorsal horn cells lay at the base of the dorsal horn in its most medial aspect. They constitute a densely packed formation, which in the rat's ascending pathway system is restricted to the spinothalamic tract. Their main characteristics were a) ongoing activity, which consisted of small groups of spikes occurring at regular intervals, with a maximal discharge during ankle extension; b) unilateral receptive fields, which were restricted to the distal parts of the limb and involved both proprioceptive (ankle, joint digits) and exteroceptive (foot skin) structures; c) input of innocuous origin (midrange articular movement, touch, pressure) that was excitatory and input of noxious cutaneous origin (radiant heat) that was inhibitory; the same areas of foot skin were thus potentially either excitatory or inhibitory, depending on the nature of the stimulus applied; d) ankle flexion could differentially modulate both ongoing activity and excitatory responses from distal parts of the limb, inhibiting the former and potentiating the latter. In consequence, the ability of these cells to be driven by both proprioceptive and cutaneous inputs from limb extremities as well as by interactions of these inputs would appear to be very favorable for informing the central nervous system about limb position in both passive postural changes and the step cycle. It is suggested that they supply the thalamus with integrated information about locomotion. Lamina VII cells also constituted a subpopulation of neurons with very homogeneous electrophysiological properties. They were characterized by widespread inhibitory receptive fields, possibly spanning both hindlimbs and the ipsilateral forelimb. Inhibition was most effective when the stimulus (pressure, pinch) was intense and applied to proximal parts of the hindlimb. Ongoing activity consisted of spikes set at regular intervals and sometimes related to midrange movements of the knee. Although the significance of the widespread inhibitory receptive fields remains unclear, it has been suggested that these neurons are involved in the transmission of proprioceptive information.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491709 TI - Visual desynchronization of cortical EEG impaired by lesions of superior colliculus in rats. AB - It is unclear whether rats with lesions of the superior colliculus (SC) neglect visual stimuli because a) they fail to notice the stimuli or b) they notice the stimuli but fail to make specific orienting movements of the eyes and head toward them. To investigate this issue, we used an index of "noticing" that does not involve overt orienting movements, namely, desynchronization of the cortical electroencephalogram (EEG) in drowsy animals. In the first experiment, large collicular lesions with some invasion of surrounding areas severely impaired EEG desynchronization to a brief overhead flash of light but did not significantly affect desynchronization to brief bursts of white noise. No impairment was found after control lesions of cerebral cortex overlying the superior colliculus or of striate cortex. A subsequent experiment found that the visual impairment was still present when lesions were confined to the superior colliculus. It appears that rats with lesions of the superior colliculus can, in certain circumstances, fail to notice visual stimuli and that in rats, the superior colliculus is concerned not only with specific orienting movements to visual stimuli but also with visual desynchronization of the cortical EEG. PMID- 6491710 TI - Response selectivity of neocortical neurons to specific odors in the rabbit. AB - Odor responses of neocortical neurons in rabbits under light pentobarbital anesthesia were studied in a restricted area in the lateral half of the prefrontal cortex close to the frontal pole. A preevent cumulative sum chart provided a visual display of the change in unit discharge rate following each odor stimulation, and critical levels on each chart provided a visual display of statistical significance. The neocortical neurons studied were activated predominantly by biologically significant odors, such as feces, urine, and dry food. Of those same neurons, 90% failed to respond to pure-chemical odors, and no neurons were found that responded to pure-chemical odors alone. Some neurons responded exclusively to one of the animal-product odors. Some odor-sensitive neurons were affected by electrical stimulation of the mediodorsal thalamic nucleus. Responses to the animal-product odors were observed after ablation of the trigeminal and/or vomeronasal inputs. The responses to these pheromone-like substances are discussed in the context of a central role for odor-sensitive neocortical neurons in cognitive aspects of discrimination of specific odor patterns in the mammals. PMID- 6491711 TI - Phase-dependent responses evoked in limb muscles by stimulation of medullary reticular formation during locomotion in thalamic cats. AB - Electromyographic and kinematic responses of all four limbs were studied when loci within the medullary reticular formation (MRF) were stimulated (30-ms train of 0.2-ms pulses at 300 Hz, strength 35 microA) during treadmill locomotion in spontaneously walking thalamic cats. Responses could be evoked in flexor or extensor muscles of any given limb by such stimulation, depending on the time during the step cycle at which the stimulus was delivered. Stimulation normally excited flexor muscles but could either excite or inhibit extensor muscles depending on the exact position of the electrode. Excitatory responses in extensor muscles were often followed by a short period of inhibition of activity. The responses in muscles of the opposing limbs of the same girdle were, in general, reciprocally organized. For instance, a stimulus delivered during the swing phase of the ipsilateral limb normally evoked excitatory responses both in flexor muscles of that limb and in extensor muscles of the contralateral limb. The same stimulus delivered during the stance phase of the ipsilateral limb evoked excitatory responses in ipsilateral extensor muscles and in contralateral flexor muscles. Responses were also observed at the same time in fore- and hindlimbs that were well organized with respect to the locomotor cycle. Seventy five percent of all responses occurred within 8-20 ms of the onset of the stimulus train. Responses evoked in muscles of the opposing limbs of one girdle (e.g., a flexor of one limb and an extensor of the other) had similar latencies, suggesting that the responses were synchronously organized on both sides of the body rather than one being a consequence of the other. Although the majority of responses in a given muscle were elicited during its period of activity, responses could occasionally be evoked when there was no activity in that muscle or could be absent despite activity in the muscle. The short trains of stimuli were normally potent enough to affect the limb trajectory, which reflected changes in the onset or the offset of the activity of most muscles. Thus the stimuli effectively changed both the duration of the period of activity in these muscles and the overall step cycle. Longer trains of stimuli (200 ms) markedly amplified these changes to the point of completely resetting the locomotor rhythm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491712 TI - Effects of stimulation of corpus callosum on precentral neuron activity in the awake monkey. AB - The effects of stimulation of the corpus callosum (CC) on precentral neurons were studied in monkeys performing motor tasks with either forelimb. Of a total of 246 precentral neurons that were tested with CC stimulation, 70 were orthodromically and 12 were antidromically activated. The percentages of neurons orthodromically activated by CC stimulation were the same in pyramidal tract neurons (PTNs) (31%) and non-PTNs (31%). The mean latency of neuronal activation by CC stimulation was similar in PTNs and non-PTNs. Precentral neurons were divided into two groups with respect to muscular contractions evoked by intracortical stimulation: neurons related to finger, wrist, and elbow movements (distal group) and those related to shoulder or axial movements (proximal group). The percentages of neurons orthodromically activated by CC stimulation were similar in both groups; 25% in distal and 29% in proximal groups. However, the mean latency of orthodromic CC activation was significantly shorter for the proximal than for the distal group. Precentral neurons were classified into three groups; neurons related to finger and/or wrist movement tasks (F-W group), those related to arm movement tasks in addition to finger and/or wrist tasks (F, W + A group), and those related to arm movements only (A group). The percentages of neurons orthodromically activated by CC stimulation were similar in the three groups. The mean latencies of neuronal activities were a little longer in the F-W group than in the A group or the F, W + A group. Precentral neurons were classified into three groups in relation to ipsilateral or contralateral forelimb movements: neurons related to ipsilateral movements (ipsi neurons, n = 13), those related to ipsilateral as well as contralateral movements (bilat neurons, n = 50) and those related to contralateral movements (contra neurons, n = 136). The percentages of neurons orthodromically activated by CC stimulation were 15 (2/13, ipsi neurons), 24.0 (12/50, bilat neurons), and 25.0% (34/136, contra neurons), respectively. The mean latencies of neuronal activation were compared between two groups; one group was composed of ipsi and bilat neurons, and the other group was of contra neurons. The mean latency was a little shorter for the ipsi + bilat group than for the contra group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6491713 TI - Auditory properties of space-tuned units in owl's optic tectum. AB - Auditory units in the optic tectum of the barn owl (Tyto alba) were studied under free-field conditions with a movable sound source. These units are selective for sound location and their spatial tuning varies systematically across the tectum, forming a map of space (8). I found that frequency tuning, response latencies, and thresholds of units changed in parallel with their spatial tuning, suggesting that as a consequence these properties also are topographically distributed in the optic tectum. Response rates were determined primarily by the location of the sound source. Regardless of sound intensity, only stimuli delivered from a restricted "best area" elicited vigorous responses. Minimum response latencies were shortest for units with frontal best areas and increased systematically for units with best areas located more peripherally. The response latencies of units with best areas centered within 25 degrees of the owl's visual axis were virtually independent of sound intensity and speaker position. The latencies of units with more peripheral best areas varied with speaker position and were shortest when the speaker was in the best area. Thresholds to noise stimuli were lowest for units with best areas directly in front of the owl and increased systematically for units with best areas located more peripherally. Thus, in the representation of frontal space, where units have the smallest receptive fields and the magnification of space is the greatest (8), units also respond to the weakest sound fields. Many units (20%) could not be driven with tonal stimuli; of those that could, most were broadly tuned for frequency. Characteristic frequencies and high-frequency cutoffs shifted lower as best areas moved peripherally. High-frequency tones, which excited units with frontal best areas, either inhibited or failed to drive units with peripheral best areas. These systematic changes in unit response properties influence how sounds from different locations are represented in the tectum and reflect integrative strategies used by the owl's auditory system in deriving a representation of auditory space. PMID- 6491714 TI - Neural control of vergence eye movements: activity of abducens and oculomotor neurons. AB - Single-unit recordings were made from neurons with horizontal eye position sensitivity in the oculomotor and abducens nuclei in alert monkeys. The animals were trained to perform a visual tracking task that resulted in conjugate eye movements or symmetrical vergence movements. Scatterplots were obtained for unit firing rate as a function of the position of the ipsilateral eye for both types of movement. The slopes of the linear regression line were computed for conjugate (kc) and vergence movements (kv). Previous recording studies implied that kv should be equal to kc for most, if not all, abducens and oculomotor neurons. Other lines of evidence suggested that kv should be zero for a substantial proportion of abducens neurons. In the abducens nucleus, we found some cells for which kv matched kc, and a few cells with a kv value of zero. However, the majority of abducens units had vergence signals that were neither equal to zero nor to their conjugate signals. Overall, kv/kc was 0.62, and the correlation between kv and kc was not significantly different from zero. Similarly, in the oculomotor nucleus, kv was significantly different from kc for a majority of the cells. A few units had kv values less than or equal to zero, whereas other cells had very high kv values. Overall, the kv/kc for oculomotor units was nearly unity (0.94), and the correlation between kv and kc was 0.31. These results confirm previous reports that most neurons in the abducens and oculomotor nuclei with a horizontal eye position sensitivity carry both conjugate and vergence eye movement signals. We do not find that the relative magnitudes of these signals are closely matched for most neurons. It is more likely that vergence and conjugate signals are matched globally, for an entire nucleus, rather than for individual motoneurons. This view is consistent with the hypothesis that conjugate and vergence signals are generated independently and combined for the first time at the motoneurons. Our results also imply that some motoneurons play a more important role than others in either vergence or conjugate movements. PMID- 6491715 TI - Halothane sensitizes cutaneous nociceptors in monkeys. AB - The effects of halothane on the responses of C-fiber (CMHs) and A-fiber (AMHs) nociceptive afferents sensitive to mechanical and heat stimuli were studied in monkeys. The response to heat stimuli was studied with use of a laser thermal stimulator that provided stepped increases in skin temperature over a 7.5-mm diameter area with rise times to the desired temperature near 100 ms. Recordings were obtained from single fibers that innervated the glabrous skin of the hand using a teased-fiber dissection technique. In initial studies the response of 32 CMHs and 45 AMHs in monkeys anesthetized with pentobarbital sodium (3-6 mg X kg-1 X h-1) was compared with the response of 12 CMHs and 23 AMHs in monkeys anesthetized with a combination of halothane (0.8%) and N2O (67%). A standardized set of 10 3-s heat stimuli ranging from 41 to 49 degrees C delivered every 30 s were applied to the receptive field. Both AMHs and CMHs had a lower threshold and greater response to suprathreshold heat stimuli under conditions of halothane-N2O anesthesia. The threshold to mechanical stimuli, as tested by von Frey hairs, was not significantly different. Five CMHs and 5 AMHs were studied in a crossover study in which responses to the 41-49 degrees C stimuli were obtained first under halothane-N2O (0.8%-67%) anesthesia, then under an ultrashort acting barbiturate, methohexital (2-9 mg/kg over 15 min), and finally once again under halothane-N2O anesthesia. For the five CMHs, the mean cumulative response was 1.8 times greater, whereas for the five AMHs the response was 4.7 times greater under halothane as opposed to barbiturate anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491717 TI - Spatial contrast sensitivity of dark-reared cats with striate cortex lesions. AB - We measured the spatial contrast sensitivity of two dark-reared cats before and after bilateral ablations of area 17 and parts of area 18. These lesions produced large deficits in the contrast sensitivity of both cats at intermediate and high spatial frequencies. This postoperative reduction in contrast sensitivity in dark reared cats is relatively similar to the sensitivity deficits produced by the same cortical lesions in normally reared cats. However, both pre- and postoperatively, the normally reared cats exhibited contrast sensitivity that is clearly superior to that of the dark-reared cats. The results demonstrate both that striate cortex is significantly involved in the spatial contrast sensitivity of dark-reared cats and that dark rearing produces widespread deficits, independent of those in striate cortex, through much of the visual system. PMID- 6491716 TI - Monosynaptic excitation of dorsal medullary respiratory neurons by slowly adapting pulmonary stretch receptors. AB - The discharges of individual slowly adapting pulmonary stretch receptors (PSRs) and single respiratory neurons of the dorsal respiratory group (DRG) within the ventrolateral subnucleus of the solitary tract were recorded simultaneously in anesthetized, paralyzed, artificially ventilated cats. DRG neurons were classified as P-cell, I-alpha, or I-beta, based on the alteration in activity during respiratory cycles when lung inflation was withheld compared to activity when the lungs were inflated in phase with central inspiratory drive. In some cases, vagal stimulation was also used to classify respiratory neurons. Synaptic input of PSRs onto DRG neurons was examined by the construction of cross correlograms for the simultaneously recorded discharge of individual PSRs (reference events) and individual DRG neurons (correlated events). Monosynaptic excitatory connections were demonstrated by peaks in 26% of the cross correlograms of PSR and P-cell pairs and 20% of the cross-correlograms of PSR and I-beta neuron pairs. The ratio of the peak number of occurrences to the background number of occurrences (k value) was comparable for P-cells and I-beta neurons: 2.96 +/- 2.09 and 1.62 +/- 0.36 (mean +/- SD), respectively. P-cells and I-beta neurons also had similar short latencies for the peak of increased probability of discharge: 2.74 +/- 0.53 and 2.57 +/- 0.63 ms, respectively. No evidence was obtained demonstrating synaptic connectivity between PSRs and I alpha neurons. Interpretations of this negative result are discussed. PMID- 6491718 TI - Dorsal root ganglia development in chicks following partial ablation of the neural crest. AB - To assess the effects of reduced competition for peripheral targets on developing brachial dorsal root ganglia (DRG), chick embryos were subjected to partial ablations of the brachial neural crest at stages 13 or 14 (Hamburger, V., and H.L. Hamilton (1951) J. Morphol. 88: 49-92), using an ophthalmological cauterization unit. In the initial studies reported here, ganglia developing from the remaining crest material were examined for ganglionic volume and neuronal size, neuronal number, and degenerative activity at stage 35. Results showed that the lesion procedure resulted in the reduction or absence of one or two ganglia on each side at the level of DRG 15 to DRG 17. Hypertrophies occurred in other ganglia remaining at these and at more rostral levels and ranged up to 220%. These hypertrophies were most pronounced, however, not in the ganglia adjacent to those lesioned but rather in more remote ganglia, including those at cervical levels. Accompanying these ganglionic changes were significant alterations in all three neuronal parameters examined. The findings clearly demonstrate a responsiveness of chick brachial DRG to reduced competition resulting from neural crest ablations and that such responsiveness occurs along several axial segments. PMID- 6491719 TI - Stimulation of protein synthesis and glucose utilization in the hypoglossal nucleus induced by axotomy. AB - The metabolic responses of rat hypoglossal nuclei to unilateral section of the 12th cranial nerve have been studied. Changes in the rates of protein synthesis and glucose utilization in the regenerating nucleus were determined with two quantitative autoradiographic techniques, the L-[1-14C]leucine method and the [14C] deoxyglucose method, respectively. The results show that both of these processes increase in the nucleus ipsilateral to the sectioned nerve and are unaffected in the contralateral nucleus as compared with sham-operated animals. The time courses of these metabolic changes have been compared with that of the return of functional innervation of the tongue. An increase in glucose utilization is first detected 24 hr postaxotomy. It is maximal between 1 and 3 days postaxotomy and constitutes an 84% increase over the rate in the contralateral control nucleus. The increase in protein synthesis is of smaller magnitude than that of glucose utilization. It is maximal at 48 hr after axotomy and constitutes a 25% increase over the rate in the contralateral nucleus. The increases in both of these metabolic processes persist even after functional recovery of the tongue at 21 days postaxotomy. Protein synthesis and glucose utilization return to normal levels between 24 and 35 days postaxotomy. Although the time courses of the changes in protein synthesis and glucose utilization are similar, the magnitude of the increase in glucose utilization is too large to be accounted for by the energy requirements of the relatively small increase in protein synthesis and probably reflects other processes as well, including altered function of the soma-dendritic membrane of regenerating neurons. PMID- 6491720 TI - Pattern and specificity of axonal outgrowth following varying degrees of chick limb bud ablation. AB - Motoneurons grow into the chick hindlimb via consistent pathways, within which they make specific decisions leading to their correct targets. To determine which axonal guidance features dictate the position of the pathways and to examine the distribution of specific cues, we totally or partially ablated the early hindlimb bud and determined how the subsequent pattern of nerve outgrowth related to the distribution of tissue remnants. Our results suggest that local elements determine the gross anatomical pattern of outgrowth. First, determinants of individual pathways could be selectively removed without altering the pattern in other regions. Second, neurites were restricted to the plexus region at the base of the leg (within which, for unknown reasons, they proceeded posteriorly) unless distal permissive pathways or nearby target remnants were present. Finally, we found that the central region of the pelvic girdle, adjacent to the plexus region, determines the position where the major nerve trunks enter the leg. When gaps were introduced in this region of the girdle, nerves traversed the gaps and directly innervated adjacent muscle. The developing girdle is probably a nonpermissive environment for axon elongation, and axons enter the leg only where it is locally absent. Our results also support the concept that the specific cues that neurites use to reach their appropriate muscles are local. We find that neurites could make correct and specific decisions in the plexus region in the absence of all tissues distal to the pelvic girdle. This shows that the cues for these decisions are independent of the target and must reside in the local mesenchyme. In addition, when muscle remnants were present they were correctly innervated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491721 TI - Differential emergence of cellular mechanisms mediating habituation and sensitization in the developing Aplysia nervous system. AB - The development of the cellular substrates underlying habituation and sensitization, two simple forms of learning, was examined at a polysynaptic sensory-to-motor connection in the neural circuit mediating defensive mucus release in the marine mollusc, Aplysia californica. Animals were studied throughout juvenile life, stages 9 (40 days of development) to 12 (95 days), and into adulthood, stage 13 (120 days), starting just after metamorphosis when mucus release first becomes evident. Homosynaptic depression, which mediates habituation, was already present in its adult form in stage 9. Heterosynaptic facilitation, which mediates sensitization, appeared in stage 10 and reached maturity during stages 11 and 12. Thus, the development of synaptic plasticity in this circuit occurs in discrete phases in which the gradual emergence of heterosynaptic facilitation occurs only after homosynaptic depression is well established. PMID- 6491722 TI - Critical periods for effects of monocular deprivation: differences between striate and extrastriate cortex. AB - The critical period of susceptibility to effects of monocular deprivation was compared in striate cortex and the lateral suprasylvian (LS) visual area of cortex. Twenty-three cats received monocular lid suture for a period of 4 weeks beginning at 4, 12, 18, 26, or 35 weeks of age or as adults. Immediately following the deprivation, single cell recordings were carried out in both cortical areas of each cat. Recordings also were made from five normally reared control cats. For both striate and LS cortex, early monocular deprivation had marked effects on neuronal ocular dominance, including an increased percentage of cells dominated by the nondeprived eye, a decreased percentage of cells dominated by the deprived eye, and a decreased percentage of binocularly driven cells. In both cortical areas, these effects were maximal in animals deprived at 4 weeks of age. Both areas then showed similar monotonic declines in effects of the deprivation following onsets from 4 to 18 weeks of age. However, in older animals there were clear differences in the effects of monocular deprivation on LS and striate cortex. In LS cortex, the monotonic decline in effects continued until 26 weeks of age, and no significant abnormalities were present in animals deprived at 26 weeks of age or older. In striate cortex, however, the effects of monocular deprivation remained relatively constant following onsets from 18 to 35 weeks of age, and significant abnormalities in all measures of ocular dominance were present when deprivation was begun as late as 35 weeks of age. Within-animal comparisons indicated that the greater effects of monocular deprivation on striate cortex than on LS cortex were present in every cat deprived at 26 or 35 weeks of age. Neither cortical area showed significant abnormalities following monocular deprivation in adult cats. These results indicate that the critical period for effects of the same regime of monocular deprivation is over sooner in LS cortex (between 18 and 26 weeks of age) than in striate cortex (after 35 weeks of age). This observation has important implications for an understanding of the sites and mechanisms of effects of visual deprivation and the mechanisms that control critical periods of development. PMID- 6491723 TI - Severe tactual as well as visual memory deficits follow combined removal of the amygdala and hippocampus in monkeys. AB - To determine whether medial temporal limbic structures are essential for memory in more than one modality, we trained monkeys preoperatively on both visual and tactual versions of a sensory memory task and then retested them after they had been given bilateral ablations of either the amygdaloid complex, the hippocampal formation, or both. Monkeys with the combined ablations were severely impaired in both modalities. By contrast, the amygdalectomized monkeys were only moderately impaired in the two modalities, while the hippocampectomized monkeys were impaired in neither. Further examination revealed that the source of the impairment in the monkeys with amygdalectomy alone, unlike that in the animals with combined lesions, was the small size of the pool from which the test objects were drawn. The latter result suggests that, whereas the sensory memory impairment following the combined lesions is basically a recognition loss, the more selective impairment following amygdalectomy alone reflects special difficulty in determining whether a recognized object was presented recently. By demonstrating that the profound sensory memory impairment that follows combined ablation of the amygdala and hippocampus extends beyond a single modality, the present results strengthen the proposals that these two structures are important for sensory memory in all modalities and the multimodal or global amnesia observed in patients with medial temporal lobe damage is likewise due to combined amygdaloid and hippocampal lesions. PMID- 6491724 TI - Antibodies to synthetic peptides defined by cDNA cloning reveal a network of peptidergic neurons in Aplysia. AB - We previously isolated and characterized a cDNA clone specifically expressed in neurons R3 to R8 and R14 of the Aplysia abdominal ganglion (Nambu, J.R., R. Taussig, A.C. Mahon, and R.H. Scheller (1983) Cell 35: 47-56). The cDNA nucleotide sequence and the inferred protein amino acid sequence suggest that this gene encodes the precursor for neuroactive peptides used by these cells. Peptides corresponding to three regions of the precursor were synthesized, coupled to a protein carrier, and used to generate antibodies. These antibodies stain a set of cell bodies, R3 to R14, and their processes in the abdominal ganglion; no other cells in the nervous system or the periphery are immunoreactive. R3 to R14 send numerous fine immunoreactive processes into the vascularized sheath that surrounds the ganglion. Each of these cells also has a large axon which exits the ganglion via the branchial nerve and terminates on the heart. In addition, R14 is anatomically distinct from R3 to R13 in that it sends additional immunoreactive processes to the vasculature near the ganglion. Immunoreactive processes and varicosities were observed on the efferent vein of the gill, the abdominal ganglion artery, and the anterior aorta. These data are consistent with previous studies suggesting that one or more neuropeptides released from R3 to R14 function as modulators of cardiovascular physiology. PMID- 6491725 TI - Hypothalamic peptidyl-glycine alpha-amidating monooxygenase: preliminary characterization. AB - An enzymatic activity capable of converting mono-[125I]-D-Tyr-Val-Gly into mono [125I]-D-Tyr-Val-NH2 was identified in a crude mitochondrial/synaptosomal preparation from rat hypothalamus. Further subcellular fractionation studies localized a majority of this enzymatic activity to fractions enriched in synaptic vesicles. The alpha-amidation activity demonstrated optimal activity at pH 7.5 to 8, was stimulated by the presence of copper ions and reduced ascorbate and required the presence of molecular oxygen. Endogenous alpha-amidation activity was inhibited by the addition of ascorbate oxidase. Kinetic analyses demonstrated Michaelis-Menten type kinetics for D-Tyr-Val-Gly as the varied substrate with the values of Km and Vmax increasing as the ascorbate concentration in the reaction increased. A variety of peptides possessing carboxyl-terminal glycine residues were potent inhibitors of the reaction, while peptides lacking a carboxyl terminal glycine residue were not, suggesting that many glycine-extended peptides may serve as substrates in the alpha-amidation reaction. The characteristics of hypothalamic alpha-amidation activity are similar to those previously reported for the alpha-amidation activity in rat pituitary and mouse corticotropic tumor cells suggesting the presence of closely related enzymes in these tissues. PMID- 6491726 TI - The effect of selective, chronic stimulation on motor unit size in developing rat muscle. AB - One of the two peripheral nerves which innervate rat lumbrical muscle was stimulated chronically in vivo during the postnatal period of synapse elimination to determine whether the differential stimulation would affect the outcome of the elimination process. Rats were anesthetized for about 4 hr a day for 5 to 6 consecutive days, during which time the sural nerve (or, in other animals, the lateral plantar nerve) was electrically stimulated. Each animal received about 10(6) stimuli. After the last stimulation period, the sizes of motor units in both nerves were estimated from motor unit tension recorded in vitro. We found that, on average, sural motor units were larger than others in animals which had received sural nerve stimulation and smaller than others in animals which had received lateral planter nerve stimulation. These results are consistent with the hypothesis that more active nerve terminals possess a relative advantage in competing for occupancy of the endplate. PMID- 6491727 TI - A neural code for auditory space in the cat's superior colliculus. AB - We have examined the intermediate and deep layers of the cat's superior colliculus for evidence of a neural representation of auditory space. We measured the responses of single units to sounds presented in a free field. The results support the following generalizations. Most auditory units in the superior colliculus have sharply delimited receptive fields which form two discrete classes distinguished by their locations and sizes. The remaining units respond to sounds presented at any location. Each auditory unit responds maximally to sounds at a particular horizontal and vertical location within its receptive field, the unit's "best area." The best areas and receptive field borders of a unit are resistant to changes in the intensity of stimulus. The locations of best areas shift systematically as a function of unit position to form a continuous map of auditory space. The horizontal dimension of space is mapped rostrocaudally, and the vertical dimension is mapped mediolaterally. This map corresponds in orientation with the map of visual space. These data permit us to infer the distribution of unit activity elicited by a sound at any given location. Regardless of its location, a sound activates a substantial portion of the superior colliculus. Indeed, sounds at some locations activate nearly all of the auditory units. However the activated portion of the colliculus contains a restricted region of units which are excited to near their maximum firing rates. The position of this focus of greatest activity varies systematically according to the location of the sound source, thus mapping the location of the sound in space. PMID- 6491728 TI - The glutamate analogue alpha-aminoadipic acid is taken up by astrocytes before exerting its gliotoxic effect in vitro. AB - DL- and L-alpha-aminoadipic acid (alpha-AA) are specific gliotoxins in vitro (Huck, S., F. Grass, and M. E. Hatten (1984) Neuroscience 12: 783-796). By combining immunohistochemical and autoradiographic techniques, we now show that DL-[14C]-alpha-AA is accumulated almost selectively by astrocytes in cultures of the dissociated postnatal mouse cerebellum, presumptive neurons being free of the radiolabel. High pressure liquid chromatography analysis of cultures incubated with D- or L-alpha-AA and DL-[14C]-alpha-AA autoradiograms conducted in the presence of D- or L-alpha-AA reveal a stereospecificity of astroglial L-alpha-AA uptake. Both the uptake of alpha-AA by astrocytes and alpha-AA-induced gliotoxicity were sodium dependent. Since 2 microM tetrodotoxin did not prevent the morphological changes, we conclude that sodium plays its role in alpha-AA induced gliotoxicity by mediating the transport of the substance. Thus, alpha-AA appears to be taken up by the astrocytes before exerting its cytotoxic effect. PMID- 6491729 TI - Enterogenous intraspinal cysts. AB - The authors have reviewed the literature and recorded the distinguishing features of intraspinal enterogenous cysts. There are no characteristic clinical findings or history associated with this disease. These congenital space-occupying lesions frequently go undiagnosed, and the patient may be treated for many years as a case of multiple sclerosis. The teratogenic "determination period" is decisive for the development of anomalies affecting one, two, or all three of the germinal layers. All of these cysts belong to the same group, and their structure is an expression of the differing determination periods. The various theories about their etiology are discussed. True intraspinal enterogenous cysts are usually found in the cervical region. After careful operative removal, the prognosis is favorable. PMID- 6491730 TI - Failed aneurysm surgery. Reoperation in 115 cases. AB - Failure to obliterate intracranial aneurysms completely during initial surgery still occurs in spite of recent technical advances. Of the 115 reoperations reported in this series, 89% of the aneurysms were obliterated, and 84% of the patients had a satisfactory outcome. Twelve patients had poor results, three (2.6%) of whom were in poor condition before reoperation. PMID- 6491731 TI - Effects of chlorpromazine on experimental delayed cerebral vasospasm. AB - Experimental delayed cerebral vasospasm was produced in the canine basilar artery by intracisternal injections of blood 2 days apart. The spastic basilar artery was exposed via the transclival route under a surgical microscope, and was dilated by topical application of chlorpromazine, a calmodulin antagonist. Dilatation was dose-dependent, with a median effective dose of 37 +/- 16 microM. In addition, 100 microM chlorpromazine was inserted into the cisterna magna until the intracranial pressure (ICP) reached 200 mm H2O for 30 minutes, inducing a complete reversal of angiographic delayed cerebral vasospasm in two of five animals. In other studies, the intracisternal perfusion of 100 microM chlorpromazine at 1.48 ml/min for 30 minutes with an ICP of less than 200 mm H2O induced no serious abnormalities in mean arterial blood pressure and pulse rate of normal animals. Electroencephalography during the intracisternal perfusion of chlorpromazine showed a slight to moderate increase in occurrence of theta waves. No neurological deficits or significant histological abnormalities ascribable to intracisternal chlorpromazine were found. PMID- 6491732 TI - Outcome in 60 consecutive patients treated with early aneurysm operation and intravenous nimodipine. AB - Sixty consecutive patients with a ruptured supratentorial aneurysm underwent operation during the acute stage, 56 of them within 72 hours after the first bleed, one on the 4th day, and three on the 5th day. Six patients were classified preoperatively in Hunt and Hess neurological Grade I, 39 in Grade II, 11 in Grade III, and four in Grade IV or V. Nine patients had severe intracerebral hematomas, and one patient had a subdural hematoma. After the aneurysm was clipped, nimodipine was applied to the exposed arterial segments in a 2.5 X 10(-5)M solution for 10 minutes. Subsequently, all patients received a continuous intravenous nimodipine infusion (2 mg/hr) for 7 to 12 days, followed by oral treatment (270 mg/day). Forty-six patients (77%) made a good neurological recovery; the morbidity rate was 22%, and mortality rate 1.5%. Of the 45 patients in good condition (Grades I to II) preoperatively, 38 (84%) made a good neurological recovery. Two patients (3% of the total series) developed a typical picture of cerebral ischemic dysfunction of delayed onset with subsequent fixed neurological deficits. The results favor the opinion that early operative intervention is beneficial in patients in good condition rather than delaying surgery, and indicate that nimodipine provides an additional anti-ischemic effect. The appearance and severity of late angiographic vasospasm did not seem to be affected by nimodipine. PMID- 6491733 TI - Surgical reconstruction of the proximal vertebral artery. AB - The authors have reviewed their experience in the management of 55 patients admitted to Henry Ford Hospital with symptoms of vertebrobasilar insufficiency and associated proximal vertebral artery stenosis or occlusion. In 48 patients, the symptoms occurred as multiple repeated events, five of which resulted in permanent deficits. The remaining seven patients had single events, four of which caused permanent deficit. These patients had been treated unsuccessfully with antiplatelet agents (37 cases) and with anticoagulant drugs (15 cases) before surgery. Most patients had multiple angiographic abnormalities, including bilateral vertebral stenosis in 19 cases, unilateral vertebral stenosis and contralateral occlusion in 18, unilateral vertebral hypoplasia and contralateral stenosis in 10, subclavian artery stenosis with steal in seven, and bilateral vertebral artery occlusion in one case. Posterior communicating arteries could not be demonstrated angiographically in 18 patients. Thirty-four patients had associated stenotic or occlusive lesions of the internal carotid artery. Forty eight underwent a vertebral-to-carotid artery transposition. Of these, 18 had an associated carotid endarterectomy and seven had a vertebral artery endarterectomy immediately before the transposition. Two patients had saphenous vein grafts, one from the subclavian and one from the common carotid artery to the vertebral artery. Other surgical procedures included vertebral artery ligation in one case, transposition of the vertebral artery to the thyrocervical trunk in two cases and to the subclavian artery in one case, and endarterectomy of the origin of the vertebral artery in one case. All but two patients had complete resolution of their symptoms: one had persistent dizziness and the other had syncopal episodes. Complications included transient Horner's syndrome (30 cases) which became permanent in four cases, vocal cord paralysis (three cases), elevated hemidiaphragm without respiratory difficulty (two cases), and superficial would infection (one case). There were no deaths. Although the presentation of patients with vertebrobasilar insufficiency is generally characteristic, we believe that a specific diagnosis can be established only by angiographic means. Anticoagulants have been used to alleviate symptoms in some cases but are ineffective in solving the primary hemodynamic problem. Surgical reconstruction of the affected area deserves further evaluation in the management of these patients. PMID- 6491734 TI - Intracranial dissecting aneurysms of the posterior circulation. Report of six cases and review of the literature. AB - Dissecting aneurysms of the intracranial posterior circulation are unusual lesions that affect otherwise healthy young adults, are difficult to diagnose and manage, and carry a high morbidity and mortality rate. Headache in the suboccipital-posterior cervical region is the most common presenting symptom. The dissection usually occurs between the intima or internal elastic lamina and the media; subadventitial dissection does occur and accounts for the infrequent finding of subarachnoid hemorrhage. A deficit in the inner layers of the vessel is the proposed source of dissection. The angiographic features are inconsistent, although an irregularly narrowed arterial segment with proximal and/or distal dilatation are typical findings. Depending on the location of the dissection, the surgical options are: ligation, trapping, or reinforcement of exposed abnormal portions of the vessel. Anticoagulation therapy is not indicated in the management of this lesion. PMID- 6491735 TI - A commentary on the biology and growth kinetics of low-grade and high-grade gliomas. AB - Cell kinetics studies of patients with various gliomas published in the past decade have shown that the average labeling index (LI) obtained from a pulse of 3H-thymidine is very high in medulloblastomas (12.0% +/- 1.3%, standard error of the mean) and glioblastoma multiforme (9.3% +/- 1.0%), low in well differentiated gliomas (less than 1%), and intermediate in anaplastic astrocytomas (4.0% +/- 0.8%). The higher the LI, the faster the tumor grows, probably reflecting a larger growth fraction. In tumor tissues obtained at autopsy, two glioblastomas diluted out the labeling compound in the 2- to 4-month interval after labeling, whereas three glioblastomas and two anaplastic astrocytomas retained labeled neoplastic cells for 3 weeks to 5 months. Most patients whose tumors contained foci of labeled cells at autopsy survived longer. Well differentiated gliomas harbored labeled cells for 2 1/2 to 7 years. These findings indicate that the kinetics of proliferation in well differentiated gliomas are different from those in glioblastomas or anaplastic astrocytomas. PMID- 6491736 TI - Growth-inhibitory effect of prostaglandin D2 on mouse glioma cells. AB - The effects of prostaglandin D2 (PGD2) on the growth of mouse malignant glioma cells were studied in vitro and in vivo. The in vitro studies consisted of various concentrations of prostaglandins (PG's) being added to cultures of mouse glioma cells. At concentrations above 2.5 micrograms/ml, PGD2 strongly inhibited the proliferation of glioma cells, whereas PGE2 had no effect at the same value. Exposure to 5.0 micrograms/ml PGD2 for more than 2 hours resulted in inhibition of glioma cell proliferation. This growth-inhibitory effect of PGD2 was related to the inhibition of DNA synthesis of the cells. The in vivo studies were performed with a subcutaneously transplanted mouse glioma model. Injection of 0.5 mg/kg PGD2 into the tumor was more effective than the same concentration given by intraperitoneal injection. In mice with intracranially transplanted glioma, daily intraperitoneal injection of 0.5 mg/kg PGD2 had no significant effect on survival time. PMID- 6491737 TI - Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal. AB - Twenty-two patients with unilateral acoustic neuromas and preoperative speech discrimination scores of 35% or more had intraoperative monitoring of the electrocochleogram (ECoG) using a transtympanic electrode, and of the brain-stem auditory evoked potentials (BAEP's) using scalp electrodes. Rapid feedback was provided about the status of the cochlear microphonics from the hair cells of the inner ear (CM of the ECoG), the compound action potential of the auditory nerve (N-1 of the ECoG or Wave I of the BAEP's) and the potentials from the lower brain stem (Wave V of the BAEP's). All patients had total removal of the tumor. In 21, the cochlear nerve was anatomically preserved, and 20 had good postoperative facial nerve function. Correlation of tumor size with postoperative hearing was as follows: discrimination scores of more than 35% in three of four patients with 1-cm tumors, two of eight with 1.5-cm tumors, two of six with 2- to 2.5-cm tumors, and one of four with tumors of 3 cm or more. Two other patients with 1.5 cm tumors had discrimination scores of less than 35%, and one patient with a 2-cm tumor had only sound perception. In two patients, the discrimination scores improved. At the end of the operation, all patients with hearing had a detectable N-1, and, when recorded, CM. All but one patient with no hearing had lost N-1, and CM was absent or reduced. Unless Wave V was unchanged, it was a poor predictor of postoperative hearing, and its absence did not preclude preservation of good hearing. The electrophysiological changes during each stage of the operation were analyzed and correlated with events during surgery. Areas in which there was an increased risk of loss of the potentials were determined. In some patients monitoring was unnecessary, because either there were no significant changes or the changes were abrupt and no recovery occurred. However, in other patients, monitoring alerted the surgeon to a possible problem and the method of dissection was altered. Possible mechanisms of hearing loss were suggested from the changes in the recordings. PMID- 6491738 TI - Tic convulsif: results in 11 cases treated with microvascular decompression of the fifth and seventh cranial nerves. AB - The syndrome of tic convulsif consists of ipsilateral concurrent trigeminal neuralgia and hemifacial spasm. Since Cushing's 1920 description of this syndrome in three patients, 37 additional cases have been reported in the world literature. Of the 15 with adequate operative descriptions, 10 had vascular abnormalities and five had tumors. The authors report 11 cases of tic convulsif treated by microvascular decompression of both the fifth and seventh cranial nerves. At operation, 21 of 22 nerves were found to have root entry zone vascular compression. One trigeminal nerve was considered normal. One seventh nerve had a tumor displacing the anterior inferior cerebellar artery into its root entry zone. The average follow-up period in this series was 6 years 2 months (range 1 to 8 1/2 years). Eight patients (73%) were pain-free, two (18%) had frank recurrences, and one (9%) had mild discomfort. Eight patients (73%) were totally free of facial spasm, and two others (18%) had only a trace of residual spasm. These results are comparable to those achieved by treating the individual syndromes with microvascular decompression. Therefore, microvascular decompression of both the fifth and seventh cranial nerves is recommended as the treatment of choice in tic convulsif. PMID- 6491739 TI - Surgical treatment of glossopharyngeal neuralgia and pain from cancer of the nasopharynx. A 20-year experience. AB - The outcome is summarized for 14 cases operated on for glossopharyngeal neuralgia, with both open and percutaneous rhizotomy techniques, between 1960 and 1984. Four patients, all with primary neuralgia, underwent open surgery. Pain disappeared, leaving only a ninth nerve deficit in all but one patient; in that patient, paroxysms of pain recurred after 3 years, mediated by the nervus intermedius. Five other patients with idiopathic neuralgia and five patients with pain secondary to carcinoma underwent percutaneous procedures. Seven patients who had retrogasserian percutaneous rhizotomy for associated trigeminal neuralgia were also pain-free. No mortality or morbidity resulted from either type of procedure. PMID- 6491740 TI - Occipital neuralgia and the C1-2 arthrosis syndrome. AB - Occipital neuralgia syndromes have been ascribed to a great many pathological alterations, some demonstrable and some hypothetical. Recently, occipital neuralgia has been attributed to developmental and posttraumatic lesions in the cervicocranial junction region, with the nerve roots at C-1 and C-2 considered to be the principal pain pathways. The authors describe a series of seven patients with an upper neck and occipital pain syndrome due to unilateral degenerative disease (arthrosis) of a C1-2 lateral articulation. Two of the cases are presented in detail. This disease is demonstrable by radiography through the open mouth by isotope bone scanning, and by computerized tomography scanning. Temporary relief may be obtained by anesthetic and steroid injection, and permanent relief achieved by C-2 dorsal rhizotomy. PMID- 6491741 TI - Subdural hematomas of the posterior fossa in normal-weight newborns. Report of two cases. AB - Two cases are reported of subdural hematoma of the posterior fossa in normal weight full-term newborn infants. The most salient factors in these cases were the lack of specific symptoms and signs indicating the nature and location of the lesion, the importance of computerized tomography for diagnosis, and the good results obtained with early surgical treatment. PMID- 6491742 TI - Spontaneous spinal subarachnoid hemorrhage and subdural hematoma. Report of two cases. AB - Two patients with spontaneous spinal subarachnoid hemorrhage are presented to emphasize the clinical and radiological features of this uncommon illness. Both had severe back pain at the onset. One patient had a subdural hematoma that compressed the conus medullaris and cauda equina, and was drained percutaneously; the other had clots in the subarachnoid space. The cerebrospinal fluid showed a polymorphonuclear pleocytosis that simulated septic meningitis. Complete spinal angiography failed to reveal a cause for the hemorrhages. PMID- 6491743 TI - Spinal cord sarcoidosis. Case report. AB - A case of spinal cord sarcoidosis is presented. Diagnosis was established from a biopsy of the hilar lymph node. The patient was successfully treated with corticosteroid drugs. The literature is reviewed and the deleterious effect of surgery is stressed. PMID- 6491744 TI - Avascular necrosis of bone following short-term dexamethasone therapy for brain edema. Case report. AB - The authors present a case of avascular necrosis of both femoral and humeral heads which developed after short-term steroid treatment for brain edema. A vascular necrosis of bone may develop after short-term as well as after maintenance steroid therapy. Early diagnosis with bone scanning and management may in some cases prevent joint destruction. PMID- 6491745 TI - The Keith needle for sharp and blunt microdissection. Technical note. AB - The Keith needle mounted in a suitable handle forms an exquisitely sharp disposable blade of which the haft can easily be shaped for precise microdissection. When reversed, the eye of the needle is suitable for blunt dissection. PMID- 6491746 TI - Pseudoappendicitis of neurosurgical origin. PMID- 6491747 TI - Treatment of shunt infections. PMID- 6491748 TI - Nitrogen-13 and xenon-133 ventilation studies. AB - Due to the solubility of xenon-133 in blood and tissues, errors are introduced in the determination of regional pulmonary ventilation. We investigated these errors by comparing the results from ventilation measurements with Xe-133 and N-13 in five normal subjects (both at rest and during exercise) and in seven patients after a pneumonectomy. In the normal subjects at rest, the upper lung fields showed no significant difference in the uptake rates of the two gases. In the middle and lower lung fields, however, the uptake rate for Xe-133 was higher than for N-13. During exercise a significant increase of the specific ventilation was found in the upper lung fields for N-13 compared with Xe-133. In the pneumonectomy patients the overall uptake rate for Xe-133 in the intact hemithorax was 25% larger than for N-13. Over the pneumonectomized hemithorax the uptake of the fastest component of Xe-133 was (8.5 +/- 1.3)% of the total. The total chest-wall contribution of Xe-133 was (27 +/- 8)% of the total count rate. PMID- 6491749 TI - Prognosis in Stage 1 malignant melanoma: seven-year follow-up study of splenic radiocolloid uptake as predictor of death. AB - In an earlier study we found that patients with clinical Stage 1 and 2 cutaneous malignant melanoma and increased splenic radiocolloid uptake had more frequent recurrence at 24 mo, compared with melanoma patients having normal liver-spleen scintigrams. This report, an 80-mo follow-up study, gives further information on 119 clinical Stage 1 patients. Fifteen of 35 patients with increased splenic uptake (42.9%) died from melanoma as opposed to only 16 of 84 (19.1%) with normal liver-spleen images (p less than 0.01). Multivariate analysis showed that augmented splenic uptake of technetium-99m sulfur colloid is a marker for adverse prognosis in patients with malignant melanoma but does not appear to be an independent variable in predicting death. In clinical Stage 1 patients, increased splenic uptake correlated significantly with pathologic stage (positive elective node biopsy) as well as thickness and mitotic rate in patients with thicker lesions. It may be that patients with thicker, pathologically aggressive tumors have an increased splenic blood flow and/or enhanced immune and reticuloendothelial response (as manifested by abnormal liver-spleen scintigram). If so, the enhanced immune response does not appear to contribute to overall survival. PMID- 6491750 TI - Technetium-thallium subtraction images for location of parathyroid adenomata. PMID- 6491751 TI - Re: Mucociliary clearance mechanism in smoking and nonsmoking normal subjects. PMID- 6491753 TI - Re: An automated quantitative analysis of ventilation/perfusion lung scintigrams. PMID- 6491752 TI - Re: Quantitative evaluation of cerebrospinal fluid shunt flow. PMID- 6491754 TI - Effect of acute and subchronic exposure to cadmium on the retention of iron in rats. AB - The influence of cadmium on the retention of a single dose of iron after acute and subchronic treatment with cadmium was studied in normal rats. Additionally the results were compared with iron retention in unexposed iron-deficient animals. Test solutions contained iron and cadmium in various molar ratios (Fe:Cd = 1:0, 1:0.5, 1:1, 1:2 mumol/kg body weight). In acute experiments iron retention of normal unexposed rats was decreased in a dose-dependent manner by cadmium. In subchronic studies the diets fed during the treatment period contained iron (28 ppm) and cadmium (28, 56, 112 ppm) in the same molar ratios as did the test solutions. After 4 weeks of feeding a cadmium-fortified diet, the retention of a single dose of 59Fe was increased in all pretreated animals. Iron retention of the cadmium-fed rats was reduced, however, only if cadmium and iron were administered simultaneously. Cadmium appears to compete with iron at the iron transfer system. Acute or subchronic exposure to cadmium did not appear to influence the capability of the intestine to adapt absorption of iron to the increased requirement of the organism or to the utilization of iron for hemoglobin synthesis. PMID- 6491755 TI - Endogenous nitrogen excretion in male highlanders of Papua New Guinea. AB - Endogenous nitrogen excretion was examined in highlanders of Papua New Guinea. Eight highlanders were fed a semisynthetic protein-free diet with about 49 kcal/kg of energy for 11 days. At the end of this period they excreted 29.2 +/- 4.0 mg N/kg of urinary nitrogen and 13.9 +/- 2.5 mg N/kg of fecal nitrogen per day. When the values were expressed per basal metabolic rate (BMR), they were 1.25 +/- 0.19 mg N/kcal BMR for urine and 0.59 +/- 0.08 mg N/kcal BMR for feces. The total amount was calculated as 43.1 +/- 4.3 mg N/kg (1.84 +/- 0.18 mg N/kcal BMR). Endogenous urinary nitrogen excretion in highlanders was the lowest so far reported; the effects of ethnic and nutritional backgrounds on obligatory urinary N loss were examined but no clear explanation was found for the highlanders' low value. PMID- 6491756 TI - Increased sensitivity to H2O2 in glutathione peroxidase-deficient rat granulocytes. AB - The role of glutathione peroxidase (GSH-Px) in protecting phagocytic function of peritoneal granulocytes (PMN) was assessed using selenium (Se)-deficient rats. Rats fed an Se-deficient diet for 12-15 weeks developed profound Se deficiency. Their PMN were found to contain 11% of control levels of GSH-Px. Previous studies have shown that at this level of enzyme activity, the metabolism of H2O2 via the glutathione cycle was impaired. Despite this, the initial rate of phagocytosis, as measured by the ingestion of opsonized oil red O particles, was normal. Prior incubation of PMN in an H2O2-generating system resulted in a time-dependent loss in the ability of the cells to ingest. GSH-Px-deficient PMN were affected to a greater degree than control PMN. Degranulation, as measured by the release of beta-glucuronidase into the extracellular medium after stimulation of PMN by opsonized zymosan in the presence of cytochalasin B, was unaffected by GSH-Px deficiency. Prior incubation of PMN in an H2O2 generating system resulted in decreased degranulation in both control and GSH-Px-deficient PMN, with GSH-Px deficient PMN being affected to a greater degree. The killing of Staphylococcus aureus 502A by both control and GSH-Px-deficient PMN was the same. There was no effect of prior H2O2 incubation on bacterial killing in either control or GSH-Px deficient PMN. Thus, GSH-Px appears to be important in protecting those aspects of phagocytic function that are sensitive to the destructive properties of exogenous H2O2. PMID- 6491757 TI - Effect of interaction of gender and energy intake on lean body mass and fat mass gain in infant baboons. AB - The hypothesis that energy intake influences differently the composition of mass gain during the preweaning period was tested in male and female baboons. Infant baboons were fed either a high (92 kcal/100 g formula) or a low (49 kcal/100 g formula) caloric formula from birth. Body mass, lean body mass and fat mass of each baboon were measured directly at weaning (18 weeks of age). Lean mass and fat mass gained from birth to 18 weeks was estimated by using body composition data from eight newborn baboons. Both energy intake and gender significantly influenced gain of total mass, lean mass and fat mass. There was a significant gender by diet interaction effect on the gain of fat mass. When fed the high caloric formula, males gained 145 g more lean mass than females, but the increase of fat mass was approximately the same. In contrast, on the low caloric formula, males gained 150 g more lean mass than females but 74 g less fat mass than females. These results indicate that fundamental differences in the development of lean mass and fat mass exist between male and female baboons during preweaning life. PMID- 6491758 TI - Interaction between ethanol and low dietary zinc during gestation and lactation in the rat. AB - Pregnant rats were fed individual liquid diets throughout gestation and lactation. The diets contained either 2 or 10 micrograms zinc/ml diet with or without 30% of the kilocalories supplied from ethanol. The low zinc diet produced a moderate zinc deficiency in dams evidenced by decreases in tissue zinc content, serum alkaline phosphatase activity and urinary zinc concentration. Despite the presence of high zinc content in the diet, ethanol antagonized the maternal zinc status to a level typical of that produced by the low zinc diet. The lowest zinc status, however, was found when low dietary zinc and ethanol were combined. The maternal interaction between ethanol and zinc also depressed offspring serum zinc and alkaline phosphatase activity in a similar manner. Ethanol, however, did not affect tissue content of calcium, magnesium or phosphorus, which indicates that ethanol is a specific antagonist of zinc utilization during gestation and lactation. PMID- 6491759 TI - Dietary vitamin E requirement of fingerling channel catfish. AB - Two experiments were conducted to reevaluate the dietary vitamin E requirement of fingerling channel catfish. Purified diets containing 1% cod liver oil, 4% stripped lard and adequate selenium supplemented with graded levels of DL-alpha tocopheryl acetate were used in both experiments. The results indicate that the previously reported requirement value, which was based on growth and pathological changes, was underestimated. The minimum dietary vitamin E requirement in the form of DL-alpha-tocopheryl acetate was determined to be 50 mg/kg of diet based on 16-week liver microsomal ascorbic acid-stimulated lipid peroxidation data. No differences were observed in growth rates or feed efficiencies in either experiment. No gross pathologies or hematological changes were evident in fish fed different levels of vitamin E for 20 weeks, except red blood cell hemolysis, which was elevated at the lower levels. Histological lesions were only observed in fish receiving the 0 mg/kg diet. A marked multifocal splenic hemosiderosis was observed in these fish. A mild multi-focal hemosiderosis was observed in the pancreatic tissue surrounding the hepatic vasculature. The pancreatic tissue appeared reduced from that observed in fish fed higher levels of vitamin E. No significant lesions were observed in the other tissues examined. PMID- 6491760 TI - Fatty acid composition of the testes of zinc-deficient rats: the effect of docosapentaenoic acid supplementation. AB - To determine if low levels of docosapentaenoic acid (22:5 omega 6), observed in the testis lipids of zinc-deficient rats, are related to some of the symptoms of zinc deficiency in rat testes, four groups of rats were fed egg white- and corn oil (CO)-based semipurified diets. One group was fed a zinc-deficient diet (ZDCO) and a control group was pair-fed a zinc-supplemented diet (PFCO). Two additional groups were treated in an identical fashion, but their diets were supplemented with 1% testis lipid (TL) containing 10-12% 22:5 omega 6 (ZDTL and PFTL). Testes weights and sperm counts were slightly higher in ZDTL compared to ZDCO, but these trends were not statistically significant. Testis zinc concentrations were significantly higher in both TL groups compared to the corresponding CO group. Dietary 22:5 omega 6 appeared to be accumulated in liver lipids; however, there was no difference between TL and CO groups in 22:5 omega 6 level in testes phospholipids or testes total lipids. These results indicate that 22:5 omega 6 concentration and spermatogenesis in the testes of zinc-deficient rats do not appear to be affected by the dietary supplementation of 22:5 omega 6 at the level used in this study. PMID- 6491761 TI - Effects of diet on norepinephrine turnover in obese (ob/ob) mice. AB - Effects of energy restriction and of supplemental sucrose or fat on norepinephrine (NE) turnover in brown adipose tissue (BAT) and heart of female obese (ob/ob) and lean mice were examined. Rates of NE turnover in BAT of control female obese mice (8 weeks old) were 39% lower than in control lean mice; no differences were evident in hearts of these mice. Energy intake of 6-week-old ob/ob mice was restricted to the intake of lean mice for 2 weeks. This restriction decreased intake by 41% and reduced rates of NE turnover in heart ( 15%), but not in BAT, of obese mice. Next, 7 1/2-week-old lean and obese mice were given access to stock diet and a 30% sucrose solution for 3-4 days. Intake of stock diet decreased by more than 50%. Total energy intake increased in lean mice (+18%), but decreased (-19%) in obese mice. When a 10% sucrose solution was offered intake of stock diet still decreased, but total energy intake was unchanged in lean and obese mice. Oxygen consumption increased in lean mice (+19 to +24%), but not in obese mice, when fed either 30 or 10% sucrose solutions, or a fat-supplemented diet where fat isocalorically replaced the sucrose consumed from 30% sucrose solution. Rates of NE turnover were not significantly increased in lean mice fed the 30% sucrose solution, but were increased in BAT (+34%) and heart (+25%) in lean mice fed the fat-supplemented diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491762 TI - The nutritive value and safety of D-phenylalanine and D-tyrosine in mice. AB - Growth studies in mice fed synthetic amino acid diets showed that: 1) the biological utilization of D-phenylalanine relative to its L-isomer ranged from 28 81%, depending on the respective concentrations of these amino acids in the diet; 2) L-tyrosine can replace about one-half of the L-phenylalanine needed to achieve maximum weight gain and 3) D-tyrosine has no similar sparing effect on L phenylalanine. In fact, addition of D-tyrosine to amino acid or casein diets depressed weight gain to 10% that of the control. This inhibition was significantly reduced by increasing the L-phenylalanine content of the amino acid diets and the protein content of the casein diets. Growth inhibition, therefore, appears to be related to the ratio of D-tyrosine to L-phenylalanine and possibly other amino acids in the diet, rather than to the absolute levels of D-tyrosine. Mechanistic rationalizations are offered to account for the toxic or antinutritional manifestation of D-tyrosine. PMID- 6491763 TI - Effects of diets deficient in glucose and glucose precursors on the growth of the Walker carcinosarcoma 256 in rats. AB - The effects of carbohydrate-deficient diets on the growth of the Walker carcinosarcoma 256 in rats and on the carcinostatic action of the glucose analogue 2-deoxyglucose were studied. All diets contained 13.0% casein with glucose levels as indicated and the balance of calories present as corn oil free fatty acids. The growth of the tumor was directly related to the glucose level in such diets; after 16 days rats fed 0.0, 1.5 and 4.5% glucose had tumors weighing 7.0, 11.1 and 13.3 g, respectively. The decrease in tumor weight was related to dietary glucose level rather than the anorexia produced by the diets low in glucose, as shown by the fact that tumors in rats fed 4.5% glucose were larger than rats fed 1.5% glucose even when the rats fed 4.5% glucose were pair-fed to the levels consumed by those fed 1.5% glucose. 2-Deoxyglucose (0.2%) also caused a reduction in tumor growth in a manner independent from the anorexia produced by its presence in the diet. This carcinostatic effect was potentiated by low glucose levels in the diets in the rats fed 4.5% glucose plus 0.2% 2-deoxyglucose had proportionally greater reductions in tumor weights due to the glucose analogue than did rats fed 20% glucose plus 0.2% 2-deoxyglucose. PMID- 6491764 TI - Nitrogen balance in men with adequate and deficient energy intake at three levels of work. AB - Two studies were conducted to investigate the effects of mild exercise on nitrogen balance in men given diets supplying adequate or slightly limiting energy. In experiment A the diet supplied 91 mg N/kg body weight (0.57 g protein/kg, the FAO/WHO safe level of intake) as egg white; in experiment B the same source was used to provide the 1980 NRC-RDA for adult males, 128 mg N/kg body weight (0.8 g protein/kg). By adjusting energy intake and activity, periods of energy equilibrium and negative energy balance (-15%) were achieved at three levels of activity (X for exercise): no programmed work (0.85X), 1 hour of treadmill walking (1.0X) and 1 hour each of treadmill and cycle ergometry (1.15X). "True" nitrogen balance (TNbal) was more positive or less negative during periods of energy equilibrium as compared to those of energy deficit. This effect of energy balance on TNbal increased with physical activity. At the lower protein intake the mean difference in TNbal between the period of energy equilibrium and that of energy deficit at 1.0X was 0.19 g N/day (nonsignificant difference) and 0.54 g N/day at 1.15X. When protein intake was increased, the difference in TNbal between periods of equilibrium and deficit was significant at all levels of activity: 0.65 g N/day at 0.85X, 0.93 g N/day at 1.0X and 1.09 g N/day at 1.15X. Physical activity was anabolic when energy balance was maintained. In experiment A the addition of 1 hour of exercise (1.0X to 1.15X) spared 2.5 mg N/kg body weight; reducing activity by 1 hour (1.0X to 0.85X) cost 1.4 mg N/kg body weight. In experiment B, TNbal was more positive with increased activity (by 5.9 mg N/kg body weight) and more negative (by 11.5 mg N/kg body weight) when the men were sedentary. During periods of energy deficit, the anabolic effect of activity was also present, although less markedly. When activity increased from 1 to 2 hours in experiment A, TNbal improved by 2.1 mg N/kg body weight and in experiment B, by 3.5 mg N/kg body weight. Thus, circumstances of negative energy balance with adequate protein intake are better tolerated when the energy deficit is generated by physical activity than when it derives from reduced intake; the picture when protein intake is marginal requires further investigation. PMID- 6491765 TI - Manganese action on protein synthesis in diabetic rat pancreas: evidence for a possible physiological role. AB - The actions of manganese on [3H]phenylalanine incorporation into pancreatic acinar protein from streptozotocin-diabetic rats were compared with the actions of several divalent cations, insulin, and pancreatic secretagogues. In the presence of Ca2+, 7 X 10(-4) M manganese greatly enhanced [3H]phenylalanine incorporation. Under similar incubation conditions, magnesium exerted only a slight stimulatory effect on incorporation, whereas cobalt and nickel failed to enhance incorporation. Removal of Ca2+ from incubation medium, or replacement of Ca2+ by either barium or strontium, abolished the stimulatory effect of manganese on incorporation. Lanthanum, at a concentration that inhibits stimulated Ca2+ influx in acini (10(-4) M), also blocked the stimulatory effect of manganese but did not alter the actions of insulin on incorporation. Dibutyryl cyclic GMP, a competitive antagonist of cholecystokinin-octapeptide, and atropine, a competitive antagonist of carbachol, blocked the stimulatory effects of the respective secretagogues on incorporation. Neither antagonist altered the actions of manganese. These findings suggest that in the face of insulin deficiency manganese enhances pancreatic protein synthesis in diabetic rats via a Ca2+ dependent mechanism that is distinct from the actions of other divalent cations, insulin and pancreatic secretagogues. PMID- 6491766 TI - Metabolic effects of histidine-deficient diets fed to growing rats by gastric tube. AB - Effects of histidine deficiency on muscle carnosine and anserine levels and on activities of enzymes associated with histidine catabolism and protoporphyrin synthesis were investigated. Male Sprague-Dawley (150 g) rats were tube-fed isonitrogenous, isocaloric, defined diets containing 0%, low (0.013%) or adequate (0.45%) histidine for 8-13 days. While histidine-deficient animals maintained body weight, muscle and plasma histidine and carnosine concentrations decreased rapidly and remained low following a 3-day histidine repletion period. Hepatic histidine ammonia-lyase and histidine-pyruvate transaminase activities were decreased in histidine-deficient animals, whereas formiminotransferase activity was unchanged. Hematocrit levels and hemoglobin concentrations declined progressively during histidine depletion and the activity of erythrocyte and hepatic delta-aminolevulinic acid dehydratase also decreased relative to controls. Evidence is presented indicating that decreased histidine catabolism combined with carnosine and hemoglobin degradation can provide sufficient histidine to explain the slow onset of negative nitrogen balance associated with histidine deficiency and that impaired protoporphyrin synthesis may partially explain the anemia observed in the absence of dietary histidine. PMID- 6491767 TI - Effect of fasting on circadian rhythmicity in deoxyribonucleic acid synthesis of several murine tissues. AB - These studies were done with CD2F1 adult mice that had been standardized to 12 hours of light alternating with 12 hours of darkness to determine what effect a 24-hour fast had on circadian rhythms in DNA synthesis of 10 different regions of the gut, as well as in the pancreas, liver, thymus, spleen, bone marrow, lung and testis. The mitotic index of the corneal epithelium also was studied. The overall responses varied rather dramatically. For example, in the different regions of the gut the response ranged from no statistically significant change in the colon to a strong statistically significant decrease in DNA synthesis in the cecum. In short, one cannot generalize about the effect of short-term fasting on the entire gut, but when there was any statistically significant effect, it always was a decrease. The spleen was the only tissue that showed no statistically significant response in DNA synthesis. In the bone marrow, however, a statistically significant increase in DNA synthesis was recorded at 8 and 24 hours after fasting began. In the lung there was a rather dramatic increase in DNA synthesis at 8 hours, but this was followed by decreases of 37 and 55% at 16 and 24 hours, respectively. There was a statistically significant increase of 83% in the mitotic index 24 hours after the fasting began. The data clearly demonstrate the necessity of considering circadian variation when evaluating the effects of fasting on cell proliferation. PMID- 6491768 TI - Gluconeogenesis from dihydroxyacetone in rat hepatocytes during the shift from a low protein, high carbohydrate to a high protein, carbohydrate-free diet. AB - Pyruvate kinase activity and rates of gluconeogenesis and glycolysis in rat hepatocytes were evaluated by production of glucose and lactate + pyruvate from dihydroxyacetone during the first 48 hours after the shift from a low protein, high carbohydrate diet to a high protein, carbohydrate-free diet. The effect of glucagon was also studied. In the absence of glucagon, 11-17 hours after the dietary shift when glycogen was lowest, gluconeogenesis was maximal and glycolysis minimal. The concentration of fructose 1,6-biphosphate was high and did not change during the experiment. The activity ratio of pyruvate kinase measured with phosphoenolpyruvate (PEP) (V0.5 mM PEP/V4 mM PEP) was high in crude extracts and low in (NH4)2SO4-treated extracts, but remained unchanged during the whole experiment. There was no correlation of the rates of gluconeogenesis or glycolysis from dihydroxyacetone with the activity ratio of pyruvate kinase. With glucagon, gluconeogenesis from dihydroxyacetone was increased and a concurrent decrease in glycolysis was paralleled with a decrease in the fructose 1,6 bisphosphate concentration and in the activity ratio of pyruvate kinase. The activity ratio of pyruvate kinase in (NH4)2SO4-treated cells represented about 50% of that in the absence of the hormone. This difference may be related to glucagon-induced phosphorylation of pyruvate kinase. PMID- 6491769 TI - Comparative absorption of 2-hydroxy-4-(methylthio)-butanoic acid and L-methionine in the broiler chick. AB - The absorption of [1-14C]2-hydroxy-4-(methylthio)butanoic acid (HMB) and L methionine (L-Met) was evaluated in the broiler chick. Methods included in vitro intestinal tissue uptake and appearance in the plasma from ligated intestinal segments in situ, and from crop intubations. Intestinal uptake of L-Met was partially inhibited with 2,4-dinitrophenol, while HMB uptake was unaffected. The uptake of L-Met conformed to Michaelis-Menten kinetics except that no plateau was reached. This indicated that L-Met absorption may be accomplished by both concentration and energy-dependent processes. The in vitro uptake of HMB in relation to concentration was linear indicating that its absorption was concentration dependent. Absorption of HMB and L-Met after crop intubation indicated higher plasma concentrations of HMB than of L-Met, particularly at higher doses. Both compounds were absorbed at similar rates at concentrations 50 100 times below physiological concentrations and absorption rates were different at different small intestinal locations. These results indicate that the ability to use HMB as a source of methionine would not be limited by absorption. PMID- 6491770 TI - Role of carnitine in the oxidation of branched-chain amino acids. PMID- 6491771 TI - Biochemical features induced by adenine feeding in rats. Polyuria, electrolyte disorders, and 2,8-dihydroxyadenine deposits. AB - Levels of sodium, potassium, calcium, and phosphate were examined in rats fed on an adenine diet. Among the electrolytes in the serum, potassium decreased significantly in the adenine-fed group as compared with the control group. A decrease was observed in the level of serum calcium on feeding with an adenine diet. Though a significant decrease in phosphate was noticed in the adenine-fed rats which were kept for 6 to 12 days, the level of phosphate was increased at the 18-30th day as compared with the control group. However, serum sodium concentration was maintained within a relatively narrow range. On the other hand, the animals that continued on the adenine diet showed a significant rise in the urinary excretion of sodium, potassium, and calcium during the test period. Dietary adenine decreased the amount of urinary phosphate. In addition, 2,8 dihydroxyadenine content in kidneys increased during the test period, while a significant increase in the urinary excretion of 2,8-dihydroxyadenine was seen until the 12th day of the feeding period. Furthermore, the results of the present study showed that feeding of adenine to rats produced a significant increase in the urine volume. However, there were no appreciable changes in the water intake of the control and adenine-fed groups throughout the experimental period. PMID- 6491772 TI - Relation of body energetic status to dietary self-selection in Sprague-Dawley rats. AB - Self-selection from carbohydrate, protein and fat sources including essential micronutrients was studied in male Sprague-Dawley rats that were 4 weeks of age at the beginning of the experiment. During the experimental period of 14 days, the intake of carbohydrate and fat was quite constant, whereas that of protein increased gradually. The mean intake of carbohydrate, protein, and fat was 31.1 +/- 3.5%, 56.1 +/- 4.6%, and 12.8 +/- 2.8% of the total energy intake, respectively. Animals fed on a mixed diet consisting of high sucrose, consumed 65.1% of their daily energy as carbohydrate, 17.6% as protein, and 17.3% as fat. Total energy intake and body weight gain were not significantly different between the rats on self-selection and those fed on the mixed diet. These results indicate that young rats on dietary self-selection were able to gain body weight comparable to that of rats fed on the mixed diet. Body energetic status affected self-selection patterns. In rats fasted for 5 days or fed on a protein-free diet for 21 days, fat intake increased, but protein intake decreased. On the other hand, fat intake decreased in animals given a sucrose diet higher in energy content than the stock diet; these animals exhibited increased accumulation of body energy. These results indicate that dietary self-selection is closely related to nutritional and physiological body requirements. PMID- 6491773 TI - Self-selection of phenylalanine in the rat. AB - The regulation of phenylalanine intake in rats was investigated by means of a self-selection feeding method. The relationship between phenylalanine intake and the alteration of phenylalanine and tyrosine concentrations in plasma and brain was also studied. Weanling rats were offered a choice of two diets differing only in phenylalanine content for 2 weeks. Weight gain and food consumption of all the self-selecting rats were not significantly different from each other and were of the same levels as those in rats fed on a 10% casein or 10% casein plus 1.0% phenylalanine diet as a fixed ratio. Phenylalanine intake of the self-selecting rats ranged from 0.31 to 2.29% of the food consumed. The phenylalanine and tyrosine concentrations in plasma and brain of self-selecting rats were within normal levels. It became clear that rats have an ability to regulate phenylalanine intake, and that they select phenylalanine to meet their requirement for the amino acid. PMID- 6491774 TI - Effects of various levels of dietary calcium during pregnancy on maternal calcium utilization and fetal growth in rats. AB - The effects of calcium-free and normal (0.6%) and high (1.0%) calcium diets on the transfer of calcium from pregnant mothers to fetuses were investigated by balance experiments. Pregnant rats receiving calcium-free, normal and high calcium diets ate totals of 353, 324 and 280 g of the diet, respectively, during pregnancy, and the food consumption of the latter two groups decreased near term. The group on calcium-free diet was able to maintain pregnancy and produce normal fetuses by using calcium resorbed from the dam's bones. The calcium retentions due to pregnancy in rats on normal and high calcium diets were 116 and 128 mg, respectively, during the first 15 days, and -9 and -109 mg, respectively, during the last 6 days of pregnancy. Fetuses contained about 130 mg of calcium at term and most of this calcium was supplied from the dam's bones, in which extra calcium were retained during early-mid pregnancy. Unexpectedly, the true rate of calcium absorption was appreciably lower during late pregnancy than during early mid pregnancy in both dietary groups. Thus, extra calcium retention during early mid pregnancy seemed to be physiological adaptation to a decrease in either food consumption or calcium absorption during late pregnancy. Phosphorus absorption and its balance were examined in relation with the dietary calcium levels. PMID- 6491775 TI - Effect of wheat flour, Bengal gram flour and corn flour on lipid metabolism in rats. AB - Male albino rats were fed on respective diets of wheat flour, Bengal gram flour and corn flour for 8 weeks at the 59% level. It was observed that the increase in weight after wheat flour and Bengal gram flour feeding was 6.8 and 12.0% respectively and that the decrease after corn flour feeding was 5.2% as compared to the control animals on sucrose diet. Serum cholesterol and liver cholesterol levels were significantly (p less than 0.01) decreased after wheat flour, Bengal gram flour and corn flour feeding. PMID- 6491776 TI - Effect of tryptophan and/or casein supplementation on NAD levels in livers of the rats fed on niacin- and protein-free diet. PMID- 6491777 TI - Brain tumors at a nuclear facility. AB - In response to an observed excess risk of brain tumor deaths among workers at the Rocky Flats Nuclear Facility (Colorado), a case-control study of all (n = 16) primary brain tumor deaths occurring among white males employed during 1952 through 1977 was conducted to investigate their relationship with occupational radiation/nonradiation exposures. For each case, four controls were individually matched on year of birth and period of employment. Although limited by a small number of cases, our study showed no statistically significant association between brain tumor death and exposure to internally deposited plutonium, external radiation, or other occupational risk factors. PMID- 6491778 TI - Psittacosis. A diagnostic challenge. AB - In the absence of recognized pneumonitis, psittacosis is unlikely to be considered as a cause of infection in patients with febrile illnesses. To identify findings useful in the diagnosis of psittacosis, the clinical and roentgenographic characteristics of 46 cases that occurred in two outbreaks among workers in turkey processing plants were reviewed. Headache (96% of patients), chills (93% of patients), and fever (89% of patients) were the most common symptoms; a nonproductive cough occurred in 65% of patients. Rales or rhonchi were detected in only six (18%) of 33 patients examined, but 21 (72%) of 29 patients receiving a chest film had roentgenographic evidence of pneumonia. We conclude that few diagnostically useful symptoms or signs occur in patients with psittacosis but that roentgenographically confirmed pneumonitis may occur commonly in patients with little clinical evidence of pneumonitis. A history of exposure to birds, in an individual with a flu-like illness, appears to be the single best clue to the diagnosis of psittacosis. PMID- 6491779 TI - Use of company stock ownership records to locate subjects lost to follow-up. AB - When 10,766 members of a refinery retrospective cohort study were assessed for vital status using conventional company and Social Security Administration records, the status of 370 remained unknown. Computerized corporate files of shareholder information yielded current addresses for 243 of those lost to follow up, and through Directory Assistance, telephone numbers were obtained for 152. Vital status was ascertained by telephone for 146 of the 370 members of the cohort whose status had been unknown. PMID- 6491780 TI - The mortality of Ontario undertakers and a review of formaldehyde-related mortality studies. AB - In a study of the mortality of Ontario undertakers, a cohort of 1,477 men first licensed during 1928 through 1957 was followed up until the end of 1977. Numbers of observed and expected deaths were determined for the period 1950 through 1977, using mortality rates of Ontario men as the standard. In all, 319 persons had died, compared with 322 expected. Ontario undertakers were not at increased risk of death from cancers at sites of contact with formaldehyde. Cirrhosis of the liver (standardized mortality ratio, 238) and chronic rheumatic heart disease (standardized mortality ratio, 199) were the only causes of death found to be significantly in excess. The data are discussed in the context of current epidemiologic information on the mortality experience of persons exposed to formaldehyde. PMID- 6491781 TI - Degenerate four-wave mixing in the presence of nonuniform pump wave fronts. AB - We derive the set of coupled equations that describes the process of degenerate four-wave mixing in the presence of spatially nonuniform pump-beam wave fronts. We investigate the influence of phase mismatch between plane-wave pump beams on the efficiency and on the fidelity of the phase-conjugation process, and we furnish, in the near-collinear geometry, the expression of the spatial degree of coherence of the phase-conjugate wave in terms of those of the input signal and of the pump beams. PMID- 6491782 TI - New glaucoma treatments. PMID- 6491783 TI - Jejunogastric intussusception. PMID- 6491784 TI - Nutrition for the practitioner IV. Current concepts in nutrition: vitamin E. PMID- 6491785 TI - Ligamentous structures of the metacarpophalangeal joint: a quantitative anatomic study. AB - The ligamentous structure of the metacarpophalangeal (MCP) joint of the index finger in human cadavers was studied by gross examination and quantitative measurement. Anatomically, the collateral ligament is separable into two layers, with the precise origin arising from the metacarpal head and inserting on the proximal phalanx. Quantitatively, the change in length of the collateral ligament was studied with biplanar radiographic techniques. The distance between the origin and insertion of the collateral ligament changed in different portions of the ligament when the joint was moved from a position of hyperextension to that of flexion. When the MCP joint was flexed from 0 degree to 80 degrees, the dorsal portions of both the radial and ulnar collateral ligaments were lengthened (3-4 mm). The middle portions of both ligaments were slightly elongated (0.4-1.0 mm), and the volar portions of the ligaments were shortened (1-2 mm). When the MCP joint extended into hyperextension, the dorsal portions of the ligaments shortened 2-3 mm, the middle thirds of the ligaments shortened slightly, and the volar thirds of the ligaments lengthened. The results of this study suggest that the dorsal and volar portions of the collateral ligament provide MCP joint constraint at the flexed and extended positions, respectively. PMID- 6491786 TI - Carrying angle of the human elbow joint. AB - Previous elbow kinematic studies have created some controversy because of conflicting and contradictory results. The lack of consistent results may be traced to the limitations and definitions of the specific measurement techniques, as well as individual variations in the specimens. To resolve this issue, a rigorous theoretical analysis of elbow kinematics was performed based on available anatomic and geometric data of the skeleton with consideration of anthropometric variations. Three definitions have been adopted previously for the measurement of the carrying angle of the elbow joint. The relationships of these three definitions of the carrying angle as a function of the elbow joint flexion angle were evaluated. Clinically, the dynamic change of carrying angle may have little practical significance. However, the variation is reflected in differences in design criteria of the resurfacing and semiconstrained elbow replacement implants. PMID- 6491787 TI - Electromyographic analysis of shoulder muscle load. AB - The influence of hand tool weight and arm position on shoulder muscle load was studied by electromyography. The investigation was made to facilitate recommendations on work place design. The aim is to reduce the occurrence of occupational shoulder disorders in industry. Nine volunteers held 21 different arm positions with the hand over waist level. In each position, the hand was loaded with 0, 1, and 2 kg. Each load was maintained for 15 s. The myoelectric activity in six shoulder muscles was recorded and analyzed automatically with respect to the amplitude. The results indicate that the degree of upper arm elevation is the most important parameter influencing shoulder muscle load. Short rotator muscles stabilizing the shoulder joint were found to be more hand-load dependent than the deltoid muscle. The ergonomic implications of this study are that work situations should be designed so that the arm can be kept close to the body and the hand load minimized. PMID- 6491788 TI - Thoracic spine centers of rotation in the sagittal plane. AB - The purpose of this study was to determine in vitro the centers of rotation of thoracic functional spinal units in the sagittal plane. The center of rotation is a convenient concept and part of a precise method of documenting the kinematics of a joint moving in a plane. Fresh cadaver functional spinal units from the thoracic region were utilized. Six load types were used that produced motions only in the sagittal plane, namely anterior and posterior shear forces, flexion and extension moments, and compression and distraction forces. The resulting motion with three degrees of freedom was measured with dial gauges. Statistical methods were used to analyze data from the viewpoint of vertebral level, load magnitude, and load type. Only the load type was found to be significantly related to the location of the centers of rotation. Although there was significant variability in the centers of rotation, there were definite locations related to each load type. The average center of rotation was 15-45 mm directly below the geometric center of the moving vertebra. The results of the present study may be helpful in the clinical interpretation of spinal kinematic studies. PMID- 6491789 TI - Development of a variable stiffness external fixation system for stabilization of segmental defects of the tibia. AB - The mechanical properties of a variable stiffness external fixation system were explored. Initial testing of a unilateral fixator configuration demonstrated that system rigidity could be increased by maximizing pin separation distance in the fracture component and the number of pins used while minimizing pin separation distance across the fracture site and the sidebar offset distance from bone. A triangulated system composed of half pin frames mounted anteriorly and medially on the tibial aspects and linked by crossbars was devised. Progressive disassembly of the frame was shown to result in progressive decreases in fixator rigidity in all planes. PMID- 6491790 TI - Effect of cement pressure and bone strength on polymethylmethacrylate fixation. AB - The effect of the quality of the bone and of the cement pressurization magnitude and duration on the fixation achieved with polymethylmethacrylate (PMMA) bone cement is studied in vitro. Seventy-one cement-bone interface specimens, prepared under various conditions of pressurization of low-viscosity bone cement, are tested in tension. The load at failure and the maximum cement penetration are measured to assess the fixation achieved, and the quality of the bone is assessed by determining the compressive strength of each of the bone specimens. Statistical analysis of the data indicates that the pressure magnitude is the most influential of the factors considered in the cement penetration behavior and in the development of failure load capacity. The duration of the pressure does not appear to be a significant factor. The cement penetration is a decreasing function of the bone strength, reflecting a decrease in the porosity and an increase in the area fraction. Although not directly measured in these tests, these latter bone properties are indirectly measured by the bone compressive strength. The effect of increasing bone strength on the failure load is nonlinear. The development of adequate failure load capacity is the result of a balance between the cement penetration allowed by the porosity of the bone and the inherent strength of the cancellous bone itself. Weak bone, although adequately penetrated by cement, cannot provide strong fixation. Stronger, denser bone limits cement penetration, but pressurization enhances development of failure load capacity through more complete infusion and interlocking of the cement in the available pore space. The strength of the fixation achievable for any bone is limited by the intrinsic strength of the bone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491791 TI - Metal ion release from titanium-based prosthetic segmental replacements of long bones in baboons: a long-term study. AB - Forty-five baboons that had received titanium-based fiber metal composite segmental bone replacements were studied along with 13 controls without implants. Thirty-eight baboons with implants were sacrificed, and titanium, aluminum, and vanadium levels were assayed in homogenized lung, kidney, spleen, liver, adjacent muscle, and regional lymph nodes. In seven living baboons with implants, blood and urine samples were obtained for trace metal analysis as well as for biochemical and hematological profiles. In the 38 sacrificed baboons with implants, increased titanium levels were noted in the lungs, spleen, adjacent muscle (quadriceps, soleus, and triceps), and regional lymph nodes (inguinal, axillary, and popliteal) in comparison to those of six sacrificed controls without implants. In addition, vanadium was significantly elevated in the lungs of some animals, while aluminum increases were noted in adjacent muscle (quadriceps, soleus, and triceps), lung, and regional lymph nodes (inguinal, axillary, and popliteal). In the seven living baboons with implants, a sixfold increase (p less than 0.0005) in the urine titanium level was noted in comparison to that of seven living controls without implants. Additionally, elevated aluminum levels were found in the serum (p less than 0.0005) of the group with implants. Biochemical and hematological studies did not indicate statistically significant differences in serum electrolytes, in liver and renal function tests, or in complete blood counts between the seven living baboons with implants and their controls. PMID- 6491792 TI - Less rigid internal fixation plates: historical perspectives and new concepts. AB - In the application of "rigid" plates for diaphyseal fractures, lack of callus healing and overprotection of the underlying bone are viewed by many investigators as undesirable consequences. Potential solutions offered to overcome these deficiencies include modification of the timing of plate removal, use of biologically degradable materials for plates so that stress-shielding can be minimized, and use of less rigid plate fixation systems. This study emphasizes the selection of appropriate design criteria for less rigid plate-fixation systems. To accomplish this goal, the axial, bending, and torsional stiffness parameters are considered in place of the oversimplified terms such as "flexible plate" or "elastic fixation." With the aid of finite element modeling and simplified bench experiments, we performed parametric studies and singled out the plate axial stiffness as the dominant factor in altering the bone stresses. As a result, we designed two experimental plates, one a thin Ti-6Al-4V (titanium with 6% aluminum and 4% vanadium) alloy plate with low stiffness in axial and bending directions, and the other a tubular stainless steel plate with low stiffness in the axial direction but moderate stiffness in bending and torsional directions. The low-stiffness Ti-6Al-4V alloy plate was first tested in a demanding bilateral canine midshaft osteotomy, and proved to be inadequate. Both experimental plates were successful in the unilateral osteotomies, with the tubular plate yielding the best results. After 6 months of plating, the bones beneath the tubular plate had superior mechanical and structural properties as compared to those of the control "rigid" stainless steel and the Ti-6Al-4V alloy plates. Application of this plate prolonged for 9 months did not cause reduction in bone properties and strength. The success of the tubular plate is due to its moderate bending and torsional stiffnesses, which provide adequate fixation to achieve callus union, while its low axial stiffness permits the underlying bone to share the physiological stresses needed for bone remodeling. These drastic changes in mechanical demands on the internal fixation plate during the early healing phase and the postunion remodeling phase are discussed. PMID- 6491793 TI - Effects of fat admixture on the strengths of conventional and low-viscosity bone cements. AB - The diametral tensile and compressive strengths of both conventional doughy and low-viscosity (LVC) bone cements were tested with sequential admixtures of up to 50% (by weight) liquified fat. The addition of as little as 5% (by weight) fat caused a significant reduction (p = 0.05) in the strengths of both cements. The LVC appeared to be affected to a greater degree by fat contaminations than did the conventional cement, although the strengths of the LVC were generally equal to or higher than those of the conventional cement. The enhanced effect of fat contamination on the LVC was thought to be due to the more fluid, tacky nature of this material during administration. PMID- 6491794 TI - In vitro growth of bovine articular cartilage chondrocytes in various capacitively coupled electrical fields. AB - Isolated articular cartilage chondrocytes from 1- to 3-week-old male Holstein calf knee joints were formed into pellets containing 4 X 10(6) isolated cells and were grown in tissue culture medium (minimum essential medium/NCTC 135) containing either 1 or 10% newborn calf serum (NBCS) in plastic Petri dishes in 5% CO2 and air at 37 degrees C in saturation humidity. On the 4th postisolation day either [35S]sulfate or [3H]thymidine was added to the medium, and the pellets were exposed for 24 h to capacitively coupled electrical fields (10, 100, 250, and 1,000 V peak-to-peak, 60 kHz, sine wave signals). The pellets were then harvested, dialyzed, hydrolyzed, and assayed for DNA, protein, [35S]sulfate incorporation, and [3H]thymidine incorporation. Results indicated that at 250 V peak-to-peak there was a statistically significant increase in [35S]sulfate in 1% NBCS and a statistically significant increase in [3H]thymidine in 10% NBCS. At potentials above or below 250 V no changes were noted. Thus, articular cartilage chondrocytes grown in pellet form can be stimulated to increase glycosaminoglycan synthesis or to increase cell proliferation by an appropriate capacitively coupled electrical field. The importance of the serum concentration in the medium in evaluation of biosynthesis in vitro is noted. PMID- 6491795 TI - Electrostimulation of rat callus cells and human lymphocytes in vitro. AB - Asymmetrical pulsing low voltage current was supplied via electrodes to cultured rat fracture callus cells and human peripheral blood lymphocytes. The [3H]thymidine incorporation of the callus cells and 5-[125I]iodo-2'-deoxyuridine incorporation of the lymphocytes were determined. The growth pattern of callus cells (estimated by cellular density) did not respond to electrical stimulation. However, the uptake of [3H]thymidine was increased at the early phase of cell proliferation and inhibited at later phases of proliferation. The [3H]thymidine uptake of confluent callus cell cultures did not respond to electrical stimulation. Lymphocytes reacted in a similar way; stimulated cells took up more DNA precursor than control cells at the early phase of stimulation. During cell division, induced by the mitogens phytohemagglutinin and Concanavalin-A, the uptake of DNA precursor by stimulated cells was constantly inhibited. The results suggest that electrical stimuli affect the uptake mechanisms of cell membranes. The duality of the effect seems to be dependent on the cell cycle. PMID- 6491796 TI - The apparent elastic modulus of the juxtarticular subchondral bone of the femoral head. AB - An experiment was undertaken to obtain approximate values for the intrinsic elastic modulus of subchondral bone. Shallow spherical caps, with uniform and incrementally controlled thickness, were machined from subchondral bone in the weight-bearing regions of 11 fresh-frozen normal femoral head autopsy specimens. Under application of polar point loads, the measured deflections were compared with a corresponding analytical shell solution, thus allowing back-calculation of the apparent modulus. Analogous tests were performed on similarly shaped specimens of stock Plexiglas of known modulus in order to estimate the precision of the testing method. The aggregate results for subchondral bone showed that its intrinsic stiffness correlated inversely with nominal shell thickness, but even the thinnest (1.0 mm thick) of these shells had an apparent modulus (mean = 1.372 GN/m2, SD = 414 MN/m2) well below that generally accepted for "pure" cortical bone (about 14 GN/m2). This stiffness deficit was very likely due to the presence of histologically evident marrow spaces. However, the low apparent modulus values measured in this study may not be fully representative of complex in vivo behavior, because in the testing of excised shells there is no radial compressive stress transfer to underlying cancellous bone. PMID- 6491797 TI - Flexor tendon repair in vitro: a comparative histologic study of the rabbit, chicken, dog, and monkey. AB - Flexor tendon healing in four different animal species was explored in a tissue culture system. Ninety percent transverse lacerations were made in 88 tendon segments obtained from rabbits, chickens, dogs, and monkeys. The tendons were removed from culture and studied by light and electron microscopy at intervals of 3, 6, 9, and 12 weeks. A characteristic sequence of repair including epitenon thickening, cellular differentiation, cell migration, and phagocytosis was seen in each of the repaired tendons. The endotenon cells of several animal tendons appeared to be synthesizing collagen. There was a consistent difference in the rate of healing between the four species. The rabbit tendons demonstrated nearly complete closure of the repair site by 12 weeks. A lesser response was seen in the chicken, followed by the dog and monkey. The differences in healing rate appeared to be due to the non-species-specific in vitro culture media. The in vitro flexor tendon culture system is particularly useful in studying the tendon repair responses of various species with the contributions of vascularity and synovial cells excluded. PMID- 6491798 TI - Force ratios in the quadriceps tendon and ligamentum patellae. AB - We measured forces in the quadriceps tendon and ligamentum patellae in six human cadaver knee joints loaded through a range of flexion angles from 30 to 120 degrees. Using standardized loads based on one-sixth of maximum isometric quadriceps moments reported in human volunteers, we measured maximum average forces at 60 degrees flexion of 532 N in the quadriceps tendon (FQ) and 470 N in the ligamentum patellae (FL). Linear extrapolation to full maximum extensor moments results in estimates of 3,200 N for FQ and 2,800 N for FL. The force ratio (FL/FQ) reached a maximum value of 1.27 at 30 degrees and minimums of 0.7 at 90 and 120 degrees knee flexion. Contrary to prevailing opinion, our results indicate that the patella is not a simple pulley that serves only to change the direction of equal forces in the quadriceps tendon and ligamentum patellae. Instead, the ratio of forces in these structures varies significantly with flexion angle. The ratio appears to be determined by the changing location of the patellofemoral contact area relative to the insertions of the tendon and ligament. These findings emphasize the biomechanical importance of patellar length and of the vertical dimensions and locations of the patellofemoral contact area. Attempts at surgical intervention for the treatment of disorders of the extensor apparatus should recognize these variations. Procedures that tend to move the contact area more proximally (at a particular flexion angle) will also tend to decrease the FL/FQ ratio. PMID- 6491799 TI - Sequential changes in the mechanical properties of viable articular cartilage stored in vitro. AB - Viable articular cartilage from the medial femoral condyles of rabbits was stored in vitro in tissue culture medium with various additives and the same site of each specimen was mechanically tested sequentially throughout a 12-day storage period. Indentation testing was performed with instantaneous and sustained loads. Preservation of sustained-load carrying capacity was observed in the condyles stored with additives, indicating maintenance of an intact cartilage matrix. However, initial testing with small sustained loads (preload) showed changes not observed at higher load levels. The changes noted at small sustained initial loads may reflect alterations in cartilage surface structure and may be an early indicator of its mechanical integrity. Chondrocyte viability and proteoglycan content, as measured by 35S incorporation and hexosamine concentration, were unchanged in comparison to fresh articular cartilage. PMID- 6491801 TI - Dynamic radioisotope bone imaging as a noninvasive indicator of canine tibial blood flow. AB - The relative values of dynamic and static bone imaging with hydroxymethylenediphosphonate technetium 99m (99mTc HDP) as an indicator of bone blood flow was investigated in the tibia of mature dogs. The dynamic bone scan consisted of 60 1-s images formed after the intravenous injection of 99mTc HDP, and the static bone scan was a 45-min uptake image. Blood flow to the tibia was determined by using radioactively labeled microspheres. Studies were carried out in control dogs, in dogs in which blood flow was increased in one leg with ATP, and in dogs in which blood flow was decreased in one leg with norepinephrine. A significant (p less than 0.001) linear relationship between the dynamic scan values and bone blood flow was found at a wide range of blood flow rates. When blood flow increased by more than 50%, the effects of "diffusion limitation" were seen in the static scans: increase in tracer uptake was disproportionately small for a significant increase in blood flow. There is no method currently available for estimating bone blood flow by a noninvasive technique. The method described here may be useful for providing a semiquantitative measure of bone blood flow. This improved versatility of bone imaging may have a role in the management of osteomyelitis or complicated fractures, or in assessing the viability of vascularized bone grafts. PMID- 6491800 TI - An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc. AB - An epidemiologic case-control study undertaken in Connecticut during 1979-1981 indicated that persons with jobs requiring lifting objects of more than 11.3 kg (25 lb) an average of more than 25 times per day had over three times the risk for acute prolapsed lumbar intervertebral disc as people whose jobs did not involve lifting objects of this weight. If the body was usually twisted while the lifting was done, this elevation in risk was apparent with less frequent lifting. An especially high risk for prolapsed lumbar disc was associated with jobs involving lifting objects of more than 11.3 kg with the body usually twisted and the knees not bent while the lifting was done. Neither lifting objects of less than 11.3 kg nor twisting without lifting was associated with an increase in risk. PMID- 6491802 TI - Age-related changes in bone in the dog: calcium homeostasis. AB - To explore the changes in the relationship between skeletal and Ca2+ homeostasis with age, we studied 50 dogs divided into four age groups. The skeletal uptake of 85Sr decreased markedly with age, and the immunoreactive parathyroid hormone (iPTH) level increased. There was a significant correlation between iPTH value and the calculated short-term exchange of Ca in bone (r = 0.55; p less than 0.001). Bone formation and bone resorption decreased with age except that in the oldest group of dogs the resorption increased (p less than 0.001). We suggest that in aging dogs the skeletal exchange of Ca falls to a very low level that decreases the immediate effect of PTH and thus leads to a chronic net increase in circulating PTH. Concomitant with this is an increase in osteoclastic bone resorption and, over a long time, loss of skeletal mass. PMID- 6491803 TI - Changes in long-bone structural properties during the first 8 weeks of plate implantation. AB - The midplate structural rigidities of metal- and plastic-plated intact canine femora were experimentally determined after initial plate application and 8 weeks after in vivo implantation. Composite beam theory significantly overestimated the bending rigidities of the metal-plated bones. The rigidities of the plastic plated bones were nearly identical to that of the isolated bone, as composite beam theory predicted. Plating with either plate increased the intracortical porosity and caused the deposition of periosteal new bone, which was greater with plastic than with metal plates. The increased rigidities provided by the attachment of the metal plates and, hence, the degree of bone strain shielding were variable. Platings for 8 weeks which provided little strain shielding with either metal or plastic plates caused an increase in bone flexural rigidity (measured after plate removal) with respect to the contralateral control. Platings that provided increasing amounts of strain shielding caused a decreasing midplate bone rigidity (measured after plate removal) and increasing bone deposition at the outer screws. These findings suggest that the surgical implantation of any plate (metal or plastic) will provide a net stimulus to bone formation and consequently increased bone structural rigidity, even though intracortical porosity is increased. If the plate significantly reduces the normal loads borne by the bone, however, there is a net stimulus to remove bone, resulting in a loss of midplate structural rigidity within 8 weeks of implantation. PMID- 6491804 TI - Radiation-induced alterations of fracture healing biomechanics. AB - The effects of irradiation on the normal temporal progression of the physical properties of healing fractures were studied in a rat model. Fractures were surgically produced in the femur, stabilized with an intramedullary pin, and irradiated. One group of rats was exposed to 2,500 rads in divided doses over 2 weeks, beginning 3 days after fracture, and compared to a control group with fractures which were not irradiated. Animals were sacrificed at periodic intervals and the bones were tested to failure in torsion. The torque, stiffness, and energy increased and the angle decreased for the nonirradiated specimens in the expected fashion. This progression was deleteriously altered in the irradiated femurs. PMID- 6491805 TI - Production of a standard closed fracture in laboratory animal bone. AB - To develop a technique for the production of a standard closed experimental fracture, a new apparatus was designed and tested on 40 male Sprague-Dawley rats. First, the femur was treated with an intramedullary Steinmann pin. The femoral diaphysis was then fractured by means of a blunt guillotine driven by a dropped weight. Radiographically, this technique resulted in a highly reproducible transverse fracture. There was minimal comminution and minimal angulation of the intramedullary pin. Histologically, there was minimal soft tissue damage. Mechanical testing showed that all fractures healed. Pin removal was accomplished with ease and without disturbance of the healed fracture site. The apparatus is simple to use and inexpensive to build. Through its use, a highly reproducible closed fracture model is established. PMID- 6491806 TI - Metal/cement interface strength in cemented stem fixation. AB - To characterize the strength of the interface between stem-type metal implants and bone cements, a fracture mechanics parameter was used. This parameter, the critical strain energy release rate (Gc), was determined from "push-out" tests of cylindrical specimens. The specimens, formed using molds of bone, were maintained and tested at body temperature. The strength of interfaces formed with cancellous bone surrounding the cement mantle was significantly less than the strength of those formed in apposition to cortical bone. A marked degradation of strength was found with saline immersion for SS316LVM/cement interfaces formed with Zimmer regular, Simplex-P, and Zimmer LVC cements. After 60 days of immersion the interface Gc was only 10-20% of the value for bulk cement. Interfaces formed with thin-film polymethylmethacrylate-precoated metals (SS316LVM, Co-Cr-Mo, and Ti-6A1 4V) yielded "dry" Gc values one order of magnitude greater than those measured with interfaces formed with uncoated metals. Moreover, the strength of precoated SS316LVM/cement interfaces formed with all three brands of cement did not change after saline immersion for 60 days. PMID- 6491807 TI - Fatigue crack propagation behavior of ultrahigh molecular weight polyethylene. AB - The relative fatigue crack propagation resistance of plain and carbon fiber reinforced ultrahigh molecular weight polyethylene (UHMWPE) was determined from cyclic loading tests performed on compact tension specimens machined from the tibial components of total knee prostheses. Both materials were characterized by dynamic mechanical spectroscopy, X-ray diffraction, and differential scanning calorimetry. The cyclic tests used loading in laboratory air at 5 Hz using a sinusoidal wave form. Dynamic mechanical spectroscopy showed that the reinforced UHMWPE had a higher elastic storage modulus than the plain UHMWPE, whereas X-ray diffraction and differential scanning calorimetry showed that the percent crystallinity and degree of order in the crystalline regions were similar for the two materials. Fatigue crack propagation in both materials proved to be very sensitive to small changes in the applied cyclic stress intensity range. A 10% increase in stress intensity resulted in approximately an order of magnitude increase in fatigue crack growth rate. The fatigue crack propagation resistance of the reinforced UHMWPE was found to be significantly worse than that of the plain UHMWPE. This result was attributed to poor bonding between the carbon fibers and the UHMWPE matrix and the ductile nature of the matrix itself. PMID- 6491808 TI - Biosynthesis and processing of collagens in different cartilaginous tissues. AB - The distribution, structure, and biosynthesis of various collagen types have been studied in growth and structural cartilage from young rabbits. The major collagen of cartilage is alpha 1(II); however, all cartilage matrix also contains 1 alpha, 2 alpha, 3 alpha (Type Cm), as well as a high molecular weight disulfide-linked collagen (Type M). Cartilage fragments in organ culture demonstrate synthesis of precursors of collagen alpha chains and processing to their final forms. Although Type Cm collagen is present in the same proportion in the matrix of growth and structural cartilage, in vitro radiolabeling of rabbit cartilage showed that only growth cartilage is capable of actively synthesizing Type Cm, except in the newborn period when synthesis of Type Cm does occur in structural cartilage. A low molecular weight collagen (designated G collagen) is synthesized in vitro by growth cartilage but not by structural or articular cartilage. Preferential distribution of these minor collagens in growth cartilage suggests a role in development during normal cartilage growth. PMID- 6491809 TI - Labeling of articular cartilage surface with cationized ferritin: aged human normal and osteoarthritic cartilage. AB - The labeling of the articular surface with cationized ferritin (CF), an electron dense marker, visualizes the anionic sites and may disclose abnormal penetration of the large CF molecule into the subsurface layers. Various areas of cartilage selected by unaided eye examination were taken from femoral heads excised in three cases of osteoarthritis and two cases of hip fracture. The fragments were examined by optical microscopy and by electron microscopy after labeling with CF. The labeling with and the penetration of CF were correlated with the morphological features of the surface. The surfaces belonging to the erosion border were disrupted and the CF penetrated approximately 2 microns into the matrix along the collagen fibers and in areas containing a patchy dense material. Prefixation with Karnovsky's fixative prevents CF penetration. The fragments taken at a distance from the erosion border showed at electron microscopical examination either an intact appearance of the surface that was labeled without penetration or a disrupted surface with penetration of the label. The osteophytes and the regeneration buds surface were labeled showing little or no penetration. The fragments from cartilage of hip fractures had either an intact surface regularly labeled or a slightly or moderately disrupted surface with moderate penetration of CF. The penetration of large molecules of CF in damaged cartilage demonstrates important permeability changes that may be significant for the pathogenetic mechanism of osteoarthritis. Similar permeability changes were previously shown in mice femoral heads treated in vitro with collagenase or trypsin and labeled with CF. PMID- 6491810 TI - Spontaneous degenerative spinal disease in the laboratory rabbit. AB - The spines of 35 rabbits (32 New Zealand white and 3 AC/J), ranging in age from 3 months to 8 1/2 years, were investigated systematically for spontaneous degenerative changes. Three types of lesion were observed. (1) The nucleus pulposus underwent chondroid metaplasia throughout the length of the vertebral column by the age of 2 years. (2) Hydroxyapatite deposition was found in the nucleus pulposus in 12 of 20 animals examined roentgenographically. The lesion occurred principally in the distal thoracic segments and was first observed in 3 month-old rabbits. (3) Spondylosis occurred in each of four macerated spines from animals greater than 24 months old. Portions of the spine spared by disc calcification were affected. PMID- 6491811 TI - Response of amputated rat limbs to fetal nerve tissue implants and direct current. AB - We have previously shown that implanted fetal nerve tissue stimulates the regeneration of amputated chick limbs. The purpose of this study was to determine whether a similar phenomenon would occur in amputated rat limbs and if addition of applied direct current (DC) would affect this process. Thus, fetal nerve tissue was implanted into amputated stumps of 3-week-old rats; variable tissue regeneration was induced that was dependent on the age of the donor implant and the presence of applied DC. Twelve or 14 day fetal neural implants induced new accessory bones containing epiphyseal plates and marrow cavities and occasionally formed joint-like structures with the host humerus. Addition of DC to 12 day neural implants increased the number of new bones formed. Eighteen day neural tissue with applied DC did not induce new bone formation but stimulated the maximal elongation of the host humerus and outgrowth of nerve fibers to the cut surface. Implantation of fetal heart tissue or implantation of fetal neural tissue into unamputated limbs failed to induce new bone formation. Although true limb regeneration was not achieved, formation of new skeletal elements did occur and this effect was enhanced by applied DC. PMID- 6491812 TI - Demonstration of increased proteoglycan turnover in cartilage explants from dogs with experimental osteoarthritis. AB - The turnover of proteoglycans (assessed by the release into the medium of newly synthesised [35S]-proteoglycan) in explant cultures of articular cartilage from various anatomical sites of the knee joints (stifle) of mature beagles with experimental osteoarthritis has been studied with the following findings: (a) The proportion of newly synthesised proteoglycans released from cartilage explants maintained in vitro was generally increased for cartilage from operated compared with nonoperated control joints. (b) At 3 weeks after surgery there was a significant increase in the release of [35S]-proteoglycans from explants of the lateral and medial tibial plateaux of operated joints compared with sham-operated joints but not from other sites. On the other hand, when this comparison was made at 3 to 6 months after surgery, significant increases in the release of [35S] proteoglycans were observed from cartilage of all anatomical areas except the patellar groove. (c) The release of [35S]-proteoglycan from cartilage explant cultures was dependent on live chondrocytes, since freeze-thawing the tissue immediately after labelling markedly reduced the release from both normal and osteoarthritic cartilage. PMID- 6491813 TI - Microinjury to the synovial membrane may cause disaggregation of proteoglycans in rabbit knee joint articular cartilage. AB - Proteoglycans (PGs) isolated from articular cartilage (AC) of mature rabbits subjected to two or more consecutive intraarticular (IA) injections of sterile saline 24 h apart showed an aggregation defect in the presence of excess hyaluronic acid (HA). Although the PG contents of experimental and control cartilages were indistinguishable, a higher proportion of PGs were extractable from the 3 X IA tissues, as assessed by uronic acid analysis. Proteoglycans from experimental and control cartilages when examined by Sepharose CL-2B chromatography showed two subunit populations, the smaller (KAV = 0.70) containing more ketatan sulphate than the larger (KAV = 0.31). Cultures of AC from IA joints released more 35SO4-labelled PGs into the media over 72 h than control tissues and consisted mainly of PG degradation products although 20% could aggregate in the presence of HA. Examination of PG aggregation 2 weeks after 2 X IA or 3 X IA injections showed that the defect initiated was still present; however, cartilage of immature rabbits was not affected by the 2 X IA procedure. PMID- 6491814 TI - Dupuytren's disease: comparative growth dynamics and morphology between cultured myofibroblasts (nodule) and fibroblasts (cord). AB - The excised palmar fascia of 11 patients with Dupuytren's disease was separated clinically into nodules and cords. Myofibroblasts were seen by light and electron microscopy in each of the nodules, but the cords generally lacked myofibroblasts. Only one cord specimen had microscopic features that were intermediate between nodule and cord. Electron microscopy demonstrated that in vivo differences between myofibroblasts from nodules and fibroblasts from cords and control skin samples could be preserved in vitro. Growth studies showed slower growth of cultured myofibroblasts (mean +/- SD generation time 68.7 +/- 15 h) than cord derived fibroblasts (mean +/- SD generation time 51.5 +/- 0.9 h). These data suggest that the life cycle of the myofibroblasts from Dupuytren's disease nodules differs from that of fibroblasts found in cordlike tissues. These myofibroblasts have biological characteristics nearly identical to those of myofibroblasts found in other contracting tissues, such as granulating wounds and breast cancer. PMID- 6491815 TI - Quantification of regional blood flow to canine flexor tendons. AB - Although the blood supply and the microcirculation of flexor tendons have been studied and defined extensively using qualitative methods, the quantitative assessment of blood flow has been lacking because of the limitations of the available experimental techniques. We studied the regional blood supply to the flexor tendons of dogs by the technique of radionuclide-labeled microspheres. Seven adult mongrel dogs were used. Microsphere injection and tissue-counting techniques previously used for other tissues were applied. Samples of proximal, isthmus, and distal portions of the profundus and superficialis flexor tendons were harvested from each digital unit of available limbs from each dog. Mean (+/- SE) flows (ml/100 g dry tissue/min) were proximal profundus 1.78 +/- 0.60 and superficialis 7.10 +/- 1.50. The differences were significant (p less than 0.01). The study suggests that regional variation in blood flow to canine digital flexor tendons exists, so that a single value for blood flow to these tendons is not relevant. Furthermore, the study supports the concept of dual (vascular and synovial) nutrition to the digital flexor tendons in dogs. These observations may have implications regarding tendon repair techniques. PMID- 6491816 TI - Clinical utility of the erythrocyte sedimentation rate in preoperative evaluation of solitary skeletal lesions. AB - We investigated the utility of the erythrocyte sedimentation rate in planning the diagnostic and surgical strategy for patients who were found by conventional radiography to have a solitary skeletal lesion. A series of 101 patients was separated into two groups according to their ultimate diagnoses. Group I included patients with skeletal metastases of unknown origin, unusual bone infections, and marrow cell tumors. Group II included benign and malignant primary bone tumors. Using the Westergren method to determine the erythrocyte sedimentation rate prior to biopsy, we found that only one of 65 Group II patients had a rate above 30 mm/h whereas 22 of 36 Group I patients had rates greater than 60 mm/h. By using Receiver Operating Characteristic analysis, we estimated the trade-offs between sensitivity and specificity that can be achieved with various threshold sedimentation rates. In particular, we found that a critical erythrocyte sedimentation rate of 30 mm/h allows separation of Group II patients from Group I patients with 96.9% sensitivity and 82.6% specificity. Our results indicate that the erythrocyte sedimentation rate can be used effectively in conjunction with conventional radiography in the planning of an appropriate further diagnostic strategy. PMID- 6491818 TI - Kinematic and EMG patterns during slow, free, and fast walking. AB - Kinematics and electromyographic (EMG) activity were recorded in seven normal women during walking at slow, free, and fast speeds. Speed-related differences were found in the stride dimensions, temporal components, and most of the simultaneous displacement patterns of body segments measured. For most of the muscles tested, the amplitude of normalized EMG activity decreased as walking speed decreased. The findings emphasize the importance of accounting for the effect of speed itself on measurements of gait. PMID- 6491817 TI - Penetration of Staphylococcus aureus into sutured wounds. AB - An animal model was developed to study whether Staphylococcus aureus could penetrate a sutured wound. Six days after bacteria were applied to sutured incisions, viable organisms could be recovered from the depths of the wounds in the majority of cases. Specifically, bacteria could be recovered in 23 of 24 wounds when they were applied 1 day after suturing, in 17 of 24 wounds when they were applied 4 days after suturing, and in 13 of 24 when applied 7 days after suturing. When Steri-strips were used to close the wounds, bacteria could not be recovered from any of 24 wounds when bacteria were applied 4 or 7 days after wound closure. When bacteria were applied 5 min after sutures had been placed but without incision, bacteria could be recovered in three of 12 cases and in two of 12 cases when they were applied 7 days after suturing. These results demonstrate that bacteria can penetrate sutured wounds. The sutures themselves probably contributed to this phenomenon. PMID- 6491819 TI - Relation of intramuscular pressure to the force output and myoelectric signal of skeletal muscle. AB - The force output of the biceps brachii muscle during static isometric contractions was studied in 26 arms of 23 subjects in relation to the simultaneously recorded level of the electromyogram (EMG) and the intra-muscular pressure (IMP). The EMG was picked up with wire electrodes and the IMP recorded through wick catheters or by infusion technique. The load at the wrist was monitored using a force transducer. A near linear relationship with correlation coefficients exceeding 0.96 was shown between the load on the wrist on the one hand and IMP and EMG on the other. The regression coefficients of the relation between the load and IMP or EMG varied considerably between individuals and between different measuring points in the same individual. In cases where the correlation between the wrist load on one hand and the IMP and EMG on the other was poor because of varying synergistic interaction between the flexor muscles, the EMG and IMP were always well correlated. This means that they change in the same way when the mechanical output of the muscle varies. This was also the case in three experiments where the IMP and EMG from all three elbow flexors were recorded while the subjects changed from a supinated to a pronated position supporting a constant load on the wrist. Considering these observations we present indirect evidence that IMP and the level of the EMG signal both are good estimators of isolated muscular force under isometric static conditions and over limited time. PMID- 6491820 TI - A biomechanical comparison of various methods of stabilization of subtrochanteric fractures of the femur. AB - Subtrochanteric femoral fractures with and without bony contact were simulated in cadaver specimens, fixed with one of seven different types of intramedullary or plate implants, and tested biomechanically. The implants used were Enders pins, Zickel nail, compression hip screw, AO angled blade plate, and intramedullary locked nail systems of the Klemm-Schellman, Brooker-Wills, and Grosse-Kempf types. Femur-implant constructs using intramedullary devices were a maximum of 5% as stiff in torsion as intact cadaveric femora tested in the same manner, while plate-fixed fractures were nearly 50% as stiff. In bending, all devices except the Enders pins were approximately 80% as stiff as intact femora. Loss of bony contact at the fracture site had little effect on stiffness except in the case of the keyless compression hip screw, where the screw rotated freely in the barrel. In combined bending and compression to failure, a test to simulate forces due to body weight, the intramedullary locked rods were found to support between 300 and 400% of body weight while the plate systems failed at loads between 100 and 200% of body weight. PMID- 6491821 TI - Experiences in war and during catastrophes and their effects upon the human mind. PMID- 6491822 TI - Notes on depression and grief in children and others. PMID- 6491823 TI - [Papillomas of the nasal cavity and paranasal sinuses. A clinicopathological study of 19 cases]. PMID- 6491824 TI - [Radiological diagnosis of ethmoidomaxillary plate]. PMID- 6491825 TI - [Host defense mechanisms of the nose. Part One. Bacterial exposure using rats with artificial nasal obstructions]. PMID- 6491826 TI - [Analysis of stamping]. PMID- 6491827 TI - [An experimental study on the role of inferior colliculus to auditory brainstem response]. PMID- 6491828 TI - [Development of the vestibular organ in the mouse--development of the crista ampullaris]. PMID- 6491829 TI - [Adrenoceptors in subjects with Meniere's disease]. PMID- 6491830 TI - [Specificity of 60 cases of subglottic carcinoma and laryngeal carcinoma extending to the subglottic region]. PMID- 6491831 TI - [Carotid sinus hypersensitivity syndrome in patients with advanced cervical lymph node metastasis--report of 5 cases]. PMID- 6491832 TI - [Fine needle aspiration biopsy of lymph nodes of the neck]. PMID- 6491833 TI - Unexpected inorganic elements in oral lesions: results of X-ray energy spectroscopy (XES) on particulate matter in paraffin sections. AB - X-ray energy spectroscopy (XES) of all particulate matter found by light microscopy in histological sections of 222 oral lesions revealed a much wider range of elements than expected from dental amalgam. Subsequent XES of a variety of endodontic materials, impression materials and toothpastes indicated possible sources for virtually all elements identified in the histopathological lesions. The range of materials identified is tabulated; histopathological lesions and probable source substances are correlated; light microscopic pointers to the elemental nature of particulate matter in sections are indicated--titanium and bismuth have characteristic appearances; possible implications of local implantation and large scale ingestion of such substances are discussed. PMID- 6491834 TI - Amiodarone lung toxicity: a human and experimental study. AB - This paper describes the pathology of pulmonary histiocytosis developing in a patient treated with amiodarone, and reports comparable changes in the lungs of rats and mice to which this drug had been administered. Ultrastructural studies indicate that the experimental lung changes are similar to those produced by iprindole and chlorphentermine. The patient also displayed focal necroses and an eosinophilic bronchiolitis; these may represent further effects of amiodarone on the lung. PMID- 6491835 TI - Improved chimaeric mouse model confirms that resident peritoneal macrophages are derived solely from bone marrow precursors. AB - The origin of resident peritoneal macrophages was studied in radiation mouse chimaeras with and without reconstitution of the peritoneum with viable isogeneic peritoneal cells. The selection of host and donor strains were such that the isoenzymes of glucose-6-phosphate isomerase could be used to distinguish host from donor bone marrow derived cells. It was found that the resident peritoneal macrophages were completely replaced by bone marrow donor derived cells within 5 6 weeks. There was little difference between the results from mice which had been additionally reconstituted with peritoneal cells and those which were not. PMID- 6491836 TI - The cumulative scanning electron microscopic changes in baby mouse lungs following prenatal and postnatal exposures to nicotine. AB - Half of the offspring from nicotine exposed and control mother mice were cross fostered at birth to form four groups of those exposed to nicotine only during the gestational period (NC), only during the lactational period (CN), throughout both periods (NN), or exposed to none (CC). Nodular mucosal bulges (neuroepithelial bodies, NEB) were found in all groups; their number decreased with the increase in the age in the control group (CC). The bulges were large and irregular in all nicotine exposed groups, especially in the NN group. Although they also decreased in number with age, NEB were significantly retained and abnormal in the NN group compared with the NC and CC groups on day 30 (p less than 0.01). In addition, the bronchioles were tortuous in the nicotine exposed groups probably due to the expansion of mucosal depressions, pits, and fenestrations. In mice, maternal exposures to a small dosage of nicotine throughout both gestational and lactating periods appear to induce more baby lung changes than when the exposure to nicotine is limited to either period alone. More importantly, nicotine induced baby lung changes observed on day 5 appear to regress by day 30, if the exposure to nicotine is discontinued at birth. PMID- 6491837 TI - An instant shot of "aah": cocaine use among methadone clients. PMID- 6491838 TI - From maintenance to abstinence in a therapeutic community: clinical treatment methods. PMID- 6491839 TI - Gastrointestinal illness and cannabis use in a rural Canadian community. PMID- 6491840 TI - Damiana. PMID- 6491841 TI - Pathway of mesocercariae of Alaria marcianae (Trematoda) through the mammary glands of lactating mice. AB - Lactating mice were infected with mesocercariae of Alaria marcianae to demonstrate more precisely how these parasites migrate within the mammary glands. The infected dam that first transmitted larvae to all of her young was necropsied and her mammary glands removed and sectioned serially. Mesocercariae penetrated the dense connective tissue surrounding the lobules. Within the stroma the larvae migrated along tracks of fat cells and were consistently found in pools of milk created from the destruction of alveoli. These pools of milk led directly into the large lactiferous ducts. It was notable that no mesocercaria was found in the lactiferous or galactiferous ducts indicating that clearance from these vessels was rapid. No larva was found in any blood vessel nor was any significant hemorrhage demonstrable. Lack of an inflammatory response surrounding the worm was characteristic, although large numbers of neutrophils were scattered diffusely throughout the lobules, and multiple, proliferative lymph nodules were present. PMID- 6491842 TI - Induction of egg maturation and oviposition in the tick Ornithodoros parkeri (Acari: Argasidae). AB - Hemocoelic injection and vaginal insertion of selected male reproductive and non reproductive tissue homogenates into fed-virgin female Ornithodoros parkeri stimulated varying degrees of ovum maturation and/or oviposition during 14 and 30 day observation periods, respectively. Mean times for oviposition and mean numbers of eggs laid per ovipositing female receiving hemocoelic injections of male reproductive tissue homogenates did not differ significantly from fed-mated controls. In addition, hemocoelic injection of male salivary glandular homogenate induced oviposition, yet synganglial homogenate did not. Although vaginal insertion induced both ovum maturation and oviposition, the effect was not as pronounced as when similar doses were administered by hemocoelic injection. These results indicate that a complex interrelated series of precopulatory and copulatory stimuli are necessary for oviposition to occur in fed O. parkeri. PMID- 6491843 TI - The shell cracker, Lepomis microlophus (Gunther), a new host for Argulus maculosus (Wilson). PMID- 6491844 TI - Comparison of heterologous adult Brugia malayi and homologous Onchocerca volvulus antigen in the enzyme-linked immunosorbent assay (ELISA) for Guatemalan onchocerciasis. AB - To determine the susceptibility of a heterologous filarial antigen for measuring Onchocerca volvulus antibodies, worms were compared using an enzyme-linked immunosorbent assay (ELISA) test. Control serum samples from helminth-free U.S. residents and from helminth-infected but filariae-free Salvadoran residents were tested and compared with serum obtained from microfilariae-positive and -negative Guatemalan residents living in an area of endemic onchocerciasis. The results showed that none of the sera from U.S. residents had positive O. volvulus ELISA titers (greater than or equal to 1:160); however, 8.51% (4/47) had positive B. malayi ELISA titers (greater than or equal to 1:640). The geometric mean titers with the B. malayi ELISA test were higher than with the O. volvulus ELISA test- in sera from 47 U.S. residents (1:219 vs. 1:49), from 108 Salvadoran residents (1:92 vs. 1:71), and from 145 microfilariae-negative (1:539 vs. 1:167) and 303 microfilariae-positive (1:1,270 vs. 1:561) Guatemalan residents. The B. malayi ELISA test exhibited slightly less sensitivity than the homologous O. volvulus ELISA test; nevertheless, a good correlation (r = 0.74) was found between the 2 test antigens, indicating that the B. malayi antigen could be used to measure O. volvulus antibodies. PMID- 6491845 TI - Eimeria confusa Joseph, 1969 and E. ontarioensis Lee and Dorney, 1971, from grey squirrels in England. PMID- 6491847 TI - The Haller's organ roof and anterior pit setae of Argas ticks (Ixodoidea: Argasidae). Subgenera Secretargas and Ogadenus. AB - Adults of the Argas subgenera Secretargas (3 species) and Ogadenus (1 species) were studied by scanning electron microscopy. In each species, the anterior pit and Haller's organ are situated in a large dorsal hump of Tarsus I and the 9 setae of the anterior pit are characteristic of the genus Argas in structure and numbers. In A. (S.) transgariepinus, an Ethiopian-Palearctic crevice-dwelling parasite of bats, the Haller's organ capsule roof is solid with a slitlike transverse aperture. In A. (S.) hoogstraali and A. (S.) echinops, Malagasy soil dwelling parasites of Oplurus (Varanidae) lizards and the hedgehog-tenrec (Insectivora: Tenrecidae), respectively, the Haller's organ is virtually unroofed but partially screened by arborescent dorsal projections from the posterior wall of the capsule, and the open capsule contains numerous fine pleomorphs. In A. (O.) brumpti, a soil-dwelling parasite of the hyrax (Procavia), other terrestrial mammals, and lizards in the Ethiopian Region, the capsule is also virtually unroofed and contains numerous fine pleomorphs. The unroofed capsule is probably phylogenetically primitive and occurs only in these 3 and 2 other Argas species. The soil microhabitat (in Argas confined to 3 of the 4 species recorded here), and the reptile or ancient mammal hosts of these 3 species, as well as the zoogeographical isolation of 2 of the species in the Malagasy Region, are distinctive in this genus of 56 species. The interrelationships between an unroofed Haller's organ capsule and unusual biological properties remain to be determined. PMID- 6491846 TI - Murine immunization by cesium-137 irradiation attenuated Schistosoma mansoni cercariae. AB - Cesium-137, becoming a more readily available ionizing gamma radiation source for laboratory use, was shown to effectively attenuate Schistosoma mansoni cercariae for vaccine production. In parallel comparison studies with the murine model, cesium-137 attenuated cercariae consistently afforded better (P greater than 0.05) protection than did the cobalt-60 prepared vaccine. Dose-response data indicated that the optimal total irradiation with cesium-137 was between 45 and 50 Krad. PMID- 6491848 TI - Bat ticks of the genus Argas (Ixodoidea: Argasidae). 13. Haller's organ roof and anterior pit setae in Carios and Chiropterargas. AB - Adults of 4 of the 6 species constituting the subgenus Carios and of 3 of the 4 species constituting the subgenus Chiropterargas were studied by scanning electron microscopy. All species parasitize Old World cave-dwelling insectivorous bats (Microchiroptera). The anterior pit setae number 10 in Carios and 10 or 11 in Chiropterargas. In most Carios, the setiform seta is replaced by a second serrate seta. In 2 of the 3 studied Chiropterargas species, 1 of the 2 grooved setae is exceptionally long. Porose setae number 3 in Carios and 3 or 4 in Chiropterargas. The Haller's organ roof in both subgenera is solid, lacking perforations; the aperture is narrowly transverse in Carios, irregularly wide or wide and transverse in Chiropterargas; uniquely, 1 or 2 sensilla protrude from the aperture of Chiropterargas species. The protruding sensilla and long grooved seta of Chiropterargas suggest a probably distinctive sensory-behavior pattern common to these ticks. Other morphological characters are discussed and compared to show relationships between these 2 subgenera and the subgenera Argas and Persicargas and distinctive characters present only in adult and/or larval Carios and Chiropterargas. PMID- 6491849 TI - Infection and transmission studies with the N-3 strain of Plasmodium fieldi in the Macaca mulatta monkey. AB - Seven different anophelines--Anopheles freeborni, An. dirus, An. maculatus, An. atroparvus, An. stephensi, An. albimanus, and An. quadrimaculatus--were shown to be susceptible to infection with the N-3 strain of Plasmodium fieldi. Transmission was obtained via the bites of An. dirus, An. stephensi, and An. maculatus mosquitoes to Macaca mulatta monkeys. Sporozoites dissected from An. freeborni were also shown to be infectious. Anopheles dirus and An. stephensi were the most suitable mosquitoes for transmission studies. Prepatent periods in M. mulatta monkeys following sporozoite inoculation ranged from 9 to 18 days with a mean of 12.3 days. Maximum parasitemias in intact animals following sporozoite inoculation ranged from 5,460 to 32,800 per mm3. Mean maximum parasitemia in splenectomized monkeys inoculated with parasitized blood was 146,000 per mm3. PMID- 6491850 TI - Glass cover slip technique for studying in vitro interactions between Giardia trophozoites and host leukocytes by TEM, SEM, and light microscopy. PMID- 6491851 TI - The efficacy of closantel against Fascioloides magna in sheep. PMID- 6491852 TI - Phospholipids of cercariae and adult Schistosoma mansoni. PMID- 6491853 TI - Formation of (1----2)-linked beta-D-mannopyranan by Leishmania mexicana amazonensis: relationship with certain Crithidia and Herpetomonas species. PMID- 6491854 TI - Emergence of larval Protostrongylus boughtoni (Nematoda: Metastrongyloidea) from a snail intermediate host, and subsequent infection in the domestic rabbit (Oryctolagus cuniculus). PMID- 6491855 TI - A wide pH range stopper for improved particulate quality in parenteral solutions. PMID- 6491856 TI - Procedures used for sterility testing of parenteral drugs by an FDA field laboratory. PMID- 6491858 TI - Integrity testing of microfiltration membranes. PMID- 6491859 TI - Retrospective view of the interfacial relationship of the pharmaceutical industry with the Food and Drug Administration and the United States Pharmacopeia. PMID- 6491857 TI - Sterility assurance for terminally sterilized products without end-product sterility testing. PMID- 6491860 TI - Project on perinatal monitoring. Symposium on new methods in perinatology. May 7th-8th 1984. Copenhagen, Denmark. Summaries of presented papers and panel discussions. PMID- 6491861 TI - Relative preference and adaptiveness of behavioral blame for observers of rape victims. AB - Observers viewed one of nine dramatized videotaped interviews of a rape victim describing her rape. Information in the interview varied the prudence of the victim's behavior (careful, careless, no information provided) and the respectability of her character (good, bad, no information provided). Behavioral blame was significantly greater than characterological blame when the victim was careless or when no information was provided about behavior, regardless of the victim's character. When the behavior was careful, behavioral blame was equal in magnitude to characterological blame. In no case was characterological blame preferred. The adaptive value of behavioral blame for preserving a belief in a controllable and meaningful world was examined using a hierarchical multiple regression. After removing the effects of the prebeliefs of the subjects and the independent variable manipulations, only behavioral blame was significantly related to the maintenance of adaptive beliefs. Implications of the adaptive value of behavioral blame are discussed along with the importance of distinguishing observers' behavioral and characterological blaming strategies in the victimization literature. PMID- 6491863 TI - Geometry of muscarinic agonists. AB - In order to account for a common geometric character of the skeleton of known muscarinic agonist molecules in the drug-receptor interaction, common key atoms, terminal methyl carbon, two oxygen, and ammonium nitrogen atoms were remarked which were shown by computer calculation to be concentrated at definite points in space and to be arranged nearly in a plane. Comparison of overlapped patterns of potent agonists and weak-acting or inactive analogues drew a conclusion that the complemental receptor site have a relatively flat shape. PMID- 6491862 TI - Studies on the combination of Glycyrrhizae Radix in Shakuyakukanzo-To. AB - The pharmacological properties of the five samples of glycyrrhizic acid, paeoniflorin, the extracts of Glycyrrhizae Radix, the extracts of Paeoniae Radix and a preparation of Chinese drug Shakuyakukanzo-To were compared by investigating their actions in the carrageenan-induced paw edema, the cotton pellet granuloma formation and acetic acid-induced writhing syndrome tests, using ddY-strain mice. The concentrations of glycyrrhizic acid and paeniflorin, the main components of Glycyrrhizae Radix and Paeoniae Radix respectively, were determined in the preparations by high performance liquid chromatography. Anti inflammatory activity was observed with the doses of glycyrrhizic acid, 3.0 and 30.0 mg/kg p.o., which are almost equivalent to the quantities contained in the extracts of Glycyrrhizae Radix, 18.0 (normal human dose per day) and 180.0 mg/kg, or in Shakuyakukanzo-To, 32.0 (normal human dose per day) and 320.0 mg/kg, respectively and with the doses of the extracts of Glycyrrhizae Radix, 18.0 and 180.0 mg/kg p.o., but not with the doses of Shakuyakukanzo-To, 32.0 and 320.0 mg/kg p.o., in carrageenan-induced edema and cotton pellet method. Doses of paeoniflorin (2.0, 20.0 and 200.0 mg/kg p.o.) and the extracts of Paeoniae Radix, 21.0 (normal human dose per day) and 210.0 mg/kg p.o., which contain almost equivalent quantities of paeoniflorin, 2.0 and 20.0 mg/kg, respectively, showed significant inhibitory effects in the writhing syndrome test. Furthermore, Shakuyakukanzo-To, 32.0 and 320.0 mg/kg p.o., which contain almost equivalent quantities of paeoniflorin, 2.0 and 20.0 mg/kg, showed strong effects in this test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491864 TI - Intestinal absorption mechanism of amino-beta-lactam antibiotics. III. Kinetics of carrier-mediated transport across the rat small intestine in situ. AB - The transport kinetics of amino-beta-lactam antibiotics was studied by an in situ rat small intestinal recirculating perfusion technique. The disappearance rates of the antibiotics from the perfusing luminal solution followed mixed-type kinetics with saturable and nonsaturable processes. The kinetic parameters were determined. Pharmacokinetic analysis of the time courses of luminal disappearance, tissue accumulation, and blood concentration indicated that the transfer of the antibiotics from the in situ luminal solution to tissue is nearly irreversible. On the assumption that the saturable transport process involves a common carrier for these antibiotics, the predicted extents of mutual inhibition using the in situ kinetic parameters were in good agreement with the experimental values for cephalexin and cephradine. The effects of cephalexin and cefadroxil on the absorption of cyclacillin were also consistent with a common transport mechanism. The dipeptides, carnosine and L-phenylalanylglycine markedly inhibited cyclacillin absorption in a competitive fashion. Furthermore, cyclacillin inhibited the absorption of carnosine. The results indicate that the absorption of amino-beta-lactam antibiotics is closely related with that of dipeptides. PMID- 6491865 TI - In vitro cytolysis of MM46 tumor cells by mouse phagocytes activated by acidic mannan fraction of bakers' yeast. AB - An acidic mannan from bakers' yeast designated as WAM025 was investigated for its augmentative effect on cytolytic activity of phagocytes obtained from the peritoneal cavity of C3H/He strain mice, which had been administered i.p. with this acidic polysaccharide, 150 mg/kg/d, 5 and 10 times. The result of assay for the cytolytic effect of WAM025-activated phagocytes by measuring the amounts of 3H-uridine of the MM46 tumor cells indicated that a marked lysis of the target cells took place by a 24-h incubation with the activated phagocytes and that a decrease of this effect was observed by the additions of either phagocytic inhibitors or active oxygen scavengers. Because generation of active oxygens from the WAM025-activated phagocytes was also diminished by the additions of the same inhibitors and scavengers, it indicated that active oxygens participated in an important role in the cytolytic effect displayed by the WAM025-activated phagocytes. PMID- 6491866 TI - An assessment of gastric ulcers in vivo: enhancement of urinary recovery after oral administration of phenolsulfonphthalein in rats. AB - The permeability of gastric wall barrier to phenolsulfonphthalein (phenol red), a poorly absorbed drug, was examined as an index of an assessment of gastric mucosal damages in vivo. The urinary recovery after oral administration of phenol red and the ulcer index of the stomach were significantly increased in rats subjected to restraint and water immersion stress. Gastric absorption of phenol red, examined by means of in situ loop technique, was increased significantly in stressed rats. However, the urinary recovery of the dye after intravenous administration did not change in ulcerated rats compared with the control. These findings suggest that the increase in the urinary recovery of phenol red is due to the increased gastric absorption. The healing period of 12 d was enough to restore to control levels both the ulcer index and the urinary recovery of the dye. Both indices remained nearly at control level by the pretreatment with atropine sulfate. Good correlation between extent of gastric damage and urinary excretion of phenol red was obtained within single groups of animals. This method may be utilized as a simple and noninvasive screening test for an assessment of gastric mucosal damages in vivo. PMID- 6491867 TI - Antitumor activity of a polysaccharide fraction extracted from cultured fruiting bodies of Grifola frondosa. AB - Antitumor activity of a polysaccharide fraction (GF-1) extracted from cultured fruiting bodies of a fungus, Grifola frondosa, was examined on allogeneic and syngeneic tumors in mice. GF-1 had a marked inhibitory activity against the growth of subcutaneously (s.c.) inoculated Sarcoma 180 by the intraperitoneally (i.p.) injection at 0.5-5.0 mg/mouse for 10 successive days. A significant antitumor activity was also observed when GF-1 at 4.0 mg/mouse was i.p. injected successively on days +1-+5, +7-+11, +14-+18 or +21-+25 if the tumor cells were inoculated s.c. on day 0. Similar results were obtained by a single i.p. injection of GF-1 at 2.0 mg/mouse on day +1, +7, +14 or +21. When GF-1 was injected i.p., intravenously (i.v.) or intratumorally (i.t.), all of them showed an equivalent level of higher inhibitory activity (inhibition ratio; over 90%). However, the oral (p.o.) administration was not effective. The pretreatment of mice with GF-1 at 2.0 or 4.0 mg/mouse for 5 times before tumor inoculation did not show a significant antitumor activity. In addition, GF-1 administered i.p. at varying times before and/or after the tumor inoculation showed no antitumor activity against ascites form of Sarcoma 180. In the syngeneic systems, GF-1 exhibited an antitumor activity against solid form of Meth A fibrosarcoma in BALB/c mice and MM46 carcinoma in C3H/He mice. PMID- 6491868 TI - A comparison of three social-psychological models of attitude and behavioral plan: prediction of contraceptive behavior. AB - We compared the predictive validities of three prominent models of attitudes and behavioral decisions: Rosenberg's instrumentality-value model, Fishbein's belief evaluation model, and Beach's adaptation of subjective expected utility theory. Seventy female undergraduates rated each of the models' components and reported their attitudes and behavioral plans toward using three different methods of contraception. With the traditional across-subjects prediction procedure, the Rosenberg model generally accounted for 5-25% less variance in subjects' attitudes and behavioral plans than the Fishbein an Beach models, which were not different. With a within-subject prediction procedure, the Rosenberg model was again the least accurate, and the Fishbein and Beach models had similar predictive accuracy. As hypothesized, within-subject predictions were more accurate than across-subjects predictions. The relatively poor performance of the Rosenberg model was attributable to the instrumentality component. In addition, we found that the Beach model could be simplified with no appreciable loss in predictive accuracy. Finally, a subject's personal normative beliefs emerged as a strong independent predictor of behavioral plan. PMID- 6491869 TI - Record keeping in two types of relationships. AB - On the basis of a distinction between communal and exchange relationships (Clark & Mills, 1979; Mills & Clark, 1982), the following predictions were made: (a) Members of exchange relationships would keep track of individual inputs into joint tasks and (b) members of communal relationships would not. These hypotheses were tested in three studies. In each study, subjects worked on a task with a partner with whom they (a) desired or had a communal relationship or (b) desired or had an exchange relationship. The task involved locating and circling number sequences in a large matrix. Whether subjects used a pen of the same or of a different color from that used by their partner served as the dependent measure. If partners worked with pens of the same color individual inputs wee obscured. If they worked with different color pens, individual inputs were clear. Given this, if the proportion of subjects in a condition choosing different color pens was greater than 50% (chance), it was taken as evidence that subjects in that condition were trying to keep track of individual inputs. If this proportion was less than 50%, it was taken as evidence that subjects were trying to avoid keeping track of individual inputs. As predicted, in all three studies the proportion of subjects in the exchange conditions who chose a different color pen was significantly greater than 50% and was significantly greater than the proportion of subjects in the communal conditions who chose a different color pen. Also as expected, in no study was this percentage greater than 50% in he communal conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491870 TI - Person x situation interactions: choice of situations and congruence response models. AB - Two models of Person x Situation interaction wee examined. The first model predicts that there is a relation between personality and the situations people naturally choose to be in; the second model predicts that when there is congruence between the situation and personality, a person will experience more positive and less negative affect. These models were investigated by using mood and activity reports gathered on 3,512 occasions sampled randomly from the everyday lives of 42 subjects. Situational dimensions were related to some but not all personality variables investigated. Need for order predicted choice of typical situations and extraversion correlated with time spent recreating socially. However, it was found that individuals did not spend more time in those settings where they experienced more positive emotions nor less time in those situations where they experienced more negative affect. In terms of the affect congruence model, several predicted relations wee found, but several others did not reach significance. The failure of the affect-congruence model to be consistently supported was probably because the affect of individuals was relatively consistent across situations. The present results suggest that although some theoretically meaningful Person x Situation interactions do occur, they are not necessarily strong or easily predictable. PMID- 6491871 TI - Self-involvement, self-attribution, and the Type A coronary-prone behavior pattern. AB - Various conceptualizations of the coronary-prone behavior pattern have at their core the idea that Type As and Type Bs differ in the ways in which they evaluate themselves. In this study the relationship between self-references in speech indicative of self-involvement and self-attributional biases was examined. Twenty Type A and 20 Type B men and women completed the Attributional Style Questionnaire, an instrument that requires subjects to make attributions for and to describe six positive and six negative events. The responses were coded for attributions and frequency of self-references. Results indicated that for positive events, both Type A and Type B subjects attributed causality to themselves. However, for negative events, Type As made self-attributions and Type Bs made situational attributions. In addition, compared with Type Bs, Type A subjects used a greater percentage of self-references in their event causes, but not in the event descriptions. The implications of these findings for a self evaluative model of Type A behavior are discussed. PMID- 6491872 TI - [Interaction in the antibacterial activity of flavonoids from Sophora japonica L. to Propionibacterium]. PMID- 6491873 TI - [Simultaneous determination of ephedrine and glycyrrhizin in human breast milk by high performance liquid chromatography]. PMID- 6491874 TI - [Influence of Corynebacterium parvum, BCG, OK-432 and Lactobacillus casei on the hepatic drug-metabolizing systems and on the oxygen radical production by fixed macrophages in liver of BALB/c mouse]. PMID- 6491875 TI - [Toxicity and general pharmacological effects of 4-methylthiophenyl dipropyl phosphate]. PMID- 6491876 TI - [Choleretic activity of Artemisia plants]. PMID- 6491877 TI - [Inhibitory effects of methanol extracts of crude drugs on the air oxidation of linoleic acid]. PMID- 6491878 TI - [Automation of biological fluid analysis by switching column liquid chromatography. An application of caffeine analysis in urine]. PMID- 6491879 TI - [Effect of serum cholinesterase activity on muscle relaxation by succinylcholine in rats]. PMID- 6491880 TI - [Nitrite ion, its stability in an aqueous solution and disappearance from rabbit blood]. PMID- 6491881 TI - [Studies on the constituents of medicinal plants in Hokkaido. II. On the whole herb of Frasera tetrapetala Pall. (2)]. PMID- 6491882 TI - [Pharmacological study on Panax ginseng C. A. Meyer. II. Effects of red ginseng on the experimental gastric ulcer (1)]. PMID- 6491883 TI - [Solvent system design for silica gel liquid chromatography of digitalis glycosides. Determination of digoxin in pharmaceutical preparation]. PMID- 6491884 TI - [Studies on resistant mechanisms in the resistant bacteria to chlorhexidine. I. Influence of chlorhexidine on biosynthesis of macromolecules and membraneous permeabilities in the bacteria]. PMID- 6491885 TI - [Metabolism of bile acids. XIV. Sarcosine conjugated bile acids]. PMID- 6491886 TI - [Studies on a plastic container for aqueous infusion]. PMID- 6491887 TI - [Pharmaceutical evaluation of hollow type suppository. I. Brilliant blue FCF release characteristics of oleaginous hollow type suppository]. PMID- 6491888 TI - [Solid dispersion obtained from nifedipine and enteric coating agents. I. Dissolution behavior]. PMID- 6491889 TI - [Stabilization of emulsions and coalescence of multilayer droplets]. PMID- 6491890 TI - [Computer-assisted structure-activity studies of chemical carcinogens: aromatic amines. II. Rat and liver data set]. PMID- 6491891 TI - [Pharmacological studies on saiko-prescriptions. IV. Effect of shosaiko-to on swelling of rat hind paws induced by carrageenin]. PMID- 6491892 TI - [Pharmacological studies on saiko-prescriptions. V. Mechanisms of actions of shosaiko-to on swelling of rat hind paws induced by carrageenin]. PMID- 6491893 TI - [Studies on the constituents of Scutellaria species. III. On the flavonoid constituents of the root of Scutellaria baicalensis Georgi (3)]. PMID- 6491894 TI - [Studies on the constituents of Scutellaria species. IV. On the flavonoid constituents of the root of Scutellaria baicalensis Georgi (4)]. PMID- 6491895 TI - [Determination of homovanillic acid using o-dianisidine-peroxidase system]. PMID- 6491896 TI - [The mechanism of disintegration time increase of tablets containing hydroxypropylcellulose by moisture absorption]. PMID- 6491897 TI - Protein binding and hepatic clearance: discrimination between models of hepatic clearance with diazepam, a drug of high intrinsic clearance, in the isolated perfused rat liver preparation. AB - The influence of protein binding on the extraction ratio, and availability, of diazepam has been examined in the single-pass isolated perfused rat liver preparation. Binding of diazepam was varied by adjusting the concentration of albumin in the perfusate. In the absence of binding the extraction ratio of diazepam was high, 0.93-0.995. Extraction decreased dramatically as the degree of binding was increased. The data are more consistent with the "parallel-tube" model than with the "well-stirred" model, two perfusion models that have been used to describe hepatic drug elimination. PMID- 6491898 TI - A physiologically based pharmacokinetic model for theophylline disposition in the pregnant and nonpregnant rat. AB - There are numerous studies which examine the disposition of theophylline from a traditional point of view. Information about the behaviour of drugs, including theophylline, is, however, very scarce when investigating the kinetics by means of a physiological flow model. This study is concerned with the development of a predictive analytical model for the pharmacokinetics of theophylline in nonpregnant and pregnant rats. This model postulates that specific organ or tissue masses may be simulated by compartments whose elements have physiological properties, e.g., tissue volumes, blood flow, and metabolic activity. A model has been developed that has blood, brain, hepatic, muscular, pulmonary, renal, and fetal tissues. With few exceptions, the agreement was good between predicted and calculated tissue data in the pregnant and nonpregnant rats. Finally, model simulations were performed to investigate the impact of different pulmonary extraction ratios on the concentration-time profile of theophylline in a "hypothetical" human patient. PMID- 6491899 TI - Definition of pharmacokinetic parameters: influence of the sampling site. AB - Taking into account drug concentration differences within the circulatory system, a unique definition of each of the basic pharmacokinetic parameters, clearance (CL), steady-state volume of distribution (Vss), and mean disposition residence time (MDRT), is given which is generally valid for linear systems. The conventional relationship MDRT = Vss/CL holds theoretically only in the case of right atrial sampling following bolus intravenous injection. The values based on blood drug concentration from a peripheral venous sampling site are influenced by the pharmacokinetic properties of the lungs and the sampling tissue. Practically, the pulmonary extraction ratio and the mean transit time through the sampling tissue may thereby be of particular importance. Thus the effect of the sampling site on the pharmacokinetic parameters estimated by standard (classical) methods is quantitatively explained. PMID- 6491900 TI - The deterministic identifiability of nonlinear pharmacokinetic models. AB - This paper deals with the deterministic identifiability of nonlinear pharmacokinetic models, namely, whether the model parameters can be identified with perfect data. It is shown that the most familiar method for analyzing the deterministic identifiability of linear models, in which the Laplace transform of the observation is examined, does not work for nonlinear models. An alternative method, in which the observation is expanded as a Taylor series about t = 0, is described and is illustrated with some examples of nonlinear models familiar in the pharmacokinetics literature, in which an elimination rate is assumed capacity limited, with Michaelis-Menten kinetics. PMID- 6491901 TI - On the identification of Michaelis-Menten elimination parameters from a single dose-response curve. AB - This paper deals with aspects of the numerical identifiability of parameters of a model with a capacity-limited elimination rate using a single dose-response curve, namely, the prospects of being able to identify model parameters with any meaning from real data. The concept of linear bounds, first proposed by Tong and Metzler, is described and it is shown that if the Michaelis-Menten constant Km is greater than all the measured concentration values, approximation by a linear model is appropriate. At the other end of the scale, if Km is small compared with measured concentration values, the nonlinear response approximates to a zero order curve. PMID- 6491902 TI - Pharmacodynamic modeling of thiopental anesthesia. AB - We have pharmacodynamically modeled the relationship between the thiopental serum concentration and its effects on the electroencephalogram (EEG). Power spectral analysis was used to calculate the spectral edge, a measure of the underlying EEG frequency that characterizes the progressive slowing of the EEG induced by thiopental. Eight male volunteer subjects had venous thiopental serum concentrations measured, and 10 surgical patients had arterial serum concentrations measured. Thiopental was infused at a rate of 75 to 150 mg/min until a burst suppression EEG pattern was evident. Frequent blood samples were obtained during and after the infusion for measurement of serum thiopental concentrations, and the EEG was recorded for subsequent off-line power spectral analysis to calculate the spectral edge. With venous blood sampling, it was not possible to demonstrate significant hysteresis between the thiopental serum concentration and the spectral edge, allowing thiopental concentrations to be directly related to the spectral edge. With arterial blood sampling, significant hysteresis was present, requiring an effect compartment to relate concentration to effect. The half-time for equilibration (mean +/- SD) between concentration and response for the arterial data was 1.2 +/- 0.30 min. This value for Keo is consistent with known values for cerebral blood flow and thiopental brain: blood partition coefficient. Arterial-venous concentration differences cause the apparent lack of hysteresis with venous blood sampling. An inhibitory sigmoid Emax pharmacodynamic model optimally characterized the relationship between thiopental concentrations and the spectral edge. This model allows estimation of the thiopental serum concentration that causes one-half of the maximal EEG slowing (IC50), which is a measure of an individual's sensitivity to thiopental. Except for the hysteresis, there was no statistical difference in the parameters of the inhibitory sigmoid Emax pharmacodynamic model when venous and arterial blood samplings were compared. Arterial blood sampling offers some distinct advantages when pharmacodynamically modeling continuous, rapidly changing measures of drug effect, such as the EEG. PMID- 6491903 TI - Relationship of chemical structure to corneal penetration and influence of low viscosity solution on ocular bioavailability. AB - Current understanding of the mechanism of corneal penetration by organic molecules proposes the epithelial layer as the rate-limiting membrane for water soluble compounds and the stromal layer as rate limiting for lipid-soluble compounds. This suggests that the relationship between corneal permeability and the logarithm of oil/water partition coefficients, for a series of drugs, should not be the typical, single, continuous, parabolic-shaped curve. Corneal penetration studies have been conducted in unanesthetized albino rabbits using various organic compounds, representing five orders of magnitude in partition coefficient, at a constant concentration of 4 X 10(-5) M dispensed in either a 1- or 90-centipoise (cps) solution. It has been shown that for non-ionizable compounds, a pair of bell-shaped curves were generated, one for lipid-soluble and one for water-soluble compounds. Small water-soluble species demonstrate very high apparent permeabilities, which may relate to the presence of aqueous pores or other paracellular drug movement. Penetration of ionizable compounds does not appear to correlate well with the structural relationships invoked for un-ionized compounds. Consistent with the proposed mechanisms of corneal penetration, oil soluble drug substances show no improvement in drug bioavailability when dosed from a 90-cps solution, and water-soluble drugs show a modest improvement in ocular drug bioavailability. Small water-soluble substances demonstrate no improvement due to their already high bioavailability. The importance of nonproductive absorption and precorneal drainage on bioavailability is addressed. PMID- 6491904 TI - Physical model approach in the study of the transport of alkyl amines across a silicone rubber membrane in a two-chamber diffusion cell. AB - The transport of hexylamine and octylamine through a silicone rubber membrane was studied as a function of buffer (phosphate) concentration and pH. The results were interpreted using a physical model which assumed a steady-state rate of transport and which accounted for the simultaneous diffusion and rapid equilibrium of all the aqueous species, the possible diffusion of both the amine and its protonated form through the membrane, and the effect of a stagnant aqueous diffusion layer on each side of the membrane. The following conclusions were reached: The thickness of the aqueous diffusion layer is approximately 100 micron, which is about the same as that previously measured for benzoic acid in this system. Transport of octylamine at pH greater than or equal to 10 is approximately 90% aqueous diffusion layer controlled, whereas hexylamine is approximately 50% aqueous diffusion layer controlled at high pH. The membrane permeability of octylamine is approximately 15-20 times that of hexylamine. This gives an incremental pi constant for the partition coefficient of approximately 0.61, as compared with the previously reported value of 0.56. At low pH (less than or equal to 5), the transport of the protonated species becomes important. The membrane permeabilities of these ammonium ions are about four or five orders of magnitude less than the membrane permeabilities of the corresponding amines. The membranes were examined at 30,000X with the scanning electron microscope, and no evidence of holes was found. PMID- 6491905 TI - Sintering technique for the preparation of polymer matrices for the controlled release of macromolecules. AB - A new method for making polymeric systems for the controlled release of macromolecular drugs is described. The method consists of mixing drug and polymer (ethylene-vinyl acetate copolymer) powders below the glass transition temperature of the polymer and compressing the mixture at a temperature above the glass transition point. The macromolecule is not exposed to organic solvent during the fabrication process. Kinetic studies indicate that there is sustained release, and the bioactivity of macromolecules tested is unchanged throughout the sintering and release processes. PMID- 6491906 TI - Renal clearance and serum protein binding of acetaminophen and its major conjugates in humans. AB - The renal clearances of acetaminophen, acetaminophen glucuronide, and acetaminophen sulfate were determined in eight healthy adults 2 h after administration of 1.5 g of acetaminophen. The renal clearance ratios (relative to creatinine) were 0.058 +/- 0.026, 0.890 +/- 0.153, and 1.43 +/- 0.250 (mean +/- SD), respectively. The renal clearance of acetaminophen increased with increasing urine flow rate, and that of acetaminophen sulfate decreased with increasing serum concentration of the conjugate. A strong positive correlation was found between the renal clearances of acetaminophen glucuronide and acetaminophen sulfate, possibly due to blood perfusion rate-dependent renal tubular secretion of the two conjugates. The serum protein binding of acetaminophen (congruent to 20%) and acetaminophen glucuronide (less than 10%) are minor. Acetaminophen sulfate is greater than 50% protein bound, as determined by equilibrium dialysis and ultrafiltration. The results of these studies are (a) consistent with previous reports of animal studies, indicating that renal excretion of acetaminophen involves glomerular filtration and passive reabsorption and that acetaminophen sulfate is subject to active renal tubular secretion, and (b) compatible with the reported occurrence of renal tubular secretion of acetaminophen glucuronide in animals. PMID- 6491907 TI - Kinetics of partitioning and binding of digoxin and its analogues in the subcompartments of blood. AB - The kinetics of digoxin and analogues (metabolites) in the subcompartments of blood, erythrocytes and plasma, were first order and concentration independent. The rate and extent of red blood cell partitioning of the tested compounds were, according to first-order kinetics, identical in the presence and absence of structurally related compounds and dependent on lipophilicity and temperature; red blood cell penetration was a reversible process. Erythrocyte partitioning of digoxin and its analogues was postulated to be by passive diffusion. There was significant intracellular binding of the compounds, and hemoglobin was the major ligand. The kinetics of red blood cell partitioning of the individual compounds were fitted according to a closed two- or three-compartment modeL. The latter indicated the existence of two kinetically separable compartments within the red blood cells. Model-independent mean transit times of red blood cell-plasma water partitioning of the compounds depended largely on the lipophilicity and were a thousand times greater for the least lipophilic analogues than for the most lipophilic derivatives. Red blood cell partitioning of digoxin and its metabolites under in vivo and in vitro conditions, were equivalent. Plasma protein binding of the tested compounds was concentration independent, unaltered in the presence of the analogues, and temperature independent between 24 degrees C and 37 degrees C. Binding to albumin in buffer solution was significantly larger than to albumin in plasma for all the compounds. Binding of digoxin and its analogues to albumin in buffer solution increased with increasing lipophilicity of the compounds. PMID- 6491908 TI - Absorption and disposition of ethambutol in rabbits. AB - The absorption and disposition of ethambutol was examined in six rabbits in a three-way crossover study. Each rabbit received 45-mg/kg doses of ethambutol in three treatments: one intravenous injections and two oral solutions, ethambutol alone and ethambutol in the presence of aluminum hydroxide (40 mg/kg). Half-lives of ethambutol ranged from 2.26 to 5.20 h when administered alone and 2.18 to 4.00 h when coadministered with the antacid; the difference was not significant (p greater than 0.3). Mean clearance after the oral administrations (189.2 mL/min/kg) was significantly greater than the mean intravenous clearance (43.7 mL/min/kg) (p less than 0.01), suggesting a first-pass metabolism of ethambutol when administered nonparenterally to rabbits. The volume of distribution ranged from 5.5 to 17.8 L/kg, suggesting an extensive distribution of ethambutol outside the central compartment and, possibly, a localized deposit within the body tissues. Mean bioavailability of ethambutol was approximately 28% and was not affected by the presence of aluminum hydroxide. The rate of ethambutol absorption, however, was slightly delayed by the antacid. PMID- 6491909 TI - Solid-solid reaction between sulfacetamide and phthalic anhydride. AB - Thermal and kinetic data for the solid-state addition reaction of sulfacetamide and phthalic anhydride are presented. A compaction method was used so that the influence of some pharmaceutical parameters (compressional pressure, particle size, concentration, and temperature) on the reaction kinetics could be observed. PMID- 6491910 TI - Long-term controlled navel administration of testosterone. AB - Male fertility has reportedly been regulated by the long-term, continuous administration of testosterone. To deliver the testosterone at a controlled rate for a month or longer, a bandage-type, testosterone-releasing, disk-shaped device was developed. In vitro drug elution studies demonstrated that a constant release profile of testosterone was achieved. In vivo studies in rhesus monkeys with the medicated device directly overlaying the navel for 46 d, yielded a fairly steady plasma level and also a constant urinary excretion rate for 32 d. A greater systemic bioavailability (more than twofold) was achieved as compared with drug disposition directly onto the navel or via the placebo device (i.e., drug is deposited onto the prefabricated placebo device). A fairly constant cumulative urinary recovery profile was achieved for longer than 1 month, in which greater than 90% of the dose was administered. The in vitro and in vivo relationship was analyzed and discussed. PMID- 6491911 TI - Phenytoin prodrugs III: water-soluble prodrugs for oral and/or parenteral use. AB - Various bioreversible derivatives of phenytoin, a poorly water soluble and erratically absorbed drug after both oral and parenteral dosing, were synthesized. Initial evaluation of these expected prodrugs, i.e., their aqueous solubility, cleavage in the presence of various animal tissues, and anticonvulsant activity in mice, confirmed that a number of the derivatives did indeed behave as prodrugs. The more promising prodrugs were the disodium phosphate ester and various amino groups containing acyl esters of 3 (hydroxymethyl)-5,5-diphenylhydantoin. PMID- 6491912 TI - Labeling suspended aerosol particles with short-lived radionuclides for determination of particle deposition. AB - Radiotracer techniques were developed to examine parameters that characterize pressurized aerosols designed to deliver insoluble particles suspended in the aerosol formulation. Microaggregated bovine serum albumin microspheres that were to be suspended were labeled with iodine-131 (t1/2 = 8 d). This iodination procedure (greater than 80% effective) is also applicable to iodine-123, which possesses superior characteristics for external imaging and further in vivo studies. This report shows that for pressurized aerosols containing suspended particles, each metered dose is approximately equal (not including the priming doses and the emptying doses). Increase in the delivery of the albumin particles out of the canister was best achieved by pretreating the valve assembly with a solution of 2% (w/v) bovine serum albumin in phosphate buffer. Use of a cascade impactor delineated the particle size distribution of the micropheres, with the majority of particles ranging in size from 2 to 8 microns. The data disclosed here indicate that the techniques developed with short-lived radionuclides can be used to quantitate each metered dose, characterize the particle size distribution profile of the aerosol contents, and determine the extent of deposition of the particles in the aerosol canister and all of its components. PMID- 6491913 TI - Effects of solvent medium on solubility III: Hydrophilic-lipophilic character exhibited by some functional groups having oxygen or nitrogen in ethanol-water. AB - Solubility data of nine derivatives of the structure p-X1-C6H4-X2 in ethanol water at 25 degrees C are reported. The correlation of such sets of data by log Sy = Py X log Sx + C yields the medium effect parameter Py for a variety of functional groups possessing either oxygen or nitrogen. Py accounts for the hydrophilic-lipophilic character exhibited by each group. PMID- 6491914 TI - Pharmacokinetics of bumetanide following intravenous, intramuscular, and oral administrations to normal subjects. AB - The pharmacokinetics of bumetanide was studied in 12 normal subjects after 1-mg intravenous, intramuscular, oral solution, and tablet administrations in a random four-treatment crossover design. Plasma and urine concentrations of intact bumetanide were analyzed by a sensitive and specific RIA. The pharmacokinetics of bumetanide after intravenous administration was characterized by a biexponential equation, including an initial disposition phase (t 1/2, alpha = 5.1 min), followed by a slower elimination phase (t 1/2, beta = 44 min). Bumetanide pharmacokinetics after intramuscular and oral administration could be described by a biexponential equation with first-order absorption and elimination. Bumetanide is rapidly absorbed via the intramuscular and oral routes, with mean +/- SD maximum plasma concentrations of 38.2 +/- 9.8 (intramuscular), 34.0 +/- 10.6 (oral solution), and 30.9 +/- 14.6 ng/mL (tablet) achieved within 0.34 +/- 0.23, 0.76 +/- 0.27, and 1.8 +/- 1.2 h after dosing, respectively. The drug is rapidly eliminated from the body after intravenous, intramuscular, oral solution, and oral tablet administrations, with half-lives ranging from 24-86, 47-139, 27 71, and 26-99 min, respectively. Approximately 70% of a parenteral dose and 60% of an oral dose are excreted as intact drug in urine taken 0-24 h after administration. The extent of bioavailability of bumetanide from the tablet and oral solution dosage forms are equivalent, and the absolute bioavailability of the intramuscular and oral preparations are approximately 100 and 80%, respectively. This is consistent with the predicted limited extent of first-pass metabolism after complete absorption of an oral dose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491915 TI - Pharmacokinetics of pentobarbital, quinidine, lidocaine, and theophylline in the thermally injured rat. AB - Previous studies have shown that rats with 15% third-degree burns show a severe depression in various in vitro hepatic drug-metabolizing enzymes. This effect was assessed in vivo by measuring the disposition of four liver-metabolized drugs in 16% third-degree burned rats at 7 d postburn. Compared with pair-fed control rats, pentobarbital demonstrated a significantly prolonged clearance and elimination half-life without a change in volume of distribution. Quinidine demonstrated a significantly increased volume of distribution and a significantly decreased clearance without a change in elimination half-life. Lidocaine showed a significantly increased volume of distribution. Theophylline, which is only 50% metabolized in the rat, showed no changes in any pharmacokinetic parameters. The free drug fractions of quinidine and lidocaine were found to be significantly decreased at 1 d postburn and normal at 7 d postburn. These results warrant pharmacokinetic studies in human burn patients. PMID- 6491916 TI - Comparative in vivo and in vitro studies of phenytoin protein binding and in vitro lipolysis in plasma of pregnant and nonpregnant rats. AB - This investigation was designed to determine the cause of the changes in drug protein binding that occur in rat plasma, particularly in plasma from pregnant animals, during in vitro drug-protein binding measurements. In vivo estimates of phenytoin binding in plasma were obtained from steady-state CSF-plasma concentration ratios in pregnant and nonpregnant rats. Immediate ultrafiltration of heparin- or EDTA-anticoagulated plasma yielded phenytoin free fraction values that were in good agreement with in vivo estimates for nonpregnant rats but that were about one-third higher than in vivo estimates for pregnant animals. In vitro free fraction values tended to increase during incubation of plasma and/or during equilibrium dialysis. The concentrations of the four major endogenous free fatty acids were similar in plasma of pregnant and nonpregnant rats if determined immediately after blood collection. Six hours of incubation at 37 degrees C caused fatty acid concentrations to increase about fivefold and twofold in heparin-anticoagulated plasma from pregnant and nonpregnant animals, respectively. The corresponding increases in EDTA-anticoagulated plasma were only about twofold and 1.14-fold, respectively. These changes were associated with decreased plasma protein binding of phenytoin. The in vivo differences between pregnant and nonpregnant rats with respect to phenytoin binding in plasma are not due to differences in fatty acid concentrations, but the in vitro differences are due primarily to corresponding differences in free fatty acid concentrations if extensive in vitro lipolysis occurs. PMID- 6491917 TI - Systematic error associated with apparatus 2 of the USP dissolution test V: Interaction of two tableted prednisone formulations with glass and plastic vessels. AB - Recently marketed glass vessels that are uniform and pass USP specifications were compared with uniform plastic vessels that also pass USP specifications. Two lots of prednisone tablets, Tablet 1 and Tablet 2, were tested in both types of vessels. Tablet 1 gave higher results (+12.7% of label claim) in glass vessels at 50 rpm but gave equivalent results in either vessel at 75 rpm. Tablet 2 gave equivalent results in either vessel at 50 rpm but gave higher results (+22% of label claim) in glass vessels at 75 rpm. The type of vessel used to obtain dissolution results for tablets should be specified. PMID- 6491918 TI - Sulpiride pharmacokinetics in humans after intramuscular administration at three dose levels. AB - Pharmacokinetics of the disinhibitory psychotropic agent sulpiride was investigated in 9 healthy male subjects after intramuscular administrations of 50, 100, and 200 mg in a 3 X 3 Latin square design. Plasma and urine concentrations were measured by HPLC for 36 and 48 h, respectively. The lowest detectable concentration was 10 ng/mL. Plasma concentration versus time and urinary excretion rate versus time curves were consistent with an open two compartment body model, where mean +/- SD apparent half-lives of the absorption from muscle, lambda 1 distribution, and lambda 2 elimination phases were 6.96 +/- 2.64 min, 0.220 +/- 0.120 h, and 6.74 +/- 2.67 h, respectively. The initial volume of distribution was 0.145 +/- 0.063 L/kg, the steady-state volume of distribution was 0.639 +/- 0.184 L/kg, and the total clearance was 89.8 +/- 22.3 mL/min. The microscopic rate constants were k12 = 2.53 +/- 1.13 h-1, k21 = 0.674 +/- 0.197 h-1, and k10 = 0.635 +/- 0.298 h-1. Comparison of total clearance (89.8 mL/min), renal clearance (83.0 mL/min), and renal clearance of unbound drug (97.6 mL/min, f = 0.15) indicated that sulpiride is mainly excreted unchanged by the renal route, 93.1 +/- 6.6% of the administered dose being recovered unchanged in urine. Statistical evaluation of all the above parameters, determined at the three dosage levels, did not show any variations related to dose; the pharmacokinetics of sulpiride, over the dose range tested, was therefore linear and independent of dose. The two-compartment body model proposed was validated by digital computer simulation on a small digital computer (32K). PMID- 6491919 TI - Pulmonary absorption and excretion of compounds in the gas phase: theoretical pharmacokinetic and toxicokinetic analysis. AB - Kinetic equations were derived that describe the plasma concentration of an inhaled compound during and following single or repeated regular and irregular pulmonary exposures. The equations are based on a diffusional type of input function and assume a linear disposition with a biexponential unit-impulse response. The use of linear system analysis avoids the complexity of modeling the disposition processes; yet, the effect of these processes is still accounted for mathematically. The approach, therefore, appears to be more general and rational than approaches based on linear compartmental modeling. The ways in which the kinetic equations can be readily applied in pharmacokinetic or toxicokinetic analyses to obtain valuable parameters that enable kinetic predictions of the cumulation during prolonged exposure are discussed. The toxicokinetic problem of comparing the effect of different work schedules in occupational environments with air contaminants is discussed. Formulas derived from considerations of the blood plasma kinetics are presented for the calculation of an adjustment factor for the adjustment of the contaminant threshold limit value for abnormal work weeks. The use of these formulas appears to be more rational than that of similar formulas that have been proposed. PMID- 6491920 TI - Synthesis of 4-substituted aminoquinoline-3-carboxylates as potential antimicrobial agents. AB - A series of 4-substituted aminoquinoline-3-carboxylates was prepared and evaluated for antimicrobial activity. Four of the compounds (VIII, XIII, XV, and XXIII) exhibited low activity against Staphylococcus aureus. PMID- 6491921 TI - Subnanogram quantitation of chlorpheniramine in plasma by a new radioimmunoassay and comparison with a liquid chromatographic method. AB - A new radioimmunoassay (RIA) procedure for the quantitation of chlorpheniramine in plasma is described. The assay allows the determination of chlorpheniramine levels up to 96 h after oral administration of a single 4-mg tablet to healthy volunteers. This procedure was sensitive to a 156-pg/mL plasma concentration when a 100-microL plasma sample was used. The mean coefficient of variation over the linear range of the assay from 0.156 to 20 ng/mL was 3.79%. The specificity of the assay was investigated, and the antisera showed 7% cross-reactivity with the N,N-didemethyl analogue and 17% cross-reactivity with the N-demethyl analogue. This high degree of specificity was also evident from the findings that the plasma concentrations determined by this newly described RIA procedure in samples of two healthy male volunteers who were administered 4 mg of chlorpheniramine maleate orally gave a strong correlation (r2 = 0.88) with values obtained by an HPLC-UV procedure. The antiserum cross-reacted 100% with brompheniramine and, thus, can be used for its analysis in plasma. The described RIA procedure is precise, simple, and capable of handling a large number of plasma samples with a minimal turnaround time. PMID- 6491922 TI - Increased skin permeability for lipophilic molecules. AB - Treatment of the epidermis with surfactants can markedly increase the transport of polar molecules but only marginally increases the transport of nonpolar (lipophilic) molecules. Thus, other vehicle systems are needed to increase the transport of lipophilic molecules. One method to accomplish this increased transport is to add small quantities of polar lipids to a base vehicle containing propylene glycol. The transport of nonpolar materials such as salicylic acid can be increased by an order of magnitude by the addition of small amounts of fatty acids or alcohols to a formulation. The effect of this mixed system is much greater than the effect of any of the agents alone. PMID- 6491923 TI - Fluorescence determination of microconcentrations of chlorambucil after photoactivation. AB - A fluorescence assay is described which measures the alkylating activity of chlorambucil or its isocyanate derivative after photoactivation in the presence of dimethyl sulfoxide. This assay has a lower limit of sensitivity of 100 ng/mL and RSD of less than 10% for chlorambucil. The method requires less than 5 micrograms of alkylating agent and the fluorophore produced is stable for at least 24 h. PMID- 6491924 TI - Quantitation of phenobarbital and phenobarbital sodium in pharmaceutical dosage forms. AB - A reverse-phase high-performance liquid chromatographic method for the quantitation of phenobarbital and phenobarbital sodium in pharmaceutical dosage forms (elixir, injection, and tablets) was developed. The method is precise and accurate with percent relative standard deviations of 0.9 (without an internal standard) and 0.7 (with an internal standard) based on six injections. The method is stability indicating and is more sensitive than the revised USP-NF method. The products of decomposition showed two new peaks in the chromatogram. PMID- 6491925 TI - Mesophase formation during cholesterol gallstone dissolution in human bile: effect of bile acid composition. AB - Duodenal bile obtained from patients with gallstones who were acutely infused with chenodeoxycholic acid, ursodeoxycholic acid, or cholic acid were examined for the propensity toward the formation of a liquid crystalline mesomorphic phase when cholesterol gallstones were incubated in these bile acids. Bile taken from patients infused with ursodeoxycholic acid was found to be enriched in ursodeoxycholic acid; mesophase formation was detected in these samples but not in bile from patients infused with chenodeoxycholic acid or cholic acid. PMID- 6491926 TI - Liquid chromatographic chiral stationary phases in pharmaceutical analysis: determination of trace amounts of the (-)-enantiomer in (+)-amphetamine. AB - A rapid and accurate method was developed for the determination of the enantiomeric composition of amphetamine preparations. Amide derivatives of the amphetamine enantiomers are first formed by using achiral 2-naphthoyl chloride. The resulting enantiomeric amides are then chromatographed on a commercially available chiral stationary phase. The capacity factors (k') of (-)- and (+)-2 naphthoylamphetamine are 20 and 22, respectively, and the separation factor (alpha) for the two enantiomers is 1.08. The method allows detection of as little as 0.5% of the (-)-enantiomer in (+)-amphetamine and is applicable to both bulk drug and single-tablet analyses. PMID- 6491927 TI - Dipole moments and conformational equilibrium in some substituted 1-phenyl-1 fluoro-2-halogenoethanes. AB - Experimental dipole moments of substituted 1-phenyl-1-fluoro-2-halogenoethanes are compared with the vectorially and the theoretically calculated values using the CNDO/2 method. Results support the existence of a conformational mixture of these compounds as solutes; gauche structures are the prevailing conformations as in the related catecholamines. PMID- 6491928 TI - Synthesis and biological evaluation of new 2,3-dihydrothiazole derivatives for antimicrobial, antihypertensive, and anticonvulsant activities. AB - A novel series of 2-arylimino-2,3-dihydrothiazole derivatives, substituted in the 3-position with a beta-phenethyl moiety and the 4-position with substituted aryl functions, was synthesized as potential antimicrobial, antihypertensive and anticonvulsive agents. While no antimicrobial or significant antihypertensive activity was observed for the products, XII, XIII, and XXI displayed potent anticonvulsant activity. PMID- 6491929 TI - Synthesis of N,N'-disubstituted N''-2-(2-quinolinylmethylthio)ethylguanidines as potential anticancer agents. AB - A simple method for obtaining the title compounds was found in the alkaline rearrangement of S-2-aminoethylisothiouronium salts, which were obtained from the condensation of thiourea or substituted thioureas with 2-bromoethylamine hydrobromide. No activity was found for the substituted guanidines against P388 lymphocytic leukemia in mice, or as H2-receptor antagonists. PMID- 6491930 TI - Assay of adinazolam in plasma by liquid chromatography. AB - A procedure for the quantitative determination of adinazolam in plasma was developed. The drug, an N-demethylated metabolite, and an internal standard were extracted from basified plasma into ethyl acetate. After evaporation, the residue was dissolved in toluene which was washed with sodium hydroxide. The toluene was evaporated and the residue was dissolved in a mixture of acetonitrile, methanol, and water for chromatography. The concentrations of the drug and the metabolite were determined using reverse-phase liquid chromatography with UV detection at 254 nm. The assay methodology showed good peak height ratio-concentration linearity, precision, and accuracy and has been used to analyze plasma samples collected from human subjects after oral administration of adinazolam mesylate in compressed tablets. The low plasma background interferences allowed the quantitative determination of concentrations as low as approximately 5 ng/mL. PMID- 6491931 TI - Effect of folic acid on the pharmacokinetics of acutely administered phenytoin in pregnant and nonpregnant rats. AB - The concentrations of both total and free phenytoin in the plasma of epileptic women tend to decrease during pregnancy, suggestive of a pregnancy-associated increase in the metabolic clearance of the drug. On the other hand, the metabolic clearance of free (unbound) phenytoin decreases during pregnancy in rats. One possible reason for this species difference is the routine dietary supplementation of folic acid in human pregnancy and the apparent ability of folic acid to lower phenytoin plasma concentrations even in nonpregnant humans. The purpose of this investigation was to determine the effect of treatment with folic acid on the pharmacokinetics of phenytoin in pregnant and female nonpregnant rats. In one experiment, the treated animals received folic acid in the drinking water, approximately 100-150 micrograms/kg/d, for 19 d. There was no apparent difference between the treated and untreated rats in the pharmacokinetics of a 10-mg/kg iv dose of phenytoin (which was administered to the pregnant rats on the 20th day of gestation), regardless of pregnancy status, In another experiment, pregnant and female nonpregnant rats received either folic acid, 400 micrograms/kg/d, or an equal volume of the solvent only, by gastric intubation for 19 d. The next day (which was the 20th day of gestation for the pregnant rats), the animals received an intravenous injection of phenytoin, 30 mg/kg. Again, pretreatment with folic acid had no apparent effect on the pharmacokinetics of phenytoin in both pregnant and nonpregnant rats. However, the results of this investigation confirm previous observations of dose-dependent phenytoin pharmacokinetics in rats and of decreased clearance of free phenytoin in late pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491932 TI - Synthesis of Methyl 2,3-bis(hydroxymethyl)-5-phenyl-7-oxabicyclo[2.2.1]hepta-2,5 diene- 6-carboxylate bis(N-methylcarbamate) derivatives as potential antitumor agents. AB - Methyl 2,3-bis(hydroxymethyl)-5-phenyl-7-oxabicyclo[2.2.1]hepta-2,5- diene-6 carboxylate bis(N-methylcarbamate) along with the p-chlorophenyl and p nitrophenyl analogues were synthesized using a Diels Alder reaction. The title compound and the p-chlorophenyl analogue were inactive against murine P388 lymphocytic leukemia. PMID- 6491933 TI - Decrease in the rate of capsule dissolution due to formaldehyde from polysorbate 80 autoxidation. PMID- 6491934 TI - Does cimetidine impair nitroreduction? PMID- 6491935 TI - Alcoholism and mortality kinetics. AB - Gompertz plots of age-specific mortality rates versus age were compared in alcoholics and the general population. Alcoholism had a dual effect, apparently increasing vulnerability to death while slowing the aging rate (longevity is a two-dimensional function). It was hypothesized that the apparent slowing of the aging rate was an artifact, resulting from population heterogeneity in vulnerability. It is recommended that in future studies, attempts be made to categorize alcoholic subjects with respect to alcoholic habit. Longitudinal studies would also be useful. PMID- 6491936 TI - pH-Solubility profile of papaverine hydrochloride and its relationship to the dissolution rate of sustained-release pellets. AB - The pH-solubility profile of papaverine hydrochloride (I) was determined using the phase-solubility technique and equilibrium solubilities in buffers. The release of I from sustained-release pellets consisting of a shellac-based matrix was determined by the USP basket technique and was found to exhibit zero-order kinetics. Release rates at various pH values of the permeating solvent were compared with the pH-solubility profile and were directly proportional to the solubility below, but not above, the apparent pHmax (3.9). This lack of proportionality was also shown by the intrinsic dissolution rates. The effect was attributed to the self-buffering action of I and the metastability of the papaverine salt-base system in the vicinity of pHmax. It is postulated that the outer layer of polymer and filler on the surface of the pellets forms a barrier which determines the rate of release. The inner matrix serves as a drug reservoir in which the internal pH may not be the same as the bulk pH. PMID- 6491938 TI - Analysis of carprofen dosage forms and drug substance by high-performance liquid chromatography. AB - A high-performance liquid chromatographic method for the analysis of carprofen in solid dosage forms and as the bulk drug substance was developed. The simple, accurate, reproducible, and stability-indicating method was shown to be applicable to drug substance and dosage form stability studies, as well as the quality control of carprofen dosage forms. PMID- 6491937 TI - Serum and myocardial kinetics of amiodarone and its deethyl metabolite after intravenous administration in rabbits. AB - The serum kinetics of amiodarone and its major metabolite the deethyl analogue were studied in rabbits after intravenous administration. The elimination of the drug and the metabolite from serum occurred as a biexponential function. Both compounds exhibited a rapid distribution phase (6.5 and 4.4 min, respectively) and had elimination half-lives of 136 and 235 min, respectively. There was a rapid uptake of both drugs by the myocardium, with maximal concentrations at 5 and 15 min. The myocardial concentrations were higher than the respective serum concentrations and declined with time. There was a wide scatter in myocardium serum ratios, which ranged from 1 to 11 for amiodarone and 12 to 29 for the metabolite. Neither the drug nor the metabolite produced significant changes in the surface electrocardiogram after intravenous administration. These data suggest that accumulation of the metabolite does not account for the slow onset of action of amiodarone. PMID- 6491939 TI - Mass and heat transfer in vial freeze-drying of pharmaceuticals: role of the vial. AB - Flow of water vapor is impeded by three barriers or resistances: resistance of the dried-product layer, resistance of the semistoppered vial, and resistance of the chamber. The relationship between heat flow and temperature difference may be described by a vial heat transfer coefficient which has contributions from three parallel mechanisms: (a) direct conduction from the shelf to the vial via points of direct contact between the vial and shelf, (b) conduction through the vapor between the vial bottom and the shelf, and (c) radiative heat transfer. This report describes experimental studies of the resistance of semistoppered vials, the resistance of the chamber, and vial heat transfer coefficients. Mass transfer through the semistoppered vial has significant contributions from both Knudsen- and viscous-flow mechanisms. Stopper and chamber resistances are of the same magnitude and are about a factor of 10 less than the dried product resistance. All three heat transfer mechanisms are significant, the relative contributions depending on both the chamber pressure and the type of vial. Vial heat transfer coefficients are sensitive to the geometry of the vial bottom, and even vials of nominally the same specifications may differ significantly in heat transfer characteristics. Vials from the same lot are relatively uniform in their heat transfer characteristics, the relative standard deviation of the vial heat transfer coefficient being only approximately 4%. The temperature distribution in the frozen product is adequately described by a constant temperature gradient in the vertical direction and the thermal conductivity of ice. PMID- 6491940 TI - Determination of the chemical constituents and spectral properties of commercial and NF reference standard potassium guaiacolsulfonate: implications of the findings on compendial analytical methodology. AB - HPLC analysis confirmed a difference in the chemical composition of commercial versus NF reference standard potassium guaiacolsulfonate. After separation by fractional crystallization, the two constituents comprising the former sample were identified by 1H-NMR as potassium guaiacol-4- and -5-sulfonate, respectively. The former isomer predominated. The reference standard material was identified as the 4-sulfonate salt by HPLC, NMR, IR, and UV. This difference raises questions concerning the validity of the compendial identification tests and assay procedure for the drug, which are based on methods requiring direct comparison between it and the reference standard. In fact, the IR test has now been shown to be unreliable as a rigorous criterion for identification, in light of significant differences found in the fingerprint regions of the spectra of the two isomers. However, because the two isomers exhibit identical UV absorption characteristics in solutions of pH less than or equal to 7 (but not in alkaline solution), the compendial UV identification test and assay procedure appear to be valid under the conditions specified. The pKa values of the isolated isomers were estimated by a spectrophotometric method to be 8.74 and 9.16 for the phenolic group of potassium guaiacol-4- and -5-sulfonate, respectively. PMID- 6491941 TI - Synthesis of bridged catechol-homocysteine derivatives as potential inhibitors of catechol O-methyltransferase. AB - Catechol derivatives, covalently joined to homocysteine by sulfide or sulfonium linkages, were synthesized as potential catechol O-methyltransferase multisubstrate inhibitors which might bridge the enzymatic binding sites for the catechol substrate and the amino acid portion of the methyl donor S adenosylmethionine. These compounds were found to be less effective inhibitors than the product inhibitor S-adenosylhomocysteine. PMID- 6491942 TI - Effects of divalent amino acids on iron absorption. AB - Solutions of each of 10 amino acids or ascorbic acid were mixed with iron and orally administered to rats. Iron was absorbed to a statistically significantly greater extent (p less than 0.05) when mixed with asparagine, glycine, serine, or ascorbic acid as compared with a control solution of iron. The largest effects were for asparagine and glycine, which also increased iron absorption to a significantly greater extent (p less than 0.001) than did serine or ascorbic acid. No statistically significant increase in iron absorption occurred when any of the other amino acids was mixed with iron. The extent of iron absorption from each test solution, as measured by area under the concentration of iron-59 in the blood-time curve (r2 = 0.0002), and the initial rate of iron absorption for each test solution (r2 = 0.01) showed no correlation with the stability constant of the amino acid-iron complex. PMID- 6491944 TI - Nasal drug delivery system of a quaternary ammonium compound: clofilium tosylate. AB - The blood levels of the [14C]clofilium ion in rats after various routes of administration of clofilium tosylate were compared. The results indicate that the blood levels after nasal administration were not statistically different from levels after intravenous administration (p greater than 0.05). Administration by the oral route resulted in considerably lower blood levels. Nasal administration of clofilium tosylate appeared to be superior to oral administration. Histological examinations of nasal mucosa were conducted. At the lower concentration, mild necrosis was observed, and large areas of mucosa were unaffected. However, necrosis of large areas of mucosa occurred after exposure to the higher concentration. Levels of radioactivity in heart, liver, lung, and kidney tissue, as a function of time, were also studied. Unlike the blood levels after nasal administration, the levels of radioactivity were persistent in heart tissue. The data suggest that the [14C]clofilium ion and/or metabolite concentrate in the heart and that blood levels of radioactivity may not be an accurate index of cardiac levels or biological response. PMID- 6491943 TI - Evaluation of high-performance liquid chromatography and gas chromatography for quantitation of dextromethorphan hydrobromide in cough-cold syrup preparations. AB - A rapid and sensitive high-performance liquid chromatographic (HPLC) procedure is described for the analysis of the antitussive dextromethorphan hydrobromide in several cough-cold syrup preparations and compared with a gas chromatographic (GC) procedure. In the HPLC procedure, the active ingredient is analyzed as the hydrobromide salt by dilution in the mobile phase and separation on a reverse phase cyano column. In the GC method, the active ingredient is analyzed as the free base, in which an aqueous solution of the antitussive is made alkaline and extracted with dichloromethane before injection onto the GC column. Excellent resolution of the antitussive agent was obtained by both systems; however, the HPLC assay is preferred for routine analysis (RSD 1%), as compared with the GC assay (RSD 4%). PMID- 6491945 TI - Methods for in vitro percutaneous absorption studies III: hydrophobic compounds. AB - The absorption of two hydrophobic compounds through rat skin was measured by in vivo and in vitro techniques. The permeation of the fragrance ingredients 3 phenyl-2-propenyl 2-aminobenzoate (I) and 1-(3-ethyl-5,6,7,8-tetrahydro-5,5,8,8 tetramethyl-2-naphthalenyl)+ ethanone (II) was measured from a petrolatum and an acetone vehicle. Increases in permeation of 8-fold (I) and 95-fold (II) were observed when the compounds were tested in vivo under conditions similar to in vitro procedures. The apparent inability of the compounds to freely enter the diffusion cell receptor fluid was partially reversed by replacing normal saline with other fluids: rabbit serum, 3% bovine serum albumin, organic solvents, and dilutions of four nonionic surfactants. The effect of the receptor fluids on the integrity of the skin barrier was assessed by measuring the permeability of control compounds (cortisone, urea, and water). A 6% solution of polyethylene glycol 20 oleyl ether was the receptor fluid of choice. Without apparent damage to the skin, 61% (petrolatum vehicle) or 73% (acetone vehicle) of the in vivo absorption of I was obtained. With II, only 32% of the in vivo absorption was achieved (petrolatum vehicle). Even when the surfactant solution is used, significant differences may still remain between in vivo and in vitro results. PMID- 6491946 TI - Kinetics of aspirin absorption following oral administration of six aqueous solutions with different buffer capacities. AB - Fifteen volunteers each received two of six aspirin solutions in a balanced incomplete block design. The solutions contained 0, 3, 6, 10, 16, and 34 mEq of sodium bicarbonate-citric acid buffer and 650 mg of aspirin. Plasma aspirin levels were measured in blood samples collected frequently during the first 2.5 h, and the accumulation of aspirin, salicylic acid, and salicyluric acid were measured over 2 and 24 h. The most rapid absorption rates occurred with solutions which contained small quantities of the antacid buffer. The 3- and 6-mEq antacid buffers had mean maximal aspirin concentrations of 17.3 and 17.8 micrograms/mL, respectively. In the absence of the buffering agent, the 650 mg of aspirin failed to dissolve completely and gave a mean maximal plasma concentration of 13.4 micrograms/mL. With 34 mEq of a buffering agent, a delay in the onset of absorption occurred and the presystemic hydrolysis increased. This was probably because more aspirin was emptied into and absorbed from the small intestine with higher concentrations of the buffering agent. PMID- 6491947 TI - Determination of ethoxzolamide in the iris/ciliary body of the rabbit eye by high performance liquid chromatography: comparison of tissue levels following intravenous and topical administrations. AB - A specific high-performance liquid chromatographic method is described for ethoxzolamide following the extraction of the material from iris/ciliary body eye tissue in rabbits. The steps consist of base extraction and protein and enzyme deactivation, followed by acid treatment, extraction into ethyl acetate, evaporation, and solubilization with a 50% aqueous methanol solution. The samples were chromatographed on a reverse-phase phenyl column with a mobile phase consisting of 50% methanol in 1% acetic acid. The recovery was 74.3% over a 10 fold range of tissue concentrations. The sensitivity was 0.03 microgram/mL, and the response was linear over the concentration range (0.03-0.5 microgram/mL) used in the study. Intravenous (2.0- and 6.0-mg/kg) and topical (1% suspension) doses of ethoxzolamide were administered to rabbits. Iris/ciliary body tissues were excised 45 min after drug administration. The tissue levels after a dose of 6 mg/kg were statistically greater than the levels obtained after a dose of 2 mg/kg. The smaller intravenous dose represented the lowest dose for which a reduction in intraocular pressure could be measured. An initial transitory drop in intraocular pressure was detected for the topical dose. Iris/ciliary body levels in the treated eye could be detected for the 2-mg/kg iv and topical doses. PMID- 6491948 TI - Factors affecting quinidine protein binding in humans. AB - The free (unbound) concentration of drug in plasma is often an important determinant of pharmacological and toxicological effects. Unfortunately, studies examining the factors influencing the free fraction of quinidine in plasma have yielded inconsistent results. It is probable that differences in the type of blood collection tubes utilized and the analytical procedure employed biased some of these estimates of quinidine binding. The present study was executed in a manner free of factors now known to introduce artifacts into estimates of the free fraction of quinidine. In healthy volunteers, the free fraction of quinidine (1.0 microgram/mL) was 0.129 +/- 0.019 (mean +/- SD) and was constant throughout the therapeutic range. A high-affinity, low-capacity binding site (K = 1.17 X 10(5) M-1; nP = 3.49 X 10(-5) M) and a low-affinity, high-capacity binding site (K = 1.33 X 10(3) M-1; nP = 3.14 X 10(-3) M) were identified. The characteristics of quinidine binding in a 4.5-g/dL solution of human serum albumin (K = 3.05 X 10(3) M-1; nP = 1.36 X 10(-3) M) suggested that the low-affinity, high-capacity binding site was on this quinidine free fraction increased from 0.114 to 0.231. A lidocaine concentration of 250 micrograms/mL caused a similar increase. Patients suffering traumatic injury had a significant increase in alpha 1-acid glycoprotein concentration (197 mg/dL) and a decreased quinidine free fraction (0.075 +/- 0.019). Patients with hyperlipidemia had free fractions similar to those observed in healthy individuals (0.118 +/- 0.019).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491949 TI - Simple, rapid method for comparing the self-emulsifiability of hydrocarbon oils. AB - A simple and rapid method for comparing the degree of self-emulsifiability of different hydrocarbon oils is described. The method involved measurement of the intensity of light scattered at an angle of 31 degrees to the incident radiation by the sample. The extent or degree of self-emulsification of selected hydrocarbon oils was observed to be affected by the nature of the oil as well as by the type and concentration of the surfactants employed. The method is useful when screening surfactant-hydrocarbon oil combinations as potential vehicles for drugs in the pharmaceutical industry or herbicides and pesticides for agricultural purposes. PMID- 6491950 TI - Analytical methods for the determination of sulindac and metabolites in plasma, urine, bile, and gastric fluid by liquid chromatography using ultraviolet detection. AB - A high-performance liquid chromatographic method using a linear elution gradient has been developed for the analysis of sulindac, sulindac sulfone, and sulindac sulfide in plasma, urine, bile, and gastric fluid. The methodology uses reverse phase, radial compression chromatography with gradient elution, and UV detection. Sulindac and its metabolites in plasma can be quantitated at 0.25 microgram/mL with a mean CV of 6.0 +/- 2.9%; urine, bile, and gastric fluid (0.5 microgram/mL) yield a mean CV of 5.5 +/- 1.9%. PMID- 6491951 TI - Microcalorimetric investigation of the binding of some chemotherapeutic agents and related molecules to calf thymus DNA. AB - Batch microcalorimetry was used to estimate directly the standard enthalpies of the binding of small molecules to DNA. These values were compared with those obtained from spectrophotometric binding constants and van't Hoff plots. The close agreement between the independently obtained enthalpies indicates that the appropriate (best) binding model has four phosphates per binding site. Thermodynamic binding constants were obtained from apparent binding constants measured at different ionic strengths. From these and the measured standard enthalpies, standard free energies and standard entropies of binding were calculated. The weak, presumably external, binding alleged to occur at high formal molar concentration ratios of ligand to DNA bases could not be detected by a measurable heat of binding. PMID- 6491952 TI - Percutaneous absorption of corticosteroids: age, site, and skin-sectioning influences on rates of permeation of hairless mouse skin by hydrocortisone. AB - As part of a long-range plan to decipher the mechanism of mass transfer of corticosteroids across skin, the permeation of [3H]hydrocortisone through hairless mouse skin was characterized by in vitro diffusion cell techniques. Age and anatomical site-related behaviors were explored mainly with whole skin but also with skin stripped of its horny layer. Permeability of the mouse skin was low shortly after birth and increased during the singular normal hair cycle exhibited by the SKH-hr-1 mouse strain. The return to a hairless state over a period of 20-35 d was accompanied by decreased permeability of hydrocortisone. A permeability coefficient of approximately 2 X 10(-4) cm/h was found for the mature mouse. For whole skin, there was no difference in the permeabilities of dorsal and abdominal skin sections, but for stratum corneum-free membranes and dermal membranes, the abdominal site appeared to be more permeable, which is consistent with its thinner dimensions. Totally stripped skin and isolated dermis are approximately 500 and approximately 1000 times more permeable than intact skin, respectively; the unaltered stratum corneum of the hairless mouse is thus shown to be the major barrier to the mass transfer of hydrocortisone. PMID- 6491953 TI - Determination of minoxidil in bulk drug and pharmaceutical formulations by ion pairing high-performance liquid chromatography. AB - An ion-pairing liquid chromatographic method with UV detection is described for the determination of minoxidil in bulk drug, compressed tablet, and topical solution formulations. The chromatographic system consists of a microparticulate octadecylsilica column and a mobile phase composed of sodium dioctylsulfosuccinate in aqueous methanol (pH 3). The bulk drug and the topical solution samples are prepared by the dissolution of the drug in internal standard solution. Sample preparation for the compressed tablet formulation involves dissolving the drug from an aliquot of pulverized sample and centrifuging to remove insoluble excipients. Quantitative recovery of minoxidil from formulation excipients was demonstrated; assay precision was less than 1% CV. PMID- 6491954 TI - Improved bioassay for glucagon by continuous glucose monitoring. AB - A simplified and rapid in vivo bioassay for glucagon is described. The test involves continuous monitoring of blood glucose which makes possible an exact rendering of the glucose peaks induced by intravenous injection of glucagon. Two injections of known amounts of glucagon (0.002 and 0.004 U) are followed by an intravenous injection of a solution containing an unknown amount of glucagon for testing. The whole procedure can be completed in 8 h. The interassay variability of 6 bioassay procedures was +/- 12.4%. The intra-assay variability was +/- 3%. PMID- 6491955 TI - Nasal absorption of testosterone in rats. AB - Testosterone levels in the blood were determined in rats following nasal, intravenous, and intraduodenal administration of 25-micrograms and 50-micrograms doses. The results indicated that the drug levels after nasal and intravenous administration were similar, whereas intraduodenal administration resulted in considerably lower levels. The bioavailability of the nasally administered drug was calculated to be 99% and 90% at the 25-micrograms and 50-micrograms doses, respectively. The intraduodenal bioavailability was only 1% at the dose studied. PMID- 6491956 TI - Colorimetric determination of gentamicin, kanamycin, tobramycin, and amikacin aminoglycosides with 2,4-dinitrofluorobenzene. AB - The reaction of 2,4-dinitrofluorobenzene (Sanger's reagent) is used to form colored products with aminoglycoside antibiotics. Stopping the progress of the reaction with acid after a fixed time allows aqueous solubility to be maintained while discharging any color due to excess reactant. The choice of an appropriate analytical wavelength results in adherence to Beer's law. Although this colorimetric method is not expected to be stability-indicating, it is convenient and should be useful in content uniformity determinations for pharmaceutical dosage forms (e.g., ointments). PMID- 6491957 TI - High-performance liquid chromatographic determination of the nitrate esters isosorbide dinitrate, pentaerythritol tetranitrate, and erythrityl tetranitrate in various tablet forms. AB - A reliable, sensitive, and specific assay for isosorbide dinitrate pentaerythritol tetranitrate, and erythrityl tetranitrate in sublingual, uncoated, sustained-release, and chewable dosage forms, using high-performance liquid chromatography, is described. The nitrate ester dosage forms were dissolved in methanol, filtered, and injected directly into the liquid chromatograph. A variable-wavelength UV detector, operated at 220 nm, and a reverse-phase C18 microporous silica column were employed. The mobile phase was methanol-water (40:60). The proposed method is quantitative and reproducible. PMID- 6491958 TI - Determination of ethylene oxide, ethylene chlorohydrin, and ethylene glycol in aqueous solutions and ethylene oxide residues in associated plastics. AB - A gas chromatographic (GC) method was developed for the determination of ethylene oxide and its two reaction products, ethylene chlorohydrin and ethylene glycol, in aqueous ophthalmic solutions. Propylene oxide was used as an internal standard. All three components were determined in one isothermal chromatographic analysis in less than 15 min. An extraction method for the determination of ethylene oxide residues in plastic components was also developed, and certain plastics with different ethylene oxide retention characteristics were identified. PMID- 6491959 TI - Anti-influenza A activity of some N-substituted bicyclo[3.2.1]octane-3-spiro-3' pyrrolidine hydrochlorides: synthesis and structure. AB - Some N-substituted bicyclo[3.2.1]octane-3-spiro-3'-pyrrolidine hydrochlorides (IX XII) prepared from bicyclo[3.2.1]octan-3-one (I), were assayed in vitro against influenza A viruses. All materials showed activity similar to 1-adamantanamine hydrochloride. A 1H-NMR study revealed only one isomer at the spiro carbon atom. PMID- 6491960 TI - Distribution and elimination of polymethyl methacrylate nanoparticles after peroral administration to rats. AB - Polymethyl [1-14C]methacrylate nanoparticles were administered orally to bile cannulated rats. Ten to fifteen percent of the administered radioactivity was absorbed and found in the bile and urine. Within 48 h, 94-97% of the absorbed radioactivity had been eliminated from the body. After 8 d, the highest residual radioactivity was found in the bone marrow, fatty renal tissue, stomach, liver, and lymph nodes. PMID- 6491961 TI - High-performance liquid chromatographic determination of acetylcholine in a pharmaceutical preparation. AB - A simple and rapid method for quantitating acetylcholine in a lyophilized preparation by high-performance liquid chromatography (HPLC) is described. A reverse-phase column with a refractive index detector was utilized for the assay. The HPLC system was able to separate acetylcholine from choline, a major degradation product, which was verified by running a degraded sample of a commercial preparation. The HPLC results were compared with the results obtained by a spectrophotometric procedure. PMID- 6491962 TI - Electron-capture capillary gas chromatographic determination of phenylpropanolamine in human plasma following derivatization with trifluoroacetic anhydride. AB - A capillary gas chromatographic analysis of phenylpropanolamine in human plasma, following extraction and derivatization with trifluoroacetic anhydride, is presented. Using an electron-capture detector, the method was sensitive enough to quantitate as little as 1 ng of drug/mL of plasma. The coefficient of variation from 5-262 ng/mL varied between 5.6 and 1.6%, respectively. Plasma concentration data following one 25-mg dose of phenylpropanolamine hydrochloride in four healthy volunteers illustrates the suitability of this analytical method for monitoring plasma levels after oral administration of a typical dosage form. PMID- 6491963 TI - Determination of sodium levothyroxine in bulk, tablet, and injection formulations by high-performance liquid chromatography. AB - Sodium levothyroxine was determined in bulk drugs, tablets, and injections by high-performance liquid chromatography (HPLC). Levothyroxine was separated from excipients and impurities on a 10-microns cyanoalkyl column using an acetonitrile water-phosphoric acid mobile phase. The HPLC method is shown to be linear, accurate, and precise, and the results obtained by the HPLC and USP XX methods are compared. PMID- 6491964 TI - Determination of isosorbide 5-mononitrate in human plasma by capillary column gas chromatography. AB - An electron-capture gas chromatographic method for the determination of isosorbide 5-mononitrate in human plasma using a capillary column is described. Isosorbide 5-mononitrate and the internal standard (isosorbide dinitrate) are extracted from the alkalinized plasma with ether. The lower limit of detection for isosorbide 5-mononitrate is 1 ng/mL of plasma. PMID- 6491965 TI - Instrumentation of a tablet breaking-strength tester. AB - The instrumentation of a tablet breaking-strength tester, for the automatic recording of hardness values, is described. A comparison is made between a computerized hardness tester and another identical model hardness tester from the same manufacturer ("standard"). Three lots of placebo tablets at different hardness values were compared. No significant difference was observed between the computerized unit compared with the "standard" unit. PMID- 6491966 TI - High-performance liquid chromatographic-ultraviolet determination of primaquine and its metabolites in human plasma and urine. AB - A high-performance liquid chromatographic method was developed for the simultaneous determination of primaquine and its metabolites from plasma and urine samples obtained after oral administration of primaquine diphosphate. Following partial deproteinization with acetonitrile, samples were chromatographed by direct injection onto a cyano column with UV detection at 254 nm. Levels as low as 100 ng/mL per 20-microL injection were quantitated. Preliminary pharmacokinetic analysis is reported for two human volunteers after oral doses of 60 mg and 90 mg. Two apparent plasma metabolites and two possible urinary metabolites of primaquine are also reported. PMID- 6491967 TI - Quantitation of metronidazole in pharmaceutical dosage forms using high performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) method for the quantitation of metronidazole in pharmaceutical dosage forms has been developed. The method is accurate and precise with an RSD of 0.68%, based on six readings. The excipients present in various dosage forms did not interfere with the assay procedure. A solution of metronidazole decomposed using heat showed 0% potency. PMID- 6491968 TI - A reply to "Problems involved with developing a suitable model for evaluating exposure to bis(2-ethylhexyl) phthalate for medical devices". PMID- 6491969 TI - Isosorbide dinitrate disposition in the rat: metabolite pharmacokinetics and interactions. AB - The pharmacokinetics of isosorbide dinitrate (ISDN) and its isomeric mononitrate metabolites (2- and 5-ISMN) were examined in the rat. At a dose of 2 mg/kg, the oral bioavailability of ISDN was found to be about 40%. This finding corrects a previous belief that organic nitrates, when administered via the oral route, are completely metabolized by hepatic first-pass metabolism. ISDN was metabolized exclusively via its mononitrate metabolites, with the 5-ISMN being the principal product (about 90%). The ratio of 2- to 5-ISMN produced was dependent on the route of administration, being 0.18 +/- 0.03 after i.v. dosing and 0.11 +/- 0.03 after oral dosing (both mean +/- S.D.). 2-ISMN was found to decrease the plasma clearance of ISDN; this metabolite interaction occurred when drug and metabolite were administered either at the same or different intravascular sites. 5-ISMN did not affect ISDN plasma clearance when these compounds were administered at different intravascular sites. However, when 5-ISMN and ISDN were given at the same vascular site, a decrease in plasma ISDN clearance was observed. These results provide an interesting example of divergent pharmacokinetic interactions exhibited by two isomeric metabolites. PMID- 6491971 TI - Selective inhibition by chloramphenicol of cytochrome P-450 isozymes in rat lung and liver involved in the hydroxylation of n-hexane. AB - Treatment of rats with chloramphenicol causes a dose-dependent and regioselective inhibition of the metabolism of the organic solvent n-hexane in both liver and lung microsomes. A dose of chloramphenicol of 100 mg kg-1 administered i.v. or i.p. results in more than 50% inhibition of 2-hexanol formation catalyzed by microsomes from both organs, but causes no inhibition of 1-hexanol formation. The effects of chloramphenicol on 3-hexanol formation are somewhat organ-specific. In the liver 3-hexanol formation is inhibited to almost the same extent as 2-hexanol formation, whereas in the lung the inhibition of the formation of 3-hexanol is markedly less. Phenobarbital induces n-hexane metabolism in the liver but not the lung, but decreases the inhibitory potency of chloramphenicol toward both organs. In vitro chloramphenicol causes both reversible and irreversible inhibition of 2 hexanol formation in control lung microsomes. The irreversible inhibition is accompanied by the covalent binding of metabolites of chloramphenicol to the lung microsomes. The covalent binding is completely inhibited by antibodies to the major phenobarbital-induced isozyme of rat liver cytochrome P-450. These antibodies also cause more than 90% inhibition of 2-hexanol formation by lung microsomes. The results suggest that chloramphenicol acts as a selective suicide substrate of a constitutive isozyme of rat lung cytochrome P-450 involved in the 2-hydroxylation of n-hexane. PMID- 6491970 TI - The neurotoxic compound N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine hydrochloride (DSP4) depletes endogenous norepinephrine and enhances release of [3H]norepinephrine from rat cortical slices. AB - The alkylating compound N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine hydrochloride (DSP4) injected to rodents blocks norepinephrine (NE) uptake and reduces endogenous NE levels in the central nervous system and in the periphery. To investigate the processes leading to these alterations, rat cortical slices were incubated in the presence of DSP4. Cortical NE was depleted by 40% after incubation of slices in 10(-5) M DSP4 for 60 min and this was blocked by desipramine. The spontaneous outflow of radioactivity from cortical slices labeled previously with [3H]NE was enhanced markedly both during exposure to DSP4 and during the subsequent washings, suggesting that NE depletion could be due to this stimulation of NE release. The radioactivity released by DSP4 was accounted for mainly by NE and its deaminated metabolite 3,4-dihydroxyphenylglycol. The enhanced release, independent of external Ca++, apparently originated from the vesicular pool as it was absent after reserpine pretreatment. Activities of the enzymes related to NE synthesis were not altered by DSP4 in vitro and only monoamine oxidase activity was inhibited at high concentrations. Thus, the depletion of endogenous NE produced by DSP4 is probably due to a persistent enhancement of its release from the vesicular pool. Fixation of DSP4 to the NE transport system is necessary but not sufficient to produce the acute NE depletion and the characteristic long-term actions of the compound. PMID- 6491972 TI - Carbamazepine decreases catecholamine turnover in the rat brain. AB - The anticonvulsant carbamazepine (100 mg/kg i.p.) increased the levels of 3 methoxy-4-hydroxyphenylglycol sulfate in the rat brain as well as its accumulation after inhibition of acid transport by probenecid. It did not interfere with 3-methoxy-4-hydroxyphenylglycol sulfation in vivo. However, this was not corroborated by the results of turnover studies. The depletion of brain norepinephrine after inhibition of tyrosine hydroxylase or dopamine (DA) beta hydroxylase rather tended to be decreased and the accumulation of DA in the rat heart after DA beta-hydroxylase inhibition was diminished. Carbamazepine also reduced the depletion of striatal DA after tyrosine hydroxylase inhibition and the accumulation of striatal dopa after central decarboxylase inhibition, but did not affect the levels of the deaminated DA metabolites, homovanillic acid and 3,4 dihydroxyphenylacetic acid, even after pretreatment with probenecid. Therefore, carbamazepine seems to reduce catecholamine turnover in spite of its enhancing action on the firing of norepinephrine and DA neurons reported in the literature. These apparently paradoxical effects might be explained by an interference with the catecholamine storage mechanism. Two other anticonvulsants, diphenylhydantoin and phenobarbital, in doses approximately equieffective to that of carbamazepine with respect to their anticonvulsant action, showed similar although somewhat weaker effects on DA, but not on norepinephrine turnover. Within the catecholamine hypothesis of affective disorders, the reduction of catecholamine turnover by carbamazepine might explain the reported antimanic and antipsychotic effects in patients. PMID- 6491973 TI - Microinjection of neostigmine into the pontine reticular formation of cats enhances desynchronized sleep signs. AB - Microinjection of the acetylcholinesterase inhibitor neostigmine into the dorsal pontine tegmentum of intact, freely moving cats produced significant changes in electrographic desynchronized (D) sleep signs and D sleep-like behavior. The percentage, frequency and duration of D sleep signs were increased and the latency to onset of D sleep signs was significantly reduced after neostigmine administration. The effects of neostigmine were dose-dependent and could be blocked by centrally administered atropine. This is the first demonstration that microinjection of an acetylcholinesterase inhibitor into the pons enhances D sleep signs. These data suggest that endogenously released acetylcholine can initiate and maintain the state of D sleep and strongly support the cholinergic hypothesis of D sleep generation. PMID- 6491974 TI - Cellular potentials, electrogenic sodium pumping and sensitivity in guinea-pig atria. AB - Intracellular recording techniques in guinea-pig atrial pacemaker and nonpacemaker cells were used to investigate 1) the role of membrane potential changes in postjunctional supersensitivity, 2) the electrogenicity of the Na+,K+ pump and 3) the role of electrogenic pumping in sensitivity of the atria to agonists. In nonpacemaker cells, ouabain (10(-6) M) had no effect on resting membrane potential (left atria) or maximum diastolic potential (right atria). However, ouabain effectively suppressed the transient hyperpolarization that followed cessation of electrical stimulation. In pacemaker cells, ouabain and chronic treatment with reserpine (0.1 mg/kg/day) produced quite different patterns of changes in intracellular potentials. Chronic treatment with reserpine induced chronotropic supersensitivity to isoproterenol but not to histamine. Ouabain did not alter the chronotropic sensitivity to either agonist. The effects of isoproterenol and histamine on intracellular potentials in pacemaker cells were investigated in the presence and absence of ouabain and in control atria vs. atria from guinea pigs chronically pretreated with reserpine. Analysis of the data indicated that 1) electrophysiological measurements do not provide a discernible explanation for chronotropic supersensitivity, 2) the Na+ pump has the capacity for electrogenic pumping under conditions of Na+ loading, but demonstrates little indication of electrogenicity under basal conditions and 3) chronic treatment with reserpine does suppress the Na+,K+ pump in some areas of the right atrium, but this activity probably does not contribute to chronotropic supersensitivity. Other possible mechanisms of postjunctional supersensitivity in atria are discussed. PMID- 6491975 TI - Distribution of methylphenidate and p-hydroxymethylphenidate in rats. AB - Rats were administered threo-dl-methylphenidate (MPH) i.v., i.p. and p.o. A gas chromatography-mass spectrometry method incorporating deuterated internal standards was used to quantify MPH and the metabolite threo-dl-p hydroxymethylphenidate (HOMPH). Accumulation and decay of MPH were evaluated in serum and brain to assess whether serum MPH correlated with brain content. HOMPH was quantified to appraise its contribution to the central action of MPH. MPH accumulated in the brain at a concentration of 3.75 microgram/g tissue within 1 min after i.v. injection of 1 mg/kg, and averaged 8 times the concentration in serum over the first 30 min. The steady-state volume of distribution was 1.47 liters/kg. The decay of MPH from brain and serum occurred biphasically with postdistribution (beta) T1/2 values of 20 and 50 min, respectively. After p.o. administration (1 mg/kg), brain MPH concentrations also exceeded those in serum. HOMPH was detected only in liver and kidney after 1 mg/kg MPH (i.v. and p.o.). Thirty minutes after 20 mg/kg of MPH (i.p.), MPH accumulated in kidney greater than lung greater than brain greater than heart greater than liver. Brain MPH concentration was 900 times that of HOMPH (0.02 microgram/g) after this dose. In liver, conjugated HOMPH was present (12.1 microgram/g). After i.v. administration of HOMPH, less localization occurred in brain than occurred for MPH. These data suggest that the central effects of MPH do not depend upon conversion to HOMPH. PMID- 6491976 TI - Pharmacokinetic and pharmacodynamic studies of acute interaction between warfarin enantiomers and metronidazole in rats. AB - This investigation was designed to determine if the reported stereoselectivity of the pharmacokinetic interaction between warfarin and metronidazole in humans occurs also in rats and if the potentiation of the anticoagulant effect of warfarin can be ascribed solely to inhibition of warfarin metabolism by metronidazole. Metronidazole had no effect on the serum protein binding of racemic warfarin in vitro over a wide concentration range but decreased the protein binding of R-(+)-warfarin and S-(-)-warfarin in vivo, perhaps indirectly through metabolite(s). Treatment with i.p. metronidazole, 100 mg/kg every 6 hr, decreased the plasma clearance of free warfarin ("intrinsic clearance"). This inhibitory effect was more pronounced with S-(-)-warfarin than with R-(+) warfarin (congruent to 60 and congruent to 30%, respectively). Metronidazole did not affect plasma prothrombin complex activity in vitro but reduced it in vivo. Metronidazole treatment increased the elimination rate constant for endogenous prothrombin complex activity and decreased the plasma concentration of free R-(+) warfarin required to decrease prothrombin complex activity synthesis rate to one half of normal (there were insufficient data to determine the effect of metronidazole on the activity of the other enantiomer). It is concluded that metronidazole preferentially inhibits the metabolism of S-(-)-warfarin in rats as in humans but that (at least in rats) the stereoselectivity is not absolute. Moreover, metronidazole has an indirect inhibitory effect on warfarin protein binding in vivo and also affects the pharmacodynamics of warfarin as well as the blood clotting process per se. PMID- 6491977 TI - Pharmacokinetic and pharmacodynamic studies of acute interaction between warfarin enantiomers and chloramphenicol in rats. AB - The purpose of this investigation was to explore the mechanisms and possible stereoselectivity of the interaction between warfarin and chloramphenicol in rats. Chloramphenicol had no apparent effect on the serum protein binding of R (+)-warfarin or S-(-)-warfarin in vitro or in vivo. Treatment with i.p. chloramphenicol, 50 mg/kg every 4 hr or 30 mg/kg every 6 hr, decreased the plasma clearance of free warfarin by one-half or more, with no apparent stereoselectivity. The volume of distribution was not significantly affected; the half-life of each warfarin enantiomer was appreciably increased by chloramphenicol. Treatment with chloramphenicol had no apparent effect on relative liver size and on serum aspartate aminotransferase activity. Prothrombin complex activity in plasma was not affected by in vitro addition or in vivo administration of chloramphenicol alone. Chloramphenicol treatment did not affect significantly the elimination kinetics of endogenous prothrombin complex activity and the plasma concentration of free R-(+)-warfarin or S-(-)-warfarin required to decrease prothrombin complex activity synthesis rate to one-half of normal. It appears that the pronounced potentiation of the anticoagulant effect of warfarin by chloramphenicol is due only to inhibition of warfarin metabolism and that this effect is not stereoselective. PMID- 6491978 TI - Leukotriene D4 inhibits cardiovascular responses to sympathetic stimulation, angiotensin and vasopressin in the pithed spontaneously hypertensive rats. AB - We have previously shown that high doses of leukotriene D4 (LTD4) induces hypotension in conscious and in pithed spontaneously hypertensive rats. The present study was designed to determine whether the hypotensive effect of LTD4 in spontaneously hypertensive rats is due to reduced sensitivity of peripheral blood vessels to pressor stimuli and/or reduced responsiveness of the sympatho adrenomedullary system. To test these possibilities we examined the effect of spinal cord stimulation, vasopressin, norepinephrine and angiotensin II on blood pressure, heart rate and plasma catecholamines of pithed spontaneously hypertensive rats, before and after treatment with LTD4 (20 micrograms/kg i.v.), a dose which produces hypotension in conscious and pithed rats. LTD4 suppressed the pressor responses to spinal cord stimulation (50 V, 1 msec, for 1 min) at 0.3 and 3.0 Hz by 64% (P less than .001) and 71% (P less than .001), respectively, and the pressor and cardiac accelerating effects of systemic injections of norepinephrine. Plasma norepinephrine response to spinal cord stimulation at 3.0 Hz was significantly (P less than .05) reduced after administration of LTD4. The evoked release of epinephrine from the adrenal medulla was enhanced (+139%, P less than .05) by LTD4, but the tachycardia was blocked. The pressor responses to 0.1 and 1.0 microgram/kg of angiotensin II were blocked by 73% (P less than .05) and 70% (P less than .01), respectively. The pressor effects produced by vasopressin (0.03 and 0.1 microgram/kg) were also attenuated (by 83 and 80%, respectively) after LTD4 administration. The depressor effect of sodium nitroprusside (0.01-0.1 mg/kg) was also attenuated by LTD4. These data suggest that LTD4-induced hypotension involves severe interference with vascular smooth muscle responsiveness to all pressor agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491979 TI - Effects of acetylcholine in the pulmonary circulation of rabbits. AB - The pulmonary and systemic vascular beds differ in their response to several vasoactive substances. Acetylcholine (ACh) is a potent systemic vasodilator; however, its effects on the pulmonary circulation are not clear. Utilizing the isolated rabbit lung preparation perfused in situ under constant flow (92 +/- 3 ml/min) with an albumin-enriched physiologic salt solution, we studied the effects of graded concentrations of ACh (10(-10) to 10(-4) M) in the recirculating perfusate on pulmonary arterial pressure (PAP). The lungs were ventilated to 15 cm of water with 97% O2-3% CO2. ACh (10(-8) to 4 X 10(-7) M) produced a dose-dependent increase in PAP which required up to 20 min to return to predrug levels. Physostigmine (10(-5) M) maintained the maximal PAP response to ACh for the duration of the experiment (up to 2 hr). Higher concentrations of ACh produced rapid increases in PAP resulting in edema. Pre- or post-treatment with the muscarinic receptor antagonist atropine (10(-5) M) completely prevented or reversed the pressor effects of ACh, respectively. Histamine receptor (H1 and H2) or angiotensin II receptor blockade had no effect on the PAP actions of ACh, however pretreatment with the prostaglandin synthesis (cyclooxygenase) inhibitor indomethacin (10(-5) M) or aspirin (10(-3) M), completely abolished the PAP response to ACh up to concentrations of 10(-4) M. In experiments in which airway pressure was allowed to vary, it rose significantly in response to increasing concentrations of ACh. ACh-induced increases in airway pressure were unaffected by pretreatment with indomethacin (10(-5) M) but were totally inhibited by pretreatment with atropine (10(-5) M).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6491980 TI - Pharmacological characterization of dopamine autoreceptors in the rat ventral tegmental area: microiontophoretic studies. AB - Extracellular single-cell recording and microiontophoretic techniques were used to characterize the presynaptic dopamine (DA) receptors (autoreceptors) on A10 DA neurons in the rat ventral tegmental area. Thus, the ability of various agonists to inhibit the activity of A10 DA neurons was compared. DA and the DA agonists N n-propylnorapomorphine (NPA), apomorphine, lisuride, pergolide, LY141865 and bromocriptine all suppressed the activity of A10DA neurons. NPA was the most potent exogenous agonist, exerting effects that were similar to an equimolar concentration of DA (0.01 M). When ejected at equimolar concentrations (0.01 M) and equivalent ejection currents, the rank order of potency for these agonists was DA = NPA greater than LY141865 greater than pergolide = lisuride = apomorphine greater than norepinephrine greater than bromocriptine. The alpha-2 adrenoceptor agonist clonidine, the beta adrenoceptor agonist isoproterenol, the D-1 specific DA agonist SKF 38393 and the hallucinogenic ergot lysergic acid diethylamide exerted only weak effects or were inactive. The D-2 specific DA antagonist sulpiride completely blocked the rate-suppressant effects of DA and DA agonists but not those of gamma-aminobutyric acid. The purported D-1 specific DA antagonist SCH 23390 failed to block the effects of either DA or the D-2 specific DA agonist LY141865. These results indicate that DA agonists suppress the activity of the majority of A10 DA neurons by acting directly on somatodendritic DA autoreceptors which exhibit the pharmacological characteristics of D-2 receptors. PMID- 6491981 TI - Autoregulation of cardiac cycle length: role of catecholamines. AB - The mechanism of autoregulation of cardiac cycle length during phasic alterations in perfusion via the sinus node artery is unclear. Inasmuch as transient catecholamine release has been documented during sinus node artery injections, we sought to determine whether autoregulation of cycle length might be related to a beta receptor-mediated process. We used chloralose-anesthetized mongrel dogs. A right thoracotomy was performed, the vagi and sympathetic inputs to the heart were cut and electrograms were recorded from the sinoatrial (SA) node, right atrium, right ventricle and His bundle. The SA node artery was catheterized and distribution verified. Perfusion of normal Tyrode's solution via the SA node artery at 3 ml/min resulted in significant cycle length slowing which was maximal immediately after onset of perfusion. Plots of the derivative of cycle length with respect to time indicated either a monophasic or biphasic pattern of response. Administration of propranolol (2 mg/kg i.v.) resulted in a significant prolongation of control cycle length. Perfusion of normal Tyrode's solution after propranolol resulted in significantly greater degrees of cycle length prolongation (as judged by integration of area under cycle length curves) as well as only monophasic response patterns. These results suggest that infusions of normal Tyrode's solution, via the SA node artery, at physiologic flow rates are accompanied by concurrent catecholamine release throughout the infusion. This catecholamine release may contribute to the homeostatic regulation of cardiac cycle length. PMID- 6491982 TI - Application of second-order polynomial equations to the study of pharmacodynamic interactions: the effect of flecainide acetate and propranolol on cardiac output and vascular resistance. AB - We have examined the analysis of pharmacodynamic data in normal subjects receiving propranolol, flecainide or the two together. We find that a second order polynomial describes accurately the response of the left ventricular ejection fraction, cardiac output and vascular resistance of the subjects to these drugs. Both single dose and multiple doses of propranolol (80 mg 3 times a day) decreased the left ventricular ejection fraction and cardiac output, but increased the vascular resistance. On the other hand, single and multiple doses of flecainide (200 mg twice a day) decreased the left ventricular ejection fraction but did not affect either the cardiac output or vascular resistance. These data demonstrate the power of the polynomial formulation in analyzing pharmacodynamic data. PMID- 6491983 TI - Hepatic and pulmonary microsomal metabolism of naphthalene to glutathione adducts: factors affecting the relative rates of conjugate formation. AB - Earlier studies demonstrating marked differences in the profile of polar metabolites formed during incubations of glutathione, naphthalene and microsomes from target (lung) and nontarget (liver and kidney) tissues of the mouse suggested that the formation of a particular reactive metabolite may be the underlying basis for the highly organ selective toxicity of this hydrocarbon. The studies reported here were done to characterize more fully the microsomal metabolism of naphthalene to 1,2-dihydro-1,2-dihydroxynaphthalene and to three glutathione-derived conjugates that were separated by high-pressure liquid chromatography. The microsomal formation of polar naphthalene metabolites was linear with time and microsomal protein; the relative proportions of each of the metabolites remained relatively stable over the range of time and protein concentrations studied. The rate of formation of naphthalene glutathione adducts, but not the dihydrodiol, was dependent upon the amount of 100,000 X g supernatant protein added. Addition of lung cytosol to liver microsomal incubations or liver cytosol to lung microsomal incubations altered the overall rate of conjugate formation but not the relative proportions of each of the three conjugate peaks. Epoxide hydrolase induction by dietary butylated hydroxyanisole or inhibition by cyclohexene oxide altered the rate of hepatic microsomal formation of naphthalene dihydrodiol in the expected manner and increased the production of conjugate peak 2. Butylated hydroxyanisole or cyclohexene oxide failed to alter the rate of formation of conjugate peak 1 or 3. Addition of piperonyl butoxide or SKF 525-A to hepatic microsomal incubations markedly decreased covalent binding of naphthalene metabolites but only slightly decreased glutathione adduct formation. Dihydrodiol formation was increased by both inhibitors. Phenobarbital or 3 methylcholanthrene pretreatment produced a marked increase in the pulmonary microsome-catalyzed formation of all four polar naphthalene metabolites. In comparison, phenobarbital increased the rates of formation of the dihydrodiol, conjugate peaks 1 and 2 but not 3 in hepatic microsomes. 3-Methylcholanthrene increased the rate of formation of the dihydrodiol and conjugate peak 2 but not 1 or 3. These studies indicate that the predominant formation of conjugate peak 2 in lung microsomal incubations in comparison to liver microsomal incubations is due to the regio- or stereoselectivity of naphthalene metabolism by cytochrome P 450 monooxygenases or epoxide hydrolases but not by the glutathione transferases. PMID- 6491984 TI - Effects of hemodynamic changes on the elimination kinetics of verapamil and nifedipine. AB - This study used a steady-state approach to evaluate the relationships between the pharmacodynamic and pharmacokinetic characteristics of nifedipine and verapamil. In anesthetized and instrumented dogs, i.v. bolus/infusion dosing regimens were used for each drug to achieve and maintain stable drug concentrations in four different ranges rapidly. For both compounds, increases in doses were associated with disproportionate higher plasma drug concentrations, greater hemodynamic effects and significant reductions in systemic drug clearance. Progressive increases in the dose of nifedipine produced reductions in arterial pressure and reflex augmentation in cardiac output, together with decreases in calculated hepatic plasma flow which closely paralleled the decline in mean aortic pressure. Increasing doses of verapamil also resulted in decreased hepatic plasma flow, which was associated with both systemic hypotension and drug-induced decreases in cardiac output. These data imply that the hemodynamic effects of both nifedipine and verapamil result in changes in hepatic plasma flow which, in turn, result in significant alterations in systemic drug clearance. In this experimental model, the calculated hepatic plasma flow and observed systemic clearance values for nifedipine and verapamil were closely related to concentrations of the respective drugs in plasma. PMID- 6491985 TI - Effects of thioridazine and its metabolites on dopaminergic function: drug metabolism as a determinant of the antidopaminergic actions of thioridazine. AB - The antidopaminergic properties of thioridazine (THD) and its major metabolites were evaluated using in vitro and in vivo estimates of dopaminergic function. THD 2-sulfone was more potent than, and THD-2-sulfoxide equipotent to, THD in displacing [3]spiperone from rat striatal membranes and in inhibiting dopamine stimulated cyclic adenosine 3',5'-monophosphate synthesis in rat striatal homogenates. Other major THD metabolites were relatively inactive. These in vitro data suggest that THD, THD-2-sulfone and THD-2-sulfoxide are potent dopamine receptor blocking agents. Intraperitoneally administered THD antagonized amphetamine-induced locomotion and also increased the concentration of the dopamine metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in terminals of the nigrostriatal dopamine system. Conversely, THD administered i.c.v. into conscious animals, did not antagonize amphetamine induced locomotion nor increase brain regional concentrations of DOPAC or HVA. On the other hand, the i.c.v. administration of THD-2-sulfone and THD-2-sulfoxide dose-dependently inhibited amphetamine-induced locomotion and also increased the concentrations of HVA and/or DOPAC in the striatum and olfactory tubercles. These apparently discrepant in vitro and in vivo data suggest that the biotransformation of THD is a major determinant in those actions of THD attributed to a blockade of dopamine receptors in the central nervous system. PMID- 6491986 TI - Effect of age on adrenergic neuronal uptake in rat heart. AB - Cardiovascular responsiveness to sympathetic influences is reduced with increasing age. This reduced responsiveness may reflect alterations in effector mechanisms or in neurohumoral transmission processes. We investigated the effect of age on the cardiac adrenergic neuronal uptake mechanism in the Fischer 344 rat by measuring the cocaine-induced potentiation of norepinephrine (NE) positive chronotropic responses. Hearts from male rats (6, 12 and 24 months old) were perfused according to a modified method of Langendorff. For each heart, chronotropic responses to increasing doses of NE were obtained. After this, hearts were perfused with 1 microM cocaine to block the neuronal uptake of NE. A second series of NE doses were administered and heart rate (HR) responses measured. Under control perfusion conditions, HR responses to NE decreased with increasing age. In the presence of cocaine, HR responses to NE were significantly augmented in the 12 and 24 months rat hearts, but not in the 6 months rat hearts. However, the cocaine-potentiated responses to NE at 12 and 24 months did not exceed responses to NE alone at 6 months. In a separate series of experiments, HR responses to isoproterenol were not modified by cocaine at any age. These results indicate that activity of neuronal uptake pump is greater in the 12 and 24 months rats than in the 6 months rats. This increased uptake activity may account at least in part for the reduced responsiveness of older hearts to NE. PMID- 6491987 TI - Disposition and anticoagulant activity of biologically active heparin fragments in the rat. AB - The disposition of biologically active [35S]heparin fragments was studied in both normal and uremic rats after an i.v. dose of 1 mg/kg. In normal animals, the amount of radioactivity in the blood rapidly decreased with a half-life of less than 2 min whereas the anticoagulant activity showed a half-life of 30 min. By 5 hr, only 0.4% of the initial radioactivity was present in the blood whereas no anticoagulant activity could be detected. The heparin fragments were rapidly excreted: by 5 hr, 85% of the initial dose was excreted into the urine, whereas only 1% of the radioactivity was present in the feces. In contrast, 55% of the initial dose of the same amount of radioactive heparin was excreted into the urine after 5 hr. By 5 hr, 5.2% of the heparin fragments was organ-associated and 3.1% was present in the skin, muscle and bone. One week after injection, 3.9% of the radioactivity was still present in the body. In uremic animals, the radioactivity in the blood decreased to 12% of the initial dose by 5 hr whereas 13.5% was organ-associated and 64% was present in the skin, muscle and bone. Comparison of heparin with di- or hexasac-charide fragments indicated that both the clearance in the blood and the excretion into the urine are size-dependent. By 5 hr, the body burden of heparin is approximately five times higher than it is after the same dose of heparin fragments. PMID- 6491988 TI - Individual and combined antiepileptic and neurotoxic activity of carbamazepine and carbamazepine-10,11-epoxide in mice. AB - Anticonvulsant effect and neurological toxicity were investigated in mice for carbamazepine (CBZ) and its main metabolites, carbamazepine-10,11-epoxide (CBZ-E) and 10,11-dihydro-10,11-trans-dihydroxy-CBZ. The compounds were first tested separately and the results were expressed in terms of brain concentrations. Brain penetration was very poor for 10,11-dihydro-10,11-trans-dihydroxy-CBZ, which had neither anticonvulsant nor neurotoxic activity. Against maximal electroshock, CBZ was slightly more potent than CBZ-E and both were ineffective against pentylenetetrazole and bicuculline. CBZ and CBZ-E displayed similar neurotoxicity. Combined administration of CBZ and CBZ-E revealed a slightly synergistic interaction with regard to both anticonvulsant and neurotoxic action, the therapeutic index of the mixture being similar to that of CBZ. These results suggest that antiepileptic activity and neurological toxicity of CBZ are proportional to the sum of the concentrations of CBZ and its metabolite CBZ-E. Furthermore, variable levels of CBZ-E in relation to CBZ do not affect the overall therapeutic index. Finally, the results do not indicate that CBZ-E alone has any advantage over CBZ with regard to neurotoxic side-effects and therapeutic index. PMID- 6491989 TI - Is acute morphine hyperthermia of unrestrained rats due to selective activation of brown adipose tissue thermogenesis? AB - Experiments were conducted to determine if the hyperthermia after acute morphine sulfate (MS) administration was due to selective activation of brown adipose tissue (BAT) thermogenesis. Interscapular BAT temperature (TIBAT) and core (rectal) temperature (TR) were measured concurrently in groups of unrestrained, male Sprague-Dawley rats kept at 21.0 degrees C before and after i.p. (0.75, 2.0 or 10.0 mg/kg) or intracerebroventricular injections (200 ng- greater than 5 ul) of MS or sterile saline. TRS and TIBATS increased 0.6-1.0 degree C after i.p. intracerebroventricular injections of MS but the time course and magnitude of the changes in TIBATS from mean preinjections readings were not different from the increases in TRS. By contrast, isoproterenol HCl (0.5 mg/kg i.p.), known to activate BAT heat production, given to rats kept at 4 or 21 degrees C raised the TIBATS significantly above changes seen in TRS. Rats given MS in which the capacity for brown fat heat production had been increased previously (cold adaptation) or decreased (fasting or bilateral denervation) again evoked increases in TIBAT and TRS that were not significantly different from one another or from the response of warm-adapted, normophagic controls. Furthermore, oxygen uptakes were reduced after MS compared to oxygen uptakes after saline injections. [3H]Guanosine diphosphate binding to interscapular BAT mitochondria isolated from rats sacrificed at peak morphine hyperthermia (greater than 1.0 degree C) was not different from that of saline control animals. The results indicate clearly that the hyperthermia occurring in unrestrained rats after acute central or peripheral opiate administration is not due to selective activation of BAT thermogenesis. PMID- 6491990 TI - Effects of vasopressin on electrolyte transport across isolated colon from normal and dexamethasone-treated rats. AB - Vasopressin enhanced the absorption of Na+ and Cl- across the short-circuited colon descendens from normal rats. This effect of vasopressin results from an increase in the mucosal to serosal movement of Na+ and Cl- and a decrease in the serosal to mucosal movement of Cl- and was accompanied with a decrease in the short-circuit current (ISC). Neither the base-line absorption of Na+ and Cl-, the vasopressin-induced increase in Na+ and Cl- absorption nor the decrease in ISC were inhibited by amiloride in the colon from normal rats. Colon descendens from rats treated for 3 days with dexamethasone had remarkably higher transmural potential difference (p.d.), tissue conductance (Gt) and ISC. The absorption of Na+ across the short-circuited colon descendens from dexamethasone-treated rats was increased 3-fold when compared to colon from normal rats. The absorption of Cl- in normal rats was reversed to Cl- secretion in treated rats. Amiloride rapidly and reversibly decreased the p.d., Gt and ISC in colon from dexamethasone treated rats. The transport of Na+ was nearly completely inhibited by amiloride in treated rats. In contrast to its enhancing effects on Na+ absorption in colon from normal rats vasopressin did not enhance Na+ absorption in colon from dexamethasone-treated rats. This enhancement of Cl- absorption by vasopressin was retained in colon from treated rats. This enhancement of Cl- transport was due solely to a decrease in the serosal to mucosal movement of Cl- and was accompanied with a decrease in ISC and Gt. The results support the hypothesis that vasopressin causes inhibition of the electrogenic secretion of Cl- in colon from dexamethasone-treated rats. Furthermore, the results suggest that the increase in the mucosal to serosal movement of Na+ and Cl- and the decrease in the serosal to mucosal movement of Cl- in colon from normal rats are caused by independent effects of vasopressin. PMID- 6491991 TI - Temperature dependence of isometric contractions of cat fast and slow skeletal muscles. AB - The influence of temperature (range 38-20 degrees C) on the isometric contractions of flexor digitorum longus (fast-twitch) and soleus (slow-twitch) muscles of the cat hind leg was examined in situ and with supramaximal nerve stimulation. The maximum tetanic tension decreased by 5-7% on cooling from 38 to 27 degrees C and by about 17% on further cooling to 20 degrees C. The results were similar between the two muscles. The twitch tension increased by 100% in flexor digitorum longus and decreased by about 40% in soleus when the temperature was lowered from 38 to 20-24 degrees C. The results are compared with those reported for fast- and slow-twitch muscles of the rat. PMID- 6491992 TI - The passive electrical properties of spheroidal aggregates cultured from neonatal rat heart cells. AB - Membrane specific resistance and capacitance of non-spontaneously active spheroidal aggregates, cultured from collagenase-dissociated neonatal rat heart cells, were calculated from changes in membrane potential due to intracellularly injected rectangular hyper- and depolarizing current pulses during diastole. The relation between steady-state membrane voltage displacement and injected current is linear for current pulses between +10 and -10 nA. No significant fall-off of electrotonic potential is measured in an aggregate at increasing distances from the site of current injection. The aggregate membrane resistance (input resistance) was best fitted by an inverse square function of the aggregate radius. This suggests selective current flow through the outer membranes of the spheroidal aggregate. Taking this into account the membrane specific resistance was calculated to be 753 +/- 38 omega cm2 (S.E. of mean; n = 39). The time course of the change in membrane potential is exponential with a time constant ranging from 5 to 26 ms, depending on the aggregate radius. The aggregate membrane capacitance is calculated from the exponential transients for each aggregate and appears to be a cubic function of the radius, indicating that the membrane area of all cells in the preparation equally contributes to the input capacitance. The membrane specific capacitance is calculated to be 0.97 +/- 0.02 microF/cm2 (S.E. of mean; n = 100). It is concluded that myocytes in aggregates are electrically well coupled and that a resistance in series with the inner membranes, if present, is negligible compared to the membrane resistance of the internal cells. In order to explain the finding that the membrane resistance was not inversely related to the cube of the aggregate radius, it is postulated that the membrane specific resistance might be a function of aggregate radius. PMID- 6491993 TI - Variation of calcium current during the cell growth cycle in mouse hybridoma lines secreting immunoglobulins. AB - Ca currents of the cell membrane were recorded during a four-day culture period using the whole-cell variation of the patch electrode voltage clamp on a mouse myeloma cell line (S194, non-secreting) and on two mouse hybridoma cell lines (MAb2-1 which secretes immunoglobulin G (IgG) and MAb7B which secretes immunoglobulin M (IgM]. The density of Ca current increased during the four-day culture period after cells were transferred into fresh medium. The average value of the maximum inward current per cell reached 57 +/- 15 pA (mean +/- S.D.) by the fourth day in hybridomas secreting immunoglobulins. The density of Ca current in hybridomas secreting IgG and IgM was greater than that in non-secreting myeloma throughout the four days of the culture cycle. The cell density showed a sigmoidal increase during the culture period and the rate of increase in the density showed no significant correlation with the density of Ca current. The immunoglobulin level in the medium increased over the culture period, as did the estimated immunoglobulin secretion per cell per day. The time course of the increase of estimated individual cell secretion resembles that of the increase of density of Ca current. PMID- 6491994 TI - Arsenazo III calcium transients and latency relaxation in frog skeletal muscle fibres at different sarcomere lengths. AB - Single, intact, frog muscle fibres were injected electrophoretically with a Ca2+ sensitive metallochromic dye, Arsenazo III, to a local concentration of 1.2-1.5 mmol/l. The intracellular concentration of free Mg2+, estimated photometrically in the presence of approximately millimolar Arsenazo III, was 3-4 mmol/l in fibres at rest. Ca2+-related changes in dye absorbance were characterized in vitro using 1 mM-Arsenazo III in solutions approximating the intracellular ionic environment. Isometric twitch contractions and related changes in light transmittance of dye-injected regions of fibre were recorded at 2.4 and 3.0 micron sarcomere lengths, at 15 degrees C. A method was developed for separating Ca2+ transients from larger, movement-related optical changes recorded as compound signals during fibre contraction. Decreases in twitch amplitude by about one-third following dye injection, together with the in vitro characteristics of the dye, suggested that millimolar intracellular Arsenazo III acted as a major Ca2+ buffer and inhibited the activation of contractile filaments. The onset of both the Ca2+ transient and latency relaxation occurred at virtually the same time in the twitch response and neither of those transition times was altered significantly with changes in sarcomere length from 2.4 to 3.0 micron. The amount of activation Ca2+ released in dye-injected regions of fibres following a single stimulus was about 0.3 mmol/l at 2.4 micron sarcomere length. The rate of rise and the amplitude of the Ca2+ transient were reversibly decreased with increase in sarcomere length from 2.4 to 3.0 micron. That finding is reviewed in relation to other evidence indicating length dependence of the intracellular release and distribution of activation Ca2+ up to 3.9 micron sarcomere length. PMID- 6491995 TI - Interaction of inactivity and nerve breakdown products in the origin of acute denervation changes in rat skeletal muscle. AB - The action of nerve breakdown products on innervated fibres of soleus and extensor digitorum longus muscles was investigated with the following procedures: partial denervation, sensory or sympathetic denervation, section of a previously transplanted foreign nerve. Each procedure was performed either in isolation or combined with chronic muscle inactivity obtained by blocking impulse conduction along the sciatic nerve. Silastic cuffs containing tetrodotoxin (TTX) and sodium chloride were utilized for the block. Partial denervation induced extrajunctional sensitivity to acetylcholine (ACh) and resistance to tetrodotoxin not only in the denervated but also in the innervated fibres. The effects in the innervated fibres were equal in magnitude to those in the denervated fibres, provided they were paralysed. The onset of the membrane changes was synchronous in the two classes of fibres and their amount correlated with the extent of partial denervation. If the innervated fibres were normally active, the membrane changes were still detectable, but considerably smaller than in the denervated fibres. Sensory denervation (removal of dorsal root ganglia L4 and L5) was followed by the development of moderate ACh supersensitivity and TTX resistance in chronically paralysed muscles. Furthermore, section of radicular nerves (total denervation, i.e. efferent plus afferent) induced larger membrane changes than those observed following section of ventral roots alone (efferent denervation). Sympathetic denervation was ineffective even when associated with chronic muscle paralysis. Section of a previously transplanted mixed nerve (superficial fibular) was ineffective if the soleus muscle was normally active, while it induced marked extrajunctional ACh sensitivity and TTX resistance when combined with chronic paralysis of the muscle. Section of a transplanted sensory nerve (sural) also induced extrajunctional membrane changes in paralysed soleus muscles, but their magnitude was much smaller than after section of mixed nerves. We conclude that products of nerve destruction, especially those of motor axons, induce membrane changes of striking magnitude when potentiated by muscle inactivity. Such an action may also explain the greater efficacy of denervation vs. pure inactivity, at least at early times after their onset. PMID- 6491996 TI - Velocity of sarcomere shortening in rat cardiac muscle: relationship to force, sarcomere length, calcium and time. AB - The relation between force and velocity was determined in sixteen trabeculae of rat right ventricle as a function of time during a twitch, of sarcomere length and of external Ca2+ concentration, [Ca2+]o. The trabeculae were studied in modified Krebs-Henseleit solution at 25 degrees C. Force was measured with a semiconductor strain gauge. Sarcomere length was measured with a laser diffraction system. A servomotor system was used in which control could be switched between sarcomere length, muscle length and force. Force-velocity relations were derived from load clamps and from contractions in which sarcomere length was initially held constant followed by a quick release and slower release of the sarcomeres at controlled velocity. Force-velocity relations were fitted by Hill's equation (Hill, 1938), (Po-P) b = (P+a) V, where P = force, V = velocity, Po = isometric force in mN/mm2 and a and b are constants. For [Ca2+]o = 2.5 mM, with both interventions the values (mean +/- S.D.) were: b = 1.00 +/- 0.45 micron/s; a = 9.52 +/- 5.60 mN/mm2; Vo measured = 13.6 +/- 3.0 micron/s; Vo calculated = 13.4 +/- 3.4 micron/s; Po measured = 96.5 +/- 25.0 mN/mm2; Po calculated = 119.3 +/- 34.5 mN/mm2. Vo rose with [Ca2+]o to a maximum at [Ca2+]o = 1.2 mM when Po was about 50% of maximum, while Po rose with [Ca2+]o to a maximum at above 2.5 mM. Vo rose with time during the twitch to a maximum at 25 ms following onset of contraction; Po was then about 50% of the maximum that was obtained at 120 ms. Vo increased with sarcomere length from zero at a sarcomere length of 1.6 micron to a maximum at 1.85 micron. Between 1.85 micron and 2.3 micron, Vo was constant. At 1.85 micron, Po was about 60% of maximum Po. These results are compatible with the hypothesis that Vo is more sensitive than Po to the amount of Ca2+ bound to the contractile proteins, and that Vo reaches a maximal value with an amount of Ca2+ bound to the contractile proteins at which Po has obtained only about 50% of its maximal value. PMID- 6491997 TI - Intraluminal distension pressure on intestinal lymph flow, serosal transudation and fluid transport in the rat. AB - Effect of distension pressure (d.p.) on the rate of lymph flow, serosal transudation and fluid transport was studied on an in vivo upper jejunal preparation. In the non-absorptive state with isotonic Na2SO4 solution as the luminal fluid, neither lymph flow nor transudation was increased with increasing d.p. from 0 to 3, 10, 20, 40 or 70 mmHg. Fluid absorption rate (Jv) increased by more than 100% when d.p. was increased from 0 to 3 mmHg whether glucose was present or absent in the luminal fluid (Krebs-Ringer solution). In the presence of glucose, there was no difference in Jv in the range of d.p. between 3 and 70 mmHg. In the absence of glucose Jv decreased when d.p. was above 10 mmHg. Whether with or without glucose, lymph flow did not change between d.p. of 0 and 10 mmHg but decreased at higher pressures. Whether with or without glucose, transudation began to appear at d.p. of 10 mmHg, increased with increasing d.p. up to 70 mmHg, but was much less in the absence of glucose. Protein concentration in the lymph (1.5-2.4% (w/v] and transudation (1.5-2.1% (w/v] was practically the same, suggesting that the latter could have originated from the lymph which leaked out of the serosal membrane. Blood flow in the subserosal capillaries and venules was remarkably reduced when d.p. was above 10 mmHg. In both jejunum and ileum, d.p. never caused fluid secretion during distension but resulted in transient fluid secretion as well as transudation following distension, apparently due to increased capillary filtration as a result of increased capillary permeability by ischaemia (during distension). From the effect of d.p. on the increase of transudation, presumably lymph, it is concluded that luminal hydrostatic pressure may play a role in fluid transport via the lymphatic system. PMID- 6491999 TI - Effects of denervating brown adipose tissue on the responses to cold, hyperphagia and noradrenaline treatment in the rat. AB - Surgical denervation of the five sympathetic nerves supplying one lobe of the interscapular brown fat of control rats caused small reductions in mass, protein content and the activity of the thermogenic mitochondrial proton conductance pathway (assessed from guanosine-5'-diphosphate (GDP) binding) when compared to the intact lobe. Denervation did not affect the acute 100% increase in mitochondrial GDP binding capacity seen after a single injection of noradrenaline. Cold-adaptation (4 degrees C for 7 days) or over-feeding (cafeteria diet for 10 days) caused marked increases in the mass, protein content and specific mitochondrial GDP binding in intact brown adipose tissue, but these changes were totally prevented by surgical denervation. These data indicate that the hypertrophy and the increased thermogenic capacity of brown fat induced by cold-adaptation or hyperphagia depend entirely upon the sympathetic innervation of the tissue. PMID- 6491998 TI - The role of motilin in periodic interdigestive pancreatic secretion in dogs. AB - The role of motilin in the periodic interdigestive secretion of the pancreas was studied in conscious dogs, each with a chronic gastric fistula, a Heidenhain pouch and a Thomas duodenal fistula. Motilin increased pancreatic water, bicarbonate and protein secretion and the motility of the stomach, duodenum and Heidenhain pouch in a manner which closely resembles the spontaneous changes which occur during interdigestive activity. Endogenous motilin released by duodenal alkalinization had the same effect as exogenous hormone. Continuous infusion of motilin did not cause continuous pancreatic secretion and gut motility but merely shortened the interval of the periodic interdigestive activity. Exogenous and endogenous motilin were ineffective following atropine. Hexamethonium abolished the pancreatic and duodenal peaks but not the changes in gastric and pouch motility induced by motilin or duodenal alkalinization. PMID- 6492000 TI - Hamster intestinal disaccharide absorption: extracellular hydrolysis precedes transport of the monosaccharide products. AB - Hydrolase-related transport was re-investigated in hamster small intestine by the tissue accumulation method. The Na+-dependent, phlorizin-sensitive monosaccharide transport system saturates with 30 mM-D-glucose. According to the hydrolase related transport hypothesis, additional glucose units will be taken up if they are given in the form of a disaccharide susceptible to hydrolysis. But in experiments with [14C]sucrose we found no evidence for any such surplus glucose uptake. The uptake of 14C label from sucrose was abolished by using Tris, a strong inhibitor of sucrase, by adding competitive inhibitors of the D-glucose transport system (D-glucose, beta-methyl-D-glucopyranoside or phlorizin), and by substituting Li+ for the Na+ in the incubation medium. Glucose and fructose derived from sucrose did not enter the tissues in equimolar amounts: the glucose moiety was taken up much faster. We conclude that in hamster intestine there is no evidence for the existence of hydrolase-related transport with sucrose as the monosaccharide donor. The enzymatic hydrolysis of sucrose and the transport of its products, glucose and fructose, are two distinct events, acting sequentially. PMID- 6492001 TI - Initiation of migrating myoelectric complex in sheep by duodenal acidification and hyperosmolarity: role of vagus nerves. AB - Gastrointestinal motility was studied in conscious sheep by X-radiography and by electromyography from chronically implanted electrodes before and after total thoracic vagotomy. Duodenal infusion of 0.5-3 mmol HCl (0.035-0.1 M-HCl) induced premature duodenal regular spiking activity (r.s.a.) within 1-7 min in fifteen of seventeen sheep studied when infused at 20 min after a natural r.s.a. There was no correlation between abomasal pH and any phase of the migrating myoelectric complex (m.m.c.). Duodenal alkalinization by infusion of 0.3 M-Tris buffer (pH 10.2) or 0.1 M-NaHCO3 had no influence on the occurrence of the m.m.c. Duodenal infusion of 20-50 ml 0.5 M-NaCl induced a premature duodenal r.s.a. within 1-5 min in seven of eight sheep. Vagotomy did not prevent the initiation or migration of the m.m.c., but reduced the rate of propagation of the r.s.a. from 40.5 +/- 7.2 (mean +/- S.E. of mean) to 16.7 +/- 0.1 cm/min in the duodenum, from 27.3 +/- 4.1 to 16.6 +/- 0.8 cm/min in the jejunum, and from 21.4 +/- 1.1 to 13.7 +/- 0.7 cm/min in the proximal ileum. Initially the frequency of r.s.a. increased, especially in the duodenum where they recurred at an interval of 98.4 +/- 6.8 min before vagotomy; and at 23.4 +/- 1.8 min in the first 24 h after vagotomy; the interval had lengthened to 86.7 +/- 5.2 min 2-3 weeks after vagotomy. Premature duodenal r.s.a. was not induced by duodenal infusion of HCl in five, or by duodenal infusion of hyperosmolar NaCl in three chronically vagotomized sheep. It is concluded that the vagus nerves contribute to the regulation of the frequency and propagation of the m.m.c. in sheep; duodenal acidification is not essential nor is it the normal stimulus for initiation of r.s.a., but duodenal infusion of HCl or hyperosmolar NaCl can initiate a premature duodenal r.s.a. via the vagus nerves. PMID- 6492002 TI - The reflex effects of changes in carotid sinus pressure upon renal function in dogs. AB - In chloralose-anaesthetized and artificially ventilated dogs, the carotid sinuses were vascularly isolated and perfused with arterial blood. Mean aortic pressure was held constant at 100 +/- 2 mmHg (mean +/- S.E. of mean, n = 19) by means of a pressure bottle connected to the aorta. Both vagus nerves were sectioned in the neck and propranolol hydrochloride (0.5 mg kg-1) was administered every 30 min. The left renal blood flow was measured by an electromagnetic flowmeter (wrap round probe), glomerular filtration rate by creatinine clearance and urinary sodium by flame photometry. Decreasing pressure in the isolated carotid sinuses from 186 +/- 10 to 63 +/- 5 mmHg resulted in significant decreases in renal blood flow from 281 +/- 35 to 177 +/- 30 ml min-1 100 g-1 renal mass; glomerular filtration rate from 40.0 +/- 7.8 to 12.3 +/- 4.4 ml min-1 100 g-1; urine flow from 0.31 +/- 0.05 to 0.12 +/- 0.03 ml min-1 100 g-1 and sodium excretion from 21.7 +/- 7.2 to 8.2 +/- 3.0 mumol min-1 100 g-1. Increasing carotid sinus pressure back to 188 +/- 11 mmHg resulted in increases in all the variables to values not significantly different from their initial values. Tying renal sympathetic nerves at low carotid sinus pressure (73 +/- 11 mmHg) caused an increase in all of the variables. After denervation there was no response to changes in carotid sinus pressure. These results show that changes in carotid sinus pressure can result in significant reflex effects on renal function and that these effects are mediated by renal sympathetic nerves. PMID- 6492003 TI - Effect of hyperglycaemia on sugar transport in the isolated mucosa of guinea-pig small intestine. AB - The effect of hyperglycaemia on sugar transport was studied by comparing transepithelial permeation and tissue content of 3-O-methyl-D-glucose (3-O-MG), beta-methyl-D-glucoside (beta-MDG) and D-glucose in isolated mucosae of guinea pig jejunum mounted in a flux chamber. Sugars were administered either to the luminal or the blood side of mucosae prepared either from normal animals or those maintained in a hyperglycaemic state by I.V. glucose infusion for 12 h. In control animals, absorptive sugar fluxes increased in the order glucose greater than beta-MDG greater than 3-O-MG. Only beta-MDG was accumulated in the tissue beyond the medium concentration. Permeation of 3-O-MG and beta-MDG in the direction blood-to-lumen was mainly paracellular as indicated by the strict correlation with the simultaneous permeation of polyethylene glycol (mol. wt. 900). Luminal addition of 10(-3) M-phlorhizin increased permeation and decreased tissue content of beta-MDG and D-glucose when administered on the blood side, suggesting that these sugars are recaptured at the brush border even from vigorously mixed solutions. For flux coefficient calculation the preparation was regarded as a three-compartment system. With all three sugars, the influx coefficient was higher at the luminal, but lower at the basolateral membrane than the corresponding efflux coefficient. 3-O-MG displayed the highest basolateral influx coefficient of all three sugars, being even higher than its luminal influx coefficient. The luminal influx coefficient of beta-MDG was 22 times greater, and its basolateral efflux coefficient 2.5 times less than the corresponding values for 3-O-MG, resulting in cellular beta-MDG accumulation. D-Glucose was suited best for transepithelial transport, having a luminal influx coefficient only 1.6 times less, and a basolateral efflux coefficient almost 10 times greater than those for beta-MDG. Prolonged hyperglycaemia increased the lumen-to-blood permeation of all three sugars 1.3-2-fold. No significant differences in tissue content to control values were observed after 45 min (3-O-MG, D-glucose) or 90 min (beta-MDG) incubation. Therefore, flux coefficients increased by the same factors in luminal and basolateral membranes, i.e. 1.7, 1.3 and 1.7 for 3-O-MG, beta-MDG and D-glucose, respectively. These results indicate that changes in both the luminal and basolateral membranes play a role in the increase of sugar transport in hyperglycaemia and that a regulatory mechanism might exist between the transport systems located in both membranes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6492004 TI - Facilitation of soleus-coupled Renshaw cells during voluntary contraction of pretibial flexor muscles in man. AB - Recurrent inhibition to soleus motoneurones, brought about by a conditioning H reflex discharge, was estimated in human subjects by a subsequent test H reflex. Changes in recurrent inhibition during voluntary ankle dorsiflexion were evaluated by comparing the amplitude of the test H reflex to a reference H reflex: both reflexes were subjected to the same type of influences which modified soleus monosynaptic reflex excitability during pretibial flexor contraction, but only the test H reflex was subject to the recurrent inhibition evoked by the conditioning H-reflex discharge. During tonic or phasic ramp contractions of the pretibial flexors the inhibition of the test H reflex, as compared to rest, was more marked than that of the reference H reflex. Evidence is presented that this may indicate a facilitation of soleus-coupled Renshaw cells. Since this facilitation of soleus-coupled Renshaw cells was also observed before ramp contraction, it is, at least in part, supraspinal in origin. Within the range of forces studied (8-45% of maximum force) there was no evidence that the facilitation of soleus-coupled Renshaw cells increased along with increased force of the pretibial flexor voluntary contraction. During voluntary phasic ankle dorsiflexion, facilitation of soleus-coupled Renshaw cells was maximum at the moment when soleus motoneurones were most facilitated by the stretch-induced soleus I a discharge. There was no evidence for changes in Renshaw cell excitability during ballistic contractions. It is suggested that this facilitation of soleus-coupled Renshaw cells may be one of the mechanisms preventing the occurrence of a soleus stretch reflex during a voluntary ankle dorsiflexion. Such a mechanism could become important if reciprocal inhibition, via I a inhibitory interneurones, were not strong enough, e.g. because of a weak gamma-drive to the contracting muscles. PMID- 6492005 TI - The effects of caffeine on tension development and intracellular calcium transients in rat ventricular muscle. AB - The effects of caffeine on tension and intracellular [Ca2+] were investigated in rat ventricular muscle using the Ca2+-sensitive photoprotein, aequorin. Contracture was induced by rapid application of 0.5-10 mM-caffeine solution at 20 degrees C. In normal Tyrode solution at 8 degrees C, or in Na+-deficient solution in which Na+ was isotonically replaced by sucrose, peak tension of caffeine contracture was potentiated and relaxation was prolonged. Caffeine contracture could not be induced immediately after a prior contracture. Repriming time was 10 min in Tyrode solution, and was much shorter in Na+-deficient solution or in high K+ solution containing 105.9 mM-K+. Caffeine prolonged the plateau of action potential dose dependently. At low temperature, prolongation of the plateau phase by caffeine was more marked. Twitch tension showed a triphasic change after application of caffeine; peak tension transiently increased in a potentiating phase (P phase), and then decreased below control level in an inhibitory phase (I phase) followed by gradual recovery in a recovery phase (R phase). The effects of caffeine on the Ca2+ transients during a twitch were also complex, depending on time after application and dose of caffeine. In low caffeine concentration (below 0.5 mM) the peak of the Ca2+ transient was potentiated in the I phase, although the peak tension was suppressed. At high concentration (above 3 mM) the peaks of both the Ca2+ transient and twitch tension were suppressed. In every concentration of caffeine tested (0.1-5 mM), time to the Ca2+ transient and twitch tension peaks was prolonged, and the falling phases of both were delayed. Caffeine might release Ca2+ from intracellular store(s) and enhance the slow inward current. The Ca2+ transient obtained in this study clearly indicate that the prolonged time to peak tension in the presence of caffeine is due to the slow rise of intracellular [Ca2+] and prolonged time to peak of the Ca2+ transient. It is also quite possible that caffeine modulates the Ca2+ sensitivity of a contractile system in dose- and time-dependent manners. PMID- 6492006 TI - Effect of extracellular calcium on contractile activation in guinea-pig ventricular muscle. AB - The problem of whether or not the alterations in twitch tension of mammalian cardiac muscle induced by changes in extracellular Ca concentration ([Ca]o) are due to the Na-Ca exchange process across the surface membrane and/or the changes in the amount of Ca in the sarcoplasmic reticulum has been re-examined by using thin bundles (70-120 micron diameter) dissected from guinea-pig papillary muscle. The observed time course of the change in the twitch tension due to a step change in [Ca]o was compared with that computed on a basis of the diffusion process of Ca ions in a circular cylinder and of the steady-state relation between [Ca]o and twitch tension. After a sudden decrease in [Ca]o from 2 mM to various lower concentrations, the isometric twitch tension of the thin bundles first fell rapidly and monotonically and then showed a much smaller and slower secondary fall. The correspondence of the observed time course of the rapid phase with the predicted time course and the observed half-time of the rapid phase ranging from 1.0 to 2.5 s indicate that the rapidity of the twitch response may be dominated by simple diffusion of Ca ions through the extracellular space. If so, the effective diffusion constant of Ca ions inside the bundles was 1.4 +/- 0.2 X 10( 6) cm2/s (mean +/- S.E., n = 9). The magnitude and direction of the step change in [Ca]o or the change at different stimulus frequencies gave rise to dissimilar time courses of the contractile change; the difference in the rapid time courses due to these factors could be explained by the simple diffusion models, but not in the much slower phase. The half-time for the Ca effect was the same as that for the rapid effect of Na ions in the external solutions. The time course of twitch decline due to [Ca]o decrease in the Na-free (Li) solution was identical to that predicted from the time course measured in the Na-rich solution and the steady-state relation between [Ca]o and tension in the Na-free solution. The half time of Ca leak from the sarcoplasmic reticulum in the skinned cardiac muscle was 40-60 s in the presence of 10 mM-EGTA, much shorter than that of the Ca leak in the skinned amphibian skeletal muscle, but much longer than that of twitch responses due to step changes in [Ca]o in the intact cardiac muscle.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6492007 TI - Release and recycling of calcium by the sarcoplasmic reticulum in guinea-pig portal vein smooth muscle. AB - The amplitude of interrupted contractions evoked by noradrenaline or caffeine in Ca2+-free, high-K+ solutions containing EGTA or La3+ was determined in small (40 60 micron thick) bundles of guinea-pig portal anterior mesenteric vein. Interrupted contractions were produced by removing the stimulating agent as soon as the amplitude of the tension record reached its peak. The distribution of intracellular Ca2+ was determined, with electron probe X-ray microanalysis, in cryosections of preparations frozen in the relaxed state and at the peak of noradrenaline-induced contractions. Interrupted contractions of maximal or near maximal amplitudes could be evoked every 2 min for up to 15 min in the virtual absence of extracellular Ca2+. If noradrenaline was allowed to remain in the solution throughout the period of spontaneous relaxation, a subsequent contraction could no longer be evoked in the absence of extracellular Ca2+. Interrupted contractions, similar to those evoked by noradrenaline, could also be stimulated by caffeine. The amplitude of reproducible interrupted contractions in Ca2+-free, high-K+ solution was graded with noradrenaline concentration. The ability of these smooth muscles to contract repeatedly and maximally in Ca2+-free solutions indicates the recycling of Ca2+ released from an intracellular store. The occurrence of these contractions in high-K+ (depolarizing) solutions supports the conclusion (Devine, Somlyo & Somlyo, 1972) that the release of intracellular Ca2+ is one of the mechanisms of pharmacomechanical coupling. The number of subplasmalemmal regions in which high Ca concentrations (greater than 10 mmol/kg dry wt.) were detected, with approximately 75 nm diameter electron probes, was reduced in muscles frozen at the peak of contraction, from 4.7/cell periphery in the relaxed to 1.4/cell periphery in the contracted preparations. In freeze substituted smooth muscles, in which the membranes of the junctional sarcoplasmic reticulum could be visualized, the regions containing high Ca were identified as part of the sarcoplasmic reticulum (s.r.), indicating that the s.r. is the store from which noradrenaline and caffeine release Ca2+. PMID- 6492008 TI - Psychiatric progress. The learned helplessness model of depression. AB - Attempts have been made to model certain human psychopathological states in the laboratory, with varying degrees of success. The animal model has emerged as an alternative to clinical studies in psychiatry because it is able to provide greater experimental control and allows the exercise of ethical discretion. Although numerous animal models of depression have been proposed in the literature, most, if not all, fail to mimic human depressive symptomatology; their main function is to act as selective screens for antidepressant drugs. The learned helplessness approach has been suggested as an animal analogue of depression because of its similarities to the human depressive state in terms of provocation, manifestation and treatment. Furthermore, the learned helplessness model, which was originally based on animal experimentation, has been shown to be reproducible in human subjects, a finding not observed with other animal models of depression. Although this model has been much criticized in the past, recent reformulation adds credence to it as a more valid analogue of human depression, given the additional cognitive constructs in depressed human subjects. PMID- 6492009 TI - Dexamethasone increases plasma free dopamine in man. AB - In man, unconjugated plasma DA is normally undetectable or present in minute amounts. Twelve medication-free volunteers received a 1 mg dose of dexamethasone which produced pronounced increases of plasma free DA but not of other catecholamines. Mean plasma free dopamine levels after dexamethasone at 8 a.m. (155 +/- 102 pg/ml) and 4 p.m. (163 +/- 70 pg/ml) were significantly higher (p less than 0.001) than those at 8 a.m. (50 +/- 18 pg/ml) and 4 p.m. (42 +/- 7 pg/ml) before dexamethasone. Although the mechanism of increased dopaminergic activity after a dose of dexamethasone remains for future research, the data presented in this paper may explain the observations that corticosteroids lower prolactin levels and may induce psychiatric disturbances, as well as the finding that depressed patients with high postdexamethasone cortisol levels are frequently psychotic. PMID- 6492010 TI - Interhemispheric differences in regional density of the normal brain. AB - In a study of regional variations in cerebral X-ray attenuation as measured by computed tomography, a relationship between bone-related beam hardening and lateralized hemispheric density differences was sought. The CT scans of 22 normal right-handed individuals were evaluated by calculating regional mean attenuation values and regional left-right differences in attenuation, comparing these to regional measurements of skull thickness. A statistically insignificant number of significant correlations was found. This is interpreted to mean that observed left-right hemispheric density differences are not due to beam-hardening through bone. It was also found that left-right differences in density persisted over the entirety of the evaluated slices, suggesting that this finding is due to inherent hemispheric structural differences. PMID- 6492012 TI - Motor control of schizophrenics--II. Manual control and tracking: sensory and motor deficits. AB - Manual control and tracking of 12 acute and chronic schizophrenics was tested for comparison with their performance in oculomotor tracking. Schizophrenics tended to be slower in a non-timed, non-tracking hand movement, and chronics made even slower movement when the experimental room was illuminated than when it was darkened. Chronics also had a significantly higher reaction time than normal controls. When tracking a constant-velocity visual target, all schizophrenics were significantly slower than normals to high-velocity (50 degrees and 60 degrees/s) targets only. When tracking a sinusoidally moving target, schizophrenics were not less accurate over-all but they showed less improvement than normals when room illumination gave visual information about background and hand position. This complex group of motor deficiencies of schizophrenics, along with their oculomotor control problems, suggests that they have sensory processing, attentional, and motor planning problems when performing orienting tasks. PMID- 6492011 TI - Eye tracking impairment: attentional and psychometric correlates in psychiatric patients. AB - The correlations between eye tracking and a set of attentional and psychometric correlates of psychopathology were studied in groups of schizophrenic, nonschizophrenic psychotic, schizotypal, and neurotic patients (DSM-III criteria), and in a normal control group. Measures of overall and of optimum eye tracking performance were employed. Attentional measures were: reaction time, crossover phenomenon, omission score on the continuous performance test, and amplitude of the contingent negative variation. Psychometric measures were: psychoticism, extraversion, and neuroticism. A measure of eye tracking based on the best cycle in the total sequence proved superior to the overall score as a correlate of psychopathology. The correlational patterns differed widely between groups. Most conspicuous were the correlations of eye tracking with psychoticism in psychotics, especially in schizophrenics, and the impressive number of significant correlations with attentional as well as psychometric variables in the schizophrenic category. PMID- 6492013 TI - Membrane abnormalities in the psychoses and affective disorders. AB - Erythrocyte ghost phospholipid data were collected on 67 psychotic and/or manic patients and compared to a group of 35 age and sex matched controls. Patients meeting DSM-III criteria for schizophreniform disorder or schizophrenia but not mania showed a small but significant decrease in membrane phosphatidylcholine (PC). In 53 of the patients data were available on lithium transport across red cell membranes. Patients in the upper quartile of the PC distribution showed a significant (-47%) decrease in the 24 h in vitro lithium ratio as compared to patients in the lower PC quartile. This difference was due to an increase in Na Li+ counterflow activity in the upper PC quartile and not to a change in passive lithium leak. These data illustrate one example of a possible relationship between membrane composition and a membrane function, counterflow activity, which has been associated with the underlying mechanism(s) of lithium action. PMID- 6492014 TI - Attributional style: degree of depression, respondent's sex, and nature of the attributional event. AB - Attributional responses made to both good and bad events by male and female Ss (N = 117) differing in degree of clinical depression were examined in light of the reformulated learned helplessness model of depression. Data comparison with control Ss provided support for the model's prediction. Clinically depressed Ss assumed more personal responsibility than control Ss for their life outcomes, especially the negative ones. While significant main effects were demonstrated in the clinical sample for all three variables, the significant two and three-way interaction effects revealed a complex relationship between causal attribution and depression. PMID- 6492015 TI - Learned helplessness: effects of noncontingent reinforcement and response cost with emotionally disturbed children. AB - In order to investigate the effectiveness of noncontingent reinforcement and response cost in inducing learned helplessness and to determine whether depressed Ss respond differently than nondepressed Ss, 28 emotionally disturbed children (20 boys, 8 girls) were tested in a modified learned helplessness paradigm. Children's Depression Inventory score and diagnosis were each used to distinguish "depressed" and "nondepressed" children. Half of the depressed group and half of the nondepressed group received noncontingent response cost, the other half of the two groups received noncontingent positive reinforcement. Results indicated that both noncontingent response cost and noncontingent reinforcement led to reduced persistence time relative to persistence under conditions of contingent reinforcement. There was only one significant difference between depressed and nondepressed Ss (differential persistence time over trials) and there were no significant interactions. Results were discussed in terms of Seligman's formulation of learned helplessness and the extension of this model to a clinical child population. PMID- 6492016 TI - Mmpi characteristics of parents referred for child-custody studies. AB - Despite a growing trend toward, and acceptance of, joint-custody decisions, the majority of contested child placements in divorce cases are still completed through the court systems. As a result, mental health professionals remain active in assisting courts in this process through custody studies where the relative merits of each parent are established. Noticeably lacking, however, has been even descriptive data on the personality characteristics of these parents. Results from a sample (N = 38) indicated that custodial parents represented themselves in a healthier fashion, coped with feelings of anger and impulsivity more effectively, were more trusting and open toward others, and received lower alcohol use scores than noncustodial parents. PMID- 6492017 TI - Helping behavior of females: effects of stress and commonality of fate. AB - In a design replication of Dovidio and Morris' study, the effects of stress and commonality of fate on helping behavior were examined. Ss were randomly assigned to one of four conditions: high stress/common fate (n = 15), high stress/dissimilar fate (n = 15), or low stress/common fate (n = 15), or low stress/dissimilar fate (n = 15). While the initial study involved male Ss, the present study involved females in order to assess the generality of the original findings. Other aspects of the original experiment were repeated as closely as possible. Consistent with the original study, a significant interaction was found, indicating that Ss were more helpful under conditions of high stress and common fate. Results also revealed a greater overall amount of helping behavior than that found by Dovidio and Morris. PMID- 6492018 TI - The abstinence violation effect and circumstances surrounding relapse as predictors of outcome status in male alcoholic outpatients. AB - The hypothesis that the cultural delusion among alcoholics--that "one drink makes a drunk"--is critical in determining how the individual copes with a "slip" was examined in a sample of 82 outpatient alcoholics taking part in an abstinence based alcohol-recovery program. No evidence was found to suggest that the cultural delusion, as measured by the Schaeffer questionnaire, was a factor in predicting postslip drinking behavior. However, circumstances surrounding the first drink--mood state, time of day, place, company, and the number of drinks taken in that session--predicted future drinking status. PMID- 6492019 TI - [Segregation of figural units by the proximity and resemblance of their components]. AB - In this second paper about structural analysis of the radiological image, we propose to teach three figural sets thanks to the practical application of resemblance and proximity. It consists in cervical triplet, metatarsal triplet and two metacarpal doublets. PMID- 6492020 TI - [Telethermography in the selection for x-ray computed tomographic study of herniated lumbar disks]. AB - Results of computed tomography and thermography examinations were compared in 80 patients with herniated disk lesions investigated by non-invasive radiological procedures. Thermography proved to be a very sensitive method but one of only relative specificity. The examination failed to contribute data in 10% of cases, and only one false-negative result was noted. Telethermography appears to be a reliable screening method enabling optimal selection of patients for scanning. PMID- 6492021 TI - [Pedicled osteoma of the maxillary sinus. A rare radiological finding?]. AB - Several cases of intrasinus bony densities above pathological dental areas are reported. Common radiological features are outlined (pediculate implantation on the sinusal floor, cortical limits, acute or chronic dental infection). In one case, an histological examination performed at the opportunity of a sinusal operation pointed out osteomatous tissues. PMID- 6492022 TI - [The organization of work in radiology. Preparation for computerized appointments]. AB - After four years' experience of the use of a computer-based system for establishing appointments for radiologic examinations, a more elaborate organization is envisaged and its broad outlines described. The developed ideas should assist preparation of one part of the specifications of a computer-based system for a department of medical imaging. PMID- 6492023 TI - [Malignant spinal hemangiopericytoma, with benign radiological appearance]. AB - A spinal intra-dural and extra-medullary tumour is described, presenting both clinically and radiologically as a benign process. However, the pathological examination, helped by electron microscopy, concluded in favour of a malignant hemangiopericytoma. The clinical cause, after surgery and radiotherapy, confirmed this latter diagnosis. PMID- 6492024 TI - [Pitfalls of the dorsal decubitus in aortography]. AB - The use of the prone position in aortography improves the visualization of the anterior wall of the aorta. This is supported by observation of an obstructed aortobifemoral by-pass and seems interesting in the study of aneurysms. More often, it is useful in case of decreased blood flow or increased local turbulence. PMID- 6492025 TI - [A rare localization of osteomyelitis in a child]. AB - The authors report a case of osteomyelitis of the anterio-inferior spina iliaca. This original observation actually illustrate the difficulty of the diagnosis of osteomyelitis. They stress the interest of plain radiographs which, if correctly read, would have enabled an early diagnosis, thus avoiding more complex examinations. PMID- 6492026 TI - Improving the effectiveness of cervical cancer screening. AB - A review of 100 cases of invasive cervical cancer was designed to assess what changes in cervical screening services might be most effective in reducing mortality. In 68 cases there had apparently never been screening: no system of individual invitation existed for unscreened women. In 10 cases the last smear was reported as normal over five years earlier: a five-year recall system existed but was inefficient. In 13 cases suspicious cervical smear reports had not been followed up adequately. Two cases might have been diagnosed earlier, in spite of ;normal or inflammatory' smears, if the symptoms had been fully elicited. For the remaining seven cases one or more smear was reported as normal within five years of diagnosis of invasive cancer. Overall, 15 cases might have been picked up earlier if suitable opportunities for screening which did arise had been exploited. It was concluded that a substantial proportion of these 100 women might have received treatment at an earlier stage solely by the rigorous implementation of the present screening policy. PMID- 6492027 TI - Adolescent patients in an Inner London general practice: their attitudes to illness and health care. AB - A postal questionnaire was sent to 121 patients aged 16-20 years identified from the age-sex register of an Inner London practice; 87 replied. Information was sought about adolescents' perceptions and experience of illness and health care, and their attitudes to preventive medicine. Few of the girls reported that they were in good health; 59 per cent of girls and 23 per cent of boys had visited their general practitioner in the previous three months. Thirty per cent of girls and 15 per cent of boys felt that there was something wrong with their health and in particular that they were overweight. Smoking and drinking were common. Adequate contraception was being practised by most girls.Detailed interviews with 18 of the respondents identified a number of family problems and difficult relations with staff in hospitals. Most of them considered that good health was not merely a matter of luck.Adolescents are usually described as being a most healthy group, but this study of an inner city practice suggests that adolescents themselves do not share this view. PMID- 6492028 TI - The role of context in primary care. AB - All doctor-patient interactions take place in a specific context-a particular physical, social or cultural setting. The important role of these contexts in doctor-patient communication, diagnosis and treatment is discussed, with reference to both hospital medicine and general practice. PMID- 6492029 TI - Open letter to the William Pickles lecturer. PMID- 6492030 TI - Menstrual history and fecundity of women exposed and unexposed in utero to diethylstilbestrol. AB - Sequential examination and interview of diethylstilbestrol-exposed (DES-exposed) and -unexposed women verified that DES exposure has no effect on age at menarche and indicated no differences in the age at first coitus, pregnancy and live birth. Analysis of variance indicated that there is an age-related increase in oligomenorrhea in DES-exposed women as compared to unexposed women that disappears as the patients reach their late 20s. Prospective data collection is required to substantiate this finding. There appears to be no substantial effect of in utero exposure to DES on women's ability to conceive. PMID- 6492031 TI - Amniocentesis in the identification of inapparent infection in preterm patients with premature rupture of the membranes. AB - Twenty-nine preterm patients with premature rupture of the membranes who were not in labor and who did not have clinical chorioamnionitis underwent successful amniocenteses. Nine fluids were positive for bacteria. Subsequent clinical chorioamnionitis and shorter latency periods were more common in these 9 patients than in the 20 with sterile amniotic fluid. Positive fluids were more likely to be obtained from patients tapped within 48 hours of membrane rupture. In most patients with heavy bacterial growth, clinically apparent infection and/or labor soon supervened. PMID- 6492032 TI - Significance of exaggerated fetal heart rate accelerations during active labor. AB - One hundred fifty-three of 1,289 patients (11.9%) monitored during labor were identified as having exaggerated fetal heart rate accelerations (EFHRAs), defined as accelerations of the fetal heart rate above the baseline of 30 beats/min or greater and lasting at least 30 seconds. Comparisons of patients with and without EFHRAs showed that the only difference between the two groups was a higher percentage of nulliparous patients in the EFHRA group. Comparisons of intrapartum complications showed a decreased incidence of meconium staining and an increased percentage of abnormal labor patterns in the EFHRA group. Comparisons of neonatal outcome statistics showed lower perinatal morbidity and higher mean birth weight in the EFHRA group. PMID- 6492034 TI - Anesthesiologists' practice of obstetric anesthesiology. AB - Physicians trained in obstetric anesthesia and no longer practicing it were questioned regarding conditions that were responsible for their leaving the field. A questionnaire was prepared to determine whether the physicians' activity in obstetric anesthesia continued after fellowship training. The survey yielded a response rate of 76%. Forty-two percent of the respondents spend more than 40% of their clinical anesthesia time in obstetric anesthesia, and 58% spend less than 40% in it. The reasons for less of an emphasis on obstetric anesthesia were finances, personal matters, lack of recognition, long hours and too much call, and lack of stimulation. PMID- 6492033 TI - Equilibration between breast surface and ambient temperature by liquid crystal thermography. AB - Controversy surrounds the need for a waiting period (equilibration, or cooling period) before obtaining a breast thermogram. Temperature differences between an intrinsic lesion (carcinoma) and the overlying skin are said to be amplified by cooling of the skin. Some investigators have found no qualitative difference between thermographic evaluations done 3-15 minutes after the patient disrobes; others assert that tests done within this period are invalid. We evaluated nine ovulatory women thermographically twice during a menstrual cycle (proliferative and secretory phases) to ascertain the significance of such a waiting period and to investigate when thermal equilibrium is achieved with the environment. Breast thermograms were obtained with a cholesteric liquid crystal contact plate at 1 minute intervals for a 20-minute period following exposure of the breast to a room temperature of 72 F (22 C). A significant drop in breast skin temperature was found to occur during the first 15 minutes before equilibrium takes place; this finding suggests that a waiting period is necessary for accurate evaluation. PMID- 6492035 TI - Reliability of contact-thermogram reading services. AB - Contact thermography has been advocated by some as a rapid, noninvasive diagnostic modality in evaluating patients at risk for breast cancer. In order to study the value of different criteria for interpreting thermograms, two sets of contact thermograms from 34 patients with benign breast disease were submitted to two different reading services. The results suggest that interrater agreement is enhanced when thermograms are classified as "normal" and "abnormal" rather than as class I-V. PMID- 6492036 TI - A plea for the plaintiff. PMID- 6492037 TI - Behcet's syndrome. PMID- 6492038 TI - Place of developmental surveillance in general practice. PMID- 6492039 TI - Hybrids and hybridity. PMID- 6492040 TI - Experimental colon neoplasia enhanced by extract of sperm (protamine). AB - An experimental study of colorectal tumorigenesis in inbred rats given the potent carcinogen dimethylhydrazine has shown that protamine, given before any tumours had developed, significantly enhanced the development of large bowel tumours (100% incidence). Those animals having no adjuvant therapy or who received either heparin or 5-fluorouracil (alone or in combination) had an approximate 50% incidence of such tumours. PMID- 6492041 TI - Hand grip--a simple test for morbidity after fracture of the neck of femur. AB - Seventy-six female patients, having sustained a fracture of the neck of femur, were assessed preoperatively by measuring their muscle strength in the form of grip using a hand-held dynamometer and by measuring serum albumin. A grip strength of less than 15 kg was found to be a reliable predictor of subsequent postoperative complications in female patients over the age of 80. Serum albumin had no predictive value. There was no significant difference in complication rates between different surgeons. PMID- 6492042 TI - Gastric sarcoidosis. AB - Two cases of gastric sarcoidosis are reported. Both patients presented with a history suggestive of peptic ulceration and the diagnosis of sarcoidosis was made after operation. PMID- 6492043 TI - Effect of family relationships on psychogeriatric patients. AB - Severe strain has been repeatedly reported in the families of psychogeriatric patients. Nevertheless, many families continue to provide a great deal of support, despite the undoubted burden involved. A retrospective study of short term outcome in 60 psychogeriatric referrals demonstrated the importance of some aspects of the relationship between the patient and their key supporting relative. In the sample as a whole, and in functional patients, the extent to which a positive communication system existed was significant. In patients with dementia, poor outcome was related to the patient being less dependent and more dominant in their interaction with the relative. The implications of this study for intervention and future research are discussed. PMID- 6492044 TI - Accessory cystic duct--an operative hazard. AB - Two patients with duplicated cystic ducts are reported. This is a rare and poorly reported anomaly. The hazards of misdiagnosis are discussed. PMID- 6492046 TI - Meaning and method in child health surveillance: discussion paper. PMID- 6492045 TI - Is there a role for radioimmunolocalization in diagnosis of intracranial malignancies?: discussion paper. PMID- 6492047 TI - Lumbar abscess resulting from appendicitis. PMID- 6492048 TI - Lymphomatoid vasculitis. PMID- 6492049 TI - Multiple congenital defects of the urinary tract. PMID- 6492050 TI - Giant meningioma of unusual origin. PMID- 6492051 TI - Prevalence of mental illness among mentally handicapped people. PMID- 6492052 TI - Amyloid deposition makes peritoneal dialysis ineffective. PMID- 6492053 TI - An outbreak of ovine listeriosis associated with poor flock management practices. AB - An outbreak of listerial meningo-encephalitis involving sheep in the Western Cape Province is recorded. Poor management practices which are described were thought to be principal precipitating cause. PMID- 6492054 TI - Prevalence and types of bacteria associated with subclinical mastitis in Bloemfontein dairy herds. AB - Bacteria associated with subclinical mastitis were isolated from machine-milked dairy herds in the Bloemfontein area supplying fresh milk during the period July to December 1980. The 151 quarter milk samples examined, were also subjected to somatic cell counts. Identification of the isolated bacterial strains showed that Staphylococcus aureus was the dominant mastitis-associated organism, constituting 66,4% of all bacteria isolated. Compared with other recent mastitis surveys a low prevalence of classical mastitis streptococci (0,7%) and of Gram-negative bacterial infections (6,3%) was encountered. The Gram-negative bacteria were almost invariably isolated from neglected herds in which the cows were generally in poor condition and the hygienic measures employed were totally inadequate. Other bacterial strains isolated included Corynebacterium bovis (6,3%) and the coagulase negative staphylococci (11,0%). The high somatic cell counts of the quarter milk samples yielding S. aureus, the mastitis streptococci and the Gram negative bacteria suggested a major pathogenic role for these isolates. The frequent occurrence of C. bovis strains and coagulase negative staphylococci in samples with high somatic cell counts similarly suggested that these organisms were more pathogenic than is generally assumed. PMID- 6492055 TI - Helminth parasites of game in Transkei. AB - Opportunities have been taken to examine sundry game animals for parasites over the past 2 years. A host parasite check list is presented from which it may be noted that Oesophagostomum columbianum is recorded for the first time in the red hartebeest Alcelaphus buselaphus and Haemochus bedfordi for the first time in the eland Taurotragus oryx. PMID- 6492056 TI - Intussusception in an ostrich chick. AB - Intussusception of the distal small intestine was observed in a 5-week old ostrich chick. The intussusception occurred at the point of attachment of the yolk sac and was speculated as being a predisposing cause to the problem, as a result of localised infection. Other predisposing causes seen in poultry such as enteritis, tumours, parasites and diet, were not evident in this case. PMID- 6492057 TI - Maduromycosis (Madurella mycetomatis) in a horse. AB - A case of maduromycosis mycetoma caused by Madurella mycetomatis is reported. The horse presented with multiple subcutaneous swelling over the right scapula. There were no discharging fistulae present. Macroscopically the lesion contained a black granular material embedded in a granulomatous mass. Microscopically large numbers of microcolonies were present containing segmented hyphae. No typical chlamydospores were observed. Cultures yielded a fungus identified as Madurella mycetomatis. Treatment consisted of surgical excision and local treatment with thiabendazole powder. PMID- 6492058 TI - Some monitoring and treatment equipment for small animals. AB - Previously used and sterilized fluid administration tubes, bottles and bags were utilized to replace expensive equipment. Urine output and central venous pressure can be readily monitored and thoracic or abdominal fluid can be easily drained using the equipment described. PMID- 6492060 TI - The Veterinary and Para-Veterinary Professions Act. Act no. 19 of 1982. PMID- 6492061 TI - [Tissue reactions and residues in slaughter cattle after administration of long acting oxytetracycline formulations]. AB - Samples from 40 slaughter cattle were investigated over 10 weeks for determining macroscopic tissue reaction following intramuscular administration of Liquamycin/LA (Pfizers) into the thigh and Terramycin/LA (Pfizers) G 333 into the neck respectively. Antibiotic residues in the lesions were assessed under ultra violet light and by microbiological means. Antibiotic residues were still detected after 7 weeks in the thigh and 5 weeks in the neck. One week old lesions in the thigh consisted mainly of a local necrotic centre, up to 120 mm in diameter, with a haemorrhagic zone and surrounded by oedema and petechia in adjacent muscle. This was gradually replaced by mainly fibrotic tissue as the weeks went by and eventually by local abscess formation still apparent 10 weeks later. Much the same pattern was seen in the neck but of milder degree and shorter duration - 6 weeks. Alarming is the fact that only in one case out of 40, a lesion could be detected in the carcass on the slaughter line, the others could have passed fit for human consumption in an abattoir. Because the manufacturer suggests a 28 day withholding period before slaughter and after administration of the product, results of this investigation raise several questions on format, completeness and contents of such directions for use and their implications for meat inspection, meat hygiene and public health. PMID- 6492059 TI - Myocardial pathology of domestic ruminants in southern Africa. AB - Myocardial pathology of ruminants in southern Africa, including lesions associated with toxic plants, other toxic agents, infectious agents and nutritional deficiency, is discussed with regard to recognition and to aetiological diagnosis. Findings are included which have not been published elsewhere. The importance and difficulties in recognition of myocardial lesions at an early stage are emphasized. Further research into the pathology of cardiac failure caused by toxic plants is clearly needed. PMID- 6492062 TI - Blood selenium levels of sheep in some districts of the Northern Orange Free State: the Bultfontein area. AB - Blood selenium levels of apparantly healthy, adult sheep from the Bultfontein area, as determined by neutron activation, varied between 0,165 and 0,500 micrograms/ml. Due to the absence of anaemia, a symptom which could be taken as one of the earliest signs of chronic selenosis, these values suggest the intake of high but non-toxic amounts of selenium. PMID- 6492063 TI - The effect of thawing temperature on post-thaw longevity of frozen bovine semen. AB - Bovine semen, diluted with a skimmed milk, 10% egg yolk, 7% glycerol extender and frozen in 0,25 ml French straws, was thawed in water at 5 degrees C, 20 degrees C or 35 degrees C for 20 seconds and then incubated at 37 degrees C. Specimens were examined periodically for motility. Semen thawed at 35 degrees C maintained motility for longer than that thawed at lower temperatures. Attempts to duplicate these findings in vivo were inconclusive but tend to correlate in vitro findings. PMID- 6492064 TI - The starch digestion test in the horse. AB - Variable results were obtained when the starch digestion test was carried out on a suspected case of malassimilation in a horse. In order to re-evaluate this test, 15 starch digestion tests were carried out using 4 horses. Results showed a marked variation in the increase in plasma glucose levels between individual horses and especially between poor and good condition horses when the dose of starch was based on body mass. Results also suggest that a fixed dose of starch may give more consistent results. PMID- 6492065 TI - A new cause of cattle mange in South Africa: Psorergates bos Johnston. AB - A herd of Bonsmara bulls in the Eastern Transvaal was found to be suffering from mange. Scrapings were made and the mites that were collected was identified as Psorergates bos. PMID- 6492066 TI - [Volvulus of the small intestine in the dog]. AB - A case of primary volvulus of the small intestines in a dog is presented. This condition is described as rare in the dog. The surgical treatment and positive results are discussed. PMID- 6492067 TI - Manifestations of bovine parafilariasis. AB - Three bovine carcases displaying inter- and intramuscular, intra-abdominal and intra-thoracic lesions attributable to Parafilaria bovicola infestations were selected for further inspection at Cato Ridge abattoir. The distribution of these lesions in the carcase is described. The condition was confirmed by the presence of eosinophils in scrapings and histological sections of the lesions and by the recovery of the parasite. PMID- 6492068 TI - A case of a highly invasive carcinoma of a salivary gland in a crossbred dog. AB - A 13-year-old male crossbred dog was presented with a unilateral swelling of the facial region, severe pain when the mouth was opened, and chronic otitis. Upon palpation it appeared that the right mandible had been fractured. At necropsy the head revealed a large tumour which had invaded the mandible and had caused areas of osteolysis. Histopathology revealed a solid highly anaplastic carcinoma of one of the serous salivary glands. PMID- 6492069 TI - Identification of helminths in ruminants at necropsy. AB - The shortcomings of faecal worm egg counts as a method of diagnosis are discussed. The best method of making a diagnosis of helminthosis is a necropsy. The equipment necessary and technique of carrying out an autopsy are described in detail. Emphasis is laid on the common nematodes which inhabit the gastro intestinal tract and their relative sizes are illustrated. A brief description of the common nematodes, cestodes and trematodes of domestic ruminants adequate for a preliminary diagnosis is given in tabular form. Full host parasite lists and the number of worms of the most common species necessary to cause clinical signs and even death are tabulated. Emphasis is laid on microscopical examination to recover and diagnose helminths. PMID- 6492070 TI - (1,3-Dialkyl-5-amino-1H-pyrazol-4-yl)arylmethanones. A series of novel central nervous system depressants. AB - A series of novel (1,3-dialkyl-5-amino-1H-pyrazol-4-yl)arylmethanones was synthesized. Pharmacological evaluation of these compounds demonstrated central nervous system depressant activity, potential anticonvulsant properties, and a low order of acute toxicity. In addition, selected compounds showed potential antipsychotic effects. This report focuses on the synthesis and structure activity relationships of these compounds. (5-Amino-1-ethyl-3-methyl-1H-pyrazol-4 yl)(2-chlorophenyl) methanone (21) was the most active compound against pentylenetetrazole-induced convulsions. (5-Amino-1,3-dimethyl-1H-pyrazol-4-yl)(3 chlorophenyl)methanone (4) also has a favorable anticonvulsant depression ratio. (5-Amino-1,3-dimethyl-1H-pyrazol-4-yl)(3-trifluoromethylphenyl)methan one (8), (5 amino-1,3-dimethyl-1H-pyrazol-4-yl)(3-thienyl)methanone (13), and (5-amino-3 ethyl-1-methyl-1H-pyrazol-4-yl)phenylmethanone (14) are very potent depressants. (5-Amino-1,3-dimethyl-1H-pyrazol-4-yl)(2-thienyl)methanone (12) possessed marked central depressant activity without anticonvulsant activity and without impairment of motor functioning. (5-Amino-1,3-dimethyl-1H-pyrazol-4-yl) (2 fluorophenyl)methanone (2) has a behavioral profile suggestive of antipsychotic activity and gave a positive Ames test result. PMID- 6492071 TI - Investigations on the chemistry of berbanes. 10. Synthesis of raunescinone analogues with hypotensive and antihypertensive activity. AB - The pharmacologically active (methylenedioxy)- and diethoxyepialloberbane keto esters I have been synthesized with use of the readily available keto esters 2 as starting material. By choice of the appropriate reaction sequence both antipodes of keto ester 2a can be employed to provide any enantiomer of the desired raunescinone analogue 1a. Hypotensive, antihypertensive, and central depressant effects of 1a are described. The principle effect observed for 1a was a potent hypotensive and antihypertensive effect of long duration without depression of the central nervous system. PMID- 6492072 TI - Studies on synthesis and anticancer activity of selected N-(2-fluoroethyl)-N nitrosoureas. AB - An activated carbamate, 2-nitrophenyl (2-fluoroethyl)nitrosocarbamate (3), was used to advantage in the synthesis of the water-soluble (2 fluoroethyl)nitrosoureas 6a--d from 2-aminoethanol, (1 alpha, 2 beta, 3 alpha)-2 amino-1,3-cyclohexanediol, cis-2-hydroxycyclohexanol, and 2-amino-2-deoxy-D glucose. In a variation of this method, 2,4,5-trichlorophenyl (2 fluoroethyl)carbamate (4) was used to prepare the urea from which the essentially water-insoluble N-(2,6-dioxo-3-piperidinyl)-N-(2-fluoroethyl)-N-nitrosourea (6e) was derived. The anticancer activity of these nitrosoureas was determined against the murine tumors B16 melanoma and Lewis lung carcinoma and found to be significant and comparable to their chloroethyl counterparts. On the basis of results from both systems, the dihydroxycyclohexyl derivative 6b may be the most effective. PMID- 6492073 TI - Structure-activity relationships for reactivators of organophosphorus-inhibited acetylcholinesterase: quaternary salts of 2-[(hydroxyimino)methyl]imidazole. AB - A series of 1,3-disubstituted-2-[(hydroxyimino)methyl]imidazolium halides were prepared and evaluated in vitro with respect to their ability to reactivate acetylcholinesterase inhibited by ethyl p-nitrophenyl methylphosphonate (EPMP) and 3,3-dimethyl-2-butyl methylphosphonofluoridate (GD). The compounds conform to the general formula N(CH3)C(CHNOH)N(CH2OR)CHCH+ X Cl-, where R = CH3, (CH2)3CH3, (CH2)7CH3, CH2C6H5, CH2C10H7, (CH2)3C6H5, CH(CH3)2, CH2C(CH3)3, and CH(CH3)C(CH3)3. For comparison we also evaluated three known pyridinium reactivators, 2-PAM, HI-6, and toxogonin. The imidazolium aldoximes exhibit oxime acid dissociation constants (pKa) in the range 7.9-8.1, bracketing the value of 8.0, believed to be optimal for acetylcholinesterase reactivation. With imidazolium compound in excess over inhibited enzyme, the kinetics of reactivation are well behaved for EPMP-inhibited AChE and depend on the nature of the alkyl ether group R. For GD-inhibited AChE, maximal reactivation was used to compare compounds because rapid phosphonyl enzyme dealkylation and enzyme reinhibition complicate interpretation of kinetic constants. PMID- 6492075 TI - Bispyridinamines: a new class of topical antimicrobial agents as inhibitors of dental plaque. AB - A series of N,N'-polyalkylenebis[4-(substituted-amino)pyridines] has been prepared, and members have been evaluated as potential anti-dental plaque agents. From among the most active members of the series, one compound, N,N'-[1,10 decanediyldi-1(4H)-pyridinyl-4-ylidene]bis(1-octanam ine) dihydrochloride, octenidine, was selected as a candidate for clinical study. PMID- 6492074 TI - 2-Phenylindoles. Relationship between structure, estrogen receptor affinity, and mammary tumor inhibiting activity in the rat. AB - A number of 2-phenylindole derivatives with one hydroxy group in the meta or para position of the phenyl ring and a second one in position 5, 6, or 7 of the indole nucleus were synthesized. In addition, different alkyl groups were introduced into positions 1 and 3 of the heterocycle. The influence of these structural variations on the binding affinity for the calf uterine estrogen receptor was studied. A prerequisite for the binding is the presence of an alkyl group at the nitrogen. Favorable are a hydroxy group located in the para position of the phenyl ring and short alkyl chains both in position 1 and 3 of the indole. The highest relative binding affinity (RBA) values (e.g., 33 for 20b, 21 for 24b, 23 for 35b) are close to that of hexestrol (RBA = 25, estradiol = 100). Depending on the positions of the oxygen functions and size of the alkyl residues, the indole derivatives behaved as strong estrogens (20c, 24c, 35c) or impeded estrogens with antagonistic activity (23c, 29c, 30c, 31c, 40c, 44c) in the immature mouse. Some of these derivatives (20c, 23c, 24c, 29c, 30c, 31c) were tested for their inhibitory effect on dimethylbenzanthracene-induced hormone-dependent mammary tumors of the rat. Both types exhibited a strong growth inhibition with a reduction of the average tumor area at appropriate dosage. A mode of action involving the estrogen receptor system is assumed. PMID- 6492076 TI - Covalent binding of isomeric 7-(2,3-epoxypropoxy)actinomycin D to DNA. AB - We have examined the ability of 7-(2,3-epoxypropoxy)actinomycin D (EPA) to bind covalently to DNA and to 2'-deoxyribonucleoside 5'-monophosphates in a simple system in vitro. We have observed initially that EPA binds to DNA and deoxymono- and deoxydinucleotides with intercalative or stacking interactions that are characteristic of actinomycin D (AMD). When EPA is incubated (37 degrees C) for a prolonged period (pH 7.4, 6 h) in contact with either DNA or deoxyribonucleotides, it forms covalent adducts. Deoxyguanosine is always the preferred site of reaction by EPA. After enzymatic digestion of EPA-DNA adduct, three deoxyguanosine (EPA-dG) adducts, one major and two minor, were isolated. These adducts are separable from one another and from other deoxyribonucleoside adducts, e.g., EPA-dA and EPA-dC by reverse-phase HPLC. The authentic EPA-dG, EPA dA, and EPA-dC adducts were synthesized by a chemical reaction of the epoxide in EPA with the deoxyribonucleotides followed by enzymatic dephosphorylation of the products. From the EPA-DNA adduct the EPA-dG adducts accounted for congruent to 2.2% of EPA employed; the remainder of EPA was completely hydrolyzed to an epoxide ring opened diol derivative, DHPA. DHPA binds to DNA by intercalation only and it does not form covalent adducts. Another model analogue of EPA (EPAMDEA) has the same epoxide-substituted chromophore but lacks the peptide lactone functions; it fails to associate with DNA and consequently it shows no covalent binding of its epoxide with DNA. Formation of a noncovalent intercalation complex between EPA and DNA appears to be a prerequisite for the covalent reaction. Presumably because of these dual interactions, EPA demonstrates superior antitumor activities both in human leukemic cells (CCRF CEM) in vitro and P388 and L1210 cells in mice. The DNA base specific alkylating activity of EPA, which is derived from a combination of the actinomycin D (AMD) structure and the new epoxide function in the molecule of EPA, attributes to EPA a potentially novel pharmacological behavior that is not inherent of AMD. PMID- 6492077 TI - Trequinsin, a potent new antihypertensive vasodilator in the series of 2 (arylimino)-3-alkyl-9,10-dimethoxy-3,4,6,7-tetrahydro-2H-py rim ido [6,1 a]isoquinolin-4-ones. AB - Series of 3-substituted-9,10-dimethoxy-3,4,6,7-tetrahydro-2H-pyrimido [6,1 a]isoquinoline-2,4-diones and 2-substituted-9,10-dimethoxy-6,7-dihydro-4H pyrimido [6,1-a]isoquinolin-4-ones were synthesized and tested for blood pressure lowering properties in anesthetized normotensive cats and conscious spontaneously hypertensive rats. Several compounds in the 2-(arylamino)-9,10-dimethoxy-6,7 dihydro-4H-pyrimido [6,1-a]isoquinolin-4-one series display a high order of activity. The most active compounds are the alkyl derivatives of the 2 mesitylamino/2-mesitylimino tautomeric forms. The 2-(mesitylimino)-3-methyl analogue trequinsin is a potent antihypertensive agent and displays a hemodynamic profile characteristic of an arteriolar dilator. It is also a potent inhibitor of both cAMP phosphodiesterase and platelet aggregation. PMID- 6492078 TI - Potential antitumor agents. 43. Synthesis and biological activity of dibasic 9 aminoacridine-4-carboxamides, a new class of antitumor agent. AB - The synthesis and biological activities of representatives of a new class of antitumor agent, the N-[2-(dialkylamino)ethyl ]-9-aminoacridine-4-carboxamides, are reported. Members of this class are stable and very water soluble with high levels of in vitro and in vivo antitumor activity. The compounds bind tightly to double-stranded DNA by intercalation, but the requirements for antitumor activity are more restrictive. They depend critically on the separation distance, positioning, and pKa values of the two cationic centers. For in vivo activity, significant bulk tolerance exists for lipophilic but not hydrophilic groups about the C-9 acridine position and for both lipophilic and hydrophilic groups on the side-chain cationic moiety. Significant attenuation of the pKa of the side-chain cationic center abolishes activity, as does alteration of either the disposition or separation distance of the side-chain charge with respect to the chromophore. PMID- 6492079 TI - Quantitative structure-activity relationship of insect juvenile hormone mimetic compounds. AB - Juvenile hormone mimetic activities on Aedes aegypti (yellow-fever mosquito) and Tenebrio molitor (yellow mealworm) of compounds having (2E,4E)-3,7,11-trimethyl 2,4-dodecadienone structures were comparatively and quantitatively analyzed in terms of their physiochemical structural parameters and by regression analysis. They were structurally composed of three classes, ester and thiol ester derivatives, amides, and ketones, depending on the C1 substituents. The results indicated that the steric dimensions and the hydrophobicity of the whole molecule are important factors in governing the activity through these classes as well as through both insect species. The effects of the structure of the C1 and C11 substituents, the two ends of the chain molecule, are specific to the insect. The length along the bond axis of the C1 substituents is significant and the hydroxy and alkoxy functions attached to the C11 atom favor the activity on A. aegypti, whereas with T. molitor the width of the C1 substituents in the direction perpendicular to the bond axis is significant and the position-specific hydrophobicity of the C1 moiety enhances the activity. The activity is also affected differently by the compound types. The amide and ketone series of compounds are more active than the corresponding ester type of compounds on T. molitor, while the favorable types on A. aegypti are the ester and ketone derivatives. Correlation equations formulated for 85 active compounds on A. aegypti and 84 compounds on T. molitor led us to draw a hypothetical "mode of action" model for each species, which visualizes the overall similarity as well as the species differences of the interaction site or the receptor and may show the structural conditions necessary for activity. PMID- 6492080 TI - Nontricyclic antidepressant agents derived from cis- and trans-1-amino-4 aryltetralins. AB - The need for drugs that lack the obtrusive and limiting side effects of the tricyclic antidepressants has prompted the search for agents with greatly enhanced selectivity for specific mechanisms believed to be essential for antidepressant efficacy. The potential role of derangements of 5-HT pathways in the etiology of depression has long been suspected and has given impetus to the development of newer compounds that accentuate inhibition of serotonin reuptake. This paper presents structure-activity relationships for a series of cis-1-amino 4-(substituted-aryl)tetralins, which are surprisingly potent and selective inhibitors of serotonin uptake in in vitro models. These compounds are pharmacologically distinct from corresponding members of the trans series, which also potently block uptake of dopamine and norepinephrine. The activity in both cis and trans series is stereospecific, being restricted to the cis-(1S,4S) and the trans-(1R,4S) enantiomers. PMID- 6492081 TI - A theoretical investigation of histamine tautomerism. AB - Geometry optimizations of the structures of histamine (neutral and monocation) in the N(3)-H and N(1)-H tautomeric forms were performed at the ab initio Hartree Fock level with the STO-3G basis set. Values of the structural parameters and their changes upon protonation and/or tautomerization are in good agreement with data from X-ray crystal-structure analysis of histamine and several analogues. Earlier predictions of the tautomeric preference from calculations using frozen geometries based on crystal-structure data are confirmed by calculations of energies of histamine in the fully optimized geometries with both the STO-3G and LP-3G basis sets and by comparisons of the minima in the molecular electrostatic potentials of the two tautomers. These results support a previously proposed model for the activation of the histamine H2 receptor. PMID- 6492082 TI - Dispersion of gravid Aedes triseriatus (Diptera: Culicidae) from woodlands into open terrain. PMID- 6492083 TI - A tick/rickettsia survey of dogs in three counties in Mississippi, USA. PMID- 6492084 TI - Esterase activity in strains of Aedes aegypti (Diptera: Culicidae) tolerant and susceptible to the organophosphate insecticide malathion. PMID- 6492085 TI - Morphogenetic and histopathological effects induced by the insect growth regulator cyromazine in Musca domestica (Diptera: Muscidae). PMID- 6492086 TI - Morphogenetic and histopathological effects of the insect growth regulator cyromazine in larvae of Culex quinquefasciatus (Diptera: Culicidae). PMID- 6492087 TI - Possible function of cephalic outgrowths of sucking lice (Anoplura) parasitic on tree shrews (Tupaiidae). PMID- 6492088 TI - Natural incidence of Setaria equina (Nematoda: Filarioidea) from Aedes canadensis (Diptera: Culicidae) in North America. PMID- 6492089 TI - Growth hormone inhibition causes increased selenium levels in Duchenne muscular dystrophy: a possible new approach to therapy. AB - Nine children with Duchenne muscular dystrophy were given Sanorex (mazindol), a growth hormone inhibitor, daily for 6 months. There was no significant change in their muscle function, but there was a significant reduction in weight gain and in levels of growth hormone, somatomedin C, hair zinc, serum zinc, and serum LDH. Selenium and glutathione peroxidase in the serum increased significantly. Thirteen other children with growth hormone deficiency had a significant reduction in hair selenium following growth hormone administration. These results show a significant relationship between growth hormone and selenium nutritional status and confirm our previous reports indicating an effect of growth hormone on zinc nutritional status. It is possible that prolonged therapy with a growth hormone inhibitor would attenuate the course and improve the longevity of patients with muscular dystrophy. PMID- 6492091 TI - A screening programme for the prospective prevention of Mediterranean anaemia in Latium: results of seven years' work. AB - Since 1975 the Rome Microcythaemia Centre has carried out every year, under the auspices of the health authorities of the Latium region, a screening of thalassaemics among intermediate schoolchildren of Latium. From these campaigns, knowledge about thalassaemias among the young adult population has grown which, in its turn, has resulted in screening of these young adults. Through screening in schools between 1975 and 1982, of 289 763 students examined, 6838 thalassaemics were identified, 6045 of whom were beta- or delta beta thalassaemics. The total number of young thalassaemics who are identified at present in the Centre through screenings of schoolchildren and young adults is about 3300 per year. Furthermore, from January 1980 to April 1983, 110 prospective couples of child-bearing age at risk (94 of whom originated from Latium) were identified at the Centre, and five homozygous fetuses (three of which originated from Latium) were diagnosed. These data derive from an area in which the frequency of thalassaemia is only 2.4%, and they show that the programme in Latium for the prevention of Mediterranean anaemia has been successful. PMID- 6492090 TI - The clinical features of homozygous alpha 2(I) collagen deficient osteogenesis imperfecta. AB - The detailed clinical features and progress of a child with homozygous alpha 2(I) collagen deficiency are described. Clinically, the disease presents as severe progressive Sillence type III osteogenesis imperfecta. The main biochemical defect is the synthesis of an abnormal pro alpha 2(I) chain which does not associate with pro alpha 1(I) chains and therefore is not incorporated into triple helical trimers of type I procollagen which can be used to assemble collagen fibres. PMID- 6492092 TI - Tuberous sclerosis: a new estimate of prevalence within the Oxford region. AB - Within the counties administered by the Oxford Regional Health Authority (population 2 328 100) the prevalence of tuberous sclerosis was estimated as 1 in 29 900 for persons under 65 years of age. For the population below 30 years of age the prevalence was 1 in 21 500 and for children under 5 years 1 in 15 400. Cases were ascertained through the records of the Department of Medical Genetics at Oxford and the Tuberous Sclerosis Association of Great Britain and also by a questionnaire sent to selected consultants within the region. A previous estimate of prevalence within the region was 1 in 100 000. This study suggests that the prevalence at birth might be even higher than 1 in 15 000. PMID- 6492093 TI - Familial hidradenitis suppurativa: evidence in favour of single gene transmission. AB - The three English families in this report have a total of 21 members (16 females and five males) suffering from chronic hidradenitis suppurativa. In family A the condition is associated with acne conglobata and there is vertical transmission of the disorder through three generations. In the others there is no associated cystic acne, but all those affected had a history of acne vulgaris with comedone formation, and the condition has been confirmed in two generations. It is likely that a male in an earlier generation in family B suffered from the disease and affected sibs in family C were born to different fathers. The familial aggregation and number of affected subjects suggests a single gene disorder and the pattern of transmission is consistent with autosomal dominant inheritance. Males and females are affected in successive generations and there is the anticipated variation in clinical severity in those suffering from the condition. PMID- 6492094 TI - Trichothiodystrophy-neurotrichocutaneous syndrome of Pollitt: a report of two unrelated cases. AB - Two unrelated children presenting with mental and physical retardation and sulphur deficient brittle hair are reported. These are thought to be further cases of the autosomal recessive neurotrichocutaneous syndrome of Pollitt, of which eight cases have been previously reported. PMID- 6492095 TI - Observations on the epidemiology of club foot in Polynesian and Caucasian populations. AB - Although Polynesians are affected by idiopathic club foot deformity more commonly than other racial groups, epidemiological surveys performed in Auckland and Glasgow showed no other significant difference in their pattern of presentation compared with Caucasians. Distinctions in sex ratio and maternal age, reported previously between groups of index cases with and without a family history of the condition, were not confirmed in either racial group, and the predominance of right sided over left sided unilateral cases was no greater in Polynesians than in Caucasians. There was an excess of sporadic cases born to very young mothers among the Maori population. PMID- 6492096 TI - Four cases of trisomy 18 syndrome with limb reduction malformations. AB - Limb reduction malformations of the arms are well documented in the trisomy 18 syndrome. Four cases of trisomy 18 syndrome with limb reduction malformations of the legs are described and compared with the upper limb malformations. PMID- 6492097 TI - Deletion of the short arm of chromosome 3: a case report with necropsy findings. AB - A male infant with partial deletion of the short arm of chromosome 3 is described. The features this patient shares with six previously reported cases include microcephaly, dolichocephaly, micrognathia, epicanthic folds, ptosis, low set or malformed ears, postaxial polydactyly, and growth or mental retardation or both. In addition, visceral anomalies not previously reported in association with this chromosomal abnormality are described. These characteristics may constitute a recognisable clinical syndrome. PMID- 6492098 TI - Partial trisomy 16p due to maternal balanced translocation. AB - A newborn oriental male with multiple malformations was found to have partial trisomy of 16p. The mother was found to be a translocation carrier: 46,XX,t(14;16) (q32;p12). PMID- 6492099 TI - Familial pericentric inversion (10) and its effect on two offspring. AB - A pericentric inversion (10)(p15q24) was observed in three generations of a family. One daughter of the inversion carrier was found to have the inv(10) and trisomy 18. The other offspring had a recombinant (10) chromosome. PMID- 6492100 TI - Trisomy 9p due to unusual maternal translocation (3;9). PMID- 6492101 TI - Effect of rising percentage of female physicians on projections of physician supply. AB - The Graduate Medical Education National Advisory Committee (GMENAC) in 1980 projected a surplus of 145,000 physicians in the year 2000. Inherent in the GMENAC prediction are several assumptions, including the assumption that the current percentage of female physicians will remain unchanged. However, the number of female physicians is increasing at a rapid rate. Since it has been estimated that female physicians work 40 percent fewer hours during their lifetimes than their male counterparts, the increasing percentage of female physicians will result in a decrease in overall physician productivity as measured by total practice hours. Using an adjustment to the GMENAC model that will take into account the changing male/female ratios of physicians, the estimated physician surplus in the year 2000 is reduced by 41,000 physicians, or approximately 28 percent of the GMENAC-predicted surplus. PMID- 6492102 TI - Perceptions of medical school faculty members and students on clinical clerkship feedback. AB - The authors in this study investigated faculty members' and students' perceptions of the feedback they provided or received, respectively, during the clerkships in all clinical departments at a university hospital. All faculty members who teach students in the clinical years and all third- and fourth-year medical students were surveyed. Respondents were asked to indicate, on a 7-point scale, the importance they attributed to eight feedback categories and to rate the frequency of actual feedback they felt was provided or received in these eight categories. The results indicate that while both faculty members and students perceived six of the eight feedback categories as equally important, they differed substantially in their ratings of the actual feedback provided or received. PMID- 6492103 TI - Experience with providing research opportunities for medical students. AB - The purpose of the program described was to provide research training experience at the Mayo Medical School for third-year students. It was hoped the students would learn sound research principles, develop skills in evaluating research literature, and, while developing an area of expertise, enhance their self-image in relation to research. Faculty members were asked to participate as advisers/preceptors and to provide laboratory support for students. Surveys of the students' attitudes have shown very positive feelings concerning their research accomplishments and the value of the time they spent doing the research. Results in terms of numbers of papers written, published, and presented at meetings by the students indicate that the program is making a worthwhile contribution to the curriculum of the medical school. PMID- 6492104 TI - Patient-generated dysphoria in house officers. AB - Patients can induce intense emotions in physicians. Such feelings can become a source of stress for the physician and interfere adversely with patient care. The authors investigated patient illnesses and conditions that caused dysphoria among three specialty groups of house officers. Tragic, horrifying, or difficult patients produced intense dysphoria in all three groups. The characteristics of the patients producing the greatest dysphoria for each specialty group fell outside the traditional expertise of that group. PMID- 6492105 TI - Analytic thinking: educating students for the practice of modern medicine. AB - The medical school curriculum is dominated by efforts to teach the mass of facts that comprise an ever-expanding pool of biomedical knowledge. As a result, little time remains for learning the scientific method, how to evaluate medical information, and how to apply analytic processes for the prevention, diagnosis, and management of disease. A new component in the medical curriculum at Emory University School of Medicine, a course titled Analytic Medicine, is proposed as a first step toward correcting these deficiencies. Analytic Medicine is intended to provide the opportunity and the necessary skills, through a problem-oriented approach, for medical students to learn to reason scientifically and to utilize analytic processes, including computers, in making clinical decisions. PMID- 6492106 TI - Effects of lecture information density on medical student achievement. AB - With the virtual explosion of biomedical information, the medical educator regularly faces a quandary regarding how much to include in the medical curriculum. Opinions differ regarding how much of the available information on a particular topic should be presented in a medical school lecture. To understand better the effect of lecture information density on learning by medical students, one of the authors gave a basic clinical lecture only or clinical lectures with varying amounts of semirelated information. Tests which measured only retention of the basic material were given before lecture attendance, immediately after the lecture, and 15 days later. The results indicated that increasing the information density of a lecture reduced retention of the basic information. The memory loss apparently was due to information presented late in the lecture displacing facts learned by the students earlier in the same hour. The data suggest that lectures to medical students are more effective aids to learning when the information density is limited to a few main points that are "essential to know." PMID- 6492107 TI - 'Patientspeak': an exercise in communication. AB - Effective patient care requires effective communication with patients. The creation of a "Patientspeak" dictionary is offered as a constructive exercise for facilitating communication between health care professionals and their patients. PMID- 6492108 TI - Contrasts in the professional identities of psychiatrists and internists. AB - Projected manpower shortages in psychiatry have prompted studies identifying factors that influence medical students in career choice. In the present study, the authors compare self-images as individuals with professional images of psychiatrists using subjects from internal medicine as a control group. A total of 353 subjects from two university clinical practices completed questionnaires that utilized the Osgood Semantic Differential to determine attitudes in the areas of evaluation, potency, and activity. The hypothesis that psychiatrists differ significantly in their self-images as individuals and their professional role images was partially confirmed. In the areas of activity and power, significant (p less than .001) differences existed in their attitudes. In the concept of evaluation, the self-images and the professional images were similar. The impact of these discrepancies on students making career choices is discussed. PMID- 6492110 TI - Patient responses to a training interview. PMID- 6492111 TI - Early detection and outpatient management of alcoholism: a curriculum for medical residents. PMID- 6492112 TI - Death counseling and psychosocial support by physicians concerning dying children. PMID- 6492113 TI - Needs assessment and problem identification of first- and second-year medical students. PMID- 6492114 TI - Introduction to interviewing patients. PMID- 6492115 TI - Emergency medicine. PMID- 6492116 TI - Physicians for the twenty-first century. Report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine. PMID- 6492117 TI - Binding of 125I-alpha toxin of Staphylococcus aureus to erythrocytes. AB - Alpha toxin purified from Staphylococcus aureus strain Wood 46 and radioiodinated by the lactoperoxidase method retained full haemolytic activity and was used to study factors affecting binding to rabbit and horse erythrocytes. A relatively fixed percentage of added toxin bound to both cell types; the percentage bound was independent of temperature, pH, cell concentration and toxin concentration. Neither a 50-fold excess of native toxin nor Concanavalin A inhibited the binding of iodinated toxin to erythrocytes. The results suggest that differences in the sensitivity of erythrocytes to haemolysis do not reflect the abundance of high affinity toxin receptors on sensitive cells, but are more probably the result of differences in the intrinsic stability of the membrane and its sensitivity to perturbation by amphiphilic agents. PMID- 6492118 TI - Inhibition of secretion of staphylococcal alpha toxin by cerulenin. AB - Secretion of alpha toxin by Staphylococcus aureus strain Wood 46 was preferentially inhibited by cerulenin, an antibiotic that stops fatty-acid synthesis by inhibiting beta-keto acyl acyl carrier-protein synthetase. At the concentrations used, cerulenin had a negligible effect on cell growth and total protein synthesis, but reduced lipid synthesis by 50%. Extracellular and membrane associated alpha toxin was absent in cultures treated with cerulenin, but toxin formation was resumed after either removal of the antibiotic or addition of exogenous fatty acids. The apparent absence of toxin precursor in membranes of inhibited cells favours inhibition at an earlier stage in toxin synthesis. PMID- 6492119 TI - Quantitative bacteriology of the vaginal flora in genital disease. AB - Samples from the posterior vaginal fornix of 102 women with various clinical conditions were analysed by a quantitative method. Aerobes were isolated from all but one of the specimens at a mean concentration of 7.2 log10 cfu/g and anaerobes from 92 specimens at a mean concentration of 8.1 log10 cfu/g. In most clinical conditions and in a control group of asymptomatic women, anaerobes outnumbered aerobes by about ten to one (one log10 unit). The most common organisms were aerobic and anaerobic lactobacilli, coryneforms, Staphylococcus epidermidis, Bacteroides spp. and anaerobic gram-positive cocci. Lactobacilli did not appear to confer any protective effect by excluding the presence of other organisms such as Gardnerella vaginalis or anaerobes. The isolation of anaerobic organisms from the vagina cannot be regarded as being of pathogenic significance without other supporting evidence. PMID- 6492120 TI - Experimental gastroenteritis in newly-hatched chicks infected with Campylobacter jejuni. AB - The susceptibility of chicks to enteritis caused by Campylobacter jejuni was studied. Three-day-old chicks did not develop enteritis after oral infection but chicks infected within 12 h of hatching developed gastroenteritis. The incubation period correlated with the inoculum size. Initially, infected chicks developed blood- and mucus-containing stools, although watery diarrhoea often occurred late in the course of the disease. Recurrences of the enteric manifestations were common but only two out of 170 infected chicks died. C. jejuni was recovered from sites throughout the intestine; the highest concentrations were present in the caecum and large intestine. Both the upper and lower gastrointestinal tract were affected and cellular infiltration of the gastric mucosa and the intestinal lamina propria was observed. Organisms resembling C. jejuni were seen within the intestinal epithelium and lamina propria by electronmicroscopy. The newly hatched chick provides a reproducible and sensitive model of campylobacter enteritis. PMID- 6492121 TI - Phage beta interaction with Vibrio cholerae. AB - The role of temperate phage beta in determining the serology and eltor-lytic phage sensitivity in Vibrio cholerae was investigated. The only serological change found in six host strains was a change to roughness. This was accompanied by failure to adsorb several of the lytic phages. Various phage-sensitivity changes were induced by phage beta in two hosts at the post-adsorption level. In strain HP47, three types of progeny were obtained of which one was universally resistant to lytic phages. These untypable lysogens were culturally stable but gave rise to segregants of the rare phage-type 6 on single colony selection. PMID- 6492122 TI - Immune responses to liver-specific lipoprotein and liver membrane antigen: a tabular interpretative review. PMID- 6492123 TI - Solubilization of immune complexes in complement factor deficient sera and the influence of temperature, ionic strength and divalent cations on the solubilization reaction. AB - The complement-mediated solubilization (CMS) of immune complexes (IC) and the initial kinetics (IKS) of this reaction in human sera depleted of or deficient in C2, C3, C8, factors B, P and I were investigated. Sera depleted of B or P and those lacking native C3 or factor I showed virtually no CMS whereas the IKS and CMS capacity of a C8-deficient serum were within the reference range. The IKS of a C2-deficient serum was markedly retarded while the CMS capacity was normal. Addition of C2 normalized the kinetics of the reaction. There was a good correlation between the kinetics of CMS determined by a radioassay and kinetic data for the binding of C3b to preformed immune complexes. The CMS capacity reached maximum at 39-41 degrees C and at an ionic strength of approximately 0.20 mu. Selective chelation of Mg2+ completely abolished the CMS of IC. Maximal CMS was observed at Mg2+ concentration of about 2mM. Chelation of Ca2+ in serum by Mg2+-ethylene glycol tetraacetic acid reduced the CMS capacity by up to 50% and the IKS was markedly retarded. Varying the Zn2+ or Mn2+ ion concentrations in serum influenced neither the IKS nor the CMS capacity. PMID- 6492124 TI - A micromodification of the CH50 test for the classical pathway of complement. AB - A micromodification of the CH50 assay of Kabat and Mayer is described in which the total reaction volume has been reduced five-fold. This assay utilizes sheep red blood cells pooled from multiple animals rather than from a single animal to avoid screening procedures of red blood cells from individual sheep. Analysis of natural hemolysin activity in normal serum revealed a correlation with elevated CH50 titers. However, this correlation does not appear to effect the clinical interpretation of the results. PMID- 6492125 TI - Mechanism of Cl secretion in canine trachea: changes in intracellular chloride activity with secretion. AB - Cl-sensitive microelectrodes were employed to investigate the mechanism of Cl secretion by canine tracheal epithelium. In control tissues with a mean calculated short-circuit current (Isc) of 18.1 microA/cm2, the intracellular Cl activity (aiCl) was 47.2 mM. This value is 30.1 mM (or 27.0 mV) above the electrochemical equilibrium for Cl across the apical membrane. Epinephrine, which stimulates Cl secretion, increased the calculated Isc to 160 microA/cm2 and decreased aiCl to 32.2 mM, a value only 11.2 mM (or 10.9 mV) above equilibrium for the apical membrane. These results indicate a secretagogue induced decrease in the impedance to Cl exist from the cell via the apical membrane. From these and prior measurements we calculate that epinephrine-induced Cl efflux from the cell can occur by simple diffusion across the apical membrane. Further implications of these calculations are also discussed. PMID- 6492126 TI - Cellular ions in intact and denervated muscles of the rat. AB - Tissue composition, membrane potentials and cellular activity of potassium, sodium and chloride have been measured in innervated and denervated rat skeletal muscles incubated in vitro. After denervation for 3 days, tissue water, sodium and chloride were increased but cellular potassium content and measured activity were little affected, despite a decrease of 16 mV in resting membrane potential which would have necessitated a decrease in cellular potassium activity of almost 50% were potassium distributed at electrochemical equilibrium. These findings, therefore, preclude a decreased electrochemical potential gradient for potassium as the cause of the membrane depolarization characteristic of denervated muscle fibers. Analysis of the data excludes an important contribution of rheogenic sodium transport to the resting potential of innervated muscles. These results strongly support the hypothesis that the decreased membrane potential in denervated fibers reflects a relative increase in the membrane permeability to sodium. PMID- 6492127 TI - Linear electrical properties of isolated cardiac cells. AB - A frequency domain equivalent circuit analysis of isolated ventricular cells indicated the presence of an internal membrane structure which has a total capacitance four- to sixfold larger than the surface membrane. The internal membrane was mainly attributed to the sarcoplasmic reticulum since other morphological studies have shown that its area is many-fold larger than that of the surface membrane. Corresponding estimates from the transverse tubular system indicate an area less than that of the surface; thus this structure is not a likely candidate for the observed internal capacitance. Measurements in hypertonic solutions showed that the access resistance to the internal membrane reversibly increased as the tonicity was elevated. Freeze-fractured electron microscopic studies confirmed that hypertonic solutions increased the volume of transverse tubular system, which thus appears to have little relation to the access resistance. The most probable source of the access resistance is the diadic junction to the sarcoplasmic reticulum, which therefore would electrically couple it to the surface membrane. PMID- 6492128 TI - Cell-to-cell communication in monolayers of epithelioid cells (MDCK) as a function of the age of the monolayer. AB - We explore the existence of cell-to-cell communication in monolayers of MDCK cells plated at high densities so that they form a continuous monolayer in a few minutes. Lucifer Yellow CH is injected in the cytoplasm of a given cell by using a glass microelectrode with a fine tip (ca. 100 M omega) and passing square pulses of current of 1.0 nA that last 10 msec, every 20 msec, during 1 to 3 min. We then examine the monolayer with fluorescence microscopy. In 27 out of 111 cells injected during the first 4 to 15 hr after plating, the dye was transferred to neighboring cells. Electron micrographs of freeze-fracture replicas prepared at this time, show that 20 to 25% of the lateral surfaces present the aggregates of intramembrane particles typical of gap junctions. These early hours correspond to the formation of occluding junctions and polarization into an apical and a basolateral domain of the plasma membrane (Cereijido, Meza & Martinez-Palomo, 1981). Cell-to-cell coupling then decreases sharply and, in the period between the 1st and 3rd day (mature monolayers), only 4 out of 49 injected cells were able to transfer the dye to their neighbors in the monolayers. No image of gap junctions was found in freeze-fracture replicas of mature monolayers. The degree of coupling between cells, as well as the number of cells coupled to the injected one, were highly variable. The lack of coupling between cells in mature monolayers observed in this article with Lucifer Yellow CH and electron microscopy is in keeping with the absence of electrical coupling observed in a previous work (Stefani & Cereijido, 1983). The transient existence of communicating junctions observed in monolayers of MDCK cells is similar to that described in the literature for embryo tissues during development. PMID- 6492130 TI - Calcium effects on electrogenic pump and passive permeability of the plasma membrane of Chara corallina. AB - Removal of Ca2+ from the medium results in depolarization of the Chara internodal cell and an increase in membrane conductance (Gm). The increase in conductance is associated with an increase in K+ conductance, as judged by Ca2+ effects on the K+ dependence of clamp current. The voltage dependence of Gm is also affected by Ca2+, as is the time course of the response of clamp current to a step change in voltage. Mg2+ restores the low conductance and the fast response to a voltage change, but not hyperpolarization at neutral pH, suggesting that there is an additional, independent effect on the electrogenic pump. The membrane does not show the normal ability to increase proton conductance at high pH in the absence of Ca2+; this is also restored by Mg2+ as well as by Ca2+. PMID- 6492129 TI - Communicating junctions and calmodulin: inhibition of electrical uncoupling in Xenopus embryo by calmidazolium. AB - This paper reports the inhibitory effects of calmidazolium (CDZ), a calmodulin inhibitor, on electrical uncoupling by CO2. Membrane potential and coupling ratio (V2/V1) are measured in two neighboring cells of Xenopus embryos (16 to 64 cell stage) for periods as long as 5.5 hr. Upon exposure to 100% CO2, control cells consistently uncouple even if the CO2 treatments are repeated every 15 min for 2.5 hr. CDZ (5 X 10(-8) - 1 X 10(-7) M) strongly inhibits uncoupling. The inhibition starts after 30, 50 and 60 min of treatment with 1 X 10(-7), 7 X 10( 8) and 5 X 10(-8) M CDZ, respectively, is concentration-dependent and partially reversible. In the absence of CO2, CDZ also improves electrical coupling. CDZ has no significant effect on membrane potential and nonjunctional membrane resistance. These data suggest that calmodulin or a calmodulin-like protein participates in the uncoupling mechanism. PMID- 6492131 TI - Intracellular chloride activity in the extensor digitorum longus (EDL) muscle of the rat. AB - Measurement of intracellular chloride activity in the extensor digitorum longus (EDL) muscle of the rat using liquid ion-exchanger microelectrodes gave an apparent resting value of 10 to 11 mmol liter-1. If chloride ions were distributed passively across the muscle fiber membrane the predicted value would be 4 mmol liter-1. In experiments in which the bathing fluid was changed by (a) reduction of external chloride, or incubation at low external chloride followed by a return to normal concentrations, (b) an increase or reduction in external potassium, (c) alteration in potassium and chloride in the bathing medium so as to maintain a constant [K] X [Cl] product, or in other experiments in which the membrane potential was caused to change by anoxia, or by addition of ouabain to the medium, changes in intracellular chloride activity were invariably consistent with the hypothesis that this ion is passively distributed. Measurements of intracellular chloride activity with recessed-tip solid-state Ag/AgCl electrodes gave a value of 4.6 mmol liter-1. Since the liquid ion-exchanger is known to be poorly selective for chloride, it is concluded that the chloride ion is passively distributed in rat EDL muscle. PMID- 6492132 TI - Thermodynamics of all-or-none water channel closure in red cells. AB - The relation of osmotic to diffusional water permeability of human red blood cells was compared after treating the cells with different concentrations of PCMBS (p-chloromercuribenzene sulfonate). After subtracting the PCMBS-insensitive permeability (presumably the water permeability of the lipid bilayer) from each, the ratio of osmotic to diffusional permeability remains invariant (approximately equal to 11) as more and more water channels are inhibited by increasing concentrations of PCMBS. This result implies that the channels close in an all-or none way and suggests a two-state model. Analysis of the dependence of osmotic water permeability on PCMBS concentration in terms of the model reveals a 1:1 stoichiometry and a dissociation constant for the PCMBS/membrane receptor complex of about 0.019 mM at 37 degrees C. Temperature dependence studies show that the reaction is entropically driven (delta H degrees approximately equal to 25 kcal/mol, delta S degrees approximately equal to 100 cal/mol-deg) and suggest the involvement of hydrophobic interactions. PMID- 6492135 TI - How effective are physiotherapeutic programmes with young mentally retarded children who have cerebral palsy? PMID- 6492133 TI - Membrane potential and surface potential in mitochondria: uptake and binding of lipophilic cations. AB - The uptake and binding of the lipophilic cations ethidium+, tetraphenylphosphonium+ (TPP+), triphenylmethylphosphonium+ (TPMP+), and tetraphenylarsonium+ (TPA+) in rat liver mitochondria and submitochondrial particles were investigated. The effects of membrane potential, surface potentials and cation concentration on the uptake and binding were elucidated. The accumulation of these cations by mitochondria is described by an uptake and binding to the matrix face of the inner membrane in addition to the binding to the cytosolic face of the inner membrane. The apparent partition coefficients between the external medium and the cytosolic surface of the inner membrane (K'o) and the internal matrix volume and matrix face of the inner membrane (K'i) were determined and were utilized to estimate the membrane potential delta psi from the cation accumulation factor Rc according to the relation delta psi = RT/ZF ln [(RcVo - K'o)/(Vi + K'i)] where Vo and Vi are the volume of the external medium and the mitochondrial matrix, respectively, and Rc is the ratio of the cation content of the mitochondria and the medium. The values of delta psi estimated from this equation are in remarkably good agreement with those estimated from the distribution of 86Rb in the presence of valinomycin. The results are discussed in relation to studies in which the membrane potential in mitochondria and bacterial cells was estimated from the distribution of lipophilic cations. PMID- 6492134 TI - Functional evidence for distinct interaction of hydrophobic arylisothiocyanates with the erythrocyte anion transport protein. AB - Human erythrocytes were treated with various hydrophobic arylisothiocyanates under conditions which favor modification of distinct proteinaceous nucleophiles. The morphological appearance of phenylisothiocyanate-treated cells was discoid and membrane-bound hydrolases (human acetylcholinesterase, sheep phospholipase A2) were fully active following membrane modification. Noncharged hydrophobic arylisothiocyanates, including phenylisothiocyanate, beta-naphthylisothiocyanate and heterobifunctional azidoarylisothiocyanates inhibited [35S]-sulfate efflux irreversibly. Protection against modification-induced inhibition of sulfate transport was attained by the simultaneous presence of the specific reversible anion transport inhibitor 4,4'-dinitrostilbene-2,2'-disulfonate. Selective protection of a functionally relevant domain of band 3 is concluded to occur based on the above-derived information. PMID- 6492136 TI - Evaluating community care for the mentally handicapped adult: a comparison of hostel, home and hospital care. AB - While community care for mentally handicapped adults has been received enthusiastically, there have been few attempts to evaluate this form of care. This paper reports a study of two hostels for mentally handicapped adults. By employing an experimental research design, it aimed to test the hypothesis that small, community based residences provide an environment in which individuals can acquire the skills necessary for independent living. Using Gunzberg's Progress Assessment Charts as an indicator, the residents of one hostel achieved significant improvements in the areas of self-help, communication, socialization and occupation over the year following admission. A group of matched controls living at home showed no such improvements, and a group of matched controls living in hospital showed a less certain and less dramatic improvement. A small group of people living in a second hostel also showed significant gains in social competence. The paper also discusses problems in the design and implementation of experimental studies in this field. PMID- 6492137 TI - Increasing physicians' awareness and use of community resources for mentally retarded persons. AB - General practitioners must frequently deal not only with the physical health of their mentally retarded patients, but also with their psychological and emotional problems and with difficulties that their families have with coping. In the present study all general practitioners in one city were questioned about their knowledge of mental retardation, their ability to counsel families with a mentally retarded member and their knowledge and utilization of community agencies which provided services for the mentally retarded and their families. The majority of the 400 physicians who satisfactorily completed the questionnaire accepted an obligation to deal with the various problems of the mentally retarded, to counsel their families and to know about and make referrals to available community services. However most also expressed lacks in their knowledge about these various matters. Subsequently, detailed information was sent to them about the available community agencies and then sometime later they were given a second questionnaire concerning their referrals to and advice to parents about the community services. The replies indicated that the physicians now had a much greater awareness of the services available, and that they more regularly made referrals to and advised parents to use these facilities. PMID- 6492138 TI - Using stimulus shaping and fading to establish stimulus control in normal and retarded children. AB - The present study was an effort to investigate whether, in addition to his IQ level, the child's ability to identify all relevant stimulus components would affect the frequency of overselective responding. Children of different IQ levels (i.e. normal, educably retarded, and trainable retarded children) participated. Subjects were trained to learn the meanings of four sets of fictitious words, i.e. two sets containing words printed in Roman letters (Roman words), and two sets containing words printed in Hebrew letters (Hebrew words). All subjects could identify the words of each set. The normal and educably retarded subjects could read aloud the Roman words, whereas the trainable retarded subjects could not. None of the subjects could read the Hebrew words. Two training procedures were used, one requiring transfer of stimulus control (fading), and one which did not (stimulus shaping). The results indicated that, firstly, the discrimination learning of the normal and educably retarded subjects covaried with the IQ level and their ability to read the words. The learning rate was not affected by the training procedures. Secondly, the trainable retarded subjects learned much better through stimulus shaping than through fading. Their acquisition rates were slow and not affected by the types of letters. Thirdly, the training procedures had no effect on the breadth of stimulus control. Instead, it covaried as a function of the IQ level (all groups) and of the child's ability to read the words (normal and educably retarded subjects). Fourthly, the training procedures had, however, considerable effect on which letters controlled the discriminations. When overselective selective responding was evident, the letters that had been associated with the prompts were more often functional than the other letters, but only for the words trained through stimulus shaping. PMID- 6492139 TI - Psychomotor development in the first year and mental retardation--a prospective study. AB - The psychomotor development of mentally retarded children (IQ less than or equal to 85) in their first year is compared here with that of healthy children on the basis of a 1-year birth cohort (1966) from northern Finland which comprised a total of 12 058 live-born children. Data on the age of reaching the main developmental milestones in the first year, standing without support, walking with and without support and speech at 12 months were obtained by means of information collected prospectively in the children's welfare centres for this purpose. Detailed information on mental retardation covering the age group 0-14 years was obtained from the school health authorities, the national hospital discharge register and other regional or national registers. The results show that mental retardation is associated with subnormal motor development in the first year, as this finding persists even after the exclusion of children with a CP syndrome. Children who could neither walk with support nor speak by the age of 12 months constituted a high-risk group for mental retardation, the risk being 14 fold higher in this group than among the other children. Even so, only 65.2% of the children with severe mental retardation and 38.2% of those with mild mental retardation fulfilled these criteria, demonstrating that psychomotor development in the first year can be apparently normal in these groups. PMID- 6492140 TI - Treatment package to reduce SIB in a Lesch-Nyhan patient. AB - Self-destructive behaviour in LNS children results in a tremendous burden to parents, teachers, staff members, and other responsible for their care. As constant vigilance is not always feasible, developing alternate methods of managing SIB becomes imperative. This report presents our efforts to improve the care of an LNS child and to ease the burden on staff members and parents by obtaining special devices (e.g. the custom-made mouthguard and the gloves) to prevent him from injuring himself. Others (e.g. Letts & Hobson, 1975) have likewise reported success in fabricating custom-designed chairs and devices in an effort to manage SIB in LNS children. Their devices were, however, more elaborate and much more expensive than the ones used in this report. The cost of obtaining a mouthguard similar to the one used with K. is estimated at between $20-$30 (US), while the gloves cost only $14.00. The major advantages of using such devices are that they safely allow employment of the extinction procedure along with allowing the child to participate more fully in activities of daily living. It is recognized that K. was in some ways an atypical Lesch-Nyhan child in that he possessed low normal receptive intelligence and scored fairly high (relative to most LNS children) on a test of verbal intelligence. His cognitive and verbal abilities made him a unique case in that he responded favourably to therapeutic instructions regarding relaxation and self-control tactics. The therapists were able to rely on K.'s verbalizations and feelings about his biting in structuring the treatment approach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492141 TI - Clinical confusion of the Noonan syndrome with the Borjeson-Forssman-Lehmann syndrome. AB - The diagnosis of Borjeson-Forssman-Lehmann syndrome in a patient reported by Veall et al. (1979) is challenged. The clinical findings were compared with those in 32 patients with the Noonan syndrome using the extensive description, dermatoglyphics, photographs and anthropometric measurements provided in the paper. The patient's findings are compatible with the Noonan syndrome based on his overall phenotypic similarity to the 32 patients, even though the severity of his mental retardation is atypical. PMID- 6492142 TI - Optimized acquisition parameters and statistical detection limit in quantitative EELS. AB - Optimizing the acquisition parameters for EELS recording has to be accomplished simultaneously from the physical and the statistical points of view; the statistical aspect of the question is covered here. Approximate probability density functions of the variables of interest are derived, which provide a global measure of signal-to-noise ratio taking into account every step of the EELS edge area estimation process. Qualitative and quantitative advice is given regarding the critical choice of the estimation and integration energy regions. The notion of visual contrast is presented; it permits the introduction of the concept of statistical detection limit. It is found that for typical experimental conditions, when other factors are equal, the required analysis time for the sample varies approximately as the inverse square of the concentration. PMID- 6492143 TI - Design and application of a freeze-fracture stage with a cleaver device for Balzers 'freeze-etching' apparatus. AB - A fracturing mechanism in the form of a double-wedged cleaver, used previously on other freeze-fracture machines, has been incorporated in the Balzers BAF 400 D apparatus. The design of the stage, with the cleaver, is explained and its performance and advantages are outlined. By minimizing mechanical damage to the exposed surface of the frozen specimen and reducing contamination by effective shrouding, an improvement in the quality of the replicas is achieved. The suitability of this mechanism for the fracturing of tough tissues such as skin is also outlined. PMID- 6492144 TI - Geometric model of the rat intestinal mucosa for stereological evaluation of villus amplification factors. AB - This study was prompted by a desire to compare villus amplification factors at various sites along the small intestine of the laboratory rat. The paper describes a precise and efficient stereological method for achieving this objective. The method relies on conventional intersection counts performed exclusively on transverse sections. Analyses are based on six adult rats. Pieces of small bowel fixed by in situ perfusion were taken from proximal, middle and distal regions. Intersection counts on villus and primary mucosal surfaces were performed on transverse and longitudinal sections through the same regions. These counts revealed that intestinal architecture can be reasonably approximated by the simple geometric model of an isotropic villus surface on an anisotropic (cylindrical) primary mucosal surface. As a result, intersection counts may be confined to transverse sections (to reduce sampling variance) and the appropriate ratio estimator multiplied by the numerical coefficient 4/pi (to obtain an estimate of surface amplification due to villi). PMID- 6492145 TI - Flash X-ray microscopy with a gas jet plasma source. AB - A novel flash X-ray source, the gas jet plasma source, has been used for contact X-ray microscopy. Using a wavelength range of 2-7 nm a resolution of the order of 30 nm can be obtained. The gas jet plasma source provides a new and unique tool which should allow future imaging of wet live cells. PMID- 6492146 TI - Temporal arteritis: case and review. PMID- 6492147 TI - Pneumopyopericardium complicating gastric cancer. PMID- 6492148 TI - Short-term and long-term effects of a high blood pressure intervention program. PMID- 6492149 TI - Physicians negligent in discharging mental patient who murdered family. PMID- 6492150 TI - Neglected iron deficiency. PMID- 6492151 TI - Metastatic tumors of the small intestine: case report and review of literature. PMID- 6492152 TI - Radiological seminar CCXL: case report: CT diagnosis of colon lipomas. PMID- 6492153 TI - Conserved dyad symmetry structures at the 3' end of H5 histone genes. Analysis of the duck H5 gene. AB - The duck H5 histone gene and its flanking DNA have been isolated and sequenced. S1 nuclease mapping reveals that transcription starts 149 nucleotides upstream of the initiation codon and that the site of polyadenylation is located 200 nucleotides downstream of the termination codon. A comparison with the chicken H5 gene demonstrates that the 3' non-translated segment of the polyadenylated H5 mRNA carries two conserved dyad symmetry sequences. The first potential hairpin is located directly after the termination codon of the H5 gene and is highly conserved, whereas the second stem and loop structure maps shortly upstream of the polyadenylation site and shows a homology block at the central part of this inverted DNA repeat. PMID- 6492154 TI - Plasmid mode of propagation of the genetic element P4. AB - The satellite bacteriophage P4, in the presence of a helper phage, can enter either the lytic or the lysogenic cycle. In the absence of the helper, P4 can integrate in the bacterial chromosome. In addition, the partially immunity insensitive mutant P4 vir1 can be maintained as a plasmid. We have found that in the absence of the helper, P4 wt also can be maintained as a plasmid, and that both P4 wt and P4 vir1 have two options for their intracellular propagation: a repressed-integrated or a derepressed-high copy number plasmid mode of maintenance. In the repressed mode, the P4 wt genome is only found integrated into the bacterial chromosome, while the P4 vir1 is found also as a low copy number plasmid coexisting with the integrated P4 vir1 genome. The clones carrying P4 in the derepressed-high copy number plasmid state are obtained at low frequency (0.3%) upon infection with P4 wt, while the vir1 mutation increases this frequency about 300-fold. Such clones can be distinguished easily because of their typical colony morphology (rosettes), due to the presence of filamentous cells. Filamentation of the bacterial host suggests that the presence of derepressed P4 genomes in high copy number interferes with the normal cell division mechanism. The derepressed clones are rather stable, but may revert spontaneously to the repressed state. Spontaneous transition from the repressed to the derepressed state was not observed; however, it can be induced by P2 or P4 vir1 superinfection of P4 wt and P4 vir1 lysogens or by growing the P4 vir1 lysogens up to the late exponential phase. The ability of P4 to choose either of two stable states and the potential to shift between these two modes of propagation indicate that the synthesis of the immunity repressor is regulated. PMID- 6492155 TI - Purification and characterization of ternary complexes containing accurately initiated RNA polymerase II and less than 20 nucleotides of RNA. AB - We have previously demonstrated that transcription of the adenovirus type 2 (Ad2) late promoter in vitro under UTP-limiting conditions results in pauses by the elongating RNA polymerase II between positions +6 and +17. We report here the purification of complexes between the paused RNA polymerase and a 260 base-pair Ad2 promoter-bearing DNA fragment. The procedure involves sedimentation through sucrose gradients, electrophoresis in agarose gels, and electroelution from the gels; the final complex pool is completely active in chain elongation. We observe a sharp discontinuity in complex stability during purification as a function of the number of bases added to the growing chains: complexes in which the polymerase has added more than ten bases are stable and are active in chain elongation even after the electroelution step, whereas complexes containing seven or fewer bases dissociate very easily. When purified complexes are extensively digested with proteinase K their electrophoretic mobility is increased considerably, yet they remain fully active in chain elongation. If purified complexes are digested with DNase I their electrophoretic mobility does not change. When the nuclease-treated complexes are allowed to continue chain elongation, they are able to add approximately 20 more bases to the nascent chains. PMID- 6492156 TI - Structural basis and dynamics of the fiber-to-crystal transition of sickle cell hemoglobin. AB - The kinetics of the assembly of structurally distinct, polymeric aggregates constituting the fiber-to-crystal transition of sickle cell hemoglobin in slowly stirred, deoxygenated solutions has been studied with the use of electron microscopy as a function of pH, as a function of the crystal structures of mutant forms of human deoxyhemoglobins employed as nucleating seeds, and as a function of hemoglobin S chemically modified at the Cys F9 (beta 93) position. The temporal order of appearance of fibers of approximately 210 A diameter, bundles of aligned fibers, macrofibers of greater than or equal to 650 A diameter, and microcrystals is observed. Microscopic fragments of end-stage crystals formed under slowly stirred conditions and introduced as nucleating seeds enhance the rate of crystallization only when added prior to the formation of large bundles of aligned fibers, while microscopic seed crystals added after the formation of bundles of aligned fibers do not alter the rate of crystallization. Over the pH range 6.3 to 7.1, the presence of macrofibers does not influence modulation of the kinetics of the transition with seed crystal fragments. Microscopic seed crystals of deoxyhemoglobin S and deoxyhemoglobin C formed under acidic conditions (pH less than 6.5) have a comparable influence on the kinetics of the fiber-to-crystal transition to that of end-stage crystals. Microscopic seed crystals of deoxyhemoglobin C formed under alkaline conditions (pH greater than 6.5) enhance the formation of macrofibers but do not alter the rate of crystallization. Under conditions associated with enhanced formation of macrofibers, metastable microscopic crystals having axial periodicities of approximately 64 A and approximately 210 A are observed in the intermediate phase of the transition, while end-stage crystals have axial unit cell dimensions identical to those of deoxyhemoglobin S crystallized from polyethylene glycol solutions of pH less than 6.5. Although the metastable crystals may arise from fragments of macrofibers, it is shown that they cannot be transformed directly into end-stage crystals under slowly stirred conditions without undergoing dissolution. These results stipulate that the pathway of the fiber-to-crystal transition proceeds according to the reaction: (Formula: see text) wherein the rate-limiting step is the alignment of fibers into large bundles, and macrofibers are not an intermediate of the fiber-to-crystal transition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6492157 TI - Preliminary crystallographic studies of triosephosphate isomerase from the blood parasite Trypanosoma brucei brucei. AB - Crystals of triosephosphate isomerase (EC 5.3.1.1) from Trypanosoma brucei brucei have been grown. These crystals diffract to at least 2 A, even after 60 hours of exposure to X-rays. The space group is P212121, with cell dimensions a = 112.4 A, b = 97.8 A, c = 48.0 A. There is one dimer per asymmetric unit. PMID- 6492158 TI - Differential expression and positioning of chemotaxis methylation proteins in Caulobacter. AB - Proteins involved in chemotaxis methylation reactions have been identified in Caulobacter crescentus and their activities, times of synthesis and cellular positions have been determined. The methyl-accepting chemotaxis proteins, the methyl-transferase and the methylesterase were all shown to be active in the flagella-bearing swarmer cell, but all three activities were lost after the swarmer cells shed their flagellum and differentiated into a stalked cell. The membrane methyl-accepting chemotaxis proteins were shown to be synthesized before cell division, coincident with the synthesis of the components of the flagellum, and to be specifically localized in the membrane of the incipient swarmer cell portion of the predivisional cell. The cytoplasmic methylesterase was also found to be differentially synthesized coincident with the period of flagellar biogenesis. Furthermore, methyltransferase activity, present in the predivisional cell, was detected only in the swarmer cell upon cell division. These results demonstrate that the chemotaxis methylation machinery is positionally biased toward one portion of the predivisional cell, and that the time of expression of a set of fla and che genes is correlated with the positioning of their gene products within the cell. PMID- 6492159 TI - A role for DNA polymerase in the specificity of nucleotide incorporation opposite N-acetyl-2-aminofluorene adducts. AB - Escherichia coli DNA polymerase I (Klenow fragment), DNA polymerase alpha from both calf thymus and human lymphoma cells and DNA polymerase beta from calf thymus and Novikoff hepatoma cells can incorporate nucleotides opposite N-guanin 8-yl-acetyl-2-aminofluorene in DNA. The polymerases incorporate dCTP opposite some AAF-dG lesions when Mg2+ is the divalent cation. Substitution of Mn2+ for Mg2+ broadens the specificity of insertion: E. coli DNA polymerase I (Klenow fragment) also inserts A, and at specific sites G or T; DNA polymerase alpha inserts any of the four dNTPs with A and C incorporated preferentially to G and T. Polymerase beta is specific, inserting mainly C even in the presence of Mn2+. The Km for addition of dATP opposite a lesion by E. coli polymerase I (Klenow fragment) in the presence of Mn2+ is about 0.5 mM. dNMPs increase the insertion of nucleotides opposite AAF-dG in the presence of Mg2+ and increase both the rate and number of sites at which incorporation occurs in the presence of Mn2+. dNTP alpha S and recA protein increase only the insertion of C. We suppose that the incorporation of dCTP reflects normal base-pairing with the AAF-deoxyguanine in the anti conformation, whereas insertion of the other nucleotides (including some of the C) reflects insertion opposite the AAF adduct in its preferred syn conformation. The fact that the DNA polymerase plays a role in determining the specificity of insertion opposite a lesion terminating DNA synthesis suggests that the spectrum of base substitution mutagenesis seen in vivo may reflect the properties of the protein components, including the polymerase, involved in bypass synthesis. PMID- 6492160 TI - Immunity repressor of bacteriophage P2. Identification and DNA-binding activity. AB - The product of gene C of the temperate bacteriophage P2, the immunity repressor, can be detected as a unique band eluting from phosphocellulose columns at 0.12 M potassium phosphate when differentially labelled with a radioactive amino acid: the band is absent when phages that either have lost gene C through deletion or carry a suppressor-sensitive mutation in the gene are used. The repressor in its monomeric form is about 11,000 in molecular weight. At near physiological salt concentrations, the form predominantly recovered is the dimer. In filter-binding assays, the partially purified repressor binds wild-type P2 DNA strongly. It does not bind DNA of P2 vir94, a deletion that removes all the genetic elements involved in the regulation of lysogeny; it also does not bind, or binds inefficiently, DNA of P2 vir3, a mutation in the operator that controls the early replicative functions of P2. At the concentrations employed, the dimer is the active form in binding. The P2 repressor clearly differs in several features from the well-studied immunity repressor of bacteriophage lambda. PMID- 6492161 TI - Stereochemistry of ATP and GTP bound to fish haemoglobins. A transferred nuclear overhauser enhancement, 31P-nuclear magnetic resonance, oxygen equilibrium and molecular modelling study. AB - This study was undertaken in order to test the models of ATP and GTP binding to carp deoxyhaemoglobin proposed by Perutz & Brunori (1982) and to find out why GTP is a more potent allosteric effector than ATP. We have determined the conformations of both nucleoside triphosphates by nuclear magnetic resonance studies and found them to be the same. The purines are in anti conformation about the glycosidic bond that links them to the ribose; the pentose ring is 3'-endo; the P-O5'-C5'-C4' torsion angle lies in the trans domain (180 degrees +/- 20 degrees); the P alpha-O-P beta and P beta-O-P gamma angles are as in the free nucleotides, i.e. the trinucleotide chain is fully extended. Models having this conformation were fitted, first manually and then by energy refinement, to the effector site of an atomic model of human deoxyhaemoglobin in which the side chains in the NA, EF and H segments had been replaced by those of carp. The results showed the location of the polar groups in carp haemoglobin to be such that (PO4) gamma can accept hydrogen bonds from Val NA1 beta 2 and from Arg H21 beta 1, while (PO4) beta and (PO4) alpha can accept hydrogen bonds from Lys EF6 beta 1 and beta 2. In ATP, the 6-amino group of the purine can donate a hydrogen bond to Glu NA2 beta 1. In GTP, the 2-amino group can donate a hydrogen bond to Glu NA2 beta 1; in addition, Val Na1 beta 1 can donate a hydrogen bond to O2' of the ribose. This additional hydrogen bond may explain why in carp haemoglobin GTP is a stronger allosteric effector than ATP. We have found the influence of the two allosteric effectors on the oxygen affinity of trout IV haemoglobin to be the same, even though the only difference in the lining of the allosteric effector sites lies in the replacement of Glu Na2 beta in carp by Asp in trout IV haemoglobin. Model building then showed that formation of a hydrogen bond between Asp Na2 beta and the 2-amino group of guanine precludes formation of a hydrogen bond between Val NA1 beta and O2' of the ribose or vice versa, which makes the number of hydrogen bonds formed between trout IV haemoglobin and GTP the same as those formed with ATP. PMID- 6492162 TI - Structural evidence for ligand-induced sequential conformational changes in glyceraldehyde 3-phosphate dehydrogenase. AB - Glyceraldehyde 3-phosphate dehydrogenase is a tetramer of four chemically identical subunits which requires the cofactor nicotinamide adenine dinucleotide (NAD) for activity. The structure of the holo-enzyme from Bacillus stearothermophilus has recently been refined using X-ray data to 2.4 A resolution. This has facilitated the structure determination of both the apo enzyme and the enzyme with one molecule of NAD bound to the tetramer. These structures have been refined at 4 A resolution using the constrained-restrained parameter structure factor least-squares refinement program CORELS. When combined with individual atomic temperature factors from the holo-enzyme, these refined models give crystallographic R factors of 30.2% and 30.4%, respectively, for data to 3 A resolution. The apo-enzyme has 222 molecular symmetry, and the subunit structure is related to that of the holo-enzyme by an approximate rigid-body rotation of the coenzyme binding domain by 4.3 degrees with respect to the catalytic domains, which form the core of the tetramer. The effect of this rotation is to shield the coenzyme and active site from solvent in the holo enzyme. In addition to the rigid-body rotation, there is a rearrangement of several residues involved in NAD binding. The structure of the 1 NAD enzyme is asymmetric. The subunit which contains the bound NAD adopts a conformation very similar to that of a holo-enzyme subunit, while the other three unliganded subunits are very similar to the apo-enzyme conformation. This result provides unambiguous evidence for ligand-induced sequential conformational changes in B. stearothermophilus glyceraldehyde 3-phosphate dehydrogenase. PMID- 6492163 TI - A base-centred explanation of the B-to-A transition in DNA. AB - In the traditional view, the bistable feature responsible for the switch between the B and A forms of DNA was the sugar-phosphate backbone. Several recent assays of the sequence-dependent structure of DNA are not compatible with that hypothesis. Here we show that certain kinds of base-pair step, mainly those of the pyrimidine-purine variety, can stack in a "bistable" fashion so as to produce one of two overall helix shapes A or B. Further, we suggest that the passive, elastic stiffness of the backbone is responsible for communicating the stacking configuration from bistable steps to their "neutral" neighbours. The role of water molecules, in stabilizing the B form of DNA over the A, may simply be to form hydrogen-bonded bridges with the minor-groove edges of neutral steps in the B configuration. PMID- 6492164 TI - Characterization of two crystal forms of neutrophil cationic protein NP2, a naturally occurring broad-spectrum antimicrobial agent from leukocytes. AB - A hexagonal crystal form (P6(3)22, a = b = 34.0 A, c = 113.5 A) and a monoclinic form (P2(1), a = 37.1 A, b = 32.2 A, c = 32.4 A, beta = 110 degrees) of neutrophil cationic protein NP2, isolated from rabbit leukocytes, have been characterized. The monoclinic form, containing two promoters (Mr = 3844) per asymmetric unit, diffracts to at least 1.8 A and is suitable for high-resolution structural studies. PMID- 6492165 TI - Crystallization of hen egg-white avidin in a tetragonal form. AB - Hen egg-white avidin has been crystallized at pH 5.7 from ammonium sulfate solutions. The crystals belong to the tetragonal space group P4(2)2(1)2, with unit cell edges a = b = 79.6 A, c = 84.3 A. Assuming a molecular weight of 15,600 per avidin monomer, this crystal form is compatible with the presence of a dimer in the asymmetric unit, and is suitable for a crystallographic structural investigation at high resolution. PMID- 6492166 TI - Dispersal process associated with the L1 family of interspersed repetitive DNA sequences. AB - We have determined the complete nucleotide sequence for five members of the L1Md repetitive family from the beta-globin gene region of the BALB/c mouse. The five repeats are different lengths, each terminating at the 5' end at different points with respect to one another. We have analyzed the nucleotides around the endpoints of the five repeats for clues as to the mechanisms involved with the dispersal and 5' truncation of this repeat family. Each L1 member is flanked by a pair of short direct repeats. Since these direct repeats differ in length and sequence in each of the five cases, the dispersal mechanism does not involve a sequence targeted process. The sequence at the 3' end is conserved and its organization resembles the 3' end of a polyadenylated RNA, suggesting that transcripts of the repeat are involved in the dispersal process either directly or as intermediates in the generation of complementary DNA copies of the sequence. One of the L1 repeats is a recent insertion, since it is found in the Hbbd chromosome, but not in the Hbbs chromosome. This suggests a dispersal process that has been active as recently as 4 million years ago. PMID- 6492167 TI - Accumulation of rare and moderately abundant mRNAs in mouse L-cells is mainly post-transcriptionally regulated. AB - We have isolated ten complementary DNA recombinant plasmids, five for moderately abundant and five for rare L-cell mRNAs. The plasmids pLc1 to pLc5 contain inserts homologous to mRNAs that accumulate 220 to 640 copies per L-cell, while the plasmids pLc6 to pLc10 are complementary to rare mRNAs that accumulate 5 to 76 copies per L-cell. The cDNA plasmids pLc1 to pLc10 hybridize to cytoplasmic polyadenylated RNAs from several tissues. Thus it appears likely that the ten investigated mRNAs are coding for "housekeeping" functions. The relative transcription rates of the genes Lc1 to Lc10 were estimated by run-off transcription experiments in isolated L-cell nuclei. The results indicate that the transcription rates of genes that specify the moderately abundant mRNAs, Lc1 to Lc5, are not significantly higher than the genes specifying the rare mRNAs, Lc6 to Lc10. Thus the steady-state concentrations of the ten mRNAs investigated are modulated mainly at the post-transcriptional level. Kinetic labelling experiments confirm this conclusion and indicate that differential mRNA stability in the cytoplasm is largely responsible for the variation in accumulation of Lc1 to Lc10 mRNAs. Since housekeeping genes comprise the large majority of active genes, post-transcriptional regulation may well be the prevalent control in eucaryotic cells to determine the individual mRNA levels. PMID- 6492168 TI - Psoralen-crosslinking of soluble and of H1-depleted soluble rat liver chromatin. AB - We purified soluble rat liver chromatin and H1-depleted chromatin and photocrosslinked its DNA with psoralen at pH 7. Digestion of this chromatin with micrococcal nuclease produced a normal nucleosomal repeat. Chromatin was photoreacted in the presence of 0 to 700 mM-NaCl and was fractionated in sucrose gradients containing the same NaCl concentrations. The dissociation of H1 occurred as in the non-crosslinked controls and no preferential dissociation of core histones was observed. The samples between 100 and 500 mM-NaCl showed precipitation. In the electron microscope, the fibers appeared indistinguishable from the controls at low ionic strength. In the presence of 40 mM-NaCl, the fibers of the photoreacted chromatin were slightly more compact than the controls, and at 500 mM-NaCl, despite the complete dissociation of H1, there were still apparently intact fibers at this ionic strength. The disruption of the psoralen-treated chromatin fibers occurred only in 600 mM-NaCl, as opposed to 500 mM-NaCl in controls. The DNA of all the photoreacted samples was spread for electron microscopy under denaturing conditions. They revealed, for all the samples, single-stranded bubbles corresponding to 200 to 400 base-pairs in size. H1-depleted chromatin containing stoichiometric amounts of core histones was photoreacted at pH 10 and very low ionic strength. Under these conditions many of the nucleosomes appeared to be unraveled, although to a variable extent. In the electron microscope, the purified DNA from these samples showed extensive crosslinking when spread under denaturing conditions. These observations show that histone-DNA interactions different from those in intact nucleosomes may be created, which allow extensive access of psoralen to the DNA. PMID- 6492169 TI - Proton nuclear magnetic resonance investigation of the allosteric transition in ligated and unligated carp hemoglobin. Evidence for structural heterogeneity in the heme pocket. AB - The proton nuclear magnetic resonance spectra of carp hemoglobin (Hb) in the unligated deoxy and ligated met-cyano and met-azido forms have been recorded as a function of pH and upon addition of inositol hexaphosphate. All protein derivatives yield spectra that are consistent with appreciable molecular heterogeneity in the heme cavity. The pattern of heme methyl hyperfine shifts in carp met-cyano Hb indicates that this heterogeneity arises from the presence of heme rotational disorder, as found in native myoglobin. In carp deoxy Hb, the T-- -R transition manifests itself in nuclear magnetic resonance spectral changes similar to those found in modified human Hb species; namely, a decrease in heme methyl and an increase in proximal histidyl imidazole ring NH hyperfine shifts indicative of a strengthening of the iron-histidine bond. The met-cyano complex exhibits heme methyl hyperfine shifts similar to the analogous R state complex of Hb A; addition of inositol hexaphosphate did not give evidence for a quaternary structural change. Carp met-azido Hb in the R state also closely resembles the electronic structure of the HbA complex. Addition of inositol hexaphosphate appeared to effect at least a partial conversion to a T state with larger high spin content than that observed for T state human metHbN3. PMID- 6492170 TI - External and internal sexual dimorphism in leiognathid fishes: morphological evidence for sex-specific bioluminescent signaling. AB - Fourteen species of leiognathid fishes (Perciformes, Leiognathidae) from the Philippine Islands, Thailand, Japan, Indonesia, and Palau were examined for accessory secondary sexual dimorphism. Thirteen species exhibit either external dimorphism (a clear patch of skin on the flanks of males, a large clear patch of skin on the opercular margins of males, or a flank stripe in males) or internal dimorphism (large light organs in males) or both. Eight of the 14 species (and possibly as many as 11) exhibit both forms of sexual dimorphism. Two species show only internal light organ volume dimorphism, and one species shows neither external nor internal dimorphism. Sexual dimorphism is thus very common in leiognathids. The externally dimorphic skin patches are closely associated with the internally dimorphic light organ system in seven species (and possibly as many as ten), indicating a potential for light emission through the clear patches. A bioluminescent signaling function by males is therefore suggested for the sexual dimorphism in leiognathids, which may play an important role in the schooling behavior as well as in species and sexual recognition of these coastal fishes. PMID- 6492171 TI - A three-dimensional muscle model: a quantified relation between form and function of skeletal muscles. AB - A three-dimensional muscle model with complex geometry is described and tested against experimental data. Using this model, several muscles were constructed. These muscles have equal optimum length but differ in architecture. The force exerted by the constructed muscles, in relation to their actual length and velocity of shortening, is discussed. Generally speaking, the constructed muscles with considerable pennation have great fiber angles, a great physiological cross section, a narrow active and steep passive length-force relation, and a low maximal velocity of shortening. The maximal power (force times velocity) delivered by the constructed muscles is shown to be almost independent of the architecture of the muscles. The steepness of the passive length-force relation is determined mainly by the shortest fibers within the group of constructed muscles, whereas maximal velocity of shortening and the width of the active length-force relation are determined mainly by the longest fibers. The validity of the three-dimensional muscle model with respect to some morphological and functional characteristics is tested. Length-force relations of constructed muscles are compared with the actual length-force relations of mm. gastrocnemii mediales and mm. semimembranosi of male Wistar rats. Moreover, actual fiber angle, fiber length, and muscle thickness of three mm. gastrocnemii mediales are compared with values found for constructed muscles. It is concluded that the three-dimensional muscle model closely approximates the actual muscle form and function. PMID- 6492172 TI - Perfusate sodium during ischemia modifies post-ischemic functional and metabolic recovery in the rabbit heart. AB - Metabolic and functional recovery following 60 minutes of low flow (0.1 ml/min) ischemia were compared in rabbit hearts perfused with normal sodium and potassium, low sodium (120 mM NaCl replaced by 120 mM LiCl), or zero potassium perfusate during ischemia. During the control, pre-ischemic, and reperfusion periods, all hearts were perfused identically with normal sodium and potassium. 31P NMR was used to monitor intracellular pH (pHi), ATP, and phosphocreatine (PGr). Developed pressure, end diastolic pressure, pHi, and the integrated areas of ATP and PCr were equivalent in the three groups in the pre-ischemic period. The fall in pHi, PCr, ATP, and developed pressure and the rise in end diastolic pressure during 60 min ischemia also did not differ among the three groups. In contrast to the lack of an effect of perfusate sodium and potassium on the decline in parameters of metabolism and function during ischemia, there was a marked difference in the recovery of these indices during reperfusion. Hearts perfused with low sodium during ischemia exhibited the best recovery (expressed as percent of control) of developed pressure (95 +/- 4%), PCr (106 +/- 6%), and ATP (51 +/- 2%) and the smallest rise in end diastolic pressure (229 +/- 50%); hearts perfused with normal sodium and potassium during ischemia had intermediate recovery values for developed pressure (53 +/- 10%), PCr (78 +/- 9%), ATP (45 +/- 4%) and end diastolic pressure (487 +/- 73%) and the hearts perfused with zero potassium solution during ischemia exhibited the poorest recovery of developed pressure (23 +/- 6%), PCr (49 +/- 6%), ATP (39 +/- 5%) and end diastolic pressure (968 +/- 185%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492173 TI - Effects of calcium flux inhibitors on contracture and calcium content during inhibition of high energy phosphate production in cultured heart cells. AB - The effects of inhibition of oxidative phosphorylation by 1 mM cyanide (CN) and of glycolysis by 20 mM 2-deoxyglucose (2DG) on contraction and relaxation of cultured monolayers of chick embryo heart cells were determined. Exposure to these agents first induced a gradual decline in contractility and a transient impairment of relaxation. Spontaneous beating then ceased, associated with increased relaxation, followed by a marked and prolonged contracture. This contracture was completely reversible after washout of metabolic inhibitors. The effects of calcium flux inhibitors on the time course of development of contracture were studied. Verapamil, which inhibits Ca influx via the slow Ca channel, delayed the onset of contracture when used in pretreatment, but had no effect if added to cultures after exposure to CN + 2DG. Lanthanum, which inhibits Ca influx both via the slow Ca channel and via Na-Ca exchange, delayed onset of contracture if added after exposure to CN and 2DG, but accelerated contracture if added prior to treatment with CN + 2DG. Cellular exchangeable calcium content, measured after exposure to CN and 2DG for the same time period that produced contracture, was reduced compared to the control level while unidirectional Ca influx rate was not measurably altered. Exchangeable Ca content was unaffected by pretreatment with verapamil and La, but was reduced if cells were exposed to La after metabolic inhibition. These findings suggest that after metabolic inhibition intracellular storage capacity for Ca+ is reduced in cultured heart cells. Ca influx via the slow Ca channel after metabolic inhibition does not appear to contribute to development of contracture in this model system. However, Ca entry via Na-Ca exchange may accelerate cellular contracture developing after metabolic inhibition of ATP production. PMID- 6492175 TI - International Society for Heart Research, Vth meeting of the European section. Geneva, September 19-22, 1984. Abstracts. PMID- 6492174 TI - On the mechanism by which caffeine abolishes the fast rhythms induced by cardiotonic steroids. AB - The abolition by caffeine of the arrhythmias induced by cardiotonic steroids was studied in canine Purkinje and ventricular muscle fibers and in guinea pig ventricular muscle perfused in vitro. Both the electrical and mechanical activity were recorded. The following results were obtained: (1) Caffeine (9 mM) quickly abolished the arrhythmias induced by strophanthidin (10(-6)M) in Purkinje fibers by inducing quiescence at a depolarized level; (2) A lower concentration of caffeine (3 mM) hastened the appearance of the arrhythmias by favoring the onset of spontaneous activity at a depolarized level but abolished the oscillatory potential at lower strophanthidin concentrations (2-5 X 10(-7)M); (3) Caffeine (9 10 mM) abolished the oscillatory potentials and after-contractions induced by cardiotonic steroids in ventricular muscle fibers; (4) Caffeine prevented the induction of oscillatory potentials and of arrhythmias by cardiotonic steroids; (5) In the presence of cardiotonic steroids and norepinephrine, the oscillatory potentials can induce fast discharge in myocardial fibers which is eliminated by caffeine; (6) High calcium and norepinephrine (singly or together) induce oscillatory potentials and after-contractions which are abolished by caffeine; (7) The elimination of the oscillatory potentials by caffeine in myocardial fibers is associated with the development of contracture. It is concluded that caffeine eliminates cardiac steroid-induced arrhythmias by quickly depolarizing Purkinje fibers and by eliminating the oscillatory potentials in myocardial fibers and (at suitable concentrations) also in Purkinje fibers. PMID- 6492176 TI - International symposium on calcium and calcium entry blockers in the cardiovascular system. Clinical and experimental aspects. Grenoble, 17-18 September 1984. Abstracts. PMID- 6492177 TI - The economics of health care for elderly blacks. AB - Inflation and spiraling medical costs are adversely affecting the income and health status of elderly Americans. Monies spent for technological advances in medicine resulting in the introduction of more sophisticated instruments and medications have resulted in higher costs for health care. Over the past decade, medical care prices have increased at a rate faster than the cost of living. The percent of the Gross National Product spent for health care has steadily increased. This paper examines the costs involved with health care delivery to the elderly black population, trends in hospitalization and individualized care, and the quality of health care given to elderly black individuals in comparison with that received by the general population. PMID- 6492178 TI - The underrepresented in graduate medical education and medical research. AB - There is a perception that the career options open to medical school graduates who are members of minority groups are restricted. This perception relates especially to those postgraduate medical training programs that have not traditionally encouraged or had significant minority participation. Data were therefore sought to determine whether this perception was well founded.Recent reports show the strikingly low numbers of minorities on medical school faculties and in administrative positions in spite of efforts to fill such positions. Information on the specialties of practicing minority physicians is limited, but accurate figures are available on the participation of minorities in various specialty postgraduate training programs. For instance, during recent years, 50 to 60 percent of all black residents have been trained in internal medicine, pediatrics, general surgery, and obstetrics and gynecology.Further studies are needed to document or disprove the conception that minority physicians have less access than other physicians to certain careers in the delivery of health care and education. In the interim, efforts should be continued to encourage minority physicians not only to seek preparation for community primary care practice, but also for professional participation in academic careers of other specialties (and subspecialties), in biomedical and clinical research, and in health care administration. The ability to enter these diverse careers is most often determined by the opportunities available at the time of completion of medical school education. Therefore, those involved in graduate medical education should address the challenge of providing opportunities for the proportionate representation of minorities in all aspects of medical care and medical education. PMID- 6492179 TI - Cancer chemotherapy: past, present, and future--Part II. AB - Cancer is of major concern today because of its high mortality. It is estimated that 66 million people in this country will eventually develop cancer; 1983 estimates were 855,000 new cases and 440,000 deaths from cancer.Because of limitations of surgery and radiation therapy in effecting a cure for cancer, chemotherapy has become increasingly important. The developments in the chemical control of cancer in man are encouraging.This two-part paper(*) covers the historical milestones in the development of the chemical and hormonal control of cancer, present successes with the use of polychemotherapy, and the hopeful trend in research. PMID- 6492180 TI - Contraceptive practices and reproductive patterns in sickle cell disease. PMID- 6492181 TI - Pulmonary sequestration. AB - Pulmonary sequestration is a disturbance in embryonic development that results in a cystic mass of nonfunctioning lung tissue. The authors present a case of this disorder and review the pertinent literature. PMID- 6492182 TI - Ethnic considerations in multidisciplinary cosmetic surgery. PMID- 6492183 TI - Functional and biochemical indicators of pneumoconiosis in mice: comparison with rats. AB - Mice were injected intratracheally with silica or Mt. St. Helens volcanic ash (0.2 mg/g body weight) and examined 6 mo later for changes in pulmonary function, histology, and hydroxyproline content. Results were compared with a similar study using rats. Mice injected with volcanic ash showed significant changes only in wet lung weights. Those injected with silica showed an approximate doubling of lung wet weight and dry weight and hydroxyproline content. Larger increases in lung weight were seen if lymph nodes were left attached. Lung compliance, total lung capacity, and the shape of the pressure-volume curve of the lung were changed as much as 22% in the silica-treated mice. A mild degree of fibrosis with no dense lung consolidation was noted microscopically in silica-treated mice. In contrast, silica-treated rats showed dense lung consolidation, threefold to fivefold increases in both wet and dry lung weights and hydroxyproline content, and up to 40% reductions in pulmonary function measurements. It is concluded that Swiss albino mice develop a milder degree of fibrosis than similarly treated Sprague-Dawley rats and that both biochemical and functional indicators are effective in detecting pneumoconiosis in these species. PMID- 6492184 TI - Combined use of a water-insoluble chemical delivery system and a metabolic activation system in whole embryo culture. AB - An integrated water-insoluble chemical delivery/metabolic activation/rat embryo culture system is described. Increasing concentrations of diallate dissolved in corn oil caused dose-related embryonic growth retardation in vitro. The presence of a metabolic activating system did not potentiate the effects of diallate in corn oil. The rat hepatic microsomal monooxygenase system was enzymatically active in the presence of a high concentration of corn oil in the rat serum incubation media. Thus, the failure of the metabolic activation system to potentiate the toxicity of diallate in corn oil is not due to an enzymatic deficiency of the hepatic metabolic activation system. As high concentrations of some organic solvents are known to act directly as embryonic poisons in vitro, rat embryos were cultured in incubation media that contained chloroform (0.5 or 2.5%) dissolved in corn oil. This treatment was found to be severely toxic to embryonic growth and differentiation in vitro. Thus, unlike diallate, the embryonic toxicity of chloroform was fully evident when dissolved in the solvent corn oil. Diallate dissolved in acetone retarded embryo growth and caused dysmorphogenesis. When a metabolic activation system and either corn oil or acetone were used together, the incidence of embryolethality and abnormalities were so high that compound treatment effects were difficult to evaluate. PMID- 6492185 TI - On the application of cultured neuroblastoma cells in chemical toxicity screening. AB - The acute toxic action of a number of common chemicals was tested by their ability to cause detachment of cultured mouse neuroblastoma C1300 cells. A TD25 value was obtained by graphic estimation of the concentration needed to cause 25% of the total cell number to detach. These TD25 values were compared with LD50 values obtained from the literature, and they were found to correlate with a coefficient of 0.86. For six of the tested substances-diuron, butylated hydroxytoluene, benzidine, cyclophosphamide, Na2SeO3, and KCN-a very poor correlation was obtained. These diverging results could be ascribed to deficiencies in the neuroblastoma cell detachment test and emphasize the necessity for combined in vitro test procedures. PMID- 6492186 TI - Mutagenic and carcinogenic activity of a hydrotreated coal liquid. AB - A fuel-oil blend (FOB) and its hydrotreated product from the solvent-refined coal (SRC) II process were evaluated for their mutagenic and carcinogenic potential. The FOB was highly active in both cellular assays, as well as in animal (skin painting) studies. Cell-transforming and mutagenic activities of hydrotreated FOB were consistently found to be lower than for untreated FOB. Finally, while most of the initiating activity (in the animal assay) was lost following hydrotreatment, the data indicate that the hydrotreated FOB still had significant skin-tumor-promoting activity. PMID- 6492187 TI - Airborne endotoxins in a rice production commune in the People's Republic of China. AB - Concentrations of total and vertical elutriated airborne dusts were quantified for five work areas within a rice production commune near Shanghai, the People's Republic of China. Mean (+/- SE) commune levels of 15.69 +/- 1.91 mg/m3 and 6.00 +/- 1.47 mg/m3 were found for total and vertical elutriated dusts, respectively. Analysis of the airborne dusts for the presence of gram-negative bacterial endotoxins resulted in mean levels of 21.23 +/- 8.63 ng/mg total dust and 14.57 +/- 7.97 ng/mg elutriated dust, with respective airborne concentrations of 492.12 and 100.22 ng endotoxin/m3. These data show that rice production in the People's Republic of China is associated with a dust burden that is contaminated with relatively high levels of endotoxins. The long-term respiratory effects of inhalation of these dusts should be studied. PMID- 6492188 TI - Effect of simultaneous prenatal exposure to ochratoxin A and citrinin in the rat. AB - Ochratoxin A (OA) and citrinin (CT) are food-borne mycotoxins produced by several fungal species of the genera Aspergillus and Penicillium. Both are teratogenic in the rat. To determine the prenatal effects of simultaneous exposure to these toxins, pregnant Sprague-Dawley rats were injected either with a single individual subthreshold teratogenic dose of OA (1 mg/kg) or CT (30 mg/kg) or with both toxins. Toxins were dissolved in 5% sodium bicarbonate and administered subcutaneously on one of gestation d 5, 6, 7, 8, 10, 11, or 14. Maternal body weight gain of animals in the combination group was similar to other treatment groups and the control. Approximately 22-40% mortality in dams occurred on gestation d 5, 6, 7, and 14. Other than d 7, there was no significant effect on the number of implants. Treatment on d 5 or 7 resulted in increased fetal resorptions. Fetal body weights were not decreased significantly. OA and CT in combination resulted in a significant increase in gross malformations on d 6 and 7, visceral anomalies on d 5, 7, 8, and 10, and skeletal defects on d 5, 6, 7, 8, 10, and 14. When administered individually, OA and CT resulted in very few fetal resorptions. Fetal body weights were not significantly different except on d 8 of gestation following CT treatment. Individual toxin treatment resulted in minimal malformations on all gestation days. These results suggest that OA and CT, when administered concurrently, may interact to enhance prenatal toxicity and teratogenicity, and these results have focussed attention on the public health hazards of contamination of food with these mycotoxins. PMID- 6492189 TI - Comparison of the acute toxicities of N-nitrosothiazolidine and N nitrosomorpholine. AB - The effects of N-nitrosothiazolidine (NNT) and N-nitrosomorpholine (NNM) on different biological parameters were investigated and compared. The oral LD50 value of NNT (1950 +/- 85 mg/kg) showed that it was about 6 times less toxic than NNM (LD50 = 320 mg/kg, po; Druckrey et al., 1967). Lethal and near-lethal doses (greater than or equal to 1500 mg/kg, po) of NNT caused central nervous system depression (reduced spontaneous motor activity, loss of righting and pain reflexes, without loss of consciousness), stereotypical behavior such as, purposeless chewing jaw movements lasting more than one hour, muscular rigidity, and in some rats, rare and brief clonic convulsions, 3 to 24 h after dosing. These neurotoxic signs, as a whole, were reminiscent of opioid intoxication. Rats that died after NNT-treatment had kidney necrosis in the distal tubules, but all survivors had normal kidneys. NNT (500 and 1000 mg/kg, sc) had no effect on the relative liver weights, but it inhibited liver mitosis at 24, 48, and 72 h after treatment. NNM (100 mg/kg, sc) decreased the relative liver weights on 3 posttreatment days; it inhibited liver mitosis after 24 h and enhanced it after 48 h in male rats. Both NNT and NNM increased the relative adrenal weights, but only NNM enhanced adrenocortical mitosis. In general, NNT had no effect on serum enzymes (SGOT, SGPT, LDH, HBDH), but it increased blood urea nitrogen (BUN) and serum creatinine 24 h after administration. Pretreatment of rats with 3 doses of NNT (150 mg/kg X d, po) increased the pentobarbital-induced sleep (PST) by 26% (not significant), while 3 doses of NNM (50 mg/kg X d, po) increased PST by 188%. In addition, NNM caused a severe centrilobular liver necrosis and glycogen depletion, associated with a marked rise in serum enzymes (SGOT, SGPT, LDH, HBDH) and fall in serum glucose. Compared with NNM, NNT, which was found in fried bacon (Kimoto et al., 1982; Gray et al., 1982), seemed to be a relatively nontoxic nitrosamine. PMID- 6492191 TI - Determination of N-nitrosamines and N-nitrosamine precursors in rubber nipples from baby pacifiers by gas chromatography-thermal energy analysis. AB - N-Nitrosamines and precursors are present in rubber products in which the accelerators and stabilizers used in the vulcanization process were derived from dialkylamines. Research was performed to develop data concerning the presence of N-nitrosamines and precursors so that the health significance of the exposure problem related to infant ingestion of these chemicals could be properly assessed. Volatile N-nitrosamines were determined in cut-up pacifier nipples by extraction with dichloromethane followed by concentration in a Kuderna-Danish evaporator, high-temperature mineral oil purge and trap, and analysis by gas chromatography--thermal energy analysis (GC-TEA). N-nitrosodibutylamine (NDBA) was the principal N-nitrosamine found, with concentrations up to 427 ppb. N Nitrosamines and precursors in cut-up and intact nipples were determined by GC TEA after a single extraction with artificial saliva. NDBA was the principal nitrosamine found, at levels up to 1040 ppb, while dibutylamine (DBA) was the principal precursor found, at levels up to 3890 ppb. The persistence of these compounds in intact nipples was determined by multiple artificial saliva extractions. Amounts of NDBA and DBA found after 15 artificial saliva extractions of intact pacifier nipples totalled 824 ppb and 15.6 ppm, respectively. N Nitrosamine levels generally showed a gradual decrease in concentration with each extraction, whereas no consistent trend could be determined for concentrations of precursors. PMID- 6492190 TI - Induction of tumors of the nasal cavity in rats by concurrent feeding of thiram and sodium nitrite. AB - Simultaneous feeding to rats of thiram with sodium nitrite was carried out to assess the possibility of formation of carcinogenic N-nitroso derivatives in vivo. Following the administration of feed containing 500 ppm thiram plus 2000 ppm sodium nitrite for 104 w, a high incidence of tumors of the nasal cavity was found in both sexes, 18 of 24 males and 15 of 24 females. No nasal-cavity tumors were seen in untreated rats, or those given 500 ppm of thiram or 2000 ppm of sodium nitrite alone. A 20% incidence of papillomas of the forestomach was also seen in the rats of both sexes given the combined treatment. The other significant difference in incidence of tumors between the rats given thiram with or without nitrite was a decreased number of animals with monocytic leukemia, which is a common neoplasm in untreated F344 rats. PMID- 6492192 TI - Haloacetonitrile excretion as thiocyanate and inhibition of dimethylnitrosamine demethylase: a proposed metabolic scheme. AB - Haloacetonitriles, contaminants present in chlorinated drinking water, were administered orally to rats, and the urinary excretion of thiocyanate was measured as an index of cyanide release. The urinary excretion of thiocyanate accounted for 14.2% of the dose of monochloroacetonitrile; 7.7-12.8% of the dose of bromochloro-, dichloro-, and dibromoacetonitrile; and 2.25% of the dose of trichloroacetonitrile. The haloacetonitriles inhibited rat-liver microsomal dimethylnitrosamine (DMN) demethylase in an in vitro assay system. Dibromo- and bromochloroacetonitrile were the most potent inhibitors of DMN demethylase, with Ki = 3-4 X 10(-5) M; dichloro- and trichloroacetonitrile were the next most potent, with Ki = 2 X 10(-4) M; and monochloroacetonitrile was the least potent inhibitor, with Ki = 9 X 10(-2) M. Trichloroacetonitrile, but not dibromoacetonitrile, when administered orally inhibited hepatic DMN demethylase activity. The relative capacity of the haloacetonitriles to inhibit DMN demethylase and to be excreted as thiocyanate did not correlate. PMID- 6492193 TI - Chromosomal aberrations induced by sodium nitrite in bone marrow of adult rats and liver cells of transplacentally exposed embryos. AB - A commonly used food preservative, sodium nitrite, was administered in the drinking water to pregnant (d 5-18 of gestation) and nonpregnant albino rats. Sodium nitrite induced chromosomal aberrations in bone marrow of both pregnant and nonpregnant adults and liver of transplacently exposed embryos. The magnitude of the effect was greater in embryonic liver cells than in adult bone marrow cells. PMID- 6492194 TI - The effects of dieldrin and chlordimeform on learning and memory in the cockroach, Periplaneta americana: a study in behavioral toxicology. AB - A one-session T-maze training procedure for cockroaches in which animals were trained to turn right or left to avoid a shock was utilized to investigate the effects of dieldrin and chlordimeform (two neurotoxic pesticides) on learning and memory. These animals were trained and then tested for retention 5 h later. Three behavioral measures were recorded: choice behavior or direction turned, the time taken to proceed down the runway (runway time), and the time taken to proceed from the runway to either choice arm (choice point time). In control animals the number of correct choices, the runway time, and the choice point time increased with succeeding trials during training. Furthermore, control animals showed retention of correct choice behavior from training to testing. A nontoxic dose (no overt behavioral signs) of dieldrin was injected 2 h before training or 15 min after training. Pretraining injections of dieldrin eliminated correct-choice learning but did not alter the increase with training in runway or choice point times. Posttraining dieldrin administration did not interfere with retention of correct-choice behavior upon testing. These findings indicate that dieldrin induces behavioral alterations in a low acute dose and that detrimental effects are more likely with more complex behavior. Furthermore, behavioral disruption is more likely the closer exposure is to the initial learning of a task. Nontoxic doses of chlordimeform injected 1 h before training eliminated correct-choice learning and facilitated an increase in runway times during training. PMID- 6492195 TI - Abnormal limb regeneration in adult newts exposed to the fungicide Maneb 80. A histological study. AB - The effects of the fungicide Maneb 80 (manganese ethylenebisdithiocarbamate, 80% active ingredient) on the regenerating limb of the adult crested newt, Triturus cristatus carnifex, was studied. Female newts were exposed percutaneously to 5 ppm Maneb 80. One group of control newts was exposed to the inert ingredients of Maneb 80 (sodium lignin sulfonate and n-butylnaphthalene sulfonate), and another control group was kept in tap water. The limbs were examined histologically at weekly intervals throughout the regeneration period and at the end of the experiment (10-12 wk postamputation). The regenerating limbs of all the animals exposed to Maneb 80 showed growth retardation and skeletal abnormalities. Histological examination provided evidence that vascular disturbances are important for the genesis of the developmental abnormalities induced by Maneb 80. The inert ingredients had a promoting effect on limb growth and had no teratogenic effects under our experimental conditions. There were no histological differences between the two control groups. PMID- 6492196 TI - Ethylenethiourea-induced hindpaw deformities in mice and effects of metabolic modifiers on their occurrence. AB - Time-mated Swiss-Webster mice were pretreated in separate experiments with phenobarbital (60 mg/kg X d sc on d 7-10 of pregnancy), SKF-525A (40 mg/kg ip on d 12 of pregnancy) or 3-methylcholanthrene (20 mg/kg X d on d 10-12 of pregnancy). On the d 12 of pregnancy (1 h after SKF-525A or 3-methylcholanthrene treatment), one group each of pretreated mice was given a single oral dose of 1600, 2000, or 2400 mg/kg of ethylenethiourea (ETU) as a 5% concentrate in a 1.5% aqueous gelatin solution, which as a vehicle was given to other pretreated groups. The respective volume doses were 3.2, 4.0, or 4.8 ml/100 g body weight with the controls given 4.8 ml/100 g body weight of vehicle alone. Maternal toxicity was observed in all groups given ETU, whether pretreated with metabolic modifiers or not. In the three experiments, treatment with ETU alone reduced fetal weight by 15% at 2400 mg/kg and 8% with the remaining 2 doses, and increased the incidence of resorptions (19-62% with the 2400 mg/kg dose, 8-59% at 2000 mg/kg, and 7-32% at the 1600 mg/kg dose). The significant defects with incidence ranges in three experiments were: hindpaw ectrodactyly, 2-6% at 1600 mg/kg, 4-20% at 2000, and 20-29% at 2400 mg/kg; and hindpaw syndactyle, 3% at 16 mg/kg, 6-14% at 2000, and 2-12% at 2400 mg/kg doses. Minor incidences of cleft palate and hindpaw polydactyly were also observed. Phenobarbital pretreatment did not change the ETU-induced maternal or fetal effects. SKF-525A enhanced the resorptions and reduced the litter-size but had no effect on fetal malformations. The 3-methylcholanthrene pretreatment reduced the ETU-induced incidences of hindpaw ectrodactyly, hindpaw syndactyly, and cleft palate at the 2000 and 2400 mg/kg doses. Previous studies with rats and hamsters revealed that SKF-525A enhanced the ETU-induced fetal malformations but phenobarbital and 3-methyl cholanthrene had no effect in these two species. PMID- 6492197 TI - Dermal oncogenicity bioassays of di-sec-butoxyacetophenone and diethoxyacetophenone. AB - Groups of 40 male C3H/HeJ mice were treated 3 times per week for their lifetime on the skin of the back with undiluted di-sec-butoxyacetophenone (DBAP), or with diethoxyacetophenone (DEAP), undiluted and as a 50% dilution in acetone. Approximate doses per application were 22.4 mg for DBAP, and 25.0 or 11.3 mg for DEAP. Two negative control groups received acetone only. Both DBAP and DEAP (undiluted) had weak tumorigenic activity. In the DBAP group, one mouse developed a squamous-cell papilloma, whereas one mouse in the high-dose DEAP group had a squamous-cell carcinoma, both tumors appearing in the treatment area. No skin tumors were observed in the other groups. Both DEAP-treated groups also had substantial incidences of hyperkeratosis, epidermal hyperplasia, and dermatitis. No significant reduction in survival was observed in the test groups. The occurrence of the skin tumors in the DBAP- and DEAP-treated groups is considered to be treatment-related and suggestive of oncogenic potential, because of the extremely low historical control incidence of skin tumors in similar studies. PMID- 6492198 TI - Male reproductive toxicity and recovery associated with acute ethoxyethanol exposure in rats. AB - Effects of 2-ethoxyethanol (EE) on semen parameters in male rats were investigated employing an animal model that allowed assessment of toxicity and recovery in the same animal. Prior to exposure, 70-d-old Long-Evans hooded males were placed with ovariectomized, hormonally primed females on several occasions and their copulatory behaviors were monitored and scored. At 100 d of age, these males were mated with females that were sacrificed 15 min postejaculation. The semen sample was recovered from the female reproductive tract and scored for sperm motility, sperm count, and abnormal sperm morphology. Following this preexposure baseline assessment, the males were intubated with 0, 936, 1872, or 2808 mg EE/kg for 5 consecutive days. The males were mated weekly for the next 14 wk. Copulatory behaviors were monitored and ejaculated semen samples analyzed on wk 1, 4, 7, 10, and 14. The males were sacrificed at wk 16 and the testes and epididymides were processed for histological evaluation. Data analyses indicated that EE produced a rapid decline in sperm counts in the two highest groups, with most of the males becoming azoospermic by wk 7. The males in the low dose group also exhibited a significant decrease in sperm counts at this week. Additionally, there was a significant increase in abnormal sperm morphology at wk 7 in the low dose males. Partial or complete recovery was apparent in the sperm parameters by wk 14, as evidenced by an increase in sperm counts and a decrease in abnormal morphology and further supported by epididymal and testicular histological assessment at wk 16. At sacrifice, there were no significant differences between groups on body weights, organ weights, or epididymal sperm counts, except for a significant depression of epididymal weight in the middle dose group. While high doses of EE produced a decline in sperm counts starting after the first week of exposure, the early spermatid-late spermatocyte stages, represented by mature spermatozoa in the wk 7 ejaculates, appeared to be particularly sensitive to this compound. Moreover, most of the males exhibited recovery following this acute dosing regimen. PMID- 6492199 TI - Metabolism of 1,2,3,4-, 1,2,3,5-, and 1,2,4,5-tetrachlorobenzene in the rat. AB - Adult male rats were given orally single doses of 14C-labeled 1,2,3,4-, 1,2,3,5-, or 1,2,4,5-tetrachlorobenzene (TCB) at 10 mg/kg body weight, and were housed in individual metabolism cages to collect urine and feces for radioassay. For 1,2,3,4- and 1,2,3,5-TCB, approximately 46-51% of the doses were excreted in urine and feces within 48 h after administration. During the same period only 8% of the administered 1,2,4,5-tetrachlorobenzene was excreted. Analysis of urine indicted that the tetrachlorobenzenes were biotransformed to a number of polar compounds. The metabolites for each of the three TCBs in decreasing order of quantities were as follows: 1,2,3,4-TCB, to 2,3,4,5- and 2,3,4,6 tetrachlorophenol and a trace of tetrachlorothiophenol and 2,3,4-trichlorophenol; 1,2,3,5-TCB, to 2,3,4,6-tetrachlorophenol, isomeric hydroxythrichlorothiophenols, and a trichlorophenol; 1,2,4,5-TCB, to 2,3,5,6-tetrachlorophenol, tetrachloroquinol, and a trichlorophenol. PMID- 6492200 TI - Metabolism of 2,4-dichlorophenol by isolated perfused rat liver. AB - The uptake and metabolism of 2,4-[14C]dichlorophenol (2,4-[14C]DCP) was studied in the isolated perfused rat liver. The uptake of radioactivity in liver increased 6.6% (25.3-31.9%) in the presence of adenosine 5'-triphosphate (ATP) and 14.9% (25.3-40.2%) in the presence of ATP and galactosamine. This increase in the uptake of radioactivity was indicative of maintaining the integrity of liver cells. The glucuronide conjugate of 2,4-DCP in bile was derivatized by permethylation and characterized by gas chromatography-mass spectrometry (GC-MS). Two unusual metabolites were isolated from the liver and perfusate by extracting with hexane. The gas chromatogram of these metabolites gave peaks at retention times 12.0 and 15.5 min, and were characterized by mass spectrometry. The fragmentation pattern of these metabolites confirmed their identity as dichloromethoxyphenols. PMID- 6492201 TI - Adrenal mediation of ethanol's inhibition of benzo[a]pyrene metabolism. AB - Previous studies in rats have demonstrated that acute ethanol (1 h) at high doses inhibits xenobiotic metabolism and that the effect is modulated by the adrenals. In this paper, we report a similar phenomenon for benzo[a]pyrene (BaP) metabolism but the inhibitory effect is restricted to detoxication without effect on activation routes. Rats were administered ethanol (5 g/kg) orally and sacrificed 1 h later. Microsomes were isolated and assayed for capacity to metabolized BaP to activated and detoxified products. Ethanol treatment inhibited detoxication, as evidenced by approximately 50% decrease in 3-hydroxy-BaP formation. There was little effect on metabolic routes forming activated products, as indicated by no change in the rate of dihydrodiol formation. To determine the role of the adrenals in ethanol's inhibitory effect towards detoxication, a similar experiment was performed in adrenalectomized (ADX) rats. ADX alone slightly decreased 3-hydroxy-BaP formation, but treatment with ethanol resulted in no significant differences from ADX controls. Corticosterone administration to ADX rats resulted in an inhibition of the formation of all metabolites. The data suggest that acute ethanol inhibits the detoxication of BaP without effecting activation and that this effect is mediated by the adrenals. This would be expected to increase the proportion of carcinogenic metabolites. PMID- 6492202 TI - General reproduction, perinatal-postnatal, and teratology studies of nitrofurantoin macrocrystals in rats and rabbits. AB - Urinary tract infections in pregnant women are common and require prompt, effective treatment. Currently, no antibacterial agents have received regulatory approbation for use without restriction during pregnancy. The choice of a drug for use in pregnant women requires careful examination of its possible maternal and fetal toxicity as well as its teratogenic potential. We conducted studies to determine the effects of nitrofurantoin macrocrystals (Macrodantin, Norwich Eaton Pharmaceuticals, Inc.), a synthetic antibacterial, on reproductive capability, fetal development, and neonatal survival in the rat and the rabbit. Doses of 10.0, 20.0, and 30.0 mg/kg.d, approximately 2, 4, and 6 times the daily human therapeutic dose, were administered orally in a methylcellulose suspension to rats and rabbits in general reproduction, perinatal-postnatal, and teratology studies. Safety was assessed by evaluating reproductive capability, fertility, gestation period, fetal and neonatal death, litter size and viability, birth weight and postnatal growth, and malformations. Under the conditions of these studies, treatment with nitrofurantoin macrocrystals in rats and rabbits before or during pregnancy or during lactation caused no adverse effects in the mother, fetus, or neonate. These findings support the premise that nitrofurantoin macrocrystals constitute a safe treatment for urinary tract infection during pregnancy. PMID- 6492203 TI - Toxicity of monochloramine in rat: an alternative drinking water disinfectant. AB - Monochloramine (NH2Cl) is under consideration as an alternative to chlorine as a disinfectant in public water supplies, to avoid trihalomethanes formation. This study was conducted to investigate the toxicity of NH2Cl (0, 1, 10, 100 mg/l) in drinking water. Glutathione (GSH) content in rat blood was decreased significantly after 4 mo treatment, and the decreases were consistent throughout the treatment period. Treatment groups showed a slight increase in blood osmotic fragility. After acute administration (3 ml) of 20 and 40 mg NH2Cl/l, blood GSH levels were increased as early as 15 min and the increases were consistent up to 1 h. After 2 h exposure, however, the GSH content returned to the control value. At 3 mo, red-blood-cell count and hematocrit were decreased significantly, while after 10 mo treatment significant decreases in hemoglobin concentration and mean corpuscular hemoglobin were observed. Monochloramine administered in drinking water for 3 mo increased the incorporation of [3H]thymidine into nuclei of rat kidney and spleen in the 1- and 10-mg/l groups, while the incorporation in testes was increased only in the 100-mg/l group. The body weight of rats was decreased significantly in the highest treatment group after 3 mo treatment, and the decrease persisted throughout the period studied. An examination of blood chloroform content in all the groups after 4, 6, 9, and 12 mo showed no significant changes compared to the control. PMID- 6492204 TI - Electrophysiologic deficits in peripheral nerve as a discriminator of early hexacarbon neurotoxicity. AB - To determine the extent of neurotoxicity of parenterally administered hexacarbons, male Sprague-Dawley rats were given either n-hexane or 2,5 hexanedione for 35 consecutive days. Electrophysiologic measurements showed a lengthening of the sciatic and sural nerve action potentials (slower conduction velocities) and increased refractory periods. These effects correlated with a shift in the nerve membrane sensitivity to potassium-induced depolarization. A similar effect can be induced by ouabain, an Na+, K+-ATPase inhibitor. These effects were seen with both n-hexane and 2,5-hexane-dione. Although the treated animals gained weight more slowly than controls, they showed no loss of motor function when tested behaviorally, and there were no signs of histopathology in the peripheral nerves. These results show that hexacarbons produce a neurotoxicity that can be demonstrated by changes in nerve excitability, prior to overt behavioral neurotoxicity. Furthermore, these electrophysiologic changes may be related to a hexacarbon-induced disruption of nerve-membrane ATPase activity. PMID- 6492205 TI - Toxicity of metallic ions in the lung: effects on alveolar macrophages and alveolar type II cells. AB - Airborne metallic particulates are associated with fossil-fueled power plants, automobile exhausts, metal mining, and metallurgical smelters. Therefore, the possible toxic effects of metals on the lung are of environmental and occupational concern. In this investigation we determined the effects of in vitro exposure to metallic ions on the following parameters: oxygen consumption and membrane integrity of alveolar macrophages and type II cells, and chemiluminescence of zymosan-stimulated alveolar macrophages. Cu2+ and Zn2+ exhibited marked toxicity to isolated alveolar macrophages and type II cells, while V3+ exhibited intermediate toxicity. In contrast, short-term in vitro exposure to As5+ and Se4+ had little effect on alveolar macrophages and type II cells. Although the data suggest that exposure to certain metals may be harmful to the lung, the various pulmonary parameters tested in this investigation display differing susceptibility to metal exposure. That is, metals are less toxic to alveolar type II cells than to alveolar macrophages. Our data also indicate that chemiluminescence is the most sensitive assay for monitoring the viability of alveolar macrophages, while oxygen consumption is a sensitive assay for type II cells. PMID- 6492206 TI - Effect of sodium selenite on the ciliary activity, adenosine triphosphate, and protein synthesis in mouse trachea organ cultures. AB - Trachea from albino mice were cut transversely into nearly identical rings and incubated in medium 199 with Hanks salts and HEPES buffer at 37 degrees C. Sodium selenite at 0.5-5 mM depressed the ciliary activity. With 1 and 5 mM sodium selenite, a 50% reduction in the activity index was observed after approximately 5 and 1.5 h, respectively. The ATP content in trachea rings was reduced with 0.05 5 mM sodium selenite, and increasing concentrations gave decreasing amount of ATP after incubation for 4 and 21 h. The rate of protein synthesis as determined by incorporation of radioactive leucine was reduced with 0.5 and 2 mM sodium selenite. The synthesis was reduced quickly by 2 mM sodium selenite, which gave a 30% reduction after incubation for 1 h. It seems that the ATP levels may be used as the most sensitive indication of sodium selenite toxicity in mouse trachea. PMID- 6492207 TI - Cellular distribution of inorganic mercury and its relation to cytotoxicity in bovine kidney cell cultures. AB - A bovine kidney cell culture system was used to assess what relationship mercuric chloride (HgCl2) uptake and subcellular distribution had to cytotoxicity. Twenty four-hour incubations with 0.05-50 micro M HgCl2 elicited a concentration related, with 1.0 nmol/10(6) cells at the IC50. Measurement of Hg uptake over the 24-h exposure period revealed a multiphasic process. Peak accumulation was attained by 1 h and was followed by extrusion and plateauing of intracellular Hg levels. Least-squares regression analysis of the cytotoxicity and cellular uptake data indicated a potential relationship between the Hg uptake and cytotoxicity (r = 0.91). However, the subcellular distribution of Hg was not concentration related. Mitochondria and soluble protein fractions accounted for greater than 65% of the cell-associated Hg at all concentrations. The remaining Hg was distributed between the microsomal (6-10%) and nuclear and cell debris (11-22%) fractions at all concentrations tested. Less than 20% of the total cell associated Hg was bound with metallothionein-like protein. PMID- 6492208 TI - Effect of 0.64 ppm ozone on rats with chronic pulmonary bacterial infection. AB - Rats were chronically infected with Pseudomonas aeruginosa by entrapping viable bacteria in agar beads and intratracheally inoculating the beads into the left lung. The infection was allowed to stabilize over a 10-d period and the animals were then placed in environmental chambers and exposed to either filtered air or 0.64 ppm ozone (23 h/d) for 14 or 28 d. Rats exposed to ozone had reduced body weight and increased lung sizes and lung weights when compared with animals breathing filtered air. Rats inoculated with beads containing live P. aeruginosa had increased lung weights when compared with rats inoculated with beads containing heat-killed P. aeruginosa or controls. Quantitation of total viable bacteria in rats exposed to ozone or to filtered air revealed no significant differences in bacterial numbers. Thus, in this model, chronic exposure to ozone produces increases in lung volume and weight but does not enhance a smoldering Pseudomonas infection. PMID- 6492209 TI - Reflex cardiopulmonary responses by stimulation to type J receptors in rats exposed to NO2. AB - To examine the role of the vagal pathway on the cardiopulmonary functions in NO2 exposed rats, phenyl diguanide, which stimulates type J receptors in the lungs, was injected to control and exposed rats at a constant dose. Based on a statistical test, a decrease in the heart rate (HR) after the injection was observed in the groups exposed to 20 ppm NO2 for 1.5 h and 3h, and 10 ppm for 24 h. On the other hand, an increase in respiratory rate (RR) was observed in the groups exposed to 10 ppm for 3 h and 4 ppm for 1 wk. No change in HR and RR was found in the group exposed to 0.4 ppm for 4 wk. These results suggest that the augmentation of the reflex cardiopulmonary responses due to stimulation to the type J receptors was produced by exposures with a higher concentration of NO2. PMID- 6492210 TI - Sulfur dioxide-induced chronic bronchitis in beagle dogs. AB - This study was done to produce a model of chronic bronchitis. Twelve beagle dogs were exposed to 500 ppm sulfur dioxide (SO2) for 2 h/d, 5 d/wk for 21 wk and 4 dogs were sham-exposed to filtered ambient air for the same period. Exposure effects were evaluated by periodically examining the dogs using chest radiographs, pulmonary function, tracheal mucous clearance; and the cellular and soluble components of bronchopulmonary lavage fluids. Dogs were serially sacrificed after 13 and 21 wk of exposure and after 6 and 14 wk of recovery. Clinical signs produced in the SO2-exposed dogs included mucoid nasal discharge, productive cough, moist rales on auscultation, tonsilitis, and conjunctivitis. Chest radiographs revealed mild peribronchiolar thickening. Histopathology, tracheal mucous clearance measurements, and lavage cytology were consistent with a diagnosis of chronic bronchitis. It is concluded that repeated exposure to 500 ppm SO2 for 21 wk produced chronic bronchitis in the beagle dog. Complete recovery occurred within 5 wk following cessation of SO2 exposure. PMID- 6492211 TI - Toxicity of a phthalate ester in the diet of a penaied shrimp. AB - The toxicity of di-2-ethylhexyl phthalate (DEHP), a ubiquitous environmental pollutant, was measured experimentally as a contaminant in shrimp aquaculture feeds. Diets containing 40 to 50,000 ppm DEHP were fed to Penaeus vannamei for 14 d at 4% body weight/d. DEHP concentrations in shrimp, diet, and water were measured by electron-capture gas chromatography. Whole-body residues in shrimp were 18 ppm at the highest dose, and bioconcentration factors were inversely proportional to dose. DEHP in water was less than or equal to 1.7 ppb for all dose levels. No increased mortality or histopathological alterations were observed at any dose. Absorption of DEHP by P. vannamei was measured in static 24 and 96-h bioassays. Diets enriched with [14C]DEHP to levels of 60, 600, and 6000 ppm were fed at 2% body weight/d. At all dose levels, 3.7% of total radioactivity was measured as body burden in shrimp and 40% as polar species in test water after 96 h. DEHP by oral administration was absorbed, metabolized, and excreted, and this process was linear with dose for the dose range studied. PMID- 6492212 TI - Behavioral modification of estuarine fish exposed to sulfur dioxide. AB - This study was designed to determine the avoidance responses of juvenile striped bass (Morone saxatilis) and Atlantic menhaden (Brevoortia tyrannus) exposed to sulfur dioxide (sulfite) at acclimation temperatures of 15, 20, 25, and 30 degrees C. Predictive models were developed and compared for each species at each acclimation temperature. Striped bass avoided 2.2, 2.3, 3.0, and 3.5 mg sulfite/l at 15, 20, 25, and 30 degrees C, respectively. Atlantic menhaden avoided 3.2, 3.6, 2.9, and 3.0 mg sulfite/l at acclimation temperatures of 15, 20, 25, and 30 degrees C, respectively. Acclimation temperature was an important factor influencing the avoidance response of each species exposed to sulfur dioxide. Striped bass avoided lower concentrations of sulfite than Atlantic menhaden at 15 and 20 degrees C. Both species avoided approximately the same concentration of sulfite at 25 degrees C. Atlantic menhaden avoided lower concentrations of sulfur dioxide than striped bass at 30 degrees C. PMID- 6492213 TI - Cadmium in wheat grain: its nature and fate after ingestion. AB - Cadmium intake in humans derives primarily from vegetable foods, yet the extent to which the chemical form and dose of cadmium in such foods influences the fate and toxicity of this metal is poorly understood. We have compared the fate in mice of trace levels--approximating that in agriculturally produced grain--and high levels of cadmium supplied as wheat grain with that of cadmium supplied as CdCl2. The amounts and forms of the metal in kidney and liver, target organs in cadmium accumulation, were compared. Results indicate that, in mice, cadmium orally administered as grain and that as CdCl2 have a similar fate in terms of organ distribution and the nature of the Cd-forms in kidney and liver. A low dose of either form resulted in higher kidney versus liver cadmium. Preliminary characterization studies indicate that cadmium in wheat grain occurs primarily as an 11,000-dalton, aqueous-soluble complex, which is not inducible by cadmium. PMID- 6492214 TI - Comments on "Persistence of symptoms after mild to moderate acute organophosphate poisoning among 19 farm field workers" by Whorton and Obrinsky. PMID- 6492215 TI - [Toxicological studies on puffer fishes:comparison of toxicities in the various species]. AB - The toxicity variations of puffer fishes toxin on species, sex, organs seasons and sea area collecting subjects were observed in 615. subjects of 15 species during 1978-1981. The remarkable differences of toxicity were found by species and/or by subjects. Takifugu pardalis, Takifugu poecilonotus and Takifugu niphobles, which are habitually eaten in Japan, had a strong toxicity and some of them were strongly toxic in the muscle. It was indicated that female puffer fishes have a higher toxicity than the male. In particular, the toxicity from genital organs was significantly higher in the female puffer fishes than in male. No difference no sex was observed in the skin. Compared with the toxicities on the collecting sea areas, Inland sea of Seto and Japan sea, the mean of toxicity and the incidence rate of toxic subjects collected in Japan sea were higher than those of in Inland Sea of Seto i.e. The difference was observed by the living sea environment of puffer fishes. The wild Takifugu rubripes was obviously more toxic than the cultured. It was suggested that the variations between the wild and cultured puffer fishes should be due to the difference of the metabolism for the production and accumulation of tetrodotoxin which would be influenced by the foods and the closed environment. PMID- 6492216 TI - [Effect of diuretic, azosemide (SK-110), in combination with antibiotic, cephaloridine, on kidney]. AB - This study was performed to compare the acute-renal toxicity of azosemide (SK 110) or furosemide (FM) treatment in combination with cephaloridine (CER). 1) Initially, the acute-renal toxicity of CER was studied after a subcutaneous administration at dose levels of 500, 1000, 1500 and 2000 mg/kg. The values of BUN, creatinine and relative kidney weights were increased in rats given CER at dose levels above 1500 mg/kg. consequently, it was considered that the threshold of CER with regard to acute-renal toxicity was 1000 mg/kg. 2) Secondarily, the acute-renal toxicity of SK-110 or FM were studied after oral administration of 40, 80, 160 or 320 mg/kg doses alone or in combination with CER. Acute-renal toxicity was evident in the 320 mg/kg-treated rats after both SK-110 and FM alone, as revealed by analysis of a number of parameters, i.e., BUN, serum creatinine, urine sediment and composition and pathological data composing both kidney weights and studies at the microscope level. However, the increase of BUN and relative kidney weights values, elevated numbers of epithelial cells in the urine and necrosis observed in the uriniferous-tubular epithelium on histopathological examination of kidneys were noted in rats given at dose levels of only 80 mg/kg with SK-110 + CER, whereas they were seen in animals treated with FM even at the lowest applied dose of 40 mg/kg in combination with CER. In conclusion, this study showed that the minimum dose of SK-110 or FM in combination with CER which causes acute-renal toxicity were, respectively, 80 mg/kg or less than 40 mg/kg. PMID- 6492217 TI - [Effect of azosemide (SK-110) and its metabolites on mouse liver]. AB - The effect of azosemide (SK-110), and its metabolites, 5-(2'-amino-4'-chloro-5' sulfamoylphenyl)-tetrazole (M-1), 2-thiophenecarboxylic acid (TC), on mouse liver was investigated using biochemical and pathological parameters as indices of hepatotoxicity. The effects were compared with that of furosemide (FM) administration. A single dose of each compound was administered orally, or intraperitoneally, while multiple oral dosing was carried out once daily for a week. The results are summarized as follows: 1) SK-110 did not produce hepatotoxicity even after a single p.o. dose as high as 5000 mg/kg, a single i.p. dose of 400 mg/kg, or multiple p.o. doses of 700 mg/kg/day. 2) M-1 also did not produce hepatotoxicity even after a single p.o. dose of 4000 mg/kg or multiple p.o. doses of 550 mg/kg/day. TC did not exert hepatotoxicity after a single i.p. dose of 150 mg/kg or multiple p.o. doses of 250 mg/kg/day, but did produce hepatotoxicity after a single p.o. dose of more than 1000 mg/kg. However, it was presumed that, in vivo, TC formed as a metabolite of administered SK-110 would hardly produce hepatotoxicity. 3) FM produced hepatotoxicity after a single p.o. dose of more than 800 mg/kg, or a single i.p. dose of more than 200 mg/kg, but not after multiple p.o. doses of 700 mg/kg/day. Based on these findings, it was concluded that, in contrast to FM, SK-110 had no hepatotoxic effect on the mouse liver. PMID- 6492218 TI - A study of external skeletal fixation systems for unstable pelvic fractures. AB - This study was undertaken to determine the feasibility of constructing an anterior pelvic external fixator capable of resisting displacement of vertical shear fractures. Newly designed tapered thread pins for cancellous bone had better bone pin fixation and their greater 6-mm diameter provided more than twice the stiffness of Hoffmann 4-mm pins when tested in clusters. Using these pins and a more rigid anterior frame as one model, various pelvic fixators were tested to determine their resistance to vertical shear forces. These tests determined that this new fixator was 16 times stiffer than a Bonnel single anterior frame and five times stiffer than a double anterior frame (both constructed of Hoffmann components). Extrapolation from the data shows that 13 mm of posterior fracture displacement would occur with loads of one half body weight using the new fixator. Additionally it was noted that Hoffmann frames constructed with two 5-mm pins performed as well as those using three 4-mm pins. PMID- 6492219 TI - The prehospital use of external counterpressure: does MAST make a difference? AB - Military anti-shock trousers (MAST) have achieved widespread civilian usage because of reported effectiveness in treating hypovolemic shock. The literature, however, consists of either case reports or series in which no controls were evaluated. No published reports exist which compare similar groups of patients treated with and without MAST in the pre-hospital setting. We reviewed the paramedic and emergency department records of 226 patients sustaining moderate to severe trauma who were transported to San Francisco General Hospital by paramedics over a 15 month period. MAST usage during this period was approximately random as a result of logistical and training constraints. For analysis, patients were divided into two groups: those in whom MAST was applied and inflated during transport and those in whom it was not used. Paramedic interventions other than MAST were similar in both groups. Trauma Scores (TS), and blood pressure index (greater than 90 = 4, 70-89 = 3, 50-69 = 2, 0-49 = 1, no pulse = 0), were calculated for initial field observations and initial emergency room evaluation after hospital arrival. Patients with isolated head injury were excluded. The average change in TS and BP index (E.R.--field value) was calculated for MAST and non-MAST groups of patients. Mortality and total field times were also evaluated. Average TS and BP index increased slightly in both groups. Use of MAST produced no significant improvement in trauma score, BP index, or mortality over non-MAST patients. There was no demonstrable field benefit of MAST in fully arrested patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492220 TI - Immediate hemodynamic consequences of MAST inflation in normo- and hypovolemic anesthetized swine. AB - Use of the military antishock trouser (MAST) remains controversial in part because its mechanism(s) of action are poorly understood. We studied two aspects of the hemodynamic response to MAST inflation in 14 anesthetized swine. First, in six swine the relation that existed between inferior vena cava flow and aortic pressure/cardiac output was determined before and during inflation of the MAST, and then before and after removal of 30% of the calculated blood volume. Inflation of the MAST before hemorrhage had little effect on cardiac output but increased aortic pressure by 25%. Inflation of the MAST after hemorrhage increased cardiac output by 41% and increased aortic pressure by 62%. Three different inflation pressures were studied (40, 80, and 120 mm Hg) and were found to give equivalent results. Inflation of the MAST translocated about 3 ml/kg of blood to the heart. A second group of eight swine were instrumented so that the radiomicrosphere technique could be used to measure organ blood flow. Inflation of the MAST following hemorrhage increased coronary perfusion by 50% and cerebral perfusion by about one third. Flow to kidney, liver, and small intestine was not changed. We conclude that, in addition to tamponade of venous bleeding and the splinting of lower extremity fractures, use of the MAST might cause a clinically important increase in the perfusion of the heart and brain in some trauma patients. PMID- 6492221 TI - The effects of the pneumatic antishock garment on intracranial pressure in man: a prospective study of 12 patients with severe head injury. AB - Changes in intracranial pressure, mean arterial blood pressure, and cerebral perfusion pressure in response to sequential inflation of the pneumatic antishock garment were monitored in 12 patients with severe head injury and initial intracranial pressure less than 20 mm Hg. The small incremental increases in intracranial pressure that occurred with inflation of the pneumatic antishock garment were compensated for by improved hemodynamic stability and elevated mean arterial blood pressure which produced a simultaneous rise in cerebral perfusion pressure. The treatment of hypotension in traumatized patients with head injuries is paramount and sequential slow inflation of the pneumatic antishock garment can be used in such patients without apparent ill effect to the brain when the initial intracranial pressure is 20 mm Hg or below. Further study is needed to determine the safety of the device in head injured patients with elevated intracranial pressures. PMID- 6492222 TI - Urethral injury in the multiple-injured patient. AB - A total of 74 patients with urethral injury due to external trauma consisted of 48 posterior urethral injuries (25 complete rupture, 23 partial rupture) and 26 anterior urethral injuries (two complete rupture, 16 partial rupture, and eight contusion). The diagnosis was made by retrograde urethrography. All 48 patients with posterior urethral injury had associated injuries, including a fractured pelvis in 46, and a mortality rate of 33%. Only seven of the 26 patients with anterior urethral injury had associated injuries and a mortality rate of 14%. The management of posterior urethral injury is changing from primary realignment of the ruptured urethra to suprapubic cystostomy alone and followed later by urethral surgery for the resulting stricture. The impotence rate is significantly lower with management with suprapubic cystostomy alone. However, the type of pelvic fracture, the urethral injury itself disrupting neurovascular structures, and the surgical dissection (initial primary realignment or delayed urethroplasty) must be investigated before it can be determined whether the impotence associated with pelvic trauma is caused by the injury itself or by the surgical dissection undertaken to reconstruct the urethra. PMID- 6492223 TI - Tracheo-carotid artery erosion following endotracheal intubation. AB - A case of tracheo-carotid artery erosion in a patient who required only endotracheal intubation is presented. This appears to be the first case reported in the world literature that was not associated with a tracheostomy. Etiologic factors leading to this complication include direct pressure from the tube tip, abrasions during intubation, mucosal damage from cuffs, and CPAP, even over a short time. Selection of an endotracheal tube with a high-compliance, low pressure cuff, careful intracuff pressure monitoring, prevention of infection and hypotension, and improvement in the patient's nutritional and immunologic status will help to prevent this complication. Any patient bleeding more than 10 ml without cause should be suspected of having this complication. Rapid treatment is necessary for survival. Patients should be intubated and the cuff inflated. Bronchoscopic examination should be done in the operating room under general anesthesia with neck and chest prepped and draped. Median sternotomy or possibly right anterior thoracotomy is recommended. Resection of involved vessels has been successful. PMID- 6492224 TI - Avulsion of a normal aortic valve cusp due to blunt chest injury. AB - The successful operative treatment of aortic valve disruption caused by forceful blunt chest trauma in a 30-year-old previously healthy man is reported. The patients' left coronary cusp was completely avulsed at its annular insertion. Aortic valve replacement with a 23-mm Carpentier-Edwards porcine xenograft was performed. The literature on this rare condition is reviewed. PMID- 6492225 TI - A case of total esophago-gastro-duodeno-jejunectomy and partial pancreatectomy for lye burns, and reconstruction with colon interposition. AB - We report a unique case of extensive surgery for severe lye burns. It included total esophago-gastro-duodeno-jejunectomy and partial pancreatectomy. We were unable to find a similar successfully treated case in English-language literature. Ninety-one days after the initial emergency surgery, the patient successfully underwent reconstruction of alimentary tract with isoperistaltic left colon interposition between proximal cervical esophagus and ileum. PMID- 6492226 TI - The safety of percutaneous transtracheal ventilation (P.T.V.) in the patient with an obstructed airway remains controversial. PMID- 6492227 TI - Pharmacokinetics in baclofen overdose. AB - The pharmacokinetics of baclofen analyzed by gas chromatography mass spectrometry in a massive intoxication case (baclofen 1230 mg orally) is presented. In contrast to earlier reports, no increase in the plasma half-life of elimination of baclofen could be observed (t1/2 = 4.58 hours). On the contrary, we found an increased plasma clearance (Clpl = 0.368 l/kg) in this highly intoxicated patient compared to the kinetics usually found in healthy subjects. PMID- 6492228 TI - Evaluation of activated charcoal-sodium sulfate combination for inhibition of acetaminophen absorption and repletion of inorganic sulfate. AB - Activated charcoal is an effective inhibitor of acetaminophen absorption while sodium sulfate can prevent the depletion of endogenous inorganic sulfate associated with the formation of acetaminophen sulfate. Administration of activated charcoal plus sodium sulfate soon after acetaminophen overdose may reduce acetaminophen absorption and facilitate the elimination of absorbed acetaminophen by providing sufficient sulfate ion for rapid sulfation of the drug. This investigation was designed to determine if sodium sulfate modifies the inhibitory effect of activated charcoal on acetaminophen absorption or if activated charcoal affects the absorption of sodium sulfate. Eight normal adults received, on separate occasions, 1 g acetaminophen, 1 g acetaminophen and 18 g sodium sulfate (decahydrate), 1 g acetaminophen with 10 g activated charcoal and 1 g acetaminophen, with 10 g activated charcoal and 18 g sodium sulfate, in random order. Urine was collected for 48 hours and assayed for acetaminophen and its major metabolites and for inorganic sulfate. The results confirm that activated charcoal can reduce acetaminophen absorption and show that oral administration of activated charcoal with sodium sulfate does not alter the inhibitory effect of activated charcoal on acetaminophen absorption or the bioavailability of the sulfate. A combination of activated charcoal and sodium sulfate may therefore be useful for the initial management of acetaminophen overdose. PMID- 6492229 TI - Treatment of acute methylmercury ingestion by hemodialysis with N-acetylcysteine (Mucomyst) infusion and 2,3-dimercaptopropane sulfonate. AB - A case of acute methylmercury ingestion was treated sequentially with oral D penicillamine, hemodialysis during N-acetylcysteine (NAC) infusion, and 2,3 dimercaptopropane sulfonate (DMPS) an experimental oral agent. Urinary organic mercury elimination rate increased almost 40-fold during and 84-fold after hemodialysis with NAC infusion, compared with elimination during initial D penicillamine therapy. Mean clearance during hemodialysis was only 13 ml/min with an extraction rate of 3.7 mcg/min. Although whole blood mercury concentrations decreased from 568 to 265 ng/ml during dialysis, a rebound to 525 ng/ml occurred. A total of 1.6 mg mercury was renally eliminated during hemodialysis and in the following 24 hours. A total of 3.3 mg of predominantly organic mercury was renally eliminated during 18 days of combined therapies. Since renal elimination of inorganic mercury is seen with chronic methylmercury poisoning, the high ratio of organic to inorganic mercury in urine supports the acute nature of this exposure. DMPS was begun on day 4 and during the two weeks of administration whole blood concentrations fell by 15% to 355 ng/ml. An expected decrease in elimination half-life to 10 days was not observed during DMPS therapy, possibly due to concurrent administration of vitamins containing zinc and copper. The amount of methylmercury ingested was estimated as 45 mg, based on a post distribution blood concentration of approximately 450 ng/ml. The patient developed no symptoms of methylmercury poisoning during the one year after the episode. We conclude that NAC may be useful to enhance renal elimination of methylmercury and merits further investigation as a potential binding agent to reduce the body burden of methylmercury. PMID- 6492230 TI - Evaluation of benefits of drug analysis in the routine clinical management of acute self poisoning. AB - A prospective study including 265 patient admissions for acute self poisoning are presented. Information on drug intake was obtained on admission. This was compared with the results from an extensive toxicological screening of blood samples drawn on admission and other information obtained later during hospitalization. The drugs used were identified clinically by the case histories and by routine laboratory analyses in 86% of the patients. In 14% either wrong drugs were suspected or the drugs were unknown. Extensive toxicological screening was needed to identify the drugs in 5% of the patients. Correct identification on admission did not seem to influence the clinical outcome. It is concluded that in this group of patients, it is possible to get reliable information concerning the drugs used by the case histories, clinical examination and routine laboratory analyses on admission. PMID- 6492231 TI - Plants that poison in Uruguay. AB - Poisoning by plants has different traits in each country, according to geographical, botanical and also socio-cultural characteristics. The incidence of "plant calls" to the Poison Control Center in Uruguay is not very high, but it is due usually to symptomatic cases affecting children. Plant poisoning in adults is less frequent, being due to home-made medicine, and, in women, to the popular belief in the abortive quality of some plants. Suicide attempts are rare. The different species that cause consultations, and the clinical characteristics are briefly analyzed, as well as the problems that a Poison Control Center usually has to face in poisoning by plants. PMID- 6492232 TI - Malaria in childhood. PMID- 6492233 TI - Cystic fibrosis in southern Iran. PMID- 6492234 TI - Tropical enteropathy (environmental enteropathy) in early childhood: a syndrome caused by contaminated environment. PMID- 6492235 TI - Cell mediated immune response at varying age periods in relation to their nutritional status among preschool children given BCG at birth. PMID- 6492236 TI - Neonatal jaundice in Pakistan. PMID- 6492237 TI - A longitudinal study in body weight of Pakistani infants as influenced by socioeconomic status. PMID- 6492238 TI - Mortality/fertility relationships in the Dominican Republic. PMID- 6492240 TI - Training of traditional birth attendants. PMID- 6492239 TI - Are daughters more at risk than sons in some societies? PMID- 6492241 TI - Echocardiographic demonstration of an aneurysm of the right coronary sinus of valsalva with dissection into the interventricular septum. PMID- 6492242 TI - The circumference of an ellipse. PMID- 6492243 TI - Effects of disopyramide on the electrocardiogram and ventricular function in the unanesthetized dog. AB - The antiarrhythmic compound disopyramide has been shown to possess negative inotropic effects. The present study was conducted to establish the effects of graded doses of disopyramide on ventricular function and electrocardiograms from healthy, awake dogs. Electrocardiograms and echocardiograms were obtained during a control period, and during an experimental period in which the six dogs on test received 7.5, 15 or 30 mg disopyramide per kg body weight orally three times per day. Six other dogs served as vehicle controls. No changes of statistical significance occurred in heart rate. The PQ interval was prolonged at all doses, the QRS complex was prolonged only at the highest dose, and the QT interval was prolonged at the intermediate and high doses. Left ventricular pre-ejection period (PEP) was prolonged in a dose-dependent relationship, and the left ventricular ejection time (ET) was shortened only at the highest dose. The percent shortening fraction of the left ventricle (% delta D) decreased significantly at intermediate and high doses, while the ratio of pre-ejection period to ejection time increased in a dose-dependent relationship. Conclusions are that even in therapeutic levels disopyramide produces significant reduction in left ventricular function, and that ratio of PEP/ET correlates better with the dose of disopyramide than did % delta D. This study demonstrates the feasibility of evaluating cardiac effects of compounds by non-invasive means. PMID- 6492244 TI - Preliminary pharmacological characterization of ovine mesenteric vasculature. AB - Spirally cut strips of ovine mesenteric vein and artery were studied in isolated organ baths. No qualitative differences were observed in the autonomic and autacoid reactivity of these blood vessels. Both arterial and venous preparations responded in a dose-related manner to 5HT greater than or equal to adrenaline greater than phenylephrine greater than histamine. The responses of venous and arterial strips to 5HT were antagonized by methysergide while mepyramine inhibited histamine-induced contractions. Phentolamine competitively inhibited adrenaline on arteries. Vascular preparations, incubated with mepyramine (2 X 10( 7) M) and contracted half-maximally with 5HT, responded with relaxations to the higher doses of histamine. Specific H2-agonists, impromidine and dimaprit also caused relaxations of half-maximally contracted venous and arterial strips. Impromidine was approximately 500-5000 times more potent than histamine and dimaprit. Trimetaquinol effectively relaxed both venous and arterial preparations while isoproterenol had either no effect or produced weak contractions/relaxations. This investigation suggested the presence of (i) both excitatory and inhibitory receptors for histamine, (ii) D-tryptaminergic receptors mediating contractile effects of 5HT, and (iii) a predominance of alpha adrenergic receptors, in the mesenteric vasculature of sheep. PMID- 6492245 TI - Standardization of an experimental disease model of Streptococcus zooepidemicus in the equine. AB - A reproducible experimental disease model in horses using Streptococcus zooepidemicus was developed. An intravenous challenge dose of 1 X 10(10) colony forming units (CFU), followed 24 h later with another challenge of 1 X 10(8) CFU of Strep. zooepidemicus produced the desired disease model. The disease was characterized by depression, pyrexia, anorexia, abnormal lung sounds, inflammation of joints, moderate to severe lameness, gradual loss of condition and emaciation. The effects of the disease on hematology, serum chemical profile and different protein fractions were studied. The disease state had no effect on serum glucose, sodium, potassium, chloride, urea nitrogen, creatinine, uric acid, calcium, phosphorus and enzymes SGOT or SGPT. However, the alkaline phosphatase showed a gradual decline. The serum iron levels dropped markedly and remained low to the last day of observations (post-infection day, PID 13). On serum protein electrophoresis, the albumin showed a gradual decrease; whereas, alpha II, beta and gamma globulin levels rose suggesting an immune response. The elevation of rectal temperatures and white blood cell counts related well with clinical observations. The serum iron levels proved very helpful in predicting the severity of clinical signs and often dropped before the onset of clinical signs and pyrexia. PMID- 6492246 TI - Effect of premedication with acetylpromazine on the disposition kinetics of thiopental. AB - This study was performed to determine whether premedication with acetylpromazine alters the disposition kinetics of thiopental in normal dogs. Based on nonlinear least squares regression analysis of the plasma concentration-time data obtained in individual dogs, a three-compartment open model was selected to describe the pharmacokinetic behavior of thiopental. While clinically premedication appears to delay time of awakening from thiopental anesthesia, statistical comparison (Student's t-test for paired data) of pharmacokinetic terms showed no significant difference. This may be largely attributed to wide individual variation in each parameter. The rate of change in volume of distribution at zero time (mean +/- SD, n = 7), which is a parameter that might have been expected to vary significantly, was 97 +/- 106 ml/min X kg for thiopental alone and 77 +/- 60 ml/min X kg following acetylpromazine premedication. Body clearance of thiopental was 1.96 +/- 0.59 ml/min X kg in dogs without premedication and 1.55 +/- 0.49 ml/min X kg following acetylpromazine. By relating observed time of awakening to plasma concentrations of thiopental it was determined that awakening from anesthesia occurred at a concentration of 20 micrograms/ml whether or not the dogs were premedicated. It can only be concluded that while premedication with acetylpromazine appears to delay time of awakening from anesthesia, it does not change the disposition kinetics of thiopental or affect the plasma concentration at the observed time of awakening. PMID- 6492247 TI - Pharmacokinetics of sulfamethazine in male, female and castrated male swine. AB - The concentration of sulfamethazine in plasma and sulfamethazine and its metabolites in urine were compared in male, female and castrated male swine. A surgical technique for placement of catheters in the urinary bladder was used to facilitate the collection of urine in males and castrated males. The elimination rate of sulfamethazine from plasma and the excretion of parent drug and metabolites into urine did not differ significantly among females, males and castrated male swine. PMID- 6492248 TI - A health index to evaluate clinically a beta-hemolytic streptococcal infectious disease model in the horse. AB - Quantification of the clinical manifestations of a disease has been a serious problem particularly as related to clinical trials or drug efficacy studies. Historically, this quantification has been limited to categorizing each patient into one of three or four groups, e.g. worse, no improvement, improved. This problem becomes serious when an investigation utilizes an experimentally induced animal disease model. A health index, which quantifies the clinical state of horses which have an experimentally induced beta-hemolytic streptococcal infection, is described. Aspects of experimental design and statistical analysis are also discussed in relationship to the use of the index for drug efficacy studies. PMID- 6492249 TI - Pharmacokinetic analysis of plasma concentration and urinary excretion of sulphamonomethoxine and its metabolite in Goettingen minipigs. AB - The plasma concentration and renal excretion after a bolus intravenous injection of a low (10 mg/kg) or high (100 mg/kg) dose of sulphamonomethoxine (SMM) were studied in five Goettingen minipigs. The time data of plasma concentration after a low dose decreased rapidly and appeared to be linear on semilog graph paper. On the other hand, a decrease in the plasma concentration after a high dose was slow at first, gradually accelerated, then became rapid, showing that SMM disposition after a high dose (100 mg/kg) seemed to be non-linear with capacity-limited elimination. A large amount of the acetyl derivative of SMM (AcSMM), which was determined to be the main excretory product of SMM in urine, was detected in the plasma after SMM injection. As the ratios of the area under plasma concentration time curve of AcSMM to that of SMM were not significantly different at either dose, the acetylation of SMM may be unsaturable by injection of 100 mg/kg of SMM. Immediately after the injection of a low dose, a rapid hyperbolic increase of the fraction of the cumulative amount of the excretory products in urine was observed. On the other hand, the fraction curve at the high dose rose slowly at first, then rapidly and hyperbolically. These results suggested that the non linear drug disposition after a high dose (100 mg/kg) of SMM in pigs may be the result of a limited capacity for renal excretion of SMM and excretory products, especially the acetyl derivative. PMID- 6492250 TI - Methylene blue: effects and disposition in sheep. AB - The disposition and urinary excretion pharmacokinetics of methylene blue were determined after its intravenous administration at 15 mg/kg to mature female sheep. Comparisons were made between methylene blue administered alone or subsequent to 50 mg/kg sodium nitrite. The overall elimination rate constant (beta) of methylene blue, 0.0076 +/- 0.0016 min-1, was not influenced by prior administration of sodium nitrite. However, the distribution rate was significantly altered by sodium nitrite. Very little of the methylene blue was eliminated in the urine either intact or as leucomethylene blue in spite of its relatively short half life. Toxicologic assessment was carried out using LD50 determination, methemoglobin production and hematologic effects as evaluation parameters. Methemoglobin production was minimal with doses as high as 50 mg/kg and no significant hematologic changes were seen up to 4 weeks after a total dose of 30 mg/kg methylene blue. The 24 h LD50 for intravenous methylene blue administered as a 3% solution was 42.3 mg/kg with 95% confidence interval limits of 37.3 to 47.9 mg/kg. From these data it appears that as conditions may warrant, the dosage of methylene blue may be safely increased up to at least 15 mg/kg in therapy of severe methemoglobinemias. PMID- 6492251 TI - Acetylation of sulphamethoxazole by the snail Cepaea hortensis. PMID- 6492253 TI - Adenovirus cyt+ locus, which controls cell transformation and tumorigenicity, is an allele of lp+ locus, which codes for a 19-kilodalton tumor antigen. AB - The early region E1b of adenovirus type 2 (Ad2) codes for two major tumor antigens of 53 and 19 kilodaltons (kd). The adenovirus lp+ locus maps within the 19-kd tumor antigen-coding region (G. Chinnadurai, Cell 33:759-766, 1983). We have now constructed a large-plaque deletion mutant (dl250) of Ad2 that has a specific lesion in the 19-kd tumor antigen-coding region. In contrast to most other Ad2 lp mutants (G. Chinnadurai, Cell 33:759-766, 1983), mutant dl250 is cytocidal (cyt) on infected KB cells, causing extensive cellular destruction. Cells infected with Ad2 wt or most of these other Ad2 lp mutants are rounded and aggregated without cell lysis (cyt+). The cyt phenotype of dl250 resembles the cyt mutants of highly oncogenic Ad12, isolated by Takemori et al. (Virology 36:575-586, 1968). By intertypic complementation analysis, we showed that the Ad12 cyt mutants indeed map within the 19-kd tumor antigen-coding region. The transforming potential of dl250 was assayed on an established rat embryo fibroblast cell line, CREF, and on primary rat embryo fibroblasts and baby rat kidney cells. On all these cells, dl250 induced transformation at greatly reduced frequency compared with wt. The cells transformed by this mutant are defective in anchorage-independent growth on soft agar. Our results suggest that the 19-kd tumor antigen (in conjunction with E1a tumor antigens) may play an important role in the maintenance of cell transformation. Since we have mapped the low-oncogenic or nononcogenic Ad12 cyt mutants within the 19-kd tumor antigen-coding region, our results further indicate that the 19-kd tumor antigen also directly or indirectly plays an important role in tumorigenesis of Ad12. Our results show that the cyt+ locus is an allele of the lp+ locus and that the cyt phenotype may be the result of mutations in specific domains of the 19-kd tumor antigen. PMID- 6492252 TI - Mapping a new gene that encodes an 11,600-molecular-weight protein in the E3 transcription unit of adenovirus 2. AB - The DNA sequence of the early E3 transcription unit of adenovirus 2 (Ad2) (J. Herisse et al., Nucleic Acids Res. 8:2173-2192, 1980), indicates that an open reading frame exists between nucleotides 1860 and 2163 that could encode a protein of Mr 11,600 (11.6K). We have determined the DNA sequence of the corresponding region in Ad5 (closely related to Ad2) and have established that this putative gene is conserved in Ad5 (a 10.5K protein). To determine whether this protein is expressed, we prepared an antiserum in rabbits against a synthetic peptide corresponding to amino acids 66 to 74 in the 11.6K protein of Ad2. The peptide antiserum immunoprecipitated a ca. 13K-14K protein doublet, as estimated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, from [35S]methionine-labeled Ad2- or Ad5-early-infected KB cells. The antiserum also immunoprecipitated a 13K-14K protein doublet translated in vitro from Ad2 or Ad5 early E3-specific mRNA purified by hybridization to Ad2 EcoRI-D (nucleotides -236 to 2437). The synthetic peptide successfully competed with the 13K-14K protein doublet in immunoprecipitation experiments, thereby confirming the specificity of the antiserum. As deduced from the DNA sequence, the 11.6K protein (and the corresponding 10.5K Ad5 protein) has a conserved 22-amino-acid hydrophobic domain, suggesting that the protein may be associated with membranes. We conclude that a gene located at nucleotides 1860 to 2143 in the Ad2 E3 transcription unit (nucleotides 1924 to 2203) in the Ad5 E3 transcription unit) encodes an 11.6K protein (10.5K in Ad5). PMID- 6492254 TI - Transcriptional mapping of human respiratory syncytial virus. AB - A transcriptional map for human respiratory syncytial virus was determined by measuring the kinetics of viral gene inactivation in response to UV irradiation. Monolayer cell cultures of respiratory syncytial virus-infected HEp-2 cells were exposed to UV light, and residual viral RNA synthesis was monitored both by gel electrophoresis and by hybridization to dot blots of cloned cDNAs of the 10 known viral genes. Target sizes for the 10 individual viral genes were calculated relative to the UV sensitivity of intracellular viral genome replication. Target size analysis indicated that the 10 viral genes were transcribed as a single transcriptional unit and that the transcription of an individual gene was dependent on the prior transcription of all the preceding genes. The order of gene transcription (with nomenclature according to encoded proteins) was determined to proceed from the promoter as follows: 14K, 11K, N, P, M, 9.5K, 36K, F, 24K, L. PMID- 6492255 TI - Large surface proteins of hepatitis B virus containing the pre-s sequence. AB - The sequence of hepatitis B virus DNA contains an open reading frame which codes for a not-yet-identified protein of at least 389 amino acids. Only the products starting at the third (GP33/GP36) or the fourth (P24/GP27) initiation signal have been characterized as components of the viral surface antigen. We found a larger protein, P39, and its glycosylated form, GP42, in hepatitis B virus particles and viral surface antigen filaments. Immunological cross-reactions showed that P39/GP42 is partially homologous to P24/GP27 and GP33/GP36. The unique portion of its sequence bound monoclonal antibodies which had been induced by immunization with hepatitis B virus particles. Proteolytic cleavage patterns and subtype specific size differences suggested that the sequence of P39 starts with the first initiation signal of the open reading frame. Its amino-terminal part (pre-s coded) is exposed at the viral surface and, probably, is highly immunogenic. A model is presented of how the open reading frame for the viral envelope leads to defined amounts of three different proteins. PMID- 6492256 TI - Mutations in the gene encoding the adenovirus early region 1B 19,000-molecular weight tumor antigen cause the degradation of chromosomal DNA. AB - The adenovirus mutant Ad2ts111 has been previously shown to contain a mutation in the early region 2A gene encoding the single-stranded-DNA-binding protein that results in thermolabile replication of virus DNA and a mutation in early region 1 that causes degradation of intracellular DNA. A recombinant virus, Ad2cyt106, has been constructed which contains the Ad2ts111 early region 1 mutation and the wild type early region 2A gene from adenovirus 5. This virus, like its parent Ad2ts111, has two temperature-independent phenotypes; first, it has the ability to cause an enhanced and unusual cytopathic effect on the host cell (cytocidal [cyt] phenotype) and second, it induces degradation of cell DNA (DNA degradation [deg] phenotype). The mutation responsible for these phenotypes is a single point mutation in the gene encoding the adenovirus early region 1B (E1B) 19,000 molecular-weight (19K) tumor antigen. This mutation causes a change from a serine to an asparagine in the 20th amino acid from the amino terminus of the protein. Three other mutants that affect the E1B 19K protein function have been examined. The mutants Ad2lp5 and Ad5dl337 have both the cytocidal and DNA degradation phenotypes (cyt deg), whereas Ad2lp3 has only the cytocidal phenotype and does not induce degradation of cell DNA (cyt deg+). Thus, the DNA degradation is not caused by the altered cell morphology. Furthermore, the mutant Ad5dl337 does not make any detectable E1B 19K protein product, suggesting that the absence of E1B 19K protein function is responsible for the mutant phenotypes. A fully functional E1B 19K protein is not absolutely required for lytic growth of adenovirus 2 in HeLa cells, and its involvement in transformation of nonpermissive cells to morphological variants is discussed. PMID- 6492257 TI - Deletion of the gene encoding the adenovirus 5 early region 1b 21,000-molecular weight polypeptide leads to degradation of viral and host cell DNA. AB - The adenovirus 5 mutant H5dl337 lacks 146 base pairs within early region 1B. The deletion removes a portion of the region encoding the E1B 21,000-molecular-weight (21K) polypeptide, but does not disturb the E1B-55K/17K coding region. The virus is slightly defective for growth in cultured HeLa cells, in which its final yield is reduced ca. 10-fold compared with wild-type virus. The mutant displays a striking phenotype in HeLa cells. The onset of cytopathic effect is dramatically accelerated, and both host cell and viral DNAs are extensively degraded late after infection. This defect has been described previously for a variety of adenovirus mutants and has been termed a cytocidal (cyt) phenotype. H5dl337 serves to map this defect to the loss of E1B-21K polypeptide function. In addition to its defect in the productive growth cycle, H5dl337 is unable to transform rat cells at normal efficiency. PMID- 6492258 TI - Adenovirus 12 nononcogenic mutants: oncogenicity of transformed cells and viral proteins synthesized in vivo and in vitro. AB - Several nononcogenic cyt mutants of adenovirus type 12 induced the same E1A (55,000 [55K] and 25K) and E1B polypeptides (55K, 19K, and 17K) as did the wild type virus, except that cyt 68 did not induce the E1B 19K protein. Tumorigenicity tests showed cells transformed by cyt 68 to be highly oncogenic in vivo. Therefore, it was concluded that the E1B 19K polypeptide is not necessary for tumor induction but may be involved in the efficiency of transformation. PMID- 6492259 TI - Modification of viral structural proteins of herpesvirus sylvilagus by glycosylation and phosphorylation. AB - The structural proteins of herpesvirus sylvilagus, a lymphotropic gamma herpesvirus, were analyzed by sodium dodecyl sulfate and two-dimensional polyacrylamide gel electrophoreses. Modification of the proteins by glycosylation and phosphorylation was shown by the incorporation of [14C]glucosamine or 32Pi into material which comigrated with [35S]methionine-labeled proteins. One dimensional gel electrophoresis resolved four major glycoproteins and four major phosphoproteins. By two-dimensional gel electrophoresis, 9 glycoproteins and 13 phosphoproteins were identified. Four proteins incorporated all three labels, indicating that these structural proteins may be both glycosylated and phosphorylated. PMID- 6492260 TI - DNA synthesis in Pseudomonas acidovorans infected with mutants of bacteriophage phi W-14 defective in the synthesis of alpha-putrescinylthymine. AB - Normal levels of the hypermodified pyrimidine, alpha-putrescinylthymine, which is formed from hydhydroxymethyluracil at the polynucleotide level (Maltman et al., J. Virol. 34:354-359, 1984), are not required in bacteriophage luminal diameterW 14 DNA for the DNA to serve as a replicative template in luminal diameterW-14 infected cells. PMID- 6492261 TI - Characterization of IM virus, which is frequently isolated from cerebrospinal fluid of patients with multiple sclerosis and other chronic diseases of the central nervous system. AB - A transmissible agent, the IM virus, antigenically related to the Japanese subacute myelo-optico-neuropathy virus, has been isolated from several human cerebrospinal fluids obtained from American patients with multiple sclerosis and other chronic diseases of the central nervous system. The isolates were propagated in human diploid fibroblast (MRC5) cells, and virus was released into the culture medium in the absence of overt cytolysis. Infection of MRC5 cells resulted in a subtle alteration in the normal growth pattern of the cells. In unstained cultures, the cell changes were so mild that it was necessary to carry out all virus assays under code to eliminate bias. Cells in late passages were more susceptible than vigorously growing cells in early passages. Analysis of the kinetics of replication revealed that newly synthesized progeny virus was first detected about 12 h postinfection, that maximal virus release occurred by 48 h postinfection, and that virus production was persistent throughout an 8-day period. Several inhibitors of DNA synthesis were effective in blocking viral replication, including cytosine arabinoside, iododeoxyuridine, and phosphonoacetic acid. A substantial decrease in infectivity was observed upon treatment of IM virus with ether, suggesting that a lipid-containing structure is essential for infectivity. Ultrafiltration studies approximated the size (diameter) of IM virus to be between 100 and 200 nm. PMID- 6492262 TI - cyt gene of adenoviruses 2 and 5 is an oncogene for transforming function in early region E1B and encodes the E1B 19,000-molecular-weight polypeptide. AB - A total of 59 cytocidal (cyt) mutants were isolated from adenovirus 2 (Ad2) and Ad5. In contrast to the small plaques and adenovirus type of cytopathic effects produced by wild-type cyt+ viruses, the cyt mutants produced large plaques, and the cytopathic effect was characterized by marked cellular destruction. cyt mutants were transformation defective in established rat 3Y1 cells. cyt+ revertants and cyt+ intragenic recombinants recovered fully the transforming ability of wild-type viruses. Thus, the cyt gene is an oncogene responsible for the transforming function of Ad2 and Ad5. Genetic mapping in which we used three Ad5 deletion mutants (dl312, dl313, and dl314) as reference deletions located the cyt gene between the 3' ends of the dl314 deletion (nucleotide 1,679) and the dl313 deletion (nucleotide 3,625) in region E1B. Restriction endonuclease mapping of these recombinants suggested that the cyt gene encodes the region E1B 19,000 molecular-weight (175R) polypeptide (nucleotides 1,711 to 2,236). This was confirmed by DNA sequencing of eight different cyt mutants. One of these mutants has a single missense mutant, two mutants have double missense mutations, and five mutants have nonsense mutations. Except for one mutant, these point mutations are not located in any other known region E1B gene. We conclude that the cyt gene codes for the E1B 19,000-molecular-weight (175R) polypeptide, that this polypeptide is required for morphological transformation of rat 3Y1 cells, and that simple amino acid substitutions in the protein can be sufficient to produce the cyt phenotype. PMID- 6492263 TI - Effects of lysosomotropic weak bases on infection of BHK-21 cells by Sindbis virus. AB - The effects of the lysosomotropic weak bases chloroquine, ammonium chloride, and amantadine as well as dansylcadaverine (an inhibitor of receptor mediated endocytosis) on the replication of Sindbis virus in tissue-cultured cells was examined. Chloroquine had no effect on the expression of virus-induced homologous interference. None of these drugs significantly affected the ability of a complex of a cell and single virion to form an infectious center. Chloroquine and ammonium chloride were found to inhibit the synthesis of virus RNA in established infections when added early in infection. These drugs also inhibited the production of progeny virions when added any time after infection. These results suggest that the antiviral activity of these agents may not be due to an ability to prevent transport of the virus genome into the cell cytoplasm. PMID- 6492264 TI - Sequencing studies of pichinde arenavirus S RNA indicate a novel coding strategy, an ambisense viral S RNA. AB - Analyses of the complete sequence of the 1.1 X 10(6)-dalton, small (S) RNA of the arenavirus Pichinde and virus-induced cellular RNA species have revealed that the viral nucleoprotein, N, is coded in a subgenomic, non-polyadenylated, virus complementary mRNA corresponding to the 3' half of the viral RNA (Auperin et al., Virology 134:208-219, 1984). By contrast, a second S-coded product, presumably the viral glycoprotein precursor (GPC), is coded in a subgenomic, virus-sense mRNA corresponding to the 5' half of the RNA. Between the two genes is a unique RNA sequence that can be arranged in a hairpin configuration and may function as a transcription terminator for both genes. The term ambisense RNA is coined to describe this novel coding strategy of a viral RNA. The unique feature of the strategy is that the presumptive GPC mRNA and its translation product cannot be made until viral RNA replication has commenced. In addition, it allows the two subgenomic mRNA species to be regulated independently from each other or from other viral mRNA species. The implications of this strategy on possible mechanisms for the induction and maintenance of viral persistence, an important attribute of arenavirus infections, are discussed. PMID- 6492265 TI - Cloned duck hepatitis B virus DNA is infectious in Pekin ducks. AB - Approximately 10% of German-bred Pekin ducks were found to be chronically infected with duck hepatitis B virus (DHBV). The genomes of three German DHBV isolates analyzed were closely related but showed substantial restriction site polymorphism compared with U.S. isolates. We tested the infectivity of three sequence variants of cloned DHBV DNA by injecting them into the liver of virus free ducklings. Most of these animals injected with double-stranded closed circular or plasmid-integrated dimer DHBV DNA developed viremia, demonstrating the infectivity of all three cloned DHBV DNA variants. The cloned viruses produced were indistinguishable from those from naturally infected animals, implying that our experimental approach can be used to perform a functional analysis of the DHBV genome. PMID- 6492266 TI - Identification of herpesvirus sylvilagus-induced polypeptides in productively infected cells. AB - Polypeptides synthesized in cell cultures infected with high multiplicities of herpesvirus sylvilagus were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of [35S]methionine-labeled cell extracts. Initiation of polypeptide synthesis was detected by 6 h after infection. The maximum intensity of many [35S]methionine-labeled viral bands was observed at 45 h after infection. Production of detectable infectious virus began between 18 and 24 h and reached a plateau at 48 h after infection. Immunoprecipitation of cell extracts identified a minimum of 45 virus-induced polypeptides ranging in molecular weight from 230,000 to 27,000. The major polypeptide appeared to have a molecular weight of 150,000. The pattern of these extracts suggested that the synthesis of host polypeptides is stimulated during the first 12 h and thereafter reduced, but not completely inhibited, during the remaining course of infection. PMID- 6492267 TI - Reovirus type 3 genome segment S4: nucleotide sequence of the gene encoding a major virion surface protein. AB - A full-length cDNA copy of reovirus double-stranded RNA genome segment S4 which codes for a major virion structural polypeptide, sigma 3, has been completely sequenced. The 1,196-nucleotide cDNA contains a single long open reading frame in the plus strand extending 1,095 nucleotides from the 5'-proximal A-T-G to a single stop codon. This corresponds to translation of 92% of the S4 gene. The inferred sigma 3 polypeptide is hydrophilic and consists of 365 amino acids, totalling 41,164 daltons. PMID- 6492268 TI - Change in inhibitory potential in urine of hyperuricosuric calcium oxalate stone formers effected by allopurinol and orthophosphates. AB - Allopurinol and orthophosphates were used in the treatment of 25 hyperuricosuric calcium oxalate stone formers. Their urines were tested by the Discriminating Index method, which measures the potential of a urine to retard calcium oxalate precipitation in vitro. The tests were performed before any treatment was begun and about 10 days after the commencement of drug intake. An insignificant effect by allopurinol and a markedly significant effect of orthophosphates on Discriminating Index were found. In a few of the patients, allopurinol seemed to cause a decrease in the urine's potential to retard calcium oxalate precipitation. Therefore the effect of allopurinol in 11 hyperuricosuric patients with no history of calcium oxalate stone formation was tested. In 5 of the 11 patients, the urine's potential to retard calcium oxalate precipitation decreased to levels similar to those of calcium oxalate stone formers. The results of this study suggest that hyperuricosuric calcium oxalate stone formers suffer from the same yet-undefined etiology of stone formation as other calcium oxalate stone formers. The results also question the role of uric acid in calcium oxalate stone formation and the efficacy of allopurinol in preventing this disease. It is suggested that allopurinol may even be related to stone formation in some patients. PMID- 6492269 TI - Diffuse papillomatosis of rat urinary bladder occurring in association with vesical calculi. AB - Repeated intravesical administrations of 0.9 per cent NaCl solution with or without bladder carcinogen N-butyl-N-(3-carboxypropyl)nitrosamine resulted in a high incidence of calculus formation in the urinary bladder. In all such cases, diffuse papillomatosis of the bladder urothelium was observed. "Invasion" of the tunica muscularis and the tunica adventitia by tumor was demonstrated as early as week 9 of the experiment. Morphologically, the lesions could not be distinguished from the bladder tumors induced by an orally administered carcinogen. Evidence was presented to conclude that they represent neoplasms of low malignant potential. The results indicate that bladder tumors may develop in the absence of known exposure to carcinogen provided the urothelium is chronically stimulated. Tumors solely attributable to N-butyl-N-(3-carboxypropyl)nitrosamine treatment did not occur. PMID- 6492270 TI - The influence of treatment with estrogens and estramustine phosphate on platelet aggregation and plasma lipoproteins in non-disseminated prostatic carcinoma. AB - The treatment of prostatic carcinoma with estrogens is associated with an increased risk of cardiovascular as well as thromboembolic complications. In the present study, patients harboring highly or moderately differentiated prostatic carcinoma without signs of metastases were treated with either polyestradiolphosphate + etinylestradiol, estramustine phosphate or given no treatment. Subsequently, these patients were investigated regarding factors (platelet aggregation, plasma and platelet phospholipid composition and lipoprotein patterns) that might contribute to increased thrombogenesis and cardiovascular risk. The results indicate the presence of increased in vitro platelet aggregation in patients treated with polyestradiolphosphate + etinylestradiol compared to those treated with estramustine phosphate or given no treatment. A possible relationship between the availability of arachidonic acid in platelet membrane phospholipids and in vitro platelet aggregation is suggested. On the other hand the alterations in plasma lipoproteins observed during treatment are generally considered positive from an atherogenic point of view and do not seem relevant to the elevated incidence of cardiovascular disease in these patients. PMID- 6492271 TI - Role of the pudendal nerves on the dynamics of micturition in the dog evaluated by pressure flow EMG and pressure flow plot studies. AB - The role of the pudendal nerves on the dynamics of micturition was studied using 16 decerebrated dogs. The voiding cycles were analyzed by pressure flow EMG and pressure flow plot studies under 3 conditions: control, after unilateral, and after bilateral pudendal nerve transection. In the control condition, highly reproducible reflex micturition with bladder contraction and spasmodic rhythmic sphincter contractions was demonstrated. Two patterns were noted following pudendal nerve transection: reflex micturition and overflow incontinence. Even though reflex micturition could be achieved in 9 out of 16 dogs after bilateral transection, there was decreased bladder emptying as well as absence of spasmodic rhythmic sphincter contractions. Overflow incontinence developed in the remaining 7 dogs (5 dogs after bilateral transection and 2 dogs after unilateral transection). It appears that the pudendal nerves play an important role in emptying the bladder of the dog. PMID- 6492272 TI - Electrophoretic and ultrastructural analysis of the rabbit's striated external urethral sphincter. AB - The male rabbit's external urethral sphincter was investigated with O'Farrell's 2 dimensional electrophoretic analysis of myosin light chains and electron microscopy. Its pattern of myosin light chains was different from that of the soleus (predominantly slow twitch muscle) but was very similar to that of the psoas (predominantly fast twitch muscle). Ultrastructurally it was shown to be red muscle resembling the soleus. Therefore the fiber type of the rabbit's external urethral sphincter was determined to be the red (fast) type. PMID- 6492273 TI - Ability of the inflatable penile prosthesis to withstand rapid changes in altitude. AB - Small air bubbles unavoidably included in the fluid of the inflatable penile prosthesis will expand upon exposure to increased altitude. Three prostheses with predetermined amounts of air underwent decompressions in an altitude chamber. The device was able to contain the expanded air bubbles with no extravasation of fluid or air or damage to the system. PMID- 6492274 TI - American Urological Association: dedication to excellence. PMID- 6492275 TI - Intraoperative 3-dimensional radiography of the kidney. Modified technique. AB - We present a technical modification of 3-dimensional intraoperative radiography of the kidney that reduces the cost of the material and makes preparation of the minichassis in the hospital laboratory possible. The radiogenic dose received by the kidney is 20 times less than when the system is used without screens. PMID- 6492276 TI - Renal oncocytoma: a diagnostic and therapeutic dilemma. AB - From 1968 to 1983, 254 patients underwent an operation for presumed renal cell carcinoma. In this retrospective review the pathological diagnosis was renal oncocytoma in 11 patients (4 per cent). Renal oncocytomas were present bilaterally in 2 patients, including 1 with a coexisting renal cell carcinoma. In 2 other patients the oncocytomas were multicentric. The angiographic, computerized tomographic and sonographic findings in these patients typified renal cell carcinoma. Surgical treatment comprised radical or partial nephrectomy for unilateral and bilateral lesions, respectively. Because of the benign nature, multicentricity, possible bilaterality and absence of pathognomonic radiographic features, renal oncocytomas should be considered in the differential diagnosis of solid renal masses. PMID- 6492277 TI - Vesicoureteral reflux in the adult. IV. Medical versus surgical management. AB - A group of 27 adults with bilateral primary vesicoureteral reflux diagnosed during a 10-year interval was managed medically for a mean of 87 months. Their outcome was compared to that of 67 adults with bilateral primary reflux treated surgically during the same interval. In both groups the presence of renal insufficiency and hypertension correlated with the severity of renal scarring. Furthermore, the fate of renal function was similar irrespective of the method of management and appeared to be determined by the severity of renal scarring, level of renal function at initial evaluation and presence of proteinuria. The 2 groups appeared to fare equally well during the followup of up to 13 years. PMID- 6492278 TI - Deoxyribonucleic acid analysis in the evaluation of transitional cell carcinoma before cystectomy. AB - Analysis of cellular deoxyribonucleic acid content via flow cytometry was done on tumor biopsies and bladder washings from 61 patients with transitional cell carcinoma who underwent preoperative irradiation (36 or 20 Gy) and cystectomy. Classification only of tumors as diploid or various forms of aneuploid did not facilitate the separation of these advanced tumors into different subgroups. In addition, the proliferation rates, which also were high, did not facilitate further subclassification. On the other hand, more than 1 aneuploid cell line in the preoperative biopsies was linked more closely to pathological than to clinical stage and was found particularly if the stage was unchanged or increased after irradiation. The deoxyribonucleic acid pattern generally was the same after irradiation in patients with residual tumor and persistent aneuploidy. However, a diploid deoxyribonucleic acid value was noted in a number of patients with residual tumors, which indicated the existence of diploid and aneuploid tumor cells, and a preferential irradiation effect on the aneuploid portion of the tumor cell population. PMID- 6492279 TI - The clinicopathological features of metastatic superficial papillary bladder cancer. AB - A review of the records of more than 1,000 patients with bladder cancer has led to the identification of 9 with superficial papillary tumors and no evidence of muscle invasion in whom distant metastases developed. The majority of these patients had multiple recurrent tumors that were difficult to control by endoscopic means and failed to respond to intravesical chemotherapy, Helmstein's therapy or radiotherapy. Of the patients 4 had superficial tumors in the prostatic ducts but no stromal invasion. In 7 patients with well or moderately differentiated tumors the histological grade was the same in the metastases. The sites of metastases were bone in 5 patients, lung in 3 and liver in 1, which suggested hematogenous spread of tumor. Histological evidence of microvascular invasion was seen in 2 of the resected bladder tumors. We conclude that failure to control bladder tumors by local means should be an indication for early cystectomy, even in patients with no evidence of muscle invasion. PMID- 6492280 TI - Simultaneous bladder and prostatomembranous urethral rupture from external trauma. AB - Simultaneous bladder and prostatomembranous (posterior) urethral ruptures from external trauma occur in 10 to 29 per cent of male patients with traumatic rupture of the posterior urethra. The records of 47 male patients with traumatic rupture of the posterior urethra were evaluated. A total of 8 patients (17 per cent) had simultaneous rupture of the bladder (4 extraperitoneal, 3 intraperitoneal and 1 both) and posterior urethra (5 complete and 3 partial ruptures). A fractured pelvis was present in all 8 patients, with an average of 3.1 associated injuries per patient. Both ruptures were diagnosed preoperatively in only 1 patient. In male patients with multiple injuries, including a fractured pelvis and rupture of the posterior urethra, a concomitant rupture of the bladder must be suspected and sought at surgical exploration. PMID- 6492281 TI - Fournier's gangrene: 5 patients treated with hyperbaric oxygen. AB - The classic syndrome of Fournier's gangrene was observed in 5 men with involvement of the external genitals and lower abdominal wall. Mixed flora of anaerobic and aerobic microorganisms were grown, and extensive necrosis of the skin and subcutaneous gas were present in all patients. Soon after hospitalization all 5 patients were treated by excision of all necrotic and undermined tissue, intravenous broad-spectrum antibiotics and hyperbaric oxygen administered at 3 atmospheres of pressure. One patient died of septic shock without any response to the therapy. The infection subsided shortly after the hyperbaric oxygen was instituted in the remaining 4 patients, who were cured. It is proposed that the treatment of Fournier's gangrene should be limited to centers capable of administering hyperbaric oxygen therapy. Our series does not prove that hyperbaric oxygenation is necessary for successful treatment but evidence suggests a beneficial effect of such therapy for nonclostridial gas gangrene. PMID- 6492282 TI - Spermatic cord block and manual reduction: primary treatment for spermatic cord torsion. AB - A total of 16 consecutive cases of acute torsion of the spermatic cord less than 24 hours in duration are presented. All patients were diagnosed and treated initially by spermatic cord blockade and attempted manual detorsion. Of the 16 patients 15 underwent successful detorsion under local anesthesia. All patients underwent subsequent bilateral orchiopexy. Testicular salvage was 93 per cent in those patients who underwent successful detorsion by manipulation. PMID- 6492283 TI - Hydrocele following internal spermatic vein ligation: a retrospective study and review of the literature. AB - We reviewed 82 consecutive infertile men with varicoceles and 1 teenage boy with a painful varicocele, all of whom underwent a total of 111 internal spermatic vein ligations (55 unilateral and 28 bilateral) by the suprainguinal approach (Palomo method). Of these patients 3 who underwent unilateral and 3 bilateral internal spermatic vein ligations subsequently suffered a total of 8 hydroceles after an average postoperative interval of 18.2 months. The protein concentration of the hydrocele fluid in the 2 most recent patients was consistent with lymphatic obstruction. PMID- 6492284 TI - Pyelonephritic scarring in 213 patients with upper and lower urinary tract infections: long-term followup. AB - Of 213 patients more than 3 years old with recurrent urinary tract infections new pyelonephritic scars formed only among those with a combination of urinary tract infection and vesicoureteral reflux. Of 61 patients with that combination new renal pyelonephritic scars developed in 7 (11.48 per cent) and severe clubbing in 2. Of 40 patients with vesicoureteral reflux who underwent an antireflux operation new scars formed in 5 and progressive renal damage occurred in 1. Most renal scars (58) were present at initial examination. Neither number of urinary tract infections, number of upper urinary tract infections localized by the bladder washout technique nor attacks of flank pain and fever were seen more often in patients who suffered new scars, and grade of reflux was not a factor. Patients in whom new scars developed during our prospective followup were younger than those who did not have new scars. However, new scars formed after an initial normal excretory urogram in only 1 patient with vesicoureteral reflux and urinary tract infection compared to 4 after an antireflux operation. PMID- 6492286 TI - The role of excretory urography in the evaluation of girls with urinary tract infection. AB - Excretory urography and cystography were done in 200 girls from less than 1 year to 14 years old with a history of urinary tract infections. In 147 girls (73.5 per cent) the excretory urogram and cystogram were normal. Reflux was demonstrated on voiding cystourethrography in 19.5 per cent of the patients. Only 3 patients were found to have a normal voiding cystourethrogram and a significant abnormal excretory urogram. In only 1 patient (0.5 per cent) was an abnormality (an ectopic obstructed ureter) identified, which was amenable to intervention. We conclude that in the evaluation of girls with urinary tract infection an excretory urogram is indicated only in the presence of vesicoureteral reflux. PMID- 6492285 TI - Suprapubic endoscopic vesical neck suspension (Stamey procedure) for control of urinary incontinence in a woman following cauda equina injury. AB - Suprapubic endoscopic suspension of the vesical neck is a popular and effective procedure for the treatment of stress urinary incontinence in women. A woman who suffered a traumatic cauda equina injury had areflexic detrusor dysfunction with normal intravesical filling pressure. The patient had moderate proximal urethral dysfunction resulting in incontinence despite an adequate intermittent self catheterization regimen and treatment with an alpha-sympathomimetic drug. Following suprapubic endoscopic vesical neck suspension she has remained totally continent on intermittent self-catheterization. PMID- 6492287 TI - Urinary tract infection: between clinical investigation and everyday practice. PMID- 6492288 TI - Primary aldosteronism due to adrenal cortical carcinoma. AB - We report a rare case of primary aldosteronism due to adrenal cortical carcinoma. Endocrinological data showed an isolated excess of aldosterone production without any associated increase in other steroids. Adrenal scintigraphy, which has not been described in cases of primary aldosteronism due to adrenal cortical carcinoma, revealed an increased uptake of the radionuclide into the affected adrenal gland without suppression in the contralateral gland. PMID- 6492289 TI - Mineralocorticoid excess secondary to adrenal cortical carcinoma. AB - Adrenal cortical carcinoma may present solely with a syndrome of mineralocorticoid excess. Primary aldosteronism, resulting from adrenal carcinoma, is unusual and has only been reported rarely. A review of the literature revealed 19 cases with marked hypertension and hypokalemia, resulting from mineralocorticoid excess produced by adrenal cortical carcinoma. We report an additional case that supports the hypothesis that adrenal carcinoma may mimic hyperaldosteronism. Extensive assay of adrenal function will demonstrate the presence of biologically inactive steroids, suggesting the presence of adrenal cortical carcinoma. PMID- 6492290 TI - Direct fibrinolytic therapy for renal vein thrombosis: radiographic followup. AB - Renal vein thrombosis is a rare entity whose true incidence is unknown. The disease occurs most frequently in patients with the nephrotic syndrome but it also can occur in the presence of other hypercoagulable states. Previous modes of therapy have been limited to systemic anticoagulation or surgery. We report a case of successful dissolution of acute renal vein thrombosis using direct fibrinolytic therapy, which was documented radiographically during treatment and at 3-month followup. PMID- 6492291 TI - An antegrade technique for ablation of posterior urethral valves. AB - Complications after transurethral ablation of posterior urethral valves frequently are iatrogenic because of urethral injury resulting in stricture or sphincteric incontinence. Smaller instrumentation and improved optics have made primary valve destruction safer and more reliable. The concept of early neonatal vesicostomy with delayed transurethral valve ablation allows maximal upper tract protection as well as somatic and urethral growth. This approach further reduces the possibility of urethral or sphincteric injury. We report our technique of antegrade incision of posterior urethral valves per vesicostomy, combining the advantages of early optimal neonatal vesicostomy drainage, avoidance of any anterior urethral instrumentation, and a technically easier, reliable and safe approach to posterior urethral valve destruction. PMID- 6492292 TI - Ventral preputial island flap technique for the repair of epispadias with or without exstrophy. AB - The preputial island flap technique introduced by Duckett for repair of severe hypospadias has met with much clinical popularity. We report the use of a modification of this technique for repair of epispadias in 3 boys with exstrophy of the bladder and in 1 with penile epispadias. The results have been excellent in 3 cases and good in 1. Minimum followup has been 18 months. PMID- 6492293 TI - Hyperammonemia after transurethral resection of the prostate: a report of 2 cases. AB - We report on 2 patients who became deeply comatose after transurethral resection of the prostate. Both patients were severely hyponatremic and hyperammonemic but the course of the comas followed serum ammonia concentrations more closely than serum sodium concentrations. The genitourinary irrigant used in both procedures was a 1.5 per cent glycine solution. Serum amino acid analyses in 1 patient suggested that the postoperative hyperammonemia was due to catabolism of glycine absorbed during surgery. The inadequate activation of normal pathways of ammonia metabolism in this patient may have been caused by a partial deficiency of the urea cycle enzyme argininosuccinate synthetase. We believe that hyperammonemia should be considered as a cause of encephalopathy after transurethral resection of the prostate. The 1.5 per cent glycine genitourinary irrigating solution may not be as nontoxic as generally believed. PMID- 6492294 TI - Pathophysiology of venous claudication. AB - Patients with chronic iliofemoral venous obstruction may develop severe thigh pain and a sensation of tightness with vigorous exercise (venous claudication). The discomfort requires 15 to 20 minutes to subside. In the seven patients studied the venous capacitance (VC) and venous outflow (VO) are lower than those of the unaffected limb even at rest. With exercise to the point of pain, the VO was unchanged but the VC decreased even further. The problem appears to rest with the venous collaterals, which have a high and fixed resistance. Because of this high outflow resistance, venous volume increases to near maximum during exercise. With this rise in venous volume, the amount the VC can increase during the period immediately following exercise is further reduced. PMID- 6492295 TI - Late survival after carotid endarterectomy for transient ischemic attacks. AB - Two hundred sixty-six consecutive patients with carotid transient ischemic attacks were treated by 310 carotid endarterectomies. The patients were followed up from 30 months to 12 years, and survival was charted by the life-table method. Comparison with an age- and sex-matched population from the same geographic region showed that survival after operation was not impaired unless there were risk factors from disease that was progressive or could not be well controlled. Hypertension and cardiac disease did not adversely affect survival-probably because they were generally well controlled and included the use of nonsynchronous coronary artery grafting when necessary. Those with impaired cardiac function severe enough to threaten perioperative myocardial infarction or acute irreversible cardiac failure during anesthesia were not recommended for operation. PMID- 6492296 TI - Cellular changes with graded limb ischemia and reperfusion. AB - Following distal arterial and venous cannulations in both hind limbs of 10 dogs, left leg arterial pressure was reduced to less than 50 torr (group I) and 50 to 75 torr (group II). Muscle membrane potential difference (PD) measurements, muscle biopsies, and arterial and venous blood samples were taken at baseline, after 3 hours of ischemia, and following 3 hours of reperfusion. Blood gas tensions and blood and muscle metabolites were measured. Muscle creatine phosphate levels fell during the ischemic period, but the adenosine triphosphate concentration remained normal. The PD fell in both groups during ischemia and declined further after reperfusion (p greater than 0.01). The deterioration in cell membrane function occurred in spite of intracellular energy repletion and persisted after reperfusion. The PD appears to be a more sensitive indicator of ischemia-induced cell dysfunction than levels of blood or intracellular metabolites. The cause of the progressive fall in the membrane potential is uncertain, but it may be due to cytotoxicity produced by oxygen free radicals. PMID- 6492297 TI - Carotid endarterectomy and completion contact arteriography. AB - Intraoperative angiography in carotid extracranial surgery demonstrates technical defects in 5% to 8% of patients. A simple and safe method of completion contact angiography (CCA) has been perfected by adapting dental x-ray equipment, small dental film cassettes, and a "shoe box" type of developing unit. The method is not technician dependent, requires only 5 ml of contrast medium, has a completion time of less than 5 minutes, and produces no measurable radiation to the operating team. CCA was performed with no complications in 40 patients undergoing carotid endarterectomy. Two unsuspected internal carotid artery defects (5%) were discovered: in one a stenosis was immediately repaired, and in the other small thrombi that were seen but not removed were probably the cause of a postoperative transient ischemic attack. Two complete occlusions and one prominent intimal flap in the external carotid artery were also identified. We believe that CCA after carotid surgery should be used routinely because it is safe and simple and reveals unsuspected operative defects that can be corrected immediately. PMID- 6492298 TI - Intimal intussusception: unusual complication of dissecting aneurysm. AB - A case is reported of a 65-year-old man operated on to relieve obstruction of the left common carotid and left subclavian arteries due to a dissecting aneurysm. At operation the obstruction was found to be due to detachment of the intima from the ascending aorta followed by intussusception into the distal aortic arch. Surgical correction consisted in resection of the ascending aorta and aortic arch and replacement with a Dacron graft. Certain technical aspects of the operation were considered important in achieving a successful outcome. PMID- 6492299 TI - Renal revascularization by extra-anatomic bypass. AB - Patients who suddenly become anuric and in whom no urinary obstruction is found should undergo arteriography both to confirm acute renal arterial occlusion and to plan surgical treatment. In acute renal arterial occlusion collateral circulation is often sufficient to maintain kidney viability and subsequent successful revascularization. Because there are no clinical or radiologic criteria to determine salvageability of the kidney, surgical exploration is advised in these patients. Such individuals who undergo successful renal revascularization often have gratifying return of renal function. Axillofemoral renal bypass is suggested as a method to accomplish this objective. PMID- 6492300 TI - Renal artery injury from a Fogarty balloon catheter. AB - A variety of complications secondary to thromboembolectomy with balloon catheters have been described. The present report describes an unusual and previously unreported complication following retrograde thrombectomy of an occluded limb of an aortofemoral graft. The variety of arterial injuries and technical misadventures attributable to balloon catheters are briefly discussed, and suggestions are made for avoiding the particular problem encountered in the patient described. PMID- 6492301 TI - Treatment of Aspergillus infection of the proximal aortic prosthetic graft with associated vertebral osteomyelitis. AB - This is a case report of an unusual vascular graft infection involving an invasive Aspergillus species with associated vertebral osteomyelitis. Successful treatment was obtained by graft incision, extra-anatomic bypass, and prolonged antibiotic therapy. To our knowledge this is the first successful treatment of invasive Aspergillus of an aortic prosthetic graft. PMID- 6492303 TI - There is no second. Presidential address. Society for Vascular Surgery. PMID- 6492302 TI - Development of a computerized vascular registry for large-scale use. AB - On the basis of the experiences of the Upstate New York Vascular Society and the Society for Clinical Vascular Surgery (total membership 526), a computerized vascular registry has been developed to collate and handle data from this multitude. After several developments a standard encoding vehicle has been arrived at, and data are entered on light-sensitive cards and processed electronically. This system has been in place for 2 years and has already revealed several trends about the practice of vascular surgery on a large-scale and/or community basis. Of importance among these are the differences in vascular surgical reconstructive success compared with the published individual reports as well as an examination of the trends in vascular surgical practice and the standards of proficiency required. The problems of inertia, resentment, and inaccurate data entry have also been addressed, and steps have been taken to overcome these as well as to ensure security of individual data. It is expected that use of such systems will eventually provide us with a much clearer picture of the overall practice and standards in vascular surgery that apply throughout the nation. PMID- 6492304 TI - Mandibular subluxation for high carotid exposure. AB - Twenty-four patients with internal carotid artery lesions extending above the second cervical vertebra underwent mandibular subluxation for additional exposure. The original technique of bilateral arch bar wiring requiring 90 minutes for application has evolved into a circummandibular/transnasal wiring technique requiring approximately 10 minutes. Subluxation of the mandibular condyle 10 to 15 mm anteriorly results in displacement of the mandibular ramus 20 to 30 mm anteriorly. This technique provides a marked increase in exposure of the internal carotid artery up to the base of the skull by transforming a triangular operating field into a rectangular field. The technique is quick, easy to perform, and not associated with objective or subjective temporomandibular joint dysfunction. PMID- 6492305 TI - The natural history of isolated carotid siphon stenosis. AB - Between August 1978 and July 1983, 93 patients (71 with unilateral and 22 with bilateral isolated carotid siphon stenosis) were identified from a review of 885 consecutive cerebral arteriograms. This yielded 115 cerebral hemispheres at risk. At the time of arteriography, 93 hemispheres were asymptomatic regarding the hemisphere with siphon stenosis (group I), whereas 22 hemispheres in 22 patients had had neurologic events referable to the hemisphere with siphon stenosis (group II). During follow-up (range 1 to 62 months, mean 22.5 months), 64.5% of initially asymptomatic hemispheres remained asymptomatic, 6.5% experienced transient ischemic attacks (TIAs), and 4.3% developed strokes. During the same follow-up period, 63.6% of initially symptomatic hemispheres became asymptomatic, 9.1% had recurrence of TIAs, and 9.1% developed strokes. Sixteen of 71 group I patients (22.5%) and 5 of 22 group II patients (22.7%) died during follow-up. The overall incidence of nonfatal stroke and TIAs was 6.5% and 8.6%, respectively. Myocardial infarction (MI) and stroke accounted for deaths in 6.5% and 4.3% of patients, respectively. There was no significant difference in the incidence of TIA, stroke, or death between group I and group II. The percentage of siphon stenosis in all patients experiencing stroke or TIA (35.4 +/- 14.4%) was not significantly different from that in patients who remained asymptomatic (32.3 +/- 10.6%). Patients with carotid siphon stenosis are at an increased risk of death, stroke, and TIAs compared with the population at large. However, the risk of stroke is less than the risk of stroke in patients with TIAs assumed to be caused by carotid bifurcation disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492306 TI - The correlation between carotid plaque ulceration and cerebral infarction seen on CT scan. AB - The purpose of the study was to determine the association between cerebral infarction seen on CT scan and macroscopic ulceration of atheromatous carotid plaques in patients undergoing carotid endarterectomy. Following carotid endarterectomy in 65 patients, specimens were examined for the presence of ulceration without knowing the result of the preoperative CT brain scan. The 65 patients thus investigated underwent 68 carotid endarterectomies: 36 for a history of transient ischemic attacks (TIAs), 13 for amaurosis fugax, and six for prior strokes; 13 asymptomatic patients had prophylactic carotid endarterectomy prior to coronary bypass. A macroscopic ulcer was present in 42 specimens. Twenty six (62%) of the patients with ulceration had one or more ipsilateral cerebral infarcts on CT scan. Only two (8%) of the 26 patients without an ulcer had cerebral infarcts. Of the 36 patients who presented with TIAs, 26 (72%) had carotid plaque ulcers and 23 (88%) of these had cerebral infarcts on CT scan also. In contrast, only three of 13 asymptomatic patients had plaque ulcers and only one of these had a cerebral infarct. There is a high incidence of cerebral infarction seen on CT scan in patients presenting with TIAs. These infarcts occur predominantly in patients with ulcerated atheromatous carotid lesions. PMID- 6492307 TI - Early carotid endarterectomy in patients with small, fixed neurologic deficits. AB - Patients who have sustained a large hemispheric stroke are not candidates for early carotid endarterectomy, but there is less agreement regarding the role of carotid endarterectomy in patients with small, fixed neurologic deficits. Accepted practice in many centers is to wait 4 to 6 weeks after the onset of the deficit before proceeding with carotid endarterectomy because of the fear that early revascularization will increase the size of the infarct. Earlier endarterectomy, however, in patients with significant residual ipsilateral carotid territory at risk may prevent repeated infarctions. For the past 5 years our approach to patients with a small stable stroke and significant stenosis (greater than 75%) has been prompt ipsilateral endarterectomy. Of the 337 carotid endarterectomies at our institution since 1979, a subset of 28 patients with hemodynamically significant carotid lesions presented with a small, fixed stroke. The period of time between the appearance of the stroke and carotid endarterectomy averaged 11 days, but 53% of patients were operated on within 7 days of the onset of symptoms. Selective shunting based on intraoperative EEG monitoring was utilized and 40% of the 28 patients required shunts. Operative mortality consisted of one death from a pulmonary embolus, and no patient sustained a new postoperative deficit. Long-term follow-up was available for 96% of patients over a mean of 2 years. During this time two new neurologic events occurred: one fatal stroke and one transient deficit. This experience indicates that patients with small, fixed neurologic deficits who continue to have carotid territory at risk may safely undergo carotid endarterectomy without waiting 4 to 6 weeks. PMID- 6492308 TI - Peroneal artery bypass: a reappraisal of its value in limb salvage. AB - In general the surgical literature has expressed pessimism about the value of bypass to the peroneal artery for limb salvage. The combination of greater technical difficulty, low patency rates, and hemodynamic failures have led to the establishment of this prejudice. In a review of 284 arteriograms in limbs with infrapopliteal arterial occlusion, the peroneal artery was the least diseased in 40% and was the only available vessel in 37% of instances. One hundred fifty-two peroneal bypasses have been performed in a 7-year period, 116 by the in situ method, 23 with excised vein, and 13 by nonautogenous conduits. During the same period 125 anterior tibial and 114 posterior tibial bypasses were also done. The mean preoperative ankle/brachial indices were 0.27 for peroneal, 0.25 for anterior tibial, and 0.29 for posterior tibial bypasses. These were converted to mean postoperative indices of 0.84, 0.86, and 0.92, respectively. Corresponding transmetatarsal/brachial indices were 0.72, 0.75, and 0.90. Rest pain was relieved in all these patients, and in 94 patients with tissue loss, there were 11 major amputations, nine healed forefoot amputations, and 20 healed digital ray amputations. Hemodynamic failures were two in the peroneal, two in the anterior tibial, and three in the posterior tibial group with one perioperative amputation in each. The cumulative limb salvage rate at 3 years for the peroneal group was 81%. This experience has shown that the patency and limb salvage rates obtained are comparable to those for the anterior and posterior tibial arteries and that hemodynamic failure is an uncommon occurrence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492309 TI - Components of outflow resistance and their correlation with graft patency in lower extremity arterial reconstructions. AB - We have used a simple reproducible method to measure total outflow resistance (OR) and its proximal and distal components in 101 bypasses (46 femoropopliteal [FP] and 55 femorodistal [FD]). All bypasses with a distal OR greater than 1.2 mm Hg/ml/min failed within 3 months and all with distal OR less than 1.2 mm Hg/ml/min remained patent for at least 3 months. To evaluate the contribution of vasospasm to OR and its role in graft failure, 60 bypasses (29 FP, 31 FD) had OR measurements before and after local infusion of papaverine hydrochloride (60 mg). Within 3 months, nine grafts (all FD) occluded and 51 remained patent. All nine failures had distal OR greater than 1.2 mm Hg/ml/min before papaverine infusion. After infusion, the mean percentage decrease in both total and distal OR for all grafts was 30% and 31%, respectively. However, there was no significant difference between these papaverine-induced decreases in OR and 3-month graft failure or success. Moreover, in three bypasses, even though papaverine lowered the distal OR from greater than 1.2 to less than 1.2 mm Hg/ml/min, early occlusion occurred. In six grafts (1 FP, 5 FD) when total and distal OR before and after papaverine was greater than 1.2 mm Hg/ml/min, the graft was extended to a second distal artery as a sequential bypass. These six grafts have remained patent over 3 months. Thus measurement of OR and particularly distal OR is a most accurate predictor of early graft success or failure. Pharmacologic manipulation does not enhance the predictive value of the OR measurement. OR measurements also help to select those FD bypass cases in which extension to a second distal artery as a sequential bypass improves patency. PMID- 6492310 TI - Acute effects of argon laser on human atherosclerotic plaque. AB - Although the laser has been demonstrated to vaporize coronary artery plaque, there is little information about its ability to resect or vaporize the range of plaques present in peripheral vessels. This study attempts to determine the ability of the argon laser to resect all grades of atherosclerotic plaque, the risk of perforation during plaque resection, the effects on surrounding arteries, and the effect of different transmission media (air, saline solution, and blood) on the delivery of laser energy to the vessel. Seventy-five adult human cadaveric aortic specimens with a range of atherosclerosis from grossly normal artery to extensive calcification with ulceration were exposed to variable energy densities (200 to greater than 20,000 J/cm2) within 48 hours of harvesting. Specimens were examined grossly for the visual effects of laser and microscopically after preparation with hematoxylin-eosin, trichrome, and/or Verhoeff's elastin stains. Our results indicate that normal arteries and noncalcified plaques absorb laser energy and are vaporized. As the atherosclerosis becomes more complex with calcification, calcified regions are not vaporized and cannot be resected. In normal arteries and noncalcified plaque, perforation times were less than 5 seconds. Where palpable calcification was present in atherosclerotic lesions, average perforation time was doubled. In some vessels areas of calcification prevented wall perforation, but areas of subintimal hemorrhage perforated rapidly because of the selective absorption of laser energy by the red color of hemorrhagic tissue. These results remain the same when saline solution is used as a transmission media, although the amount of energy required to achieve the effects is increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492311 TI - Impact of routine arteriography on management of penetrating neck injuries. AB - We evaluated the impact of routine arteriography on the management of 105 patients with penetrating injuries to the neck and upper chest. Of 72 patients with bullet wounds and 33 with knife wounds, surgical exploration on an emergency basis was performed in three patients because of shock; the remaining 102 underwent aortic arch or selective arteriography. Surgical exploration was performed in 18 patients because of abnormal arteriograms and in 13 (10 with normal arteriograms) because of shock or suspected hemorrhage. Operative findings confirmed the angiographic interpretation in 26 of the 31 patients who were explored. The angiogram underestimated the arterial injury in two patients and failed to identify an associated venous injury in three. Seventy-two patients with negative arteriograms received expectant treatment without subsequent complications. Routine arteriography is integral to expeditious triage and accurate diagnosis of patients with brachiocephalic trauma. A negative study in almost 80% of patients permits safe nonoperative management, whereas a positive study allows the surgeon to plan his operative approach more judiciously. Endoscopic procedures are important adjuncts in selected patients. PMID- 6492312 TI - Antithrombin III deficiency as a reflection of dynamic protein metabolism in patients undergoing vascular reconstruction. AB - Antithrombin III (AT-III) deficiency has been associated with increased risk of venous and arterial thromboses and arterial graft failure. Deficiency of this circulating glycoprotein may be congenital; however, acquired deficiencies may develop in protein-losing or protein-wasting states. In the present study, AT-III levels of 108 patients undergoing vascular surgical procedures were determined preoperatively and at intervals (third, fifth, and seventh days) postoperatively. The mean AT-III level was then compared to the patient's protein status. The effect of reduced AT-III activity on early graft failure was also noted. A low preoperative AT-III level (less than 80%) was found in 16.3% of the patients studied. Among 83 patients with serum albumin levels greater than 3.0 gm/dl or transferrin levels greater than 180 mg/dl, reduced AT-III activity was present in only 10 (12%). In contrast, when serum albumin levels were less than 3.0 gm/dl, AT-III deficiency was found in 12 of 25 patients (48%) (p less than 0.01). Early thrombosis of a femorodistal graft occurred in 5 of 15 patients (33%) with reduced AT-III levels. When AT-III levels were normal, early bypass failure occurred in only 9 of 67 grafts (13.4%). However, this difference was not statistically significant. An additional 15 patients had sequential pre- and postoperative measurements (up to 3 weeks) of serum protein and AT-III levels to illustrate the relationship between the dynamics of protein metabolism and AT-III levels. There was a clear temporal relationship between albumin, transferrin, and AT-III levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492313 TI - "Coral reef" atherosclerosis of the suprarenal aorta: a unique clinical entity. AB - Localized obstruction in a suprarenal aorta of normal diameter is rare. Between 1970 and 1983, nine patients (all women, mean age 51 years) required aortic reconstruction to relieve severe lower extremity ischemia (nine patients), hypertension (nine), visceral ischemia (two), and congestive heart failure (three) caused by an eccentric, heavily calcified polypoid lesion originating from the posterior surface of the suprarenal aorta. This mass typically began at the level of the diaphragm and extended to the level of the renal arteries, almost totally occluding the aortic lumen. The rock-hard, irregular, gritty, whitish surface strongly resembled a coral reef. Elective revascularization was carried out in eight patients, and an emergency procedure was necessary in one patient who had acute aortic thrombosis with catastrophic visceral, renal, and lower extremity ischemia. The suprarenal atheroma was removed en bloc through a retroperitoneal thoracoabdominal aortic endarterectomy. Concomitant aortoiliofemoral revascularization was necessary in seven patients (five prosthetic grafts, two endarterectomies). Two patients died postoperatively. The seven long-term survivors remain asymptomatic at a mean follow-up interval of 4 years after revascularization, without evidence of recurrence of this lesion. Suprarenal "coral reef" atherosclerosis should be considered if visceral, renal, and limb ischemia is not adequately explained by the arteriographic pattern of conventional atherosclerosis. This unusual atheroma exhibited extensive calcification and metaplastic bone formation, although its precise pathophysiology remains to be defined. PMID- 6492314 TI - Femoral-tibial bypass. Introductory remarks. PMID- 6492315 TI - In situ saphenous vein arterial bypass to the tibial arteries. PMID- 6492316 TI - Gore-Tex autogenous vein composite grafts for tibial reconstruction. PMID- 6492317 TI - Technical aspects of umbilical bypass to the tibial vessels. PMID- 6492318 TI - Presence of neutralizing antibodies to rabies virus in striped skunks from areas free of skunk rabies in Alberta. AB - Nine percent of 198 serum samples from striped skunks, Mephitis mephitis (Schreber) from five areas of Alberta were positive for rabies neutralizing antibody. Positive samples were minimal (2%) from specimens sampled in an area enzootic for rabies and occurred at greater rates in areas negative for skunk rabies. Transmission of rabies virus to skunks may have been from a source other than skunks in those areas, most probably from bats. PMID- 6492319 TI - Blood parasites of amphibians from Algonquin Park, Ontario. AB - During a 5 wk period beginning May 25, 1983, 329 amphibians, which included specimens of Rana catesbeiana Shaw, Rana clamitans Latreille, Rana septentrionalis Baird, Rana sylvatica LeConte, Hyla crucifer Wied, Bufo americanus Holbrook, and Plethodon cinereus Green, from Lake Sasajewun, Algonquin Park, Ontario, Canada were examined for blood parasites. The prevalences of species of Trypanosoma, Haemogregarina, Lankesterella, Babesiasoma, and Thrombocytozoons in these amphibians were determined. Two species of microfilaria (probably Foleyella spp.) and two intraerythrocytic forms, inclusions of an icosahedral cytoplasmic DNA virus (ICDV) and groups of rickettsial organisms, were also observed. The following are new host records: Trypanosoma ranarum (Lankester, 1871) in B. americanus; Trypanosoma ranarum (Lankester, 1871) in R. sylvatica; Trypanosoma pipientis Diamond, 1950, Babesiasoma stableri Schmittner and McGhee, 1961 and Thrombocytozoons ranarum Tchacarof, 1963 in R. septentrionalis. The aquatic frogs generally showed a much higher prevalence of infection with blood parasites than the terrestrial frogs, toads and salamanders, which is suggestive of an aquatic vector. The leech Batracobdella picta Verrill, 1872, which was found on many of the aquatic frogs, is the most likely vector in the study area. Also, an increasing prevalence of parasites was noted with increasing sizes (ages) of Rana clamitans and R. catesbeiana suggesting that longer exposure to water makes these species more likely to acquire blood parasites. The presence of Trypanosoma ranarum in B. americanus appeared to coincide with their attainment of sexual maturity. PMID- 6492320 TI - Blood and gastrointestinal parasites of eastern wild turkeys from Kentucky and Tennessee. AB - Fifty-nine gastrointestinal tracts and 52 blood samples were collected from eastern wild turkeys (Meleagris gallopavo silvestris Vieillot) during the spring turkey hunts of 1979-1980 from two areas in western Kentucky and Tennessee. Eight species of parasites were recovered, and included (combined prevalence): Haemoproteus meleagridis Levine, 1961 (25%), Hymenolepis carioca (Magalhaes, 1898) (44%), Metroliasthes lucida Ransom, 1900 (25%), Raillietina georgiensis (Reid and Nugara, 1961) (15%), R. williamsi Fuhrmann, 1932 (64%), Ascaridia dissimilis Perez Vigueras, 1931 (83%), Capillaria caudinflata (Molin, 1858) (2%), and Heterakis gallinarum (Schrank, 1788) (27%). A significant difference existed between the intensities of A. dissimilis from the two states. Twenty-two subinoculations of collected blood were made in 1979, but no Plasmodium infections were recovered. Helminths of wild turkeys from 11 southeastern states were compared using similarity and diversity indices. High similarities were observed in helminth populations of two groups of states: 1) Alabama, Mississippi, Arkansas, Virginia, and Tennessee; and 2) Tennessee, Kentucky, and Illinois. Simpson's diversity index indicated helminth populations of wild turkeys in Florida were the most diverse (0.10), while those in Louisiana turkeys were the least diverse (0.33). PMID- 6492321 TI - Pathology and epizootiology of Dirofilaria scapiceps (Leidy, 1886) (Nematoda: Filarioidea) in Sylvilagus floridanus (J.A. Allen) and Lepus americanus erxleben. AB - Dirofilaria scapiceps was found between the synovial sheath and tendons, i.e., within the tendon sheath, in the ankle region of eastern cottontail rabbits (Sylvilagus floridanus) and snowshoe hares (Lepus americanus). In cottontail rabbits, tendons and sheaths appeared normal and all worms were adults. Only one (4%) of 24 infected rabbits contained dead worms. All female worms were gravid in rabbits killed in late winter or early spring. Microfilaremias in rabbits were high (approximately 30-100 microfilariae/60 microliter blood) and of long duration (at least 8-28 mo), and rabbits were considered normal hosts of D. scapiceps. In some snowshoe hares, tendons and sheaths also appeared normal; however, in other hares a chronic proliferative tenosynovitis, characterized by fibrinous exudate, hyperplasia and hypertrophy of the intima and inflammatory cell (predominantly lymphocytes and plasma cells) infiltration of the intimal and fibrous layers of the synovial sheath led to encapsulation of worms. Dead subadult, dead adult, and live adult worms were found in the ankles of hares; 86 (46%) of 186 infected hares contained some or only dead worms. Fibrosis commonly occurred around dead worms. Dead subadults were also found in subcutaneous connective tissues over the trunk of the body. Degenerate embryos and amorphous material were observed in uteri of some female worms in hares killed in late winter or early spring. Few (1-5 microfilariae/60 microliter blood) or no microfilariae were observed in the peripheral blood of hares and microfilaremias were of short duration (less than 8 mo). Microfilariae in hares are probably trapped and destroyed in the chronic inflammatory lesions in the tendon sheaths since normal, degenerate, and calcified microfilariae were observed in the capsules around adult worms. Some microfilariae might also be destroyed in lymph nodes. Although D. scapiceps can be maintained within snowshoe hare populations, hares are considered abnormal hosts of D. scapiceps. Dirofilaria scapiceps may have spread from cottontail rabbits to snowshoe hares relatively recently. PMID- 6492322 TI - Helminth fauna of sandhill crane populations in Texas. AB - Three species of trematode [Orchipedium jolliei Schell, 1967; Prohyptiamus grusi Kocan, Waldrup, Ramakka, and Iverson, 1982; Echinostoma revolutum (Froelich, 1802)], three species of nematode (Tetrameres grusi Shumakovich, 1946; Synhimanthus sp.; Contracaecum sp.), and one species of cestode (Anomotaenia sp.) were recovered from 146 sandhill cranes, Grus canadensis (Linnaeus), collected in Alaska, Canada, and two areas in Texas. The only common and abundant species were O. jolliei and T grusi. Of cranes collected in Texas, those that came from the Canadian breeding grounds had significantly greater abundances of O. jolliei and T. grusi than those from Alaska. However, cluster analysis using rank abundances of helminth species across the four geographic regions and stepwise multiple discriminant analysis using the grouping variable of the presence or absence of a subspecies-specific pancreatic protein indicated that classification of cranes into populations based on helminth abundances was impractical as a management technique. PMID- 6492323 TI - Seasonal variations in physiological indices of adult female white-tailed deer in Texas. AB - Seasonal variations in blood chemistry, urine chemistry, fat reserves, and crude protein levels of rumen contents were determined for free-ranging adult female white-tailed deer (Odocoileus virginianus Zimmermann) in central Texas. Seasonal variations (P less than 0.05) existed for serum total protein, albumin, globulin, albumin/globulin ratios, blood urea nitrogen (BUN), cholesterol, alkaline phosphatase, creatinine, phosphorus, and sodium; and urinary urea/creatinine (U/C) ratios, rumen crude protein, the kidney fat index (KFI), femur marrow fat (FMF), and dressed weights. Variations in BUN, urinary U/C ratios, dressed weights, KFI, and FMF were attributed partially to the nutritional demands of late gestation and lactation. PMID- 6492324 TI - Levels of trace elements in the liver and diet of free-living koalas, Phascolarctos cinereus (Goldfuss). AB - The mean liver concentrations of copper, manganese, zinc and cobalt were 0.25, 0.20, 2.97 mmol/kg and 2.81 mumol/kg respectively in free-living koalas in Victoria, Australia. The mean plasma copper concentration was 9.2 mmol/liter which was somewhat below the level in other hindgut fermenters. The mean concentrations of copper, manganese and zinc in their diet (Eucalyptus spp.) were 0.08, 4.46 and 0.27 mmol/kg respectively. Analysis of the data established a significant correlation between the age of the koalas and the inverse of the concentration of the copper (r = -0.67, P less than 0.001) in the liver. There were no such correlations apparent for manganese, zinc or cobalt. The concentrations of trace metals in the Eucalyptus diet for the koala were comparable to those recommended in the diets for other hindgut fermenters such as horse, rabbits and rats. However there was evidence for suboptimal plasma copper levels (mean 9.2 mmol/liter) in some koalas, and reduced liver copper levels in older koalas. Liver histology revealed the presence of brown intracytoplasmic granules in hepatocytes. The size and number of these granules per cell was noted to increase with increasing age of the koala but the chemical nature and the role of the granules was not determined by the histochemical techniques used. PMID- 6492325 TI - Rangiferine brucellosis in a Muskox, Ovibos moschatus moschatus (Zimmermann). PMID- 6492327 TI - Dermatophilosis in a mule deer, Odocoileus hemionus (Rafinesque), from Wyoming. PMID- 6492326 TI - Erysipelothrix rhusiopathiae serotype 5 isolated from a white-tailed deer in Iowa. PMID- 6492328 TI - Granulomatous peritonitis in a fish caused by a flagellated protozoan. PMID- 6492329 TI - Transmission of Cytauxzoon felis Kier, 1979 from bobcats, Felis rufus (Schreber), to domestic cats by Dermacentor variabilis (Say). PMID- 6492330 TI - Prevalence and distribution of larvae of Trichinella sp. in cougars, Felis concolor L., and grizzly bears, Ursus arctos L., in Alberta. PMID- 6492331 TI - Carpometacarpal deformity in giant Canada geese (Branta canadensis maxima Delacour). PMID- 6492332 TI - Idiopathic scoliosis in a newborn sea otter, Enhydra lutris (L.). PMID- 6492333 TI - Spondylitis deformans in a Bryde's whale (Balaenoptera edeni Anderson) stranded on the southern coast of Queensland. PMID- 6492335 TI - Discrepancy between hemocytometer and electronic counts of blood cells. PMID- 6492334 TI - Dicrotophos poisoning of great-tailed grackles in Texas. PMID- 6492336 TI - Cystic fibrosis linked to chloride ions' inability to cross certain cells. PMID- 6492337 TI - Lengthened survival raises problems in cystic fibrosis. PMID- 6492338 TI - Progress continues against cystic fibrosis. PMID- 6492339 TI - Leads from the MMWR. Congo-Crimean hemorrhagic fever--Republic of South Africa. PMID- 6492340 TI - Treat yourself, right? PMID- 6492341 TI - The use and efficacy of child restraint devices. The Tennessee experience, 1982 and 1983. AB - The Tennessee Child Passenger Protection Act, mandating the use of child restraint devices for children younger than 4 years, took effect in 1978. In the years 1978 through 1983, eighty-one children younger than 4 years died in Tennessee traffic accidents; only two were in child restraint devices. During this period, as child restraint device use rose from 8% to more than 30%, the number of deaths among children younger than 4 years declined more than 50%. Analysis of supplemental accident reports filed in investigations of motor vehicle accidents involving children younger than 4 years during 1982 and 1983 showed that child restraint devices are highly effective in preventing death and in preventing or reducing injury. Children not in child restraint devices were 11 times more likely to die in an accident than children in child restraint devices. Children traveling in the arms of an adult were exposed to a risk of injury or death comparable to that of children left entirely unrestrained. PMID- 6492342 TI - Managing the care of the difficult patient in the emergency unit. AB - An approach to managing the care of "difficult" patients in emergency units is presented in both theoretical and practical terms. Understanding the conflicts these patients create and how these are exacerbated in an emergency unit setting can often lead to straightforward plans for management. These plans should emphasize consistency as a way of both setting limits and reassuring patients and should set reasonable expectations for health care providers working with these patients. Clinical examples are given to illustrate the use of these principles. PMID- 6492343 TI - A physician's guide to asbestos-related diseases. Council on Scientific Affairs. PMID- 6492344 TI - Histologic observations after closed chest ablation of the atrioventricular conduction system. AB - Postmortem examination of the heart was done in a case with disabling supraventricular tachyarrhythmia successfully treated by closed-chest ablation of the His bundle. A ventricular aneurysm developed as a result of a previous myocardial infarction, and death occurred suddenly five months after the procedure. Histologic studies of the atrioventricular (AV) junctional tissue demonstrated severe damage to the nearby AV node and penetrating His bundle. No damage to the branching His bundle or either bundle branch was observed. PMID- 6492345 TI - Adjuvant chemotherapy. Eight years later. PMID- 6492346 TI - Bless the seats and the children: the physician and the legislative process. PMID- 6492347 TI - Antibody studies claim awards spotlight. PMID- 6492348 TI - 'Saw-tooth' pattern on a flow-volume loop following neck surgery. PMID- 6492349 TI - Posttransfusion hepatitis A in a neonatal intensive care unit. AB - A single unit of infected blood transfused into 11 neonates resulted in a large multistate outbreak of 55 cases of hepatitis A, 35 of which were symptomatic. The person who donated the blood to the 11 neonates became ill with hepatitis A one week after the donation. Hepatitis A infection was then acquired by nurses and physicians having direct contact with the neonates and by parents and relatives. Three additional newborns who had not received transfusions with the infected unit also acquired hepatitis A. The neonates with hepatitis A were all asymptomatic. The attack rate in susceptible nurses was 16%; in susceptible physicians, 4%. A survey of the relatives of the 11 newborns who received transfusions revealed eight symptomatic cases of hepatitis A in 32 immediate family contacts, ie, mother, father, and siblings, with a resulting attack rate of 25% uncorrected for prior immunity. The setting of the neonatal intensive care unit appears to be ideal for the transmission of hepatitis A. PMID- 6492350 TI - Nosocomial hepatitis A. A multinursery outbreak in Wisconsin. AB - Seven premature infants contracted asymptomatic hepatitis A while hospitalized in an intensive care nursery (nursery A) from May through August 1981. Fifteen secondary cases occurred between Aug 13 and Oct 14 and included six family members of nursery A infants, five nursery A nurses, and three nurses and a physician at two other nurseries--B and C. Nurseries B and C had each received an infected infant transferred from nursery A in July. An epidemiologic investigation was conducted to determine the mode of transmission of hepatitis A in infants. A common vehicle was not identified. Review of dates of onset of illness in adults suggested that hepatitis A was transmitted in at least two generations of illness in infants at nursery A. Evaluation of infant handling in nursery A, using a case-control study, suggested that hepatitis A was transmitted among infants by nurses. Asymptomatic infected premature infants can be a source of hepatitis A in nursery infants and personnel and in the community. PMID- 6492351 TI - Scientific challenges in the application of randomized trials. AB - In recent years, scientific challenges in the application of randomized trials have become more apparent, especially with the extension of such trials to the assessment of nondrug treatments, such as health education, psychotherapy, and health care provision. Six issues (individual v group randomization, blinding and unblinding, the effect of trial participation on outcome, selective subject participation, treatment compliance, and standardized v individualized treatment) are discussed in terms of their impact on internal validity, generalizability (external validity), and clinical relevance. Specific design strategies may be necessary to enhance these methodological and clinical desiderata. Attention to these challenges should lead to improvements in future randomized trials. PMID- 6492352 TI - The appropriate use of diagnostic imaging. Avoidance of the red goggle syndrome. PMID- 6492353 TI - Hepatitis A in neonatal care units: not rare enough? PMID- 6492354 TI - Changing climate seen in efforts to tell public about smoking, health. PMID- 6492355 TI - Smoking draws fire at yet another medical facility. PMID- 6492356 TI - Smokeout could preface 'smoke-free society'. PMID- 6492357 TI - Many physicians following own advice about not smoking. PMID- 6492358 TI - Leads from the MMWR. Cancer mortality--Tennessee, 1960 to 1980. PMID- 6492360 TI - Leads from the MMWR. Shigellosis--United States, 1983. PMID- 6492359 TI - Leads from the MMWR. Lung cancer among women. PMID- 6492361 TI - Fatal hospital-acquired burns. PMID- 6492362 TI - Manpower requirements in radiology. PMID- 6492363 TI - Smoking and coronary heart disease mortality in the elderly. AB - Data from a longitudinal study of 2,674 persons aged 65 to 74 years were analyzed to ascertain whether cigarette smoking retained its adverse effect on survival in an elderly population. Current cigarette smokers had a risk of coronary heart disease death 52% higher than nonsmokers, ex-smokers, or pipe and cigar smokers. The excess risk of mortality declined within one to five years after smoking cessation. Even elderly smokers should be encouraged to quit. PMID- 6492364 TI - Do physicians preach what they practice? A study of physicians' health habits and counseling practices. AB - We examined the relation of physicians' clinical specialty, personal health habits, and health-related beliefs to their practices in counseling about smoking, weight, exercise, and alcohol. We surveyed a random sample of members of a county medical society in selected specialties. Physicians with better personal health habits and more positive attitudes toward counseling counsel a broader range of patients and counsel more aggressively. Surgeons counsel less than nonsurgeons, even after controlling for differences in health-related attitudes and personal habits. PMID- 6492365 TI - Tobacco addiction and tobacco mortality. Implications for death certification. AB - Addictive disorders now cause more than one fourth of all deaths in the United States--more than a half million deaths in 1982. But this essential fact is obscured in the nation's vital records and statistics by the general practice of certifying addictive disease deaths to their innumerable anatomic manifestations. However, this situation need not continue indefinitely. Physicians have both an opportunity and a responsibility to state their knowledge of the underlying causes of deaths occurring under their care, and the diagnostic category "Tobacco Use Disorder/Tobacco Dependence," listed in the ninth revision of the International Classification of Diseases is available for their use. By routinely ascertaining the lifetime smoking experience of each patient and stating on each death certificate the role of tobacco, physicians can contribute substantially to improvement of vital statistics, epidemiology, and public health. PMID- 6492366 TI - Weight, smoking, and mortality. AB - A controversy has existed concerning the relationship between body habitus and mortality. Original studies found that overweight persons were at risk for increased mortality, but later studies suggested that the very lean were also at high risk. The existence of a U-shaped relationship between mortality and body mass index was confirmed in a reanalysis of a 25-year follow-up of 1,503 men and 1,464 women, initially aged 40 to 65 years. Cigarette smoking did not explain the higher mortality among persons in the lowest body mass index category. PMID- 6492367 TI - The possible role of tobacco cigarette smoking in hyponatremia of long-term psychiatric patients. PMID- 6492368 TI - Arterial O2 saturation and maximum O2 consumption in moderate-altitude runners exposed to sea level and 3,050 m. AB - Twelve trained runners, who were moderate-altitude (1,520 m) residents, were acutely exposed to sea level and 3,050-m altitude in a hypo-hyperbaric chamber. At 1,520 m, maximum O2 consumption (VO2 max) was 67.7 +/- 0.9 mL/kg/min, minute ventilation (V) at maximum exercise was 169.8 +/- 4.6 L/min, and arterial O2 saturation (SaO2) decreased from 93.3% +/- 0.9% at rest, to 84.5% +/- 1.6% at maximum exercise. Exposure to 3,050 m produced a lower VO2max (56.5 +/- 1.5, 16.5%), a similar V at maximum exercise (169.9 +/- 6.0), and a similar fall in SaO2 (from 89.1% +/- 0.8% to 79.5% +/- 0.8%). Exposure to sea level increased VO2max to 72.4 +/- 1.4 (+6.9%), reduced V at maximum exercise to 158.8 +/- 6.5, and induced a smaller fall in SaO2 (from 96.9% +/- 0.4% to 92.1% +/- 1.0%). These changes are comparable with those reported previously in athletes at sea level exposed to similar altitudes, suggesting that residence at 1,520 m does not improve VO2max in highly trained athletes acutely exposed to lower or higher altitudes. PMID- 6492369 TI - National Institutes of Health consensus report on precursors to malignant melanoma. A difference in opinion. PMID- 6492370 TI - The role of the addictive process as a key step in causation of all tobacco related diseases. PMID- 6492371 TI - Effects of sublingual isosorbide dinitrate on left ventricular performance during exercise in patients with myocardial infarction. AB - In order to investigate left ventricular performance during exercise in patients with myocardial infarction and evaluate the effects of sublingual isosorbide dinitrate (ISDN) on left ventricular performance, we performed a symptom-limited multigraded exercise test using a bicycle ergometer in supine position. Thirty seven patients with myocardial infarction were evaluated in order to clarify the hemodynamic responses to exercise with and without sublingual ISDN. Patients were subdivided into 3 groups according to the level of pulmonary capillary pressure (PCP) and cardiac index (CI) at peak exercise as follows: Group I (14 patients); PCP less than 18 mmHg, CI greater than or equal to 5.0 or CI less than 5.0 L/min/m2, Group II (11 patients); PCP greater than or equal to 18 mmHg, CI greater than or equal to 5.0 L/min/m2, Group III (12 patients); PCP greater than or equal to 18 mmHg, CI less than 5.0 L/min/m2. Exercise capacity without ISDN (control study) was correlated with left ventricular performance during exercise. Although left ventricular performance in patients who complained of dyspnea or chest pain at peak exercise was worse than those who complained of leg fatigue, we could not predict hemodynamics during exercise from the level of hemodynamic parameters at rest in each patient. Determinant factors of left ventricular performance during exercise were age, previous history of myocardial infarction, the severity of coronary artery lesion and the extent of left ventricular wall motion abnormality which was estimated by left ventriculogram as an index of infarct size. After sublingual ISDN (ISDN study), exercise capacity was improved. No patient terminated exercise because of chest pain and only one did because of dyspnea.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492372 TI - Reconstruction of pulmonary artery with substitute valve--with special reference to size of conduit and valve. AB - Operative risk factors and postoperative late results were evaluated in 26 patients undergoing pulmonary artery reconstruction with a substitute valve. Seventeen extracardiac conduits bearing a valve were used in 16 patients and an in situ pulmonary valve insertion was carried out in the other 10. The surgical results were influenced by complexity of the underlying cardiac lesions and pulmonary vascular status, with a high mortality rate in patients with several cardiac defects including single ventricle, asplenia syndrome, complete atrioventricular canal etc. The mortality rate was 6% in patients with an immediate post-repair Ppv/sv of less than 0.75 and 77.8% in those with a Ppv/sv over 0.75. Postoperative Ppv/sv was mainly regulated by valve area index and a close correlation was obtained for the regression equation Ppv/sv = 0.41/(VAI)2 + 0.36 (r = -0.61, p less than 0.05). To obtain excellent hemodynamics with a Ppv/sv of less than 0.50, valve area index should be over 1.7 cm2/M2, and to eliminate re-implantation of the conduit after reaching adulthood, the diameter of the conduit should be 18 mm or more and the valve size 23 A, or more when a SJM valve is used. PMID- 6492373 TI - Postoperative changes of pulmonary vascular resistance in patients with complete atrioventricular canal defect. Relation to the age at primary repair. AB - The postoperative changes of pulmonary vascular resistance (PVR) of two age groups of children with complete atrioventricular canal (CAVC) were compared. Patients were divided by age at the time of primary repair; Group-1 (G-1, n = 4) with age below 2 years (average 13.8 mo.) and Group-2 (G-2, n = 5) with age over 2 years (average 44.0 mo.). All except one were Down's syndrome. Preoperatively, pulmonary to systemic resistance ratio (Rp/Rs) were 0.87 +/- 0.50 in G-1 and 0.41 +/- 0.13 in G-2 (n.s.), and postoperative study (average 6.5 mo.) showed no significant falls in Rp/Rs in both groups. However, G-2 showed significantly lower Rp/Rs postoperatively (0.79 +/- 0.19 in G-1 vs 0.27 +/- 0.12 in G-2, p less than 0.05). Mean pulmonary artery pressure (mPA) showed significant fall after surgery in only G-2 (66.8 +/- 6.6 to 31.8 +/- 11.6 mmHg, p less than 0.005). Anatomically, type-A showed better postoperative change in mPA compared to type C. This study summarized the early progression of pulmonary vascular obstructive disease with poor postoperative improvement even the primary repair was done before 2 years of age. The less advanced pulmonary vascular disease in G-2 might have some relations to the natural selection of the disease. PMID- 6492374 TI - Hereditary hemorrhagic telangiectasia with a pulmonary arteriovenous fistula. PMID- 6492375 TI - Clinical features, problems in medical management and therapeutic planning in severe valvular heart disease. AB - Clinical features and pathological findings were reviewed in 90 postmortem cases of valvular heart disease (VHD) to clarify the problems and limitations of medical management. The clinical features of severe mitral valve disease included congestive heart failure (CHF), with tricuspid regurgitation in many cases, atrial fibrillation, frequent ventricular premature beats, ventricular hypertrophy, cardiomegaly, increased pulmonary arterial pressure and abnormal hepatorenal function. The most common causes of aortic valve disease (AVD) were rheumatic fever and infective endocarditis, and the major causes of death were sudden death and intractable CHF. Autopsy in cases of AVD revealed marked left ventricular hypertrophy and dilatation, vegetations, thickening, adhesion and calcification in the aortic valve. Some patients died of cardiogenic shock due either to severely impaired cardiac function or to associated myocardial or pulmonary infarction. Abrupt onset of embolism was also related to death of the patients. The management of VHD must include the treatment of CHF and arrhythmias and the prevention of embolism. Appropriate timing for surgery and close follow up by cardiologists is mandatory. PMID- 6492376 TI - Studies on non-operative cases of acquired valvular heart disease. AB - Of the 652 cases with acquired valvular heart disease, 153 patients did not receive surgical therapies following cardiac catheterization studies. There were three types of reasons: mild symptoms, complications or high operative risks, and refusal. One hundred cases were not operated on immediately because of their mild symptoms, but 24 cases of them were aggravated during the follow-up periods and 15 underwent operations later. Twenty five cases were not operated on because of their complications or high operative risks. Eight of them died, 5 cardiac and 3 non-cardiac deaths. One was operated on later and another was aggravated with congestive heart failure. Twenty eight were refusal cases. Two of them died, 6 were aggravated and 7 were operated on later with one operative death. In this paper, several criteria were proposed for indications of surgery for the mild cases, and the limitations of the surgical therapies in the severe or complicated cases and the management of the refusal cases were discussed. PMID- 6492377 TI - In-vitro and clinical evaluation of cardiac valve substitutes. AB - One of the major causes of postoperative morbidity and mortality after valve replacement surgery is the prosthetic valve substitute itself. In this discussion, therefore, we make a fundamental evaluation of hydrodynamic valve function and present our clinical results following valve replacement with the Bjork-Shiley valve prosthesis, the Hancock porcine xenograft and the Ionescu Shiley bovine pericardial xenograft. In an experimental study using a mechanical simulator system, the pericardial xenograft displayed superior hydrodynamic characteristics compared to other two valve substitutes. Postoperative hemodynamic evaluation further indicated that the pericardial xenograft performed significantly better than the porcine xenograft regarding transvalvular pressure gradient, effective valve area and cusp opening. In addition, data from 387 patients with aortic, mitral or both types of valve replacement who had received one of the three kinds of valve substitute were analyzed. Systemic thromboembolic complications occurred in one patient with an aortic Bjork-Shiley valve (0.6% per patient-year), six with mitral Hancock xenografts (2.8% per patient-year) and one with an aortic and mitral Hancock xenograft (2.2% per patient-year). The incidence of prosthetic valve endocarditis was 0.84% per patient-year for the Hancock xenograft and 1.84% per patient-year for the Ionescu-Shiley xenograft. It was concluded that the hemodynamic and antithrombogenic advantages of the pericardial xenograft proven by our mid-term follow-up study make it the valve substitute of choice. However, careful attention is required regarding prosthetic valve endocarditis tissue heart valves, which are more susceptible to infection than mechanical ones, and the long-term durability of the pericardial xenograft remains to be confirmed. PMID- 6492378 TI - Optimal time for replacement surgery in chronic aortic valve disease. AB - The purpose of this study was to clarify the characteristic features of aortic valvular heart disease (VHD) compared with mitral VHD and to discuss the optimal time for replacement surgery. Serial echocardiographic studies on a medically treated group with aortic regurgitation disclosed that those patients presenting with congestive heart failure or dying during follow-up period showed the systolic dimension of the left ventricle (LVDs) over 55 mm and percentage fractional shortening (%FS) to be less than 27%. Factors influencing the result of replacement surgery for aortic regurgitation was studied by comparing the group in which the postoperative course was uneventful with the group in which postoperative support with catecholamine of the intra-aortic balloon pumping (IABP) was necessary. Systolic dimension of the left ventricle, %FS and mVcf by echocardiography were significantly different in the two groups. It is concluded from these results that aortic valve replacement for the aortic regurgitation should be performed just before, or immediately after, LVDs exceeds 50 mm, %FS falls below 28% and mVcf falls below 0.9, even in asymptomatic patients. PMID- 6492379 TI - A long-term follow-up study of valve replacements. AB - We have studied the long-term results of valve replacement operations in 591 patients, one year or more after surgery, and also analyzed rates of social return in 523 patients (response rate, 86.1 per cent) by questionnaire. Of the 591 patients, 81 patients suffered early death (mortality rate, 13.7 per cent) and 41 patients late death (mortality rate, 6.9 per cent). The causes of the latter were left atrial thrombus (18 cases), heart failure (10 cases), artificial valve failure (five cases), renal failure (two cases) and hepatic insufficiency, infection and accident (one case each). Second replacement was performed in 18 patients (3.0 per cent), 49 months on average from the first operation. The survival rate at the 12th postoperative year was 68.7 per cent. The overall rate of social return after valve replacement was 64.8 per cent, including 74.8 per cent for mitral valve replacement, 54.3 per cent for aortic and 51.5 for multivalvular. The rate of social return has been improved to 76.4 per cent in the last five years. PMID- 6492381 TI - The role of prosthetic valves in the treatment of valvular disease of the heart- with particular attention to the quality of life after valve replacement. PMID- 6492380 TI - Re-evaluation of the indications for cardiac valve replacement. AB - We re-evaluated the indications for mitral valve replacement and reconstruction, and attempted to determine the optimal time for aortic valve replacement. (1) The actuarial event-free survival rate in patients undergoing open mitral commissurotomy for mitral stenosis with far-advanced subvalvular deformities was 78 per cent at 11 years after surgery and similar in patients undergoing mitral valve replacement for mitral stenosis. Postoperative clinical improvements compared favorably with those in patients undergoing mitral valve replacement. If quality of postoperative life in patients not requiring anticoagulants is borne in mind, open mitral commissurotomy should be given strong consideration as the procedure of choice for the majority of patients with mitral stenosis. (2) The long-term results of reconstructive procedures for mitral regurgitation largely depend upon the pathological anatomies contributing to the development of mitral regurgitation. The results were less satisfactory in patients with fibrotic changes of valvular and subvalvular tissue than in patients undergoing mitral valve replacement for mitral regurgitation. (3) In aortic valve replacement, the postoperative prognosis was poor in patients with a preoperative left ventricular end-systolic volume index exceeding 200 ml/m2 and left ventricular ejection fraction less than 0.35. Operative management of patients with aortic valve disease should be considered, before severe left ventricular systolic dysfunction is evident. PMID- 6492382 TI - Observations on the timing of operative intervention for aortic regurgitation. AB - We examined the application and timing of valve replacement in 105 cases of aortic regurgitation, from the aspect of etiology, clinical findings and prognosis. The mortality for patients after aortic valve replacement was 12.9%. This was lower than that for the patients not operated up on, which was 35.0%. The mortality after valve replacement for patients having acute aortic regurgitation due to active endocarditis was as high as 80%, which showed the limitations of medical and surgical therapy. In cases of chronic aortic regurgitation, if valve replacement is performed within 3 years of the appearance of heart failure symptoms, the mortality is 0. Even after three years, valve replacement is applicable if there are no ventricular premature contractions. CTR 65%, %FS 21%, R/Th 2.9 and EF 38% were considered to be the critical factors for postoperative prognosis. PMID- 6492383 TI - Antithromboembolic treatment after cardiac valve replacement. AB - Antithrombotic medication is effective in the prevention of thromboembolic complications after valve replacement. Therapy with oral anticoagulant (warfarin), platelet inhibitor drugs and long-term warfarin administration an have good clinical results. However, thrombosis may occur in the early postoperative period, when the oral administration of warfarin is impossible. We have evaluated treatment with urokinase, low-dose heparin and dipyridamole, administered intravenously, instead of warfarin, during the early postoperative period. This procedure was carried out in 30 patients, among whom there was no evidence of thrombosis or of such side-effects as bleeding or a marked tendency to bleed. PMID- 6492384 TI - Pacemaker implantation in Japan--1982. The Japanese Committee on Cardiac Pacing. PMID- 6492385 TI - [Studies on the method of susceptibility test of Campylobacter jejuni to fosfomycin]. AB - Conditions for the susceptibility test of Campylobacter jejuni to fosfomycin (FOM) were studied and it was concluded that the following procedure is most appropriate for routine tests. The test organisms were subcultured in 0.5 ml of heart infusion broth (Difco) in test tubes for a microplanter (Sakuma Seisakusho) and incubated in a GasPak jar with a CampyPak and catalyst (BBL) at 37 degrees C for 44--48 hours. The cultures were then diluted 100-fold in the same broth and inoculated with a microplanter on test plates. The test plates were nutrient agar (Difco) supplemented with 0.2% MgCl2 and 5% defibrinated horse blood. The plates were then incubated under the condition as described above and the growth of the cells was examined. It should be noted that drying of plates for more than 1 hour caused significant loss of viability of the cells. PMID- 6492386 TI - Intraarterial infusion of 4'-O-tetrahydropyranyl-adriamycin for head and neck tumors. AB - THP-adriamycin was administered in a dose of 5 to 20 mg, 3 times a week, and the results showed 4 cases of CR, 5 cases of PR, 3 cases of MR and 2 cases of NC with the accumulated total dose of less than 100 mg. Histological effects were slight in a total dose of less than 50 mg, while the effects appeared in a total dose of 60 to 70 mg and further effects were obtained after about 1 week of the termination of the therapy. Leukopenia occurred in 6 of 14 cases. The side effects of THP-adriamycin were milder than those of ADM. PMID- 6492387 TI - [Studies on tissue concentrations of cefoperazone and piperacillin classified by the site of the wall of gallbladder and concentration of piperacillin in the bile after operation]. AB - In selection of drugs to be used in the treatment of biliary tract infections, sensitivity of causative organisms to drugs and tissue concentrations of the drugs constitute important factors. In the present study we treated patients with cholelithiasis with cefoperazone (CPZ) and piperacillin (PIPC), both of which have been reported to show high concentrations in the bile, and concentrations of the drugs in serum, cholecystic bile and various sites of the wall of gallbladder were determined. In addition the drug concentrations in the serum and bile at the 1st and 7th postoperative days were also determined. The following results were obtained. Comparison of concentrations of CPZ and PIPC at various sites of the wall of gallbladder revealed that both drugs showed high levels in the bottom, body and neck areas of the gallbladder with no difference by sites. The concentration ratios against serum for these drugs were 71.8 and 83.6%, showing good transference into tissue. The mean concentrations of CPZ and PIPC in the cholecystic bile were as high as 448.8 and 381.6 micrograms/ml, the ratio against serum being about 4:1. The serum concentrations of PIPC at the 1st and 7th postoperative days were 116 and 137 micrograms/ml at 60 minutes after starting drip infusion, with no difference between these 2 days. In the bile concentrations of PIPC on both postoperative days showed the peak levels of 2,587 and 1,157 micrograms/ml at 120 minutes after starting drip infusion. The concentrations at the 1st postoperative day were higher. The recovery rate of PIPC from the bile was also higher at the 1st postoperative day. From the results that both drugs showed high levels in the wall of gallbladder and also showed high levels in the bile immediately after the operation, PIPC and CPZ are considered to be effective drugs for biliary tract infections. PMID- 6492388 TI - [Pharmacokinetic and clinical studies of latamoxef (moxalactam) in neonates and premature infants]. AB - Studies were carried out on the in vivo kinetics and clinical efficacy of latamoxef (LMOX) in neonates and premature infants. The results are summarized below. Serum concentration and T1/2 following intravenous injection of LMOX to neonates LMOX was intravenously administered to neonates as one shot doses of 10 mg/kg and 20 mg/kg. The serum concentration of LMOX showed a dose-response to the 10 and 20 mg/kg doses in each of the 0--3 day-old group, 4--7 day-old group and 8 -28 day-old group. The T 1/2 values were as follows; for the 10 mg/kg dose, 5.17 hours in the 0--3 day-old group, 3.28 hours in the 4--7 day-old group and 2.79 hours in the 8--28 day-old group; for the 20 mg/kg dose, 5.58 hours in the 0--3 day-old group, 3.46 hours in the 4--7 day-old group and 3.14 hours in the 8--28 day-old group. Thus, it is seen that the half-life of both dosages decreased as the infants became older. Serum concentration and T 1/2 following intravenous injection of LMOX to premature infants Similar to the case of neonates described above, the concentration of LMOX in the serum of the premature infants showed a dose-response to the 10 mg/kg and 20 mg/kg dosages. The T 1/2 values for the 0- 3, 4--7 day-old and 8--28 day-old groups were 7.54, 3.93 hours and 6.25 hours, respectively, for the 10 mg/kg dose, and 10.8, 4.05 hours and 3.23 hours, respectively, for the 20 mg/kg dose. Again, it is seen that the half-life of both dosages decreased as the age of the prematurely-born infants increased. Serum concentration and T1/2 following 1-hour intravenous drip infusion of LMOX to neonates LMOX was administered to neonates in doses of 10 mg/kg and 20 mg/kg, by i.v. drip infusion over a 1-hour period. With both dosages, the peak serum concentration of LMOX occurred at the time of completion of the infusion. The T1/2 values for the 0--3, 4--7 day-old and 8--28 day-old groups were 5.41, 3.68 hours and 1.92 hours, respectively, for the 10 mg/kg dose, and 5.31, 2.67 hours and 4.86 hours, respectively, for the 20 mg/kg dose. Urinary excretion of LMOX in neonates and premature infants. The percentage of the administered LMOX dose contained in the urine excreted during the 6-hour period following intravenous administration of LMOX to neonates and premature infants was determined.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6492389 TI - [Fundamental and clinical studies on latamoxef in the perinatal period]. AB - Fundamental and clinical studies on latamoxef (LMOX) in the perinatal period were carried out, and following results were obtained. Concentration of LMOX was showed high peak levels in maternal serum, umbilical serum and amniotic fluid. LMOX seemed to be a very transferable compound to human tissues. LMOX was administered to 28 cases of various perinatal infections. Clinical responses were excellent in 13 cases, good in 15 cases and poor in none. And 140 cases of prophylactic use in the field of perinatal period were evaluated in good. No side effect was seen and an abnormal laboratory finding, the increase of GPT, was observed in only 1 case. LMOX was a highly useful antibiotic in perinatal infections, the safe dose range of LMOX into the perinatal mothers was estimated to be 2 g/day, with the maximum safe dose being 4 g/day. PMID- 6492390 TI - [The pharmacokinetic studies on astromicin in rats. Intramuscular, intravenous or drip intravenous administration]. AB - Absorption, tissue distribution and excretion of astromicin (ASTM) were studied in rats after intramuscular (i.m.), intravenous (i.v.) or drip intravenous (d.i.v.; for 15, 30 min. or 60 min.) administration at a dose of 20 mg/kg. The pharmacokinetic studies of ASTM were carried out using one-compartment open model (i.m.) or two-compartment open model (i.v. and d.i.v.). The peak values of ASTM observed in serum were 48.6 micrograms/ml (i.m.), 255.3 micrograms/ml (i.v.), 57.5 micrograms/ml (15 min. d.i.v.), 45.9 micrograms/ml (30 min. d.i.v.) and 39.1 micrograms/ml (60 min. d.i.v.). The pharmacokinetic parameters of ASTM after 15 min. d.i.v. administration were calculated as follows: Kel 0.110 min-1, T1/2 21.4 min., Vd beta 0.310 L/kg, Tmax 15.0 min., Cmax 58.6 micrograms/ml, AUC 1,991 micrograms X min/ml. ASTM was rapidly distributed into the kidneys and lungs. The peak values of ASTM in the kidneys were 156.8 micrograms/g (i.m.), 185.2 micrograms/g (i.v.), 132.9 micrograms/g (15 min. d.i.v.), 135.3 micrograms/g (30 min. d.i.v.) and 117.3 micrograms/g (60 min. d.i.v.). Urinary recovery rates of ASTM amounted to 85.5% (i.m.), 99.5% (i.v.) or 87.9% (30 min. d.i.v.). After i.m. or 30 min. d.i.v. administration of ASTM, no active metabolite was found in urine of rats. PMID- 6492391 TI - [Pharmacokinetics and clinical studies of fosfomycin in bile duct infections]. AB - Serum and bile levels of fosfomycin sodium (FOM-Na) were evaluated and the pharmacokinetic parameters were estimated in 10 patients with various forms of biliary drainage (PTCD or T-tube). Clinical trials of FOM-Na were also performed in another 11 patients with bile duct infections and the clinical efficacy was estimated. Mean serum level of FOM-Na after drip infusion of 2 g fosfomycin sodium was 145.43 micrograms/ml at 1 hour, meanwhile bile level was 31.49 micrograms/ml at 2 hours. Serum level of FOM-Na was interpreted by the pharmacokinetic analysis after the damping GAUSS-NEWTON method using the one compartment open model and bile level of FOM-Na by the damping GAUSS-NEWTON method and deconvolution method. Mean Vd was 12.16 L/body and half-time of serum level was 1.75 hours. Lag-time of bile level was 0.9 hour, Tmax 2.01 hours. The clinical efficacy of FOM-Na was determined excellent without any adverse effect. FOM-Na was remarkably effective in 91% of the patients. Hence, the first choice of FOM-Na against bile duct infections could be recommended. PMID- 6492392 TI - [Chemical structure and biosynthesis of bile acids]. PMID- 6492393 TI - [Outline of metabolic pathways of bile acids]. PMID- 6492394 TI - [Interconversion of hydroxyl group of bile acids]. PMID- 6492395 TI - [Bile acid kinetics in man and bile acid pool size]. PMID- 6492396 TI - [Mechanism of bile secretion and bile acids]. PMID- 6492397 TI - [Pharmacophysiological functions of bile acids]. PMID- 6492398 TI - [Isolation and determination of bile acids]. PMID- 6492399 TI - [Chemical determination of bile acids]. PMID- 6492400 TI - [HPLC in the determination of bile acids]. PMID- 6492401 TI - [Analysis of bile acids by gas chromatography-mass spectrometry]. PMID- 6492402 TI - [Abnormal bile acids in acute and chronic hepatitis]. PMID- 6492403 TI - [Abnormal bile acids in benign recurrent intrahepatic cholestasis]. PMID- 6492404 TI - [Cholelithiasis and abnormal bile acids]. PMID- 6492405 TI - [Pancreatic diseases and abnormal bile acids]. PMID- 6492406 TI - [Bile acids and diseases of the small and large intestines]. PMID- 6492407 TI - [Thyroid diseases and bile acids]. PMID- 6492408 TI - [Hyperlipidemia and bile acids]. PMID- 6492409 TI - [Cerebrotendinous xanthomatosis and bile acids]. PMID- 6492410 TI - [Significance and limitations of oral UDCA loading in liver function test]. PMID- 6492411 TI - [Etiology of cholesterol gallstone]. PMID- 6492412 TI - [Indications and limitations of drug therapy in gallstone]. PMID- 6492413 TI - [Bile acids and cancer of the large intestine]. PMID- 6492414 TI - [Cancer therapy manual]. PMID- 6492415 TI - [Analysis of the hepatic reserve by the liver tolerance tests]. PMID- 6492416 TI - [Clinical use of serum acid-soluble proteins]. PMID- 6492417 TI - [Problems in interpreting biochemical data--a method for detecting the clerical mismatch of clinical samples]. PMID- 6492418 TI - [Quantitative determination and normal response of seven components of 17-KS in urine by high performance liquid chromatography]. PMID- 6492419 TI - [Peripheral lymphocyte subset analysis by monoclonal antibodies in patients with malignant lymphoma]. PMID- 6492420 TI - [Automated microplate-photometry for titration of anti-diphtheria toxin by cell culture method and by enzyme-linked immunoassay]. PMID- 6492421 TI - [A method detecting heterozygotes for adenosine deaminase deficiency with blood samples dried on filter paper]. PMID- 6492422 TI - [Relation of the anion gap to acid-base balance]. PMID- 6492423 TI - [Study of cryoglobulin associated with no retraction of clot in multiple myeloma]. PMID- 6492424 TI - [Magnetic resonance imaging in the clinical medicine--its present status]. PMID- 6492425 TI - [Computed tomography of post-operative maxillary cyst]. PMID- 6492427 TI - [Diagnostic efficacy of computed tomography and radionuclide imaging on detecting SOL of liver disease and liver cirrhosis]. PMID- 6492426 TI - [Study of multiple gastric cancer]. PMID- 6492428 TI - [Radiotherapy for carcinoma of the hypopharynx and cervical esophagus]. PMID- 6492429 TI - [A case of cystic meningioma]. PMID- 6492430 TI - [Catheter embolization for intractable back pain due to metastatic spinal epidural tumor]. PMID- 6492431 TI - [A case of pulmonary tuberculosis followed by interesting clinical findings]. PMID- 6492433 TI - [A case report of histologically proven reactive lymphoreticular hyperplasia (RLH) of the cecum]. PMID- 6492432 TI - [A case of agenesis of the pancreatic tail]. PMID- 6492434 TI - [A case of rectal leiomyosarcoma]. PMID- 6492435 TI - [Axial neural arthropathy in tabes dorsalis]. PMID- 6492436 TI - [Radionuclide imaging of Paget's disease of bone]. PMID- 6492437 TI - [Tumors in children]. PMID- 6492438 TI - [Scanning electron microscopic observations and analysis of growth kinetics of the fibroblasts in vitro--comparison between normal skin and abnormal scars]. PMID- 6492439 TI - [Reactive perforating collagenosis--report of 2 cases among siblings and differentiation from similar conditions]. PMID- 6492440 TI - [Ultrastructural observation of the horny and granular layers in tinea versicolor]. PMID- 6492441 TI - [A case of allergic granulomatosis (Churg-Strauss) and statistical observation on cases in Japan]. PMID- 6492442 TI - [Hydrogen peroxide release from peritoneal macrophages of immunodefective mice]. PMID- 6492443 TI - [Basal lamina formation by human epidermal cells in culture]. PMID- 6492444 TI - [The effects of ultraviolet ray, PUVA and retinoid on experimental carcinogenesis -including observations on -SH groups and S-S bonds during the process of carcinogenesis]. PMID- 6492445 TI - [Leukocytoclastic vasculitis in a patient with so-called asymptomatic carrier of HB antigen: demonstration of immune complex in the serum and the blood vessel walls in urticarial lesions]. PMID- 6492446 TI - [Follow-up study in patients with arsenical poisoning from dry powdered milk]. PMID- 6492447 TI - [A case of incontinentia pigmenti demonstrated an eosinophil chemotactic factor]. PMID- 6492448 TI - [Keratoma hereditaria mutilans--treatment with retinoid (Ro-10-9359)]. PMID- 6492449 TI - [Studies on the percutaneous absorption and the systemic effects of corticosteroids in rats--with special reference to the relation between distribution and change of organs]. PMID- 6492450 TI - [Scanning electron microscopic observation of hyperkeratosis lenticularis perstans]. PMID- 6492451 TI - [Amino-terminal fragment of human big gastrin-like immunoreactivity in antral mucosal extracts from patients with upper gastrointestinal diseases]. PMID- 6492452 TI - [Morphogenesis of gastric polyp in Peutz-Jeghers syndrome]. PMID- 6492453 TI - [The healing process of peptic ulcer and coagulation factor XIII]. PMID- 6492454 TI - [Serum cholinesterase activity in non-alcoholic fatty liver. Effect of obesity on the activity and role of its measurement in the differential diagnosis in chronic hepatitis]. PMID- 6492455 TI - [Changes of HBeAg/anti-HBeAb system in chronic type B hepatitis, especially acute hepatitis from HBsAg carriers and persistent hepatitis]. PMID- 6492456 TI - [The nature and clinical significance of human serum ribonuclease measured by using synthetic substrate]. PMID- 6492457 TI - [A case of adenoma of the appendix diagnosed by magnification endoscopy]. PMID- 6492458 TI - [Differential diagnosis of hepatic tumors by computed tomography: significance of peripheral low density area]. PMID- 6492459 TI - [The effects of unpleasant sounds on human EEGs]. PMID- 6492460 TI - [Gold metabolism in rats]. PMID- 6492461 TI - Nutritional evaluation of serum lactate dehydrogenase levels in humans. PMID- 6492462 TI - [Changes in blood acid-base equilibrium in mice exposed to carbon monoxide]. PMID- 6492463 TI - [Effect of ligation as an effective treatment for Conus-sting especially due to geographur cone, Conus (Gastridium) geographus Linne, 1758]. PMID- 6492464 TI - [An estimation of the most dangerous species of cone shell, Conus (Gastridium) geographus Linne, 1758, venom's lethal dose in humans]. PMID- 6492466 TI - [A mathematical model for the temporal trends of age-specific mortality rates from cerebrovascular diseases in Japan]. PMID- 6492465 TI - [The in vivo formation of mutagenic N-nitroso compounds from methamphetamine and ephedrine]. PMID- 6492467 TI - The day to day variations of urinary hydroxyproline and creatinine excretions, and dietary protein intake. PMID- 6492468 TI - [Sister chromatid exchanges in lymphocytes and smoking habits]. PMID- 6492469 TI - [Present and future of the image processing computer system in nuclear medicine]. PMID- 6492471 TI - Proceedings of the 23rd annual meeting of the Japanese Society of Nuclear Medicine. September 23, 24, 25, 1983, Takatuki. Abstracts. PMID- 6492470 TI - [Evaluation of right ventricular infarction using Fourier analysis]. PMID- 6492472 TI - [The evaluation of coronary artery disease through the analysis of left ventricular diastolic phase indices obtained from S2-gated equilibrium scintigraphy]. PMID- 6492473 TI - [Development of positron tracer for in vivo estimation of brain MAO-B activity: theoretical consideration of metabolic-trapping tracers and evaluation of 11C-N,N dimethylphenylethylamine]. PMID- 6492474 TI - [A comparison of the measurements of serum free triiodothyronine concentration by Amerlex Free T3 RIA kit and by equilibrium dialysis method]. PMID- 6492475 TI - [Clinical evaluation of renal function study using I-123 orthoiodohippurate (I 123 OIH) in patients with obstructive uropathy]. PMID- 6492476 TI - [Radioimmunoassay of serum free triiodothyronine (FT3). An evaluation of Amerlex Free T3 RIA kit]. PMID- 6492477 TI - [Analysis of left ventricular filling in patients with coronary artery disease by a new radionuclide ventriculographic method using second heart sound and forward and backward ECG gating techniques--impairment of early diastolic filling and the contribution of atrial contraction to total filling]. PMID- 6492478 TI - [Frequency characteristics of temporal filters used in ECG gated blood pool scintigraphy]. PMID- 6492479 TI - [Application of Fourier analysis to the movement of ventricular edge: a new method for quantification of segmental wall motion]. PMID- 6492480 TI - [Experiment with respiratory gated liver imaging with Fourier analysis in patients with liver cirrhosis]. PMID- 6492481 TI - [Experimental on the application of liposome to tumor imaging agents]. PMID- 6492482 TI - [Evaluation of a pancreatic secretory trypsin inhibitor RIA kit]. PMID- 6492483 TI - Studies of circulating parathyroid hormone in man by a homologous amino-terminal specific radioimmunoassay. AB - A homologous radioimmunoassay specific for amino-terminal portion of human parathyroid hormone(PTH) was developed in order to study the clearance of biologically active species of the hormone in the circulation in man. Characterization of the assay system with synthetic analogues of human PTH (1-34) indicated that the carboxyl-terminal region of human PTH(1-34) is an important recognition site. Plasma amino-terminal PTH levels were less than 0.3 ng/ml in all of 35 normal subjects. The levels were elevated above 0.3 ng/ml in 15 of 24 patients with primary hyperparathyroidism. In 5 patients in whom the levels were determined before and after parathyroidectomy, the elevated levels were all normalized within 60 minutes after the removal of adenomata. The disappearance of exogenous human PTH(1-34) was studied after intravenous administration in 17 patients with hypoparathyroidism. A graphical analysis of the data disclosed two major components of the disappearance curve with estimated half-disappearance time of 3 and 28 minutes respectively, suggesting that multiple mechanisms are involved in the clearance of the peptide from the circulation. These results demonstrate usefulness of homologous radioimmunoassay for human PTH(1-34) in diagnosis and management of hyperparathyroidism, as well as in studying the clearance of amino-terminal portion of PTH which is known to represent biological activity. PMID- 6492484 TI - The changes in plasma lipoproteins in a case of heterozygous familial hypercholesterolemia after plasmapheresis. AB - The changes in plasma lipoproteins after plasmapheresis were estimated in a case of heterozygous familial hypercholesterolemia. Two and a half liters of plasma were exchanged with the same volume of Plasmanate. The effects of cholestyramine on the changes in plasma lipoproteins were also studied after the second plasmapheresis. Fasting plasma was collected serially, and plasma VLDL, IDL, LDL1 (1.019 less than d less than 1.045), LDL2 (1.045 less than d less than 1.063), HDL2 (1.063 less than d less than 1.125) and HDL3 (d greater than 1.125) were separated by ultracentrifugation. The cholesterol and apoprotein contents in these lipoprotein fractions were analyzed. Apoprotein AI, AII, B, CII and E were measured by single radial immunodiffusion. VLDL-C and plasma apoprotein CII and E increased very rapidly. The IDL-C increase was slightly slower than that of VLDL C. LDL1-C continued to increase for three weeks, but LDL2-C reached a plateau around a week after plasmapheresis and declined thereafter. The change of apoprotein B was similar to that of cholesterol in VLDL, IDL, LDL1 and LDL2. Cholesterol amounts in HDL2 and HDL3 changed in a parallel manner, as did apoprotein AI and AII. HDL2 and HDL3 reached their preplasmapheresis levels in a week. Cholestyramine did not inhibit the increase of VLDL, IDL, LDL1 or LDL2 in this case. PMID- 6492485 TI - Hereditary spherocytosis associated with a variant of band 3 protein in the erythrocyte membrane. AB - A 17-year-old woman with hereditary spherocytosis was found to be heterozygous for an unusual variant of the band 3 protein in erythrocyte membranes. The variant had a molecular weight of 95,000 daltons which was larger by about 3,000 daltons than the 92,000 m.w. normal band 3, and was phosphorylated less efficiently when intact cells were incubated with 32P-inorganic phosphate. It is discussed that this variant may affect the integrity of the membrane skeletons. PMID- 6492486 TI - Study on the striatal dopamine availability in Parkinson's disease. AB - Striatal dopamine availability in connection with the plasma levodopa levels was studied in 12 parkinsonian patients treated with optimal doses of levodopa. Three patients showed the wearing-off phenomenon and the 9 others showed no daily fluctuations in disability. All of the 3 patients with the wearing-off phenomenon showed an up-and-down pattern of dopamine availability index. Out of the 9 patients presenting no fluctuations in disability, 6 showed an ascending pattern of the dopamine availability index and 3 an up-and-down pattern. Of the former 6 patients, 2 received short-term (less than one year) levodopa therapy and the other 4 had the first onset at 42 years or under. In the latter 3 patients, the onset was at over 50 years of age and the duration of levodopa treatment was more than 3 years. In these 3 patients, the mode of action of dopamine in the striatum was considered to be insufficient despite the absence of fluctuations in disability. Thus, the dopamine availability index was considered to be very significant from the viewpoint of prognosis of levodopa therapy. PMID- 6492487 TI - A case of nephrotic syndrome with urinary excretion of lipoproteins. AB - A 47-year-old woman with nephrotic syndrome (membranous glomerulonephropathy) who excreted high, low density lipoproteins (HDL, LDL) which are almost similar to serum HDL and LDL, and small amount of slightly deformed very low density lipoprotein (VLDL) in the urine has been presented. PMID- 6492488 TI - A case of cornstarch granuloma. AB - A 57-year-old female was diagnosed as having asymptomatic cornstarch granuloma. The disseminated small nodules over the peritoneum were incidentally discovered at operation for cholelithiasis, when she was misdiagnosed as carcinomatosis peritonei. Histological observations revealed a characteristic finding of tuberculoid granuloma with caseous necrosis, a rather rare histological type of cornstarch granuloma. Polarized light microscopic examination of biopsy specimens is particularly important for the diagnosis. We emphasize that cornstarch granuloma should once be considered when tuberculoid or unknown abdominal granuloma are observed in patients with history of abdominal surgery. PMID- 6492489 TI - A case of sicca syndrome due to primary amyloidosis. AB - We report the rare occurrence of sicca syndrome associated with primary amyloidosis. A 63-year-old man with apparent keratoconjunctivitis sicca and xerostomia died of the cardiac failure. Neither sialography nor labial gland biopsy revealed findings compatible with Sjogren's syndrome. Macroglobulinemia and a positive Bence-Jones protein were noted in urine testing. Amyloid deposition was demonstrated by Congo red staining on biopsied rectal tissues, and by typical birefringence under polarized light microscopy. At autopsy, the amyloid deposition was identified histochemically in the submandibular gland and the minor salivary glands of oral cavity. PMID- 6492490 TI - Conjugated hyperbilirubinemia in an autopsy case with myocardial infarction and sepsis. AB - The marked conjugated hyperbilirubinemia in a 72-year-old patient with myocardial infarction and sepsis is reported. The serum bilirubin, which was predominantly composed of conjugated bilirubin, was elevated to 21 mg/100 ml, while serum bile acid and alkaline phosphatase levels were normal or slightly elevated. Postmortem examination of the liver revealed slightly proliferated bile ductules and some bile thrombi with little liver cell necrosis. PMID- 6492491 TI - Peptostreptococcal empyema in akinetic mutism. AB - Peptostreptococcal empyema occurred in a 54-year-old man who had suffered from diabetes mellitus and had been in akinetic mutism. Ultrasonic tomogram was useful to detect the space of empyema and to identify the decrease in volume of the empyema space with treatment. PMID- 6492492 TI - Baroreflexive suppression of heat production and fall in body temperature following peripheral administration of vasopressin in rats. AB - Intravenous injection of vasopressin (lysin-8-vasopressin, LVP) in unanesthetized rats at an ambient temperature of 18 degrees C caused a decrease in heat production (M) followed by a fall in colonic temperature (Tco1). These changes were preceded by an elevation of aortic blood pressure (BP) and bradycardia, and were related to the dosage of LVP administered. Temperature of the interscapular brown adipose tissue (BAT) significantly fell after LVP injections. Therefore, it can be said that the decrease in metabolism by the peripheral LVP is at least partly due to suppression of BAT thermogenesis. After bilateral sino-aortic deafferentation, however, the changes in these variables were greatly but not completely reduced except for the elevation of BP. LVP of 0.25 micrograms, more than sufficient to cause a significant elevation of BP when administered peripherally, had no effect on M and Tco1 when injected into the anterior hypothalamus. From these results, we conclude that the hypothermic effect of vasopressin administered peripherally is largely attributed to the baroreflexive suppression of nonshivering thermogenesis, and is not due to the action on the temperature regulatory centers. The slight but insignificant suppression of metabolism in the sinoaortic denervated rats following injection of LVP may be caused by a decreased blood flow to the thermogenic tissues. PMID- 6492493 TI - Effects of divalent cations on the inhibitory potentials in the duodenal smooth muscle cells of the guinea-pig. AB - The effects of divalent cations and some Ca2+ antagonists on the non-adrenergic inhibitory potential (i.p.) in the duodenal smooth muscle cells of the guinea-pig were investigated intracellularly. The membrane potential was a function of the external Ca2+ (0.25-7.5 mM) and Mg2+ (1.2-24 mM) concentrations. The latency and the time to peak of the i.p. were prolonged by low Ca2+ and excess Mg2+. The amplitude and the rate of hyperpolarization of the i.p. were reduced by low Ca2+ and excess Mg2+. The effects of Mn2+ (5-10 mM) on the i.p. were similar to those by excess Mg2+ except for the small depolarization. The i.p. evoked in the Ca2+ free solution was considerably restored by the addition of Ba2+ (1.25 mM) and Sr2+ (2 mM). The actions of Ba2+ and Sr2+ on the i.p. were inhibited by verapamil (10(-4)g/ml). Verapamil (2 X 10(-5)-2 X 10(-4)g/ml) and gentamicin (10(-3)g/ml) reduced the amplitude and the rate of hyperpolarization of the i.p. The latency and the time to peak of the i.p. were prolonged by verapamil but not by gentamicin. In nifedipine (10(-4)g/ml), the two-peaked i.p. was evoked by a single stimulus. This potential was similar to that evoked by a paired pulse in normal solution. The results obtained suggest that the released of the non adrenergic inhibitory substance requires Ca2+ which moves into the non-adrenergic inhibitory neurons through the Ca2+ conductance pathway. PMID- 6492494 TI - Effects in vitro of progesterone and estradiol-17 beta on the contractile and electrical responses in rat myometrium. AB - Uterine longitudinal and circular muscles from pre- and post-term rats were studied in vitro for their contractile and electrical activities under the influence of 20-100 microM progesterone, 20 microM estradiol-17 beta, or 20 microM stilbestrol. Uterine longitudinal or circular muscle strips were irrigated by Krebs solution at 37 degrees C containing one of the hormones mentioned above, dissolved by the use of ultrasonic wave. Muscle contractions were recorded by a force displacement transducer, and electrical activities of the muscle membrane were studied using an intracellular microelectrode. At diestrus and Day 14 of pregnancy, progesterone depressed the contractions of longitudinal muscle. At pre term, progesterone potentiated the contractions and prolongated the membrane burst discharge of longitudinal muscles, while estradiol inhibited their contractions and suppressed spike activities. At the same stage of pregnancy, both progesterone and estradiol inhibited contractions of circular muscles. At post-partum, progesterone potentiated and then depressed longitudinal muscles, while estradiol inhibited their contractions. At this stage, both progesterone and estradiol inhibited contractions of circular muscles, although vigorous spike discharges were observed. Stilbestrol depressed contractions of both longitudinal muscles from diestrus rats and longitudinal ileal muscles from a guinea pig. In view of these findings, it was deduced that these ovarian hormones exert dual action on the uterine muscle in vitro, one through changes in the membrane activity and the other through dissociation of excitation-contraction coupling. PMID- 6492495 TI - Blood mobilization by regional vascular beds during cerebral ischemic pressor response in rabbits. AB - The mobilization of blood volume from regional vascular beds during cerebral ischemic pressor response was studied in anesthetized rabbits. The visceral beds of the kidney, jejunum, and liver served as volume reservoirs from which blood was mobilized during cerebral ischemia. The renal bed gave the largest volume decrease, from 24 to 13%. The magnitude of weight change in the renal and intestinal regions varied in parallel to the volemic state of the animal. Superimposition of pressure oscillation on the systemic pressor response was created by progressive restriction of the blood supply to the brain. Regional tissue weights also oscillated with a period equal to that seen in arterial pressure but almost 180 degrees out of phase. Such variations gave evidence of active venoconstriction in the reservoir response of all regional beds except the hind paw. The responses noted in the hind paw were passive except during complete restriction of the blood flow to the brain. Autoregulation of skeletal muscle and especially liver volume was present with moderate elevations in systemic arterial pressure. PMID- 6492496 TI - Effects of external calcium reduction on biphasic potassium contractures and action of divalent cations on the calcium reduction in frog single twitch muscle fibers. AB - The effects of external Ca2+ reduction on the biphasic potassium (K) contractures and the action of divalent cations under conditions of the Ca2+ reduction were examined in detail, using frog single twitch muscle fibers. The peak tension of the initial component of 80 mM K+ contractures was greatly potentiated by exposing the fiber to low Ca2+ solution for 30 sec, and the degree of this potentiation was decreased with increasing the exposing time. In contrast, the peak tension of the secondary component was rapidly inhibited by Ca2+ reduction. The potentiation of the initial component was removed by 3 mM Mg2+ or 0.5 mM Ni2+. The inhibition of the secondary component, especially the shortening of its time course, was reversed partially by 3 mM Mg2+ and almost completely by 0.5 mM Ni2+. The difference between the inhibitory effect of 10 mM Mg2+ or 1-3 mM Ni2+ on the initial component and that on the secondary component was also demonstrated. The tension development of the secondary component was completely inhibited by external Ca2+ reduction for 20 min, but it was observed in the presence of 3 mM Mg2+, although its time course was shorter. These results indicate that the actions of Mg2+ and Ni2+ on the initial component differ from those on the secondary component and suggest the possible mechanisms of the actions of these divalent cations on the biphasic K contractures. PMID- 6492497 TI - Automated continuous measurement of erythrocyte volume under isotonic conditions. AB - The time course of volume changes of erythrocytes, suspended in isotonic solutions containing permeable substances, was studied using a cell monitoring system which was assembled on the basis of Coulter's principle. For comparison, the hematocrit method was employed. The data obtained demonstrated that urea, glycerol, ethanol, and methanol induced a rapid volume increase, whereas glucose and galactose induced a slow volume increase. These results correspond well to the data obtained by the hematocrit method. The present method, which requires only a minimum volume of blood, showed high accuracy and high reproducibility. Thus, the method was considered applicable to experimental and clinical studies of membrane permeability of erythrocytes. PMID- 6492498 TI - Inhibitory effects of cerebellar cortical stimulation on sympathetic nerve activity in rabbits. AB - In anaesthetized and paralyzed rabbits, renal sympathetic nerve activity was observed by integrating and averaging impulse discharges. The activity was readily depressed by stimulation with a train of a few pulses of lobules I, II, III, VIIa, and VIIIa. The effective sites which caused the marked depression on the sympathetic nerve activity were distributed in the ipsilateral vermal cortex, predominantly in the medial part. The latency of depression was around 200 msec. Stimulation of these lobules caused a reduction of the systemic blood pressure, but this effect required stimulation by repetitive pulses, for a period of up to 10 sec. PMID- 6492499 TI - Peak blood lactate after 400 m sprinting in sprinters and long-distance runners. AB - Peak blood lactate following 400 m sprinting was determined in 8 sprinters and 8 long-distance runners. The mean velocity of 400 m run and peak blood lactate were significantly higher in the sprinters than in the long-distance runners. It was suggested that peak blood lactate may be a useful indication of anaerobic work capacity in long-distance runners, but not in sprinters. PMID- 6492500 TI - Electrical and mechanical events through activation of muscarinic receptor in the smooth muscle of guinea-pig vas deferens. AB - Electrical and mechanical responses of the guinea-pig vas deferens to exogenous acetylcholine (ACh) were observed by means of a single sucrose-gap method. ACh at various concentrations evoked a contraction consisting of two components. The initial component seemed to be independent of a depolarization, while the second one was dependent on it. All ACh responses were abolished by Ca removal from the external solution. The results suggest the existence of a pathway by which ACh even at low concentrations causes a Ca influx without potential changes. PMID- 6492501 TI - [Analysis of tracking behavior in patients with muscular dystrophy]. AB - A compensatory tracking experiment was performed to investigate, on the basis of control theory, the dynamic characteristics of control movement in patients with progressive muscular dystrophy (limb-girdle type) and with myotonic dystrophy. Error scores and operator's transfer functions were estimated from the tracking data. The latter were approximated by a model which was composed of a gain constant, a delayed time constant and a dead time. The results showed that error scores for the muscular dystrophy patients and for the myotonic dystrophy patients were, in this order, greater than those for the normal subjects; the dynamic characteristics described by the transfer functions of the three groups were different from each other in terms of gain, phase lag and linearity of their operation. These results were discussed in terms of the stage of disability of motor function and the deterioration of intelligence with disease. PMID- 6492502 TI - Bile acid metabolism in patients with non-strangulated intestinal obstruction. AB - The intraluminal changes of bile acids were studied in 42 patients with intestinal obstruction, treated from 1978-1982. Twenty-two patients received surgical treatment and twenty were treated conservatively. Bile acid analysis of the intestinal contents was performed by thin-layer and gas-liquid chromatography. A marked reduction of bile acid concentration was observed before treatment. A decreased percentage of deoxycholic acid, a lowered G : T ratio, and presence of deconjugated bile acids were also present. After relief and/or removal of the obstruction, the concentration of bile acids, the percentage of deoxycholic acid, and the G : T ratio increased. Bile acid deconjugation decreased immediately after surgical treatment but was not affected by conservative treatment. We conclude that bile acid metabolism is altered quantitatively and qualitatively in patients with an intestinal obstruction. PMID- 6492503 TI - Rapid long tube intubation of the jejunum--an improved technique. AB - This study details improvements in the intubation of a long intestinal decompression tube by use of a new flexible tip guide wire and a new intestinal decompression tube. The intubation route of the endoscope was changed from the oral to the nasal cavity. Although the guide wire formerly used (TGBD-65-345) could be inserted into the descending part of the duodenum by passing it through the biopsy channel of the endoscope, with this new method, the guide wire (TGBD 65-450) could be inserted into the upper jejunum. The endoscope could also be left in the stomach, when this method was used. The long tube was introduced along this guide wire into the upper jejunum. As a result of these improvements, the intubation rate for long intestinal decompression tubes was significantly more rapid and the time reduced. Intubation rate to the jejunum was 96 percent successful, as compared with a former success rate of 75 percent. The intubation time was decreased to 11.3 +/- 5.6 min. to the duodenum and 18.6 +/- 8.6 min. to the upper jejunum. This differs markedly from the former method which required 16.0 +/- 5.3 min. and 39.6 +/- 22.7 min, respectively. PMID- 6492504 TI - Histochemical acetylcholinesterase reactions in total colonic aganglionosis. AB - Reliability of the histochemical diagnosis in total colonic aganglionosis is controversial. We studied histochemical acetylcholinesterase (AChE) reactions in three children with total colonic aganglionosis. In all three, there was an increase in AChE positive nerve fibers in the rectal mucosa, obtained when the patients were over the neonatal period. However, a proximal extension of the increase in AChE positive nerve fibers was noted in the distal end of the resected bowel obtained at the definitive operation in two cases out of three. In one, there was no proximal extension in the resected bowel, and in another, there was an increase in AChE positive nerve fibers in the mucosa of the ganglionic ileum. Our findings indicate that the histochemical study of AChE activity in rectal suction biopsy is useful, even in cases of total colonic aganglionosis. PMID- 6492505 TI - Ileocecal resection in neonates--a follow-up study. AB - From 1977 to 1982 ileocecal resection was done in five neonates admitted to our pediatric surgical units. The growth and development of these infants were examined and comparisons were made with age matched controls. Two who had undergone ileocecal resections had a slight diarrhea. Physical examination, hematology and blood chemistry, including serum levels of rapid turnover proteins, were all within the normal ranges. Significant differences between data on these patients and the controls were not noted. Our findings indicate that ileocecal resection with less extensive ileal resection can be done in neonates as an adequate nutrition is physiologically feasible. PMID- 6492506 TI - Spontaneous remission of hypercalcemia in a functioning parathyroid cyst. AB - We treated a patient with a hyperfunctioning parathyroid cyst detected incidentally and which disappeared spontaneously. High levels of plasma PTH disappeared after removal of the cystic lesion of the parathyroid gland. Histologically, a secondary pseudocyst resulting from a cystic degeneration of an adenoma was observed. Minor hemorrhage of an unknown cause, within the adenoma, led to the large cystic lesion of the parathyroid gland. PMID- 6492507 TI - A duodenal duplication cyst communicated with an accessory pancreatic duct. AB - We treated a 49 year-old woman with acute pancreatitis, in whom there was an accessory pancreatic duct which opened into a duodenal duplication cyst. Epigastric pain associated with vomiting and fever were present. Laboratory data showed leukocytosis and hyperamylasemia. An upper G-I series revealed a stricture at the pyloric region. At operation a spherical mass of 6 cm in diameter was present between the greater curvature of the pyloric region and the head of the pancreas. The cyst was removed by hemigastrectomy and partial resection of the head of the pancreas. The accessory pancreatic duct opened into the cyst. Taking particular note of the communication with the pancreatic duct, this cyst was diagnosed as one of duodenal duplication. A duodenal duplication cyst communicating with the accessory pancreatic duct is rare and is dissimilar to any of the 20 cases of duodenal duplication reported in Japan since 1960. PMID- 6492508 TI - Intraarterial lymphocytes injection for treatment of lymphedema. AB - We noted a marked improvement of lymphedema in a patient with recurrence of cancer 3 years after amputatio recti and with post-thrombotic syndrome of the leg, as the result of injection of a suspension of lymphocytes administrated as therapy against advanced cancer. Subsequently lymphocytes-injections were given 39 times to 7 patients with lymphedema of one limb, of various causes. A suspension of lymphocytes was injected repeatedly into the proximal artery of the affected limb. In one patient, lymphocytes were injected 4 times at intervals of 1 or 3 weeks. In most cases, this injection resulted in a marked reduction in the swelling of the affected limb and improvement was seen for several weeks or months. In all cases, there was a marked, continuous softening of the tissue. PMID- 6492509 TI - Motility of the anorectum after "rectoplasty with posterior triangular colonic flap" in Hirschsprung's disease. AB - Clinical assessment of fecal continence and anorectal manometry were carried out in 22 patients with Hirschsprung's disease who had undergone "Rectoplasty with posterior triangular colonic flap". Satisfactory postoperative continence was achieved in 18 out of these 22 patients. The result of anorectal manometry disclosed that normal rectal compliance (reservoir function of the rectum), together with normal resting pressure of the anorectum and rectoanal reflex, is indispensable for an adequate postoperative continence. PMID- 6492510 TI - Efficacy of endoprosthesis for internal biliary drainage in patients with nonresectable carcinoma of the proximal bile duct. AB - Surgical endoprosthesis as an internal biliary drainage was performed as a palliative treatment for 12 patients with a nonresectable carcinoma of the proximal bile ducts. In most of these patients jaundice was relieved, they were able to return to their homes, and their survival was substantially prolonged. The efficacy of this procedure was more favorable, compared to the results in patients in whom external drainage or cholangiojejunostomy was performed. PMID- 6492511 TI - [Factors affecting the postmortem lung culture]. PMID- 6492513 TI - [Diagnostic significance of liquid-filled alveolography (LFA) in idiopathic or collagenosis-induced interstitial pneumonia]. PMID- 6492512 TI - [Oxygen concentrators in long-term home oxygen therapy]. PMID- 6492514 TI - [Experimental hypersensitivity pneumonitis: the mechanism of early specific allergic response provoked by inhalation provocation test]. PMID- 6492515 TI - [Study on changes of the bronchial and pharyngeal mucosa by long-term inhalation of beclomethasone dipropionate]. PMID- 6492516 TI - [A case of sarcoidosis associated with IgA nephropathy]. PMID- 6492517 TI - [Atypical scimitar syndrome: "scimitar sign" with normal pulmonary venous drainage]. PMID- 6492518 TI - [A case of sarcoidosis with severe multiple bronchial stenosis]. PMID- 6492519 TI - [A case of acquired toxoplasmosis with diffuse reticulo-nodular shadows in chest X-ray]. PMID- 6492520 TI - [Chronologic changes of activities of macrophage-associated nonspecific esterases in the developing and healing experimental pulmonary granulomas]. PMID- 6492521 TI - [Pathological studies on farmer's lung by transbronchial lung biopsy]. PMID- 6492522 TI - [Establishment of a new cell line from human mediastinal teratocarcinoma]. PMID- 6492523 TI - [The relationship between bronchial response to acetylcholine inhalation and the lung function prior to inhalation in adolescent patients with bronchial asthma]. PMID- 6492524 TI - [NK cell activity in asbestosis]. PMID- 6492525 TI - [A case of lymphoid interstitial pneumonia]. PMID- 6492526 TI - [2 cases of bronchial asthma developing in healthy women with bronchial hypersensitivity]. PMID- 6492528 TI - [Urinary gamma-carboxyglutamic acid in calcium stone-formers]. PMID- 6492527 TI - [Isoantigens ABH in bladder tumors as an indicator of malignant potential. II. Results of a long-term follow-up and technical problems]. PMID- 6492529 TI - [A pharmacokinetic study of gentamicin sulfate in rabbits with hydronephrosis]. PMID- 6492530 TI - [Thoracoabdominal radical nephrectomy for renal cell carcinoma]. PMID- 6492531 TI - [Clinical study of interstitial cystitis. 1-(2) The etiological consideration of 4 cases of interstitial cystitis with advanced contracted bladder]. PMID- 6492532 TI - [6 years' experience of ureterovesiconeostomy with special emphasis on the factors contributing to the failure and result of the second operations]. PMID- 6492533 TI - [The contractile proteins of upper urinary tract smooth muscle and response of their contents to chronic ureteral obstruction]. PMID- 6492534 TI - [Study of urinary stone weight correlated with composition]. PMID- 6492535 TI - Vascular system of paracloacal vascular body in the guinea fowl, Numida meleagris. PMID- 6492536 TI - Production of experimental arteriosclerosis in spontaneously hypertensive rats, SHR/NCrj. PMID- 6492537 TI - Relationship between anticapsular antibody and protective activity of a capsular antigen of Haemophilus paragallinarum. PMID- 6492538 TI - Determination of Clostridium botulinum toxin by reversed passive latex agglutination. PMID- 6492539 TI - Diagnostic ultrasound imaging in domestic animals: two-dimensional and M-mode echocardiography. PMID- 6492540 TI - Alterations in the heart rate of Thoroughbred horse, pony and Holstein cow through pre- and post-natal stages. PMID- 6492541 TI - Studies on canine babesiosis in Okinawa Island. PMID- 6492542 TI - Effects of quercetin and butylated hydroxytoluene on cigarette smoke inhalation toxicity in Syrian golden hamsters. PMID- 6492543 TI - Ulceric lesions of articular cartilages distal to carpal and tarsal joints in Japanese black beef cattle. PMID- 6492544 TI - Isolation of a papovavirus-like agent from young budgerigars with feather abnormalities. PMID- 6492545 TI - Zygomatic salivary glands in Japanese serows, Capricornis crispus. PMID- 6492546 TI - Undifferentiated astrocytoma in a cow. PMID- 6492547 TI - [Five year follow-up study on the short-course chemotherapy for pulmonary tuberculosis in Niigata Prefecture]. PMID- 6492548 TI - [Recent trend of tuberculosis and the results of treatment in the area around Shimada city]. PMID- 6492549 TI - [Effect of rifampicin on cell mediated immunity in patients with pulmonary tuberculosis--with special reference to interferon-producing ability of peripheral blood lymphocytes]. PMID- 6492550 TI - [2 cases of atypical mycobacteriosis associated with bronchiectasis]. PMID- 6492551 TI - [Tuberculosis problem and its control in East Asia and the South Pacific area]. PMID- 6492552 TI - [Roentgenological features of disseminated tuberculosis following long-term corticosteroid therapy]. PMID- 6492553 TI - [Effect of isonicotinic acid hydrazide on mycolic acid synthesis in Nocardia rubra]. PMID- 6492554 TI - [Dipyridamole test in the diagnosis of coronary disease]. PMID- 6492555 TI - [Coronarographic possibilities of evaluation of the patency of the sinoatrial node artery]. PMID- 6492556 TI - [Clinical course and cause of death in a second myocardial infarction]. PMID- 6492557 TI - [Changes in individual plasma lipoprotein fractions in children with simple obesity]. PMID- 6492558 TI - [Effect of a meal on the results of the Master test and the degree of electrocardiographic features of ischemia in patients with chronic coronary disease and normal rest electrocardiogram]. PMID- 6492559 TI - [Use of axial angiocardiography in the diagnosis of Fallot syndrome in children]. PMID- 6492560 TI - [Effect of sanatorium rehabilitation of patients after myocardial infarct on various echocardiographic parameters reflecting the inotropic state of the myocardium]. PMID- 6492561 TI - [Studies on various hemodynamic indicators in healthy pregnant women using echocardiography]. PMID- 6492562 TI - [Effect of a single dose of lanatoside C on the left heart ventricle in patients with primary congestive cardiomyopathy]. PMID- 6492563 TI - [Early results of 130 operations in congenital heart defects under extracorporeal circulation]. PMID- 6492564 TI - [Use of the probability method in the diagnosis of non-invasive ischemic heart disease]. PMID- 6492565 TI - [The extent of necrosis determined on the basis of serial CK-MB tests and the clinical course of recent myocardial infarction]. PMID- 6492566 TI - [Value of the determination of polycardiographic indicators of diastole of the left ventricle for the evaluation of its function in ischemic heart disease]. PMID- 6492567 TI - [Value of echocardiographic analysis of posterior aortic wall motion for the assessment of left-ventricular systolic activity in coronary disease]. PMID- 6492568 TI - [Changes in coronary disease risk factors in men employed in the quicklime processing industry after 5 years' implementation of the coronary disease prevention program]. PMID- 6492569 TI - [Diagnostic value of selected reflex tests in the diagnosis of sinoatrial node insufficiency]. PMID- 6492570 TI - [Usefulness of M-presentation and two-dimensional echocardiography in the diagnosis of transposition of great vessels in children]. PMID- 6492571 TI - [Improvement in left-ventricular function as a result of mitral commissurotomy. Use of the hand-cooling test in the study of left-ventricular function]. PMID- 6492572 TI - [Dynamics and pathogenesis of ischemic contracture of the heart]. AB - In experiments on 34 dogs, the authors studied myocardial rigidity, ATP levels and Ca2+-accumulating function of the membranes of the sarcoplasmic reticulum (SR) in the external (subepicardial) and internal (subendocardial) layers of the myocardium at 1 and 2 h of total ischemia at 37 degrees C and also 30 min after cardiac reperfusion by heterotopic transplantation. It was revealed that contracture changes in ischemia first affect the internal and then the external layer of the myocardium which corresponds to the initial and completed phases of ischemic contracture (IC) of the heart, correspondingly. IC of the heart is irreversible and in cases of total contracture of all layers of the myocardium (the completed phase) the heart loses contractile function. Changes in the contractility in the external and internal layers of the myocardium show a stronger inverse correlation with the capacity of SR membranes to absorb Ca2+ rather than with ATP levels in the tissues which indicates an essential role of the Ca2+ accumulating function of SR in the pathogenesis of IC. PMID- 6492573 TI - [Hyperuricemia in ischemic heart disease]. PMID- 6492574 TI - [Diagnosis of myxoma of the left atrium using ultrasonic sectoral scanning]. PMID- 6492575 TI - [Cardiac involvement in a patient with systemic scleroderma]. PMID- 6492576 TI - [Secondary amyloidosis with predominant involvement of the heart in a psoriasis patient]. PMID- 6492577 TI - [Echocardiographic studies in congestive cardiomyopathies]. AB - Twenty-seven patients with congestive cardiomyopathy and 34 patients with coronary heart disease (postinfarction cardiosclerosis) as well as 30 healthy subjects were studied using one- and two-dimensional echocardiography with a subsequent computerized analysis. Patients with congestive cardiomyopathy showed an increased end-diastolic size, mitral-septal separation, right ventricular and left atrial diameters and left ventricular mass as compared to the other groups. Unlike in coronary heart disease, patients with congestive cardiomyopathy had a decreased mitral ring area, a prolonged isovolumetric relaxation phase, a decreased increment of the anteroposterior diameter during rapid filling. PMID- 6492578 TI - [Pathogenesis of diabetic lesions of the myocardium]. AB - On the basis of both literature data and their own observations, the authors suggest the identification of various forms of diabetic cardiopathy in relation to the pathogenetic mechanisms of the development of this complication. The microangiopathic form of diabetic cardiopathy develops as a result of cardiac diabetic microangiopathy. Vegetoneuropathic cardiopathy arises secondary to the impairment of the cardiac performance neural regulation associated with damage to the parasympathetic and/or sympathetic innervation of the heart secondary to diabetic vegetoneuropathy. Diabetic metabolic cardiopathy is induced by diabetic disorders in myocardial metabolism. A combined form of diabetic cardiopathy results from the combined lesion of the heart under the impact of the above specific mechanisms. PMID- 6492579 TI - [Cardiovascular disorders, autonomic disorders and atherogenic dyslipoproteinemias in young women with the sclerotic ovary syndrome]. AB - The authors studied 158 young women with the syndrome of sclerocystic ovaries (SCO) and 40 healthy subjects. The patients showed a high rate of vegetovascular dystonia, predominantly according to the hyperparasympathicotonic type, cardialgia and dyspnea. In 54.5% of the patients lipid metabolism disturbances of the atherogenic nature were elicited, being most pronounced in the hypothalamic pituitary form of the disease. It is postulated that in cases of the SCO syndrome, the deficit of estrogens and pregnanediol decreases "immunity" of females to the development of atherogenic dyslipoproteinemias while a relative or absolute hyperandrogenia accounts for the transformation of the "female" type of the lipid spectrum into the "male" type with lower levels of cholesterol of high density lipoproteins (LP) and higher levels of TG, and cholesterol of very low density LP and of low density LP. It is recommended that the SCO syndrome should be included into the risk factors for atherosclerosis and coronary heart disease. PMID- 6492580 TI - [Importance of ultrasonic diagnosis to medical expert evaluation of the work capacity of ischemic heart disease patients]. AB - Using the methods of ultrasonic diagnosis such as M-mode echocardiography and sectoral scanning, the cardiac activity of 92 myocardial infarction survivors was studied. Initially, the patients were examined 3-3.5 months after the infarction, then one year later. The findings of the primary examination suggest that factors aggravating the prognosis of the disease and adversely affecting the work fitness of the patients include the detection of the zones of a- and dyskinesia of the myocardium, an enlargement of the cardiac cavities, a decrease in the rate of the circulatory shortening of myocardial fibers, a reduction in the blood stroke volume and in the ejection of the left ventricle. It is concluded to be advisable to use the ultrasonic data for solving questions of medical evaluation of the work fitness of myocardial infarction survivors. PMID- 6492581 TI - [Echocardiography in the evaluation of cardiodynamics in patients with the Eisenmenger syndrome in different physiologic states]. AB - The author has reviewed the results of echocardiographic studies in 51 patients with Eisenmenger's syndrome including 15 pregnant women. In 41 cases the parameters of ultrasonic examination are compared with the results obtained from the catheterization of the cardiac cavities and major vessels. The most informative parameters of the echocardiogram in Eisenmenger's syndrome are identified. PMID- 6492582 TI - [Possibility of noninvasive determination of left ventricular volume from a single minor axis]. AB - The authors analyzed the left cinoventriculography data in 425 patients with various heart diseases in whom the volumes of the left ventricle varied from the normal to considerably increased values. It was established that the ratio of the transverse axis to the longitudinal one varied from 0.25 to 0.85 which suggests that it is not advisable to calculate the volume of the left ventricular chamber according to the formula of the volume of the ellipsoid of revolution whose long axis is replaced by the double value of the minor axis. Actually, the acceptable accuracy of the calculation of the volume by this formula may be obtained only when the transverse axis equals 4-4.5 cm. The studies have shown that the formula suggested by L. Teichholz is most optimal. The results obtained with the formula showed a good correlation with the volumes determined with the help of the cinoventriculogram (r = 0.93 +/- 0.04). This formula (Formula: see text) should be used for calculating the volumes of the left ventricle during echocardiography. PMID- 6492583 TI - [Cardiomyopathies: classification and diagnosis]. PMID- 6492584 TI - [Use of lidocaine peridural anesthesia in patients in the acute phase of a myocardial infarct]. AB - Peridural anesthesia was performed in 18 patients with acute myocardial infarction aimed at controlling the pain syndrome. In 12 of these patients, the authors studied for 24 hours the central hemodynamics by exploring the pulmonary artery with a Swan-Ganz balloon catheter and thermodilution. The central hemodynamics was also studied in the control group of patients in whom the analgesic methods conventially used in acute myocardial infarction were employed. During the first hour of peridural anesthesia in patients with myocardial infarction, the authors revealed a significant decrease in the blood pressure, heart rate, cardiac output, and in the end diastolic pressure in the pulmonary artery as compared with the initial values and the parameters in the control group. No significant changes in the cardiac stroke volume, stroke performance, the index of the cardiac stroke performance, and the total peripheral resistance were detected in these patients. The use of peridural anesthesia proved highly effective for controlling pain in acute myocardial infarction. PMID- 6492585 TI - [A new psychophysiologic test, "The Information Test", and its possible use in cardiology]. AB - The authors describe a new psychophysiological test based on the use of commercially available television apparatuses and aimed at determining the efficiency of information processing. The use of the test in 346 people has demonstrated its acceptability for building up psychoemotional tension and detecting the hypertensive hemodynamic response. The analysis of the results of the testing conducted in normal subjects and cardiovascular patients has permitted the selection of the most informative criteria of the test. These include the coefficient of information processing, and also the increment and time-course of the blood pressure. This standardized psychophysiological test may be employed in the diagnosis of the early stages of arterial hypertension and neurocirculatory dystonia. PMID- 6492586 TI - [Optimizing surgical tactics for treating injuries of the major arteries of the extremities based on predictions of the efficacy of the restorative surgery]. AB - The algorithm elaborated to predict the efficacy of restorative surgery makes it possible to determine reliably the viability of the limb on the basis of ordinary clinical data and may be used for selecting a method of surgical intervention in an individual patient with an injured major artery. PMID- 6492587 TI - [Evaluation of the contractile function of the myocardium using tetrapolar thoracic rheography in the late stages of mitral stenosis]. AB - Using apparatus RPG2-02 to obtain the differential rheogram and postulating that at the very onset of the systolic ejection of the blood from the ventricle there are conditions approximately corresponding to the isotonic regime of cardiac performance, the authors suggest formulae to calculate the volumetric rate (Formula: see text) volumetric acceleration (Formula: see text) and maximum volumetric acceleration of ventricular ejection (Nmax = N X DD). It is concluded that a noninvasive method can be used in the follow-up of patients and the assessment of myocardial contractility. PMID- 6492588 TI - [Features of postoperative immunosuppression according to the results of studies of the functional activity of peripheral blood monocytes of patients with acquired heart defects]. AB - The article analyzes post-surgery immunosuppression as judged by the data on the functional activity of peripheral blood monocytes in 34 patients with rheumatic heart disease following its surgical correction. It has been established that prolonged immunosuppression may serve as an additional criterion of myocarditis development in the early post-surgery period. PMID- 6492589 TI - [Acute disorders of the mesenteric circulation among heart defect patients]. AB - The author analyzes the clinical picture, diagnostic methods, and results of the treatment of mesenteric artery thromboembolism in 30 patients with rheumatic heart disease. The early symptoms that permit the physician to suspect mesenteric thromboembolism include sudden convulsive pains in the abdomen, vomiting, diarrhea, leukocytosis, and the discrepancy between the clinical picture of the complication and scarce objective data from examining the abdominal cavity. When the diagnosis of the acute occlusion of the mesenteric vessels has been made, urgent surgical intervention is indicated which is to include the resection of the non-viable portion of the intestine and the surgical correction of the blood flow in the superior mesenteric artery. PMID- 6492590 TI - [Effect of adrenaline on incorporation of 125I-LDL into the aorta]. AB - Adrenaline in concentrations of 10(-7)-10(-4) M increased the incorporation of 125I-low density lipoproteins (LDLP) into the perfused rabbit aorta, stimulating predominantly the non-specific uptake of 125I-LDLP. It was parallelled by the swelling of the endothelial lining of the aorta, expansion of the intercellular borders and an increase in the argyrophilic cell properties. The adrenoreceptor blockers phentolamine and propranolol prevented the morphological changes in the endothelium and in the incorporation of 152I-LDLP into the vascular wall. The authors feel that the catecholamine-induced damage to the endothelial lining of the aorta presents one of the mechanisms of atherogenesis stimulation following psychoemotional stress. PMID- 6492591 TI - [Surgical treatment of combined ulcers of the stomach and duodenum]. PMID- 6492592 TI - [Systemic morphological characteristics of the digestive organs in peptic ulcer and postgastrectomy complications]. PMID- 6492593 TI - [Surgical treatment of the sequelae of a chemical burn of the stomach]. PMID- 6492594 TI - [Truncal vagotomy with pyloroplasty in perforating ulcers]. PMID- 6492595 TI - [Choice of the surgical treatment method in patients with complicated duodenal peptic ulcer and hypersecretion]. PMID- 6492596 TI - [Effect of selective proximal vagotomy on the evacuatory motor function of the stomach in the early postoperative period]. PMID- 6492597 TI - [Interdigestive motility of the gastric stump and small intestine in dumping syndrome patients]. PMID- 6492598 TI - [Gastric motor evacuatory function after various types of vagotomy]. PMID- 6492599 TI - [Gastric secretory function after resection for excluding a duodenal ulcer]. PMID- 6492600 TI - [Microflora of the gastric contents in duodenogastric reflux patients]. PMID- 6492601 TI - [Disorders of duodenal patency in digestive organ diseases and their correction]. PMID- 6492602 TI - [Immediate results of using selective proximal vagotomy in gastric peptic ulcer]. PMID- 6492603 TI - [Rare perforations of gastroduodenal ulcers]. PMID- 6492604 TI - [Surgical characteristics of gastric and duodenal peptic ulcer complicated by perforation into the pancreas]. PMID- 6492605 TI - [Duodenoplasty in the treatment of postampullar duodenal stenosis]. PMID- 6492606 TI - [Surgical treatment of peptic pyloroduodenal stenosis in the middle-aged and elderly]. PMID- 6492607 TI - [Surgical treatment of peptic ulcers of a gastroenteroanastomosis]. PMID- 6492608 TI - [Clinico-expert evaluation of the late surgical results in gastric and duodenal peptic ulcer]. PMID- 6492609 TI - [Diagnostic characteristics of peptic and recurrent ulcers after vagotomy]. PMID- 6492610 TI - [Gallbladder function in peptic ulcer patients before and after gastric resection with preservation of the pylorus]. PMID- 6492611 TI - [Mechanisms of the evacuatory function disorders of the gastric stump following a Billroth II resection and their diet therapy]. PMID- 6492612 TI - [Choice of type of surgical intervention in the dumping syndrome after a Billroth I gastric resection]. PMID- 6492613 TI - [Combined operations on the abdominal organs]. PMID- 6492614 TI - [Hydrochloric acid solution in the combined preoperative therapy of decompensated pyloric stenosis]. PMID- 6492615 TI - [Comparative characteristics of the gastric mucosa in duodenal ulcer patients undergoing various types of surgical treatment]. PMID- 6492616 TI - [Changes in the protein composition of the blood plasma in obstructive jaundice patients undergoing hemosorption on activated charcoal]. PMID- 6492617 TI - [Enzyme diagnosis of obstructive jaundice]. PMID- 6492618 TI - [Acute cholecystitis complicated by peritonitis in middle-aged and elderly patients]. PMID- 6492619 TI - [Transcutaneous transhepatic cholangiostomy as a treatment method for obstructive jaundice patients]. PMID- 6492620 TI - [Characteristics of the postoperative treatment of suppurative cholangitis]. PMID- 6492621 TI - [Use of an autovenous valve for peritoneovenous shunting in patients with liver cirrhosis complicated by ascites]. PMID- 6492622 TI - [Use of novocaine block in treating cholestatic hepatitis]. PMID- 6492623 TI - [Diagnosis and treatment of suppurative cholangitis]. PMID- 6492624 TI - [Transduodenal papillosphincteroplasty in middle-aged and elderly patients]. PMID- 6492625 TI - [Repeat operations after cholecystostomy]. PMID- 6492626 TI - [Acute cholecystitis in obese patients]. PMID- 6492627 TI - [Indications for duodenal intubation in acute and chronic cholecystitis patients]. PMID- 6492628 TI - [Empyema of the gallbladder in planned cholecystectomy]. PMID- 6492629 TI - [Modeling of acute liver failure]. PMID- 6492630 TI - [Functional and neuromorphological interrelation of the extra-hepatic bile ducts and the pancreas in acute cholecystitis in an experiment]. PMID- 6492631 TI - [Anomalous structure of the biliary tract]. PMID- 6492632 TI - [Arterioportal fistula as a complication of transcutaneous transhepatic portography]. PMID- 6492633 TI - [Cholecystitis complicated by cholecystoduodenal fistula and phlegmon of the stomach]. PMID- 6492634 TI - [Cystiform dilatation of the common bile duct]. PMID- 6492635 TI - [Cysts of the common bile duct]. PMID- 6492636 TI - [Cyst of the common bile duct]. PMID- 6492637 TI - [Multichamber pseudocyst of the liver with malacoplakia]. PMID- 6492638 TI - [Liver ascariasis]. PMID- 6492639 TI - [Postoperative anaerobic gangrene of the liver]. PMID- 6492640 TI - [Liver adenoma with disintegration and transformation into trabecular cancer complicated by intra-abdominal hemorrhage]. PMID- 6492641 TI - [Transcutaneous transhepatic dilatation of a stricture of a hepaticojejunal anastomosis]. PMID- 6492642 TI - [A bougie-guide for drainage of the common bile duct across the stump of the cystic duct]. PMID- 6492643 TI - [Endoscopic operations on patients with residual choledocholithiasis in the early postoperative period]. PMID- 6492644 TI - [Prevention of blood loss in operations for portal hypertension]. PMID- 6492645 TI - [New method of pancreatoduodenal resection with preservation of the excretory function of the pancreas]. PMID- 6492646 TI - [Ligature vascular clamp]. PMID- 6492647 TI - [Rational surgical approach to the cardia and abdominal portion of the esophagus]. PMID- 6492648 TI - [Thoracic duct drainage in the combined surgical treatment of obstructive jaundice patients]. PMID- 6492650 TI - [Arterial embolisms in surgical heart patients]. PMID- 6492649 TI - [Late treatment results with thoracocentesis and aspiration drainage in the pleural complications of acute suppurative lung diseases in childhood]. PMID- 6492651 TI - [Ratios of oxygen consumption to the changes in hemodynamics and oxygen transport in hemorrhagic shock]. PMID- 6492652 TI - [Possibilities for the classification of functional respiratory changes in experimental hemorrhagic shock]. PMID- 6492653 TI - [Nonepithelial tumors of the stomach]. PMID- 6492654 TI - [Atypical seminoma tumors]. PMID- 6492655 TI - [Burns of the lower extremities based on data from the Thermal Trauma Clinic of the N. I. Pirogov Institute during a 6-year period (1978-1983)]. PMID- 6492656 TI - [Possibilities of using peridural analgesia in orthopedics and traumatology and its effect on hemodynamics, acid-base balance and the biochemical indices of the blood serum]. PMID- 6492657 TI - [Surgical treatment of terminal ileitis]. PMID- 6492658 TI - [Centralized control of anticoagulant treatment]. PMID- 6492659 TI - [Arteriovenous fistula for the hemodialysis treatment of chronic kidney failure]. PMID- 6492660 TI - [Experimental and clinical observations of the cytotoxic effect of antiseptics used in surgical practice]. PMID- 6492661 TI - [A case of anaerobic gas infection following pyelolithotomy]. PMID- 6492662 TI - [A case of renal chyluria]. PMID- 6492663 TI - [Ureterocele and bladder tumor]. PMID- 6492664 TI - [Appendiceal peritonitis in the early postoperative period after a Billroth II gastric resection]. PMID- 6492665 TI - [Patient with a hemorrhaging peptic ulcer of the jejunum successfully recovered from hemorrhagic shock and clinical death]. PMID- 6492666 TI - [Successful extirpation of a huge retroperitoneal sarcoma]. PMID- 6492667 TI - [Method of removing fertile and suppurative echinococcal cysts and a device for its realization]. PMID- 6492668 TI - [Pseudophakia and the pupil]. AB - Postoperative disturbances of the pupil are discussed on the basis of experience with more than 2500 intraocular lenses implanted after extracapsular cataract extraction (planned extracapsular or phacoemulsification). Apart from the changes to the pupil caused by an iris-fixed intraocular lens itself, the pupil may also be affected by blood, fibrinous inflammation, or remnants of cortex material or the anterior capsule after posterior chamber lens implantation. These conditions are frequently followed by synechiae between the pseudophakia and the iris. Mechanical damage to the iris or the sphincter muscle may also occur. Changes in the shape of the pupil often affect its function, and synechiae do so regularly. Secondary cataract necessitating treatment occurred in about 10% of our patients over a 7-year period. Today, YAG laser surgery represents the best means of restoring clarity to the pupil, though there are still a number of unresolved problems with the method. Neither primary nor secondary capsulotomy after pseudophakia implantation can be recommended. The methods of extracapsular cataract extraction with posterior chamber lens implantation are still at a stage of development which is not altogether satisfactory, since optic irregularities of the pseudophakia or the central posterior capsule may result in glare, disturbing the patient in spite of good visual acuity. PMID- 6492669 TI - [Results of cyclocryocoagulation in chronic narrow-angle glaucoma]. AB - Cyclocryocoagulation is successful in 86% of eyes with narrow-angle glaucoma, i.e., intraocular pressure is lowered to a maximum of 23 mm Hg with or without additional local therapy postoperatively. Therefore, this procedure represents a real alternative to the fistulating operation, especially with regard to prevention of malignant glaucoma. One interesting observation was the postoperative widening of the chamber angle. It is still not known whether the pressure-lowering effect is caused not only by a reduction in aqueous production but also by an improvement in outflow. PMID- 6492670 TI - [Initial results in percutaneous radiotherapy of malignant melanomas of the choroid with the linear accelerator]. AB - Twenty-seven eyes harboring a choroidal melanoma which could not be treated by other methods were treated with external beam radiation using a linear accelerator. After a mean follow-up period of 15.6 months 3 eyes had to be enucleated. In two eyes fresh tumors developed, which were successfully treated with local beta-radiation. In the remaining 22 eyes the tumor growth was stopped or the tumor regressed. External beam therapy for choroidal melanomas seems to be an effective alternative to enucleation in eyes with tumors not accessible for other methods of treatment and which cannot be enucleated, e.g., single eyes. PMID- 6492671 TI - [Effect of various stimulation filters on tear film breakup time]. AB - The tear break-up was determined in 30 patients with healthy eyes aged from 18 to 67 using two different types of filter combinations: (1) Schott Filter OG 530 and Schott Filter BG 12. (2) Schott Filter OG 530 and Zeiss Filter 485. In view of the filter characteristics, we expected a reduction of the variance of the tear break-up time with the second filter combination. This did not occur. There was no difference between the two filter combinations described according to the Wilcoxon Test on the 5 percent level. The reasons are discussed. PMID- 6492672 TI - [Biometric studies on the rabbit eye]. AB - Echographic and ophthalmometric in vivo studies concerning the axial length of the bulbus, the depth of the anterior chamber, the thickness of the lens as well as the radius and the power of refraction of the cornea were carried out on 24 eyes of 12 male inbred rabbits. In addition, in vitro studies of the bulbi were also performed with regard to the axial and equatorial length, the different diameters of the cornea, the depth of the chamber angle and the sulcus ciliaris, and the diameter of the lens. Results are shown separately for right and left eyes. PMID- 6492673 TI - [Therapy-refractory secondary open-angle glaucoma caused by epithelialization of the anterior chamber following cataract extraction]. AB - Histologic findings are presented which relate to a case of primary diffuse epithelial downgrowth into the anterior segment after surgery, with subsequent secondary open-angle glaucoma which resisted all attempts at therapy. Possible types of early therapy are discussed. PMID- 6492674 TI - [Clinical picture of an embolism of the central retinal artery caused by cholesterol crystals]. AB - On the basis of six relevant personal observations the ophthalmoscopic signs of an embolism in the retinal vessels caused by cholesterol crystals are described. In the fundus characteristic red and yellow iridescent light reflexes from the crystals and muff formation around the afflicted vessels can be observed. Fluorescence angiography illustrates the grade of impediment to the blood circulation. Embolism caused by cholesterol crystals in the retina is a bad prognostic sign with respect to the patient's life. PMID- 6492675 TI - [Familial binasal visual field contraction]. AB - A 45-year-old heavy smoker was referred to the clinic for acute unilateral visual acuity reduction and irregular visual field constriction. An ischemic optic neuropathy with ipsilateral pit of the disc and medullated parapapillar nerve fibres was diagnosed. In spite of a normal fundus a visual field contraction in the upper nasal quadrant was found on the other eye. The son of the patient had bilateral crater-like holes of the disc with binasal visual field contraction. Similar visual field defects were found in the patient's daughter, with pseudopapilledema. PMID- 6492676 TI - [Choice of the physiologic implantation site for artificial lenses]. AB - The consideration for the choice of intracapsular lens-implantation are presented, and the surgical technique of the implantation of the new Binkhorst "all in the bag" lens is described in detail. PMID- 6492677 TI - [Threshold-adjusted supraliminal pattern perimetry with the Goldmann perimeter]. AB - This paper describes a method of supraliminal pattern perimetry for use with a Goldmann perimeter. In this method, the stimuli are adjusted in stages in accordance with the normal physiological sensitivity gradient. The threshold is determined on four meridians located 10 degrees and 30 degrees from the center. These threshold values are used to define three different levels of brightness which exceed the threshold by approximately the same amounts in three sectors of the field of vision extending from 2 degrees to 10 degrees, 10 degrees to 20 degrees and 20 degrees to 30 degrees. The points arranged in a rectangular pattern at intervals of 3 1/3 degrees are used to check for relative and absolute defects in the patient's field of vision. Supraliminal pattern perimetry can be performed manually on the Goldmann perimeter in a manner similar to automatic supraliminal perimetry to detect small defects in the field of vision. Manual perimetry, though, allows the physician to use his clinical experience directly and also makes it possible to combine screening and detection into a single procedure, since it is then possible to alter pattern density and to switch from supraliminal pattern perimetry to kinetic and free static threshold determination during the actual course of the examination. The flexibility of the manual method may well save both physician and patient time and effort, especially in difficult cases. With automatic perimetry, however, such flexibility is hampered by the fact that programs must be run through in succession (with the exception of the Octopus Program 4). PMID- 6492678 TI - [Cryoenucleation in malignant melanoma of the choroid]. AB - The works of Zimmermann, Fraunfelder et al. and Migdal offer reasons for postulating atraumatic procedures for the enucleation of malignant melanoma of the choroid. Cryosurgery represents an effective method of blocking the melanoma prior to enucleation in such a manner that an intraoperative dissemination of tumor cells is unlikely. The technology which is at present widely used for this purpose (Fraunfelder et al.) has considerable disadvantages. For examples cryoapplication is only possible with favorable, i.e., peripheral tumor localization, since the cryoapplicator cannot be introduced into the orbit. Therefore, a cup-shaped cryoapplicator chilled by liquid nitrogen has been developed which can be introduced into the orbit. The operating temperature of 196 degrees C causes the half of the eyeball in which the tumor is located to freeze within 100 seconds. Subsequently the applicator is removed and the enucleation is continued in the traditional manner. The technical suitability of this procedure has meanwhile been demonstrated in 12 enucleations. PMID- 6492679 TI - [2 forceps for implantation of Choyce-Mark IX anterior chamber lenses]. AB - Two pairs of forceps for the implantation of Choyce Mark IX anterior chamber lenses are described. Both pairs of forceps can be used for problem-free implantation of the Choyce Mark IX lens. The mouth of one of them is so flat that it enables the surgeon to implant the lens without flattening the anterior chamber. The second pair of forceps is used in the rate event that an exchange of the Choyce Mark IX lens is desired. It allows a firm, secure grip on the lens. PMID- 6492680 TI - [Social deprivation in early childhood: endangered development and prevention]. AB - In view of present-day knowledge and findings relating to the development of young children, the stimulating interaction between the child and its social and material surroundings must be considered of supreme importance. Any disturbance or radical restriction of the structure of social relationships can thus seriously endanger the development of young children on all levels. Aspects of prevention are discussed with this in mind. PMID- 6492681 TI - [Cardiovascular diagnosis in thoracopagus twins]. AB - The case of a thoracopagus with atrial and ventricular connection and of a thoracoischiopagus with atrial connection and multiple cardiac defects are reported. For the assessment of cardiac fusion, ECG, radionuclid-studies and CT are of limited value. By means of angiocardiography it is possible to classify patients in those with pericardial union only, with venae-cavae - or atrial connection and with ventricular connection. While separation of twins with pericardial fusion is often performed, successful separation of twins with atrial fusion is only once described, of twins with ventricular fusion never described. PMID- 6492682 TI - [Value of 2-dimensional echocardiography in the diagnosis of infectious endocarditis]. AB - Cross sectional and simultaneous M-mode echocardiograms were performed on 15 consecutive patients with infective endocarditis, 14 of whom had pre-existing cardiac lesions. Patients were divided into two groups based on the presence or absence of echocardiographically detected vegetative lesions. In 10 out of 15 patients vegetations were present (66%): aortic valve 5, mitral valve 1, tricuspid valve 1, both aortic and mitral valves 1 and left ventricular endocardium associated with aortic valve lesion 2. In this group 3 had systemic embolic episodes and 2 died, whereas none of the 5 patients without detectable vegetations had complications. In 6 the preoperative echocardiographic findings could be confirmed at surgery or autopsy. Emergency surgery without catheterization was performed in 2 patients. Two dimensional echocardiography provides an important non invasive method of assessing a significant percentage of vegetations, but a negative echocardiogram does not exclude infective endocarditis. From the present experience and that of others the detection of vegetations by echocardiography identifies a subgroup of patients with a higher risk for complications in whom early operative intervention without catheterization can be performed. Cross sectional echocardiography may also prove helpful for serial examination of valve vegetations. PMID- 6492683 TI - [Echocardiographic detection of endocarditis vegetations of the tricuspid valve in 2 children with ventricular septal defect]. AB - Two children with ventricular septal defect and tricuspid valve endocarditis are presented. One of them had ongoing endocarditis with septic pulmonary embolism, the other suffered from florid endocarditis presumably 3 months before the study. M-mode echocardiography showed echodense masses in the right ventricular outflow tract in one and anomalous systolic anterior movement of tricuspid valve tissue in the other patient. Sectorechocardiography demonstrated in both children abnormal masses originating from the tricuspid valve and extending into the right ventricular outflow tract. Surgery confirmed endocarditic vegetations and destructions of the tricuspid valve. After operative closure of the ventricular septal defect and reconstruction of the tricuspid valve both children are well. Our experience underlines the usefulness of echocardiography, especially sectorechocardiography, in demonstrating endocarditic vegetations originating from the tricuspid valve. PMID- 6492684 TI - [Seizures in premature and newborn infants under 2,500 grams birth weight]. AB - Seizures in premature babies pose a special problem which occur more often than in term neonates. The data of 156 neonates weighing less than 2 500 grams consecutively admitted to a neonatal intensive care unit during a 6 month period were evaluated. 33 infants (21%), of whom 21 were less than 31 weeks of gestational age suffered from seizures. Almost all of these 33 infants had a very bad outcome. Only 9 of them survived and only 4 showed normal development. In 26 infants a CT or brain autopsy was performed. The outcome was influenced by the presence of intraventricular haemorrhage. But even those preterm neonates without morphological abnormalities of the brain have only a small chance of developing normally in the presence of seizures. The EEG is an important diagnostic tool: Most of the patients showed paroxysmal activity. The background activity of the interictal EEG has prognostic value even in the preterm infant. There is, however, discrepancy between the EEG and the morphological findings. Therefore the EEG has to be seen as functional test which gives important additional information beyond brain imaging methods. PMID- 6492685 TI - [Screening for congenital metabolic diseases in mentally retarded patients in 6 psychiatric institutions of Lower Saxony]. AB - The results of screening for inborn errors of metabolism in patients in six institutions for the mentally retarded in Lower Saxony are presented. A battery of standard chemical and chromatographic tests for amino acids, carbohydrates and mucopolysaccharides in urine were employed. Combined gas chromatography-mass spectrometry was used to detect organic aciduria. All together 975 patients - 347 females and 628 males - aged from 5 to 93 years were studied. 78.6% of the patients were over 20 years of age. There were positive findings in 56 cases: phenylketonuria (n = 8), alcaptonuria (1), pentosuria (5), galactosuria (2), tryptophanuria (1), xanthurenic aciduria (3), mucopolysaccharidosis type III A (1), hyperglycinemia with hyperglycinuria (1), renal hyperaminoaciduria (9, lactic aciduria (3), 4-hydroxyphenylaceticaciduria (2), organic aciduria (12) and mellituria (8) of unknown type. The organic acids most often detected in urine were lactic, 4-hydroxyphenylacetic and 3-hydroxybutyric acids. Only 20 of the patients (2.0%) excreted appreciable amounts of benzoic acid in urine. The results are discussed and compared with other investigations. PMID- 6492686 TI - [Growth and growth hormone in children with congenital lip and palatal clefts]. AB - In order to investigate the correlation supposed between cleft lip and palate of children and growth hormone deficiency we determined the amount of growth hormone in the blood serum of 199 children with cleft lip and palate and partly with other additional diseases. In contrast to a previous result we could not find a significant relation between the cleft-syndrome and growth hormone deficiency. All patients had a normal and sufficient concentration of the hormone. As result of our work we propose to determine the hormone concentration only in those cases in which less growth is observed too. PMID- 6492687 TI - [Echocardiographic diagnosis and successful resection of a left ventricular rhabdomyoma in the neonatal period]. AB - Among the rare heart tumours in childhood rhabdomyomas are mostly found in the neonatal period. They cause in 50% left- or right-sided obstruction. By means of 2D-echocardiography extent and relation to neighbouring structures can clearly be disclosed. Because of the severe natural history - mortality in the first year of life between 60 and 78% - successful operation was performed in a 2,5 kg weighing neonate. PMID- 6492688 TI - [Compression syndrome of the upper thoracic outlet (thoracic outlet syndrome)- report on a 13-year-old girl]. AB - The thoracic-outlet-syndrome, a symptom complex consisting of arterial, venous and neural disorders of the upper extremity, is caused by compression of the neurovascular structures between the clavicle and the first rib. Other reasons are congenital abnormalities like a cervical rib, an abnormal first rib, acquired anatomic lesions like fractures and traumata or functional factors. The younger and middle-age groups are most commonly involved. The symptoms are depending upon the point at which compression occurs and include pain, paresthesias, numbness, fatigue, pallor, coolness or swelling and enlargement of the arms. At physical examination a systolic murmur is heard in the supraclavicular region in 30 percent and the pulse of the upper extremity often is reduced. Diagnostic measurements include roentgenogram of the chest and the cervical spine, pulsed doppler-ultrasonography, nerve conduction-velocity testing and an arterio venography. Treatment is nonoperative in patients with mild symptoms (shoulder girdle-exercises) and operative in patients with severe or persistent symptoms. The operative treatment of choice is resection of the first rib by an axillary route. Risks are minimal, and the results are good to excellent in 90% of the cases. Because the thoracic outlet syndrome is very rare in childhood, we report a 13 year old girl which has undergone bilateral operation with excellent result. PMID- 6492689 TI - [Ascites puncture for the differential diagnosis in acute abdomen in the newborn infant]. AB - In 13 newborn infants with acute abdomen and ascitis paracentesis was performed. This technique is helpful for differential diagnosis and indication for operation. PMID- 6492690 TI - [Comparison of the acetylcholine receptor antibody titer and clinical course in neonatal myasthenia]. AB - Ten to fifteen percent of infants of myasthenic mothers develop neonatal myasthenia independent of the severity of the maternal disease. The antiacetylcholin receptor-protein antibodytiter (AChR-AK) was followed through the first twelve months in a boy who's mother suffered from myasthenia gravis (M.G.) since twelve years. Only unspecific symptoms for an impaired neuromuscular transmission were found, the diagnosis however was confirmed by determination of AChR-AK (alpha-Bungarotoxin binding assay, Lindstrom 1979). Maternal AChR-AK did not change during the observation period: values were between 120 X 10(-9)mol/l and 140 X 10(-9)mol/l. The neonatal titer on day one was 100 X 10(-9) mol/l, somewhat below the corresponding maternal titer (120 X 10(-9)mol/l). By 7 months the AchR-AK had decreased to the reference value according to the half time for IgG (t/2 = 17 days). In contrast to Keesey and Donaldson we found no relationship between AChR-AK levels and clinical course. PMID- 6492691 TI - [The gastrointestinal tract as an immunologic organ: the gut-associated immune system]. AB - The gastrointestinal mucosa separates the intraluminal gastrointestinal fluid, which contains a high number of antigens from different sources, and prevents free access of antigens to the body. Simultaneously, it allows some vital host environment interactions. A number of unspecific factors are important in preventing antigen invasion. The specific mucosal immunity is related to secretory IgA. IgA is derived from mucosal plasma cells after antigen-induced proliferation of its precursors in Peyer's patches. These IgA-positive B lymphoblasts migrate through the systemic circulation and then "home" to the mucosa. IgA is translocated as a dimer to the gut lumen after attachment to the secretory component (SC). Part of it is excreted into the bile via small bile ducts after portal and possibly systemic circulation and binding to SC. T cells and mast cells are also considered to show migration and homing phenomena. In addition to the gut, some other mucosa-associated lymphoid tissues, (e.g. bronchus, mammary, salivary and lacrimal glands as well as the female genital tract), can participate in homing. Little is known about the local regulatory mechanisms, which allow an immunoglobulin class specifity of immune responses. Induction of local immunity and specific systemic tolerance seems to be a characteristic immune response of the gut-associated lymphoid tissue (GALT). The knowledge of the local immune system allows a better understanding of many aspects of gastrointestinal pathology, especially in immuno-inflammatory and immunoproliferative diseases as well as in gastrointestinal immunodeficiency syndromes. PMID- 6492692 TI - Differential generation of chemiluminescence--detectable oxygen radicals by normal polymorphonuclear leukocytes challenged with sera from systemic lupus erythematosus and rheumatoid arthritis patients. AB - The generation of chemiluminescence (CL)-detectable oxygen radicals by normal human polymorphonuclear leukocytes (PMN) after challenging with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) sera is described. CL was measured in a luminol-dependent assay and referred to a standard obtained when performed immune complexes (Ic) (human tetanus toxoid-antitoxoid Ic resuspended in normal pooled serum) were tested on PMN. Normal sera gave rise to CL activity by PMN between 0% and 50% of the standard Ic (mean +/- standard error of the mean (SEM): 20.7 +/- 4.8). Sera from SLE and RA patients induced strikingly different biological effects on PMN. SLE sera generally induced a high CL-detectable generation of oxygen metabolites which may be causally related to the intense tissue damage (vasculitis) frequently observed in this disease. In contrast to SLE, RA sera induced a CL-detectable respiratory burst by PMN that was included in the normal range. Thus, the biological effects of these sera in terms of stimulation of toxic oxygen radical generation by phagocytes are quite different. This generation of oxygen radicals might reflect a different clearance of circulating Ic by PMN in SLE and RA disease. PMID- 6492693 TI - Negative inotropic effects of aldosterone antagonists in isolated human and guinea-pig ventricular heart muscle. AB - The effects of K+-canrenoate (Aldactone pro inj.) and its metabolite canrenone on isometric force of contraction were measured in isolated guinea-pig and human papillary muscle preparations driven electrically at a frequency of 1 Hz. In guinea-pig hearts both substances exerted a concentration-dependent negative inotropic effect; the IC50 of K+-canrenoate and canrenone were 129 +/- 22 mumol l 1 (n = 5) and 85 +/- 11 mumol l-1 (n = 12), respectively. At the maximally tested concentration canrenone (250 mumol l-1) and K+-canrenoate (1,000 mumol l-1) reduced force of contraction by 68 +/- 4% (n = 12) and 83 +/- 3% (n = 5), respectively. The negative inotropic effects of canrenone and K+-canrenoate were not affected by 10 mumol l-1 atropine. The negative inotropic effect of canrenone was also not affected by 14 mumol l-1 aldosterone, but canrenone (10 mumol l-1 diminished the maximal positive inotropic effect of dihydro-ouabain from 554 +/- 75% (n = 4) to 269 +/- 39% (n = 4) of the predrug value. In human heart muscles K+-canrenoate and canrenone also exerted a concentration-dependent negative inotropic effect. K+-canrenoate (1,000 mumol l-1) and canrenone (250 mumol l-1) reduced force of contraction by 57 +/- 7% (n = 8) and 67 +/- 2% (n = 6), respectively. A positive inotropic effect of both substances was never observed. It is concluded that the improvement of cardiac performance after application of aldosterone antagonists observed in patients cannot be explained by a direct effect on the heart. K+-canrenoate and canrenone are devoid of any direct cardiotonic action. Instead, K+-canrenoate and canrenone have direct negative inotropic effects at high concentrations. PMID- 6492694 TI - [Embolectomy in patients with pulmonary embolism without symptoms of shock]. AB - The therapeutic spectrum for the management of patients with pulmonary embolism includes either drug therapy with anticoagulants or with thrombolytic agents, or embolectomy. The indications for either form of therapy are not always clearly separable, but, in general, surgery is reserved for those patients with massive embolism and shock. Large, mobile thromboemboli located centrally, either within the right heart or in the main pulmonary artery, bear the risk of further, possibly fatal, embolisation that might actually be increased by thrombolytic therapy. Therefore, demonstration of such a thromboembolus seems to justify the decision for prompt surgical removal even in the absence of shock as exemplified in the two cases presented here. PMID- 6492695 TI - Importance of early postprandial insulin delivery in insulin-dependent diabetics. AB - In nine insulin-dependent diabetics postprandial glucose control under closed loop insulin infusion by an artificial endocrine pancreas was compared with that obtained under open loop infusion employing identical infusion profiles which were advanced 20 min by time in the case of open loop infusion. The earlier increase of insulin infusion rates in the latter case resulted in lower postprandial glucose concentrations during the first 90 min after meal intake. Incremental areas under the blood glucose curves during this time were significantly lower when insulin infusion rates rose earlier (4.5 X 10(3) +/- 0.5 X 10(3) vs 2.1 X 10(3) +/- 0.6 X 10(3) mg/dl X min; p less than 0.02). Insulin was administered at maximum rates 45-50 min after the start of the meal during closed loop infusion (196 +/- 38 mU/min) and 25-30 min after the meal during open loop infusion (192 +/- 35 mU/min). Correspondingly, mean free insulin concentrations which are available from six patients rose to 135 +/- 47 (40 min) or 141 +/- 50 muU/ml (20 min). Glucagon levels did not differ between both parts of the study. It is concluded that increases of postprandial insulin infusion rates occurring earlier than increases of blood glucose levels are important for optimizing glucose profiles and possibly reflect physiologic conditions. PMID- 6492696 TI - Effects of fluoride on thyroid hormone biosynthesis. Studies in a highly sensitive test system. AB - In view of the recommendation that fluoride supplements via drinking water or table salt prevent dental caries, we analyzed whether fluoride had antithyroid properties in a sensitive experimental model. Rats were given either 60 or 200 micrograms/ml fluoride in the drinking water. This raised the serum fluoride concentration from 0.165 to 0.246 in the first and to 0.576 micrograms/ml in the second instance. Although the higher fluoride dose was near the toxic range, no antithyroid effect was observed. Neither organification of iodine, nor any subsequent step of thyroid hormone biosynthesis (transformation of monoiodotyrosine to diiodotyrosine and then to thyroxine) were affected. Fluoride had no effect on thyroglobulin content of the thyroid gland or on the degree of iodination of thyroglobulin. PMID- 6492697 TI - Possible coumarin-like mechanism of action for cephalosporins. AB - In three patients treated with cephalosporins (one patient with latamoxef, two patients with cefazedone) vitamin K1 was injected to investigate whether this was followed by an increase in vitamin K1 2,3-epoxide plasma concentrations as compared to controls. Such a rise in K1-epoxide concentrations in the plasma can be demonstrated following treatment with coumarins. This reflects an inhibition of the vitamin K1-epoxide reductase in the liver. Coumarins are thought to induce hypoprothrombinaemia by such a mechanism. In all three patients we found a considerable increase in the vitamin K1-epoxide plasma concentrations following injection of 10 mg vitamin K1, whereas in normal subjects only traces of K1 epoxide could be detected (less than 0.030 micrograms/ml). The K1-epoxide concentrations found in our three patients treated with cephalosporins were 0.12, 0.16 and 0.19 micrograms/ml, respectively. This indicates that latamoxef or cefazedone might reduce clotting factor synthesis by a coumarin-like mechanism of action in these patients. Although the effect of cephalosporins in enhancing vitamin K1-epoxide plasma concentrations is less than that of coumarins, it might cause severe hypoprothrombinaemia in the presence of latent vitamin K deficiency. PMID- 6492698 TI - [Late outcome of viral hepatitis associated with acute hepatic insufficiency]. PMID- 6492699 TI - [Orthostatic hypotension]. PMID- 6492700 TI - [Serum monoamine oxidase activity in alimentary obesity]. PMID- 6492701 TI - [Various characteristics of lipid metabolism disorders in obesity]. PMID- 6492702 TI - [Acute hypervitaminosis D in adults]. PMID- 6492703 TI - [Clinical aspects of herpes infection]. PMID- 6492704 TI - [Use of nipride in patients with acute myocardial infarction with rupture of the interventricular septum]. PMID- 6492705 TI - [Idiopathic dilatation of the pulmonary artery trunk]. PMID- 6492706 TI - [Revascularization of intestinal transplants]. PMID- 6492707 TI - [Various characteristics of the course of erythromelalgia]. PMID- 6492708 TI - [Clinical symptoms of Reiter's disease]. PMID- 6492709 TI - [Risk factors in clinical medicine]. PMID- 6492710 TI - [New findings in the cytology of the respiratory organs]. PMID- 6492711 TI - [Prognosis of the course of ischemic heart disease after posterior myocardial infarction]. PMID- 6492712 TI - [Differential diagnosis of angina pectoris and esophageal diseases]. PMID- 6492713 TI - [Clinico-morphological parallels in recurrent myocardial infarct]. PMID- 6492714 TI - [Cardialgia, physical exertion tolerance and personality characteristics in patients with climacteric cardiopathy]. PMID- 6492715 TI - [Potentials of computerized tomography in the diagnosis of heart aneurysm]. PMID- 6492716 TI - [Clinical characteristics of lesions of the celiac artery branch of the abdominal aorta]. PMID- 6492717 TI - [Principles of current physical therapy]. PMID- 6492718 TI - [Rheovasography in the differential diagnosis of vascular diseases of the lower limb]. PMID- 6492719 TI - [Incidence and conditions for development of symptomatic gastroduodenal ulcers]. PMID- 6492720 TI - [Effect of cerucal and cimetidine on evaluation from the stomach of various types of food in patients with peptic ulcer]. PMID- 6492721 TI - [Complex endoscopic diagnosis of cancer of the hepato-pancreato-duodenal region]. PMID- 6492722 TI - [Gallbladder diseases and lithogenic properties of the bile]. PMID- 6492723 TI - [Diagnosis and the results of treatment of acute appendicitis in pregnancy]. PMID- 6492724 TI - [Diffuse membranous glomerulonephritis]. PMID- 6492725 TI - [Pathogenesis of neurological and mental disorders in uremia]. PMID- 6492726 TI - [Lipomatosis of the renal sinus (differential diagnosis using computerized tomography]. PMID- 6492727 TI - [HLA-related repeated cases of generalized forms of meningococcal infection and purulent meningitis of different etiology]. PMID- 6492728 TI - [State of the stomach and duodenum in patients with periodic disease]. PMID- 6492729 TI - [Psychological characteristics of patients with chronic gastritis and secretory deficiency]. PMID- 6492730 TI - [Total amnesia syndrome]. PMID- 6492731 TI - [Case of giant cell (temporal) arteritis]. PMID- 6492733 TI - [Pancreatic ascites]. PMID- 6492732 TI - [Martorell's syndrome]. PMID- 6492734 TI - [Case of thrombophilia caused by antithrombin III deficiency]. PMID- 6492735 TI - [Case of eosinophilic fasciitis]. PMID- 6492736 TI - [Differential diagnosis of arthritis and arthrosis]. PMID- 6492737 TI - [Diagnosis of diseases presenting with high temperature in therapeutic practice]. PMID- 6492738 TI - [Analgesic nephropathy]. PMID- 6492739 TI - [Influence of the sympathetic nervous system on basal gastric secretion in duodenal ulcer and chronic gastritis]. PMID- 6492740 TI - [Mild hypertension as a risk factor for stroke]. PMID- 6492741 TI - [Soviet SRT-1000M computed tomograph in the diagnosis of cerebrovascular disorders]. PMID- 6492742 TI - [Tonus of cerebral blood vessels in the early stages of cerebrovascular diseases]. PMID- 6492743 TI - [Intracranial hemorrhages in chronic alcoholism]. PMID- 6492744 TI - [Prevention and treatment of arterial hypertension at the population level]. PMID- 6492745 TI - [Experience with the detection of arterial hypertension in a population of males aged 30-59 in an urban polyclinic]. PMID- 6492746 TI - [Relation of cardiac pain syndromes and arterial hypertension to spinal osteochondrosis]. PMID- 6492747 TI - [Clinical picture of hypertension and secondary arterial hypertension in middle aged and elderly patients]. PMID- 6492748 TI - [Treatment of patients with ulcers combined with hypertension]. PMID- 6492749 TI - [Changes in central hemodynamics in patients with ruptured cerebral aneurysms]. PMID- 6492750 TI - [Diagnosis of disseminated sclerosis]. PMID- 6492751 TI - [Informativeness of adrenograms in neuroses]. PMID- 6492752 TI - [Clinical assessment of circulating immune complexes in infectious endocarditis]. PMID- 6492753 TI - [Immunologic studies in exogenous allergic alveolitis]. PMID- 6492754 TI - [Alveolar macrophages in patients with chronic bronchitis]. PMID- 6492755 TI - [Immunologic control of antibacterial treatment of chronic obstructive bronchitis]. PMID- 6492756 TI - [Clinico-immunologic characteristics of food poisoning]. PMID- 6492757 TI - Intracellular localization of estrogen receptors: implications for interaction mechanism. PMID- 6492758 TI - Biosynthesis of platelet-activating factor. VI. Precursor of platelet-activating factor and acetyltransferase activity in isolated rat kidney cells. AB - Isolated glomeruli and tubular and medullary cells obtained from perfused kidneys from Wistar rats were stimulated with ionophore A 23187 (0.5 to 6 microM) or kept overnight at pH 9.5. The amount of platelet-activating factor (Paf-acether) formed was measured in the ethanolic cell extracts using aggregation of washed rabbit platelets. 2-Lyso Paf-acether present in cells was transformed into Paf acether by chemical acetylation and measured in the same manner as Paf-acether. Microsomes from glomeruli and medullary and tubular cells were prepared, and the acetyltransferase activity was measured. Paf-acether was formed in a dose dependent fashion by glomeruli and medullary cells, and maximal formation with 3 microM ionophore A 23187 was 1.9 +/- 0.2 and 1.1 +/- 0.2 pmoles/mg of protein, respectively. Paf-acether was not recovered from tubular cells. Three cell types produced large amounts of 2-lyso Paf-acether when incubated at alkaline pH. Only glomeruli generated appreciable quantity of 2-lyso Paf-acether upon ionophore A 23187 stimulation. The acetyltransferase specific activities in ionophore A 23187 stimulated glomeruli and medullary and tubular cells were 3.8 +/- 0.8, 0.3 +/- 0.1, and 0.2 +/- 0.1 nmoles of Paf-acether/10 min/mg of protein, respectively. This study demonstrates the formation of Paf-acether by two distinct populations of kidney cells, pointing out the glomerular cells, besides the already known medullary cells, as capable of forming Paf-acether. PMID- 6492759 TI - Rapid epithelial restitution of the rat gastric mucosa after ethanol injury. AB - The superficial gastric epithelia of anesthetized rats were exposed to absolute ethanol for 30 to 45 seconds and fixed at intervals of 0, 3, 7, 15, 30, and 60 minutes thereafter. The repair or restitution process was evaluated by quantitative light microscopy and by transmission and scanning electron microscopy. The brief exposure to absolute ethanol destroyed more than 95% of the superficial epithelial cells without producing deeper, macroscopic, hemorrhagic lesions. Three minutes after ethanol treatment more than 90% of the superficial necrotic epithelial cells had broken loose from the mucosa and exposed the basal lamina. Within 7 minutes about 45% of the exposed basal lamina was recovered by migrating squamous-low cuboidal epithelial cells from the gastric pits. After 15 minutes about 85% of the damaged surface was already covered with mucous cells, and at 1 hour about 95% of the previously denuded basal lamina was recovered with more normal appearing columnar epithelial cells. Migrating mucous cells from the gastric pits extended large lamellipodia over the denuded basal lamina and moved at approximately 1 to 2 micron/minute. Exposure of the healing surface to 10(-4) M cytochalasin-D inhibited lamellipodial formation and impeded cell migration. In addition, this drug produced large lucent vacuoles in the persisting mucous cells. These results suggest that destruction of the normal superficial gastric mucosa of the rat may not be as detrimental as generally assumed since the repair process is extremely rapid and efficient. PMID- 6492760 TI - Electron probe X-ray analysis on human hepatocellular lysosomes with copper deposits: copper binding to a thiol-protein in lysosomes. AB - Livers of eight patients with chronic liver diseases were investigated by energy dispersive x-ray analysis. First, three kinds of preparations (osmium-Epon sections, glutaraldehyde-frozen sections, and unfixed-frozen sections) were compared for element detectability at a subcellular level. The glutaraldehyde frozen sections were satisfactory as far as copper, sulfur, and phosphorus were concerned. Five patients (one patient with Wilson's disease, one chronic cholestasis, one chronic hepatitis, and two asymptomatic primary biliary cirrhosis) yielded x-ray images of copper and sulfur consistent with hepatocellular lysosomes. Second, the glutaraldehyde-frozen sections were utilized for a study of copper deposits in the patients' livers. There was a significant correlation between copper and sulfur contents in the lysosomes of all patients studied but no correlation in the remainder of the cytoplasm. Zinc was not detected in the lysosomes. Whatever the content of copper in the lysosomes, the ratio of delta copper to phosphorus (weight/weight) to delta sulfur to phosphorus was 0.60. These data indicate that most lysosomal copper binds to a thiol protein, probably metallothionein, in the liver. PMID- 6492761 TI - Parallel tubular arrays in large granular lymphocytes. PMID- 6492762 TI - An isolated rat liver model for the evaluation of thermal techniques to quantify perfusion. AB - An isolated, thermally regulated, perfused rat liver model system is presented. The model was developed to evaluate thermal methods to quantify perfusion in small volumes of tissue. The surgically isolated rat liver is perfused with an isothermal oxygenated Krebs-Ringer bicarbonate buffer solution via the cannulated portal vein. A constant-pressure head variable-resistance scheme is utilized to control the total flow to the liver. Total flow is quantified by hepatic vein collection. The spatial distribution of perfusion within the liver is determined using two independent methods. In the first method, radio-labelled microspheres are injected into the portal vein, and the regional flow distribution is determined from the relative radioactivity of each section of tissue. In the second method, the tissue is thermally perturbed, and the time constant of the tissue temperature recovery is measured. The regional distribution is determined from the relative time constants of each section of tissue. Both methods require the measurement of total liver flow to determine the absolute perfusion at each point. Results obtained by the two methods were well correlated (0.973). The rat liver system offers a stable, controllable, and measurable perfusion model for the evaluation of new perfusion measurement techniques. PMID- 6492763 TI - The simultaneous measurement of thermal conductivity, thermal diffusivity, and perfusion in small volumes of tissue. AB - An improved technique is presented for the "in-vivo" determination of thermal conductivity, thermal diffusivity, and perfusion using a self-heated spherical thermistor probe. In the presence of flow, solution of the time-dependent, probe tissue coupled thermal model allows the measurement of "effective" thermal conductivity and "effective" thermal diffusivity, which represent the thermal properties of the perfused tissue. Perfusion can be quantified from both "effective" thermal properties. In the presence of flow, it has been shown that the transient power responses does not follow t-1/2 as has been previously assumed. An isolated rat liver preparation has been developed validate the measurement technique. Radioactive microspheres are used to determine the true perfusion from the total collected hepatic vein flow. Experimental data demonstrates the ability to quantify perfusion in small volumes of tissue. PMID- 6492764 TI - Parameter estimation using the quasi-linear viscoelastic model proposed by Fung. AB - Using the quasi-linear viscoelastic model proposed by Fung for the description of the viscoelastic properties of soft biological tissues, the parameters governing their time-dependent behavior are commonly estimated from relaxation experiments. Exact quantification is possible from the response to a step change in the strain. Since it is physically impossible to realize a true step change in the strain, in practice the response to a steplike strain change is used. In the present study the discrepancies between the exact and the estimated parameter values are investigated using a hypothetical quasi-linear viscoelastic material. The parameter tau 1, governing the fast viscous phenomena, is found to be subject to the largest errors. Methods for obtaining better estimates of tau 1 are outlined in a number of special cases. PMID- 6492765 TI - Kinematic and force data collection in biomechanics by means of sonic emitters- I: Kinematic data collection methodology. AB - In this paper, first, the principles of sonic digitizing are presented. Next, a description of quantitative determination of the relative motion between two body segments by utilization of sonic emitters is provided. A new kinematic data collection methodology and data analysis is proposed to check continuously the accuracy of the data collected by means of the sonic emitters. The first part of the paper is terminated by establishment of an accuracy criteria and selection of the most accurate data set and associated error analysis. Quantitative results based upon the kinematic data collection methodology of Part I were obtained for the forced kinematic motion of the human shoulder complex and are presented in Part II. PMID- 6492766 TI - Kinematic and force data collection in biomechanics by means of sonic emitters- II: Force data collection and application to the human shoulder complex. AB - In multisegmented mathematical models of the human body the most difficult and the least successful modeling of a major articulating joint has been the shoulder complex because of the lack of appropriate biomechanical data as well as the anatomical complexity of the region. In this paper, quantitative results on the variability of the stiffness of the shoulder complex dependent upon orientation of the upper arm are presented by applying the principles and theory developed in Part I. The paper starts with a description of a multiple-axis force and moment transducer and its utilization with sonic emitters in determining direction as well as location of the general force and moment vectors applied on a body segment. The numerical results which are presented for three subjects are in the form of plots showing the passive resistance of the shoulder complex as functions of drawer displacements of the upper arm along its long bone axis. Exponential and power curve fitting of the numerical results are also provided to establish intra-subject variations and similarities of the behavioral patterns of the axial stiffness characteristics of the human shoulder complex. PMID- 6492767 TI - The intraaortic balloon pump: a nonlinear digital computer model. AB - A computer based model for in-series cardiac assistance by intraaortic balloon pumping was developed in this study. The model, obtained from the Navier-Stokes and Continuity equations, was capable of computing pressures, volumetric flow rates and radii through the arterial system. The model was used to study the effects of a wide range of assist device timing adjustments on the benefits of ventricular assistance under conditions corresponding to those measured during animal experiments. The model was also used to study the relationship between device timing adjustments and the benefits of ventricular assistance under constant cardiovascular state conditions. Such studies are important in isolating the response of the system to assist device phasing from the response associated with system state. The results obtained in this study demonstrate that the hemodynamic response of the cardiovascular system to intraaortic balloon pumping is a sensitive function of both the state of the cardiovascular system and phasing of the assist device. PMID- 6492768 TI - Large deformation mechanics of the enucleated eyeball. AB - Large deformation of enucleated pig eyeballs under rigid cylindrical indenters was studied analytically and experimentally. The analytic model for the eyeball consists of a fluid-filled spherical membrane composed of an incompressible, elastic material with an exponential strain energy function. The Rayleigh-Ritz technique provided an approximate solution via a potential energy formulation. Comparison with results from tests on eyeballs and a water-filled rubber (Mooney Rivlin) shell shows good agreement at large deflection, where membrane action dominates. Due to the highly nonlinear stress-strain relations for the sclera, the load remains relatively small until the indenter displacement approaches 40 60 percent of the eyeball radius, and then the load increases rapidly. Depending on the indenter size, either a perforation or a rupture type of failure occurs. PMID- 6492769 TI - A crack model of a bone cement interface. AB - This paper is concerned with the fracture mechanics of a bone-cement interface that includes a cohesive zone effect on the crack faces. This accounts for the experimentally observed strengthening mechanism due to the mechanical interlock between the crack faces. Edge crack models are developed where the cohesive zone is simulated by a continuous or a discrete distribution of linear or nonlinear springs. It is shown that the solution obtained by assuming a homogeneous material is fairly close to the exact solution for the bimaterial interface edge crack problem. On the basis of that approximation, the analysis is conducted for the problem of two interacting edge cracks, one at the interface, and the other one in the cement. The small crack that was observed to initiate in the cement, close to the bone-cement interface, does not affect much the mode I stress intensity factor at the tip of the interface crack. However it may grow, leading to a catastrophic breakdown of the cement. The analysis and following discussion point out an interdependency between bone-cement interface strength and cement strength not previously appreciated. The suggested crack models provide a framework for quantifying the fracture mechanisms at the bone-cement interface. PMID- 6492770 TI - Calculation of long jump performance by numerical integration of the equation of motion. AB - The aerial phase of the long jump is calculated by numerical integration of the equations of motion. Consideration is given to the effects on performance of the horizontal and vertical components of velocity at takeoff, aerodynamic drag, wind assistance and the vertical displacement of the center of mass which occurs during the course of the jump. For still air conditions it is shown that an analytical solution due to Lamb compares very favorably with the numerical solution, providing an excellent description of the trajectory. Calculations neglecting the effect of aerodynamic drag are shown to overestimate the jump distance of world-class athletes by from 9 to 11 cm under still air conditions. PMID- 6492771 TI - Electro-mechanical behavior of wet bone--Part I: Theory. AB - The remodeling properties of bones due to various stimuli have been of substantial interest to the scientists. Examination of electro-mechanical properties of bone and their relation to remodeling and osteogenesis have been investigated mainly by experimental means. In this study, by using continuum physics, it is shown that the remodeling of bones can be formulated theoretically in terms of electrical and mechanical effects. The interactions among the constituents of bone (bone matrix, bone salts, electrolytes and hydrogen ions) and effects of various stimuli (mechanical, electrical and chemical) on the remodeling mechanism of bone tissue are interpreted with this model. Moreover, the stimulation of osteogenesis by electrical means is predicted. PMID- 6492772 TI - Electro-mechanical behavior of wet bone--Part II: Wave propagation. AB - In this study, a general mixture model, which was developed for wet bone, has been used to analyze the flexural wave propagation in long bones. The electrical conduction is taken into account as well as the piezo-electric properties of bone tissue. The general formulation is simplified and certain assumptions made to yield a particular set of equations. The solution of the magnetic induction vector outside the bone due to the mechanical wave propagation is obtained. The results are compared with a similar problem using dry bone. The results indicate that the electro-mechanical properties of bone tissue could be used for monitoring the rate of fracture healing in long bones. PMID- 6492773 TI - Patterns of flow in the left coronary artery. AB - The purpose of this investigation is to describe our preliminary observations of the overall pattern of flow in a mold of the left coronary artery of a pig. Flow in the coronary mold was visualized by the injection of dye into the sinus of Valsalva. Studies were performed during steady flow at rates of 100, 200, 300, 400, and 500 mL/min. Studies were also performed during pulsatile flow, using a pulse duplicator that simulated the magnitude and phasic pattern of coronary flow at rest and during reactive hyperemia. At conditions that simulated rest, mean coronary flow was adjusted to 121 mL/min of which 24 mL/min (20 percent) was systolic. During simulated reactive hyperemia, mean flow was 440 mL/min. Visualization of flow revealed the absence of disturbances of turbulence during both steady and pulsatile flow in the left anterior descending (LAD) and left circumflex (CIRC) coronary arteries throughout the entire range of flow studied. Prominent spiraling of flow occurred during steady and pulsatile flow. Spiraling of flow was not observed in the LAD at rest during pulsatile flow, but developed during simulated reactive hyperemia. Helical flows were observed in the CIRC both during simulated rest and reactive hyperemia. These observations suggest that helical flows may be characteristic features of flow in the left coronary artery; whereas turbulence may not be a feature of this flow field. Whether the spiraling of flow that we observed related to the spiral distribution of early atheroma reported by others, is undetermined. PMID- 6492774 TI - Determination of muscle orientations and moment arms. AB - In muscle force analysis, orientations and moment arms of the muscles about a joint provide essential coefficients in the equilibrium equations. For the determination of these parameters, several experimental techniques, including geometric measurement, tendon-joint displacement measurement and direct load measurement, are available. Advantages and disadvantages associated with each of the techniques are reviewed and compared based on our extensive experience. PMID- 6492775 TI - Measurement of the laser exposure levels for burn threshold in biological tissue. AB - Experiments for the evaluation of the laser energy density required to induce burn threshold in biological tissue are presented. The results are compared with a theoretical model. The values obtained for soft tissue are higher than the pain threshold and the safety standards for the maximum permissible exposure. This is due to the different nature of injury associated with the surgical process. PMID- 6492776 TI - Systemic thermochemotherapy: toxicity and plasma pharmacokinetics of methotrexate and doxorubicin. AB - Chemotherapy administered during systemic hyperthermia is more tumoricidal than either modality used alone. The purpose of this study was to evaluate plasma drug pharmacokinetics and host toxicity when methotrexate (MTX) or doxorubicin (adriamycin--ADR) was given at 37 or 43 degrees C. Eight dogs were heated to 43 degrees C for 1 hr without chemotherapy; eight dogs received MTX (5 mg/kg) and four dogs received ADR (2 mg/kg) intravenously as a constant infusion at 43 or 37 degrees C. Blood samples were obtained at 0, 1, 2, 24, and 48 hr. Mean plasma MTX levels were not significantly different at 1, 2, and 6 hours in 43 and 37 degrees C dogs, but at 24 and 48 hr mean plasma MTX levels were significantly elevated in heated (43 degrees C) dogs compared with sham-heated (37 degrees C) dogs. Plasma MTX concentration multiplied by time (area under curve) was 131 g . hr/liter in 43 degrees C dogs compared with 73 g . hr/liter in 37 degrees C dogs (P less than 0.001). Vomiting and bloody diarrhea lasted an average of 4 days in heated control dogs (no drugs) 4 days in 37 degrees C dogs, and 5 to 7 days in 43 degrees C MTX dogs. Mean plasma ADR levels were similar in 37 and 43 degrees C dogs at all time intervals. Vomiting and bloody diarrhea lasted at least 7 days in 43 degrees C dogs compared with only 1 day in 37 degrees C dogs treated with ADR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492777 TI - The influence of infused calcium on the postischemic myocardium. AB - Despite evidence for calcium-induced damage in the postischemic myocardium, calcium remains a frequently used inotropic agent following cardiopulmonary bypass surgery with cardioplegic arrest. The purpose of this study was (1) to challenge the postischemic myocardium with incremental doses of ionized calcium, and (2) to relate postischemic calcium reperfusion concentration to final recovery of left ventricular contractile function. Rabbit hearts (N = 38) were perfused and equipped with a ventricular balloon to monitor developed pressure (DP) +/- dp/dt, and left ventricular end diastolic pressure (LVEDP). Hearts underwent 40 min of global ischemia. Hearts were then assigned to one of four groups to receive a variable calcium concentration (0.6, 1.2, 2.5, 5.0 mM) for the initial 5 min of reperfusion followed by 55 min of reperfusion (Ca+2 = 1.25 mM). No differences were found between groups for final recovery of DP +/- dp/dt, or final LVEDP. It was concluded that: (1) within the physiologic range, variable calcium infusions during the first 5 min of postischemic reperfusion do not impair final recovery of LV contractile function, (2) irreversible partial recovery of left ventricular function appears due to mechanisms other than mitochondrial or myofibrillar calcium loading during reperfusion, and (3) infused calcium is a safe inotropic agent even in the postischemic myocardium. PMID- 6492778 TI - The use of pig mononuclear cells to inhibit pulmonary tumor formation in isogenic mice. AB - A-strain mice received 1 X 10(5) A-strain mammary carcinoma, B72, cells iv on Day 0. At the same time fragments of the same tumor were implanted into the ileal mesentery of a pig together with fragments of cellulose sponge. The middle third of the pig mesenteric lymph node chain was resected. Sponge fragments of equivalent size, shape, and total weight were implanted alone into the jejunal mesentery. Seven days later, separate cell suspensions were made from the (disconnected) proximal (nonimmune) and distal (tumor-immune) segments of lymph node chain. Cells were also expressed by digital pressure from the sponges removed from the jejunal (nonimmune) and ileal (immune) segments of mesentery. A comparison was made between the antitumor action of immune lymph node cells and the two categories of sponge cell. Cells (4 X 10(6] were injected iv into the mice on Day 7 and the number of pulmonary tumors counted after killing the mice on Day 14. Cells obtained from the "immune" sponges were significantly more effective in reducing the number of pulmonary tumors than cells from the "nonimmune" sponge, or from the immune lymph nodes. The antitumor action of all cell suspension was abolished when 4 X 10(6) cells from the "interface" layer, following centrifugation on a Ficoll-triosil column, were injected into the mice. Antitumor activity was found to be correlated with the presence of "blast" cells in the pig mononuclear cell suspensions. PMID- 6492779 TI - Identification of nonviable muscle in electric burns with nitroblue tetrazolium. AB - Both experimental and clinical evaluation of nitroblue tetrazolium (NBT) as a method of identifying ischemic and necrotic muscle is described. Colorless NBT was reduced to a blue formazin by viable muscle but remained colorless in necrotic muscle. Muscle samples were rated for viability on a scale of 0-100% based on the relative amount of muscle sample that reduced NBT. There was good correlation between gross appearance, distribution of staining, and histologic findings in all nonviable experimental and clinical muscle specimens. All tissue that reacted with NBT proved to be viable histologically. Metabolically active or viable muscle fibers are rich in respiratory enzymes (dehydrogenases). The loss of dehydrogenase activity from ischemic or necrotic muscle can be detected by NBT reduction capacity. NBT technique identified nonviable tissue, clearly showed the even distribution of muscle damage characteristic of electric burns, was useful in defining ischemic muscle prior to obvious necrosis, and was a rapid, simple, and reliable semiquantitative test that can be used intraoperatively. PMID- 6492780 TI - Characterization of the immunosuppressive effect of burned tissue in an animal model. AB - The immunosuppressive effect of burned tissue was studied using a mouse burn model. To evaluate the immunologic status an in vivo measure of cell-mediated immunity (CMI) involving contact sensitization of mice by painting the skin with dinitrofluorobenzene was used; mice were challenged 5 days later by painting the ear with the same antigen. Ear swelling in response to antigenic challenge was used as a quantitative measure of CMI; diminution in ear swelling in treatment mice compared to sensitized, unburned control mice indicated the degree of immunosuppression. A full-thickness steam burn covering 20% body surface ares (BSA) was profoundly immunosuppressive as reflected by ear swelling of 45 to 60% of that found in normal mice; partial thickness burns and burns of 10% BSA extent were not significantly immunosuppressive. Transfer into unburned mice of burned skin equivalent in size to a 20% BSA burn eschar resulted in marked immunosuppression, but transfer of smaller amounts of burned skin, or of larger amounts of unburned skin and normal and burned liver tissue, did not produce immunosuppression. Mice receiving a very high-temperature (300 degrees C), dry burn were only slightly more suppressed than mice receiving a standard steam burn. Normal immunity was preserved in burned mice which received daily application of cerium nitrate to the wound for 7 days, but application of other topical agents commonly used in burn treatment did not preserve immunity. Postburn immunosuppression thus appears related quantitatively to toxic factors in burned skin, and these toxic factors can be abrogated in burned mice by the topical application of cerium nitrate. PMID- 6492781 TI - Organized medicine--today and tomorrow. PMID- 6492783 TI - Market strategies for private practice. PMID- 6492782 TI - Changing trends for hospitals, physicians, and medical staffs. PMID- 6492784 TI - The medicolegal climate in Tennessee. PMID- 6492785 TI - Medical ethics, etiquette, and discipline in a competitive environment. PMID- 6492786 TI - Geriatric abuse intervention team in a family practice setting. PMID- 6492787 TI - EKG of the month. Ventricular pacemaker functioning normally with ectopic electrode position. PMID- 6492788 TI - Elective sterilization: no guarantees. PMID- 6492789 TI - Molybdate-sensitive and molybdate-resistant activation-labile glucocorticoid receptor mutants of the human lymphoid cell line CEM-C7. AB - The basis for the glucocorticoid resistance of three (3R7, 3R43 and 4R4) genetically independent mutants derived from the glucocorticoid-sensitive human lymphoid cell line CEM-C7 was examined. Each mutant contained significant, albeit reduced, amounts of steroid binding activity measured in both whole and broken cell assays. These activities were of similar high affinity and specificity to that seen in the sensitive parent, suggesting that the steroid binding portion of the receptors in these mutants was normal. However, nuclear translocation of steroid-receptor (SR) complexes was defective in all three clones. Analysis of SR complex activation by DEAE-cellulose chromatography established that receptors from the mutant clones were extremely labile under conditions which would activate normal SR complexes. Such lability was not exhibited by the unoccupied or occupied but unactivated forms of these receptors, indicating that all three were "activation labile" (act1). SR complexes of clones 3R7 and 4R4 were completely protected by the inclusion of molybdate during attempted activation and were classified as act1:molybdate-sensitive. However, SR complexes of clone 3R43 were unstable during attempted activation, even in the presence of 50 mM molybdate, and were thus classified as act1:molybdate-resistant. Our results suggest that while the act1 phenotype may predominate among spontaneously derived glucocorticoid-resistant mutants derived from CEM-C7, this phenotype may be the consequence of at least two different mutations. PMID- 6492790 TI - Estrone sulfatase activity in the human brain and estrone sulfate levels in the normal menstrual cycle. AB - When the plasma concentrations of estrone sulfate (E1S) were measured in five menstrual cycles, the highest concentrations were found on the day of LH peak (14.25 nmol/l +/- 2.94 [SE]). Peak levels of E1S were 20 times higher than the highest E2 levels measured (0.769 +/- 0.276 nmol/l). To determine whether E1S can be metabolized by adult and fetal tissues we examined estrone (E1) sulfatase activity in brain and other tissues. E1 Sulfatase activity was present in all tissues studied including adult endometrium, fat and skin. When the rate of sulfatase activity was measured in homogenates of fetal hypothalamus, frontal cortex and pituitary (n = 4), the hypothalamic activity (306.0 +/- 39.1 [SE] pmol/min/mg protein) was significantly higher than that of the frontal cortex (127.4 +/- 19.4, P less than 0.002) or pituitary (193.7 +/- 43.3, P less than 0.03). This was not apparent in the adult (n = 2) where the enzyme activity was similar in the hypothalamus (413.9 +/- 27.3) and frontal cortex (446.3 +/- 82.2) and lower in the pituitary (98.2 +/- 19.2). The Km for E1 sulfatase in the fetal frontal cortex was 28.9 microM. The high E1 sulfatase activity in estrogen responsive target tissues, particularly fetal hypothalamus, accompanied by a large circulating reservoir of E1S, suggest that this enzyme could possibly have a regulatory role in controlling the level of intracellular estrogens and in modulating their intracellular function. PMID- 6492791 TI - Plasma protein binding interaction of prednisone and prednisolone. AB - The plasma protein binding interaction of prednisone and prednisolone were characterized by equilibrium dialysis. Prednisone and prednisolone are bound equally but weakly to human albumin (affinity constant, K approximately equal to 1 X 10(3) M-1). Transcortin affinity for prednisolone is 10-fold greater (51.3 X 10(6) M-1) than that for prednisone (4.3 X 10(6) M-1). In competition under pharmacologic conditions, prednisolone inhibits prednisone binding to transcortin producing linear binding averaging 55%. Prednisone does not affect prednisolone binding and does not complicate pharmacokinetic studies of the latter. PMID- 6492792 TI - Validation and use of centrifugal ultrafiltration-dialysis in the measurement of percent free oestradiol in serum. AB - The validity of the centrifugal ultrafiltration-dialysis method in the measurement of the percentage of oestradiol and testosterone which is not bound to protein (free) in human serum was assessed. In an initial validation, the values of % free steroid obtained for oestradiol and testosterone in protein-free ultrafiltrates of human serum were higher than expected. Filter paper discs used in the system were shown to adsorb [3H]oestradiol from protein-free solution. Their replacement with glass-fibre discs, which did not adsorb oestradiol, decreased but did not eliminate the discrepancy between observed and expected results for % free oestradiol in ultrafiltrates. The use of polyethylene rather than polypropylene vials then reduced the discrepancy to insignificant levels. The estimates for % free oestradiol in serum were reduced by these modifications. PMID- 6492793 TI - Increased 3-hydroxy-3-methyl-glutaryl coenzyme A reductase activity in a virilizing adrenal carcinoma. AB - HMG-CoA reductase activity was determined on microsomal preparations of an adrenal carcinoma and on a control adrenal obtained from palliative surgery for breast carcinoma. In both tissues we also measured [14C]pyruvate incorporation to study the formation of sterols. The endogenous adrenal content of cholesterol and its esters was quantitated. The content of various steroids was also determined in tissues and media before and after incubations in Krebs-Ringer. The carcinoma had a HMG-CoA reductase activity of 972.0 pmol/mg protein/min vs 13.8 for the control adrenal. The tumor incorporated 4.6 pmol of [14C]pyruvate per mg protein per 90 min into digitonin precipitable sterols compared to 0.5 pmol found for the control gland. Free cholesterol and cholesterol esters in tumoral tissue were 0.09/100 mg and 0.02/100 mg tissue respectively, compared to 0.18 and 2.56 in control tissue. The output of corticosteroids and androgens was very high when calculated for the whole tumor. These results suggest that the carcinoma had acquired a high capacity for de novo synthesis of cholesterol which could have served as substrate for the observed high plasma androgen level. PMID- 6492794 TI - Structures and concentrations of fifteen different steroid sulfates in human breast cyst fluids. AB - By applying capillary gas chromatography (GC) and gas chromatography mass spectrometry (GC-MS), a simultaneous quantitation of all important steroid sulfates present in a number of breast cyst fluids, has been obtained. The fact that prevailing androgen sulfate structures in the cyst fluids are different from those in blood suggests at least intracystic metabolism of blood-born precursors. Particularly greater amounts of 5 alpha-reduced steroids are found in breast cysts. 5 alpha-Androstane-3 alpha,17 beta-diol is a major androgen sulfate of breast cyst fluids, its concentration being some 2000-fold that of blood. After prolonged topical application of progesterone on the breast, an accumulation of the sulfates of several pregnanediol isomers could be observed. PMID- 6492795 TI - Quantitative structure-activity relationships of cardiotonic steroids using empirical molecular electrostatic potentials and semiempirical molecular orbital calculations. AB - Empirical molecular electrostatic potentials and a rigid receptor H atom model are used to calculate differences in the interaction energy of cardiotonic steroids with the digitalis receptor. An attempt is made to map the receptor H binding sites for two different steroid conformations with respect to 17 beta side-chain orientation. The calculated interaction energies using single-crystal X-ray structure data indicate linear relationships with the Na+, K+-ATPase inhibitory activity. On the basis of these correlations, the activity of 8 so far pharmacologically not investigated steroids containing C = O in 17 beta substituents are estimated with the help of structural data determined by means of the semiempirical CNDO molecular orbital theory. PMID- 6492796 TI - Influence of phosphatase inhibitors and nucleotides on [3H]dexamethasone binding in cytosol of human placenta. AB - The purpose of this investigation was to establish the properties of [3H]dexamethasone binding sites in cytosol of human placenta at term. Cytosol containing 20 mM sodium molybdate (MoO4Na2) was incubated for 120 min at 20 degrees C with 40 nM [3H]dexamethasone. The following properties were observed: (a) a single population of binding sites of high affinity and low capacity was measured by Scatchard analysis; (b) potent glucocorticoids such as dexamethasone and cortisol displaced the tritiated ligand, progesterone showed an intermediate activity, whereas cortisone, testosterone and 17 beta-estradiol were ineffective competitors; (c) ultracentrifugation on 16-41% glycerol gradients containing 20 mM MoO4Na2 yielded sedimentation values of 10.25 +/- 0.35 S (n = 4 placentas); (d) the binding sites could be differentiated from the enzyme 11 beta hydroxysteroid dehydrogenase, as the activity of the former, but not that of the latter, was greatly dependent on the presence of MoO4Na2 in the incubation medium. Inactivation of binding sites labelled with [3H]dexamethasone by incubation at 20 degrees C was prevented by phosphatase inhibitors such as 20 mM MoO4Na2 (P less than 0.01), 20 mM sodium tungstate (WO4Na2) (P less than 0.01) and to a lower extent by 5 mM ATP and cAMP (P less than 0.05). 50 mM NaF, 5 mM GTP or cGMP had no effect. The protection afforded by MoO4Na2 and WO4Na2 was correlated with a significant inhibition of the activity of acid phosphatase, but not alkaline phosphatase. Neither ATP nor cAMP modified phosphatase activity. It is suggested that binding sites for [3H]dexamethasone in cytosol of human placenta showed properties similar to those described for glucocorticoid receptors in target cells, and that these binding sites are regulated by phosphorylation and dephosphorylation mechanisms. PMID- 6492797 TI - Monoclonal antibodies for use with 125iodine-labeled radioligands in progesterone radioimmunoassay. AB - The interactions of heterologous and homologous 125I-iodinated radioligand with polyclonal and monoclonal antibodies directed against 11-hydroxyprogesterone hemisuccinate conjugated to bovine serum albumin were compared. Our data show that, with a polyclonal antibody, the use of the same bridge in the tracer and the antigen results in a low sensitivity while a heterologous tracer can decrease markedly the titer of antibody but increases the sensitivity of the radioimmunoassay. Due to the high specificity of monoclonal antibodies, the interaction with heterologous and homologous iodinated tracers is extremely variable from one antibody to another but the present results demonstrate that radioimmunoassays of very high sensitivity can be obtained with homologous and heterogeneous tracers. However, an appropriate tracer has to be selected to meet the requirement of such an assay. PMID- 6492798 TI - Dehydroxylation of cholic acid at C12 and epimerization at C5 and C7 by Bacteroides species. AB - Freshly isolated cultures (2060) of human intestinal bacteria of the predominant flora, among them 1029 strains of saccharolytic Bacteroides species, were tested for cholic acid transformation. Eight Bacteroides strains reduced cholate to chenodeoxycholate, while 73 strains dehydroxylated at C7, producing deoxycholate. Concurrent oxidation of hydroxyl groups, mainly at C7, was seen with many strains. No strain was able to dehydroxylate simultaneously at C7 and C12. One isolate, identified as a mixed culture of Bacteroides fragilis and B. uniformis, epimerized cholic acid at C5 and simultaneously epimerized, oxidized and dehydroxylated at C7. The following transformation products were identified: 3 alpha,7 alpha,12 alpha-trihydroxy-5 alpha-cholanoic acid, 3 alpha,7 beta,12 alpha trihydroxy-5 beta-cholanoic acid (ursocholic acid), 3 alpha,12 alpha-dihydroxy-7 keto-5 beta-cholanoic acid, 3 alpha,12 alpha-dihydroxy-5 alpha-cholanoic acid and a 3 alpha,12 alpha-dihydroxy-5 alpha-cholenoic acid. Dehydroxylating and epimerizing abilities were detected when fresh isolates were tested first for cholate transformation. They were no longer recognizable after some serial transfers. Dehydroxylation at C12 of cholate could not be demonstrated with mixed fecal cultures. The possible intermediate, however, 3 alpha,7 alpha-dihydroxy-5 beta-chol-11-enoate, was abundantly hydrogenated by stool suspensions. PMID- 6492799 TI - Characterization of a specific androgen receptor in non-Hodgkin's lymphoma cells. AB - The use of a competitive binding assay has permitted us to detect a cytoplasmic androgen receptor in cells of node biopsies of several patients suffering from non-Hodgkin's malignant lymphomas (NHML). These same cells appear to contain very low or undetectable numbers of estrogen receptor. The androgen receptors are saturated at approximately 2 X 10(-10) M [3H] 5 alpha DHT and Scatchard analyses of the binding data indicated a high affinity constant (Kd = 0.29 +/- 0.19 10(-9) M). The range of receptor sites is 19-327 fmol/mg protein (median = 42 fmol/mg protein). These cytoplasmic receptors are inactivated at 37 degrees C and pronase. The [3H] 5 alpha DHT receptor complex migrates in linear 5-20% sucrose gradients with a sedimentation coefficient of 7S and this peak is shifted to the 4S region under high salt conditions. Physiochemical properties of the binding including binding capacity and steroid specificity, are quite similar to those reported in target organs. PMID- 6492800 TI - Characterization of human spleen tumor glucocorticoid receptors using [3H]cortisol as ligand. AB - The present report describes an assay system allowing the quantification and characterization of [3H]cortisol binding to glucocorticoid receptors in bloodrich human tissue. The essence of this assay lies in the selective binding of 17 beta carboxylic acids of natural corticoids to corticosteroid binding globulin (CBG). In the presence of 1240 nmol/l 11 beta-hydroxy-3-oxo-4-androstene-17 beta carboxylic acid only glucocorticoid receptors were detectable with the expected properties: high affinity for synthetic and natural glucocorticoids, but failure to bind to the respective 17 beta-carboxylic acids, apparent Kd's at 0-4 degrees C for [3H]cortisol of approx 30 nmol/l, Nmax similar to those determined with [3H]dexamethasone and the typical sequence of relative binding affinities (dexamethasone greater than cortisol greater than progesterone greater than 17 beta-methyl-testosterone, estradiol). PMID- 6492801 TI - Enhanced metabolism of [2,4,6,7-3H] estradiol-17 beta in the diabetic rat. AB - The peripheral metabolism of [3H]estradiol-17 beta (E2(3)H) was studied in ovariectomized, streptozotocin induced diabetic rats, in an attempt to understand the reduced nuclear retention time and the decreased activity on protein synthesis of E2 in diabetic rat uterus as reported recently. E2(3)H was injected intraperitoneally and the kinetics of 3H metabolites were followed in plasma extracts obtained between the time intervals of 10-210 min after injection. Diabetics accumulated about 15 times more ether insoluble metabolites by the tenth minute as compared to the controls. The metabolites contained relatively more glycurono- and less sulfoconjugates in diabetics. After hydrolysis of either fraction, most of the radioactivity migrated as estrone or was less polar than estrone on LH20 column chromatography. Half of the ether insoluble material was not hydrolyzable by Helix pomatia gastric juice. The ether soluble fraction contained more estrone and non polar material, but less estradiol in the diabetics than in the controls. The plasma disappearance rates of all fractions were faster in the diabetics. For estradiol itself, the half life was two to three times shorter in the diabetics after either intravenous or intraperitoneal injection of the tracer. The metabolic clearance rate of E2(3)H measured by constant intravenous infusion was 1746 +/- 326 ml/h and 1136 +/- 347 ml/h in diabetics and controls (P less than 0.001). In conclusion, E2(3)H was cleared much faster from the peripheral circulation in diabetics, resulting in an early accumulation of ether soluble and non soluble metabolites; the latter contained proportionately less sulfo- and more glycuronoconjugates than in the controls. The rapid disappearance of E2 from the plasma of diabetics may play a role in the shorter retention time of the hormone-receptor complex and the reduced activity of the hormone at the uterine level. PMID- 6492802 TI - Side-chain cleavage of C27-3-oxo-4-ene sterols. AB - In this study various C27 sterols with a 3-oxo-4-ene structure were incubated with adrenal cortex mitochondrial preparations. (22R)-22-Hydroxy-4-cholesten-3 one and (20R,22R)-20,22-dihydroxy-4-cholesten-3-one were found to be converted into progesterone. This suggests the existence of a pathway for adrenal progesterone formation analogous to the normal 3 beta-hydroxy-5-ene pathways. (20S)-20-Hydroxy-4-cholesten-3-one was hydroxylated at C25. 4-Cholesten-3-one, 25 hydroxy-4-cholesten-3-one and (22S)-22-hydroxy-4-cholesten-3-one were not converted to a measurable extent. With 3-oxo-4-ene C27 sterols as substrates, the cholesterol side-chain cleaving enzyme system seems to require the presence of a 22R-hydroxyl group in the substrate. The clinical relevance of these observations is discussed. PMID- 6492804 TI - Salivary testosterone levels in normal and testosterone treated monkeys. AB - Testosterone concentrations in saliva and matched serum samples were measured by radioimmunoassay, in normal and testosterone treated adult male cynomolgus monkeys (Macaca fascicularis) and in untreated rhesus monkeys (Macaca mulatta). Saliva and serum samples were collected under ketamine anaesthesia. In 4 cynomolgus monkeys, the mean basal testosterone levels were 195 +/- 22 pmol/l in saliva and 24 +/- 2 nmol/l in serum (n = 17). The salivary testosterone corresponded to 0.9 +/- 0.1% of the serum testosterone concentration. In 5 rhesus monkeys the mean testosterone concentrations were 147 +/- 10 pmol/l in saliva and 17 +/- 2 nmol/l in matched serum samples with a percent ratio of 1.6 +/- 0.3 (n = 15). Following a single i.m. injection of 50 mg testosterone propionate to 4 monkeys, both salivary and serum testosterone levels increased promptly and in parallel. The salivary testosterone levels correlated well with the serum testosterone values. The study suggests that, as in the human, determination of salivary testosterone can be used as an index of free testosterone in this animal. Moreover, the monkey can be used as a model for studies in the human involving monitoring of salivary testosterone. PMID- 6492803 TI - Comparative pharmacokinetic studies of tixocortol pivalate and cortisol in the rat. AB - Comparative pharmacokinetic studies of [14C]tixocortol pivalate ([14C]TP) and [14C]cortisol were carried out in rats. A 2.5 mg/kg i.v. dose (TP and cortisol) and oral doses of 1 and 25 mg/kg (cortisol), 25-250 and 1500 mg/kg (TP) were given separately to male and female rats. 14C-Radioactivity, [14C]cortisol, [14C]TP and [14C]T were determined in plasma samples, using TLC determinations and HPLC analysis. The results showed that plasma clearance and volume of distribution values of TP were respectively 6 and 10 times larger than those of cortisol (ClC = 4.7 l/h/kg and ClTP = 33.3 l/h/kg; VdC = 1.9 l/kg and VdTP = 21.7 l/kg). TP was rapidly converted into T whose plasma concentrations were close to those of TP. By the oral route, the bioavailability of cortisol was complete, whereas that of TP and T was 0.10-0.20. For the same 25 mg/kg p.o. dose, plasma Cmax values of TP and T were 100 times less than those of cortisol. It is concluded that a faster rate of metabolism combined with a larger volume of distribution and a low oral bioavailability all contribute to the lack of systemic activity of TP compared with cortisol. PMID- 6492805 TI - Ultrafiltrable plasma testosterone and 5 alpha-dihydrotestosterone as measured across the human testes. AB - It has been confirmed that within the human plexus pampiniformis a venous arterial transfer of testosterone (T) (5.95%) and of dihydrotestosterone (DHT) (16.58%) occurs. It could be established that in the testicular artery the percentage of ultrafiltrable DHT was significantly lower compared with the venous compartment. It is assumed that by this means a biological recycling of the active androgen DHT into the testis is achieved. PMID- 6492806 TI - Deficiency of 5 alpha-steroid formation in guinea pig ovaries compared with immature rat and hamster ovaries. AB - Activities of 4-ene-5 alpha-reductase and the metabolism of progesterone were estimated in ovaries of guinea pigs, rats and golden hamsters. In the ovaries of 20-90-day old guinea pigs, the major C21-17-hydroxysteroids and C19-steroids formed from progesterone were 4-ene-3-ketosteroids, such as 17-hydroxy-4-pregnene 3,20-dione and 4-androstene-3,17-dione, and 5 alpha-C21-17-hydroxysteroids and 5 alpha-C19-steroids were not produced. In contrast, the major steroids formed by the ovaries of immature rats and immature hamsters were 5 alpha-steroids, such as 3 alpha, 17-dihydroxy-5 alpha-pregnan-20-one and androsterone, and no 4-ene-3 ketosteroids were found. The 5 alpha-reductase activity (nmol/g tissue/h) in the ovaries of immature hamsters was approx 150 times higher than those in the ovaries of guinea pigs of different ages. In contrast to rats and hamsters, the ovaries of immature guinea pigs do not form a significant amount of 5 alpha androgens. PMID- 6492807 TI - Ontogeny of estradiol-2-hydroxylase activity in discrete brain areas of Wistar rats. AB - Estradiol-2-hydroxylase activity was assayed radio-enzymatically in microsomes of six different brain areas of male and female Wistar rats between 22 and 77 days of age. The hypothalamus consistently showed the lowest activity and the hippocampus the highest, with the other areas falling in between. This pattern was seen in both sexes and at all the ages studied. In both sexes all six brain areas showed a steady increase in activity with increasing age. No statistically significant sexual differences in activity were observed for any area. The relatively low estradiol-2-hydroxylase activity in the hypothalamus is noteworthy since it contradicts the published evidence that this area has the highest in vitro catecholestrogen forming capacity in the brain. PMID- 6492808 TI - Delayed cutaneous hypersensitivity, lymphocyte count, and blood tests in patients with breast carcinoma. AB - General immunocompetence was examined in 125 patients with various stages of breast cancer. Tests include peripheral blood lymphocyte count, serum protein electrophoresis, quantitative immunoglobulins, CEA level, and delayed cutaneous hypersensitivity (DCH) reaction to six recall antigens (PPD, Monilia, mumps, Varidase, histoplasmin, and coccidioidin). About one third of the patients responded positively to each of the first four antigens, whereas 12% reacted to histoplasmin and 4% to coccidioidin. In this study, DCH to recall antigens had no prognostic value because the distributions of skin test reactivity were similar among patients with different stages of breast carcinoma. And among patients with similar stage of disease the relapse rates were similar for those who reacted and those who were anergic. But peripheral lymphocyte count had definite prognostic value because patients with advanced stage (group III/IV) and those who were anergic had significantly lower lymphocyte counts. Among patients with relatively early stages of breast carcinoma (group I/II), those who had higher lymphocyte count (greater than or equal to 2,000/mm3) had lower chance of having relapse up to 5 years after mastectomy. PMID- 6492809 TI - A technique for isolated hyperthermic liver perfusion. AB - Hyperthermia, either alone or combined with chemotherapy, has been shown to be effective in treating cancer. Because some investigators believe that regional hyperthermia may be more effective than whole body hyperthermia, we developed a technique to heat only the liver to 42-43 degrees for 4 hr. The procedure was adapted from a previously described animal model and was performed in four humans. Vascular isolation of the liver was accomplished by cannulating the hepatic artery, the portal vein, and the inferior vena cava followed by occluding the suprahepatic vena cava and the liver was then perfused with blood and nutrients from an oxygenated reservoir. Preliminary results show radiologic and histologic evidence of tumor necrosis or cessation of tumor growth in three of the patients. We believe this technique is safe enough for clinical experimental use and deserves further investigation. PMID- 6492810 TI - The giant apocrine hidrocystoma. AB - We report a patient with a large apocrine hidrocystoma. These tumors are almost always under 10 mm in diameter. In this 40-year-old man the tumor measured 20 mm. Apocrine hidrocystoma must be considered when evaluating a patient with a large cystic lesion of the face. Surgical management is similar to that of other benign cystic lesions of this region. PMID- 6492811 TI - The role of post-operative radiation therapy in the treatment of malignant tumors of the parotid gland. AB - Twenty-nine patients treated with postoperative radiotherapy for malignant tumors of the parotid gland were reviewed at the Joint Center for Radiation Therapy. Most patients were treated between 5,000 and 6,500 rad. All were treated because of microscopic residual disease, extra capsular extension, or tumor close to the facial nerve. The overall results showed one in-field failure, two marginal recurrences, and eight patients failed distantly. Poor prognostic factors included high-grade, extracapsular extension, and nodal involvement. We conclude that patients with malignant tumors of the parotid should be treated with postoperative radiation therapy if any of the bad prognostic signs are present. This may enable the surgeon to spare the facial nerve and obtain local control results equal to or better than more radical surgical procedures. PMID- 6492812 TI - Tissue effects of neodymium:YAG laser photoradiation of canine ureters. AB - Although the entire ureter and renal collecting system are accessible for endoscopic treatment with a neodymium:YAG, (Nd:YAG) laser, specifications for safe laser application within the ureter are not established. After various doses of Nd:YAG laser energy were delivered, the midureters of six mongrel dogs were studied to determine tissue effects. Doses which are appropriate within the bladder (35 watts X 2 seconds) resulted in perforation and urine leak from the ureters. Higher doses (60-65 watts) of short duration were tolerated without problems and nonstrictured healing ensued. Further studies are necessary before Nd:YAG laser treatment of mid-ureteral tumors is recommended. PMID- 6492813 TI - Cancer of nasopharynx in young patients. AB - From 1961 to 1980 17 patients with nasopharyngeal carcinoma who were less than 30 years old at time of diagnosis were treated at the two oncologic hospitals in Puerto Rico. Fourteen of the tumors were lymphoepitheliomas and the remaining three were anaplastic carcinomas. Ninety-four percent of the patients were found to have neck adenopathy at the initial examination and in 65% of them the adenopathy was bilateral. The 5-year actuarial survival was 14. The main cause of failure was the distant metastasis. Seventy-one percent of our patients developed distant metastasis sometime during the course of their disease. Carcinoma of the nasopharynx is uncommon in Puerto Rico as in other western countries. The post adolescent age incidence peak reported from different countries is also present among Puerto Ricans. PMID- 6492814 TI - Streptococcus bovis subacute bacterial endocarditis as a presenting symptom of occult double carcinoma of the colon. AB - A case of double carcinoma of the colon is presented in association with subacute bacterial endocarditis due to Streptococcus bovis. The presence of Streptococcus bovis septicemia is a strong pointer in favour of associated colon carcinoma even in the absence of gastrointestinal symptomatology. PMID- 6492815 TI - Long survival after ovarian and hepatic metastasis from carcinoma of the large bowel: report of a case. AB - Herein we present the case of a woman who is now 19 years post abdominoperineal resection for a Dukes' C1 rectal carcinoma, 10 years post right hemicolectomy for a Duke's C1 carcinoma of the ascending colon and removal of a solitary hepatic metastasis and now 9 years post resection of an ovarian metastasis. She had 5 fluoracil, postoperatively. This is the ninth case reported in the literature of a 5-year survivor free of disease following oophorectomy for metastatic adenocarcinoma of the large bowel. The finding of ovarian and hepatic metastases from her colorectal carcinoma would have indicated a poor prognosis. We feel that those rare patients who have an unexpected long survival should be reported for accumulation of clinical data, illustration of their clinical management, and analyses of the applied therapeutic interventions. PMID- 6492816 TI - Colocutaneous fistula complicating Tenckhoff catheter placement for intraperitoneal chemotherapy. AB - In view of the characteristic intra-abdominal spread of carcinoma of the colon and rectum [1-3], the use of intraperitoneal chemotherapy may offer an alternative to intravenous or oral drug therapy and even radiation therapy for recurrent disease [4,5]. Several investigators have demonstrated that intraperitoneal drug administration may result in portal vein levels ten to 20 times higher than those observed in peripheral venous blood samples [6]. Traditionally, intraperitoneal chemotherapy has been administered through the Tenckhoff catheter system which was originally developed for peritoneal dialysis in patients with acute or chronic renal failure [7,8]. We report a case of Tenckhoff catheter erosion into the colon with subsequent fistulization developing 20 days after intra-operative placement for intraperitoneal or "belly bath" chemotherapy; this complication occurred in a patient with locally recurrent colorectal adenocarcinoma in whom pelvic peritoneal implants without hepatic metastases were identified at reoperation. This complication of the Tenckhoff catheter system has not previously been reported in the surgical literature. PMID- 6492817 TI - Malignant neoplasm of mixed mesenchymal and neuroepithelial origin (ectomesenchymoma) of thigh. AB - A 49-year-old man had a malignant soft tissue tumor of the right thigh with metastasis to the femoral region and lower quadrant of the anterior abdominal wall on the right side and the left supraclavicular lymph nodes. The neoplasm showed features of chondrosarcoma and primitive neuroectodermal tumor (combined neuroblastoma, ependymoma, astrocytoma, and oligodendroglioma). The gliomatous part of the mixed tumor was confirmed by identification of the glial fibrillary acidic protein (GFAP). The diverse cellular population suggests a tumor origin from the ectomesenchymal remnant of the neural crest. The mesenchymal component of the neural crest would differentiate into the chondrosarcoma and the neuroectodermal component into the primitive neuroectodermal neoplasm. These various neoplastic elements, then, would form a neoplasm of mixed mesenchymal and neuroepithelial origin or an ectomesenchymoma. PMID- 6492818 TI - [Electrophysiological study of the arrhythmogenic effects of digoxin in ventricular myocardial fragments of guinea pigs stimulated at low frequency. Inhibitory action of caffeine]. AB - Arrhythmogenic effects of digoxin were studied in guinea pig ventricular myocardium driven at a low frequency, using microelectrode technique. Prolonged exposure to digoxin made two distinct phases of arrhythmias to appear: the first phase early occurred without apparent alteration in membrane diastolic potential of the impaled ventricular cells, the second phase was later initiated from oscillatory afterpotentials in diastolic potential. It is proposed that phase 1 of arrhythmias is initiated from oscillatory afterpotentials generated in Purkinje fibers more sensitive to digoxin-induced arrhythmogenic effects than myocardial cells. Phase 2 of arrhythmias would be originated in ventricular muscle fibers. Caffeine abolished oscillatory afterpotentials and suppressed sustained rhythmical activities of phases 1 and 2. The results indirectly confirm the important role of calcium movements between the myoplasm and sarcoplasmic reticulum in the origin of digoxin-induced arrhythmias triggered by oscillatory afterpotentials. PMID- 6492819 TI - [Cardiovascular effects of elliptinium. The mechanism of action]. AB - The effects of elliptinium were studied: Firstly, in the dog, in comparison with the effects of histamine, on heart rate and arterial blood pressure. Secondly, in guinea-pig isolated atria. When smaller doses were used (0.375; 0.75; 1.5 mg/kg) elliptinium only induced variations of heart rate. With the dose of 3 mg/kg hypotension and tachycardia appeared. The time-course of these effects was different from that of histamine (5 micrograms/kg): later onset and longer duration. Elliptinium was inactive in isolated guinea-pig atria, as observed in tracheal or digestive isolated smooth muscle. Thus, the cardiovascular activity of this antitumoral agent seems to implicate an indirect mechanism of action. This result is in accordance with the previous results obtained on bronchopulmonary system. PMID- 6492820 TI - [The effects of propranolol and sotalol on the electrophysiologic and enzymatic impact of myocardial ischemia induced in vitro in the guinea pig heart]. AB - Antiarrhythmic and cardioprotective effects of propranolol and sotalol were examined by studying their action on cellular electrical activity (recorded using standard microelectrode techniques) and creatine-kinase leakage (measured in the effluent from the experimental bath chamber) in the in vitro guinea-pig left ventricular myocardium exposed to conditions mimicking severe or moderate ischemia. Returning the tissue to the normal conditions was considered as equivalent to ischemic-heart reperfusion. Propranolol (2 X 4 mg/kg) was intraperitoneally administered to guinea-pigs, daily for 21 days. It was perfused in vitro (1.10(-6) M) during the whole experiments. Propranolol decreased action potential duration in control conditions (p less than 0,05), precipitated the occurrence of inexcitability during severe ischemia (p less than 0,01) and improved the recovery of cellular excitability during reperfusion. Propranolol did not significantly affect the creatine-kinase leakage during ischemia and reperfusion. PMID- 6492821 TI - An immune response profile model for immunogenicity quantitation. AB - We propose an analytical model, which can simultaneously depict many fundamental characteristics of the immunogenicity of various vaccines. This model, the Immune Response (IR) profile, conveniently expresses the mathematical relation between pre- and post-vaccination titers. A vaccine's IR profile is antigen-specific, dose-dependent and post-vaccination interval-dependent. The maximal capability for serological response to a vaccine can be determined using this model irrespective of the dose administered, the post-vaccination assay interval, or the live or killed state of the vaccine. The IR profile obtained from analysis of booster vaccine responses in a limited number of seropositive study subjects can be used to predict maximal antibody titers which are expected after vaccination and can predict the geometric mean post-vaccination antibody titer of a cohort of subjects undergoing primary immunization. Using this model, it is anticipated that the immunoregulation implied by the IR profile may also prove to be correlated with cellular subpopulations and idiotypic antibody functions. Although derived from influenza vaccines analyses, the model successfully describes immune response characteristics following natural infection with malaria and following diphtheria and rubella vaccine administration. PMID- 6492822 TI - The time of a conscious sensory experience and mind-brain theories. AB - Libet et al. and Popper & Eccles have the view that some single hypothesis about the time of a conscious sensory experience has certain consequences for various mind-brain theories. The view involves a fundamental inconsistency, which may cast doubt on experimental findings, and two hypotheses rather than one. The preferable hypothesis is doubtful. The preferable hypothesis has been thought to have mind-brain consequences principally because it has not been distinguished from a different hypothesis. The preferable hypothesis in fact does not have the supposed mind-brain consequences. The different hypothesis, which in fact does have the given consequences, is entirely unacceptable. PMID- 6492823 TI - A comment on "some aspects of the role of quantum mechanics in the theory of muscle contraction". PMID- 6492824 TI - Stasis: a coevolutionary model. AB - Traditional neo-Darwinian explanations for stasis involve limited variation, developmental constraints and stabilizing selection. Of these, stabilizing selection is regarded as the mechanism operating most widely. Arguments based on stabilizing selection, however, implicitly assume a one-way evolutionary relationship between organism and environment. In this paper, I suggest that stasis may arise in a number of different ways as a result of organism/environment coevolution. The chief causes of stasis may be the attainment of coadapted equilibria between organism and environment and periods of quiescence within and between arms races. I also suggest that many cases of stasis in the fossil records may be apparent rather than real due to a reliance on gross morphological trends and that apparently large environmental changes during which stasis persists may not reflect change in the coadapted components of the organisms' environment. PMID- 6492825 TI - The physico-chemical mechanism of mediated transport. II. Osmotic and isosmotic volume flow. AB - The process of volume change of cells subject to osmotic shocks or isosmotic entrance of permeant solute is formulated on the basis of the accepted structure for the plasma membrane and a physico-chemical approach similar to that recently developed. The effect of relevant parameters is discussed and theoretical equilibrium values for the variables are calculated in connection with water and permeant solute permeability determinations. Although a sorption-diffusional mechanism for solute and/or water volume flow within the membrane is assumed in both cases, the kinetics of volume change is shown to be totally different between them. In the isosmotic process a fixed relationship, given by the total solute concentration, is shown to exist between the permeant solute and volume fluxes to the cell, thereby implying a definite value for the volume fraction of water in the migration pathway, higher than 90%. The bi-phase osmotic regulatory response caused by permeant solute is simulated on the basis of an osmotic and isosmotic processes in series, showing good agreement with general behavior. Finally, an explanation to the problem of volume flow and forces in connection with a diffusional mechanism in biological and artificial membranes, is presented. PMID- 6492826 TI - The discrepancy between in vivo and in vitro experiments with polycyclic aromatic hydrocarbon(PAH) carcinogens: a hypothetical explanation. AB - The hypothesis suggested in this paper is an attempt to explain a discrepancy between in vivo and in vitro polycyclic aromatic hydrocarbons (PAH) carcinogenesis experiments, described frequently in the literature. Whereas, in pretreated animals, a higher level of induced PAH-metabolizing enzymes reduces PAH-carcinogenicity, in the tissues or homogenates from pretreated animals the induced PAH-metabolizing enzymes increase the carcinogenic effects of PAH. In our model, both the pretreatment or route of administration should cause a frameshift in the alternation of active and inactive metabolites in the compartments. In pretreated animals the carcinogenicity of PAH administered per os is reduced, because the PAH metabolism is completed to tetrol, the ultimate inactive metabolite, before it reaches the target tissue. The hypothesis explains the discrepancy and makes predictions which can be tested experimentally. PMID- 6492827 TI - A simple method for the calculation of low energy packings of alpha-helices--a threshold approximation. I. The use of the method to estimate the effects of amino acid substitutions, deletions and insertions in globins. AB - A simple method is developed for computing low energy packings in alpha-helical proteins. This method is based on a simplified representation of a protein molecule in which the backbone of the alpha-helix is represented by a cylinder and the side chains of the amino acids by hard spheres. The energy function includes hydrophobic, electrostatic and Van der Waals' interactions. This method is used to compute low energy packings of an assembly of the alpha-helices of a globin molecule. The effect of mutations, deletions and insertions of a single amino acid resulting in drastic distortion of the spatial structure of sperm whale myoglobin was studied. The results demonstrated that these events can produce a breakdown of the spatial structure of the protein molecule. PMID- 6492828 TI - A model for the establishment of pattern by positional differentiation with memory. AB - A new model for the establishment of a pattern in a developing organism by means of positional differentiation is proposed. The model is capable of regenerating pattern in an amputated organism. The model uses a short range inductor and a long range inhibitor as signal carriers, as in many earlier works, but the following properties are different from previous (explicit) models: the processes of establishment of chemical and differentiated patterns proceed simultaneously; memory is included; there is no direct interaction between morphogens. Formulation of the model is in terms of linear differential equations, which are ordinary in the one dimensional case. Application to the slime mold Dictyostelium discoideum is discussed. PMID- 6492829 TI - Quantitative genetics and developmental constraints on evolution by selection. AB - It has often been argued that the principles of random mutation and selection are insufficient to account for macroevolutionary phenomena, such as the origin of morphological novelty and directionality in evolution. A third, epigenetic, principle is said to be required and this principle is thought not to be included in microevolutionary theory. The third principle has most recently been identified as internal selection and/or non-random phenotypic effects of mutation. It is shown that the genetic variance/covariance matrix of quantitative genetic theory measures developmental constraints due to internal selection and non-random mutation. The genetic variance/covariance matrix causes the response to selection to deviate from the optimal rate and direction as specified by the selection gradient, which measures direct selection on the phenotypes. Therefore, microevolutionary theory takes account of developmental constraints on evolution by natural selection through the genetic variance/covariance matrix. Theories for predicting the pattern of genetic variance and covariance from stabilizing selection and the phenotypic effects of mutation are discussed. PMID- 6492830 TI - The directionality of the frog ear described by a mechanical model. AB - The frog ear can be modelled as two coupled eardrums with an additional sound pathway through the mouth cavity. In a previous version of this model, with realistic parameters, we were able to account very well for empirical measurements of the eardrum vibration under free- and closed-field acoustic conditions. This earlier model does not, however, adequately predict the directional characteristics of the frog ear as determined empirically. In this paper we present a modified model which will account for the directionality together with the free- and closed-field frequency responses, and which is also consistent with anatomical considerations. PMID- 6492831 TI - The concept of plants as teachers among four mestizo shamans of Iquitos, northeastern Peru. AB - In the city of Iquitos and its vicinity there is even today a rich tradition of folk medicine. Practitioners, some of whom qualify as shamans, make an important contribution to the psychosomatic health of the inhabitants of this area. Among them there are those called vegetalistas or plant specialists and who use a series of plants called doctores or plant teachers. It is their belief that if they fulfill certain conditions of isolation and follow a prescribed diet, these plants are able to "teach" them how to diagnose and cure illnesses, how to perform other shamanic tasks, usually through magic melodies or icaros, and how to use medicinal plants. Four shamans were questioned about the nature and identity of these magic plants, what are the dietary prescriptions to be followed, how the transmission of shamanic power takes place, the nature of their helping spirits, and the function of the magic melodies or icaros given to them by the plant teachers. PMID- 6492832 TI - Phytochemical screening of Tanzanian medicinal plants. I. AB - To evaluate traditional medicine, which is an important part of the health-care system in Tanzania, three different regions, Coast, Morogoro and Kilimanjaro were surveyed for the herbs used by traditional healers. For each species, the botanical name, vernacular name, collection number and medical uses are given. Phytochemical screening of the 52 plant samples collected representing 49 species, 42 genera and 28 families was carried out. The analyses indicated that 94% plant samples contained steroids/triterpenoids, 50% saponins, 40% carotenoids and 17% alkaloids. PMID- 6492833 TI - Medicinal plants used in a Totonac community of the Sierra Norte de Puebla: Tuzamapan de Galeana, Puebla, Mexico. AB - Totonac Indians, like other aboriginal peoples, use many plants, animals and minerals in treating illness. We collected our information among mountain dwelling Totonacs (totonacos de la Sierra). These Totonacs from the mountain areas are only beginning to be studied from an ethnobotanical viewpoint. Here we report on their herbal remedies and briefly discuss their traditional medicine. Finally, the role of Western medicine in Totonac life is analyzed. PMID- 6492834 TI - Oral hypoglycaemic activity of some medicinal plants of Sri Lanka. AB - Investigations were carried out to evaluate the oral hypoglycaemic activity of some Sri Lankan medicinal plants. Approximately 40 plants available locally are reputed to have oral hypoglycaemic activity. Of these, the mostly widely used are (a) Salacia reticulata (Celastraceae) (b) Aegle marmelos (Rutaceae) and (c) Momordica charantia (Cucurbitaceae). Aqueous decoctions of these plants were investigated for their ability to lower the fasting blood glucose level and improve the glucose tolerance in laboratory animals. The results indicate that the aqueous decoctions of all three plants possess significant hypoglycaemic effect. The magnitude of this effect showed time related variation with the three plants. The highest oral hypoglycaemic activity and the maximum improvement of the oral glucose tolerance were associated with the extract of Momordica charantia while the least but significant effects were shown by Salacia reticulata. PMID- 6492836 TI - Perioperative blood transfusion adversely affects prognosis after resection of Stage I (subset N0) non-oat cell lung cancer. AB - Recent studies suggest that pretransplant blood transfusions prolong kidney graft survival by nonspecific immune suppression. Since immune suppression in patients with cancer is associated with early recurrence and poor prognosis, we studied the relationship of perioperative blood transfusion to recurrence of Stage I (subset N0) lung cancer. Technique-related variables were minimized by limiting the study to one surgeon (P. A. K.). Life-table and Cox proportional hazards analysis of age, sex, tumor size, histopathology, admission and discharge hematocrit values, estimated operative blood loss, duration of operation, extent of resection, anesthetic agents, and blood transfusion revealed two statistically significant prognostic factors: extent of resection (p = 0.0056) and use or non use of transfusions (p = 0.0283). The cumulative 5 year disease-free survival rate of the 15 patients undergoing pneumonectomy was 42% compared to 75% for 150 patients undergoing lobectomy and lesser procedures. Transfused patients had lower disease-free rates within 5 years than nontransfused patients (62% versus 76%, p = 0.0132). Survival advantage was also noted in nontransfused patients after deleting patients subjected to pneumonectomy. These results indicate that perioperative transfusion in patients with lung cancer undergoing resection accelerates the appearance of recurrent or metastatic cancer. This supports the findings of previous studies of breast and colon cancer that blood transfusion is detrimental to the patient with cancer. PMID- 6492835 TI - Screening for biological activity of different plant parts of Tabernaemontana dichotoma, known as divi kaduru in Sri Lanka. PMID- 6492837 TI - Primary myocardial revascularization. Trends in surgical mortality. AB - From 1970 to 1982, 24,672 patients underwent primary isolated myocardial revascularization: Group I, 4,517 patients operated upon from 1970 to 1973; Group II, 6,181 patients from 1974 to 1976; Group III, 6,869 patients from 1977 to 1979; and Group IV, 7,105 patients from 1980 to 1982. Operative mortality was 1.2% for the entire experience and 1.2%, 1.4%, 1.6%, and 0.8% for Groups I to IV, respectively. Mortality for Group IV was significantly lower (p less than 0.001). In decreasing order of significance, the risk factors were emergency operation, congestive heart failure, left main disease, female gender, history of congestive heart failure, advancing age, normothermic arrest, number of grafts, poor ventricular function, and incomplete revascularization. The same analysis of Groups I to IV demonstrated that advanced age, emergency operation, female gender, and congestive heart failure persisted as risk factors while incomplete revascularization and abnormal electrocardiogram emerged as new risk factors. Cardiac causes accounted for 203 (66.2%) patient deaths. This gradually decreased from 75.3% in Group II to 58.5% in Group IV. Neurological deficit was the second most frequent cause of death, 29 (9.6%), reaching a high in Group IV (18.9%). We conclude that (1) morbidity and mortality have decreased significantly despite increasing risk factors; (2) congestive heart failure has replaced emergency operation as the principal risk factor; (3) left main disease, number of grafts, and poor ventricular function have been neutralized as risk factors; and (4) cardiac causes of death are decreasing and being replaced by other system failure. PMID- 6492838 TI - Early and late risk of aortic valve replacement. A 12 year concomitant comparison of the porcine bioprosthetic and tilting disc prosthetic aortic valves. AB - Aortic valve replacement was performed in 912 consecutive patients from January, 1972, to January, 1983. The 616 male and 296 female patients, whose ages ranged from 16 to 95 years (mean 60.6 years and median 63 years), received 663 bioprosthetic valves and 249 tilting disc valves. A higher incidence of Functional Class IV heart disease and ascending aortic aneurysms was noted in the group receiving the tilting disc valve. Six hundred fifty-seven patients had primarily aortic stenosis and 255 had primarily aortic regurgitation. Associated procedures were done in 308 patients (33%): 233 had coronary bypass grafting, 46 had replacement of ascending aortic aneurysms, and 29 had miscellaneous procedures. The overall operative mortality was 6.4% (59/912). The operative mortality was 4.5% (29/640) for isolated aortic valve replacement, 4.2% (21/233) for valve replacement plus coronary bypass, and 17% (8/46) for valve replacement plus replacement of an ascending aortic aneurysm. The mortality was 4.2% (20/663) for the group receiving bioprostheses and 12.4% (31/249) for those receiving tilting disc valves. The operative mortality for 1983 for all aortic valve replacement procedures was 2.1%; for isolated valve replacement, 1%; for valve replacement plus coronary bypass, 4.4%; and for valve replacement plus aortic aneurysm replacement, 0%. The long-term follow-up was analyzed as of Jan. 1, 1984, so that there was a minimum follow-up of 12 months (mean 55 months and median 51 months). The actuarial survival rate at 108 months for all patients was 67% +/- 2%; for valve replacement alone, 71% +/- 3%; for valve replacement plus coronary bypass, 58% +/- 7%; for valve replacement plus ascending aortic aneurysm replacement, 45% +/- 10%; for aortic stenosis, 70% +/- 3%; for aortic regurgitation, 61% +/- 4%; for Functional Classes I to III, 77% +/- 3%; for Class IV, 53% +/- 4%; for age less than 63 years, 75% +/- 3%; and for age greater than 63 years, 57% +/- 4%. At 108 months, the probability of freedom from thromboembolism was 85% +/- 3% after bioprosthetic valve replacement and 83% +/- 3% after replacement with a tilting disc valve (p = NS). The probability of freedom from hemorrhage at 108 months was 98.6% +/- 7% for the bioprosthetic valve group and 89% +/- 2% for the tilting disc valve group (p less than 0.001). The valve thrombosis rate was 0.34% per patient-year for the tilting disc valves and 0.07% per patient-year for the bioprostheses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6492839 TI - The St. Jude Medical bileaflet valve prosthesis. A 5 year experience. AB - A 5 year experience with the bileaflet St. Jude Medical valve is reported. Between March, 1978, and June, 1982, 198 patients received 233 such valves (90 mitral, 73 aortic, and 35 double mitral-aortic valve replacements). Total follow up was 4,896 patient-months; survivors were followed up for 1 to 5 years (mean 35 months). Early (30 day) mortality was 6.6% overall and 11.1% after mitral, 2.7% after aortic, and 2.9% after double valve replacement. Total late mortality was 15.2%; the actuarial survival rate at 4 years was 67% after mitral, 79% after aortic, and 79% after double valve replacement. Ischemic mitral valve disease was associated with an early mortality of 26.7% and a 4 year survival rate of 34%; without this high-risk subset, early mortality was 3.3% and the 4 year survival rate was 77% after mitral valve replacement. A multivariate logistic regression model identified three preoperative patient characteristics associated with increased postoperative mortality: ischemic mitral valve disease (p less than 0.001), a depressed left ventricular ejection fraction (less than 55%; p less than 0.05), and advanced New York Heart Association class (IV; p less than 0.05). Valve-related complications occurred in 14 patients (3.4% per patient-year). There were no instances of primary structural failure or hemolysis. Thromboembolism (nine patients, 2.2% per patient-year) occurred more frequently after double (3.7% per patient-year) or mitral valve replacement (2.3% per patient-year) than after aortic valve replacement (1.3% per patient-year) and more frequently in 12 patients receiving aspirin and dipyridamole (6.5% per patient-year) than in 173 patients receiving warfarin (1.9% per patient-year). No thromboembolic event was fatal. Reoperation was necessary because of one valve thrombosis, one valve erosion, and two perivalvular leaks due to endocarditis; three of the four patients survived reoperation (one valve-related death, 0.5%). Of 154 patients alive at latest follow-up, 85% were in New York Heart Association Class I or II, and 90% had improved by at least one class. This intermediate experience with the St. Jude Medical valve indicates that, in addition to its previously demonstrated excellent hemodynamic performance, there have been no instances of primary structural failure or hemolysis. Warfarin anticoagulation is recommended in all patients. PMID- 6492841 TI - Long-term follow-up of the Ionescu-Shiley mitral pericardial xenograft. AB - In a group of 40 patients discharged from the hospital after mitral valve replacement with an Ionescu-Shiley pericardial xenograft from January, 1977, to December, 1980, seven instances of valve failure occurred. This unprecedented incidence of bioprosthetic dysfunction after mitral valve replacement with the Ionescu-Shiley pericardial xenograft led us to update the follow-up of our patients receiving this valve in the mitral position. The results of our survey showed, at 6 years postoperatively, an actuarial survival rate of 72%, an actuarial probability of being free from emboli of 62%, and an actuarial freedom from prosthetic failure of 60%. The explanted valves showed complete absence of the neoendothelial lining of the Dacron-covered frame and lesions resembling those observed in Ionescu-Shiley pericardial xenografts removed from our fatigue test system after a mean of 29 +/- 17 X 10(6) cycles. This similarity prompted a classification of tears occurring in the mitral Ionescu-Shiley pericardial xenograft, which is of extreme importance, since the clinical presentation and outcome of patients with a failing valve differs according to the type of rupture. The lesions of the cusp observed in clinical specimens were possibly related to the continuous trauma of the tissue against the bare Dacron cloth during closure of the valve. It is concluded that (1) actual durability and thrombogenicity of the Ionescu-Shiley pericardial xenograft in the mitral position needs to be carefully reassessed, (2) close follow-up of such patients by clinical and two-dimensional echocardiographic evaluation is advisable after the third postoperative year, and (3) failure of the mitral Ionescu-Shiley pericardial xenograft may occur suddenly, and awareness of this complication is the clue to prompt recognition and treatment of such patients. PMID- 6492840 TI - Mitral valve replacement for mitral regurgitation with and without preservation of chordae tendineae. AB - Left ventricular function was compared in 15 patients who had conventional mitral valve replacement (Group 1) and 12 patients who had replacement with preservation of chordae tendineae and papillary muscles (Group 2) for isolated chronic mitral regurgitation. Function was assessed by radionuclide ventriculography. The two groups were similar in terms of age, preoperative functional class, valve pathology, and preoperative left ventricular function. There was uniform intraoperative and postoperative management by a single surgeon. All patients received porcine bioprostheses. Left ventricular function was assessed 1 day before and 3 to 6 months after the operation. Left ventricular ejection fraction decreased from 0.55 +/- 0.09 to 0.48 +/- 0.14 in Group 1 (p less than 0.01) and did not change significantly in Group 2 (from 0.53 +/- 0.14 to 0.52 +/- 0.16). Left ventricular end-diastolic volume, end-systolic volume, and stroke volume indices decreased significantly in both groups. During maximal postoperative bicycle exercise with the patient supine, left ventricular ejection fraction and stroke volume index increased significantly in Group 2 only. Cardiac output increased in both groups during exercise, but this increase was due to increased heart rate in Group 1 and to increased heart rate and stroke volume in Group 2. These findings suggest that preservation of chordae tendineae and papillary muscles during mitral valve replacement for chronic mitral regurgitation has a beneficial effect on postoperative left ventricular function. PMID- 6492842 TI - Surgical management in interrupted aortic arch and atrioventricular canal. AB - This report concerns the management of two infants born with a combination of interrupted aortic arch with atrioventricular canal and possible left ventricular hypoplasia. Staged management including initial reconstruction of the aortic arch followed by partial intracardiac correction and, finally, closure of intentionally created atrial septal defects was successful. PMID- 6492843 TI - Modified Blalock-Taussig shunt in newborn infants. AB - The modified Blalock-Taussig shunt, interposing an expanded polytetrafluoroethylene graft between the subclavian and pulmonary arteries, was performed in 30 neonates with a mean age of 8.8 days and a mean weight of 3.14 kg. Underlying lesions included severe tetralogy of Fallot or its variant (N = 10), transposition complex (with pulmonary stenosis or atresia) (N = 6), single ventricle equivalents (with pulmonary atresia or stenosis) (N = 9), and pulmonary atresia with intact ventricular septum (N = 5). The mean preoperative arterial oxygen tension prior to prostaglandin E1 therapy was 29.5 torr. The shunt was performed through a right thoracotomy in 18 patients, through a left thoracotomy in nine, and through a median sternotomy in three. A 5 mm graft was used in 21 patients and a 6 mm graft in nine patients. The mean postoperative arterial oxygen tension was 64.1 torr (p less than 0.001). The incidence of early shunt occlusion was 3.3% and the hospital mortality was 3.3%. Actuarial functional life of the shunt (no death or reoperation related to shunt failure) was 91% at 3 years' follow-up. Nine patients were recatheterized. There was no distortion of the pulmonary artery. The ratios of the diameter of the right pulmonary artery and pulmonary valve anulus to that of the descending aorta increased after the operation by 50% (p less than 0.001) and 52% (p less than 0.05), respectively. Our experience indicates that the modified Blalock-Taussig shunt has an excellent function, offers several technical advantages, and lacks most of the drawbacks of other systemic-pulmonary artery shunts. It may be the shunt of choice in patients less than 1 month of age. PMID- 6492845 TI - The risk of thromboembolism following valvular operations: how does one know? AB - The adequacy of published reports for providing valid information on the risk of thromboembolism after valvular heart operations is questioned, and this concern is supported by a review of recently published reports of the late results of such operations. None of the 51 reports sampled was considered completely adequate. The average rating for the reports, on a scale of 0 to 17, was only 7.6. Investigations will need to be improved in the future if this extremely important consideration in choosing the correct procedure for managing valvular heart disease is to be properly addressed. PMID- 6492844 TI - Transaortic closure of ventricular septal defect in atrioventricular discordance with pulmonary stenosis or atresia. Results in five patients. AB - In five patients (aged 5 to 11 years) with atrioventricular discordance, pulmonary stenosis or atresia, and origin of the aorta from the right ventricle, transaortic closure of the ventricular septal defect was performed. Double-outlet right ventricle was confirmed in four patients. All patients underwent placement of an extracardiac valved conduit from the anatomic left ventricle to the pulmonary artery. Neither operative death nor postoperative complete heart block resulted. Postoperative follow-up periods were from 3 months to 4 years (average 35 months), and one patient who had no evidence of complete heart block died suddenly 2 years postoperatively. Aortic regurgitation developed in two patients from possible trauma during the operation: Regurgitation was mild (causing symptoms) in one patient who had had poor surgical exposure with a subpulmonic ventricular septal defect and a well-developed subaortic conus; it was trivial (asymptomatic) in the other patient. Transaortic ventricular septal defect closure, suturing a patch on the anatomic left ventricular side in patients with atrioventricular discordance and double-outlet right ventricle or similar anomalies, might help to avoid postoperative complete heart block if the aorta is large and the subaortic conus is not well developed. PMID- 6492846 TI - Strut fracture of the Bjork-Shiley aortic valve. AB - The following case report describes a fatal complication of a convexo-concave Bjork-Shiley prosthetic valve in the aortic position (60 degree orifice opening). PMID- 6492847 TI - Preparation of pulmonary artery banding tapes. PMID- 6492849 TI - Brain damage in profound hypothermia. PMID- 6492848 TI - Skeletal muscle graft for myocardial repair. PMID- 6492850 TI - Late results of coronary artery grafting: is there a flag on the field? PMID- 6492851 TI - Current management of carcinoma of the lung. AB - Fifty years of surgical management of carcinoma of the lung has been associated with much enthusiasm in a search for improvement in survival rate. Preoperative evaluation (including node sampling), subsequent staging, responsible resection, and avoidance of serious postoperative complications have all led to an increasingly objective system of management. Unfortunately, this has not been associated with a marked improvement in overall rate of survival following pulmonary resection. PMID- 6492852 TI - The rediscovery of host defense enhancement. AB - The innate limitations of sterile technique, vaccines, and antibiotics apparent in host defense enhancement provide fertile ground for the study of other concepts. The goals of this new research are to avoid infection or facilitate recovery in the surgical setting and to develop new, safe, and efficient host defense stimulants. Current laboratory work with surgically simulated infection suggests that nonspecific host defense enhancement may offer genuine improvement in selected clinical situations. PMID- 6492853 TI - Surgical reconstruction of the outflow portions of the right and left ventricles. PMID- 6492854 TI - Immunological characterization of the leukemic megakaryocytic line at light and electron microscopic levels. AB - Twenty cases of leukemia involving platelet precursors have been identified by a panel of monoclonal and polyclonal antiplatelet antibodies and by the ultrastructural demonstration of platelet peroxidase (PPO). The two techniques were in close agreement both for identification and for the quantitation of the blast cells except in three cases where PPO was present in the absence of the immunological markers. The immunological appearance of the leukemic megakaryocytic precursors was identical to that of their normal counterparts; the cells were positive with J 15 (anti GP IIb-IIIa complex), C 17 (anti GP IIIa), J 2 (anti GP 26,000) AN 51 (anti GP Ib). A diffuse cytoplasmic labelling was observed with anti factor VIII vwF and anti platelet factor 4 (PF 4). In addition, the leukemic maturation was quite similar to normal megakaryocyte differentiation since in micromegakaryocytes the expression of Gp Ib was strong and an intense granular pattern of labelling with anti factor VIII vwF and anti PF 4 was observed. In no case was the leukemic megakaryocytic series labelled by anti-erythroid antibodies, anti myeloid antibodies or J 5, B 1, OKT 11 antibodies. Using ultrastructural immunoferritin with J 15 it was possible to demonstrate that labelling with this antibody only occurred on PPO-positive cells. Immunogold or peroxidase labelling with AN 51 at the EM level in cases of mixed leukemia showed that Gp Ib was absent from proerythroblasts and myeloblasts. Therefore, in no case were specific platelet markers expressed in the leukemias of other cell lineages. PMID- 6492855 TI - Enrichment of high proliferation potential colony forming cells from mouse marrow by selecting low-density cells expressing receptors for wheat germ agglutinin. AB - Suspensions enriched for high proliferation potential colony forming cells (HPP CFC's) were prepared from mouse marrow by selecting low-density cells stained with fluoresceinated wheat germ agglutinin on a fluorescence activated cell sorter. HPP-CFC's were 12-fold more concentrated in the final suspensions and co enriched with a population of primitive CFUs detected in the spleens of irradiated mice reconstituted 13 days earlier with marrow. This is consistent with previous observations suggesting that these populations are closely related. The degree of enrichment for other haemopoietic progenitors was in the order HPP CFC greater than day 8 CFUs greater than BFUe greater than GM-CFC greater than CFUe. "Extra" colonies developed when human placental conditioned medium (HPCM) was added to cultures of enriched suspensions already containing pregnant mouse uterus extract (PMUE). HPP-CFC's probably formed most of these and we discuss why counting these extra colonies may be more reliable than the conventional "size" assay for HPP-CFC's. PMID- 6492856 TI - PHA-ICC, ADCC and NK in patients with ANLL in CR: human fibroblastic interferon fails to increase NK-active cell frequency. AB - PHA-ICC, ADCC and NK activity of PBL were studied in ten patients with ANLL in CR and in eighteen normal controls in the presence and absence of HFIF. No statistically significant differences were recorded among the two groups with regard to basic lymphocyte functions. Although the parameters of lymphocyte function remained analogous for those tested, the analysis at the single cell level revealed that HFIF stimulation increases the number of NK active cells and target binding cells among normals, but not in leukemic patients. PMID- 6492857 TI - Chronic lymphocytic leukaemia presenting as a blast cell crisis. AB - A man presented with a short history suggestive of anaemia and thrombocytopenia. Haematological investigations showed him to have an absolute peripheral lymphocytosis and the bone marrow was almost totally replaced by lymphoid blasts. A lymph node biopsy was interpreted as showing immunoblastic lymphoma supervening on chronic lymphocytic leukaemia. Cell surface marker studies performed on cells from peripheral blood and the excised lymph node demonstrated that the lymphocytes and blast cells carried the same surface monoclonal immunoglobulin and expressed OKT1/Leu I positivity. He was treated with a cytotoxic regimen for adult acute lymphoblastic leukaemia but did not respond. This appears to be the first report of a patient with chronic lymphocytic leukaemia who presented at the time of immunoblastic crisis. PMID- 6492858 TI - A simplified method for computerized densitometry of complex shapes in 2 deoxyglucose autoradiographs. AB - A simple, computerized densitometer is described which can be used to measure densities of photographic prints by means of a fiber-optic reflectance densitometric probe coupled to the movable cursor of a digitizing tablet. The cursor, with its attached probe, is moved by hand along a scan trajectory determined by the operator. In its configuration for use with 2-deoxyglucose autoradiographs, the histological section from which the autoradiograph was derived provides architectonic landmarks for guiding the path of the scan. The X, Y and density values taken along a scan line are sequentially stored in the computer memory. Algorithms are presented for plotting densities along unfolded scan lines within layers of structures with complicated shapes, for normalizing non-linearities introduced during photographic processing, for standardizing the data sets with reference to the density of average gray matter in different animals, for calculating total integrated density within defined boundaries along the scan line, for generating averages of multiple scans, and for stacking sequential scans to form pseudo-3-dimensional plots. This system allows densitometric measures to be made from autoradiographs in anatomically defined regions, thereby permitting precise correlation between isotope concentration and histological structure. PMID- 6492859 TI - An electronic device for accurate quantification of neuronal mass activity based on a digital integration method. AB - Quantification of different kinds of neuronal mass activity was performed using an integrative method. For this purpose an electronic device was designed and constructed which is based on a fully digital approach. High precision of the method and an easy way to interface with a digital computer are the advantages of this strategy when compared to other techniques. Performance of quantification and the possibility of the universal use of the device are demonstrated by two examples. (1) Quantitative analysis of whole nerve bundle activity is demonstrated in the case of phrenic nerve mass activity. (2) The usefulness of the digital integrator is further verified in quantification of theta waves of the human EEG as a rather different field of application. In addition, the device is valuable as a tool for the analysis of EMGs. The described digital integrator has many advantages compared to conventional analog integrators, such as autorange feature, very high dynamic range, excellent long-term stability, in principle unlimited integration times and interface capability to a digital computer; it avoids all problems associated with the application of high impedance integrator operational amplifiers. PMID- 6492860 TI - A simple electronic unit allowing extracellular recording and stimulation through the same wire hook or suction electrode. AB - A simple and easily constructed unit was designed using a buffer amplifier, a programmable transconductance amplifier and an active filter. The unit allows extracellular recording and stimulation through the same electrode. Thus in experiments where it is required to stimulate a nerve and record the effects of the stimulation from the same nerve, the stimulating and the recording electrodes can be combined in one. PMID- 6492861 TI - A simple method for the construction of electrode arrays. AB - A simple method is described for the construction of electrode arrays consisting of insulated metal wires (33 microns diameter) spaced at small, equal distances (0.1 mm). No specialized instrumentation and techniques are needed, as only simple mechanical tools are sufficient. The electrode arrays are used for field potential recording from in vitro brain slice preparations. PMID- 6492862 TI - A technique for microiontophoretic study of single neurons in the freely moving rat. AB - An adaptation of a miniature microdrive allows unit recording and microiontophoresis in freely moving rats. Multibarrel glass micropipets are inserted into the detachable microdrive daily, and advanced manually into superficial or deep brain structures. The demonstration of stability in recording neuronal responses to iontophoretically applied drugs suggests that this technique will be useful in studying drug actions on single neurons across a wide range of conscious behaviors. PMID- 6492863 TI - Continuous measurement of pentylenetetrazol concentration by a liquid ion exchanger microelectrode. AB - A double-barrelled microelectrode is described, which permits the continuous measurement of the concentration of the epileptogenic agent pentylenetetrazol (PTZ). The electrode is based on the liquid potassium exchanger (Corning No. 477 317) and enables measurements of PTZ concentration in physiological salines down to 1 mM. The electromotive behaviour of the liquid membrane against PTZ cannot directly be described by the Nicolsky-Eisenman formalism. It is suggested that specific interactions of the PTZ molecule with the Corning ligand are involved in the potential generating mechanisms. PMID- 6492865 TI - Culturing spinal cord explants in a collagen gel. AB - A new method for culturing spinal cord slices or explants is presented which entails the use of a commercially available purified collagen, Vitrogen. Vitrogen provides a stable three-dimensional matrix for culturing spinal cord explants which is superior to the conventional method of applying explants to moist dishes coated with rat tail collagen. The use of Vitrogen facilitated the culturing of spinal cord explants which remain viable for over 2 1/2 weeks in culture, in addition to enhancing neuritic growth. PMID- 6492864 TI - A He-Ne laser position-detector for recording jaw movements: principle of operation and application in animal experiments. AB - A new equipment for recording jaw movements in animals by use of a He-Ne laser and a phototransistor (PhT) array is described. The principle of operation of this equipment is that the beam angle of the He-Ne laser is continuously controlled to irradiate the center of the PhT array by a feedback mechanism composed of a microcomputer (CPU) and XY scanners. The driving currents sent from the CPU to the XY scanners are utilized for monitoring two-dimensional jaw movements. The linearity of this recording system is preserved both vertically and horizontally over a range of 11 mm from the center of the scanning field of the laser beam within less than 1.5%, which is satisfactory for monitoring rabbit jaw movements. When this equipment was applied to the rabbit, there was no sign of disturbance to the animal during chewing carrots. PMID- 6492866 TI - On the calculation of surface areas of objects reconstructed from serial sections. AB - This paper concerns certain aspects of the calculation of the surface area of objects reconstructed from serial sections. The main points discussed are (1) the relative importance of the number of sections compared to the number of segments taken around the contour in each section; and (2) the fact that the error in the estimated surface area may actually become worse as the number of sections increases. The number of sections should be made large enough to reproduce the three-dimensional shape of the object, but not too much larger; the number of segments around the contours should then be made large enough that the segment size is similar to or smaller than the section thickness. PMID- 6492867 TI - Pulmonary alveolar proteinosis: prospective clinical experience in 23 patients for 15 years. PMID- 6492868 TI - Ciliated cell differentiation in regenerating rat tracheal epithelium. PMID- 6492869 TI - Passive transfer of arthritis to mice by injection of human anti-type II collagen antibody. AB - The serum IgG fraction from a patient with seronegative rheumatoid-like arthritis which contained a high anti-type II collagen antibody titer was injected intravenously into mice susceptible to type II collagen-induced arthritis. A mild, transient, inflammatory arthritis was observed in 20 to 25% of the animals, whereas histologic signs of disease were evident in most of the injected mice. Purified human anti-type II collagen immunoglobulin injected into the knee joints of mice was also shown to induce a transient, inflammatory arthritis. Radiolabeled human anti-type II collagen IgG was shown to accumulate in the peripheral joints of mice, and the specificity of the antibody was shown to be similar to the specificity of anticollagen antibody eluted from the joints of mice with collagen-induced arthritis. PMID- 6492870 TI - Continuous-wave Doppler determination of the pressure gradient across pulmonary artery bands: hemodynamic correlation in 20 patients. AB - The feasibility and accuracy of continuous-wave Doppler echocardiography in measuring pressure gradients across the pulmonary artery band were assessed. Simultaneous continuous-wave Doppler and catheter pressure measurements were prospectively performed in 20 patients with complex congenital heart disease and prior pulmonary artery banding. In two other patients, adequate Doppler signals could not be obtained. Doppler velocity was converted to pressure gradient by using the modified Bernoulli equation. Simultaneous continuous-wave Doppler spectral envelopes and catheter pressure wave forms were digitized at 10-ms intervals to obtain maximal instantaneous, mean, and peak-to-peak pressure gradients. The maximal Doppler gradient ranged from 23 to 154 mm Hg, and the simultaneous maximal catheter pressure gradient ranged from 34 to 168 mm Hg. The correlation (r) between these two measurements had a coefficient of 0.98 and a standard error of the estimate (SEE) of 7 mm Hg. The peak-to-peak systolic gradient ranged from 17 to 156 mm Hg and correlated with the maximal Doppler gradient (r = 0.95; SEE = 11 mm Hg). The mean Doppler and mean catheter pressure gradients also were correlated (r = 0.93; SEE = 9 mm Hg). As Doppler echocardiography measures instantaneous velocity and therefore instantaneous pressure gradient, the more precise correlation was between Doppler gradient and maximal instantaneous catheter gradient rather than peak-to-peak systolic gradient. Continuous-wave Doppler echocardiography is an accurate noninvasive technique for measurement of pressure gradients across pulmonary artery bands. In combination with clinical evaluation and two-dimensional echocardiography, it should substantially aid clinical decision making. PMID- 6492871 TI - HemoQuant test for occult blood: the Sherlock Holmes test? PMID- 6492872 TI - Hospitalization in dialysis patients. AB - During 1981, 946 patients with advanced renal failure who were maintained by dialysis were studied to assess the frequency and the duration of hospitalizations and to identify complications that prompted hospitalization. Five hundred fifty-eight patients (59%) were hospitalized for a total of 1,207 times (mean of 1.8 stays/yr and 15 days/yr at risk for the entire group). The major reasons for hospitalization were dialysis access problems (25%), gastrointestinal complications (13%), and cardiac complications (13%). Both the rate of stays/yr and the rate of days/yr increased with advancing age and were highest in patients who died during the year of study. Both the rate and the duration of hospitalization were higher for patients maintained by peritoneal dialysis than for those on hemodialysis (P less than 0.001). In patients younger than 45 years of age, diabetics had more frequent and more prolonged hospitalizations than nondiabetics, whereas in those 46 to 60 years of age, complications other than diabetes predisposed to hospitalization. In those 61 years of age or older, in whom hospitalization rates were the highest, no single risk factor could be identified as predisposing to hospitalization other than age and peritoneal dialysis. Although the interactions of these factors were not assessed, considerable agreement existed with previous studies that had been analyzed in a more sophisticated manner. PMID- 6492873 TI - Survival rates of 2,728 patients with end-stage renal disease. AB - This multicenter regional study analyzes survival of a large group of patients who began chronic dialysis or received their first renal transplant during the 5 1/2-year period that ended in June 1983. Survival was determined from the onset of renal replacement therapy, irrespective of changes in treatment modality. Univariate life-table analysis was used to examine more than 35 risk factors. Age of patients at entry into the therapeutic program significantly affected survival. General survival rates were lower for patients with diabetes than for nondiabetics, irrespective of treatment modality, with the exception of those older than 60 years of age. Five-year graft survival was lower for diabetics than for nondiabetics in all age groups, irrespective of source. Patients with systemic lupus erythematosus, focal glomerulosclerosis, or glomerulonephritis had the highest survival rates, whereas those with primary renal malignant lesions, primary hypertensive disease, or diabetes mellitus as the cause of renal failure had the lowest. Concurrent morbid conditions that adversely affected survival included arteriosclerotic heart disease, peripheral vascular disease, noncutaneous malignant lesions, chronic pulmonary disease, and multiple coexisting morbid conditions. Although the objective of this study was to analyze survival for single patient characteristics, irrespective of treatment modality, analyses of survival rates by treatment modality for a control group indicated that minimal differences were evident by the third year among the four treatment groups: in-center hemodialysis, home hemodialysis, living related donor transplantation, and cadaver transplantation; however, recipients of cadaver grafts had lower survival rates than all other groups, even those maintained by in-center hemodialysis (P = 0.025).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492875 TI - Autoantibodies to type II collagen. PMID- 6492874 TI - Hemorrhagic cardiac tamponade: a clinicopathologic correlation. AB - Staphylococcus aureus pericarditis and recurrent episodes of hemorrhagic cardiac tamponade developed in a 31-year-old man. He later died of exsanguination and at autopsy was found to have a ruptured infective pseudoaneurysm of the aortic arch. When hemorrhagic pericardial effusions of undetermined cause are encountered, the heart and great vessels should be evaluated as potential sources of the hemorrhage. PMID- 6492876 TI - Is temporal artery biopsy prudent? PMID- 6492877 TI - Does chronic cerebral vasospasm precede development and rupture of intracranial aneurysms? PMID- 6492878 TI - Revision of guidelines for high blood pressure therapy. PMID- 6492879 TI - Characteristics of physician practice patterns in Maryland, 1981-1982. Health Manpower and Planning Committee. PMID- 6492880 TI - Public opinion on health care issues Maryland 1983. PMID- 6492881 TI - One man's quest for excellence. PMID- 6492882 TI - The Maryland Task Force on Family Physicians: deliberations and recommendations. PMID- 6492883 TI - Radiation-enhanced resistance to oxygen: a possible relationship to radiation enhanced longevity. AB - Shortly after gamma-irradiation, flour beetles (Oklahoma strain of Tribolium confusum) exhibited a decline in resistance to oxygen toxicity. Beginning about two weeks after irradiation, however, the LD50 exposure time in pure oxygen was much greater than that of nonirradiated beetles, and this enhanced resistance persisted for about 6 months. The magnitude of the enhancement was a function of dose, and decreased with increasing age at irradiation. These characteristics of a radiation-enhanced resistance to a stress are comparable to the characteristics of radiation-enhanced longevity in Tribolium, in that after irradiation mortality rate is less than that of controls for about 6 months, the magnitude of the effect is dose-dependent, and older beetles are refractory to the effect. Irradiation under anoxic conditions reduced the development of oxygen resistance to the same degree that it reduced acute radiation lethality, suggesting that the amount of biological damage is the critical factor. These results are discussed in terms of the "induced repair" theory of radiation-enhanced longevity of insects. PMID- 6492884 TI - The content and size distribution of membrane-bound and free polyribosomes in mouse liver during aging. AB - The method of Ramsey and Steele [Anal. Biochem., 92 (1979) 305--313] was used to examine the size distribution of membrane-bound and free polyribosomes from the liver of male C57 BL/6 mice over the life span. Optimization of the concentration of Mg2+ and liver cell sap suppressed breakdown by ribonuclease and presumably gave preparations that approximate the integrity of native polyribosome populations. The content of polysomes per unit liver tissue from 7 groups of fed mice aged 10--35 months showed an age-related increase of subunits and monomers (+54%) and dimers-to-pentamers (+76%) in membrane-bound polyribosomes. The dimer to-pentamer class of free polyribosomes also increased (+52%). Polysomes larger than nonamers showed 13% and 21% decreases that were not statistically significant. Total tissue ribosomes increased 15%, while the membrane-bound/free polyribosome ratio remained nearly constant at about 1.15. In a subsequent study, both 6 h-fasted and fed mice showed decreases (-20% to -33%) in membrane-bound and free polyribosomes larger than nonamers during aging from 15 to 35 months. The dimer-to-pentamer class of free polyribosomes in fed mice increased (+26%), while this class in the other groups underwent increases (+26 to +39%) that were not statistically significant. We conclude that the liver in old mice is not obviously deficient in either quantity or general quality of ribosomes. Old animals do tend to show an increase in small polysomes and a decrease in large polysomes, which is consistent with a reduction in the rate of translation. PMID- 6492885 TI - The senescence of postmitotic mammalian cells: a cell-clock hypothesis. AB - A cell-clock hypothesis for the senescence of long-lived postmitotic cells is proposed, based on the concept that the cells cycle regularly between a synthetic and a degradative phase and that the synthetic phase of each cycle is initiated by transcription of a family or families of highly repetitive DNA. The initiator transcripts are conceived to activate other segments of DNA controlling the transcription of mRNAs. The basic senescence mechanism is postulated to be the uncorrected progressive conversion of 5-methylcytosine in repetitive DNA to thymine by hydrolytic deamination, causing an age-related decline in the number of active initiator transcripts and a progressive loss of cell vigor. PMID- 6492886 TI - Age-dependent structural changes in the myocardium of rats. A quantitative light- and electron-microscopic study on the right and left chamber wall. AB - Myocardial fine structure of 6-week-old and 2-year-old female Wistar rats was examined after fixation by perfusion. Qualitatively, lipid droplets, lipofuscin granules and myelin figures were found more often in the older animals. Quantitatively, the volume density of the interstitium of the right ventricular myocardium had significantly increased (52%) in the 2-year-old rats. In these animals a reduction (9%) in the volume fraction of mitochondria in the left ventricular myocytes was seen, while the volume fraction of myofibrils had increased by 10%. The numerical density of mitochondria had significantly increased in the left ventricular myocardium of the older rats by 42%. A decrease in the average size of a mitochondrion by 36% could be shown in the left and by 11% in the right ventricular myocytes of the 2-year-old rats. In these animals the myofibrillar transverse diameter diminished by 15% in the left and by 6% in the right ventricular wall, while the number of myofibrils had increased by 36% and 12%, respectively; these findings signify a close relationship in the number of mitochondria and myofibrils in myocytes. Quantitative alterations in the myocytes of aged rats are more obvious in the left than in the right chamber wall. A reduced mitochondria/myofibril ratio may contribute to the diminished functional adaptability of the aging heart. PMID- 6492887 TI - Survival and aging of a small laboratory population of a marine mollusc, Aplysia californica. AB - In an investigation of the postmetamorphic survival of a population of 112 Aplysia californica, five animals died before 100 days of age and five after 200 days. The number of survivors among the 102 animals which died between 100 and 220 days declined approximately linearly with age. The median age at death was 155 days. The animals studied were those that died of natural causes within a laboratory population that was established to provide Aplysia for sacrifice in an experimental program. Actuarial separation of the former group from the latter was justified by theoretical consideration. Age-specific mortality rates were calculated from the survival data. Statistical fluctuation arising from the small size of the population was reduced by grouping the data in bins of unequal age duration. The durations were specified such that each bin contained approximately the same number of data points. An algorithm for choosing the number of data bins was based on the requirement that the precision with which the age of a group is determined should equal the precision with which the number of deaths in the groups is known. The Gompertz and power laws of mortality were fitted to the age specific mortality-rate data with equally good results. The positive values of slope associated with the mortality-rate functions as well as the linear shape of the curve of survival provide actuarial evidence that Aplysia age. Since Aplysia grow linearly without approaching a limiting size, the existence of senescence indicates especially clearly the falsity of Bidder's hypothesis that aging is a by-product of the cessation of growth. PMID- 6492889 TI - Mutation frequency in human lymphocytes increases with age. AB - Several theories of ageing predict that somatic mutations should increase with age. This prediction was tested for human lymphocytes using a recently developed clonal technique for enumeration of mutations, and an increase of 1.6% per year in mutations with age was detected. PMID- 6492888 TI - Age-related changes in the excision repair capacity of Turbatrix aceti. AB - Excision repair capacity was measured in the free-living nematode Turbatrix aceti, a model aging system. Excision repair was assessed by both repair synthesis activity and the actual removal of pyrimidine dimers from the genome. The young organisms removed lesions more rapidly and completely than the old for all fluences tested. Repair synthesis began and peaked earlier for young nematodes than old. The data consistently indicated a decline in DNA excision repair capacity with age in the nematode. PMID- 6492890 TI - Effect of aging on human plasma growth hormone response to clonidine. AB - The effect of the oral administration of 0.150 mg/m2 clonidine on the plasma level of human growth hormone (hGH) was studied in 53 adults (25 males and 28 females) aged from 28 to 68 years, of which 15 were healthy volunteers and 38 were hypertensive. Both the normal and hypertensive subjects of both sexes showed an age-related responsiveness of hGH to clonidine, with a normal or partial response in the younger subjects and blunting or lack of response in the more elderly subjects. In the females the blunting of the hGH response appeared at an earlier age than in the males. It is speculated that an alteration in the sensitivity of the central alpha-adrenergic receptors and a decrease in the sex steroid hormones may account for the progressive reduction in hGH secretion with advancing age. PMID- 6492891 TI - Growth rate and life span in Drosophila. II. A biphasic relationship between growth rate and life span. AB - The relationship between growth rate and life span was studied in Drosophila by varying the amount of yeast available to each developing larva at constant temperature, 25 degrees C. With one approach the larvae developed in a standard medium at constant larval density and a varying amount of yeast added on the medium. Across the entire growth rate range covered in this way (10-100 micrograms/day, male flies) imaginal life span depended on growth rate in a biphasic way, the relationship having a parabolic form with a maximum at about 55 to 60 micrograms/day. Similar covariation of growth rate and life span was obtained by varying larval density at a constant amount of added yeast. With both these approaches growth rate variation was due to opposite variations of both components of growth rate, i.e. duration of development and body size. However, development in a medium without nutrients but with a varying amount of added yeast at constant larval density led to a similar biphasic relationship between growth rate and life span although duration of development did not vary. Therefore, the present results are not compatible with the hypothesis that there is a single causal negative relationship between growth rate and life span and demonstrate that duration of development is not a causative factor of the biphasic relationship between growth rate and life span established here. PMID- 6492892 TI - Growth rate and life span in Drosophila. III. Effect of body size and developmental temperature on the biphasic relationship between growth rate and life span. AB - The previous finding of a biphasic relationship between life span and growth rate of Drosophila, developed at 25 degrees C, was confirmed at other temperatures in the usual range (19-28 degrees C) and for development in either a standard medium or one deprived of nutrients but with varying amounts of yeast added on the medium. The role of body size in this relationship was studied by developing flies in a nutrient-less medium with a constant, submaximal amount of added yeast and varying temperature. It was found that under these conditions, which abolished the usual inverse relationship between body size and developmental temperature, body size variations did not account for the observed variations in life span. Thus, corroborating previous studies from this laboratory, body size was ruled out as a causative factor in the life span-growth rate relationship. PMID- 6492893 TI - The effect of ageing and exercise on skeletal muscle function. AB - The contractile and selected biochemical properties of fast- and slow-twitch skeletal muscle were studied at 9, 18, and 28 months of age in sedentary and regularly exercised rats. The isometric twitch duration was prolonged with aging in both the fast- and slow-twitch muscle. This effect was primarily due to a prolonged one-half relaxation time (1/2RT), which developed late in life. Regular exercise tended to further prolong the twitch duration, particularly in the slow twitch soleus. Surprisingly, twitch and tetanic tension (Po), peak rate of tension development and decline, and the maximal shortening velocity were all unaltered between 9 and 28 months of age. Furthermore, regular exercise (running or swimming) had little or no effect on these properties. The prolonged 1/2RT with aging could not be explained by a decreased rate of Ca2+ sequestration by the sarcoplasmic reticulum, as the rate of Ca2+ uptake measured in muscle homogenates was unaltered in any of the muscles studied between 9 and 28 months. The degree of muscle fatigue (decline in Po) with 30 min of contractile activity in the slow-twitch soleus was not affected by aging. However, lactate reached two fold higher levels and glycogen fell to considerably lower levels in the muscles of the old rats. This suggests an increased glycolysis and glycogen utilization during contractile activity in aged rats. PMID- 6492894 TI - Histone acetylation and deacetylation in senescent human diploid fibroblasts. AB - We measured the kinetics of histone H4 hyperacetylation and kinetics of deacetylation for all core histones in young and senescent human diploid fibroblast-like cells. Both cell populations contained a fraction of histone H4 characterized by very rapid acetylation and deacetylation. The kinetics of these reactions were similar in young and senescent cells. The distribution of acetylated species of core histones was also similar in young and senescent human diploid fibroblast-like cells. These results indicated that previously-reported alterations in chromatin template activity in senescent cells were due to a mechanism other than histone acetylation. PMID- 6492896 TI - DNA repair deficiencies and cellular senescence are unrelated in xeroderma pigmentosum cell lines. AB - Senescence of skin fibroblast cultures from normal individuals occurred after 23.9 +/- 6.3 (S.D.) passages; senescence in DNA repair-deficient cell lines from xeroderma pigmentosum patients occurred at 22.9 +/- 5.5 passages. Cells from xeroderma pigmentosum variant and Cockayne syndrome patients reached senescence at similar passage numbers. Xeroderma pigmentosum patients contract skin cancer as a consequence of their repair deficiencies but show no symptoms of premature ageing; neither do their cells age prematurely in vitro. The clinical spectrum and the life-span of fibroblasts in culture therefore lend no support for a correlation between ageing and the DNA repair or DNA replication deficiencies found in xeroderma pigmentosum and Cockayne syndrome cells. PMID- 6492895 TI - Age-related changes in sensitivity of rat urinary bladder to autonomic agents. AB - Experiments were done to determine if age-related changes occur in autonomic regulation of rat urinary bladder. The maximum contractile responses to acetylcholine were 63% and 15% greater in isolated bladders from 29-month and 17 month animals, respectively, as compared to 7-month animals. The amounts of [3H]quinuclidinyl benzilate bound to membrane preparations were 46% and 7% greater. In contrast, no age-related changes were observed in phenylephrine induced contraction or in isoproterenol-induced relaxation of bladder. Thus, the urinary bladder of aged rats appears to develop increased sensitivity to cholinergic stimuli because of an increase in the number of muscarinic cholinergic receptors. PMID- 6492897 TI - Age-dependent alterations in the physicochemical properties of rat liver microsomes. AB - Aging results in a significant decline in liver drug metabolism which is largely attributable to changes in the microsomal mixed function oxidase system. For example, the mixed function oxidase system in the livers of senescent rats is characterized by: (1) a reduced cytochrome P-450 content; (2) a decline in the specific activity of NADPH-cytochrome c (P-450) reductase; and (3) a slower rate of ethylmorphine N-demethylation in comparison to young adult animals. Since several factors intrinsic to the microsomes may influence the efficacy of the mixed function oxidase system, e.g. the phospholipid and cholesterol contents, the saturation index of the fatty acids and the fluidity of the membranes, we conducted a physicochemical analysis of liver microsomes isolated from young adult (3-4 months), mature (12-16 months) and senescent (25-27 months) male Fischer rats. Although the microsomal cholesterol content did not change appreciably between maturity and senescence, there was a marked decline in the total phospholipid content. This resulted in a significant increase in the cholesterol/phospholipid ratio, 0.49 to 0.65 between 16 and 27 months of age. The age-related changes in the total phospholipid content were largely reflected in each of the major fractions, i.e. phosphatidylcholine, phosphatidylinositol and phosphatidylethanolamine + phosphatidylserine. Small increases in the relative percentages of highly unsaturated fatty acid species were offset by similar decreases in the more frequent and more saturated species as a function of increased age. As a result, the net change in the fatty acid saturation index was probably minimal. However, the increase in the cholesterol/phospholipid ratio most likely contributes to the significant decline in the order parameter of microsomes isolated from old rats which, in turn, may impair the functional capacity of the hepatic mixed function oxidase system. PMID- 6492899 TI - Fluorescence microscopical study on fibre formation from carotid bodies from normal or dexamethasone-treated postnatal rats in intraocular transplants to adult rats. AB - Carotid bodies from untreated newborn and adult rats or dexamethasone-treated 7 day-old and adult rats were homologously transplanted into the anterior eye chamber of adult female rats. The eyes of the host rats were sympathetically denervated one day before the transplantation. The transplants and irides were examined at various times postoperatively by formaldehyde-induced catecholamine fluorescence. Transplants attached to and were vascularized by the iris of the host eye. The carotid body glomus cells in the transplants from untreated newborn and dexamethasone-treated 7-day-old rats regularly migrated on the iris, while migration from the adult carotid body transplants occurred only occasionally. The migrated glomus cells usually grew only short processes, but in one out of 55 transplants from untreated newborn rats and in one out of 48 transplants from untreated adult rats a fibre network was formed around the transplant. Twenty three transplantations from 7-day-old dexamethasone-treated rats were made and in 5 of them a fibre network was formed around the transplant. In some cases the nerve fibres could be seen to extend from individual glomus cells. There was no fibre outgrowth from the 13 carotid bodies transplanted from dexamethasone treated adult rats. Pieces of adrenal medullary tissue, which previously has been shown to partially reinnervate the sympathetically denervated iris, was transplanted for comparison. They always formed a fibre network around the transplant. It is concluded that carotid body glomus cells do not have the phenotypic plasticity to form nerve fibres in intraocular transplants as do the adrenal medullary cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492898 TI - Longevity-dependent organ-specific accumulation of DNA damage in two closely related murine species. AB - To measure directly the accumulation of DNA damage with age, and to understand better the effect of modulators of DNA damage in vivo, the DNA of brain, liver, and kidney of two mice from different families, Mus musculus and Peromyscus leucopus, have been examined for age-dependent accumulation of single-strand breaks plus alkali-labile bonds, by the alkaline sucrose sedimentation method. These two species of small rodents are closely related taxonomically, yet differ significantly in maximum achievable lifespan. Using the reciprocal of the number average molecular weight for estimation of DNA size, these analyses indicate that: (a) DNA damage does not measurably accumulate in brain tissue; (b) the accumulation of DNA damage was more pronounced in hepatic DNA than other tissue DNA; and (c) the rate of accumulation of DNA damage in liver and kidney cells with age was greater in the shorter-lived species (M. musculus) and was inversely proportional to maximum achievable lifespan. There are suggestions that a similar threshold might exist for tolerance of DNA damage in the two species in specific organs, and that these species differ in the rate at which this threshold is reached as a function of maximum achievable lifespan. PMID- 6492901 TI - An evaluation of the index of medical underservice. Results from a rural consumer survey. AB - The validity of the Index of Medical Underservice (IMU) was evaluated by examining the ability of the IMU to discriminate among levels of need for health services reported by rural consumers in response to a mail survey questionnaire. It was hypothesized that if the IMU is a valid indicator of medical underservice, then where the IMU value for an area was relatively low, respondents would report relatively less access and availability of health services, less utilization of health services, a lower health status level, and less satisfaction with available health services. The IMU was not found to be an effective discriminator among levels of need for health services as reported by the survey respondents. Further, the dichotomous designation of areas as medically underserved or not medically underserved according to IMU values was found to display even less discriminatory ability. A comparison of areas at opposite extremes of the range of IMU values accounted for only a small proportion of the variance in six criterion measures. The findings raise serious questions about the utility of the IMU for determining funding priorities for health services programs. It is recommended that use and interpretation of the IMU be made with caution and supplemented by additional data as much as possible. PMID- 6492900 TI - Neurochemical studies on central dopamine neurons--regional characterization of dopamine turnover. AB - A simple and rapid dissection procedure was adopted to sample representative areas of the main meso-telencephalic dopaminergic (DA) neuron systems (nigrostriatal and meso-limbic-cortical) in the rat CNS. The object was to explore nerve terminal fields, cell body groups and dendrites, and to investigate the DA utilization rates in these regions. DA and its metabolites 3,4 dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) as well as noradrenaline (NA) were determined by liquid chromatography with electrochemical detection. Selective NA denervation with the neurotoxin DSP4 did not significantly change the DA levels in any of the regions studied, showing that the main part of the DA analysed originated from DA neurons. Administration of the tyrosine hydroxylase inhibitor alpha-methyl-p-tyrosine (H44/68) resulted in a time-dependent, often multi-phasic, DA and NA depletion pattern that varied between different regions. Comparison between the rate of DA decline and DOPAC/DA or HVA/DA ratios (also indices for DA utilization) in the various regions showed that the initial rate of DA disappearance after H44/68 appeared to be the most relevant index of DA utilization. The most rapid initial DA decline after H44/68 was found in the cortical regions (frontal, cingulate, and entorhinal) and the cell body areas A9 and A10, in particular in the cingulate cortex (t1/2 approximately equal to 20 min), indicating a very rapid DA turnover in this region. DA disappearance was clearly slower in striatum (t1/2 approximately equal to 45 min) and the slowest rates were found in the olfactory tubercle and the nucleus accumbens (t1/2 approximately equal to 1.5-2 h). The DA disappearance (t1/2 approximately equal to 45 min) pattern in the dendritic area (substantia nigra, pars reticulata) suggested an axon-terminal like behaviour of the DA dendrites with respect to DA utilization. In general, the DA metabolite/DA ratios obtained for the various regions agreed closely with these results. The rate of NA disappearance after H44/68 was slower than that of DA in most regions. The most rapid NA decline was found in the cortical regions (t1/2 approximately equal to 1-2 h), while very slow in the A9 and A10 regions (t1/2 approximately equal to 3-5 h). PMID- 6492902 TI - When surgical rates change. Workload and turnover in Manitoba, 1974-1978. AB - This research analyzes the changes in individual physician surgical workload and accompanying changes in surgical rates in Manitoba, Canada between 1974 and 1978. Data covering essentially all operations on provincial residents age 25 years and older were analyzed using information from the health insurance data base. The most dramatic change was a 50% rise in outpatient surgery. An overall pattern of increased specialization seemed to be emerging; surgeons' surgical workloads were gradually growing while those of general practitioners were slowly declining. Changes in the frequency of several common surgical procedures were due much more to changes in workload of physicians remaining in the same hospital service area throughout the 1974-1978 period than to turnover (older physicians leaving practice and newer physicians coming in). PMID- 6492903 TI - Cognitive predictors of compliance in chronic disease patients. AB - Variables derived from the health locus of control construct and the Health Belief Model were used to predict compliance with medical regimen in chronically ill patients (adult-onset diabetics, hypertensives, and pulmonary disease patients). Stepwise multiple regression analyses were conducted with predictor variables: age, socioeconomic status, Internal Health Locus of Control (HLC), powerful others HLC, chance HLC, perceived severity of illness, outlook on illness, experienced symptoms, satisfaction with treatment, family support, and support of others. Dependent variables included three measures of compliance with medication regimen and two measures of compliance with self-management regimen. Patient satisfaction was a significant predictor of medication compliance, and lack of symptoms was most strongly associated with self-management compliance. Limitations of cognitive variables in predicting compliance in many chronic disease patients are discussed. PMID- 6492904 TI - Self-care. Substitute, supplement, or stimulus for formal medical care services? AB - This article examines the relationship between selected self-care practices during an episode of illness and the use of formal medical care. Stimulated by conflicting evidence and assertions, the general question addressed is: "Is self care a substitute, a supplement, or a stimulus for use of formal medical care services?" Multiple Classification Analysis was used in a secondary data analysis of a 1976 nationwide study on access to medical care. The results suggest that self-care users may visit the physician less often and stay fewer days in the hospital, and thus they are expected to have lower expenditures for hospital and physician services. Therefore, the self-care activities examined appear to be substitutes for, rather than supplements or stimuli to, health services utilization. The results must be viewed with some caution due to limitations in the data. However, the results also argue for a greater research emphasis on self care. PMID- 6492905 TI - A comment on "Does practice make perfect?". PMID- 6492906 TI - The sensitivity of mental health care use and cost estimates to methods effects. AB - The authors determined the sensitivity of estimates of the use and cost of outpatient mental health care to two methods effects: the definition of a mental health visit and strategies for allocating mental health care costs. They use data from the Rand Health Insurance Study, which has a random sample of the nonaged noninstitutionalized civilian population in six United States sites. Estimates of the use of mental health specialists are insensitive to alternative methods. However, estimates of the use and cost of the mental health care delivered by nonpsychiatrist physicians (e.g., internists) are quite sensitive to methods effects. Nevertheless, the cost of care from nonpsychiatrist physicians is so low that the total cost of outpatient mental health care is not meaningfully affected by methods effects. PMID- 6492907 TI - Use of a surrogate for the Sickness Impact Profile. AB - The use of a surrogate Sickness Impact Profile (SIP) score was investigated in a sample of 66 chronically or terminally ill homebound patients and their caretakers. Statistically significant differences in category scores (P less than 0.05) were found in only two categories. Profile analysis revealed no systematic differences between patient and caretaker responses, and agreement was generally quite high. Agreement of a surrogate SIP was somewhat lower if the patient was suffering from a terminal condition, if the patient had lower educational attainment, or if the caretaker did not live in the same household as the patient. Agreement did not appear to be affected by a diagnosis of a neurologic or psychiatric condition, by the patient's age or degree of dysfunction, or by the relationship of the caretaker to the patient. Overall, the results of the study are encouraging with regard to use of surrogate SIP total and dimension scores for group-level analysis of chronically ill patients if the surrogate is a family member who is closely involved in the patient's care. PMID- 6492908 TI - The validity of self-reported physician utilization measures. AB - Respondents' reports of outpatient medical care use in the preceding year are compared with actual utilization. The authors examine the predictors of the discrepancy between reported and actual utilization as well as the extent to which reporting error biases models of utilization behavior. The average reporting error in this study is relatively small, but the impact of biased reporting on prediction models can be substantial. PMID- 6492909 TI - Consumer values and subsequent satisfaction ratings of physician behavior. AB - The role of respondents' values in their evaluation of and satisfaction with medical care was explored in four health education settings. Two hundred and twenty-seven nursing, medical, and health psychology students completed a forced choice instrument designed to measure their value preferences for technical quality of care, psychosocial concern, courtesy, and mutual participation style of interacting in a medical visit. They subsequently watched a standardized 14 minute videotape of a simulated physician-patient interaction and evaluated the physician's behavior from the patient point of view on the four dimensions using two popular methods for assessing patient satisfaction. Respondents' ratings of the medical encounter were more often significantly influenced by their values when the more subjective satisfaction measure was considered. In addition, respondents who valued technical quality more highly were more satisfied with the other three dimensions of physician behavior, while respondents who more highly valued psychosocial concerns were less satisfied with these three dimensions. Ratings of satisfaction with technical quality were not affected by respondents' values. The importance of these findings in assessing patient satisfaction is discussed. PMID- 6492910 TI - Broken appointments at a neighborhood health center. Emphasis on weather. AB - Broken appointments have been a major problem at the Anthony L. Jordan Health Center since it opened in 1968. In an earlier 6-month study of broken appointments at the center the authors found 48% of pediatric appointments and 43% of medicine appointments to be broken. Daily broken appointment rates were correlated between the two departments and were associated with day and time scheduled and with certain weather conditions. Specifically, highest broken appointment rates were noted for Mondays, for afternoon and evening hours, and for days with precipitation. PMID- 6492911 TI - Evaluation of a measure of neonatal morbidity. AB - The neonatal risk score of Hobel et al. was evaluated as a measure of neonatal morbidity in a sample of 1,600 singleton infants born alive at two institutions. The score was evaluated for internal consistency, the appropriateness of weight assigned to factors, criterion validity, and conformity to the negative binomial distribution. The results are encouraging for the use of the score as a measure of neonatal morbidity. It appears internally consistent. All risk factors occur with some frequency with at least one other and, in most instances, with several others. With one exception, all factors distinguish infants with high and low scores. The neonatal score, defined by a weighted score and by the number of factors, is highly correlated with length of infant stay in the nursery. Correlations are higher for scores of events measured after birth than for scores of events measured directly at birth. The authors recommend that the number of risk factors be used in preference to the weighted neonatal score since it conforms to the negative binomial distribution and is simpler to calculate. The potential uses of a quantitative, comprehensive measure of neonatal morbidity ar discussed. PMID- 6492912 TI - Utilization patterns of health maintenance organization disenrollees. AB - This article addresses several questions about the effect of disenrollment on the start-up phenomenon in health maintenance organizations that were raised in a recent exchange of articles and comments in this journal. The results show that disenrollees, like continuous enrollees, go through a start-up phase of utilization that decreases over duration of membership to a stable lower level. The study also differentiates between voluntary and involuntary disenrollees, both of which go through start-ups. The different characteristics of the start ups of both groups of disenrollees are contrasted with those of continuous enrollees. The implications of these findings for planners and administrators are discussed, and a future research agenda is recommended. PMID- 6492913 TI - Differences in use of health services by children according to race. Relative importance of cultural and system-related factors. AB - Black children make substantially less use of health services than do their white counterparts, despite their demonstrably poorer health status. This relationship is true regardless of income. Various authors have suggested that such differences are due to system-related barriers to access to care by black children. Alternatively, others have noted that blacks have cultural patterns related to health and illness, and these culturally determined beliefs and behaviors may account for the observed differences. The present study compared use of health services by black and white children within a system of care that has sought to decrease barriers to access to care by black children. Within this system, black and white children used health services in a similar fashion, suggesting that system-related factors that assure equity of access to health services may be more important than client-related cultural factors, or that these cultural factors may be overcome. PMID- 6492914 TI - Nursing home patients admitted to a medical intensive care unit. AB - To investigate admissions from nursing homes to a medical intensive care unit (ICU), the authors detailed the major interventions, costs, and outcomes for such patients (n = 67) over a 3-year period and then compared them with those for ICU patients receiving home care or visiting nurse services (240 patients) before admission and all others older than 65 years of age (949 patients). These three groups comprised 37% of total ICU admissions. In contrast to younger patients admitted primarily with acute ischemic heart disease, nursing home patients were more likely to be admitted with cardiopulmonary arrest, infection, and gastrointestinal bleeding. Major interventions of intubation and mechanical ventilation were most frequent for nursing home patients, but total hospital charges differed little among the groups. In-hospital mortality for the nursing home group (28%) was significantly higher than for the home care group (7%) and others older than 65 years of age (7%). Cumulative mortality for the nursing home group reached 66% by 8 months, versus 32% and 26% in the other groups, respectively. PMID- 6492915 TI - Utilization of hospital-based computed tomography scanning in California. PMID- 6492916 TI - [Ergometric evaluation of the antihypertensive efficacy of clonidine]. PMID- 6492917 TI - [Interaction between theophylline and cimetidine. Effect of cimetidine on the serum clearance of theophylline]. PMID- 6492918 TI - [Vaccination against viral hepatitis type B in Spain. Commentaries on a royal decree]. PMID- 6492919 TI - [Lithium therapy: past, present and future]. PMID- 6492920 TI - [Paramyotonia congenita. Presentation of a Spanish family]. PMID- 6492921 TI - [Neurobiology of schizophrenia. I. Nosologic models]. PMID- 6492922 TI - [Berger's disease associated with typhoid fever]. PMID- 6492923 TI - [Pseudopregnancy and gastric adenocarcinoma]. PMID- 6492924 TI - [Posttraumatic amnesia, a frequently met symptom]. PMID- 6492925 TI - [2 cases of scrofula following the ingestion of milk]. PMID- 6492926 TI - [Pulmonary disease caused by amiodarone]. PMID- 6492927 TI - [The adenyl cyclase system in asthma patients]. PMID- 6492928 TI - Symposium on cardiac arrhythmias II. PMID- 6492929 TI - Evaluation of the patient with wide QRS tachycardia. AB - Acute and long-term therapy as well as prognosis in patients with wide QRS tachycardia differ depending on the mechanism of the arrhythmia. Twelve-lead electrocardiography and prolonged electrocardiographic monitoring are often diagnostic. However, additional techniques such as esophageal and right atrial electrocardiography, or His bundle electrocardiography with detailed electrophysiologic studies, are sometimes necessary to delineate the mechanism of the arrhythmia. PMID- 6492930 TI - Arrhythmias in patients with mitral valve prolapse. Types, evaluation, and therapy. AB - A wide spectrum of cardiac rhythm and conduction disorders occur in patients with all types of valvular heart disease. However, certain types of valvular disease have a special predilection for arrhythmias, including atrial and ventricular tachyarrhythmias as well as bradyarrhythmias, inherent to the etiology of the condition itself. Most notable in this regard is mitral valve prolapse, in which cardiac dysrhythmia is now recognized as the complication of highest frequency. The principal purpose of this article is the delineation of the characteristics and management of rhythm disorders in the mitral valve prolapse syndrome. PMID- 6492931 TI - Arrhythmias in pacing. AB - The spectrum of cardiac arrhythmias that may be encountered in paced patients is vast; as multiprogrammable and dual-chamber pacemakers have become more sophisticated, the problems of electrocardiographic interpretation have multiplied. The arrhythmias may be broadly classified as follows: those due to abnormal functioning of the device, those due to normal functioning of the device, and those due to the interaction of the pacemaker with a spontaneous arrhythmia occurring in the patient. PMID- 6492932 TI - Exercise stress testing in the management of cardiac rhythm disorders. AB - Exercise testing is an important tool for exposing symptomatic arrhythmias as well as asymptomatic but potentially serious ventricular tachyarrhythmias. When evaluating the effect of antiarrhythmic drugs, exercise testing is an adjunctive modality. PMID- 6492933 TI - Arrhythmias in pediatric patients. AB - The six most common arrhythmias or conduction disturbances in children are discussed. For each arrhythmia, the electrocardiographic criteria in children, the common clinical situations in which the arrhythmias are see, the diagnostic work-up, the suggested treatment, and prognosis are presented. Throughout, the differences between children and adults are emphasized. PMID- 6492934 TI - Evaluation of the patient with syncope. AB - The evaluation of the syncopal patient is often expensive and may not yield a specific diagnosis. An understanding of the cardiac and noncardiac causes of syncope can be helpful in making a specific goal-oriented evaluation of these patients. PMID- 6492935 TI - Clinical pharmacology. Clinical uses of pharmacokinetic principles in prescribing cardiac drugs. AB - Drug disposition is the sum of the processes of absorption, distribution, metabolism, and elimination. Knowledge of the factors affecting the rates and extent of these processes facilitates the design of dosing regimens, including calculation of loading dose, maintenance dose, and infusion rate. This information is especially useful in treating patients with low cardiac output, or with intrinsic hepatic or renal disease. PMID- 6492936 TI - Operative therapy for ventricular arrhythmia. AB - The history of surgical attempts to control ventricular arrhythmia is reviewed and current methodology is presented in detail. The results of the various surgical approaches and future trends in the management of this troublesome condition are discussed. PMID- 6492937 TI - [Hemolytic properties of Yersinia. I. Use of solid media]. PMID- 6492938 TI - [Preparation of delayed-action staphylococcal vaccine. I. Effect of the vaccine on local skin infection in rabbits]. PMID- 6492939 TI - [Preparation of delayed-action staphylococcal vaccine. II. Effect of the vaccine on the course of generalized infection in mice]. PMID- 6492940 TI - [Oxidation of amino acids by pathogenic and non-pathogenic coagulase-negative staphylococci]. PMID- 6492941 TI - The protection from hepatotoxicity of some compounds by the synthetic immunomodulator muramyl dipeptide (MDP) in rat hepatocytes and in vivo. AB - Muramyl dipeptide (MDP) protection from acrolein, chloroform and carbon tetrachloride toxicity was tested using isolated rat hepatocytes prepared by collagenase perfusion method. Hepatotoxin lethal effects were assessed using trypan blue exclusion and ascertained by LD leakage test. Incubation of hepatocyte suspensions with acrolein (143 mumol/ml), CHCl3 (124 mumol/ml) and CCl4 (103.5 mumol/ml) for 15 min reduced viability to 62%, 13% and 27%, respectively. Pretreatment of hepatocytes in incubation media with MDP (20.6 nmol/ml) increased viability significantly to 83%, 27% and 46%, respectively (P less than 0.01 and P less than 0.05). MDP single treatment in vivo (8.26 mumol/kg) produced a three-fold decrease in the high serum aspartate and alanine transaminases induced by CCl4 (5.2 mmol/kg). MDP modulation of CCl4 hepatotoxicity was not accompanied by reduction of lipid peroxides either in liver homogenates, microsomes or hepatocytes in the present conditions. It is suggested that MDP in certain dosages may produce nonspecific stabilization of cytoplasmic membranes towards the studied cytotoxins. PMID- 6492942 TI - Tyramine pressor test: implications and limitations. AB - Tyramine, an indirectly acting sympathomimetic amine, can be used as a pharmacological tool to assess the peripheral adrenergic activity and its interactions with drugs in man. Of the various techniques used, the tyramine pressor test appears to be the most reliable method. It is convenient to perform and carries no significant morbidity, provided the subjects are selected carefully and the investigation is closely monitored. Basically, the tyramine pressor test involves measurement of systolic blood pressure in response to bolus intravenous tyramine injections. Tyramine sensitivity, which is taken as an index of peripheral adrenergic function, is defined as the amount of tyramine required to increase the systolic blood pressure by 30 mm of Hg and is determined from the dose response curve. Drugs which influence the adrenergic system are likely to alter the tyramine sensitivity. It provides valuable guidance regarding drug interactions and is useful in the assessment of certain neuropsychiatric conditions. However, since tyramine does not cross the blood brain barrier, information regarding only the peripheral effect is obtained. PMID- 6492943 TI - The efficacy of indapamide in hypertensive patients failing to respond to a beta blocker alone. AB - A double-blind, placebo-controlled, cross-over study was carried out to evaluate the efficacy and safety of 2.5 mg indapamide in 24 hypertensive patients failing to respond to oxprenolol alone. An additional 6 patients were assessed by ambulatory blood pressure recordings over a 15-hour period with a Remler M2,000 semi-automatic sphygmomanometer. On average, indapamide reduced supine blood pressure by 18.5/10 mmHg and standing blood pressure by 19.6/8.9 mmHg. The ambulatory recordings carried out in 6 patients detected a fall in diastolic pressure not observed using clinic readings in these 6 patients, suggesting that this is a more sensitive method of detecting antihypertensive effect. These responses were not associated with significant changes in heart rate or body weight and there was no significant postural fall in blood pressure. No serious side-effects were reported. Changes in serum potassium, chloride and urate similar to those seen with diuretics were observed. These results suggest that indapamide is a useful and safe adjunct to beta-adrenoceptor blocking therapy for uncontrolled hypertension. PMID- 6492944 TI - The influence of indapamide on serum lipoproteins in essential hypertension. PMID- 6492946 TI - [An enuresis alarm as a cause of burn injury]. PMID- 6492945 TI - [Single-drug and multiple drug therapy of lower urinary tract infections]. PMID- 6492947 TI - [Meningitis caused by metronidazole]. PMID- 6492948 TI - [Subcutaneous implantation of gestagens. A new alternative for safe contraception]. PMID- 6492949 TI - [A frequency-varied heart-stimulating pacemaker system is under further development]. PMID- 6492950 TI - [Classification of ankle fractures--according to Lauge-Hansen or AO (Arbeitsgemeinschaft fur Osteosynthesefragen)?]. PMID- 6492952 TI - [Surgical treatment of bedsores]. PMID- 6492951 TI - [Computer tomography--indications and technology]. PMID- 6492953 TI - [Adrenaline in aerosol administration in dangerous allergic reactions]. PMID- 6492954 TI - Experiments on voice qualities of vowels in males and females and correlation with acoustic features. PMID- 6492955 TI - Nurturant talk to children. PMID- 6492956 TI - Laryngeal management at utterance-internal word boundary in American English. PMID- 6492957 TI - [Limits between normal and pathologic auditory fatigue following acoustic stress with high peak pressures in its significance for acoustically-induced hearing loss]. AB - The extent of hearing fatigue as a consequence of acoustic impacts is an important factor in predicting an anticipated hearing impairment. It is essential to know whether hearing fatigue is due to physiological or pathological conditions. Mass screenings of thousands of soldiers suffering from hearing fatigue due to acoustic impact, showed that hearing fatigue is subject to considerable individual fluctuation. The time of recovery, or rather the time required by the auditory reception to return to the preimpact threshold, is of paramount importance. Recovery from an audiometrically traceable TTS within 10 minutes can be considered unobjectionable. Recovery time of up to half an hour can be found in 10--20% of the screened personnel, depending on the impact. This is within physiological variation range and can be considered unobjectionable. Recovery times of a TTS of up to 3 hours constitute a limit beyond which pathological effects in the cochlea can be expected. Recovery times of 24 hours and more signify a definite impairment if impacts continue. PMID- 6492958 TI - [Spontaneous perforation of the membrane of the round window--a major cause of sudden deafness?]. AB - In 1983, 45 out of 63 clinically treated patients with sudden hearing loss underwent an exploratory tympanotomy. In 27 cases (60%) a perforation of the round window membrane was found, whereas in 18 cases (40%) the round window membrane was intact and there was no perilymph fistula. From 1982 to the end of 1983 30 perforations of the round window membrane were found which are reported here, most of them being spontaneous perforations without any preceding trauma. Audiometrically, hearing losses were found ranging from medium to high degree. These included all types of hard hearing, such as loss of high or low tones and losses over all frequency ranges to total deafness. All patients complained of tinnitus. One-third of the patients with perforated membrane had dizziness or vertigo combined with disturbances of balance. Treatment consisted of sealing the round window membrane with a plug of fascia or periostium. When the patients were discharged, or shortly after their discharge, audiometry revealed normal hearing in three patients, improved hearing in 8 patients, no change in 14 patients, and further deterioration in 3 patients. In 8 patients with perforated membrane, the sudden hearing loss had occurred 1 to 12 months back and in 6 patients only 8 to 30 days ago. The study will continue, but we can already see from the present results that every sudden hearing loss should be examined for a possible spontaneous perforation of the round window membrane. For this reason, exploration of the round window should be done within the first few days. The study yields new knowledge of the pathogenesis of the sudden hearing loss.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6492959 TI - [Sudden deafness in gastrointestinal infections: microbial genesis or autoimmune reaction?]. AB - The pathogenetic mechanisms are discussed from the observations made in 3 cases of typical acute bilateral sudden deafness as a result of coincident gastrointestinal infections. PMID- 6492960 TI - [Multifactorial malignancy analysis--modern knowledge in the practical diagnosis of head and neck tumors]. AB - A pretherapeutical multi-step-check method of the diagnosis of malignancy is suggested as a basis of an individual therapy of tumours. It must comprise clinical tumour diagnosis (staging)--the tumour localizations, size and spreading of metastases--histopathological and histochemical grading of malignancy, and histological classification. Results of these diagnostic methods of 186 squamous cell carcinomas of the head and neck were related to the survival rate. Histochemical LDH and G6PDH reactions and histopathological grading (G 1-group and G 3-group) are important criteria for prognosis. PMID- 6492961 TI - [Demarcation of the forms of osteofibrous tumors of the facial bones]. AB - By means of a case report, we show that the general classification of different forms of osteofibrous skull tumours does not always agree with the clinical, pathological and roentgenological findings. A classification based on these requirements is discussed. PMID- 6492962 TI - Otosclerosis and Meniere's syndrome: diagnosis and treatment. AB - Occasionally a patient with otosclerosis and a conductive hearing loss will develop typical findings of Meniere's syndrome in the involved ear, years later. A review of clinical and pathological studies in the literature and in our laboratory and clinic indicates a likely cause-and-effect relationship for these cases. The pathology and pathogenesis of the syndrome of otosclerosis and Meniere's syndrome is discussed. A stapedectomy/sacculotomy was used to treat 17 patients, 13 of whom acquired a satisfactory result in terms of improvement of hearing and control of vertigo. This technique and findings are described and discussed. PMID- 6492963 TI - Hearing preservation after removal of acoustic neurinoma. AB - Between January 1, 1978, and July 1, 1983, 149 patients underwent acoustic neurinoma removal (151 procedures). Of these, 119 ears (118 patients) had had some degree of hearing on the affected side preoperatively, and in all of them the tumors had been removed by a posterior cranial fossa approach. Fourteen (12%) had measurable hearing preserved postoperatively--serviceable in eight ears and poor in six. The patients with preserved hearing had had their hearing loss for a shorter period, slightly better preoperative hearing levels, and a smaller tumor. The complications, morbidity, and mortality in this group were comparable to those in other series. It is concluded that preservation of hearing is a worthwhile goal that can be achieved without increased risk. PMID- 6492964 TI - Diagnostic value of vestibular function tests: an analysis of 200 consecutive cases. AB - The contribution that vestibular function tests can make in achieving a topographic and etiologic diagnosis is being increasingly questioned. A greater reliance is therefore being placed on audiometeric tests including auditory brain stem tests. Our experience with vestibular testing has been most favorable, using photoelectric nystagmography and the Torok monothermal differential caloric test. This analysis of 200 consecutive cases shows that patients with normal vestibular function can be differentiated with certainty from those with organic disorders. In the latter group the site of lesion could be confirmed with greater than 90% accuracy. The reasons why vestibular tests in general are non-productive are discussed. PMID- 6492965 TI - Hypoglossal-facial nerve anastomosis: a review of forty cases caused by facial nerve injuries in the posterior fossa. AB - Hypoglossal-facial anastomosis has been our procedure of choice in the repair of the permanently injured facial nerve in the cerebellopontine cistern, when the nerve cannot be primarily repaired. Total failures are few and complications are rare. Most results are good to excellent, if assessment is based upon realistic expectations. These include: 1. normal facial symmetry in repose, 2. good midface voluntary motion, 3. no reflex or emotional facial movement, 4. some synkinesis and donor-injected mass facial movement, and 5. surprisingly little functional loss from hypoglossal paralysis. Our experience indicates better results in younger patients and in those repairs completed shortly after injury. These findings correlate well with the experience gained in peripheral nerve repair in the extremities. There appears to be no absolute time period between injury and repair beyond which this anastomosis is definitely contraindicated. Finally, this procedure does not negate adjunctive plastic surgical procedures. Most of our patients have had tarsorrhaphy or physiologic protection of the eye, but few have had corrective cosmetic surgical procedures until the past few years. We have never used cervical sympathectomy to reduce the size of the palpebral fissure. Better surgical procedures to correct both extracranial and intratemporal facial nerve injuries have significantly reduced the indication for anatomosis procedures. Additionally, over the past two decades, the improved diagnostic and surgical techniques for posterior fossa tumors have considerably reduced the incidence of facial paralysis. As these trends continue, the number of patients requiring nerve anastomosis for facial paralysis will continue to decline and what was once the only surgical procedure to repair the paralyzed face will become a rare operation. PMID- 6492966 TI - Otitic hydrocephalus. AB - Otitic hydrocephalus is one of the less common intracranial complications of infectious ear disease, consisting of elevated intracranial pressure without focal neurologic abnormalities other than those due to the elevated pressure. A representative case is discussed in this report, followed by a review of the literature. The clinical course, diagnosis, treatment, and prognosis are outlined. The etiology and the association with lateral sinus thrombosis remains obscure. PMID- 6492967 TI - Primary melanoma of the middle ear. AB - We present a case of a 52-year-old white female with what we believe is the first documented example of a primary melanoma of the middle ear. Multiple myringotomies and two tube insertions over a 14-month period were carried out until frank hemorrhage was encountered on the last one. Middle ear exploration found the lesion to be a primary melanoma. The supposed course of her diseased ear is discussed as regards the lag between effusion and frank blood when tumor was finally hit on the last myringotomy. PMID- 6492968 TI - Bilateral congenital middle ear cholesteatomas. AB - Congenital middle ear cholesteatomas remain of interest because of their relative rarity and unknown origin. A 4-month-old child presenting with bilateral congenital middle ear cholesteatomas forms the basis for this report. The nature of the epithelial debris found suggests an external origin. An extended transcanal tympanotomy approach for removal, based upon an operative experience of 11 similar ears, will be discussed. PMID- 6492969 TI - Acoustic Neuroma Suspicion Index: an aid to investigation and diagnosis. AB - A clinical scale, the Acoustic Neuroma Suspicion Index (ANSI) is presented. It was based initially on the retrospective analysis of 397 patients suspected of having an acoustic neuroma of whom, following full investigation, 263 (66%) were found to have space occupying lesions. After minor modifications, the Index was re-tested on 98 patients of whom 56 proved to have tumors while 47, who did not, formed a control group. All tumor cases were confirmed surgically. Neuro otological investigations can be expensive, time consuming and occasionally unpleasant for patients; furthermore they are not always readily available. Though the diagnosis of an acoustic tumor or other cerebellopontine angle lesion is often straightforward, atypicality of presentation occurs often. The ANSI uses simple selected data from the history and clinical examination, with routine audiological, vestibular and radiological investigations to calculate a score. If this score exceeds the predetermined threshold, further investigations should be undertaken. PMID- 6492970 TI - Microorganisms isolated from infected aural fistulas. AB - Aural fistula is a congenital deformity of the external ear relatively common in Orientals and rare in Caucasians. Suppuration tends to occur, and chemotherapy rather than surgical drainage should be attempted. However, the lack of information concerning infected aural fistulas has made appropriate chemotherapy difficult. Microorganisms isolated from 13 cases of infected aural fistulas were studied from January 1981 to December 1982. Six species and 22 strains were isolated; nonsporeforming faculative anaerobes were detected in 12 cases. The isolated pathogens included Peptococcus sp (10 cases), Peptostreptococcus sp (3), Bacteroides sp (3), and Fusobacterium sp (2). One case exhibited only Staphylococcus aureus. Our data also stresses the etiologic importance of anaerobic gram-positive cocci in infected aural fistulas. PMID- 6492971 TI - Fatal malformations of the larynx and upper trachea. AB - Five infants with a spectrum of rare malformations of the larynx and trachea are presented. All infants died because of problems with intubation and ventilation. The series reflects the wide variety and complexity of malformations that may co exist, and successful management may require open tracheotomy. PMID- 6492972 TI - Light and electron microscopic studies of a case of middle ear adenoma. AB - An adenomatous neoplasm from the middle ear was studied. Two distinct groups of cells were present. Electron microscopy suggested that one group was epithelial and the other neuroendocrine in origin. The features supported the hypothesis that such tumors arise from middle ear mucosa. PMID- 6492973 TI - Teratomas of the head and neck in childhood. AB - Teratomas are tumors consisting of tissue arising from all three embryonic germ layers. Their occurrence in the head and neck region is rare. Three patients with this lesion are presented. Although exhibiting progressive uncoordinated growth, histologic evidence of malignancy in the head and neck form of this tumor is distinctly uncommon. Mortality associated with teratomas is most often secondary to respiratory compromise. Complete surgical extirpation is the treatment of choice to lower mortality and recurrences. The use of fine needle aspiration in the management of neck masses in children is discussed. PMID- 6492974 TI - Laryngotracheoplasty with costochondral grafts--a clinical correlate of graft survival. AB - Laryngotracheoplasty utilizing composite costal cartilage-perichondrium grafts placed both anteriorly and posteriorly within the cricoid ring has provided a significant advance in the management of acquired subglottic stenosis in children. Histopathologic data from a child who died after a laryngotracheoplasty is presented which indicates both the anterior and posterior grafts survive and grow. PMID- 6492975 TI - Relationship of optic neuritis to disease of the paranasal sinuses. AB - The relationship of paranasal sinusitis to optic neuritis remains an intriguing curiosity to both the otolaryngologist and the ophthalmologist. The literature is replete with anecdotal case reports of patients whose sinusitis appears to have caused optic neuritis. There is much speculation about the pathophysiological mechanisms which relate these two distinct disease entities. Five new cases are described which highlight distinct pathophysiologic routes through which paranasal sinus disease has caused optic neuritis. These include compressive optic neuropathy secondary to mucoceles and/or pyoceles; direct extension of sinus infection to the optic nerve from suppurative paranasal sinusitis; and, in one case, from osteomyelitis of the ethmoid and sphenoid sinuses. The usefulness of computerized axial tomography of the orbits and paranasal sinuses to evaluate optic neuritis and to elucidate in detail the pathophysiology of its relationship to disease of the paranasal sinuses is emphasized. Currently, optic neuritis is felt to be a rare complication of paranasal sinusitis. Paranasal sinus surgery is advocated in those cases where sinus suppuration is suspected, or when a compressive optic neuropathy is caused by a sinus mucocele or pyocele. Since in most cases, however, optic neuritis is self-limited, it is difficult to evaluate the results of surgery in circumstances other than those mentioned already. Continued careful evaluation, management, and documentation of this group of patients is necessary to help better define the relationship between these two disease entities. PMID- 6492976 TI - Flexible fiberoptic and rigid telescopes for intranasal photography. PMID- 6492977 TI - Prototype airway management system for use during laser surgery. AB - A Norton metal endotracheal tube with a Merav parachute cuff cemented to the distal end has solved many of the problems involved in administration of anesthesia for laser surgery of the upper aerodigestive tract. The tube is fireproof and provides an air-tight seal for positive pressure ventilation without the impediment of a cuff channel. It is ideal for laser surgery of the oral cavity and pharynx and may be used effectively for glottic lesions in many instances. PMID- 6492978 TI - The combined "H" advanced flap. PMID- 6492979 TI - Making pressure equalizing tubes. PMID- 6492980 TI - Air contrast computed tomography in diagnosis of small acoustic neuromas. PMID- 6492981 TI - Facial scar revision. PMID- 6492982 TI - Procedure for resection of carcinomas of the oral cavity and oropharynx. PMID- 6492983 TI - A survey of the eye complications of leprosy in South Korea. PMID- 6492984 TI - The American Peace Corps Survey of the ocular complications of leprosy in South Korea: an evaluation and appraisal. PMID- 6492985 TI - A follow-up investigation of the Malta-Project. PMID- 6492986 TI - Leprosy treatment in Nepal with multidrug regimens. PMID- 6492987 TI - Multidrug treatment of leprosy--practical application in Nepal. PMID- 6492988 TI - A further investigation of skin-test responsiveness and suppression in leprosy patients and healthy school children in Nepal. PMID- 6492989 TI - Hepatotoxicity of combined therapy with rifampicin and daily prothionamide for leprosy. PMID- 6492990 TI - Different mode of circulating immune complexes and anti-ssDNA antibodies in sera of lepromatous leprosy and systemic lupus erythematosus. PMID- 6492991 TI - Elevation of plasma triglyceride levels due to 2-deoxy-D-glucose in conscious rats. AB - Hypertriglyceridemia due to 2-deoxy-D-glucose administration was observed in conscious rats. Plasma triglyceride levels were elevated dose-dependently 2 or 3 hrs after administration of 2-deoxy-D-glucose (5-40 mg/100 g body weight). Prior to the rises in triglyceride, plasma epinephrine levels were elevated rapidly, whereas plasma insulin was not increased depspite continuous hyperglycemia. Elevation of plasma triglyceride was suppressed by addition of phentolamine, whereby insulin release was remarkably enhanced. Plasma lipoprotein lipase release by heparin infusion was significantly suppressed 2 hr after 2-deoxy-D glucose administration. In conclusion, it is suggested that the hypertriglyceridemic effect of 2-deoxy-D-glucose may be mediated by decreased clearance of endogeneous lipoprotein particles (mostly chylomicrons) attributable to a lowered lipoprotein lipase activity. PMID- 6492993 TI - Dopamine receptors in the guinea-pig heart. A binding study. AB - The binding of dopaminergic agonists and antagonists to guinea-pig myocardial membrane preparations was studied using 3H-dopamine and 3H-spiperone as radioligand. 3H-Dopamine bound specifically to heart membranes while 3H-spiperone did not. A Scatchard analysis of 3H-dopamine binding showed a curvilinear plot indicating the presence of two dopamine receptor populations that we have termed high- (Kd = 1.2 nM, Bmx = 52.9 fmol/mg prot.) and low- (Kd = 11.8 nM, Bmx = 267.3 fmol/mg prot.) affinity binding sites, respectively. The characterisation of the high-affinity component of 3H-dopamine binding indicated that the binding is rapid, saturable, stereospecific, pH- and temperature-dependent, and displaced by dopaminergic agonists and antagonists known to act similarly in vivo. The finding that pretreatment with dibenamine (which has been described as an alpha adrenoceptor irreversible blocker) did not affect the binding of dopamine to cardiac membrane preparations suggests that alpha-adrenoceptors and dopamine receptors have separate recognition sites in the heart. We conclude that 3H dopamine binds to specific dopamine receptors in the heart of guinea-pigs. PMID- 6492992 TI - Differential effects of chronic clorgyline and amfonelic acid on desensitization of striatal dopamine receptors. AB - Chronic treatment of rats with the MAOI clorgyline significantly reduced the density (Bmax) of cortical beta-adrenergic receptors but did not alter either the Bmax or dissociation constant (Kd) of 3H-spiperone binding to striatal DA receptors. Clorgyline co-treatment also did not significantly affect either behavioral supersensitivity to apomorphine or the increase in 3H-spiperone binding induced by chronic haloperidol. In contrast, repeated treatment with the DA uptake inhibitor amfonelic acid elicited behavioral subsensitivity and reduced striatal 3H-spiperone binding. Furthermore, amfonelic acid co-treatment prevented haloperidol-induced behavioral and receptor binding changes. The possible relevance of these findings in relation to drug choice in clinical trials of receptor sensitivity modification are discussed. PMID- 6492994 TI - The effects of ketamine, phencyclidine and lidocaine on catecholamine secretion from cultured bovine adrenal chromaffin cells. AB - The ability of ketamine, phencyclidine and analogues to alter catecholamine secretion from cultured bovine adrenal chromaffin cells was investigated. Both ketamine and phencyclidine specifically inhibited nicotinic agonist-induced secretion at concentrations which did not alter secretion induced by elevated K+ depolarization. The inhibition of nicotinic agonist-induced secretion was not overcome by increasing concentrations of nicotinic agonist. The effects of stereoisomer pairs of phencyclidine-like drugs - dexoxadrol, levoxadrol and (+)PCMP, (-)PCMP - did not reveal stereospecificity for the inhibition, in contrast to the stereospecific behavioral effects of the drugs. The local anesthetic lidocaine (0.3 mM) also noncompetitively inhibited nicotinic agonist induced secretion without inhibiting elevated K+-induced secretion. The data indicate that ketamine and phencyclidine at clinically relevant concentrations specifically inhibit the adrenal chromaffin cell nicotinic receptor at a site similar to or identical with the site of action of local anesthetic. Although the nicotinic receptor inhibition is probably not related to the anesthetic and behavioral effects of ketamine and phencyclidine, it is likely that the centrally mediated increase in sympathetic nervous system activity which is characteristic of these drugs is moderated by the peripheral blocking effects on catecholamine secretion from the adrenal medulla. PMID- 6492995 TI - Novel 8 alpha-ergolines with inhibitory and stimulatory effects on prolactin secretion in rats. AB - Four derivatives of the ergot dopamine (DA) agonist lisuride (LIS), namely 6-n propyl-lisuride (6-n-propyl-LIS), transdihydrolisuride (TDHL), 6-n-propyl-transdi hydrolisuride (6-n-propyl-TDHL) and 2-bromolisuride (2-Br-LIS) were investigated in female rats with regard to their influence on hyperprolactinaemia induced by pretreatment with reserpine (2 mg/kg i.p., 24 h) at various intervals following their subcutaneous or oral administration (0.05 mg/kg). Two hours after administration, LIS, 6-n-propyl-LIS, and 6-n-propyl-TDHL caused a statistically significant inhibition of reserpine-induced hyperprolactinaemia of about the same extent. Eight hours after administration 6-n-propyl-LIS and 6-n-propyl-TDHL were as active as after 2 h in inhibiting prolactin (PRL) secretion whereas LIS was almost ineffective in this respect. TDHL caused a statistically significant inhibition of PRL secretion at 2 and 8 h after oral administration; this effect was less pronounced after s.c. administration. In contrast to the aforementioned derivatives 2-Br-LIS further increased the reserpine-induced hyperprolactinaemia. In normal male rats pretreatment with 2-Br-LIS (0.025-6.25 mg/kg s.c., 2 h) dose dependently stimulated PRL secretion. The present data support the assumption of the longlasting DA agonistic action of 6-n-propyl-LIS and 6-n-propyl-TDHL and of the antidopaminergic properties of 2-Br-LIS recently derived from behavioural studies. PMID- 6492996 TI - Dexamethasone increases both catecholamines and methionine-enkephalin in cultured bovine adrenal chromaffin cells and human extramedullary pheochromocytoma cells. AB - The effect of dexamethasone on dispersed cells in primary monolayer culture from bovine adrenal medulla and human extramedullary pheochromocytoma was examined by estimating the level of catecholamines (CAs) and Methionine-enkephalin (Met-enk) in the medium and cells. In cultured bovine adrenal chromaffin cells, dexamethasone caused significant increase in Met-enk levels 18 hours after administration. There was no release of Met-enk and CAs in the medium 10 min after administration, although nicotine did cause a significant release of Met enk and CAs. A dose response increase in the level of CAs and Met-enk in bovine adrenal chromaffin cells was obtained with doses varying between 0 and 10(-6)M dexamethasone 18 hours after administration. In cultured human extramedullary pheochromocytoma cells, dexamethasone significantly increased the levels of norepinephrine and Met-enk in a dose dependent manner 24 hours after administration. These results suggest that dexamethasone does not act as a secretagogue but may be related to the synthesis of Met-enk and CAs. PMID- 6492997 TI - Mechanisms of methacholine-induced coronary vasospasm in an experimental model of variant angina in the anesthetized rat. AB - Methacholine (Mch), when injected near the ostia of the coronary arteries, induces an intense coronary vasospasm which can be measured by the degree of S wave elevation monitored from an electrocardiogram (ECG). The observed ECG changes resemble those occurring in patients with variant angina. The effects of Mch were blocked by atropine, but not by d-tubocurarine, hexamethonium, adrenergic receptor blockade, or prior reserpinization, indicating that Mch is acting directly on muscarinic receptors to produce a vasoconstriction of the coronary arteries. This model of Mch-induced coronary vasospasm appears to be useful for testing spasmolytic agents which might be of benefit in variant angina. PMID- 6492998 TI - Biopterin cofactor biosynthesis: GTP cyclohydrolase, neopterin and biopterin in tissues and body fluids of mammalian species. AB - Levels of GTP cyclohydrolase, neopterin and biopterin were determined in tissues and body fluids of humans, monkey, dog and mouse. Highest levels of GTP cyclohydrolase and biopterin were found in pineal, liver, spleen, bone marrow, whole adrenal gland and small intestine. High levels of biopterin were found in the urine of all species examined. High levels of neopterin were found only in the urine of humans and monkeys, very low levels could be detected in dog, while none could be detected in mouse, rat, guinea pig or hamster urine. PMID- 6492999 TI - A pharmacological investigation of the biphasic nature of the contractile response of rabbit and rat vas deferens to field stimulation. AB - It has been demonstrated previously with the vas deferens of the guinea-pig that the first and second phases of the contractile response to motor nerve stimulation are preferentially antagonized by the P2-purinoceptor antagonist arylazido aminopropionyl ATP (ANAPP3), and the alpha 1-adrenoceptor antagonist prazosin, respectively. We have now investigated the effect of the two antagonists on the biphasic contraction in the vas deferens of two other species; rabbit and rat. ANAPP3, in a concentration which antagonized responses to exogenously applied ATP but not those to exogenous norepinephrine, preferentially reduced the initial phasic response of the rabbit vas deferens to motor nerve stimulation without significantly reducing the secondary, tonic phase of the response. Prazosin had the opposite effect; antagonizing the response to norepinephrine but not to ATP and reducing the tonic response to motor nerve stimulation without significantly reducing the initial phasic response. Results obtained with the rat vas deferens were similar. The present results combined with previous findings suggest that ATP and norepinephrine act as cotransmitters in the vas deferens of several species. PMID- 6493000 TI - The effect of ethanol on prolactin secretion in vitro. AB - In order to investigate the action of ethanol on the anterior pituitary gland, the effect of ethanol on prolactin secretion in vitro was studied. Ethanol significantly increased the in vitro incorporation of 3H-leucine into both prolactin contained within the pituitary gland and that released into the medium. The enhancement of 3H labelled-prolactin synthesis induced by ethanol was suppressed by cycloheximide. These results support the hypothesis that ethanol stimulates the in vitro synthesis and release of prolactin by the pituitary gland. PMID- 6493001 TI - Changes in lipid composition of cortical synaptosomes from different age groups of mice. AB - Lipid composition of cortical synaptosomes differed with age in C57BL/6NNIA mice. Significant age differences were observed for cholesterol and the ratio of cholesterol to total phospholipid phosphorus content. The phospholipid to protein ratio of individual phospholipids also increased with age with diacyl-sn-glycero 3-phosphocholine (PC) increasing the most. Acyl group composition of individual phospholipids, however, showed little age difference. The double bond index for PC decreased significantly with age. Changes in membrane composition may help explain differences in the effects of ethanol on the physical and biochemical properties of membranes from different age groups that have been reported previously. PMID- 6493002 TI - Effects of melatonin and 6-methoxy-tetrahydro-beta-carboline in light induced retinal damage: a computerized morphometric method. AB - The effects of melatonin and a related 5-methoxy-indole, 6-methoxy-1,2,3,4 tetrahydro-beta-carboline (6-MeO-THBC) were investigated in rats on the development of retinal degeneration in presence of high intensity illumination (HII). A morphometric method is used in which the degree of degeneration was evaluated by a computer-coupled graphical analyzer. Instead of measuring individual thicknesses of different retinal layers at various loci we measured large areas of retinal light microscopic sections. Thus the influence of sporadic artefactual and other fluctuations in the thickness of various layers of the retina can be essentially reduced. Continuous light produced significant degeneration of the retina and the degree of degeneration was further increased by both studied compounds and even more by 6-MeO-THBC. The role of melatonin and 6-MeO-THBC in retinal physiology is discussed. PMID- 6493003 TI - Effect of bromocriptine, a dopamine receptor agonist, on the experimentally induced gastric ulcers in albino rats. AB - The effect of bromocriptine, a dopamine receptor agonist, has been studied on the aspirin, phenylbutazone and reserpine induced gastric ulcers in rats. A single dose of bromocriptine 4 mg/kg s.c. produced a significant exacerbation of gastric ulcers induced by all the three ulcerogenic drugs, whereas in the same dose administered once daily for 5 consecutive days, it produced a marked protective effect in all the models. A review of the literature shows that different mechanisms may be involved in the opposite effects of acutely and chronically administered bromocriptine observed in this study. The study also points towards a role of dopamine in the pathogenesis of gastroduodenal ulceration. PMID- 6493005 TI - Does dehydration contribute to retarded fetal growth in rats exposed to alcohol during gestation? AB - An earlier study showed that pregnant rats given ethanol in drinking water exhibited a significant degree of dehydration. The objective of the present study was to determine whether dehydration alone contributes to fetal growth retardation in alcohol treated rats. Female Sprague-Dawley rats were divided into 4 dietary groups. Group 1 (alcohol) received 20% ethanol in drinking water for four weeks prior to mating and 30% alcohol in drinking water throughout pregnancy and a stock diet ad libitum. Group 2 (pair-fed) was given an amount of food equal to that consumed by the alcohol group with the alcohol isocalorically substituted by corn starch. Water was available ad libitum. Group 3 (pair-water) was given an amount of food and water equal to that consumed by the alcohol animals. Group 4 (ad libitum) was given food and water ad libitum. On day 21 of gestation body weights of the alcohol exposed fetuses were significantly lower than those of the other three treatment groups. The difference in fetal body weights between the pair-fed and pair-water groups was not significant. Placentas were significantly heavier in the alcohol group than in the pair-fed and pair-water groups. Maternal plasma osmolality was significantly higher in the alcohol treated rats when compared to the pair-fed and ad libitum controls but not the pair-water group. No significant differences were seen in fetal plasma osmolality among the four treatment groups. It is concluded that dehydration does not contribute significantly to retarded fetal growth in rats given alcohol in drinking water as the sole source of fluid prior to and during gestation. PMID- 6493004 TI - Functional tolerance to alprazolam-induced neurologic deficits in mice. AB - Tolerance to alprazolam-induced neurologic deficits was assessed in mice by a rotarod test. Tolerance was found following a second administration of 2 mg/kg alprazolam 24 h after the first dose and it decayed gradually over a period of several weeks. Brain and plasma concentrations of alprazolam indicated that this tolerance was functional. PMID- 6493006 TI - Induction of retinol esterification in retinal pigment epithelial cells by butyrate. AB - Butyrate induced marked morphological changes in cultured human retinal pigment epithelial (RPE) cells. The cells assumed a flattened structure within six hours of exposure to butyrate. The butyrate-treated retinal pigment epithelial cells possessed an enhanced capacity to esterify retinol. Among all short chain organic acids tested, butyrate was by far the most effective, followed by pentanoate and hexanoate. The inductive effect of butyrate was specific for retinol esterification, since the incorporations of fatty acid into phosphatidyl choline and cholesteryl ester were not enhanced. Time-dependent, butyrate-enhanced retinol esterification may be related to the inhibition of cell proliferation. This represents the first report on the induction of retinol esterification in cultured retinal pigment epithelial cells. PMID- 6493007 TI - In vivo binding of spiroperidol and bromospiroperidol at low drug loadings. AB - The binding of spiroperidol and bromospiroperidol, in vivo, was studied over a wide range of drug dosages. It was found that while spiroperidol and bromospiroperidol bind selectively in vivo to tissues known to be high in dopamine receptor binding sites, this specificity of binding does not persist at very low doses. Such anomalous binding behavior can have implications for the non invasive imaging of these drugs. PMID- 6493008 TI - [Aggressiveness of drug addicts]. PMID- 6493009 TI - [Drug dependence. Analysis of the activity of the District Mental Health Service, U.S.L. No. 3, Imperia]. PMID- 6493010 TI - [Evaluation of the "climate of well-being" as a social indicator of health]. PMID- 6493011 TI - [Rorschach profiles in a group of heart patients and a group of patients with gastroenteropathies. Comparative analysis]. PMID- 6493012 TI - Death during recreational exercise in the State of Rhode Island. AB - From January 1, 1975 to May 1, 1982, 81 individuals died during or immediately after recreational exercise in the State of Rhode Island. Deaths occurred during a variety of activities, but the majority of deaths occurred during golf (23%), jogging (20%), and swimming (11%). Atherosclerotic coronary heart disease (ASHD) was the presumed cause of 88% of the deaths, primarily in subjects over age 29 with known cardiac abnormalities. Only 7% of ASHD victims had no relevant medical history or ASHD risk factors and were considered healthy by their families and physicians. In contrast, deaths in young subjects were rarely associated with ASHD or prior knowledge of cardiovascular disease. Only six deaths in individuals aged 29 or younger occurred during the study period. These deaths were associated with congenital cardiovascular disease (N = 2), valvular heart disease (N = 1), hemorrhagic gastritis (N = 1), idiopathic myocardial hypertrophy (N = 1), and hypertrophic cardiomyopathy with ASHD (N = 1). A diagnosis was made before death only in the individual with valvular disease. We conclude that death during recreational exercise is predominantly due to ASHD and occurs in men with recognized ASHD risk factors, relevant medical histories, or known disease. Death during exercise in asymptomatic subjects is rare and relatively more frequent in younger age groups. PMID- 6493013 TI - Bone mineral content and menstrual regularity in female runners. AB - The relationship between bone mineral content and menstrual regularity in 10 amenorrheic runners (0-3 menses during the past year), 12 runners with regular menstrual cycles (10-12 menses during the past year), and 15 non-athletic women with regular menstrual cycles was investigated. Comparisons of the two groups of runners indicated no significant differences in body fatness, average weekly running distance, or average daily intake of calcium (Ca), phosphorus (P), and Ca/P ratios. Mean bone mineral content for the three groups, measured by photon absorptiometry, was 0.508, 0.529, and 0.544 g X cm-2, respectively, at 3 cm distal radius, and 0.707, 0.700, and 0.707 g X cm-2, respectively, at one-third distal radius, indicating no significant differences among the groups (P less than 0.05). However, a significant relationship (r = 0.77) was noted between bone mineral content and body fatness only in the amenorrheic runners. Within the amenorrheic population, the five thinnest runners had significantly lower mean bone mineral content values at 3 cm distal radius (0.457 g X cm-2) than the five runners with higher relative body fatness (0.559 g X cm-2). We conclude, therefore, that amenorrhea, independent of body composition, was not related to reduced bone mineral content in female runners. However, the combination of excessive thinness and amenorrhea may, in fact, predispose female athletes to reduced bone mass. PMID- 6493014 TI - Specificity of arm training on aerobic power during swimming and running. AB - The specificity of aerobic training for upper-body exercise requiring differing amounts of muscle mass was evaluated in 25 college-aged male recreational swimmers who were randomly assigned to either a non-training control group (N = 9), a 10-wk swim(S)-training group (N = 9), or a group that trained with a standard swim-bench pulley system (SB; N = 7). For all subjects prior to training, tethered-swimming peak VO2 averaged 19% below treadmill values (P less than 0.01), while SB-ergometry peak VO2 was 50% and 39% below running and swimming values, respectively (P less than 0.01). Significant (P less than 0.01) increases of peak VO2 in tethered swimming (11%) and SB (21%) were observed for the SB-trained group, while the S-trained group improved (P less than 0.01) 18% and 19% on the tethered swimming and SB tests, respectively. No changes were observed during treadmill running, and the control subjects remained unchanged on all measures. Comparisons between training groups indicated that although both groups improved to a similar extent when measured on the swim bench, the 0.53 l X min-1 improvement in tethered-swimming peak VO2 for the S-trained group was greater (P less than 0.05) than the 0.32 l X min-1 increase noted for the SB trained group. The comparisons between SB and S exercise vs treadmill exercise support the specificity of aerobic improvement with training and suggest that local adaptations contribute significantly to improvements in peak VO2. Furthermore, the present data indicate that SB exercise activates a considerable portion of the musculature involved in swimming, and that aerobic improvements with SB training are directly transferred to swimming. PMID- 6493015 TI - Physiological responses to prolonged upper-body exercise. AB - To date, investigators have not examined physiological responses to prolonged upper-body exercise. Knowledge of the feasibility of performing this type of exercise and the elicited responses could have application in designing continuous training programs for upper-body muscle groups. Nine males, with a peak oxygen uptake (means +/- SD) of 49 +/- 7 for cycle (CY) and 35 +/- 6 ml X min-1 X kg-1 for arm crank (AC) exercise, completed four 60-min exercise tests. The subjects performed AC and CY exercise at the same absolute (ABS) oxygen uptake (1.6 1 X min-1) and at the same relative (REL) percent of ergometer specific peak oxygen uptake (60%). During the ABS tests, AC exercise elicited significantly (P less than 0.05) greater heart rate (HR), ventilatory equivalent of oxygen (VE X VO2(-1), blood lactate (La), and percent decrease in plasma volume (PV) than CY exercise. During the REL tests, HR was lower and VE X VO2(-1) was higher for AC than CY exercise; there were no differences between AC and CY exercise in La or PV responses. These data demonstrate that upper-body exercise can be performed for 60 min at a relative intensity which might be sufficient to elicit a cardiovascular training effect. However, because heart rates are lower during upper-than lower-body exercise at the same relative intensity, exercise prescriptions based on heart rate alone may need to be modified for upper-body exercise. PMID- 6493016 TI - Haptoglobin and serum enzymatic response to maximal exercise in relation to physical fitness. AB - This study investigated the potential value of specific cellular responses to acute and chronic exercise as indices of physical fitness. Muscle enzymatic and hemolytic responses following a progressive cycle-ergometer test to maximal aerobic capacity were studied in 12 women and 12 men, aged 27 to 55 yr, who had been previously assigned to "high" and "low" fitness groups. Venous blood samples were obtained at rest prior to the cycle test, immediately following maximal effort, and 1, 2, 4, 6 and 24 h post exercise. The samples were analyzed for hematocrit (Hct), hemoglobin (Hb), lactate dehydrogenase (LDH), serum glutamic oxalacetic transaminase (SGOT), creatine phosphokinase (CK), CK isoenzymes, and haptoglobin (Hapt). Hemoglobin and Hct were the only variables to rise significantly (P less than 0.05) following exercise, and at all sampling times were significantly lower in the women compared with the men; CK was constituted in the MM isoenzyme band at all times; and Hapt levels were significantly lower in high-fitness men and women as compared with low-fitness men and women. These results indicate that one progressive test to maximal aerobic capacity is not sufficient to induce significant muscle enzymatic or hemolytic stress responses. They do suggest, however, that a chronic hemolytic condition exists as a result of aerobic conditioning activity. PMID- 6493017 TI - Influence of intense endurance training on aerobic power of competitive distance runners. AB - This study examined the time course of the aerobic response to strenuous training in well-conditioned distance runners when intensity was held fairly constant relative to maximal aerobic power, and the effect of this training on 10-km run time. Seven runners trained 6 d/wk for 6 wk. On 3 d/wk they ran as far as possible in 40 min, with the intention of running a greater distance each run. On alternate days the subjects performed five 5-min rides on a cycle ergometer (CE) separated by 5-min intervals of jogging, with the resistance adjusted to induce peak-CE VO2 during minutes 4 and 5 of each ride. Peak-CE VO2 increased (56.1 to 65.0 ml X min-1 X kg-1, P less than 0.05) in a linear manner (r = 0.95, P less than 0.01) during the first 5 wk. The average weekly increase was 0.11 l X min-1. Unexpectedly, peak-CE VO2 decreased significantly after week six. Treadmill VO2max was not significantly different after training. The mean decrease (P less than 0.05) in 10-km run time was approximately 81 S. These data suggest an adaptation of constant magnitude of the factor(s) which limit peak-CE VO2 when training intensity is maintained relative to improvement. However, this linear response and training intensity may be maintained only on a limited basis without expecting some decline in performance and aerobic power. PMID- 6493018 TI - Kinematic factors influencing performance and injury risk in the bench press exercise. AB - The purpose of this research was to identify kinematic factors that could be relevant to performance and injury risk in the bench press. The methods used included: use of high-speed, 2D cinematographic procedures to record the performances of 36 subjects (19 experts and 17 novices), determination of the kinematic and kinetic differences between the groups, and identification of a rationale describing how those kinematic differences could lead to the kinetic differences. Kinematic factors so identified could influence performance and injury risk. In addition to the fact that experts were able to lift 79% more weight than the novices, the pertinent kinetic differences included the following: 1) the difference in peak force exerted while lowering the bar was only 43%; 2) the difference in peak force exerted while raising the bar was only 45%; and 3) the difference in minimum force exerted while raising the bar was 87%. There was no significant difference in torque required at the shoulder. The relevant kinematic differences were: 1) the expert group maintained a smaller bar speed while lowering the bar, 2) the expert group used a bar path closer to the shoulders; and 3) the expert group used a different sequence of bar movements. The roles of these kinematic factors in the bench press merit further investigation. PMID- 6493019 TI - Kinetic sources of lower-limb angular displacement in the recovery phase of sprinting. AB - One female sprinter was filmed at the 100-m mark (speed 6.5 m X S-1) of a 400-m run. Four moments occurring at each end of the thigh and shank segments during lower-limb recovery were calculated. These were: proximal and distal net muscle moments, a moment due to proximal joint accelerative force and, a moment due to distal joint-force resulting from motion and inertia of the distal connected segment. Individual contributions of each moment to segmental angular displacement were calculated by double integration, and angular velocity at toe off was multiplied by time to yield its contribution. Contributions of the proximal muscle moments throughout recovery were 21 rad and 7.5 rad for the thigh and shank segments, respectively. Such large angular displacements did not occur because the three remaining moments opposed the proximal muscle moment. These large moments are mutually offsetting and interactive, acceleration of proximal joints provides a substantial moment during contralateral stance, and segmental angular velocity at toe-off is a significant contributor. Consequently, a phenomenon producing a change in any moment (e.g. muscular fatigue, slippery surface) will require modification of other moments for angular displacement to be maintained within reasonable limits. PMID- 6493020 TI - The influence of somatotype on anthropometric prediction of body composition in young women. AB - The influence of somatotype on the validity of anthropometric prediction of body density (Db) in young women (N = 92) was investigated. Three groups of predominantly endomorph (N = 27), mesomorph (N = 35), and ectomorph (N = 30) women were identified by the Heath-Carter and Sheldon somatotyping methods. Discriminant analysis revealed a 100% accuracy in somatotype group determination. Thirteen diameters, 26 girths, and 8 skinfolds were measured and used in a STEPWISE regression analysis to derive somatotype-specific regression equations to predict body density. Combining all the measures provided very good prediction accuracy in all three groups with multiple correlation coefficients (R) of 0.98, 0.90, and 0.90, and the standard error of estimate (SEE) of 0.003, 0.005, and 0.005 for Db (gm X cc-1) in the endomorphs, mesomorphs, and ectomorphs, respectively. A cross-validation study confirmed the accuracy of the somatotype specific regression equations and demonstrated an inherent weakness in using some generalized equations on specific somatotypes. The use of non-somatotype-specific equations resulted in mean Db prediction errors ranging from -0.018 to +0.023 gm X cc-1 (8.5 to -10.7% Fat). Although all equations tested demonstrated specific weaknesses in one or more of the somatotype groups when predicting Db, the Jackson et al. (1980) equation performed better than most of the non-somatotype specific prediction equations. These findings suggest that the anthropometric estimation of Db may not be sample specific in the same manner as had been previously thought and that greater accuracy may be achieved by using regression equations which have been generated on a previously somatotyped population sample. PMID- 6493021 TI - Body composition prediction in university football players. AB - This study was intended to determine if previously-developed body composition prediction equations were valid for use with a Division I university football team. A sample of 68 Division I football players with a mean age of 19.7 yr, was assessed for body density (BD) by underwater weighing (UWW), residual volume by helium dilution, and 26 selected anthropometric measures. A predicted BD was obtained by using two sets of equations developed from college football players and from three generalized equations. The differences between predicted and observed body densities were analyzed. Seven of the nine models examined failed to accurately predict the BD for this population of university football players. One sport-specific equation of White, Mayhew, and Piper for individuals in the backfield and a generalized model of Jackson and Pollock (JP) containing two circumferences performed well when considering the mean of differences and the magnitude of total error relative to the published standard error. However, both of these models overestimate body density for players with low BD and underestimate BD when actual BD is high. Using the JP model for a player whose actual BD is near the sample mean of 1.070, the estimated mean is very close at 1.069. However, for players with actual BD of 1.050, the estimated mean is 1.054, and if actual BD is 1.085, the JP estimated mean is 1.078. The bias is linear between these points. PMID- 6493022 TI - Body composition by hydrostatic weighing at total lung capacity and residual volume. AB - Body density and percent fat were determined by hydro-static weighing (HW) at residual volume (RV), total lung capacity measured on land (TLCL), and total lung capacity measured in water (TLCW) in 50 male and 50 female subjects. Residual volume was measured on land by using the helium dilution method. Vital capacity was measured both on land and with the subject submerged to the neck in water. Total lung capacity was reduced during water submersion by 6.7 and 5.1% in males and females, respectively. Body density was 1.0588 +/- 0.0215, 1.0581 +/- 0.0207, and 1.0634 +/- 0.0214 for males, and 1.0246 +/- 0.0219, 1.0242 +/- 0.0233, and 1.0276 +/- 0.0238 for females at RV, TLCW, and TLCL, respectively. Percent fat was 17.7 +/- 9.7, 18.0 +/- 9.3, and 15.7 +/- 9.5 for males, and 33.4 +/- 10.3, 33.5 +/- 10.8, and 32.0 +/- 11.0 for females at RV, TLCW, and TLCL, respectively. Body density and percent fat were similar when measured by HW at RV and by HW at TLCW. Body density and percent fat measured by HW at TLCL were different than when measured by HW at RV (P less than 0.001). The subjects, using a modified 10 point Borg Scale, rated the HW procedure easier to perform at TLC than at RV (P less than 0.001). The results of this study indicate that measurement of body density and percent fat by HW at TLCW and HW at RV are similar, but if measured by HW at TLCL, body density is overestimated and percent fat is underestimated. PMID- 6493023 TI - Optimum design of diving snorkels. AB - This manuscript deals with the development of theoretical and experimental procedures for investigating the flow phenomena associated with the clearing and breathing phases of the simple J-type snorkel. Special test stands have been built to monitor the effect of changing the snorkel geometrical parameters on its clearing efficiency and breathing resistance characteristics. The experimental results are used to check the validity of the mathematically-developed models that simulate the flow during the clearing and breathing phases. These models are then used as a basis for the development of a rational design procedure that would enable snorkel designers to select the optimum geometrical parameters in a way that guarantees a balance between the breathing and clearing requirements in snorkels. The developed procedures are general in nature and can be readily extended to study snorkels of more complex shapes when operating under various conditions and constraints. PMID- 6493024 TI - Regression analysis in physiological research: some comments on the problem of repeated measurements. AB - The statistical implications of repeated-measures linear regression, in which each subject contributes several pairs of measurements to the analysis, are discussed in the context of physiological research. The major point of the paper is that standard least-squares procedures cannot be applied without modification to regression problems with repeated measures. An example is given. PMID- 6493025 TI - Microscopic anatomy of the adult human brachial plexus: an anatomical and histological basis for microsurgery. AB - On the basis of 100 brachial plexus dissections in adult subjects, the angular variations of roots in their intrarachidian and cervical portions are examined. Serial histological sections of 21 brachial plexuses allow one to define fascicular histologic organization. These descriptions of biometric anatomical variation and complexity in histological fascicular organization help to elucidate the difficulties that must be overcome following nerve suture in order to achieve a satisfactory functional recovery. PMID- 6493026 TI - Liver revascularization with the left gastric artery following portocaval shunt in rats: technique and preliminary results. AB - The technique of liver arterialization with the left gastric artery after portocaval shunt in the rat is described. The operation was carried out with three different modalities, and the best results were obtained when suturing was carried out after enlargement of the arterial caliber (0.4-0.5 mm external diameter), advantage of a vessel bifurcation. Eighty percent of the anastomosis were patent without any anticoagulant treatment 1 month after surgery. Preliminary results show the positive effect of liver arterialization compared to treatment with portocaval shunt alone. PMID- 6493027 TI - Resection and anastomosis of a cervical vertebral artery aneurysm. AB - A patient with a fusiform aneurysm of the cervical vertebral artery at C-1 presenting with posterior circulation infarctions is reported. Exposure via the posterolateral approach, resection of the aneurysm, and end-to-end anastomosis are described. The authors emphasize the importance of the surgical approach and ability to expose and mobilize a generous portion of the cervical vertebral artery. PMID- 6493028 TI - Implantable pulsed Doppler cuff for long-term monitoring of free flaps: a preliminary study. AB - High-frequency (20 mHz) ultra-sonic Doppler in a pulsed mode rather than continuous mode allows blood flow detection in small arteries using a 1-mm crystal embedded in a silastic cuff. The "probe factor" used to determine flow was first established in an in vitro system and found to be reliable. The probe was then tested in five dogs on the saphenous artery and found to be highly responsive to hemodynamic changes in the pedicle. Finally, in 15 long-term studies of island flaps and free flaps, the probes were implanted to obtain daily readings and then removed at 7 days. Except for some dog-related problems and technical errors, the system produced reliable flow data in the percutaneous cable. It is anticipated that such immediate and direct information on the pedicle blood flow would be useful in monitoring flaps. PMID- 6493029 TI - Organization and implementation of a community hospital microsurgical service for the management of amputation injuries. AB - The genesis of a voluntary referral system with the establishment of a microsurgical replantation center in a community hospital is described. Specific hospital and emergency care protocols are outlined, along with the percentage distribution of peripheral hospitals utilizing this service. Over the initial 6 year period, a success rate greater than 85% has been achieved in those cases that have satisfied the criteria for revascularization and replantation. PMID- 6493030 TI - New small-caliber antithrombotic vascular prosthesis: experimental study. AB - Vascular prostheses with the inner diameter smaller than 1 mm were implanted to the common carotid artery of rats, and their patency was examined. Four types of tubes were prepared for this purpose in Experiment 1: polyethylene (PE), poly (acrylic acid)-grafted polyethylene (PE-AA), polyacrylamide-grafted polyethylene (PE-AAm), and poly(vinyl alcohol) (PVA) tubes. Comparative studies made using nonsuture anastomosis revealed that the PE-AAm and PVA tubes were antithrombotic, although disconnection was noted at the anastomotic sites within 1 week and 1 month, respectively. Thereafter in Experiment 2, the PVA tubes were implanted to the common carotid artery of 20 rats using conventional anastomosis. Neither anticoagulants nor fibrinolytic agents were used in both series of experiments. Patency of the PVA tubes was 80% after 1 week and 70% after 1 month. In patent cases after 1 month, the luminal surfaces of the prostheses and the host arteries were examined using scanning electron microscopy. The lumen of the arteries and anastomotic sites was covered with endothelial cells, while the lumen of the PVA tubes was free from thrombi and there was no neointima formation. So far, there has been reported no manmade material that has completely antithrombotic property in vivo. However, our studies disclosed that PVA is antithrombotic and one of the most promising materials for the inner surface of small vascular prostheses. PMID- 6493031 TI - Free transplantation of venous network pattern skin flap: an experimental study in rabbits. AB - Free skin flaps using rabbit ear to replace rabbit scalp have been accomplished using only arteriovenous and venous-venous anastomosis, without arterio-arterial anastomosis. The technique produced excellent graft survival in 30 of 33 rabbits. Without the vascular anastomosis control grafts did poorly. The mechanism of flow reversed revascularization is discussed. PMID- 6493032 TI - Dystrophic calcification, cataracts, and enamel hypoplasia due to long-standing, privational vitamin D deficiency. AB - A 19-year-old Indian girl presenting with intermittent tetany, enamel hypoplasia, bilateral cataracts, and calcification of the basal ganglia is described. Dental evidence suggested a calcification defect had been present from the age of 2-3 years. Hypocalcemia, hyperphosphatemia, and low levels of immunoassayable parathyroid hormone (iPTH), urinary cAMP, 25-hydroxyvitamin D, and 1,25 dihydroxyvitamin D were documented, suggesting hypoparathyroidism with vitamin D deficiency. A bone biopsy showed osteomalacia. Following ultraviolet irradiation and oral calciferol therapy, a symptomatic and biochemical response typical of privational vitamin D deficiency occurred. iPTH levels rose to normal and remained normal following withdrawal of treatment, indicating that the clinical features were entirely due to long-standing vitamin D deficiency. PMID- 6493033 TI - Three-dimensional distribution of mineral in bone at a resolution of 15 micron determined by x-ray microtomography. AB - The application of x-ray microtomography (computerized axial tomography) to the histomorphometry of bone at a resolution of approximately 15 micron is described. Serial sections (obtained without physically cutting the sample) separated by 25 micron were made from an 0.8 mm square rod of human femoral bone. These showed several haversian canals and changes in mineralization within individual sections. The results obtained are quantitative in terms of the x-ray linear absorption coefficient, which is closely related to the degree of mineralization. Thus x-ray microtomography has the potential for the nondestructive determination of the fractional bone volume, with the ability to select the degree of mineralization of the bone used to determine the fraction. PMID- 6493034 TI - Expansion of the medullary cavity at the expense of cortex in postmenopausal osteoporosis. AB - Transilial biopsies from postmenopausal osteoporotic patients showed that static features and remodeling activity tended to form a pattern, with the area midway between the cortices having less bone and lower remodeling activity than the area closer to the inner boundary of the cortex. The appearance, enlargement, and coalescence of the resorption cavities within the subendosteal area of the cortex lead to negative bone balance and a progressive trabeculation of the cortex, resulting in the formation of a transitional zone. Therefore, in most cases we can distinguish two different zones, transitional and trabecular zones, within the area usually known as the trabecular bone area. The transitional zone undergoes more active remodeling than the trabecular zone and has an important role in evaluation of the traditional trabecular bone volume and remodeling dynamics depending on the field selection for this evaluation, i.e., the proportion between transitional and trabecular zones within the selected fields. We postulate that the appearance of resorption cavities in the subendosteal area of the cortex depends on excessive osteoclast work, and bone loss in the resulting transitional zone depends on a combination of excessive osteoclast work and defective osteoblast work, with the osteoclast excessive work predominating. PMID- 6493035 TI - Reconstruction of the resorptive site in iliac trabecular bone: a kinetic model for bone resorption in 20 normal individuals. AB - The variations with time in function and morphology at the resorptive site in normal iliac crest trabecular bone were reconstructed from tetracycline double labeled iliac crest bone biopsies from 20 normal individuals. Resorption depths below osteoclasts, mononuclear cells, and preosteoblast-like cells were measured by counting the number of lamellae of known thickness eroded. Mean resorption depth below osteoclasts was 19.0 (+/- 4.9) micron. Lacunae containing mononuclear cells were deeper (P less than less than 0.0001), with a mean resorption depth of 49.1 (+/- 10.2) micron. The deepest lacunae were lacunae containing preosteoblast like cells, with a mean resorption depth of 62.6 (+/- 12.5) micron. This depth was significantly deeper (P less than 0.001) than the resorption depth found below mononuclear cells. Median total resorption period was 48 days (31-68; 95% confidence interval). Median osteoclastic function period was 8 days (6-12), median mononuclear cell function period was 34 days (24-48), and median period where preosteoblast-like cells were present in lacunae before matrix synthesis started was 9 days (6-13). Distribution curves describing the occurrence of the three cell types in relation to resorption depth showed that osteoclasts occupied the more superior parts of the resorption lacunae, with mononuclear cells and preosteoblast-like cells situated in the deeper parts. The distribution curves support the hypothesis that osteoclasts precede mononuclear cells, which again precede preosteoblast-like cells. Based on this hypothesis, curves showing the variation in resorption depth with time were constructed in duplicate. Resorption rates were calculated for three periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493036 TI - Reconstruction of the formative site in iliac trabecular bone in 20 normal individuals employing a kinetic model for matrix and mineral apposition. AB - A stereologic procedure for the reconstruction of matrix and mineralized bone growth curves at formative sites in trabecular bone is presented. Iliac crest bone biopsies obtained from twenty normal individuals after tetracycline double labeling were investigated histomorphometrically. Corresponding values for osteoid width and apparent distance between bone markers and width of mineralized bone walls were classified using a sector plotting system. Observed structure widths were converted to three-dimensional structure thicknesses by a stereologic unfolding procedure. Osteoid thickness, calcification rate, and fractional labeling of osteoid varied characteristically with increasing wall thickness and permitted the construction of curves describing the time-dependent variations in matrix and wall thicknesses. The mean thickness of completed walls was 61.9 +/- 1.5 micron (SE), and the mean bone formation period (Sigma f) was 145 days (124 168; 95% confidence interval.). The initial appositional rates for bone matrix (2.1 microns3/microns2/day) (1.4-2.9) and bone mineral (1.1 micron3/micron2/day) (0.4-1.9) declined gradually toward zero at the end of Sigma f. The initial mineralization lag time was 15 days (12-24) and increased to a maximum of 27 days during the first 45% of Sigma f. Thereafter, it decreased gradually toward zero. The height of the osteoblast nuclei gradually declined from 6.7 +/- 0.5 micron at the start of bone formation to 1.2 +/- 0.1 micron at the end. The study demonstrates that it is possible to reconstruct growth curves for trabecular bone walls based on three-dimensional values for structure thicknesses using different sections for light and fluorescence microscopy and avoiding classification according to osteoblastic nuclear morphology.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493037 TI - Computerized simulation of bone remodeling: graphic demonstration of dynamic processes. AB - A computerized simulation model has been developed to study the histologic patterns of dynamic remodeling processes in trabecular bone. The osteoid seam thickness and the distance between the tetracycline labels are calculated based on (partly hypothesized) parameter values, such as matrix appositional rate, mineralization rate, number and life span of the osteoclasts, resorption rate, and mineralization lag time. The results of a simulation run are demonstrated using computer graphics. Such simulation results cast doubts on the validity of some approaches that attempt to infer details of remodeling processes from histologic measurements. For example, the distance between the tetracycline labels obtained by simulation illustrates the difficulty of over-or underestimating the matrix appositional rate by measuring it from a histologic section. PMID- 6493038 TI - Osteoclast populations in congenital osteopetrosis: additional evidence of heterogeneity. AB - Osteopetrosis is a metabolic bone disease characterized by excessive accumulation of skeletal mass due to a reduction in bone resorption. The pathogenesis of osteopetrosis is reduced osteoclast function. Reports of osteoclast numbers in several mammalian mutations exhibiting osteopetrosis have shown them to be increased, decreased, or normal in numbers. The present investigation quantitated the osteoclast populations and examined the cytology of osteoclasts by light microscopy in calvarial and tibial sites in one rabbit and two mouse mutations and compared them with their normal littermates. Our observations show that osteoclast numbers are, depending on the particular mutation, increased, decreased, or comparable to those found in normal littermates. In each mutation, however, osteoclasts fail to exhibit the cytoplasmic vacuolization next to bone surfaces seen in normal osteoclasts. These data provide additional evidence of heterogeneity in the congenital mammalian osteopetrosis and suggest that these mutations may be significant sources of new information about the biology of osteoclasts. PMID- 6493039 TI - Direct and indirect measurements of osteoid seam width in human iliac crest trabecular bone. AB - The osteoid thickness index, calculated from the relative osteoid volume and surface, has been compared with the mean osteoid seam width, measured directly, in iliac crest trabecular bone from 57 normal subjects and 33 patients with privational or malabsorption metabolic bone disease. In normal biopsies the osteoid thickness index overestimated mean osteoid seam width by a variable amount and the two variables were only weakly correlated (r = 0.32, P less than 0.01). In patients with hyperosteoidosis there was a stronger correlation between the osteoid thickness index and the true mean seam width (r = 0.89, P less than 0.001). Examination of the mean width of individual seams pooled from 15 randomly selected patients in each group revealed a skewed distribution with thin seams predominating, especially in normal biopsies. Median seam width was significantly lower than mean seam width in both groups studied. We conclude that osteoid thickness index is an inaccurate method of predicting the mean osteoid seam width, especially in biopsies with normal osteoid amount. Median values of osteoid seam width are more representative of average seam width, both in normal and abnormal biopsies. PMID- 6493040 TI - Measurement of total resorption surface in iliac crest trabecular bone in man. AB - Total resorption surface has been measured under ordinary light and polarized light in trabecular iliac crest bone from 57 healthy subjects and 40 patients with privational or malabsorption metabolic bone disease. Results obtained with the two methods were similar, although values for total resorption surface measured under polarized light were usually lower than those obtained under ordinary light in both groups of subjects studied. This most likely reflects the greater accuracy in the microscopic identification of resorption surface under polarized light. PMID- 6493041 TI - Collagen orientation in compact bone: I. A new method for the determination of the proportion of collagen parallel to the plane of compact bone sections. AB - Previous work has shown that different types of osteons that have different mechanical properties with regard to tension and compression can be identified and studied by polarized light microscopy. This study reports the development of an automated method for the analysis of that proportion of collagen in transverse sections of human femurs that lies parallel with the plane of section. The method is based upon the use of circularly polarized light to detect collagen with a major component lying in the plane of the section, correcting the measurement for bright collagen under these circumstances with a corresponding darkfield measurement to determine the area of bone within each field of the section analyzed. The method has been validated in several different ways. The measured value of bright collagen under circularly polarized light depends upon the section thickness, since a linear relationship was found between section thickness and bright areas for a large number of microscopic fields. Plane parallel sections are therefore recommended for this study. The pattern of distribution of bright areas was the same for different observers and different set detection levels in any one section. The pattern found in adjacent sections from the same region of the shaft was identical. PMID- 6493042 TI - Collagen orientation in compact bone: II. Distribution of lamellae in the whole of the human femoral shaft with reference to its mechanical properties. AB - Starting from a previous personal investigation (Portigliatti Barbos et al., 1983) indicating that the distribution of osteons and interstitial bone in the middle of the femoral shaft is related to their structure, a new procedure has been devised to allow information of the same kind to be gathered from the whole of the femoral diaphysis. Twenty-three exactly plane parallel cross-sections, 100 micron thick, each located 1 cm from the next, were prepared using an annular blade microtome. The distribution of longitudinal lamellae (whose fiber bundles and crystallites have longitudinal course and withstand loading by tension) and transverse lamellae (whose fiber bundles and crystallites have a transverse course and withstand loading by compression) was determined for both osteonic and interstitial bone, using circularly polarized light as the illuminating source and a Quantimet 720 image analyzing computer. The results show that along the femoral shaft the transverse and longitudinal lamellae from osteonic and interstitial bone have a characteristic rotational distribution consistent with the distribution of the bending forces normally operative in bone. PMID- 6493043 TI - Microdissection--elemental analysis of the mineralizing growth cartilage of the normal and rachitic chick. AB - The concentrations of elements in avian growth cartilage were studied by electron probe x-ray emission microanalysis (EDX). The cartilage was prepared for analysis by freezing, freeze-fracturing, freeze-drying, and carbon coating techniques. Cells and matrix fragments were removed from the tissue by microdissection with a tungsten needle in a scanning electron microscope (SEM) equipped with a real-time stereoscopic viewing facility. The samples were analyzed in the same SEM by EDX. Elemental analyses were performed on each fragment at a distance from the tissue sample, and hence background radiation due to the sample was eliminated. An important finding was that the intracellular potassium concentration of chondrocytes in calcified cartilage was similar to the levels in the premineralized zones. This observation supports the view that chondrocytes do not die in the process of, or as a consequence of, mineralization of the surrounding matrix. Calcium peaks were seen in the matrix at all levels and in chondrocytes immediately prior to mineralization. In contrast, phosphorus levels were always high in cells and low or absent from the premineralized matrix. At the mineralization front the appearance of a phosphorus peak in the matrix just preceded the deposition of mineral. We propose that the transfer of phosphorus from cell to matrix is a rate-limiting step in mineralization. Finally, when rachitic and normal cartilage were compared, little difference was seen in the profile of either intracellular or extracellular elements. However, in rickets the mineralized matrix remained soft in consistency. We suggest that this may reflect a phosphorus-related calcification defect that prevents growth and interlocking of the apatite crystallites. PMID- 6493044 TI - Dietary omega-3 fatty acids prevent carbohydrate-induced hypertriglyceridemia. AB - Dietary fish oils rich in omega-3 fatty acids are remarkably hypotriglyceridemic in both normal and hypertriglyceridemic subjects. This present study was designed to examine the hypothesis that dietary fish oils could prevent the usual sharp increase in plasma triglyceride and very low-density lipoprotein (VLDL) levels that occur physiologically after the induction by a high-carbohydrate diet. Seven healthy volunteers consumed three experimental liquid formula diets: the baseline diet (45% fat, 10% protein, 45% carbohydrate) and two high-carbohydrate diets (15% fat, 10% protein, 75% carbohydrate), one as a control diet and the other containing fish oil. The baseline and control dietary fats were a mixture of peanut oil and cocoa butter, whereas the fish oil diet contained high levels of omega-3 fatty acids. The plasma triglyceride levels rose from 105 mg/dL during baseline diet to 194 mg/dL during the high-CHO control diet (P less than 0.005). VLDL triglyceride levels increased from 69 to 156 mg/dL (P less than 0.005) and VLDL cholesterol from 18 to 34 mg/dL (P less than 0.005). When fish oil was substituted for the control fats, plasma triglyceride levels fell from 194 to 75 mg/dL (P less than 0.005), VLDL triglyceride and cholesterol levels were reduced from 156 to 34 mg/dL (P less than 0.005) and from 34 to 12 mg/dL (P less than 0.005), respectively. These effects were noted by two to three days after beginning the fish oil diet. Thus, dietary omega-3 fatty acids from fish oil rapidly and markedly reduced VLDL triglyceride levels even in the face of a high carbohydrate diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493045 TI - Whole-body tyrosine flux in relation to energy expenditure in weight-losing cancer patients. AB - Whole-body tyrosine flux was measured in seven weight-losing cancer patients and compared with that of seven noncancer patients with malnutrition. L[U-14C] tyrosine was infused intravenously (IV) after an overnight fast under resting conditions and flux rates, oxidation, and incorporation into proteins of tyrosine were calculated from plateau values of specific activity of tyrosine in plasma and of labeled expired carbon dioxide. Rates of protein synthesis were calculated from the flux rate of tyrosine after subtracting the proportion oxidized. Simultaneous measurements of whole-body carbon dioxide production and oxygen uptake were also performed in each subject. Cancer patients had elevated whole body tyrosine flux, protein synthesis, and energy expenditure when expressed in relation to body weight and whole-body potassium while the differences in tyrosine kinetics became of borderline significance when expressed in relation to energy expenditure. Tyrosine incorporation into whole-body proteins corresponded to a synthesis rate of 2.70 +/- 0.17 protein/kg/d in cancer patients and 2.18 +/- 0.17 in control patients (P less than 0.025). The results show that elevated protein synthesis in weight-losing cancer patients may explain not more than one third of the elevated energy expenditure. Therefore, other systems that utilize energy must increase in activity. PMID- 6493046 TI - 3'-Monoiodothyronine degradation in rat liver homogenate: enzyme characteristics and documentation of deiodination by high-pressure liquid chromatography. AB - Characteristics of 3'-monoiodothyronine (3'-T1) degradation were examined in vitro in rat tissue homogenates. In rat liver homogenates, 3'-T1 degradation was optimal at pH 7.4, and was dependent upon time, temperature, and tissue concentration. The Michaeli's constant (Km) = 0.84 mumol/L. 3'-T1 degradation was enhanced by dithiothreitol and inhibited by propylthiouracil, sodium ipodate, ANS, and sodium azide but not by methimazole. Animals that fasted for three days had significant reductions in both hepatic T4 to T3 conversion (199 +/- 12 v 116 +/- 12 pg T3 generated/mg protein; P less than 0.001) and 3'-T1 degradation (588 +/- 31 v 148 +/- 53 pg 3'-T1 degraded/mg protein; P less than 0.001). To document that 3'-T1 degradation was occurring by deiodination, both liver and kidney homogenates were incubated with 125I-3'-T1 (approximately 3 microCi; 13.1 nmol/L). The reaction products were separated on a reverse-phase high pressure liquid chromatography (HPLC) column. In both tissues an iodide peak was generated, and no other radiolabeled peaks appeared except for 125I-3'-T1. These data suggest that 3'-T1 is metabolized by phenolic-ring monodeiodination and is enzymic in nature. PMID- 6493047 TI - Effect of low-dose oral contraceptives on lipoproteins and lipolytic enzymes: differences between two commonly used preparations. AB - Changes in circulating lipoproteins, which may be related to the risk for atherosclerotic vascular disease, were studied in a control group and in two groups of 24 or 26 women using different preparations of low-dose oral contraceptives for 3 months. One preparation contained 150 micrograms levo norgestrel and 30 micrograms ethinylestradiol (Stediril-d 150/30); the other contained 750 micrograms lynestrenol and 37.5 micrograms ethinylestradiol (Ministat). No significant changes were found with either of the preparations in serum cholesterol or high density lipoprotein cholesterol (HDL-C) levels. Apolipoprotein A-II levels increased during Ministat treatment from 50.4 to 61.4 mg/dL and during Stediril-d 150/30 treatment from 52.7 to 58.9 mg/dL (both P less than 0.001). These changes differed significantly from each other (P less than 0.01). Apolipoprotein A-I levels increased significantly during use of Ministat only. Apolipoprotein B in low density lipoprotein increased by about 20% (P less than 0.001) in both groups. Post-heparin lipoprotein lipase activity did not change, but hepatic lipase activity decreased to the same extent in both groups (P less than 0.001). Reductions in post-heparin lipase activity were not correlated with increases in HLD-C. PMID- 6493048 TI - Reduced norepinephrine turnover in mice with monosodium glutamate-induced obesity. AB - The disappearance of norepinephrine from the heart, interscapular brown adipose tissue (BAT), and pancreas has been examined in mice with monosodium glutamate (MSG)-induced obesity and in untreated controls. MSG-treated mice became obese in the absence of increased food intake and their core temperature was significantly lower compared to control mice. The rate of norepinephrine turnover following blockade of norepinephrine synthesis with alpha-methyl-para-tyrosine was significantly slower in heart and interscapular BAT of these mice than in untreated controls, but MSG had no effect on the pancreas. It is suggested that reduced norepinephrine turnover may be a major factor in the development of obesity after neonatal administration of MSG. PMID- 6493049 TI - Severe depression of high-density lipoprotein cholesterol levels in weight lifters and body builders by self-administered exogenous testosterone and anabolic-androgenic steroids. AB - The effects of nonphysician prescribed, self-obtained, self-administered exogenous anabolic-androgenic steroids and testosterone on plasma total, high- and low-density lipoprotein cholesterol (HDLC, LDLC), and triglycerides were evaluated in 14 adult white men, 11 body builders and 3 power weight lifters. Lipids and lipoprotein cholesterols were quantified during active physical conditioning, both on (for at least 1 month, mean +/- SD 1.8 months) and off (for at least 4 months, 7.3 +/- 2.7 months) self-administered exogenous androgenic steroids. The subjects took 50 to 100 mg methandrostenolone daily plus weekly injections of testosterone 100 to 200 mg and nandrolone decanoate 100 to 200 mg per week. Mean (SD) HDLC on exogenous androgenic steroids, 29 +/- 8 mg/dL, was severely depressed, and was less than 50% of the consistently elevated mean HDLC when exogenous steroids were not used (61 +/- 14 mg/dL, P less than .01 for paired differences). During anabolic steroid use, HDLC was less than or equal to the age- race- and sex-specific 10th percentile in 11 of the 14 men, whereas while off anabolic steroids, HDLC was greater than or equal to the 90th percentile in 7 of the 13 men, and in the top quartile for 3 of the remaining 6 men. Mean LDLC was higher on androgenic steroids (150 +/- 44) than off (125 +/- 38 mg/dL), P less than .05 for paired differences. The ratio of LDLC/HDLC during exogenous steroid use (6.0 +/- 3.7) was nearly triple the ratio obtained when steroids were not taken (2.2 +/- 1.0), P less than .01 for paired differences.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493050 TI - Carbamylation of hemoglobin in renal failure and clinical aspects. AB - It was revealed that in renal failure hemoglobin A1 (HbA1) was formed by the binding of substances other than glucose to Hb. It was elucidated that the formation of HbA1 increased in urea-added medium and further increased in media containing urea either stored at 37 degrees C for 1 week or heated at 100 degrees C for five minutes. The increment of HbA1 was proportional to the amount of cyanic acid produced by the treatment of the medium after the addition of urea. We found that there was the best correlation between the HbA1 level and the BUN level of 1 to 2 weeks before. Therefore, it appeared that HbA1 could be an indicator of the state of renal failure of 1 to 2 weeks earlier in patients with renal failure without impaired glucose tolerance, especially in patients on hemodialysis. PMID- 6493051 TI - Posttranslational modifications. Part A. PMID- 6493052 TI - Pyridoxal phosphate-binding site in enzymes; reduction and comparison of sequences. PMID- 6493053 TI - Amino-terminal acetylation of proteins: an overview. PMID- 6493054 TI - Ion-exchange chromatography of some amino acid derivatives found in proteins. PMID- 6493055 TI - Actin amino-terminal acetylation and processing in a rabbit reticulocyte lysate. PMID- 6493056 TI - Amino-terminal protein transacetylase from wheat germ. PMID- 6493057 TI - Detection of an N-terminal glucuronamide linkage in proteins. PMID- 6493058 TI - High-performance liquid chromatography probes for posttranslationally modified amino acids. PMID- 6493059 TI - Identification of posttranslationally modified amino acids in proteins by mass spectrometry. PMID- 6493060 TI - Nomenclature and symbolism of alpha-amino acids. PMID- 6493061 TI - Histidinoalanine: a naturally occurring cross-linking amino acid. PMID- 6493062 TI - S beta-(bilin)cysteine derivatives: structures, spectroscopic properties, and quantitation. PMID- 6493063 TI - Covalent attachment of flavin to flavoproteins: occurrence, assay, and synthesis. PMID- 6493064 TI - Purification and characterization of (ADP-ribosyl)n proteins. PMID- 6493066 TI - Measurement of nonenzymatic protein glycosylation. PMID- 6493065 TI - Quantification of protein-bound ADP-ribosyl and (ADP-ribosyl)n residues. PMID- 6493067 TI - In vivo racemization in mammalian proteins. PMID- 6493068 TI - Skull x-ray assessment of head injuries: a decision analytic approach. PMID- 6493069 TI - Bayesian models for clinical studies. PMID- 6493070 TI - Multistate survival analysis: an application in breast cancer. PMID- 6493071 TI - Studies on the enteropathogenic mechanism of non-O 1 Vibrio cholerae isolated from the environment and fish in Toyama Prefecture. AB - Enteropathogenic mechanisms of non-O 1 Vibrio cholerae were investigated using strains from the environment and those from fish in Toyama Prefecture. None of the 93 non-O 1 V. cholerae strains produced a detectable level of choleratoxin like-enterotoxin (CT-like-enterotoxin) in Syncase medium, while 23 strains showed a distinct fluid accumulation in the rabbit ileal loop test (RIL). These RIL positive strains neither produced CT-like-enterotoxin in vitro in the other four kinds of media which are considered suitable for CT production, nor in vivo in the ligated ileal loop. Approximately one-third of RIL-positive strains produced a fluid accumulating factor (FAF) which was not neutralized with anti-CT serum. FAF of a representative strain (Strain 79-9-2) was inactivated by heating at 100 C for 10 min, and has a molecular weight within the range of 50,000 to 100,000 daltons. Most accumulated fluids in RIL after inoculation with whole cultures of RIL-positive strains contained both hemolytic and cytotoxic principles. Desquamation of epithelial cells, inflammatory edema, neutrophile infiltration, loss of goblet cells and frequent hemorrhages were observed in sections of ligated ileal loop inoculated with whole cultures or concentrated culture filtrates of CT-like-enterotoxin-negative but RIL-positive strains. In contrast, neither desquamation of epithelial cells nor hemorrhage was observed in sections after inoculation with those of a CT-like-enterotoxin positive strain (Strain E 8498). These results indicated that most RIL-positive non-O 1 V. cholerae strains from the environment and fish isolated in Toyama Prefecture produce little CT like-enterotoxin, but some of them produce FAF with cytotoxic activities. PMID- 6493072 TI - Phospholipases of Leptospira. I. Presence of phospholipase A1 and lysophospholipase in Leptospira biflexa. AB - The hydrolysis of phosphatidylethanolamine, phosphatidylcholine, lysophosphatidylcholine, and trioleoylglycerol by Leptospira biflexa strain Urawa was studied in vitro. Phospholipase A1 was identified by the formation of 32P- and 14C-labeled lysoderivatives from 32P-phosphatidylcholine, 32P phosphatidylethanolamine, or 1-acyl-2-[1-14C]oleoyl-sn-glycero-3 phosphorylcholine. Phospholipase A1 activity was independent of lipase in the microorganism since 14C-labeled trioleoylglycerol was scarcely attacked under the same conditions in which the phospholipids were hydrolyzed. Lysophospholipase activity was also demonstrated using 32P- and non-labeled lysophosphatidylcholine. The activity of phospholipase A1 was found in a broad range of pH but no optimal pH was determined. The pH optimum of lysophospholipase was 8.0. Both enzymes were labile to heat. Phospholipase C activity, however, could not be detected because no radioactive di- and monoacylglycerol was found in the experiment with 1-acyl-2-[1-14C]-oleoyl-sn-glycero-3-phosphorylcholine as the substrate. It was inferred that phosphatidylethanolamine, which was the major component of phospholipids in leptospirae, was hydrolyzed serially by phospholipase A (A1 and/or A2?) and lysophospholipase to glycerophosphorylethanolamine via 2-acyl-type-lyso-derivative as one metabolic pathway of the substrate. PMID- 6493073 TI - Slow development of measles virus (Edmonston strain) infection in the brain of nude mice. AB - The Edmonston strain of measles virus caused neurologic disease in athymic nude mice by intracerebral inoculation. The incubation periods of the disease, however, were extremely long, ranging from 59 to 140 days when the mice were inoculated with 10(4) plaque forming units (PFU) of the virus. The Edmonston strain was highly infectious in the nude mouse brain since virus infection was established even with 1 PFU of the virus. Virus titers in the brains of infected mice increased with the time of incubation. These results indicate that the extremely long incubation period of the disease is ascribed to very slow development of virus infection in the mouse brain. On the other hand, the incubation periods of the Biken strain of SSPE virus were very short (generally within 2 weeks) even with inoculations of 1 PFU of the virus. However, the extent of the dissemination of infection in brains was not significantly different between the two viruses as examined by immunofluorescent staining. PMID- 6493074 TI - Development of a new cell system for the infectivity assay of dengue viruses: plaque formation and virus growth of prototype and wild-type dengue virus strains in a newly established cell line, GK. AB - A newly established cell line, GK, derived from the kidney tissue of Mongolian gerbils, produced plaques by infection of prototype and wild-type dengue virus strains. Both prototype and wild strains of type 2 virus grew in GK cells and formed plaques at 35.5 C and at 31 C, while types 1, 3, and 4 wild strains grew and formed plaques only at 31 C. In GK cells, plaque formation and the growth of dengue viruses depended on the high (35.5 C) and low (31 C) incubation temperatures. Virus yields in GK cells of all the 14 dengue virus strains tested, including four prototype and ten wild-type viruses, were 5 to 1,000-times lower than those in C6/36 cells. After five serial passages in GK cells, types 2, 3, and 4 prototype viruses and type 2 wild strain increased virus yields, and one strain of prototype virus and one strain of wild-type virus decreased mouse neurovirulence. PMID- 6493075 TI - Distribution of two types of regular-array particles in the cell wall of Bacillus aneurinolyticus (Kimura et Aoyama). PMID- 6493076 TI - [Immunological etiopathogenesis of senile and complicated cataract]. AB - In this study, anti - lens antibody and auto - antibody levels have been searched in the sera and aqueous of 69 patients with different kind of senile cataract and 9 patients with complicated cataract after glaucoma, and in sera of 50 healthy persons as control group. Antibody levels were not significant in patients with cataract. PMID- 6493077 TI - [Antibody titers in the serum of patients suspected of typhoid using the classical Widal and microagglutination tests]. AB - Blood serum samples taken from typhoid fever suspected patients during the last typhoid fever epidemic in Ankara in 1981 were tested comparatively with classical Gruber-Widal test and microagglutination technique using safranin-stained Salmonella typhi O and H antigens. Results showed that microagglutination technique was more reliable, less time and antigen consuming and permitted a more objective evaluation of agglutinin titers. PMID- 6493078 TI - [First isolation of Salmonella haardt and Salmonella ahuza serotypes in humans in Turkey]. AB - S. haardt and S. ahuza have been isolated first time from the feces and the urine cultures of the patients in Turkey. S. ahuza has been previously isolated from Citellus citellus gelengius in Turkey. PMID- 6493079 TI - [Brucellosis and rheumatic fever]. AB - Brucellosis and Acute Rheumatic Fever can not be verified by only clinical manifestations and the pattern of joint involvement. Four patients presented below had high fever, sweats, severe arthralgia and swelling of one or multiple joints, elevated sedimentation rate and positive C - reactive protein test and even leukocytosis. Therefore they were treated with anti - rheumatic drugs for 4 to 7 days after onset till brucellosis was considered or its specific tests became positive. PMID- 6493080 TI - [Zoonoses and their importance in our country]. PMID- 6493081 TI - Acquired immune deficiency syndrome (AIDS). Hypotheses on the etiology. AB - AIDS could be caused by a mutant hepatitis B virus or even a prion-like agent. Hepatitis B, as a retro-like virus, might induce cancerous cells, which, like other malignant cells, could produce substances that inhibit macrophages and their activation of T-cells. Hepatitis B, by reverse transcription, might become a provirus in or adjacent to the Ir gene of the major histocompatibility locus (MHC) altering the Ia antigen on macrophages and inhibiting the immune response. A prion could by reverse translation produce a similar effect on the Ir gene or by protein----protein replication create new antigenic proteins which could confuse immune signals from the macrophages to T-cells; create enzymes modifying existing antigenic determinants; and create proteins not recognized as "self" that could initiate a frank, but subtle autoimmune phenomenon. Any one, or an interaction of these events, could create a "negative autoimmunity": the immune system would attack itself. PMID- 6493082 TI - The role of IgE in atopic diseases. AB - The fact that about 20% of the patients with severe atopic disease have normal or subnormal serum IgE levels, and that the severity of the disease does not always correlate with IgE levels, does not reduce the importance of this antibody in the onset of the illness. A possibility is suggested here that even low IgE concentrations are capable of playing a key role in the pathogenesis of the disease, and being directly responsible for its clinical manifestations. Namely, atopic patients who show low IgE levels seem to have high tissue sensitivity even to these low levels of IgE and to react with these low concentrations of the antibody. PMID- 6493083 TI - Three steps mutation model of carcinogenesis. AB - Based on recent data, this model supposes that benign and malignant tumors arise when a specific mutation takes place in a specific protein-kinase encoded by a proto-oncogene in a pluripotent stem cell or a committed stem cell. Protein kinases which are regulated by tissue growth stimulating factors, tissue growth inhibiting factors and differentiating factors phosphorylate specific proteins that can derepress specific genes leading to cell division and cell differentiation. Malignant tumors arise when three mutations happen in a same pluripotent stem cell or committed stem cell: positive mutation at the level of tissue growth stimulating factor; negative mutation at the level of tissue growth inhibiting factor; negative mutation at the level of tissue differentiating factor. Higher expression of oncogenes and amplification reflect the relationship between tumor and host. Chromosomal rearrangements are secondary events that can be important because they may involve genes which are normally not involved in cell division and cell differentiation. PMID- 6493084 TI - A proposed mechanism for cooperativity among oncogene products in cancer cells. AB - A widely studied model for the mechanism of oncogenic transformation involves the insertion of an oncogene or the activation of a proto-oncogene in a normal cell. Both the nature of the oncogene- and proto-oncogene-products and the mechanisms by which they act to transform the cell are poorly understood. Oncogenic transformation in tissues is believed to involve a phenomenon called cooperativity in which more than one oncogene or proto-oncogene must be activated to effect transformation. It is proposed that the various oncogene and proto oncogene-products that lead to the transformation of a given cell type either mimic or are the enzymes and other proteins involved in mediating the mitogenic signal to which that cell type responds. Cooperativity among oncogenes follows from this because increased activity or increased levels of mediators in the mitogenic sequence could increase the efficiency of transmission of mitogenic signals from the cell surface, thereby lowering the threshold level of growth factor activity required to initiate DNA synthesis. PMID- 6493085 TI - Analysis of the oncogene hypothesis. AB - Cancer may be a natural biological event commencing at birth. Its activity is dependent upon the absence of an anti cancer gene agent or agents which are also present from birth. PMID- 6493086 TI - Kwashiorkor. AB - Kwashiorkor kills millions of young children in the tropical Third World. It was believed to be a disease of protein starvation. The medical team headed by Professor Ralph Henrickse of the Liverpool School of Tropical Medicine has discovered that aflatoxin, a fungus toxin, may be the triggering factor in this disease which also impairs liver function. In New Zealand, we have a pasture fungus, the spores of which produce a liver toxin that has killed millions of animals this century and impaired the performance of millions more. New Zealand is a pastoral farming country with 70 million sheep and several million cattle. We now protect the animal with zinc medication. This paper describes the similarities between Kwashiorkor and the mycotoxic liver disease in New Zealand livestock, known locally as Facial Eczema. It describes briefly my discovery that pharmacological doses of zinc protected farm animals from pasture contaminated with the spores of the fungus Pithomyces chartarum, which contains the toxin sporidesmin. This paper proposes that Kwashiorkor and Facial Eczema are diseases with similar beginnings and a common end. PMID- 6493087 TI - Negative pressure and reductio ad absurdum. AB - The popular theory of "Negative Pressure", and its implications, conflict with the facts established by radiologists, divers, submarines and modern aviation. Though pressure in the body (belly or thorax) may at times seem negative, under ordinary circumstances it cannot be less than atmospheric, and in fact averages slightly more. The spontaneous movement of air from a pneumothorax or pneumoperitoneum, out into the atmosphere, proves this. The fact that elimination of a pneumoperitoneum or pneumothorax can take days or more, proves that pressure in the pleural or peritoneal cavities averages only slightly greater than pressure in the lymphatics/veins/atmosphere. Using Euclid's test for a hypothesis of examining its implications, one finds that negative pressure cannot exist in the body. Further, function of the contractile organs; heart, lungs, bowels, uterus, etc. are favored by pressure which stays close to neutral or zero, that is atmospheric. Atmospheric pressure is the bottom line, whereas "Negative Pressure" like "vacuum" is merely a theoretical concept. PMID- 6493088 TI - Philadelphia chromosome--an artifact. PMID- 6493089 TI - Can hypoglycaemia cause obsessions and ruminations? AB - Two cases of obsessional ruminations apparently secondary to functional hypoglycaemia are described. Both patients are young Caucasian males with obsessional histories at the start of dietary treatment of 18 and 6 years, respectively. In both cases, reactive hypoglycaemia was confirmed by glucose tolerance test. The first case made a complete recovery on dietary treatment which has lasted over two years; previous treatment with drugs, behaviour therapy, and counselling were unsuccessful The response of the second case has been less outstanding due to poor compliance, but improvement and worsening have been systematically related to the extent of his adherence to the suggested dietary regimen. These cases raise questions for further research on this neglected subgroup of obsessional patients. PMID- 6493090 TI - Sleep promotion, hospital practice and recovery from illness. AB - Is sleep especially beneficial in times of illness? Despite the widespread use of hypnotics, the medical position on this question is equivocal, for hospital practices seem rarely designed to encourage maximum sleeping. Sleep promotion is defined as the arrangement of conditions so that patients can achieve as much sleep as possible. It is hypothesised that sleep promotion is of benefit, at least by improving patient well-being, possibly also be hastening healing processes. Some background to the hypothesis and some possible consequences of it are discussed. It is recommended that hospital procedures should be designed to encourage sleeping. PMID- 6493091 TI - Cognitive determinants of the perception of mental health status. AB - This paper suggests that an individual's perception of his health and mental health status may be largely determined by his concept or definitions of health and mental health and that how one defines these terms are a function of one's level of awareness of higher needs. A conceptual model is presented that locates these cognitive variables within the causal framework relative to help-seeking behavior and provides the theoretical basis for a methodology of determining the mental health needs of a population, especially in a developing country, based on self-assessment of health status. PMID- 6493092 TI - Synovial fluid circulation in the hip joint. AB - Early in our study of the role of incongruency in the hip (Ref. 1) we observed by x-ray screening that, under load, a drop of barium sulphate placed between the articular surfaces spread out between them and a substantial portion was extruded from the intercartilage space into the fossa; all the barium was drawn back as load was reduced. This observation and others (Ref. 2) which demonstrated the location, size and behaviour of intercartilage space with movement and load, prompted exploration of the hypothesis that the space due to joint incongruency serves as a pump to transport synovial fluid in the articular cavity in aid of nutrition and lubrication. This had already been suggested by others (Ref. 3); but none have closely studied the hypothesis. The following is an expansion of this idea, which leads to the concept of a systematic circulation of fluid through the hip joint. PMID- 6493093 TI - Caloric balance, brain to body ratio, and the timing of menarche. AB - Caloric availability regulates female reproductive function. Menses do not normally occur until the amount of stored fat is sufficient to meet the nutritional requirements of pregnancy. Unusual energy drains such as heavy exercise cause a reversible cessation of menses. The brain appears to monitor the balance between the availability of calories and their utilization, and reproduction is suppressed when the balance is unfavorable. We postulate that the juvenile human brain, with its unique metabolic requirements, constitutes an important energy drain in the premenarchal girl, and that caloric utilization by the brain may explain the delay of reproductive competence in man. It follows that the changing energy requirements of the brain relative to the body during normal premenarchal growth may play a key role in the timing of menarche. Pathological examples of altered brain to body ratios support this hypothesis: an increase of the brain to body ratio has been observed to delay menarche, a decrease of the brain to body ratio to advance menarche. We explore several clinical implications of this hypothesis and present suggestions for its experimental evaluation. PMID- 6493094 TI - Chronic pain: an addiction. AB - Chronic pain is distinguished from persistent pain and it is proposed that chronic pain involves addiction to the endogenous opioid system. Even when the organic lesions responsible for pain are removed, chronic pain can be maintained as an internal state preventing the withdrawal or abstinence syndrome associated with endorphins and enkephalins. PMID- 6493095 TI - Further observations on tissue heating patterns using an invasive ground probe with radiofrequency hyperthermia system. AB - Critical modifications have been made in the grounded elements of a previously reported hybrid radiofrequency heating system with inductive, capacitive, and grounded elements designed for deep focal heating. These modifications facilitate introduction of the ground probe, the single invasive element of the system, into animals and humans. The modified grounded elements also enable monitoring and optimization of ground point current, thereby improving control of heating rate, and greatly increase the volume of tissue that can be heated using a single invasive grounding element, embedded in a lossy dielectric field in the near field of the radiofrequency hyperthermia system. PMID- 6493096 TI - Potential hazard to cardioversion patients. AB - Differences in the operating protocols of various defibrillators may result in a safety hazard to the patient during cardioversion. PMID- 6493097 TI - Perspectives on electrical equipment used in oxygen-enriched atmospheres. AB - The medical community has not seriously examined the safety of using medical devices in oxygen-enriched atmospheres (OEA) or with nitrous oxide. A review of applicable codes and standards, reports of actual incidents, and experiments on minimum ignition energy and on determining the extent of OEA around a patient receiving respiratory therapy suggests that guidelines are needed. Several means of ensuring the safety of electrical equipment to be used in conjunction with oxygen are recommended. These include: compliance with standards for flammable atmospheres; sealing to prevent OEA from reaching electrical components; ventilating to limit oxygen concentration; and limiting potential spark energy and surface temperatures. These recommendations are made in the hope that the medical community will address this issue further. PMID- 6493098 TI - Budget restrictions, equipment obsolescence, and risk: the quandary of whether to replace, to be without, or never to acquire. PMID- 6493099 TI - Evaluation of electronic, digital blood pressure monitors: failure rates and accuracy. AB - Four electronic, digital blood pressure monitors intended for home use were evaluated for failure rate and accuracy. Blood pressures from the electronic monitors were compared to standard clinical, manual auscultatory blood pressure measurements, concurrently and sequentially recorded. The instruments were evaluated for accuracy by linear regression and coefficients of correction. Wide variations were observed in the accuracy and failure rates of these monitors. It appears, therefore, that there are significant differences between the various electronic, digital blood pressure monitors available. Some of these may not be suitable for home use at the present time. PMID- 6493100 TI - Membrane invasion culture system (MICS). AB - New methods for studying the invasive properties of malignant neoplasms are being developed continually. The advantages and disadvantages associated with currently available models have been capitalized upon in the development of a new system that is versatile, reliable, fast, and simple to operate. In order for a tumor cell to metastasize, it must be capable of traversing many complex biological barriers. Because treatment metastatic neoplasms poses many problems for the clinician, the elucidation of the invasion process is of vital importance for the successful treatment of malignant disease. We have developed a system for studying the invasive properties of cells that can be performed accurately with relative ease within a short period of time. This versatile system offers extensive applications for studying invasion properties and parameters. Our model is classified as the Membrane Invasion Culture System. PMID- 6493101 TI - Bioequivalent chemical steam sterilization indicators. AB - Biological indicators used to monitor steam sterilization cycles have two major shortcomings--the incubation period needed to determine if sterilization was accomplished, and the reliance on test packs for gathering information in each load. Chemical indicators do not suffer from these shortcomings. Chemical indicators can respond to time, temperature, and steam parameters to thus parallel the BI reaction. Nine commercially available chemical indicators and four biological indicators were evaluated under the conditions of dry heat, in a biological indicator-evaluator resistometer vessel, and in a hospital sterilizer. The results indicate that wider use of integrated chemical steam sterilization indicators is recommended. PMID- 6493102 TI - A testing and evaluation protocol for in-hospital sterilization containers and its application to a new container system. AB - A new containerized sterilization system has been designed to fulfill the needs of central supply departments and operating rooms, as well as the recommendations of various professional associations and accrediting agencies. The testing that was performed to demonstrate the function and efficacy of the system in the hospital environment illustrates the evaluation criteria that should be applied to any containerized sterilization system. Among the unique features of this containerized system are: a tortuous-path lid design to protect the permeable biobarrier portion of the container from direct challenge, a drain to allow condensation to exit the container, and reusable valves to allow steam entry and air removal. Evaluation of containers with reusable valves revealed the cause of a previously unexplained phenomenon that affects drying and suggested means by which this phenomenon can be prevented. PMID- 6493103 TI - Clinical engineering education in the high technology hospital. AB - The application of high technology in the critical care field has created two potential approaches: (1) development of critical care technicians to coordinate clinical engineering educational support; and (2) modification of the hospital organization to streamline communications between the clinical engineers and those they support. At one university hospital studied from 1978 to 1982, both the use of high technology equipment and the number of critical care technicians approximately doubled. With emphasis on technician coordination of engineering support, the in-service education lectures increased 134%, while the engineering staff and the corrective maintenance workload remained unchanged. PMID- 6493104 TI - Automated indirect blood pressure measurement--a response. PMID- 6493105 TI - Privacy and medical research. PMID- 6493106 TI - Epidemiological research and privacy protection. PMID- 6493107 TI - Boxing--time for fresh action. PMID- 6493108 TI - The incompetent diagnosis of cancer. PMID- 6493109 TI - Medical teaching and the rural doctor. PMID- 6493110 TI - Micronutrient deficiencies in the 1980s. PMID- 6493111 TI - "The grave yawns for the horseman." Equestrian deaths in South Australia 1973 1983. AB - The fatalities associated with the riding and handling of horses in South Australia over the 11-year period 1973-1983 are reviewed. There were 18 deaths, including two sudden natural deaths in the saddle and one drowning. The 15 cases of horse-related trauma represent a death rate of approximately one per million population per annum. Thirteen of the deaths were the result of a head injury after a fall. Nine persons were not wearing protective headgear. The two principal groups at risk were male professional riders with a mean age of 32 years and female amateurs with a mean age of 19 years. PMID- 6493112 TI - Riboflavin status of adolescents in southern China. Average intake of riboflavin and clinical findings. AB - The average riboflavin intake of 11 200 schoolchildren, aged 12-19 years, in Guangdong Province, China, was measured. Food intake was measured by weighing, and riboflavin intake was calculated by means of food tables. The average intake of riboflavin was 0.45 mg/day. In addition, clinical observations were made in 1313 adolescents in the dietary survey. The findings were consistent with the low intake of riboflavin. The observed clinical signs of riboflavin deficiency were scrotal dermatitis (7.9% of boys), angular stomatitis (5.8% of boys, 2.7% of girls), cheilosis (8.0% of boys, 5.6% of girls) and magenta tongue (36.0% of boys, 40.8% of girls). Corneal vascularization was found only in two of the 1313 children. Scrotal lesions resolved within three to six days after the oral administration of riboflavin (15 mg/day); the resolution of tongue and lip signs progressed more slowly. PMID- 6493113 TI - Perennial rhinitis. A common childhood complaint. AB - Symptoms of rhinitis in 595 children who attended an allergy clinic over a four year period were examined to determine the relative frequencies of perennial rhinitis and seasonal rhinitis (hay fever). Perennial rhinitis was much more common than seasonal rhinitis at all ages, and only 12% of children with rhinitis had symptoms restricted to the grass pollen season. The detection of eosinophils in nasal smears from subjects with rhinitis was uncommon (10% of cases), while mast cells were found in one third of cases. Rhinitis was the most common symptom of atopic disease. PMID- 6493114 TI - Search for possible fatal cases of toxic shock syndrome. AB - Records of Australian women of menstrual age whose deaths were registered in 1978 and 1979 were examined. Unrecognized toxic shock syndrome could not be excluded as the cause of one of these deaths. PMID- 6493115 TI - An experiment in privacy protection. AB - During investigation of toxic shock syndrome in New South Wales, record keepers were requested not to disclose the identities of subjects. Nevertheless, many record keepers disclosed these identities to the investigator. Covering letters giving extra stress to privacy protection had no special effect. The extent of disclosure appeared to be greater for record keepers who either are infrequently approached for research data or lack the facilities to prepare non-identified abstracts of personal information. These record keepers may benefit from education about their responsibilities. PMID- 6493116 TI - Parental perinatal grief as viewed by a community health sister. PMID- 6493117 TI - Princely medicine. PMID- 6493118 TI - The art of bicycle propulsion. A personal view of medical education. PMID- 6493119 TI - Rubella warning. PMID- 6493120 TI - Teenage drinking and drunkenness. PMID- 6493121 TI - Cimetidine and peptic ulcer. PMID- 6493122 TI - Allergy supplement. PMID- 6493123 TI - AIDS and blood donors. PMID- 6493125 TI - Lead levels in deciduous teeth of Queensland children. AB - Lead levels in the deciduous teeth of 292 Queensland children aged between 4 and 9 years are reported. Samples were obtained through the cooperation of parents of children attending kindergartens throughout the State in 1981. Information relating to the child's place of residence, home environment and parents' occupation was also gathered with the aid of a questionnaire. Tooth lead levels ranged from 0 to 29 micrograms/g (mean, 3.4 micrograms/g; SD, 4.1 micrograms/g). Possible relationships between aspects of the subject's history and lead levels are discussed and the data are compared with those of similar, already published studies. PMID- 6493124 TI - AIDS and community supportive services. Understanding and management of psychological needs. PMID- 6493126 TI - Cost of nitroimidazoles. PMID- 6493127 TI - Guts. PMID- 6493128 TI - Autologous blood transfusion for elective surgery. PMID- 6493129 TI - Effects of swimming on health. PMID- 6493130 TI - The overuse of tenosynovitis. PMID- 6493131 TI - Sudden death mechanisms in the alcoholic. PMID- 6493133 TI - [Interactions in antihypertensive therapy]. PMID- 6493132 TI - [Inflammation of the female genital organs]. PMID- 6493134 TI - [Essential hypertension: what's new?]. PMID- 6493136 TI - Continuing medical education with a personalized monthly newsletter. AB - The periodic newsletter is an approach to continuing medical education whose value is difficult to measure. A six-page monthly newsletter covering cancer and ambulatory medicine topics has been developed in two departments of a university medical center to meet perceived educational needs of new regional primary care practitioners and to maintain a helping relationship between university based and practicing physicians. The newsletter is sent free of charge to requesting clinicians. Each issue of the newsletter is introduced by a personalized letter signed individually by the editor. A reader survey was conducted to evaluate the interest of recipients and the content, usefulness, and format of the newsletter. A usable response rate of 76% was achieved. The evaluation documented that most readers found the publication useful in their practices, remembered receiving issues specifically, kept issues themselves after circulation to colleagues, and read the cover letter. Compared with conference or formal journal instructional methods of continuing medical education, a newsletter may consistently reach a larger audience at a fraction of the cost. PMID- 6493135 TI - Treatment of multiple sclerosis with anti-measles cow colostrum. AB - Previous virological and immunological studies have suggested that multiple sclerosis (MS) is an auto-immune disease triggered by a virus infection. In order to inhibit the growth of measles virus in the patient's jejunum, we obtained an IgA-rich cow colostrum containing anti-measles lactoglobulin resistant to proteases. This colostrum was orally administered to patients with MS to investigate its effect on the course of the disease. Measles-positive antibody colostrum was orally administered every morning to 15 patients with MS at a daily dosage of 100 ml for 30 days. Similarly, measles-negative antibody (less than 8) control colostrum was orally administered to 5 patients. As a clinical assessment, disability scores developed by the International Federation of Multiple Sclerosis Societies were used. As a result, of 7 high NT titre (512 5120) anti-measles colostrum recipients 5 patients improved and 2 remained unchanged. Among 8 low NT titre (8-32) anti-measles colostrum recipients 5 patients improved and 3 remained unchanged. However, of 5 negative NT titre (less than 8) colostrum recipients 2 patients remained unchanged and 3 worsened. No side-effects were observed in colostrum recipients. These findings suggest the efficacy of orally administered anti-measles colostrum in improving the condition of MS patients (P less than 0.05). PMID- 6493137 TI - Involved field (IF) irradiation with or without chemotherapy in the management of children with Hodgkin's disease. AB - The present policy at Memorial Sloan Kettering Cancer Center (MSKCC) of treating children with Hodgkin's disease [HD] is as follows: involved field (IF) irradiation only (3,600 rad) for Stages IA and IIA; IF irradiation (2,400 or 2,000 rad) combined with multidrug chemotherapy (MDP) protocol for all other stages. A somewhat higher recurrence rate is accepted for Stages IA and IIA in view of the good salvage rate for these recurrences and in view of side effects of more aggressive types of radiation treatment. One hundred forty-two patients with HD, 2-19 years of age, were treated at MSKCC between 1970 and 1981; 98 of these were treated according to the present policy (SP group), and 44 (NP group) were treated differently. All SP patients underwent staging laparotomy. The follow-up time was 12 to 146 months with a median of 65 months; two patients were lost to follow-up. For the SP group, all stages, 10-year disease-free survival is 77%, and 10-year survival is 93%. By comparison, in the NP group 10-year disease free survival is 64%, and 10-year survival is 80%. The disease-free survival of SP patients in Stages IA and IIA treated with IF radiation alone is 72%, and survival is 95%. The disease-free survival of SP patients in advanced stages treated with combined radiation and chemotherapy is 87%; the salvage rate of recurrent disease in these stages is poor. The survival was apparently better (P = 0.07) in the SP group as compared to the NP group. All 6 patients of the SP group who died had a nodular sclerosing type of HD. None of the patients in the SP group have developed secondary malignancies, and no severe bone growth retardations or late effects to other organs were observed. In our opinion, IF irradiation alone might at present be suitable treatment for children in Stages IA and IIA of Hodgkin's disease, and addition of IF radiation with low doses of MPD improves the survival of patients in advanced stages. PMID- 6493138 TI - Retinoblastoma, eosinophilic granuloma, and malignant melanoma: a case report. AB - The case history of a patient treated for unilateral hereditary retinoblastoma who subsequently developed malignant melanoma and eosinophilic granuloma is presented. Although the association between retinoblastoma and second malignancies including malignant melanoma is established, we have found no reports of third malignancies occurring in such individuals. PMID- 6493139 TI - Recurrent fibroma of the neck in an infant. PMID- 6493140 TI - [Contrast echocardiography in the diagnosis of intracardiac shunt]. PMID- 6493141 TI - [Leukoplakia of the larynx--a precancerous condition]. PMID- 6493142 TI - [Hypertrophic stenosis of the pylorus--a 10-year review of 107 surgically treated infants]. PMID- 6493143 TI - [Diagnostic contribution of nuclear medicine methods in congenital anomalies of the kidney]. PMID- 6493144 TI - [Morphologic characteristics of the olivary complex during its ontogenesis in man]. PMID- 6493145 TI - [Experience in the treatment of increased blood pressure with a combination of dihydroergotoxine, reserpine and hydrochlorothiazide]. PMID- 6493146 TI - [Echocardiographic diagnosis of cardiac tumors]. PMID- 6493147 TI - [Current possibilities in the diagnosis of the Sturge-Weber-Dimitrii syndrome]. PMID- 6493148 TI - [A case report of anogenital oxyuriasis]. PMID- 6493149 TI - [2 cases of papilloma of the nose and paranasal sinuses]. PMID- 6493150 TI - [Gout and nephropathy]. PMID- 6493151 TI - [Pregnancy and labor in women with congenital heart defects]. PMID- 6493152 TI - [Changes in the frequency of admission and the structure of the discharge diagnosis of depressives states during a period of 1 decade]. PMID- 6493153 TI - [Ender nails in the therapy of transtrochanteric fractures]. PMID- 6493154 TI - [Myoma and labor]. PMID- 6493155 TI - [The child's health--the wealth of tomorrow]. PMID- 6493156 TI - Effect of treatment with dihydrotachysterol on renal function in patients with chronic renal failure. AB - 16 patients with advanced renal failure and histologic evidence of renal osteodystrophy were treated with dihydrotachysterol (DHT) in a dose of 0.125 0.375 mg/day. All patients had creatinine clearances of less than 22 ml/min, but none were undergoing dialysis. The rate of deterioration in renal function was determined by serial measurements of the serum creatinine and by plotting the reciprocal of the serum creatinine against time. The duration of follow-up was 17.0 +/- 8.6 months. There was no significant deterioration in renal function in 12 patients. The remaining 4 patients showed acceleration in the rate of deterioration, but the relationship to DHT therapy was unclear. PMID- 6493157 TI - Gluconeogenesis and phosphate reabsorption in isolated lactate- or pyruvate perfused rat kidneys. AB - Recent experiments suggest that cytoplasmic free NAD inhibits renal phosphate reabsorption and that gluconeogenesis, by increasing NAD concentration, inhibits phosphate reabsorption. To examine these relationships further we measured phosphate reabsorption by isolated kidneys perfused with either lactate or pyruvate. Lactate perfusion increased the ratio of the cytoplasmic redox couple (glycerol-3-phosphate/dihydroxyacetone phosphate) in snap-frozen kidneys 3-fold relative to the ratio with pyruvate perfusion (p less than 0.001). Inulin clearance and fractional phosphate reabsorption were lower with lactate than with pyruvate perfusion. Phosphate reabsorption decreased throughout the lactate perfusion but was constant for 1 h of pyruvate perfusion. Basal and norepinephrine (NE)-stimulated gluconeogenesis were lower with lactate than with pyruvate perfusion. With lactate and pyruvate perfusions, NE induced equal increases in fractional sodium reabsorption, although only with pyruvate perfusion was there increased phosphate reabsorption. In these experiments, oxidative phosphorylation, not cytoplasmic free NAD concentrations, influenced phosphate reabsorption, and NE-stimulated gluconeogenesis was associated with increased phosphate reabsorption. PMID- 6493158 TI - Normocalcemic primary hyperparathyroidism: resistance to PTH effect on tubular reabsorption of calcium. AB - The mechanism accounting for normal calcemia in certain cases of primary hyperparathyroidism (HPT) remains unclear and more generally the relative importance of each determinant of calcemia has not been systematically studied so far. 52 primary HPT patients with stable calcemias, ranging from 95 to 137 mg/l, were investigated. They all exhibited identical ionized to total plasma calcium ratios. Values of serum iPTH and nephrogenous cyclic AMP were similarly elevated in all patients, and all displayed similar high values for net bone resorption and intestinal absorption of calcium. Tubular reabsorption of calcium was normal or slightly subnormal in the normocalcemic subgroup, and rose in proportion to the increase in serum calcium in the hypercalcemic subgroup. No correlation was found between tubular reabsorption of calcium on the one hand and serum immunoreactive calcitonin, degree of phosphate depletion, sodium urinary excretion or magnesemia on the other. Plasma acid base equilibrium was normal in all patients. Finally, after surgical removal of adenomas, fasting calciuria and intestinal absorption of calcium returned to normal. It is concluded that (1) the main determinant of plasma calcium value in stable calcemia primary HPT is tubular reabsorption of calcium and (2) the absence of correlation between the tubular reabsorption of calcium and the degree of PTH hypersecretion suggests that as yet undetermined factors interfere with the tubular action of PTH. PMID- 6493159 TI - Accelerated accumulation of aluminum by osteoid matrix in vitamin D deficiency. An animal model of aluminum toxicity. AB - To investigate the possibility that aluminum (Al) salts might associate specifically with osteoid matrix in bone, an animal model was developed in which hyperosteoidosis was controlled independently by the vitamin D status. Nonuremic rats were weaned on a vitamin D-free diet (D-) and half were given intraperitoneal AlCl3 (9.25 mg Al over 33 days). At sacrifice, serum calcium was significantly higher in Al-treated D- rats compared to D- controls (9.4 +/- 0.3 vs. 6.9 +/- 0.8 mg/dl, p less than 0.01). Serum and bone Al content were measured by flameless atomic absorption spectroscopy; Al content was 318 +/- 38 micrograms/l in serum, and 248 +/- 11 mg/kg dry bone weight in Al-treated rats, compared to almost undetectable levels in D- controls. Al was identified histochemically in Al-treated rats by its heavy deposition in subepiphyseal trabecular bone; where it occupied almost 50% of the linear trabecular bone surface, usually sandwiched between bone and osteoid seams. Both groups of animals had severe osteomalacia, but there was no evidence that Al induced a more severe lesion in addition to vitamin D deficiency. Parenteral Al was also given to rats fed a similar diet, but supplemented with vitamin D3 (D+) (cumulative dose of Al, 37.25 mg over 70 days). At sacrifice, serum Al was 671 +/- 50 micrograms/l, but bone Al was only 142 +/- 10 mg/kg, significantly less than bone Al in D- Al-treated rats. There was no evidence of osteomalacia in D+ Al-treated rats in which histochemical staining for Al was essentially negative.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493160 TI - Calcium homeostasis in morbid obesity. AB - Calcium homeostasis in morbidly obese subjects has attracted little attention. Prompted by reports of elevated serum levels of parathyroid hormone in such patients, calcium homeostasis was investigated in 36 patients with morbid obesity and in 44 normal weight controls. Concerning serum immunoreactive parathyroid hormone (C-terminal), serum ionized calcium (Ca++) and serum albumin corrected magnesium no significant differences between the groups were detected. When albumin corrected, serum total calcium turned out to be significantly elevated (p less than 0.0001) in the obese subjects. Also, serum alkaline phosphatase activity was significantly raised in the obese state. The results demonstrate that calcium homeostasis, as expressed by the metabolically active serum Ca++, is normal in morbid obesity. But the results also point towards an abnormal calcium binding due to either an increased calcium binding to albumin or to calcium complexing small anions. PMID- 6493161 TI - Renal osteodystrophy in CAPD patients. AB - To assess the influence of continuous ambulatory peritoneal dialysis (CAPD) on the evolution of renal osteodystrophy, we studied 36 adult patients with end stage renal failure before starting dialysis and after 7-30 months. 17 patients (12 males and 5 females) were treated by CAPD as first treatment and 19 (14 males and 5 females) received maintenance hemodialysis. The two groups were age- and sex-matched and no patient received vitamin D. All patients had adequate clinical and metabolic follow-up with a radiological survey and quantitative bone histology at the start of dialysis and at the end of the study. Serum phosphate concentrations were much easier to control in CAPD than in hemodialysis patients. There was no difference in the evolutive pattern of vascular and periarticular calcifications in the two groups. The 25-hydroxyvitamin D3 levels were frequently lower in CAPD than in hemodialysis patients. In some CAPD patients, there was a significant loss of trabecular bone volume at the end of the study. The radiological and histological appearances of secondary hyperparathyroidism improved or seemed to worsen to a lesser degree in CAPD compared to hemodialysis patients. PMID- 6493162 TI - Plasma calcium fraction dynamics in uremic patients undergoing hemodialysis. AB - 22 patients with chronic renal failure, maintained on chronic maintenance dialysis with a dialysate calcium of 1.5 mmol/l, were randomly selected for measurement of pre- and postdialysis plasma calcium fractions. Total, ionized and protein-bound calcium fractions in plasma showed significant increases following dialysis, but with correction for hemoconcentration due to ultrafiltration from dialysis, only protein-bound calcium showed a significant increase. Change of in vitro pH from 7.35 to 7.44 did not influence calcium binding. Similarly, in vitro addition of calcium to pre- and postdialysis blood samples did not result in significant differences for protein-bound calcium fractions. Comparison of dissociation constants for protein-bound calcium between pre- and postdialysis samples showed a significant change. Our results indicate that dialysis alters the affinity of serum protein by some unexplained mechanism and may contribute to the genesis of dialysis-bone disease. PMID- 6493163 TI - Enterohepatic cycling of vitamin D and its metabolites. PMID- 6493164 TI - [Apnea as a probable expression of gastroesophageal reflux in 2 newborn infants]. PMID- 6493165 TI - [Evaluation of transcutaneous bilirubinometry in newborn infants]. PMID- 6493167 TI - [Correlation between blood xylose and the morphology of the intestinal mucosa]. PMID- 6493166 TI - [Diagnosis of 'acute enteritis' in children. The importance of virologic studies]. PMID- 6493168 TI - [Apolipoproteins A and B in the first year of life]. PMID- 6493169 TI - [Long-term control of newborn infants with the surfactant deficit syndrome. Auxologic, neurologic and pneumologic aspects]. PMID- 6493170 TI - [Impact of maternal hypnosis in labor and parturition on various biochemical aspects of the newborn infant]. PMID- 6493171 TI - [Persistent pubertal gynecomastia. A longitudinal study of 3 patients]. PMID- 6493172 TI - The corporate transformation of medicine in Minnesota: the struggle by independent physicians for a place in the twin cities market. Sixth in a series. PMID- 6493173 TI - Internal medicine. MMIE risk Management Committee. PMID- 6493174 TI - The physician's role in health care marketing. PMID- 6493175 TI - Group health program to reduce the incidence of preterm deliveries. PMID- 6493176 TI - Pleuropulmonary manifestations of rheumatoid disease. PMID- 6493177 TI - Fellowship in Chemical Dependency University of Minnesota Hospitals and Clinics. PMID- 6493178 TI - Pneumonia and meningoencephalitis in a female adolescent. Case report. PMID- 6493179 TI - Kaposi's sarcoma and the diagnosis of acquired immunodeficiency syndrome. Case report and brief review. PMID- 6493180 TI - Primary pulmonary leiomyosarcoma with digital clubbing and pleural effusion. Case report. PMID- 6493181 TI - Preferred provider organizations. Part II--Legal issues presented by PPOs. PMID- 6493182 TI - [Studies on changes of lysozyme activity during pre- and postoperative periods in alimentary tract surgery]. AB - From the clinical and experimental studies, the following results were obtained. The serum lysozyme activity decreased postoperatively and returned to the preoperative level 2 weeks later. Postoperative changes of the activity reflected the state of surgical stress inflicted on the subjects, namely, the changes were parallel to the degree of the stress and their postoperative courses. The postoperative elevation of lysozyme activity in anastomosed colonic tissues or abdominal walls, in which the activity was not determined preoperatively was supposed to be a reasonable phenomenon and closely related to tissue regeneration or protection from bacterial infection. The mechanism of this local elevation should be due to migration from the peripheral blood and movement of the lysozyme producing or -secreting cells to the wounds. The phagocytic activity of peritoneal macrophage hyperfunctioned postoperatively. This might suggest lysozyme synthesis or secretion by peritoneal macrophage and participate in the protective action of the subjects. The postoperative serum lysozyme activity was maintained at the normal level by preoperative peroral administration of egg white lysozyme preparation, therefore, the administration was thought to be very effective to the acceleration of protective action of the subjects on whom the surgical stress was imposed. PMID- 6493183 TI - [Experimental study on the optimal potassium and magnesium concentrations in the cardioplegic solution]. AB - Minimum concentration of potassium and magnesium in cardioplegic solution to get cardiac arrest was studied. The isolated rat hearts were perfused by Langendorf perfusion with Modified Krebs-Henseleit bicarbonate buffer solution, and their heart rates were measured. The perfusion of infusate of 15 mM per liter of K aspartate stopped the heart beat completely, and as the same way it was necessary 25 mM per liter of MgCl2 to get cardiac arrest. By their combination, however, heart was arrested with infusate of 10 mM per liter of K-aspartate and 15 mM per liter of MgCl2, which were lower concentration than K-aspartate or MgCl2 alone. In order to determine the optimal concentration of potassium and magnesium in cardioplegic solution, the isolated rat hearts were preserved in relatively disadvantageous condition; such as 37 degrees C of infusates, non-oxygenation, continuous perfusion and perfusion pressure 50 cmH2O during 120 minutes. Sixty isolated rat hearts were divided into eleven groups. Each group received a different proper combination of KCl (5.9, 15, 25, 40, 60 mM/L) and MgCl2 (1.2, 13, 25, 33, 50 mM/L) in cardioplegic solution. Using the isolated working rat heart apparatus, hemodynamic indices after 120 minutes preservation were compared with control values of the same hearts, and their percent recoveries were compared with one another. In conclusion it appears that in the isolated working heart model combination of KCl 40 mM/L and MgCl2 13 mM/L in Basic-Modified-Krebs Solution might offer the best myocardial protection of all combinations tested. PMID- 6493184 TI - [The effects of failure of arterial reconstruction on limb status]. AB - During the last 8 years, arterial reconstructive operations such as bypass grafting, thrombendarterectomy and percutaneous transluminal angioplasty were performed on 282 lower extremities with chronic arterial occlusion. Operative indications were intermittent claudication in 57.1% and limb salvage in 42.9%. Early and late failure rate following operations was 31.2%: for claudication group 24.0% and for limb salvage group 40.7%. In 30.6% of claudication group and in 45.7% of limb salvage group, ischemia of limbs, compared to their preoperative status, worsened following occlusion. These limb worsening-rates were high and not negligible. Main causes of failures were poor run off and poor graft. Because chronic arterial occlusion is not a malignant disease, it is not forgivable to worsen limb status by surgery. Therefore, the operative indication for claudicant should be the need of patients in their daily life. For femoro-popliteal bypass grafting in claudicant, not artificial graft but auto vein graft should be used. When no suitable vein is available, conservative therapy is the choice of treatment. In case of limb salvage, artificial graft may be used. PMID- 6493185 TI - [Three surgically treated cases of spontaneous rupture of the esophagus with reference to a new surgical approach--eversion stripping and esophagogastrostomy through the posterior mediastinum]. AB - Three surgical cases of spontaneous rupture of the esophagus were reported. Case 1 was a 56-year-old man who was admitted 3 days after the onset was treated with open drainage. He had no complications whatsoever 8 years after the treatment. In case 2 (a 55-year-old man), eversion stripping of the esophagus and gastrostomy were performed 2 months after diagnosis, but esophageal reconstruction was not successful. He died of acute congestive heart failure 5 years after surgery. The Third case was a 60-year-old women whose rupture was confirmed 11 days after the onset. Cervical esophagostomy, gastrostomy and jejunostomy were performed 16 days after the rupture. Thereafter, esophageal eversion stripping and esophagogastrostomy through the posterior mediastinum were successfully carried out 2 months after the first surgery. She had no postoperative complications. Eversion stripping of the esophagus with esophagogastrostomy through the posterior mediastinum is an effective and safe method for some advanced cases of spontaneous esophageal rupture. We have not found any reports of surgical cases with spontaneous esophageal rupture treated by this approach in the literature. PMID- 6493186 TI - [Granular cell tumor of the esophagus: a case report and a review of the literature]. AB - A case of granular cell tumor of the esophagus was reported. A 48-year-old man was admitted with a history of intermittent dysphagia and postprandial substernal discomfort. Esophagography demonstrated a 3 cm filling defect in the lower portion of the esophagus. Esophagoscopy identified a white-yellowish, plaque-like tumor with small ulceration on the posterior esophageal wall of 35 cm distant from the incisor teeth. Because of the high suspicion of esophageal cancer, esophageal resection with retrosternal esophagogastrostomy was performed on March 21, 1980. The surgical specimen revealed a 2.5 X 2.5 cm submucosal tumor with superficial ulcer near the esophagogastric junction, and histologically it was diagnosed as granular cell tumor. Postoperative course was uneventful. Clinical features of this lesion were reviewed in 69 cases in the literature. PMID- 6493187 TI - [A successfully treated case of Wolff-Parkinson-White syndrome with Ebstein's anomaly complicated with protein-losing gastroenteropathy]. AB - A 17-year-old male underwent the division of the double accessory pathways under the diagnosis of Wolff-Parkinson-White (WPW) syndrome. At this time, we perceived that Ebstein's anomaly was combined with WPW syndrome, but we didn't treat Ebstein's anomaly, because it was slight. After this operation he relieved from the tachycardia attack completely. Ten months later, he was re-admitted to our hospital because of cardiomegaly and systemic edema. Hypoproteinemia was pointed out. On the basis of the intracardiac catheterization and 131I-RISA test, it was made to be sure that hypoproteinemia was caused by the protein-losing gastroenteropathy due to the tricuspid valve regurgitation of Ebstein's anomaly. After the tricuspid valve replacement with Hancock valve, protein-losing into the gastrointestinal tract disappeared. The aggravation of the tricuspid regurgitation was unrelated to the division of the accessory pathways, and was caused by the natural course of Ebstein's anomaly. PMID- 6493188 TI - [Experimental studies of hyperthermia against MH134 tumor on mice. Antitumor effects under various conditions of heating]. AB - The antitumor effects of local hyperthermia on MH134 tumor inoculated on mice under various conditions of heating were studied. 2 X 10(5) cells of MH134 were inoculated on the hind limbs of mice. The tumor was heated in a water bath at different temperatures, onsets, durations, times and intervals. The tumor growth rate, survival time, the degree of lymph node involvement and histological damage of heated tumors and normal tissue were examined in comparison with untreated tumors. The following results were obtained. Normal tissue received irreversible damage under conditions of either 45 degrees C, over 30 min. or 42 degrees C, over 240 min. Antitumor effects were observed significantly in the following conditions compared with untreated group. 1) temperature: 42 degrees C, 2) onset of hyperthermia: within the 20th day after inoculation, 3) duration of hyperthermia: over 30 min., 4) times of hyperthermia: twice or more, 5) interval of hyperthermia: over 48 hrs. Thermotolerance was induced when the interval of hyperthermia was less than 24 hrs. This tolerance was considered to be clinically important. Local lymph node metastasis was suppressed in the early stage of hyperthermia. Systemic lymph node metastasis, however, was found with the passage of time in all groups of hyperthermia. PMID- 6493189 TI - [Effect of burns on cardiac performance in the dog]. AB - Changes in cardiac performance after a third-degree 50% burn were studied using seventeen mongrel dogs divided into three groups: A, sham burn (n = 6); B, burn (n = 5); C, burn + fluid therapy (n = 6). From the measurements of local ventricular dimension and left ventricular pressure (P), end-systolic pressure length ratio (Emax) mean velocity of circumferential fiber shortening (mean Vcf), peak dp/dt, and percent shortening (% delta L) as indices of myocardial contractility were calculated. Cardiac output (CO), aortic pressure (Aop) and heart rate (HR) were also measured. All measurements were repeated every 30 minutes until 360 minutes after burning. In group B and C, CO as well as left ventricular end-diastolic pressure (LVEDP) and length (EDL) as indices of the preload were significantly decreased as compared with group A. All indices of myocardial contractility in B and C were significantly lower than those in A. These results indicate that, in severe thermal burns, cardiac pump function is depressed by the fall of myocardial contractility in addition to the decrease in the preload. PMID- 6493190 TI - [Study on the catecholamine-containing fibers in the vagus]. AB - To clarify the nature and the origin of the catecholamine in the vagus, a quantitative estimation of dopamine, norepinephrine and epinephrine in the human abdomen, canine cervical and supradiaphragmatic vagus was performed. The human abdominal vagus was obtained during surgical operations. The canine cervical vagus was taken out with superior cervical ganglion and its branch between superior cervical ganglion and vagal trunk. The canine supradiaphragmatic vagus was ligated doubly. The control segment (between two ligatures) was removed immediately after the ligations. The proximal segment (1 cm above the cranial ligature) and the distal segment (1 cm below the caudal ligature) were taken out four hours after the ligations. The human and canine vagus contained dopamine and norepinephrine not epinephrine. The canine cervical vagus, which was cranial part to the unite of the branch from the superior cervical ganglion, contained dopamine and norepinephrine. Dopamine and norepinephrine levels in the proximal segment was greater than that in the control segment. Dopamine and norepinephrine levels in the distal segment was less than that in the control segment. Based on these results, it is concluded that: (1) catecholamine s in the human and canine vagus are dopamine and norepinephrine not epinephrine; (2) the catecholamine containing fibers in the canine vagus originate partially in the vagal trunk; (3) dopamine and norepinephrine may be transported distally in the canine vagus. PMID- 6493191 TI - [Hematological disorders in patients with gastric cancer]. AB - Changes of coagulation and fibrinolysis with regard to the difference among histopathological features of cancerous tissue and postoperative alteration of hematological disorders were studied in 95 patients with gastric cancer. Platelet, fibrinogen, platelet aggregation and FDP were increased and plasminogen, alpha 2-macroglobulin and antithrombin III were decreased as the stage of the cancer progressed. Increase of these hematological disorders with the advance of cancer was observed regardless of histopathological characteristics. Although degree of hematological derangement were increased with the advance of medullary type of cancer, these findings were not observed in scirrhous cancer. Furthermore, fibrin deposition around cancerous tissue was not observed in scirrhous cancer but in medullary cancer. After complete resection of cancerous tissue was performed, hematological disorders were normalized. On the other hand, platelet, fibrinogen, plasminogen, alpha 2-macroglobulin and antithrombin III were decreased and FDP was increased markedly after incomplete resection of cancer. These results suggested that hematological disorders in the advanced stage of gastric cancer, especially medullary cancer, were inclining to the level of DIC and patients in case of incomplete resection of cancer might be on the verge of DIC with residual cancerous tissue. PMID- 6493192 TI - [Group I pepsinogen (PG I) in the serum and urine after total gastrectomy]. AB - Since the origin of group I pepsinogen (PG I) is no other than gastric mucosa, PG I has been considered to disappear in total gastrectomized patients. We, however, have found proteolytic activity in the urine of one-half of total gastrectomized patients and the activity has proven to be PG I by both gel chromatography and agar gel electrophoresis. Serum and urine PG I levels also have been determined by radioimmunoassay in 40 subjects. PG I was detected in almost all of them and the mean level of serum was 4.17 ng/ml and that of urine was 32.2 ng/ml. The levels had no relation to age and sex but elevated in the patients with recurrent gastric cancer after total gastrectomy. A few possibilities can be considered as to the source of PG I after total gastrectomy, in which heterotopic gastric mucosa or gastric gland metaplasia is most possible. An interesting result in this study was that both serum and urine PG I levels elevated in the recurrent patients. This phenomena suggests that gastric cancer may produce PG I. PMID- 6493194 TI - [Experimental study of the effect of portal vein occlusion on the mesenteric microcirculation]. AB - The effect of portal vein occlusion (PVO) on the mesenteric microcirculation was studied with light microscope and electronmicroscope in the following three groups of mongrel dogs; the first group consisted of 3 dogs with laparotomy only, the second consisted of 10 dogs with PVO and the third consisted of 10 dogs with PVO and porto-femoral vein bypass using the antithrombogenic catheter (Anthron bypass tube). In the second group, dilatation of venula and slow blood flow in venula, patent A-V shunt and stasis in the capillary network were seen after 15 minutes. Hemorrhage and stasis in venula were observed after 15-30 minutes. Sludging and stasis in arteriole were also observed after 45-60 minutes. The hemorrhage of venula was progressive. Electronmicroscopically the vascular endothelial cell began to show abnormality after 15-30 minutes, and the microvilli of small intestinal mucosa showed pathological changes after 30 minutes. In the third group, the disturbance of the mesenteric microcirculation was mild even 4 hours after PVO. Both vascular endothelial cell and microbilli of the small intestinal mucosa were not damaged. We concluded that PVO causes the pathological changes of mesenteric microcirculation and intestinal mucosa at an early stage and the porto-femoral vein bypass using the antithrombogenic catheter is a safe and useful procedure when PVO is needed. PMID- 6493193 TI - [Influences of the biliary reconstructions by Roux-en Y method and jejunal interposition method on the gastric acid secretion in dogs]. AB - This study was made to examine the influences on the gastric acid secretion and serum gastrin level after the oral administration of beef extract, and on the inhibitory mechanism of the gastric acid secretion after the intraduodenal injection of either lipid or glucose in dogs which had reconstructed biliary tract by means of either Roux-en Y cholecystojejunostomy or cholecystoduodenojejunostomy; jejunal interposition between the gallbladder and the duodenum. The excreted gastric acid secretion from Heidenhain pouch showed a slight increase after cholecystojejunoduodenostomy, while it increased significantly after Roux-en Y cholecystojejunostomy. The serum gastrin showed no significant changes after either reconstruction. The gastric acid secretion after the intraduodenal injection of glucose was inhibited almost to the degree before and after either reconstruction. The inhibitory effects on the gastric acid secretion after the intraduodenal injection of lipid were not observed after Roux en Y cholecystojejunostomy but it was significantly inhibited after cholecystojejunoduodenostomy. It can be concluded from these results that jejunal interposition will be more suitable for the gastric acid secretion or its inhibitory mechanism than Roux-en Y type. PMID- 6493195 TI - [Experimental studies on splenic autotransplantation in rats]. AB - To determine if splenic implants in the body regain vascularization and grow, and to determine the effects of any interaction between implant and remnant on growth of these spleen fragments, we conducted experiments on rats. 1) Spleen fragments were implanted in the omentum (20 cases), in the subcutaneous space (20 cases), or in the liver (10 cases), and the weight of splenic portions and its histological findings were observed 12 and 24 weeks after operation. The best splenic growth was observed in the group of implant in the omentum. 2) Total, 4/5, 2/3, 1/3 and 1/5 spleen were implanted in the omentum and the weight of implants were measured 6 weeks after the operation. The rate of growth of implanted spleen was the highest in the group of 1/5 and was the lowest in the group of whole spleen. 3) Two groups of rats underwent 1/3 splenectomy, and the 1/3 spleen portions was implanted in the omentum. One group had the remaining 2/3 spleen removed, the other group had the remaining 2/3 spleen left in place. In group at 6, 12 and 24 weeks postoperatively the splenic portions was weighed. The implants regenerate with time in rats of both groups. The rate of weight-gain was, however, slow in the group with 2/3 spleen and there was no regeneration on the remaining 2/3 spleen. PMID- 6493196 TI - [A comparison with Dardik graft and Mindich graft on arterial bypass]. AB - Arterial reconstruction using human umbilical cord vein graft as a vascular prosthesis was carried out in 24 patients, 26 legs, with arteriosclerosis obliterans. Dardik grafts were used in 13 legs and Mindich grafts in 13 legs. Twenty-six operations were divided into two groups; one with the proximal anastomosis above the femoral artery (proximal group) and the other with the proximal anastomosis below the femoral artery (distal group). Postoperative evaluation of all patients was performed at intervals of one to twenty-two months. To make the determination of graft patency, at least, it was required that the graft pulse was palpable. Cumulative patency rates were 54% and 69% in the Mindich grafts and Darkik grafts, respectively. In the proximal group, patency rates were 60% and 50% in Mindich grafts and Dardik grafts, respectively. While in the distal group, patency rates were 37.5% and 78% in Mindich grafts and Dardik grafts, respectively. The causes of the graft obstruction were as follows: 1) graft infection in 4 (2 with Mindich and 2 with Dardik grafts) 2) pseudointimal hyperplasia of the distal anastomosis in 4 with Mindich graft, 3) progression of atherosclerosis in one case with Dardik graft, and 4) substandard Dardik graft in one. It was concluded that Dardik graft should be used as first choice when compared with Mindich graft and these grafts should not be used easily, since these grafts were apt to be infected. PMID- 6493197 TI - [A clinical study on 164 patients with extensive burn--with special reference to improved survival factors]. AB - One hundred and sixty four patients with extensive burn were treated over 6 years, 1976 through 1981. Clinical data were analyzed, dividing into successive period; Grod: Group I (83 patients, 1976-1978) and Group II (81 patients, 1979 1981). The mean age was 28.9 years, the mean burn area was 52.6% body surface area (% BSA) and Burn Index was 38.7 in group I, whereas in Group II 33.7 years, 56.0% BSA, 41.8, respectively. There are no statistical difference between the two groups. The mortality of the 164 patients was 50.6%. That of Group I was 55.4% and 45.7% in Group II. Excluding patients with almost fatal burns over 70% BSA or over 60 years of age, the former mortality is 33.3% and the latter is 21.3%. When a mortality rate was analyzed in patients with 50-70% BSA and aged less than 60 years in Group I, it was 65.0% and in Group II 36.8%. The main difference in the treatment between the two periods are as follows. Air fluidized beds were used in the latter period. As topical agents, silver sulfadiazine cream was administered in the former period, and silver sulfadiazine cream nitrate was administered in the latter period. Concerning debridement and skin graft, surgery was carried out 2-3 weeks after burn in the former period, while it started within one week in the latter period. In the latter period, active nutritional support and new generation of Cephem were used. These facts reveal that progress in various aspects of the treatments in the latter period have resulted in improvement of the mortality rate. PMID- 6493198 TI - [Preservation of the nipple and areola for breast cancer--histopathological study on cancerous involvement of the nipple and areola]. AB - In 141 mastectomy specimens, performed for invasive or non-invasive carcinomas, histopathologic study was performed to assess the extent of nipple-areola involvement by the tumor. In this study, patients were excluded when 1) the tumor was located beneath the areola, 2) nipple and/or areola abnormalities were clinically present. Tumor involvement of the nipple and/or areola was found in 44 of 141 specimens (31%), with intraductal growth in 36 (82%) of 44, stromal invasion in 3 (7%) and ductal & stromal invasion in 5 (11%). Analysis of nipple areolar involvement with consideration of the different variables indicates that it occurred in association with tumor size, tumor-areola distance and histological type. Such information provides clinically relevant guide lines in decision making for limited breast surgery. PMID- 6493199 TI - [Estrogen receptor in human breast cancer: relationship between the receptor contents and the histological and cytomorphological characteristics]. AB - Cytoplasmic estrogen receptor (ERC), nuclear estrogen receptor (ERN), and cytoplasmic progesterone receptor (PRC) were studied in 217 human breast cancers. ERC was found in 48.4%, ERN in 37.8%, and PRC in 32.7%. Histological grade was significantly correlated with ERC, ERN and PRC. Well-differentiated tumors were more frequently positive for the receptors while poorly differentiated tumors were generally negative for the receptors. Seventy one percent of the most differentiated tumors were ERC(+) ERN(+) PRC(+) and ERC(+) ERN(+) PRC(-). The histological grading system consists of tubule formation, nuclear pleomorphism and mitotic activity. There were significant correlations of receptor contents with nuclear pleomorphism and more mitotic activity. This was also confirmed by the study on the relationships between receptor contents and thymidine labeling index or mitotic index. The possibilities of receptors decreased with an increase in nuclear diameter. And there was a significant correlation between the receptor contents and the numbers of intracellular organellas in ultrastructural features of breast cancer cells. Among 33 cases of advanced or metastatic breast cancer submitted to endocrine therapy, 13 cases showed clinical response (CR or PR) These cases were both ERC and ERN positive independently of PRC status. Therefore, it is suggested that hormone receptor may be used as an independent prognostic factor in breast cancer. PMID- 6493200 TI - [Surgical treatment of Crohn's disease]. AB - Fourteen patients with Crohn's disease underwent operation at our department. Twelve were males and 2 were females, with a mean age of 28 years. The lesions were found in the small intestine in 5 patients, in the small and large intestines in 5 and in the large intestine in 4. The indications for laparotomy were stenosis in 43%, intractability in 43% and others in 14%. Stenosis was most commonly indicated in the small intestinal lesions, and intractability in the large intestinal lesions. For 12 patients, resection of the involved intestine was carried out, however for another 2, partial resection of the involved intestine was performed to avoid short bowel syndrome. Postoperative recurrence rate, in the cases where the involved intestine was totally resected, was 40% in the small intestinal lesions, 33% in the small and large intestinal lesions and 0% in the large intestinal lesions. Postoperative quality of life for most patients was excellent or good, and hematological status at follow-up showed an almost normal range. From these results, in patients with Crohn's disease, it was thought that the operation should be performed soon after medical treatment has failed. PMID- 6493201 TI - [Clinicopathological studies on carcinoma of the pancreas with special reference to pathological factors affecting the prognosis and lymph node involvement]. AB - A total of 63 cases of pancreatic carcinoma (52 cases of the head and 11 of the body and tail) which were resected for the past 12 and a half years were analyzed according to the General Rules for Surgical and Pathological Studies on Cancer of Pancreas issued by the Japanese Pancreatic Society. Carcinoma of the head of the pancreas The prognosis was remarkably influenced by the size of tumor (T), infiltrative growth (INF), lymphatic infiltration (ly), venous infiltration (v), perineural infiltration (ne), capsular infiltration (s) and histological lymph node involvement (n). Postoperative results were increasingly poor as these factors proceeded. Rate of lymph node metastasis was 75.0% and was influenced by anterior capsular invasion (S), ly, s and duodenal infiltration (du). The posterior and anterior portions of the head of the pancreas and the origin of SMA, in the order named, were the most common sites of lymph node metastasis. In pancreatic cancer, perineural infiltration was a characteristic finding in the surrounding tissue of the lymph nodes which occurred even in 25% of n0 cases. Carcinoma of the body and tail of the pancreas Rate of lymph node metastasis was 40%. The pattern of lymph node involvement was different from that of the carcinoma of the head of the pancreas, probably because that the lymph nodes were not so much metastasized as directly invaded by tumor. PMID- 6493202 TI - [Renovascular hypertension with a solitary kidney associated with retrocaval ureter: a case report]. AB - A case of renovascular hypertension in a patient with a congenitally solitary kidney associated with retrocaval ureter is reported. Aortorenal bypass with autogenous saphenous vein graft and concomitant mobilization of the ureter by division and reanastomosis of the inferior vena cava were performed. Pathogenesis of the stenotic lesion of the renal artery was fibromuscular dysplasia. Postoperative improvement of hypertension was not so good as expected. Soon after administration of nifedipine (20mg/day) was started, blood pressure decreased down to 130/80mmHg and had been well controlled. Problems regarding renovascular hypertension with a solitary kidney and surgical treatment of retrocaval ureter are discussed. PMID- 6493203 TI - Practical toxicologic diagnosis. AB - Strychnine toxicosis is characterized by inducible tetanic seizures and metaldehyde poisoning by fine fasciculations progressing to generalized tremors and seizures. Intoxication with 1080 causes seizures, random running movements, vomiting, defecation, urination, acidosis and hyperglycemia. Intoxication with rodenticides causing coagulopathy is characterized by hemorrhage into body cavities but not necessarily external hemorrhage. Anticholinesterase insecticides cause salivation, urination and defecation, while chlorinated hydrocarbon insecticides cause CNS disturbances. Ethylene glycol intoxication results in ataxia, depression, coma, vomiting and tachypnea, followed by acute renal failure. Urea poisoning causes bloat and CNS signs in cattle. Monensin intoxication in horses lasts several days and causes stiffness, colic, uneasiness and recumbency. Salt poisoning results in depression, seizures and hypernatremia. Lead poisoning is associated with central and peripheral nervous system signs, as well as increased numbers of nucleated RBC and basophilic stippling of RBC. Arsenic poisoning results in GI pain, diarrhea, weakness and death. Copper toxicosis in sheep is manifested by hemolytic anemia, hemoglobinemia and hemoglobinuria. Plants that may intoxicate domestic animals include sorghum, greasewood, halogeton, water hemlock, Japanese yew, larkspur, lupine, milk-weed, philodendron, oleander, castor bean and precatory bean. PMID- 6493204 TI - Heparin anticoagulant therapy in equine colic. AB - In horses with large bowel disease, those with circulating endotoxins but no evidence of altered hemostasis had a good prognosis for survival. Those with circulating endotoxins and evidence of altered hemostasis (fibrin degradation products) had a poor prognosis. Portal vein infusion of endotoxins over 24 hours caused hoof discomfort, evidenced by shifting of weight and standing with all 4 feet together, and a decreased hoof temperature. Clinical signs appeared within 30 minutes of initiation of infusion and subsided within 4 hours despite continued infusion. Long-term heparin therapy results in rapid depletion of RBC but no detectable bleeding. Heparin therapy should be initiated before colic surgery is begun. Coagulation is monitored with the activated partial thromboplastin time. Heparin should initially be given IV, followed by SC or intrafat injections, and should never be given IM. The anticoagulative effects of heparin can be reversed with protamine sulfate. PMID- 6493205 TI - Field trials of a bovine respiratory syncytial virus vaccine. AB - A vaccine against bovine respiratory syncytial virus (BRSV: Norden), a cause of pulmonary edema-emphysema and pneumonia in calves, was evaluated in field trials on western Nebraska beef calves at branding, preweaning, weaning and postweaning. Of calves with undifferentiated respiratory infection at weaning, 20.9% of 2-dose vaccinates (169/810) and 27.5% of 1-dose vaccinates (230/837) required treatment, vs 48.2% of unvaccinated controls (397/823). At postweaning, 2.4% of 2-dose vaccinates (13/548) and 4.7% of 1-dose vaccinates (28/598) required treatment, vs 20.5% of controls (181/885). Studies in the 2 subsequent years revealed 11.3% of calves vaccinated at preweaning (263/2312) required treatment, vs 24.4% of controls (387/1587). Average costs from respiratory disease in 5 herds ranged from $12.83/head to $46.99/head before BRSV vaccination and 4/head to 54/head after vaccination. PMID- 6493206 TI - Eliminating swine dysentery from selected herds. AB - In attempts to eliminate swine dysentery from a herd, the total cost of nitroimidazole medication in the water can be estimated at 16/gal over 3-4 weeks and for carbadox in the feed at 70/100 lb over 6-8 weeks. Use of dimetridazole or ipronidazole in the water for 3-4 weeks or carbadox in the feed for 6-8 weeks eliminates Treponema hyodysenteriae from the porcine gut. A 30-day (10 weeks with carbadox) preslaughter withdrawal time should be provided. Impervious surfaces should be thoroughly sanitized, while permeable surfaces and lots should be cleaned, dried and aired well for 2-3 weeks in warm, dry weather and for at least 60 days in cool, damp weather. Animal vectors and fomites must be controlled. Isolation of new breeding stock for 3-4 weeks helps prevent recontamination. While elimination of swine dysentery is not practical in many herds because of poor facilities or lack of producer commitment, a properly designed program can result in economic benefits. PMID- 6493207 TI - Salivary mucocele in a dog. AB - A 4-year-old German Shepherd, with a 3-week history of anorexia, intermittent dysphagia and a serous nasal discharge, had a fluctuant mass protruding from its left pharyngeal wall. Cytologic examination of an aspirate suggested a salivary mucocele. Creation of a window in the mucocele did not prevent recurrence, so the lining of the sac was resected, after which the mucocele did not recur. PMID- 6493208 TI - Primary renal disease in a dog. AB - A 7-month-old Lhasa Apso with a history of polydipsia and vomiting was depressed, thin and dehydrated. Serum chemistry assays revealed hyperphosphatemia and azotemia, and urinalysis revealed isosthenuria, suggesting azotemia of renal origin. Antemortem renal biopsy specimens contained several sclerotic glomeruli, a few embryonic renal tubules and interstitial fibrosis, indicating renal dysplasia. PMID- 6493209 TI - Comparison of the sodium dependency of uptake of meta-lodobenzylguanidine and norepinephrine into cultured bovine adrenomedullary cells. AB - Radioiodinated meta-iodobenzylguanidine (MIBG), a scintigraphic agent used for the detection of human pheochromocytomas, is thought to utilize the same uptake and retention mechanism(s) as norepinephrine (NE). Using cultured bovine adrenomedullary cells, we compared the mechanism(s) of uptake of MIBG to that of NE. Two different uptake systems were identified. NE and MIBG were taken up by a sodium-dependent system that was characterized by: 1) temperature dependency; 2) high affinity: Km of 1.22 +/- 0.12 microM for MIBG and 1.41 +/- 0.50 microM for NE; 3) low capacity: Vm (picomoles/10(6) cells/10 min) of 64.3 +/- 3.3 for MIBG and 36.6 +/- 7.2 for NE; 4) saturability; 5) ouabain sensitivity; and 6) energy dependency. However, NE and MIBG also were taken up by a temperature-dependent, sodium-independent, apparently unsaturable, and energy-independent system. The sodium-dependent uptake system fulfills many of the criteria for Uptake1 whereas the sodium-independent uptake system is most likely a passive diffusion process. NE uptake proceeded predominantly by the sodium-dependent process. Uptake of MIBG occurred by both pathways at low concentrations, but at high concentrations (greater than 10 microM) uptake was predominantly (75 to 100%) by the sodium independent process. Inhibition studies suggest that MIBG and NE are transported by the same carrier involved in the sodium-dependent system. Scintiscans of the human adrenals and pheochromocytomas appear to reflect uptake of [131I]MIBG by the sodium-dependent system. PMID- 6493210 TI - The effect of aliphatic adenine analogues on S-adenosylhomocysteine and S adenosylhomocysteine hydrolase in intact rat hepatocytes. AB - The aliphatic adenine analogues, D-eritadenine, L-eritadenine, L threoeritadenine, and 9-(S)-(2,3-dihydroxypropyl)adenine [(S)DHPA] function as inhibitors/inactivators of purified S-adenosylhomocysteine (AdoHcy) hydrolase, but these compounds did not induce reduction of enzyme-bound NAD+. D-Eritadenine, L-eritadenine, (S)DHPA, and L-threo-eritadenine inactivated AdoHcy hydrolase in hepatocytes, and the efficiency decreased in the order mentioned. Concurrently, there was an increase in the AdoHcy content. The accumulation of AdoHcy in the presence of (S)DHPA was more pronounced than would be expected from the inactivation of enzyme activity, suggesting that this compound may function as a reversible inhibitor as well. Furthermore, the inactivation of the intracellular enzyme by (S)DHPA is remarkable in the light of the fact that this compound induces no inactivation of purified AdoHcy hydrolase, but merely functions as an inhibitor of the enzyme. At low concentration of D-eritadenine (less than 6 microM), a distinct lag period could be demonstrated before accumulation of AdoHcy occurred. This suggests that the AdoHcy hydrolase activity must be decreased below a certain level to cause an increase in cellular AdoHcy. None of the analogues tested completely inactivated AdoHcy hydrolase and a residual enzyme activity was observed. The adenosine deaminase inhibitor, 2' deoxycoformycin, did not potentiate the effect of these compounds on AdoHcy catabolism. The inactive enzyme formed in the presence of aliphatic adenine analogues was not reactivated under conditions where the inactivation induced by 9-beta-D-arabinofuranosyladenine was reversible. PMID- 6493211 TI - Inhibition of erythrocyte sickling by thiol reagents. AB - The antisickling effects of eight thiol reagents that cross the red cell membrane and then react with the cysteine beta 93, the only accessible thiol group of hemoglobin, have been investigated at various pO2 values. In spite of completely reacted hemoglobins, the potent antisickling effect varied from one compound to the other and was partially related to the extent of the increased oxygen affinity of intact sickle cells induced by these compounds. The formation of methemoglobin upon the incubation of red blood cells with some disulfides had only a small effect on the sickling process. PMID- 6493212 TI - Effect of cytosolic components on the metabolism of the hydrazide iproniazid. AB - The effects of thiols, such as glutathione (GSH), and the cytosolic glutathione S transferases on the microsomal metabolism of the hydrazide iproniazid to hydrocarbon products were investigated. Thiol compounds stimulated propane production and depressed propylene production. Addition of preparations of cytosolic proteins to the microsomal reaction mixtures in the presence of GSH depressed production of propane by more than 80% and propylene by 50% compared to the GSH-mediated reaction. The purified glutathione S-transferases A and B were most potent in eliciting this effect; isozymes AA, C, and E had little or no effect on hydrocarbon production. Further, a mixture of these purified isozymes in the concentrations known to exist in cytosol affected hydrocarbon production in a manner similar to cytosol. Experiments performed with isolated hepatocytes and an inhibitor of these cytosolic enzymes further supported the involvement of these enzymes in altered hydrocarbon production. These isozymes were subsequently shown to catalyze the formation of a GSH conjugate, S-(2-propyl)glutathione. The decreases in hydrocarbon production by microsomes in the presence of the glutathione S-transferases and GSH were accompanied by production of slightly larger amounts of conjugate. These data indicate that the cytosolic glutathione S transferases interact with an oxidative microsomal metabolite of iproniazid to enzymatically produce an S-(2-propyl)glutathione conjugate and thus prevent formation of a reactive species which would otherwise chemically decompose to yield hydrocarbons or to covalently bind to cellular macromolecules. PMID- 6493213 TI - Effect of lipids on activity and conformation of lysolecithin:lysolecithin acyltransferase from rabbit lung. AB - Lysolecithin:lysolecithin catalyzing two types of reaction, transacylation or hydrolysis, with the same substrate. Both activities have shown to be dependent on several environmental conditions and among them, the presence of lipids. The addition of several classes of lipids activated in all the cases the enzyme, decreasing the hydrolysis/transacylation molar ratio. This effect was higher for PC/PE/Chol mixture than for other lipids assayed. Circular dichroism spectra of the enzyme did not show any change with the addition of lipids, concluding that the effect of lipids was not due to any structural change in the protein. The hypothesis has been made of an influence of lipids on the physical state of the substrate as well as, possibly, on the enzyme-substrate interaction. The significance of these effects on the physiological role of lysolecithin lysolecithin acyltransferase from soluble fraction of rabbit lung is discussed. PMID- 6493214 TI - Rabbit red blood cell hexokinase:intracellular distribution during reticulocytes maturation. AB - The intracellular localization and isozyme distribution of hexokinase were studied during rabbit reticulocyte maturation and aging. In reticulocytes 50% of the enzyme was particulate while in the mature erythrocytes all the hexokinase activity was soluble. The bound enzyme co-sediments with mitochondria and by column chromatography it was found to be hexokinase Ia. The cytosol of reticulocytes contains hexokinase Ia (38%) and hexokinase Ib (62%) while the mature erythrocytes contain only hexokinase Ia. The amount of bound hexokinase decreases very quickly during cell maturation and aging as was shown by following in vivo reticulocyte maturation or by analysis of hexokinase compartmentation in cells of different ages, obtained by density gradient ultracentrifugations. A role for this intracellular distribution of hexokinase is suggested. PMID- 6493216 TI - Role of anions in the lymphocytolytic action of corticosteroids and fatty acids. AB - Rat thymocytes were exposed in vitro to the corticosteroid dexamethasone, 10 nM, for 10 min, or to oleic acid, 500 nM for 2 min. This results in cytolysis after 6 hr, if incubation is continued. Instead, the cells were centrifuged, the supernatant fluid decanted, and the cells subjected to osmotic shock in 1.5 mM MgCl2. The naked nuclei were incubated at 37 degrees C and examined by light and electron microscopy. Nuclear edema was evident early, and most nuclei showed damage with variation in shape and size and distinct folds, which was maximal by 1-2 hr as a result of these treatments. This was true also if nuclei were incubated in MgF2 or Mg(NO3)2 but not in MgBr2, MgI2, MgSO4 or Mg-citrate. Spleen lymphocyte nuclei showed similar damage but only after incubation with 20 microM oleic acid, and not at all with corticosteroids. The effects of both steroid and fatty acid, even at greatly increased concentrations, were inhibited by tri-n butyl tin chloride, 10 microM, and by 4-4'-diisothiocyanostilbene-2,2'-disulfonic acid, sodium salt, 10 microM, both of which block chloride ion transport. It is concluded that the cytolytic effects of both corticosteroids and free fatty acids involve influx of chloride ion resulting in nuclear edema, which subsequently leads to fragmentation of chromatin, karyorrhexis and, ultimately, cytolysis. PMID- 6493215 TI - Effects of ganglioside GM1 on the thermotropic behavior of cholera toxin B subunit. AB - The B, or binding, subunit of cholera enterotoxin forms a pentameric ring structure in the intact toxin, and also when the subunit is isolated from the A subunit. The thermal denaturation of the B subunit ring was examined by differential scanning calorimetry in the presence and absence of ganglioside GM1, its natural 'receptor'. In the absence of ganglioside an irreversible endotherm was observed with maximal excess apparent heat capacity, Cmax, at 74.6 degrees C. When the ganglioside was added in increasing amounts, multiple transitions were observed at higher temperatures, the most prominent having a Cmax at 90.8 degrees C. At high ganglioside concentrations, the 74.6 degrees C transition was not observed. In addition to the thermodynamic results a model is proposed for the interaction of GM1 and B subunit pentamer. This model is derived independently of the calorimetric results (but is consistent with such data) and is based upon considerations of the geometry of the GM1 micelle B subunit pentamer. PMID- 6493217 TI - Structural organization of high-Mr mammalian aminoacyl-tRNA synthetases. Comparison of multi-enzyme complexes from different sources. AB - Many mammalian aminoacyl-tRNA synthetases have been isolated as high-Mr multi enzyme complexes. These complexes often contain variable contents of synthetase activities. The complexes may also contain molecules other than synthetases such as tRNA. The observed variations in size, polypeptide composition, and content of enzyme activities of the high-Mr synthetase complexes have been sources of confusion in the understanding of the structural organization of these complexes. A unified scheme of structural organization which encompasses most observations on high-Mr complexes reported in the literature is presented. PMID- 6493218 TI - Tuftsin (Thr-Lys-Pro-Arg), a natural modulator of macrophage activity: further studies. AB - Tuftsin, Thr-Lys-Pro-Arg, that activates macrophage functions, binds to specific receptors on these cells. The receptor capacity to bind tuftsin is diminished by prior treatment of the cells with dithiothreitol. Adherent mouse peritoneal macrophages bind tuftsin to a far less extent than non-adherent macrophages. Michaelis constant (Km) of tuftsin for phagocytic stimulation of macrophages is 111 eta M. The half maximal binding concentration of tuftsin by these cells is 117 eta M. These are similar values and indicate that full occupancy of the receptors by tuftsin is a necessary prerequisite for maximal phagocytosis. PMID- 6493219 TI - Effect of estrogen on Xenopus laevis albumin mRNA levels. AB - Accurate quantitation of concentrations of albumin mRNA by hybridization to albumin cDNA allows analysis of the estrogen effect on the Xenopus laevis albumin mRNA levels in the liver cytoplasm during the primary stimulation. Administration of estradiol-17 beta to male Xenopus laevis increases the amount of both total cellular RNA and poly(A)-RNA but has no effect on the albumin mRNA level and the amount of albumin mRNA per cell is constant. PMID- 6493220 TI - Quantization of chloroplast DNA using dot blot filter hybridization with double stranded probes. AB - Hybridization characteristics of purified chloroplast DNA, immobilized in 'dot blots' on nitrocellulose filters using radiolabeled chloroplast DNA restriction fragments or recombinant DNA probes were investigated. Conditions are described which proved a near linear relationship between amounts of hybridization and amounts of immobilized DNA. A standard curve constructed using such data provided a simple means for quantizing specific chloroplast DNA sequences in partially purified total DNA from protoplast extracts. Using this technique, DNA sequences corresponding to about 0.01% of the total immobilized DNA could be detected. PMID- 6493221 TI - The influence of inorganic phosphate and ATP on the kinetics of bovine heart muscle pyruvate kinase. AB - The mechanism of activation by inorganic phosphate and ATP of cardiac muscle pyruvate kinase was studied with the aid of steady-state kinetics. The enzyme was purified to homogeneity to a final specific activity of 400 units/mg (phosphate buffer, pH 7.6, 25 degrees C). At pH 7.6 the enzyme displays Michaelis-Menten kinetics with respect to both its substrates, phosphoenolpyruvate and ADP. Substrate kinetic constants are: app.Km(phosphoenolpyruvate) = 0.04 mM, app.Km(ADP) = 0.22 mM. Under the conditions used in the standard assay the specific activity is greatly enhanced by inorganic phosphate (50 mM) or ATP (2.5 mM). Each of these modifiers, acting separately, increases the Vmax without seriously affecting Michaelis constants and Hill coefficients. In the presence of both Pi and ATP, only a decrease in Vmax was observed. The kinetics of activation by inorganic phosphate of pyruvate kinase was examined. Studying the effect of varying concentrations of Pi on the initial rate we obtained a hyperbolic saturation curve with the app.Km(Pi) = 20 mM and Vmax = 167 units/mg. The evidence is presented that inorganic phosphate is a substrate for a side reaction catalyzed by cardiac pyruvate kinase. It is shown that in the presence of pyruvate, inorganic phosphate and ATP in the assay system, Pi is incorporated into acid-labile products of this reaction, inorganic pyrophosphate being one of them. These findings indicate the existence of an alternative reaction catalyzed by pyruvate kinase by which energy may be stored in the form of inorganic pyrophosphate. PMID- 6493223 TI - Physiochemical and immunological properties of acetylcholine receptors from human muscle. AB - The acetylcholine receptor protein from human muscle was extracted with the non ionic detergent Triton X-100 and purified by affinity chromatography on alpha Naja toxin sepharose 4B. Further purification on Dicap-MP sepharose 4B, a choline analog compound, led to ACHR preparations with specific activities of 2-7 nmol/mg protein. The isolated receptor, labeled with 125I-alpha-bungarotoxin was characterized by different methods and compared to ACHRs from Torpedo californica electroplax and rat-denervated skeletal muscle. Gel filtration on Ultrogel AcA 34 resulted in a stokes radius of 70 A for the receptor monomer and 99 A for the dimeric form. Sucrose density gradient centrifugation showed sedimentation coefficients of 9.1 S and 13.5 S. From these data the molecular weight of the ACHR monomer was estimated as 254 000 D and 540 000 D for the receptor dimer. The isoelectric point of the 125I-alpha-bgt-ACHR complex was determined by thin-layer isoelectric focussing to be pH 5. Purified ACHRs were used for immunization of rats and mice which developed an EAMG as verified by clinical observation and electrophysical measurements. Sera from the immunized animals as well as from myasthenia gravis patients were subsequently used to compare the cross-reactivity of ACHR preparations from different sources. While antibodies of rats immunized with Torpedo ACHRs cross-reacted with ACHR preparations from rat and human skeletal muscle, antibodies from mice immunized with rat ACHR only reacted with preparations from rats and mice. Antibodies from mice immunized with ACHR of human origin exhibited a broad cross-reactivity, as did antibodies from MG patients. PMID- 6493222 TI - Is there a higher level genetic code that directs evolution? AB - Because the genetic code is redundant for most amino acids, different codons can be used in a given position without altering the structure of the protein for which the gene codes. This flexibility permits information encoding structural, and therefore functional, properties of RNA and DNA to be transmitted simultaneously by a protein-coding sequence of DNA. Among the other messages that might be transmitted, it is proposed, is one modulating the evolution of the DNA itself. PMID- 6493224 TI - Enhanced binding of phosphatidylserine-containing lipid vesicle targets to RAW264 macrophages. AB - Phosphatidylserine was found to significantly enhance the binding of phospholipid vesicles to RAW264 macrophages. We have measured the kinetics of non-specific uptake of unilamellar vesicles as a function of phosphatidylserine concentration in these model target membranes. Dimyristoylphosphatidylcholine was the principle component of these phospholipid vesicles. In most experiments, radiolabeled phospholipid and 1 mol% each of both a fluorescent phospholipid and a hapten containing lipid headgroup were utilized. In the presence of specific anti-hapten antibody phosphatidylserine-containing vesicles are rapidly taken up via phagocytosis. The antibody-independent non-specific uptake of phosphatidylserine free vesicles was low, as previously reported. However, the presence of 5 mol% phosphatidylserine dramatically enhanced the uptake of phospholipid vesicles by macrophages. This uptake was shown to be principally due to binding to the macrophage surface. Incubation of macrophages in the presence of sodium azide or at 4 degrees C, conditions which are known to inhibit phagocytosis, do not influence the uptake of the lipid vesicles. Fluorescence video-intensification microscopy was used to observe the interaction of carboxyfluorescein-loaded vesicles with macrophages. Fluorescence could not be observed when using phosphatidylserine-free vesicles. However, phosphatidylserine-containing vesicles can be observed bound to the cell periphery. Intracellular fluorescence could not be observed. The binding of phosphatidylserine-containing vesicles was enhanced roughly four-fold over phosphatidylserine because the effect could not be observed with membranes containing 1 mol% or 2.5 mol % phosphatidylserine. In addition, the binding enhancement required the presence of divalent cations in the incubation medium. PMID- 6493225 TI - The fluidity of plasma membranes from ethanol-treated rat liver. AB - Male Wistar rats were maintained for 35-40 days on a liquid diet containing 36% of calories as ethanol. Ethanol was replaced by carbohydrates in the isocaloric diet fed to control animals. The effect of ethanol consumption has been studied on the fluorescence polarization of rat liver plasma membranes and artificial lipid vesicles and on the lipid composition of the membranes. Fluorescence polarization in both membranes and vesicles was determined using DPH and TMA-DPH as fluorescence markers; from these data, the polarization term (ro/r-l)-1 and flow activation energy (delta E) were calculated. The ethanol consumption induces a more fluid environment within the membrane core of liver plasma membranes; the ethanol-fed rat membranes are more resistant to the in vitro effect of ethanol disordering the membrane structure. Vesicles obtained with lipids from either control membranes or ethanol-fed rat membranes were treated with ethanol and the changes in polarization paralleled to those exhibited by the membranes. The absence of phase transitions and of delta E changes was also shown in temperature dependence studies. The lower cholesterol content found in ethanol-fed rat plasma membranes might be responsible for observed variations in the microviscosity. PMID- 6493226 TI - Cardiac actin is the major actin gene product in skeletal muscle cell differentiation in vitro. AB - We examined the expression of alpha-skeletal, alpha-cardiac, and beta- and gamma cytoskeletal actin genes in a mouse skeletal muscle cell line (C2C12) during differentiation in vitro. Using isotype-specific cDNA probes, we showed that the alpha-skeletal actin mRNA pool reached only 15% of the level reached in adult skeletal muscle and required several days to attain this peak, which was then stably maintained. However, these cells accumulated a pool of alpha-cardiac actin six times higher than the alpha-skeletal actin mRNA peak within 24 h of the initiation of differentiation. After cells had been cultured for an additional 3 days, this pool declined to 10% of its peak level. In contrast, over 95% of the actin mRNA in adult skeletal muscle coded for alpha-actin. This suggests that C2C12 cells express a pattern of sarcomeric actin genes typical of either muscle development or regeneration and distinct from that seen in mature, adult tissue. Concurrently in the course of differentiation the beta- and gamma-cytoskeletal actin mRNA pools decreased to less than 10% of their levels in proliferating cells. The decreases in beta- and gamma-cytoskeletal actin mRNAs are apparently not coordinately regulated. PMID- 6493227 TI - Amplification and expression of human alpha-globin genes in Chinese hamster ovary cells. AB - We studied the effects of gene amplification on human globin gene expression in Chinese hamster ovary cells. The normal human alpha-globin gene (N alpha 2) and a hybrid gene (M alpha G) containing the 5' promoter-regulator region of the mouse metallothionein gene and the human structural alpha 2-globin gene were linked to a modular SV2-cDNA dihydrofolate reductase (DHFR) gene. The recombinant DNA molecules were introduced into Chinese hamster ovary cells by calcium phosphate precipitation. After initial selection to retain the DHFR and linked sequences, the cells were cultured in increasing concentrations of methotrexate up to 0.2 mM. Southern blot analysis of total cellular DNA showed an approximately 500- to 1,000-fold increase in the number of copies of DHFR and human alpha-globin genes. The transcription of the alpha-globin and DHFR genes increased as their copy number within the cells increased. The transcription of the amplified hybrid M alpha G gene was also inducible with cadmium treatments. Both mature mRNA and "read-through" transcripts were observed. DHFR constituted approximately 10% of pulse-labeled cellular proteins in these cells, but no human alpha-globin was detected. In vitro translation of polyadenylated RNA from these cells showed that alpha-globin mRNA transcribed from the amplified alpha-globin genes was functional and directed alpha-globin chain synthesis. In situ hybridization of 3H labeled alpha-globin and DHFR DNA probes in chromosome preparations from the two cell lines indicated that both genes were coamplified in the same chromosomal locations in each cell type. These results indicate that gene amplification enhances human globin gene expression in cultured Chinese hamster ovary cells. PMID- 6493228 TI - Regulated transcription of c-Ki-ras and c-myc during compensatory growth of rat liver. AB - We examined the transcription of six cellular oncogenes during the process of compensatory growth in rat liver after partial hepatectomy. We have previously reported that transcripts of c-rasH are elevated during regenerative growth of the liver. We now report that transcripts of c-rasK and c-myc genes are significantly elevated after partial hepatectomy, whereas transcripts of c-abl and c-src are essentially unchanged and transcripts of c-mos are undetectable in either normal or regenerating rat liver. In liver regeneration after partial hepatectomy or chemical injury, changes in c-myc transcripts occur before DNA synthesis. The elevation of c-myc and c-ras transcripts is sequential in that highest levels of c-myc transcripts were detected 12 to 18 h after partial hepatectomy, whereas the levels of c-rasH and c-rasK were maximal by 36 to 48 h. Transcripts of all three activated oncogenes returned to their basal levels by 96 h. PMID- 6493229 TI - Stress mRNA metabolism in canavanine-treated chicken embryo cells. AB - Four major chicken stress mRNAs with apparent molecular weights of 1.2 X 10(6), 0.88 X 10(6), 0.59 X 10(6), and 0.25 X 10(6) to 0.28 X 10(6) were separated on acidic agarose-urea gels. Using cell-free translation, the coding assignments of these mRNAs were determined to be stress proteins with apparent molecular weights of 88,000, 71,000, 35,000, and 23,000. Despite high levels of translational activity in vivo and in vitro, no newly synthesized mRNA for the 23-kilodalton stress protein was detected on gels under conditions which readily allowed detection of other stress mRNAs, suggesting activation of a stored or incompletely processed mRNA. Cloned Drosophila heat shock genes were used to identify and measure changes in cellular levels of the two largest stress mRNAs. Synthesis of these mRNAs increased rapidly during the first hour of canavanine treatment and continued at a high rate for at least 7 h, with the mRNAs attaining new steady-state levels by ca. 3 h. Both of these inducible stress mRNAs had very short half-lives compared with other animal cell mRNAs. Using an approach-to steady-state analysis, the half-lives were calculated to be 89 min for the mRNA encoding the 88-kilodalton stress protein and 46 min for the mRNA encoding the 71 kilodalton stress protein. Chicken 18S and 28S rRNA synthesis was inhibited, and actin mRNA levels measured with cloned cDNA encoding chicken beta-actin slowly declined in canavanine-treated cells. PMID- 6493230 TI - Isolation and characterization of revertants from four different classes of aryl hydrocarbon hydroxylase-deficient hepa-1 mutants. AB - Revertants were selected from aryl hydrocarbon hydroxylase (AHH)-deficient recessive mutants belonging to three complementation groups and from a dominant mutant of the Hepa-1 cell line. The recessive mutants had low spontaneous reversion frequencies (less than 4 X 10(-7] that were increased by mutagenesis. The majority of these revertants also had reacquired only partial AHH activity. Revertants of group A mutants were identical to the wild type with respect to both in vivo and in vitro enzyme stability and the Km for the substrate, benzo [alpha]pyrene, and therefore failed to provide evidence that gene A is the AHH structural gene. Group B and group C mutants are defective in the functioning of the Ah receptor required for AHH induction. Revertants of these groups were normal with respect to in vivo temperature sensitivity for AHH induction and for the 50% effective dose for the inducer, 2,3,7,8-tetrachlorodibenzo-p-dioxin, and thus provided no evidence that the B and C genes code for components of the receptor. Two rare group C revertants possessed AHH activity in the absence of induction. The phenotype of one of these was shown to be recessive to the wild type. Spontaneous revertants of the dominant mutant occurred at a frequency 300 fold greater than those of the recessive mutants, and this frequency was not increased by mutagenesis. These revertants all displayed complete restoration of AHH activity to wild type levels. These observations and the results from cell hybridization studies suggest that the dominant revertants arose by a high frequency event leading to functional elimination of the dominant mutation. PMID- 6493231 TI - High levels of intron-containing RNAs are associated with expression of the Drosophila DOPA decarboxylase gene. AB - We have examined the structure and expression during embryonic development of the Drosophila DOPA decarboxylase gene, Ddc. The Ddc gene is transcribed to make at least five different size classes of RNA. These RNA species first appear late in embryogenesis, coincident with induction of Ddc enzyme activity. The most abundant and smallest RNA appears to be Ddc mRNA. The sequences encoding this RNA are split by two intervening sequences. Each of the larger RNA species contains some or all of the intervening sequences. We have noted two unusual features of Ddc expression during embryogenesis. First, the intervening-sequence-containing RNAs are present as 20% or more of the polyadenylated Ddc RNA molecules, an exceptionally high proportion. Second, these RNAs do not disappear as rapidly as Ddc mRNA after Ddc enzyme activity reaches fully induced levels. These observations indicate slow rates of RNA processing relative to mRNA half-life and suggest that post-transcriptional steps participate in regulating Ddc expression. Although four of the five RNA species were detected at multiple developmental stages during which Ddc is expressed, one was found uniquely during embryogenesis. This RNA differs from Ddc mRNA in length and in time of expression during embryogenesis but is transcribed in the same orientation and from the same genomic sequences as the Ddc primary transcript. PMID- 6493232 TI - Griseofulvin resistance mutation of Chinese hamster ovary cells that affects the apparent molecular weight of a congruent to 200,000-dalton protein. AB - A single-step griseofulvin-resistant mutant (GrsR-4) of CHO cells which exhibit very specific cross-resistance towards certain microtubule inhibitors showed the absence of a protein of molecular weight congruent to 200,000 (designated P5) and the concomitant presence of a new protein spot, M5, of lower molecular weight (Mr congruent to 180,000) which is not present in other cell lines. Peptide mapping studies showed that proteins P5 and M5 are related to each other and that M5 may be missing a peptide fragment present in P5. In GrsR-4 X GrsS cell hybrids, both P5 and M5 were present in equal amounts, which provided evidence against post translation mechanisms in the origin of M5 and indicated that the GrsR-4 mutant most likely contains a nonsense mutation in the structural gene for protein P5, which causes its premature termination and leads to the formation of M5. Our studies also showed that in different Chinese hamster cell lines the two alleles of the protein P5 are nonidentical and make protein products which differ from each other in isoelectric points. It is suggested that protein P5 and its isoelectric variant P6 may constitute microtubule-associated proteins. PMID- 6493233 TI - tk Enzyme expression in differentiating muscle cells is regulated through an internal segment of the cellular tk gene. AB - Thymidine kinase (tk) enzyme expression is shut down when cultured skeletal muscle cells terminally differentiate. This regulation is mediated by a rapid and specific decline in the abundance of cellular tk mRNA. tk-deficient mouse myoblasts were transformed to the tk-positive phenotype by using both the cellular tk gene of the chicken and the herpesvirus tk gene. Myoblasts transformed with the cellular tk gene effectively regulate tk enzyme activity upon terminal differentiation. Conversely, myoblasts transformed with the herpesvirus tk gene continue to express tk enzyme activity in postreplicative muscle cells. A regulated pattern of expression is retained when the promoter of the cellular tk gene is replaced by the promoter of the herpesvirus tk gene. Moreover, the cellular tk gene is appropriately regulated during terminal muscle differentiation when its 3' terminus is removed and replaced by the terminus of the viral tk gene. Thus, the element of the cellular tk gene sufficient to specify its regulation is entirely intragenic. PMID- 6493235 TI - Isolation of Chinese hamster ovary cells that overproduce asparaginyl-tRNA synthetase. AB - Temperature-resistant revertants, derived from the temperature-sensitive CHO asparaginyl-tRNA synthetase mutant, Asn-5, were isolated and characterized. Several lines of evidence indicate that the temperature-resistant phenotype of the revertants is due to their overproducing the same altered enzyme present in the Asn-5 parent. PMID- 6493234 TI - Tissue specificity of type I collagen gene expression is determined at both transcriptional and post-transcriptional levels. AB - We analyzed the control of type I collagen synthesis in four kinds of differentiated cells from chicken embryos which synthesize very different amounts of the protein. Tendon, skin, and smooth muscle cells were found to have identical amounts of type I collagen RNAs; however, the RNAs had inherently different translatabilities, which were observed both in vivo and in vitro. Chondrocytes also had substantial amounts of type I collagen RNAs, even though they directed no detectable synthesis of the protein either in vivo or in vitro. Type I collagen RNAs in chondrocytes display altered electrophoretic mobilities, suggesting that in these cells the reduction in translational efficiency may be mediated in part by changes in the RNA structure. These data indicate that control of type I collagen gene expression is a complex process which is exerted at both transcriptional and post-transcriptional levels. PMID- 6493236 TI - Quantitative red cell morphology. PMID- 6493237 TI - Image analysis of cells in the sediment of voided urine. PMID- 6493239 TI - [Inpatient, day clinic and ambulatory care of children with cancer]. PMID- 6493238 TI - Predictive value of digitized cell images for the prognosis of cervical neoplasia. PMID- 6493240 TI - [Ambulatory care of children with heart diseases]. AB - The out-patient unit for pediatric cardiology is important in establishing diagnoses and caring for children with congenital heart disease. In addition it provides postoperative care and helps the local physician to decide whether a heart-catheter or a heart operation is necessary. Innocent murmurs in children can be recognized, cardiac arrhythmias analyzed and treated. In this sense the pediatric cardiology out-patient unit is expected to maintain the work of a locally practising pediatric cardiologist, as well as providing student and postgraduate training facilities in pediatric cardiology. PMID- 6493241 TI - [Inpatient, day clinic and ambulatory care of children with lung diseases]. PMID- 6493242 TI - [Does the introduction of pediatric treatment methods miscarry due to lack of care-related legal insurance?]. PMID- 6493243 TI - ["Hypertension" caused by blood pressure determination with a small cuff]. AB - Blood pressure reading in children needs cuffs with appropriate width (and length). Using wrongly small cuffs results in "hypertension" causing unnecessary diagnostic and therapeutic procedures. This presentation of three cases is intended to underline this problem. PMID- 6493244 TI - [Clinical management of bronchopulmonary dysplasia]. AB - Bronchopulmonary dysplasia is caused by several factors. Avoidance of bronchopulmonary dysplasia is directed at its causes and should always attempt the rapid weaning of the patient from the respirator. Some of the preventive measures include a) avoiding an oxygen injury; b) prevention of barotrauma; 3) sufficient moisturization and warming of the respiratory gases; d) regular cleaning of the respiratory tract and bacterial controls of the tracheal secretion; e) administration of vitamin E; f) reconsideration (restricting the use) of parenteral nutrition. Assistance in the weaning from the respiratory means a) avoidance of an open ductus arteriosus; b) paced reduction of FiO2, respiratory pressure and frequency up to intermittent mandatory ventilation and final transition to spontaneous respiration with increased mean respiratory pressure; c) avoidance of cardiac insufficiency; d) administration of corticosteroids; e) theophyllin, and f) physical therapy. The number of patients with bronchopulmonary dysplasia has remained the same in the last six years. However, the mortality until 1979 round about 50% has been reduced to 1/3, in the years 1980/81. PMID- 6493245 TI - [Alcoholism as a career]. PMID- 6493246 TI - Mutagenic action of monochromatic UV radiation in the solar range on human cells. AB - Mutations to ouabain resistance (selecting for base modifications at the co dominant Na+K+-dependent ATP-ase locus) and thioguanine resistance (selecting for a wide range of genetic changes at the recessive hypoxanthine-guanine phosphoribosyl transferase locus) were measured in a repair-proficient human lymphoblastoid line with defined monochromatic radiations in the UVC (254 nm), UVB (302 nm, 313 nm), UVA (334 nm, 365 nm) and visible (405 nm) ranges. No mutations were detected at wavelengths in the range 334-405 nm. At 254 nm and 313 nm, both mutations to thioguanine resistance and survival were consistent with those expected from the relative levels of cyclobutane-type pyrimidine dimers induced. However, at 313 nm, the ratio of ouabain-resistant to thioguanine resistant mutants is 10 times higher than at 254 nm, indicating that a unique type of pre-mutagenic base damage is induced at the longer wavelength. Radiation in the UVA (334 nm) range reduced the induction of mutations by a UVC (254 nm) wavelength at both mutation markers. These results suggest, first, that distinct types of biologically expressed genetic damage may be induced in the UVB region of sunlight and, second, that strong interactions may occur between the different wavelength regions of sunlight that can modify the expression of this genetic damage in human cells. PMID- 6493247 TI - Characterization of an unscheduled DNA synthesis assay with Syrian hamster embryo cells. AB - The Syrian hamster embryo cell transformation assay is widely used for studies of carcinogenesis. The characterization of an unscheduled DNA synthesis (UDS) assay for these cells is reported. Benzo[a]pyrene, aflatoxin B1 and UV light induced UDS in the cells in a dose-dependent manner without exogenous metabolic activity. Nitrosopiperidine induced UDS as well as gene mutations and cell transformation only in the presence of an exogenous metabolic activation system. The utility of this UDS assay with these cells is discussed. PMID- 6493248 TI - A mutagenesis-enhancing activity of 12-O-tetradecanoylphorbol 13-acetate detected in Chinese hamster ovary cells. AB - Tumour-promoting agents may bring about the completion of multi-step carcinogenesis by acting as enhancers of mutagenesis, recombinogens or clastogens. We report here that the classical mouse skin tumour promoter TPA, although non-mutagenic per se, can enhance the induction of OuaR CHO-K1 cell mutants by MNNG approximately 2-fold. This observation was made at a concentration approaching the compounds aqueous solubility limit which was non cytotoxic. Mutagenesis enhancement was dependent on TPA being present throughout mutation expression and mutant selection. It was not accompanied by any modification of cell sensitivity to mutagen killing. In the same treatment protocol TPA did not enhance either EMS- or UV-induced mutagenesis. TPA exposure over 2 rounds of cell replication failed to produce an increase in the frequency of SCE in control or mutagen-treated CHO-K1 cultures. Likewise TPA exposure over 1 round of cell replication failed to produce an increase in the frequency of chromosomal aberrations. Apparently TPA is not a recombinogen or clastogen but in the right exposure regime is capable of acting to enhance mutagenesis by certain genotoxic agents, an action which may contribute to tumour promotion. PMID- 6493249 TI - Antagonizing effect of 3-aminoharman on induction of sister-chromatid exchanges by mutagens. AB - 3-Aminoharman (3AH, 3-amino-1-methyl-9H-pyrido[3,4-b]indole), which has been reported as a novel substance with an antagonistic effect on induction of sister chromatid exchange (SCE) by polycyclic mutagens in the presence of the metabolic activation system, was examined with a cultured human lymphoblastoid cell line, NL3, for its effect on SCE induction by direct-acting mutagens such as mitomycin C (MMC), nitrogen mustard N-oxide (NMO), methyl methanesulfonate (MMS), N-methyl N'-nitro-N-nitrosoguanidine (MNNG), 4-nitroquinoline 1-oxide (4NQO) and 3 hydroxyamino-1-methyl-5H-pyrido[4,3-b]indole (OH-Trp-P-2), and also by ultraviolet light (UV) irradiation. The results obtained on simultaneous treatment with 3AH and mutagens were as follows: (1) 3AH suppressed more than 50% of SCEs induced by MMC, NMO and OH-Trp-P-2; (2) 4NQO- and MNNG-induced SCEs were also suppressed by 3AH but to a lesser degree; (3) MMS-induced SCEs were not, however, altered by 3AH; and (4) the suppression of SCE by 3AH was dose dependent. Treatment of cells with 3AH for 2 h immediately before MMC exposure suppressed SCE induction to a significant degree similar to the simultaneous treatment, but post-treatment with 3AH was much less effective. 3AH inhibited SCE induction by NMO when 3AH treatment was carried out either before or after NMO treatment, to an extent similar to the simultaneous treatment. Treatments with 3AH either before or after UV exposure did not change the UV-induced SCEs. Results with these direct-acting mutagens ruled out the relevance of metabolic activation as a necessary step for the antagonizing effect of 3AH. PMID- 6493250 TI - Sister-chromatid exchanges in human lymphocytes after a non-S-phase incubation period to allow excision DNA repair-in vitro exposure to N-acetoxy-2 acetylaminofluorene and ethylene oxide. AB - Sister-chromatid exchanges (SCE) were analyzed in human peripheral blood lymphocytes at the baseline level, after induction of DNA damage by N-acetoxy-2 acetylaminofluorene (NA-AAF) and ethylene oxide (EO), and after a subsequent 18-h DNA-repair incubation period. There was a significant difference between the baseline SCE frequencies as compared to those after 1 h of NA-AAF or EO treatment. There was no significant difference between the SCE frequencies after 1 h of NA-AAF treatment and those after 18 h of DNA-repair incubation, suggesting that only a low level of NA-AAF damage to DNA had been removed. However, there was a significant difference between the SCE frequencies after 1 h of EO treatment and those after 18 h of DNA-repair incubation, indicating that a significant level of EO induced DNA lesions had been repaired. Thus, it seems likely that the EO induced DNA damage is more easily recognized, and hence more rapidly repaired than the NA-AAF induced damage. The reason for this may be the different chemical nature of the DNA lesions induced, which, in turn, leads to different kinetics of DNA repair. PMID- 6493251 TI - Sister-chromatid exchange (SCE) report on control subjects in a study of occupationally exposed workers. AB - The range and distribution of Sister-Chromatid Exchange (SCE) scores in 479 control persons were determined. All SCE readings were performed in a single laboratory according to the same protocol and regularly checked by referee readers to assure consistency. A mean SCE per cell value of 9.9 and a 95th percentile of 13.4 were established for this study sample. The range of SCE scores across all non-exposed individuals tested was 5.0-17.5 SCE per cell. Differences in SCE scores were associated with reader, smoking, sex, and, to a small extent, age. Individual test results showed reasonable consistency across the entire control group, but, as with most clinical measurements, care should be taken to avoid placing too much emphasis on a single test result when communicating with an individual. This report on the largest control group studied to date provides necessary normative data for further SCE investigations in occupational settings. PMID- 6493252 TI - Sister-chromatid exchanges in association with occupational exposure to ethylene oxide. AB - Sister-chromatid exchange (SCE) frequencies in employees potentially exposed to ethylene oxide (ETO) were compared with those in unexposed control groups. Three worksites where the previous environmental control of ETO was known to have differed were chosen. Within these worksites, subjects were categorized into high potential exposed, low potential exposed and control groups. An additional community control group was obtained. Blood samples for chromosome studies of peripheral lymphocytes were drawn at several time points over a period of 24 months. The effects on SCE of age, sex, smoking habits and reader variation were considered. Worksites I, II and III, respectively, represented increasing levels of exposure. At Worksite III large differences among groups persisted over 24 months. At Worksite II, the SCEs in the high potential exposed workers were higher than those in the other groups. At no time was the low potential exposed group at Worksite II statistically significantly higher in mean SCE than the worksite controls. No consistent differences among groups were noted in Worksite I. PMID- 6493253 TI - Rapid detection of DNA-damaging agents using repair-deficient CHO cells. AB - A screening method is introduced to detect and classify DNA-damaging agents using DNA repair-deficient strains of Chinese hamster ovary cells. Differential cytotoxicity (relative growth) of the mutant cells compared to the wild-type cells was interpreted as a measure of lethal, potentially repairable damage to DNA. The assay consists of exposing the wild-type cells and three mutant strains to the test compound in a 24-well tray and using staining intensity to estimate growth after 72 h. The battery of mutants consists of two UV-sensitive strains (UV4 and UV5) that are deficient in different aspects of nucleotide excision repair, and strain EM9, which is defective in DNA-strand-break rejoining. The assay was highly reproducible, and the magnitude of the differential cytotoxicity response compared favorably with the amount of differential killing measured by colony-formation survival curves for several chemicals. 15 direct-acting and 7 metabolism-dependent agents that were expected to produce bulky, covalent DNA adducts were tested in the assay, and all produced a differential cytotoxicity response in at least two of the mutants. UV4 and UV5 showed a response to all of the test compounds whereas EM9 showed a response to 7 of the test compounds. Thus, the pattern of mutant responses presumably reflects the types of DNA damage produced by a compound. Although this aspect is still under development, these results indicate the potential of a larger battery of mutants to classify a wide spectrum of chemicals according to the lesions they produce. 13 non-DNA damaging agents were also tested and none produced a differential cytotoxicity response, suggesting that this endpoint is specific for DNA damage. We conclude that this assay may be a cost-effective alternative or adjunct to the existing short-term tests. PMID- 6493254 TI - The use of sister-chromatid exchange in Chinese hamster primary lung cell cultures to measure genotoxicity. AB - Primary cell cultures derived from Chinese hamster lung (CHL) were established, and their response for the induction of sister-chromatid exchange (SCE) by direct and indirect-acting mutagens was characterized. An increase in SCE frequency was induced in CHL cells by 3-methylcholanthrene (MCA), benzo[a]pyrene (BaP), and 2 aminoanthracene (2AA). The SCE frequency increased slightly after exposure to cyclophosphamide, but did not respond to the hepatocarcinogen dimethylnitrosamine (DMN). A slight increase in SCE frequency by DMN was observed in the CHL system with use of Aroclor-1254-induced rat liver homogenate fraction (S9). This response to DMN in CHL cells was lower than that seen when CHO cells were the target in the presence of S9. At low (1) and high (20) passages, the CHL cells responded with a similar dose-related increase in SCE frequency to direct- (ethyl methanesulfonate, EMS) and indirect-(MCA) acting mutagens. This response indicates that even after prolonged culturing in vitro, the cells retained the ability to metabolically activate xenobiotic promutagens. The induction of SCE by MCA occurred at concentrations that also induced macromolecular binding. SCE induction was also examined in primary lung cell cultures from animals exposed by nose-only inhalation to MCA aerosol. A significant increase in SCE frequency above controls was observed in cells from animals after a single exposure to MCA. No detectable increase in SCE frequency was observed after repeated inhalation exposures. Because CHL cells are of lung origin and showed metabolic activity, the CHL system appears to be appropriate for study of the genotoxic potential of inhaled compounds. PMID- 6493255 TI - Use of low temperature for growth arrest and synchronization of human diploid fibroblasts. AB - The growth kinetics of human diploid fibroblasts at two different temperatures were followed. Proliferation of exponentially growing cells is reduced and eventually stops upon incubation at low temperature (i.e. 30 degrees C). The cells which are in S phase at the time of switching to low temperature complete their DNA synthesis and become arrested in the G1 phase of the cell cycle. The arrested cells can be stimulated to proliferate by restoration of the optimal growth temperature (37 degrees C). The kinetics of entry into S phase were investigated by measuring [3H]thymidine incorporation into TCA-precipitable material, by autoradiography and by flow cytofluorimetry. The synchronized cells initiate DNA synthesis at approximately 8 h and DNA synthesis peaks at 20.4 +/- 0.7 h after stimulation. In addition, the rates of UV-induced excision repair at 30 degrees C and 37 degrees C were compared. The results indicate that at 30 degrees C the excision-repair process is operative but at a slightly reduced rate in comparison with repair at 37 degrees C. This method will be useful for the study of S-phase-dependent processes, as well as for repair studies in the absence of cell division. PMID- 6493256 TI - Environmental mutagenesis and carcinogenesis: test method development, validation and utilization. PMID- 6493257 TI - Selected abstracts of papers presented at the 12th annual meeting of the Environmental Mutagen Society of Japan. 28-29 October 1983, Tokushima (Japan). PMID- 6493258 TI - Excision repair of mouse and human fibroblast cells, and a factor affecting the amount of UV-induced unscheduled DNA synthesis. AB - Excision-repair ability and the amount of unscheduled DNA synthesis (UDS) after UV irradiation of fibroblast cells (in vitro passage 5) from C57BL mouse embryos were compared with those of human skin fibroblast cells. UDS in the mouse cells was approximately 75% of that in the human cells, although the disappearance of T4 endonuclease-V-susceptible sites and the accumulation of single-strand breaks in the mouse cell DNA indicated that the excision-repair capacity of the mouse cells was 20-35% of that in the human cells. This apparent discrepancy was ascribed to the difference in intracellular dTTP pool size, which was approximately twice as large in the human cells as in the mouse cells. UDS may not be suitable as a quantitative measure of excision repair when comparing the cells from different species. PMID- 6493259 TI - Kinetics of recombinational hybrid formation in X-irradiated mammalian cells: a possible first step in the repair of DNA double-strand breaks. AB - It is known that mammalian cells repair X-ray-induced double-strand breaks (DSB). The mechanism of this repair is, however, as yet unknown but it is thought that the repair may involve recombination between homologous DNA strands. We have investigated the presence and kinetics of occurrence of recombinational molecular intermediates or 'heavy-heavy' (HH) hybrids in DNA of X-irradiated mouse Ehrlich ascites tumour cells unifiliarly substituted with bromodeoxyuridine. Purified DNA from density-labelled cells was analysed using isopyknic CsCl density centrifugation. After rebanding of the high-density material, the relative amount of HH-hybrid material was determined. When the cells were incubated after X-ray exposure, hybrids accumulated with an apparently biphasic kinetic; first a rapid accumulation directly after irradiation followed by a second, more slowly appearing peak. When DSB repair was inhibited by the nucleoside analogue 9-beta-D arabinofuranosyladenine (ara-A), a powerful DNA polymerase inhibitor, the kinetics of the HH-hybrid formation were similar to those during the incubation after X-irradiation without ara-A. We interpret this as indicating that the first step in repair of DSB i.e. hybrid formation, occurs in the absence of DNA synthesis as predicted by the Resnick model of DSB repair. In an experiment in which the ara-A was washed away from the irradiated cells after 8-h treatment with the drug and replaced by fresh growth medium, so allowing DSB to repair, a similar HH-hybrid kinetic response was found to that occurring directly after irradiation in the absence of ara-A. The reasons for this are not yet clear. In this case, however, the response of the ara-A-treated cells after X-irradiation was much stronger than that in the untreated cells where only approximately 20% of the DSB remained. These kinetic results which show a temporary appearance of HH hybrids, indicate that a net exchange of genetic material does not take place; they therefore lend support to the postulated recombinational model of Resnick in which a temporary exchange between homologous DNA strands takes place during DSB repair. PMID- 6493260 TI - Effect of ultraviolet light on DNA replication in excision-deficient mammalian cells. AB - DNA replication after exposure to 254-nm ultraviolet light was examined in wild type (AA8) and excision-deficient (UV-5) Chinese hamster ovary (CHO) cells. DNA replication was examined by measuring the incorporation of [3H]thymidine into acid-precipitable form and by DNA fiber autoradiography. Following exposure to UV both cell lines exhibited a fluence-dependent reduction in the rate of incorporation of thymidine. For exposures of 3.25 and 6.5 J/m2 the response was quantitatively similar in both cell lines for the first hour or two following exposure, with thymidine incorporation dropping to less than 50% of the control rate within the first 1-2 h. For the AA8 cells the depression was only temporary with the rate of thymidine incorporation eventually recovering to control levels. UV-5 cells, on the other hand, never exhibited a recovery in the rate of thymidine incorporation, even at a fluence as low as 0.8 J/m2. DNA fiber autoradiographic analysis revealed that for both AA8 and UV-5 lines there were about a 40% reduction in the rate of chain growth in the first 40 min after exposure to 6.5 J/m2. The rate of DNA chain elongation recovered to normal rates in less than 5 h in AA8 cells while little or no recovery in the rate of DNA chain elongation was observed for up to 5 h in the UV-5 cells. From these results it appears that the steps of excision repair that are missing in the UV-5 cells are required not only for excision repair, but also for the ability of cells to recover normal rates of DNA replication following exposure to UV. PMID- 6493261 TI - Kinetics of ultraviolet induced DNA excision repair in rat and human fibroblasts. AB - To obtain more information on the well-documented low excision-repair capacity of rodent cells in comparison with human cells, we have studied this form of DNA repair in UV-irradiated human and rat skin fibroblasts. For this purpose, we have determined (i) unscheduled DNA synthesis (UDS), using autoradiography, (ii) the number and size of repaired sites with the bromodeoxyuridine (BrdU) photolysis assay and (iii) the removal of Micrococcus luteus UV-endonuclease susceptible sites (ESS). We found rat cells to be quite capable of performing DNA-repair synthesis, as demonstrated by both UDS and BrdU photolysis, whereas they almost completely lacked the capacity to remove pyrimidine dimers, as indicated by the persistence of ESS. This discrepancy will be discussed in terms of the types of mechanisms by which mammalian cells may recognize and remove UV-induced photoproducts. PMID- 6493262 TI - Effects of age and liquid holding on the UV-radiation sensitivities of wild-type and mutant Caenorhabditis elegans dauer larvae. AB - The dauer larva is a facultative developmental stage in the life cycle of the nematode Caenorhabditis elegans. Dauer larvae, which can survive under starvation for over 60 days, resume normal development when feeding is resumed. Wild-type (N2) and 4 radiation-sensitive (rad) mutant dauer larvae were tested for their abilities to develop into adults after UV-irradiation. The rad-3 mutant was over 30 times as sensitive as N2; rad-1, rad-2 and rad-7 mutants were not hypersensitive. Irradiation also delayed development in survivors. Wild-type dauer larvae did not differ in radiation sensitivity from 0 through 50 days of age. There was no liquid holding recovery (LHR); that is, survival did not increase when wild-type dauer larvae were held in buffer after irradiation. PMID- 6493264 TI - Induction in human skin fibroblasts of sister-chromatid exchanges (SCEs) by photoaddition of two new monofunctional pyridopsoralens in comparison to 3 carbethoxypsoralen and 8-methoxypsoralen. AB - The induction of SCEs in human fibroblasts by photoaddition of a pyrido[3,4 c]psoralen (PyPs) and its 7-methyl derivative (MePyPs), two newly synthesized monofunctional agents proposed for photochemotherapeutic use, was compared to that of another monofunctional agent, 3-carbethoxypsoralen (3-CPs) and to the bifunctional compound, 8-methoxypsoralen (8-MOP). The yield of SCEs/cell and of SCEs/chromosome was determined at equimolar concentrations (10(-6) M) of all the drugs with increasing doses of 365 nm radiation (UVA). In the dark, the drugs alone had either no effect (8-MOP, PyPs) or a very slight effect (3-CPs, MePyPs). Nor did UVA alone demonstrate at inducing action (14.4 kJ/m2). With all the agents the average frequencies of SCE increased with increasing UVA doses, reaching a plateau level for the monofunctional compounds. The order of effectiveness for the linear part of the induction curves was MePyPs greater than PyPs greater than 8-MOP much greater than 3-CPs, whereas at the maximal level the order was 8-MOP greater than PyPs greater than MePyPs greater than 3-CPs. Determination of the frequencies of 2nd generation mitosis indicates that MePyPs is the most cytotoxic. The results focus the attention on the importance of the structure of psoralen monoadducts which, for certain genetic endpoints, might be as efficient as cross-links. PMID- 6493263 TI - Biological monitoring of workers in the rubber industry. II. UV-induced unscheduled DNA synthesis in the lymphocytes of vulcanizers. AB - DNA-repair ability was estimated in a group of vulcanizers by measuring in vitro UV-induced unscheduled. DNA synthesis (UDS) in peripheral lymphocytes, and compared with that of an adequate control group. A considerable interindividual variability was shown by the UDS responses of the subjects studied both in the control and exposed population. Significantly (P = 0.0158) decreased UDS values were observed among the vulcanizers as compared to the referents. Neither age nor cigarette-smoking was observed to affect the UDS response, thus suggesting an association between the industrial exposure and decrease in the DNA-repair rate. PMID- 6493265 TI - Biological monitoring of workers in the rubber industry. I. Chromosomal aberrations and sister-chromatid exchanges in lymphocytes of vulcanizers. AB - To evaluate the possible genetic consequences of the industrial exposure among the vulcanizers of a rubber plant we measured the in vivo levels of chromosomal aberrations and sister-chromatid exchanges in peripheral lymphocytes of 34 vulcanizers and in an adequate control population. The observed chromosomal aberration frequencies were 1.9 +/- 1.4 aberrations/100 cells in the exposed group and 2.1 +/- 1.5 aberrations/100 cells in the controls. No difference was found between the two groups for the mean value of sister-chromatid exchanges (5.2 +/- 1.3 in the exposed, 5.2 +/- 0.7 in the control group). Cigarette-smoking was clearly associated with increased sister-chromatid exchange frequencies both in the exposed and in the control groups, while chromosomal aberration frequencies were not correlated with smoking habits. PMID- 6493266 TI - Ultraviolet light and mitomycin C induced sister-chromatid exchanges in fibroblasts from patients with retinoblastoma. AB - Ultraviolet light and mitomycin C (MMC) induced sister-chromatid exchanges (SCEs) were investigated in 6 diploid fibroblast strains derived from 3 patients with deletion 13 and retinoblastoma, one patient with a hereditary form of retinoblastoma, one patient with trisomy 13, and one normal control. Two fibroblast strains with del(13)(q14q22) showed a significant increase in SCEs compared to the control after UV and MMC treatments. In contrast, cell strains with del(13)(q12q14) and trisomy 13 did not show increased SCEs. The frequency of SCEs in fibroblasts from a patient with autosomal dominant retinoblastomas (no deletions) was significantly increased by UV, but not by MMC. The results suggest that cell strains with different deletions of chromosome 13 have different SCE responses to UV and MMC inductions. The cells with del(13)(q14q22) may have a DNA repair defect. PMID- 6493267 TI - Mutagenicity of instant coffee on cultured Chinese hamster lung cells. AB - Coffee showed mutagenic activity in cultured Chinese hamster lung (CHL) cells as assessed by using diphtheria toxin resistance as a selective marker. Most of the mutagenicity was suppressed in the presence of sodium bisulfite. The contribution of methylglyoxal to the total mutagenicity of coffee was less than 3%. PMID- 6493268 TI - Measurement of genotoxic activity in multiple tissues following inhalation exposure to dimethylnitrosamine. AB - Chemically-induced DNA repair was measured as unscheduled DNA synthesis (UDS) in selected tissues isolated from rats following in vivo exposure to inhaled dimethylnitrosamine (DMN). UDS was evaluated in epithelial cells from rat nasal turbinates and trachea, in hepatocytes and in pachytene spermatocytes from the same treated animal. At nominal concentrations of 500 and 1000 ppm of DMN in air, chemically-induced DNA repair was observed in the epithelial cells of the upper respiratory system. DMN also entered the circulation, as evidenced by a strong DNA-repair response in hepatocytes. No DNA repair was observed in pachytene spermatocytes indicating either that DMN or its active metabolites did not reach the testes in sufficient concentration to induce DNA repair or that the testes lacked the capability to metabolically activate the compound. These results illustrate the potential of this approach to assess the organ-specific genotoxicity of environmental chemicals. PMID- 6493269 TI - Novobiocin-mediated inhibition of polymerization and ligation of DNA in vitro. PMID- 6493270 TI - Preferential repair of nuclear matrix associated DNA in xeroderma pigmentosum complementation group C. AB - The distribution of ultraviolet-induced DNA repair patches in the genome of xeroderma pigmentosum cells of complementation group C was investigated by determining the molecular weight distribution of repair labeled DNA and prelabeled DNA in alkaline sucrose gradients after treatment with the dimerspecific endonuclease V of bacteriophage T4. The results were consistent with the data reported by Mansbridge and Hanawalt (1983) and suggest that DNA repair synthesis in xeroderma pigmentosum cells of complementation group C occurs in localized regions of the genome. Analysis of the spatial distribution of ultraviolet-induced repair patches in DNA loops attached to the nuclear matrix revealed that in xeroderma pigmentosum cells of complementation group C repair patches are preferentially situated near the attachment sites of DNA loops at the nuclear matrix. In normal human fibroblasts we observed no enrichment of repair labeled DNA at the nuclear matrix and repair patches appeared to be distributed randomly along the DNA loops. The enrichment of repair-labeled DNA at the nuclear matrix in xeroderma pigmentosum cells of complementation group C may indicate that the residual DNA-repair synthesis in these cells occurs preferentially in transcribing regions of the genome. PMID- 6493271 TI - Chromosome aberrations and sister-chromatid exchange frequencies in pathology staff occupationally exposed to formaldehyde. AB - Past studies have shown that formaldehyde is mutagenic in microbial tests and Drosophila and causes chromosomal aberrations in cultured mammalian cells. Chromosomal analysis of bone marrow cells and spermatocytes from exposed laboratory animals has failed to show any genotoxic effect. Information on individuals occupationally exposed is limited and there is no evidence to date that formaldehyde can induce chromosome damage at occupational levels of exposure. This study examines the chromosome aberration and sister-chromatid exchange frequencies in lymphocytes from a group of 6 pathology workers and 5 unexposed controls. No detectable differences could be found between the groups in either chromosomal aberration induction or sister-chromatid exchange frequencies. PMID- 6493272 TI - Induction of chromosome aberrations and sister-chromatid exchanges in CHO-K1 cells by o-phenylphenol. AB - o-Phenylphenol (OPP), is used in Japan as a fungicide in food additives for citrus fruits. The induction of chromosome aberrations and sister-chromatid exchanges (SCEs) by OPP in cultured Chinese hamster ovary (CHO-K1) cells was studied. Cells were exposed to various concentrations of OPP ranging from 50 to 175 micrograms/ml for 3 h, and further incubated for 27 and 42 h. These incubation periods are almost equal to 2 and 3 cell cycles. SCEs and chromosome aberrations were induced by OPP at concentrations of 100, 125 and 150 micrograms/ml after the incubation for 27 h. For chromosome aberrations, chromatid breaks and exchanges there was a dose-dependent increase. Diplochromosomes due to endoreduplication were also caused by the same concentrations of OPP in a dose-dependent manner. After incubation for 42 h, chromosome aberrations were also increased by OPP at concentrations of 100 and 125 micrograms/ml, but the frequencies of SCEs were not significantly different from those of the control. These results suggest that OPP has a cytogenetic toxicity, and that the DNA damage resulting in SCEs induced by OPP is relatively short-lived and can be repaired during the longer incubation time. PMID- 6493273 TI - The association of smoking with cardiomyopathy. AB - We investigated the possibility that smoking has an association with ventricular wall-motion abnormalities that is independent of its known association with coronary occlusion. We studied 4763 men between the ages of 35 and 74 who had diagnostic coronary angiography and ventriculography. We considered three kinds of wall-motion abnormalities: hypokinesis in one to four ventricular segments, hypokinesis in five to six ventricular segments (diffuse hypokinesis), and akinetic or dyskinetic wall motion in at least one segment. Among men younger than 55, the relative risk of diffuse hypokinesis was 2.78 (1.1 to 6.99) for heavy smokers as compared with nonsmokers. Adjusting for the degree of coronary occlusion or eliminating subjects with a history of myocardial infarction did not change this relative risk. Among men who were 55 or older the relative risk (odds ratio for heavy smokers as compared with nonsmokers) was not significant (0.55 to 2.28). Regardless of age the relative risk of akinesis or dyskinesis, adjusted for coronary stenosis, was significant: 1.84 (1.28 to 2.65) for men under 55 and 1.57 (1.12 to 2.19) for men 55 or older. These results suggest that smoking is related to both cardiomyopathy and transmural myocardial infarction and that the relationships are largely separate from the association of smoking with coronary stenosis. PMID- 6493274 TI - Infarction-associated pericarditis. Rarity of diagnostic electrocardiogram. AB - To examine how often pericarditis is associated with myocardial infarction and how often it is diagnosable by electrocardiographic changes, we determined the frequency of diagnostic (Stage I) ST-segment changes in 423 consecutive patients admitted to the coronary-care unit. Careful auscultation and electrocardiography were performed at least once daily in all patients and at least twice daily in those presenting with new chest pain of any description or a pericardial rub. Thirty-one patients had pericardial rubs, usually detected within the first four days after admission. Only 1 of the 31 had diagnostic electrocardiographic changes. The 31 patients with pericarditis differed significantly from the 392 patients without pericarditis in several respects: male predominance; Killip Classes II, III, and IV; and Q-wave infarcts. However, differences in the location of the infarct and in mortality were not statistically significant. We conclude that during acute infarction-associated pericarditis the pericardial rub is the most frequent clinical sign, and ST-segment changes diagnostic of pericarditis are rare. Our findings are consistent with the confinement of pericardial involvement to the infarct zone. PMID- 6493275 TI - Short-chain acyl-CoA dehydrogenase deficiency associated with a lipid-storage myopathy and secondary carnitine deficiency. PMID- 6493276 TI - Unraveling the mystery of idiopathic anaphylaxis. PMID- 6493277 TI - The new language of hospital management. PMID- 6493278 TI - Hard lessons learned. PMID- 6493279 TI - Predicting diabetic nephropathy. PMID- 6493280 TI - First-trimester diagnosis of Krabbe's disease by direct enzyme analysis of chorionic villi. PMID- 6493281 TI - Tamoxifen in the treatment of refractory lymphoma. PMID- 6493282 TI - Increased growth of eyelashes in a patient given leukocyte A interferon. PMID- 6493283 TI - Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. AB - Debate continues on whether aging or estrogen deficiency is the more important determinant of postmenopausal bone loss. We compared 14 women who had undergone oophorectomy during young adulthood, 14 normal perimenopausal women, and 14 normal postmenopausal women (mean ages, 54, 52, and 73 years, respectively; mean duration of estrogen deficiency, 22, 0.3, and 22 years, respectively). Bone mineral density was assessed by single-photon and dual-photon absorptiometry. As compared with the perimenopausal group, the other two groups had significantly lower bone mineral density at the midradius, femoral neck, femoral intertrochanteric area, and lumbar spine (-15 per cent, -25 per cent, -16 per cent, and -23 per cent, respectively, in the oophorectomized group and -18 per cent, -28 per cent, -26 per cent, and -23 per cent, respectively, in the postmenopausal group). Because bone loss in the oophorectomized group (differing from the perimenopausal group in menopausal status but not in age) was almost as great as in the postmenopausal group (differing in both characteristics), we suggest that estrogen deficiency, and not aging, may be the predominant cause of bone loss occurring during the first two decades after natural menopause. PMID- 6493284 TI - Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain. AB - The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and - 1.4 +/- 1 per cent, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29 per cent) and in 4 of the 20 without it (20 per cent) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1 per cent, in contrast to the patients without coronary disease, who had an increase of 6 +/- 1 per cent (P less than 0.001). An exercise induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48 per cent), as compared with 3 of the 38 without it, (8 per cent) (P less than 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain. PMID- 6493285 TI - Ear-canal hair and the ear-lobe crease as predictors for coronary-artery disease. PMID- 6493286 TI - Familial nature of Alzheimer's disease? PMID- 6493287 TI - Oxygen therapy in sickle-cell anemia. PMID- 6493288 TI - Bone mineral content of female athletes. PMID- 6493289 TI - Individual differences in gastrointestinal absorption of aluminum. PMID- 6493290 TI - A lament for conservative treatment. PMID- 6493291 TI - Moonlighting house officers: the silent majority. PMID- 6493292 TI - More on Transderm Scop patches. PMID- 6493293 TI - Transdermal scopolamine and basal acid secretion. PMID- 6493294 TI - Oral candidiasis and AIDS. PMID- 6493295 TI - Role of the parasympathetic system in airway obstruction due to emphysema. PMID- 6493296 TI - Zollinger-Ellison syndrome associated with pancreatic cystadenocarcinoma. PMID- 6493298 TI - Analyzing data from ordered categories. PMID- 6493297 TI - Meningococcemia in a patient with acquired complement deficiency and myeloma. PMID- 6493299 TI - The new paradox of psychiatric malpractice. PMID- 6493300 TI - Breast cancer in mothers given diethylstilbestrol in pregnancy. AB - We compared the incidence of breast cancer in 3033 women who had taken diethylstilbestrol (DES) in pregnancy during the period from 1940 to 1960 with the incidence in a comparable group of unexposed parous women. We ascertained vital status in 95 per cent of the exposed women and in 93 per cent of the unexposed women and received completed questionnaires for 88 and 85 per cent, respectively. With over 85,000 woman-years of follow-up in each group, the incidence of breast cancer per 100,000 woman-years was 134 in the exposed group and 93 in the unexposed group, yielding a crude relative risk of 1.4 (95 per cent confidence interval, 1.1 to 1.9). The elevated incidence did not appear to be due to bias or to confounding by other risk factors measured in the study. Breast cancer mortality was slightly higher in the exposed women (relative risk, 1.1) but not significantly so (95 per cent confidence interval, 0.7 to 2.0). We conclude that the incidence of breast cancer is moderately increased in women given DES, but we cannot exclude the possibility that some unrecognized concomitant of DES exposure accounts for this increase. PMID- 6493301 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 48-1984. A 43-year-old Haitian man with headaches and visual abnormalities. PMID- 6493302 TI - Diethylstilbestrol exposure--1984. PMID- 6493303 TI - Serum sickness and immune complexes. PMID- 6493304 TI - Respiratory effects of timolol. PMID- 6493306 TI - Does phenelzine relieve aphthous ulcers of the mouth? PMID- 6493305 TI - Antithrombotic potential of low-dose aspirin. PMID- 6493307 TI - Idoxuridine for herpes labialis--a case report. PMID- 6493308 TI - Esophageal spasm in a case of drug overdose. PMID- 6493309 TI - Fiberoptic bronchoscopy. PMID- 6493310 TI - Exportation of hazardous substances. PMID- 6493311 TI - The President vetoes stricter congressional oversight of NIH. PMID- 6493312 TI - Isolation of Exophiala jeanselmei associated with esophageal pathology--three cases, laboratory and clinical features. AB - Exophiala jeanselmei was isolated from three esophageal cultures over an 11-month period at Lutheran General Hospital. We believe this provides evidence for a new site of isolation, since previous reports of the organism's incidence were confined to skin and lung. Case 1 is an eight-year-old female with a three-year history of gagging and vomiting. Esophagoscopy revealed a mass biopsied as vegetable material. Case 2 is a 66-year-old retired male with a history of obesity, diabetes and spinal stenosis. Following back surgery, the patient developed odynophagia. Esophageal biopsies showed ulceration and bacterial colonies with no evidence of fungus. Case 3 is a 62-year-old male gardener who is also a nail biter. Esophagoscopy revealed a gastro-esophageal stricture with reflux and evidence of a hiatus hernia. Material biopsied was consistent with Barrett's esophagus and evidence of fungi was seen. The esophageal mass of case 1 and the esophageal brushings of case 2 and 3 grew E. jeanselmei. Aspiration, reflux, and mechanical disruption of the esophageal mucosa are possible predisposing factors in colonization of esophageal lesions by this ubiquitous, normally low virulence organism. PMID- 6493313 TI - Isolation of Sporothrix schenckii from potting soil. PMID- 6493314 TI - Evaluation of an indirect hemagglutination inhibition technique for identifying antibody in animals experimentally and naturally exposed to fungi. AB - Rabbits were exposed to aerosols containing spores of Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, or of a Penicillium sp. Sera from these rabbits were tested by indirect hemagglutination (IHA) and by IHA inhibition. The serologic reactions with the rabbit sera were compared to reactions with sera from cattle naturally exposed to airborne microorganisms. By three months of age, most cattle had positive IHA reactions to A. fumigatus and Penicillium antigens. The IHA inhibition tests indicated that antibody production in 12 of the 20 cattle probably resulted from exposure to A. flavus. One calf reacted as if sensitized by A. niger. Two were totally nonreactive. Five of the cattle had reactions that were not identifiable relative to the reactions in rabbits. PMID- 6493315 TI - The interaction between additives, yeast and patulin production in grass silage. AB - Both laboratory-prepared and sterile farm silage was found to support growth of Paecilomyces sp. and patulin production. The formation of patulin was affected by the levels of yeast present in the silage, and it was found that there was an inverse relationship between yeast population levels and patulin concentration. The commercial silage additive, "Sylade' had a greater lethal effect on yeast and fungi than "Add F', the latter allowing the formation of patulin by Paecilomyces sp. in the silage. PMID- 6493316 TI - [Tinea nigra. 1st clinical case in Uruguay]. AB - The first case in Uruguay of 'tinea nigra' is described in a 44-year-old male patient with a maculous pigmented lesion on the right foot. It represents the most meridional case of the disease yet recorded in South America. Exophiala werneckii was isolated in cultures (strain 1905 IHM). PMID- 6493317 TI - Studies on sporotrichosis. Pathogenicity and morphogenesis in the Transvaal strains of Sporothrix schenckii. AB - In the Transvaal, two epidemiologic patterns of Sporothrix infection occur in man. Evidence gathered from nature, the clinic and the laboratory suggests that these patterns are not the result of either a fixed strain specificity or a random mutation. The differences represent a developmental trend, determined by environmental factors, which gradually transform the wild strains of Sporothrix schenckii into variants resembling the earlier descriptions of Sporothrix beurmannii. This change, moreover, is regular and predictable. PMID- 6493318 TI - [The quantitative composition of the intestinal lactoflora before and after space flights of different lengths]. AB - Due to the emotional stress before the take off the lactoflora of 24 cosmonouts shows distinct changes regarding the spectrum of different species of Lactobacilli. Compared to long-time flights after short-time flights even stronger alterations are observed. The reason is that the disturbances which take place before the take-off as to the short space of time cannot be balanced by the macroorganism. Additionally, after a certain adaptive period the factors of the space travel begin to act. There are characteristic individual particularities regarding the number of Lactobacilli in the saliva and the feces of the cosmonouts. PMID- 6493319 TI - [The effect of nutrition on intestinal flora]. AB - In several groups of probands the influence of nutrition on the gut flora has been examined. In old people there is a striking decrease in the numbers of Bifidobacteria whereas those of Clostridium perfringens strongly increase and those of Enterobacteriaceae and Lactobacilli can be found somewhat higher than in the compared group. In a group of longevitial old aged men nourished with a fibre rich diet these alterations are found less striking. Changing from a mixed Japanese diet to a "western diet" a tendentious decrease in the total number of bacteria and in the numbers of Bifidobacteria, Eubacteria, and in moderate, in the numbers of Streptococci, too, could be determined. Simultaneously, a considerable development of nitrosamines occurred. In C3H/Hemice a glucomannan containing (fibre-rich) diet caused a substantial increase in the evidence frequency of Bifidobacterium and in the numbers of Enterobacteriaceae. Parallel with these results incidence and average number of noduli of manifested hepatic carcinoma decreased remarkably. PMID- 6493320 TI - Some studies of the bacterial flora associated with the mucosa of the human gastrointestinal tract. AB - Specimens of mucosal tissue of the small and large bowel obtained either by a colonoscope or during surgical operations were investigated quantitatively for their bacterial flora. A detailed prescription of the methodology using an anaerobic chamber is given. Most of the mucosal specimens of the small intestine as well as all the specimens of the large intestine contained bacteria (about 10(4) germs/g). Predominantly, Bacteroides, gram-positive rods, and cocci were isolated. In contrast to the gut lumen flora anaerobic bacteria of the mucosal flora did not outnumber the aerobes. In patients with inflammatory bowel disease or with carcinoma of the colon the mucosal flora showed no demonstrable alterations even after undergoing a sulphonamide therapy. PMID- 6493321 TI - [Adhesive properties of lactobacilli isolated from the human gastrointestinal tract]. AB - The adhesive and hemagglutinating properties of 34 tribes of Lactobacillus have been examined. 21 tribes came from human saliva and feces. 23.5% of the tribes showed strongly, 50% weakly adhesive properties. The remaining tribes showed average effects. Most of the strongly adhering tribes were isolates from human specimens. In the group of weakly adhering tribes those from collections dominated. 4 of 9 examined species differed in their adhering capacity. These were L. acidophilus, L. salivarius, L. casei, and L. fermentum. Only weakly adhering tribes showed hemagglutination of human erythrocytes. Therefore, there exists obviously, a reversed relation between the adhering and the hemagglutinating properties of Lactobacilli. PMID- 6493322 TI - [Adherence to the gastrointestinal wall and potential pathogenicity of gastrointestinal germs]. AB - Under certain circumstances--invasion of adhesive germs, abundant reproduction of the germs at the mucosa, a lowered resistance of the body--the adhesive flora can become a pathogenic factor itself. All hitherto known researchers point out that, in this connection, adhesions at the small intestinal wall is of main importance, as could be shown by our experiment with gnotobiotic rats, too. From the results of our experiments regarding the adhesion mechanisms, we conclude that the possibilities of prophylaxis and therapy of gastrointestinal disturbances induced by microbial effects could be extended by means of aimed inhibition of such adhesion forces. PMID- 6493323 TI - [The metabolic processes of intestinal flora]. AB - Man is habitat of 10(14)-10(15) bacteria, most of them colonizing the digestive tract, mainly the large intestine. Here microbial metabolic processes are going on like in a black box. Their quality, quantity, dynamics and effects on the host are discernible only in fragments or from their net effect. Almost all organic compounds and nutrients, fiber, xenobiotics, digestive secretions and desquamated epithelial cells of the host enter into macroorganismic/microorganismic metabolic chains and processes, which are not known or measurable in detail. Examples are given for the metabolization of nutrients, esp. amino acids. Some information is concerned with morphological, physiological, biochemical immunological and pathological effects of the gastrointestinal flora, discernible from experiments with gnotobiotic animals. Microbial influences upon basic life processes of the host are described in a few examples. PMID- 6493324 TI - Mechanisms of malabsorption in the "Contaminated Small-Bowel syndrome". AB - The mucosa of the upper small intestine in humans is repeatedly exposed to potentially harmful environmental influences: infective, toxic and antigenic. One of the most significant manifestations of the control over environmental risks is how the upper intestinal milieu is kept relatively sterile and pathogen-free despite constant exposure to a potentially hostile and pathogen-ridden environment. This control is lost in the so-called "Contaminated Small-Bowel Syndrome" when profuse numbers of bacteria contaminate the contents of the upper bowel. This can occur in a vast array of clinical situations ranging from infancy to old age. The consequences of upper intestinal bacterial overgrowth are very diverse. The mechanisms causing diarrhoea and malabsorption in this syndrome illustrate facets of pathophysiology of many inter-relating processes of intestinal digestion and absorption. PMID- 6493325 TI - [Structural and functional findings in experimental blind loop syndrome]. AB - Proximal and distal the blindsack a villus and crypt prolongation connected with a decreasing absorption of octanoate could be pointed out. The structural changes are very likely a hyperplasia of the mucosa. Within the blindsack a hyperplasia in connection with an accelerated proliferation of cells and an almost three and a halffold enlargement of the surface of the villi could be found. Simultaneously, the mucosa was damaged. An artificial bile duct as well as a neomycin therapy caused a decrease of the structural and functional changes but did not prevent the mucosal hyperplasia. These results are explained with adaptive processes of the small intestinal mucosa in a sense of hyperregeneration alterations of sprue typus. PMID- 6493326 TI - [Metronidazole and neomycin in wound infection prophylaxis in colon and rectal surgery]. AB - Anaerobes (e.g. Bacteroides) are more important in postoperation wound infections due to surgical operations of the large intestine than expected in the past. Prophylaxis of wound infection is possible by means of metronidazol and neomycin. Metronidazol affects anaerobes, exclusively. PMID- 6493327 TI - Microecology of the gastrointestinal tract and the immunological status under food allergy. AB - In children suffering from food allergy the microecology of the gut and the immune status were examined. As a rule, sensitization due to the penetration of the epithelial barrier of the intestinum by macromolecules of the food is not accompanied by deficiency of secretory IgA. In all cases dysbacteriosis of different degree was observed with a characteristic picture of deficiency of Bifidobacteria and Lactobacilli combined with rising numbers of Enterobacteriaceae. Correlations to an altered immune response are obvious. PMID- 6493328 TI - [Formation of secretory immunoglobin by the hepatic clearance mechanism]. AB - In patients suffering predominantly from several types of dermatosis as well as from cholecystitis and cholelithiasis relationships to the formation of secretory immunoglobulin by the hepatic clearance mechanism have been investigated. In the duodenal content and in operatively yielded gall-bladder bile, immunoglobulins, complement C3, and albumin were detected. The amount of immunoglobulins and of albumin in the duodenal content was substantially increased if infectious germs could be detected in the stomach content. PMID- 6493329 TI - Immune responses to anaerobic gram-negative bacteria in health and disease. AB - In the serum of healthy and sick persons antibodies to Bacteroidaceae and Veillonella have been detected. The antibody titres to these anaerobic bacteria are commonly low, in adults, however, higher than in children. High antibody titres could be found in patients suffering from Crohn's disease and in cancer patients. Immune responses to anaerobic bacteria occur in periodontal processes, too. These antibodies belong mainly to the IgM class of immunoglobulins. On the contrary, antibodies observed in patients with sepsis belong to the IgG class. PMID- 6493330 TI - [The influence of nutrition of Gram-negative anaerobes in the intestinal tract]. AB - Concluding from the hitherto known results regarding nutritive influences on the intestinal microbial population, particularly the gramnegative flora, it was found that the human intestinal flora is maintained mainly by endogenous mechanisms. Furthermore, the postnatal intestinal flora shows a weaker stability than that of adults. Also in the period of infancy, influences on the gut flora are most efficient in case of changes within the milieu (ph EH etc.). Cause and importance of longitudinal alterations within the postnatal intestinal flora are obscure. PMID- 6493331 TI - [Gas chromatographic analysis in the detection of anaerobes]. AB - By means of gaschromatography a rapid (ca 30 min) diagnosis of anaerobic infections is possible. The principle of a simple technique regarding the equipment and the laboratory-chemical process is presented. PMID- 6493332 TI - Medical shoestring pared down. PMID- 6493333 TI - Animal welfare: Berkeley again in trouble. PMID- 6493334 TI - Bovine-like rhodopsin in algae. PMID- 6493335 TI - Creationism in confusion. PMID- 6493336 TI - A rhodopsin is the functional photoreceptor for phototaxis in the unicellular eukaryote Chlamydomonas. AB - Rhodopsin is a visual pigment ubiquitous in multicellular animals. If visual pigments have a common ancient origin, as is believed, then some unicellular organisms might also use a rhodopsin photoreceptor. We show here that the unicellular alga Chlamydomonas does indeed use a rhodopsin photoreceptor. We incorporated analogues of its retinal chromophore into a blind mutant; normal photobehaviour was restored and the colour of maximum sensitivity was shifted in a manner consistent with the nature of the retinal analogue added. The data suggest that 11-cis-retinal is the natural chromophore and that the protein environment of this retinal is similar to that found in bovine rhodopsin, suggesting homology with the rhodopsins of higher organisms. This is the first demonstration of a rhodopsin photoreceptor in an alga or eukaryotic protist and also the first report of behavioural spectral shifts caused by exogenous synthetic retinals in a eukaryote. A survey of the morphology and action spectra of other protists suggests that rhodopsins may be common photoreceptors of chlorophycean, prasinophycean and dinophycean algae. Thus, Chlamydomonas represents a useful new model for studying photoreceptor cells. PMID- 6493337 TI - Interactions between enkephalin and GABA in avian retina. AB - In addition to conventional neurotransmitters such as acetylcholine, dopamine, glycine and gamma-aminobutyric acid (GABA), a number of peptide-immunoreactive substances have recently been localized in the vertebrate retina. The functional roles of these retinal peptides and their interactions with conventional neurotransmitters are largely unknown. We have previously shown that exogenous opiates affect both the release of GABA and the firing patterns of ganglion cells in the goldfish retina, and we have now begun a systematic characterization of the opioid pathways in the chicken retina, because, among vertebrate retinas, avian retinas contain the highest concentration of enkephalins. Monoclonal antibodies specific for enkephalin have been used to demonstrate that a subpopulation of enkephalin-containing amacrine cells exists in the chicken retina. This retina also synthesizes Met-enkephalin and releases it on cell depolarization. The enkephalin-induced inhibition of GABA release in goldfish retina led us to examine whether similar interactions occur in chicken, and if so, whether enkephalins and GABA coexist in the same amacrine cells. Our results, presented here, indicate that exogenous enkephalins do indeed inhibit GABA release in the chicken retina. Surprisingly, we found that although some amacrine cells contain both enkephalin and GABA, others contain only one or the other. PMID- 6493338 TI - Prehistory of Amazonian Indians. PMID- 6493339 TI - Animal crackers. PMID- 6493340 TI - Cancer mortality: US half-rate goal in dispute. PMID- 6493341 TI - New evidence that growth in 3T3 cell cultures is a diffusion-limited process. AB - When a confluent culture of 3T3 cells is wounded, new growth occurs at the wound margins. This indicates that the suppression of growth in the intact confluent sheet is under local control, a phenomenon known as 'topoinhibition', and it has been suggested that intercellular contact is responsible. An alternative explanation for topoinhibition is possible, however, namely that a soluble factor necessary for growth is locally depleted from the medium by cells so that each cell in a confluent sheet normally receives an insufficient supply and its growth is inhibited. Here we show that the pattern of release from topoinhibition in a wounded culture can be distorted simply by inducing a gentle laminar flow of medium across the wound. Growth remains suppressed at the upstream margin of the wound despite the reduced level of intercellular contact at wound edges. We conclude that the signal for topoinhibition is carried by the flow as would be predicted if it were the local depletion of growth factor. PMID- 6493342 TI - [Urban ecology]. AB - Within the cities, natural environmental conditions become manifold modified. Thereby, together with the high density of population, enduring effects upon human feeling results. In order to ensure reasonable conditions of life, in spite of the many effective factors in the cities, enforced interdisciplinary research and teaching will be necessary. PMID- 6493343 TI - Local histopathological reactions to aluminum-adsorbed tetanus toxoid. PMID- 6493344 TI - Structure-activity relationship of a bitter compound: denatonium chloride. PMID- 6493345 TI - [Drug research in the university and in industry]. AB - Since the beginning of this century, innovations in drug research have increasingly emanated from industrial laboratories rather than from universities. Despite this fact, the significance of universities for the innovation capacity of society must not be underrated. In the Federal Republic of Germany, however, the present conditions for successful cooperation between industry and universities are revealing a diverging tendency in view of this--admittedly utopian--optimum. PMID- 6493346 TI - Is the architecture of astrocytic membrane crucial for axonal regeneration in the central nervous system? PMID- 6493347 TI - Role of muscarinic cholinergic mechanisms in the substantia nigra pars reticulata in mediating muscular rigidity in rats. AB - Bethanechol chloride (5-25 micrograms), when injected into the substantia nigra pars reticulata (SNR) of rats, produced muscular rigidity in a dose-dependent way, and in addition, catalepsy and ipsilateral posture. The effects of bethanechol in the dose of 25 micrograms were prevented by co-administration of 10 micrograms scopolamine hydrochloride. Injections of 25 micrograms bethanechol or 10 micrograms scopolamine into the reticulata only slightly affected the muscular rigidity produced by 15 mg/kg i.p. morphine hydrochloride. The results suggest that muscarinic cholinergic mechanisms in the substantia nigra pars reticulata, although effective by themselves, affect by expression of at least one striatal functional alteration, the muscular rigidity, in a less effective way than GABAergic or endogenous opioid mechanisms do. PMID- 6493348 TI - Effect of an extract of Ginkgo biloba on rat brain energy metabolism in hypoxia. AB - The purpose of the present investigation was to determine brain energy metabolism under hypoxic conditions as influenced by an extract of Ginkgo biloba (EGB). Male Sprague-Dawley rats treated with EGB were exposed to hypobaric or hypoxic hypoxia, and at various time points during or after hypoxia the levels of high energy phosphates and some substrates of glycolysis were measured in brain cortical tissue. Rats treated with EGB (100 mg/kg, intraperitoneally) survived hypobaric hypoxia for a much longer period than controls (e.g. controls: 3.9 +/- 1.8 min, EGB-treated: 23.6 +/- 10.5 min). The brain glucose level was elevated by EGB in most experimental series, and the lactate concentration was slightly lower than in control brains. The lowering of lactate/pyruvate ratio was due to the decreased level of lactate and to the enhanced concentration of pyruvate as well. When hypoxia was sufficiently severe the breakdown of high-energy phosphates was less pronounced in EGB-treated animals. After oral application of EGB for 14 days the rats survived hypobaric hypoxia for 25.7 +/- 2.5 min whereas controls survived for 11.5 +/- 5.1 min. However, brain energy metabolism was not significantly influenced by this oral treatment. It is suggested that changes in brain energy metabolism and blood flow may contribute to the protective effect of EGB against hypoxia. PMID- 6493349 TI - Antihypertensive effects of chronic 5-hydroxytryptamine (5-HT2) receptor blockade with ketanserin in the spontaneously hypertensive rat. AB - The effects of chronic oral treatment with the 5-hydroxytryptamine (serotonin) receptor blocking agent ketanserin (17 mg/100 g dry food) on blood pressure, heart weight, peripheral vascular reactivity, baroreceptor sensitivity, central cardiovascular reactivity and central catecholamine turnover were investigated in the spontaneously hypertensive rat. Blood pressure measurements were performed in conscious rats 24 h after insertion of catheters. After 6 weeks treatment basal blood pressure was reduced (16%) compared to control rats (given identical food, except for ketanserin). Both heart weight and body weight were reduced (both to 93% of control values) leaving heart weight/body weight ratio unchanged. Pressor responses to phenylephrine and depressor responses to isoprenaline (after pretreatment with reserpine and atropin) were not different while the blood pressure increase to 5-hydroxytryptamine was inhibited, indicating that after 6 weeks treatment the blood pressure reduction is not directly related to alpha adrenoceptor blockade. Cardiovascular response to stress (jet air), baroreceptor sensitivity (bradycardia to phenylephrine) and central catecholamine synthesis rates (accumulation of 5-hydroxytryptophan and dihydroxyphenylalanine after synthesis inhibition) were unchanged supporting earlier evidence that central mechanisms probably do not contribute to the hypotensive effects of ketanserin. PMID- 6493350 TI - The kinetic characteristics of the extraneuronal Q-methylating system of the dog saphenous vein and the supersensitivity to catecholamines caused by its inhibition. AB - The "half-saturating outside concentration" and the Vmax of the extraneuronal O methylating system of the dog saphenous vein were determined in vitro for 3 catecholamines: isoprenaline, adrenaline and noradrenaline. Strips pretreated with 1 mmol/l pargyline were exposed to 30 mumol/l cocaine for 30 min before and during the 30 min incubation with the amines. Two methods were used to reach our aims: a) the classical one in which the 3H-O-methylated metabolites formed from a mixture of unlabelled and labelled amine were determined by using final concentrations of the substrate ranging from 0.2 and 12.8 mumol/l and b) an indirect one in which 0.2 mumol/l 3H-(+/-)-isoprenaline was used to assess the extraneuronal O-methylation of the tracer amine, and then those concentrations of unlabelled amines were determined which reduce the O-methylation of 3H-(+/-) isoprenaline by 50% (IC50). The "half-saturating outside concentrations" and the Vmax obtained by the first method were: 1.3, 2.5 and 3.4 mumol/l and 241, 317 and 294 pmol/g/min for 3H-(+/-)-isoprenaline, 3H-(+/-)-adrenaline and 3H-(-) noradrenaline, respectively. The IC50s obtained by the second method used were: 1.1, 0.6, 0.7 and 1.4 mumol/l for (+/-)-isoprenaline, (-)-isoprenaline, (-) adrenaline and (-)-noradrenaline, respectively. It was observed that the contraction of the strips caused by adrenaline and noradrenaline distorted IC50 values. In the presence of 1 mumol/l phentolamine the IC50 for adrenaline and noradrenaline was about 2.5 times higher than in its absence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493351 TI - Selective inhibition by amiflamine of monoamine oxidase type A in rat brain, liver and duodenum. AB - Amiflamine (FLA 336(+)), N-desmethylamiflamine (FLA 788(+)) and N,N didesmethylamiflamine (FLA 668(+)) were examined for their monoamine oxidase (MAO) inhibitory effects in rat brain, liver and duodenum and were compared with the irreversible inhibitors clorgyline and (-)-deprenyl. The potency of each FLA compound was the same in each tissue both in vitro and after oral administration with either serotonin or tyramine as substrate. The in vitro effect of FLA 788(+) was 2-6 times stronger than that of amiflamine although the compounds were equipotent after oral administration. FLA 668(+) was 2-3 times less potent than amiflamine in vitro and had very poor activity after oral administration. The deamination of phenethylamine was weakly affected by the three FLA compounds. Clorgyline inhibited strongly the deamination of serotonin and tyramine in the duodenum after oral administration, being 1,000 times more potent than in the brain and the liver. Similar results were obtained for (-)-deprenyl which, however, was more potent in inhibiting the deamination of phenethylamine than that of serotonin and tyramine. Amiflamine was a reversible MAO inhibitor with no MAO inhibitory capacity 24 h after a single oral dose. On the other hand the irreversible inhibitor clorgyline had a maximal effect on brain MAO 48 h after a single dose while the inhibitory effect in the duodenum had almost disappeared. The influence of amiflamine on the excretion of acid and basic metabolites of orally administered 14C-tyramine (58 mumol/kg) in rat was examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493352 TI - Protection against diisopropylfluorophosphate intoxication by pyridostigmine and physostigmine in combination with atropine and mecamylamine. AB - Atropine (A), mecamylamine (M), pyridostigmine (Py) and physostigmine (Ph) are pretreatment components of Mix I (A = 0.79, M = 0.79, Py = 0.056 mg/kg) and Mix II (A = 0.79, M = 0.79, Ph = 0.026 mg/kg). They have been successfully used in antagonizing Soman intoxication in experimental animals. Rats were pretreated with either Mix I or Mix II and subsequently exposed to diisopropylfluorphosphate (DFP). Pretreatment with Mix I or Mix II (i.m.) 30 min before DFP (i.v.) protected rats from the lethal effects of DFP. The protective ratios were 2.8 (Mix I) and 6.9 (Mix II). Changes in brain levels of acetylcholine (ACh) were measured to help understand the basis for effectiveness of these pretreatments. In the absence of DFP, pretreatments had no significant (P greater than 0.05) effect on bound or free ACh. Pretreatment did not prevent the DFP-induced rise in bound and free ACh nor the agent-induced physical incapacitation at 30 min post exposure. At 2 h after DFP exposure, rats pretreated with Mix II, but not Mix I, showed significant recovery from signs of physical incapacitation. At 30 min after the administration of 3.3 mg/kg of DFP (i.v.), the levels of free and bound ACh in rats given Mix I or Mix II pretreatment increased above control levels by 705% and 116% and 120% and 43%, respectively. By 2 h after DFP, cerebral ACh levels had changed to 437% and 91% with Mix I pretreatment and 26% and 50% with Mix II pretreatment. These data suggest a correlation between DFP-induced increases in the levels of cerebral ACh, possibly free, and physical incapacitation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493353 TI - Changes in myocardial substrate utilisation and protection of ischemic stressed myocardium by oxfenicine [(S)-4-hydroxyphenylglycine]. AB - Potential protective effects of oxfenicine [(S)-4-hydoxyphenylglycine] in ischemic stressed canine myocardium have been studied. This compound is characterized as a drug leading to metabolic inhibition of free fatty acid (FFA) metabolism. The drug (0.06 mmol . kg-1 body weight) caused no changes in hemodynamics or energy demand (Et) but depressed myocardial oxygen consumption (MVO2) by 11% (P less than 0.02). Significant changes in FFA and lactate metabolism were observed: lactate extraction (EX) increased from 22.5-37.1 mumol/Min, extraction ratio (EXR) from 16.5-30% and oxygen extraction ratio (OER) from 24.8-38%; EX of FFA decreased from 6900-5000 nmol/min, EXR from 48.2-31.4% and OER from 59.7-46.6%. Arterial concentrations of FFA and lactate remained unchanged. EX, EXR and OER of glucose were not affected under basic conditions. In the same collective, repeated ischemia (3 min) was produced by proximal occlusion of the left anterior descending artery (LAD). The efficiency of the drug was examined by (a) the amounts of ischemia metabolites released in the early reperfusion and (b) quantification of O2-debt and O2-repayment in the occlusion- and reperfusion periods. Compared to control occlusions, premedication led to a reduced O2-debt (P less than 0.01) combined with a reduced amount of oxygen additionally taken up in the early reperfusion (P less than 0.05). Furthermore, release of potassium increased (+7.1%; P less than 0.05); release of lactate (-32%, P less than 0.001) and inorganic phosphate (-34%, P less than 0.01) decreased. These data give support to the concept that a pharmacologically induced shift of cardiac metabolism with reduction of FFA utilisation may be favourable in circumstances with limited oxygen supply. PMID- 6493354 TI - Plasma protein binding and interaction studies with piroxicam. AB - The binding of non-steroidal antirheumatic drug piroxicam to human serum albumin, human plasma and serum has been studied by equilibrium dialysis at 22 degrees C, pH 7.4. The binding data were analyzed according to Scatchard model. The values of binding parameters obtained for human serum albumin are quite similar to those obtained for human plasma and serum (N1 = 0.3, K1 = 3.0 x 10(5) l/mol; N2 = 7, K2 = 3.5 x 10(3) l/mol). We suggest that piroxicam interacts with the albumin fraction in human plasma proteins. The displacement of piroxicam (in the therapeutical concentration of 4.5 x 10(5) mol/l) from the binding to human serum albumin and human plasma has been studied. The concentration of albumin and albumin fraction in plasma was 2.9 x 10(-4) mol/l. The displacement substances were drugs--diazepam, warfarin and salicylic acid, and endogenous substances bilirubin and palmitic acid. Only in the presence of salicylic acid in high clinical concentration (14.5 x 10(-4) mol/l) and palmitic acid in the molar ratio to albumin 5:1, free piroxicam substantially increased, which may be of clinical significance. Other studied substances displaced piroxicam only in high concentrations exceeding the therapeutical and physiological range. The evidence was found for the similarity of piroxicam and warfarin high-affinity binding site. PMID- 6493355 TI - Noradrenaline uptake inhibitors do not reduce the presynaptic action of clonidine on 3H-noradrenaline release in superfused synaptosomes. AB - The interaction between clonidine, as an agonist at the alpha 2-autoreceptors regulating noradrenaline release, and inhibitors of noradrenaline neuronal uptake was investigated in superfused synaptosomes, i.e. in conditions preventing accumulation of the released transmitter in the vicinity of presynaptic autoreceptors. Desipramine or cocaine did not release the inhibitory action of clonidine on the release of 3H-noradrenaline evoked by 15 mM KCl from rat cortex synaptosomes, even when the concentration ratio between uptake inhibitor and clonidine was very high. The present results do not support the hypothesis of an interaction between imidazolines and noradrenaline uptake inhibitors at the level of alpha 2-autoreceptors, or that of a functional coupling between presynaptic alpha 2-autoreceptors and noradrenaline uptake mechanism. PMID- 6493356 TI - Ethanol induces an increase of harman in the brain and urine of rats. AB - Harman occurs in rat brain, with the highest concentration in the cerebellum and the lowest in the striatum. 2 g/kg ethanol were ineffective with respect to the concentration of harman in the brain whereas 5 g/kg ethanol caused a time dependent increase in the cerebral cortex as well as the cerebellum. A toxic dose (8 g/kg) of ethanol elicited no change of harman in the brain 3 h following the application. The rise in the harman concentration in the brain did not correlate with the increase of acetaldehyde in the blood after treatment with ethanol suggesting that several mechanisms are involved in the changes of the levels of harman. In subchronic experiments rats were treated with ethanol over a period of 5 or 6 days. Harman increased in the brain whereby the effect seemed to be more pronounced in the cerebellum than in the cerebral cortex. The concentration tended to increase over time and reached control levels again during withdrawal. The time course of the excretion of harman into the urine was similar to that of the brain in that it increased continuously during the period of ethanol treatment and reached control levels again during withdrawal. PMID- 6493357 TI - The contribution of diffusion to the entry of catecholamines into guinea-pig trachealis smooth muscle cells. AB - In smooth muscle or cartilage preparations of guinea-pig trachea incubated in 0.1 mumol/l 3H-isoprenaline, extraneuronal uptake inhibitors (corticosterone, normetanephrine, phenoxybenzamine) caused only partial inhibition (64-75%) of the formation of 3-O-methylisoprenaline. Thus, isoprenaline appeared to be exposed to catechol-O-methyltransferase by diffusional entry as well as by extraneuronal uptake in both the smooth muscle and cartilage regions of the trachea. Fluorescence microphotometric measurements of catecholamine uptake in trachealis smooth muscle cells, when tissues were incubated in 200 or 1,200 mumol/l isoprenaline, adrenaline or noradrenaline in the absence and presence of extraneuronal uptake inhibitors (corticosterone, normetanephrine, phenoxybenzamine), showed that the contribution of diffusional entry to the uptake of the amines into the cells fitted with the order of their lipophilicities, viz. isoprenaline much greater than adrenaline greater than noradrenaline. A kinetic analysis of the uptake of isoprenaline into the trachealis smooth muscle cells was carried out in the absence and presence of 100 mumol/l corticosterone. The kinetic analysis (a) showed that the corticosterone resistant component of total uptake was not saturable, supporting the view that it represented diffusional entry of isoprenaline into the cells, and (b) provided Km and Vmax values (112 mumol/l and 101 F/min, respectively) for the saturable extraneuronal uptake of isoprenaline into the cells. The study provided evidence for marked diffusional entry of the lipophilic amine isoprenaline into guinea-pig trachealis smooth muscle cells. The diffusional entry of adrenaline was much less and that of noradrenaline negligible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493358 TI - Evidence for two opposite effects of clonidine on gastric acid secretion in the dog. AB - The effects of clonidine on gastric acid secretion were studied in conscious dogs with both gastric fistulae and Heidenhain pouches. Clonidine infused systemically at graded doses under basal conditions produced a significant increase in acid secretion from both gastric fistulae and Heidenhain pouches. Acid secretion from gastric fistulae submaximally stimulated by pentagastrin was dose-dependently reduced by clonidine while 2-deoxy-D-glucose-induced secretion was completely suppressed. Under these conditions a significant enhancement of secretion from Heidenhain pouches was recorded. An increase in acid secretion from both main stomachs and Heidenhain pouches was observed for clonidine with submaximal doses of bethanechol and histamine as stimulants, though clonidine showed no effect on maximal stimulation by histamine. The stimulant effect of clonidine from gastric fistulae and Heidenhain pouches under basal conditions was fully prevented by cimetidine, while the inhibitory effect of clonidine on acid secretion stimulated by pentagastrin from gastric fistulae was reversed by yohimbine. The present results suggest that clonidine displays two simultaneous yet opposite effects on dog gastric secretion. The inhibitory effect might be mediated through a decrease of vagally released acetylcholine following the activation of alpha 2 adrenoceptors both at central and peripheral sites, while the stimulatory effect probably depends on the histamine-like properties of the drug. PMID- 6493359 TI - Different responses of the isolated canine coronary artery superfused with blood or Krebs-Henseleit solution. AB - Responses of ring segments of the isolated canine coronary artery superfused with arterial blood from a donor dog were compared with responses of segments superfused with Krebs-Henseleit (K-H) solution. KC1 (1 - 30 mg) caused contraction in a dose-dependent manner both in K-H solution- and in blood superfused preparation. However, CaCl2 (1 - 100 mg) and nifedipine (0.1 - 30 micrograms) contracted and relaxed, respectively, only blood-superfused preparation but not K-H solution-superfused one. These results show that even in the same region of the coronary artery, different superfusates result in different responses to contracting or relaxing agents. This difference may be explained by the idea that Ca2+-channels are activated and endow basal tension in blood-superfused preparations, but not in K-H solution-superfused ones. PMID- 6493360 TI - Treatment with clorgyline and pargyline differentially decreases clonidine induced hypotension and bradycardia. AB - A study was made of the effects of acute and chronic treatment with monoamine oxidase (MAO) inhibitors on the peripheral and central cardiovascular response induced by clonidine in anaesthetized normotensive rats. Clonidine (30 nmoles X kg-1 i.v.) produced a biphasic change in mean blood pressure; an initial transient increase was followed by a prolonged hypotensive effect, coinciding with the maximal bradycardia. Twenty-four hours after acute (single) or chronic (daily for 7 days) administration of MAO inhibitors (pargyline 10 mg X kg-1 SC or clorgyline 0.3 mg X kg-1 SC) there was no effect either on the basal cardiovascular parameters or on the initial pressor response induced by clonidine. Chronic but not acute treatment with clorgyline, an inhibitor of type A MAO, greatly decreased the hypotension and bradycardia induced by clonidine for as long as 5 days after its discontinuation. On the other hand, after chronic administration of pargyline (10 mg X kg-1), a preferential type B MAO inhibitor, the hypotension and bradycardia caused by clonidine were differently affected. There was a reduction in the bradycardia up to the third day following the discontinuation of pargyline, whereas the hypotensive response induced by clonidine was only attenuated for 24 h and unaffected with a lower dose of pargyline (0.3 mg X kg-1). It is concluded that chronic administration of the type A MAO inhibitor, clorgyline, attenuates the central responses to clonidine through the reduction in sensitivity of brain alpha-adrenoceptors. Pargyline, that preferentially inhibits type B MAO, reduces only the bradycardia induced by clonidine. This result may indicate a different modulation of the receptors involved in this response to clonidine. PMID- 6493361 TI - Effects of morphine on dopamine metabolism in rat striatum and limbic structures in relation to the activity of dopaminergic neurones. AB - Administration of morphine results in efflux of dopamine provided that the nerve impulse flow of the dopaminergic neurones is impaired. In the present study we investigated whether the morphine-induced increase in dopamine metabolite levels is related to impulse flow in a similar way. Pretreatment with gamma butyrolactone to impair nerve impulse flow, abolished the effect of morphine on the concentrations of dihydroxyphenylacetic acid and homovanillic acid. Pretreatment with apomorphine had a similar effect, as well as combined pretreatment with gamma-butyrolactone and apomorphine. Since gamma-butyrolactone and apomorphine both reduce nerve impulse flow, but gamma-butyrolactone increases while apomorphine decreases dopamine biosynthesis, it would appear that the antagonism of morphine-induced increases in dopamine metabolites is due to the common property of impulse flow reduction. It was also shown, however, that pretreatment with alpha-methyl-paratyrosine, which inhibits dopamine biosynthesis, resulted in antagonism of morphine's effect on dopamine metabolite levels. It is concluded, therefore, that morphine-induced dopamine efflux is observed under conditions when no effect on dopamine metabolism is observed, and vice versa. Three effects of morphine on dopaminergic neurones can be distinguished: an increase in impulse flow in nigrostriatal dopaminergic neurones, increased dopamine biosynthesis and catabolism, and efflux of dopamine. The first effect probably is effected in the cell body areas, while the latter two effects may be produced at the level of the nerve terminals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493362 TI - 3H-Dopamine binding sites differ in rat striatum and pituitary. AB - 3H-Domperidone (3H-DOMP) binding sites were compared in rat striatum and pituitary, regarding the effects of the non-hydrolysable GTP analog, Gpp(NH)p and inhibition by various dopamine (DA) antagonists. Gpp(NH)p (0.1 mM) elicited in both tissues a rightward shift in DA concentration-inhibition curves, but the changes in either IC50 values or pseudo-Hill coefficients were larger in pituitary than in striatum. Computer analysis of the data showed that, in the presence of Gpp(NH)p, the curve obtained in striatum is best explained by the presence of two classes of binding site, a high-affinity site (Ki = 95 nM, 27% of total binding) and a low-affinity site (Ki = 5, 100 nM, 73% of total binding), whereas in pituitary only a low-affinity site (Ki = 5,070 nM) could be detected. In striatum, several discriminant benzamide derivatives (DBD), (-)-sulpiride and recently developed compounds, allowed to distinguish two components among 3H-DOMP binding sites: a high-affinity site representing one-third of total binding and a low-affinity component displaying a 8-17 fold lower affinity. Classical neuroleptics like haloperidol, chlorpromazine and metoclopramide inhibited striatal 3H-DOMP binding in a monophasic manner. In pituitary a single component could be detected for all tested antagonists including the DBD and Ki values for the latters were identical to those found for the low-affinity component in striatum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493363 TI - The effects of neonatal capsaicin treatment on growth and subsequent reproductive function in the rat. AB - The results of the present study describe the following effects of neonatal capsaicin treatment on growth and reproductive function in the rat. Neonatal capsaicin treatment in the rat resulted in a retardation of body growth through adulthood most pronounced at 35 days of age. Capsaicin-treated rats had normal estrous cycles, but mated significantly less frequently than age-matched controls. Confirmed matings in capsaicin-treated female rats resulted in significantly fewer pregnancies compared to controls. Male rats treated with capsaicin as neonates produced significantly fewer pregnancies when mated with untreated females compared to controls. Ovulation, sperm transport, and fertilization occur normally in capsaicin-treated rats. The decidual response was markedly diminished in mated capsaicin-treated rats. These findings led to the conclusion that the neurohormonal reflex, which is normally initiated through the stimulation of the cervix by copulation, and which ultimately stimulates secretion of pituitary luteotropic hormones, did not occur in capsaicin-treated rats. Thus, ovarian progesterone secretion was not facilitated resulting in inadequate hormonal support for implantation, pregnancy or pseudo-pregnancy. These data further suggest that the sensory limb of this neurohormonal reflex may consist of capsaicin-sensitive, possibly substance P containing, primary afferent fibers. PMID- 6493364 TI - Determination of free fractions of tricyclic antidepressants. AB - The plasma protein binding of amitriptyline, imipramine, clomipramine, and their primary demethylated metabolites were studied by means of a method combining dialysis and gas chromatography. Equilibrium in dialysis of serum containing amitriptyline and its metabolite nortriptyline was attained in about 0.5 h with the drug dissolved in the serum compartment, and in about 2 h with the drug passing from the buffer to the serum compartment. The calculation of free fractions was influenced by variations with dialysis time in the volumes of serum and buffer. Increase of pH in serum increased the protein binding of the weakly basic drugs studied, and made the Donnan distribution effects more pronounced. At pH 7.4, the Donnan effect was negligible. Binding parameters for the 6 tricyclic antidepressant substances studied were estimated for the binding to alpha 1-acid glycoprotein and for total binding in serum. For alpha 1-acid glycoprotein, the k values ranged from 1 X 10(5) to 8 X 10(5) M-1, and for pooled serum from 0.4 X 10(5) to 8 X 10(5) M-1. The determined number of binding sites on the alpha 1 acid glycoprotein was, on average 0.87 for the 6 substances. In serum, the binding capacity was 2-14 times the concentration of alpha 1-acid glycoprotein. PMID- 6493365 TI - [Handlebars in the belly, dust in the eyes? Pancreatic pseudocyst in children caused by trauma]. PMID- 6493367 TI - [Abnormal transaminase values in children: consider the muscles]. PMID- 6493366 TI - [Lymphocytic meningoradiculitis following insect bites (Bannwarth' syndrome)]. PMID- 6493368 TI - [Molluscum contagiosum]. PMID- 6493369 TI - [Treatment for rabies in the Netherlands before and after exposure]. PMID- 6493370 TI - [Prophylactic administration of antibiotics in patients with a blood vessel prosthesis]. PMID- 6493371 TI - [Dutch cell-culture rabies vaccine for use in humans]. PMID- 6493372 TI - [Rabies: how to manage it in the Netherlands]. PMID- 6493373 TI - [When is desensitization with bee and wasp venoms indicated in children?]. PMID- 6493374 TI - [Between ointments and creams]. PMID- 6493375 TI - [Tendon sheath panaritium]. PMID- 6493376 TI - [The elimination of bacteria from the bladder in geriatric patients]. PMID- 6493378 TI - [Vitiligo]. PMID- 6493377 TI - [The treatment of urinary tract infections with sulfafurazole; a single dose or a 7-day course?]. PMID- 6493379 TI - [An allergic reaction from contact with Pediculus humanus capitis (head lice)]. PMID- 6493380 TI - [Life-threatening obstruction caused by inflammation of the upper respiratory tract in children]. PMID- 6493381 TI - [Periodic survey of organ donations and transplantations in the Netherlands]. PMID- 6493382 TI - [Seeing is the look which searches; visual agnosia as a special form of vision impairment]. PMID- 6493383 TI - [Immune status for poliomyelitis, rubella and measles of the Dutch population 10 years or older in 1980; a serological study]. PMID- 6493384 TI - [Is coronary arteriography indicated in all patients younger than 60 who, after an initial infarct, exhibit little or no angina pectoris?]. PMID- 6493385 TI - [Diagnosis of disorders of spatial orientation in children]. PMID- 6493386 TI - [The treatment of a patient with ergotism]. PMID- 6493387 TI - [Indications for coronary arteriography]. PMID- 6493388 TI - Progress in prevention, detection and treatment of cancer. PMID- 6493389 TI - Is the usual normal? The quest for the ideal cholesterol range. PMID- 6493390 TI - Cancer cytogenetics. PMID- 6493391 TI - Acute renal failure associated with amoxapine overdose. PMID- 6493392 TI - "Medicine in transition". The moral and ethical dilemmas. PMID- 6493393 TI - [Model studies of mechanisms of the rhythmic activity of mammalian neurons]. AB - A model of electric excitability of mammalian neurons is developed based on described properties of the corresponding ionic currents. It is shown that these neurons may possess two types of rhythmic activity. The first type corresponds to the combination of the fast sodium and delayed potassium currents, the average period of membrane potential oscillations being 74 +/- 27 ms. The second type is determined by calcium and Ca-dependent potassium currents, and its interspike interval is equal to 850 +/- 40 ms. Two mechanisms of adaptation (elongation of the interspike interval) of rhythmic activity are predicted for these neurons. The former is determined by the fast potassium current and the latter is due to accumulation of calcium ions inside the cell and the development of Ca-dependent potassium conductance. PMID- 6493394 TI - [Modular organization of callosal neurons in the sensomotor area of the cerebral cortex in the rabbit]. AB - The density of distribution of callosal neurons in rabbit sensorimotor cortex was studied by means of horseradish peroxidase injection into the homotopic cortical area. The irregularity of density was evaluated visually and/or computed. Labelled callosal units were mostly small and medium-size pyramidal cells located primarily in layer III-IV and more rarely in layers V and VI. Layer III-IV revealed different patterns of labelled units grouping: in pairs, in 5-8 vertically situated cells, in clusters 120-200 micron wide, separated by areas with decreased density. The obtained results confirm previously made conclusion based on electrophysiological studies about the modular organization of callosal connections in sensorimotor cortex of rabbits. PMID- 6493395 TI - [Determination of the topical organization of the discharges of identified mollusk neurons]. AB - Identified RPa1, RPa2 neurons of the right parietal ganglion of Planorbis corneus were investigated. Coherent analysis of accumulated electrical activity in periferal nerves and spike discharges in identified neurons was done. Using this analysis, the presence of axon processes of RPa1 and RPa2 cells in the left and right pallial nerves was determined. Some polysynaptic pathways activated by discharges of these neurons were demonstrated. It is shown that the topical organization of the outputs of the investigated neurons remains invariant for different preparations. PMID- 6493396 TI - [Frequency characteristics of central neurons of the electroreceptor system of the skate in response to exposure to electric and magnetic fields]. AB - Responses of single units to sinusoidal homogenous electrical and magnetic field stimulation were studied in the lateral-line lobes of the skate Raja radiata. The voltage gradient thresholds were in the range of 0.03-10 microV/cm. Optimal frequency ranges for electrical and magnetic stimuli were 0.05-0.5 and 2-3 Hz, respectively. Possible mechanisms and functional significance of frequency characteristics of the neurons are discussed. PMID- 6493397 TI - [Evoked potentials in the visual and association cortex of alert cats in response to paired homogeneous stimulation of the lateral geniculate body and pulvinar]. AB - Similar shape of evoked potentials' recovery curves in the association and visual cortex to paired stimulation of the pulvinar was shown in unrestrained cats. Depression of the test response was observed only at the 10 ms interstimulus interval and powerful (2-4 times) facilitation of the second response occurred at the 40 ms interval as a result of increasing of the negative component N1. The facilitation was less expressed at 60-100 ms intervals gradually decreasing to the interval of 200 ms. Cortical evoked potentials' recovery curve to paired stimulation of the lateral geniculate body differed significantly from that of the pulvinar stimulation and was characterized by a gradual increase of the second response (from its strong depression at 10 ms interval to slight facilitation at 200 ms interval). Slower recovery of the test response in the association cortex was found at 10-80 ms intervals. The data are discussed from the standpoint of intracortical excitation spread as a result of activation of geniculo- and pulvinar-cortical information channels. PMID- 6493398 TI - [Mechanism of directional selectivity of neurons with complex receptive fields in the visual cortex of the cat]. AB - Spatio-temporal interactions within complex receptive fields were investigated in the visual cortex of a cat by means of sequential presentation of two stationary stimuli. When two stimuli were presented in the phase (on-on or off-off) and sequential presentation corresponded to preferred movement direction, the response to second stimulus was enhanced (or less inhibited). When sequential presentation corresponded to opposite movement direction, the response was inhibited. Sequential presentation of two stimuli with opposite phase (on-off or off-on) in preferred direction inhibited the response to the second stimulus, but in nonpreferred direction the response was enhanced (or less inhibited). The strength of interactions depended on distance between stimuli presented in the receptive field and interstimulus time interval. It is concluded that direction selectivity is provided by asymmetry of spatio-temporal interactions between on inputs and between off-inputs. Interactions between on- and off-inputs, which occur in case of multiedge stimulus movement may be used by the visual system for detecting an object from visual environment, for estimating object size and relative movement velocity. PMID- 6493399 TI - [Spatial-phase relations of dominant fluctuations of brain potentials in the rabbit]. AB - Phase shifts of cortical electrical activity and their role in excitation irradiation from the visual zone to the motor one were studied in rabbits before and during light stimulation. Different variations of the phase relations were observed both in the background activity and during stimulation. In most cases, however, a gradual increase in the theta-waves phase shift was observed parallel with an increase in the distance between the recording electrodes. The most motor reactions were carried out by the animal, if a phase shift gradient was expressed. Therefore the brain status characterized by spatial phase gradient of the theta-waves was supposed to be optimal for realization of the motor reaction. Light stimulation increased the quantity of synphasic oscillations between EEG processes in the points situated not far from each other and decreased the variability of the phase shift value between the sensorimotor and visual cortex, i.e. stabilized the phase gradient. This stabilization was expressed in the increase of wave coherence. Motor reactions of the rabbit in response to stimulation were realized when the most stable phase shift between the theta waves in the sensorimotor and visual cortex was recorded. PMID- 6493400 TI - [Morphologic differentiation of neuroblastoma cells induced by dimethyl sulfoxide]. AB - Morphological features of neuroblastoma cells cultured in the presence of 1.0% dimethyl sulfoxide (DMSO) were investigated. The induced differentiation was characterized by appearance of long axon-like processes (neurites), cell size enlargement and inhibition of cell growth. Quantitative criteria for cell differentiation depending on survival time in the modified medium were estimated. The increase of total length of neurites was linear with time, the rate of their extension being 20.0 +/- 3 micron/h. The area of differentiated cell soma is 6-7 times higher than that of control cells. Increase of the DMSO concentration to 2.0% did not intensify neurite growth and enlargement of cell size but suppressed mitosis. Morphological criteria of cell differentiation are compared with probable functional changes in these cells. PMID- 6493401 TI - [Synchronization of the work of pedal ganglia of pteropod mollusks during locomotion]. AB - Two wings of the marine mollusc Clione limacina oscillate synchronously during swimming. These movements are controlled by pedal ganglia. Synchronization of rhythmic activities in the ganglia is produced by interneurons of groups 7 and 8 whose axons pass to the contralateral ganglion through the pedal commissure. After destruction of commissural pathways, rhythmic activities in the two ganglia become independent. The synchronization restores with the regeneration of axons of interneurons from groups 7 and 8. PMID- 6493402 TI - [Neurons of the pedal ganglia of a pteropod mollusk regulating locomotor generator function]. AB - Neurons whose excitation affected the locomotory rhythm were recorded in the isolated pedal ganglia of the marine mollusc Clione limacina. Some of these neurons generated "plateau" potentials, i.e. they remained depolarized for a long period after termination of the initial depolarizing current. A role of the command neurons in the motor behaviour of Clione is discussed. PMID- 6493403 TI - [Ultrastructural characteristics of nodes of Ranvier]. AB - Three types of the Ranvier nodes (conductive, presynaptic and receptor-like) were distinguished on the basis of investigations of the ultrastructure of peripheral and central nerve fibres of the frog and cat. Presynaptic nodes are characterized by the presence of large asymmetrical prominences, synaptic vesicles and membrane specialization. Receptor-like nodes have symmetrical prominences filled with mitochondria, nude neurolemma similar to that of receptor plates. In all types of nodes microtubules usually do not enter the protrusions of the neuroplasm. PMID- 6493404 TI - [Effect of bulbar microinjections of noradrenaline, isoproterenol and phentolamine on the spino-bulbo-spinal reflex in the cat]. AB - In chloralose-anesthetized cats a long lasting depression of spino-bulbo-spinal (SBS) reflex discharges following microinjections of noradrenaline and its agonist (isoproterenol) in the medial bulbar reticular formation was revealed. Microinjections of phentolamine (alpha-adrenoceptor antagonist) were followed by prominent enhancement of SBS-reflexes. Depressive action of the locus coeruleus stimulation on SBS-responses essentially decreased after these microinjections. The data evidence for a specific noradrenergic nature of inhibitory locus coeruleus influences on reticular centre of SBS-reflexes. PMID- 6493406 TI - The normal flora of the gastrointestinal tract. PMID- 6493405 TI - [Modulation of reflex discharges in the respiratory nerves of the cat upon stimulation of superior laryngeal afferents]. AB - Cyclic changes of reflex discharges in phrenic, external and internal intercostal and lumbar nerves evoked by electrical stimulation of the superior laryngeal nerve were investigated in cats under light nembutal anaesthesia. Intensity of discharges and their latency varied in different nerves during the respiratory cycle. Reflex discharges of the greatest intensity with the shortest latency appeared at the end of the inspiratory or at the beginning of the expiratory phase in lumbar and internal intercostal nerves. Significant or complete depression of reflex discharges was observed before the inspiratory phase in these nerves. In contrast, reflex discharges in the phrenic and external intercostal nerves appeared only during the inspiratory phase and their intensity increased towards the end of this phase. Pronounced modulation of reflex discharges depended directly on changes in the respiratory centre excitability. PMID- 6493407 TI - The relationships of leucocytes in peripheral blood and in infected and uninfected ascitic fluid. PMID- 6493408 TI - Carbohydrate malabsorption and intestinal gas production. PMID- 6493409 TI - The role of calcitonin in calcium stone formation. PMID- 6493410 TI - Plasma and blood volumes in patients with the nephrotic syndrome. AB - In 88 patients with the nephrotic syndrome (NS) we estimated plasma volume (PV) with 131I-albumin (RISA) and calculated blood volume (BV) from PV and whole body hematocrit (Ht). To assess whether this method gives erroneously high values in the NS, the transcapillary escape rate of albumin (TER) and large vessel Ht/whole body Ht ratio (F-cell ratio) were measured in two subsets of these patients (n = 19 and 24, respectively). Although TER appeared to be increased and F-cell ratio slightly decreased in the NS as compared to normals, it could be calculated that overestimation of PV and BV from these sources will not exceed +/- 1%. Taking these errors into account PV and BV appeared normal or increased in the NS (62.8 +/- 9.6 and 94.9 +/- 15.1 ml/kg vs. 56.0 +/- 7.1 and 88.5 +/- 10.1 ml/kg lean body mass in 51 normal controls). We conclude that PV can be measured reliably in the NS with 131I-albumin, and that even after appropriate corrections are made, PV and BV are normal or increased in most patients with the NS. PMID- 6493411 TI - Sodium kinetics across dialysis membranes. AB - The kinetics of sodium across dialysis membranes were studied during diffusion and during convection utilizing cuprophan and cellulose hydrate membranes. During diffusion the changes in plasma water sodium concentration are correlated to the sodium concentration gradient between plasma water and dialysate but an increase also occurs when the gradient is annulled, due to the Donnan effect. During convection the plasma water sodium concentration increases during the passage through the dialyzer and the ultrafiltrate sodium concentration is significantly lower than the plasma water sodium concentration; this is due to the fact that the plasma proteins, as anions unable to cross the membrane, affect the kinetics of the sodium cations. Therefore, during diffusion the kinetics of sodium are mainly affected by the sodium concentration gradient and by the plasma protein concentration, while during convection the plasma protein concentration is the main factor affecting the kinetics of sodium. PMID- 6493412 TI - Microsurgery for Brescia-Cimino fistula construction in pediatric patients. AB - Many previous series reporting the construction of Brescia-Cimino fistulae in children describe a high rate of immediate and late patency failure. Using microsurgery, we have constructed 23 Brescia-Cimino fistulae in 23 children, 10 weighing less than 20 kg and 13 weighing more than 20 kg. An immediate patency rate of 100% was achieved in both weight groups with a late patency rate of 90% 100%, in those under and over 20 kg, respectively. We recommend using microsurgery for all such angioaccess procedures. PMID- 6493413 TI - [Intracisternal length of the brain path and nerve tracts of the I to IV cranial nerves]. AB - The olfactory bulb has a length of 12.27 mm whereas the length of the olfactory tract from the beginning to where it crosses the optic nerve is 21.2 mm (mean). The intracranial portion of the optic nerve is 10.3 mm long. From the brain stem to its dural exit the III nerve measures 18.82 mm, and the IV nerve 32.65 mm. The range of variation in the lengths of the nerves, as well as their immediate relations are included in the investigation. PMID- 6493414 TI - [Experimental microsurgical exposure of cranial nerves III, IV and VI in the cat]. AB - The operative techniques for experimental microsurgical studies on the third, fourth and sixth cranial nerves in the cat are described. We have found that the oculomotor nerve is best reached by a subtemporal approach. The trochlear nerve is easily exposed by a posterior temporal craniotomy while the abducens nerve should be approached through the clivus. PMID- 6493415 TI - Ophthalmological signs and prognosis in patients with a subarachnoid haemorrhage. AB - In cases of subarachnoid haemorrhage from various causes, ophthalmological signs can be a feature. In the clinical examination they can be of assistance in determining the site of the aneurysm or other responsible lesion, and they can also be of prognostic value. In a series of 48 cases the significance of these ocular signs is evaluated and discussed. PMID- 6493416 TI - [Extradural angiomas with venous perimedullary drainage]. AB - This report is dealing with a relatively rare type of vascular malformation of the spinal cord. The clinical, anatomo-angiographic aspects as well as the favourable possibilities of treatment are described. PMID- 6493417 TI - [Recurrence following burr hole trephination of chronic subdural hematomas]. AB - In a consecutive series of 100 patients suffering from Chronic subdural haematomas, which were treated by burr-hole evacuation and closed external drainage, in 23 patients repeated operations became necessary. The reasons for further operations were: true recurrences in 11 cases, superimposed haematomas in five cases and haematomas on the opposite side in seven cases. All these patients were treated again by burr-hole evacuation and closed external drainage. In contrast to the common opinion craniotomy and removal of the membranes was not necessary in any case. PMID- 6493418 TI - [Electromyography and electroneurography in the follow-up study of carpal tunnel syndrome patients]. AB - Electromyography is an useful method for the postoperative follow-up of carpal tunnel syndrome. In patients without sensory and motor signs EMG is able to differentiate those still suffering from subjective symptoms such as pain and paraesthesias. PMID- 6493419 TI - Rupture of intracranial aneurysms during angiography and CT: coincidental or causal event? A case report. AB - The rare event of rupture of a saccular aneurysm of the internal carotid artery during cerebral angiography and of a fusiform aneurysm of the basilar artery following contrast enhanced CT are reported. Whereas some angiographic findings point at a causal relationship between rupture of the aneurysm and the examination procedure itself, this relationship between possible contrast medium effects and rupture of the basilar artery aneurysm during CT remains uncertain. Possible mechanisms are discussed. PMID- 6493420 TI - Rupture of aneurysms during angiography. Report of two cases and review of the literature. AB - Two cases of rupture of intracranial aneurysms with contrast extravasation during angiography are reported. One was an aneurysm of the internal carotid bifurcation and the other a carotid posterior communicating aneurysm. The previously reported cases are analysed and the pathogenetic mechanisms thought to underlie the phenomenon discussed. The prognosis is anyway very poor. PMID- 6493421 TI - Neurinoma of the spinal accessory nerve. A case report. AB - A case of neurinoma of the spinal accessory nerve without evidence of von Recklinghausen's disease is described. The difference in the clinical symptoms and radiological findings between this tumour and a jugular foramen neurinoma is especially emphasized. Other cases in the world literature are also reviewed and the peculiarities of the tumour are discussed. PMID- 6493422 TI - Hyperresponsiveness to methylphenidate in rats following prenatal ethanol exposure. AB - Rats exposed in utero to ethanol are hyperresponsive to methylphenidate when tested as neonates or adults. Long-Evans rats were maintained on liquid diets containing either ethanol or maltose-dextrin (35% of total calories) or on lab chow and water throughout pregnancy. Male offspring, who were raised by foster mothers maintained on lab chow and water throughout pregnancy and lactation, were used in two experiments to examine the effects of methylphenidate on activity. In Experiment 1, a time-sampling procedure revealed that methylphenidate (0, 1, 2 & 4 mg/kg) increases the frequency of ambulation in young (26-38 day old) ethanol treated offspring more than in control offspring. In Experiment 2, an open-field procedure revealed that methylphenidate (0, 2, 4, 6 & 8 mg/kg) produces greater increases in number of squares covered and the total duration of ambulation during 5-min tests in adult (100-184 day old) offspring treated prenatally with ethanol than in control offspring. Both studies revealed that the hyperactivation effect increases with increased doses of methylphenidate. PMID- 6493423 TI - Effects of trimethyltin chloride on differential-reinforcement-of-low-rate responding. AB - The effects of a range of doses of trimethyltin chloride (1.8-7.0 mg/kg, TMT) on responding maintained under a differential-reinforcement-of-low-rate 15-sec schedule of water presentation were examined in rats. TMT produced a large decrease in the percent of reinforced responses and consequently a decrease in the rate of reinforcement. These effects were due primarily to prolonged bursts of nonreinforced responses. In contrast to the gradual dose-related decrease in body weight produced by TMT, responding was disrupted only at the highest dose tested, i.e., 7.0 mg/kg. The results were discussed in terms of the neurotoxic effects of TMT on the limbic system. PMID- 6493424 TI - Cellular lesions in the central nervous system of Periplaneta americana following insecticide treatment in vitro and in vivo. I. Nerve cell bodies and the neuropile. AB - Cellular lesions in the metathoracic ganglion of P. americana following insecticide treatment have been examined. Treatment of the isolated ganglia with dieldrin (10 microM) and bioresmethrin (5 microM) induced mitochondrial damage in the neuropile and nerve cell bodies. The mitochondria in treated nerve cells were swollen with broken cristae and devoid of normal morphological appearance. Following in vivo treatment of cockroaches with these insecticides, this type of mitochondrial damage was observed even at the onset of poisoning. In the prostrate cockroaches, however, the mitochondrial swelling was accompanied by the accumulation of electron dense granules. In addition, the neuropiles of insecticide-treated ganglia contained secondary lysosomes which increased in size and number with the progress of poisoning and showed signs of depletion of synaptic vesicles. The action of dieldrin upon the ultrastructure was completely abolished by pretreatment of ganglia with 10 mM Mg2+. On the other hand, pretreatment of ganglia with tetrodotoxin and pentobarbital-sodium had very little effect on the action of dieldrin though these compounds blocked the action of bioresmethrin. The results of this study suggest that cellular lesions in the insect CNS, caused by dieldrin, are due to an enhanced uptake of calcium into nerve terminals which may occur independent of membrane depolarization. The effects of bioresmethrin upon the ultrastructure of the CNS are apparently mediated by nerve excitation and membrane depolarization. It is concluded that treatment of intact cockroaches with dieldrin and bioresmethrin initiates catabolic processes in the nerve cells leading to cellular lesions which are indicative of neuronal degeneration. PMID- 6493425 TI - Cellular lesions in the central nervous system of Periplaneta americana following insecticide treatment in vitro and in vivo. II. Glial cells. AB - Glial cell damage in the central nervous system of P. americana following insecticide treatment has been studied. Treatment of isolated metathoracic ganglia with 10 microM dieldrin caused an increase in the electron opacity of the inner and outer glial cells without effecting such a change in the structure of glial cells in the ventral connectives. Glial cells in the ganglia and ventral connectives treated with 5 microM bioresmethrin were found to be swollen and even more electron lucent than the control cells. In the prostrate cockroaches (24 hr after the treatment) the action of bioresmethrin and dieldrin upon peripheral glial cells was identical. Both insecticides caused vacuolation and darkening of outer glial cells; their effects extended to include glial cells in the ventral connectives. At the onset of poisoning, 20-30 min following the application of dieldrin, outer glial cells exhibited slight increase in electron opacity while the inner glial cells showed increase in lysosomal activity. The observed action of dieldrin upon the ultrastructure of glial cells was prevented by pretreatment of the nervous tissue with 10 mM Mg2+. Though tetrodotoxin and sodium pentobarbital had very little effect upon the action of dieldrin, these drugs blocked bioresmethrin-induced alterations in the fine structure of glial cells. The results of this study suggest that alterations in the ultrastructure of insect neuroglia following treatment with insecticides tested in this study are probably due to perturbations in the neural element of the nervous system. PMID- 6493426 TI - Factors affecting toluene-induced ototoxicity in rats. AB - Seven experiments with young male Fischer rats were done to examine concentration and exposure parameters necessary and sufficient to cause toluene-induced ototoxicity. Hearing loss, measured by behavioral and electrophysiologic methods, was repeatedly observed after as few as 2 weeks of exposure to 1000 ppm toluene for 14 hours per day, but lower concentrations (400 and 700 ppm) were without effect even after 16 weeks of exposure. Three-day exposures to 1500 ppm for 14 hours per day or 2000 ppm for 8 hours per day were ototoxic, whereas single exposures to 4000 ppm for 4 hours or 2000 ppm for 8 hours were without effect. Intermittent exposure to 3000 ppm for 30 minutes every hour for 8 hours per day caused hearing loss within 2 weeks, but a similar exposure schedule for 4 hours per day was ineffective even after 9 weeks. The results of these experiments repeatedly confirmed our earlier finding that toluene causes hearing loss in rats and defined many of the exposure parameters important to this effect. The results are discussed in terms of their relevance to industrial exposure, industrial accidents, and, especially, voluntary, high-level exposure by solvent abusers. PMID- 6493427 TI - Acute behavioral toxicity of the organophosphate sarin in rats. AB - Three experiments were performed to determine the behavioral effects of acutely administered isopropyl methylphosphonofluoridate, sarin (61-115 micrograms/kg, SC) to male rats. Dosages of 71 micrograms/kg or greater produced conditioned flavor aversions while spontaneous locomotor activity was increased at 61 micrograms/kg and significantly decreased at dosages of 84 to 115 micrograms/kg, when compared to vehicle control levels. Significant decrements in rotorod performance were observed at 98 and 115 micrograms/kg sarin. The LD50 of sarin was determined to be 165 micrograms/kg. Behavioral alterations were thus obtained at dosages that were between 37 and 59 percent of the LD50. PMID- 6493428 TI - [Diagnosis of relative hypomagnesurea in calcium lithiasis: reference values for a new parameter]. AB - In calcium stone formers, the ratio of urinary magnesium concentration to urinary calcium concentration (Mg/Ca) is used to express the already reported low Mg excretion relatively to Ca excretion. However the Mg/Ca value depends on the Ca excretion rate, decreases after oral Ca load and is not directly related to Mg excretion. Therefore when studying patients with different Ca excretion rates, or when performing an oral Ca load, Mg/Ca is not directly useful to express a relative hypomagnesuria. We established a new parameter from the normal relationship between urinary Mg and Ca excretion rates. Its value is above - .065 in 97.5% of 99 control urinary samples. It is stable for any studied Ca excretion rate, including post Ca load excretion rates, and is highly correlated with Mg excretion rate. This parameter allows for the accurate diagnosis of relative hypomagnesuria in stone formers. PMID- 6493429 TI - [Self dialysis: a new method of treatment for end-stage renal disease]. AB - Self-hemodialysis in a limited-care facility could be a good alternative for patients who are reluctant to home dialysis for several reasons. Through reduction of nursing personnel and elimination of physician attention at each dialysis, self-hemodialysis in a limited-care facility, where the patient dialyses himself and cleans his own machine without assistance, has reduced the cost to about one-half of center cost. From March 1980 to December 1982, out of 65 dialysed patients from Beauce and Perche Area, 33 patients were treated in the Hemodialysis Unit-Chartres Hospital (50.8%), only 5 were on home dialysis (7.6%), 15 were on CAPD (23.1%) and 12 were on self-hemodialysis in a limited-care facility (18.5%). Self-hemodialysis is a practical addition to various modalities treating end-stage renal disease and, in our experience, full compliance to the dialysis regimen was achieved in all patients. PMID- 6493431 TI - [Acute renal failure caused by clometacin hypersensitivity]. AB - Renal involvement is not frequently observed during therapy with clometacine and its mechanism not fully understood. We report on a case of acute renal failure occurring four times in conjunction with acute hepatitis before the causative effect of clometacine was demonstrated. Drug hypersensitivity was documented by anatomical findings consisting in renal interstitial infiltration by mononuclear cells and eosinophils and by hypereosinophilia, increase in plasma IgE and a positive basophil degranulation test. PMID- 6493430 TI - [Anaphylactic reactions during hemodialysis: responsibility of the dialysis membrane (cuprophane)]. AB - Iterative hemodialysis causes only exceptionally anaphylactic reactions. In those cases it has been possible to incriminate sterilizing agents (ethylene oxide, formaldehyde) and in a few cases the membrane. We report the case of one patient suffering from a chronic renal failure who had been undergoing hemodialysis treatment for more than six years in whom we noticed anaphylactic reactions at the beginning of each dialysis session carried on with cuprophan. We were able to use three different types of dialysis membranes: cuprophan, polyacrylonitrile and cellulose acetate, and two means of sterilization: ethylene oxide and gamma rays. The disorders we observed do not seem to be related to the phenomena usually observed during hemodialysis. The clinical signs linked with hypereosinophilia (13,000/mm3), hyperbasophilia (140/mm3) and an increase in total serum IgE disappeared when cuprophan membrane was replaced by cellulose acetate. One year later, hypereosinophilia had disappeared, hyperbasophilia had subsided, total IgE remained high. We conclude that IgE dependent anaphylaxis might be due to one component of the cuprophan membrane. PMID- 6493432 TI - [Extra-membranous glomerulonephritis during the treatment of rheumatoid polyarthritis with diclofenac]. PMID- 6493433 TI - Depletion and recovery of neuronal monoamine storage in rats of different ages treated with reserpine. AB - The effect of reserpine on dopamine, noradrenaline, adrenaline and serotonin concentrations in different brain regions, and the recovery of normal levels of these monoamines after such treatment were studied in rats aged 5, 15 and 27 months. In a preliminary experiment we found that distribution of the drug was not altered in the aged rats. Then we observed that a single dose of reserpine (5 mg/kg IP) had a similar depleting effect on all the brain monoamines, in all the brain regions considered in all three age groups. The curves expressing recovery of monoamine storage in all the nerve terminals, several days after treatment, were superimposable. These results suggest that in the rat, age does not influence the effect of reserpine on the storage mechanism of brain monoamines. Moreover, as restoration of this mechanism depends on the synthesis of new vesicles, the similarity in the rates of recovery in adult, old and very old rats indicated indirectly that synthesis of these neuronal organelles is not affected by aging. PMID- 6493434 TI - The effect of aging on extra-adrenal catecholamine storing cells of the rat. AB - Cell number and catecholamine histofluorescence were determined in three extra adrenal chromaffin tissues: the abdominal paraganglia, the carotid body and SIF (small intensely fluorescent)-cells, of male Fischer-344 rats at different ages. Catecholamines were demonstrated using the formaldehyde-induced fluorescence method. The number of paraganglia cells in the retroperitoneal area increased 13.6 fold between 3 and 33 months of age, and the volume of abdominal paraganglia approached 65% of the volume of one adrenal medulla. The emission color of some paraganglia cells shifted from greenish-yellow to yellowish-brown with aging, but differences were not observed in cell number of fluorophore color in the carotid body, a chemoreceptor type of paraganglion. The number of SIF cells (an intraganglionic variant of extra-adrenal chromaffin tissue) in the hypogastric ganglion increased significantly between 3 and 33 months. The pronounced increase of the volume of the paraganglia in aged rats may contribute to elevated concentrations of circulating catecholamines in these animals. PMID- 6493435 TI - Meeting Report: Alzheimer's disease: advances in basic research and therapies. PMID- 6493436 TI - Stability of neuronal number in the human nucleus basalis of Meynert with age. AB - Numbers of neurons in the nucleus basalis of Meynert were estimated in seventeen non-demented patients who died of chronic hepatic or cardiopulmonary disease. Neurons were counted at the site of maximal neuronal density (SMND). This site was chosen by reviewing serial sections around the decussation of the anterior commissure and appeared to be comparable in different individuals. No correlation between numbers of neurons and age could be found. It appears that no uniform neuronal loss occurs in the nucleus basalis with age. Taken together with biochemical studies of cerebral cortical choline acetyltransferase activity, these findings suggest that there is no overall change in cholinergic input to cerebral cortex with age. PMID- 6493437 TI - Neuromodulation of lymphocyte reactivity in aged rats. AB - Numerous reports indicate that both central nervous system (CNS) and immune system functions decline with age. We have previously shown that the CNS can modulate both mitogen-induced spleen cell proliferation and NK activity in young Fischer 344 rats. In the present study we have determined the effects of AHT lesions on the lymphocyte reactivity of aged Fischer 344 rats. These data show that lesions in the AHT of aged rats cannot modulate splenic mitogen responsiveness, however, NK activity is impaired. This differential effect may be due to multiple factors including enhanced splenic suppressor cell activity, the inability of the brain to send modulatory signals following lesioning, or the failure of the immune system to receive a neural signal and react to it. PMID- 6493438 TI - Aging-related morphological changes in the main olfactory bulb of the Fischer 344 rat. AB - Aging-related changes in several structural characteristics of the main olfactory bulb (MOB) were evaluated using Fischer 344 rats 3, 18, 30 or 36 months of age. Histological examination of the nasal mucosa revealed no evidence of concurrent rhinitis in any of the animals studied. The internal granular layer of the MOB exhibited continual growth, increasing in volume by a factor of 63% over the range of ages studied. The sizes of MOB mitral cell perikarya and nuclei, expressed either as observed cross-sectional areas or as estimated mean volumes, did not change significantly as a function of age. The numbers of mitral cells exhibiting 2 nucleoli in the plane of section decreased from about 22% in the youngest animals to about 4% in the 18- and 30-month old animals and to nil in the oldest animals. These results are discussed in relation to findings of other investigators using Sprague-Dawley or Wistar rats. It is concluded that major structural age changes in the rat MOB are strain dependent. PMID- 6493439 TI - P-31 nuclear magnetic resonance analysis of brain: normoxic and anoxic brain slices. AB - Perchloric acid extracts were prepared from liquid-N2-frozen gerbil and guinea pig brain slices studied under one of three conditions: O2-incubated, N2 incubated or O2-incubated recovery following N2 incubation. Mole percentages of the various phosphatic components contained in the extracts were determined by phosphorus-31 nuclear magnetic resonance spectroscopy. The brain slice extract spectrum revealed a previously unreported group of brain phosphodiesters at -0.73 delta relative to 85% orthophosphoric acid. Although the phosphatic profiles from O2-incubated slices from gerbils and guinea pigs revealed only minor species variations, which differed quantitatively rather than qualitatively, species specific differences were made readily apparent and amplified by incubating brain slices under oxygen-deficient conditions. Despite these differences which were most prevalent during the recovery phase, the overall metabolic changes described herein in response to N2-incubation were in accord with the results obtained by other analytical techniques. Inorganic orthophosphate (2.63 delta) was increased, while nucleoside (principally, adenosine) triphosphate (alpha-, -10.92 delta, beta-, -21.45 delta, and gamma-, -5.80 delta) and phosphocreatine (-3.12 delta) levels were decreased in response to N2 incubation. In addition, inosine monophosphate (3.78 delta) was increased and the levels of a partially characterized acid-labile phosphate (0.85 delta, guinea pig) were decreased upon N2 incubation. Phosphoglyceride metabolism also appeared to be altered by oxygen deprivation (gerbil). These latter findings provide additional information concerning the metabolic responses of cerebral tissue to oxygen deficient conditions. PMID- 6493440 TI - Synergistic effect of phosphatidylserine with gamma-aminobutyric acid in antagonizing the isoniazid-induced convulsions in mice. AB - The influence of phosphatidylserine (PS) on the isoniazid-induced convulsions has been studied in mice. Sonicated dispersions of this phospholipid given intravenously do not show anticonvulsant activity but they do so when gamma aminobutyric acid (GABA) is simultaneously injected. GABA alone is inactive. The synergism between PS and GABA is influenced by the structure of the phospholipid liposomes. In contrast to multilamellar vesicles, oligolamellar vesicles are active. Under these conditions the effect shows head group specificity, in that the neutral phosphatidylcholine (PC) or the acidic phosphatidylinositol (PI) are inactive, either in the presence or in the absence of GABA. Lysophosphatidylserine (lysoPS), the deacylated PS derivative, shows increased efficacy as an isoniazid antagonist in the presence of GABA, and has anticonvulsant activity also in the absence of GABA. Other lysophospholipids are inactive. It is suggested that PS, after its metabolic conversion to lysoPS, enhances the anticonvulsant effect of GABA. PMID- 6493441 TI - Influence of intermittent hypoxia and pyrimidinic nucleosides on cerebral enzymatic activities related to energy transduction. AB - The effect of intermittent normobaric hypoxia and of biological pyrimidines (uridine and cytidine) on the specific activities of some enzymes related to cerebral energy metabolism were studied. Measurement were carried out on the following: homogenate in toto; purified mitochondrial fraction; crude synaptosomal fraction, in different areas of rat brain: cerebral cortex, hippocampus, corpus striatum, hypothalamus, cerebellum, and medulla oblongata. Intermittent normobaric hypoxia (12 hours daily for 5 days) caused modifications of the enzyme activities in the homogenate in toto (decrease of hexokinase in cerebellum; increase of pyruvate kinase in medulla oblongata), in the purified mitochondrial fraction (increase of succinate dehydrogenase in the corpus striatum) and in the crude synaptosomal fraction (decrease of cytochrome oxidase activity in cerebral cortex, hippocampus, and cerebellum; decrease of malate dehydrogenase in hippocampus and cerebellum; decrease of lactate dehydrogenase in cerebellum). Daily treatment with cytidine or uridine altered some enzyme activities either affected or unaffected by intermittent hypoxia. PMID- 6493443 TI - Abstracts of communication of the Japanese Neurochemical Society. Osaka, November 14-16, 1983. PMID- 6493442 TI - Influence of aminooxyacetic acid on the potassium-evoked release of [3H]gamma aminobutyric acid from slices of rat cerebral cortex. AB - The release of [3H]GABA from superfused slices of rat cerebral cortex was investigated in the presence and absence of the GABA-transaminase inhibitor aminooxyacetic acid (AOAA). In the latter case, an ion-exchange column chromatographic technique was used to separate [3H]GABA from tritiated metabolites released with it into the superfusate. In the absence of AOAA, omission of Ca2+ from the superfusion medium reduced the release of [3H]GABA evoked by a 30 mM K+ pulse by 81.6%, whereas in comparable experiments carried out in the presence of AOAA omission of Ca2+ reduced the K+-evoked release by only 23.5%. Similar results were obtained when a 50 mM K+ pulse was used, whereupon omission of Ca2+ reduced [3H]GABA release by 78.7% in the absence of AOAA as compared with a reduction of only 47.9% when AOAA was present. It is concluded that the presence of AOAA decreases the Ca2+-dependence of K+-evoked [3H]GABA release in this system. PMID- 6493444 TI - Evidence that the dopaminergic incerto-hypothalamic tract has a stimulatory effect on ovulation and gonadotrophin release. AB - 2 micrograms dopamine (DA) were injected into particular hypothalamic sites containing dopaminergic nerve terminals, on the morning of pro-oestrus in cyclic rats, in which ovulation was blocked by administration of 35 mg/kg pento barbitone Na, in the afternoon of pro-oestrus. DA in a specific area of the zona incerta (ZI) (medial area at A 5.4 mm; de Groot atlas), and medial anterior hypothalamus (AH) overcame the pentobarbitone block and induced ovulation. Injections into the median eminence and preoptic area were ineffective, as were injections of 5-hydroxytryptamine and nor-adrenaline into the ZI. Injection of 2 micrograms haloperidol and lesions in the ZI inhibited ovulation in otherwise untreated cyclic rats. Lesions induced constant dioestrus for 14 +/- 0.7 days, but the animals were not pseudopregnant. 2 micrograms DA were also injected into the ZI of ovariectomised rats primed with 2 micrograms oestradiol benzoate 48 h before; this treatment stimulated a rise in plasma LH approximately 40 min later. These findings indicate that the dopaminergic incerto-hypothalamic tract which has nerve terminals in the ZI and AH has a stimulatory role in the control of gonadotrophin release. PMID- 6493446 TI - Effect of vertebral, carotid and intravenous infusions of lysine vasopressin on plasma vasopressin and cardiovascular function. AB - The cardiovascular and vasopressin-releasing effects of vertebral artery, carotid artery and intravenous (i.v.) infusions of lysine vasopressin (150 microU/kg X min) were studied in anesthetized dogs. Vertebral and carotid artery infusions of lysine vasopressin led to similar decreases in cardiac output as i.v. infusions. Heart rate, however, decreased to a greater extent with vertebral and carotid artery infusions of lysine vasopressin than i.v. infusions. There were no changes in either mean arterial blood pressure or the plasma vasopressin concentration. The results indicate that peripheral vasopressin: has a central effect to reduce heart rate; has a peripheral effect on the heart to reduce cardiac output, and probably does not feed back to inhibit its own release. PMID- 6493445 TI - Bioavailability of oral melatonin in humans. AB - We administered crystalline melatonin (80 mg) in gelatin capsules to 5 young male volunteers and measured serum and urinary melatonin levels at intervals. Changes in serum melatonin levels were best described by a biexponential equation with an absorption constant (ka) of 1.72 h-1 (half-life = 0.40 h) and an elimination constant (ke1) of 0.87 h-1 (half-life = 0.80 h). Peak serum melatonin levels, ranging from 350 to 10,000 times those occurring physiologically at nighttime, were observed 60-150 min after its administration, remaining stable for approximately 1.5 h. The fraction of ingested melatonin that was absorbed, estimated from the area under the curve describing serum melatonin concentrations as a function of time after melatonin administration (the concentration-time curve), varied by 25-fold among subjects. 3 additional volunteers received three melatonin-containing capsules (80 mg each) at 60-min intervals. This regimen extended the duration of elevated serum melatonin levels to 4-6 h. Melatonin excretion closely paralleled serum melatonin levels until 9 h after the hormone's administration, after which urinary levels tended to be higher than those predicted from serum levels. However, the area under the concentration-time curve for serum melatonin correlated well (r = 0.96) with the cumulative melatonin excretion during the initial 15 h after melatonin's administration, indicating that either approach can be used to estimate the absorption of orally administered melatonin. PMID- 6493447 TI - Changes in serotonin levels, N-acetyltransferase activity, hydroxyindole-O methyltransferase activity, and melatonin levels in the pineal gland of the Richardson's ground squirrel in relation to the light-dark cycle. AB - Pineal serotonin and melatonin levels and the activities of hydroxyindole-O methyltransferase (HIOMT) and N-acetyltransferase (NAT) were studied over a 24 hour period in the pineal gland of the diurnally active Richardson's ground squirrel (Spermophilus richardsonii). Under alternating light-dark conditions (light:dark hours 14:10), pineal serotonin and melatonin levels exhibited a rhythm with high values occurring either during the day (serotonin) or during the night (melatonin). NAT activity was also markedly increased during darkness. HIOMT activity exhibited no 24-hour variation. Exposure of squirrels to constant light for 7 days exaggerated the serotonin rhythm, but obliterated the cycles of NAT and melatonin. Under constant darkness (for 7 days), the rhythms in serotonin, melatonin and NAT persisted, each having a period of about 24 h. In the second study, ground squirrels were exposed to light-dark cycles of either 8:16, 10:14 or 14:10. Under each of these photoperiodic environments, rhythms in pineal NAT and melatonin were apparent. Increasing the daily dark period from 10 to 14 h caused a prolongation of the elevated NAT and melatonin levels. However, a further prolongation of the daily dark period (to 16 h) did not further increase the duration of the rise in NAT and melatonin. The results show that continual light exposure (irradiance of 200 microW/cm2) for 7 days suppresses the pineal rhythms in both NAT activity and melatonin level in the Richardson's ground squirrel. Conversely, light exposure, rather than depressing the serotonin rhythm, actually exaggerates it. Constant darkness for 7 days has little influence on the 24-hour rhythms of either NAT or melatonin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493448 TI - Daily fluctuations in the activity of the tuberoinfundibular GABAergic system and plasma prolactin levels. AB - In view of the role exerted by gamma-aminobutyric acid (GABA) in the control of prolactin (PRL) secretion the circadian periodicity of hypothalamo-pituitary GABAergic activity and PRL secretion was evaluated in adult male rats to ascertain if a meaningful correlation between biochemical and endocrine indices may be evidenced. Anterior pituitary and median eminence GABA concentrations peaked during the late afternoon hours (18.00 h), while the glutamic acid decarboxylase activity reached higher concentrations at 15.00 h. Plasma PRL presented two circadian surges at 15.00 h and at midnight. Although the changes of GABA in the hypothalamo-pituitary complex and the PRL surges did not show a close temporal relation, the possibility may be considered that GABA circadian changes occurred as a delayed response to PRL circadian surges. However, it cannot be excluded that changes in the biochemical indices could be related to other neuroendocrine events. PMID- 6493449 TI - Facilitation of vasopressin release from the neurohypophysis by application of electrical stimuli in bursts. Relevant stimulation parameters. AB - The physiological significance of the 'bursting' pattern of firing exhibited by activated vasopressin-secreting neurones was investigated by delivering bursts of electrical stimuli to isolated rat neurohypophyses incubated in vitro and by determining vasopressin release. The stimuli were delivered in bursts at three different average frequencies (2.5, 5.0, and 7.5 Hz). For each average frequency, stimuli were delivered at a constant 10 Hz, and the durations of the burst and silence periods were altered, so that the stimulator was switched on for 25, 50 or 75% of the total time. The burst duration varied from 2.5 to 30 s. The vasopressin release generally increased with the average frequency of stimulation, but varied widely for different burst durations. The vasopressin release per stimulus pulse was found to correlate extremely well (r2 = 0.91) with burst durations of up to 20 s, regardless of the average frequency. If it is assumed that complete recovery from the effects of each burst of stimuli took place during the intervening silence periods, it can be shown that vasopressin release per burst increased as the square of burst duration. By analogy with other neurosecretory systems, facilitation of calcium entry during the bursts may be responsible. PMID- 6493450 TI - Hydrocephalus in infancy and childhood: diagnosis and indication for operation. AB - Improvement of the prognosis for children suffering from hydrocephalus requires prompt diagnosis and reliable indication of surgical treatment. Today, intrauterine hydrocephalus is detectable within the first three months of pregnancy; in infancy, before the cranial sutures have fused, pathological growth of the head is the principal sign confirming together with anatomical examinations (ultrasound, CT scan) the indication of operative treatment. In later childhood, surgical treatment is only definitely indicated by symptoms and morphological examination of clearly active hypertensive hydrocephalus. Intermittently normotensive hydrocephalus (not "normal-pressure-hydrocephalus"!) showing symptoms adapted to childhood, however, often requires exact examination of intracranial pressure dynamics, including quantitative volume provocation test. "Step-by-step-procedure" is advisable (Table III). PMID- 6493451 TI - EEG spectral power and coherence analysis in healthy full-term neonates. AB - Continuous, bipolar EEG recording was performed in nineteen healthy full-terms during quiet sleep (Q), REM sleep (R) and wakefulness (W). Spectral power was calculated for the bilateral fronto-central (FC), centro-parietal (CP), parieto occipital (PO) and temporal (TT) derivations. Coherence was determined for the interhemispheric biFC, biCP, biPO and biTT locations, as well as for the left and right intrahemispheric FC-PO and TT-PO combinations. Power was highest in Q in the CP derivations at 0.4-12/s. Generally, power was higher in Q than in R. In most derivations, Q and R power ran parallel. W power behaviour was different. Up to 8/s, power in W was intermediate between Q and R power. From 10/s, it became highest, particularly in the TT and FC derivations. PO power was low. Highest coherence values occurred in the lowest frequencies. Up to 8/s, biFC, biCP and biPO interhemispheric coherences were highest in R and usually lowest during Q. In the alpha-beta range, highest coherences occurred during Q and lowest during R or W, without much variance between stages. BiPO coherences were remarkably high during all stages. BiTT and intrahemispheric coherences were low and less consistent. These data suggest high synchronization of theta-delta activity between biPO regions, particularly during R. We hypothesize active common generators of neonatal theta-delta activity in the posterior regions, indicating less autonomy and more interdependent behaviour of these areas especially during R. PMID- 6493453 TI - Paroxysmal kinesigenic choreoathetosis. AB - A twelve and a half-year-old boy is reported who presented with paroxysmal kinesigenic choreoathetosis. Family history lead to the diagnosis. The differential diagnosis to paroxysmal dystonic choreoathetosis of Mount and Reback (1940) is discussed, and treatment is commented upon. PMID- 6493452 TI - Infantile behavioural regression and respiratory impairment. AB - Three girls showed psychomotor regression arising between the 1st and 2nd year of life, after an initially normal development. Language, gait, chewing and swallowing were especially affected, whereas elementary sensory and motor functions were relatively spared. All displayed a particular disorder of breathing, which was irregular and inadequate during wakefulness, returning to normal during sleep. There are similarities between these patients and the syndrome of cerebral atrophy with hyperammonaemia, even though brain CT and biochemical studies, including ammonaemia, were all normal. PMID- 6493454 TI - Neurophysiological studies on conjoined twins. AB - EEG, VEP and BAEP studies were performed on conjoined (craniopagus parieto occipitalis) twins, born prematurely without any common neural tissue, but with shared venous channels and contiguous posterior poles. At thirty-three wks (CA) the EEG of one of the twins showed higher amplitudes and less quiescence, suggesting a more mature cerebrum but the same twin also showed longer latencies in the BAEP, suggesting a less mature brainstem. Sleep spindles at four and a half months frequently occurred at the same time in both of the twins, at times synchronous and at other times with a latency of onset 0.5-0.8 sec from one to the other, providing further evidence for a circulating "sleep-promoting factor". VEPs were recorded that were distinctive of each of the twins. Flash stimulation of one twin produced VEPs in the other that were characteristic, not of the stimulated twin, but of the other, suggesting that evoked responses from one area can activate non-volume conducted responses from another region characteristic of that latter region, presumably by physical contiguity alone. PMID- 6493455 TI - Influence of histamine and prostaglandin on desensitization to neurotensin in rat blood pressure. AB - Triphasic depressor-pressor-depressor blood pressure responses to neurotensin (NT: 1.67 micrograms/kg i.v.) in anesthetized rats were not elicited when the second dose of NT was administered 20 min after the first injection. Pretreatment of animals with histamine markedly reduced the depressor response to NT, and vice versa. The triphasic blood pressure pattern remained unaffected with acetylcholine and serotonin treatment, and hypotensive effects of acetylcholine and serotonin were not modified by NT. Attenuation of depressor response induced by the second injection of NT was antagonized by pretreatment with prostaglandin synthesis inhibitors such as indomethacin, mefenamic acid and acetylsalicylic acid. These results suggest that histamine and prostaglandins play a role in the development of desensitization to NT in rat blood pressure. PMID- 6493456 TI - A new immunological approach to the detection and the quantitation of the Met5 enkephalin precursors in rat brain. AB - We describe a new approach to the detection and quantitation of the enkephalin precursor. The approach is based on the production of antibody against a sequential determinant which is obtained specifically and quantitatively from the enkephalin precursor by tryptic hydrolysis. We chose the hexapeptide Tyr-Gly-Gly Phe-Met-Arg and developed antibody against the C-terminus of this peptide. The hexapeptide is released from the precursor by mere tryptic cleavage. The antibody permits us to detect the Met-enkephalin precursor at the picomole level. Using this approach, we have quantitated the precursor forms in rat striatum and hypothalamus. The precursor/Met-enkephalin ratio was close to 3/4. This result was in very good agreement with the ratio determined previously in the bovine adrenal medulla. PMID- 6493457 TI - Failure of chronic haloperidol treatment to alter levels of cholecystokinin in the rat brain striatum and olfactory tuberclenucleus accumbens area. AB - We have studied the effect of chronic haloperidol (HAL) treatment on CCK-8 levels in two rat brain regions. HAL administration using two different protocols, daily injections and infusion with subcutaneously implanted minipumps, did not produce any significant changes in CCK-8 levels in the striatum or olfactory tubercle nucleus accumbens area. PMID- 6493458 TI - Coexisting cervical and lumbar spinal stenosis: diagnosis and management. AB - An attempt has been made to identify and manage patients symptomatic from both cervical and lumbar spinal stenosis. The order of operative intervention was related to the degree of myelopathy and radiculopathy. Patients requiring cervical surgery first had absolute stenosis with a spinal canal equal to or less than 10 mm in anteroposterior diameter. Those requiring lumbar surgery first presented with stenosis and a canal between 11 and 13 mm in depth. In the latter group, patients presented with radiculopathy in their upper and lower extremities. A significant portion (50%) had intermittent neurogenic claudication (INC). Motor and sensory changes were severe in those with absolute as compared to relative stenosis. After cervical laminectomy, myelopathy improved or stabilized, and the subsequent lumbar decompression could be completed with less risk. Cervical cord decompression often resulted in improvement in lumbar symptoms with resolution of pain, spasticity, and sensory deficits of myelopathic origin. However, latent symptoms of INC caused by lumbar stenosis were not affected by cervial decompression and increased in severity. Electrodiagnostic studies were helpful in that somatosensory evoked potentials showed conduction delays in the cervical cord in patients with significant disease. The identification of motor neuron disease and peripheral neuropathies was essential. The surgical management included extensive, multiple level laminectomy, unroofing of the lateral recesses, and foraminotomy. Neurolysis and untethering of the spinal cord was essential. Significant improvement was shown by 90% of these patients. PMID- 6493460 TI - Clinical use of a portable bedside cerebral blood flow machine in the management of aneurysmal subarachnoid hemorrhage. AB - Recent advances in electronics and microprocessors have enabled the development of a compact portable cerebral blood flow (CBF) machine capable of being transported to the patient's bedside. We have used such a device, the Novo Cerebrograph 2a, during the past 7 months on a regular basis in the day to day management of our patients with intracranial aneurysms. One hundred three studies were performed in 23 cases of suspected intracranial aneurysm. Twenty-two cases presented with acute subarachnoid hemorrhage. Patients were studied on admission, preoperatively, in the recovery room, on postoperative Days 1, 5, and 14, and whenever the clinical condition of the patient warranted. The preoperative admission grade was found to correlate well with the mean CBFisi (ISI: initial slope index). Grade III and IV patients had flows significantly lower than those of Grade I and II patients. Serial CBF measurements proved useful in the management of 18 of 22 cases admitted with acute subarachnoid hemorrhage. Delayed ischemic deficits secondary to vasospasm occurred in 6 cases, with a concomitant average fail in mean flow in the symptomatic hemispheres of 27.9%. After volume expansion, an average increase in flow of 29.7% was noted. Low preoperative flows influenced management decision-making in 8 cases. In a further 4 cases, serial CBF measurements were helpful in the differential diagnosis of new neurological signs. PMID- 6493459 TI - Effects of naloxone during high dose barbiturate anesthesia. AB - This experiment was performed to investigate the ability of naloxone to reverse high dose barbiturate anesthesia or produce cerebrovasodilation or changes in cerebral metabolism in dogs neuronally depressed by high doses of barbiturate. Six dogs were deeply anesthetized with sufficiently high doses of sodium pentobarbital to produce and then maintain isoelectric activity or cerebral silence on the electroencephalogram (EEG). Blood flows were determined using the radioactive microsphere technique both before and after the intravenous bolus injection of naloxone (10 mg/kg), which failed to produce any significant changes in cerebral blood flow, the cerebral metabolic rate of oxygen, cerebrovascular resistance, or EEG activity. Cardiovascular parameters were also essentially unchanged. Naloxone in a dose of 10 mg/kg i.v. produced no changes in the cerebral or systemic circulations or in brain metabolism during high dose sodium pentobarbital anesthesia. PMID- 6493461 TI - A prospective study of radiofrequency rhizotomy in the treatment of posttraumatic spasticity. AB - Posttraumatic spasticity severely impedes rehabilitation potential and nursing care. Treatment of severe spasticity has included medical therapy, spinal cord ablative procedures, anterior and posterior root lesions and peripheral denervations, and tendon releases. Open rhizotomy and percutaneous radiofrequency rhizotomy have achieved good results. We prospectively studied 25 patients with severe spasticity to assess the efficacy of percutaneous radiofrequency rhizotomy. All or most of the prospectively identified goals were accomplished in 24 of the 25 patients, with improvement persisting during an average follow-up period of 12 months. The improvement due to decreased tone was much greater than the improvement due to increased range of motion. PMID- 6493462 TI - Augmentation of cerebral blood flow induced by hemodilution in stroke patients after superficial temporal-middle cerebral arterial bypass operation. AB - Experimental hemodilutional therapy has been shown to raise collateral perfusion to acutely ischemic brain regions distal to occluded internal carotid (ICA) and middle cerebral (MCA) arteries and to reduce infarct size. Superficial temporal (STA)-MCA anastomosis surgically establishes additional regional collateralization, and this bypass angiographically enlarges over time. Despite bypass patency verification by Doppler recording made at the edge of the craniectomy, the microsurgical STA-MCA anastomosis in 11 stroke patients did not produce early changes in cerebral perfusion parameters in the MCA territory of either hemisphere as determined by 133xenon inhalation. Therefore, hemodilution was initiated in an effort to increase cerebral perfusion during this marginal period when the STA was beginning to dilate progressively. Incremental venesections with equal intravenous volume replacement with 5% human serum albumin caused a significant lowering of the hematocrit from 40 +/- 1 to 33 +/- 1%. This isovolemic hemodilutional therapy resulted in significant mean regional cerebral blood flow (rCBF) elevations of 23 +/- 5% (SE) in the bypassed MCA territory and of 25 +/- 6% in the opposite MCA region. The mean gray flow (F1) in the involved and homologous MCA regions significantly increased 27 +/- 8% and 30 +/- 11%, respectively. Similarly, the initial slope index (ISI2) significantly rose by 17 +/- 5% in the bypassed MCA territory and by 18 +/- 6% in the homologous region. These data objectively support the premise that reductions in hematocrit without intravascular volume expansion augment cerebral blood flow, probably by reducing blood viscosity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493463 TI - Intramedullary neurofibroma of the cervical spinal cord: case report with review of the literature. AB - A case of cervical intramedullary neurofibroma diagnosed and surgically treated is reported. This patient, a 27-year-old man, had no evidence of von Recklinghausen's disease. The case is discussed, and a review of literature is presented. PMID- 6493464 TI - Transverse myelitis from intraarterial penicillin. AB - A child was given intramuscular benzathine penicillin and experienced manifestations of sudden, irreversible transection of the spinal cord in the lower thoracic region. The biopsy supported an intravascular injection with occlusion of the spinal vasculature as the etiological mechanism. A review of similar cases reveals a recurring pattern--intramuscular injection with standard techniques and sites into a small muscle mass without evident blood return followed by rapid progression of paralysis. The problem seems to turn upon an inability to recognize the inadvertent intraarterial injection. PMID- 6493465 TI - Intraoperative imaging with a therapeutic computed tomographic scanner. AB - A therapeutic computed tomographic (CT) scanner uniquely dedicated to surgical usage allowed intraoperative CT imaging during precise resections of glial brain tumors in three patients. Intraoperative CT scanning provided accurate tumor localization, superior contrast and spatial resolution of the lesion, and cross sectional anatomy of the entire brain. Further development of intraoperative CT guidance will allow safer or even complete removal of some previously unresectable brain tumors. PMID- 6493466 TI - Familial osteodysplasia associated with trigeminal neuralgia: case report. AB - A 24-year-old woman suffering from left trigeminal neuralgia presented with the familial occurrence of skeletal anomalies simulating Hajdu-Cheney syndrome. She was of a short stature and had low-set ears, protrusion of the bilateral temporal and occipital bones, platybasia, basilar impression, and dental anomaly. Vertebral angiography disclosed marked displacement to the left and dorsally of the basilar artery, which was confirmed during the operation to have compressed the left trigeminal nerve in the cerebellopontine angle narrowed by the unusually protruded bony structure. Cases of Hajdu-Cheney syndrome have occasionally been reported, a few combined with facial spasm, but Hajdu-Cheney syndrome with trigeminal neuralgia is very rare. The patient's family members were surveyed. The possible cause of the neuralgia with its relation to the osteodysplasia is briefly discussed. PMID- 6493467 TI - Massive preoperative pulmonary embolism and suprasellar brain tumor: case report and review of the literature. AB - A 57-year-old man presented to our facility with the diagnosis of a suprasellar mass and died on the 2nd post-admission day from a massive pulmonary embolism. At autopsy, the mass was diagnosed as craniopharyngioma. This case report and review of the literature suggest an intimate relation between brain tumors and thromboembolic complications as evidenced by the high incidence of this association, the frequent occurrence of coagulopathies in patients with brain tumors, and the prevalence of tumors in the suprasellar location. The specific mechanisms that may be at play are reviewed. PMID- 6493468 TI - Giant intracranial aneurysms presenting with massive cerebral edema. AB - Two cases of giant left middle cerebral artery aneurysm presenting with rapidly progressing hemiparesis and aphasia are presented. In both, the computed tomographic scan showed recent intraaneurysmal thrombosis and massive edema and swelling of the cerebral hemisphere. There was no evidence of recent hemorrhage in either case. In both patients, surgical resection of the aneurysm was accomplished, but the outcome was disastrous. The literature is reviewed and the possible mechanisms responsible for brain swelling in these cases are discussed. PMID- 6493469 TI - Intrathecal paraganglioma of the cauda equina. AB - A 33-year-old obese woman with chronic pain in her lower back presented with weakness of her right quadriceps and diminution of her patellar reflex. Her myelogram revealed an intradural oval mass at level of the interspace between her 3rd and 4th lumbar vertebrae. Operation disclosed an encapsulated mass attached to her filum terminale. Histopathological examination showed a paraganglioma with typical dense core granules, confirmed by electron microscopic examination. We report our patient to call attention to intrathecal paragangliomas as a rare and treatable cause of the cauda equina syndrome. PMID- 6493470 TI - Nuclear magnetic resonance of the spine: clinical potential and limitation. AB - Magnetic resonance can visualize the vertebral bodies, discs, neural structures, cerebrospinal fluid (CSF), neural foramina, and extradural structures in the sagittal, axial, and coronal planes. The normal nucleus pulposus can be differentiated from the anulus and changes associated with degeneration. Infection, trauma, and neoplastic conditions can be identified. The signal intensity of the CSF relative to extradural and neural structures can be increased to provide evaluation of the size and configuration of the contents of the thecal sac without the use of an intrathecal contrast medium. Impingement by disc, tumors, fracture segments, and expansile masses can then be accurately evaluated. It is the most accurate modality for the evaluation of the foramen magnum, Chiari malformation, syringomyelia, infection, and degeneration of intervertebral discs. It can identify paravertebral soft tissue and bony changes when plain films and computed tomographic (CT) studies are negative or equivocal. Not only can lesions be localized, but significant information regarding the nature of the process can be obtained. Using variations of the spin-echo technique with appropriate T1 and T2-weighted images, magnetic resonance can produce tissue contrast distinctions not possible with CT scans or conventional angiography. PMID- 6493471 TI - Surgical management of the frontal sinus. AB - The management of frontal sinus injury from trauma or operation has been controversial. Case reports and extensive literature review emphasize the importance of careful treatment of the frontal sinus whenever it is violated. The principles of management are reviewed. PMID- 6493472 TI - Observations on the selection of neurosurgical residents. PMID- 6493473 TI - Aneurysm clips. PMID- 6493474 TI - Neuropsychological tests. PMID- 6493475 TI - Evoked responses and the laser. PMID- 6493476 TI - Carotid artery injections. PMID- 6493477 TI - EEG asymmetry during sleep. AB - The ratio of integrated EEG amplitude from left and right temporal areas was analyzed during sleep in normal subjects for two consecutive nights. The results showed that the differences between the subjects were similar in both nights and were much larger than the differences between the stages of sleep. No significant variation was found between stages, although stage 1 tended to show greater relative right activation in night 1. Also, the relative right activation was greater in wakefulness in night 2 as compared to night 1. The classification of the correlation coefficients between stages corresponded to the physiological transitions between stages, suggesting that the small source of variance due to sleep stage contains relevant information. PMID- 6493478 TI - Stress-induced release of cortisol and prolactin during dilatation and curettage under general and local anesthesia. AB - Comparison of the effect of general and local anesthesia on serum prolactin and cortisol concentrations in response to the stress of dilatation and curettage revealed that short surgical procedures under general anesthesia resulted in no significant change in mean serum cortisol and in a significant decrease in mean serum prolactin. By contrast, short surgical procedures under local anesthesia resulted in a significant increase in serum prolactin and cortisol concentrations. Our findings support the importance of using general anesthesia during dilatation and curettage. PMID- 6493479 TI - Differential drug effects identified by 3-way configural frequency analysis. AB - 48 acute paranoic schizophrenics were treated by high or low dosages of haloperidol and rated for improvement after 3 weeks of treatment. The treatment effect was a differential one in that so-called plus-type schizophrenics improved from low dosages of haloperidol while so-called minus-type schizophrenics improved from high dosages of haloperidol. Testing for differential effects was made by 3-way configural frequency analysis. PMID- 6493480 TI - Computerized topo-EEG spectral maps: difficulties and perspectives. AB - An electric potential measurement tells us only about the difference between two electrode locations. When prior experiments or present measurements prove that an electrode's location is inactive (especially in 'mono-polar' or scalp-to reference technique), then EEG records and EEG maps can be interpreted regionally near each electrode location. Topographical mapping requires spatial interpolation which is one factor involved in spatial resolution. The interpolation algorithm has been studied by changing the power exponent n of the interelectrode distance d. When n is close to zero, interpolated values are all equal to the average of the four electric potential measurement Vs bounding the quadrilateral in which the interpolated points of the EEG map are located. When n is very high (n = 20 or higher), the values are essentially equal to the V which is at the minimum distance d. For n = 1, the map seems unlikely to represent the true scalp field. The choice between n = 2 and n = 3 is difficult, but n = 3 EEG mapping looks better (more plausible) and is our regular choice. The choice of recording/reporting method has also been studied. If the quantitative EEG map is linearly calculated from observations, the interpretation of record activity resulting from charge separation near the non-reference electrode attached to a particular channel is only possible when inactivity can be assured. This is completely different when the quantity mapped is not linearly calculated from observations (like power values or rms amplitudes in microvolts).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493481 TI - Poststimulatory endocytosis, microvesicle repopulation and changes in smooth endoplasmic reticulum in nerve endings of the median eminence superfused in vitro. AB - Mediobasal hypothalami of adult rats were superfused in vitro. A single 5 min pulse of 60 mM KCl-containing medium was infused, followed by either 15, 30, 45, 60 or 75 min superfusions with standard medium. In some experiments, 5 or 10% dextran was added followed by a 15 min recovery. Morphologically, two recovery phases were recognized. The early phase (15-30 min) was characterized by two features: (1) A clear-cut increase in the quantity of large, pleomorphic vacuoles occupying the axoplasm of nerve endings; these vacuoles were observed to be connected to caveolae of the same diameter in the axolemma and they were either coated or uncoated. (2) Progressive increase in the quantity of microvesicles (synaptic vesicles) from an initial depleted state. The vacuoles were found to contain dextran aggregates. Microvesicle-like protrusions bulged from the membrane of vacuoles. The late phase, from 45 min poststimulation onward, was typically identified after the appearance of tubules of smooth endoplasmic reticulum at the most distal segments of the nerve terminals. During this period, large vacuoles tended to decrease in quantity. Granular vesicles remained scant during the entire observation period. Images suggesting formation of microvesicles from tubules of smooth endoplasmic reticulum were observed. These results open the possibility that endocytosis of patches of membranes forming large vacuoles be an important mechanism for retrieving the membranes belonging to microvesicles and granular vesicles. Some of these large vacuoles may contribute to the early regeneration of microvesicles. More microvesicles could later be produced from the smooth endoplasmic reticulum. PMID- 6493482 TI - Isolation and partial characterisation of neuronal growth cones from neonatal rat forebrain. AB - We have devised a method for the isolation of viable neuronal growth cones from neonatal rat forebrain. The method involves differential and density gradient centrifugation and exploits the relatively low buoyant density (approximately 1.018 g/cm3) of growth cones. There are no known biochemical markers for growth cones and it was necessary therefore to monitor for their presence during the isolation using transmission electron microscopy. Several criteria were used to identify isolated growth cones including the presence of filopodia, an extensive system of branching, tubular smooth endoplasmic reticulum and a region rich in microfilaments subjacent to the plasma membrane. These morphological features are similar to those of growth cones identified unequivocally in intact developing brain and in tissue culture. Electron microscopical analysis showed that greater than 90% of membrane-bound, identifiable objects in one fraction were growth cones by these criteria. The major contaminant consisted of membrane sacs and vesicles of unidentified origin. There were only small amounts of isolated rough endoplasmic reticulum and mitochondria. Isolated growth cones were roughly spherical in shape with a diameter of 1.9 +/- 0.5 micron (mean +/- 1 SD). They usually contained mitochondria, large granular vesicles and small vesicles, and occasionally contained coated vesicles, lysosomes, lamellar bodies and multivesicular bodies, and only very rarely, intermediate filaments. Occasionally, growth cones had rudimentary synapses on them. The viability of isolated growth cones was investigated by observing their behaviour in short-term culture. After a few hours in culture on poly-D-lysine-coated coverslips, growth cones flattened down and extended filopodia-like processes. This behaviour was inhibited by cytochalasin B and reversibly by cold (4 degrees C). We conclude that physiologically active growth cones can be isolated rapidly and in large numbers by the method described here. PMID- 6493483 TI - Membrane properties of rat locus coeruleus neurones. AB - Intracellular recordings were made from neurones in the locus coeruleus contained within a slice cut from rat pons and maintained in vitro. Most neurones fired action potentials spontaneously at frequencies of between 1 and 5 Hz; this did not arise from spontaneous synaptic input but appeared to result from endogenous properties of the membrane conductances. Under voltage clamp at potentials near threshold for action potential generation (-55 mV) there was a persistent inward calcium current. This current became less with membrane hyperpolarization and was abolished at about -70 mV. Two potassium currents were observed. The first had properties similar to that generally described as the "fast" potassium current (IK,A); it flowed transiently (for about 200 ms) when the membrane potential passed from about -65 to -45 mV, and was blocked by 4-aminopyridine. The second was a calcium-activated potassium current (IK,Ca); it flowed for several seconds following a burst of calcium action potentials. Spontaneous and evoked action potentials had both tetrodotoxin-sensitive and tetrodotoxin-resistant components. The latter was apparently due to calcium entry. The potential changes occurring during the spontaneous firing of locus coeruleus neurones could be reconstructed qualitatively from the ionic conductances observed. The membrane properties of the locus coeruleus neurones were remarkably uniform; however, about 5% of cells impaled within the region of the locus coeruleus were electrophysiologically distinct. These atypical cells had short duration action potentials, did not fire spontaneously and had large spontaneous depolarizing synaptic potentials. PMID- 6493485 TI - Cerebellar influence on the time structure of movement in the electric fish Eigenmannia. AB - To determine how cerebellar activity influences motor co-ordination, a simple motor act of an electric fish, Eigenmannia spp, was studied. Whenever the fish encounters an object of conductivity different from water, it bends the caudal two-thirds of its body towards the object. This behavior, called "probing", was analysed in the normal fish and in fish with a small cerebellar lesion. Probing could be described as a wave travelling along the body very similar to what one observes when shaking a rope of moderate elasticity. In normal fish, the wave starts at the tipe of the tail and proceeds towards the head, dying out after about two-thirds of the body length. A lesion in the corpus cerebelli causes this wave to start at the head and move towards the tail, though it is otherwise the same as in normal fish, i.e. it has the same frequency components as revealed by Fourier analysis. In addition to the change in probing, the lesioned fish also undulates its body while swimming whereas it is normally kept straight. This undulating wave turns out to be the same as that during probing where it is executed whilst the fish keeps itself on the spot with its locomotory apparatus, the anal fin, which is driven by muscles independent of the trunk muscles used for probing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493484 TI - Sensory representation in the cerebellum of the catfish. AB - Sensory representation in the catfish cerebellum was studied with physiological stimuli, with electric shocks applied to peripheral nerves and with electric shocks to central structures of the brain. Evoked field potentials and unit responses were recorded in different places in the cerebellum. In the catfish, different sensory modalities are represented by discrete, only partly overlapping areas of the cerebellum. Most units are unimodal by present criteria; only in the valvula a fraction of the units are responsive to two or more modalities. Visual and somatosensory areas are the largest and they occupy the bulk of the corpus cerebelli and the valvula. In the corpus, most of the visual units are near the midline and in the dorsal tier while the somatosensory units are more lateral and ventral. Mechanical lateral line input is represented in the eminentia granularis and the valvula. Acoustic units are found in the valvula. Electroreceptive units are recorded from the lateral lobus caudalis, and to a lesser degree, from the eminentia granularis and valvula. Sinusoidal tilting and vibration units are in the lobus caudalis pars medialis. Receptive fields of units, regardless of modality, are generally large and diffuse. Some visual units respond best to moving objects. Topographical organization of receptive fields only exists among the somatosensory units. Besides these findings of modality segregation, the features of interest for comparative neurology are the following. Most units are identifiable as Purkinje cells with a characteristic mossy fiber-granular cell pattern, and but in contrast to most experience with mammals, in response to direct brain or nerve stimulations, the simple spikes have different dynamic responses for different modalities. Some are first excited, then inhibited, others vice versa. Some units are not responsive to any sensory input we delivered. Some units not meeting the criteria for Purkinje cells meet several criteria for eurydendroid cells; they give large spikes and are influenced by sensory stimuli after relative long latencies. Complex spikes, however, were only consistently observed in some of the visual units. PMID- 6493486 TI - Feeding induced by injections of muscimol into the substantia nigra of rats: unaffected by haloperidol but abolished by large lesions of the superior colliculus. AB - Intense activation of central dopamine systems has been associated with oral stereotyped behaviour, whereas less intense stimulation of these systems can increase feeding in non-deprived animals. There are several lines of evidence which suggest that the gamma-aminobutyric acid-containing striatonigral and nigrotectal projections are essential pathways mediating dopamine-related oral stereotypy. The present series of experiments was conducted to examine whether the same output route also mediates dopamine-related feeding. In the first experiment it was shown that bilateral injections of a sub-stereotypic dose of muscimol (0.05 nM) into the substantia nigra increased feeding of non-deprived rats. In Experiment II the feeding response was further characterised by demonstrating that food intake was initially suppressed for 30 min after which it was potentiated for 90 min. In Experiment III it was shown that a single dose of haloperidol (0.4 mg/kg), which was adequate to suppress overall food intake, was ineffective in preventing the increase in feeding produced by intranigral muscimol (0.05 nM). In contrast, it was demonstrated in Experiment IV that large lesions of the superior colliculus completely abolished the muscimol-induced increase in feeding. These results suggest that the striatonigral and nigrotectal projections may be important efferent pathways for both the oral stereotypy and the feeding responses linked with central dopamine transmission. PMID- 6493487 TI - The number and distribution of sympathetic neurons that innervate the rat pineal gland. AB - The sympathetic innervation of the rat pineal gland was examined using a variety of anatomical techniques. Following the injection of horseradish peroxidase into the pineal gland, approximately 250 labeled neurons were found in the ipsilateral superior cervical ganglion. No labeled neurons were found in the middle or inferior cervical ganglia. In animals whose left internal carotid nerve was lesioned prior to the injection of peroxidase, an average of only three labeled neurons was found in the ipsilateral superior cervical ganglion. These data suggest that most, if not all, of the sympathetic neurons innervating the pineal gland exit from the superior cervical ganglia via the internal carotid nerves. The distribution of sympathetic neurons innervating the pineal gland was similar, though slightly more rostrally placed, than the distribution of the entire population of superior cervical ganglion neurons which project into the internal carotid nerve. Both the small number of neurons innervating the pineal gland and their wide distribution in the rostral part of the superior cervical ganglion indicate that their study at the level of the ganglion would be difficult. Sympathetic axons reach the pineal gland via the nervi conarii. Electron microscopic studies indicate that in each nervus conarii there are about 440 axons which make contact with the surface of the pineal gland. In certain cases, bundles of axons from the left and right nervi conarii were found to fuse. Additional evidence for the intermingling of axons from the two nervi conarii was seen in orthograde transport studies with horseradish peroxidase. PMID- 6493488 TI - Myocardial infarction and stroke. AB - We used a computer data bank to evaluate 740 consecutive patients admitted to a cardiac care unit with myocardial infarction. Stroke occurred in 18 (2.4%) patients in the hospital; the anterior circulation was involved in 76% of strokes. Hospital mortality was 61% in patients with stroke and 13% in patients without stroke. Atrial arrhythmia was a significant (p less than or equal to 0.03) risk factor for stroke, but peak creatine kinase and ventricular arrhythmia were not. Cardiac pump failure, apical or anterior-lateral myocardial infarction, and history of previous stroke were associated with an increased risk of stroke. Clinical and pathologic data suggested an embolic etiology for most strokes that complicate acute myocardial infarction. PMID- 6493489 TI - Transient and persistent right ear extinction in dichotic listening: subcortical lesions. AB - Nine patients with aphasia had right ear extinction in dichotic listening to words in the first month after an ischemic stroke; they were reassessed after 3 months. Four showed complete recovery from the right ear extinction; in five, the abnormality persisted. In those who recovered, CT revealed a subcortical lesion lateral to the frontal horn of the lateral ventricle without a lesion of Heschl's gyrus or geniculo-temporal pathways; a lesion in those structures was found in patients who did not recover. As reported for subcortical aphasia, a subcortical mechanism may explain contralateral ear extinction in dichotic listening. PMID- 6493490 TI - Striatocapsular infarction: large infarcts in the lenticulostriate arterial territory. AB - A specific form of deep cerebral hemisphere infarction was identified in 11 of 1,600 stroke register patients. Despite the CT finding of a deep striatocapsular lesion, these patients showed evidence of both cortical and capsular abnormalities. Angiography showed significant proximal carotid artery lesions as well as evidence of occlusive or obstructive lesions in the region of the T junction of the internal carotid artery. The combination of these pathologic entities would explain this particular clinical picture. PMID- 6493491 TI - Calcium and magnesium content in fetuses at risk and prenecrotic Duchenne muscular dystrophy. AB - We measured calcium (Ca) and magnesium (Mg) content in muscles of fetuses at risk of Duchenne muscular dystrophy (DMD) and in a premature infant who later developed typical DMD. There was a three- to six-fold increase in muscle Ca in the fetuses and in the premature infant. In contrast to our previous reports of reduced muscle Mg in DMD children, there was an 18 to 57% increase of Mg in the fetuses at risk. Opaque and Ca-positive fibers, rarely observed in normal fetuses, were numerous in fetuses at risk and in the premature infant. No necrotic fibers were detected in the fetuses or the premature infant. These findings suggest that excessive Ca accumulation precedes necrosis in DMD. Other factors related to growth and development that occur after birth may trigger the necrosis that follows muscle Ca accumulation. PMID- 6493492 TI - Pathology of olivopontocerebellar atrophy with glutamate dehydrogenase deficiency. AB - We report the neuropathologic findings in the first patient with recognized glutamate dehydrogenase (GDH) deficiency to come to postmortem examination. He had progressive cerebellar ataxia beginning at age 21. He died at age 47 of pulmonary emboli. Postmortem examination revealed pancerebellar, olivary, and mild pontine atrophy, demyelination of the posterior columns, degeneration of anterior horn and dorsal root ganglion cells, and reduction of myelinated fibers in the sural nerve. In addition, there was neuronal storage of lipopigment diffusely throughout the CNS and the autonomic neurons, with cell distention, atrophy, and loss in selected areas. PMID- 6493493 TI - Mitochondrial encephalomyopathy: fluctuating symptoms and CT. AB - We describe a 29-year-old man with mitochondrial encephalomyopathy. The patient's disorder was characterized by lactic acidosis, hemiparesis, seizures, aphasia, and hemianopia. CT revealed low-density areas that corresponded to the symptoms. His 56-year-old mother is also involved subclinically, demonstrating that muscle biopsy is an important requisite in the final determination of a familial inheritance pattern in mitochondrial myopathy. Neuronal mitochondrial disorders are suggested as the pathogenesis of his neurologic symptoms. PMID- 6493494 TI - Recovery of naming in aphasia: relationship to fluency, comprehension and CT findings. AB - We assessed oral naming skill after left hemisphere ischemic stroke in 54 right handed aphasics. Initially, almost all had moderate to severe disability in oral naming. After 6 months, normal scores were achieved by one-third of the patients, all with lesions less than 60 cm3 in volume. Only 2 of 18 patients who were nonfluent at 6 months had normal naming then. Among patients with lesions less than 60 cm3 and persistently poor naming, there were two discrete lesion sites: posterior superior temporal-inferior parietal (semantic paraphasic errors) and insula-putamen (phonologic paraphasic errors). Individual variability was notable, with several patients regaining normal naming ability despite posterior temporal or insula-putamen lesions. PMID- 6493495 TI - Brain mitochondrial metabolism in experimental thiamine deficiency. AB - Thiamine deficiency causes Wernicke's encephalopathy, although the precise mechanism is unknown. We used a low-thiamine diet in conjunction with a thiamine analog, pyrithiamine, as a model of severe thiamine deficiency in rats. We investigated the function of intact, coupled mitochondria isolated from both brain and liver. State 4 respiration did not change in the thiamine-deficient animals. Brain state 3 rates fell in thiamine-deficient animals when pyruvate/malate, alpha-ketoglutarate, or glutamate were used as substrate. Liver state 3 rates were depressed only when pyruvate/malate was substrate. Activities of brain and liver pyruvate dehydrogenase complex and alpha-ketoglutarate dehydrogenase complex were depressed in the thiamine-deficient group. We conclude that the mitochondrial abnormalities resulting from thiamine deficiency are secondary to depression of thiamine-mediated enzyme activity, rather than from a putative role of thiamine in chemiosmotic coupling, and that the resulting abnormalities in ATP synthesis and perhaps in glutamate catabolism result in the irreversible neurologic defect seen in this disease. PMID- 6493496 TI - New aspects of the genetic, etiologic, and clinical puzzle of Leber's disease. PMID- 6493497 TI - Ban boxing. PMID- 6493498 TI - Genetic linkage analysis in primary torsion dystonia. AB - We studied five families, each containing two siblings affected with torsion dystonia and having phenotypically normal parents, for linkage of dystonia to 18 marker systems, including HLA. Analysis assumed an autosomal recessive mode of inheritance. Linkage was not found. Two markers, HLA and MN, were excluded from tight linkage, and evidence against tight linkage to ABO, Rh, GC, and GLO was obtained. PMID- 6493499 TI - Friedreich's ataxia: intravenous pyruvate load to demonstrate a defect in pyruvate metabolism. AB - Nine patients with typical Friedreich's ataxia had normal levels of pyruvate and lactate in blood, urine, and CSF. Glucose, pyruvate, and lactate levels were also within the reference ranges after oral glucose loading. After intravenous pyruvate loading, the relative increase in blood pyruvate and lactate levels was significantly higher in Friedreich's ataxia patients than in controls. Significant differences between the two groups were also observed in lactate pyruvate ratios at various times after infusion. The pyruvate loading test can be useful in demonstrating a defect in pyruvate metabolism in Friedreich's ataxia patients. PMID- 6493500 TI - Disordered swallowing due to a syrinx: correction by shunting. AB - Disturbed deglutition is common in diseases of the brainstem and lower cranial nerves, but little is known about the mechanisms involved. We studied a 49-year old man with symptoms of syringomyelia and syringobulbia lasting 7 years. Esophageal motility studies showed inability to initiate swallowing, esophageal hypomotility, and absence of the lower esophageal sphincter. After decompression of the syrinx by shunting, these abnormalities were corrected, and the patient could once again eat without aspiration. Medullary dysfunction caused by the syrinx was probably responsible for the swallowing difficulties. PMID- 6493501 TI - Adrenoleukodystrophy: abnormality of very long-chain fatty acids in erythrocyte membrane phospholipids. AB - Long-chain fatty acids in erythrocyte membrane phospholipids were analyzed in three patients with adrenoleukodystrophy (ALD) and four diseased controls with other neurologic diseases by high performance liquid chromatography (HPLC). HPLC chromatograms showed the increase of a very long-chain fatty acid C26:0 in glycerophospholipids of ALD erythrocyte membranes, which was not so prominent in sphingomyelin. The ratio of C26:0 to C22:0 increased in glycerophospholipids as well as sphingomyelin in ALD. These results suggest that ALD has a generalized abnormal metabolism of very long-chain saturated fatty acids. PMID- 6493502 TI - Respiratory arrest in subarachnoid hemorrhage. AB - Sudden loss of consciousness and cardiorespiratory disorders occurred in 43 of 254 patients with subarachnoid hemorrhage. Two patients had ventricular fibrillation, 37 had one or more episodes with a disturbance of respiratory rhythm that required assisted ventilation, and 4 died suddenly without recorded vital signs. Sixteen patients recovered after resuscitation. The outcome could not be predicted at an early stage from the anatomic type of hemorrhage on CT, the initial presence or absence of brainstem reflexes, or the type of cardiorespiratory disorder. Spontaneous respiration and responsiveness returned within 1 hour in all patients who recovered. PMID- 6493503 TI - Diagnostic errors discovered by CT in patients with suspected stroke. AB - We assessed the frequency of stroke diagnostic errors revealed by CT in 197 patients. In five patients, CT was an emergency procedure. In the other 192 patients, CT was used to check diagnosis based on routine investigations. All but eight diagnoses (4%) were thereby confirmed. Either hemorrhage was discovered where an ischemic lesion had been suspected (2 cases) or the reverse (3 cases). Disorders other than stroke were found in three patients--subdural hematoma, hydrocephalus, and suspected tumor. Thus, few but important errors were revealed by the CT investigations. PMID- 6493504 TI - Response variations in the treatment of Parkinson's disease. AB - The problems of long-term levodopa therapy tend to occur earlier if levodopa is combined from the start with a decarboxylase inhibitor. We conducted a retrospective study of 123 patients. Among patients treated with levodopa without a decarboxylase inhibitor, only 25% had response variations (end-of-dose deterioration, on-off response fluctuation) after 6 years of treatment. Among patients treated with both levodopa and a decarboxylase inhibitor, 90% showed response variations after 6 years of therapy. PMID- 6493505 TI - Head trauma and seizures as risk factors of glioblastoma. AB - This is a case-control study of 160 persons with glioblastoma and 128 of their "best friends" as controls. Subjects came mainly from greater Boston, and data were gathered by questionnaire and telephone interview. Among those who had had a "severe" head injury at age 15 or later, the age-adjusted rate ratio (RR) of glioblastoma was 10.6, p = 0.004. There were six cases and no controls who had seizures for 15 or more years. The related RR is inestimable, but has a p value of 0.03. We could not evaluate whether the latter association implies a direct relationship between the causes of seizures and the causes of glioblastoma, or if it reflects the effect of another factor, such as medications to control the seizures. PMID- 6493506 TI - Erythrocyte calcium transport in myotonic and facioscapulohumeral muscular dystrophy. AB - We studied calcium transport in inside-out erythrocyte vesicles from patients with myotonic or facioscapulohumeral dystrophy and age- and sex-matched controls. No significant difference was noted in the affinity of the transporter for calcium or the maximum reaction velocity. Under identical conditions, we previously found that Duchenne dystrophy membranes differed from controls in affinity for calcium and maximum velocity. The results reported here imply that the abnormality in Duchenne dystrophy is specific and not an abnormality found in all forms of dystrophy. PMID- 6493507 TI - Parkinsonism and basal ganglia infarcts. AB - A subacute parkinsonian syndrome was seen in three patients with CT evidence of basal ganglia infarcts. The clinical picture improved spontaneously, making the diagnosis of idiopathic Parkinson's disease untenable, and other causes of parkinsonism were not detected. This extrapyramidal syndrome was therefore compatible with "vascular parkinsonism," even though it lacked features often ascribed to this syndrome, such as a history of previous strokes and the presence of dementia and corticospinal tract signs. PMID- 6493508 TI - Blepharospasm associated with palatal myoclonus and communicating hydrocephalus. PMID- 6493509 TI - Arsenic-induced encephalopathy. PMID- 6493510 TI - New form of familial Parkinson-dementia syndrome and progressive supranuclear palsy. PMID- 6493512 TI - Phenylpropanolamine issue. PMID- 6493511 TI - Role of iron in free radical formation and brain edema. PMID- 6493513 TI - Methysergide therapy in human stroke. PMID- 6493514 TI - Surgical operating microscopes, series M 600 from WILD Heerbrugg Ltd. AB - A description of important design features serves to explain to the user the most significant characteristics and possible fields of use of the new M 600 Series of surgical operating microscopes from Wild Heerbrugg Ltd. PMID- 6493515 TI - A new zoom illumination system for constant image brightness at all magnification in the surgical operating microscope. AB - The article describes a new illumination system for operating microscopes. An optical zoom system keeps the image brightness constant at all magnifications. For the surgeon the visual acuity remains the same whatever the enlargement of the image. PMID- 6493516 TI - Ultrasonic aspiration in neurosurgery. AB - A short review describes the equipment of the ultrasonic aspirator CUSA, the microscopic and ultramicroscopic changes of brain tissue exposed to ultrasonic aspiration, as well as the indications and clinical experience in brain tumour operations. PMID- 6493517 TI - Efficient atraumatic liquid suction by means of slit suction tubes combined with a pressure control unit. AB - In 1976 a modified suction system for neurosurgery and precision surgery was presented. It was developed to meet the need for efficient and atraumatic liquid suction. the system consists of suction tube ends provided with three vertical slits in the suction edge (W-tubes), a Pressure Control Unit (PCU) and an independent suction pump with an air capacity of 25-30 litres per min. This system has subsequently been modified for microsurgery. The PCU normally controls the negative pressure to 20 kPa (corresponding to 200 cm of water) for atraumatic suction of liquid, which is needed during most of the operating time. For suction of various tissues or cleaning the system, the surgeon can set the pressure limit to 50 or 90 kPa by means of a foot-operated IR-transmitter in a pedal with a kick down function. The PCU and the W-tubes, which neutralize the pressure load on tissue and the sudden interruption of liquid flow that are inevitable with conventional suction tips, form a system with a high liquid suction capacity in spite of the atraumatic suction pressure. This is possible because the slits maintain a large active suction area. Crushed or soft tissues and coagulated blood are aspirated as and when required, if necessary by elevation of the negative pressure limit. The W-tubes are not provided with an air inlet hole on the tube because that method of pressure control proved unpredictable and variable and reduced the suction capacity by interfering with the flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493518 TI - Automatically controlled bipolar electrocoagulation--"COA-COMP". AB - Modern bipolar electrocoagulation has certain limitations, especially regarding the regulation of the short coagulation course. Studies on the electrical parameters of tissues during heating led to the conclusion that impedance changes in a typical and reproducible way. Furthermore, the impedance value proved to be close to minimal at the moment of coagulation. Laboratory tests were performed to correlate the pressure strength of the sealed artery to the impedance change. The tests proved that strong seals were achieved when the coagulation was interrupted soon after minimum impedance. Good seals were also achieved with later interruption of the heating but the well-known phenomena of sticking of the forceps to tissues and charging of the tips with charred tissue became more prominent. Further electrocoagulation gives carbonisation, fulguration and risk of new haemorrhage. Based on these results, micro-computerized equipment was built which cut off the coagulation soon after minimum impedance, i.e. when good strength without sticking was achieved. This equipment was tested clinically and the trials showed that the method is practical and most reliable. The microcomputer also allows automatic start of the coagulation as needed during opening or closing of wounds, as well as providing a built-in test of the equipment. This equipment saves time and labour and increases safety. PMID- 6493519 TI - Intraoperative Doppler and real time sonography in neurosurgery. AB - Ultrasound Doppler sonography with miniaturized probes and high resolution offers new possibilities of intraoperative control of neurovascular procedures. Patency, flow direction stenoses and changes in resistance can be investigated atraumatically, repeatedly and without additional preparation. In bypass and aneurysm surgery, about 10% of the cases were shown by Doppler examinations to be unsatisfactory, with stenoses and occlusions. These could be immediately corrected without loss of time. In normal cases, the information on the local haemodynamics enlarges the knowledge as to the effects of the operation and make it safer. Real time ultrasonography, which can be easily adapted to neurosurgery, is a new atraumatic tool for localizing, in two dimensions, subcortical intrinsic processes, haematomas, ventricles ect. It is useful for guided biopsies and punctures and for the centering of the dura and brain incision over the middle of the lesion, especially in microsurgical procedures. PMID- 6493520 TI - Intraoperative angiography in cerebral aneurysm and AV-malformation. AB - The device is constructed for intra-operative angiographic studies. The main features of the unit are: semi-automatic positioning of the tube into preset coordinates, TV camera serving as receptor, reproduction of the videosignal with twice the number of lines compared with that used normally, retrieval technique permitting one to study the flow of the contrast medium in slow motion at the required speed. Further advantages: Intra-operative control of the correct operative technique. No need for postoperative anaesthesia and cerebral angiography. PMID- 6493521 TI - An improved neurosurgical system: new operating table, chair, microscope and other instrumentation. AB - We have developed what we call the instrument trio in the neurosurgical operating theatre: a remote-controlled operating microscope with magnetic lock, an operating table with remote-controlled X-Y shifter, and a floating operating chair. In addition other important improvements in instrumentation have been made; they include a quick sterilization system for the operating microscope, a multipurpose head frame and an improved retractor system. The instruments and their characteristics are described in detail. PMID- 6493522 TI - Operating tables and accessories for neurosurgical operations. AB - Two tables are described which are specially suited for neurosurgical operations. One has a fixed column and a removable table-top and the other is a mobile, battery-powered table. The facilities include different positions with special neurosurgical accessories for positioning anatomically adapted to the patient's body and for maximum stability of the operating field. PMID- 6493523 TI - Combined retractor and hand-rest system for neurosurgery. AB - A combined self-retaining retractor and hand-rest system for neurosurgery is presented. It was developed from the original Leyla system but has the advantage of an integrated hand-rest. PMID- 6493524 TI - Zeiss operating microscopes for neurosurgery. AB - The OPMI operating microscope system for use in micro-neurosurgery is here described. Its various illumination systems, tubes, eyepieces, objectives and other accessories make it extremely versatile and it also offers excellent possibilities for documentation (photo, film, video). Furthermore, over and above its facilities for dual observation and assistants, it also enables two surgeons to work together during an operation. A variety of floor stands and ceiling mounts ensure that all requirements regarding mobility and economic use of space are fulfilled. Possible uses for CO2 and Nd-YAG lasers are also given. PMID- 6493525 TI - Moller UNIVERSAL operation unit. AB - The technicalities of the UNIVERSAL operation unit, the UNIMOBIL chairstand and the UNISTAT microscope stand are described. PMID- 6493526 TI - [Role of smoking in determining coronary heart disease. Hypothesis on the possible mechanism of myocardial damage]. PMID- 6493527 TI - [Changes in plasma lipids induced by long-term treatment with atenolol in patients with hypertension]. PMID- 6493528 TI - [Licorice as a possible cause of arterial hypertension. Description of a clinical case]. PMID- 6493529 TI - [Effects of hemodialysis on the left ventricular function in uremic patients]. PMID- 6493530 TI - [A case of phenformin-induced lactic acidosis complicated by total atrioventricular block]. PMID- 6493531 TI - [Elective surgery in aneurysms of the abdominal aorta]. PMID- 6493532 TI - [Surgery of the lower popliteal artery and its branches. Our experience]. PMID- 6493533 TI - [Experience with thrombolytic therapy using urokinase]. PMID- 6493534 TI - [Arterial injuries of the limbs]. PMID- 6493535 TI - [Vascular injuries in children. Personal experience]. PMID- 6493537 TI - [Validity of two-dimensional echocardiography in the diagnosis of aortic coarctation. Description of a case]. PMID- 6493536 TI - [Variations in the duration of electromechanical systole and R wave voltage in normal subjects during dynamic exercise]. PMID- 6493538 TI - [Electromechanical intervals in the neonatal period and early infancy]. PMID- 6493539 TI - [Effects of a water-soluble benzodiazepin: midazolam on intracranial pressure]. PMID- 6493540 TI - [Controlled hypotension induced by sodium nitroprusside in orthopedic surgery on the spine]. PMID- 6493541 TI - [Role of cerebrospinal fluid lactic acid in the evaluation of cranial injuries. Review of the literature]. PMID- 6493543 TI - [Cardiac output with thermodilution after open-heart surgery. Experience in 32 cases]. PMID- 6493542 TI - [Independent ventilation of the lungs as treatment of the massive loss of gas due to bronchopleural fistula]. PMID- 6493544 TI - [Anaphylactic shock caused by spinal anesthesia]. PMID- 6493545 TI - [The influence of various inhalation anesthetics on disorders tissue perfusion in metabolic acidosis]. PMID- 6493546 TI - [The effect of anesthetics and site of surgical intervention on hepatic function]. PMID- 6493547 TI - [Hypovolemic hypotension and hepatic function. Comparison of halothane and enflurane]. PMID- 6493548 TI - [The so-called hepatotoxic effects of enflurane. Ultramicroscopic study of human biopsies]. PMID- 6493549 TI - [Biochemical changes in the liver and erythrocytes of rats exposed to chronic enthrane poisoning]. PMID- 6493550 TI - [Reinterventions in biliary surgery]. PMID- 6493551 TI - [Role of splenectomy in the therapy of hypersplenism associated with intrahepatic portal hypertension]. PMID- 6493552 TI - [Concepts of surgical anatomy for the controlled exeresis of the liver. Personal experience at the Viet Duck Hospital in Hanoi]. PMID- 6493553 TI - [Current attitudes on the treatment of traumatic mobile parietal flaps of the thorax]. PMID- 6493554 TI - [Mastectomy technics favoring the surgical reconstruction of the breast]. PMID- 6493555 TI - [Radiotherapy in the treatment of carcinoma of male breast]. PMID- 6493556 TI - [26 cases of early gastric cancer surgically treated]. PMID- 6493557 TI - [Cholecystogastrostomy versus choledochoduodenostomy in non-resectable carcinoma of the head of the pancreas]. PMID- 6493558 TI - [A new type of internal biliary drainage positioned by percutaneous transhepatic approach]. PMID- 6493559 TI - [Cholecystectomy without drainage. Randomized clinical study]. PMID- 6493560 TI - [Clinic-pathologic, therapeutic and prognostic aspects of carcinoma of the anus. Considerations on 35 cases]. PMID- 6493561 TI - [Surgical anatomy of nerve trunks of the axilla and of the pectoral muscles. Considerations relative to the intervention of mastectomy based on a study of 30 cadavers]. PMID- 6493562 TI - [Clinico-biologic and therapeutic aspects of 76 cutaneous melanomas]. PMID- 6493564 TI - [Treatment of pilonidal sinus by radical excision and primary closure. Our experience]. PMID- 6493563 TI - [Peritoneal lavage in generalized peritonitis]. PMID- 6493565 TI - The Popeye syndrome--brachial artery entrapment as a result of muscular hypertrophy. AB - In eight patients a diagnosis of entrapment of the brachial artery in the cubital fossa was established. All were muscular middle-aged men, who had performed heavy work with their arms for many years. For no immediately apparent reason they began to complain of weakness of the musculature of forearm and hand. The clinical details, diagnosis and simple treatment, which resulted in every case in complete relief of symptoms, are described. PMID- 6493566 TI - Primary leiomyosarcoma of the breast. AB - The history of a 50-year-old female patient with a primary leiomyosarcoma of the breast is described. A survey of the literature is given. Surgery remains the treatment of choice. The biologic behaviour of the tumour has a favourable effect on prognosis. PMID- 6493567 TI - [Cardiopathies and pregnancy]. PMID- 6493568 TI - [The karyotype in couples with spontaneous abortion]. PMID- 6493569 TI - [Acute renal insufficiency in pregnancy. A case of the uremic-hemolytic syndrome in the post-partum period]. PMID- 6493570 TI - [Extrauterine tubal pregnancy. Clinico-statistical considerations]. PMID- 6493571 TI - [The significance of Barr's chromatin in carcinoma of the breast]. PMID- 6493572 TI - [The non-significance of plasma testosterone as endocrine marker in diagnosis and follow-up of carcinoma of the ovary]. PMID- 6493573 TI - [Ultrasonic fetal biometry in the second and third trimesters of pregnancy]. PMID- 6493574 TI - [A rule for the calculation of various echographic parameters]. PMID- 6493575 TI - [Importance of hysteroscopic diagnosis in uterine pathology]. PMID- 6493576 TI - [Changes of bladder stasis in relation to the Burch colposuspension operation]. PMID- 6493577 TI - [Post-coital contraception with estrogens. Mechanism of action, results and sequelae in a caseload of 123 cases]. PMID- 6493578 TI - [Masked depression in obstetrics and gynecology]. PMID- 6493579 TI - [Comparative activity of clotrimazole and nifuratel plus nystatin in vaginal infections of various etiologies]. PMID- 6493580 TI - Comparison of the in vitro activity of azlocillin and carbenicillin against 856 clinical bacterial isolates. AB - Eight hundred and fifty-six strains of more than ten species: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Escherichia coli, Klebsiella spp, Proteus mirabilis, Proteus vulgaris, Enterobacter spp, Pseudomonas spp and Acinetobacter spp, were tested by the disc diffusion method against azlocillin and carbenicillin. Azlocillin was found to be superior to carbenicillin against Pseudomonas spp, and more than 90% of the tested strains had minimal inhibitory concentration (MIC) values well below the serum levels attainable after recommended doses of azlocillin. Against Enterobacteriaceae and Gram-positive cocci, however, azlocillin seemed to have little to offer. PMID- 6493581 TI - External quality assessment for clinical microbiological laboratories in Norway 1983. AB - The external quality assessment scheme for clinical microbiology (EQA-M) used in Norway in 1983 is described and the results are evaluated. Altogether three distributions, each consisting of 3--4 simulated clinical specimens, were carried out. All specimens were distributed as "open" tests (identifiable by the participants as EQA-M tests), but two were also simultaneously distributed as "blind" tests (not identifiable by the participants as EQA-M tests). The EQA-M in 1983 has revealed some problem areas concerning the isolation, identification and reporting procedures, the more important being: The clinical information given seems often to be ignored The reported priorities of different microorganisms recovered from one specimen often seem to be accidental rather than the results of thorough considerations The isolation rates of Shigella sp and Yersinia enterocolitica from faecal specimens are too low A great number of laboratories seem to overestimate the quantities of bacteria in dip-slide cultures. PMID- 6493582 TI - Late sequelae after meningococcal disease. A controlled study in young men. AB - The occurrence of sequelae 3-15 years after meningococcal disease has been investigated in a study on 71 patients and 64 controls. The patients were young men, aged 18 to 24 years at the time the disease was contracted. Participants filled in a questionnaire on possible symptoms. Audiometry and EEG were also carried out. The response rates were 84% among patients and 75% among controls. We found that 61% of the patients had one or more symptoms of possible sequelae compared to 20% in the control group (p less than 0.001). The symptoms were generally light and of mental or neurological type. Among the patients 13% stated that they had obvious complaints commonly attributed to meningococcal disease, compared to 2% only in the controls (p less than 0.05). Twenty-nine per cent of the patients stated that the disease had affected their education or working capacity. No statistical differences between patients and controls were demonstrated by audiological or EEG examinations. In only one single ear could deafness unequivocally be attributed to the disease. PMID- 6493583 TI - Intra- versus extracellular recovery of 16S acetylcholinesterase following organophosphate inactivation in the rat. AB - Acetylcholinesterase (AChE) inhibitor treatments were used to study the temporal course of intra- versus extracellular 16S AChE recovery in endplate regions of adult rat anterior gracilis muscles previously exposed to a brief, in situ application of diisopropylfluorophosphate (DFP). Following such enzymatic inactivation (95-100%), extracellular 16S AChE recovery began significantly later than that of intracellular (onset at approximately 36 and 12 h, respectively) but, once begun, progressed at approximately the same rate (1.32%/h). The recovery of AChE molecular form activities subsequent to identical DFP inactivation was blocked to a large extent (65-85%) by in vivo treatment with cycloheximide, a protein synthesis inhibitor. These results support the hypothesis that extracellular 16S AChE at mammalian skeletal muscle motor endplates is primarily derived from complete, previously assembled 16S molecules originating in myofibers. PMID- 6493584 TI - Effect of lesion of subcommissural organ on sleep in cat. AB - We examined the possibility that subcommissural organ is implicated in the mechanisms of sleep-waking cycle. Electrolytic lesions of this structure were performed in two cats without disturbing the organization of sleep nor modifying the daily quantities of paradoxical sleep and slow-wave sleep. These results indicate that subcommissural organ does not play a major role in sleep mechanisms. PMID- 6493585 TI - Horseradish peroxidase studies on thalamic and striatal connections of the mesial part of area 6 in the monkey. AB - In monkeys (Macaca fuscata), horseradish peroxidase (HRP) was injected in the mesial part of area 6a alpha and 6a beta of the Vogts (presumed supplementary motor area). Groups of retrogradely labelled neurons were found in the dorsolateral half of VA, VLc, X and VLm. Other groups of retrogradely labelled neurons extended through Pcn, Csl, the dorsal edge of Cn.Md, Pf, Cl, MDmf, MDdc and MDpc in the thalamus and the claustrum. Anterogradely labelled terminals were found in turn in these thalamic portions. The neostriatum, the claustrum and the medial part of pars parvocellularis of the red nucleus were noted to receive dense anterogradely labelled terminals. These connections are similar to those of the dorsolateral part of area 6 (premotor area) with some topographical differences. PMID- 6493586 TI - Localization and characterization by quantitative autoradiography of [125I]LSD binding sites in rat brain. AB - The binding of [125I]LSD in rat brain was characterized and localized by quantitative autoradiography. Frozen 32 microns thick brain sections were labeled in vitro with [125I]LSD and exposed for 24 h against LKB Ultrofilm to generate autoradiograms. Nonspecific binding was defined as the labelling in the presence of 1 microM D-LSD. Scatchard analysis by densitometry indicated that the binding of [125I]LSD was saturable, with a Kd of 0.2 nM. In agreement with the results of Hartig and co-workers [5,6], [125I]LSD showed a high affinity for 5-HT2 serotonin receptors with some overlap with D-2 dopamine receptors. High concentrations of [125I]LSD sites were observed in layer IV of the cerebral cortex, caudate putamen, claustrum, olfactory tubercle, nucleus accumbens, ependyma, mammillary nucleus and inferior olive. Co-incubation of sections with sulpiride to block binding to D-2 receptors resulted in a uniform 20-30% reduction in the amount of specific [125I]LSD binding, with no qualitative difference in the pattern of labeling. However, co-incubation with ketanserin to block 5-HT2 receptors resulted in a pattern of binding that was similar to previous descriptions of the location of D-2 receptors, with high levels of residual binding in caudate putamen, olfactory tubercle, nucleus accumbens and inferior olive. Our results indicate that [125I]LSD is a suitable ligand for quantitative autoradiography of both 5-HT2 and D-2 receptors, and that there is a strong anatomical correspondence between these receptor subtypes, perhaps implying a functional interaction. PMID- 6493587 TI - Disappearance of low affinity adenosine binding sites in aging rat cerebral cortex and hippocampus. AB - A1 adenosine receptor binding was investigated, using the selective agonist, [3H]cyclohexyladenosine, on membranes prepared from the cerebral cortex and hippocampus of 3- and 24-month-old rats. The Scatchard analysis of the binding results obtained in the cerebral cortex of young animals showed two distinct binding sites with apparent Kd of 2 and 24 nM and Bmax of 259 and 675 fmol/mg protein, respectively. Conversely, in the old rats only one population of high affinity binding sites with a Kd of 2.2 nM and a Bmax of 450 fmol/mg protein was found. Displacement curves of labelled ligand carried out on hippocampal membranes also demonstrate the disappearance of a low affinity subpopulation of A1 receptors in the old rat brain. PMID- 6493588 TI - Identification of melatonin in the compound eyes of an insect, the locust (Locusta migratoria), by radioimmunoassay and gas chromatography-mass spectrometry. AB - Melatonin, a well-known pineal substance implicated in conveying photoperiodic information in vertebrates, appears also to be present in the compound eyes of an insect, the locust. The identification of melatonin in the eyes of an invertebrate suggests that it may be an evolutionary conservative molecule, principally involved in the time transduction of photoperiodic information in all living organisms. PMID- 6493589 TI - Physiological properties of lateral line receptors of the lamprey. AB - Single unit recording from the lateral line nerve of the lamprey revealed the existence of two types of afferents. One type reacts to electric fields (threshold 10-30 microV/cm) and is insensitive to weak mechanical stimuli. The other type is very sensitive to water displacement and does not respond to weak electric fields. The properties of the electroreceptors of the lamprey are discussed and compared with other types of electroreceptors. PMID- 6493590 TI - Recovery of function is not associated with proliferation of retinogeniculate synapses after chronic deafferentation in the dorsal lateral geniculate nucleus of the adult cat. AB - A restricted recovery of visual excitation occurs in the partially deafferented dorsal lateral geniculate nucleus (dLGN) of the cat after retinal lesions. In the absence of axonal growth an increase of retinogeniculate synapses at the peripheral dendrites of deafferented cells could be a possible underlying mechanism. We labeled optic tract terminals with horseradish peroxidase and [3H]proline. The size and density of labeled boutons in the vicinity of regions deafferented by chronic retinal lesions were not different from those in normal parts of the dLGN. There was no indication for synaptic proliferation as a response to partial visual deafferentiation in the adult cat dLGN. PMID- 6493591 TI - Dichotomizing somatic nerve fibers exist in rats but they are rare. AB - Electrophysiological methods that resolve problems of current spread were used to reinvestigate recent claims that over 40% of myelinated afferent neurons in rats have dichotomizing axons in which branches are maintained in two separate hindlimb nerves. Out of a sample of about 6400 axons recorded in rat hindlimb nerves including 3641 myelinated afferents, 14 axons were found to have a branch in both the sciatic nerve and a second somatic nerve. Examples were found of dichotomizing myelinated afferents, myelinated efferents and unmyelinated afferents. PMID- 6493592 TI - Identification of motoneurons innervating the tensor tympani muscle in the rabbit: a retrograde horseradish peroxidase study. AB - After injecting horseradish peroxidase into the tensor tympani muscle in the rabbit, neuronal cell bodies labeled retrogradely with the enzyme were seen in the ventrolateral regions of the pontine tegmentum. These tensor tympani motoneurons were located in the 'nucleus n' as well as in the rostrodorsal part of the medial 'cell group k' of Meessen and Olszewski [4]. PMID- 6493593 TI - Functional representation of eye movements in the flocculus of monkeys (Macaca fuscata). AB - The flocculus of the monkey was mapped with microstimulation methods in chronic preparations. Three types of low threshold, disconjugate eye movements were elicited: (1) a lateral deviation of the ipsilateral eye, (2) a downward deviation of the ipsilateral eye and (3) counterclockwise rotation of the ipsilateral eye. Horizontal eye movements were obtained from folia 2, 3, 4 and 6 10 of the flocculus, and the region eliciting horizontal eye movements was traced in the sagittal plane over a distance of 4 mm in one animal. However, sites flanking these horizontal movement sites produced either vertical movements, rotatory movements or failed to produce a movement of either eye. These findings suggest a zonal organization of flocculus functions in monkeys that is consistent with the differential projections of flocculo-vestibular connections revealed by retrograde tracing studies [2]. PMID- 6493594 TI - Pineal gland size and serum melatonin levels in male rats are not correlated. AB - As both the size of the pineal gland and the serum levels of melatonin are known to be variable it was decided to assess whether the two parameters are interrelated. For this purpose male Sprague-Dawley rats were killed at 12.00 and 24.00 h, respectively. Trunk blood was collected for melatonin radioimmunoassay. The pineal glands were prepared for histological examination, serially sectioned, and from planimetric tracings the volume of the gland was computed. Neither at day nor at nighttime was there a correlation between the volume of the pineal gland and the levels of serum melatonin. There was also no correlation between body weight and the volume of the pineal gland or the levels of serum melatonin. PMID- 6493595 TI - Depolarization of the mitochondrial membrane potential increases free cytosolic calcium in synaptosomes. AB - Intracellular calcium transients in synaptosomes, isolated from the guinea pig brain, were measured using entrapped metallochromic indicator arsenazo III. Addition of 1 microM carbonyl cyanide p-trifluoromethoxyphenyl hydrazone (FCCP) increased rapidly the absorbance of the entrapped arsenazo III, indicating an increase in the cytosolic free calcium. The FCCP-induced increase in cytoplasmic free Ca2+ was not blocked by 200 microM verapamil, while the increment in calcium caused by 40 microM veratridine was verapamil-sensitive. The absorbance changes induced by FCCP were not significantly increased when the extracellular potassium concentration was elevated from 5.4 to 50 mM. These data indicate that in nerve endings of mammalian brain, cytoplasmic free calcium, which is essential for the release of transmitter, is increased on depolarization of major intracellular calcium buffers, mitochondria. PMID- 6493596 TI - Acetylcholinesterase-containing cells in the lateral hypothalamic area are immunoreactive for alpha-melanocyte stimulating hormone (alpha-MSH) and have cortical projections in the rat. AB - Small injections of the retrograde fluorescent tracer Fast blue into different cortical areas, including the hippocampal region, labeled cells in the zona incerta and the lateral hypothalamic area. A majority (approximately equal to 90%) of the retrogradely labeled cells cross-reacted with an anti-serum to the opioid peptide alpha-melanocyte stimulating hormone (alpha-MSH). Sequential staining of the same tissue sections showed that a majority of the alpha-MSH stained cells in the lateral hypothalamic area and the zona incerta also contain the enzyme acetylcholinesterase (AChE) but not cholineacetyltransferase. These results suggest that cortical AChE resides partly in non-cholinergic terminals and that some of these arise from alpha-MSH immunoreactive cells in the hypothalamus and subthalamus. PMID- 6493597 TI - Ultrastructural analysis of the noradrenergic innervation of rat supraoptic nucleus. AB - The noradrenergic innervation of the rat supraoptic nucleus (SON) was examined by high resolution radioautography after animals had been intracerebrally injected with [3H]noradrenaline (NA). In the medial portion of the SON, noradrenergic varicosities were scattered throughout this nucleus, but were preferentially concentrated in its ventral subdivision. 25.5% of these NA varicosities displayed typical synaptic contacts, with either the somatic or proximal dendritic portions of neurosecretory neurons (9.2%) or with small dendritic processes of such neurons (16.3%). The possibility is discussed that at least some of the dendritic NA synapses detected in the ventral subdivision of the SON, which preferentially contains vasopressinergic perikarya, may affect the neurosecretory neurons located in the dorsal part of this nucleus, which preferentially contains oxytocinergic perikarya. PMID- 6493598 TI - Commissural afferents to the cortex surrounding the posterior part of the superior temporal sulcus in the monkey. AB - Commissural afferents to the cortex surrounding the posterior part of the superior temporal sulcus were studied in Japanese monkeys by the horseradish peroxidase method. After injection of the enzyme, many callosal neurons were labeled contralaterally in the cortical area corresponding to the injection site (homotopical area) and in other regions (heterotopical area). Most of the callosal neurons were triangular in shape, occurring for the most part in layer III of both homotopical and heterotopical areas (about 75-90% of the total number of labeled cells). Mean diameters of the cell bodies were about 11-13 micron. PMID- 6493600 TI - Identification of different subpopulations of neostriatal neurones projecting to globus pallidus or substantia nigra in the monkey: a retrograde fluorescence double-labelling study. AB - Fluorescent tracers (Nuclear Yellow, True Blue, Fast Blue) were injected, in various combinations, into the globus pallidus and substantia nigra in three marmosets. Examination of perikarya in the ipsilateral neostriatum, well removed from pallidal injection sites, revealed that the predominant pattern was of single-labelled cells, retrogradely labelled from either the globus pallidus or substantia nigra. It is suggested, on the basis of this evidence and data previously available, that the striatum contains at least three types of efferent neurones, one projecting exclusively to the globus pallidus, one projecting exclusively to the substantia nigra, and another projecting to both structures. PMID- 6493599 TI - Recovery cycle of the masseter inhibitory reflex in man. AB - The masseter inhibitory reflex from stimulation of the mental nerve has been recorded electromyographically in 10 healthy subjects. The recovery cycle of the two silent periods interrupting the tonic contraction of the masseter muscles have been studied with the paired shock technique. There was a clear dissociation between the recovery of early and late inhibition, the latter being far more affected by a preceding impulse. It is concluded that the two silent periods are mediated by separate neural nets. The differences with the recovery curves of the two components of the blink reflex are discussed. PMID- 6493601 TI - Increased projection from the locus coeruleus to the lateral geniculate nucleus and visual cortex in young adult rats following unilateral enucleation. AB - Rats of 30 and 60 days of age were subjected to removal of one eye, and electrophysiological experiments were carried out to see if the density of the projection from the locus coeruleus to the visual centers such as the lateral geniculate nucleus and visual cortex increased. In rats with an eye removed at 30 days, the projection of locus coeruleus neurons increased in the lateral geniculate nucleus contralateral and visual cortex ipsilateral to the removed eye, whereas rats with an eye removed at 60 days did not show any notable change in the density of the projection. PMID- 6493602 TI - Infrasound responses in the midbrain of the guinea fowl. AB - The electrophysiological audiogram of the Guinea fowl has been obtained using auditory evoked potentials from the MLD of unanesthetized birds. In restricted regions of MLD, phase-coupled responses to extreme low-frequency sinusoids (2-10 Hz) could be recorded at moderate intensities. The tonotopy of MLD extends continuously to the infrasound region at the rostrodorsal margin. Single-cell recording of infrasound responses show phase-locked firing of neurons with different phase delays for different cells. PMID- 6493603 TI - Cerebroprotective effect of dexamethasone by increasing the tolerance to hypoxia and preventing brain oedema in newborn piglets with experimental pneumothorax. AB - The effect of dexamethasone (DXM) pretreatment in newborn piglets with experimental pneumothorax (EPT) was studied. Neither low DXM doses nor those administered 1 or 2 h prior to the induction of EPT were found to be effective against its course. In contrast, 5 mg/kg of body wt. of DXM given subcutaneously 4 h prior to EPT improved significantly both the tolerance and laboratory data of the animals. The extent of brain oedema, measured 4 h after recovery, was also considerably lowered. Actinomycin D pretreatment prevented almost completely the beneficial effect offered by DXM suggesting the involvement of newly synthesized protein(s) in the cerebroprotective effect of DXM. PMID- 6493604 TI - Segmental serotoninergic innervation of spinal cord arterial circulation. AB - A rich serotoninergic innervation of the anterior spinal artery has been evidenced by histofluorescence. The main contribution to this adventitial serotoninergic plexus appears to originate from a serotonin fiber network in the anterior horns: serotonin-containing fibers reach the dorsal termination of the sulcocommissural artery and run within its wall in a ventral direction, toward the anterior spinal artery. This segmental arrangement of blood vessel innervation could be the basis for a neurogenic control of local blood circulation. PMID- 6493605 TI - Autoradiographic localization of muscarinic cholinergic receptors at various segmental levels of the human spinal cord. AB - Muscarinic cholinergic receptors were localized autoradiographically at different segmental levels of the normal human spinal cord after in vitro labelling using [3H]quinuclidinylbenzilate. The highest densities of muscarinic receptors were found in laminae II (substantia gelatinosa) and IX (motor neurons) of the gray matter. Lower densities of receptors were present in the other laminae and no binding sites were found in the white matter. This pattern of distribution of muscarinic receptors was similar at the cervical, thoracic, lumbar and sacral levels of the cord. These data suggest that muscarinic receptors may not only take part in motor function but also in the processing of sensory information. PMID- 6493606 TI - Claustral afferents to the rat's visual cortex. AB - Horseradish peroxidase (HRP) was injected electrophoretically into the rat's primary visual cortex (V1), and three other retinotopically organized cortical areas, anterior medial visual area (AM), posterior medial visual area (PM) and anterior lateral area (AL). While the HRP injections into V1 labelled many neurons in the ipsilateral claustrum, the injections in any of the three other visual areas labelled very few claustral neurons. PMID- 6493607 TI - Activity of caudate nucleus neurons in cat performing a reaction time task. AB - During a reaction time task, single units were recorded in the caudate nucleus of freely moving cats. Neuronal changes of activity were related to CS, to initiation of movement or to reinforcement. It is suggested that these changes of activity are involved in a process in which informations on the CS and on the on going movement are associated with information on the occurrence of reinforcement. PMID- 6493608 TI - Peculiarities of cerebellar excitation of facial nucleus motoneurons. AB - Excitatory postsynaptic potentials (EPSPs) of facial nucleus motoneurons evoked by stimulation of the cerebellar nuclei, were studied in anesthetized cats. It is shown that the stimulation of nucleus interpositus and dentatus evoked mono-, oligo- and polysynaptic EPSPs in facial motoneurons. From the experiments with lesions in the red nucleus it is suggested that this structure is implicated in the mechanisms and pathways through which the cerebellar control over facial nucleus motoneurons is realized. PMID- 6493609 TI - Pathogenesis of hypoxic-ischemic brain injury in a perinatal rodent model. AB - Exposure of immature rats to 8% oxygen after unilateral carotid artery ligation (UCL) causes metabolic, neurochemical and histopathological changes in the ipsilateral forebrain that resemble those in human perinatal hypoxic-ischemic encephalopathy. Regional cerebral perfusion in this model was examined by visual analysis of India ink trapped in cerebral vessels and measurement of [14C]iodoantipyrine [( 14C]IAP) and [3H]flunitrazepam extraction into the brain. UCL alone reduced [14C]IAP accumulation in the ipsilateral hemisphere by 20% and hypoxia superimposed on UCL progressively reduced ipsilateral hemisphere perfusion by 71% at 2 h. Hypoxia probably injures neurons in this model by causing a critical reduction in cerebral perfusion, an effect which also appears to be important in the human disorder. PMID- 6493610 TI - Tissue calcium levels in CaCl2-induced myelopathy. AB - CaCl2-induced myelopathy was produced in rats by the application of a solution of CaCl2 to exposed leptomeninges of lumbosacral spinal cord. Equal lengths of remote cervical and lumbar cord were removed at intervals following Ca2+ application. The total Ca2+ in tissue from lumbar cord was significantly elevated over autologous cervical cord and homologous lumber controls after after 2 h. The maximum Ca2+ increase in lumbar cord was 3.9-fold that of homogolous control and was reached by 8 h post Ca2+ application. The time course for the elevation of Ca2+ as measured by atomic absorption spectrophotometry, resembles that found in spinal cord following direct physical trauma. These findings as well as similar changes in morphology and neural proteins from previous studies suggest that Ca2+ is involved in and may potentiate the degeneration of axons and myelin via Ca2+ activated neutral proteinases. PMID- 6493611 TI - Diabetes-associated changes in estradiol accumulation in the aging C57BL/KsJ mouse brain. AB - The effects of aging and diabetes on the uptake and incorporation of [3H]estradiol (E) in various brain areas was analyzed in C57BL/KsJ mice. Control (C; +/?) and diabetic (D; db/db) mice were pulse treated (30 min) with 10 muCi of [3H]E at 1, 2 and 4 months of age and the brains were subsequently microdissected, digested and the amount of incorporated [3H]E assessed. The pituitary and amygdala exhibited the highest levels of [3H]E incorporation of all brain areas, with the hypothalamus, septal nuclei, midbrain, hippocampus, medulla and parietal cortex exhibiting moderate retention levels at one month of age in C animals. All brain areas in D mice had significantly lower incorporation rates than in matchpaired, C animals. An age-related decrease in [3H]E accumulation was observed in all brain regions in both C and D groups, with a significant depression in [3H]E incorporation occurring between 1 and 4 months of age. These data demonstrate that an age-related decrease in [3H]E uptake occurs in most brain areas in the C57BL/KsJ mouse, and that the diabetic condition exacerbates this phenomenon. PMID- 6493612 TI - Corrective responses to perturbation applied during walking in humans. AB - Modulation of the flexor reflex response during walking in humans following stimulation at 5 points in the step cycle was studied. At heel strike, an extensor response was observed at the ankle and the knee which would allow one to stabilize and plant the ipsilateral foot fast. Later on in the stance, there was a dorsiflexor and an extensor response at the ankle and the knee, respectively, which would result in the removal of the foot from the stimulus without collapsing at the knee. During mid-swing, a flexor reflex response was observed at the ankle and the hip joint. There was a tendency for the normal stride to be longer than the perturbed stride in mid swing and early stance while it was of shorter duration in late stance and early swing. PMID- 6493613 TI - Dopaminergic activity is reduced in diabetic rats. AB - Dopamine synthesis rates in synaptosomes prepared from the striata of alloxan diabetic rats were considerably lower than in control preparations. Striatal dopamine metabolite levels, after an initial increase, were also reduced at 3 and 6 weeks after alloxan administration. These findings suggest that dopaminergic functioning may be impaired in diabetic rats. PMID- 6493614 TI - Effects of leukocytic pyrogen and sodium salicylate on hypothalamic thermosensitive neurons in vitro. AB - The effects of leukocytic pyrogen and sodium salicylate (Sal) were studied on the single-unit activities of neurons in the preoptic and anterior hypothalamus (PO/AH) recorded in tissue slices in vitro. The pyrogen applied to the immediate vicinity of the recorded neurons decreased the firing rate of the majority of warm-sensitive neurons, but had no effect on the activities of thermally insensitive neurons. The pyrogen-induced inhibition of warm-sensitive neurons was reversibly blocked by local application of Sal. The results support the view that the pyretic and antipyretic effects of intrahypothalamic pyrogen and Sal are caused by their offsetting actions on the PO/AH thermosensitive neurons. PMID- 6493615 TI - Growth of dissociated neurons in culture dishes coated with synthetic polymeric amines. AB - Polyornithine and polylysine, the most commonly used coating materials in the preparation of neuronal cultures, can be replaced by polyethyleneimine (PEI) and other synthetic polymeric amines. PEI supports attachment and growth of neurons from fetal rat brain equally well as polyornithine. Furthermore, differentiation of the cultured neurons, as judged by the expression of choline acetyltransferase and of binding sites for substance P, was very similar in cultures grown in dishes coated with PEI or polyornithine. PMID- 6493616 TI - Structure and function of aberrant perforant path synapses in the hippocampus of neonatally X-irradiated rats. AB - We have examined the functional and morphological characteristics of synapses made by perforant path fibres projecting from the entorhinal cortex to the medial zone of the dentate area in adult rats which had been X-irradiated at birth, a procedure which prevents the proliferation of granule cells in that zone. We provide ultrastructural evidence that perforant path fibres in this region make synaptic contact with dendritic spines, and demonstrate that these synapses generate functional responses when the perforant path is stimulated. The evidence suggests that aberrant functional connections are made with the elongated basal dendrites of pyramidal cells. PMID- 6493617 TI - Muscarinic cholinergic receptors in the rat deep cerebellar nuclei: a quantitative autoradiographic study. AB - The distribution of muscarinic cholinergic receptors within the rat deep cerebellar nuclei was analyzed using in vitro receptor binding of [3H]quinuclidinylbenzilate (QNB) in conjunction with autoradiography. The highest density of QNB binding sites occurred in the lateral cerebellar (dentate) nucleus. Interpositus nuclei displayed an intermediate density of muscarinic cholinergic binding sites with the posterior interpositus nucleus demonstrating higher binding than the anterior nucleus. The fastigial (medial) cerebellar nucleus exhibited the lowest levels of QNB binding among the four cerebellar nuclei. These results indicate that muscarinic cholinergic receptors are present in the deep cerebellar nuclei and that differences in receptor density occur among the four nuclear groups. PMID- 6493618 TI - Nerve growth factor in three neurologically deficient mouse mutants. AB - The activity of nerve growth factor (NGF) in the salivary glands and in the sciatic nerve was compared between normal mice and mice affected by either of three neurological mutations by the use of a biological assay. No evidence was obtained for defects in amount or activity of NGF associated with the sprawling or splotch mutations. A reduction in the NGF content was found in salivary glands and sciatic nerve in homozygous dystonia musculorum mice. It is pointed out that the low amounts of NGF in dtJ/dtJ mice is likely to be a consequence of the general disturbances in development seen in this mutant rather than the specific cause for the neurological disorder. PMID- 6493619 TI - Responses of the primary auditory cortex to pitch changes in a sequence of tone pips: neuromagnetic recordings in man. AB - Auditory evoked magnetic fields of the human brain were recorded with a four channel 1st order gradiometer. Pitch deviance in a sequence of repetitive tone pips elicited magnetic evoked-response changes with a topography suggesting that a neuronal mismatch process to the deviant tones activates the primary auditory cortex. PMID- 6493620 TI - Absence of catecholamine uptake mechanism in the isolated perfused adrenal gland of the rat. AB - The left adrenal gland of the rat was perfused in vitro via the adrenal vein with Krebs-bicarbonate solution to study accumulation of exogenous catecholamines and secretion of endogenous norepinephrine and epinephrine by exposing the gland to various sympathomimetic agents. Perfusions with high concentrations of norepinephrine for 30 min did not result in its accumulation over the endogenous norepinephrine content. High concentrations of dopamine, norepinephrine and phenylephrine failed to displace significant quantities of endogenous catecholamines in the perfusate over those secreted spontaneously. Agents known to release norepinephrine from sympathetic nerves, such as tyramine and ephedrine, were ineffective in causing secretion of catecholamines from the rat adrenal gland. We have concluded that chromaffin cells of the isolated rat adrenal gland do not exhibit an efficient uptake system across their membrane for transporting catecholamines. PMID- 6493621 TI - Regular orientation of horizontal cells in the river lamprey retina. AB - In isolated retinas of the river lamprey (Lampetra japonica), two types (fast and slow) of light-induced responses (S-potentials) were recorded from two distinct classes of axon-bearing horizontal cells. After the spectral responses of recording cells were examined, a fluorescent dye Lucifer yellow CH (LY) was ionophoretically injected into individual cells. Such a cellular marking was made for 15-25 points per retina successively in time and in space. Then the retinas were processed as flatmounts for fluorescence microscopic observation. Horizontal cells marked with LY were correlated with the recordings and mapped in the retinal field. Both classes of horizontal cells were found to be regularly arranged in space around the optic disc; the long axes of somata and axonal processes are oriented in parallel with the latitude line of the eyeball through the optic disc. PMID- 6493622 TI - Neuropharmacology of delta-aminolaevulinic acid. II. Effect of chronic administration in mice. AB - delta-Aminolaevulinic acid (ALA) is suspected of being responsible for the neuropsychiatric symptoms of acute porphyria. The object of this study was to examine the effects of continuous administration of ALA in vivo on behaviour known to be affected in acute porphyria. ALA was administered to mice via minipumps implanted subcutaneously. Mean urinary excretion of ALA over the ensuing 7 days was approximately 80 mumol/kg b. wt./day. No significant effects on locomotor activity, motor co-ordination and grip and noci-perception were noted. These results do not support the hypothesis that chronic exposure of animals to ALA may produce a porphyria-like syndrome. PMID- 6493623 TI - Cerebral evoked potentials associated with the compensatory reactions following stance and gait perturbation. AB - We have studied the gastrocnemius electromyographic (EMG) responses and the cerebral potentials evoked in normal subjects by perturbations of stance and gait in the form of short treadmill acceleration impulses. In the stance condition a small EMG response (LM1; latency around 40 ms) was followed by a strong muscle activation (LM2; latency 75-90 ms). Following perturbation during gait, LM1 was lacking and LM2 appeared a little earlier (65-75 ms). In the stance condition, the cerebral potentials appeared with shorter latency (42 ms as compared to 83 ms) and a larger amplitude (41 microV as compared to 21 microV) than those seen in the gait condition. These changes can be explained by a presynaptic inhibition of group I afferent signals during gait, which are assumed to be responsible for the early EMG and EEG responses. It is suggested that the LM2 and the cerebral responses evoked by gait perturbation are mediated by signals from group II and III afferents. PMID- 6493624 TI - Stimulated drug uptake in a photoreceptor cell. AB - In many cells, organelle translocation requires structural integrity of microtubules [2,6,11,14, 5]. We have found that extracellular application of the antimicrotubular drug colchicine, which was expected to enter cells simply by diffusion, was ineffective at blocking pigment granule migration (PGM) inside fly photoreceptors. However, illumination of these receptors in the presence of colchicine resulted in complete PGM block. From a combined study using microphotometry, microfluorometry and intracellular recordings, we inferred that light permeabilized the cell to the drug. This hypothesis was supported by the observation that illumination caused the photoreceptor to take up an inert dye. The results show that target cells optically selected from a homogeneous population can be induced to take up an agent from the extracellular fluid. Remarkably, this process of light-induced drug uptake does not affect cell viability. PMID- 6493625 TI - Substantia innominata: critical link in the behavioral expression of mesolimbic dopamine stimulation in the rat. AB - The 'supersensitive' locomotor response to apomorphine resulting from 6 hydroxydopamine (6-OHDA)-induced denervation of the nucleus accumbens (N.Acc.) was studied in animals following selective damage to cell bodies within the substantia innominata (SI) and lateral preoptic region (LPO). Ibotenic acid induced lesions of the SI and LPO dramatically attenuated the locomotor response to apomorphine in 6-OHDA-infused animals. Thus, the locomotor response that follows dopaminergic stimulation within the N.Acc. depends to a great degree on the integrity of cells within the SI and LPO region. PMID- 6493626 TI - Quantitative autoradiography of nicotinic [3H]acetylcholine binding sites in rat brain. AB - Quantitative autoradiography was used to localize nicotinic [3H]acetylcholine (ACh) binding sites in rat brain. High concentrations of nicotinic [3H]ACh binding sites were observed in the anterior and medial nuclei of the thalamus, the medial habenula and the superficial layer of the superior colliculus. Moderate levels of binding sites were observed in a variety of brain regions such as the frontoparietal cortex and the hippocampus. Low levels of nicotinic ACh sites occurred throughout the hypothalamus and the primary olfactory cortex. PMID- 6493627 TI - In vivo electrochemical detection of 5-hydroxyindoles in rat cerebral cortex and spinal cord: differential effects of p-chloroamphetamine, probenecid and clorgyline. AB - Differential pulse voltammetry associated with carbon fiber microelectrodes was used to detect the 300 mV signal which is known to reflect the concentration of 5 hydroxyindoles in the spinal cord and cerebral neocortex of rats anesthetized with urethane or chloral hydrate. The intraperitoneal injection of p chloroamphetamine resulted in an increase in the amplitude of the signal in the neocortex but not in the spinal cord. Administration of clorgyline did not consistently modify the signal monitored in the neocortex whereas it decreased in the spinal cord. Probenecid induced a larger increase in 5-hydroxyindoles in the neocortex than in the spinal cord. These results demonstrate that different parts of the serotonergic system might be differentially sensitive to drugs affecting serotonin metabolism. PMID- 6493628 TI - The activity of pars compacta neurons of the monkey substantia nigra is depressed by apomorphine. AB - In the substantia nigra of anesthetized and awake monkeys, presumptive dopamine cells of the pars compacta were electrophysiologically discriminated against non dopaminergic cells of the pars reticulata by their lower discharge rate (0.5-8 vs 20-130 imp./s), their longer impulse duration (means 2.05 vs 0.92 ms), and their exclusive depression following systemic injection of the dopamine agonist apomorphine (24 out of 30 compacta neurons at 0.05-0.1 mg/kg s.c.). PMID- 6493629 TI - Distribution of premotor neurons for orbicularis oculi motoneurons in the cat, with particular reference to possible pathways for blink reflex. AB - After injecting horseradish peroxidase into the facial nucleus regions containing orbicularis oculi motoneurons, labeled neuronal cell bodies were found in the lateral medullary reticular formation, pretectal olivary nucleus, sensory trigeminal nuclei, lateral and medial parabrachial nuclei, ventromedial reticular formation medial to the facial nucleus, red nucleus and its surroundings, anterior horn of the upper cervical cord, medullary raphe nuclei, oculomotor nucleus and its surroundings, nuclei of Darkschewitsch, Cajal and Edinger Westphal, ventral part of the midbrain central gray, pontine tegmentum, lateral vestibular nucleus and deep layers of the superior colliculus. PMID- 6493630 TI - Voltammetry in unanesthetized rat: increases of striatal dopamine turnover after unilateral haloperidol injection into the substantia nigra. AB - In freely moving rats, effects of unilateral haloperidol injection into the substantia nigra were monitored with in vivo voltammetry in the bilateral striata. The electrochemical responses at 120 mV versus Ag-AgCl, reflecting mainly a level of 3,4-dihydroxyphenylacetic acid (DOPAC), increased both in the striata within 1.5 h after 5 micrograms of haloperidol treatment. In the experiments of high-performance liquid chromatography with electrochemical detection, the ratio of DOPAC to dopamine in the striata significantly increased at 2.75 h after drug treatment. These data support the idea that unilateral injection of haloperidol into the substantia nigra in freely moving rats increases dopamine turnover in the bilateral striata. PMID- 6493631 TI - Dual effect of verapamil on K+-evoked release of endogenous dopamine from arcuate nucleus-median eminence complex. AB - The effect of verapamil, a calcium-entrance blocker, on K+-evoked release of endogenous dopamine from tuberoinfundibular neurons incubated in vitro was studied. This compound, added to the incubation medium, at the dose of 10(-6) M, significantly reinforced K+-induced dopamine release, whereas, at higher doses (10(-5), 5 X 10(-5) and 10(-4) M), it completely prevented the stimulated dopamine release. The results obtained with the higher doses showed the calcium dependence of K+-evoked release of endogenous dopamine from central neurons. The opposite effect, seen with the lower dose of verapamil, could be due to different pharmacological properties of the drug. PMID- 6493632 TI - Effects of 4-aminopyridine on the field potentials of hippocampal slices. AB - In addition to promoting long-lasting negative (and positive) dendritic field potentials elicited by stimulation of Schaffer collaterals in hippocampal slices, 4-aminopyridine causes a slow negative wave which may have another origin than the dendritic potentials. PMID- 6493633 TI - Lateralization of choline acetyltransferase (ChAT) activity in fetus and adult human brain. AB - Choline acetyltransferase (ChAT) activity was measured in the first temporal gyrus (Brodmann area 22) and in the gyrus precentrale (Brodmann area 4) of both hemispheres in post-mortem human fetus and adult brains. In fetal brains the ChAT values were higher in the right first temporal gyrus in comparison to the left one (P less than 0.05). Conversely in adult brains ChAT activity was higher in the left first temporal gyrus than in the controlateral one (P less than 0.05). Absolute values of ChAT were similar in the right first temporal gyrus of fetus and adult brains. No asymmetry was found in the fetal and adult gyrus precentrale. These findings could be interpreted in terms of differential rates of development of cholinergic synapses in left and right human temporal lobes. PMID- 6493634 TI - Akinesia after locally applied morphine near the nucleus raphe pontis of the rat. AB - Morphine (10 micrograms/microliter) was injected into different sites within the pontine brainstem in different groups of rats with indwelling guide cannulae. The rats were tested for the persistence of abnormal postures as a measure for the degree of akinesia. Local morphine was most effective in inducing akinesia at a site identical or close to the nucleus raphe pontis. Midline injections were effective in contrast to bilateral injections. Fenfluramine, a serotonin releaser, strongly potentiated morphine akinesia. PMID- 6493635 TI - Postsynaptic fibers reaching the dorsal column nuclei in the rat. AB - Postsynaptic fibers reaching the dorsal column nuclei were investigated in rat by means of retrograde transport of wheat germ agglutinin-horseradish peroxidase conjugate. Each nucleus received only ipsilateral afferents with most of the labeled cells forming a band which covered the mediolateral extent of the dorsal horn in an area that resembled lamina IV in the cat. The labeling excluded the reticular extension of the neck of the dorsal horn. Lumbosacral afferents were restricted to the gracilis nucleus and cervicothoracic afferents to the cuneatus nucleus. Cervical and anterior lumbar levels showed additional projections coming from their most medial parts. The organization of this second-order pathway in rat is similar to that in cat and monkey. PMID- 6493636 TI - The distribution of acetylcholinesterase in brainstem auditory nuclei of canaries. AB - Previous research on brainstem auditory nuclei of avians has focused on cytoarchitecture, connectivity and synaptology. As an initial investigation of the neurochemistry of these structures, we examined the distribution of acetylcholinesterase (AChE) in n. angularis, n. magnocellularis and n. laminaris in canaries. Histochemical analyses revealed intense staining of neuronal somata in n. angularis and n. magnocellularis and light-to-moderate staining of neuronal somata in n. laminaris. Neuropil of n. angularis and n. laminaris stained positively, and the former was more intense than the latter. These findings suggest that neurons in n. angularis and n. magnocellularis are very rich in AChE, whereas neurons in n. laminaris are not. PMID- 6493637 TI - Evidence for a physiological role of GABA in the control of guinea-pig intestinal motility. AB - Rhythmic neurally mediated spontaneous relaxations of the longitudinal muscle in the isolated ileum of the guinea pig are modified by GABA antagonism. Bicuculline methochloride, a GABAA-receptor antagonist, and picrotoxinin, a Cl--ionophore blocker, as well as GABA desensitization reduced or most often abolished these naturally occurring periodic spontaneous relaxations, indicating a physiological involvement of GABA in the control of intestinal motility. The possible mechanism whereby GABA may induce such relaxations is discussed in relation to GABA actions in the enteric nervous system where GABA is a neurotransmitter. PMID- 6493638 TI - Development of retinohypothalamic projections in the chick embryo. AB - The retinal projection to the hypothalamus was investigated in embryonic as well as hatched chick using wheat germ agglutinin-conjugated horseradish peroxidase as an anterograde tracer. The presence of an aggregation of anterogradely labeled terminals in the hypothalamus was used to identify the suprachiasmatic nucleus (SCN). The first clear labeling of retinal fibers in the SCN was found on embryonic day 16, whereas labeling was found in the other primary visual projections, in the diencephalon and mesencephalon, several days earlier. Thus, the retinohypothalamic projection is the last primary visual pathway to develop in the chick embryo. PMID- 6493639 TI - A suggested role for copper in the biological activity of neuropeptides. AB - We have shown that a proline residue in the second or third position of a tetrapeptide chain acts as a 'break-point' to Cu(II) coordination dividing the peptide chain into two parts which coordinate independently. Proline also encourages a beta-conformation for the peptide chain presenting the terminal residues in a suitable conformation to form an abnormally large chelate ring. Many neuropeptides contain proline residues and it is likely that Cu(II) ions assist in holding these peptide molecules in the biologically favourable beta conformation by bridging across the ends of the chain. PMID- 6493640 TI - Local cerebral glucose utilization rate following intermittent exposures to 2 atmosphere absolute oxygen. AB - Previous studies have shown significant increases in regional cerebral metabolic rate for glucose (rCMRgl) in 14 of 28 investigated brain structures in rats exposed to 1-h oxygen at 2 atmosphere absolute (ATA O2). Continuous 4-h exposure to 2 ATA O2 resulted in significant increases only in superior olivary nucleus and inferior colliculus. In the present study, the rCMRgl was autoradiographically measured by the [14C]2-deoxyglucose technique during the last 30 min of 4 intermittent 1-h exposures to either 2 ATA O2 or air at atmospheric pressure, with 3 h of breathing air outside the pressure chamber between each oxygen or air exposure. Statistically significant reductions in rCMRgl of the oxygen-exposed rats were observed in superior olivary nucleus and inferior colliculus, while no changes were observed in 26 other investigated structures. The previously observed increases in rCMRgl in a single 1- or 4-h exposure at 2 ATA O2 were reduced or reversed during the intermittent hyperbaric oxygen exposure. The relation of the observed changes in rCMRgl during single and intermittent hyperbaric oxygen exposures to the extension of tolerance to hyperbaric oxygenation is discussed. PMID- 6493641 TI - Fictive locomotion of the forelimb evoked by stimulation of the mesencephalic locomotor region in the decerebrate cat. AB - Fictive locomotion, rhythmic nerve discharges mimicking locomotor activities, of the forelimb was found to be evoked by stimulation of the mesencephalic locomotor region (MLR), as that of the hindlimb, in immobilized decerebrate cats with the lower thoracic cord transected. The effective area for fictive locomotion was highly localized in the dorsolateral portion of the MLR, whereas a locomotor movement on the still belt of the treadmill was elicited from a slightly wider area and that on the moving belt from a further expanded area. PMID- 6493642 TI - Nebraska NP legislation forgoes "laundry" lists. PMID- 6493643 TI - The child with sickle cell anemia: implications and management. AB - Sickle cell anemia is a chronic illness affecting eight percent of the black population in the United States. It is an autosomal recessive, genetic disease. The clinical manifestations include anemia and vaso-occlusion. If these manifestations are properly managed, life threatening side effects can be prevented. Comprehensive medical care can prevent and minimize these crises and identify problem areas of concern before major damage is done to the organ systems of the body. PMID- 6493644 TI - Preventing diabetic foot problems. AB - Complications of diabetic foot disease may be prevented through regular office followup that includes inspection of the feet and patient education. Peripheral vascular disease and neuropathy are the pathophysiological factors underlying the development of ulcers and gangrene. Evaluation should include careful assessment of the neurological and vascular integrity of the legs and feet, risk factors for underlying disease and self-care abilities. When ulceration occurs, management includes bed rest, appropriate antibiotic therapy, topical care and treatment of any underlying large vessel disease. Worthwhile goals in caring for the diabetic individual's feet include: appropriate choice of shoes; good nail and skin care; excellent blood sugar control; smoking cessation; regular exercise; and maintaining normal blood pressure, cholesterol and triglyceride levels; and infection-free feet. Involving the family, the visiting nurse and/or the podiatrist may be helpful in achieving these goals. PMID- 6493645 TI - Protocol: congestive heart failure. AB - Congestive heart failure is a serious pathological heart state which is manifested by cardiorespiratory signs and symptoms. It is present in the chronic state in many elderly people and in those with previously damaged hearts. An understanding of the pathophysiology and etiology of congestive heart failure along with the factors predisposing the elderly to congestive heart failure aids in the initial diagnosis and treatment. Management of the patient with chronic congestive heart failure and prevention of acute congestive heart failure requires very close followup and assessment of the patient for early signs and symptoms of congestive heart failure. Active involvement of the patient in the care plan along with ongoing education and counseling is essential for good management. PMID- 6493646 TI - Oral contraceptives: the risks in perspective. AB - In 1968 three large prospective cohort studies were begun for the purpose of studying the long-term effects of oral contraceptive use. In all three studies, the major serious side effect of oral contraceptive use was an increased risk of circulatory mortality; this risk, however, was concentrated in older women who smoked and all women over the age of 45. The concept of risk is poorly understood by many consumers and providers of health care. This article explains the concept of risk and how it is determined, and reviews the most recent findings of the cohort studies relative to pill-related mortality. Comprehension of the concept of risk relative to pill-related mortality and its implications for nursing practice will assist nurses in providing their clients with the knowledge base necessary for an informed choice regarding contraceptive method. PMID- 6493647 TI - Blood glucose monitoring in childhood diabetes. AB - Diabetic complications may result from chronic elevations in serum glucose concentrations and the consequent counter regulatory mechanisms. Maintaining normal glycemic control is beyond the capability of urine testing for glucose. Blood glucose testing has provided the means to more normal glucose management in diabetics. The use of home blood glucose monitoring devices by diabetic children has been very successful. The test gives an immediate reading of blood glucose level, which has allowed both patients and their family members to become more actively involved in the management of diabetes. PMID- 6493648 TI - Marketing strategies for competitive advantage. PMID- 6493649 TI - False imprisonment. PMID- 6493650 TI - Dinner with the family as an effective assessment method. PMID- 6493651 TI - A business for profit can help the NP role. AB - Nurses are entering the business world in increasing numbers. A nurse practitioner service operated by a nurse practitioner is one business that appears to be valuable in increasing the utilization of NPs and in strengthening the role. A nurse practitioner service was started in March 1982 in Southern California. It was started because of a strong desire to strengthen the role of the nurse practitioner, and to have the experience of a nurse starting and operating a business. The business is now in its third year of service. It has grown steadily. Its growth pattern strongly indicates that the role of the nurse practitioner increasingly accepted as being used in more and more practice setting. PMID- 6493653 TI - Drug overdose during pregnancy: an overview from a metropolitan poison control center. AB - Suicide attempts during pregnancy usually present as intentional drug overdoses after interpersonal conflicts. During a recent four-year period, 119 (0.07%) of all 179,893 telephone inquiries at a metropolitan poison control center involved drug overdoses by 111 pregnant women. This was usually the first such attempt and telephone notification occurred primarily within the first hour. The ingested substance was known in 109 (98%) cases and consisted mostly of an excess of a single drug. The 50 different types of over-the-counter and prescription medications consisted primarily of analgesics (most notably acetaminophen), vitamins or iron, sedatives, antibiotics, and antihistamines or decongestants. No maternal deaths were reported. Signs or symptoms were nonexistent or mild in 61 (55%) women, and major or life-threatening in 50 (45%) women. Compliance with recommendations given by telephone and referral to the primary physician or emergency room was good, especially when major symptoms or life-threatening illnesses were apparent. Close emotional support and a search for depression during pregnancy and the postpartum period are recommended. PMID- 6493652 TI - Mental development of children whose mothers smoked during pregnancy. AB - Data were analyzed from a large prospective study to try to determine whether or not women's smoking during pregnancy affects their children's mental development. Many confounding variables were controlled by multiple regression analysis and by intrapair comparisons of siblings whose mothers had smoked during one but not in the other of the two pregnancies. Hyperactivity, short attention span, and lower scores on spelling and reading tests were more frequent for children whose mothers had smoked throughout pregnancy. The cognitive abnormalities were mild, with achievement test scores only 2 to 4% lower in children whose mothers had smoked during pregnancy. The behavioral abnormalities in children of smokers were associated with elevated neonatal hemoglobin levels and low birth weights, suggesting that fetal hypoxemia possibly may contribute to the genesis of behavioral abnormalities. PMID- 6493654 TI - Epidural analgesia for planned vaginal delivery following previous cesarean section. AB - The effect of lumbar epidural on the course of labor, delivery, and outcome was studied in 115 parturients with a previous cesarean section who were given a trial of vaginal delivery. One hundred three women were multiparous and 12 were grandmultiparous. Uterine contractions and fetal heart rate (FHR) were monitored continuously in all patients. Epidural block was performed using 8 mL of 0.35% bupivacaine without adrenaline. Supplemental doses were administered through an indwelling catheter. At the beginning of the second stage, 10 mL of 0.25% bupivacaine was added in the sitting position. Forty-eight women delivered spontaneously and 54 had an assisted second stage. Thirteen women delivered by a repeat low segmental cesarean section; dehiscence was observed in only one woman. Fetal outcome was satisfactory and similar to that of the authors' general parturient population. PMID- 6493655 TI - Continuing role of the nonstress test in the management of postdates pregnancy. AB - A retrospective analysis of 239 postdate patients who delivered within seven days of their last nonstress test between 1 July 1980 and 30 June 1981 was done to determine whether or not there was a relationship between variable fetal heart rate (FHR) decelerations, a decline in the FHR of at least 15 beats per minute and lasting 15 seconds, on the nonstress test and pregnancy outcome. Of the 505 nonstress tests, the results were considered either reactive (424 to 84%) or nonreactive (81 to 16%). Variable FHR decelerations or bradycardias were encountered on 95 nonstress tests (18.8%) in 80 (33.5%) postdate patients. Fetal heart rate bradycardia was encountered in nine patients (3.8%). Based on the last nonstress test, pregnancy outcome for the nonreactive group was less favorable than for the reactive group. However, when the reactive group was separated as to whether FHR decelerations or bradycardias were present or absent on the last test, the reactive group with FHR decelerations had a significant increase in meconium passage, cesarean delivery for fetal distress, and Apgar scores less than 7 at one minute. This group also had a similarly poor outcome as the nonreactive group of postdates patients. These data suggest that the nonstress test, when reactive without evidence of FHR decelerations, is a reliable indicator of fetal well-being in the postdate pregnancy. However, a reactive nonstress test with evidence of FHR decelerations is associated with a significant increase in perinatal morbidity. PMID- 6493656 TI - Vaginal delivery for the selected frank breech infant at term. AB - A retrospective analysis of 254 term breech deliveries was done, with term breech presentations managed by a protocol in which cesarean section was done for nonfrank breech presentation, or estimated fetal weight in excess of 4000 g. Patients with frank breech presentation were assigned to one of three groups based on x-ray pelvimetry and estimated fetal weight. Of 70 group 1 patients (adequate pelvis with estimated fetal weight less than 3600 g), 79% had a vaginal delivery. Of 21 group 2 patients (borderline pelvis or estimated fetal weight of 3600 to 4000 g), 67% delivered vaginally. In group 3 (contracted pelvis or estimated fetal weight greater than 4000 g), all patients were delivered by cesarean section. The overall cesarean section rate for frank breech infants was 36%. Apgar scores were not significantly different for infants delivered vaginally or abdominally. The crude perinatal mortality rate was 11.8; the corrected perinatal mortality rate was 0. These findings further substantiate the safety of these criteria in management of term breech presentations. PMID- 6493657 TI - Use of breast stimulation for antepartum stress testing. AB - Bilateral breast stimulation was used to evoke a spontaneous contraction stress test. The success rate and incidence of abnormal uterine activity using the stimulus was compared with patients tested by the authors' standard oxytocin stress test protocol. Bilateral breast stimulation was initially used for 346 tests between 32 and 43 weeks of gestational age. A satisfactory test, or three contractions within ten minutes, was obtained in 239 (69%) patients. The testing time was reduced with successful breast stimulation. The incidence of abnormal uterine activity after breast stimulation was not statistically different from that observed with oxytocin administration alone. However, when oxytocin was administered after breast stimulation, there was a significant increase in the incidence of prolonged contractions. PMID- 6493658 TI - Decidual morphology and F prostaglandin in amniotic fluid in stretch-induced abortion. AB - Two to four stems of Laminaria were inserted into the cervixes of seven healthy women at second trimester. Forty-eight hours later, the Laminaria in each patient were replaced with a rubber balloon (100 mL capacity) that was inflated with 150 to 180 mL of physiologic saline solution, and traction of 800 to 1000 g was applied for an additional 24 hours. During Laminaria application, marked cervical softening was noted in all cases, and weak but definite uterine contractions were initiated in three women. During the balloon application regular uterine contractions were initiated or increased in all patients, with three late second trimester patients aborting within 24 hours. Light and electron microscopic studies of the decidua parietalis obtained during apparent uterine activity and after abortion revealed normal cell morphology. A significant increase in amniotic fluid F prostaglandin was noted after the balloon treatment (P less than .05). The authors conclude that uterine stretching induces uterine activity and a rise of prostaglandin in amniotic fluid without disfunction of decidual cells. PMID- 6493659 TI - Microsurgical reversal of tubal sterilization: factors affecting pregnancy rate, with long-term follow-up. AB - Among 48 women with long-term follow-up after microsurgical reversal of tubal sterilization, the pregnancy rate correlated closely to the length of tube on the longest side. Aside from an accurate anastomosis, no other factor significantly affected pregnancy rate. PMID- 6493660 TI - Complications of low-dose heparin prophylaxis in gynecologic oncology surgery. AB - The clinical and laboratory effects of low-dose heparin prophylaxis was prospectively studied in a controlled trial of 182 patients undergoing major surgery for gynecologic malignancy. Low-dose heparin was given in 5000 U subcutaneously two hours preoperatively and every 12 hours for seven days postoperatively. Low-dose heparin-treated patients had a significantly increased daily retroperitoneal hemovac drainage. Although not statistically significant, low-dose heparin was associated with increased estimated intraoperative blood loss, transfusion requirements, and wound hematomas. Fifteen percent of patients receiving low-dose heparin were found to have an activated partial thromboplastin time greater than 1.5 times the control value. In these patients, all clinical bleeding parameters were significantly increased. Low-dose heparin-treated patients also had significantly prolonged activated partial thromboplastin time and lower final platelet counts as compared with the control patients. When using low-dose heparin for thromboembolism prophylaxis, patients should be closely observed for clinical hemorrhagic complications. Activated partial thromboplastin times and platelet counts should be monitored throughout therapy. PMID- 6493661 TI - Gynecologic carcinoma associated with dermatomyositis-polymyositis. AB - Dermatomyositis-polymyositis was associated with gynecologic carcinoma in ten patients treated at the Mayo Clinic between 1952 and 1982. Only two patients did not manifest the typical skin changes of acute dermatomyositis. In all ten cases, the onset of dermatomyositis-polymyositis preceded evidence of carcinoma. The intervals between initial symptoms of dermatomyositis-polymyositis and subsequent diagnosis of carcinoma ranged from three months to six years. Usually, the carcinoma became evident within two years. The carcinomas were ovarian in five cases, cervical in three, endometrial in one, and vaginal in one. Ages of the ten patients ranged from 40 to 66 years (mean, 53 years). In most cases, symptoms of dermatomyositis-polymyositis regressed markedly after diagnosis and treatment of the underlying carcinoma. In selected patients for whom more detailed follow-up information was available, the manifestations of dermatomyositis-polymyositis progressed and regressed in synchrony with tumor spread and effective treatment, respectively. PMID- 6493662 TI - Vaginal cancer after hysterectomy for benign disease: value of cytologic screening. AB - Of 87 patients who were treated at the author's institution for primary cancer of the vagina, 31 had undergone total hysterectomy for benign disease. In this group of 31 patients, vaginal bleeding was the most common presenting symptom, although there were eight patients who were entirely asymptomatic and were diagnosed on routine examination. The stage of cancer was more advanced in the symptomatic patients than in the asymptomatic patients. There were seven patients with stage 0 disease, and four of these were asymptomatic and diagnosed by routine Papanicolaou smear. Overall, Papanicolaou smears were positive in 12 of 19 patients tested, a sensitivity rate of 63%. The authors recommend that patients who have a hysterectomy for benign disease continue to have Papanicolaou smears taken from the vaginal vault at regular intervals. PMID- 6493664 TI - High failure rate of a plastic tubal (Bleier) clip. AB - Sixteen intrauterine pregnancies (8.6%) have been documented among 187 women who had undergone direct placement of American-made Bleier clips for sterilization. Of these, five pregnancies (10.2%) followed clip placement in 49 cesarean deliveries, nine pregnancies (8.2%) followed 110 infraumbilical postpartum procedures, and two pregnancies (7.1%) occurred in 28 interval minilaparotomy patients. Resterilization by tubal segment excision has been performed in five unsuccessful cases. In one case, the excised portions of tube with clips in place were studied by radiologic and histologic methods. Tubal patency may persist if the oviduct is trapped in the catch portion of the clip. PMID- 6493663 TI - Lymphocyte cytotoxicity in the peritoneal cavity and blood of patients with ovarian cancer. AB - After an intensive course of combination chemotherapy, 16 patients with minimal residual ovarian cancer that was documented at second-look laparotomy, had an indwelling Tenckhoff catheter placed and underwent multiple peritoneal saline lavages. Lymphocyte-enriched populations from the peritoneal cavity and peripheral blood were obtained by density gradient centrifugation and examined for cell-surface phenotype and a variety of immune functions, including natural killer cytotoxicity and antibody-dependent cell-mediated cytotoxicity. Phenotypic characterization revealed that peritoneal lymphocytes consisted primarily of T cells and cells bearing receptors for the crystallizable fragment of immunoglobulin G (IgG) (crystallizable fragment-receptor), and contained a very low number of B cells. Peritoneal natural killer lymphocyte cytotoxicity and antibody-dependent cell-mediated cytotoxicity were very low in all but two patients. Incubation of peritoneal lymphocytes with Corynebacterium parvum and interferon in vitro did not result in augmented cytotoxicity against susceptible targets. Supernatants from cultured peritoneal cells of all patients markedly inhibited natural cytotoxic activity of normal donor blood lymphocytes. These results suggest that lymphocytes collected from the peritoneal cavity of patients with minimal residual ovarian cancer are deficient in natural and antibody dependent cytotoxic effector function. This deficiency may influence the host's ability to control the spread and proliferation of tumor cells in the peritoneal cavity. PMID- 6493665 TI - Triplet pregnancy with second trimester abortion and delivery of twins at 35 weeks' gestation. AB - A triplet pregnancy is described in which there was a second trimester abortion of one fetus at 16 weeks' gestation. A cervical cerclage was placed, and tocolysis was used. The other two triplets were delivered 131 days later (at 35 weeks' gestation) by cesarean section. Both infants survived. This case is unique in the literature. PMID- 6493666 TI - Fetal supraventricular tachycardia: in utero therapy with digoxin and quinidine. AB - Digoxin has been successfully used to treat fetal supraventricular tachycardia. When therapy with digoxin fails, alternative therapies have met with equivocal success. In this report, successful fetal therapy with maternally administered digoxin and quinidine is presented in three consecutive patients with fetal supraventricular tachycardia. The arrhythmia was eliminated in each instance. Fetal ascites, present in two fetuses, was completely reversed. Intrapartum fetal distress was not observed. The rationale of this therapy and a review of pertinent literature are also presented. PMID- 6493667 TI - Emphysematous pyelonephritis in a patient with diabetes mellitus and total pelvic exenteration. AB - A case of emphysematous pyelonephritis in a women with diabetes mellitus who previously underwent total pelvic exenteration is presented. The emergency nature of this syndrome and its therapy are discussed. PMID- 6493668 TI - Neonatal outcome among low birth weight infants delivered spontaneously or by low forceps. PMID- 6493669 TI - The intrauterine device and uterine perforation. PMID- 6493670 TI - Judge physicians by care, not income. PMID- 6493671 TI - It's not fun anymore. PMID- 6493672 TI - What the state found out about health care costs. PMID- 6493673 TI - Switch. An investigation of change during medical school. PMID- 6493674 TI - Where are we . . . and where do we go from here? An overview from the deans of Ohio's six allopathic medical schools. PMID- 6493675 TI - Where are we . . . and where do we go from here? Viewpoints from six Ohio students. PMID- 6493676 TI - Medical education: who pays the bill? PMID- 6493677 TI - Our future in medicine. PMID- 6493678 TI - Management of failing filtering blebs with the Argon laser. AB - Using the Argon laser and a special lens, the authors have developed a technique for cutting trabeculectomy flap sutures through the overlying conjunctiva. The technique is described and three case reports are presented. The availability of this technique permits suturing the scleral flap tightly, thus minimizing postoperative flat chambers. If filtration is inadequate in such cases, suture cutting with the laser can open the flap and permit more successful filtration. PMID- 6493679 TI - Trabeculectomy vs. nonpenetrating trabeculectomy: a retrospective study of two procedures in phakic patients with glaucoma. AB - In a retrospective study we compared the efficacy and safety of trabeculectomy and nonpenetrating trabeculectomy (NPT). In the latter procedure under a thin scleral flap, juxtacanalicular trabecular meshwork with Schlemm's canal is excised leaving the innermost trabecular meshwork behind. Trabeculectomy was performed on 86 eyes (66 blacks, 20 whites), whereas 71 eyes underwent NPT (44 blacks, 27 whites). The mean follow-up period was 1.7 years. Postoperatively at one year, trabeculectomy controlled 70.3% of patients with no or topical antiglaucoma medication, whereas 83.7% of NPT patients were similarly controlled. There was a difference in the number and severity of complications between trabeculectomy and NPT. Postoperative flat anterior chamber, uveitis, hyphema, vitreous loss, and choroidal detachment occurred more frequently after trabeculectomy. PMID- 6493680 TI - The use of the Mayfield headrest to perform retinal surgery in the prone position. AB - A Mayfield neurosurgical headrest positioned at the end of a standard operating room table may be utilized to achieve the prone positioning necessary to perform certain types of ophthalmic procedures, such as the unfolding of the inverted flap of a giant retinal break. We describe the technique of employing this readily available headrest. PMID- 6493681 TI - A new method for inferior capsulotomy in the face of ruptured zonules. AB - During routine planned extracapsular cataract extraction, rupture of the inferior zonules was noted while performing the superior portion of the anterior capsulotomy. After the nucleus expression and cortical aspiration, a Sheets glide was placed in the anterior chamber between the anterior and posterior capsule, deep into the capsular bag. This provided a platform for the performance of a controlled inferior capsulotomy in the face of weakened zonular support. PMID- 6493682 TI - Orbital hemorrhage with proptosis following a dacryocystorhinostomy. AB - A 65-year-old patient with chronic leukemia underwent an uncomplicated dacryocystorhinostomy. On the first postoperative day, the eye was proptotic and chemotic with restricted movements. A CT scan revealed a medial juxtabulbar hemorrhage that blocked the surgical osteotomy. A clot was locally suctioned through the nose, and the symptoms resolved over the following weeks. PMID- 6493683 TI - A simplified light filter for microsurgery. AB - A simple, no-cost filter has been devised by the authors to prevent potentially harmful light from reaching the retina during a microsurgical procedure. The filter is made by cutting a 6-mm circle from the edge of a Weck-cel package, then soaking it in balanced salt solution. The disc is placed on the cornea except when manipulations are being performed in the anterior chamber. PMID- 6493685 TI - New instrument: a wet-field cordless coagulator. PMID- 6493684 TI - Evidence of zonular rupture: free cortical material in the patellar fossa. AB - Free floating cortical material beneath the posterior capsule is a sign which should alert the surgeon to the presence of zonular rupture. PMID- 6493686 TI - YAG capsulotomy and IOP rise. PMID- 6493687 TI - Marked intraocular pressure rise following Nd:YAG laser capsulotomy. PMID- 6493688 TI - Corneal endothelial cell density in acute angle-closure glaucoma. AB - The endothelial cell density of 44 eyes after an acute attack of angle-closure glaucoma is statistically lower than the cellular density of 174 control eyes. The decrease in endothelial cell density increases the risk of edematous corneal dystrophy, more specially after surgery (e.g. cataract extraction). The modifications in corneal endothelial cell density are compared with the alterations of the iris after a crisis of angle-closure glaucoma. PMID- 6493689 TI - Topical treatment of periocular basal cell epithelioma with solcoderm. AB - 25 patients with 29 histologically confirmed periocular basal cell epitheliomas were treated by topical application of Solcoderm, a solution of organic and inorganic acids and ions. The cure rate of the 29 lesions, which were followed for a mean period of 32 months, was 80%. The overall cure rate following second Solcoderm treatment of the 6 recurrent lesions was 96.7%. The cosmetic and functional results were excellent and there were no serious complications and side effects. PMID- 6493690 TI - Atrophies 'like flows' of the retinal pigment epithelium: a neuroepithelium draining method of the posterior pole. AB - 17 cases of eyes affected jointly by diseases of the posterior pole (central serous chorioretinopathy, serous detachment of pigmented epithelium, melanoma, osteoma, hemangioma) and flow-like atrophy of the pigmented epithelium, originating from the lesion and always directed downwards, are presented. It is likely that serous detachment of the neuroepithelium constituting the original wound (central serous chorioretinopathy) or the secondary one (serous detachment of the pigmented epithelium) of the posterior pole prolongs itself downwards, leaving a localized atrophy as a mark on the pigmented epithelium. The eventual draining role of serous detachment of the neuroepithelium by this 'flow' is disputed. PMID- 6493691 TI - Unilateral central retinal vein occlusion in systemic lupus erythematosus. AB - A case of unilateral central vein occlusion occurring in a normotensive patient with systemic lupus erythematosus (SLE) is reported. This vasculitis is related to SLE. In spite of the observation of circulating immune complex and a positive response to the human basophil degranulation test in the presence of bovine soluble retinal antigen, the real pathogenesis of this unilateral vasculitis remains obscure. PMID- 6493692 TI - Cavitary melanocytoma of the ciliary body. AB - The clinical and pathologic findings of a patient with an unusual cavitary melanocytoma of the ciliary body are presented. Clinically and with ultrasonography the lesion appeared to have a cystic component. Differential diagnoses included a malignant melanoma or a cyst, and the lesion was excised by iridocyclectomy. PMID- 6493693 TI - Retinitis pigmentosa associated with astrocytic hamartomas of the optic disc. AB - A case of retinitis pigmentosa associated with astrocytic hamartomas of the optic disc is described. The rarity of tuberous sclerosis in this association is discussed, as well as differences between optic nerve head drusen and astrocytic hamartomas ('giant drusen') which can both be associated with retinitis pigmentosa. PMID- 6493694 TI - Experimental investigations on the effect of desferrioxamine on the aqueous level of iron administered intraorbitally. AB - Rabbits with an iron foreign body in the orbit were given transconjunctival injections of desferrioxamine every 4th day. It was found that after 12 months the level of iron in the aqueous of their eyes was distinctly lower than in another group, which received no medication. Under the conditions of the experiment, desferrioxamine distinctly prevented extrabulbar iron from penetrating into the eyeball. PMID- 6493695 TI - Excess of cancer deaths in close relatives of patients with bilateral retinoblastoma. AB - Cancer deaths among close relatives of 19 patients with bilateral retinoblastoma were reviewed. Altogether 18 deaths of nonocular cancer were found in 5 families. These constitute 5% of the entire material of 365 relatives. The main types of cancer were stomach (6 cases), bronchial (3 cases), urinary bladder carcinoma (2 cases), as well as 2 cases of reticulosarcoma and 1 of leukemia. The retinoblastoma gene may also be associated with higher incidence of cancer in families of retinoblastoma patients. PMID- 6493696 TI - Letter legibility and the construction of a new visual acuity chart. AB - The ability to identify letters of different size remains, in relation to the allowed effort, the most informative measure of visual capacity. Numerous letter charts have been produced with varying design, size, and size progression of the letters. Attempts to 'standardize' letter testing have been fruitless. In Sweden, the most commonly used letter charts show deficiencies in letter selection, size, and progression. In the present study, letter legibility was studied. 10 letters of average legibility were selected and a new chart constructed using these letters in sizes corresponding to acuities from 0.1 to 2.0. A geometric size progression was found optimal (factor 1.26). PMID- 6493697 TI - A little-known phenomenon: allergic reaction to hyaluronidase. PMID- 6493698 TI - Early corneal findings in Cogan's syndrome. AB - We evaluated the ocular manifestations of Cogan's syndrome in 13 consecutive patients. The most frequent and earliest ocular finding was bilateral peripheral subepithelial keratitis consisting of faint, nummular lesions. The subepithelial keratitis was responsive to topical administration of corticosteroids. Peripheral subepithelial keratitis was seen in four patients and strongly suspected on review of history in three additional patients. Deep stromal keratitis was seen in two patients, while only one patient developed classic findings of Cogan's syndrome, ie. interstitial keratitis with vascularization. Additionally, five patients presented with noncorneal ocular inflammatory disease and deafness (atypical Cogan's syndrome). Early subepithelial keratitis in Cogan's syndrome may be mistakenly diagnosed as trival ocular inflammatory disease, and suppressed by topical corticosteroids, resulting in delayed diagnosis of Cogan's syndrome in the absence of classic corneal findings. Early diagnosis of Cogan's syndrome is important inasmuch as prompt treatment of cochlear symptoms with systemic corticosteroids may prevent or ameliorate deafness. PMID- 6493699 TI - Dominant optic atrophy, deafness, ptosis, ophthalmoplegia, dystaxia, and myopathy. A new syndrome. AB - Twenty-three members of a 96-member family exhibited an autosomal dominant disorder which has not previously been described. This disorder involves progressive optic atrophy, abnormal electroretinography without retinal pigment changes, and progressive sensorineural hearing loss usually evident in the first or second decade of life. In midlife, ptosis, ophthalmoplegia, dystaxia, and a nonspecific myopathy occur. PMID- 6493700 TI - The Gardner syndrome. Significance of ocular features. AB - Gardner syndrome is a dominantly inherited familial cancer syndrome characterized by intestinal polyposis, bony hamartomata, and various soft tissue tumors. The risk of malignancy during adult life is essentially 100%, but as yet no phenotypic marker nor biochemical or serological linkage have been useful to identify the presence of the gene in early life. We studied three families in which multiple and bilateral patches of congenital hypertrophy of the retinal pigment epithelium are related uniquely to other phenotypic features of the Gardner gene. This readily identifiable characteristic may be useful to identify early in life individuals at risk for malignancy. We also suggest that the Gardner syndrome may be genetically heterogeneous. PMID- 6493701 TI - Ocular findings in Turner syndrome. A prospective study. AB - We performed complete ophthalmological examinations of 30 consecutive patients with Turner syndrome. Twenty-three had 45XO and 7 had 45XO/46XX karyotypes (mosaicism). Non-familial strabismus was the most prominent ocular abnormality and was present in 33% of the patients. Other eye findings included ptosis (16%), hypertelorism (10%), epicanthus (10%), and antimongoloid slants (10%). Red-green color deficiency was found in 10% of the patients. One patient had congenital periodic alternating nystagmus. PMID- 6493702 TI - Ocular involvement in neuroblastoma: prognostic implications. AB - Neuroblastoma is one of the commonest childhood malignancies. The most important prognostic factor is age at diagnosis; early diagnosis, when the tumor is still localized and surgically resectable, is second in importance. On retrospective review of children seen at the Hospital for Sick Children, ophthalmic involvement was seen in 80 of 405 (20%). The three major eye signs of neuroblastoma, proptosis, Horner's syndrome and opsoclonus, are closely related to the site, stage of tumor, and outcome of the patient. Proptosis or periorbital ecchymosis due to orbital metastases was present in 60 of 80 children (bilaterally in 33). The 3-year survival rate was 11.2%. In 53 of 60 cases with orbital metastases the neuroblastoma originated in the abdomen. Unilateral Horner's syndrome occurred in 14 children, as the presenting sign in 9, related to localized disease in 11 and in a favorable location (cervical or thoracic neuroblastoma) in 8. The 3-year survival rate was 78.6%. Opsoclonus-myoclonus was the presenting sign of occult, localized neuroblastoma in all 9 children in whom it occurred. The 3-year survival rate was 100%. For all presentations, girls had a significantly better survival rate than boys (48.7% vs. 22.4%). Children presenting with any of these ophthalmological signs should undergo thorough and repeated investigations searching for neuroblastoma. PMID- 6493703 TI - Scleritis, pericarditis, and aortic insufficiency in a patient with rheumatoid arthritis. AB - A 55-year-old black man developed anterior nodular scleritis in his left eye in November 1981. He had no symptoms of systemic disease, and initial laboratory tests revealed only a positive rheumatoid factor. Fourteen months later he presented with pericarditis and aortic insufficiency requiring aortic valve replacement. Examination of excised valvular and pericardial tissue showed changes compatible with rheumatoid disease. Shortly after the surgery he developed florid rheumatoid arthritis. The clinical course of this patient illustrates how scleritis can be the initial sign of severe systemic disease. PMID- 6493704 TI - Grating and recognition acuities of pediatric patients. AB - Acuities for gratings obtained by preferential looking (PL) that differed from expectations based upon the ophthalmologic examination prompted this study. Older pediatric patients (124 patients; mean age, 6.5 years) were tested by the PL grating test and a test of recognition acuity (pictures or letters). On the average, grating acuity was better than recognition acuity. In patients with dense amblyopia or foveal abnormalities, very large discrepancies between grating and recognition acuities were found. In nonamblyopic patients, acuities were no more discrepant than for children with normal eyes. Amblyopia was less dense by grating acuities than by recognition acuities; grating acuities were sensitive, however, to refractive and organic amblyopia but not to strabismic amblyopia. Possible explanations include the heterogeneity of patients' eye disorders, single vs. linear acuity, stimulus size and relative complexity of stimuli. These results can aid in evaluating PL grating acuities of preverbal patients, and suggest modifications of stimuli to investigate amblyogenesis. PMID- 6493705 TI - Delayed conjunctival closure in adjustable strabismus surgery. AB - Adjustable suture strabismus surgery has proved to be a significant aid in handling difficult strabismus cases, and various methods of conjunctival closure have been discussed. A new method of conjunctival closure, enabling direct visualization and manipulation of the muscle with minimal tissue drag during adjustment, is described. The conjunctiva can be fully closed over the knot after adjustment, providing increased patient comfort and a better cosmetic result. PMID- 6493706 TI - Conjunctival resection for superior limbic keratoconjunctivitis. AB - Ten patients with superior limbic keratoconjunctivitis were examined. Eight patients were female and 9 had bilateral disease. Five of the 10 patients had a history of thyroid disease. Two of the patients had filaments and four had a significantly decreased tear production. A conjunctival resection was carried out in all of the patients. Postoperatively, eight of these patients were either asymptomatic or much improved. Two patients with decreased tear production showed no improvement. Preoperatively, a normal Schirmer's test is helpful in predicting the success of conjunctival resection. PMID- 6493708 TI - Functional anatomical reconstruction in an oculofacial prosthesis. AB - The exenterated, maxillectomy, and/or palatectomy patient is ideally referred prior to surgery for two primary reasons: (1) to reassure the patient of an attempt to restore appearance and function to nearly the same as before ablative surgery, and (2) to make an entire face alginate impression for post surgical replication. The sixth week postoperatively, a second full-face alginate impression is made of existing wound and remaining anatomy. Photographs are taken for comparative sculpting. The prosthesis is designed to redirect airflow to a normal pattern in order to avoid "blow out" of the prosthesis from a sneeze or cough. Bone-like acrylic sinus replication provides normal speech resonance, a bonding surface for Silastic "skin" and a hollow socket for an impression-fitted prosthetic eye. The prosthetic eye, intrinsic pigmentation and extrinsic pigmentation, eye lashes and brows are incorporated into completed prosthesis. A combination of aesthetic and functional elements into a single three- or four piece prosthesis provides restoration of natural appearance, improved functions of facial anatomy, and improved breathing, sinus drainage, speech articulation and resonance. PMID- 6493707 TI - Prevention of ocular gunshot injuries using polycarbonate lenses. AB - Two patients lost three eyes, and one his life, secondary to ocular gunshot wounds. In both patients, the pellets gained entry into the central nervous system through the eye and orbital bones despite only superficial wounds to other areas of the body. These tragic injuries prompted a study of polycarbonate lenses to determine their effectiveness in preventing small caliber ocular gunshot wounds. This investigation determined that 3.0 mm and the 2.2 mm polycarbonate lenses could prevent such injuries at distances greater than 15 yards. In comparing the two lenses, it was found that the 3.0 mm lens sustained less damage at 70 degrees F, but the 2.2 mm lens was more resistant to penetration at 32 degrees F. Since most hunting is done in the fall and winter months, the brittle nature of the thicker lens is significant. Polyamide sports frames with a posterior rim were also tested and found to prevent posterior lenticular expulsion at 15 yards. Standard acetate frames were shown to be ineffective in this regard at 30 yards. PMID- 6493709 TI - Malignant syringoma of the eyelid. AB - Two cases of malignant syringoma of the eyelid are reported. The first patient, a 20-year-old woman, presented with a one year history of a slowly growing nodule in the left lower eyelid. The lesion recurred five months after excision, slowly grew over the ensuing two and one-half years, and was reexcised. The second case was an 18-year-old man who was first examined by an ophthalmologist because of a slowly enlarging, painless induration of his right lower eyelid for two years. Histologic examination of the excised lesions from both patients disclosed proliferated ducts lined by two layers of epithelium infiltrating the dermis and subcutaneous tissue; there was skeletal muscle and perineural invasion, but only minimal cellular atypia. Malignant syringomas are rare forms of sweat gland carcinoma, which most often occur on the upper lip and to our knowledge have not been reported on the eyelid. These tumors probably arise from eccrine ducts, are more common in women, and have a peak incidence in the fifth decade. The histologic feature that best indicates prognosis is the degree of cellular atypia. Patients with cytologically well-differentiated tumors do well following complete local excision. Features that help to distinguish malignant syringoma from its benign counterpart are the larger size, solitary nature, and subcutaneous, muscular, and perineural invasion. PMID- 6493710 TI - Ocular abnormalities in abetalipoproteinemia. A clinicopathologic correlation. AB - The present paper documents the clinical characteristics and ocular pathology in a patient with abetalipoproteinemia. Noteworthy were: the predominant involvement of the posterior fundus characterized by a loss of photoreceptors; loss or attenuation of the pigment epithelium (producing a sharply demarcated white appearance on ophthalmoscopy); preservation of the submacular pigment epithelium with an excessive accumulation of lipofuscin (including bizarre laminar profiles by electron microscopy); invasion of the retina by macrophage-like pigmented cells. The retina and pigment epithelium in the periphery were morphologically normal. The patient died of a presumably unrelated brain tumor which was believed to have accounted for the terminal blindness and loss of ganglion cells in the retina. PMID- 6493711 TI - Retinal telangiectasia. PMID- 6493712 TI - Argon laser trabeculoplasty. Studies of mechanism of action. AB - The effects of argon laser trabeculoplasty (LTP) on outflow facility, Schlemm's canal morphology, trabecular cellularity, and trabecular glycosaminoglycan composition were determined in 33 pairs of eye-bank human eyes. At two levels of intraocular pressure, measured outflow facility did not immediately drop in response to LTP. Schlemm's canal distention was observed only at 40 mmHg intraocular pressure, where the canal normally tends to collapse. Trabecular cell density was reduced by about 40% in the eyes receiving laser treatment. The organ cultured trabecular meshworks in response to LTP altered their incorporation of 35S-sulfate, compared to controls, suggesting a change in the synthesis or turnover of the extracellular matrix of the trabeculum after trabeculoplasty. At least three potential mechanisms were identified in response to laser trabeculoplasty, including some mechanical distortion of the trabeculum at high intraocular pressures. We also hypothesize that laser trabeculoplasty dislodges some trabecular cells and may stimulate the remaining cells to renew more active synthesis and/or turnover of the trabecular extracellular matrix. PMID- 6493713 TI - Trabeculectomy in aphakic eyes. AB - One hundred twenty-seven trabeculectomies performed on aphakic eyes at the Bascom Palmer Eye Institute (BPEI) between 1972 and 1982 were reviewed. Forty-five cases were excluded from data analysis: 28 in eyes with confounding conditions, such as neovascular glaucoma; ten with follow-up of less than six months; and seven that were the second or third trabeculectomy performed at the BPEI in six eyes. Of the remaining 82 trabeculectomies in 82 eyes: 32 (39%) were categorized as successes (eyes that achieved an intraocular pressure of less than or equal to 21 mmHg with medication or less than or equal to 25 mmHg without medication); eight (10%) were categorized as qualified failures (eyes that had an intraocular pressure of greater than 21 mmHg despite medication or greater than 25 mmHg without medication); and 42 (51%) were categorized as complete failures (eyes that underwent further glaucoma surgery, had further glaucoma surgery recommended, or lost light perception). In the 20 eyes of the patients younger than 50 years of age, only one (5%) was categorized as a success; while in the 62 eyes of the patients 50 years of age or older, 31 (50%) were categorized as successes. PMID- 6493714 TI - Modern goniosynechialysis for the treatment of synechial angle-closure glaucoma. AB - A new and successful technique for goniosynechialysis is described. The essentials of the technique include: (1) use of the chamber deepening procedure to provide a wide, safe entrance to the angle; (2) use of sodium hyaluronate to hold the deepened configuration and to stop and localize bleeding, thus maintaining visibility; (3) use of an irrigating cyclodialysis spatula to hold the deepened chamber, to stop bleeding and to perform the lysis; and (4) direct visualization of the angle. Four cases with severe synechial angle closure of one year's duration or less were cured. An additional case of longer duration was significantly improved. The procedure should be considered for those patients who have developed significant synechial angle closure and high pressure, and in whom the synechiae have not been present for a prolonged period of time. PMID- 6493715 TI - Glaucoma in Sturge-Weber syndrome. AB - Trabeculectomy specimens from three eyes with Sturge-Weber syndrome were examined histopathologically. Changes in the trabecular meshwork-Schlemm's canal system were similar to findings in old age and in primary open-angle glaucoma. Two mechanisms for glaucoma are theorized. In cases with buphthalmos and congenital glaucoma, the chamber angle is often anomalous, as in other types of congenital glaucoma. In later onset juvenile cases, the chamber angle more often appears normal. A premature aging of the trabecular meshwork Schlemm's canal complex, as shown by us histopathologically, is a primary cause of juvenile glaucoma. It is suggested that both mechanisms relate to the abnormal hemodynamics of episclera and chamber angle, due to persistence of Streeter's primordial vascular plexus. PMID- 6493717 TI - Ptosis and underaction of the superior rectus muscle. AB - It is suggested that the association of ptosis and superior rectus muscle underaction is most likely due to the common embryological origins of these two muscles from the same superior mesodermal complex. PMID- 6493716 TI - Timing of vitrectomy after penetrating ocular injuries. AB - The visual outcome, as well as the preoperative sensory and anatomic status, of 49 eyes undergoing vitrectomy within 72 hours after a penetrating injury, was compared to 54 eyes with penetrating injury operated on by vitrectomy at longer intervals. The eyes operated on within 72 hours of the injury had a better visual outcome than those operated on later, but this difference was not statistically significant. However, there were important differences between the two patient groups. Eyes undergoing vitrectomy within 72 hours had a better initial visual acuity after injury, a greater percentage of anteriorly located lacerations, fewer cases of severe vitreous hemorrhage, and a higher proportion of cases with an intraocular foreign body. Each of these factors had been shown previously to be associated with a comparatively favorable visual prognosis in eyes treated by conventional means of wound repair without vitrectomy. Therefore, the visual acuity differences among the two main groups in this study are probably due to differences in the types of cases selected for early versus later vitrectomy, rather than to the difference in the timing of surgery. PMID- 6493718 TI - Limitations of computerized tomography in the localization of intraocular foreign bodies. AB - Computerized tomography (CT) scanning was used to evaluate nine patients with intraocular foreign bodies. We found that significant limitations of this method still exist, even with high resolution scanners, in the localization of extremely small, multiple or relatively radiolucent foreign bodies and those located near the ocular wall. PMID- 6493719 TI - Histoplasma capsulatum in the eye. AB - The ocular pathologic findings in an immunosuppressed patient who died of disseminated histoplasmosis are described. Histoplasma capsulatum was found in large numbers within the endothelial cells of the choroid, in one area each of the ciliary body and trabecular meshwork. There was a minimal inflammatory response. No granulomas were noted. Previously reported cases of ocular histoplasmosis in immunosuppressed patients are similar in that, with one exception, granulomatous inflammation was not demonstrated. Thirteen eyes in which histoplasma organisms have been found in the eye are reviewed. PMID- 6493720 TI - Polyclonal orbital and systemic infiltrates. AB - Two unusual cases of benign lymphoproliferative disease associated with orbital and systemic involvement are described. Both have occurred in adults with longstanding histories and clinical manifestations that have mimicked lymphomas. The orbital disease has been both antecedent and subsequent to the systemic lesions. These cases emphasize the spectrum of lymphoproliferative disorders and call attention to the possibility of multisystem disease in patients with benign lymphoproliferative lesions. PMID- 6493722 TI - 1984 annual meeting program: American Academy of Ophthalmology. Atlanta, November 11-15. PMID- 6493721 TI - Nonteratoid medulloepithelioma of the ciliary body. AB - A 34-month-old girl was treated for anterior uveitis, a superiorly subluxated cataract, rubeosis iridis and secondary glaucoma of the right eye of 3 months duration. She was diagnosed as having medulloepithelioma only after a mass was subsequently identified on the anterior surface of the iris. A low grade malignant nonteratoid medulloepithelioma was found to involve the ciliary surface throughout the circumference of the enucleated right globe. These tumors are generally associated with a good prognosis for survival, but are potentially lethal when they extend extrasclerally. PMID- 6493723 TI - Measurements of mass, length and valve diameters from normal formalin-fixed ovine hearts. AB - Hearts from 60 Merino sheep of known age, sex and live mass and with no known history of disease were collected and fixed in buffered 10% formalin. Systematic light microscopical examination did not indicate any abnormality in hearts of any of the sheep. The mass of various parts of the hearts, the length of the hearts and the diameters of the heart valves were measured to establish a basis for quantitative assessment of possible pathological changes associated with the ingestion of cardiotoxic plants. The mass measurements and, to a lesser degree, the lengths of the hearts varied considerably, but the ratio of the mass of the left ventricle plus ventricular septum divided by the right ventricular free wall mass was remarkably stable, and is promising as an indicator of right ventricular hypertrophy. PMID- 6493724 TI - Seasonal abundance and distribution of Parafilaria bovicola ovipositional blood spots on cattle in South Africa. AB - More than 23 000 cattle of both sexes and different ages were examined for blood spots caused by egg-laying females of P. bovicola. Although these studies extended over four years and involved 5 farms in different parts of the Transvaal Bushveld, the overall results were the same. Ovipositional bleeding was strongly seasonal with blood spots first appearing in winter (June), reaching a peak in spring (September-November) and thereafter declining rapidly as summer progressed. In a single year at Zoutpan Research Station up to 92,1% of the 1st year heifers had already bled by November and this proportion increased only slightly to 95,1% by the end of the bleeding season (May). The number of blood spots per animal showed a similar seasonal abundance except for a second peak of abundance in June for 1st year heifers and oxen. The prevalence of blood spots in cattle of different ages and sex varied markedly. At Mara Research Station half as many oxen bled in their 2nd year as in their 1st year, while at Zoutpan 19,2% fewer heifers bled in their 2nd year than in their 1st. Bulls bled the most, then 1st year oxen, 1st and 2nd year heifers and 2nd year oxen, with breeding cows bleeding the least. A high female hormone level appears to be associated with the development of immunity. The shortest period from birth to 1st blood spot (the apparent prepatent period) was 191 days, while 81,8% of oxen bled for the 1st time within 279 days after birth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493725 TI - The longevity of adult Parafilaria bovicola and the persistence of their associated carcass lesions in cattle in South Africa. AB - The slaughter of naturally-infected heifers and oxen at regular intervals after the first P. bovicola ovipositional blood spots appeared revealed that no female worms with embryonated eggs could be found after 259 days, no live worms after 372 days, and no carcass lesions after 519 days. In one bull, however, blood spots and carcass lesions persisted throughout 2 seasons. With the possible exception of bulls, therefore, annual reinfection of cattle appears to be necessary for the continuation of the transmission cycle of P. bovicola. PMID- 6493726 TI - Pathology of a nervous disorder (pushing disease or "stootsiekte") in cattle caused by the plant Matricaria nigellifolia DC. (Asteraceae). AB - Brains from 10 bovine field cases of pushing disease, a nervous disorder caused by the plant, Matricaria nigellifolia, were examined by light microscopy. Moderate to marked encephalitis, characterized by predominantly perivascular microgliosis, perivascular lymphocytic infiltrates and reactive changes in astrocytes, was present in all the brains. The lesion was concentrated in the white matter throughout the forebrain and midbrain. Dried, milled M. nigellifolia was dosed to 6 steers. Clinical signs of pushing disease, which included docility, clumsiness and pushing against objects, appeared abruptly in 5 of the steers after a latent period that varied from 16-44 days. The lowest total dose of plant that proved toxic was 10 g/kg. The length of the latent period appeared to be related inversely to the total dose. Encephalitis, which was similar in nature and distribution to those in the field cases, was demonstrated in the 5 affected steers. The lesion was minimal in the brain of the steer that did not develop pushing disease. The cerebral lesion is sufficiently consistent and distinctive to be useful in establishing a diagnosis of pushing disease. The perivascular distribution of microgliosis suggests that the site of the toxic insult is the cerebral vasculature. Botanical information is presented. PMID- 6493727 TI - Parasites of South African freshwater fish. II. Redescription of the African species of the genus Phyllodistomum Braun, 1899 (Trematoda: Gorgoderinae) and the description of a new species. AB - During 1980 a survey of the parasites of freshwater fish was conducted in the Sabie and Crocodile Rivers in the southern part of the Kruger National Park, Transvaal. A new species of Phyllodistomum, Braun, 1899, for which the name Phyllodistomum bavuri is proposed, was found in the urinary bladder of many of the catfish, Clarias gariepinus (Burchell, 1822), examined. The new species resembles Phyllodistomum linguale Odhner, 1902 and Phyllodistomum vanderwaali Prudhoe & Hussey, 1977, but may be differentiated from the former species in that the ovary and the vitellaria are smooth, while those of P. linguale are irregularly lobed. The ovary of P. vanderwaali is irregularly lobed while that of P. bavuri never has more than 3 indistinct lobes. In addition, P. bavuri is much larger than P. vanderwaali. P. bavuri is readily differentiated from the other 4 African species of Phyllodistomum, namely, Phyllodistomum spatula (Odhner, 1902), Phyllodistomum spatulaeforme (Odhner, 1902), Phyllodistomum ghanense Thomas, 1958 and Phyllodistomum symmetrorchis Thomas, 1958. For comparative purposes the African species are briefly redescribed and illustrated. P. bavuri occurred throughout the year and their numbers do not appear to fluctuate seasonally in the Kruger National Park. PMID- 6493728 TI - Laboratory and field trials with two Bacillus thuringiensis var. israelensis products for Simulium(Diptera: Nematocera) control in a small polluted river in South Africa. AB - The effects on Simulium adersi and S. hargreavesi larvae of 2 Bacillus thuringiensis var. israelensis products, the liquid formulation "Teknar" (Sandoz) and a powder formulation produced by the Ben Gurion University, Israel, were compared in the laboratory and in the Pienaars River. This river was heavily polluted with effluent from a nearby sewage works and contained 77 mg/l chloride. In the laboratory S. adersi and S. hargreavesi larvae showed 26; 48; 95 and 100% mortality 6 hours after a 10-minute application of 0,8; 1,6; 3,2 and 16 ppm "Teknar" in rain water. The powder formulation applied at 0,2; 1,0; 2,0 and 30 ppm resulted in a 7; 17; 35 and 100% mortality. In polluted river-water the mortality was 85% with 16 ppm "Teknar" and 80% with 30 ppm B. thuringiensis powder. In the field trials "Teknar" at 1,6 ppm and B. thuringiensis powder at 3 ppm did not cause any larval mortality at flow rates of 3 060 l/min and 2 040 l/min, respectively. However, 24 hours after application of the powder formulation, numbers of S. hargreavesi decreased significantly (P = 0,05) 20 m below the application point. A further 24 hours later, after "Teknar" had been applied, the numbers of S. adersi decreased and those of Chironomidae increased significantly. There was a significant increase in S. hargreavesi 200 m downstream after treatment with "Teknar". PMID- 6493729 TI - Parasites of domestic and wild animals in South Africa. XVII. Arthropod parasites of Burchell's zebra, Equus burchelli, in the eastern Transvaal Lowveld. AB - Thirty-five Burchell's zebra, Equus burchelli, were shot for arthropod parasite recovery during the period November 1978-January 1982 in the Kruger National Park. Six species of gasterophilid larvae, 2 species of oestrid larvae, 2 louse species and 7 ixodid tick species were recovered. The distribution of the Gasterophilus spp. larvae within the gastrointestinal tract and their seasonal prevalence were determined. The seasonal prevalence of the oestrid larvae and 4 of the 7 ixodid tick species was also ascertained. PMID- 6493730 TI - Furunculosis in rainbow trout (Salmo gairdneri) raised in sea water. AB - Ulcerative skin lesions were encountered in rainbow trout raised in sea water by a commercial concern in the Western Cape, South Africa. Grossly, the lesions resembled furunculosis but, histopathologically, they differed from typical furunculosis in that bacterial colonies were rarely found in the organs, and also the kidneys and spleens were minimally involved. The causative organism was identified as an achromogenic Aeromonas salmonicida that shared characteristics with all 3 subspecies, salmonicida, masoucida and achromogenes. This is the first report of an outbreak of this disease in South Africa. PMID- 6493731 TI - Further physiopathological features of experimental Homeria glauca (Wood & Evans) N.E.Br. poisoning in Merino sheep. AB - Three Merino sheep were given 3 g/kg of dried, finely-milled Homeria glauca (Natal yellow tulp) plant material intraruminally. Plasma glucose, cortisol, catecholamines and lactate were measured hourly and also at the moment of death. Rising plasma glucose was shown to be associated with rising plasma cortisol and catecholamines, and the metabolic component of tulp-associated acidosis was shown to be the result of lactate accumulation. PMID- 6493733 TI - Symposium on metabolic bone disease. PMID- 6493732 TI - Factors affecting the immunogenicity of Pasteurella haemolytica in mice. AB - An appreciable level of immunity from intraperitoneal infection with Pasteurella haemolytica was established in mice by using a vaccine prepared in a conventional bacteriological culture medium, with aluminium hydroxide gel as adjuvant. The level of immunity could not be elevated by using bacteria grown in tissue culture media, enriched brain heart infusion broth, the addition of serum to the media or by using bacteria that had been harvested in the logarithmic growth phase. Although various extracts of the bacteria elicited a distinct immunity, the immunogenicity of vaccines containing bacteria could not be enhanced by augmentation with those products. The potential application of the vaccine in cattle and sheep is discussed. PMID- 6493734 TI - The tissue pathologic features of metabolic bone disease. AB - In this article, an explanation and definition of basic terms used in metabolic bone disease are presented, with a review of histomorphometric findings in osteoporosis, osteomalacia, Paget's disease, and hyperparathyroidism. An appropriate bone biopsy protocol for diagnostic purposes is also presented. PMID- 6493735 TI - Renal osteodystrophy. AB - Patients with chronic renal failure often suffer from severe metabolic bone disease. This is usually either osteitis fibrosa cystica or osteomalacia. While parathyroidectomy is indicated in osteitis fibrosa cystica, desferrioxamine is an exciting new development in the treatment of osteomalacia. PMID- 6493736 TI - Treatment of osteoporosis with sodium fluoride and calcium: effects on vertebral fracture incidence and bone histomorphometry. AB - This article contains a report of the results of a study of 10 postmenopausal women with uncomplicated osteoporosis who were treated with sodium fluoride, calcium supplementation, and vitamin D. Spinal fractures ceased by 18 months, trabecular bone mass increased 26 per cent per year, and patients reported symptomatic improvement. PMID- 6493737 TI - Gaucher's disease. AB - This is a review of the classification, pathophysiology, and clinical manifestations of Gaucher's disease. The orthopedic manifestations of the disease include bone pain syndromes, pathologic fractures, and avascular necrosis of the femoral head in children and adults. PMID- 6493738 TI - The treatment of osteogenesis imperfecta. AB - In this article, the author discusses the classification, genetic patterns, histologic and radiographic features, and treatment of osteogenesis imperfecta. Four types of treatment are available: (1) drugs or medications to increase the strength of bone and decrease fractures, (2) physical therapy, (3) bracing and splinting, and (4) surgery, with the most effective treatment being an operation consisting of multiple osteotomies and intramedullary rod fixations. PMID- 6493739 TI - [Our experience with the surgical treatment of spinal osteochondrosis]. PMID- 6493740 TI - [Magnetotherapy in the complex treatment of lumbar osteochondritis]. PMID- 6493741 TI - [Fractures of the transverse processes of the lumbar vertebrae (clinical picture and diagnosis)]. PMID- 6493742 TI - [1-stage anterior and posterior spondylodesis]. PMID- 6493743 TI - [Features of the biochemical adaptation of intervertebral disks following experimental disruption of segmental circulation]. PMID- 6493744 TI - [Functional state of the lumbar intervertebral disks upon exposure to rapidly acting dynamic vertical stress]. PMID- 6493745 TI - [Mechanism of compression fractures of vertebrae as a result of falling on the spine]. PMID- 6493746 TI - [Venospondylography in the diagnosis of complications of inflammatory diseases of the spine]. PMID- 6493747 TI - [Corrector for surgery of the spine (1st clinical attempt at application)]. PMID- 6493748 TI - [Complex dynamic study of experimental papain arthritis]. PMID- 6493749 TI - [Hypermobility of the wrist joint in athletes]. PMID- 6493750 TI - [Mechanism of fractures of the navicular bone and the reliability of fixing its fragments with a screw]. PMID- 6493751 TI - [Using residual work capacity after hand injuries]. PMID- 6493752 TI - [Relation between the economic efficiency of treating patients with open hand injuries and the method of performing primary surgical treatment of the wound]. PMID- 6493753 TI - [Manual method of correcting subluxation of the cervical vertebrae in osteochondrosis]. PMID- 6493754 TI - [A device for the dynamic fixation of the spine]. PMID- 6493755 TI - [An apparatus for treating fractures of the phalanges of the fingers]. PMID- 6493756 TI - [An apparatus for arthroplasty of the interphalangeal joints and synthesis of the phalanges of the fingers]. PMID- 6493757 TI - [Hinged distraction apparatus for treating various injuries and diseases of the radiocarpal and metacarpophalangeal joints]. PMID- 6493758 TI - [An instrument for measuring movement in the finger joints]. PMID- 6493759 TI - [Clinico-electromyographic parallels in the evaluation of the results of treating lumbar osteochondrosis by the papain nucleolysis technic]. PMID- 6493760 TI - [Cyclic polychemotherapy of Hodgkin's disease]. PMID- 6493761 TI - [Serum L-DOPA oxidase activity in patients with malignant cutaneous melanoma]. PMID- 6493762 TI - [Premature labor and intrauterine infection]. PMID- 6493763 TI - [Double contrast irrigoscopy in the detection and differential diagnosis of polypoid lesions of the cecum]. PMID- 6493764 TI - [Prevention of the recurrence of bladder tumors with local adriamycin therapy]. PMID- 6493765 TI - [Idiopathic refractory sideroblastic anemia, with special reference to diagnosis and clinical course]. PMID- 6493766 TI - [Corpus luteum insufficiency, the primary cause of habitual abortion: its successful therapy]. PMID- 6493767 TI - [Multiple calcareous enthesopathy. A newly detected complication of adult alcoholism]. PMID- 6493768 TI - [New results of studies of plasma lipoprotein metabolism and the pathogenesis of hyperlipoproteinemias]. PMID- 6493769 TI - [The role of tubulo-interstitial tissue damage in the progression of IgA glomerulonephritis]. PMID- 6493770 TI - [Bacteriologic examination of the small intestine in the diagnosis of chronic intestinal diseases]. PMID- 6493771 TI - [The myoglobin latex test in the early diagnosis of myocardial infarct]. PMID- 6493773 TI - [Effect of riboflavin (vitamin B2) on the serum bilirubin level in neonatal jaundice requiring exchange transfusion]. PMID- 6493772 TI - [Septic pelvic complications with fatal outcome caused by an IUD]. PMID- 6493774 TI - [Changes in the size of pulmonary metastases, originating from malignant bone tumors, during therapy]. PMID- 6493775 TI - [Subacute necrotizing lymphadenitis]. PMID- 6493776 TI - [Tibial shaft fractures. Anatomical, biomechanical and pathophysiological aspects]. PMID- 6493777 TI - [Conservative treatment of fresh closed tibial shaft fractures using the Lorenz Bohler method]. PMID- 6493778 TI - [Functional treatment of shaft fractures of the tibia with the Sarmiento brace]. PMID- 6493779 TI - [Intramedullary nailing of tibial shaft fractures]. PMID- 6493780 TI - [Plate osteosynthesis of closed tibial shaft fractures]. PMID- 6493781 TI - [The use of monofixation in closed tibial shaft fractures]. PMID- 6493782 TI - [Tibial shaft fractures in children]. PMID- 6493783 TI - [Special aspects of the prevention of thromboembolism following fractures of the lower extremity]. PMID- 6493785 TI - [Early postoperative infections of tibial fractures]. PMID- 6493784 TI - [Aseptic bone healing disorders following tibial shaft fractures]. PMID- 6493786 TI - [Chronic osteitis of the lower leg]. PMID- 6493787 TI - [Indications and technic of lower leg amputations]. PMID- 6493788 TI - Re: A brief comment on 'the headache scale: a new approach to the assessment of headache pain based on pain descriptions'. PMID- 6493789 TI - Two separate components of pain produced by the submaximal effort tourniquet test. AB - Human subjects could discriminate two separate components of pain during the submaximal effort tourniquet test. Since the effect of several test parameters was different on these two pain components it is suggested that attention would be paid to the discrimination of these pain components in the future studies with this methodology. PMID- 6493790 TI - Pain assessment: differences in quality and intensity of the words pain, ache and hurt. AB - A study was undertaken to investigate if the concepts pain, ache and hurt differ from each other in intensity and quality and to identify discriminating semantic correlates for each of these concepts. Forty-one nurses with different backgrounds in nursing and 12 patients with chronic pain syndrome were included in the study. The methods used were a questionnaire, the visual analogue scale (VAS), and the McGill Pain Questionnaire (MPQ). There was a statistically significant difference in the intensity of the words pain, ache and hurt on both the VAS and the MPQ. Pain was shown to have the highest intensity, followed by ache with hurt having the lowest. Semantic correlates consisting of sensory and affective words which best discriminate between the concepts pain, ache and hurt were identified. Semantic correlates for pain were: cutting, crushing, tearing, sharp, dreadful, killing, torturing and suffocating: for ache were: aching, pulling, gnawing, irritating, annoying, troublesome, exhausting, unbearable and terrifying; for hurt were: pricking, pinching, stinging, sore, fearful, unhappy. PMID- 6493791 TI - Pain in infancy: neonatal reaction to a heel lance. AB - A combined single subject and group design was used to investigate changes in heart rate and crying in response to a heel lance, non-invasive tactile stimulation and baseline periods in 10 male and 10 female infants, each in their second full day of life. Heart rate was measured with an electrocardiogram. Percentage of time crying was computed from observations of audiotapes. Results for individual subjects indicated that heart rate and percentage of crying were consistently increased by the heel lance but that there was often wide baseline variability in the two measures. Analysis of variance indicated that responses to heel lance were higher than responses to tactile stimulation which were in turn higher than responses to baseline for both heart rate and percentage of crying (P less than 0.01). No significant sex differences were found. It was suggested that the increases in heart rate and crying in the context of a tissue damaging stimulus indicated that the infants experienced pain and that pain in infants can be reliably measured in clinical settings. PMID- 6493792 TI - Pain reactions in pregnant women. AB - Reactions to radiant heat stimuli were measured in pregnant women and in a control group of non-pregnant women matched in age. Receiver operating characteristic curve parameters were computed for each of the stages of pregnancy from the 6th month until the postpartum period. When painful stimuli were used, a group by stage of pregnancy interaction was found in the analysis on the response criterion for reporting pain. Pregnant women were found to be significantly more willing to label radiant heat stimuli as painful during the last 2 weeks of pregnancy than during any of the other stages of pregnancy. The control women tested during the same time sequence as the pregnant women showed stable response criteria across the 6 month testing period. There were no group or stage of pregnancy effects evident when the discrimination accuracy measures were analyzed; nor were any effects found with responses to thermal stimuli. The results suggest that the changes in pain reaction associated with pregnancy are based on non-sensory factors that influence the subject's willingness to report pain. PMID- 6493793 TI - The formalin test: a tonic pain model in the primate. AB - The formalin test has been used in monkeys for assessing pain. After formalin injection in the palmar surface of the hand just proximal to the base of the fingers, the monkey's responses are rated for 1 h according to objective behavioral criteria. The present 'tonic' pain model has a fair degree of objectivity, validity, reproducibility and quantifiability. The analgesic effects of morphine and pethidine have been evaluated. PMID- 6493794 TI - Dislocations of the cervical spine: closed reduction under anaesthesia. AB - This paper reviews 101 patients with dislocations and fracture-dislocations of the cervical spine with neurological involvement, treated by closed reduction under anaesthesia. All were admitted to a specialised unit where early accurate diagnosis was followed by the application of Crutchfield tongs and an early attempt at closed reduction. Of the 101 patients so treated, 82 were fully reduced. Partial reduction was obtained in six. Open reduction and posterior fusion was performed on four patients following failed closed reduction. Open reduction was not attempted in 9 patients because of their poor general condition. Twenty three patients had delayed spinal fusion because of instability demonstrated radiologically at between 6 weeks and 12 weeks. Of the 56 patients with complete lesions, five showed major neurological recovery after 6 months, and there were 10 deaths at periods from 4 to 25 days after injury. Of the 45 patients with incomplete lesions, six made a full clinical recovery, 28 made major recovery, and there were three deaths from 9 to 14 days after injury. Our results lead us to believe that the method is safe and reliable, even in patients received over 24 hours after the injury. PMID- 6493795 TI - Incidence of medical complications in spinal cord injury: patients in specialised, compared with non-specialised centres. AB - Facilities providing a co-ordinated 'system' of care to the spinal cord injured are now more accepted as being preferable to fragmented 'non-system' facilities. Data reflecting the incidence of selected complications common to spinal cord injury were collected over a 2-year period from a system located outside the United States and from 'non-systems' within the United States. The latter was defined as care provided in community facilities prior to entry into one of 14 model United States spinal cord injury centres. All complications occurred more frequently in the American group, particularly decubitus ulcers and urinary tract infections. The data suggest that system care is preferable to non-system care in its capacity to prevent costly complications and the sooner the spinal cord injured patient is referred to a spinal cord centre capable of meeting all his needs, the less likely will he be exposed to complications that could slow the rehabilitation effort. PMID- 6493796 TI - Rehabilitation after spinal cord injuries complicated by previous lesions. AB - Since Sir Ludwig Guttmann introduced the comprehensive modern clinical approach to the rehabilitation of spinal cord injured patients much experience has been accumulated. Modern spinal cord injuries centres have opened throughout the world, treating mainly acute spinal cord injuries in young patients. At Stoke Mandeville Hospital we have had the opportunity to treat several spinal patients who had suffered previous neurological or orthopaedic disorders. These complicated combinations affected the rehabilitation process and the presentations show clearly different aspects of the problem. PMID- 6493797 TI - Underseat pressure distribution in the sitting spinal injury patient. AB - A device has been developed that can display underseat pressure distributions during sitting. We have found this device to be particularly useful in monitoring the effect of pressure sore surgery on the underseat pressure patterns, in the design of pressure-relieving cushions, and as a device to enable spinal injury staff to locate areas of high pressure at which tissue breakdown (pressure sores) may occur. PMID- 6493798 TI - Benzene poisoning as a possible cause of transverse myelitis. AB - A case of transverse myelitis in a 25-year-old patient was described. The transverse myelitis was caused by toxic cause, probably as a result of benzene poisoning. This diagnosis was based on: The differential diagnosis. The patient's occupation. The abnormal high urinary phenol levels. The coincidence of decreasing urinary phenol values with an amelioration of the clinical condition of patient. After consulting the literature, we think that this case of transverse myelitis based on a benzene poisoning is the first ever described. PMID- 6493799 TI - The role of the home visiting nurse in the total education programme of spinal cord injured persons. AB - The provision of a Home Visiting Nursing Service, as part of the total rehabilitation team, plays an important part in preventing re-admission to hospital of spinal cord injured patients suffering from urinary tract infections or pressure sores. The Home Visiting Nurse provides discharged patients with a reinforcement of the educational aims of the rehabilitation programme, leading to greater success in their re-introduction both emotionally and physically leading to independent living. PMID- 6493800 TI - An apparatus making possible restoration of simple functions of the tetraplegic hand. AB - In the Rehabilitation Institute at Konstancin investigations and clinical tests have been carried out over the last ten years with a view to restoring the tetraplegic hand function by means of implanted stimulation of the peripheral nerves of the upper extremity. Lately, an apparatus for a tetraplegic has been constructed, based on patient controlled stimulation of the median and radial nerves. In this report the principle of the apparatus and also the initial clinical tests are discussed. Investigations carried out so far have demonstrated that grasping function of the hand is compatible with the projected programme and that the induced function of the hand is useful for the patient. PMID- 6493801 TI - Traumatic cerebral flaccid paraplegia. AB - Two cases of paraplegia caused by head injuries sustained in recent military conflicts are presented. The underlying pathological disturbances could be related to the CT scan appearances and are discussed in the light of previously reported series. Both cases were remarkable for an early and prolonged paraplegia which was flaccid, rather than spastic, and for the sensory impairment produced. PMID- 6493802 TI - Non-operative management of extra-peritoneal rupture of the urinary bladder in a tetraplegic patient. AB - A 65-year-old male sustained a cervical spine injury and simultaneous extraperitoneal rupture of the urinary bladder. Because of co-existent severely impaired respiratory function the vesical rupture was managed conservatively and bladder drainage was provided by a 24 Fr. indwelling urethral catheter. Serial cystograms performed at 4, 7 and 9 weeks post-injury showed complete healing by 63 days. We suggest that non-operative management of vesical rupture should be considered in selected patients with associated serious other body system involvement. PMID- 6493803 TI - [Laboratory animal infection in modeling intestinal schistosomiasis]. AB - A comparative efficiency of different regimes for infecting laboratory animals has been determined in order to find out optimal conditions under which an experimental model of intestinal schistosomiasis (infection with Schistosoma mansoni) can be maintained. When evaluating the results of laboratory definitive hosts infection we took into account the character of Schistosoma distribution in animals, which with high probability rate was modelled by means of negative binomial distribution. The main parameters of this distribution were used for determination of effective doses and methods of animals infection alongside with generally accepted indices of infection rate and intensiveness. Analysis of the data obtained has shown that the infection of 150 cercarians per mouse and 200 cercarians per golden and striped hairy-footed hamster by their subcutaneous administration creates optimal density of parasites in the host. Results of investigations have shown that striped hairy-footed hamsters can be used as definitive hosts of Schistosoma. PMID- 6493805 TI - Parasite evasion of the immune response. PMID- 6493804 TI - [Breeding sites of horseflies (Tabanidae) in the southern and central regions of Tomsk Province]. AB - Breeding places of 10 species of tabanids from southern and central regions of the Tomsk district were studied. They are connected with the Ob river, its tributaries Tom and Chulym, with the Baksa, Kirgizka, Chernaja and Ushaika rivers, flood-plain waterbodies, meadow lowlands, forest bogged up areas and with water bodies near animal breeding farms. The average density of larvae is 7.3 spec./m2. Most abundant were members of the genus Hybomitra (54.4%) and Tabanus (38.4%). The density of larvae depends on the time of their collection and their generic belonging. PMID- 6493806 TI - Sequestration--beneficial to both host and parasite. PMID- 6493807 TI - Stage-specific antigens of Trichinella spiralis. AB - Infective larvae, adults and newborn larvae of Trichinella spiralis were surface labelled with radioactive iodine, and the surface material was solubilized in the mild detergent sodium deoxycholate. The radio-isotope labelled products were stage-specific glycoproteins that were few in number (2-4 components) and antigenic in infected mice and rats. Antibodies synthesized in infected animals against these biochemically defined surface antigens may or may not interact with the surface of the living worm. The latter type of antibody is unlikely to be involved in the initial phase of parasite rejection and is therefore another example of a non-protective host antibody response. The stimulus for its synthesis must be the observed release of surface antigen. A monoclonal antibody to a surface glycoprotein of newborn larvae protected against infection, and also promoted eosinophil killing in vitro. This observation emphasizes the importance of surface antigens in protection against infection, suggests a role for granulocytes in vivo, and provides encouragement for the possible use of nematode surface antigens in protection. An example of regional specialization of the nematode cuticle was given by a monoclonal antibody reactive with only the surface of the male intromittent organ and not the female or remainder of the male. The same stages were labelled in vitro with radioactive methionine, and the secreted proteins were also found to be stage-specific. Some, but not all, were antigenic in infected mice. The total concanavalin A-binding somatic glycoproteins of each stage exhibited considerable individuality, and hence stage specificity, when resolved by two-dimensional gel electrophoresis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493808 TI - Evasion of the immune response: survival within low responder individuals of the host population. AB - It is proposed that, for many species of parasites, evasion of the host immune response may be achieved passively through enhanced survival within host individuals that have a genetically determined low responsiveness to infection. Evasion by this means may contribute significantly to continued transmission of infection in man and domestic animals and influence the severity of pathology. Low responsiveness plays an important role in determining over-dispersion of parasites within host populations, and the common occurrence of this form of distribution is seen as supporting evidence for the proposition, although few of the examples available provide conclusive proof. The extensive individual and strain variation in response to parasitic infection in laboratory strains of mice is taken as a homologue of the natural situation and allows analysis of the mechanisms underlying low responsiveness. Two examples are considered in detail. In Leishmania infections both non-H-2 and H-2-linked genes influence resistance, but the primary expression of genetically determined low response is at the level of the macrophage. Genetic influences upon acquired immunity regulate macrophage T-cell interactions. In Trichinella spiralis H-2-linked and non-H-2 genes influence development of the intestinal responses necessary for expulsion of the adult worm, the former through the response of helper T-cells to worm antigen and the amplification of this response through other T-cells, the latter through an effect upon the response of myeloid stem cells to T-cell signals. Modification of genetically determined low responsiveness is discussed in terms of improving host responsiveness through vaccination or non-specific immunostimulation and altering host genotype through selective breeding or the introduction of resistance alleles into a population. PMID- 6493810 TI - Use of immunological manipulations in studying genetically controlled responses to Leishmania donovani infection in mice. PMID- 6493809 TI - Variation in 'target' antigens between appropriate and inappropriate hosts of Taenia saginata metacestodes. AB - The antibody response of the appropriate hosts (cattle) to Taenia saginata larvae was compared with that of an inappropriate host (Balb/c mice) using gel electrophoresis followed by immunoelectrotransfer blot techniques (Western blotting). Three groups of cattle were included, those known to be resistant to challenge infection because of repeated oral challenge with T. saginata eggs over a 1-year period, a previously infected but known susceptible group and a group of uninfected controls. Serum from the mice and the two groups of infected cattle contained antibodies recognizing different 'target' antigens, some of which may be related to host resistance. The potential value of the technique of Western blotting in dissecting the humoral response of a particular host species to parasitic infection and in the identification of those antigens suitable for the production of effective vaccines is discussed. PMID- 6493811 TI - [Toxoplasmosis and rubella in Moroccan women. Results of a serological survey]. AB - A prospective sero-immunological enquiry of the rubella and toxoplasmosis immune status of 200 pregnant women in Casablanca (Morocco) revealed that 66,5% are immune to rubella and 51,5% are immune to toxoplasmosis. A study of the relation between the immune status and age shows that serum conversion takes place most frequently between the ages of 21 and 25. 7 women had high levels of anti toxoplasmosis antibodies. The authors compare their results with those obtained in other regions of Morocco and in other countries. They also present a range of epidemiological and technical correlations. They conclude that the prevention of congenital toxoplasmosis and rubella must be integrated into a national programme of mother-and-child protection, notably by means of obligatory prenatal serological tests and the continued monitoring of those women who are not immune. PMID- 6493812 TI - [Plasma acetate and bicarbonate kinetics and intolerance to acetate during and after renal dialysis]. AB - Plasma acetate kinetics, acid-base homeostasis and clinical tolerance were monitored in 7 patients with chronic renal failure during and after hemodialysis with standard conditions. In 6 patients, without severe clinical symptoms acetate levels became stable during the last hour of dialysis (4.86 +/- 0.44 mmol/l) and decreased according to first order kinetics (half-life (8.82 +/- 3.42 mn). Simultaneously bicarbonate levels significantly increased (p less than 0.005). At the opposite the 7th patient has been characterised by a continuous rise in acetate levels (12.3 mmol/l at the end of the dialysis), a slower elimination (half-life: 31.0 mn), a collapse of plasma bicarbonate and severe acetate intolerance. Moreover symptomatic patients were characterised by an increase of plasma levels and half-lives. Therefore it seems that during dialysis of comparable efficiency, an insufficient rate of acetate metabolism may be at the origin of a worsening of metabolic acidosis as well as an increase of acetate load, responsible for severe acetate intolerance. PMID- 6493813 TI - [Assay of glycosylated hemoglobin by agar gel electrophoresis in an acid pH. Value of the determination of the stable fraction in clinical biology]. AB - Total glycosylated haemoglobin (Hbg) has been determined by electrophoresis on agar gel, using commercially available materials. This method is simple and unaffected by changes of temperature or buffers pH. With a performing densitometer, its coefficient of variation is less than 4% within batch, less than 6% between batch. There is a significant correlation with the small column separation technique (r = 0,93; p less than 0,001). The labile glycosylated haemoglobin is removed by 5 methods: 18 hrs dialysis of haemolysate at 4 degrees C; 30 mn incubation of whole-blood with semi-carbazide and aniline at pH 5 and 37 degrees C; 6 hrs saline incubation of erythrocytes at 37 degrees C; 18 hrs saline incubation of erythrocytes at 25 degrees C; 7 days storage at 4 degrees C. The two first methods appear to be the best. In our study we can conclude that: 1) In basal conditions the size of the labile fraction of Hb g was close to the limits of variability of the methods (less than or equal to 10%). 2) Therefore, except for brittle diabetics, it is not necessary to determine the labile fraction routinely. PMID- 6493814 TI - [Serum assay of anti-wasp venom IgG by radioimmunoprecipitation. Application to patients during desensitization]. AB - Rapid, specific and reproducible radioimmunoprecipitation assay (RIP) for measuring IgG antibodies against Yellow Jacket Venom (YJV) has been developed. The YJV-I125 is added to serum sample and the immune complexes are precipitated by a second antibody with polyethylene glycol. IgG antibodies were measured by RIP in 24 patients receiving Yellow Jacket Venom immunotherapy. RIP assays were compared for 159 sera to a solid phase procedure (RAST IgG). PMID- 6493815 TI - [Evaluation of a reference chromatographic method for the determination of blood levels of carboxyhemoglobin]. AB - The FID chromatographic analysis of methane obtained by the catalytic reduction of CO on nickel is a valuable method for the quantity control of the HbCO analyzer in clinical routine. For Hb levels between 9 and 18 g%, the coefficient of variation for the chromatographic method is to 2% for HbCO ranging from 100 to 2%, and 2 to 6% for HbCO ranging from 2 to 0.2%. A simple method for the extraction of blood CO is evaluated. PMID- 6493816 TI - [Gastric stump cancer after distal resection]. PMID- 6493817 TI - [Effect of immunosuppressive, anticoagulant and anti-inflammatory agents on experimental glomerulonephritis. VI. Encorton, immuran and cyclophosphamide]. PMID- 6493818 TI - [Effect of chronic hexachlorobenzene-induced hepatic porphyria on the course of acetylaminofluorene carcinogenesis in Wistar rats]. PMID- 6493819 TI - [Subcellular structures of the peripheral blood lymphocytes in patients with burns]. PMID- 6493820 TI - [Globocellular ependymoma: morphologic picture in 2 cases]. PMID- 6493821 TI - [Morphology of the liver in ulcerative colitis]. PMID- 6493822 TI - Detection of carcinoembryonic antigen as an aid in differential diagnosis of cells in pleural and peritoneal effusions. PMID- 6493823 TI - [Microscopic, submicroscopic and gravimetric examinations of the guinea pig thyroid gland in acute experimental anaphylactic shock]. PMID- 6493824 TI - [Effect of immunosuppressive, anticoagulant and anti-inflammatory agents on experimental glomerulonephritis. IV. Encorton and immuran]. PMID- 6493825 TI - How is linguistic memory accessed? A psychophysiological approach. AB - The role of "subvocalization" during language comprehension, especially reading, is examined. Four arguments against it having a role in accessing memory are erroneous because 1) its latency is much shorter than is conventionally stated; 2) rate of visual information processing is erroneously estimated by failing to distinguish between reading and scanning; 3) covert speech does not disappear in the competent language performer; and 4) the argument that subvocalization is an epiphenomenon is irrelevant. Rather, data support the generalization that covert speech is present during all cognitive functioning and that its specific topography is discriminatively related to the class of phoneme being processed. It is thus inferred that during cognition the speech musculature generates a phonetic code that may function to access linguistic memory. However, since there are also numerous other psychophysiologic events associated with covert speech, a multichannel processing system is hypothesized wherein speech, visual, and kinesthetic modalities interact with the brain. Illustrations are given of how this accessing model is compatible with existing holographic and feature analyzer models of memory. Data are presented that illustrate how phonetically encoded neuromuscular events can be directly measured through psychophysiologic methods. It is hypothesized that cognitive processes are generated when cybernetic neuromuscular circuits selectively interact. Consequently, all components of these neuromuscular circuits serve a function during cognition so that a role for "subvocalization" (a muscular component) cannot be ruled out in an apriori manner. PMID- 6493826 TI - Tonic and phasic stimulus control of blood pressure responses using opposing unconditional stimuli. AB - The transswitching paradigm was used in the present study to investigate the effects of tonic (long duration) environmental stimuli paired with opposing unconditional stimuli on human blood pressure. Sixty volunteers participated for two sessions, one week apart. Subjects were presented with a pseudorandom sequence of four trials of red lights (five minutes each) and four trials of blue lights (five minutes each) within each session. All subjects received the cold pressor test during the red lights. During the blue lights, half the subjects received warm water and the other half received a neutral temperature water. Subjects received the presentations of the water in one of three methods: as determined by the experimenter, preceded by a warning signal, or self administered. The results indicated that conditional and unconditional responses during the red lights were progressive increases in blood pressure. During the blue lights associated with warm water, conditional and unconditional responses were often progressive decreases in blood pressure. The method of administration of the water affected the magnitude of the unconditional responses. Evidence for phasic stimulus control was not as unequivocal as tonic stimulus control. The present results indicated that it is possible to modify blood pressure in two directions (increases and decreases) when two high contrast, opposing unconditional stimuli are presented. PMID- 6493827 TI - [Morphology and histogenesis of the cicatricial process in ischemic cardiopathy]. PMID- 6493828 TI - Adamantinoma of long bones. PMID- 6493829 TI - [Cardiac myxoma in adolescence. Clinico-pathologic study of 3 patients]. PMID- 6493830 TI - [Proliferation of fibroblasts in the hypertrophic cicatrix]. PMID- 6493831 TI - [Ciliated cylindrical cells in the urine]. PMID- 6493832 TI - Mesothelial proliferation: a questionable boundary with malignancy. PMID- 6493833 TI - [Influence of splenectomy on the synthesis of collagen and on steatosis of the rat liver induced by treatment with carbon tetrachloride and progesterone]. PMID- 6493834 TI - [A case of secondary echinococcosis of the pleura diagnosed by cytologic examination]. PMID- 6493835 TI - [Hibernoma: description of a case]. PMID- 6493836 TI - [Microfollicular thyroid adenoma in ovarian stroma. Description of a case]. PMID- 6493837 TI - Assessment of biotransformation during transfer of propoxyphene and acetaminophen across the isolated perfused human placenta. AB - The purpose of this investigation was to assess the extent of biotransformation of drugs by the human placenta during their transfer from the maternal to the fetal circulation. Propoxyphene was used to determine N-demethylation, and acetaminophen served as a substrate for glucuronide and sulfate conjugation. Human full-term placentae were dually perfused in vitro, with one or the other drug being added to the maternal circulation. Propoxyphene and acetaminophen concentrations reached an essentially constant fetal/maternal ratio within 1 hour, with a half-time of about 20 minutes. The concentrations of both drugs in the placental tissues were higher than in the perfusion fluids; this accumulation was particularly pronounced in the case of propoxyphene. No metabolites of either drug were found in the maternal or fetal circulations, but norporpoxyphene, the N demethylated metabolite of propoxyphene, was detected in placental tissue. PMID- 6493839 TI - Chloral hydrate toxicity in a preterm infant. AB - Ventilator care in premature infants with hyaline membrane disease (HMD) may be complicated by episodes of irritability and "fighting" the respirator, resulting in significant hypoxemia. Neuromuscular blockade with pharmacologic agents such as pancuronium bromide is frequently used to manage this problem [Crone and Favorito, 1980]. This therapy results in the loss of important clinical signs, such as alterations in muscle tone and spontaneous movements, which are important in monitoring the critically ill newborn. As a result of these considerations, we occasionally have utilized the sedative-hypnotic effects of chloral hydrate to achieve adequate ventilation and oxygenation in these infants. We report, however, a case of a preterm infant who developed severe chloral hydrate toxicity after its administration as an adjunct to the treatment of HMD. PMID- 6493838 TI - Polymorphic acetylation of 7-amino-clonazepam in human liver cytosol. AB - The N-acetylation of the reduced metabolite of clonazepam 7-amino-clonazepam was studied in cytosolic preparation from human fetal and adult livers. The metabolite formed 7-acetamido-clonazepam was measured with high performance liquid chromatography. A bimodal distribution of the N-acetyltransferase activities was observed in cytosols from human adult livers. These activities were 117 +/- 11 and 27 +/- 16 pmoles X mg-1 X min-1 for rapid and slow acetylators, respectively. The data observed in the fetal specimens did not allow any conclusion about bimodality because of a low number of samples. PMID- 6493840 TI - Favorable effect of dimethyl sulfoxide on secondary amyloidosis in juvenile rheumatoid arthritis. AB - A girl with secondary amyloidosis as a complication of juvenile rheumatoid arthritis was administered dimethyl sulfoxide by topical application to the skin. Her gastrointestinal symptoms and massive proteinuria improved. Decreased left ventricular function and creatinine clearance also improved remarkably. The favorable effect of dimethyl sulfoxide in this single patient deserves further study in a controlled trial. PMID- 6493841 TI - Precursor prothrombin status in two mother-infant pairs following gestational anticonvulsant therapy. AB - Protein in vitamin K absence (PIVKA) is the prothrombin precursor found in plasma when carboxylation to prothrombin is impaired. We report on two cases in which mother-infant PIVKA concentrations were measured at birth after chronic anticonvulsant therapy during pregnancy. Maternal values were 2.4 and 4%, and infant values 20.0 and 18% in cases 1 and 2, respectively. This demonstrates that, despite the normal coagulation profiles previously described, mothers on chronic anticonvulsant therapy may have a subclinical carboxylation defect, while their infants are at risk for hemorrhagic disease. Estimation of maternal PIVKA levels may be of value for predicting risk of hemorrhage in the neonate. PMID- 6493842 TI - Pharmacokinetics of cefoperazone in newborn infants. AB - We studied the disposition of two 100 mg/kg doses of cefoperazone given intravenously 12 hr apart in ten newborn infants. Peak levels were a mean 352 +/- SD 75 and 371 +/- 68 micrograms/ml immediately after the first and second dose, respectively, with corresponding troughs of 60 +/- 10 and 76 +/- 28 mcg/ml 12 hr later. Mean half-life was 6.5 +/- 0.9 hr and decreased with increasing gestational age and birthweight. Steady-state volume of distribution averaged 410 +/- 40 ml/kg and total clearance 0.78 +/- 0.13 ml/min X kg and neither varied with gestational age nor birthweight. No untoward physical or laboratory effects were noted. Additional studies including postnatal age effects on kinetics, efficacy, and cerebrospinal fluid penetrance are necessary prior to widespread use of this potentially valuable antibiotic in newborn infants. PMID- 6493843 TI - Acute isoniazid intoxication: reversal of CNS symptoms with large doses of pyridoxine. AB - Acute toxicity from ingestion of isoniazid (INH) is manifested by coma and seizures unresponsive to conventional therapy. Though small doses of pyridoxine can reverse the seizure activity of acute isoniazid toxicity, large doses of pyridoxine (B6) are needed to completely reverse the symptoms. A case report is presented demonstrating the need for large doses of pyridoxine to reverse the symptoms of isoniazid intoxication and the literature of isoniazid toxicity in the pediatric age group is reviewed. PMID- 6493844 TI - Molecular defect of spectrin in the family of a child with congenital hemolytic poikilocytic anemia. AB - We present the study of a black family in which the proband suffered from a severe neonatal hemolytic anemia with poikilocytosis. Both the parents, sister's, and brother's proband were clinically normal. The presence of poikilocytes in proband led to a search for a red cell membrane skeleton defect. Owing to recent improvements in the erythrocyte membrane knowledge, it is now possible to approach the diagnosis by means of biochemical evaluation of both parents, even if they are asymptomatic. So, the first time discovery of a spectrin self association defect in both parents allowed us to suspect double inheritance of this abnormality in the proband. A complete morphological and biochemical evaluation of the family allowed us to propound the diagnosis of heterozygous type I hereditary elliptocytosis (HE) for both parents and the sister and the diagnosis of homozygous type I HE for the proband owing to the following reasons: slight ovalocytosis was present in both parents and the sister; cell deformability ektacytometric studies gave the same profiles of curve as those observed in patients with HE. Defective spectrin dimer self-association found in both parents was also observed in the sister and proband, associated with the same abnormal spectrin digest pattern, namely a decrease in the amount of a 80,000-dalton peptide and a corresponding increase in a 74,000-dalton peptide. However, clinical presentation of the proband was consistent either with hereditary pyropoikilocytosis or homozygous hereditary elliptocytosis; erythrocyte thermal sensitivity studies in the proband could not be conclusive because of the presence of transfused cells. Both these diagnoses are discussed in detail.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493845 TI - Anion transport and 2,3-diphosphoglycerate in cystic fibrosis red blood cells. AB - The monovalent and divalent anion transport in red blood cells from patients with cystic fibrosis and controls is not significantly different. The protein pattern of the erythrocyte membrane, as seen by sodium dodecyl sulfate-polyacrylamide gel electropherograms, is similar in cystic fibrosis and control red blood cells. The 2,3-diphosphoglycerate content of the investigated cystic fibrosis red blood cells is normal. PMID- 6493846 TI - Pulmonary function of the reserpine and isoproterenol models of cystic fibrosis. AB - Two experimental animal models exhibiting functional and morphologic changes of exocrine glands similar to those seen in patients with cystic fibrosis (CF) have been reported in the rat: chronic stimulation with reserpine (Martinez et al. 1973 Pediatr. Res. 9:463, 470) and chronic stimulation with isoprenaline (Sturgess and Reid 1973 Br. J. Exp. Pathol. 54:388). We have studied the pulmonary function of these models induced by injecting rats subcutaneously with reserpine (RES, 0.5 mg/kg/day), isoproterenol (ISO, 25 mg/kg/day), or saline (Con, 1.0 ml/kg/day) for 6 days. Plethysmographic measurements were made for functional residual capacity (FRC), airways resistance (Raw), specific airways conductance (sGaw), phase difference between air flow rate and mean alveolar pressure (PD), frequency of breathing (f), and tidal volume (VT) of the anesthetized rats. In the RES and ISO rats, the FRC, Raw and f were not different from Con values. The PD was greater and the VT was less than Con values (p less than 0.05). The results of both studies indicate uneven ventilation (increased PD) and penduluft (decreased VT) consistent with maldistribution of resistance and/or compliances of the peripheral airways and/or alveolar compartments. These physiologic effects can be related to the morphologic changes reported for the airways of rats under chronic adrenergic stimulation (ISO) and expected for rats under chronic catecholamines depletion (RES). Since peripheral airways involvement is usually the earliest pulmonary lesion found in CF, these studies indicate that the RES and ISO models may be representative of the early pulmonary involvement of CF. PMID- 6493847 TI - Freeze-etching and biochemical analysis of human fetal erythrocyte membranes. AB - In order to test the hypothesis that there are ultrastructural and supramolecular differences between fetal and adult erythrocyte membranes that are manifested in their functional characteristics, the cells were studied by freeze-etching and transmission microscopy and biochemical methods. Freeze-etching and transmission electron microscopy of fetal erythrocyte membranes showed that the protoplasmic and exoplasmic fracture faces have 24% and 45% greater intramembrane particles respectively compared to adult cells (p less than 0.01). The apparent diameters of the intramembrane particles estimated on the exoplasmic fracture face averaged as follows: 4.84, 7.74, 11.42, and 15.64 nm, which are similar to estimates in adult cell membranes, suggesting similar dimensions for the presumptive glycoprotein structures in the fluid mosaic complex of the cell membranes. The average total cholesterol, phospholipid, and protein content per fetal erythrocyte ghost as well as ratios of protein/lipid, protein/cholesterol, and protein/phospholipids were all significantly greater than in the adult ghost (p less than 0.01). Analysis of fetal and adult ghost proteins by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed similar qualitative and quantitative polypeptide and glycopeptide bands except for the intense appearance of bands 4.5 and 8 in the fetal samples. Polypeptide chains per ghost membrane were significantly greater in fetal ghosts than in adult ghosts. However, the molar ratios of the major polypeptides relative to band 3, the predominant protein in the ghost membrane, are comparable for the two cell types except for bands 4.5 and 8. These findings suggest that the molecular characteristics of the erythroid plasma membrane vary with the developmental age. PMID- 6493848 TI - Sudden infant death syndrome: abnormalities in short term fluctuations in heart rate and respiratory activity. AB - In order to test the hypothesis that a defect in cardiorespiratory regulation contributes to death of infants from sudden infant death syndrome (SIDS), we analyzed the power spectra of heart rate and respiratory activity during 256-sec epochs of quiet sleep. Data were obtained from pneumogram recordings performed for 12 h at night on eight infants who subsequently died from SIDS and 22 age matched control infants. We computed the heart rate and respiratory power spectra from a single epoch on each infant using an algorithm developed for an 8085 microprocessor system dedicated to this investigation. There was no statistically significant difference between SIDS and controls based on mean respiratory and heart rates. Spectral analysis revealed enhancement of low frequency power in the 0.02 to 0.1 Hz band in the heart rate power spectrum in the SIDS group compared to control (p less than 0.002) and dispersion in respiratory frequency as determined by the respiratory band width (p less than 0.00001). These data suggest that a predisposition to SIDS manifests itself in an abnormal pattern of fluctuations in heart rate and respiratory activity. PMID- 6493849 TI - Prenatal thyroid function abnormalities in infants with idiopathic respiratory distress syndrome. AB - Thyroxine (T4), triiodothyronine (T3), and thyrotropin (TSH) concentrations were measured on cord sera of 21 preterm infants with idiopathic respiratory distress syndrome (IRDS) and were compared to the values obtained from 15 healthy preterm infants. When log T3, log T4, and log TSH were considered as the dependent variables in the multivariate test Hotelling-Lawley-Trace, there was an overall difference between the two groups: F = 3.94, p = 0.03. When log T3 and log T4 were considered separately in an analysis of covariance, there was a significant difference between the two groups for log T3 after adjusting for birth weight and gestational age (F = 7.98, p = 0.008). However, for log T4 and TSH, there was no difference between the IRDS and control infants. These findings exclude the possibility of antenatal thyroid dysfunction in babies with IRDS. An explanation for reduced cord blood T3 concentration in infants with IRDS is lacking at present. Extrathyroidal factors that predispose to IRDS may also affect peripheral T3 generation. Alternatively, one might postulate that there is relative immaturity of both peripheral T3 generating pathway and lung development in infants who develop IRDS. PMID- 6493850 TI - Respiratory metabolism in preterm infants: the measurement of oxygen consumption during prolonged periods. AB - We have developed a method for measuring oxygen consumption (Vo2) in preterm infants in their normal incubator environment over prolonged periods. The results of measurements made over 24 h in 18 infants are presented. In normally grown infants, the mean Vo2 was 9.66 +/- 1.25 liters/kg X 24 h (SD) (6.71 +/- 0.87 ml/kg X min), and in small for gestation infants it was 10.09 +/- 1.21 liters/kg X 24 h (7.00 +/- 0.84 ml/kg X min). During the 24-h measurements, the highest mean Vo2 during 3 consecutive h was 7.75 +/- 0.89 ml/kg X min and the lowest was 5.95 +/- 0.92 ml/kg X min. The difference between the highest and the lowest values was significant (p less than 0.001). There is room for considerable error if short term measurements are assumed to represent values over a whole day. "Short" measurements should be made over at least 6 h. PMID- 6493851 TI - The effect of intra-amniotic injection of triiodothyronine on pulmonary maturity in lambs at 130 days gestation. AB - Saline or triiodothyronine (T3) (50-1000 micrograms) was injected into the amniotic sac of 17 pregnant ewes under general anesthesia at 130 days gestation. Forty-eight h later, the lambs were delivered by hysterotomy. Cord plasma T3 and cortisol and amniotic fluid T3 were assayed, and the maturity of the fetal lung was assessed in terms of its pressure-volume response and its surfactant (lamellar body phospholipid) content. With the highest dose of T3, cord plasma T3 and cortisol were raised, and lung maturity was enhanced compared with saline treated controls; the pressure-volume curve showed increased hysteresis on inflation and deflation, and the lung retained air on return to zero pressure. There was also an apparent, but not statistically significant, increase in the lamellar body phospholipid content of the lung. Irrespective of treatment, lungs which were more mature, in terms of their pressure-volume characteristics, tended to contain a higher proportion of lamellar body phospholipid relative to total phospholipid. PMID- 6493852 TI - Effects of dichloroacetate on pyruvate metabolism in rat brain in vivo. AB - The effects of dichloroacetate (DCA) on the activity of the pyruvate dehydrogenase (PDH) complex and associated changes in the lactate and glucose levels in rat brain were investigated in vivo. The average activities of the active form of the PDH complex in the brain, liver and muscle of starved rats were respectively 0.40 +/- 0.04, 0.07 +/- 0.04, and 0.17 +/- 0.11 mumol/min/g tissue, and amounted to 21, 11, and 16% of the total activity of the complex. Intraperitoneal injection of DCA (125 mg/kg) increased the percentage of the active form of the PDH complex in the brain, liver, and muscle to 107, 40, and 84%, respectively. DCA significantly lowered the lactate and glucose concentrations of the brain and blood. A lower dose of DCA (12.5 mg/kg) also caused significant increase in activity of the PDH complex in the brain, but did not significantly change the lactate or glucose concentration of the brain. These results suggest that DCA crosses the blood-brain barrier reasonably well. PMID- 6493853 TI - Microvillus membrane differentiation: quantitative difference in cholera toxin binding to the intestinal surface of newborn and adult rabbits. AB - Microvillus membranes (MVM) were isolated from newborn and adult New Zealand rabbit small intestine. The isolation procedure provided a mean enrichment of 25 +/- 4 for sucrase activity in adult preparations and of 27 +/- 3 for lactase activity in newborn preparations. These purified MVM were incubated with increasing concentrations of 125I-labeled cholera toxin (CT). 125I-CT binding to adult MVM reached saturation at 6.4 X 10(-9) M; in contrast 125I-CT binding to newborn MVM did not reach saturation but instead continued to increase with increasing 125I-CT concentrations. Scatchard plot analysis of adult data supported the existence of a single binding site (Kd = 1.2 +/- 0.2 X 10(-9) M); analysis of newborn data, however, suggested the existence of additional binding sites, as 125I-CT binding to newborn MVM was inhibited by preincubation with unlabeled CT. These results show that CT binding to both preparations is quantitatively different and is higher in newborn preparations. This difference may be accounted for by the existence of additional binding sites in newborn MVM preparations in contrast to the presence of only the unique receptor previously reported in adult MVM preparations. PMID- 6493854 TI - [Natural feeding and child development]. PMID- 6493855 TI - [Diagnostic value of the respiratory hydrogen test in hypolactasia]. PMID- 6493856 TI - [Disorders of tryptophan conversion to nicotinic acid in children with obstructive bronchitis]. PMID- 6493857 TI - [NBT reduction test in newborn infants with intrauterine dystrophy syndrome and infections]. PMID- 6493858 TI - [Risk factors in pregnancy and labor and the survival time of low-birth-weight infants]. PMID- 6493859 TI - [Effect of various factors on the survival time and mortality of low-birth-weight infants]. PMID- 6493860 TI - [Development of adrenergic activity in boys and girls with emotiono-vegetative disorders during puberty]. PMID- 6493861 TI - [Cerebrovascular disorders in Ehlers-Danlos syndrome in children in the early development stages]. PMID- 6493862 TI - [Neonatal hepatitis with severe cholestasis as a complication of infantile septicemia]. PMID- 6493863 TI - [Principles and necessity of cooperation between psychologists and pediatricians]. PMID- 6493864 TI - [Neonatal neurology]. PMID- 6493865 TI - [Convulsions in the early neonatal period based on data from selected neonatology departments]. PMID- 6493866 TI - [Psychomotor development and the neurological status of 5-year-old children with pathology of the early neonatal period]. PMID- 6493867 TI - [Results of treatment of children with brain neoplasms]. PMID- 6493868 TI - [Acute hemiplegia in children]. PMID- 6493869 TI - [Use of the ethanol test in the differential diagnosis of cerebrospinal meningitis in children]. PMID- 6493870 TI - [Clinical aspects of enterovirus cerebrospinal meningitis in children treated at the Clinic of Infectious Diseases of Childhood in Wroclaw from June to December 1982 during the Wroclaw epidemic]. PMID- 6493871 TI - [Results of psychological tests in children in stages I and II of subacute sclerosing panencephalitis]. PMID- 6493872 TI - [Neurological complications in children with Ehlers-Danlos syndrome]. PMID- 6493873 TI - Heterogeneous growth and mental development of intrauterine growth-retarded infants during the first 3 years of life. AB - Postnatal growth and development were studied in two groups of term infants with intrauterine growth retardation (IUGR) and one group of infants with normal birth weight up to 3 years of age (total sample, 205 infants). Infants with IUGR were classified as having low ponderal index (IUGR-LPI) or adequate ponderal index (IUGR-API). At birth, the two groups of infants with IUGR had similar birth weight, but length and head circumference measurements were significantly different. Overall, the IUGR-API infants remained lighter and shorter and had smaller head circumferences up to 30 months of age. The IUGR-LPI infants experienced catch-up growth in weight during the first months, because of greater fat deposition. At 24 months of age, the IUGR-API infants scored below the others on mental items. At 3 years of age the IUGR-API infants had the lowest values on seven of eight developmental measures and on the composite score; at these two time periods, the group with normal birth weight scored the highest, and the IUGR LPI infants obtained intermediate values. It is concluded that infants with IUGR tend to follow postnatal growth and developmental patterns that are associated with their physical characteristics at birth. PMID- 6493874 TI - Trampoline-related quadriplegia: review of the literature and reflections on the American Academy of Pediatrics' position statement. AB - A review of the world's literature documenting cervical spine injuries has been made in an attempt to determine common factors regarding patient characteristics, environment, injury mechanisms, and pathology. The policy statements and safety guidelines of both the American Academy of Pediatrics and athletic administrative bodies have been reviewed in order to evaluate what effect, if any, these policies and guidelines have had on documented injuries. On the basis of this review, it is believed that the AAP was ill-advised in altering its position on the use of trampolines. The opinion is presented that both the trampoline and minitrampoline are dangerous devices when used in the best of circumstances, and their use has no place in recreational, educational, or competitive gymnastics. PMID- 6493875 TI - Thoracic trauma in children. AB - A 20-year experience at The University of Chicago in dealing with chest injuries in pediatric patients has been reviewed. The clinical presentation, including results of diagnostic measures, and the initial and definitive management of thoracic trauma in children are discussed. The condition of the majority of patients was stable at time of presentation. The most frequent surgical intervention performed was intercostal tube placement. Thoracotomy was infrequently required and laparotomy for associated injuries was more common. Trends in the causes and epidemiology of thoracic trauma in an inner city environment over this 20-year period were noted: Blunt trauma, which is increasing in frequency, most commonly involves the younger age group and is usually related to automobile accidents. Penetrating injuries are generally seen in older patients within the pediatric age groups and are similar to those seen in the adult population. PMID- 6493876 TI - Moped injuries in children. AB - Moped injuries are an important cause of traffic-related injuries in children. An attempt was made to define the epidemiology as well as the nature and severity of injuries sustained in 88 moped-related accidents. Bicycle injuries among children (579) were used as a control. The patients with moped injuries were younger than expected (mean 12.8 years with a minimum legal driving age of 14 years in the study area). Among 26 hospital admissions due to moped accidents, there were 11 admissions to the intensive care unit, demonstrating the severe nature of the injuries. Fifty percent of the patients had orthopaedic injuries and 46% had neurologic injuries. These injuries resulted in an average length of hospitalization of 8.5 days (intensive care unit admissions lasted an average of 14.6 days). Recommendations are made to aid pediatricians in the counseling of patients and parents. PMID- 6493877 TI - Degenerative changes in neutrophils: an indicator of bacterial infection. AB - A review was made of 195 peripheral blood smears of 157 neonates who required sepsis work-up in the first month of life. Degenerative changes of neutrophils including vacuolization and toxic granulation were observed frequently in infants with culture-proven bacterial sepsis. Of 21 peripheral blood smears from 20 neonates subsequently proven to have bacterial infection, 17 had vacuolization present in the neutrophils for a sensitivity of 81%, a specificity of 93%, and a positive predictive accuracy of 59%. Toxic granulation changes in neutrophils showed similar results. This simple test can be performed easily in all hospitals; it does not require special laboratory facilities. The test appears to provide a valuable adjunct in the early detection of neonatal bacterial infection. PMID- 6493879 TI - Staphylococcus epidermidis bacteremia in neonates: further observations and the occurrence of focal infection. AB - The frequency and clinical significance of Staphylococcus epidermidis isolates from blood cultures of neonates collected during a 17-month period in The New York Hospital neonatal intensive care unit (NICU) were reviewed. Twenty-three episodes of clinically significant S epidermidis bacteremia were detected using the criteria of isolation from 3/3 blood culture bottles from a single culture, or isolation from two or more blood cultures taken at different times, or simultaneous isolation from blood and fluid, pus or vascular catheter. Of these 23 episodes of S epidermidis bacteremia, ten were associated with colonized vascular catheters, and four episodes occurred in infants with necrotizing enterocolitis. Focal S epidermidis infection occurred in ten episodes, and persistent bacteremia occurred frequently in this setting. S epidermidis was the most frequent cause of bacteremia in the Neonatal Intensive Care Unit during the period reviewed. Of the isolates determined to be clinically significant, 74% were resistant to methicillin and cephalothin and 91% were resistant to gentamicin. All isolates were sensitive to vancomycin. In addition to removing vascular catheters suspected of being colonized and searching for potential sites of focal infection, an antibiotic regimen that includes vancomycin should be initiated once significant S epidermidis bacteremia has been recognized in the neonate. PMID- 6493878 TI - Upper gastrointestinal endoscopy in infants: diagnostic usefulness and safety. AB - Although fiberoptic, upper gastrointestinal (UGI) endoscopy has become an accepted diagnostic technique in the older child and adult, concerns about safety have limited the use of this procedure in infants. A 1-year experience with 49 upper gastrointestinal endoscopies in infants less than 25 months of age is reported. There were varied indications for the procedures, including upper gastrointestinal hemorrhage and obstruction, but evaluation for esophagitis secondary to gastroesophageal reflux was most common. Procedures were performed without sedation in 45% of all infants studied, including 87% of infants less than 3 months of age; procedures were well tolerated. General anesthesia was used on only three occasions. A thorough examination was always possible, and biopsies were taken whenever indicated. Only one complication, transient bradycardia, occurred in a critically ill infant. This experience demonstrates that upper gastrointestinal endoscopy is a safe and effective diagnostic aid in infants, and it can often be performed with little or no sedation. PMID- 6493880 TI - Causal thinking in practice: strengths and weaknesses of the clinical vantage point. AB - The place of causal inference in clinical practice is considered. One function relates to the validation of existing knowledge, as in the evaluation of the medical literature, and is exemplified by the process of editorial selection. A second function relates to the validation of potential knowledge, as in the testing of hypotheses, and is exemplified by the pursuit of a nutritional cause of retarded mental development. Features of clinical practice that contribute strengths or weaknesses to causal inference are then examined. These include the diagnostic process, the effect of cumulative clinical experience, continuity of observation and follow-up, and the focus on disease. PMID- 6493881 TI - Hereditary transcobalamin II deficiency with subnormal serum cobalamin levels. AB - An infant with transcobalamin II deficiency had the unusual feature of a low serum cobalamin level. Moreover, the level did not rise greatly with cobalamin therapy. Clinically, the features of the infant's illness were unexceptional other than the somewhat delayed onset of symptoms at 3 1/2 months of age. In addition, the patient's impaired antibody response to specific antigen challenge was not completely corrected following cobalamin therapy, and this result contrasts with the findings in the only previous examination of this feature of the disorder. As in previous cases, the transcobalamin II deficiency was accompanied by findings in the serum of complexing of the patient's R binder and the relative prominence of a cobalamin-binding peak eluting at a molecular weight of approximately 70,000 on Sephadex G-200 gel chromatography. In addition, the total serum R binder (free and complexed) level was low. This case demonstrates that transcobalamin II deficiency should be considered in any infant with a low serum cobalamin level in the first few months of life. PMID- 6493882 TI - Efficacy of metolazone and furosemide in children with furosemide-resistant edema. AB - The effect of a combination of metolazone (0.2 to 0.4 mg/kg/d) and furosemide (2 to 4 mg/kg/d) in achieving a natriuresis and diuresis was measured in 14 children during 22 episodes of edema resistant to furosemide alone. Urinary volume increased from 24 +/- 14 mL/kg/d for patients receiving furosemide to 51 mL/kg/d with combined diuretic therapy (P less than .01), and sodium excretion increased from 34 +/- 5 mEq/d to 155 +/- 176 mEq/d (P less than .01). Two children with severe hypoalbuminemia (serum albumin level less than 1.5 g/dL) and normal renal function, and five children with chronic renal insufficiency (71%) did not respond to combined diuretic therapy. The combination of furosemide and metolazone offers a useful and effective oral therapy in most children with edema resistant to furosemide. Children with chronic renal insufficiency and furosemide resistant edema did not respond to combination diuretic therapy. PMID- 6493883 TI - Evaluation of group well-child care for improving burn prevention practices in the home. AB - The inclusion of counseling on home safety procedures has been recommended by the American Academy of Pediatrics as a routine part of well-child care. However, few, if any, data exist to give direction to the pediatrician interested in advising parents about home safety. In the present study, 58 couples were randomly assigned, prospectively, to an experimental group and a control group. Both were enrolled in a single group well-child care class that lasted 90 minutes. The control group was provided with information and discussion on nutrition, dental care, safety in the car and home, child development, child rearing, illness management, and immunizations. The experimental group received information and discussion on the same topics, and they also received specific information on burn prevention: hot water heater settings and smoke detectors. On a subsequent home visit, 65% of the couples in the experimental group had their hot water temperature measured at 54.4 degrees C (130 degrees F) or less, whereas all of the couples in the control group had hot water temperatures of more than 54.4 degrees C (130 degrees F) (a significant difference). Although only one couple in the experimental group did not have an operational smoke detector, enough of the couples in the control group had operational smoke detectors that results were not significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6493884 TI - Fragile-X syndrome ascertained by the presence of macro-orchidism in a 5-month old infant. AB - The fragile-X syndrome, an X-linked form of mental retardation, is estimated to affect one in every 1,000 to 2,000 live-born male infants. Most commonly, fragile X syndrome has been detected only after patients clearly demonstrate developmental delay, and frequently detection occurs only if the family history is consistent with X-linked mental retardation. Macro-orchidism is a finding commonly associated with the fragile-X syndrome. It has been suggested that the sparsity of reports of macro-orchidism among prepubertal boys with the fragile-X syndrome might be due to lack of careful measurement of the tests rather than to initiation of the enlargement at puberty. A 5-month-old infant with fragile-X syndrome, ascertained through testicular enlargement noted by actual measurement of testicular size as part of his physical examination, is reported. PMID- 6493885 TI - Zinc and low birth weight: relationship questioned. PMID- 6493886 TI - Pathogenesis of prune-belly syndrome. PMID- 6493887 TI - Administration of thyroxine to very low-birth-weight, premature infants. PMID- 6493888 TI - Fever therapy failure. PMID- 6493889 TI - A call for clinical prudence in use of DTP and other vaccines. PMID- 6493890 TI - Cutis laxa, ligamentous laxity, and delayed development. PMID- 6493891 TI - Pediatric patient education: challenge for the '80s. PMID- 6493892 TI - Role of the pediatrician in patient education. AB - Although most pediatricians agree on the importance of teaching parents and children about health care, they may not succeed in patient education because of a lack of the requisite communication skills, inadequate printed materials to augment personal involvement, a tendency to substitute such materials for personal involvement, and inadequate compensation. Physician recognition of an obligation to teach is a requisite for effective education. Adjustment of current practices is essential: use of educational materials must be systematically incorporated; educational efforts must make effective use of time and be cost effective. Information should be readily understood, parents given an opportunity to ask questions, and effectiveness of the education evaluated. Pediatricians must have a constant source of supplementary material to use in patient education. Videotapes and interactive computer programs should be considered for more effective communication. Residency programs must teach future pediatricians how to educate parents and children. PMID- 6493893 TI - What do patients and parents want to know? What do they need to know? AB - Health, or patient, education is important in enhancing patient cooperation and compliance with medical regimens. When communication flows in only one direction (from the physician to the patient), education is relatively ineffective. The process of patient education should be viewed as a joint venture, in which the patient helps to determine what information should be provided. The physician must consider not only what the patient needs to know, but also what he or she wants to know. The physician should find out specifically what a patient on a particular occasion would like to have explained. If necessary, the physician can effect a bridge between the information that is deemed to be appropriate and the patient's perceived needs. Anxiety may block the patient's receptiveness to health care information. The physician can alleviate these fears by creating a "therapeutic alliance." A helpful tactic is to speak in language the patient can understand, keeping the message simple and specific. Timing is also crucial; the physician must be able to judge when a patient is ready to receive certain information. The degree of detail offered will depend on the patient's needs and preferences. The hallmark of a pediatric practice is an open mind and continued readiness to assess the patient's knowledge, receptiveness to additional health information, and current needs. PMID- 6493894 TI - Effective approaches to patient education for the busy pediatrician. AB - Pediatricians spend 35% to 41% of their direct patient care time on patient education and counselling. However, studies indicate that teaching alone generally is ineffective. It is logical that the patient or parent must have an understanding of the basics of the regimen in order to follow the pediatrician's advice. However, teaching, even when supplemented by pamphlets or audiovisual programs, generally is not sufficient to bring about behavior change. A "stepped approach" to patient education is recommended. This approach consists of three steps: (1) using interpersonal skills to establish rapport and provide reassurance; (2) teaching about the illness, regimen, and other health matters; and (3) identifying and overcoming obstacles to behavior change. Step 3 is not necessary if steps 1 and 2 have been successful in achieving patient adherence to physician recommendations. By questioning the patient or parent at the follow-up visit, the pediatrician can identify the obstacles that are interfering with acceptance of his or her advice--this process is the "behavioral diagnosis." Once the cause of the problem has been determined, selection of the appropriate solution is usually straight-forward. This three-step approach to patient education can be more effective and less time-consuming than traditional approaches. PMID- 6493895 TI - Coughs and colds. AB - Coughs and colds are seldom associated with serious diseases or complications, but they frequently cause patient discomfort, prompting many telephone calls and visits to hospitals and physicians' offices. Parents often harbor misconceptions regarding the etiology, diagnosis, and management of these conditions, leading to inappropriate treatment and home "remedies." The pitfalls associated with treating coughs and colds can be minimized when the physician takes time to educate patients and parents. Education should be anticipatory, reassuring, and unrushed. Adequate communication requires practice and thought. Good techniques include asking open-ended, nonthreatening questions and avoiding the use of jargon. Parents must be asked about their understanding of and fears concerning coughs and colds. Education must include repetition, with feedback and rewards by someone who believes in the value of education and transfers this belief to patients and parents. Effective patient education in the treatment of coughs and colds may be achieved by adopting the above common-sense techniques. PMID- 6493896 TI - The wheezing child. AB - Asthma self-management is a new concept. Asthma Care Training for Kids (A.C.T.) was developed at the University of California at Los Angeles (UCLA); its concepts have been incorporated into the daily management of the asthmatic child. The child is allowed to be in the driver's seat, to have some control of his or her disease. Using the colors of the traffic signals--red, yellow, and green- pediatricians teach children about their symptoms, aggravators, and medications. The children keep daily diaries, which result in better control of disease, along with increased compliance. Causes of asthma are presented; pediatricians are advised to explain to their patients and the parents the concept of hyperreactive ("twitchy") airways; that is, asthma can be caused or aggravated by many things, including allergens, infection, and exercise. Proper home management is detailed, including environmental control. The use of antiasthmatic medications is stressed, especially the side effects. PMID- 6493897 TI - Vomiting and diarrhea. AB - Vomiting and diarrhea are frequently encountered in pediatric patients. Dehydration, a serious consequence of both vomiting and diarrhea, results in the deaths of more than 700 children annually in the United States. With appropriate parent education, both morbidity and mortality can be reduced, and much of the anxiety about these problems can be alleviated. Parents must be educated to recognize the associated signs and symptoms that indicate serious disease and warrant notifying the physician. Fluid therapy should be individualized, and parents should be informed of the appropriate steps to take. Parents must make quantitative observations and keep records not only to enable the physician to assess adequate fluid balance but also to be able to demonstrate to themselves the effectiveness of the treatment. It is just as important for the physician to reassure parents, who will have concerns about long-term nutritional or growth consequences. PMID- 6493898 TI - Abdominal pain. AB - Chronic abdominal pain affects 10% to 12% of school-aged children. In 90% to 95% of such patients, no organic cause can be elicited. Certain behavioral and personality characteristics are frequently evident in these children. Significant stress is usually present in the families. The goal of the evaluation is education of the child and family about the abdominal pain. The reality of the pain is acknowledged, but the stress is dealt with as the primary issue. PMID- 6493899 TI - Introduction to preventive pediatrics. AB - Pediatricians can do much to ensure an active, forceful, and rational approach to the prevention of childhood injury and disease. The extent of progress over the next decade will, in large measure, be determined by the ability of pediatricians to work with the nonmedical community in implementing meaningful accident prevention efforts. PMID- 6493900 TI - Patient education for immunizations. AB - Many physicians and parents consider immunizations routine; as a result, they fail to discuss this important aspect of health care. Parents should be educated about each vaccine and the role it plays in the well-being of their child. To ensure that parents will be able to give informed consent to have their child immunized, the physician should provide information on the nature, prevalence, and risks of the disease; the type of immunization product to be used; expected benefits; risk of side effects; and required follow-up. In addition, the concept of individual immunity as a contribution to community well-being should be discussed. Parents should be appraised of the importance of maintaining accurate immunization records. Verbal communication of this information at the time of vaccination can be reinforced by written documents. One way to verify that parents have understood the information is for the physician to question them at the next office visit. PMID- 6493901 TI - Poison prevention education. AB - Physicians can significantly decrease the frequency and severity of poisoning by educating parents and families in poison prevention. Appropriate strategies for poison prevention education require an examination of epidemiologic characteristics of exposures and potential intervention techniques. Parents should be taught immediate first-aid steps, such as initiating basic life-support measures and irrigation and dilution, that can be taken before seeking medical assistance. Other consumer actions, such as inducing emesis, require medical supervision. The poison control center is the best source for information and advice on treating poisoning. To decrease the frequency of poisoning, parents should be taught to purchase, store, and handle potentially toxic products appropriately. The purchase of household chemicals and drugs in child-resistant safety packaging should be encouraged. To decrease the severity of poisoning, parents should post the phone number of the local poison center, be able to initiate first-aid measures, and keep ipecac syrup on hand. Ideally, a physician should establish a preventive education schedule and discuss poison prevention with parents at regular well-child visits, beginning when the child is very young. PMID- 6493902 TI - Prevention of childhood injuries. AB - Accidents account for more deaths among children aged 1 to 14 years than the next five most common causes. Thinking about accidents as injuries that happen in a context comprising a host, an agent, and an environment may help prevent them. Until a profile of the family and child at risk of injuries is developed, causal factors must be identified and removed, and parents and children educated about injury prevention. Different problems occur at different stages of a child's development. The agents most commonly associated with injuries are automobiles, bicycles, swimming, and animals. The special vulnerability of infants was addressed by the American Academy of Pediatrics' "First Ride/A Safe Ride" program, which encouraged the use of safety seats. Design changes have reduced the number of bicycle injuries, but human factors continue to contribute significantly. Most drownings occur in fresh water, with many children within a few feet of safety; continuing education is essential. Inculcating respect for animals, learning safety rules for interaction, and advice on pet ownership help to reduce animal bite injuries. PMID- 6493903 TI - TIPP usage. AB - In recent years, physicians have become more concerned about the prevention of childhood accidents. Developed to help physicians teach parents how to avoid unintentional injury, The Injury Prevention Program (TIPP) is significant because anticipatory guidance has now been recognized as being as much a part of routine health supervision as the history and physical examination. The American Academy of Pediatrics' policy statement enclosed with each TIPP package states five goals that deal with major causes of childhood mortality; three can be achieved with a single purchase or action--buying a smoke alarm, buying a bottle of ipecac, and turning down hot water temperature. TIPP comprises three elements: A parent questionnaire (the Framingham safety survey) is used to identify at-risk behavior. Safety sheets to be handed out at the next visit reinforce the information provided by the physician in his or her discussion of the questionnaire results. A model counseling schedule suggests how to incorporate the questionnaire and safety sheets into an effective office program. By gradually phasing TIPP into an office practice, physicians can become familiar with TIPP materials and integrate it in a controlled manner. The AAP Committee on Accident and Poison Prevention is studying measures to increase the usefulness of TIPP. PMID- 6493904 TI - [Changes in the phospholipid content of the erythrocyte membranes in children with chronic hepatitis, and their correction after its treatment]. PMID- 6493905 TI - [Disorders of water-electrolyte balance in children with severe forms of acute intestinal infection]. PMID- 6493906 TI - [Effectiveness of the treatment of neurological forms of epidemic parotitis with leukocytic interferon]. PMID- 6493907 TI - [Metabolic correction in acute complicated pneumonia in young children]. PMID- 6493908 TI - [Effect of vitamin E in children with life-threatening acute suppurative destructive pneumonia]. PMID- 6493909 TI - [Regulation of motor reactions in infant during the first few months of life]. PMID- 6493910 TI - [The familial nephrotic syndrome]. PMID- 6493911 TI - [Characteristics of chemotactic properties of phagocytes in children with thymomegaly]. PMID- 6493912 TI - [Parathyroid diseases in children]. PMID- 6493913 TI - [Preventive examinations of children for the detection of diabetes mellitus]. PMID- 6493914 TI - [Dispensary observation of children with a history of the pleural form of acute destructive pneumonia]. PMID- 6493915 TI - [Effectiveness of treatment of obese children in a pioneer camp of a sanatorium type]. PMID- 6493916 TI - [Activities of the laboratory for socio-hygienic problems in maternal and child care]. PMID- 6493917 TI - [Control of enterobiosis among children in preschool institutions]. PMID- 6493918 TI - [Recurrent viral hepatitis in children]. PMID- 6493919 TI - [American specialists in the program of developing maternal and child health care in the United States]. PMID- 6493920 TI - [Rheological properties of blood in children with chronic active hepatitis B]. PMID- 6493921 TI - Acute angle enlargement and the Zoellner illusion. AB - The direction rather than the magnitude of the Zoellner illusion was assessed for intersect angles greater than 40 degrees. Data support the illusion's description as an instance of the principle of acute angle enlargement. PMID- 6493922 TI - Bender scores and the horse as a distinct item on object assembly of the WISC. AB - This exploratory study investigated the relationship between two measures of perceptual-motor problems. Ratios derived from the Object Assembly subtest of the WISC with errors greater than 1 SD on the Bender test using Koppitz' scoring system were compared. The sample of 66 white middle-class children was 6 to 11 yr. old. The particular ratio studied was statistically significantly associated with the Bender, whereas ratios of other Object Assembly items were not. The Horse ratio was also significantly associated with the presence of learning problems shown in children's files. PMID- 6493923 TI - Contribution of sex-differentiated experiences to spatial and mechanical reasoning abilities. AB - For 137 women and 115 men first-year college students tested spatial visualization and mechanical reasoning were most strongly correlated with four everyday spatial abilities--understanding mathematics/science and graphs/charts, drafting and drawing things, and arranging objects. Despite greater practice on only 2 of 10 activities, men uniformly judged they had significantly better spatial ability compared to their same-gender peers than did the women. PMID- 6493924 TI - Neurobehavioral deficit and computed tomographic abnormalities in three samples of schizophrenic patients. AB - Recent reports have suggested that schizophrenics show brain abnormalities as reflected on computed tomography (CT Scan). We present data on three groups of schizophrenic patients which replicate our original report of this phenomenon with associated neuropsychological test results. The over-all evidence for an increased rate of neuropsychological abnormalities and related CT structural anomalies in groups of schizophrenics in several studies is robust. The biological dynamics, cause-effect relationships, and clinical applicability of this phenomenon in the individual case, however, are far from clear. Diagnostic agreements between behavioral and structural abnormalities should simultaneously sound a note of clinical caution and stimulate further study. PMID- 6493925 TI - Relationships of oral stereognostic ability to age and sex of children. AB - A battery of items testing oral stereognostic ability was individually presented to 168 children, 12 boys and 12 girls at each of seven age levels from 4-5 to 11 4. Age was significantly related to oral stereognostic scores; older subjects scored significantly higher than younger subjects. Sex was also significant; girls scored higher than boys. The interaction of age and sex was not significant. PMID- 6493926 TI - Age differences in self-reported anxiety and psychomotor performance. AB - 10 young and 10 older adults completed a self-report questionnaire on Debilitative and Facilitative Anxiety both prior to and following 10 psychomotor coding trials. Older adults were higher on Facilitative Anxiety at both times. These scores were negatively correlated with coding task performance for the total group but not for the individual age groups. There was no age effect for Debilitative Anxiety, although it was lower at Time 2, particularly for older adults. Debilitative Anxiety was not correlated with psychomotor performance. These results do not support the hypothesis that the psychomotor performance of older adults is differentially negatively affected by anxiety. PMID- 6493927 TI - Organization in children's recall of information about movement. AB - Children's recall of five randomly presented movement distances was studied as a function of three organization groups. The group given subjective organization was free to recall the movements in any order. The group given experimenter presented order had to recall the movements from shortest to longest. The forced random group was required to recall the movements in the same order in which they were randomly presented. 60 boys and girls, 7 to 8 and 11 to 12 yr. old, volunteered. No appreciable difference in mean absolute error was found between the first two groups, but they did recall the movement distances with less error than the forced-random group. It was concluded that the organization of movement information is important for effective recall by children, but subjective organization was not superior to an organization imposed by the experimenter. PMID- 6493928 TI - A simple procedure for evaluating exercise-based health promotion programs in a worksite. AB - This study discussed the formulation of a simple evaluation system for a business which conducted an exercise-based health promotion program. The needs, objectives, and initial procedures for this type of system were outlined. Results from one program session were presented to illustrate the simplicity, as well as practicality, of establishing such an evaluation system. PMID- 6493929 TI - Judgment of facial expressions of emotion as a function of exposure time. AB - The purpose of this experiment was to study the accuracy of judgment of facial expressions of emotions that were displayed for very brief exposure times. Twenty university students were shown facial stimuli that were presented for durations ranging from 10 to 50 msec. The data showed that accuracy of judgment reached a fairly high level even at very brief exposure times and that human observers are especially competent to process very rapid changes in facial appearance. PMID- 6493930 TI - Do confusing information and egocentric instructions influence perception? AB - In an investigation of psychological differentiation, Witkin's personality dimension, 12 field-dependent and 12 field-independent students were selected from a population of college men in summerschool based on their Embedded Figures Test scores. They were assigned to conditions, given egocentric or gravitational instructions, and provided clarified or obscuring feedback about their performance on the Rod and Frame Test. Although instructions had no effect, students with clarified feedback performed better than those whose feedback was confusing. Field-independent men had less difficulty with the confusing feedback than did field-dependent men. PMID- 6493931 TI - Misinterpretation of instructions in an aftereffect task. AB - Some subjects in studies of kinesthetic aftereffect erroneously believe the task is to show the width of the aftereffect inducing rather than the standard stimulus. Although such subjects may be encountered rarely, the errors they make are very large. Precautionary steps are indicated. PMID- 6493932 TI - Subjective assessment of sleep by Sleep Questionnaire. AB - A 55-item Sleep Questionnaire is presented for possible use as a standardized instrument in psychological studies of sleep. A factor analysis of responses from 145 adults to the questionnaire indicated 7 factors accounted for 71.7% of the total variance. These factors are congruent with sleep dimensions discussed in the literature and with other factor analytic investigations. A set of 11 clinical judgment scales are also presented. The reliabilities of both factor and clinical scales are adequate as judged by test-retest, internal consistency, and comparisons of self vs spouse ratings. The construct validity is supported by three studies showing significant differences between (a) medical patients with and without sleep disturbances, (b) psychiatric patients with and without symptoms of depression, and (c) short and long sleepers. PMID- 6493933 TI - A classification of object and environmental spatial tests. AB - A classification of object and environment spatial tests was derived from a comparison of 187 object tests and 11 environment tests, and a grouping of these tests was obtained from an examination of the perceived differences in their stimulus dimensionality and the inferred similarities of their task requirements. PMID- 6493934 TI - Influence of arm positions on EMG-reaction time of the biceps brachii for elbow flexion and forearm supination. AB - The influence of starting positions of the arm on EMG-RTs of the biceps brachii muscle for elbow flexion and forearm supination was examined using 16 normal subjects. Two angles of the elbow joint, 45 degrees and 110 degrees flexion, and two positions of the forearm, 45 degrees supination and 90 degrees pronation, were used as the factorial combinations of all four. The EMG-RT for elbow flexion decreased in the order of 110 degrees Pronation greater than 45 degrees Pronation = 110 degrees Supination greater than 45 degrees Supination, and that for forearm supination decreased in the order of 45 degrees Supination greater than 45 degrees Pronation = 110 degrees Supination greater than 110 degrees Pronation. These results were kinesiologically interpreted that variations of EMG-RTs were based on the change in the number of synergic muscles participating in an intended movement and the muscle length of the prime mover at the start of the movement. PMID- 6493935 TI - Barrier and penetration scores in relation to some objective and subjective somesthetic measures. AB - Barrier and Penetration scores in relation to some variables, such as muscular tone at rest, sensitivity to tickle, and body perception were studied in a group of 35 female subjects. While no correlations appear within the whole group of subjects between Barrier scores and the other variables, on the left side of the body. Dividing subjects on the basis of Barrier scores, three groups with different characteristics appear: 12 subjects with high Barrier scores show an inverse relation of Barrier scores with sensitivity to tickle on the right side of the body; 12 subjects with middle Barrier scores show a direct relation of Barrier scores with muscular tone and an inverse one with both latency of tickle on the right half of the body and body perception; 11 subjects with low Barrier scores show an inverse relation of Barrier scores with durations of tickle on both sides of the body. PMID- 6493936 TI - Anxiety, perception, and control of heart rate. AB - 8 women and 8 men took Cattell's IPAT-anxiety questionnaire and later McFarland's test of ability to perceive heart activity. The second test involved subjects' tracking their own heart rates, then they enrolled in an EKG biofeedback session to evaluate ability to increase and decrease heart rate from subjects' resting baselines. At the end of the session each subject completed Blanchard, et al.'s questionnaire to specify the cognitive strategies used for heart-rate control. Heart rate, abdominal respiration rate, respiration amplitude, EEG percent power in theta, alpha, and beta bands were evaluated. Success of heart-rate decrease seemed to depend mainly on activity levels: the subjects who achieved high scores on the activity test decreased heart rate significantly better than did low scorers. The relationship between scores for perception of heart and increases in heart rate was nonsignificant: increased heart-rate seemed to depend on differences in respiration between the rest and periods of increase. The significant, negative correlation between trait anxiety and perceptions of heart activity suggested that anxiety affected subjects' ability to perceive heart rate. The theta EEG power of the right hemisphere was significantly higher in subjects scoring high than for those low in perception of heart activity. During heart-rate increase tasks subjects mainly reported use of 'arousal responses,' similarly during heart-rate decrease tasks they reported use of relaxation responses. PMID- 6493937 TI - Children's embedded figures test: an examination of item difficulty in grades K 4. AB - Indices of item difficulty for both the Tent and the House series of the Children's Embedded Figures Test are reported from a sample of 240 children in grades K-4. Results indicate that the failure rule should be re-considered and the test shortened. PMID- 6493938 TI - Evoked potentials by letters in printed and script forms. AB - Visual evoked potentials were recorded for 6 adult male subjects in response to single vowels and consonants in printed and script forms. Analysis showed the vowels in the printed form to have evoked responses with shorter latency (component P1 at about 133 msec.) and larger amplitude (component P1-N1) than the other letter-typeface combinations. No hemispheric asymmetries were found. The results partially agree with the behavioral data on the visual information processing of letters. PMID- 6493939 TI - Comparison of three cognitive strategies in altering pain behaviors on a cold pressor task. AB - The efficacy of three cognitive strategies for coping with pain was examined in a cold-water pressor task in a sample of college students. Subjects were pretested and then randomly assigned to one of three treatment conditions (Paradoxical Intention, Rational Self-statement, or Self-observation) or to an expectancy control group. Following training in the respective cognitive strategies, all groups were given a posttest in the cold-water pressor to determine the effectiveness of the treatment. Pain thresholds, tolerances, and discomfort ratings were recorded for subjects in each condition. No differences were found between the Paradoxical Intention or Rational Self-statement groups and the Expectancy Control on any of the pain measures. The Self-observation treatment condition, however, had significantly higher pain tolerance scores than the Expectancy Control group. The findings were attributed to the subjects' dissociating the sensory aspects of the pain experience from the anxiety when focusing upon the coldness and wetness of the cold water. PMID- 6493940 TI - Cognitive processing capacity and heart rate in recognition memory for numbers and random shapes. AB - Heart rate was measured in 30 men during a recognition-memory task using both numbers and random shapes as stimuli. Findings for the number, but not the shape material, provided support for the hypothesis that availability of cognitive processing capacity is reflected by heart rate. This was considered an indication of separate cognitive processors. PMID- 6493941 TI - Visual recognition memory of severely head-injured patients. AB - 14 severely head-injured adults were compared with 14 normals on a recognition procedure, Kimura's Recurring Figures Test, which requires identification of eight recurring shapes among a series of 160. The head-injured patients showed, by far, more incorrect responses than the control group. PMID- 6493942 TI - The limits of verbal pain descriptors. AB - The evidence that verbal descriptors can reliably portray the sensory and affective qualities of pain states and various clinical groupings of pain patients is examined. Support for the proposition that different pain syndromes can be distinguished on the basis of such word patterns is lacking. PMID- 6493943 TI - Anxiety responses to a divergent production task among high and low divergent performers. AB - Undergraduate psychology students (4 men, 17 women) completed the Spielberger State-Trait Anxiety Inventory, wrote down as many uses as they could think of for each of a list of 30 items, and completed the anxiety inventory again. Divergent performance was defined as the total number of uses a subject listed. The hypothesis that divergent performance would be correlated with a reduction in state anxiety was confirmed. PMID- 6493944 TI - Short-term memory for colors and color names in the absence of vocalization. AB - In a previous experiment, Allen found no release from proactive inhibition using the Brown-Peterson procedure in a group who were shifted from recalling colors to recalling the names of colors. The lack of release suggests that colors and color names are encoded in similar ways. It was argued that the similarity of encoding might have been caused by the procedure of requiring the subjects to say out loud the names of the colors at the time of stimulus presentation and recall. In the present experiment, a procedure was devised that eliminated the need for verbalization of the colors. The same pattern of results was obtained, namely, release from proactive inhibition in the group shifted from recalling color names to colors but not in the group shifted in the opposite direction. It was concluded that if subjects encode colors as a verbal label, then this encoding strategy is not caused by the procedure of requiring the subjects to verbalize the colors. PMID- 6493945 TI - Representation of spatial relations on the specific test, Draw-A-Person-With-Face In-Front, as indicative of literacy skills in Australian aboriginals and "Westerners". AB - A novel test, Draw-A-Person-With-Face-In-Front, uses simple measurement with a ruler to detect subtle misrepresentation of spatial relations within the pattern of the human face (in contradistinction to facial recognition tests). Studies have repeatedly shown a close association between misrepresentation of the face and low or absent skills in widely diverse cultural populations and time periods. Recent criticism by Davidson that neglects to consider this particular test and the replications of similar results does not address the main point of my study of Australian Aboriginal children or the specification of remedial intervention made possible by fractionating factors of specific under-used capability within a cultural context. PMID- 6493946 TI - Effect of stimulus intensity on lingual vibrotactile fusion thresholds. AB - Lingual fusion thresholds for a two-pulse stimulus were obtained at a 15-dB sensation level and a 35-dB sensation level for 15 subjects (18 to 22 yr.). The 35-dB sensation level provided better temporal resolution thresholds as well as less variable responses. PMID- 6493947 TI - Use of the NCA-modified assessment with a population of intoxicated drivers. AB - Given the proliferation of state laws affecting drunk drivers, the recently passed Wisconsin provision which mandates alcohol assessment for all convicted offenders is of particular interest. When applied during a 2-yr. period in Racine County, WI (1 yr. prior to the enactment of the policy and 1 yr. after passage), most of the persons assessed for operating a vehicle while intoxicated were judged to be irresponsible users of alcohol (social drinkers). Those assessed as alcohol dependent were numerous and were sent to treatment rather than educationally oriented rehabilitation programs. Addressing the issue of predicting which factors would influence the referral to education versus treatment programs, the study showed that repeaters, users of the human services, and those persons having higher concentrations of blood alcohol tended to be sent to treatment. Use of the MOD-CRIT assessment instrument provides the state alcohol treatment system with a means by which drinking drivers can systematically be referred to appropriate rehabilitation programs. Although some margin of error may exist during the assessment process, mandatory assessment is deemed preferable to individualized reports that are open to bias and interpretation. PMID- 6493948 TI - Specific stimulus-evoked violent action in psychotic trigger reaction: a seizure like imbalance between frontal lobe and limbic systems? AB - A recently proposed diagnostic class, psychotic trigger reaction, is deduced from careful clinical studies of eight white men, who upon a very specific trigger stimulus committed murder or attempted to (and in one case also rape). The new class is defined as a sudden ego-alien, motiveless (at least with respect to aggression), motor-wise well organized, violent complex action without emotional concomitants. The action is evoked (not provoked) by an individually unique stimulus within a specific context reviving repeated past traumatic experience. Typically there is no (significant) loss of consciousness and practically full recall. Observed are first-time hallucinations (visual, auditory, tactile, somesthetic, but not olfactory as in temporal lobe epilepsy) and signs of imbalance in the autonomic nervous system (loss of bladder control, ejaculation, profuse sweating, nausea). Only four of these men had previous psychiatric diagnoses (and then various ones) or abnormal EEGs at some time in their lives. Variety in prior diagnoses would be consistent with a seizure-like disorder, here specifically implicating an imbalance in functioning between limbic and frontal lobe systems. Clinical tests for the latter were prevailingly indicative of dysfunctioning. A detailed clinical analysis of the violent acts within their context suggests behaviors are analogous to certain limbic system mechanisms, especially the kindling phenomenon. PMID- 6493950 TI - Time urgency of type A individuals: two replications. PMID- 6493949 TI - Manual performance in the cold with gloves and bare hands. AB - Previous research aimed at quantifying and reducing the decrements encountered in performing manual tasks in cold weather has not described the relationships between task characteristics and cold-induced impairments. The amount of decrement and, often times, the optimal means for reducing the decrement, appear to be task-specific. The research reported here is one in a series of studies formulated to explore those relationships. The strategy is to use tasks from the battery developed by Fleishman (1967) to measure the factorially 'pure' abilities needed to perform all manual tasks. 24 U.S. Marines performed this battery of nine tasks across a range of cold temperatures. To determine if the decrement due to wearing gloves might be less than the decrement due to cold hands as the air temperature decreased, performance on the battery of tasks was measured with and without gloves. Only three of the tasks (abilities) were affected by cold temperatures, and the amount of decrement increased as the air temperature decreased. Three tasks deteriorated due to wearing of gloves, two of those affected by cold and one other. Temperature affected performance independently of the glove effect. Half of the subjects did not complete bare-handed testing at 18 degrees C (approximately 20 min.), indicating this is the lower end of the temperature range in which bare-handed performance for more than a few minutes is practical. PMID- 6493951 TI - Structured time and subjective acceleration of time. AB - The present paper gives some evidence that differences in subjective time acceleration with aging are correlated with differences in the extent to which time is structured for the individual, as opposed to free time. Lemlich's 1975 hypothesis relating this speeding up of time to the subjective duration of the time interval was only partially supported by the evidence. Subjective change perceptions of happiness were not correlated significantly with this phenomenon of time perception. PMID- 6493952 TI - Anatomical Rorschach responses of gravely psychosomatic patients. AB - In all four groups of 97 gravely psychosomatic patients the scores of the anatomical Rorschach responses are higher than the reference value, the responses being mostly of the bony/skeletal type. At responses can give information of issues related to the body self and disorders in body image, self-awareness, self concept, or individual identity. PMID- 6493953 TI - Treatment versus non-treatment in reduction of symbol reversals by first grade children. AB - A correcting program for symbol reversals by first grade children (n = 38) did not significantly reduce symbol reversals below those of a non-treated control group (n = 39). There were significant reductions in reversals within both groups. The practice of remediating reversals and the use of directionality to explain symbol reversals are both questioned. The possibility that maturation plays a role seems plausible as an explanation of the changes. PMID- 6493954 TI - Cerebral specialization and hemispheric performance asymmetries in narrative memory. AB - Data on cerebral specialization derived from studies of human head-injuries have long implicated the left hemisphere's critical role in speech processing and verbal memory. We report a relatively simple paradigm which demonstrates an analogous asymmetry in narrative recall performance in normal subjects when either one hemisphere or the other is concurrently engaged with control of a secondary motor task. Caution in generalizing these data to performance asymmetries in brain-injured patients is nevertheless required. PMID- 6493955 TI - Residual effect of delayed auditory feedback on normal speaking rate and fluency. AB - The present study was designed to investigate possible residual effects of delayed auditory feedback on paragraph readings performed by normal speaking college students. No residual effect was shown under any of the experimental conditions employed. PMID- 6493956 TI - Awakenings: subjective and objective relationships. AB - Electroencephalographic measures of awakenings and subjective estimates of amount and frequency of awakenings were compared. The subjects were 65 men and 69 women between 50 and 70 yr. of age; their scores showed ranges on these measures. The relationships between the measures were low. Analyses of scores on the perceptual task indicate the reasons for the low relationship. The functional meaning of these findings is discussed. PMID- 6493957 TI - Illusional effects of spatial distance between focal and contextual parts of a modified Muller-Lyer figure. AB - Visual integration of spatially separated stimuli was studied in a modified Muller-Lyer illusional pattern by varying the distance between the shaft and the contextual lines. Using the method of constant stimuli, the data from 265 participants indicated a significant inverted-U trend which is contrary to previously reported findings. PMID- 6493958 TI - Smooth pursuit eye movements in normal and dyslexic children. AB - This paper describes a detailed study of horizontal eye movements associated with visual tracking of a smoothly moving target. Essentially all children, even at target velocities as low as 5 degrees/sec., show some saccadic eye movements superimposed on smooth tracking movements. Detailed analysis of pursuit eye movements from a group of 26 poor readers and 34 normal controls (8 to 13 yr.) showed that about 25% of poor readers have an abnormally raised saccadic component in smooth pursuit. This suggests that studies of eye movements during tracking of smoothly moving targets at low velocity, combined with a quantitative approach to data analysis, may be useful for early detection of a significant proportion of poor-reading children. PMID- 6493959 TI - Retinal versus extraretinal influences in flash localization during saccadic eye movements in the presence of a visible background. PMID- 6493960 TI - Eye-position signals in successive saccades. PMID- 6493961 TI - Adaptive estimation of phoneme boundaries and selective adaptation for speech. PMID- 6493962 TI - Dimensional interaction of hue and brightness in preattentive field segregation. PMID- 6493963 TI - Modeling feature perception in brief displays with evidence for positive interdependencies. PMID- 6493964 TI - Shape constancy: the effects of changing shape orientation and the effects of changing the position of focal features. PMID- 6493965 TI - Effect of duration on detection by the chromatic and achromatic systems. PMID- 6493966 TI - Strength/duration relationships for electrocutaneous sensitivity: stimulation by capacitive discharges. PMID- 6493967 TI - The effect of phase-reversed and flashed presentations upon the apparent contrast of sinusoidal gratings. PMID- 6493968 TI - Frames of reference in preschoolers' perception of motion. PMID- 6493969 TI - Contrast variability lightens subjective figures. PMID- 6493970 TI - [The maintenance dose of digoxin--a simple method of calculation]. PMID- 6493971 TI - [Peptides and human reproduction]. PMID- 6493972 TI - Reproductive performance in gilts through their first two parities. AB - Fertility data were collected for 766 gilts from 12 breeding and commercial herds. The age at first breeding was 244.5 days and at first farrowing 363.2 days. The litter size was 9.91 piglets born (9.16 live). The farrowing rate at the first service was 87.8%. The total farrowing rate was 95.5% of the mated gilts and 88.4% of all the gilts. 9.8% were repeat breeders. 2.6% of the once mated gilts never returned to oestrus and still did not farrow. The culling rate was 11.6%. The major reason for culling was delayed puberty/anoestrus (7.7%). Of the 565 gilts having a first litter 85.3% were mated after weaning. The age at second farrowing was 541.7 days. The litter size was 10.9 piglets born (10.3 live). The farrowing rate after first service was 83.0%. The total farrowing rate of the 482 sows was 92.9% and of the 565 weaned sows 79.3%. 12.2% were repeat breeders. 4.8% of the sows once mated never returned to oestrus and still did not farrow. The culling rate was 20.7%. Culling because of anoestrus was 4.4%. The month of birth significantly influenced the number of gilts culled because of anoestrus, the age at first breeding and at first and second farrowing. The season also influenced the interval from weaning to service, the percentage of sows served within 7 days of weaning and culled because of anoestrus. No correlation between a high ultrasonic index and lowered fertility was found. The age at first breeding was 1.12 days younger per unit higher ultra-sonic index. PMID- 6493973 TI - Numbers of airborne bacteria and fungi in calf houses. AB - Counts of airborne bacteria colony forming particles (BCFP) and fungi were made at intervals throughout one year in three calf houses using a six stage Andersen Sampler. House 1 was insulated, mechanically ventilated and heated, House 2 was insulated and provided with a controlled natural ventilation system, while House 3 was uninsulated with natural ventilation. Each house contained 36 bought-in bull calves. Every six weeks the 12 oldest calves were removed and replaced by 12 four-week-old calves. The mean count of BCFP was highest in House 2 (101.6 X 10(3) m-3) and lower in House 3 (67.6 X 10(3) m-3). The mean count of aerial fungi was significantly lower in House 3 (40.5 X 10(3) m-3) than in Houses 1 and 2 (119.3 X 10(3) m-3 and 127.1 X 10(3) m-3, respectively). The count of aerial BCFP and fungi showed large seasonal fluctuations, but there was a general trend towards lower counts during the winter period. The mean incidence rate of respiratory disease among the experimental calves was 67.7%. The highest mean incidence rate was recorded in House 2, but differences between houses were not significant. The results are discussed in relation to the environmental requirements for raising of calves, and in the light of the current concept of air hygiene as a major predisposing factor in the web of causation of calf respiratory disease. PMID- 6493974 TI - Haemophilus pleuropneumoniae serotypes--cross protection experiments. AB - Pigs vaccinated with a killed 6-hour culture of Haemophilus pleuropneumoniae serotype 2 with Freund's incomplete adjuvant were not protected against challenge with serotypes 1, 5, 6 or 8. Equivalent results were obtained when pigs were vaccinated with serotypes 4 or 5 and challenged with serotype 2. In earlier studies of immunity induced by intranasal immunization with live H. pleuropneumoniae organisms, it was clearly shown that intranasal inoculation with one serotype of H. pleuropneumoniae would induce a strong immunity to both homologous and heterologous serotypes (Nielsen 1979). The present study has shown that cross immunity is not obtained with parenteral immunization. The results strongly suggest that the immune response of the pig to parenteral vaccination is different from the response seen after natural infection, and indicate that an important part of the defence mechanism against H. pleuropneumoniae infection is a local immune-barrier which is effective in preventing the bacterium from penetrating the mucosa. In earlier vaccination experiments 90 per cent of vaccinates were protected against homologous challenge (Nielsen 1976). In the present work a vaccine containing serotypes 1 through 6 was fully protective against serotypes 2 and 3 and also against serotype 8, which shares antigenic determinants with serotypes 3 and 6. These results indicate that the protection obtained by parenteral immunization is serotype-specific. Vaccines must therefore contain the serotypes existing in the swine population. PMID- 6493975 TI - Hemophilia in dogs, with special reference to hemophilia A among German shepherd dogs in Denmark. II: Clinical study, therapy and prophylaxis. AB - Clinical data, pedigrees, screening tests (APTT, PT and TT) and specific tests (VIII:C, VIIIC:Ag, VIIIR:Ag and IX:C) were used to diagnose hemophilia A (classical hemophilia) in two colonies of German Shepherd dogs in Denmark. The affected individuals in both colonies were males, and they descended from a common, hemophilic ancestor. All observations were in accordance with X-linked, recessive inheritance. Therapeutic and prophylactic measures are discussed. PMID- 6493976 TI - Ergot from meadow grass in Norway--chemical composition and toxicological effects in sheep. AB - A sample of ergot from meadow grass collected in the south-western part of Norway was examined for alkaloids and dosed orally to four lambs about 10 months old. Sclerotia were dosed at a rate of 0.12-0.75 g per kg body weight per day for 4-27 days. The concentration of total alkaloids in the sclerotia was estimated to be about 0.4%. Ergosine, ergocristine, ergotamine and the three corresponding isomers were identified by thin-layer chromatography. Of the total alkaloids, ergosine and ergocristine constituted 35% each, ergotamine 15% and the isomers 5% each. Three lambs dosed outdoors in cold and wet weather all became ill, with anorexia and increased pulse rate. No symptoms nor post mortem lesions were seen in the single lamb kept indoors. On post mortem examination of the three lambs showing symptoms, hyperemic mucosae, haemorrhages, erosions and necroses in the digestive tract, most pronounced in abomasum and cecum, were demonstrated. In two lambs, slight oedema was found distally in some of the limbs and tail, but no sign of gangrene was observed. PMID- 6493977 TI - Physical structure and genetic organisation of the genome of maize streak virus (Kenyan isolate). AB - The structure of the maize streak virus genome (Kenyan isolate, MSV-K), as determined from the sequence of clones obtained from DNA isolated from virus particles, is composed of one major DNA component of about 2.6 kb. MSV virion DNA is partially double-stranded, composed of a full-length virion (V) strand and a short (70-80b) primer (P) strand. The primer strand has a fixed 5'-end capped with alkaline labile material, presumably 1-2 ribonucleotides. The MSV genome has two major coding regions oriented on opposite strands and flanked by two small intergenic regions. The coding region on the P strand is composed of two major open reading frames (ORFs), arranged in tandem and in the same reading frame. Because the predicted protein derived from a composite of these two ORFs closely corresponds to the product from a single ORF in the cassava latent virus genome, it is likely that this region encodes two proteins with common amino-termini, one a read-through product of the amber codon terminator in the first ORF. The intergenic regions contain potential transcription start and stop signals oriented in the direction of the two opposing coding regions. Considerable DNA sequence heterogeneity was observed, mostly silent or conservative third base substitutions in coding regions and base substitutions, small insertions and small, close-range transpositions in intergenic regions. PMID- 6493978 TI - Adenovirus mutants with DNA sequence perturbations in the intragenic promoter of VAI RNA gene allow the enhanced transcription of VAII RNA gene in HeLa cells. AB - Ad2 VAI gene strongly competes for transcription with VAII gene in vitro. It has been suggested that this competition may be a basis for the large excess of VAI gene transcription in virus infected cells at late times. We have studied the effect of the DNA sequence perturbations of the intragenic promoter of the VAI gene on transcription of VAII gene at the level of viral chromosome. Several Ad5 mutants with mutations in the promoter of VAI gene were constructed and transcription of their VAI and VAII genes were analyzed in the infected cells. It was found that transcription of VAII gene increased dramatically when either Box A or Box B promoter sequences of VAI gene were mutated or when the entire VAI gene was replaced by a DNA segment with an unrelated DNA sequence. Thus, at late times, active transcription of VAI gene appears to partially repress transcription of VAII gene. Those mutants which synthesized large quantities of VAII RNA only grew more slowly yielding a titer which was 1/10 of that of their parent but 5 to 6 fold higher than that of an Ad5 mutant lacking both VAI and VAII genes. PMID- 6493979 TI - The adenovirus major late promoter TATA box and initiation site are both necessary for transcription in vitro. AB - Mutagenized DNA templates and HeLa whole cell extracts were used to study the effects of promoter-specific base changes on in vitro transcription. DNA templates where the initiating adenine (+1) was changed to thymidine (AT+1) in the adenovirus 2 major late transcription unit were transcribed with 50% efficiency of the unaltered template. We have described a mutant at the TATA box, where the A at position -28 was changed to a C (AC-28). Transcription efficiency was reduced to less than 20% of control in the AC-28 mutant (Concino et al., 1983, J. Biol. Chem. 258: 8493-8496). Primer extension analysis revealed increased 5' end heterogeneity for in vitro transcripts derived from AC-28 and AT+1 DNA templates. Specific transcription was completely abolished from AT+1 DNA templates when a second change was introduced within the TATA sequence, creating a double mutant (AC-28 . AT+1). Neither the AC-28 nor the AT+1 change alone had such an effect, suggesting a coordinated interaction in transcription initiation involving both the TATA box and the initiation site. PMID- 6493980 TI - Circular dichroism measurements show that C.C+ base pairs can coexist with A.T base pairs between antiparallel strands of an oligodeoxynucleotide double-helix. AB - We have studied the coil-to-helix transition of the DNA oligomer d(C4A4T4C4), using circular dichroism measurements to monitor the formation of A.T base pairs within the central self-complementary A4T4 region and the formation of protonated C.C+ base pairs at the ends of the oligomer. We found that both A.T and C.C+ base pairs formed in a coordinated fashion as the temperature and pH were lowered. The CD data of the helix form of the oligomer were consistent with the presence of paired oligomers, but not with hairpin loops. The pKa for formation of C.C+ base pairs between the C4 ends of the oligomer was higher than the pKa for formation of C.C+ base pairs in d(C8), indicating that the formation of C.C+ base pairs in the oligomer was influenced by the presence of a paired A4T4 region. We conclude that A.T and C.C+ base pairs coexist in the self-complex of the oligomer and, therefore, that C.C+ base pairs can form between antiparallel DNA strands. PMID- 6493981 TI - Synthesis and conformational studies of ribooligonucleotides which contain an alternating C-G sequence and show unusual circular dichroism spectra. AB - The poly [r(C-G)] duplex shows an unusually large negative CD band in the long wavelength region. In order to elucidate this phenomenon, r(C-G-C-G) and r(C-G-C G-C-G) were synthesized by a phosphotriester method and their properties were examined by UV, CD, 1H and 31P NMR spectroscopy. These ribooligomers form self duplexes at low temperature, the CD spectra of which show negative bands at around 290 nm and positive bands at around 265 nm. The results of 1H nuclear Overhauser effect experiments, 1H chemical shift-temperature profiles of base protons, and the sharp singlet observed for all H1' protons are consistent with a normal A-RNA structure but not with a Z-DNA like structure. The CD-temperature profiles and 31P NMR spectra support this conclusion. These results indicate that RNA duplexes with an alternating C-G sequence can give an unusually large negative CD band in the long wavelength region despite their right-handed helical structure. PMID- 6493982 TI - A functional map of the nopaline synthase promoter. AB - This paper describes the first functional map of a promoter expressed from the plant chromosome. We have constructed a series of overlapping deletion mutants within the region upstream of the Ti-plasmid encoded nopaline synthase (nos) gene. By monitoring nos expression in tumour tissue we have inferred a functional map of the nos promoter. The maximum length of sequence upstream of the transcription initiation point required to express wild type levels of nopaline synthase is 88 bp. Within this region, the "CAAT" box is essential for maximal activity; deletion of this sequence reduced apparent nos expression by over 80%. Presence of an intact or partial "TATA" box in the absence of the "CAAT" box supports a barely detectable level of nopaline synthase. Removal of all sequences upstream of the nos coding sequence results in no detectable activity. PMID- 6493983 TI - The photoreactivity of T-A sequences in oligodeoxyribonucleotides and DNA. AB - Photoaddition between adjacent adenine and thymine bases occurs, with a quantum yield of approximately 5 X 10(-4) mol einstein-1, when d(T-A), dT-A, d(pT-A), d(T A-T), d(T-A-T-A) and poly(dA-dT) are irradiated, at 254 nm, in aqueous solution. The photoadduct thus formed is specifically degraded by acid to the fluorescent heterocyclic base 6-methylimidazo[4,5-b]pyridin-5-one (6-MIP) with retention of C(8) of adenine and the methyl group of thymine. This reaction, coupled with either spectrofluorimetric or radiochemical assay of 6-MIP isolated by high voltage paper electrophoresis, has been used to demonstrate formation of the adenine-thymine photoadduct on UV irradiation of poly(dA-dT).poly(dA-dT) and both native and denatured DNA from calf thymus and E. coli. Estimated quantum yields for this new type of photoreaction in DNA show that it is substantially quenched by base pairing. Possible biological implications of the photoreaction are discussed. PMID- 6493984 TI - The photochemistry of d(T-A) in aqueous solution and in ice. AB - When d(T-A) is irradiated at 254 nm in aqueous solution an internal photoadduct is formed between its constituent adenine and thymine bases. The resultant photoproduct, designated TA*, arises from a singlet excited state precursor; a similar photoreaction is not observed with d(C-A) or d(T-G). In contradistinction, irradiation of d(T-A) in frozen aqueous solution yields a dimeric photoproduct in which two d(T-A) molecules are coupled together by a (6 4) photoadduct linkage between their respective thymine bases. Both photoproducts have been extensively characterised by a combination of electron impact and fast atom bombardment mass spectrometry, UV, CD, 1H NMR and fluorescence spectroscopy. Acid treatment of TA* gives 6-methylimidazo[4,5-b]pyridin-5-one whose identity was established by an independent chemical synthesis involving photorearrangement of 6-methyl-imidazo[4,5-b]pyridine N(4)-oxide. A tentative mechanism is presented to account for the acid degradation of TA*. The structure of the dimeric ice photoproduct follows from its cleavage, by snake venom phosphodiesterase, to 5' dAMP and the (6-4) bimolecular photoadduct of thymidine; on acid hydrolysis it gives adenine and 6-(5'-methyl-2'-oxopyrimidin-4'-yl) thymine. PMID- 6493985 TI - Introduction: an integrated view of inhibited repair. PMID- 6493986 TI - DNA repair and its inhibition. PMID- 6493988 TI - Mechanism of potentiation by caffeine of genotoxic damage induced by physical and chemical agents. PMID- 6493987 TI - The accumulation of DNA breaks due to incision; comparative studies with various inhibitors. PMID- 6493989 TI - Possible correlations between cell killing, chromosome damage and DNA repair after X-irradiation. AB - To gain information about the possible pathway from primary DNA damage to cell killing via the formation of chromosome aberrations, we have examined the effects of the DNA synthesis inhibitor ara A on survival, on the occurrence of chromosome abnormalities and on the repair of DNA strand breaks. Our results are not inconsistent with the idea that the increased expression or 'fixation' of PLD measured after treatment with ara A is a reflection of an increase in the formation of chromosome damage comprising both exchange type and deletion type aberrations. These aberrations may arise from unrepaired or misrepaired dsb in the DNA. Treatment of irradiated cells with ara A results in a larger number of residual dsb which may be partly the reason for the increase in the frequency of acentric chromosome fragments. The reasons for the increase also in the frequency of exchange aberrations in the presence of ara A are not known but one possibility is that the probability of interaction between two dsb remains high during treatment with ara A due to the strong inhibition of dsb repair, whereas in untreated controls this probability decreases steeply with time after irradiation. PMID- 6493990 TI - Novobiocin inhibition of dark repair and longevity in Paramecium. PMID- 6493991 TI - Prematurely condensed chromosomes: a model system for visualizing effects of DNA damage, repair and inhibition at the level of chromosome structure. PMID- 6493992 TI - The relation of three-dimensional DNA structure to DNA repair as studied by nucleoid sedimentation. PMID- 6493993 TI - Effects of inhibitors on repair DNA synthesis in in vitro systems. PMID- 6493994 TI - Symposium on the chemistry of heterocyclic compounds (VIIIth) and of nucleic acid components (VIth). Prague, Czechoslovakia, September 2nd-8th, 1984. Abstracts. PMID- 6493995 TI - [Theory of the spread of malignant neoplasms in the early stage of their development. A discussion article]. PMID- 6493996 TI - [Routes of the spread of breast cancer in the radiological image. Early diagnosis of lymphangiosis carcinomatosa--its effect on prognosis, planning and monitoring of treatment. Preliminary report]. PMID- 6493997 TI - [Comparison of the value of preoperative and postoperative irradiation of patients with locally advanced breast cancer]. PMID- 6493998 TI - [Morphological evaluation of gastric mucosa in the light of endoscopic mass screening]. PMID- 6493999 TI - [Radiotherapy of spinal cord tumors at the Institute of Oncology in Gliwice 1960 1980]. PMID- 6494000 TI - [Preliminary evaluation of acyclovir treatment of patients with herpes zoster at the Chemotherapy Clinic, Institute of Oncology, in Warsaw]. PMID- 6494002 TI - [Oncologic surgery--current state and perspectives]. PMID- 6494001 TI - [Comparison of 5-year survival of patients with malignant neoplasms from the urban and rural areas 1972-1974]. PMID- 6494003 TI - [Progress in the diagnosis of pulmonary embolism]. PMID- 6494004 TI - [Area measurement--a new mathematical method of comprehensive evaluation of patient health status. Its use in cases of chronic obstructive lung disease]. PMID- 6494005 TI - [Automatic diagnosis of bronchial asthma, chronic bronchitis and pulmonary emphysema]. PMID- 6494006 TI - [Effect of long-term panodin treatment of patients with chronic bronchitis on peripheral blood leukocyte migration in vivo]. PMID- 6494007 TI - [A case of pulmonary sarcoidosis with atypical radiological picture]. PMID- 6494008 TI - [Pulmonary aspergillosis in lymphoproliferative disease]. PMID- 6494009 TI - [Value of the determination of carcinoembryonic antigen (CEA) in the serum for the diagnosis of lung cancer; evaluation of its extent and prognosis in conservatively treated patients]. PMID- 6494010 TI - [Limited suppurative meningoencephalitis with the clinical course resembling tuberculosis of the central nervous system. Description of 2 cases]. PMID- 6494011 TI - Neutrophil storage pool depletion in septic, neutropenic neonates. AB - A prospective study was done to determine the incidence of neutrophil storage pool (NSP) depletion in clinically septic neonates with peripheral neutropenia (less than 1500/mm3). Infants with NSP depletion were then randomized in a controlled study of polymorphonuclear leukocyte transfusions. Bone marrow examinations were done in 13 patients, and NSP depletion was noted in 3 (23%) patients. All patients with no NSP depletion had peripheral neutrophil recovery and 8 of 10 survived. Complications of meningitis contributed to both deaths. Two of the three patients with NSP depletion died. Neither the initial severity of illness nor the degree of peripheral neutropenia were predictive either of NSP depletion or of mortality. Most neonates with severe peripheral neutropenia and clinical sepsis had peripheral neutrophil recovery and survived with conservative management. Those at high risk could be identified only by examination of the NSP. Only those patients with NSP depletion should be considered for controlled studies of polymorphonuclear leukocyte transfusions. PMID- 6494012 TI - Evaluation of a latex particle agglutination kit in pneumococcal disease. AB - Latex particle agglutination for Streptococcus pneumoniae was evaluated in 76 patients. Fifteen of these patients had invasive disease due to S. pneumoniae including 12 with meningitis, 2 with occult bacteremia and 1 with suppurative arthritis. Five of the patients with meningitis also had bacteremia. Pneumococcal antigen was detected in the cerebrospinal fluid of 9 of the 12 patients with meningitis (sensitivity 75%). However, antigen was detected in the serum of only two of the six patients with bacteremia (sensitivity 33%) and was detected in the urine of none of five patients with bacteremia (sensitivity 0%). Consequently latex particle agglutination appears to be useful when cerebrospinal fluid is examined in patients with pneumococcal meningitis but does not appear to be sufficiently sensitive to warrant its use with serum or urine in patients with invasive disease due to S. pneumoniae. The specificity of the system used here appeared satisfactory, since pneumococcal antigen was not detected in any of the body fluids from the 61 patients without evidence of invasive pneumococcal disease (specificity 100%). PMID- 6494013 TI - A nosocomial common source outbreak caused by Pseudomonas pickettii. AB - Pseudomonas pickettii, a Gram-negative bacillus which has been recovered rarely from clinical specimens, was isolated from the respiratory tracts of 9 of 29 (31%) pediatric intensive care unit patients. The reservoir of the organism was intrinsically contaminated single dose vials of tracheal irrigant solution. Four additional hospitals in three other states have notified the Centers for Disease Control of respiratory colonization with aerobic nonfermentative Gram-negative organisms and have associated this colonization with the use of the same tracheal irrigant solution. Because of the potential for intrinsic contamination, single dose vials must be added to the list of potentially hazardous environmental agents. PMID- 6494014 TI - Nosocomial Clostridium difficile reservoir in a neonatal intensive care unit. AB - A new bacteriophage/bacteriocin typing system was used to study Clostridium difficile colonization in a neonatal intensive care unit. C. difficile was isolated from 21 of 62 (34%) stools from 15 of 37 (41%) infants. Colonization was reduced during antimicrobial therapy and for about 1 week thereafter. One of five nurses and one of two parents studied were carriers. Eight isolates were cultured from environmental surfaces. Thirty of 31 C. difficile isolates were found to be a single type, Cld 6,9,10,13; bacteriocin 1320,1537,2304. No C. difficile was found in 29 specimens obtained in the delivery room from mothers and infants, and there was no association of early colonization with vaginal delivery. The data provide strong evidence for nosocomial acquisition of C. difficile by infants in the neonatal intensive care unit. No obvious pathologic role for C. difficile could be identified among colonized infants. Among 22 C. difficile isolates from 7 adult inpatients with diarrhea and 13 healthy infants attending the center's well baby clinic, 4 were the same type as the strain found in the intensive care nursery. Only one of these patients had had direct contact with the neonatal intensive care unit, indicating that the nursery strain may also be found elsewhere in the community. PMID- 6494015 TI - Cat-scratch adenitis. PMID- 6494016 TI - Criteria for the evaluation of new diagnostic tests. AB - The overall scheme for evaluating a new diagnostic test is presented in Fig. 2. The office-based practitioner has encountered a new diagnostic test (A). The purpose of the new test seems to be one that would be useful in an office practice, for the suspected disease is seen frequently enough to justify stocking an office test (B), and the benefits of the test, if true, would augment the delivery of patient care (C). From the manufacturer, appropriate literature references are obtained which compare the new test with either the current office test or an accepted standard; the article is from a peer review journal (D). This article is then examined more carefully (E). The conclusions contained in the Abstract, if true, would lead the practitioner to change his current office procedure. The Methods section of the article is now examined for evidence that an independent clinical standard of comparison was used; a patient population was described similar to that in the office practice; a wide spectrum of disease presentations was evaluated; a sensible definition of "normal" was utilized; the study was "blinded" to avoid bias; and a detailed description of the test techniques was provided. In the Results section, one notes the precision and inter-observer variability of the test, and an appropriate statistical analysis is verified. Finally, the Discussion is skimmed to find out whether the authors have commented on the utility of the test in an office setting.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494017 TI - Tetanus in a partially immunized infant with burns. PMID- 6494019 TI - Aeromonas toxins. PMID- 6494018 TI - Meningococcal meningitis associated with cerebrospinal fluid shunts. PMID- 6494020 TI - Aeromonas infection in an infant with aplastic anemia. PMID- 6494021 TI - Prophylaxis for herpes simplex infection. PMID- 6494022 TI - Quantification of the permeability of the blood-CSF barrier to alpha-MSH in the rat. AB - The ability of alpha-MSH to cross the blood-CSF barrier of the rat was assessed by measurement of the rate of appearance of immunoreactive alpha-MSH in a cerebrospinal fluid (CSF) perfusate following intravenous injection of peptide. Comparisons were made with the rate of appearance of a simultaneously administered dose of 14C-inulin which is poorly permeable at the blood-CSF barrier. Concentrations of drugs measured in plasma were fitted to two compartment pharmacokinetic models, and those measured in the CSF perfusate to one-compartment open systems receiving an input from the plasma compartment. The rate constant for entry of alpha-MSH into CSF was 0.00087 min-1, which was not significantly different from that for inulin of 0.00055 min-1. As alpha-MSH penetrated into CSF at a rate comparable to inulin, it was concluded that the limited entry of peptide was by aqueous diffusion along with other water-soluble macromolecules. PMID- 6494024 TI - Autonomic effects of central injections of D-Ala2-Met-enkephalinamide (DAME) in the conscious monkey. AB - The use of naloxone (NAL), an opioid receptor antagonist, has provided indirect evidence that endogenous opioids contribute to cardiovascular depression during shock. To determine if endogenous opioids act centrally to influence cardiovascular function, injections of D-Ala2-Met-enkephalinamide (DAME), a potent Met-enkephalin analog, were made into the 3rd cerebral ventricle (ICV) of 5 conscious cynomulgus monkeys restrained in primate chairs. Systolic blood pressure (SBP) and heart rate (HR) were determined every 10 min during a 30-60 min control period and for up to 5 hr post-injection. Colonic temperature (Tc) was monitored continuously. SBP declined from baseline values with 50 and 100 micrograms (85.2 and 170.4 nM) doses but was significant (p less than 0.001) for only the 100 micrograms dose between 15-125 min post-injection. HR also decreased but did not exhibit any significant variation with time. However, when averaged across time, HR fell significantly (p less than 0.001) from baseline: -9.1 +/- 2.3 and -15.0 +/- 2.1 b/min for 50 and 100 micrograms DAME, respectively. Tc displayed a nonsignificant, delayed (greater than 2 hr) rise in Tc with the 50 micrograms dose, whereas the 100 micrograms dose caused a significant (p less than 0.001) decline in Tc (from 65-125 min post-injection). NAL injected ICV attenuated the effects of DAME but had no effect on SBP, HR or Tc when injected alone. Systemic injection of DAME (300 micrograms) in one monkey produced a transient decline in SBP (26 mmHg within 2 min) which returned to baseline values 4 min post-injection. HR and Tc were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494023 TI - Structure-activity studies of dermorphin. The role of side chains of amino acid residues on the biological activity of dermorphin. AB - Seventeen analogues of dermorphin were synthesized and bio-assayed to determine the influence of side chains of the individual amino acid residues forming the sequence of dermorphin on the biological activity of this opioid peptide. Syntheses were carried out using solid-phase procedure, and the analogues obtained were purified by gel filtration on Sephadex G-10. Biological activities determined in guinea pig ileum (GPI) and mouse vas deferens (MVD) tests showed that the N-terminal tetrapeptide is responsible for the activity of dermorphin. Substitutions in the C-terminal fragment, particularly in position 5, for other amino acid residues results in substantial differentiation towards mu and delta receptors. PMID- 6494025 TI - Vasopressin analgesia: specificity of action and non-opioid effects. AB - Recent neuroanatomical and behavioral evidence has indicated that vasopressin (VP) increases pain thresholds. In the present study intracerebroventricular (ICV) administration of both arginine VP (AVP: 75-500 ng) and 1-deamino-8-D arginine vasopressin (DDAVP: 150-500 ng) elevated tail flick latencies. Oxytocin (OXY, ICV), also elevated tail-flick latencies (150-1000 ng); however this increase was accompanied by "barrel-roll" seizure activity. VP analgesia was eliminated by pretreatment with 1-deamino-penicillamine-2(O-methyl)tyrosine-AVP (dPTyr(me)AVP: 500 ng, ICV), a VP antagonist, but not naloxone (1 or 10 micrograms, ICV), suggesting that VP modulates nonciceptive thresholds through its own binding sites. Conversely, pretreatment with naloxone (1 micrograms, ICV) but not dPTyr(me)AVP (1 microgram, ICV) attenuated the analgesic efficacy of systemic morphine (10 mg/kg), further dissociating VP and central opiate analgesic processes. Finally, systemic pretreatment with dexamethasone potentiated VP analgesia. These data support the notion that VP is a specific non opioid pain inhibitor. PMID- 6494026 TI - Parallel bioassay of litorin and phyllolitorins on smooth muscle preparations. AB - Phyllolitorin and Leu8-phyllolitorin, two nonapeptide amides from the skin of the South American frog Phyllomedusa sauvagei, are representatives of a novel bombesin subfamily, characterized by the occurrence in their molecule of a serine residue substituting the usual histidine residue at position 3 from the C terminus. In parallel bioassay on ten different smooth muscle preparations and rat blood pressure, phyllolitorin and Leu8-phyllolitorin were virtually equiactive, but the two peptides appeared remarkably less potent that litorin in all test preparations, except the rat urinary bladder. The shape of contractions produced by the phyllolitorins and promptness of cessation of their action upon washing seem to indicate a looser binding of these peptides to their receptors and/or a more rapid inactivation, in comparison to litorin. PMID- 6494027 TI - The influence of the inter-dose time interval on the cardiovascular response to methionine-enkephalin in the conscious dog. AB - Intravenous injection of methionine-enkephalin (10 micrograms/kg) into the conscious dog increased both heart rate and mean systemic arterial pressure. Progressive shortening of the inter-dose time interval from 5 min to 1 min and then to 30 sec did not alter the response, as the maximal mean systemic arterial pressure elevation was maintained and the maximal heart rate response increased slightly. In contrast to the results after discrete bolus dosing, continuous infusion of methionine-enkephalin at a constant rate of 10 micrograms/kg/min produced an initial elevation in heart rate and mean arterial pressure, but these parameters then began to return toward pretreatment levels despite continuous infusion at the same rate, indicating receptor desensitization. This desensitization pattern is most compatible with receptors of the nicotinic cholinergic type. These data indicate the importance of dosing techniques in assessing cardiovascular responses to systemically administered enkephalins. PMID- 6494028 TI - Vasopressin analog (DDAVP) improves memory in human males. AB - One specific analog of arginine vasopressin, 1-desamine-8-D-arginine vasopressin (DDAVP), has been shown to improve learning and memory in humans. Healthy young male adult subjects treated with DDAVP demonstrated better memory for implicational sentences than did control subjects. The same treatment had no influence on women given the same memory task. These results suggest that DDAVP may have a sexually dimorphic effect on learning and memory. PMID- 6494029 TI - Is vasoactive intestinal polypeptide (VIP) a sleep factor? AB - Vasoactive intestinal peptide (VIP) was tested in order to determine its hypnogenic properties in cats. VIP was administered intraventricularly in doses of 10 and 100 ng and compared to Ringer controls. In addition the dose of 100 ng was tested in cats pretreated with 150 mg/kg of chloramphenicol (CAP). The results showed that the 100 ng dose of VIP had small but significant REM enhancing properties, but that it did not protect the animals from the specific REM inhibiting properties of CAP. The results suggest that VIP may participate in the regulation of REM sleep. PMID- 6494030 TI - [Kinsbourne's myoclonic encephalopathy in the light of our clinical observations]. PMID- 6494031 TI - [Barium sulfate as a foreign body in the bronchial tree in newborn infants]. PMID- 6494032 TI - [Acute disulfiram poisoning in a 16-year-old girl]. PMID- 6494033 TI - [Therapeutic and non-therapeutic methods of interacting with patients]. PMID- 6494034 TI - [Endoscopic verification of dyspeptic disorders]. PMID- 6494035 TI - [Treatment of acute hepatic porphyria]. PMID- 6494036 TI - [Severe septicemia caused by Yersinia enterocolitica]. PMID- 6494037 TI - [Evolution of the concept of disease with particular reference to psychosomatic disorders]. PMID- 6494038 TI - [Echocardiographic examination in Wolff-Parkinson-White syndrome]. PMID- 6494039 TI - [Polycardiographic indicators of left-ventricular systolic and diastolic time intervals in patients with mitral valve prolapse]. PMID- 6494040 TI - [The Rubenosticon test in hematologic and lymphoreticular diseases]. PMID- 6494041 TI - [Quinidine interactions with propranolol, phenytoin, verapamil and procainamide]. PMID- 6494042 TI - [Various risk factors in deep venous thrombosis after surgery]. PMID- 6494043 TI - [Prevention of recurrent thrombophlebitis by long-term use of fibrinolysis activating drugs]. PMID- 6494044 TI - [Effect of submaximal physical exertion on serum lipid levels and the blood coagulation and fibrinolysis systems in patients with arteriosclerosis]. PMID- 6494045 TI - [Control angiography after microsurgical anastomosis of extra- and intracranial arteries in the cerebral ischemia syndrome; transient obstruction of the anastomosis]. PMID- 6494046 TI - [Effect of propranolol on serum HDL cholesterol levels]. PMID- 6494047 TI - [Acute mental disorders in myocardial infarction]. PMID- 6494048 TI - [Circulating platelet aggregates in various vascular diseases]. PMID- 6494049 TI - [Various problems related to potassium supplementation during treatment of hypertension with diuretics]. PMID- 6494050 TI - [Clinico-statistical analysis of 1000 panendoscopies of the upper segment of the digestive tract in the population of eastern Libya (Cyrenaica)]. PMID- 6494051 TI - [Primary APUDoma of the liver with hypokalemia]. PMID- 6494052 TI - [Anal pseudofistula]. PMID- 6494053 TI - [Psychogenic urethral stricture]. PMID- 6494054 TI - [Cyclosporin A--a new immunosuppressive drug]. PMID- 6494055 TI - [Complications of puncture biopsy of the prostate]. PMID- 6494056 TI - [Treatment of kidney calculi. (Report on a visit at the Urological Clinic, Ludwig Maximilian University, in Munich). I]. PMID- 6494057 TI - Action of prolactin in regressing prostate: independent of action mediated by androgen receptors. AB - Hyperprolactinemia, achieved by grafting pituitaries under the renal capsule, has been shown to cause a delay in the rate of castration-induced prostatic regression in rats. The mechanism of this prolactin action is not established, although it has been suggested that the action of prolactin in the rat prostate is mediated through the action of androgen. To explore the possibility that a small amount of residual endogenous androgen present in the prostate at the time of castration acts synergistically with prolactin to cause this delay in prostatic regression, Flutamide has been used in the present study in an attempt to inhibit this residual androgen effect by blocking its interaction with androgen receptors. Two experiments were conducted. In experiment 1, daily sc injections of Flutamide (25 mg/kg) for 7 days to castrated rats supplemented with dihydrotestosterone-filled silastic tubing either 1 or 4 cm long completely suppressed both prostatic weight and protein content to the level that was normally observed in castrated rats receiving empty tubings. Furthermore, treatment of Flutamide to castrated rats did not cause an increase in prostatic weight and protein content over those of castrated rats treated with the vehicle only. These results indicate that Flutamide, at this dosage, is a potent antiandrogen and that the compound itself does not have any androgenic activity in the rat prostate. In experiment 2, adult male rats were castrated and received two female pituitaries grafted under the renal capsule. One week later, their serum prolactin levels increased from 20 +/- 3 ng/ml to 102 +/- 8 ng ml. This elevated level of serum prolactin was associated with a delay in the rate of prostatic regression. Administration of Flutamide, at a dose (25 mg/kg) which completely suppressed prostatic growth, failed to inhibit the delay in prostatic regression in castrated rats bearing the pituitary grafts. Since Flutamide inhibits the androgen action in the prostate by blocking the binding of intracellular dihydrotestosterone to androgen receptors, the failure of Flutamide to block the effect of prolactin suggests that the prolactin action in regressing prostates is not mediated by androgen receptors. PMID- 6494058 TI - The prostate of the gorilla. AB - The prostate gland from a 32-year-old gorilla was examined. The prostate weighed 15 g and was composed primarily of dilated cystic acinar areas with only modest stromal thickening. The acini were lined by a low cuboidal epithelium. A second minor population of smaller glands with extensive papillary projections was also present. The epithelial cells stained densely for acid phosphatase and prostatic specific antigen. Human prostatic acid phosphatase content of the gland as determined by radioimmunoassay was 2.3 mg/g protein. This is the first published histologic description of a gorilla prostate. The animal was in late middle age but did not display predominant prostatic stromal hyperplasia. Prostatic acid phosphatase from the gorilla cross-reacts immunologically, or is identical to human prostatic acid phosphatase. PMID- 6494059 TI - The use of steroid-containing Silastic implants in male nude mice: plasma hormone levels and the effect of implantation on the weights of the ventral prostate and seminal vesicles. AB - The effects of implantation of steroid-containing capsules into male nude mice on steroid concentrations in plasma and weight of accessory sex organs were studied. Intact male nude mice had plasma levels of testosterone (T) of 8.0 +/- 2.4 ng/ml, while T implantation (length 1.0 cm) of a group with castrated male mice resulted in a mean level of 8.1 +/- 0.3 ng/ml. This level was reached within 2 days after implantation and lasted for at least 40 days. After longer periods of application (up to 75 days) physiological levels could still be attained. Treatment of intact male nude mice with estradiol (E2)-containing implants (length 0.5 cm) resulted in constant levels of plasma-E2 (250 pg/ml) also lasting for at least 32 days. This treatment resulted in a mean plasma-T level of 1.0 +/- 0.2 ng/ml, which was still significantly higher than that obtained after castration (0.14 +/- 0.03 ng/ml). Up to 16 days after implantation E2 did not cause a decrease of the weights of the accessory sex glands in intact male mice, while after 32 days a significant reduction (50% of the control animals) of the organ weights was observed. The present data obtained with T and E2 implantation show that this route of administration of hormones is also very applicable in the nude mouse model. PMID- 6494060 TI - Effects of diethylstilbestrol and estramustine phosphate (estracyt) on natural killer cell activity and tumor susceptibility in male mice. AB - The effects of estramustine phosphate (EMP) and diethylstilbestrol (DES) on natural killer (NK) cell activity, tumor growth, and artificial metastases were investigated in male C57BL/6 mice. Kinetic analysis and studies at the single cell level indicated that EMP did not influence the number of NK cells but interfered with their lytic activity thereby reducing the actual killer capacity. NK cells from EMP-exposed animals responded normally to the interferon inducer Poly I:C which restored NK activity to control levels. Spleen cells from DES treated animals had lytic activity comparable to that of control animals. However, more detailed analysis showed that DES reduced the number of lymphocytes able to recognize target cells, while the individual NK cell had an increased lytic activity and recycling capacity. Moreover, NK cells from DES-treated animals were refractory to poly-I:C stimulation, suggesting that they were prestimulated in vivo. The pertubations of the NK cell system induced by both EMP and DES were reversible and normalization of NK activity was reached within a week. The incidence of tumor takes after subcutaneous inoculation of the syngeneic Lewis lung carcinoma was increased in EMP as well as DES-treated animals. Artificial lung metastasis produced by intravenous injection of the same tumor was increased in EMP but not in DES-exposed animals. PMID- 6494061 TI - Animal models and treatment of prostate cancer. AB - Model systems for prostate cancer in rats have been developed and used for investigations on tumor biology and therapy. The "Pollard tumors" provide a combination of in vitro and in vivo attributes by which investigations can be directed at local tumor development and spontaneous metastasis. The evolution and early applications of this model system are reviewed, and the therapeutic benefits of delayed release of cyclophosphamide are presented. PMID- 6494062 TI - Henoch-Schonlein purpura. AB - The clinical features of 25 children with Henoch-Schonlein purpura are presented, with particular emphasis on the cutaneous features. Although every patient exhibited purpura on the buttocks and lower extremities, it was preceded by a maculopapular or urticarial rash in nine. Moreover, cutaneous features were preceded by arthralgia or abdominal pain by up to two weeks in 40% of the patients. Other dominant clinical features included arthralgia in 84%, abdominal pain in 76%, nephritis in 44%, and gastrointestinal bleeding in 40%. Laboratory studies reflected the acute, systemic nature of the illness, but generally were of limited diagnostic value. PMID- 6494063 TI - Eosinophilic pustular folliculitis in infancy. AB - Five infants under 1 year of age were reported with a syndrome of recurrent crops of pruritic papulopustules of the scalp. In three children there were also intermittent outbreaks on the trunk and extremities. Cultures showed the pustules to be sterile. Biopsies of scalp and skin tissues showed eosinophilic folliculitis. Some patients had eosinophilia during outbreaks of pustules. These cases are similar to the eosinophilic pustular folliculitis reported in a few adult patients with the exception that there was predominant scalp involvement in the children. We propose that eosinophilic pustular folliculitis of infancy is a distinct pustular dermatosis. PMID- 6494064 TI - Twenty-nail dystrophy of childhood: a sign of localized lichen planus. AB - A 9 1/2-year-old girl was seen with 20-nail dystrophy. Lichen planus was suspected and further examination revealed other lesions localized to the oral mucosa. The diagnosis was confirmed as lichen planus by biopsy of tissue from the oral lesions. Careful examination of all mucocutaneous surfaces is recommended before accepting the diagnosis of so-called isolated 20-nail dystrophy of childhood. PMID- 6494065 TI - Angiolymphoid hyperplasia with eosinophilia. AB - Angiolymphoid hyperplasia has become a well-recognized entity in adults. Kimura's disease is a similar and possibly identical disease occurring in Oriental children. This is a case report of angiolymphoid hyperplasia with eosinophilia occurring in a 12-year-old Caucasian boy with elevated levels of serum IgE. The condition responded to intralesional triamcinolone. A brief review of the literature is presented and various modes of therapy are discussed. PMID- 6494066 TI - A survey of skin disorders seen in pediatric general and dermatology clinics. AB - One-week surveys of office visits to a general pediatric clinic were carried out at monthly intervals over a six-month period. Skin complaints accounted for 24% of the primary and secondary reasons for initiating clinic visits. Six categories of dermatologic conditions accounted for 81.5% of the pediatric clinic visits, with skin infections comprising 38.5%. A survey of new referrals to a pediatric dermatology clinic over a similar seasonal span revealed that the same six categories made up 51.8% of diagnoses. The surveys indicate that skin disorders are common reasons for pediatric office visits and suggest some areas that should be emphasized in the training of physicians in dermatologic diagnosis and management. PMID- 6494067 TI - Cutis marmorata telangiectatica congenita: a case report. AB - Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular disorder that was first described in 1922 by Van Lohuizen (1). The clinical presentation is one of persistent cutis marmorata, phlebectasia, telangiectasia, and areas of ulcerations. The disorder shows slow clinical improvement over time. Previously, CMTC has also been described as congenital generalized phlebectasia (2-7), congenital phlebectasia (8), nevus vascularis reticularis (9), congenital livedo reticularis (10), and livedo telangiectatica (11). The following is a case report. PMID- 6494068 TI - Efficacy versus systemic effects of six topical steroids in the treatment of atopic dermatitis of childhood. AB - Six groups of children suffering from widespread atopic dermatitis were treated once daily with six topical steroids of different potency. Systemic effects were measured by the morning estimation of plasma cortisol. A clear relationship was demonstrated between clinical efficacy of the steroid treatment and degree of reduced adrenal function. This study demonstrated that a rapid and marked therapeutic effect can be obtained with potent topical steroids applied once daily without occlusion, but in children is accompanied by a fall in plasma cortisol. PMID- 6494069 TI - Blindness, anonychia, and oral mucosal scarring as sequelae of the Stevens Johnson syndrome. AB - In its most severe form, bullous erythema multiforme is known as the Stevens Johnson syndrome (SJS). A case of SJS is reported in which ophthalmic complications caused blindness and ultimate enucleation, and in which there occurred permanent loss of nails as well as scarring of the oral mucosa. PMID- 6494070 TI - Menkes's syndrome. AB - Menkes's syndrome (trichopoliodystrophy) is an x-linked, recessive genodermatosis characterized by hair defects, severe retardation, convulsions, progressive neurologic deterioration, and early death. Recent studies in copper metabolism suggest that Menkes's syndrome may be a storage disease in which copper is irreversibly trapped in some tissues by metallothionein, a heavy-metal-binding protein. This then gives rise to a deficiency elsewhere, particularly in the brain, causing irreversible damage in the fetus. We present a patient with Menkes's syndrome and review the clinical and metabolic aspects of this disease. PMID- 6494071 TI - Special symposia. The management of disseminated eruptive hemangiomata in infants. PMID- 6494072 TI - Nephrotic syndrome and pregnancy. Potential problems for mother and child. AB - The pregnant patient with nephrotic syndrome should be carefully evaluated for the presence of chronic renal disease. Proteinuria itself may be associated with an increase in perinatal mortality and in the incidence of small-for-gestational age infants. Coexistent hypertension and/or renal dysfunction add to the risk of an unsuccessful pregnancy. The use of tocolytic agents in pregnant women with nephrotic syndrome theoretically may be hazardous. The patient with systemic lupus erythematosus may be at particular risk of unsuccessful pregnancy if the disease is active; postponement of conception until a remission of six months or longer has been achieved may be well advised. PMID- 6494073 TI - Mental health hits the gutter. The sad outcome of a 'noble' experiment. PMID- 6494074 TI - Fluid and electrolyte abnormalities in nephrotic syndrome. Pathogenesis and management. AB - Generalized edema, a cardinal feature of the nephrotic syndrome, may be associated with a low, normal, or high blood volume. Symptoms can usually be improved by a regimen that includes rest, proper diet, and careful use of diuretic agents. Hypovolemic patients are particularly prone to complications of diuretic therapy, which are the major source of the electrolyte disturbances encountered in patients being treated for nephrotic syndrome. PMID- 6494075 TI - Nephrotic syndrome and neoplasm. The findings to date, with practical implications. AB - The following points should be kept in mind in cases of nephrotic syndrome. Neoplasm (malignant or benign) occurs in approximately 10% of adults with nephrotic syndrome (15% of those over age 60). The neoplasm may be evident before, after, or simultaneously with the development of the nephrotic syndrome. Minimal change lesion in the kidney suggests possible Hodgkin's disease, while membranous nephropathy is more suggestive of possible carcinoma, although there are many exceptions to this generalization. Membrano-proliferative and focal sclerosis renal lesions also occur with diverse tumors. Strong evidence exists that in cases of carcinoma and nephrotic syndrome, the renal lesion is generally due to immune complexes--either tumor-associated antigens, fetal antigens, or viral antigens. In cases involving Hodgkin's disease, T-cell deficiency may be relevant in the genesis of the minimal change lesion and the nephrotic syndrome. Nephrotic syndrome often responds to effective treatment of the tumor and commonly recurs with relapse of the neoplasm. Nephrotic syndrome without apparent cause in an adult compels consideration of an associated neoplasm. PMID- 6494076 TI - Nuclear magnetic resonance imaging. The case for prudent use in clinical diagnosis. PMID- 6494077 TI - Computer security. 1. Protecting data from prying eyes. PMID- 6494078 TI - Transfusion-induced precocious puberty is speculation only. PMID- 6494079 TI - The Pap smear revisited. Controversies and recent developments. AB - Despite the widespread acceptance of the Pap smear as an effective means to reduce morbidity and mortality due to cervical carcinoma, many experts now recommend less frequent screening for women with a negative cytologic history and factors carrying a low degree of risk. This view has been countered by those who feel that less frequent screening may result in a dangerous delay in diagnosis and treatment for some women. The trend toward a longer screening interval places a burden on the primary care physician, the pathologist, and cytotechnologists to minimize false-negative smears through optimum communication, technical preparation, and quality control. In addition to the changes in thinking regarding frequency of Pap smear screening, the concept of cervical carcinogenesis is undergoing striking modification. The human papillomavirus has been associated with many lesions that have classically been considered low-grade dysplasias. Termed flat condylomas, these lesions frequently regress spontaneously but may be associated with the full spectrum of preinvasive and invasive disease. Cervical condylomas require biopsy and appropriate treatment. PMID- 6494080 TI - Hyperlipidemia. What is 'normal,' who should be treated and how. AB - Considering that over half of Americans will die from cardiovascular disease, the over-whelming majority of those deaths being from atherosclerosis, we need to accept and act on the vast body of information derived from investigation of coronary risk factors. Identification of persons at risk needs to be done early- when the patient is in his or her 20s or 30s--not after an infarction has occurred or an angiogram indicates a problem. Although high serum lipid levels are obviously not the only factor involved in development of atherosclerosis, their early identification is a simple, cost-effective way to start preventive care. The concept of "normal" levels of cholesterol and triglyceride must be revised, and that of "safe" levels should be adopted instead. Patients with abnormal electrophoretic patterns should not be the only target; they are only the tip of the iceberg. A typical workup in a young patient consists merely of measurement of cholesterol and triglyceride levels. Further evaluation is necessary if the levels are high or the family history suggests a problem. Lipoprotein electrophoresis and computation of the ratio of high-density lipoprotein to low-density lipoprotein are then used not just as predictors but as a guide to therapy. Basic therapy begins with a change in life-style to incorporate dietary reduction of saturated fats and cholesterol and substitution of polyunsaturated fats. Other measures such as cessation of cigarette smoking, introduction of an appropriate exercise program and, most importantly, reduction of body weight complete the game plan.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494081 TI - Antibiotic resistance. A new kind of epidemic. PMID- 6494082 TI - Mycoplasmal pneumonia. Three severe cases of a common infection. AB - Mycoplasma pneumoniae is one of the most common causes of community-acquired pneumonia. Infection is usually self-limited, but fulminant pneumonia and extrapulmonary complications can supervene. Usually, unilateral confluent, patchy, or nodular infiltrates of the lower lobe are seen on roentgenograms. Diagnosis is achieved by isolation of the organism or by serologic methods. Treatment with either erythromycin or tetracycline is effective, although organisms can be recovered during therapy. In the three cases of mycoplasmal pneumonia reported here, infection was resistant to initial therapy but patients recovered when appropriate antimicrobial therapy was instituted. PMID- 6494083 TI - Nephrotic syndrome. Pathogenesis, clinical and therapeutic considerations. AB - The nephrotic syndrome is the result of a variety of immunologic mechanisms which damage the glomerular capillary wall and cause excessive protein loss. The great number of potential predisposing factors and clinical settings necessitates a thorough history and a careful examination that includes well-defined laboratory studies. Appropriate therapy covers a broad range, from doing nothing more than reducing additional insults, to the aggressive use of combined modalities, depending on the factors involved in the individual case. PMID- 6494084 TI - Breast problems in 1,000 consecutive referrals to surgical out-patients. AB - One-thousand consecutive referrals of breast complaints to surgical out-patients are presented with breakdown according to the pathological groups of final diagnoses. The relationship of these groups to parity, breast feeding and age are discussed as also is the clinical management of these cases. PMID- 6494086 TI - Prospective measurement of glomerular filtration rate and effective renal plasma flow during treatment of malignant essential hypertension. AB - A longitudinal study of sequential measurement of glomerular filtration rate and effective renal plasma flow was conducted over a 5-year period of antihypertensive drug treatment, in four adult patients admitted to hospital with previously untreated malignant essential hypertension. Treatment produced a substantial and sustained lowering of systemic arterial blood pressure, compared with grossly elevated pretreatment levels. Nevertheless, glomerular filtration rate and effective renal plasma flow remained relatively stable in all four patients, at roughly the same level at which they were admitted. It was concluded that effective therapy for hypertension may not necessarily reverse the vascular changes of arteriolar fibrinoid necrosis, which characterize malignant essential hypertension. Permanent damage to the renal arterioles, and the territory of kidney supplied by these vessels, may be a feature of this condition. PMID- 6494085 TI - Hyperthyroidism and immune thrombocytopenia. AB - Hyperthyroidism and immune thrombocytopenia occurred concurrently in five patients; in a sixth, thyrotoxicosis developed after successful treatment of the thrombocytopenia. Correction of the hyperthyroidism was followed by a variable pattern of clinical response. In one case with mild asymptomatic thrombocytopenia spontaneous complete remission occurred. Two patients required adrenocorticosteroids to control severe thrombocytopenic purpura during the period of hyperthyroidism, after which complete remission occurred. Another patient with severe symptomatic thrombocytopenia remains with a partially compensated thrombocytolytic state but is without purpura and off all therapy. A fifth patient required splenectomy for drug-resistant thrombocytopenia and remains critically dependent on immunosuppressive therapy. The sixth patient had a relapse of immune thrombocytopenia with subsequent development of thyrotoxicosis but platelet count spontaneously returned to normal after correction of the hyperthyroidism. Pregnancy in two of these six patients was not associated with recurrence of either hyperthyroidism or thrombocytopenia. Management of symptomatic purpura in adults with co-existent hyperthyroidism may differ from that customarily employed since adrenocorticosteroid therapy may need to be extended until euthyroidism has been established before proceeding to splenectomy. When surgery is necessary, the risk of thyrotoxic storm should be anticipated, and the patient appropriately premedicated. PMID- 6494087 TI - Meningococcal meningitis presenting with bilateral deafness and ataxia. AB - A 50-year-old man presented with bilateral deafness and ataxia of sudden onset and without constitutional symptoms or signs of meningeal irritation. He was subsequently proved to have meningococcal meningitis, and the deafness and ataxia resolved following appropriate antibiotic therapy. PMID- 6494088 TI - Exocrine pancreatic insufficiency and idiopathic haemochromatosis. AB - The case history of a 34-year-old patient with precirrhotic idiopathic haemochromatosis and severe chronic steatorrhoea is presented. The pancreas had a normal appearance on ultrasonography and endoscopic retrograde pancreaticography. However, pancreatic function tests revealed significant abnormalities. The pancreatic output of trypsin, amylase, lipase and bicarbonate was deficient and basal and stimulated serum pancreatic polypeptide levels were subnormal. In contrast, the oral glucose tolerance test was unimpaired. The pancreatic insufficiency had started suddenly during a summer vacation and may have had a viral aetiology. The hypothesis is advanced that in haemochromatosis the iron laden pancreatic acinar and PP-producing cells are more susceptible to damage by viruses than normal pancreatic cells. PMID- 6494089 TI - Myocardial damage due to hypokalaemia and hypophosphataemia. AB - A case of severe hypokalaemia with stupor, skeletal muscle and heart muscle damage is reported. An initial infusion of glucose-insulin and potassium (GIK) produced a temporary clinical improvement with reduction of creatine kinase (CKMB) and elevation of serum K+. On the 4th day of treatment, neuromuscular and cardiovascular deterioration occurred accompanied by a further rise of CKMB. This deterioration was coincident with a serum phosphate of 0.26 mmol/l. The impaired left ventricular (LV) function was measured using echocardiography and detecting the ejection fraction (EF). GIK was stopped and a potassium phosphate infusion commenced. As the phosphate and potassium deficiencies were corrected, the neuromuscular and cardiac abnormalities resolved, CKMB fell to normal and LVEF rose from 40% to 72%. We suggest that additional cardiac damage due to hypophosphataemia may have occurred in this patient, who already had cardiac impairment as a result of profound hypokalaemia. Possible mechanisms are discussed. PMID- 6494090 TI - Crohn's disease and pericarditis. AB - A patient is described who developed acute pericarditis during a severe first attack of Crohn's disease. The opportunity was taken to measure levels of circulating immune complexes, both during the acute phase of the illness and during convalescence; no significant change in these levels from normal values was found. The Crohn's disease and the associated pericarditis responded to systemic corticosteroid therapy, and no relapse has occurred during 14 months of follow-up. PMID- 6494091 TI - Eosinophilic fasciitis in an African--possible benefit of chloroquine treatment. AB - A 58-year-old black woman with eosinophilic fasciitis is reported, this being the first report to our knowledge of the condition from Africa. The patient showed a subjective and objective improvement in symptoms on two occasions when treated with chloroquine. PMID- 6494092 TI - Human placental lactogen (hPL) deficiency in a normal pregnancy. AB - A case of human placental lactogen (hPL) deficiency together with normal oestriol levels associated with a normal pregnancy in a woman in her second pregnancy is reported. The woman gave birth to a healthy male infant. The placenta was normal. Extremely low hPL levels may be compatible with the delivery of a healthy infant. PMID- 6494093 TI - Gallstone perforation of the ileum without obstruction. AB - A case of perforated ileum due to an impacted gall stone without associated intestinal obstruction, is reported. The problem in diagnosis and management are discussed. PMID- 6494095 TI - Extreme hypernatraemia in association with renal failure following caecocystoplasty. AB - A case of extreme hypernatraemia (serum sodium 212 mmol/l) occurring in association with renal failure following a caecocystoplasty procedure is reported. The causative factors in extreme hypernatraemia are reviewed and an unusual reabsorptive mechanism via the transposed intestinal segment is proposed to explain the degree of hypernatraemia present in this case. PMID- 6494094 TI - Cholecystoduodenocolic fistula and gallstone ileus. AB - A patient with cholecystoduodenocolic fistula and gallstone ileus is described. Barium enema and barium meal and follow through demonstrated the passage of the gallstone from the gallbladder region to the small bowel. The clinical features and operative management are discussed in the light of four previously recorded cases. PMID- 6494096 TI - Heavy proteinuria following urinary diversion. AB - Two patients are described, both of whom developed heavy glomerular proteinuria in excess of 10 g/24 hr after urinary diversion operations. PMID- 6494097 TI - Probable adverse interaction between oral metoprolol and verapamil. AB - A combination of an oral beta-adrenergic blocking agent and verapamil has been advocated as a safe treatment for angina. A case of Wenckebach type atrioventricular block occurring in a patient on metoprolol and verapamil is reported. It is suggested that this combination is used with caution. PMID- 6494098 TI - Pancreatitis and inguinal swelling. PMID- 6494099 TI - A chick model for impaired renal function. AB - To evaluate some of the metabolic consequences of impaired renal function (IRF) in the chick, a surgical method to induce IRF was developed that involves the destruction of approximately 85% of the renal mass by ureteral ligation. It is relatively simple with minimal time and labor required, produces low mortality, requires little specialized postoperative care, and is readily reproducible. Three-week-old control, sham-operated, and IRF chicks were bled by cardiac puncture and biochemical measurements were made on serum samples. Serum uric acid concentration was the most sensitive indicator of IRF, with mean levels in the IRF chicks being increased above control and sham-operated chicks 3.3-, 2.7-, 2.0 , and 1.2-fold at 1, 3, 7, and 14 days, respectively. The gradual decline in uric acid levels is most likely related to the functional recovery and hypertrophy of the remaining renal mass. The IRF chick model will be useful to provide information on renal aspects of the toxicity, distribution, metabolism, and elimination of nephrotoxic agents. PMID- 6494100 TI - Biological availability of manganese sources and effects of high dietary manganese on tissue mineral composition of broiler-type chicks. AB - An experiment was conducted with male broiler-type chicks to study tissue uptake of Mn as a measure of biological availability of Mn sources. A basal corn-soybean meal diet (116 ppm Mn) was supplemented with 0, 1000, 2000, or 4000 ppm Mn as either reagent grade sulfate, carbonate, or monoxide and fed ad libitum for 26 days. No toxic effects were noted as expressed by feed intake, weight gain, feed conversion, hematocrit, hemoglobin, or mortality. Analysis of Mn in tissues revealed a highly linear relationship between liver or bone Mn concentration and dietary Mn for all three sources. Manganese concentration in all tissues increased (P less than .01) as dietary Mn increased. Liver and bone Mn accumulation appeared to be excellent indicators of relative biological availability. On the basis of tissue uptake and solubility tests, MnSO4 X H2O was the most available, followed by MnO and MnCO3, respectively. There were no effects of Mn source or level on concentration of Ca, P, Mg, Cu, Zn, or Fe in tissues studied. PMID- 6494101 TI - Effect of dietary phosphorus level and source on productive performance and egg quality of two commercial strains of laying hens. AB - An experiment was conducted to study the influence of dietary total phosphorus (TP) level and source on the performance of two strains of commercial layers for two consecutive production years (26 to 68 and 76 to 116 weeks of age, respectively). Diet 1 contained .4% TP; Diets 2, 3 and 4 contained .5, .6, and .7% TP with supplemental P from dicalcium phosphate (DCP); Diets 5 and 6 contained .5 and .6% TP, respectively, with supplemental P from a sample of raw rock phosphate (RRP-1); Diets 7 and 8 contained .5 and .6% TP, respectively, with supplemental P from a second sample of raw rock phosphate (RRP-2). Calcium level was 2.75% in all diets, and crushed oyster shell provided ad libitum to all birds increased the total calcium to about 3.00%. Diet 1 was inferior to the average of all supplemented diets relative to feed consumption rate (P less than .005) and egg weight (P less than .005) during the first year. Diet 1 was also inferior relative to egg production rate (P less than .01), feed consumption rate (P less than .005), and egg weight (P less than .005) during the second year, whereas it was superior in shell quality (P less than .05) during the first year. Increasing TP from DCP resulted in a significant linear increase in feed consumption (P less than .05), feed conversion ratio, and Haugh units (P less than .005). Increasing TP from DCP also resulted in a significant linear decrease in shell quality (P less than .05) and significant linear and quadratic decreases in egg weight (P less than .005) during the first year. During the second year, increasing TP from DCP resulted in a significant linear decrease in egg production rate (P less than .005) and feed efficiency but significant linear (P less than .01) and quadratic (P less than .05) increases in feed consumption, and significant linear and quadratic increases (P less than .005) in Haugh units. Hens receiving RRP diets responded differently during the first and second years. The DCP supported greater egg weight than the RRP during the second year and permitted better feed conversion during both years. Strain A produced larger eggs than Strain B regardless of treatment (P less than .005). When egg production rate and most other response criteria were considered, .5% TP with DCP as the supplemental source gave the best results in both production years. A TP of .6% from RRP-2 gave similar results in both years. PMID- 6494102 TI - Effect of bile acids and diet composition on lipid absorption in chickens with cannulated bile ducts. AB - The effect of bile acids on lipid research was examined in meat-type chicks, 8 weeks of age, with cannulated cystic and hepatic ducts. The procedure allowed for biliary collection in free-roving birds. Shams retained 90 to 92% dietary fat and those with cannulated ducts retained 43 to 72%. Addition of .04, .08, or .16% cholic acid or .08% freeze-dried chicken bile did not improve lipid retention significantly. The percentage retained for tallow and corn oil was 57 and 64%, respectively, far less then the 75 and 90% values, respectively, obtained in normal chickens. Neither practical-type nor purified-type diets, saturated (tallow) nor unsaturated (corn oil) fats at 8% of the diet significantly influenced lipid retention in chickens with cannulated ducts. In these chickens, percent dry matter retained of the purified diet was 81%, a significantly higher value than the 62% retained of the practical-type diet. PMID- 6494103 TI - The effect of cyclic and constant ambient temperatures on feed consumption, egg production, egg weight, and shell thickness of hens. AB - Groups of 18 hens, 230 days of age, were housed in each of three climatic chambers with light schedules of 14L:10D. One was maintained at a constant temperature of 23.9 C, the second was cycled between 15.6 and 37.7 C (mean, 26.7 C), and the third was cycled between 21.1 and 37.7 C (mean, 29.4 C). In Experiment 1, the high temperature peaked during the dark period at 0200 hr and in Experiment 2, the high temperature peak was at 1400 hr during the light period. The birds had free access to a commercial breeder feed in these two experiments. The results from three 2-week observation periods indicated no significant differences in percent hen-day production, grams of feed per gram of egg mass, or overall body weight change but feed intake per day, egg weight, and shell thickness were significantly reduced by mean temperatures of 26.7 and 29.4 C in cycling chambers. The pair-feeding of birds in the 23.9 C constant chamber compared with those in the cycling 29.4 C chamber resulted in production of significantly heavier eggs with thicker shells without significantly influencing any of the other parameters. The reductions in egg weight and shell thickness observed at cyclic temperatures were not simply a result of a reduction in nutrient intake at high temperatures but also the direct effect of heat stress on the hens. In the 23.9 C constant temperature chambers, a reduction in AME of the feed for the hens fed ad libitum was observed but not for hens pair-fed to hens in the 29.4 C cyclic chamber. PMID- 6494104 TI - Detection and incidence of yellow turkey semen on commercial breeder farms. AB - Seminal plasma from 270 commercial Large White breeder turkeys (30 males from each of nine farms) was evaluated for protein concentration, color, and opacity. Yellow semen syndrome (YSS) was detected by identifying seminal plasma having both a yellow color and a high protein concentration (greater than 20 mg/ml) and was present in 11.8% of the males. Normal white semen males, with seminal plasma protein less than 20 mg/ml and white or slight yellow in color, were found in 85.9%. Using this method only 3.3% of the males did not fit either category. Protein concentrations were clustered near 10 mg/ml but values ranged from 3.7 to 79 mg/ml. A low protein group (less than 8 mg/ml; 13.3% of the males) had 34 white, 2 slight yellow, and 0 yellow samples. A median protein group (10 mg/ml; 74.1%) had 175 white, 21 slight yellow, and 4 yellow. The high protein group (greater than 20 mg/ml; 12.5%) had 2 white, 14 slight yellow, and 18 yellow. There was large variation among farms, ranging from 0% to 23.3% YSS. Protein concentration was not correlated with the age of the males, and opacity of the seminal plasma was lowly correlated with color (r = .17; P less than .01). Refractive index was useful for estimating the seminal plasma protein concentration (r = .87; P less than .0001), which along with color, could be used as a simple method for estimating the quality of turkey semen on the farm. PMID- 6494105 TI - The musculus complexus of normal and dystrophic chicken embryos. AB - Abnormalities have previously been reported in the pectoral muscle of embryos and young chicks from a pure strain of New Hampshire Red chickens homozygous for inherited muscular dystrophy. Fine structural studies of the musculus complexus in normal and dystrophic embryos were undertaken because of a sharp decrease in hatching by the diseased birds. Ultrastructural differences found between the normal and dystrophic embryos included a leached sarcoplasm, swollen and distorted mitochondria and tubular components, a lack of polyribosomes (myosin synthesis), and the formation of pseudostraps during differentiation of the myopathic hatching muscle. These differences may curtail differentiation until a point after the critical hatching time. PMID- 6494106 TI - Dietary approaches to the reduction of blood pressure: the independence of weight and sodium/potassium interventions. AB - This study was designed to determine the feasibility of teaching mildly hypertensive individuals to select a diet, using normally available food products, that either would produce a 5% reduction in percentage of overweight (without altering sodium (Na), potassium (K), or Na:K ratio) or would decrease Na to less than 70 mEq and increase K to greater than 100 mEq (without affecting weight) and to compare the resulting changes in blood pressure. Fifty-two participants with mild hypertension were randomly assigned to either a weight loss or a Na:K intervention. Blood pressure, weight, 3-day diaries, and 24-h urinary excretion of Na and K were measured before and after an 8-week intervention. Participants in the weight-loss intervention had significantly greater changes in weight and calorie intake than those in the Na:K intervention, while changes in Na:K ratio were greatest in the intervention targeted for that change. The percentage of participants who were able to meet the dietary goals is presented and the implications of these data for the selection of dietary goals are discussed. PMID- 6494108 TI - Preventing the onset of cigarette smoking in Norwegian adolescents: the Oslo youth study. AB - As part of a 2-year multiple risk factor intervention study, a school-based, multicomponent smoking prevention program for 10- to 15-year-old students in Oslo, Norway, resulted in a significant reduction in the onset of smoking relative to a reference group. Based on reported smoking behavior, the intervention group (N = 278) experienced a smoking onset rate of 16.5% and the reference group (N = 208) a rate of 26.9%. Intervention students had a significantly larger increase in scores on a smoking knowledge index; they also reported a significantly larger increase in frequent exercise and a significantly smaller increase in consumption of alcoholic beverages. A stepwise discriminant analysis showed that the smoking prevention program was an important discriminator of smoking onset. In both reference and intervention groups, students who reported smoking at the follow-up survey had already displayed risk taking tendencies at the time of the baseline survey 2 years earlier, whether or not they smoked at baseline. Follow-up smokers had more smoking friends and siblings at baseline and evidenced greater acceptability of smoking; they ate sweet, fatty, and salty snack foods more often, exercised less often, and drank more beer and hard liquor than students who were nonsmokers at the follow-up survey. PMID- 6494107 TI - Assessment of potential exposure to antineoplastic agents in the health care setting. AB - In response to reports of measurable air levels of antineoplastic agents in hospitals and preliminary evidence of exposure to personnel handling these agents, a survey was designed and conducted to document the current handling practices of injectable antineoplastic drugs by hospital and health care workers at two major teaching hospitals and three affiliated community hospitals. The survey included assessment of drug preparation, administration, and disposal. A sample of nurses, pharmacists, physicians, and other staff who routinely come in contact with these drugs was interviewed for validation of the observed results. Typical working conditions encountered and the potential numbers of people at risk and their job titles are presented here. Drug preparation facilities and methods were not uniform even within a single institution, including local preparation in the pharmacy under controlled or uncontrolled conditions, as well as individual drug preparation and administration on the hospital floors. Handling practices for drug preparation were not consistent from practitioner to practitioner. In some cases, where laboratory coats and disposable gloves were provided, it was not a routine practice to wear them. Based on such analysis of risk factors, recommendations for improved practices are given. PMID- 6494110 TI - Asbestos-exposed populations: prevention, care, and compensation. AB - In Israel, the prevention and care of asbestos-associated diseases with latency periods of one to four decades (asbestosis, mesothelioma, increased frequency of cancer of the lung and other sites) are not satisfactory, and new national policies are required. Such policies have three major goals: (a) elimination or reduction of exposure to asbestos dust; (b) measures to promote cessation or drastic reduction of cigarette smoking among those currently or formerly exposed; and (c) equitable compensation for the consequences of past exposures. The practical elements of a program to achieve these three goals include (a) exposure standards and control technology; (b) identification of sources, routes, and levels of exposure and groups at risk; (c) compensation and job security; (d) medical monitoring and follow-up; (e) smoking cessation; (f) selective substitution of other substances for asbestos; and (g) establishment of a panel for policy supervision and the overseeing of compensation programs. Delay in implementation risks higher death rates for asbestosis and cancer among previously exposed workers, greater exposure among current workers, loss of experienced workers from the work force, and unnecessary hardship for families not adequately compensated. PMID- 6494109 TI - The family heart dietary intervention program: community response and characteristics of joining and nonjoining families. AB - A random sample of 501 eligible families was selected from a designated neighborhood in Portland, Oregon, and given the opportunity to join a 5-year intervention program promoting a low-fat and low-cholesterol eating pattern designed to reduce risk for coronary heart disease. Participation entailed three baseline assessments of clinical, dietary, and psychological indices, periodic follow-up measurements, and monthly small group meetings led by psychologists and nutritionists. A prior home health survey allowed comparisons of respondents from joining and nonjoining families in terms of reported health status, health beliefs, health locus of control, knowledge about health and nutrition, and demographic characteristics. Almost half (47%) of all invited families agreed to join this long-term nutrition intervention program and completed the necessary baseline assessments. Factors discriminating joiners and nonjoiners were not generally consistent with the health belief model of preventive health behavior. Joiners were similar to nonjoiners in terms of perceived susceptibility to disease, family health histories, and reports of elevated plasma cholesterol levels in the family. However, families with hypertensive members were less likely to join this heart disease prevention program. Positive predictors of participation included higher occupational status, greater knowledge about heart disease, a more internal health locus of control, and the belief that there are few barriers preventing the adoption of a healthier low-fat eating pattern. These findings indicate that there is widespread community interest in optimal nutrition, and they also provide suggestions as to what motivates the general public to take preventive health actions. PMID- 6494112 TI - Prevention and the public health. PMID- 6494111 TI - Update on the delayed effects of the "five day plan to stop smoking". PMID- 6494113 TI - Preventive strategies for reducing hyperlipidemia in childhood. PMID- 6494114 TI - [Psychological selection of pilots and cosmonauts]. PMID- 6494115 TI - [Characteristics of post-vaccine scars and the sensitivity of the skin to tuberculin in children in contact with patients with tuberculosis]. PMID- 6494116 TI - [Risk factors in the development of complications after BCG vaccination]. PMID- 6494117 TI - [Differential diagnosis of tuberculosis and nonspecific lung diseases]. PMID- 6494118 TI - [Comparative evaluation of the results of diagnostic thoracotomy and thoracoscopy with biopsy in disseminated lung diseases]. PMID- 6494119 TI - [Clinical classification of sarcoidosis]. PMID- 6494120 TI - [Classification of sarcoidosis]. PMID- 6494121 TI - [Antigen inhalation provocation test in the diagnosis of exogenous allergic alveolitis]. PMID- 6494122 TI - [Bronchial obstruction in radionuclide imaging]. PMID- 6494123 TI - [Complex treatment of patients with sarcoidosis of the respiratory organs]. PMID- 6494124 TI - [Clinico-laboratory comparisons in patients with pulmonary tuberculosis, hepatitis B and the association of these diseases]. PMID- 6494125 TI - [Tuberculosis among the rural population]. PMID- 6494126 TI - [Role of microcirculatory disorders in the pathogenesis of pulmonary hypertension in chronic nonspecific lung diseases]. PMID- 6494127 TI - [Difficulties in the differential diagnosis of various disseminated processes in the lungs]. PMID- 6494128 TI - [Idiopathic fibrosing alveolitis]. PMID- 6494129 TI - [Changes in the incidence of tuberculosis among the population of an agricultural region of Bashkiria during a 25-year period]. PMID- 6494130 TI - [Exudative pleurisy in sarcoidosis]. PMID- 6494131 TI - [Autoimmune thrombocytopenia in sarcoidosis]. PMID- 6494132 TI - Dental health practices among Finnish university students. PMID- 6494133 TI - DMF scores in different tooth surfaces among 20 year old university students in Helsinki. PMID- 6494134 TI - Multiple odontomas. Review of the literature and report of a new case. PMID- 6494135 TI - Zonarc MLA program for parotid sialography. PMID- 6494137 TI - Congenital lip pits. Report a case. PMID- 6494136 TI - The impact of juvenile rheumatoid arthritis on the growth of the mandible. PMID- 6494138 TI - Dental caries of children, their parent's social status and knowledge of the prevention of the disease. PMID- 6494139 TI - Mechanism of the antihypertensive effect of TR2515, a potent serotonin antagonist. PMID- 6494140 TI - Interaction between digoxin and verapamil in isolated cardiac muscle. PMID- 6494141 TI - Response to increases in extracellular calcium in the presence or absence of verapamil in normotensive or hypertensive cardiac muscle. PMID- 6494142 TI - Dual effects of amrinone and caffeine on cardiac contractility: positive versus negative inotropy. PMID- 6494143 TI - Mechanical effects of ethyl alcohol on muscles of the proximal stomach. PMID- 6494144 TI - Regulation of slow wave propagation in the stomach. PMID- 6494145 TI - The contractile effect of phentolamine on the smooth muscle of isolated guinea pig urinary bladder. PMID- 6494146 TI - Technique for perfusion of rabbit thoracic aorta. PMID- 6494147 TI - Centrally administered bombesin stimulates intestinal motility. PMID- 6494148 TI - Pharmacologic and toxicologic basis of cyanide antagonism. PMID- 6494149 TI - The effect of the vasopressin antagonist d(CH2)5dTyrVAVP on the cardiovascular responses to stimulation of the paraventricular nucleus. PMID- 6494150 TI - Protective effect of drug metabolism inducer and inhibitor on O,O,S-trimethyl phosphorothioate induced delayed toxicity in rats. PMID- 6494151 TI - Antagonists for toxic heavy metals. AB - From a consideration of the donor preferences of toxic metals and the acceptor preferences of commonly used therapeutic chelating agents it is often possible to get a good estimate of the kinds of chelating agent which may be effective antagonists. The relative importance of extracellular vs. intracellular metal, however, introduces an important factor which can severely limit the utility of a given chelating agent with a toxic metal with which it forms very stable complexes. In general an effective antagonists of a specific toxic metal will be a chelating agent which can gain access to the metal in vivo and which forms a very stable complex, of modest toxicity with that metal ion which is rapidly excreted without damage to the kidney or liver. Such effective antagonists are not known for all metals. PMID- 6494152 TI - Roles of dopamine and GABA in neurotoxicity of organophosphorus cholinesterase inhibitors. PMID- 6494153 TI - Basal developed force and inotropic characteristics of myocardial tissue isolated from streptozotocin diabetic animals. PMID- 6494154 TI - Characteristics of the coronary blood flow response to human PTH-(1-34). PMID- 6494155 TI - Differential inotropic and dromotropic effects of cholinergic stimulation: competition with adrenergic stimulation. PMID- 6494156 TI - A study of tissue acetylcholinesterase in fishes. PMID- 6494157 TI - Effects of the irreversible acetylcholinesterase inhibitor soman on match-to sample behavior of the juvenile baboon. PMID- 6494158 TI - A preliminary evaluation of radioenzymatic, HPLC and chemiluminescent methods for the measurement of acetylcholine released from the vascular perfused rat phrenic nerve-hemidiaphragm preparation. PMID- 6494159 TI - Responses of the isolated buffalo sculpin heart to stabilized venom of the lionfish (Pterois volitans). PMID- 6494160 TI - Seasonal variations in rattlesnake venom proteins. PMID- 6494161 TI - Isolation of highly purified iodinated peptides by high pressure liquid chromatography. PMID- 6494162 TI - In vitro metabolism of 8-methoxypsoralen. PMID- 6494163 TI - Evidence for distinct carboxylesterases/amidases for hydrolytic metabolism of procaine, acetanilide and 2-acetylaminofluorene. PMID- 6494164 TI - Correlation of hepatic blood flow as measured by laser Doppler velocimetry with hepatobiliary transport in trout. PMID- 6494165 TI - Effect of benzyl alcohol on lactate dehydrogenase isoenzymes. PMID- 6494166 TI - Rat plasma heart and testicular lactate dehydrogenase: subcellular distribution and kinetic properties. PMID- 6494167 TI - Evaluation of four homologs of 4-(2-bromo-4,5-dimethoxyphenyl)-octahydro-2H quinolizin-2-one (JB-1-0) for their capacity to prevent carrageenan induced pedal edema in the rat. PMID- 6494168 TI - Comparison of three enzymatic models for evaluation of reactivators of organophosphorus ester inhibited acetylcholinesterase. PMID- 6494169 TI - Biochemical observations in rats following exposure to soman. PMID- 6494170 TI - Detoxification of soman and o-cyclopentyl-s-diethylaminoethyl methylphosphonothioate in vivo. PMID- 6494171 TI - Analysis of pulmonary collagen production by high performance liquid chromatographic separation of radiolabeled hydroxyproline and proline. PMID- 6494172 TI - Influence of TR2515, a serotonin antagonist, on the electrical and behavioral effects induced by stimulation of the olivo-cerebellar system. PMID- 6494173 TI - Voltage clamp comparison of the organic calcium channel blockers D-600 and nisoldipine. PMID- 6494174 TI - Cholinergic agonist and antagonist interactions on the putative nicotinic cholinoceptor of motor neurons. PMID- 6494175 TI - Evidence for internalization of opioid peptides but not opiate drugs in brain slices. PMID- 6494176 TI - Atypical calcium sensitivity of chemically skinned smooth muscle of the guinea pig vas deferens. PMID- 6494177 TI - Pharmacological characterization of the development of presynaptic mechanisms controlling pineal gland N-acetyl-transferase activity. PMID- 6494178 TI - Potentiation of the vasoconstriction to norepinephrine in the isolated perfused rat kidney by 5-hydroxykynuramine, an endogenous amine related to 5 hydroxytryptamine. PMID- 6494179 TI - Effects of the venom of the Southern Pacific rattlesnake, Crotalus viridis helleri, and its fractions on striated and smooth muscle. PMID- 6494180 TI - The effects of pentobarbital on isolated rabbit vascular smooth muscle. PMID- 6494181 TI - Bombesin stimulates motility of the canine isolated small intestine by a neurogenic mechanism. PMID- 6494182 TI - Hypercholesterolemia and the response of the rabbit ear and basilar arteries to biogenic amines. PMID- 6494183 TI - Lymphoma, analgesia and excitability after morphine administration in mice. PMID- 6494184 TI - Lymphoma and behavioral responses to psychomotor drugs. PMID- 6494185 TI - Oxytocin stimulates glucose oxidation in rat thymocytes. PMID- 6494186 TI - In vivo effect of chronic cadmium dosage on phagocytosis of sheep red blood cells. PMID- 6494187 TI - Relation of serum and urinary fluoride levels to fluoride intake in healthy men. PMID- 6494188 TI - Influence of cadmium on isolated peritoneal macrophage populations: I. Cadmium interferes with Fc receptor function. PMID- 6494189 TI - Influence of cadmium on isolated peritoneal macrophage populations: II. Cadmium inhibits Fc receptor internalization. PMID- 6494190 TI - Studies in vivo and in vitro on N-acetylphenelzine. PMID- 6494191 TI - Ethanol reinforced lever pressing of rats: the role of gender. PMID- 6494192 TI - Footshock induced hyperthermia. PMID- 6494193 TI - Carbamate prodrugs of phenylethylamines: a neurochemical investigation. PMID- 6494194 TI - Chronic maternal methadone exposure and response to analgesics. PMID- 6494195 TI - Species differences in phenytoin induction of cytochrome P450 due to pharmacokinetic differences. PMID- 6494196 TI - Stereoepimer specific inhibition in vivo of enkephalin degrading brain aminopeptidase. PMID- 6494197 TI - Effects of N-propionylcadaverine on the visual and central nervous systems of the mouse. PMID- 6494198 TI - The pro-enkephalin A derivative, peptide E, is centrally processed to active fragments. PMID- 6494199 TI - The use of chemical agents and coping with the harsh realities of existence. PMID- 6494200 TI - Effects of nicardipine, nifedipine, verapamil, and diltiazem on urine volume, sodium and potassium excretion and plasma aldosterone levels in the rat. PMID- 6494201 TI - Neuromuscular blockade of selected E,E- and Z,Z-isomeric oxime ethers of delta 4 androstene-3,17-dione dioxime as compared to D-tubocurarine and decamethonium. PMID- 6494202 TI - Transuterine passage of drugs in the rat. PMID- 6494203 TI - Increased incidence of death during warming in hypertensive rats treated with clonidine--possible lung pathology involvement. PMID- 6494204 TI - [Pyrogens and the Limulus test]. PMID- 6494205 TI - [Unity through diversity: the use of multivariate methods in drug research]. PMID- 6494206 TI - Mental rehearsal of a task under ethanol facilitates tolerance. AB - Male social drinkers learned a motor-skill task and then drank the same dose of ethanol (0.66 g/kg) on five sessions. Sessions 1 and 5 provided pre- and post treatment measures of performance under ethanol. During treatment sessions, one group (P) practiced and another (M) mentally rehearsed the task after ethanol was administered. A control group (C) rested. On the posttreatment session, groups P and M did not differ and both were less impaired (i.e., more tolerant) than C. These results suggest that the development of ethanol tolerance is sensitive to the same training procedures which facilitate drug-free learning of a task. PMID- 6494207 TI - A comparative study of the behavioral effects of the locus coeruleus and the dorsal noradrenergic bundle lesions in the rat. AB - The effects of bilateral lesions of the dorsal noradrenergic bundle (DB) or of the locus coeruleus (LC) on the rat's behavior in different anxiogenic behavioral situations have been studied. The DB rats defecate less but ambulate more than shams in the open-field (O.F.); these data suggest a decrease in the reactivity of these animals to novelty. Furthermore, the LC rats have a behavior identical to that of shams in the O.F. We note moreover that the DB rats do not habituate to a novel stimulus. During the Henderson test, the behavioral inhibition of all lesioned animals seems to be less important than that of shams. These results are discussed in relation to existing hypotheses of the DB function. The lesions of DB induce a decrease in the noradrenaline (NA) cortical level and in the catecholamines level in hypothalamus. The lesions of LC produce 30% loss of forebrain NA. These results reveal a discrepancy between the effects induced by the lesioning of DB fibers and those produced by lesions of LC, which originate in the DB. The presence of non-noradrenergic elements, fibers of passage, which do not travel with the DB fibers or terminals in the LC region may be elements for interpretation. PMID- 6494208 TI - Locomotor activity and opiate effects in male and female hamsters. AB - Locomotor activity of golden Syrian hamsters was investigated in three experiments. In Experiment 1, running wheel activity of male and female hamsters was compared under the following conditions: no injection, saline injection, morphine injection (15 mg/kg) and naltrexone injection (1 mg/kg). During two hour test sessions, females maintained high levels of activity, whereas males slowed down considerably during the second hour. The difference between males and females was evident under all conditions except following morphine which produced a biphasic time-effect pattern in both sexes. Naltrexone, however, had no detectable effects on either males or females. Experiment 2 investigated the effects of four doses of naltrexone (0.3, 1, 3, 10 mg/kg) on hamster locomotion. Results indicated that none of the doses tested had an effect. Experiment 3 demonstrated that a 1 mg/kg dose of naltrexone antagonizes two of morphine's (15 mg/kg) effects on activity. First, naltrexone partially blocked morphine elicited sedation. Second, naltrexone blocked the increase in activity that characterizes recovery from morphine. PMID- 6494209 TI - Antagonism of the behavioral effects of L-phenylisopropyladenosine (L-PIA) by caffeine and its metabolites. AB - Three male Sprague-Dawley strain rats were trained to respond under a multi component time out 5 min variable ratio 15 (VR15) schedule of food reinforcement. Cumulative, within session dose-effect curves were determined for L-PIA alone and after methylxanthine pretreatment. L-PIA alone produced dose related decreases on VR15 responding at doses between 0.032 and 0.178 mg/kg. Significant antagonism of L-PIA was demonstrated from pretreatment with caffeine, theophylline, theobromine, paraxanthine, 3-methylxanthine, and 7-methylxanthine. No antagonism of L-PIA was observed following pretreatment with 1-methylxanthine. Consistent with the adenosine receptor blockade hypothesis, caffeine also antagonized the effects of 5'-N-ethylcarboxamide adenosine (NECA) on VR15 responding. PMID- 6494210 TI - Tolerance to the depressant effects of diazepam in the drug discrimination paradigm. AB - Seven groups of rats (n = 35) were run in operant drug experiments. All groups were trained on a Fixed Ratio 10 schedule to discriminate diazepam from saline. Two groups (n = 7, n = 6), after extensive drug discrimination training (doses of 2.0 and 3.0 mg/kg diazepam), were submitted to generalization experiments with various doses of the training drug. Two additional groups, (n = 6, n = 8) in the initial phase of drug discrimination, were trained on intermediate and high doses of diazepam (i.e., 5.0 and 10.0 mg/kg). The development of tolerance to the depressant effects of diazepam for these two groups was compared to the low dose sophisticated rats. Of the above-mentioned groups, two groups were given tests after a waiting period in drug discrimination training. In this test the two groups were compared to an additional group (n = 8) in its initial phases of drug discrimination training. The results show that a large number of low doses (i.e., doses below 3.0 mg/kg) is not able to induce any tolerance to the depressant effects of diazepam in this particular paradigm. Intermediate doses of diazepam (i.e., 3.0 mg/kg), administered in a large number, induced some tolerance to the depressant effects, while another intermediate dose (5.0 mg/kg) and a high dose (10.0 mg/kg) rapidly induced a significant tolerance. Once developed, the tolerance persisted for 51 days. PMID- 6494211 TI - Prenatal stress: effect on development of rat brain adrenergic receptors. AB - Female rats were subjected to stress treatments during pregnancy and the offspring were studied at several different ages. The ligands [3H]WB-4101, [3H]clonidine and [3H]dihydroalprenolol were used to measure alpha 1, alpha 2 and beta receptor binding in several brain regions. At 16 but not at 23, 40 or 60 days of age the offspring showed reduced alpha 1 and beta receptor binding in cerebral cortex whereas a previous study had shown a similarly transient elevation of norepinephrine (NE) level at 16 days of age. The 60 day-old offspring showed only a reduced alpha 2 binding which appeared to have no regional specificity. Consistent with our previous finding that in 60 day-old offspring NE levels were not significantly affected by maternal stress exposure in almost all brain regions studied, we find no effect on the ability of nerve endings to synthesise catecholamines. These data provide additional support for the proposal that prenatal stress results in permanent neurochemical changes and suggest that there may be a delayed or impaired development of the postsynaptic elements of noradrenergic neurons. PMID- 6494212 TI - Incremental repeated acquisition in the rat: acute effects of drugs. AB - Rats lever pressed for food and learned new response sequences on three levers. At the beginning of each daily session, responses on only one of the levers produced food. After meeting criterion on one lever, the task was "incremented" so that sequential responses on two levers were required and so on up to five sequential responses. Each new required response was added in front of the previously performed sequence. Sequences of lever presses required to produce food changed each session. Following establishment of stable acquisition behavior, the acute effects of d-amphetamine (0.30-3.0 mg/kg), diazepam (0.125 4.0 mg/kg), morphine (0.30-10.0 mg/kg), pentobarbital (1.0-17.5 mg/kg), and chlorpromazine (0.10-3.0 mg/kg) were examined. All drugs decreased the number of response sequences completed in a dose-dependent fashion. Response rates generally decreased at or below those doses that caused an increase in errors. For d-amphetamine, the profound disruption of incremental repeated acquisition behavior was primarily due to drug-induced perserverative responding. Pentobarbital and chlorpromazine increased errors both when the sequence was incremented and within the sequence whereas diazepam only increased errors when the sequence was incremented. Morphine generally increased within sequence errors without affecting errors when the sequence was incremented. PMID- 6494213 TI - [D-Ala2]-methionine enkephalinamide reflexively induces antinociception by activating vagal afferents. AB - Experiment 1 showed that intravenous administration of [D-Ala2]-methionine enkephalinamide resulted in dose-dependent inhibition of the tail-flick reflex, mild hypotension, and bradycardia. The enkephalinamide-induced inhibition of the tail-flick reflex and cardiovascular effects were eliminated in the bilateral cervical vagotomized anesthetized rat preparation, but were unaffected by either a unilateral right vagotomy or bilateral sinoaortic deafferentation in the conscious rat preparation. Experiment 2 demonstrated that the antinociceptive and cardiovascular actions of enkephalinamide were eliminated by pretreatment with intravenous administration of the opioid-receptor antagonist naloxone. These experiments strongly suggest that peripherally circulating enkephalins could reflexively induce analgesia by activating cardiopulmonary receptors whose afferents travel in the vagi. PMID- 6494214 TI - Chlordiazepoxide injection elevates the NaCl solution acceptance-rejection function. AB - Injection (SC) of chlordiazepoxide (2-8 mg/kg) increased the intake of NaCl solution (0.5-3.0% NaCl) as well as water in water-deprived rats when these fluids were made available singly during daily 1-hr rehydration periods. The marked enhancement of this drug effect when NaCl solution was the available fluid does not appear to be due to the induction of a sodium appetite or the mimicking of an increase in water deprivation. The exaggeration of the drug effect when an NaCl solution is the drinking fluid, as opposed to water, may be useful as a sensitive index of action for punishment-attenuating (anxiolytic) drugs. PMID- 6494215 TI - Differential effects of phencyclidine and MDA on complex operant behavior in monkeys. AB - In one component of a multiple schedule, patas monkeys acquired a different four response chain each session by responding sequentially on three keys in the presence of four geometric forms (learning). In the other component, the four response chain was the same each session (performance). The response chain in each component was maintained by food presentation under a fixed-ratio schedule. Errors produced a brief timeout but did not reset the chain. With increasing doses of phencyclidine the overall response rate in each schedule component decreased, the percent errors in each component increased, and there was less within-session error reduction (acquisition) in the learning component. MDA (3,4 methylenedioxyamphetamine), a hallucinogen that is self-administered in nonhuman primates, was similar to phencyclidine in producing dose-related rate-decreasing effects in both schedule components. Unlike phencyclidine, however, MDA had little or no effect on accuracy in either learning or performance. PMID- 6494216 TI - Apomorphine and haloperidol-induced effects on male rat sexual behavior: no evidence for actions due to stimulation of central dopamine autoreceptors. AB - The administration of apomorphine (0.2-0.8 mg/kg IP) or (+)3-PPP(4-8 mg/kg IP) produced a facilitation of the male rat sexual behavior. Apomorphine in lower doses, as well as the selective DA autoreceptor agonist (-)3-PPP were ineffective. Except for a decrease in number of intromissions and an increase in the postejaculatory interval at the highest dose (0.32 mg/kg IP) there were no effects after administration of haloperidol. These data indicate that activation or inhibition of the presynaptic dopamine receptor does not affect male rat sexual behavior. PMID- 6494217 TI - Enhancement of memory by a cholinesterase inhibitor associated with muscarinic receptor down-regulation. AB - Rats trained on a passive avoidance task 24 hours following a single intraperitoneal injection of diisopropyl fluorophosphate (DFP, 1.2 mg/kg) showed enhanced retention when tested 7 days later. In a parallel group of rats, reduced cortical [3H] quinuclidinyl benzilate binding was demonstrable 24 hours following DFP administration. The association of reduced muscarinic receptor binding and enhanced performance on a memory task contradicts previous reports which suggested that retention was impaired by treatments which down-regulate muscarinic receptors. This contradiction may be reconciled if pre-synaptic factors such as agonist availability are considered in conjunction with post synaptic receptor effects. PMID- 6494218 TI - Regression of atherosclerotic lesions and control of plasma lipids and lipoprotein cholesterol by Anna Pavala Sindhooram therapy. AB - Plasma and lipoprotein distribution of cholesterol and triglycerides were measured in experimentally induced hypercholesterolemia associated with moderate hypothyroidism and after Anna Pavala Sindhooram (APSm) therapy in rat models. Feeding atherogenic diet increased all the three lipoprotein classes (HDL, LDL and VLDL). When APSm was administered for 90 days at a dose of 30 mg/rat/day, orally with and without atherogenic diet, it brought down the already raised levels of cholesterol and triglycerides in LDL and VLDL. Histological studies on the aorta revealed that APSm therapy produces regression of the atherosclerotic lesions. PMID- 6494219 TI - Effects of rociverine on the human ureter: in vivo and in vitro experimental study. AB - An in vitro and in vivo study was conducted to verify the effects of rociverine- a new spasmolytic agent--on peristalsis in the human ureter. In vitro (human ureter strips), rociverine exerted a spasmolytic activity both on the baseline motility and on the spasm induced by direct contractants (eledoisin, KCl) or by histamine. It may therefore be concluded that rociverine is a predominantly myotropic spasmolytic. In the in vivo study, conducted in patients with cutaneous ureterostomy, the drug showed a marked inhibitory effect on the amplitude and frequency of the ureteral rhythmic spikes, without affecting the baseline tone. PMID- 6494220 TI - Fructose-1,6-diphosphate counteracts potassium effects on cardiac muscle. AB - Fructose-1,6-diphosphate (FDP) counteracts the inhibition of contractile strength of rabbit cardiac muscle induced by KCl "in vitro" and the valinomycin induced depolarization. FDP also protects in a dose-dependent fashion, up to 100 mg/kg, different strains of mice from the lethal effect of KCl that is due to a complete atrio-ventricular block and related to a high value of plasma potassium level. A protective effect of FDP is observed when increasing doses of (+/-) propranolol are injected before maximum non lethal dose of KCl. PMID- 6494221 TI - In vitro effects of nicardipine on vascular and cardiac muscle preparations. AB - Nicardipine, a new 1,4-dihydropyridine derivative with Ca++-antagonist activity, was tested on rabbit aortic strips contracted with K+ and NA, and on an isolated guinea pig heart perfused at constant flow. It inhibited K+-contraction in the aortic strips and reduced coronary resistance with the same potency as nifedipine resulting about 10 time less potent than the latter in depressing the myocardial contractility. The effects of nicardipine appear to be related essentially to its Ca++-antagonist activity rather than to any antiphosphodiesterase activity. PMID- 6494222 TI - Amiloride, a diuretic with in vitro antimicrobial activity. AB - The effect of amiloride, an inhibitor of passive sodium influx in animal cells, was investigated on the in vitro bacterial growth. Amiloride blocked the growth of different bacterial strains at concentrations ranging from 25 to 1,300 micrograms/ml. While generally the block was bacteriostatic and bacteria, on amiloride removal, recovered their ability to growth, the drug showed a killing activity on hemolytic streptococci. Gram-positive bacteria revealed a greater susceptibility to amiloride than gram-negative ones. Although an hitherto unknown effect of amiloride cannot be excluded, from the known mechanism of action of amiloride on animal cells it might be suggested that sodium permeability plays a critical role on bacterial multiplication. PMID- 6494223 TI - Antitubercular and CNS activities of some 2-aryl-3-[N-(2/3/4-benzimidazol-2 yl)phenyl]iminomethylenyl indoles. AB - The title 2-aryl-3-[N-(2/3/4-benzimidazol 2yl)phenyl]iminomethylenyl indoles were synthesised by condensing 2-aryl-indol-3-aldehydes with 2-(2/3/4 aminophenyl)benzimidazoles in isopropanol and characterised by elemental and spectral (IR, PMR) studies. Compounds were screened in vivo for toxicity and gross CNS effects on albino mice and in vitro for antitubercular activity against human tuberculosis bacteria, Mycobacterium tuberculosis, H37RV. The tested compounds were nontoxic and CNS depressant. Some of them have been found to possess significant antitubercular activity, comparable with streptomycin. PMID- 6494224 TI - [The history of dosage form from the German Pharmacopoeia I to II of East Germany]. PMID- 6494225 TI - Decomposition of 1-aryl-3-dimethylamino-1-propanone methobromides under weakly acidic conditions. AB - Under basic conditions, some 1-aryl-3-dimethylamino-1-propanone methodbromides (2) were shown to decompose too readily to measure by the electronic absorption spectroscopy technique available. However, at pH = 5.9 and 20 degrees centigrade, the rate of deamination to the corresponding 1-aryl-2-propen-1-ones was able to be followed using Guggenheim's method and a Hammett plot showed that the rate of deamination correlated with the arly substituent constants (o). The rho value for this process was +1.00. In contrast the corresponding 1-arly-3-dimethylamino-1 propanone hybrobromides (1) did not decompose under simulated physiological conditions (pH = 7.4, 37 degrees centigrade). Neither 1 or 2 were active against P388 lymphocytic leukemia in mice but the methobromides displayed greater murine toxicity. PMID- 6494226 TI - Cyclodextrin polymer, a new tablet disintegrating agent. AB - Cyclodextrin (CD) polymer, a type of crosslinked cyclodextrin, has been evaluated as a new tablet disintegrating agent in comparison with four common disintegrants (crosslinked polyvinylpyrrolidone, crosslinked carboxymethyl cellulose, formaldehyde casein and corn starch). Physical properties of the disintegrants have been studied. Tablets made by direct compression using microcrystalline cellulose as binder, magnesium stearate as lubricant and talc as antiadherent have been compared. The parameters evaluated were disintegration time, hardness and friability. CD polymer performs well as a tablet disintegrating agent with results paralleling those of crosslinked carboxymethyl cellulose (Ac-Di-Sol) and superior to the other three. PMID- 6494227 TI - [Studies on the distribution and transport kinetics in membrane and distribution models]. AB - The concentration-time dependence of two weak acids (salicylic acid, benzoic acid), one weak base (benzocaine) and one neutral agent (acetanilid) has been studied in membrane or distribution models by polyacrylat-D 340-membranes or cyclohexane phases. The transport rate constants of outflow from the donator compartment or influx into the acceptor compartment as well as the distribution coefficients membrane/water or cyclohexane/water had been calculated from the concentration-time courses. In contrast to the polyacrylate membrane, the outflow from the donator compartment and the influx into the acceptor compartment proportionate to the corresponding distribution coefficient with the use of the cyclohexane phase. The influx into the acceptor compartment is in the polyacrylate membrane delayed by interactions between the membrane and the permeant. The membrane/water distribution coefficients figured out from the permeation test correspond with values formerly derived from equilibrium tests. PMID- 6494228 TI - [Methodology and importance of determining patient compliance]. PMID- 6494229 TI - [The effect of diseases and surgery of the gastrointestinal tract on the pharmacokinetics of caffeine]. PMID- 6494230 TI - [The stabilization of urea and prednisolone in a L/W emulsion ointment]. PMID- 6494231 TI - Biological systems: recognition of covariance. AB - 'Hold all variables constant except one', is not a feasible approach to the study of the many biological systems in which variables are not independent, but covariant. Covariance means that the efficacy of a variable depends on the values of other variables. The presence of covariance in biological systems must be recognized in the design of experiments and the analysis of results. PMID- 6494232 TI - Decarboxylation of L-dopa and 5-hydroxytryptophan in dispersed rat pancreas acinar cells. AB - Amino acid decarboxylation activity in dispersed rat pancreas acinar cells and fractions derived by differential centrifugation of homogenate of these cells was studied. The rate of decarboxylation was measured by determining the rate of production of the [3H]-amine from [3H]-amino acid or the rate of production of 14CO2 from the [14C]-carboxy-labelled amino acid. Only the hydroxylated amino acids L-dopa and 5-hydroxytryptophan are decarboxylated by intact dispersed pancreas acinar cells or cell homogenates at all pH values and amino acid concentrations tested. The decarboxylase activity is located exclusively in the cell cytosol. Each substrate competitively inhibits the decarboxylation of the other and the decarboxylation of each is inhibited by NSD-1055. The estimated Km and Vmax are, for L-dopa, 4.8 X 10(-5) M and 2.5 nmol/mg protein/min and for 5 hydroxytryptophan, 2.9 X 10(-5) M and 0.3 nmol/mg protein/min. The pH optimum for 5-hydroxytryptophan decarboxylation is from 7.0-8.5 while that for L-dopa is 7.0. It is concluded that pancreas acinar cells possess a single aromatic amino acid decarboxylase specific for the hydroxylated amino acids L-dopa and 5 hydroxytryptophan, and which is similar in all properties studied to the aromatic amino acid decarboxylase found in several other mammalian tissues. PMID- 6494233 TI - Hemodynamic effects of two ergot derivatives in the conscious spontaneously hypertensive rat. AB - The effect of acute and chronic administration of two ergot derivatives, dihydroergosine (DHESN) and ergosinine (ESNN), on blood pressure, heart rate, cardiac output and total peripheral resistance was studied in conscious spontaneously hypertensive rats. Acute administration of either DHESN or ESNN (50 100 micrograms/kg) resulted in prompt and significant (p less than 0.01) decrease of both blood pressure and heart rate, which lasted for more than 12 h. The decrease in blood pressure was due to reduction in total peripheral resistance, as cardiac output remained unchanged. Prolonged treatment (50 micrograms/kg, i.p., every second day for 12 days) with either DHESN or ESNN significantly (p less than 0.01) decreased blood pressure. In chronically treated rats, total peripheral resistance was found to be decreased while no changes in cardiac output and heart rate were observed. The results indicate that both DHESN and ESNN are potent antihypertensive agents, due to their vasodilator effects. The hypotensive effect of DHESN could be partially blocked by haloperidol, but not by yohimbine. Both, DHESN and ESNN antagonized the effect of phenylephrine on blood pressure. PMID- 6494234 TI - Effects of verapamil on the arrhythmogenic action of acetylstrophanthidin. AB - Although coadministration of verapamil and digoxin results in significant increases in plasma glycoside concentrations, evidence of digitalis toxicity appears to be infrequent with this combination. To evaluate the effect of verapamil on electrophysiologic toxicity from digitalis, 5 anesthetized dogs were instrumented for physiologic recording and given acetylstrophanthidin by intravenous infusion until evidence of toxicity appeared. Each animal was then treated with verapamil intravenously, with mean steady-state plasma levels of 177 +/- 30 ng/ml, and acetylstrophanthidin infusion repeated; after return of sinus rhythm, the verapamil infusion was increased (producing mean levels of 379 +/- 50 ng/ml) and acetylstrophanthidin given a third time. Prior to verapamil dosing, ventricular ectopy was the manifestation of glycoside toxicity; following the first verapamil infusion, only 20% of the dogs developed ectopy, the remainder having second- or third-degree atrioventricular (AV) block, or AV junctional tachycardia. With the higher verapamil dose, AV block or junctional tachycardia occurred in all animals during acetylstrophanthidin infusion. In addition, the dose of glycoside required to produce electrophysiologic toxicity was significantly increased by verapamil. Therefore, verapamil appears to exert a protective effect against the development of digitalis-induced arrhythmia, possibly by suppressing delayed afterpotential generation, and significantly increases the dose of digitalis required to produce AV block. PMID- 6494235 TI - Evidence for an indirect component of the action of histamine on canine portal vein. AB - Histamine caused contraction of spiral strips of the canine portal vein. This is an H1 response and no evidence of any H2 receptor activity was observed. The response to histamine was blocked by the alpha-adrenoceptor antagonists phentolamine and prazosin, but not by the alpha 2-receptor blocker yohimbine. Pretreatment of the tissue with 6-hydroxydopamine significantly reduced the response to histamine and tyramine while the response to noradrenaline was unchanged. A marked tachyphylaxis developed to tyramine and histamine, but not to noradrenaline. We conclude that a component of the contractile activity of histamine on the canine portal vein involves release of endogenous catecholamines and that this response is mediated by H1 receptors. PMID- 6494236 TI - Verapamil and norverapamil determination in human plasma by gas-liquid chromatography using nitrogen-phosphorus detection: application to single-dose pharmacokinetic studies. AB - A sensitive (to 0.5 ng/ml) and specific method for the determination of verapamil and norverapamil which utilizes gas-liquid chromatography with nitrogen phosphorus detection is described. A basic extraction with acid back-wash and final basic reextraction is used for the preparation of plasma samples. Standard curves using alpha-isopropyl-alpha-[(N-methyl-N-homoveratryl)-beta-aminoethyl]- 3,4- dimethoxyphenylacetonitrile hydrochloride (D-517) are linear for concentrations from 0.5 to 200 ng/ml for both verapamil and norverapamil. Within day and between-day reproducibility is good with a coefficient of variation less than 10% for all concentrations. Recovery is complete for both verapamil and norverapamil. Application of the method is demonstrated by a pharmacokinetic study in a normal volunteer who received 10 mg verapamil hydrochloride by intravenous infusion. PMID- 6494237 TI - Effect of extra- and intracellular calcium blockers on histamine and antigen induced bronchospasms in guinea pigs and rats. AB - The extracellular calcium antagonists, nifedipine and verapamil, the mixed extra/intracellular calcium antagonist diazoxide and the intracellular calcium antagonist TMB-8 were studied for their effects on histamine-induced bronchospasm in guinea pigs and on antigen-induced bronchospasms in guinea pigs and rats when administered directly to the tracheobronchial tree. Nifedipine and verapamil inhibited histamine and antigen-induced bronchoconstriction in guinea pigs, and verapamil was effective in preventing antigen-induced bronchospasms in rats. However, using doses of the extracellular blockers which produce these pulmonary effects, significant reduction of blood pressure occurred in both guinea pigs and rats. Diazoxide was inactive against histamine and antigen-induced bronchoconstrictions in guinea pigs. TMB-8 was inactive against histamine and antigen-induced bronchospasm in guinea pigs and rats. These studies demonstrate the antibronchoconstrictor activity of extracellular Ca2+ antagonists in guinea pigs and rats, but indicate that intracellular Ca2+ antagonists are not antibronchospastic agents in these species in vivo. PMID- 6494238 TI - Effects of aminoglycosides on glomerular ultrastructure. AB - Effects of the aminoglycosides, gentamicin, netilmicin and tobramycin (30 mg/kg/day X 7, i.p.), on glomerular ultrastructure were determined in male Wistar rats. Glomerular ultrastructure was studied by scanning and transmission electron microscopy. The average number of capillary endothelial fenestrae per 5 microns of capillary wall decreased from a control value of 10.8 to 8.2 and 8.1 in gentamicin- and tobramycin-treated rats, respectively, as shown by transmission electron microscopy (TEM). Scanning electron microscopy (SEM) showed that the density of endothelial fenestrae decreased to about 80% of control in gentamicin- and tobramycin-treated rats. In addition, gentamicin and tobramycin produced a marked reduction in the number of granulated myoepithelioid++ cells of the juxtaglomerular apparatus. Netilmicin appeared to have no effect on glomerular ultrastructure. Both TEM and SEM, indicate that the nephrotoxic aminoglycosides gentamicin and tobramycin alter the ultrastructure of the fenestrated endothelia of the glomerular capillaries. These ultrastructural changes appear to be correlated to the impairment of the glomerular permeability for different compounds. PMID- 6494239 TI - Biliary and renal excretion of paracetamol in man. AB - In 6 postsurgery patients with T tubes inserted in their common bile ducts, biliary excretion of paracetamol amounted to 2.6% of an oral dose (1 g), consisting of unchanged paracetamol (0.57%) and conjugates of sulfate (0.36%), glucuronic acid (0.36%) and cysteine (1.63%). Renal recovery in the same patients was 35.3%, consisting of 2.6% unchanged paracetamol, 12.7% paracetamol sulfate, 9.0% glucuronide, 3.9% cysteine conjugate and 4.0% mercapturate. PMID- 6494240 TI - Therapist compliance or phase IV necessities. PMID- 6494241 TI - Phase-IV research: specifics, objectives and methodology. AB - The development of therapeutics is a step-by-step process. The laboratory phase O is followed by the preclinical phase the hypothesis generating phase II, the hypothesis testing phase III, and the routine treatment phase IV. Each of these treatment development and evaluation phases has its own specifics, objectives and methodologies. Phase IV comprises all scientific efforts to enhance the knowledge about a given therapy under routine treatment conditions. In phase IV the final test is done on security, effectiveness and feasibility of a treatment. Research with and on practitioners needs special non-reactive research designs. PMID- 6494242 TI - Setting relevant patient differences--a problem in phase-IV research. AB - A treatment outcome study included patients from a hospital outpatient clinic and a general practice. All patients who entered the study fulfilled the RDC criteria for primary major depressive disorder and had a minimum score on the Beck Depression Inventory of 14. In spite of these identical inclusion criteria GP patients and hospital outpatients showed marked differences with regard to sociodemographic variables, psychopathology and course of illness. Most importantly, treatment outcome was different depending on the setting, although treatment procedures were identical. These findings strongly suggest that treatment recommendations for patients in different settings must be evaluated in these various settings. Generalisations from one setting to the other are not acceptable. PMID- 6494243 TI - Studies in general practice: interpractice differences. AB - Based on results of a recent epidemiological study in general practice, interpractice differences are described and found to be rather marked. They include differences in patients population, case definitions and ability to diagnose nosologic groups. Based on relevant literature and own experiences, measures are described which help to reduce interpractice differences and to improve the quality of study data. Examples of training procedures, exchange of information and technical support are given. As a consequence of the interpractice differences these measures are found to be not only desirable but imperative. PMID- 6494244 TI - Drug safety in psychiatry--an objective for drug monitoring in phase IV. AB - This survey deals with methods to achieve drug safety within the phase IV of psychotropic drug development. Data related to adverse drug reactions (ADRs) are very heterogeneous and have to be collected from very different sources. A sophisticated method, called hospital-based drug monitoring, serves as an important tool for assessment of ADRs in in-patients. The techniques of assessment developed in the context of drug monitoring will be described in detail in this paper. The data obtained may also serve for the evaluation of efficacy and economy of drug treatment in psychiatric in-patients. Moreover, drug monitoring in hospitals may have some value for residents' training in psychiatry, and for generating of hypotheses in clinical pharmacology and biological psychiatry. PMID- 6494245 TI - The private practice study group as phase-IV research tool. AB - Research in the routine field of psychiatry must include psychiatrists in private practice. A majority of psychiatric patients is treated as outpatients and many of these are only seen by private psychiatrists. Setting or patient variables pose restrictions on the therapy which leads to the development of specific treatment strategies. Because these are empirically based, it can be expected that the knowledge of practitioners can make a major contribution to the development of optimal treatment recommendations. Research in private practice requires special organisational efforts. One way to get access to this field are collaborative study groups which bring together scientists and their research facilities with practitioners and their surgeries. Such an instrument may allow: access to patients, which may never show up in any other research institution; monitoring of patient characteristics and treatment modalities under routine conditions; elaboration of special skills, insights and treatment strategies developed by the practitioner. These study groups can vary with regard to type of practice, type of collaboration and type of research. Studies can rely on information from patient self-reports, observations by the practitioners themselves or their office assistants and on data gathered by scientific staff working occasionally or continuously in the practice. PMID- 6494246 TI - Phase IV research by pharmaceutical companies. AB - The paper reviews the objectives and methods of phase IV studies performed by a pharmaceutical company with psychoactive drugs. After the introduction of a new drug additional information is needed especially regarding the safety of the drug. The term Post-Marketing Surveillance (PMS) covers all the methods used to collect this tolerability data. They include spontaneous monitoring by physicians, monitored release and related techniques, intensive monitoring typically in a hospital setting, case-control studies and cohort studies. Typical examples of new patient populations which are not usually studied extensively during the premarketing phases of drug development and which therefore need to be studied in more detail in phase IV are children and the elderly. In both of these groups certain special aspects have to be taken into consideration when planning and conducting clinical trials. Extension of the drug to new indications often starts spontaneously as observations of alert clinicians which then lead to systematic controlled trials. The methods used in the monitoring of physicians' prescription habits include the use of available commercial statistics, ad hoc physician surveys and the collecting of information through the medical representatives of the company. PMID- 6494247 TI - Measurement of radiation dose distributions by nuclear magnetic resonance (NMR) imaging. AB - A method is described for determining the spatial distribution of radiation dose in a tissue-equivalent phantom using nuclear magnetic resonance imaging. The conversion of ferrous ions to ferric by ionising radiation alters the magnetic moment and electron spin relaxation times of the metal ion. The spin relaxation times (T1 and T2) of the hydrogen nuclei in an aqueous solution of a ferrous salt are consequently reduced substantially. These changes in T1 and T2 can be measured using standard NMR techniques. The same conversion is used in conventional Fricke dosimetry, which can be used to calibrate the technique. PMID- 6494248 TI - The measurement of energy imparted to patients during diagnostic x-ray examinations using the Diamentor exposure-area product meter. AB - The mean energy imparted to the patient has been proposed as a practical quantity which may be useful for assessing somatic risk in X-ray diagnostic radiology. A technique is described for estimating energy imparted during most common X-ray examinations of the trunk or complete head from a measurement of exposure-area product conveniently provided by the Diamentor transmission ionisation chamber. The necessary energy imparted calibration for the Diamentor has been deduced from consideration of incident spectral energy fluence and Monte Carlo calculations of the fraction of total beam energy imparted to mathematical phantoms representing the patient. The relationship between energy imparted and exposure-area product depends primarily on the applied potential and total filtration of the X-ray beam, and to a lesser extent on voltage waveform and X-ray target angle. Direct measurements of energy imparted to an Alderson Rando phantom for a range of irradiation conditions provided an excellent verification of the technique developed. Using the energy imparted per exposure-area product factors presented, overall uncertainties of less than +/- 15% and +/- 20% should be possible for measurements of energy imparted during examinations of the trunk and head respectively using the Diamentor. PMID- 6494249 TI - On the relationship of image intensifier contrast ratios measured by two techniques. AB - In recent years the contrast ratio (CR) has played an important role in the quantitation of imaging performance of X-ray image intensifiers. In practice, one uses either a lead disc or strip for measurement of contrast ratios. A theoretical relationship relating contrast ratios measured by both disc and strip techniques is discussed and experimental results are presented. The theoretical analysis uses the point spread function model to describe veiling glare for an image intensifier. It has been shown that one can predict strip contrast ratios after a determination of the veiling glare point spread function from a measurement of disc contrast ratios. PMID- 6494250 TI - Response of x-ray intensifying screens to scattered and primary radiation. AB - The energy dependence of the luminance ratio due to scattered and primary radiation has been determined for four types of X-ray intensifying screens. A water phantom of 30 cm X 30 cm X 20 cm was used as the scattering medium. Ten narrow band X-ray spectra were used as incident radiation: the mean energies of these spectra ranged from 28 to 84 keV. Using the monoenergetic data, results were calculated for broad spectra and compared with measured results for broad spectra. For tube voltages up to 50 kV the calculated results agreed well with the measured results: for higher tube voltages a small difference occurred. PMID- 6494251 TI - A microprocessor-based system for readout of x-ray penetrameter films. AB - A microprocessor-based instrument has been constructed which allows rapid analysis of a standard penetrameter film using a handheld probe. Compensation for non-uniformity of the X-ray viewing box used as a light source is automatic and there is a paper record of procedures and results. Calibration data for the penetrameter can be easily modified. The instrument can also be used for spot readouts of optical density. PMID- 6494252 TI - Radiation dose to the breast during mammography: a comprehensive, realistic Monte Carlo calculation. AB - Certain assumptions have been made regarding the composition of the breast in different age groups: these are believed to be more realistic than existing assumptions and have been used in comprehensive Monte Carlo calculations of radiation dose to the breast and of appropriate indicators of risk as follows: (i) Mean dose to the sensitive tissues in an average breast. This may be used to compare risk in different mammographic techniques, and has been calculated for a wide variety of techniques, including some not previously explicitly studied. (ii) Integral dose to the sensitive tissues in a breast, which is a good indicator of risk in an individual case, has been calculated for two commonly used mammographic techniques and for four different breast compositions and thicknesses. The results have been compared with results obtained using other approaches. PMID- 6494253 TI - An inexpensive patient imaging table for gamma camera work. PMID- 6494254 TI - Assessment of the energy absorbed by patients during diagnostic radiology examinations by a calorimetric method. PMID- 6494255 TI - Median nerve F-wave conduction in healthy subjects. AB - This study of the normal median nerve was designed to compare techniques of using the shortest and average F-wave latencies, F-wave values between extremities, and F-wave values with the conventional motor response values and to determine the relationships between F-wave latency and arm length. We examined 40 median nerves in 20 subjects with no known pathology. The motor response latency was measured from wrist and elbow stimulation sites by conventional techniques. We then applied multiple stimuli at the same sites to record a series of 10 F-wave latencies and determined shortest and average F-wave latencies. Values of F-wave and M-response conduction are reported. No significant difference was found in F wave latency or velocity between extremities within subjects, using either the shortest or average latency technique. We propose a formula for calculating the estimated F-wave distal latency based on the conventional motor response distal latency. The F-wave conduction velocities of the forearm were faster and more variable than the motor nerve conduction velocities. A high correlation was found between F-wave distal latency and arm length. Using the method described, the F wave can be a useful measure in evaluating the conduction of proximal segments of peripheral motor nerves. PMID- 6494256 TI - Basic requirements for initiating an interdisciplinary process. AB - The basic requirements for starting an interdisciplinary process are common value commitments, interpersonal communication skills, similarity between disciplines, and low level of perceived threat. We have drawn on our own experience in discussing the relationships between these requirements and suggest effective strategies for developing an interdisciplinary process. We conclude that the interdisciplinary process facilitates service and communication among all participants and that research is needed to determine optimum combinations of disciplines and group size. PMID- 6494257 TI - Physical therapy treatment of a patient with a conversion reaction. A case report. AB - Physical therapists are important members of the treatment team involved in the diagnosis and treatment of a patient with a conversion reaction. A physical therapist can assist a physician in making the diagnosis by performing various tests, such as manual muscle tests and nerve conduction studies, and guide the patient's return to normal physical function. This goal can be reached by the physical therapist who structures the patient's treatment by understanding that a patient suffering from a conversion reaction is not consciously aware that the problem is psychogenic in origin. PMID- 6494258 TI - Assessing maximal static ventilatory muscle pressures using the "bugle" dynamometer. Suggestion from the field. PMID- 6494259 TI - Compact device for positional biofeedback. Suggestion from the field. PMID- 6494260 TI - The 1984 presidential address. Robert W. Richardson. President, American Physical Therapy Association. PMID- 6494261 TI - Nineteenth Mary McMillan lecture. PMID- 6494262 TI - [Photoplethysmography: 12 years' experience]. AB - The author draws his conclusions from photoplethysmographic studies and twelve years of experience. This technique, based on the variation in permeability to light of human tissue, has the great advantage of being able to give reliably exact information about the condition of the deep and superficial venous circulation, locally. The information given is as precise as that produced by the techniques termed "invasive". PMID- 6494263 TI - [Non-invasive measurement of venous circulatory resistance in man]. AB - Plethysmography using the mercury gauge was applied to measure the changes of volume in the calf caused by venous congestion at varying pressures, achieved using an inflated pneumatic band round the thigh. By analysing the deposit graphs, it is possible to calculate a value for the circulatory resistance of the venous system. The significance of this parameter, notably for the diagnosis of venous thrombosis, is explained. PMID- 6494264 TI - [Diagnosis of microangiopathy by measurement of cutaneous circulation]. AB - One method for measuring the cutaneous circulation is described: heat conductibility, dependent on the variations of the circulation in the superficial layers of the skin, is measured. These variations are obtained by total temporary arterial occlusion, then by application of a vasodilatory cream. With this technique we can show not only arteriolar spasm, but also the organic occlusion of the cutaneous vessels in the case of arteriolar sclerosis (microangiopathy). The practical advantage of the measurement method is that it is possible to examine microangiopathological ulcerations, and those of mixed origin. The results make it possible to locate Martorell's hypertonic ulceration, for instance, or atherosclerotic ulcerations complicated by microangiopathy, or venous ulcers complicated by arteriolar sclerosis. PMID- 6494266 TI - [Theory and practice of the nuclear magnetic resonance test]. PMID- 6494265 TI - [Functional phlebological diagnosis using light reflection rheography]. AB - Light-reflexion rheography is a method which can confirm or invalidate the results of clinical examination and which, in any case, makes it possible to approach the diagnosis of haemo-dynamic disorders much more precisely. The author describes this technique and gives an account of the results obtained by applying this method to the various types of superficial or deep, complicated or uncomplicated, varicose veins. PMID- 6494267 TI - [Measurements of skin elasticity in patients with lipedema of the Moncorps "rusticanus" type]. AB - Patients with lipoedema of the typus rusticanus Moncorps show a skin elasticity deficit of the skin of the calf. This is partly due to the derma oedema in the skin of these patients and seems partly to be due to an intrinsic connective tissue defect in the skin of such patients. The auteurs put forward the hypothesis that also present calf muscle pump dysfunction in these patients is the result of a connective tissue defect of the fascia of the muscular compartment, as an expression of a more generalized connective tissue defect. PMID- 6494268 TI - [Determination of venous capacity and flow by plethysmography with occlusion of the veins]. AB - These examinations are based on the knowledge that mercury-in-rubber strain gauge method for venous occlusion plethysmography is suitable for measuring the venous capacity and venous return. This research reports on the value of this method in diagnostics. The results are as follows: the venous capacity decreases markedly in the group of patients with deep vein occlusions of the legs. However, it is not possible, basing on the measurements, to differentiate between occlusions above and those below the knee. The same applies to multiple occlusions in the same vein meaning that venous occlusions in the deep veins of the lower limb cannot be examined separately. The results of a single patient are mostly but not always similar to those of this corresponding group. Therefore venous occlusion plethysmography does not have the same diagnostic value as phlebography in deep vein occlusions for the individual patient. PMID- 6494269 TI - [Post-traumatic ulcers in the elderly subject]. AB - The occurrence of ulceration after minor traumatism in the older patient free from arterial disorders, can be explained by the decreased elasticity of the subcutaneous tissues, which thus provokes arterial rupture, which in turn brings on major bruising and the appearance of an area of necrosis whose surface is proportionately large or smaller according to the damage done to the arterioles. The treatment is straight forward, and usually leads to quick healing without scarring. PMID- 6494270 TI - [Systemic diseases and ulceronecrotic angiodermatitis]. AB - The discovery of ulceronecrotic angiodermititic ulceration should mean that systematic clinical and paraclinical examination is carried out to look for a general cause. During these examinations the search should be for infectious causes on the one hand, and haemoglobinopathy on the other, and an examination of the ganglionic areae and of the spleen should be carried out. The examination might also lead to the discovery of localised or systemic vascularitis: the clinical examination should check for any disintegration of the general state, temperature, signs of neurological, digestive, cardiac, pulmonary localization, etc. The biological examination should show up any signs of inflammation and, eventually, a biopsy of cutaneous elements or of muscle should be able to show vascularitis. Ulceronecrotic angiodermititis should therefore not always be considered as a local pathology but sometimes as an element of systemic affection. PMID- 6494271 TI - [Leg ulcers of venous origin. Rate of basic healing. Practical consequences]. AB - The formula necessary for this study includes seven points of which the most important is the measurement of the reduction of the surface area of each ulcer. 100 leg ulcers, venous in origin, and representing a total surface area of 2.052 cm2, healed at varying speeds, directly proportionate to their initial surface area. To each surface area of ulcer there corresponds a length of time of half the cicatrization, equalling or less than thirty days which makes it possible to establish a point of reference in the development of cicatrization, and therefore a basic short-term prognosis. Once this time has passed, the diagnosis and the treatment are again the issue, with all that involves. PMID- 6494272 TI - [Clinical tests of medications aimed at healing: proposal for a methodology. Classification of leg ulcers]. AB - The author analyses the difficulties encountered in practical medicine when, attempting to obtain the cicatrization of leg ulcers. He underlines the necessity, in order to evaluate the action of a drug in a controlled experiment, to impose and to impose upon oneself, certain restrictions so as to be able to observe closely their development and to compare cases, some being tested with an active drug and others with a placebo. Telethermography would seem to be non surgical instrumental method of great benefit for following the development of the ulcer and assessing the effectiveness of a treatment. Whilst aware of both ethical and economic problems, the author proposes an analytical formula defining the indications of clinical and telethermographical seriousness and a classification of leg ulcers in the light of such an analysis. PMID- 6494273 TI - [Report of an update on products used in the treatment of ulcers]. AB - We have studied some of the new products either at experiment stage, or else already on the market, used in the treatment of leg-ulcers. In terms of the way in which they act we draw a distinction between: synthetic powders with adsorbent power (Bard and Iodosorb); synthetic dressings with a semi-adsorbent power (Aloxan and Silastic); and synthetic dressings with no adsorbent power (Synthaderm). We give a personal impression of each of them, together with their indications, advantages, and disadvantages. PMID- 6494274 TI - [Leg ulcers: so-called active dressings]. PMID- 6494275 TI - Palatability of sucrose before and after glucose ingestion in dieters and nondieters. AB - The present study examined the pleasantness of sucrose solutions as rated by dieters and nondieters, before and after the ingestion of a glucose solution. Subjects were 36 University of Toronto female undergraduates between 18 and 21 years old. After a 12 hour overnight fast, each subject tasted and rated five concentrations of sucrose solutions (2.5, 5.0, 10.0, 20.0, and 40.0%) for pleasantness and sweetness, at three minute intervals, over five separate trials. Two trials were run before the ingestion of a 200 ml 25% glucose solution and three trials after. The dieters rated the 20% and 40% sucrose solutions tasted prior to glucose ingestion as significantly less pleasant than did the nondieters; this difference was evident after glucose ingestion as well. A decrease in the palatability of the sucrose solutions induced by the glucose load (negative alliesthesia) was evident in both groups of subjects. Results were interpreted as requiring reconsideration of the assumption that dieters are below their set-points for body weight. Consideration of the role of cognitive factors in the perceived palatability of sweets may also be required. PMID- 6494276 TI - Courtship ultrasonic vocalizations in male Swiss-Webster mice: effects of hormones and sexual experience. AB - The effects of testosterone and its metabolites (estradiol and 5 alpha dihydrotestosterone) on male mouse ultrasonic vocalizations were investigated using Swiss-Webster mice. In the first experiment daily treatment with 50 micrograms or 200 micrograms of testosterone propionate (TP) restored ultrasonic calling in castrated sexually naive males. Treatment with 200 micrograms of dihydrotestosterone propionate (DHTP) also activated ultrasound production, but treatment with 50 micrograms of DHTP or estradiol benzoate (EB 0.5 microgram and 2 micrograms/day) failed to have a significant effect on this measure. In experiment two, the animals used had shown male sexual behavior before castration. These sexually experienced males showed a marked reduction in ultrasound production after castration but significantly increased ultrasound production after daily treatment with either TP (50 micrograms or 200 micrograms), DHTP (50 micrograms or 200 micrograms) or 2 micrograms of EB. Hormones that facilitated ultrasound calling also activated other components of male sexual behavior in this and previous studies with Swiss-Webster mice. The results indicate that hormone dose and precastration sexual experience interact to determine the effects of postcastration treatment on male vocalizations. PMID- 6494277 TI - The relative effectiveness of progestins for facilitation and inhibition of sexual receptivity in hamsters. AB - In a series of experiments, we studied the biphasic actions of 4 progestins on sexual receptivity in female hamsters. Based on previous reports, we selected doses of progesterone (P), desoxycorticosterone acetate (DOCA), 5-alpha dihydroprogesterone (DHP) and 20-alpha-hydroxyprogesterone (20-OHP) that were expected to have initial facilitative and/or subsequent inhibitory actions on sexual receptivity. Estrogen-primed ovariectomized female hamsters were given one of 4 doses of a progestin at hour 44 post EB, and were tested for facilitation (with tape over their vaginas to prevent intromissions) 4 hours later. At hour 68, all animals received 500 micrograms P and were tested for the inhibitory effects of the test progestin 4 hours later. In additional experiments, similar procedures were followed with an alternate vehicle (1% Tween-80 instead of sesame oil) and a longer initial progestin-to-facilitation test interval (8 rather than 4 hours) in attempts to improve bioavailability of the steroids. P and DOCA were clearly the most behaviorally effective progestins tested, and they were equally potent for facilitation and inhibition in an oil vehicle at the 4 hour interval. DHP given in oil caused some inhibition but no facilitation. 20-OHP had no behavioral effects at the doses tested. The results are discussed in light of previous results with these steroids in hamsters and other rodent species. Also, the differing patterns of effectiveness across conditions provide some, although qualified, support for our view that the biphasic actions of progestins may be controlled by separate mechanisms. However, an alternate explanation is also discussed. PMID- 6494278 TI - Diet selection following area postrema/nucleus of the solitary tract lesions. AB - Ten adult Long-Evans male rats were offered access to fat, protein and carbohydrate from separate sources. After adaptation to this diet, 5 animals received thermal lesions of the area postrema and adjacent caudal-medial portion of the nucleus of the solitary tract (AP/cmNTS). The remainder were sham operated. AP/cmNTS lesioned rats ate significantly less and lost more weight than controls during the first postsurgery measurement period (Days 4-13 after lesioning). The decrease of food intake of AP/cmNTS lesioned rats was due to reduced fat consumption. Carbohydrate and protein intakes of lesioned animals did not differ from those of controls. Food intakes and weight changes of lesioned rats did not differ from those of controls during days 14-23 after lesioning. Intake of fat by lesioned animals remained low but was no longer significantly different from that of controls. Carbohydrate and protein intakes of lesioned rats increased slightly but did not differ significantly from those of nonlesioned controls. PMID- 6494279 TI - Feeding behavior responses of Zucker rats to naloxone. AB - The effects of naloxone on feeding patterns were studied in both obese and lean Zucker rats during both light and dark phases of the diurnal cycle. Eight female obese (471 +/- 9 g) and lean (225 +/- 6 g) Zucker rats were trained to bar press for food. They were administered 0, 0.5, 1.0 or 2.0 mg/kg naloxone at the initiation of the light or dark phase of the diurnal cycle and feeding behavior was recorded for the subsequent 12 hr using an automated real-time data collection system. First meal size and duration were decreased and first postmeal interval was increased by naloxone and responses did not vary with phenotype or phase of the diurnal cycle. Naloxone decreased food intake during the 12-hr period by decreasing average meal size but meal frequency was not affected. Overall, the feeding behavior responses of obese rats to naloxone were greater than those of lean rats, supporting the hypothesis of an association between opioid peptides and obesity. Opioid involvement in diurnal control of food intake is also supported by the greater responses generally demonstrated in the light compared with dark phases. PMID- 6494280 TI - Splitting of the circadian rhythm of body temperature in the golden hamster. AB - The circadian rhythm of hamster locomotor activity "splits" into two distinct circadian components during conditions of constant illumination. To determine if the circadian rhythm of body temperature also splits under these conditions, body temperature and locomotor activity were monitored concurrently in animals housed in constant illumination. Splitting of the body temperature rhythm into two circadian components was observed in animals manifesting split activity rhythms. Concurrent splitting of both rhythms suggests a common mechanism either for the generation or coupling of these rhythms. PMID- 6494281 TI - Electrical self-stimulation of the mesencephalic central gray area: facilitation by lateral hypothalamic stimulation. AB - Three experiments were performed with BALB/c mice implanted both in the lateral hypothalamus (LH) and the dorsal part of the mesencephalic central gray area (CG). Initially, the effects of a brief electrical stimulation (0.2 sec) of the LH on approach and escape responses produced by continuous stimulation of the dorsal CG, were studied in a shuttle-box. Starting at an intensity of 10 microA, imposed LH stimulation both reduced approach latency and increased escape latency with CG stimulation. In the second and third experiments, the animals were placed in a standard self-stimulation (ICSS) box; depressions of a lever delivered brief electrical stimulations (0.2 sec). During the second experiment, it was observed that the very weak ICSS behavior produced by dorsal CG activation was greatly improved by forced LH stimulation. Finally, in the third experiment, simultaneous ICSS in LH and CG was compared with ICSS in LH alone. When low current intensities were used, simultaneous ICSS in LH and CG was more intense than ICSS in LH alone. These data especially suggest that dorsal CG stimulation has an appetitive component, and consequently that neuronal elements related to the positive reinforcement system are present in the dorsal CG area. Furthermore, the fact that one can obtain interactions between mesencephalic and hypothalamic ICSS is in accordance with the claim that the LH has connections with the CG area. PMID- 6494282 TI - Enhanced blood pressure responses to loud noise in offspring of monkeys with high blood pressure. AB - Sixteen unanesthetized immature Macaca fascicularis monkeys, 18-43 months of age, were tested for mean arterial blood pressure (MBP) and heart rate (HR) responses to 30 minutes of continuous broadband noise (95 dB). Eight animals (OH group) were offspring of monkeys with high blood pressure (parents' MBP = 115.5 +/- 1.0 (SEM) mmHg), and eight (OC group) were offspring of control animals with normal blood pressure (parents' MBP = 96.6 +/- 1.7 mmHg). Resting MBP during a 17-24 hour period prior to the experiment in the OH group was 100.6 +/- 1.9 mmHg, significantly higher (p less than 0.05) than the MBP of the OC group (94.3 +/- 2.2 mmHg.) Immediately prior to noise exposure, MBP in the OH group was stable for 30 minutes, at 104 +/- 3 mmHg. During noise exposure, MBP increased significantly to 108 +/- 4 mmHg. In the OC group, MBP during the 30 min baseline interval was 95 +/- 2 mmHg, and during noise exposure was not significantly changed at 94 +/- 3 mmHg. Heart rate decreased significantly during noise in the OC group and did not change in the OH group. The results indicate that the offspring of monkeys with high blood pressure had higher resting MBP than control animals and showed significant MBP increases in response to loud noise. Control animals showed no change in MBP and decreases in HR in response to noise. PMID- 6494283 TI - Subcutaneous glycerol injection fails to reduce food intake in rats fed a high protein diet. AB - To test whether glycerol utilization might contribute to glycerol-induced hypophagia, cumulative food intake was measured following subcutaneous glycerol injection in rats fed a high carbohydrate (HC), a high fat (HF) or a high protein (HP) diet, because food composition is known to influence the activity of several glycerol metabolizing enzymes. In additional experiments, the effect of glycerol injection on plasma glycerol, blood glucose, and liver glycogen levels was also investigated in HC-, HF-, and HP-rats. Subcutaneous glycerol injection (6.3 mmoles/kg b.w.) significantly reduced food intake in HC- and HF-rats, but failed to decrease feeding in HP-rats. Five hours after glycerol injection, plasma glycerol levels were significantly elevated in HP-rats, but did not differ from the glycerol levels of controls in HC- and HF-rats. Subcutaneous glycerol injection did not affect blood glucose concentration or liver glycogen content 5 hours after injection in any feeding group. The results suggest that oxidation of the injected glycerol might contribute to the glycerol-induced hypophagia in HC- and in HF-rats. PMID- 6494284 TI - Neural and behavioral responses to taste stimuli in the mouse. AB - Neural responses to lingual stimulations with varying kinds of chemicals were recorded from the chorda tympani nerve of the ddy mouse and preferences for NaCl, sucrose and Na saccharin were measured using the two bottle-choice technique. Sucrose, Na saccharin, HCl, and quinine produced large neural responses compared with that for NaCl. Divalent salts also elicited larger responses than NaCl response. The effectiveness of cations was in the order of Sr greater than Mg = Ca greater than Li not equal to Na not equal to NH4 greater than K. Neural response magnitudes for Na salts with varying anions decrease with the relative hydrated size of anions. Mice highly preferred sucrose and Na saccharin but showed a poor preference for NaCl. Similarity in the gustatory responses between mice and hamsters as well as macaque monkeys, and difference between mice and rats are pointed out. PMID- 6494285 TI - Cortical mechanisms underlying acquisition of latch-box problems in the white rat. AB - Adult rats, previously subjected to bilateral frontal, parietal, occipital, frontocingulate or posterior cingulate ablations, were required to learn two discrete latch-box tasks (sliding a barrel-bolt to the right and elevating a hook). Those groups showing significant learning impairments had lesions to either the frontal cortex or frontocingulate cortex. The data suggest that the neocortical focus for latch-box deficits lies rostral to Level 8 on the Lashley brain diagram, while the frontocingulate focus for latch-box deficits lies within the prelimbic area. PMID- 6494286 TI - Development of the drinking deficit to hypertonic saline in rats after abdominal vagotomy. AB - After abdominal vagotomy, rats drink significantly less water in response to hypertonic saline. The drinking deficit could be due to the disconnection of vagal afferent fibers from a peripheral receptor stimulated by hypertonic saline or the loss of a more complex, tonic, fascilitatory function. The loss of the phasic afferent fiber function should appear immediately after vagotomy, but the loss of the tonic function might take more time to develop. We attempted to distinguish between these two possibilities by preparing 5 different groups of vagotomized rats that were each tested with 1 M NaCl (1% BW) at one of five postoperative days--2, 4, 7, 14 or 21 days. The drinking response was significantly decreased from preoperative intake in the groups tested on postoperative days 7, 14, and 21, but not in the groups tested on postoperative days 2 and 4. Since the drinking deficit is not present 2 and 4 days after vagotomy, the effect of vagotomy is not the result of lesioning afferent fibers that mediate a peripheral phasic stimulation elicited by hypertonic saline. The postoperative delay of at least 7 days for the deficit to appear suggests that the effect of vagotomy is the loss of some more complex neurological function that is necessary for a normal drinking response. The nature of this lost function is unknown. PMID- 6494287 TI - Respiratory behavior in groups of deaf and non-deaf GFF male mice. AB - Carbon dioxide emission (VCO2) of groups of 10 GFF mice, genetically deaf and non deaf, were compared, in controlled conditions of temperature 20-21 degrees C, humidity 50-80% and light (LD12:12; L = 108 lux). A circadian rhythm of VCO2 was evidenced in both genotypes, with levels in D and in L significantly (0.001 less than p less than 0.01) greater in deaf than in non-deaf mice. Photic VCO2 variations were significantly (0.001 less than p less than 0.05) smaller at L--- D and D----L in the deaf than in non-deaf genotype. Ultradian (tau greater than 20 minutes) rhythms were evidenced in both genotypes; Fourier periodic analysis showed several significant (0.001 less than p less than 0.05) differences between these 2 genotypes concerning mainly amplitudes, whilst spectral analysis showed slight frequency differences between them. Survival to an acute nitrogen hypoxia or to an acute carbon monoxide intoxication which was significantly (p less than 0.001 and p less than 0.05) lower in deaf than in non-deaf individuals confirms the differences in respiratory behavior of groups of these two strains of mice. PMID- 6494288 TI - Inhibitory controls of ingestion in 6-day-old rat pups. AB - The ability of gastric preloads of milk, water, and isotonic saline to inhibit ingestion was studied in deprived 6-day-old rat pups being fed through oral cannulas. Preloads were delivered through gastric cannulas or by gavage, and both the volume of the load and the interval between the preload and testing were varied in order to assess the relative contributions of pre- and post-absorptive cues from the loads. Pups' willingness to initiate ingestion in short (10 min) tests (appetite) was unaffected by the degree of gastric filling produced by a load but was depressed by post-absorptive changes in hydrational state. On the other hand, pups terminated ingestion in long (30 min) tests (satiety) in response to gastric filling. Cessation of intake in long tests was only slightly influenced by post-absorptive factors. These results reveal two distinct phases of ingestion in infant rats and show that each is controlled in a different manner. PMID- 6494289 TI - No basic rest-activity cycle in head, wrist or ankle. AB - Kleitman's theory of a Basic Rest-Activity Cycle (BRAC) was tested by recording activity of the head, wrists, and left ankle from 10 healthy subjects. No 90-100 min rhythms in activity were found. PMID- 6494290 TI - Two eyes are better than one: superior binocular discrimination learning in pigeons. AB - Four groups of pigeons each were trained to perform four visual-discrimination tasks of varying difficulty. Two groups received the training binocularly and the other two monocularly. Two types of stimulus displays were used. In one display the two pecking keys were mounted in a horizontal arrangement, whereas, in the other display, the two keys were mounted in a vertical arrangement. In both displays binocular learning was more rapid than monocular learning. This difference increased with problem difficulty. Moreover, training with the horizontal key arrangement resulted in more rapid learning with either viewing condition. These results suggest that the inferiority of monocular learning was not caused by restriction of the visual field along the horizontal plane, and the failure to detect monocular-binocular differences in learning in previous reports may have resulted from inadequate task difficulty. Finally, the results suggest that monocularly-viewing birds should not be regarded as "natural split-brain" preparations. PMID- 6494291 TI - Perception of drinking water temperature and effects for humans after exercise. AB - Subjects rated the perceived temperature and hedonic values of four samples of drinking water (5 degrees, 16 degrees, 22 degrees, 38 degrees C) after exercise and on a control day. Ad lib drinking of any of the four samples was permitted for 20 minutes after exercise and intake was measured. Subjects completed questionnaires pertaining to their subjective states. Sensory thermal neutral water was found to be close to 22 degrees C which was also judged to be affectively neutral. Subjects rated 16 degrees C water higher on the hedonic scale after exercise than they did on a control day, despite the fact that no change in the perception of this temperature was observed. Responses to the symptoms questionnaire showed a marked effect of exercise on the perception of thirst, sweating, body warmth and dryness in the mouth. Sensations of stomach fullness could not account for the incomplete rehydration of most subjects in the time allotted. It was suggested that a rapid reduction in symptoms which initiate drinking was responsible for drinking termination. The role of water temperature in the reduction of thirst symptoms was discussed. PMID- 6494293 TI - A versatile integrated circuit activity monitor for small animals. AB - An easily constructed and inexpensive device for use in monitoring motor activity in small animals is described, which utilizes a suspension system and integrated circuit photodetector technology. Its sensitivity is readily adjusted, making it useful in a variety of applications. It provides a reasonably natural environment with minimal disturbance to the animal subject. PMID- 6494294 TI - "De-satiation" produced by liquid diet in rats satiated for glucose solution. AB - Previous work has shown that after rats have drunk a glucose solution to "satiety," and during the time when solution intake would remain inhibited, intake can be reinstated by offering powdered glucose. This "de-satiation" phenomenon shows that solution intake comes to an end before any limit on caloric or solute intake has been reached. Here we show that a milk-based liquid diet can also reinstate ingestion in the solution-sated rat. And such a rat increases its intake further when the diet is diluted with water. Therefore, the original "satiety" for glucose solution does not reflect a refusal of fluid per se, or of water; nor does it reflect an inhibition on the lapping response. PMID- 6494292 TI - Noradrenergic feeding elicited via the paraventricular nucleus is dependent upon circulating corticosterone. AB - Feeding behavior elicited by injection of norepinephrine (NE) into the paraventricular nucleus (PVN) of satiated rats has been shown to be abolished by hypophysectomy. To determine the specific nature of this dependence of NE's action on pituitary hormones, the efficacy of PVN-injected NE was examined in rats subjected to hypophysectomy, as well as to adrenalectomy, thyroidectomy, and gonadectomy, and also in operated rats receiving hormone replacement therapy. The feeding response induced by NE was almost completely abolished in adrenalectomized as well as hypophysectomized animals, but remained unimpaired after thyroidectomy and gonadectomy. The NE response was significantly restored in hypophysectomized rats by daily subcutaneous injections of corticosterone, but not by thyroxine, testosterone, insulin, or the mineralocorticoid deoxycorticosterone. In adrenalectomized rats, subcutaneous corticosterone implants as well as daily corticosterone injections (as opposed to deoxycorticosterone injections) effectively restored the NE eating effect. Radioimmunoassay of plasma corticosterone indicated that the level of hormone was positively correlated with the strength of the animals' response to the NE injection. These findings demonstrate that the loss of response to NE subsequent to hypophysectomy is due to a disruption of the hypothalamo-pituitary-adrenal axis. The glucocorticoids of the adrenal gland appear to be the essential humoral factor interacting permissively with PVN-injected NE to elicit feeding. PMID- 6494295 TI - Caloric regulation in the rat: evidence for a calibration mechanism. AB - Rats were given access to small quantities of a 50% oil/water mixture on each of 7 baseline days. On the eighth day, a 30 min compensation test was conducted during which control rats had access to the 50% oil/water mixture and experimental rats had access to either a more concentrated or a more dilute oil/water mixture. Experimental rats given the more concentrated mixture consumed significantly less than controls, while rats given the dilute mixture consumed significantly more than controls. These results suggested that rats can immediately adjust their food intake in response to changes in the caloric density of their diets. In a second experiment, immediate adjustment for caloric change was inhibited by giving rats a supplementary meal directly after access to the 50% oil/water mixture during the baseline phase. These results were discussed in terms of a hypothetical "calibration" mechanism which allows rats to estimate the density of novel caloric concentrations on the basis of a standard concentration. PMID- 6494296 TI - Visual evoked potentials and nociceptive thresholds in high and low self stimulators. AB - Tail flick latencies (TFL) were examined in order to distinguish between rats from genetically high (HI) and low (LO) self-stimulation lines (LC2-HI and LC2 LO). In addition, slow secondary negative wave (SNW) of the visual evoked potential, which is considered to be a sensitive index of normal and pharmacologically-induced behavioral arousal, was analysed. Small, albeit statistically significant enhancement of SNW was obtained in LO rats. Unlike LO animals, HI rats gained in SNW amplitude during repeated photic stimulation. The difference between the lines was highly significant. TFL assessment yielded slightly reduced (NS) values for HI rats. However, when TFL and SNW data were compared it appeared that TFL vary as a function of SNW amplitude in LO but not in HI rats, (r = 0.9). SNW may be employed as a predictor of the nociceptive threshold in rats. PMID- 6494297 TI - Hippocampal stimulation limits performance but does not retard acquisition of food-reinforced learning. AB - Facilitation of the usually very slow acquisition of hippocampal (HPC) self stimulation (SS) by prior, non-contingent HPC stimulation may be due to the progressive attenuation of a disruptive effect of the stimulation on learning. We attempted to answer two questions: (1) Does HPC stimulation disrupt food reinforced learning when it follows each lever-press as in SS experiments? (2) Does prior exposure to the stimulation attenuate any such disruptive effect? We observed no significant differences in the rate of acquisition when each food reinforced response was paired contingently with a 0.5 sec train of dorsal HPC stimulation (CS group), or when 0.5 sec trains were administered randomly throughout the session (RS), compared with an implanted control group (IC). Although acquisition was rapid in all groups, performance on the second day was significantly lower in the CS group than in the IC animals. These same electrode placements later supported SS. The same results were obtained with 3 similarly treated groups that had previously received a program of daily HPC stimulation (kindling). The results imply that kindling does not produce its facilitating effect on acquisition of HPC SS by removing a disruptive effect of the stimulation. PMID- 6494298 TI - Differential behavioral responsiveness to ipsilateral and contralateral visual stimuli produced by unilateral rewarding hypothalamic stimulation in the rat. AB - Rats were trained to respond to a visual cue signalling availability of brain reward on the left or the right side of a small chamber. Most of the rats began to respond more accurately to the visual cue presented on the side contralateral to brain stimulation than to the ipsilateral cue as the training progressed. The facilitation of the rat's response to the contralaterally presented visual cue was more evident when tested with visual cues presented simultaneously in both ipsilateral and contralateral sides. However, when tested with visual cues removed from both sides, this tendency became unclear. Additionally, monocular training gave evidence of identifying the visual cue ipsilateral to the open eye, irrespective of the electrode side. The results are interpreted as signifying that the ipsilateral hemisphere is activated by the brain stimulus and leads to improved discrimination of the contralateral visual cue because the visual system in the rat is crossed. PMID- 6494299 TI - Bilateral lesions of the SCN abolish lipolytic and hyperphagic responses to 2DG. AB - The effects of intracranial injection of 2-deoxy-D-glucose (2DG) on the plasma free fatty acid (FFA) concentration and food intake in the light (11:00 hr) and dark (23:00 hr) period were examined in male Wistar rats under a 12-hr light (08:00-20:00) and 12-hr dark (20:00-08:00) cycle. In sham-operated rats 2DG injection induced increase in plasma FFA concentration and in food intake in the light period, but not in the dark period. Bilateral lesions of the suprachiasmatic nucleus (SCN) resulted in complete loss of the lipolytic and feeding responses to 2DG in the light period. From these findings it is concluded that the lipolytic and feeding responses to 2DG are photoperiodic and that the SCN is involved in these phenomena. PMID- 6494300 TI - Pharmacological and anatomical aspects of cholinergic activation of female sexual behavior. AB - Forebrain infusion of cholinergic agonists activated the sexual response, lordosis, in ovariectomized female rats that had been primed with a low dose of estrogen. Carbachol, an agonist with both muscarinic and nicotinic properties, and oxotremorine, an agonist with a primarily muscarinic action, produced dose related increases in the frequency of lordosis elicited by stimulus male rats. This facilitation of lordosis was prevented when females were pretreated systemically with atropine or scopolamine, two muscarinic receptor antagonists. These results indicate that the effect of carbachol and oxotremorine on lordosis is mediated by cholinergic muscarinic receptors. The location of these receptors within the brain has not been identified. Ventricular infusion of carbachol was as effective as infusion directly into the medial preoptic area (POA) and more effective than infusion directly into the ventromedial hypothalamus (VMH). Furthermore, when carbachol or oxotremorine was delivered to the POA through cannulae angled to avoid traversing the lateral ventricles, no facilitation of lordosis was observed. These data suggest that muscarinic receptors stimulated by central infusion of cholinergic agonists may not be located in either the POA or the VMH, two regions traditionally implicated in the regulation of lordosis. PMID- 6494301 TI - Facilitation of generalization performances in spatial learning problems by posttrial stimulation of the mesencephalic reticular formation. AB - The effects of low posttrial stimulation of the mesenphalic reticular formation (MRF) on spatial learning problems were studied in two consecutive stages. First, the performances of stimulated (S) and no-stimulated (NS) subjects were assessed in a reconvergent three-arm maze. Secondly, the same animals were tested in a generalization paradigm, since they had to solve a similar task in a radial four arm maze, each group being divided into newly stimulated (S-S, NS-S) or no stimulated (S-NS, NS-NS) subjects. In the first experiment, no differences were found between the acquisition processes of groups S and NS. Conversely, in the second experiment, previously stimulated animals (S-S and S-NS) showed better generalization of the experimental rule. The results are discussed in terms of preservation of the neural activity after the early MRF stimulation. From a functional point of view, our data indicate that an enhancement of the neural activity during acquisition facilitates not only a high accessibility of memories concerning the experimental rule in a subsequent similar situation but also the capability to apply a previously elaborated response system in a more complex situation. PMID- 6494302 TI - A simple device to aid impalement of cells using conventional microelectrode drives. AB - Consistent penetration of cell membranes by micropipettes is facilitated by using electrode accelerators or high velocity step drives. Notwithstanding, much intracellular work is still done with conventional mechanical or hydraulic drives; cell membrane penetration is achieved by means of gentle taps on any convenient part of the set up. A remote control device is described which performs this function and is compact enough to be fixed on either the microelectrode holder or the preparation mounting. It consists of a small magnetized rod freely suspended in a pot-core coil. A current pulse through the coil jolts the rod; the inertial reaction of the coil frame provides the sudden movement required by the micropipette tip to overcome the elastic resistance of the cell membrane. PMID- 6494303 TI - Factors in the dose-response effect of testosterone in the male ring dove. AB - The dose-response effect of testosterone propionate on six behavioral patterns was examined in the castrated male ring dove. There was no dose-response effect when all behaviors were compared on the 13th day, the last day of systemic injection. However, a discernible dose-response effect in two behavioral patterns (Bow-coos and Nest-coos) was found on the day when maximal response was manifested. The latency (days) of maximal response differs from one behavioral pattern to the next, but is generally constant for each behavioral pattern at all dose levels. PMID- 6494304 TI - Effects of chronically elevated intake of different concentrations of saccharin on morphine tolerance in genetically selected rats. AB - Sixty-four LC2-Hi and LC2-Lo female rats were chronically supplied with either water or a solution of 1, 3 or 30 mM of sodium-saccharin. Pain sensitivity, as well as its reduction by a 2.5 mg/kg morphine injection, were measured in a hot plate test. High saccharin consuming LC2-Hi rats did not exhibit significant morphine-induced analgesia (MIA) compared to baseline, after 38 days of drinking of saccharin, irrespective of concentration. MIA of those rats were maintained on water was significant. In contrast, the low consuming LC2-Lo animals maintained either on water or on 1 and 30 mM saccharin showed significant MIA compared to baseline, following the same exposure period. The findings demonstrate that chronically elevated saccharin intake, activates an endogenous opiate system leading ultimately to cross-tolerance to the analgetic effects of morphine. PMID- 6494306 TI - Rapid eye movement sleep and its relationship to feeding behavior in the adult cat. AB - The aim of this study was to corroborate a previous report that, in cats kept on a 12:12-hr light-dark schedule, there is a highly significant negative correlation between the quantity of REM sleep in a 12-hr period and food intake in the subsequent 12-hr interval. Analyses of sleep-wake and food intake measures from freely behaving adult cats failed to disclose any consistent correlations between food consumption and REM sleep quantities in the same or adjacent 12-hr periods; amounts of waking (or total sleep) and slow-wave sleep also showed no consistent relationship to food intake. These findings question assertions that REM sleep participates directly in regulating the expression of motivated behaviors. PMID- 6494305 TI - Sensory versus dietary factors in cafeteria-induced overweight. AB - Normal Wistar rats became hyperphagic and obese when presented with high-fat, high-sugar or "cafeteria" diets. This phenomenon could be due to the very palatability of the offered foods but a metabolic factor could be suspected. In an attempt to distinguish the effects of the nutritional characteristics from those of the sensory properties of food, a new cafeteria diet, the "isocafeteria" diet, was developed. It consists of a choice of foods of similar, well-balanced composition but varying in taste, smell and texture. It was confirmed that in normal Wistar rats, the high-fat and the traditional "cafeteria" diet led to extra-weight gain. It was demonstrated that the daily presentation of a new choice of the palatable foods which composed the "isocafeteria diet" led also to a sustained increase in food intake and to overweight. Variety and high palatability are per se sufficient factors to overcome regulatory mechanisms. It was shown that the metabolic efficiency of such a regimen was strikingly higher than those of high-fat and traditional cafeteria diets. PMID- 6494307 TI - Caloric regulation of 3.2% ethanol consumption by rats. AB - Increasing the caloric density in an ethanol containing drinking fluid from that of 3.2% ethanol alone, 0.18 kcal/ml, 2.33-fold to 0.42 kcal/ml with the addition of lactose and glycerol, did not significantly alter ethanol consumption. Increasing the caloric density of the drinking fluid to 0.56 kcal/ml significantly reduced ethanol consumption. The decrease in ethanol consumption was neither due to the taste of the added glycerol and lactose nor to the total caloric content of the solution but rather to an interaction between ethanol and caloric density. Increasing the caloric density of the solid diet and adding a feeding stimulant, sucrose, significantly decreased 3.2% ethanol consumption. PMID- 6494308 TI - Deficits in visual discrimination performance following neglect-producing unilateral lateral hypothalamic lesions in the albino rat. AB - Adult male albino rats were trained with water reinforcement on a lateralized visual discrimination task. For six rats the correct head turn--nose poke response was to the same side as the discriminative stimulus (Turn Towards group). For six others the correct response was to the side opposite from the discriminative stimulus (Turn Away group). Immediately after a rat had mastered its task, a unilateral electrolytic lesion was made under ether anesthesia through a stainless steel electrode previously implanted in the lateral hypothalamus (LH). Discrimination training continued until the rat's performance returned to criterion. The lesions produced contralateral neglect as demonstrated by deficits in turning and orientation contralateral to the lesion. The lesions also disrupted all measures of discrimination performance (% correct, latency, and duration of observing response) for trials on which responses contralateral to the lesion were correct, regardless of whether the discriminative stimulus was also contralateral (Turn Towards group) or was ipsilateral (Turn Away group). These data are interpreted as showing that contralateral neglect following LH lesions is associated with a deficit in initiating instrumental responses contralateral to the lesion. They also confirm previous results from a similar task using tactile discriminative stimuli. PMID- 6494309 TI - Area postrema lesions cause overconsumption of palatable foods but not calories. AB - Rats with lesions of the area postrema and immediately adjacent solitary nucleus consume greater amounts of highly palatable food during short exposures than do control rats. When a highly palatable substance (cookies or glucose solutions) is available continuously along with laboratory chow, lesioned rats exhibit average 24 hour calorie intakes which are not different from those of control rats. Nevertheless, the lesioned animals ingest a significantly greater proportion of total calories as the highly palatable substances than do control rats. The data suggest that lesions involving the area postrema and adjacent nucleus of the solitary tract enhance intake of highly palatable food without causing overconsumption of calories. PMID- 6494310 TI - Validation of the cuff pedestal technique for rapid eye movement sleep (REMs) deprivation by electrophysiological recordings. AB - Twenty-four-hour recordings of electrophysiological correlates of the sleep waking cycle in the rat were performed during different stages of cuff pedestal treatment. It was found that rats adapted to live on pedestals with the cuff raised displayed undisturbed patterns of sleep and wakefulness. Lowering the cuff for three days resulted in virtually total disappearance of rapid eye movement sleep (REMs), while slow wave sleep (SWs) was only slightly reduced. Raising the cuff induced a prominent rebound increase of REMs. These results accord with data obtained by means of the conventional flowerpot procedure and corroborate the validity of the cuff pedestal technique. PMID- 6494311 TI - Recovery of absolute threshold with UVA-induced retinal damage. AB - A within-trial psychophysical procedure tracked the initial loss and subsequent recovery of visual thresholds in albino rats exposed to ultraviolet light at 350 nanometers and 0.4 milliwatts per square centimeter. Absolute thresholds increased up to 5 log units immediately following the 15 hour ultraviolet exposure, with a daily recovery of 1-2 log to asymptotic thresholds over a 7-day post-exposure period. The corresponding retinal damage on Day 1 included extensive vesiculation of the photoreceptor outer segments, vacuolation of the inner segments, and pyknosis of cell nuclei. The total number of photoreceptor nuclei and outer segments was unchanged relative to control eyes through post exposure Day 3. Both nuclei and outer segment counts then consistently decreased 15-20 percent between Days 3-7. The two-stage loss of photoreceptors but daily recovery of absolute thresholds again suggests a significant dissociation of retinal structure and psychophysical function in light-induced ocular pathology. PMID- 6494312 TI - Conditioned taste aversions: generalization to taste mixtures. AB - Rats were trained to take their daily water ration within a 30-min session, during which the number of licks per 10-sec presentation of a drinking tube could be recorded. During one of these sessions, one of three stimuli (sucrose, NaCl or HCl) was presented, followed by the administration of cyclophosphamide to produce a conditioned taste aversion. When tested with mixtures of the conditioned stimulus (CS) with the other two stimuli and also with quinine hydrochloride, the animals avoided mixtures containing the CS in proportion to its concentration in the mixture. Although the natural preferences and aversions for these stimuli interacted somewhat with the learned taste aversions, rats responded to the presence of a CS in a mixture and did not generalize to other stimuli not containing the CS. Thus, the generalization of conditioned taste aversions provides a good measure of the behavioral similarities among gustatory stimuli. PMID- 6494313 TI - Effects of oral chemical irritation on taste. AB - Oral irritation was induced by rinses with capsicum oleoresin and with piperine, constituents of red and black pepper, respectively. The perceived intensities of two concentrations of each of four tastants representing the four classical taste qualities were evaluated after rinsing with these irritants. Comparing taste intensity after rinses with capsicum and after control rinses with emulsifying agents or water, there were significant decrements in taste intensity of citric acid and quinine, and on one concentration of sucrose, but no effect on salt. The effects of piperine were more broad, with significant decrements in perceived intensity relative to emulsion controls for all substances. PMID- 6494314 TI - Diurnal cycle of mother-young contact in Norway rats. AB - Mother rats maintained on a LD 12:12 photoperiod (lights on 0800 hrs) had longer contact bouts with their offspring during the day than during the night and maternal brain temperature peaked during the night. When the daily temperature cycle was suppressed by removal of adrenal and ovarian hormones, the daily maternal contact cycle was also suppressed. These data are consistent with a thermal model for the limitation of mother-young contact bout duration. PMID- 6494315 TI - Characterization of the basic replicons of the chimeric R/Ent plasmid pCG86 and the related Ent plasmid P307. AB - Restriction-enzyme fragments that can replicate autonomously after circularization were isolated from the chimeric R/Ent plasmid pCG86 and the Ent plasmid P307. Two such regions containing a basic replicon were located in each plasmid. One of the basic replicons of P307, RepFIB, is almost identical with one of the basic replicons of pCG86. The other basic replicon in P307, RepFIC, is partly homologous with the second basic replicon in pCG86, RepFIIA/RepFIC. The latter is a hybrid basic replicon and is in addition partly homologous with RepFIIA, a basic replicon present in IncFII R plasmids. By restriction-enzyme mapping and nucleotide-sequence analysis we have determined a site in the hybrid replicon where it ceases to be homologous with the RepFIIA basic replicon contained in the IncFII miniplasmid pSM1. The 2410-bp region of homology with pSM1 corresponds with a segment containing the origin of replication and all the genes responsible for replication control of pSM1. PMID- 6494316 TI - Reciprocal intrapool variation in plasmid copy numbers: a characteristic of segregational incompatibility. AB - An experimental analysis of the concept that incompatible plasmids occupy a common intracellular pool from which copies are drawn at random for replication and assortment is presented. Intrapool variations in an incompatible heteroplasmid strain are inevitable and it is shown that these variations can be exploited by differential selection to amplify one plasmid at the expense of the other. Constant overall copy number is demonstrated for isogenic wild-type replicons and also for isogenic copy mutants whose copy numbers are so great that segregational incompatibility cannot be measured. In the test system used, that of the Staphylococcus aureus plasmid pT181, the rate of replication is probably determined by the availability of a trans-active initiator protein, RepC. In heteroplasmid strains containing wild-type and dominant copy mutant plasmids, although intrapool variation occurs, the total copy number is not constant but varies as a consequence of selection for or against the mutant plasmid. This is because all of the RepC is synthesized from the mutant plasmid (the wild-type is hyper-repressed) and therefore the selection affects the supply of RepC at the same time that it affects the copy number of the plasmid. None of these effects are seen with single plasmids or with compatible pairs. PMID- 6494317 TI - RepFIC, a basic replicon of IncFI plasmids that has homology with a basic replicon of IncFII plasmids. AB - It was found that a DNA segment containing genes for autonomous replication and its control (basic replicon) present in the IncFI plasmid P307 has homology with RepA, a basic replicon present in IncFII plasmids. The basic replicon in P307 is referred to as RepFIC and the homologous basic replicon in IncFII plasmids is referred to as RepFIIA. In 11 other IncFI plasmids studied a region that has homology with RepFIC and RepFIIA was demonstrated. Thus, of the several basic replicons present in IncFI plasmids, RepFIC is evolutionarily related to a basic replicon of IncFII plasmids. PMID- 6494318 TI - Selective alteration of palpebral fissure form by lateral canthopexy. AB - A method is described for altering the shape and position of the palpebral fissure at the lateral canthus. Three steps are essential to alter shape and position. They are (1) identification of a lateral canthal soft-tissue mass consisting of periosteum, lateral canthal ligament, and orbicularis muscle, (2) extensive subperiosteal soft-tissue mobilization of the lateral canthal soft tissue mass (LCSTM) from a point just superior to the zygomaticofrontal suture and inferiorly along the infraorbital rim to a point corresponding with a vertical line drawn from the pupil downward, and (3) cutting of all soft tissue, including orbicularis muscle from dermis to bone and from bone to conjunctiva, from the lateral canthal soft-tissue mass medially to a point equal to a vertical line drawn from the pupil downward. After tension-free shifting laterally and superiorly has been accomplished, the lateral canthal soft-tissue mass is fixed into bone with minimal overcorrection. If there is still soft-tissue skin resistance, then overcorrection is desirable. The most difficult judgments in the procedure are the amount of superior and lateral tension to be placed on the palpebral fissure. As an aid in these judgments, the lateral-most extent of the palpebral fissure should be approximately 3 mm above the medial canthus horizontally and 3 to 4 mm medial to the medial-most portion of the lateral orbital rim. If overcorrection occurs, it can be released relatively simply. PMID- 6494319 TI - Evaluation of velopharyngeal closure by CT scan and endoscopy. AB - Computerized tomography (CT) and endoscopy were used for the objective evaluation of velopharyngeal closure. In 19 patients with cleft palates and 9 normal subjects, CT scans of the velopharynx were made both at rest and during vowel phonation with a scanning time of 3.0 seconds and slicing width of 3 mm. At the same time, endoscopic observations of the velopharynx through the nose were carried out both at rest and during phonation. CT scan during phonation clearly demonstrated the mobility of the velopharynx, i.e., elevation of the soft palate, inward movement of the lateral pharyngeal walls, and protrusion of the posterior pharyngeal wall, in a single picture. Its disadvantage is exposure to x-rays and a rather complicated procedure. However, endoscopy is simple with no exposure to x-rays, but its disadvantage is occasional incomplete visualization because of the dead angle created by the elevated soft palate. Thus the combined use of CT and endoscopy can help to determine a rational choice of treatment for cleft palates. PMID- 6494320 TI - Surgical treatment for frontal baldness: the long temporal vertical flap. AB - Not only is the long temporal vertical flap not centered on the temporosuperficial artery, but it is also countercurrent to this artery. The difficulties of its design are largely compensated for by the natural aspect of the anterior area once achieved. It must be emphasized that all techniques of transplantation can only be techniques of camouflage. They can only redistribute harmoniously the hair of a patient taken from a zone that will never grow bald. PMID- 6494321 TI - Transaxillary subpectoral augmentation mammaplasty: long-term follow-up and refinements. AB - Transaxillary subpectoral augmentation locates the scar in a less visible position in multiple body positions than approaches that locate scars on the aesthetic unit of the breast. In 90 patients, 63 with 2 to 5 years of follow-up, using the surgical technique described, the Baker III/IV capsular contracture rate was 5.6 percent. There was no occurrence of hematoma, periprosthetic space infection, permanent loss of nipple sensation, or significant axillary wound morbidity. Scar results suggest that the axilla is an anatomically favorable location for both high-quality final appearance and minimal visibility. The transaxillary subpectoral approach is an excellent alternative to inframammary and periareolar approaches in all types of breasts requiring augmentation except the ptotic breast or breasts requiring extremely large prostheses. PMID- 6494322 TI - Shoulder defect correction with the island latissimus dorsi flap. AB - Reconstruction of normal shoulder contour is possible utilizing a latissimus dorsi musculocutaneous flap at the end of a long neurovascular pedicle. The thoracodorsal vessels and their lateral divisions form the basis of the pedicle. The nerve in the pedicle is left intact if maintenance of muscle bulk is desired and sectioned if atrophy is preferred. The amount of muscle taken in conjunction with the skin island is determined by the nature of the defect to be corrected. The twin goals of a single-stage reconstruction and a satisfactory aesthetic result are achieved with this method. PMID- 6494323 TI - A new system of infiltration anesthesia and sedation for plastic surgery. AB - This technique produces patient cooperation during the phase of local anesthetic injection by judicious use of intravenous ketamine. The addition of diazepam and a narcotic drug to low-dose ketamine may account for a low incidence of hallucinations and psychic sensations. The use of a dilute solution of lidocaine and a very low concentration of epinephrine allows large areas to be anesthetized. The ultralow concentration of epinephrine provides effective vasoconstriction. The result is good patient acceptance, a stable blood pressure and heart rate, and a low incidence of complications classically associated with local anesthetic toxicity. PMID- 6494324 TI - Cleft palate and congenital alveolar synechia syndrome. AB - This report describes a newborn boy with cleft palate and congenital trismus preventing normal feeding. After surgical division of the fibrous bands between the maxillary and mandibular alveolar ridge, oral feedings progressed without difficulty. Historical reports of congenital oral bands are reviewed. PMID- 6494325 TI - Trichoepithelioma: successful treatment with the argon laser. AB - The cosmetic concern associated with multiple trichoepitheliomas is obvious. Previous modes of therapy have proven to be only temporary. However, multiple trichoepitheliomas appear to respond to the thermocoagulation and epidermal atrophic effects of the argon laser without recurrence over an extended follow-up period. Although these lesions are not as highly vascular as port-wine hemangiomas, their dramatic response to the argon laser is similar. This report documents a case of multiple trichoepitheliomas treated successfully with the argon laser from the face and scalp of a 29-year-old white woman. The benefits of the argon laser in treatment of multiple trichoepitheliomas include eradication of the lesions without apparent recurrence, restriction of spread of solitary trichoepithelioma into adjacent tumors, and prevention of obstruction of the periorbital region and auditory canal. The treatment may be accomplished as a simple outpatient procedure under local anesthesia with minimal pain or disability. PMID- 6494326 TI - Subepineural pacinian corpuscle: a cause of digital pain. AB - A patient is presented who had chronic digital pain as a result of an abnormally located subepineural pacinian corpuscle. The patient had complete relief of her symptoms and return of normal digital function following removal of the pacinian corpuscle. A review of the literature concerning this entity revealed very few reported cases. However, these cases shared many of the same symptoms, as well as both physical and operative findings. It is suggested that patients suffering from digital pain of unknown etiology with a previous history of direct or indirect trauma may benefit from a localized operative exploration of the digit to remove an abnormally located pacinian corpuscle affecting the digital nerve. PMID- 6494327 TI - The stair-step flap for nasal alar reconstruction. AB - The stair-step flap is a simple one-stage replacement of alar tissue with excellent viability, minimal "biscuiting" and notching, and good color and texture match. While not replacing other techniques of alar repair, it appears to be a significant addition to the armamentarium for reconstruction in this area. PMID- 6494328 TI - Subcutaneous endoscopy in suction lipectomy. AB - Subcutaneous photographs of tissues treated by suction lipectomy have been obtained by adapting fiberoptic endoscopy equipment. These photographs document the presence of an intact neurovascular supply to the overlying skin and lend support to the concept of suction lipectomy with the blunt cannula. The technique of subcutaneous endoscopy is described, and additional uses for the method are suggested. PMID- 6494329 TI - The construction of end-in-end (sleeve) anastomoses. PMID- 6494330 TI - Benign lipoblastoma of the neck. PMID- 6494331 TI - Polyurethane-covered breast implant. PMID- 6494332 TI - Margins in excision of skin cancer. PMID- 6494334 TI - Combatting capsular contracture. PMID- 6494333 TI - Transdermal scopolamine. PMID- 6494335 TI - Cannula for liposuction. PMID- 6494336 TI - [Multiphasic clinical types of methamphetamine psychosis and its dependence]. PMID- 6494337 TI - [Psychiatric emergency service in Tokyo: from the viewpoint of the help-seeking behavior of the family]. PMID- 6494338 TI - [WPA Kyoto symposium (4). Psychiatric education in various countries]. PMID- 6494339 TI - [Psychiatry in Japan--a synoptic presentation]. AB - After presenting an appropriate historical outline, the author describes the current position of psychiatry in Japanese medicine. Particular attention is paid to transcultural aspects. PMID- 6494340 TI - [Differential diagnosis of akinetic mutism]. PMID- 6494341 TI - [Effect of drugs on human discrimination ability]. AB - The effects of phenobarbital, nitrazepam, diazepam, medazepam, chlordiazepoxide, phenytoin, carbamazepine, thioridazine and caffeine on the detail discrimination ability of healthy subjects were compared with those of a placebo by means of the d2-test and the Bourdon-Wiersma test. The impairment of performance induced by phenobarbital, thioridazine and diazepam varied with dosage. The improved performance yielded by caffeine was related to both dose and time. Both deletion tests yielded the same results. They are suitable for detecting the effects of drugs and have proved useful for clinicopharmacological and clinicopharmacological and clinicopsychopharmacological studies. PMID- 6494342 TI - [Drinking behavior in the chronic phase of alcoholism]. AB - 40 patients in the chronic phase of alcohol addition were questioned in order to identify drinking stereotypes with regard to consumption in the course of the day and year. Alcohol intake reaches a maximum between 8 and 9 PM. No clear differences were found in this respect between days of abstinence for social reasons and days without such social pressures. In the course of the year, alcohol consumption reaches a maximum in autumn and a minimum in spring. The uniform, repetitive drinking rituals are suspected to have become habitual in the course of several years until they are finally unaffected by environment. This leads to a convergence of addiction forms, but the duration of the daily abstinence period still permits differentiation between gamma and delta addicts even when addiction has reached an advanced stage. PMID- 6494344 TI - [Normative and legal procedure prerequisites in the commitment of psychiatric patients in relation to Paragraph 6 of the Commitment Law of East Germany]. AB - An analysis has revealed the following typical mistakes in the application of article 6 of the Commitment Act: Commitment is often not preceded by an interview with the patient. Many of the patients committed under article 6 would have agreed to hospitalisation anyway. In most cases, the reasons given for commitment under the Act are inadequate and too vague. The patients are not usually given the commitment order in writing. The district medical officers often fail to inform the local councils or the state attorney. The patients are very rarely instructed of their rights. In many cases the demands placed on the hospital responsible for treatment are inadmissible, such as commitment to closed wards or requests for indefinite hospitalisation. PMID- 6494343 TI - [Catamnestic surveys on somato-psychosocial development in childhood and adolescence of patients with unipolar depressive and bipolar manic-depressive psychoses]. AB - The somatic and psychosocial development of 80 subjects with manifest affective phasic psychoses is studied retrospectively and compared with that of an identically sized control group consisting of neuropsychiatrically healthy subjects. Statistically significant differences were found particularly in the answers to questions dealing with social situation and social adaptability. Achievement at school and vocational qualifications were lower among the parents of the patients than among those of the healthy subjects. Characteristic features of the patients' childhood and adolescence were transient depression, often for no apparent cause, and maladaption, and vocational wishes were fulfilled less often than among the controls. The patients experienced greater difficulty in settling in to a new group due to their contact difficulties. PMID- 6494345 TI - [Short trips by chronic psychiatric patients as effective sociotherapeutic measures]. AB - The article reports on experience gained with short excursions (day trips and brief holidays) for chronic psychiatric patients. Such trips have a beneficial effect on the patients' mental status and improve the image of in-patient psychiatric treatment. To the patients, this form of sociotherapeutic activity represents an enrichment in the overall therapeutic scheme at psychiatric sanatoria. PMID- 6494346 TI - [Direct observation of early interactions or the basis of interactional epigenesis]. PMID- 6494347 TI - [Family self-reference]. PMID- 6494348 TI - [Research on the infants of deprived families]. PMID- 6494349 TI - [Ghost hunters. Intellectual inhibition, team problems and family secrets]. PMID- 6494350 TI - [The child and the family in the kibbutz: continuity and change]. PMID- 6494351 TI - [Formation and configuration of the Oedipus complex: clinical observations and hypotheses]. PMID- 6494352 TI - [Childhood schizophrenia]. PMID- 6494353 TI - [Early infantile autism and autistic phenomena. Psychoanalytic reflections]. PMID- 6494354 TI - [Epilepsy and child psychoses]. PMID- 6494355 TI - [Object relations of the parents of schizophrenics]. PMID- 6494356 TI - [Types of work with relatives in psychiatry]. AB - A review is presented of recently developed forms of therapeutic work with relatives of psychiatric patients. Using the dimensions of "dominance of the expert" and "dominance of the relative" a typology of work with relatives is presented, which besides different forms of group work encompasses also "family therapy" at the one end of the spectrum and "self-help" at the other end. PMID- 6494357 TI - [Reflections on family-oriented work in a psychiatric acute station]. AB - The following contribution considers whether family dynamics can offer a profitable approach in a psychiatric ward for acute schizophrenics. Basing these considerations on a family-oriented origin of the schizophrenic disturbance, the relationships between family, patient, and clinic are outlined within the framework of a psychiatric crisis situation. Subsequently, practically relevant problems are discussed: Which therapeutic attitude should be adopted towards family members of our patients? Which specific tasks arise in the early stages of in-patient treatment? In conclusion, the author shows by means of a case report in which manner a supporting type of family-oriented work can be a meaningful complement to other therapeutic measures performed by the ward physician and medical staff. PMID- 6494358 TI - [Patients, families and reform psychiatrists. A study on the relation between relatives of psychiatric patients and personnel of the psychiatric service in the province Arezzo/Italy]. AB - Discussions with relatives of patients whose patterns of signs and symptoms, case histories and fate can be considered as quite typical of the area to be looked after by psychiatric teams in Italian rural districts, show that the strictly outpatient psychiatric care approach practised by Italian psychiatrists according to the new regulations can work successfully wherever psychiatric teamworkers do more than just their duty. As a matter of fact, the so-called "reform law 180" is very vaguely worded when describing the tasks, responsibilities and competences of the medical and administrative personnel. The interviews of the author with the person concerned also showed clearly that psychiatric reform "alla italiana" need not result in chaos, although such chaos reigns supreme in Italy almost everywhere where psychiatric reform had been imposed by decree "from above" without any genuine readiness on the part of employees and coworkers of the institutions and without an appropriate cognitive and emotional process of learning which would have been absolutely necessary before translating the new approach into reality. We must say, however, that the chaotic conditions encountered here and there are not representative of Italian psychiatry as a whole; at the same time, the conditions seen by the author in the Casentino district are also definitely not representative of the conditions in Italy in general.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494359 TI - [Self-help groups--the idea of self-help and the concept of discussion self-help groups]. AB - In recent years self-help-groups have grown in importance. The reason is an increasing gap between the needs of the population and the services, the medical system can supply. The patients themselves have started to take over the initiative to deal with the psychosocial aspects in connection with their illness. They no longer want to be passive objects but rather subjects, who take responsibility for their own well-being. After the creation of AA many other self help-groups have been set up, which concern themselves with very diverse illnesses and emotional and social problems. In the above paper the group setting variables and the concept of the therapeutic work of self-help-groups are being presented. Also the model of "Gesamttreffen" is introduced, where several members of different self-help-groups join monthly to share view-points and experience. These "Gesamttreffen" can be accompanied by a professional from the medical or psychological field, whose help is offered if so needed. PMID- 6494360 TI - [The residential structure as a therapeutic instrument]. AB - The frequency of residential placements in homes and households contrasts with the scarcity of its evaluation with respect to therapeutical effects. In order to facilitate evaluative studies, relevant structural elements and suggestions for a typology are discussed as well as methodological problems. Examples of empirical studies and their results are presented. PMID- 6494361 TI - Diseases of civilization? PMID- 6494362 TI - Scrapie and Alzheimer's disease. PMID- 6494363 TI - Dietary and metabolic effects on rhesus social behaviour: neonatal thyroxine reductions. AB - Assessment was made of the behavioural development of 3 monkeys whose levels of thyroxine were reduced by being given 131I and another 3 monkeys given a thyroxine depressant (TCAP) during the first weeks of life and maintained with low thyroxine levels for 3 months. When subsequently tested at normal thyroxine levels, these experimental subjects showed less positive social behaviour when compared with controls. When confronted with unfamiliar monkeys, the two experimental groups were less fearful than controls and also showed a lack of differential responsiveness in varying social situations, suggesting a low level of emotion. A foetal athyreotic group is also described. PMID- 6494364 TI - Life stress and symptom pattern in out-patient depression. AB - The relationship was examined between symptoms rated in a sample of out-patient depressives, and measures of life stress derived from a separate interview. There was an association between symptoms reflecting the endogenous-neurotic distinction and life stress. However, the association was relatively weak, and was mainly with total social problems at the time of presentation, rather than with life events at onset. These findings are consistent with other studies which indicate that the absence of prior life events and the presence of the endogenous symptom pattern are only weakly related. PMID- 6494365 TI - The clinical EEG and personality in mentally abnormal offenders. AB - A retrospective survey was undertaken of the clinical EEG in a series of consecutive admissions to Broadmoor Special Hospital (N = 265). Following reporting of the records by visual inspection, the EEGs were classified according to 4 descriptive categories: predominantly monorhythmic; low voltage fast, 'choppy'; dysrhythmic with excess theta; and dysrhythmic with paroxysmal features. The last 3 categories constituted EEG patterns with atypical or anomalous features. The EEGs of patients with high scores on Welsh's MMPI Anxiety scale ('withdrawers') were compared with those of patients with low scores ('approachers'). Lateralization of paroxysmal EEG features was studied with reference to MMPI personality measures (Blackburn's Impulsivity and Sociability and Welsh's Anxiety), legal diagnosis, type of offence, and relationship to victim. The EEGs were studied in a further sample of 29 admissions who had been assessed, using Hare's Research Scale for the Assessment of Psychopathy (Hare, 1980). While the overall incidence of atypical EEG features reported in the present study (around 60% of cases) was comparable with that reported previously for offender populations, they occurred significantly more frequently in 'withdrawers' than in 'approachers'. This suggests that the high frequency of atypical EEG features in abnormal offenders may be due to the preponderance of 'withdrawers' in this population. Patients who had committed violent offences against strangers, as opposed to people known to them, tended to have bilateral paroxysmal features in their EEG. High scores on Hare's Psychopathy scale were significantly associated with prominent Posterior Temporal Slow Activity. The study offers some prospect that the combined use of EEG and personality assessments may be of potential value in the assessment of dangerousness. PMID- 6494366 TI - Amnesia for criminal offences. AB - Nearly 10% of a sample of men charged with a variety of offences claimed amnesia for their offence. The amnesia occurred only among those who had committed violence and was most frequent following homicide. All the amnesics had a psychiatric disorder, four having a primary depressive illness and the remainder being almost equally divided between schizophrenia and alcohol abuse. None of the amnesias had any legal implications. The circumstances of the offences suggested a variety of mechanisms to account for the amnesia, including repression, dissociation and alcoholic black-outs. Psychological defence mechanisms were probably of some importance, even when alcohol was an important factor. PMID- 6494367 TI - Hallucinations in children with conduct and emotional disorders: I. The clinical phenomena. AB - In a retrospective study, children referred to the Maudsley Hospital with conduct or emotional disorders who also suffered from hallucinations were found to be older than other children seen with similar diagnoses, more of them had below average IQs and they were more frequently admitted as in-patients. In most cases hallucinations were auditory. When compared with a group of 20 controls matched on these differentiating features, the 20 children with hallucinations had more precipitants of illness, a shorter duration of the disorder, symptoms of depression, and a family history of mood changes. They also had more symptoms suggestive of cognitive-perceptual dysfunction. PMID- 6494368 TI - Hallucinations in children with conduct and emotional disorders: II. The follow up study. AB - In a controlled study, 20 children with hallucinations and emotional or conduct disorders were followed up into adulthood. The mean follow-up time was 17 years and the mean age at follow-up was 30 years. Hallucinations in childhood did not carry an increased risk for psychoses, depressive illness, organic brain damage or other psychiatric disorders. The continuation of hallucinations and episodes of altered awareness in some of the subjects may indicate a special predisposition to hallucinate. PMID- 6494369 TI - Unemployment and psychological ill-health: the moderating role of duration and age. AB - The relationship between length of unemployment and psychological ill-health was examined in a sample of 954 unemployed working-class men, selected to cover all levels of age and several levels of duration of unemployment. The association between length of unemployment and psychological ill-health was found to be strongest in the middle age groups, with greater ill-health among those with a longer duration since job loss. No association between duration and ill-health was found for those who had recently entered the labour market or who were close to the end of their working lives. Desire for a job and financial stress were shown to be additional mediators of psychological ill-health during employment. A cumulative stress model is proposed to account for these findings. PMID- 6494370 TI - Type A and type B behaviour patterns, task type and sensitivity to noise. AB - The present study examined sensitivity to noise in subjects with Type A and Type B behaviour patterns as a function of the type of task being performed. Twenty Type A and 20 Type B subjects, selected by means of Bortner's scale (French version), were exposed to steadily increasing noise levels (68-110 dBA) while performing two tasks. The first was simple (crossing out) and the second was more complex (memorizing nonsense syllables). There was no difference between the groups on the simple task, but on the more complex task Type A and Type B subjects reacted differently, the former maintaining their level of tolerance while the latter lowered theirs. High investment and the desire to succeed may lead Type A subjects to ignore the acoustic environment and/or to deny the aversive aspects of noise as cognitive strategies for coping with stress. PMID- 6494371 TI - Foulds' hierarchical model of psychiatric illness in a Dutch cohort: a re evaluation. AB - In order to evaluate Foulds' hierarchical model of psychiatric illness, a study was carried out using data from a 3-year follow-up of patients suffering from functional non-affective psychoses. Of the 177 Present State Examinations carried out 86% yielded symptom patterns compatible with the model. It was shown that failures to fit the hierarchy can be explained either by measurement error or by the masking of major symptoms by the simultaneous presence of minor ones. A one dimensional scale to measure the severity of psychiatric illness was constructed. Patients' scores were compared with ratings on the Index of Definition and the diagnosis of current mental state. The results of these comparisons were considered to be supportive validatory evidence. Some of the implications of the model and the data are discussed. PMID- 6494372 TI - Suicidal intent and repeated self-harm. AB - The value of identifying self-harm patients who repeat with rising suicidal intent is discussed. A study is described measuring changes in intent with repetition by means of an intent scale. Patients repeating once in 5 years scored significantly higher in intent for their second episodes, while multiple repeaters tended to score lower for second episodes. Patients under the age of 35 were most at risk for repetition with increasing intent within 2 years. No correlation emerged between the rise in intent and the time interval between episodes over a 7-year period. The 5-year suicide rate was higher among rising intent repeaters than other cases. These findings are discussed. PMID- 6494373 TI - Suicide among psychiatric patients of a district general hospital. AB - Twenty-two psychiatric patients who committed suicide while receiving hospital treatment or within 3 months of discharge from psychiatric care were studied using general population statistics, a random sample of 100 psychiatric patients and a control group matched individually with the hospital suicides. The rate of suicide among psychiatric in-patients was over 50 times that in the general population. A higher vulnerability to suicide was detected among in-patients (v. other patient groups), men (v. women) and middle-aged patients (v. older and younger patients). Suicides were differentiated from controls in having suffered more losses (P less than 0.05), being psychiatrically ill for the first time (P less than 0.05), having a past history of deliberate self-harm (P less than 0.05), and not receiving a schizophrenic diagnosis (P less than 0.02). People with mid-life crises, patients who swing rapidly into depression while receiving treatment, and individuals who are judged to be depressed because of personal problems may carry a particularly high suicide risk during psychiatric treatment. PMID- 6494374 TI - Sudden deaths in the mentally handicapped. AB - Trends in the incidence and causes of sudden deaths in a hospital group for the mentally handicapped were identified during a 50-year period, and the two halves of the period were compared. There were significantly more deaths in the second 25-year period than in the first. Longevity was greater during the second period, and a decrease in deaths due to status epilepticus was outweighed by an increase in deaths from arterial degenerative disease in the larger number of older patients. In the second period there was also a significant rise in sudden deaths due to asphyxia, probably attributable to modern medication with side-effects giving rise to feeding difficulties. PMID- 6494375 TI - Discrimination and matching within and between hues measured by reaction times: some implications for categorical perception and levels of information processing. PMID- 6494376 TI - Do letter features migrate? A note of caution. PMID- 6494377 TI - Nontarget columns and parafoveal target identification: some limits on previously observed effects. PMID- 6494378 TI - Global-local precedence in picture processing. PMID- 6494379 TI - Infection, frequency, and the word superiority effect. PMID- 6494380 TI - Motor programme information as a separable memory unit. PMID- 6494381 TI - Melatonin in relation to body measures, sex, age, season and the use of drugs in patients with major affective disorders and healthy subjects. AB - Serum melatonin levels over a 24 hr period were studied in 30 acutely ill patients with major depressive episode, 24 patients with a history of unipolar or bipolar major affective disorder in remission and 33 healthy subjects. A significant negative correlation (-0.45) between body height and maximum nocturnal serum melatonin level was found. Maximum serum melatonin levels during the night were lower in both patient groups than in the healthy controls. No difference was found between maximum nocturnal serum melatonin levels in 26 patients investigated when ill and again in remission. We thus propose low nocturnal melatonin to be a trait-dependent marker for major depressive disorder. A difference in the morning but not night melatonin levels was found between samples taken during the dark, winter season versus samples taken during the bright, spring-summer season. Melatonin levels were not lower in females than in males, when melatonin levels were adjusted for body height. Similar results were found when the nocturnal areas under the curve for melatonin were analyzed. PMID- 6494382 TI - Human memory and neurohypophyseal hormones: opposite effects of vasopressin and oxytocin. AB - A classical task of experimental psychology, the retention of lists of words, was given twice to three groups of subjects treated with lysine vasopressin (LVP), oxytocin or saline. From a baseline session (no treatment) to a second session with treatment, the LVP and placebo groups showed an enhancement of the number of words remembered correctly, whereas the oxytocin group did not. Rather, oxytocin impaired memory performance. However, we cannot claim a memory enhancing effect of LVP, because placebo treatment enhanced memory performance to the same extent. PMID- 6494383 TI - Serum aldosterone following dexamethasone in depressed patients. AB - Serum aldosterone and cortisol responses to dexamethasone were studied in 17 patients with major depressive disorder, 16 nondepressed hospitalized patients and seven healthy controls. Serum aldosterone was neither blunted nor stimulated following dexamethasone in any of these three groups. Cortisol nonsuppression following dexamethasone, based on a criterion greater than 5 micrograms/dl, was noted in five depressed patients and two nondepressed patients. None of the seven patients with cortisol nonsuppression revealed any apparent abnormalities in their serum aldosterone secretory responses following dexamethasone. Thus, the incorporation of aldosterone measurements was not a useful extension of the dexamethasone test under the clinical conditions of this study. PMID- 6494384 TI - Endocrine abnormalities in solvent sniffers. PMID- 6494385 TI - Behavioral assessment of the type A behavior pattern. AB - The present study attempted to assess systematically a set of behavioral subcomponents associated with the Type A behavior pattern. Sixty middle-aged men underwent the structured interview (SI) and a repeated version of the SI after a four-month interval. A high degree of interrater reliability was established for a number of behavioral components including speed and volume of speech, motoric activity, expiratory sighs, response latency, interruptions, unevenness of speech, plosive words, and potential for hostility. In general, these behaviors were stable over the four-month interval, although they did not all distinguish Type As from Type Bs. Only four behaviors successfully discriminated Type As and Bs at both interview sessions: speed of speech, volume of speech, number of interruptions, and potential for hostility. The results are discussed in terms of how these behavioral subcomponents may contribute to increased risk of premature coronary disease. PMID- 6494386 TI - Cardiovascular reactions and impatience in type A and B college students. AB - The cardiovascular responses of male student volunteers varying in the component behaviors comprising Type A were compared in a choice reaction (RT) task. Since the incidence of coronary heart disease is correlated with Type, the relation of cardiovascular responses to these components is of interest. One component of Type A, impatience, was elicited by a choice RT task with long intertrial intervals. A second component, competitiveness, was elicited by varying monetary reward. Instructions were varied to induce both relatively fast, inaccurate, and relatively slow, accurate RTs. Only persons who were high on the Speed- Impatience component of Type A demonstrated variability in second by second heart rate responses when their RTs were paced at different speeds. Type As (Jenkins Activity Survey and Structured Interview) showed sympathetic-like physiologic changes and performed less well during trials requiring accurate, controlled performance when monetary reward was low. Finally, volunteers high in Competitiveness showed greater trial-to-trial cardiac variability than those who ranked low on this component but were less influenced by reward. Individuals high on the Speed--Impatience and Competitiveness components of Type A may show a brief, intense cardiovascular involvement during performance, but an absence of physiologic involvement between trials. In another study using the same paradigm (1), older, impatient volunteers also had altered heart rate responses, but the exact adjustments differed between age groups. A life span developmental perspective on the psychophysiologic adjustment of Type As is advocated. PMID- 6494387 TI - Life change stress, psychiatric symptoms, and natural killer cell activity. AB - Previous research has linked stress with adverse health change; however, the immunologic mechanisms mediating these changes remain poorly understood. To test whether "stress" was associated with alterations in cell-mediated immunity, we examined the correlations of self-reported life change stress (LCS) and psychiatric symptoms with natural killer cell activity (NKCA) among 114 healthy undergraduate volunteers. Although the bivariate correlation between LCS and NKCA was not significant, subjects reporting few psychologic symptoms in the face of large amounts of LCS ("good copers") had significantly higher NKCA than those experiencing high levels of both symptoms and LCS ("poor copers"). Furthermore, self-reported psychiatric symptoms were found to inversely correlate with NKCA, suggesting that symptoms such as anxiety and depression may negatively affect immunity. PMID- 6494389 TI - A biopsychosocial perspective to psychotropic drug use in psychophysiologic conditions. PMID- 6494388 TI - Generalizing from laboratory studies to field studies of human stress physiology. AB - In studying physiologic responses to behavioral stressors, there are two competing strategies. Laboratory studies offer greater experimental control but less provocation. Field studies provide poorer experimental control but potentially greater provocation. Despite these differences, comparison within subjects of neuroendocrine responses to these different settings has not been performed. We studied 11 healthy young men in the field during public speaking and in the laboratory during carefully controlled mental arithmetic calculations. There were marked differences in self-report and in plasma levels of catecholamines in the two settings. PMID- 6494390 TI - The role of psychiatric assessment in the management of functional bowel disease. PMID- 6494391 TI - Apomorphine does not lower the concentration of homovanillic acid in the plasma of normal humans. PMID- 6494392 TI - Piracetam and event-related potentials in dyslexic children. PMID- 6494393 TI - Choline flux in human erythrocytes. PMID- 6494394 TI - Kinetic analysis of central nervous system supersensitivity induced in rats by long-term haloperidol administration. Part II: KB determination. PMID- 6494395 TI - Effect of piracetam on the single word and prose reading of dyslexic children. PMID- 6494396 TI - Caerulein stimulates [3H]-spiperone binding in vivo after long-term haloperidol administration. PMID- 6494397 TI - Teaching the biopsychosocial model to medical residents in an outpatient clinic. PMID- 6494398 TI - Survey of 500 callers to a national cocaine helpline. PMID- 6494399 TI - Psychological effects of vulvectomy. PMID- 6494400 TI - Benzodiazepines: guidelines for use in correctional facilities. PMID- 6494401 TI - Mania in two patients following cyclobenzaprine. PMID- 6494402 TI - Detecting physical illness in patients with mental disorders. PMID- 6494403 TI - Use of an integrative interview to manage somatization. PMID- 6494404 TI - Sociocultural and interactional influences on somatization. PMID- 6494405 TI - Treatment of post-traumatic stress disorder with imipramine. PMID- 6494406 TI - Psychiatric consultation to the burn unit: the surgeon's perspective. PMID- 6494407 TI - Psychiatric consultation to the burn unit: the psychiatrist's perspective. PMID- 6494408 TI - Progressive supranuclear palsy presenting as pseudodementia. PMID- 6494409 TI - Capgras' syndrome with dysmorphic delusion in an adolescent. PMID- 6494410 TI - An alternative extrinsic coagulation pathway and oral anticoagulant treatment. PMID- 6494411 TI - [Pre-analysis variability: the effect of evaporation on the error of measurement, with special reference to sodium and potassium]. AB - Among the general causes of preanalytical variability, one of the most important is represented by the error due to the sample evaporation. The measure of the sodium and potassium concentration on the serum pools and on a saline solution has allowed to define the different variables effect. On the ground of the experimental data the error by operative loss is: a) directly proportional to the evaporative time; b) directly proportional to the exposition temperature for values of relative humidity of 60-70%; c) remarkably influenced by the air-flow in the environment; d) widely conditioned by the container-geometry and particularly by the height/diameter ratio; e) the minimum evaporative loss happens with cups filled up to the 50-60%, with much higher values below the 30% of filling; f) the influence of the different cup composition (either glass or plastic) as well as the different medium (either serum or saline solution) is negligible. The actual analytical error can be kept into moderate and acceptable ranges (lower than 1% in the eight hours) if the environmental ventilation is controlled, and if it is chosen the proper shape of the cup, the right sample cup capacity and a suitable operative procedure. In particularly unfavourable conditions, on the contrary, the entity of the evaporative error can even exceed the 100% in the eight hours time of the daily work. PMID- 6494412 TI - [Antibiograms performed on Gram-negative bacteria isolated from urine cultures. Results and considerations]. AB - The authors have isolated 938 Gram-negative germs from 3141 urinocultures. In the work is reported the percentage of sensitivity of the single tested antibiotics and it is recommended an exact therapy, if we won't have clamorous failures. PMID- 6494413 TI - [Reference values of erythrocyte zinc-protoporphyrin in monitoring occupational exposure to lead]. AB - On the basis of the determination of zincprotoporphyrin and blood lead levels in 290 subjects working in various industrial and service branches, not occupationally exposed to lead risk, reference values of erythrocytary zincprotoporphyrin are calculated (mean value 16.8 micrograms/dl, upper limit 32.4 micrograms/dl) and proposed to be adopted in biological monitoring of lead exposure. PMID- 6494414 TI - [The influence exercised by various temperatures on platelet aggregation in vitro]. AB - To obtain a regular haemostasis is necessary that the platelets are numerically sufficient and functionally normal. Many factors influence on platelet aggregation; among these platelet shape, dimensions and volume. In our study we have analysed the temperature influence on platelet aggregation. In a group of 27 subjects we have demonstrated that the platelet rich plasma pre-incubation for 30 minutes in ice-bath does not modify the platelet aggregation capacity. On the contrary, the platelet rich plasma pre-incubation for 30 minutes at 37 degrees C reduces considerably the platelet aggregation, probably for the platelet volume reduction. PMID- 6494415 TI - [Radial counter-immunoelectrophoresis in the determination of specific anti hydatidosis antibodies. Preliminary observations]. AB - Radial counter-immunoelectrophoresis was evaluated with sera from surgically confirmed hydatidosis cases, patients with other parasitic diseases and healthy controls. Radial counter-immunoelectrophoresis was a sensitive as classic counter immunoelectrophoresis based on the same positivity criterion and was equally specific for the immunodiagnosis of human hydatidosis. The procedure appears to be simple and rapid (the immunoprecipitation step requires just 5 minutes) and merits consideration. PMID- 6494416 TI - [The Coulter counter S-plus model: accuracy and normal values in platelet count]. AB - An evaluation of performance characteristics and accuracy of clinical results for automated multiparameter whole-blood platelet Counter Coulter Mod. S-Plus is described. Instrument precision is assessed in terms of reproducibility, linearity, carry-over. The results of all are impressive. Comparison of results with those obtained by manual reference method show excellent correlation. Normal values are defined for the platelet's parameters. PMID- 6494417 TI - [Platelet hyperaggregation and the HDL-LDL ratio of the serum]. AB - In this research the authors had examined the possibility of showing correlation between the plates hyperaggregability tested with PAT Breddin system and ratio HDL-LDL in serum. The result is satisfactory and shows an interesting comparison. PMID- 6494418 TI - [Radioimmunoassay of high specificity for vincristine]. AB - The authors set up a simple and fairly rapid radioimmunoassay for vincristine, that shows a good sensitivity, precision and specificity. In particular, the higher specificity in comparison with other similar dosage techniques is likely due to the marked specificity of the used anti-vincristine serum, which displays a low interference even by molecules with a vincristine-like structure. Therefore, the suggested radioimmunoassay technique seems quite suitable for studying vincristine pharmacokinetics and for monitoring blood levels of this alkaloid in treated patients. PMID- 6494419 TI - [Improvement in the efficiency of an ambulatory service case load by applying a computerized method (patient flow analysis)]. AB - The authors describe the application of a technique called Patient Flow Analysis aimed at the improvement of Clinic Personnel efficiency and reduction of patient waiting time. Results were satisfactory and encourage further experiences. PMID- 6494420 TI - Effects of mixed neutron-gamma irradiation in vivo on the cell surfaces of murine blood cells. AB - For studies on cell membranes, mice were exposed to mixed neutron + gamma reactor radiation in the range of total doses from 0.5 to 4.5 Gy. Changes in functional activity of plasma membranes of erythrocytes, platelets, and lymphocytes were followed by a lectin-binding technique at various intervals afterwards. The amount of 3H-concanavalin A bound to cells altered considerably during the 1st h after irradiation in all cell types. Lymphocytes and platelets, however, were more sensitive than erythrocytes as increased lectin-binding could already be observed after 0.5 Gy. The binding ability of these cells performed oscillatory behaviour. In addition, alterations in shapes and ultrastructure of cell surfaces and intracellular membranes were observed. PMID- 6494421 TI - Comments on "Seed germination as a thermobiological problem". AB - In the above mentioned article [1] the notion of a time-dependent Gibbs free energy has been introduced to explain the observed time-pattern of embryo growth in seeds. Furthermore, the notion of a 'non-random thermal communication' has been inferred from an inspection of the shapes of germination time distributions. It can be shown, however, that the reasoning leading to the time-dependent thermodynamic potential is based on inappropriate interpretation of kinetic equations, and that the shape of the distributions of germination time might be a natural consequence of the initial distribution of embryo size in the seeds. PMID- 6494422 TI - The effect of 220 kVp X-rays with different spectra on the dose response of chromosome aberrations in human lymphocytes. PMID- 6494423 TI - The use of viscoelastometry to determine survival curves for intact genomes. AB - Viscoelastometry enables one to determine both size (Mr) and number concentration (L1) of intact genome molecules in solution. Comparison of four parameters, corrected for shear stress, as functions of 60Co gamma-ray dose showed that (1) the principal retardation time (tau 11,0) remained constant, indicating that intact genomes (bacteriophage T4c) were being measured; (2) the principal recoil (gamma 11,r,0) decreased with dose directly proportionately to (and determining) L1; (3) both the total recoil (gamma r,0) and the recoil area (Ar,0), under conditions of high solvent viscosity decreased with dose almost as sensitively as gamma 11,r,0. The DNAD37 was 540 +/- 25 Gy and the biological PFUD37 was 410.1 +/ 4.5 Gy yielding 75.9 +/- 3.6% of inactivating events explicable by one double strand break (DSB) per genome. This value is comparable to Freifelder's [Virology 36, 613-619 (1981)] value of 86% for phage T4r48+, and the Frankenberg-Schwager et al. (Br. J. Cancer, in press) value of 0.84 DSB/cell/lethal event in diploid mutant rad54-3 yeast under conditions restrictive for DSB repair. Therefore, T4c may be an excellent model system for DNA damage repair studies with relevance to pro- and eukaryotes. Viscoelastometry, working near its lower size limit, provided precise estimates of the proportion of genomes lacking DSBs. It is not subject to the molecular deformation upper size limitations of the other biophysically understood size measurement methods (e.g., sedimentation rotor speed dependence). Therefore, it should be the method of choice for the study of genomes larger than those of the T even bacteriophages. PMID- 6494424 TI - The action of caffeine on X-irradiated HeLa cells. VI. Damping of the structured age-survival function. AB - Postirradiation treatment of synchronous HeLa S3 cultures with 4 mM caffeine until greater than or equal to 32 hr after mitotic collection, following exposure to 220-kV X rays at various times during interphase, severely damps the fluctuations in the age-survival curve. Not only does the dose-survival curve essentially lose its shoulder, as reported previously, but it becomes steeper and displays a virtually age-independent terminal slope (D0 congruent to 0.5 Gy). It becomes multicomponent, at least early in the cycle. The residual structure in the interphase age-survival curve, if any, appears to reflect mainly an age dependent fluctuation in the size of a subpopulation of cells having marked sensitivity to X rays (D0 congruent to 0.25 Gy), though there might be small residual fluctuations in the size of the shoulder and the slope. Mitotic cells also respond to postirradiation treatment with caffeine; they yield a dose survival curve whose slope is similar to that of the sensitive subpopulation seen in interphase. These findings indicate that most of the structure in the unperturbed age-survival function derives from repair of potentially lethal radiation damage. PMID- 6494425 TI - Radiation resistance and the CuZn superoxide dismutase, Mn superoxide dismutase, catalase, and glutathione peroxidase activities of seven human cell lines. AB - CuZn superoxide dismutase, Mn superoxide dismutase, catalase, and glutathione peroxidase form the primary enzymic defense against toxic oxygen reduction metabolites in cells. To test the importance of these protective enzymes in the cellular radiation response, the enzymic activities of seven different human cell lines were determined in parallel with their clonogenic survival characteristics. A positive correlation between the content of glutathione peroxidase in cell lines and their extrapolation numbers (n) and quasithreshold doses (Dq) was detected. Between the cellular contents of the other enzymes and D0, n, and Dq no positive correlations could be established. An interesting finding was a very high Mn superoxide dismutase content in a malignant mesothelioma cell line P7, which had an extremely high D0, 5.0 Gy. PMID- 6494426 TI - An analysis of various aspects of atomic bomb dose estimation at RERF using data on acute radiation symptoms. AB - The dose-response curves for acute radiation symptoms reported by atomic bomb survivors are compared by dose estimation method (the method used to calculate the transmission factor), shielding category, and city. Circular symmetry is also investigated. It is found that response rates for acute symptoms differ considerably by dose estimation method and shielding category even after controlling for both gamma and neutron exposure as well as for city, sex, and age at the time of the bomb. One explanation of these results is that the doses of survivors in Japanese type houses estimated by the nine parameter method are subject to less random measurement error, while doses of those survivors who were in the open and shielded by terrain, who were totally shielded by concrete buildings, and who were in factories are subject to especially large random errors. The degree to which systematic bias contributes to these differences could not be determined. These results have important implications for comparisons between cities since Nagasaki includes a far greater proportion of survivors in shielding categories showing weak dose-response relationships than does Hiroshima. The hypothesis that doses might be higher in the westerly direction in Hiroshima is not supported by acute effects analyses, but excess acute effects are found in the north of Hiroshima. PMID- 6494427 TI - Squamous cell carcinoma in the jaws of beagles exposed to 90Sr throughout life: beta flux measurements at the mandible and tooth surfaces and a hypothesis for tumorigenesis. AB - We present the first detailed dose-response measurements for 90Sr-induced soft tissue tumors other than hemopoietic dyscrasias in chronically exposed beagles. Twenty-four of 387 dogs exposed to 90Sr beginning in utero and by continuous ingestion to 540 days of age developed squamous cell carcinoma of the jaw during their lifetime. Eleven of the 24 tumors were observed in dogs ingesting 12 microCi/day and receiving cumulative average doses of 6500-12,000 rad. None of these tumors was observed in dogs ingesting less than 1.25 microCi/day and receiving cumulative skeletal average doses of 2100-3900 rad, but four were observed at this level. The teeth of these animals acquired a 90Sr burden that is not removed by skeletal remodeling. Measurements of the radiation dose to soft tissue adjacent to the mandible and teeth of dogs chronically fed 90Sr indicated the first 10 micron of soft tissue adjacent to teeth received a radiation dose initially about the same as the average skeletal doses. By 2000-3000 days, these tissues received about two to three times that calculated for the average skeletal dose, or about four to six times the mean marrow dose. We suggest that these tumors arise from epithelial rests, which are embryonic tissue trapped in the periodontal membrane between teeth and bone. PMID- 6494428 TI - Radiation survival properties of cultured vascular smooth muscle cells. AB - Vascular injury has been suggested as a possible mechanism for late radiation damage to various organs. However, little is known about the radiobiology of cells of the blood vessel wall. We have studied the radiation survival properties of exponentially growing cultures of vascular smooth muscle cells. Medical smooth muscle cells were obtained from the thoracic aortas of 3- to 4-month-old Sprague Dawley rats and were propagated in cell culture using standard techniques. Cultures from different strains were irradiated using 137Cs gamma radiation after varying periods in culture. Clonogenic survival was measured via colony formation assays. The mean D0 for seven survival curves utilizing four different strains of cells was 147 +/- 22 rad (range 117-176) and the mean extrapolation number (corrected for colony multiplicity) was 3.7 +/- 2.7 (range 1.1-9.5). Split dose survival assays demonstrated repair of sublethal radiation damage within the first 4 hr with recovery factors approximately equal to the extrapolation number. We conclude that rat aortic medial smooth muscle cells show moderate radiosensitivity similar to that measured in vitro for a variety of mammalian cell lines and in vivo for epithelial tissues in rodents. PMID- 6494429 TI - Skin cancer incidence among children irradiated for ringworm of the scalp. AB - A series of about 2200 children who received X-ray treatment for ringworm of the scalp (tinea capitis) during the 1940s and 1950s, and a comparable group of 1400 treated without X ray, have been followed by mail questionnaire for an average of 26 years since treatment to tabulate the incidence of skin cancer. The X-ray treatment consisted of 300-380 R to five overlapping fields on the scalp, to cause complete depilation. This delivered doses of 300-600 rad to various portions of the scalp, with lower doses to the skin of the face and neck. In the irradiated group, 41 persons have had one or more basal cell carcinomas of the scalp or face while only three have been diagnosed in controls. There was a high prevalence of multiple skin cancers in the irradiated group (80 lesions among 41 cases). The minimum latent period for radiation-induced skin cancers was long- about 20 years--and this may be attributable to the young age of the population. The skin cancer risk was particularly pronounced on the face, where there would be more UVR exposure in addition to X-ray exposure. Lightness of complexion proved to be an important factor in the skin cancer risk. In addition, skin cancers were found only among caucasians, even though 25% of the study population were blacks. These findings suggest that UVR exposure levels or sensitivity to such exposure interact with ionizing radiation exposure in defining skin cancer risk. PMID- 6494430 TI - Binding site specificity of gamma-radiation-induced crosslinking between phenylalanine and a phenylalanine-containing tetrapeptide. AB - The binding site specificity of crosslinking mediated by the hydroxyl radical has been investigated in a simple model system: a tetrapeptide, Gly-Gly-Phe-Leu, and 14C-labeled phenylalanine. Crosslinking leads to the tetrapeptide-phenylalanine adduct which has been isolated by gel filtration. The amino acid analysis of these adducts compared with those of gamma-radiation-induced dimers of the tetrapeptide and of the dipeptide, Gly-Phe, shows that only the phenylalanine residue is affected and that the same new peaks appear in each case. Spectrophotometric measurement indicates that the extinction coefficient at 260 nm of dimeric tetrapeptide is four times higher than that of monomeric, as is dimeric phenylalanine compared to monomeric. These observations suggest a common crosslinking mechanism in all three cases that involves the aromatic ring of phenylalanine. The appearance of several radioactive peaks in the gel filtration separation of the acid hydrolysate of the adduct suggests that the crosslinking involves more than one possible modification of the phenylalanine. Three distinct tetrapeptide-Phe species, corresponding to molecular weights of 555, 573, and 591, were observed by fast atom bombardment mass spectrometry. The partial release of radioactive phenylalanine from the tetrapeptide-phenylalanine adducts by acid hydrolysis indicates the liability of some phenylalanine-phenylalanine bonds. PMID- 6494431 TI - Sister chromatid exchange frequency in human lymphocytes exposed to ionizing radiation in vivo and in vitro. AB - This paper reports statistically significant elevations in peripheral blood lymphocyte sister chromatid exchange frequencies in persons occupationally exposed to low levels of ionizing radiation when compared with unexposed persons. Low doses of X or gamma rays administered in vitro also produce significant elevations in sister chromatid exchange frequencies, though the magnitude of the increases is dependent upon culture medium and other factors. PMID- 6494432 TI - Some effects of radiation on the healing of transected mouse ear. AB - Both histological assessments and measurements of epidermal and dermal components are used to describe some effects of radiation on wound healing in mouse ear. A pattern of early wound closure followed by wound reopening was seen after doses of about 20 Gy and above. After 10 Gy X rays wound closure was comparable with that in unirradiated wounds but the nature of the tissue repair was different. The results suggested that the severity of radiation damage to epidermis is relatively unaffected by wounding but that the time course of expression of the radiation damage is appreciably accelerated. The observations are discussed in terms of their clinical relevance and of current radiobiological hypotheses. PMID- 6494433 TI - Kerma factor of carbon for 14.1-MeV neutrons. AB - Using microdosimetric techniques, a direct measurement was made of the kerma factor of carbon for 14.1-MeV neutrons. Kerma was inferred from charged particle energy depositions measured with a small graphite-walled proportional counter. Measurements with an ionization chamber and a proportional counter, both constructed with A150 plastic walls, as well as induced 24Na activity from the 27Al(n, alpha) reaction, determined the neutron fluence. The resulting carbon kerma factor was 0.178 +/- 0.11 X 10(-8) cGy X cm2 which is lower than published tabulations but in agreement with recent microscopic cross-section measurements. PMID- 6494434 TI - Inhibition by hyperthermia of repair synthesis and chromatin reassembly of ultraviolet-induced damage to DNA. AB - We have investigated the effects of hyperthermia treatment on sequential steps of the repair of UV-induced DNA damage in HeLa cells. DNA repair synthesis was inhibited by 40% after 15 min of hyperthermia treatment at 45 degrees C; greater inhibition of repair synthesis occurred with prolonged incubation at 45 degrees C. Enzymatic digestion of repair-labeled DNA with Exonuclease III indicated that once DNA repair was initiated, the DNA repair patch was synthesized to completion and that ligation of the DNA repair patch occurred. Thus the observed inhibition of UV-induced DNA repair synthesis by hyperthermia treatment may be the result of inhibition of enzymes involved in the initiating step(s) of DNA repair. DNA repair patches synthesized in UV-irradiated cells labeled at 37 degrees C with [3H]Thd were 2.2-fold more sensitive to micrococcal nuclease digestion than was parental DNA; if the length of the labeling period was prolonged, the nuclease sensitivity of the repair patch synthesized approached that of the parental DNA. DNA repair patches synthesized at 45 degrees C, however, remained sensitive to micrococcal nuclease digestion even after long labeling periods, indicating that heat treatment inhibits the reassembly of the DNA repair patch into nucleosomal structures. PMID- 6494435 TI - Effects of oxygen and misonidazole on cell transformation and cell killing in C3H 10T1/2 cells by X rays in vitro. AB - The effects of oxygen (air) and misonidazole on the transformation and killing of 10T1/2 cells by X rays were examined. The oxygen effect for the cell transformation end point was very similar to that for cell killing. Misonidazole enhanced both cell killing and cell transformation to a similar extent. The enhancement of both end points by misonidazole occurred only in the absence of oxygen during irradiation and was of lesser magnitude than that observed for oxygen. These results demonstrate that the radiation chemical processes leading to cell killing and cell transformation, respectively, are affected similarly by these two enhancers of radiation action. PMID- 6494436 TI - The application of track calculations to radiobiology. III. Analysis of the molecular beam experiment results. AB - Survival data from the molecular beam experiment are used to obtain an estimate of the function gamma (chi), describing the probability for two energy transfers a distance chi apart to produce a lesion. A comparison is made between the functions gamma (chi) obtained using proximity functions calculated with Monte Carlo-generated tracks and with simplifying assumptions (the LET approximation). The results differ substantially, which shows that the results are very sensitive to the degree of detail used in characterizing the physics of the irradiating field. PMID- 6494437 TI - On the stochastic treatment of fast chemical reactions. AB - A Monte Carlo code was developed to stimulate stochastically the fast reactions of radiolysis products in water. The results of these calculations show that treatments based on deterministic kinetic rate equations do not reproduce correctly the evolution in time of the number of species. Ad hoc initial distributions of species in spurs, of the type used in deterministic approaches, are compared with more realistic distributions obtained from Monte Carlo generated particle tracks. The effects of using either type of distribution, stochastically or deterministically, are discussed. PMID- 6494438 TI - Peroxidation of the dried thin film of lipid by high-energy alpha particles from a cyclotron. AB - High-energy alpha particles produced a dose-dependent linear increase in different lipid peroxidation products (e.g., malondialdehyde (MDA), conjugated dienes, and hydroperoxides) in the dried thin film state. An inverse dose-rate effect was observed when the dose rate was varied by changing either the alpha particle fluence rate or the alpha-particle energy. The antioxidants alpha tocopherol and butylated hydroxytoluene (BHT) suppressed the alpha-particle induced lipid peroxidation in the dried thin film state, and in this respect alpha-tocopherol was found superior to BHT. It was found that alpha-tocopherol was equally efficient in inhibiting lipid peroxidations by alpha particles and ultraviolet light. PMID- 6494439 TI - Subchromosomal DNA synthesis in synchronous V-79 chinese hamster cells after X irradiation. AB - A substantial fraction of replicon initiation events in Chinese hamster V-79 cells have been shown to be refractory to the effects of X irradiation immediately after exposure. This study examines the possibility that the initiation radiorefractive portion is the result of changes in replicon radiosensitivity as a function of position in S phase. The data obtained from DNA fiber autoradiograms and kinetic incorporation of radiolabeled thymidine from cells irradiated at various positions in S phase showed only slight changes in the proportion of replicons refractive to X irradiation immediately after exposure. These results indicate that initiation radiorefractive replicons may be an intrinsic property of V-79 cells and that cell-cycle-specific heterogeneity in radiation response cannot fully account for this phenomenon. The results also indicate that delayed inhibition of initiation events may play a larger role in the observed radiorefractive fraction than previously thought. PMID- 6494440 TI - Delayed inhibition of subchromosomal DNA synthesis in V-79 Chinese hamster cells after gamma irradiation. AB - Existence of a substantial fraction of replicon initiation events refractory to the effects of X irradiation in Chinese hamster cells has been reported by several laboratories. The work reported here examined whether this apparently refractive fraction resulted from a delayed inhibition of initiation events. Data obtained from velocity sedimentation studies indicated that the extent of inhibition increased over the first hour after irradiation from 35% inhibition immediately following exposure to 3 kR to 75% inhibition of initiation 1 hr after irradiation. Analysis of subsequent recovery of initiation radiosensitivity was performed using DNA fiber autoradiograms prepared from cells incubated up to 4 hr between 2-kR exposures. The data from these experiments indicated that some recovery occurs within 1 hr of irradiation and thus separation of the inhibition and recovery processes in V-79 cells may not be feasible. PMID- 6494441 TI - Relative biological effectiveness measurements using murine lethality and survival of intestinal and hematopoietic stem cells after fermilab neutrons compared to JANUS reactor neutrons and 60Co gamma rays. AB - The relative biological effectiveness (RBE) of the 25-MeV (average energy) neutron beam at the Fermi National Accelerator Laboratory was measured using murine bone marrow (LD50/30) and gut (LD50/6) lethality and killing of hematopoietic colony forming units (CFU-S) or intestinal clonogenic cells (ICC). The reference radiation was 60Co gamma rays. The LD50/30 and LD50/6 for mice exposed to the Fermilab neutron beam were 6.6 and 8.7 Gy, respectively, intermediate between those of JANUS neutrons and 60Co gamma rays. The D0 values for CFU-S and ICC were 47 cGy and 1.05 Gy, respectively, also intermediate between the lowest values found for JANUS neutrons and the highest values found after 60Co gamma rays. The split-dose survival ratios for CFU-S at intervals of 1 6 hr between doses were essentially 1.0 for both neutron sources, while the corresponding split-dose survival ratio for 60Co gamma rays was consistantly above 1, reaching a maximum of 1.7 with a 1-hr interval between doses. The 3-hr split-dose survival ratios for ICC were 1.0 for JANUS neutrons, 1.85 for Fermilab neutrons, and 6.5 for 60Co gamma rays. The RBE estimates for LD50/30 were 1.5 and 2.3 for Fermilab and JANUS neutrons, respectively. Based on LD50/6, the RBEs were 1.9 (Fermilab) and 3.0 (JANUS). The RBEs for CFU-S D0 were 1.4 (Fermilab) and 1.9 (JANUS) and for jejunal microcolony D0 1.4 (Fermilab) and 2.8 (JANUS). PMID- 6494442 TI - Effects of bremsstrahlung and electron radiation on rat motor performance. AB - Relatively high, rapidly delivered doses of ionizing radiation have been reported to produce an immediate decrement in performance (PD) in a number of animal species. This study investigated the effects of bremsstrahlung and electron radiation on the performance of rats unilaterally exposed by a linear accelerator (LINAC facility) at a midline tissue dose rate of 2000 rad/min. Relative radiation effects were determined by establishing median effective doses (ED50) for rats trained on the accelerod, which is a shock-avoidance test of motor performance. The ED50s were based on 10-min postexposure performance. Subjects were also tested at 15, 30, 60, and 120 min and 24 hr after exposure. Fifty-seven trained rats were exposed to bremsstrahlung radiation, and 40 trained rats were exposed to electrons. The ED50 was 8121 rad for the bremsstrahlung field and 6110 rad for the electron field, for a significantly different relative effectiveness of the electron field in producing PD of 1.35. The data imply that different radiation fields are not equally effective in producing PD. PMID- 6494443 TI - The genotoxicity of alpha particles in human embryonic skin fibroblasts. AB - Cell inactivation and induced mutation frequencies at the hypoxanthine-guanine phosphoribosyl transferase (HGPRT) locus have been measured in cultured human fibroblasts (GM10) exposed to alpha particles from 238Pu (LET at the cell surface was 100 keV/microns) and 250 kVp X rays. The survival curves resulting from exposure to alpha particles are exponential. The mean lethal dose, D0, is approximately 1.3 Gy for X rays and 0.25 Gy for alpha particles. As a function of radiation dose, mutation induction at the HGPRT locus was linear for alpha particles whereas the X-ray-induced mutation data were better fitted by a quadratic function. When mutation frequencies were plotted against the log of survival, mutation frequency at a given survival level was greater in cells exposed to alpha particles than to X rays. PMID- 6494444 TI - Reduced oxygen enhancement ratio at low doses of ionizing radiation. AB - A decreased oxygen enhancement ratio (OER) at lower radiation doses has been previously reported (B. Palcic, J. W. Brosing, and L. D. Skarsgard, Br. J. Cancer 46, 980-984 (1984]. The question remained whether or not this effect is due to a possible oxygen contamination at low doses, which was not the case at high doses. To ensure a sufficient degree of hypoxia prior to the start of irradiation, Chinese hamster cells (CHO) were made hypoxic by gas exchange combined with metabolic consumption of oxygen at 37 degrees C. At the same time oxygen levels in cell suspension were measured using a Clark electrode. It was found that under experimental conditions used in this laboratory for hypoxic irradiations, the oxygen levels before the start of irradiation are always below the levels which could give any significant enhancement to radiation inactivation by X rays. Full survival curves were determined in the dose range 0-30 Gy using the conventional survival assay and in the dose range 0-3 Gy using the low dose survival assay. The results confirmed the earlier finding that the OER decreases at low doses. It is therefore believed that the dose-dependent OER is a true radiobiological phenomenon and not an artifact of the experimental method used in the low dose survival assay. PMID- 6494445 TI - The effect of misonidazole as a hypoxic radiosensitizer at low dose. AB - Using an automated low dose survival assay, the radiosensitizing effectiveness of misonidazole at low radiation dose (0-6 Gy) was measured in cultured mammalian cells. Also measured was its effectiveness at high doses of radiation (0-35 Gy) using the conventional survival assay. In both cases, several concentrations of the drug from 0 to 5 mM were used. The data at low doses were analyzed by a two parameter mathematical equation with linear and quadratic dose terms, S = e-alpha D-beta D2, which proved to be a good fit to the experimental data at all misonidazole concentrations. It is shown that whereas the coefficient of the quadratic dose term, beta, increases significantly with increasing misonidazole concentration, the drug does not significantly affect the coefficient of the linear term, alpha. The enhancement ratio (ER) of misonidazole is shown to be decreased at lower doses. The clinical implications of this result are discussed. PMID- 6494446 TI - Response of human fibroblasts to low dose rate gamma irradiation. AB - Cells from 11 human strains, including fibroblasts from patients with the genetic diseases of ataxia telangiectasia (AT), xeroderma pigmentosum (XP), and Fanconi's anemia (FA), were exposed to gamma radiation at high (1.6-2.2 Gy/min) and at low (0.03-0.07 Gy/min) dose rates. Survival curves reveal an increase in the terminal slope (D0) when cells are irradiated at low dose rates compared to high dose rates. This was true for all cell lines tested, although the AT, FA, and XP cells are reported or postulated to have radiation repair deficiencies. From the response of these cells, it is apparent that radiation sensitivities differ; however, at low dose rate, all tested human cells are able to repair injury. PMID- 6494447 TI - Effect of 2450 MHz microwave radiation on hematopoiesis of pregnant mice. AB - In this study, the influence of 2450 MHz CW microwave radiation on hematopoiesis in pregnant mice was examined. Dams (mice CD-1 strain) were irradiated during Days 1-6 or 6-15 of pregnancy. The animals were irradiated for a total of 8 hr per day (two 4-hr exposures in 9 hr) at an average power density of 30 mW/cm2. Peripheral blood and bone marrow samples were obtained on Day 18 of pregnancy. The total leukocyte and differential leukocyte counts of peripheral blood samples were not affected by either exposure regimen. In addition, no effects were noted in either the erythroid or myeloid mitotic indices of bone marrow samples. Exposure of pregnant mice to microwave radiation under the conditions of these experiments had no effects on the investigated aspects of hematopoiesis. PMID- 6494448 TI - The importance of motivating radiology department employees. AB - Motivational theories are viewed as management tools concerned with human resources. The premise of most theories is that human needs give rise to certain behavior. The performance of radiographers and their relationships with others depend upon this internal force. A technologist whose job does not meet his need for acceptance and ego satisfaction is not likely to be productive. Therefore, management must develop an environment that is supportive, caring, and encourages each radiographer to grow. PMID- 6494449 TI - Magnetic resonance: a new imaging modality. AB - Magnetic resonance utilizes the magnetic properties of atoms within the tissues of the body to produce images. This paper is intended to provide the reader with the most basic information concerning magnetic resonance. The principles, fundamental parameters, equipment, and site planning considerations are presented to familiarize the radiologic technologist with this new imaging modality. PMID- 6494451 TI - [Paget's osteitis deformans. Significance and control]. AB - Follow-up observation of patients with Paget's disease by conventional radiology is useful to evaluate the spontaneous course of the disease in untreated cases and to determine the regeneration of the affected bone after therapy. This also includes complications of the otitis deformans Paget--mainly complete or incomplete fractures, severe deformations as well as rare malignant changes. PMID- 6494450 TI - Predicting certification examination scores in a college-based program. AB - Factors that may predict student performance on the ARRT examination are discussed and statistically examined. For students in the program studied, performance on a simulated registry and grade point average proved to be statistically significant predictors of success. Implications of such models for student motivation are addressed, and a general need to explain differences in student performance is discussed as a step needed to facilitate examination of differences in various educational programs. PMID- 6494452 TI - [Course of Paget's osteodystrophia deformans--exemplified by the roentgen morphology of the cranial bones]. AB - The still unknown etiology and pathogenesis of Paget's disease or Osteodystrophia deformans Paget are discussed; localisation of skeletal lesions and clinical findings of the disease are described. The skull bones are used to give an example for the 4 phases of the course of the disease, shown by X-ray pictures. Typical X-ray findings of changes in structure, pattern, size, and shape of the skull bones are compared with the pathological and anatomical picture. PMID- 6494453 TI - [Rare localization of Paget's osteodystrophia deformans in the skeleton]. AB - Frequency of rare skeletal lesions in Paget's disease is compared with normal localisations. Radiological morphology of rare localisations of Paget's disease of the scapula, of the lower arm bones, of the hand bones, of the patella and the calcaneus are described. Thickening of trabeculae in the spongy bone and porosity of compact bone, deformation and enlargement of the bones are typical; this has to be differentiated and related to a small number of other bone diseases. PMID- 6494454 TI - [Lumbosacral dysplasias]. AB - By means of some selected examples, the myelographic and CT characteristics are presented of different lumbosacral dysplasias. The advantage of the different methods of examination (CT, CT myelography and myelography) and the improved presentation of pathological-anatomical details by means of a combination of these methods in the diagnosis of hyperplasia of the filum terminale, diastematomyelia, tethered conus, intracorporeal and anterior sacral meningocele are shown. PMID- 6494455 TI - [Enzyme determination in the urine for the evaluation of kidney tolerance of the water-soluble roentgen contrast medium iopamidol]. AB - The renal toxicity of the ionic, very hyperosmolaric megluminamidotrizoate was compared with the toxicity of the non-ionic, slightly hypertonic iopamidol after intravenous injection of 0.7 ml/kg body weight (i.e. about 300 mg iodine/ml) in a randomized study of 20 individuals with normal kidneys. Quantitative measurements of the excretion of the enzymes, lactate dehydrogenase (LDH), alkaline phosphatase (AP), and N-acetylglucosaminidase (NAG) in 24-h urine samples, serum creatinine, and the endogeneous creatine clearance were conducted to determine the possible renal damage. All 20 subjects tolerated both contrast mediums well. Reduced renal function as measured by the creatinine blood level and the endogeneous clearance did not occur. The ionic, hyperosmolaric megluminamidotrizoate++ caused significantly elevated enzymuria of NAG, AP, and LDH (P less than 0.01) following tubular irrigation, whereas iopamidol showed no significant enzymuria. Therefore, it appears that the non-ionic contrast medium, iopamidol, is less toxic for kidneys than the ionic megluminamidotrizoate. PMID- 6494456 TI - Obscured aortic arch on the lateral view as a sign of coarctation. AB - Forty patients with coarctation of the aorta were compared with 80 normal subjects matched by sex and age. The aortic arch was invisible on the lateral radiograph in 84% of patients preoperatively and 88% postoperatively. Only 6 normal subjects (8%) had a similar finding. The authors conclude that an obscured aortic arch on the lateral view could be a clue to the presence of coarctation. Possible explanations for this phenomenon include (a) dilatation of the brachiocephalic arteries (particularly the left subclavian artery), obscuring the superior margin of the arch; (b) hypoplasia and anteromedial displacement of the distal portion of the arch; and (c) diffuse hypoplasia of the arch combined with focal coarctation. PMID- 6494457 TI - Computed and conventional arthrotomography of the glenohumeral joint: normal anatomy and clinical experience. AB - The glenohumeral joint was studied in 25 cadavers and 136 patients using computed arthrotomography (CAT) and conventional arthrotomography (AT) to assess shoulder instability. Cadaver shoulders were injected with air or latex, sectioned with a band saw, and normal articular anatomy outlined. CAT was performed in 81 patients and characterized the glenoid labrum as normal, abnormal, or detached in 38 of the 44 patients who had surgery or arthroscopy (sensitivity, 96%; accuracy, 86%). Hill-Sachs defects were seen in 20 out of 29 patients with anterior labral abnormalities, while bicipital tendon abnormalities were evident on CAT in 6. Of 55 patients who had AT, the status of the labrum was clarified in 13 of the 16 patients who had surgery or arthroscopy (sensitivity, 86%; accuracy, 81%). Both methods can characterize the labrum; however, CAT is more comprehensive and appears ideal for both detection of Hill-Sachs defects and imaging the bicipital tendon. CAT requires less technical expertise and radiation than AT and is tolerated better by patients in pain. PMID- 6494458 TI - Elbow arthrography: a reassessment of the technique. AB - Twenty-six elbow arthrograms were retrospectively reviewed. Each arthrogram consisted of conventional radiography, conventional tomography, standard double contrast arthrography, and arthrotomography. Each of these four components was independently interpreted in a blinded fashion by six radiologists, each working alone. The four components were evaluated for presence or absence of intraarticular bodies, cartilage loss, or fractures. The results showed that conventional tomography was the most accurate single study. Arthrotomography rarely improved the diagnostic accuracy of noncontrast methods. It was useful in those few patients where detection of purely cartilaginous bodies, precise position of mineralized densities, or status of articular cartilage was desired. It may be possible to reduce the number of elbow arthrograms, thereby reducing time, cost, and radiation dose factors. PMID- 6494459 TI - Periarticular calcifications in association with intra-articular corticosteroid injections. AB - The authors report on three patients who received intra-articular corticosteroid injections (IACI) in the small joints of their hands for the symptomatic relief of local inflammation. In these cases radiographs showed that among the complications of IACI are periarticular soft-tissue calcifications. Evidence suggests that these calcifications are composed of hydroxyapatite crystals, which may themselves produce inflammatory arthritis. PMID- 6494460 TI - Spondylolysis of the lumbar spine: demonstration of defects and laminal fragmentation. AB - Fifty-six cases of spondylolysis were encountered in 1500 lumbar spine reports reviewed. The frequency of detecting isthmus defects on anteroposterior (AP), lateral, 45-degree right and left oblique, 30-degree up-angled AP, and collimated lateral views was determined. The collimated lateral view showed the largest number of pars defects, 84% of cases. The 30-degree up-angled AP view was more sensitive than the AP view, showing 55% versus 32% of cases. A previously unreported sign of spondylolysis, fragmentation of lamina demonstrated on the AP or AP up-angled view, was found in 14.2% of cases of spondylolysis. PMID- 6494461 TI - Splenic abscess: percutaneous drainage. AB - Experience with percutaneous drainage in four cases of splenic abscess is presented. Percutaneous drainage and antibiotics were curative in three of four cases. The one case not adequately treated by antibiotics and percutaneous drainage was also complicated by ascites and multilocular collections. Percutaneous drainage in this case did not adversely affect subsequent curative surgery. Percutaneous catheter drainage of splenic abscess under radiologic guidance can be a safe, effective treatment. PMID- 6494462 TI - Computed tomographic analysis of deformity and dimensional changes in the eyeball. AB - Computed tomography (CT) was performed in 40 patients with a confirmed ophthalmic diagnosis and a change in the dimensions or configuration of the eyeball. Abnormalities studied included coloboma, microphthalmus, buphthalmos, axial myopia, macrophthalmus, phthisis bulbi, trauma, neoplasm, posterior staphyloma, granuloma, pseudotumor, and surgical scleral banding for retinal detachment. CT findings could be grouped into three categories depending upon whether the eye was small, large, or normal in size, with the findings in each group allowing distinction of most disease processes. PMID- 6494463 TI - Syringomyelia and hydromyelia: magnetic resonance evaluation. AB - Magnetic resonance (MR) imaging of 13 proved cases of syringomyelia or hydromyelia and one case of myelomalacia is described. Most intramedullary cysts were evident on sagittal partial saturation recovery (PSR) images. One cyst containing viscous fluid was not demonstrated on PSR images, but was suggested on a sagittal spin echo image. The case of myelomalacia was indistinguishable from a syrinx on axial PSR and spin echo images. Not all cases of syringomyelia and hydromyelia had the typical MR appearance previously described in the literature. Atypical cysts, spinal cord degeneration, and tumors may have a similar appearance on MR. PMID- 6494464 TI - Calcification in cerebral infarction. AB - In 3 patients with CT-documented non-hemorrhagic cerebral infarction, calcific deposits were found in the infarcted region on subsequent scans. PMID- 6494465 TI - Chordomas: their CT appearance in the cervical, thoracic and lumbar spine. AB - We reviewed 25 CT scans of 21 patients who had chordomas in the cervical, thoracic, or lumbar spine. Nine patients were studied at the time of initial presentation and 12 after tumor recurrence. All scans showed vertebral body destruction coupled with an associated soft tissue mass located anteriorly or laterally. Additional CT findings included septated areas of low attenuation within the tumor, amorphous soft tissue calcification, tumor extension into the spinal canal, disk space involvement, and contrast enhancement. PMID- 6494466 TI - Cholesterol granuloma of the petrous apex: CT diagnosis. AB - Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these are analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with brain and nonenhancing on CT, is in all probability a cholesterol granuloma. Cholesterol granuloma and cholesteatoma of the petrous apex are different lesions and treated differently. Cholesterol granuloma can be treated simply and effectively by drainage and permanent fistulization. Preoperative recognition by CT is important for planning proper treatment. PMID- 6494467 TI - The neck after total laryngectomy: CT study. AB - Computed tomographic scans in 23 patients who had undergone total laryngectomy were analyzed retrospectively to determine normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Nine patients without clinical evidence of recurrence illustrated the normal postoperative changes: a round or ovoid neopharynx connecting the base of the tongue with the cervical esophagus and intact fat planes surrounding the neopharynx, neurovascular bundles, and sternocleidomastoid muscles. In the 12 patients with recurrent neoplasm, the CT manifestations included masses involving the internal jugular lymph node chain (adjacent to the neopharynx, neurovascular bundles, or sternocleidomastoid muscles), tracheostomy site, or paratracheal region. Recurrence was mimicked on CT in two patients, one with an abscess and one with metastases from an adenocarcinoma of unknown primary site. In eight patients, a distended neopharyngeal lumen correlated with benign or malignant stricture. CT supplemented physical examination and indirect mirror examination, providing data regarding presence and extent of recurrent tumor and aiding in planning the mode and scope of therapy. PMID- 6494468 TI - Coronal magnetic resonance imaging of the chest: normal and abnormal. AB - In order to determine the value of coronal magnetic resonance (MR) in diagnosing thoracic abnormalities, the multisection coronal spin echo MR images were reviewed of 10 normal subjects and 20 patients with thoracic abnormalities. In the abnormal patients, coronal images were compared with transaxial MR images obtained with TR values of 0.5 and 2.0 sec. In general, coronal imaging was of value in several situations. It allowed structures oriented in the coronal plane to be imaged along their longitudinal axes, provided an additional perspective and increased the confidence of diagnosis, and helped clarify anatomic relationships difficult or impossible to resolve on transaxial images because of volume averaging. Specifically, coronal images were sometimes superior to transaxial images in evaluating the aorticopulmonary window and masses at the lung apex or base. Transaxial images were often superior in evaluating the pretracheal space, subcarinal space, and hili. Within the pulmonary hili, lateral hilar masses were better defined on coronal images than were anterior or posterior hilar masses. Coronal images obtained with a TR of 1.0 sec (10 sections) allow evaluation of most node-bearing mediastinal compartments and provide adequate mass/fat contrast. PMID- 6494469 TI - Hepatic cirrhosis: magnetic resonance imaging. AB - The effect of periportal collagen deposition on magnetic resonance images and T1 and T2 relaxation times was studied in the rat. Hepatic cirrhosis was induced in 29 rats by chronic intraperitoneal thioacetamide injections. Another 14 rats in which liver abnormalities did not develop were used as controls. The rats were imaged using a small-bore resistive magnet. Histologic correlations and hydroxyproline measurements were performed to document the changes in periportal collagen deposition. The T1 and T2 relaxation times, determined both in vivo and in vitro with spectroscopy, were compared between the normal group and the group with moderate to severe histologic evidence of cirrhosis. The deposition of two to four times the normal amount of collagen in the liver did not affect the T1 or T2 relaxation time. Relatively pure periportal collagen fibrosis does not appear to affect the magnetic resonance image or T1 or T2 relaxation times of the rat liver. PMID- 6494470 TI - In vivo MR spectroscopic imaging with P-31. Work in progress. AB - Magnetic resonance imaging techniques were applied to in vivo spectroscopic analysis of spatially resolved phosphorus spectra in the cat brain to determine whether changes associated with stroke could be detected. Two-dimensional images of separate phosphorus-containing compounds, as well as spectra arising from spatially localized points, demonstrated that metabolism within tissue could be monitored in this manner. Preliminary results of phosphorus imaging of the human body in vivo are reported. PMID- 6494471 TI - Computed tomographic findings in penetrating peptic ulcer. AB - Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Additional findings, not seen in all patients, included (d) edema involving the base of the ulcer and/or the adjacent bowel wall and (e) loss of fascial planes between the base of the ulcer and the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a confident diagnosis of this important complication of peptic ulcer disease. PMID- 6494472 TI - CT evaluation of the bile ducts in patients with fatty liver. AB - Computed tomographic (CT) evaluation of the bile ducts in the fatty liver can be difficult, since hepatic attenuation decreases with increased triglyceride content, and liver parenchyma may become isodense with bile. Forty-seven patients with fatty infiltration of the liver were retrospectively identified. In 7 of these patients, attenuation of liver and bile differed by less than 10 HU. In 2 patients, dilated intrahepatic ducts were invisible using CT, because bile was isodense with fatty liver parenchyma. Thus, the fatty liver presents a potential pitfall in CT evaluation of the bile ducts. Obstructive jaundice can be diagnosed in patients with fatty liver, if the extrahepatic ducts and peribiliary vascular plexus region are carefully scrutinized. For maximal accuracy, scans should be obtained both before and after administration of intravenous urographic contrast material. PMID- 6494473 TI - Uriniferous pseudocyst: computed tomographic findings. AB - The computed tomographic (CT) scans of nine consecutive patients with proved uriniferous pseudocyst (UP) were analyzed retrospectively. Analysis disclosed perirenal space tumefaction in seven patients, tumefaction outside the perirenal space in two patients, cystlike uniformity of attenuation (with specific exceptions) in all nine patients, contrast medium-opacified urine extravasating into the UP in three patients, contrast material within the dependent portion of the UP in one patient, anterior and superior displacement of the kidney in seven patients, hydronephrosis in all nine patients, and associated findings suggesting the underlying cause of UP in five patients. Although these CT findings appear to be quite specific, consideration of this uncommon entity in the CT differential diagnosis requires knowledge of its reported causes, the patient's medical history, and the clinical presentation. PMID- 6494474 TI - Triplane fracture of the distal tibial epiphysis: radiographic and CT studies. AB - We analyzed six cases of triplane fracture of the ankle and reviewed the literature. A previously undescribed fracture pattern was identified in one patient. CT studies proved to be useful diagnostic tools in the evaluation of triplane fractures when operative reduction was contemplated. PMID- 6494475 TI - Vertebral burst fractures: CT analysis of the retropulsed fragment. AB - Ten cases of retropulsed thoracolumbar vertebral body fragments that had been documented by CT were reviewed to define and characterize the nature, appearance, and position of the retropulsed fragment. All of the retropulsed fragments arose from the superior aspect of the vertebral body. Five of ten patients had a vertical fracture within the retropulsed fragment. Three of ten fragments had anteriorly rotated 90 degrees +/- 60 degrees, so that the cartilaginous end plate faced anteriorly; also, they had migrated 3-8 mm in a craniad or caudad direction. Six of ten patients had an associated vertical or Y-shaped fracture originating from the region of the basivertebral foramen and passing into the inferior one-half of the vertebral body. The presence of a retropulsed fragment is nearly pathognomonic of an axial compression injury. Characteristics of this lesion that may hinder surgical reduction are the intra-fragment fracture, rotation, and craniocaudad movement. PMID- 6494476 TI - Untreated Paget disease of bone studied by scintigraphy. AB - We determined that the concentration of radioactivity in a lesion of Paget disease correlates with the grade of radiological deformation and the frequency of pain; the total skeletal uptake correlates with the severity of the biochemical abnormalities. We suggest that the major determinant of uptake in untreated lesions is abnormal metabolic activity, and in lesions in remission it is structural deformation of mineralized tissue. It is likely that the metabolic activity, and possibly also the rate of progression of the individual lesions, will differ in the individual patient, and that metabolic activity determines the amount of deformation and the chance of pain. Lesions not visible on the radiograph usually show only low uptake of Tc-99m-Sn-EHDP; the majority of these lesions are asymptomatic and reflect low activity of the disease. Radiological differentiation between sclerotic and osteolytic lesions does not reflect differences in either scintigraphic uptake, metabolic activity, or pain. PMID- 6494477 TI - Osteomyelitis and infarction in sickle cell hemoglobinopathies: differentiation by combined technetium and gallium scintigraphy. AB - Clinical records and scintigrams were reviewed of 18 patients with sickle cell hemoglobinopathies who had undergone combined technetium and gallium scintigraphy during 22 separate episodes of suspected osseous infection. The combined scintigrams were correctly interpreted as indicating osteomyelitis in four studies. Ga-67 localization was abnormally increased in all of these studies, including one where the Tc-99m MDP bone scan showed decreased activity, another where the bone scan was normal at the site of Ga-67 uptake, and two where the distribution of Tc-99m MDP and Ga-67 were incongruent. Of 18 studies in patients with infarction, the combined scintigrams were correctly interpreted in 16 and showed either no local accumulation of Ga-67 or less accumulation than that of Tc 99m MDP at symptomatic sites. In the other two studies, the scintigrams were falsely interpreted as indicating osteomyelitis and showed congruent, increased accumulation of both Tc-99m MDP and Ga-67 (with the latter of similar or greater intensity). This pattern must be considered indeterminate. Overall, the results indicate that the combination of technetium and gallium scintigraphy is an effective means to distinguish osteomyelitis from infarction in patients with sickle cell hemoglobinopathies. PMID- 6494478 TI - Combined external and interstitial irradiation in the treatment of stage III breast cancer. AB - One hundred six patients with locally advanced carcinoma of the breast underwent definitive radiation therapy for loco-regional control following incisional and/or needle biopsy. Doses of external and interstitial irradiation were 5000 rad (50 Gy) in 5 to 6 weeks, and 3000 to 4000 rad (30-40 Gy) in 60 to 80 hours, respectively. Forty-eight of 106 patients (45%) also received adjuvant systemic chemotherapy. Loco-regional control was observed in 93 of the 106 patients (88%), with five-year disease-free survival of 47%. Distant metastases developed in 59 of the 106 patients (56%). Good to satisfactory cosmetic results were obtained in the majority of these patients; morbidity was at an acceptable level. Locally advanced breast cancer can be treated adequately and satisfactorily without mastectomy by a combination of external and interstitial irradiation. PMID- 6494479 TI - Chemical shift misregistration effect in magnetic resonance imaging. AB - A low intensity artifact appearing at the junction of perirenal fat and renal parenchyma on MR images was recently described. A symmetrical high intensity artifact is also observable on the opposite side of the kidneys as well as at the junction of the right lobe of the liver and adjacent adipose tissue. Both artifacts can be explained as exhibitions of pixel misregistration due to the difference in chemical shifts of fatty and non-fatty organs. Identification of the chemical shift misregistration effect is important since the existence of this artifact may cause erroneous diagnosis of calcification and/or fluid collections. PMID- 6494480 TI - Metrizamide-iophendylate layering technique for thoracolumbar myelography. AB - Iophendylate was used to displace a full dose of metrizamide from the capacious lumbar thecal sac superiorly, outlining the conus medullaris. The method is safe, rapid, and convenient. PMID- 6494481 TI - Diuretic radionuclide renography to evaluate suspected ureteral obstruction on bone scans. AB - Diuretic radionuclide renography is accurate in the assessment of nephroureteral dilatation. We have extended this technique to include evaluation of nephroureteral dilatation noted on the bone scans of two patients. PMID- 6494482 TI - Nonpalpable breast abnormalities: a realistic view of the accuracy of mammography in detecting malignancies. AB - The true-positive biopsy rate for nonpalpable breast abnormalities demonstrated by mammography is in the range of 20 to 30%. This is comparable to the true positive biopsy rate for palpable breast lesions. Both radiologists and surgeons must be familiar with the limitations of mammography, since unrealistic expectations of this examination can lead to its underutilization. PMID- 6494483 TI - Re: Chloral hydrate as a sedative in children during imaging procedures. PMID- 6494485 TI - Re: Radiology in Papua New Guinea. PMID- 6494484 TI - Re: Controversies in lumbosacral spine radiography: indications, projections, and clinical implications. PMID- 6494486 TI - (D-Met2,Pro5) enkephalinamide causes a decrease in plasma prolactin levels of lactating rats continuously suckled and an increase in those deprived of their litter. AB - The effect of an enkephalin analogue, (D-Met2,Pro5)enkephalinamide (EKNH2) on prolactin (PRL) secretion of lactating rats continuously suckled or separated from their pups was investigated. In rats together with their pups 0.5 mg/kg EKNH2 caused a dramatic decrease, 0.25 mg/kg a mild and short-lasting reduction in plasma PRL levels. In contrast, in lactating rats separated for 4 h from their pups 0.5 mg/kg of the drug induced a slight and 1.0 mg/kg a considerable increase in plasma PRL levels. The data indicate that in lactating rats depending on the circumstances the enkephalin analogue causes opposite effects on PRL secretion. PMID- 6494487 TI - Bombesin-induced stimulation of cardiac parasympathetic innervation. AB - The central nervous system effects of bombesin on cardiovascular function were examined in conscious, freely-moving rats. Intracerebroventricular administration of bombesin elevated mean arterial pressure, reduced heart rate and inhibited cold-induced tachycardia. Adrenalectomy prevented bombesin-induced elevations of mean arterial pressure. In contrast, bombesin-induced bradycardia was neither adrenal-dependent nor a baroreceptor-mediated reflex response to increased arterial pressure. Systemic atropine methyl nitrate treatment attenuated bombesin induced bradycardia, suggesting that bombesin acts within the central nervous system to stimulate cardiac vagal activity. PMID- 6494488 TI - Modelling of cosmic-ray muon exposure in building's interior. AB - Physical parameters on the exposure indoors from cosmic ray muons were determined in order to undertake computer simulations. The hitherto known information was compiled, and the unknowns were newly calculated. Assumptions and approximations required in making a practical model were also described. The stopping power and the range of muons in a normal concrete as well as the air were calculated for the energy up to hundreds GeV. The consistency of those results with ready-made tables was found satisfactory although the comparisons were available only in the low energy tail. The scattering effect of cosmic ray muons in building's interior was examined numerically through very simple model calculations. It was revealed that the overall scattering effect would be ignored unless very small variations are wanted. The iron fraction in a reinforced concrete as well as the density of the concrete was also shown to be an ineffective factor. PMID- 6494489 TI - Calculation on cosmic-ray muon exposure rate in non-walled concrete buildings. AB - Computer simulations on the exposure indoors from cosmic ray muons were practiced in the framework of non-scattering and non-cascade assumptions. The model buildings were two-dimensional, rectangular, and were made of a normal concrete. A stratified structure was assumed in each building, where no mezzanine was considered. Walls were not taken into account yet. The distributions of the exposure rates in 26-story buildings were illustrated in contour maps for various sets of parameters. All of them gave basically archlike patterns. Analyses of the results showed that the exposure rate is affected most largely by the floor board thickness. The ceiling height would be an insignificant factor for short buildings. The min/max ratio of the muon exposure rate in a moderate size building was estimated to be more than 0.7. PMID- 6494490 TI - [Efficiency of tritium enrichment by electrolytic cell with multi-nickel-plates electrode and its application to the determination of tritium in environmental water]. AB - For the purpose of speeding up the tritium enrichment by electrolysis, we have produced an electrolytic cell with the multi-plate-electrode system instead of the commonly used single-plate-electrode, and examined the efficiencies for the tritium enrichment under the conditions of different current densities and electrode gaps. From the results, the tritium recovery and the separation factor beta were found to be maximized under the condition of 70 mA/cm2 of current density and 1.6 mm of electrode gap, and they were 90 percent and 23, respectively. Using this cell, it took 28 hours to reduce 100 ml of a sample water to 10 ml, and took 2 days, including the time required for other operations, to determine the tritium concentration of 1.85 Bq/l (50 pCi/l) with the counting error of within +/- 10 percent. This method has been applied to determining the tritium concentrations of environmental samples from Yamato River region during July 1981-February 1983. They were in the range of 1.11-9.48 Bq/l (30-256 pCi/l). PMID- 6494491 TI - Whole-body distribution of 11C-(4)-L-aspartic acid in rats. AB - Enzymatic synthesis of 11C-(4)-L-aspartic acid was undertaken using commercially available wheat germ phosphoenolpyruvate carboxylase. Whole-body distribution of the radioactive compound in rats showed higher accumulation in the salivary gland, glandular stomach and the pancreas, as well as in the lungs. Within 60 minutes after intravenous injection of 11C-(4)-L-aspartic acid, about 60% is removed as 11CO2 by expiration, indicating that the carbon atom at the fourth position of the radioactive compound is easily subjected to decarboxylation. PMID- 6494492 TI - [Quality control of radioimmunoassay by bivariate analysis]. AB - Automatic calculation of control charts for precision and accuracy of radioimmunoassay was reported by Faure, et al. Duplicate control samples independently measured was assumed to have a bivariate normal distribution. In this case they assumed that the correlation coefficient between each value of the pairs of control samples is zero. Our experience using this method revealed that a considerable number of assayed samples distributed outside the calculated control limits in case of "accuracy control". It was considered that this happened because in radioimmunoassay the between-assays precision is usually larger than the within-an-assay precision and there is a significant correlation between values of duplicates. We also found equal probability density did not make a true circle but a long circle. Therefore in the present paper we proposed for control charts of radioimmunoassay an equal probability long circle calculated by bivariate analysis of Mahalanobis' generalized distance. It was found that a Mahalanobis' long circle could explain the density distribution of radioimmunoassay with a reasonable percent of samples outside the calculated control limits. What happened here can be interpreted by a large between-assays variability shown by some commercial kits. This automatic calculation method could be applied not only for quality control but also for evaluation and comparison of radioimmunoassay system or commercial kits. Control survey could also be analyzed by such a method. PMID- 6494493 TI - [Sensitive determination of haloperidol in human serum by radioimmunoassay]. AB - An improved procedure for the sensitive determination of the neuroleptic drug, haloperidol, in human serum is described. The method is based on a single hexane extraction procedure and a radioimmunoassay. Antiserum was elicited in guinea pigs immunized with haloperidol hemisuccinate derivative coupled to bovine serum albumin. Any appreciable cross-reactivity was observed neither with known metabolites of haloperidol nor with haloperidol decanoate (KD-136). Some devices in the extraction procedure, e.g. the use of 10 ml of extraction solvent, made it possible to measure haloperidol levels as low as 0.05 ng/ml. The accuracy and reproducibility of the method were shown to be sufficient. The present method can be used to study the pharmacokinetics of haloperidol in the phase 1 study of KD 136. In addition, it is simple enough for use in clinical laboratories that are monitoring haloperidol concentrations in the blood of psychiatric patients. PMID- 6494494 TI - The clinical application of intestinal 47Ca absorption test by employing our developed arm counter. PMID- 6494495 TI - [Experimental and clinical evaluation of a pancreatic secretory trypsin inhibitor radioimmunoassay kit]. PMID- 6494496 TI - [Proposal on a code for nuclear medicine based on ICPM code of WHO]. PMID- 6494497 TI - Evaluation by electron microscopy techniques of asbestos contamination in industrial, cosmetic, and pharmaceutical talcs. AB - Talc powders from national and international markets were analyzed in order to assess their fiber contents and the proportion of asbestos in the fibrous material. Samples of talc powders used as excipients in pharmaceutical and cosmetic preparations demonstrated fiber contents up to 30% of total particles. About a half of the talc powders revealed the presence of asbestos: in five samples chrysotile (a serpentine asbestos) was present, in the other ones tremolite and anthophyllite (an amphibole asbestos). The amounts of asbestos vary up to 90% in the different samples of the fibrous fraction. About 75% of observed asbestos fibers were thinner than 0.4 micron, i.e., below the resolving power of light microscopy which until now was the most utilized technique for evaluating the environmental pollution due to asbestos. PMID- 6494498 TI - The effects of di- and trichloroacetic acid on sheep erythrocytes: an animal model with a glucose-6-phosphate dehydrogenase deficiency. AB - Erythrocytes of Dorset sheep, an animal model with an erythrocyte glucose-6 phosphate dehydrogenase (G-6-PD) deficiency, responded in a dose-dependent manner to the oxidant stress of di- and trichloroacetic acids (DCA and TCA) as measured by increases in methemoglobin (METHB) and decreases in glutathione (GSH). Given the fact that TCA and DCA are now being found in community drinking water supplies at levels greater than 100 micrograms/liter, there is a need to further investigate their effects on biological systems, including those with a compromised ability to deal with oxidant stress (e.g., G-6-PD-deficient erythrocytes). PMID- 6494499 TI - Estimating risk for carcinogenic environmental contaminants and its impact on regulatory decision making. AB - Increasingly risk analysis and risk estimation are important tools used in regulatory decision making. To appreciate the complexities of this multifaceted field and gain some understanding of it, a broad overview is the first step. This paper attempts to do this. The view is admittedly imperfect and incomplete, but should help the reader see more clearly many of the features and limitations of risk estimation for environmental contaminants. A scheme is suggested for use of quantitative individual risk rates and population risk rate estimates in regulatory decision making. PMID- 6494500 TI - Toxicological screening. AB - Well-defined dose- and time-related toxic effects of chemicals can often be detected using simple tests with small numbers of animals. The strategies for the establishment of toxicological screening tests are discussed. The most important steps are the definition of the targets, the selection of the methods, and the setting of the test criteria. Screening tests must then be validated with standard reference chemicals, and the test criteria must be adjusted so that the standards can be detected regularly. Maximal flexibility is allowed in the design of the tests. For evaluation, the results obtained in treated animals can be compared with those of controls, using conventional concepts of biostatistics. It is also possible to base the evaluation on preset test criteria. Toxicological screening tests do not replace conventional safety studies, but they help in selecting the most promising candidates in a series of related chemicals and in establishing priorities for further testing. As an example, a screening for the hemolytic effects of chemicals is presented. PMID- 6494501 TI - Toxicologic studies associated with the agricultural use of municipal sewage sludge and health effects among sewage treatment plant workers. AB - The proposed use of municipal sewage sludges as soil amendments on agricultural land involves potential health risks. Sludges may contain toxic heavy metals, synthetic organics, and pathogens. Studies of animals inhabiting sludge-amended soils, or foraging on crops grown on such soils, have shown an increased deposition of cadmium and polychlorinated biphenyls in animal tissues, hepatic microsomal enzyme induction, altered blood profiles, appearance of mutagens in blood and excreta, and lowered feed intake, feed efficiency, and milk production. Epidemiologic evidence of possible adverse health effects among sewage plant workers exposed to aerosolized pathogens or synthetic organic vapors during wastewater treatment or land spreading of sludge is still inconclusive. Other possible deleterious environmental effects include pollution of groundwater and toxicity to birds consuming worms or insects inhabiting sludge-treated soils. PMID- 6494502 TI - Carcinogenicity evaluation and regulatory decisions. PMID- 6494503 TI - [Radiculomyelitis following acute hemorrhagic conjunctivitis caused by enterovirus 70. Report of the 1st corroborated case in America]. PMID- 6494504 TI - [Cutaneous leishmaniasis in Panama. A brief review]. PMID- 6494505 TI - [An epidemic of viral meningitis caused by ECHO 4 occurring in Panama in 1981]. PMID- 6494506 TI - [Examination of feces for the detection of parasites. A comparison of 2 methods]. PMID- 6494507 TI - [The problem of urticant and poisonous lepidopterans in Panama]. PMID- 6494508 TI - [1st isolations of Campylobacter jejuni in Panama]. PMID- 6494509 TI - [Systems for computers developed in the field of scientific and medical research]. PMID- 6494510 TI - [Identification of adults and pupas of the most common species of Panamanian Simuliidae (Diptera: Simuliidae)]. PMID- 6494511 TI - [Laboratory maintenance and various experimental uses of the night monkey, Aotus]. PMID- 6494512 TI - [The spinal vacuum phenomenon. Radiographic and tomodensitometry aspects]. AB - The spinal vacuum phenomenon is readily recognized by computed tomography: there fore its observation has become frequent enough. The side of the gaseous collection (intervertebral disk, vertebral body, apophyseal joint) depends on the disease inducing the phenomenon. Radiological and CT aspects of this findings are discussed. The usefulness of vacuum phenomenon in the diagnosis of several pathological conditions is examined. PMID- 6494513 TI - [Preoperative embolization of intracranial meningiomas]. AB - Embolization of very vascular intracranial meningiomas prior to operation will reduce the loss of blood during the operation. The indications and the technique of preoperative embolization are discussed and 20 cases are presented. PMID- 6494514 TI - [Radiosensitivity and effect of dose fractionation in cultured cells]. AB - Survival, division delay and repair of sublethal damage were studied as a function of the cellular age in cells of EUE line exposed to 31 MeV protons, (LET of 1.83 keV/micron in tissue). The findings are compared with data reported in the literature on various mammalian cell lines exposed to X and gamma rays, common behaviours are pointed out and the characteristics parameters quantified. Survival varies with cell age and reaches a maximum value at mid S and its minimum at late G1; the ratio between maximum and minimum ranges between 1.5 and 15 depending on the survival level. Division delay resulted to be equal to 6 and 12% of the generation time per Gy for mid G1 and mid-late S respectively. All the investigated lines are able to repair as much as 50% of the sublethal damage within one hour. PMID- 6494515 TI - [Radiotherapy of local recurrences of surgically treated rectal and rectosigmoidal cancer]. AB - Local surgical failures of rectal and rectosigmoidal cancer are often observed and represent a heavy clinical problem from the viewpoint of quality of life. After having referred bad results of radiotherapy in a group of 55 patients locally relapsed after radical surgery, the authors analyse causes of therapeutic failure, underlining that ineffectiveness of radiation treatment comes mainly from late and, frequently, not complete diagnosis. Computed tomography must be currently considered the best way for monitoring these patients in order to get an earlier detection and the most correct radiation treatment plan. PMID- 6494516 TI - [Role of computerized tomography in the diagnosis and evaluation of aneurysms of the abdominal aorta]. AB - The authors report their experience in CT diagnosis of abdominal aorta aneurysms and surgical complication in synthetic aortic grafts. This work is based on a study of 47 patients. Findings, methods, indications and limits of CT in the pathology of aortic aneurysms are shown and discussed. PMID- 6494517 TI - [Computerized tomography in the study of rupture of abdominal aneurysms]. AB - The authors present the CT aspect of 3 patients with massive retroperitoneal hemorrhage, caused by leaking of aneurysms of the lumbar aorta (2 cases) and of the right iliac artery (1 case). CT is a first choice examination in studying suspect ruptured aneurysms; in fact it can show dimensions and place of the aneurysm, and it is also possible an exact evaluation of retro and intraperitoneal hematoma. PMID- 6494518 TI - [Xeroradiography in the evaluation of surgical scars and in research on recurrence of sarcomas in soft tissues]. AB - Xeroradiography was performed for the follow-up of 182 patients operated for soft tissues sarcomas. In 63/182 cases, xeroradiographic examination was repeated twice or more times during the course of years, so that the overall amount of diagnostic evaluations reached the number of 283 useful examinations. In 115/182 cases the presence of a neoplastic recurrency was demonstrated on histopathological or clinical grounds; in the remaining 67/182 cases no evidence of tumoral growth was found. The xeroradiographic diagnosis of neoplastic recurrencies was correct in 271/283 evaluations (95,75%). The false negative diagnosis were prevailing (11/283 = 3,9%), while only 1/283 false positive result occurred (0,35%). The xeroradiographic features of surgical scars within soft tissues are discussed and the semeiologic landmarks of neoplastic recurrencies are outlined. PMID- 6494519 TI - [Infection and tuberculous disease in Spain yesterday and today. (Perspectives for the future through 43-years' experience in serial examinations]. PMID- 6494520 TI - [Study of the familial occurrence of pre-excitation syndromes in our environment (VI)]. PMID- 6494521 TI - [Experience in the routine use of the subclavian vein in hemodialysis]. PMID- 6494522 TI - [Oral overload of calcium in the diagnosis of primary hyperthyroidism with intermittent hypercalcemia]. PMID- 6494523 TI - [Myeloma and polyneuropathy. Review apropos of 3 cases, one of them with endocrine and cutaneous changes]. PMID- 6494524 TI - [Preliminary study of the phospholipids of HDL in ischemic cardiomyopathy]. PMID- 6494525 TI - [Therapeutic efficacy of the combination of chlorquinaldol plus promestriene in infections of the vagina]. PMID- 6494526 TI - [Immunologic changes during the development of malaria]. PMID- 6494527 TI - [Acute lead encephalopathy. Apropos of a case in an adult]. PMID- 6494528 TI - [Carcinoma of the adrenal cortex. Presentation of a case]. PMID- 6494529 TI - [Nail mycoses of opportunistic type]. PMID- 6494531 TI - Rapid diagnosis of peste des petits ruminants (PPR) infection, application of immunoelectroosmophoresis (IEOP) technique. PMID- 6494530 TI - [Diffuse gliomatosis cerebri. Anatomoclinical study. Report of a case]. PMID- 6494532 TI - Experimental infection of goats with Mycoplasma capri and "peste des petits ruminants" virus. PMID- 6494533 TI - [Results of surveys on helminthiasis in camels in the Zinder Department (Rep. of Niger); their development during the year--means on control]. PMID- 6494534 TI - Tapeworm infection (Taenia hydatigena) in lion (Panthera leo) in captivity. A case report. PMID- 6494535 TI - [Copper deficiency in domestic ruminants in the Awash area (Ethiopia)]. PMID- 6494536 TI - Hair as indicator of mineral status in Yankassa sheep. PMID- 6494537 TI - Repeat breeding in West African dwarf goats. PMID- 6494538 TI - [The importance of cardiovascular epidemiology as a basis for the efficient organization of cardiology]. PMID- 6494539 TI - [Control of arterial hypertension: benefits of a program of intervention]. PMID- 6494540 TI - [Salt and arterial hypertension: sodium excretion in untreated essential hypertension]. PMID- 6494541 TI - [Dopaminergic stimulants: a new type of antihypertensive drug without cardiac repercussions?]. PMID- 6494542 TI - [Effects of the length of the stimulation cycle and of autonomic block on the refractory periods of the atrioventricular node]. PMID- 6494543 TI - [Surgical treatment of double-outlet right ventricle]. PMID- 6494544 TI - [New surgical technic for orthoterminal correction. Experimental development]. PMID- 6494545 TI - [Regurgitation of the original aortic valve. A late complication of "anatomical" correction of transposition of the great arteries]. PMID- 6494546 TI - [Technical modification of aortoplasty using the subclavian artery in coarctation of the aorta]. PMID- 6494547 TI - [Femoro-popliteal hydatid embolism and subsequent multiple embolization in a patient with recurring myocardial hydatidosis]. PMID- 6494548 TI - [Cardiac hydatid cyst. Bidimensional echocardiographic study]. PMID- 6494549 TI - [Electrical cardiac stimulation in carotid sinus syndrome]. PMID- 6494551 TI - [Mechanisms of duodenal inhibition of gastric secretion: experimental study of its behavior in the ulcer patient]. PMID- 6494550 TI - [LDH isoenzymes in the gastric tissue of patients subjected to surgical treatment for cancer]. PMID- 6494552 TI - [Immediate postoperative development of partial gastrectomies. Apropos of a series of 100 cases]. PMID- 6494553 TI - [Proximal gastric vagotomy and gastric ulcer]. PMID- 6494554 TI - [Perioperative antimicrobial prophylaxis in abdominal surgery]. PMID- 6494555 TI - [Deficit of intestinal absorption in the short bowel syndrome]. PMID- 6494556 TI - [Clinico-morphologic correlation in 12 cases of hepatocutaneous porphyria tarda]. PMID- 6494557 TI - [Traumatic rupture of a hepatic hydatic cyst in the abdominal cavity. Therapeutic aspects]. PMID- 6494558 TI - [Pneumatosis cystoides intestinalis in the adult. Review apropos of 3 cases]. PMID- 6494559 TI - [Abdominal actinomycosis. Study of a case]. PMID- 6494560 TI - [The hepatotoxicity of pyrazinamide]. PMID- 6494561 TI - [Our experience and results with valvuloplastic technics in the surgery of hiatal hernia]. PMID- 6494562 TI - [Clinical results observed for more than 6 years in patients gastrectomized for gastric carcinoma]. PMID- 6494563 TI - [Carcinoembryonic antigen in gastric cancer. Evaluation of the usefulness of periodic control]. PMID- 6494564 TI - [Gastric cancer and gastric adenomatous polyp]. PMID- 6494565 TI - [Results of surgical treatment in intestinal infarcts: study of 19 cases with clinico-pathologic correlation]. PMID- 6494566 TI - [Tumors of the cecum and anemia]. PMID- 6494567 TI - [New contribution to the clarification of the etiopathogenesis of chronic appendix diseases]. PMID- 6494568 TI - [Our experience in the surgical treatment of malignant ampulla tumors]. PMID- 6494569 TI - [Cysts of the choledochus. Apropos of a case]. PMID- 6494570 TI - [Cystic lymphangioma of the pancreas]. PMID- 6494571 TI - [Duodenal wounds in closed injuries of the abdomen]. PMID- 6494572 TI - Predictive drug testing on human tumor cells. PMID- 6494573 TI - In vitro growth of human malignancies in a cloning assay. PMID- 6494574 TI - Development of a nucleotide precursor incorporation assay for testing drug sensitivity of human tumors. PMID- 6494575 TI - Predictive relevance for clinical outcome of in vitro sensitivity evaluated through antimetabolic assay. PMID- 6494576 TI - In vitro chemosensitivity assay based on the concept of total tumor cell kill. PMID- 6494577 TI - A replenishable soft agar colony assay for human tumour sensitivity testing. PMID- 6494578 TI - Pharmacologic pitfalls in the human tumor clonogenic assay. PMID- 6494579 TI - Heterogeneity and variability of test results as limiting factors for predictive assays. PMID- 6494580 TI - Interlaboratory comparison of in vitro cloning of fresh human tumor cells from malignant effusions. PMID- 6494581 TI - Evaluation of schedule dependency of anticancer drugs in the human tumor clonogenic assay. PMID- 6494582 TI - In vitro effect of interferon-alpha on human granulocyte/macrophage progenitor cells and human clonogenic tumor cells. PMID- 6494583 TI - Drug combination testing with in vitro clonal cultures. PMID- 6494584 TI - Usefulness of the human tumor colony forming assay for new drug development. PMID- 6494585 TI - In vitro characterization of new antiestrogens in human mammary tumor cells. PMID- 6494586 TI - Improving techniques for clonogenic assays. AB - A serum-free medium has been developed which supports colony formation by cells from several human tumor cell lines, one colon adenocarcinoma (WiDr) and four melanoma (Me43, Me85, MP6, MeIuso). This medium consists of a 1:1 mixture of an enriched Dulbecco's modified Eagle's medium (EMED) and a modified Ham's F-12 nutrient mixture (FMED) supplemented with 0.9% methylcellulose, 1% bovine serum albumin, 80 micrograms/ml human transferrin, 3 micrograms/ml insulin, 2.8 micrograms/ml linoleic acid, 2.6 micrograms/ml cholesterol, 20 microM ethanolamine, and trace elements. Colony formation by WiDr cells is linear with the numbers of cells plated, having a plating efficiency (PE) of 34%, as compared to 26% in serum-containing medium. Two of the melanoma cell lines. MP6 and MeIuso, exhibit linear relationships between colony numbers and cell concentration with PEs of 21% and 70% respectively. Colony formation by the other two melanoma cell lines appears to be nonlinear. This work represents a step toward standardizing culture conditions for human tumor clonogenic cell assays. PMID- 6494587 TI - Analysis of malignant effusions by cellular composition, proliferation kinetics, and in vitro clonogenicity. PMID- 6494588 TI - Direct cloning of human ovarian cancer in soft agar: clinical limitations and pharmacologic applications. PMID- 6494589 TI - Technical problems with soft agar colony formation assays for in vitro chemotherapy sensitivity testing of human solid tumors: Mayo Clinic experience. AB - If soft agar colony formation assays for primary human tumor cells are going to be performed and the results assessed by optical analysis of colony formation, then we believe it is mandatory in such assay techniques to objectively count control plates on the day of culture initiation using stained plates, use universal cytotoxic control compounds which should uniformly eliminate all viable cell proliferation, and use a vital stain such as the tetrazolium dye INT to document the presence or absence of viable cell colonies when cultures are assessed. There is no question, however, after careful observation of thousands of soft agar cultures of primary human tumor cells in my laboratory, that significant proliferation of small tumor cell aggregates often takes place in vitro and can in fact be used to assess cytotoxic drug effects in vitro. We do not believe that this is demonstrably stem cell or clonal growth. Nevertheless, it almost certainly is in vitro tumor cell proliferation. With very careful controls, we believe that optical methods can be used reliably to evaluate drug effects on this soft agar proliferative capacity of primary human tumor cells. However, it may eventually prove more useful to study human tumor cell proliferation in vitro (even soft agar colony growth) by other methods, such as incorporation of radiolabeled bases into newly synthesized DNA or other macromolecules, or by the simple use of vital dyes, as discussed elsewhere in this volume.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494590 TI - Cloning of human tumor cells in methylcellulose-containing medium. PMID- 6494591 TI - Development and applications of a human tumor colony assay for chemosensitivity testing. AB - Using the human tumor colony assay, the growth and chemosensitivity of clonogenic tumor cells present in fresh biopsies of human tumors can be investigated. Excellent evidence has been obtained that colonies grown in HTCA are comprised of tumor cells, and that clonogenic cells within tumor colonies have self-renewal properties (the defining feature of tumor stem cells). Clinical correlations have been made between in vitro chemosensitivity and the response of patients with metastatic cancer to chemotherapy. In a series of trials, HTCA has had a 71% true positive rate and a 91% true negative rate for predicting drug sensitivity and resistance respectively of cancer patients to specific chemotherapeutic agents. HTCA has also had several areas of application to new drug development and screening. Ongoing developmental research is needed to improve growth rates for many tumor types and to further improve assay methodology and thereby enhance its applicability to predictive drug sensitivity testing. PMID- 6494592 TI - Chronically ill children in America. PMID- 6494593 TI - Ketogenesis during sepsis in relation to hepatic energy metabolism. AB - The concentrations of acetoacetate, beta-hydroxybutyrate, and adenine nucleotides, and the mitochondrial phosphorylative activities, induced by cecal ligation and punctured in the liver of septic rats, were determined. The concentrations of glucose, free fatty acids (FFA), and free amino acids in arterial blood were also studied along with ketone body concentrations. Hepatic energy charge levels decreased from 0.84 to 0.77 at 12h after the induction of sepsis (P less than 0.01) and to 0.60 at 18h (P less than 0.001). Mitochondrial phosphorylative activity was enhanced at 6h (P less than 0.001) and decreased at 18h later. Ketone body concentrations in the liver and the arterial blood decreased concomitant with the decrease in hepatic energy charge. The mitochondrial redox state increased significantly at 12 and 18h after the induction of sepsis (P less than 0.01) concomitant with a marked decrease in the concentrations of ketone bodies (P less than 0.01). Blood glucose levels remained within normal limits except for a transient increase at 6h, but plasma FFA levels decreased (P less than 0.01). The plasma concentrations of aromatic amino acids (P less than 0.001), proline, and alanine (P less than 0.05) increased slightly at 18h. It is suggested that the ketogenic capacity of the liver is inhibited during sepsis, but that the liver maintains gluconeogenesis at relatively normal levels until a more advanced stage of sepsis. PMID- 6494594 TI - Effects of low-molecular-weight heparin on platelets as compared with commercial heparin. AB - Five subjects were injected with 5,000 IU of commercial heparin and low-molecular weight heparin at an interval of 20 days after each injection. Both heparins produced the same platelet factor 4 release immediately after administration (commercial heparin 114.6 +/- 21.6 ng/ml, low-molecular-weight heparin 113.1 +/- 22.1 ng/ml). However, commercial heparin induced a more evident potentiating effect on ADP-induced platelet aggregation and was still present 60 min after injection. Low-molecular-weight heparin had a higher anti-Xa-specific activity than that determined by activated partial thromboplastin time. The opposite was true for the commercial preparation. PMID- 6494595 TI - Effects of starvation and plasma exchange on lecithin: cholesterol acyltransferase activity and cholesterol efflux in cholesterol-fed pigs. AB - The effects of starvation and of plasma exchange with a cholesterol-free substitute on efflux of tissue cholesterol and on lecithin: cholesterol acyltransferase (LCAT) activity in plasma and peripheral lymph were investigated in two pigs fed a cholesterol diet for 3-4 months. The pigs were labelled with i.v. [14C]cholesterol before plasma exchange or starvation. The cholesterol diet increased plasma total cholesterol concentration and LCAT activity in plasma and lymph, but had little effect on the rate of esterification of cholesterol in plasma or lymph. During cholesterol feeding, and when the animals were fed a normal diet, cholesterol esterification rates in plasma and lymph were much lower than the maximum rates achieved when LCAT was saturated with substrate, suggesting that LCAT in normal pig plasma and lymph is not saturated with substrate. Plasma exchange, carried out when the specific activity of tissue cholesterol exceeded that of plasma cholesterol, was followed by a brief rise in the specific activity of plasma cholesterol to a maximum value between the specific activities of muscle and adipose-tissue cholesterol, reflecting the transfer of radioactive cholesterol from tissue to plasma. During the rise in plasma total cholesterol specific activity there were no differences between the specific activities of low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol in plasma or lymph. Starvation had no effect on the plasma-cholesterol specific-activity curve. From about day 14 after labelling, cholesterol-specific activity decreased in the order: tissues greater than lymph greater than plasma. This suggests that the transfer of cholesterol from tissues to plasma was mediated by lipoproteins in the interstitial fluid. PMID- 6494596 TI - Antibiotics in sediments and run-off waters from feedlots. PMID- 6494597 TI - Environmental transformations of DPA, SOPP, benomyl, and TBZ. PMID- 6494598 TI - The effect of the phenoxyacetic acid herbicides 2,4,5-trichlorophenoxyacetic acid and 2,4-dichlorophenoxyacetic acid as ascertained by direct experimentation. PMID- 6494599 TI - Bronchoalveolar lavage in the normal lung. 2. Cell distribution and cytomorphology. AB - Bronchoalveolar lavage, performed on 15 healthy volunteers, enabled quantification and characterization of the alveolar cell populations. The subjects studied were 8 nonsmokers (5 males, 3 females) and 7 smokers (6 males, 1 female). It was found that in the smokers the macrophages increased compared with nonsmokers, both in absolute number (419,000 vs. 138,000/ml; p less than 0.005) and in percentage (93.8 +/- 3.0 vs. 88.1 +/- 4.8%; p less than 0.02), causing a significant increase in the total number of cells recovered after bronchoalveolar lavage (471,000 vs. 163,000/ml; p less than 0.005). Lymphocytes and neutrophils do not significantly vary in the two groups, even though among the smokers there is a tendency for the concentration of these cells to increase in the lavage liquids. The importance of the data obtained from healthy subjects lies in the possibility thus afforded of having reference values for the study of various lung pathologies with bronchoalveolar lavage. PMID- 6494600 TI - Sustained-release anhydrous theophylline in preventing exercise-induced asthma. AB - A number of drugs have been taken into consideration as to their efficacy in preventing exercise-induced asthma (EIA), which may be a reliable model for the investigation of bronchodilating agents. 15 asthmatic patients (mean age 21.1 +/- 10.7), EIA positive (free running test), were selected for a double-blind cross over study of a sustained-release theophylline preparation against placebo. Patients underwent four subsequent bronchoprovocation tests by means of free running, at a 3-hours' interval, with a prior administration (3 h before the first test) of the drug at the dose of 7-8 mg/kg or the placebo. Lung function was tested (FEV1.0, FEF50, FEF25, sGaw) after the four induction tests as regards to the plasma concentrations of theophylline. After 6, 9 and 12 h, respectively, from administration of the drug, theophylline plasma levels between 7 and 9 micrograms/ml were found, which are to be considered more than satisfactory after an acute administration. A continuous protective activity has been noted against the exercise stress, with a significant difference between drug and placebo, for all lung function parameters with the obvious exception of the first one in which a satisfactory level of theophylline absorption was not reached. The finding of this new positive aspect of the drug investigated appears to be extremely interesting, particularly if added to the already well-known therapeutic activity, and to the fact that often other classes of drugs do not show a good correlation of protective action against EIA and prevention of spontaneous asthmatic attacks. PMID- 6494601 TI - Different performance of two commercial nebulizers. AB - Two different nebulizers, the DeVilbiss 646 and the Mefar were tested for differences in output characteristics (air flow rate, amount of nebulized liquid and particle size) and it was found that there is a high variability between nebulizers of both brands. In the light of these findings, neither of these devices can be chosen as a standard nebulizer for bronchial provocation. PMID- 6494602 TI - Preliminary observations on short-course chemotherapy in tuberculous serositis. AB - Short-course chemotherapy has not been previously assessed in tuberculous serositis. In this study, 18 patients with tuberculous serositis were studied. 600 mg of rifampicin, 300 mg of isoniazid and 25 mg of pyridoxine were given daily for 6 months. 14 patients completed the therapeutic regimen and were evaluated. 11 of these showed excellent results on the long-term follow-up (18-24 months) and 3 of shorter-term follow-up (9-12 months). Short-course chemotherapy appears to be efficacious in the treatment of tuberculous serositis. However, further and larger trials are recommended. PMID- 6494603 TI - Pulmonary air meniscus sign. AB - In chest roentgenograms, the pulmonary meniscus sign is a crescent-shaped inclusion of air surrounded by consolidated lung tissue. The common cause is aspergilloma. A hydatid cyst is, however, the most common cause in endemic areas. In this study, 10 cases with meniscus sign are presented and the pertinent literature is reviewed. PMID- 6494604 TI - Airway function in stage I and stage II pulmonary sarcoidosis. AB - Airway function was studied in 39 patients with stage I sarcoidosis and in 20 patients with stage II sarcoidosis. All of our patients were nonsmokers. Characteristic functional changes of restrictive lung disease was observed in 4 patients with stage II sarcoidosis. Specific airway conductance and % FEV1 were abnormal in 3 patients with stage II sarcoidosis. Abnormal small airway function was demonstrated in several patients with stage I and stage II sarcoidosis, always by multiple tests. Frequency dependence of dynamic compliance was demonstrated in 40% of stage I and 50% of stage II sarcoidosis. Maximal flow (Vmax50, Vmax25) was decreased respectively in 36 and 30% of patients of stage I sarcoidosis and in 56 and 62% of patients with stage II sarcoidosis. The ratio of closing volume to vital capacity was increased above corrected predictions in 30% of stage I and 44% of stage II sarcoidosis. delta Vmax25 decreased and Visov/VC (%) increased in more than 50% of patients. Upstream airway resistance was abnormally increased in 50% of patients with stage I and in 73% with stage II sarcoidosis. These results suggest that small airway dysfunction is common in early sarcoidosis without restrictive defect. PMID- 6494605 TI - Pulmonary haemodynamics at rest and during exercise in patients with sarcoidosis. AB - Pulmonary haemodynamics at rest and during exercise was studied in 30 patients with histologically confirmed sarcoidosis. All subjects were divided into three groups according to the stage of the disease assessed by radiological image of pulmonary lesions. At rest, in stage I and II patients, the mean pulmonary pressure (PAP) was normal. In stage III patients, a slight pulmonary hypertension was found. During exercise, a rise in PAP in stage I and II subjects was within the normal limits for a given workload, although in individual stage II subjects a rise in PAP was abnormally high. In all stage III patients a rise in PAP was pathologically elevated. PMID- 6494606 TI - Reduction of pulmonary function indices: comparison of two hierarchical methods. AB - From tests for evaluating pulmonary function many indices may be calculated. In order to reduce their redundancy, two hierarchical methods for selecting the most significant indices are applied to data collected on a group of 228 firemen. The first method consists in a stepwise linear discriminant analysis which selects the indices according to their discriminant value for distinguishing between asymptomatic and symptomatic subjects. The second one is derived from a stepwise multiple correlation procedure, which selects the indices on the basis of their linear relationships. These two methods lead to different results and the choice between them should be made according to the aims intended for data reduction. PMID- 6494607 TI - [Calculation of normal values in lung compliance]. AB - Within a study of standard values, investigations of the static and dynamic lung compliance were performed in 162 test persons in a good state of health of heart and lungs. Age, size, constitution, and intrathoracical gas volume are necessary parameters for calculation of an individual standard value of the dynamic compliance, whereas age and intrathoracical gas volume only are needed for calculation of a standard value of the static compliance. The new standard values are compared with the values known from the literature. PMID- 6494608 TI - Influence of a minimal surgical transection around the trachea on bronchoconstriction in cats. AB - The influence of a minimal surgical transection around the trachea on ACH- and allergen-induced bronchoconstriction was studied in a series of 21 cats. A significant smaller bronchoconstriction was observed after surgical transection around the trachea. The trachea isolation itself induced a smaller nonsignificant bronchoconstrictive response. This diminished response of the airways after this surgical intervention assumes an interruption of syncytial connections, which alters the response to bronchoconstricting stimuli of the whole bronchial system. The exact role of these syncytial connections has yet to be clarified. PMID- 6494609 TI - Functional effects of pneumonectomy and bilobectomy for lung cancer. AB - 28 patients with lung cancer had pulmonary function studies before and 3 months to 3 years after pneumonectomy or bilobectomy. Preoperative profiles showed a slight obstructive pattern with air trapping and perturbated gas exchange. The obstructive pattern was not related to endoscopy findings, but the alveoloarterial gradient oxygen gradient was smaller in those with complete lobar occlusion. After surgery, the volume loss was related to the amount resected, being greater after right pneumonectomy than after left pneumonectomy and least after bilobectomy. The obstructive pattern remained unchanged. Diffusion of carbon monoxide decreased significantly less than volumes after pneumonectomy but proportionally after bilobectomy. Those with increased alveoloarterial oxygen gradient or increased physiologic dead space experienced a significant improvement of their gas exchange after surgery. PMID- 6494610 TI - Pulmonary involvement in Sjogren's syndrome. AB - In this study we tried to value the frequency and the characteristics of the physiological abnormalities affecting the lungs in Sjogren's syndrome (SS). We studied 18 female nonsmokers (average age 53 years). The diagnosis has been made on the presence of at least two of the following abnormalities: keratoconjunctivitis sicca (Schirmer's test), xerostomia (scanning of the salivary glands, lip biopsy) and collagen vascular disease. We made the following tests: clinical examination, chest roentgenogram, spirometry, TGV, RAW and SAW valuation, study of the flow-volume curves, diffusion capacity test, bronchoalveolar lavage, bronchial biopsy. The physiological results have demonstrated the presence of a restrictive syndrome affecting above all the small airways (MEF25-32.7%) and a decrease of the diffusion capacity (DLCO-25%). There is, moreover, a constant lymphocytic infiltration of the bronchial mucosa and of the lung's interstitium. In conclusion the pulmonary involvement in SS seems to be constant, unpredictable and of remarkable clinical-physiological importance. PMID- 6494611 TI - Grass pollen allergoid. A 4-year follow-up study. AB - In an open comparative study with 31 grass pollen-allergic patients, two allergen extracts ('allergoid' extract/semi-depot extract) were examined. In the 1st year of treatment the allergoid group showed better results in relation to symptom score, drug consumption and IgG response, however, in the course of further treatment this difference was not evident anymore. Treatment was successful in both groups. A significant correlation between total antigen dose and IgG response was found. The better clinical results for the allergoid group in the first season after the 1st and 4th year of observation do indicate a better long term therapeutic effect compared to the semi-depot group. This finding probably is due to the much higher antigen dose (4-fold) in the allergoid group. PMID- 6494612 TI - Late prognosis of bronchial asthma in children. AB - The authors present data on the natural course of childhood bronchial asthma. They made a follow-up on 441 formerly asthmatic patients after the age of 14 years. The follow-up was based on questionnaires accompanied with personal interviews, physical examination, etc. The disease began in 167 (38%) patients before the age of 2; at the 'end' of childhood, at the age of 14, 34% were still asthmatic. In young adult age symptoms recurred in some cases and at the age of 26, 43% of the patients showed asthmatic complaints. The frequency of asthmatic attacks was significantly less in the young adults compared with that of childhood. Death occurred in 5 former patients, but only 2 of them died as a consequence of asthmatic disease. The authors constructed a diagram on the natural course of childhood asthma and show the practical use of this curve. PMID- 6494613 TI - Atropine resistance in asthma: definition and provisional hypothesis. AB - Out of a group of 55 asthmatics, 16 fitted the strict definition of atropine resistance (less than 20% FEV1 response to inhaled anticholinergic drugs, with a 20% or more FEV1 response to subsequent inhalation of beta 2-adrenergic stimulants). 26 were defined as atropine responsive in that they had a 20% or more FEV1 response to anticholinergic drugs. Significantly more atopic than non atopic asthmatics were in the atropine-resistant group (chi 2 = 6.12; p less than 0.025). Atropine resistance is not related to age. It is probably due to excessive vagal activity resulting from sensitization of vagal irritant receptors by antigen. Atropine resistance appears to be ameliorated by treatment with corticosteroid drugs or disodium cromoglycate. These features suggest a link between allergic and vagal components in asthma. PMID- 6494614 TI - The dyskinetic cilia syndrome in childhood. Modifications of ultrastructural patterns. AB - The syndrome of cilia dyskinesia is known as a heterogenous ciliary dysfunction caused by morphological defects of the dynein arms, the nexin links, the radial spokes and by the transposition of microtubules. Supernumerary tubules have been regarded as acquired morphological defects on the background of other bronchopathies. The report of a 9-year-old girl with the clinical signs of ciliary dyskinesis is considered to be an attribution to the clinical and pathological features of this syndrome. The girl's history of chronic bronchopulmonary infections and nasal polyposis resistant to therapy made her suspected to be ill of Kartagener's syndrome. The results of ultrastructural investigations of the mucosa from ciliated epithelium revealed a ciliary structural defect in the bronchi as well as in the nose and the sinuses with supernumerary microtubular doublets and singles, a decentration of the central tubules and shortened dynein arms. The regularity of the electron optical abnormalities implicates a systemic disorder of ciliated epithelium, which is to be summarized to the syndrome of cilia dyskinesis. PMID- 6494615 TI - [Tracheal stenosis in the cat: anatomopathologic repercussions on the pulmonary parenchyma]. AB - A calibrated stenosis of the trachea was performed in 6 young cats and 1 old one (TS cats); the animals were observed for 8 or 15 weeks thereafter. The percentage of macrophages in bronchoalveolar lavage fluid was greater in the TS cats than in the controls. An irregular distribution of pulmonary lesions was found. 4 TS cats presented with a real emphysema with tracheobronchial inflammation, a parenchymatous infection which was histologically shown or quantified in lavage fluid (Haemophilus (10(8]. They exhibited episodes of hypoventilation which followed in quick succession. The alveolar section of the TS emphysematous lung was equal or greater (up to 88% of the lung surface observed) than that of both the same-aged controls (81.5%) and of an old emphysematous cat (88 months). The alveoli were more homogeneous (lower deviation). TS lung was characterized by a higher amount of dry tissue protein but hydroxyproline varied individually. A possible synergy between infection and ventilatory obstruction may be a tentative explanation for the etiogeny of this emphysema which appears to be secondary to tracheal stenosis. PMID- 6494616 TI - Use of sulfur hexafluoride, SF6, in the management of the postpneumonectomy pleural space. AB - After a pneumonectomy in patients of advanced age with lung cancer, overinflation of the contralateral lung causes a further emphysematous change. This aggravation of emphysematous disturbances occasionally leads to serious cardiopulmonary dysfunctions. Therefore, we have devised a new therapeutic method which consists in injecting sulfur hexafluoride, SF6, an inert gas, into the postpneumonectomy pleural space so as to maintain the chest cavity. As SF6 gas is slowly absorbed through the pleura, gas injection at intervals of 6 months can maintain a clear pleural space with neither retention of pleural effusion nor deformity of the thorax. As a result, in 23 patients who were treated by this method, overinflation of the contralateral lung after unilateral pneumonectomy could be prevented, and respiratory functions could be improved, i.e., the vital capacity increased about 20% and the residual volume decreased over 20% after SF6 gas injection. All patients have been in good condition of their performance status, and it was not disadvantageous to continue the SF6 gas injection for a long term such as several years. PMID- 6494617 TI - Restoration of pulmonary functions after reinflation in chronic atelectasis. AB - Recovery of the lungs after the reinflation of chronic atelectasis was studied experimentally using adult dogs. Obstructive absorption atelectasis was induced by banding the left main bronchus with a thin metallic plate. Tests were conducted 1 month after reinflation of the lungs. In the group of dogs which had suffered atelectasis for 3 months, static compliance and pulmonary blood flow were decreased by half at 1 month after reinflation; the conditions of reduced PO2, increased A-aDO2, and increased shunt flow rate in the affected lung persistently continued, and histological findings also showed collapse of the majority of alveoli and dilatation of the peripheral bronchioli, while macroscopically the lungs appeared to be aerated. It was therefore assumed that further aeration of the alveolar areas was impossible. The pulmonary function of the dogs within 1 month of atelectasis was restored to the same degree as that of the control group. PMID- 6494618 TI - Lung mechanics in orally immunized mice after aerolized exposure to influenza virus. AB - A method is described which allows the investigation of lung mechanics during artificial ventilation in live mice. Inhalation of nebulized influenza virus (A/PR/8/34, H1N1) decreased in NMRI mice compliance (means = 0.012 ml/cm H2O, n = 18) due to severe virus pneumonia and edema on days 5-7 after infection. In comparison to noninfected controls (means = 0.029 ml/cm H2O, n = 17) compliance was unchanged in infected, but orally immunized mice (means = 0.030 ml/cm H2O, n = 21). The results demonstrate that decreased compliance due to influenza virus pneumonia can be prevented by oral immunization with influenza viruses. PMID- 6494619 TI - Prediction of pulmonary hypertension from postural changes of pulmonary transfer factor. AB - The differences between lung transfer factor values measured in supine and standing positions were correlated with pulmonary artery pressures in 61 patients with chronic obstructive lung disease and in 34 patients with recurrent pulmonary embolism. No significant correlation was found. The postural change of transfer factor cannot be used as a noninvasive indicator of pulmonary artery pressure in these diseases. PMID- 6494620 TI - [Influence of chronic smoking on leukocytes]. AB - The authors showed a significant increase in total leukocyte count (2p less than 0.001), neutrophil concentration (2p less than 0.001) and lymphocyte concentration (2p less than 0.01) in 21 chronic smokers compared to 22 non smokers. However, only the total leukocyte count and the neutrophil count proved to be correlated to carboxyhemoglobin saturation. Slightly different hypotheses are proposed to explain the increase in leukocyte count: the carbon monoxide and/or the carboxyhemoglobin acts directly on peripheral blood leukocytes or indirectly, via the adrenalin secretion. The average leukocyte count in smokers corresponds to the upper borderline in nonsmokers; therefore, it seems pertinent to take into consideration the number of cigarettes smoked per day when assessing a smoker's leukocytosis. PMID- 6494621 TI - Respiratory function in normal Chinese: comparison with Caucasians. AB - We found that respiratory measurements in Chinese visitors to Colorado differed from those in height- and weight-matched Western residents of Denver, Colo., in the following ways (p less than 0.05): The Chinese had higher respiratory frequencies (15.5 +/- 0.93 vs. 11.4 +/- 0.85 breaths/min), lower tidal volumes (530 +/- 35.9 vs. 693 +/- 477.7 ml), lower alveolar ventilation (4.0 +/- 0.15 vs. 4.7 +/- 0.21 liters), lower forced vital capacities (4.53 +/- 0.16 vs. 5.43 +/- 0.12 liters), lower total lung capacities (6.25 +/- 0.26 vs. 7.16 +/- 0.17 liters), higher resting PaCO2 (36.3 +/- 0.94 vs. 33.6 +/- 0.74 Torr) and lower pHa (7.406 +/- 0.004 vs. 7.419 +/- 0.004). The Chinese also had lower ventilatory responses to CO2 (1.40 +/- 0.10 vs. 2.00 +/- 0.201/min/mm Hg) than did the Caucasians. The measurements made in the Chinese in Denver were similar to those reported for Chinese in China. Thus there may be differences in respiratory function between normal Chinese and normal Western subjects. PMID- 6494622 TI - [Contribution of nocturnal polygraphy to the diagnosis of Pickwickian syndrome. 10 cases]. AB - The authors studied a series of 10 obese patients with respiratory failure referred for treatment because of sleep disorders and diurnal, sometimes uncontrollable, episodes of somnolence. 8 parameters were recorded in the polygraphic study performed during a night of hospitalization: electroencephalogram, electrocardiogram, electro-oculogram, chin electromyogram, thoracic movements, and nasal and buccal air flows. SaO2 and transcutaneous PO2 were recorded simultaneously. A sleep apnea syndrome was diagnosed in 6 of the 10 patients, whose apnea index was markedly above the limit of 5 apneas per hour. The apnea index was below 5 in the other 4 patients. Most patients with sleep apnea syndrome suffer from obstructive apneas of varying duration taking up as much as 48% of total sleep time. The cardiorespiratory effects of these events are apparent, with a drop in PO2 and SaO2 and a decrease in heart rate at the end of apnea. Polygraphic studies seem useful in the diagnosis of the pickwickian syndrome. They allow the type of apnea and its effects to be specified and thus guide treatment. PMID- 6494623 TI - Pulmonary emphysema and the crossover point. AB - In 13 healthy subjects and 34 patients with chronic obstructive lung disease (COLD) (23 patients without and 11 patients with emphysema) the breath number at crossover point, using He and SF6 as test gases, and some pulmonary functions (spirometry, body plethysmography and washout curves) were investigated. Although the patients with emphysema did show a more severely impaired lung function than the patients without emphysema, no clear lung function pattern for patients with emphysema was demonstrated in comparison to the patients without emphysema. The pattern of the breath number at crossover point was unpredictable. Most probably this breath number is more related to the severity of impaired gas mixing than to the degree of emphysema. So the clinical diagnosis of emphysema in patients with COLD remains difficult, in spite of the use of advanced technology for fast and accurate analysis by mass spectrometry. PMID- 6494624 TI - Maximal ventilation at rest and exercise in patients with chronic pulmonary disease. AB - 74 subjects of different ages: normal children, 19 boys (A) and 7 girls (C) aged between 11 and 15 years; asthmatic boys (n = 7, group B) and girls (n = 7, group D), with similar ages; normal male adult subjects (n = 10, group E) and pulmonary patients with restrictive (n = 8, group G) or obstructive (n = 16, group F) ventilatory impairment, were submitted to measurements of vital capacity (VC), forced expiratory volume in 1 s, (FEV1), maximal voluntary ventilation (MVV), maximal peak expiratory (PEF) and inspiratory (PIF) flows at rest, and two maximal exercise stress tests in which the ventilation at maximal exercise (MEV) were retained. Indirect MVV was obtained by multiplying the FEV1 by 35 and 37.5. The correlation coefficients between MVV and VC, FEV1, PEF and PIF were always as high as r greater than 0.76. (p less than 0.001), with a discrepancy between the calculated and measured MVV. The average ratio MVV/FEV1 always exceeds 39 and is much higher in groups B, C and G. The mean percent values of the ratio MEV/MVV were 0.63 in normal men and 0.74 in normal boys. In patients, this ratio is higher than in adult normals: F = 0.81 and G = 0.88, and is not due to methodological errors, but seems to correspond to several physiological features playing only a role during exercise (MEV). This work shows the difficulty in predicting correctly the MVV at rest and in assessing the ventilatory reserve during maximal exercise in chronic pulmonary patients. PMID- 6494625 TI - Xerotrachea and interstitial lung disease in primary Sjogren's syndrome. AB - 22 patients with primary Sjogren's syndrome were prospectively studied for respiratory system involvement with clinical, roentgenological and functional parameters. 12 patients (55%) had respiratory manifestations. In 10/12 (83%), respiratory symptoms occurred before or concomitantly with the classical symptoms of Sjogren's syndrome. There were two distinct forms of respiratory involvement: xerotrachea, manifested by dry cough without other symptoms and negative roentgenological and functional evaluation and diffuse interstitial lung disease manifested by dyspnea with or without dry cough with bibasilar rales, compatible chest roentgenogram, restrictive pattern in spirometry and/or hypoxemia. Xerotrachea was more common in patients with glandular form of Sjogren's syndrome (3/10) and diffuse interstitial lung disease in patients with extraglandular form (6/12). None of the 22 patients had pleurisy or other forms of respiratory involvement. Antibodies to Ro (SSA) and La (SSB) antigens were more common in patients with the extraglandular form of the syndrome but did not correlate with diffuse interstitial lung disease. PMID- 6494626 TI - Complex thoracic fistula in hereditary hemorrhagic telangiectasia. AB - Pulmonary arteriovenous fistula are not an uncommon finding in hereditary hemorrhagic telangiectasia; however, systemic pulmonary fistulas are exceptional. A case, characterized by its complex anatomical constitution, is described; the right suprascapular artery is the afferent systemic vessel and the efferent systemic and pulmonary drainage network sprung from a cirsoid aneurysmal tangle. The reasons for the development of the fistula are uncommon and probably multifactorial. Clinical diagnosis and management problems are discussed. PMID- 6494627 TI - Uncontrollable life-threatening status asthmaticus--an indicator for termination of pregnancy by cesarean section. AB - Two pregnant women with severe status asthmaticus unresponsive to intensive medical treatment are reported. Termination of pregnancies by cesarean section was followed by a dramatic improvement within 24 h. Termination of pregnancy is indicated in life-threatening status asthmaticus. PMID- 6494628 TI - Lung cancer in patients with tracheostomy due to cancer of the larynx. AB - During 3 years, a prospective study was undertaken to investigate the frequency of lung cancer (LC) in patients with a tracheostomy after laryngectomy for neoplasm of the larynx (LxC). The protocol required a thorax radiography (RX) and a bronchofiberscopy (BF) every 6 months in each patient. Of the 286 cases studied, a diagnosis of LC was made in 36 (12.5%). In 6 of these 36 patients, there were no symptoms suggestive of LC and the RX was normal, and the diagnosis of LC was made only by systematic BF. A surgical treatment of LC was possible in only 7 cases. These results suggest that there is a high frequency of LC in patients with tracheostomy due to LxC, and also that it would be better to restrict the follow-up with systematic BF to those patients suitable for thoracotomy. PMID- 6494629 TI - Variability of peak expiratory flow rate as a prognostic index in asymptomatic asthma. AB - The prognostic relevance of an enhanced variability of peak expiratory flow rate (PEFR) throughout the day was evaluated in asthmatics in remission: it was expressed as the coefficient of variation (CV) of values recorded 4 times daily for 2 weeks. Outcome at 3, 6, and 12 months was assessed in 2 groups of 16 patients each, differing because of a CV respectively higher (group A) and lower (group B) than 8%. A significantly higher frequency of abnormal PEFR values during the subsequent 3 months was recorded in patients of group A, and found as correlated to the magnitude of CV; in the same group a significantly worse clinical status--scored on the basis of response to treatment--was pointed out. Therefore, a high CV of PEFR may be assumed as a reliable indicator of the risk of exacerbation--not otherwise predictable--both in a short and a longer term; on this basis home monitoring of PEFR may be recommended as a useful tool in the evaluation of all the cases of asthma in remission. PMID- 6494630 TI - Treatment of retinal detachments due to macular holes. AB - The authors successfully treated seven consecutive cases of retinal detachment due to macular holes using vitrectomy, an intravitreal bubble, and postoperative prone positioning. In five cases with preoperative posterior vitreous detachment, laser photocoagulation was applied to the edges of the macular hole after the retina had been flattened. No photocoagulation was used in the two cases without preoperative posterior vitreous detachment. PMID- 6494631 TI - Atopic dermatitis. Retinal detachment associated with atopic dermatitis. AB - Retinal detachments occurred in six eyes of five patients suffering with atopic dermatitis. Retinal detachments occurred before cataract surgery in all but one eye. In each eye, a retinal dialysis was the cause of retinal detachment. Detachment of ciliary epithelium was present in five eyes and pars plana cysts were found in one eye. Retinal dialysis was one of the commonest features of retinal detachment associated with atopic dermatitis. PMID- 6494632 TI - Retinal angiomatous mass. A complication of retinal detachment surgery. AB - Retinal angiomatous masses were observed as a very late complication in four patients following scleral buckling procedures with drainage of subretinal fluid. The lesions manifested 5-19 years after the original surgical procedure, and the presenting complaint was decreased vision secondary to vitreous clouding. In three patients a vascularized retinal mass greater than 3 disc diameters in size was observed at the site of choroidal perforation for drainage of subretinal fluid. A fourth patient demonstrated a similar lesion in the location of a suture used to anchor the encircling element, possibly the point of accidental choroidal perforation. Three of the four patients were treated by photocoagulation or cryocoagulation with cicatrization of the angiomatous mass and obliteration of the vascular net. This resulted in clearing of vitreous opacities and subretinal exudates, with restoration of vision to a level prior to the onset of symptoms. PMID- 6494633 TI - Treatment of idiopathic exudative retinal detachment. AB - Three patients with idiopathic exudative retinal detachment are presented. Fluorescein angiography and/or angioscopy was used in each case to demonstrate an area of leakage from the choroid into the subretinal space, accounting for the detachment. The leakage sites were treated by cryopexy or photocoagulation, resulting in reattachment of the retina in each case (four eyes). This method of examination and treatment should be considered in all cases of idiopathic exudative retinal detachment. PMID- 6494634 TI - Reduction of immediate complications after panretinal photocoagulation. AB - With the use of either argon laser or xenon arc panretinal photocoagulation, 42 eyes with diabetic retinopathy were treated in two or more sessions at least 2 weeks apart. In the week following completion of photocoagulation, choroidal detachment was noted in 34 eyes (81%), shallowing of the anterior chamber in 16 eyes (38%), exudative retinal detachment in 5 eyes (12%), and increased intraocular pressure in 3 eyes (7%). These complication rates are lower than those reported in a similar series of 50 eyes in which panretinal photocoagulation was completed in 1-3 days. PMID- 6494635 TI - Crystalline retinopathy. AB - A 52-year-old Japanese woman had retinal crystalline deposits with atrophy of the pigment epithelium and choriocapillaris and pigment clumps in the periphery. The patient did not have corneal crystals. The crystals were seen biomicroscopically in all layers of the retina and on the retinal vessels. The diagnosis of crystalline retinopathy was made. The progressive nature of the disease was confirmed, based on a 9-year follow-up. The authors reviewed this condition in the Japanese literature and believe that crystalline retinopathy may not be as rare in the Orient as previously thought. PMID- 6494636 TI - Retinal S antigen reactivity in patients with retinitis pigmentosa and Usher's syndrome. AB - Cell-mediated immunity to retinal antigens as determined by in vitro assays has been detected in a variety of retinal degenerative and retinal destructive conditions. The authors studied the in vitro reactivity to the soluble retinal S antigen of peripheral blood mononuclear cells from patients with simplex and multiplex retinitis pigmentosa (RP) and Usher's syndrome along with normal controls. The cellular stimulation index (SI) was calculated by comparing 3H thymidine incorporation in cells exposed to either purified S antigen, crude whole human retinal antigen, or human choroidal antigen with that in unstimulated control cultures. Eight of 15 patients with RP and 5 of 6 with Usher's had a SI greater than the tolerance limits of normal values. These results indicate that the immune system may be involved either primarily or secondarily in RP. PMID- 6494638 TI - [Embolization technic in cerebral arteriovenous malformation]. PMID- 6494637 TI - A shorter scleral needle. AB - A scleral needle for retinal detachment surgery, which has a shorter length than has previously been available, has been developed. This shorter length makes the passage of the needle easier in the limited space available posterior to the equator of the eye. PMID- 6494639 TI - [The reference point of the central venous pressure]. PMID- 6494640 TI - [Clinical significance of U-wave inversion during attacks of variant angina]. PMID- 6494641 TI - [Studies on various factors affecting the body plethysmographic pressure-flow diagrams using a simulation method]. PMID- 6494642 TI - [Clinical findings and prognosis of aortitis syndrome associated with pulmonary vascular disease]. PMID- 6494643 TI - [Limit of the reversibility of the left ventricular function after aortic valve replacement for aortic regurgitation]. PMID- 6494645 TI - Modulation of haemocyanin oxygen affinity in the intertidal prawn Palaemon elegans (Rathke). AB - The modulation of haemocyanin oxygen affinity was studied at 10 degrees C in the blood of the intertidal prawn Palaemon elegans. On increasing the L-lactate concentration in dialysed blood from 0 to 9.1 mM, P50 decreased from 27 to 11 torr at pH 7.8. Undialysed blood exhibited a higher oxygen affinity than dialysed blood with the same lactate concentration indicating the presence of an unidentified factor which increased oxygen affinity. After dialysis both winter and summer blood exhibited the same intrinsic oxygen affinity and response to lactate. The response of oxygen affinity to lactate was exponential, low concentrations of lactate (0-5 mM) markedly increasing oxygen affinity. The lactate effect in dialysed blood expressed as delta logP50/delta log[L-lactate] was -0.56 at pH 7.8 and -0.63 at pH 7.4. The effect of lactate on oxygen affinity, delta P50, was similar in dialysed and whole blood. The effect of the unidentified factor (delta P50, between dialysed and undialysed blood) at the same lactate concentration was 13.1 and 15.1 torr at pH 7.8 in winter and summer blood, respectively. At pH 7.4 the delta P50 was 38 torr for both summer and winter blood. Differences in oxygen affinity between blood collected in summer and winter could be explained by differences in blood lactate concentrations. PMID- 6494644 TI - [Effects of Ca++-antagonist (nicardipine) on advanced A-V block--efficacy of Ca++ antagonists]. PMID- 6494646 TI - Skeletal muscle capillary supply in a fish that lacks respiratory pigments. AB - The relationship between capillary density and mitochondrial volume density has been investigated for the slow trunk muscle of the haemoglobinless 'Icefish', Chaenocephalus aceratus Lonnberg. In general, for teleost slow muscles capillary densities, NA(c,f), are positively correlated with mitochondrial volume densities, Vv(mit,f). However, the capillary density for the slow trunk muscle of the Icefish is low (544 +/- 24 capillaries/mm2) when compared with teleosts of similar mitochondrial volume densities (0.34 +/- 0.01). For example, for slow muscle fibres in Saithe (Pollachius virens) Vv(mit,f) is 0.35 +/- 0.02 but the capillary density is 4507 capillaries/mm2. Estimates of capillary surface and volume densities for the Icefish (198 and 0.035 cm-1, respectively) are in the range reported in the literature for other teleost species. Thus, for C. aceratus NA(c,f) provides a relatively poor index of the functional properties of the peripheral exchange vessels. Mean capillary cross-sectional area for C. aceratus (64 +/- 7 micron2) was two to three times greater than that found in most teleost species. The low peripheral resistance reported for the Icefish, C. aceratus is therefore the result of the presence of large bore capillaries, the resulting high flow rates also allowing the maintenance of favourably high capillary - tissue PO2 gradients. PMID- 6494647 TI - The split-respiratory centre in the cat: responses to hypercapnia. AB - In 22 cats anaesthetized with halothane, vagotomised, paralyzed with d tubocurarine and artificially ventilated, the medulla was split in the midline and the response of phrenic motoneurones, efferent vagus nerve and medullary respiratory neurones to hypercapnia was studied. In 18 successful experiments the mid-sagittal incision abolished all electrical activities but an inhalation of a 5% CO2-oxygen mixture promptly restored rhythmic firing in both the medullary units and efferent nerves when PaCO2 reached 55 mm Hg on the average (mean pH = 7.20). Switching the ventilation back to normocapnia was followed by a gradual disappearance of the activities usually when PaCO2 and pH returned to control values. We conclude that splitting the brainstem in cat affects the respiratory rhythmogenesis, presumably by increasing the CO2-threshold of medullary respiratory neurones. PMID- 6494648 TI - Loss of peripheral chemoreflexes to hypoxia after carotid body removal in the rat. AB - Young Sprague-Dawley female rats (16-18 days old) were subjected to bilateral carotid glomectomy or the sham operation under halothane anaesthesia. After recovery, the rats were placed with non-operated peers. One to six months later glomectomised, sham-operated and control animals were anaesthetized with sodium pentobarbital. Respiratory minute volume and arterial pressure were recorded. Respiratory responses to few-breath administration of oxygen or nitrogen, and arterial pressure responses to carotid occlusion or tugging were tested. Oxygen produced transient hypoventilation and nitrogen transient hyperventilation in control, sham and 3 of 31 glomectomised rats. Bilateral vagotomy did not abolish these responses. In only those 3 glomectomised rats was carotid glomus tissue histologically identifiable. Carotid occlusion raised and tugging lowered arterial pressure in all animals. Glomectomy did not affect serum levels of GH, FSH, LH or PRL hormones but produced right ventricular hypertrophy. We conclude that peripheral chemoreception requires the presence of glomus tissue. PMID- 6494649 TI - Effects of expiratory threshold loading on thoracoabdominal motion in cats. AB - Expiratory muscle activity may alter rib cage and abdominal configuration at end expiration and thereby affect the pattern of thoracoabdominal motion during subsequent inspiration. In this study, expiratory muscles were stimulated by the application of a series of expiratory threshold loads (ETL) (range: 0 to + 10 cm H2O) in 10 cats lightly anaesthetized with pentobarbitone. Thoracoabdominal motion was monitored by inductance plethysmography. Peak internal intercostal and abdominal muscle electrical activity increased proportionately with the magnitude of the ETL, suggesting comparable activation of both expiratory muscle groups. Increases in end-expiratory abdominal volume, however, were greater than increases in end-expiratory rib cage volume, during ETL. This resulted in a shift of the end-expiratory thoracoabdominal position to the right of the relaxation characteristic. During ETL, there was inward movement of the abdomen in early inspiration and this decrease in abdominal volume correlated closely with the change in end-expiratory abdominal volume and the magnitude of the ETL (mean r = 0.95, P less than 0.01). In three animals, sectioning the abdominal muscles resulted in a further increase in end-expiratory abdominal volume for a given ETL. Deepening anesthesia progressively reduced and eventually abolished expiratory muscle activation and under these conditions, ETL increased end expiratory rib cage and abdominal volume along the thoracoabdominal relaxation characteristic. The results of this study indicate that while abdominal muscle activation acts to decrease abdominal volume at end-expiration, the action of the expiratory intercostal muscles predominates during ETL to produce a smaller rib cage volume at the expense of an enlargement of abdominal volume. PMID- 6494650 TI - Stimulus-response curves of the lung inflation cardio-depressor reflex. AB - In order to determine the relationship between extent of lung expansion and reflex depression of cardiovascular function in dogs, we used a preparation in which the left lung, isolated in situ, was subjected to a series of inflations ranging between 5 and 55 cm H2O (60 and 800 ml) before and following left cervical vagotomy. The threshold level of left lung inflation that would cause bradycardia and hypotension was 15 cm H2O transpulmonary pressure (63 ml) when the preceding level of inflation pressure was lower, and 10 cm H2O (102 ml) when the preceding level was higher. Increasing inflation pressure and volume above threshold produced a graded fall in heart rate and blood pressure until maximum expansion was reached at 40 cm H2O (778 ml). Maximum expansion caused a transient 45% fall in heart rate and 30% fall in blood pressure. Division of the ipsilateral (left) cervical vagosympathetic trunk eliminated these responses to unilateral lung inflation confirming the predominant, if not exclusive, afferent pathways. These data suggest that the lungs, as a function of the degree of expansion, impart a control over the neural regulation of the cardiovascular system. PMID- 6494651 TI - Metabolic hydrolysis of isoniazid by subcellular fractions of rat liver. AB - The characteristics of isoniazid amidase which hydrolyzes isoniazid to isonicotinic acid and hydrazine was examined in vitro using rat liver subcellular fractions. The activity of isoniazid amidase was estimated from the amount of hydrazine produced from a substrate, isoniazid, by means of GC-MS. High activity of the amidase was observed in the microsomal and lysosomal fractions, and at pH 7.4-7.8 in the microsomal fraction. The amidase was not inhibited by acetanilide, but by procaine and bis(p-nitrophenyl)phosphate. As expected, acetylisoniazid, a main metabolite of isoniazid, also inhibited the amidase. Not only the microsomal monooxygenase but also amidase was strongly induced by pretreatment with phenobarbital, 3-methylcholanthrene and rifampicin, respectively. PMID- 6494652 TI - [An experiential learning course on teaching humanistic skills to medical students--effect on empathy and regard for others]. AB - The "humanization" of medical practice is regarded as one of the topics of present day medicine. A number of models and educational programs for teaching humanistically oriented medicine has appeared, but few studies have been done to illustrate the effects of such programs. In the present paper, the authors report a study that they conducted in which the effects of participating in a seminar on counseling skills were demonstrated. The subjects were 11 first and second year medical students who took part in an elective course in medical humanities, in which counseling skills, active listening and experimental focusing were taught. The class met for 10 sessions every other week, in which students were exposed to these techniques. On weeks when the class did not meet, students practiced these techniques in pairs among themselves. At each of these sessions, students filled out a relationship scale and recorded the session into a cassette tape. Furthermore, students filled out personality tests at the first and last class. A comparison of the results of the relationship scale between the first and last session showed a significant increase in the students' ability for empathy (P less than 0.02) and for unconditional positive regard (P less than 0.02). Not enough personality tests were handed in at the last class to provide a useful comparison. Tapes of the sessions are currently being investigated in another study using a different measurement. The authors discuss the need for such experimental courses for medical students to overcome the Cartesian view of seeing others as "objects" and for developing humanistic ways of relating to other persons. PMID- 6494653 TI - [Chronic dacryocystitis cured by probing of the duct]. AB - A seven-year-old case with chronic dacryocystitis resulting from congenital obstruction of the nasolacrimal duct was cured not by a dacryocystorhinostomy but by probing of the duct. Our results show that even in case of planned dacryocystorhinostomy, probing of the duct should be performed at least once. PMID- 6494654 TI - [Preleukemic (or myelodysplastic) syndromes]. PMID- 6494655 TI - [Prognostic factors following severe cranial injuries]. PMID- 6494656 TI - [Role of the general practitioner in the treatment of the cancer patient]. PMID- 6494657 TI - [Dupruyten's disease: results of a simplified technic]. PMID- 6494658 TI - [Free and pedicled flaps in face and neck surgery]. PMID- 6494659 TI - [Review of 250 breast reconstructions after mastectomy]. PMID- 6494660 TI - [A new chronology in the treatment of lip and palatal clefts]. PMID- 6494661 TI - [Microsurgery, a basic surgical technic]. PMID- 6494662 TI - [Vasomotoricity of the pulmonary circulation]. PMID- 6494663 TI - [Practical problems in urodynamics. II. The clinician's viewpoint]. PMID- 6494664 TI - [Results in the medical treatment of peptic esophagitis]. PMID- 6494665 TI - Functional organization of mouse and rat SmI barrel cortex following vibrissal damage on different postnatal days. AB - This study was undertaken to determine the functional properties of neurons in the anatomically altered somatosensory cortex after neonatal whisker damage. In mice and rats neonatal lesions of the facial vibrissae change the anatomical organization of barrels in the contralateral SmI cortex. These changes depend on the pattern and severity of the peripheral damage and the developmental age of the animals. To understand some of the functional correlates of these anatomical changes, the middle row of vibrissae (row C) was damaged in mice on postnatal days 1, 3, and 5 and in rats on postnatal days 1 and 5. The receptive field properties of single cortical units were studied after the animals matured. In 24 mice and 15 rats a total of 1,370 units were characterized in microelectrode penetrations which passed through the somatosensory cortex either tangential or perpendicular to the pia. Units were localized anatomically with respect to both barrel and laminar boundaries, and the extent of the peripheral damage was assessed histologically. The data revealed an orderly representation of the sensory periphery that coincided with the altered cytoarchitectonic organization of the SmI cortex. Specifically: (1) Units in the enlarged row B or row D barrels responded primarily to row B or row D whiskers. (2) In layer IV, units in the altered row C cortex either could not be reliably driven from the periphery, were activated by stimulation of scar tissue in the damaged facial row C, or were driven by adjacent, intact row B or row D whiskers. (3) Units in supra- and infragranular layers either had no row C representation or incorporated scar tissue in their receptive fields in a topographically correct fashion. Responses of units to stimulation of scar tissue were qualitatively similar to those elicited from intact vibrissae, which also activated them. (4) In SmII, units that responded to whiskers had receptive fields whose organization matched the representation of the periphery observed in SmI. (5) There was no mapping of nonmystacial pad structures in the barrel cortex, and there were no units with abnormal multiwhisker interactions when laminar boundaries were taken into account. These data indicate that neonatal damage to the whiskers alters both the anatomical arrangement of the barrels and the physiologically determined somatotopic representation of the sensory periphery in a parallel and predictable fashion. PMID- 6494666 TI - Electrophysiology of raccoon cuneocerebellar neurons. AB - Electrophysiological experiments were undertaken in order to locate and functionally characterize cells of the raccoon main cuneate nucleus (MCN) that can be activated by electrical stimulation of the cerebellum. A total of 98 such units were studied in pentobarbital sodium-anesthetized, methoxyflurane anesthetized, or decerebrate preparations. Aside from a greater likelihood of resting discharge in the decerebrate preparations, no appreciable variability in physiological properties of the neurons could be attributed to differences in the type of preparation. Using constant latency of response and ability to be blocked by collision as principal criteria, both antidromically (n = 31) and synaptically (n = 67) activated neurons of the main cuneate nucleus could be identified. A small number of MCN neurons could be activated by both cerebellar and thalamic stimulation, but no unit was antidromically activated from both locations. MCN neurons projecting to the cerebellum are located primarily in the ventral polymorphic cell region of the nucleus at and rostral to the obex, corresponding to the "medial tongue" region of Johnson et al. (1968). In contrast, neurons synaptically activated from the cerebellum are found throughout the dorsoventral extent of the rostral MCN, including the "clusters" region. The majority of antidromically activated units responded to mechanical stimulation of deeper tissues, and most of these were activated by muscle stretch. Only a small portion (13-15%) of either antidromically or synaptically activated units were classed as light touch units with peripheral receptive fields (RFs) restricted to glabrous surfaces of the forepaw. Glabrous skin RFs located on the digital surfaces are smaller than those located on the palm pads. In both cases, RFs are larger than those associated with primary afferent fibers, but toward the low end of the distribution for MCN neurons not activated by cerebellar stimulation. All MCN units activated by cerebellar stimulation, regardless of modality, respond to mechanical stimulation with trains of irregularly spaced single spikes. Glabrous skin cutaneous mechanoreceptive MCN neurons, whether rapidly or slowly adapting, respond to ramp indentations with an instantaneous frequency which may be described as a power function of ramp velocity, with exponents less than one. These values are in the same range as those previously reported for primary afferents of the cuneate fasciculus (Pubols and Pubols, 1973). PMID- 6494667 TI - Fine structure of subepithelial "free" and corpuscular trigeminal nerve endings in anterior hard palate of the rat. AB - Axonally transported protein labeled many trigeminal nerve endings in subepithelial regions of the anterior hard palate of the rat. Sensory endings were most numerous in the lamina propria near the tips of the palatal rugae where large connective tissue and epithelial papillae interdigitated. Two kinds of sensory ending were found there: "free" endings, and a variety of corpuscular endings. The "free" sensory endings consisted of bundles of unmyelinated axons separated from the connective tissue by relatively unspecialized Schwann cells covering part or all of their surface and a completely continuous basal lamina; they were commonly found running parallel to the epithelium or near corpuscular endings. The corpuscular sensory endings all had a specialized nerve form, specialized Schwann cells, and axonal fingers projecting into the corpuscular basal lamina or connective tissue. There were at least four distinct types of corpuscular ending: Ruffini-like endings were found among dense collagen bundles, and they had a flattened nerve ending with a flattened Schwann lamella on either side. Meissner endings had an ordered stack of flattened nerve terminals with flattened Schwann cells and much basal lamina within and around the corpuscle. Simple corpuscles were single nerve endings surrounded by several layers of concentric lamellar Schwann processes. Glomerular endings were found in lamina propria papillae or encircling epithelial papillae; they were a tangle of varied neural forms each of which had apposed flattened Schwann cells, and a layer of basal lamina of varied thickness. Fibroblasts often formed incomplete partitions around Meissner and simple corpuscles. The axoplasm of all kinds of subepithelial sensory endings contained numerous mitochondria and vesicles, as well as occasional multivesicular bodies and lysosomes; the axoplasm of all endings was pale with few microtubules and neurofilaments. The specialized lamellar Schwann cells had much pinocytotic activity. Four kinds of junctions were found between the corpuscular sensory endings and the lamellar Schwann cells: (1) symmetric densities that resemble desmosomes; (2) asymmetric densities with either the neuronal or glial membrane more dense; (3) neural membrane densities adjacent to Schwann parallel inner and outer membrane densities; and (4) sites of apparent Schwann endocytosis associated with neural blebs. The "free" sensory endings only made occasional desmosome-like junctions with their Schwann cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6494668 TI - Effects of cytotoxic deletions of somatic sensory cortex in fetal rats. AB - Pregnant rats were injected on the 14th day of gestation with the cytotoxic drug methylazoxymethanol acetate. This compound causes the death of neural precursor cells that were synthesizing DNA at the time of injection. After birth, the progeny of treated mothers grew to maturity with a neocortex that was greatly reduced in area by the death of all cells, particularly at the frontal and occipital poles but at medial and lateral margins of neocortex as well. In the remaining cortex layers II through IV failed to develop. The experiment deprived growing thalamocortical axons, which innervate the somatic sensory cortex late in development, of part of their normal target area and of a substantial number of their definitive target cells. It also deprived them of any cues they might have received from these target cells migrating through them as the axons accumulate beneath the cortical plate. Anatomical experiments indicated that, despite these defects, thalamocortical axons could still colonize the sensorimotor areas and form synapses in their typically bilaminar pattern, though the outer, denser lamina of terminations occurred abnormally at the level of the apices of layer V pyramidal cell bodies. Receptive field mapping of single and multiunit responses in the somatic sensory region showed brisk responses and receptive fields of normal size. It also indicated the formation of a body map that was topographically intact except for deletions at its periphery; that is, a total map was not compressed into a smaller area. This suggests that somatic sensory thalamocortical fibers recognize only remaining cortical target cells in appropriate fields. Moreover, successful ones among them seem to recognize neighborhood relations and conserve synaptic space at the expense of those that would have innervated the deleted peripheral parts of the area. Pyramidal neurons in the remaining cortical layers and in ectopic islands of cells that had incompletely migrated from the neuroepithelium, probably on account of destruction of radial glial cell precursors, were shown by retrograde labeling to send their axons only to appropriate subcortical targets. Pyramidal neurons, though recognized as such, also adopted a variety of abnormal orientations, such as inversion, apparently in an attempt to grow apical dendrites toward major zones of synaptic terminations. PMID- 6494669 TI - Glutamic acid decarboxylase-containing neurons in the dorsal column nuclei of the cat. AB - The retrograde transport of horseradish peroxidase (HRP) and immunocytochemistry for glutamic acid decarboxylase (GAD) have been employed to examine whether local circuit neurons (LCNs) exist in the dorsal column nuclei (DCN) and whether these neurons may be GABA-ergic. Observations focused on the dorsal part of the middle cuneate nucleus (MCd), since this region has been previously shown to contain projecting neurons whose axons terminate almost exclusively in the contralateral thalamus. After large injections of HRP in the nucleus ventralis posterolateralis and surrounding structures of the feline thalamus, the majority of neurons in MCd are labeled. These represent about 89% of the neurons in MCd as counted in 40 microns frozen sections, and about 69% as counted in plastic-embedded, 2.5 microns-thick section. Unlabeled by the same injections are some medium to large neurons at the dorsal rim of MCd, and many characteristically small (mean = +/- 250 microns2) neurons at the periphery of the cell clusters formed by thalamic projecting neurons. These small neurons represent 10-12% of the neuronal population of MCd, as counted in 40-microns-thick frozen sections, and about 30%, as counted in plastic-embedded, 2.5-microns-thick sections. Neurons in this size range are also unlabeled after injection of retrograde tracer in the pretectal area, inferior and superior colliculi, inferior olivary complex, and/or spinal cord. These injections, however, result in the labeling of neurons along the dorsal rim of MCd and/or in other regions of the cuneate nucleus. In adult, colchicine-treated cats, the use of anti-GAD serum reveals a population of labeled neurons uniformly distributed throughout the DCN. In MCd, these are small (mean = +/- 235 microns2) neurons mainly intercalated between cell clusters, and represent about 25% of the neuronal population of this nuclear subdivision as counted in plastic-embedded, 2.5-microns-thick sections. Labeled processes densely infiltrate the cell clusters, and labeled varicosities appear to cover the soma and dendrites of unlabeled neurons. At the electron-microscopic level, most labeled profiles contain vesicles and correspond to F boutons usually involved in "axoaxonic" contacts with terminals of dorsal root afferent and presynaptic to dendrites. Other vesicle-containing, GAD-positive endings seem to correspond to the P boutons described by Ellis and Rustioni (1981) and are believed to be, at least in part, of dendritic origin. It is suggested that GAD positive neurons are GABA-ergic LCNs and that these can mediate both pre- and postsynaptic inhibition.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6494670 TI - The influence of rate of skin indentation on threshold and suprathreshold tactile sensations. AB - The effects of skin indentation depth and rate on threshold and suprathreshold tactile sensations were investigated. Indentation rates between 0.3 and 10 mm/sec had little effect on the absolute tactile thresholds measured in terms of indentation depth. Slower rates resulted in increased absolute thresholds. Estimates of the growth in intensity of tactile sensations were made as functions of indentation depth and rate. The fastest rate used (10 mm/sec), for a given depth of indentation, produced the most intense sensation; the slowest (0.1 mm/sec), the least intense sensation. The tactile sensation magnitude estimates, with rate as the parameter, could be described by power functions. At the slowest indentation rate the exponent of the function was 1.36. At faster indentation rates (0.4, 1.0, and 10 mm/sec), two functions of markedly different slopes were required to describe the estimates. The exponents of the power functions were between 0.38 and 0.49 for indentation depths up to about 0.9 mm, and between 1.07 and 1.43 for deeper indentation depths. PMID- 6494671 TI - [The general practitioner as a forensic medical officer at the examination of a corpse]. PMID- 6494672 TI - [Granulomatous hepatitis and portal hypertension. Sarcoidosis? Primary biliary cirrhosis? Brucellosis?]. PMID- 6494673 TI - [Acquired complement deficiency in myeloma]. PMID- 6494674 TI - [The treatment of psychotic and schizophrenic patients in a psychiatric outpatient service]. PMID- 6494675 TI - [Sexual problems of patients in general practice]. PMID- 6494676 TI - [Kala-azar (visceral leishmaniasis) following a stay in a Mediterranean country]. PMID- 6494677 TI - [Gray areas of upper panendoscopy]. PMID- 6494678 TI - [Therapeutic endoscopy. Gray areas in the gastro-duodenal region]. PMID- 6494679 TI - [Endoscopic assessment of esophageal variceal pressure]. PMID- 6494680 TI - [Diagnosis and therapy of pancreatobiliary duct anomalies in childhood]. PMID- 6494681 TI - [Cardiogoniometry as a method for the diagnosis of coronary disease. Comparison with myocardial scintigraphy]. PMID- 6494682 TI - [The complexity of the clinical appearance of depressive disease as shown in 2 examples]. PMID- 6494683 TI - [Neuropsychiatric syndromes of alcoholic origin. Diagnosis and treatment]. PMID- 6494684 TI - [The lying Baron as patient or problems in the diagnosis of artificial diseases]. PMID- 6494685 TI - [Psychiatric aspects of the Munchausen syndrome]. PMID- 6494686 TI - [Factitious edema--a frequently overlooked disease picture]. PMID- 6494687 TI - [Scalpellophilia--surgical aspects of the Munchausen syndrome]. PMID- 6494688 TI - [Artificial subcutaneous emphysema of the facial soft-tissues]. PMID- 6494689 TI - [Artificial infectious diseases. Factitious fever and self-induced infections]. PMID- 6494690 TI - [Cutaneous artefactual disease. A survey with case examples]. PMID- 6494691 TI - [Munchausen syndrome in gynecology]. PMID- 6494692 TI - [Clinical aspects, pathophysiology and diagnosis of artificial metabolic diseases]. PMID- 6494693 TI - [Diuretics and renal failure]. PMID- 6494694 TI - [New developments in the surgical treatment of lithiasis]. PMID- 6494695 TI - [Renal failure and the protein-restricted diet]. PMID- 6494696 TI - [Should we rethink the final authority of expertise based on Article 13 of the Swiss Penal Code?]. PMID- 6494697 TI - [Mentally abnormal delinquents and penal justice]. PMID- 6494698 TI - [The psychiatric verdict: from the responsibility of the defendant to the responsibilities of psychiatry]. PMID- 6494699 TI - [Health policy in a confederation of states]. PMID- 6494700 TI - [Current problems in Swiss surgery]. PMID- 6494701 TI - [Renal carcinoma and hypercalcemia]. PMID- 6494702 TI - [Evaluation of patients' nutritional status]. PMID- 6494703 TI - [Nutritional status of patients undergoing heart valve surgery. Preliminary study]. PMID- 6494704 TI - [Theo-dur: sustained-release theophylline]. PMID- 6494705 TI - [Planning and distribution of diets]. PMID- 6494706 TI - [The debate about intelligence]. PMID- 6494707 TI - Graft-versus-host disease. PMID- 6494708 TI - [Balo's concentric sclerosis]. AB - A clinico-pathological case of concentric sclerosis (Balo type) is reported. A 30 year-old man experienced dizziness, nausea and vomiting. Twelve days later he developed gait disturbances. Neurological examination showed broad based gait, brisk tendon reflexes, bilateral extensor plantar responses, right hemihypoesthesia, cerebellar dysmetria, and a left lateral gaze palsy. CSF examination showed, 520 mg p. 100 ml protein, 7500 red blood cells, 31 lymphocytes and 9 polymorphonuclear leukocytes/mm3, 18 p. 100 gammaglobulin. Three CT scans were performed and showed a round hypodensity in the parieto occipital white matter with contrast enhancement on one occasion, and several other hypodensities in the contralateral parieto-occipital white matter and in both frontal lobes. 23 days after the onset of the disease, the patient became comatose. A cerebral biopsy was obtained from one of the frontal lesions. He died from aspiration bronchopneumonia 2 months after the first signs. Neuropathological examination showed numerous concentric zones of demyelination which involved the white matter of both hemispheres, brain stem, and cerebellum. On light microscopy sudanophilic myelin breakdown products were numerous in the bands of demyelinisation. Astrocytic proliferation was marked, with frequent Rosenthal fibers. Edema was noted in some lesions. Myelin-axonal dissociation was obvious, but some axonal swelling were observed. Electron microscopy demonstrated the integrity of oligodendrocytes and of blood vessels and confirmed the prominent alterations of the astrocytes. Fifteen similar cases of the literature have been reviewed. The present case seems to be the first one with CT scan examination and electron microscopic study of a brain biopsy. The nosological situation of Balo's disease among the inflammatory demyelinating diseases of the group of MS is discussed. PMID- 6494709 TI - [Transformation of cerebral infarction into hemorrhage during x-ray computed tomography in a patient under anticoagulant treatment]. AB - Repeated CT scans provide the only means of confirming the initial ischemic nature of a cerebrovascular accident and its eventual course towards a hemorrhage. Precise data can be obtained as to the frequency of this complication as a function of factors such as the embolic origin of the infarct or associated anticoagulant therapy. The present case shows that contrast medium, at least in patients receiving anticoagulant treatment, may constitute a risk factor by increasing the possibility of transformation of a pale infarct into a hemorrhagic one. Possible relevant properties of iodized contrast media with respect to this type of complication are considered. PMID- 6494710 TI - [Acute hemiplegia complicating Kawasaki disease]. AB - An infarct in the left middle cerebral artery territory in a 9 months old girl occurred in the course of Kawasaki's disease which in addition had induced a coronary aneurysm and a myocardial infarct. Embolism from the myocardial infarct was likely to have provoked the cerebral infarction. Neurological symptoms and signs are unusual in Kawasaki's disease. PMID- 6494711 TI - [Crural hemiparesis with ipsilateral ataxia]. AB - A 61 year-old man with severe hypertension present with a crural paresis and ipsilateral ataxia. CT scan showed a low density area suggestive of a lacuna in the posterior limb of the internal capsule. PMID- 6494712 TI - [Tumoral spinal meningeal hemorrhage during anticoagulant treatment]. AB - Tumoral spinal meningeal haemorrhages are exceptional. A case during an anticoagulant treatment is reported. The tumor, an ependymoma of the filum terminale was smaller than usually. PMID- 6494713 TI - [Polyradiculoneuritis in a developmental flare-up of Behcet's disease]. AB - A patient with Behcet's disease developed a polyradiculitis that was mainly motor. It was associated with an acute episode of mucocutaneous, articular and inflammatory symptoms and the neurological disorders regressed in a few months. A possible cause effect relationship is considered. Peripheral nerve lesions are rare in Behcet's disease. Only a few cases of polyneuritis radiculitis and mononeuritis multiplex have been reported. PMID- 6494714 TI - [Orthodontic treatment of C5 subtype anomalies of the basal-distal relationship]. PMID- 6494715 TI - [Antibiotic therapy of odontogenic infections]. PMID- 6494716 TI - [Epilepsy and dentistry]. PMID- 6494717 TI - [Acute cholecystitis. Early surgical treatment]. PMID- 6494718 TI - [Esophageal perforation and its treatment]. PMID- 6494719 TI - [Duodenal ulcer in children]. PMID- 6494720 TI - [Pancreatico-duodenal angiodysplasia associated with carcinoid of the pancreas]. PMID- 6494721 TI - [Neoplasms of the digestive tract. Review of 70,055 cases of surgical and necropsy material]. PMID- 6494722 TI - [Pulmonary and renal injuries in acute pancreatitis. Retrospective study of autopsy material]. PMID- 6494723 TI - [Prognostic value of increased conjugated bilirubin during hemolytic crises. Study of 112 patients]. PMID- 6494724 TI - [Diagnostic value of hepatic function tests in metastatic carcinoma of the liver]. PMID- 6494725 TI - [Surgical treatment of portal hypertension. Experience with 20 patients]. PMID- 6494726 TI - [Correlations among clinical, caudographic, electromyographic examinations and surgical findings in lumbosacral disc herniations: value of electromyography]. AB - The Authors examined 50 patients affected by lumboischialgy deriving from disk herniation and on the basis of the surgical results determined the degree of reliability of the clinical examination the caudography and the electromyography. The electromyography resulted the most trustworthy test of the three demonstrating a degree of accuracy equal to 85% against that of 80% of the caudography and of 67.5% of the clinical examination. Moreover a statistical elaboration of data is carried out. PMID- 6494727 TI - [Epidemiology of epilepsy in the U.S.L. 34, Copparo, Emilia-Romagna]. AB - Incidence and prevalence investigations on childhood epilepsy, throughout the world, have suggested wide variations in the frequency of convulsive disorders. Also the few studies presently available from Italy mirror such a disagreement. However, these studies cannot be completely comparable owing to a marked methodological dishomogeneity in definition of epilepsy, classification of seizures, and ascertainment, collection, and selection of the cases. Therefore, to verify the true frequency of childhood epilepsy in our country, we performed an epidemiologic study of convulsive disorders in 0-14 age children of the U.S.L. 34 (Copparo, Northern Italy). The prevalence per 1.000 children on October 24, 1981 was 6.14 (6.4 if standardized to the Italian population). The average annual incidence for the period 1964 through 1980 was 95.1 per 100,000 (98.9 if standardized). These results, similar to those found in other Western countries, support the view that the frequency of childhood epilepsy in Italy as a whole is higher than that indicated by previously published Italian studies and furthermore suggest that epilepsy is evenly distributed in Europe and the United States. Antecedents which could be considered potential causes of seizures were found in 40.2% and 43.6% of the incidence and prevalence cases, respectively; for both groups, perinatal brain injuries were the most frequent event. These results point out the urgency of planning precautionary measures in Italy to improve prenatal and perinatal medical care. PMID- 6494728 TI - [Electrophysiologic findings in a case of Fisher syndrome]. AB - A case of Fisher syndrome is presented, with an electrophysiological study including EMG, Conduction Velocity, Brain stem Auditory evoked potentials and Somatosensory Evoked Potentials. The results seem to confirm the peripheral origin of ophthalmoplegia, ataxia and areflexia. PMID- 6494729 TI - Olefinic hydrocarbons: a first risk estimate for ethene. AB - The exhalation of ethene oxide by rats exposed to ethene now allows a first estimate of the genotoxic risk of ethene on a pharmacokinetic basis. The distribution (Keq, Kst) of ethene oxide under conditions of inhalation of ethene oxide, or high levels of ethene and consideration of the saturation behaviour of metabolism of ethene lead to the conclusion that inhalation exposure of rats to 1000 ppm ethene or more would theoretically correspond to about 7.5 ppm ethene oxide exposure. Available carcinogenicity data for inhaled ethene oxide were utilized into a comparison of the genotoxic risks of low levels of ethene oxide and ethene. It has been shown that consideration of ethene as a "simple asphyxiant" is inappropriate. The new intended TLV of 1 ppm for ethene oxide would be consistent with a TLV of 100 ppm for ethene. PMID- 6494730 TI - Potency of carcinogens derived from covalent DNA binding and stimulation of DNA synthesis in rat liver. AB - In order to investigate the role of the stimulation of cell division for the initiation (and possibly promotion) of liver tumors by chemical carcinogens, the incorporation of radiolabelled thymidine into liver DNA was determined in male rats. Single doses of various levels of aflatoxin B1, benzidine and carbon tetrachloride (all known to be genotoxic via DNA binding) did not affect cell division, whereas several hepatocarcinogens known not to bind to DNA (alpha-HCH, clofibrate, and 2,3,7,8-tetrachlorodibenzo-p-dioxin) gave rise to a dose dependent stimulation of liver DNA synthesis within 24 h. An equation combining the influences of mitotic stimulation, expressed as dose required to double the control level of DNA synthesis, and DNA binding potency, expressed as the Covalent Binding Index, correlated well with the carcinogenic potency for both classes of hepatocarcinogens. PMID- 6494731 TI - Morphologic features and incidence of spontaneous hyperplastic and neoplastic mammary gland lesions in Wistar rats. AB - A morphologic study of spontaneous proliferative lesions of the mammary gland was based on histologic examination of mammary glands from 1020 male and 1145 female albino Wistar rats aged 6 to 110 weeks. Three hundred and seventy-five mammary tumors representing an overall incidence of 33% were identified in the female groups, while the males had a total of five tumors which represented an incidence of 0.5%. Histologically, the most common types of tumors in females were: fibroadenoma (236), carcinoma (85), adenoma (40) and fibroma (8). Duct papilloma (1), lobular carcinoma (1), fibrosarcoma (1) and phyllodes tumor (1), were rare and constituted less than 2% of mammary neoplastic lesions. Mammary tumors were rare before one year of age, but increased with age thereafter. Nine percent of female rats studied also had proliferative non-neoplastic lesions that showed a mixture of benign ductular and/or lobular hyperplasia. One hundred and six of these lesions were identified, representing 22% of all grossly palpable nodules, thus stressing the importance of histologic examination of all gross mammary nodules for tumor evaluation. PMID- 6494732 TI - Morphological effects of subchronic oral sulfamethazine administration on Fischer 344 rats and B6C3F1 mice. AB - One hundred and forty-four Fischer 344 rats and 144 B6C3F1 mice (72/sex/species) were fed either a control diet or a diet containing 300, 600, 1200, 2400 or 3600 ppm sulfamethazine for 90 days. They were then necropsied and tissue specimens were evaluated for pathological changes by light and transmission electron microscopy. No gross or light microscopic lesions related to sulfamethazine administration were evident in the mice. Thyroid gland enlargement was evident at necropsy in one half of the rats (12 of 24) which received the 3600 ppm level of sulfamethazine and in 1 of 24 rats fed the 2400 ppm level. By light microscopy, thyroid gland hyperplasia was evident in rats which received all 5 dose levels of the compound, but this change was more pronounced and more frequent in those animals administered the higher concentrations. This thyroid hyperplasia was observed in rats of both sexes, but with greater incidence in males than in females, among the groups receiving the lower concentrations of compound. Ultrastructural changes included markedly dilated rough endoplasmic reticulum, altered microvilli, and diminished colloid droplets involving the thyroid follicular cells and compartmentalization of colloid within the follicular lumina. PMID- 6494733 TI - Chemical carcinogenesis: xenobiotics and biotransformation. Second international symposium sponsored by the Universities of Sassari and Cagliari. PMID- 6494735 TI - Acinar cell carcinoma of rat pancreas: mechanism of deregulation of cholesterol metabolism. AB - The mechanism of deregulation of cholesterol metabolism was studied in fast and slow growing nude mouse tumors and cancer cells in culture derived from azaserine induced rat pancreatic acinar cell carcinoma. The tumors showed a loss of feedback control of the de novo synthesis of cholesterol, probably due to a loss of low density lipoprotein (LDL) receptors on plasma membranes or to a defect in the binding and internalization of LDL in the cancer cells. The hexosemonophosphate shunt pathway is stimulated in the cancer cells, presumably because of an increased demand for NADPH in cholesterol synthesis and for ribose phosphate in DNA synthesis. The uncontrolled de novo synthesis of cholesterol is one of the factors responsible for the high rate of cell proliferation in the tumors. PMID- 6494734 TI - Thyroid and chemical hepatocarcinogenesis: further insights from the hepatocarcinogen ZAMI 1305. AB - The beta-blocker DL-1-(2-nitro-3-methyl-phenoxy)-3-tert-butylaminopropan-2-ol (ZAMI 1305), oncogenic to the liver of the female but not of the male Wistar rat, was used to investigate some aspects of the relationship between liver and thyroid during chemical hepatocarcinogenesis. Thyroidectomy (TDX) strongly reduces the amount of hepatic DNA damage induced by a single administration of ZAMI 1305 in the female Wistar rat. One week of treatment with triiodothyronine (T3) completely restores the susceptibility of the liver of thyroidectomized animals to the genotoxic activity of the molecule. The amount of hepatic DNA damage in intact females varies with the age of the animal, being maximal in rats of 4-8 weeks of age, when T3 serum concentration are also maximal. An increase of relative thyroid weight, coupled with histological hyperplasia of the gland, is observed in female Wistar rats treated for 6 months with ZAMI 1305. Minimal changes of the thyroid are observed in ZAMI 1305-treated male rats. The increase of relative thyroid weight in female rats appears to be related to the severity of preneoplastic and neoplastic liver changes. These findings and several suggestions from the literature lead us to propose a model for the interaction between liver and thyroid during chemical hepatocarcinogenesis. PMID- 6494736 TI - Subcellular distribution of styrene oxide in rat liver. AB - The subcellular distribution of (3H )-styrene-7,8-oxide was studied in the rat liver. The compound was added to liver homogenate to give a final concentration of 2 X 10(-5); 2 X 10(-4) and 2 X 10(-3) M. Subcellular fractions were obtained by differential centrifugation. Most of styrene oxide (59-88%) was associated with the cytosolic fraction. Less than 15 percent of the compound was retrieved in each of the nuclear, mitochondrial and microsomal fractions. A considerable percentage of radioactivity was found unextractable with the organic solvents, suggesting that styrene oxide reacted with the endogenous compounds. The intracellular distribution of this epoxide was also studied in the perfused rat liver. Comparable results with those previously described were obtained. The binding of styrene oxide to the cytosolic protein was investigated by equilibrium dialysis and ultrafiltration. Only a small percentage of the compound was bound to protein. PMID- 6494737 TI - Thioacetamide effects on protein metabolism in the liver: lessons from isolated hepatocytes. AB - The effects of a short-term treatment with thioacetamide have been studied in isolated hepatocytes obtained from intoxicated rats. A technique has been developed which utilizes leucine alternatively labeled with either [14C] or [3H] and permits the simultaneous evaluation of protein synthesis, catabolism and secretion in the same cell during the same incubation period. The results indicate that short-term thioacetamide treatment causes an overall slowing-down of protein metabolism. Protein synthesis, however, decreases less than protein degradation and total protein secretion; albumin secretion, which is also less than normal, seems to be less compromised than total protein secretion. PMID- 6494738 TI - The role of toxicological interactions in chemical carcinogenesis. AB - Toxicological interactions may occur not only when exposure to two or more chemicals is simultaneous, but also when exposures are separated in time. Often the sequence of exposure determines the nature of the toxicological response. This is illustrated with the two hindered phenolic antioxidants, butylated hydroxytoluene (BHT) and butylated hydroxyanisole (BHA). Evidence available suggests that in certain tissues exposure to BHT first and then to a carcinogen is without significant consequences, whereas exposure to BHT after a carcinogen may enhance tumor formation. On the other hand, exposure to BHA before carcinogen administration often has a protective effect, whereas exposure to BHA after a carcinogen sometimes protects and sometimes is without any influence. Mechanisms underlying these interactions may be induction of mixed function oxidases, production of cell hyperplasia or other, as yet ill-defined, events such as modification of biological reactivity. PMID- 6494739 TI - Liver hyperplasia and regression after lead nitrate administration. AB - The effect of a single intravenous injection of lead nitrate on liver, was investigated in male Wistar rats. Lead nitrate at 5 and 10 mumoles/100 g of body weight stimulated a 19-fold increase in the incorporation of 3H-thymidine into liver DNA and resulted in temporal changes in DNA synthesis, as determined by assays of specific activity. Thirty-six hours after lead nitrate administration, the incorporation of 3H-thymidine reached its maximum and returned to normal levels within 3 days. A significant increase in the number of cells entering mitosis at 36 hours indicated the capacity of lead to stimulate liver cell proliferation. Enlargement of the liver after lead treatment was also observed in both female Wistar rats as well in male Fischer rats. This stimulatory effect of lead on liver growth was reversible; during the involution of the liver, cell death morphologically similar to the one described as apoptosis was observed in histological sections of liver from animals sacrificed 4-7 days after lead treatment. PMID- 6494740 TI - Toward a universal tumour marker. PMID- 6494741 TI - [Roentgen symptoms of renal osteopathy]. AB - Chronic renal insufficiency is associated with metabolic disturbances which ultimately lead to typical, partly extremely painful changes in the skeletal system the longer the disease persists. Regular x-ray control of certain skeletal segments allows early detection of renal oesteopathy if the radiological findings described in this article are carefully scrutinised and interpreted. PMID- 6494742 TI - [Foreign body aspiration in childhood: diagnostic problems]. AB - The authors report on 33 children with aspirated foreign bodies not casting a shadow. These included 21 children who had been referred to hospital after more than 24 hours, in some cases only after weeks and months following aspiration or onset of symptoms, and in whom bronchoscopy was thus performed with considerable delay. The study shows that most of the patients presented a pathological x-ray pattern of the thoracic organs; but it also shows that even a "n.a.d." finding should never be an excuse not to perform bronchoscopy if there is the slightest suspicion of aspiration. The authors analyse the reasons causing the delay in diagnosis and treatment. PMID- 6494743 TI - [Significance of a nonionic renographic contrast medium (Iopamidol 300) in the roentgen diagnosis of the kidneys and urinary tract in children]. AB - The ionic contrast media used so far have been associated with considerable risks in infants and children. The high osmolality of these media did not always permit a dosage sufficient for kidney imaging in the nephrographic and in the pyelographic phase. The new non-ionic contrast media have largely reduced these risks so that their general application in infants and young children should be recommended. Intravenous urographies using the non-ionic contrast medium Iopamidol 300 (Solutrast 300) were performed in 195 children aged one day to 12 years. Good to superior urograms were obtained in 85% of the investigations. No adverse reactions caused by the osmolality of the contrast media had been observed in spite of the relative high dosage. As a result of their low osmolality and non-ionic property a safe application of high doses was possible. PMID- 6494744 TI - [Value of iopamidol in radiologic diagnosis]. AB - The effect of the contrast medium Iopamidol/Iopamiro, Bracco (Milano) was studied in 31 patients via intravascular or intraarticular injection, as well as in experiments on dogs with 32 kidneys, employing selective angiography and histological examination. In all cases, we obtained good x-ray films showing plenty of detail, the patient tolerance being good. Blood pressure, pulse rate and UN, SGOT, and SeBi values did not show any significant change. In some cases we noticed a moderate proteinuria. In the animal experiments, the kidneys showed histological changes in two cases only which could be ascribed to the action of the contrast medium; however, even these changes were of a minimal nature and degree, and were reversible. Iopamidol was found to be a very favourable contrast medium as far as the kidneys are concerned. PMID- 6494745 TI - [Radiologic diagnostic aspects of breast swelling in the male]. AB - Diseases of the male mammary gland are clinically manifested as unilateral or bilateral, well-defined or diffuse consolidations in the breast. In some cases, the affected tissues are extremely tender on pressure. Gynaecomastia is most frequently seen (n = 22), whereas inflammatory or tumourous changes of the glandular parenchyma are rare (n = 2). The most important causes of gynaecomastia are shifts in hormonal balance where the controlling impulses acting on the glandular parenchyma are enhanced. Gynaecomastia is frequently found in patients who have cirrhosis of the liver or are taking certain drugs. 29 cases are described from the author's own patient material. The radiological image, the clinical findings, the possible aetiological aspects, as well as histological findings, if any, are described and discussed in relation to literature. Closer examination of this poly-aetiological disease pattern--namely, swelling of the male mammary gland--leads to a number of interesting differential diagnoses which sometimes require internistic and endocrinological clarification before the correct diagnosis can be found. PMID- 6494746 TI - [Computerized tomography diagnostic criteria in lateral neck cyst]. AB - Although well known, the morphology of branchial cysts has not been sufficiently presented in CT literature. In the present case report, diagnostic criteria are given, such as typical site of occurrence, ductal extension towards the supratonsillar fossa, and cystic, but occasionally soft tissue density. Differential diagnosis is given for cases which cannot be classified according to these criteria. PMID- 6494747 TI - [Masking of a parathyroid adenoma: false interpretation in computerized tomography]. AB - Parathyroid tumors can be identified via CT in the region of the neck and ectopically in the mediastinum as a hypodense mass. This article reports on a case in which the parathyroid adenoma had been concealed by a large haematoma, as became evident during operation. PMID- 6494748 TI - [Computerized tomographic differentiation of adenocarcinoma and malignant lymphoma of the stomach]. AB - CT examinations in gastric adenocarcinoma (12 patients) differ clearly from the diffuse wall thickenings in malignant gastric lymphoma (7 patients) by displaying focal thickenings of the gastric wall. Before performing biopsy, it is often necessary to effect differentiation and staging, and to lay down a preliminary interdisciplinary oncological treatment concept. PMID- 6494749 TI - [Radiation-induced vasculopathy of the carotid artery and vertebral artery]. AB - The article reports on a case of radiation-induced vasculopathy of the vessels of the head and neck causing a transitory ischaemic attack 14 years after primary radiation of a squamous cell carcinoma. The correlation of the radiation-induced vasculopathy with regard to applied radiation dose and time latency is discussed on the basis of published references. PMID- 6494750 TI - [Pheochromocytoma of the bladder in computerized tomography]. AB - In 10% of the cases, phaeochromocytomas are extra-adrenal. This is a report on an 18 year old patient in whom the tumour was identified via sonography and computed tomography in the urinary bladder wall. PMID- 6494751 TI - [Surgery of the thyroid gland in 1984]. PMID- 6494752 TI - [Operative risk in cardiac surgery]. PMID- 6494753 TI - [Breast reconstruction]. PMID- 6494754 TI - [Splenic preservation in injuries of the spleen]. PMID- 6494755 TI - [Hypospadias]. PMID- 6494756 TI - [Tumors of the upper excretory urinary tract]. PMID- 6494757 TI - [Necrotizing fasciitis]. PMID- 6494758 TI - [Management of acute respiratory insufficiency in adults]. PMID- 6494759 TI - [Management of severe symptomatic hypercalcemia in adults]. PMID- 6494760 TI - [Epidural hematoma]. PMID- 6494761 TI - [Recent traumatic rupture of the aortic isthmus]. PMID- 6494762 TI - [Diagnosis of thoracic pain in an emergency context]. PMID- 6494763 TI - [Laryngeal edema in adults]. PMID- 6494765 TI - Echocardiographic approach to the early diagnosis of congestive cardiomyopathies. AB - M-mode echocardiography was used to study left ventricular (LV) function in 25 patients with congestive cardiomyopathy (CC). Good discrimination of patients with CC from a control group of normal subjects was possible using echocardiographic parameters. Symptomatic patients (group II) with CC had a significantly larger LV end-diastolic diameter (LVED) than the asymptomatic ones (group 1) but the differences in the shortening fraction (SF), ejection fraction (EF), and mean velocity of circumferential fiber shortening (Vcf) were not statistically significant. Asymptomatic patients showed significant differences from normal in LVED, SF, EF and Vcf. End-systolic wall stress is a quantitative index of true myocardial afterload that can be plotted against LV end-systolic diameter to give an index of contractility independent of loading conditions. End systolic wall stress in normal subjects (64.80 +/- 19.50 X 10(3) dyn/cm2) was significantly lower than in patients with CC (169.6 +/- 13.43 X 10(3) dyn/cm2). In conclusion the LV echocardiographic parameters can be conveniently combined to provide a good recognition and estimation of patients with CC, even in early stages. PMID- 6494764 TI - Fibrinolysis in diabetes mellitus. Role of overweight and hypertriglyceridemia. AB - The variations of dilute blood clot lysis time (DBCLT) in 103 diabetic patients were investigated in terms of insulin dependency, body weight, serum lipids and presence of diabetic vascular diseases. The results showed that DBCLT was significantly longer in the 34 overweight diabetic patients (437 +/- 68 min) than in the 69 diabetics at or below the ideal body weight (240 +/- 28 min) or in the 76 normalipidemic normal weight control subjects (253 +/- 12 min). DBCLT was also longer in the hypertrigliceridemic diabetic patients than in the normolipidemic ones. The mean lysis time was similar in diabetic patients with and without retinopathy. However, a higher level of fibrinolytic inhibitors was found in patients with diabetic small vessel disease. In vitro inhibition of plasma factor XIII by p-chlormercuribenzoate (PCMB) caused an acceleration of DBCLT and the differences between lysis time in the overweight diabetics and in the controls were attenuated. These results suggested that deficient thrombolysis is rather due to overweight and to disturbances of lipid metabolism than to diabets and/or its vascular complications and that enhanced fibrin crosslinking is at least partially responsible for delayed clot lysis. PMID- 6494766 TI - Parasystolic ventricular tachycardias in young healthy patients. AB - Seven patients with short episodes of parasystolic ventricular tachycardia, in the absence of organic heart disease, and in good healthy state, are presented. The tachycardic episodes were analyzed through simultaneous esophageal and standard electrocardiographic recordings. The persistent fetal dispersion of nodal and Hiss bundle fragments within the ventricular septum is proposed as a possible explanation. PMID- 6494767 TI - Drug allergy: incidence in terms of age and some drug allergens. AB - The authors studied the incidence of drug allergy in 3 groups of subjects. In the first group the incidence was established in terms of the subjects' age: 1.8% in children up to 14 years old (323 subjects), 5.8% in middle-aged subjects (389 subjects) and 2.9% in the elderly (243 subjects). In the second partly selected group, drug allergy was studied in patients admitted to the 3rd Medical Clinic- Craiova between 2 Jan. 1981 and 31 Dec. 1982; 103 of the 8,760 patients admitted presented allergic reactions, a relatively high incidence rate (1.01%) as compared to other published reports. The third group of previously selected cases consisted of 197 patients who had come to the allergology service with complaints of present or past sensitivity to drugs. The total number of patients was 336 selected or preselected from about 10,000 subjects, to which 17 patients with a diagnosis of "asthmatic triad" must be added. Drug allergy in terms of the drug used was dominated by penicillin, pyramidon-algocalmin, aspirin, iodine preparations, etc.; foremost among the clinical syndrome were the dermatologic syndromes types I, III and IV; syndromes of the "anaphylactic shock" type, "serum sickeness" bronchial asthma, angioneurotic oedema. PMID- 6494768 TI - Acute renal failure in obstructive diseases of the extrahepatic biliary ducts. AB - A series of 46 patients with obstructive disease of the bile ducts complicated by acute renal failure (ARF) is presented. The patients exhibited obstructive jaundice with prevalence of conjugated bilirubine. In 80% of the cases biliary obstruction was associated with cholangitis. Disturbances of the liver function (from mild cholestasis to biliary cirrhosis) were also present. The renal damage was due to biliary disorders and was either present on admission (33 cases) or developed postoperatively (13 cases). Most of the patients presented nonoliguric ARF as well as poor perfusion resulting from decreased circulating blood volume (dehydration and electrolyte loss). Among the criteria used to determine the type of ARF, the urinary/plasma creatinine ratio less than 10 and urinary/plasma osmolarity ratio less than 1.1 were the most valuable. Management of ARF by dialysis alone was not satisfactory. Attention is called to the surgical treatment of the biliary disorder as being essential to prognosis. Patients not treated by radical surgery died in proportion of 87 to 100%. From the rest of 18 patients in whom the operation provided an adequate biliary drainage, in 15 the renal function was restored and 12 survived. Better prognosis in these patients was dependent not only on the ability to cure the cholestasis and infection, but on the early surgical treatment. The ultimate prognosis depends on the improvement of the liver function. PMID- 6494769 TI - Gallstones--mineralogical and chemical investigations. AB - A comparative study of the mineralogical-structural characteristics and chemical composition of gallstones was performed on stone samples removed intraoperatively from the gallbladders of 12 patients. The study included all the types of gallstones. Their chemical components determined were: bilirubin, cholesterol, phospholipids, calcium, proteins. The stones were examined physically (size, number, shape, color) and the radial or concentric disposition of the layers was estimated on cross-sections. Thin sections (2 X 10(-2)mm) were obtained and examined by polarizing microscope in order to observe the inner structural characteristics. The crystallographic analysis of all the types of stones studied is reported. In all the samples, a perfect concordance was found between the mineralogical structure and the chemical composition of the gallstones. The results obtained are valuable premises for further research in the formation of stones, since a mineralogical study offers the possibility to estimate variations of crystal aggregation, according to the local changes of the gallbladder (inflammation, bacterial growth, pH, etc.). PMID- 6494770 TI - Cancer of the gastric stump. Diagnostic considerations. AB - A presentation is made of the experience accumulated from over 1200 superior digestive endoscopies of which 150 were made for disturbances of operated stomach. After some considerations on the different methods of diagnosis in gastric stump neoplasm the diagnostic criteria are discussed critically in terms of endoscopic results. PMID- 6494771 TI - Dysglobulinemias revealing rheumatoid arthritis. AB - Fifteen patients (with dysglobulinemia, ranging in age from 35 to 52 years, were studied over a period of 6 years. The following parameters of immune response and immunoelectrophoresis of serum proteins were checked: total hemolytic complement (CH50), serum cryoglobulins, presence of circulating immune complexes (CIC), beta 2-microglobulins, rheumatoid factor (RF). Of the 15 patients investigated, 6 (40%) developed during the period of study severe forms of rheumatoid arthritis (RA) which required the introduction of continuous cortisone therapy. In a control group, ranging between the same age limits but without immune disturbances, no case of RA was observed. It should be noted that polyclonal hypergammaglobulinemia preceded by at least 5 years the appearance of articular inflammation. The changes of serum complement were also significant. CH50 was found constantly decreased below 40 HU/ml, particularly in the patients with febrile forms of RA; positive latex fixation test greater than 1/80 was observed at least 6 months before the appearance of articular tumefactions. Increase of beta 2-microglobulins in the serum and the presence of cryoglobulins was also observed in the 4 patients with RA. Dysglobulinemia has often been observed in the course of RA but it has seldom been presented as a preceding disturbance predicting the disease. The originality of the observations reported in this paper consists in a case of malignant RA appeared in the course of dysglobulinemia. PMID- 6494772 TI - Mental and growth retardation with congenital atrichia and papular lesions. PMID- 6494773 TI - Orienting response extinction in nocturnal enuresis. PMID- 6494774 TI - Conservative treatment of supratentorial intracerebral hematomas. PMID- 6494775 TI - Prophylaxis of dyslexia in town children to prevent learning failure. PMID- 6494776 TI - [Cellular aspects of the aging of articular cartilage. I. Condylar cartilage with a normal surface sampled from normal knees]. AB - The authors studied the cellular density of articular cartilage taken from the femoral condyles of 77 autopsy subjects at Hopital Lariboisiere in Paris. This study showed a decrease in the cellular density (number of chondrocytes per mm2) going from the superficial zone towards the calcified zone of the cartilage in all layers, as a function of the age of the subjects. The decrease in cellular density is in the order of about 50% of the total chondrocyte number when subjects younger than 40 are compared with those older than 80. The demonstration of a regular increase in the number of empty lacunae per mm2 with the age of the subjects, i.e. lacunae without chondrocytes, suggest that the cause of this decrease in cellular density of the cartilage with age could be a physiological necrosis due to "exhaustion" of the chondrocytes. The metabolic activity of the chondrocytes may also decrease with age, as suggested by the increasing proportion of alcianophobic cells, cells which are weakly or not at all labeled by radioactive sulfates which indicate the sites of biosynthesis of proteoglycans. These cellular modifications could play a role of senile fibrillation of articular cartilage and in arthrosis. PMID- 6494777 TI - [The hyperostotic shoulder]. AB - A systematic study of shoulder joints in 30 DISH patients demonstrates the frequency of shoulder involvement in this disease and its characteristic radio clinical features. Radiological abnormalities observed in DISH shoulders are contrasted with those encountered in rotator cuff tears. However, both disorders can occur together, producing a "complex shoulder" syndrome. The most typical aspect of this is the presence of an osteoarthritic pseudoarthrosis between the greater tuberosity and the acromion which has developed from the subacromial enthesopathy. PMID- 6494778 TI - [Plasma and synovial fibronectin. Results of personal research]. AB - The authors report the results of an assay of plasma fibronectin and synovial fluid fibronectin conducted in 104 patients with arthropathy, including 26 cases of rheumatoid arthritis, 43 cases of mechanical arthropathy and 35 cases of non rheumatoid arthritis. The plasma fibronectin levels do not vary significantly between the different groups of patients, but the mean value for the whole group of patients is significantly lower than that of a control population. The mean value of synovial fluid fibronectin was significantly higher in the patients with rheumatoid arthritis (583 +/- 76 mg/1) than in the patients with non-rheumatoid arthritis (379 +/- 58 mg/1) or mechanical arthropathy (367 +/- 32 mg/1). The assay of synovial fibronectin could therefore provide useful information for the aetiological diagnosis of inflammatory arthropathies. The local origin, from the synovial membrane itself, of the fibronectin in the synovial fluid is suggested by the fact that the synovial concentration of this protein is superior to the serum concentration in 50 to 90 per cent of cases, depending on the disease. PMID- 6494779 TI - [Unicompartmental femorotibial arthroplasty and lateral gonarthrosis. Outcome of 52 prostheses implanted for more than 5 years]. AB - The results of 52 Lotus unicompartmental knee implants with a follow up time exceeding 5 years are analysed. Forty-one prostheses with a mean follow-up of 6.5 years have given very good or good relief of pain. In almost all cases, flexion range exceeds 90 degrees and the preoperative motion has been most often clearly improved. Except for those due to prosthesis infection, all the poor and fair results in terms of pain, are explained by mechanical causes i.e. persistence of a frontal instability, loosening of the tibial component (2 cases) or narrowing of the nonprosthetic femorotibial space (11 cases). The latter is not related to the presence of any radiological chondrocalcinosis. These poor anatomical and clinical results appear to be preventable by a correct operative technique. In particular, the complete correction, by the prosthesis, or the angular deformity which has caused the lateral knee OA must be avoided. This is in contrast to what must be done in osteotomies. Unicompartmental prostheses thus have to stay in stress so that their long term future is uncertain. In the surgical management of lateral knee OA, these prostheses are not to be preferred to correction of frontal angular deformity by osteotomy, except in the elderly, when deformity cannot be completely corrected. Unicompartmental prostheses are particularly indicated in unstable knees in which osteotomies are known to be difficult to perform correctly. PMID- 6494780 TI - [Developmental study of rhizomelic pseudopolyarthritis. Apropos of 97 cases]. PMID- 6494781 TI - [Vasculitis following guanethidine block treatment in algodystrophy of the foot]. PMID- 6494782 TI - [Erosion of cervical intervertebral foramen by a buckle of the vertebral artery]. PMID- 6494783 TI - [The calcitonin-induced hypocalcemia test. For a simplified protocol]. PMID- 6494784 TI - Diagnosis and treatment of hyperthyroidism in elderly patients. AB - The clinical signs of hyperthyroidism in the elderly are often atypical and have an insidious onset. The hyperkinetic form and the exophthalmic syndrome are rare. Apathetic thyreotoxicosis occurs, with few exceptions, in the elderly. Part of the clinical signs of hyperthyroidism may be erroneously attributed to the normal aging process. Most authors consider radioiodine as the treatment of choice in elderly hyperthyroid patient. PMID- 6494785 TI - Effect of magnesium ion upon the calcitonin content of rat thyroid. AB - Thyroid calcitonin level was assayed in male rats after administration of magnesium gluconolactate. The resulting acute hypermagnesemia caused a significant decrease in calcitonin. However, calcemia showed unimportant changes, which suggests that the inhibitory action of magnesium is exerted directly on calcitonin secretion and is not affected by the calcium ion. PMID- 6494786 TI - The effects of endocrine therapy on plasma steroids in prostatic carcinoma patients. AB - Plasma testosterone (T), 5 alpha-dihydrotestosterone (DHT), T/DHT ratio, estrone (E1), estradiol (E2), E2/T ratio and 17-hydroxyprogesterone (17-OH-P) were measured in 70 patients with prostatic carcinoma (PCA) (T34, N01, M01), after endocrine therapy including: steroidal estrogens (polyestradiol phosphate = Estradurin monthly in injections of 80 mg; estradiol - 17 beta: 5 mg/d), nonsteroidal synthetic estrogens (DES: 5 mg/d; chlorotrianisene = TACE: 24 mg/d; DES-diphosphate = Honvan: 360 mg/d), orchidectomy and their combinations. All these forms of treatment lowered T, DHT, T/DHT ratio and 17-OH-P, the maximal suppression being observed after castration. No further decrease of the mentioned parameters was achieved by estrogen treatment of castrated patients, as compared with castration alone. In the noncastrated patients, steroidal estrogens were less effective than nonsteroidal ones, in terms of lowering T, DHT and T/DHT ratio. Significant decreases in estrone (p less than 0.05) and estradiol (p less than 0.01) levels were observed after nonsteroidal estrogen treatment and castration respectively, and extremely high values of circulating estrogens were found after steroidal estrogen administration. PMID- 6494787 TI - Somatotype of children with gonadal dysgenesis and structural anomalies of genitalia. AB - The somatotype of 92 children with sexual structural anomalies of whom 28 with female Turner's syndrome, 22 with Klinefelter's syndrome, 20 with adreno-genital syndrome, 14 with hypospadias, 2 with Reinfenstein's syndrome and 6 with feminizing testis was established on the basis of biometric and genetically determined morphologic characteristics (dermatoglyphics, pigment complex). A morphogram utilizing 12 anthropometric and 5 dermatoglyphic parameters was constructed; it can be used in phenotypical differentiation of the anatomo clinical variants of structural anomalies of the genitalia and gonads. The 12 anthropometric parameters were: weight, stature, height of the head + neck segment, the sternum-symphysis distance, length of arms and legs, the biacromial and bitrochanterian diameters, the circumference of the thorax, abdomen, hips and head. The dermatoglyphic parameters were: the digital delta index, TFRC, a-b ridge count, the ATD angle and the A line obliquity. For longitudinal assessment of the phenotype of children with structural anomalies of genitalia and gonads, the authors propose utilization of the percentile diagrams regarding weight, stature, pubes to floor distance, and the biacromial and bitrochanterian diameters. PMID- 6494788 TI - Primary hyperparathyroidism associated with galactophorous ducts calcification. AB - A 49-year-old woman at recent climacterium was admitted to our hospital for a dyspeptic-type symptomatology, weight loss, bone pain, moderate polyuric polydipsic syndrome and in a marked astheno-depressive state. Paraclinical explorations revealed constant hypercalcemia with hypophosphoremia, calciuria, chronic renal failure in the polyuric phase with retention of nitric bases. X-ray films showed diffuse osteoporosis, right nephrocalcinosis and diffuse calcifications of the galactophorous ducts in both breasts. Computerized tomography revealed and surgery confirmed the presence of tumoral tissues on the anterior aspect of the trachea. Histopathologic examination revealed a parathyroid adenoma. PMID- 6494789 TI - [Estrogenic and progesterone receptors in cancer of the breast]. PMID- 6494790 TI - [New views on the treatment of colorectal carcinoma]. PMID- 6494791 TI - [Experience with cryodestruction therapy of surgically unremovable tumors]. PMID- 6494792 TI - [Significance of fat globulinemia in the pathogenesis, onset and development of traumatic fat embolisms]. PMID- 6494793 TI - [Problems in gerontotraumatology]. PMID- 6494794 TI - [Mesotheliomas]. PMID- 6494795 TI - [Changes in dehydrogenase and aminotransferase activity in the serum and brain of rats adapted to repeated normobaric hypoxia]. PMID- 6494796 TI - [Importance of hyperphosphatemia in the development of experimental and spontaneous mediocalcinosis (postreproductive arteriopathy)]. PMID- 6494797 TI - [Osteopathies associated with hypercortisolism and vitamin D metabolism]. PMID- 6494798 TI - [The effect of levamisole on immunologic indicators]. PMID- 6494799 TI - Ear drum mobility and middle ear volume measured with tympanometry. AB - Tympanometry was evaluated as a measure of the volume of the air-containing space of the middle ear cleft as well as of tympanic membrane displacement in persons with intact tympanic membranes. Static compliance reduced with compliance of ear canal volume at -400 mm H2O, was determined with 0.22 kHz probe tone frequency. Further the difference in compliance obtained at +/- 400 mm H2O was regarded as a measure of ear drum mobility. The volume of the middle ear cleft including the mastoid air cell system was measured indirectly by X-ray of the ear in a lateral projection. No relation was found to exist between static compliance and mastoid air cell area measured on the X-ray film. Nor was there any relation found between ear drum mobility measured with tympanometry and size of the mastoid air cell system. PMID- 6494800 TI - Is there an ototraumatic interaction between noise and solvents? AB - A review of the literature and four case reports are presented. The patients had all been exposed to noise as well as to organic solvents and they demonstrate a much more pronounced sensorineural hearing loss than would be expected from their noise exposure only. In one of the cases a psycho-organic syndrome due to solvent exposure was verified. Audiograms from 32 painters in a shipyard who had been exposed to noise and solvents did not, however, show any clustering of inexplicably pronounced sensorineural hearing losses. With reference to the above cases it is suggested that there might be a possibility of an ototraumatic interaction between solvents and noise. In view of the neurotoxic effects of organic solvents, such an interaction is conceivable. PMID- 6494801 TI - Preferred hearing aid gain and bass-cut in relation to prescriptive fitting. AB - The insertion gain versus frequency, preferred by a group of moderately hearing impaired, elderly, untrained hearing aid users was investigated both in everyday listening situations and in an acoustically specified test situation in the laboratory. The subjects used experimental binaural hearing aids with modified controls, which could be easily and accurately operated. They adjusted both gain and bass-cut while using the aids. Preferred insertion gain was compared with recommendations from three methods of prescriptive fitting. These methods significantly overestimated preferred gain by about 10 dB. Preliminary fittings should allow a gain reserve of about 15 db. Intra-individually, a gain range of about 11 dB is often sufficient for different everyday situations. PMID- 6494802 TI - Tympanometric middle-ear pressure determination with two-component admittance meters. AB - Exact tympanometric determination of the middle-ear pressure based on the location of the (central) extremum of susceptance, conductance, admittance, impedance, reactance or phase-angle tympanograms is not possible. None of these immittance components reaches its extremum exactly at middle-ear pressure neither at 220 nor at 660 Hz, due to the hysteresis caused by the viscoelastic behaviour of the soft biological tissue of the middle-ear structures. These effects cannot be avoided by lowering the rate of the pressure change during the recordings. The error on the middle-ear pressure determinations using a tympanometric method can be estimated to be of the order of 15 daPa. PMID- 6494803 TI - The reliability of insertion gain measurements using probe microphones in the ear canal. AB - Two methods are now available for measuring the insertion gain as a clinical procedure; the ear canal microphone- and the soft probe tube microphone-system. It was decided to investigate some of the variables affecting the reliability of the insertion gain measurements, such as the measurement location and head movement effects, as well as factors related to the presence of the ear canal microphone in the auditory canal. The last variable exhibited significant systematic differences of -2 to 4 dB in the measured insertion gain with the ear canal microphone compared to the measurement obtained with the probe tube microphone. The intrasubject standard deviations were about the same for both methods and less than 4 dB in the frequency range 0.25 to 4.0 kHz. Finally when making clinical hearing aid recommendations using the probe tube microphone technique the errors in one insertion gain measurement are within 95% probability +/- 2 to +/- 8 dB in the frequency range 0.25 to 4.0 kHz. PMID- 6494804 TI - Analysis of hearing aid fittings using insertion gain measurements. AB - Insertion gain was measured in 166 persons after they were fitted with a hearing aid according to the Swedish prescription guidelines. Fitting was considered inadequate (1) when the levels of the long-term RMS speech spectrum were not amplified above the tone threshold at 1.0, 1.5 and 2.0 kHz, or (2) when the speech peak levels did not exceed the tone thresholds at 3.0 and 4.0 kHz. At least 40% of the subjects were found to have inadequate amplification according to these criteria. This number increased further when the measured insertion gain was compared with the gain recommended by other investigators. Our results indicate that real ear insertion gain measurements should be introduced as a routine clinical procedure in the fitting of hearing aids. PMID- 6494805 TI - Quality estimation of averaged auditory brainstem responses. AB - In its clinical use, the auditory brainstem responses, ABR, are recovered from the background noise by averaging a number of post-stimulus time epochs, sweeps. Normally, the test protocol prescribes a fixed number of sweeps to be employed and recording of replications is frequently recommended, too. Since both the ABR and the background noise differ in magnitude among patients and test sessions, such a test protocol can never ensure a given minimum "quality" or signal-to noise ratio, SNR, of the averaged ABR. In an attempt to solve this problem, a method is proposed to evaluate, in statistical terms, the "quality" or SNR of the averaged recording. This is done by calculating the ratio between the estimated magnitude of the ABR and that of the averaged background noise. The method can be employed "on-line" in an adaptive strategy to estimate the number of sweeps necessary to obtain a given minimum "quality" of the averaged ABR. It can be used in suprathreshold recordings as well as in automatic "threshold" detection and it is a practical tool to analyze and improve the cost-benefit of the ABR test. PMID- 6494806 TI - A clinical comparison between a laboratory and a commercial impedance audiometer. AB - Impedance audiometry is a useful tool in the diagnosis of retrocochlear lesions, provided that adequate normal values regarding the stapedius reflex thresholds and decay are used. The normal values in Sweden (and elsewhere) have been obtained with a laboratory impedance audiometer that is not in common use. We have compared a commercial impedance audiometer, the Grason-Stadler 1723, with this laboratory model to determine whether the normal values are valid. We found that the Grason-Stadler 1723 audiometer gives reliable stapedius reflex thresholds, but at 2-4 dB higher levels. The reflex decay curves, however, are unsatisfactory. Possible explanations for the results are discussed. We have also proposed a modification of the recorder of the commercial audiometer. The study demonstrates that normal values cannot be transferred freely between different equipments. PMID- 6494807 TI - Venting of earmoulds with acoustic horn. AB - Earmoulds according to the horn principles often lack the necessary space for a vent parallel to the sound canal. The present paper shows that a 2 mm vent ending in the sound canal itself near the tip of the earmould does not affect the frequency characteristics of the hearing aid measured at the eardrum. PMID- 6494808 TI - Subclass distribution of human anti-Staphylococcus aureus alpha toxin antibodies: suggestion of an IgG1, IgA1, IgG4 switch pattern. AB - The subclass distribution of antibodies against alpha toxin from Staphylococcus aureus in man was investigated. Antibodies were restricted to IgG1, IgA1, and IgG4 and appeared to develop sequentially. These data suggest a distinct pattern of class and subclass switches in response to protein antigens. However, studies in immunodeficient (class- or subclass-deficient) donors show that the proposed patterns is not obligatory. PMID- 6494809 TI - Immune characteristics of the beige-nude mouse. A model for studying immune surveillance. AB - Double immunodeficient mice, homozygous for both the beige and the nude genes, were developed on C57BL/6N-beige and N:NIH(S)-nude background through five steps of mating. The animals were healthy and had a life span comparable to that of regular nude mice. Beige and regular nude mice showed a significant difference in natural killer (NK) activity, with mean +/- SE values of 6 +/- 1.0% and 25 +/- 2.8%, respectively. The response to the T-cell mitogens phytohaemagglutinin and concanavalin A was similar in beige and NIH mice of the same genotypes for the nude genes. Both groups of nu/nu mice also showed some response in these assays, as well as in the plaque-forming cell assay, indicating that nude mice are not completely devoid of functional T or T-like cells. The nude genes were found to increase the response to the B-cell mitogen lipopolysaccharide in both the beige and NIH animals, whereas the response was reduced in mice of the beige genotypes. The viable, low NK beige-nude mice here reported on may be a valuable tool for studying factors involved in host defence against tumours. Interestingly, no spontaneous tumours have so far been observed in such mice. PMID- 6494810 TI - Rubella immune state and rubella vaccination of female university students. AB - At the Finnish Student Health Service, we have measured rubella antibodies in 3 consecutive academic years--1979-80, 1980-81 and 1981-82--in 2 483 first year female students. In 1979-80, 16.4% were seronegative, the following year the figures were 10.4% and in the third year 7.4%. Among students less than or equal to 19 yr of age the seronegatives decreased from 19 to 2% in 3 yr. This decrease shows that the national rubella vaccination programme which began in 1975 has been more successful than expected. A hemolysis-in-gel (HIG) test has proved a suitable screening method and the health examination of first year students a suitable occasion to test the immunity against rubella. Seroconversion occurred in 81.4% of those vaccinated. PMID- 6494811 TI - Comparative study of netilmicin/tinidazole versus netilmicin/clindamycin in the treatment of severe abdominal infections. AB - The efficacy of netilmicin combined with tinidazole (N + T) or clindamycin (N + C) in the treatment of severe abdominal infections was evaluated in a prospective randomized study with 20 patients in the N + T group and 21 patients in the N + C group. Normally the maintaining dose for netilmicin was 2.25 mg/kg every 12 h, for tinidazole 400 mg every 12 h and for clindamycin 300-600 mg every 6-8 h. The mean duration time of treatment was 8 days in the N + T group and 10 days in the N + C group respectively. In the N + T group 18 patients were cured and in the N + C group 17 patients. Among aerobic bacteria Escherichia coli was most frequently isolated and among anaerobes Bacteroides sp. All aerobic bacteria with 2 exceptions were susceptible to netilmicin and all anaerobic bacteria but 2 to tinidazole or clindamycin. Adequate serum levels were obtained for each antibiotic during therapy. In this study with a small number of patients the combination of netilmicin and tinidazole was as effective as netilmicin and clindamycin. PMID- 6494812 TI - Comparative determination of sulfonamide concentration in serum by chemical and microbiological assay. AB - Analysis of sulfamethoxazole in serum from patients treated with trimethoprim sulfamethoxazole was performed with the agar diffusion assay which is supposed to measure only unconjugated sulfonamide and with the spectrophotometric method which enables one to measure both unconjugated and conjugated sulfonamide. The two methods gave serum concentrations in the same range when used in patients with intact kidney function. In patients with decreased renal function the chemical method yielded higher values, probably due to accumulation of conjugated sulfamethoxazole. The agar diffusion assay gives an accurate answer if the clinical question concerns the therapeutic effect only. The spectrophotometric analytical method has a broader potential since it may be employed irrespective of the clinical question that motivated the analysis. PMID- 6494813 TI - Persistence of pneumococcal antigens in sputum after treatment of pneumonia. AB - Persistence of pneumococcal capsular antigens (PCA) in sputum was studied by counterimmunoelectrophoresis (CIE) in 36 cases of pneumococcal pneumonia. Antigens were still detected 24 and 48 h after start of antimicrobial treatment, in 92% and 76% respectively of the patients with lobar or multilobar infiltrates. Persistence of PCA was associated with radiologic extension of lung infiltrate. CIE appears to be a valuable diagnostic tool for pneumococcal pneumonia, when treatment has been instituted before admission to the hospital. PMID- 6494814 TI - Survival factors in replantation and revascularization of the amputated thumb--10 years experience. AB - An unabridged series of 73 thumb amputations subjected to replantation or revascularization surgery in the years 1971 to 1980 has been examined in detail as a combined prospective and retrospective study to determine the factors playing a role in survival and failure. The causes of failure and complications are demonstrated. The overall failure rate was 27%. The factors influencing the outcome were: the injury--mechanical type and degree of amputation; the patient- age and amputation level; and the surgeon--frequency of utilization of vein grafts. The highest failure was seen in the complete amputation with avulsion/diffuse crush injury group (63%). Incomplete amputations had the lowest failure rate, particularly if the injury type was guillotine/local crush and at a level proximal to the metacarpophalangeal joint. Patients aged 11 to 20 years had a low failure rate (18%) whereas children under 5 years had a high failure rate (40%). Arterial thrombosis was the most frequent complication and cause of failure. The surgeon could modify the result by frequent use of vein grafts for arterial reconstruction and by reoperation for thrombotic complication. Five thumbs failed to revascularize at the primary operation and were removed at this primary operation. PMID- 6494815 TI - The role of histamine and serotonin in the inflammatory reaction in an experimental model of open wounds in the rat. AB - The role of histamine and serotonin in the inflammatory reaction in the granulation tissue of open wounds in the rat was studied. The model involved plastic chambers attached to the edges of two open circular full-thickness skin wounds. Five days post-wounding, agonists or antagonists were applied in one of the two chambers, the adjacent wound serving as control. Thereafter blood flow and albumin extravasation were measured. Application of histamine (100 microM) caused an increase in granulation tissue blood flow by 36%, but left albumin extravasation unaffected. Treatment with mepyramine (H1 antagonist, 20 microM), cimetidine (H2 antagonist, 20 microM) or methysergide (serotonin antagonist, 20 microM) did not influence the level of either blood flow or albumin extravasation. It is suggested that endogeneous histamine and serotonin play a minor role in the inflammatory process in the granulation tissue of this model of healing wounds. PMID- 6494816 TI - The morphology and patency of arterial and venous microvascular anastomoses throughout the first post-operative year. A histological study. AB - End-to-end microvascular suture anastomoses, 40 arterial and 41 venous, from the rabbits carotid artery and posterior facial vein were harvested at 5 different time intervals (1, 2, 3, 6 and 12 months) post surgery and evaluated with light microscopy. A 100% long-term patency was noted both in arteries and veins. Quantitative measurements of the width of the vessel wall components indicated that a statistically significant temporary hypertrophic response occurred in the arterial intima, culminating in the third month when the width of the vessel wall at the anastomotic level almost doubled the normal. After that the width of the vessel wall again declined but it remained thicker than the adjacent vessel wall at one year post surgery. Among the venous anastomoses, however, the wall thickness at the anastomotic level remained thinner than the adjacent vessel wall throughout the evaluation period. The original vessel wall characteristics are not restored at the anastomotic site with intimal hyperplasia compensating for medial necrosis. Despite these events a technically satisfactory microvascular anastomosis should remain patent for years. PMID- 6494817 TI - Endothelialization following end-to-end and end-in-end (sleeve) microarterial anastomoses. A scanning electron microscopic study. AB - Eighteen microvascular end-to-end and eighteen end-in-end anastomoses were performed on the central arteries (diameters 0.8-1.2 mm) of rabbit ears. Specimens taken after intervals of 1-2 hours and 3, 7, 14, 30 and 90 days were studied using a scanning electron microscope. At 1-2 hours platelets and to a minor extent erythrocytes and fibrin had accumulated in defects between the vessel ends on sutures and at the suture holes of all end-to-end anastomoses. This had also occurred at the distal end of the telescoped segment in all end-in end anastomoses. At 3 days endothelial desquamation at anastomotic sites and clamp sites was found in both end-to-end and end-in-end anastomoses. The exposed subendothelial surface was covered with a carpet of platelets, and frequently numerous leucocytes were found. Between 3 and 7 days, new endothelial cells appeared at the junction between the vessels in end-to-end anastomoses and in all areas damaged by vascular clamps. At the ends of the sleeved segments reendothelialization was observed over platelet aggregates. Between 7 and 14 days neo-endothelialization seemed to be virtually completed in both types of anastomosis. In the vicinity of the anastomoses, the appearance of the new endothelium was frequently abnormal with irregularly formed cells. Characteristic clefts and holes were seen between these abnormal (pleomorphic) endothelial cells. Histological findings from the same vessel specimens show that areas with abnormal endothelialization correspond to segments with intimal hyperplasia. Such areas were found in specimens throughout the entire period studied.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494818 TI - Cross-face nerve grafting followed by free muscle transplantation in young patients with long-standing facial paralysis. Reanimation of the cheek and the angle of the mouth. AB - For reanimation of the cheek in 8 young patients with long-standing facial palsy a method with cross-face nerve grafting followed by free muscle transplantation has been used. The sural nerve was used as nerve graft and placed in a subcutaneous tunnel across the face. In the normal cheek 3-4 fascicles of the nerve were anastomosed to facial nerve branches innervating muscles elevating the angle of the mouth. Four to 13 months later the extensor digitorum brevis muscle to the second toe or the palmaris longus was transplanted to the paralysed cheek. It was attached between the zygomatic arch and the angle of the mouth. The end of the nerve was sutured to the muscle after taking a biopsy. The follow-up period has been 7-30 months. At 7 months 6 patients had positive EMG, either on voluntary movement or on stimulation of the contralateral facial nerve. Three of them had also a slight movement in the cheek. Two patients are as yet only 7 months postoperative. In the remaining two cases, No. 2 and 4, there were no signs of reinnervation. At 18 months 4 out of 6 patients had a synchronous natural contraction in the cheek giving increased balance to the mouth. These patients had a positive EMG. In patients No. 2 and 4 there was neither innervation nor improvement. At 30 months there was additional improvement in two cases but as previously in patients No. 2 and 4 there was neither improvement nor signs of innervation of the muscle on the EMG. The other 4 patients have not reached this postoperative stage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494819 TI - Interobserver variation and cosmetic result of submuscular breast reconstruction. AB - Four experienced plastic surgeons judged the results of 6 different variables in 99 breast reconstructed women. In the range good to poor the observers assessed symmetry of size, position of the submammary fold, symmetry of shape, nipple areola reconstruction and scars. The grand mean for total cosmetic results was 2.16 (2 = good, 3 = acceptable). Our material shows a great variance between patients in the total cosmetic result. We considered that no variable here shown has unacceptable reliability in terms of interobserver within patients and interpatients within observers variance ratio. The strongest correlations to the total cosmetic result were shown by symmetry of shape, position of the submammary fold and symmetry of size. Thus, in order to improve the total cosmetic result it is important to focus attention on these three aspects. PMID- 6494820 TI - Late results following mastectomy for cancer and breast reconstruction. AB - A series of 100 women had been surgically treated for breast cancer and reconstructed by implantation of a submuscular prosthesis. The patients intensely desired the procedure and were supposed to have a realistic anticipation concerning the results. There was one late extrusion of prosthesis and one prosthesis was removed because of a local recurrence. Six patients had local or distant recurrences. Breast reconstruction was not a disadvantage in the treatment of these recurrences. In 48% of the cases the patients thought that the reconstructed breast was harder than desired. The corresponding figure for the independent examiner was 31%. After breast reconstruction, ipsilateral arm complications increased in number or severity by about 5%. In 82%, life-style and in 53%, social relations had improved after breast reconstruction. One of the 100 patients regretted the reconstruction and three were indifferent to it. For 14 patients it was so important as to be possibly psychologically vital. PMID- 6494821 TI - Effect of post-surgical jaw-orthopaedic treatment in unilateral cleft lip and palate patients. AB - Reduction of the contraction of maxillary segments in newborn infants with unilateral cleft lip and palate by means of post-operative maxillary orthopaedic treatment was evaluated in 32 consecutive patients. Early surgery was performed in three stages and jaw-orthopaedic treatment with an acrylic plate was started one week after the first and again after the second operation. Between the first and second operation, between the second and third operation and during the period from the first operation to the age of three years there were no significant differences in changes of maxillary width dimensions between half of the children using the plates most frequently and the other half, with one exception. This difference was probably due to differences in initial values between the two groups of children. Thus, the influence on maxillary dimensions and dental occlusion of jaw-orthopaedic treatment, carried out according to our routines, was very limited. On the other hand, other treatment objectives might have been facilitated. PMID- 6494822 TI - Separate clefts of the lip and the palate. A variant of cleft lip and palate. AB - Separate clefts of the lip and of the palate (CL-CP) may belong to the same etiological class as the cleft lip with or without cleft palate CL(P), or a child may have two separate anomalies, CL and CP. This theory was tested in Finnish cleft patients. Among 2471 cleft cases, there were 66 CL-CP (2.7%). Adequate medical records were available for 62 children: 45 boys (73%) and 17 girls (27%). Familial occurrence was recorded in 6 cases (10%). Of the cleft cases among the near relatives, 5 were CL(P) and one CP. The prevalence of hypodontia was 37% among 38 subjects studied, as compared with 8.2% in the CL-, 29.8% in the CP- and 48.1% in the CLP controls. Conical elevations of the lower lip were observed in none, as compared with 0.8% of the CL(P)- and 39% of the CP controls. It was therefore assumed that the CL-CP belongs to the same etiological class as the CL(P). PMID- 6494823 TI - On the pathogenesis of cleft palate in the Pierre Robin syndrome. AB - In a series of Pierre Robin syndrome (PRS) and isolated cleft palate patients (ICP) both U- and V-formed clefts were observed with equal frequency, but the PRS clefts were in average slightly wider. There were totally submucous clefts among the PRS patients. There was no statistical difference between the groups in the prevalence of clefts in the relatives of the patients. The incidence of (genetically influenced) conical elevations in the lower lip was lowest in the noncleft subjects, high in ICP and highest in PRS children. The incidence of hypodontia, which acceptedly is genetically influenced, was also highest in the PRS group. Thus the foetal malposition with the tongue between the palatal shelves does not seem to play any decisive role in the pathogenesis of most PRS clefts. The cause for the PRS is more likely a genetically influenced growth disturbance in the maxilla and the mandible, which due to the organogenetic differences leads to diverging end results, micrognathia and cleft. PMID- 6494824 TI - Wrist flexion strength after excision of the pisiform bone. AB - Diseases of the pisiform triquetral (P-T) joint and the pisiform itself are often treated with excision of the pisiform bone. The flexor carpi ulnaris (FCU) tendon inserts on the volar aspect of the pisiform, suggesting a loss of strength in wrist flexion following excision of the bone. Isometric and dynamic, isokinetical measurements were made using a strain-gauge dynamometer (Cybex II). Slight postoperative reduction of wrist flexion strength, compared with the contralateral wrist, was noted but not of clinical significance. It is concluded that one should not refrain from excision of the pisiform bone for fear of considerable strength loss in wrist joint flexion. PMID- 6494825 TI - Lunate implant arthroplasty. Evaluation of 19 patients. AB - The results of lunate implant arthroplasty are unpredictable and many untoward postoperative problems are encountered. A retrospective review of 19 patients operated on for lunatomalacia (Kienbock's disease) by Silastic (HP) implant arthroplasty suggests that prevention of postoperative scapholunate dissociation seems to be the key to successful results. Knowledge of the predominant role played by the palmar ulnolunate and radiolunate ligaments is important to the understanding of this mechanism. The intrinsic stability accomplished by the geometry of the carpal bones requires adequate ligamentous support. This restraint, however, may be weakened by pre-existing absence of certain palmar fibres, by the disease process or by the surgery. In the present study three operative methods have been assessed: dorsal approach and implant stem fixation; dorsal approach, removal of implant stem and Kirschner-wire fixation; volar approach, removal of implant stem, no internal fixation but palmar capsuloligamentous reinforcement. Consistently good results have been obtained using the latter technique. It seems as if most of the usual postoperative problems of lunate implant arthroplasty can be avoided by this method which warrants continued trial. PMID- 6494826 TI - Cervical spondylitis as a complication of secondary cleft palate surgery--a rare variety of the "maladie de Grisel". Case report. AB - Spontaneous atlanto-axial dislocation, due to metastatic lymphogenous infection and rupture of the transverse ligament is a well-known but rare complication of nasopharyngeal infections and/or operations. Previously one such case has been reported following a velopharyngeal flap (distally based) in a child with cleft palate. This is a report of two adult cleft patients with spondylitis of C III resulting in spontaneous fusion of C II-III, following a combined (cranially based) velopharyngeal flap and a dynamic muscle sphincter operation in one stage. Prolonged postoperative pain and stiffness of the neck should make one suspect this rare complication. PMID- 6494827 TI - Bone scintigraphy and serum phosphatases in the detection and follow-up of bone metastases in prostatic cancer. AB - Bone scintigraphy, serum acid phosphatase activity (ACP), prostatic acid phosphatase by radioimmunoassay (PAP) and alkaline phosphatase activity (ALP) were studied in 117 consecutive patients with prostatic cancer. Serum PAP was more sensitive than ACP in indicating prostatic cancer in the 63 patients with normal bone scans: 28% had positive PAP tests and 15% positive ACP tests. In the 54 patients with bone metastases no difference in the frequency of positive PAP (84%) and ACP (85%) test was observed. Serum PAP and ACP, but not ALP, were useful for the assessment of the response to therapy particularly in patients without bone metastases. In the follow-up of patients with bone metastases the scan was more informative than any of the phosphatase assays studied. PMID- 6494828 TI - The surgical treatment of mixed phosphatic renal lithiasis. Long-term follow-up. AB - Of a total of 36 patients operated on for mixed phosphatic renal lithiasis without renal cooling, 26 were re-examined after a mean postoperative interval of 51 1/2 months. Pelvic and calyceal stones had been present in 17 of these patients and staghorn stones in 9. All the patients had presented with persistent urinary tract infection. The total of kidneys operated on was 41. Examination 1 to 3 months after the operation showed complete stone clearance in 85% of these kidneys nd freedom for urinary tract infection in 78% of the patients. At long term follow-up 73% of the patients had no urinary tract infection. The follow-up investigation suggest that tiny fragments of stone may be left in difficult operations, since such fragments do not necessarily lead to formation of new stones and are not necessarily accompanied by persistent urinary tract infection. PMID- 6494829 TI - A simple diagnostic method of peritonitis in patients on CAPD. AB - The major complication of continuous ambulatory peritoneal dialysis (CAPD) still is peritonitis, therefore, early and simple methods for detection of infection are important. Peritoneal effluent cellularity is a predictor of peritonitis and can be detected by Cytur-Test, a test-strip developed for detection of leucocytes in urine. The purpose of the study was to evaluate the usefulness of Cytur-Test as a diagnostic test in peritonitis in patients on CAPD. A total of more than 5 000 tests were performed. During the period we diagnosed 46 cases of peritonitis. The Cytur-Test was positive in all cases. There were no false negative tests. In two cases only, the test appeared positive for 48 hours without clinical signs of peritonitis. PMID- 6494830 TI - Arterial calcifications in uraemic rats treated with 1-alpha hydroxycholecalciferol and parathyroidectomy. AB - The effect of 1-alpha-hydroxycholecalciferol (1-alpha-OH-D3) on the incidence of arterial calcifications, and the influence of parathyroidectomy on the effect of this vitamin D treatment, were studied in uraemic rats. Uraemia was induced by 3/4 kidney resection, and parathyroidectomy was achieved by electrocoagulation. 1 alpha-OH-D3 in a dose of 3, 10 or 125 ng/100 g body weight (b.w.) was given in the drinking water. The animals were killed after 12 or 16 weeks. Aorta and small arteries in the heart and in anterior tibial muscle were studied by light microscopy. Arterial lesions were frequently found in uraemic rats and were characterized by medial necrosis and calcifications. Following a 1-alpha-OH-D3 dose of 125 ng/100 g b.w. in uraemic rats both serum calcium and serum phosphate were increased and there was a high incidence of arterial calcifications both in the aorta and the small arteries. In uraemic rats receiving 10 ng/100 g b.w. of 1 alpha-OH-D3 serum calcium was only slightly elevated although the incidence of arterial calcifications (mainly in the aorta) was such higher than in uraemic rats without vitamin-D treatment. A dose of 3 ng/100 g b.w. of 1-alpha-OH-D3 given to uraemic rats did not result in any serum calcium increase, nor did it alter the incidence of arterial calcifications. Parathyroidectomy prevented arterial calcifications. Parathyroidectomy prevented arterial calcification in uraemic rats, but this effect was abolished by 1-alpha-OH-D3 in a dose of 10 ng/100 g b.w. which only raised the serum calcium to a subnormal value. In uraemia, treatment with 1-alpha-OH-D3 may increase the serum calcium X phosphate product, but this cannot fully explain the increased incidence of arterial calcifications. It is therefore suggested that vitamin D causes changes in the arterial wall which increase its susceptibility to the development of calcifications. PMID- 6494831 TI - The aortic content of glycosaminoglycans, hydroxyproline and calcium in experimental uraemia with special reference to parathyroidectomy and vitamin-D treatment. AB - The contents of the various glycosaminoglycan (GAG) fractions, hydroxyproline and calcium in the thoracic aorta from the rat were studied. The effect on these contents of induced uraemia (3/4 kidney resection) combined with parathyroidectomy and/or 1-alpha-hydroxycholecalciferol (1-alpha-OH-D3) treatment was evaluated. Confirming earlier results increased levels of GAGs (predominately of chondroitin and dermatan sulphate) were found in the aortae of uraemic rats. The present study showed that parathyroidectomy or treatment with 1-alpha-OH-D3 did not significantly further alter the aortic content of GAGs in uraemic rats. Arteriosclerotic changes (calcifying medial necrosis) were only found in non parathyroidectomized uraemic rats given 1-alpha-OH-D3. The aorta from these rats had a lower total content of GAGs, mainly due to a decrease in hyaluronic acid, than that from uraemic rats without calcifications. The aortic content of calcium was lowest in uraemic parathyroidectomized rats. Treatment with 1-alpha-OH-D3 increased this content, which was augmented 100-200-fold when calcifications were present. No correlation between the aortic contents of calcium and GAGs was found. There was a statistically significant correlation between the aortic content of calcium and the serum calcium X phosphate product. A significantly lower content of hydroxyproline was found in uraemic non-parathyroidectomized rats given 1-alpha-OH-D3, especially in those with arteriosclerosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494832 TI - Pelvic lipomatosis causing constriction of the lower urinary tract and the rectum. Case report. AB - Pelvic lipomatosis is a rare condition characterized by excessive accumulation of fat in the pelvis. The symptoms and the course of the disease are related to compression of the lower urinary tract and rectum. The clinical findings and radiological characteristics are described. PMID- 6494833 TI - Primary ureteral leiomyosarcoma. AB - Primary leiomyosarcoma is a rare tumor of the ureter. Including the two patients here presented, only 14 cases have been reported. Both of our patients also had other, unrelated malignancies. PMID- 6494834 TI - Hip load moments and muscular activity during lifting. AB - The load on the hip joint during lifting was studied. Healthy subjects lifted a 12.8 kg box from floor to table level with straight and flexed knees in four different ways. The loading moment of force about the bilateral hip axis was calculated by means of a computerized static sagittal plane model. The highest load moment, 124 Nm, occurred initially in the straight knee lift and the compressive joint reaction force was 2.7 times body-weight. The lowest load moment, 82 Nm, occurred in the flexed knee lift with the burden moved close to the trunk, the compressive force was 3.2 X bw. The load moment was also discussed in relation to the strength capability. The EMG levels of seven different hip muscles were normalized and expressed as a percentage of the recorded level of each muscle group during an isometric maximum voluntary contraction. The initial activity in the hamstrings was higher in the straight knee lift compared to flexed knees. The gluteus maximus was activated to a moderate level. PMID- 6494835 TI - Autotraction versus manual traction in patients with prolapsed lumbar intervertebral discs. AB - Forty-nine patients with lumbago-sciatica and prolapsed lumbar intervertebral discs, comparable concerning anamnestical and clinical data were randomized for autotraction and manual traction given by the same therapist for a period of one week while strict bed rest was prescribed. A blind overall assessment performed immediately after the traction period, after two weeks follow-up training and three months after hospitalization showed that the two traction modalities are equally efficient. As treatment for hospitalized patients with lumbar intervertebral disc prolapses the relatively simple manual traction variety should be preferred, if any. Traction is suggested to be used as a prognostical aid. Pain intensity was significantly reduced in all body parts. About one fourth of patients avoided operation. After two years there was no recurrence of symptoms. PMID- 6494836 TI - Katz index of independence in ADL. Reliability and validity in short-term care. AB - This article deals with the Katz Index of Independence in Activities of Daily Living and presents a study of its reliability and validity carried out at a Department of Internal Medicine in Sweden. Enrolled nurses assessed independently 100 aged patients. Scalability and interobserver variability were tested with Guttman scale-analysis. The results indicated that the activities are ranked according to a cumulative scale and that the index is reliable. Patients independent in ADL had shorter hospitalization and were discharged home more often than were the dependent patients. This indicates that the scale is valid. One year later most dependent patients were either dead or living in institutions: thus the index has a predictive potential. The systematic errors of scale were used to refine the index for use in short-term care. It is recommended as a basic measure of functional ability among aged abled or disabled patients also in short-term care. PMID- 6494837 TI - Glenohumeral malalignment in the hemiplegic shoulder. An early radiologic sign. AB - A new radiologic sign is described which seems to diagnose an early presubluxation phase of glenohumeral malalignment in hemiplegic shoulders. The sign consists of a V-shaped widening of the upper part of the space between the humeral head and the glenoid cavity on anteroposterior shoulder films in the erect position. Twelve of 14 patients showing this sign went on to develop chronically painful shoulders, and four of them developed radiologically evident subluxation within several months. The sign may be helpful in diagnosing shoulder pathology following stroke at an early stage, when orthotic measures may still have preventive value. PMID- 6494838 TI - A battery-alarm system for phrenic nerve stimulators. AB - A simple alarm circuitry for unilateral diaphragm pacer transmitters has been constructed. The system, which is attached to the 9 V battery powered transmitter, will trigger an alarm sound when the battery voltage decreases to 8 V. The system may diminish or abolish the need for special supervision of patients with phrenic nerve stimulators. PMID- 6494839 TI - Hip joint load and muscular activation during rising exercises. AB - The load on the hip joint and activation of the gluteus maximus, hamstrings, adductor magnus and rectus femoris muscles during rising exercises including different adaptive adjustments were investigated in nine healthy subjects. The joint load was calculated from forces recorded with a force-measuring platform and pictures on cine-film. Levels of muscular activity were recorded with rectified, low-pass filtered, time-averaged and normalized EMGs. The loading moment about the hip joint was about 45 Nm during the initial part of the rising exercise, decreasing with smaller hip angle. Increase of the backward inclination of the trunk increased the load moment, which was maintained at about the same level during the rising exercise. Two adaptive adjustments lowered the joint load: foot position further backward and reduced resistance from the device. Foot position further forward increased the joint load. The levels of muscular activity in the hip extensors were low to medium and were slightly increased by posterior foot position and increased resistance from the device. Increased backward trunk inclination increased the activity in the final part of the rising exercise. PMID- 6494840 TI - Mortality of English furniture makers. AB - Men (5,108) who worked in the Buckinghamshire furniture industry before 1968 have been followed to the end of 1982; 1,638 (32.1%) had died. With the exception of nasal cancer, there was no significant increase in mortality, nor any trend towards increasing mortality with increasing dustiness of the work, for cancer of any site. PMID- 6494841 TI - Extensions to a technique for relating mortality and environment--exemplified by nasal cancer and industry. AB - The use of geographic data to interrelate mortality rates and environmental variables is an important approach to determining reasons for the variations in disease frequency. An alternative methodology to standard regression analysis was recently suggested, which is particularly useful when there are a large number of geographic areas and relatively few deaths. An extension of this technique is described, which includes a modified regression approach using areas aggregated according to their level of the environmental factor. An example is given relating nasal cancer mortality to the distribution of industry in England and Wales. The known hazards in the furniture and leather industries are indicated and other potential risk industries, including tailoring, are suggested. PMID- 6494842 TI - Effect on the uptake kinetics of serotonin (5-hydroxytryptamine) in platelets from workers with long-term exposure to organic solvents. A pilot study. AB - Six workers from a paint industry were examined concerning the concentration of solvents in the breathing zone, the platelet count and kinetic uptake of serotonin [5-hydroxytryptamine (5-HT)], the serum concentration of calcium, potassium and sodium, and pH. The degree of exposure was found to be moderate. The results showed a decrease in platelet count in whole blood and platelet-rich plasma. The maximum uptake rate for serotonin in platelets (Vmax) was significantly increased compared to that of nonexposed subjects. No changes in the ionic concentration and pH of serum were observed. One worker was reexamined after a six-week period of nonexposure. Though the measured platelet variables were still aberrant, the values approached normal. PMID- 6494843 TI - In vitro study on lead and alcohol interaction and the inhibition of erythrocyte delta-aminolevulinic acid dehydratase in man. AB - The effect of lead (Pb) and ethanol (EtOH) interaction on the inhibition of erythrocyte delta-aminolevulinic acid dehydratase (ALAD) was investigated in human blood in vitro. Two different doses of ethanol (equivalent to 16.28 mmol of EtOH/l of blood and 108.53 mmol of EtOH/l of blood) and lead (equivalent to 2.17 mumol of Pb/l of blood and 4.34 mumol of Pb/l of blood) were examined separately and in combination. The dose-effect (EtOH-ALAD) relationship for a wide range of ethanol concentrations (0-217.06 mmol of EtOH/l of blood) was also investigated. The results obtained indicate that ethanol by itself does not inhibit ALAD, while lead does it readily. Neither ethanol concentrations significantly altered ALAD activity. The dose-effect (EtOH-ALAD) relationship did not reveal any inhibitory effect of ethanol on ALAD either; however, a weak trend towards increased ALAD activity was found. The effect of ethanol combined with lead indicated no significant difference as compared to the effect of the same dose of lead per se; however, a weak trend towards decreased ALAD activity was found. These findings support the hypothesis that the effect of ethanol on the transient inhibition of ALAD activity in vivo does not occur directly, but possibly through the intermediary action of lead from the body lead pool. PMID- 6494844 TI - In vivo study on lead and alcohol interaction and the inhibition of erythrocyte delta-aminolevulinic acid dehydratase in man. AB - The effect on alcohol (EtOH) consumption on the inhibition of erythrocyte delta amino-levulinic acid dehydratase (ALAD) was investigated in 13 male lead workers and 7 "normal" male subjects. Lead and zinc protoporphyrin in blood and lead, delta-aminolevulinic acid, porphobilinogen and coproporphyrin in 24-h urine specimens were also determined. During 1 h the subjects drank 122.8 (SD 18.65) ml of an almost lead-free brandy, ie, a dose of 11.07 mmol/kg of body weight. This dose resulted in a trend toward a parallel decrease in ALAD activity and an increase in lead in blood (PbB), both of which approached the prealcohol value 24 h after the initial alcohol ingestion. A trend toward increased lead excretion in urine (PbU) was observed on the day of alcohol ingestion, as compared to the preceding and succeeding 24-h urine specimens. However, the observed increase in PbB and PbU cannot be attributed to the small amount of lead ingested through the brandy, ie, 7.09 (SD 1.06) nmol. The characteristic dose-effect relationship between PbB and ALAD (examined prior to and 1, 3, 5, and 24 h after the initial alcohol ingestion) reached the highest correlation coefficient 3 h after the initial alcohol ingestion (p less than 0.001). The data obtained appear to support the hypothesis of a possible role for the body lead pool and the lead mediated influence of alcohol consumption on ALAD activity in man. PMID- 6494845 TI - Improved techniques for sampling airborne fungal particles in highly contaminated environments. AB - Nuclepore filters (polycarbonate) were compared with a slit sampler for the collection of airborne fungi particles. To enable high spore-concentration sampling, the slit sampler method was modified by the use of collection gels consisting of agar or glycerol/gelatin. The exposed gels were homogenized (agar) or melted (glycerol/gelatin), diluted, and spread on cultivation media. No significant difference was found between the Nuclepore filter method and the slit sampler method when glycerol/gelatin gels were used in the interval 10(3)-10(8) colony-forming units (cfu) per cubic meter. The lower trapping efficiency with agar gel was probably caused by water evaporating from the medium. The efficiency of a personal cascade impactor (Sierra) was compared with that of the Nuclepore filter method. The collection media used in the personal cascade impactor was modified for the determination of colony-forming units by moistening the collection filters with glycerol. The exposed filters were extracted with sterile water, and the suspension was diluted and spread on cultivation media. In trapping efficiency, the personal cascade impactor was similar to the Nuclepore filter method. The cut point of the personal cascade impactor showed high conformity with that of an Andersen sampler. PMID- 6494846 TI - Cancer mortality among workers in a thermoelectric power plant. AB - At a thermoelectric power plant in Turbigo (Milan, Italy), an analysis of the technological process has shown the presence of exposure to several carcinogens: polycyclic aromatic hydrocarbons, asbestos, hydrazine, polychlorinated biphenyls, chromium, nickel, and beryllium. An epidemiologic study was carried out to quantify the effect of the detected exposures on the workers, and the cancer mortality of the cohort was compared with the corresponding rates from the closest town and with cancer register data from a nearby province. Excess mortality was found for workers with 10 or more years of employment; the median latency time was about 20 years. PMID- 6494847 TI - Solvent exposure in construction and maintenance painting. AB - Exposure to solvents in interior house painting was determined by industrial hygiene surveys and questionnaires on work history. Painting work was observed in 92 work situations at 18 sites, mainly during maintenance work. The effects of the size of the work area, the volume of air, the type of paint, the amount used, the method of application, and the use of ventilation on the solvent concentrations were also studied. In small, poorly ventilated rooms the concentration of solvent naphtha averaged 275 ppm when alkyd paints were used. Wall and ceiling painting with alkyd paints yielded an average solvent naphtha concentration of 210 ppm, and window and door painting 80 ppm. The presence of a strong draft reduced the solvent concentrations by two-thirds. The painters' average lifetime dose of solvent naphtha was 12.2 kg, the average annual dose 0.54 kg. These levels decreased over the study period. The mean 8-h concentration of solvent naphtha in the breathing zone averaged 40 ppm over the painters' total worklife. PMID- 6494848 TI - Differences in the respiratory capacity of workers with long-term exposure to vapors from paints free from or containing organic isocyanates. PMID- 6494849 TI - British studies on the neuropsychological effects of solvent exposure. PMID- 6494850 TI - Description of the tests in the London School of Hygiene test battery. PMID- 6494851 TI - The Rorschach test in behavioral toxicology. PMID- 6494852 TI - Neuropsychological assessment in behavioral toxicology--developing techniques and interpretative issues. PMID- 6494853 TI - The Halstead-Reitan neuropsychological test battery. Description and application. PMID- 6494854 TI - Neuropsychological investigation with Luria's methods. PMID- 6494855 TI - Cognitive approaches to neuropsychological assessment. PMID- 6494856 TI - The measurement of subjective symptoms. PMID- 6494857 TI - Current research in behavioral toxicology in Scandinavia. PMID- 6494858 TI - [Follicular thyroid cancer. A multivariate analysis]. AB - The prognosis of malignant tumors is determined by a number of factors and their interaction. These factors may be assessed statistically by means of regression models for the hazard rates, which are assumed to be proportional. 89 follicular thyroid cancers from 1952 to 1975 were analysed according to clinical, macropathological and special histological criteria. Those variables which significantly influence the survival function were defined precisely and quantified by multivariate analysis. The age of the patients at the time of diagnosis (primary operation), sex, and local tumor extent (and therefore radical surgery) proved to be prognostically significant. Thus, the TNM system alone is sufficient neither for individual prognostic pronouncements nor for forming risk groups. PMID- 6494859 TI - [Acute subdural hematomas, prognostic factors]. AB - Subdural hematomas are considered to be acute when diagnosed within 24 hours of trauma. The high mortality rate associated with them demonstrates the need to improve their outcome, especially by study of prognostic variables. The authors have studied 35 patients with acute subdural hematoma (ASDH) treated surgically. The diagnosis of ASDH was documented by clinical examination and computerized axial tomography scan (CAT-scan). Follow-up of the patients shows that age, sex, and pre-operative neurological examination, including depth of coma and pupillary changes, are significant prognostic variables. Post-operative intracranial pressure (ICP) is an important factor in determining the outcome, since all the patients with an ICP over 50 mm Hg died. Furthermore, the patients treated surgically by craniotomy have a better outcome and a rate of good recovery much higher than those treated by burr holes only. Thus, the prognosis of ASDH may be improved by careful and systematic monitoring of the ICP with adequate treatment when it reaches critical levels, and by large decompressive craniotomy for evacuation of the clot. PMID- 6494860 TI - [Brainstem encephalitis and vesicular exanthema caused by Mycoplasma pneumoniae]. AB - Serologically proven Mycoplasma pneumonitis followed by vesicular mucocutaneous eruptions and aseptic brainstem encephalitis was observed in a 4-year-old boy. Both neurological and dermatological symptoms occurred approximately 2 weeks after the onset of pneumonia. The patient was treated with tetracyclines, corticosteroids and general supportive care and recovered completely over several months. An etiological relationship between mycoplasmal infection and neurological and dermatological symptoms, as already described in the literature, is postulated. A viral etiology was excluded by appropriate serological and cultural investigations. PMID- 6494861 TI - [Concerning the article "Problem of heparin dosage" by G. Mombelli]. PMID- 6494862 TI - [Pathophysiology of epilepsy]. AB - Epilepsy is a paroxysmally occurring disturbance of brain function. The neurones directly involved in the epileptic process show characteristic behaviour of the membrane potential, which consists of a rectangular-shaped depolarization recorded in neurones during all experimental models of epilepsy investigated up to now. Occasional recordings in patients have shown a similar reaction of the membrane potential. The membrane potential fluctuation is therefore regarded as the specific reaction of a neurone directly involved in the epileptic process, and the accordingly termed "paroxysmal depolarization shift" (PDS) was found to be the expression of pathophysiologic behaviour by the neuronal membrane. The "epileptic" neurones are hemispherically surrounded by neurones which are simultaneously inhibited. The mechanisms capable of overcoming the surrounding inhibition and thus leading to the spread of epileptic activity are not fully understood as yet: seizure-related changes in the extracellular ionic environment appear to support the spreading process. The termination of an epileptic event is not necessarily the result of metabolic exhaustion of the nerve cells involved. Recent data indicate a prominent role for primary neuronal mechanisms in the termination of a seizure. However, the cortical tissue participating in a partial seizure shows increased vulnerability to hypoxia. Brain damage found in central nervous tissue of epileptics may therefore be the result of secondary cerebral hypoxia consequent on seizure-related disturbances of breathing and circulation. PMID- 6494863 TI - [Diagnosis of epilepsy in private practice]. AB - Careful recording of family and personal history is all-important in the diagnosis of epilepsy. If possible, a description of seizures should be obtained from an observer. Occasional seizures are to be distinguished from real epilepsy. The indications for cranial computerized tomography (CCT) are discussed: the indication is imperative in fresh partial epilepsies with elementary symptoms (some 30% brain tumors) and less so in fresh partial epilepsies with complex symptoms (some 5-10% brain tumors). In late epilepsy (onset after age 20-30, negative family and personal history), CCT is always worth considering. PMID- 6494864 TI - [Social problems of epilepsy]. AB - Epilepsy is not only a cerebral but also a social reality. The social problems surrounding this afflication must usually be faced throughout the patient's life: in childhood remedial measures or special schools are usually necessary, and when school has ended the question of employment arises. In addition, the wish to drive a motor vehicle is often expressed. Structural analysis of the "epileptic personality" reveals, over and above the unmodifiable components, a number of therapeutically accessible areas; in special cases even creative leanings are observable. PMID- 6494865 TI - [Diagnostic problems in hysterical seizures]. AB - The steeply increasing number of publications on psychogenic seizures during the last few years does not appear to be due to an increase in their incidence but to the introduction of videography into clinical practice. By this method, analysis of seizures and differential diagnosis between hysterical and epileptic seizures has become much easier. Out of the total of 40 seizures which have been recorded on video at the Neurological Department of the University of Berne during 1982 through 1983, 13 were obviously of psychic origin. The case of a patient with both hysterical and epileptic seizures is reported to illustrate the diagnostic difficulties in differentiating these two types of attack. PMID- 6494866 TI - [Diagnostic value of cerebrospinal fluid analysis]. AB - The increasing importance of cerebrospinal fluid (CSF) analysis as a diagnostic tool in neurology is the consequence of major advances in neuroimmunology. Thus, immunological mechanisms are involved not only in acute infections of the CNS but also play a role in many subacute and chronic inflammatory diseases of the nervous system as well as in neoplastic disorders. CSF analysis is important to the clinician in providing clues for the detection of immune processes that are restricted to the brain. A wide variety of techniques, including cytological, bacteriological, virological and immunological methods, are now available as routine clinical laboratory tests. A few clinically relevant applications in study of the CSF are discussed. PMID- 6494867 TI - [Acquired immune deficiency syndrome in the region of Zurich. Report on 12 cases]. AB - Observations of 12 patients with AIDS at this institution from March 1981 to April 1984 are reported. Ten patients were homosexuals and two were bisexual. The majority had travelled abroad (USA, Haiti) and reported multiple anonymous sexual contracts. Eleven patients reported symptoms and signs, of 2-12 months' duration, frequently seen in pre-AIDS: fatigue (10), weight loss (10), diarrhea (7), night sweats (5), fever (4), and generalized lymphadenopathy (1). Laboratory studies showed anemia (10), lymphopenia (9), leukopenia (7), decreased T-helper/T suppressor ratio (10) and cutaneous anergy to multiple skin-test antigens (9). P. carinii pneumonia was diagnosed in three patients, P. carinii pneumonia and Kaposi's sarcoma in one patient and Kaposi's sarcoma in six patients. Another patient had a chronic mucocutaneous infection with herpes simplex and another an intestinal cryptosporidiosis and Kaposi's sarcoma. Alpha-A-interferon was used to treat patients with Kaposi's sarcoma and three patients with limited disease showed a favorable response. Six patients with advanced disease died. PMID- 6494868 TI - [Ergometrically determined work capacity in chronic hemodialysis treatment]. AB - To evaluate the degree of physical activity in hemodialysis patients, working capacity was assessed by bicycle ergometry in 16 hemodialysis patients (mean age 47 +/- 12 [SD] years). The mean length of dialysis treatment was 21 +/- 17 months. The laboratory and clinical findings were as follows (mean values +/- SD): urea 34 +/- 6 mmol/l; creatinine 1127 +/- 169 mumol/l; potassium 5.7 +/- 0.63 mmol/l; calcium 2.25 +/- 0.22 mmol/l; phosphate 1.76 +/- 0.54 mmol/l; hemoglobin 8.54 +/- 1.02 g/dl; hematocrit 26.1 +/- 2.9%; blood pressure 140 +/- 18/86 +/- 9 mm Hg; nerve conduction velocity 39.5 +/- 6.5 m/sec. Mean working capacity was 58 +/- 31 W (41 +/- 24% of normal values) and the specific working capacity (watts/kg body weight) was 0.79 +/- 0.54. The duration of exercise testing was 4.9 +/- 2 min. The ergometry had to be discontinued because of the following reasons: leg fatigue (10 patients); general fatigue (3); dyspnea (1); attainment of maximal heart rate (2). The maximal blood pressure during exercise testing was 149 +/- 21/86 +/- 14 mm Hg and the maximal increase in heart rate 117 +/- 34 beats/min. In patients treated with a beta-blocker agent for hypertension, maximal increase in blood pressure was comparable to normotensive patients. There was a negative correlation between working capacity and the age of the patients (r = 0.77; p less than 0.01). A positive correlation was found between working capacity and the serum creatinine level (r = 0.52; p less than 0.05). PMID- 6494869 TI - [Reactivity of the bronchi in pollen rhinitis and pollen asthma the before and during the pollen season]. AB - Nonspecific bronchial reactivity was investigated during and out of the pollen season in 28 pollen-allergic asthmatics and 25 hay fever patients without bronchial asthma. The degree of the reactivity was measured by the decrease of inspiratory specific airway conductance (sGI) after voluntary hyperventilation. Before hyperventilation the mean values for the sGI in both groups of patients were within the low normal range and revealed no seasonal fluctuations. During the pollen season 26 (93%) asthmatics and 14 (56%) hay fever patients showed bronchial hyperreactivity. Out of season 22 (79%) asthmatics and only 8 (32%) hay fever patients were hyperreactive. Thus, in the absence of the relevant allergens, most of the pollen sensitive asthmatics showed a significant increase in unspecific bronchial reactivity which was somewhat higher during the pollen season. The seasonal increase of bronchial reactivity in hay fever patients suggests a relationship with pollen asthma. 12 pollen-allergic asthmatics, who were examined again in the next pollen season after one period of preseasonal specific hyposensitization with pollen extracts, displayed a significant decrease in nonspecific bronchial reactivity. PMID- 6494870 TI - Lipoprotein genes and hyperlipidemia. AB - The hyperlipidemias, with hypertension, diabetes mellitus and cigarette smoking, are amongst the major risk factors for the development of atheroma. The inter relationships of hyperlipidemia and atheroma are complex but both appear to have a strong inherited component. Amongst the multiple genetic factors determining the common forms of hyperlipidemia, the apolipoprotein genes coding for the major peptides of the plasma lipoproteins (chylomicrons, VLDL, LDL and HDL) may be of particular relevance since the latter form a system of inter-converting particles for the delivery of lipid (triglyceride and cholesterol) to peripheral tissues (including the arterial wall). Recently several apolipoprotein genes have been isolated. Particularly interesting results have been obtained with the apolipoprotein AI and CIII genes. The DNA sequence of both genes and their immediate flanking region was determined. The two genes are physically linked and convergently transcribed. The cloning of the apolipoprotein genes made possible a detailed genetic study of patients with defects in lipid metabolism. An altered apo AI gene was shown to be inherited as a Mendelian trait linked to premature atherosclerosis in an affected family. Furthermore, the alteration of the apo AI gene seems to affect the expression of the apo CIII gene. Another DNA polymorphism that generates a new SstI site was shown to be present at low frequency (8%) in a random sample of the population. However, its frequency increased dramatically (42%) in a group of hypertriglyceridemic patients. It is thus not inconceivable that further studies of the genes involved in lipid metabolism will eventually help to replace the present phenotype based classification of lipid metabolism disorders by a genotype based system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6494871 TI - [Mechanisms of activation and function of oncogenes]. AB - Transforming genes (oncogenes) were first identified and characterized as genetic elements of tumorviruses. It has been demonstrated that these genes are derived from cellular genes by transduction. The corresponding cellular genes are ubiquitous in nature and have been well conserved during evolution. It is therefore very likely that they are important elements in normal regulation of cell growth, e.g. during development. Several mechanisms of oncogene activation have been observed. Qualitative as well as quantitative changes in oncogene expression lead to cell transformation. According to their mechanism of action, at least 4 functional groups of oncogenes can be distinguished. It has recently been shown that the transformation of a normal cell into a tumor cell proceeds in several steps involving different oncogenes. PMID- 6494872 TI - [Septic granulomatosis in adults]. AB - Chronic granulomatous disease is a usually X-linked disorder of granulocyte bacterial killing. At least 8 variants can be distinguished biochemically. Two male patients aged 20 and 24 years with a relatively benign clinical course are presented. A partial defect of the membrane-bound cytochrome b-245 with a residual bactericidal capacity was detected in both. Due to continuous antibacterial prophylaxis (trimethoprim/sulfamethoxazol) and treatment of infections with intracellularly accumulating agents (e.g. rifampicin, fosfomycin, clindamycin), even patients with complete defects of bacterial killing can reach adulthood today. Physicians and surgeons should be aware of this disorder, which is no longer a "fatal granulomatous disease of childhood". PMID- 6494873 TI - [Effect of alcoholic hyperlipoproteinemias on the deformability and viscosity of erythrocytes]. AB - This pilot study set out to evaluate the influence of the metabolic disorder due to acute alcohol toxicity on red blood cell (RBC) deformability. RBC deformability was measured optoelectronically by microcomputer-assisted polymicroviscometry (filtrometry). Chronic alcoholic patients (n = 12) with transient haemolytic anaemia, jaundice and hyperlipoproteinaemia were studied during the acute and the remittent phase of alcoholic disease. RBC obtained from patients in the acute phase revealed a markedly impaired deformability as compared with RBC suspensions studied when the alcoholic symptoms had subsided. The study lends further support to the hypothesis that predominantly during acute alcohol toxicity patients experience a marked impairment of the adhesive and rheological properties of RBC, which may finally impair the peripheral microcirculation of the whole blood. PMID- 6494874 TI - [Hereditary erythrocyte pyruvate kinase abnormality: another kindred from Aargau Canton]. AB - A Swiss family with abnormal red cell pyruvate kinase is described. In two new born siblings the red cell defect was responsible for marked hyperbilirubinemia. At the present time both children have compensated hemolysis and are clinically healthy. The abnormal enzyme is unstable and has a decreased Hill coefficient and a decreased substrate affinity. It is different from two other enzyme variants found in the same area. PMID- 6494875 TI - [Veterinary practitioner and swine production]. PMID- 6494876 TI - [Enzootic nodular ulcerative thelitis with Mycobacterium infection in cows]. PMID- 6494877 TI - [Efficacy of spiramycin treatment in subclinical and clinically manifested Staphylococcus aureus mastitis in the udder of lactating cows]. PMID- 6494878 TI - [Terminal ileitis in sheep]. PMID- 6494879 TI - [Biochemical basis for transmembrane potential changes during myocardial ischemia]. PMID- 6494880 TI - [Mechanism of abnormal vascular muscle functions and their roles in the pathogenesis of hypertension]. PMID- 6494882 TI - [Spectrin of the erythrocyte membrane]. PMID- 6494881 TI - [Research on thixotropy, elasticity and viscosity of blood and its clinical significance]. PMID- 6494883 TI - [Regulation of cardiovascular function by plasma serotonin]. PMID- 6494884 TI - [Autoregulation of nephron function: tubular-glomerular feedback]. PMID- 6494885 TI - [Principles of diagnosing aerobic and anaerobic capacity]. PMID- 6494886 TI - [Principles and methods of diagnosing biomechanic performance]. PMID- 6494887 TI - [Methodological problems of diagnosing performance in the laboratory]. PMID- 6494888 TI - [Diagnosing aerobic capacity at the Swiss School for Physical Education and Sports at Magglingen]. PMID- 6494889 TI - [Knee disorders in sportsmen: treatment possibilities using correction of statics]. PMID- 6494890 TI - Hypertension and calcium. PMID- 6494891 TI - Heterochronic mutants of the nematode Caenorhabditis elegans. AB - Mutations in the Caenorhabditis elegans genes lin-14, lin-28, and lin-29 cause heterochronic developmental defects: the timing of specific developmental events in several tissues is altered relative to the timing of events in other tissues. These defects result from temporal transformations in the fates of specific cells, that is, certain cells express fates normally expressed by cells generated at other developmental stages. The identification and characterization of genes that can be mutated to cause heterochrony support the proposal that heterochrony is a mechanism for phylogenetic change and suggest cellular and genetic bases for heterochronic variation. PMID- 6494892 TI - Congress votes NIH a big budget boost. PMID- 6494893 TI - Medical education under fire. PMID- 6494894 TI - Saving chimps for research. PMID- 6494895 TI - FDA hit on device regulation. PMID- 6494896 TI - New regulatory mechanism of parasitism. PMID- 6494897 TI - Veto looms over NIH legislation. PMID- 6494898 TI - Salad, house dressing, but hold the sulfites. PMID- 6494899 TI - Congress gives blessing to New York primate lab. PMID- 6494900 TI - Parasite research gets $17-million boost. PMID- 6494901 TI - Isolation and culture of a tetraploid subpopulation of smooth muscle cells from the normal rat aorta. AB - Smooth muscle cells with 4C (double diploid) DNA content have been found in major arteries. The proportion of 4C cells increases with normal aging and with hypertension. These cells may represent a state of arrest at the G2 phase of the cell cycle or may be examples of true tetraploidy. Flow cytometric cell sorting was used to isolate 4C smooth muscle cells from the rat aorta, and the cells were cultured. Flow cytometry, Feulgen microdensitometry, and karyotyping of the progeny of the 4C cells established the presence of true tetraploid cells. These findings demonstrate the presence of reproductively viable tetraploid cells in a normal mammalian tissue. PMID- 6494902 TI - Dairy product consumption. AB - In the announcement of the 1985 winter schedule of the Gordon Research Conferences (5 Oct., p. 77), the dates for the conference "Multiple Opiate Receptors" (on p. 79) were incorrectly given. The conference will be held in February, not January. The days of the month were correct. PMID- 6494903 TI - EPA scraps radionuclide regulations. PMID- 6494904 TI - Human ornithine transcarbamylase locus mapped to band Xp21.1 near the Duchenne muscular dystrophy locus. AB - The gene for the mitochondrial enzyme ornithine transcarbamylase was mapped to the short arm of the X chromosome by in situ hybridization experiments, with DNA complementary to the human ornithine transcarbamylase gene used as a probe. A series of cell lines with X chromosome abnormalities was used to localize the gene to band Xp21.1. Because the gene maps near the Duchenne muscular dystrophy locus, the ornithine transcarbamylase probe may be useful in carrier detection and prenatal diagnosis of Duchenne muscular dystrophy as well as of ornithine transcarbamylase deficiency. PMID- 6494905 TI - Detection of high molecular weight forms of platelet-derived growth factor by sequence-specific antisera. AB - Antisera to synthetic peptides representing sequences of both chains of platelet derived growth factor (PDGF) were used to structurally analyze PDGF isolated from outdated human platelets and PDGF-like proteins in normal and transformed cells. Most PDGF isolated from platelets did not contain the carboxyl portion of PDGF-2 in contrast to p20sis, the major form of p28sis detected in simian sarcoma virus transformed cells. In addition, higher molecular weight forms of molecules containing PDGF-1 and PDGF-2 sequences were detected in all cell lines tested. These lines were heterogeneous with respect to species, cell type, and transforming agent. PMID- 6494906 TI - Transcription and promoter usage of the myc gene in normal somatic and spermatogenic cells. AB - In somatic cells the level of myc transcription is not restricted to particular cell types but correlates closely with the rate of cell division. Such transcription involves the use of two active myc promoters and produces two messenger RNA species that are differentially represented among the transcripts of different tissues. In apparent contrast to somatic cells, mitotically and meiotically dividing germ cells have very few myc transcripts and appear to proliferate, at least for a few divisions, in the absence of myc transcription. These results raise interesting questions regarding the role of the myc gene product in terminally differentiating cells, particularly of the germ line series. PMID- 6494907 TI - Unequivocal delayed hypersensitivity in mast cell-deficient and beige mice. AB - It has been suggested that reserpine blocks expression of delayed hypersensitivity in mice because it depletes stores of the vasoactive amine serotonin in mast cells. To determine whether mast cell serotonin or other mast cell-derived mediators are essential for delayed hypersensitivity, responses to contact sensitizers in mast cell-deficient W/Wv or Sl/Sld mice were studied. Because blood platelets represent another potential source of serotonin in delayed hypersensitivity responses, beige mice, whose platelets contain less than 1 percent of the normal levels of serotonin, were also examined. By the criteria of tissue swelling, infiltration of iodinated leukocytes, or histology, mast cell deficient or beige mice expressed delayed hypersensitivity reactions whose intensity generally equaled or exceeded that of reactions in littermate controls. In addition, reserpine blocked delayed hypersensitivity in W/Wv and beige mice, suggesting that effects on mast cell or platelet serotonin cannot explain this drug's action in delayed hypersensitivity. PMID- 6494908 TI - President vetoes NIH bill. PMID- 6494910 TI - New study adds to antibiotic debate. PMID- 6494909 TI - Mo cell case has its first court hearing. PMID- 6494911 TI - Do antibodies prefer moving targets? PMID- 6494912 TI - Tumor-prone mice--and myc. PMID- 6494913 TI - A major human histone gene cluster on the long arm of chromosome 1. AB - A human histone gene cluster was assigned to chromosome 1 by Southern blot analysis of DNA's from a series of mouse-human somatic cell hybrids with 32P labeled cloned human H4 and H3 histone DNA as probes. Localization of this histone gene cluster on the long arm of chromosome 1 was confirmed by in situ hybridization of this DNA probe to metaphase chromosomes. PMID- 6494914 TI - Ratio of serum urea to serum creatinine in wild black bears. AB - In winter, the ratio of serum urea to serum creatinine is 10 or less in denning female and male bears. In midsummer it is 22 or more, similar to that of other mammals. However, in late summer and early fall, while food is available, the urea-to-creatinine ratio approaches or becomes 10 or less. The low value of this ratio appears to indicate the biochemical state of hibernation, and many bears are in this state weeks before they den. PMID- 6494915 TI - Reaction of the antitumor antibiotic CC-1065 with DNA: structure of a DNA adduct with DNA sequence specificity. AB - Sequence-dependent variations in DNA revealed by x-ray crystallographic studies have suggested that certain DNA-reactive drugs may react preferentially with defined sequences in DNA. Drugs that wind around the helix and reside within one of the grooves of DNA have perhaps the greatest chance of recognizing sequence dependent features of DNA. The antitumor antibiotic CC-1065 covalently binds through N-3 of adenine and resides within the minor groove of DNA. This drug overlaps with five base pairs for which a high sequence specificity exists. PMID- 6494916 TI - Amino acid sequence similarity between rabies virus glycoprotein and snake venom curaremimetic neurotoxins. AB - Evidence was presented earlier that a host-cell receptor for the highly neurotropic rabies virus might be the acetylcholine receptor. The amino acid sequence of the glycoprotein of rabies virus was compared by computer analysis with that of snake venom curaremimetic neurotoxins, potent ligands of the acetylcholine receptor. A statistically significant sequence relation was found between a segment of the rabies glycoprotein and the entire sequence of long neurotoxins. The greatest identity occurs with residues considered most important in neurotoxicity, including those interacting with the acetylcholine binding site of the acetylcholine receptor. Because of the similarity between the glycoprotein and the receptor-binding region of the neurotoxins, this region of the viral glycoprotein may function as a recognition site for the acetylcholine receptor. Direct binding of the rabies virus glycoprotein to the acetylcholine receptor could contribute to the neurotropism of this virus. PMID- 6494918 TI - Models of carcinogenesis. PMID- 6494917 TI - Effect of cell-cell interactions on drug sensitivity and growth of drug-sensitive and -resistant tumor cells in spheroids. AB - Multicellular spheroids were grown from mixtures of rat brain tumor cells sensitive (9L) and resistant (R3) to 1,3-bis(2-chloroethyl)-1-nitrosourea. Percentages of each cell subpopulation in these spheroids were estimated with the sister chromatid exchange assay and were found to be approximately the same as those used to initiate spheroids. Spheroids grown from 9L cells alone had a higher growth rate than spheroids grown from R3 cells alone. However, the growth rate of mixed-cell spheroids was essentially the same as that of pure 9L spheroids and was independent of the percentages of R3 cells in mixed-cell spheroids. The sensitivity of 9L cells in mixed-cell spheroids treated with 1,3 bis(2-chloroethyl)-1-nitrosourea, estimated by changes in the number of sister chromatid exchanges per metaphase induced by treatment, decreased as the percentage of R3 cells increased. These effects are probably the result of an interaction between the two cell subpopulations held in three-dimensional contact, a situation similar to that in tumors in situ. The results suggest why one cell subpopulation of tumors does not become dominant during growth and indicate that interactions between cell subpopulations can influence the sensitivity of one subpopulation to 1,3-bis(2-chloroethyl)-1-nitrosourea. PMID- 6494919 TI - Environmental risk management. PMID- 6494920 TI - Electron transfer between metal complexes: retrospective. PMID- 6494921 TI - Reagan versus the social sciences. PMID- 6494922 TI - Lukewarm reception for NIH study. PMID- 6494923 TI - AIDS amendment angers cancer institute. PMID- 6494924 TI - More on the T-cell receptor. PMID- 6494925 TI - Autoimmunity and increased c-myb transcription. AB - A single recessive gene, lpr, induces an autoimmune-lymphoproliferative syndrome in several strains of mice. The lymphoid organs of lpr/lpr mice contained cells with increased amounts of myb RNA, which codes for a protein found in the nucleus. A similar human lymphoproliferative disorder also had an increase in c myb expression. Mouse T cells induced by mitogens to proliferate did not express large amounts of myb RNA, indicating that marked myb expression is not a general feature of lymphocyte activation and proliferation. PMID- 6494926 TI - Prolonged Ca2+-dependent afterhyperpolarizations in hippocampal neurons of aged rats. AB - The possibility that calcium is elevated in brain neurons during aging was examined by quantifying afterhyperpolarizations induced by spike bursts in CAl neurons of hippocampal slices from young and aged rats. The afterhyperpolarizations result from Ca2+-dependent K+ conductance increases and are blocked in medium low in Ca2+ and prolonged in medium high in Ca2+. The afterhyperpolarization and associated conductance increases were considerably prolonged in cells from aged rats, although inhibitory postsynaptic potentials did not differ with age. Since elevated intracellular Ca2+ can exert deleterious effects on neurons, the data suggest that altered Ca2+ homeostasis may play a significant role in normal brain aging. PMID- 6494927 TI - Selective deficits in the sense of smell caused by chemical modification of the olfactory epithelium. AB - A chemically selective procedure for covalent modification of Schiff base-forming binding sites in proteins is demonstrated in vitro. In vivo studies show that the same procedure produces a selective anosmia ("odor blindness") when applied to the olfactory epithelia of experimental animals. Surgical experiments confirm that the sense of smell is specifically affected. PMID- 6494928 TI - The definition of lymphocyte subpopulations: new approaches to an old problem. PMID- 6494929 TI - Extraluminal gas in the upper abdomen. PMID- 6494930 TI - CT of upper abdominal trauma. PMID- 6494931 TI - Angiography in the management of abdominal trauma. PMID- 6494932 TI - Mucolipidosis I. Roentgenographic follow-up. AB - A patient with mucolipidosis I (ML I) is presented. The roentgenographic findings in the skull, hands, ribs, vertebral column, pelvis, and tubular bones are described. Special emphasis is laid on the evaluation of the skeletal alterations during a 13-years follow-up. The similarities to and the differences from the so called dysostosis multiplex (DM) are outlined. Some peculiarities which may be specific to ML I are discussed. Attention is given to an exceptional feature in our case of this very rare condition, namely, the marked thickening which developed on the frontal portions of the base of the skull, including the sellar region. PMID- 6494933 TI - Femoral neck fractures complicating Gaucher disease in children. AB - In normal children, fractures of the femoral neck are uncommon and accompany severe trauma and multiple injuries elsewhere in the skeleton [16, 17]. In children with Gaucher disease, a rare hereditary disorder of lipid metabolism, midcervical or basicervical fractures can occur with minor or no trauma and without other injury to the skeleton. Three children with Gaucher disease who developed pathologic fractures of the femoral neck are described. In all three, the fractures occurred between five and nine years of age, and the fracture lines passed through areas of abnormal bone characterized by poorly defined patches of increased and decreased density and cortical thinning along the medial femoral necks. In the affected hips, there was no evidence of avascular necrosis of the femoral heads at the time of injury. One child's fracture was preceded by multiple bone "crises" localized to the proximal femora. PMID- 6494934 TI - Radiology of postnatal skeletal development. XII. The second cervical vertebra. AB - The development of the second cervical vertebra is complex. The dens (odontoid process) develops two primary ossification centers that usually coalesce within three months following birth. These centers are separated from the primary ossification center of the vertebral centrum by a cartilaginous region--the dentocentral synchondrosis. This synchondrosis is a slow growing, bipolar physis similar to the triradiate cartilage of the acetabulum. It contributes to the overall heights of both the dens as well as the vertebral body. Anatomically the dentocentral synchondrosis is below the level of the C1-C2 articulations. This cartilaginous structure is continuous throughout the vertebral body with similar cartilage in both the facet regions as well as the neurocentral synchondroses. These various cartilaginous continuities progressively close--first, the connections to the facet regions, next the neurocentral synchondroses, and finally the dentocentral synchondrosis. Remnants of the incompletely closed dentocentral synchondrosis must be distinguished from a fracture, which usually propagates along this structure as a physeal injury in infants and children. The cartilaginous epiphysis at the tip of the dens may be transverse or may form a cleft ("V") shape. At eight to ten years, a secondary ossification center--the ossiculum terminale--develops in this proximal dens epiphysis. Fusion of the ossiculum terminale with the rest of the dens occurs between ten and thirteen years. PMID- 6494935 TI - The radiological diagnosis of tuberculosis of the adult spine. AB - Tuberculosis remains endemic in the United States with an estimated incidence of 15.9 cases per 100,000 population. In North America and Saudi Arabia tuberculosis of the spine is primarily a disease of adults. In Saudi Arabia the average age on presentation is 41 years. Spinal tuberculosis begins classically in the anterior inferior portion of a vertebral body. The infection spreads beneath the anterior longitudinal ligament to involve adjacent vertebral bodies. Disc space narrowing is a secondary phenomenon, occurring when destruction of the cancellous bone permits herniation of the disc into the affected vertebral body. Initially the lesion is purely lytic, so that in the early phase bone scanning, both with technetium polyphosphate and gallium, is often negative. With combination chemotherapy virtually all patients are curable, but early treatment demands early diagnosis. As the incidence of Pott disease has decreased so too has the medical awareness of this condition. Many physicians now believe it to have been totally eradicated. Particularly in the older age group, in whom other infections, tumours, and metabolic conditions are common, the differential diagnosis of a spinal lesion should include tuberculosis. The grossly destructive changes observed characteristically in children tend to develop only late in adults, making recognition of the early manifestations of the infection in the older patient much more important. PMID- 6494936 TI - Hemangioma of bone arising in the maxilla. AB - Hemangioma of the maxilla is a rare lesion with a variable and atypical radiographic appearance. A case presenting as an expansile, destructive antral mass is reported. The radiographic workup, differential diagnosis, pathology, and treatment of this rare lesion are discussed. PMID- 6494937 TI - The value of computed tomography in osseous hydatid disease (echinococcosis). AB - The authors report three cases of osseous hydatid disease (echinococcosis) in which examination by computed tomography (CT) was found to be helpful in establishing the diagnosis. Recognition of this rare bone infection in orthodox radiographs is notoriously difficult, but is aided by knowledge of the patient having lived in an area in which the disease is endemic. In two instances, one involving the shoulder and the other the thoracic spine, radiological abnormalities had been attributed at first to tuberculosis. In the third case, in which a destructive lesion in the sacrum had been interpreted correctly, CT studies provided confirmation of a recurrence. CT has proved to be an effective and sensitive method of demonstrating these destructive lesions in bone, of determining their spread, and of establishing the presence of other hydatid cysts in adjacent soft tissues. This technique has been found to be of value in preoperative planning of the surgical approach to hydatid lesions of the skeleton. PMID- 6494938 TI - Widespread osteolytic lesions of the long bones in basal cell nevus syndrome. AB - Three members of a family, father, daughter, and son, with the basal cell nevus syndrome are presented. A very unusual manifestation of widespread cyst-like osteolytic lesions in all the tubular bones was observed in the father, together with osteoblastic spotty "osteopoikilotic" lesions in the skull and the mandible of the same patient. Cyst-like osteolytic lesions have been described previously in this syndrome, mainly in the phalanges. We believe that such lesions can occur in any bone. PMID- 6494939 TI - Joint fluoroscopy before arthrography: detection and evaluation of loose bodies. AB - Fluoroscopy before injection of contrast medium increased the usefulness and accuracy of arthrography in 14 of 22 patients with possible intra-articular loose bodies. Although loose bodies wedged between articular surfaces deep within the joint were immobile, a typical tumbling motion on fluoroscopy reliably identified most free-floating loose bodies. Fluoroscopy sometimes revealed abnormalities more clearly than the plain radiographs or arthrograms. PMID- 6494940 TI - Case report 280: intraosseous lipoma of the tibia. PMID- 6494941 TI - Case report 286: gas within a solitary bone cyst of the proximal end of the left humerus. PMID- 6494942 TI - Case report 288: osteomalacia and secondary hyperparathyroidism (dialysis induced), with aluminum deposition. PMID- 6494943 TI - The revival of injured microbes. PMID- 6494944 TI - Radiation damage and its repair in non-sporulating bacteria. PMID- 6494945 TI - The recovery of injured bacteria from water, sewage and sewage effluents: a round table discussion. PMID- 6494946 TI - Analyzing surveys on deaf adults: implications for survey research on persons with disabilities. AB - Differences in operationalizing definitions of disability, variations in methods of data collection and diversities in salient characteristics of disabled persons are generic problems in conducting social research surveys with persons who have disabilities. These problems are of concern not only to social scientists seeking to improve survey methods, but they also have practical significance to decision makers needing high quality information to guide social policies that influence the provision of health care, education and social services to persons with chronic impairments. Reports of 41 surveys on deaf adults in the United States and Canada conducted between 1959 and 1981 were analyzed to determine how rates of response, a key indicator of reliability of survey data, are affected by three methods of data collection, degree of verification efforts, scope of the sample and socio-demographic characteristics of those in the survey populations. Measurable results are provided so that planners of future surveys can correct for anticipated rates of sample attrition under various survey conditions. Other data indicate that trade-offs can be made between changes in the size of the sample and method of data collection to lead to more effective surveys. Important terms such as deafness, deaf population and deaf community are discussed as these relate to interpreting the results of survey studies on deaf adults. Discussion is also given to conducting social surveys with groups of individuals having other disabilities besides loss of hearing. PMID- 6494947 TI - Methodological and conceptual issues in measuring the long term impact of disability: the experience of poliomyelitis patients in Manitoba. AB - This paper is based on a Canadian study which is examining the long term impact of disability among people who developed respiratory or non-respiratory polio during the epidemics of the 1950s and who were admitted to the same Manitoba hospital, the centralized treatment centre for the Province. This research is exploring change in the lives of these individuals by focusing on three conceptually distinct, although empirically overlapping areas or dimensions. The first is called the 'trajectory of disability' and refers to changes in functional status. The second includes those changes which are the product of the interaction between the normal processes of aging and the long term impact of poliomyelitis. The third is changes in the context of disability. This refers not only to changes in medical and technological knowledge, but sociopolitical developments including the emergence of a Disabled Rights Consumer Movement. This paper discusses the methodological and conceptual issues involved in the study, particularly its combination of different methods of data collection and the value of its historical-prospective design for capturing the effects of change over time in each of these different dimensions. PMID- 6494949 TI - Life history model of adaptation to disability: the case of a 'congenital amputee'. AB - Life histories can be used to describe adaptation over time to disabling conditions and the context and meaning of disabilities. Data from the life history of Diane DeVries, a 33-year old woman born with quadralateral limb deficiencies (upper extremity hemimelia, lower extremity amelia) illustrate a model for eliciting, presenting and interpreting life histories of persons with disabilities. Substantively, the life history of Diane DeVries indicates, at this time, survival within a niche of institutional supports that include marriage, church membership, and government for the disabled. Her life history is also characterized by choices that support independent living in the community and a cognitive orientation toward her own cultural normality. PMID- 6494948 TI - Psychosocial metaphors of physical distress among MS patients. AB - This paper explores the dynamics between chronic illness and culture and analyzes how a person's expressions of chronic illness are culturally constituted. The analysis focuses on the ways physical symptoms among multiple sclerosis patients are expressed and experienced as psychosocial problems. The process of transforming a biological construct into a social one is discussed. These transformations are explored through the doctor/patient transaction and the solidification of psychosocial problems among MS patients during their interaction with their 'significant others' and then transferred to their larger social-cultural sphere. PMID- 6494950 TI - [Sex determination using a pulled out hair]. AB - Authors original preparation technology is presented for sex determination by sex chromatin and Y-chromosome detection even in one torn up hair. PMID- 6494951 TI - [Evaluation of alcohol in the cerebrospinal fluid]. AB - Authors studied alcohol in cerebrospinal fluid as well as in blood and showed that the blood alcohol level cannot be commonly estimated from the examination of alcohol level in cerebrospinal fluid. PMID- 6494952 TI - [Mass poisoning with an agrochemical]. AB - A person showed signs of cholinesterase blockade after having a cup of coffee. Authors succeeded in proving an insecticide Lannate 90 WS in coffee grounds by mass spectrometry and thin-layer chromatography . The compound was later found in a table located in the building where intoxication had occurred and more persons had suffered from a sudden disease with similar signs previously. PMID- 6494953 TI - [Areas of contact in forensic medicine, social medicine and the law]. PMID- 6494954 TI - Surgical procedures in patients aged 90 years and older. AB - During the past five years 75 patients aged 90 years or more had 85 major surgical procedures at the Metropolitan Nashville General and Vanderbilt University hospitals. The most common operation was exploratory laparotomy. The second was lower extremity amputation for peripheral vascular disease and/or gangrene. Fifty-seven percent had general endotracheal anesthesia. Associated medical problems were common, and included congestive heart failure (24%), hypertension (21%), diabetes mellitus (13%), chronic arrhythmias (9%), history of myocardial infarction (8%), and history of cerebrovascular accident (5%). Eleven patients (13.4%), six of whom had general anesthesia, died after operation. Of these, two had postoperative pneumonia, two did not recover from bowel perforation and peritonitis, one had a postoperative myocardial infarction, another had a cerebrovascular accident, and one had sepsis. One patient's sudden death was likely due to myocardial infarction or pulmonary embolus. The other three deaths occurred in patients with extensive carcinomas (gallbladder carcinoma in one and widely metastatic carcinoma of unknown origin in two). These three patients died of the disease for which they were operated upon when the operation failed to alter its course. When surgical procedures are necessary to prolong and/or improve the quality of life in elderly patients, these procedures may be done in most cases with acceptable results. PMID- 6494955 TI - Carcinoma of the cervical esophagus: diagnosis, management, and results. AB - Nine of 168 patients (5.3%) with carcinoma of the esophagus had primary tumors in the cervical esophagus. The principal symptoms and signs of carcinoma of the cervical esophagus were dysphagia, hoarseness, neck mass, and weight loss. The esophagogram was a very reliable study, revealing the abnormality in all nine patients. The true extent of the disease was better delineated by computerized tomography which demonstrated not only the intraluminal mass but also the extraesophageal spread. Endoscopic examination of the cervical esophagus was the definitive procedure to establish the diagnosis. All nine patients were treated with definitive radiotherapy, three surviving two to five years. The major cause of death was the failure to control local disease. PMID- 6494956 TI - Anal syphilis. AB - We report an unusual case of anorectal syphilis. The literature reviewed supports the difficulty in identifying the varied presentations of this disease. Diagnostic and therapeutic maneuvers are based on an understanding of the pathophysiology of luetic infections. Penicillin remains the drug of choice in treating all stages of syphilis. PMID- 6494957 TI - Early detection in suspected herpes simplex encephalitis. AB - In a retrospective study of ten patients who had brain biopsy because of suspected herpes simplex encephalitis, the diagnosis was confirmed in only three patients. However, in four patients whose clinical presentation was indistinguishable from that of herpes simplex encephalitis, biopsy revealed other treatable conditions. These findings, together with a review of the recent literature, indicate that brain biopsy is the appropriate way to evaluate such patients. PMID- 6494958 TI - Unexpected diagnosis of cystic fibrosis at autopsy. AB - Over an 11-year period, we encountered four cases in which an unexpected diagnosis of cystic fibrosis (CF) was first established on the basis of typical autopsy findings. Our experience suggests that the occurrence of such cases is more common than generally appreciated and emphasizes the often crucial role of the autopsy in medical practice. PMID- 6494959 TI - Continuing neonatal morbidity in infants of women with class A diabetes. AB - Despite having implemented rigorous glucose control for women with gestational diabetes early in the third trimester, we found excessive morbidity among the neonates of these women. To accurately assess the risk of newborn complications, we did a five-year review (1977 to 1981) of infants of class A diabetic mothers to determine the incidence and scope of morbidity in these infants. Fifty-one infants of class A mothers were identified (group 1) and randomly matched with 102 infants of nondiabetic mothers (group 2). The distribution of morbidity between the two groups was as follows: hypoglycemia 9/51 (18%) vs 0/102 (P less than .001); birth injuries 4/51 (8%) vs 1/102 (2%) (P less than .05); pulmonary edema 3/51 (6%) vs 0/102 (P less than .05); respiratory distress 4/51 (8%) vs 7/102 (7%) (NS); macrosomia 18/51 (35%) vs 23/102 (23%) (NS); and hyperbilirubinemia 3/51 (6%) vs 8/102 (8%) (NS). There were two fetal deaths and three infants with major congenital anomalies among the diabetic pregnancies compared to none from the nondiabetic pregnancies. Compared to insulin-dependent diabetes, class A diabetes is accompanied by relatively mild metabolic disturbances in the mother. On the other hand, the infant of a mother with class A diabetes appears to be at risk for serious and life-threatening complications, both before and after birth. These results raise the question of whether earlier identification, subsequent meticulous diabetic management, and altered timing of delivery might reduce the complications experienced by these infants. PMID- 6494960 TI - Neonatal necrotizing enterocolitis: an update. AB - We reviewed 91 cases of neonatal necrotizing enterocolitis (NNEC), which continues to be a devastating disease occurring in 2% to 4% of all newborn intensive care unit admissions. Onset now occurs in older infants (11.9 days). The morbidity is significant (22%), with strictures (8%) and recurrences (8%) the primary problems. Recurrences are more likely to require surgical intervention and result in a high mortality. Early diagnosis of necrotic bowel before perforation, peritoneal contamination, and sepsis is difficult and contributes to the still high, but improved, overall mortality of 36%. PMID- 6494961 TI - Computerized tomography in acute and chronic pancreatitis. AB - Modern imaging techniques have revolutionized the diagnostic evaluation of pancreatitis, primarily demonstrating its complications. Computerized tomography (CT) is a more sensitive method than ultrasonography and pancreatic ductography. A chart review revealed 214 patients at our hospital with a discharge diagnosis of pancreatitis. Sixty patients had CT for evaluation of possible complications. Only five scans were normal. Of 37 cases of acute pancreatitis, 92% demonstrated localized or diffuse enlargement, and 65% showed loss of pancreatic outline. Other frequent findings included thickening of perirenal fascia (49%), ileus (43%), edema of mesentery (35%), and inflammatory exudate (32%). Abscess and pseudocyst were each detected in 8% of cases. In chronic pancreatitis 65% of patients showed localized or diffuse pancreatic enlargement. Atrophy of the gland (30%), calcification (30%), pseudocyst (26%), and dilated pancreatic ducts (17%) were also seen. CT is effective in evaluating pancreatitis and its complications. PMID- 6494962 TI - Serial dexamethasone tests for predicting relapse in depressive disorder. AB - The dexamethasone suppression test (DST) was given to 86 patients with unipolar depression at the time of admission to the hospital. Thirty-three patients (38%) had abnormal DST responses. There was no difference in treatment response or outcome between patients with normal or abnormal DST responses on admission. Of the 33 patients who had abnormal DST responses on admission, 25 (76%) showed normal responses by the time of discharge. Five of the eight patients (63%) with "persistent" nonsuppression despite symptomatic improvement and discharge had relapse within six months, while only four of 25 patients (16%) whose DST response became normal (P less than .05) and ten of 53 patients (19%) who had normal DSTs at the time of admission (P less than .05) had relapse. These findings suggest that persistence of abnormal DST responses may provide a useful prognostic marker of risk for early relapse in depressive disorder. PMID- 6494963 TI - Enhancing supervision of psychotherapy. AB - This paper reports the efforts of a psychiatry training faculty to explicitly study the supervisory process and enhance the faculty's supervisory skills. To accomplish this, a psychiatry resident permitted the videotaping of her supervision. These videotapes were then reviewed and presented in an ongoing conference to members of the training faculty. Through these conferences, the faculty was able to learn methods of elucidating issues within the supervisory process. Techniques for assisting residents in the development of their psychotherapeutic skills were elaborated. PMID- 6494964 TI - Small fenestra stapedectomy: technique and advantages. AB - We discuss the rationale and advantages of the small fenestra technique (SFT) of stapedectomy. When results from conventional stapedectomy techniques are compared with those of SFT, the small fenestra technique shows improved hearing in the high frequencies of 2,000, 4,000, and 8,000 Hz, improved speech discrimination, reduced vestibular disturbance, and reduced iatrogenic trauma to the cochlea. PMID- 6494965 TI - Selenium availability in Texas: possible clinical significance. AB - In light of recent reports that have indicated that selenium is an essential micronutrient and possible natural cancer inhibitor, data on the geographic distributions of selenium in Texas were gathered and compared with the distribution of age-adjusted cancer mortality rates. We considered concentrations of selenium measured in ground and surface water to be indicators of its presence in rocks, soil, and locally grown crops. Texas water sources were found to be poor in selenium, except for the Panhandle and the West Texas regions, where soil consists of erosion products from the selenium-rich Rocky Mountains. In general, lower cancer mortality was observed for the selenium-rich regions of Texas compared with cancer mortality for the selenium-poor regions. Even though the risks from cancer-provoking factors also differed geographically, the observed pattern was sufficiently suggestive to warrant further attention to selenium. PMID- 6494966 TI - Surgical specialty training and certification in North America: indications for surgical intervention? PMID- 6494967 TI - The internship year: a study of sleep, mood states, and psychophysiologic parameters. AB - Previous reports have suggested that first-year graduate physicians have a high incidence of psychologic distress and may show cognitive impairment as a result of sleep deprivation. We periodically evaluated 27 interns during their training year to determine amount of sleep, mood states, reaction time, critical flicker fusion, and symptoms of depression. We found the incidence of major depression in our subjects (four of 27) to be lower than previously reported but higher than expected for that age group in the general population. Risk factors for depression during the internship year were history of major depression, female sex, and unmarried status. The only significant change in average mood state was that anger progressively increased during the year. Subjects slept an average of 5.95 hours per 24-hour day during the year. Correlational analysis indicated that, contrary to predictions, performance on reaction time and critical flicker fusion improved with less sleep. At the end of the year, subjects regarded the year as stressful but not more so than had been anticipated. PMID- 6494968 TI - Cerebrospinal fluid penetration of anti-infective agents. PMID- 6494969 TI - Chest fluoroscopy: an underused technique for evaluating apparent pulmonary opacities. PMID- 6494970 TI - Intermittent premature mitral valve closure in combined acute severe aortic and mitral regurgitation. AB - We have described the clinical, hemodynamic, and echocardiographic features of torn aortic cusps with mitral valve fenestration in a patient with infective endocarditis. Hemodynamic studies showed left atrial pressure intermittently exceeding left ventricular end-diastolic pressure. This phenomenon corresponded with intermittent premature mitral valve closure, which may serve as a marker for M-mode echocardiographic diagnosis in combined severe acute aortic and mitral regurgitation. PMID- 6494972 TI - Synovial calcifications associated with long-term steroid therapy for chronic arthritis. AB - Radiologically detected synovial densities may be related to one of several distinct causes. The associated articular appearance may give a clue to the diagnosis. We have described the stippled appearance of innumerable distinct densities in the knees of two patients who had progressive destructive changes associated with long-term steroid therapy. We suggest that prolonged steroid therapy be added to the list of processes associated with diffuse small synovial calcifications. PMID- 6494971 TI - Spondylolysis after spinal instrumentation in osteogenesis imperfecta. AB - Spondylolysis occurred distal to spinal instrumentation and fusion to a lower lumbar level in a patient with osteogenesis imperfecta. Initial extension to the sacrum may avoid this complication in patients with a weakened spinal column. PMID- 6494973 TI - Heterogeneous acute leukemias. AB - We have reported two cases of Philadelphia-chromosome-negative acute leukemia with heterogeneous populations of leukemic cells and reviewed six cases from the literature. The cases were identified by several methods, including morphology, cytochemistry, enzymatic analysis, cytogenetic analysis, and electron microscopy. Predisposing factors were probably present in three cases and may partially account for the seemingly increasing incidence, as has been the experience with other secondary leukemias. The prognosis was variable, but most of the complete remissions were seen only when lymphocytic and nonlymphocytic antileukemic chemotherapeutic regimes were used. The occurrence of these unusual acute leukemias strongly supports the concept of a lymphoid-myeloid stem cell. PMID- 6494974 TI - Coccidioidomycosis with cutaneous involvement. AB - Coccidioidomycosis is a fungal disease endemic in the southwestern United States and northern Mexico. Disseminated disease is often associated with a variety of skin lesions, including ulcerating or intact nodules with underlying sinus tracts. We have reported a case demonstrating that the diagnosis of coccidioidomycosis may be accomplished by histopathologic examination and culture of skin lesions, even when cultures from other sites are negative. PMID- 6494975 TI - Acute poststreptococcal glomerulonephritis progressing to rapidly progressive glomerulonephritis. AB - We have reported a rare, well documented case of poststreptococcal glomerulonephritis followed by rapidly progressive glomerulonephritis after weeks of stable renal function. The patient was successfully treated with steroids, azathioprine, and plasmapheresis. Progression of stable proliferative poststreptococcal glomerulonephritis to rapidly progressive glomerulonephritis appears to be uncommon. PMID- 6494976 TI - Lithium intoxication associated with acute renal failure. AB - Lithium can produce transient natriuresis, nephrogenic diabetes insipidus, and partial distal renal tubular acidosis. Lithium intoxication is commonly associated with mild renal insufficiency and may produce acute renal failure. We have described a case of acute renal failure in a patient with severe lithium intoxication, as well as cardiac arrhythmias and hypothyroidism, both of which have been reported to occur with lithium toxicity. Treatment with daily hemodialysis eventually produced complete recovery. Lithium clearance occurs quickly with hemodialysis, but a rebound effect occurs as lithium in intracellular water equilibrates with extracellular fluid. Prolonged dialysis may be required to reduce the blood lithium level to the therapeutic range. We conclude that lithium intoxication may produce severe reversible renal failure as a result of direct tubular epithelial damage. PMID- 6494977 TI - Polyneuropathy after herpes simplex type 2 meningitis. PMID- 6494978 TI - Protothecosis. AB - We have reported the 22nd case in the literature of protothecosis, a rare disease of man and animals due to infection with non-chlorophyll-producing algae of the genus Prototheca. The skin is most often affected, but generalized, disseminated involvement has been reported. Infection is usually severe and may be fatal. Amphotericin B in combination with tetracycline is the treatment of choice. PMID- 6494979 TI - Burn therapy. PMID- 6494980 TI - Symptomatic mitral valve prolapse and diagnostic considerations. PMID- 6494981 TI - Invasive diagnostic procedures in the surgically ill. PMID- 6494982 TI - Hypokalemia and massive transfusion. PMID- 6494983 TI - Antibiotic therapy in surgical patients. PMID- 6494985 TI - How do the experiences of the early separated and the early bereaved differ and to what extent do such differences affect outcome? PMID- 6494984 TI - Social support and mental health among mothers of preschool and school age children. PMID- 6494986 TI - [Standardization of a scale for measuring life change events]. PMID- 6494987 TI - Home and away: the disposition of mentally ill old people in an urban population. PMID- 6494988 TI - [Erythrocyte indices in workers exposed to pesticides]. PMID- 6494989 TI - [Vascular tonus of the limbs in frostbite]. PMID- 6494990 TI - [The pituitary-thyroid system in patients with duodenal ulcer]. PMID- 6494992 TI - [Combined gastric and duodenal ulcers]. PMID- 6494991 TI - [Blue phlebitis]. PMID- 6494993 TI - [Pathogenesis of acute pyelonephritis in the contralateral kidney]. PMID- 6494994 TI - [Changes in the nervous system after long-term immobilization]. PMID- 6494995 TI - [Role of specialized fluorographic departments in the diagnosis of stomach cancer]. PMID- 6494996 TI - [Echocardiographic signs of tricuspid valve insufficiency]. PMID- 6494997 TI - [Echocardiographic indicators in pregnant women with mitral valve defects]. PMID- 6494998 TI - [Clinico-morphological comparisons in myocardial infarction in patients with chronic bronchitis]. PMID- 6494999 TI - [Side effects of antitubercular drugs in patients with pulmonary tuberculosis and chronic alcoholism]. PMID- 6495000 TI - [Bronchospastic syndrome in acute pneumonia]. PMID- 6495001 TI - [Follow-up of patients with a history of gastroduodenal hemorrhage caused by peptic ulcer]. PMID- 6495002 TI - [A method of external electroenterography in surgical practice]. PMID- 6495003 TI - [Leucine aminopeptidase in the differential diagnosis of viral hepatitis and mechanical jaundice]. PMID- 6495004 TI - [Characteristics of abdominal typhus in children]. PMID- 6495005 TI - [Psychopathological disorders in somatic diseases]. PMID- 6495006 TI - [Treatment of alcoholic delirium]. PMID- 6495007 TI - A microsurgical anterior osteophytectomy for cervical spondylotic myelopathy. AB - Cervical spondylotic myelopathy was treated by a microsurgical anterior approach removing osteophytes completely. Follow-up results of 43 patients showed that 39 patients (91%) exhibited overall improvements of either 1, 2, or 3 grades on Nurick's grading. Four (9%) remained unchanged. Even severely affected myelopathic patients exhibited neurologic recovery. Cases that also had narrow cervical canals were treated by the same anterior osteophytectomy, and they showed similar responses. Six out of ten patients who had osteophytectomies without fusion developed neck and arm pain postoperatively, although the presence or absence of an interbody fusion did not affect the postoperative recovery from myelopathy. PMID- 6495008 TI - Scoliosis in young men with spondylolysis or spondylolisthesis. A comparative study in symptomatic and asymptomatic subjects. AB - While an increased incidence of scoliosis in symptomatic spondylolysis and spondylolisthesis has been established previously, a comparison of its occurrence in symptomatic and asymptomatic individuals has not been performed. The present study is a comparison of symptomatic and asymptomatic young men with analysis as to the incidence of scoliosis. Idiopathic scoliosis was not found and all cases were due to spasm scoliosis or olisthetic scoliosis with the spasm type being much more common. Scoliotic curves were divided into mild (0-9 degrees) and moderate (10-20 degrees). No case of a curve greater than 20 degrees was seen. Scoliosis incidence in asymptomatic individuals without a pars break was 6.65%. In the groups of: (1) asymptomatic unilateral spondylolysis, (2) asymptomatic bilateral spondylolysis, (3) symptomatic bilateral spondylolysis, and (4) asymptomatic spondylolisthesis the scoliosis incidence was similar, ranging from 13.3-23.8%. These figures are significantly higher than those seen in the asymptomatic subjects without a pars break, but they are in the same range as in symptomatic patients without a pars break, suggesting that muscle spasm is the principal cause of the scoliosis. PMID- 6495009 TI - Rib transposition vascularized bone grafts. Hemodynamic assessment of donor rib graft and recipient vertebral body. AB - Twelve canine rib transposition grafts were harvested and evaluated for preservation of subperiosteal and medullary canal blood flow using the hydrogen washout technique. Blood flow using hydrogen washout technique also was studied in the T11 vertebral body. The mean hydrogen washout blood flow was 0.201 ml/min/ml tissue for the subperiosteal rib measurement, 0.058 ml/min/ml tissue for a rib medullary measurement, and 0.085 ml/min/ml tissue for the vertebral body. The medullary canal hydrogen washout values were consistently less than the subperiosteal values. The results have demonstrated that the blood supply to the vascularized rib pedicle can be retained and quantitated in harvesting the rib graft using the hydrogen washout technique. PMID- 6495010 TI - Controlled hypotensive anesthesia during spinal surgery. A retrospective study. AB - A retrospective study has been made of 264 posterior spinal fusions performed between 1972 and 1978 at the Good Samaritan Hospital in Cincinnati. Two hundred ten of the procedures were performed under hypotensive anesthesia. Blood loss and total blood replacement were related to the mean arterial pressure (MAP) during surgery. A 42% reduction in total intraoperative loss and a 28%reduction in total blood requirements were demonstrated. The results were significantly different when patient age was considered in adults maintained below 80 mmHg MAP, blood loss was decreased by 33%, but the total blood requirement was decreased by only 6%; in children under 18 years of age maintained below 90 mmHg MAP, the blood loss was decreased by 49% and the blood requirement by 42%. PMID- 6495011 TI - Measurements of trunk movements during work. AB - To study spinal movements during work, an instrument that measured angles and angle changes in relation to a vertical plane was adapted to continuously measure forward flexion of the trunk. The instrument, which is battery-powered and worn on the back, registers the amount of flexion and its distribution over time during a work cycle by recording the time spent in each of five 18 degrees intervals between 0 degrees and 90 degrees. Also the number of times that the angle of flexion changed from one interval to another is recorded. A total of 43 subjects from three occupations--dentistry, nurses' aide work, and warehouse work -were each tested during a 60 minute work cycle. On the average, the dentists spent most of the time (52.2 minutes) in a semi-flexed position not exceeding 36 degrees and performed eight deep forward flexions (greater than 73 degrees). The nurses' aides spent one-half of the work cycle (34.4 minutes) in an upright position (0-18 degrees) and performed 70 deep forward flexions. The warehouse workers spent less than one-half of the work cycle in an upright position (27.5 minutes) and performed 153 deep forward flexions that nearly always were associated with lifting. PMID- 6495012 TI - Sexual complications of anterior fusion of the lumbar spine. AB - Recently, there is renewed interest in anterior fusion for spondylolisthesis and congenital and paralytic scoliosis with pelvic obliquity. Some of the candidates are prepubertal boys. Sterility after surgery in urogenitally normal prepubertal boys will not be determined until these patients mature. A worldwide survey of 20 surgeons with 15-20 years of experience (4,500 cases) reports the frequency of sterility (retrograde ejaculation) to be 19 cases (0.42%) and impotence 20 cases (0.44%). One-fourth of the retrograde ejaculation cases resolved and became normal. Impotence is non-organic. The complication of retrograde ejaculation does not appear to be related to approach, though it was related to technique. While the complications of sterility and impotence following anterior fusion have been over-exaggerated, caution and informed consent from adult males and parents of prepubertal male children is advisable. PMID- 6495013 TI - Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. AB - The relationship between herniated lumbar disc and abnormalities of the transverse process of the lumbosacral junction was investigated. Two hundred consecutive patients with positive myelographic findings of herniated lumbar disc were reviewed. Sixty patients presented abnormalities of the transverse process to satisfy the criteria for lumbosacral transitional vertebra. A new classification of lumbosacral transitional vertebra is presented based upon the morphologic and clinical characteristics with respect to herniated nucleus pulposus. Type I represents a "forme fruste" of lumbosacral transitional vertebra and shows no difference in the incidence of the location of herniations. In types III and IV, there are no herniations at the level of the lumbosacral transitional vertebra and no increase in the incidence of herniations just proximal to the lumbosacral transitional vertebra. The Type II lumbosacral transitional vertebra presents herniated lumbar disc at the level of transition. It also presents a greater than normal incidence of herniations at the level just above the lumbosacral transitional vertebra. PMID- 6495014 TI - The diagnosis of disc sequestration. AB - Sequestration of a disc herniation is an important cause of failure of chemonucleolysis. It therefore is important to recognize this particular variety of disc herniation before considering enzymatic discectomy. In order to determine the clinical and myelographic signs of sequestration, we reviewed the charts, myelograms, and surgical findings of 98 patients operated on for a disc herniation. A correlation was made between the three anatomic types of disc herniation found during surgery and the clinical and myelographic signs observed preoperatively. No characteristic clinical sign was found. No pathognomonic myelographic features were discovered. However, when the myelographic defect appears irregular and at a distance from the disc space, sequestration should be highly suspected. PMID- 6495015 TI - A critique of the surgical management of lumbar disc disease in a private neurosurgical practice. AB - The magnitude of the lumbar disc problem is reviewed and a profile of medical and surgical therapeutic expectations is presented. A study of a 5-year epoch of a neurosurgical practice indicated that 64% of all patients requiring disc surgery had satisfactory results and 12% were frank failures. The younger patients with single level disc rupture had the best results, and 18% of all patients required further surgery for recurrent disc problems. The complication rate was 4%. The bias of compensation invalidates any critique of a therapy mode and creates a tremendous economic impact. The need for improvement in the surgical management of lumbar disc disease is established. PMID- 6495016 TI - Neurologic evaluation of cervical spinal cord injuries. PMID- 6495017 TI - Current status of spinal cord cooling in the treatment of acute spinal cord injury. AB - In order to determine any beneficial effects of parenteral steroid administration and local cord cooling following complete cord injury, ten patients in the present series were treated by a combination of these modalities within 8 1/2 hours after injury. There was a better than expected rate of recovery of motor function and sensation and the mortality rate was reduced compared with more traditional forms of therapy. A literature review showed that local cord cooling had been applied to 52 patients with complete cord injuries in various centers. The rate of neurologic improvement was 48%, the ambulation rate was 17% and the 1 year mortality rate was reduced to 17%. These figures appear considerably better than the comparable expected rate for traditional treatment of such injuries. The results are encouraging enough to suggest further trials of treatment using localized cord cooling where such treatment can be instituted within 4 hours following injury. PMID- 6495018 TI - Surgical results in the treatment of cervical spinal cord injury. PMID- 6495019 TI - Neurologic recovery following injuries to the cervical spinal cord and nerve roots. AB - From this literature, we have made the following conclusions: (1) Complete cord lesions do not recover cord functional motor control. (2) Complete lesions recover one nerve root level of function at the fracture site. (3) Partial lesions recover partially. (4) The less the injury, the greater the recovery. (5) Brown-Sequard lesions recover more than central cord syndromes, which recover more than anterior cord syndromes. (6) Reduction of dislocated facets facilitates nerve root recovery. (7) Better documentation of specific pathology and recovery rates are necessary to determine the surgical benefits in complete lesions, incomplete lesions, and nerve root recovery. PMID- 6495020 TI - Thoracic cord compression from chondroma of rib. A case report. PMID- 6495021 TI - Fracture of the spine after spinal fusion for idiopathic scoliosis. PMID- 6495022 TI - The treatment of a herniated lumbar disc in a young adult with developmental spinal stenosis. PMID- 6495023 TI - A study of computer-assisted tomography. PMID- 6495024 TI - A study of computer-assisted tomography. I. The incidence of positive CAT scans in an asymptomatic group of patients. AB - In order to study the type and number of CAT scan abnormalities of the lumbar spine that occur in asymptomatic people, 52 studies from a control population with no history of back trouble were mixed randomly with six scans from patients with surgically proven spinal disease, and all were interpreted by three neuroradiologists in a blinded fashion. Irrespective of age, 35.4% (26.6%, 51.0%, and 31.3%) were found to be abnormal. Spinal disease was identified in an average of 19.5% (23.8%, 22.7%, and 12.5%) of the under 40-year-olds, and it was a herniated nucleus pulposus in every instance. In the over 40-year-old age group, there was an average of 50% (29.2%, 81.5%, and 48.1%) abnormal findings, with diagnoses of herniated disc, facet degeneration, and stenosis occurring most frequently. PMID- 6495025 TI - A study of computer-assisted tomography. II. Comparison of metrizamide myelography and computed tomography in the diagnosis of herniated lumbar disc and spinal stenosis. AB - One hundred twenty-two patients with surgically confirmed pathology consisting of either herniated lumbar disc, spinal stenosis, or both were included in this investigation. For each of these patients, preoperative metrizamide myelography and computerized tomography were performed. Each myelogram and CT scan was read blindly so that the neuroradiologist interpreting the study had no knowledge of the patient's surgical pathology, clinical examination, nor any knowledge of the interpretation of the other preoperative test. A painstaking attempt was made to describe precisely both the exact nature of the preoperative myelogram and CT scan interpretations. The correlations between the preoperative interpretation of each test and the observed surgical findings then were analyzed statistically. Based upon this analysis, myelography was found to be more accurate than computed tomography in the diagnosis of herniated lumbar disc (83% vs. 72%). In the diagnosis of spinal stenosis, myelography was slightly more accurate than computed tomography (93% vs. 89%). Based upon the results of this study, the authors conclude that metrizamide myelography is more accurate than computed tomography in the diagnosis of both herniated lumbar disc and spinal stenosis and remains the diagnostic study of choice for these conditions. Furthermore, metrizamide myelography gives the added advantage of visualizing the thoracolumbar junction and, thus, affords the opportunity to diagnose occult spinal tumors. PMID- 6495026 TI - Computer analysis of spinal segment motion in degenerative disc disease with and without axial loading. AB - The center of rotation of the spinal motion segment is an indicator of spinal instability. However, the motion segment does not move about a single fixed axis of rotation, but rather a locus of instantaneous axes of rotation, the centrode. This paper studies centrodes in various stages of degenerative disc disease comparing them with normal spines. Computer analysis is undertaken in 47 cadaveric spines, 22 of which also were evaluated with axial loading. The normal centrode fell within the posterior half of the disc space and averaged 21 mm in ten specimens. In the earliest stages of degenerative disc disease, the centrode lengths increased significantly (average 116 mm). Specimens with moderate disc degeneration also migrated inferiorly into the L5 vertebra. Axial loading did not appear to influence the centrode lengths or position. This technique is highly sensitive, detecting 94% of the abnormal spines as compared with only 25% detected by means of measuring an excessive range of motion on flexion and extension radiographs. This method provides a highly reliable and quantifiable method of detecting early changes in spinal motion in degenerative disc disease prior to the well recognized radiographic abnormalities. PMID- 6495027 TI - Lumbosacral spinal fusion. A biomechanical study. AB - The effects of spinal fusion on fused segment and the adjacent, unfused segments play a significant role in the clinical effectiveness of spinal fusion for low back pain with or without sciatica. Much of the information on this important subject is derived from clinical impressions. The purpose of this biomechanical study is to investigate the altered kinematics and biomechanics of the three different types of spinal fusion (posterior, bilateral-lateral, and anterior) on the adjacent, unfused segment as well as within the fused segment and to investigate their clinical implications. Sixteen fresh human cadaver lumbosacral spines were tested under a simulated physiologic loading condition. The test specimens included three motion segments, L3-4, L4-5, and L5-S1. To study the mechanics of the lumbar spine under combined compression and bending loads, a special apparatus was designed. These loads were applied by an MTS machine through two sets of pulley systems. The loads, as well as displacement data from both actuators, were recorded. A video camera system was utilized to record the kinematics of the spinal motion segment. The unfused specimen was tested first, and the fused specimen then was retested under the identical loading conditions. A total of 16 spine specimens were tested and evaluated--five posterior, four bilateral-lateral, and seven anterior fusions. All types of fusion resulted in increased bending and axial stiffnesses. Overall, anterior fusion provided the largest increase in stiffness, followed by bilateral-lateral fusion and posterior fusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6495028 TI - Axial rotation and lateral bending in the normal lumbar spine measured by three dimensional radiography. AB - A three-dimensional radiographic technique was used to investigate the ranges of active axial rotation and lateral bending plus the accompanying rotations in the planes other than that of the primary voluntary movements in two groups of normal male volunteers. There was approximately 2 degrees of axial rotation at each intervertebral joint with L3-4 and L4-5 being slightly more mobile. Lateral bending of approximately 10 degrees occurred at the upper three levels, while there was significantly less movement of 6 degrees and 3 degrees at L4-5 and L5 S1, respectively. In the upper lumbar spine, axial rotation to the right was accompanied by lateral bending to the left and vice versa. At L5-S1, axial rotation and lateral bending generally accompanied each other in the same direction, while L4-5 was a transitional level. These measurements in vivo demonstrated that there was no simple mechanical coupling of the rotations, and that the lordotic shape of the lumbar spine together with muscular control are probably the two principal factors determining the relation between the primary and accompanying rotations. PMID- 6495029 TI - Morphologic changes in annulus fibrosus during aging. An ultrastructural study in rats. AB - Morphologic studies of annulus fibrosus of newborn, young, and old rats were carried out to determine the tissue changes occurring with aging. Newborn annulus consists of an inner portion containing chondroblast-like cells, a middle portion showing cells with intermediate features between chondroblasts and fibroblasts, and an outer portion containing fibroblast-like cells. The cells, arranged in rows, show a prominent ergastoplasm and are surrounded by pericellular lucunae. In the inner portion, the collagen fibers in the matrix are oriented randomly; in the middle and outer portions, the fibers between adjacent cell rows are arranged parallel, forming fibrous lamellae. The collagen fibers have fairly uniform diameters (average 510 nm), are strongly positive to the PASM reaction, and are surrounded by small proteoglycan granules. Both immature and mature elastic fibers are present. Young annulus consists of a transition zone, composed of large cells with no definite arrangement and bundles of collagen fibers oriented in various directions, and a lamellar zone consisting of fibrous lamellae separated by interlamellar septa containing the cells. These show intermediate features between chondrocytes and fibrocytes and well-developed ergastoplasm. The interlamellar septa consist of collagen fibrils and proteoglycans and contain few aggregates of electron dense material. The collagen fibers have highly variable diameters (average 740 nm). The larger fibers are scarcely periodate-silver methenamine (PASM) positive. The proteoglycans are similar in size to those in the newborn. Few, mature elastic fibers are present. In old annulus, the transition zone is larger than in the young tissue. The cells are less numerous, and most of them show a sparse ergastoplasm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6495030 TI - Pressure changes within the cauda equina following constriction of the dural sac. An in vitro experimental study. AB - In order to register pressure changes within the cauda equina, a highly sensitive pressure measuring catheter was inserted through a hole in the dural sac. Its tip was placed among the nerve roots of the cauda equina at levels L2, L3, and L4 in seven freshly removed human specimens. The cross-sectional area of the dural sac then was decreased gradually by constriction of a circular clamp. The inside diameter of the clamp and the corresponding area was determined when further reduction of the circumference of the clamp caused the first signs of a pressure increase, the critical size, among the nerve roots. The average critical size was 76.9 mm2 at the L2 level, corresponding to a diameter of 11.4 mm At the L3 level, the corresponding figures were 71.5 mm2 and 11.1 mm, and at the L4 level 64.8 mm2 and 10.6 mm, respectively. It seemed reasonable to assume that the critical sizes determined in this way could be threshold values below which a further constriction of the size of the dural sac would cause an impairment of the circulatory and/or the nerve function of the cauda equina. PMID- 6495031 TI - Acute prolapsed lumbar intervertebral disc. An epidemiologic study with special reference to driving automobiles and cigarette smoking. AB - An epidemiologic case-control study to identify risk factors for acute prolapsed lumbar intervertebral disc was undertaken in Connecticut during 1979-1981. This paper focuses on nonoccupational factors of possible etiologic significance. Persons in their 30s were affected most frequently. Among surgical cases, the ratio of men to women was 1.5 to 1, while among probable and possible cases not undergoing surgery, the male to female ratio was about 1 to 1. Cigarette smoking in the past year was associated with an increased risk for prolapsed disc. The greater the number of hours spent in a motor vehicle, the higher the risk. Use of Swedish and Japanese cars was associated with a lower-than-average risk, while use of other cars was associated with a higher-than-average risk. For each type of car, older cars were associated with higher risks than newer cars. Variables that did not affect the risk for prolapsed lumbar disc in this study included height, weight, number of pregnancies, number of children, frequency of wearing shoes with high heels, smoking cigars or pipes, and participation in baseball or softball, golf, bowling, swimming, diving from a board, tennis, bicycling or jogging. PMID- 6495032 TI - A prospective investigation into the orthopaedic and psychologic predictors of outcome of first lumbar surgery following industrial injury. AB - One hundred sixteen patients randomly selected by officers (authors excluded) of the Workers' Compensation Board of Ontario were studied over a 3-year period. The selection criteria used were no previous back surgery and first back operation now scheduled. The purpose was to establish a battery of clinical and psychologic tests to be used in arriving at a prognosis for preoperative patients. The tests included orthopaedic examination, 10-minute Hendler questionnaire, nonorganic component assessment, psychologic interview, Minnesota Multiphasic Personality Inventory, pain drawing, locus of control, McGill Pain Questionnaire. The most striking of the many computer results obtained was an 82% prognosis success rate. The five predictor variables that most significantly predicted outcome were English proficiency, the nonorganic signs test, back pain versus leg pain, hypochondriasis scale of the MMPI, and the pain drawing. PMID- 6495033 TI - The thoracolumbar crush fracture. An experimental study on instant axial dynamic loading: the resulting fracture type and its stability. AB - Seven vertebral preparations of L1, with surrounding discs, facet joints, and ligaments were exposed to an instant axial dynamic force in order to produce a burst or crush fracture. The resulting fractures were similar to fractures observed clinically and showed a comminuted vertebral body with fractured vertebral end-plates, dislocated disc nucleus, bone fragments severely encroaching upon the spinal canal, and facet joint laxity. The flexion-extension range was increased considerably. This implies that this fracture type should be regarded as unstable with a risk of progressive flexion deformity, neurologic deterioration and pain. The fracture could be reduced by an axial distraction force of 400 N simulating the effect of Harrington distraction rods. However, the distraction resulted in an "empty" vertebral body with small areas of spongious bone mixed with fragments of the disc nucleus and fragments of the vertebral end plate. PMID- 6495034 TI - Effectiveness of braces in mild idiopathic scoliosis. AB - Despite the wide use of bracing for the treatment of idiopathic scoliosis, controlled studies apparently have not been performed to examine whether bracing, in fact, alters the natural history of spine lateral curves. We studied 255 female patients, ages 8-17 years, with idiopathic scoliosis who had curves with initial Cobb measures from 15-30 degrees. They were divided into two groups: one group consisted of 144 patients who had received a Milwaukee or Boston brace; and the other, a control group, consisted of 111 patients who remained untreated through a mean period of 1.9 years. The groups had similar mean ages, ages of menarche and curve severities. The results showed a slight but nonsignificant trend, suggesting that bracing reduced the overall probability of progression in the braced curves. However, noting that nearly 75% of the control group curves were nonprogressive, it is possible that a similar proportion of the braced curves need not have been braced. Moreover, bracing failed to prevent eight curves in seven patients (5%) from progressing. These curves progressed at a mean rate of 8 degrees per year. Our retrospective results suggest that bracing probably is not necessary in a large proportion of patients who meet current, clinical criteria for bracing. Given the limitations of retrospective studies like this one, a controlled prospective trial of bracing effectiveness in idiopathic scoliosis seems warranted. PMID- 6495035 TI - Clinical evaluation of spinal cord monitoring in scoliosis surgery. AB - The somatosensory evoked potential (SEP) is a technique that can be used to monitor sensory conduction within the spinal cord throughout the course of spinal surgery. The authors describe the technique, stimulation, and recording parameters, which most critically affect the success and reliability of monitoring trials. In addition, we show that in all 40 patients tested fully, the SEP results were in complete agreement with the clinical findings at the time of the wake-up test. In this series, there was no instance of a "false-positive" SEP result, or of the SEP failing to detect neural damage. Temporary, neurologic deficit occurred on two occasions, which are described in detail. These show that the SEP is rapid, enables neurologic complications to be detected at an early stage of surgery, and can identify lateralized problems. It is concluded that the technique may provide a clinically valuable method for continuous and prolonged monitoring of spinal cord function. PMID- 6495036 TI - Prevalence study of trunk asymmetries and structural scoliosis in 10-year-old school children. AB - The prevalence of trunk asymmetries was studied in 6464, 10-year-old, school children in Malmo City. All those with visible trunk asymmetries were moire photographed and a subset roentgenographed. Moire, positive findings were seen in 13% of the boys and in 16% of the girls. A more prominent moire asymmetry (a deviation of two moire contour lines or more) was seen in 0.6% of the boys and 0.9% of the girls. The Cobb angles in this latter group varied between 14-25 degrees. Children with small clinical and moire asymmetries (deviations of less than one moire fringe) had no or very small (less than 10 degrees), lateral deviations seen on the x-ray and should, therefore, be regarded rather as normal variations of the shape of the trunk. On the other hand, these small asymmetries cannot be disregarded as possible indications of a risk group in which structural scoliosis can develop later during the period of growth. PMID- 6495037 TI - Hydatid disease of the spine causing paraplegia. The combined treatment by surgical drainage and mebendazole: a case report. AB - Hydatid disease of the spine is a rare disease with a poor prognosis. Paraplegia is a severe complication and has a low chance for recovery. Surgical drainage and decompression has been the treatment of choice although success was limited. Medical treatment with mebendazole was introduced in 1977 for cystic and alveolar Hydatid disease of the liver. In this paper, a case with Hydatid disease with complete paraplegia is presented. He was treated by combined surgical and medical treatment that included several surgical drainages, decompression, and fusion procedures, accompanied by high dose mebendazole for three years. Recovery from the paraplegia was complete except for the persistence of a neurogenic bladder. Neither clinical nor laboratory evidence of activity of the disease existed after six years of follow-up. This case must encourage further clinical trials in such cases, combining surgical treatment with mebendazole. PMID- 6495038 TI - Continuous recording of neck rotation: preliminary observations. AB - An instrument is described that allows continuous recording of neck rotation for periods of up to 12 hours. This allows analysis of how the neck actually is used rather than its range of positions on static testing. This technique will be helpful in evaluating the severity of disorders of the neck and the effectiveness of treatment. PMID- 6495039 TI - Spondylolisthesis: the angle of kyphosis. AB - A reproducible method of measurement of kyphosis in spondylolisthesis using the cranial surface of the fifth lumbar vertebra and the caudal surface of the first sacral vertebra is described. This measurement is useful in the prognosis of spondylolisthetic patients as the progression of slipping is determined by both the angle of kyphosis and degree of slip. The angle is also important in operative correction of spondylolisthesis. This method is readily used and reproduced in severe slips. PMID- 6495040 TI - [The effect of the degree of deafness on the prognosis of the surgical treatment of otosclerosis]. PMID- 6495041 TI - [Neurologic manifestations of sympathoblastoma in children]. PMID- 6495042 TI - [Personal experience in the prevention of asthma in children using ketotifen]. PMID- 6495043 TI - [Immunologic profile of cerebrospinal fluid in multiple sclerosis in childhood]. PMID- 6495044 TI - [Mitral valve prolapse and cerebral ischemia]. PMID- 6495045 TI - [The most frequent sequelae of chronic alcoholism in women in the reproductive years]. PMID- 6495046 TI - [Study of muco-ciliary transport]. PMID- 6495047 TI - [Acute organic psychosyndrome during therapy with disulfiram]. PMID- 6495048 TI - [Acute uremia due to ethylene glycol poisoning (antifreeze)]. PMID- 6495049 TI - [A case report of extrapulmonary tuberculosis with pancytopenia]. PMID- 6495050 TI - [Possibilities of the surgical treatment of defective pseudoarthroses of the forearm]. PMID- 6495051 TI - [Congenital malformations in the otorhinolaryngologic area in newborn infants]. PMID- 6495052 TI - [Immunologic damage due to chemotherapy and radiotherapy in children with lymphoma]. PMID- 6495053 TI - [The effect of favorable climatic factors on levels of immunoglobulin E in children with asthma]. PMID- 6495054 TI - [Levels of acid-base equilibrium factors in arterial blood and cerebrospinal fluid in patients with cerebral apoplexy]. PMID- 6495055 TI - [Acute peripheral arterial insufficiency in patients with diabetes mellitus]. PMID- 6495056 TI - [Pancreatic cancer in Serbia]. PMID- 6495057 TI - [Botulism. Clinico-electromyographic correlations]. PMID- 6495058 TI - [Schizophrenia in a patient due to multiple sclerosis]. PMID- 6495059 TI - [Transitory incomplete bilateral ophthalmoplegia of vascular origin]. PMID- 6495061 TI - [Asymptomatic idiopathic hyperuricemia. Diagnosis, risk factors and therapy]. PMID- 6495060 TI - [New trends in the treatment of scoliotic deformities of the spine in children and adults]. PMID- 6495062 TI - [Visit to the National School of Public Health in Rennes and the Centers for Preventive Medicine and Social Hygiene in Nancy, France, 1983]. PMID- 6495063 TI - [The etiology and treatment of complications in femoropoliteal vein bypass]. PMID- 6495064 TI - [The fate of artificial arterial prostheses in areas of low flow]. PMID- 6495065 TI - [Arterial damage by diagnostic catheterization]. PMID- 6495066 TI - [Endoscopy--a necessary examination in diseases of the upper part of the digestive tract]. PMID- 6495067 TI - [Hydatid cysts of the breast]. PMID- 6495068 TI - [Autotransplantation of the spleen--a basic change in the care of the injured spleen]. PMID- 6495069 TI - [Reoperation after Crohn's disease]. PMID- 6495070 TI - [Isolated necrosis of the gallbladder with complete detachment after stomach resection]. PMID- 6495071 TI - [Spigelian hernia]. PMID- 6495072 TI - [Ileus as a complication of colorectal carcinoma]. PMID- 6495073 TI - [Cancer of the large intestine and rectum in patients over 70 years of age]. PMID- 6495074 TI - [A Rochard hook of our own manufacture]. PMID- 6495075 TI - Venous thrombogenesis--a century after Virchow. PMID- 6495076 TI - The principles, structure and function of the J.G. Strijdom Hospital pre operative assessment clinic. PMID- 6495077 TI - Skin reactions to beta-blockers. PMID- 6495078 TI - Update on mortality from ischaemic heart disease in white South Africans. AB - Mortality rates (MRs) per 100 000 for ischaemic heart disease (IHD) of White males and females in the RSA in the age group 15-64 years decreased substantially in 1980 compared with 1970, the male rates decreasing from 256,1/100 000 to 200,3/100 000 (-22%) and the female rates decreasing from 79,3/100 000 to 56,6/100 000 (-29%). In this period, the White male population increased from 1,20 to 1,48 million and the White female population from 1,18 to 1,45 million, but the number of deaths from IHD fell from 3 064 to 2 720 in males and from 936 to 756 in females. For the year 1980 MRs for acute myocardial infarction (AMI) and IHD in White males and females of the RSA were compared with the MRs of males and females in the USA, Australia, England and Wales, and Scotland. The MRs for both AMI and IHD of males in the USA and Australia fell well below the figure for England and Wales, which contrasted markedly with the situation in 1970. The MRs for AMI and IHD of males in Scotland and the RSA were similar and were much higher than the MRs of males in the other countries. The MRs for AMI and IHD of females in the USA, Australia, and England and Wales were similar and well below the MRs of females in Scotland and the RSA, the MRs of females in Scotland being higher than the MRs of females in all the countries studied. PMID- 6495079 TI - Plasma vitamin E values in the newborn. AB - Plasma vitamin E values of newborn infants in a Coloured population of Cape Town have been determined. The mean plasma alpha-tocopherol value was 3,2 +/- 0,8 mg/l. A significant correlation between the plasma alpha-tocopherol level and plasma total lipid content (r = 0,45; P less than 0,001) and plasma cholesterol level (r = 0,65; P less than 0,001) has been found. However, maternal and neonatal plasma vitamin E levels were unrelated. PMID- 6495080 TI - Black fertility patterns--Cape Town and Ciskei. AB - The reproductive and contraceptive experience of 491 Black women in urban and rural areas (Cape Town and Ciskei) is presented. The 'average woman' in the sample was 31 years old and first became pregnant by the age of 19,8 years; she had had 3,5 pregnancies, 2,9 living children and wished for 3,9 children. Family size was related to the level of education, degree of urbanization and age of the mother. A sizeable minority of the women experienced at least 1 miscarriage or the death of at least 1 child. Most of the women (65,5%) used some method of contraception between pregnancies, and 57% were using contraception when interviewed. All but 20,7% of those using contraception were receiving an injectable progestogen (Depo-Provera). In urban areas a significant minority used oral contraceptives or sterilization for contraception. Very few women used an intra-uterine contraceptive device. The results of our survey suggest that it is more difficult for the poor to maintain their desired family size. There is a need for family-planning services to be accessible to all, and especially to teenagers. The strongest motivation for a decrease in family size probably results from the settled family life and job opportunities which characterize urban life. PMID- 6495081 TI - Experimental paraquat poisoning--histological, electron microscopic and autoradiographic changes in the lung. AB - Paraquat is a potent and widely used herbicide which acts as a specific pulmonary toxin and causes lung fibrosis in man and animals. Some controversy still exists concerning the details of the morphogenesis of the pulmonary lesions. The lungs of rats exposed to intravenous injections of paraquat and sacrificed 6-24 days later were examined by light and electron microscopy. Autoradiography was used to detect possible paraquat accumulation in the lung 5 hours after a single intravenous injection. The findings on microscopy suggested an acute phase of damage to alveolar lining epithelium followed by epithelial regeneration. The most pronounced light and electron microscopic findings were: signs of disruption of the alveolar wall; type II alveolar epithelial hyperplasia; mobilization of mononuclear cells, and migration and accumulation of fibroblast-like cells in the intra-alveolar and interstitial spaces. After three equally spaced intravenous injections of paraquat signs of interstitial connective tissue proliferation could be seen. Autoradiography showed low-grade radioactivity over the alveolar wall, indicating possible active uptake of paraquat by alveolar epithelium; this coincides with in vitro evidence of an active transport mechanism for paraquat by alveolar epithelial cells. PMID- 6495082 TI - Systemic lupus erythematosus in 3 black South African men. Case reports. AB - Only 1 case of systemic lupus erythematosus (SLE) has been documented in a South African Black man. We report 3 further patients, 1 each from Cape Town, Durban and East London, diagnosed between 1978 and 1982. All 3 patients fulfilled the revised American Rheumatism Association criteria for the classification of SLE. PMID- 6495083 TI - Continuous heart murmurs in childhood. Case reports and a review. AB - The causes of continuous heart murmurs in childhood are reviewed, and 2 case reports illustrate the features of a coronary artery fistula and a ruptured sinus of Valsalva. PMID- 6495084 TI - Obstruction of a breathing circuit. A case report. AB - Preventable mishaps resulting from human error contribute to anaesthetic risk, as demonstrated in the case report presented. The incidence of anaesthetic associated deaths has fallen steadily since 1935, and general anaesthesia is now a very safe procedure, provided the anaesthetist takes the requisite precautions. PMID- 6495085 TI - Acyclovir and varicella pneumonia. PMID- 6495086 TI - Gastric bile acid content and concentration in asymptomatic adults. AB - Overnight gastric aspiration was performed on 15 fasting asymptomatic adults in the erect and supine positions. The pH of the gastric aspirates was not directly related to the bile acid concentration, which ranged from 0 to 1116 mumol/l. The total bile acid content of the 12-hour aspirates varied from 0 to 122 mumol. A change in posture had no significant effect on the duodenogastric reflux of bile when subjects were fasting or when gallbladder contraction was stimulated by intravenous pancreozymin. The clinical relevance of these findings is discussed. PMID- 6495087 TI - Effect of intramuscular atropine and glycopyrrolate on the cardiovascular response to tracheal intubation. AB - The effect of premedication with intramuscular atropine and glycopyrrolate on the cardiovascular changes resulting from the performance of laryngoscopy and tracheal intubation has been evaluated in two groups of 25 patients undergoing surgery. Neither atropine nor glycopyrrolate attenuated the hypertensive and tachycardic response to laryngoscopy and intubation; both significantly enhanced it (P less than 0,05). PMID- 6495088 TI - Mobile eye-care teams and rural ophthalmology in southern Africa. AB - Almost all ophthalmic services in southern Africa are located in large urban centres beyond the reach of many patients in isolated rural areas. The Bureau for the Prevention of Blindness organizes mobile eye-care teams which tour these areas to provide free ophthalmic therapy and surgery. The structure and aims of the mobile teams, with reference to a specific tour, are described; the problems encountered in providing rural ophthalmological services are discussed and some possible solutions proposed. PMID- 6495089 TI - Student attachment to a general practice in Cape Town. A report of 5 years' experience. AB - Five years' experience of student attachment to a Cape Town general practice as part of a community medicine 'block' is described. The students found the proceedings valuable and specially mentioned that the holistic approach to patient care, continuing care and the importance of the doctor-patient relationship were issues which they had become aware of for the first time--in sharp contrast to their experience of patient care in the teaching hospital situation. Nearly all the students complained that the time allotted to their attachment and to general practice as a whole was far too short. Various aspects of attachment are discussed, e.g. the doctor's approach, the handling of students' anxieties and the doctor-student relationship. Certain inferences are drawn concerning overall undergraduate medical training. PMID- 6495090 TI - Anaesthetic hazards in undiagnosed myotonia dystrophica. A case report. AB - Respiratory and cardiovascular complications in a patient in the immediate postoperative period led to the ultimate diagnosis of myotonic dystrophy. The features and anaesthetic-related hazards of the myotonic syndromes are discussed. PMID- 6495091 TI - [Hand infections--approach and management]. AB - Infections of the hand are always very serious conditions and should therefore be treated aggressively. Early diagnosis, adequate anaesthesia, a bloodless field and thorough drainage including debridement, elevation and early active mobilization are the cornerstones of treatment. Antibiotics need not be given routinely, but under certain circumstances (for example in the case of human bites) combination antibiotic treatment is imperative. Management of hand infections along these lines is most rewarding and should prevent a chronic infection or a disastrous osteitis which would result in a permanent lesion and disablement. The management of specific hand infections is discussed. PMID- 6495092 TI - Bronchobiliary fistula after chronic pancreatitis. A case report. AB - A case of cholangitis secondary to chronic pancreatitis is reported. A liver abscess ruptured into the chest and the patient presented coughing bile. Symptoms were cured by a choledochojejunostomy, providing drainage for the obstructed common bile duct. To our knowledge this is the first reported case of a bronchobiliary fistula developing as a result of chronic pancreatitis. The principles of treatment are discussed. PMID- 6495093 TI - Splenic artery ligation--an adjunct to splenorraphy in children. Case reports. AB - Three patients in whom blunt splenic trauma involving the hilum threatened the success of splenic preservation were treated by main splenic artery ligation as an adjunct to other techniques. Definition of the traumatic lesion required full splenic mobilization, which in 1 case resulted in extension of the trauma. In all patients a viable, in situ spleen was retained and no complications attributable to the abdominal surgery occurred. PMID- 6495094 TI - Splenectomy in onyalai. A report on 5 cases. AB - Onyalai is an acquired immune thrombocytopenia with 10% mortality. Conservative measures such as traditional medicines, corticosteroids and blood transfusion have not always controlled severe bleeding or prevented death. Five patients (2 male, 3 female) with onyalai who had uncontrollable haemorrhage, thrombocytopenia and documented previous attacks of severe bleeding, underwent splenectomy. The patients were screened for malaria, sickle-cell anaemia and bilharzia. Vitamin K and epsilon-aminocaproic acid were administered pre-operatively, and fresh blood was given during surgery. The duration of follow-up varied between 280 and 544 days. There were no operative complications. Bleeding stopped in all patients and the platelet counts increased within 24 hours. All achieved normal platelet counts, but these were not always sustained. Three patients remained free of disease with normal platelet counts up to days 539, 539 and 544 of follow-up. Two patients had a recurrence of bleeding and died from cerebral haemorrhage and haemorrhagic shock. PMID- 6495095 TI - Generic substitution--the other side of the coin. PMID- 6495096 TI - The opioid and anti-opioid system in addiction. PMID- 6495097 TI - Essential fatty acids and cardiovascular disease. PMID- 6495098 TI - Improving the outcome of tuberculous meningitis in childhood. AB - Two groups of 28 children with tuberculous meningitis (TBM) and hydrocephalus were matched for age and stage of the disease and treated with appropriate antituberculosis therapy. The patients in one group were subjected to ventriculoperitoneal or lumboperitoneal cerebrospinal fluid shunting procedures. The results of treatment were assessed in both groups. The outcome in the group of patients subjected to shunting was clearly superior to that in the group in which shunting was not carried out. The hydrocephalus associated with TBM is associated with a significant mortality and morbidity if the obstruction to cerebrospinal fluid flow is not relieved. PMID- 6495099 TI - Microbiological studies during the perinatal period. An attempt to correlate selected bacterial and viral infections with intra-uterine deaths and preterm labour. AB - An investigation of the genital, amniotic fluid, placental and neonatal microflora in a population with a high prevalence of amniotic fluid infections and perinatal deaths is reported. Women presenting with preterm labour and intra uterine death were investigated for the presence in vaginal secretions of a selected variety of pathogenic organisms, and the findings in these patients were compared with those in three groups of controls who presented with normal labour at term or late delivery or who required elective caesarean section as a result of cephalopelvic disproportion. Indirect evidence of infection was also sought by assaying cord blood for immunoglobulin levels and by testing for specific antibodies to well-known congenitally acquired pathogens. The results showed a significant relationship between gonococcal infection, serological evidence of Chlamydia trachomatis infection and preterm labour. PMID- 6495100 TI - Childhood mortality rates, infant feeding and use of health services in rural Transkei. AB - Childhood mortality rates in rural Transkei were calculated using data obtained from a sample survey of about 5 000 women who were questioned about the outcome of their pregnancies. There was almost a 1 in 5 risk of children dying before the age of 5 years. The greatest risk was in the 1st year; the infant mortality rate was 130/1 000. About 75% of infant deaths occurred in the postneonatal period. We suggest that many postneonatal deaths are probably caused by diarrhoea and could be prevented by community-based oral rehydration programmes. About 75% of the children were breast-fed beyond the age of 1 year; however, 66% of them were also given other milk before they were 4 months old. Over 80% of women attended an antenatal clinic at least once, although only about 33% of the babies were delivered by the health services. Health services had been attended by 85% of children over 3 months old. The survey methods used were found suitable for ascertaining childhood mortality rates in rural areas of southern Africa. They should be applied more extensively to provide information for planning health services. PMID- 6495101 TI - Paragangliomas of the petrous temporal bone. AB - The natural behaviour, clinical diagnosis and treatment of paragangliomas of the petrous temporal bone are reviewed. Nine patients with this tumour treated at Groote Schuur Hospital are presented; 2 patients had tympanic paragangliomas and 7 jugular paragangliomas. Surgical excision is recommended as the primary treatment. However, in poor-risk patients or when tumour growth is extensive, irradiation may be of benefit. Although rare, this eventually life-threatening lesion can be successfully removed if diagnosed early enough. PMID- 6495102 TI - Ergometrine-provoked coronary vasospasm on angiography without angina or ischaemia on ECG. A case report. AB - A 32-year-old White man suffered a large transmural inferoposterior myocardial infarction (MI). Coronary vasospasm is strongly suspected of having caused this MI since the ergometrine maleate provocation test gave rise to severe coronary vasospasm resulting in total occlusion of the dominant right coronary artery, without angina or ECG or haemodynamic features of myocardial ischaemia. This is a most unusual response to ergometrine maleate. Possible explanations are suggested and the implications are briefly discussed. PMID- 6495103 TI - In vitro fertilization and embryo transfer in Pretoria. AB - Details of the in vitro fertilization and embryo transfer programme at the Department of Obstetrics and Gynaecology of the H. F. Verwoerd Hospital and the University of Pretoria are presented. From 1 March 1982 to 30 November 1983, 67 cycles in 47 patients were induced using clomiphene citrate and human chorionic gonadotrophin (hCG) (46 patients) and human postmenopausal gonadotrophin/hCG (1 patient). In 5 patients ovum recovery was unsuccessful owing to severe adhesions. In the remaining 42 patients 59 oocyte recoveries out of a total of 62 attempts were successful, a 95% recovery rate. One hundred and seventy-nine ova were recovered (2,9 per laparoscopy), of which 143 (80%) were viable. Forty-six per cent of fertilized ova cleaved actively. Forty-one transfers of 66 embryos (average 1,6 embryos per transfer) resulted in 5 pregnancies (12% pregnancy rate per transfer). Three preclinical pregnancies aborted spontaneously. Two pregnancies are ongoing at 30 and 32 weeks' gestation. Thus, the programme has so far led to 2 third-trimester pregnancies. Consolidation and refinement of techniques should lead to a steady increase in success at this centre. PMID- 6495104 TI - Liquid-crystal thermographic mammography. A preliminary assessment of a controversial modality. AB - Thermography is a simple and safe technique for examination of the breast. An analysis of 200 subjects examined by means of this non-invasive investigation demonstrates that it is a reasonably sensitive method. Its main applications are in the young symptomatic patient, mass surveys and the annual assessment of the 30-50-year age group. PMID- 6495105 TI - Aeromedical transportation via commercial airlines. AB - A report on 72 patients requiring medical escorts on long international flights by commercial airlines is presented. From experience gained, advice is given on facilitating medical attention during such journeys. Adequate preflight planning is the most important aspect. PMID- 6495107 TI - Acute transmural myocardial infarction--coronary vasospasm, thrombosis or coronary embolus? A case report. AB - A very fit 28-year-old Coloured athlete presented with an acute transmural anteroseptal and non-transmural anterolateral myocardial infarction (MI). He had no significant risk factors for coronary artery disease apart from moderate cigarette smoking. Cardiac catheterization 2 months later demonstrated a significant area of myocardial damage as well as a large mural thrombus, but the coronary arteries appeared normal apart from a large irregular filling defect in the proximal left anterior descending (LAD) branch, apparently due to a thrombus. Cardiac catheterization a further 4 months later documented no further filling defect in the LAD branch and the coronary arteries appeared free of disease. Ergometrine maleate provocation on this occasion failed to demonstrate any coronary vasospasm. Possible pathophysiological mechanisms for the unexpected MI are outlined. PMID- 6495106 TI - Simultaneous early carcinomas of the ampulla of Vater and the stomach. Report of a case involving chronic inactive hepatitis. AB - Early carcinoma occurred simultaneously in both the stomach and the ampulla of Vater of a 69-year-old Japanese woman. A tentative diagnosis of early carcinoma of the stomach and acute hepatitis was made and needle biopsy of the liver revealed chronic inactive hepatitis. A carcinoma in the ampulla of Vater was detected by duodenoscopy. Cholangiography did not reveal the biliary tract. Pancreatoduodenectomy was performed and histological study of the resected specimen showed an early carcinoma restricted to the mucosa and an early carcinoma of the ampulla of Vater invading the sphincter of Oddi. There was no apparent metastasis or invasion of surrounding tissues. PMID- 6495108 TI - Unstable angina precipitated by nifedipine. PMID- 6495109 TI - Treatment of septic arthritis with intra-articular anti-lipopolysaccharide plasma. PMID- 6495110 TI - Bacterial meningitis in Johannesburg--1980-1982. AB - A 2-year retrospective study of aetiology, age distribution, seasonal variation and antimicrobial sensitivity patterns of bacteria isolated from patients with meningitis in five Johannesburg hospitals for White, Black, Coloured and Asian patients was performed. Neisseria meningitidis was isolated most frequently, followed by Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli and Streptococcus group B. In the Black population 73% of the meningococcal infections occurred in patients over 3 years of age, and the majority of these infections were caused by serogroup A organisms. Virtually all (93%) of the H. influenzae infections occurred in children of less than 3 years of age. Of the isolates tested, 16% of the meningococci, 4,5% of the H. influenzae and 47% of the pneumococci were resistant to sulphadiazine, ampicillin and penicillin respectively. PMID- 6495111 TI - [Staphylococcal pneumonia : a review of 18 cases at Tygerberg Hospital]. AB - A retrospective study of 18 cases of staphylococcal pneumonia is described. The majority of patients were young males without any predisposing factors. A vasculitic rash, three-organ failure and diffuse intravascular coagulation were poor prognostic factors. The value of steroids was doubtful but plasmapheresis probably played a part in the survival of 3 patients with fulminating staphylococcal pneumonia. The case fatality rate for the whole group was 38%. Primary staphylococcal pneumonia probably had a better prognosis but left more residual lung damage than the secondary form of the disease. PMID- 6495112 TI - Neonatal pancreatic function in infants born to mothers with gestational and overt diabetes. AB - Neonatal pancreatic function was assessed in infants born to non-diabetic mothers and to mothers with well-controlled gestational diabetes (GD) and overt diabetes (OD) using cord blood C-peptide estimations and the calculation of cord C peptide/glucose ratios. Exaggerated pancreatic function was present in infants born to mothers with GD. In these infants the increased cord C-peptide values and cord C-peptide/glucose ratios correlated with their increased birth weight ratios. These results could not be explained on the basis of maternal hyperglycaemia and a possible intrinsic difference in pancreatic response between infants born to mothers with GD and those born to mothers with OD is suggested. PMID- 6495113 TI - Iopamidol for myelography--practical implications. AB - Iopamidol (Jopamiron 200) is a new water-soluble, non-ionic contrast medium for myelography, which recommends itself for reasons of safety, diagnostic effectiveness, economy and convenience. It has been used in a small series of 185 patients in doses of 10-15 ml and found to be highly satisfactory for myelography of the lumbosacral, thoracic and cervical regions. PMID- 6495114 TI - Pulmonary embolism due to hepatic tissue--a forensic vital sign? A case report. AB - A case of pulmonary embolism due to hepatic tissue occurring after trauma is presented. This finding may be of forensic value in indicating the antemortem nature of an injury by constituting evidence of an intra vitam phenomenon. PMID- 6495115 TI - Buerger's disease. A case report and review of the literature. AB - A case of thrombo-angiitis obliterans (Buerger's disease) in a 30-year-old man is reported. Irremediable gangrene necessitated amputation of both legs, and distal amputation of the fingers and thumb of the right hand. PMID- 6495116 TI - Drug therapy in patients with hepatic encephalopathy--suggested guidelines for sedation and treatment of delirium tremens. PMID- 6495117 TI - A fatal bite by the shield-nose snake (Aspidelaps scutatus) PMID- 6495118 TI - Anesthesia in a patient with Friedreich's ataxia. PMID- 6495119 TI - Leading causes of death among children under 5 years of age in the various population groups of the RSA in 1970. AB - The mortality rates (MRs) of children under 5 years of age in the various population groups of the RSA were calculated as deaths/10(5) for various causes of death and groupings of causes of death as classified by the International Classification of Diseases. In 1970 the ten leading causes of death among Coloured and Black children under 5 years of age in the RSA were similar to those among children in developing countries. The rank order of causes of death (in MRs/10(5] among Coloured children was as follows: gastro-enteritis (1 733), pneumonia (725), immaturity (405), ill-defined causes of death (168), nutritional deficiencies (167), measles (126), anoxia (97), 'other bacterial diseases' (91), inflammatory diseases of the nervous system (55) and tuberculosis (48). The ten leading causes of death among White children in the RSA were characteristic of children in Western developed countries. The rank order (in MRs/10(5] was as follows: immaturity (144), anoxia (94), pneumonia (46), gastro-enteritis (41), congenital heart disease (32), other accidents (19), birth injury (19), ill defined causes of death (12) and inflammatory diseases of the nervous system (11). PMID- 6495120 TI - Trends in the mortality rates for the ten leading causes of death among white, coloured and Asian children under 5 years of age in the RSA, 1968-1977. AB - The mean mortality rates (MRs) for the ten leading causes of death among Coloured children in the RSA over the 10-year period 1968-1977 were consistently higher, and in some instances substantially higher, than the MRs among White children; the MRs among Asians were intermediate between those for the White and Coloured children. For certain causes of death the differences between the MRs of White and Coloured children were large; the MR for gastro-enteritis of Coloured children was 42 times higher than that of White children, the MR for tuberculosis was 64 times higher, the MR for measles was 52 times higher, the MR for nutritional deficiencies was 57 times higher, and the MR for pneumonia was 17 times higher. There were, however, certain important causes of death in Coloured children in which dramatic improvements occurred over the 10-year period. For example, the decrease in the MR for gastro-enteritis was 21 times as fast as the change in the MR among White children. Also, the MR for nutritional deficiencies among Coloured children decreased at a faster rate than the MRs among the other children. Unfortunately there were no improvements over the 10-year period in MRs for tuberculosis, measles and pneumonia in Coloured and White children. This is a cause for concern since these are preventable diseases. PMID- 6495121 TI - Suicide attempts or threats by children and adolescents in Johannesburg. AB - Current literature on suicide attempts by children and adolescents is reviewed. The records of children and adolescents in the 10-15-year age group who were referred to a child psychiatric unit over the 6-year period 1 January 1977-31 December 1982 were analysed. The results are presented and discussed. Suicide attempts or threats together constituted an average of 10% of the psychiatric referrals in this age group, the figure for 1982 being substantially increased. The peak incidence was among 13-year-olds for both boys and girls. The female: male referral ratio was 2:1. Drug overdosage was the most common method, the commonly employed drugs being analgesics and benzodiazepines. In about 30% of both the boys and girls referred because of taking an overdose, a multiple-drug overdose had been used. Methods other than this were used three times more frequently by boys than by girls. Major predisposing and antecedent factors were family stress (especially divorce), psychiatric illness in the patient or a family member, and school problems. Some 30% had previously made suicide attempts or threats, and at least 7% made further serious suicide attempts after initial treatment. These results suggest a need for further investigations into factors relating to suicide attempts or threats in children and adolescents and their subsequent management. PMID- 6495123 TI - Acute puerperal uterine inversion. A case report and review of the literature. PMID- 6495122 TI - Bone changes after alcohol abuse. AB - In this study bone morphometric findings in 19 heavy or moderate drinkers are compared with those in 43 non-drinkers (22 non-osteoporotic patients with osteo arthritis (OA) and 21 osteoporotic patients with femoral neck fractures (FNFs). Transiliac bone biopsy specimens were examined for assessment of trabecular bone volume and thickness, bone resorption and formation, osteoid seam length and width and the mineralization front by quantitative histomorphometry and microradiography. Trabecular bone volume and thickness were significantly diminished in the drinking group when compared with those in the 22 non-drinking patients with OA (P less than 0,005 and P less than 0,0001 respectively). Bone formation was significantly lower in the drinkers than in the OA group (P less than 0,0005), and bone resorption was significantly greater in the drinkers than in the OA (P less than 0,005) and FNF (P less than 0,01) groups. In heavy drinkers bone formation was significantly lower (P less than 0,05) than in moderate drinkers. The extent of the mineralization front was significantly lower in the drinking group than in the OA (P less than 0,005) and FNF (P less than 0,0005) groups. Osteoid seam length and width did not differ in the three groups. The presence of abnormal liver function test results did not significantly affect any of the parameters. It is concluded that alcohol abuse is associated with: (i) uncoupling of bone resorption and bone formation; (ii) reduced trabecular bone volume and thickness; and (iii) a mild mineralization defect. PMID- 6495124 TI - [Double pylorus and pyloroduodenal fistulas: two case reports and discussion]. AB - Congenital double pylorus is extremely rare; only 2 cases have been found in the English and French literature. Acquired double pylorus occurs more often; up to 1982, 66 cases had been reported. During 6 810 consecutive barium meal examinations over a period of 2 years, we diagnosed the condition in 5 patients. Two came to operation, at which the diagnosis was confirmed. These 2 cases are described. Acquired double pylorus is in reality a short pyloroduodenal fistula situated next to the pylorus, usually on the lesser curvature side. In the majority of cases it results from a pyloric ulcer penetrating into the duodenum. In a minority of cases the primary lesion is a duodenal ulcer penetrating into the pyloric area. Cases initially present with peptic ulcer symptoms. With the formation of the fistula, symptoms may disappear. Some authorities consider this to indicate spontaneous cure of the ulcer, thus obviating the need for further medical or surgical treatment. In the present 2 cases there was no remission of symptoms. None of the cases has been associated with malignant disease. It is thought that the condition may be recognized more often in future. PMID- 6495125 TI - The abuse of analgesics leading to nephropathy in South Africa. PMID- 6495126 TI - What grows beneath Op-Site surgical wound dressing? PMID- 6495127 TI - Chemical analysis of cool drinks and pure fruit juices--some clinical implications. AB - The pH of cool drinks and fruit juices is very low and ranges from 2,4 (Pepsi Cola) to 3,7 (fresh orange juice). The osmotic concentration of most cool drinks and fruit juices is considerably higher than that of blood and, with the exception of Isotonic Game, ranges from 430 mOsm/kg (Coca Cola) to 1 297 mOsm/kg (Liquifruit Grape). Glucose, fructose and sucrose contribute from 72% to 98% of the osmotically active particles in cool drinks and fruit juices and their high carbohydrate content causes concern about substrates for oral bacteria to produce acid as well as daily energy intake. The sodium (Na), potassium (K), calcium (Ca) and phosphorus (P) content of cool drinks is low although K and P may contribute significantly to dietary intake when most fruit juices are consumed. K is virtually absent in Coca Cola and its use in replacing lost minerals, e.g. in infantile gastro-enteritis, is disputed. The relatively high levels of K and P in fruit juices could be harmful to patients suffering from chronic uraemia. The selected cool drinks and fruit juices analysed contain very little Na and should not pose problems to hypertensive patients. PMID- 6495128 TI - Meningitis in Cape Town children. AB - A prospective clinical and microbiological survey of 213 children who presented to the teaching hospitals of the Cape Peninsula with meningitis was performed during a winter month. The predominant bacterium isolated was Neisseria meningitidis and this survey uncovered an outbreak of viral meningitis due to echovirus 4 of the Du Toit strain. In comparison with previous studies, the absence of fever in 20% of the cases of meningococcal disease and the isolation of N. meningitidis group B organisms which were resistant to sulphonamides are noted. Cases of N. meningitidis meningitis with initial clinical and cerebrospinal fluid findings indistinguishable from those in echovirus 4 meningitis are presented to emphasize the difficulties encountered in making a differential diagnosis. We recommend that in endemic areas all children with meningitis should be observed in hospital for at least 48 hours until the diagnosis of N. meningitidis has been excluded bacteriologically. PMID- 6495129 TI - Are high schools adequately prepared to cope with serious rugby injuries? AB - A survey of 29 Western Cape high schools showed that 45% of schools had either no or an inappropriate stretcher available for the treatment of injured first-team rugby players, that 35% did not provide splints for the immobilization of limb fractures, and that 59% had no neck braces available. All schools provided field side medical care for at home first-team rugby matches; in 21% of cases a doctor was always present and in a further 41% trained first-aid personnel were available, but 38% of the schools relied on rugby coaches. Furthermore only 62% of all first-team rugby coaches had some rudimentary training in the management of rugby injuries. Of the 38% of coaches who had received no training in first aid, fully 73% provided the sole field-side medical cover for rugby injuries. When questioned about the management of serious head and neck injuries, 93% of coaches were unaware that before a conscious player with a head injury is moved he must be asked whether or not his neck hurts, and 80% were unaware that an unconscious player should be treated as if he has an unstable neck injury. The implications of these findings are discussed. PMID- 6495130 TI - Diagnostic hysteroscopy after postmenopausal uterine bleeding. AB - Hysteroscopy was done immediately before diagnostic fractional curettage in 93 patients with postmenopausal uterine bleeding, as well as in 84 control patients with premenopausal abnormal uterine bleeding. About 13% of patients in both groups were receiving hormonal therapy, while patients with intra-uterine devices were excluded from the study. Bleeding within the uterine cavity obscured the view at hysteroscopy in 3,6% of premenopausal patients, but in none of the postmenopausal patients. Comparison of the final diagnoses in the two groups revealed more endometrial polyps and carcinoma in the postmenopausal patients. However, no tissue for histological examination was obtained at fractional curettage in 28% of the postmenopausal patients, compared with only 4,8% of premenopausal patients (P less than 0,0001). Thus the combined use of hysteroscopy and fractional curettage significantly improves diagnostic accuracy in postmenopausal patients. PMID- 6495131 TI - Is a combined Western and traditional health service for black patients desirable? AB - With the growing interest in traditional forms of healing has come pressure to provide a combined Western and traditional health service for patients of non Western cultures. The present study investigated attitudes of Black South African psychiatric patients to their choice of healer and trends in their usage of isangoma (indigenous healers). It emerged that the patients favoured a two-phase treatment plan in which they consult a Western doctor while in hospital and then consult a traditional healer at their home. PMID- 6495132 TI - Econometric models and the study of the economic effects of Social Security. AB - This article provides a relatively nontechnical discussion of previously published research on the use of econometric models in the study of the economic effects of social security. It illustrates the role of econometric model building by focusing on three major applications: forecasting, policy simulation, and hypothesis testing. A series of three macroeconomic examples serves to emphasize that the development and use of such models puts the focus of the analysis on the underlying economic structure. The first example presents a program-specific model of the Social Security system, the second a large-scale model of the U.S. economy, and the third a single-equation analysis of a specific issue. PMID- 6495133 TI - Present policies and methods regarding the long-term adjustment of benefits. AB - If beneficiaries are to maintain their standard of living at a level close to what it was before they left the workforce, the payments they receive under the Social Security program must be periodically adjusted to account for changes in the cost of living. This article describes the policies and practices employed by the Social Security Administration to accomplish this objective. It describes the historical development of various automatic-adjustment provisions, how contributions are indexed to determine the initial benefit, and how the purchasing power of the benefit is adjusted as the result of changes in the Consumer Price Index. Other factors that will affect long-term benefits, such as changes in the normal retirement age and in the size of the delayed retirement credit, are also explored. PMID- 6495134 TI - Income changes at and after Social Security benefit receipt: evidence from the Retirement History Study. AB - This article details the changes in total income and the composition of its sources that occur upon initial receipt of Social Security benefits, and in the first 4 years thereafter. The study shows that, for many persons, "retirement" is a gradual process rather than an immediate cessation of all paid work. About half the persons entering the rolls continue at least some paid employment after benefit receipt. Even more do so if previous earnings were low or if they have no pension to supplement their benefits. In real terms, the average couple initially loses about one-third of its previous income, while nonmarried women, with less to begin with, lose somewhat less. In the time period studied, inflation was high in historical terms: the Consumer Price Index rose by approximately one-third in the 4-year period following benefit receipt. During that time, the real income of beneficiaries declined by about 10 percent from the levels immediately after benefit receipt. Fewer beneficiaries continued to work 4 years later, so earnings played a smaller role in total income. The real value of private pensions declined by about 20 percent in the 4-year period, but because most persons with such pensions had other, better-protected sources of income, their total income declined by less than 10 percent. PMID- 6495135 TI - Symposium on laser surgery. PMID- 6495136 TI - Argon laser skin surgery. AB - The argon laser is a useful instrument that, during the last 5 years, has become a widely accepted and available tool in cutaneous surgery. Its primary use is in the treatment of various cutaneous lesions, although it also produces very satisfactory results when applied to professional decorative tattoos. These procedures are described and illustrated. PMID- 6495137 TI - Laser surgery for benign laryngeal disease. Conservation and ergonomics. AB - In surgery, the era of tissue conservation and advanced engineering ergonomics has arrived. As a surgical tool, lasers will undergo extensive development. The most precise of surgical tools, its ability to focus to spots equal to its wavelength will permit intracellular surgery. A new technology must be mastered by the operator, who must have a solid foundation in laser physics. The small spot size possible with the new laser laryngoscopy coupler introduces one more refinement in the growing trend toward "conservational" surgery of the larynx for both benign and malignant laryngeal disease. PMID- 6495138 TI - The relationship of transcutaneous PO2 and laser Doppler measurements in a human model of local arterial insufficiency. AB - Transcutaneous PO2 and laser Doppler measurements were made over areas of unheated and heated skin of the feet of normal volunteers. Stepwise elevation of the foot above the level of the heart systematically reduced the local arterial pressure and, thus, the local arteriovenous gradient in these areas. Results indicated that transcutaneous PO2 and laser Doppler measurements reflect changes in local arteriovenous gradient when made over areas of warmed skin, but not unwarmed skin. Comparison of skin surface and subcutaneous temperatures obtained with two heater types revealed the importance of heater configuration. Results confirm a previously hypothesized nonlinear relationship between transcutaneous PO2 and local cutaneous blood flow and indicate that a transcutaneous PO2 reading of zero may be obtained in the presence of significant local cutaneous blood flow. PMID- 6495139 TI - Colonic inhibition of cholecystokinin release and pancreatic protein secretion in dogs. AB - We have shown that the colon is capable of exerting profound inhibition on pancreatic enzyme secretion. This inhibition is brought about, at least in part, by significant suppression of release of cholecystokinin. Pancreatic polypeptide does not appear to be involved in colonic inhibition of pancreatic secretion. PMID- 6495140 TI - In vivo evaluation of pyridoxalated-polymerized hemoglobin solution. AB - Previous evaluations of stroma free hemoglobin solutions (SFHS) revealed two problems, a low P50 (13 to 15 torr) which theoretically limits oxygen off-loading to tissues, and a short intravascular half time of only 3.5 hours. To correct these problems the hemoglobin molecule was pyridoxalated and polymerized to raise the P50 (20 to 22 torr) and to increase the plasma half-disappearance time to 25 hours. In the current investigation, rats exchange transfused to 75 per cent of their initial blood volume with SFHS exhibited centrilobular liver necrosis 12 and 24 hours after the transfusion as a result of the hypovolemic state induced by the hemoglobin diuresis. In contrast, animals administered pyridoxalated polymerized hemoglobin solution (Pr-Pl-Hb) displayed a normal hepatic morphologic finding. Renal morphologic findings in the two groups were similar except for the smaller quantities of hemoglobin observed in the proximal and distal tubules of Pr-Pl-Hb animals. This finding may be a result of the slower degradation of Pr-Pl Hb in the intravascular compartment. Renal function in Pr-Pl-Hb remained normal after exchange transfusion, while the BUN in SFHS treated animals increased significantly due to the state of dehydration. Thus, Pr-P1-Hb represents an improvement over the previously tested SFHS in both P50 and intravascular half time and, because of lowered osmotic and oncotic activities, it may be used in higher concentration to improve oxygen carrying capacity. PMID- 6495141 TI - Conservative treatment of selected patients with colovesical fistula due to diverticulitis. AB - Thirty patients with colovesical fistula due to diverticulitis were encountered in the past ten years. Six patients did not receive any of the standard operative therapies. Four of these patients were observed for three to 14 years with nonoperative management, with little inconvenience and without significant complications. Five of the 24 patients in the surgical group died in the postoperative period. Nonoperative therapy seems to be a viable option in selected patients. PMID- 6495142 TI - The initial evaluation of masses of the neck by needle aspiration biopsy. AB - Needle aspiration biopsy for cytologic study is a simple, safe and accurate procedure for evaluation of cervical masses. It is a valuable initial step for evaluation of undiagnosed neck masses and is most efficacious for follow-up evaluation of patients previously treated for cancer. The procedure does not interfere with subsequent treatment. Information obtained from aspiration cytologic findings is used to plan subsequent evaluation and treatment in the simplest and most cost effective manner. PMID- 6495143 TI - The unpredictable outcome of autotransplanted adrenal gland tissue after bilateral surrenalectomy for Cushing's disease. AB - Sixty-two patients have been operated upon for Cushing's disease at our Surgical Department. Thirteen with adrenal bilateral hyperplasia underwent autotransplantation of thin slices of adrenal gland in order to overcome the inevitable disadvantages that occur after total adrenalectomy. Only in two instances was good functional activity of the transplant observed and the patients could be weaned of steroid replacement therapy. In the other patients, the transplanted tissue was an unsatisfying source of steroid hormone. In disagreement with the results of previous promising reports, adrenal autotransplantation after total adrenalectomy provided unfavorable results in the patients we studied. Eucortisolism is achieved at a low rate, increasing skin pigmentation and Nelson syndrome are not prevented. Furthermore, the transplant may hyperfunction and determine a new state of hypercortisolism. Considering our discouraging data when Cushing's syndrome has been clearly established, the use of microsurgical treatment of the pituitary gland should be favored in adult patients. PMID- 6495144 TI - Sequential electrocoagulation and resection for carcinoma of the rectum. AB - Sequential electrocoagulation followed by resection of carcinoma of the rectum provides better survival results than have been previously obtained. More than 200 patients have been treated by this combined approach during the past ten years. The over-all five year survival rate is 67 per cent. The preferred method of treatment is sequential electrocoagulation followed by low anterior resection. When this procedure was done, 55 of the 65 patients have survived a minimum of five years. If abdominoperineal resection is necessary, the over-all survival rate is 61 per cent. The specific advantages of sequential electrocoagulation and resection are several. This procedure is safe and relatively easy to do. Electrocoagulation may be done at the time of initial biopsy as part of the preoperative evaluation. The usual interval between electrocoagulation and resection is three to five days. This may be longer in selected instances. Preoperative electrocoagulation of carcinoma of the rectum helps to prevent local recurrence on anastomoses and in the perineum. Local recurrence occurred in only 5 per cent of the patients. Electrocoagulation destroys rectal tumor cells in an area in which vascular isolation technique and wide resection of the mesentery are not possible. The efficacy of electrocoagulation in destroying tumor cells is confirmed by pathologic study of our clinical material. Combining electrocoagulation with resection may extend the limits of low anterior resection for favorable lesions allowing use of sphincter-saving procedures with less likelihood of local recurrence. Electrocoagulation, radiation therapy and surgical treatment are not mutually exclusive treatment methods. Rather, we view these modalities as complimentary in offering the potential for additive benefits. PMID- 6495145 TI - Clinical judgment versus delayed hypersensitivity skin testing for the prediction of postoperative sepsis and mortality. AB - In 59 patients operated upon for malignant disease of the gastrointestinal tract, skin testing with recall antigens was compared with assessments based upon clinical judgment alone for prediction of risk of postoperative septic complications. Clinical judgment alone could identify patients with a significantly increased risk for postoperative sepsis and mortality. Prediction based upon clinical judgment is superior to prediction based upon delayed hypersensitivity skin testing. PMID- 6495146 TI - Drainage of pericardial effusions using the peritoneal and pericardial window technique. AB - We have treated nine patients with persistent pericardial effusions using the peritoneal and pericardial window technique, over the past four years, without surgical mortality and with effective results; reoperation was not necessary for reaccumulation of effusion. PMID- 6495148 TI - An anterior approach for excision of benign tumors of the middle part of the rectum. AB - The removal of benign tumors of the rectum is usually accomplished using well recognized transanal procedures. Occasionally an abdominal approach with limited excision as described herein may be appropriate. PMID- 6495147 TI - An easier method for identification of the antral nerves for a simplified proximal gastric vagotomy. AB - A practical method of easily identifying the antral nerves for marking the boundary between the antrum and the parietal cell bearing proximal stomach is suggested. This has reduced the operative time, simplified PGV and proved to be clinically effective in 79 patients who underwent operation. PMID- 6495150 TI - Aneurysmal subarachnoid hemorrhage. Total annual outcome in a 1.46 million population. PMID- 6495149 TI - Initiation of complement activation. AB - The complement system is an excellent one to look at as an example of a triggered enzyme system. It is found to use almost all the strategies of enzyme cascades and for initiation which were discussed in the introduction. The classical pathway is a fine example of an active zymogen form of activation and the alternative pathway is the canonical example of a tickover. Both may also be activated by exogenous enzymes from other systems. The strategies of enzymes waiting for substrates, of substrates waiting for enzymes, and of both waiting for modifying proteins are all seen in various stages of the reaction. There is an association of a linear cascade with the positive feedback amplification loop. This degree of evolutionary adaptation is not only aesthetically pleasing but must be taken to mean that the system is of considerable biological importance and has been over a long evolutionary time span. PMID- 6495151 TI - Thromboembolic complications of ventriculoatrial shunts. AB - Ventriculoatrial shunts were first developed in the 1940s and shortly thereafter became the treatment of choice for noncommunicating hydrocephalus. Although the mortality rate for noncommunicating hydrocephalus has fallen from 80% to 20%, ventriculoatrial shunts continue to have major life-threatening complications such as thromboemboli, infection, and shunt malfunction. This report presents the cases of two adult hydrocephalic patients who developed pulmonary emboli and sepsis after being treated with ventriculoatrial shunts. One patient, whose complications were not recognized until late in the course, died of pulmonary hypertension and right heart failure despite removal of the shunt and aggressive medical therapy. Complications in the second patient were discovered early, the shunt was removed, and intravenous antibiotics were used for weeks to combat sepsis and bacterial endocarditis. PMID- 6495153 TI - Intracranial cavernous angioma angiographically mimicking venous angioma in an infant. AB - We present a case of a 15-month-old infant with intracranial cavernous angioma in the right frontal lobe in which the cerebral angiogram revealed transmedullary collecting veins characteristic of venous angioma around the lesion. This vascular malformation was histologically confirmed to be a cavernous angioma. PMID- 6495152 TI - The protective effect of vitamin E on cerebral ischemia. AB - Using the "canine model of the completely ischemic brain regulated with a perfusion method," the effects on cerebral ischemia of vitamin E, which is known to act as an antioxidant, were investigated. After pretreatment with vitamin E by oral or intravenous administration, cerebral blood flow was reduced to 1/10th the normal state and, 1 hour later, allowed to return to normal. Subsequent changes in electrical activity were observed, and the effects of vitamin E were evaluated. In the control group, no recovery of electrical activity was seen. In the groups given vitamin E, the recovery time was significantly shortened in the dogs given 30 mg/kg of vitamin E intravenously. Furthermore, in the groups treated with vitamin E, distinct recovery of electroencephalographic potentials at 3 hours after recirculation was apparent. These effects were more favorable in the case of intravenous administration than in the case of oral administration. These experimental results indicate that the administration of vitamin E is effective in protecting the brain from cerebral ischemia. PMID- 6495154 TI - Giant posterior inferior cerebellar artery aneurysm with dysphagia. AB - Presented is a case of giant aneurysm of the posterior inferior cerebellar artery with the unusual clinical presentation of dysphagia to the point of inability to swallow even oral secretions, resulting in severe malnutrition. A computed tomography scan with contrast-medium enhancement appeared normal. The correct diagnosis was suspected from the results of metrizamide myelocisternography and was confirmed at angiography. The patient underwent ligation of the feeding right vertebral artery with subsequent improvement in her dysphagia and resolution of her other neurological deficits. Discussion of the incidence, diagnosis, and treatment of this uncommon lesion is presented. PMID- 6495155 TI - Aggressive choroid plexus papilloma. AB - A young woman, who was initially treated for an Arnold-Chiari malformation, was found 7 years later to have a posterior third ventricular tumor. A superior cerebellar approach allowed total resection of the mass, which was an aggressive choroid plexus papilloma. The patient was treated with whole cerebrospinal axis radiation. There is no clinical or computed tomographic evidence of recurrence after 4 years. The literature is reviewed and a discussion of aggressive choroid plexus papilloma (carcinoma) is presented. PMID- 6495156 TI - Changes in parenchymal and ventricular pressure with experimental epidural compression. AB - A rabbit model was used to study the changes in intracranial pressure and parenchymal morphology that accompany epidural compression. A catheter in the left lateral ventricle and an intraparenchymal moist wick in each cerebral hemisphere were used to monitor intracranial pressures. With the balloon uninflated, the pressures in 12 rabbits were similar: 67.8 +/- 34.9 mmH2O for the left lateral ventricle, 61.7 +/- 31.0 mmH2O for the right parenchymal wick, and 58.3 +/- 29.1 mmH2O for the left parenchymal wick (mean +/- S.D.). With inflation of a right parietal epidural balloon to 0.4 cm3, the left ventricular pressure rose significantly to 168 +/- 57.5 mmH2O (p less than 0.001, Student's t-test) and the right hemisphere parenchymal pressure to 114.3 +/- 52.1 mmH2O (p less than 0.001). The left frontal parenchymal pressure increased, but not significantly. There was no evidence of blood-brain barrier breakdown by the Evans blue dye technique 2 hours after compression. Similarly, there was no infarction as gauged by 235triphenyl-2M-tetrazolium chloride infusion at 2 weeks. These data demonstrate that significant pressure asymmetries between hemispheres occur with epidural compression. In the rabbit, a 0.4-cm3 mass is not enough to cause blood-brain barrier breakdown or tissue necrosis. In the first 2 hours of compression th ventricular pressure is higher than the parenchymal pressure, perhaps because of obstruction of cerebrospinal fluid flow around the convexities. PMID- 6495157 TI - Suprasellar germinoma occurring two years after total removal of pineal teratoma. AB - A rare case of a suprasellar germinoma occurring 2 years after total removal of a pineal benign teratoma is presented. The suprasellar germinoma was not considered a recurrence or dissemination from the pineal tumor, but to have been transformed from germ cells present in the suprasellar region. Although it is controversial whether radiation treatment should be given to a patient with a totally removed benign teratoma, careful follow-up computed tomography scans are indispensable for detecting a possible occurrence of other germ cell tumors. PMID- 6495158 TI - Aneurysms of the proximal anterior cerebral artery. AB - The authors report eight cases of aneurysm of the anterior cerebral artery proximal to the anterior communicating artery (A1 segment). In six of these cases, the aneurysms arose from the proximal anterior cerebral artery at the origin of either a cortical branch (on case), the accessory middle cerebral artery (one case), or a perforating branch (four cases). In another case the aneurysm arose at the proximal end of the fenestration, whereas in the one remaining case no branch was present at the site of the aneurysmal neck. PMID- 6495159 TI - Nontraumatic intracerebellar hematomas: prognostic value of volumetric evaluation by computed tomography. AB - Thirty-two consecutive cases of nontraumatic intracerebellar hematomas detected by computed tomography are reviewed. A strong correlation was found between the clinical course and the volumetrically calculated size of the hematomas. Prompt evacuation has the best prognosis in cases that have an acute or subacute course (hematoma size, 22.5 to 66 cm3). Conservative treatment was most successful in chronic cases (hematoma size, 8 to 16 cm3). Surgical treatment should be the treatment of choice in very acute cases also (hematoma size, over 70 cm3) if the hematoma is diagnosed immediately after the onset of bleeding. Early detection and volumetric evaluation by computed tomography have great prognostic value for managing nontraumatic intracerebellar hematomas. PMID- 6495160 TI - Association of arteriovenous malformation and intracranial aneurysm in the posterior fossa. AB - Two cases of a saccular aneurysm of the posterior inferior cerebellar artery associated with an anatomically related arteriovenous malformation are presented. The aneurysms were clipped and the arteriovenous malformations were totally extirpated in one-stage operations in both cases. The association of arteriovenous malformation and arterial aneurysm in the posterior fossa was reviewed in the literature. PMID- 6495161 TI - Lipomas in the corpus callosum and the forehead, associated with a frontal bone defect. AB - This report concerns a case of lipomas in the corpus callosum, possibly both lateral ventricles, and the forehead, which were associated with a defect in the frontal bone. It is thought that the lipoma originated in the interhemispheric fissure and extended to the forehead by at least the second month of gestation. It interfered with the development of the corpus callosum, and the collagenous capsule of the lipoma remained till birth. It caused a defect in the frontal bone in the midline, in spite of the development of both frontal bones. PMID- 6495163 TI - Cerebral arteriovenous malformation: papilledema as a presenting sign. AB - Papilledema as a presenting sign of arteriovenous malformation without evidence of a space-occupying lesion or hydrocephalus is an unusual finding. The pathogenetic theory that seems to explain such cases is the increase of cerebral blood volume leading to intracranial hypertension, thus resulting in papilledema. We present the case of a 31-year-old woman complaining of headaches, with papilledema as the only objective finding. Computed tomography scan and right carotid angiography demonstrated a right mid rolandic arteriovenous malformation. The lesion was totally removed under intraoperative angiographic control. PMID- 6495162 TI - Alterations in serum sialyltransferase activities in patients with brain tumors. AB - The activities of serum sialyltransferase were determined in patients with brain tumors. Blood samples from normal volunteers were used as controls. Serum specimens were obtained from patients with brain tumors both before and after operations. The preoperative serum sialyltransferase activities of the brain metastasis group showed significant increase, but the enzyme levels decreased after removal of the tumor. The serum sialyltransferase activities in the glioma group and the neurilemoma group increased significantly after operation, but no significant difference was found between the preoperative means of these two groups and that of the control. Surgical treatment produced significant differences between the preoperative and the postoperative serum sialyltransferase activities in the brain metastasis and the glioma and neurilemoma groups. Alterations of this enzyme in the blood of patients with brain tumors and its possible clinical applications are discussed. PMID- 6495164 TI - Experimental vasospasm: experiences with a canine model and failure of naloxone therapy. AB - Experimental vasospasm was studied in a canine model utilizing subarachnoid injection of autologous blood. Alterations in the size of the basilar artery were noted angiographically. Naloxone, an opioid receptor antagonist, has been reported to have a beneficial effect on neurological dysfunction secondary to cerebral ischemia. No significant change in the diameter of the basilar artery was noted in dogs either with or without spasm when treated with naloxone. We have concluded that naloxone has no detectable vasodilatory effect on the cerebral arteries of dogs. PMID- 6495165 TI - Fatal congestive heart failure associated with an iatrogenic caval aortic fistula following surgical removal of a herniated intervertebral disk. PMID- 6495166 TI - Brain abscess secondary to intracranial extradural epidermoid cyst. AB - A case of brain abscess in the right temporal lobe secondary to an intracranial extradural epidermoid cyst in the right parasellar region is reported. The etiology of the brain abscess in this particular case was deduced using the findings of computed tomography, carried out several times over a 3-year period, after an initial operation to remove the epidermoid cyst. One of the scans showed a very-low-density spot in the right parasellar region compatible with air, suggesting a communication between the intracranial space and the paranasal sinuses. PMID- 6495167 TI - Fracture of the dens in the aged. AB - Six elderly patients with fractures through the base of the dens are presented. Early posterior fusion with wire and acrylic is recommended after reduction and maintenance of alignment with skeletal traction and treatment of coexistent injuries and illnesses. Uncommon problems and associated injuries complicating treatment in this group of patients are discussed. Some patients in this age group may best be treated with a collar because of concurrent cardiopulmonary disease. PMID- 6495168 TI - Acromegaly with multiple secreting pituitary adenomas. AB - A case of acromegaly with two separate growth hormone-secreting pituitary adenomas is presented. The multiplicity was suspected on computerized tomographic scan and confirmed at transsphenoidal surgery. Possible occurrence of multiple adenomas is discussed. PMID- 6495169 TI - Visual abnormalities with multiple trauma. AB - The diversity of pathogenetic mechanisms involved in posttraumatic visual impairment was reviewed in a study of the hospital records of 24 patients admitted with multiple injuries. Most major visual abnormalities occurred in young people (average age 33 years) who presented with a wide range of overall severity of injury (injury severity score 13-47) and involvement of the central nervous system (Glasgow coma scale 5-15). Bilateral or monocular blindness developed in 63% of patients. Seventy percent of the injuries involved the anterior visual pathways with damage to the optic nerve alone accounting for 35%. Fractures of the sphenoid bone, particularly of the body, accompanied optic nerve and chiasmal injuries and some cases of traumatic carotid-cavernous fistulas. Pathogenetic mechanisms varied according to the site of injury and included vitreous hemorrhage and optic atrophy secondary to raised intracranial pressure, retinal hypoxia from carotid-cavernous fistulas, shearing and compression injuries of the optic nerve, traumatic chiasmal syndrome, temporoparietal and occipital contusions, and transtentorial herniation with occipital infarction. Visual abnormalities varied in severity from moderately reduced visual acuity and diverse hemianopias and scotomas to blindness. The incidence of posttraumatic residual visual abnormalities is likely to increase in the wake of improved acute care of the traumatized victim. PMID- 6495170 TI - Choroid plexus papilloma with cerebrospinal fluid rhinorrhea. AB - Intermittent cerebrospinal fluid rhinorrhea occurred in a 34-year-old male with a papilloma of the choroid plexus in the fourth ventricle. Surgical removal of the tumor preceded plastic repair of the frontonasal fistula. I report an observation 28 years after operation. PMID- 6495171 TI - Progressive idiopathic anterior dislocation of the upper cervical spine with severe myelopathy. AB - Three unusual and rare cases are reported with progressive anterior dislocation of the cervical spine of unknown etiology causing severe myelopathy. Spinal pathology was confined to a single level and at different locations in each case. Narrowing of the spinal canal resulted in three different neurological syndromes, each requiring a different operative approach: one anterior, one posterior, and one both. Two patients made complete functional recovery. One patient died 3 days after operation of aspiration pneumonia. PMID- 6495172 TI - Late outcome of operations for supratentorial convexity meningiomas. Report on 207 cases. AB - Brief remarks on the immediate outcome of operations on 207 convexity meningiomas are followed by a fuller discussion of the late sequelae, the problem of recurrences and relevance of histology, and the persistence or de novo onset of epilepsy. While the immediate outcome is more than satisfactory, there is still room for improvement in the late outcome of surgical treatment for this category of intracranial tumor. PMID- 6495173 TI - The efficacy of routine completion operative angiography in reducing the incidence of perioperative stroke associated with carotid endarterectomy. AB - Routine operative angiography was performed during a 14 1/2-year period ending June 1982, during which 603 consecutive carotid endarterectomies were performed. For the purpose of standardization, a functional classification of stroke in terms of severity was established: class I--minimal, class II--moderate, class III--marked, class IV--severe, and class V--coma or death. Patients were analyzed to determine the cause of the stroke, the severity of the stroke, and the efficacy of routine operative angiography in reducing the incidence of perioperative stroke caused by technical error. Perioperative stroke occurred in 18 patients (2.9%), with only one having been caused by technical error. Fifteen patients underwent revision of the endarterectomy before wound closure because of unsatisfactory operative angiography results. None of the patients developed permanent neurologic deficits. Permanent perioperative neurologic deficits resulted from embolization (six patients), hypertensive episodes with cerebral hemorrhage (three patients), conversion of ischemic to hemorrhagic infarcts (two patients), spontaneous thrombosis (one patient), clamp ischemia (two patients), and other factors (three patients). Nine patients died, two of myocardial infarction and seven of stroke, for a combined mortality and morbidity rate of 3.3%. There were three class II, five class III, two class IV, and eight class V strokes that were determined to be related to the procedure. In this series stroke may have been prevented in 15 patients who underwent revision of the endarterectomy because of an unacceptable technical error demonstrated on operative angiography. PMID- 6495174 TI - Does contralateral carotid occlusion influence neurologic fate of carotid endarterectomy? AB - Divergent opinions regarding operative risks and late prognosis of patients undergoing endarterectomy for carotid stenosis with contralateral carotid occlusion have prompted a review of the experience at Emory University Hospital from Jan. 1, 1978, through Dec. 31, 1982. Fifty-four patients (37 men, 17 women; mean age 63 years) who underwent carotid endarterectomy (CEA) with contralateral carotid occlusion (group I) were compared with 410 demographically similar patients without contralateral carotid occlusion (group II) who underwent 503 CEAs during the same interval. CEA indications in group I were the following and were proportionately similar to those of group II: hemispheric transient ischemic attacks, 22 patients; asymptomatic stenosis, 12 patients; nonhemispheric symptoms, 11 patients; previous cerebral infarction, eight patients; and vascular tinnitus, one patient. General anesthesia, routine intraluminal shunting, systemic heparinization, and arteriotomy closure without patch were routinely employed in both groups. Three patients in group I suffered permanent neurologic deficits after operation (5.6%) and two had transient postoperative deficits with complete recovery. Ten patients (2.0%) in group II suffered permanent neurologic deficits and 10 patients experienced transient neurologic events after operation. Neither the transient nor the permanent neurologic deficit rates were statistically different (p greater than 0.05; Fisher exact test) in the two groups. Operative mortality rates for group I and group II were 0% and 0.8%, respectively, and were not significantly different (p greater than 0.10; Fisher exact test). Late postoperative ischemic brain infarctions occurred in two patients in group I (3.8%) and in 13 patients (3.6%) in group II (p greater than 0.10; Fisher exact test). Kaplan-Meier survival analyses were virtually identical in both groups, with the majority of deaths caused by cardiac occlusion may undergo CEA with morbidity and mortality rates similar to those without contralateral occlusions. Contralateral carotid occlusion does not necessarily portend an unfavorable early or late prognosis after CEA. PMID- 6495175 TI - Surgical management of the occluded carotid artery. AB - Of 36 patients with symptomatic total occlusion of the common carotid and/or internal carotid arteries, ipsilateral operation was performed in 20. Twenty eight patients had occlusion of the internal carotid artery, four of the common carotid alone, and four had occlusion of both vessels. Thirteen patients had completed stroke. Noninvasive examination erroneously suggested internal carotid patency in three patients. Of six patients with occluded common carotid arteries, two underwent thromboendarterectomy, two underwent saphenous vein bypass, and two underwent Dacron graft bypass procedures. Five patients underwent attempted internal carotid thromboendarterectomy and three patients underwent external carotid endarterectomy. Seven patients underwent primary temporal to middle cerebral bypass procedures. There were no perioperative deaths and no patients had permanent neurologic deterioration. There were two postoperative complications. At follow-up 1 to 43 months after operation, five of six patients who had undergone common carotid revascularization had improved neurologically while other treatment groups had no definite improvement. Revascularization of an occluded common carotid artery is a safe procedure that successfully alleviates symptoms of cerebral ischemia. Internal carotid disobliteration and external carotid endarterectomy alone provide limited neurovascular benefit. Benefits of extracranial-to-intracranial bypass were not apparent from this small series. PMID- 6495176 TI - Patency of femoropopliteal and femorotibial grafts after outflow revascularization (jump grafts) to bypass distal disease. AB - Repair of failing femorodistal bypass grafts with secondary distal "jump" grafts was performed 34 times in 33 patients. Indication for operation was limb salvage for all distal jump grafts and for 85% of the initial femorodistal bypass grafts. Autogenous vein bypass grafts were used in 28 of 33 initial femorodistal grafts (85%) and in 29 of 34 secondary jump grafts (85%). Sixteen of the 33 initial grafts in jeopardy extended to the infrapopliteal level (48%) and 19 of the jump grafts terminated in foot or ankle arteries (56%). The 12 jump grafts performed in the first 2 months of the initial graft were associated with high rates (9%) of graft thrombosis and amputation. Early loss of viability of initial grafts probably resulted from technical and judgment errors or underestimation of distal disease. Progression of distal disease produced late failure after 1 year of implantation of the initial grafts. The 1-year patency rate of the initial femorodistal grafts was 63% but only 32% of these grafted limbs were viable and were not at risk of amputation. Distal jump grafts produced a 49% improvement in limb viability (to an 81% limb salvage rate) and an 11% increase in the initial graft patency rate (to 74%) at 1 year. PMID- 6495177 TI - Management of arm arterial injuries. AB - Management, morbidity, and mortality of arterial injuries of the arm are dependent upon site of injury, promptness and accuracy of diagnosis, and involvement of contiguous structures. To determine results and establish principles of management, a retrospective analysis was undertaken of 109 arm arterial injuries from the thoracic inlet to the wrist in 102 patients. Iatrogenic injuries were excluded. Arterial injuries were classified into those affecting the upper arm (subclavian, axillary, and brachial) and those affecting the lower arm (radial, ulnar, and interosseous). This proved to be a useful classification because of differences in management and results at these two levels. Thirty-six or one third of injuries involved the upper arm (13 subclavian, seven axillary, and 16 brachial) and 73 involved the lower arm (30 radial, 29 ulnar, 12 radioulnar, and two interosseous). Of the 19 individuals in hypovolemic shock when first examined, 12 (63%) had sustained upper arm injuries. Fifty-four percent of all patients had nerve involvement when initially examined, the majority (76%) sustaining lower arm injuries. Vein grafts were required during 19 repairs whereas resection and end-to-end repair were successful on 62 occasions. No synthetic grafts were used. Ligation alone was performed 18 times, only among those with lower arm injuries. Two patients died, both of hypoxic brain damage. Twenty-eight percent of patients suffered late disability despite an adequate vascular repair. Overall, 7% of patients with upper arm injuries and 21% of those with lower arm injuries were disabled when last seen. Upper arm arterial injuries are more of a threat to life than are lower arm injuries, but lower arm arterial injuries are more disabling, mainly because of associated nerve involvement. PMID- 6495178 TI - Arterial injuries in extremity shotgun wounds: requisite factors for successful management. AB - The extremity shotgun wound presents a surgical challenge in the treatment of peripheral arterial trauma. Adherence to specific principles of management is required for optimal limb salvage. Thirty-four vascular injuries in 31 patients were reported. Arteriography is mandatory since the presence of distal palpable pulses was an unreliable indicator of the absence of arterial injury in 13 patients. Intraoperative arteriography was essential to demonstrate distal sequential injuries. Arterial reconstruction was necessary in 28 patients who sustained 31 significant vascular injuries. Autogenous interposition grafts were required in 10 patients. Seventeen patients underwent resection of the injured arterial segment followed by an end-to-end anastomosis. Arteriovenous fistulas were ligated in two patients, while two sidewall injuries were treated with lateral repair. Delay of operative intervention with subsequent infection, failure to reconstruct all vessels injured, and inadequate initial fasciotomy were factors that contributed to an amputation in two patients. Successful management of arterial injuries in extremity shotgun wounds requires attention to the following requisite factors: preoperative and intraoperative arteriography, prompt operative intervention, fracture stabilization, repair of all injured major vessels, use of autogenous graft tissue, venous reconstruction, thorough debridement, and fasciotomy. Twenty-nine of 31 patients retained a functional limb by adhering to these principles of management. PMID- 6495179 TI - Value of periangiography hydration. AB - The value of contrast dye to the planning and evaluation of cardiovascular disease cannot be overestimated. However, adverse renal sequellae may cause the surgeon to hesitate in obtaining an arteriogram, especially in patients with compromised renal function. The purpose of this study was to evaluate the incidence of renal dysfunction in patients requiring angiography. Standard contrast angiography for cerebral or peripheral vascular disease was administered to 150 consecutive patients (89 men and 61 women), with an average age of 63.3 years (range 49 to 89 years). All patients received 100 to 150 ml of dye, with a concentration of approximately 50% iodine. Patients were hydrated with 0.5 N saline/5% dextrose, intravenously, for 8 hours before the procedure (1 to 3 ml/kg/hr). In 31 patients (11 women and 20 men) the serum BUN and/or creatinine levels were elevated (mean BUN value of 48 +/- 9 mg/dl; mean creatinine level of 2.8 +/- 0.6 mg/dl). The patients with abnormal renal function received an additional 300 to 500 ml of intravenous fluid, plus 20 to 40 mg intravenous furosemide, 1 hour before roentgenography to establish a diuresis. All patients were hydrated for 6 hours after angiography with the same solution at the same rate (1 to 3 ml/kg/hr). There were no episodes of compromised renal or cardiopulmonary dysfunction because of contrast angiography. In no patient did the BUN or creatinine level rise, nor was there evidence of acute tubular necrosis, as documented by oliguria and abnormal cells in the urine. Angiography is a safe procedure, even with patients who may have compromised renal function, if appropriate prehydration/posthydration and diuretic measures are undertaken. PMID- 6495180 TI - The vascular steal phenomenon: an experimental model. AB - A model for the vascular steal phenomenon was designed and evaluated in 10 mongrel dogs in which the aortic bifurcation was used to represent a parent artery with two distal vascular beds. Right lower extremity flow was increased with a femoral arteriovenous fistula, and progressively greater stenoses were applied to the distal abdominal aorta. Significant decreases in left lower extremity flow (a steal) occurred only when the stenosis of the aorta exceeded 60%. There was a direct relationship between the pressure drop across the aortic stenosis and the degree of steal from the left lower extremity. The stenosis required for a steal phenomenon to occur is analogous to a critical arterial stenosis for a given velocity of flow and the specific cross-sectional area of the distal arterial bed. PMID- 6495181 TI - "Peel away" technique for Denver shunt insertion. PMID- 6495182 TI - Popliteal vein pseudoaneurysm: a case report. AB - This is a case report of an athletic, middle-aged man with a remote history of penetrating right leg trauma who developed a pulmonary embolism, thrombosis of the popliteal vein, a mass in the popliteal fossa, and acute ischemia of the right lower leg. At operation a thrombosed pseudoaneurysm was found arising from a defect in the popliteal vein with extrinsic compression of the popliteal artery. The defect was patched with autogenous vein and the long-term result was excellent. Pseudoaneurysm of the popliteal vein is a previously unreported entity. Popliteal venous aneurysms usually begin with phlebitic or pulmonary thromboembolic manifestations and present a diagnostic challenge. Venous aneurysms in general are uncommon pathologic entities with a diverse etiology; the current etiologic concepts and classification are briefly discussed in the text. A new differential diagnosis for masses in the popliteal fossa is introduced by this report. PMID- 6495183 TI - Infrarenal aortic dissection--is there a clue? PMID- 6495184 TI - Rupture of a thrombosed aorta. PMID- 6495185 TI - Re: Successful long-term results with resection of pancreatic carcinoma in children. PMID- 6495186 TI - Shunts versus no shunts in carotid endarterectomy. PMID- 6495187 TI - [Disorders of amino acid pool in the blood and gastric mucosa in patients with peptic ulcer]. AB - It has been demonstrated that peptic ulcer patients manifest hypo- and dysaminoacidemia and a dramatic increase in the amino acid pool of the gastric mucosa which are accounted for by neurogenic dystrophy leading to catabolic orientation of the processes not only in the mucous membrane of the gastroduodenal zone but also in other organs with a high level of protein synthesis, particularly in the liver. Based on the coefficients that determine amino acid transformation in the liver and analysis of the blood serum content of replaceable amino acids, peptic ulcer patients were discovered to have marked impairment of the amino acid-forming function of the liver. PMID- 6495188 TI - [Effectiveness of echocardiography in the diagnosis of heart pathology in ambulatory care]. PMID- 6495189 TI - [Thin-needle aspiration biopsy under echographic control]. PMID- 6495190 TI - [Chronic noncalculous cholecystitis with refractory relapsing course (clinico laboratory correlates)]. AB - The immunological (lymphocyte blast transformation with PHA, determination of IgA, IgM, IgG), cytochemical (the mean cytochemical index of neutrophil lipids, glycogen, peroxidase content), hematological (the leukocyte, lymphocyte and neutrophil counts), and biochemical tests were employed to study immune responsiveness in 108 patients with chronic non-calculous cholecystitis running a refractory relapsing course. The patients showed the signs of immune deficiency. Some of the above described tests turned out informative for detecting such deficiency. It has been demonstrated that conventional therapy does not provide any stable clinical effect, aggravating the manifestations of immune deficiency. The introduction into the complex of treatment measures of diphenhydramine, saparal and levamisole, in particular, favoured more rapid elimination of the clinical symptoms of a relapse, of allergic reactions, psychoemotional disorders and reduced the signs of a decrease in immune responsiveness in patients with chronic non calculous cholecystitis running a refractory relapsing course. PMID- 6495191 TI - [Disorders of microcirculation in patients with acute surgical diseases of the biliary tract]. AB - The authors provide the results of studying the microcirculation in 85 patients with acute cholecystitis and 56 patients with mechanical jaundice caused by choledocholithiasis. The data were obtained with the aid of bulbar capillaroscopy during conservative and surgical treatment. Considerable alterations were detected in all the components of the microcirculation (perivascular, vascular, intravascular), correlating with the gravity of destructive lesions in the gallbladder, duration and degree of jaundice. The times and degree of the normalization of microcirculatory disorders were defined. PMID- 6495192 TI - [Relapsing polychondritis]. PMID- 6495193 TI - [Clinical aspects and diagnosis of temporal arteritis]. PMID- 6495194 TI - [State of the microcirculatory component of hemostasis and microhemodynamics in patients with diabetic angiopathies]. AB - A total of 150 patients presenting with diabetes mellitus were examined. Patients with diabetic angiopathy demonstrated substantial impairment of platelet aggregation (secondary adhesion, spontaneous aggregation), of the functional activity of heparinocytes, lipid metabolism and microhemodynamics. PMID- 6495195 TI - [Early diagnosis of specific lesions of the liver in lymphogranulomatosis]. AB - To identify a group of patients who are likely to have specific liver damage (a risk group), 88 patients with lymphogranulomatosis were examined. The examination program included clinical studies, liver scanning, peripheral blood analysis, blood serum biochemistry, study of the bone marrow, liver biopsy in all the patients. Eleven patients manifested specific liver damage. In all the patients with liver lymphogranulomas, the disease ran an unfavourable course; they frequently demonstrated the symptoms of intoxication enlargement of the liver size, focal changes on the scanogram and concurrent damage to the bone marrow. According to the biochemical tests, high activity (over 200 U/l) of alkaline phosphatase was recorded exclusively in patients with the lymphogranulomatosis induced liver damage. Nevertheless, none of the above-enumerated signs regarded separately cannot serve as criterion of the diagnosis of lymphogranulomatosis metastases to the liver. Analysis of the rate of association of individual clinical symptoms and laboratory findings demonstrated that the most informative were associations of high alkaline phosphatase activity and enlargement of the liver size, as well as association of thrombocytopenia and anemia. However, histological study of liver biopsies is the most reliable method of diagnosis of lymphogranulomatosis metastases to the liver, particularly in patients with clinical stages I-II, since in such patients with lymphogranulomatosis, specific liver damage runs an asymptomatic course. PMID- 6495196 TI - [Diagnostic difficulties in herpes zoster]. AB - The authors have analysed the clinical and laboratory findings in 170 patients with herpes zoster (HZ). Of these, 21 patients (12.3%) had been erroneously diagnosed before the appearance of herpetic eruption as having other diseases (erysipelas, renal colic, acute pancreatitis, acute abdomen, and so forth). The authors point to the difficulties encountered in making the diagnosis at the initial disease period with emphasis on the great importance for early diagnosis of HZ of the analysis of the clinical findings, prodromal period and hemogram data. PMID- 6495197 TI - [Relations between the myocardial state and several indicators of the myocardial function of the left ventricle in patients with ischemic heart disease]. AB - Forty-six patients aged 39 to 59 years with coronary heart disease were examined. The control group comprised 10 healthy men. The myocardial injury was evaluated according to the ECG data. All the patients were subjected to selective coronarography and left roentgenokinoventriculography. To appraise the left ventricle myocardial contractility, the following indicators were made use of: the end diastolic pressure, ejection and the ratio of the peak systolic pressure in the left ventricle to the end systolic volume relative to the body surface. During kinoventriculography, left ventricle asynergy was detected in 65.2% of cases, whereas the reduction in the magnitudes of ejection and in the Ppeak/ESV X m2 index in 60.9 and 54.3% of cases, respectively. The false-negative result was 17.4% for ejection and 6.5% for the Ppeak/ESO m2 X index. Ejection and the Ppeak/ESV X m2 index were found to be highly informative. However in cases with a relatively preserved function of the left ventricle, it is necessary to take into account the magnitude of the Ppeak/ESV m2 X index which may attest to the pathological alterations in the myocardium in 62% of cases. PMID- 6495198 TI - [Acute intermittent porphyria and necrotic lesions of the myocardium]. PMID- 6495199 TI - [Clinical aspects of the use of the method of recording chemiluminescence of the blood]. PMID- 6495200 TI - [Diagnosis of coronary artery lesions during the exercise test according to electrocardiotopographic data in patients with ischemic heart disease]. AB - It has been shown that electrocardiotopography applied during the exercise test in patients with coronary heart disease makes the test more sensitive without changing its specificity as compared with the ECG in common 12 leads. The depression of the ST segment occurs on the electrocardiotopogram in the areas of the precardial zone, corresponding to an isolated or pair lesion of the definite coronary arteries. Upon the involvement of all the three main arteries of the heart the site of the depression is indefinite, but its degree rises, being maximal in patients with stenosis of the left coronary artery and right coronary artery. In these patients, the displacement of this segment spreads to all the areas of the precardial zone. PMID- 6495201 TI - [Characteristics of the clinical aspects and symptomatology of ischemic heart disease with various degrees of stenosis of the left coronary artery]. AB - The case histories, painful syndromes, clinical pictures, ECG at rest, and the exercise ECG test data were examined in 169 patients with degrees I-IV of left coronary artery stenosis. The gravity of the clinical picture was found to be augmented with the stenosis degree. The number of daily angina pectoris attacks and their gravity increased, while the pains at rest, night time, after meal, and during transition from the vertical to the horizontal position occurred more frequently. As the stenosis degree progressed, the coronary insufficiency area on the ECG at rest became larger. The exercise tolerance threshold appeared particularly low in patients with degrees II-IV of stenosis, being slightly higher in those with degree I of stenosis. The number of patients who survived myocardial infarction declined with stenosis progression. Patients with degree I of stenosis manifested a grave clinical picture. Stenosis of the left coronary artery up to 50% of the initial trunk was a clinically significant lesion. PMID- 6495202 TI - [Diagnosis of impairment of segmental myocardial contractility during the acute phase of infarction using sector scanning]. AB - The paper is concerned with sector scanning for early diagnosis of acute myocardial infarction. A total of 157 patients were examined within the first 2 to 6 hours after transmural infarction. The segments of the left ventricle which are mostly affected in infarctions of different sites were defined. Application of two-dimensional echocardiography permitted an earlier detecting of the segmental disorders and the extent of the focus of lesion as compared with the ECG. The method appeared particularly informative in the diagnosis of conduction impairment and repeated lesions of the left ventricular myocardium. It has been demonstrated that involvement of over 65% of left ventricular segments is an unfavourable sign from the standpoint of the disease prognosis. PMID- 6495203 TI - [Diagnosis of thrombosis of the left ventricle in patients with acute myocardial infarction using 2-dimensional echocardiography]. AB - The authors demonstrate the possibilities of two-dimensional echocardiography in the diagnosis of left ventricular thrombosis (LVT) with special reference to patients with acute myocardial infarction (AMI). Provide the data of echocardiographic examination of 34 patients with transmural AMI. LVT was identified in 8 patients with anterior AMI. The authors show the relationship between the development of LVT and the site and extent of lesion, and the degree of left ventricular contractility disorders. Outline the prospects of further studies into LVT in patients with AMI. PMID- 6495204 TI - [Chemiluminescence of the leukocyte mass in the diagnosis of acute myocardial infarction]. PMID- 6495205 TI - [Echocardiography: results of its use and prospects of development in the USSR]. PMID- 6495206 TI - [Changes in ECG indicators during bicycle ergometry in patients having suffered myocardial infarction]. AB - Altogether 218 patients with a history of myocardial infarction were subjected to bicycle ergometry. The ECG recorded at the height of the exercise showed a significant increase in the heart rate and in the amplitudes of P and R waves. The diastole and electric systole shortened. As the load was raised, the rate of A-B conduction was relatively decelerated. PMID- 6495207 TI - [Comparative study of the exercise tolerance of patients with autonomic circulatory dystonia, angina pectoris and previous myocardial infarction]. AB - Ninety-eight men were examined. Of these, 13 were practically healthy, 29 had vegetovascular dystonia, 15 stable angina pectoris, and 41 men suffered myocardial infarction. Each group was appraised for work fitness. The double product, work, chrono- and inotropic reserves of the heart, as well as the index of energy losses of the heart per unit of work were calculated. A significant decrease in chrono- and inotropic reserves of the heart were revealed in patients with demonstrable coronary pathology and with cicatricial lesions after myocardial infarction. The patients with vegetovascular dystonia showed inadequate response to the exercise, manifested by greater energy losses of the heart per unit of work as compared to normal. PMID- 6495208 TI - [The state of microcirculation, hemoperfusion and tissue oxygen consumption in patients with ischemic heart disease and angina pectoris]. AB - In patients with associated coronary heart disease and angina pectoris functional classes II-IV, microcirculatory disorders are linked with the gravity of the patients' clinico-functional status. Application of the functional tests (inhalation of 100% moistened oxygen, regional occlusion of the vessels of the limb under study) revealed the presence of latent deficiency of oxygen transport to the cellular substrate. In functional classes III and IV of disease, an appreciable reduction in the level of tissue hemoperfusion, of tissue oxygen supply, and an increase in the summary conjunctival index were recorded. PMID- 6495209 TI - [Work capacity evaluation of patients with sick sinus syndrome]. AB - Thirty-four normal subjects, 30 patients with sinoatrial node weakness (SANW), and 129 patients with coronary heart disease (CHD) without the signs of sinoatrial node involvement were examined. The work fitness was studied with the aid of indirect estimates (PWC 170, maximal oxygen consumption per kg bw, double product), spiroergometry (oxygen pulse, rest quotient) and central hemodynamic data (cardiac and stroke indices). The work fitness in SANW patients was low, depending on the disease etiology and chronotropic reserves of the heart. PWC 170, maximal oxygen consumption per kg bw, oxygen pulse were found to overestimate the genuine level of the SANW patients' physical status. In view of this fact these estimates cannot be used for its evaluation. It is inferred that the power of the threshold loading, the rest quotient, the cardiac index, and double product adequately reflect the work fitness of SANW patients. PMID- 6495211 TI - [Hemodynamic changes in patients with arterial hypertension during isometric exercise]. AB - Forty-two patients aged 35 to 58 years with arterial hypertension were examined. The patients did not manifest any clinical signs of heart failure or coronary heart disease. All the patients were subjected to the leg form of isometric exercise test with a 100% maximal force. The blood pressure, heart rate, heart contractility and pump function were examined in the course of the test. It was demonstrated that in patients with arterial hypertension, the pressor reactions in response to the exercise were similar to those in healthy subjects but were more pronounced. In patients with stage IIA arterial hypertension, the increase of blood pressure occurred due to the inotropic reaction of the myocardium and triggering of Frank-Starling's mechanism. In patients with stage IIB arterial hypertension, the increase of blood pressure was caused by the total peripheral resistance elevation. The leg form of isometric exercise permits the detection of early signs of heart failure in patients with arterial hypertension. PMID- 6495210 TI - [Characteristics of blood pressure in schoolchildren 7-17 years old (based on one stage and prospective studies)]. AB - One-stage epidemiological survey permitted one to define the limits of normal blood pressure values in schoolchildren aged 7-17 years for each age-sexual group differentially. Isolated blood pressure elevation was found to be rare, amounting to 4.4% in boys and to 3.1% in girls. The rate of new cases of elevated blood pressure per 100 subjects was equal to 8.2 cases for systolic and 10.3 cases for diastolic blood pressure. PMID- 6495212 TI - [Detection of latent hemodynamic disorders of the lesser circulation in patients with chronic obstructive bronchitis and bronchial asthma]. AB - Thirty-three patients with infectious allergic bronchial asthma and chronic obstructive bronchitis and 47 normal subjects were examined with the aid of a complex of bloodless research methods for the pulmonary circulation and central hemodynamics under graded physical exercise of minor power. Investigation at rest did not disclose any hemodynamic disorders in the greater and pulmonary circulation. Application of bicycle ergometry to patients with chronic obstructive bronchitis and bronchial asthma in a stage of remission made it possible to reveal latent hemodynamic disorders of the pulmonary circulation that manifested by long-term elevation of the pressure in the pulmonary artery and pulmonary vascular resistance, restitution of the central hemodynamics according to the hyperkinetic type. The use of the generally accepted formulas for calculating the proper magnitudes of the ejection period and mechanical systole with the heart rate exceeding 90 per minute resulted in overdiagnosis of the overload of the right ventricle. The authors offer the regression equations for calculating these parameters during tachycardia. PMID- 6495213 TI - [Acute pneumonia in the practice of polyclinical internists (current problems of prevention, diagnosis, treatment and rehabilitation)]. AB - The overwhelming part of patients with acute pneumonias are treated at home by district internists (only 10.2% of the sick was admitted to hospitals). Early disease diagnosis, adequate selection of patients who need hospitalization, adequacy of the treatment, control over rehabilitation, wise decision as to the time of reporting to work, and efficient dispensarization largely depend on the activities of district internists. Considerable reserves for improving this trend in the activities of polyclinics have been revealed. PMID- 6495214 TI - [Importance of roentgenobronchological studies in patients with chronic pneumonia]. AB - A study was made of the role of bronchography and bronchozonography in the diagnosis of bronchial patency impairment in patients with chronic pneumonia. 144 patients were subjected to a comprehensive x-ray examination. The x-ray signs were divided into 3 groups: Group I included the signs of bronchiostenosis, Group II those of dilatation, and Group III included combined stenosis and dilatation. A definite interrelationship was found between the degree of the morphological impairment of bronchial patency and lesions in the lung parenchyma. During insignificant or marked stenosis and dilatation of the bronchi of the medium size, the lung tissue commonly showed negligible lesions or gross alterations, respectively. PMID- 6495215 TI - [Prognostic significance of ECG changes in acute pneumonia]. AB - A total of 293 patients with acute pneumonia were examined for the relationship between ECG changes and the gravity and immediate outcomes of disease. The pneumonia gravity was determined by the mathematic method based on the computation of the prognostic index of pneumonia (Z. K. Trushinsky et al., 1978). It was established that the overload of the right atrium, malfunction of automatism, excitability and conduction, depression of the ST segment and T wave inversion were in a good agreement with the gravity of pneumonia. In patients with severe and medium-severe disease, the above alterations were more demonstrable than in patients with mild pneumonia. Atrial fibrillation and intraventricular blockades, hypertrophy of the left ventricle and changes in the end part of the ventricular complex were observed more frequently in patients discharged from the hospital with residual phenomena as compared to the recovered patients. This indicates a prognostically unfavourable importance of the ECG signs while evaluating the immediate prognosis. In patients with associated acute pneumonia and coronary heart disease, the ECG changes (arrhythmias, displacement of the ST segment and T wave inversion) were more pronounced and steadier, which was linked with the development of more profound dystrophic lesions of the myocardium. PMID- 6495216 TI - [Differential diagnosis of spontaneous pneumothorax]. AB - Spontaneous pneumothorax runs its course in the presence of the main symptoms such as pain in the side, dyspnea, tachycardia, often leading to erroneous diagnoses: angina pectoris, myocardial infarction, renal and liver colic, and so forth. Sometimes these errors lead to grave consequences. While differentiating between the most severe complication, spontaneous valvular pneumothorax, and similar diseases it is necessary to bear in mind that the main symptomatology of the complication involves the presence on the side of the complication of a box sound, sometimes with a tympanic tone, reduced respiration or its absence, and heart displacement toward the side opposite to the pneumothorax. PMID- 6495217 TI - [Determination of the correlations between oxidant and antioxidant systems in bronchial asthma]. AB - The authors devised a method for calculating the correlations of alpha-tocopherol and superoxide dismutase (SOD) activity to lipid peroxidation (LPO), presented in the form of the following coefficients: K1 = alpha-tocopherol/LPO, K2 = = SOD/LPO X 100. In patients with a bronchial asthma attack, there was an appreciable decrease in the K1 and K2 with a tendency toward recovery in the inactive disease phase. The coefficients ascended to relatively high values if the patients responded well to the treatment. As the disease duration increased (up to 5 years), there was a progressive lowering of the coefficients, with the LPO values being the highest and with those of alpha-tocopherol and SOD being low. The estimates under study were discovered to depend on the external respiration as shown by spirography and pneumotachometry. It has been demonstrated that the coefficients suggested by the authors characterize not only the level of the LPO AOA system compensation but also of the pathological process on the whole. The data obtained point to the importance of determining the coefficients for the assessment of the patient's status gravity, the degree of the improvement following treatment, the disease gravity, and prognosis. PMID- 6495218 TI - [Semeiotics of abdominal tuberculosis]. AB - Examination of 119 patients with abdominal tuberculosis permitted the description of the characteristic semiotics of the illness. Today the patients with abdominal tuberculosis are mainly women of child-bearing age with a long-term tuberculosis catamnesis and intoxication, with a history of tuberculosis of different sites, those suffering from tuberculosis or its sequels at present (64%), those with pains (94%), discomfort or swelling of the abdomen (79%), malfunction of the gastrointestinal tract (65%), weight loss (86%), malnutrition (72%), anemia (63%), not infrequently with inflammatory induration (43%) or ascites in the abdominal cavity (39%). In addition to this characteristic semiotics, the patients with abdominal tuberculosis may demonstrate the most different and unexpected symptoms up to acute abdomen (23%). To make differential diagnosis of abdominal tuberculosis, one has often to resort to diagnostic laparotomy, laparoscopy, Koch's test and to trial therapy. PMID- 6495219 TI - [Prognosis of the course and outcome of peptic ulcer with localization of lesions in the stomach]. AB - Wald's sequential analysis was made in four stages based on the data obtained during examination of 120 patients with peptic ulcer, in 60 of whom the disease ran a complicated course. The morphofunctional data on the gastric mucosa and the endoscopic data were found to be the most informative for disease prediction. PMID- 6495220 TI - [Basal and food-stimulated blood gastrin in duodenal ulcer]. AB - It has been demonstrated that the basal gastrin level in the blood of patients with peptic ulcer of the duodenum is similar to that in normal subjects. Food stimulation raises blood gastrin in normal subjects and patients. However, in patients, the peak of the blood hormone rise is higher, with this rise lasting for a longer time. Besides, the total output of the hormone is greater. These changes are most marked during an incomplete disease remission, being less remarkable when exacerbation gets attenuated and during a complete remission. A correlation has been noticed between the acid-forming function of the stomach and basal blood gastrin level that increases as the acid content in gastric juice descends. In patients experiencing a complete remission and in those in the stage of an incomplete remission and attenuated exacerbation, a direct correlation was ascertained between the stimulated hypergastrinemia and duration of the intragastral pH elevation in response to food intake. It is suggested that in peptic ulcer of the duodenum, hypergastrinemia occurs as a defence reaction aimed at the activation of trophic processes in the mucous membrane of the gastroduodenal zone. PMID- 6495221 TI - An anatomical study of human otocephaly. AB - This study describes the gross anatomic variations observed in a 32-week male fetus diagnosed as having otocephaly. Special attention was given to the muscular, peripheral nervous, and vascular systems of the entire body. External features included approximation of the ears on the front of the neck, underdevelopment of the lower jaw, and a small oral cavity. The mandible, maxillae, and zygomatic bones were smaller than normal and appeared shifted in a ventrocaudal direction. The middle ear ossicles were fused and abnormally positioned. The tongue was positioned abnormally and malformed. The muscles of mastication were fused in the midline and formed the floor of the oral cavity. The variations were similar to the spectrum of abnormalities reported in two cases in the literature. Because of this finding, it is possible that the causative events leading to these deviations were similar in the three cases. Possible mechanisms are considered which could lead to the observed malformations seen in these cases. There were also several muscle and nerve anomalies outside of the head region. PMID- 6495222 TI - Acentric craniofacial cleft in a newborn female prenatally exposed to a high dose of diazepam. AB - A newborn female with craniofacial clefts, including cleft lip and palate, was studied. The mother had ingested 580 mg of diazepam in a single dose at about the 43rd day of gestation. The synchronism of the drug intake and the embryological development of the affected structures suggests an etiopathogenic relationship. PMID- 6495224 TI - Vascular abnormalities due to hyperthermia in chick embryos. AB - Intraembryonic vascular abnormalities were studied in chick embryos exposed to temperatures 3 degrees C and 4 degrees C above normal temperature (38 degrees C) from the beginning of incubation. The average duration of hyperthermia was 54 and 53 hours, respectively. Immediately after exposure, the embryos were examined with FITC-Dextran microangiography in vivo. Following hyperthermia various abnormalities in the heart, ventral aortae, aortic arches, omphalomesenteric arteries, and the distal dorsal aortae frequently occurred. There were also significant microvascular changes in the head, in the lateral and caudal parts of the embryos, and in the pellucid area of the yolk sac. In another series incubation at 41 degrees C, hyperthermia of 3 degrees C during the first 3 days of development produced several extraembryonic vascular abnormalities. These included duplication and abnormal branching of the cranial vitelline vein, absence or abnormal course of the omphalomesenteric vessels, aneurysmatic dilatation or abnormal course of the caudal vitelline vein, and aneurysmatic dilatation or occlusion of the abdominal venous sinus. Most frequent findings were blind, congested, and dilated microvascular segments in the pellucid area, commonly associated with an irregular microvascular pattern and perivascular swelling. The abnormalities described are assumed to be caused by the direct effects of hyperthermia upon the developing vessels resulting in microvascular insufficiencies, pathological leakage, and perivascular oedema. Such disturbances may have serious consequences for embryonic vascular development and microcirculation, which in turn may have adverse effects on further embryonic growth and development. PMID- 6495223 TI - Fetal alcohol syndrome in the ferret (Mustela putorius). AB - Gastric intubation of 1.5 g ethanol/kg maternal body weight produced a significant teratogenic response in ferrets (Mustela putorius) treated once daily from gestational days 15 through 35. This response was evident by a rise in the frequency of fetuses with one or more malformations (21%), and by a rise in the frequency of litters with one or more malformed fetuses (50%). Palatoschisis and greater relative intermedial canthi distance observed in this study are diagnostic features of the fetal alcohol syndrome (FAS). Although mean (+/- SEM) peak blood alcohol levels of 207 +/- 9 mg/dl did not affect other reproductive parameters, high doses of alcohol (3.0 g/kg) resulted in the inability of treated females to consume adequate food or water, in the complete resorption of litters, and in significant maternal mortality (88%). Fetal deaths occurred prior to gestation day 17 in the high-dose alcohol group. Based on objective evaluation of differences among ethanol-treated, pair-fed sucrose-treated, and untreated ad libitum diet controls, the ferret would seem a valuable alternative animal species for future studies of FAS. PMID- 6495225 TI - Threshold for carbon monoxide induced fetotoxicity. AB - Carbon monoxide (CO) is said to be the most widely encountered occupational and environmental contaminant. Threshold for CO-induced fetotoxicity was studied using mouse as an experimental animal. Pregnant animals of CD-1 strain were exposed to 0, 65, 125, 250, or 500 ppm CO from gestation day 7 to 18. The animals were sacrificed on gestation day 18, and their uterine horns were examined for live or resorbed fetuses. The data suggest that maternal CO exposure to as low as 125 ppm affects fetal growth and higher levels affect viability. The data also suggest that the developing organism is sensitive to chronic CO exposure, and this sensitivity is dose dependent. The fetal mouse is influenced at levels of exposure below those found transiently for human cigarette smokers and ambient CO concentrations associated with various occupations. PMID- 6495226 TI - Reproduction and fetal development in rats exposed to nitrous oxide. AB - The effects of 24 hours of nitrous oxide exposure on reproductive indices and fetal development were examined in Sprague-Dawley rats. Four different experiments employing four concentrations of nitrous oxide--0.75%, 7.5%, 25% and 75%--established that the threshold of toxicity was greater than 25%. At 75% nitrous oxide there was a significant increase in early and late resorptions, and a consistent teratogenic effect (e.g., runts, ocular malformations, limb deformities). Neither the stress of shipping dams while pregnant nor the withholding of food during nitrous oxide exposure resulted in additional adverse effects. Exposure to 25% nitrous oxide was associated with increased deoxyuridine suppression values; however, adverse reproductive effects were not seen at this nitrous oxide concentration. The results of this and other studies which have examined the reproductive and teratogenic effects of nitrous oxide do not contraindicate its use in operating rooms nor, when necessary, as an anesthetic for pregnant surgical patients. PMID- 6495227 TI - Cervicovaginal abnormalities in BALB/c mice treated neonatally with sex hormones. AB - Newborn female BALB/cCrgl mice received hormone treatments (daily for 5 days): 10(-1) micrograms diethylstilbestrol (DES), 2 X 10(-1) micrograms DES, 2 micrograms DES, 100 micrograms progesterone (P), 137 micrograms 17 alpha hydroxyprogesterone caproate, 10(-1) micrograms DES + 100 micrograms P, 2 micrograms DES + 100 micrograms P, 5 micrograms testosterone (T), 20 micrograms T, 20 micrograms 5 alpha-dihydrotestosterone (DHT), or sesame oil and were examined at 25 days, 35 days, or from 10 to 30 days of age. Three major cervicovaginal abnormalities were noted: adenosis (heterotopic columnar epithelium) in the fornices; altered common cervical canal (aberrantly simplified cervical lumen), and twin fornix (lateral branching of either or both fornices). Only DES, administered alone or in conjunction with P, resulted in adenosis and altered common cervical canal. At 25 days, all mice given 2 X 10(-1) micrograms DES showed adenosis. At 35 days, 75% of mice given 10(-1) micrograms or 2 micrograms DES showed adenosis. Adenosis incidence following 10(-1) micrograms DES was decreased by concomitant P. Altered common cervical canal was present in more than 90% of mice treated with DES alone at both 25 and 35 days; concomitant P lowered the incidence in mice receiving 10(-1) micrograms DES. Neonatal exposure to endogenous prolactin from a pituitary transplant did not modify the response. Twin fornix was not evident 10 days after neonatal androgen treatment. The frequency increased significantly by day 15 of treatment, reaching 100% by day 20; incidence then declined to 86% and 63% on days 25 and 30 after treatment, respectively. Thus, neonatal sex hormone administration results in various cervicovaginal changes, some transient, decreasing with age in young mice. PMID- 6495228 TI - Ethanol teratogenicity in mice: an electron microscopic study. AB - In this study, the neuroepithelium (NE) cells of the mouse embryo were examined with the electron microscope at various intervals after maternal injection of 0.03 ml/g body weight 25% (v/v) ethanol on day 9 of gestation (plug day = day 1), by the intraperitoneal route. Within 1 hour of treatment, the mitochondria of the NE cells became greatly swollen but could recover. Recovery occurred in two phases: a rapid one during the second hour after treatment, followed by a more gradual one that lasted until 12 hours after treatment. About 5 hours after treatment, dying and fragmenting cells were seen in the NE of all embryos examined. The debris from this necrosis was phagocytosed by neighbouring healthy cells. Also at 5 hours after treatment there was an apparent expansion of the intercellular space of the NE and an enlargement of the apical pseudopodial processes of the NE cells. The latter two changes may have been the result of failure of energy-dependent cell fluid homeostasis consequent to mitochondrial dysfunction. All of these changes were reversed by 15 hours after treatment. Although all embryos examined had abnormalities of the NE, including cell necrosis, at 24 hours after treatment only 28% had failed to complete neural tube formation. Hence, either the degree of ethanol-induced damage varies between embryos in the same litter, or the sensitive period is so restricted that variations in stage of development within a litter can account for the lack of concordance between the presence of cellular damage and the subsequent occurrence of a neural tube defect. PMID- 6495229 TI - [Transfusion medicine and blood donor services. The organization of the Blood Donor Service of the Swiss Red Cross]. PMID- 6495230 TI - [Blood components. Preparation in regional centers]. PMID- 6495231 TI - [Fresh blood. Indications and application]. PMID- 6495232 TI - [Erythrocyte concentrates. Indications and applications]. PMID- 6495233 TI - [Platelet concentrates. Indications and applications]. PMID- 6495234 TI - [Fresh frozen plasma. Indications and applications]. PMID- 6495235 TI - [Albumin. Indications and applications]. PMID- 6495236 TI - [Serology of blood groups for blood transfusion practice]. PMID- 6495237 TI - [Risk of infection in blood transfusions]. PMID- 6495238 TI - [Guidelines of the Blood Donor Service of the Swiss Red Cross for standardizing preserved blood and blood components]. PMID- 6495239 TI - Progress in research on cystic fibrosis. PMID- 6495240 TI - Serum type III procollagen peptide concentration in cryptogenic fibrosing alveolitis and its clinical relevance. AB - The serum concentrations of a metabolite produced during synthesis type III collagen, type III procollagen peptide (PCP), were measured in patients with cryptogenic fibrosing alveolitis, and the results were related to the course of the disease and its response to treatment. The mean PCP concentration was significantly higher for patients untreated at the time of sampling than for an age and sex matched control group (p less than 0.001). Seventeen of these patients subsequently started treatment and their response to treatment was assessed by measurement of changes in the transfer coefficient (KCO) and forced vital capacity (FVC) at six months and one year later. Those patients showing a response to treatment, indicated by an increase in the percentage predicted KCO or FVC of more than 10% one year after starting treatment, had a significantly higher mean PCP concentration (p less than 0.01 and p less than 0.001 respectively) than patients with stable or deteriorating physiological indices. When the PCP concentrations of these patients were compared with repeat measurements three to six months after the commencement of treatment 14 out of 17 showed a decrease in PCP levels. This percentage change in PCP concentrations correlated significantly with the change in the percentage predicted KCO and FVC at 12 months after the commencement of treatment (p less than 0.01). These results suggest that measurement of PCP concentrations in patients with cryptogenic fibrosing alveolitis may be useful in the assessment of response to treatment. PMID- 6495241 TI - Scanning electron microscope study of the development of the human respiratory acinus. AB - Plastic corrosion casts were made of lungs from fetuses aged from 19 weeks' gestation to term and of lungs from a child and two adults to study the development of the respiratory acinus. To achieve reliable infusion of the most peripheral airspaces a high viscosity plastic was used that is not known to have been employed previously for corrosion casting of lungs. The casts were examined in the scanning electron microscope and showed the increase both in number and in length of the airways distal to the terminal bronchiole and also the change in shape and complexity of the most peripheral airspaces as the lung matures. The terminal airspaces change from short, simple, tubular endings at 19 weeks' gestation to short, shallow saccules from around 30 weeks' gestation to full term and contrast with the deep cup shaped alveoli in the adult. Measurements of the size of the terminal airspace at various stages of development are presented. This new approach, allowing three dimensional study of the peripheral airspaces of the developing lung, will be useful for investigating the lung pathology of neonates. PMID- 6495242 TI - Pulmonary function in aluminium smelters. AB - Two studies were conducted at an aluminum smelter employing 113 male workers in the smelting process. Twenty one of the 111 men in the first study experienced chest tightness more often than once a week and had a higher prevalence of cough, dyspnoea, and nasal symptoms but not of positive skin test responses than symptomless men. Lung function in these men did not differ significantly from that in the symptomless men at the beginning of the working week and only marginal deterioration occurred over the week. In the second study serial spirometric measurements were obtained over several shifts in a subset of 31 men from the first study. Impairment of ventilatory function on exposure to smelting fumes was demonstrated in 18 men. Analysis of all data from the 31 subjects revealed that ventilatory function varied significantly in association with heavy exposure to potfumes and a history of recurrent chest tightness. The findings of these two studies indicate that aluminum smelting fumes can cause bronchoconstriction in susceptible individuals. The reaction is dose dependent and is more severe in those with a history of recurrent chest tightness. PMID- 6495243 TI - Asbestos related pleuropulmonary lesions and the erythrocyte sedimentation rate. AB - Asbestos related lesions of the lung parenchyma and the pleura can be divided into three main types: parietal pleural plaques, diffuse interstitial fibrosis ("classical asbestosis"), and a third type of reaction affecting both the pleura and the lung parenchyma. The last type includes such lesions as acute pleurisy, diffuse pleural thickening, and rounded atelectasis. Among 1344 patients with asbestos related pleural lesions, 1190 had pleural plaques, 29 of whom also had pulmonary fibrosis (asbestosis); 83 had unilateral sequelae of pleurisy, of whom nine had asbestosis; and 71 had bilateral sequelae of pleurisy, of whom 23 also suffered from asbestosis. The erythrocyte sedimentation rate (ESR) was measured in 184 patients--79 with pleural plaques, 44 with unilateral sequelae of pleurisy, and 61 with bilateral sequelae. In patients with pleural plaques with or without asbestosis the ESR was usually normal, the mean being 9.6 mm in one hour. Among patients with sequelae of pleurisy, however, many had a raised ESR. The mean ESR was 25.7 mm in one hour in those with bilateral changes and 13.2 in those with unilateral changes. Statistical analysis showed that in this group of subjects the presence of sequelae of pleurisy was a highly significant determining factor for the ESR (p less than 0.0001). Asbestosis alone was not a significant determining factor but there was a low grade of significance for the combined effect of asbestosis and sequelae of pleurisy (p less than 0.05). These findings suggest that the pathogenesis of the various changes is different. PMID- 6495244 TI - Circadian rhythms in peak expiratory flow rate in workers exposed to cotton dust. AB - One hundred and sixty two people working in various departments of cotton spinning and weaving mills measured and recorded their own peak expiratory flow rate (PEFR) at two hourly intervals during Monday, Wednesday, and Thursday of the same work week, from waking in the morning throughout the day until going to bed and a last time the following morning after waking. The circadian rhythm in PEFR was computed by the Halberg program. The mean amplitude of the rhythm in the group was found to be 3.3% and the acrophase fell approximately in the middle of the waking hours. Older workers and those claiming to suffer from symptoms of chronic bronchitis were found to have an amplitude significantly higher (4.1% and 3.9% respectively) than their younger or symptom free counterparts (2.6% and 2.9% respectively; p less than 0.03). The amplitude of cardroom workers (2.4%), workers with byssinosis (2.7%), and those with much exposure to airborne cotton dust (3.3%) and bacteria (2.9%) tended to be lower than that of less exposed groups such as office staff (3.9%), though the difference was significant only in the case of cardroom workers (p less than 0.04). This may be due to airborne contaminants in the working environment. PMID- 6495245 TI - Temperature corrections in routine spirometry. AB - Forced expiratory volume (FEV1) and forced vital capacity (FVC) were measured in nine normal subjects with three Vitalograph and three rolling seal spirometers at three different ambient temperatures (4 degrees C, 22 degrees C, 32 degrees C). When the results obtained with the rolling seal spirometer were converted to BTPS the agreement between measurements in the three environments improved, but when the Vitalograph measurements obtained in the hot and cold rooms were converted an error of up to 13% was introduced. The error was similar whether ambient or spirometer temperatures were used to make the conversion. In an attempt to explain the behaviour of the Vitalograph spirometers the compliance of their bellows was measured at the three temperatures. It was higher at the higher temperature (32 degrees C) and lower at the lower temperature (4 degrees C) than at the normal room temperature. These changes in instrument compliance could account for the differences in measured values between the two types of spirometer. It is concluded that the ATPS-BTPS conversion is valid and necessary for measurements made with rolling seal spirometers, but can cause substantial error if it is used for Vitalograph measurements made under conditions other than normal room temperature. PMID- 6495246 TI - Abnormalities in the flow-volume loop in obstructive sleep apnoea sitting and supine. AB - We evaluated the effect of posture on the sensitivity and specificity of abnormalities in the flow-volume loop in 30 patients with suspected obstructive sleep apnoea. Flow-volume loops were judged as abnormal if the FEF50/FIF50 ratio was greater than 1 or if the sawtooth sign was judged to be present by at least two of three chest physicians. Detailed nocturnal recordings confirmed the presence of obstructive sleep apnoea in 17 of the 30 patients. Our results showed that both the sensitivity and the specificity of each of the flow-volume criteria for the diagnosis of obstructive sleep apnoea were higher when the loops were recorded in the supine than when they were recorded in the sitting position. The sensitivities were low, however, even with the supine posture--sawtoothing 41% and FEF50/FIF50 ratio greater than 1 47%. The highest sensitivity (71%) was obtained by considering a positive result as being the presence of either of the abnormalities in either the sitting or the supine posture. This sensitivity of the flow-volume loop was too low to recommend it as a routine screening test for the diagnosis of obstructive sleep apnoea but the presence of the sawtooth sign had a high specificity (92%) for the diagnosis of obstructive sleep apnoea. Furthermore, there was a greater fall in oxygen saturation in patients with apnoea who had sawtoothing than in those without sawtoothing. The presence of the sawtooth sign should increase the suspicion of sleep apnoea and suggest the need for further investigation. The effect of posture on the occurrence of abnormalities in the flow-volume loop suggests that position alters the configuration of the upper airway. PMID- 6495248 TI - Penetrating injuries of the pleural cavity. AB - Two hundred and fifty one cases of penetrating wounds of the chest were studied prospectively. Clinical evidence is presented to show that: basal intercostal drains are adequate to remove both air and fluid from within the pleural cavity; frequent chest radiographs are unnecessary and intercostal drains may be removed on clinical grounds alone; long term antibiotic prophylaxis is unnecessary; eight per cent of those undergoing initial observation will develop a delayed haemothorax or pneumothorax of sufficient size to require drainage; subcutaneous emphysema is of no prognostic significance in the symptomless patient with minimal intrapleural damage on admission; and outpatient follow up is not required. PMID- 6495247 TI - Pulmonary disease in patients with Marfan syndrome. AB - Hospital case notes and chest radiographs of 100 patients with Marfan syndrome were investigated for evidence of pulmonary disease. The criteria for inclusion of details of a given patient in the study were the occurrence of Marfan abnormalities in at least two separate body systems (skeletal, cardiovascular, ocular) or in one body system where there was a family history of a classically affected first degree relative. Selection of cases was biased towards those with cardiorespiratory problems by virtue of the hospitals from which the patients were drawn. Forty eight patients underwent cardiac surgery. Eleven patients had a history of spontaneous pneumothorax, which had been recurrent in 10 cases and bilateral in six. Eight had had pneumonia or excessively frequent respiratory infections and two had bronchiectasis. Chest radiographs showed emphysematous bullae in five, upper lobe fibrosis in four, and aspergilloma in two. The cases reviewed together with other published evidence suggest that spontaneous pneumothorax and bullae are causally related to Marfan syndrome. The presence of idiopathic upper lobe fibrosis in four Marfan patients is interesting but provides insufficient evidence to assess possible causality. PMID- 6495249 TI - Delayed rupture of the diaphragm presenting as gastric outlet obstruction. PMID- 6495250 TI - Amiodarone pneumonitis: three further cases with a review of published reports. PMID- 6495251 TI - Platelet survival in streptozotocin-induced diabetic rats. AB - Platelet survival in diabetes mellitus may be decreased or normal, and it is not clear whether altered platelet survival is due to a platelet or to a non-platelet defect. Therefore, platelet survival studies were performed at intervals up to 28 days in streptozotocin-induced diabetic and normal rats, using washed platelets from diabetic or normal animals. When compared to platelets from control rats, there was a significant decrease in platelet survival when platelets from 7 and 14 day diabetic rats were injected into normal controls or into diabetic rats. After 28 days of diabetes, platelet survival in diabetic rats was significantly lengthened, whether the platelets came from control or diabetic rats. Conclusions. Shortened platelet survival in the diabetic rat is caused initially by a platelet defect. Later, non-platelet factors become dominant. These findings may help explain reported discrepancies in results of platelet survival in diabetes mellitus. PMID- 6495252 TI - Effect of vitamin E on platelet aggregation in diabetes mellitus. AB - Vitamin E is known to be an inhibitor of platelet prostaglandin production and aggregation. The rate of platelet aggregation induced by adenosine diphosphate was significantly increased in diabetics with proliferative retinopathy and the enhanced production of thromboxane B2, a stable metabolite of thromboxane A2, was demonstrated in those patients. On the other hand, vitamin E in platelets was significantly reduced in diabetics compared with age matched controls. In addition, it was shown that vitamin E content in platelets examined in diabetic and control subjects inversely correlated with both the rate of platelet aggregation and thromboxane B2 production during aggregation. It is suggested that the reduced vitamin E levels in diabetic platelets can contribute to the mechanisms of the enhanced platelet thromboxane production and aggregation which relate to the development of vascular complications. PMID- 6495253 TI - Effect of plasma dilution on adsorption of fibrinogen to solid surfaces. AB - The adsorption of various plasma proteins to three solid surfaces has been studied as a function of plasma concentration. Albumin adsorption on glass showed no dependence on plasma concentration and increased to a plateau value on both polyethylene and siliconized glass. Immunoglobulin G (IgG) adsorption showed no dependence on plasma concentration on any surface. Fibrinogen adsorption increased with plasma concentration and then decreased, the maximum occurring at about 1% normal plasma concentration and varying somewhat with the surface. On glass the kinetics of fibrinogen adsorption was dependent on plasma concentration: at concentrations less than the adsorption maximum, the kinetics was conventional, with adsorption increasing onto a plateau; at concentrations greater than the adsorption maximum, kinetics curves also showed maxima the position of which shifted to longer times as plasma concentration decreased. These data are interpreted in terms of competitive adsorption between fibrinogen and other, as yet unidentified species in plasma. The data reported are in general agreement with the model of Vroman (12) for plasma-surface interactions which holds that initially adsorbed fibrinogen is later replaced by high molecular weight kininogen (HMWK), the rate of replacement depending on the relative activity of the surface in promoting coagulation. PMID- 6495254 TI - Influence of vitamin E on plasma malondialdehyde-like material in man. AB - The behaviour of plasma malondialdehyde-like material (MDA-LM) was evaluated in 13 healthy subjects by a single-blind study that consisted of placebo (30 days), vitamin E treatment (300 mg/day) (30 days) and placebo (30 days). The study demonstrated that MDA-LM did not change during placebo treatment while it significantly decreased after vitamin E administration. PMID- 6495255 TI - Intra-platelet platelet factor 4 (IP.PF4) and the heparin-mobilisable pool of PF4 in health and atherosclerosis. AB - Some patients with clinical evidence of atherosclerosis and others with diabetes were compared with appropriate controls. The intraplatelet level of platelet factor 4 (PF4) was significantly decreased in the arteriopaths and was lower in the diabetics when compared with controls. Patients with transient ischaemic attacks and stroke have even lower values. Intravenous heparin liberates large amounts of PF4 from an unknown reservoir, perhaps the endothelium, into the plasma. Arteriopaths liberated significantly more PF4 than the controls and the diabetics most. If a second heparin injection is given 24 hr after the first, the resultant plasma PF4 level was on average half that achieved after the first injection and again the patients had higher levels than the controls. Thus the reservoir originally "emptied" of PF4 by the heparin had been partially refilled in 24 hr and the reservoir in the atherosclerotic patients then contained more than the controls. Patients with atherosclerosis and especially diabetics differ from controls in the PF4 content of their platelets and in their response to heparin and in the rate of refill of the "heparin-mobilisable pool of PF4". PMID- 6495256 TI - Inhibition by heparin of platelet accumulation in vivo. AB - In vivo platelet aggregation has been studied using a novel, minimally invasive technique. No aggregatory effects of heparin were observed on normal circulating platelets nor was there enhancement of aggregation of platelets during activation by intravenous injection of ADP, collagen, PAF acether or thrombin. On the contrary, high doses of heparin were found to inhibit platelet accumulation induced by ADP, collagen or PAF-acether. Inhibition of these responses necessitated doses of heparin in excess of those required for anti-coagulant effects. The present experiments do not establish a mechanism for such inhibition. Extension to other species, including man, is needed before attributing clinical relevance to the present observations. PMID- 6495257 TI - Hypercoagulable state induced by combination chemotherapy in patients with acute leukemia. PMID- 6495258 TI - Prothrombin evaluation as obtained by kinetics studies of antigen-antibody reaction in a laser nephelometer. AB - Laser nephelometry is a technique which allows the evaluation of the concentration of several serum proteins and clotting factors. By means of this technique it is also possible to study the kinetics of the reaction between antigen and antibody. We studied the kinetics of the reaction between prothrombin and an antiprothrombin antiserum using several prothrombins namely: Prothrombin Padua, prothrombin Molise, which are two congenital dysprothrombinemias, cirrhotic, coumarin or normal prothrombins. Different behaviors in the kinetics of the reactions were shown even when the concentration of prothrombins was about the same in all plasma tested. These differences were analyzed by means of a computer (Apple II 48 RAM) programmed to solve four unknown equations (Rodbard's equation). From the data so obtained one can see that when voltages at the beginning and at the end of the reaction are in all cases about the same, a clear difference in the time required to reach half the maximum value of the voltage can still be demonstrated. This parameter, which is expressed in minutes, is longer in coumarin and prothrombin Molise than in controls. On the contrary it is shorter in prothrombin Padua and has about the same value of controls in the cirrhotic patient. Moreover the time at which the maximum rate is obtained is longer in coumarin and prothrombin Molise than in controls and shorter in liver cirrhosis and prothrombin Padua. In conclusion data obtained show that coumarin prothrombin behaves in a different way from cirrhotic prothrombin and also that there is a different behaviour between the two congenital dysprothrombinemias. PMID- 6495259 TI - Biological and thrombolytic properties of proenzyme and active forms of human urokinase--I. Fibrinolytic and fibrinogenolytic properties in human plasma in vitro of urokinases obtained from human urine or by recombinant DNA technology. AB - The fibrinolytic and fibrinogenolytic properties of recombinant pro-urokinase (Rec-pro-UK) and recombinant urokinase (Rec-UK) obtained by expression of the human urokinase cDNA in E. coli, were compared with those of natural urokinase (Nat-UK) of urinary origin and of tissue-type plasminogen activator (t-PA) in a system, composed of a radioactive human plasma clot immersed in citrated human plasma. The specific fibrinolytic effects of Nat-UK, Rec-pro-UK and Rec-UK were very similar, causing significant clot lysis at concentrations of 100 IU/ml plasma or more. t-PA caused equivalent degrees of clot lysis at 10-fold lower concentrations. Activation of the fibrinolytic system in the plasma (fibrinogenolysis), was not observed with t-PA in concentrations which induced complete clot lysis within 5 hr (20-30 IU/ml plasma). With Nat-UK and Rec-UK, all concentrations which caused significant clot lysis (100-200 IU/ml plasma) also caused extensive activation of the plasma fibrinolytic system. With Rec-pro-UK an intermediate response was obtained. The highest amounts required for complete clot lysis in 5 hr (200 IU/ml plasma) also caused significant fibrinogenolysis. At intermediate concentrations (50-100 IU/ml), however, significant clot lysis (40-80%) was observed without systemic fibrinolytic activation. PMID- 6495260 TI - Biological and thrombolytic properties of proenzyme and active forms of human urokinase--II. Turnover of natural and recombinant urokinase in rabbits and squirrel monkeys. AB - The turnover of recombinant pro-urokinase (Rec-pro-UK), recombinant urokinase (Rec-UK) and natural urinary urokinase (Nat-UK) was studied in rabbits and in squirrel monkeys (Saimiri sciureus). Following intravenous injection, urokinase activity disappeared rapidly from the blood. The initial disappearance rate could be described by a single exponential term with a t 1/2 of 3 to 6 min for each molecular form of urokinase in both species. Urokinase related antigen, measured with a radioimmunoassay in the plasma of the squirrel monkeys disappeared with a t 1/2 of 3.5 min for Rec-pro-UK, 6.0 min for Rec-UK and 8.0 min for Nat-UK. The clearance and organ distribution of Rec-pro-UK, Rec-UK and Nat-UK was studied with the use of 125I-labeled preparations. In each case the radioactivity initially disappeared rapidly from the plasma, also with a t 1/2 of a few min, but then the disappearance rate slowed down. Labeled Rec-UK in which the active site histidine was irreversibly blocked by alkylation, disappeared equally rapidly from the plasma. Measurement of the organ distribution of 125I at different time intervals revealed that all three types of urokinase were rapidly accumulated in the liver, which was followed by release of degradation products in the blood. Experimental hepatectomy prolonged the t 1/2 of each type of urokinase very markedly (t 1/2 greater than 30 min). These findings indicate that urokinase is rapidly removed from the blood by clearance and degradation in the liver. Recognition by the liver does not require a functional active site and is not mediated via carbohydrate side chains. Inactivation by plasma protease inhibitors does not represent a significant pathway of urokinase inhibition in vivo. PMID- 6495262 TI - Evaluation of dose and route effects of platelet activating factor-induced extravasation in the guinea pig. AB - Platelet-activating factor (PAF) is a naturally occurring lipid that is reported to induce vessel hyperpermeability leading to loss of protein-rich plasma (extravasation). We have quantitated the systemic extravasation effects of synthetic PAF in the guinea pig by monitoring increases in hematocrit. When given intravenously (10-170 ng/kg), PAF produced dose-dependent increases in hematocrit, with maximal hemoconcentration developing in 5-7 min. In leukopenic animals the expected hematocrit increase was reduced by 57%. PAF given intra arterially produced the dose-dependent changes in hematocrit similar to the intravenous effects of PAF. However, PAF given intraperitoneally (10-2500 micrograms/kg) was 800-1100-fold less effective than the other routes and hemoconcentration continued for 30-45 min until a maximal hematocrit was observed. These results show that PAF may markedly influence extravasation of plasma in a dose and route-dependent manner. PMID- 6495261 TI - Biological and thrombolytic properties of proenzyme and active forms of human urokinase--IV. Variability in fibrinolytic response of plasma of several mammalian species. AB - The fibrinolytic and fibrinogenolytic properties of recombinant pro-urokinase (Rec-pro-UK) and recombinant urokinase (Rec-UK) were compared with those of natural urokinase (Nat-UK) and of tissue-type plasminogen activator (t-PA) in an in vitro system consisting of 125I-labeled autologous plasma clots immersed in plasma of humans, five primate species, dogs, rabbits and pigs. With each of the four plasminogen activators, a dose-dependent clot lysis was observed, the degree of which differed, however, very markedly from one species to the other. At a concentration of 100 IU/ml of urokinase extensive plasma clot lysis was obtained in plasma of man, Macaca mulatta, Macaca fascicularis and Macaca radiata, while the plasma clots of Papio cynocephalus, Papio anubis and rabbit, dog and pig were much more resistant to lysis. No significant differences in the extent of lysis were observed between Rec-pro-UK and Rec-UK nor between Rec-UK and Nat-UK. Comparable degrees of lysis were obtained with t-PA at 3- to 5-fold lower concentrations. Lysis with Rec-UK or Nat-UK was always associated with extensive activation of the fibrinolytic system in plasma, evidenced by fibrinogen breakdown and plasminogen activation and alpha 2-antiplasmin consumption. With t PA, extensive clot lysis was obtained in the absence of fibrinolytic activation in the plasma. With Rec-pro-UK the response was intermediate; at high concentrations (200 IU/ml) extensive lysis in the reactive species was associated with fibrinogen consumption, while at intermediate concentrations (50-100 IU/ml) significant clot lysis was obtained in the reactive species in the absence of marked activation of the fibrinolytic system in the plasma. PMID- 6495263 TI - Morphometric analysis of platelets in Bernard-Soulier syndrome: size and configuration in patients and carriers. AB - Quantitative ultrastructural morphometric analysis has been carried out on thin sections of platelets from two Bernard-Soulier sisters and their parents. Measurements were made for the major and minor axes, axial ratios, cross sectional circumference and cross-sectional area. Platelets were collected either into CPD anticoagulant or directly into glutaraldehyde. The results confirm that Bernard-Soulier platelets are significantly larger than normals (p less than 0.05) in all the parameters mentioned and indicate (I) that the morphology of platelets from Bernard-Soulier patients is affected by the presence of anticoagulant, and (II) a more spherocytic configuration is characteristic of Bernard-Soulier disease both in patients and carriers. PMID- 6495264 TI - Preoperative AT-III values and clinical postoperative thrombosis: a comparison of three antithrombin-III assays. AB - Three antithrombin-III assays (Sigma functional plasma, von Kaulla functional serum, and Calbiochem-Behring radial immunodiffusion) are compared using preoperative serum and plasma from 48 patients admitted for cardiovascular or other major vascular surgery. Medical records were reviewed for evidence of thrombotic complications. Eight patients (17%) in this selected population had clinical evidence of postoperative thrombotic complications. The sensitivity and specificity for each AT-III assay were calculated, and the positive and negative predictive values in this population were determined. Sigma's plasma AT-III had the highest positive predictive value (67%) and negative predictive value (100%). The functional serum and RID assays had significantly lower positive predictive values (23% and 38% respectively) and negative predictive values of 86%. Using the Two Sample t-Test to evaluate differences in AT-III values between the two patient groups, i.e., those who experienced thrombotic complications and those who did not, only the functional plasma AT-III method was statistically significant at a 95% confidence interval. PMID- 6495265 TI - Comparison of platelet interaction with subendothelium of human renal and umbilical arteries and the extracellular matrix produced by human venous endothelial cells. AB - Platelet interaction with subendothelium of human renal and umbilical arteries and with the extracellular matrix produced by cultured human venous endothelial cells was compared in flowing citrated blood by using an annular and a rectangular perfusion chamber. The renal arteries were post mortem specimens from adults showing, often pronounced, intimal fibrosis, whereas the umbilical arteries had well organized parallel arranged smooth muscle cells, without elastic membranes. The extracellular matrix obtained after removal of endothelial cells with Triton X-100 was homogenously attached to its substratum. Significantly more platelets adhered to the extracellular matrix than to the subendothelia. This discrepancy was most pronounced in reconstituted blood with plasma from a patient with homozygous severe von Willebrand's disease (subtype III). No differences in platelet adherence and platelet aggregate formation were noted between the subendothelia. Platelet aggregate formation was poor on all surfaces. These data indicate that the extracellular matrix produced by endothelial cells is at least as reactive for the interaction with platelets as subendothelium, probably partly synthesized by smooth muscle cells. PMID- 6495266 TI - Elimination of intravenously administered radiolabelled antithrombin III and heparin in humans. AB - Antithrombin III was purified from normal plasma by DEAE-Sephadex chromatography and heparin affinity chromatography; the protein was subsequently radiolabelled with 125I. 125I-antithrombin III alone and 125I-antithrombin III in the presence of high affinity 35S-heparin fractions were injected into normal humans. 125I radiolabel and protein bound 35S-radioactivity were followed separately. In semilogarithmic plots 125I-antithrombin III disappeared according to a double exponential curve with a half-life in the second phase of 56.8 hr in the absence of heparin and of 33.7 hr in the presence of heparin. Protein bound 35S radioactivity disappeared much faster than the 125I-radiolabel. These data support the concept that heparin disappears as free heparin from the equilibrium heparin - antithrombin III in equilibrium heparin + antithrombin III. Immuno reactive antithrombin III decreased from 100% to 85-90% immediately after injection of 125I-antithrombin III in the presence of heparin and returned to normal values within 30 min. This suggests that antithrombin III is transiently sequestered, possibly in trimolecular complexes consisting of antithrombin III, heparin and either lipases or other vascular bound proteins. PMID- 6495267 TI - Triglyceride-rich lipoproteins are responsible for thrombin generation induced by lipid peroxides. AB - Previous studies have shown that lipid peroxides promote thrombin generation in platelet-poor plasma. In the present study, it has been shown that triglyceride rich lipoproteins, especially chylomicra of dietary origin, are responsible for this procoagulant activity. The generation of thrombin by lipid peroxides is also enhanced by their inhibitory action on antithrombin III. These results suggest a possible new relationship between dietary fat, lipid peroxidation and thrombus formation. PMID- 6495269 TI - The effect of dietary cholesterol on platelet survival in the rabbit--a study using 14C-serotonin and 51chromium double-labelled platelets. AB - Hypercholesterolemic men and monkeys have shortened platelet survival but attempts to demonstrate this in rabbits have been unsuccessful. The present study examines platelet survival in cholesterol-fed rabbits. Platelets were double labelled in vitro with 51Cr and 14C-serotonin or in vivo by intravenous injection of 14C-serotonin. In the double-label experiments 51Cr survival was always shorter than 14C survival but changes in survival of one label were accompanied by similar changes in the other label. Survival was shortened after 4 and 7 weeks of cholesterol feeding. This was demonstrated when the donor platelets were from normal rabbits for both cholesterol and control recipients but no shortening was demonstrated when cholesterol-rich platelets were injected into cholesterol-fed recipients and normal platelets were injected into the control rabbits. When 14C serotonin was injected intravenously 14C survival was the same as when platelets were labelled ex vivo prior to injection and 14C survival was shortened in rabbits fed cholesterol for 1, 2, and 6 weeks. These results indicate that cholesterol-feeding shortens platelet survival. This effect may be masked if the test platelets are not identical in both test and control groups. PMID- 6495268 TI - Effect of amino sugars on platelet aggregation and on fibrinogen binding. AB - The amino sugars glucosamine, galactosamine and mannosamine (30 mM) inhibited aggregation of human or rabbit platelets induced by ADP, collagen, thrombin, PAF or high concentrations of sodium arachidonate. 125I-fibrinogen binding during ADP induced aggregation, and release of amine storage granule contents were also inhibited. Increasing the calcium concentration of the suspending medium to 5 mM did not overcome the inhibitory effect on the release reaction. The amino sugars deaggregated rabbit platelets that had been aggregated by ADP, collagen or thrombin, but deaggregated human platelets readily only when ADP was used as the aggregating agent. Fibrinogen-induced aggregation of chymotrypsin-treated platelets was blocked by the amino sugars. They did not inhibit platelet adherence to a collagen-coated glass surface, nor affect release of granule contents from the adherent platelets. Aggregation and release induced by low concentrations of sodium arachidonate or the divalent cation ionophore A23187 were potentiated, indicating that the effects of the amino sugars on platelets are more complex than simple inhibition of the lectin-like activity that becomes available on the surface of platelets that have undergone the release reaction. One of the effects of the amino sugars, however, is interference with the binding of fibrinogen to platelets. The effects of the amino sugars are shared by other primary amines. PMID- 6495270 TI - The release of platelet factor 4 (PF4) induced by heparin and related glycosaminoglycans (GAGs) PMID- 6495271 TI - [A follow-up study of voluntarily hospitalized drug addicts in a medical department]. PMID- 6495273 TI - [Salt and blood pressure in a male population from Sogn and Fjordane counties]. PMID- 6495272 TI - [Determination of urinary glucose. Simple determination of urinary glucose with a new semi-quantitative reagent stick; the Diabur Test 5000]. PMID- 6495274 TI - [Surgical treatment of primary lung neoplasms]. PMID- 6495275 TI - [Primary dissecting aneurysm of the left coronary artery. An unusual cause of myocardial infarction]. PMID- 6495276 TI - [Lymphocutaneous fistula of the popliteal fossa following a varicose operation]. PMID- 6495277 TI - [Nephrotic syndrome in epidemic nephropathy]. PMID- 6495278 TI - [Mammaplasty in a general surgical department]. PMID- 6495279 TI - [Reduction mammaplasty for hypertrophic breasts]. PMID- 6495280 TI - [The anatomy and physiology of the spleen]. PMID- 6495281 TI - [Magnetic resonance tomography of the central nervous system]. PMID- 6495282 TI - [Results of accident prevention activity in general practice]. PMID- 6495283 TI - [Use of cathartics in small health institutions before and after instruction and written directions]. PMID- 6495284 TI - [Hemoglobin diseases in Norway. 7 years' case material]. PMID- 6495285 TI - [Diagnosis of hemoglobinopathies and thalassemia]. PMID- 6495286 TI - [Diuretics. An etiological factor in non-insulin dependent diabetes mellitus?]. PMID- 6495287 TI - [Surgical treatment of spondylolisthesis]. PMID- 6495288 TI - [Non-surgical treatment of ovarian cancer]. PMID- 6495289 TI - [Pulmonary complications following nitrofurantoin]. PMID- 6495290 TI - [Acute renal failure after chlorprothixene (Truxal) poisoning]. PMID- 6495291 TI - [Primary treatment of severe hand injuries]. PMID- 6495292 TI - [Orienting study on the treatment of cattle with human chorionic gonadotropin on the day of insemination]. AB - A report on two experimental studies in which 1,500 I.U. of HCG were administered to dairy cows on the day of insemination. The first experimental studies were done in 113 subfertile animals in which clinical examination did not reveal any clinically perceptible changes. HCG was injected intravenously in the animals of the experimental group, 0.9 per cent sodium chloride being injected intravenously in the controls. The pregnancy rates were 47 (sixty-one animals) and 30 per cent (fifty-two animals) in the experimental group and in the controls respectively. This difference was significant (P = 0.047). The ultimate pregnancy rates were 66 and 58 per cent (P = 0.32) respectively. The other experimental studies were done on a single dairy herd. The animals to be inseminated all were alternately assigned to an experimental group and a group of controls, regardless of the sequence of insemination. The pregnancy rates in the experimental group and the group of controls were 40 (ninety-eight inseminations) and 43 per cent (ninety six inseminations) respectively. In concluding, it can be stated that routine administration of HCG to cattle with a view to increasing the pregnancy rate of the first or second insemination cannot be expected to be effective. Treatment with HCG may possibly be successful in a particular group of cattle which have difficulty in becoming pregnant. PMID- 6495293 TI - [Detection of antibiotics and/or chemotherapeutic agents in slaughtering pigs by a captive impedance measurement using the M 120 Bactometer]. AB - A study was performed to compare the use of capacitive impedance measurement with EEC 4-plate method for the detection of antibacterial residues. Urine, meat, kidney and spleen were the matrices used in the impedance measurement. Meat was used in the EEC 4-plate method. Capacitive impedance measurement is quick, relatively simple, and reliable method, in which objective interpretation of the test results is guaranteed by automatic apparatus. Using meat and kidney as matrices, the test appears to be an efficient screening test for export meat and edible offal. As far as domestic Meat Inspection legislation is concerned, the test described may provide more specific information than the methods presently in use. PMID- 6495295 TI - [Uterine inversion and prolapse in a cat]. AB - Inversion and prolapse of the uterus in cats is a rare complication of parturition. It is usually observed within a few hours after a previously normal birth, though it may also be observed during parturition. Possible complications are discussed. Possible forms of treatment are also reviewed. In simple uncomplicated cases, the manual reposition is to be preferred. In other cases, amputation may also be contemplated, although there are drawbacks to this method. In many cases, particularly when complications have occurred, combined laparotomy and ovariohysterectomy is preferable. PMID- 6495294 TI - [Salmonella fyris in a dog]. AB - Salmonella fyris was isolated from a three-month-old Dutch sheep dog showing symptoms of enteritis. This was the first time that this uncommon serotype of Salmonella was isolated from an animal in the Netherlands. The infection could not be traced to its source. PMID- 6495296 TI - [Campylobacter jejuni: an important cause of food poisoning in humans]. PMID- 6495297 TI - [Diagnosis of paratuberculosis in the preclinical stage]. AB - Those tests which are common practice in the diagnosis of Johne's disease in the Netherlands, namely the intradermal johnin hypersensitivity test, the complement fixation test and microscopic examination as well as examination of the faeces by culture, were carried out in twenty-one cattle from four herds infected with Johne's disease. In addition, the johnin lymphocytic stimulation test was performed. A number of animals of various ages, which were tested, showed positive johnin hypersensitivity tests prior to the beginning of the 1982 grazing period (Table 1). M. paratuberculosis was isolated from five of these twenty-one animals after death. Six animals showed a positive complement fixation test one or several times; M. paratuberculosis was isolated from four of these animals after death. On the other hand, M. paratuberculosis was isolated from an animal in which this hypersensitivity test had been constantly negative. The other animals from which M. paratuberculosis was isolated, showed positive johnin hypersensitivity tests in some and negative tests in other cases. Not a single shedder of M. paratuberculosis was identified using microscopic examination of the faeces. When the faeces were examined by culture, one of the three animals found to be positive after death was identified. The animals from the suspected herds showed a higher average johnin stimulation index (SI) than did those from herds free from Johne's disease. However, when the LST was used, all carriers of M. paratuberculosis also were not detectable. In conclusion, it has to be stated that none of the tests studied in these cases removed all doubt as to whether the animals were or were not subclinically infected with M. paratuberculosis. PMID- 6495298 TI - [Sleeper syndrome in beef cattle; meningoencephalitis caused by Haemophilus somnus]. AB - Central nervous system disturbances, among which somnolence was a particularly marked feature, were observed in a herd of four-month-old beef cattle. Laboratory studies showed that the clinical picture was due to meningo-encephalitis, from which Haemophilus somnus was isolated. Other animals of this herd showed a serological response with regard to the micro-organism. The importance of further studies on the incidence of this infection in the Netherlands is stressed. PMID- 6495299 TI - [Animal experiments and restriction of laboratory animals]. AB - The position of animals in the community is being increasingly considered today. Interest is particularly directed to a number of controversial relations between man and animals, including experimental studies. This last-named category requires approximately 1.4 million animals annually. Experimental studies have undoubtedly contributed to the current levels of prosperity and welfare. However, there are ethical, scientific and economic reasons for advocating a policy directed towards restriction of the number of experimental animals. A policy of this type, directed to the substitution, reduction or refinement of experimental studies, should be both regulative and innovatory in character. Regulative in referring to the authorities, innovatory in referring to the development of methods of investigation which will relieve experimental animals, the so-called alternatives. The veterinarian, in his position of representative of the interest of animals, should direct a laboratory-animal-restricting policy either as a laboratory animal scientist or indirectly as a practitioner. PMID- 6495300 TI - [Paramyxovirus in racing pigeons]. PMID- 6495301 TI - [Caseous lymphadenitis (CL)]. PMID- 6495302 TI - [Declaration of vaccination in connection with paramyxovirus vaccination of racing pigeons]. PMID- 6495303 TI - [Detection of ventricular septal defects using pulsed Doppler echocardiography]. AB - Introduction of Echo-Doppler methods has changed diagnostic procedures in case of a VSD. Case reports of four children are described. In future E/D-examination is to be expected highly valuable in evaluation VSD severity, while heart catheterisation will be less necessary. PMID- 6495304 TI - [Hydrometrocolpos, polydactylia and congenital heart defect (the McKusick-Dungy Kaufman syndrome)]. AB - The McKusick-Dungy-Kaufman syndrome is characterized by hydrometrocolpos, polydactyly and congenital heart disease. Two of these 3 main symptoms should be present for the diagnosis. Associated anomalies are mainly found in the urogenital tract, the gastro-intestinal tract and the skeletal system. On the basis of 2 patients and the literature the clinical features and the genetic aspects of this syndrome are reviewed. The clinical variability and the severity of the syndrome are stressed. Evidence for an autosomal recessive inheritance is given. Because of the clinical variability it seems preferable to use the term complex rather than syndrome. PMID- 6495306 TI - [Noninvasive blood pressure determination in newborn infants]. AB - In 69 newborns (birth weight 900-3820 grams; gestational age 27-41 weeks) the Dinamap device was used to establish normative values for systolic and diastolic blood pressure, mean arterial pressure and pulse pressure for this indirect, non invasive blood pressure monitoring system. Reference values for the first day after delivery in different birth weight groups are given and the changes during the first three days of life are shown. Blood pressure variability as a possible additional parameter in neonatal monitoring was found to be independent of birth weight and gestational age. PMID- 6495305 TI - [Chronic disease and family problems: a descriptive model for the pediatrician]. AB - Starting from Minuchin's system interaction model on so-called psychosomatic families, and based on theories about coping with serious life events, the tasks are described that have to be faced by families with a severe ill or handicapped child. From clinical psychological practice it is learned that the majority of the families can cope adequately with the illness of their child. In a few families however serious problems emerge that impede the growth and development of the sick child. Characteristics of these families are elaborated into a model that may serve the pediatrician in the early diagnosis of these high-risk families. PMID- 6495307 TI - [Bruising: a coagulation disorder, abuse or abnormality of the vessel wall?]. AB - The case history is presented of a boy with easy bruising from the age of 7 months. There were neither abnormalities of clotting factors and platelets, nor child abuse. Physical examination suggested the diagnosis of Ehlers-Danlos syndrome. The subcutaneous bleedings are caused by collagen abnormalities in the vessel wall. PMID- 6495308 TI - [The wrong sex]. AB - Sexual ambiguity may cause problems in determining the sex, in which a child would be reared. Three case histories of such patients are presented, in which the initial diagnosis proved to be incorrect. Arguments which lead to the ultimate choice of the sex of the child ranged from strict medical, to psychosocial and even cultural considerations. A simple classification of causes of ambiguous external genitalia is used both for investigation and management of these patients. Only expert examination shortly after birth allows an early and definite decision, avoiding more serious problems in later life. PMID- 6495309 TI - [Effect of age and sex on the enzyme activities of serum aspartate and alanine aminotransferases]. AB - Reference values of ASAT and ALAT are calculated from all the results over a period of two years. For each test age- and sex-related variations were assessed and reference values were estimated for six different age groups. The activities of both enzymes are sex independent. The activity of ASAT decreased with increasing age whereas the activity of ALAT did not show different reference values between the age categories. PMID- 6495310 TI - [Radiography or fluoroscopy. Considerations beyond radiation protection]. AB - A comparison is made between taking radiographs versus fluoroscopy in veterinary medicine. In this evaluation three main features are of importance: financial restrictions, diagnostic quality of x-ray image, radiation protection or radiation hazards. All three aspects show unequivocally that radiography has to be preferred. Fluoroscopy should be the exception and should be used only for special examinations. PMID- 6495311 TI - [A fixed dressing with a rubber sole for horses and cattle]. AB - A synthetic fixed dressing for great animals is described, which is worked up in such a manner that it is possible to fix on its soles a non-abrasive rubber plate. PMID- 6495312 TI - [Foot-and-mouth disease: the nature and importance of the disease]. AB - The Federal Republic of Germany is at present free from Foot-and-Mouth Disease (FMD). In many countries of the world, however, FMD is still an enzootic disease. Therefore, countries free from FMD have to be constantly on guard against importing the disease. The plurality of the agent as well as ways of transfer of the disease are described. In particular, clinical signs and pathological injuries are described and illustrated by photographs. Methods of preparing specimens from infected animals for laboratory diagnosis are pointed out. PMID- 6495313 TI - [Dynamics of abrasion of lead pellets in the gizzard of domestic ducks]. AB - Experiments were made with 6 control and 6 experimental ducks. 10 lead shot were given for once into the gizzard of the experimental animals. During a period of 6 days, changes of the form of the grains of shot, the ALAD-activity, the hematocrit and the hemoglobin have been examined. Finally, significant changes of the form as well as the surface of the lead shot could be seen. The average loss of mass of one grain of shot in 24 hours (former mass 0,15 g) came up to 0,01 g. Already 24 hours after the ducks had received the grains of shot, the ALAD activity decreased from 70,07 to 5,43 U/l-1. As far as the hematocrit and the hemoglobin are concerned, compared with the control ducks, there were no important differences. PMID- 6495314 TI - [Anesthesia in the horse]. AB - The paper describes the problems of injection anaesthesia in the horse. Different commonly used methods, drugs and drug combinations are explained. Their actions and side-effects are compared and discussed. PMID- 6495316 TI - [Surgical treatment of rectal prolapse in a 1-year-old mare resecting only the mucous membrane]. AB - A mare with rectal prolaps was operated at Vienna University. The prolaps was corrected by mucosal resection only. The remaining vital layers of the corresponding intestinal section were saved. The advantage of a special tissue saving operating technique in the rectal area is seen in avoiding postoperative complications. PMID- 6495315 TI - [Diagnosis and therapy of guttural pouch diseases in horses]. AB - Using a fibreoptic endoscope ("small gastroscope" with outside diameter of 9.3 mm) a simple and sparing inspection of the guttural pouch is performed. The flap type tube cover is opened by means of medial leverage with a guidance probe shifted through the work duct of the endoscope. The same procedure is used in diagnostic specimen collection and therapeutical measures such as irrigations. Guttural pouch topography and pathological disorders are illustrated by endoscopic photography. The different diseases such as follicular hyperplasia, ascending pharyngeal catarrh, perforating abscesses of the retropharyngeal lymphnodes, empyema and chondroid formation, guttural pouch mycosis leading to arrosion of the carotid artery, tympanites of the guttural pouch in foals caused by congenital defects of the eustachian tube flap and rarely observed tumors are discussed. PMID- 6495317 TI - [Hypophyseal adenocarcinoma in a horse. A case study]. AB - The paper presents the case-history of a 5-year-old pony suffering from an adenocarcinoma which proceeded from the pars intermedia of the pituitary gland. Neurological and patho-morphological findings are reported. PMID- 6495318 TI - [A metacercarial disease in the dogfish species Umbra limi (Teleostei) and a trematode infestation in a Physa sp. (Mollusca)]. AB - A metacercarial infestation is reported in Canadian Umbra limi and a mass infestation by trematodes in Physa sp. from the same locality. Trials made by using parasitised snails showed that both parasites are not of the same species. PMID- 6495319 TI - Diagnosis of submucosal tumor by injecting a water soluble contrast medium: development pattern and growing of tumors. AB - With the application of our endoscopical method of contrasted X-ray imaging, gastric submucosal tumors were studied with chief regards to their modes of growing up and patterns of development. It has become known that, of extra gastric developing tumors, larger ones tend to show Pattern IVa and smaller ones Pattern IVb. Generally, the tumors showed a tendency of becoming larger in older patients. Periodical checking disclosed about 15% of the tumors growing larger with the lapse of time. It has been surmised that as tumors grow up, their development possibly turns from intra-gastric to intramural and mingled in pattern. Their modes of growing could be classified as follows: Abruptly growing large at a certain time and then remaining without notable changes, step-by-step enlarging, and gradually growing up straight forwardly with years. PMID- 6495320 TI - The Eaton-Lambert myasthenic syndrome and long-term treatment with prednisolone. AB - A 34-year-old women with the Eaton-Lambert myasthenic syndrome was treated with prednisolone for over a year. Proximal muscle weakness and breathing difficulty due to weakness in the respiratory muscles showed improvements after long-term administration of prednisolone. Electrophysiological studies before treatment revealed decreased amplitudes of the compound muscle action potential (CMAP), a decrement in CMAP to low frequency nerve stimulation, an increment on high frequency stimulation and posttetanic facilitation over 300%. Following administration of prednisolone, these electrophysiological parameters became almost normal. This case suggests that immunosuppressive drugs such as prednisolone may have a place in the management of the patients with myasthenic syndrome, especially of those who has no evidence of malignant tumor. PMID- 6495321 TI - Pneumonia due to Chlamydia trachomatis in Japanese infants. AB - Sera from 109 Japanese infants with pneumonia were tested for antibody to Chlamydia trachomatis (C. trachomatis) L2 strain by an indirect immunofluorescence (IF) technique. Nasopharyngeal swabs were also collected to isolate C. trachomatis. Clinical specimens were inoculated onto cycloheximide treated McCoy cells and DEAE-dextran-treated HeLa 229 cells. Of 109 patients, 32 (29%) were positive for IgM antibodies (titer, greater than or equal to 1:16) to C. trachomatis. C. trachomatis was isolated from 21 (66%) of 32 IgM antibody positive infants as compared with 5 (7%) of 77 IgM antibody-negative infants. Detectable levels of IgM antibody were common in infants during the first four months of life. Clinical characteristics of pneumonia of these IgM antibody positive patients were also described. This is the first report of serology and clinical characteristics of C. trachomatis pneumonitis from Asian countries including Japan. PMID- 6495322 TI - Diagnosis of submucosal tumors by injecting a water soluble contrast medium: judgement of tumor developing pattern and endoscopic lumpectomy. AB - With the remarkable increases in the number of cases of endoscopical removal of submucosal tumors spurred by the application of high-frequency current, it has become more and more important to apply beforehand some reliable methods like ours to differentiate between tumors and other tumescent lesions due to extra gastric pressure similar in configuration to tumors and also to confirm the development patterns of tumors either intra-gastric or extra-gastric. Such preparatory arrangements seem indispensable to minimize the risk of perforation incidental to the endoscopical treatment of tumors. To cope with another danger of major bleeding following tumor resection, securing on hand an effective hemostatic is indispensable as well. In our care of the patients after their undergoing endoscopical lumpectomies, we usually subject them to quiet rest and fasting for two or three days; then when they are to resume a regular diet, we endoscopically examine them before and after each meal to confirm the presence or absence of bleeding. In 12 subjects of this series treated with our routine and finally with lumpectomies for gastric submucosal tumors, no serious adverse reactions developed. PMID- 6495323 TI - Chronic intermittent atrial standstill with intraatrial block and split atrial potentials. AB - A 24-year-old male with chronic atrial standstill underwent an electrophysiologic study. No atrial activity was recorded from the right atrium which did not respond to stimulation with up to 10 volts. After the administration of atropine, non-localized split atrial potentials appeared, and intraatrial phase 4 block and atrial flutter with intraatrial 2:1 block were observed. The atrium then responded to electrical stimulation (less than 2 volts). Persistent sinus node activity with intraatrial block was found during post-pacing atrial pauses. PMID- 6495324 TI - Three-dimensional morphology of gastric adenocarcinoma. Atypical glands as a basis for histopathologic diagnosis. AB - The basic architectural pattern of adenocarcinoma was established by 3-D reconstruction of carcinomatous glands and their lumina from serial histologic sections in four gastrectomy specimens to establish strict morphologic criteria of adenocarcinoma and related lesions on structural basis. The carcinomatous glands in the moderately differentiated type had multiple anastomoses with one another forming a 3-D network, a pattern quite different from the arborescent normal glands, whereas the lumina were separated into many small parts, giving the cell masses a porous character. Well differentiated tumor had more connections between lumina, giving rise to the formation of dense luminal network, while in the poorly differentiated variety the glands lost unity, broken up into fragmental nests. These analyses provided a new viewpoint from which to establish a basis for the discrimination of dysplastic from overtly malignant lesions. PMID- 6495326 TI - Statistical factor analysis and cluster analysis in the etiology of climacteric symptoms. AB - Factor analysis and cluster analysis were applied to a set of 17 climacteric symptoms data obtained from 194 premenopausal and postmenopausal women. Six distinct factors were extracted and the women were divided into 7 groups by hierarchical cluster analysis in terms of their factor scores. Only one representative factor was identified in 3 groups out of the 7. These 3 groups including 87 women were tentatively designated as vasomotor symptom, neurotic, and sensory disturbance groups. These results confirmed statistically that at least 3 simple etiological factors exist among climacteric symptoms. PMID- 6495325 TI - Rapid radioimmunoassay of plasma GH and its application to the judgement of surgical results in patients with acromegaly. AB - To improve the surgical results in patients with acromegaly, rapid radioimmunoassay (RIA) of plasma GH was developed and this method was applied for quick judgement of whether transsphenoidal hypophysectomy was performed successfully or not. The best reaction temperature and the shortest incubation time were proved to be 40 degrees C and 16 min, respectively. The GH values obtained by this method and the usual RIA method were correlated well (r = 0.9, p less than 0.001). Using the rapid RIA it became possible within 35 min just after the termination of the hypophysectomy to report the data to the neurosurgeons. This RIA method was applied for 5 patients with acromegaly undergoing transsphenoidal hypophysectomy. In two cases plasma GH decreased markedly (62.0 71.4% decreases from preoperative value) at the termination of the hypophysectomy, and later fell to normal ranges. The other three cases showed only slight decreases (7.7-17.3%), and the operation was judged as unsuccessful. Therefore, two of these cases were followed by further removal of residual tumors which resulted in steep declines of GH. In the remaining one the further operation was not performed, because surgical removal of the adenoma was believed by the surgeons to be complete. In conclusion, rapid RIA of plasma GH is possible within 16 min and this method is of significant value to improve the surgical results of acromegalic patients. PMID- 6495327 TI - Consecutive bestatin-hormone regimen induces redifferentiation of cancer cells in vitro. AB - When undifferentiated murine mammary adenocarcinoma cells were consecutively exposed to bestatin and estradiol or testosterone in vitro, morphological signs of redifferentiation of the cells were observed along with cellular enlargement and subsequent cell loss. These observations suggest that similar treatments can be applied clinically to cancers of the breast and prostate. PMID- 6495328 TI - Exfoliation as a mode of cancer elimination in rectal carcinoma. AB - A histopathological survey of surgical materials from 143 patients with rectal carcinoma subjected to chemotherapy and low-dose radiotherapy with tegafur and bleomycin was carried out. The chemotherapy combined with radiotherapy brought about better results than chemotherapy alone. In 4 of the 58 patients treated with radiochemotherapy, no cancer cells could be found in surgical specimens. Exfoliation into the rectal lumen of cohorts of cancer cells may occur in some cases of rectal carcinoma thus treated, resulting in cancer cell elimination. PMID- 6495329 TI - An animal model for nonimmunologic contact urticaria. AB - The suitability of the guinea pig for studies on nonimmunologic contact urticaria (NICU) was investigated. Groups of five, female Hartley guinea pigs were challenged by applying 50 microliters of various concentrations of human NICU agents, benzoic acid (BA), sorbic acid (SA), cinnamic acid (CA), cinnamaldehyde (CAL), methyl nicotinate (MN) and dimethyl sulfoxide (DMSO), in absolute ethyl alcohol to both sides of the earlobe. The thickness of the ear (0.85 +/- 0.11 mm, means +/- SD, 100 animals) was measured with a string micrometer before application and at 5- to 30-min intervals thereafter. Maximal increase in ear thickness was produced within 30 to 40 min by 20% BA (0.70 +/- 0.09 mm), 10% SA (0.30 +/- 0.05 mm), 15% CA (0.58 +/- 0.12 mm), 5.0% CAL (0.37 +/- 0.09 mm), 0.2% MN (0.80 +/- 0.03 mm), and 100% DMSO (0.74 +/- 0.11 mm). All responses were dose dependent. The histology of the maximal reactions showed dermal edema, and intra- and perivascular infiltrate of heterophils (neutrophils in man), eosinophils, and some lymphocytes. DMSO also caused vacuolization of the epidermal cells. CAL, MN, and DMSO, applied to different parts of the guinea pig body, produced only erythema most frequently on the upper back, but BA, SA, and CA did not cause any reactions. The guinea pig ear-swelling test provides a quantitative animal model to screen human NICU agents. PMID- 6495330 TI - Carbon monoxide enhances development of hypertension in Dahl rats. AB - The influence of carbon monoxide (CO) on the development of systemic hypertension was studied in Dahl rats selectively bred for susceptibility (DS) and resistance (DR) to NaCl-induced hypertension. This study was designed to examine the interactions among rat line (DS or DR), NaCl content of diet, and exposure to CO. The rats were exposed to 500 ppm CO or conditioned air, 21 hr/day, for 62 to 63 consecutive days. Carbon monoxide exposures affected blood pressure only in DS rats fed a high NaCl diet, where it enhanced the development of NaCl-induced hypertension. Whole-body weights were not affected by CO, but organ weight changes in the form of cardiomegaly ranging from 22% (DR, low NaCl) to 36% (DS, high NaCl), and splenomegaly ranging from 29% (DR, low NaCl) to 98% (DS, high NaCl) were observed. The mean equilibrium carboxyhemoglobin concentration was 42% in the CO-exposed rats. The hematologic responses to the CO exposures were elevated total hemoglobin and hematocrit. PMID- 6495331 TI - Statistical consequences of reducing the number of rabbits utilized in eye irritation testing: data on 67 petrochemicals. AB - Data from 67 six-rabbit eye irritation tests were used to generate two-, three-, and four-rabbit Draize scores. The 15 two-rabbit, 20 three-rabbit, and 15 four rabbit "subsample" scores for each of the 67 petrochemicals tested were used to establish prediction intervals for the original six-rabbit scores. Prediction interval length shortens with increasing sample size, is widest in the middle portion of the Draize scale, and can be used to select the minimum number of rabbits necessary to satisfy a required level of precision. Also, the ability of each subsample size to correctly classify the test materials according to an in house irritation classification system was evaluated. Results indicate that subsamples of size 2, 3, 4, and 5 were 88, 93, 95%, and 96% accurate, respectively (compared to six rabbits), at correctly classifying the irritation potential of the materials tested. PMID- 6495332 TI - Macromolecular weight specificity in covalent binding of bromobenzene. AB - Bromobenzene is a hepatotoxicant that causes centrilobular necrosis. Pretreatment of animals with 3-methylcholanthrene decreases and phenobarbital pretreatment enhances the hepatotoxic action of this compound. We have investigated the macromolecular weight specificity of the covalent interactions of bromobenzene with liver macromolecules following incubation of [14C]bromobenzene in isolated hepatocytes. Hepatocytes were prepared from Fischer-344 rats treated for 3 days with 3-methylcholanthrene, phenobarbital, or normal saline. After a 1-hr incubation, total covalent binding, as measured by sodium dodecyl sulfate equilibrium dialysis, was twofold less in hepatocytes from 3-methylcholanthrene treated rats and sixfold greater in hepatocytes from phenobarbital-treated rats, as compared to hepatocytes from control animals. Analysis of the arylated macromolecules by electrophoresis on 15% sodium dodecyl sulfate-polyacrylamide disc gels indicated that in the first 1 to 3 min of incubation substantial amounts of covalently bound radiolabel were associated with macromolecules of between 20,000 and 40,000. The amount of radioactivity associated with these macromolecules rapidly diminished in hepatocytes from control and 3 methylcholanthrene-treated animals. In hepatocytes from phenobarbital-treated animals, the amount of radioactivity associated with macromolecules, 20,000, increased throughout the incubation. The amount of radiolabel associated with macromolecules, 20,000, increased in all incubations. When nontoxic doses of phenylmethylsulfonyl fluoride, a specific inhibitor of serine proteases, were added to control hepatocytes incubated with [14C]-bromobenzene, the decrease in radioactivity associated with larger (greater than 20,000) macromolecules was inhibited and a corresponding lack of increase in radioactivity associated with smaller macromolecules was observed. In hepatocytes from phenobarbital-treated rats, either the rate of adduct formation with higher molecular weight macromolecules greatly exceeded the rate of their breakdown or the phenobarbital treatment compromised the degradation process. The toxicity induced by bromobenzene may result from the covalently bound material altering the biological function of macromolecules. The result of this study suggest that cellular degradation of the arylated macromolecules may be one mechanism of detoxification. Persistence of the arylated macromolecules within the cell may be associated with the toxic action of bromobenzene. PMID- 6495333 TI - Pharmacokinetics of picloram in male volunteers. AB - The fate of picloram (4-amino-3,5,6-trichloropicolinic acid), an active ingredient in TORDON brand herbicides, was defined in 6 healthy male volunteers following single po doses of 5.0 and 0.5 mg/kg, and a dermal dose of 2.0 mg/kg. Picloram was administered orally as the sodium salt in grape juice. The dermal dose was applied to the volunteers' backs as the free acid dissolved in ethanol. The data indicate picloram was rapidly absorbed from the gastrointestinal tract (t1/2 = 20 min) and rapidly excreted unchanged in the urine. Over 90% of the po dose was recovered as unchanged picloram in the urine excreted through 72 hr; most of the dose (greater than 75%) was excreted within 6 hr and the remainder was excreted with an average half-life of 27 hr. By comparison picloram was slowly absorbed through the skin (t1/2 = 12 hr) and, based on the quantity of picloram excreted in the urine, only a small fraction (0.2%) of the picloram applied to the skin was absorbed. These data indicate that picloram because of its rapid excretion has a low potential to accumulate in man during repeated or prolonged exposures. In addition, picloram was poorly absorbed through human skin and it is unlikely that acutely toxic quantities will be absorbed by this route. PMID- 6495334 TI - Pyrethroid-mediated skin sensory stimulation characterized by a new behavioral paradigm. AB - Occupational exposures to pyrethroids have been associated with skin sensory effects characterized by transient itching/tingling sensations. This effect had not been detected in "Draize" skin irritation tests and exists in the absence of visible skin irritation. The objective of this investigation was to develop an animal model to study this phenomenon. Guinea pigs were treated with pyrethroid solutions on one side of their shaved back and control substances on the other side. The animals responded by licking, rubbing, scratching, or biting the test sites and activity was quantified by counting the number of times the animals responded to pyrethroid or control treated sites. Animals responded to pyrethroid more than to control substances and this behavioral activity was apparently maximum during the first hour and essentially over by the fourth hour after treatment. The sensory response did not directly correlate with overt visible signs of skin irritation. However, a chemical irritant (oil of mustard) was able to restimulate the behavioral activity when applied within 24 hr after pyrethroid application. Skin sensory stimulation produced by cyano-containing synthetic pyrethroids was significantly greater than that produced by a non-cyano containing pyrethroid. This behavioral model provides a quantitative means to evaluate pyrethroid nonerythematous skin sensory stimulation. PMID- 6495335 TI - Two-year inhalation toxicity study of propylene in F344/N rats and B6C3F1 mice. AB - Chronic toxicity studies of propylene were conducted by exposing groups of 50 F344/N rats and 50 B6C3F1 mice of each sex in chambers to air containing the chemical in concentrations of 5000 and 10,000 ppm, 6 hr per day, 5 days per week, for 103 weeks. Groups of 50 rats and 50 mice of each sex in similar chambers received clean air only on the same schedule and served as controls. Survival and mean body weights of exposed and control male and female rats and mice were similar. In exposed rats, increased incidences of nonneoplastic lesions were observed in the nasal cavity. These consisted of epithelial hyperplasia in female rats exposed to the high concentration, and squamous metaplasia in female rats exposed to both concentrations and in male rats exposed to the low concentration. In addition, inflammatory changes characterized by an influx of lymphocytes, macrophages, and granulocytes into the submucosa and by granulocytes into the lumen occurred in male rats of both exposure groups. There was no evidence of nasal cavity lesions in exposed mice, suggesting a species difference in sensory irritation to propylene. There were no treatment-related increases or decreases in tumor incidence in the exposed groups relative to controls for either rats or mice. These data suggest that inhaled propylene induces signs of nasal cavity toxicity in rats but not in mice, and that the chemical is not carcinogenic to either species at the concentrations tested. PMID- 6495336 TI - The metabolism and nephrotoxicity of tetrafluoroethylene in the rat. AB - Exposure of rats to 6000 ppm tetrafluoroethylene for 6 hr produced marked damage to the proximal tubule of the kidney with no effect on the liver. The toxicity was characterized by very high concentrations of urinary glucose and by marked increases in the concentrations of several urinary enzymes. The no observed effect level for a 6-hr exposure was 2000 ppm. Tetrafluoroethylene was metabolized to S-(1,1,2,2-tetrafluoroethyl)glutathione by rat liver fractions in vitro; the reaction was catalyzed by both microsomal and cytosolic glutathione S transferases. The rate with microsomes was four times that with cytosol fractions. Evidence for this metabolic pathway in vivo has been obtained by the identification of the cysteinylglycine and cysteine conjugates of tetrafluoroethylene in rat bile. Cytochrome P-450 oxidation, a common metabolic route for haloalkenes, does not appear to occur in the metabolism of tetrafluoroethylene. When administered po to rats, the synthetic cysteine conjugate of tetrafluoroethylene causes renal damage identical to that caused by tetrafluoroethylene itself. The conjugate was metabolized by renal slices in vitro giving pyruvate, ammonia, and a reactive species which caused marked inhibition of organic ion transport into slices. Purified renal beta-lyase also cleaved this conjugate giving stoichiometric amounts of pyruvate and ammonia. The nephrotoxicity of tetrafluoroethylene is believed to derive from the hepatic glutathione conjugate of this compound. Following excretion and degradation of this conjugate in bile, the cysteine conjugate is reabsorbed and further metabolized in the kidney by the enzyme beta-lyase to a cytotoxic species. PMID- 6495337 TI - Sensory irritation tolerance and cross-tolerance in F-344 rats exposed to chlorine or formaldehyde gas. AB - Inhalation of chlorine (Cl2) or formaldehyde (HCHO) stimulates the trigeminal nerve endings in the nasal mucosa and results in respiratory rate depression in a concentration-dependent manner. To determine tolerance and cross-tolerance, the concentration-response curves of respiratory depression were compared between naive rats and rats pre-exposed to Cl2 or HCHO. Chlorine tolerance development was time and concentration dependent, being significant following a 1-day (6 hr/day), 10 ppm exposure, and reaching the maximum in 4 days. At 2.5 ppm of Cl2, tolerance was significant only after 10 days of exposure. Rats tolerant to Cl2 also showed cross-tolerance to HCHO. Tolerance to HCHO was observed in rats exposed to 28 ppm for 4 days, but not in groups exposed to 15 ppm for 1, 4, or 10 days. However, significant cross-tolerance to Cl2 was evident following a 1-day exposure to 15 ppm HCHO, with greatest effect seen in the group exposed for 10 days. Tolerance was reduced after a 7-day recovery following a 4-day exposure. Cross-tolerance was reduced also, but to a much lesser extent. These results suggest a common mechanism for tolerance and cross-tolerance development, but different reactive sites may exist for Cl2 and HCHO at the trigeminal nerve endings. PMID- 6495338 TI - Tin distribution in adult rat tissues after exposure to trimethyltin and triethyltin. AB - The time course of distribution of tin in the adult rat was determined in brain, liver, kidneys, heart, and blood following single ip administrations of trimethyltin hydroxide (TMT) and triethyltin bromide (TET). Adult Long-Evans rats were killed 1, 4, 12, and 24 hr, and at 5, 10, or 22 days following injection of TMT and TET (N = 6/time), and tissues were analyzed for total tin by atomic absorbance spectroscopy. TET exposure resulted in higher tin concentrations in brain, liver, and kidney tissues, while the two trialkyltins resulted in approximately equal tin concentrations in the heart and blood. Rates of elimination of tin (expressed as elimination rate constants, Kel) were greater in all tissues following TET exposure than following TMT exposure. The concentration of tin in the brain 12 hr after TMT exposure was 4.4, 8.5, and 12.7 ng tin/mg protein for dosages of 3.0, 6.0, and 9.0 mg/kg, respectively. Tin was evenly distributed across the cerebellum, medulla-pons, hypothalamus, hippocampus, and striatum following TMT exposure. These results describe major differences in the disposition and rates of elimination of tin from body tissues after TMT and TET exposure, and demonstrate that the regional disposition of tin is not related to the region-specific pathology reported following TMT exposure. PMID- 6495339 TI - Pulmonary toxicity of aerosolized oil-formulated fenitrothion in rats. AB - To evaluate the potential risk of pulmonary damage due to aerial spraying of the insecticide fenitrothion, rat lungs were examined under light and electron microscopy at 3, 7, 21, and 60 days after exposure. Rats were exposed by a "nose only" apparatus for 1 hr to 2 or 500 mg/m3 of aerosolized fenitrothion (15%) mixed with solvent Cyclosol 63 (35%) and diluent oil 585 (50%). Aerosol size particles were monitored by a light scattering apparatus. Only minor modifications of lung alveolar tissues were observed after exposure to the high concentration. At 3 days, discrete foci of mild inflammation were detected, including interstitial edema, cellular infiltration, and increased number of alveolar macrophages. At 7 days, signs of irritation were diminished while at 21 and 60 days alveolar tissues were essentially normal. Exposure to lower concentration induced more limited changes at 3 days; no modifications were seen at later periods. It is concluded that a single exposure to this fenitrothion mixture at 500 mg/m3 presents no serious hazard of pulmonary toxicity. PMID- 6495340 TI - Inhalation teratology study on monochlorobenzene in rats and rabbits. AB - The embryotoxic and teratogenic potential of inhaled monochlorobenzene (MCB) was evaluated in rats and rabbits. Bred Fischer 344 rats and inseminated New Zealand White rabbits were exposed to 0, 75, 210, or 590 ppm of MCB via inhalation for 6 hr/day during the period of major organogenesis. Exposure to 590 ppm caused elevated liver weights in both species and decreased body weight gain and feed consumption in rats. Inhalation of MCB vapors during gestation was not embryotoxic or teratogenic in rats. In rabbits, a few MCB-exposed fetuses exhibited visceral malformations which were not observed among concurrent controls, though no dose-related increase in malformations occurred. To further evaluate the effects of MCB in rabbits, additional groups were exposed to 0, 10, 30, 75, or 590 ppm. This subsequent study did not result in any increase in malformations in the MCB-exposed groups. Fetal effects were limited to a slight delay in skeletal development which occurred only in rats exposed to 590 ppm, a maternally toxic concentration. PMID- 6495341 TI - Degranulation of mast cells and inhibition of the response to secretory agents by phototoxic compounds and ultraviolet radiation. AB - The symptoms of cutaneous phototoxicity from coal tar compounds and the nonsteroidal anti-inflammatory drug benoxaprofen are characterized by wheal and flare formation which is mediated by histamine released from dermal mast cells. Rat serosal mast cells were used as an in vitro model system to study the direct effect of phototoxic compounds on mast cell degranulation. The coal tar compounds studied included acridine and pyrene. Combined exposure of cells to acridine and UVA (320 to 400 nm) radiation caused mast cells to degranulate, as assayed by the release of [3H]serotonin. Maximum [3H]serotonin release (70 to 80%) was obtained with 50 microM acridine and 300 kJ/m2 UVA. Pyrene (25 microM), when photoexcited with UVB (280 to 360 nm) radiation, caused about 80% release of [3H]serotonin. No degranulation occurred with 20 microM benoxaprofen and UVB doses up to 7.2 kJ/m2. Trypan blue staining correlated well with degranulation caused by acridine plus UVA; however, with pyrene plus UVB there was greater [3H]serotonin release than dye uptake. Excitation of photosensitizers with doses of UV radiation that did not cause trypan blue staining suppressed degranulation of mast cells in response to chemical stimulation. Acridine, pyrene, and benoxaprofen in the presence of UV radiation inhibited the mast cells from responding to compound 48/80 or the calcium ionophore, chlortetracycline. Two other phototoxic compounds, chlorpromazine and deoxytetracycline, also abolished degranulation by compound 48/80. These findings indicate that phototoxic compounds: (1) cause degranulation in the presence of high doses of UV radiation; and (2) suppress degranulation of mast cells in response to secretory stimuli at doses of UV radiation that do not cause release of mediator. PMID- 6495342 TI - An in vitro assay for teratogens with cultures of rat embryo midbrain and limb bud cells. AB - A short-term in vitro assay for teratogens has been evaluated and shown to have a high predictability (greater than 90%). Cultured cells derived from midbrain (CNS) and limb buds (LB) of 34 to 36 somite rat embryos were exposed to 46 compounds (27 teratogens, 19 nonteratogens) in a blind trial. Rat liver post mitochondrial supernatant fraction plus cofactors were included in the cultures to provide metabolizing enzymes. Differentiation of neurons from CNS cells and chondrocytes from LB cells was measured after 5 days of culture. Inhibition of differentiation (assessed by reduction of number of foci) was the indicator of potential teratogenicity. Variation between experiments was limited. In repeat experiments with two direct-acting teratogens, aldrin and diphenylhyantoin, interexperiment variability was low (coefficient of variation; range 7 to 24%). Of 27 teratogens 25 (93%) and only 2 of 19 nonteratogens (11%) inhibited differentiation (CNS or LB). Inhibition of differentiation in one cell type alone was less predictive (CNS: 85%, LB: 82%). PMID- 6495343 TI - Capsaicin sensitive sensory neurons mediate the response to nasal irritation induced by the vapour phase of cigarette smoke. AB - Cigarette-smoke exposure in awake guinea-pigs induced reproducible nose wipings with the fore-paws. This behaviour was used as a model to study the mechanisms underlying the irritant effect of cigarette smoke. The nose wipings upon smoke exposure were abolished after local anaesthesia of the nasal mucosa, which indicates that this response was due to activation of nasal protective reflexes. Removal of the particulate phase of the smoke including nicotine using a Cambridge filter only slightly reduced the wiping response, and nicotine-free cigarettes also induced marked irritation. This suggests that irritant chemicals in the vapour phase of the smoke caused this effect. Systemic capsaicin pretreatment, which is known to cause a functional impairment of chemosensitive C fibre afferents, abolished the nose wiping behaviour seen upon smoke exposure. Local pretreatment of the nasal mucosa with capsaicin also significantly reduced the number of smoke-induced nose wipings. It is concluded that smoke-induced irritation, as indicated by nose wipings, is primarily due to activation of capsaicin-sensitive sensory nerves in the nasal mucosa by vapour-phase components. PMID- 6495344 TI - A simple machine for smoke analytical studies and total particulate matter collection for biological studies. AB - The need for modest quantities of smoke for use in biological studies resulted in the development of a simple machine for smoke analytical studies and total particulate matter (TPM) collection. The machine can be used for the study of mainstream and sidestream smoke and the gas phase of both, with the accuracy and precision of more complex smoking machines. The machine is described and machine performance is evaluated by TPM data obtained under typical operating conditions. One gram of TPM can be collected from a high TPM delivery cigarette by one technician in 2 h. When sidestream smoke is collected, the machine can be operated without the escape of smoke components to the laboratory atmosphere. PMID- 6495345 TI - The effects of Penicillium roqueforti toxin on the activity of rat hepatic DNA polymerases. AB - PR toxin, a mycotoxin from cultures of Penicillium roqueforti, inhibited the in vitro activities of rat liver DNA polymerase alpha, beta, and gamma irrespectively of the nature of template-primer used. The concentration required for 50% inhibition of DNA polymerase alpha was 5-6 X 10(-6) M, while those for DNA polymerase beta and gamma were several times higher. By using DNA polymerase beta as a model, and based on the enzyme and template-primer concentration effects and also from the kinetic analysis on PR toxin inhibition, we concluded that two action mechanisms of PR toxin inhibition on in vitro DNA synthesis are operative. Inhibition of the in vitro DNA synthesis directed by DNA template was mediated primarily through alteration of the enzyme itself, whereas in the DNA synthesis reaction directed by RNA template DNA primer, the impairment of template or primer function due to PR toxin treatment probably had occurred. The inhibition of DNA polymerase by PR toxin persisted even after exhaustive dialysis. Addition of PR toxin to an ongoing reaction also inhibited DNA synthesis. Inactivation of DNA polymerase activity of PR toxin likely involved some essential amino acid residues other than sulfhydryl groups. PMID- 6495346 TI - The autoradiographic localisation of retained orally administered cadmium tracer within Paneth cells of rat duodenum. AB - Rats not previously exposed to cadmium and rats whose sole source of drinking water for the previous 9 months contained 0.2 g/litre (200 ppm) cadmium were given 100 microCi Cd109 Cl2 by oral intubation. After 96 h more isotope was retained in the duodenums of rats not previously exposed to cadmium than in the duodenums of cadmium-exposed rats. Autoradiographic studies showed that in the rats not previously exposed to cadmium, radioactivity was concentrated in the Paneth cells at the base of the crypts of Lieberkuhn. This result did not occur in cadmium-exposed rats. Paneth cells are known to contain zinc and metallothionein but their retention of cadmium has not previously been reported. Since exposure to environmental cadmium is largely via contaminated food and water, the role of Paneth cells may be of significance in cadmium toxicology. PMID- 6495347 TI - Chronic lead exposure differentially affects dopamine transport in rat striatum and nucleus accumbens. AB - Dopamine release and uptake were investigated in striatum and nucleus accumbens slices of rats chronically exposed to lead. No indication of altered endogenous dopamine release under basal or depolarized conditions was observed in both areas. On the other hand lead intoxication inhibited striatal dopamine uptake while stimulating it at the mesolimbic level. Cocaine binding, that is related to the uptake system, appeared to be down-regulated in the striatum and unaffected in the nucleus accumbens. The results suggest that chronic lead might interfere with dopaminergic transmission at the presynaptic level through specific and differential interactions with the uptake process depending on the area examined. PMID- 6495348 TI - Metabolic fate and disposition of [14C]hydroquinone given orally to Sprague Dawley rats. AB - Hydroquinone (HQ) is used widely in industry and in commerce and is considered to have a low degree of toxicity. Although the metabolism of HQ has been studied elsewhere, a complete materials balance has not been reported. We investigated the metabolism of HQ in naive and HQ pretreated male Sprague-Dawley rats. [14C]HQ was administered by gavage in single doses of 5, 30, or 200 mg/kg to naive rats. HQ was given repeatedly by gavage to male rats at 200 mg/kg for 4 consecutive days followed by a single dose with 200 mg/kg of [14C]HQ. In separate studies rats were fed 5.6% unlabeled HQ in the diet for 2 days or were dosed by gavage with 311 mg/kg [14C]HQ. The excretion patterns of [14C]HQ and its metabolites were similar for rats dosed singly or repeatedly. Rats given a single dose of 200 mg/kg of [14C]HQ excreted 91.9% of the dose in the urine within 2-4 days; 3.8% was excreted in the feces, about 0.4% was excreted in expired air, and 1.2% remained in the carcass. Radioactivity was widely distributed throughout the tissues with higher concentrations in the liver and kidneys. A decrease in 14C tissue concentrations occurred from 48 to 96 h. The only radiolabeled compounds in the urine were HQ (1.1-8.6% of the dose), hydroquinone monosulfate (25-42%), and hydroquinone monoglucuronide (56-66%). Similar findings were observed for rats given HQ in the feed. There were no significant increases from controls for absolute or relative liver weights, liver microsomal protein concentrations, cytochrome b-5, cytochrome P-450 or cytochrome c reductase activity in rats dosed repeatedly with 200 mg/kg HQ. Cytochrome P-450 values were slightly but significantly decreased in rats dosed repeatedly with HQ compared with controls. PMID- 6495349 TI - Improvement in soluble dehydrogenase histochemistry by nitroblue tetrazolium preuptake in sections: a qualitative and quantitative study. AB - An improvement in the histochemical demonstration of soluble dehydrogenase enzymes has been obtained by preincubating frozen sections in a nitroblue tetrazolium (NBT)/acetone solution, followed by routine incubation in polyvinyl alcohol (PVA) enriched media. Tissue binding properties of NBT were shown clearly to be decreased in histochemical media containing the colloid PVA for soluble enzymes, thus causing loss of the final reaction product (formazan) from the sections. The preincubation step in NBT/acetone allows tetrazolium salt to bind firmly to tissue lipoprotein (substantivity) and diminishes the loss of reduced formazan from heavily reacting tissue sections. The time course of NBT substantivity was examined and it was found that NBT binds rapidly to tissues (liver, kidney, heart) during preincubation, so that a preincubation of 30-60 seconds at room temperature is sufficient to improve the final morphological results greatly. Microspectrophotometric measurements of matched controls and NBT/acetone preincubated sections show that the preincubation step may slightly decrease lactate dehydrogenase (LDH) and glucose-6-phosphate dehydrogenase (G6PDH) activities. This decrease was probably due to increased binding efficiency of formazan to cell lipoproteins but was judged, however, to be irrelevant compared to the morphological advantages produced by the NBT/acetone preincubation procedure. PMID- 6495350 TI - Heterokaryon identification through simultaneous fluorescence of tetramethylrhodamine isothiocyanate and fluorescein isothiocyanate labelled protoplasts. AB - Protoplasts were separately stained with the fluorescent dyes fluorescein isothiocyanate (FITC) and tetramethylrhodamine isothiocyanate (TRITC). Following fusion, doubly stained heterokaryons were identified under fluorescence microscopy by using the Zeiss filter set 48 77 05 (excitation filter 450-490 nm, dichroic reflector 510 nm, and barrier filter 520 nm) which allowed simultaneous fluorochrome emissions. Previously, either emission spectrum, but not both, was possible for any single filter set. PMID- 6495351 TI - A simple method for mass embedment of microvessels for cross sectioning. PMID- 6495352 TI - [Radioiodine therapy of differentiated thyroid cancer. 10-year results of a standardized therapy in 269 patients]. AB - Between 1969 and 1977, 269 patients submitted to thyroidectomy were treated exclusively with radioiodine according to a standardized irradiation scheme. The patients were observed during thirteen years. 195 patients were free of metastases at the time of the first therapy, whereas 74 patients had lymph node metastases or remote metastases. The survival rates of the total group were 89% (five years) and 76% (10 years), respectively. Patients with regional lymph node metastases had a ten-year survival rate of 74%. The fourty patients suffering from remote metastases had a five-year survival rate of 75% and a ten-year survival rate of 40%. Patients who were in stage T3 at the moment of diagnosis had a survival probability of 74% for five years and of 59% for eight years. None of these patients presented with remote metastases during the follow-up period. Taking into consideration these results and the small rate of complications, we are of the opinion that a routine combination therapy with external post irradiation is not necessary. PMID- 6495353 TI - [CT volumetry of intrathoracic space-occupying processes]. AB - Preoperative CT volumetry was performed in 39 patients with intrathoracic neoplasms. The results are compared to postoperative volume measures of the surgical preparation. The correlation of both measuring series was very high (p = .94). The estimated influence of systematic and stochastic errors was only 10 to 15%. The authors outline the consequences for clinical practice: by means of the better quantification in the T category of the TNM system, the surgeon is in a position to make a more precise preoperative planning. The reliable numeric in vivo determination of regression and growth velocity of tumors and/or metastases allows for the first time an exact quantification of control examinations during and after radiotherapy or chemotherapy. This will possibly lead to a more precise individual prognosis. In experimental radiotherapy a more detailed description of the evolution of experimental tumors in the living animal will be possible by this procedure. PMID- 6495354 TI - Radiation dosimetry of 12 MV photons from a CGR Therac 20 MeV Saturne linear accelerator. AB - Typically useful clinical radiation dosimetry characteristics of 12 MV photon beams from a CGR Therac 20 MeV Saturne linear accelerator are briefly outlined. Central axis percent depth dose data are compared with other published data. Beam profiles for small, medium and large fields are delineated to show the uniformity of beams at various depths. PMID- 6495355 TI - [Attached head support for an Mk1 patient-treatment table]. AB - The author presents a head support which can be attached to the bottom-end of the treatment couch Mk1 (AECL teletherapy units). This head support facilitates the reproducible position of patients in case of irradiations of the skull and irradiations of head and neck and makes only possible to apply all techniques of irradiation of the skull and of head and neck. By means of suitable connection elements, the head support can also be used with the treatment couch of other manufacturers. PMID- 6495356 TI - The effect of a hypoxic cell sensitizer on cancer radiotherapy: an analysis by a model. AB - Misonidazole has been studied for its sensitizing effect of radiation on hypoxic cells in vitro and in vivo. However, clinical trials have not always shown improvement of cure rate in radiotherapy. The enhancement ratio when irradiation was performed with misonidazole was analysed by a model to examine the effectiveness of misonidazole, considering the hypoxic fraction in cancer and reoxygenation. It was shown from this model that misonidazole should be effective for cancer which had a hypoxic fraction of more than 10%, and in which reoxygenation did hardly occur, and that the effect of misonidazole was not dependent on the size of dose per fraction for radioresistant cancer. PMID- 6495357 TI - [Possibilities and limits of practice-oriented daily control measurements of linear accelerators]. AB - Daily control measurements of the dose taken at a linear accelerator are described in order to present a practice-oriented measurement and evaluation method rendering possible a long-term quality control. This method allows to establish sudden parameter variations as well as to determine in a simple and precise manner long-term drifting effects with an amplitude within the range of measurement variations and a period of many months. During the time of six months, not only a drifting effect with a long period and an amplitude within the range of pro mille, but also a variation coefficient smaller than 0,3% could be determined. PMID- 6495358 TI - [Individual face masks as aids in quasi-3-D planning and completion of irradiation of tumors of the head and neck]. AB - Apparatus for immobilizing the patient's head in an identically reproducible position is required, if the advantages of exact quasi-3-D-therapy planning are to be fully exploited for the irradiation of irregular target volumes in the head and neck area. The topics of this report are the production and application of individual thermoplastic masks in connection with special head supports for CT planning scans, simulation and irradiation. PMID- 6495359 TI - Histological examination of the effect of differently fractionated irradiations in rat and mouse organs. III. Autoradiographic examination of DNA synthesizing cells in locally X-irradiated rat spleens. AB - The spleen of rats was irradiated with 50 Gy dose local X-rays in two different fractionation rhythms, i.e. twice a week given high and daily applied lower fractions of radiation. According to the results of 3H-thymidine autoradiography made after the last irradiation 24 hours later both in the white and the red pulp the labelling index was less on the effect of twice in a week applied high radiation fractions than in case of daily given lower fractions. This indicate in correlation with the results of earlier analogous histological experiments that the damaging effect of rarely given higher fractions of radiation in the spleen is especially obvious. PMID- 6495360 TI - Measuring accessibility to family planning services in rural Thailand. AB - There are a variety of ways to conceptualize and measure accessibility to contraceptive services and supplies. Using detailed data for rural Thailand, a multiplicity of reasonable measures are developed that reflect time and/or distance to various government program outlets. Many of these are only moderately correlated with one another, and to an important extent, different measures show different associations with levels of contraceptive prevalence. Clearly there is a general need in this area of investigation to pay more attention to the measurement of accessibility as a community characteristic and to consider the sensitivity of results to alternate measures. PMID- 6495361 TI - Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh. AB - An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated. PMID- 6495362 TI - Ethnic differences in contraceptive use in Sri Lanka. AB - In Sri Lanka in 1975, the majority Sinhalese had a much higher use of contraception than either the Sri Lanka Tamils or the Moors. This study uses a national sample of women of childbearing age gathered by the Sri Lanka World Fertility Survey in 1975 to assess four possible reasons for differential contraceptive use: (1) differences in socioeconomic position; (2) cultural differences; (3) minority status; and (4) differential access to family planning services. The first three explanations focus on differences in the demand for contraception while the fourth explanation focuses on differences in the availability of contraceptives. The socioeconomic, cultural, and minority status hypotheses fail to explain the higher contraceptive use among the Sinhalese. The evidence is consistent with the idea that ethnic differences in contraceptive use were largely caused by differential access to family planning services. PMID- 6495363 TI - Oral contraception in Bangladesh. AB - In rural Bangladesh, the continuation rate of oral contraceptives (OCs) is the lowest among all methods except for condoms, and the pregnancy rate for OC users is comparable to that for users of traditional methods, which lies halfway between that for foam and condom users (high) and Depo-Provera and IUD users (low). To determine why postpartum amenorrheic OC acceptors have shorter pregnancy intervals than postamenorrheic OC acceptors who were matched on time of acceptance as well as on age and parity, subintervals of the pregnancy interval are examined. Results reveal significantly shorter duration of use by amenorrheic acceptors. This short duration of use overrides their significantly longer duration to pregnancy since discontinuation, to give overall shorter duration to pregnancy since last birth. PMID- 6495364 TI - Menstrual patterns after female sterilization: variables predicting change. AB - Previous studies of the changes in menstrual pattern characteristics following sterilization have been flawed by methodologic errors. As a result, contradictory findings have been reported. Appropriate methodologic approaches to the study of poststerilization menstrual patterns are presented, and a new methodologic approach-an index of menstrual pattern change-is offered, which evaluates four menstrual parameters simultaneously. A carefully controlled study using this index indicates that most women report no change in menstrual pattern at 12 months poststerilization, and among those who do experience change, changes in one direction are balanced by changes in the other direction. The changes reported include improvements as well as changes for the worse. The best predictor of whether a woman would experience menstrual pattern change after sterilization is whether her pattern had any abnormal characteristics during the three months prior to the procedure. Surgical variables and special subgroups of women are also evaluated. PMID- 6495366 TI - Minor antigen graft-versus-host reactions revealed in irradiated spleen and popliteal lymph node assays. AB - The graft-versus-hot (GVH) reaction across minor (non-H-2) histocompatibility barriers was studied in mice, in vivo. To increase GVH potential and to mimic clinical bone marrow transplantation protocols, we modified the popliteal lymph node (PLN) and the splenomegaly assays by irradiating the recipients before they received allogeneic lymphoid cell suspensions. In several combinations across major (H-2), minor (non-H-2) and multiple minor (non-H-2 plus minor lymphocyte stimulation) barriers, increased recipient organ weight (a measure of GVH activity) was seen with irradiated F1 recipients of parental cells. The irradiated splenomegaly (x-splenomegaly) assay was more sensitive than the (x PLN) assay, but both correlated with in vivo GVH experiments of the P----F1 variety. The x-splenomegaly test indicated histoincompatibility in a system (B10.D2----BALB/c) in which the primary in vitro mixed leukocyte reactions is nonreactive, but in which systemic GVH can be induced. The x-splenomegaly test should be useful in analyzing complex reactions involving minor histocompatibility antigens in vivo. PMID- 6495365 TI - Thymic interdigitating reticulum cells demonstrated by immunocytochemistry. AB - The lymphoid interdigitating cell (IDC) was investigated in human and rat thymus. A glial protein, S-100, was demonstrated in IDCs found in the human and rat thymic medulla by light microscopic immunocytochemistry. This marker served to distinguish IDCs from conventional macrophages of the thymic cortex. IDCs were S 100+, lysozyme-. Cortical macrophages were S-100-, lysozyme+. Thymic epithelial cells and lymphocytes possessed none of these markers. Examination of human fetal thymic tissue revealed that the IDC is present within the thymus very early in embryogenesis. Ultrastructural analysis of a developmental series of the rat thymus identified IDCs and macrophages. Medullary IDCs possessed many of the morphologic features of the epidermal Langerhans cell including the Birbeck granule. Cortical macrophages contained many inclusion bodies and lysosomes indicative of active phagocytosis. Some changes in IDC shape and structure were noted during maturation in the rat that may reflect the migration of this cell into the thymic parenchyma. PMID- 6495368 TI - Essential health care: a framework for its definition and implementation in health districts. AB - This paper presents a framework for the definition and implementation of essential health care. It is based upon current experiences in developing countries. Its aim is to facilitate the description, in operational terms, of a range of activities for clearly defined targets--individuals, families and communities. It seeks to bring to the attention of responsible citizens and professionals the major areas which they should address in the search for "Health for All by the year 2000". It is hoped that this will facilitate integration of health care into socio-economic development activities; and promote a partnership between people and governments in community health development. PMID- 6495367 TI - Vasopressin supplementation in a porcine model of brain-dead potential organ donors. AB - The use of vasopressin to limit the polyuria of the brain-dead organ donor is a controversial subject. It is held that the associated vasoconstriction may result in ischemic damage to transplantable organs. However, the derangements in the intravascular--and thereby interstitial and intracellular--fluid and electrolyte balances associated with diabetes insipidus may lead to gross fluid shifts in the organ donor. Aggressive resuscitation with crystalloid solutions may aggravate these fluid shifts, contribute to the development of interstitial and intracellular edema, and ultimately result in cardiovascular failure and the rejection of the organs for transplantation. Theoretically, a minute amount of vasopressin is required for the maintenance of normal intravascular fluid and electrolyte balance, and it is best administered as a continuous i.v. infusion. We report on our study of an animal model of a brain-dead organ donor, in which polyuria, hypernatremia, and hyperosmolality developed. The administration of low dose (2-10 microU/kg/min) vasopressin by continuous infusion maintained plasma sodium and osmolality in the normal range over the course of the experiments (24 hr) in the experimental group. Cardiovascular function remained stable in both control and experimental vasopressin-infusion) groups, with the only significant difference being a moderate rise in pulmonary artery pressure. It would appear that early low-dose vasopressin supplementation by continuous i.v. infusion may improve donor management. The maintenance of intravascular homeostasis may contribute to the quality and number of organs for transplantation. PMID- 6495369 TI - Training rural health staff for oral rehydration therapy in southern Sudan. AB - From February 1980 to August 1982 a very definite change occurred in the treatment pattern for diarrhoea among the rural health staff in Torit and Kapoeta districts in Eastern Equatoria Province in Sudan. This paper describes a training and supervision programme for promoting use of ORT in diarrhoeal diseases and at the same time discouraging the use of sulphonamides in simple diarrhoea. In the training programme emphasis is put on increasing the knowledge of the health staff both about the medical facts and about communication with their communities. ORS as treatment for diarrhoea has been well accepted by the public, who consider the sugar/salt solution as "good medicine". The use of sulphonamides for diarrhoea has decreased from 75% to 22% of the diarrhoea cases, while use of ORS has increased from 7% to 72% of the diarrhoea cases. PMID- 6495370 TI - Management of missile injuries in a peripheral hospital. PMID- 6495371 TI - Serious complications associated with uvulectomy performed by a "native doctor". PMID- 6495372 TI - Suprapubic cystostomy: indications and complications. PMID- 6495373 TI - Transtracheal ventilation in anaesthesia for those unable to open the mouth. PMID- 6495374 TI - Ketamine anaesthesia for Caesarean section. PMID- 6495376 TI - Management of singleton breech presentation. PMID- 6495375 TI - Psychiatric illness and the role of religion in a developing country. PMID- 6495377 TI - Screening for cervical cancer in Butha Buthe, Lesotho. A study of Papanicolaou (Pap) smears in a previously unscreened community over a one-year period. AB - The results of 2896 cervical smears taken from 2713 women at the outpatient department of Butha Buthe Government Hospital between January and December 1981 are reported. A high prevalence of mild and moderate dysplasia (18 per 1000) and of frank invasive carcinoma (5.2 per 1000) was found in this previously unscreened population. The rate of carcinoma-in-situ was 2.8 per 1000. The positive results are compared with other studies and analysed according to age and parity. The problems of treating cervical cancer in a Third World country with limited facilities are revealed and a cost/benefit analysis is attempted. Criteria for selecting a risk group are examined. PMID- 6495378 TI - Traditional treatment of pregnancy anaemia in Nigeria. An indication for modern therapeutics. AB - Investigation of 122 women early in the second trimester of pregnancy who complained of constant dizziness during pregnancy, and used traditional "black rings on their middle fingers" as a prophylactic measure, revealed that 59% were anaemic (haemoglobin less than 10 g/100 ml). None of them had blood pressure above 120/70 mmHg. After two months of treatment with ferrous gluconate 300 mg three times daily, folic acid, weekly antimalarial drug, and individual regular nutrition counselling, the incidence of anaemia was reduced to 22.7%. The mean haemoglobin levels before and after initiation of drug therapy were 8.5 and 10.8 g/100 ml respectively. There was a significant difference between the two means (P less than 0.05). There was also a marked difference between the mean haemoglobin levels of ring-wearers and non-ring-wearers in the less educated members of the two groups (P less than 0.001). It can be inferred from this study that the wearing of black rings indicates that the patients are likely to be anaemic, and that educated women seem less likely to rely on this type of traditional treatment of pregnancy anaemia. PMID- 6495379 TI - Congenital renal ectopia in Nigeria. Report on 23 cases. PMID- 6495380 TI - Camel injuries. AB - Camels use their teeth to bite, lift and throw their enemies, their feet to kick, paw or trample over, their whole body to knock over, press and squeeze, and their spit or regurgitated food to cover their perceived adversaries. Camel injuries can be very serious, resulting in fractures and severe lacerations of skin, muscle, tendons and nerves. Deaths have been reported. PMID- 6495381 TI - Changing significance of haemoptysis in the tropics: experience from Benin City, Nigeria. PMID- 6495382 TI - Cleidocranial (sans cleidal) dysostosis. PMID- 6495383 TI - Retrospective long-term study of effects of berenil by follow-up of patients treated since 1965. AB - 99 persons, 67 males and 32 females, who had earlier been diagnosed as having early stage disease of African Trypanosomiasis (AHT) and been treated with berenil were traced and brought to UTRO (Uganda Trypanosomiasis Research Organisation) for examination. These patients had each received 3 doses of berenil 5 mg/kg body weight at one or two day intervals. Each patient had a thorough physical and laboratory examination. All the cases were found in good physical health. The laboratory investigations were all found within normal limits. The period between when the cases were last treated with berenil and this examination varied between 12 months and over 109 months. Although various side effects were seen during treatment, the same were not seen when these cases were re-examined. Berenil is certainly effective in the treatment of early stage AHT though it produces some side effects which are not permanent. Furthermore these side effects are no more serious than the side effects produced by other trypanocidal drugs such as suramin. Berenil should, therefore, be considered as an alternative drug for treatment of early stage AHT. PMID- 6495384 TI - Haemagglutinins and parasite agglutinins in haemolymph and gut of Glossina. AB - Agglutinating activity was found in the haemolymph and in extracts of midgut and hindgut of Glossina austeni against calf, guinea pig and chicken erythrocytes for the first time. Trypanosoma brucei procyclic forms were also agglutinated by midgut and hindgut extracts, but not by haemolymph. The 3 fractions tested failed to react with erythrocytes of four other vertebrates and other trypanosomatids (Leishmania hertigi and Crithidia fasciculata) examined. The reciprocal titre of agglutinating activity of the 3 fractions against calf, guinea pig and chicken erythrocytes were approximately the same at a dilution of 64. Both midgut and hindgut agglutinins showed higher titres against T. brucei at reciprocal dilutions of 128 and 256 respectively. Sialidase treatment, reduced the agglutinating activity to half its normal range while trypsinisation had no effect. The results of attempts to inhibit the agglutinating activity using a variety of sugars and glycoproteins revealed that midgut and hindgut were specific for D+glucosamine suggesting that midgut and hindgut agglutinin were possibly of the same origin. This is the first report of haemagglutinating and parasite agglutinating activity in Glossina tissues which may play a role not only in insect defence reactions but also in the determination of parasite establishment and infection in vectors. PMID- 6495385 TI - Onchocerciasis in Venezuela: prevalence of microfilaraemia in Amerindians and morphological characteristics of the microfilariae from the Upper Orinoco Focus. AB - Data are presented on microfilaraemia in 191 Yanomami Amerindians from two areas of Venezuela's Upper Orinoco Basin, where an endemic focus of onchocerciasis has been recently detected. Onchocerca microfilariae were found in the blood of 12.6% of the persons examined. In the village with the higher number of examined individuals (N = 162), the prevalence of microfilaraemia in the age groups covaried with the prevalence of microfilariae in the skin and with the parasite load (mf/mg of skin). A positive correlation was found between age and these three variables. The prevalence of Onchocerca microfilaraemia in the Upper Orinoco focus is high, and may be related to the ability of the strain to invade the blood stream. Morphobiometric characteristics of the Onchocerca microfilariae isolated from human blood are similar to those of O. volvulus fixed in formalin from skin and from the uterus of female O. volvulus worms. All have a very short cephalic space. Comparisons with the entity from the Upper Caura river designated as Microfilaria bolivarensis were also made. It was concluded that there are no valid biometric differences in thick blood smears between microfilaria bolivarensis and microfilaria of O. volvulus from the Upper Orinoco deme. A more striking difference may be in the concentration of microfilariae observed in the blood, which in one case of mf. bolivarensis was more than forty times the highest number recorded for microfilaria O. volvulus in Parima. PMID- 6495386 TI - Effect of diethylcarbamazine on serum-dependent cell-mediated immune reactions to microfilariae in vitro. AB - The effect of diethylcarbamazine citrate (DEC) on serum-dependent cellular adherence and cytotoxicity to sheathed and exsheathed microfilariae of Litomosoides carinii and Brugia pahangi in vitro has been investigated. DEC at 5 micrograms/ml promoted antibody-mediated neutrophil adherence and cytotoxicity with sheathed L. carinii microfilariae. With exsheathed parasites, the drug promoted significantly complement-and antibody-mediated cellular adherence and cytotoxicity. In the case of B. pahangi, antibody-dependent cell-mediated cytotoxicity (ADCC) of neutrophils to sheathed and exsheathed microfilariae were similarly stimulated by DEC. Pre-incubation of microfilariae with DEC promoted the cellular adherence and cytotoxicity whereas pre-incubation of cells had no such effect. DEC stimulated the adherence of eosinophils to both sheathed and exsheathed microfilariae of the two species but the adherence resulted in cytotoxic effect only on the L. carinii microfilariae. DEC at higher concentrations (100 or 500 micrograms/ml) inhibits these processes. Data on the role of different serum factors involved in this phenomenon have been presented and discussed. PMID- 6495387 TI - Genetic selection for tolerance to niclosamide and copper in Biomphalara glabrata (Mollusca: Pulmonata). AB - Successive generations of the PR-79 and M-line laboratory stocks of Biomphalaria glabrata were exposed in the LC90 of niclosamide or copper sulfate. Survivors from each generation produced the succeeding generation by self fertilization. The PR-79 stock showed no evidence of tolerance to either molluscicide following five generations of selection. On the other hand, M-line F5 snails demonstrated approximately two-fold higher tolerance to both molluscicides than did non selected M-line snails. PMID- 6495388 TI - Nephrotic syndrome in Zaire. Morphological and aetiological aspects. AB - Morphological and aetiological aspects of 88 renal biopsies for nephrotic syndrome (NS) from Zaire are reported. About 52% were associated with a single or multiple infectious diseases particularly of parasitic origin. Three additional cases were associated with local non infectious conditions including the sickle cell disease and the abuse of mercuric-containing compounds. However, the histopathology was indistinguishable in both "idiopathic" and parasite-associated NS, and showed a wide range of common glomerulopathies. We conclude that the glomerular damage of the majority of NS from this area is probably mediated by nephritogenic immune complexes induced by several parasitic diseases, and would need further immunocytochemical investigations. PMID- 6495389 TI - Are flaviviruses again active in Mali? AB - Using a hemagglutinating yellow fever antigen, a serologic investigation was done on 1237 blood samples collected between 1979 and 1983 in five regions of Mali. The results showed that the percentage of positive reactions (greater than 1:10) was higher in the sera of mothers than in their new borns (24.8 versus 12.4). In young children (6 months to 3 years old) the percentages of positive sera varied between 4.4 and 9.6. The values were much higher for persons between 15 to 70 years (28.3% to 43.7%). The presence of high antibody titers in sera of adults, the occurrence of seroconversion in young children (less than 1:10 to 1:40) are arguments for supposing that yellow fever virus or other flaviviruses were active in Mali in the period of our investigation. PMID- 6495390 TI - [Ultrastructure and behavior of the nucleoli and fibrillar centers during cell differentiation of liver erythroblasts of 12-day-old mouse embryos]. AB - The transformation of nucleolus and its structural components in the main groups of erythroid cells (from pronormoblasts to reticulocytes and dividing ones) has been studied. It is shown that during inactivation of the nucleolus, the granular component is reduced, and the degree of chromatin condensation increases. Enlargement and "naking" of fibrillar centres are also observed. At the stage of basophilic and polychromatophilic erythroblasts, the nucleolus has a mushroom like shape with well developed fibrillar centres, which lie at the border of the nucleolus. Nucleolar RNP components consist predominantly of a fibrillar component and forms "caps" of these mushroom-like structures. Therefore, at this stage "free" fibrillar centres are found on ultrathin sections, if the section plane runs only through the fibrillar centre, or through ring-shaped nucleoli, i.e. the fibrillar centre surrounded by sheet of nucleolar RNP fibrilles, when the mushroom-like nucleolus is cut tangentially. Using serial section technique, small round nucleoli with an extremely weakly developed RNP material or free fibrillar centres, resembling those in telophase nuclei, are shown on the terminal stage of nucleolus transformation. It is noted that the main groups of erythroid cells differ from each other not only in the chromatin condensation degree, but also in the development of nucleolus material and in the size of fibrillar centres. However, such differences exist in either cell group. Consequently, we can distinguish between cell populations being on different stages of maturation. On this basis, we described on intermediate population of cells, which possess signs of pronormoblasts and basophilic erythroblasts. In all the cases, strands of electron opaque material bound with the condensed chromatin are present in fibrillar centres.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6495391 TI - [Effect of avitaminosis A on retinal photoreceptor ultrastructure in adult hens]. AB - A-avitaminosis has been shown to provoke important ultrastructural changes in the external segments of the rods whose membrane disks disorient and disappear. No changes in the external segments of the cones were observed. The ellipsoid and paraboloid of visual cells, both rods and cones, undergo changes. The increase in the number and length of mitochondrial cristae and also the increase in the number of mitochondria themselves is noted in the ellipsoid. In the paraboloid, on the membranes of elements of endoplasmic reticulum, the number of ribosomes increase, and the number of polyribosome complexes increases in the cytoplasm. By means of the colorimetrical method, a decrease in the quantity of vitamin A is shown in the liver and retina of the sick hens. Their feedings on vitamin A provokes a restoration of the ultrastructure of membrane disks of the external segments of the rods. PMID- 6495392 TI - [Ultrastructural organization of the epithelial layers and surface morphological characteristics of cells in adenocarcinomas of the cervix uteri]. AB - The cell interrelations, and cellular attachment to the stroma in normal columnar epithelium and adenocarcinoma of the cervix uteri were examined by transmission and scanning electron microscopy. The application of rapid enzymatic digestion technique allows to visualize the topography of cell membranes, otherwise disguised in ordinary conditions. Four types of disordered epithelial sheets characterized by different apical, lateral and basal cell surface changes are described. Various alterations in morphology of the basement membrane and adjacent conjunctive tissue are associated with the tumor appearance. Marked deviations in cell-stroma contact may lead to the inversion of cell polarity revealed in cervical adenocarcinoma: cellular parts adjoining to stroma acquire characteristic features of the apical pole. PMID- 6495393 TI - [Liposome transport as a model of substance absorption in the small intestine studied by electron microscopic autoradiography and scanning microscopy]. AB - Using electron microscope autoradiography and scanning microscopy, evidence was provided on the space-time character of the transport of enterally introduced liposomes containing 125I-lecitin and 3H-cholesterine. Liposomes underwent degradation on the mucous surface of the epithelial cells, followed by the appearance of monolayer vesicles to be transported to the glycocalix area between the microvilli. This is accompanied with the release of the radioactive trait from liposomes and its transporting to enterocytes. PMID- 6495395 TI - [DNA reduplication cycle during chromosome polytenization in the salivary gland cells of Chironomus thummi larvae. III. The determination of the duration of the DNA synthesis period]. AB - The duration of DNA synthesis in the salivary gland cells of Chironomus thummi larvae of the IV instar was determined by means of autoradiography and cytophotometry. Cells of different levels of ploidy differ in the duration of their DNA synthesis period. The tS of 2(10)c and 2(11)c cells was equal to 17 and 22 hours, respectively. The doubling of DNA content of the chironomid salivary gland cells leads to a 1.3 time increase in the duration of S-phase. PMID- 6495394 TI - [Spectrophotometric study of intact and trypsin-treated erythrocyte membranes using a phthalocyanine dye]. AB - The sorption of vital phthalocyanine dye--Heliogen Blue (HB)--by red cells and their ghosts after trypsin treatment has been studied. The structural alteration in the outer and inner surface of the membrane was detected using the monomer dimer ratio (M/D) deduced from the absorption spectra of the sorbed dye. The trypsin treatment causes the increase in the M/D ratio. It is greater (44%) when both the membrane surfaces are exposed to trypsin (unsealed ghosts), and is only 19% when the whole erythrocytes are treated. The similar alteration (M/D increased by 18%) is obtained for red blood cells stained after incubation in the isotonic buffer solution at 37 degrees C. Recent findings show a good agreement with our previous data on the influence of changes in the membrane surface on the value of the M/D ratio. A possibility of using HB in determination of structural changes of a native membrane is discussed. PMID- 6495396 TI - [Dependence of the entry of NIH 3T3 cells into a period of DNA synthesis on the duration of their preliminary resting state]. AB - Using radioautography and cell fusion technique, we studied cell kinetics and functional properties of NIH 3T3 mouse fibroblasts stimulated to proliferate after being quiescent for 3, 7 and 14 days. The resting state was achieved by cultivating cells in the medium with 0.5% of serum, the stimulation being achieved by replacement of the depleted medium for a fresh one containing 10% of serum. It was found that the longer cells had been kept resting, the longer their prereplicative period lasted after the stimulation, the lesser was the fraction of cells that entered the S-period. Cell-fusion experiments revealed that the ability of the resting nuclei to suppress the onset of DNA synthesis in the nuclei of stimulated cells in heterodikaryons increased as the cells stayed in the resting state before fusion, and that the period of suppression was prolonged. The data are consistent with the idea of cells going into deeper resting states. It may be concluded that the resting cells undergo a gradual development resulting in the changes of their functional properties. PMID- 6495397 TI - [DNA synthesis in the mono- and binuclear cells of regenerating rat liver after x ray irradiation]. AB - The effect of X-irradiation on the dynamics of DNA synthesis during the S-period in bi- and mononucleated of regenerating rat liver was studied autoradiographically and microphotometrically. Rats were treated with X-rays at doses 3.84 X 10(-2), 15.48 X 10(-2), and 30.96 X 10(-2) Kl/kg 23 hours after a partial hepatectomy, and were sacrificed one hour after irradiation. In the control liver the rate of DNA synthesis was the lowest at the beginning of the S period and the highest at the last quarter of this period in both mono- and binucleated cells. The irradiation results in the inhibition of DNA synthesis mainly at the end of the S-period depending on doses employed. This inhibition was the same in bi- and mononucleated cells. In addition, the increase of correlation of the 3H-thymidine incorporation rate and DNA content was found between nuclei of binucleated cells after irradiation. PMID- 6495398 TI - [In vitro culture of the hypothalamic supraoptic nucleus. I. General morphological characteristics]. AB - Kinetics and morphology of supraoptic nuclei (SON) organ culture of newborn rat hypothalamus have been described. Explants of SON were cultured for 7-90 days. Cell migration, growth of neuron sprouts, formation of nerve bundles and growth zone, and mitotic activity were followed. Neurosecretory cells (NSC) differing in size, shape and degree of activity, were identified in addition to other cell elements of SON. The neurosecret was shown to appear at the beginning of the second week of cultivation in large and middle size NSC. In small and old cultures of NSC no neurosecrete was discovered. It was established that NSC complete the terminal differentiation and maintain for a long time their viable and functional activity in vitro. PMID- 6495399 TI - [Calculation of Steel's cell loss factor and cell kinetic parameters for a population with exponential growth of cell number and cell death in the G1 and/or G0 phase with probabilities less than 1]. AB - The method of calculation of the proliferative pool and of the Steel's loss factor was shown to be the same for the exponential growth state with cell death at the G1-phase and/or at the G0-phase with propabilities less than one (the model of F type), and for the exponential growth state model of C type. A method is proposed for calculation of the number of the cell kinetics parameters on the data of percentage of labeled cells cultivated with 3H-thymidine. An unsatisfactory agreement between the exponential growth state model of F type with the interpretation of the experimental of Drewinco e. a. (1978) was shown. A more satisfactory explanation of these data has been offered. PMID- 6495400 TI - [DNA degradation in resting cultured Chinese hamster cells]. AB - A gradual accumulation of the alkali-labile sites in DNA of cultured Chinese hamster cells during "stationary phase ageing" was shown by ultracentrifugation in alkaline sucrose gradients. A possibility is discussed of using the stationary phase mammalian cell cultures as a model for studies of ageing mechanisms. PMID- 6495401 TI - [Use of the method of nucleus sedimentation fractionation for studying the dynamics of cell populations in the regenerating liver]. AB - In different periods after partial hepatectomy (0, 11, 18, 24, 48 and 72 hours) isolated liver cell nuclei were separated according to their sizes using free sedimentation at 1 g in the exponential 0.1-1.0 M concentration gradient of sucrose at 4 degrees C. A sedimentogram of the intact liver cell nuclei displays three peaks corresponding to the nuclei of stromal cells, and diploid and tetraploid nuclei of hepatocytes. At 18 and 24 hours after the operation, but not at 0 or 11 hours, a curve of 3H-thymidine incorporation is represented by three maxima suggesting the influx of hepatocytes of different ploidy in the S-period. Then, 48 and 72 hours after the partial hepatectomy two additional peaks appear corresponding to 8- and 16-ploid nuclei, and a decrease in the portion of diploid nuclei is seen up to the full absence of the corresponding peak. Thus, the method of sedimentation at unit gravity of isolated nuclei using radioisotope labeling allows to obtain the information on the structure of the heterogeneous proliferating cell population. PMID- 6495402 TI - [Relation between the optimum pH of protein immobilization and its isoelectric points]. AB - Data available in literature concerning pH-dependence of immobilization of certain proteins are analyzed. A conclusion is drawn that an optimal pH of the enzyme binding with the matrix surface is determined by properties of the enzymes themselves rather than by the matrix origin. Linear dependence between the pH optimum of immobilization and the value of their isoelectric points is shown on 19 proteins. PMID- 6495403 TI - [The effect of 3',5'-AMP-dependent protein kinase on the release of cathepsin B from lysosomes of rat skeletal muscles and heart under exertion]. AB - Single prolonged physical exercises are found to lower the total and bound activity of cathepsin D in the lysosome fraction and to enhance the nonsedimentary activity of the enzyme the dissolved fraction of the skeletal muscles and heart lysosomes. Systematic physical exercises make higher the ability of 3':5'-AMP-dependent protein kinases to regulate the yield of cathepsin D from lysosomes. PMID- 6495404 TI - [Changes in K+ transport in the liver mitochondria of gophers in hibernation]. AB - Liver mitochondria of awake and hibernating squirrels maintain the same amount of K+ due to a decrease of K+-permeability during hibernation. The rates of DNP stimulated K+-efflux and respiration-dependent K+-influx in mitochondria are diminished during hibernation. A two-fold increasing of K+-content and activation of K+-transport are observed at the arousing. Variations of K+-transport in mitochondria correspond to the changes in the channel-formed activity of K+ transporting protein isolated from the liver of this animals. This activity is maximal during arousal and is least during hibernation. PMID- 6495405 TI - [The degree of iodination and sulfhydryl group level in the thyroglobulin molecule]. AB - A decrease in a degree of thyroglobulin iodination under thyroid pathology does not affect the content of SH-groups in albumin. The obtained experimental data permit supposing the existence of conformation changes in a thyroglobulin molecule under the iodine deficiency. PMID- 6495406 TI - [The effect of growth marker proteins on the ionic permeability of rabbit liver mitochondria]. AB - The growth marker proteins from blood serum of new-born rabbits and G-myeloma bearing people were studied for their effect on ionic permeability of rabbit liver mitochondria. The proteins under study induce an increase in nonspecific ionic permeability and swelling of mitochondria. Thiol compounds, in particular CoA8H (in small concentrations) neutralize the effect of growth marker proteins on the bioenergetic characteristics of mitochondria and lower considerably the protein-induced nonspecific ionic permeability. PMID- 6495407 TI - [Ca2+ release from rat liver mitochondria subjected to deep freezing]. AB - Freezing-thawing of rat liver mitochondria evokes a release of Ca2+ into the incubation medium containing oxidation substrates: succinate and phosphate. The release is accompanied by a decrease in the membrane potential value. ATPase and NADH-dehydrogenase inhibitors when introduced into the medium simultaneously with mitochondria prevent the both processes, but only till Ca2+ release. ADP added during Ca2+ release, initiates its uptake. When succinate is replaced by NAD dependent substrates (malate in combination with glutamate) and in the presence of the antioxidant (ionol) Ca2+ is not released from mitochondria. It is supposed that Ca2+ release from mitochondria due to freezing-thawing is evoked by activation of lipid peroxidation and is controlled by the degree of pyridine nucleotide reduction. PMID- 6495409 TI - [Acute iron poisoning in children]. PMID- 6495408 TI - [Immunity to tetanus among the 25 to 30-year-old population]. PMID- 6495410 TI - [Conservative treatment of ileus caused by adhesions, with a Miller-Abbott tube. A retrospective study]. PMID- 6495411 TI - [Congenital pseudoarthrosis of the clavicle]. PMID- 6495412 TI - [Intercostal blockade with morphine chloride in multiple rib fractures]. PMID- 6495413 TI - [Acute omental infection]. PMID- 6495414 TI - [Primary aortoenteric fistula of the 3d portion of the duodenum]. PMID- 6495415 TI - [Cytologic screening in pregnancy]. PMID- 6495416 TI - [Barbiturate poisoning cases in the poison control center in 1980]. PMID- 6495417 TI - [Encopresis, a symptom of multifactor etiology]. PMID- 6495418 TI - [Serum digoxin and mobilization]. PMID- 6495419 TI - [Should simple-to-moderate hypertension in the aged be treated?]. PMID- 6495420 TI - [Encephalopathy in printers in the flexoprinting industry]. PMID- 6495421 TI - [Chronic toxic encephalopathy following occupational exposure to organic solvents. The course after cessation of exposure illustrated by a neurophysiological follow-up study]. PMID- 6495422 TI - [Poisoning by organic solvents in a group of serigraphic workers in the plastic industry]. PMID- 6495423 TI - Methods for specimen thickness determination in electron microscopy. AB - A new method is described for specimen thickness determination in transmission electron microscopy. This is carried out by marking specimens with gold particles and analysing the images of a tilt series by computer. The method makes it possible to distinguish populations of particles on different planes and calculate the distance between the planes with statistical variation. We have applied it to carbon films as test objects and compared the results with those obtained by transverse sectioning, STEM mass measurement, optical density and frequency change of a quartz crystal oscillator. We have then used the method for thickness measurement of multilayered protein crystals and thin sectioned cells. PMID- 6495424 TI - Inexact three-dimensional reconstruction of a biological macromolecule from a restricted number of projections. AB - A computer-generated three-dimensional model of Lumbricus terrestris hemoglobin has been obtained by reconstruction from four STEM low-dose computer-averaged micrographs. X-ray projections of a wooden model constructed from the calculated two-dimensional sections through the molecule were generally consistent with the original STEM projections of the hemoglobin and suggest the presence of large gaps between the central regions of adjacent 1/12th subunits of opposite tiers. PMID- 6495425 TI - Preparation of frozen-hydrated specimens for high resolution electron microscopy. AB - A method is presented for preserving the high resolution structure of biological membranes in a frozen-hydrated environment for electron microscopy. The technique consists of sandwiching a specimen between two carbon films and then waiting while some of the solvent evaporates. When the solvent layer is judged to be of an appropriate thickness, the specimen is then frozen in liquid nitrogen. The specimen can then be inserted into the precooled stage of an electron microscope. Electron diffraction studies of the purple membrane of Halobacterium halobium recorded at -120 degrees C have shown that the structure can be preserved to a resolution of 3.5 A. The main advantage of this method over previous techniques is that the hydrating conditions can be accurately controlled. PMID- 6495427 TI - A crystalline test specimen for checking the performance of high-resolution electron microscopes. AB - A thin single crystal (001) film of gold with a favourable perforation is described. Examples of its versatile applications to test procedures and calibrations in high-resolution electron microscopy are illustrated. The advantage of such gold films mainly results from the good visibility of dark field/bright-field image displacements at perforation edges in well defined crystallographic orientations. PMID- 6495426 TI - An HVEM for high resolution low-dose studies of biomacromolecules. AB - A 1 MeV EM-7 TEM has been modified to investigate the possibility that low-dose studies of biomacromolecular crystals might be more effectively carried out in an HVEM. The modifications include a TV viewing system, a deflection-type minimum exposure system, a side-entry, -150 degrees C transfer cold-stage and improvement of the working resolution to 0.2 nm. The advantages of HVEM for this type of study include a possible reduction in radiation damage rate, greater depth of focus on tilted specimens, broader instrumental contrast transfer function and a reduction in dynamical effects on thicker samples. Disadvantages and possible solutions to them are also discussed. Preliminary results on radiation damage in catalase at 400, 600 and 800 kV and images of catalase and squaric acid are included. PMID- 6495428 TI - [Differential diagnostic aspects of posttraumatic shoulder pain]. PMID- 6495429 TI - [Osteosynthesis of calcaneus impression fractures. Indication, technic and results in 120 cases]. PMID- 6495430 TI - [New aspects of secondary fracture healing during intramedullary nailing. Biomechanical analysis]. PMID- 6495431 TI - [Ambulatory operation of fresh ruptures of lateral ligaments of the ankle joint]. PMID- 6495432 TI - [Reaction of bones to silicone rubber implants. Results of histology, microradiography and polychrome sequence labeling]. PMID- 6495433 TI - [Acute respiratory distress syndrome: treatment possibilities]. PMID- 6495434 TI - [Endoprosthesis in the treatment of the radius head following fractures of the radius head in children]. PMID- 6495436 TI - [Treatment of a tibial fracture in recessive epidermolysis bullosa herditaria dystrophica]. PMID- 6495435 TI - [Injury from lifting heavy weights and accident insurance]. PMID- 6495437 TI - [The National Sailing School, St-Pierre-Quiberon (South Britany): its role in sports medicine]. PMID- 6495438 TI - [Medical follow-up of the French Team]. PMID- 6495439 TI - [Study of the heart rate while sailing or windsurfing by ambulatory monitoring]. PMID- 6495440 TI - [Kinesitherapy and preparation for Olympic sailing]. PMID- 6495441 TI - [Evaluation of renal function and preoperative preparation of high-risk patients]. PMID- 6495443 TI - [General observations on statistical tests of hypothesis]. PMID- 6495442 TI - [Potential drug interactions in elderly patients receiving home care]. PMID- 6495444 TI - [Corticoadrenal insufficiency (Addison's disease)]. PMID- 6495445 TI - Possibilities for an extended classification of bladder cancer. AB - Patients with bladder cancer were evaluated for T-class, histo-pathological grade and U-CEA (urinary carcinoembryonic antigen) before treatment and the cytological picture 4 months after treatment. Previous work has shown that these variables are not significantly intercorrelated. Scores were computed, consisting of the sums of these (dichotomized) variables. In a statistical analysis with the life table technique, the scored variables have been log-rank tested for a prognostic trend. In 155 patients, p for symptom-free survival between subgroups with low and high scores was 0.0019 and for relative survival 0.0005. This implies that a combination of variables may have predictive value in bladder cancer. PMID- 6495446 TI - Changes in bladder volumes with repetition of water cystometry. AB - Fifty-six patients were investigated by repetitive cystometry in the supine or sitting position. The incidence of detrusor hyperreflexia and the circumstances under which it was found did not differ from previous studies. The cystometry data concerning volumes showed a remarkable degree of variability. Values for first sensation and maximal capacity could vary more than 500%. An increment from the first cystometry to the fourth was consistently found. The increments were most pronounced when cystometry with fast filling followed cystometry with medium filling regardless of the patient's position. The major factor in the changes is considered to be the patient's adaptation to the investigational situation. This finding might have major significance in the evaluation of drug studies where repeated cystometries with different time intervals are used. PMID- 6495447 TI - Detrusor activity at rest in patients with idiopathic detrusor hyperreflexia. AB - The detrusor activity of the bladder at rest was investigated in the supine position for one hour following instillation of 100 cc of saline in 8 patients with idiopathic hyperreflexia. During the investigation, 5 patients showed bladder hyperreflexia. In 4 cases the activity was accompanied by an increase in the anal sphincter activity, while 1 case showed decreasing sphincteric activity prior to contractions. An analysis of the distribution of the contractions revealed a predominant frequency. The frequency and the amplitude of the detrusor contractions were independent of the bladder volume. Low provocation prolonged cystometry might be a future method of studying bladder activity and bladder pharmacology. PMID- 6495448 TI - Tamm-Horsfall mucoprotein promotes calcium phosphate crystal formation in whole urine: quantitative studies. AB - Fresh samples of human urine adjusted to pH 6.8 were rapidly evaporated at 37 degrees C to 1,250 mosmol/kg. The calcium phosphate precipitated was washed and the calcium measured by flame atomic absorption spectrophotometer. This procedure was found to be reasonably reproducible. When macromolecules were first removed by ultrafiltration the precipitated calcium was reduced by 76.9%. Addition of human Tamm-Horsfall mucoprotein (T-H) to the urine ultrafiltrates prior to evaporation largely but not completely restored the precipitated calcium. Clumping of crystals was studied quantitatively by passage through a nylon mesh. Mean retention on the mesh was strikingly reduced after ultrafiltration and increased by addition of T-H to the ultrafiltrates. These findings support the view that T-H triggers calcium phosphate crystal formation and clumping in whole urine. PMID- 6495449 TI - A study of the ultrastructure of urinary calculi by scanning electron microscopy. AB - A study of urinary stones obtained from patients after surgery in the Medical College Hospital, Trivandrum, under the scanning electron microscope showed the presence of calcium oxalate and calcium biphosphate crystals as the main constituents. However, the pattern of the different phases of crystal growth was not uniform. Within the crystal lattice, fibrous structures, possibly of protein matrix, were invariably observed. Electron microscopy may be usefully adapted as a particularly suitable method for ultramicroscopic investigation of the fine structure of urinary stones including single crystal surface structure, section of urinary calculi and for possible presence of hitherto unknown components within the calculus. PMID- 6495450 TI - Surgical management of benign renal cysts causing obstruction of renal pelvis. AB - During the last fifteen years, 6 adult patients were treated in whom obstruction of the ureteropelvic junction or the renal pelvis was caused by a benign renal cyst. The cyst extended from the renal hilus in each case and had turgor sufficient to overcome the pressure of intrapelvic urine. Operative unroofing of the cyst relieved the obstruction in each. In 5 of 6 cases, the postoperative radiographic appearance of the kidney showed marked improvement. Each patient was followed for at least five years, and no recurrence of the obstruction was noted. Operative treatment is recommended when a renal cyst causes significant obstruction of the major calyceal or renal pelvic outflow. PMID- 6495451 TI - Bladder exstrophy: penile lengthening procedure. AB - A review of bladder exstrophy experience at our institution was undertaken with reference to penile adequacy and intersymphyseal distance. Drift of the symphysis apart even with iliac osteotomy was noted to occur within two years of initial closure but remained stable after three years. This drift can be prevented if the sacral tuberous and sacral spinous ligaments are sectioned. Further, the adequacy of the phallus seems to depend directly on the intersymphyseal distance. Thus, we suggest a variation in the staged approach to bladder exstrophy repair with these facts in mind. PMID- 6495452 TI - Testicular needle biopsy in diagnosis of infertility. AB - Testicular needle biopsies were performed on 10 patients who at the same time underwent open testicular biopsy. The tracts and puncture sites were explored on each of these patients, and an open biopsy was obtained at the puncture site simultaneously. Both needle specimen and open tissue specimen were fixed in Bouin solution and sent for histologic examination. In none of the cases was there found to be bleeding or extrusion of the testis at the puncture site. In one of the needle specimens, however, insufficient tissue was obtained for diagnosis. In the other 19 specimens, diagnostic accuracy was not compromised by the technique. The main differences appear to be fewer tubules obtained by the needle technique as well as decreased preservation of the interstitial tissue. This is a rapid, simple, and inexpensive method for testes biopsy which has proved to be both safe and diagnostically accurate. PMID- 6495453 TI - Occupation and urinary tract stone disease. AB - Certain occupations have a high incidence of urinary tract stone disease and in view of the potential nephrotoxic effects of metals and the heavy industry in the Glasgow area, a review of occupations of patients attending our stone clinic was done to discover if patients had been exposed to hot-metal processes. Sixty-three per cent of male patients had been exposed to hot-metal fumes for periods ranging from one to fifty years. A random population of asymptomatic stone formers discovered on epidemiologic screening showed that only 26 per cent of these patients could have had exposure to hot metals. Certain epidemiologic aspects of stone disease are reviewed. Little work has been done on occupational aspects of stone disease, and there is scope for further investigation in this area. PMID- 6495454 TI - Surgical correction of rectoprostatic fistula. AB - A rectoprostatic fistula is a rare complication of prostatic operations, and the literature on the subject is scanty. Three men were treated for rectoprostatic fistulas representing complications of prostatic surgery. Mason's transsphincteric transrectal operation resulted in prompt, primary healing of the fistula. Subsequent colostomy closure left all 3 patients with normal urinary and fecal control. A systematic three-step sequence of operation is advocated for the treatment of rectoprostatic fistulas. The Mason technique provides excellent exposure and reliable closure of rectourinary fistulas. PMID- 6495455 TI - In vitro growth of renal cell carcinoma after preoperative renal infarction. AB - Renal cell carcinoma tissue was cultured from 2 patients who underwent embolization of the tumor before surgery and from 2 patients who did not have the tumor embolized. A combination of small Gelfoam particles and polyvinyl alcohol foam particles (250-590 mu diameter) was used to devascularize maximally the tumors that were embolized. The tumor cells from all 4 patients grew in short term tissue cultures and demonstrated histology and growth properties characteristic of tumor cells. Successful embolization of renal cell carcinomas may not completely infarct the primary tumor, and local tumor growth may continue. PMID- 6495456 TI - Impotence in diabetics: organic versus psychogenic factors. AB - Four types of impotence were diagnosed in 75 consecutive impotent diabetic patients: chronic persistent organic type due to vascular and/or neurologic factors (44%), temporary organic types due to medical illness other than diabetes (10.6%) or uncontrolled metabolic state (6.6%), and psychogenic impotence (38.6%). Despite higher incidence of organic etiology (61.3%) the incidence of psychogenic impotence was significant. None of the methods used to diagnose the type of impotence in the present study proved 100 per cent accurate, and we advise a combination of history-taking including the wife's history, physical examination including vascular and neurologic tests, nocturnal penile tumescence studies, and therapeutic trials with sex therapy to differentiate between true organic, temporary organic, and psychogenic types of impotence in diabetic patients. This differentiation is mandatory since the latter two types may have a better prognosis. PMID- 6495457 TI - Ifosfamide: chemotherapy with new promise and new problems for the urologist. AB - Ifosfamide, a chemotherapeutic agent, offers new hope as well as new problems for the uro-oncologist. The "good news" is that this drug is achieving marked benefits in treating resistant testis tumors and may even hold hope for patients with renal cell carcinoma. The "bad news" is that a price must be paid in toxicity--predominantly a severe and restrictive hemorrhagic cystitis. A breakthrough is the finding that oral administration of acetylcysteine (Mucomyst) may, to a large extent, prevent this untoward side effect. PMID- 6495458 TI - Artificial perfusion in impotence. AB - The physiology of normal erection is contrasted to that induced by artificial perfusion. The diagnostic value of the procedure is limited. Perfusion may be useful in monitoring the effect of drugs instilled into the penis or in choice of procedure. PMID- 6495459 TI - Comparison of histologic and flow cytometric evaluation of cyclophosphamide induced testicular damage. AB - This study evaluates the ability of DNA histograms obtained by flow cytometry to detect and quantify reversible alterations in spermatogenesis induced by cyclophosphamide, a known inhibitor of spermatogenesis. Evaluation of per cent of cells in each of the haploid (lc), diploid (2c), and tetraploid peaks (4c) as determined by flow cytometry in treated and control Balb/C mice over a six-week period, and comparison with routine histologic evaluation have led us to conclude that DNA histogram evaluation is a rapid and accurate means of identifying testicular damage and recovery. This technique may be useful in sequential monitoring of the effects of malignancy and/or treatments applied on spermatogenesis in young men. PMID- 6495460 TI - Testicle transposition in children who undergo low-pelvic or scrotal irradiation. PMID- 6495461 TI - New steerable catheter for use in percutaneous nephrolithotomy. PMID- 6495462 TI - Window operation: new technique for hydrocele. PMID- 6495463 TI - Congenital renal arteriovenous fistula (cirsoid aneurysm). AB - "Cirsoid aneurysm" represents the pathologic substratum of congenital arteriovenous fistula. Congenital renal arteriovenous fistulas are rare clinicopathologic entities usually first manifested by hematuria. Recently, several studies of this malformation have been reported, but few have made reference to the pathologic findings. We report 2 cases of this lesion made up of arteries, veins, and nondeterminated vessels localized between calyceal or pelvic wall and renal parenchyma. In addition, both cases showed signs of both old and recent hemorrhages, explaining the upper tract bleeding. PMID- 6495464 TI - Urethral verumontanal polyp: evidence of prostatic origin. AB - A papillary adenomatous polyp of the verumontanum was studied morphologically and immunochemically. This rare polypoid neoplasm displayed rather typical prostatic acinar epithelium, and by immunoperoxidase method differentiation products of prostatic origin could be demonstrated easily. Findings support the concept that this type of lesion is prostatic in origin and probably arising from ectopic prostatic tissue in the prostatic urethra. The clinical symptoms of this lesion usually are hematospermia or hematuria, and this lesion can be effectively treated by transurethral excision. PMID- 6495465 TI - Case profile: bilateral pelvic ectopic kidneys. PMID- 6495466 TI - Tunnelled renal stone. PMID- 6495467 TI - Theory of propagation of peristaltic waves along ureter and their simulation in electronic model. AB - Various aspects of the propagation of peristaltic waves along the ureter, in particular the effect of the duration of the interperistaltic intervals on the propagation velocity of these waves and on the electromyographic response, are explained on the assumption that local tissue refractoriness is the underlying cause of these effects. The concept of local reaction time being determined by the slope of the local myogenic stimulus pulse is also introduced. An electronic model of the propagation process is described. The operation of this model suggests that a gradient in refractory period along the ureter is responsible for stopping the peristaltic waves. It is further concluded that the minimum interstimulus interval at which terminating peristaltic waves are generated is a measure of the local conductivity of the ureter. PMID- 6495468 TI - The diaphragm: an accomplice in recurrent UTI. PMID- 6495469 TI - Radical excision of adenocarcinoma of prostate with pelvic lymph node involvement: surgical gesture or curative procedure. AB - From 1967 to 1981, 100 patients with carcinoma of the prostate and positive lymph node involvement underwent pelvic lymphadenectomy and radical retropubic prostatectomy. At surgery, adjuvant treatment consisted of none in 52, orchiectomy in 37, and other (radiation and/or diethylstilbestrol) in 11 subjects. Of all the variables assessed (tumor bulk, grade, seminal vesicle involvement, number of positive nodes, and adjuvant treatment), only the number of positive nodes was found to affect survival and progression when no adjuvant treatment was given. Progression was significantly limited by orchiectomy, which had an equalizing effect on all patients with positive nodes, possibly independent of the number of positive nodes. PMID- 6495470 TI - Cardiorenal failure: treatment of refractory biventricular failure by peritoneal dialysis. AB - Fifteen patients with New York Heart Association Class IV functional cardiac disability whose mild-to-moderately severe renal failure had produced life threatening fluid overload underwent dialytic therapy. Ten were dialyzed by the peritoneal route initially and five were switched from hemodialysis to peritoneal dialysis because of hemodynamic instability. All patients improved, resulting in renewed responsiveness to more conservative measures (2), stabilization for cardiac surgery (4), or less-restricted lifestyle out of hospital (9). We recommend consideration of peritoneal dialysis when biventricular and renal failure are refractory to conventional therapy. PMID- 6495471 TI - Hemodialysis neutropenia and dialyzer reuse: role of the cleansing agent. AB - As part of a study to evaluate the safety and efficacy of dialyzer reuse, a comparative study of two methods of dialyzer reprocessing, manual and automated, was conducted. Five stable end-stage renal disease patients on center hemodialysis were evaluated as to hematological and metabolic parameters throughout two series of three consecutive dialyses using first new and then reused dialyzers reprocessed according to each of the two methods. New dialyzers and reused dialyzers following automated reprocessing always induced a profound fall in circulating neutrophil counts shortly after the start of dialysis. Hemodialysis neutropenia was not observed, however, with reused dialyzers reprocessed manually unless the concentration of sodium hypochlorite (bleach) employed was made equal to that required in automated reprocessing by being raised from 1.0 to 4.3%. It would be reasonable to conclude from these results that among the various differences between the two dialyzer reprocessing methods, restoration of the original level of biocompatibility of the reused dialyzer's membrane is related to the concentration of the cleansing agent. PMID- 6495472 TI - Membrane cascade plasmapheresis: theoretical analysis and in vitro studies. AB - As the donor plasma required in plasmapheresis therapy is not only expensive but may also cause side effects and transfer of infections, attempt was made in the present work to generate continuously autologous purified plasma. A membrane cascade plasmapheresis (MCP) system was developed which: 1. Separates plasma from blood using a membrane plasma separator 2. Fractionates this plasma into two fractions using a secondary filter, one fraction rich in albumin and the other rich in immunoglobulins 3. Returns to the patient filtered blood combined with albumin-rich plasma fraction Ringer solution was used to compensate for the loss of plasma volume rejected as immunoglobulins. The main problem is to maximize the clearance of IgG and recovery of albumin. Theoretical analysis of the system shows that the clearance of IgG increases with the increase in Ringer solution flow rate. However, this increase in clearance of IgG is accompanied by a decrease in albumin recovery. Theoretical analysis presents a relationship between the clearance of protein as a function of their sieving coefficients of the secondary filter, plasma separation rate, and the priming volume. In vitro evaluation of the system using patient's plasma and a Kuraray 2A filter (secondary filter) show that the relative clearances of IgG and albumin lie in the range of 65-70% and 40-45%, respectively. Further improvement in the selectivity of the secondary filter is necessary to minimize the clearance of albumin and to increase the clearance of IgG. PMID- 6495473 TI - Individualized dialysis for CAPD patients: a review of the experience at the University of Missouri. AB - The efficiency of continuous ambulatory peritoneal dialysis (CAPD) depends on dialysate flow rate or daily drainage volume. With an increase in the volume of an exchange, the number of exchanges can be diminished while retaining the efficiency of dialysis. A great variation among patients in metabolic generation rate, residual renal function, intraperitoneal volume tolerance, and peritoneal mass transfer necessitates an individualization of dialysis schedule. Changes in serum urea and creatinine concentrations combined with clinical assessment are usually sufficient guides for the prescription of dialysate flow rate to achieve adequate dialysis. Only if the reason of underdialysis is not apparent, the evaluation of peritoneal dialysis kinetics may be needed for optimized treatment. PMID- 6495474 TI - Further discussions on the representation of hemodialyzer performance. AB - To express the solute-removing capacity of a dialyzer, two diagrams are used in combination: one to represent the relation between the mass transfer coefficient and the solute molecular weight (M), and the other between the extraction ratio and the number of mass transfer units. It is shown that membrane permeation properties can be deduced from the first diagram, a limiting factor of removal can be understood from the second diagram, both can be used to compare performances with different blood or dialysate flow rate (QB or QD) or membrane area, and this method of representing dialyzer performance is more informative than the conventional ones in which dialysance (DB) is plotted against QB or M. Discussion is also given on the conditions under which the relation between DB and log M, or log DB and log M, becomes linear. Numerical evaluation of DB/QB for cross-flow geometry is presented in the Appendix. PMID- 6495475 TI - [Function of the other eye in patients with an acute attack of primary glaucoma]. PMID- 6495477 TI - [Effect of Tenon's capsule on the formation and functioning of a postoperative fistula]. PMID- 6495476 TI - [A new gonioscopic test in the differential diagnosis of functional and organic blockage of the anterior chamber angle]. PMID- 6495478 TI - [Postoperative changes in glaucomatous excavation of the optic disk in young people]. PMID- 6495479 TI - [Experience in examining the relatives of glaucoma probands]. PMID- 6495480 TI - [Morphological analysis of the reasons for enucleating the eye following cataract extraction with intraocular lens implantation]. PMID- 6495481 TI - [Correction of high myopia with an extrapupillary iris lens (preliminary report)]. PMID- 6495482 TI - [Choice of the optimal type of corneal incision in cataract extraction]. PMID- 6495483 TI - [Surgical characteristics of retinal detachment in patients with aphakia of various etiologies]. PMID- 6495485 TI - [Method of restoring binocular vision using colored light filters]. PMID- 6495484 TI - [Use of an alternating magnetic field in the combined treatment of acute keratoconus]. PMID- 6495486 TI - [Birdshot chorioretinopathy--a new clinical syndrome]. PMID- 6495487 TI - [Experimental study of intraocular collagen-based medicated films with dexamethasone and kanamycin]. PMID- 6495488 TI - [Nuclear gamma resonance method in studying eyeball pulsations]. PMID- 6495489 TI - [Chromatic ERG for assessing retinal function in traumatic hemorrhages into the vitreous body]. PMID- 6495490 TI - [Intraocular foreign body of an artiphakic eye]. PMID- 6495491 TI - [Malignant glaucoma]. PMID- 6495492 TI - [Characteristics of the residual hearing in sensorineural deafness]. PMID- 6495493 TI - [Otoneurological examination of patients with acute sensorineural deafness]. PMID- 6495494 TI - [Possibilities for the acoustic correction of the frequency characteristics of hearing aids in auditory prosthesis]. PMID- 6495495 TI - [Comparative audiological and electroencephalographic tests for the early diagnosis of hearing disorders in epidemic parotitis in children]. PMID- 6495496 TI - [Importance of determining echinocytosis in the early diagnosis of laryngeal and pharyngeal neoplasms]. PMID- 6495497 TI - [Indices of nonspecific resistance in laryngeal cancer patients in the late period after combined treatment]. PMID- 6495498 TI - [Catamnestic and dispensary examination of children with acute laryngotracheitis]. PMID- 6495499 TI - [Clinical aspects, diagnosis and treatment of chronic maxillary sinusitis in patients with chronic nonspecific suppurative lung diseases]. PMID- 6495500 TI - [Characteristics of the teaching of otorhinolaryngology to medical students from developing countries]. PMID- 6495501 TI - [Acute frontoethmoiditis complicated by osteomyelitis of the frontal bone and subperiosteal and extradural abscess of the anterior cranial fossa]. PMID- 6495502 TI - [Variant operation in cicatricial laryngostenosis]. PMID- 6495504 TI - [Cementoma of the frontal sinus]. PMID- 6495503 TI - [Petrositis complicated by cavernous sinus thrombosis]. PMID- 6495505 TI - [Audiological characteristics of Meniere's disease based on recording data on brain stem-evoked auditory potentials]. PMID- 6495506 TI - [Traumatic shock in multiple fractures of bones of the limbs in children]. AB - An analysis of 11230 case histories of children aged to 15 who had fractures of the extremity bones has shown multiple fractures of the extremity bones in 3% of the patients. It was established that traumatic shock in children with multiple fractures of the extremities was diagnosed in 14,1% (I degree--in 51%, II--in 42,6% and III--in 6,4%). The article concerns the incidence and severity of shock in children of different age groups as well as fractures of bones of various character and localization. PMID- 6495507 TI - [Etiology of diseases of the hip joint in children]. AB - The rentgenometric examination of the hip joint in 165 children with a high degree of reliability of the coxitis syndrome has revealed a displastic nature of the disease in 49,5% of them. It was mainly due to non-correct orientation of the proximal end of the femur. The overstrain of such joint causes its functional incompetence, pain, restricted functioning and lameness. The investigation performed enabled the author to establish the etiology of the disease, to assess the degree of maldevelopment of the hip joint and to find new ways of pathogenetic therapy. PMID- 6495508 TI - [Chyloperitoneum in children]. PMID- 6495509 TI - [Rare complication of pneumoirrigoscopy]. PMID- 6495510 TI - [Use of fibrinogen in hemorrhages in surgical practice]. AB - Fibrinogen was used in 62 out of 380 patients with chronic hemorrhages. A conclusion is made that when choosing the dosage of fibrinogen it is necessary to take into account its content in other injected hemostatic drugs. The authors emphasize the danger of thromboses resulting from the unjustified use of fibrinogen. PMID- 6495511 TI - [Hemodynamic reactions to autologous blood transfusion in patients with heart defects and active bacterial endocarditis]. AB - An analysis of changes of indices of integral rheography and blood composition in 34 patients before and after exfusion of 450-600 ml of blood has shown the safety of preparing such doses of autoblood for the substitution of blood loss 4-5 days before cardiosurgical operations. PMID- 6495513 TI - [Method of diagnosing closed injuries of tubular abdominal organs]. PMID- 6495512 TI - [Early detection and treatment of diseases of the arteries of the legs in patients with diabetes mellitus under ambulatory conditions]. AB - The paper describes the 5-year experience with prophylactic examinations of 1700 patients suffering from diabetes mellitus. In 405 out of them (23,8%) abnormalities of the lower extremity vessels were detected. The prophylactic examinations of patients with diabetes mellitus are believed by the authors to facilitate diagnosis of early stages of diseases of the lower extremity peripheral vessels and thereby to improve perspectives of treatment. PMID- 6495514 TI - [Lymphohemosorption--a new method of detoxication]. PMID- 6495515 TI - [Diagnosis and treatment of incarcerated diaphragmatic hernias]. AB - Observations of 17 patients with incarcerated hernias are presented. The authors describe their peculiar clinical picture, diagnosis and treatment. They recommend to make timely rentgenological examinations, the contrast substance being administered either orally or by enema. PMID- 6495516 TI - [Immediate results of segmental pneumonectomy in bronchiectasis]. AB - An analysis of case histories of 225 patients with bronchiectasis subjected to lung resections of various volume has shown high efficiency of isolated and associated resection of the basal pyramid with an intact apical segment. The apical segment remaining intact gives positive effects on the rearrangement of the architectonics of the bronchial tree preventing a considerable displacement of the remaining bronchi. The postoperative period in the patients who had an additional treatment of the wound surface of the sixth segment was more favorable as compared with the patients with open wounds. PMID- 6495517 TI - [Various progressive and conservative trends in the treatment of fractures]. PMID- 6495518 TI - [Clinical classification of acute peritonitis (on the article by Skobelkin, Korepanov and Brekhov, "Various disputable problems of etiology, pathogenesis and treatment of diffuse peritonitis")]. PMID- 6495519 TI - [Roentgenomorphological changes in gastric and duodenal stumps after pylorus sparing operations]. AB - Rentgenological examinations of 114 patients subjected to pylorus-preserving resections of 3 types for ulcer disease and benign tumors of the stomach have revealed characteristic alterations of the stump of the stomach, gastro gastroanastomosis, duodenal bulb in different variants of operations. PMID- 6495520 TI - [Effect of the surgical treatment of portal hypertension on central hemodynamics]. AB - The complex investigation of central hemodynamics by methods of sphygmography and tachooscillography was carried out in 98 patients with the syndrome of portal hypertension (59 with cirrhosis of the liver and 39 without cirrhosis) who were subjected to various operations. Central hemodynamics was shown to be normalized by shunting operations especially by proximal splenorenal venous anastomosis in combination with splenectomy. Organ anastomoses in combination with splenectomy are inferior in this respect to vascular anastomoses and ligation of the splenic artery. PMID- 6495521 TI - [Surgical treatment of intrahepatic forms of cholestasis]. AB - Intrahepatic forms of cholestasis were detected in 2,9% of patients operated upon for hepatobiliary pathology. The optimum method of the surgical treatment of cholestatic forms of hepatitis and early stages of liver cirrhosis is considered to be periarterial nephrectomy of the proper hepatic artery in combination with omentohepatodia-phragmopexy which was successfully fulfilled in 50 patients. PMID- 6495522 TI - [Method of long-term retroperitoneal block in acute pancreatitis]. AB - Prolonged retroperitoneal blockades were performed in 20 patients with acute pancreatitis. Positive effects were obtained in 17 patients. The use of prolonged retroperitoneal novocain blockade with the help of a catheter during operation and in the postoperative period facilitated early liquidation of postoperative paresis of the intestine and arrest of acute manifestations of pancreatitis. PMID- 6495523 TI - [Pancreatojejunostomy in chronic pancreatitis]. AB - An analysis of remote results of the treatment of 117 patients with pancreatojejunal anastomoses has shown them to be identical irrespective of the operation technique: good results were obtained in 70,1%, satisfactory-in 23,3%, unsatisfactory in 9,6% of the patients. Pancreatojejunostomy was shown not to prevent malignization of the pancreas and progressing chronic pancreatitis. One of the causes of unsatisfactory results were dyskinesia of the duodenum and duodenostasis. PMID- 6495524 TI - [Surgical tactics in small polyps in patients with polyposis of the large intestine]. AB - Experience with the treatment of patients with multiple polyps of the colon is analyzed. They had large polyps and polyps with the diameter not more than 0,5 cm. The findings of morphological examination of such polyps and results of the dispensary observation of patients with non-ablated small polyps are described. A conclusion is made of the expediency of more active surgical tactics in relation to polyps less than 0,5 cm in diameter in this group of patients. PMID- 6495525 TI - [Results of the surgical treatment of acute thrombosis of the major arteries of the limbs]. AB - An analysis of the surgical treatment of acute arterial trombosis of the extremities in 86 patients is presented. The causes of thrombosis were mainly obliterating atherosclerosis, artery trauma and postembolic occlusion. Best results of reconstructive operations were obtained in patients with postembolic occlusion of the arteries and their posttraumatic trombosis, worst results - in obliterating atherosclerosis. Thrombendarterectomy and autovenous shunts and prostheses were found to be the mos effective reconstructive operations. PMID- 6495526 TI - [Functional and morphological changes in the crural muscles in the post thrombophlebitis syndrome of the lower limbs]. AB - Electromyographic and histologic examinations were used to establish progressing decrease of the function of muscular system of the shin in patients with the postthrombophlebitis syndrome of lower extremities which was a result of morphological alterations in the muscular fibres. PMID- 6495527 TI - [Peripheral circulation in deforming arthrosis]. AB - The examination and treatment of 320 patients with deforming arthrosis have shown the disturbance of the regional peripheral blood circulation on the corresponding extremities as well as the increased coagulating activity of blood. So the author recommends the methods improving the peripheral blood circulation, rheological properties of blood and liquidation of pain (such as novocain blockades, intraarterial injection of medicine, anticoagulating drugs etc.) to be included in the treatment. PMID- 6495528 TI - [Paradoxical embolism]. PMID- 6495529 TI - [Perforation of the intestine by bones]. PMID- 6495530 TI - [Intra-abdominal hemorrhage in uterine fibromyoma]. PMID- 6495531 TI - [Characteristics of surgical interventions on the heart in active infectious endocarditis]. AB - On the basis of the experience with 158 operations for acquired and congenital heart diseases in active infectious endocarditis the author gives a description of specific features of the method and technique of the operative correction of the disease with a simultaneous sanitation of the heart cavity. PMID- 6495532 TI - [Analysis of the causes of the fatal outcome of injuries in traffic accidents and their diagnosis]. AB - The cause of death of victims of traffic accidents is thought to be, as a rule, an associated injury of the skull and brain, locomotor system and inner organs followed by blood loss and shock and complicated by pneumonia and pyo-septic processes. PMID- 6495533 TI - [Treatment of suppurative post-traumatic gonitis]. AB - Results of the treatment of 47 patients with purulent gonites enabled the authors to recommend a method of complex treatment with using microartrotomy, drainage of the anterior and posterior portions of the articulation, prolonged running lavage of the articulation cavity by antiseptics in combination with massive antibiotic and immune therapy and other means of the correction of homeostasis. Near and late results were good. PMID- 6495534 TI - [Successful resuscitation of a patient with injury of the left heart ventricle and massive blood loss]. PMID- 6495535 TI - [Penetrating injury of the abdomen with a metallic tube]. PMID- 6495536 TI - [Postoperative adhesive intestinal obstruction in children]. AB - An analysis of 110 cases is presented. Pathogenesis, diagnosis, policy of treatment and prevention of adhesive intestinal obstruction (AIO) are considered. Progressing peritonitis, underestimation of the operative findings and insufficient intensive therapy are thought to be causes of postoperative AIO. Careful sanitation of the abdominal cavity during operation, refusal of an injection of antibiotics into the abdominal cavity, combination of prolonged peridural analgesia with intensive therapy are recommended to prevent postoperative AIO. Recurrent AIO were noted in 8,1% of the operated patients. PMID- 6495537 TI - [Combined gunshot injury to the organs of the abdominal cavity and retroperitoneal space]. PMID- 6495538 TI - [Rupture of the brachial artery in dislocation of the forearm in a multiple injury victim with shock]. PMID- 6495539 TI - [The cleft sternum]. AB - An analysis of 14 patients with cleft sternum is presented. Eleven patients were operated upon. A classification of this defect is proposed. The clinical picture of each type of cleft sternum is given with a description of the operative technique. There were no lethal outcomes. Remote results were good. PMID- 6495540 TI - [Late results of the surgical treatment of anal atresia with a fistula into the vaginal vestibule]. AB - 60 operations for elimination of atresia of the anus and fistula are reported. A modification of the Stone method is described. Remote results were good in 58 patients. PMID- 6495541 TI - [Basis for the operative approach and the surgical technic in frequently encountered localizations of acute hematogenic osteomyelitis in children]. PMID- 6495542 TI - [Basic principles and important practical details in treating burn patients]. PMID- 6495543 TI - [Apparatus for applying an intestinal anastomosis in children undergoing Swenson's operation]. PMID- 6495544 TI - [Use of foam polyurethane for cleansing purulent cavities and wounds]. PMID- 6495545 TI - [Surgical treatment in peptic ulcer complicated by acute hemorrhage]. AB - Results of the surgical treatment of 168 patients with acute ulcer hemorrhage are analyzed. The main type of operation was gastric resection (87,0%), vagotomy with organ-preserving operations being also used. Total postoperative lethality was 8,3%. PMID- 6495546 TI - [Significance of infection in the development of acute gastric and duodenal ulcers]. AB - The postmortem examination of 79 patients with acute gastric and duodenal ulcers enabled the author to conclude that parallel with other causes infection is of substantial significance in the development of acute ulcers and erosions. PMID- 6495548 TI - [Study of thrombus resistance of materials using the prothrombin consumption test]. AB - The work presents a simple and informative method of the assessment of thromboresistivity of opaque materials by the test of determination of prothrombin consumption in vitro. The average time of prothrombin consumption in the blood after its contact with a glass was 136 +/- 13,3 sec., after the contact with a siliconized glass it was 62 +/- 3,45 sec. which suggests higher thromboresistivity of silicon. The difference of the indices is highly significant (P less than 0,001). A conclusion is made that the method concerned is a reliable one. PMID- 6495547 TI - [Treatment of acute pancreatitis patients with functional liver failure]. AB - Methods of extracorporal detoxication hemo- and lymphosorption, intraportal injection of drugs and oxygenated solutions as well as ultraviolet irradiation of auto-blood are included in the routine scheme of treatment of patients with acute pancreatitis. The treatment concerned was used in 77 patients with acute pancreatitis and advanced hepatic insufficiency and resulted in arresting the latter in 43 of the patients. To prevent the development of acute hepatic insufficiency proved to be possible in 20 patients with a destructive form of acute pancreatitis. The intraportal injection of oxygenated solutions against the background of acute experimental pancreatitis contributed to prevention of hypoxia of the liver. PMID- 6495549 TI - [Treatment of complicated appendicitis]. AB - Metronidazole (trichopol) included in the complex of curative measures in acute appendicitis complicated by local or diffuse peritonitis resulted in a substantially decreased amount of pyo-inflammatory complications after appendectomy and shorter time of staying at the hospital. PMID- 6495550 TI - [The surgeon's procedure in appendicular infiltrates]. AB - The surgeon's tactics in appendicular infiltrate should be chosen following a complete examination of the patient and careful observation. Appendectomy is indicated in loose appendicular infiltrate. Conservative therapy is a method of choice for the treatment of a dense appendicular infiltrate. Periappendicular abscess should be opened and drained. PMID- 6495551 TI - [Strangulated internal hernias of the abdominal cavity]. AB - Analysis of 8 cases with incarcerated hernias has been made. The incarceration of an internal hernia was first shown to simulate other diseases of abdominal organs followed by the development of symptoms of intestinal obstruction. PMID- 6495552 TI - [Kinetics of the resorption of protein products following extensive and subtotal resection of the small intestine]. AB - Under study was the resorption function of the small intestine after resection of 80% of its proximal or distal portion in 59 dogs. It was established that an improved absorption after extensive resection of the small intestine can be achieved by performing a latero-lateral intestinal anastomosis and using an antiperistaltic intestinal segment. The use of a recirculation loop fails to improve the resorption function. PMID- 6495553 TI - [Risk factors for the occurrence of postoperative adhesions]. AB - The investigation of regularities in the appearance and development of postoperative adhesive disease enabled the authors to find out a number of the external and internal factors which are of special significance in the appearance of new cases of the disease. PMID- 6495554 TI - [Prevention and treatment of adhesions]. AB - The pyrogenal therapy was used for the treatment and prophylaxis of the adhesive disease (both the acute and chronic forms). In acute forms parallel with pyrogenal the intraperitoneal administration of a warm 0,25% solution of novokain was used. The method is thought by the author to improve the immediate and late results of the treatment. PMID- 6495555 TI - [Late results of esophagoplasty in cicatricial strictures]. AB - The remote results following the small intestine esophagoplasty in 110 out of 211 patients subjected to the operation are described. The artificial esophagus diseases were found in 24%. Methods for the treatment and prevention of the disease of the artificial esophagus are proposed. PMID- 6495556 TI - [Successful treatment of injury to the esophagus, mediastinal pleura and bronchus by active drainage]. PMID- 6495557 TI - [Transposition of the diaphragm in an operation for a large irreducible diaphragmatic hernia]. PMID- 6495558 TI - [Technic for draining the portal vein via the umbilical vein]. PMID- 6495559 TI - [Anatomy of the bile ducts in cholelithiasis]. PMID- 6495560 TI - [Chylous peritonitis of alimentary etiology]. PMID- 6495561 TI - [Characteristics of the clinical picture and neurological examination in combined craniocerebral injury against a background of shock]. AB - The authors have performed an analysis of the clinical picture of the associated cranio-cerebral trauma accompanied by shock in 181 patients. It has been shown that of the greatest diagnostic significance in the period of shock is the assessment of the patient's consciousness, hemodynamics and respiration, the external symptoms of the injury of the brain and skull, investigation of the eye symptoms, motor disturbances, pathological pyramid symptoms. PMID- 6495562 TI - [Pathogenetic characteristics of cardiogenic shock in closed chest injury with cardiac contusion]. AB - An analysis of clinico-laboratory examinations of 60 patients with a suspected contusion of the heart in an isolated and associated trauma of the chest and experimental investigations on 46 dogs have shown that the closed trauma of the chest with a contusion of the heart is accompanied by disorders of the contractive function of the myocardium and hemodynamics which contributes to the development of cardiogenic shock. PMID- 6495563 TI - [Free-radical oxidation and the hemostatic system in the dynamics of traumatic disease]. AB - Growing hypercoagulation is revealed in patients with a critical mechanical trauma parallel with a pronounced prolonged activation of lipid peroxidation. The disorders in the lipid metabolism and hemostasis system are most pronounced in a complicated course of the trauma disease and its unfavorable outcome. PMID- 6495564 TI - [Closed transosseous osteosynthesis using the Ilizarov method in treating patients with condylar fractures of the femur and crus]. AB - The article is devoted to the application of the method of perosseous osteosynthesis with the Ilizarov apparatus for the treatment of patients with fractures of the femoral and tibial condyles. The analysis of 75 clinical observations is given. Results of the treatment show the efficiency of the method. PMID- 6495565 TI - [Comparative evaluation of different treatment methods in inveterate fracture subluxations of the ankle joint with injury to the tibiofibular syndesmosis]. AB - An analysis of remote results of the treatment of 162 patients has shown apparent advantages of the treatment of long-standing subluxation fractures of the talocrural articulation with injured intertibial syndesmosis by "meeting tractions" and with the help of a compressing device. PMID- 6495567 TI - [Preservation of the limb in a female patient with comminuted gunshot fractures of both shin bones and damage to the anterior and posterior tibial arteries]. PMID- 6495566 TI - [Compression-distraction osteosynthesis in the sequelae of double fractures of the tibia]. PMID- 6495568 TI - Monitoring for swine dysentery: six years' experience with a control scheme. AB - A control scheme for swine dysentery was initiated in Britain by the Pig Health Control Association in January 1978. To qualify, herds must not show clinical signs suggestive of swine dysentery or, if any suspicious signs arise, laboratory tests must be negative for Treponema hyodysenteriae. In addition, a range of pharmaceutical compounds that might mask the disease or its laboratory diagnosis may not be used routinely after weaning, either for treatment or as food additives. Qualifying herds can import pigs only from other qualifying herds or via hysterectomy/hysterotomy or embryo transfer methods; artificial insemination is also permitted. During the first six years, 91 herds qualified at some stage, and at the end of 1983, 56 herds (average size 200 sows) were still listed. By this date, 72 herds had imported stock from 36 other qualifying herds; despite this degree of inter-herd connection, no evidence of swine dysentery has occurred within the scheme since its inception, nor has this disease appeared in herds established entirely from listed herds. It seems, therefore, that freedom from swine dysentery (unlike enzootic pneumonia) can be readily maintained in a controlled group of pig herds identified by these monitoring methods. PMID- 6495569 TI - Pelvic dimensions, bodyweight and parturition in rare breeds of sheep. AB - External pelvic measurements were made in 837 adult ewes of 21 different breeds, the majority of which were rare breeds. The pelvic measurements were the intertuber coxal diameter, the distance between the lateral tuber ischii and medial tuber ischii and the rump length. There was a considerable breed variation with the Soay ewes having the smallest and the Suffolk the largest pelvic dimensions. However when the relationship between pelvic size and ewe's bodyweight was compared, the ratio of the medial tuber ischii:bodyweight and sum of four pelvic dimensions:bodyweight of the Soay was over twice that of the Suffolk ewes. When the size of the pelvis was related to the lamb's birth weight the Soay's was relatively larger. Dystocia caused by feto-maternal disproportion occurred in 19 ewes, all with singletons. In 16 cases involving four different breeds the birth weights of the lambs were significantly larger than those lambs which were born normally. PMID- 6495570 TI - Infection by leptospires of the Pomona serogroup in cattle and pigs in south west England. AB - Leptospires belonging to the Pomona serogroup were isolated from calves involved in two outbreaks of acute haemolytic disease which were characterised by jaundice, haemoglobinuria and high death rates. Retrospective case studies in which serological evidence of Pomona serogroup infection was found are also presented. Serovar pomona is the leptospire of the Pomona serogroup most commonly incriminated in clinical disease in domestic species, but the organisms isolated in this study were antigenically different to pomona and may represent a new serovar. The limited information available on the epidemiology of sporadic infection with leptospires of the Pomona serogroup in domestic species in the south west of England supports the contention that a serovar other than pomona is involved. PMID- 6495571 TI - Furazolidone poisoning associated with cardiomyopathy in chickens. PMID- 6495572 TI - Isolation of a mesogenic strain of Newcastle disease virus from a hen. PMID- 6495573 TI - Composition of milk from Ailuropoda melanoleuca, the giant panda. PMID- 6495574 TI - Distemper in vaccinated dogs. PMID- 6495575 TI - Nicarbazin toxicity in broilers. PMID- 6495576 TI - Persistent vaginal haemorrhage in five mares caused by varicose veins of the vaginal wall. AB - Persistent bleeding from the vulva was the only presenting clinical sign in five non-pregnant pluriparous mares varying in age from eight to 20 years. These were two hunter types, one shire, one thoroughbred and one Arab pony. The haemorrhage originated from ulcerated varicose veins present on the dorsal wall of the vagina adjacent to the vestibulovaginal junction. All five mares were successfully treated, by submucosal resection (two), ligation of vessels (two) or diathermy (one). In four mares there was evidence of vulval incompetence caused by depression of the perineum. The importance of this and the role of impaired venous return during and after pregnancy are discussed. PMID- 6495577 TI - Effect of bedding on the incidence of exercise induced pulmonary haemorrhage in racehorses in Hong Kong. AB - An investigation into the incidence of exercise induced pulmonary haemorrhage (EIPH) in thoroughbreds in Hong Kong was carried out between the 1981 and 1983 racing seasons. A total of 1039 post race endoscopic examinations were performed in 1982-1983 and the results indicated that 46.8 per cent of runners had EIPH. This was not statistically different from the percentage of horses showing EIPH during 1981-82 (46.9 per cent). As it had been postulated that dust, especially from straw, could be implicated in lung haemorrhage a proportion of horses were bedded on paper in the 1982-83 season. No significant differences could be demonstrated in the incidence of EIPH resulting from the use of paper bedding in preference to straw. PMID- 6495578 TI - Strategic feeding of high yielding dairy cows. AB - Computerised management schemes are widely used in British dairy herds yet the standardised lactation curves might not be the most appropriate in particular herds. The shape of these curves is more a reflection of feeding than lactational physiology. Experimental evidence supports the approach of prediction of yield potential for each cow in early lactation, the mean rate of fall for the herd and appropriately tailored feeding. Daily pattern of supplementary feeding interacts with body energy balance and might have implications in the incidence of metabolic diseases and infertility. Compositional quality and total yields of milk constituents are influenced by the level of nutrition used at the onset of each lactation. PMID- 6495579 TI - A survey of fractures in the dog and cat in Malaysia. AB - A survey of 61 canine and 26 feline fractures diagnosed between January 1980 and June 1983 at a veterinary teaching hospital was conducted. More than 80 per cent of the fractures occurred in animals less than two years old. Male animals were more frequently involved. In the dog, the femur, tibia, pelvis, radius and ulna were most often affected while in the cat, the femur, mandible, pelvis and spine were more often involved. All the findings were consistent with other reports in the literature. PMID- 6495580 TI - Generalised muscle weakness in the Labrador retriever. PMID- 6495581 TI - Effect of tylosin on milk yield and dry matter intake of lactating dairy cows. PMID- 6495582 TI - Avian anaesthesia. PMID- 6495583 TI - Formaldehyde poisoning in cattle. PMID- 6495584 TI - Colouring for dips. PMID- 6495585 TI - Parvovirus vaccination. PMID- 6495586 TI - Exsanguination of animals at slaughter and the residual blood content of meat. AB - About 40 to 60 per cent of the total blood volume is lost at exsanguination. The loss can be influenced slightly by differences in traditional slaughter techniques and is considerably reduced after cardiac arrest in sheep and cattle. Blood not lost at sticking is probably largely retained in the viscera rather than the carcase. The residual blood content of lean meat is 2 to 9 ml/kg muscle. There is no evidence that this amount is affected by different slaughter methods or that large amounts of residual blood influence the microbiology of meat. PMID- 6495587 TI - Induction of parturition in cattle using dexamethasone and cloprostenol: economic performance and disease incidence after treatment. AB - Details are given of clinical management and disease problems associated with the routine induction of parturition on a herd basis, as well as the veterinary costs involved. A review of the economic performance of cows calved by this method is made and some guidelines laid down as to the conditions under which such a technique could be used as a management tool. PMID- 6495588 TI - Parasitic liver damage in lambs with particular reference to the migrating larvae of Ascaris suum. AB - It has been suggested that the larvae of the pig nematode Ascaris suum is a possible cause of rejection of lambs' livers in the abattoir. However, this assertion was not substantiated in an experimental study in which lambs were dosed with infective A suum eggs. This produced, at the worst, small trivial lesions (up to 2 mm diameter) which would probably have been missed at meat inspection under commercial conditions. No evidence of ascarid lesions was observed in the livers of 5873 lambs and hoggs slaughtered between June and August. The most important causes of rejection were lesions caused by Cysticercus tenuicollis and migrating Fasciola hepatica, and these accounted for 90 and 8 per cent, respectively, of 1337 livers rejected either totally or partially by the meat inspectors. PMID- 6495589 TI - Avian anaesthesia. PMID- 6495590 TI - Summer mastitis. PMID- 6495591 TI - Protecting the future guide dog. PMID- 6495592 TI - Apparent reinfection of enzootic-pneumonia-free pig herds: early signs and incubation period. AB - Since 1959, the Pig Health Control Association (PHCA) has run a national health control scheme for pig herds believed to be free from enzootic pneumonia. During this time, many herds developed this disease without a simple explanation. From 1968, 55 such unexplained breakdowns have been studied in detail. The first signs in 50 breakdowns were either coughing in growing pigs (52 per cent of outbreaks), illness in adult stock (34 per cent of outbreaks) or pneumonia in routinely slaughtered pigs (14 per cent of outbreaks). In some outbreaks, enzootic pneumonia appeared to grow out of a pre-existing respiratory infection, which was not identified as enzootic pneumonia, in suckling pigs, suggesting that either Mycoplasma hyopneumoniae was already present in a latent state, or it more readily seeded damaged respiratory tracts from outside. In three outbreaks of this type, where pathological material was collected during the transition period, no laboratory evidence was obtained for the presence of M hyopneumoniae in the primary respiratory disease. Analysis of breakdowns in two national testing stations indicated that clinical/pathological signs might not develop until three to five months after the introduction of an infected group of weaners. It is possible, therefore, that a pig herd might not show obvious signs of the disease until up to six months or more after initial infection. There was little evidence to indicate that unexplained breakdowns arose from long term latent infection in other herds from which stock had been imported. There was considerable evidence, however, to suggest that breakdowns arose from extraneous sources.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6495593 TI - Liver lesions resembling ovine white liver disease in cobalt deficient lambs. PMID- 6495594 TI - Direct transfer of frozen cow embryos in glycerol-sucrose. PMID- 6495596 TI - Retrieval of nematode larvae. PMID- 6495595 TI - Therapy for cardiac failure in small animals. PMID- 6495597 TI - Serum isoamylases and canine pancreatic insufficiency. PMID- 6495598 TI - Persistent orf. PMID- 6495599 TI - Declawing cats. PMID- 6495600 TI - Paramyxovirus infection in pigeons. PMID- 6495601 TI - Newcastle disease vaccination in Malaysia: application of oil emulsion vaccine. AB - An experimental oil emulsion Newcastle disease vaccine was evaluated for its efficacy in broiler chickens. A group of chickens vaccinated at one day old with a live lentogenic Newcastle disease vaccine and subsequently revaccinated at three and eight weeks old with the experimental oil emulsion vaccine showed satisfactory haemagglutination inhibition antibody response which persisted for 18 weeks. Between 90 and 100 per cent of the vaccinated chickens were protected when challenged with the velogenic viscerotropic Newcastle disease virus. Although the vaccinated chickens were protected against clinical disease, virus could be isolated from a number of birds. By day 10 to 12 after challenge all the chickens were free from Newcastle disease infection. PMID- 6495602 TI - Osteodystrophy in growing lambs fed a diet rich in wheat bran. PMID- 6495603 TI - Cupric oxide needles in the prevention of bovine hypocuprosis. PMID- 6495604 TI - Suspected wild garlic poisoning in sheep. PMID- 6495605 TI - Removal of growth from lioness's lip. PMID- 6495606 TI - Fluorescein-diacetate, a fluorescent dye compound stain for rapid evaluation of the viability of mammalian oocytes prior to in vitro studies. AB - A method for a quantitative measurement of the fluorescence activity of porcine egg cells is described. The non-polar fluorescein-diacetate molecules enter the cell, are hydrolyzed by cell esterases, and fluorescein is produced. This polar compound can not leave the cell because it is unable to pass through the intact cell membrane, and it therefore accumulates in the cytoplasm of the cell. Damaged cells however show a distinct loss of fluorescein through the cell membrane. With the aid of a fluorescence microscope, a photometer and a recorder, the amount of radiated light can be measured. The advantages of this method in oocyte research are briefly discussed. PMID- 6495607 TI - Ecological studies of Yersinia enterocolitica. II. Experimental infection with Y. enterocolitica in pigs. AB - Fattening pigs were inoculated with the human pathogenic strains of Yersinia enterocolitica, biovar 4 serovar 3 phagovar 8 and biovar 2 serovar 5.27. Each pig received 2.6 X 10(9) organisms by catheter into the stomach and thereafter 10% sodium bicarbonate solution, by the same route. The serovar 3 strain became established in the intestines of four out of six 11-week-old pigs and in all three 24-week-old pigs. Serovar 5.27 established in the intestines of all four 10 week-old pigs. In these pigs, both serovars were excreted in the feces at 10(2) 10(6) cells g-1 for a few weeks. However, the serovar 5.27 was excreted in the feces at less than 10(3.3) cells g-1 for 2 weeks by 24-week-old pigs. Horizontal transmission with the serovar 5.27 strain was observed on the 5th-11th day, and the bacteria were present in the intestines during the 2nd week. However, the serum titers to O-agglutinin were 1/10 and less, but in one pig, the titer was 1/40 against serovar 5.27 strain. PMID- 6495608 TI - Ecological studies of Yersinia enterocolitica. III. Cross-protection against fecal excretion between Y. enterocolitica serovars 3 and 5.27 in pigs. AB - Yersinia enterocolitica biovar 4 serovar 3 and biovar 2 serovar 5.27 failed to establish in the intestines of pigs when challenged with the homologous or heterologous strains. After inoculation, the serum O-agglutinin titers were 1/10 or less and were not boosted by challenge with either serovar. Y. enterocolitica were not recovered in any specimens at the time of slaughter. PMID- 6495609 TI - Production of enterotoxin(s) by Staphylococcus hyicus. AB - Five strains of Staphylococcus hyicus (3 of subspecies hyicus and 2 of chromogenes) were tested serologically for their ability to produce known and unknown enterotoxin(s) and were also examined using monkey bioassays. None of the 5 strains produced any detectable level of the known enterotoxins A--E. However, all of them produced emetic responses in 2 or more of 6 cynomologus monkeys when culture growth was fed intragastrically. One of the 5 strains (S. hyicus subspecies hyicus, VII 76) produced emetic responses in 3 of 6 monkeys with 50 ml of culture growth. The other 4 strains required 1 l of culture broth (concentrated 20-fold) to produce an emetic response in at least 2 of 6 monkeys. Enterotoxin production is, therefore, not unique to S. aureus species. Since some of these organisms do not produce coagulase and thermonuclease, they would be ignored in food hazard evaluation. PMID- 6495610 TI - Infectious nature of Clostridium spiroforme-mediated rabbit enterotoxaemia. AB - Newly weaned rabbits had diarrhoea only if they were infected with Clostridium spiroforme. In adult rabbits exposure to both clindamycin and C. spiroforme was necessary to induce disease. All diseased animals harboured C. spiroforme and its toxin. Adult rabbits given a course of clindamycin survived when held in a protected environment as did those challenged with C. spiroforme alone. At necropsy none of these apparently healthy animals showed signs of diarrhoea or caecitis. These findings suggest that, in the development of enterotoxaemia, weaning or clindamycin treatment and infection with C. spiroforme are separate events and that disease follows infection with this organism from the environment, as opposed to overgrowth by undetectable levels of C. spiroforme resident in the gut. Our data indicate that C. spiroforme is not a normal component of the rabbit gut flora and that the normal bowel ecology of the adult must be disrupted before C. spiroforme will colonize. PMID- 6495611 TI - A test in vero cell monolayers for toxin production by strains of Pasteurella multocida isolated from pigs suspected of having atrophic rhinitis. AB - Monolayers of Vero cells showed a morphological change after exposure to supernatants of certain porcine Pasteurella multocida cultures. It appeared possible to screen Pasteurella multocida isolates for their ability to produce toxin and to cause atrophic rhinitis in pigs. A close correlation with the guinea pig skin test was demonstrated. PMID- 6495612 TI - Resistance of chickens immunized against Mycoplasma gallisepticum is mediated by bursal dependent lymphoid cells. AB - Newly hatched chickens were significantly protected against challenge by the virulent S6 strain of Mycoplasma gallisepticum after vaccination with the TS 100 mutant. Removal of the thymus did not abolish the protective effect of the vaccine, but removal of the bursa of Fabricius did. The results suggest that the resistance induced by vaccine is mediated by the bursal-dependent lymphoid cells. PMID- 6495613 TI - [Diagnostic and therapeutic possibilities of transhepatic catheterization of the bile ducts]. PMID- 6495614 TI - [Combination of pharmaco-x-ray examination of the biliary tract and alimentary canal in the diagnosis of cholecystitis and the postcholecystectomy syndrome]. PMID- 6495615 TI - [The place of double contrast examination in the diagnosis of cancer of the stomach]. PMID- 6495616 TI - [Improved contrast medium for x-ray examinations of the upper portions of the digestive tract]. PMID- 6495617 TI - [X-ray picture of anaerobic lesions of the lungs and pleura]. PMID- 6495618 TI - [Differential diagnosis between calcified pleural adhesions and persistent pleural effusion]. PMID- 6495619 TI - [X-ray characteristics of the heart in the acute period of myocardial infarct]. PMID- 6495620 TI - [X-ray diagnosis of space-occupying processes in the pancreas]. PMID- 6495621 TI - [Methods and diagnostic significance of the detection of calcium deposits in the coronary arteries]. PMID- 6495622 TI - [Experimental basis and first clinical trial of x-ray-intravascular blood vessel prosthesis]. PMID- 6495623 TI - [Diagnostic possibilities for computer tomography in adrenal diseases]. PMID- 6495624 TI - [Status and tasks of x-ray services to the rural population of the Ukrainian SSR]. PMID- 6495625 TI - [X-ray diagnosis of pancreatic fistula]. PMID- 6495626 TI - [The "jet" sign in cicatricial strictures of the esophagus]. PMID- 6495627 TI - [Gas phlegmon of the gallbladder]. PMID- 6495628 TI - [Electroroentgenography in the diagnosis of pathologic changes in the pleural cavity]. PMID- 6495629 TI - [2 cases of aneurysm of the right atrium]. PMID- 6495630 TI - Immune reactivity to autochthonous ovine squamous cell carcinomata. AB - The immune reactivity of tumor-bearing sheep to autochthonous tumor cells was investigated in the efferent lymph of a lymph node distant from the primary tumor site. This was done while the primary tumor was in situ and after its resection. The immune response to challenge with tumor cells while the primary tumor was in situ was associated with the detection of antibodies which were specific for the tumor cells but did not cause their demise. However, both humoral and cellular cytotoxic reactivities were detected in the lymph following removal of the primary tumor and rechallenge with tumor cells. This response had the characteristic of a secondary immune response which indicates sensitization to tumor antigens by the host. Thus the presence of the primary tumor has interfered with pre-existing host immunity. PMID- 6495631 TI - Immunoglobulin levels in tears and aqueous humor of horses before and after diethylcarbamazine (DEC) therapy. AB - A quantitative investigation of equine tear and aqueous humor immunoglobulins was done using normal horses and ponies as well as horses and ponies infected with Onchocerca cervicalis. The equine immunoglobulin isotypes IgGa, IgM, IgA and IgG(T) were quantitated by either single radial immunodiffusion (SRID) or radioimmunoassay (RIA). Tear immunoglobulin levels for IgGa (128 +/- 151 micrograms/ml), IgA (1,664 +/- 1,038 micrograms/ml) and IgM (106 +/- 74 micrograms/ml) were measured, while IgG(T) was not detectable. In horses with ocular inflammation the IgGa was 18-fold higher in the tears, 2,269 +/- 3,077 micrograms/ml. Aqueous humor obtained by paracentesis of the normal equine eye under anaesthesia, resulted in values for IgGa (45.2 +/- 20.0 micrograms/ml), IgG(T) (5.2 +/- 2.0 micrograms/ml), IgM (1.3 +/- 4.8 micrograms/ml) and IgA (0.8 +/- 1.0 micrograms/ml). A pooled sample of normal aqueous fluid obtained from over 100 horses at an equine abbatoir in Indiana gave values of 1,150 micrograms/ml for IgGa, 65 micrograms/ml for IgG(T), 2.5 micrograms/ml for IgA and 3.0 micrograms/ml for IgM. In animals infected with 0. cervicalis and treated with Diethylcarbamazine (DEC), there was a marked elevation of IgGa and IgG(T) in the tears and aqueous humor while IgA and IgG(T) were also elevated slightly in the aqueous. The findings of elevated immunoglobulin isotypes in the aqueous humor may not be related to the DEC treatment and 0. cervicalis infections but rather to repeated paracentesis and the development of acute inflammation of the equine eye as a result of the trauma of paracentesis. The elevations in equine immunoglobulin isotypes in the tears after DEC treatment are not subject to the same caveat. The preferential elevation in IgGa and IgG(T) in the tears precedes the development of corneal opacities observed in the same horses. The concentration of specific antimicrofilarial antibody in these tears remains to be determined but may well account for a major share of the total immunoglobulins detected. PMID- 6495633 TI - The shedding of a virulent Kabete O strain of rinderpest virus by cattle. AB - A Muguga substrain of the virulent Kabete O strain of rinderpest virus was demonstrated in the ocular, nasal, oral and rectal swabs collected from infected cattle. Ocular shedding was detected at the onset of viraemia and before the onset of clinical signs whilst virus shedding in nasal, oral and rectal discharges appeared at the same time as lesions. It is suggested that virus isolation from ocular and nasal swabs should be considered in the diagnosis of rinderpest in addition to the other methods currently employed, as virus was isolated from swabs collected from dead animals. PMID- 6495632 TI - Regulation of hepatic triacylglycerol synthesis and secretion. AB - Triacylglycerols are the most concentrated storage form of energy for the mammalian organism. These lipids are synthesized and secreted by the liver and serve as a fuel for other tissues. This paper presents a brief review of the regulation of hepatic triacylglycerol synthesis and secretion. Particular attention will be given to the dissociation of the synthesis of triacylglycerols from that of the metabolically closely related nitrogenous phospholipids. Recent evidence is presented which suggests that triacylglycerol synthesis (and secretion) is regulated, at least partially, at the diacylglycerol branchpoint. PMID- 6495634 TI - Vaccination of cattle with live and inactivated rabies vaccines: a study of antibody response. AB - The authors vaccinated 152 cattle divided into three groups against rabies. The first group received the ERA strain and the second group an inactivated vaccine. The third group received the inactivated vaccine on two occasions with an interval of 60 days between the two doses. Their antibody response was surveyed with the fluorescent foci-inhibition test carried out on blood samples collected during a 10-month period. All animals developed an almost identical antibody response. However, at the sixth and tenth months, there was a higher number of seropositive animals in the groups vaccinated with the killed vaccine. PMID- 6495635 TI - The pharmacokinetics of fenbendazole and oxfendazole in cattle. AB - The pharmacokinetics of fenbendazole and oxfendazole in cattle are described. The pharmacokinetics of oxfendazole were not significantly different when administered orally and by intra-ruminal injection. At a dose rate of 4.5 mg/kg, administered orally, fenbendazole gave rise to mean peak concentrations in plasma of fenbendazole and oxfendazole of 0.11 and 0.13 microgram/ml respectively. Oral administration of oxfendazole, at 4.5 mg/kg body weight, gave rise to plasma peak concentrations of fenbendazole and oxfendazole of 0.10 and 0.20 microgram/ml respectively. Following intra-ruminal administration of oxfendazole, the peak concentrations were 0.11 and 0.18 microgram/ml respectively. PMID- 6495636 TI - Clinical evaluation of ketone bodies in body fluids of cows in late pregnancy and their fetuses. AB - Ketone body concentrations were determined in six body fluids of cows in late pregnancy and their fetuses (blood plasma and urine of cows, amniotic and allantoic fetal fluids, and fetal blood serum and urine) using the head-space gas chromatographic method. Physiological ratios O/T% of oxidized (acetone and acetoacetic acid) to total (acetone, isopropanol, acetoacetic and 3 hydroxybutyric acid) ketone bodies were below 10% in cow blood plasma and urine, fetal serum and urine, and allantoic fluid, and below 20% in amniotic fluid. A scheme for the evaluation of the degree and duration of ketosis based on the O/T% ratio is proposed. The existence of a renal regulatory mechanism for excretion of ketone bodies is suggested by analogy with the renal acidobasic regulation. PMID- 6495637 TI - A stathmokinetic study on the ruminal epithelium of sheep. AB - The metaphase arresting method using colchicine was applied to a kinetic study of the proliferation of sheep ruminal epithelium. Mitotic rate, calculated from the regression coefficient of the metaphase accumulation, was 0.0025 mitoses/cell per hour. Assuming the cell cycle time is about 24 hours as reported by Goodlad (1981), the growth fraction was calculated to be about 9%. The validity of the stathmokinetic method for ruminal cell kinetics is discussed. PMID- 6495638 TI - Lactate dehydrogenase isoenzymes in the lungs of sheep with acute and chronic pneumonia. AB - Total lactate dehydrogenase and the absolute and percentage levels of its isoenzymes were measured in lung lesions and macroscopically normal areas of lung from lambs with chronic proliferative exudative pneumonia and acute pasteurella pneumonia. Lung lesions had a higher total enzyme activity which was associated mainly with increases in the activity of the LDH4 and LDH5 isoenzymes, particularly in chronic pneumonia, and gave lung lesions a considerable potential for altering the serum isoenzyme distribution. Thus, the nature of any changes in the serum isoenzyme distribution will depend on whether the isoenzymes are released from abnormal or normal areas of lung. This appears to be the first report on lactate dehydrogenase isoenzymes in ovine pneumonia. PMID- 6495639 TI - Studies of Streptococcus suis type 2 infection in pigs. AB - Investigations into the immunology, pathogenesis and epidemiology of Streptococcus suis type 2 infections were carried out in experimental pigs and in naturally-occurring field outbreaks of disease. The capsular polysaccharide from Str. suis type 2 was shown to induce opsonic antibodies in pigs when injected with Freund's incomplete adjuvant, but difficulties encountered in experimental production of the disease prevented a study of their protective effects. Problems with the bactericidal tests led to an investigation of other assays for antibodies against Str. suis type 2, namely, a phagocytic test with pig neutrophils, a mixed reverse passive antiglobulin haemagglutination test and an indirect haemagglutination test. There was evidence that with modifications both the latter tests would be useful. Transmission studies in 39 conventionally reared and 7 hysterectomy-derived, colostrum-deprived pigs yielded interesting results with regard to the distribution of the organism in relation to the disease process. Tonsil carriage in clinically-healthy pigs was demonstrated after experimental and natural infection. Detectable carrier rates varied between 0 and 59%. The organism was shown to persist in the presence of circulating opsonic antibodies and in pigs on penicillin-medicated feed. Attempts to isolate the organism from the genital tract were unsuccessful. Medicated early weaning and classical SPF techniques applied to infected herds appeared to be effective in producing pigs free from Str. suis type 2 infection. PMID- 6495640 TI - Infectious tenosynovitis in broilers and broiler breeders in Egypt. AB - Two infectious tenosynovitis-producing viruses were isolated from tendon sheaths and synovial fluids of 59 broilers and 15 broiler breeders obtained from different flocks in Egypt during June to October 1983. The viruses grew well on the chorioallantoic membrane of developing chicken embryos, produced small localized white pock lesions with oedematous swellings at the inoculation sites and death of most of the embryos 72 to 96 hours post-inoculation. They also induced cytopathic effect in chicken embryo rough, Vero and MS cell lines. The viruses were neutralized by reovirus S1133 antiserum, both in tissue culture and on the chorioallantoic membrane. Inoculation of the viruses into 2-day-old broiler chicks via the foot pad, intramuscular and oral routes reproduced the disease with the development of characteristic clinical, pathological and serological responses. The infection was transmitted to in-contact control chicks. This is the first report of the disease and of the isolation and identification of the causative virus in Eqypt. PMID- 6495641 TI - [Attempt to design a factorial model of Newcastle disease in poultry in Bulgaria for the period 1970-1979]. AB - Literature data on the statistical methods relating to many objects (informational, factorial, clusteral, regressional, etc.) in the study of epizootic processes have shown that these methods could be employed to raise the quality of the epizootiologic analysis. An attempt has been made to build a factorial model for Newcastle disease in this country. Use has been made of a programme for factorial analysis, substantiated by a computer. The information is presented in the form of a matrix, containing 27 rows (the number of districts) and 15 columns (the number of indices). The latter include parameters of the epizootic processes as well as indices, characterizing the economic status of the individual districts. The factorial model has made it possible to state the correlations of a great number of measurable indices and through these to disclose 4 basic factors that cannot be measured directly which may largely contribute to the elucidation of the epizootic status. The concept has been confirmed that the character of the epizootic process with the Newcastle disease within the size of concrete territorial-and-administrative units (the districts) is determined to a great extent by the economic features of the districts. The programme used in the factorial analysis of Newcastle disease can be applied also to investigate the epizootic process with other infectious diseases of farm animals and birds along with the use of a computer and available information. PMID- 6495642 TI - [Effect of different doses of D, L-methionine on biochemical indices in the blood, rumen contents and urine]. AB - Experimental studies were carried out with lambs to study the effect of gradually increasing amounts of the D,L-methionine, applied directly into the rumen, on the general state, the amount of free amino acids, and some biochemical indices characterizing the nitrogen metabolism and the rumen processes. It was found that doses of 0.10 and 0.13 g/kg body mass had a favourable effect on the appetite and the general state as well as on the indices studied, particularly on Hb, blood sugar, amino acid index and urea of the blood serum, and ammonia gas, volatile fatty acids, and total count of infusoria in the rumen content. At rates of 0.66 and 0.83 g/kg body mass there was loss of appetite and dullness, and at 1.0 and 1.16 g/kg along with the full loss of appetite there were trembling, difficult breathing, clonal and tonal spasms of skeletal muscles. On the sixth day following treatment there were deaths only with those of the animals that were given methionine at 1.16 g/kg body mass. It was also found that total sulfur in the blood serum increased parallel to the rising amounts of methionine, chiefly to the detriment of free inorganic sulfur. The addition of excessive amounts of methionine led to the sharp drop of the essential amino acids and rise of the free methionine in the blood serum of the test animals. PMID- 6495643 TI - [Clinical course of experimental coccidiosis in turkey poults infected with E. adenoeides and E. meleagrimitis]. AB - Turkey poults were experimentally infected with various doses of oocysts of the E. adenoeides and E. meleagrimitis species. The results of the clinical development of the disease, mortality rate, and changes in the feces were followed up. It was established that clinically the disease was manifested between the third and fourth day with E. adenoeides, and between the fourth and fifth day with E. meleagrimitis with dullness, bristling of feathers, head dropping, going off feed or full loss of appetite, thirst, and aggregation into groups. The feces were changed--either softened or fully watery, with bloody filaments (E. adenoeides). Mortality rate ranged from 0 to 100 per cent, depending on the species and the infective amount. The shedding of oocysts was followed up from the fifth up to the fifteenth day. It proved highest from the 5th to 7th day following infection. It was also found that the changes in the body weight showed as essential difference between infected and control birds. It was as early as the seventh day that there set in a rise of the live weight with all infected birds, which was negligible with those treated with high amounts--80 000 oocysts of the E. adenoeides sp. PMID- 6495644 TI - [Biochemical changes in the blood of turkey poults experimentally infected with E. adenoeides]. AB - An experiment was carried out with three groups of 3-week-old turkey poults. The first and second group were infected with 80 000 and 120 000 oocysts of the E. adenoeides species, and the third one was kept as control. Studied were the changes taking place in the total serum protein, serum lipids, blood sugar on the third, sixth and tenth day and the serum carotene on the third, sixth, seventh, and tenth day following infection. It was found that the levels of the total serum protein and serum carotene dropped, while the blood sugar as well as the serum lipids rose. The changes were mostly manifested on the sixth day of the infection, and by the tenth day the condition seemed to come back to normal. PMID- 6495645 TI - [Hemorrhagic septicemia in rainbow trout due to Yersinia ruckeri sp. nov]. AB - Bacterial hemorrhagic septicemia in rainbow trout is reported for the first time in this country, with Yersinia ruckeri as causative agent. The identification of the isolated strains was carried out on the basis of morphologic, cultural, and biochemical properties. Described are the morphologic changes, giving some epizootiologic data. Stated is the employment of an immunochemical method for differential diagnosis, based on changes that take place in the plasmal lipoproteins of diseased trouts. It has been found that the immunoelectrophoresis of sera of trouts infected with Yersinia ruckeri, using rabbit antisera against trout plasmal proteins reveals only traces of the molecularly destroyed alfa- and beta-lipoproteins. PMID- 6495647 TI - Animal DNA viruses analyzed by colour electron microscopy. AB - Black-and-white and colour transmission electron micrographs of three DNA viruses (infectious bovine rhinotracheitis virus, bovine adenovirus type 5 and Molluscum contagiosum) are comparatively presented. The colour images have been obtained by an original method of computer-assisted analogic processing of black-and-white micrographs, using the Romanian electronic device OPTIMISCOP. A comparative analysis of the two types of images demonstrates the variety of additional information provided by the new processing technique. PMID- 6495646 TI - [Dextrofer-100 with B12 and dextrofer-100--comparative pharmacological and clinico-pharmacological studies]. AB - Comparative studies were carried out with dextrofer-100 with B12 and dextrofer 100 in terms of acute toxicity (albino mice), absorption (rabbits, pigs, and lambs), deposition of iron in the liver and spleen (rabbits, pigs, and lambs) and antianemic action (pigs and lambs). It was found that LD50 of dextrofer-100 with B12 at i/v introduction into 18-20-gram albino mice was 1750 mg Fe3+/kg body mass; with regard to toxicity it was shown to correspond to the British Veterinary Code. The toxicity of dextrofer-100, studied by the same test, was practically undeterminable. By the level of sideremia dextrofer-100 with B12 did not differ essentially from dextrofer-100 and was said to belong to preparations with rapid absorption. It was most rapidly absorbed in pigs, rabbits and lambs following next. It supplied enough iron to the reticuloendothelial organs--in pigs it was (on a percent basis) highest in the liver, and in lambs--in the spleen. In pigs on the 10th day following treatment with dextrofer-100 with B12 the liver was shown to have vitamin B12 5 times as much. By its antianemic effect at i/m application to newborn pigs and lambs dextrofer-100 with B12 did not differ essentially from dextrofer-100 (its action was negligibly broader), however, it was beneficial to the growth of pigs. PMID- 6495648 TI - Changes in light scattering, absorption, fluorescence and biological characteristics of influenza virus A(H1N1) exposed to sonication. AB - Influenza virus A/Brasil 11/78 (H1N1) was sonicated for different time intervals (2-328 sec) in a continuous flow Ultrasonics F600 device at 20 kHz, 600 W. Marked changes in the structure of the virions were made evident by light scattering, absorption and fluorescence measurements. Light scattering data indicated that the turbidity of the influenza virus samples is inversely proportional to the square of the wavelength. A sharp decrease in hemagglutinating activity and infectivity occurred following sonication for more than 50 sec. PMID- 6495649 TI - Multiple sclerosis and exposure to household dogs. Preliminary observations. PMID- 6495650 TI - ERV3, a full-length human endogenous provirus: chromosomal localization and evolutionary relationships. AB - A full-length human endogenous provirus termed ERV3 was isolated from a human fetal recombinant DNA library by low stringency hybridization with two probes: baboon endogenous virus LTR; and a pol-env subclone from the endogenous chimpanzee provirus, CH2. DNA sequencing within the clone and comparisons with other retroviruses revealed that ERV3 contains gag and pol gene sequences that are significantly related to those of mammalian type C retroviruses and previously described human endogenous proviruses. The ERV3 genome was determined to reside at a single locus on human chromosome 7 using a panel of rodent X human somatic cell hybrids. PMID- 6495651 TI - The organization of frog virus 3 as revealed by freeze-etching. AB - A variety of freeze-fracture techniques has been employed in this study with the aim of dissecting the frog virus 3 virion and obtaining further information about its architecture. The icosahedral capsid has a skew symmetry with a triangulation number of 133 or 147. The capsomers are closely packed with a center-to-center spacing of 72 A. The inner membrane contains transmembrane proteins which appear as intra-membranous particles on both fracture faces. Rod-like structures (about 100 A in diameter) are present in the virus interior suggesting that the DNA protein complex is highly organized. PMID- 6495652 TI - Infection of a Chlorella-like alga with the virus, PBCV-1: ultrastructural studies. AB - Ultrastructural studies revealed that the virus, PBCV-1, adsorbs to the surface of the Chlorella-like green alga NC64A and enzymatically digests a portion of the host cell wall. The viral DNA is then released into the interior of the cell leaving an empty capsid on the surface. Thus uncoating of the viral genome occurs at the surface of its host. PBCV-1 also adsorbs to and digests the host wall of either heat-killed, methanol-extracted, or purified cell wall fragments. PMID- 6495653 TI - Transcription of adenovirus cores in vitro. AB - Transcription in whole HeLa cell extracts of the nucleoprotein core complexes released from adenovirus type 2 or type 5 virions has been examined. The average length of transcripts from deproteinized DNA templates increased steadily during a 90-min reaction in vitro, exhibiting an elongation rate of approximately 70 nucleotides per minute. On the other hand, transcripts made from viral core templates were restricted to a length of less than 2000 nucleotides. Accordingly, efficient transcription of cores (50 nucleotides elongated/min) ceased after 10 20 min of incubation in whole-cell extracts. Deproteinized viral DNA and viral nucleoprotein complexes appeared to support the initiation of a similar number of transcripts per template molecule, but the rate of initiation was faster when cores were provided as templates. Deproteinized viral DNA supported the synthesis of VA-RNA and of transcripts that hybridized to the region of the viral genome containing the 5' portion of the major late transcriptional. Viral cores also directed the synthesis of RNA products which hybridized to fragments of the viral genome containing E1A, E1B, and E4 regions. The results of nuclease protection experiments indicated that the presence of core proteins did not preclude accurate initiation of transcription from the E4 region. PMID- 6495654 TI - Biological properties of a hemagglutinin mutant of influenza virus selected by host cells. AB - Chick embryo fibroblast (CEF)-grown stocks of the WSN strain of influenza A(HINI) contain two variants which were designated F and C for fuzzy and clear plaque morphology on Madin-Darby bovine kidney (MDBK) cells. During growth in MDBK cells plaque-isolated F virus was completely replaced by C virus (L. Noronha-Blob and I.T. Schulze (1976), Virology 69, 314-322). The parental (F) and the mutant (C) viruses contain hemagglutinins which differ in their ability to bind to host cells. In addition, the host cells from which the purified viruses are obtained affect their binding properties. Thus, as compared to MDBK-grown F virus (FBK), MDBK-grown C virus (CBK) produced high amounts of mRNA and high virus yields in MDBK cells. CBK had greater affinity for SA alpha 2,3Gal and SA alpha 2,6Gal linkages on derivatized human erythrocytes than did FBK, independent of whether neuraminidase was present on the virions. CBK was also resistant to components of calf serum which inhibited FBK hemagglutination at 37 degrees. As compared to FBK, CBK had increased ability to bind to both MDBK cells and CEF at 37 degrees in the presence or absence of an inhibitor of neuraminidase. In addition, when cells with virus bound at 0 degrees were transferred to 37 degrees, CBK remained cell associated whereas about 80% of FBK dissociated from both cells. Thus, mutation from F to C increased the ability of the virus to associate with MDBK cell receptors. Studies carried out with F and C viruses from both cells indicated that the expression of the mutation depended in part on the host cells in which the virus was grown and in part on the cells used to measure the binding properties. A model relating these observations to selection of HA variants in nature is presented. PMID- 6495655 TI - Studies on the synthesis of the influenza V virus NB glycoprotein. AB - The synthesis of the influenza B virus glycoprotein NB has been demonstrated in cells infected with four different virus strains isolated from 1940 to 1983. Time course studies have shown that the neuraminidase protein (NA) and NB appear simultaneously in infected cells, in agreement with the previous observation that both proteins are translated from a single, bicistronic mRNA. Pulse-chase experiments indicated that the NB protein disappears from infected cells within 3 hr after synthesis. The influenza B virus nonstructural protein NS2 was also observed to disappear rapidly from infected cells, with none detected 1 hr after synthesis. Immunoprecipitation of viral proteins from infected cells using hyperimmune mouse serum has demonstrated antigenic cross-reactivity among the NB proteins of the four virus strains studied. The finding of polypeptides smaller than NB that exhibit a labeling pattern with different amino acids which is characteristic of NB and which are precipitated by the mouse antiviral serum suggests that specific cleavage products of NB may be formed in infected cells. PMID- 6495656 TI - Genetic relatedness between A/Swine/Iowa/15/30(H1N1) and human influenza viruses. AB - The nucleotide sequences of the M and NS1 genes of influenza virus A/Swine/Iowa/15/30 (A/SW/IW/30)(H1N1) were determined with cloned DNAs and compared with reported sequences of human and avian influenza viruses. A/SW/IW/30 virus was found to be closely similar to A/PR/8/34(H1N1) virus in the nucleotide sequences of the M and NS1 genes, the base differences between the two strains being 64 out of 1027 nucleotides in the M gene and 52 out of 740 in the NS1 gene. Based on the assumptions that these two viruses were derived from a common ancestor and that the rate of base changes per year was the same in man and in swine, it was estimated that the progenitor virus was in circulation during the period from 1915 to 1920. This estimation was compatible with the epidemiological findings suggesting that the progenitor of the swine influenza virus was the agent of the 1918 influenza pandemic. Furthermore, the M and NS1 gene sequences of A/FPV/Rostock/34(H7N6) virus were much closer to those of A/SW/IW/30 and A/PR/8/34 viruses than to A/duck/Alberta/60/76(H12N5) virus, but not as close as the A/SW/IW/30 virus was to A/PR/8/34 virus. PMID- 6495657 TI - Sequence of the black beetle virus subgenomic RNA and its location in the viral genome. AB - BBV (black beetle virus) RNA3, the subgenomic messenger RNA for BBV protein B and its double-stranded form (dsRNA3) were purified from cells infected with BBV and were sequenced. RNA3 is 389 bases long. The sequence is homologous to that of the 3'-terminal region of virion RNA1. RNA3 has a very limited homology to virion RNA2. RNA3 is capped at its 5' terminus and has a structural feature at its 3' terminus that renders it inert to the action of the enzymes RNA ligase and poly(A) polymerase. RNA3 has two overlapping reading frames for putative proteins of size 10,768 and 11,633 Da. The positive and negative strands of dsRNA3 are not capped and correspond in length and sequence to RNA3 itself. PMID- 6495658 TI - Recombination in adenovirus: analysis of crossover sites in intertypic overlap recombinants. AB - Overlap recombination has been used as a means of generating intertypic recombinants with crossover sites located within a defined region of the adenovirus genome. Using terminal DNA fragments of adenovirus type 2 and type 5 that overlap within the vicinity of the hexon coding region (51.6-59.7 map units), two different crosses could be studied; in one the overlap entirely encompasses the hexon and there are homologous regions at either side of the overlap where recombination is expected, and in the other only one side of the overlap is capable of sustaining recombination. The overall distribution of crossover sites within the overlap has been determined by restriction endonuclease mapping, and analysed in terms of the extent of homology between Ad2 and Ad5 in this region as defined by the DNA sequences (R. Kinloch, N. Mackay, and V. Mautner (1984). J. Biol. Chem., 259, 6431-6436; G. Akusjarvi, P. Alestrom, M. Pettersson, M. Lager, H. Jornvall, and U. Pettersson (1984). Submitted). Crossovers are found only in regions of relatively high DNA homology, as previously shown for intertypic recombination between temperature-sensitive viruses (M. E. G. Boursnell and V. Mautner (1981). Virology 112, 198-209). The presence of a free DNA end within the heterologous zone is insufficient to overcome the barrier to recombination. In crosses where recombination is confined to a relatively small homologous zone (45.9-53.0 mu) there is no special distribution of crossovers within the interval; no "hot spot" is discernible at the free DNA end, suggesting that a free DNA end is not especially recombinogenic, nor at the junction between the homologous and heterologous zones, suggesting that branch migration up to the heterology does not always occur. A cross designed to furnish evidence for gene conversion gave rise to a "conventional" recombinant with a crossover located within a 21-nucleotide tract of homology. PMID- 6495659 TI - Hepatitis B virus particles of plasma and liver contain viral DNA-RNA hybrid molecules. AB - Hepatitis B virions in plasma (Dane particles) are known to contain small circular DNA molecules. The experiments described here indicate that virions in plasma, as well as particles from hepatitis B virus-infected human liver, also contain viral DNA-RNA hybrid molecules, and deoxynucleotides can be incorporated into the DNA of these hybrids by DNA polymerase activities in the virions. Thus, two viral DNA synthetic reactions appear to take place in virions: repair of the single-stranded region of circular DNA molecules and synthesis or elongation of the DNA strand of DNA-RNA hybrid molecules. Centrifugation of virion nucleic acid to equilibrium in Cs2SO4 density gradients revealed the presence of viral DNA-RNA hybrid molecules over a density range of 1.45 to 1.60 g/cm3. Distinct species of hybrid molecules were found with an average density of 1.57 g/cm3 in Dane particles and 1.52 and 1.57 g/cm3 in particles from liver. Fractionation of nucleic acid from Cs2SO4 density gradients by gel electrophoresis demonstrated that the majority of hybrid molecules migrated faster than molecules with the density of pure DNA (1.42 g/cm3). One notable exception was the finding of DNA RNA hybrid molecules migrating slower than open circular viral DNA. Characterization of viral DNA-RNA hybrids by heat denaturation Cs2SO4 density gradient fractionation, and recombinant M13-HBV single-stranded probe hybridization revealed that the hybrid molecules consisted of viral plus-strand RNA hydrogen bonded to viral minus-strand DNA sequences. Data obtained by pancreatic ribonuclease digestion revealed that the hybrid molecules at density 1.45 to 1.52 g/cm3 contained HBV RNA strands base paired over only part of their length in contrast to the hybrid species at density 1.57 g/cm3 which contained RNA strands apparently base paired over most of their length. Further characterization showed that the hybrid at 1.57 g/cm3 contained genome-length minus-strand viral DNA. The experiments rule out the possibility that the hybrid molecules are transcriptional complexes. Data presented in a companion manuscript indicate that the hybrid molecules may represent intermediates in the synthesis of viral DNA in the endogenous DNA polymerase reaction. PMID- 6495660 TI - Hepatitis B viral DNA-RNA hybrid molecules in particles from infected liver are converted to viral DNA molecules during an endogenous DNA polymerase reaction. AB - Particles purified from the liver of hepatitis B virus-infected patients were previously shown by us to incorporate 32P-deoxynucleotides into viral DNA and DNA RNA hybrid molecules when incubated in a DNA polymerase reaction mixture. In this investigation, similar particles from duck and ground squirrel livers infected with viruses closely related to HBV were also shown to incorporate 32P deoxynucleotides into viral-specific DNA and DNA-RNA hybrid molecules when incubated in vitro in a DNA polymerase reaction mixture. The particles from duck hepatitis B virus-infected liver contained a heterogeneous population of hybrid molecules, while those from ground squirrel hepatitis virus-infected liver contained hybrid molecules with densities similar to those found in HBV particles including a distinct population of molecules with an average density of 1.57 g/cm3. Brief endogenous DNA polymerase reactions with particles from all three livers, resulted in incorporation of 32P-deoxynucleotides into viral DNA of DNA RNA hybrid as well as viral DNA molecules. When the reaction was continued in the presence of a 1000-fold molar excess of unlabeled deoxynucleotides, a decrease in [32P]DNA in the DNA-RNA hybrid region of the Cs2SO4 density gradient and a proportional increase in [32P]DNA in the DNA region of the gradient was observed. This effect was seen most dramatically with particles isolated from freshly obtained ground squirrel hepatitis virus-infected livers in which 90% of the pulse labeled DNA in the hybrid species at the buoyant density of 1.57 g/cm3 appeared to be converted to a form with the buoyant density of pure DNA (1.42 g/cm3). Storage of virus particles at 4 degrees, or prior freezing of infected ground squirrel liver almost completely abolished the ability of the endogenous DNA polymerase activity to incorporate 32P-deoxynucleotides into hybrid molecules, while incorporation into DNA molecules was apparently unaffected. These results suggest that different enzymatic activities catalyze synthesis of the viral DNA in DNA-RNA hybrids and in molecules with buoyant density of pure DNA. Thus particles from infected liver synthesize DNA of DNA-RNA hybrid molecules which can be converted in the particles into molecules with the buoyant density of pure DNA. This indicates that DNA-RNA hybrids may be intermediates in viral DNA replication and that the mechanism of hepatitis B virus (and closely related viruses of ground squirrels and ducks) DNA replication differs from that known for other DNA viruses. PMID- 6495662 TI - [Chronic lymphatic leukemia and evaluation of its prognostic signs]. PMID- 6495661 TI - Asymmetric replication of hepatitis B virus DNA in human liver: demonstration of cytoplasmic minus-strand DNA by blot analyses and in situ hybridization. AB - In situ and blot hybridization techniques have been used with strand- and region specific probes to characterize the forms of hepatitis B virus (HBV) DNA in the liver of a patient with chronic active hepatitis B. The hepatocytes contain a heterogeneous population of rapidly migrating DNA species in the 0.5-1.4 kb position that are localized predominantly in the cytoplasm and are of minus strand polarity. The findings indicate that the replication is asymmetric, with separate pathways for plus- and minus-strand synthesis of HBV DNA; that viral DNA synthesis is initiated at a site near the nick in the minus strand of virion DNA; and that actively replicating forms of HBV DNA can be identified at the cellular level by in situ hybridization. PMID- 6495663 TI - [Dispensary care of inborn hemorrhagic conditions in Slovakia]. PMID- 6495664 TI - [Catalytic activity of transketolase in erythrocytes in chronic kidney failure]. PMID- 6495665 TI - [Smoker's cardiomyopathy]. PMID- 6495666 TI - [Electrocardiographic mapping of the middle and end part of the QRS complex in the WPW picture]. PMID- 6495667 TI - [Hypertension in obesity]. PMID- 6495668 TI - [Epidemiology of joint hypermobility]. PMID- 6495669 TI - ["Arthritis" as the first clinical sign of polycythemia vera]. PMID- 6495670 TI - [Induced hemoptysis--a new clinical sign in the diagnosis of pulmonary thromboembolism]. PMID- 6495671 TI - [The galenic laboratory in a health service region. Technology of drug production and formulation]. PMID- 6495672 TI - [The "personality" factor and its significance in the occupational suitability of the pilot for combat aviation]. PMID- 6495673 TI - [Epidemiologic characteristics of Q fever in Vojvodina]. PMID- 6495674 TI - [Corticosteroid therapy test in the evaluation of the reversibility of respiratory airways obstruction]. PMID- 6495675 TI - [Determination of the antacid value of the preparation Mixtura antacida]. PMID- 6495676 TI - [Importance of artificial ventilation in the treatment of patients with the fat embolism syndrome]. PMID- 6495677 TI - [Septic shock]. PMID- 6495678 TI - [Raeder's paratrigeminal syndrome]. PMID- 6495679 TI - [Induced psychosis--folie a deux. Case report]. PMID- 6495680 TI - [Late complications of surgical and combined therapy of breast cancer]. AB - The paper deals with an analysis of complications in 114 breast cancer patients after surgical and combined (surgery + radiation) treatment. Radiation treatment was followed by higher complication rates and, particularly, edema of the upper extremity. PMID- 6495681 TI - [Lipid peroxidation in patients with gastric ulcer and cancer]. AB - Levels of certain metabolites of peroxidation of lipids such as diene conjugates malonic dialdehyde, ascorbic acid, dehydroascorbic acid and diketogulonic acid were compared in 39 cases of gastric ulcer, 25 patients with gastric cancer and 14 healthy subjects. Diene conjugates and malonic dialdehyde levels appeared to be increased in cases of gastric ulcer and cancer. This was matched by a decrease in ascorbic acid and dehydroascorbic acid levels. Ulcer patients revealed enhanced diketogulonic acid concentration. PMID- 6495682 TI - [Effect of phenformin and succinic acid on the transplacental carcinogenic effect of N-nitroso-N-ethylurea in rats]. AB - The study was concerned with the influence of a long-term postnatal treatment with an antidiabetic biguanide-phenformin and a biologic stimulating agent succinic acid upon the realization of transplacental carcinogenic effect of N ethyl-N-nitrosourea (ENU) in rats. Phenformin treatment inhibited the development of induced tumors in the nervous system and kidneys, significantly decreased the total incidence and multiplicity of these tumors, the incidence of brain and spinal cord tumors and multiplicity of brain tumors. Succinic acid did not influence the transplacental carcinogenic effect of ENU. PMID- 6495683 TI - [Method of processing past records for evaluating methods of treating breast cancer]. AB - The work includes the form, containing 380 properties for evaluation of the breast cancer treatment. The form embraces practically all clinical signs, which may influence the breast cancer prognosis, i.e. the results of its clinical treatment. PMID- 6495684 TI - [Role of specialized fluorographic centers in diagnosing cancer and chronic diseases of the stomach]. AB - The experience of running a specialized photoroentgenographic station of the Institute is discussed. The total of 4,052 examinations (healthy subjects for prophylaxis and patients with gastrointestinal complaints) were carried out. The percentage of early gastric cancer diagnosed by means of prophylactic photoroentgenography was significantly higher than that yielded by standard out patient examination procedures. Such centers should be set up primarily at large polyclinics, regional hospitals, etc. PMID- 6495685 TI - [Rare case of a primary multiple neoplastic process with 5 sites of malignant and benign tumors]. PMID- 6495686 TI - [Endometriosis of the breast (case report)]. PMID- 6495687 TI - [Conclusion of a discussion of the article by V. S. Turusov and Iu. D. Parfenov "Problem of a threshold in chemical carcinogenesis"]. PMID- 6495688 TI - [The oncological component in a mass screening system]. PMID- 6495689 TI - [Physicians against nuclear war]. PMID- 6495690 TI - [Pneumatic compression in the treatment of lymphatic edema of the arm in patients subjected to radical surgery for breast cancer]. AB - Air compression procedure was used in the treatment of 32 females radically operated on for breast cancer. The desired pressure of compressed air was fed successively in the proximal direction to the six chambers of a cuffed sleeve unit which was fitted over the patient's arm enclosing it from shoulder joint to fingers. The study will be continued because good results were obtained following application of three courses of the treatment. PMID- 6495691 TI - [Use of tamoxifen in patients with disseminated and local breast neoplasms]. AB - The efficacy of tamoxifen treatment was studied in 46 postmenopausal patients with localized and disseminated breast cancer. Objective remissions were observed in 47.8, stabilization of tumor process-in 21.7%, mostly in cases of metastasis into the skin, subcutaneous fat, lymph nodes, pleura and bones. Tamoxifen proved sufficiently effective both in primary treatment and as a measure taken when the effect of a specific therapy (radiation, cytostatic or hormonal) was over. Side effects were slight and were registered in 19.6%. PMID- 6495692 TI - [Characteristics of left lung resection for advanced cancer]. AB - Due to the difficulties involved in establishing an early diagnosis, advanced cases make up about 70% of lung cancer patients admitted to specialized surgical wards. According to more than 30 year-old experience gained at the Academy's Hospital Surgical Clinic and evaluation of the end results of extensive and combined resection of the lung for the treatment of cancer, over 26% of cases operated on at the advanced stages of the disease survive for more than 5 years. Special surgical procedures should be carried out in such cases. PMID- 6495693 TI - [Clinico-morphological rationale for surgical tactics in local peripheral hamartomas of the lung]. AB - The report deals with a retrospective clinico-morphological study of the data on 91 cases of local peripheral hamartoma of the lung. Both the authors' observations and literature data point to their non-tumor nature. Malignant transformation of lung hamartoma or relapse occur extremely rare. Therefore, small peripheral hamartomas of the lung, which do not tend to grow, should not be treated surgically, lung, provided the clinico-roentgenological diagnosis has been confirmed by a morphological procedure (puncture or aspiration biopsy). PMID- 6495694 TI - [Approaches to improving the methods of treating esophageal cancer]. AB - The paper deals with an analysis of the results of treatment of 344 patients with cancer of the thoracic part of the esophagus. Out of those, 104 received surgical and combined treatment and 240 (inoperable cancer) were given radiotherapy alone or in combination with local hyperthermia, general chemotherapy or intratumoral iontophoresis of chemotherapeutic agents. The procedure after Dobromyslov-Torek proved to be insufficient in most of surgical cases because there were metastatic lesions below the diaphragm. A surgical procedure which takes care of metastases is suggested. Local hyperthermia potentiated the effect of radiation treatment. The immediate results of treatment improved after intratumoral sarcolysin iontophoresis was used in conjunction with radiation therapy. PMID- 6495695 TI - [Ganglioside and carcinoembryonic antigens in the diagnosis of malignant tumors of the gastrointestinal tract]. AB - Radioimmunologic procedures were used in a comparative assay of ganglioside and carcinoembryonic antigen levels in the blood plasma of patients with benign and malignant lesions at different sites. Measurements of ganglioside antigen level proved to be an efficient test for differentiating between benign and malignant tumors of the pancreas. However, it cannot be used as an aid to carcinoembryonic antigen test for detection of stomach and rectal cancers or their recurrences and metastases into the liver. PMID- 6495696 TI - [Routes of lymph outflow from the operated stomach]. AB - The pathways of lymph discharge from the stomach at different stages after resection and gastroenterostomy were studied by filling the lymphatics with 50% Indian ink. The study used 55 noninbred dogs and 12 preparations of human resected material obtained in repeated surgery. It was found that lymph is discharged through intact lymphatic via within 40 days after subtotal resection and 10 weeks after partial resection and gastroenterostomy. At later stages lymph is discharged via newly developed vessels which extend from the stomach across anastomosis axis onto intestinal wall and further on to the lymph nodes of its mesentery. At month 3 after subtotal resection and month 5 after partial resection and gastroenterostomy, the lumen diameter of such lymphatics matched that of intact lymphatics of the stomach. Postoperative formation of lymph discharge via suggests that cancer may be directly disseminated from the operated stomach into the mesenteric lymph nodes. PMID- 6495697 TI - [Steroid hormone receptors in malignant tumors of the large intestine]. AB - Receptors of steroid hormones (estrogens, androgens, progesterone and glucocorticoids) were studied in 60 patients with stage II-III primary cancer of the large bowel. In 58%, tumors were receptor-positive, with receptors of estrogens and glucocorticoids being the most frequent. No correlation between the frequency of receptor identification and the patients' sex, age, tumor's site or stage was established. Since it is suggested that large bowel cancer may be hormone-sensitive, it makes the case for development of new methods of prevention and treatment of the disease. PMID- 6495698 TI - [Myofibroblasts in the stroma of colonic tumors]. AB - An ultrastructural examination of 18 colonic carcinomas detected myofibroblasts in 13 tumors. An inverse correlation was established between the level of myofibroblasts and the number of inflammatory cells. A multi-layered vascular basal membrane was found in the capillary vessels of 5 carcinomas. Myofibroblasts were invariably accompanied by altered smooth muscle cells corresponding to pericytes with smooth muscle traits. The findings suggest that myofibroblasts may develop from fibroblasts, smooth muscle cells of the intestinal wall and cells of vascular structures. PMID- 6495699 TI - [Combined treatment of uterine cancer using preoperative intracavitary gamma therapy]. AB - Low-fractionated intracavitary gamma-therapy from the AGAT-B installation was given to 212 patients as the initial component of combined treatment. The treatment was well tolerated and was followed by a partial regression of tumor. It did not interfere with surgical intervention nor did it involve an increase in postoperative complication incidence. Application of the procedure raises the effectiveness of combined treatment of uterine cancer. PMID- 6495700 TI - [Effect of selenium on transplacental carcinogenesis]. AB - The effect of prolonged postnatal treatment with sodium selenite dissolved in drinking water upon transplacental carcinogenicity of N-ethyl-N-nitrosourea (ENU) was studied in noninbred albino rats and that of urethan in noninbred albino mice. Selenium treatment (4 ppm) did not produce a significant influence upon the development of neurogenic tumors and mesenchymal kidney tumors induced by transplacental administration of ENU (75 mg/kg) in rat offsprings. On the contrary, in mice progeny, selenium (2 ppm) showed an inhibitory effect upon the development of lung adenomas induced by transplacental administration of urethan (1 g/kg). However, it decreased significantly tumor multiplicity only. Inhibition of non-epithelial tumor development by selenium treatment seems to be less effective at the stage of carcinogenesis promotion. PMID- 6495702 TI - [Response to the discussion of the article by Turusov and Parfenov entitled "The problem of threshold in chemical carcinogenesis" (1982)]. PMID- 6495701 TI - [Ineffective concentrations of chemical carcinogens and the problem of threshold]. PMID- 6495703 TI - [Genetic variability of the human influenza virus during adaptation in mice]. AB - After 12 passages of a mouse-nonpathogenic influenza A/USSR/90/77 virus in mouse lungs a pathogenic virus was obtained causing death of the animals at 4-7 days after intranasal inoculation. The genetic and structural analysis of the initial and pathogenic viruses performed by oligonucleotide mapping of individual virus genes demonstrated that in the course of adaptation to mice structural changes had occurred at least in 5 out of 8 genes of virus with the exception of the genes coding for matrix and nonstructural proteins. The greatest differences were found in the genes coding for surface glycoproteins: hemagglutinin and neuraminidase. The experimental results indicate an important functional role of surface glycoproteins of influenza virus, particularly hemagglutinin, in the process of adaptation and formation of the pathogenic properties of virus. PMID- 6495705 TI - [Viral hepatitis and normal killers]. AB - The results of the study of functional activity of normal killers in different liver diseases: acute virus hepatitis A (26 patients), acute virus hepatitis B (24 patients including 3 with hepatic coma), and 12 patients with chronic liver diseases including 8 with chronic persisting hepatitis and 4 with chronic active hepatitis are presented. A control group included 17 apparently normal subjects. The most marked decrease of the level of activity of normal killers was found in hepatic coma and in chronic active hepatitis. The expedience of determinations of the activity level of normal killers for prognosis of immediate and remote outcomes of viral hepatitides as well as for the development of new methods of immunocorrecting therapy is discussed. PMID- 6495704 TI - [Detection of influenza virus A antigens by radioimmunological methods in patients' nasopharyngeal washings]. AB - 9olid-phase radioimmunoassay (SPRIA) was used for the detection of influenza A (H3N2,H1N1) and B viruses in nasopharyngeal washings of patients admitted in January-March, 1983, to the 1st Clinical Hospital of Moscow City with acute respiratory diseases. The solid phase consisted of nitrocellulose filters and plastic plates which were coated with nasopharyngeal washings of the patients. Rabbit or horse antiviral immunoglobulins were used as antibodies. 125I-labeled protein A was the indicator system. In 61 out of 211 patients examined influenza A (H3N2) virus was detected; from 20 of the influenza A (H3N2), from 7 influenza A (H1N1) virus was isolated, but no influenza B virus was ever found. Comparisons of the results of SPRIA and IF techniques yielded similar but not identical data. Diagnostic rises of antibodies were demonstrated in 48 out of 61 patients. The lack of complete correlation between antibody rises and detection of influenza A virus antigen appears to be due to early discharge of the patients when humoral immunity had not reached its peak. The SPRIA is a highly sensitive and specific technique for influenza A virus detection in nasopharyngeal washings of the patients and may be recommended for use in properly equipped laboratories where highly specific hyperimmune sera are available. It gives an objective information on the proportion of influenza in the period of epidemic rise of ARD incidence. PMID- 6495707 TI - [Tissue reaction and influenza virus infectiousness during multiplication in tissue culture in the presence of remantadine]. AB - The effect of remantadine in tissue culture of primary chick embryo fibroblasts (CEF) infected with classical fowl plague virus (FRV) was found to be dual. On the one hand, in low concentrations remantadine effectively inhibited in CEF reproduction of the virus sensitive to it. On the other, in high (subtoxic) concentrations in CEF infected with either sensitive or remantadine-resistant FPV variants it induced virus reproduction. The latter became noninfectious for normal CEF but retained its capacity for multiplication in cells treated with high concentrations of remantadine. PMID- 6495706 TI - [Results of human immunization with a new rabies vaccine containing no neuroallergenic brain tissue factor]. AB - Immunization with a vaccine prepared from sheep-brain-grown fixed rabies virus inactivated with beta-propiolactone was given to 146 subjects. The vaccine was by 80-90% purified from waste brain tissue substances (protein content less than 2 mg/ml) and showed no neuroallergenicity in guinea pig tests. Simultaneously 86 subjects were vaccinated with commercial Fermi vaccine. Immunization was performed according to the schedules accepted in the USSR. The new vaccine produced much fewer local reactions than Fermi vaccine (in 39.6% and 60.9% vaccinees, respectively) and 5 times as few systemic reactions (in 6.03% and 31.3% vaccinees, respectively). The antigenic potency of the new vaccine was as good as that of Fermi vaccine. PMID- 6495708 TI - [Clinical and immunological studies of an experimental series of vaccines against hepatitis B]. AB - Two experimental lots of hepatitis B vaccine were prepared by purification of HBsAg from human plasma, inactivation at 100 degrees C for 2 min and at 37 degrees C for 72 hours with formalin in a concentration of 1:4000. The former lot comprises purified HBsAg (40 mg/ml) adsorbed with 0.32 mg % Al(OH)3, the latter consists of purified HBsAg stabilized with 0.1% human albumin and adsorbed with 1 mg% Al(OH)3. The immune response after vaccination with the first lot was observed in 54.54% of the vaccinees. The second vaccine after 3 administrations of 80 micrograms/ml each produced a very good primary and a very good secondary immune response. Both vaccines are nonreactogenic and well tolerated by the vaccinees. PMID- 6495709 TI - [Continuous kidney cell line No. 4647 from an adult green monkey and its use in virological practice]. PMID- 6495710 TI - A functional breakdown of the goal of "Health for all by the year 2000". PMID- 6495711 TI - Catheter-associated urinary tract infections. Part I: Epidemiology, pathogenesis and bacteriology. PMID- 6495712 TI - Berry aneurysms of the circle of Willis. Results of an autopsy study at the University Hospital of the West Indies. PMID- 6495713 TI - Paired maternal and umbilical cord serum cholesterol and triglyceride levels in Jamaicans. Normal values and the influence of some perinatal factors. PMID- 6495714 TI - Polymyositis at the University Hospital of the West Indies. PMID- 6495715 TI - Clinical features of non-Hodgkin's lymphoma in Jamaica. PMID- 6495716 TI - Intrapericardial heart and great vessel injuries. PMID- 6495717 TI - Antibiograms of gram-negative bacteria recovered from clinical specimens at the University Hospital of the West Indies (August, 1982--January, 1983). PMID- 6495718 TI - Socio-economic status and lung function in Jamaican children. PMID- 6495719 TI - The syndrome of insulin resistance, acanthosis nigricans and an autoimmune disorder in diabetes mellitus treated with immunosuppressants. PMID- 6495720 TI - Hepatic artery ligation for spontaneous hepatic rupture in pregnancy. PMID- 6495721 TI - Delayed presentation of brain abscess following penetrating cranial wound. PMID- 6495722 TI - Health status of Southeast Asian refugees. AB - The rates of several diseases have been reported to be higher among Southeast Asian refugees compared with those of indigenous North Americans. When we prospectively evaluated 991 refugees new to the Denver metropolitan area for their health and immunization status over a 12-month period, 38% were found to be tuberculin-positive, 71% carried one or more enteric parasites, 15% were HBsAg positive, 13% had anemia and 31% either presented without immunization records or required continuation of vaccination sequences begun in overseas camps. Age and ethnicity were important variables with regard to tuberculosis, hepatitis B and anemia. The rates of specific parasitic infestations varied among the four ethnic groups, though the overall rates of parasitosis remained constant across ethnic lines. PMID- 6495723 TI - Differences between right and left arm blood pressures in the elderly. AB - Recommendations vary on whether blood pressures should be measured in the right or in the left arm because no frequency distributions for a pressure difference between the arms exist. We took a total of 12 blood pressure determinations in both arms of 174 elderly persons and analyzed the data by a least-squares components of variance method. The mean difference between the arms (right minus left) was 0.93 mm of mercury for systole and 0.70 mm of mercury for diastole. For systole the proportion of persons having arm pressure differences exceeding 10 mm of mercury is 1.4% and that exceeding 7.5 mm of mercury is 6.5%. For most people, the pressure difference between the arms is small. PMID- 6495724 TI - Auscultatory blood pressure measurement--effect of pressure on the head of the stethoscope. AB - Excessive pressure on the stethoscope head in auscultatory blood pressure measurement does not affect systolic blood pressure value but it does erroneously lower diastolic readings and frequently causes the sounds to persist to zero. Consequently, the lightest possible pressure should be placed on the stethoscope head. PMID- 6495725 TI - Magnified risks from cigarette smoking for coronary prone families in Utah. AB - The contribution of currently accepted risk factors to the familiality of early coronary heart disease (CHD) is poorly understood. In a telephone and mail survey, risk factor and disease morbidity and mortality data were collected from 100 proband and 185 control families encompassing about 40,000 person-years of experience. Probands were white married men who had died of CHD by age 45. There was a threefold increase in CHD incidence among first-degree relatives of probands compared with control families. In all, 67% of probands had at least one first-degree relative with early CHD, and 29% had two or more first-degree relatives with early CHD compared with 8% of the control families with two or more cases of early CHD. The most striking new finding of this study is the apparently magnified liability of cigarette smoking in families prone to have early coronary heart disease. This effect was seen strongly at younger ages (under 50). Furthermore, in about a third of all families with a history of early CHD, smoking seemed to be the only risk factor contributing to the familial occurrence of the disease. The findings show a large excess absolute risk for CHD among smoking members of proband families and further suggest a possibly heritable susceptibility to the deleterious effects of smoking in many families prone to early coronary disease. Modification of coronary risk factors, especially cigarette smoking, would be of greatest benefit among members of high risk families. PMID- 6495726 TI - Febrile gastroenteritis due to Salmonella thompson. Report of an outbreak. AB - Salmonella thompson, a common pathogen of poultry, has received scant attention as a cause of human gastroenteritis. At least 45 persons were infected with S thompson in Sacramento, California, after eating at a chicken restaurant and 38 became symptomatic. Ten required admission to hospital, and all were treated with antibiotics and improved. In 19 cases cultures of stool specimens for S thompson over a 60-day period showed slower but statistically insignificant differences in salmonellal elimination in 7 patients who received antibiotics when compared with 12 who were untreated. We report this outbreak to increase awareness of the virulence and prevalence of gastroenteritis due to S thompson. PMID- 6495727 TI - Reye's syndrome. AB - Reye's syndrome (encephalopathy with fatty infiltration of the viscera) is an acute illness of childhood that produces hepatic dysfunction and metabolic encephalopathy. The disease is fatal in as many as 40% of cases. The cause is unknown. Several environmental agents, particularly salicylates and aflatoxin, have been implicated as possible toxins in this disorder. Treatment is directed at controlling intracranial pressure, reversing metabolic abnormalities and providing intensive supportive care. Normal neurologic function returns in most survivors. PMID- 6495728 TI - Reye's syndrome--still an elusive entity. PMID- 6495729 TI - On measuring both quality and costs in patient care. PMID- 6495730 TI - Peutz-Jeghers syndrome with cervical adenocarcinoma and enteritis cystica profunda. PMID- 6495731 TI - Treatment of rattlesnake bites. PMID- 6495732 TI - Ergonovine-induced chest pain not due to coronary or esophageal spasm. PMID- 6495733 TI - [Does stopping tobacco smoking affect long-term prognosis after myocardial infarction?]. PMID- 6495734 TI - [Usefulness of the sphyngo-oscillometric method of determining arterial blood pressure under clinical conditions]. PMID- 6495735 TI - [Traumatic rupture of the spleen]. PMID- 6495736 TI - [Cicatricial esophageal stenosis in gastric or duodenal ulcer complicated by reflux esophagitis]. PMID- 6495737 TI - [Hysterectomy: analysis of the results of histopathological examinations]. PMID- 6495738 TI - [Heart injuries at the site of origin of the pulmonary artery and aorta]. PMID- 6495739 TI - [A case of hemiturrispondylia]. PMID- 6495740 TI - [The ri-du-chat syndrome]. PMID- 6495742 TI - [Clinical symptoms of histiocytosis X of the Letterer-Siwe type in an infant]. PMID- 6495741 TI - [Prune belly syndrome in a newborn infant]. PMID- 6495743 TI - [Acute disorders of hemostasis]. AB - Acute acquired hemostatic disorders are of widespread origin. Coagulation disorders (severe liver damage), platelet disorders (impairments of platelet function and number, immunologic and/or toxic myelosuppression) or various combinations (e.g. disseminated intravascular coagulation). According to the various etiologic factors different diagnostic and therapeutic approaches are appropriate. PMID- 6495744 TI - [The hypertensive crisis]. AB - As hypertensive crisis may lead to death or to permanent organic defects a rapid therapy is necessary. In addition to general therapies a series of highly efficient antihypertensive agents are at our disposal. Advantages as well as disadvantages of these substances and their consequences to the hemodynamic are being discussed. Giving preference to an antihypertensive agent is mainly determined by the clinical symptoms and the available monitoring devices. PMID- 6495745 TI - [Catecholamines in internal medicine emergencies]. AB - The most important indications for the application of the catecholamines dopamine and dobutamine in the internal intensive medical care are acute disturbances of the peripheral vascular regulation and acute heart failure. Differential therapeutic considerations are due to the different actions of both pharmaceutics. Disturbances in peripheral circulation and in renal function are of great importance in case of the septic shock. Dopamine is highly advisable for its vascular and renal efficacy. Whereas the application of dobutamine or a therapy combining the application of dobutamine and dopamine has to be preferred in case of a cardiogenic shock. A retrospective examination has shown that the mortality of patients with a cardiogenic shock after an acute myocardial infarction could be lowered by a therapy of the current catecholamines dobutamine and dopamine. PMID- 6495746 TI - [Passive immunoprophylaxis in hepatitis B]. PMID- 6495747 TI - [Effect of synthetic secretin and GIH-cholecystokinin on serum gastrin levels]. AB - In response to the report of a false-positive increase in serum gastrin with the use of natural secretin (Boots), 11 test persons were enlisted in order to examine the effect of a new synthetic secretin (Hoechst), both alone and in combination with natural CCK, on serum gastrin concentration. 6 of the test persons were subjected to a randomised cross-over study under NaCl infusion. Under secretin (0 to 60 minutes) there was a significant fall in gastrin from 32 +/- 2.3 pg/ml to 23 +/- 2 pg/ml (p less than 0.01). When CCK was also administered (60 to 120 minutes) the gastrin level increased to 46 +/- 3.5 pg/ml (75 versus 0 minutes: p less than 0.01), 75 versus 60 minutes: p less than 0.001). At the end of the infusion the gastrin level had fallen significantly once more to 21 +/- 2 pg/ml (135 versus 120 minutes: p less than 0.001, 135 versus 0 minutes: p less than 0.01). On the basis of in vitro studies -- which revealed a cross-reaction of 2.4% - the increase in gastrin under CCK is not regarded as being due to cross-reaction with CCK but rather to contamination by other peptides. PMID- 6495748 TI - [Endoscopy of the upper gastrointestinal tract: changes in the concentration of vasoactive intestinal polypeptide and gastrin?]. AB - The report of a significant increase in plasma VIP concentration (PVC) during endoscopy of the upper gastrointestinal tract prompted us to examine this question under comparable experimental conditions, with simultaneous determination of serum gastrin concentration (SGC). Thirteen patients took part in a study wherein PVC and SGC were determined before, during and after oesophagogastroduodenoscopy (OGD). Before OGD the value for PVC was 30 +/- 2.5 pg/ml (means +/- SEM); during endoscopy it tended to increase slightly, to 35 +/- 3.2 pg/ml immediately after the examination (p greater than 0.05). By contrast with this finding, the SGC increased rapidly and significantly from 47 +/- 4.7 pg/ml prior to the examination to maximal values up to 68 +/- 6 pg/ml on inspection of the fundus (p less than 0,005), and was at a significantly increased level (p less than 0.05), with a value of 61.5 +/- 7.2 pg/ml, as much as thirty minutes after the examination. Sixty minutes after the examination the values had fallen to their original level (47.5 +/- 7.5 pg/ml). The present study shows that OGD has no significant influence on PVC, but that it is possible that stimulation of the VIP-ergic system is accompanied by a trivial increase in PVC. By contrast with this OGD significantly increases the concentration of endocrinally secreted gastrin, an effect which lasts as much as thirty minutes after the examination. The release of gastrin is a result of the combined effect of mechanical stimulation, distension due to insufflation of air and simultaneously induced neural influences. However, these mechanisms exert at most an insignificant influence on PVC - if indeed they have any effect on it at all. PMID- 6495749 TI - [Psychological adaptation in coronary patients]. AB - Summarizing some essential results from empirical investigations about the individual adaptation and coping with coronary heart diseases five principles are formulated: It ist not possible to predict the individual reactions to a coronary disease from the knowledge of the pathophysiological aspects. The behaviour pattern of these patients are different and complex determined. The individual reactions to the outbreak of the disease equally depend on familial, occupational, social and public health care factors on one side and on intrapsychical factors of the patient on the other side (i.e. personality structure, psychological status before the event etc.). The fact of a coronary or myocardial disease does not necessarily lead to a life-crisis or maladaptation. For the patient's style of life positive and/or negative effects of the disease can be differentiated. The patient's appraisal of a therapeutic success depends therefore on the intraindividual reinforcement-value of such a success. Adaptation and coping strategies are not uniform in phenomenological or time aspects. The emotional, cognitive and behavioural patterns primarily tend to help to cope with anxiety and uncertainty (f.i. denial, depression, aggression, building up a new identity). In the patient's mind a myocardial infarction is not necessarily the most important event in his actual life-situation. Concerning the heart disease fears about the own capacity of work and financial outcome are dominant. They are followed by concerns about the medical prognosis or course of disease, family life and partnership, satisfaction with future life and its meaning, and aspects of the social or ecological environment. Over all these patients show relatively optimistic prospects to their own future. PMID- 6495750 TI - [Diagnosis of infertility in women wanting children]. AB - The diagnosis of the female infertility is concentrated on five main points: monitoring of the female cycle, diagnosis of tubal, cervical, immunologic and psychosomatic factors. Outpointed is the endocrinological control in the female cycle and there disturbances. An important role in insufficiency of ovaries plays the hyperprolactinemic, the hyperandrogenemic and the thyroidogenic state. Also important for the diagnosis of female infertility are functional explorations like Metoclopramide and TRH tests. PMID- 6495751 TI - [Possibilities of reconstructive tubal surgery]. AB - Technical possibilities and some results of reconstructive tubal surgery with microsurgical technique are presented. 50% livebirth as calculated figure for the overall results of different groups of good tubal surgery, including refertilisation, on an international basis are proposed for discussion. PMID- 6495752 TI - Obturator hernia. PMID- 6495753 TI - Microsurgery as an adjunct to reconstructive surgery at the Medical College of Wisconsin. PMID- 6495754 TI - Echocardiographic manifestations of carcinoid heart disease. PMID- 6495755 TI - Physician resistance to treating the elderly: facing our own future. PMID- 6495756 TI - The malpractice problem: a surgeon's viewpoint. PMID- 6495758 TI - Studies related to the metabolism of anabolic steroids in the horse: the phase I and phase II biotransformation of 19-nortestosterone in the equine castrate. AB - The metabolism of 19-nor[4-14C]testosterone has been studied in the equine castrate. Following XAD-2 extraction of aliquots of the 0-24 h urine samples, the glucuronic acid and sulphate conjugates were separated by Sephadex LH-20 column chromatography. After hydrolysis of the conjugates, the neutral phase I metabolites of 19-nortestosterone were extracted, purified and identified by g.l.c.-mass spectrometry. In phase I metabolism stereospecificity was observed in the reduction of the A-ring with the formation of the 5 alpha, 3 beta-isomers of estranediol. Epimerization at C-17 and hydroxylation at C-16 were the other major pathways. In phase II metabolism the C-17 alpha steroid epimers were predominantly conjugated with glucuronic acid and the C-17 beta epimers with sulphuric acid. One animal showed a slight variation in metabolism with a tendency towards the formation of polar metabolites. PMID- 6495757 TI - Determination of metabolites of xenobiotics in the bile of fish from polluted waterways. AB - An h.p.l.c.-fluorescence technique was used to estimate relative concentrations of metabolites of xenobiotics in bile of 103 English sole (Parophrys vetulus) from both polluted and minimally polluted (reference) sites in Puget Sound, WA. Fish from polluted sites had concentrations of xenobiotics in bile with naphthalene-, phenanthrene- and benzo[a]pyrene-like fluorescence that averaged 9, 14 and 19 times, respectively, those of fish from reference sites. Within a polluted site, fish with liver lesions had significantly higher bile concentrations of xenobiotics with benzo[a]pyrene-like fluorescence than did fish without liver lesions. Individual metabolites of fluorene, phenanthrene, anthracene, biphenyl and dimethylnaphthalene were determined by g.l.c.-mass spectrometry in extracts of hydrolysed bile of three English sole from polluted waterways; concentrations ranged from 90 to 19000 ng/g, wet wt. Other xenobiotics were tentatively identified, but not quantified. PMID- 6495759 TI - Urinary metabolites of felodipine, a new vasodilator drug, in man, dog, rat and mouse. AB - The urinary excretion of total 14C after oral administration of 25 mg (approximately 1 mumol/kg) 14C-felodipine to man, and intragastric administration (5 mumol/kg) to dog, rat and mouse, was 70, 39, 44 and 53% dose, respectively, in 72 h. Metabolites of felodipine were separated and quantified by h.p.l.c. Unchanged felodipine and its oxidized analogue were not excreted by any of the species studies. Three metabolites, present in all species studied, were isolated from urine and identified as products of the oxidation of felodipine to its pyridine analogue followed by hydrolysis of one or both of the pyridine carboxylic acid esters. PMID- 6495760 TI - The formaldehyde-donating activity of N5,N10-methylene tetrahydrofolic acid in xenobiotic biotransformation. AB - Reaction of reproterol, (7-(3-[2-(3,5-dihydroxyphenyl)-2 hydroxyethylamino]propyl)theophyl line (I), with formaldehyde liberated in a solution of N5,N10-methylene tetrahydrofolic acid at pH 7.3 led to the formation of 7-[3-(4,6,8-trihydroxy-1,2,3,4-tetrahydroisoquinolinyl-2)propyl]th eophylline (II), but no such reaction was observed in a solution of N5-methyl tetrahydrofolic acid. Compound II was also formed by incubation of I with rat liver subcellular fractions. The highest formaldehyde-donating activity was found in the soluble fraction but some activity was also observed with washed mitochondria and microsomes. Dimedone was transformed to methylene bisdimedone by incubation with the soluble fraction. The amount of formaldehyde liberated in the soluble fraction during a four hour incubation at 22 degrees C was 1-3.6 mumol/g of liver. Metaproterenol and terbutaline, structurally related to I, reacted with formaldehyde to yield the corresponding tetrahydro-isoquinolines. The rate of this chemical reaction for the three drugs correlated with the amount of the tetrahydroquinolines formed by incubation with the soluble fraction and in orally dosed rats. PMID- 6495762 TI - Teenage pregnancy in the Bahamas: trends and characteristics. AB - This survey of 99 pregnant teenagers in clinics on the island of New Providence, Bahamas, produced data suggesting that they are similar to their counterparts in urban clinics in the U.S.A. The pregnancies usually came from relationships of many months' standing, which were meaningful to the young mothers, rather than from "promiscuous" sexual behavior. Few of the young mothers had been using birth control before they became pregnant, sometimes because of a lack of expectation of needing it or from fear or ignorance about birth control, and sometimes due to an inability to organize their lives sufficiently to find, purchase, and use regularly the contraception that would have prevented the pregnancy. Most of the young mothers felt that abortion was sinful and would not have used it at any time. It is suggested that these general characteristics of teenage pregnancy are common in Western societies and are related to the perceived loneliness and uselessness of the teenage period. The pregnancies often may be seen as an attempt by teenagers, who see relatively little future for themselves in traditional education and employment, to strive for a creative life rooted in loving relationships. PMID- 6495761 TI - A clinical scoring system for detection of patients with pheochromocytomas. AB - We analyzed the medical records of patients admitted to 11 hospitals over a 15 year period, looking for those with metabolically active sporadic pheochromocytomas (Group A) and those in whom the diagnosis was highly suspect but excluded (Group B). Fifty-three patients in Group A and 25 patients in Group B were found. We then devised a scoring system based on the presence or absence of typical symptoms and signs (SSS) and another which also included the results of routine 24-hour urine studies for catecholamines or metabolites (SSLS). The point values given for each symptom and sign were based on those felt to be most characteristic of the disease and points were subtracted if the typical manifestation was absent. Additional points were given if the symptom or sign were paroxysmal. In a high-risk population, the sensitivity of the SSS and the SSLS was 96 percent and the specificity was 64 percent and 88 percent, respectively. The predictive value of a positive SSS was 85 percent and of a positive SSLS was 94 percent. In a large group of patients with essential hypertension (Group C) only 17 of 385 (4.4 percent) had a positive SSS and only one of 385 had a positive SSLS. We feel this scoring system can help detect those hypertensive patients in whom further extensive and potentially invasive evaluation is warranted. PMID- 6495763 TI - [Biologic aging. 22. Oxygen and aging]. AB - By means of the experimental-gerontological literature the question of causality between oxygen and ageing and the age-associated alterations, influencing oxygen utilisation, were discussed. Under normal conditions there are no significant decreases of high-energy compounds in the most organs, although under a strain of organism it is possible to show a reduction of adaptation and regulation on different levels. Oxygen deficiency as a primary cause of ageing could not be showed experimentally. On the other hand the classification of free radicals (= the products of oxygen activation) as primary factors of ageing are more conceivable. The estimation of causal relations is difficult because of the interlocking of physiological and pathological processes of ageing. PMID- 6495764 TI - [Aging of the population and problems of the social and medical care of elderly citizens]. AB - The authors analyse the demographic situation in the Ukraine SSR and lead away the consistency for the complex care for people in old age. PMID- 6495765 TI - [Examples of the coincidence of fluoride osteosclerosis and prostatic neoplasm]. AB - Report on two patients with coincidence of osteosclerosis caused by fluorides and prostatic cancer. The necessity of co-operation between several fields of medicine in the differential diagnosis of the symptom osteosclerosis is accentuated. PMID- 6495766 TI - [Circadian rhythms of various components of the blood in the aged]. AB - Chronobiological modifications in advanced age were already observed for several biochemical parameters and biological functions. Within a review about the circadian rhythms of some blood constituents in the aged, personal results about blood picture, antithrombin III, serum iron and transferrin, immunoglobulins and some enzymes are reported. A circadian rhythm was evident for almost all parameters considered. Differences with respect to young persons were evidenced for IgA, IgG and antithrombin III. The circadian system in the aged is, in general, similar to that of the adult in the middle life. PMID- 6495767 TI - [Ventilation-improving measures without assistance]. PMID- 6495768 TI - [Simple aids for improving respiration in emergency patients]. PMID- 6495769 TI - [Extra-clinic emergency treatment of respiration disorders in infants and young children]. PMID- 6495770 TI - [Cardiologic emergencies in the prehospital phase]. PMID- 6495771 TI - [Antiarrhythmic drug therapy and prevention of cardiac emergencies in the prehospital phase]. PMID- 6495772 TI - [Possibilities of electrotherapy of the heart in the prehospital phase]. PMID- 6495773 TI - [Possibilities of ECG recording in emergency medical care conditions]. PMID- 6495774 TI - [Shock--diagnosis and therapy within the scope of rapid medical care]. PMID- 6495775 TI - [Access to the venous system]. PMID- 6495776 TI - [Effectiveness of extrathoracic heart massage and implications for education]. PMID- 6495777 TI - [Intubation, tracheal puncture and coniotomy at the emergency site]. PMID- 6495778 TI - [Experiences with transesophageal stimulation in emergencies]. PMID- 6495779 TI - [Rescue stations--a necessity for emergency care]. PMID- 6495780 TI - [The rescue station with expanded responsibilities]. PMID- 6495781 TI - [The need for interdisciplinary cooperation exemplified by patients with exogenous poisoning]. PMID- 6495782 TI - [Aspects of medical undergraduate, graduate and continuing education in emergency medicine]. PMID- 6495783 TI - [Continuing education of physicians and dentists in East Germany]. PMID- 6495784 TI - [Scientific bases for the effective use of drugs in medical care based on an analysis of drug utilization. Goal and content of utilization analysis. Use of analysis results in the collaboration of pharmaceutical and medical care areas]. PMID- 6495785 TI - [Identification of parasitic infestations by fecal examination]. PMID- 6495786 TI - [Nonverbal communication and physician-patient relations]. PMID- 6495787 TI - [Urolithiasis and the solitary kidney]. PMID- 6495788 TI - [Value of the EEG in the diagnosis of minimal brain dysfunction in early childhood]. PMID- 6495790 TI - [Work capacity in exposure to chemical industrial substances]. PMID- 6495789 TI - [A methodological solution for perinatal instrumental monitoring]. PMID- 6495791 TI - [Regional differences in mortality in East Germany]. PMID- 6495792 TI - [Effect of electric fields on performance and affect in healthy probands]. PMID- 6495793 TI - [Content and formal evaluation of a psychoticism factor in multi-dimensional personality inventories. Exemplified by the Paranoid-Neuroticism-Depression Scale versions in relation to the Freiburg Personality Inventory and the Giessen Test]. PMID- 6495794 TI - [Psychophysiologic correlates of chronic headache]. PMID- 6495795 TI - [Analysis of the Aggressive Behavior Scale in children at a counseling service and normal samples]. PMID- 6495796 TI - [Effect of an inpatient exercise therapy program on the R and RS amplitude in the stress ECG]. AB - The ECG after work of 60 patients after an acute myocardial infarction was examined before and after a 4-week physical training as well as 6 months after the acute phase of the infarction. In the precordial leads the changes of the amplitude of the R-waves and the RS-complex as well as the depression of the ST segment during the bicycle ergometer load and the delta-values were determined. The investigations evoked to the end of the training programme a significant decrease of the delta-values, which again increased at a later control. The change is explained by the haemodynamic and anti-ischaemic effect of the training programme. PMID- 6495797 TI - [Results and value of a submaximal and symptom-limited stress test in the 3d week following acute myocardial infarct]. AB - In the third week after acute, definitive myocardial infarction in 45 patients (34 males, 11 females) at an average age of 63 years a submaximal and symptom limited, respectively, exercise test was performed. With 57 watt and a watt pulse of 0.53 the males reached significantly higher performances than the females. 17 patients who had to finish the test above all on account of the transition of the submaximal heart rate showed a high performance of more than 50 watt. On the other hand, patients showed low performances who in the acute phase had transient, medicamentously controllable bradytachycardias, right cardiac insufficiency or depression of the blood pressure or finished the test on account of the depression and the elevation, respectively, of the ST segment. In the first year died 5 patients who all were older than 70 years and had shown low performances between 25 and 50 watt in the exercise test of the third week, connected with depressions of the ST segment of higher degree. PMID- 6495798 TI - [Incidence of primary heart tumors]. AB - Report on 9 primary tumours of the heart as well as of pericardium (3 sarcomas, 3 myxomas, 1 rhabdomyoma as well as 1 mesothelioma and 1 lipoma). Discussion of histology, complications, diagnostics and therapy of these neoplasias on the basis of own material as well as of literature. PMID- 6495799 TI - [Clinical etiological findings in chlamydial urethritis in men]. AB - 120 patients with abacterial urethritis were studied for chlamydia. Clinical, cytological, serologic and electronenmicroscopic tests were performed. 66.60% of the tested persons were seropositive for C. trachomatis, 32.50% of all patients and 48.80% of the seropositive patients showed positive cytological tests. Direct electron microscopy of biopsy material of the urethra of 30 patients revealed chlamydial bodies in high concentrations. The incubation period was about 1-2 weeks. Oxytetracycline was used for 8 days, but had to be one- to four times repeated in resistent cases. PMID- 6495800 TI - [Psoriasis vulgaris--sulfur brine therapy in 140 patients]. AB - 140 patients suffering from generalized chronic psoriasis were treated with the help of the natural sulphur resources of St. Peter-Ording over a period of 4 to 6 weeks. In 135 of these cases (96.4%), the skin became well improved. In 4 patients (2.9%) the skin lesions remained unchanged, while in only one case (0.7%) the lesions worsened. PMID- 6495802 TI - [Biography as giving sense to the senseless?]. PMID- 6495801 TI - [Electron microscopic demonstration of spirochete-like structures in acrodermatitis atrophicans Herxheimer]. PMID- 6495803 TI - [The virile crisis in the 6th decade]. PMID- 6495804 TI - [Dysmorphophobia--self concept and self identity]. PMID- 6495805 TI - [Hyperkinetic syndrome. Approaches to an integrative theory and research program II]. PMID- 6495806 TI - [Effects of self concept on causal attributions and emotional reactions in imagined success and failure situations]. PMID- 6495807 TI - [A category system for the analysis of verbal interactions of couples with a depressive partner]. PMID- 6495808 TI - [Formation of homogeneous psychosomatic therapy groups by use of cluster analysis algorithms]. PMID- 6495809 TI - [Hemodynamic effects of the new calcium antagonist nimodipine in normal and increased blood pressure]. AB - The new compound nimodipine, a calcium channel-blocking agent, belongs to the dihydropyridine derivatives. In experimental studies it exhibits a preferential vasodilator action on cerebral vascular smooth muscle. We studied the hemodynamic effects of nimodipine in 8 normotensives (5 male, 3 female, mean age 47.8 +/- 3.7 years) and 8 patients (6 male, 2 female, mean age 57.4 +/- 2.6 years) with a systolic blood pressure greater than or equal to 165 mm Hg. After administration of nimodipine in hourly increasing doses of 0.015 mg/kg/h, 0.030 mg/kg/h and 0.045 mg/kg/h by an i.v. infusion, the following parameters were measured continuously: systolic, diastolic and mean arterial pressure (brachial artery), systolic and diastolic pulmonary artery pressure, pulmonary wedge pressure, cardiac and stroke volume index, total vascular resistance, stroke work index, blood flow in the legs by venous occlusion plethysmography and heart rate. Nimodipine provided a significant reduction of systolic, diastolic and mean arterial blood pressures when 0.015 and 0.030 mg/kg/h were infused. The higher dose of 0.045 mg/kg/h did not reduce these values any further. In normotensives cardiac index increased significantly. Hardly any changes in heart rate were observed. Total vascular resistance decreased significantly. Preload remained nearly unchanged. From these results it is concluded that the new calcium antagonist nimodipine provides potent vasodilator effects with a moderate reduction of blood pressure and without significant changes in heart rate. PMID- 6495810 TI - [Effects of diltiazem on rest and stress hemodynamics in coronary disease]. AB - The acute hemodynamic effects of the Ca-antagonist Diltiazem were measured in the course of diagnostic cardiac catheter examinations in 10 patients with coronary heart disease. After initial step-wise ergometric stress, Diltiazem (D) was applied intravenously for 5 min at a dose of 0.3 mg/kg. The effects on right and left ventricular performance as well as on arterial pressure and heart rate were registered 1, 3, 5, 10 and 15 min after termination of the infusion. Then, a second period of ergometric exertion under identical stress conditions was performed. The results under resting conditions show that D effects a significant increase in left ventricular filling pressure (p greater than 0.005), which, however, only lasts a few minutes. After D, the systolic and mean arterial pressure decreases significantly (p greater than 0.001); there is no reflex induced increase in the heart rate, which on the contrary is significantly lower (p greater than 0.005) 15 min after termination of the infusion than the initial value. The stroke volume index increases from 40 to maximally 48 ml/m2 after D. Comparison of the hemodynamic parameters under ergometric stress before and 20 min after D shows that, on termination of stress, the filling pressure of the left ventricle is reduced. This behavior can largely be attributed to the reduction of the systolic pressure after D (maximal value before D 181, after D 167 mm Hg). Also, the stress-induced increase in the heart rate takes a flatter course after D than before it. The results obtained thus provide evidence that, at a dosage of 0.3 mg/kg, D has no significant negative inotropic effect and probably leads to a decrease of the myocardial oxygen consumption reducing the systolic pressure and, to a lesser degree, heart rate. PMID- 6495811 TI - [Comparative studies on the anti-arrhythmic and anti-fibrillatory effectiveness of verapamil and nifedipine following acute coronary artery occlusion and reperfusion]. AB - The ability of the two calcium-antagonists Verapamil and Nifedipine to reduce ventricular electrical instability following acute transient coronary artery occlusion and release and to prevent ventricular arrhythmias, particularly fibrillation, was evaluated on a total of 25 anaesthetized and artificially ventilated dogs. In all animals repeated coronary occlusions, lasting 20 min each, with a reperfusion period of 120 min between subsequent ligations, were performed. Time course and extent of ventricular ectopic activity were continuously registered, and the changes in ventricular vulnerability were assessed by measuring the ventricular fibrillation threshold at different times both after coronary artery occlusion and reperfusion. Verapamil displayed strong antiarrhythmic and antifibrillatory action on ventricular arrhythmias during occlusion. Ventricular tachycardia and fibrillation were completely prevented during phase la of arrhythmia (2nd to 10th min after coronary artery occlusion) and significantly reduced during phase lb (15th to 20th min after coronary artery occlusion). By contrast, Nifedipine failed to exert any antiarrhythmic and antifibrillatory effect, respectively. Following release of coronary artery occlusion, none of the compounds proved to reduce the frequency of ventricular fibrillation immediately after the onset of reperfusion. However, either drug was able to accelerate significantly the increase in the ventricular fibrillation threshold during the early post-reperfusion period. The different antiarrhythmic and antifibrillatory action of Verapamil and Nifedipine after coronary artery occlusion can be assumed to result from differences in the electropharmacological properties of these compounds, whereas the enhancement of the electrical stability of the myocardium after release of coronary artery occlusion may be due to "cardio-protective" effects of these drugs. PMID- 6495812 TI - [Spontaneous occlusion of a congenital coronary artery fistula]. AB - Cardiac catheterisation of a 6-month-old asymptomatic infant with a continuous precordial murmur revealed a congenital coronary artery fistula draining into the right ventricle. Following a period with no complications and the disappearance of the cardiac murmur, recatheterisation at the age of 4 years showed spontaneous complete closure of the fistula. This case in connection with 3 similar cases from the literature suggests that in asymptomatic patients with a congenital coronary artery fistula surgery might be delayed until school age in order to give spontaneous closure a chance. PMID- 6495813 TI - [A simple procedure for the immunoturbidimetric determination of apolipoprotein B]. PMID- 6495814 TI - [A fully automated method for the determination of butanol-extractable iodine using the automatic flowthrough device of the Medingen VEB MLW Prufgeratewerk]. PMID- 6495815 TI - [Testing a test strip for determining the specific gravity of urine]. PMID- 6495816 TI - [Precipitation reactions with Toxoplasma antigen in diagnostic practice]. PMID- 6495817 TI - [Management decisions of medical directors for responding to reasonable demands in laboratory diagnosis]. PMID- 6495818 TI - Studies on the possible mechanism of inactivation of phenylalanine hydroxylase by destructive oxygen species. AB - The enzymic hydroxylation of phenylalanine by phenylalanine hydroxylase (E.C. 1.14.16.1.) in vitro is dependent on the presence of hydrogen peroxide removing processes. The loss of phenylalanine hydroxylase activity can be prevented to the same extent by catalase as well as the presence of optimized amounts of both peroxidase and superoxide dismutase. Peroxidase alone exhibited only two third of the maximal protective effect of catalase whereas superoxide dismutase alone was not able to exert any protective influence on phenylalanine hydroxylase. These findings suggest that the termination of phenylalanine hydroxylation in the absence of hydrogen peroxide removing reactions is probably due to destructive oxygen species generated at the active site iron of phenylalanine hydroxylase in the presence of H2O2 and the tetrahydropterin cofactor. PMID- 6495819 TI - Polycation-cell surface interactions and plasma membrane compartments in mammals. Interference of oligocation with polycationic condensation. AB - At lower concentrations, polyarginine, polylysine, protamine, histones H1, H2A, H2B and H3 cause lysis of human erythrocytes, whereas at higher concentrations inner histones are not hemolytic but induce only surface condensation and alterations in the cell-shape. Antibody coated erythrocytes treated with polyarginine result in ghost-like spheres having globular bodies 1 micron in diameter on the surface. Human fibroblasts and lymphocytes, and Ehrlich ascites cells treated with polyarginine also form surface globular bodies similar in size. Nucleate cell-polyarginine mixtures with lower polycation doses result in cytolysis, while higher polycation doses produce pyknosis of the cell surface accompanied by reorganization of a membrane-like structure. Changes in spectrofluorometric values result from 1,6-diphenyl-1,3, 5-hexatrien binding to cell lipids, match the plasma membrane alterations. Reciprocal shake incubation amplifies and/or conditions these polycation-induced alterations. The homogeneity of pyknotic surface bodies and the apparent polycationic membrane reorganization requiring oscillatory friction forces suggest the preexistence of a multizonal glycocalyx distribution corresponding to plasma membrane compartments. The possible role of this compartmentalization in receptor and membrane recycling, as well as the involvement of reversible catalytic-like polycation condensation in macromolecular changes are discussed. PMID- 6495821 TI - "We are doing the best we can". PMID- 6495820 TI - In vivo metabolism of [4-13C]phenacetin in an isolated perfused rat liver measured by continuous flow 13C NMR spectroscopy. AB - Continuous flow 13C NMR spectroscopy has been used for the first time to monitor the metabolism of a 13C labeled drug in an isolated liver. Continuous and almost immediate information on the metabolite formation could be obtained using 13C labeled phenacetin without alteration of the biological system. The data are consistent with those observed by conventional techniques (HPLC, aliquot 13C NMR measurements). From the biological point of view the sensitivity of continuous flow 13C NMR spectroscopy is still low (10(-3) M). The results presented demonstrate however that non-invasive and non-radioactive real time monitoring of drug metabolism in intact organs is possible. PMID- 6495822 TI - Recent advances in diagnosing and treating heart failure. PMID- 6495823 TI - Life Support Learning Center. PMID- 6495824 TI - What you can do about colorectal cancer. PMID- 6495825 TI - Attention deficit disorder beyond childhood. PMID- 6495826 TI - [Pseudotumor cerebri]. PMID- 6495827 TI - [Enzyme therapy of tumors]. PMID- 6495828 TI - [New enzymatic systems of mammalian peroxisomes]. PMID- 6495829 TI - [Molecular forms of acid phosphatase in malignant lung tumors]. PMID- 6495830 TI - [Multiplicity of monoamine oxidases]. PMID- 6495831 TI - [Prenatal diagnosis of hereditary enzymopathies]. PMID- 6495832 TI - [Analysis of hexokinase isoenzymes in the differential diagnosis of malignant and benign tumors]. PMID- 6495833 TI - [Problems and prospects of using low temperatures in pediatric surgery]. PMID- 6495834 TI - [Clinico-experimental basis for an organ-preserving procedure in splenic injuries in children]. PMID- 6495835 TI - [Treatment of severe open bone fractures of the extremities in children using local gnotobiological isolation]. PMID- 6495836 TI - [Achievements, problems and the scientific prospects in pediatric surgery, anesthesiology and intensive therapy]. PMID- 6495837 TI - [Current methods of diagnosing and determining the level for resection of the large intestine in megacolon in children]. PMID- 6495838 TI - [Functional dependence between pressure in the pulmonary artery and venous admixing in the lungs in diseases in children]. PMID- 6495839 TI - [Evaluation of the effectiveness of the anesthesiological protection of the child's body from surgical trauma]. PMID- 6495840 TI - [Effect of central analgesics on hemodynamics under combined anesthesia in children]. PMID- 6495841 TI - [Central hemodynamics and blood volume in children with urinary diseases during the performance of hypervolemic hemodilution in surgery]. PMID- 6495842 TI - [Effectiveness of hyperbaric oxygenation in the combined treatment of severe surgical diseases in children]. PMID- 6495843 TI - [Catheterization of the thoracic aorta for the purpose of long-term intra-aortic infusions in children with destructive bacterial pneumonias]. PMID- 6495844 TI - [Evaluation of the hemodynamic effect of dopamine in newborn infants with the respiratory disorder syndrome]. PMID- 6495845 TI - [Pathogenetic basis for the dietary prevention of fluorosis]. PMID- 6495846 TI - [Rhythms of the electroencephalogram and their functional significance]. PMID- 6495847 TI - [Lateralization of perception of short time intervals and cortical evoked activity in man]. AB - Recognition of short time intervals (10, 60, and 180 ms) between visual stimuli presented to the left or right hemisphere was studied in adult healthy people. The interval of 180 ms is recognized better than that of 10 or 60 ms. Learning with repeated tests with 180 ms intervals proceeds better than that with short intervals. The predominance of the left hemisphere has been revealed only for perception of 10 ms interval. The other time intervals asymmetry is not observed. It is suggested that the left hemisphere is predominant in estimation of short (less than 60 ms) time intervals. In formation of time nervous model a significant role is played by local activation of the cortical zone where the standard stimulus is addressed. PMID- 6495848 TI - [Features of the associative function of the brains of children with high and low lability of nervous system processes]. AB - Characteristics of brain associative functions in children of 6 years old with different lability of nervous processes, were compared by methods of conditioning and informational analysis. In children with a low lability, these functions were 1.6 time slower than in other children. Enhanced demands to lability (limitation of time, acceleration of signals presentation) lead to their further slowing and successive inhibition. In children with a high lability, in such conditions an activation of brain associative functions was recorded followed by expressed successive excitation. These differences may be considered as typological. In cases of learned inertness of motor reactions, the characteristics of these functions corresponded to those in children with a high lability of nervous processes. PMID- 6495849 TI - [Learning characteristics and long-term memory in rhesus macaques]. AB - The use of entropy of choices distribution in studying the processes of learning and long-term memory in rhesus monkeys during differentiation of periodic and non periodic visual stimuli, showed that the transition from the unlearned state to the learned one proceeds not gradually but in two stages; the first stage--the accumulation of information and externally random behaviour, the second stage- rapid transition to the learned behaviour. For "filters" selective to spatial frequency, the change of stimuli orientation leads to an increase of the behaviour entropy. For "filters" selective to the bar width, the entropy practically does not change. During prolonged storage of acquired information, in the long-term memory, its partial loss takes place leading to an increase of the behaviour entropy. The difference between the entropy determined directly after the learning and that determined again after a prolonged storage of the memorized habit characterizes the quantity of information lost during the storage period. PMID- 6495850 TI - [Conditioned reflex transformation of unconditioned flexion of the limbs of the dog into extension]. AB - In response to electro-skin stimulation of the left forelimb eliciting its flexion,--an escape instrumental reflex was elaborated in five dogs in the form of extension of the stimulated limb (pressure on the support), i.e. a reaction antagonistic to the inborn one. The reaction was elaborated due to conditioned transformation of the unconditioned flexion: the flexion became gradually inhibited and the new form of reaction, previously not inherent in the animal increased and became stable. Such transformation of one reaction into another is connected with the reorganization of inborn coordinations. PMID- 6495851 TI - [Participation of the head of the caudate nucleus of the dog in mechanisms of conditioned reflex postural reorganization]. AB - On the model of instrumental defensive reflexes, components of conditioned postural reorganization were analyzed in 5 dogs before and after preliminary stimulation of the caudate nucleus head (CNH) of the contralateral (with respect to the active limb) hemisphere. The disturbance of normal function of the striatum caused by electric stimulation of CNH or by pathological changes elicited by a prolonged (during two-four years) CNH stimulation led to a significant change in the main mechanisms of posture reorganization: disturbances of the centre of gravity transfer and sharp rise of time of weight redistribution to the supporting limbs. Changes elicited by caudate pathology and by CNH stimulation went in the same direction. It is suggested that disturbances in the initiation of voluntary movement in striate pathology, are mainly caused by disturbances in posture initiation and reorganization, necessary for movement execution. PMID- 6495852 TI - [Conditioned reflexes before and after lesioning the substantia innominata in the cat]. AB - It has been shown that bilateral lesion of the substantia innominata has caused temporary depression of unconditioned and conditioned alimentary reflexes, disturbances of the elaboration and performance of conditioned reflexes. It is suggested that the latter produced by the operative memory disturbances. PMID- 6495853 TI - [Relation between the frequency of self stimulation and stimulus duration and its correlation with the duration preferred by the animal]. AB - The effect of duration of stimulus addressed to the lateral hypothalamus on self stimulation (SS) frequency was studied in rabbits. In the first experimental series, durations preferred by the animals were determined. Histograms of pression durations were obtained, and modal (Tm) and mean (T mean) durations were assessed. In the second series, stimuli were used of fixed duration equal to Tm, T mean and multiples to them--longer and shorter impulse bursts. Three types of distribution histograms of pression durations were obtained, which differed from each other by the form of the envelop as well as by variation coefficients of deviation of self regulated durations from the mean (T mean). These parameters were of a character of individual differences independently from localization of the stimulating electrodes tips. SS frequency was maximal when stimulation durations were 2 Tm and 1/2-1/4 T mean. Prolongation or shortening of the stimulation led to weakening of its reinforcing effect. The concept is discussed of two-component mechanism of reaction to stimulation of the SS hypothalamic zones: motivational excitation against the background of current action and positive reinforcement in post-stimulation period. PMID- 6495854 TI - [Correlation of electric potentials of the hippocampus, amygdala and neocortex during instrumental conditioned reflexes in the dog]. AB - Coherence and spectral functions of biopotentials of the hippocampus, amygdala, frontal and sensorimotor cortical areas were estimated in dogs during instrumental alimentary behaviour and during self-stimulation of emotionally positive brain areas. Formation of functional systems: frontal cortex--amygdala, frontal cortex--hippocampus, and sensorimotor cortex--amygdala, synchronously acting in delta- and theta bands of electrical activity, was observed at the stage of a stabilized motor habit. THe hippocampus and amaygdala poorly co operated, probably reflecting their different roles in the organization of behaviour. PMID- 6495855 TI - [Spatio-temporal characteristics of the EEG of the cat during formation of a delayed conditioned reflex before and after lesioning the temporal neocortex]. AB - Regular changes in dynamics of spatial distribution of single EEG theta oscillations was revealed in experiments on 5 cats during elaboration of a delayed conditioned reflex, before and after the ablation of the neocortical temporal zones. The data point to an important role of cortical associative areas in the processes of learning and of brain damages compensation. PMID- 6495856 TI - [Interaction between neurons of the visual and sensomotor areas of the neocortex during elaboration and extinction of a conditioned defense reflex]. AB - Cooperation in activities of pairs of neurones situated in projection cortical areas of conditioned and unconditioned stimuli was studied in rabbits during intertrial intervals at different stages of elaboration and extinction of conditioned defensive response by means of auto- and crosscorrelation analysis of impulse fluxes. At the stage of generalization the number of pairs of neurones discharging in correlation was shown to increase a little (64 per cent) in comparison to that at the initial stage of conditioning (50 per cent) and pseudoconditioning (54 per cent). At the stage of stabilization and during extinction the number of pairs of neurones discharging in correlation decreased correspondingly to 34 and 32 per cent. Parallel analysis of correlation in neuronal discharges and simultaneously recorded electroencephalogram allowed to suppose that excitatory synchronizing influences and inhibitory cortical system play a great part in synchronization of activities of cortical neurones. Participation of these two systems is not the same at different stages of conditioning and extinction. PMID- 6495857 TI - [Background activity and responses of caudate nucleus neurons to a conditioned stimulus during polarization of the centrum medianum of the thalamus]. AB - In chronic experiments on cats, the background and evoked activity of caudate nucleus neurones was studied, with the nucleus of thalamic median centre intact, but functionally eliminated by anodic polarization. During structure polarization, in 30 caudate nucleus cells an increase of mean frequency of action potentials was recorded, and in 22 cells--a decrease. The sign of conditioned reaction of caudate nucleus cells to a positive conditioned stimulus remained stable when the intact median centre nucleus was functionally eliminated. However, polarization of this structure changed the intensity and duration of individual components of the impulse response. PMID- 6495858 TI - [Fluorescence of dopaminergic terminals during elaboration of alimentary conditioned reflexes in the cat]. AB - A decrease of intensity of fluorescence of dopaminergic terminals in the nigrostriate and mesolimbic systems of rats was revealed under alimentary deprivation and during conditioned alimentary reaction. This decrease detected against the background of catecholamines synthesis blockade (alpha-methyl-para thyrosine 40 and 80 mg/kg intraperitoneally) testifies to an activation of dopaminergic terminals and participation of nigrostriate and mesolimbic systems in conditioned alimentary reaction. PMID- 6495859 TI - [Effect of noradrenaline on spatial synchronization and evoked potentials in the cerebral cortex of the rabbit]. AB - Noradrenaline application on the cerebral cortex of rabbits leads to an increase of the level of spatial correlation of neocortical potentials. At low doses of noradrenaline, the amplitude of EPs in the visual cortex initially decreases and then increases. With increases of the noradrenaline dose, the amplitude of EPs continues to increase. Amplitude of the EPs is enhanced also in the sensorimotor cortex for which the light stimuli are not specific. Analysis of data obtained and those published by other authors, allows to suppose that in the process of conditioning, noradrenaline may act as a positive as well as a negative reinforcing factor depending on the type and the stage of conditioning. PMID- 6495860 TI - [Characteristics of the process of image representation with changing exposure times]. PMID- 6495861 TI - [Signal system interaction during the process of visual form recognition in children]. PMID- 6495862 TI - [Features of the initial stage of elaboration of the food-getting reflex during rat ontogeny]. PMID- 6495863 TI - [Relation between evoked potentials of the auditory rea of the cerebral cortex of the cat and the sequential position of a click in a repeated standard series]. PMID- 6495865 TI - [Features of the background activity of nearby neurons of the motor cortex of the rat in situations of free general motor activity]. PMID- 6495866 TI - [Effect of desglycyl-8-arginine vasopressin on cerebral cortical neuronal activity in the alert cat]. PMID- 6495864 TI - [Cross-correlation interactions in the cortex upon stimulation of the posterolateral hypothalamus and raphe nuclei]. PMID- 6495867 TI - [Method and device for evaluating the emotionally-positive effects of pharmacologic agents]. PMID- 6495868 TI - Heavy metals at trace level in edible mussels (Mytilus galloprovincialis Lamarck) from the gulf of Trieste. AB - The concentration of heavy metals (cobalt, nickel, copper, cadmium, mercury and lead), which are present at trace levels in the edible part of mussels (Mytilus galloprovincialis Lamarck) from hatcheries in the gulf of Trieste, is normally or log-normally distributed, according to a statistical test sensitive to asymmetry of the distribution. A log-normal distribution appears valid for describing nearly all trace metals, in particular toxic heavy metals like cadmium, mercury and lead. The frequency distribution of these metals has nearly the same asymmetry, although the one-way analysis of the variance shows that sample means come from different population means characterising the particular hatchery. PMID- 6495869 TI - Multivariate data analysis of some xenobiotic trace metals in mussels from the gulf of Trieste. AB - The concentration of Cd, Hg and Pb in the soft part of mussels has been studied by means of bi- and multi-variate statistical approaches. In particular, the principal component analysis has been applied to study the association among these toxic metals in mussels sampled from the gulf of Trieste, which is a critical area as far as mercury pollution is concerned. PMID- 6495870 TI - [Spoilage of fruit juice by bacilli: isolation and characterization of the spoiling microorganisms]. AB - A Bacillus-strain was isolated from spoiled apple juice. This strain was acidophilic with a growth range between pH 2.5 and 5.5. Lipid analysis demonstrated the occurrence of omega-cyclohexane fatty acids and hopanoids. As these cell constituents have among bacilli been found only in Bacillus acidocaldarius strains, our isolated microorganism seems to be related to this species. Our organism could be a threat to fruit juices during storage at elevated temperatures (greater than or equal to 26 degrees C) because its spores were able to survive pasteurization conditions. PMID- 6495872 TI - [Formic acid in ginger bread--an adulterant?]. AB - Formic acid is a constituent of ginger-bread, formed by the baking process, in concentrations up to 1 000 mg/kg. PMID- 6495871 TI - The metabolism of several carboxylic acids by lactic acid bacteria. AB - The anaerobic metabolism of citrate, fumarate, gluconate, malate, 2-oxoglutarate and pyruvate by 137 strains of 23 species of lactic acid bacteria was investigated. The bacteria were from various sources (plant material, meat and dairy products, dough and wine) and belonged to the genera Lactobacillus, Leuconostoc, Pediococcus, and Streptococcus. The ability of metabolize the acids was determined by thin layer chromatography or by enzymatic analysis after growth of the strains in a glucose-containing medium. All strains metabolized pyruvate and only 12 mainly heterofermentative strains were malate negative. These strains were also unable to decompose citrate. This acid was fermented by 23 strains, all of which metabolized malate. Many lactic acid bacteria reduced 2-oxoglutarate to hydroxyglutarate. The strains of Lactobacillus plantarum did not metabolize 2 oxoglutarate whereas all strains of Leuconostoc oenos decarboxylated this acid and formed 4-hydroxybutyrate and succinate. Gluconate was fermented by 52 mainly heterofermentative strains. No correlation was observed between the ability to ferment citrate, malate or gluconate. PMID- 6495873 TI - [Ergot alkaloids in cereals--description of an analytical method]. AB - A method is described for the isolation, separation and quantitative determination of ergot alkaloids in cereals and cereal products. PMID- 6495874 TI - Corrosive ingestion in children. AB - In the 31-year-period 1950-80 there were 560 children admitted following possible ingestion of corrosive substances. 99% being under the age of 5 years, 6 children were admitted with late complications of corrosive ingestion. Of the 554 admitted in the acute phase, 149 had burns in the mouth, and 79 of these had burns in the oesophagus which were deep circumferential in 36. These children were commenced on a regime of antibiotics, corticosteroids and daily bouginage in an attempt to prevent stricture formation. Some narrowing of the oesophagus occurred in 15 and was severe in 8. PMID- 6495875 TI - Serum gastrin levels and lower oesophageal sphincter pressures in infants with congenital hypertrophic pyloric stenosis. AB - Serum gastrin levels in 16 patients with congenital hypertrophic pyloric stenosis (CHPS) were measured and oesophageal manometric studies were performed in 14 of these 16 patients before and after pyloromyotomy. Hypergastrinaemia was found in the patients with CHPS, and the 7th postoperative serum gastrin level was much higher than the preoperative pressure. However, there was no significant correlation between the LES pressure change and the serum gastrin change. These results indicate that competence of LES after pyloromyotomy in patients with CHPS is maintained not only by endogenous gastrin rise but also by other factors. PMID- 6495876 TI - Intestinal malrotation beyond the neonatal period. AB - Of 162 children with intestinal malrotation treated during a 13-year period, only 20 were first seen and treated outside the neonatal period. These presented with symptoms that were largely non-specific and there was a delay between the initial consultation and the making of the correct diagnosis of up to 5-years. The clinical features, radiologic findings and management are discussed, the importance of the history and radiographic findings stressed. PMID- 6495877 TI - Histochemical confirmation of the acetylcholinesterase-activity in rectal suction biopsy from neonates with Hirschsprung's disease. AB - Proliferating patterns of acetylcholinesterase (AChE) positive nerve fibres were investigated in 23 neonates with Hirschsprung's disease. All subjects were separated into three groups, according to age. In group A (0-10 days old) adn groups B (11-20 days old, no increase in AChE positive nerve fibres was evidenced in the lamina propria mucosae, whereas 7 out of 9 cases in group C (21-28 days old) showed a moderate or marked increase in AChE positive nerve fibres in the lamina propria mucosae. A typical pattern of this proliferation up to the lamina propria mucosae was seen in 30.4% only of all cases in the series, and was limited to group C, where the positive AChE reaction from the submucosa to the muscularis mucosae (including the submucosa only), the rate was 91.3%. Re examination was preformed in 14 cases over sthe neonatal period. All showed a positive AChE reaction up to the lamina propria mucosae. Suction biopsy specimen from neonates is sometimes inadequate with respect to the lack of inclusion of the muscularis mucosae and submucosa, as a result of a weakly negative pressure by suction. The normal reactions of AChE activity in the lamina propria mucosae do not exclude Hirschsprung's disease in neonates. Therefore, when a histochemical diagnosis of Hirschsprung's disease using rectal suction biopsy for staining of AChE activity is required in the neonatal period, the diagnosis is safe and relatively easy at least over three weeks of age as mentioned above. PMID- 6495878 TI - New application of catecholamine fluorescence histochemistry using glyoxylic acid for diagnosis of Hirschsprung's disease by rectal biopsy. AB - Catecholaminergic innervation was studied in the rectal biopsy specimen obtained from patients with Hirschsprung's disease. The histofluorescence of catecholamine was examined using glyoxylic acid and magnesium without freeze-drying. Aganglionic specimens exhibited no fluorescent network of terminals or fibres in the submucosal plexus, whereas ganglionic specimens showed ganglion cells surrounded by a network of catecholaminergic terminals and fibres. These results of rectal biopsy could be obtained easily and quickly with good reliability. Examination of the catecholaminergic innervation by this histofluorescence method provides a new approach to the diagnosis of Hirschsprung's disease. PMID- 6495879 TI - [Achalasia in the neonatal period and early childhood]. AB - Achalasia is a rare unusual lesion of the oesophagus in children under one year of age. The present report describes a boy of 2 months of age suffering from symptoms of oesophageal achalasia and pylorospasmus. Literature is reviewed in order to discuss frequency, pathogenesis and therapy. The infant underwent a successful Heller oesophago-cardio-gastric myotomy completed by fundoplicatio as a reflux barrier. PMID- 6495880 TI - Persistent cervical thymus with a small cyst in a newborn infant. AB - A boy, aged 1 month, who showed a tumour mass in the right neck, is presented. Operation disclosed that the tumour was a cervical thymus with a small cyst. The cervical thymus degenerated gradually into hypoplasia or thymic cyst due to the abnormal descent of the thymus. It is rare that cervical thymus and/or thymic cyst is detected before the age of one year. PMID- 6495881 TI - Infected and ruptured urachal cyst causing peritonitis. AB - Urachal cysts are rare and usually as asymptomatic until they become infected. The route the infection follows is uncertain. A very unusual case is reported of a newborn female afflicted with a posteriorly ruptured urachal cyst causing incapsulated peritonitis, in which we obtained a visualization of the cyst during fistulography PMID- 6495882 TI - Prenatal perforation of the extraperitoneal part of the rectum, associated with a developmental defect of the pelvic floor. AB - Perforation of the extraperitoneal part of the rectum during foetal life is an exceptionally rare event. Two cases are reported where this has been associated with a para-rectal defect in the pelvic floor. It is postulated that in these instances, the rectal lesion is due to this abnormality. As a consequence of the perforation meconium extravasates into the buttock. This has a classic presentation which should be immediately recognised. Urgent rectal decompression, as an emergency measure before surgery, is required if further serious complications are to be prevented. PMID- 6495883 TI - Non-invasive intracranial pressure monitoring. A technique for reproducible fontanelle pressure measurements. AB - Anterior fontanelle pressure was measured in 14 infants. A technique is described for preforming reproducible measurements utilising the Rotterdam Teletransducer. One gradually increasing the dept of the transducer relative to the fontanelle a characteristic pressure depth curve is obtained. The importance of positioning the transducer according to the pressure depth curve is described. PMID- 6495884 TI - [Determination of the time of death by measurement of central brain temperature]. AB - The central brain temperature was recorded in 53 human corpses, stored at constant ambient temperatures between 10 degrees and 30 degrees C. The measurements were started on average 1.6 h post mortem and continued for 8-50 h. The sigmoidal shape of the temperature curves fitted the mathematical model of Marshall and Hoare (1962). This model provides a precise description of the temperature curves. For 44 corpses, studied at temperatures between 10 degrees and 25 degrees C, the time of death was calculated using fixed values for the adaptation parameters of the model. The margins of error for the 95% tolerance limit were +/- 1.5 h up to 6.5 h post mortem, +/- 2.5 h between 6.5 and 10.5 h post mortem and +/- 3.5 h between 10.5 and 13.5 h post mortem. For the recommended practical application a "brain temperature--time of death" nomogram is presented. We found that the rate of cooling was influenced by the amount of hair. Furthermore, it has been argued that the study method could be improved further. In consequence, we expect the central brain temperature to be even more accurate in the calculation of the time of death than has been discussed and shown on the basis of the present material. PMID- 6495885 TI - Serum levels of digoxin in sudden cardiac deaths. AB - Digoxin was determined in postmortem serum samples from 100 patients who died suddenly of cardiac disease. Twenty patients had digoxin levels below the therapeutic range. Twenty-one patients had normal values within the therapeutic range (1.2-2.5 nmol/l). In ten cases there was probably an overdosage. Another 15 patients had markedly elevated levels. No digoxin concentration was found (below 0.5 nmol/l) in 34 patients. The importance of determination of digoxin levels both by the clinician and the pathologist is stressed as well as the necessity of using a correct sampling technique at autopsy. PMID- 6495886 TI - [Bolus death in abnormalities of the brain]. AB - A man 61 years of age had fallen ill 4 years before he died. He suffered from hypertension and from pseudobulbar palsy. While he was eating he suddenly died. The cause of death was asphyxia by an alimentary bolus. No influence of alcohol and/or drugs was found. There were several malformations in the brain: absence of corpus callosum, heterotopias and porencephaly. The death is regarded as connected with these malformations. PMID- 6495887 TI - [Hole fracture of the base of the skull following a fall on the chin]. AB - A 26-year-old healthy female died a few hours after having fallen on her chin. Death had been caused by an epidural hematoma which originated from a hole fracture following impression of the condyle of the mandible through the socket of the temporo mandibular joint. PMID- 6495888 TI - [Computer tomography of lumbar disk prolapse and vertebral canal stenosis]. AB - Computed tomography of the herniated lumbar disc, bulging disc and spinal stenosis represents an investigation of great diagnostic reliability. It is based on the interpretation of visual evaluation, roentgenometry and profilography. PMID- 6495889 TI - [Telangiectasias in progressive systemic sclerosis (generalized scleroderma). Observation on 120 cases]. AB - 120 patients with progressive systemic sclerosis (PSS) were studied and subdivided into five groups according to the PSS classification of Giordano et al. ("acute diffuse scleroderma", "intermediate syndrome", "acrosclerosis sensu stricto", "sclerodactylia" and "sclerosis sine scleroderma"). In all five subgroups telangiectasias incidence was high (from 75% to 100%). The "ramosus" and "telangiectatic mats" types occur more frequently than other forms of telangiectasias. The former particularly involves the face, neck and chest; whereas the latter more usually involves the upper extremities and is the only type which appears at the lips. Cuticular telangiectasia is a third type, as important as the others but less frequent. The incidence of telangiectasias is related to disease duration. Similar telangiectasias have been observed in rarer patients with other connective tissue diseases (SLE, RA, dermatomyositis and undifferentiated connective tissue diseases). PMID- 6495890 TI - [Effect of histamine-blocking substances on mitogen-induced lympho proliferation in rheumatic diseases]. AB - Peripheral blood lymphocytes of patients with rheumatoid arthritis, psoriatic arthritis and healthy controls, isolated by a ficoll density gradient, were incubated with different concentrations of histamine, cimetidine and diphenhydramine (DPH) and simultaneously stimulated with phytohemagglutinine (PHA). In comparison to healthy control persons the lymphoproliferation rate in arthritic patients could be increased about 20% by addition of the histamine blocking agents cimetidine and DPH. This suggests the existence of in vivo histamine-induced suppressor cells in arthritic patients, which can be inhibited by receptor blocking agents. PMID- 6495891 TI - [Kinetics of mofebutazone in plasma and synovial fluid]. AB - The kinetics of mofebutazone in the plasma and in the synovial fluid was investigated in a pharmacokinetic study. To this purpose 7 volunteers and 36 patients were injected with one ampule Mofesal (650 mg mofebutazone sodium) i.m. The determination of mofebutazone in the plasma and in the synovial fluid was carried out by means of high performance liquid chromatography. The kinetics in the plasma and in the synovial fluid showed a dissociated course of development. Maximum concentrations of the active substance were reached after 1.4h in the plasma and after approx. 2 h in the synovial fluid. While mofebutazone in the plasma is eliminated with a half life time of 1.9 h, the half life time in the synovial fluid amounted to 7.7 h. According to pharmacokinetic simulation calculations no accumulation in the plasma occurred even after the administration of 1 ampule Mofesal three times daily, on the other hand a steady state is presumably reached in the synovia after 4-5 injections. On the basis of this study we regard it once again as essential that the kinetics in the synovial fluid should without doubt be preferred to the kinetics in the plasma for the calculation of a dosage schedule for non-steroidal antiphlogistics. PMID- 6495892 TI - [Interaction of isoxicam and digoxin]. AB - The influence of maintenance therapy with Isoxicam, 200 mg daily, on digoxin steady-state plasma levels was studied on 12 healthy volunteers. One person dropped out from the investigation program on account of cardiac sensations following the invasion phase with digoxin. No statistically significant differences could be shown during concomitant therapy or after withdrawal of Isoxicam. Neither were toxic glycoside plasma concentrations observed. There were no pathological clinicochemical parameters, in particular no changes in renal function values. PMID- 6495893 TI - [Manual medical findings in relation to the site of pain in vertebral disorders]. AB - Segmental functional disturbances of the spinal column are important and frequent causes of pain in the locomotor and supporting system. Results of the examination of the clinical function of the vertebral column of 151 patients are compared with the site of pain and possible connexions as well as characteristics are discussed. PMID- 6495894 TI - [Hemorheologic changes in ankylosing spondylitis]. AB - In nineteen patients with a definite ankylosing spondylitis haemorheological parameters were measured: serum, plasma and whole blood viscosity, haematocrit, red cell flexibility and aggregation, fibrinogen and ESR. Compared to matched controls these variables were significantly altered in patients. The pathophysiological meaning of this finding is as yet unclear and needs further investigation. PMID- 6495895 TI - [Measurement of activated whole blood coagulation as a control parameter for heparin dosage in hemodialysis]. AB - A precise dosage of heparin is necessary especially in acute dialysis, but also in chronic dialysis. This can be checked by measuring the partial thromboplastin time, the thrombin time, the coagulation time according to Lee-White or, recently, by automatic measurement of activated whole-blood coagulation. For the latter only 0.5 ml of whole blood is necessary. In a total of 44 examinations the activated whole-blood coagulation time was shown to be well reproducible. In the 40 patients examined there was considerable variation in the sensitivity to and the elimination rate of heparin, which indicates the necessity of individual heparin dosage. Measuring the activated whole-blood coagulation time proved to be suitable for classifying the patients. PMID- 6495896 TI - [Contrast medium elimination by hemodialysis]. AB - In 6 patients with no apparent kidney function the elimination of contrast medium was examined using 125I-labelled diatrizoic acid. Also blood level time curves and concentrations of dialysate were measured, showing a biexponential fall. The kinetic data established by computer-aided analysis according to the two compartment model yielded elimination values not achieved by a healthy kidney; however a maximum elimination rate of 80.7 +/- 4.7% of the dose administered was calculated for a dialysis period of more than 10 hours. As the contrast medium plasma level was reduced the efficacy of haemodialysis fell. PMID- 6495897 TI - [Behavior of copper and manganese in serum in hemodialysis]. AB - The extent to which chronic dialysis alters the serum copper and manganese content was examined. The copper content was not significantly altered, whereas the level of manganese in the blood rose highly significantly. This manganese originates from the dialysis fluid. The behaviour of the manganese level during dialysis treatment suggests that the element is deposited in the body. Its transport is clearly connected with protein, since the manganese is not found in the ultrafiltrate. The is no fear of manganese intoxication. PMID- 6495898 TI - [Hair loss following chronic hemodialysis]. AB - Attention is drawn to the frequent occurrence of loss of hair in chronically dialysed patients. No examinations were undertaken to find the cause of this phenomenon. However it is possible that, besides insufficiently eliminated toxins, hypothyrosis is also involved. PMID- 6495899 TI - [Prospective studies of diet compliance in the chronic hemodialysis program]. AB - For 25 patients with terminal renal insufficiency predictions were made on their later dietic compliance under dialysis conditions and documented, before they were admitted to the chronic dialysis programme. These predictions were based exclusively on observation of the patients' behaviour during consultations with kidney specialists and during periods of hospitalization. In 18 cases the dietic compliance observed during the first two years of dialysis matched the prediction. It is thus also possible for a nephrologist to recognize early those patients who are likely to violate the fluid restrictions frequently during subsequent dialysis treatment. As long as those personality features and reaction types which cause non-compliance are known, normal consultation and hospital contact suffice. PMID- 6495900 TI - Production of cyanocobalamine by Azotobacter chroococcum. AB - A strain of Azotobacter chroococcum was found to produce a considerable amount of cyanocobalamine especially when cultivated in a medium enriched with 0.3% ammonium chloride. Maximal production of the vitamin was achieved after six days of incubation in static cultures. The organism required molybdenum, iron (Fe++), cobalt and ascorbic acid for optimal production of cyanocobalamine. The initial supplementation of the medium with cyanocobalamine did not affect the formation of the vitamin. The least concentration of ascorbic acid tested greatly initiated the production of vitamin B12. Higher concentrations were not effective. In the presence of molybdenum, iron, cobalt and ascorbic acid maximal secretions of cyanocobalamine was attained in the presence of 3% sucrose or an amount of hydrolyzed rice-bran containing 2% sugar. Higher concentration of rice-bran was toxic to the organism. PMID- 6495901 TI - [Late results following the operative treatment of congenital postero-lateral diaphragmatic hernia]. PMID- 6495902 TI - [Experiences with Marberger's reduction plasty of the clitoris in female and male pseudohermaphroditism]. PMID- 6495903 TI - [Indications and timing of genital operations in children with male and female pseudohermaphroditism]. PMID- 6495904 TI - [Results of funnel chest treatment--a retrospective 20-years analysis]. AB - In the last 20 years 33 children suffering from funnel chest were operated on to reconstruct the deformity. Indication and time of operation are discussed. The authors hold the opinion that stabilising the mobilised and flattened funnel will yield the best late results. PMID- 6495905 TI - [Studies following bladder reconstructions in cystoschisis]. AB - The question how to perform the best surgical repair of bladder exstrophy is still being discussed. By various urodynamic investigations following bladder reconstruction we came to the conclusion that the new built bladder and its outlet tract can function normally. PMID- 6495906 TI - [Tarsal fractures in childhood]. AB - The treatment of tarsal fractures in children was analysed in a joint research project performed in eight GDR surgical clinics of various size. 63 fractures of the tarsal bones were treated over a seven-years period. Each single bone of the tarsus was analysed separately. For reasons of comparison, however, the results were evaluated of all tarsal fractures in the follow-up in connection with Seyfarth's classification as applied with respect to calcaneal fractures. The findings show that tarsal fractures in children can be thoroughly cured by conservative treatment. Operative treatment is indicated only in few cases. PMID- 6495907 TI - [Soft tissue and skeletal tumors of the hand in infancy and childhood]. AB - From 1967 to 1983, 82 neoplasms of the infantile hand were seen at our clinic. According to the WHO-Classification 30 were genuine tumours and 52 tumour-like lesions. An analysis of the cases is given. Surgery is the therapy of choice. PMID- 6495908 TI - [Urinary bladder tumors in childhood]. PMID- 6495909 TI - [An ischemic-septic disease picture following acute occlusion of the superior mesenteric artery]. AB - The pattern of symptoms which evidences acute mesenterial infarction has been investigated on more than 40 pigs by applying diverse non-surgical therapeutic approaches during transarterial balloon occlusion of the A. mesenterica superior. All animals died within 38 hours, much earlier after central occlusion than after blockage of the peripheral branches of the artery. A convincing delay could only be observed in the group treated by antibiotics. In two groups of clinical patients, 20 before and 28 after the experimental study, we found a significantly better prognosis in the latter group. About 46% of them got an antibiotic treatment immediately after being admitted to hospital. However, recently the time elapsing from the vascular accident to laparotomy has been shorter than in the last two decades. This contributes to better chance of survival in mesenterial ischaemia. Thus, antibiotic protection and early surgical intervention can be considered to be crucial for survival after mesenterial infarction. PMID- 6495910 TI - [Lead fracture--a still frequent cardiac pacemaker complication?]. AB - The frequency of pacemaker complications has decreased during later periods of observations. The rate of pacing lead fractures has been reported to amount to 6.2%. According to our experience and data based on 3607 pacemaker implantations for over 15 years this retrospective study examines the following parameters: patient's data, year of implantation, interval till fracture, implantation vena, localisation of the fracture and therapeutic measures. In 1% (36 cases) of our pacemaker patients repeating operations were necessary due to lead fractures. In electrodes implanted after 1977 no break could be observed. Tested material and production methods as well as save implantation modus, avoidance of bending, coiling with a short radius and also a tied fixation ligature, can improve the results. PMID- 6495911 TI - [Supravalvular ring in the left atrium]. PMID- 6495912 TI - [The jejunum for the retrosternal reconstruction of the esophagus]. PMID- 6495913 TI - [Prevention of infections in surgery of the colon]. AB - The value of perioperative antibiotic prophylaxis in colorectal surgery is undisputed, since for the first time the rate of wound healing disorders could be reduced from 30 to 50% previously to less than 10%. In 3 prospectively randomized studies different kinds of prophylaxis were tested: short-time prophylaxis over 48 hours, ultra-short time prophylaxis over 24 hours, "one-shot" administration during surgery. The effective spectrum of the used cephalosporines should affect aerobic as well as anaerobic pathogens, as septic complications are caused by intraoperative bacterial dissemination. Cephalosporines such as Cefoxitin, Lamoxactam and Cefotaxime having sufficiently high serum and tissue levels at the time of enterotomy, may be used successfully as a perioperative antibiotic prophylaxis. "One-shot" administration in 100 patients has led to a drastic reduction of wound healing disorders to 4% (four mild wound healing disorders, four anastomotic leaks (9.4%). We prefer the perioperative antibiotic "one-shot" administration not only for this reason, but also because of the lowered possibility for the development of resistances and bacterial selection. PMID- 6495914 TI - [Experiences with fibrin adhesives in surgery of the rectum and colon]. AB - Fibrin glue was used for sealing a total of 45 anastomoses in colonic and rectal surgery. ILS, SPTU and EEA staplers were used performing anterior resection (low 26, high 15). The incidence of dehiscence of anastomoses after anterior resection of the sigmoid colon and rectum was studied by radiological examination after a Peritrast-enema about 2 weeks after surgery. Suture dehiscence was roentgenologically detected in 2 patients, no clinical insufficiency. Only 1 patient, aged 80, died from haemorrhage. The rate of postoperative complications was very low. PMID- 6495915 TI - [Experiences with pancreas occlusion following cephalic duodenopancreatectomy]. AB - 68 patients suffering from complications of chronic pancreatitis or tumours of the periampullary region respectively underwent partial duodeno-pancreatectomy (modified Whipple procedure) with or without obstruction of the remaining duct of the pancreas. These patients were followed-up and examined for glucose tolerance, serum insulin and C peptide levels until 2 years after surgery. There were no significant differences in endocrine function between patients with or without pancreatic duct obliteration by acrylate glueing. PMID- 6495916 TI - [Nutritional status and quality of life following gastrectomy]. AB - The nutritional status of 18 patients after total gastrectomy was recorded by anthropometric measures, serum protein and immunological investigations. 15 patients underwent gastrectomy due to carcinoma, the others due to benign diseases. Those patients with carcinoma had been free of signs of malignancy for at least 6 months. According to the elected criteria no patient had a normal nutritional status, there were slight to moderate disturbances of the protein metabolism. By mass reduction the body of the gastrectomised patients had adapted to the decreased intake of protein and calories. In this way the body reaches a new balance and remains efficient. The quality of life of most gastroectomised patients is satisfactory. It depends on the incidence of alimentary complaints and the ability of intake of sufficient food. On the basis of these results there are no serious arguments against Graham's oesophagojejunostomy. PMID- 6495917 TI - [Late results of radical surgery of stomach cancer. Study of 380 patients from 1967 to 1977]. AB - The report is based on the analysis of 380 cases. There was an absolute 5-year survival rate of 12.6%, and a relative 5-year-survival rate of 25.3%. The dependence of late results on factors characterizing the tumorous process has been analysed and the modalities for improving the results are discussed. PMID- 6495918 TI - [Myelolipoma of the adrenal gland]. PMID- 6495919 TI - [Leiomyosarcoma of the duodenum]. PMID- 6495920 TI - [Prevention of intraperitoneal suture insufficiency using fibrin adhesives]. PMID- 6495921 TI - [Premature uterine contraction from the psychosomatic viewpoint. A critical literature review of methods]. AB - Premature labor is often followed by premature delivery. This is to be prevented because of the increased perinatal mortality and morbidity. Etiology of premature uterine activity has not been elucidated up to now neither medically nor psycho socio-somatically. There are many contradictory findings examining imminent premature labor with view to psychosomatics. In this review they are listed tabularly and investigated critically with regard to methodological structure. It is evident, that conflicting results are caused by disregard of fundamental principles of planning experiments and data analysis. The procedure should be thought over newly and exact research aspired including interdisciplinary knowledge. PMID- 6495922 TI - [Tasks of family-oriented obstetrics in the maternity ward]. AB - Psychological drawbacks of intensive obstetrics on the one hand and the results from psychology in the perinatal period on the other hand demand a new mental hygiene in the delivery room and on maternity wards. The "family-oriented obstetrics" met these problems best. Interviews were made with 650 mothers, just after delivery to find on the attitude for "family-oriented obstetrics". Presence of husband in the delivery room is wanted from 47,4% of the married couple. 98,15% from the mothers wanted nursing and 83,69% rooming-in. PMID- 6495923 TI - [Significance of serum uric acid determination for the early detection of complications of hypertensive pregnancy in primigravidae]. AB - In 100 healthy primigravidae the concentration of serum uric acid was examined in a prospective longitudinal study between the 12th and 40th gestational week. Serum uric acid increased continuously and was elevated significantly in 9 women who developed toxaemia of late pregnancy at the 16th, 32nd, and 36th week of pregnancy. If serum concentration are higher than 220 mumol/l or 241 mumol/l in the 32nd gestational week they were considered for a increased risk of developing a hypertensive complication. Sensitivity, specificity and the predictive value of a "positive test" were low in the 16th (22 or 20%) and 32nd (16 or 17%) week of pregnancy. The predictive value of a "negative test" was relative high in the 16th and 32nd week with 93 or 90% respectively 95 or 92%. PMID- 6495924 TI - [Changes in the immunoglobulins IgG, IgA and IgM in pregnancy and the puerperium]. AB - Immunoglobulin IgG, IgA and IgM levels in maternal serum of 16 healthy pregnant women are analysed between 7th and 37th week (n = 95) and additionally at second day after delivery. Serum immunoglobulin concentrations of 54 healthy non pregnant young women are the base for laboratory-specific normal levels. IgA and IgG raise at the beginning of pregnancy and decrease after 17th week; IgA levels after 20th week of pregnancy are not different from concentrations of non pregnant women. Compared to this, IgG levels fall below the prepregnancy niveau significantly. This continuous decrease lasts anabatedly till the second day following delivery. On the contrary, IgM decrease immediately with starting pregnancy, whereas the following decrease is unessential. After delivery levels rise rapidly. A shortlasting decrease of the concentration of all three immunoglobulins IgG, IgA and IgM with consecutive increase between the 11th and 14th gestational week is a special characteristic sign. PMID- 6495925 TI - [Determination of circulating immune complexes in the serum of patients with cytologically suspected and cytologically positive cervix smears]. AB - In a pilot study there was taken away venous blood from 26 women for quantitative examination of circulating immune complexes because of cytologic suspected or positive diagnosis of the cervix uteri before planned conization. The concentration of immune complexes would be opposed to the colposcopic, cytologic and histologic diagnoses. In comparison to 26 women with cytological inconspicuous cervix diagnoses there is a light increase of immune complex concentration, but there is no significant difference between both groups. PMID- 6495926 TI - [Microelements in the placenta, in maternal blood and in umbilical cord blood]. AB - The content of copper, zinc, plumbum and cadmium was determined in maternal blood, umbilical blood and placental tissue using atomic absorption method. In umbilical blood the concentration of copper and zinc was significantly lower, independent from sex and birth weight of the newborns and from age and residence of the mothers. Cadmium and plumbum did not show such differences. Placenta is permeable to cadmium. PMID- 6495927 TI - [Quality control from the viewpoint of clinical obstetrics]. AB - Recommendation of the Society for Perinatal Medicine of the GDR for quality control in clinical obstetrics and early neonatology. A continuous data collection and periodical summary of the recommended most important figures are the supposition for internal and external comparison and the prediction of average efficiency for hospitals with different specialisation in obstetrics and early neonatology. PMID- 6495928 TI - [Primary squamous cell carcinoma of the uterus]. PMID- 6495929 TI - [Free amino acids in the brain of vertebrates]. AB - Studies have been made on the content of free amino acids in the brain of the pike Esox lucius, frog Rana ridibunda, pheasant Phasinus colhidus, hare Lepus europaeus, as well as their distribution in the white and grey matter of healthy human subjects. Differences in the distribution of free amino acid pool were found between man and animals. In the grey matter of human brain, large quantities of free ornithine, phenylalanine, lysine, serine, glycine, alanine, tyrosine, tryptophan, methionine, leucine and isoleucine, as well as lower level of aspartic acid, glutamic acid and threonine were found as compared to the white matter. The content of ornithine, serine and threonine increases in the row birds greater than fishes greater than man greater than mammals greater than amphibians; histidine and arginine pool increases in the following sequence: birds greater than fishes greater than mammals greater than amphibians greater than man. PMID- 6495930 TI - [Amplitude of miniature potentials of motor neurons in the frog Rana ridibunda]. AB - Miniature synaptic potentials have been recorded from motoneurones of the isolated spinal cord of the frog Rana ridibunda. In normal Ringer's solution, their frequency varied from 5 to 50/sec, whereas their amplitude reached 2-5 mV. Only 50-300 microV (rarely 0.5-1.5 mV) potentials persisted when TTX was added to Ringer's solution and/or Ca was replaced by Mn. However, in Ca-free solution, TTX in combination with Mn did not decrease the amplitude of miniature potentials, provided the initial values varied within 50-300 microV. Noise fluctuations did not exceed 40-50 microV, and the ratio of the number of miniature potentials of 50 microV to the number of 50 microV noise potentials was about 10:1. The observed miniature potentials with an amplitude of 50-100 microV coincide with the quantal units calculated by other authors from statistical analysis of the unitary EPSPs evoked by primary afferents or by ventrolateral tract fibers. PMID- 6495931 TI - [Evoked potentials in the parietal cortex in response to stimulation of the posterolateral nucleus of the thalamus in kittens of different ages]. AB - In kittens of the first month of postnatal life, studies have been made of the evoked potentials in the parietal cortex elicited by stimulation of the posterior lateral thalamic nuclei. It is suggested that within the first days of life the EPs result mainly from the electrical activity of the deep (V-VI) layers of the cortex. This suggestion is confirmed by a significant increase in the velocity of the rising phase and the decrease of the duration of the EPs in the deep layers in newborn animals, as well as partial inversion of the negative wave of the EP at the level of these layers in 1-week kittens. Total depth of the median layers in 1-week kittens is twice less than that in 1 month old ones. To the end of the 2nd week, the input of the activity of the median layers into total activity increases: the focus of partial inversion of the negative wave of the EPs is translocated upward to the border of layers II-III. In 1-month kittens, the general pattern of the EPs in the parietal cortex is the same as in adult cats. PMID- 6495932 TI - [Comparative evaluation of the biological activity of glucagon from hens and mammals in in vitro experiments]. AB - Crystalline glucagon has been obtained from hens and its biological activity was compared with that of mammalian glucagon. Biological activity of the hormones was evaluated in two test systems; either by hormonal activation of adenylatecyclase in plasmatic membranes of the liver of chicks and rats or by their ability to stimulate lipolysis in chick adipocytes. It was shown that glucagon of hens exhibits its biological activity in the same range of concentrations, as the mammalian hormone (1.10(-9)-1.10(-5) M). Hen glucagon is less effective as compared to mammalian one, irrespectively of the test system used for the assay of its activity. PMID- 6495933 TI - [Development of the contractile activity of the thoracic duct in dogs in postnatal ontogenesis]. AB - It has been demonstrated that the thoracic lymph duct in newborn puppies exhibits only tonic (spontaneous) contractile activity. Rhythmic activity in the duct appears at the age of 2 1/2-3 months. PMID- 6495934 TI - [Electroencephalographic and computer-tomographic correlations in cerebral circulatory disorders]. AB - The results of electroencephalographic (EEG) and computer-aided tomographic (CT) examinations were compared in order to specify the possibilities of EEG in the topical diagnosis in cases of the compromised cerebral circulation (a hundred patients had been studied). The CT and EEG findings were closely correlated (80%) when the focus was localized in the hemispheres; discrepancies were observed (20%) in cases of extensive haemorrhages, with blood invading the ventricular system, in cases of microfoci lying in the deep portions of the cerebral hemispheres and also when foci were present in both hemispheres. In cases of the trunk localization of the focus, the EEG and CT findings were correlated in only 37%. The discrepancies of the two methods predominantly concerned impairments of the lower portions of the trunk where the EEG technique proved more informative. PMID- 6495935 TI - [Results of secondary prevention of stroke in a polyclinic setting]. AB - Using special prediction forms, a high risk group for the development of cerebral stroke was identified, including 64 subjects (50 males, 14 females), aged 40-65 years, working in different establishments. Preventive measure were conducted under out-patient conditions for three years. The number of cerebral strokes was 13 in 1980; 8 in 1981; and five cases in 1982. The indices of a temporal loss of the working capacity in this group decreased from 21 cases and 516 days to 6 cases and 159 days. It was established that long-term and systematic prophylaxis of cerebral stroke contributes to its "aging". Thus, in the presence of adequate prophylaxis, a secondary cerebral stroke in individuals under 60 years of age with a history of cerebral stroke occurred only in 17.7%, while in cases of inadequate prophylaxis or its absence, the respective figure was 60.1%. PMID- 6495936 TI - [Hyperbaric oxygenation and prevention of recurrent cerebral circulatory disorders in the acute stage of a stroke]. AB - The course of the acute period of cerebral stroke was compared in two groups of patients matched by the major clinical criteria: the test group receiving hyperbaric oxygenation (HBO) and the control one given no such treatment. It was found that the patients of the test group developed no recurrent impairments of the cerebral circulation in the acute period whereas in the control group this complication occurred in ten patients. Possible mechanisms of action of hyperbaric oxygen in preventing recurrent cerebral strokes are discussed. PMID- 6495937 TI - [Clinico-epidemiologic characteristics of cerebral circulatory disorders recorded in the Ukrainian Carpathian zone]. AB - A total of 845 patients with various forms of cerebral circulation impairments (CCI) were examined for the clinical picture and epidemiology of this pathology. High risk factors of acute impairments of the cerebral circulation have been identified. The effect of the meteorologic factors on the incidence and course of cerebral strokes has been established. It is concluded that salt hypertension is less frequently associated with acute impairments of the cerebral circulation as compared to other forms of essential hypertension. PMID- 6495938 TI - [Treatment of primary neuritis of the facial nerve with compresses of dimexide and nicotinic acid]. AB - The author describes a method of treating Bell's palsy by compresses of the following composition: 10 ml dimexide (DMCO), a 1% solution of nicotinic acid (5 ml) and physiological saline (5 ml). Compresses are applied onto the area of the papillary process of the involved side. A course of treatment consisted of 10-12 sessions. Sixty-five patients with Bell's palsy were treated using this method. The therapeutic efficacy was compared with the results of the conventional treatment of Bell's palsy in the control group. The new method of treatment was associated with a statistically significant increase in the rate of those cured and a decrease in the therapy duration. PMID- 6495939 TI - [Injuries of the supraspinatus muscle within the structure of humeroscapular periarthroses and their surgical treatment]. AB - The collective diagnosis of humeroscapular periarthritis (HSP) may imply a number of diseases different both in the genesis (inflammation, a degenerative process, trauma, cervical osteochondrosis) and localization (tendons of the humeral short rotators, biceps, synovial sheaths, bursae, etc.). A large proportion of HSPs are inveterate lesions of musculus interspinalis requiring surgical intervention. Despite the analogous pattern of many clinical symptoms, close collaboration of neuropathologists and traumatologists may allow the differential diagnosis of primary and secondary HSPs. PMID- 6495940 TI - [Dynamics of negative disorders and the problem of differentiating paroxysmal schizophrenia (epidemiologic study)]. AB - The task was set to elaborate, using random material, a systematics of paroxysm like schizophrenia on the basis of the characteristics of the time-course of negative disturbances and comparison with the current systematics formed on the basis of the clinical experience. The authors analyzed the course of the disease in all registered patients with paroxysm-like schizophrenia (3928 individuals) living in four administrative districts of Moscow. Seven major variants of paroxysm-like schizophrenia have been identified. The prognosis of the disease is more favourable in cases where it first manifests itself by mild negative changes. The time-course of adverse changes determines the development of productive disturbances and their level both in paroxysms and remissions. The relationship between these phenomena indicates certain pathogenetic independence of each of the identified variants of the disease course. PMID- 6495941 TI - [Features of the social and vocational adaptation of schizophrenic patients with a favorable course according to the results of a clinico-epidemiologic study]. AB - Using a uniform system of clinical identification of schizophrenic patients, a clinico-epidemiological examination of 173 patients with favourable schizophrenia (periodic and torpid) and a prolonged duration of the disease (over 20 years) was conducted to compare the characteristics of their social and occupational adaptation. The parameters of the social and occupational adaptation under analysis included education, qualification, the degree of disability, marital status, family composition and familial relationships. The results obtained show that patients with favourable schizophrenia are characterized by high adaptation potentialities. Social and occupational adaptation of patients with periodic schizophrenia is better than in patients with torpid schizophrenia. PMID- 6495942 TI - [Clinical features of the defect in the initial stages of juvenile malignant schizophrenia]. AB - On the basis of a long-term follow-up of 48 patients with terminal juvenile process schizophrenia the authors studied the major structural characteristics of their marked personality changes and the regularities of their formation. It has been established that the key feature of the pattern of schizophrenic defect in these patients is the total loss of activity in all spheres of mental functioning combined with pronounced retardation of psychic maturation not infrequently with the signs of personality regress. It has been revealed that the first signs of personality defect in these patients can be detected already at the initial stage, the disease beginning with negative disturbances. PMID- 6495943 TI - [Various statistical patterns in the course of malignant schizophrenia]. AB - A statistical study of process schizophrenia (101 cases with the completed process selected from 1198 observations in six psychiatric institutions) has made it possible to establish that the process has the constant rate of progression throughout the active course of the disease up to the development of the residual state without productive disorders. The quantitative expression of the rate of progression is reflected in the fact that the proportion of patients in whom the given clinical stage of the disease course comes to the end constitutes some 30% annually. PMID- 6495944 TI - [Comparative-age features of the dynamics of delusional syndromes in the course of paranoid schizophrenia]. AB - The characteristics of the time-course of delirious syndromes in paranoid schizophrenia with the psychotic manifestation in juvenile (under 20 years) and elderly age (over 45 years) were studied. Patients with juvenile manifestations of psychosis (20 men and 11 women) exhibited the complexity and variability of delirious syndromes. At the same time, the stability and intensity of the manifestations of individual psychopathological phenomena attended with the homogeneity of the psychosis structure were noted. The absence of the phenomenological clarity of delirious emotions was associated with an unfavourable course of psychosis. In a group of patients with a late manifestation of psychosis (11 males, 57 females), the delirious syndromes were inert in nature. The phenomenological structure of the syndrome consisted of the reduced and chronic forms of delirious perception and delirious imagination with time, ideas of persecution assumed greater prominence in the content of psychosis. PMID- 6495945 TI - [Clinical picture and forensic psychiatric significance of jealousy delusions in schizophrenic women]. AB - A study of 63 schizophrenic females with jealousy delirium has shown that the disease differs from that in males by the type of its course, premorbid characteristics, the time of the development of jealousy delusion, and its duration. The patients who have broken the law also differ from control patients with regard to personality changes, the acuteness of psychological symptomatology and specific features of delirious behaviour. PMID- 6495946 TI - [Various methods of overcoming secondary resistance to treatment developing in relation to adaptation to psychotropic drugs during long-term treatment (clinico experimental study)]. AB - Clinical and experimental studies into the phenomenon of adaptation to neuroleptic agents and into the methods of its overcoming were carried out. An experimental study of the long-term administrations of haloperidol revealed the formation of adaptation to the drug which can be overcome by a zigzag-like sharp elevation of the dosage followed by rapid reduction to the baseline level. The trial of this method under clinical conditions showed that it was expedient to use on a large scale the experimental findings on the specific features of the formation and prevention of the secondary therapeutic resistance. PMID- 6495947 TI - [Preventive treatment of affective psychoses with finlepsin]. AB - The prolonged (up to two years) use of finlepsin in manic-depressive and schizoaffective psychoses in 35 patients has shown this drug to possess a prophylactic effect comparable with the prophylactic action of lithium. In the course of treatment, the average cumulative duration of the morbid state considered in proportion to the observation period reduced from 87% to 37%. The dose of finlepsin reached as high as 1400 mg daily, with the average maintenance dose being 821 mg/day. Both critical and lytic variants of phasic reduction are traced. PMID- 6495948 TI - [How realistic is primary prevention?]. PMID- 6495949 TI - [Several contemporary trends in studies on social rehabilitation in the USA]. PMID- 6495950 TI - [Clinico-morphologic analysis of traumatic disease of the spinal cord]. AB - The clinical findings in 8 spinal patients were compared with the morphological changes in the spinal cord and peripheral nervous system revealed postmortally. The study disclosed clinico-morphological parallels and peculiarities of the dystrophic processes in the tissues in the course of traumatic disease of the spinal cord. PMID- 6495951 TI - [Studies of efferent conductivity along the spinal cord after traumatic injury]. AB - Study of the audiospinal effect on the monosynaptic reflex in healthy individuals showed that sound stimulations increased the amplitude of the H-reflex response. Intensification of the H-response was evidence of functioning efferent conduction along the spinal cord pathways. This provided the basis for using the audiospinal effect for testing the functional condition of the efferent spinal pathways in patients with traumatic lesion of the spinal cord. Twenty two patients with spinal cord injury were examined. Sound stimulation increased the H-response amplitude in 9 patients with paraparesis and in 6 patients with paraplegia. In the other 7 patients with lower limb paraplegia the H-response was not intensified by sound stimulation. This was evidence of disturbed efferent conduction along the spinal cord, which corresponded clinically to total impairment of all conduction functions of the spinal cord for a long time after the trauma. PMID- 6495952 TI - [Surgical treatment of bedsores, trophic ulcers and osteomyelitis in patients with injuries of the spine and spinal cord]. AB - Bedsores, trophic ulcers, and osteomyelitis in 250 patients with injury of the spine and spinal cord were treated by surgery. Surgical treatment of bedsores in the sacral region with a skin graft in which all the layer and the subcutaneous fat are preserved and which has independent circulation proved most effective. The graft was formed from the lumbar or gluteal region and transposed to the skin defect formed after removal of the nonviable skin areas and scars. In the region of the greater trochanters the grafts were formed from the adjacent to the bedsore tissues of the gluteal region or thigh and the greater trochanters involved in the osteomyelitic process were resected. The surgical management of bedsores in the region of the ischial tuberosities consisted in excision of the skin margins of the bedsore together with the infectious granulomas, bursae, and the cicatrico-granulomatous tissue. In osteomyelitis of the ischium and bedsores in the gluteal region, the bone was resected. A total of 54 resections of the ischial in 47 patients were carried out. PMID- 6495953 TI - [Principles of emergency neurosurgery]. PMID- 6495954 TI - [Relation between the protein composition of glial tumors and various clinico morphologic indices]. AB - The work was concerned with the study of 57 gliomas, among which were 30 glioblastomas, 20 astrocytomas, and 7 oligodendrogliomas. Specimens collected from 26 patients who underwent operation for severe craniocerebral trauma, meningioma, and carcinoma metastasis were examined as controls. The proteins of the tumor tissues and those of the brain matter surrounding the tumor and of normal brain matter were fractionated in polyacrylamide gel. It was found that the amount of water soluble protein, both in the total protein content and in all its fractions, was much greater in the glial tumors than in normal brain matter. The effect of 11 factors on the tissue protein composition was studied by factor analysis. The histological structure and extent of vascularization of the tumor as well as the presence of intracranial hypertension were found to produce the highest effect on the fractional distribution of the proteins. PMID- 6495955 TI - [Surgical approach to an aneurysm of the anterior cerebral-anterior communicating artery]. PMID- 6495956 TI - [Rupture of an intracranial aneurysm induced by postintubation arterial hypertension]. PMID- 6495957 TI - [Primary melanoblastosis of meninges of the brain and spinal cord]. PMID- 6495958 TI - [Results and problems in the use of total hip joint prostheses in inflammatory rheumatic diseases]. PMID- 6495959 TI - [Diagnostic and therapeutic differences between primary and secondary coxarthrosis and femur head necrosis]. PMID- 6495960 TI - [Reconstruction of the acetabulum in reconstructive operations of the hip joint using total endoprostheses]. PMID- 6495961 TI - [Treatment of juvenile bone cysts using topical administration of methylprednisolone acetate]. PMID- 6495962 TI - [Scoliosis and diastematomyelia]. PMID- 6495963 TI - [Incidence of congenital dislocations of the hip joint in the Martin District]. PMID- 6495964 TI - [Abbreviation osteotomy]. PMID- 6495965 TI - [Generalized ligament laxity. I. Theoretical part]. PMID- 6495966 TI - [Seasonal changes in serum alkaline phosphatase (EC 3.1.3.1) activity in ontogenetically homogeneous groups of rabbits, in healthy human volunteers and in patients with malignant bone tumors. Significance in diagnosis]. PMID- 6495967 TI - [Architecture of bones from the aspect of biomechanics]. PMID- 6495968 TI - [Progressive fusion of vertebral bodies of a noninflammatory etiology in adolescents]. PMID- 6495969 TI - [Surgical treatment of the painful groin]. PMID- 6495970 TI - [Proximal epiphysiolysis of the tibia]. PMID- 6495971 TI - [Personal experience with arthroplasty of the hip joint using Collon's method]. PMID- 6495972 TI - [Munchausen syndrome]. PMID- 6495973 TI - Prediction of malignancy in the solitary thyroid nodule by physical examination, thyroid scan, fine-needle biopsy and serum thyroglobulin. A prospective study of 100 surgically treated patients. AB - A prospective study was made of 100 consecutive patients selected for surgical treatment of a clinically solitary thyroid nodule. Anamnestic data and findings at physical examination, thyroid scan, fine-needle aspiration biopsy and measurement of serum thyroglobulin were correlated with the postoperative histologic diagnoses. The histologic findings were malignant in 18 cases and benign in 82. Familial occurrence of benign goiter was reported more frequently by patients with benign than by those with malignant histology (46 and 11%). Of the 11 nodules that were hard at palpation, 7 were malignant. All 12 scintigraphically "hot" nodules were benign, but 13 of 59 "solitary, cold" nodules were malignant. The cytologic specimens were reviewed and reclassified. The needle aspirate was insufficient for cytologic diagnosis in 11 cases. Papillary carcinoma was cytologically recognized in four cases. Of 36 lesions cytologically reported to be neoplasm of unspecified type, 12 were histologically shown to be malignant, 20 were follicular adenomas and 4 were colloid goiter. Benign lesion was the cytologic diagnosis in 47 cases. One diagnosis was false negative, but the cancer lay beneath the index nodule. The thyroglobulin level was significantly higher in patients with thyroid cancer than in those with benign disorders, but the test's predictive value was low. Thyroglobulin levels more than tenfold the upper limit of normal were found only in three patients with thyroid cancer and two with thyrotoxicosis. Although all of the mentioned investigative data were helpful in the management of solitary thyroid nodule, fine-needle biopsy was the best single method. When cytologic examination shows malignancy or unspecified neoplasm, surgery is indicated. For most patients with cytologically benign lesions, careful follow-up will suffice. PMID- 6495974 TI - Popliteal artery injury in Kuwait. AB - While there is an abundant literature on popliteal artery injury secondary to penetrating trauma, few reports deal with popliteal artery injury caused by severe blunt trauma with or without fracture. Eight cases of popliteal artery injury are described. Seven of the patients had sustained blunt trauma, usually resulting also in damage to bone and soft tissues. The popliteal vein was involved in five of the injuries. The time lag between causal trauma and vascular repair averaged 25 hours. Delay was due mainly to failure to consult the vascular surgeon at an early stage. Leg amputation was necessary in two cases. Two patients died. The importance of early recognition of the vascular injury and appropriate surgical measures was illustrated in this small series of patients from a developing Middle Eastern country. Adequate fasciotomy, venous repair, use of intraoperative Doppler and repeated postoperative debridement are discussed in connection with management. PMID- 6495975 TI - Hemodynamic findings before and after resection of abdominal aortic aneurysm. AB - A preoperative and postoperative hemodynamic study was performed in 20 consecutive patients undergoing elective resection of abdominal aortic aneurysm. Screening for venous thrombosis and pulmonary embolism with 125I uptake test, measurements of maximal venous emptying and pulmonary perfusion scintigraphy were also done before and after the operation. Only five patients complained of intermittent claudication preoperatively, but the laboratory investigations revealed signs of peripheral arterial insufficiency in 15 cases. Maximal venous emptying from the legs was markedly decreased on the first postoperative day and remained significantly below normal on the sixth day. Signs of postoperative thromboembolism appeared in eight patients. These patients did not differ from the others in regard to the pattern of maximal venous emptying. In the three-year follow-up period, the calf blood flow and the ratio of systolic toe pressure to systemic systolic blood pressure were further decreased, despite significant rise in systemic blood pressure. PMID- 6495976 TI - Postoperative complications in abdominal vascular surgery. AB - Two hundred patients who consecutively underwent abdominal vascular surgery were retrospectively studied with regard to early (less than 30 days) postoperative complications. The mortality was 4% after elective surgery and 30% after emergency surgery, which was chiefly for aortic aneurysm. The main causes of death were cardiac and renal diseases. Postoperative morbidity was mainly of cardiopulmonary or renal origin. Quantitatively, however (length of hospital stay), the foremost complications were local--haematoma, lymph fistula and necrosis in the incisions, especially in the groins. Against this background, the importance of scrupulous technique in vascular surgery is stressed. PMID- 6495977 TI - Demonstration of splenic functions following splenectomy and autologous spleen implantation. AB - Autologous splenic tissue was implanted in 14 patients undergoing splenectomy for traumatic rupture or peroperatively arising lesion of the spleen. To demonstrate function of the implanted splenic tissue, spleen scintigraphy using 99mTc labelled heat-damaged autologous erythrocytes, and percentage measurement of vacuolated erythrocytes in peripheral blood were performed one and three months after the splenectomy. The spleen scans were positive in eight patients after one month and in 12 patients after three months, demonstrating splenic phagocytic function. The numbers of vacuolated erythrocytes also indicated some restoration of the pitting function due to the implanted splenic tissue. No alterations were seen in serum immunoglobulins, but a moderate thrombocytosis still persisted after three months. The clinical significance of implantation of autologous splenic tissue is discussed. PMID- 6495978 TI - Endoscopic papillotomy in patients with gallbladder in situ. Is subsequent cholecystectomy necessary? AB - Endoscopic papillotomy was performed for choledocholithiasis in 22 high-risk patients with gallbladder in situ. The procedure was well tolerated by the patients and was performed without serious complications. Pathologic laboratory findings normalized in most cases during the first week after papillotomy. The median hospital stay was four days. Laparotomy was subsequently performed in five cases, in one because of impaction of a 3 cm stone two days after the papillotomy, and in four because of biliary symptoms during a five-year follow-up period. On the basis of experience with this patient series and recent reports in the literature, primary endoscopic papillotomy is recommended as the sole therapeutic procedure for high-risk patients. PMID- 6495980 TI - Bacterial contamination of blood transfusion: an unusual cause of sepsis. AB - Severe septicaemia resulted from transfusion of blood contaminated with Serratia liquefaciens. Although only a small volume of contaminated blood was administered, the patient reacted with severe hypotension, followed by renal, pulmonary, circulatory and hepatic failure together with protracted thrombocytopenia. The causal gram-negative rod, S. liquefaciens, frequently occurs in the oral cavity and is generally considered to be harmless. The source of the contamination was not detected, however. Early recognition of septicaemia and institution of intensive supporting treatment contributed to the rapid resolution in this case of multiple system failure. PMID- 6495979 TI - Long-term follow-up after Billroth I and II partial gastrectomy. Gastrointestinal tract function and changes in bone metabolism. AB - Late results of Billroth I (BI) partial gastrectomy for peptic ulcer in 19 patients were compared with those in 19 patients who had undergone Billroth II (B II) operation. The groups were matched for age and sex and were re-examined 21 to 27 years postoperatively. The study included notation of abdominal symptoms and haematologic status and tests of calcium metabolism with serum D-vitamin concentrations [S-25(OH)D2 and S-25(OH)D3], A-vitamin absorption, lactose and d xylose tolerance and barium meal transit time to assess intestinal function, gastroscopy with biopsies, and measurement of bone mineral density, using the 241Am gamma ray attenuation method. In the paired comparisons of B I and B II patients, no significant difference was found in haematologic status or results of intestinal function tests. The serum alkaline phosphatase activity was significantly higher after B II than after B I, whereas S-25(OH)D2 and S-25(OH)D3 were significantly higher in the B I group. Other data for calcium metabolism showed no significant intergroup difference. Bone mineral density likewise was not significantly different in the two groups, but in both of them the values were significantly lower than in healthy control subjects. Most patients in both Billroth groups had atrophic mucosal gastritis. PMID- 6495981 TI - Popliteal entrapment syndrome. AB - Three surgically treated cases of popliteal entrapment syndrome are reported. Two of the patients were consanguineous. This unusual syndrome is caused by an anomalous relationship between the popliteal artery and the musculature in the popliteal fossa. Arterial compression usually results in ischaemic calf pain. Popliteal entrapment syndrome seems to be underdiagnosed. Pathogenesis, diagnosis and treatment are discussed. PMID- 6495982 TI - Abdominal aortic aneurysm complicated by rectal necrosis. An unusual complication. AB - Spontaneous ischemic colitis is an often dramatic but common condition. Following resections of abdominal aneurysms it is not an unusual complication. Most cases will have mild symptoms. In patients with multiple arteriosclerotic disease there is an increased risk for rectal necrosis when the flow from the internal iliac arteries is impaired. We report a patient with multiple arteriosclerotic disease who developed necrosis of the left colon and rectum following occlusion of the inferior mesenteric artery. PMID- 6495983 TI - Herniation through the foramen of Winslow. A case report. PMID- 6495984 TI - Occult gallbladder microlithiasis causing acute recurrent pancreatitis. A report of three cases. AB - Gallbladder microlithiasis may be a cause of acute recurrent pancreatitis. When this process cannot be detected with routine investigative procedures, a precise etiologic diagnosis cannot be formulated. In such circumstances, endoscopic collection of bile followed by microscopic examination for presence of cholesterol crystals constitutes a valid diagnostic tool. Three cases of acute recurrent pancreatitis are presented in which cholesterol crystals were found in the bile. The technique and advantages of the method are described and a useful diagnostic approach is proposed. PMID- 6495986 TI - Scleroderma of the colon presenting with acute abdominal symptoms. AB - A 66-year-old woman with long-standing systemic sclerosis presented with fever, acute abdominal pain and tenderness. She was treated with antibiotics. At laparotomy six weeks later, a narrow, stiff, friable and fibrotic right colon was found with histological features of scleroderma. The acute attack was interpreted as an ischaemic episode of the colon which later healed by fibrosis. PMID- 6495985 TI - Posttraumatic and postoperative acute acalculous cholecystitis. AB - Acute acalculous cholecystitis has been described following surgery unrelated to the biliary tract and after multiple trauma (DuPriest et al., 1979; Gately & Thomas, 1983; Herlin et al., 1982; Howard, 1981; Long et al., 1978; Orlando et al., 1983). Mortality rate is high, probably in part reflecting delayed diagnosis and treatment, since symptoms and signs of the primary disease often mask the symptoms of cholecystitis. Increased awareness of this rare condition might lead to more accurate diagnosis and treatment and thereby improved outcome. In this report three patients who developed acute acalculous cholecystitis following unrelated surgery or multitrauma are described. PMID- 6495987 TI - Comparison of methionyl human growth hormone and pituitary growth hormone on somatic growth of hypophysectomized rats. AB - In hypophysectomized male rats the biological effects of two batches of methionyl human growth hormone, Somatonorm, (met-hGH), have been compared to those of human pituitary growth hormone, Crescormon (hGH). The rats were treated with doses ranging from 10 mIU per day to 145 mIU per day for 10 days. The parameters studied were total weight gain, longitudinal bone growth, measured by the tetracycline method and indirect cartilage growth, measured by uptake of radioactive sulphate. The results obtained demonstrated that Somatonorm stimulated weight increase in a linear and dose-dependent way, similar to that seen with the native hormone. Longitudinal bone growth, measured by the tetracycline method and the growth of different cartilages, measured as uptake of radioactive sulphate, were also similar between the two hormones. PMID- 6495988 TI - DDAVP (1-desamino-8-D-arginine vasopressin) clearance rate. AB - Utilizing a highly sensitive radioimmunoassay (RIA) for 1-desamino-8-D-arginine vasopressin (DDAVP) and a constant infusion kinetic protocol we measured DDAVP clearance rates (CR) in 6 non-pregnant ewes. Despite mean (and SEM) plasma DDAVP levels as high as 5349 (+/- 151) pg/ml, no changes in blood pressure or heart rate were observed. The CR of DDAVP was 3.6 (+/- 0.2) ml/kg X min. This CR is only 23% of the mean arginine vasopressin (AVP) CR measured in similar animals in an earlier study. The relatively decreased CR of DDAVP appears to account largely for the approximately 5-fold prolongation of antidiuresis of this synthetic derivative relative to AVP. PMID- 6495989 TI - Effects of long-term treatment with thyroxine on pituitary TSH secretion and heart action in patients with hypothyroidism. AB - The effects of thyroxine (T4) treatment on pituitary thyrotroph cells and on the heart were studied in 68 female patients with hypothyroidism. During the initial 12 months of T4 treatment, relatively small doses of T4 (1.3 micrograms/kg) normalized serum T4, triiodothyronine (T3), TSH and lipid concentrations in mild hypothyroidism, while moderate doses of T4 (1.7-2.0 micrograms/kg) normalized serum T4, T3 and lipid concentrations but not serum TSH levels or the volume of sella turcica in moderate and severe hypothyroidism; however, serum TSH levels and the volume of sella turcica returned to normal with continuation of these doses of T4. Systolic time intervals (ET/PEP) can discriminate between euthyroid and hyperthyroid states and agree well with serum TSH levels. However, ET/PEP was unequivocally elevated in about 40% of treated hypothyroid patients with normal serum T3, T4 and TSH levels which had been maintained over 48-54 months. Since the reciprocal relationship between free T4 and TSH levels was maintained in all treated patients, elevated ET/PEP with normal TSH levels indicates that the heart is more sensitive to thyroid hormones than the pituitary thyrotroph in 40% of treated hypothyroid patients. During T4 treatment in patients with hypothyroidism, ET/PEP should be followed and T4 doses adjusted to maintain normal ET/PEP rather than normal serum TSH levels, especially in older patients in whom T4 may aggravate angina pectoris or provoke myocardial infarction. PMID- 6495990 TI - A stimulation test with calcitonin for differential diagnosis of hypercalcaemia. AB - Experimental studies have suggested that in primary hyperparathyroidism (HPT) the cells of the hyperfunctioning parathyroid tissue retain some capacity for stimulation and that an increase in secretion of parathyroid hormone (PTH) can occur when the extracellular calcium concentration is lowered within the hypercalcaemic range. We have tested this hypothesis in 23 patients with HPT, 10 patients with hypercalcaemia of other origin (7 of whom had disseminated malignant disease) and 17 normal subjects. In all three groups a single injection of 100 MRC units of salmon calcitonin caused a reduction in serum calcium of approximately 3 to 5%. In the hypercalcaemic patients this reduction was correlated to the basal calcium level (r = -0.57, P less than 0.01). In the patients with HPT, although they all remained hypercalcaemic, the decrease in serum calcium was associated with a mean increase in serum PTH of 10%. Only in 2 patients did such an increase fail to occur despite an adequate decrease in serum calcium. These 2 patients had high basal PTH levels and the lack of response might have been due to a high degree of autonomous parathyroid function. Calcitonin also reduced serum calcium and increased serum PTH in normal subjects. None of the patients with hypercalcaemia of other origin than primary HPT displayed a secretory PTH response to serum calcium reduction. Thus, this test could be of practical clinical value, particularly in patients with borderline PTH values. A calcitonin-induced rise in PTH while serum calcium is lowered within the hypercalcaemic range strongly suggests primary HPT. PMID- 6495991 TI - Alteration of the development of mammary hyperplastic alveolar nodules and uterine adenomyosis in SHN mice by different schedules of treatment with CB-154. AB - The effect of different schedules of bromocriptine-mesilate (CB-154; 0.2 mg/day) treatment on the development of precancerous mammary hyperplastic alveolar nodules (HAN) and uterine adenomyosis was investigated in a virgin SHN strain of mice. CB-154 treatment for 7 weeks beginning at 4 weeks of age enhanced the development of HAN at an advanced age, the shorter period of treatment having no effect. In contrast, spontaneous development of adenomyosis was markedly inhibited in mice treated with CB-154 for more than 4 weeks beginning at 4 weeks of age, but not for less than 3 weeks of the treatment. The inhibitory effect of CB-154 was not counteracted by pituitary grafting. Furthermore, CB-154 treatment between 11 and 18 weeks of age also accelerated HAN formation, but had no effect on the development of adenomyosis. These results indicate that in mice a certain period of CB-154 treatment is necessary to produce changes in the development of HAN and adenomyosis, and that the inhibitory effect of CB-154 on the development of adenomyosis is age-dependent. The different response between mammary gland cells and uterine cells to CB-154 exposure is discussed with special reference to cell proliferation. PMID- 6495992 TI - X-chromatin in congenital virilizing adrenal hyperplasia. AB - X-chromatin body (XCB) frequencies in oral mucosa were investigated in 14 female patients with the simple non-salt-losing form of congenital virilizing adrenal hyperplasia (CVAH) due to 'partial' 21-hydroxylase deficiency (CVAH-type I), using toluidine blue (TBS) and Feulgen's stains (FS). They were found to be lower than normal controls by both TBS (12.6 +/- 1.73 vs 18.38 +/- 0.41) and FS (13.60 +/- 2.16 vs 17.94 +/- 0.76) methods. After 4-5 weeks on glucocorticoid therapy, XCB frequencies overlapped with those of normal controls using both TBS (16.54 +/ 1.76) and FS (17.09 +/- 1.98). Karyotypes performed in 8 of the 14 cases showed a normal female pattern. Two possible interpretations are proposed: First, variations of XCB counts may reflect the average nuclear size of the cell populations studied. Second, high androgen levels found in untreated cases with CVAH-type I might lead to partial chromosome depiralization and increasing euchromatic areas. At present the first possibility appears more likely. PMID- 6495993 TI - Demonstration and characterization of immunoreactive methionine-enkephalin, leucine-enkephalin, methionine-enkephalin-Arg6-Gly7-Leu8 and methionine enkephalin-Arg6-Phe7 in human phaeochromocytoma. AB - To elucidate whether or not human phaeochromocytoma contains methionine enkephalin-Arg6-Gly7-Leu8 (Met-enkephalin-Arg-Gly-Leu) and methionine-enkephalin Arg6-Phe7 (Met-enkephalin-Arg-Phe) together with methionine-enkephalin (Met enkephalin) and leucine-enkephalin (Leu-enkephalin), all of which are known to exist in the same precursor molecule (preproenkephalin A), we examined extracts from 16 phaeochromocytomas using high performance liquid chromatography (HPLC) and gel exclusion chromatography coupled with radioimmunoassays (RIAs) for these four opioid peptides. Met-enkephalin-Arg-Gly-Leu-like immunoreactivity (-LI) and Met-enkephalin-Arg-Phe-LI existed together with Met-enkephalin-LI and Leu enkephalin-LI in 16 phaeochromocytomas. There was a wide variation in contents of Met-enkephalin-LI, Leu-enkephalin-LI, Met-enkephalin-Arg-Gly-Leu-LI and Met enkephalin-Arg-Phe-LI. Significant positive correlations were observed among the contents of these four opioid peptides in 16 phaeochromocytomas. HPLC and gel exclusion chromatography followed by the RIAs showed the presence of Met enkephalin, Leu-enkephalin, Met-enkephalin-Arg-Gly-Leu and Met-enkephalin-Arg-Phe together with their high molecular weight forms, which existed in variable amounts. Molar ratios of the contents of these four opioid peptides determined after HPLC varies from case to case. These results indicate the co-existence of Met-enkephalin, Leu-enkephalin, Met-enkephalin-Arg-Gly-Leu and Met-enkephalin-Arg Phe in human phaeochromocytomas, suggesting the preservation of amino acid sequences of these four opioid peptides even in neoplastic tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6495994 TI - [Atrophic gastritis and cancer: the role of nitrosamines]. PMID- 6495995 TI - [Atrophic gastritis of the fundus]. PMID- 6495996 TI - [Gastritis and immediate hypersensitivity]. PMID- 6495997 TI - [Is there a correlation between duodenogastric reflux and gastric histology?]. PMID- 6495998 TI - [Evaluation of activity in Crohn's disease and ulcerative colitis]. PMID- 6495999 TI - An index of inflammatory activity in patients with Crohn's disease. PMID- 6496000 TI - Endoscopic aspects of recurrences or relapses of ileal Crohn's disease. PMID- 6496001 TI - [Contribution of biologic tests to the management of inflammatory bowel diseases]. PMID- 6496002 TI - [Appraisal of the activity of Crohn's disease after ileocolic surgery. A prospective study of clinical, biologic and radiologic data toward the early detection of recurrence]. PMID- 6496003 TI - Thiopental loading during controlled hypotension for intracranial aneurysm surgery. AB - In this study we report our clinical experience with supplementary thiopental loading, based on 30 patients undergoing surgery for intracranial aneurysm after a recent episode of subarachnoid haemorrhage. As standard procedure we used pentobarbitone induction, pancuronium relaxation, endotracheal intubation, maintenance with halothane 0.5%, N2O 66% in oxygen, fentanyl, and moderate hypocapnia. A thiopental load of up to 20 mg X kg-1 was supplied while the aneurysm was approached. Satisfactory and well-controlled hypotension was obtained in five cases after thiopental alone, and after thiopental and sodium nitroprusside (SNP) (means +/- s.d.) 1.3 +/- 0.9 microgram X kg-1 X min-1 in the remaining 25 patients. No ECG sign of myocardial ischaemia was observed. One disadvantage was a prolonged recovery period, which in some cases necessitated controlled ventilation for some hours. We conclude that thiopental loading can be used safely as a supplement to neuroanaesthesia for aneurysm surgery. PMID- 6496004 TI - Minimum cerebral blood flow and metabolism during craniotomy. Effect of thiopental loading. AB - Cerebral blood flow and metabolism were measured repeatedly during surgery for cerebral tumours by a modification of the classical Kety & Schmidt method using 133Xe infusion intravenously. Our standard procedure for neuroanaesthesia (pentobarbitone-fentanyl induction, halothane-nitrous oxide maintenance) reduced blood flow from 47.1 to 24.2 ml X 100 g X ml-1 and metabolism from 3.30 to 1.83 ml O2 X 100 g-1 X ml-1. PaCO2 was reduced by hyperventilation from 5.3 to 3.6 kPa. Additional thiopental loading and maintenance using 4 + 4 mg X kg-1 (n = 5) or 8 + 8 mg X kg-1 (n = 5) reduced cerebral metabolism by an additional 15% (P less than 0.01) and blood flow by 16.5% (P less than 0.01), while mean arterial blood pressure fell from 11.0 to 9.9 kPa (P less than 0.05). PaCO2 remained unchanged. This additional reduction in cerebral metabolism and blood flow is small, but we nevertheless conclude that it may well be of clinical interest to the problem of protecting the brain in case of episodes of focal cerebral ischaemia which may arise peroperatively during intracranial surgery. PMID- 6496005 TI - Determination of skin blood flow by 133Xe washout and by heat flux from a heated tc-PO2 electrode. AB - 133Xe washout measurements were used to determine cutaneous and subcutaneous blood flow beneath a specially designed double-thermostat tc-PO2 electrode. The skin blood flow was determined using thermal methods based on reduced heat dissipation during blood flow cessation. A total of 20 measurements were performed on two healthy volunteers, using the volar side of the right forearm as the experimental area. Cutaneous as well as subcutaneous blood flow increased with increasing electrode temperature. The cutaneous blood flow increased from 12.3 +/- 1.3 ml (100 g)-1 X min-1 (37 degrees C) to 49.1 +/- 5.4 ml (100 g)-1 X min-1 (45 degrees C) and the subcutaneous values from 20.9 +/- 0.2 ml (100 g)-1 X min-1 to 57.3 +/- 0.5 ml (100 g)-1 X min-1. Preheating of the measuring area or injection of papaverine as blood flow accelerator did not increase the maximum blood flow values. A considerable inter-individual difference between cutaneous and subcutaneous blood flow was observed, but in spite of that a good overall correlation between the 133Xe washout measurements and the two thermal flow measurements was found (r = 0.932 and 0.945, respectively). It is concluded that in some cases, but not always, measurements of tc-PO2 at electrode temperatures of 45 degrees C take place on a maximally perfused skin and that it is possible to determine skin blood flow by means of determinations of the heat dissipated from the tc-PO2 electrode to the underlying skin. PMID- 6496006 TI - Natural killer cell activity after open-heart surgery. AB - We studied the effects of elective open-heart surgery with cardiopulmonary bypass on peripheral blood natural killer (NK) cell activity in 12 patients with heart disease. Separated mononuclear cells from patients and control cells taken from healthy volunteers were incubated in microtiter plates for 24 h with 3H-thymidine labelled K 562 cells as target cells. In this test system, higher counts per minute (cpm) values represent a greater number of surviving target cells and thus weaker NK activity. Results of cultures prepared from blood samples taken preoperatively were compared with those taken 2, 7 and 14 days postoperatively. NK cell activity was depressed (P less than 0.01) for 2 days after surgery. NK cell activity in the control samples did not change significantly. The results show an impairment of NK cell activity immediately after open-heart surgery. PMID- 6496007 TI - Delayed hydrothorax following percutaneous central venous cannulation. AB - Isolated cases of delayed complications associated with prolonged use of percutaneous central venous lines have been reported. We report four patients who developed hydrothorax more than 24 h after central venous cannulation due to perforation of an intrathoracic vein wall by the catheter tip. The patients were all adults of average body habitus. Left-sided catheters were placed in the operating room after anesthetic induction by experienced personnel using the Seldinger technique and secured in position with a dressing and tape. Chest x rays taken in the recovery room showed all catheter tips terminated in the central vein and no evidence of hydrothorax. Hydrothorax was manifested in the post-operative period and occurred 1-7 days postcannulation. We are left with the conclusion that the delayed hydrothorax resulted from gradual penetration of the vein wall by the catheter tip. We feel a combination of factors probably contributed to the vein wall erosion. First, the insecure fixation of the catheter combined with head, neck, and cardiopulmonary motion has been shown to result in the back-and-forth movement of the catheter tip. Second, the stiff catheters in the left jugular system take a curved course to the superior vena cava bringing the catheter tip into close proximity to the wall of the superior vena cava. We therefore conclude that late developing hydrothorax can be minimized by using a soft, pliable catheter, sutured firmly in place. Right-sided line placement is preferable to left-sided placement because of the anatomic relationships. PMID- 6496008 TI - Cardiac dysrhythmias during outpatient dental anaesthesia with enflurane. The role of "beta blockade". AB - In a study of 120 unpremedicated outpatients presenting for outpatient dental anaesthesia, the incidence of dysrhythmias was lower with enflurane than had previously been found with halothane (1). The intravenous use of the cardioselective beta adrenergic blocking agents practolol and metoprolol, in a dose of 0.05-0.22 and 0.16-0.17 mg/kg body weight, respectively, proved effective in the treatment of sinus tachycardia in excess of 150 beats/min and/or ventricular dysrhythmias. Although metoprolol, unlike practolol, has no intrinsic sympathetic activity, there were no side-effects related to either beta-blocker in the dosages used during enflurane anaesthesia. PMID- 6496009 TI - Impairment of postural stability following perivascular axillary block with mepivacaine. AB - Perivascular axillary block was performed on 10 patients using a catheter technique. All patients received a standard dose of 50 ml mepivacaine 1% with adrenaline 1:200 000. Using a quantitative Romberg-test performed on a computerized force-plate system, postural stability was tested before and 40 min after the local anesthesia. There was a significant increase in body-sway following axillary block (P less than 0.01). Nine out of 10 patients had an increased sway-tendency, an average of 31%. A proportionate increase in postural imbalance has been found in normal persons after alcohol consumption, when blood levels were 0.8 mg/ml. PMID- 6496010 TI - Peroperative hypothermia. AB - Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs were investigated using a warming blanket, humidified heated inspired anesthetic gases at 37-40 degrees C, or both these methods together. A fourth group of patients received no active warming. A warming blanket used alone gave no protection against hypothermia when compared with no active warming. In the abdominal surgical group, there was a steady fall in temperature throughout the operation if no warming method was employed. In this group the use of humidified, heated inspired gases was significantly better than no treatment after 2 h of anesthesia (P less than 0.05). The combination of humidified and heated inspired gases and a warming blanket gave significantly better heat preservation after 40 min (P less than 0.05). Patients undergoing peripheral vascular surgery had similar but smaller drops in temperature with the different types of warming procedures employed. The differences in temperature between the intra-abdominal and extra-abdominal operations were statistically significant after 3 h (P less than 0.05). PMID- 6496011 TI - Changes in heart rate and impulse conduction after a single dose of succinylcholine. AB - The effect of 1 and 2 mg/kg b.w. succinylcholine on changes in cardiac rate and rhythm was studied in 40 fit, adult patients undergoing non-emergency surgery. Induction of anaesthesia consisted of atropine 0.007 mg/kg b.w., pancuronium 0.015 mg/kg b.w., thiopental 5 mg/kg and succinylcholine 1 or 2 mg/kg b.w. Succinylcholine 1 mg/kg b.w. intravenously resulted in a significant decrease in heart rate after 1 min. This decrease persisted after 2 min. The heart rate was unchanged 1 and 2 min after succinylcholine 2 mg/kg b.w. When the two groups were compared, no significant difference was found. No serious cardiac arrhythmias were seen. These results suggest that the larger single dose of succinylcholine is not more likely to cause severe bradycardia or asystole. PMID- 6496012 TI - Diazepam does not prevent succinylcholine-induced fasciculations and myalgia. A comparative evaluation of the effect of diazepam and d-tubocurarine pretreatments. AB - To determine the effectiveness of diazepam pretreatment in preventing succinylcholine (SCh)-induced fasciculations and body pains, 587 patients were randomly allocated to six groups. Patients in Group I received no pretreatment and served as controls. Patients in Groups II and III were pretreated with 0.05 mg/kg of diazepam either 4-5 min (Group II) or 8-10 min (Group III) prior to SCh administration. Patients in Groups IV and V received 0.1 mg/kg of diazepam either 4-5 min (Group IV) or 8-10 min (Group V) prior to SCh administration, while patients in Group VI were pretreated with 0.05 mg/kg of d-tubocurarine (dTc) 4-5 min prior to SCh. The succinylcholine dosage was 1.0 mg/kg in Groups I through V and 1.5 mg/kg in Group VI. Fasciculations, intubation conditions and postoperative body pains were evaluated in all groups. Fasciculations were seen in 90% of patients in the control group and 15% in the dTc pretreatment group, while diazepam was ineffective in altering the frequency or intensity of fasciculations. Conditions for intubation were judged to be clinically adequate in all groups. Body pains were seen in 33% of patients in the control group and 28-36% in diazepam-pretreated groups and in only 8% of patients in the dTc pretreatment group. There was no statistically significant difference in the incidence of body pains by virtue of site of operation, age, sex, and inpatient/outpatient status. It is concluded that the problem of postoperative myalgia is significant and that dTc pretreatment is the effective method for prevention of fasciculations and postoperative myalgia. Diazepam pretreatment was ineffective for the prevention of fasciculations and myalgia. PMID- 6496014 TI - Rectal administration of morphine hydrogel: absorption and bioavailability in women. AB - Seven patients undergoing radiological treatment for carcinoma of the uterus were given morphine intramuscularly (0.15 mg X kg-1) and morphine in a starch hydrogel rectally (0.56 mg X kg-1) on two separate occasions. The hydrogel preparation was used to order to improve the contact between the rectal mucosa and thus improve and possibly prolong the absorption of morphine. Plasma concentrations of morphine were followed for 8 h and analysed with a GC/MS technique. It was found that 45-120 min after administration of morphine hydrogel, a mean maximum plasma morphine concentration of 61 ng X ml-1 was obtained. After 8 h, the mean plasma concentration was 10 ng X ml-1. The mean biological availability of morphine hydrogel was 48% (range 31-72%). It is suggested that morphine hydrogel, given rectally, can be clinically useful. PMID- 6496013 TI - Kinetics of morphine in cerebrospinal fluid after epidural administration. AB - Forty patients undergoing arthroscopy were given an epidural dose of 0.05 mg morphine-HCl in 0.1 ml saline/kg body weight to study the disposition of morphine in the cerebrospinal fluid (CSF). In each patient one to three CSF samples were collected (86 samples in total). A mean peak concentration of 13 890 nmol/l was achieved 75 min after morphine administration. The compiled data show an elimination half-life of 162 min (r = 0.98). Individual half-lives in seven patients with three samples ranged from 61-172 min. Large interindividual variations were found in CSF-concentrations of morphine, 9- and 8-fold at 3 and 8 h, respectively, after the dose. However, 16 h after administration no patient had a concentration less than 81 nmol/l. At 8 h after the dose, CSF concentrations of morphine were significantly higher (P less than 0.05) in a group of patients (n = 5) kept uptilted (80 degrees), as compared to those in the supine position (n = 5). Such a difference was not observed 3 h after the dose. The sampling procedure and age also seemed to influence CSF concentrations of morphine. There was no correlation between the dose given in mg and the CSF concentrations achieved. Strict standardization is thus mandatory when studying the disposition of opiates in CSF after epidural or intrathecal administration. Since our calculated half-lives of morphine in CSF were similar to those reported in plasma, the long-lasting effect is probably related to the high initial morphine concentrations in CSF. PMID- 6496015 TI - Prevalence of viral hepatitis in the staff in Norwegian anaesthesiology units. AB - The prevalence of markers for present or past hepatitis B infection has been studied in 1230 staff members of anaesthesiology units throughout Norway. HBsAg was not detected in any of the participants in the study. The prevalence of antibodies against hepatitis B in the younger participants was similar to that in the control group, but was significantly increased among the older participants and in those with longer seniority in medical work. This result was to some extent influenced by a fairly large number of staff members who had grown up or had had professional experience in countries with a higher prevalence of hepatitis B. The results may be interpreted as reflecting a very moderate incidence of hepatitis B infections in anaesthesiology units during the last 15 years. However, relevant to the discussion of vaccination programs for these units are three reported cases of hepatitis B infections with a fatal outcome among Norwegian anaesthesiologists, suggesting a greater severity of hepatitis B infections within this occupational group. PMID- 6496016 TI - Effects of ephedrine on haemodynamics and oxygen consumption in the dog during high epidural block with special reference to the splanchnic region. AB - High lumbar epidural block was induced in seven dogs with 0.5% bupivacaine, causing a fall in mean arterial blood pressure (AP) from 19.2 +/- 3.2 to 10.5 +/- 3.2 kPa, owing to equal reductions in cardiac output (QT) and systemic vascular resistance (SVR). After the administration of ephedrine (a single injection of 200-300 micrograms X kg-1 b.w. followed by a continuous infusion of 10-20 micrograms X kg-1 b.w. X min-1) AP, QT and SVR rose to pre-epidural values. Furthermore, the hypokinetic circulation following the epidural block returned to normokinetic levels. Portal venous blood flow was increased from 16.5 +/- 6.2 to 25.5 +/- 4.3 ml X kg-1 b.w. X min-1 by ephedrine, while the hepatic arterial blood flow was unchanged and remained at its pre-epidural level. In spite of a slight rise in hepatic oxygen consumption from 1.2 +/- 0.4 to 1.6 +/- 0.6 ml X kg 1 b.w. X min-1, the percentages of oxygen extracted from the portal vein and the hepatic artery decreased significantly. It is concluded that ephedrine restores central and splanchnic haemodynamics in a desirable manner during high epidural anaesthesia. PMID- 6496017 TI - Cardiovascular response to endotracheal intubation during four anesthetic techniques. AB - In order to investigate the impact of four different anesthetic regimens on the cardiovascular response to endotracheal intubation, 24 patients were anesthetized to approximately the same depth of anesthesia (MAC-fraction) using one of four supplements to N2O-O2 (60:40) anesthesia: Group 1 = morphine 0.5 mg/kg i.v., Group 2 = Innovar 0.1 ml/kg i.v., Group 3 = halothane, 0.4% end-tidal, Group 4 = enflurane 0.7% end-tidal. Cardiovascular variables were recorded from radial arterial and thermistor-tipped pulmonary artery catheters and were determined at the following times: (1) while the patients were awake prior to induction of anesthesia; (2) after a stable level of anesthesia had been induced; and (3) within the first minute after endotracheal intubation. Only the groups receiving morphine and halothane sustained significant increases in heart rate, rate pressure product and pulmonary capillary wedge pressure after intubation. It is concluded that N2O-O2 anesthesia supplemented with either morphine or halothane at the 1 MAC dose level does not adequately prevent cardiovascular response after endotracheal intubation, and that these techniques require additional anesthetic depth or other adjuvant drugs in order to prevent cardiovascular complications. PMID- 6496018 TI - Laryngospasm during anaesthesia. A computer-aided incidence study in 136,929 patients. AB - With the aid of a computerized anaesthetic record-keeping system, the incidence of laryngospasm during anaesthesia was studied, in order to quantify the risk of this complication. 136,929 patients given 156,064 anaesthetics were studied. There were 1,232 cases of laryngospasm recorded in 1,197 patients. The incidence of laryngospasm was calculated in subgroups characterized by age, sex, preanaesthetic conditions, premedication, anaesthetic technique, type of surgery and concomitant complication. An incidence exceeding 50 laryngospasms in 1,000 patients was observed when giving anaesthesia to children with bronchial asthma, with airway infection, in those who had a previous anaesthetic complication, during oesophagoscopy and when correction of hypospadias was performed. Extirpation of skin tumours and scars in males 50-59 years old was also accompanied by a similarly high incidence. Figures exceeding 25 laryngospasms in 1,000 patients were seen in the age group 1-3 months and in children undergoing appendicectomy, oral endoscopy and plastic surgery, when tracheal intubation had been performed and when a gastrointestinal tube was used. In the age group 50-59 years, an incidence exceeding 25 in 1,000 patients was seen when there had been preoperative airway obstruction and in females when the anaesthetic technique included spontaneous breathing and face mask, or apneic oxygenation. Dilatation of the anal sphincter and mediastinoscopy in males were also associated with an increased incidence of laryngospasm. PMID- 6496019 TI - Micro-drop size and intravenous administration of sedative-anaesthetic solutions. AB - The variation in micro-drop size was studied for a series of sedative-anaesthetic solutions administered via a standard paediatric infusion set in combination with an infusion pump and drop counter. Of the solutions tested, only Diazemuls 20 mg% failed to alter micro-drop size. Solutions containing Ketalar, Apozepam, Hypnomidate and Althesin all caused a decrease in drop size and therefore in administered volume. The largest error (37%) occurred with a solution containing althesin 20% (v/v). PMID- 6496020 TI - Can the "sympatho-galvanic reflex" (skin conductance response) be used to evaluate the extent of sympathetic block in spinal analgesia? AB - The skin conductance response (SCR) (the "sympatho-galvanic reflex") was studied in volunteers and in a few patients undergoing spinal analgesia. Electrical stimulation over the clavicle, breath-holding during inspiration, a short, deep breath and a sharp sound provoked a marked change in conductance not only in the hand and foot but also in dermatomes T5, T9, T12-L1. Thus, the SC response can be used to study sympathetic activity not only in the hand and foot, but also on the chest and abdomen. Electrical stimulation over the clavicle or a short, deep breath were the best means of provoking SC responses in patients receiving spinal analgesia. This restricted pilot study indicates that skin conductance response is maintained at dermatome levels far below anaesthetised levels during spinal analgesia, and a larger study is now under way to investigate these results further. PMID- 6496021 TI - Spinal analgesia with glucose-free bupivacaine--effects of volume and concentration. AB - Spinal analgesia using 22.5 mg glucose-free bupivacaine, given either as 3.0 ml of 0.75% solution or 4.5 ml of 0.5% solution was studied in a double-blind fashion in 40 patients scheduled for transurethral surgery. No differences in onset, duration and regression of analgesia or motor blockade were noticed, indicating that dosage (in mg) is more important than either volume or concentration when glucose-free bupivacaine solutions are used for spinal analgesia. The cardiovascular effects were small and no side-effects attributable to the spinal anaesthetic were seen. PMID- 6496022 TI - Specific risks of anesthesia in patients with osteoarticular disease. AB - Anesthesia in patients with either treated or untreated osteoarticular disorders poses a number of specific problems. The authors deal with risks resulting from mechanical deformities produced by these disorders, by the involvement of a large number of functional systems, by changes in the immune status of such patients and by alterations in the reactions of arthritic patients resulting from prior or concurrent treatments. The authors emphasise the crucial points which require evaluation and observation before and during anesthesia. PMID- 6496023 TI - Clinical assessment of midazolam for induction of anesthesia. AB - Intravenous midazolam was tried as a hypnotic agent for induction of anesthesia in 63 surgical patients. Three dosages were used: 0.2, 0.3 and 0.4 mg/kg body weight. Indices of induction, changes of vital parameters, incidence of apnea and side effects and the duration of the drug effect on central nervous system functions were evaluated. No significant differences were observed between the effects of the different doses of midazolam on the cardiac and respiratory parameters. The drug provided a satisfactory degree of sleep in all patients of maximal intensity at three minutes but anesthetic induction was not achieved in several patients of each dose group (overall failure rate 11%). A short-lasting apnea was seen in 13% of the patients and seemed not related to the administered dose of midazolam. The awareness of the surroundings was satisfactorily obtunded by the anti-recall effect of the drug. The sedative effects of midazolam on central nervous system functions lasted fairly long. Indeed, mental arousal, sensory functions and muscle tone still had not returned to preinjection values 20 min after midazolam administration. A reliable relationship between dose of midazolam and intensity of cerebral depressive effect was not evident. PMID- 6496024 TI - Epidural anesthesia with plain bupivacaine 0.75% for elective caesarean section. AB - The clinical effects of epidural anesthesia with bupivacaine 0.75% for elective caesarean section were investigated in 20 healthy pregnant women. The mean total dose of bupivacaine which offers sufficient sensory and motor block, provided the epidural catheter is properly placed, was 137.5 mg. Maternal hypotension occurred in 4 patients in spite of prehydratation and left uterine displacement. No maternal systemic toxicity or local neurotoxicity was found. The results of the Apgar scoring and the neonatal acid-base studies showed that there is no clinically important neonatal depression with this technique. PMID- 6496025 TI - Hazard of non reinforced pre-formed tracheal tubes. AB - A near fatal accident is described with a non reinforced RAE tube, used because of fear of accidents previously described using armoured tubes and because of the more easy adaptation possibilities with the new RAE tubes. This report states that there is still a place for reinforced tubes. PMID- 6496026 TI - [A right-sided aortic arch with the left subclavian artery as the last branch]. PMID- 6496027 TI - [On the arterial supply of the human trapezius muscle]. PMID- 6496028 TI - [Arterial supply to the masseter muscle in rabbit]. PMID- 6496029 TI - [A case of situs inversus viscerum totalis associated with various abnormalities]. PMID- 6496030 TI - Isolated benign cerebral vasculitis. Case report and review. AB - A case of isolated cerebral vasculitis showing benign outcome is presented. Review of pertinent literature suggests that isolated benign arteritis of the CNS should be considered as a distinct entity, in a heterogeneous group of vasculitides. The common features of the syndrome are as follows: 1(0) benign evolution; 2(0) sensitiveness to cortisone; 3(0) absence of CSF alterations; 4(0) constant angiographic pattern of arteritis. Early cortisone treatment is suggested in any case of cerebral arteritis. PMID- 6496031 TI - [Incidence and treatment of subdural hygroma in severe head injuries]. AB - In a population of 109 subjects with severe head injury (Liege score less than or equal to 12) we observed secondary development of subdural hygroma in sixteen patients. These liquefying processes were mostly secondary to the entry of CSF in the subdural space from tears in the arachnoid. Half the accumulations were accompanied by increased subdural pressure. Drainage of the subdural fluid brought clinical improvement in patients with elevated subdural pressure (greater than 15 torr). PMID- 6496032 TI - [Aneurysms of the anterior communicating artery. Diagnostic, clinical and anatomic difficulties]. AB - Aneurysm in the anterior communicating artery always presents diagnostic difficulties of a clinical and sometimes neuropathological nature. The authors describe the anatomic aspects of 21 cases of this type of aneurysm, together with the clinical background: anatomic recognition of clinically undetected aneurysms is not always straightforward. An inferior frontal inter-hemispheric hematoma suggests the diagnosis, but only macroscopic dissection of the whole hematoma and large vessels allows confirmation. Histological examination often reveals a hemorrhagic lesion in the fronto-polar area. Clinical investigation of these cases shows the reasons for certain classic diagnostic errors. Although this exercise reveals no original concepts, it draws attention to some classic facts that are often unexplainably overlooked. An uncommon speech disorder is described in two cases, but the mechanism of development is not clear. PMID- 6496033 TI - [Continence disorders in hereditary spinocerebellar degeneration. Comparison of clinical and urodynamic findings in 55 cases]. AB - Urodynamic exploration with cystometry was performed at random on 55 of the 195 patients suffering from hereditary spinocerebellar degeneration (Friedreich's disease 43 cases, Pierre-Marie hereditary ataxia nine cases, Strumpell-Lorrain disease three cases). The authors observed disturbances in continence without urinary disorders, even when the bladder was atonic. In the case of Friedreich's disease, among the 18 patients with urgent urination or with urinary leakage, the bladder was found to be normal in only two cases. Although 25 patients evidenced no urinary disturbances, a through study revealed nine abnormal bladders. In the case of Pierre-Marie disease, six normal bladders and three pathological bladders were found. A single abnormal bladder was found in Strumpell-Lorrain disease. Two types of pathological bladder were observed: the atonic bladder was compared with the traumatic bladder, and was found primarily in conjunction with peripheral sensory disturbances. The hypertonic bladder appears when sensory involvement is not evident. The authors discuss the pathophysiology of these disturbances of continence. PMID- 6496034 TI - Reflex epilepsy evoked by specific psychic activity. A case report. AB - A patient with epileptic seizures and epileptiform EEG abnormalities precipitated by specific type of intellectual activity is presented. Clinical and subclinical epileptic seizures were accompanied by specific EEG discharges--the left parieto occipito-temporal spike-and-wave complexes with various grade of generalization. On the basis of detailed EEG and activation studies, it is concluded that seizures in this patient were evoked by higher cognitive processes associated with decision making, anticipation and spatial function. PMID- 6496035 TI - The distribution of hypoglycemic brain damage. AB - Rats were exposed to insulin-induced hypoglycemia resulting in periods of cerebral isoelectricity ranging from 10 to 60 min. After recovery with glucose, they were allowed to wake up and survive for 1 week. Control rats were recovered at the stage of EEG slowing. After sub-serial sectioning, the number and distribution of dying neurons was assessed in each brain region. Acid fuchsin was found to stain moribund neurons a brilliant red. Brains from control rats showed no dying neurons. From 10 to 60 min of cerebral isoelectricity, the number of dying neurons per brain correlated positively with the number of minutes of cerebral isoelectricity up to the maximum examined period of 60 min. Neuronal necrosis was found in the major brain regions vulnerable to several different insults. However, within each region the damage was not distributed as observed in ischemia. A superficial to deep gradient in the density of neuronal necrosis was seen in the cerebral cortex. More severe damage revealed a gradient in relation to the subjacent white matter as well. The caudatoputamen was involved more heavily near the white matter, and in more severely affected animals near the angle of the lateral ventricle. The hippocampus showed dense neuronal necrosis at the crest of the dentate gyrus and a gradient of increasing selective neuronal necrosis medially in CA1. The CA3 zone, while relatively resistant, showed neuronal necrosis in relation to the lateral ventricle in animals with hydrocephalus. Sharp demarcations between normal and damaged neuropil were found in the hippocampus. The periventricular amygdaloid nuclei showed damage closest to the lateral ventricles. The cerebellum was affected first near the foramina of Luschka, with damage occurring over the hemispheres in more severely affected animals. Purkinje cells were affected first, but basket cells were damaged as well. Rare necrotic neurons were seen in brain stem nuclei. The spinal cord showed necrosis of neurons in all areas of the gray matter. Infarction was not seen in this study. The possibility is discussed that a neurotoxic substance borne in the tissue fluid and cerebrospinal fluid (CSF) contributes to the pathogenesis of neuronal necrosis in hypoglycemic brain damage. PMID- 6496036 TI - Microvascular permeability in induced astrocytomas and peritumor neuropil of rat brain. A high-voltage electron microscope-protein tracer study. AB - Brain tumors, benign and malignant, are characteristically more permeable to various types of tracer molecules than the neuropil in which they are embedded. Impermeability of brain neuropil capillaries is imparted by the blood-brain barrier, the anatomic basis of which is the network of interendothelial zonulae occludentes that seal capillary endothelial cells. To explore both the vascular elements of brain neoplasms and the route of tracer extravasation from them, as well as the possible effects of brain tumors on the permeability of peritumoral neuropil capillaries, brain tumors were induced in newborn Wistar rats by intracerebral (i.c.) injection of C-6 astrocytoma cells. The protein tracer horseradish peroxidase (HRP) was injected systemically into both normal and tumor bearing rats to mark the pathway along which it flowed into the tumor parenchyma tissue spaces, and to signal any concomitant tracer loss from the tumor extracellular compartment or peritumoral brain capillaries, into the neuropil extracellular milieu. Electron-microscopic examination of thin plastic sections of tumor and peritumoral neuropil revealed massive extravasation of tracer into the tumor tissue spaces, but none was seen outside of the capillaries in the surrounding brain neuropil. Zonulae occludentes of both tumor capillary endothelium and brain capillary endothelium were devoid of tracer and judged tight (sealed). Tracer was seen in pinocytotic vesicles in the highly attenuated endothelium of tumor capillaries and also in cytoplasmic vesicles within the tumor cells. The peritumoral and contralateral neuropil capillary endothelium exhibited reaction product-filled pinocytotic vesicles and vesiculo-tubular conduits. Often, one end of a HRP-filled vesiculo-tubular channel appeared continuous with either the luminal or abluminal plasmalemma. High-voltage electron microscopy of these conduits often showed them to be continuous with both luminal and abluminal surfaces of the endothelium, thus forming a continuum across the capillary wall. In addition, these transendothelial channels, clearly constituted as chains of fused vesicles, were often seen in close proximity to, or fused with, dense bodies in the endothelial cytoplasm. In spite of the presence of HRP-filled structures in the peritumoral neuropil capillary endothelium of tumor-bearing rats, no evidence of tracer extravasation from these vessels was apparent. These results suggest that although peritumoral and contralateral neuropil capillaries possess the machinery for extravasation of tracer, likely as a response to the presence of the neoplasm, tracer is not lost but, instead, is degraded by endothelial enzymes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6496037 TI - Observation of cultured peripheral non-neuronal cells implanted into the transected spinal cord. AB - We have previously reported that cultured peripheral non-neuronal cells could be used as an adjunct to spinal cord reconstruction with the delayed nerve graft technique. The cultured cells appeared to enhance axonal regeneration and with their use the time it took for axons from the spinal cord stumps to reach the nerve graft was reduced. To gain insight into the possible mechanisms through which peripheral non-neuronal cells can foster CNS regeneration, we have now investigated the behaviour of the peripheral non-neuronal cells after implantation into the spinal cord. Autologous mixed non-neuronal cell cultures were prepared from cat sciatic nerve biopsies and labeled in culture with tritiated thymidine. The labeled cells were implanted so as to completely fill the gap in the spinal cord produced by a narrow "slit transection". Light-and electron-microscopic autoradiography was used to identify the cells 3 and 7 days after implantation and to determine their proximity to, and possible interaction with, axons in the spinal cord stumps. The implanted peripheral cells were frequently found near spinal cord axons and axon terminals. Some of the labeled cells ensheathed axons in which case they displayed morphological characteristics of Schwann cells. Other labeled cells had characteristics of fibroblasts and were surrounded by an extracellular matrix rich in collagen fibrils. Many of the labeled cells contained phagocytosed myelin debris. These observations are consistent with the implanted cells acting to enhance regeneration in the spinal cord either by direct interaction with axons (ensheathment) or indirectly via the production of soluble neuronotrophic factors or a favorable extracellular matrix. The ability of the implanted cells to rapidly move into the spinal cord stumps and attain positions close to spinal cord axons would be an important factor for any of these mechanisms. PMID- 6496038 TI - Acid phosphatase activity in human neuronal and glial lipofuscin. AB - The ultrastructural demonstration of acid phosphatase activity in neuronal and glial lipofuscin of the aged human brain indicates lysosomal activity. Contrary to the constantly high enzyme activity of astroglial lipofuscin and low activity of oligodendroglial lipofuscin, the enzyme activity of neuronal pigment differs in different locations, i.e., in different neuronal populations. The activity is probably based on the importation of lysosomal enzymes into the pigment component of lipofuscin. These facts indicate the possibility of a continuous autophagosomal function of lipofuscin in neuronal and glial cell physiology. Therefore, the findings are arguments against the view that lipofuscin is a wear and-tear material only and claim for it an active role in cell metabolism. PMID- 6496039 TI - Quantitation of the Schmidt-Lanterman incisures in juvenile, adult, remyelinated and regenerated fibres of the chicken sciatic nerve. AB - Morphometric studies of peripheral nerves in various species have shown that the number of Schmidt-Lanterman incisures in an internode is proportional to the fibre diameter. In the rat sural nerve it appears that following remyelination, the relationship between the numbers of incisures per internode and the fibre diameter remains unaltered despite the fact that the remyelinated internodes are uniformly short. We quantitatively examined the insertion of incisures in adult, juvenile, remyelinated and regenerated fibres of the chicken sciatic nerve. Remyelinated fibres were examined 100 and 200 days following the intraneural injection of diphtheria toxin, and regenerated fibres 200 days after a nerve crush. Our results show that the incisures are more abundant in the chicken than in all other species previously reported, and for both juvenile and adult hens the number of incisures in an internode is proportional to the fibre diameter. Following both remyelination and regeneration the internodal lengths were shorter than control fibres and the distances between the incisures were reduced by approximately 20% for all fibre diameters. Significantly, the numbers of incisures in an internode were related to the length of the remyelinated or regenerated internode and not to the fibre diameter. This finding is in marked contrast to previous reports for rat peripheral nerve. Our findings are discussed in relation to the hypothesis that the Schmidt-Lanterman incisures are vital to the maintenance of the myelin sheath and/or the associated axon. PMID- 6496040 TI - Neuroaxonal pathology of central and peripheral nervous systems in cerebrotendinous xanthomatosis (CTX). AB - We studied three siblings and one unrelated patient with cerebrotendinous xanthomatosis (CTX). Of two unrelated patients, we examined biopsies of sural nerve, soleus muscle, and achilles tendon. We also performed neurophysiologic investigations. Another patient died, and a postmortem examination of both brain and spinal cord was made. It was concluded that both the central and the peripheral nervous system were involved in CTX, but the peripheral system only to a slight degree, and that the pathology was predominantly neuroaxonal rather than demyelinating in character. PMID- 6496041 TI - Acute effects of maternal smoking on fetal heart beat intervals. AB - The purpose of this study was to analyse the acute effects of maternal cigarette smoking on the fetal heart beat intervals and their variability during the last trimester of a normal gestation. The fetal heart beat intervals were monitored continuously by abdominal electrocardiography for 60 min before and 60 min after smoking in 10 pregnant women. The mean intervals, their long-term variability (SD) and short-term variability (standard deviation of interval differences (SDID], calculated for 30-sec periods, showed a steady state before smoking. During the control period, the mean beat interval was negatively correlated with daily cigarette consumption and the short-term variability was positively correlated with the maternal plasma nicotine level. After smoking, the mean beat interval and the short-term variability decreased transiently, the values of both these parameters being positively correlated with the maternal nicotine values before smoking. The acute response of fetal heart beat intervals and their variability to one cigarette is distinct but transient, and the results suggest that the effects are modified by the chronic smoking habits of the women. PMID- 6496042 TI - Red cell 2,3-diphosphoglycerate and hemoglobin--oxygen affinity during normal pregnancy. AB - The concentration of red cell 2,3-diphosphoglycerate (2,3-DPG), hemoglobin-oxygen affinity and other oxygen transport variables were determined during first, second and third trimester of normal pregnancy as well as 3 months post partum in 18 healthy women. The median concentration of red cell 2,3-DPG increased significantly from the first to the third trimester (16.1 to 17.0 mumol/gHb, p less than 0.01), whereas 2,3-DPG decreased significantly post partum (p less than 0.01). Normal pregnancy was also associated with relative anemia, a significant increase in arterial pH, hypocapnia and hypophosphatemia. The difference in hemoglobin concentration from the first trimester to 3 months post partum was correlated inversely with the difference in red cell 2,3-DPG content (r = -0.52, p less than 0.05). In spite of the variations in red cell 2,3-DPG, hemoglobin oxygen affinity expressed as P50 at actual pH remained unchanged during pregnancy and post partum. The study suggests that the increased level of 2,3-DPG during pregnancy may in part represent compensation for physiologic anemia and also compensate for a factor leading to increased hemoglobin-oxygen affinity during pregnancy. PMID- 6496044 TI - Cryosurgery for dysplasia of the uterine ectocervix. A randomized study of the efficacy of the single- and double-freeze techniques. AB - This prospective, randomized study of 142 women with mild or moderate dysplasia of the uterine ectocervix shows that the double-freeze technique is significantly more effective than the single-freeze technique, the recurrence rates being, respectively, 6.2% and 16.3%. The highest recurrence rate was found in the group treated with a single freeze and having the most extensive portio involvement. All patients were examined colposcopically before cryosurgery in order to exclude patients with lesions extending into the cervical canal and in order to evaluate the size of the lesion. Recurrent lesions were usually diagnosed within the first year (75%) and in only one patient more than 2 years after treatment. None of the patients developed invasive cancer. The mean follow-up period was 27 months (24 42 months). We consider cryosurgery to be an acceptable treatment for selected patients. Our criteria for entry were mild or moderate dysplasia of the uterine ectocervix, and colposcopic visualization of the entire transformation zone to ensure that the lesion does not extend into the cervical canal. Our experience from the present study is that the following criteria should be added: the portio involvement must not be too extensive and the patient must agree to follow-up examination. When these conditions are fulfilled, future treatment in our department will consist of a double freeze extending 3 mm beyond the lesion, with a thaw interval of 4 min. PMID- 6496043 TI - Red cell 2,3-diphosphoglycerate and hemoglobin-oxygen affinity during diabetic pregnancy. AB - Factors involved in blood oxygen transport were measured serially in the first, second and third trimester of pregnancy in 23 insulin-dependent diabetic women. Twenty-six non-pregnant diabetic patients served as a reference group. Diabetic pregnancy was associated with relative anemia, a significant increase in arterial pH, and hypocapnia. The concentration of red cell 2,3-diphosphoglycerate was significantly higher in the first trimester of diabetic pregnancy compared with non-pregnant diabetics (median value 16.4 vs. 15.0 mumol/g hemoglobin, p less than 0.02) and increased gradually from the first to the third trimester (16.4 to 17.2 mumol/g hemoglobin, p less than 0.01). The hemoglobin A1c concentration decreased simultaneously from 8.1% to 7.3% (p less than 0.01). The level of hemoglobin A1c in the first trimester was significantly lower than that in the non-pregnant diabetic patients (8.1 vs. 9.3%, p less than 0.01). In spite of the increase in red cell 2,3-diphosphoglycerate content and the decrease in hemoglobin A1c, factors known to reduce hemoglobin-oxygen affinity, the position of the oxyhemoglobin dissociation curve remained unchanged during diabetic pregnancy: P50 at actual pH in the first trimester, was 26.0 mmHg; in the second trimester, 26.9 mmHg, and in the third trimester, 26.8 mmHg (NS). These values of P50 at actual pH were identical with the value in the non-pregnant group (26.6 mmHg). Other factors influencing hemoglobin-oxygen affinity, such as hemoglobin concentration, hydrogen ion concentration and arterial oxygen saturation remained unchanged during diabetic pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496045 TI - Ovarian tumors in pregnancy. AB - The results of 90 pregnancies complicated by an ovarian tumor are analysed. On this basis it seems advisable to follow a 'wait-and-see' policy until the 16th week. Tumors persisting into the second trimester can best be extirpated between the 16th and 20th week. Ovarian tumors present after the first trimester can lead to serious complications. However, an ovarian tumor discovered in the second half of pregnancy calls for temporization of treatment. Cesarean section at term with simultaneous extirpation of the tumor is the treatment of choice. PMID- 6496047 TI - Analysis of intrapartum fetal deaths: their decline with increasing electronic fetal monitoring. AB - Over a 12-year period, from 1970 to 1981, 30 600 babies were born at the Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland. During that period, the use of electronic fetal monitoring increased remarkably, being involved in 9, 12, 33 and 95% of all vaginal deliveries during four consecutive 3-year periods. The number of intrapartum deaths during the same 12-year period was 52, giving an overall rate of 1.7 per thousand. When 15 lethally malformed infants are excluded, the rate becomes 1.2 per thousand. In the four consecutive 3-year periods, the death rates were 1.7, 1.9, 1.0 and 0.3 per thousand. Electronic fetal monitoring was not undertaken in any of the cases leading to fetal death. The main factor leading to fetal death could be considered to be hypoxia in approximately 90% of the deaths of normally formed babies. The most common reasons for hypoxia were placental abruption and cord entanglement, yet in many cases only the decreased placental perfusion could be suggested to have caused the hypoxia. The mean weight of those babies that died intrapartally decreased significantly, being approximately 1 250 g during the last 3-year period. PMID- 6496046 TI - Pregnancy and delivery in Ehlers-Danlos syndrome. Role of copper and zinc. AB - Two pregnancies of a patient with the mitis type of the Ehlers-Danlos syndrome (EDS) were followed up. The first pregnancy ended at 26 weeks. The second one proceeded to term, but the infant had a low birth weight and the placenta showed dysmaturity. In view of these pregnancies, the authors consider the vaginal route as an alternative to caesarean section for delivery of patients with the mitis type of EDS. In connection with both deliveries, serum zinc and copper levels were determined with the method of particle-induced X-ray emission (PIXE); the concentrations of both trace elements were low. The ceruloplasmin levels, on the other hand, were within the normal range. The relevance of these findings is discussed. PMID- 6496048 TI - Changing panorama of perinatal and infant mortality in diabetic pregnancy. AB - In a 21-year study covering 1960 to 1980, perinatal and infant mortality in 237 infants of diabetic mothers were analysed. The study was divided into three 7 year periods related to changes in management. In period I (1960-66) the perinatal mortality was 24.3%, decreasing to 5.0% in period II (1967-73) and to 1.1% in period III (1974-80). The corresponding figures for infant mortality were 31.4%, 7.5% and 4.6% respectively. Today the difference between the perinatal mortality rate in diabetic vs. non-diabetic pregnancies is almost negligible. However, perinatal mortality may give a false impression of pregnancy outcome, since owing to the high rate of lethal malformations in period III, infant mortality was still twice that of the non-diabetic population. During the 21-year period studied, complications of diabetic pregnancies such as severity and duration according to the White classification, hypertension and pyelonephritis in pregnancy and preterm delivery all decreased. Consequently the influence of these complicating factors on the overall outcome of diabetic pregnancies has declined. PMID- 6496049 TI - Consideration of pin diameter and insertion technique for external fixation in diaphyseal bone. PMID- 6496050 TI - [Instability of the carpus. Ligamentous lesions of the wrist and their radiologic examination]. PMID- 6496051 TI - Antero-posterior instability in knee replacements. PMID- 6496052 TI - The Putti-Platt operation for recurrent anterior dislocation of the shoulder. PMID- 6496053 TI - [The treatment of hallux rigidus. Apropos of 33 cases]. PMID- 6496054 TI - Stabilization of the hip joint after resection of caput and collum femoris by osteotomy of the femur. PMID- 6496055 TI - Severe acute cervical spine injuries. Conservative treatment. PMID- 6496056 TI - [The treatment of fractures of the humeral diaphysis with fasciculated intramedullary pins by the Hackethal method. Apropos of 194 cases]. PMID- 6496057 TI - Effects of pure tone on endocochlear potential and potassium ion concentration in the guinea pig cochlea. AB - Preliminary results presented here indicate a simultaneous decrease in endocochlear potential (EP) and in endolymphatic potassium ion concentration (K+e) under noise exposure. Maximum changes were observed after 20 min and 30 min of sound stimulation, respectively for EP and Ke+. EP recovery was faster than that of K+e. Noise-induced K+e alterations varied with the pure-tone frequency, and the locus along the basilar membrane where the measurements were performed. This supports the hypothesis that the noise has a tonotopic effect correlate with the shape of the travelling wave. Results obtained with ethacrynic acid, administered at the end of the recovery period which followed the noise exposure, indicate that the sound stimulation parameters which were used did not irreversibly alter the ionic transport in the cochlea. PMID- 6496058 TI - Are two muscles needed for the normal functioning of the mammalian middle ear? AB - Why do two muscles occur in the middle ear of most mammals? In this article selected explanations as to why two muscles occur are critically evaluated. It is argued that these explanations are not compelling. Data are then reviewed that indicate that the tensor tympani has no function to fulfil in the normal operation of the middle ear. PMID- 6496059 TI - Histochemical characteristics of the tensor tympani muscle in relation to the medial gastrocnemius muscle of the cat. AB - Serial 10-micron cryostat cross-sections of the tensor tympani muscle and of the medial gastrocnemius muscle from adult domestic cats were incubated for myofibrillar ATPase, NADH tetrazolium reductase (NADH-TR), succinic dehydrogenase (SDH), malate dehydrogenase (MDH) and menadione-linked alpha-glycerophosphate dehydrogenase (alpha GPDH). The optical density of individual tensor tympani and gastrocnemius muscle fibres after different incubation procedures was measured photometrically. The absorbance values of the tensor tympani fibres were related to the values of the type I, type IIA and type IIB fibres of the gastrocnemius muscle. Only two different types of fibre could be demonstrated in the tensor tympani, one type resembling the type I and another resembling the type IIA of the gastrocnemius muscle. The findings are discussed in relation to other, recent immunohistochemical studies on cat tensor tympani muscle fibres. PMID- 6496060 TI - Acute otitis media. An animal experimental study. AB - This paper describes an investigation performed to study the middle ear events ensuing from Staphylococcus aureus induced infection in the middle ear cavity of the rat. To obtain an evaluation at both the cell and the tissue level, scanning electron microscopy, transmission electron microscopy and histology were used. Staphylococcus aureus infection appears to be characterized by five major events: (i) cellular response, (ii) humoral response, (iii) mucociliary response, (iv) fibroblastic response, (v) bony response. Since these occurrences correspond to the events witnessed in the human middle ear affected by acute otitis media, S. aureus achieved infection might prove a useful tool for the further study of this disease, by means of animal experiments. PMID- 6496061 TI - Fibre population of the vestibulocochlear anastomosis in the cat. AB - Olivocochlear fibres were studied by light and electron microscopy in the microdissected vestibulocochlear anastomosis of adult cats. The anastomosis was found to contain at least two types of fibres--one myelinated variety with mean axonal diameter 1.7 micron and numbering 498; the other, an unmyelinated variety, with mean axonal diameter 0.4 micron and numbering 868. The average total number of axons was 1356. The ratio of unmyelinated to myelinated axons was usually about 1.5, with a single cat having a bilateral ratio close to 3.5. PMID- 6496062 TI - Development of postrotatory nystagmus time constants. AB - Models of the slow phase portion of postrotatory nystagmus in the adult include time constants which describe primary and secondary nystagmus. The cupular time constant (T1) is believed to reflect the activity of the cupula of the semicircular canal, while the adaptation time constant (Ta) defines the rate of change of the baseline firing rate. Values for T1 and Ta have been published for the adult. In this study 37 normal infants under one year of age and 12 children, 3 to 13 years of age were examined for postrotatory nystagmus, and values for the two time constants were determined. The cupular time constant does not change with age and is concluded to be at an adult level at birth. This is correlated with the relative maturity of ear morphology at birth. The adaptation time constant increases from 79.5 sec at one month of age to 260.7 sec at 12-13 years of age, implying that maturation of adaption is a relatively slow process. PMID- 6496063 TI - A study of the synthesis and inactivation of prostaglandin E by pig nasal mucosa. AB - Prostaglandins of the E series have been shown to be more potent than adrenaline as nasal decongestants. We now present evidence that prostaglandins of the E series (PGE) can be synthesised and inactivated by the nasal mucosa of the pig. This study demonstrates that PGE may be formed by pieces of pig nasal mucosa in vitro and that PGE formation by the nasal mucosa is inhibited by indomethacin. The nasal mucosa was also shown to contain 15-hydroxy prostaglandin dehydrogenase activity and this enzyme is involved in the inactivation of PGE. The findings of this study may help towards a better understanding of the role of PGE in nasal physiology and nasal disease. PMID- 6496064 TI - Nasal epithelium in woodworkers in the furniture industry. A histological and cytological study. AB - The incidence of nasal adenocarcinoma is greatly increased in wood dust exposed furniture workers. The background is discussed and histological and cytological examinations are performed in 45 workers. The histological findings are compared with different kinds of cytological methods, May-Grunwald-Giemsa and Papanicolau. It was a significant increase in cuboidal cell metaplasia revealed by histology and Papanicolau stained cytology. MGG, on the other hand, revealed significantly raised occurrence of goblet cell hyperplasia. These findings are discussed in relation to a morphogenetical model which could explain some features in the development of premalignant changes which could precede nasal adenocarcinomas. PMID- 6496065 TI - Arylhydrocarbonhydroxylase inducibility and smoking habits in patients with laryngeal carcinomas. AB - There is considerable evidence that the inducible enzyme aryl hydrocarbon hydroxylase (AHH) plays an important role in the activation of polycyclic aromatic hydrocarbons (PAH) to ultimate carcinogens. In man, a genetic heterogeneity of AHH inducibility has been demonstrated, and correlated to susceptibility to bronchogenic carcinomas following exposure to PAH. We assessed AHH inducibility in a control group of 102 healthy Swedish citizens and in 41 patients with laryngeal carcinomas. Frequencies of the three phenotypes of high, intermediate and low AHH inducibility in our control group; 8.8%, 42.2% and 49%, respectively, did not differ significantly from frequencies found in a white US population. In the laryngeal carcinoma group, there was a statistically highly significant overrepresentation of patients with high AHH inducibility, 36.6%, whereas 43.9% had an intermediate and 19.5% a low level. Most of the patients were heavy smokers. These findings add further support to the concept that susceptibility to PAH-induced carcinomas is associated with high levels of inducible AHH activity. PMID- 6496066 TI - Laryngeal obstruction after Teflon injection. AB - Respiratory effects of injection of teflon were studied in twelve patients with unilateral vocal cord paralysis by determination of the orolaryngeal airway resistance (Rol). Ordinary spirometry and flow volume loops were also performed but were found to be less adequate than determination of Rol. Within the first week postoperatively, Rol increased by on average about 75%. Only one patient had clinical symptoms of laryngeal obstruction. One month after the injection of teflon, Rol was in all patients the same as preoperatively. It is concluded that teflon injection should be used with caution in patients with severe respiratory impairment but could be used without fear of induced future respiratory effects in patients with progressive pulmonary disease. PMID- 6496067 TI - [The peripheral facial nerve: anatomo-clinical findings]. PMID- 6496068 TI - [Combined modality sialogram-sialo computerized tomography in parotid pathology]. PMID- 6496069 TI - [Value and limits of the auditory potentials of the brain stem in forensic medicine]. PMID- 6496070 TI - [Elaboration of a rhinogram and statistical identification of the range of normality with digital rhinomanometry]. PMID- 6496071 TI - [Recent findings on the pathogenesis of ozena in children]. PMID- 6496072 TI - [Multiple neurinomas of the facial nerve: considerations on a case and review of the literature]. PMID- 6496073 TI - Effect of smoking on the fetal coronary arteries. AB - The effects of maternal smoking on the fetal coronary arteries were studied in 50 babies who died during the first month of life. The intimal layers of the coronary arteries of babies whose mothers smoked during pregnancy were smaller than those of babies of non-smoking mothers. The difference was independent of sex, birthweight, heartweight and infection. Tobacco smoking seems to prevent normal development of the intimal layer of fetal coronary arteries. PMID- 6496074 TI - The junction zone of human epithelium and foreign stroma. Ultrastructural observations in human oral mucosal transplants in nude mice. AB - This study describes ultrastructural features of epithelial-stromal junction of human buccal and palatal mucosal transplants and their outgrowths in nude mice. The investigation included transplant epithelium overlying human connective tissue in 27 cases, epithelial outgrowth formed over murine connective tissue in 33 cases, and over Millipore filter in 12 cases. The epithelial-stromal junction of the transplants differed from the normal state only in the presence of lamina densa loops projecting into the connective tissue and in lamina densa interruptions and duplications. In contrast the epithelial outgrowths demonstrated flattening of epithelial basal cells, lack of proximal epithelial cell projections, lack of complete hemidesmosome complexes, lack of distinct lamina densa, and lack of anchoring fibrils. It is suggested that these changes may be due to lack of necessary interaction between the human epithelium and the foreign stroma. PMID- 6496075 TI - S-100 protein in melanocytic tumors. An immunohistochemical investigation of benign and malignant melanocytic tumors and metastases of malignant melanoma and a characterization of the antigen in comparison to human brain. AB - An immunohistochemical investigation regarding the presence of S-100 protein in benign and malignant, primary and metastatic melanocytic tumors is reported. The studied series consisted of 15 benign nevi, 3 blue nevi, 4 juvenile melanomas, 1 balloon cell nevus, 30 primary malignant melanomas of skin, mucous membranes and conjunctiva and 30 metastatic malignant melanomas. The immunohistochemical analysis showed positive staining for S-100 protein within the majority of the tumor cells in all benign tumors examined, except the balloon cell nevus, as well as in all the primary and metastatic malignant melanomas, including low differentiated epitheloid or spindle-cell types without demonstrable melanin pigment. The results indicate that S-100 protein is a valuable marker for melanocytic tumors, especially in the fairly frequent dilemma of malignant melanoma presenting as a solitary non-pigmented metastasis of uncharacteristic light-microscopic appearance, and without known primary tumor. A characterization and quantification of the S-100 protein immunoreactivity in 5 metastatic malignant melanomas is presented. Using immuno-electrophoresis, the presence of 3 antigenic S-100 determinants was demonstrated within homogenates from the malignant melanomas, including the previously characterized S-100 A (alpha/beta) and S-100 B (beta/beta), and suggesting the presence of a hitherto undescribed variant of S-100 protein, possibly consisting of 2 alpha-subunits. Using rocket immuno-electrophoresis, the amount of S-100 protein was estimated. PMID- 6496076 TI - The normal parathyroid glands of the Mongolian gerbil. A quantitative structural study. AB - The parathyroid glands of the normal Mongolian gerbil were studied by light and electron microscopy, using stereology and semi-automatic image analysis. Basic quantitative data are presented for various nuclear parameters, and for mitochondria, endoplasmic reticulum, Golgi complex, secretory granules, storage granules, lysosomes and lipoid bodies. Chief cells predominate in the normal gland. Atrophic cells are only rarely encountered. The chief cells can be qualitatively subclassified into light, dark and intermediate variants, but quantitatively there is no difference among these variants with regard to the volume densities of mitochondria, lamellar rough endoplasmic reticulum, Golgi complex, secretory granules and storage granules, suggesting that the subclassification of the chief cells plays no functional role. A statistically significant correlation between volume densities of Golgi complex and secretory granules was found. Compared with the chief cells, the atrophic cells exhibit significantly less lamellar rough endoplasmic reticulum and secretory granules, whereas the content of vesicular rough endoplasmic reticulum is increased. The atrophic cells are suggested to be a degenerative variant of the chief cells. PMID- 6496077 TI - Myocardial angiolipoma. AB - Intramyocardial lipomas are rare, making up only one quarter of all cardiac lipomas which constitute less than 9% of all primary cardiac tumours. Vascular cardiac lipomas, corresponding in architecture to angiolipomas of the soft tissues, do not appear to have been reported previously. A case of an asymptomatic intramyocardial angiolipoma is reported in an 86-year-old woman who died of a ruptured abdominal aortic aneurysm. PMID- 6496078 TI - [Studies on antimalarials. XI. Synthesis and antimalarial activities of some 2,4 diamino-6-(N-substituted-p-chlorobenzylamino)quinazoline derivatives]. PMID- 6496079 TI - [Synthesis and analgesic activity of a series of substituted piperidyl benzimidazolinone]. PMID- 6496080 TI - [Chemical studies on active principles of Veratrum stenophyllum. I. Structure of stenophylline B and identification of other components]. PMID- 6496081 TI - [McCall's observation method--a discussion on the method of observation of partition efficiency of partition chromatography]. PMID- 6496082 TI - [Determination of diosgenin in Dioscorea]. PMID- 6496083 TI - [Application of orthogonal function spectrophotometry to the determination of amidoprine in compound amidoprine and caffeine tablets]. PMID- 6496084 TI - [Study on chemical stability of streptomycin sulfate in an aqueous solution]. PMID- 6496085 TI - [The pharmacokinetics and bioavailability of O-methyldihydroartemisinine in the rabbits]. PMID- 6496086 TI - [Effect of artane on the rate of chlorpromazine metabolism in the mouse liver microsomal system]. PMID- 6496087 TI - [Preliminary study on the mechanism of inhibition of protein synthesis by harringtonine]. PMID- 6496088 TI - [Stereospecific synthesis of deoxyharringtonine and homoharringtonine]. PMID- 6496089 TI - [Optical rotatory dispersion and circular dichroism studies on nor sesquiterpene lactone degradation from qinghaosu (arteannuin)]. PMID- 6496090 TI - [Chemical studies on active principles of Veratrum stenophyllum. II. Studies on the structure of a new blood pressure lowering agents--stenophylline A]. PMID- 6496091 TI - [Polarographic study on gossypol]. PMID- 6496092 TI - [Bonded normal phase high performance liquid chromatographic determination of anordrin]. PMID- 6496093 TI - [Bioavailability and pharmacokinetic analysis of riboflavin preparations on partially gastrotomized patients]. PMID- 6496094 TI - [Studies on the medicinal plants of Magnoliaceae. II. Botanical origins and resource utilization of a Chinese drug "hou pu"]. PMID- 6496095 TI - [Effect of gossypol acetic acid on the uterus and ovary]. PMID- 6496096 TI - [Pharmacokinetic studies on aristolochic acid in rats by an ultraviolet spectrophotometric method]. PMID- 6496097 TI - [Synthesis of analogs of agrimophol]. PMID- 6496098 TI - [Studies on saponins of rhizomes of Panax zingiberensis Wu et Feng]. PMID- 6496099 TI - [Analysis of DL-15-methyl prostaglandin F2 alpha methyl ester]. PMID- 6496100 TI - [Antimalarial activity of some 2,4-diamino-6-substituted amino sulfonyl quinazoline derivatives]. PMID- 6496101 TI - [Studies on the schistosomicidal mechanism of fluoroacetic acid]. PMID- 6496103 TI - [Chemical constituents of Zanthoxylum podocarpum Hemsl]. PMID- 6496102 TI - [Structure and stereochemistry of maoyancaosu (M-SU)]. PMID- 6496105 TI - [Investigation on the botanical origin of the Chinese traditional drug xu-duan]. PMID- 6496104 TI - [Physical stability of intravenous injection of polyphase liposome (139) in the form of suspension]. PMID- 6496106 TI - [Effect of anti-arrhythmia agent, gallanilide, on hepatic drug metabolizing enzymes in rats]. PMID- 6496107 TI - [Studies on antimalarials. IX. Synthesis of 5-substituted phenoxy-6-methoxy-8-[(1 ethyl-4-aminobutyl) amino] quinolines]. PMID- 6496109 TI - [Studies on the alkaloids of Veratrum genus]. PMID- 6496108 TI - [Chemotherapeutic studies on schistosomiasis. XIV. Synthesis of coumaran derivatives and its analogs]. PMID- 6496110 TI - Antimuscarinic activity of oxybutynin in the human plasma quantitated by a radioreceptor assay. AB - The antimuscarinic activity of oxybutynin was measured as oxybutynin equivalents by a radioreceptor assay (RRA). The activity was studied in plasma samples of five volunteers after a single oral dose (10 mg) or after a single intravenous dose (28 micrograms/kg) of oxybutynin hydrochloride. The results were compared to the concentrations of the drug measured by gas liquid chromatography (GLC). Following oral administration, the maximum concentration measured by RRA was significantly higher (706 nmol/l) than that by GLC (38 nmol/l). In contrast, equal concentrations were measured after intravenous administration by both methods. Metabolites with antimuscarinic activity are possibly formed through first-pass metabolism after orally administered oxybutynin. The total antimuscarinic activity of oxybutynin and its metabolites are measured by RRA, but only the parent drug by GLC. PMID- 6496112 TI - Potent bronchodilating effects of enprofylline and theophylline on contractions induced by egg albumin or by slow reacting substance (SRS). AB - Isolated sensitized guinea pig tracheal smooth muscle tone was induced by use of egg albumin or SRS-A (slow reacting substance of anaphylaxis). The dose-response relationships of theophylline and enprofylline were studied on these preparations. Enprofylline was more potent than theophylline in relaxing the egg albumin- or SRS-A-induced tracheal muscle tone. The theophylline relaxation-curve was significantly shifted to the left after addition of adenosine-deaminase to the egg albumin-contracted trachea, but this was not observed with the enprofylline relaxation-curve. In SRS-A-contracted tracheas, the addition of adenosine-deaminase did not significantly alter the relaxation curves of theophylline or enprofylline. It is therefore suggested that the relaxing effects of theophylline and enprofylline on SRS-A-induced contractions, at the therapeutically relevant concentrations demonstrated in this study, might be of importance for the anti-asthmatic effects of xanthines. PMID- 6496111 TI - A comparative study of guanine N7-alkylation in mice in vivo by the organophosphorus insecticides trichlorphon, dimethoate, phosmet and bromophos. AB - Following intraperitoneal administration to male mice (strain AB Jena/Halle) of 14C-methyl-labelled trichlorphon, dimethoate, phosmet and bromophos, 10-20 Ci/mol, in dosages of 0.06-0.55 mmol/kg, DNA from liver and kidneys was analyzed for 14C in N-7 methylguanine (7-MeG). The extents of methylation were in the range of 5-10 mumol 7-MeG/mol guanine for trichlorphon and dimethoate and of 0.2 0.4 for phosmet and bromophos, for high doses, respectively Excretion half-lives of 7-MeG were differing between trichlorphon (5 hrs, high dose, and 15-17 hrs, low dose) and dimethoate (23-160 hrs, high dose). The extents of methylation at 0 6 of guanine were estimated to be around 0.01 mumol 0-6 MeG/mol guanine for high doses of organophosphates of sufficient water solubility. Factors associated with the partition of organophosphates in mammalian systems are useful for estimating DNA attack by organophosphates in mammals in vivo. PMID- 6496113 TI - N-acetylpenicillamine potentiated excretion of methyl mercury in rat bile: influence of S-methylcysteine. AB - N-acetylpenicillamine, 5 mmol/kg body weight increased biliary excretion of methyl mercury more than three fold. Upon simultaneous administration of the same dose of N-acetylpenicillamine and 2,5 mmol/kg body weight of S-methylcysteine biliary excretion of methyl mercury increased only 1.5 fold. In both cases biliary sulfhydryl concentration increased to the same extent, about 5 fold. Decreased biliary excretion of methyl mercury, as a result of liver depletion of reduced glutathione by cyclohexene oxide, could be restored by N acetylpenicillamine. This restoration could be depressed by S-methylcysteine. The experiments undertaken indicate that N-acetylpenicillamine potentiated methyl mercury excretion occurs by a glutathione S-transferase dependent mechanism. Bile, collected after successive administration of methyl mercuric chloride, cyclohexene oxide, S-methylcysteine and N-acetylpenicillamine contained the methyl mercuric derivatives of N-acetylpenicillamine and glutathione together with other methyl mercury carrying components not present in control bile. Whether these components play any role in the mechanism of N-acetylpenicillamine potentiated methyl mercury excretion cannot be stated from the present investigation. PMID- 6496114 TI - Structural and functional impairment of mitochondria from rat livers chronically injured by thioacetamide. AB - The effect of prolonged application of thioacetamide (TAA) on structural and functional properties of isolated liver mitochondria from rats was studied. Mitochondria prepared either from micronodularly cirrhotic livers (TAA application for 3 months) or from macronodularly cirrhotic ones (TAA application for 6 months) exhibited loss of respiratory control due to increased state 4 respiration and decreased state 3 respiration. The mitochondrial content of cytochromes aa3 and b was lowered only after 6 months exposure to TAA. The Mg2+ content of mitochondria from macronodularly cirrhotic livers was reduced to 50%. Mitochondria isolated from rats chronically treated with TAA exhibited lowered Ca2+ uptake rates and a decreased Ca2+ retention time. The analysis of mitochondrial phospholipid fatty acids revealed marked alterations in phosphatidylcholine and cardiolipin leading to a decreased 20:4/18:2 ratio. The functional and structural alterations of the liver mitochondria from chronically treated rats remained unaffected for at least 2 weeks after cessation of TAA application. PMID- 6496115 TI - Effects of physostigmine, paraoxon and soman on brain GABA level and metabolism. AB - The effects of sublethal doses of physostigmine, paraoxon and soman on GABA levels and metabolism were studied in small rat brain areas (hypothalamus, striatum, cerebellum, rest of the brain). Physostigmine induced a significant decrease in striatal GABA level and a reduction of synthesis index in the rest of the brain while organophosphates have little or no effect on GABA level and metabolism. This work provides new data about the physostigmine effect on brain GABA which could be related to the action of the anticholinesterase agents on other non-cholinergic neurotransmitters. PMID- 6496116 TI - Alleviation of paraquat toxicity by Kayexalate and Kalimate in rats. PMID- 6496117 TI - Liquid chromatographic assay for CSF catecholamines using electrochemical detection. AB - A liquid chromatographic assay for noradrenaline (NA), dopamine (DA), and 3,4 dihydroxyphenylacetic acid (DOPAC) in human and monkey cerebrospinal fluid (CSF) is described. The limits of sensitivity vary between 0.1-0.3 pmol/ml of each catechol. Within-day precision as indicated by mean coefficient of variation (CV) of five days varied between 8.0-14.8 for NA (3.0-0.1 pmol/ml), 6.9-27.4 for DA (6.0-0.1 pmol/ml), and 4.1-17.6 for DOPAC (30-1 pmol/ml). Between-day precision (CV) was estimated to be 12.3, 14.9 and 16.6 for 4 pmol/ml of NA, DA and DOPAC, respectively. The method was reproducible enough for reliable quantitation of CSF free NA and DOPAC levels at physiological concentrations while the sensitivity for DA was too low to measure the free amine in less than 3 ml of human lumbar CSF. After acid hydrolysis total (free + conjugated) DA can, however, be quantified in CSF. Ranges for CSF NA and DOPAC levels were 0.13-2.0 and 0.43-14.6 pmol/ml in normal volunteers (n = 72), 0.19-3.19 and 0.7-7.09 pmol/ml in untreated chronic schizophrenic patients (n = 52), and 1.1-3.2 and 9.8-22.7 pmol/ml in rhesus monkeys (n = 8), respectively. PMID- 6496118 TI - Determination of conjugated dopamine in cerebrospinal fluid from humans and non human primates with high performance liquid chromatography using electrochemical detection. AB - A simple and reliable procedure for the determination of conjugated dopamine (DA) in cerebrospinal fluid (CSF) is described. The conjugate, presumably a sulfate, is conveniently hydrolyzed in 0.4 M sulfuric acid at 95 degrees. Thereafter, dopamine is quantitated using HPLC with electrochemical detection. Sensitivity (0.5 pmol/ml) is sufficient for clinical studies. Only 400 ul of CSF are required for the assay. The within assay coefficient of variation was 3.2% for conjugated DA (concentration of 11.8 pmol/ml). In a material consisting of 261 samples of lumbar CSF from unmedicated psychiatric patients and normal control subjects, a concentration range of 1.3-21.7 pmol/ml was found. No clear differences were evident between the major diagnostic groups. PMID- 6496119 TI - Hormones, receptors, cyclic nucleotides and calcium. Presentation at the International Congress on Cyclic Nucleotides and Calcium. Copenhagen, April 11 14, 1984. Abstracts. PMID- 6496120 TI - Opiate-like peptides. Part VI. Synthesis and analgesic activity of four enkephalin analogues with C-terminal methylthioamide groups. PMID- 6496122 TI - The effects of feeding and fasting on self-stimulation. AB - The effects of ad libitum feeding and 72 hr fasting on intracranial electrical self-stimulation behaviour (ICSS) were tested in cats. In contrast to previous studies it was found that the opposite manipulations in food intake, i.e. ad libitum feeding fasting, often induced identical changes in lever-pressing rate even in cases of lateral hypothalamic self-stimulation. Both increase and decrease in lever-pressing rate for ICSS could be observed depending rather on the electrically elicited behaviours than the precise anatomical location of the stimulating electrodes. It is concluded that changes in ICSS induced by food intake and food deprivation are probably secondary to the changes in activity level. PMID- 6496121 TI - alpha-Substituted 2-phenylethylamines and N-oxidized congeners. Chemistry, metabolism and ligand interactions with cytochrome P-450. PMID- 6496123 TI - The effects of aminopyridines on the cortical evoked potentials. AB - The effects of 3-AP, 4-AP and 3,4-DAP were studied on auditory and somatosensory evoked potentials of the cat. Particular attention was paid to differentiation between the effects exerted in the pre-convulsive and convulsive phase of AP action. Surface recording and depth analysis were carried out with simultaneous surface-depth records presented in case of 3,4-DAP. All three APs exerted a general depressant action on the evoked potentials in the preconvulsive phase. The most sensitive to depression proved to be the surface negative wave. In the ictal periods of the convulsive phase the potentials were strongly facilitated and broadened. In subsequent periods of the convulsive phase the surface records became similar to the deep ones, as a consequence of depression of the surface positive and enhancement of the surface negative wave. In interictal periods the depression remained dominant. PMID- 6496124 TI - Abstracts of the lectures and posters delivered and demonstrated at the 48th congress of the Hungarian Physiological Society. Debrecen, July 4-6, 1983. PMID- 6496125 TI - Circulatory and EEG changes during resuscitation in experiments. AB - In anaesthetized dogs blood pressure (BP), carotid artery flow (CAF), oxygen tension of arterial blood (paO2) and brain surface (bs-pO2), ECG, frequency analyzed EEG were measured and/or recorded. The changes in these parameters were detected before and during ventricular fibrillation with external and direct heart massage as well as after defibrillation. Comparisons were made between the effect of oxygen and room air ventilation. The ratio of successful resuscitation was 88% with direct heart massage and O2 respiration, 76% with external thoracic massage and O2 ventilation, and 68% with external massage combined with room air respiration. The highest BP and CAF could be achieved with direct heart massage. The results suggest that the minimal requirement for success is to achieve a BP of 5 kPa (40 mmHg) and 13 ml/min CAF. In dogs with large and stiff thorax this minimal pressure and flow could not be attained. During effective massage with room air ventilation brain surface pO2 increases moderately, but with O2 respiration it returns to normal. Small or no changes in bs-pO2 indicates unfavourable prognosis. The start bs-pO2 elevation coincides with the reappearance of the first EEG waves, while pO2 increase on the brain surface precedes the normalization of EEG. PMID- 6496126 TI - Possible origin of amniotic fluid constituents affecting thromboplastic activity. AB - The clotting-accelerating activity of amniotic fluid (AF) has been known for long, but a clinical importance has only recently been attributed to this phenomenon. In order to obtain some informations on the origin of AF component(s) responsible for this action, the effects on the coagulation process of extracts prepared from the placenta, fetal membranes and fetal excretes were investigated. Normal saline extracts from the placenta, the amniotic and chorionic membranes, and those from the mucus aspirated from the upper respiratory tract of the fetuses were shown to accelerate, whereas meconium extract and untreated fetal urine were found to inhibit blood coagulation. Results presented in this paper indicate that AF components affecting the thromboplastic system in one way or other may be of both fetal and extrafetal gestational tissue origin, and that the quality of the actual effect exerted on the clotting system by AF depends on the relative amount of AF constituents oppositely affecting the hemostatic system. PMID- 6496127 TI - Footshock sensitivity of rats after adrenalectomy and glucocorticoid treatments. AB - The threshold of flinch-jump response to electric footshock was measured after adrenalectomy (ADX) in male albino rats. The ADX-rats showed higher threshold from the 2nd to 6th postoperative days than the sham-operated animals. Daily subcutaneous administration of 100 micrograms/100 g b.w. corticosterone (CS) led to restoration of the footshock sensitivity of ADX-rats. The same effect was observed following dexamethasone (DEX) treatment. DEX but not CS administration resulted in a decrease of the footshock sensitivity in the sham-operated rats. On the 9th and 18th days after adrenalectomy, in contrast to the early postoperative period, the threshold for footshock sensitivity was significantly lower than in sham-operated controls. It is suggested that an excess release of endogenous opiates from the pituitary are involved in the changes of pain threshold under the conditions studied. PMID- 6496128 TI - Role of the nervous system in regulation of the sarcoplasmic membrane function in different muscle fibres. AB - The influence of the nervous system on the Ca2+ uptake of sarcoplasmic reticulum (SR) of the slow-twitch and fast-twitch muscle was investigated by the application of denervation, immobilization and tenotomy. Denervation and immobilization produced an increase of Ca2+ uptake in SR of the slow-twitch muscle. No significant change could be observed in fast-twitch muscle. Inactivity atrophy induced by tenotomy had no effect on the Ca2+ uptake in SR of the slow muscle. The results suggest that the nervous system has a greater effect on SR function in the slow than in the fast-twitch muscle. The continuous effect of the nervous system characteristic of slow-twitch muscle fibres with tonic function plays a role in preservation of the low Ca2+ uptake capacity, in contrast to the fast-twitch muscle fibres with phasic function, which have a high Ca2+ uptake capacity. PMID- 6496129 TI - Ca2+ uptake of sarcoplasmic reticulum in experimental glucocorticosteroid myopathy. AB - The effect of twenty-one days dexamethasone treatment was investigated on the Ca2+ uptake of sarcoplasmic reticulum (SR) of slow-twitch (soleus) and fast twitch (semi-membranosus) muscles. The SR Ca2+ uptake decreased in fast-twitch muscle significantly, while in slow-twitch muscle there was no detectable change. PMID- 6496130 TI - Effect of induced hypothyroid state on the mechanical and electrical properties of the rat ventricular myocardium. AB - The effect of hypothyroid state on the transmembrane potential was studied in isolated cardiac ventricular trabeculae of rats. Hypothyroid state was induced by methimazole treatment or thyroidectomy and checked by determining serum thyroxine level. Hypothyroidism decreased the maximum rate of depolarization (Vmax) and the resting potential, increased the overshoot and the duration of action potential at 20, 50 and 90% repolarization. These changes were more pronounced after methimazole treatment than after thyroidectomy. The results strongly suggest that in hypothyroidism the significant alterations in the voltage-time course of the transmembrane action potential influencing Ca2+-movement across the sarcolemma may have an indirect role in the decreased myocardial contractility. On the other hand, methimazole has an aspecific cardiac effect which may modify the cardiac effect of hypothyroidism induced by the drug. PMID- 6496131 TI - Membrane symposium. Sumeg, May 16-20, 1983, Hungary. Abstracts. PMID- 6496132 TI - [Diamino-1,3,5-triazine derivatives. VI. Synthesis and hypoglycemic properties of various 6-amino-2-arylo-1,2-dihydro-4-3(3,5,5-trimethylo-2-pyra zolino)-1,3,5-t riazine]. PMID- 6496133 TI - [Biopharmaceutical evaluation of aminophylline suppositories. II. Biological availability of aminophylline (theophylline) from suppositories with normal and prolonged time of total deformation]. PMID- 6496134 TI - Morphological and biochemical effects of long-term enteral administration of low doses of cadmium and lead in rats. PMID- 6496135 TI - [Synthesis and metabolic effects of various phenylthio-2 pyridinesulfonamides-5]. PMID- 6496136 TI - [Synthesis of aminoacyl derivatives of 4-aminoantipyrine. IV. Amino acid derivatives with D configuration]. PMID- 6496137 TI - [Search for anticholinergic compounds. XLII. Synthesis of 3-(2-aminoethyloamino) 8-butylo-8-aza-bicyclo[3.2.1]octane derivatives]. PMID- 6496138 TI - [Synthesis and biological properties of isoxazolo[5,4-d]pyrimidine derivatives]. PMID- 6496139 TI - [Studies on products of transformation of 4-carboethoxymethyl-1,2,4-triazoline-5 thione derivatives. I. Synthesis of 4-beta-aminoethylo-1,2,4-triazolino-5-thione with potential pharmacological action]. PMID- 6496140 TI - [1,1-dioxo-1,4,2-benzodithiazine derivatives. I. Synthesis of various 7-carboxy-3 mercapto-1,1-dioxo-1,4,2-benzodithiazine]. PMID- 6496141 TI - [Detection and determination of neurotropic drugs in human blood. III. Detection and determination of amitriptyline and doxepin]. PMID- 6496142 TI - [Isolation and determination of diazepam in biological matter and study of the effect of altitude anoxia on the distribution of the drug in tissue]. PMID- 6496143 TI - [Biopharmaceutical evaluation of aminophylline suppositories. I. Pharmacological parameters of theophylline from aminophylline suppositories with normal and prolonged time of total deformation]. PMID- 6496144 TI - Problems posed for supporting relatives of geriatric and psychogeriatric day patients. AB - Relatives of patients attending geriatric and psychogeriatric day hospitals throughout Scotland were asked to provide details of the problems they experienced looking after their elderly dependent. They also completed Goldberg's General Health Questionnaire (GHQ), to provide an index of degree of emotional disturbance. While differences emerged in the type of problems these two groups of supporters experienced with their dependent, the overall prevalence of emotional disturbance was high in both groups. Implications for the service provided by both types of day hospital are discussed. PMID- 6496145 TI - Women with nonorganic psychosis: factors associated with pregnancy's effect on mental health. AB - Pregnancy's effect on mental health during pregnancy was studied in relation to 17 variables representing the pregnant woman's demographic, social, material, physical and attitudinal characteristics, in an attempt to explain the highly varied effect of pregnancy on mental health which had been observed both among 88 index women with a history of nonorganic psychosis and among 104 demographically similar pregnant control women. Little explanation or predictability was found for the varied effect of pregnancy. Among index cases, only maternal age and the experienced effect of pregnancy on physical health were significantly related to its effect on mental health. In controls, the presence of material-situational problems and a negative/ambivalent initial reaction to pregnancy were each related to increased change in mental health, i.e. to both improvement and worsening in mental health associated with pregnancy. PMID- 6496146 TI - The incidence of schizophrenia in New South Wales, Australia. A psychiatric register study. AB - Age-specific estimates of the incidence of schizophrenia in NSW, Australia, have been made using two methods, one based on a psychiatric register and the other based on routinely collected hospital morbidity data. Similar results were obtained by both methods. The estimates lie towards the bottom of the range of incidence estimates of schizophrenia that have been published for some other countries, and are lower than estimates from a number of U.S. studies. The diagnostic criteria of schizophrenia employed by Australian psychiatrists conform closely to DSM-III criteria. PMID- 6496147 TI - Glomerular filtration rate during lithium therapy. A longitudinal study. AB - In order to investigate the side effect of lithium on renal function the glomerular filtration rate (GFR) was measured before (to) and after a mean of 16.5 months (t1) (range 12-25 months) lithium treatment in 13 consecutive patients aged 32-67 years (mean age 46 years). The patients had a normal renal function before the treatment was started; none of them had previously been treated with lithium. During treatment GFR (ml/min) fell from 101.9 to 98.3 which was not significant. However, standard-GFR (ml/min/1.73 m2) fell from 88.4 to 84.8 (P less than 0.05) mainly due to a significant rise in body weight and estimated surface area during treatment. No significant changes appeared in plasma creatinine. It is concluded that lithium therapy for a mean of 16.5 months does not affect the glomerular filtration rate; but considerably longer observations of GFR during lithium therapy should be done by means of a reliable GFR measurement method. PMID- 6496148 TI - Postdexamethasone prolactin and cortisol: a biological state variable in depression. AB - In 70 inpatients with major depressive disorder postdexamethasone cortisol and prolactin, but not baseline cortisol and prolactin, was found to correlate significantly with various state variables of depression. Postdexamethasone prolactin appeared to be a more specific state variable of depression compared with postdexamethasone cortisol. While prolactin was decreased following dexamethasone in controls and nonendogenous depressed patients, in endogenous depressed patients prolactin was increased by 30%. Due to this inverse prolactin response to dexamethasone, the sensitivity of this test should be considerably increased by using a higher dexamethasone dosage. The DST failed to be a diagnostic marker for any subgroup of depression. PMID- 6496149 TI - Erythrocyte cation transport in endogenous depression: clinical and psychophysiological correlates. AB - Clinical (psychometric), psychophysiological and biochemical (erythrocyte membrane transport) variables were studied in 44 patients with endogenous depression (unipolar/bipolar) during acute depressive episode and in remission. All parameters studied showed paralleled and unidirectional changes when depression was compared with remission period. During a depressive episode, unipolar patients had greater intensity of depression than bipolar patients. Ouabain-dependent sodium fluxes were significantly lower in female than in male patients during depression than in remission. In male bipolar patients, the indexes of active transport in erythrocytes showed significant correlations with clinical ratings and with results of psychophysiological tests. The results point to a possible relationship between various levels of physiological functioning in endogenous depression. This suggests a generalised "background" defect of energy dependent membrane transport pertaining to both erythrocytes and nerve cells, which may be linked to disturbances of activational processes within the central nervous system. PMID- 6496150 TI - Presentation of a subscale for the rating of depression and some additional items to the Comprehensive Psychopathological Rating Scale. AB - From the Comprehensive Psychopathological Rating Scale (CPRS) a subscale for depression has been derived in the course of a study of depression in which 209 patients took part. The subscale presented in this article comprises 28 items from the original pool and two additional items constructed later. The scale has a high degree of internal consistency and is satisfactorily reliable also among previously unskilled raters who have undergone a minimum of training. It is able to significantly differentiate between ill and recovered patients and among patients with syndromes of different severity according to various classification principles. Reported symptoms rated by the subscale correlated significantly with self-ratings of depression. Since the original CPRS pool also comprises items for the rating of manic manifestations, the scale is particularly suitable for the study of patients suffering from affective disorders, also when a switch from depression to mania could occur in the course of treatment. PMID- 6496151 TI - Depression and ventricular enlargement. AB - Compared with controls, 46 depressed patients showed increased ventricular-brain ratio (VBR). Patients with poor outcome, single episode, onset at 50 years or over, or without melancholia were found to have greater VBR than controls. PMID- 6496152 TI - Dexamethasone suppression test in acute grief reaction. AB - The authors report a study on the response to the dexamethasone suppression test of bereaved first-degree relatives. Of the 21 subjects who took part two were non suppressors (plasma cortisol greater than 138 mmol/l), but their grief scores were no higher than the suppressors. Both subjects showed a suppressor response 3 months later. PMID- 6496153 TI - Class drift and schizophrenia. AB - This study is part of an ongoing analysis of 207 children with schizophrenic mothers (high-risk subjects) and 104 low-risk controls begun in 1962 by Mednick & Schulsinger. The purpose of this study was to examine class mobility in schizophrenics, using a prospective paradigm. In the present study, 14 high-risk schizophrenics were matched with 14 high-risk non-schizophrenics and 14 low-risk non-schizophrenics on age, sex and social class origin. Groups were compared on highest class attainment and socio-economic status in 1972. Results indicated that while high-risk non-schizophrenics were comparable in class attainment to low-risk non-schizophrenics, the high-risk schizophrenics were downwardly mobile in comparison to their non-schizophrenic high-risk counterparts. The class drift hypothesis was thus supported. PMID- 6496154 TI - A psychosocial study of Igbo schizophrenic patients treated at a Nigerian psychiatric hospital. AB - A study of the sociodemographic and clinical characteristics of schizophrenics of Igbo origin treated at a psychiatric hospital in Nigeria over a period of 6 months was made together with a limited follow-up. Males exceeded females in the proportion of 2:1. About 66% were below the age of 30 years. While there were more married females than single, there were more single males than married. However, single persons on the whole predominated. The majority (61%) were either illiterate or had low education while 52% were either unemployed or unskilled persons. Paranoid and catatonic schizophrenias were the commonest diagnostic subgroups. The short-term prognosis was very good in that 96% were greatly improved at the time of discharge. There was, however, a high dropout rate of 57% over a period of 5 years. Of those still attending, 73% remained improved. The possible sociocultural basis of some of the findings is discussed. PMID- 6496155 TI - The couvade syndrome: background variables. AB - In a prospective study of couples expecting their first child, 20% of the men suffered from the couvade syndrome. They were older than the unaffected men, and more often had older parents. More of them showed attachment to and identification with their mothers. Men with the couvade syndrome suffered from a greater number of mental symptoms during the pregnancy than did the unaffected men. The couvade syndrome was also commoner when the woman was anxious about the pregnancy as well as parturition. PMID- 6496156 TI - Effects of ECT on diabetes mellitus. An attempt to account for conflicting data. AB - The authors review the recent, conflicting findings of the effect of ECT on diabetes mellitus. To further explore this relationship, they present case reports of three adult-onset diabetic patients with varying degrees of diabetic management who were treated for depression with ECT. The results point to the variability of effects which ECT may have on blood glucose in diabetic patients. ECT may produce a potentially dangerous hyperglycemia in severely diabetic patients, but ECT does not appear to exert a major diabetogenic or diabetolytic effect on patients with mild diabetes mellitus. Possible mechanisms by which ECT affects blood glucose levels are discussed. PMID- 6496157 TI - The relationship of social setting to major depression. AB - Sixty middle-aged women with a major depressive episode diagnosed in a community survey were compared with those 400 participants of the study who had no history of major depression. The husband's income and the family income were lower in the depressed group even when adjustment was made for age and marital status. The depressives were more often divorced or widowed than were controls. As a direct consequence of this, women with major depression lived in smaller residences and were more seldom owners of a summerhouse. The proportions of women working full time, part-time or not working outside home were the same in those with major depression and the controls. The level of adversity (life events and long-term major difficulties) during the year preceding the study was increased in the depressed group when adjustment was made for age, marital status and social class differences. A larger proportion of the depressed women reported marital and job dissatisfaction. Variables reflecting social isolation did not differ between groups. There were no differences between depressed and undepressed regarding churchgoing, but fewer of the former stated that they believed in God. PMID- 6496158 TI - The relationship of personality to social network aspects and loneliness in depressed patients. AB - In a study of 110 depressed patients possible relationships between personality and social contact features, loneliness and contact difficulties, have been investigated. The results yielded numerous correlations between personality characteristics and different aspects of the social environment. Most pronounced were the relationships with loneliness and contact difficulties. PMID- 6496159 TI - Dexamethasone suppression test in depression: association with duration of illness. AB - Plasma cortisol response to 1 mg dexamethasone suppression test was investigated in 37 patients with primary major depressive illness. Non-suppression of plasma cortisol was found in 14 of 37 (38%) patients. Duration of the index episode of illness was significantly shorter in the non-suppressors (11.1 +/- 9.1 weeks) than in the suppressors (29.7 +/- 25.6 weeks). The two groups were not distinguished by age, sex, polarity or severity of depressive symptoms. Eighty per cent of the non-suppressors (4/5) and 57% of the suppressors (8/14) had severe life events or major difficulties in the 6 months preceding the onset of illness, but this difference failed to reach statistical significance. PMID- 6496160 TI - Stupor: a review of 25 cases. AB - Twenty-five cases of stupor referred to a psychiatric teaching hospital over 15 years are reviewed. Ten cases presented with a depressive syndrome, four cases with catatonic phenomena and a further 10 cases with established organic aetiology; one case was considered to be psychogenic in origin. The overall mortality was high (16%), attributable to the basic pathology. Compared with earlier series there was a reduction in cases with catatonic features with a corresponding increase in the proportion of organic cases. PMID- 6496161 TI - A rating scale for emotional distress in patients with malignant diseases. AB - As a contribution to assessment of quality of survival in malignant disease a rating scale for emotional distress (EDS) has been developed. The scale consists of eight items with explicit definitions, and the ratings are based on short interviews. The scale was applied on 34 patients with malignant blood diseases, and ratings were performed at regular intervals both prior to and during cytostatic treatment courses. The patients accepted the interview procedure well and the scale proved to be easy to apply in a clinical setting. Raters with little previous experience (nurses and physicians) had good interrater reliability (r = 0.98). The EDS scores of patients in good somatic condition increased significantly (P less than 0.01) during cytostatic treatment courses while no change was found among the more severely ill. There was a tendency for pure cytostatic schedules to inflict more discomfort than those also containing high doses of steroids, indicating that the scale may discriminate between various treatments. There was a significant correlation (r = 0.73, P less than 0.01) between the EDS scores and the physical condition of the patients. The results indicate that the EDS may be a reliable and sensitive instrument which adds an important aspect to the evaluation of the quality of survival in the treatment of malignant disease. It may also be of value when comparing different treatment regimens. PMID- 6496162 TI - The effects of opening a geriatric psychiatry day hospital. AB - Referrals of elderly patients with organic brain syndromes to a Geriatric Psychiatry Service were studied before and after the introduction of a Day Hospital. The Day Hospital was used for more patients than predicted and was perceived to be of benefit. However, there was little change in the number of patients admitted to hospital or put on the waiting list for in-patient care in the year after referral. PMID- 6496164 TI - Research perspectives on decision making under uncertainty. Basic theory, methodology, risk and applications. Selected proceedings of the Ninth Research Conference on Subjective Probability, Utility and Decision Making, Groningen, August 29-September 2, 1983. PMID- 6496163 TI - Mental illness and sex chromosome aberration: renewed interest in light of a current survey. AB - Chromosome determination in 134 men with psychotic disorder revealed sex chromosome aberrations in three patients; one with karyotype 47, XXY, one with 47, XXY/46, XY, and one with 46, XY/45, XO. The frequency of sex chromosome changes in our population (2%) was significantly increased compared to that in newborns. Since sex chromosome aberrations may play an important role in the etiology of psychiatric disorders, chromosome determination should be included among the routine investigations of patients with psychotic symptoms. PMID- 6496165 TI - [Neurologic disorders in infants and computerized tomography of the brain]. PMID- 6496166 TI - [The significance of E and EAC rosettes, acid phosphatase and beta-glucuronidase activity in lymphocyte rosettes, and the level of glycogen in peripheral blood leukocytes in patients with viral hepatitis]. PMID- 6496167 TI - [Platysmal myocutaneous flap in the reconstruction of the oral cavity and pharynx]. PMID- 6496168 TI - [Incidence of cervical cancer 5 years after mass screening in the community of Medvescak]. PMID- 6496169 TI - [Reciprocal translocation detected in a proband with an unbalanced karyotype- partial trisomy 10q]. PMID- 6496170 TI - A boy with congenital hypothalamic hypothyroidism. PMID- 6496171 TI - Transaminative metabolism of L-cysteine in guinea pig liver and kidney. AB - Transaminative metabolism of L-cysteine was investigated using homogenates of guinea pig liver and kidney. L-Cysteine was transaminated in the presence of 2 oxoglutarate and the homogenate of either liver or kidney. S-(2-Hydroxy-2 carboxyethylthio)cysteine (HCETC) (3-mercaptolactate-cysteine disulfide) was formed by liver homogenate, but the amount was very small. On the other hand, a relatively large amount of HCETC was formed in the presence of kidney homogenate. Transamination between 3-mercaptopyruvate and certain amino acids was catalyzed actively by both liver and kidney homogenates in the presence of L-glutamate. However, more half-cysteine was formed by liver than kidney, and more HCETC was produced by kidney than liver. L-Glutamate was the most potent amino donor, and L aspartate strongly inhibited the reaction. Results indicate that L-cysteine can be transaminated both in liver and kidney of the guinea pig, and that kidney is more active than liver. 2-Oxoglutarate is the most active 2-oxo acid for cysteine transamination. Oxaloacetate (and aspartate in the reverse reaction) is inhibitory to the reaction. These results are in agreement with the previous conclusion that cysteine aminotransferase is identical with aspartate aminotransferase. PMID- 6496172 TI - Relationship of tyrosine concentration to catecholamine levels in rat brain. AB - Rats were fed a choline-free low protein diet for 12 or 26 weeks. In the 12-week group, the brain tyrosine concentration did not change. Dopamine levels were low in both the cerebral cortex and striatum. Norepinephrine level was low in the diencephalon. In the 26-week group, the tyrosine concentration was high in the brain. However, the dopamine and norepinephrine levels did not change in the cerebral cortex, striatum and hypothalamus. Furthermore, in another group of rats which were intraperitoneally injected with tyrosine, the brain tyrosine concentration was high, whereas the dopamine and norepinephrine levels in the hypothalamus were not significantly different from control levels. PMID- 6496173 TI - The etiology of "sports anemia". A physiological adaptation of the oxygen dissociation curve of hemoglobin to an unphysiological exercise load. PMID- 6496174 TI - Iron metabolism and "sports anemia". I. A study of several iron parameters in elite runners with differences in iron status. AB - Several reports have suggested that iron deficiency might explain "sports anemia" especially in long distance runners. The present study was made to further study the iron metabolism in runners as the proposed cause of "sports anemia" is abstruse considering the good iron nutrition in these athletes. Based on a screening of 43 elite male runners, using bone marrow hemosiderin, serum ferritin and transferrin saturation, two groups of subjects were selected for a very extensive study on iron metabolism. In group 1 (n = 5) iron depletion was suggested in at least one of the screening studies. In group 2 (n = 7) at least one test strongly indicated good iron repletion. This experimental design was chosen to obtain two groups with similar body composition and exercise load but different iron metabolism. The studies comprised determinations of red cell and plasma volumes, plasma iron turnover and red cell incorporation of radioiron, red cell indices, plasma iron and transferrin, red cell protoporphyrin, serum ferritin, serum haptoglobin, urinary iron losses, iron absorption, bone marrow hemosiderin, dietary intake of energy and nutrients and a Desferal test. Pooling the results together it was obvious that none of the subjects were truly iron deficient. A few occasional findings suggesting low iron stores cannot be satisfactorily explained and indicate that further studies are needed. PMID- 6496175 TI - Iron metabolism and "sports anemia". II. A hematological comparison of elite runners and control subjects. AB - A hematological comparison was performed between 43 middle and long distance male runners and 119 male controls. The hematocrit, serum iron, transferrin saturation and serum ferritin values were significantly lower in the athletes. The amount of bone marrow hemosiderin was also lower in the athletes than in a group of non athletic men of the same age. Even if these values were clearly lower than in the controls, they were not low enough to indicate iron deficiency. The observations that sideroblast counts in bone marrow smears were normal and that both red cell indices and red cell protoporphyrin were normal strongly support the conclusion that lack of iron had not limitated erythropoiesis or the formation of an optimal red cell mass. Low serum haptoglobin values in most athletes indicated an increased intravascular hemolysis. As the hemoglobin-haptoglobin complex formed is taken up by hepatocytes, this implies that there is a shift in the red cell catabolism in these athletes from the reticuloendothelial system to the hepatocytes. This shift may explain the paradoxical findings of low serum ferritin concentrations and reduced contents of bone marrow hemosiderin. This is consistent with the observed normal erythropoiesis. It was concluded that runners "anemia" is no true anemia and not caused by iron deficiency. "Sports anemia" is thus no indication for routine iron supplementation. PMID- 6496176 TI - Does iron deficiency in treated polycythemia vera affect whole blood viscosity? AB - The relation between whole blood viscosity and iron status was studied in 11 patients with polycythemia vera (PV) who were treated with venesection without iron supplementation. Six were already iron deficient at the start of the study, five were followed from normal iron status to deficiency. Iron status was investigated with serum ferritin, erythrocyte protoporphyrin, mean cell volume and mean cell hemoglobin. There was no correlation between whole blood viscosity at a fixed erythrocyte volume fraction of 44% and any of these variables. The mean whole blood viscosity during iron deficiency and during normal iron state did not differ. Even after several months of iron deficiency there was no increase in whole blood viscosity. It is concluded that iron deficiency in treated PV does not give increased whole blood viscosity. PMID- 6496177 TI - Effects of timolol on platelets in coronary sinus blood and on myocardial ischemia during pacing-induced angina. AB - The effect of timolol on blood platelet function was studied in coronary sinus and caval vein blood at rest and during pacing-induced angina in 20 patients with coronary heart disease. During pacing-induced angina, lactate measurements confirmed that coronary sinus blood was sampled from ischemic regions in 13 men. The ischemia did not influence platelet function. In blood from non-ischemic myocardium, platelet activation was found during pacing: the ADP-induced aggregation, platelet retention and plasma beta-thromboglobulin levels increased moderately but significantly. Timolol administration prevented this platelet activation, possibly by inhibiting catecholamine release from the myocardium, and reduced the ischemic response during pacing as judged from lactate measurements and ST depressions. It is concluded that timolol reduced platelet activation induced in non-ischemic regions of the heart during tachycardia stress as well as myocardial ischemia. PMID- 6496178 TI - The effects of a highly purified hyaluronidase preparation on experimental myocardial infarction in the rat. AB - Several substances have been claimed to be effective in reducing the area of necrosis in acute myocardial infarction. The effects of a highly purified hyaluronidase preparation (Hyalas) on experimental myocardial infarction in the rat have been evaluated in this study. In the first series, one group of rats was treated with hyaluronidase 1 500-2 000 IU/kg injected intravenously 2, 4, 18, 24, 28 and 42 hours after induction of infarction by coronary artery occlusion. Another group was treated with NaCl solution. The infarction size was evaluated by serum lactate dehydrogenase and weight of infarcted myocardium. In a second series, the substances were administered immediately after the occlusion. In this experiment, the infarction size was estimated by planimetry. The percentage of salvaged myocardium in the hyaluronidase-treated groups was within the range of 20%. It seems reasonable to suggest that the use of highly purified hyaluronidase may be of clinical value for reduction of the myocardial infarction size. PMID- 6496179 TI - Responses of plasma catecholamines to tilt in patients with diabetes mellitus. AB - The immediate heart rate acceleration, blood pressure reaction, plasma adrenaline (PA), and plasma noradrenaline (PNA) responses to a 90 degrees and 2 sec tilt were evaluated in 13 male patients with type I diabetes. A disturbed immediate acceleration, as measured by a previously described acceleration index (AI), was found in 5 patients. All patients with normal AI but only one of those with abnormal AI showed an increase in PA during the first minute after tilt (p less than 0.02). A late diastolic blood pressure fall occurred in 6 patients and the fall was minor (5 mmHg) in 5 of these. Patients with a late diastolic blood pressure fall showed a significantly lower increase in PNA 1-8 min after tilt than those without (55 +/- 13% versus 163 +/- 24% (mean +/- SE), p less than 0.005). An abnormal immediate acceleration to tilt is associated with an impaired sympatho-adrenal reaction, and even a minor diastolic blood pressure fall indicates peripheral sympathetic denervation. PMID- 6496180 TI - Nicholson score for prescribing digoxin compared with Jellife nomogram. AB - A series of 84 medical inpatients were treated in random order with oral digoxin in doses calculated according to the newly introduced Nicholson score and the Jellife formula and nomogram. The daily dose of digoxin was lower (p less than 0.01) according to the Nicholson score (mean 2.1 digoxin tablets of 62.5 micrograms daily). The mean serum concentration of digoxin was also lower (p less than 0.01) according to the Nicholson score (1.27 nmol/l) than according to the Jellife nomogram (1.84 nmol/l). Estimated by the Nicholson score the serum concentration of digoxin was not optimal (p less than 0.01) and not within an acceptable therapeutic range (p less than 0.01) in more patients than when estimated by the Jellife nomogram. It is concluded that the Nicholson score is not suitable for medical inpatients. PMID- 6496181 TI - Isolated right ventricular myocardial infarction. A case report. AB - Isolated right ventricular infarction is uncommon. A 73-year-old man without previous cardial complaints was admitted pulseless to hospital. An infarct of the left ventricle was suspected. Autopsy showed a fresh thrombus located in a small branch artery of the right coronary artery accompanied by a fresh infarction of the anterior free wall of the right ventricle. Only 8 cases of isolated right ventricular infarction located in the anterior free wall were found in a review of the literature of right ventricular infarction. The diagnosis, treatment and prognosis of right ventricular infarction are discussed. PMID- 6496182 TI - Ideal body weight--for whom? PMID- 6496183 TI - Clinically suspected severe ischaemia-induced mitral regurgitation. Spectrum of lesions and features of high surgical risk by echocardiography. AB - Eighteen patients with clinical signs suggesting severe mitral regurgitation secondary to ischaemic heart disease were assessed by echocardiography. Non ischaemic diseases needing specific therapy were revealed in six patients. In the other 12 patients echocardiography demonstrated myocardial lesions explaining the mitral regurgitation. Apart from the distinction between non-ischaemic conditions and lesions induced by ischaemia, echocardiography seems to be helpful in the demonstration of severe yet operable mitral valve regurgitation due to a small ischaemic lesion. Such cases are opposed to functional mitral regurgitation caused by extensive myocardial injury as demonstrated by two-dimensional echocardiography and reflected by a minimum mitral valve/septum separation of more than 2 1/2 cm on the M-mode echocardiogram. These conditions make symptomatic improvement by mitral valve surgery unlikely and carry an extremely high operative mortality. A more precise definition by heart catheterization is required when serious clinical heart failure is not explained by the echocardiographic finding of severe global myocardial impairment. PMID- 6496184 TI - High risk of cerebro-cardiovascular morbidity in well treated male hypertensives. A retrospective study of 40-59-year-old hypertensives in a Swedish primary care district. AB - In a retrospective study of 121 hypertensives aged 40-59 years in comparison with 138 controls selected from the population in the same primary care district, male hypertensives had a high odds ratio of cerebro-cardiovascular (CCV) diseases even when their blood pressure had been well treated. The estimated odds ratio (corrected for small numbers) was 13.7 (2.5-76.7). In female hypertensives there was a trend towards more CCV diseases than in their controls. Although the hypertensives' blood pressure was reduced in accordance with what has been internationally accepted, their values were still at least 10-11 mmHg higher than those of the controls. A reduction of this magnitude may be accomplished by (further) weight reduction and, probably, intervention with factors linked to obesity. This may be one way to reduce the excess risk in hypertensives. PMID- 6496185 TI - Parental obesity combined with hypertension--an indicator of excess risk of hypertension in offspring. A case-control study in a Swedish primary care district. AB - A case-control study was performed to estimate the excess risk of hypertension in a defined population. The study comprised 121 hypertensive patients, aged 40-59 years, and 138 non-hypertensive controls selected from the same primary care district. Parental obesity combined with hypertension proved to be a stronger risk indicator of hypertension in offspring than parental hypertension itself. Other risk indicators were obesity, hypertension in siblings and a positive family history of myocardial infarction. In order to study the size of the problem we estimated the prevalence of hypertension and borderline hypertension in the district. Patients with these diagnoses amounted to about one fourth of the middle-aged population in the district. More than 80% of the hypertensives had been diagnosed before this study, but only about 20% of the borderline hypertensives were previously known. PMID- 6496186 TI - The antithrombotic effect of heparin in deep venous thrombosis: relation to four heparin assays. AB - In a prospective study, 280 patients with phlebographically proven deep venous thrombosis received intravenous heparin infusion; 224 of the patients were subjected to control phlebography after 5-8 days of treatment. Females above 70 years showed least phlebographic improvement despite similar heparin dosage and heparin activity. Heparin activity in daily drawn blood samples was determined by four different assays. Chromogenic substrate (CS) assay (Coatest heparin), activated partial thromboplastin time (Cephotest), and thrombin time with recalcified plasma (CaTT) showed weak but significant correlations with thrombus resolution judged by phlebography (p = 0.004, 0.003 and 0.018, respectively). A linear prediction equation showed that the phlebographic result was about equally influenced by the mean dose and by the result of any of the three heparin assays. Thrombin time with citrated plasma showed no correlation. CS assay and CaTT showed significantly lower mean heparin activity in patients with (n = 13) than without clinically diagnosed pulmonary embolism (p = 0.012 and 0.001, respectively). PMID- 6496187 TI - Analgesics and risk of coronary and other death in middle-aged men in eastern Finland. AB - The association between oral analgesics and the risk of death from ischaemic heart disease (IHD), cardiovascular disease, disease other than IHD, and any disease was studied in a cohort of 3551 men aged 30-59 years, based on a random sample from the population of eastern Finland. A number of potential coronary risk factors were allowed for in multiple logistic models. On the basis of these data, a regular use of oral analgesics is associated with a decreased risk of death from IHD. The relative risk was 0.6 with 95% confidence interval (CI) of 0.2-0.9 for IHD death and 0.6 (95% CI = 0.4-0.9) for cardiovascular death. No significant association was found between oral analgesics and the risk of death from diseases other than IHD. PMID- 6496188 TI - Validity of hospital discharge data in a prospective epidemiological study on stroke and myocardial infarction. AB - The validity and coverage of hospital records of stroke and myocardial infarction were evaluated in a Finnish epidemiological cohort consisting of 57000 men and women. Information on their hospitalizations after the baseline examination was obtained by record linkage to the National Hospital Discharge Register. As compared to data based on re-examination of survivors after five years, the discharge register covered 78.2% of hospital treatments. A specific diagnosis code had been recorded for 81.7% of the definite strokes and for 84.7% of the definite myocardial infarctions. The 5-year incidence rates based on both hospital records and deaths were clearly lower than the rates previously reported from local registers of stroke and myocardial infarction in Finland. Although hospital discharge information underestimates morbidity in the population, the data are sufficiently valid for many epidemiological purposes, e.g. research on predictors of diseases. PMID- 6496189 TI - Failure of long-term acclimatization in smokers moving to high altitude. AB - It was found that several foreign experts recruited for an irrigation project in southern Peru could not cope with their work at an altitude of 3 200 m. When we analyzed the haematological acclimatization to high altitude in 109 adult males, we found that the moderate differences in haematocrit level (0.9) and haemoglobin concentration (0.2 g/100 ml) between male smokers and non-smokers at low altitude were almost quadrupled at 3 200 m height. The haemoglobin concentration increased in both groups during the first month, after which it remained constant. Of 51 Swedish employees, 25 smokers and 26 non-smokers, 14 were obliged to terminate their contracts. All 10 who had failed to cope with their work for other than purely medical reasons were smokers. This group of smoking men also had an overconsumption of alcohol. We therefore conclude that life style determines long term acclimatization to high altitude. PMID- 6496190 TI - Biliary cystadenoma of the common bile duct with secondary biliary cirrhosis. Report of a case. AB - A case of cystadenoma of the common bile duct is described. An erroneous diagnosis made in a young woman caused secondary biliary cirrhosis with fatal outcome. The diagnosis of cirrhosis should never be established without thorough visualization of the entire biliary tract in patients with biochemical or clinical jaundice of unknown origin. PMID- 6496192 TI - Overdosage of piroxicam. AB - A 54-year-old woman took an overdose of 1 800 mg piroxicam. She complained of nausea and abdominal pain. Endoscopy revealed multiple superficial ulcerations in the pyloric antrum and the first part of duodenum. There were no symptoms or signs from other organ system and recovery was uneventful. The highest serum concentration was 241.6 mg/l, which is about 30 times the usual therapeutic level of 5-10 mg/l. PMID- 6496191 TI - Fatal mumps myocarditis. AB - A case of fatal mumps myocarditis in a 38-year-old male is reported. The disease started with orchitis, and severe cardiac symptoms developed within 1 1/2 month. The patient died 5 months later from congestive heart failure. The possible interrelation between late stages of viral myocarditis and dilated (congestive) cardiomyopathy is emphasized. PMID- 6496193 TI - Projections of the amygdaloid body to the insular cortex in the cat. AB - Experiments were performed on brains of 15 cats with the use of horseradish peroxidase (HRP) retrograde transport method. After injections of HRP to the insular cortex, relatively great numbers of labeled neurons were found in all main nuclei of the amygdaloid body. After injections to the anterior part of the granular insular cortex numerous labeled neurons were located in the lateral, central lateral, basal dorsal and basal ventral nucleus of the amygdaloid body. Injections to the agranular insular cortex labeled neurons in the lateral, basal dorsal and basal ventral nucleus and in the claustrum prepiriforme. These results indicate the presence of large projections from vast areas of the amygdaloid body to the agranular insular cortex and the anterior part of the granular insular cortex. PMID- 6496194 TI - Cerveau isole and pretrigeminal rats. AB - Cortical and hippocampal EEG activity was analysed in 14 cerveau isole and 8 pretrigerninal rats. In the acute stage, waking EEG patterns were absent in the cerveau isole, whereas sleep EEG patterns were absent in the pretrigeminal preparations. However, already on the second day the EEG waking-sleep cycle recovered in the majority of rats. Paradoxically, stimuli directed to the caudal part of preparations evoked stronger cortical and hippocampal EEG arousal than olfactory and visual stimuli. The behavior of the caudal part was observed in 25 preparations. Although in abortive form, the rats did show some locomotor and grooming behavior, and could be fed orally. The peripheral events of paradoxical sleep appeared only on the fourth or fifth day of survival of the cerveau isole rats. It is concluded that the activity of the isolated cerebrum of the rat is similar to that of cat preparations, but that functions of the caudal neuraxis are superior in rats. PMID- 6496195 TI - Circadian variation of yawning behavior. AB - Circadian variation of spontaneous yawning is demonstrated in a line of Sprague Dawley rats, genetically selected for high frequency of this motor pattern. Yawning is highest in late light and early dark hours, both under natural and artificial illumination. The hypothetical neurotransmitters underlying this physiological rhythm in yawning are discussed. PMID- 6496196 TI - Prediction of cerebral vasospasm value of fibrinogen degradation products (FDP) in the cerebro-spinal fluid (CSF) for prediction of vasospasm following subarachnoid haemorrhage due to a ruptured aneurysm. AB - In a new treatment regimen with antifibrinolytic drugs in patients with aneurysmal subarachnoid haemorrhages, we have systematically controlled the level of fibrinogen degradation products (FDP) in the cerebrospinal fluid (CSF). The frequency of severe vasospasm with clinical ischaemia has been compared with the patient's initial level of FDP. Fifty patients have been included in this study. (All in Hunt and Hess's grades I or II on their arrival.) Patients with a secondary deterioration unrelated to vasospasm were excluded. The FDP levels were measured in the first three days following the bleeding and we were informed of them at the end of the study. The diagnosis of severe vasospasm was confirmed by arteriography and computed tomography (CT) and it was named "severe" when accompanied with signs of clinical ischaemia. Twenty patients developed a severe vasospasm with clinical ischaemia. In these patients, the mean value of the initial FDP level was between 80 and 320 mcg/ml compared with 20 to 80 mcg/ml for those who had not developed clinical ischaemia (p = 0.0009). Furthermore, two different groups may be discriminated by their initial FDP level: FDP greater than 80 mcg/ml; n = 23, 65% severe vasospasm; FDP less than 80 mcg/ml; n = 27.8% no severe vasospasm (p less than 0.001). These results do not imply a direct role of FDP in pathophysiological mechanisms of vasospasm, but they suggest a relationship between the clot lysis and the appearance of vasospasm with clinical ischaemia. To our knowledge this is the first time that such a predictive role can be attributed to the initial FDP level in the prognosis of vasospasm. PMID- 6496197 TI - Intra- and perioperative aspects of the hemodynamics of supratentorial AV malformations. AB - The risks which result from hemodynamic changes after surgery of 35 patients with supratentorial arterio-venous angiomas were investigated. With the help of a miniaturized 20 MHz Doppler probe flow and resistance were measured before, during, and after operations. The Doppler findings were compared with pre- and postoperative angiograms and intraoperative surgical findings. Postoperative angiograms were performed immediately after operation. The risk of haemorrhage and oedema was found to be high in cases of large vessels with slow flow and high resistance, in high flow angiomas, in stagnating arteries visible longer than 10 s and a length more than 6 cm, and in cases of pre-operative steal. These hemodynamic risky angiomas must be treated either by multiple step-operation or hypotension. PMID- 6496198 TI - Flow patterns at the site of extracranial to intracranial end to side anastomosis. An experimental rheological study. AB - Flow property measurements were performed in a plexiglass model of six various types of end-to-side anastomosis (as clinically shown in extracranial to intracranial arterial bypass surgery). Three anastomoses were made without, another three anastomoses with a ringshaped stenosis restricting the lumen to between 25 and 46% of the cross-section as it occurs clinically by formation of thrombi out of the striching canals. A rectangular type and two of 45 degree oblique types--one directed centrally and one directed peripherally--were tested. Pressure head losses at the site of anastomosis were measured under various circumstances of different anastomoses and different flow speeds along the proximal portion of the middle cerebral artery and the superficial temporal artery. Flow resistance values originated by the different types of anastomoses were expressed in terms of additional recipient vessel length. Differences between different types of anastomoses with and without stenosis were very small and under no circumstances exceeded the equivalent of lengthening the recipient vessel by 2 cm. Theoretically, the optimal type of anastomosis is the oblique and centrally directed version; the worst type is the rectangular form. Practically, however, such differences are not relevant. The explanation for such unexpectedly small differences can rheologically be given by considering the dominating role of blood viscosity under the given circumstances, other variables such as short stenosis and angling of flow playing a secondary role. PMID- 6496199 TI - Benign outcome in unoperated large cerebellar haemorrhage. Report of 2 cases. AB - We studied two patients with large cerebellar haemorrhages, who were conscious on admission and did not deteriorate during the following days. Surgical decompression was not performed and the patients regained their former level of activity, except for moderate persisting ataxia. We suggest that cerebellar haemorrhage may have a benign spontaneous outcome, more often than previously assumed from autopsy series. The main selection criteria for surgery is an impaired state of consciousness and evidence of neurological worsening. Taken alone, the size of the haemorrhage on computerized tomography is not a reliable criterion for surgery. PMID- 6496200 TI - Proceedings of the congress of the Societa Italiana di Neurochirurgia, Bari, September 20-October 1st, 1983. Abstracts. PMID- 6496201 TI - Cigarette smoking as a risk for cardiovascular disease V: Biochemical parameters with increased and decreased nicotine content cigarettes. AB - Cigarette smokers were assessed for customary smoking behavior and then were assigned a cigarette which was 0.4 mg higher or lower in nicotine and after 4 weeks, were returned to their customary brand. Biochemical indices of smoking behavior including blood carboxyhemoglobin (COHb), plasma nicotine, cotinine and thiocyanate (-SCN) were measured every 2 weeks. When nicotine availability was increased, smokers received an increased nicotine bolus per puff as determined by plasma nicotine and did not alter smoking topography or cigarettes per day. Over the 4 weeks, plasma cotinine increased without corresponding increases in COHb and -SCN. The return to standard brand resulted in declining cotinine levels but increasing COHb and -SCN, suggesting altered inhalation patterns. In smokers switched to a low yield cigarette, there was a decrease in the nicotine obtained per cigarette followed by a steady rise in plasma cotinine, -SCN and blood COHb over the 4-week period. A positive correlation was observed between cotinine and the gas phase constituents during the change to lower yield and back to standard brand cigarettes. These results indicate that cigarette smokers compensate for decreased nicotine yield with concomitant increases in gas phase components. In addition, increased nicotine availability results in an increased body burden of nicotine and "tar," but not gas phase constituents. The relative risks of cardiovascular disease under these two situations, which increase exposure to nicotine or gas phase components, deserve careful consideration. PMID- 6496202 TI - The effects of cigarette smoking on pain and anxiety. AB - The antinociceptive and anxiolytic consequences of smoking a nicotine-containing cigarette or a zero-nicotine cigarette were investigated in minimally deprived habitual smokers, using a within-subject design. Five subjects were studied in each of two experiments. In one, pain was induced using the cold pressor test; in the other, anxiety, using unsolvable anagrams. All subjects exhibited pain- and anxiety-reduction after smoking a nicotine-containing cigarette. The results support the hypothesis that nicotine from smoking can produce psychological changes that are independent of the state of nicotine withdrawal. PMID- 6496204 TI - Verbal impairment in alcoholics. AB - Research utilizing psychometric and neuropsychological measures has shown that alcoholics are impaired on visual-spatial tasks. Recent studies have also shown alcoholics are impaired on novel verbal tasks as well. The present study was undertaken to determine the degree of impairment among alcoholics in visual spatial versus verbal tasks. Limited support for the hypothesis that alcoholics are impaired in verbal abilities was obtained in that the WAIS Vocabulary subtest discriminated between alcoholics and nonalcoholics. These findings are discussed in light of both the tendency to interpret neuropsychological tests in a rather simple fashion and the need for further research into the verbal functioning of alcoholics. PMID- 6496203 TI - Superiority of a low-contrast smoking cessation method. AB - Methods of quitting smoking that deplete body nicotine levels without simultaneously reducing cigarette nicotine levels serve to increase the contrast between these two levels. High-contrast enhances the salience of each cigarette. In this study a low-contrast nicotine fading procedure (NiF) was compared with a high-contrast number fading treatment (NuF). With 76 persons it was found that NiF was statistically superior to NuF. It was also found that caffeine is correlated with cigarette smoking in both males and females and with alcohol intake in males. It is suggested that future smoking cessation programs be based on low-contrast methods, and that results could probably be enhanced by the elimination of caffeine and minimization of alcohol intake. A contrast theory of addiction is briefly discussed. PMID- 6496205 TI - A minimal contact smoking cessation program at the worksite. AB - This article describes a minimal contact, broad-spectrum behavioral smoking cessation program conducted at the worksite. At 6-month follow-up, the abstinence rate was equivalent to most similar interventions, but with a surprisingly robust 50% maintenance rate for those who succeeded in quitting. PMID- 6496206 TI - Comparison of reactive and non-reactive measures of smoking cessation at follow up. AB - Subjects who had completed a smoking cessation program were contacted at 3- and 4 month follow-up to assess self-reported frequency of daily cigarette smoking. Subjects were randomly assigned to a reactive or non-reactive condition of telephone contact in obtaining the self-report. In the reactive condition, the telephone caller seeking self-report identified herself as an assistant in the original smoking cessation treatment program. In the non-reactive condition the telephone caller identified herself as an employee of a firm conducting a market research survey of the use of various consumer products. There were no statistically significant differences between the conditions in either self report of abstinence or absolute frequency of daily cigarette consumption. PMID- 6496207 TI - Winners revisited: an 18-month follow-up of our successful weight losers. AB - In Addictive Behaviors, Volume 8, Number 3, the authors described 54 men and women who were defined as successful weight losers by stringent criteria. Eighteen months later, 42 subjects were recontacted. Body weights have remained very stable (+/- 3.5 lb., on the average) through a variety of life stresses. Subjects' perceptions of reasons for their success are given. Authors conclude that the original criteria for defining success are a useful standard for future research. PMID- 6496208 TI - The effect of duration of breath-holding on expired air carbon monoxide concentration in cigarette smokers. AB - Exhaled alveolar air contains carbon monoxide that has passed from the blood during a period of breath holding and so provides an accurate guide to carboxyhaemoglobin concentration, itself affected by inhaling tobacco smoke. It has been claimed that breath hold duration makes no appreciable difference to the expired air carbon monoxide (ECO) concentration obtained. A study was conducted to determine the relationship between duration of breath holding prior to exhalation and ECO value. It was found that ECO concentration increased systematically up to 25 seconds of breath holding, with the curve beginning to flatten off after 15 seconds. It is concluded that where possible a breath hold duration of at least 20 seconds should be used and that shorter durations do not provide ECO concentrations comparable with the 20-second value. PMID- 6496209 TI - Behavioral treatment of obesity with monetary contracting: two-year follow-up. AB - Reported is a 2-year follow-up of a behavioral weight reduction program for men using monetary contracts of varying size and group versus individual contingencies. Although initial weight losses were large, in the absence of an effective maintenance program weight losses at two years were modest, similar to those obtained with less effective initial weight loss procedures. Group contracts were significantly more effective in producing long term loss than individual contracts. Reported behaviors associated with weight loss at 2 years are presented. PMID- 6496210 TI - Covariation among health-related behaviors. AB - There is substantial covariation in the use of alcohol, cigarettes, and hard drugs and it has been suggested that different types of drug use are part of a "syndrome" of behavior that may include other health-related and "problem" behaviors. A critical challenge is the determination of the behaviors included within this syndrome and the mapping of the perimeter. In this study, six health related behaviors (meal regularity, hard drug use, alcohol use, cigarette use, exercise, hours of sleep) were intercorrelated and factor analyzed in both a high school and a college sample. Consistent with previous research, alcohol use, cigarette use, and hard drug use were significantly associated in each of four subsamples (sex by sample) and formed a cohesive drug use factor. The measures of meal regularity, exercise, and hours of sleep were found to lie outside the perimeter of the drug use behaviors, with meal regularity consistently residing closest to the perimeter. PMID- 6496211 TI - Agreement among Feighner, RDC and DSM III criteria for alcoholism. AB - Three sets of diagnostic criteria for alcoholism, Feighner criteria, Research Diagnostic Criteria (RDC), and DSM III criteria, were examined to determine the concordance among them. The alcohol section of the Diagnostic Interview Schedule (DIS), which provides information allowing for diagnoses by all three sets of criteria, was administered to 484 blue collar workers. Overall, there was substantial agreement among the diagnostic systems, with 86% of the men receiving the same diagnosis by all three systems. However, more detailed analyses indicated that approximately one quarter of those receiving a diagnosis of alcohol abuse or alcohol dependence according to DSM III were not diagnosed as alcoholic by Feighner criteria. It was suggested that this discrepancy was due to DSM III criteria (as represented in the DIS) diagnosing heavy drinkers with no attendant problems as alcoholic. PMID- 6496212 TI - Complement system in abnormal pregnancy and chorionic neoplasia: immunotherapy and chemotherapy of chorionic neoplasia. AB - In normal pregnancy, the activity of the alternate pathway elevates latently and compensatorily for the suppression of cellular immunity. Aging of the placenta becomes a trigger for the onset of labor and production of C3-a. In cases of hydatidiform mole, abruptio placentae, threatened abortion, and chorionic malignancy, the activity of the complement system is depressed, especially that of C3-activator and alternate pathway. This may in turn result from activation of complement by the pathologic lesion of the chorionic villi. In pathologic lesions of the placenta, activation of alternate pathway can lead to a number of diseases. Immunotherapy is effective in the prevention of malignant transformation of hydatidiform mole. Immunotherapy and combination chemotherapy are markedly effective for treatment of metastatic chorionic malignancy. PMID- 6496213 TI - Placental senescence. AB - As the nature of any intrinsic biologic aging process or even of its existence independent of disease is unknown, it is not possible to state whether or not the placenta gets old. As term approaches, the placenta accumulates a variety of lesions which seem pathological. In most cases, however, it is not certain that they represent intrinsic disease in the sense that older people tend to develop cancer or atherosclerosis. Several placental functions decrease near term, but it is not possible to attribute these to aging. In fact, some may represent adaptive additional maturation. A variety of laboratory phenomena seen in aging cells may be detected in the placenta but again, their significance is uncertain. In short, the placenta looks and acts as if it grows old. That is clinically important and probably all the clinician needs to know, but whether or not it truly grows old remains a mystery, an important point for the biologist. For if the placenta truly ages, then the embryo and its placenta represent genetically identical tissues which age at different rates. Such a model might give us much more specific information about our limits than a currently popular reference, the 90th Psalm. PMID- 6496214 TI - The role of trophoblast differentiation in the control of the hCG and hPL genes. AB - Normal trophoblast of the human placenta elaborates at least two major protein hormones, hCG and hPL. Molar and choriocarcinoma tissues characteristically synthesize large amounts of hCG and small quantities of hPL. To examine the role of trophoblast differentiation in the expression of the hCG and hPL genes, we studied the cytological distribution of their mRNAs in tissue sections of human hydatidiform mole and choriocarcinoma by in situ hybridization. Histologically, these tissues are in different stages of cellular differentiation. In normal placenta, hCG alpha and hCG beta mRNAs can be localized to some cytotrophoblasts and primarily to the syncytium, whereas hPL mRNA appears only in the syncytial layer. In hydatidiform mole, which still retains placental villous morphology, the hPL gene and hCG alpha and hCG beta genes are expressed but are poorly localized because of the admixture of cyto- and syncytiotrophoblasts. By contrast, choriocarcinoma, which is devoid of placental villous pattern but in which the cyto- and syncytiotrophoblast-like components are distinguishable, expresses hCG alpha and hCG beta in the syncytial-like areas but little, if any, hPL. These results suggest that a certain level of trophoblast differentiation, such as villus formation, is associated with hPL expression, while the hCG alpha gene and the hCG beta gene can be expressed in more disorganized tissues which contain cytotrophoblastic elements. PMID- 6496215 TI - Nutritional and toxicological aspects of food safety. PMID- 6496216 TI - Defenses against aflatoxin carcinogenesis in humans. AB - Aspects of work on aflatoxin mainly from the author's studies are discussed, emphasizing procedures, strategies and insights related to protection against aflatoxin carcinogenesis in man due to transmission in the food chain. Five lines of defense are discussed. First, is the interfacing of the farm animal as a biologic filter between contaminated crop (feed) and human food derived from animal products. Second, is chemical detoxification of meals with ammonia and of contaminated milk by ultraviolet light. Third is prevention of mold growth and aflatoxin elaboration with ammonium carbonate for potential application during storage and drying of agricultural products. Fourth, is the development of ultrasensitive analytical methods for aflatoxins with structural proof of identity. And, fifth are natural defenses related to the role of hydroxylation of mammalian metabolism in detoxification, especially the pathway to aflatoxin Q1, a major detoxifying mechanism in primates, and the epoxidation pathway and its relation to prevention of aflatoxin residue transmission into edible tissues. PMID- 6496217 TI - Differential effects of sodium selenite and methylmercury(II) on membrane permeability and DNA replication in HeLa S3 carcinoma cells: a preliminary report regarding the modification of organomercurial toxicity by selenium compounds. AB - When viewed in terms of their concentration in the growth medium, sodium selenite and methylmercuric hydroxide--administered individually to HeLa S3 cells--are of equal efficacy in inhibiting DNA synthesis: the dose-response curves overlap and 50% residual DNA synthesis occurs at 6.13 microM of either chemical. A different picture, however, emerges if replication is expressed as a function of the actual amounts of toxicant bound per cell. Now, the dose-response curves do not overlap and Na2SeO3 is much more toxic than CH3HgOH: 50% inhibition of DNA replication exists at 5.37 X 10(-17) moles of Se bound per cell and at 3.63 X 10(-15) moles of Hg bound per cell. Further, selenite is taken up by the cells more slowly than methylmercury and its (limiting) cellular concentration is below that of the organomercurial. Lastly, much higher levels of selenite in the growth medium are required to bring about the same degree of membrane damage as the one caused by methylmercury. These differential effects may have a bearing on the observation, well-known but thus far unexplained, that selenite and methylmercury are strikingly less toxic to animals when administered simultaneously than they are when administered individually: selenium may counteract the membrane destabilizing characteristics of methylmercury and it may retard its binding to the cells. Data on the inhibition of DNA synthesis have been obtained when selenite and methylmercury are administered simultaneously to HeLa S3 cells in varied molar ratios. Best mutual protection appears to exist when the two chemicals are present in equimolar amounts or when there is a slight excess of selenite. PMID- 6496218 TI - Minimizing the saponin content of alfalfa sprouts and leaf protein concentrates. AB - Biologically active saponins were found to be concentrated in the white and green alfalfa leaf protein fractions at levels higher than in the original alfalfa. Coagulation and washing of the leaf protein at pH 8.5 resulted in a fourfold decrease in saponin compared to the protein coagulated at pH 6.0 and washed at pH 4.5. The press cakes from high and low saponin alfalfa retained 65 and 87% of the saponin. Protein fractions prepared from a low saponin alfalfa contained saponin levels less than 0.07%, compared to a saponin level of 1.33% in leaf protein prepared form a high saponin alfalfa. The saponin contents of three varieties of alfalfa sprouts ranged from 1.55 to 7.27% depending upon the maturity of the sprouts. The saponin content rapidly increased after sprouting and reached a maximum after eight days' growth. Both starch and total sugar decreased with the age of the sprouts while fiber increased from 8 to 18.7%. PMID- 6496219 TI - Nutritional studies of a carboxypeptidase inhibitor from potato tubers. AB - Carboxypeptidase inhibitor from potato tubers was fed to newly hatched chicks at a level equal to that present in diet containing 50% raw potato, which caused severe growth depression and 20% mortality. At this level the effects of the inhibitor on growth was small but the following effects were noted: (a) increased fecal protein (the increase mainly consisting of low molecular weight proteins); (b) poorer feed efficiency; and (c) a significant decrease in pancreatic digestive proenzyme levels, although no hypertrophy was noted. In addition, the inhibitor was not digested readily in the intestinal tract and it increased in concentration in intestinal contents as it progressed down the tract. Potato Inhibitor II, a potent trypsin inhibitor, when fed to chicks, also at the level found in a 50% raw potato diet, was severely growth depressing. It significantly increased fecal protein and caused pancreatic hypertrophy. The trypsin inhibitor may be a major growth depressing agent in raw potatoes whereas the carboxypeptidase inhibitor probably contributes little to the growth depression. PMID- 6496220 TI - Nutritional consequences of the reactions between proteins and oxidized polyphenolic acids. AB - The chemical and enzymatic browning reactions of plant polyphenols and their effects on amino acids and proteins are reviewed. A model system of casein and oxidizing caffeic acid has been studied in more detail. The effects of pH, time, caffeic acid level and the presence or not of tyrosinase on the decrease of FDNB reactive lysine are described. The chemical loss of lysine, methionine and tryptophan and the change in the bioavailability of these amino acids to rats has been evaluated in two systems: pH 7.0 with tyrosinase and pH 10.0 without tyrosinase. At pH 10.0, reactive lysine was more reduced. At pH 7.0 plus tyrosinase methionine was more extensively oxidized to its sulphoxide. Tryptophan was not chemically reduced under either condition. At pH 10.0 there was a decrease in the protein digestibility which was responsible for a corresponding reduction in tryptophan availability and partly responsible for lower methionine availability. Metabolic transit of casein labelled with tritiated lysine treated under the same conditions indicated that the lower lysine availability in rats was due to a lower digestibility of the lysine-caffeoquinone complexes. PMID- 6496221 TI - Mutagens in cooked food: chemical aspects. PMID- 6496222 TI - Mutagens in cooked foods--metabolism and genetic toxicity. AB - Recently developed in our laboratories is an efficient extraction procedure incorporating XAD resin adsorption which yields from 200 degrees C grilled ground beef an extract containing 230 Salmonella TA1538 revertants per g fresh weight of original ground beef. These mutagenic components are specific for frameshift sensitive Salmonella strains and have an absolute requirement for metabolic activation. S9 activation by cytochrome P-448 inducers, Aroclor 1254 (PCB), 3 methylcholanthrene (3-MC) and B-naphthoflavone (BNF), resulted in the largest mutagenic response. Phenobarbital induction gave 20% of the PCB response and Pregnenolone-16a-carbonitrile and corn oil were inactive. Human liver microsomes and BNF-induced rodent intestinal S9 were also active metabolizing fractions. Normal-phase HPLC separation of methanol-extractable metabolites generated from reaction of 2-amino-3-methylimidazo [4,5-f]quinoline (IQ), a mutagenic component of broiled food, rat liver microsomes and cofactors resulted in one direct-acting mutagenic peak and a second more polar peak still requiring metabolic activation. Two potent thermally-produced bacterial mutagens, Trp-P-2 and IQ, were examined in mammalian cells. In excision repair-deficient CHO cells, Trp-P-2 exposure caused cytotoxicity, mutagenicity (thioguanine and azaadenine resistances), sister chromatid exchange, and chromosomal aberrations at concentrations more than 30-fold lower than those for IQ. In normal repair-proficient CHO cells Trp-P 2 was one-half as active and IQ was inactive. Relative to Trp-P-2, IQ is much more potent in the Salmonella bacterial system than in mammalian CHO cells. PMID- 6496223 TI - The olivopontocerebellar atrophies. PMID- 6496224 TI - A classification for ataxia. PMID- 6496225 TI - The pharmacology of olivopontocerebellar atrophy. PMID- 6496226 TI - Dominantly inherited ataxia with abnormal urinary glycolipid content. PMID- 6496227 TI - Clinical features of sporadic (Dejerine-Thomas) olivopontocerebellar atrophy. PMID- 6496228 TI - Clinical expression of glutamate dehydrogenase deficiency. PMID- 6496229 TI - Morphological changes of olivopontocerebellar atrophy in computed tomography and comments on its pathogenesis. PMID- 6496230 TI - An apology and an introduction to the olivopontocerebellar atrophies. AB - The OPCAs are not, as Dejerine and Thomas (6) and subsequent writers have suggested, a unitary morbid entity. They comprise a heterogeneous group of disorders sharing certain major clinical and morphologic features with the hereditary and acquired ataxias and with the extrapyramidal system disorders, such as Parkinson's disease and the hereditary and acquired choreas, yet distinct from both these general groups of neurodegenerative diseases. Some of the OPCAs are sharply defined morbid entities of known etiology identified on combined genetic and clinical grounds or by a unique biochemical defect; most are of uncertain provenance and may themselves represent a collection of multiple, as yet undetermined entities. The nosologic concept of OPCA survives today in part because of its (Formula: see text) clinical usefulness in categorizing patients with mixed cerebellar and extrapyramidal syndromes and its importance in the differential diagnosis of both extrapyramidal and cerebellar disorders. PMID- 6496231 TI - Cerebellodiencephalic interactions in olivopontocerebellar atrophy. PMID- 6496232 TI - Clinical relevance of basic concepts in substance abuse. PMID- 6496233 TI - Critical interpretation of urinary phencyclidine monitoring. AB - A critical appraisal of issues and problems in monitoring urinary phencyclidine (PCP) is presented. Problems may be related to impurities of ingested material and/or metabolites, and methods that are not sensitive enough to detect PCP in the nanogram/ml amounts which may be present in blood or urine. Possible false positives found with some methods are discussed. Most complicated of all is the unpredictable excretion of PCP which can result in negative urines followed by urines which test positive for PCP without necessity of any further ingestion of PCP. A set of guidelines for use in monitoring and interpreting PCP values is included. PMID- 6496234 TI - Solvent abuse associated pulmonary abnormalities. AB - Organic solvent inhalation leading to intoxication has become an important medical problem. Pulmonary function studies were performed on 42 young (ages 11 31) solvent inhalers and on 20 controls (ages 10-26). Ventilatory studies were normal in the majority, but residual volumes of inhalers were significantly higher (136.26% +/- 32.64% S.C.) than in controls (104% +/- 27.78% S.C.)--p less than 0.001. Lung tissue obtained at autopsy, from three known solvent inhalers was found to contain microscopic abnormalities similar to those seen in experimental panlobular emphysema and it is assumed these changes are consistent with increased residual volumes. PMID- 6496235 TI - Multidimensional impact of treatment for substance abuse. AB - The establishment of a multi-facility patient registry system has facilitated the routine documentation of problems associated with substance abuse. The comparison of information on 1,020 adult inpatients from the six-month period before and the six-month and twelve-month periods after treatment is reported. The multidimensional approach to program evaluation suggests significant economic impact of inpatient treatment on vocational functioning, health care demands, and arrests. Treatment for alcohol and other substance abuse appears to have an extremely significant potential for economic payback to local, state and federal governments, insurance providers, corrections agencies, private industry, and, of course, patients and their families. PMID- 6496236 TI - Psychiatric illness in residential homes for the elderly: a survey in one London borough. AB - The mental state, demographic details, dependency level and presence of problem behaviours have been recorded for 438 (82%) of the residents of the 12 Part III homes, managed by the London Borough of Camden, using standard interview. One third of the residents were suffering from severe dementia, another third from mild to moderate dementia and one third were free of dementia. Of the latter two groups, 38% were depressed. The prevalence rate of dementia increased with the age of the resident and was higher among females. Depression was associated with the presence of visual handicap and incontinence, and was commoner when the resident had been admitted from his own home or belonged to a minority religion. A third of residents needed daily help with dressing and use of the lavatory, one quarter were incontinent each day. Depression and dementia both were associated with increased rates of dependency and of problem behaviours (incontinence, wandering, aggression). This survey has revealed evidence of sufficient psychiatric morbidity in these homes to support a re-appraisal of their current aims, staffing and health-care provision. PMID- 6496237 TI - A health survey of the very aged in Tampere, Finland. AB - The population aged 85 years or over (n = 674) living in Tampere, Finland, was surveyed in 1977-78. Altogether, 561 persons (83%)--99 men and 462 women--were examined. The study comprised questionnaire, medical examination, laboratory tests, ECG and chest X-ray examination. Of the subjects, 24% were hospitalized, 22% were in old people's homes and 54% lived at home. The most common symptoms were aches and pains (24%), vertigo (22%), defective vision (15%) and defective hearing (12%). Congestive heart failure (49%), dementia or confusional state (28%) and urinary tract infection (22%) were the most common diseases. PMID- 6496239 TI - Geriatric day hospital in Hong Kong: a three-year follow-up study. AB - In this study, 477 elderly patients who attended the day hospital at Princess Margaret Hospital, Hong Kong in the years 1979-81 are reviewed. Our patients are on the whole younger than those in the UK, with an approximately equal sex ratio. The day hospital has an important function for the rehabilitation of stroke patients. A longer stay of patients has reflected the lack of day hospital places. A low New Patient Index resulted from the lack of day care centres. PMID- 6496238 TI - Mineral density of calcaneus in men at different ages: a population study with special reference to life-style factors. AB - The mineral density of the calcaneus was measured in representative samples of men, aged 31-35, 51-55, and 71-75 years, utilizing a 125I-gamma-ray attenuation method. There was a gradual decrease in bone mineral density from the youngest to the oldest age group. Those men who participated in regular physical activity or who were non-smokers showed higher values for bone mineral density when compared to sedentary men or smokers, respectively. Furthermore, bone mineral density correlated positively with physical performance capacity and negatively with the prevalence of chronic diseases. PMID- 6496240 TI - Upper gastro-intestinal endoscopy for Chinese elderly in an acute geriatric unit: a review. AB - From December 1982 to August 1983, a total of 242 oesophago-gastro-duodenoscopies were performed for 208 elderly patients in the Geriatric Unit, Princess Margaret Hospital, Hong Kong. These were done as part of an investigatory procedure in the Geriatric Unit, the first of its kind in Hong Kong. In the 9-month survey, it was found that upper gastro-intestinal endoscopy is a safe and useful diagnostic investigation. It also provides in-service training and stimulation for staff working in the unit to look at one of the many facets of geriatric medicine. PMID- 6496241 TI - Age and the daily dose of thyroxine replacement therapy for hypothyroidism. AB - The initial prescriptions and later adjustments of thyroxine (T4) replacement have been analysed in 2246 hypothyroid patients who have been monitored by a thyroid follow-up register for a mean period of 6 years (range 1-13 years). In 465 (21%) patients of 65 years or over, initial T4 doses were on average only 20 micrograms lower than in younger patients. However, only 40% of the elderly were taking 200 micrograms of T4/day or more, compared with 60% of the younger patients. Over 10 years, the predicted proportion of patients who have a downward adjustment of their T4 prescription is 3%, but there is no difference in recognized overtreatment between older and younger patients. The findings suggest that the majority of the elderly may receive larger doses of T4 than are required for optimal replacement. There are strong reasons for the standardization of thyroxine prescribing in the elderly and for the provision of routine surveillance of thyroxine replacement through the type of follow-up system used in this study. PMID- 6496242 TI - Acute renal failure in the elderly can have a good prognosis. AB - Acute renal failure in the elderly is generally held to have a poor prognosis. Since January 1982, 22 patients aged 65 or over have presented acutely in renal failure requiring dialysis. Although nine of these patients had an underlying malignancy, the outcome was favourable, with survival in 14 (64%) patients, 12 of whom achieved an independent existence. As a significant number of these patients can survive with a good quality of life, and there are particular problems with their assessment and management, early referral to a renal unit is warranted. PMID- 6496243 TI - Serum potassium levels, red-blood-cell potassium and alterations of the repolarization phase of electrocardiography in old subjects. AB - Seventeen elderly patients are described, who showed minor changes in the e.c.g. recovery phase. Serum potassium levels appeared to be normal, but red-blood-cell potassium was found to be more or less markedly reduced. Restoration of the latter to normal values, which followed treatment with potassium salts was also associated with normalization of the e.c.g. pattern. These observations demonstrate that electrolyte disorders, and particularly hypokalaemia, may determine 'minor' alterations of repolarization much more frequently than is usually thought, and that determination of serum potassium levels is not a reliable tool for detecting potassium depletion, which is more accurately reflected by red-blood-cell potassium concentration. PMID- 6496244 TI - Drug induction of hepatic enzymes in the elderly. AB - Previous workers have suggested that hepatic enzyme induction by drugs does not occur in the elderly. We have studied the effect of a potent enzyme inducer- glutethimide--on a group of nine patients over the age of 70 years, using antipyrine clearance as a measure of hepatic drug metabolism. After six days treatment with glutethimide, antipyrine clearance rose from 22.8 +/- 4.5 ml/min to 38.3 +/- 7.6 ml/min (P less than 0.001). The results suggest that the elderly are at risk for the full range of drug interactions due to hepatic microsomal enzyme induction. PMID- 6496245 TI - [The results of cataract surgery in retinitis pigmentosa]. PMID- 6496246 TI - [Characteristics of fluorescein angiogram in chronic myeloproliferative disorders]. PMID- 6496247 TI - [Studies of the kinetic vitreous fluorophotometry. (1) Normal individuals]. PMID- 6496248 TI - [An analysis of congenital nystagmus: velocity characteristics of slow phase component of optokinetic nystagmus (OKN)]. PMID- 6496249 TI - [A ophthalmological survey of aged in a Japanese town (Nambu-cho, Yamanashi Pref.)]. PMID- 6496250 TI - [A clinical picture of the superior ophthalmic vein thrombosis--based upon our 4 cases and review of the literature]. PMID- 6496251 TI - [Clinical studies on macular changes in diabetic retinopathy. Part 3. Studies on pathology of retinal capillary beds in and around the macula in diabetic retinopathy]. PMID- 6496252 TI - [Studies on the toxicity of newly developed drugs for ophthalmic use on the rabbit cornea by scanning electron microscopy]. PMID- 6496253 TI - Effects of mercuric chloride on several scavenging enzymes in rat kidney and influence of vitamin E supplementation. AB - Administration of HgCl2 at a dose of 5 mg/kg body weight/day for 15 days to male albino rats brought about a marked depression of the scavenging enzymes viz. glutathione peroxidase and glutathione S-transferase, in kidney. There was an adaptive rise in the levels of catalase and no increased lipid peroxidation was observed. The levels of both glutathione and glutathione reductase were decreased, whereas total thiol increased. In the intoxicated rats, Vitamin-E was effective in bringing back glutathione levels to normal. The adaptation in this group of animals is reflected by increased superoxide dismutase activities. Feeding of Vitamin-E alone could cause a depression of the scavenging enzymes like glutathione peroxidase and glutathione S-transferase along with a slight lowering of glutathione levels. PMID- 6496254 TI - Effect of polyprenoic acid (E5166) on a human neuroblastoma cell line in culture. AB - The antineoplastic effects of a novel retinoid derivative E5166 on cultured human neuroblastoma, GOTO cells, were investigated. E5166, as well as retinoic acid and retinol, suppressed the proliferation of GOTO cells and the synthesis of DNA, RNA and protein; the inhibitory potency of E5166 was not stronger than that of the natural vitamin A derivatives. E5166 also inhibited amino acid transport, but was found to stimulate sugar transport in the neuroblastoma cells. PMID- 6496255 TI - 1-alpha-OH-cholecalciferol (1-alpha-OHD3) and low phosphate diet in predialysis chronic renal failure: effects on renal function and on secondary hyperparathyroidism. AB - The effect of 1-alpha-OHD3 on the rate of decline of renal function was studied in 18 patients with predialytic chronic renal failure. 9 patients with serum creatinine 4.19 +/- 1.63 mg/dl, were treated with 1-alpha-OHD3 0.4 +/- 0.11 micrograms/day and a low phosphate diet and 9 patients, with serum creatinine 3.69 +/- 1.24 mg/dl, received the low phosphate diet alone. In the first group retrospectively in 8 patients up to 3-44 months and prospectively in all patients reciprocal values of serum creatinine levels fell linearly with time. Comparison of the slopes of the regression lines before and following the start of treatment did not show statistical differences in 6 cases, in 1 case the decline of renal function improved significantly and in 1 case it became positive. Serum calcium increased significantly (p less than 0.025), alkaline phosphatase decreased (p less than 0.005) and serum iPTH decreased in 6 of 8 cases. In the low phosphate diet group, serum calcium, alkaline phosphatase did not change while iPTH increased in 8 of 9 cases. The rate of decline of renal function before treatment in 3 cases did not improve after the institution of the diet. In conclusion improvement or prevention of secondary hyperparathyroidism in predialytic chronic renal failure can be achieved with daily doses of less than or equal to 0.5 micrograms 1-alpha OHD and a low phosphate diet. The small increment in serum calcium levels induced by the treatment did not accelerate the deterioration of renal function while showing a better control of alkaline phosphatase and serum iPTH than the low phosphate diet alone. PMID- 6496256 TI - Transient lipoprotein deficiency at birth: a cause of low levels of vitamin E in the newborn. AB - In newborns, the level of vitamin E in blood is very low as compared to that of placental intervillous blood and maternal blood. In our attempt to investigate the role of placenta in the transfer of vitamin E from the maternal to the newborn circulation, we have discovered that vitamin E is able to enter placental blood but is not being efficiently transferred from the placental to the newborn circulation. It appears from our preliminary study that the most limiting factor in the transfer of vitamin E from the placental to the newborn circulation is the transient deficiency of prebeta lipoprotein in the newborn blood at birth. A transient lipoprotein deficiency is implicated as a cause of low levels of vitamin E in the newborn. PMID- 6496257 TI - Ascorbic acid in thyroidectomized rats. I) Biosynthesis and catabolism. AB - Thyroidectomized rats showed a decrease in ascorbic acid and dehydroascorbic acid, with almost no alterations in the diketogulonic acid in liver and kidney. Total ascorbic acid in urine was found to be increased, whereas glucuronic acid in urine decreased significantly. There were no significant changes in the activities of ascorbic acid synthesizing enzymes. Activities of the degrading enzymes were found to increase significantly in the liver, with no remarkable change in their activities in kidney. Daily administration of thyroxine for 10 days to thyroidectomized rats normalized the activities of dehydroascorbatase and 2,3 diketoaldonate decarboxylase in the liver, whereas single administration of thyroxine on the 7th day after thyroidectomy could not bring about such restoration. It seems that thyroxine has no direct role on ascorbic acid metabolism in rats. PMID- 6496258 TI - Action of vitamin P like compounds on lysosomal fragility in hypercholesterolemia: implication of ascorbic acid and its metabolites. AB - Possible mechanisms responsible for hepatic lysosomal fragility in hypercholesterolemic rats have been investigated. It was found that certain factor(s) present in the intracellular environment of liver were required for the release of lysosomal enzymes. Elevated hepatic dehydroascorbic acid content in hypercholesterolemic rats is thought to render the lysosomes fragile in this pathological state, since this compound was found to labilise the lysosomes in vitro. Quercetin and hesperidin were found to be responsible for lysosomal stability, probably by reducing the content of dehydroascorbic acid to a normal level in the hypercholesterolemic condition. PMID- 6496259 TI - Cicatrizing pleuritis with rounded atelectasis associated with asbestos exposure. PMID- 6496261 TI - Observations on the pre-excitation syndromes with one long-term follow-up of a case of Wolff-Parkinson-White syndrome. PMID- 6496260 TI - Adenocarcinoma of the colon in young patients: an analysis. PMID- 6496262 TI - Endometriosis classification. PMID- 6496263 TI - Partial anomalous pulmonary venous return. PMID- 6496264 TI - Principles of alcohol detoxification. AB - The family physician serves as the physician of first contact for the alcoholic entering an inpatient detoxification facility. Abstinence is essential for recovery. The patient must be observed for evidence of the withdrawal syndrome. This is treated with supportive care, mild sedation, and mineral and vitamin replacement. The postwithdrawal period involves educating the patient about his illness, counseling him and his family, and planning his discharge. PMID- 6496265 TI - Preparation for vasectomy. AB - The physician has a moral and legal responsibility to ensure that the patient understands any procedures to be performed. This is especially important when the procedure is totally elective and the sexual psyche is involved. Patient selection and counseling are the two main components of preparation for vasectomy. The family physician is particularly well prepared for this process because of his long-term knowledge of the patient's health and emotional well being. PMID- 6496266 TI - Erythema nodosum. AB - This self-limiting disease is characterized by painful, red, cutaneous and subcutaneous nodules, and is often a manifestation of a systemic illness. Sarcoidosis, tuberculosis, coccidioidomycosis, streptococcal infections, inflammatory bowel disease and several drugs can be associated. The lesions, usually on the lower extremities, evolve from raised and tender nodules to a bruised appearance to complete resolution. The prognosis of the skin lesions is excellent, but the clinician's attention must be directed toward the presence of an underlying disease process. PMID- 6496267 TI - Water and health. AB - The systems protecting the quality of drinking water in the United States are deteriorating. Many urban water and sewer systems are obsolete. Industrial wastes are imposing a burden on wastewater treatment facilities. In the U.S., outbreaks of water-borne disease are primarily limited to enteritis associated with viruses or Giardia. Issues in the contamination of drinking water by toxic substances include disposal practices, accidental contamination, agricultural runoff and chlorination byproducts. Physicians must support stringent enforcement of water quality standards. PMID- 6496269 TI - Retained surgical sponges and intra-abdominal abscesses. PMID- 6496268 TI - Complications of vasectomy. AB - The most common complications of vasectomy are ecchymosis and sperm granuloma. A sperm granuloma may increase the chance of spontaneous recanalization. Orchitis and epididymitis generally respond best to treatment with anti-inflammatory drugs and antibiotics. Although antibodies frequently develop against different portions of the sperm, long-term studies have not shown any adverse effects of these antibodies. PMID- 6496270 TI - Nitrous oxide: a potentially lethal euphoriant inhalant. PMID- 6496271 TI - Nonsurgical removal of intravascular fragmented catheter. AB - Embolization of a fragmented catheter in the vasculature is a serious complication. In two patients with catheter fragment emboli, one in the pulmonary artery and one in the right jugular vein, a nonsurgical technique was effective in removing the fragments. Because nonoperative techniques are simple, safe and cost-efficient, they should be considered the method of choice for managing this complication. PMID- 6496272 TI - Thyroid cancer. AB - Thyroid cancers are especially common in patients who have received irradiation to the head and neck region for benign diseases. Well-differentiated papillary and/or follicular carcinomas are the most common types of thyroid cancer. They grow slowly and have a very good prognosis when managed with an appropriate combination of surgical and medical therapy. Other types of thyroid cancer often require more intensive therapy and follow-up. It is especially important to evaluate relatives of patients with medullary thyroid cancer. PMID- 6496273 TI - Medical complications of infectious mononucleosis. AB - Infectious mononucleosis is usually a benign, self-limited disease, but complications may develop in up to 5 percent of patients. The complications can be life-threatening and may precede, follow or coincide with the usual symptoms of infectious mononucleosis. Occasionally, a complication is the only clinical manifestation of the disease. Complications may be due to an autoimmune response, a lymphocytic infiltrative reaction, generalized edema of the airway tissues or enlargement of the spleen. PMID- 6496274 TI - Cerebrovascular disease in children. AB - Cerebrovascular disease in children is more common than was once recognized. It is typically associated with an underlying anatomic anomaly or systemic disease. The most common underlying anomaly found with thrombotic or embolic stroke is congenital or acquired heart disease, while the most common predisposing factors to intracranial hemorrhage in children, other than trauma, are the leukemias and arteriovenous malformations. Many of the disorders associated with childhood stroke are treatable. Children tend to show more recovery after a stroke than adults do. PMID- 6496275 TI - Nephrotoxicity of nonsteroidal anti-inflammatory drugs. PMID- 6496276 TI - The effectiveness of a low lipid diet and exercise in the management of coronary artery disease. AB - To evaluate the effects of a high complex carbohydrate, low lipid diet on the management of coronary artery disease, we reviewed data on 32 patients, who had participated in a diet and exercise program, and compared the results with 40 patients who had been managed only with exercise. After a follow-up period of 10 to 16 weeks the patients on the diet-exercise program showed significant reduction in body weight (-6 +/- 2 kg mean +/- standard deviation), serum cholesterol (-43 +/- 41 mg/dl), and triglycerides (-51 +/- 70 mg/dl), while patients who were managed only with exercise had no significant changes in weight or serum lipids. Both the diet-exercise and the exercise groups showed significant improvement in working capacity and reduction in resting systolic blood pressure. Patients on the diet-exercise program had significantly less angina (21.9%) occurring on the exercise test after the program compared to before, even though the same double product was reached. Multiple logistic regression analysis of the data for patients with angina on the exercise test demonstrated that the only significant (p = 0.004) contributor for reduction in angina was the dietary intervention. Beta-blocking drugs did not affect the results. Although randomized controlled trials must be run in order to ascertain the significance of this finding, this study strongly suggests that a low lipid, high carbohydrate diet is a useful addition to exercise in the management of patients with coronary disease. PMID- 6496277 TI - Detection of occult pericardial hemorrhage early after open-heart surgery using technetium-99m red blood cell radionuclide ventriculography. AB - Pericardial or mediastinal hemorrhage requiring reoperation occurs in 2% to 5% of patients, usually early (0 to 48 hours), after open-heart surgery. This hemorrhage may be occult, and resulting cardiac tamponade may easily be misinterpreted as ventricular dysfunction, common early postoperatively. In such cases, appropriate and timely intervention may not occur. Of 50 patients evaluated by technetium-99m red blood cell gated equilibrium radionuclide ventriculography (RNV) because of early postoperative cardiogenic shock of uncertain etiology, 17 had unique scintigraphic images suggestive of intrathoracic hemorrhage. Of these 17, 5 had a generalized "halo" of abnormal radioactivity surrounding small hyperdynamic right and left ventricles, 11 had localized regions of intense blood pool activity outside the cardiac chambers (two with compression of single chambers), and one demonstrated marked radionuclide activity in the right hemithorax (2000 ml of blood at reoperation). Twelve patients had exploratory reoperation for control of hemorrhage as a direct result of the scintigraphic findings, three were successfully treated with fresh frozen plasma and platelet infusions along with medical interventions to optimize cardiac performance, and two patients died in cardiogenic shock (presumed tamponade) without reoperation. In the 12 reoperated patients, all were confirmed to have active pericardial bleeding. Scintigraphic localization of abnormal blood pools within the pericardium corresponded to the sites at which active bleeding was witnessed at reoperation. The abnormal bleeding was etiologically related to the tamponade state, with marked improvement in hemodynamics after reoperation. Nine additional patients were reoperated for presumed tamponade after RNV revealed an exaggerated halo of photon deficiency surrounding the cardiac chambers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496278 TI - Relationship between lipids and angiographically defined coronary artery disease in Japanese patients. AB - The relationship between the severity and extent of coronary artery disease (CAD) and the lipid profiles was evaluated in 120 Japanese male patients, who underwent coronary angiography. Analysis of the lipid quartile distribution showed that the percentage of patients with significant CAD increased as the total cholesterol (TC) increased and high-density lipoprotein cholesterol (HDL-C) decreased. In addition, as the number of vessels with marked coronary artery stenosis increased, TC and TC/HDL-C increased while HDL-C decreased. However, within this population, triglyceride level, high blood pressure, and smoking were not significantly associated with coronary angiographic findings. PMID- 6496279 TI - Relationship of specific coronary lesions and regional left ventricular dysfunction to prognosis in survivors of sudden cardiac death. AB - We prospectively evaluated the relationship of specific coronary arterial and left ventricular segments to subsequent clinical outcome in 80 persons who were survivors of sudden cardiac death and had failed conventional antiarrhythmic therapy. There were 68 men and 12 women with an average age of 51 years who were treated with investigational antiarrhythmic agents, rendered asymptomatic, and followed for 16 +/- 14 (SD) months. At the end of the study 48 patients (60%) were alive and asymptomatic while 32 (40%) had experienced either recurrent syncope (five) or sudden cardiac death (27). The independent relationship of clinical and angiographic variables was performed in a univariate fashion using a Kaplan-Meier survival analysis and then multivariate logistic analysis was used to simultaneously consider all clinical and arteriographic variables. The results reconfirmed the importance of ejection fraction and left ventricular filling pressure on outcome. However, coronary arterial and left ventricular segmental analyses provided additional predictive power. Specifically, the survival outcome was found to be inversely related to the degree of proximal left anterior coronary (LAD) arterial narrowing: at 1 year 90% of patients with minimal LAD narrowing were alive/asymptomatic in contrast with 70% who had partial and 40% who had complete proximal LAD obstruction (p less than 0.005). Analysis of the posterobasal left ventricular segment wall motion demonstrated that 100% of patients with minimal dysfunction were alive/asymptomatic at 1 year, whereas only 52% of patients with severe dysfunction were alive (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496281 TI - The role of Holter monitoring in patients with recurrent sustained ventricular tachycardia: an electrophysiologic correlation. AB - The significance of spontaneous ventricular premature depolarization (VPD) frequency and severity in patients with sustained ventricular tachycardia undergoing serial electrophysiologic studies (EPS) are unknown. Nineteen patients with sustained ventricular tachycardia were studied with 24-hour Holter recordings prior to control EPS and prior to each drug trial. Successful drug or surgical treatment (with the exception of amiodarone) was based upon noninducibility of ventricular tachycardia in the laboratory. Among the eight noninducible and nonamiodarone medically treated patients, two (25%) had significant VPD reduction and/or Lown class improvement. The remaining six (75%) had no change or worsening of Holter findings, despite noninducibility of sustained VT. Among the six amiodarone-treated patients, five of whom were persistently inducible prior to discharge, four (66%) had improved and two (33%) had worsened Holter findings compared to control. None of the five (100%) surgically managed patients were inducible postoperatively, and three of the five (60%) had no change or worsening of Holter findings. We conclude that (1) EPS are superior to Holter findings in assessing successful management; and (2) Holter findings may be concordant or discordant during EPS serial drug trials or following surgery and therefore cannot predict the success or failure of the intervention. PMID- 6496280 TI - Prognostic implications of complicated ventricular arrhythmias early after hospital discharge in acute myocardial infarction: a serial ambulatory electrocardiography study. AB - To assess the prevalence and prognostic implications of complicated ventricular ectopic depolarizations (VEDs) after hospital discharge in patients with acute myocardial infarction (AMI), we obtained serial 24-hour Holter recordings in 85 patients during the first 6 weeks after AMI. Recordings were obtained during two coronary care unit time intervals, two hospital ward time intervals, and during four weekly time intervals after discharge. Complicated VEDs were defined as unifocal VEDs greater than or equal to 10/1000 beats for 24 hours, multiform VEDs, pairs, or ventricular tachycardia. At 1 year follow-up, there were nine cardiac deaths (six sudden deaths and three deaths from recurrent AMI). The mean left ventricular ejection fraction at discharge in the cardiac death patients was 29 +/- 12% (sudden death patients 24 +/- 11% and AMI death patients 40 +/- 6%) compared to 49 +/- 13% in the survivors (p less than 0.001). Patients with complicated VEDs at discharge (2 weeks after AMI) or during the first 4 weeks after discharge (3 to 6 weeks after AMI) were significantly more likely to have sudden death at follow-up compared to patients without complicated VEDs. Of the six sudden death patients, four (66%) had complicated VEDs at discharge compared to 18 of 68 survivors (26%) (p less than 0.05). One of three patients who died of recurrent AMI had complicated VEDs. No Holter data were obtained at hospital discharge in eight of the survivors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496282 TI - Acute electrophysiologic effects of bethanidine sulfate in patients with ventricular tachycardia or fibrillation. AB - Ten patients with a history of ventricular tachycardia or ventricular fibrillation underwent electrophysiologic study with programmed stimulation before and 90 minutes after oral administration of bethanidine sulfate, 20 mg/kg. Mean plasma bethanidine concentration was 2.62 +/- 2.2 (+/- SD) micrograms/ml at the start of repeat testing. This dose of bethanidine produced no effect on sinus node function, atrioventricular conduction, or atrial or ventricular refractoriness. Ventricular tachycardia or fibrillation, inducible in all patients during the control study, could still be initiated by ventricular stimulation in 9 of 10 patients after bethanidine. Bethanidine suppressed the ability to initiate an arrhythmia in one patient with ventricular fibrillation during control stimulation. Orthostatic hypotension was seen in all patients despite pretreatment with the tricyclic antidepressant, protriptyline, 15 mg every 8 hours. The results suggest that bethanidine has few electrophysiologic effects and is of limited efficacy during electrophysiologic testing in patients with life-threatening ventricular arrhythmias. PMID- 6496283 TI - The electrophysiologic effects of upright posture. AB - In order to determine the effects of upright posture on the electrophysiologic properties of the human heart, 12 patients underwent electrophysiologic studies in the supine and upright positions. Compared to supine, the upright position significantly reduced basic cycle length from 818 +/- 111 to 680 +/- 141 msec, sinoatrial conduction time from 186 +/- 94 to 135 +/- 56 msec, corrected sinoatrial recovery time from 206 +/- 104 to 108 +/- 55 msec, interatrial conduction time from 76 +/- 17 to 70 +/- 16 msec, and the AV nodal conduction time (AH interval) from 88 +/- 19 to 78 +/- 14 msec (all p less than 0.05). Right intra-atrial and His-Purkinje (HV interval) conduction times were not altered. When the subjects assumed the upright position, the effective refractory periods of the right atrium, atrioventricular node, and right ventricle decreased significantly at basic and paced cycle lengths. For the group as a whole, the upright posture did not significantly augment repetitive responses to atrial and ventricular extrastimuli. PMID- 6496284 TI - Clinical effects of digoxin on sinus node and atrioventricular node function after pharmacologic autonomic blockade. AB - The effects of digoxin on sinus node and atrioventricular (AV) node function were studied in 18 patients (mean age 53.6 years) with normal intrinsic heart rates. Electrophysiologic testing was performed both during basal state and after autonomic blockade with propranolol and atropine. Full digitalization was achieved by intravenous administration of digoxin (0.02 mg/kg) given in three divided doses over a 24-hour period. The following day, after a basal recording, autonomic blockade was again induced and the study was repeated. During basal state, digoxin significantly prolonged the sinus cycle length (SCL) (p less than 0.01) and the AH interval (p less than 0.01). However, when the intrinsic sinus node functions were compared (i.e., the values obtained after autonomic blockade), digoxin did not produce significant changes in intrinsic SCL, corrected sinus node recovery time, and sinoatrial conduction time. No significant changes were noted even in the intrinsic AH interval and AV nodal refractory periods. These findings suggest that: (1) intravenous administration of digoxin in therapeutic doses does not produce any depression of the intrinsic functions of the sinus node and AV node; and (2) the depressant effects induced by digoxin during basal state appear to be mediated through the autonomic nervous system. PMID- 6496285 TI - Chronic administration of amiodarone and thyroid function: a follow-up study. AB - In order to evaluate the effects of amiodarone on thyroid function in chronically treated patients, 43 consecutive patients, who had been taking a mean weekly dose of 1420 +/- 488 mg for more than 9 months (mean 16.5 months), were studied. In a first evaluation, three patients with hypothyroidism and two with hyperthyroidism were discovered. In the remaining 38 patients, mean T4 (131 +/- 38 nmol/L) and rT3 (0.85 +/- 0.3 nmol/L) levels were significantly higher than reference values (p less than 0.05 and p less than 0.001, respectively), and mean T3 levels (1.89 +/- 0.73 nmol/L) were significantly lower (p less than 0.001). Thirteen patients showed hyperresponsiveness to thyrotropin-releasing hormone (TRH) stimulation testing. In a second evaluation, performed 12 to 18 months later, two new cases of hypothyroidism were discovered. T3 levels showed significantly lower values (p less than 0.02) than in the first evaluation, whereas basal thyroid-stimulating hormone levels and levels 30 and 60 minutes after TRH stimulation were significantly higher than those in the first evaluation (p less than 0.001). Five new hyperresponders to TRH were found. In the present series, the progressive appearance of clinical thyroid dysfunction with an elevated total incidence (16%) is demonstrated. Moreover, a progressively high prevalence of hyperresponsiveness to TRH stimulation is shown. These findings indicate that chronic amiodarone administration may carry a high risk of thyroid dysfunction. PMID- 6496286 TI - Concomitant calcium antagonist plus isosorbide dinitrate therapy for markedly active variant angina. AB - The present study was performed to assess the efficacy of concomitant calcium antagonist/isosorbide dinitrate therapy in patients with frequent episodes of variant angina and to compare such combination therapy with isosorbide dinitrate alone. We enrolled nine such patients (six men and three women, aged 47 +/- 9 [mean +/- standard deviation] years) in a long-term comparison of (1) oral isosorbide dinitrate (117 +/- 63 mg per day) alone, (2) verapamil (453 +/- 75 mg per day) + isosorbide dinitrate (given in the same dose as stated above), and (3) nifedipine (71 +/- 14 mg per day) + isosorbide dinitrate (also given in the same dose as stated), each administered for 2 months. During isosorbide dinitrate therapy, these nine patients averaged 23.7 +/- 37.3 chest pains per week, consumed 24.4 +/- 47.4 sublingual nitroglycerin tablets per week, and demonstrated 46.5 +/- 43.2 episodes per week of transient ST segment deviations on calibrated two-channel Holter monitoring. During therapy with verapamil/isosorbide dinitrate and nifedipine/isosorbide dinitrate, the frequency of angina and ST segment deviations was dramatically reduced (verapamil/isosorbide dinitrate, 3.9 +/- 3.6 chest pains per week and 3.5 +/- 2.6 ST segment deviations per week, p less than 0.05; nifedipine/isosorbide dinitrate, 3.1 +/- 4.0 chest pains per week and 5.5 +/- 6.6 ST segment deviations per week, p less than 0.05). In all respects, verapamil/isosorbide dinitrate and nifedipine/isosorbide dinitrate were similar to one another.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496287 TI - Reflex heart rate and blood pressure changes during ST segment elevation in patients with variant angina. AB - Responses of heart rate and blood pressure to transient myocardial ischemia were analyzed in patients with variant angina. Heart rate changes during ST segment elevation were examined by means of a Holter ECG monitoring system. All 27 ST segment elevations from 10 patients with anterior ischemia were accompanied by an increase in heart rate by 12 +/- 2 bpm (mean +/- SEM, p less than 0.001) at peak ST segment elevation. With inferior ischemia in nine patients, heart rate decreased significantly by 4 +/- 1 bpm (n = 28, p less than 0.001). However, 9 of these 28 ST segment elevations showed a biphasic response of heart rate, that is, an initial increase and subsequent decrease. Such heart rate changes were not different between ST segment elevations with and without chest pain. With chest pain systolic blood pressure rose in anterior ischemia by 42 +/- 5 mm Hg (n = 10, p less than 0.001) but fell in inferior ischemia by 22 +/- 8 mm Hg (n = 7, p less than 0.05). We conclude that a different cardiovascular reflex occurs in response to inferior versus anterior ischemia and it is independent of chest pain. PMID- 6496289 TI - Relationship between auscultatory events and structural abnormalities in mitral valve prolapse: a two-dimensional echocardiographic evaluation. AB - The purpose of this study was to examine the relationship between the valvular abnormalities and auscultatory findings of patients with mitral valve prolapse (MVP). Forty patients with typical auscultatory and two-dimensional echocardiographic (2DE) findings were studied. Eleven of 14 patients with anterior leaflet MVP (group I) had mid to late systolic clicks without murmurs of mitral regurgitation, while eight of nine patients with posterior leaflet prolapse (group II) and 13 of 17 patients with combined anterior and posterior prolapse (group III) had murmurs of mitral regurgitation. In each subgroup the mitral anulus size was greater than a control group (group I = 3.8 +/- 0.1 cm, p less than 0.025; group II = 3.9 +/- 0.1 cm, p less than 0.005; group III = 4.2 +/ 0.2 cm, p less than 0.001; and control = 3.4 +/- 0.1 cm), but the largest anulus was present in patients with combined prolapse. As demonstrated by 2DE, prolapse of a single mitral leaflet may occur in many instances of MVP. Murmurs of mitral regurgitation occur frequently when the posterior mitral leaflet alone prolapses, while isolated clicks are found with anterior mitral leaflet prolapse. PMID- 6496288 TI - Nuclear magnetic resonance analysis of acute and chronic myocardial infarction in dogs: alterations in spin-lattice relaxation times. AB - The purpose of this study was to evaluate the effects of acute and chronic ischemic injury on myocardial spin-lattice relaxation times (T1) in dogs. Ligation of the left anterior descending coronary artery was performed on 23 dogs which were divided into four experimental groups and killed at 3 hours (n = 6), 4 days (n = 6), 21 days (n = 5), and 56 days (n = 6) after coronary occlusion. T1 was measured in vitro with a 2.5 kg nuclear magnetic resonance (NMR) spectrometer using tissue from ischemic and control areas of the myocardium. Both the 3-hour and 4-day groups showed prolongations in T1 (p less than 0.01) for tissue from the ischemic area. In the 21-day group, two infarcts showed an increase in T1, two showed a decrease in T1, and one showed no significant change. The 56-day old infarcts had a lower mean value for T1 than control myocardium (p less than 0.01). The differences in myocardial water content between control and infarcted myocardium were found to parallel changes in T1 values in each experimental group. Pathologic examination of the myocardial scar from 21- and 56-day-old infarcts revealed extensive fibrosis in the infarcts with lower T1 values and tissue water contents than control myocardium. We conclude that myocardial edema in 3-hour and 4-day-old infarcts results in association with prolongations in T1. Twenty-one-day-old infarcts may be edematous (with increased T1) or fibrotic (with T1 values lower than normal myocardium), while 56-day-old infarcts are fibrotic and have shorter T1 values than normal myocardium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496290 TI - Natural history of subarterial infundibular ventricular septal defect. AB - Development of aortic valvular deformities was studied retrospectively in 395 inpatients with subarterial infundibular ventricular septal defect (siVSD). Aortic valvular deformities included prolapse into siVSD without aortic regurgitation (77 patients), prolapse and aortic regurgitation (95 patients), and aneurysm of the sinus of Valsalva (36 patients). No aortic valvular deformity was found in 187 patients, and 111 of these 187 patients had associated pulmonary hypertension. Prolapse and regurgitation of the aortic valve developed most frequently at the age 5 to 8 years. Aneurysm of the sinus of Valsalva was not found before the age of 10 years but began to develop during the teens and was diagnosed most frequently in the twenties. Patients with pulmonary hypertension did not develop aortic valvular deformities except in one instance. All inpatients with siVSD and without pulmonary hypertension over the age of 30 years had developed some aortic valvular deformities. PMID- 6496291 TI - The prognostic significance of proteinuria: the Framingham study. AB - Despite considerable clinical experience with proteinuria, its prognostic meaning in the ambulatory general population is poorly documented. From a 16-year study of 5209 men and women in the Framingham cohort it is evident that proteinuria, even in casual urine specimens, carries substantial risk with the mortality rate increased threefold. Proteinuria was three times as common in hypertensive persons and also occurred to excess in diabetic patients and in persons with cardiac enlargement. In the absence of these factors, proteinuria was so uncommon that its risk could not be accurately assessed. Among persons with these associated risk factors, those with proteinuria have higher death rates than those without proteinuria. In men, overall mortality and cardiovascular mortality rates remained significantly increased even when other contributors to risk were taken into account. Proteinuria in the ambulatory general population is not a benign condition and carries a serious prognosis. It appears to reflect widespread vascular damage. PMID- 6496292 TI - Right ventricular myocardial contusion simulating constrictive pericardial disease. PMID- 6496293 TI - Recurrent systemic emboli following myocardial contusion. PMID- 6496294 TI - Traumatic right ventricular tachycardia. PMID- 6496295 TI - Two-dimensional echographic visualization of free ventricular wall rupture in acute anterior myocardial infarction. PMID- 6496296 TI - Delayed abrasion perforation of two intra-aortic balloons. PMID- 6496297 TI - Detection of posterior mediastinal lymphoma by pulsed Doppler echocardiography. PMID- 6496298 TI - Right ventricular metastasis of cervical squamous cell carcinoma. PMID- 6496299 TI - Echocardiographic diagnosis of right atrial thromboembolism resulting in massive pulmonary embolization. PMID- 6496300 TI - Origin of the left anterior descending coronary artery from the left mammary artery. PMID- 6496301 TI - Nonimmunologic hydrops fetalis associated with congenital aortic valvular stenosis. PMID- 6496302 TI - Group A beta-hemolytic streptococcus endocarditis. PMID- 6496304 TI - Computers and health care. PMID- 6496303 TI - Visibility for your pharmacy. How to stand out in a crowd. PMID- 6496305 TI - Will your user-friendly system bite your hand after six months? PMID- 6496306 TI - Can I afford a computer? PMID- 6496307 TI - The pharmacist's responsibility to determine limits to prescribing authority. PMID- 6496308 TI - New drugs and drug delivery systems in the year 2000. PMID- 6496309 TI - Quick to promote, slow to warn. PMID- 6496310 TI - Adopt an orphan disease: hemochromatosis. PMID- 6496311 TI - Pharmacists were sabotaging my patient care. PMID- 6496312 TI - Identifying the pharmacist's professional status. PMID- 6496313 TI - The accreditation of academic programs in industrial hygiene. AB - The American Academy of Industrial Hygiene has initiated a program to accredit academic programs in industrial hygiene. Guidelines, criteria, and procedures to be employed by the Accreditation Committee are summarized, along with a status report of activities currently underway. PMID- 6496314 TI - 1984 Stokinger lecture. Some questions and opinions on issues in toxicology and risk assessment. PMID- 6496315 TI - Workplace protection factor measurements on powered air-purifying respirators at a secondary lead smelter: results and discussion. AB - A study was conducted at a secondary lead smelter to evaluate the workplace performance of the 3M W-344 and Racal AH3 powered air-purifying respirators equipped with helmets and high efficiency filters. The research protocol developed for the study has been described in a companion paper. The results of the study indicate that the mean lead concentrations, measured inside the facepiece of both PAPRs, were significantly less than the OSHA lead exposure limit of 50 micrograms/m3. The means of the workplace protection factor measurements on both PAPRs were significantly less than the PAPR selection guide protection factor classification of 1000. Correlation analysis of preshift quantitative fit factors and corresponding workplace protection factors indicated no linear association between these two measures of performance. This finding suggests that for PAPRs equipped with helmets and high efficiency filters quantitative fit factors as presently determined are not indicative of the workplace protection which the respirators provide. Since the PAPR protection factor classification of 1000 was originally based on quantitative fit factors, the lack of a demonstrated association between quantitative fit factors and workplace protection as found in this study may explain why their performance was significantly less than expected. PMID- 6496316 TI - Laboratory validation and field verification of a new passive air monitoring badge for sampling ethylene oxide in air. AB - A new diffusion colorimetric air monitoring badge for sampling ethylene oxide is described. The Du Pont Pro-Tek C-70 badge has been laboratory validated over the range of 4-375 ppm-hours (0.5-47 ppm on an 8-hour TWA) using standard spectrophotometer readout in 1 centimeter (10 mm) cells. The lower range can be extended to 2 ppm-hours (0.25 ppm) by using 4 cm (40 mm) cells. The badge has an overall sampling and analytical method accuracy of +/- 13.5%. It meets NIOSH accuracy criteria and has a mean coefficient of variation CVT = 0.059. The badge has no temperature, pressure, relative humidity or face velocity effects over practical ranges. The response time is adequate to sample peak concentrations over short time periods. The badge may be used to determine ambient formaldehyde levels if suspected to be present along with ethylene oxide. Badges are shown to agree very well with the industry accepted and proposed ASTM pump/charcoal tube method in three extensive plant field tests. Badges were more precise than the charcoal tube/pump method in all field tests conducted. PMID- 6496317 TI - Field validation study of the MDA Instant Working Level Meter in a high gamma background mine environment. AB - Accurate and reproducible radon daughter measurements are essential to protect workers in the mining industry and assure compliance with federal regulations. The precision and accuracy of the MDA Model 811 Instant Working Level Meter (IWLM) has been questioned when it is used in a high gamma environment of an underground uranium mine due to the increased statistical uncertainty associated with the background radiations. Comparative side by side sampling at a single underground mine station exhibiting a 3.0 mR/h "gamma background" was conducted utilizing the IWLM, the Kusnetz and the Tsivoglou methods. A total of fifty sets of samples were taken, with half using an unshielded IWLM and the other half using a lead shield to reduce the effect of the high gamma background radiation. IWLM, Kusnetz and "baseline" Tsivoglou measurements were then analyzed. A significantly large error was associated with the IWLM in both the shielded and unshielded data groups. PMID- 6496318 TI - Vapor pressure and solvent vapor hazards. AB - This paper discusses applications of vapor pressure to industrial hygiene. Vapor pressure is the quantitative term characterizing solvent volatility; it is also equivalent to the concentration of solvent vapor at the liquid surface. The ratio between this concentration at the source and the acceptable concentration at the breathing zone is an intrinsic property of each chemical but varies over 6 orders of-magnitude among common organic chemicals. The name Vapor Hazard Ratio (VHR) is introduced quantifying this ratio; and its logarithm is termed the Vapor Hazard Index (VHI). Thus, while vapor pressure is directly relatable to the economic effects of solvent evaporation and to airborne concentrations, the VHI has the added component of occupational toxicity. To be used safely and/or acceptably within the workplace, vapors must be diluted from concentrations at the source by a ratio equal to or greater than the Vapor Hazard Ratio, either by general or local exhaust ventilation. It is argued that the VHI can be used currently to predict the relative hazards of vapor concentrations of proposed substitute solvents to be used in similar settings and in hazard communication programs, and in the future with vapor dilution profiles to anticipate achieving quantitative compliance levels with new processes, work practices or ventilation controls. A review of the pertinent vapor pressure literature is also provided. PMID- 6496319 TI - Determination of benzoic acid in air. AB - A gas chromatographic method is described for direct determination of free benzoic acid in air samples. Benzoic acid is absorbed from air on Porapak Q packing in the presence of other compounds, thermally desorbed at 240 degrees C with helium flow into a capillary column, and detected with a flame ionization detector. The method is calibrated by injecting benzoic acid standard solutions into the Porapak Q. The method was validated with dynamic standards and recovery yields were good. Benzoic acid levels of 0.1-1.0 ppm (v/v) in air can be determined with sampling volumes of 8-24 L. PMID- 6496320 TI - Timing of the right ventricular apical electrogram during sustained ventricular tachycardia: relation to surface QRS morphology and potential clinical implications. AB - To evaluate the timing of the right ventricular (RV) apical electrogram in relation to the QRS complex during ventricular tachycardia (VT), 94 episodes of sustained uniform VT were analyzed in 56 patients. The timing of the RV apical electrogram varied and could be recorded from 33 ms before to 180 ms (mean 77 +/- 44 ms) after the onset of the QRS complex. The timing of the RV apical electrogram, expressed both as an absolute value and as a percentage of a QRS width, was significantly different when right bundle branch block (BBB) morphology VT (95 +/- 37 ms) and left BBB morphology VT (40 +/- 341) were compared (p less than 0.001). The timing of the RV apical electrogram, expressed as a percentage of the QRS width, was significantly different when VT with different axes were compared in the right BBB VT group (p less than 0.01). A left BBB VT, as compared to a right BBB VT, predicted an RV apical electrogram occurring in the first 35% of the QRS with a sensitivity of 74%, a specificity of 91%, and a positive predictive value of 84%. Right BBB VT with a right and inferior axis were usually associated with the latest occurring RV apical electrogram. A right BBB VT with a right and inferior axis predicted an RV apical electrogram inscribed in the latter half of the QRS with a sensitivity of 65%, a specificity of 84% and a positive predictive value of 80%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496322 TI - Early changes in plasma and urinary potassium in diuretic-treated patients with systemic hypertension. AB - Two groups of patients with uncomplicated systemic hypertension were studied. Group 1 included 11 patients who had overt hypokalemia with diuretic drug treatment, and group 2 included 11 patients who remained normokalemic. After baseline studies without treatment were performed, both groups received hydrochlorothiazide, 50 mg twice daily. Plasma potassium (PK) was significantly reduced within the first day of treatment and stabilized by day 7 in both groups. The average decrease in PK was 1.0 +/- 0.1 mEq/liter (p less than 0.01) in the first group and 0.6 +/- 0.2 mEq/liter (p less than 0.01) in the second group. Cumulative losses of K were approximately 200 mEq in the hypokalemic group and were minimal in the normokalemic group as assessed by 24-hour urinary collections. Patients in the hypokalemic group also had a greater reduction in body weight and blood pressure. Supplementation with KCl, 96 mEq/day, or triamterene, 200 mg/day, in 9 hypokalemic patients resulted in an increase of PK to approximately 3.5 mEq/liter leveling off by day 7, and a cumulative K retention of approximately 200 mEq. Thus, overt thiazide-induced hypokalemia was associated with small and biologically unimportant losses of K from body stores. With replacement therapy the estimated amount of retained K was also small. PMID- 6496321 TI - Propafenone for refractory ventricular arrhythmias: correlation with drug plasma levels during long-term treatment. AB - The efficacy of propafenone, a new antiarrhythmic drug, was studied in 21 patients with ventricular arrhythmias refractory to previous antiarrhythmic medications. Group A included 10 patients with chronic ventricular premature complexes (VPCs), 6 of whom had nonsustained ventricular tachycardia (VT) and 4 of whom had recurrent, sustained VT; all received propafenone, 900 mg/day. Group B included 11 patients, all with chronic VPCs, 9 of whom had nonsustained VT and 5 of whom had sustained VT; all received propafenone, 450 mg/day. Drug efficacy was evaluated as a 70% or greater reduction in VPC frequency with complex VPC abolition in ambulatory monitoring and suppression of nonsustained VT and sustained VT during a follow-up period up to 154 +/- 58 days in group A and 96 +/ 42 days in group B. Drug plasma levels were measured during chronic therapy in pharmacologic steady state. In group A, propafenone reduced the frequency of chronic VPCs in 9 patients and abolished nonsustained VT in 4 of 6 and sustained VT in 3 of 4; in group B, propafenone reduced the frequency of chronic VPCs in 6 patients and abolished nonsustained VT in 6 of 9 and sustained VT in 3 of 5. Two patients with recurrences of sustained VT in this group were later successfully treated with propafenone, 900 mg/day; overall, 8 of 9 patients with recurrences of sustained VT were successfully treated with 900 mg/day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496323 TI - Long-term beneficial effects of endralazine, a new arteriolar vasodilator at rest and during exercise capacity in chronic congestive heart failure. AB - Hemodynamic measurements were made at rest and during submaximal and maximal exercise in 12 patients with chronic congestive heart failure before and after oral endralazine (EN). After acute assessment, patients received endralazine, twice daily, for a mean of 2.8 months, when hemodynamic measurements were repeated. The drug was withdrawn for 3 to 4 days and subsequently reintroduced. Three patients with greatly elevated pulmonary wedge pressures were assessed after 30 mg of isosorbide dinitrate, which was also chronically administered. Resting mean cardiac and stroke volume indexes increased by 44 and 33%, respectively (p less than 0.01), with concomitant reduction of the systemic resistance. This improvement was maintained on a long-term basis in 8 of the 11 surviving patients. Withdrawal and subsequent reintroduction of EN confirmed that there was worsening of left ventricular dysfunction in the other 3 subjects. Chronic but not acute therapy produced a modest reduction in wedge pressure. At maximal exercise, cardiac and stroke volume indexes increased by 29 and 18%, respectively (p less than 0.01), after EN; the duration of exercise increased in 7 of the 10 subjects after acute therapy and this was maintained on a long-term basis. Mean creatinine clearance increased by 34% (p less than 0.01). The results confirm that EN produces acute and long-term hemodynamic and functional improvement without tolerance in congestive heart failure. PMID- 6496324 TI - Failure of low doses of amrinone to produce sustained hemodynamic improvement in patients with severe chronic congestive heart failure. AB - Although amrinone produces acute hemodynamic improvement in patients with severe chronic congestive heart failure (CHF), it has not produced clinical benefits in long-term controlled trials. To determined if the administration of subtherapeutic doses of amrinone may account for its lack of efficacy in these studies, the dose requirements of the drug were investigated in 30 patients with severe CHF. Doses of 100 mg of oral amrinone produced moderate increases in cardiac index (0.35 liters/min/m2) and decreases in pulmonary capillary wedge pressure (6.8 mm Hg) and systemic vascular resistance (16%) (all p less than 0.01); these effects, however, were short-lived (less than 2.5 hours). Doses of 200 mg of oral amrinone produced marked increases in cardiac index (0.56 liters/min/m2) and substantial decreases in left ventricular filling pressure (9.9 mm Hg) and systemic vascular resistance (30%) (all p less than 0.01), and these effects persisted for longer than 4 hours. Only 4 patients showed hemodynamic responses with 100 mg of the drug that were sufficiently marked and long-lasting to merit chronic therapy, whereas 28 patients had such a response with the 200-mg dose. When 200 mg of amrinone was administered orally every 8 hours, sustained hemodynamic benefits were seen for 48 hours. However, 16 of 22 patients who received 600 mg of the drug daily for more than 1 week had intolerable adverse reactions that required drug withdrawal. In conclusion, hemodynamically effective doses of amrinone (600 mg/day) cannot be tolerated for long periods by most patients with severe chronic CHF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496325 TI - Calcification of aortic versus mitral porcine bioprosthetic heart valves: a radiographic study comparing amounts of calcific deposits in valves explanted from the same patient. AB - Calcium detected by radiography was compared in 10 pairs of aortic and mitral glutaraldehyde-treated porcine bioprosthetic heart valves explanted from 10 patients (7 men and 3 women), aged 19 to 68 years (mean 43). Both valves of 6 pairs of valves had undergone primary tissue failure (revealed by cardiac catheterization and angiography) and 1 valve of the other 4 pairs of valves had undergone primary tissue failure. These porcine valves had been implanted from 2 1/4 to 9 years (mean 5 3/4). All 20 explanted valves contained calcium. The grade of calcium was the same in 4 pairs of valves (grade 2+ or 3+), and 1 grade different in 4 pairs of valves (grade 1+ to 4+), with the greater calcium evenly divided between the 2 valve positions. There was more than 1 grade greater mitral valve calcium in 2 pairs of valves (grade 3+ and 4+ mitral vs 1+ and 2+ aortic, respectively). Thus, calcium is usually present in both aortic and mitral valve positions when bioprosthetic valves of this type in either valve position fail as a result of primary tissue failure, and radiographic calcium in porcine bioprosthetic valves is usually similar in grade in both the aortic and mitral valve positions. PMID- 6496326 TI - Mechanisms of compensation and decompensation in dilated cardiomyopathy. AB - Left ventricular (LV) function was evaluated in 32 patients with dilated cardiomyopathy (DC) who underwent cardiac catheterization during the past 6 years (group 4), and the results were compared with the data of 30 normal subjects (group 1). The patients were divided into mildly (group 2, 12 patients) and severely symptomatic subgroups (group 3, 20 patients). DC was characterized by dilated and poorly contracting left ventricle with increased muscle mass, reduced cardiac output and elevated systemic vascular resistance. LV volume was larger, ejection fraction was lower, and end-diastolic and end-systolic stresses were higher in group 3 than in groups 1 and 2. No significant differences were seen in LV muscle mass and wall thickness between groups 2 and 3. A significant inverse correlation was seen between ejection fraction and end-systolic stress in patients with DC (Y = -0.05x + 48.7, r = 0.57, p less than 0.01). The slope of the correlation line between end-systolic stress and volume in DC (Y = 1.20x + 135, r = 0.52, p less than 0.02) was less steep than that of normal subjects (Y = 3.68x + 40, r = 0.64, p less than 0.001). These observations indicate that the primary problem of DC is depressed contractility.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496327 TI - Right oblique subxiphoid view for two-dimensional echocardiographic visualization of the right ventricle in congenital heart disease. AB - Two-dimensional echocardiography in the right oblique subxiphoid view (ROSV) was used to visualize all right ventricular components in 351 patients younger than 2 years of age (100 normal and 251 with various types of congenital heart disease). The ROSV, which is anterior and parallel to the ventricular septum, displays all right-sided cardiac components, the left atrium and the aorta. This view provided the correct diagnosis in patients with pulmonary stenosis or atresia with intact ventricular septum, Ebstein's anomaly, tricuspid atresia, infundibular ventricular septal defect, tetralogy of Fallot and truncus arteriosus. In all patients studied with the ROSV, an excellent definition of morphologic characteristics, equivalent to that in the right oblique axial angiocardiographic view, was achieved. The ROSV should be used routinely to delineate the right ventricular anatomy in all infants with congenital heart disease. PMID- 6496328 TI - Cardiac involvement in myotonic muscular dystrophy (Steinert's disease): a prospective study of 25 patients. AB - The presence, degree and frequency of disorders of cardiac conduction and rhythm and of regional or global myocardial dystrophy or myotonia have not previously been studied prospectively and systematically in the same population of patients with myotonic dystrophy. Accordingly, 25 adults with classic Steinert's disease underwent electrocardiography, 24-hour ambulatory electrocardiography, vectorcardiography, chest x-rays, echocardiography, electrophysiologic studies, and technetium-99m angiography. Clinically important cardiac manifestations of myotonic dystrophy reside in specialized tissues rather than in myocardium. Involvement is relatively specific, primarily assigned to the His-Purkinje system. The cardiac muscle disorder takes the form of dystrophy rather than myotonia, and is not selective, appearing with approximately equal distribution in all 4 chambers. Myocardial dystrophy seldom results in clinically overt ventricular failure, but may be responsible for atrial and ventricular arrhythmias. Since myotonic dystrophy is genetically transmitted, a primary biochemical defect has been proposed with complete expression of the gene toward striated muscle tissue, whether skeletal or cardiac. Specialized cardiac tissue and myocardium have close, if not identical, embryologic origins, so it is not surprising that the genetic marker affects both. Cardiac involvement is therefore an integral part of myotonic dystrophy, targeting particularly the infranodal conduction system, to a lesser extent the sinus node, and still less specifically, the myocardium. PMID- 6496329 TI - Exercise testing and hemodynamic performance in healthy elderly persons. AB - To determine the effect of age on cardiovascular performance, 39 healthy elderly men and women, 70 to 83 years old, underwent treadmill thallium-201 exercise perfusion imaging and radionuclide equilibrium angiography at rest and during supine bicycle exercise. Five volunteers who had a positive exercise thallium test response were excluded from the study. Radionuclide left ventricular ejection fraction, regional wall abnormalities, relative cardiac output, stroke volume, end-diastolic volume and end-systolic volume were measured. Seventy-four percent of the subjects maintained or increased their ejection fraction with exercise. With peak exercise, mean end-diastolic volume did not change, end systolic volume decreased and cardiac output and stroke volume increased. Moreover, in 35% of the subjects, minor regional wall motion abnormalities developed during exercise. There was no significant difference in the response of men and women with regard to these variables. However, more women than men had difficulty performing bicycle ergometry because they had never bicycled before. Subjects who walked daily performed the exercise tests with less anxiety and with a smaller increase in heart rate and systolic blood pressure. PMID- 6496330 TI - The heart in massive (more than 300 pounds or 136 kilograms) obesity: analysis of 12 patients studied at necropsy. AB - Observations are described in 12 massively obese patients (5 women, 7 men), aged 25 to 59 years (mean 37), who weighed 312 to more than 500 pounds (mean 381). Seven patients had had systemic hypertension, 4 hypersomnia or sleep apnea, 2 diabetes mellitus, and 1 patient symptomatic coronary artery disease. Five patients died suddenly from undetermined causes, 2 from right-sided congestive heart failure, 1 patient from acute myocardial infarction; 1 from aortic dissection; 1 from intracerebral hemorrhage; 1 from a drug overdose, and 1 soon after an ileal bypass. The heart weight was increased in all 12 patients. The heart weight to body weight ratio expressed as a percent ranged from 0.22 to 0.61 (mean 0.37) (normal for men 0.42 to 0.46 [mean 0.43], normal for women 0.38 to 0.46 [mean 0.40]). The left ventricular cavity was dilated in 11 patients and the right ventricular cavity in all 12. Only 2 patients (aged 42 and 59 years) had 1 or more major epicardial coronary arteries narrowed greater than 75% in cross sectional area by atherosclerotic plaque, 1 of whom had no symptoms of myocardial ischemia. Of 664 five-millimeter segments from the 4 major epicardial coronary arteries from 11 patients (mean 60 per patient), 431 (65%) were narrowed 0 to 25% in XSA, 143 (21%) were narrowed 26 to 50%, 73 (11%) were narrowed 51 to 75%, and 17 (3%) were narrowed 76 to 100%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496331 TI - Effects of acute coronary occlusion on hemodynamics in an adjacent coronary artery in dogs. AB - The effects of acute occlusion of 1 coronary artery on flow responses in another were studied in 24 open-chest dogs. Left circumflex (LC) flow was measured with and without LC stenoses before and during reactive hyperemia. In 19 dogs the left anterior descending artery (LAD) was occluded and measurements were repeated after 1 hour (group 1). Four dogs had measurements before and after 1 hour without LAD occlusion (group 2). In group 2 no systemic, left ventricular (LV) or coronary hemodynamic changes were observed after 1 hour. In group 1, an hour after LAD occlusion, heart rate and aortic pressure had not changed but stroke volume decreased slightly (-8 +/- 7%, mean +/- SD, p = not significant) and LV end-diastolic pressure had increased (2 +/- 3 mm Hg, p less than 0.05). Basal LC flow was not changed by less than 90% LC stenosis. Ninety percent LC stenosis decreased LC flow both before and after LAD occlusion. During reactive hyperemia without LC stenosis, LC flow decreased after LAD occlusion in 15 of 19 dogs (from 154 +/- 80 to 141 +/- 75 ml/min, p less than 0.05). With 60 and 80% LC stenoses, LC flow during reactive hyperemia decreased before LAD occlusion (110 +/- 62 and 74 +/- 40 ml/min, respectively), but decreased further (both p less than 0.05) after LAD occlusion (98 +/- 54 and 63 +/- 43 ml/min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496332 TI - Mechanism of inferior electrocardiographic ST-segment depression during acute anterior myocardial infarction in a baboon model. AB - Controversy exists concerning the mechanism of electrocardiographic (ECG) ST segment depression in leads remote from an area of acute myocardial infarction. Thus, 13 baboons were studied during ligation of the distal third of the left anterior descending coronary artery. The morphologic pattern of the ECG limb leads in the supine baboons resembled that of an asthenic human and did not change when the chest was opened. The visually apparent infarct area of the distal anterior wall was confirmed by epicardial ECG mapping 30 minutes after ligation, and by tissue creatine kinase and histologic study at 24 hours. All 13 baboons had ST depression in leads III and aVF of 0.1 to 1.2 mV at 30 minutes, and 11 of 13 had similar changes in lead II. Also, all 13 baboons had ST elevation in lead aVL (n = 10) or aVR (n = 11), suggesting that the ST vector from the infarct area was directed away from the inferior leads. In no baboon did inferoposterior wall ventricular epicardial mapping show evidence of myocardial ischemia, and mean creatine kinase content from the infarct sites was markedly lower than that from posteroinferior sites (12.7 +/- 2.8 vs 20.6 +/- 2.1 IU/mg protein, p less than 0.01). In addition, the inferoposterior myocardium was normal histologically. In conclusion, acute myocardial infarction often results in reciprocal ST depression at sites distant from the area of acute necrosis and need not represent "ischemia at a distance." PMID- 6496333 TI - Relation between mixed venous oxygen tension and pulmonary vascular tone during normoxic, hyperoxic and hypoxic ventilation in dogs. AB - To evaluate the relation between the oxygen tension of pulmonary arterial blood (PvO2) and pulmonary vascular resistance (PVR), an extracorporeal circuit was used to vary the PvO2 of blood perfusing the left lung in 3 groups of open-chest dogs mechanically ventilated with an inspired fraction of oxygen of 0.35 (group I), 0.21 (group II), or 0.10 (group III). Left lung pulmonary blood flow, left atrial pressure and perfusate, and systemic pH and PCO2 did not change significantly as PvO2 was varied over a range of 11 to 52 mm Hg in groups I and II. There was no correlation between decreases in PvO2 and the percent change in left lung PVR compared with baseline (PvO2 approximately 40 mm Hg) in group I (r = 0.12, difference not significant). In contrast, there was a significant correlation between decreases in PvO2 and the percent change from baseline in PVR in group II (r = -0.50, p less than 0.02). Left lung alveolar oxygen tension (PAO2) decreased significantly when PvO2 was at its lowest in group II (p less than PAO2 0.05). Both groups I and II had a significant pulmonary vasoconstrictor response to hypoxic ventilation, indicating that vasoreactivity was preserved in this model. The increase in PVR with hypoxia was significantly blunted in dogs perfused with blood that had a high PvO2 (41 +/- 12.4 mm Hg, group IIIa) compared with dogs perfused with blood that had a low PvO2 (25 +/- 6 mm Hg, group IIIb), despite comparable values for PAO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496334 TI - Use of intravenous verapamil for ventricular tachycardia. PMID- 6496335 TI - Aortic dissection masquerading as acute myocardial infarction: implication for thrombolytic therapy without cardiac catheterization. PMID- 6496336 TI - Acute myocardial infarction with angiographically normal coronary arteries. PMID- 6496337 TI - Prognostic significance of exercise-induced complex ventricular arrhythmias in coronary artery disease with normal and abnormal left ventricular ejection fraction. PMID- 6496338 TI - Mechanism of tachycardia using a nodofascicular Mahaim fiber. PMID- 6496339 TI - Subcostal M-mode echocardiography of atrial septum for diagnosis of atrial flutter. PMID- 6496340 TI - Interaction of amiodarone and diphenylhydantoin. PMID- 6496341 TI - Infection within a degenerated Starr-Edwards silicone rubber poppet in the aortic valve position. PMID- 6496342 TI - Combined atrial septal aneurysm and mitral valve prolapse: detection by two dimensional echocardiography. PMID- 6496343 TI - Aneurysm (redundancy) of the atrial septum (fossa ovale membrane) and prolapse (redundancy) of the mitral valve. PMID- 6496344 TI - Emergency differentiation of vasovagal syncope from Stokes-Adams attack. PMID- 6496345 TI - Lipomatous hypertrophy of the atrial septum: diagnosis by combined two dimensional echocardiography and computerized tomography. PMID- 6496346 TI - Diagnosis of aortic dissection by transesophageal echocardiography. PMID- 6496347 TI - Intracavitary echoes in the aortic arch in type III aortic dissection. PMID- 6496348 TI - Internal mammary arteriovenous fistula. PMID- 6496349 TI - Congestive heart failure cured by a Coude catheter. PMID- 6496350 TI - The worst heart disease. PMID- 6496351 TI - Noninvasive assessment of right ventricular systolic pressure in atrial septal defect. PMID- 6496352 TI - Pulmonary valve endocarditis. PMID- 6496353 TI - Sudden death during ambulatory monitoring. PMID- 6496355 TI - QT/QS2 ratio as index of automatic tone. PMID- 6496354 TI - Thallium-201 scintigraphy in left bundle branch block. PMID- 6496356 TI - Sudden death in a child with ventricular tachycardia. PMID- 6496357 TI - Changes in rest and exercise myocardial perfusion and left ventricular function 3 to 26 weeks after clinically uncomplicated acute myocardial infarction: effects of exercise training. AB - The effects of exercise training on exercise myocardial perfusion and left ventricular (LV) function in the first 6 months after clinically uncomplicated acute myocardial infarction (AMI) were assessed in 53 consecutive men aged 55 +/- 9 years. Symptom-limited treadmill exercise with thallium myocardial perfusion scintigraphy and symptom-limited upright bicycle ergometry with equilibrium gated radionuclide ventriculography were performed 3, 11 and 26 weeks after AMI by 23 men randomized to training and 30 randomized to no training. Peak cycle capacity increased in both groups between 3 and 26 weeks (p less than 0.01), but reached higher levels in trained than in untrained patients (803 +/- 149 vs 648 +/- 182 kg-m/min, p less than 0.01). Reversible thallium perfusion defects were significantly more frequent at 3 than at 26 weeks: 59% and 36% of patients, respectively (p less than 0.05), without significant inter-group differences. Values of LV ejection fraction at rest, submaximal and peak exercise did not change significantly in either group. The increase in functional capacity, i.e., peak treadmill or bicycle workload, that occurred 3 to 26 weeks after infarction was significantly correlated with the increase in peak exercise heart rate (p less than 0.001), but not with changes in myocardial perfusion or LV function determined by radionuclide techniques. Changes in myocardial perfusion or LV function do not appear to account for the improvement in peak functional capacity that occurs within the first 6 months after clinically uncomplicated AMI. PMID- 6496358 TI - Effect of successful thrombolytic therapy on right ventricular function in acute inferior wall myocardial infarction. AB - In 19 patients undergoing intracoronary fibrinolytic therapy for acute myocardial infarction, the site of coronary obstruction was in the proximal right coronary artery. Time between onset of symptoms and hospitalization was less than 4 hours. These patients were studied prospectively by radionuclide techniques immediately after admission, 48 hours and 4 weeks after AMI. Right and left ventricular (RV and LV) ejection fractions (EF) were calculated from gated blood pool scintigrams and the size of the LV perfusion defect was assessed by thallium-201 scintigraphy. Before the intervention, RV performance was significantly lower (RVEF 29 +/- 8%) than normal (53 +/- 7%). The size of the LV perfusion defect was relatively small (less than 25% of LV circumference), and as a consequence, LV pump function was only marginally impaired (LVEF 54 +/- 11%). Recanalization of the infarct artery was achieved in 12 patients (group A); in 7 patients the infarct artery remained occluded (group B). Early after the intervention (48 hours), RV performance in group A recovered significantly (RVEF: 30 +/- 9% vs 39 +/- 7%, p less than 0.01), and further improvement was noted at 4 weeks (RVEF 43 +/- 5%, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496359 TI - Diagnosis of acute myocardial infarction by detection of circulating cardiac myosin light chains. AB - A radioimmunoassay for human cardiac myosin light chains (CM-LC) was developed and evaluated as a selective diagnostic test for acute myocardial infarction (AMI). The assay had a sensitivity of 1.0 ng/ml (+/- 2 standard deviations) in serum. Eighty-three patients with confirmed AMI all showed an elevated plasma concentration of CM-LC at some time during the course of their illness. Of 9 patients from whom early blood samples were obtained, 7 had diagnostic concentrations within 6 hours from the onset of chest pain. Only 2 had an elevated total creatine kinase level at this time. CM-LC concentrations peaked on days 2 to 4, but remained elevated in patients with large AMIs for more than 1 week. In preinfarction syndrome, 8 of 15 patients had elevated CM-LC levels at least once. Of 15 patients with stable angina pectoris, only 1 patient, who had congestive heart failure, showed elevated light chain levels. CM-LC levels were not detectable by this method in the sera of healthy persons (n = 72), patients with recent intramuscular injection (n = 3), or those with a variety of systemic illnesses (n = 14). In initial studies using an antiserum having 25% cross reactivity between cardiac and skeletal muscle myosin light chains, 3 patients who had extensive skeletal muscle damage appeared to have elevated concentrations. Patients with this finding have not yet been examined with a more specific antiserum (8% cross-reactivity).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496361 TI - Naloxone and asymptomatic ischemia: failure to induce angina during exercise testing. AB - Endorphins and endorphin receptors are believed to modulate pain perception. To investigate whether naloxone, a specific antagonist, could initiate anginal pain during exercise-induced myocardial ischemia in asymptomatic patients with angiographically defined coronary artery disease, a single-blind trial was conducted in 10 men with prior positive exercise electrocardiograms. Multistage treadmill exercise tests were performed twice within a week. On the second test, patients received naloxone, 2 mg intravenously, by a syringe infusion pump. Exercise was terminated because of fatigue in 6 patients and completion of the protocol in 4. No patient reported chest pain during exercise. Naloxone did not significantly alter exercise duration, heart rate, blood pressure and ST-segment changes compared with control testing. It is concluded that endorphins do not play a significant role in the recognition of anginal pain in patients who have asymptomatic exercise-induced ischemia. PMID- 6496360 TI - Pathoanatomic correlates of regional left ventricular wall motion assessed by equilibrium radionuclide angiocardiography: a postmortem correlation. AB - The pathoanatomic correlates of qualitative assessment of regional wall motion (RWM) on routine equilibrium radionuclide angiocardiography (ERNA) were evaluated in 62 patients who had ERNA within 3 months before they died. Of 51 patients with abnormal RWM, 46 (90%) had gross myocardial lesions at autopsy. Of 11 patients with normal RWM, 9 (82%) had normal myocardium. Complete agreement of RWM with postmortem findings in all left ventricular segments occurred in 32% of the patients. Compared with postmortem findings, abnormal RWM on ERNA overestimated the number of macroscopically abnormal segments in 21% of the patients and underestimated in 47%. Of 372 segments analyzed, the overall sensitivity, specificity and predictive value of abnormal RWM on ERNA for detecting gross myocardial infarction or fibrosis was 73%, 75% and 83%, respectively. There were 35 false-positive segments (9%) (15 patients). In 27 of these segments (77%), severe stenosis of the coronary artery supplying the segment or electrocardiographic left bundle branch block could explain these findings. There were 61 false-negative segments (16%) (30 patients). In 55 of these segments (90%), either nontransmural infarction or masking by severe adjacent asynergy provided a potential explanation. Thus, qualitative analysis of RWM on routine ERNA correlates well with postmortem findings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496362 TI - Left and right ventricular function in inferior acute myocardial infarction and significance of advanced atrioventricular block. AB - Of 139 consecutive patients with a first inferior acute myocardial infarction, 26 (19%) had advanced atrioventricular (AV) block and 113 (81%) did not. All were evaluated by 2-dimensional echocardiography (2-D echo) and radionuclide angiography. Patients with advanced AV block had lower radionuclide left ventricular (LV) ejection fraction (51 +/- 10 vs 58 +/- 11%, p less than 0.01), higher LV wall motion score on 2-D echo (5.6 +/- 2.6 vs 3.1 +/- 2.7, p less than 0.001), lower radionuclide right ventricular (RV) ejection fraction (32 +/- 15 vs 39 +/- 16%, p less than 0.001) and higher RV wall motion score on 2-D echo (3.4 +/- 1.7 vs 1.5 +/- 2, p less than 0.002) than did patients without AV block. The incidence rate of RV dysfunction was higher in patients with advanced AV block (78 vs 40%, p less than 0.02), and the mortality rate was also higher (although not significantly) in patients with advanced AV block (15 vs 6%). In conclusion, patients with inferior acute myocardial infarction and advanced AV block have larger infarct sizes (as seen on radionuclide angiography and 2-D echo) and lower RV and LV function than patients without AV block. This finding may explain the higher mortality rate observed in this group. PMID- 6496363 TI - Significance of early and late anterior precordial ST-segment depression in inferior myocardial infarction. AB - In 24 patients with acute inferior myocardial infarction, the presence and duration of ST-segment depression in lead V2 correlated with the presence of left anterior descending coronary artery (LAD) stenosis and depressed left ventricular ejection fraction (LVEF). Early changes in lead V2 (within 4 hours after the onset of pain) were 67% sensitive and only 42% specific, whereas late changes (after onset of inferior Q waves and more than 6 hours after the onset of pain) were 42% sensitive, but 100% specific for the presence of LAD stenosis or decreased LVEF or both. Thus, in patients with inferior infarction, only the late repolarization change is helpful in identifying those with LAD stenosis or decreased LVEF. The absence of lead V2 ST-segment depression on either early or late electrocardiograms does not imply a normal LAD or LVEF. PMID- 6496364 TI - Repetitive, monomorphic ventricular tachycardia: clinical and electrophysiologic characteristics in patients with and patients without organic heart disease. AB - The clinical and electrophysiologic characteristics of 6 patients who had repetitive monomorphic ventricular tachycardia (VT) after a remote myocardial infarction (group A) were compared with those of 22 patients who had this arrhythmia without structural heart disease (group B). VT had a right bundle branch block morphologic pattern in 5 of 6 group A patients and a left bundle branch block morphologic pattern in all group B patients. Endocardial catheter activation mapping was performed in 4 group A patients and in 9 group B patients during VT. In all group A patients, the site of VT origin was on the border of the previous infarction; in all group B patients VT originated at the right ventricular outflow tract. Pacing and programmed stimulation induced VT in 5 of 6 group A patients and 7 of 22 group B patients (p = 0.03). Isoproterenol infusion provoked VT in 4 group A patients and 9 group B patients. Type I antiarrhythmic agents suppressed VT in 4 group A patients and in 14 group B patients, whereas propranolol suppressed VT in 3 of 3 group A patients tested and in 12 of 20 group B patients. Verapamil suppressed spontaneous VT in 1 group A patient and in 4 group B patients. During a mean follow-up of 19 months for group A and 40 months for group B, no patient had died suddenly or had cardiac arrest. PMID- 6496365 TI - Effect of propafenone on left ventricular ejection fraction. AB - The effects of orally administered propafenone on ejection fraction (EF) determined by radionuclide angiography were studied in 2 groups of patients receiving different dosing regimens. Fourteen group A patients had no clinical evidence of left ventricular (LV) dysfunction and were not receiving digoxin therapy. In this group a mean daily dosage of 879 mg resulted in a decrease in resting LVEF from 52 +/- 9% to 48 +/- 11% (p less than 0.05). Eight group B patients had clinical radionuclide evidence of LV dysfunction and were receiving digoxin therapy. In this group, a daily dosage of propafenone of 600 mg/day resulted in no significant change in LVEF. No clinically significant effects on cardiac compensation were evident in either group. These data suggest a negative inotropic effect that is either related to propafenone dosage or at least partially attenuated by digoxin therapy. Further studies are necessary to define precisely the effects of propafenone on LV function. PMID- 6496366 TI - Antiarrhythmic and electrophysiologic effects of oral propafenone. AB - Twenty-six patients had ventricular tachycardia initiated at control electrophysiologic study and had a repeat study during oral propafenone therapy. Ten patients had had sustained ventricular tachycardia, 6 cardiac arrest and 10 symptomatic, nonsustained ventricular tachycardia. Twenty-two patients had heart disease, 18 of whom had coronary artery disease. During propafenone therapy, ventricular tachycardia could not be initiated during programmed ventricular stimulation in 5 patients, and in 21 patients the cycle length of induced ventricular tachycardia increased from 246 +/- 42 ms at control to 355 +/- 96 ms (p less than 0.001). Seventeen patients were discharged with propafenone therapy and have been followed for a mean of 11 months. No symptomatic ventricular tachycardia recurred in the 5 patients without inducible ventricular tachycardia during drug treatment. Six of 12 patients with inducible ventricular tachycardia during the drug study have remained asymptomatic. In conclusion, propafenone substantially prolongs the cycle length of ventricular tachycardia, and initiation of ventricular tachycardia by programmed ventricular stimulation at drug study does not preclude a favorable clinical outcome. PMID- 6496367 TI - Effect of propafenone in the Wolff-Parkinson-White syndrome: electrophysiologic findings and long-term follow-up. AB - The electrophysiologic and long-term efficacy of propafenone, a relatively new antiarrhythmic agent, was assessed in 47 patients with accessory pathways. In 23 patients (group I), the electrophysiologic effects were assessed initially. In 19 patients in this group and in 24 additional patients (group II), long-term therapy with oral propafenone was initiated. The mean age of the patients was 38 years in group I and 41 years in group II. The duration of a history of tachycardia in both groups was 12 years (mean); 14 patients previously had had attacks of syncope. During the electrophysiologic study in group I, propafenone did not change the spontaneous sinus rate. Corrected sinus node recovery time as well as the AH interval, HV time, QRS duration and effective refractory periods of the atria and ventricles was significantly prolonged. The effective refractory period of the accessory pathway increased from 238 to 322 ms (p less than 0.02). The 1:1 conduction capacity of the accessory pathway decreased from 231 to 176 beats/min (mean; p less than 0.01). Complete block in the anterograde direction occurred in 6 patients. The shortest RR interval during atrial fibrillation increased from 232 to 303 ms (p less than 0.05). The retrograde refractory period of the accessory pathway was prolonged from 245 to 295 ms (p less than 0.01). Complete or 2:1 retrograde block during basic drive occurred in 3 patients and 1 patient, respectively. In 6 of 15 patients, propafenone made sustained supraventricular tachycardia (SVT) either no longer inducible or nonsustained. The cycle length of induced SVT increased from 324 to 395 ms (p less than 0.01). During long-term administration (follow-up duration 2 to 3 years), 17 of 43 patients did not report any episode of symptomatic tachycardia. In another 18 patients, tachycardia was rare, slower and self-terminating. In only 3 patients, the frequency and severity of attacks had not changed. One patient with dilated cardiomyopathy died suddenly. Side effects necessitating discontinuation of medication were observed in only 2 patients. The remaining side effects, if present, were tolerated, and dosage dependent. In conclusion, propafenone is an effective and well-tolerated antiarrhythmic agent in the long-term management of patients with the Wolff-Parkinson-White syndrome. PMID- 6496368 TI - Propafenone treatment of recurrent ventricular tachycardia: comparison of continuous electrocardiographic recording and electrophysiologic study in predicting drug efficacy. AB - Propafenone was administered to 29 patients who had multiple episodes of recurrent ventricular tachycardia (VT) or ventricular fibrillation (VF) despite previous antiarrhythmic therapy. All patients had 24-hour continuous electrocardiographic recording and electrophysiologic study in a drug-free control state and while receiving maximum doses of propafenone. During propafenone treatment, the mean frequency of ventricular premature complexes (VPCs) decreased 74% (p less than 0.05). There was more than an 83% decrease in VPC frequency in 17 of 29 patients, and 11 patients had 99 to 100% decreases. Propafenone prevented VT induction at electrophysiologic study in 6 patients, whereas another 12 patients were judged to have satisfactory electrophysiologic responses on the basis of slower VT rates and absence of hemodynamic compromise during VT. After long-term treatment from 2 to 26 months, 9 patients continued propafenone without evidence of recurrent arrhythmia. Six of these 9 patients had not VT induction at electrophysiologic study while receiving propafenone. The decrease in VPC frequency produced by propafenone was a poor predictor of a successful electrophysiologic study and of long-term therapy. In conclusion, propafenone has potential as an effective antiarrhythmic agent, but better methods to stratify risk for recurrence of VT and VF are needed. PMID- 6496369 TI - Propafenone: noninvasive evaluation of efficacy. AB - Propafenone, a new antiarrhythmic drug, was administered to 60 patients with a history of refractory ventricular tachyarrhythmias, including ventricular fibrillation in 16 and ventricular tachycardia (VT) in 44. A noninvasive protocol was followed utilizing ambulatory monitoring and exercise testing for evaluation of drug effect. The protocol involved acute drug testing with 450 mg of propafenone followed by maintenance therapy with 150 to 300 mg t.i.d. for 4 days. The protocol was completed by 57 patients; in 3 patients side effects developed that necessitated discontinuation of the drug before evaluation. When evaluated by monitoring, 34 patients (60%) responded to the drug, with total elimination of runs of VT, a greater than 90% reduction in couplets and a greater than 50% decrease in the frequency of ventricular premature beats. Based on exercise testing, 36 patients (63%) were deemed responders. When both exercise and monitoring were considered, 30 of 57 patients (53%) responded to propafenone. The acute drug test predicted the response to maintenance therapy in 84% of patients. Propafenone did not change left ventricular function in patients with normal ejection fractions (greater than 50%). However, in those with an ejection fraction less than 50%, propafenone significantly reduced this value (34% vs 29%, p less than 0.01). Side effects occurred in 20 patients (33%) and included nausea, congestive heart failure, aggravation of arrhythmia and conduction abnormalities. Eleven patients have continued on propafenone for an average of 16 months with continued efficacy and freedom from side effects. PMID- 6496370 TI - Development of the implantable transvenous cardioverter. AB - The development of the transvenous cardioverter, from the initial animal studies, to the clinical studies using temporary leads, to the initial permanent implants is described. Shocks less than or equal to 2.0 joules synchronized to the QRS complex and delivered through a specially designed catheter electrode placed in the apex of the right ventricle successfully terminate most episodes of ventricular tachycardia in patients. The implanted unit which also serves as a demand ventricular pacemaker, can be used to perform programmed electrophysiologic studies. Future devices must be capable of defibrillation and more accurate arrhythmia detection. PMID- 6496371 TI - Clinical pharmacology of propafenone: pharmacokinetics, metabolism and concentration-response relations. AB - Propafenone is a promising new antiarrhythmic agent marketed in Europe for the past 7 years. The drug is remarkable for great interindividual variability in its pharmacokinetic and pharmacodynamic properties. Propafenone undergoes extensive presystemic clearance that appears to be saturable, with bioavailability increasing as dosage increases. The drug is highly protein bound. Elimination half-life is 5 to 8 hours in most patients, although a range of 2 to 32 hours has been reported. Propafenone slows intracardiac conduction in a concentration dependent manner. It is a weak beta-adrenergic blocker, but this property is of uncertain clinical significance. The major metabolic pathway for propafenone begins with aromatic ring hydroxylation, a pathway that may be determined by genetic factors. PMID- 6496372 TI - The organogenesis of murine striated muscle: a cytoarchitectural study. AB - The ultrastructure and the three-dimensional cytoarchitecture of the developing murine extensor digitorum longus muscle has been studied in spaced, serial, transverse and longitudinal ultrathin sections of the muscles of 12-, 14-, 16-, and 18-day in utero, newborn, and 5-day-old 129 ReJ mice. Despite the fact that in vivo myogenesis is asynchronous (i.e., during most of the fetal period, multiple stages of myogenesis can be seen in a single developing muscle mass), a distinct temporal pattern of development can be seen across the entire width and length of the developing muscle. At 12 days in utero, the developing extensor digitorum longus muscle consists of primary myotubes surrounded by a pleomorphic population of mononucleated cells devoid of myofilaments. At this stage, blood vessels and nerves are found peripheral to but not within the developing muscle mass. A delay of 2 days occurs between the time of formation of the primary and secondary myotubes. Clusters (consisting of one primary myotube and secondary myotubes), axon bundles, capillaries, and primitive motor endplates are found in the muscle by 16 days in utero. Evidence is presented consistent with the hypothesis that cluster formation and cluster dispersal occur simultaneously in the developing muscle, beginning as early as 16-days in utero. By 18 days in utero, many of the primary myotubes of the cluster and the independent myotubes (i.e., single myotubes enclosed in their own basal lamina) have begun to acquire the polygonal shape, fascicular arrangement, and ultrastructure characteristic of more mature myofibers. At birth, clusters are infrequently encountered, and intramuscular axons have begun to undergo myelination. At this time, the only undifferentiated, mononucleated cells present in the muscle are myosatellite cells. The first week postnatal was characterized by further maturation of the myofibers. PMID- 6496373 TI - Organogenesis of the mouse extensor digitorum logus muscle: a quantitative study. AB - A quantitative analysis of the pattern of development and growth of the fetal extensor digitorum longus muscle of the 129 ReJ mouse was carried out in spaced, serial ultrathin sections with computer-assisted morphometry. Muscle from 12-, 14 , 16-, and 18-day in utero mice and from newborn and 5-day postnatal mice was analyzed to determine age-related changes in such factors as the maximal girth and length of the muscle, the number of myotubes, the "cluster" frequency, and the diameters and lengths of the myotubes and muscle units. A distinct temporal pattern of development was established. It was quantitatively determined that a delay less than or equal to 2 days occurs between the formation of primary myotubes (present at 12 days in utero) and secondary myotubes (present at 16 days in utero). By 16 days in utero, groups of myotubes, consisting of one primary myotube and a variable number of secondary myotubes, form "clusters" surrounded by a common basal lamina. Morphometric analyses of diameter distributions establish that most, if not all, secondary-generation myotubes are formed in association with larger, more mature myotubes. Quantitative data support the hypothesis (Ontell and Kozeka, 1984) that cluster formation and cluster dispersion occur simultaneously, beginning sometime between 16 and 18 days in utero. By 18 days in utero, the adult number of myofibers is present in the developing muscle mass. Analyses of lengths and diameters of the same fibers establish that the pattern of growth of the last-formed myotubes of the developing muscle mass is different from that of myotubes formed earlier in development. PMID- 6496374 TI - Characterization of putative secretory sites on ameloblasts of the rat incisor. AB - The distribution and structure of the putative sites where enamel matrix is secreted from the ameloblast were studied by correlating the external topography with the distribution of organelles in Tomes' process cut in various planes of section. Both the interrod and rod secretion sites are associated with deep membrane infoldings. It was found that the interrod secretion site completely surrounds each ameloblast, and the marked interdigitation of adjacent cells results in a cooperative growth front for interrod enamel. In contrast, the rod secretion site is present on only one surface of the interdigitating portion of Tomes' process. Numerous granules were observed adjacent to the membrane infoldings associated with both sites, and granules were seen fused to membrane infoldings suggesting that the matrix of enamel is a merocrine secretion product. PMID- 6496375 TI - Microdissection by ultrasonication: porosity of the intestinal epithelial basal lamina. AB - The porosity of the epithelial basal lamina of normal rat intestine was studied by SEM. Epithelial removal was accomplished by prolonged fixation of tissue samples in OsO4 or immersion in aqueous H3BO3, followed by dehydration in acetone and microdissection by ultrasonic vibration. The underlying basal lamina of intestinal epithelium reveals numerous pores of variable size. These pores are more numerous in small than in large intestine and penetrate the entire thickness of the basal lamina. Within the basal lamina overlying lymph nodules, they are numerically increased. Their occurrence is evident in fixed and unfixed, sonicated and unsonicated tissue samples. Microprojections of epithelial cytoplasm are often observed within these pores. The results of this study suggest that migrating cells or epithelial-cell processes induce pore formation in epithelial basal laminae and that these pores may be eventually repaired. PMID- 6496376 TI - Ultrastructure of the thick ascending limb of Henle in the rat kidney. AB - The thick ascending limb of Henle (TAL) in the rat until recently has been considered a morphologically homogeneous structure despite physiologic and biochemical evidence to the contrary. The present study was designed to examine the ultrastructural characteristics of the TAL in the inner cortex and the outer and inner stripes of the outer medulla using qualitative and quantitative transmission electron microscopy. Kidneys of male Sprague-Dawley rats were preserved by in vivo perfusion with glutaraldehyde for light and electron microscopy. The peritubular diameter and cell height were determined by direct measurements on tubule cross sections. Morphometric analyses were performed on montages of tubule cross sections. The peritubular diameter of the TAL was similar in the three regions under investigation, but the TAL cells were taller in the inner stripe than in the inner cortex and outer stripe. Morphometry revealed significant differences between the three regions with respect to the mean tubular cross-sectional area (AT), the surface density (SV), and the surface area per mm of tubule (ST) of apical and basolateral plasma membranes, and the volume density (VV) of mitochondria. The major morphologic division appeared to be between the inner stripe segment and the remainder of the TAL. These findings document the presence of significant morphologic heterogeneity of the rat TAL. PMID- 6496377 TI - Seasonal variations in the fine structure of the Necturus maculosus urinary bladder epithelium: low transporters and high transporters. AB - Although the urinary bladder of Necturus maculosus provides an important model system for studying the mechanisms of active Na absorption, little critical attention has been paid to the fine structure of its epithelium. Moreover, two distinct groups of urinary bladders, low and high Na transporters, have been described based on short-circuit current or transepithelial potential difference. In the present study, over an 11-month period, stable electrical parameters (short-circuit current, transepithelial potential difference, and resistance) were recorded from 63 chamber-mounted bladders. Analysis of these parameters revealed a highly significant difference between two groups (low transporters and high transporters) occurring at different times of the year. Consistent with these data, in urine collected from the bladders, the Na concentration in low transporters was significantly higher than that in high transporters. A subpopulation of these bladders was subsequently fixed and examined at the light and/or electron microscopic level. Low-transporting bladders were characterized unequivocally by a thin, stratified squamous epithelium only 6-15 micron thick. High-transporting bladders were composed predominantly of columnar-shaped granular cells up to 70 micron in height, with ciliated, mitochondria-rich, and basal cells present in small numbers. There is thus a correlation between transport activity, as measured by electrophysiological techniques and urine sodium analysis, and the structure of the tissue. Moreover, these parameters exhibit significant seasonal variation, the underlying mechanisms of which remain obscure. PMID- 6496378 TI - Excretion of urinary catecholamine metabolites in anorexia nervosa: effect of body composition and energy intake. AB - Metabolites of norepinephrine and dopamine were measured in urine from 12 women of normal body weight and from six women undergoing treatment for anorexia nervosa. The women with anorexia nervosa had 48% less body fat (14 +/- 1 versus 27 +/- 1%, p less than 0.001), 9% less fat-free mass (36 +/- 1 versus 40 +/- 1 kg, p = 0.05), and 26% higher energy intake (2217 +/- 147 versus 1750 +/- 43 kcal, p less than 0.01) on collection days compared to the normal weight women. Twenty-four-hour excretions of norepinephrine metabolites, 3-methoxy-4 hydroxyphenylethylglycol, 3,4-dihydroxyphenylethylglycol, and vanilmandelic acid were reduced (p less than 0.01) in anorexia nervosa by 44, 48, and 39%, respectively. Excretion of homovanillic acid, the dopamine metabolite, was the same for both groups. Urinary 3-methoxy-4-hydroxyphenylethylglycol content was best predicted by percentage body fat in the normals (r = 0.63, p less than 0.05) and for both groups combined (r = 0.79, p less than 0.001). Urinary vanilmandelic acid showed a strong relationship with fat-free mass in the normal group (r = 0.84, p less than 0.001) and for both groups combined (r = 0.79, p less than 0.001). In contrast, urinary 3-methoxy-4-hydroxyphenylethylglycol and vanilmandelic acid and energy intakes were only weekly associated in the normals, but unrelated in the anorexics, or when the data from both groups were combined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496379 TI - Absorption kinetics of oxalate from oxalate-rich food in man. AB - The absorption of oxalate was investigated in a healthy subject after ingestion of oxalate-rich meals (spinach and rhubarb) with and without addition of 14C labeled oxalic acid and calcium oxalate, and after oxalate-free meals with addition of nonlabeled sodium oxalate and calcium oxalate. Under these conditions, calcium oxalate was absorbed to the same extent as soluble oxalate; only a small percentage (2.4 +/- 0.7) of the total oxalate load was absorbed. Significant oxalate absorption occurred within 1 to 8 h after ingestion. The results suggest that under normal conditions the proximal part of the small bowel is a major absorption site. PMID- 6496380 TI - Energy depot replenishment in rats during refeeding after fasting: effect of exercise. AB - The effect of progressive moderate exercise on body weight gain, visceral and muscle protein stores, and thyroid hormone levels during an 8-day refeeding period after 65 h of starvation was studied in 2-month-old male Sprague-Dawley rats. Twenty-four animals were divided into three groups and acclimated for 5 days while being fed with ordinary Purina Chow. After the fasting phase, a group of rats was killed in order to provide base-line information concerning fasting induced changes in body composition; a sedentary group was fed Purina Chow ad libitum; and a treadmill-exercised group was pair fed with the sedentary rats. During the refeeding phase, the exercised animals regained significantly less weight than the sedentary animals (p less than 0.001), but the two groups did not differ significantly with respect to visceral, muscle, eviscerated carcass, and skin protein. Total body fat content was lower in the exercised than the sedentary group. The thyroid hormone levels were not significantly different for the two refed groups. These results indicate that exercise during refeeding may alter the pattern of body weight gain during refeeding after fasting such that the replenishment of adipose tissue stores is reduced without compromising the restoration and growth of lean tissue. PMID- 6496381 TI - Influence of starvation on sucrase regulation by dietary sucrose in the rat. AB - We have studied the action of sucrose on jejunal sucrase activity. Rats (175 g) were first starved or fed a digestible carbohydrate-free diet for 60 h and then fed a high sucrose diet for varying times up to 84 h. 1) Rats starved for 60 h showed mucosal atrophy with a decrease in protein content/10 cm (18.00 +/- 1.4 versus 40.1 +/- 3 mg (controls p less than 0.001) and in villus height (357 +/- 18 versus 526 +/- 5 microns, p less than 0.001) which was fully repaired only after 60 h on the sucrose diet (528 +/- 11 microns). Rats on digestible carbohydrate-free diet showed no mucosal atrophy. 2) Starved rats had a delayed (60 h) sucrase activity response to sucrose (53 +/- 7 versus 122 +/- 4 microns/mg protein, p less than 0.001). Maximum activity was obtained after 12 h on sucrose diet in rats maintained on the carbohydrate-free diet: 38 +/- 1 versus 108 +/- 2.3 microns/mg protein, p less than 0.001. 3) Villus and crypt cell analysis after starvation and 12 h on a high sucrose diet localized the increase in sucrase activity to the villus-crypt junction. No change occurred in the upper villus. The increase was complete all along the villus by 36 h. In contrast, after the carbohydrate-free diet, sucrase activity increased maximally at all levels of the villus by 12 h on the high sucrose diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496383 TI - Iron, zinc, and copper balance in short bowel patients on oral nutrition. AB - Data are presented of a 5-day balance study for iron, zinc, and copper in seven patients with short bowel syndrome on oral nutrition. The small bowel remnant of these patients varied from 40 to 110 cm (mean 64 cm) and was radiologically normal in all patients. The study was carried out an average 2.7 yr (range 1 to 5 yr) after intestinal resection. Balance materials (diets, urine, and stools) were measured with neutron activation analysis. Mean iron balance was +28.6 mumol/day (+/- 10.6 SD). Mean zinc balance was +5.4 mumol/day (+/- 6.5 SD) and mean copper balance was +1.5 mumol/day (+/- 2.3 SD). These results are comparable to those reported in healthy controls. When taking into account integumentary losses of these substances, the balance of each individual trace element remained acceptable. It is concluded that a satisfying iron, zinc, and copper status can be achieved in patients after an extensive small bowel resection on oral nutrition. PMID- 6496382 TI - Changing the Mediterranean diet: effects on blood lipids. AB - A study was carried out on 48 healthy middle-age men and women habitually subsisting on a "Mediterranean type" diet in a rural area of southern Italy. Their freely chosen natural diet was modified for a period of 42 days by partially substituting animal fats for olive oil. Currently available foods were used, and the subjects maintained their habitual lifestyle. Dietary fat content changed from 33 to 37% of total energy and the polyunsaturated to saturated fatty acid ratio changed from 0.48 to 0.22. The base-line serum total cholesterol of men increased during the dietary intervention period from 214 +/- 30 mg/dl (mean and SD) to 245 +/- 33 mg (+15%). Low-density lipoprotein cholesterol increased 19%, while high-density lipoprotein cholesterol remained unmodified. Women, while exhibiting a similar trend in serum total cholesterol (+16%), showed also a 19% increase in their high-density lipoprotein cholesterol (p less than 0.001). Apoprotein B increased in parallel with low-density lipoprotein cholesterol in both sexes. The results of the study confirm the impact of the dietary factor on blood lipids. They also provide additional evidence on the response of high density lipoprotein cholesterol to diet in free-living populations. PMID- 6496384 TI - The composition of preterm milk in relation to the degree of prematurity. AB - Fifty-one samples of 24-h milk collections obtained during the 1st month of lactation from mothers who delivered after gestations of 26 to 31 wk (VPT) contained higher concentrations of nitrogen (297 +/- 11 mg/dl), total fatty acids (4.46 +/- 0.17 g/dl), percentage medium chain fatty acids (10.8 +/- 0.7), and energy (78.3 +/- 2.0 kcal/dl) than either or both those from 32 to 36 wk (PT) and term (T) gestations. PT collections did not differ from T milk with regard to nitrogen (250 +/- 13 versus 259 +/- 13), total fatty acids (3.94 +/- 0.20 versus 3.20 +/- 0.30), percentage medium chain fatty acids (9.1 +/- 0.5 versus 8.1 +/- 0.7) and energy (69.0 +/- 2.7 versus 66.6 +/- 2.4). Although postpartum age (5 to 10 versus 11 to 30 days) did not change the nutrient and energy content of VPT, PT, and T collections, it is only in 11 to 30 day VPT milk that nitrogen and energy content became higher (p less than 0.05) than either or both PT and T milk. We conclude that the differences in macronutrient composition of PT milk are limited to VPT milk and the data from repeated milk collections in the same mother (28 wk) suggest that there is considerable variability in its composition. PMID- 6496385 TI - Vitamin C nutrition during prolonged lactation: optimal in infants while marginal in some mothers. AB - Prolonged breast-feeding is practiced by mothers in the hope of improving their infants' health and preventing diseases. In this study of the nutritional adequacy of breast-feeding, 200 mothers with healthy, full term newborns were encouraged to breast-feed exclusively. At age 6 months 116 infants and at age 9 months 36 infants remained exclusively breast-fed. The control infants were weaned early and they received vitamin C through a supplemented milk formula and solid food. The exclusively breast-fed infants were able to maintain their plasma vitamin C concentration at the same or a higher concentration than the vitamin C supplemented controls. Their plasma concentration was about 2-fold compared with the maternal concentration. It was relatively independent of maternal nutrition and of vitamin C concentration in milk. The mother's intake of vitamin C influenced their plasma and milk concentrations. About 6% of the mothers had subnormal plasma concentrations without symptoms. The lowest concentrations occurred 2 months postpartum and during the spring. Thus, exclusively breast-fed infants are well protected against vitamin C deficiency, but marginal intake in lactating mothers is more common than assumed for a well-nourished population. PMID- 6496386 TI - A stable isotope study of zinc absorption in young men: effects of phytate and alpha-cellulose. AB - A 63-day study was conducted with young men confined to a metabolic unit to study the effects of a alpha-cellulose and phytate on zinc absorption. A liquid formula diet was used throughout the experiment. During each of three dietary treatments, (basal diet, basal diet + alpha-cellulose, or basal diet + phytate), 67Zn, a stable isotope of zinc, was added to the diets to measure zinc absorption. Zinc absorption was determined by fecal monitoring of 67Zn, measured by thermal ionization mass spectrometry. Analytical precision of all measurements was within 1%. Average zinc absorption was 34.0 +/- 6.2% from the basal diet and 33.8 +/- 2.9% from the diet with 0.5 g alpha-cellulose per kg body weight added. Zinc absorption fell to 17.5 +/- 2.5% when 2.34 g of phytate as sodium phytate were added to the basal diet. The phytate/zinc molar ratio of the diet was 15. The decrease in zinc absorption was accompanied by increased fecal zinc and decreased urinary zinc. The results suggest that phytate inhibits zinc absorption and high levels of dietary phytate could result in zinc deficiency in man. PMID- 6496387 TI - An evaluation of vitamin E status in premature infants. AB - Prematurely born, low birth weight infants are abnormal by their very existence ex utero. Thus, the well-documented finding in such infants of low plasma vitamin E concentrations when compared to the adult poses philosophical and pragmatic difficulties as to whether or not a true deficiency state exists: do these low levels represent age-adjusted reference values or do they in fact represent a deficiency state, warranting treatment? We examined multiple measures of vitamin E status in 62 prematurely born, low birth weight infants in order to address this issue. Mathematical and statistical modeling of these measures during the first 21 days of life lead us to conclude that the ex utero antioxidant protective role of vitamin E is best achieved at plasma concentrations of tocopherol very close to those observed in the adult; specifically, when total tocopherol is greater than 0.64 mg/dl and alpha-tocopherol is greater than 0.50 mg/dl. Thus, at birth, a true deficiency in vitamin E exists for most preterm, low birth weight infants and early treatment is warranted. PMID- 6496388 TI - Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency. AB - Preschool-age rural Indonesian children were reexamined every 3 months for 18 months. An average of 3135 children were free of respiratory disease and or diarrhea at the examination initiating each of the six, 3-month follow-up intervals. Children with mild xerophthalmia (night blindness and/or Bitot's spots) at the start and end of an interval developed respiratory disease and diarrhea at twice (p less than 0.001) and three times (p less than 0.001) the rate, respectively, of children with normal eyes during the same interval, independent of age and anthropometric status (weight for length). The risk of respiratory disease and diarrhea were more closely associated with vitamin A status than with general nutritional status. These results may explain much of the excess mortality recently reported for mildly vitamin A-deficient children. PMID- 6496389 TI - Assessment of zinc and copper status of healthy elderly people using metabolic balance studies and measurement of leucocyte concentrations. AB - Metabolic balance studies for zinc and copper were carried out in 24 apparently healthy elderly people aged 69.7 to 85.5 yrs, living in their own homes and eating self-selected diets. The zinc and copper concentration in whole blood, plasma, and leucocytes were also measured. Mean daily intakes for zinc and copper were 137 and 20.1 mumol with mean retentions of 1.0 and -0.8 mumol, respectively. These values did not differ significantly from equilibrium (p less than 0.01). For zinc and copper, respectively, mean concentrations were 11.0 and 19.4 mumol/l in plasma, 120 and 11.5 mumol/10(6) cells in leucocytes, and 99 and 13.4 mumol/l in whole blood. These data will provide normal standard values for elderly people in good health and should serve as a basis for the investigation of elderly people with suspected deficiencies of these trace metals. PMID- 6496390 TI - Comparison of the phospholipid composition of breast milk from mothers of term and preterm infants during lactation. AB - Phospholipids were determined in milk on postpartum day 3 (colostrum) and days 7, 21, 42, and 84 from mothers of 18 very premature (26 to 30 wk gestation age), 28 premature (31 to 36 wk), and 6 term (37 to 40 wk) infants. Lipids were analyzed by thin-layer and gas-liquid chromatography. Total fat content increased during lactation whereas phospholipids and cholesterol declined. Phospholipids were separated from neutral lipids by column chromatography and distributed by preparative thin-layer chromatography into classes, sphingomyelin, phosphatidyl choline, serine, inositol, and ethanolamine for fatty acid analysis. Phospholipids exhibited a remarkable constancy in class percentages in milks from mothers giving birth prematurely or at term. Changes were observed in fatty acid composition within each of the phospholipid classes as secretion progressed from colostrum (3d) to transitional (7d) to mature milk (21, 42, 84d). These changes in phospholipid fatty acid composition occurred only during the first 3 wk of lactation. Mature milk was found to be relatively constant in phospholipid composition. PMID- 6496391 TI - Interaction between maternal size and birth size and subsequent weight gain. PMID- 6496392 TI - Glycemic responses to foods: possible differences between insulin-dependent and noninsulin-dependent diabetics. AB - The effect on the blood glucose response of varying the amount (25 or 50 g) and type (bread or beans) of carbohydrate (CH2O) in test meals and of adding fat and protein was examined in a group of insulin dependent and noninsulin dependent diabetic volunteers. With noninsulin-dependent diabetics, the blood glucose area after a half bread portion was 48% that of the full bread meal (p less than 0.001). White pea beans (50 g CH2O) gave a blood glucose response of 41 +/- 5% (p less than 0.001) that of bread (50 g CH2O). A combined meal of bread (25 g CH2O) and beans (25 g CH2O) gave a blood glucose response of 60 +/- 8% of the full bread meal (p less than 0.005) and similar to that expected. Addition to bread of butter and skim milk cheese either singly or in combination had little effect on the glycemic response although a reduced rise was seen after addition of fat and protein as peanut butter. Insulin-dependent diabetics tended to respond similarly to noninsulin-dependent diabetics but their greater variability indicates that other factors in addition to the nature of the food may also be major determinants of their glycemic responses to foods. PMID- 6496394 TI - Thermic effect of food during graded exercise in normal weight and obese men. AB - The thermic effect of food during incremental cycle ergometer exercise was compared in six normal weight and six obese men (mean +/- SEM 104 +/- 5% and 160 +/- 11% ideal body weight, respectively). Graded exercise tests were performed after a 12-h fast and 60 min after the start of a 910 kcal mixed meal, on separate days. The thermic of food during exercise, which is the fed minus the fasting oxygen consumption (VO2), was significantly greater for the normal than the obese men at submaximal intensities from O (unloaded cycling) to 100 W (p less than 0.05). The mean slope of the regressions of VO2 (ml . min-1) on power output (W), which reflects the rate of increase in energy expended relative to increases in external work performed, did not differ significantly between the fed and fasting conditions for either group, but the mean (+/- SEM) intercept was significantly higher for the normal, but not the obese men, in the fed than the fasting state (599 +/- 53 versus 497 +/- 47 ml O2 . min-1 for the normal men and 819 +/- 126 versus 821 +/- 145 ml O2 . min-1 for the obese men). These results indicate that the thermic effect of food during exercise, which is virtually absent in the obese men, does not increase significantly across submaximal power outputs for the normal men and therefore does not reflect a significant reduction in efficiency. PMID- 6496393 TI - A comparison of the effect of diets containing beef protein and plant proteins on blood lipids of healthy young men. AB - The effect of plant and animal protein on blood lipid levels was investigated in eight healthy normolipidemic men aged 18 to 27 yr. All subjects were fed both plant and animal protein diets in a cross-over design. Each diet was consumed for a 21-day period. Proteins from commonly used plant sources made up the plant protein diet. Beef protein was substituted for 55% of the plant proteins in the animal protein diet. Fasting venous blood samples were collected at the beginning of the study and at 7-day intervals throughout the 42-day study. Serum was analyzed for total cholesterol and triglycerides. Plasma low-density and high density lipoprotein cholesterol were determined. There were not any statistically significant differences in mean serum total cholesterol or mean plasma low density lipoprotein cholesterol when subjects consumed the diets. Mean plasma high-density lipoprotein cholesterol levels were significantly (p less than 0.05) elevated at the end of the 21-day period when the animal protein diet was consumed (48 +/- 3 mg/dl) compared to the period when the plant protein diet was fed (42 +/- 2 mg/dl). Mean serum triglyceride values were significantly (p less than 0.05) increased at day 7 of the plant protein diet period (136 +/- 19 mg/dl) compared to the same time period when the animal protein diet was consumed (84 +/ 12 mg/dl). The results of the study indicated that the ingestion of a diet in which 55% of the protein was supplied by beef protein was not associated with a hypercholesterolemic effect in healthy normolipidemic young men. PMID- 6496395 TI - Antihemostatic effect of Hsien-Ho-T'sao (Agrimonia pilosa). AB - Bleeding time in rats was markedly prolonged after the administration of the water extract of Hsien-Ho-T'sao. This antihemostatic effect was more marked in the group of i.p. injection of the drug than in the group of p.o. administration for 2 or 7 consecutive days. Blood coagulation studies showed that plasma prothrombin time, activated partial thromboplastin time and stypven time were prolonged, while thrombin time and fibrinogen level were not changed. The thromboelastographic recording showed that reaction time was prolonged and maximal elasticity of clot was decreased. In addition, ADP- and collagen- induced aggregations of platelet-rich plasma were suppressed. In conclusion, the prolongation of the bleeding time might be due to both anticoagulant and antiplatelet action of the drug. PMID- 6496396 TI - The pharmacological studies in central nervous system on the interaction of Taiwanese Veratri Formosani Rhizoma and Sophorae Radix. AB - The eighteen opposing drugs were to be recognized as absolute incompatibility of Chinese herbs. Ku-Shen (Sophorae Radix) opposed Li-Lu (Veratri Rhizoma) is one of these incompatible drugs. In this study, we attempted to investigate and identify the interactions of these two drugs in the CNS by means of modern pharmacological technics. The results elucidate that toxicity, number of retching movements, change of locomotor activity and the concentration of monoamines' metabolites of Li-Lu can be changed by Ku-Shen. From these results, further evidence was provided that the involvement of Li-Lu and Ku-Shen in the eighteen opposing drugs of Chinese ancient Pentsao are deemed to be significant. PMID- 6496397 TI - Acupuncture and developing countries. AB - Promotion of Acupuncture is the need of time but due to lack of integrated efforts, this target has not been achieved. Acupuncture may prove helpful in solving the basic health problems of developing countries so its promotion is more important for them. Ways and means to promote the art of Acupuncture internationally are discussed in this article. PMID- 6496398 TI - Acupuncture points of the cranial nerves. AB - An attempt is made to name most of the acupuncture points in the face and forehead region using anatomic nomenclature known to western medicine. All acupuncture points in the face and forehead region are located along terminal or cutaneous branches of the trigeminal nerve and the motor points formed between muscular branches of the facial nerve to the muscles of facial expression. It is believed such nomenclatures will be comprehensible to basic medical scientists and clinical practitioners who have knowledge of anatomical sciences. PMID- 6496399 TI - Acupuncture points of the cervical plexus. AB - Acupuncture points in the neck region are basically distributed along the terminal branches of the cervical plexus. There are two components of the plexus, cutaneous and muscular. The cutaneous component of the cervical plexus consists of four major branches which are the lesser occipital, great auricular, transverse cervical, and supraclavicular nerves. Practically all of the acupuncture points in the neck are found along the routes of these cutaneous nerves. It is suggested that acupuncture points in this region be names according to the anatomical designation of these nerves. PMID- 6496400 TI - Immunologic abnormalities and their significance in sinus histiocytosis with massive lymphadenopathy. AB - In a computerized case registry, containing 220 cases of sinus histiocytosis with massive lymphadenopathy (SHML), 23 patients were identified with clinical or routine laboratory findings suggestive or diagnostic of immune dysfunction. We divided the abnormalities into hematologic autoantibodies (nine patients), glomerulonephritis (three patients), Wiskott-Aldrich syndrome (two patients), joint disease (nine patients), unusual infections (three patients), and miscellaneous (six patients). Nine of the patients had more than one finding prompting inclusion in this study. In five patients, at least one abnormality preceded the onset of SHML. A major difference between this subgroup of 23 patients and the remaining registry population was the mortality rate. Ten of the 23 patients have died, and in many cases the cause of death could be linked to the immunologic abnormality. This study establishes an association between SHML and clinically significant immune dysfunction and provides further evidence that this frequently multisystemic disease may be one manifestation of disordered immunity. PMID- 6496401 TI - Medullary carcinoma of the thyroid in fine-needle aspiration biopsies. AB - A study of fine-needle aspiration biopsies (FNAB) in six cases of medullary carcinoma of thyroid (MCT) revealed that the presence of spindle cells in addition to the more usually recognized polygonal cells is a common feature and a significant clue to the diagnosis. Both spindle and polygonal cells contain cytoplasmic granules that stain positively for calcitonin by the immunoperoxidase technic. Amyloid, when present, can be identified presumptively in the Papanicolaou stain. This can be confirmed by restaining with Congo red. Both immunoperoxidase staining for calcitonin and amyloid staining for Congo red work well on the decolorized Papanicolaou-stained smears. PMID- 6496402 TI - Comparison of needle aspiration and solid biopsy technics in the flow cytometric study of DNA distributions of surgically resected tumors. AB - Flow cytometric analysis (FCM) of DNA content of nuclei was performed on simultaneously obtained tissue samples and needle aspirates from 37 primary colorectal cancers and from 21 other tumors. There was a marked increase in the proportion of the nondiploid cell population in 18 of 58 aspirates when compared with the corresponding tissue samples, presumably because of selective aspiration of tumor cells. The difference was significant at level alpha much less than 0.01 by a paired t-test and was most pronounced in tumors wherein a nondiploid population constituted more than 20% of the sample. The difference did not correlate with the grade or stage of the tumor. These observations suggest that the sampling of surgically resected tissue specimens for DNA analysis by FCM is performed best by needle aspiration, which may increase the yield of nondiploid cells, does not interfere with histologic diagnosis, and may prove especially useful in the analysis of small surgical specimens. PMID- 6496403 TI - Fungal sinusitis in healthy and immunocompromised individuals. AB - Clinical and microbiologic aspects of fungal sinusitis occurring in six patients are presented. Three of the six patients were immunosuppressed. Fatal disseminated fungal disease developed in two of those immunosuppressed. The three patients with normal immune function had fungal infections confined to the nasal sinuses. Aspergillus fumigatus and Aspergillus flavus were recovered from the immunosuppressed patients and Sporothrix schenckii, Alternaria species, and Pseudallescheria boydii were recovered from the immunocompetent patients. Surgical debridement was performed on all patients; however, anti-fungal therapy only was prescribed in patients who were at risk of progressive fungal disease. The microbiology laboratory aids in the diagnosis of fungal sinusitis by examining surgical biopsy material for fungal organisms and by culturing the material for recovery of the fungal pathogen. PMID- 6496404 TI - IgA nephropathy: dimeric IgA-secreting cells are present in episcleral infiltrate. AB - Recent publications have reported a frequent association between IgA nephropathy and episcleritis. In this article, the authors report on the immunohistologic study of an episcleral biopsy obtained in a female patient with Berger's disease and frequent episodes of episcleritis. Numerous dimeric-IgA-secreting cells were demonstrated in the episcleral inflammatory infiltrate. It also should be mentioned that microhematuria often occurred within a few days after the beginning of episcleritis in this patient. These results suggest the participation of ocular mucosal immunity in some cases of IgA nephropathy. PMID- 6496405 TI - Rhinosporidiosis. A report of two cases from Arkansas. AB - Two human native cases of ocular-conjunctival rhinosporidiosis from Arkansas are believed to be the first documented reports in this part of the country. The common mode of infection was accidental injury to the eye by possible contaminated soil-dust. The appearance of the polypoid growth was relatively fast, 6-16 days, and unresponsive to topical antibiotic and steroid treatment. Surgical excision, with one recurrence in one case, was the elective treatment. Both patients are asymptomatic 10-12 months after treatment, respectively, with no evidence of other recurrence, dissemination, or major complications. From 1939 to September, 1983, only nine cases of conjunctival rhinosporidiosis were reported in the United States. PMID- 6496406 TI - Glomerulocystic kidney disease. Report of an adult case. AB - A case of glomerulocystic kidney disease (GCK) in an adult is reported. The patient described here had no other congenital malformations, and there was no family history of renal disease. The histopathologic findings support the glomerular origin of GCK. This case illustrated that GCK may be associated with stable renal function for many years. In view of this, GCK should be considered in the differential diagnosis of cystic kidney disease in the adult. PMID- 6496407 TI - Anomalous coronary artery simulating parachute mitral valve. AB - Anomalous left coronary artery, arising from the pulmonary valve, may produce a clinical and radiologic picture mimicking parachute mitral valve (PMV). The pathogenesis is related to left myocardial hypoxia and consequent fibrosis. The authors report a patient with such involvement of the myocardium and contiguous anterior papillary muscle. The result was fibrous atrophy with consequent physiologic and radiologic abnormalities that occur in PMV because of the absence of this muscle, and superficial resemblance to its characteristic morphology. PMID- 6496408 TI - Concurrent multiple myeloma and chronic lymphocytic leukemia. AB - A patient with concurrent multiple myeloma and B-cell chronic lymphocytic leukemia (CLL) is presented. Immunologic studies showed an identity between the myeloma protein and surface immunoglobulin of CLL cells. PMID- 6496409 TI - More on reliability of the DuPont aca system in measuring antithrombin III. PMID- 6496410 TI - Corrections for calculated predictive values. PMID- 6496411 TI - Japanese American response to psychological disorder: referral patterns, attitudes, and subjective norms. AB - The underutilization of services by Japanese Americans has raised questions as to the variables that account for this phenomenon. The present study examined the referral patterns and their bases using the Fishbein-Ajzen model of attitude behavior relationships. Vignettes describing disorders were each responded to by 106 Japanese Americans. Results indicated that self resources were the most commonly mentioned referral across disorders and generations, and that mental health resources only occasionally crossed the person's mind. Attitudes were as favorable for psychologists as preferred intentions though subjective norms were less favorable for psychologists. More severe disorders yielded more favorable attitudes and more permissible social norms than disorders of a lesser degree. These data suggest implementing mental health education programs in Japanese American and other Asian-Pacific communities to increase service utilization by increasing awareness of mental health personnel as resources and to increase social norms in support thereof. PMID- 6496412 TI - Professional help use among black Americans: implications for unmet need. AB - Previous findings on black utilization have been largely obtained from racial comparison studies. Little attention has been paid to sociodemographic differences or the social psychological processes that affect help-seeking behavior within the black group. The present study analyzed data obtained from a national probability sample of the black population. A multidimensional contingency table analysis revealed that problems experienced by the lower income group were more serious than those experienced by the upper income group. Low income respondents were also more likely to state that their personal distress was caused by a physical health problem. Income, however, was not related to the decision to seek professional help. The implications of these findings for understanding black illness behavior and the underutilization of services was discussed. PMID- 6496413 TI - Positive life events and social support and the relationship between life stress and psychological disorder. AB - This study investigated the relationship between negative life events and psychological disorder and the roles of positive life events and received and perceived social support in moderating this relationship. A prospective design was used and statistical analyses were based on a hierarchical regression model. College undergraduates served as subjects. Negative events were significantly related to psychological disorder at each of two measurement periods. This relationship was found even when initial disorder was statistically controlled. The cross-sectional analyses, but not the prospective analyses, provided some support for the stress-buffering (interaction) effects of positive events. There was no support for the stress-buffering effects of received social support, but the cross-sectional and prospective regression analyses provided strong support for the stress-buffering effects of perceived social support. PMID- 6496414 TI - Stress and social support: the burden experienced by the family of a mentally ill person. AB - The present research examined the burden experienced by the families of a mentally ill person and the relationship between this stress and social support. The participants were 56 parents of a schizophrenic person who were members of a self-help group for the families of psychiatric patients. Results indicated that low levels of burden were associated with small dense social networks, satisfaction with support received, satisfaction with the support from the self help group, and spouse involvement with the patient. Qualitative data revealed that the stress encountered was chronic in nature, that the families lacked relevant information, and that the self-help group was beneficial. Implications for future research were discussed. PMID- 6496415 TI - Effects of the community mental health centers program on the growth of mental health facilities in nonmetropolitan areas. AB - Using a quasi-experimental design, changes in the numbers of mental health facilities between 1964 and 1974 were examined for a sample of 50 nonmetropolitan catchment areas that established a Community Mental Health Center (CMHC) before January 1973 and a sample that did not. Compared to non-CMHC areas, CMHC areas had a slightly greater number of general hospital psychiatric units in 1974. Nevertheless, the rate of increase in such units over the 10-year period was not significantly different between the two types of areas. Other findings supported the conclusion that the number of outpatient and day/night facilities continued to increase in areas not participating in the CMHC program, but that the program produced even greater numbers of such facilities in areas that did participate. This growth, though, occurred both through introducing additional facilities and supplanting existing ones. PMID- 6496416 TI - Helping styles of crisis interveners, psychotherapists, and untrained individuals. PMID- 6496417 TI - A regional poison control system. Effect on response to hypothetical poisonings. AB - Poisoning of young children frequently results in parents seeking help. Parents either telephone for poison treatment information or go directly to a physician's office, hospital clinic, or emergency room. To determine if a regional poison control system reduces the inappropriate use of medical treatment services, parents attending suburban and inner-city clinics were presented hypothetical pediatric poisoning episodes and asked how they would respond. Parents living in a state serviced by a regional poison information center (Massachusetts) telephoned for information significantly more often and consequently used medical treatment services 19% less than did parents living in a state with only local poison information centers (New Jersey). In both states, inner-city populations went for care whereas suburban populations called. Both inner-city and suburban populations responded to a regional poison center but to a different extent. More severe ingestions tended to increase the use of the regional center by the Massachusetts suburban population, whereas other populations tended to use even more direct services. PMID- 6496418 TI - The deterrent effect of poison-warning stickers. AB - We examined the effect of poison-warning stickers on toddler behavior before and after an education program. Twenty children aged 12 to 30 months were randomly assigned to an experimental or control group. We observed the children for two five-minute sessions in a room containing ten pairs of containers, half of which were labeled with Mr Yuk stickers. Each child was allowed to play freely on the floor, and we recorded the manipulations of the labeled and unlabeled containers. During session 1, neither group showed a statistical preference for labeled or unlabeled containers. During session 2, control subjects again did not show a preference for labeled or unlabeled containers. We found that children in the experimental group preferred to touch labeled containers after undergoing education. Our findings suggest that toddlers may not be deterred from manipulating containers that are labeled with poison-warning stickers. PMID- 6496419 TI - Longitudinal exercise hemodynamics in children with sickle cell anemia. AB - To define further the natural history and causative factors in exercise-related cardiac dysfunction in children and adolescents with sickle cell anemia (SS), we studied the results of 74 patients' initial and follow-up exercise tests. The follow-up study was done one to three years after the first study in 36 children and four to seven years after initial testing in 38 children. Split-plot analysis of covariance did not show any temporal deterioration in exercise hemodynamic variables. Correlation analysis defined hemoglobin and hematocrit levels as critical determinants of cardiac functional reserve capacity in these patients. Several exercise ECG patterns, formerly considered abnormal in children with SS, are now considered to be variants of normal. Studies are presently in progress that should further define the nature and severity of the cardiac impairment during exercise in children with SS. PMID- 6496420 TI - Behavior and academic achievement in hyperactive subgroups and learning-disabled boys. A six-year follow-up. AB - Hyperactive boys with and without conduct disorder and a contrast group of boys with specific reading disability were compared on behavior ratings and academic achievement six years after their initial examination to clarify the relationship between hyperactivity and learning disability. Both hyperactive groups were rated as problematic on dimensions of overactivity, inattention, and impulsivity. Hyperactive boys who had earlier been undersocialized and aggressive continued to have problems with aggression, while the "pure" hyperactive boys did not. Achievement measures showed performance to be normal for both subgroups, and the incidence of learning disability was only 8%. Reading-disabled youngsters, in contrast, showed only a behavior problem with inattention, yet they all continued to exhibit significant achievement delays. These findings suggest that, while hyperactivity and learning disability may coexist, the incidence of such overlap is less than previously estimated. PMID- 6496421 TI - Oxytocin and neonatal hyperbilirubinemia. Studies of bilirubin production. AB - We studied the effect of oxytocin induction or augmentation of labor on rates of bilirubin production in newborns at three different institutions. Bilirubin production, assessed quantitatively by the pulmonary excretion rate of carbon monoxide or qualitatively by the blood carboxyhemoglobin concentration, was not elevated when compared with appropriately matched control groups. Previous studies have implicated administration of large volumes of electrolyte-free dextrose solutions together with oxytocin as an important factor contributing to hemolysis in the infant. The mothers in our studies received minimal amounts of free water. We conclude that oxytocin induction or augmentation of labor does not result in neonatal hemolysis and subsequent hyperbilirubinemia when it is administered without large volumes of sodium-free intravenous solutions. PMID- 6496422 TI - Chickenpox hospitalizations among residents of Olmsted County, Minnesota, 1962 through 1981. A population-based study. AB - Age-specific incidence rates were determined for hospitalizations resulting from complications of chickenpox. We reviewed medical records for all Olmsted County, Minnesota, residents hospitalized for chickenpox during the 20-year period 1962 through 1981. Incidence rates based on these 25 cases showed good agreement with national rates computed from information compiled by the Commission on Professional and Hospital Activities for 669 statistically selected patients, representing about 5% of US varicella hospitalizations from January 1979 through June 1982 (about 4,000 hospitalizations annually). The most common complications were bacterial superinfections in children younger than 5 years old, varicella encephalitis (mainly acute cerebellar ataxia) and dehydration in 5- to 9-year olds, and varicella pneumonia in adults. The high prevalence of chickenpox and its association with infectious and neurologic complications make it a continuing source of morbidity. PMID- 6496423 TI - Attempting to predict hospital admission in acute asthma. AB - If accurate predictions of outcome could be made, the emergency care of patients with asthma would be expedited. To evaluate how well initial peak flow determinations predicted hospitalization when used alone and when combined with other clinical variables, we prospectively studied 200 visits for the care of acute asthma. Using discriminant analysis, we selected the variables that best predicted discharge or admission for the first 100 cases. The best predictive variables were initial peak flow, history of treatment in preceding 24 hours, age at onset of asthma, and number of previous hospitalizations for asthma. This combination correctly predicted admission or discharge for 82% of the 200 cases. Despite this overall accuracy, admission was not well predicted. In the first 100 cases, only six of the 18 admissions were correctly predicted, and in the second 100 cases, none of the 15 admissions were correctly predicted, Initial peak flow measurements, even when combined with other variables, cannot predict hospitalization well enough to be substituted for a therapeutic trial. PMID- 6496424 TI - Impairment of urate excretion in patients with cardiac disease. AB - The serum uric acid levels and uric acid clearance rates were evaluated in 28 patients who had congenital heart disease. Based on hemodynamic assessments, the patients were divided into three groups: group 1, with normal cardiac output and normal arterial oxygen saturation; group 2, with hypoxemia (normal cardiac output with a decreased arterial oxygen saturation); and group 3, with cardiomyopathy (decreased cardiac output). The blood levels of uric acid were elevated in group 3. The mean serum uric acid levels were as follows: group 1, 4.2 mg/dL; group 2, 4.8 mg/dL; and group 3, 11.7 mg/dL. All the patients in groups 2 and 3 had decreased uric acid clearance rates. The mean uric acid clearance rates were as follows: group 1, 10.1 mL/min/sq m; group 2, 4.2 mL/min/sq m; and group 3, 1.7 mL/min/sq m. The patients in group 3 had the most severe abnormalities. Patients with congenital heart disease may have marked impairment of their uric acid excretion, which can occur in the absence of significant renal disease, and may be found in acyanotic as well as cyanotic patients. PMID- 6496425 TI - Stridor due to radiotransparent esophageal foreign body. PMID- 6496426 TI - Naloxone in clonidine toxicity. PMID- 6496428 TI - Chemical dependency and adolescence. PMID- 6496427 TI - Factitious hyponatremia in a child. PMID- 6496429 TI - Secondary sexual characteristics and menstruation. PMID- 6496430 TI - Growth of breast-fed infants. PMID- 6496431 TI - Treatment of febrile infants. PMID- 6496432 TI - Fatal choking in infants and children. AB - Food asphyxiation in infants/children follows a different pattern from the adult "cafe coronary." In the absence of ethanol intoxication, infants/children are prone to mishandling nonfriable, firm, slippery foods/objects with a rounded contour. The Dade County Medical Examiner's files were searched from 1956 to mid 1983 for accidental pediatric choking deaths. Seventeen food and six foreign body asphyxiations were found. The male/female ratio was 1.4/1 and 1/1, respectively. The white/black ratio was 0.9/1 for food asphyxiation whereas no black victims were encountered choking upon foreign objects. Seventy-eight percent of all victims were between 2 months and 4 years of age. Infants/children asphyxiated on items such as a hot dog, hard candy, peanut, toy rattle, tissue paper, balloon, marble, etc. The choking event was recognized by nearby adults in most instances. Risk factors include the availability of riskful foods/objects, natural diseases with difficulty feeding, poor eating habits, and uneducated or ignorant parents/others at the scene. Although public education, package labeling, and changes in food/object design may be appropriate, the ubiquituous risk foods and small foreign objects will, on occasion, escape the eye of even the most watchful parent. PMID- 6496433 TI - Seizure disorders. The Dade County experience from 1978 to 1982. AB - This article concerns seizure disorders that occurred in the medical examiners' population of Metropolitan Dade County between 1978 and 1982. These accounted for 2% of the natural and accidental manners of death. The percentage of males was more frequent than females, with an equal proportion of blacks and whites. The age distribution was half under age 40 and half over age 40. Alcohol abuse was common, although alcohol was absent at time of autopsy in at least 42.5%. Brain pathology and absence of seizure medicine are also discussed. PMID- 6496434 TI - Diffuse axonal injury. AB - Diffuse axonal injury is a distinct form of head injury, induced by direct external forces at the time of the trauma, and not produced by secondary changes due to a primary injury. This type of lesion may be without conspicuous findings on gross brain examination, or may be found with coexisting conventional types of brain injuries. It is characterized by diffuse retraction balls (axonal swellings), hemorrhage or laceration of the corpus callosum, and hemorrhages in the brain stem. It is of utmost importance for forensic pathologists to be aware of this little-recognized entity. Five illustrative cases are presented. PMID- 6496435 TI - Fluidity of cadaveric blood after sudden death: Part I. Postmortem fibrinolysis and plasma catecholamine level. AB - In rats, fibrinolytic activity and plasma catecholamine levels increased rapidly after death. Postmortem fibrinolysis was affected by the method of sacrifice, but catecholamine level was not always affected. Immediately after death, the plasma adrenalin level was higher than the noradrenalin level, but then adrenalin remained unchanged or tended to decrease while noradrenalin tended to increase gradually with time. In human subjects after rapid death, the plasma catecholamine and fibrinolytic activity levels were high. However, in cases after slow death they were low. PMID- 6496436 TI - Never say never. Negligible carboxyhemoglobin in the victim of a smoldering mattress fire. AB - For many years, a high blood carboxyhemoglobin concentration has been used as a criterion for determining that a victim of conflagration was alive in the fire. We report a case in which a man died from the combined effects of burns and hypertensive cardiovascular disease. He had a negligible blood carboxyhemoglobin concentration, but the environmental evidence and autopsy findings are indicative of life in the fire, which arose in a smoldering mattress. We conclude that uncritical, rigid adherence to the requirement that fire victims have high carboxyhemoglobin concentrations can be misleading. PMID- 6496437 TI - Hydrofluoric acid poisoning. AB - A case of suicidal ingestion of hydrofluoric acid is presented. Death of the victim while in police custody was one of the more unique aspects of the case. This is the sixth case of poisoning of this type reported in Dade County. Clinical, pathological, and toxicological aspects of fluoride poisoning are discussed. PMID- 6496438 TI - Commotio cordis, revisited. AB - Nonpenetrating cardiac injuries due to direct precordial blunt impacts are a commonly encountered phenomenon in medicolegal offices. These injuries vary from contusions to valvular lacerations, or papillary muscle rupture to coronary arterial injury with resulting infarction. A less commonly occurring manifestation of nonpenetrating injury is a concussion of the heart (commotio cordis), often with dramatic physiological consequences but no morphologic cardiac injury. We describe four case reports of this entity. The cases were collected over a 5-year period (1978-1983) from the Wayne County Medical Examiner's Office in Detroit, Michigan. PMID- 6496439 TI - Bullet embolism with radiologic documentation. A case report. AB - A case of bullet embolism is reported wherein a handgun missile, fired during a "shoot-out," perforated (among other structures) the anterior and posterior walls of the thoracic aorta, rebounded into the aortic lumen, and was transported to the left femoral artery where it came to rest. Roentgenographic study was instrumental in promptly locating the errant bullet whose recovery established the identity of the responsible firearm. The implications of bullet embolism of the arterial, venous, and paradoxical types for the forensic pathologist and the clinician are discussed briefly. PMID- 6496440 TI - A psychiatric view of another survivor of homicide. The cop who kills. PMID- 6496441 TI - Forensic services in Australia. AB - Australia is comparable in size to the United States without Alaska, but two thirds of the continent is desert or semidesert. The population of approximately 15 million is largely centered around major cities near the coastline. There is a federal system of government, and independent forensic services are based in the capital cities of each of the six states and two territories. The need to service both the densely populated urban areas as well as sparsely populated outback regions has created logistic problems. The forensic services in each state and territory have evolved independently and have resulted in a diversity of organizational forms. The organization of forensic services in Australia is described and contact addresses are provided. PMID- 6496442 TI - A device which allows dictation of the autopsy report during the autopsy. AB - We describe a device for the simultaneous recording of the autopsy findings during the autopsy, thereby offering a convenient way of obtaining correct and timely autopsy reports. PMID- 6496443 TI - Anomolous right coronary artery. PMID- 6496444 TI - Medicolegal system in Greece. PMID- 6496445 TI - Haloperidol (Haldol) and possible association with fatal sickle cell disease (Hgb S-C) PMID- 6496446 TI - Risk factors in dengue shock syndrome: a prospective epidemiologic study in Rayong, Thailand. I. The 1980 outbreak. AB - In January 1980, the municipal area of Rayong, Thailand, and contiguous suburban villages were chosen for a long-term study on dengue epidemiology. From 3,185 children randomly sampled in schools and households, the population prevalence of neutralizing antibody to the four dengue serotypes was estimated. To estimate the incidence of infection with each dengue virus serotype (dengue seroconversions), first grade children were re-bled in January 1981 (cohort study). Children admitted to hospital were studied for dengue virus isolation and antibody responses in paired sera. An epidemic of dengue occurred in 1980. Plaque reduction neutralization tests of 1,009 pre-epidemic sera from children aged less than 1-10 years of age determined that 3.3% were immune to dengue 1, 13.2% to dengue 2, 6.4% to dengue 3, and 5.8% to dengue 4. Examination of pre- and post epidemic cohort blood samples revealed that the incidence of dengue infection in 251 seronegative children was 39.4% (15.1% dengue 1, 11.1% dengue 2, 2.0% dengue 3, 4.8% dengue 4, and 6.4% two or more dengue viruses). Among the 52,935 residents of the study area, there were 22 cases of virologically and clinically confirmed dengue shock syndrome, in children 15 years or younger. All 22 shock syndrome cases had secondary type antibody responses. Eight of 22 had been included in the random serologic sample prior to onset of shock; five had been immune to dengue 1, two to dengue 3, one to dengue 4, and none to dengue 2. Despite the high rate of dengue 1 infections in 1980, only dengue 2 viruses were recovered from dengue shock syndrome cases, including two dengue 1 immune children with pre-illness serum specimens. Although the pre-epidemic prevalence of antibodies to dengue 1 was the lowest to any type, children with this immunologic background contributed disproportionately to shock cases. In descending order of magnitude, risk factors for dengue shock syndrome in Rayong were secondary infections with dengue 2 which followed primary infections with dengue 1, dengue 3, or dengue 4. PMID- 6496447 TI - Interaction between cigarette smoking and diabetes mellitus in the prediction of death attributed to cardiovascular disease. AB - Previous studies have shown that the increased risk of cardiovascular disease in adults with diabetes is independent of heart disease risk factors and have suggested that the effect of these risk factors is similar in diabetics compared with nondiabetics. To determine whether there was interaction between diabetes and the classic heart disease risk factors (cholesterol, blood pressure, and cigarette smoking) in the prediction of cardiovascular death, the etiologic fraction due to interaction was assessed in a nine-year follow-up of 2,620 older Caucasian adults (60-79 years) who resided in Rancho Bernardo, California, 8.7% of whom had diabetes by history of fasting hyperglycemia. In these older adults, the frequency of categoric hypertension, hypercholesterolemia, or current cigarette smoking did not differ significantly among diabetics compared with nondiabetics. Overall, the age-adjusted relative cardiovascular mortality risk among diabetics was similar to that in nondiabetics for all risk factors except cigarette smoking, for which the relative risk for diabetics was 2.2 compared with 1.2 for nondiabetics. High cholesterol and systolic blood pressure levels showed no interaction with diabetes, but cigarette smoking had a large and significant interaction with diabetes, such that an estimated 65% of the cardiovascular disease deaths among diabetics could be attributed to the interaction of diabetes and cigarette smoking. If confirmed, these data have important implications for the prevention of cardiovascular death in older diabetics. PMID- 6496448 TI - Alcoholic beverage consumption and breast cancer incidence. AB - Recent case-control studies have suggested that alcohol consumption may be associated with breast cancer incidence. This report is a retrospective cohort study of over 95,000 women who were members of the Kaiser Foundation Health Plan of Northern California. The stated alcohol consumption of these women was recorded at a multiphasic screening examination taken from 1964 to 1972 prior to any diagnosis of breast cancer. The incidence of breast cancer in this cohort was greater for women who drank, and among these drinkers, incidence increased in an irregular trend with heavier alcohol consumption. Control for the effects of race, education, smoking, and reproductive variables related to breast cancer all but eliminated the overall increased relative risk of drinkers compared with that of nondrinkers. However, the relatively small group of women who stated that they had three or more alcoholic drinks per day (5.2 per cent of the total) had a significantly elevated relative risk of 1.4 (p = 0.035) compared with nondrinkers, despite control for all available confounding variables. No significant interaction effect of smoking and alcohol was found. Women who had less than three drinks per day had no increased relative risk over nondrinkers. The results of this study might be explained either by an unrecognized carcinogenic effect of alcohol on breast tissue or by the confounding effect of other factors associated with heavy alcohol use. PMID- 6496449 TI - A multivariate analysis of risk factors for hepatitis B virus infection among hospital employees screened for vaccination. AB - Previous studies of risk factors for hepatitis B virus infection among hospital employees have been based on surveys in single institutions or have been analyzed with univariate techniques. From November 1980 through August 1981, the authors performed a multi-institutional seroepidemiologic survey of hospital employees screened for entrance into a hepatitis B vaccine trial who represented groups at high risk for hepatitis B infection. Using a logistic regression model for the analysis of risk factors, the investigators determined the relative odds and 95% confidence intervals for risk of hepatitis B infection to be as follows: race (nonwhite/white: 3.4; 2.4-4.8) (p less than 0.001); history of acute viral hepatitis of an unspecified type (3.6; 2.2-5.9) (p less than 0.001); and employment at hospitals 1 through 5 as compared with hospital 6 (1.8; 1.1-2.9) (p = 0.015). In addition, certain job categories and the duration of employment within some of these categories were associated with increasing risk for hepatitis B infection over time. Laboratory workers (1.4; 1.2-1.7), surgical staff (1.2; 1.1-1.4), and medical staff (1.3; 1.1-1.5) had significant (p less than 0.05) increased risk of prior infection with longer duration of employment. Such time-job interaction was not demonstrable for nursing staff, anesthesiology staff, dental personnel, pathology staff, or ancillary personnel. The logistic regression model also shows that the highest gradient of risk for laboratory workers, surgeons, and medical staff occurs during the first five years of employment. An effective preventive strategy, such as the use of hepatitis B vaccine, should be targeted for these groups at the time of initial employment. PMID- 6496450 TI - Immunogenicity and safety of a plasma-derived heat-inactivated hepatitis B vaccine (CLB). Studies in volunteers at a low risk of infection with hepatitis B virus. AB - The safety and immunogenicity of a plasma-derived heat-inactivated hepatitis B vaccine (CLB) were evaluated in 471 healthy human volunteers, who, both in their occupations and in their private lives, had been at minimal risk of being infected with hepatitis B virus. The first 202 individuals received three 3 micrograms doses of heat-inactivated hepatitis B surface antigen (HBsAg) at one month intervals (trial A). A total of 42% one month after the first injection, 84% after two months, and 93% after five months had become anti-HBs (antibody to hepatitis B surface antigen) positive. In a second randomized study (trial B), the immunogenicity of five different dosages of the vaccine was compared in 269 volunteers. When the dose of HBsAg was diminished from 3 micrograms to 1.5, 0.6, and 0.25 microgram, no decrease of the anti-HBs response was observed. However, when the dose was diminished to 0.1 microgram of HBsAg, the anti-HBs response dropped significantly to 63% (p less than 0.001). In the recipients of all five vaccine dosages, no influence of sex and age was found on the anti-HBs conversion rates. During the eight-month observation period, none of the vaccinees became HBsAg and/or anti-HBc (antibody to hepatitis B core antigen) positive, and none developed antibodies associated with autoimmune liver disease. No serious side effects were observed. PMID- 6496451 TI - Selection effects of repeatability criteria applied to lung spirometry. AB - The potential for introducing bias in studies of pulmonary function by the exclusion of subjects with nonrepeatable measurements was examined in a cohort of Vermont granite workers followed for five years. At each annual survey, a "test failure" was defined as a test in which the two largest forced expiratory volumes in one second (FEV1) differed by more than 200 ml. "Persistent test failure" was defined in terms of 1) the number of test failures for each worker over the six surveys and 2) the difference between the two best efforts at each survey, averaged over all surveys for each worker. The rate of FEV1 loss was estimated for each subject based only on repeatable measurements. It is widespread practice to exclude subjects from analysis who do not perform repeatable lung function tests. The authors found that subjects with persistent test failure were losing FEV1 at a faster rate than subjects without. The results suggest that the application of rigid repeatability criteria may bias epidemiologic findings by the exclusion of many subjects with accelerated loss of lung function. PMID- 6496452 TI - The relationship of staff to the incidence of diarrhea in day-care centers. AB - Sixty randomly selected day-care centers in Houston, Texas, were surveyed for cases of diarrhea by weekly telephone calls during the period October 1980 to May 1981. Visits to each day-care center were made upon enrollment and again to collect self-administered questionnaires which had been mailed to the staff of each center. During the eight-month survey, 986 cases of diarrhea were reported, with an average day-care center incidence of 1.15 cases per 100 person-weeks of observation. A significant positive correlation (p less than 0.05 to p less than 0.01) was found between the incidence of diarrhea in a day-care center and each of the following variables reported by the day-care center staff: the average frequency of diapering, the average frequency of working with children less than two years of age, the average frequency of meal preparation, the average frequency of serving food to the children, and the percentage of staff who both diaper and either serve food or prepare meals daily. Day-care centers which accepted children less than two years of age had a 3.55-fold higher incidence of diarrhea compared with centers which did not accept children less than two years of age. Day-care centers in which one or more staff members prepared meals, served food, and diapered children on a daily basis had a 3.28-fold higher incidence of diarrhea compared with centers in which staff did not combine on a daily basis the duties of diapering children with either meal preparation or food service. The results suggest that staff members may play a role in the transmission of diarrhea in day-care centers through diapering, meal preparation, working with children less than two years of age, or a daily combination of diapering and either meal preparation or food service. PMID- 6496453 TI - Lysogenicity and prophage type of the strains of Vibrio cholerae O-1 isolated mainly from the natural environment. AB - Attention has recently been given to the increasingly frequent detection of atypical Vibrio cholerae O-1 in the natural environments throughout the world. Lysogenicity of V. cholerae O-1, mainly isolated from environmental sources in nine areas, including the United States, was studied by electron microscopy and a cross-lysis test between bacteria and the culture supernatants. A total of 38 strains isolated in Texas in 1973 and in Louisiana in 1978 were lysogenic, whereas there were no lysogenic strains among those isolated in Louisiana in 1979. Because these phages were identical in terms of serology and host range, the phage in them was named T-L phage. T-L phage differed in host range from the k type phage in the epidemic strain of the seventh cholera pandemic. Although the T-L phage was neutralized by antiserum to the k type phage and vice versa, the two phage types were not serologically identical. By a prophage typing method, strains of V. cholerae O-1 isolated from the environment in Guam, Bangladesh, and Japan were classified as either of the Celebes type (epidemic strain) or the Classic-Ubon type. All strains isolated in Brazil, the Chesapeake Bay, and England were nonlysogenic and classified as Classic-Ubon type. PMID- 6496454 TI - Loglinear modeling with inexpensive computing equipment. AB - Loglinear models are finding increasing application in the analysis of data from epidemiologic studies and increasing attention in statistics courses taken by epidemiologists in training. This paper describes a program for microcomputers, written in BASIC, which fits hierarchic loglinear models to categoric data organized into multiway contingency tables of any dimensionality. For each model specified by the user, the program can be directed to calculate and display 1) two goodness-of-fit statistics and their corresponding degrees of freedom and p values; 2) expected cell counts under the fitted model; 3) maximum likelihood estimates of the model's terms and, for saturated models, their standard errors; and 4) for models involving a dichotomous response variable, the corresponding logistic regression model. The program can be run on most microcomputers with at least 16K bytes of random access memory, including some costing less than $100. PMID- 6496456 TI - Excluding controls: misapplications in case-control studies. PMID- 6496455 TI - Biochemical screening for pheochromocytoma. Superiority of urinary metanephrines measurements. PMID- 6496457 TI - Test-retest reliability of diet and drinking estimates for pregnancy and post partum. PMID- 6496458 TI - Treatment of polycythemia vera with hydroxyurea. AB - Conventional treatment of polycythemia vera (PV) with radioactive phosphorus or alkylating agents is associated with a significant excess of acute leukemia and cancer of the gastrointestinal tract and skin. There is thus a need for a nonmutagenic agent in the treatment of this disorder. Hydroxyurea (HU) was administered to 118 patients with a loading dose of 30 mg/kg/day for 1 week, which was then reduced to 15 mg/kg/day. Initial control of the elevated hematocrit and platelet count was achieved within 12 weeks in over 80% of patients. Long-term disease control was defined and the accumulative 1-year failure-free survival was 73% in the previously untreated patients and 59% in those patients previously treated with other myelosuppressive modalities. The HU was well tolerated and cytopenia, which generally occurred within the first 8 weeks of therapy, was transient and of little clinical significance. However, it is recommended because of this toxicity that HU be administered initially at a dose of 15-20 mg/kg/day. Three patients developed acute leukemia; two were untreated and one had had myelosuppressive therapy. Hydroxyurea is an effective agent in the treatment of PV, but continued assessment of its mutagenic potential is necessary. PMID- 6496459 TI - Heparin-induced thrombocytopenia: a prospective study. AB - Thrombocytopenia is a well-described complication of heparin therapy. Few studies describe the incidence of thrombocytopenia when low-dose heparin (10,000-15,000 units/day) is used for prophylaxis of deep venous thrombosis. In our study, ten of 66 courses (15%) of heparin prophylaxis in coronary care unit patients were accompanied by a mild thrombocytopenia with platelet counts below 150 X 10(3)/mm3. In all cases the platelet count returned to normal despite continued heparin therapy. Patients who became thrombocytopenic had significantly lower initial platelet counts. No cases of severe thrombocytopenia were seen (platelet count below 100 X 10(3)/mm3). No patient developed thrombosis, bleeding or elevated fibrin split products. Mild thrombocytopenia occurring after 2-5 days of low-dose heparin is common, but clinically insignificant. PMID- 6496460 TI - Kinetics of platelet density subpopulations in splenectomized mongrel dogs. AB - Autologous 51Cr-platelet kinetic studies were performed in splenectomized mongrel dogs. Mean survival time of PRP-platelets was 5.4 +/- 1.5 (SD) days (n = 6). The curves, though slightly curvilinear, showed mostly a linear type of decay, denoting that platelet removal from the circulation is mainly determined by aging of the cells. High-density (HD) and low-density (LD) platelet cohorts were isolated in Stractan gradients from samples drawn daily after infusion of labeled platelets. Specific radioactivity in HD cohorts declined rapidly postinfusion (T1/2 = 1.3 days), but specific radioactivity in LD platelets increased for 2 days and steadily declined for 4 days thereafter (n = 6). Labeled HD platelets, comprising 11.7% of the total population, lived significantly longer in circulation than LD platelets (19.1% of the total population) (n = 3). The patterns of decay of the radioactivity, however, do not have all the characteristics of pure age-cohort survival curves; 3.7 days after the infusion of labeled HD platelets, the specific radioactivity in LD cohorts was six times higher than on day 1, but attained only 20% of the initial specific radioactivity in HD platelets. After the infusion of labeled LD platelets no radioactivity was recovered in circulating HD cohorts. These findings indicate that mongrel dog platelets decrease in density with aging, but also that platelet density heterogeneity is in part determined during the thrombopoietic process. These data are consistent with those of other authors in rabbits and rhesus monkeys, but contrast with the observations that platelets in humans, baboons, and Macaca fascicularis monkeys increase in density with age, suggesting that the displacement of platelets toward compartments of either higher or lower density depends on the species under study. PMID- 6496462 TI - Spurious automated red cell values in warm autoimmune hemolytic anemia. AB - Two patients with warm autoantibodies to their red cells had a mean cell volume artifactually elevated by red cell agglutination. Red cell size distribution histograms directly showed doublets and triplets of normal-size red cells. This phenomenon is similar to the spurious macrocytosis previously reported due to cold agglutinins, but was not reversible by warming. PMID- 6496461 TI - Preparation of low-affinity red cells with dimethylsulfoxide-mediated inositol hexaphosphate incorporation: hemoglobin and ATP recovery using a continuous-flow method. AB - Incorporation of IHP into red cells decreases oxygen affinity as a result of the binding of this compound to the 2,3-DPG site of hemoglobin. This investigation describes a continuous-flow method which utilizes the osmotic pulse technique to transport IHP into RBC. Using this procedure, it is possible to obtain a significant increase in P50 while maintaining in vitro cellular integrity. For example, IHP incorporation sufficient to cause an increase in the P50 of 20 mm Hg may be achieved with recovery of approximately 75% of the hemoglobin and with maintenance of ATP levels compatible with good viability. The continuous-flow method allows uniform treatment of large, unit-size volumes of red cells with a relatively small quantity of reagents. The final cell product is macrocytic/hypochromic with an increased number of stomatocytes. PMID- 6496463 TI - Hemoglobin C in heterozygote carriers. PMID- 6496464 TI - Adequacy of dialysis. AB - Adequacy of dialysis, both hemodialysis and peritoneal dialysis, has been the subject of a number of meetings and papers in the past. Nevertheless, it still remains defined only in general terms. Calculations of clearance of patients on intermittent peritoneal dialysis have shown the importance of residual renal function in patients with peritoneal dialysis. PMID- 6496465 TI - A comprehensive report on the experience of patients on continuous ambulatory peritoneal dialysis for the treatment of end-stage renal disease. AB - This article summarizes highlights of data from the National Institutes of Health Continuous Ambulatory Peritoneal Dialysis Registry Report released in early 1984. Follow-up data for 6,656 patients were collected from January 1981 through June 1983 and were analyzed for this report. PMID- 6496466 TI - Experience with intermittent peritoneal dialysis and continuous cyclic peritoneal dialysis. AB - Acceptance of peritoneal dialysis as a standard modality of therapy for end-stage renal disease (ESRD) was initially slow due to various technical problems and the difficulty of quantitating peritoneal membrane function. Development of reliable, permanent access to the peritoneum and the availability of dependable automated equipment stimulated the development of intermittent peritoneal dialysis (IPD), which demonstrated initial success. However, the failure rate was noted to increase with time, primarily due to insufficient dialysis and malnutrition. The introduction of continuous ambulatory peritoneal dialysis (CAPD) allowed better clearances and the maintenance of a more physiologic steady state. However, the twin problems of inconvenience and frequent infections proved to be significant. Continuous cyclic peritoneal dialysis (CCPD) was then developed to allow exchanges at night on a more convenient basis, reduce the rate of peritonitis by circumventing some of the technical disadvantages of CAPD, and decrease the stress on any helpers who may be involved. Experience with CCPD has demonstrated acceptable control of nitrogenous waste products, fluid balance, adequate maintenance of nutrition in the great majority of patients, and satisfactory maintenance of hemoglobin and acid-base balance. CCPD also offers flexibility of prescription accomplished by varying the frequency and length of nocturnal automated cycles. The preliminary experience with peritoneal kinetic modeling suggests that quantitation of peritoneal function will be significantly improved in the future and that standards of adequacy of dialysis will be more precisely defined. PMID- 6496467 TI - Choosing a dialysis therapy for children with end-stage renal disease. AB - Although transplantation is the optimal therapeutic modality for the child with ESRD, it is usual for the child to require short- or long-term dialysis prior to obtaining a successful transplant. Various factors such as age, mental and psychosocial status, and primary renal disease influence the choice of dialysis therapy. The medical and psychosocial benefits of home peritoneal dialysis are the determining factors influencing the increasing use of CAPD/CCPD in children requiring prolonged dialysis therapy. PMID- 6496468 TI - Choosing a dialysis therapy: narrative summary of a panel discussion. PMID- 6496469 TI - Dialysate flow rate and peritoneal clearance. AB - We evaluated the influence of dialysate flow rates upon peritoneal clearance of urea, creatine, protein losses into dialysate, glucose disappearance from dialysate, sodium removal from the patient during dialysis, and ultrafiltration rate in 64 patients undergoing intermittent peritoneal dialysis. We evaluated three dialysate flow rates: 2 L/h, 3 L/h, and 4 L/h. All dialysate contained 1.5% glucose. The clearance of urea in milliliters per minute (2-L series 14.0, 3-L series 15.1, 4-L series 17.6) and creatinine in milliliters per minute (2-L series 9.3, 3-L series 10.6, 4-L series 11.6) determined at a dialysate flow rate of 4 L/h was significantly greater than the clearances determined at 3 and 2 L/h of dialysate flow (P less than 0.05). The clearance of glucose from the peritoneal cavity in milliliters per minute (2-L series 6.9, 3-L series 7.9, 4-L series 8.9) was significantly greater for the 4-L series as compared with the 2-L series (P less than 0.05). There were no other significant differences. Neither sex, race, previous episodes of peritonitis, nor etiology of renal failure influenced the results. Given the high cost of dialysate, we recommend dialysate flows of 2 L/h if a patient has a residual renal clearance of 2.5 mL/min. Although increasing dialysate flow rate may compensate for renal clearances significantly less than this, we believe the patient should be offered hemodialysis, continuous cyclic peritoneal dialysis (CCPD), or continuous ambulatory peritoneal dialysis (CAPD). PMID- 6496470 TI - Amphotericin selectively increases peritoneal ultrafiltration. AB - Because amphotericin B is known to affect transport rates across biologic membranes, the effects of this agent on transport parameters in an animal model of peritoneal dialysis were investigated. When amphotericin B in doses ranging from 0.5 to 25 mg/kg was instilled intraperitoneally with commercial dialysis solution, diffusive clearances of phosphate and urea did not differ from control values measured in the same animals, and only a modest increase in potassium clearance was detected. Ultrafiltration due to the osmotic gradient induced by the dextrose content of the dialysis solution increased significantly to 0.31 mL/kg/min with amphotericin B, compared with control values of 0.18 mL/kg/min. The drug did not affect dextrose transport and the osmotic gradient did not differ in the two groups. Hence, the ultrafiltration coefficient was higher with amphotericin B (14 microL/kg/min/mosm), than during control dialyses (6 microL/kg/min/mosm). Increased water flux was detected at the lowest dose and there was no dose relationship over the range studied. Amphotericin B may be the type of agent that will be clinically useful in patients with reduced peritoneal ultrafiltration capacity, and safer analogues should be explored. PMID- 6496471 TI - Beta-thalassemia disease prevention: genetic medicine applied. AB - We report here an evaluation of a program for thalassemia-disease prevention, comprising education, population screening for heterozygotes, and reproductive counseling; the evaluation includes cost analysis. A preprogram survey in 1978 of 3,247 citizens in the high-risk communities (85% were high-school students) showed that 88% favored a program but that only 31% considered fetal diagnosis as an acceptable option. Screening in high school or before marriage was preferred by 56%. In a 25-month period (December 1979-December 1982), we screened 6,748 persons, including 5,117 senior high-school students, using MCV/HbA2 indices. The participation rate was 80% in the high-school group. The frequency for beta thalassemia heterozygosity was 4.7% with 10-fold variation among ethnic groups at risk; the overall frequency for all variants found was 5.4%. We surveyed 60 carriers and 120 noncarriers after screening high-school students (response rate 77%): most carriers told parents (95%) and friends (67%) the test result; and 38% of the carriers' parents (vs. 18% of the noncarriers' parents) were also screened. Carriers would ascertain their spouses' genotype (91%) and approved uniformly (95%) the high-school screening experience and its goal. We performed 11 fetal diagnoses in a 25-month interval (greater than 75% participation in target population) either by fetoscopy and globin-chain analysis or by amniocentesis and genomic DNA analysis; two of three affected fetuses were aborted at parental request, there was one spontaneous abortion (after fetoscopy), and seven live births. The at-risk couples claimed pregnancy would not be contemplated without the fetal-diagnosis option. We analyzed economic costs of the program: cost per case prevented is approximately equal to $ 6,700, slightly less than cost-per-patient-treatment-year or about 4% of undiscounted treatment cost incurred in the first 25 years of life for an affected individual. These findings indicate: collective acceptance of the program, appropriate attitudes among carriers, general acceptance and efficacy of fetal diagnosis, and global cost-effectiveness. PMID- 6496472 TI - Segregation analysis of schizophrenia and related disorders. AB - Segregation analysis was applied to 79 nuclear families ascertained through chronic schizophrenic probands. Analysis was performed on the diagnosis of schizophrenia alone and on schizophrenia and schizotypal personality disorder (milder phenotype) combined. The models used were the transmission probability model and the mixed model. Because the disease is associated with reduced fertility, all likelihoods were calculated conditional on parental phenotypes. However, compatibility of the mating-type distribution predicted by each model with the observed was also examined. In all analyses, results suggested consistency with genetic transmission. In the analysis of schizophrenia alone, discrimination among models was difficult. In the analysis including the milder phenotypes, all single-locus models without polygenic background were excluded, while pure polygenic inheritance could not be eliminated. The polygenic model also gave good agreement with supplementary observations (lifetime disease incidences, mating-type distribution, and monozygotic twin concordance). The estimated components of variance for the polygenic model were: polygenes (H) 81.9%; common sib environment (B) 6.9%; random environment (R) 11.2%. Although the polygenic model was parsimonious, segregation analysis and the supplementary observations were also consistent with a mixed model, with a single major locus making a large contribution to genetic liability. Such a locus is more likely to be recessive than dominant, with a high gene frequency and low penetrance. The most likely recessive mixed model gave the following partition of liability variance: major locus, 62.9%; polygenes, 19.5%; common sib environment, 6.6%; and random environment, 11.0%. PMID- 6496474 TI - Paternal effects on the human sex ratio at birth: evidence from interracial crosses. AB - The effects of interracial crossing on the human sex ratio at birth were investigated using United States birth-certificate data for 1972-1979. The sex ratio was 1.059 for approximately 14 million singleton infants born to white couples, 1.033 for 2 million born to black couples, and 1.024 for 64,000 born to American Indian couples. Paternal and maternal race influences on the observed racial differences in sex ratio were analyzed using additional data on approximately 97,000 singleton infants born to white-black couples and 60,000 born to white-Indian couples. After adjustment for mother's race, white fathers had significantly more male offspring than did black fathers (ratio of sex ratios [RSR] = 1.027) and Indian fathers (RSR = 1.022). On the other hand, after adjustment for father's race, white mothers did not have more male offspring than did black mothers (RSR = 0.998) or Indian mothers (RSR = 1.009). The paternal race effect persisted after adjustment for parental ages, education, birth order, and maternal marital status. The study shows that the observed racial differences in the sex ratio at birth are due to the effects of father's race and not the mother's. The study points to paternal determinants of the human sex ratio at fertilization and/or of the prenatal differential sex survival. PMID- 6496473 TI - Comparisons of different sampling designs for the determination of genetic transmission mechanisms in quantitative traits. AB - The power provided by several sampling designs to detect segregation at a major locus was investigated in a simulation study using phenotypes constructed from a major-locus genotypic mean, a background polygenic effect, and an individual specific environmental effect. Questions of which relatives, how many relatives, and how many independent pedigrees to collect were considered, using configurations ranging from nuclear families of size 5 to 4-generation pedigrees of size 45. Each configuration contained a single proband whose phenotype exceeded the 95th percentile in a population where 2.5% carry the disease susceptibility allele. Results suggest that, under the conditions simulated, when total sample size is fixed, samples composed of 3-generation pedigrees of intermediate size provide a greater magnitude of support for the presence of a major locus than do samples composed of nuclear families or 4-generation pedigrees. This study is the first to consider both the discriminatory power and estimation efficiency in comparing alternative sampling strategies for pedigree data. PMID- 6496475 TI - Bilirubin binding by variant albumins in Yanomama Indians. AB - Sera of Yanomama Indians homozygous for the common albumin allele exhibited greater total effective-binding capacities for bilirubin than did sera of individuals homozygous for the Yan-2 albumin variant in the in vitro experiments described herein. Total effective binding capacities of heterozygous samples were close to those of homozygotes for AlA. Individuals homozygous for Yan-2 might experience a higher risk of bilirubin toxicity and related disorders during the neonatal period. Further studies of binding and displacement of bilirubin by competitors, such as dietary or medicinal coumarins, might help explain the existence of these polymorphisms and the significance of phenotypic differences in binding to bilirubin. PMID- 6496476 TI - Survey of reproductive hazards among oil, chemical, and atomic workers exposed to halogenated hydrocarbons. AB - Several halogenated hydrocarbons are suspected of causing adverse reproductive effects. Because of such concerns, the Oil, Chemical, and Atomic Workers International Union surveyed the reproductive histories of two groups of workers. One group worked at plants engaged in the production or use of halogenated hydrocarbons (exposed) whereas the others had no such opportunity for exposure (nonexposed). Although a low response rate precludes firm conclusions, the 1,280 completed questionnaires provide useful data for generating hypotheses in this developing field of interest. A history of diagnosed cancer was reported more frequently among exposed workers. The infant mortality rate was also significantly elevated among the offspring of exposed workers. No risk gradient was observed for episodes of infertility, fetal loss, congenital defects, or low birthweight offspring. Concerns with nonresponse, exposure characterization, possible confounding factors, and limited statistical power are addressed. The results provide further suggestions which help to direct studies of occupational reproductive risks. PMID- 6496477 TI - Mortality among rubber workers: VII. Aerospace workers. AB - This study evaluated cause-specific mortality among 3,161 men who were employed in the aerospace division of a rubber manufacturing company. Compared to other production workers at the plant, aerospace workers in deicer and fuel cell manufacturing jobs experienced a 60% excess of deaths from lung cancer. Deicer and fuel cell workers who were under 65 years of age had lung cancer rates that were approximately twice those of other rubber workers of comparable age. Aerospace division employees also had elevated rates of bladder cancer, leukemia, lymphoma, and multiple myeloma. However, detailed analyses suggested that, with the exception of lung cancer, these cancer excesses were not likely to be attributable to employment in the aerospace division. PMID- 6496478 TI - Mortality among rubber workers: VIII. Industrial products workers. AB - This report compares the mortality experience of 6,533 men employed in the industrial products division of a rubber manufacturing company with that of U.S. males and of other rubber workers. For most causes of death the mortality rates of industrial products workers were lower than those of U.S. males and similar to those of other rubber workers. Relative to other rubber workers, men in the industrial products division had a 50% excess of deaths from lymphoma, a 90% excess of deaths from multiple myeloma, and a 20% excess of deaths from bladder cancer during the study period. The excesses of lymphoma and multiple myeloma were strongest during recent follow-up in 1970-78 (observed/expected deaths: 10/4.3 for lymphoma; 10/4.4 for multiple myeloma), whereas bladder cancer mortality was not excessive during this calendar period. PMID- 6496479 TI - Biochemical and electrophysiological study of subjects with a history of past lead exposure. AB - The effects of lead on porphyrin metabolism and peripheral nervous system were studied in a group of 38 subjects who had not been exposed for a period of time, ranging from 3 to 27 years. The mean values for blood lead (PbB), chelated lead(PbUEDTA), and free erythrocyte protoporphyrin (FEP) were found to be significantly higher in the subjects with past lead exposure than in controls. In all cases the neurological examination was negative. The mean values for maximum motor conduction velocity (MMCV) and conduction velocity of the slower fibers (CVSF) of the ulnar and peroneal nerves were found to be significantly lower in the subjects with past lead exposure than in the control group of 23 subjects standardized for age. Signs of partial denervation were present in four cases, with two presenting a decrease of the motor conduction velocity (MCV) as well. No correlation was found between electrophysiological findings and biochemical indicators of dose and effect. The length of exposure showed a significant negative correlation only with the MMCV of the ulnar nerve. A significant difference from controls standardized for age was observed only in subjects with exposure of more than 6 months for all the electromyographic (EMG) parameters. It does not appear that the EMG findings could depend upon modest lead deposits still present in the organism; they should rather give evidence to the permanent effect of alterations that occurred during the prolonged exposure to lead. PMID- 6496480 TI - The rules of the game: an analysis of OSHA's enforcement strategy. AB - Although OSHA promulgates standards for chemical exposures on the basis of workers' relative risk of acquiring chronic disease, it interprets the limits as absolute levels never to be exceeded. This poses a dilemma to the gathering of useful information which can be used to assess and reduce exposures, because employers can maximize compliance outcomes by minimizing exposure monitoring. The result is that, in the absence of adequate information, the working population's true risk of acquiring disease is essentially unknown and average exposures of several times the permissible exposure limit (PEL) can be declared in compliance. The dilemma could be resolved if OSHA would define compliance in terms of one or more parameters of the cumulative exposure distribution. Since OSHA's current method of assessing risks is based upon average exposures, enforcement of the PEL as the limit of each worker's true mean exposure would be internally consistent. This change could have the effect of encouraging employers to monitor exposures since the confidence interval surrounding the mean can be narrowed with increased sample size. PMID- 6496481 TI - A proportionate mortality analysis of California agricultural workers, 1978-1979. AB - There are few published reports of epidemiologic studies of the risks of agricultural work. Members of this occupational group have been of special concern because of their exposure to pesticides, some of which are mutagens and animal carcinogens. A previous proportionate mortality study of California agricultural workers was based on deaths recorded among white males of this occupational group during 1959-1961. We have conducted a proportionate mortality analysis of all deaths recorded during 1978-1979 among California farm workers and farm owner/managers. In general, the findings of our study are consistent with those of the previous study. For farm workers, we found proportionate mortality ratios (PMRs) which were consistently elevated for all race and sex categories (in which there were 6 or more decedents) for deaths due to motor vehicle accidents, all respiratory disease, and all infective and parasitic diseases. The PMRs for the former three causes of death were also found to be elevated across several race and sex categories for farm owner/managers. We also found a significant and consistent deficit of deaths among farm workers and farm owner/managers due to arteriosclerotic heart disease. The proportionate cancer mortality ratios (PCMRs) for cancer of the stomach and cancer of other lymphatic tissue were elevated, although not necessarily statistically significantly, for several race and sex categories among farm workers and farm owner/managers. The PCMR for cancer of the cervix was statistically significant for white female farmworkers. PMID- 6496482 TI - Establishing a heparin-flush protocol for central venous catheters. PMID- 6496483 TI - Simplified method of preparing lactate-free peritoneal-dialysis solution. PMID- 6496484 TI - Role of pharmacy technicians on the cardiac-arrest team. PMID- 6496485 TI - Ideal body weight revisited. PMID- 6496486 TI - Stirring the pot. PMID- 6496487 TI - Are we losing our way? PMID- 6496488 TI - Consultant evaluation of a hospital medication system: analysis of the existing system. AB - A consultant team's evaluation of a system for distributing and controlling medications in a large teaching hospital is described. Through interviews with key personnel from administration, pharmacy, nursing, and the medical staff, an interdisciplinary research group identified problems in the reliability and response times of the hospital's existing medication system. After assessing staff expectations regarding acceptable standards for medication errors and response times and their attitudes toward proposed changes in the medication system, medication-error rates were determined using a pharmacist-observer method. Observations during 34 five-hour periods on four nursing units were conducted over a 17-day period. Medication-error rates were calculated as the frequency of medication errors during the observation period divided by the total opportunities for error (OE), which were defined as doses ordered plus unauthorized doses given. Response times for processing "now," "stat," and routine orders were also determined using work-sampling methods. The total medication-error rate for the nursing units studied was 9% excluding wrong-time errors; more than a third of doses were given more than 30 minutes before or after their scheduled administration times. Response times for "now" and "stat" orders averaged about 23 minutes, in conformance with the desired standard of 30 minutes. However, processing of routine orders required an average of two hours and seven minutes, much of which was attributed to delays in the messenger service. The basic design of the existing unit dose medication system contributed to problems in the reliability and efficiency of the system. PMID- 6496489 TI - Consultant evaluation of a hospital medication system: synthesis of a new system. AB - Recommendations of consultants for the implementation of a new medication system at a large teaching hospital are described. Based on a previous analysis of the hospital's existing drug distribution and control system that revealed problems in reliability and response time, an interdisciplinary consultant group offered 14 recommendations, which included implementation of a computerized unit dose delivery system and selected clinical pharmacy services. Functions identified for which computerization would produce the greatest benefits included maintenance of patient census data, medication order entry and retrieval, and preparation of a medication administration record for nursing. Recommendations for improving the unit dose system in the hospital consisted of increasing the number of medications packaged in true unit dose form, increasing the frequency of daily deliveries of scheduled medications, sending p.r.n. medications on an on-call basis, decreasing the lead time for preparation of i.v. solutions, and using a pharmacist-manned portable medication cart to reduce workload on the central pharmacy during peak workload periods. Clinical pharmacy services identified as having the greatest cost-benefit ratio were discharge consults, drug therapy monitoring, and drug-use review. Using information from published studies and cost data from the hospital, a net annual savings of over +152,000 was projected with implementation of these services. Improvements in the unit dose system and implementation of clinical pharmacy services were expected to result in substantial cost savings in the study hospital. PMID- 6496490 TI - Consultant evaluation of a hospital medication system: implementation and evaluation of the new system. AB - The effects of consultant-recommended modifications in a hospital medication system on medication-error rates and response times were evaluated. Fourteen recommendations for improving the medication system in a large teaching hospital were implemented to varying extents over a period of 1.5 years. The response times and medication-error rates of the newly implemented system were then measured using pharmacist-observers as was done in the old medication system. Medication-error rates were then compared on one medical-nursing unit and two surgical-nursing units both before and after implementation of the new system on the medical unit alone. Response times for routine medication orders decreased by 55% compared with the previous system; for "now" and "stat" orders, response times were reduced by 57% for orders filled from the central pharmacy and by 70% for orders filled from medication carts on the nursing units. No significant differences in medication-error rates were found when the old and new medication systems were compared. This finding was attributed primarily to the hospital's failure to implement recommendations related to computer printing and sorting of orders, use of dispensing envelopes for delivering medications in true unit dose form, and packaging of all medications in unit dose form. This study illustrates how the benefits of a unit dose system can be compromised in implementation and the need for close monitoring to ensure that performance standards are maintained. PMID- 6496491 TI - Applying for a certificate of need for unit dose and i.v. admixture services in a Connecticut hospital. AB - The process of obtaining regulatory-agency review of a proposal for unit dose and i.v. admixture services is described. In a 901-bed community hospital in Connecticut, a pharmacy department proposal for instituting unit dose distribution and expanding the i.v. admixture service was supported by the hospital administration and included in hospital budget projections. A state body that regulates hospital revenues, the Commission on Hospitals and Health Care (CHHC), rejected the proposal for these changes in pharmaceutical services. The pharmacy and hospital administration subsequently petitioned the Health Systems Agency in that jurisdiction for a certificate of need (CON); the procedure required that the application also be simultaneously submitted to CHHC. Implementation of the program over a three-year period was proposed. The CON application was submitted in July 1981; it required detailed information from pharmacy, nursing services, and hospital administration. During the nine months following application for the CON, further questions were asked and five hearings were held. In April 1982, CHHC approved the program and the capital expenditures but did not approve the proposed 10% increase in drug revenue needed to support the services. The hospital ultimately committed funding for implementation of the program over three years. The net result of the application procedure was a delay in implementation of expanded pharmaceutical services. PMID- 6496492 TI - Antineoplastic admixture service in a tertiary-care hospital. AB - The rationale and decision-making processes involved in the development and implementation of an antineoplastic admixture service in a 1027-bed teaching hospital are described. Because of concerns expressed by nurses about the potential health hazards of handling antineoplastic drug products, the department of pharmacy was asked to prepare all injectable antineoplastic agents within the institution. At the time of the request, the pharmacy department operated 12 decentralized pharmacies and one central pharmacy; no i.v. admixture services were provided, except for total parenteral nutrient solutions. In developing the service, the pharmacy department considered the advantages and disadvantages of (1) a centralized versus decentralized organization, (2) various physical facilities, and (3) various staffing patterns. An ad hoc committee of the P & T committee was formed to develop multidisciplinary guidelines for the appropriate handling of these products. A centralized service open from 0800 to 1600 daily was established. A supervisor was hired to train and manage the rotation of the entire pharmacy staff through the area. A vertical laminar-airflow biologic safety cabinet and exhaust adapter were purchased, and policies and procedures for handling the antineoplastic agents were developed for all involved personnel. Since opening in July 1983, the antineoplastic admixture service has been positively received by health-care providers in this institution, and no major problems have been associated with the program. PMID- 6496493 TI - Establishment and operation of an oncology satellite pharmacy. AB - The justification, establishment, and operation of an oncology satellite pharmacy in a 545-bed university teaching hospital are described. The oncology satellite pharmacy was established because of concerns expressed by nurses about the potential health hazards of handling cytotoxic drug products. The satellite pharmacy, which is located near the three floors that serve the majority of the adult and pediatric oncology inpatients, is responsible for preparing all injectable cytotoxic drug products used in the institution; this includes inpatient and outpatient use. The satellite is staffed by one full-time equivalent (FTE) supervisor, two FTE staff pharmacists, and 1.4 FTE technicians. It is open nine hours a day during the week and four hours a day on weekends. Pharmacists working in the satellite prepare all cytotoxic drug products in a laminar-flow biological safety cabinet. The pharmacists also provide clinical services for oncology patients, such as monitoring drug therapy and providing drug information to patients, nurses, and physicians. The implementation of an oncology satellite has allowed this pharmacy department to expand its services and decrease the potential risks to personnel involved in preparing and administering cytotoxic drug products. PMID- 6496494 TI - Medical committee enforcement of policy limiting postsurgical antibiotic use. AB - A hospital policy enforced by medical staff committees limiting prophylactic antibiotic use is described. The pharmacy department is authorized to discontinue prophylactic antibiotic orders at 72 hours postoperatively for patients in whom there is no sign of infection. Decentralized pharmacists screen antibiotic orders for formulary status and appropriateness. Forty-eight hours postoperatively, pharmacists evaluate patients for infection and document in each patient's chart that the antibiotic will be discontinued within 24 hours unless renewed by the physician. Pharmacists document situations in which a physician renews the antibiotic and no infection is present. Audits of antibiotic use are performed, and the quality assurance, medical credentialing, and surgery committees deal with noncompliant physicians. For 153 prophylactic antibiotic orders audited in January 1981 before the program was implemented, approximately 50% were discontinued within 72 hours. During the same period in January 1984 when the 72 hour policy had been in effect one year, this percentage had increased to 85%. Two individual surgeons and one group of surgeons (urologists) who never complied with the policy were referred in 1983 to the surgery committee. After consultation, the two surgeons changed their standing orders to comply with the policy, and the urologists were granted an exception that was to be reviewed annually. The support of the medical staff in ensuring physician compliance has been the key element in the success of this policy. PMID- 6496495 TI - Contract for educational services between a college of pharmacy and private hospitals. AB - A fee-per-student reimbursement system for clinical clerkships that evolved between a college of pharmacy and a private community hospital is described. The faculty member is a hospital employee with the college compensating the hospital on a per-student basis for the provision of clerkship instruction. Both the hospital and the college were concerned about the allocation of costs, responsibility for the supervision of the program and personnel, and finding a way to accommodate their different goals and objectives. The hospital provides (1) the necessary clinical training facilities and resources for the clerkship program, (2) 60 hr/yr of drug-therapy lectures, and (3) 40 hr/yr of release time to attend faculty and department meetings at the college. The hospital employs the clinical pharmacist to provide clinical services to its family medicine center and the clerkship program. A written contract specifies the responsibilities of both parties, and an addendum is negotiated annually to state the actual fees, number of students per year, and number of hours spent in lectures and committee participation at the college. The contractual relationship has been extended successfully to four other sites. The college and the hospital have found this reimbursement approach to be flexible, effective in promoting organizational communication, and mutually beneficial in allowing both organizations to achieve their goals. PMID- 6496496 TI - Use of medicinal plants by ambulatory patients in Puerto Rico. AB - The use of medicinal plants by the patients at the outpatient clinics of five health-care centers in Puerto Rico was evaluated. Medication histories were obtained for 802 patients ranging in age from two months to 91 years. The most frequent medical diagnosis was cardiovascular disease (54% of the patients). Respiratory and digestive disorders were the least frequent conditions, identified in only 9% and 6% of the cases, respectively. Medicinal plants were used by 57% of the population. Patients 65 years or older tended to use herbal remedies more often. Seven of the 11 most commonly used plants were used to treat gastrointestinal disorders. Other medicinal uses given were for sedation, sleep disorders, elevated blood pressure, kidney disorders, and respiratory ailments. The most frequently used plant was Citrus aurantium L. (sour orange), which was used as a sedative by 39% of the patients and for gastrointestinal disorders by 17%. Two potentially toxic plants, Solanum americanum and Annona muricata, were among the most commonly used plants. Medicinal plants were used widely by the outpatient population studied. Most herbs were used to treat self-limiting conditions but some were used to treat potentially serious medical problems, such as hypertension. PMID- 6496497 TI - Stability of theophylline in human serum and whole blood. AB - The effect of various storage conditions on serum theophylline results using a fluorescence polarization immunoassay (FPI) method was studied. Two human subjects received sufficient oral theophylline to produce low and high therapeutic serum theophylline concentrations. Aliquots of venous whole blood (without anti-coagulant) and serum from each subject were sealed in polypropylene plastic and glass containers and stored at 4 degrees C and 25 degrees C. Additional aliquots of serum from each subject were stored in glass and polypropylene containers at -20 degrees C. FPI assays were performed on days 0 and 3 for room temperature serum samples, days 3 and 7 for refrigerated serum samples, and days 3, 7, 14, 28, 56, 168, and 336 for frozen serum samples. All whole blood samples were assayed on day 3 after removal of the clot. Some samples were tested using FPI for 1,3-dimethyluric acid, a metabolite of theophylline, and results from spiked samples and samples tested with high-pressure liquid chromatography were compared with FPI results to determine cross-reactivity of the metabolite. No appreciable change in the assayed theophylline values occurred under any storage temperature, nor was there any difference in results from samples stored in glass versus polypropylene containers. At a concentration of 20 micrograms/ml, 1,3-dimethyluric acid produced a cross-reactivity of 3.5% with the FPI system. The FPI method is not affected by storage of samples under the specified conditions over the time period studied. PMID- 6496498 TI - Nifedipine stability in cardioplegic solution. AB - The stability of nifedipine in cardioplegic solution was studied. Cardioplegic solutions containing nifedipine at 275 and 500 micrograms/liter were stored in plastic bags covered in brown plastic wrappers (1) under normal room light at 25 degrees C and (2) in a dark refrigerator at 4 degrees C. Samples were removed periodically for 48 hours. Infusions of cardioplegic solution containing 275 micrograms/liter were simulated using tubing and flow rates of 100, 200, and 300 ml/min; bags were covered with aluminum foil, while tubing was exposed to normal room lighting or yellow lighting, which does not degrade nifedipine. Gas chromatography was used for nifedipine assays. Nifedipine degraded more rapidly at 25 degrees C than at 4 degrees C. However, even when protected from light and refrigerated, nifedipine concentrations declined to less than 90% of original potency by approximately six hours after preparation. There was no significant degradation during the simulated infusion regardless of light exposure or flow rate. Cardioplegic solutions containing nifedipine should be prepared immediately before the surgical procedure, refrigerated until use, and protected from light until administration. PMID- 6496499 TI - Effect on moisture permeability of typewriting on unit dose package surfaces. AB - The effects of typewriting on labels of two unit dose packages with respect to moisture permeability were examined. Using an electric typewriter, a standard label format was imprinted on two different types of class A unit dose packages: (1) a heat-sealed paper-backed foil and cellofilm strip pouch, and (2) a copolyester and polyethylene multiple-cup blister with a heat-sealed paper-backed foil and cellofilm cover. The labels were typed at various typing-element impact settings. The official USP test for water permeation was then performed on typed packages and untyped control packages. The original untyped packages were confirmed to be USP class A quality. The packages for which successively harder impact settings were used showed a corresponding increase in moisture permeability. This resulted in a lowering of USP package ratings from class A to class B and D, some of which would be unsuitable for use in any unit dose system under current FDA repackaging standards. Typing directly onto the label of a unit dose package before it is sealed will most likely damage the package and possibly make it unfit for use. Pharmacists who must type labels for the unit dose packages studied should use the lowest possible typewriter impact setting and test for damage using the USP moisture-permeation test. PMID- 6496500 TI - Legal aspects of termination of employment. AB - Legal issues involved in termination of employment are identified, and practical implications of these issues for employers and employees are discussed. There is no general protection against arbitrary dismissal from employment in the United States. Federal statutes restricting termination at will are listed; each state also may have laws protecting employees from arbitrary dismissal. Cases in which state courts have established exceptions to the termination-at-will general rule are described; these suits have been based upon breach of contract, tort, or "public policy" exceptions such as refusing to commit an unlawful act, performing a public obligation or upholding the law, and whistle-blowing. Considering the evolving limits on the termination-at-will general rule, practical advice for employers and employees regarding documentation of interviews, content of appointment letters, and recognition of employee rights is presented. While the termination-at-will general rule appears to be eroding, there does not seem to be a clear trend against which to draw any general conclusions. The cases indicate that courts will find some theory to redress outrageous conduct or clear violations of an employer's policies. PMID- 6496501 TI - Objectives of an effective inventory control system. AB - Quantitative decision-making processes are examined as they relate to hospital pharmacy inventory control. The objective of an inventory-control system is to make inventory decisions that minimize the total cost of inventory, which is distinctly different from minimizing inventory. It is often more expensive to run out of an item (and thus be forced to obtain it through more expensive channels) than simply to keep more units in stock. Several models have been proposed in the literature for minimizing the total cost of inventory through the use of an economic order quantity, which attempts to balance the carrying costs of inventory with the cost of running out of an item. Most pharmacy inventory decisions involve replenishment--how much to order, when to decide to order, and when to place the order. There are three costs associated with pharmacy inventory: (1) carrying costs, (2) shortage costs, and (3) replenishment costs. Many of the proposed models (which are discussed in detail in the article) make certain assumptions that do not hold in the realm of hospital pharmacy. For instance, the "costs" associated with running out of a drug product used in critical care might well involve increased morbidity and mortality, clearly an unacceptable situation. However, the basic tenets of these inventory-control systems should be examined by hospital pharmacy managers and applied when appropriate. The availability of microcomputers and relatively powerful spreadsheets will increase the utility of complex models of inventory control that are too complicated for manual calculations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496502 TI - Unit dose drug distribution: a 20-year perspective. PMID- 6496503 TI - Our drug distribution responsibilities. PMID- 6496504 TI - What we do not know about unit dose drug distribution. PMID- 6496505 TI - Computer applications in unit dose drug distribution systems. PMID- 6496506 TI - Performance standards in unit dose drug distribution. PMID- 6496507 TI - Layoffs: a positive response. PMID- 6496508 TI - Involvement of a state society in pharmacist-prescribing legislation. PMID- 6496509 TI - Drug information requests from practitioners outside an institution. PMID- 6496510 TI - Hospital pharmacy externship: the Alaska experience. PMID- 6496511 TI - Improving pharmacy and therapeutics committee operations. AB - A panel discussion of various aspects of the operations of pharmacy and therapeutics (P & T) committees is presented. Pharmacy and therapeutics committee operations in various types and sizes of hospitals are described. Ways of stimulating physicians' interest in P & T committee activities, difficult problems faced, scope of issues dealt with by P & T committees, functions of P & T subcommittees, the value of drug information from pharmaceutical representatives, and the influence of research funds from the pharmaceutical industry on committee decisions are discussed. Panel members also present their views on therapeutic alternates, FDA-nonapproved use of drugs, and counter detailing. Finally, suggestions for improving P & T drug evaluations, cost containment issues, and the authority of P & T committees are discussed. A well prepared agenda, good educational material, active members, and strong leadership are important for successful P & T committee operations. PMID- 6496512 TI - Monitoring a primary wholesaler depot program. AB - Techniques for monitoring a primary wholesaler depot program used by a university hospital pharmacy department are described. One year after the program began, data from the past four months, obtained from monthly management reports provided by the wholesaler, were reviewed. Attention was focused on the drugs and drug categories that represented the bulk of purchases (in dollar value). Summary purchase orders showed that approximately half the drugs were purchased at the most favorable prices (usually contract bid prices). Most drugs not purchased at the most favorable bid prices were accounted for by sole-source items, inadequate computer documentation by the wholesaler, and atypical orders. A study of ordering patterns revealed that 16 of the top 40 drugs ordered (by volume and dollar expenditures) were ordered less than once per month; the inventory management goal was to order a two-week supply. The wholesaler could not completely fill orders for 18% of the contract drugs, often because of back orders from manufacturers. Although the computerized management reports used in this study did not allow evaluation of all aspects of the primary wholesaler depot program, they provided a convenient mechanism for concurrent assessment of the program's effectiveness. The program appeared to be advantageous to the pharmacy department, and most problems encountered were easily remedied. Several performance measures for institutions considering depot programs are recommended. PMID- 6496513 TI - Diversification strategies for hospital pharmacies. AB - Several ways used by the pharmacy department of a large university hospital to generate revenue through diversification are described. The department offers its facilities and staff as a resource in training medical service representatives for several pharmaceutical manufacturers, which is projected to provide $85,000 in net income for fiscal year (FY) 1983-84. The pharmacy department also conducts a six-month program for training pharmacy technicians, which yields a small net profit. The pharmacy department actively participates in educational programs such as college courses and clerkships earning extra income. An apothecary-style outpatient pharmacy was set up under a for-profit corporation. Services have been expanded to include the preparation of i.v. solutions that support home care. A durable medical equipment (DME) business is planned. The ambulatory and home-care programs are expected to generate approximately $165,000 in net profit next year. Contract pharmaceutical services are provided to another hospital. The net income generated through diversification in this pharmacy department will exceed $250,000 in FY 1983-84. PMID- 6496514 TI - National survey of pharmacy-coordinated investigational drug services. AB - A national survey of 703 pharmacy departments was conducted to obtain information on the status and scope of investigational drug services (IDS). Questionnaires were mailed to the directors of pharmacy departments of general medical and surgical hospitals with 300 or more beds and a university affiliation. The survey consisted of 27 questions that were primarily based on the ASHP guidelines for the use of investigational drugs in institutions. A total of 403 questionnaires were returned, 386 of which could be evaluated, 386 of which could be evaluated. Only 33% of the pharmacy departments adopted a minimal subset (7 of 11) of the recommended procedures based on the ASHP guidelines. All pharmacy departments with more than 40 protocols reported having a research pharmacist or a need for one. Of all of the protocols, 43% were sponsored by the National Institutes of Health, 34% by pharmaceutical companies, 16% by investigators and physicians, and 7% by various other sponsors. Drug information, monetary reimbursement for services,a dn coordination and communication were the most frequently cited areas in need of improvement by the drug sponsors. The most common types of protocols involved cancer research (56%) and infectious disease and cardiovascular studies (12% and 13%, respectively). Directors of pharmacy departments should review their investigational drug policies and procedures for compliance with ASHP guidelines as the first step in developing the IDS concept. PMID- 6496515 TI - Appropriateness of sampling times for therapeutic drug monitoring. AB - Serum sampling for drug concentration was evaluated for usefulness in pharmacokinetic calculations and dosage adjustment. The prospective study included serum samples for 11 drugs in hospital inpatients during a four-week period. Appropriateness of sampling regarding (1) time of drug administration and (2) steady state was determined. Both of these evaluations were used in the final rankings of appropriateness of the samples with regard to ease of interpretation and clinical usefulness. Digoxin, theophylline, tobramycin, and phenytoin accounted for 81% of the 466 samples evaluated. Sampling time was recorded for 56% of all samples. Based on time of dose administration, 54% of samples were obtained at the recommended time; 38% of samples were obtained at steady state. Basic pharmacokinetic methods could be used to interpret 15% of samples, while 44% required complex pharmacokinetic methods, 34% required assumptions about sampling time versus dosing history, and 7% should not have been used in dosage adjustment. The majority of plasma drug samples required more than basic pharmacokinetic methods for evaluation. For assessment of therapeutic drug regimens by monitoring serum drug concentrations, sophisticated pharmacokinetic consultation services are needed. PMID- 6496516 TI - Stability of cytarabine, methotrexate sodium, and hydrocortisone sodium succinate admixtures. AB - A high-performance liquid chromatographic (HPLC) method was developed for simultaneous determination of cytarabine, methotrexate sodium, and hydrocortisone sodium succinate, and the stability of the three drugs mixed together in four infusion fluids was assessed. Solutions were prepared with two concentrations of the three drugs similar to those administered intrathecally. Admixtures were prepared in Elliott's B solution, 0.9% sodium chloride injection, 5% dextrose injection, and lactated Ringer's injection. and lactated Ringer's injection. Solutions were filtered and kept in a disposable syringe in a 25 degrees C water bath for 24 hours. An HPLC assay capable of separating the three drugs and their degradation products was developed and validated. With one exception, all three drugs were stable in all four solutions for 24 hours. Hydrocortisone sodium succinate concentrations decreased to less than 90% of initial concentration in one of the admixtures with Elliott's B solution. No precipitation was noted in any admixture during the first eight hours of storage, but longer storage led to precipitation of unknown substances in some solutions. Admixtures of these three drugs in the four solutions tested are stable for at least 10 hours at 25 degrees C. However, intrathecal and administration of such admixtures within several hours of preparation is encouraged since none contains antibacterial preservatives. PMID- 6496517 TI - Pros and cons of mainframe pharmacy computer systems. PMID- 6496518 TI - Progressive discipline. AB - A structured, stepwise approach to employee discipline is described in which penalties increase in severity if problems are not corrected. Managers should apply all disciplinary measures consistently and should comply with hospital, union, or personnel department procedures where applicable. The steps of progressive discipline include oral counseling, written warning notices, suspension without pay, and termination of employment. Disciplinary sessions should be documented and follow-up sessions should be held to evaluate progress. An oral counseling session should be held immediately after a problem appears and should include a specific description of the problem and its implications by the supervisor, an explanation and suggestions for correction by the employee, and agreement on a specific plan of action. If the problem persists, the manager should give a written warning notice and again discuss the problem and a specific plan of action. One or more suspensions for three or five days may be used, depending on policy and the manager's judgment. When firing an employee, the manager should review previous disciplinary measures and explain the institution's appeal process. If all disciplinary steps have been followed, the appeal should be denied. Use of the progressive discipline process encourages satisfactory employee performance. The specific steps ensure that employees are treated fairly, and documentation of the process supports the manager's action when an employee must be fired. PMID- 6496519 TI - Impact and cost justification of a surgery drug newsletter. PMID- 6496520 TI - Visual compatibility of cimetidine hydrochloride with common preoperative injectable medications. PMID- 6496521 TI - Fractional adjustment of predicted creatinine clearance in females. PMID- 6496523 TI - Residency training: the path to professional and personal dignity. PMID- 6496522 TI - Chemical carcinogenicity and the antineoplastic agents. AB - The subject of chemical carcinogenicity is reviewed with discussions of the involved environmental factors, proposed mechanisms of mutagenesis and carcinogenesis, dose-response considerations, secondary tumor development, and an emphasis on the potential carcinogenicity of antineoplastic agents. Although the causes of various cancers are complex, 70-90% of human cancers are thought to be caused by environmental factors. The factors that have been strongly implicated are excessive cigarette use, heavy alcohol consumption, and disordered dietary practices. Of the minor possible causes of cancer, the administration of prescribed pharmaceutical agents such as the antineoplastic drugs accounts for a suspected 1% of total cancer deaths in the United States. Chemical carcinogenesis involves a multistep process of initiation, promotion, and progression. The development of cancer in man usually takes several years and may be associated with specific tissue susceptibility. Although antineoplastic agents have been recognized for their potential ability to cause cancer, it is difficult to assess from the literature their actual carcinogenic effects in man. Important determinants that modify the ability of the host to deal with carcinogenic substances and the subsequent effects have not been fully evaluated. The control of chemical carcinogenesis must involve reduction of exposure to potential hazards wherever possible. To reduce the risks involved in handling antineoplastic agents, health-care professionals should follow a method of systematic avoidance by adhering to appropriate procedures. PMID- 6496524 TI - Cost containment associated with decreased parenteral antibiotic administration frequencies. AB - Multi-region time and motion studies were conducted in hospitals of various sizes to determine the cost of personnel and supplies associated with the preparation, dispensing, and administration of reconstituted parenteral antibiotics. The administration systems studied included the piggyback intravenous admixture (including several batch methodologies), the volume control intravenous set, and intramuscular techniques. Supply costs were calculated for each system. Projections of potential cost savings resulting from decreased administrations of parenteral cephalosporins were calculated for surgical prophylaxis, 10-day treatment course, and average per bed hospital use. The projected cost savings for the first 24 hours of surgical prophylaxis, or a 10-day treatment course changing from every eight- to six-hour dosing to a single daily dose ranged from $5.60 to $24.25 and $28 to $145, respectively. The average hospital's projected cost savings potential per hospital bed resulting from decreased administration of parenteral cephalosporins depended on the administration system or systems used and ranged from $35 (25 percent reduction in doses) to $364 (75 percent reduction in doses). An algorithm is presented for individual hospitals to use in calculating cost containment estimates. Clinicians and health care managers should seriously consider the cost containment advantages provided by the substitution of newer antibiotics which permit reduced administration frequency. PMID- 6496525 TI - Oral candidiasis. AB - Candidiasis is, by far, the most common mycotic infection of the human oral cavity. The usually manifested clinical expression of oral candidiasis at all ages from the newborn to the elderly is thrush. Other forms that affect the mouth include acute atrophic candidiasis associated with oral antibiotic therapy, chronic atrophic candidiasis attributable to the wearing of full upper dentures, candidal cheilosis ascribable to perleche or decreased vertical dimension in the lower third of the face, chronic mucocutaneous candidiasis emanating from a T lymphocyte deficiency, and candidal leukoplakia. Extensive use of antibiotics and immunosuppressive drugs have greatly increased the number of Candida-induced oral infections. Patients debilitated by irradiation, cancer chemotherapy, organ transplants, diabetes mellitus, and defects in cell-mediated immunity are particularly vulnerable. Fortunately, the vast majority of cases of oral candidiasis are not life-threatening and readily respond to appropriately administered anticandida agents. It must always be remembered, however, that the organism has the capacity to produce fulminating fatal infection by hematogenous dissemination from seemingly innocuous oral infections that serve as a portal of entry to the systemic circulation. Consequently, all oral candidal infections in compromised patients must be treated vigorously and effectively. PMID- 6496526 TI - Allopurinol toxicity and frequent relationship to reduced renal function. PMID- 6496527 TI - Fever on drug-free day of alternate-day steroid therapy. PMID- 6496528 TI - Therapy for stable angina pectoris. PMID- 6496529 TI - Basophils in peripheral blood and bone marrow. PMID- 6496530 TI - The death of death with dignity. PMID- 6496532 TI - Effect of aerobic exercise training on patients with systemic arterial hypertension. AB - One hundred five patients with established diastolic hypertension were enrolled in an exercise program to examine the effect of aerobic conditioning on blood pressure. In four patients, the decrease in mean blood pressure was less than 5 mm Hg; in all others, there was a significant decline in arterial blood pressure. In 58 patients who were not taking drug medication in the pre-exercise period, mean blood pressure decreased by 15 mm Hg. Of 47 patients receiving drug therapy during the pre-exercise period, 24 were able to discontinue all medication. Mean blood pressure in this group fell from 116.9 +/- 6.5 mm Hg to 97.2 +/- 9.2 mm Hg as a result of exercise. In patients still taking antihypertensive drugs, mean pressure decreased from 120.9 +/- 28.8 mm Hg to 104.4 +/- 17.9 mm Hg after three months of exercise. It is concluded that in patients physically and emotionally able to exercise, a significant decline in blood pressure can be achieved. PMID- 6496531 TI - Adrenomedullary response to maximal stress in humans. AB - The most important neuroendocrine response to stress is an increase in plasma epinephrine concentration. To investigate the clinical significance of this response, plasma catecholamine levels were measured (single-isotope derivative assay) in chronic stress (severe illness; n = 22) and acute maximal stress (cardiac arrest; n = 23). The results were then compared with the values from 60 normal resting subjects: epinephrine (mean +/- SEM) 0.034 +/- 0.002 ng/ml; norepinephrine 0.228 +/- 0.01 ng/ml. Chronic stress (intensive care unit patients) was associated with a fourfold elevation of epinephrine concentration (0.14 +/- 0.06 ng/ml; range 0.01 to 1.37; p less than 0.01 versus normal control subjects). Acute maximal stress (resuscitation following cardiac arrest) resulted in a greater than 300-fold increase in the plasma epinephrine level (10.3 +/- 2.9 ng/ml; range 0.36 to 35.9; n = 15; p less than 0.01). Peak plasma epinephrine levels in successfully resuscitated patients (n = 6) ranged from 0.36 to 273 ng/ml (three patients had received epinephrine therapy). The plasma norepinephrine level was increased twofold in intensive care unit patients (0.52 +/- 0.06 ng/ml; p less than 0.01) and 32-fold after cardiac arrest (7.37 +/- 1.8 ng/ml; p less than 0.01). During resuscitation, the correlation between the simultaneous epinephrine and norepinephrine levels was highly significant: r = 0.76; p less than 0.01. It is concluded that (1) chronic, severe stress produces only moderate elevations of plasma epinephrine levels (up to 1.37 ng/ml), whereas acute stress produces marked increases of plasma epinephrine that may reach the extraordinarily high level of 35.9 ng/ml, (2) the potential toxicity from the adrenomedullary response to acute stress is further exacerbated by the parallel release of norepinephrine, and (3) under close medical monitoring, it is possible to survive with plasma epinephrine concentrations as high as 273 ng/ml. PMID- 6496533 TI - Antibody-dependent cell-mediated cytotoxicity in serum samples from patients with ulcerative colitis. Relationship to disease activity and response to total colectomy. AB - A group of six medically treated patients with ulcerative colitis were followed for up to 30 months along with eight additional patients who underwent proctocolectomy. Patients were examined frequently, and serum samples were collected for antibody-dependent cell-mediated cytotoxicity studies. Clinically active disease was substantiated by history, physical examination, laboratory investigations, proctoscopy and, when feasible, by rectal and/or colonic biopsy specimens. During active clinical disease, serum samples from patients with ulcerative colitis showed antibody-dependent cell-mediated cytotoxicity of 16.5 +/- 1.6 percent (range 8.2 to 25.8 percent). During remission of the disease, serum samples from the same patients demonstrated a mean antibody-dependent cell mediated cytotoxicity value of 5.9 +/- 1.3 percent (range 0.4 to 11.1 percent) (p less than 0.01). In the eight patients who underwent proctocolectomy, mean preoperative antibody-dependent cell-mediated cytotoxicity value was 19.5 +/- 2.3 percent (range 4.1 to 38.6 percent). One month after proctocolectomy, antibody dependent cell-mediated cytotoxic activity decreased by 72 +/- 11 percent of the preoperative value (p less than 0.001). These findings reveal a positive correlation between the antibody-dependent cell-mediated cytotoxicity with RPMI 4788 and clinical activity of ulcerative colitis, and support the hypothesis that the antibody being studied has direct relation to the presence of the ulcerative colitis colon in situ. PMID- 6496534 TI - Acquired immune deficiency syndrome. No evidence of the presence of cyclosporine. AB - It has been postulated that the acquired immune deficiency syndrome (AIDS) may be a result of the systemic presence of an immunosuppressive cyclosporine-like molecule released in chronic fungal infections. This possibility was examined by analysis of blood, plasma, or serum samples obtained from AIDS patients, from subjects with prodromal AIDS, and from healthy subjects belonging to several of the recognized "AIDS risk groups" for cyclosporine-like substances. The sensitivity of the analytic methods and the stability of cyclosporine during the storage of blood were verified by analysis of blood specimens obtained from a normal volunteer after oral ingestion of various doses of cyclosporine. Radioimmunoassay, high-pressure liquid chromatography, and analysis by combination of these two methods failed to detect cyclosporine or cyclosporine like substances in subjects with established or prodromal AIDS and in AIDS-free persons belonging to the risk groups. These results indicate that the breakdown of cellular immunity in AIDS is not due to circulating cyclosporine. PMID- 6496535 TI - Elevated hemoglobin A1c and low-density lipoprotein cholesterol levels in thiazide-treated diabetic patients. AB - Despite the well-known hyperglycemic effect of thiazide diuretics, these agents are often administered to diabetic patients. This study compared 89 insulin treated diabetic patients receiving hydrochlorothiazide, 57 receiving furosemide, and 255 receiving no diuretic. Hemoglobin A1c level was 7.2 +/- 1.8 percent (mean +/- SD) with hydrochlorothiazide, significantly higher than the levels of 5.9 +/- 2.3 percent with furosemide and 6.4 +/- 2.0 percent with no diuretic. Low-density lipoprotein cholesterol level was 154 +/- 43 mg/dl with hydrochlorothiazide, but 134 +/- 42 mg/dl with furosemide and 130 +/- 42 mg/dl with no diuretic. Multivariate analysis showed that the associations remained significant after adjustment for age, sex, race, type and duration of diabetes, body mass index, blood pressure, serum potassium level, insulin dose, and treatment with other medications. These findings suggest that treatment with thiazide diuretics in the diabetic population may increase low-density lipoprotein cholesterol and hemoglobin A1c levels. PMID- 6496536 TI - Dialysis hypoxemia. Role of dialyzer membrane and dialysate delivery system. AB - Arterial blood gas values, carbon monoxide diffusion capacity, oxygen consumption, carbon dioxide production, respiratory quotient, minute ventilation, and pulmonary capillary blood flow were determined before and during hemodialysis. In addition, the effect of single passage through the dialyzer on blood carbon dioxide tension, pH, and bicarbonate concentration was evaluated. Acetate-based dialysate was used in all experiments. Cellulosic dialyzer with single-pass dialysate delivery system was used in one group, and polyacrylonitrile dialyzers with recirculating delivery system in another. Although hypoxemia occurred in both groups, it was more severe in the former group. Dialyzer carbon dioxide loss was significantly greater with single-pass dialysate delivery system and cellulosic dialyzers than with recirculating delivery system and polyacrylonitrile dialyzer. To differentiate the role of dialysate delivery system from that of the membrane, the experiments were repeated using recirculating delivery system and cellulosic dialyzer. This resulted in marked attenuation of hypoxemia and dialyzer carbon dioxide tension losses. Since other experimental conditions were the same, the observed differences were thought to be due to the difference in the mode of dialysate delivery. It thus appears that the mode of dialysate delivery per se can modify the changes in arterial oxygen tension during hemodialysis and should be added to the list of factors implicated in the genesis of dialysis hypoxemia. PMID- 6496537 TI - Contaminated medication nebulizers in mechanical ventilator circuits. Source of bacterial aerosols. AB - The contamination rates of medication nebulizers inserted into mechanical ventilator circuits were studied. Semiquantitative techniques were used to sample the reservoir fluid from in-line nebulizers during the first 24 hours after a circuit change. In the initial survey, high levels of contamination (organism concentrations above 10(3)/ml) were present in 13 (68 percent) of the 19 nebulizer reservoirs, and bacterial aerosols were produced by 10 (71 percent) of 14 nebulizers. Gram-negative bacilli were the predominant organisms isolated. Nebulizer contamination originated primarily from reflux of contaminated condensate in the ventilator circuit. When nebulizers were cleaned after each treatment, a reduced rate of contamination was found. Small bacterial aerosols (less than 3 microns in size) were produced in vitro after inoculation of nebulizers with gram-negative bacilli in concentrations isolated from in-use nebulizers. Contaminated in-line medication nebulizers generate small-particle bacterial aerosols that may increase the risk of ventilator-associated pneumonia and therefore should be cleaned or disinfected after each treatment rather than every 24 hours. PMID- 6496538 TI - Scintigraphic localization of adrenal lesions in primary aldosteronism. AB - Dexamethasone suppression adrenal cortical scintiscanning was performed in 87 patients with primary aldosteronism. Fifty patients had adrenal cortical adenomas and 37 had bilateral adrenal hyperplasia. The diagnosis of adrenal cortical adenoma was confirmed by surgery in 49 of 50, and bilateral adrenal hyperplasia was confirmed by adrenal vein aldosterone sampling in 33 and at operation in four. Dexamethasone suppression adrenal scintigraphy correctly identified the lesion(s) in 82 of the 87 patients. There were three false-negative and two false positive adrenal cortical scintiscanning results. Computed tomography was performed in 33 patients and correctly identified 14 of 23 patients with adrenal cortical adenomas and two of 10 patients with bilateral adrenal hyperplasia and bilateral enlarged adrenals, whereas the remaining eight were considered to have normal findings. These data indicate that, when properly performed, adrenal cortical scintigraphy is an accurate and efficacious modality for the localization of adrenal cortical adenomas and in the differentiation of adrenal cortical adenoma from bilateral adrenal hyperplasia in primary aldosteronism. PMID- 6496539 TI - High-dose cytosine arabinoside. Active agent in treatment of non-Hodgkin's lymphoma. AB - Seventeen extensively pre-treated patients with non-Hodgkin's lymphoma in relapse were treated with high-dose cytosine arabinoside given at a dose of 3 g/m2 on a 12-hour basis for two to eight doses per course. Seventy percent of patients (12 of 17) showed response with this regimen, including three patients who achieved a complete response. The time to response was quite rapid, occurring between three and 14 days, with median duration of complete responses of 12 weeks and of all responses, five weeks. Toxicity was acceptable, including predictable myelosuppression and thrombocytopenia, occasional drug fever, infrequent conjunctivitis and dermatitis, and no central nervous system toxicity. The dramatic, albeit short-lived, responses to high-dose cytosine arabinoside in this refractory population suggest that it is an active agent against non-Hodgkin's lymphoma and should be further evaluated. PMID- 6496540 TI - Serum estradiol levels in male cigarette smokers. AB - Serum estradiol levels were compared in smoking and nonsmoking men in two separate samples. Sample I consisted of 41 young adult male volunteers ranging in age from 18 to 24 years. Twenty-three men smoked an average of 24.5 +/- 6.9 cigarettes daily. The duration of smoking averaged 5.2 +/- 2.2 years. Sample II consisted of 35 husbands who had been evaluated for infertility; they ranged in age from 19 to 49 years. Eighteen men smoked an average of 21.6 +/- 7.9 cigarettes daily. The duration of smoking averaged 11.5 +/- 4.5 years. Age, height, and weight did not differ significantly between smokers and nonsmokers within either group. Serum estradiol levels were significantly elevated in smokers compared with nonsmokers in both groups (p less than 0.001 and p less than 0.0001 in Samples I and II, respectively). No significant correlations were found between serum estradiol levels and the number of cigarettes smoked daily, or with the duration of smoking in either sample. The differences in serum estradiol levels between smokers and nonsmokers could not be attributed to the differences in marijuana and alcohol use that existed between the smokers and nonsmokers in each sample. The recent reports of elevated serum estradiol levels as a possible risk factor in coronary heart disease are discussed in view of the known relationship of cigarette smoking to coronary heart disease. PMID- 6496541 TI - Value of laboratory tests in the differential diagnosis of hypercalcemia. AB - Eighteen laboratory tests were compared in the differentiation of primary hyperparathyroidism from hypercalcemia associated with malignancy. Statistical comparisons of the test results were carried out in four patient groups and two control groups. The patient groups evaluated were those with confirmed primary hyperparathyroidism, those with malignancy with hypercalcemia, those with malignancy without hypercalcemia, and those with surgically cured primary hyperparathyroidism. These groups allowed determination of the relative diagnostic values of the tests and a rationale for their value. After exclusion of patients with renal failure from the patient and control groups, these data indicated that the laboratory tests with the greatest differential diagnostic value, in order of efficacy, were: albumin, carboxy-terminal parathyroid hormone, venous pH, cholesterol, chloride, alkaline phosphatase, phosphorus, and the chloride/phosphate ratio. Hemoglobin, hematocrit, and red blood cell count also had some value, particularly in male patients. However, none of these tests individually achieved better than an 81 percent classification accuracy. With application of logistic discriminant analysis, only three tests--albumin, parathyroid hormone, and chloride--were identified as statistically significant in jointly improving the diagnostic separation between these two patient groups. Although the 94.4 percent classification accuracy achieved by use of these three variables in a logistic discriminant function was better than that obtained with any individual variable, incorrect classification was still a significant problem, particularly in the case of patients with malignancy and high concentrations of parathyroid hormone. With the exception of albumin and chloride measurements, the commonly available ancillary laboratory tests proposed to aid this differential diagnosis do not give any more information than the analysis of parathyroid hormone alone and merely add to the increased cost of medical care. PMID- 6496542 TI - Short-term protein loading in assessment of patients with renal disease. AB - The effect of short-term protein loading on the glomerular filtration rate in normal persons and patients with renal disease was evaluated. Previous studies have demonstrated that in healthy subjects, protein loading results in an increased glomerular filtration rate. By determining the glomerular filtration rate preceding (baseline glomerular filtration rate) and following (test glomerular filtration rate) oral protein loading, it was possible to define (1) the filtration capacity (test glomerular filtration rate) and (2) the renal reserve (test glomerular filtration rate - baseline glomerular filtration rate) of the kidney. In normal persons, filtration capacity averaged 157 +/- 13 ml per minute and renal reserve 34 ml per minute. The test glomerular filtration rate was reproducible and independent of protein intake, whereas baseline glomerular filtration rate was significantly influenced by diet. Patients with renal disease were found to have a reduced renal reserve and/or a diminished filtration capacity. The reduction in filtration capacity appears to correlate with the damage sustained by the organ. It is suggested that an abnormal response to protein loading in renal disease may herald the fall in the baseline glomerular filtration rate and the rise in plasma creatinine level. PMID- 6496543 TI - Benign mesothelial proliferation with effusion. Clinicopathologic entity that may mimic malignancy. AB - The clinical and pathologic features of five cases of a previously poorly defined syndrome, benign mesothelial proliferation with effusion, are described. Although this is a benign process, both the gross and the microscopic findings may mimic metastatic papillary adenocarcinoma. Three of five patients had dysynchronous involvement in more than one body cavity developing over intervals of one, two, and six years. The clinical course is unpredictable and is usually associated with a good prognosis, but two of three patients with pericardial involvement required pericardectomy for pericardial tamponade. The entity of benign mesothelial proliferation with effusion and its distinction from true malignant conditions are discussed. PMID- 6496544 TI - Lupus pregnancy. Case-control prospective study demonstrating absence of lupus exacerbation during or after pregnancy. AB - To assess whether pregnancy is associated with exacerbation of systemic lupus erythematosus (SLE), a variety of clinical markers of disease activity in 28 pregnant patients with SLE (33 pregnancies) were compared with the same markers in age-, race-, organ system-, and disease severity-matched nonpregnant women with SLE. Both groups were followed up for periods of up to one year after delivery. Eight patients elected abortion for nonmedical reasons. In all patient groups, there were no differences between pregnant and nonpregnant patient groups in frequency of any disease activity marker studied including therapy. However, new proteinuria occurred in four pregnant patients compared with one nonpregnant patient, and thrombocytopenia attributable to SLE occurred in five pregnant patients and one nonpregnant patient. Renal disease, when it occurred, more closely resembled pregnancy-induced hypertension than lupus nephritis. It is concluded that pregnancy complications are frequent, but the assertion that pregnancy causes exacerbation of SLE remains unproved. PMID- 6496545 TI - Hyperosmolar hyperglycemic nonketotic syndrome. Report of 22 cases and brief review. AB - In a series of 22 patients with the hyperosmolar hyperglycemic nonketotic syndrome managed during a five-year period in a community hospital setting, 21 patients were known to be diabetic and only six patients were in coma. The overall mortality was 36.3 percent, and seven of the eight deaths were explained by associated nonmetabolic causes. In this study, hyperosmolarity was not related to coma or to final outcome of treatment. Patients were managed with relatively small amounts of fluid, and the type of fluid used did not influence the final outcome. PMID- 6496546 TI - Nifedipine-induced renal dysfunction. Alterations in renal hemodynamics. AB - Nifedipine caused acute, reversible deterioration in renal function in four patients with chronic renal insufficiency. The absence of hypotension, clinical course, benign urinary sediments, and normal results of renal ultrasound examinations excluded acute tubular necrosis, pyelonephritis, interstitial nephritis, obstructive uropathy, and acute glomerulonephritis. It is postulated that this slow calcium channel blocker produced deleterious intrarenal hemodynamic alterations in the setting of moderate to severe renal functional impairment. Nifedipine may alter renal function by blocking calcium entry into renal vascular smooth muscle, thereby reducing the efficacy of vasoconstrictor hormones in regulation of renal blood flow and glomerular filtration rate. An alternative explanation is that nifedipine may inhibit the compensatory synthesis of vasodilatory prostaglandin E2 analogous to the clinical observation of acute deterioration in renal function by nonsteroidal anti-inflammatory drugs in patients with pre-existing renal insufficiency. These observations suggest that clinicians should monitor renal function closely and exercise caution when administering nifedipine to patients with underlying renal insufficiency. PMID- 6496547 TI - Diagnostic utility of pleural fluid eosinophilia. AB - It has been stated that pleural fluid eosinophilia (defined as greater than 10 percent eosinophils in the pleural white cell differential count) is not helpful in the diagnosis of exudative effusions. By review of the recent literature, it was found that pleural fluid eosinophilia was associated most often with idiopathic effusions or with air previously introduced into the pleural space. Also, a high proportion of "idiopathic" and benign asbestos effusions were characterized by pleural fluid eosinophilia, a previously unrecognized phenomenon. The diagnostic utility of finding eosinophils in the pleural space was assessed from its impact on prior probabilities of disease. Estimates of pretest likelihoods of malignant versus nonmalignant pleural effusions and the prevalence of eosinophilia in effusions of known cause were obtained from extensive literature review. These were modified by using Bayes' rule to estimate the revised probability of disease in the presence of an eosinophilic effusion. The presence of pleural fluid eosinophilia considerably reduced the probability of malignancy or tuberculosis and increased the likelihood of an underlying benign disorder. Pleural fluid eosinophilia is a useful finding that can aid in the diagnosis of an exudative pleural effusion. PMID- 6496548 TI - Thrombolytic therapy for acute transmural myocardial infarction. Intracoronary versus intravenous. AB - The application of coronary angiography in coordination with streptokinase administration directly into the occluded coronary artery has served to focus attention on the clinical potential of such therapy. About 75 percent of patients with acute transmural myocardial infarction have been shown to have reperfusion after intracoronary administration of streptokinase. However, the data do not prove that the beneficial effect required regional perfusion. Analysis of biochemical data suggests that the active agent was not confined to the locale of the thrombus, but in fact circulated in significant concentration; furthermore, systemic (intravenous) treatment resulted in reperfusion of a significant proportion (50 percent) of coronary arteries as well. Comparative studies are needed to critically compare angiographic results after regional or systemic therapy and also to assess the impact of reperfusion on possible reduction in long-term morbidity and mortality. Although intracoronary therapy appears to be more effective for inducing reperfusion, intravenous therapy has the potential for greater clinical impact, since it can be instituted more quickly after the onset of symptoms and does not require specialized cardiac catheterization facilities. PMID- 6496549 TI - Diarrhea and weight loss in a 73-year-old woman. PMID- 6496550 TI - Pathologic hip fractures secondary to amyloidoma. Case report and review of the literature. AB - Amyloidoma primarily involving bone and lymph node is described in a 60-year-old male patient. The patient had pathologic fractures of both hips through a deposit of amyloid in the neck of the femur. The prolonged insidious course of the disease was uncomplicated by hypercalcemia, hematologic abnormalities, or renal failure so characteristic of untreated myeloma. The bone marrow contained less than 10 percent plasma cells in different stages of maturity. Radionuclide bone scanning demonstrated other osseous amyloid lesions that were not detected by routine radiologic examination. This is the first reported case of pathologic fractures of both hips secondary to amyloidoma. PMID- 6496551 TI - Cyclic Cushing's syndrome. AB - Cyclic Cushing's syndrome is a rare but increasingly recognized disorder of periodic fluctuations of adrenal steroid production. A case of cyclic Cushing's syndrome due to a pituitary adenoma is described. The patient demonstrated a prolonged cycle length of approximately six months, during which a spontaneous remission occurred both clinically and biochemically. Previously documented cases of cyclic Cushing's syndrome are reviewed, and the pitfalls in interpretation of results of dexamethasone suppression testing in the presence of spontaneous fluctuations in cortisol production are discussed. PMID- 6496552 TI - Coronary artery spasm and cardiac arrest in carcinoid heart disease. AB - Previously reported cardiac manifestations of carcinoid disease include right sided valvular dysfunction and vasomotor disturbances. This report describes a 62 year-old white man who had electrocardiographically documented widespread elevation of the S-T segment, arrhythmias, and cardiac arrest after exercise. Noninvasive and laboratory studies confirmed the diagnosis of malignant carcinoid disease with tricuspid valve involvement. Coronary angiography revealed mild atherosclerosis. Thus, coronary artery spasm is a previously unrecognized manifestation of carcinoid heart disease and introduces what may be an important relationship of endogenous, excessive vasoactive amines to human coronary vasospasm. PMID- 6496553 TI - Sinusitis caused by Legionella pneumophila in a patient with the acquired immune deficiency syndrome. AB - A patient with the acquired immune deficiency syndrome and Legionella pneumophila infection of the maxillary sinus is described. The organism was identified by direct immunofluorescence staining of sinus tissue. Because the Legionella species are intracellular pathogens, it is not surprising that this patient with a cellular immune defect was infected. However, no other site of Legionella infection was found. This appears to be the first reported case of upper respiratory tract infection by a Legionella species. PMID- 6496554 TI - Diuretic-induced potassium deficits: principles, opinions, and practical therapeutics. PMID- 6496555 TI - Site and mechanism of action of diuretics. AB - Diuretics have a central role in the treatment of edema and hypertension. This function is primarily an induction of a net negative balance of solute and water. Reviewed herein are the transport properties of each nephron segment that governs salt and water reabsorption with specific reference to the mechanisms by which the various diuretic agents affect those transport processes. Under normal circumstances, the proximal tubule reabsorbs about 50 to 66 percent of the filtered fluid by both active and passive mechanisms. However, diuretics that inhibit proximal reabsorption are "weak" diuretics since distal compensatory mechanisms can overcome their effect. The thin descending limb of Henle is highly permeable to water and relatively impermeable to solutes. Thus, its main physiologic function is to allow osmotic water abstraction. Although diuretics have no direct epithelial effect on this segment, many of the diuretics decrease fluid reabsorption from it by abolishing the papillary osmotic gradient. The decreased water absorption from the descending limb of Henle has a major role in over-all increased diuresis since nephron segments distal to the descending limb are impermeable to water in the absence of vasopressin. The thin ascending limb of Henle is impermeable to water while being highly permeable to sodium and chloride. Diuretics have no direct effect on the thin ascending limb of Henle. The medullary and cortical segments of the thick ascending limb of Henle absorb sodium chloride by active mechanisms as a result of a secondary active chloride transport mechanism that depends on the presence of sodium (co-transport mechanism). This transport mechanism is located on the luminal membrane. Most of the "loop" diuretics effect this process from the luminal side by having a direct inhibitory effect on this co-transport process. The diuretics that have a primary effect on the medullary segment (furosemide, bumetanide, ethacrynic acid) inhibit the concentrating mechanisms, whereas the diuretics that are effective primarily in the cortical segment (thiazides plus the diuretics affecting the medullary segment) inhibit the urinary diluting mechanism. The loop diuretics are physiologically the most potent family of diuretics. The cortical collecting duct segment reabsorbs sodium by active mechanisms. These processes are stimulated by aldosterone. The diuretics that affect these processes are considered weak diuretics, but they do have the metabolic effect of potassium sparing.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6496556 TI - Diuretic-induced hypokalemia. AB - Diuretic therapy is the most common cause of potassium deficiency. Although the extent of potassium deficiency usually does not exceed 200 or 300 mEq, under appropriate circumstances such modest deficiency may have important consequences. Factors that tend to increase the incidence or severity of potassium deficiency in patients who take diuretics include high salt diets, large urine volumes, metabolic alkalosis, increased aldosterone production, and the simultaneous use of two diuretics that act on different sites in the renal tubule. There are many serious complications of potassium deficiency, including cardiac arrhythmias, muscle weakness, rhabdomyolysis, glucose intolerance, and several complications that result directly from increased ammonia production, such as protein and nitrogen wasting and hepatic coma. Emphasized herein are those conditions that impose potential danger in patients with mild hypokalemia. Important factors that identify specific causes of potassium deficiency and its treatment are discussed briefly. PMID- 6496557 TI - Potassium and magnesium abnormalities: diuretics and arrhythmias in hypertension. AB - Thiazide diuretics are widely accepted as the cornerstone of antihypertensive treatment programs. Hypokalemia is a commonly encountered metabolic consequence of long-term thiazide therapy but the effect of thiazide on serum magnesium is less well known. Thirty-eight patients (22 low renin, 16 normal renin) with moderate diastolic hypertension were treated with hydrochlorothiazide administered twice a day. The initial daily dose was 50 mg; this was increased at four week intervals to 50 mg, 100 mg, 150 mg, and 200 mg. Dose escalation was discontinued when either normalization blood pressure was attained or the 200 mg dose level was reached. Patients were then maintained with their hydrochlorothiazide dose for 24 weeks of continuous thiazide monotherapy. The serum potassium during the control period was 4.5 +/- 0.2 mmol/liter. During dose escalation and long-term maintenance therapy, the serum potassium and magnesium levels fell in a step wise, dose-dependent fashion. In another 38-patient study, the effects of hydrochlorothiazide therapy (100 mg daily) on the occurrence of premature ventricular contractions were observed during rest as well as during static and dynamic exercise. During rest 0.6 +/- 0.08 premature ventricular contractions per minute (mean +/- SEM) were observed, and during dynamic exercise 0.8 +/- 0.15 premature ventricular contractions per minute. During hydrochlorothiazide therapy (50 or 100 mg per day) premature ventricular contractions per minute were 1.4 and 5.7, respectively. The occurrence of premature ventricular contractions correlated significantly with the decrease observed in serum potassium (r = 0.71, p less than 0.001) and in serum magnesium (r = 0.68, p less than 0.001). Thiazide therapy appears to cause both potassium and magnesium depletion, and decreases in both correlate well with the appearance of ventricular ectopic depolarizations. PMID- 6496558 TI - Calcium and cardiovascular function. Intracellular calcium levels during contraction and relaxation of mammalian cardiac and vascular smooth muscle as detected with aequorin. AB - Calcium ion (Ca++) plays a central role in excitation-contraction coupling of both cardiac and vascular smooth muscles and have important functional interactions with other cations, including sodium, potassium, and magnesium. Ca++ transients associated with contraction-relaxation cycles of the heart and vasculature can now be recorded directly by use of aequorin, a bioluminescent protein that emits light when it combines with Ca++. After microinjection or chemical loading of aequorin into the sarcoplasm, light output provides an index of intracellular [Ca++]. In cardiac muscle, intracellular Ca++ increases more quickly than tension and decreases toward basal levels by the time peak tension is reached. The calcium transients of working myocardium in both human subjects and other mammalian species appear to be dominated by the release and uptake of Ca++ from intracellular stores under all conditions studied. Drugs and disease states produce marked changes in the amplitude and time course of the Ca++ transient and the corresponding contractile response. In vascular smooth muscle, there are stimulus-specific patterns in intracellular Ca++ associated with tonic contractions. Although Ca++ is related to tension development, the relationship appears to be more complex than that in cardiac muscle. As a result, tension development cannot be used as an index of free Ca++ levels in vascular smooth muscle. Selection of the most effective therapy to reverse a tonic contraction in states of spasm or hypertension may depend on the specific stimulus that caused the increased tone. PMID- 6496559 TI - Effect of bioavailability on dose-response relationships. AB - To achieve the goals of drug therapy one must not only select the appropriate drug but also ensure that it is administered in the proper dose. Sufficient drug should be administered to achieve a therapeutic effect, yet not so much as to produce unwanted side effects. One desirable effect of hydrochlorothiazide, for example, is the control of hypertension. An undesirable effect is excessive potassium loss. The dosage range that is likely to cause the hypotensive effect without the potassium loss has been called the "therapeutic window." In principle, hydrochlorothiazide can be combined with a potassium-sparing diuretic, such as triamterene, to lower blood pressure with a decreased risk of hypokalemia, and thus to "widen" the therapeutic window. The term "dose," however, requires further description. Because of compliance problems we know that the patient does not necessarily adhere to the prescribed dosage schedule. Furthermore, because of the bioavailability of the pharmaceutical formulation, the dose the patient "takes" may not be the one that he or she actually gets. The formulation of the drug product determines how rapidly and completely the active ingredient of the drug dissolves in the gastrointestinal tract and subsequently gets absorbed into the bloodstream. Thus, the time course of the drug concentration in serum has become the measure of dose that is most directly related to dose-response relationships. Incompletely absorbed drug products are said to be poorly bioavailable. Such products are undesirable, not only because the patient receives a dosage that is on the average less than that expected, but also because poor bioavailability may lead to a great variation in dose. Thus, poorly bioavailable drug formulations increase the variability in dose-response relationships among patients and as a result jeopardize the attainment of therapeutic objectives. PMID- 6496560 TI - Bioequivalence study of a new tablet formulation of triamterene and hydrochlorothiazide. AB - A three-treatment, single-dose, crossover bioequivalence study was conducted in healthy volunteers to compare urinary drug recovery following administration of hydrochlorothiazide tablets, the currently marketed capsule formulation of triamterene and hydrochlorothiazide (Dyazide), and a new tablet preparation of these active ingredients (Maxzide). No significant differences were observed in the urinary recovery of hydrochlorothiazide after the administration of hydrochlorothiazide tablets and Maxzide tablets. However, only about one-half as much hydrochlorothiazide was recovered following the administration of Dyazide capsules. Similarly, the urinary recovery of triamterene and the sulfate ester of hydroxy-triamterene after administration of Dyazide capsules was approximately one-half the levels observed after giving the new tablet formulation. The clinical consequences of the limited bioavailability of the active ingredients of Dyazide are discussed. PMID- 6496561 TI - Renal lithium clearance as a measure of the delivery of water and sodium from the proximal tubule in humans. AB - The delivery of tubular fluid from the proximal straight tubule to the thin descending limb of the loop of Henle was measured in nine volunteers by the lithium clearance method and by the water diuresis method. Lithium clearance and urine flow during water diuresis varied in proportion to each other with a high degree of correlation (r = 0.93, p less than 0.001). The proportionality between lithium clearance and urine flow was unaffected by variations in fractional sodium excretion. The results support the assumption that lithium clearance can be used as a measure of the delivery of tubular fluid from the proximal tubule in humans with sodium intakes within the normal range. PMID- 6496562 TI - Relationship of peak systolic pressure/end systolic volume ratio to standard ejection phase indices and ventricular function curves in coronary disease. AB - In order to determine the relationship of the peak systolic pressure/end-systolic volume (PSP/ESV) ratio to standard ejection phase indices [ejection fraction (EF), mean normalized systolic ejection rate (MNSER), mean velocity of circumferential fiber shortening (Vcf)], and ventricular function curves (VFC), hemodynamic and angiographic studies were carried out in 38 subjects: 11 normal controls (Group I) and 27 with coronary artery disease (CAD). The CAD patients were subdivided into those without (Group II) and those with (Group III) regional asynergy. EF, MNSER and Vcf were calculated from the ventriculogram using standard formulae. The slope of the left ventricular function curve was constructed by determining left ventricular stroke work index and left ventricular end-diastolic pressure before and after ventriculography, and dividing the change in the left ventricular stroke work index by the change in the left ventricular end-diastolic pressure. Peak systolic left ventricular pressure was determined before left ventriculography; minimal systolic volume was measured from the left ventriculogram. PSP/ESV ratio in the control group (Group I) was 6.4 +/- 2.8. This differed significantly from the ratio in patients (Group II) with CAD but without asynergy (4.7 +/- 2.2 p less than 0.025) and from that in patients (Group III) with CAD and asynergy (2.4 +/- 1.4, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496563 TI - The tricho-rhino-phalangeal syndrome(s): chromosome 8 long arm deletion: is there a shortest region of overlap between reported cases? TRP I and TRP II syndromes: are they separate entities? AB - Critical cytogenetic (re)evaluation of 2 of our own cases of tricho-rhino phalangeal syndrome II (TRP II), or Langer-Giedion syndrome (LGS), and 10 cases from the literature, suggests that the shortest region of overlap of the 8q deletion is a part of band q24.1. This region is assumed to be causally related to this syndrome, and possibly also to TRP I syndrome which, therefore, may not be a causally separate entity. PMID- 6496564 TI - Maternal reproductive loss and cleft lip with or without cleft palate in human embryos. AB - Recognized spontaneous abortions in previous pregnancies were significantly more frequent in mothers of 87 Japanese embryos with cleft lip with or without cleft palate (CL(P] than in mothers of normal embryos. The number of prior pregnancies was found to be smaller in mothers of CL(P) embryos with additional defects, suggesting that unrecognized abortions might also occur more frequently in these women. The higher incidence of abortions was associated with more severe forms of CL(P), ie, CL(P) with associated anomalies rather than isolated CL(P), and bilateral rather than unilateral CL. These results are compatible with the "multifactorial two-threshold" model with a lower threshold beyond which the malformation occurs and a higher one beyond which the embryo dies. The present results are in contrast with the reduced spontaneous abortion rates in families of CL(P) probands reported previously. The reduced rates may be due to selection of those families in which CL(P) embryos escaped spontaneous abortion and survived to birth, although the effects of compensatory reproduction or maternal recall bias in postnatal data cannot be ruled out completely. PMID- 6496565 TI - Multiple congenital anomalies/mental retardation (MCA/MR) syndrome due to interstitial deletion 1q. AB - A severely retarded male infant was found to have a previously undescribed multiple congenital anomalies/mental retardation (MCA/MR) syndrome including microdolichocephaly, prominence of metopic suture, coarse scalp hair, epicanthus, anteverted nostrils, micrognathia, posteriorly angulated malformed auricles, preaxial hexadactyly, clinodactyly, camptodactyly, hypospadias, cryptorchidism, inguinal hernias, agenesis of left kidney, and pyloric stenosis. This syndrome was due to an interstitial del(1)(q25.2q31.2) associated with a paracentric inv(1)(q31.2q44). PMID- 6496566 TI - Segregation analysis in reciprocal translocation carriers. AB - Segregation analysis of the offspring of balanced translocation carriers was performed on 327 pedigrees collated from published sources and personal communications. Correction was made for bias of ascertainment. Translocations studied involved chromosome arms 1p, 4q, 6p, 6q, 7p, 8p, 10p, 10q, 11q, 14q, 16q, and 17p. Findings included similar rates of occurrence of abnormal liveborn offspring in male and female carriers except for a reduction of risk in male carriers of translocations segregating by 3:1 mode; an elevated risk of fetal loss (spontaneous abortions and stillbirths) in female carriers of 6q, 11q, and 16q translocations compared to male carriers of these translocations; a fetal loss rate exceeding general population estimates in female carriers of 6q and 10q translocations and in male carriers of 6p, 8p, 10q, and 14q translocations including a rate of nearly 50% among female 6q translocation carriers; a higher than expected number of balanced carriers among liveborn offspring; and a low risk of abnormal liveborn children among carriers ascertained by means other than through unbalanced probands. We propose that some translocation carriers may be helped by consideration of more specific empiric risk figures than have traditionally been used. PMID- 6496567 TI - Namaqualand hip dysplasia: an autosomal dominant entity. AB - A unique inherited skeletal disorder has been identified in 45 persons in five generations of a kindred of mixed ancestry in South Africa. Discomfort in the hip joints develops in childhood and the course is progressive, with handicap in middle age. General health is good, height is not reduced by any significant degree, and there is no nonskeletal involvement. The major changes are in the femoral capital epiphyses, which are flattened and fragmented; secondary degenerative arthropathy develops at a later stage. Platyspondyly of variable but mild degree is present in about 60% of affected persons. Other minor changes, including iliac exostoses, are present occasionally. Pedigree data indicate autosomal dominant inheritance, with a reasonably consistent phenotypic expression. In view of the geographic distribution of this condition we propose the designation "Namaqualand hip dysplasia" (NHD). PMID- 6496568 TI - Opsismodysplasia: a new type of chondrodysplasia with predominant involvement of the bones of the hand and the vertebrae. AB - The name opsismodysplasia is proposed for a new chondrodysplasia, which was studied in three patients. Clinically, the condition is recognized at birth on the basis of shortness, short hands, and facial abnormalities with a short nose and a depressed bridge of nose. The most characteristic radiographic signs are: very retarded bone maturation; marked shortness of the bones of the hands and of the feet with concave metaphyses; and thin, lamellar vertebral bodies. The growth cartilage studied in one case showed a wide hypertrophic area containing thick connective tissue septa, irregular provisional calcification, and vascular invasion. Type I collagen was detected in the hypertrophic area by immunohistochemical and microchemical tests. The transmission of opsismodysplasia is probably autosomal recessive. PMID- 6496569 TI - Interstitial deletion of chromosome 3p: report of a patient and delineation of a proximal 3p deletion syndrome. AB - We report on a patient with a de novo interstitial deletion of the proximal portion of the short arm of chromosome 3 (p12----14.2). The deleted portion excludes the constitutive fragile site assigned to band 3p14. The phenotype of the patient, together with that of three previously reported cases, seems to be sufficiently characteristic to allow the delineation of a proximal 3p deletion syndrome. PMID- 6496570 TI - Pulmonary arteriovenous malformations related to Rendu-Osler-Weber syndrome. AB - Interest in Rendu-Osler-Weber (ROW) syndrome has been renewed because of new treatment for the pulmonary artery fistulae that occur in approximately one-half of the patients. Pulmonary arteriovenous malformations (AVM) can be occluded safely by the transvenous placement of a silicone balloon thus avoiding the many potential complications of thoracotomy. Thirty-three members of four generations of a family with ROW illustrate the varied manifestations of the syndrome and provide a basis for review of clinical findings and therapeutic approaches to the management of pulmonary AVMs during the last 25 years. Special attention is given to early detection and prevention of major complications. Since ROW syndrome is an inherited trait, informed genetic counseling is an important component of the overall management of families with this disorder. PMID- 6496571 TI - Tetraploidy: a report of three live-born infants. AB - We present three live-born infants with tetraploidy and compare them with two previously reported live-born infants with the same genetic defect. Common anomalies noted included microcephaly; a prominent, narrow forehead; microphthalmia/anophthalmia; cleft palate; orthopedic anomalies; genital ambiguity; and abnormalities of the central nervous system, including pituitary hypoplasia. Together these constitute a rather characteristic phenotype. An error in cytoplasmic cleavage is theorized to be a mechanism for the chromosome anomaly and is supported by the presence of parental polymorphisms in one of our cases; however, the presence of a small percentage of tetraploid cells in the leukocytes and skin fibroblasts of this patient's mother does not exclude maternal mosaicism as the basis for polyploidy in certain instances. PMID- 6496572 TI - Brief clinical report: neural tube defects in dup(11q). AB - We describe clinically and cytogenetically a fetus with multiple congenital anomalies and partial dup(11q) born to a phenotypically normal mother with a 3:1 translocation. Fetal anomalies included complete cleft of lip and palate, small penis, myelomenigocele, and abnormal palmar creases. We think chromosome analysis should be performed when neural tube defects are observed in otherwise dysmorphic neonates, stillbirths, and abortuses. PMID- 6496573 TI - Age structure and the distribution of rare genetic diseases. AB - Equilibrium frequencies of rare deleterious genes in an age-structured population have been studied by using mathematical models. In the models, variable age-of onset and variable penetrance of a trait have been incorporated. Numerical analyses show that the equilibrium gene frequencies can be approximated extremely well to those in nonoverlapping generations, as Haldane [1927] claimed. This property of rare deleterious genes in an age-structured population is important because population dynamics of such genes in a finite population can be studied easily. PMID- 6496574 TI - The tricho-rhino-phalangeal syndrome with exostoses (or Langer-Giedion syndrome): four additional patients without mental retardation and review of the literature. AB - We report on four patients with tricho-rhino-phalangeal syndrome with exostoses (TRPSE) who were not mentally retarded and review 32 previously published cases. These data enable more complete delineation of the phenotype and document the variability of the clinical and radiographic manifestations. Information on the genetics and the association with del(8q) is discussed, as are management and avenues for further investigation. The apparent variability of intelligence in TRPSE patients together with the high incidence of other problems, including significant delay in speech development and hearing loss, make systematic multidisciplinary evaluation and long-term treatment necessary to achieve the best outcome. PMID- 6496575 TI - Genetic analysis of cleft lip with or without cleft palate in Danish kindreds. AB - The present study population consists of 2,532 families ascertained through non syndromic cleft lip with or without cleft palate (CL +/- P) surgical probands born in Denmark between 1941 and 1971. Three samples were derived for analyses of the trait "clefted (CL +/- P) or not." Sample 1 consists of the 26 largest multigenerational families with four or more affected members. Both samples 2-MG and 2-N consist of nuclear families with at least two children and at least one proband among the children. Sample 2-MG contains 846 nuclear families derived from the kindreds with three or more generations. Sample 2-N contains a further 1,181 kindreds with only two generations, nuclear family information available. Four methods of analysis were used: 1) Pedigree analysis was performed on each of the multigenerational kindreds of Sample 1. Results were consistent with autosomal recessive inheritance in eight families and codominant inheritance in three families. These simple genetic hypotheses could not be distinguished in the remaining 15 families. 2) The goodness-of-fit of the multifactorial threshold (MF/T) model was tested in Samples 2-MG and 2-N. The MF/T model was rejected in both samples. 3) Classical segregation analysis was performed on Samples 2-MG and 2-N. Results were consistent with a possible recessive major gene for CL +/- P in Sample 2-MG, but not in Sample 2-N, and with significant admixture of sporadic cases in both samples. 4) Complex segregation analysis under the mixed model was performed on Samples 2-MG and 2-N. In Sample 2-MG, results were consistent with either the general mixed model or with an hypothesis of no major gene. In Sample 2-N, four hypotheses were equally likely: the mixed model with no polygenic component, the mixed model with the major gene component, the mixed model with no sib environmental correlation, and major gene alone. Three conclusions may be drawn: 1) The data provide no support for the MF/T model. 2) The data are consistent with the possibility of a major gene in a portion of the kindreds. 3) The data provide evidence for genetic heterogeneity for CL +/- P. PMID- 6496576 TI - Cardiac size and function in pregnancy-induced hypertension. AB - The physiologic cardiac enlargement characteristic of normal pregnancy could result in important left ventricular dysfunction in the presence of elevated blood pressure. Using M-mode echocardiography, we measured left ventricular dimensions, fractional shortening, and radius-to-wall thickness ratio in 23 patients who had a diagnosis of pregnancy-induced hypertension at rest and during isometric exercise. Seventeen subjects with normal pregnancies were similarly studied and served as controls. The average gestation of patients with pregnancy induced hypertension was 38 +/- 2 weeks, and that of control subjects was 37 +/- 1 weeks. The average age was 25 +/- 5 years for patients with pregnancy-induced hypertension, and that for control subjects was 29 +/- 4 years. The patients with pregnancy-induced hypertension did not show the normal eccentric cardiac enlargement observed during pregnancy; the average radius-to-wall thickness ratio was reduced in patients with pregnancy-induced hypertension. Fractional shortening, a reflection of ventricular performance, was maintained both at rest and during exercise in the hypertensive group. One patient, who did not show a reduced radius-to-wall thickness ratio, had marked reduction of left ventricular performance in the presence of severe pregnancy-induced hypertension. Left ventricular performance in most subjects with pregnancy-induced hypertension is normal. Preservation of left ventricular performance despite increased arterial pressure may be related to the absence of eccentric gestational cardiac enlargement. PMID- 6496577 TI - Implantation of the rabbit blastocyst: sequential changes in estradiol and progesterone and their receptors. AB - To determine the temporal relationship of the endocrine events involved in rabbit blastocyst implantation, (1) progesterone (P) and estradiol (E) in plasma and uterine flushings, (2) P and E in the cytosol of endometrium and myometrium, and (3) P receptors (PR) and E receptors (ER) in endometrium and myometrium were examined from days 0 through 7 post coitum by radioimmunoassay and radioreceptorassay. Plasma P levels increased significantly from 0.3 +/- 0.06 to 76 +/- 9.4 ng/ml (p = less than 0.005) 2 hours after mating (day 0), declined to 10.0 +/- 1.2 ng/ml by day 6, and increased to 12.0 +/- 1.2 ng/ml by day 7. Cytosol P levels of endometrium and myometrium increased from 3.2 +/- 0.2 to 22.8 +/- 2.2 ng/gm and 2.1 +/- 0.4 to 14.1 +/- 2.1, respectively, from days 1 to 6. On day 7, cytosol P levels of the embryonic segment (8.2 +/- 0.5 ng/gm) were lower than those of the interembryonic segment (12.4 +/- 1.8 ng/gm). P levels in uterine flushings increased significantly from 0.05 +/- 0.01 ng/ml on day 0 to 19.9 +/- 0.7 ng/ml on day 7 (p = less than 0.001). In contrast, E levels in plasma, uterine flushings, and cytosol of uterine tissues showed no significant change from days 1 through 7, but the levels from 6 hours after mating were significantly higher than those before mating (p = less than 0.05). ER in the cytosol and nucleus of all uterine regions increased significantly after mating but decreased after implantation. In contrast, PR in the cytosol and nucleus of all uterine regions showed no significant change on days 0 to 6 post coitum. After implantation, the embryonic segment had significantly higher PR in the nucleus than that in the cytosol (13.0 +/- 1.5 versus 8.0 +/- 0.5 fmol/micrograms), whereas the interembryonic segment had significantly higher PR in the cytosol than that in the nucleus (12.0 +/- 0.5 versus 9.0 +/- 0.5 fmol/micrograms DNA). These findings showed that changes in P in the plasma and uterine flushings preceded those in uterine tissues before implantation. The changes in uterine tissue ER and PR after mating but before and after implantation suggest that the putative nidatory sites are prepared for implantation but undergo endocrine changes to protect the conceptus immediately after implantation. PMID- 6496578 TI - Glycosylated hemoglobin as a screening test for carbohydrate intolerance in pregnancy. AB - The usefulness of glycosylated hemoglobin as a prenatal screening test for carbohydrate intolerance was studied in 806 consecutive subjects by correlating glycosylated hemoglobin to 1-hour post-50 gm Glucola plasma glucose (1 degree G) levels, and 3-hour oral glucose tolerance tests (3 degrees GTT). Sixty-seven subjects whose 1 degree G greater than or equal to 150 mg/100 ml received a 3 degrees GTT; 12 were diagnostic of carbohydrate intolerance. Compared to carbohydrate-tolerant controls, carbohydrate-intolerant gravid patients had higher 1 degree G (p less than 0.001) and glycosylated hemoglobin (p less than 0.05) levels. Linear regression analysis of 1 degree G and glycosylated hemoglobin demonstrated r = 0.35 (p less than 0.0001). Compared to the glycosylated hemoglobin test, the 1 degree G screening test has greater specificity, sensitivity, and predictive value for a positive diagnosis. Consequently, the 1 degree G is a better routine screening test for carbohydrate intolerance than is glycosylated hemoglobin. PMID- 6496579 TI - Effect of fetal intravascular 4-aminoantipyrine infusions on myometrial activity (contractures) at 125 to 143 days' gestation in the pregnant sheep. AB - Myometrial activity of low amplitude and long duration--contractures--is present throughout gestation in the pregnant ewe and other species. This activity differs from the contractions of labor and delivery. Between 125 and 143 days' gestation, 4-aminoantipyrine infused into the fetus at rates that produced maternal uterine vein plasma concentrations of 4-aminoantipyrine of 5.95 +/- 1.23 (mean +/- SEM, n = 5) mg X 100 ml-1 markedly depressed both total myometrial electromyographic activity to 28.6% and frequency of contractures to 30.5% of preinfusion values. By 60 minutes of infusion, maternal uterine vein plasma 13,14-dihydro-15-keto prostaglandin F2 alpha concentration was reduced to 14% of the resting level. Two conclusions were drawn from this study. First, prostaglandins are involved in the regulation of contractures. Second, when infusions of 4-aminoantipyrine are used to quantify uterine or umbilical blood flow, the possibility exists that changes will occur in physiologic systems that are modified by prostaglandins. PMID- 6496580 TI - Estrogen and progesterone receptor and hormone levels in human myometrium and placenta in term pregnancy. AB - Estradiol and progesterone receptors in the myometrium, decidua, placenta, chorion, and amnion of eight women who underwent elective cesarean section at term were determined by means of an exchange assay. The hormone levels in the peripheral plasma and cytosol of these tissues were measured by radioimmunoassays. Maternal plasma and the placenta had high concentrations of estradiol and progesterone, with the placenta having 12 times more progesterone than in maternal plasma but only half the concentrations of estradiol in maternal plasma. The decidua and placenta had detectable levels of cytosol and nuclear estradiol receptors, but the myometrium had no measurable cytosol estradiol receptors, whereas the chorion and amnion had neither cytosol nor nuclear estradiol receptors. However, the chorion and amnion had significantly higher concentrations of estradiol in the cytosol than those in the decidua and myometrium. Only the decidua and myometrium had cytosol and nuclear progesterone receptors, but the placenta, amnion, and chorion had neither cytosol nor nuclear progesterone receptors. In contrast, progesterone hormone levels were significantly higher in the placenta, amnion, and chorion than in the decidua and myometrium. The findings indicate that, in the term pregnant uterus, (1) the placenta, amnion, and chorion are rich in progesterone, estradiol, and nuclear estradiol receptors but have no progesterone receptors, (2) the decidua and myometrium have nuclear estradiol and progesterone receptors, and (3) the myometrium has a higher progesterone/estradiol ratio than that of the peripheral plasma, thus suggesting a highly progesterone-dominated uterus. PMID- 6496581 TI - Longitudinal evaluation of hemodynamic changes in eclampsia. AB - Eight primigravid women with eclampsia underwent invasive hemodynamic monitoring shortly after admission and showed initial low right and left ventricular filling pressures, hyperdynamic left ventricular function, and elevated systemic vascular resistance. These findings persisted throughout 12 postpartum hours, with management that consisted of restriction of fluid, magnesium sulfate, and intermittent hydralazine for severe hypertension. Thereafter, those women without spontaneous diuresis had elevated pulmonary capillary wedge pressures despite hyperdynamic ventricular function. We hypothesize that this phenomenon was due to mobilization of extracellular extravascular fluid prior to diuresis. Comparison of these women with those with severe preeclampsia previously reported by others suggests that their hemodynamic status is significantly influenced by differences in fluid management. PMID- 6496582 TI - Hepatic oxygenation during arterial hypoxemia in neonatal lambs. AB - We identified the effects of reductions in arterial blood oxygen concentration from 15.0 to 4.0 ml O2/dl blood on hepatic blood flow, oxygen delivery, oxygen consumption and oxygen extraction in nine chronically catheterized lambs, 9 +/- 1 (SD) days of age. Hypoxemia was induced by administering a gas mixture low in oxygen to the unanesthetized lambs. Hepatic blood flow was measured with the radioactive microsphere technique; hepatic oxygen delivery, extraction, and consumption were calculated with modifications of the Fick principle. When the lambs breathed room air, hepatic blood flow was 235 +/- 30 ml/min/100 gm (mean +/ SD); hepatic oxygen delivery, 24.6 +/- 3.0 ml O2/min/100 gm; oxygen extraction, 37 +/- 11%; and hepatic oxygen consumption, 8.9 +/- 1.9 ml O2/min/100 gm. As arterial blood oxygen concentration was reduced from 15 to 6.5 ml O2/dl blood, hepatic blood flow did not change. When the concentration was less than 6.5 ml O2/dl, hepatic blood flow decreased as a result of a decrease in portal blood flow. Hepatic oxygen delivery decreased in the whole range of arterial blood oxygen concentrations studied. Despite reductions in oxygen delivery of up to 50%, hepatic oxygen consumption did not fall because hepatic oxygen extraction increased as compensation. Oxygen consumption, however, was stable only when hepatic blood flow did not change in response to hypoxemia. When hepatic blood flow fell, hepatic oxygen consumption also fell. Our data indicate that hepatic oxygen requirements can be met during hypoxemia by increases in hepatic oxygen extraction as long as hepatic blood flow does not change. When hepatic blood flow falls, hepatic oxygen consumption decreases even though oxygen reserves are still present. These data indicate that hepatic oxygenation in the neonate, as in the adult, is dependent on stable hepatic perfusion rather than adequate oxygen supply. PMID- 6496583 TI - The relationship between reproductive performance and blood pressure in the spontaneously hypertensive rat. AB - Blood pressure was measured serially throughout pregnancy in spontaneously hypertensive rats and in normotensive control rats of the Wistar-Kyoto strain. Changes in blood pressure were also correlated with the outcome of pregnancy. In control rats there was a small but significant decrease in blood pressure between days 20 and 22 of pregnancy (day of birth = day 22.5). In the spontaneously hypertensive rat this decrease occurred earlier, between days 18 and 19 of pregnancy, and was of greater magnitude. There was a positive correlation in the spontaneously hypertensive rat between the number of live-born pups and the magnitude of the decrease in blood pressure. Perinatal mortality, but not litter size, was greater in the spontaneously hypertensive rat than in control rats. Thus the physiologic mechanisms responsible for the decrease in blood pressure in the normal rat are preserved in the spontaneously hypertensive rat, and the successful completion and outcome of pregnancy depend on the capacity of the hypertensive rat to amplify these processes. Consequently, the spontaneously hypertensive rat is not an appropriate experimental model for hypertension of human pregnancy, in particular for preeclampsia, in which the presence of the conceptus characteristically causes blood pressure to rise, especially during the last trimester. However, an investigation of the factors responsible for the profound antihypertensive effect of pregnancy in rats could provide new insights into the mechanisms by which blood pressure is regulated during pregnancy and suggest new therapeutic approaches. PMID- 6496584 TI - Correlation of semen transferrin concentration and sperm fertilizing capacity. AB - To determine whether a correlation exists between semen transferrin and sperm fertilizing capacity, transferrin concentration was determined in the semen of 52 male patients referred for the hamster ova penetration test (group 1) and in 17 men participating in the human in vitro fertilization program (group 2). In both groups 1 and 2 seminal transferrin levels were also compared to semen volume, sperm density, and motility. Serum follicle-stimulating hormone and luteinizing hormone concentrations that were determined in 34 individuals (24 in group 1, 10 in group 2) showed no correlation with seminal transferrin levels. In conclusion, low seminal transferrin levels correlated with low sperm density and with poor fertilizing ability of human oocytes in vitro. PMID- 6496585 TI - C-reactive protein as a predictor for chorioamnionitis in cases of premature rupture of the membranes. AB - We evaluated C-reactive protein for its ability to predict the occurrence of clinical chorioamnionitis in 51 patients with spontaneous premature rupture of the membranes at less than or equal to 34 weeks of gestational age. All the patients had determinations of C-reactive protein on admission, and then 25 patients were tested daily. Of the total 51 patients, 14 developed clinical signs compatible with a diagnosis of chorioamnionitis. An analysis was conducted to compare the use of C-reactive protein to that of white blood cell count in predicting febrile disease. Our study indicates that C-reactive protein is an accurate and early marker for predicting clinical chorioamnionitis. White blood cell and differential counts are less accurate in such prediction, especially after steroid treatment. PMID- 6496586 TI - Cholesterol synthesis by human fetal hepatocytes: effect of lipoproteins. AB - The purpose of the present investigation was to determine the effect of various lipoproteins on the rate of cholesterol synthesis of human fetal liver cells maintained in culture. This was accomplished by measuring the rate of incorporation of tritium from tritiated water or carbon 14-labeled acetate into cholesterol in human fetal liver cells. Optimal conditions for each assay were determined. When human fetal liver cells were maintained in the presence of low density lipoprotein, cholesterol synthesis was inhibited in a concentration dependent fashion. Intermediate--density lipoprotein and very-low-density lipoprotein also suppressed cholesterol synthesis in human fetal liver cells. In contrast, high-density lipoprotein stimulated cholesterol synthesis in human fetal liver cells. The results of the present as well as our previous investigations suggest that multiple interrelationships exist between fetal liver cholesterol synthesis and lipoprotein-cholesterol utilization by the human fetal adrenal gland and that these processes serve to regulate the lipoprotein cholesterol levels in fetal plasma. PMID- 6496587 TI - Prolactin response to breast stimulation in lactating women is not mediated by endogenous opioids. AB - Several reports have shown that the prolactin response to suckling in rats can be blunted by administration of the opiate antagonist naloxone. In order to investigate whether the prolactin response to breast stimulation in women is similarly affected by naloxone, nine healthy lactating women participated in 10 studies. Each woman served as her own control and was studied on two occasions, receiving pretreatment with either saline solution or naloxone. Prolactin was measured in the baseline state and for 60 minutes after the onset of a 20-minute period of nipple stimulation by use of the Egnell mechanical breast pump. Neither baseline nor stimulated prolactin values were different by paired t test. Thus, in contrast to rats, an opioid pathway does not appear to be involved in the prolactin response to suckling in humans. PMID- 6496588 TI - Low-dose prostaglandin E2 analogue for cervical dilatation prior to pregnancy termination. AB - The trauma of mechanical cervical dilatation preceding abortion is directly related to the degree of cervical resistance. Prostaglandins may reduce cervical rigidity but are accompanied by undesirable side effects. Our aims were to ascertain if a low-dose (10 mg) analogue (9-deoxo-16, 16 dimethyl-9-methylene PGE2) is effective and well tolerated and, if so, to try to determine the possible mechanism by which it works. To this end, we studied 39 women with gestational ages ranging from 7 to 19 weeks who were given a single vaginal suppository 1 to 4 hours before suction curettage. In addition to demographic data on age, gravidity, parity, and previous abortions, we determined progesterone, human chorionic gonadotropin and prostaglandin plasma levels. This low-dose prostaglandin E2 analogue was found to be effective in achieving cervical dilatation and softening with minimal side effects (mild nausea in one patient only). Mean cervical dilatation achieved was 7.8 +/- 2.3 mm. Softening was apparent and facilitated additional instrumental dilatation when required. No correlation was found between drug effectiveness and gravidity, gestational age, or duration of action. There was no detectable trend with regard to baseline progesterone or human chorionic gonadotropin levels. This suggested a specific sensitivity to the local effect by the drug, apparently unrelated to dosage. PMID- 6496589 TI - Ultrastructure of normal, metaplastic, and abnormal human uterine cervix: use of montages to study the topographical relationship of epithelial cells. AB - The ultrastructure of the entire thicknesses of normal and abnormal human uterine cervical epithelia is studied with the use of slit-type grids. In four normal squamous epithelial specimens, basic similarities in the maturational sequence were apparent; however, significant variation in the progression of differentiation was also obvious. Because of this variation, it was not possible to always correlate cellular structure with cellular location within the epithelial strata. Four normal specimens containing combinations of squamous, columnar, and metaplastic cells show variations in the topographical relationships of these cells and stages in the transition of reserve to squamous cells in metaplastic zones. The presence of cells with features characteristic of squamous and columnar epithelia suggests a bipotentiality of reserve cells. Six abnormal specimens share several morphologic features, which usually, but not regularly, vary quantitatively with the extent of abnormality. Because of the inconsistent gradation of cellular features with lesion severity, it was essential that numerous ultrastructural parameters be considered in order to evaluate the extent of abnormality. Cellular features peculiar to individual specimens include edema, keratinization, phagocytic squamous cells, and cells similar in appearance to koilocytes described in condylomas. Electron micrograph montages of extensive unobstructed areas of normal and abnormal cervices and higher-magnification micrographs of cell components provide improved documentation of the variation in morphology of normal and abnormal epithelia. Use of montages also results in a clear view of ultrastructural changes accompanying the transition from normal to abnormal cervical epithelium. PMID- 6496590 TI - Wide local excision in the treatment of vulvar carcinoma in situ: a reappraisal. AB - A retrospective study of 56 patients treated for carcinoma in situ of the vulva over a 24-year period has shown a relative increase in the occurrence of this neoplasm. Only 6.7% of patients in the first 14 years of the study period were less than 35 years of age, as compared with 29.3% in the last decade. In the earlier years of the study, simple vulvectomy was the primary treatment, and 81.3% of the patients were disease-free at 5 years. Wide local excision, used in the later years, resulted in a rate of 46.2% with no evidence of disease. Involvement of surgical margins played a significant role in this increased incidence of recurrence. Only one patient, originally treated by simple vulvectomy, later developed early stromal invasion. A wide local excision technique should be strongly considered as initial management of this multifocal neoplasm. Close follow-up is mandatory. Recurrence of disease may be treated with appropriate wide excision. PMID- 6496591 TI - Effect of methyldopa on menopausal flushes, skin temperature, and luteinizing hormone secretion. AB - The effect of methyldopa (100 mg intravenously), the precursor of the alpha receptor agonist alpha-methylnorepinephrine, on subjectively experienced menopausal flushes, skin temperature, and luteinizing hormone secretion was investigated in seven women in a double-blind, saline-controlled, crossover study. Subjects were monitored over a 3-hour period. Methyldopa significantly decreased the number of subjective flushes (p less than 0.05) and the number of cutaneous temperature peaks (p less than 0.05) but had no effect on the number of luteinizing hormone secretory pulses, variability of luteinizing hormone secretion, or total luteinizing hormone secretion. These studies indicate that alpha-adrenergic mechanisms (central and/or peripheral) play a role in the pathophysiology of menopausal flushes. PMID- 6496592 TI - Cardiorespiratory efficiency at submaximal work in young and middle-aged women. AB - Seventeen middle-aged women and 26 younger women were studied while walking at 3 mph and a 5% grade on a motorized treadmill. This was submaximal work for all subjects and is equivalent to the intensity of everyday activity. The middle-aged women had a significantly greater oxygen uptake, ventilatory equivalent, and heart rate, suggesting a relative cardiorespiratory inefficiency at this submaximal work intensity. This phenomenon is most likely a function of body size, however, since dividing the submaximal oxygen uptake by body weight rendered the mean difference between the two groups statistically insignificant. The age-associated reduction in cardiorespiratory efficiency at submaximal exercise is thus due primarily to weight gain rather than to actual systems degeneration. Maximal oxygen uptake, that associated with maximal physical effort, was significantly reduced in the older subjects, and this is probably due to a combination of previous life-style habits and aging. PMID- 6496593 TI - Preterm delivery is not predicted by serial plasma estradiol or progesterone concentration measurements. AB - Previous studies suggest that plasma estradiol-17 beta and progesterone concentration values differ between patients who deliver before term and those who deliver at term. To determine if these values would aid in preterm delivery risk prediction, we measured plasma estradiol-17 beta and progesterone concentrations serially in 90 patients at high risk for preterm delivery. Measurements from 17 patients who developed documented preterm labor and/or were delivered before term were compared to the tenth and ninetieth percentiles of 42 patients who were delivered at term. The sensitivity of these measurements to predict preterm delivery was very low. Also, the mean plasma estradiol-17 beta and progesterone concentrations in patients with preterm labor who had term deliveries and in patients with preterm labor that progressed to preterm delivery were not different from each other or from patients delivering at term. No change in plasma estradiol-17 beta or progesterone concentration was noted preceding labor. We conclude that serial measurements of plasma estradiol-17 beta and progesterone concentrations do not improve preterm delivery risk prediction. PMID- 6496594 TI - Human chorionic gonadotropin and thyroid function in patients with hydatidiform mole. AB - In view of the controversy regarding the role of human chorionic gonadotropin as the stimulator of thyroid function in patients with trophoblastic tumors, especially hydatidiform mole, we conducted studies to explore whether a correlation between serum human chorionic gonadotropin levels and thyroid function was demonstrable in such patients. Among 47 patients studied, only one was clinically hyperthyroid, although 10 had serum total thyroxine values exceeding those found in normal pregnancy (8 to 17 micrograms/dl). Among 34 patients in whom free thyroxine indices could be calculated, 18 had elevated values for the free thyroxine index (greater than 10.6), and nine had elevated values for both total thyroxine and free thyroxine index. Serum total 3,5,3' triiodothyronine concentrations were also measured in 17 patients, and only one of them had a value (400 ng/dl) above the normal limit for pregnancy (greater than 350 ng/dl). Among the 13 patients for whom free 3,5,3'-triiodothyronine indices were calculated, three had values above the normal range (greater than 215). A weakly positive correlation (r = 0.35, p less than 0.05, n = 47) between the serum human chorionic gonadotropin levels and serum total thyroxine concentrations was observed in these patients. However, no correlation was found between serum human chorionic gonadotropin levels and free thyroxine index values (r = 0.32, p greater than 0.05, n = 34). Also there was no correlation between serum human chorionic gonadotropin levels and either serum total 3,5,3' triiodothyronine concentrations (r = 0.32, p greater than 0.1, n = 17) or free 3,5,3'-triiodothyronine index values (r = 0.27, p greater than 0.1, n = 13). chi 2 Analysis revealed no significant relationship between elevations of serum human chorionic gonadotropin concentration and abnormally high values of the free thyroxine index. These studies do not support the premise that human chorionic gonadotropin per se is the thyroid stimulator of molar pregnancy and suggest that a substance or substances, distinct from human chorionic gonadotropin and elaborated by the gestational trophoblastic tissue, are responsible for thyrotoxicosis observed in patients with trophoblastic tumors. PMID- 6496595 TI - A comparison of intravenous and intramuscular magnesium sulfate regimens in preeclampsia. AB - A prospective study comparing continuous intravenous magnesium sulfate to intramuscular magnesium sulfate was performed in 32 preeclamptic patients. Eighteen patients received the intramuscular regimen for mild and severe preeclampsia as recommended by Pritchard. The remaining 14 patients received an intravenous regimen consisting of a 4 gm loading dose administered over 15 minutes followed by a maintenance dose of either 1 gm/hr (n = 7) or 2 gm/hr (n = 7). All groups were similar regarding maternal age, height, weight, fetal gestational age, and laboratory findings. The intravenous regimen with a maintenance dose of 1 gm/hr produced serum magnesium levels that were much lower than those achieved with the intramuscular regimen. There was no significant difference after 3 hours of therapy between the mean magnesium levels achieved with the intramuscular regimen and the levels achieved with the intravenous regimen with a maintenance dose of 2 gm/hr. However, during the first 3 hours of therapy the intramuscular regimen for severe preeclampsia produced mean magnesium levels that were significantly higher than those levels obtained with the intravenous regimen with a maintenance dose of 2 gm/hr (p less than 0.001). Both methods were safe. However, the intravenous regimen with a maintenance dose of 1 gm/hr is inadequate in management of preeclamptic patients. PMID- 6496596 TI - Altered effect of 3% dietary cholestyramine on plasma lipids and biliary bile acid output in the pregnant rat. AB - The effects of a diet containing 3% (w/w) cholestyramine on plasma total, free, and high-density lipoprotein cholesterol and triglycerides and on bile flow and composition were compared between pregnant rats fed the resin from before mating until the twentieth day of gestation and virgin rats fed the resin for an equivalent length of time. Pregnant and virgin rats consuming a similar diet but not receiving cholestyramine were also studied. In the nonpregnant rat the usual response to cholestyramine was observed as a significantly elevated plasma high density lipoprotein cholesterol level and biliary bile acid secretion. Plasma cholesterol levels and bile composition were not altered by cholestyramine in the pregnant rat. The inability of resin therapy to change plasma high-density lipoprotein cholesterol and bile composition during pregnancy is likely to be causally related to a reduced efficacy of cholestyramine treatment when administered during gestation. PMID- 6496597 TI - Umbilical cord plasma concentrations of deoxycorticosterone sulfate in anencephalic fetuses. AB - In the present investigation, we determined the levels of deoxycorticosterone sulfate in mixed umbilical cord plasma of anencephalic abortuses and newborn infants. The anencephalic fetus is an interesting model with respect to the production of deoxycorticosterone and deoxycorticosterone sulfate on several accounts. There is profound adrenal atrophy in most such fesuses, and, in consequence, there also is relatively profound hypoestrogenism. This is an important consideration in the formation of deoxycorticosterone and deoxycorticosterone sulfate since it is known that estrogen acts to stimulate extra-adrenal steroid 21-hydroxylase and 21-hydroxysteroid sulfotransferase activities. The plasma levels of deoxycorticosterone sulfate in 22 anencephalic abortuses and newborn infants delivered between 21.5 and 45.5 weeks of gestation ranged from 1.8 to 30.3 ng/ml. The concentrations of deoxycorticosterone sulfate in umbilical cord plasma of anencephalic fetuses and newborn infants were not related to gestational age or method of delivery and, at term, were less than 13% of those in umbilical cord plasma of normal newborn infants. These data can be interpreted to indicate (1) that deoxycorticosterone sulfate normally is secreted directly by the fetal adrenal or (2) that placental estrogen normally derived largely from fetal adrenal dehydroisoandrosterone sulfate is essential for the maintenance of plasma deoxycorticosterone sulfate levels in the fetus by stimulating extra-adrenal deoxycorticosterone sulfate production from plasma progesterone, or both. PMID- 6496599 TI - Uterine contractility after rupture of the gravid uterus: a case report. PMID- 6496598 TI - The association between cesarean birth and outcome in vertex presentation: relative importance of birth weight, Dubowitz scores, and delivery route. AB - The effect of the obstetrician's choice for delivery route on infant outcomes was studied in 17,260 mothers in labor, with the fetus alive at the onset of labor, in vertex presentation, and without major congenital anomalies. At birth weight categories, stratified by 500 gm increments, there was no improvement in intrapartum and neonatal mortality or in neonatal morbidity associated with the cesarean birth route. The major dependent variables important in neonatal outcome were birth weight and neonatal maturity. The association between cesarean section delivery and outcome in vertex presentations is limited. This information documents the need for prospective randomized and controlled studies with respect to proposed changes in birth route for the very low-birth weight fetus. PMID- 6496600 TI - Management of acute and subacute puerperal uterine inversion with terbutaline sulfate. PMID- 6496601 TI - Primary hyperaldosteronism during pregnancy. PMID- 6496603 TI - Fetal femur length and its relationship to birth weight. PMID- 6496602 TI - Squamous cell carcinoma arising from ovarian benign cystic teratoma. PMID- 6496604 TI - Hemoglobin A1c levels and variant hemoglobins. PMID- 6496605 TI - Inappropriate fetal bradycardia. PMID- 6496606 TI - Autologous blood for elective cesarean hysterectomy. PMID- 6496607 TI - The incidence of neural tube defects in the fetus and neonate of the insulin dependent diabetic woman. PMID- 6496608 TI - A device for continuously measuring rotation of the fetal head. PMID- 6496609 TI - Efficacy and safety of low-dose 15-methyl prostaglandins F2 alpha for cervical ripening in the first trimester of pregnancy. PMID- 6496610 TI - Acyclovir in the treatment of herpetic stromal disease. AB - Seventeen patients (ten women and seven men, 23 to 72 years old) with stromal herpetic disease were treated with topical and oral acyclovir for 14 days. Of the 12 patients with disciform edema, five showed minimal improvement, four showed no change, and three showed worsening of their disease. Of the five patients with necrotizing stromal keratitis, one improved, one showed no change, and three became worse. The patients who had been treated with corticosteroids previously had a statistically significantly worse outcome than those who had not been so treated. One patient with necrotizing stromal keratitis showed virus particles in tissue specimens obtained by superficial lamellar keratectomy. Thus, acyclovir was not effective in the treatment of disciform edema or necrotizing stromal keratitis. Further studies are needed to ascertain whether the drug is therapeutically ineffective or whether acyclovir did not reach the stroma in amounts sufficient to affect the course of stromal disease in the human eye. PMID- 6496611 TI - Color as a risk factor in iris melanoma. AB - We reviewed 23 iris melanomas for iris color and gross tumor pigmentation. Patients with iris melanoma had lighter irides than both population controls (x2 = 58.0; P less than .0001) and other patients with uveal melanoma (x2 = 17.1; P = .002). Amelanotic and lightly melanotic tumors occurred predominantly in the patients with light irides. PMID- 6496612 TI - Diffuse and localized nerve fiber loss in glaucoma. AB - To estimate the usefulness of photographs of the retinal nerve fiber layer in demonstrating glaucomatous neural tissue changes, we examined such photographs of 51 patients with glaucoma, 52 patients with ocular hypertension, and 29 normal individuals. The photographs were assessed in a masked fashion. A semiquantitative damage score was given in subsectors of the arcuate, papillomacular, and nasal nerve fiber bundle areas, separately for localized and diffuse loss of nerve fibers. The coefficients of variation of the reproducibility of retinal nerve fiber layer assessment were 0.22 for diffuse damage and 0.11 for localized damage. We detected abnormal retinal nerve fiber layer changes in 48 of the patients with glaucoma, in 27 of those with ocular hypertension, and in five of the normal control subjects. Generalized reduction of nerve fibers with or without localized defects was more common in patients with glaucoma than in those with ocular hypertension whose abnormal findings were primarily localized defects. PMID- 6496613 TI - Microvascular aspects of acquired immune deficiency syndrome retinopathy. AB - Twelve of 13 patients with the acquired immune deficiency syndrome exhibited ophthalmoscopically detectable retinal findings, including cotton-wool spots, hemorrhages, Roth spots, and microvascular changes. When we used fluorescein angiography, we detected focal nonperfusion and microvascular changes in all 13 of our patients. Most patients had no visual complaints unless they had cytomegalovirus involvement of the optic papilla or the central retina. One patient lost central visual acuity from loss of perfusion in a portion of his perifoveal capillary net. Histopathologic studies demonstrated the loss of retinal capillary cells and focal occlusions of small vessels. Retinal vessel walls were also thickened with PAS-positive material. PMID- 6496615 TI - Lacrimal drainage system inflammatory masses from retained silicone tubing. AB - In two cases studied we found inflammatory masses of the lacrimal system associated with retained silicone material. We saw the first patient two years after a failed dacryocystorhinostomy. A mass of the superior punctum mimicking a lacrimal sac or canalicular neoplasm consisted of chronic granulomatous inflammation centered around retained silicone tubing. In the second patient, a foreign body giant cell inflammatory reaction occurred in the lacrimal sac in which there were retained knots of silicone tubing. We believed the inflammation in these patients to be caused by the knots and the cut ends of the silicone tubing present in the lacrimal drainage system. PMID- 6496614 TI - Pseudo-internuclear ophthalmoplegia after surgical paresis of the medial rectus muscle. AB - Unilateral or bilateral limitation of adduction with jerk nystagmus of the abducting eye occurred after a weakening operation of the medial rectus muscle in five patients aged 9 to 39 years. The nystagmus waveform was indistinguishable and the clinical findings were similar to those in internuclear ophthalmoplegia. Persistence of the abducting nystagmus after occluding the adducting fellow eye in four of the five patients reflected a continued attempt of the central nervous system to increase neural activity to the paretic eye. This hypermetric response disappeared after several days of patching of one eye, only to reappear after removal of the patch. These observations suggested that the generation of abducting nystagmus in conjunction with medial rectus muscle palsy of the fellow eye does not necessarily depend on lesions in the median longitudinal fasciculus, but may also be caused by a gain-step mismatch of the saccadic generation system. PMID- 6496616 TI - Floppy eyelid with hyperglycinemia. AB - A 31-year-old man with spastic paraparesis (diagnosed when he was 10 years old) and hyperglycinemia (diagnosed when he was 19 years old) had an intermittently swollen right eye and blurred vision. His right upper eyelid was S-shaped and edematous, the lateral canthal tendon was flaccid, and the eyelid everted easily. After the floppy eyelid syndrome was diagnosed, the patient underwent a tarsal strip procedure to shorten and tighten the lax upper eyelid. This relieved his symptoms, which have not recurred in the year since surgery. PMID- 6496617 TI - Immunoglobulin deposition in localized conjunctival amyloidosis. AB - Immunofluorescent studies were performed on tarsus and tarsal conjunctiva from a 30-year-old woman with blepharoptosis secondary to localized nonfamilial amyloidosis. Both kappa and lambda light chains were identified in abundance in the resected tissue. There was no evidence of any systemic disease or of amyloid deposition elsewhere. Six months after the patient underwent surgery, there was no sign of recurrence. The antigenic determinants of the amyloid suggested that the pathogenesis of localized nonfamilial ocular amyloidosis involves the accumulation of proteins similar to immunoglobulin. PMID- 6496618 TI - Radiating folds in Descemet's membrane as a sign of impending corneal perforation. PMID- 6496619 TI - Corneal curvatures in premature infants. PMID- 6496620 TI - Light-induced maculopathy from the operating microscope. PMID- 6496621 TI - Unilateral night blindness with normal fundus. PMID- 6496622 TI - Progressive glaucomatous visual field loss after neodymium-YAG laser capsulotomy. PMID- 6496623 TI - Use of the infrared fundus reflection for an identification device. PMID- 6496624 TI - Viewing of fluorescein angiograms by closed-circuit video low-vision apparatus. PMID- 6496625 TI - Optokinetic nystagmus tape. PMID- 6496626 TI - Diagnosing sarcoidosis by transconjunctival biopsy of the lacrimal gland. PMID- 6496627 TI - A randomized comparison of surgical procedures for infantile esotropia. PMID- 6496628 TI - A randomized comparison of surgical procedures for infantile esotropia. PMID- 6496629 TI - Vertical tarsal buckling as a complication of levator aponeurosis repair for acquired blepharoptosis. PMID- 6496630 TI - Angioid streaks associated with hereditary spherocytosis. PMID- 6496631 TI - Successful treatment of postoperative Candida endophthalmitis in an eye with an intraocular lens implant. PMID- 6496632 TI - Structural factors in the pathogenesis of ischemic optic neuropathy. PMID- 6496633 TI - Albinotic characteristics in congenital nystagmus. PMID- 6496634 TI - Ocular staphylococcal infections. PMID- 6496635 TI - A perspective on occupational therapy education. PMID- 6496636 TI - Understanding theory: the first step in learning about research. AB - This article describes a teaching method used to explain to undergraduate students how a theory is organized and how a practice model is derived based on the theory. Kielhofner's temporal adaptation of Neville's application of temporal adaptation in practice are used as examples of a developing theory and practice model. The relevance of theory analysis to research design and methods is stressed. PMID- 6496637 TI - The influence of curriculum format on learning preference and learning style. AB - Undergraduate occupational therapy students were given the Rezler-French Learning Preference and the Kolb Learning Style Inventories at the introduction of professional course work (pretest) and upon completion of junior year course work and Level 1 fieldwork (posttest) 1 year later. The students' course work was a guided-study, modified competency-based program that included guided independent study, laboratory work, small group study, and one-to-one tutorials in preference to, but not excluding, the more traditional lecture method. After experiencing different modes of instruction, the students indicated no significant difference in their preferences for ways of learning or in processing information. Implications of these findings for the teaching-learning process are discussed. PMID- 6496638 TI - Meridional variations of corneal shape. AB - The corneal shape of 196 eyes was determined by photokeratoscopy and subsequent fitting of a conicoid equation to four individual corneal meridians. This conicoid was found in almost all instances to be ellipsoidal, with the asphericity not varying between meridians. The corneal radius of curvature did vary as expected between meridians. The radii of curvature of these corneal meridians also varied with the age of the subjects, resulting in reduced corneal astigmatism, while the asphericity of each meridian did not vary substantially with age. PMID- 6496639 TI - Average thickness of a hydrogel lens for gas transmissibility calculations. AB - Several attempts have been made to calculate the average thickness of hydrogel lenses for the purpose of calculation of oxygen transmissibility. The deficiencies of these equations are discussed and a new equation is given. Results of average thickness calculations with variation in different parameters are presented. These results indicate that the effect of thickness variation in higher powered lenses has been seriously underestimated. The parameters which cause a major difference in the average thickness compared to the center thickness are power, chord radius, and water content. PMID- 6496640 TI - Application of hydrogel lens average thickness. AB - The equation for the average thickness of a hydrogel lens is a complex function. This report gives a simple method of estimating this parameter. By structuring the information into nomograms, an accurate system is derived which facilitates the design of a contact lens to provide a required average oxygen transmissibility. Several examples of the accuracy of the estimated value compared to the calculated value are shown. Details of the use of these nomograms are given with a discussion on the worth of an average thickness value as compared to a local thickness value. PMID- 6496641 TI - Bayes' theorem and X-linked ophthalmic disorders. AB - Many X-linked disorders are confined to the eye or have ocular manifestations. The provision of genetic counseling for potential carriers requires accurate risk assessment. An application of Bayes' theorem to risk assessment for the daughter of an obligate carrier, and her daughter, is given. PMID- 6496642 TI - A general relation between changing surface radii of flexing soft contact lenses. AB - Many models have been proposed to describe the simultaneous changes which occur in front and back radii of curvature of a hydrogel contact lens flexing or "wrapping" onto the surface of a human eye. This study first discusses the concept that the change in front radius (delta r1) may be related to the change in back radius (delta r2) by a simple constant which may change with lens design, and then develops a separate new general relation from observed lens behavior: delta r1/delta r2 = 1 - 0.05 F, where F is unflexed lens back vertex power. PMID- 6496643 TI - Stereopsis in small-angle strabismus. AB - Our purpose was to evaluate the presence of stereopsis in a number of small-angle strabismic patients, using several stereotests, and to attempt to associate the presence of stereopsis with certain clinical characteristics of the strabismus- the magnitude of the deviation, the severity of the amblyopia, the depth of the anomalous correspondence, and the etiological category. The evaluation of stereopsis was performed using the Titmus, Randot, Random-dot E, TNO, and Frisby stereotests. Thirty-two percent of the small-angle strabismic patients examined demonstrated no stereopsis on any of the stereotests. Patients having strabismic deviations exceeding 5 delta, showing anomalous correspondence on multiple tests, and having had extraocular muscle surgery were the least likely to demonstrate stereopsis. The test that most often indicated the presence of stereopsis was the Titmus stereo test, and the tests that least often indicated the presence of stereopsis were the Random-dot E and the TNO stereotests. Our results indicate that careful consideration should be given to the clinical characteristics of the strabismus and the selection of the stereotest when evaluating small-angle strabismic patients for the presence of stereopsis. PMID- 6496644 TI - Surrogate color vision by luster discrimination. AB - A selective filter, such as the X-chrom lens, which is placed before one eye, serves to create a luminance difference between the two eyes. The amount of the luminance difference is dependent upon the wavelength distribution of the stimulus and could therefore serve as a clue to assist color discrimination. The ability to detect and discriminate levels of luster is investigated. One of three subjects shows a crude ability to discriminate levels of luster. The performance level is such that a filter may aid dichromacy but not anomalous trichromacy. PMID- 6496645 TI - Adaptive changes with prolonged effect of comitant and incomitant vergence disparities. AB - When comitant and incomitant vergence disparities are induced for prolonged periods of time, the adaptive state becomes more stable. When the change is complete, the adaptive ability of the oculomotor system to a further disparity should be the same as that before any induced effect. Comitant change was investigated in five subjects who wore a 2 delta base-up Fresnel prism for prolonged periods of time (1 to 3 days). Adaptation was periodically monitored with a further 2 delta base-up prism. In three subjects the rate of adaptation to the additional prism approached that which occurred before the experiment. In two subjects, both of whom suffered asthenopic symptoms with the initial disparity, adaptation to the additional prism remained slow and incomplete. Incomitant change was investigated in two subjects who wore a -3.00 contact lens-spectacle lens (CL-SL) system for 2 to 3 days. Adaptation was monitored with a further 1.50 CL-SL system at the start and the end of the prolonged wear. Both these subjects had a much faster rate of adaptation at the end of the prolonged period than they had at the beginning. PMID- 6496646 TI - Short-term effects of induced aniseikonia on the binocular pattern VER. AB - The amplitude and implicit time of the P-1 component of the binocular transient pattern visually evoked response (VER) was recorded at four levels of induced aniseikonia. No significant changes were found in these VER parameters over a 10 min test period. Several possible explanations for these observations are presented. PMID- 6496647 TI - Physiological response of the contralateral cornea to monocular hydrogel contact lens wear. AB - Previous authors have suggested that monocular contact lens wear can induce changes in the contralateral eye. However, most of these contralateral responses have yet to be substantiated or satisfactorily explained. This paper reports a randomized, controlled, single-masked experiment in which corneal thickness, corneal oxygen consumption, and the endothelial bleb response were monitored for 3 hr in both eyes of eight unadapted subjects who wore thick hydrogel lenses on one eye only. No significant contralateral effect was observed in any of the parameters examined. These findings reaffirm the validity of using the contralateral eye as a control in experiments with hydrogel contact lenses. PMID- 6496648 TI - Solution intolerance among users of four chemical soft lens care regimens. AB - The incidence of solution intolerance in 161 soft contact lens patients was about 33% in those using chlorhexidine plus thimerosal chemical disinfecting systems. Those who disinfected their lenses with systems based primarily on thimerosal developed intolerance in 5 to 8% of cases. A family history of allergy appears not to be significant. PMID- 6496649 TI - Histocompatibility (HLA) antigens in keratoconus. AB - To determine if susceptibility to keratoconus is associated with the histocompatibility (HLA) system, we HLA-typed 39 keratoconic patients and 208 normal controls for 63 HLA-A, -B, and -C antigens. The antigen frequencies for the keratoconic patients did not differ significantly from the frequencies for the control patients. These results suggest that susceptibility to keratoconus is not associated with the HLA system. PMID- 6496650 TI - Oxygen tension measurements: a comparison of methodologies. AB - The equivalent oxygen percentage (EOP) technique of Hill and the technique of Rasson and Fatt are two commonly used methods to quantify the oxygen tension underneath a contact lens for the open-eyelid case. This study compares these two techniques. Five subjects and six contact lenses of various center thicknesses and oxygen transmissibilities were used. Each subject wore each lens for which the oxygen tension was measured by these two methods. For lenses of approximately 0.23 mm center thickness, the two methods gave similar oxygen values. For contact lenses significantly thicker or thinner, the two methods gave very different oxygen values. However, these oxygen values were related in a specific manner; a strong linear relation was found for contact lens center thickness vs. the ratio of the two oxygen values found by the two methods. PMID- 6496651 TI - Ophthalmic services in New Zealand. AB - A random sample of 2000 persons throughout New Zealand was questioned on the use of and attitudes toward vision care. One-half of the respondents had had a vision examination within the past 4 years. Of those that had been examined, 72% were seen by an optometrist and 22% were seen by an ophthalmologist. Fifty-two percent of the sample wore spectacles or contact lenses, and in the 25 to 34 year age group 12.5% wore contact lenses. The majority (66%) reported no visual problems, and of this group 42% would visit a medical practitioner, 41% an optometrist, and 11% an ophthalmologist if they were to develop a visual problem. At the last visual examination 28% were advised that they did not need a refractive correction, 22% were told their present aid was adequate, and 46% were prescribed new spectacles. PMID- 6496652 TI - Functional difficulties resulting from traumatic anisocoria. PMID- 6496653 TI - Bandage lenses in atypical erythema multiforme. PMID- 6496654 TI - A comparative study of fibroblasts in healing freeze and burn injuries in rats. AB - In rats, the healing process of a full-thickness dermal freeze injury differs from that of a burn wound. Whereas burn wounds heal by wound contraction, the movement of surrounding normal skin over the defect, freeze wounds heal without wound contraction. That absence of contraction may be due to the freeze wound's lack of myofibroblasts, the cells reportedly associated with wound contraction. Myofibroblasts can be demonstrated histologically by staining the F-actin filaments of the stress fibers with NBD-phallacidin, a fluorescent reagent specific to F-actin filaments. Fibroblasts in normal dermis have no staining stress fibers. However, staining myofibroblasts are uniformly distributed in the granulation tissue of the healing burn and in the islands of granulation tissue between residual connective tissue fibers in the healing freeze wound. These residual dermal fibers were identified by their patterns of birefringence. Residual connective tissue matrix persists following cold trauma and acts like an internal splint. Burn trauma destroys cells and the connective tissue matrix, which is completely replaced with granulation tissue which undergoes wound contraction. Freeze trauma kills the cellular components of dermis, while some residual connective tissue fibers endure. This study shows that the connective tissue matrix can play an important role in the control of wound contraction. PMID- 6496655 TI - Facilitation of granulocyte migration into bovine pulmonary artery intimal explants by intact viable endothelium. AB - To characterize the role of normal endothelium in granulocyte chemotaxis, the authors measured granulocyte adherence to and migration into bovine pulmonary artery intimal explants. Explants were placed, endothelium uppermost, in chemotaxis chambers with zymosan-activated plasma in the lower well and 5 X 10(6)/ml 51Cr-labeled granulocytes in the upper well. After 15, 30, 60, 120, 180, or 240 minutes incubation at 37 C, granulocyte adherence was measured by removal of adherent granulocytes from the endothelial layer with a 0.1% trypsin wash and counting of radioactivity in the wash. Scanning electron microscopy confirmed that this technique removed the majority of adherent cells from the endothelial surface without disrupting its continuity. Migration was calculated by counting of the remaining radioactivity in the explant. Granulocyte migration with Medium 199 alone in the lower well (random migration) was 36 +/- 3% by 3 hours. Chemotaxis-induced migration at each time studied was 1.5-2 times random migration. Granulocyte adherence was between 4% and 9% in both groups at all times examined. In some experiments, either endothelium was removed from explants or explants were fixed with glutaraldehyde prior to experimentation. Removal of endothelium resulted in a two-fold increase in granulocyte adherence but no significant difference in migration, compared with intact intimal explants. Glutaraldehyde fixation of explants resulted in more tightly adherent granulocytes and significantly less migration. With lactate dehydrogenase as a marker of endothelial cell damage, granulocyte migration in response to zymosan activated plasma did not injure endothelium. It is concluded that, in blood vessels, chemotaxis is an interactive process between granulocytes and endothelium and that intact, viable endothelium facilitates granulocyte migration. PMID- 6496656 TI - Perturbation of podocyte plasma membrane domains in experimental nephrosis. A lectin-binding and freeze-fracture study. AB - Alterations in the ultrastructural organization of podocyte plasma membrane domains were quantitatively assessed in puromycin aminonucleoside-treated rats by the use of 1) Helix pomatia lectin-gold complexes for detection of a specific glycocalyx component(s) normally associated with foot process bases and 2) freeze fracture for detection of intramembrane particles and endocytotic invaginations on the plasma membrane. Lectin-binding sites were significantly reduced on podocyte foot process bases during the 7-day treatment period; and in freeze fracture, the plasma membrane of the foot process base showed an increase in intramembrane particle number and size and an increased number of endocytotic invaginations, compared with the numbers in control animals. The cell body of nephrotic animals also had a significantly increased intramembrane particle density, compared with the control animals. These results provide direct evidence that the normal structure of specific plasma membrane regions is perturbed in podocytes that have lost their characteristic array of foot processes and support a role for these domains in the maintenance of normal podocyte architecture. PMID- 6496657 TI - The effects of intermittent starvation on lung development in suckling rats. AB - The effect of starvation on postnatal lung growth in rats was investigated. Litters were starved twice, each time for 24 hours, on Day 1 and Day 5 after birth. One group of littermates was sacrificed on Day 7, and another group, on Day 14 of postnatal life. Intermittent starvation diminished lung growth. This was accompanied by reduced somatic growth. On postnatal Day 7, lung volume, total number of alveoli, and internal surface area of the lung were decreased in starved rats, but structurally their lungs appeared similar to control lungs. On postnatal Day 14, a striking morphologic difference was observed between the lungs of control and starved pups. Following starvation, retardation of lung growth was manifested in all the parameters studied. One week of normal uninterrupted suckling could not overcome the starvation-induced initial effects on growing lungs. It is concluded that starvation, soon after birth, affects adversely the normal development of lung. PMID- 6496658 TI - Family resemblance for cranio-facial measurements in Velanti Brahmins from Andhra Pradesh, India. AB - Maximum likelihood estimates of familial correlations are presented for 12 cranio facial measurements taken on 399 nuclear families from Southern India. Marital resemblance is significantly different from zero for head circumference, head breadth, minimum frontal breadth, bizygomatic breadth, total facial height, and nasal height, but not for bigonial breadth, nose breadth, nose depth, or ear dimensions. All other familial correlations are significantly greater than zero except for the father-daughter correlation for nasal depth. Path analysis with a TAU transmission model with sex effects reveals that family resemblance for head circumference, head length, bigonial breadth, total facial height, and nasal height, but not for bigonial breadth, nose breadth, nose depth, or ear dimensions. All other familial correlations are significantly greater than zero except for the father-daughter correlation for nasal depth. Path analysis with a TAU transmission model with sex effects breadth, and sex effects in transmission were found for head breadth and nose dimensions. Sex effects in this sample may be due to the fact that different anthropometrists were used for male and female subjects. PMID- 6496659 TI - The time and energy expenditure of indigenous women horticulturalists in the northwest Amazon. AB - The energy cost of subsistence activities and the daily time and energy budgets of Tatuyo women were assessed as part of a village energy flow study. The Tatuyo are swidden horticulturalists relying on bitter manioc (Manihot esculenta) as a staple crop. Except for the actual felling of new gardens, women are responsible for most of the horticultural work and food preparation. Time budgets were assessed using 24-hour activity diaries. Rates of energy expenditure in typical activities were measured by indirect calorimetry using a Max-Planck respirometer. Daily energy expenditure was calculated using these rates in conjunction with the activity diaries. Rates of energy expenditure in standard activities were moderate and broadly comparable to published values for other populations living in tropical environments. The mean daily energy expenditure was 2,133 kcal (8.9 MJ). This value is similar to that reported for other subsistence horticulturalists and close to the FAO recommendation for energy intake for moderately active individuals. PMID- 6496660 TI - Principal axis analysis of dental attrition data from two Australian Aboriginal populations. AB - Dental attrition scores from two distinct Australian Aboriginal populations were compared by principal axis analysis. The first group was composed of members of the Narrinyeri group who occupied the river basin and mouth of the River Murray. The second group consisted of members of the Kaurna tribe who occupied the coastal plain to the west of the Narrinyeri. The groups were isolated both physically and culturally and as a result differences in patterns of tooth wear might be expected. In the Narrinyeri sample, attrition tended to be more rapid in females for all but the anterior teeth. The only sex difference in the Kaurna was for the maxillary central incisors, which wore more rapidly in females. Interpopulation differences in the pattern of tooth wear were also evident. The incisors, canines, and premolars of Kaurna subjects tended to wear more rapidly, while the rate of posterior tooth wear tended to be greater in the Narrinyeri. The application of the principal axis method to quantitative attrition data provided a sensitive, objective evaluation of tooth wear. The reasons for the observed differences between the two groups are still not completely clear but may reflect both functional and morphological differences between groups. PMID- 6496661 TI - Population structure in the Connecticut Valley. I. Marital migration. AB - This study reports on an analysis of marital migration among 12 communities in the Connecticut River Valley of Massachusetts during the years 1790-1849. Genetic inferences are drawn, and the requisite assumptions considered. The effect of geographic distance on genetic kinship is predicted using Malecot's isolation-by distance model. The resulting estimates are discussed in terms of geographic and historical factors. The configuration of communities as predicted by kinship values approximates closely their actual geographic locations. Estimated genetic heterogeneity was low for the historical Connecticut Valley population, and community isolation breaks down rapidly over time. The region thus assumes its place among a number of sedentary, agricultural populations for which the isolation-by-distance model provides an adequate representation. A regression analysis which includes variables in addition to distance indicates that historical and economic factors contribute some additional explanatory power to the distribution of mating frequencies. PMID- 6496662 TI - A comparison of methods for measuring cortical bone thickness. AB - Repeated measures of periosteal and endosteal widths of the left second metacarpal from two samples of radiographs were made independently with either a dial caliper or an electronic digitizer connected to a microcomputer. In addition, periosteal and endosteal bone widths of a common sample of radiographs were measured with dial calipers and the electronic digitizer. Dial calipers and an electronic digitizer are both very reliable, but intraobserver errors produced with the use of the digitizer are significantly less than those produced with the use of dial calipers. However, measurements made with the electronic digitizer are systematically larger than corresponding widths measured with dial calipers, but this difference is very small. PMID- 6496663 TI - Effect of thyroid status on K+-stimulated metabolism and 45Ca exchange in rat skeletal muscle. AB - In the perfused hindlimbs of hypo-, eu-, and hyperthyroid rats, high K+o (20 mM) markedly stimulated glucose uptake, lactate production, and O2-consumption to levels increasing with the thyroid status. At Ca2o+ less than 50 microM, all the responses became transient. In the hypothyroid preparations, caffeine (5 mM) produced no stimulation, but in those obtained from eu- and hyperthyroid rats, it increased all the metabolic parameters as well as K+ release in proportion to thyroid status. In isolated soleus and extensor digitorum longus muscles, both high K+o and caffeine stimulated 45Ca-efflux, with the response increasing in proportion to thyroid status. This stimulation was reduced by 70-100% with dantrolene (10(-5) M), which in earlier studies was shown to suppress the metabolic effects of high K+o and caffeine. High K+o also increased 45Ca-influx but produced no change in muscle calcium contents. The results support the idea that thyroid hormones control substrates availability and energy consumption in skeletal muscle by increasing the amount of sarcoplasmic reticulum and thereby the rate of Ca2+ mobilization into the cytosol. PMID- 6496664 TI - Dopamine 3-sulfate inhibits aldosterone secretion in cultured bovine adrenal cells. AB - It has been demonstrated that dopamine inhibits the aldosterone (Aldo) secretion in bovine adrenal cells in vitro. Because the majority of the total circulating dopamine (DA) in bovine plasma (72%) is present in sulfoconjugated form (6.8 +/- 3.4 pmol/ml) and free DA, DA sulfate, and phenolsulfotransferase (PST) activity can be found in the bovine adrenal cortex, we examined whether the inhibitory action of free DA on angiotensin II- (ANG II) stimulated Aldo secretion by cultured bovine adrenal cells can also be reproduced by sulfoconjugated DA analogues. Cells from the bovine adrenal glands cultured for 3 days before testing responded to 10(-8) M ANG II stimulation by a 10- to 12-fold increase in Aldo output. This stimulatory effect was partially inhibited by the addition of free DA and DA 3-sulfate, whereas DA 4-sulfate was inactive. Both free DA and DA 3-sulfate produced their maximal inhibitory effect at a concentration of 100 microM, with a decrease in Aldo secretion by 61% (free DA) and 44% (DA 3 sulfate). The slightly different inhibition curves for DA and for DA 3-sulfate on Aldo secretion cannot be explained by liberation of free DA through hydrolytic processes because less than 1% free DA was detected after the incubation of the cells with sulfoconjugated DA. These in vitro findings suggest that DA 3-sulfate may be effective in complementing the dopaminergic inhibition of Aldo secretion at the adrenal level. PMID- 6496665 TI - Bioactive parathyroid hormone in canine progressive renal insufficiency. AB - Bioactive parathyroid hormone and hormonal actions were monitored as hyperparathyroidism evolved in a model of progressive canine renal failure. Circulating levels of bioactive and immunoreactive parathyroid hormone rose as renal insufficiency worsened, but elevations, especially in bioactivity, were most marked in the final stage of uremia. By gel filtration analysis, the major circulating bioactive moiety was similar to the major glandular form of parathyroid hormone, although a smaller-molecular-weight entity was seen in the final stage of renal failure. Renal phosphate threshold fell, urinary hydroxyproline corrected for glomerular filtration rose, and plasma 1,25 dihydroxyvitamin D fell but remained detectable, as renal function deteriorated. The results demonstrate a progressive rise in bioactive parathyroid hormone, show the appearance of a small-molecular-weight bioactive entity in severe renal disease, and correlate effects of the rising bioactive parathyroid hormone with changes in renal phosphate handling and with skeletal resorption. PMID- 6496666 TI - Vasopressin in plasma and cerebrospinal fluid of dogs during hypoxia or acidosis. AB - Hypoxia and hypercapnia have been shown to cause an increase in the concentration of vasopressin in plasma, but their effects on vasopressin in cerebrospinal fluid (CSF) are not known. In addition, the effect of metabolic acidosis on plasma and CSF vasopressin has not been reported. In this study, plasma and CSF vasopressin levels were measured in anesthetized dogs subjected to either hypoxia, hypercapnia, or metabolic acidosis. Rate and depth of respiration were closely regulated with the aid of muscle paralysis and mechanical ventilation. Vasopressin increased markedly in both plasma and CSF during severe hypoxia (10% O2) and during hypercapnia (10% CO2) but did not change during either mild (15% O2) or moderate (12.5% O2) hypoxia. Although mild hypoxia by itself did not affect either plasma or CSF vasopressin, it did potentiate the increase in plasma and CSF vasopressin that was induced by severe hypercapnia, thus suggesting that hypoxia and hypercapnia may exert synergistic effects on vasopressin secretion. Metabolic acidosis produced by slow intravenous infusion of 1 N hydrochloric acid decreased arterial pH to values comparable to those induced by hypercapnia and increased vasopressin in plasma; CSF vasopressin was unchanged. These results are consistent with the concept that the source of vasopressin secreted into plasma may be different from that secreted into CSF. PMID- 6496667 TI - Diabetes-induced alterations of glucose metabolism in rat cerebral microvessels. AB - The effect of diabetes on the metabolism of glucose and lactate was examined in isolated rat cerebral microvessels. In rats with diabetes induced with streptozotocin, glucose oxidation to CO2 by the microvessels was decreased by 54 83% and its conversion to lactate by 21-61%. Insulin therapy for several days or starvation for 48 h both lowered blood glucose levels in the diabetic rats and restored microvessel glucose metabolism to normal. Cerebral microvessels consist principally of the capillaries that constitute the blood-brain barrier. Direct assessment of the blood-brain barrier in vivo using the brain uptake index (BUI) technique revealed a close parallel to the findings in the microvessels. Thus, hexose transport was diminished in diabetic rats and restored to normal by both insulin therapy and starvation. The oxidation of [1-14C]lactate to CO2 like that of glucose was depressed in microvessels of diabetic rats. In contrast to glucose, however, the transport of lactate across the blood-brain barrier in vivo was not altered. These findings suggest that diabetes suppresses glucose metabolism in rat cerebral microvessels and downregulates glucose transport across the blood-brain barrier. They also suggest that both of these processes are regulated by chronic alterations in blood glucose concentration rather than by insulin per se. PMID- 6496668 TI - Cerebral oxygen and energy metabolism during and after 30 minutes of moderate hypoxia. AB - Sixty-four isolated canine brain preparations were subjected to either 15 or 30 min of perfusion with blood equilibrated at either Pao2 30 mmHg or Pao2 40 mmHg followed by up to 60 min of reoxygenation with blood having a Pao2 greater than 100 mmHg. Pao2 30 mmHg perfusion decreased oxygen availability and the cerebral metabolic rate for oxygen (CMRo2) to 44 and 49% of normal, respectively, whereas Pao2 40 mmHg perfusion decreased oxygen availability and CMRo2 to 64 and 70% of normal, respectively. Creatine phosphate was markedly decreased (0.6 and 4% of normal, respectively) and ATP was only slightly decreased (73 and 90% of normal, respectively) in these preparations during the hypoxic period. Although ATP returned to normal during the reoxygenation period in both groups, creatine phosphate and CMRo2 returned to normal only in the Pao2 40 mmHg preparations. In brains perfused at various Pao2 levels for periods ranging from 6 to 30 min, the total oxygen deficit (the cumulative difference over time between normal and actual CMRo2) rather than tissue lactate levels appeared to influence the restoration of CMRo2 to normal following hypoxia. An oxygen deficit in excess of 25 mumol/g precluded return to a normal CMRo2 following reoxygenation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496669 TI - Excess in vitro prolactin secretion by pituitary cells from ovariectomized old rats. AB - Various in vivo and in vitro pituitary lactotropic and gonadotropic functions were measured in mature (6-7 mo, normally cycling) and old (24 mo, constant diestrus) female Wistar rats. Serum prolactin (PRL) levels were higher (P less than 0.001), whereas luteinizing hormone (LH) values were similar (P greater than 0.05) in old versus mature rats both before and 3 days after ovariectomy. Serum PRL levels decreased significantly (P less than 0.005) postovariectomy only in the mature rats. The in vitro release of PRL and LH was measured for 4 days in primary adenohypophyseal cell cultures from the ovariectomized rats. Both basal and 17 beta-estradiol (E2)-stimulated PRL release (P less than 0.001) and production (P less than 0.005) were greater by cells from old rats. In contrast, both basal release and E2-stimulated LH release were greater (P less than 0.001) by cells from mature rats. Peak PRL release by cells from both old and mature rats occurred after exposure to E2 doses 1/100th of those required for peak LH release. These data support the hypothesis that intrinsic derangements in anterior pituitary function contribute to the reproductive decline in aging female rats and that different pituitary cell types exhibit discordant age changes in estrogenic sensitivity. PMID- 6496670 TI - Maitotoxin stimulates hormonal release and calcium flux in rat anterior pituitary cells in vitro. AB - The marine dinoflagellate toxin maitotoxin (MTX), an activator of calcium channels, stimulates the release of prolactin (PRL), growth hormone (GH), thyroid stimulating hormone (TSH), and luteinizing hormone (LH) from monolayers of anterior pituitary cells in a dose-dependent manner. Maitotoxin significantly increased PRL, GH, and LH release within 1.5 min and TSH release within 3.5 min, and the stimulation continued for at least 1 h (P less than 0.01). MTX-stimulated hormonal release was blocked by the calcium channel blocker manganese (P less than 0.01). In freshly dispersed perifused pituitary cells in columns, exposure to MTX for 10 min markedly increased PRL, GH, TSH, and LH release for at least 1 h after withdrawal of the toxin. In other experiments, MTX significantly stimulated 45Ca2+ exchange by dispersed pituitary cells within 30 s, continuing for at least 30 min. We conclude that MTX increases anterior pituitary hormonal release, possibly by activating calcium channels, thereby increasing cellular calcium influx. Thus MTX may be a useful agent for investigating the involvement of Ca2+ in hormonal secretory processes. PMID- 6496671 TI - An experimental model of syndrome of inappropriate antidiuretic hormone secretion in the rat. AB - An experimental model of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) was developed using continuous subcutaneous infusions of arginine vasopressin (AVP) or 1-desamino-8-D-arginine vasopressin (DDAVP) in conscious unrestrained rats drinking 5% dextrose solution. Retention of both ingested water and endogenously generated free water from tissue catabolism was the primary determinant of hyponatremia using either AVP or DDAVP infusions. Natriuresis occurred transiently following water expansion but only slightly further lowered plasma [Na+]. Cessation of antidiuretic infusion resulted in free water excretion with correction of plasma [Na+]. Erythrocyte cell volume was significantly increased in hyponatremic animals and intracellular [K+] and [Na+] both decreased equivalently, consistent with dilution of intracellular fluid by retained water. This model of SIADH differs significantly from those previously described, in that escape from the hydroosmotic effect of AVP and DDAVP does not occur in the absence of high urinary flow rates. The observed results using this model suggest that the retained water in SIADH primarily resides intracellularly following isotonic equilibration of extracellular fluid volume. PMID- 6496672 TI - Performance of LH pulse-detection algorithms at rapid rates of venous sampling in humans. AB - To assess the influence of the sampling rate on the quantitative characterization of pulsatile luteinizing hormone (LH) release, we withdrew blood at 4-min intervals for 8 h in five men and at 1-min intervals for 2 h in six other men. For comparative purposes, significant LH pulses were enumerated by three independent, computerized pulse-detection algorithms currently available. Our results indicate that, although the absolute number of LH pulses detected was influenced by the particular algorithm used and the estimate of intra-assay variance, all three analyses yielded increased pulse-frequency estimates at more intensive rates of venous sampling. Moreover, using a fourth, modified pulse detection algorithm intended to maximize recognition of true-positive LH pulses while minimizing both false-positive and false-negative pulses, we observed that venous sampling at 4- and 1-min intervals exposed 4- and 12-fold more LH pulses, respectively, than could be discerned at conventional sampling rates. At rapid rates of venous sampling, the pattern of LH pulses comprised high-frequency, low amplitude LH pulsations superimposed on lower-frequency LH peaks. This pattern suggests that the pituitary gland is responsive to high rates of intermittent neural stimulation. Moreover, these observed profiles are consistent with rapid initial rates of LH disappearance and/or distribution that we could demonstrate after intravenous bolus injections of purified LH in hypogonadotropic volunteers. In conclusion, we have compared results from three different pulse-detection algorithms at various rates of venous sampling and demonstrated a critical influence of sampling rate on apparent LH pulse frequency in humans. PMID- 6496673 TI - Pulsatile glucagon delivery enhances glucose production by perifused rat hepatocytes. AB - We have compared the effects of pulsatile and continuous glucagon administration on hepatocyte glucose production in order to clarify the physiological role of pulsatile hormone secretion. Two identical columns containing freshly isolated rat hepatocytes mixed with polyacrylamide gel beads were perifused with oxygenated tissue culture medium. A fixed total amount of glucagon was delivered to one column as a continuous 90-min infusion and to the other column as a series of six 3-min pulses. A 15-min interpulse interval was chosen in order to approximate the 10- to 12-min interval observed in primates while permitting the resolution of individual hepatocyte responses. With this protocol, the EC50 values for pulsatile and continuous glucagon administration were 186 +/- 41 and 884 +/- 190 (SD) pg/ml, respectively. For glucagon concentrations less than 1,000 pg/ml, pulsatile administration always led to greater hepatocyte glucose production than continuous administration (P = 0.008) and, in the dose range equivalent to concentrations in portal plasma, pulsed glucagon enhanced glucose production twofold. The data suggest that pulsatile secretion is the more efficient means for islet A cells to stimulate hepatic glucose production. PMID- 6496674 TI - Analysis of hydrogen ion concentration in the gastric gel mucus layer. AB - Secretion of HCO-3 by the gastric epithelium has been thought to lower the concentration of H+ in the gastric mucus layer. This has been analyzed mathematically to include the HCO-3-H+ reaction, bulk water flow, diffusion, ion ion electrical interaction, and ion-fixed charge interaction. The reaction electrodiffusion problem is solved by use of singular perturbation theory. We show that there is a very thin layer for the reaction, equivalent to a sink of H+. In this layer there is negligible HCO-3 accumulation. A steady-state model is satisfactory if gastric mixing motions are more frequent than every 3 min. H+ concentration at the epithelium decreases with increased bicarbonate secretion, increased volume flow associated with bicarbonate secretion, increased thickness of the mucus layer, increased fixed negative charge of the mucus, and decreased cation flux into the lumen. The resultant lowering of H+ concentration may be as small as 5 mM but is probably considerably larger. Determining the actual drop will depend on more precise experimental measurements of the parameters of the problem. PMID- 6496675 TI - Chemical adrenalectomy by aminoglutethimide and the pancreas in suckling rats. AB - The role of corticosterone in the development of pancreatic enzymes of suckling rats was studied through a partial and transient blockade of steroidogenesis by aminoglutethimide. Rats were injected with aminoglutethimide the night before their 14th day of age. Ten hours later they showed a transient decrease of serum total corticosterone level as compared with rats injected only with the vehicle. At 34 and 58 h after injection, their corticosterone levels returned to that of control rats. Pancreatic weight, protein, DNA contents, and total activities of amylase, lipase, and trypsinogen were depressed only in the aminoglutethimide treated pups 34 h after injection. These pancreatic parameters returned to the control level 58 h after injection. Hydrocortisone given to another group of rats completely abolished the effect of aminoglutethimide on the pancreas. Thus, a transient suppression of serum corticosterone level caused a delay in the developmental accumulation of pancreatic exocrine enzymes that resumed only after the serum corticosterone returned to the control level. These results further confirm that corticosterone is an important modulator of pancreatic enzyme development in the rat. PMID- 6496676 TI - Cardiovascular and flux relationships in canine ileum. AB - Blood flow and pressure in denerved ileum of anesthetized dogs were altered by occlusion of the mesenteric artery or vein or by infusion of intra-arterial sodium nitroprusside (0.015-1.5 mg/min). Unidirectional Na and H2O fluxes were measured and absorptive site blood flow was estimated from the clearance of tritiated H2O. Net Na and H2O absorptions were reduced by mesenteric venous or arterial occlusion. Net secretion occurred with mesenteric venous occlusion. Nitroprusside reduced net absorption only at an infusion rate of 0.15 mg/min. The absorptive Na and H2O fluxes were reduced by both mesenteric venous or arterial occlusion, with venous occlusion being more effective. Nitroprusside reduced the absorptive Na flux at an infusion rate of 0.15 mg/min but not the absorptive H2O flux. The secretory flux of Na was increased by mesenteric venous occlusion but reduced by arterial occlusion and not changed by nitroprusside infusion. The secretory H2O flux was decreased by moderate degrees of mesenteric venous occlusion but was unchanged at greater levels. Arterial occlusion decreased secretory H2O fluxes. Nitroprossude infusion increased secretory H2O fluxes at an infusion rate of 0.015 mg/min. The absorptive and secretory Na and H2O fluxes were significantly correlated with absorptive site blood flow plus estimated capillary pressure. Absorptive site blood flow was primarily responsible for changes in absorptive fluxes and estimated capillary pressure for changes in secretory fluxes. Absorptive site blood flow affected the secretory and absorptive fluxes of H2O more equally than the Na fluxes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496677 TI - Rat lingual lipase: partial purification, hydrolytic properties, and comparison with pancreatic lipase. AB - We have partially purified lingual lipase from the serous glands of rat tongue. With a combination of Triton X-100 extraction or Triton X-114 phase-separation techniques, Bio-Bead SM-2 treatment, dialysis, and gel filtration on Sephadex G 200 or Sephacryl S-300, we obtained a sparingly soluble lipid-free protein demonstrating hydrolytic activity against triglycerides and negligible phospholipase or cholesteryl esterase activities. Compared with homogenate, specific activities of the enzyme were enriched 3- to 5-fold prior to gel filtration and 10-fold after gel filtration. Analysis by sodium dodecyl sulfate polyacrylamide gel electrophoresis and gel filtration under denaturing conditions (6 M guanidine X HCl or 0.1% sodium dodecyl sulfate) revealed one major glycoprotein band with Mr approximately 50,000. Gel filtration of the active enzyme in 0.1% Triton X-100 gave an Mr approximately 270,000-300,000, suggesting extensive self-aggregation. With both tributyrin and triolein, the pH optimum of the purified enzyme was 4.0 and activity extended from pH 2.0 to 8.0. In contrast to purified human pancreatic lipase, lingual lipase hydrolyzed triglyceride emulsions and mixed micelles stabilized with both short-chain (dihexanoyl) and long-chain (egg) lecithin and were inhibited only slightly (18-25%) by micellar concentrations of two common bile salts, taurodeoxycholate and taurocholate. Our results suggest that the hydrolysis of dietary fat by lingual lipase may extend from the pharynx through the esophagus and stomach and into the upper small intestine. PMID- 6496678 TI - Characteristics of cysteine uptake in intestinal basolateral membrane vesicles. AB - Uptake of cysteine in intestinal basolateral membrane vesicles was independent of Na+, was sensitive to medium osmolarity, exhibited saturation kinetics, and was selectively inhibited by other amino acids in a concentration-dependent manner, indicating transport by a carrier-mediated process. The kinetics indicated the existence of two transport systems: a high- and a low-Km system with Km and Vmax values that differed by greater than one order of magnitude. The substrate specificity pattern indicated two principal transport systems for cysteine: one corresponding to the high-Km system and one to the low-Km system. The high-Km system was inhibited primarily by neutral amino acids with small or polar side chains (alanine, serine, threonine, and glycine), resembling the ASC system in its specificity. The low-Km system was inhibited primarily by neutral amino acids with large, nonpolar side chains (leucine, phenylalanine, and methionine) and by the leucine analogue beta-2-aminobicyclo(2,2,1)heptane-2-carboxylic acid, identifying it as the L system. The two systems also exhibited trans stimulation, but only with those amino acids that caused cis inhibition. PMID- 6496679 TI - Hepatic clearance of rat plasma intestinal alkaline phosphatase. AB - The mechanism and route of clearance of intestinal alkaline phosphatase from plasma have been studied in rats to define the magnitude of hepatic extraction and biliary excretion of the enzyme. Plasma clearance, tissue distribution, and biliary excretion of enzyme were followed after intravenous administration of physiological amounts of 125I-labeled rat intestinal alkaline phosphatase. The plasma disappearance curve was biphasic; the initial phase was rapid, during which 50% of injected enzyme was selectively extracted by the liver over 5 min. Less than 4% of total hepatic radioactivity was excreted into bile over 80 min; this was shown by chromatographic analysis to be degraded enzyme only. Rapid clearance of enzyme could be significantly slowed by injection of large amounts of mannan or N-acetylglucosamine-bovine serum albumin, but not by desialylated fetuin, demonstrating that clearance was probably mediated by mannose/N acetylglucosamine-specific receptors. It is concluded that, under physiological conditions, rat plasma intestinal alkaline phosphatase is rapidly cleared from the circulation by the liver. However, biliary excretion of undergraded enzyme is negligible, and a physiologically significant enterohepatic circulation seems most unlikely. PMID- 6496680 TI - Hydrocortisone inhibits mucin secretion from guinea pig gallbladder. AB - We studied the effects of hydrocortisone, an inhibitor of phospholipase A2, on the secretion of mucin and release of prostaglandins from guinea pig gallbladder explants. We measured mucin using [3H]glucosamine as a precursor and prostaglandins by radioimmunoassay of 6-keto-prostaglandin F1 alpha. Mucin secretion and prostaglandin release were studied under basal conditions and after arachidonate stimulation. Hydrocortisone sodium succinate reversibly inhibited basal secretion of mucin by 24% at 10(-5) M (P less than 0.05 compared with control) and 34% at 10(-4) M (P less than 0.01). Hydrocortisone, 10(-4) M, also reversibly inhibited arachidonate-stimulated secretion of mucin (P less than 0.01 compared with controls incubated with arachidonate alone). Release of prostaglandin F1 alpha was significantly inhibited by hydrocortisone under basal (P less than 0.01) and arachidonate-stimulated (P less than 0.01) conditions. The inhibitory effect of hydrocortisone was mediated by inhibition of hydrolysis of arachidonate from membrane phospholipids, suggesting that exogenous arachidonate is incorporated into membrane phospholipids prior to conversion to prostaglandins. PMID- 6496681 TI - Sinoaortic baroreceptors and the control of blood volume in the nonhuman primate. AB - The purpose of this study was to determine the role of the aortic and carotid baroreceptors in regulating blood volume in the conscious non-human primate. Eighteen control animals were surgically instrumented to permit the recording of blood pressure, pulse rate, and left atrial pressure. After a urethral catheter was inserted into the bladder, the animals were given an intravenous infusion equal to 20% of the estimated blood volume. Renal function was determined before and after the volume expansion. Nine monkeys received the same infusion after undergoing chronic sinoaortic denervation. The denervated animals responded with a potentiated diuresis and natriuresis. The control animals excreted 24% of the infused volume and 4% of the infused salt while the sinoaortic-denervated animals excreted a volume equal to 113% of that infused and an amount of sodium equal to 46% of that infused. We conclude that high-pressure receptors exert an inhibitory influence on whatever mechanisms are involved in the renal response to acute volume expansion. PMID- 6496682 TI - Mechanisms of Na+ uptake into renal brush border membrane vesicles. AB - Brush border membrane vesicles were used to investigate the pathways for Na+ uptake across the apical membrane of the renal proximal tubular cell. The kinetics of uptake in the absence of organic solutes were consistent with parallel saturable and nonsaturable pathways. At pH equilibrium (pHin = pHout = 7.5), the Jmax and Kt for saturable uptake were 41 +/- 15 (+/- SE) nmol X mg-1 X min-1 and 33 +/- 9, respectively, and the apparent permeability coefficient, P'Na, was 0.27 +/- 0.02 microliters X mg-1 X min-1. As the equilibrium pH was varied between 6.0 and 8.0, no consistent trend for Kt or P'Na was observed; Jmax varied up to twofold. In contrast, in the presence of an outward H+ gradient (pHin = 6.0 vs. pHout = 7.5), the Kt decreased by an order of magnitude, with little change in Jmax. At low sodium concentrations (1 mM) external Li+ and NH+4, and to a lesser extent K+, Rb+, and Cs+, inhibited Na+ uptake. Amiloride (10(-3) M) inhibited 1 mM Na+ uptake by 80% even in the absence of a H+ gradient. Uptake also varied with the anion composition at high sodium concentrations (100 mM), as predicted from the anion permeabilities. Sodium uptake was more sensitive to variations in membrane potential at high sodium concentrations than at low concentrations. On the basis of these experiments we suggest that the saturable Na+ uptake occurs via an electroneutral Na+-H+ antiporter and that the diffusive flux occurs through a conductive pathway. PMID- 6496683 TI - Prostaglandin synthesis inhibitors and vasa recta erythrocyte velocities in the rat. AB - Vasa recta erythrocyte velocities (VRBC) in the exposed renal papilla of anesthetized water-loaded rats were determined before and 60 min after intravenous administration of a prostaglandin synthesis inhibitor (indomethacin, meclofenamate) or the inhibitor vehicle alone. The change in VRBC of ascending and descending vasa recta for the inhibitor group [-17 +/- 5% (SE)] was different from that for controls (+12 +/- 4%, P less than 0.002). Erythrocyte velocities were also determined in vasa recta of antidiuretic rats before and 30 min after administration of indomethacin or vehicle alone. Prostaglandin synthesis inhibition was again associated with a significant decrease in VRBC compared with control (-24 +/- 4% vs. +28 +/- 20%, respectively, P less than 0.025). These findings suggest that prostaglandins play a similar role in regulating blood flow in the renal medulla in water diuresis and antidiuresis. PMID- 6496684 TI - Ischemic acute renal failure in the rat: protective effect of uninephrectomy. AB - Experiments were performed to investigate the effect 2-wk prior nephrectomy has on the recovery from a 40-min renal artery occlusion. Two groups were initially examined. Group 1 animals underwent sham nephrectomy and group 2 animals right nephrectomy 14 days prior to a 40-min left renal artery clamp. The percent recovery of inulin clearance in group 2 (33 +/- 6%) was not significantly different from that in the group 1 (36 +/- 8%) when measured 3 h after reflow. At 24 and 48 h of reflow, however, group 2 animals had a significantly higher percent recovery of inulin clearance (24 h: 31 +/- 5%; 48 h: 50 +/- 11%) than group 1 animals (24 h: 1 +/- 1%; 48 h: 8 +/- 4%). Similarly the histology was better preserved at 24 and 48 h in group 2. To further investigate this enhanced recovery, three additional groups were studied. Group 3 underwent right nephrectomy at the time of renal artery occlusion. Group 4 had right uretero venostomies created immediately prior to the ischemic insult, and group 5 had their aortas rather than left renal arteries clamped. Each group shared with group 2, ischemia to all functioning excretory tissue. The percent recovery of inulin clearance in group 3 (48 +/- 9%), group 4 (54 +/- 5%), and group 5 (42 +/- 6%) were each significantly (P less than 0.005) higher than in group 1 (8 +/- 4%) when measured at 48 h. We conclude that the protection offered by uninephrectomy is not a consequence of hypertrophy but that alterations in the environment which follow ischemia to all functioning excretory renal tissue are responsible for the enhanced recovery seen. PMID- 6496685 TI - Interactions between phosphate and oxidative metabolism in proximal renal tubules. AB - These studies examine the phosphate dependence of fluid absorption and oxidative metabolism in proximal tubules from rabbit kidney. Removal of inorganic phosphate from intraluminal fluid in isolated perfused tubules reduced fluid absorption (Jv) from 1.0 nl X mm-1 X min-1 to zero and removal of phosphate from the medium bathing tubules in suspension reduced O2 consumption rates (coupled, uncoupled, ouabain sensitive, and ouabain insensitive) and ATP contents by 30-40%. Inhibitions induced by removal of phosphate could be altered by addition of selected organic substrates to ambient fluids. Addition of succinate, citrate, or malate preserved uncoupled respiration and partially preserved Jv (0.4-0.9 nl X mm-1 X min-1), with succinate being most effective. Addition of short-chain fatty acids (butyrate or valerate) to phosphate-free media had little or no effect on Jv. n-Butylmalonate, an inhibitor of dicarboxylate anion transport into mitochondria, reduced oxidative metabolism, ATP content, and Jv when added to phosphate-containing media but had no further effect on these tubular functions when added to phosphate-free media. Together these results suggest that phosphate limitation reduces dicarboxylate anion availability to mitochondria and that this inhibition may contribute to the overall reduction in oxidative metabolism and Jv observed under these conditions. PMID- 6496686 TI - Stimulation of phosphate transport in the proximal tubule by metabolic substrates. AB - Studies of phosphate transport in the proximal tubule have recently focused on interactions with cellular metabolism. The present studies demonstrate that two fatty acids, valerate and butyrate, and two tricarboxylic acid cycle intermediates, succinate and malate, stimulate net phosphate transport in the rabbit proximal tubule by 34-117%. Valerate had no effect on the total uptake of inorganic [32P]phosphate into suspensions of proximal tubules but did enhance the initial rate of influx. Net fluid transport was unaffected by these substrates although glucose absorption increased by 10-15% following the addition of either valerate or succinate. Since valerate, butyrate, and succinate are known to stimulate gluconeogenesis and respiration, we evaluated the role of gluconeogenesis in the stimulation of phosphate transport. The addition of 3 mercaptopicolinate (1 mM), an inhibitor of gluconeogenesis, did not alter phosphate transport, nor did it prevent the valerate-induced stimulation of phosphate transport. We conclude that valerate, butyrate, succinate, and malate enhance phosphate transport by the proximal convoluted tubule. This action appears to be unrelated to effects on gluconeogenesis and may be related to close links between phosphate transport and oxidative metabolism. PMID- 6496687 TI - Effect of ouabain on K secretion in cortical collecting tubules from adrenalectomized rabbits. AB - Previous studies have shown that Na-K-ATPase activity in the cortical collecting tubule of the rabbit increases significantly with mineralocorticoid stimulation and decreases significantly with adrenalectomy. The present study examined the effects of 10(-4) M ouabain on K secretion in the isolated perfused cortical collecting tubules from normal, adrenalectomized, and mineralocorticoid stimulated animals. Potassium secretion was similar in the tubules from adrenalectomized (3.42 +/- 0.53 pmol X mm-1 X min-1) and from normal rabbits (3.38 +/- 0.36 pmol X mm-1 X min-1). K secretion was greater (15.1 +/- 3.0 pmol X mm-1 X min-1) in tubules from animals receiving 11-deoxycorticosterone acetate (DOCA). Ouabain inhibition of K secretion was 74% for the adrenalectomized group, 86% for the normal group, and 98% for the DOCA-treated group. The degree of inhibition was statistically equivalent among the three groups and not statistically different from complete inhibition of K secretion. Ouabain had no effect on the lumen-positive transepithelial voltage of the cortical collecting tubules from adrenalectomized rabbits but reduced the lumen-negative voltage in tubules from normal rabbits and reversed the polarity of the transepithelial voltage in cortical collecting tubules from DOCA-treated animals. Thus adrenal mineralocorticoids may be necessary for maximal K secretion by the cortical collecting tubule, but they are not essential to maintain K secretion during "normal" K intake. In all groups K secretion is totally dependent on Na-K-ATPase. The lumen-positive transepithelial voltage from DOCA-treated animals after addition of ouabain suggests an additional effect of mineralocorticoid to stimulate secretion of cations (protons) or reabsorption of anions. PMID- 6496688 TI - Inter- and intracompartmental osmotic gradients within the rat cochlea. AB - The osmolality and the electrochemical composition of the endolymph, a potassium rich positively polarized extracellular fluid in the cochlea, was studied in the rat. Endolymph of each cochlear turn was hyperosmotic to perilymph and plasma. Osmolalities (mosmol/kg H2O) were 329 +/- 2.9 (mean +/- SE) (n = 13) in basal turn endolymph, 322 +/- 2.7 (n = 9) in middle turn endolymph, 317 +/- 5.2 (n = 3) in apical turn endolymph, 289 +/- 3.1 (n = 14) in perilymph of the scala vestibuli, and 298 +/- 1.8 (n = 7) in plasma. Moreover, differences in osmolality and electrochemical composition of endolymph, involving resting potential and K and Cl concentrations, were observed between the basal and the middle cochlear turns, suggesting the presence of an electrical and osmotic gradient within endolymph, declining from the base to the apex of the cochlea. The active potassium transport into endolymph, located presumably in the stria vascularis, could account for both the internal and external osmotic gradients. PMID- 6496689 TI - Time course of adaptation to altered K intake in rats and sheep. AB - The early time course of adaptation to large step increases in K intake was examined in sheep and rats. Fifteen 3-day experiments were performed on four mature ewes. They received on each day a single meal (730-930 meq K/day) and on days 2 and 3 a rumen KCl supplement (600 mM/day). Adaptation to the changed intake occurred within 47 h and was defined by the ratio of urinary K/K intake approximating normal preloading ratios. K excretion did not correlate significantly with plasma K or with Na excretion. Three groups of four rats, body wt 210 g, were studied over 19 days. Four rats fed a basal diet excreted 1.96 +/- 0.04 (n = 19) meq/day K. For four rats, the basal diet was supplemented with KCl on days 5-15, during which time K excretion was 9.34 +/- 0.36 (n = 11) meq/day; four rats with a higher KCl supplement on days 5-15 excreted 15.37 +/- 0.69 (n = 11) meq/day K. For rats, adaptation to increased and decreased intake was rapid, occurring on the first day of changed intake when urinary K excretion approximated intake. The rapid K adaptation was contrary to the generally accepted, but experimentally unverified, view that adaptation is a chronic process requiring 1 or more weeks to develop. PMID- 6496690 TI - Substrate support for renal functions during hypoxia in the perfused rat kidney. AB - Do the substrates that can be utilized for anaerobic ATP production by cytosolic (G, glycolytic) and/or mitochondrial (M) metabolic pathways support renal function during marked hypoxia? The isolated rat kidney was perfused at 38 degrees C, pH 7.4, at a mean pressure of 120 mmHg for 110 min with a Krebs-Ringer bicarbonate solution containing 6 g/100 ml substrate-free albumin (SFA0). After substrate-free aerobic (PO2 = approximately 646 mmHg) internal control observations were made, the perfusate was gassed with 95% N2/5% CO2 (n = 15) and substrates (each 5 mM) were added (G, glucose, K, alpha-ketoglutarate, A, aspartate), or SFA0 perfusion was continued. Perfusion flow rate (PFR) increased 20-43% during hypoxia; thus there was no limitation in substrate delivery to the kidney. Although GFR decreased during all hypoxic perfusions, due to the variations in GFR, the reductions in GFR were not significant. Fractional Na+ reabsorption (%TNa+) was reduced in the hypoxic kidney but the decreases in %TNa+ in the presence of G or M substrates were significantly smaller (-26 to -36%) than the decreases observed during hypoxic SFA0 perfusion (-44%). Free water clearance decreased markedly during substrate-free hypoxic perfusion; by contrast, addition of G or M substrates either increased or maintained CH2O. G increased hypoxic CH2O (+194% to +440% of internal control) more than did M substrates. It is postulated that the increases in %TNa+ in the presence of substrates during hypoxia results in the increases in GFR. By making substrates available that can be oxidized anaerobically in cytosol or in mitochondria, the kidney can better maintain a portion of its tubular functions during severe hypoxia. PMID- 6496691 TI - Estimated lean body mass as an index for normalization of body fluid volumes in humans. AB - Blood volume was measured in 66 healthy subjects (38 males, 28 females), and extracellular fluid volume in 54 subjects (31 males, 23 females). Volumes were normalized against body weight, height, body surface area, leanness index, and lean body mass (estimated from body weight and height). The regression lines of body fluid volumes against lean body mass passed through the origin on extrapolation and were not different for males and females. None of the other indices fulfilled these criteria. It is concluded that estimated lean body mass is a suitable index for normalization of body fluid volumes. A single set of normal reference values can be used for males and females. PMID- 6496692 TI - Transepithelial and cell membrane electrical resistances of the rabbit proximal convoluted tubule. AB - A technique using double-barreled perfusion pipettes and intracellular microelectrodes was developed to measure transepithelial, apical, and basolateral membrane electrical resistances in isolated rabbit proximal convoluted tubules (PCT). This technique has been tested successfully with respect to cable analysis: the transepithelial resistance (RT) did not change with tubule length and the measured core resistance of the lumen (RC) varied according to prediction with lumen diameter and perfusate resistivity. In control solutions, a linear I-V relationship was observed at the entry of the tubule for current varying from 300 to +300 nA. The mean RT was 1,050 +/- 70 omega X cm (n = 33) (a specific resistance of 8.2 omega X cm2). Bath proteins and large variations in transtubular hydrostatic pressure had no significant effect on RT, whereas RT was not systematically related to transepithelial PD or to the sodium-to-chloride permeability ratio (n = 22). Perfusate substitution of 50 mM NaCl by mannitol increased RT by 21% (n = 7) but the same maneuver in the peritubular solution had no significant effect after a 5-min equilibration period. The ratio of apical to basolateral cell membrane resistance (RA/RBL) determined with intracellular microelectrodes was 3.1 +/- 0.3 (n = 27) in control solutions and increased within 1 min by 36% (n = 8) when glucose and alanine were replaced by mannitol in the perfusate solution. Using simultaneous initial changes in transepithelial and basolateral potential differences when glucose and alanine were removed, the individual values of RA and RBL were determined. Mean RBL was 4,900 +/- 990 omega X cm (39 +/- 1.3 omega X cm2) and mean RA was 15,000 +/- 4,300 omega X cm (118 +/ 33 omega X cm2). PMID- 6496693 TI - Ontogeny of renal mineralocorticoid receptors and urinary electrolyte responses in the rat. AB - We examined the ontogeny of cytosol mineralocorticoid receptors in renal inner medulla-papilla (IM-PAP) and outer medulla-cortex (OM-CX) and of a biological response to administered corticosteroids (urinary K+/Na+ ratio). Rats at early (7 9 days), intermediate (13-15 days), and late (23-30 days) stages of maturation were used. Young rats were found to be essentially insensitive to aldosterone, in contrast to rats aged 13-15 days and older. Scatchard analysis of IM-PAP and OM CX cytosol showed equivalent high-affinity aldosterone binding sites at all ages. The affinity of these sites was constant (Kd, 4 degrees C approximately 0.5 nM) and their concentration varied only slightly over maturation. In a series of in vivo nuclear transfer studies, the hyposensitivity to aldosterone in young rats did not seem to be due to a difference in the nuclear binding of aldosterone receptor complexes. The resistance of the immature (7-9 days) rat kidney to aldosterone thus appears to be a postreceptor phenomenon. The maturational events allowing expression of mineralocorticoid-inducible genes in the kidney remain to be determined. PMID- 6496694 TI - Enhanced tubuloglomerular feedback activity in rats developing spontaneous hypertension. AB - Tubular microperfusion was used to evaluate tubuloglomerular feedback (TGF) mediated changes in single nephron glomerular filtration rate (SNGFR) and stop flow pressure (SFP) in euvolemic 6- and 11- to 14-wk-old spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Young SHR compared with WKY had an elevated mean arterial pressure (107 vs. 90 mmHg, P less than 0.001) and a lower proximally measured SNGFR (14 vs. 17 nl/min, P less than 0.001) with no loop perfusion. Perfusion at 32 nl/min produced a greater decrease in SNGFR of SHR (6 vs. 2 nl/min, P less than 0.001). Although basal SFPs were identical (39 mmHg), loop perfusion elicited a greater maximal decline in SFP ( 10 vs. -4 mmHg, P less than 0.001) and reactivity of SFP (-1.2 vs. -0.5 mmHg X min X nl-1, P less than 0.001) in young SHR; a lower rate produced a half-maximal decrease in SFP (7 vs. 10 nl/min, P less than 0.02). In adult rats, SNGFRs with no flow through Henle's loop were the same (27 and 28 nl/min) and perfusion at 32 nl/min produced similar decrements in SNGFR (-13 vs. -11 nl/min). The maximal change in SFP was greater in adult SHR (-12 vs. -10 mmHg, P less than 0.02), but there were no strain differences in maximal SFP reactivity (-1.8 vs. -1.3 mmHg X min X nl-1) and the rate eliciting half-maximal SFP changes (12 vs. 12 nl/min). Reduction of arterial pressure to the normotensive range did not alter responses in either age group of SHR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496695 TI - Metabolic machinery of the alligator kidney. AB - Crocodilians such as caimans and alligators are uricotelic and ammoniotelic animals. They are carnivorous but they excrete ammonium ions in an alkaline urine. The metabolic organization of the kidney of the Mississippi alligator was studied by measuring the renal metabolite profile, the activities of enzymes, and the behavior of kidney tubules in vitro. The liver and tail muscle were also studied. Both awake and anesthetized animals were in a state of low plasma bicarbonate and low blood pH with high plasma lactate concentration. This did not prevent the excretion of an alkaline urine (pH 7.76). alpha-Ketoglutarate was low in all three tissues and lactate was high. Glutamate concentration and glutamate dehydrogenase activity were highest in the kidney with a low equilibrium constant for alanine aminotransferase (KGPT). Glutaminase I was found only in the kidney. It could not be detected in liver or muscle. Glutamine synthetase was found only in the liver. Phosphoenolpyruvate carboxykinase (PEPCK) was present in both liver and kidney. Alanine aminotransferase and malic enzyme showed high activity in the kidney but were inconspicuous in liver and muscle. Malate dehydrogenase and lactate dehydrogenase were present in all three tissues. Renal tubules incubated with glutamine and alanine were ammoniagenic and gluconeogenic. Lactate was gluconeogenic. Enzyme activities were measured at both 30 and 37 degrees C. The studies on renal tubules were also performed at these two temperatures. Temperature had little effect on the data including acid-base values in the blood. Our findings demonstrate that the kidney of the alligator is perfectly equipped for various metabolic functions and especially for ammoniagenesis and gluconeogenesis. PMID- 6496696 TI - Some consequences of body size. AB - The question of the proper size denominator for metabolic indices is addressed. Metabolic rate among different species is proportional to the 3/4 power of body weight, not surface area. Muscle power also varies with the 3/4 power of weight, suggesting that metabolic rate is determined mainly by muscle power. Power-to weight ratio, specific metabolic rate, and a number of metabolic periods, including heart rate, all vary inversely with the 1/4 power of body weight. Thus the relative times required for physiological and pathological processes in different species may be estimated from the average resting heart rate for the species. There are not many small humans among athletic record holders in events involving acceleration and hill climbing, as would be expected if they had higher power-to-weight ratios. Thus the relationship between size and metabolic rate in different species should not be applied within the single species of humans. Evidence is reviewed showing that basal metabolic rate in humans is determined mainly by lean body mass. PMID- 6496697 TI - Monitoring of mitochondrial membrane potential in isolated perfused rat heart. AB - Optical methods were tested for measuring the membrane potential changes of mitochondria in isolated perfused rat hearts. Safranin was found to be rapidly taken up by the Langendorff-perfused heart, and after loading with the dye there was practically no washout of the stain during perfusion with Krebs-Ringer bicarbonate solution. Staining with safranin induced the appearance of an intense absorption band in the reflectance spectrum of the heart, but the absorbance spectrum changes were not useful for monitoring the mitochondrial membrane potential changes because of interference by endogenous hemoproteins. The fluorescence intensity, however, responded in a manner which indicated that its changes originated from dye attached to the mitochondria. A decrease of the fluorescence was found on energizing the mitochondria by decreasing the cellular energy consumption by arrest induced by 18 mM K+ or by decreasing the beating rate of an electrically paced heart from 5 Hz to the endogenous ventricular frequency of 1.5 Hz. In hearts arrested by Ca2+ depletion, 18 mM K+ did not affect the safranin fluorescence. This was taken to indicate that under these conditions the safranin fluorescence was not sensitive to the plasma membrane potential. The uncoupler carbonyl cyanide m-chlorophenylhydrazone induced an intense enhancement of safranin fluorescence in the perfused heart, demonstrating that the probe is sensitive to mitochondrial membrane potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496698 TI - Influence of cardiac denervation on subsidiary atrial pacemaker stabilization. AB - Overdrive suppression was determined by measuring cardiac cycle lengths after rapid atrial pacing in nine alert conscious dogs sustaining total intrapericardial denervation. Rapid atrial pacing was performed at 125-400% of spontaneous heart rate for 30 s and at 200% spontaneous rate for 30, 60, 120, and 180 s, with and without cholinergic (atropine 0.2 mg/kg iv) or adrenergic blockade (propranolol 0.5 mg/kg iv). Corrected recovery time (CRT) was defined as the first recovery cycle length minus average control cycle length. To compare responses of the intact sinoatrial node (SAN) and subsidiary atrial pacemakers, CRT was measured in the conscious animal before and after SAN excision. Immediately after SAN excision, a junctional rhythm was frequently observed, but within a short time (min-h), subsidiary atrial pacemaker dominance was established with well-formed P waves and P-R interval averaging 85.3 +/- 3.4 ms. CRT before SAN excision ranged from 100 to 300 ms. Following pacing at 125-400% of spontaneous heart rate soon after SAN excision, CRT was markedly prolonged, ranging up to 6,000 ms. Atropine and propranolol did not influence CRT in the denervated preparation. CRT of subsidiary atrial pacemakers in the normally innervated dog heart returned to control pre-SAN excision values in 1-2 wk. In the denervated heart complete autonomic denervation exaggerated time required for return to control CRT values to 5-8 wk. PMID- 6496699 TI - Left ventricle-aortic coupling: prediction of contraction pattern. AB - In control heart beats of six open-chest dogs we established a relationship between ventricular diameter and change in volume during systolic ejection, described ventricular mechanical performance by a time-dependent pressure diameter relationship, and represented ventricular afterload in subsequent variably loaded test beats by aortic input impedance calculated from aortic flow and pressure. Impedance was manipulated by means of an inflatable balloon in the aorta. A computational procedure was developed which combined the independent and general descriptions of ventricle (1 and 2 above) and load (3 above) to predict the time course and mean values of aortic pressure, flow, ventricular pressure, and diameter over a broad range of aortic impedance. Predicted data were compared with those directly observed at identical impedance. High degree of accordance between predicted and observed data of stroke volume, mean aortic and mean ventricular pressure was found, but diameter shortening was less accurately predicted. Previously assessed dependency of the ventricular pressure-volume-time relationship on aortic flow and "ejection history" was also incorporated in the calculations. This caused improved prediction of the flow pulse configuration, but the quality of predictions of mean values of pressures and flow was not enhanced. PMID- 6496700 TI - Isotonic length transient of cat heart muscle in Ba2+-induced contracture. AB - To characterize mechanical properties of activated heart muscle, the length response to step (4 ms) decrease in tension in Ba2+-induced contracture in kitten papillary muscle was analyzed. The amplitudes of tension steps were varied at the maximum contracture level (Tc), different initial muscle lengths [0.90 Lmax to Lmax], and different temperatures (20-35 degrees C). When the tension decrease was less than 0.7 Tc, the length response comprised four different phases. The amplitude of shortening in the second phase, after the initial rapid shortening in the first phase, increased up to approximately 3.5% of the initial muscle length quite linearly with increasing amplitude of tension reduction. The amount of lengthening in the third phase, however, increased to a maximum (up to approximately 1.4% initial length) at the tension reduction of approximately 0.4 Tc. The third phase of lengthening was larger at shorter initial muscle length. Increasing temperature markedly decreased the amplitude and shortened the duration of the length response in the second and third phase independently of initial muscle length. Unlike that of the muscle in contracture, the length response of the resting and of the rigor muscle changed in a nearly stepwise fashion. One explanation of these phenomena is that the transient length responses following a rapid tension reduction are mostly determined by the kinetics of the attachment and detachment of cross bridges between actin and myosin filaments. PMID- 6496701 TI - Effects of chronic tobacco smoke exposure on arterial blood pressure regulation. AB - The purpose of this study was to determine the effects of long-term consumption of tobacco smoke on arterial blood pressure regulation. Male Sprague-Dawley rats were administered tobacco smoke for 6-8 mo. Two groups of animals (A and B) received tobacco smoke containing different levels of nicotine (group A: high nicotine, 4 mg/cigarette; group B: low nicotine, 1 mg/cigarette), while a third group (C) served as a sham control by receiving only puffs of room air. Reflex adjustments in mean arterial blood pressure (MAP), heart rate (HR), lower body blood flow, and lower body vascular resistance were compared between the three groups. In the anesthetized control state, no significant difference existed for the cardiovascular parameters measured in the three groups. However, perturbating the cardiovascular system by reducing central blood volume via a 60 degrees head up tilt elicited less of a fall in MAP in the two smoke groups compared with the sham group. Percent decreases in MAP follow: group A, 23%; group B, 22%; and group C, 48%. Increasing MAP with phenylephrine elicited a significantly greater (P less than 0.05) reduction in HR in groups A and B (smoke treated) compared with group C (sham treated). Finally, varying carotid sinus pressure elicited significantly greater (P less than 0.01) changes in MAP in the smoke-treated animals (A and B) compared with the sham group (C). It is concluded that chronic tobacco smoke administration to laboratory rats increases the sensitivity of the reflex control of the cardiovascular system. PMID- 6496702 TI - Effects of afferent renal nerve stimulation on renal hemodynamic and excretory functions. AB - In anesthetized cats (n = 9) renal afferent fibers were electrically stimulated for 11 min, and the response of the contralateral innervated kidney was compared with that of the ipsilateral denervated one. Before stimulation, renal blood flow, glomerular filtration rate, and water and sodium excretions were significantly lower in the innervated kidney than in the denervated one. Afferent renal nerve stimulation augmented arterial pressure and also increased sodium and water excretions from both kidneys without concomitant changes in glomerular filtration rates and renal blood flows. Absolute and percent changes in sodium and water excretions from the innervated kidney were similar to those observed in the denervated one. The same results were obtained in cats (n = 4) which underwent bilateral adrenalectomy to avoid the effect of circulating catecholamines. In another group of cats (n = 5), the increase in renal perfusion pressure due to the stimulation was prevented by an aortic snare: this resulted in a slight but equal decrease of all variables in both kidneys. These experiments do not show a reflex control of renal function from renal afferents. PMID- 6496703 TI - Unidirectional block between Purkinje and ventricular layers of papillary muscles. AB - Previous work has characterized the Purkinje-ventricular junction (PVJ) of papillary muscles as a region of low safety factor with some delay between P and V activation. We have previously shown that the P strand action potential activates a layer of P cells over most of the papillary muscle surface, but activation of the underlying V cells occurs only at specific junctional sites, generally near the base of the muscle. Our present results from both dog and rabbit left papillary muscles show that the junctional regions for propagation from the V layer up into the P layer include not only these specific P-to-V sites but also other sites located more toward the apex of the muscle. These results show that the papillary muscles have regions of potential unidirectional block, although the manifestation of unidirectional block at these sites requires the premature excitation of the ventricular layer. PMID- 6496704 TI - Propagation through electrically coupled cells: two inhomogeneously coupled cardiac tissue layers. AB - Most of the ventricular endocardial surface is covered with a layer of Purkinje (P) cells which provide a rapid spread of activation into the underlying ventricular (V) cells. We have shown experimentally that the P-V junctional region of papillary muscles is spatially inhomogeneous with different regions showing bidirectional conduction, bidirectional block, or unidirectional block between the P and V layers. We have now extended our one-dimensional simulations to a double layer of excitable cells with spatially inhomogeneous electrical coupling between the two layers. Our simulations show that a partial uncoupling can actually increase the common conduction velocity of the two layers and can produce successful P-to-V conduction at regions that would otherwise show P-to-V block, and inhomogeneous spatial distributions of coupling resistivity between two excitable layers can simulate the observed spatial distribution of spatially variable conduction block in papillary muscles. Our simulations indicate that a partial regional electrical coupling may be a useful design feature of the heart to enhance the velocity and safety factor of ventricular activation, but the further increases in uncoupling that may be associated with ischemia may provide a structural basis for the occurrence of arrhythmias. PMID- 6496705 TI - Load sensitivity of ventricular force-interval relations in conscious dogs. AB - The influence of the interval between beats on myocardial contractility was examined in conscious dogs previously instrumented with a left ventricular micromanometer and ultrasonic crystals measuring left ventricular major and minor diameters and parietal wall thickness during control state and after inflation of an aortic cuff. Ventricular contraction was measured during variations of diastolic intervals (DI) produced by respiratory arrhythmia or atrial pacing. During control before aortic stenosis, minor equator shortening (% delta L) increased slightly after long (L) DI compared with short (S) DI with a corresponding decrease of end-systolic stress. During aortic stenosis, LDI were associated with a significant increase of % delta L compared with SDI although end-systolic stress was larger. Thus end-systolic stress-diameter relations were not modified during control but they were significantly shifted to the left after LDI during aortic stenosis. Inotropic state is thus increased after LDI during acute pressure overload but not during control, suggesting that the restitution phenomenon is load sensitive. PMID- 6496706 TI - Baroreflex control of plasma arginine vasopressin in humans. AB - We postulated an interaction between the osmoreceptor and baroreceptor regulation of arginine vasopressin (AVP) release in humans such that the modulating effects of the baroreceptors on AVP release may be undetectable unless the serum osmolality is elevated. We studied normal subjects in both a water-replete (WR, n = 9) and water-deplete (WD, n = 9) state. We monitored blood pressure, central venous pressure, and forearm blood flow. In both WR and WD subjects selective unloading of cardiac baroreceptors with lower body negative pressure (LBNP) -15 mmHg for 30 min did not increase AVP levels. Combined unloading of cardiac and arterial baroreceptors by LBNP -40 mmHg for 10 min significantly increased AVP levels in only the fluid-deplete group [3.54 +/- 0.40 to 8.09 +/- 1.40 (SE) microU/ml, control vs. LBNP -40 mmHg, P less than 0.05]. Mean arterial pressures did not decrease with LBNP -40 mmHg for 10 min. Further analysis of the data based on serum osmolalities (OSM) indicated that LBNP -40 mmHg significantly increased AVP levels (3.72 +/- 0.43 to 13.59 +/- 3.63 microU/ml; P less than 0.05; n = 9) during sessions with OSM greater than 294 mosmol/kg, but not during sessions with OSM less than 294 mosmol/kg (2.85 +/- 0.29 to 4.66 +/- 1.15 microU/ml; P = NS; n = 11). This study demonstrates that significant baroreflex mediated regulation of vasopressin can occur in humans in the absence of overt hypotension. Second, it reveals an interaction between osmoreceptor and baroreceptor regulation of vasopressin levels in humans such that physiological unloading of cardiac and arterial baroreceptors significantly increases plasma vasopressin levels only when serum osmolality is increased. PMID- 6496707 TI - An automated simultaneous transmural cardiac mapping system. AB - The origin and propagation sequence of cardiac depolarization in situ requires accurate simultaneous three-dimensional information from multiple sites. Likewise, the mechanism underlying an arrhythmia can often be elucidated by determining the course of impulse propagation through the heart, particularly if information can be obtained from multiple sites simultaneously, allowing analysis of transient or rapidly occurring events. The most significant problem with obtaining such detailed continuous information is the large amount of data storage required as well as the need for rapid analysis. In the present system these problems are overcome by immediate conversion of all electrograms from analog to digital for all subsequent storage and processing. The bipolar electrogram information is acquired from 240 cardiac sites simultaneously at a sampling rate of 2 kHz with continuous and total data storage of up to 60 min. Rapid two-dimensional isochronic maps at multiple depths (effective 3-dimensional information) are presented via computer-generated interactive graphics. System design permits easy expansion to almost 2,000 simultaneous sites. Surgical electrophysiological intraoperative studies in humans are performed at an operating room located 2,000 ft from the computer facility with all communications carried by a fiber-optic link. The system allows both experimental and clinical cardiac mapping from multiple sites from a single cardiac depolarization, minimal redundancy of costly hardware, and direct rapid visualization of all original electrogram data. PMID- 6496708 TI - An array of microelectrodes to stimulate and record from cardiac cells in culture. AB - An array of extracellular microelectrodes containing 25 recording and 6 stimulating electrodes was fabricated using microelectronics technology. Ventricular myocardial cells from 8- to 10-day chick embryos were cultured on the surface of the microelectrode array. Extracellular potentials were recorded simultaneously from multiple sites. Simultaneous recordings of extracellular and transmembrane potentials were made from single sites. Extracellular potentials were also recorded simultaneously with cell motion from single sites. Cells were paced by means of electrical stimuli applied via the stimulating electrodes. Conduction velocity in a strip of cells varied linearly as a function of temperature from 0.21 m/s at 26 degrees C to 0.38 m/s at 36.5 degrees C. PMID- 6496709 TI - Microinjection of vasopressin into the locus coeruleus of conscious rats. AB - To determine whether vasopressin plays a role in central neural control of cardiovascular function by acting on the locus coeruleus we monitored arterial pressure and heart rate responses to graded injections of vasopressin (1-30 ng, 0.1-0.3 microliter) in the locus coeruleus of conscious, restrained rats. Cannulas were stereotaxically implanted in the locus coeruleus 2-5 days prior to experiment. Injections of vasopressin into the locus coeruleus produced dose related increases in mean arterial pressure (12 +/- 2 to 57 +/- 6 mmHg) and heart rate (27 +/- 6 to 123 +/- 16 beats/min), which lasted over 1 h at the highest dose. Injection of the antipressor vasopressin antagonist d(CH2)5Tyr(Me) arginine vasopressin (10 ng) into the locus coeruleus blocked the cardiovascular responses to vasopressin. Administration of vasopressin into an area lateral to the locus coeruleus had no effect on mean arterial pressure but produced an increase in heart rate. Equivalent doses of saline, angiotensin II, and norepinephrine (NE) had minimal or opposite (NE) effects on arterial pressure and heart rate. Peripheral alpha-adrenergic blockade with phentolamine and beta-adrenergic blockade with propranolol blocked the cardiovascular responses to injection of vasopressin in the locus coeruleus. These results suggest that vasopressin may act in the region of the locus coeruleus to exert a central action on the cardiovascular system that is mediated by a stimulation of sympathetic outflow. PMID- 6496710 TI - Influence of renal nerves on noradrenergic responses to changes in arterial pressure. AB - Renal denervation has been shown previously to lower the increased arterial pressure as well as the increased hypothalamic and peripheral noradrenergic activity found in neurogenic and Goldblatt models of experimental hypertension. In the present study conscious Wistar rats with or without renal nerves were subjected to 60 min of saline infusion (controls), hypotension (intravenous sodium nitroprusside), or hypertension (intravenous phenylephrine HCl). Changes in the turnover of norepinephrine (NE) in the anterior hypothalamus, posterior hypothalamus, kidney, intestine, and skeletal muscle were assessed by measuring the decline of NE concentration 90 min after administration of alpha-methyl tyrosine. There was a significant increase in NE turnover in the posterior hypothalamus and all peripheral organs examined in the nitroprusside-infused group with intact renal nerves. In renal-denervated animals, acute hypotension produced similar changes in NE turnover in peripheral organs, but no significant change was observed in the posterior hypothalamus. In the acutely hypertensive group with intact renal nerves, there was no significant change in NE turnover in the hypothalamic sections or the peripheral organs; however, the turnover of NE was significantly decreased in both the anterior and posterior hypothalamus of the renal-denervated hypertensive group. Overall these studies suggest the presence of an interaction between inhibitory influences from baroreceptor afferents and excitatory influences from renal afferents on noradrenergic activity in the hypothalamus and changes in noradrenergic activity in hypothalamic structures may not be directly related to changes in sympathetic outflow. PMID- 6496711 TI - Relationship between type L hormone-sensitive lipase and endogenous triacylglycerol in rat heart. AB - The purpose of this study was to determine whether, under physiological conditions, intracellular lipoprotein lipase [type L hormone-sensitive lipase (HSL)] activity varied inversely with triacylglycerol (TG) content of the heart. The results show that fasting from 7:30 A.M. to 7:30 P.M. increased type L HSL activity from 72 +/- 1 to 96 +/- 1 U/g wet wt tissue (P less than 0.001) in the myocardium. At the same time, cardiac TG stores decreased from 1.83 +/- 0.03 to 1.37 +/- 0.01 mumol/g tissue (P less than 0.001). In a separate experiment, one night of eating a fat-rich diet (60% of calories from fat) caused a 42% increase in type L HSL activity, which was accompanied by a 42% reduction in the TG content of the heart. Likewise cold exposure (overnight) activated type L HSL (73%) and, at the same time, decreased cardiac TG stores (44%). When data from the fasting, fat-feeding, and cold-exposure experiments were combined, a significant correlation coefficient of -0.81 was obtained between type L HSL activity and TG content of the heart (P less than 0.001). These data provide evidence for a physiological relationship between intracellular lipoprotein lipase activity and cardiac TG content. PMID- 6496712 TI - Cardiovascular responses to arterial and venous hemorrhage in neonatal swine. AB - The cardiovascular effects of graded arterial or venous hemorrhage were evaluated in developing swine (less than or equal to 1 day, 2-5 days, 1 wk, and 2 wk of age) anesthetized with halothane in 50% N2O-50% O2. Serial 5-ml/kg aliquots of arterial or venous blood were removed at 3- to 4-min intervals to a cumulative total of 20 ml/kg. Tachycardia occurred in most animals. Decreases in aortic pressure to arterial, but not to venous, hemorrhage were age dependent. Renal, femoral, and carotid arterial flows decreased with hemorrhage in all animals; the decreases in blood flow did not differ among the three circulations and were not age dependent. Increases in femoral resistance were obtained to both arterial and venous hemorrhage only in the 2-wk-old group. As the degree of hemorrhage was increased, aortic pressure, regional blood flow, and femoral resistance (2 wk olds) responses were larger in magnitude. Aortic pressure in piglets 1-5 days of age could not be restored to within 20% of the prehemorrhage level at a smaller bleeding volume with arterial than with venous hemorrhage. Pressor responses to norepinephrine (0.5 micrograms/kg) and to bilateral common carotid occlusion were still present after 20-ml/kg hemorrhage. These responses indicate the presence of a progressive maturation-related compensation to the stress of arterial but not venous hemorrhage. PMID- 6496713 TI - Differing luminal potential difference of cystic fibrosis and control sweat secretory coils in vitro. AB - Transepithelial potential difference (PD) of isolated segments of the secretory coil of both human control and cystic fibrosis (CF) eccrine sweat glands was measured during stimulation with methacholine (MCh) and isoproterenol (ISO) in vitro. Negative luminal PD of about 10 and 16 mV developed across the secretory coil epithelium in control and CF secretory coil, respectively, during maximal MCh stimulation. ISO (10(-5) M) stimulation generated a mean of 1.9-mV negative luminal PD in control glands; however, ISO failed to enhance the luminal PD beyond the resting level of 0.9 mV in the CF secretory coil. The inhibition of ISO-induced (10(-5) M) luminal PD in control secretory coil by propranolol (5 X 10(-5) M) but not by atropine (10(-5) M) indicated its pharmacologic specificity. The possibility is discussed that this lack of electrical driving force during ISO stimulation could be one of the mechanisms for the absence of sweating response to beta-adrenergic stimulation in CF sweat glands reported recently (8). The mechanism for the higher MCh-induced luminal PD in the CF secretory coil remains to be studied. PMID- 6496714 TI - Role of ventromedial hypothalamus on sympathetic efferents of brown adipose tissue. AB - Previous studies have suggested the presence, in hypothalamic obesity, of an impairment of the energy-dissipating capacity of brown adipose tissue ascribed to a functional disconnection of the sympathetic innervation of this tissue. The following observations demonstrate, with electrophysiological techniques, the presence of a functional link between the ventromedial hypothalamic (VMH) area and the interscapular brown adipose tissue (IBAT) in the rat: the spontaneous activity of the efferent sympathetic nerves reaching the IBAT of normal rats was increased in response to an acute cold stimulus, whereas this increase failed to occur in nerves of VMH-lesioned rats studied 4-7 days after the lesions; and the spontaneous activity of the efferent sympathetic nerves of IBAT decreased rapidly (by greater than or equal to 80% within 30 min) after acute lesions of the VMH area. It is suggested that the VMH area plays a role in increasing the activity of the efferent sympathetic nerves of IBAT during an acute cold stimulus and that alone or in relationship with other, as yet undetermined, central nervous system sites, it has a tonic stimulatory effect on the final common pathways that innervate the IBAT via the efferent sympathetic nerves. PMID- 6496715 TI - Sleep changes in long-term fasting geese in relation to lipid and protein metabolism. AB - The proportion and the distribution over 24 h of the different arousal stages characterized in geese--wakefulness (W), drowsiness (D), and slow-wave (SWS) and paradoxical sleep (PS)--were studied in caged birds when fed and then fasted during about 40 days. In both the fed and fasted state, each arousal stage was distributed through numerous episodes of a short duration. The geese slept a little more during the night than during the day, a difference that was moderately emphasized during the fast. Fasting induced only a slight decrease in W. There were important changes in SWS and D in relation to the periods of fasting that were previously found to correspond to changes in lipid and protein utilization. When proteins were spared and lipids accounted for most of the energy expenditure, the fasted geese went more and more rapidly from W to SWS (proportion of D decreased from 33 to 13%/day) and slept for progressively longer periods (SWS increased from 23 to 49%/day). By contrast, when protein utilization rose, the general trend in sleep was a decrease in SWS and an increase in D. During the fast, changes in PS were in the same proportion as those in SWS. These reactions are examined for their implications in energy-saving and sleep mechanisms. PMID- 6496716 TI - Effects of a muramyl dipeptide on the temperature and sleep-wake cycles of the squirrel monkey. AB - The circadian sleep-wake and body temperature cycles of squirrel monkeys were monitored continuously in an environment free of time cues before and after a 50 nmol injection of a synthetic muramyl dipeptide (MDP) either 1 h after wake-up time (subjective day) or just before sleep time (subjective night). At both phases decreases in percent time awake (relative to saline controls) were observed. After administration of MDP early in the subjective day, the animals exhibited alert wakefulness only 47.4% of the daytime, compared with a mean 86.7% of daytime after a saline control injection. The transitional stage was significantly elevated from 6.2 to 28.7% of time after MDP. Nonrapid-eye-movement (REM) sleep was elevated in four of five animals, but in the fifth animal, which had the least consolidated base-line sleep-wake pattern, a small decrease in non REM sleep was seen. Regression analysis demonstrated a significant (P less than 0.01) relationship between the degree of sleep-wake consolidation and the effect of MDP on non-REM sleep. Normal sleep behaviors and spontaneous arousals were observed. MDP given at the circadian nighttime of two animals resulted in sleep and transitional episodes occupying 84% of the subjective night vs. 73% of time asleep after control injection. Again, these were mostly transitional and non-REM sleep stages, and they persisted 4-5 h into the predicted circadian daytime. REM sleep appeared to be suppressed in the early hours after injection at either time of day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496717 TI - Vagal inhibition of respiratory-linked efferent activity in the carotid sinus nerve. AB - The hypothesis tested in this study was that glossopharyngeal efferent nerve activity coursing through the carotid sinus nerve has a central origin. Efferent activity in the carotid sinus nerve exhibited a respiratory rhythm in spontaneously breathing, closed-chest, mongrel dogs anesthetized with pentobarbital sodium (30 mg/kg iv). Carotid sinus nerve activity was recorded from the intact or cut central end of the carotid sinus nerve. Diaphragm electromyogram (D-EMG), carotid sinus pressure, systemic blood pressure, and electrocardiogram were also recorded. Before vagotomy, small increases in carotid sinus efferent nerve activity (CSENA) synchronous with increases in the D-EMG were observed during spontaneous inspiration. Section of the contralateral cervical vagosympathetic trunk markedly potentiated the increases in CSENA. Bilateral superior cervical ganglionectomy or nodose ganglionectomy failed to alter the increases in CSENA. Section of the ipsilateral glossopharyngeal nerve near the skull abolished the CSENA. This study demonstrates that respiratory modulated glossopharyngeal efferents course through the carotid sinus nerve to the carotid sinus or carotid body. These efferents may be part of a central respiratory regulatory mechanism that may rapidly alter the sensitivity of the carotid sinus baroreceptors and/or carotid body receptors on a breath-to-breath basis. PMID- 6496718 TI - Calculation of brain elastic parameters in vivo. AB - In an earlier study [Am. J. Physiol. 232 (Regulatory Integrative Comp. Physiol. 1): R27-R30, 1977], we defined the concept of brain elastic response in vivo as measured by a pressure-depth ratio (G0) derived from a graphic analysis of the elastic response tests. These tests have shown that brain elastic response in vivo is sensitive to changes in the intracranial system and that the response is nonlinear. In this study we identify a second parameter, G0, a second-order pressure-depth ratio that characterizes the nonlinear behavior and, along with G0, can be evaluated from a mathematical relation that models the experimental results obtained from the elastic response test. The equation is a logarithmic function relating the pressure and the subpial insertion depth. From this we obtain G0 and G0 as the slope and curvature of the response function at the subpial position. In animal experiments we correlated the changes in these parameters with those of cerebral hemodynamics during hemorrhagic and drug induced hypotension. The calculated values of G0 and G0 are reproducible and reflect changes in cerebral blood flow and/or volume. PMID- 6496719 TI - Isovolumetric performance of isolated ground squirrel and rat hearts at low temperature. AB - The effects of low temperature on mechanical performance of the isolated left ventricles of the 13-lined ground squirrel (a hibernator) and the rat (a nonhibernator) were studied. In addition, low-temperature performance of hearts from summer-active, winter-hibernating, and winter-active ground squirrels were compared. By measuring pressure (P) generated against a balloon inserted into the left ventricle, maximum developed pressure (DP) and maximum rate of increase of P (peak dP/dt) were determined over a temperature range of 5-20 degrees C. The DP and dP/dt of the rat ventricle exhibited significantly greater reduction in magnitude at reduced temperature, compared with those of ground squirrel ventricle. Rat, but not ground squirrel, hearts exhibited arrhythmias of various kinds, including extra-systoles, tachycardia, pulsus alternans, and periods of asystole. Hearts from winter-active ground squirrels developed greater pressures than those from winter-hibernating and summer-active animals. This evidence suggests that disruption of cell communication in the nonhibernator ventricular myocardium plays an important role in the failure of the nonhibernator heart at low body temperatures. Contractility of the seasonal hibernator's heart is influenced by both season and hibernation itself, possibly through shifts in myocardial metabolism. However, seasonal adaptations appear not to be required to confer the special resistance of the seasonal hibernator's heart to the deleterious effects of low temperature. PMID- 6496720 TI - Uptake of free amino acids by bacteria-free larvae of the sand dollar Dendraster excentricus. AB - Larvae of Dendraster excentricus were produced by collecting gametes and carrying out fertilization under aseptic conditions. Since gametes are free of bacteria in the gonad, bacteria-free (axenic) suspensions of larvae result. Net rates of entry of 14 amino acids and the rate of production of ammonia were simultaneously determined by high-performance liquid chromatography. The net rates of uptake of neutral amino acids were an order of magnitude greater than rates for basic and acidic amino acids. Influx of 14C-labeled leucine, arginine, and glutamate accurately reflects the net entry rate of these substrates. Uptake of amino acids by axenic suspensions of larvae was compared with uptake by suspensions prepared without aseptic precautions. There was no significant difference in net uptake of the 14 amino acids or in the pattern of oxidation and assimilation of [14C]leucine during short-term experiments of 4-h duration or less. PMID- 6496721 TI - Stimulation of mucus secretion, ciliary activity, and transport in frog palate epithelium. AB - Particle transport velocity and ciliary beat frequency, at the level of a single cell of the epithelium, were measured simultaneously. The preparation used keeps the mucociliated epithelium of the frog palate functionally intact but is thin enough for light to be transmitted. The observations confirm that there exists a resting, or unstimulated, state of the epithelium in which the cilia do not beat. It is shown that tactile stimulation (contact with a small 50- to 75-microns foreign particle or with a fine wire probe) restarts ciliary beat. If the epithelium has not been depleted of its mucus, normal ciliary beat frequency is restored, and there is particle transport at the normal velocity. Only the cilia surrounding the moving particle in a patch about 10 times larger are beating at one time. Beat frequency is highest in the center of the patch, near the particle, and tapers to zero toward the edge. Mucus has to be present for particle transport to occur. Particles impacted on a depleted epithelium are not moved. The placement of previously collected endogenous mucus onto a depleted epithelium produces full ciliary activity and normal particle transport. The moving patch of beating cilia corresponds to a plaque of mucus surrounding the particle being transported. This plaque was produced upon first impact of the particle, presumably by mucus secretion, from the epithelial region which then surrounds it. Stimulation of a quiescent nondepleted epithelium with a wire probe induces a normal ciliary beat frequency that gradually decreases to zero. Stimulation by a wire probe of a mucus-depleted epithelium produces a level of initial beat frequency much below normal. Depletion of the epithelial preparation is by an episode of "creeping" over a glass surface. Depletion of the epithelium could be demonstrated histochemically. Analysis of the data of particle velocity and beat frequency is consistent with a wave-length of 45 microns for the metachronous wave. PMID- 6496722 TI - Na regulates growth of kidney epithelial cells induced by lowering extracellular K concentration. AB - Accelerated kidney growth and increased tissue Na content have been observed in rats fed a K-deficient diet. These observations suggest that enhanced Na influx could mediate renal growth, a hypothesis that was tested in cultures of kidney epithelial cells of the BSC-1 line. Reduction of the K concentration in the culture medium from 5.4 to 3.2 mM augmented cell growth and induced a transient increase in the cellular content of Na and a decrease in that of K. That low-K induced growth was Na dependent was shown by decreasing the medium Na concentration from 155 to 150 mM, which abolished the increases in both growth and cell Na content in a concentration-dependent manner. The stimulation of glyceraldehyde-3-phosphate dehydrogenase (G3PD) activity that occurs in cells exposed to low-K medium for 1 h was similarly prevented by decreasing the medium Na concentration. Thus decreased availability of extracellular Na prevented the increase in cell Na content, stimulation of G3PD activity, and accelerated growth induced by low-K medium. The hypothesis was also tested by adding vasopressin to cultures of BSC-1 cells exposed to low-K medium; the hormone prevented the increments in cell Na content, G3PD activity, and growth to the same extent as did decreased availability of extracellular Na. These results are consistent with the interpretation that transient accumulation of Na is a critical determinant of the initiation of kidney epithelial cell growth. PMID- 6496723 TI - Solute-excluded volumes near the Novikoff cell surface. AB - A differential centrifugation technique, in which all extracellular water except that intimately associated with the cell (pericellular domain) is removed, has been applied to isolated Novikoff hepatoma cells. The pericellular volumes accessible to albumin, inulin, raffinose, and sucrose were inversely related to the molecular weights of the test solutes. This phenomenon was not detectable in erythrocytes or in fat cells. Selective removal of cell surface components by enzymatic treatment produced proportional changes in the relative volumes of distribution accessible to the solutes. This discrimination in the volume accessible to each of the solutes is analogous to that obtained in gel chromatographic separation and represents, in effect, excluded volumes which are inversely related to solute size. This exclusion is associated with components of the Novikoff cell surface, including the surface coat and the microvilli that cover the Novikoff cell. These structures provide an additional level of discrimination for the Novikoff cell not seen in certain other cell types. PMID- 6496724 TI - Osmotic tolerance of human granulocytes. AB - Human granulocytes are injured when returned to isotonic conditions after exposure at 0 degree C to hyperosmotic solutions of NaCl or sucrose with osmolalities above 0.6 osmolal. The damage was expressed as a loss of membrane integrity [fluorescein diacetate (FDA) assay] only after 60-90 min incubation at 37 degrees C. Survival after exposure to a 1.4-osmolal solution at 0 degree C was dependent on the extent of subsequent dilution. Dilution to below 0.6 osmolal was damaging, but cells could be returned to near-osmotic conditions provided that the solute concentration was increased again to 0.64 osmolal before the cells were incubated at 37 degrees C. Granulocyte cell volumes were measured under various osmotic conditions by computer-assisted micrometry. The cells did not display a minimum volume but behaved as osmometers over the observed range of 0.2 1.4 osmolal. Granulocyte volume at a given osmolality was independent of whether the cells had first been exposed to a strongly hyperosmotic medium, indicating that no solute loading occurred in hyperosmotic sucrose solutions. Even though the cells did not survive sequential exposure to greater than 0.6 osmolal solutions, subsequent return to isotonicity, and incubation at 37 degrees C, neither cell lysis nor loss in FDA-positive cells occurred after the first two steps. This finding is not consistent with the critical-surface area-increment theory of freezing injury. The mechanism of cell injury in hyperosmotic solutions is thus not known. However, the results show that osmotic stress is potentially a major damaging factor both in the equilibration of cells with protective additives and during freezing and thawing. PMID- 6496725 TI - Toxic and osmotic effects of glycerol on human granulocytes. AB - Human granulocytes are damaged by exposure to concentrations of glycerol as low as 0.5 M. We therefore investigated the addition of glycerol to granulocytes and its subsequent dilution under various conditions to try to distinguish between toxic and harmful osmotic effects of glycerol. The lesion caused by glycerol at 0 degree C was expressed as a loss of plasma membrane integrity (as visualized by fluorescein diacetate) only after incubation (greater than or equal to 1 h) at 37 degrees C. This damage was not ameliorated when osmotic stress was lessened by reducing the rates of addition and dilution of glycerol to keep the computed cell volume within 80-170% of isotonic cell volume. However, when osmotic stress was reduced further by increasing the temperature of addition and dilution of glycerol from 0 degree C to 22 degrees C, the tolerance of the cells to 1 M glycerol increased somewhat. Reducing exposure to glycerol to 3 min or less at 0 degree C greatly increased survival, but this time was too short to allow glycerol to equilibrate intracellularly. Finally, the presence of extra impermeant solute (NaCl or sucrose) in the medium to reduce the equilibrium cell volume to 60% of isotonic cell volume enabled granulocytes to survive 30-min exposure to 1 M glycerol at 0 degree C, but cells had to remain shrunken during the 37 degrees C incubation to prevent the loss of membrane integrity. Suspensions that contained damaged granulocytes formed aggregates when incubated at 37 degrees C, and these aggregates were responsible for a major fraction of the observed loss in viability. PMID- 6496726 TI - Uptake and metabolism of transferrin and albumin by rat yolk sac placenta. AB - The uptake of radiolabeled albumin and transferrin by the rat yolk sac and their subsequent transport to the embryo were studied. Transferrin uptake increases with incubation time whether the results are expressed in terms of the total amount accumulated or per milligram embryo or yolk sac protein, whereas albumin levels increase only in absolute terms. The fate of transferrin and albumin was examined by partitioning 125I into low- and high-molecular-weight fractions. Nearly all the embryonic radioiodine originally derived from transferrin is in the low-molecular-weight fraction, compared with only 60% albumin. These results have been extended by examining the uptake and hydrolysis of transferrin and albumin by the isolated yolk sac. Transferrin is taken up more rapidly than albumin. The release of hydrolyzed transferrin to the incubation medium occurred 40 min after the initiation of incubation, compared with 20 min for albumin. Transferrin uptake by the yolk sac at different transferrin concentrations showed an initial rapid phase followed by a slower linear phase, whereas albumin uptake increased linearly with concentration. There was no competition between the two proteins for uptake. Transferrin was released from the yolk sacs at approximately twice the rate of albumin. Results demonstrate at least two uptake mechanisms in the rat visceral yolk sac, one for transferrin, which probably involves receptor mediated endocytosis, and one for albumin, by which transferrin can also be transported, which probably involves pinocytotic mechanisms. PMID- 6496727 TI - Uptake of tyrosine and leucine in vivo by brain of diabetic and control rats. AB - The uptake of tyrosine and leucine by brain of control and diabetic rats was examined using the Oldendorf intracarotid injection technique. The brain uptake indexes (BUI) for tyrosine and leucine were identical in diabetic and control rats when the injectate consisted of labeled amino acids in Krebs saline. When the injectate consisted of radioactive amino acids added to plasma from either normal or diabetic rats, there was a decreased BUI for tyrosine from diabetic plasma compared with that from normal plasma. This was evident in both control and diabetic rats. Fractional uptake of leucine was unchanged in all situations. Because leucine level is elevated in plasma of diabetic rats there is an absolute increase in leucine uptake in diabetes. Branched-chain amino acids, added to normal plasma in the concentrations at which they occur in diabetic plasma, inhibited the uptake of tyrosine to the same extent as diabetic plasma did. We conclude that the decreased brain uptake and decreased brain level of tyrosine in diabetes is due to the high circulating levels of branched-chain amino acids and cannot be attributed to intrinsic changes in the blood-brain transporter for large neutral amino acids or to changes in other constituents of plasma. PMID- 6496728 TI - Solid-state optical scanning system for remote measurements in biomechanical systems. AB - A remote optical sensing system, employing a self-scanning photodiode array, is described, and its operation is demonstrated for measurements of rapid dimensional changes in contracting smooth muscle preparations. The single-line sensor array, a commercially available charge-coupled device integrated circuit, with 256 elements at 25-microns intervals, is mounted in the image plane of an optical system focused on a backlit test object. The amplitude profile of each scan is proportional to the illumination reaching the individual sensory elements. Auxilliary circuitry generates a raster of successive scan lines on the face of a storage oscilloscope. Spatial and temporal information about the target and its motions may be derived from the displayed raster scan. Performance is illustrated using an artificial target and a muscle fiber bearing opaque markers. Successive lines may be scanned in as briefly as 5 ms (at 10-ms intervals) or in as long as 50 ms (at 1-s intervals). Each raster may contain up to 256 lines, although not all of the lines need to be displayed. The spatial resolution is determined by the photodiode spacing in the sensory array and by the magnitude of the optical system in use; as described here, the resolution is on the order of 0.2 mm for a 20-mm scan length. PMID- 6496729 TI - Intracellular pH of perfused single frog skin: combined 19F- and 31P-NMR analysis. AB - Intracellular pH (pHc) has been determined in frog skin by applying two different methods of pH measurement, 19F and 31P nuclear magnetic resonance (NMR) analysis, to the same tissues. Results from both NMR approaches confirm an observation by Lin, Shporer, and Civan [Am. J. Physiol. 248 (Cell Physiol. 17): 1985] that acidification of the extracellular medium reverses the sign of the pH gradient present under baseline conditions. The fluorinated probe, alpha-(difluoromethyl) alanine methyl ester, was introduced into the epithelial cells by preincubating skins for 4.7-10.4 h at room temperature in Ringer solutions containing 1 mM ester. The free amino acid was subsequently released by intracellular esterase activity, thus providing a high enough probe concentration for NMR analysis to be practicable. From measurements of short-circuit current and transepithelial resistance under base-line and experimental conditions and the appearance of phosphocreatine (PCr) in the 31P spectrum of preloaded tissues, the fluorinated probe appears to be nontoxic to frog skin. Measurement of the chemical shift of methylphosphonate relative to PCr permitted calculation of extracellular pH. Estimation of the intracellular pH was performed both by measurement of the chemical shift of inorganic phosphate (Pi) relative to PCr and by measurement of the central peak spacing of the 19F spectrum. From four direct comparisons of the two techniques in two experiments, the difference in the estimated pH was only 0.03 +/- 0.07 pH units, supporting the concept that 31P-NMR analysis is a valid method of measuring pH in this tissue. PMID- 6496730 TI - Testicular function and sexual activity in senescent mice. AB - The steroidogenic potentials of testes from 6-mo-old and approximately 28-mo-old CB6F1 mice were compared by measuring the secretion rate of 11 steroids produced by testes perfused in vitro. Testes from 6- and 28- to 30-mo-old mice secreted similar amounts of testosterone, but marked differences in the secretion of testosterone biosynthetic intermediates were discovered. Testes of old mice produced significantly more (P less than 0.01) delta 5-steroids than young male mouse testes. The presence or absence of sexual activity among old male mice was not correlated with changes in testicular steroidogenesis or plasma steroid levels. The results suggest that selected alterations in androgen biosynthesis occur during aging, but that the decline in reproductive performance among old mice is not attributable to deficits in testicular steroidogenesis. Rather, age associated losses in sexual activity may be mediated by disturbances in the central nervous system. PMID- 6496731 TI - Uterine blood flow and substrate uptake in conscious rabbit during late gestation. AB - The aim of this study was the quantitation of the metabolic demands of the uterus in rabbits between days 24 and 30 of gestation, a time at which there is a fourfold increase in fetal weight. Serial measurements of substrate concentrations in maternal artery and uterine vein were performed over this period. Uterine blood flow was measured on days 24 and 30. Uterine substrate uptake was calculated by application of the Fick principle. Over the gestation range studied, the absolute uterine blood flow increased proportionally to the uterine weight gain. The uterine arteriovenous differences for glucose (G), lactate (L), free fatty acids (FFA), ketone bodies (KB), and oxygen (O2) were constant throughout the study. At both gestational ages, the weight-specific uterine substrate consumption (G, FFA, KB, O2) and production (L) were respectively similar. On days 24 and 30 the amount of G directed to the gravid uterus represented approximately 13 and approximately 36% of the maternal glucose turnover rate, respectively. The maximum contributions of G and FFA to the uterine oxygen consumption on day 24 were 80 and 30%, respectively. We have thus confirmed that at term the gravid uterus is a site of high glucose consumption. Finally, we demonstrated that in a nonruminant species, FFA would be a substantial source of carbon. PMID- 6496732 TI - Evidence for an intestinal mechanism in hypercalciuria of spontaneously hypertensive rats. AB - To define the mechanism for the hypercalciuria in spontaneously hypertensive rats (SHR), Ca clearance was evaluated in fasted 23-wk-old SHR and normotensive Wistar Kyoto (WKy) controls. There was no exaggerated calciuria before or after parathyroidectomy. Ca balance was therefore measured in the nonfasted animals, which revealed hyperabsorption in SHR of both sexes with increments 10-fold that of Ca excretion, supporting the primacy of intestinal hyperabsorption. In situ duodenal Ca uptake was also increased in the SHR. Parathyroidectomy did not affect the hyperabsorption. Hypercalcemia (total and ionized) and hypercalciuria in SHR associated with reduced adenosine 3',5'-cyclic monophosphate excretion, were abolished by fasting. Correction of hypertension for 6 mo failed to abolish the hypercalciuria. Bone Ca deposits were increased in 1-yr-old SHR. Ten-week-old SHR, in contrast, displayed mild malabsorption. Our data do not support the "renal leak" hypothesis. Instead, the adult SHR is characterized by increased Ca retention due to primary hyperabsorption, absorptive hypercalciuria, and increased bone Ca deposition. These phenomena are independent of sex, parathyroid hormone, and treatment of the established hypertension. PMID- 6496733 TI - Alanine kinetics in humans: influence of different isotopic tracers. AB - Whole-body alanine kinetics were studied using continuous infusions of [15N]-, [3,3,3-2H3]-, [1-13C]-, and [3-13C]alanine tracers in healthy male subjects in the postabsorptive state. Alanine kinetics were highly dependent on the choice of isotopically labeled alanine. Highest rates of alanine flux (mean +/- SE) were obtained with the [3,3,3-2H3]alanine (474 +/- 41 mumol X kg-1 X h-1). [1-13C]- and [3-13C]alanine tracers gave intermediate values (297 +/- 12 and 317 +/- 22 mumol X kg-1 X h-1, respectively). The slowest rates of alanine turnover were measured with [15N]alanine (226 +/- 7 mumol X kg-1 X h-1). These results emphasize the heterogeneous metabolism of different portions of the alanine molecule and the importance of choosing an appropriate alanine tracer for studying different aspects of alanine metabolism. PMID- 6496734 TI - Reduced and S-carboxymethylated human growth hormone: a probe for diabetogenic action. AB - The biological activity profile of reduced and S-carboxymethylated human growth hormone (RCM-hGH) was determined to establish its suitability for study of the diabetogenic property of hGH. RCM-hGH was found to have greatly attenuated in vivo growth-promoting activity in the 9-day weight-gain test in hypophysectomized rats (approximately 1%) and to have a similar low order of in vitro activity in stimulating amino acid incorporation into the protein of the isolated rat diaphragm. RCM-hGH also only had approximately 1% of the in vitro insulin-like activity of the native hormone on isolated adipose tissue from hypophysectomized rats. In contrast, RCM-hGH retained substantial in vivo diabetogenic activity in the ob/ob mouse, appearing to have approximately 50% of the activity of the native hormone. RCM-hGH was also found to retain significant, although attenuated (25%), in vitro lactogenic activity when tested for the ability to stimulate amino acid incorporation into a casein-rich protein fraction in mouse mammary gland explants. Because RCM-hGH exhibits a high degree of diabetogenic activity, although lacking significant anabolic or insulin-like activities, it will be useful as a "monovalent" probe for the study of the molecular mechanism of the diabetogenic action of GH. PMID- 6496735 TI - Enhancement of adrenomedullary catecholamine release by adrenal cortex in fetus. AB - Catecholamines (CA) release from ovine fetal adrenomedullary cells was greatly enhanced by coincubation with adrenocortical cells. Total CA release was significantly elevated at 2 and 6 h of preincubation by seven- and twofold, respectively. With continuous coincubation of the two cell types, the enhancement of release was found to occur as early as 30 min and maintained for at least 6 h. A similar enhancement effect was observed when adrenomedullary cells were incubated in adrenocortical cell incubation medium (ACM). The stimulation of release was demonstrated for each of the three CA: dopamine, norepinephrine, and epinephrine. The effect of adrenocortical cells differed from that of adrenal steroids, because cortisol selectively stimulated the release of epinephrine only by one- to threefold after a latency of 6 to 9 h, whereas dehydroepiandrosterone had no effect on the release of the three CA at any time tested. Finally, the CA stimulatory activity in ACM was acid and heat stable, not extractable by ether but inactivated by proteolytic digestion. These results suggest that the adrenal cortex of the near-term ovine fetus secretes a factor that stimulates the release and perhaps synthesis of CA from the adrenal medulla. PMID- 6496736 TI - A contribution to analysis of three-compartment models for intestinal weak electrolyte absorption. AB - The flux ratio equation used to describe intestinal weak electrolyte absorption in terms of a three-compartment model, with an intermediate compartment of distinctive pH, was examined in detail. This took the form of fitting the function to experimental data from the literature, using several different parameter sets. Within wide limits, estimation of intermediate compartment pH is seen to be arbitrary due to redundancy in the model. Several pairs of pH values can satisfactorily fit experimental data. Inspection of the function reveals that it contains four basic submodels whose distinct identity depend on whether or not pH2 greater than pH, and which of the two membranes in series has the highest discrimination between ionized and non-ionized forms. Further analysis of the function reveals that it provides an infinite but bounded set of values for intermediate compartment pH. The model is therefore redundant, nonlinear function fitting reveals ill conditioning, and estimates of pH2 from the present model cannot be regarded as definitive. PMID- 6496737 TI - Gastric blood flow determination: intramural distribution and arteriovenous shunting of microspheres. AB - Total and regional gastric blood flows were measured in 23 anesthetized cats by labeled 10-micron (range 8-12 microns) and 15-micron (range 12-20 microns) microspheres. Total blood flow correlated closely with the gastric venous outflow. Flow estimates by 10-microns spheres were 2.95% lower than simultaneous 15-micron estimates. Approximately 2% of the 10-micron spheres and 0.1% of the 15 micron spheres were shunted through the gastric vasculature. The diameter distribution of 6,245 embolized spheres, measured by microscopy, corresponded to that of the injectate, except for a lack of the smallest spheres. Within the mucosa, the 10-microns spheres predominantly lodged in the glandular layer, whereas larger spheres gradually lodged more basally; 50% of the 15-microns population appeared in the lamina propria below the gland bases. Vasodilation did not alter the intramucosal distribution. Spheres in the subglandular lamina propria represented blood flow mainly to the glandular layer. It is therefore essential for reliable estimation of blood flow to the glandular layer of the mucosa that the lamina propria is completely included in the specimens. The submucosa contained only 0.5% of the 10-microns and 2.2% of the 15-micron embolized spheres. Spheres of 10.5-17 microns in diameter are considered the most suitable for determination of gastric blood flow. PMID- 6496738 TI - Bile acid efflux precedes mucosal barrier disruption in the rabbit esophagus. AB - In a rabbit model of esophagitis, bile acids are one of the agents capable of disrupting the normal esophageal mucosal barrier to diffusion. They are of particular interest because they may play a central role in causing reflux esophagitis, a major clinical problem. Bile acid efflux from the lumen of the esophagus occurs when bile acids disrupt the normal esophageal barrier. Whether this entry of bile acids into the mucosa is a critical step in the pathophysiology of bile acid injury to the mucosa or a result of the injury that is occurring by some other means is unknown. To differentiate these two possibilities, the temporal relation between bile acid efflux from the esophageal lumen and disruption of the mucosal barrier was studied with an in vivo perfused model of esophagitis in anesthetized New Zealand White rabbits. Solutions containing taurocholic acid or chenodeoxycholic acid at pH 2 or 7 were perfused for 4 h while bile acid, hydrogen ion, glucose, and erythritol flux rates were measured. In each case in which the bile acid caused barrier disruption, the highest rate of bile acid efflux occurred during the 1st h of perfusion. In contrast, the increase in flux rates of hydrogen ion, glucose, and erythritol, indicators of mucosal barrier disruption, were the highest during the 2nd or 3rd h of exposure. These data suggest that entry of bile acids into the esophageal mucosa is a cause rather than an effect of the bile-induced increase in mucosal permeability. PMID- 6496739 TI - Role of humoral factors in the intestinal hyperemia associated with chronic portal hypertension. AB - The role of neural, metabolic, physical, and humoral factors in the intestinal hyperemia associated with chronic portal hypertension was examined by use of the rat portal vein stenosis model. Intestinal blood flow and splenic pulp pressure were increased, while systemic arterial pressure and total vascular resistance were reduced in portal vein-stenosed rats as compared with controls. The reduction in total vascular resistance was entirely due to a fall in precapillary resistance and was accompanied by an increase in intestinal capillary pressure, which exceeded that produced by acute portal pressure elevation to the same level. Arteriovenous shunting of 15-micron microspheres was four times higher in portal-hypertensive rats. Cross-perfusion of control intestinal preparations with arterial blood from portal-hypertensive rats produced a 30% increase in blood flow. Plasma glucagon levels in portal-hypertensive rats were three times higher than in controls. Intra-arterial infusion of glucagon (at a rate that achieved the concentration measured in portal-hypertensive animals) produced a 20% reduction in intestinal vascular resistance. The results of these studies indicate that humoral factors, including glucagon, are primarily responsible for the hyperemia associated with portal hypertension. PMID- 6496740 TI - Localization of cholesterol synthesis in the small intestine of diabetic rats. AB - Previous studies have demonstrated that cholesterol synthesis is increased twofold in the small intestine of diabetic animals. The present study demonstrates that the stimulation of small intestinal cholesterol synthesis by diabetes is a generalized phenomenon occurring in all segments of the small intestine. Quantitatively, in control animals the proximal two segments of the small intestine account for the majority of the total small intestinal cholesterol synthesis, whereas in the diabetic animals, because of the generalized stimulation in cholesterogenesis, the contribution of the terminal segments to total small intestinal cholesterol synthesis is of increased importance. The various manipulations that regulate cholesterol synthesis in the small intestine of diabetic animals also affect cholesterol synthesis in all portions of the small intestine. In diabetic animals cholesterol feeding and the limitation of food intake decrease cholesterol synthesis in the total small intestine and in all segments of the small intestine. Conversely, colestipol feeding increases cholesterol synthesis in all segments of the small intestine. These results demonstrate that, despite the obvious structural, functional, and environmental differences among the various segments of the small intestine, the stimulation of cholesterol synthesis that occurs secondary to diabetes mellitus is a generalized phenomenon. Similarly, the factors that regulate small intestinal cholesterol synthesis do so in a generalized manner. PMID- 6496741 TI - Swallowing induces sequential activation of esophageal longitudinal smooth muscle. AB - We examined the mechanical activity of the longitudinal and circular muscles of the esophagus at three different levels (9, 5, and 1 cm above the lower esophageal sphincter) during peristalsis induced by swallows or vagal stimulation in anesthetized opossums with miniature strain gauges applied in the axis of muscle fibers. The onset of longitudinal muscle contraction occurred in an aboral sequence with swallows but simultaneously with vagal stimulation. The speed of longitudinal muscle activation with swallows was 7.6 +/- 1.7 cm/s. Circular muscle contraction occurred in an aboral sequence with vagal stimulation and swallowing with speeds of 4.1 +/- 0.8 and 2.3 +/- 0.1 cm/s, respectively. Longitudinal muscle contracted before the circular muscle at all sites. The duration of longitudinal muscle contraction increased aborally (P less than 0.05) with swallowing or vagal stimulation. These studies show that 1) during swallowing, esophageal longitudinal and circular smooth muscle contract in a sequential fashion, 2) the longitudinal muscle sequential contraction is due to central mechanisms, whereas circular muscle sequential contraction may be due to both central and peripheral mechanisms, and 3) peripheral neuromuscular mechanisms produce regional differences in the duration of longitudinal muscle contraction. PMID- 6496742 TI - Three-dimensional dynamic x-ray-computed tomography imaging of stomach motility. AB - The dynamic spatial reconstructor (DSR), an x-ray-computed, tomography-based imaging machine, scans a cylindrical volume up to 39 cm in transaxial diameter and 21.5 cm in axial height with scan repetition rate up to 60 per second. We applied this technique to three dogs in order to investigate the accuracy with which stomach shape, dimensions, and motility can be measured. Single peristaltic waves of one dog's stomach filled with air and two other dogs' stomachs filled with different volumes of contrast-enhanced semisolid meals (10% Gastrografin) were scanned at 2-s intervals at scan apertures between 0.011- and 1-s duration. On completion of the scan sequence, images of oblique sections perpendicular to the local long axis of the stomach fundus, corpus, and antrum were computed from the DSR scan data. Measurements of differential motion of defined points on the stomach wall surface, propagation velocities, acceleration, and amplitudes of peristalsis as well as gastric volume determinations were made. This approach overcomes problems of superposition and ambiguity inherent in projection imaging. Measurements of the volumes of ingested first meal were accurate to within 1.5% (of the actual volume of solid food introduced into the stomach) using a 0.40-s scan aperture. Wall motion could be detected with an SEE of 1.5 mm (pixel size used was 1.4 mm) using a 0.40-s scan aperture. PMID- 6496743 TI - Salt depletion inhibits cerebral-induced natriuresis in the dog. AB - Experiments were carried out in the conscious dog to determine whether renal responses to intracarotid (IC) infusion of hypertonic NaCl are altered in the sodium-depleted state. In the sodium-replete animal, both IC and IV infusion of hypertonic NaCl produced significant increases in sodium excretion and significant decreases in free water clearance. However, both of these renal responses were more rapid in onset with IC infusion. Both IC and IV infusion decreased free water clearance. In the sodium-deplete animal, IC hypertonic NaCl infusion had no effect on sodium excretion but did decrease free water clearance. It is concluded that total body sodium is a determinant of the gain of the cerebral sodium-sensing mechanism and that this mechanism is different from the osmosensitive mechanism. PMID- 6496744 TI - Isolation of calcium oxalate crystal growth inhibitor from rat kidney and urine. AB - Glycoproteins that slow the growth rate of calcium oxalate monohydrate crystals were purified from rat kidney homogenate and urine by selective heat denaturation (for rat kidney homogenate), DEAE-cellulose column chromatography, and gel permeation column chromatography. Both kidney and urine inhibitors were glycoproteins with an apparent mol wt of 1.4 X 10(4), as determined by high performance liquid chromatography. They contained gamma-carboxyglutamic acid and a high percentage of aspartic acid and glutamic acid but had few aromatic amino acid residues. Both inhibitors contained fucose, mannose, glucose, galactose, glucosamine, galactosamine, and N-acetylneuraminic acid but no glucuronic acid. Kinetic studies suggest that purified inhibitors bind to calcium oxalate monohydrate seed crystals according to a Langmuir adsorption isotherm with similar dissociation constants of 14 X 10(-8)M for rat urine inhibitor and 8.7 X 10(-8) M for rat kidney inhibitor. The isolation of similar glycoproteins from kidney and urine suggests that urinary crystal growth inhibitor may be produced in the kidneys. PMID- 6496745 TI - Lead flux through the kidney and salivary glands of rats. AB - The blood disappearance curve of lead injected intravenously into rats and its appearance curve in the saliva reflect a three-compartment open model. Urinary elimination rate showed many fluctuations in the first 10 days but decreased progressively afterward. In clearance experiments, with low lead infusion (4 micrograms/min), renal reabsorption accounted for nearly all the filtered lead load, and salivary secretion was on the order of 1 ng/min. Experiments with renal and salivary tissue fragments indicated maximal accumulation in both tissues. Contrary to salivary tissue uptake, renal accumulation of lead decreased in the presence of KCN and 2,4-dinitrophenol, and in Na+-deficient media. Renal lead uptake contains, therefore, an important energy-dependent component. In vitro evidence that the lead transport mechanisms of the kidney and salivary glands are fundamentally different is consistent with the results of the pharmacokinetic study. The resemblance between the early profile of salivary lead secretion and its disappearance from the blood indicates that salivary glands represent diffusion barriers for the metal, in contrast to the kidney where lead uptake may be influenced by energy- and metabolism-dependent mechanisms. PMID- 6496746 TI - Quantitative characterization of the tubuloglomerular feedback response: effect of growth. AB - Studies were performed to characterize quantitatively the effect of changing loop of Henle flow rate on single nephron glomerular filtration rate (SNGFR) in male Sprague-Dawley rats of varying body weight. Rats weighing 100, 220, and 350 g were studied using standard renal micropuncture techniques. The relationship between loop of Henle flow rate (VLP) and SNGFR was characterized for individual nephrons by multiple determinations of SNGFR during loop perfusion. An inverse sigmoidal relationship was observed that could be described as delta SNGFR = a/(1 + ek(b-VLP], where delta SNGFR is the change in SNGFR from the value measured at zero loop flow, a is delta SNGFRmax, the maximum change, b is V1/2, the flow rate at which the response is half maximum, and k is [4f' (V1/2)]/a with f' (V1/2) the slope at V1/2. delta SNGFRmax increased with increasing body size (7.9 +/- 1.16, 18.9 +/- 0.90, and 25.2 +/- 2.73 nl/min, respectively, in the three groups), and the curve shifted to the right (V1/2 = 10.3 +/- 0.8, 15.4 +/- 0.83, and 22.3 +/- 1.22 nl/min). The maximum slope increased (f' (V1/2) = 0.9 +/- 0.19, 1.7 +/- 0.16, and 3.2 +/- 0.70), but the exponential constant k was uninfluenced by growth. Independent of rat size, a 10% increase in loop flow at the midpoint produced at 5-10% decrease in SNGFR. Free-flow values of SNGFR and VLP were found to lie in the most sensitive range of the feedback curve. PMID- 6496747 TI - Axial heterogeneity in the rat proximal convoluted tubule. I. Bicarbonate, chloride, and water transport. AB - To measure simultaneously the concentration profiles of bicarbonate, chloride and inulin along the length of the superficial proximal convoluted tubule, free-flow micropuncture measurements were made sequentially from the end-proximal tubule to Bowman's space in 10 tubules of hydropenic Munich-Wistar rats. Bicarbonate and volume reabsorption were 354 +/- 21 pmol X mm-1 X min-1 and 5.9 +/- 0.4 nl X mm-1 X min-1 in the first millimeter and fell progressively in the remaining 3.8 mm of tubule, averaging 83 +/- 4 pmol X mm-1 X min-1 and 2.3 +/- 0.5 nl X mm-1 X min-1, respectively. The values in the initial millimeter represents a high transport capacity since they exceed rates that have been observed when comparable or even higher mean luminal substrate concentrations were presented to the late proximal tubule. In contrast, chloride reabsorption was only 206 +/- 55 peq X mm-1 X min-1 in the first millimeter compared with a mean of 306 +/- 22 peq X mm-1 X min-1 in the rest of the tubule. In conclusion, there is substantial axial transport heterogeneity, with bicarbonate and water reabsorption higher but chloride reabsorption lower in the early compared with the late superficial proximal convoluted tubule. PMID- 6496748 TI - Axial heterogeneity in the rat proximal convoluted tubule. II. Osmolality and osmotic water permeability. AB - To assess whether proximal luminal fluid becomes hypotonic with respect to plasma, free-flow micropuncture measurements were made sequentially from the end proximal tubule to Bowman's space in 10 tubules of hydropenic Munich-Wistar rats. Osmolality in Bowman's space was 2.8 +/- 0.3 mosmol less than in plasma. Tubular fluid osmolality fell along the tubule and by the end-proximal tubule was 7.5 +/- 0.7 mosmol/kg less than in plasma or 4.7 mosmol/kg less than in Bowman's space. Since luminal fluid became hypotonic, the reabsorbate was hypertonic. The transepithelial osmotic water permeability (Pf) was calculated using simultaneously measured water reabsorption rates. The osmotic gradient responsible for water reabsorption was assumed to be either lumen-to-reabsorbate or lumen-to-peritubular plasma, with a reflection coefficient for sodium chloride of 0.7-1.0. The Pf was then estimated to be between 0.2 and 2.0 cm/s in the first millimeter of tubule and to have fallen to 0.1-0.2 cm/s by the end of the tubule. In conclusion, luminal hypotonicity develops in the rat proximal convoluted tubule and must be considered as part of the osmotic driving force for water reabsorption. PMID- 6496749 TI - Response of ammoniagenesis to acute alkalosis. AB - To examine the response of ammonia production to acute alkalosis, isolated rat kidneys were perfused with 5 mM glucose and 0.5 mM glutamine for an initial 45 min at pH 7.7, achieved by raising the perfusate HCO3 concentration or reducing the PCO2, followed by one or more 45-min periods at a normal pH. During the initial high pH period, respiratory alkalosis had no effect on NH3 production in comparison with perfusions at a normal pH. However, during the subsequent 45-min period at a normal pH, kidneys exposed initially to a high pH produced less NH3 than those perfused at a normal pH for the entire experiment. This suppression of ammoniagenesis abated during an additional 45 min of perfusion at a normal pH. Kidneys exposed to metabolic alkalosis produced more NH3 than controls during the initial 45 min of perfusion. However, similar to respiratory alkalosis, NH3 production was lower than controls during the subsequent 45 min of perfusion at a normal pH. Hence a high bicarbonate concentration can rapidly, but transiently, stimulate NH3 production by the isolated rat kidney. However, a high pH, whether produced by metabolic or respiratory manipulations, suppresses ammoniagenesis. This suppressive effect requires 45 min of exposure to an elevated pH to be manifest and at least 45 min of exposure to a normal pH for reversal. The delayed response to alkalosis contrasts strikingly with the immediate effects of acute acidosis on NH3 production by the perfused kidney and suggests that different mechanisms account for the regulation of ammoniagenesis in response to acute decrements and elevations in pH. PMID- 6496750 TI - Transport by epithelia with compliant lateral intercellular spaces: asymmetric oncotic effects across the rat proximal tubule. AB - Mathematical models of the proximal tubule are considered in which the lateral intercellular spaces distend in response to increased interstitial pressures and basal outlet permeabilities increase as a result of interspace widening. An approximate analytical model of the interspace reveals the possibility that such compliance may introduce an asymmetry to the effect of protein oncotic forces on transepithelial volume flow. Peritubular oncotic forces close the interspace, enhance interspace hypertonicity, and thus substantially increase volume reabsorption (enhanced intraepithelial solute-solvent coupling). The model also predicts a decline in epithelial water permeability (Lp), salt reflection coefficient, and salt permeability, with the application of peritubular protein. When parameters are chosen so as to represent the rat proximal tubule, the predicted effect on solute permeability is comparable to the observed changes in electrical resistance of the epithelium. However, when the luminal solution is slightly hypotonic to blood and proximal reabsorption has become isosmotic, the models show relatively small protein effects, which are dependent upon cell and tight junction permeabilities and are little influenced by interspace compliance. The capability of such models to represent the peritubular protein enhancement of isosmotic salt and water reabsorption by the proximal tubule in vivo is questioned. PMID- 6496751 TI - Morphology of the constricted arteriolar wall: physiological implications. AB - Microvessels undergo complex shape changes during constriction that could have profound implications for control of resistance. We exploited in vitro cannulation techniques in combination with electron microscopy to assess the effects of physiological degrees of vasoconstriction on the size and form of the lumen of isolated rat mesenteric arterioles. Photomicrographs of vasoconstricted vessels revealed that the luminal surface is folded and thrown into longitudinal ridges several hundred microns long. These ridges begin to form and encroach on the lumen as the vessel is constricted. Ridge height may increase to 5-10 microns, and as many as 50 ridges were observed around the circumference of a 70 microns vessel. Ridges are comprised of endothelial cells, basal elastic lamina, and portions of the smooth muscle cytoplasm including thick filaments. The ridges are major determinants of the relationships among stress on smooth muscle contractile elements, intraluminal pressure, and luminal diameter. The ridges may also limit the precision of measurement of microvessel diameter in situ since it is not known whether the apex or the base of the ridge is measured under typical conditions of in vivo microscopy. Our findings emphasize the need for additional detailed study of wall morphology to fully understand the regulation of microvessel flow resistance by smooth muscle function. PMID- 6496752 TI - Vascular effects of free radicals generated by electrical stimulation. AB - Electrical field stimulation (9 V, 1.0 ms, 4 Hz) of isolated segments of rat tail arteries and dog coronary arteries inhibits contractile responses to exogenous norepinephrine and elevated potassium concentration. This inhibitory effect of electrical stimulation is blocked by various agents that alter oxygen metabolism: superoxide dismutase, catalase, glutathione, ascorbate, and dimethyl sulfoxide. The observations suggest that the inhibitory effect is due to an action of oxygen free radical metabolites that are generated by the electrical stimulation of the oxygen-rich buffer. These free radical metabolites have two actions: 1) they oxidize drugs in the experimental system, and 2) they exert a direct inhibitory action on vascular smooth muscle. PMID- 6496753 TI - Chronic immunosuppression attenuates hypertension in Okamoto spontaneously hypertensive rats. AB - Recent evidence suggests that hypertension in the Okamoto spontaneously hypertensive rat (SHR) may be the result of an autoimmune disorder. To test this hypothesis SHRs were given chronic immunosuppressive therapy (cyclophosphamide). The development of spontaneous hypertension was studied in SHRs receiving cyclophosphamide beginning at age 3 wk. The arterial pressure of the cyclophosphamide-treated SHRs was significantly lower than that of untreated control SHRs once the rats were 8 wk old, and this reduction in blood pressure was maintained for the duration of treatment. Also the effect of chronic immunosuppressive therapy on the maintenance of spontaneous hypertension was determined by beginning treatment in 16-wk-old SHRs. Arterial pressure was significantly less than that of untreated control SHRs after 2 wk of treatment. According to tail-cuff measurements, the level of hypertension in the SHRs was reduced by approximately 50% following 6 wk of immunosuppressive therapy. The mean arterial pressure was significantly reduced after 6 wk to 158 +/- 5.0 mmHg in immunosuppressed SHRs (n = 10) compared with 174 +/- 2.6 mmHg in control SHRs (n = 7). Cyclophosphamide treatment did not have a significant effect on the blood pressure of Wistar or Wistar-Kyoto rats or on the development or maintenance of deoxycorticosterone acetate hypertension. Chronic immunosuppression attenuates hypertension in the Okamoto SHR. These results support the hypothesis that spontaneous hypertension may be due in part to an autoimmune disorder. PMID- 6496754 TI - Regional myocardial perfusion and wall thickening during ischemia in conscious dogs. AB - We examined in conscious dogs the effects of reductions in myocardial blood flow (MBF) in three different layers across the wall on regional myocardial contractile function in the ischemic zone, measured as systolic wall thickening (%WT). In 16 dogs, %WT was measured with sonomicrometry and MBF was determined with microspheres (10- to 12-microns diam) during coronary stenosis of the left circumflex coronary artery. The stenoses were categorized into six groups by the effect on %WT (each group representing progressive 20% decrements in %WT from control), and individual and pooled regression analyses were performed on data from six of the dogs having multiple data points to evaluate the shape (linear or curvilinear) of the relationships between MBF and changes in %WT. Transmural contractile function was highly sensitive to acute reductions in MBF, especially reductions in the subendocardium. The shape of the normalized subendocardial MBF %WT relation was mildly curvilinear by regression analysis (quadratic equation, gamma = -0.75x2 + 2.15x -0.39, r2 = 0.92). Likewise, mean transmural and midmyocardial MBF correlated well and closely with changes in %WT. Subepicardial MBF, however, correlated poorly with changes in %WT, there being no change in subepicardial MBF until %WT had been reduced more than 50%. PMID- 6496755 TI - Red blood cell deformability and protein adsorption on red blood cell surface. AB - Effects of protein and NaCl concentrations in plasma on red blood cell (RBC) deformability were studied using fresh human blood and a 5-microns Nuclepore filtration test. The protein and salt concentrations were varied by diluting the plasma with saline and adding crystalline NaCl to the fluids, respectively. The mean pore passage time of the RBCs, which was measured as an index of the deformability, increased with increasing plasma protein and NaCl concentrations. A marked interdependence was observed; the relation of RBC deformability with plasma protein was accentuated by an increase in plasma NaCl, whereas the effect of increasing plasma NaCl was diminished by a decrease in plasma protein. It is suggested that the RBC-protein interaction which is modified by the fluid ionic strength plays a dominant role in producing these characteristic changes in RBC deformability with protein and salt contents in the plasma. An analysis is made of the cell-protein interaction; the electric repulsive and van der Waals attractive forces are calculated with a result that the protein adsorption on a RBC increases with increasing fluid ionic strength above normal. This analysis, furthermore, provides information on the surface charge distribution on a RBC. PMID- 6496756 TI - Validation of 3-deoxy-3-fluoro-D-glucose as a glucose transport analogue in rat heart. AB - Four aspects of the behavior of 3-deoxy-3-fluoro-D-glucose (D-3FDG) were studied. The distribution of label in rat tissues after intravenous administration of [18F]D-3FDG was compared with that seen with labeled 3-deoxy-3-fluoro-L-glucose (L-3FDG). Results were consistent with a larger volume of distribution for the physiological D-isomer coupled with some degree of reabsorption by the kidneys. L 3FDG, but not its D-isomer, was excluded from the brain. D-3FDG competitively inhibited uptake of glucose by isolated perfused rat hearts. The inhibition constant was 12.8 +/- 1.6 mM compared with 6.1 +/- 1.1 mM for 3-O-methyl-D glucose. Residue curves obtained after bolus administration of [18F]D-3FDG to isolated hearts indicated phosphorylation of the tracer at a lower rate than for 2-deoxy-2-fluoro-D-glucose but with subsequent dephosphorylation at a faster rate. Chromatographic analysis of 18F remaining in tissues after administration of [18F]D-3FDG revealed in addition to free D-3FDG three other peaks. These disappeared after treatment with alkaline phosphatase and were thus assigned as phosphates. The principal metabolite had the same retention time as D-3FDG-6 phosphate prepared with hexokinase. No phosphorylated metabolites were detected in blood. D-3FDG labeled with 18F may be a useful tracer in studies of glucose transport and metabolism. PMID- 6496757 TI - Role of acidosis in early contractile dysfunction during ischemia: evidence from pHo measurements. AB - To investigate the contribution of acidosis to contractile dysfunction during early myocardial ischemia, miniature intramyocardial pH electrodes (0.2 mm tip diam) were used to correlate changes in extracellular pH (pHo) with tension in the isolated arterially perfused rabbit interventricular septum. A number of findings argue against acidosis as the major cause of contractile failure during early ischemia. During hypoxia without glucose present, the rate and pattern of tension decline was very similar to total ischemia, suggesting that a common mechanism is involved. Throughout the initial period in which tension declined by 50%, however, pHo increased in the six of eight preparations during hypoxia without glucose. During hypoxia with glucose present, tension fell less rapidly than during hypoxia without glucose despite a significantly greater fall in pHo in the former case. The maximal rate of relaxation (-dT/dt) was markedly more sensitive to ischemia, hypoxia, or exposure to inhibitors of aerobic metabolism (2,4-dinitrophenol and Na azide) than the maximal rate of force development (+dT/dt). In contrast, +dT/dt and -dT/dt decreased almost symmetrically during exposure to respiratory acidosis. During ischemia, the change in pHo associated with 50% reduction in tension was 0.11 +/- 0.04 units. During respiratory acidosis, this value was 0.45 +/- 0.02 units. From these observations we concluded that acidosis is unlikely to be a major factor in the early decline of tension during ischemia. PMID- 6496758 TI - End-systolic pressure-length relations during changes in regional contractile state. AB - End-systolic pressure-length relationship (ESPLR) was examined in the heterogenously contracting heart in open-chest dogs. Regional length was measured sonomicrometrically in the areas of both the left circumflex coronary artery (LCX) and left anterior descending coronary artery (LAD). ESPLR was linear during a transient reduction in arterial pressure following occlusion of the inferior caval vein (IVC). In group 1 (12 dogs), saline as a control condition (Cont) and isoproterenol (Iso, 0.05 microgram/min) to enhance the regional contractile state were infused into the LCX. Percent shortening in the LCX area increased from 13 to 16% (P less than 0.01) in Iso. The slope (Ees) of ESPLR increased from 57 to 71 mmHg/mm (P less than 0.01) in Iso. The extrapolated X-axis intercept (Lo) of ESPLR was unchanged. In the LAD area, Ees and Lo remained constant. In group 2 (13 dogs), lidocaine (1 mg/min, Lid 1; 5 mg/min, Lid 5) was infused into the LCX to induce mild and severe hypokinesis, respectively. Percent shortening in the LCX area was reduced from 14 to 8% (P less than 0.01 vs. Cont) in Lid 1 and 5% (P less than 0.01 vs. Cont, P less than 0.05 vs. Lid 1) in Lid 5. Ees tended to decrease in Lid 1 but to increase in Lid 5 (statistically not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496759 TI - Filtration through damaged and undamaged rabbit thoracic aorta. AB - The influence of luminal pressure and endothelial removal on fluid filtration across the arterial wall has been studied in the rabbit thoracic aorta. Segments of aorta were excised in such a way as to prevent shortening and depressurization and were filled with a 4% albumin-Tyrode solution. Experiments were carried out at two controlled pressure levels (70 and 180 mmHg). The hydraulic conductivity (Lp) of the total wall, calculated from the filtration data, was 4.00 +/- 1.31 and 2.44 +/- 0.80 (SD) X 10(-8) cm/(s X mmHg) in intact wall at 70 and 180 mmHg, respectively (P less than 0.01), whereas values for deendothelialized arteries were higher (P less than 0.01), being 5.36 +/- 1.62 and 5.27 +/- 0.84, respectively. The apparent pressure dependence of conductivity of the intact wall may be due to altered strain of the interstitial matrix. Removal of the endothelium can increase the hydration and porosity of the medial interstitium but, assuming that the conductivity of the deendothelialized wall at 70 mmHg is the same as that of the normal media, the calculated conductivity of the endothelium is 15.76 X 10(-8) cm/(s . mmHg). PMID- 6496760 TI - Decreased defibrillator-induced dysfunction with biphasic rectangular waveforms. AB - High-intensity electric shocks used for cardiac defibrillation produce arrhythmias, S-T segment changes, and a low percent success in situ. Cultured myocardial cells exhibit similar postshock arrhythmias that are caused by a prolonged depolarization of the cell membrane. Since this dysfunction is ameliorated by biphasic RLC-type waveforms, we examined rectangular biphasic waveforms to maximize this beneficial effect and clarify the dysfunction-inducing mechanism. Cultured myocardial cells were subjected to electric field stimulation with monophasic 5-ms rectangular waveforms of about 80 V/cm to produce a postshock arrest of contractile activity lasting 4 s. Shocks given with this control waveform were alternated with biphasic test waveforms having the same initial portion followed by negative "tails" 1-100 ms in duration and 5-100% of the initial positive portion in amplitude. Results from 31 biphasic waveforms demonstrated significant alterations in postshock dysfunction. Waveforms with up to 10% undershoot and ranging from 5 to 100 ms in duration decreased arrest time by up to 50%; waveforms with greater than 20% undershoot led to protracted postshock arrest times. These results strengthen the hypothesis that electromechanical breakdown of the myocardial cell membrane underlies postshock dysfunction and show that biphasic waveforms with low amplitude tails ameliorate this dysfunction. PMID- 6496761 TI - Contribution of sodium to the mechanism of one-kidney, renal-wrap hypertension. AB - The early and chronic stages of one-kidney, figure-8 renal-wrap hypertension were studied during low or normal dietary sodium intake in rats. The renal-wrap procedure caused a significant elevation in arterial pressure at 3 and 28 days postwrap with normal sodium diet. Sodium-depleted rats did not experience an increased arterial pressure following renal wrapping. Blockade of angiotensin II receptors with [Sar1-Ala8]angiotensin II caused a greater decrease in arterial pressure in the sodium-depleted, renal-wrapped animals compared with sham operated rats. In sodium-replete rats, angiotensin receptor blockade did not lower arterial pressure. Total ganglionic blockade decreased arterial pressure significantly more in the wrapped animals than in the sodium-replete sham operated rats and the wrapped or sham-wrapped, sodium-deplete animals. Thus the early and chronic phases of normal sodium, one-kidney, figure-8 renal hypertension are supported by an increased sympathetic nervous system function. These observations suggest that sodium is necessary for the development of one kidney, figure-8 renal-wrap hypertension and that the presence of sodium in the diet permits a functional activation of the sympathetic nervous system in response to the renal-wrap procedure. PMID- 6496763 TI - Acute resetting of carotid sinus baroreceptors. I. Dissociation between discharge and wall changes. AB - The purpose of this study was to assess whether mechanical changes in the carotid sinus wall could account for acute resetting of the carotid sinus baroreceptors in chloralose-anesthetized dogs. Threshold pressure and pressure-discharge curves for single-unit baroreceptors were determined before and after the vascularly isolated carotid sinus was exposed to brief increases or decreases in base-line pressure. When intrasinus pressure was increased by 30 mmHg for 15 min, threshold pressure increased by 9 +/- 1.3 (SE) mmHg (n = 12), and when intrasinus pressure was decreased by 30 mmHg threshold pressure decreased by 14 +/- 4.2 mmHg (n = 9), with no change in gain of the pressure-discharge curves. In 14 experiments carotid sinus pressure was increased from 70 (control) to 160 mmHg for only 5 min (reset) and returned to 70 mmHg for 10 min (recovery). After exposure to the higher pressure, threshold pressure increased from 75 +/- 3.8 to 94 +/- 4.4 mmHg, and carotid sinus diameter (sonomicrometer) and calculated wall strain at each pressure increased. After the recovery period, baroreceptor threshold pressure returned to 75 +/- 4.1 mmHg, but diameter and wall strain remained elevated. We interpret our finding that baroreceptor resetting and recovery are not accompanied by reciprocal changes in carotid sinus diameter to indicate that a mechanical mechanism alone cannot explain acute resetting. PMID- 6496762 TI - Effects of dipyridamole on myocardial adenosine and active hyperemia. AB - Dipyridamole, a vasodilator that potentiates the actions of exogenous adenosine, is known to inhibit cellular uptake of adenosine, but its effects on cellular adenosine release, and thus interstitial adenosine levels, are disputed. We used the accumulation of adenosine in pericardial infusates (PCI) as an index of interstitial adenosine concentration and observed the effects of dipyridamole on relationships among coronary blood flow (CBF), myocardial oxygen consumption (MVO2), and PCI adenosine concentrations during steady-state alterations of cardiac work. Dipyridamole increased CBF and PCI adenosine concentration without altering MVO2. The relationship between PCI adenosine and CBF was unaltered, supporting a cause and effect relationship between interstitial adenosine concentration and CBF. In addition, we determined that unlike previous studies in isolated perfused hearts the washout of adenosine by coronary plasma was unaffected by dipyridamole. The results support previous suggestions that, whereas dipyridamole inhibits adenosine uptake, it does not alter cellular adenosine release, and therefore interstitial adenosine levels are increased. The constant relationship between PCI adenosine and CBF supports hypotheses that attribute the hyperemias associated with increased cardiac work or with dipyridamole to increased interstitial adenosine. PMID- 6496764 TI - A hermetically sealed cardiac dimension transducer for long-term animal implantation. AB - Pulse transit sonomicrometry is a well-accepted method for assessing cardiac dimensions and function in research animals. Unfortunately, this technique has been hampered in chronic applications by a significant incidence of transducer failure secondary to leakage of corrosive biological fluids into the piezoelectric material. The fluid leakage generally occurred at the interface between the encapsulating epoxy and the bioelectric cable and resulted in progressive functional deterioration with time. In this paper, a new hemispheric ultrasonic dimension transducer is described with a mechanical hermetic seal at the bioelectric cable-transducer interface. The hermetically sealed transducers withstood 400 psi compressed air without leakage, while conventional transducers routinely leaked at 60 psi. The performance characteristics of the new transducers were similar to those previously reported with omnidirectional designs, and no failures have occurred during 3 yr of experience with repeated transducer implantations. PMID- 6496765 TI - O2 reserve of left ventricle of isolated, saline-perfused rabbit heart. AB - The heart from the pentobarbital-anesthetized rabbit was isolated, and a fluid filled balloon was placed in the left ventricular chamber for assessment of isovolumic pressure development. The bicarbonate-buffered, physiological perfusate was aerated initially with 95% O2-5% CO2, and then progressive decreases in arterial O2 content (CaO2) were produced in a stepwise fashion by substituting N2 for O2 in the aerating gas mixture. If, for a specified set of experimental conditions, no change in ventricular function occurred after the initial decrease in CaO2, it was concluded that the heart was oxygenated adequately prior to the first CaO2 decrement. Accordingly, with perfusate flow constant at 35 ml/min, adequate oxygenation was achieved during aeration of perfusate with 95% O2 when ventricular contraction rate was 30 beats/min and temperature (T) 22 degrees C. The preparation may have been just marginally O2 sufficient when rate was 60 beats/min (T, 25 or 30 degrees C), but probably was hypoxic when contraction rate was 120 beats/min (T, 30 or 37 degrees C). Perfusion with pressure kept constant at 80 mmHg did not appear to alleviate this hypoxia when metabolism was elevated (rate, 120 beats/min; T, 37 degrees C). Thus, unless the contraction rate is very low, the addition of an O2-carrying vehicle to the perfusate appears to be necessary if O2 delivery to the isolated rabbit heart preparation is to be supramaximal. PMID- 6496766 TI - Persistent coronary vasodilation during long-term, supramaximal doses of adenosine. AB - Active and reactive hyperemias have been observed in the skeletal muscle circulation tachyphylactic to exogenous adenosine following 3-h supramaximal doses of the vasodilator. These findings failed to support a need for adenosine in metabolic control of skeletal muscle blood flow. The present study was conducted to determine if the coronary circulation also develops tachyphylaxis to adenosine while remaining sensitive to other metabolically linked vasodilator mechanisms. Experiments were conducted in eight pentobarbital-anesthetized, open chest dogs whose blood flow in the left anterior descending coronary artery (LAD) was measured electromagnetically during 3-h infusion of adenosine into the LAD. Measurements of regional myocardial blood flow (radioactive microspheres), myocardial O2 consumption (Fick principle), and percent segment shortening (ultrasonic crystals) were also obtained. Adenosine was infused into the LAD at a rate of 27.0-72.0 mumol/min, depending on blood flow rate. Calculated concentration of adenosine in LAD blood averaged 0.484 +/- 0.111 mumol/ml, which was well in excess of that required for maximal coronary vasodilation. LAD blood flow averaged 21.5 +/- 2.2 ml/min during the preadenosine control condition. LAD blood flow after 3 h adenosine (123.3 +/- 23.0 ml/min) was not significantly different from that after 1-3 min adenosine (105.8 +/- 17.9 ml/min). There was no significant transmural variation in LAD blood flow during adenosine infusion. Adenosine had no significant effect on myocardial O2 consumption or percent segment shortening. Our results demonstrate persistent transmural vasodilation in the canine coronary circulation during long-term, supramaximal doses of adenosine and are consistent with a role for endogenous adenosine in maintenance of coronary vasodilation during sustained elevations in myocardial energy demands. PMID- 6496767 TI - Fetal whole-body interstitial compliance, vascular compliance, and capillary filtration coefficient. AB - Fluid movements across the capillary wall were studied in chronically catheterized, near-term fetal sheep. We hemorrhaged 15 fetuses and infused isotonic saline in seven fetuses. The average experimental changes in arterial pressure, venous pressure, and blood volume were then analyzed by using mathematical modeling and parameter optimization techniques to estimate mean values for the average whole-body interstitial and vascular compliances of the fetus and for the average whole-body fetal capillary filtration coefficient. After fetal hemorrhage, interstitial compliance averaged 45 ml X mmHg-1 X kg-1 of fetal weight and vascular compliance averaged 3.0 ml X mmHg-1 X kg-1, whereas the capillary filtration coefficient averaged 0.4 ml X min-1 X mmHg-1 X kg-1. For intravenous saline infusions, interstitial compliance averaged 45 ml X mmHg-1 X kg-1, and vascular compliance averaged 3.5 ml X mmHg-1 X kg-1, whereas the capillary filtration coefficient averaged 0.8 ml X min-1 X mmHg-1 X kg-1. These data suggest that the fetus has a high whole-body interstitial compliance and a high capillary filtration coefficient compared with the adult. In addition, it appears that the fetus has the ability to decrease its vascular compliance and capillary surface area after a fetal hemorrhage. PMID- 6496768 TI - Kinetics of intravenous saline infusion and selective IgG removal in rabbits. AB - Selective removal of approximately 60% of the plasma immunoglobulin G (IgG) mass in conscious rabbits was studied and compared with similar procedures combined with intravenous saline infusions equal to 7.5% body weight. Plasma concentrations of 125I-IgG and endogenous IgG were employed in model analysis to examine if saline infusions could be used to shift IgG from extra- to intravascular pool, thereby making more protein available for removal by extracorporeal plasma treatment. After IgG removal, the fractional metabolic clearance and the extra- to intravascular transfer coefficient were 40-50% lower than before IgG removal, and model simulations indicated that this may be caused by IgG binding. Saline infusion resulted in 40% more IgG mass in plasma 24 h after treatment compared with procedures without saline. Model analysis indicated that the increased IgG mass in plasma after saline procedures could be explained by a three- to fourfold increase in lymphatic clearance. Crystalloid infusions may be a method to increase the efficacy of repeated plasma exchange treatment. PMID- 6496769 TI - Hepatic handling of pancreatic glucagon and glucose during meals in rats. AB - Prandial changes in plasma pancreatic glucagon, blood glucose, and liver glycogen levels were studied during the first meal after 12 h of food deprivation in rats. To determine whether pancreatic glucagon secretion is influenced by the composition of the diet, the experiments were performed in rats fed high carbohydrate (HC), high-fat (HF), or high-protein (HP) diets. Plasma glucagon levels in the hepatic portal vein increased about 100% during meals in all feeding groups, whereas glucagon levels in the hepatic vein changed very little. Blood glucose concentration in the hepatic portal vein increased during meals in HC diet-fed rats but decreased in HF and in HP diet-fed rats. Blood glucose in the hepatic vein also increased in HC and HP diet-fed rats. In addition, liver glycogen content decreased during meals in HC and HP diet-fed rats and by 14 min after the meal in HF diet-fed rats. These results demonstrate that a considerable amount of the glucagon released during meals in HC, HF, and HP diet-fed rats remains in the liver. This is consistent with the hypothesis that the liver is important for the satiety effect of glucagon. The results also suggest that glucagon contributes to the meal-induced changes in hepatic carbohydrate metabolism observed in all groups. PMID- 6496770 TI - Regulation of metabolic rate in Svalbard and Norwegian reindeer. AB - Food intake, body weight, serum levels of triiodothyronine (T3) and free thyroxine (FT4), and metabolic rate were measured at intervals in Svalbard (SR) and Norwegian (NR) reindeer. From summer to winter food intake decreased 57 (SR) and 55% (NR), while body weight decreased 8.6 (SR) and 3.8% (NR). In SR T3 and FT4 changed seasonally, whereas this was only evident for T3 in NR. Resting (standing) metabolic rate (RMR) in winter was 1.55 (SR) and 2.05 W X kg-1 (NR), lower critical temperature (TLC) being -50 (SR) and -30 degrees C (NR). RMR in summer was 2.15 (SR) and 2.95 W X kg-1 (NR), TLC being -15 (SR) and 0 degrees C (NR). Seasonal changes in T3 and FT4 did not coincide with changes in food intake or RMR in either SR or NR. RMR did, however, correlate with food intake. This indicates that seasonal changes in RMR are due to the thermic effects of feeding and represent no physiological adaptation aimed at conservation of energy during winter. PMID- 6496771 TI - Quantitation of reticuloendothelial iron kinetics in humans. AB - Reticuloendothelial iron kinetics were investigated in a simultaneous dual isotope study in 10 healthy adult subjects in whom 55Fe-ferric hydroxide phosphate colloid was used to label the reticuloendothelial iron pools, and 59Fe transferrin was used to define plasma iron kinetics. The simultaneous clearance of 55Fe and 59Fe from plasma and the uptake of each into red blood cells were measured over 14 days. The 55Fe-colloid was cleared almost immediately, and its iron was rapidly released to bind to plasma transferrin. Red cell incorporation of 55Fe was, however, much slower than that of 59Fe bound to transferrin in vitro. The data were analyzed by a new model of reticuloendothelial iron metabolism that contained two reticuloendothelial iron pools; one had a rapid turnover and donated iron to transferrin, and the other, a storage pool, had a slower turnover. The transit pool contained a mean of 164 mumol iron with little variation between subjects, whereas the storage pool was somewhat larger (mean 873 mumol iron) and showed more marked variation between subjects. In general an equal proportion of the iron leaving the transit pool went to transferrin and to the storage pool. The distribution between the two routes did not appear to be related either to plasma iron concentration, latent iron-binding capacity, or transferrin saturation. PMID- 6496772 TI - Ultradian glucocorticoid rhythms in monkeys and rats continue during stress. AB - Previously we showed that rhesus monkeys have ultradian cortisol rhythms with periods of about 90 min that persist during the infusion of large amounts of adrenocorticotropin. The experiments reported here showed that rats exhibit ultradian corticosterone rhythms with a similar period (median period 61 min). However, rat ultradian corticosterone rhythms were distorted by large slow trends that had to be removed before the rhythm could be adequately assessed. The need for sophisticated trend removal suggests that physiological variables that have been described as exhibiting episodic fluctuations (e.g., human cortisol) may actually be periodic and ultradian. The ultradian glucocorticoid rhythm persisted during stress both in monkeys (median period 80 min) and rats (median period 52 min). However, the glucocorticoid stress response appeared to produce large slow trends in both monkeys and rats, indicating that environmental influences may introduce slow trends that make raw data difficult to evaluate. More importantly, the fact that ultradian glucocorticoid rhythms persist during stress provides further evidence of limits on the classical concept that glucocorticoid secretion is tightly and inseparably linked to hormonal events in the hypothalamic pituitary unit. PMID- 6496773 TI - Should blood transport kinetics be modeled in metabolic processes? AB - We analyze the interaction between blood transport phenomena and uptake processes when drug kinetics are studied with compartmental models. Relevant advantages in the physiological interpretation of the model parameters are obtained when blood transport is explicitly included in the model. This is done by aggregating into a single compartment all the blood spaces where no exchange with extravascular spaces takes place and separating into different blood compartments those spaces where some uptake and/or return occurs. The proposed strategy extensively uses all available a priori information about the physiological system, instead of considering only the information available in the measurements. This modeling approach has three main advantages: it provides greater insight into the identified quantities; it allows the introduction of quantitative a priori information; and it facilitates the experiment design task. PMID- 6496774 TI - Pentobarbital anesthesia suppresses basal and 2-deoxy-D-glucose-stimulated plasma catecholamines. AB - Since pentobarbital anesthesia is known to attenuate certain autonomic reflexes, we tested whether pentobarbital would suppress both basal and stimulated levels of plasma catecholamines and whether a large stimulus might counterbalance this suspected suppression. In untrained dogs, sampled by venipuncture, pentobarbital (30 mg/kg iv) decreased the plasma concentration of epinephrine (E) from 146 +/- 9 to 38 +/- 8 (SE) pg/ml (n = 46) and norepinephrine (NE) from 276 +/- 13 to 91 +/- 10 pg/ml (both P less than 0.0005), suggesting that barbiturate anesthesia suppresses sympathetic outflow in these mildly stressed animals. Pentobarbital also had a marked suppressive effect on the lower baseline catecholamines (E, 84 +/- 14 pg/ml; NE, 118 +/- 10 pg/ml; n = 6) of trained, chronically catheterized dogs, suggesting that it was capable of suppressing resting sympathetic outflow as well. To determine whether pentobarbital anesthesia also suppressed reflex activation of the sympathetic nervous system, the plasma catecholamine response to the neuroglucopenic agent, 2-deoxy-D-glucose (2-DG), was measured in conscious and in pentobarbital-anesthetized dogs. In conscious dogs, the administration of 2-DG (100 mg/kg iv) doubled the base-line plasma concentration of E and NE 30 min after the 2-DG injection. In contrast, the administration of 2-DG (100 mg/kg iv) to pentobarbital-anesthetized dogs produced no significant increase of either plasma catecholamine, suggesting marked suppression of this sympathetic reflex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496775 TI - Scapular brown fat removal enhances development of adiposity in cold-exposed obese Zucker rats. AB - To investigate the contribution of brown fat (BAT) to the development of obesity in genetically obese Zucker rats (fa/fa), scapular brown fat (SBAT) was removed from obese and lean 4-wk-old females. Eight weeks after surgery there was no regrowth of SBAT. Lipectomy had no effect on body weight gain, food intake, and body composition when rats were housed at 25 degrees C. Lean rats completely compensated for the lipectomy by increasing BAT mass, protein, cellularity, and activity of citrate synthase (CS) in axillary, perirenal, and thoracic depots. beta-Hydroxyacyl-coenzyme A dehydrogenase (HOAD) activity was increased, but compensation was incomplete. In lipectomized obese rats, only BAT protein and cell number were increased sufficiently for complete compensation. In a second experiment SBAT was removed from obese and lean rats, but rats were housed in the cold (10 degrees C) for 8 wk. In lean rats, although compensation was incomplete, it was sufficient to maintain a weight gain and body composition comparable with sham-operated lean rats. In obese rats, where there was little or no compensation for lipectomy, weight gain and fat deposition were greater than observed in sham operated obese controls. These data support the hypothesis that reducing the amount of functional BAT contributes to the development of increased adiposity. PMID- 6496776 TI - Homeostatic capability of rate-sensitive feedback system: mathematical model. AB - We have predicted the mathematical model of rate-sensitive feedback control system and have investigated its homeostatic capability by using computer simulations. The results are summarized as follows. By installing a cyclic enzyme system as feedback control element, we could assume the rate-sensitive feedback system at molecular level. This type of feedback had realistic constant-value control capability for external perturbations. This feedback system was more effective for the exclusion of perturbation than was the concentration-sensitive feedback. A large-loop feedback was more stable for perturbation than was short loop feedback. In sequential feedback system, every key enzyme sensitive to feedback control had to vary the activity at same time for the system to keep homeostasis. PMID- 6496777 TI - Nuclear death: an unprecedented challenge to psychiatry and religion. AB - The growing danger of a nuclear holocaust has intensified two aspects of the human predicament that concern both religion and psychiatry: the inevitability of death and the disastrous consequences of the characteristic termed "pride" by theologians and "narcissism" by psychiatrists. For the first time, humans have power to exterminate themselves and death threatens all ages equally. Pride of power causes leaders to exaggerate their ability to control nuclear weapons; moral pride leads to demonizing enemies. The author considers implications for psychiatrists and clergy, with special reference to preventing a nuclear holocaust. PMID- 6496778 TI - Medical, judicial, and statutory regulation of ECT in the United States. AB - The standards for ECT recommended by an APA task force report and those embodied in federal court orders and state statutes and regulations are compared. The authors conclude that there is serious boundary and role confusion owing to progressive intrusion of state authority into areas traditionally held to lie in the domain of medical judgment and clinical care. In spite of comprehensive safeguards promulgated by the psychiatric community, overregulation by legislatures and courts is commonplace, interposing law between physicians and patients and resulting in delays or denials of service while failing to resolve critical legal issues involving competence and consent. PMID- 6496779 TI - A new rating scale for Alzheimer's disease. AB - A new rating instrument, the Alzheimer's Disease Assessment Scale, was designed specifically to evaluate the severity of cognitive and noncognitive behavioral dysfunctions characteristic of persons with Alzheimer's disease. Item descriptions, administration procedures, and scoring are outlined. Twenty-seven subjects with Alzheimer's disease and 28 normal elderly subjects were rated on 40 items. Twenty-one items with significant intraclass correlation coefficients for interrater reliability (range, .650-.989) and significant Spearman rank-order correlation coefficients for test-retest reliability (range, .514-1) constitute the final scale. Subjects with Alzheimer's disease had significantly more cognitive and noncognitive dysfunction than the normal elderly subjects. PMID- 6496780 TI - Biopsychobehavioral correlates of insomnia, V: Clinical characteristics and behavioral correlates. AB - The authors compared two large samples of insomniac patients with a group of control subjects. Sleep difficulty usually began before the age of 40 and generally persisted for many years (average duration, 14 years). Several characteristic behaviors were correlated with the symptom of insomnia. During the day and at bedtime, patients reported difficulty relaxing and frequently described themselves as tense, anxious, overly preoccupied, worried, and depressed. Reports of poor mental and physical health were far more prevalent in the insomniac patients than in control subjects. These results indicate that psychiatric factors need to be a primary focus in the multidimensional treatment of chronic insomnia. PMID- 6496781 TI - The impact of object relations theory on psychodynamic group therapy. AB - Object relations theory is seen as a conceptual framework that adds to the classical Freudian structural theory. The synchrony between the two theories is manifest in psychodynamic group psychotherapy. This paper explores the convergence of these theories, emphasizing concepts from object relations theory and focusing on three major aspects as they appear in therapy groups: the evolution of the transference neurosis, group membership as a transitional phenomenon, and group therapy for the resolution of ego-syntonic character pathology. Examples of patients emerging from schizoid to paranoid and then to depressive positions of ego organization illustrate the concepts. PMID- 6496782 TI - The syndrome of identity diffusion. AB - The author delineates the syndrome of identity diffusion as consisting of six clinical features: 1) contradictory character traits, 2) temporal discontinuity in the self, 3) lack of authenticity, 4) feelings of emptiness, 5) gender dysphoria, and 6) inordinate ethnic and moral relativism. This syndrome implies severe character pathology and is distinct from adolescent identity crisis. The conceptualization has a significant bearing on the differential diagnosis and psychotherapy of personality disorders. PMID- 6496783 TI - Families of borderline patients: literal-minded parents, borderline parents, and parental protectiveness. AB - While borderline personality disorder is a well-established psychiatric diagnosis, less is known about family functioning and interactional patterns in subjects with the disorder. The authors describe interactional patterns in families of borderline children where one parent has a severe personality disorder and the other fails to protect the child adequately against the effects of that psychopathology. Two types of parents are described: the literal-minded parent and the borderline parent. The literal-minded parent resembles an alexithymic patient, lacking the ability to empathically understand and respond to the child's feelings and needs. The borderline parent uses the child as the target of projections and reality distortions. Therapy should mobilize the active protective functions of the healthier parent. PMID- 6496784 TI - ECT: please, no more regulations! PMID- 6496785 TI - Anorexia nervosa and affective disorders: a controlled family history study. AB - Analysis of family history information from a prospectively studied group of 40 young female patients with anorexia nervosa and 23 normal control female subjects of similar age showed more depression and substance use disorders in first- and second-degree relatives of anorexia nervosa patients. Further, the pedigrees of the patients differed significantly from those of the control subjects in the higher frequency of depression and substance use disorders in consecutive generations and in the family "loading" of these disorders. These findings, consistent with previous reports, add to the growing evidence of an association between anorexia nervosa and familial risk for affective and related disorders. PMID- 6496786 TI - Clinical findings in patients with anorexia nervosa and affective illness in their relatives. AB - The most prevalent psychiatric disorders in the families of patients with anorexia nervosa are bipolar and unipolar major affective disorder. The presence of affective disorder, self-induced vomiting, or bulimia in the patient is not predictive of affective illness in the relatives. Thus these features do not define genetic heterogeneity within anorexia nervosa. There may be genetic factors shared between anorexia nervosa and affective disorders. PMID- 6496787 TI - Organic affective illness associated with lead intoxication. AB - Psychiatrists treating patients with depression or nonspecific somatic complaints seldom think of lead intoxication as a possible cause. Because occupational exposure to lead is so common, these disturbances may often be associated with lead intoxication. To facilitate earlier clinical recognition and proper treatment among the many individuals at risk, the authors describe four cases of organic affective disturbance associated with lead intoxication, review the neuropsychiatric disturbances that have been reported with chronic exposure to lead, and report the results of their experience evaluating the psychiatric aspects of lead intoxication among individuals exposed in their work. PMID- 6496788 TI - Cholinergic receptor binding in the frontal cortex of suicide victims. AB - Muscarinic binding sites were assessed in the frontal cortex of 22 suicide victims and 22 control subjects. There were no significant differences between the two groups in either the number of binding sites (Bmax) or their relative affinity (Kd). The results of this study are discussed in reference to the cholinergic hypothesis of affective disorders. PMID- 6496789 TI - The dexamethasone suppression test and depressive symptoms in early and late withdrawal from alcohol. AB - Results of the dexamethasone suppression test (DST) in 30 alcoholic patients tested on day 5 and again on day 25 after their last drink are presented. Nineteen patients (63%) failed to suppress cortisol on day 5; three (11%) failed to suppress cortisol on day 25. Depressive symptoms, measured by the Beck Depression Inventory, were significantly correlated with DST results; the lifetime diagnosis of depressive illness was not. The authors conclude that the DST is not useful in detecting primary affective disorders during the early phase of withdrawal from alcohol. PMID- 6496790 TI - Consumer evaluation of a community mental health service, II: Perceptions of clinical care. AB - Using patient self-report and therapist questionnaires, the authors investigated the perceptions of patients at a community mental health service about several aspects of their clinical care: what they expected from treatment, what they found helpful about treatment, how they thought treatment could be improved, their therapist preferences, and their perceptions of their treatment outcome. The patients' desire for advice and the perceived helpfulness of the advice given in therapy, the patients' limited preference for a therapist of their own ethnicity, and other findings are discussed, as is the usefulness of such consumer evaluations in mental health care delivery. PMID- 6496791 TI - Bereavement after homicide: a descriptive study. AB - The act of homicide specifically influences the clinical presentation of subsequent bereavement. Retrospective reports of 15 individuals who lost a relative through homicide revealed cognitive, behavioral, and affective reactions associated with the homicide. Several of these reactions match those described in the DSM-III diagnosis of posttraumatic stress disorder, chronic or delayed type. The identification of bereaved individuals with the homicide and the therapeutic implications of bereavement after homicide are discussed. PMID- 6496792 TI - Meningeal cryptococcosis misdiagnosed as a manic episode. AB - A 63-year-old man had symptoms and a history suggestive of a manic episode. Meningeal cryptococcosis with normal pressure hydrocephalus was later found to be the underlying cause. Antifungal treatment resulted in sustained improvement of all mental functions. PMID- 6496793 TI - Glucose tolerance testing in panic disorder. AB - Seven of nine patients with panic disorder given a standard glucose tolerance test developed symptomatic hypoglycemia but not panic attacks. These findings suggest that hypoglycemia is an unlikely cause of "spontaneous" panic attacks in this population. PMID- 6496794 TI - The dexamethasone suppression test in organic affective syndrome. AB - Of six patients with a DSM-III diagnosis of organic affective syndrome, four exhibited cortisol nonsuppression on the dexamethasone suppression test (DST). Three nonsuppressors were retested after successful treatment and before discharge; two had normal DSTs, and the other patient's DST normalized after discharge. PMID- 6496795 TI - Depression in the spouses of demented patients. AB - The authors present three cases of depression requiring hospitalization in spouses of patients with progressive dementia. They discuss the stress of caring for demented people and the need for clinicians to inquire about depressive symptoms in care givers. PMID- 6496796 TI - Outcome study of familial and nonfamilial alcoholism. AB - Among 2,215 male Navy alcoholic inpatients, a higher number of alcoholic first degree relatives correlated significantly with poorer treatment outcome, measured by follow-up reports of job performance from their commands over 2 years. PMID- 6496797 TI - Complete heart block following a single dose of trazodone. AB - Forty minutes after receiving a single starting dose of trazodone, a patient developed complete heart block. The case illustrates that, despite the results of earlier studies, trazodone's effect on cardiac conduction may be severe in individuals at risk for conduction delay. PMID- 6496798 TI - Trazodone administration during ECT associated with cardiac conduction abnormality. PMID- 6496799 TI - Cognitive, psychotic, or educational impairment in schizophrenia? PMID- 6496800 TI - Conduct disorder as a valid diagnosis. PMID- 6496801 TI - More on compassion and competency. PMID- 6496802 TI - Questions unanswered in article on DST in adolescents. PMID- 6496803 TI - Other determinants of therapeutic modality choice. PMID- 6496804 TI - Depression is not obsessive-compulsive disorder. PMID- 6496805 TI - Care needed in counting inpatient episodes. PMID- 6496806 TI - Two case reports of mazindol-induced depression. PMID- 6496807 TI - Facilitation of length discrimination using real and imaged context frames. AB - In the first experiment we showed that difficult length discriminations can be facilitated by imagining a visual context frame that serves to emphasize small length differences between pairs of horizontal and vertical lines. This facilitative effect of imagery cannot be attributed to response-bias or expectancy effects because we have separated the object to be imagined from the objects to be discriminated. In the second experiment we showed that real context facilitates the line-length discrimination in much the same way as imagined context does. The results from these experiments suggest that (a) functional interactions can occur between imagery and perception at feature-processing levels of the visual system, and (b) there is a functional equivalence between the imagination and perception of helpful context. Results of a third experiment suggest that although imagery and perception may be functionally equivalent at the levels of visual processing where parts of patterns are combined, they are not functionally equivalent at the lower levels of simple detection. PMID- 6496808 TI - Direct estimation considered within a comparative judgment framework. AB - Two experiments that employed the dimension of line length were conducted to support an interpretation of direct estimation within the framework of comparative judgment. It was reasoned that because memorial and processing demands increased, decreasing amounts of transmitted information should be found in discrimination, categorization, and estimation tasks when considered in that order. The data of the first experiment supported the prediction. However, external anchors provided to reduce demand in estimation had no apparent effect. A second study did indicate a marginal effect of anchors when subjects were instructed to employ them but, more strikingly, demonstrated that the shape of the psychophysical function was sensitive to the differential labels that accompanied the anchors. Labels derived from a Fechnerian assumption about psychophysical relations produced a Fechnerian function, whereas labels derived from the actual ratio of the stimulus line to the largest line produced a function consistent with Stevens's power law. It was concluded that the evidence favored a view of direct estimation consonant with cognitive interpretations rather than with the idea of a universal psychophysical function. PMID- 6496809 TI - Learning as a function of haptic discriminability among items. AB - In Experiment 1, braille symbols for the letters A-J were found to be more haptically discriminable from one another than braille symbols for the letters K T. In Experiment 2, subjects learned the names for the A-J symbols faster than for the K-T symbols. Experiment 3 demonstrated that faster learning of the names for the A-J than for the K-T symbols is attributable to characteristics of the symbol sets themselves (probably to the discriminability of the items from one another) and not to what they are called. The effects of discriminability on learning in these experiments are similar to those from experiments in which other modalities have been used. PMID- 6496810 TI - An alertness decrement hypothesis of response inhibition to repeatedly presented stimuli. AB - Both inhibitory and facilitative effects of repeated stimulus presentation have been observed. Two-factor theory attributes both kinds of effects to changes in specific components of attention. The theory claims that repeated exposure (a) decreases the alerting capacity of a stimulus and (b) facilitates encoding. The purpose of the present research was to provide further evidence that alertness decrement underlies the inhibitory effects of stimulus repetition. Adults were exposed to 30 presentations of a colored circle prior to performing a choice reaction time (RT) task on which the targets were the familiarized stimulus and a novel stimulus. A warning signal occurred at one of three intervals prior to target onset. It was predicted from the literature on the temporal characteristics of alertness that the relative speed of responding to the familiarized stimulus would vary as a function of the warning signal-target interval. As predicted, responses to the familiarized stimulus were (a) slower than to the novel stimulus at intervals of 0 and 2,500 ms, but (b) faster than to the novel stimulus at 450 ms. The convergence of these findings with the alertness literature suggests an alertness decrement interpretation of response decrements to repeatedly presented stimuli. PMID- 6496811 TI - Effect of blank time on picture recognition. AB - An experiment was conducted to evaluate the effect of blank time between picture presentations on retention of two types of picture information: specific detail information and general visual information. A series of slides of "everyday" scenes was presented, and the blank time between slide presentations was varied. After presentation of the series of slides, memory for specific details and general visual information was probed using a forced-choice testing procedure. Although previous research failed to find blank-time effects using similar stimuli, it was thought that by keeping both slide presentation times and blank times constant within each experimental block, an effect of blank time might be found. The results indicated that retention of both specific details and general visual information was aided by the extra rehearsal opportunity afforded by longer blank times; there was no interaction between the type of information probed and the duration of blank time. It is suggested that because the blank time variable affected retention of specific detail and general visual information equally, the two types of information may be held by a common coding system. PMID- 6496812 TI - The new educational opportunities for public health professionals. PMID- 6496813 TI - Toward a smoke-free society. PMID- 6496814 TI - Factors associated with adolescent use of family planning clinics. AB - Clinic records were reviewed for a sample of 498 adolescent family planning clients to document clinic use patterns. For a subsample of 359 adolescents, relationships are explored between clinic use and contraceptive use, demographic characteristics, social relationships, and contraceptive attitudes. The average adolescent was observed for 15 months and made 3.5 visits to the clinic. Twenty two per cent of the adolescents never returned after an initial visit. Revisits tended to occur in three-month intervals. In the first six months, the probability of making the first revisit was .70; the probability of a second revisit was .45. Adolescents whose visit patterns deviated from the routine clinic protocols were more likely to be inconsistent contraceptive users. The single significant correlate of regular clinic use was the adolescents' satisfaction with their contraceptive methods. Service providers should ensure that adolescents select a suitable contraceptive method and closely follow adolescents whose clinic use patterns deviate from standard protocols. PMID- 6496815 TI - Women's drinking and drinking problems: patterns from a 1981 national survey. AB - A 1981 national survey of women's drinking interviewed 917 women in the general population, stratified on the basis of screening interviews to include 500 moderate-to-heavy drinkers. The survey found no evidence of any major recent increase in women's drinking, and no evidence of unusually heavy drinking among working wives. Adverse drinking consequences and episodes of extreme drinking were most common among women aged 21-34; women who were unmarried, divorced or separated, or cohabiting; and women with frequent drinkers as spouses or companions. Alcohol-related behavior problems and symptoms of alcohol dependence were closely related to levels of alcohol consumption. Among women averaging one ounce or more of ethanol per day, 45 per cent had driven while intoxicated in the past year, and 36 per cent reported memory lapses while drinking. Women at this consumption level were also more likely to report experiences with depression (61 per cent). Women with extremely high consumption levels were more likely to have histories of obstetrical and gynecological problems. Some women with alcohol related problems reported periods of temporary abstention, a pattern not studied heretofore. PMID- 6496816 TI - Occurrence and impact of zoonoses in pet dogs and cats at US Air Force bases. AB - A descriptive epidemiologic study was conducted to quantitate the occurrence of zoonoses in pet animals (almost exclusively dogs and cats) at 30 Air Force bases in nine regions of the United States during 1980 and 1981. Reviews of reported cases of pet-associated zoonoses in humans at these bases were included. Occurrence of a zoonotic disease in dogs and cats was expressed as a ratio of reported cases per 100 rabies vaccinations (cs/Crv). Overall, the four zoonoses reported most frequently from these pets were hookworms, roundworms, tapeworms, and fleas. Annual ratios revealed geographic variations: for example, hookworms in dogs and cats in the southeast ranged from 12.3 to 9.4 cs/Crv; in the northern Great Plains, hookworms ranged from 0.9 to 0.4 cs/Crv. Dermatomycoses in the southeast ranged from 1.3 to 1.1 cs/Crv, and in Alaska from 0.3 to 0.2 cs/Crv. Quarterly zoonoses occurrence revealed seasonal variations in several regions. Reports of zoonoses in people from these bases indicated that five less frequent zoonoses in dogs and cats (Microsporum canis dermatomycosis, fleas, Sarcoptes scabiei var canis, Gram-positive bacterial infections, and rabies) presented greater acute threats to humans than did the four most frequent zoonoses reported from their pets. PMID- 6496817 TI - Resource requirements for evaluating ambulatory health care. AB - We implemented the most frequently used form of quality assurance activity: abstracting information on the quality of patient care from medical records and communicating findings to providers in 16 ambulatory care groups. Site providers accepted the evaluation criteria, agreed that deficiencies in care were detected, and, for some medical tasks, effected improvements in care. Direct costs in 1980 dollars for the quality assurance cycle including data system development were $46 per evaluated case. Per-case costs varied considerably among tasks, decreased with larger numbers of cases and as experience grew, and were reduced through computerization. Measured costs were high due to: a demanding research design; our extended accounting of direct, indirect, and induced costs; and the substantial resource requirements of rigorously performed evaluations. PMID- 6496818 TI - Therapeutic abortions following rubella infection in pregnancy: the potential impact on the incidence of congenital rubella syndrome. AB - In 1977, a large rubella outbreak occurred in Hawaii. Because attack rates were high among women of childbearing age, we conducted extensive surveillance efforts to detect both pregnancies complicated by rubella and cases of congenital rubella syndrome (CRS). Initial surveillance included a survey of physicians and hospitals, review of fetal death and birth certificates, and cord blood screening for rubella-specific IgM of infants born following the epidemic. Two years after the outbreak, the medical community was again surveyed to identify affected children who were missed initially. No case of CRS was identified either shortly after the outbreak or in the ensuing two years. In addition, none of the 5,605 cord serum samples obtained was found to contain rubella-specific IgM antibody. Through active surveillance, we received 12 reports of rubella in pregnant women, of whom 11 elected to terminate their pregnancies. The extensive use of therapeutic abortion by exposed women may have prevented the birth of infants with CRS. Surveillance for rubella-related abortions is an important component in assessing the health impact of rubella in a community. PMID- 6496819 TI - Pneumoconiosis and exposures of dental laboratory technicians. AB - One hundred and seventy-eight dental laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years' grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean values for per cent predicted FVC and FEV1 were reduced among male nonsmoker technicians compared to male nonsmoker controls; after controlling for age, there was also a reduction in spirometry with increasing work-years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Salt Lake City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures in dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis. PMID- 6496820 TI - Feasibility of an Extended MPH Degree Program for fully employed practicing health professionals. AB - This report describes the first four years of operation of the Extended MPH Degree Program of the University of Washington School of Public Health and Community Medicine and the features that might explain its initial success. The format of the curriculum is radically different from the traditional two-year program of studies leading to the master of public health degree. Over a three year span of intensive, on-campus courses and seminars, students are able to fulfill all academic and institutional requirements necessary for the MPH degree. Many more applicants have enrolled for the Extended Degree Program than for the regular MPH program. The 94 students who have matriculated into the program are employed mainly in government agencies in eight western states and British Columbia; most have their prior professional training in nursing and medicine with a median of nine years professional experience. The academic performance of these students is comparable to that of regular full-time MPH program students. The administrative, fiscal, and instructional problems raised by such a transformation have been overcome and the demand for the program and our experience to date suggest that extended MPH degree programs are both feasible and desirable. PMID- 6496821 TI - The role of motor vehicle crashes in causing certain injuries. AB - Hospital discharge data from Rhode Island were used to assess the role of motor vehicle crashes in causing several types of serious injuries. Motor vehicle crashes were the cause of injury for approximately two-thirds of patients hospitalized with injuries to the chest organs, liver, and spleen, and approximately one-third of those with traumatic pneumothorax or hemothorax, and injuries to the head, kidney, intestine, distal femur, pelvis, and patella. PMID- 6496822 TI - Campylobacter enteritis associated with undercooked barbecued chicken. AB - An outbreak of Campylobacter enteritis occurred in 1982 among 11 of 15 members and friends of an extended family gathering in Colorado. Median onset for illness, characterized by diarrhea, abdominal cramps, fever and headache, was four days after the party. Illness was associated with eating undercooked chicken. Two ill persons had stool specimens positive for C. jejuni. Eight of ten ill persons tested had Immunoglobulin-M-specific indirect fluorescent antibody (IFA) titers to C. jejuni greater than or equal to 32. IFA titers to C. jejuni peaked within three weeks of exposure and decreased to control levels within three months after exposure. Inadequate cooking of poultry may increase the risk of these infections. PMID- 6496823 TI - Nurse-midwifery practice in the United States, 1982. AB - During 1982 the American College of Nurse-Midwives conducted a national survey of certified nurse-midwives residing in the United States. About 68 per cent of the 1,584 respondents (response rate 76 per cent) were practicing nurse-midwifery. Most of them were providing prenatal and family planning care. The 937 participants who were conducting deliveries reported that they conducted about 1.8 per cent of the estimated 3,704,000 deliveries which took place in the United States during 1982. PMID- 6496824 TI - The effects of physicians' training and personality on test ordering for ambulatory patients. AB - We studied records of 351 hypertensive patients cared for by 30 internists in private office practice. We correlated the use of outpatient diagnostic tests with personal characteristics of the prescribing physicians. Doctors trained in medical schools with academic orientations used more tests than other physicians. Patterns of use were not strongly related to the number of years since medical school graduation, or physicians "intolerance of ambiguity" as measured by a standard psychological instrument. These findings suggest that certain types of training may predispose physicians to be high testers. PMID- 6496825 TI - Mortality among laundry and dry cleaning workers in Oklahoma. AB - The mortality experience of 440 laundry and dry cleaning workers for the period 1975-81 was analyzed, using Oklahoma death certificate data. Results did not show an overall increase in total cancer, but an elevated risk was found for homicide, lung cancer, and kidney cancer. A decrease in risk was noted for ischemic heart disease and for breast cancer. PMID- 6496826 TI - Post-cesarean section insertion of intrauterine devices. AB - Among 52 women who delivered by cesarean section in a medical center in Beijing, China and had either a Delta Loop or Delta T intrauterine device (IUD) inserted manually through the incision wound, the expulsion rates were significantly lower than among a comparable group of 147 women who both delivered and had the IUD inserted vaginally (4.1 versus 20.5 per 100 women at six months post-insertion). Since the cesarean delivery rate is increasing worldwide, we deem this preliminary finding important for postpartum contraception programs and urge further studies. PMID- 6496827 TI - Why the British courts rejected the American doctrine of informed consent (and what British physicians should do about it). PMID- 6496829 TI - Elbow flexion analysis in Bristow patients. A preliminary report. AB - Seven male nonathletes who had Bristow procedures for shoulder dislocation were analyzed by dynamic electromyography (EMG) and Cybex strength measurement to evaluate the function of elbow flexion. Bilateral strength of elbow flexion also was measured in the 10 controlled subjects to compare the dominant and nondominant arms. The EMG data showed the operated short head of biceps function at low constant intensity, compared with the nonoperated side, while the long head of biceps and brachialis increased their activity. The strength measured by the Cybex demonstrated the elbow flexion on the operated side was not significantly different from the normal group. These data demonstrated that the Bristow procedure reduced the dynamic response of the short biceps which was compensated for by the increase in level of activity of the long heads and brachialis muscle. As a result, normal range of elbow function was restored. Our patients had had intense rehabilitation programs. This appears to be an essential part of the postoperative management to develop the needed compensatory muscle action. PMID- 6496828 TI - Anterior dislocation of the shoulder joint sustained through skiing. Arthrographic findings and prognosis. AB - Over a period of 10 years we have studied 14,952 cases of skiing injuries. Of these, 660 cases (4.5%) were injuries to the shoulder with 291 cases (44.1%) being anterior dislocations of the shoulder. One hundred forty-three cases revealed an initial dislocation (49.1%), and 148 cases were recurrent dislocations (50.9%). We examined the arthrography of the dislocated shoulder in 89 cases. Of these initial dislocations, one-half of the capsular detachment type were redislocated, but no redislocation had occurred in the capsular tear type. In addition, almost all of the recurrent cases were of the capsular detachment type. Thus, through arthrography of the anterior dislocated shoulder, we have been able to discover the mechanism of the dislocation and decide upon the necessary duration and method of fixation of the shoulder after reduction. PMID- 6496830 TI - Osteochondrosis of the humeral capitellum. AB - Seven cases of osteochondrosis of the capitellum occurring in five high performance female gymnasts between the ages of 11 and 13 are presented. Two of the patients were treated by surgical excision of the loose osteochondral fragment in three elbows. Four of the five gymnasts, including the two who underwent surgical treatment, were able to return to full workouts without recurrence of symptoms within the 3 year followup. All conditions in gymnasts were detected after symptoms had presented. A survey of 37 actively competing gymnasts at a nationally known gymnastics academy was performed, including a detailed history and physical examination and radiographic examination. No other cases of osteochondrosis were detected. It was postulated that this condition represents a lateral compression injury because of repetitive valgus overload. Investigation of the capitellar blood supply indicates that the common factors in osteochondrosis of the capitellum are repetitive or prolonged trauma to a vulnerable epiphysis on a basis of vascular interruption. Gymnastics maneuvers require forceful weight-bearing through the upper extremities. Medical personnel and coaches associated with gymnastics need to be aware of the condition of osteochondrosis of the capitellum so that any gymnast who presents with a painful, tender, swollen or locked elbow is appropriately investigated and treated. PMID- 6496831 TI - The snapping hip syndrome. AB - The snapping hip syndrome is a symptom complex characterized by hip pain and an audible snapping of the hip with exercise typically seen in young individuals. "External" and "internal" etiologies have been described, although the "internal" etiology is poorly understood. A clinical, radiographic, and anatomical study of eight patients with this disorder, secondary to an internal etiology, was undertaken to aid in the diagnosis and surgical treatment. Iliopsoas bursography with cineradiography revealed subluxation of the iliopsoas tendon to be an apparent cause of the snapping hip. The anatomy of the hip in relationship to the iliopsoas tendon is defined with the anterior inferior iliac spine, iliopectineal eminence, and lesser trochanter assuming a significant role in the syndrome. An operative approach involving a partial release and lengthening of the iliopsoas tendon, with minimal resection of a lesser trochanteric bony ridge, if involved, is described. PMID- 6496832 TI - Acute anterolateral compartment syndrome secondary to rupture of the peroneus longus muscle. PMID- 6496833 TI - Prophylaxis and management of hamstring muscle injuries in intercollegiate football players. AB - Hamstring muscle strains were responsible for the loss of playing time of a significant number of football players at the University of Nebraska in the early 1970s. After the acquisition of a Cybex II isokinetic dynamometer, the number of injuries was noted to decrease. A retrospective study was performed over the period 1973 to 1982. Players in Group I, from 1973 to 1977, underwent a training program consisting of a supervised winter running program and self-designed year long stretching, running, and weight lifting. Hamstring injuries were managed with rest, ice, and elevation initially and, by the third day, mild running was instituted. On the average, by the 14th day the athlete had demonstrated adequate speed and agility and was allowed to return to action. Group II consisted of players from the 1978 to 1982 period. These players received supervised winter running programs and staff-designed year-long stretching, running, and weight lifting programs. In addition, all athletes had baseline testing of hamstrings and quadriceps. Deficits were corrected to a desired ratio of 0.60. Injured players in Group II were treated with rest, ice, and elevation initially. High speed isokinetic workouts were begun on the third day with testing on the fifth day. They were allowed to begin jogging when the peak torque of hamstrings equaled 70% of baseline. Players returned to action when peak-torque reached a level of 95% of the baseline score or a hamstrings:quadriceps ratio of 0.55 or greater. Average time out of action was 2 weeks.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496834 TI - Knee stability in orthotic knee braces. AB - The ability of six commercially available orthotic knee braces to stabilize ligamentous injuries of the knee was evaluated using fresh cadaver specimens. Anterior, valgus, and rotational forces were applied to the intact knee, after the anterior cruciate and medial collateral ligaments were cut, and after application of the knee braces. Bony displacement was measured using half pins and an external fixator applied to the tibia and femur. There was a significant difference in brace performance, most likely due to differences in brace design. Of the six braces tested, the 3D 3-Way Brace provided the greatest knee stability. PMID- 6496835 TI - Patellar and quadriceps tendon ruptures--jumper's knee. AB - We reviewed 13 patients with end stage jumper's knee, 10 with patellar tendon ruptures, and 3 with ruptures of the quadriceps tendon to evaluate our long-term results in treating these tendon ruptures in an athletic population. The focus was on the natural history, the time until return, and the level of return, to athletic activity. Jumper's knee affected all patients to a varying degree prior to rupture. Basketball was the most common sport involved. At followup, averaging 4 1/2 years, patients underwent functional and clinical, as well as Cybex and roentgenographic, evaluations. Results indicated patellar tendon ruptures, where the ruptures are complete, have a more favorable prognosis than those of the quadriceps tendon which are incomplete. All of the latter patients continued to have quadriceps tendinitis following repair. In both groups, the poor results were obtained in patients with chondromalacia and/or patella alta. Cybex testing yielded results of greater than 100% strength in three patients with patellar tendon ruptures, but no patient with quadriceps rupture had comparable test results. There was no apparent relationship between ruptures and cortisone injections. Patellar and quadriceps tendon ruptures from indirect injury in athletes represent the end stage of jumper's knee and result from repetitive microtrauma. Excellent function usually follows repair of patellar tendon ruptures when surgery is performed early and care is taken to restore normal patellar tendon length. Results of quadriceps ruptures are less satisfactory since these ruptures are usually incomplete and all degenerative tissue may not be involved in the healing response. PMID- 6496836 TI - Ski fractures of the femur. AB - There have been few reports of femoral ski injuries. Twenty-four cases of femoral ski fractures (as well as one dislocation), collected over 8 years, are presented. Two-thirds of the patients were under 30 years of age. The largest single cause of injury (one-third of the cases) involved collision. High speed skiing with loss of control and falling on icy surfaces were other frequent causes of injury. Internal fixation methods were usually chosen for skeletally mature patients, with traction and casting used in children. Femoral injuries have occurred in recent years despite improvements in ski equipment, snowmaking, and trail-grooming. It is felt that these improvements have led to faster skiing with increased kinetic forces of injury, and more severe consequences of a fall or collision. PMID- 6496837 TI - The tibialis posterior muscle compartment. An unrecognized cause of exertional compartment syndrome. AB - Exertional compartment syndrome in the deep posterior compartment of the leg is well recognized. This paper reports investigations which were performed to prove that the tibialis posterior muscle is contained in its own osseofascial compartment, separate from the rest of the deep posterior compartment. Radiographs following the injection of radio-opaque dye into the tibialis posterior muscle demonstrated the fluid-impermeable, osseofascial boundaries surrounding this muscle. Compartment syndromes created in cadaver legs reveal that traditional techniques of fasciotomy of the deep posterior compartment are inadequate in decompressing the tibialis posterior muscle. Intracompartmental pressure measurements in athletes with a clinical diagnosis of exertional compartment syndrome proved the existence of isolated exertional compartment syndrome in the tibialis posterior muscle. From these results we may conclude that the tibialis posterior muscle is contained in a separate osseofascial muscle compartment which may be the site of an isolated exertional compartment syndrome and that common techniques of fasciotomy of the deep posterior compartment do not decompress the tibialis posterior muscle. PMID- 6496838 TI - Femoral nerve block in knee joint surgery. AB - Assessment is made of the effectiveness of femoral nerve block, administered either before or after surgery, in supplementing postoperative analgesia for knee joint (anterior cruciate) reconstruction surgery. Femoral nerve block, performed before surgery, with Bupivacaine 0.5%, reduced intramuscular opiate administration by 80% in the recovery room and 40% in the first 24 postoperative hours. An effective and rapidly performed technique for femoral nerve block is described. PMID- 6496839 TI - Stenosing tenosynovitis of the flexor hallucis longus tendon in a classical ballet dancer. A case report. PMID- 6496840 TI - Stress fracture of the diaphysis of the ulna in a body builder. PMID- 6496841 TI - Clinical implications of progressive transformation of germinal centers. AB - Fifty patients whose lymph node biopsies showed reactive follicular hyperplasia with the presence of progressive transformation of germinal centers were evaluated for current status of health, prior or subsequent development of Hodgkin's disease, and etiology of the lymph node hyperplasia. Histologically, on a background of reactive follicular hyperplasia, the nodes contained one or more germinal centers showing progressive transformation. These were three to four times the diameter of the other germinal centers and composed predominantly of small, round lymphocytes admixed with scattered immunoblasts and occasional benign histiocytes. Clinically, the majority of these patients were young males presenting with an asymptomatic solitary enlarged lymph node. fifteen had prior Hodgkin's disease. Five had concurrent progressive transformation of germinal centers and lymphocytic predominance Hodgkin's disease (two of these also had a subsequent biopsy showing only progressive transformation of germinal centers). All are currently free of Hodgkin's disease at 1-21 years. The largest group of 31 patients had no prior or subsequent Hodgkin's disease. One of the 50 developed multiple myeloma. Recognition of this phenomenon is important so that it will not be misconstrued as recurrent Hodgkin's disease, as de novo Hodgkin's disease, or as follicular lymphoma, which occurred in 12 (24%) of the cases. PMID- 6496842 TI - Six cases of well-differentiated adenocarcinoma simulating fetal lung tubules in pseudoglandular stage. Comparison with pulmonary blastoma. AB - Six cases of well-differentiated adenocarcinoma resembling fetal lung were studied histologically, immunohistochemically, and ultrastructurally, and compared with three cases of pulmonary blastoma. The six cases had no sarcomatous features, unlike the pulmonary blastoma. Individual tumor cells characteristically possessed clear cytoplasm with plentiful glycogen and were similar to the epithelial cells of the branching tubules in the pseudoglandular stage of the fetal lung, as well as the epithelial component of pulmonary blastoma. They also showed little differentiation toward mucous cells and ciliated cells. Although cells containing endocrine-type granules were not found ultrastructurally, a few tumor cells possessed the characteristics of endocrine cells, i.e., cytoplasm was immunohistochemically reactive with anticalcitonin and antigastrin-releasing peptide. Therefore, this type of adenocarcinoma is considered to have a histogenesis similar to that of pulmonary blastoma and may be a tumor with one-sided development of pulmonary blastoma showing only an epithelial component. PMID- 6496843 TI - Angiomyolipomas of the liver. AB - Twelve cases of primary angiomyolipoma of the liver are presented. Histologically the tumors were similar to renal angiomyolipomas, containing tortuous blood vessels, smooth muscle, and fat. Some also contained prominent hematopoietic elements (angiomyomyelo-lipomas). The tumors may have necrosis and pleomorphic epithelioid smooth muscle cells which have led some to be mistaken for malignancies. Despite the similarity to their renal analogs, hepatic angiomyolipomas are not associated with tuberous sclerosis. PMID- 6496844 TI - Colorectal polyps in Cowden's disease (multiple hamartoma syndrome). AB - Colorectal polyps are described in five patients with Cowden's disease. A brother sister kindred and two unrelated patients had multiple colonic polyps 0.1-0.4 cm in diameter. Microscopical examination of seven polyps removed from these four patients showed distinctive lesions which were probably hamartomatous, and characterized by disorganization and proliferation of the muscularis mucosae with minimally abnormal overlying mucosa. The fifth patient had a solitary 2-cm epitheloid leiomyoma resected from the rectum. Review of all cases of Cowden's disease in the English literature suggests that gastrointestinal polyposis may be a frequent finding if it is specifically searched for. It does not appear that the previously reported association of Cowden's disease with gastrointestinal cancer is valid. The discovery of multiple colonic polyps 0.1-0.4 cm is diameter with a rectosigmoid distribution and a hamartomatous microscopical appearance is characteristic of Cowden's disease. Cowden's disease should be included in the differential diagnosis of gastrointestinal polyposis states. PMID- 6496845 TI - Mucosal ganglioneuromatosis associated with multiple colonic polyps. AB - Two unusual cases of colonic ganglioneuromatosis are described. One case was associated with multiple adenomatous polyps in a 74-year-old man and the second case was associated with juvenile polyps in a 16-year-old boy. To our knowledge this is the first report of colonic mucosal ganglioneuromatosis associated with multiple adenomatous polyps and the second report associated with multiple juvenile polyps. In the first case the ganglioneuromatosis was found in colonic mucosa without adenomatous changes, while in the second case ganglioneuromatosis was found both within normal mucosa and within juvenile polyps. The relationship between mucosal ganglioneuromatosis and multiple colonic polyps remains unclear. Neither patient has yet developed features to suggest either multiple endocrine neoplasia type 2b or von Recklinghausen's disease. PMID- 6496846 TI - Infantile digital fibromatosis occurring outside the digit. AB - This report illustrates an extradigital fibromatosis located in the right upper arm. The clinical, light-, and electron-microscopic features were identical to those found in the recurrent digital fibromatosis of childhood. As is typical for infantile digital fibromatosis, this reported lesion recurred once. Light microscopy showed eosinophilic, perinuclear inclusions which by electron microscopy were nonmembrane-bound, compact fibrillary structures. Whereas major reviews state that infantile digital fibromas occur exclusively on the digits, this unique case describes the rare occurrence outside the digit. PMID- 6496847 TI - Prostatic granulomas. PMID- 6496848 TI - The bacteriostatic field in urology. AB - Infections related to wound drain sites, cystoscopy, transurethral resection, open prostatectomy, and urinary catheter drainage systems are preventable by the appropriate application of bacteriostatic fields which seal off these systems from environmental bacteria incorporating bacteriostatic and bacteriocidal compounds. A high level of sterility is achieved without the routine use of antibiotics. PMID- 6496849 TI - Rhythm abnormalities of the biliary and pancreatic sphincters: diagnosis by endoscopic manometry. AB - Abnormal phasic wave activity was noted in the biliary duct sphincter, pancreatic duct sphincter, or both in 43 patients. This abnormality consisted of a tachyrhythmia in 40 patients and absent phasic wave activity in 3 patients. Tachyrhythmia was encountered in patients with elevated basal sphincter pressures. In four patients with tachyrhythmia, administration of intravenous naloxone failed to modify phasic wave activity. Three patients with normal basal sphincter pressures had absent phasic wave activity. This abnormality occurred in two patients with cirrhosis and in one patient with suspected cirrhosis. In one patient with cirrhosis, administration of intravenous morphine did not induce phasic wave activity. PMID- 6496850 TI - Cholecystectomy for acute cholecystitis: timing of operation, bacteriologic aspects, and postoperative course. AB - There is still considerable controversy among surgeons regarding the most opportune moment for surgical intervention in the case of acute cholecystitis. For this reason, 471 patients cholecystectomized for acute cholecystitis from 1970 through 1982 were studied. During the first period, there were two types of surgical intervention: during hospitalization after resolution of the acute episode, and during a second hospitalization 2 to 3 months later. During the second period, early cholecystectomy within 72 hours of the onset of symptoms became the option. Emergency operations did not reflect a surgical choice but rather conditions of necessity. The results of this study demonstrate that early cholecystectomy is preferred for a variety of reasons, the most important of these being a low incidence of positive results of bile culture in this phase, a negligible percentage of postoperative complications and mortality, and a short hospitalization period with resulting cost containment. PMID- 6496851 TI - A bacteriologic study comparing closed suction and simple conduit drainage. AB - A simple experimental study was designed to determine if closed suction drainage reduces the migration of pathogenic bacteria along a drain tract. Sixty New Zealand rabbits, equally divided into three groups, were splenectomized through midline incisions. Group I served as the control group and received no drainage. Groups II and III had drainage of the splenic bed with simple latex conduit drains (Penrose drains) and closed suction drains (Jackson-Pratt drains), respectively. The skin near the drain exit site was inoculated with a Streptococcus organism. The animals were sacrificed after 72 hours, and intraperitoneal culture specimens were obtained. None of the control rabbits had positive cultures on intraperitoneal specimens. Eighteen of 20 rabbits (90 percent) in Group II (Penrose) had positive cultures on specimens from the splenic bed, whereas 75 percent had positive cultures on drain specimens. Only 4 of 20 (20 percent) of the Group III rabbits had positive cultures on the drain or splenic bed specimens. This difference was statistically significant by chi square analysis (p less than 0.001). Retrograde migration of bacteria along a drain tract does occur with relatively high frequency with simple conduit drainage and is significantly less with closed suction drainage. PMID- 6496852 TI - Superior mesenteric artery syndrome. Diagnostic criteria and therapeutic approaches. AB - The hospital records and radiographs of 44 patients diagnosed as having superior mesenteric artery syndrome were reviewed using strict clinical and radiographic criteria. Only six (14.6 percent) of the patients fulfilled these criteria, suggesting over-diagnosis of the disorder. An acute change in clinical status, such as an operation or complication of a medical disease, appeared to precipitate the superior mesenteric artery syndrome in these patients, all of whom had chronic debilitating diseases. In four of the six patients conservative therapy failed, and they required surgical decompression. PMID- 6496853 TI - The "pinch-off sign": a warning of impending problems with permanent subclavian catheters. AB - The roentgenographic presence of the pinch-off sign indicates potential serious problems with central venous Silastic catheters and is an indication for immediate catheter removal and replacement at another site or position. PMID- 6496854 TI - The Hemasite-incorporated graft. Operative technique and early results. AB - A new device (the Hemasite-incorporated graft), has been available to provide access for hemodialysis. Herein, we have described the technique to insert the device and reviewed our early experience. Sixteen Hemasite-incorporated grafts were inserted in 11 patients over a 16 month period. Cumulative functional patency at the end of 1 year was 70 percent. The major complication rate was 0.15 per dialysis month. Patient comfort was considerably increased compared with what was achieved with other grafts. The need for temporary blood access methods is also decreased. More patients may be able to receive hemodialysis at home. PMID- 6496855 TI - Obliteration of the pelvic space with pedicled omentum after excision of the rectum for cancer. AB - From 1979 through 1982, removal of the rectum for cancer in 67 patients (50 of whom underwent preoperative radiotherapy) was completed by obliteration of the resulting dead space with pedicled omentum. No complication could be related to the method. After abdominoperineal resection (54 patients), primary healing of the perineal wound was achieved in 77 percent of the patients (85 percent during the last 2 years), and the mean postoperative hospital stay was 22 days. Minor perineal suppuration occurred in 10 patients with a 40 day average time of healing, and major suppuration occurred in 1 patient only with a 3 month time of healing. After the extended Hartmann operation (12 patients), no pelvic abscess was observed and the median hospitalization stay was 19 days. Pelvic filling in the management of patients undergoing rectal excision is an adjunctive procedure that is mainly intended to provide a better postoperative course. It might also facilitate postoperative radiotherapy. PMID- 6496856 TI - The negative effect of splenectomy on the prognosis of gastric cancer. AB - During the 11 year period from 1970 through 1980, 103 patients underwent total gastrectomy for gastric cancer. Splenectomy was performed in 53 of the patients because of perioperative accidental injury or an operative finding of tumor metastasis to the lymph nodes or direct invasion to the splenic hilus. Retrospective comparisons were carried out among the 53 splenectomized and 50 nonsplenectomized patients in terms of the long-term survival rate and early and late complications. The two groups of patients were quite similar with regard to rates of curative resection and stages of disease. The 5 year cumulative survival rates overall and in the splenectomized and nonsplenectomized groups were 23.1, 21.8 and 23.8 percent, respectively. Splenectomy did not affect the prognosis of gastric cancer. In addition, there were no differences between the two groups in the incidences of early surgical complications and infectious disease of late onset. Our results suggest that, in the treatment of gastric cancer, splenectomy may not be avoided, either when the spleen is injured perioperatively or when cancer involvement is suspected in the splenic hilus. PMID- 6496857 TI - Fine needle aspiration in the diagnosis and management of solid breast lesions. AB - Follow-up data were obtained for 449 fine needle aspirations of solid breast masses from January 1979 through December 1980. The accuracy with which a concordant benign or malignant diagnosis was made was 92 percent. There was a 9.6 percent false-negative rate and a 0.9 percent false-positive rate. Emphasis was placed on the utility of fine-needle aspiration for assessing patients with chronic fibrocystic disease. In 104 cases, patients with a benign cytologic report were followed clinically for 12 months or more. There was a 1.7 percent false-negative rate in this group of patients. We stress that a biopsy should be immediately performed on any worrisome mass, despite the repeatedly negative results of fine needle aspiration. Guidelines for the prevention of false negative and unsatisfactory cytologic reports have been presented herein. We believe that by careful clinical assessment of the mass, careful performance of the procedure, and close follow-up of the patient, the number of inaccurate fine needle aspirations can be kept at a minimum. PMID- 6496858 TI - Outpatient excision and primary closure of pilonidal cysts and sinuses. Long-term follow-up. AB - Long-term follow-up data are reported on 52 patients who underwent outpatient excision and primary closure of pilonidal cysts, sinuses, and abscesses while under local anesthesia. The procedure consists of conservative excision of all sinus tracts and cavities plus primary closure with a dead-space-obliterating monofilament suture. Sitting was restricted for 1 to 2 weeks after surgery. Primary healing was obtained in all of the patients, and with follow-up on 84 percent of the patients, no late recurrences have appeared. PMID- 6496859 TI - Intestinal endometriosis. AB - Endometriosis involving the intestine usually takes the form of asymptomatic, small, superficial serosal implants on segments of bowel lying in the pelvis in proximity to the genital organs. Deeper and more extensive intestinal wall involvement may result in obstruction and occasionally bleeding and requires distinction from a neoplasm or other inflammatory bowel process. Intestinal endometriosis should be considered in the differential diagnosis of recurring lower abdominal pain and other episodic bowel symptoms in women of child-bearing age. The diagnosis may be suspected based on the patient's history and frequently associated gynecologic symptoms. Due to the extramucosal location of the endometrioma, preoperative evaluation is unlikely to establish the diagnosis with certainty. Intestinal involvement by endometriosis, to the degree that it produces symptoms, almost always requires excision. Asymptomatic serosal lesions found incidentally at celiotomy for other disease should be biopsied and the diagnosis confirmed by frozen section. Symptomatic disease should be treated by resection of the involved intestine or by local excision, if the latter is feasible, and primary colon carcinoma can be excluded with confidence. Decisions regarding concurrent treatment for the underlying endometriosis should be made after consultation with an experienced gynecologist and must be based on the patient's menstrual status, age, and desire for future pregnancy. PMID- 6496860 TI - Right upper lobectomy. PMID- 6496861 TI - Omphalocele and gastroschisis. Trends in survival across two decades. AB - During the decade from July 1970 through June 1980, 57 patients with omphalocele and 64 with gastroschisis were treated at the Childrens Hospital of Los Angeles. Among the patients with omphalocele, the mortality was not significantly different between those with an abdominal wall defect smaller than 4 cm (5 of 24 patients) and those with a larger defect (6 of 33 patients); between those with a birth weight of less than 2,500 g (3 of 13 patients) and those with a higher birth weight (8 of 44 patients); between patients who had part of their liver in the omphalocele sac (6 of 29 patients) and those who did not (5 of 28 patients); and between patients who had primary fascial closure of the abdominal wall defect (3 of 24 patients) and those who had staged closure (4 of 25 patients). The overall mortality of 19 percent (11 of 57 patients) is not significantly different from that seen in patients treated during the preceding decade, 1960 through 1970 (23 percent, 5 of 22 patients), in our institution. Major chromosomal and other associated anomalies adversely affected the survival rate in these patients. In contrast, the overall survival rate of gastroschisis patients has markedly increased over the past two decades (91 percent in 1975 to 1980). In these patients, the difference in survival between those who had primary fascial closure (73 percent) and those who had staged closure by skin flaps or silon chimney (81 percent) was not statistically significant. Prematurity, bowel complications, and candida septicemia associated with the use of total parenteral nutrition contributed to the mortality. PMID- 6496862 TI - Evaluation of a new hydrogel coating for drainage tubes. AB - The performance of silicone drains has been improved by coating their surfaces with a hydrogel polymer. This hydrogel is formed by reacting polyvinylpyrrolidone with an isocyanate prepolymer. By absorbing water, the hydrogel creates a drain surface with a low coefficient of friction. The results of this experimental study demonstrate that the surface coating reduces the adherence of blood clots to the drain and facilitates its removal from the wound. On the basis of these and other experiments, the Food and Drug Administration has allowed the use of hydrogel for coating surgical drains for use in patients. PMID- 6496863 TI - Cancer of the breast after prophylactic subcutaneous mastectomy. AB - We have reported a case of carcinoma of the breast in a patient that occurred after bilateral prophylactic subcutaneous mastectomy. We recommend that the patient and physician be aware of the limitations of prophylactic mastectomy in terms of cancer prevention and that patients who undergo prophylactic mastectomy continue to be carefully followed. PMID- 6496865 TI - Bacteriologic comparison of closed suction and Penrose drainage. PMID- 6496864 TI - Sclerosing cholangitis after surgical treatment of hepatic echinococcal cysts. Report of three cases. AB - Three patients with sclerosing cholangitis after surgical treatment of echinococcosis of the liver are described. Before surgery, they had clinical symptoms that suggested a communication between the cyst and the biliary tract and, in two of them, the communication was later demonstrated by cholangiography. In each case, the cyst was injected with formalin solution. Soon after operation chronic cholestasis developed, with operative, cholangiographic, and histologic data suggesting sclerosing cholangitis. The role of formalin in the pathogenesis of this condition is discussed herein. PMID- 6496866 TI - The vascular anatomy of the gerbil cochlea. AB - The vascular pattern of the cochlea was studied in 12 adult gerbils (Meriones unguiculatus) using the Berlin blue (Prussian blue) contrast injection technique. The capillary areas of the gerbil cochlea are similar to those of other mammals studied. As in some other mammals, the vessel of the basilar membrane was inconsistently identified in the basal turn. It was usually replaced by a larger uninjected channel, supporting the suggestion that the vessel of the basilar membrane may be more functionally important in fetal life than in adulthood. The vascular pattern of the external cochlear wall is well maintained from base to apex, although a simplification of vasculature can be observed apically. PMID- 6496867 TI - An overview of preoperative chemotherapy: where do we go from here? PMID- 6496868 TI - Cochlear vascular and sensory cell changes induced by elevated temperature and noise. AB - The vascular anatomy of the chinchilla cochlea was quantitatively analyzed and compared in animals exposed to 155- or 160-dB impulse noise at normal (37 degrees C) and elevated (40 degrees C) body temperatures. Vascular changes persisted 45 days after noise exposure in all experimental animals. Six variables were most susceptible to change in one or more of the vessels studied: 1) irregularities in the vessel lumen, 2) plasma spaces between red blood cells (RBCs) and the vessel wall, 3) columns of RBCs, 4) variability in density of RBCs, 5) pigment clumps in the stria vascularis, and 6) perivascular cells compressing the vessel lumen. These vascular changes, which indicate a reduction in blood flow, were present throughout the length of the cochlea, with a tendency toward maximum change in areas of maximum hair cell loss. There was no evidence in the vascular results to support an interaction between noise and increased body temperature. However, the cochleograms from the experimental animals indicate that at the 160-dB exposure level the noise and high temperature may have interacted to increase hair cell loss. PMID- 6496869 TI - The role of testosterone in laryngeal carcinogenesis. AB - Testosterone levels in the plasma of 25 women and 25 men with carcinoma of the larynx and of 15 women and 15 men with hyperplastic aberrations in the laryngeal mucosa were determined to evaluate the etiologic relation between hyperplastic aberrations in the laryngeal mucosa (including cancer) and the male sex hormones. Patients with laryngeal cancer showed statistically significant increases in plasma testosterone levels compared with the control group. No statistically significant differences were found in plasma testosterone levels or in the testosterone/estradiol index between patients with hyperplastic aberrations of the laryngeal mucosa (including precancerous conditions) and the control subjects. The authors believe that greater attention should be paid to endogenous factors, particularly the male sex hormones, in further studies of the etiology of laryngeal carcinoma. PMID- 6496871 TI - The role of research in universities. PMID- 6496870 TI - Chondrosarcoma of the larynx: review of the literature and report of three cases. AB - Three patients with laryngeal chondrosarcoma were observed at the ENT Department of Padua University from 1966 to 1983. Including the present observations, about 150 of these neoplasms have been described in the literature. The male to female ratio was 3:1, and the age at diagnosis ranged from 33 to 91 years (median, 66 years). The rate of metastasis was 8 per cent, and histologically positive lymph nodes developed in only five patients. Surgery is the treatment of choice for laryngeal chondrosarcoma. Radical neck dissection does not appear to be indicated, unless results of clinical examination suggest metastatic lymph nodal involvement. PMID- 6496872 TI - Caffeine and its dimethylxanthines and fetal cerebral development in rat. AB - The relationship between the distribution and pharmacokinetic behavior of caffeine and its dimethylxanthines in pregnant rats and fetuses and fetal cerebral development was compared in four groups with different modes of oral caffeine ingestion by the mothers. During the premating period and pregnancy, female Wistar rats were divided into 0.04% caffeine (C) and water (W) groups, respectively. When the groups are expressed as W or C before mating-W or C during pregnancy, the fetal body weight was low in the three caffeine-treated groups (W C, C-W and C-C) and the fetal cerebral weight was the lowest in the W-C group. The mean concentration of caffeine or metabolites in maternal plasma, maternal liver, placenta and fetal cerebrum on gestational day (g d) 21 was increased in the W-C group compared to in the C-C group. The concentration of caffeine in fetal cerebrum was increased but that of metabolites was not, compared to the concentration of caffeine or metabolites in the placenta. Radioactivity in fetal cerebrum after intraperitoneal injection of 14C-caffeine was higher in the W-C group than in the other three groups. After intravenous injection of caffeine the apparent volume of distribution of caffeine in maternal plasma was markedly decreased in the W-C group, and the plasma molar concentration ratio of theophylline to caffeine was significantly increased in both the W-C and C-C groups. The adverse effect of maternal caffeine ingestion on the fetal cerebrum may be associated with the decreased apparent volume of distribution of caffeine in maternal plasma and the high caffeine content of fetal cerebrum. PMID- 6496873 TI - A genetic study of the Fukuyama type congenital muscular dystrophy. AB - A genetic study was carried out on 153 families with 186 Fukuyama type congenital progressive muscular dystrophy (FCMD) patients. Consanguineous marriage of parents was found in 41 families (26.80%). Inbreeding coefficients in the patients was 10 times as high as that of the general population. Both sexes were almost equally affected (M:F = 1.1:1.0). No single parent of the patients was affected. Recurrence among siblings was frequent (9 out of 41 siblings in offspring of related parents and 18 out of 110 siblings in offspring of unrelated parents were affected. The segregation ratio was 23.91-27.08% in offspring of related parents, 20.00-22.94% in offspring of unrelated parents, these values being not significantly different from the 25% expected from the assumption of autosomal recessive mode of inheritance. In the sample two twin pairs were included, of which one male isosexual pair was concordant. Sporadic cases were not significantly more numerous than expected. All these data indicate that the disorder is caused by homozygosity of an autosomal recessive gene. Frequency of the gene was estimated to be 5.2-9.7 X 10(-3) and frequency of the patients 6.9 11.9 X 10(-5). Mutation rate was estimated to be 6.9-11.9 X 10(-5). PMID- 6496874 TI - Arthrogryposis multiplex congenita in an infant with posterior agenesis of the corpus callosum. AB - A term male infant with arthrogryposis multiplex congenita and agenesis of the corpus callosum is described. Physical examination revealed multiplex dysmorphic features and fixed joints. A muscle biopsy showed type II fibers to be more than 12% smaller than type I fibers, consistent with the diagnosis of fiber type disproportion. The CT scan disclosed absence of the posterior corpus callosum and moderate atrophy of the cerebellar hemispheres. The pathogenetic mechanism for the muscle (and thus joint) abnormalities of this infant is discussed with respect to a central etiology. PMID- 6496875 TI - Multiple ring enhancement in a case of acute reversible demyelinating disease in childhood suggestive of acute multiple sclerosis. AB - A 5-year-old Japanese boy was admitted to our hospital because of progressive visual disturbance and quadriplegia. Computed tomography (CT) revealed multiple low density areas in the cerebral white matter, and intravenous injection of contrast medium resulted in ring enhancement around these areas. Exploratory aspiration of one of the low density areas gave a xanthochromic, viscous fluid. Pathologic examination of the drained fluid demonstrated small pieces of brain tissue with necrotizing lesions surrounded by demyelinating areas. The patient has been followed up for 3 years with corticosteroid treatment, and marked improvement has been achieved both in neurological examination and CT findings. From these clinicopathological findings an acute form of multiple sclerosis (MS) in childhood was suspected. PMID- 6496876 TI - Fukuyama type congenital muscular dystrophy--two Dutch siblings. AB - Two Dutch siblings, diagnosed as suffering from Fukuyama type congenital muscular dystrophy (FCMD) on the basis of clinical, computerized tomography (CT), and muscle and brain biopsy findings, are reported. Hypoplasia of the chorioidea was observed for the first time in FCMD. Autopsy of the first case revealed the major pathological changes of FCMD, i.e. micropolygyria, loss of cytoarchitecture, hypoplasia of the pyramidal tract, leptomeningeal thickening. Heterotopias of nervous tissue in the spinal arachnoidal spaces were found. This is the first case in which brain tissue has been investigated on two separate occasions. In the biopsy specimen--at the age of 14 months--myelination was poor and astrogliosis marked. At autopsy--4 years later--myelination proved to be only slightly less than normal. However, white matter hypodensities on the successive CT's did not change. There is no ready explanation for this discrepancy. Typical FCMD is compared to FCMD-like cases from outside Japan. There are arguments in favor of the concept of a continuum of diseases--with the same (unknown) etiology -representing both typical FCMD and other types of congenital muscular dystrophy with CNS lesions. PMID- 6496877 TI - To be brief. PMID- 6496878 TI - No double standard for patient care. PMID- 6496879 TI - Poor biopsy technique: an obstacle course for the general pathologist. PMID- 6496880 TI - Rationale for specific immunotherapy of grass pollen allergy with extracts of rye pollen. Skin test reactivity and immunochemical relationship between pollen allergens from rye and other common grasses. AB - In immunotherapy of grass pollen allergy, an extract of rye (Secale cereale) is often included. The aim of this study was to investigate by skin prick test (SPT) and immunochemical methods whether rye pollen contains specific allergens justifying the use of this extract separately. Twenty grass pollen allergic patients were skin prick tested with a dialysed freeze-dried raw extract of rye pollen (Sc), timothy extract (Soluprick SQ, 1 HEP) and two other rye extracts (Soluprick). Sera from the patients were RAST-tested using Sc and timothy (Pp). CRIE was performed using Sc and rabbit-anti grass (aNG) antibodies. The antigenic relations between rye and common grasses were investigated by CLIE using Sc and aNG as references, and by RAST inhibition. The ability of aNG to absorb the allergen activity of Sc was also tested. Significant correlations were found between timothy and rye when compared by means of SPT and RAST. The immunochemical analyses did not reveal any rye antigens containing rye epitopes only. However, the possibility of rye antigens with several epitopes, of which at least one is specific for rye, could not be excluded. Clinical symptoms supposedly elicited by rye alone can be explained quantitatively by the strongly time-limited and concentrated natural exposition. Diagnosis and treatment can, however, be performed with extracts of common grasses. PMID- 6496881 TI - IgG subclass antibody response in grass pollen-allergic patients undergoing specific immunotherapy. Prognostic value of serum IgG subclass antibody levels early in immunotherapy. AB - All four subclasses of IgG antibodies to timothy grass pollen extract were measured by a three-layer immunoradiometric assay in sera from 20 grass pollen allergic patients who underwent specific immunotherapy in a 3-year prospective study. Both IgG1 and IgG4 antibody levels rose significantly during the first 8 weeks of immunotherapy. IgG1 antibody level passed its peak (median 5.4 U/ml) after 12 weeks. At this time, the ratio between the medians of IgG1 and IgG4 antibodies was 2.25. IgG4 antibody level reached its peak (median 11.6 U/ml) just before termination of immunotherapy. At this time IgG1/IgG4 ratio was 0.43. Two years after the end of immunotherapy, IgG1 and IgG4 antibody levels were 0.0 and 1.8 U/ml in median, respectively. The amounts of IgG2 and IgG3 antibodies detected in the sera were less than 1.6 U/ml and were considered insignificant. Preseasonal serum IgG1 and IgG4 antibody levels did not correlate significantly with symptom scores in the subsequent season. Serum IgG4 level obtained after 12 weeks of immunotherapy was significantly correlated to symptom score in the third season, i.e. the season just after termination of therapy (rs = 0.529, t = 2.567, P = 0.02). In this work, a serum IgG4 antibody level higher than 8.0 U/ml after 12 weeks of therapy predicted poor clinical result at the end of immunotherapy with 100% sensitivity and 87% specificity. An IgG4/IgG1 ratio greater than 1.0 after 12 weeks' therapy had the same predictive value. PMID- 6496882 TI - Atopic allergy and serum IgE concentrations in randomly selected children followed up from 8 to 12 years of age. AB - A total of 159 children selected at random were followed up from the age of 8 to 12 years regarding the development and cumulated incidence of atopic disease as well as serum IgE concentrations. The cumulated incidence, including healed cases, rose to 25.8%. The highest prevalence was found for allergic rhinitis (12.2%). Serum IgE concentrations decreased significantly in both healthy and atopic subjects, and indicated a peak in total IgE concentration in early school age. The allergy predictive value of elevated IgE concentrations was confirmed. Low concentrations of allergen-specific IgE were found in 14.1% of children healthy before and during the observation period, indicating that transient production of IgE antibodies is a normal phenomenon. Finally, the stability of IgE was excellent during the first 2 years at -20 degrees C but later on concentrations tended to decrease, especially in the lower range. PMID- 6496883 TI - Urticaria in children. Retrospective evaluation and follow-up. AB - A retrospective study supplemented with follow-up was carried out in 163 children, aged 6 months to 16 years, who were hospitalized because of acute, recurrent or chronic urticaria in 1976-1980. Etiologic agents were identified in 55% of cases. Physical factors were the commonest causes, especially in cases of chronic urticaria, while infections predominated in acute urticaria. 81% of the children participated in the follow-up study. Follow-up for a year or more revealed that 53% of the children had become symptom-free, 36% still had symptoms but less frequently and in 11% urticaria was unresolved. The results indicate that the etiologic factors in childhood urticaria are similar to those found in adults and that prognosis is favorable, particularly when the etiology is established. PMID- 6496884 TI - Insect allergy. A comparative study including case histories and immunological parameters. AB - One hundred and seventeen persons all stung by yellow jacket (YJ) and/or bee were examined by means of skin prick test with venom of these insects, skin prick test with 10 inhalant allergens and analyses of total IgE, specific IgE and IgG against honey bee and YJ venom. Eighty-seven persons had had a systemic reaction to YJ or bee sting, the rest had reacted normally or with a large local reaction. Positive correlations (P less than 0.05) were found between results of skin prick tests and specific IgE against venoms and, for YJ, between the severity of symptoms after sting and the size prick test with the venom. That some of the more severe symptoms could have been caused by non-immunological mechanisms could explain why a significant correlation was present only between the results of the prick test and specific IgE and not between these tests and the clinical symptoms. Specific IgE values against YJ and honey bee venom showed covariation, although no correlation could be demonstrated between the clinical symptoms after stings from these insects, or between skin prick test results using the two different extracts. The severity of the sting reactions was not correlated to age, atopic disposition, amount of total IgE, number of stings during life, or positive skin prick test to inhalant allergens. It is concluded that in insect allergy, specific IgE analysis and skin prick tests are supplementary. PMID- 6496885 TI - Isolation of patient-related antigens from allergen extracts by means of protein A-sepharose-patient IgG1,2,4 bio-affinity chromatography. AB - A method is described for bio-affinity purification of patient-specific IgG reactive antigens by using protein A-sepharose allergic patient serum and the corresponding antigen/allergen extract. The optimal conditions for each step have been determined and it is shown that the non-specific binding of both serum proteins and antigens can be kept at very low levels by a high ionic strength. The specificity of the reaction has been shown by biospecific elution of 125I labelled antigens by non-labelled antigens and also by comparison of the amount of antigen bound by sera from hyposensitized patients with that from non-atopic individuals. It is suggested that the isolated antigen-IgG-immune complexes could be used for a specific and active immunotherapy. PMID- 6496886 TI - [Inhalation injury of the lung]. AB - Because of the complex composition of smoke generated during fires and the possible combination of inhalation injury with other pulmonary complications of burns, the clinical course of inhalation injury is variable. Because clinical manifestations may be delayed several hours and furthermore are not specific, fiberoptic bronchoscopy is most appropriate in diagnosing pulmonary injury at the time of admission. Dominating pathological feature is a membraneous tracheobronchitis. Acute airway occlusion with sloughed bronchial mucosa, oedema formation and pulmonary infection are the most common complications. Treatment includes administration of oxygen, use of bronchodilators, and, when necessary, mechanical ventilation. Supplemental oxygen delivered at high concentrations will increase CO elimination and should be administered to all patients until the blood level of carboxyhaemoglobin has been measured. PMID- 6496887 TI - [Experiences with combined catheter-peridural anesthesia and nitrous oxide-oxygen ventilation in patients at risk in gynecology and obstetrics]. AB - In 271 gynaecological or obstetrical patients a "combined anaesthesia method" was applied, consisting of lumbar catheter epidural analgesia and controlled ventilation with nitrous oxide/oxygen. We aim to show that by mere interaction of the local anaesthetic, with nitrous oxide, and the drugs used for premedication and during induction of anaesthesia a stage of sleep can be achieved, which, on the patient's behalf is identical with his idea of "full anaesthesia", while at the same time the use of centrally acting agents can be kept at a minimum. In incidents of sympatho-adrenergic-stimulation due to insufficient cephalad spread of the blockade and not amenable to additional doses of local anaesthetic, i.v. fentanyl or low concentrations of volatile anaesthetics were added. In the postoperative phase the patients showed a high degree of vigilance. Epidural morphine offered best pain relief with full mobility maintained. In cases with postoperative hypertensive crises, morphine was combined with bupivacaine injections. Even marked obesity or senile degenerative changes in the vertebral column proved not to constitute contraindications for this method. PMID- 6496888 TI - [Successful therapy of consumption coagulopathy in EPH gestosis with multiple organ failure]. AB - A 23 year old primipara with EPH gestosis after caesarean section suffered massive disseminated intravascular coagulation resulting in anuria, respiratory failure, gastrointestinal bleeding and disturbance of liver function. By treatment with antithrombin-III concentrates, fresh blood and fresh frozen plasma we were able to normalise coagulation disorders and to restore organ functions. Causes and therapeutical management of these diseases are discussed. PMID- 6496889 TI - [Gestational diabetes]. PMID- 6496890 TI - [Ovarian tumors in childhood. Report of a case of giant cystoadenoma]. PMID- 6496891 TI - [Massive osteolysis. Presentation of a new case]. PMID- 6496892 TI - [Surgical treatment of pulmonary emphysema]. PMID- 6496893 TI - [Composition and structure of renal calculi. Presentation of a book of the same title]. PMID- 6496894 TI - [Florid oral papillomatosis or verrucous carcinoma]. PMID- 6496895 TI - Mixed venous oxygen saturation changes during tension pneumothorax and its treatment. AB - A case is reported of tension pneumothorax following left subclavian venous cannulation for placement of a fibreoptic pulmonary artery flotation catheter. Mixed venous oxygen saturation was continuously monitored and a fall in this was the first indication of the problem. Observations on the cardiovascular consequences of tension pneumothorax were made and followed during its treatment. The value of continuous monitoring of mixed venous oxygen saturation in the early detection of haemodynamic disturbances is emphasized. PMID- 6496896 TI - Anaesthesia in babies with congenital dystrophia myotonica. AB - The anaesthetic procedures used in two babies with congenital dystrophia myotonica are described, and the problems of providing anaesthesia in patients with the adult and congenital forms of the condition discussed. PMID- 6496897 TI - Ritodrine-induced pulmonary oedema in labour. Successful management using epidural anaesthesia. AB - A case is described in which unusually high doses of intravenous ritodrine were used for 6 weeks to postpone premature labour. Treatment was complicated by tachydysrhythmias and pulmonary oedema. Epidural analgesia was used successfully for pain relief during labour and Caesarean section. The pathophysiology is discussed. PMID- 6496898 TI - Massive swelling of the face and tongue. A complication of posterior cranial fossa surgery in the sitting position. AB - A case of massive swelling of the tongue and face following posterior cranial fossa surgery in the sitting position is described. Prolonged tracheal intubation was required postoperatively. This serious complication appeared to relate to prolonged flexion of the neck. PMID- 6496899 TI - Intrathecal ketamine for war surgery. A preliminary study under field conditions. AB - Intrathecal ketamine, which has not previously been described in man, has been administered to 16 patients with war injuries of the lower limbs. The first five received varying doses from 5 to 50 mg in a volume of 3 ml of 5% dextrose, to determine a dose-response curve (Group 1). The optimal dose was then administered to a further 11 patients who received ketamine 50 mg in a volume of 3 ml in 5% dextrose with the addition of adrenaline 0.1 mg (Group 2). A distinct sensory level was obtained in all patients. In Group 2, nine of the eleven patients obtained satisfactory surgical analgesia and two required supplementation with local anaesthetic. Central effects (drowsiness, dizziness, and nystagmus) also occurred in nine patients, but they remained conscious throughout; one patient experienced no central effects, and one patient developed dissociative anaesthesia. Central effects were more intense the higher level of block. There were no significant changes in mean systolic arterial blood pressure, pulse, or respiratory rates. Surgical analgesia for the blocked dermatomes lasted for a mean of 58 minutes (range 45-90), and recovery was complete and uncomplicated; mild generalised analgesia persisted for a further one to three hours following return of sensation. Ketamine alone did not produce motor block, but addition of adrenaline resulted in complete motor block, and may have intensified sensory blockade. Motor loss persisted for the same duration as surgical analgesia. Adrenaline neither delayed the onset of central effects, nor reduced their intensity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496900 TI - Pruritus after spinal anaesthesia. PMID- 6496901 TI - Herpes simplex after spinal morphine. PMID- 6496902 TI - Extradural analgesia and dystrophia myotonia. PMID- 6496903 TI - A rare complication of extradural analgesia. PMID- 6496904 TI - An interesting dural tap. PMID- 6496905 TI - Intravenous cannulation: a rare complication. PMID- 6496906 TI - Postoperative vomiting. PMID- 6496907 TI - A new venturi attachment for the Cape ventilator, to facilitate control of FIO2. PMID- 6496908 TI - Unusual instrument for intubating the trachea of a small child. PMID- 6496909 TI - Another use for an oxygen analyser. PMID- 6496910 TI - Portex epidural catheters--a change for the worse. PMID- 6496911 TI - Pain-free venepuncture. Effect of timing of application of local anaesthetic cream. AB - This study was designed to assess the effect of time on the analgesic effect of a local anaesthetic cream consisting of a mixture of 5% lignocaine and prilocaine. The cream and placebo were compared in a double-blind, randomized study in 114 children aged 4-17 years, with application times of 20 minutes and longer. A regression analysis revealed no difference in analgesic effect between cream and placebo when application times were less than 60 minutes. A cusum test showed that the effect of the cream became evident at about 60 minutes. Local adverse reactions consisted mainly of transient paleness of the skin, which did not constitute any clinical problem. PMID- 6496912 TI - Mortality amongst multiple trauma patients admitted to an intensive therapy unit. AB - A retrospective review of 428 severely injured patients admitted to an intensive therapy unit between 1969 and 1982 was performed. The patients' primary injuries were assessed using the injury severity score (ISS), and subsequent complications using the complications impact index and sepsis score. Between 1969 and 1980 mortality fluctuated between 19% and 29% but rose to 47% (p less than 0.05) during 1981-82 in spite of an unchanged ISS. The increased mortality was confined to ventilated patients surviving more than 5 days from injury and was associated with multiple organ failure and severe infection. The rapid and sustained increase in mortality could not be explained by any obvious change in severity of injury or referral pattern. The only deliberate change in management related to the combination of analgesic/sedative drugs used in ventilated patients. During 1979 to 1982 mortality was 28% in patients given morphine with or without benzodiazepines and 77% in those given morphine and etomidate (p less than 0.0005). After discontinuation of the latter regimen (May 1983) and resumption of the former analgesic/sedative combination, mortality fell to 25% (p less than 0.005). Possible mechanisms leading to increased mortality include adrenocortical insufficiency or depth of anaesthesia. PMID- 6496913 TI - The effect of labour and epidural analgesia on pain threshold. AB - Pain thresholds were measured using forehead pressure in 30 women before amniotomy and then during labour up to the point of their requesting analgesia. Measurements continued subsequently only in those having epidural analgesia alone. No significant change in pain threshold was seen in any patient up to the administration of analgesia, nor thereafter in the ten patients having epidurals. This study fails to confirm previous reports in animals of significant rises in pain threshold during parturition. It calls into question the view that previously reported changes in plasma endorphin levels may be associated with altered pain thresholds. PMID- 6496914 TI - The use of radiotelemetry techniques for the in vivo assessment of antacids. AB - The use of the pH radio pill for the assessment of antacid effect has been evaluated. The correlation between the pH pill and a conventional pH electrode system was high (r2 = 0.997). The records of in vivo pH against time allow unique measurements of antacid efficacy (defined as the integrated area under the pH against time curve) and duration of action to be obtained. Using a free pill, antacid assessments were performed in 13 subjects in the left lateral position. The effects of repeated antacid administrations were studied in five subjects using a pH pill which was prevented from leaving the stomach by tethering it to the teeth. These longer studies were performed in the sitting position. The efficacy (p less than 0.02) and duration of action (p less than 0.02) of sodium citrate 0.3 M were less in those subjects in whom the pill was tethered. The differences between the results of the studies using either a free or a tethered pill can be attributed to posture. The overall duration of action of sodium citrate 15 ml was short, the mean (SEM) value being 42.4 (4.5) minutes in the left lateral position and 21.2 (4.0) minutes in the upright position. PMID- 6496916 TI - [Do the adverse effects of cortisol disturb anesthetists?]. PMID- 6496915 TI - Bupivacaine leak past inflated tourniquets during intravenous regional analgesia. AB - A small leak of bupivacaine was detected in 13 out of 52 cases (25%) during intravenous regional analgesia for the upper limb whilst the tourniquet cuff remained properly inflated. The plasma levels of bupivacaine (range 0.2-0.4 microgram/ml) were well below the toxic range, and no adverse sequelae resulted. PMID- 6496917 TI - [The anesthesia protocol]. AB - It has long been recognised that it is necessary to document all medical actions. Every anaesthesia is to be documented on an anaesthetic transcript. Such a transcript has various purposes. It serves principally as an adequate patient support, but also has administrative, statistical, scientific and forensic purposes. The transcript used at the Mannheim Klinikum is a printed form, which, apart from recording intra-operative events, also has room for entering pre- and post-operative test results. The recording of an anaesthetic transcript is an essential part of the duties of the anaesthetist in the clinic. Today, with the application of the most differentiated administrations of narcosis, it would seem that we can no longer do without a properly made anaesthetic transcript. PMID- 6496918 TI - [The occurrence of intra- and postoperative cardiovascular and pulmonary complications in relation to the preoperative condition of patients. A prospective study]. AB - 700 patients were prospectively studied and their development analysed from date of premedication to 28 days postoperative or date of discharge. Concomitant diseases and intra- and/or postoperative complications were documented. Analysing the patients an increasing frequency of risk classes 3 to 5 depending on age were found. Cardiac disorders were more frequently observed after the age of 41.33% of the observed patients were recompensated in respect to the myocardium, 4.5% suffered from angina pectoris and 1.5% showed clinical signs of cardial insufficiency. ECG abnormalities were registered particularly after the age of 41; nevertheless 2.5% of young patients to the age of 20 showed pathological electrocardiograms (ECG). More than 33% of the patients studied were hypertensive and 15% suffered from concomitant lung or airway diseases. Analysing the complications of the cardiocirculatory system an overall frequency of 70% was found, depending on corresponding side diseases and their underlying therapy. Intraoperative complications of the respiratory system are rare; in the postoperative course they became important and were 3 times more common in patients with lung or airway disorders. We conclude that one may achieve a risk diminution by appreciating the risk and by very careful preoperative examination and therapy. PMID- 6496919 TI - [Antithrombin III substitution for optimization of the heparin effect during extracorporeal circulation in heart surgery]. AB - In a prospective randomised study 20 patients undergoing coronary bypass surgery were assigned to two groups. Patients in group I (n = 10) received initially 250 IU heparin X kg-1 before the start of extracorporeal circulation. Patients in group II (n = 10) were given the same amount of heparin and in addition 1 000 units of purified human antithrombin III (AT III) concentrate. A highly significant lower heparin coefficient [2.69 +/- 0.57 IU X kg-1 X min-1, which is a parameter of heparin consumption (units of heparin X kg-1 given per minute during the time of heparinisation)], was found in group II compared to group I (3.73 +/- 0.56 IU X kg-1 min-1). Heparin sensitivity, measured as an increase in the ratio of activated coagulation time (ACT) X IU heparin-1 X kg-1 as a response to initial heparin dose, was found to be significantly higher (1.22 +/- 0.30 sec X IU heparin-1 X kg-1) in patients receiving AT III as measured in the control group (0.95 +/- 0.23 s X IU heparin-1 X kg-1). Mean values of ACT during the period of heparinisation were comparable (group I: 533 +/- 81 s, group II: 512 +/ 62 s) in the two groups. The substitution of AT III led to an increase of plasma AT III activity of 1.4% per substituted unit AT III X kg-1. AT III plasma activity, corrected to initial haematocrit levels to avoid dilution dependency, decreased as a consequence of extracorporeal circulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496920 TI - [Long-term experiences with continuous peridural opiate analgesia with an implanted pump]. AB - Continuous epidural opiate analgesia with an implantable, percutaneously refillable pump was induced in 6 patients with chronic pain of malignant origin. The efficacy of this method was compared with that of on-demand bolus-injections of epidural opiate. Side-effects and development of tolerance were not observed during a more than one year period of treatment. Increased daily doses for some days were only necessary in case of additional pain sources, e.g. induced by an intermediate operation. There were no hygienic problems (bacteriologic investigations) or problems due to technique of implantation (localisation of the implant, stability of the fixation, patency of the catheter). Examination of post mortem explanted pumps (determination of the flow rate, inspection for precipitation within the pump, testing of permeability of filters) and catheters (electron microscopy, testing of the material for surface conditions, tensile strength and elongation) as well as histological findings for local compatibility did not reveal adverse reactions after long-term treatment. Indications for this new method of pain treatment were established. PMID- 6496921 TI - Use of t-butyldimethylsilylation in the gas chromatographic/mass spectrometric analysis of physiologic compounds found in plasma using electron-impact ionization. AB - The use of N-methyl-N-(t-butyldimethylsilyl)trifluoroacetamide to prepare the t butyldimethylsilyl derivatives of a number of organic compounds (selected amino acids, alpha-keto acids, ketone bodies, free fatty acids, urea, glycerol, lactate, and pyruvate) is reported. These derivatives are particularly useful for gas chromatographic/mass spectrometric analysis involving the use of stable isotopes and selected ion monitoring, since a peak of sufficient abundance at 57 mass/charge units below the molecular ion was always present, and was the result of the loss of one t-butyl group. In each case, this fragment contained the entire skeleton of the original compound, which permitted easy analysis using electron-impact ionization of these compounds alone or when labeled with stable isotopes in any nonexchangeable position. PMID- 6496922 TI - Determination of ketone body turnover in vivo with stable isotopes, utilizing gas chromatography/mass spectrometry. AB - JH imple and reliable method for the determination of ketone body turnover in vivo using a primed, continuous infusion of [3,4-13C2]acetoacetate is described. Mole percent enrichment of beta-[13C2]hydroxybutyrate and [13C2]acetoacetate is determined by gas chromatography/mass spectrometry using electron-impact ionization and selected ion monitoring. Ketone body flux data are provided from preliminary dog experiments. The method is readily applicable to the study of ketone body metabolism in both laboratory animals and humans. PMID- 6496923 TI - Radioimmunoassay for the amino-terminal sequences of type III procollagen in human body fluids measuring fragmented precursor sequences. AB - Antisera specifically directed against the amino-terminal precursor sequence of bovine p-N-collagen type III (Col 1-3 III) have been raised in rabbit. When tested in a radioimmunoassay, parallel displacement curves and complete cross reactivity were observed between bovine and human purified Col 1-3 III. However, these displacement curves were not parallel to that obtained with serially diluted human sera which presented a smoother slope. Cleavage of the Col 1-3 III peptide by collagenase at high temperature yielded an immunoreactive preparation containing two smaller peptides (Col 1 plus Col 2) III. The displacement curves obtained with human or bovine (Col 1 plus Col 2) preparations were parallel to those obtained with serially diluted human sera or other human body fluids (amniotic and ascitic fluids). Quantitative measurements of the circulating antigen in normal and pathological conditions are possible only when the (Col 1 plus Col 2) is used as standard antigen. This radioimmunoassay represents an original and simple technique offering good accuracy. The amount of (Col 1 plus Col 2) III in human adults is 69.1 +/- 27.7 ng/ml, with a distribution of frequency close to the normal. It is increased in liver cirrhosis and other conditions characterized by an active neoformation of connective tissue. PMID- 6496924 TI - Preparation of (-)-5,6,7,8-tetrahydrofolate using immobilized dihydrofolate reductase. AB - Dihydrofolate reductase from methotrexate-resistant Lactobacillus casei was immobilized on carbodiimide-activated CH-Sepharose. The immobilized enzyme was utilized in the synthesis of (-)-5,6,7,8-tetrahydrofolate from dihydrofolate and NADPH in a batchwise reaction system. The products of the reaction, (-) tetrahydrofolate and NADP+, were separated on a Sephadex G-10 column equilibrated with 50 mM NH4HCO3 containing beta-mercaptoethanol and ethanol. The tetrahydrofolate was then characterized by ultraviolet and circular dichroic spectra and its reactivity as a cofactor in the thymidylate synthetase reaction. PMID- 6496925 TI - Analysis of S-adenosylmethionine and related sulfur metabolites in animal tissues. AB - A high-performance liquid chromatographic method was devised that separates S adenosylmethionine and related sulfur metabolites on a Radial-PAK SCX cation exchange column using a four-step NH4COOH/(NH4)2SO4 elution gradient. This new procedure permits, in a single run of 60 min, the quantitative analysis of S adenosylmethionine, S-adenosylhomocysteine (AdoHcy), 5'-deoxy-5' methylthioadenosine, decarboxylated S-adenosylmethionine, decarboxylated AdoHcy, inosylhomocysteine, and other related metabolites. Furthermore, this method allows the detection in rat tissues of novel sulfur metabolites, S inosylhomocysteine and decarboxylated AdoHcy. Perturbation of the levels of some of these metabolites could be detected in rat livers and spleens after the administration of 3-deazaadenosine, an inhibitor of AdoHcy hydrolase, but could not be detected in rat adrenal glands. It is notable that decarboxylated AdoHcy disappeared in the livers of rats treated with 3-deazaadenosine. HeLa cells incubated with [35S]methionine displayed the incorporation of the labeled sulfur into S-adenosylmethionine, AdoHcy, decarboxylated S-adenosylmethionine, S inosylhomocysteine, and 5'-deoxy-5'-methylthioadenosine. PMID- 6496926 TI - A semi-integrated method for the determination of enzyme kinetic parameters and graphical representation of the Michaelis-Menten equation. AB - A semi-integrated method for the determination of the enzyme kinetics parameters (Km and V) and graphical representation of the Michaelis-Menten equation is proposed as a variation of determination of initial reaction rate (v) as a function of initial substrate concentration ([S]0). The method is based on the determination of the time required to exhaust half of the initial substrate concentration as a function of the initial substrate concentration. The advantages and limitations of this method are discussed. PMID- 6496927 TI - Use of avidin to prepare biotin-free culture media. AB - Dialysis of avidin-treated casein hydrolysate and peptone solutions produced biotin-free dialysates which, when incorporated into growth media resulted in media devoid of biotin. Wright-Skeggs medium supplemented with dialyzed, avidin treated, casein hydrolysate did not support significant growth of Bacillus coagulans or Lactobacillus plantarum without biotin supplementation. Eagle's minimal essential medium supplemented with avidin-treated, peptone dialysate (MEMAPD) would not support the growth of LM strain mouse cells through more than a single passage without biotin supplementation. MEMAPD supplemented with biotin supported good growth of the LM cells through repeated passages. Using this medium it was possible to demonstrate that LM cells require biotin for growth and that they cannot utilize avidin-complexed biotin. Avidin treatment of peptone or casein hydrolysate solutions allowed accurate control of the biotin content in culture media and did not remove significant amounts of substances other than biotin. By comparison, activated charcoal nonspecifically removes biotin as well as other essential nutrients and adds unknown substances to the medium which interfere with the growth of tissue culture cells. PMID- 6496928 TI - A competitive displacement assay to detect saxitoxin and tetrodotoxin. AB - An assay is described which detects saxitoxin (STX) and tetrodotoxin (TTX) by their competitive displacement of [3H]saxitoxin from its receptor in rat brain membranes. The assay has a sensitivity of 0.15 ng STX/ml and 0.8 ng TTX/ml for buffer samples. The assay was also applied to detection of these toxins in unextracted human plasma and found to have a sensitivity of 0.5 ng STX/ml and 0.6 ng TTX/ml. The competitive displacement assay appears to be the most sensitive procedure yet for detection of STX and TTX. PMID- 6496929 TI - Fluorometric measurement of tin-protoporphyrin in biological samples. AB - Sn-protoporphyrin is a potent competitive inhibitor of heme oxygenase, can suppress neonatal and other forms of hyperbilirubinemia in laboratory animals, and represents a potential new approach to the treatment of neonatal jaundice in humans. In order to study the disposition of Sn-protoporphyrin in vivo we have developed a sensitive fluorometric method for the quantitation of this metalloporphyrin in biological samples. The method is sensitive to concentrations as low as 0.01 nmol/ml, and is specific for Sn-protoporphyrin even in the presence of other porphyrins such as protoporphyrin. PMID- 6496930 TI - Mapping endpoints of partial proteolysis fragments from regulatory subunit of type I cyclic AMP-dependent protein kinase. AB - Methods for mapping endpoints of partial proteolysis fragments from regulatory subunit of type I cyclic AMP-dependent protein kinase are described with a view to using such data for fine-structure analysis of mutations and/or modifications affecting the protein's electrostatic charge. Peptides generated from [35S]methionine-labeled regulatory subunit were separated by high-resolution two dimensional gel electrophoresis. Sites of papain cleavage in denatured regulatory subunit were deduced from the kinetics of the appearance, molecular weights, and relative isoelectric points of the fragments produced. These sites and sites of chymotrypsin digestion in the native protein were confirmed by studying peptide overlaps. Carboxy-terminal peptides were identified both by overlaps with cyclic AMP-binding chymotryptic fragments and by their preferential labeling during polysome runoff mediated by pactamycin, an inhibitor of protein initiation. Since peptides containing modifications or mutations that alter protein charge can be identified by shifts in first-dimension isoelectric focusing gel positions, knowledge of fragment endpoints will permit rapid mapping of sites of such alterations by two-dimensional gel analysis of partial proteolytic digests. Such a mapping procedure is inexpensive, can be applied to partially purified proteins or to proteins eluted from polyacrylamide gels, requires only nanogram amounts of the protein of interest, and does not require sequence data to determine relative positions of peptides. Therefore, it provides an attractive alternative to more classical peptide analysis for studying point mutations in cellular proteins of low abundance. PMID- 6496931 TI - Simultaneous determination of uric and ascorbic acids in human serum by reversed phase high-performance liquid chromatography with electrochemical detection. AB - A rapid, easy, and accurate method for the determination of uric acid and ascorbic acid in human serum by reversed-phase high-performance liquid chromatography with electrochemical detection has been developed. Human serum (0.5 ml) was mixed with 1.5 ml of an aqueous solution containing 2.0% metaphosphoric acid and the mixture was centrifuged at 3000g for 30 min. The supernatant was passed through a membrane filter to remove the particulate matter. Ten microliters of the filtrate was injected into the chromatographic system employed in this study. Complete separation of uric acid and ascorbic acid was achieved in about 2 min. The assay limit for quantitation was about 10 pg for uric acid and ascorbic acid under the present chromatographic conditions. The analytical recoveries of uric acid and ascorbic acid in human serum samples were found to be almost 100%. PMID- 6496932 TI - Preparation of chloroplast DNA from pea plastids isolated in a medium of high ionic strength. AB - A simple, rapid, and inexpensive method for the preparation and purification of chloroplast DNA (cpDNA) from pea has been developed. The crucial step is the isolation of chloroplasts in a medium of high ionic strength (I congruent equal to 1.40 M). CpDNA from pea prepared according to this method has successfully been used for restriction enzyme mapping, Southern transfers, and cloning. PMID- 6496934 TI - A statistical method for determining the breakpoint of two lines. AB - A method is presented for determining the breakpoint of a line which suddenly changes slope at some unknown point. A statistical test is given for testing whether the broken line is a significantly better fit to the data than a single straight line. An approximate confidence interval can be obtained for the position of the breakpoint. PMID- 6496933 TI - Hydrogenation of triton X-100 eliminates its fluorescence and ultraviolet light absorption while preserving its detergent properties. AB - The ultraviolet-light absorption and fluorescence of Triton X-100 were virtually eliminated by hydrogenation to its reduced cyclohexyl analog, RTX-100. The critical micelle concentration of RTX-100 was 12% higher than that of Triton X 100. RTX-100 and Triton X-100 were quite similar in their abilities to extract proteins from human erythrocyte membranes. PMID- 6496935 TI - A batch assay using Calcofluor fluorescence to characterize cell wall regeneration in plant protoplasts. AB - A batch assay to study and measure the regeneration of cell walls during the early days of culture of primary protoplasts is presented. The assay involves the measurement of Calcofluor White fluorescence on a scanning fluorometer when the Calcofluor is adsorbed to the cellulosic component of the newly synthesized cell walls. The Calcofluor fluorescence, when standardized with microcrystalline cellulose, provided a measure of cell wall cellulose. The assay was used to study cell wall regeneration in Hyoscyamus muticus L. protoplasts during 8 days of culture. PMID- 6496936 TI - Typing and subtyping of haptoglobin from native serum using disc gel electrophoresis in alkaline buffer: application to routine screening. AB - A method with which the six common phenotypes of human haptoglobin can be identified using unseparated serum is described. In contrast to other reported methods, both typing and subtyping of haptoglobin can be performed by polyacrylamide gel electrophoresis in alkaline buffer using 0.1-4.0 microliter of native serum with hemoglobin added. Haptoglobin-hemoglobin complexes are visualized by their peroxidase activity using benzidine and barium peroxide. This relatively inexpensive and fast method seems particularly well suited for the typing and subtyping of haptoglobin from minute amounts in large series of sera and other body fluids and thus may be useful in medical genetics and forensic medicine. PMID- 6496937 TI - Preparing nuclei from cells in monolayer cultures suitable for counting and for following synchronized cells through the cell cycle. AB - A procedure is described for preparing nuclei from cells in monolayer culture so that they may be counted using an electronic particle counter. It takes only 10 to 15 min, and consists of swelling the cells in hypotonic buffer and then lysing them with the quaternary ammonium salt, ethylhexadecyldimethylammonium bromide. The cells are completely lysed, yielding a suspension of clean single nuclei which is stable, free of debris, and easily counted. The method was developed for a cell line of epithelial origin (MCF-7), which is often difficult to trypsinize to single cells. It works equally well at all cell densities up to and beyond confluence, and has been used with a variety of cells in culture, including 3T3 cells, bovine macrophages, rat mammary epithelial cells, mouse mammary tumor cell lines, and human fibroblasts. The size of the nuclei produced by this procedure is related to their DNA content, and the method is thus suitable for following cultures of synchronized cells through the cell cycle, and for performing differential counts of cells with substantial differences in DNA content. PMID- 6496938 TI - Simple and small-scale breakdown of yeast. AB - A simple and small-scale method for the preparation of homogenate from yeast was developed. The principle of this new method involves the shaking of a small amount of yeast-cell suspension with glass beads on a tower-shaped mixer. When this method is used the cells in 1 ml of cell suspension are broken down and 14 samples can be simultaneously processed under controlled conditions. The degree of cell breakdown, the amount of soluble protein liberated from the cells, and the increase in each enzyme activity in prepared homogenate correlated to the shaking time: maximum values were obtained at 20 min. Enzyme activities in the homogenate were equivalent to or higher than that procured with former methods. This new method is applicable to various species of yeasts. PMID- 6496939 TI - Quantitation of types I and III collagens in human tissue samples and cell culture by cyanogen bromide peptide analysis. AB - A procedure for the quantitation of types I and III collagens by cyanogen bromide peptide analysis was developed with the aim of eliminating certain problems associated with this method. Ion-exchange chromatography reduced high background levels on gel scans used to quantitate the peptides; reduction with beta mercaptoethanol substantially increased the efficiency of the cyanogen bromide cleavage; use of a concave gradient in acrylamide from 8 to 20% improved the resolution of cyanogen bromide peptides separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis; and a normalization procedure eliminated variations due to differences in the amount of material loaded on the gel system. This method of quantitation was applied to human aorta samples and to collagen secreted by human skin fibroblasts. Metachromasy of type I and type III collagen cyanogen bromide peptides stained with Coomassie blue R-250 was established and this was used as an index of the purity of the cyanogen bromide peptide preparations. Type I and III collagens were prepared from human placental tissue, and these purified collagens were used to construct calibration curves to determine the relationship between the quantity of diagnostic cyanogen bromide peptides present and the composition of the sample in terms of types I and III collagens. PMID- 6496940 TI - Determination of copper in biological materials by atomic absorption spectroscopy: a reevaluation of the extinction coefficients for azurin and stellacyanin. AB - A new method for the determination of copper in biological materials by graphite furnace atomic absorption spectroscopy is presented. This new procedure is an extension of the classic method of standard additions, where the analyte concentration is determined in a series of identical samples to which various amounts of metal standard have been added. The concentration of metal in the original sample is determined from an extrapolation of a plot of absorbance versus added analyte. In the new method, the amount of copper is determined by the method of standard additions for different concentrations of the sample under investigation as well. From an extrapolation of the data, the concentration of copper in the absence of interfering matrix is obtained. Studies with fetal bovine serum demonstrate that the new extrapolation technique is precise. Furthermore, considerably more copper is detected than by the classic method of standard additions applied to a nitric acid treated sample. The matrix effects of phosphate, nitrate, albumin, and serum were also examined. Both phosphate and serum, at physiological pH, decrease the detectability of added copper, while nitrate and albumin were without effect. The accuracy of this method has been verified by determining the extinction coefficients of stellacyanin and azurin. The values obtained, 4.33 X 10(3) and 3.75 X 10(3) M-1 cm-1, respectively, are considerably different from those determined by the method of standard additions on nitric acid digests of these proteins, but were close to values previously reported and determined colorimetrically. PMID- 6496941 TI - A coupled fluorometric rate assay for pyruvate dehydrogenase in cultured human fibroblasts. AB - A method for measuring the activity of the pyruvate dehydrogenase complex (PDC) by coupling acetyl-CoA production to acetylation of a fluorescent dye is described. Acetylation of cresyl violet acetate by pigeon liver acetyltransferase results in a shift of its fluorescence spectrum from lambda ex max = 575, lambda em max = 620 nm to lambda ex max = 475, lambda em max = 575 nm. The rate of appearance of acetylated dye was followed fluorometrically and was proportional to PDC activity in extracts of cultured human fibroblasts. The assay showed appropriate substrate and cofactor dependence and had a working range between 0.04 and 70 munits. It is 10 times more sensitive than the spectrophotometric assay on which it is based (working range 0.4-31 munits) and is equally convenient. Unactivated PDC activity in fibroblast extracts was 0.75 (0.60-0.92) munits/mg protein (mean and range for six cell lines). PMID- 6496942 TI - Oven-drying method for polyacrylamide gel slab packed in cellophane sandwich. AB - Polyacrylamide gel slabs can be dried quickly without elaborate tools and the results are similar or even better than those obtained with a commercial drying apparatus. The discontinuous, sodium dodecyl sulfate, and gradient polyacrylamide gel slabs yielded similar results regardless of the staining methods, e.g., Coomassie blue, periodate-Schiff's reagent, or ammoniacal silver. PMID- 6496943 TI - Amino acid analysis of angiotensin I by proton nuclear magnetic resonance spectroscopy. AB - The chemical shifts of the isoleucine and histidine protons of angiotensin I were assigned and the chemical shifts of the protons of the other amino acids in the peptide were confirmed at a field strength of 400 MHz. These chemical shift assignments were used to determine the amino acid composition of angiotensin I. These data were then compared to the amino acid composition which was determined by chromatographic analysis of the peptide hydrolysate. The results obtained by the chromatographic method were similar to those obtained by the NMR method. The standard deviations of the results were similar, indicating that these methods are equally precise. The major advantages of the NMR method are that it permits the recovery of the peptide after completion of the analysis and improves the quantitation of amino acids which are either partially destroyed by the hydrolysis procedure or require special derivatization methods for detection and quantitation. PMID- 6496944 TI - Precipitation of collagens by polyethylene glycols. AB - Types I, II, and III collagens are readily precipitated at neutral pH by polyethylene glycols (PEG). As the molecular weight fraction of the polyethylene glycols increases, they become more effective as precipitants on a weight basis. The amount of PEG required for precipitation depends on the pH, the ionic strength, and the nature of the buffer or salts present. In tissue culture media, low concentrations of collagens and procollagens may be quantitatively precipitated and readily collected by low-speed centrifugation. Polyethylene glycol precipitation can be used to obtain collagens and procollagens from tissue culture media at either analytical or preparative scale, and since the polyethylene glycols do not bind to collagens, the precipitates may be further analyzed directly by chromatographic or electrophoretic methods. PMID- 6496945 TI - Structural characterization of oligosaccharides by high-performance liquid chromatography, fast-atom bombardment-mass spectrometry, and exoglycosidase digestion. AB - A method for structural characterization of oligosaccharides after preparing uv absorbing derivatives is described. The derivatives can be rapidly analyzed and purified by high-performance liquid chromatography, with separation of various structures determined primarily by size and sugar composition. Derivatization requires as little as 0.5-1.0 nmol of oligosaccharide, and detection of down to 50 pmol of oligosaccharide is possible by monitoring absorbance at 229 nm. In addition, the carbohydrate portion of the derivative was found to retain its sensitivity to exoglycosidases, allowing sequential enzymatic digestions for determination of sugar sequence and anomerity to be performed. The derivatives also possessed a site of potential positive charge, making them amenable to analysis by fast-atom bombardment-mass spectrometry. Permethylation of the derivatives permitted their separation by capillary gas chromatography, thus allowing investigation of their structures by gas chromatography-mass spectrometry. The combination of these techniques will allow almost the complete structure of small amounts of oligosaccharides to be determined. PMID- 6496946 TI - An enzymatic fluorimetric assay for myo-inositol. AB - An enzymatic assay for myo-inositol (MI) is described. The method is based on the oxidation of MI by NAD+-dependent myo-inositol dehydrogenase, coupled to reoxidation of NADH with oxalacetate and malate dehydrogenase. The resultant malate is measured fluorimetrically. Several variations of the assay are described for measuring MI in serum and in tissues in amounts ranging from 0.2 pmol to 8 nmol. Highest sensitivity is achieved by applying an oil-well technique for handling small droplets, and by using the principle of enzymatic cycling. The potential of the technique is illustrated by MI measurements in several tissues of normal and diabetic rats and Chinese hamsters. PMID- 6496948 TI - A new kinetic diagnostic for enzymatic mechanisms using alternative substrates. AB - When the concentration of substrate A is varied against fixed and saturating concentrations of alternative substrates B, B', B", etc., and B is similarly varied against alternatives of A, unique pairs of kinetic patterns are generated for each of the major classes of kinetic mechanism for enzymatic catalysis involving two substrates. Thus, a determination of mechanism may be obtained from just two kinetic patterns. The diagnostic has the following advantages over previous usages of alternative substrates and the traditional approach using initial velocity patterns: efficiency (fewer assays are needed), accuracy (large changes in slopes and intercepts are possible), and precision of assays (one substrate is always saturating). PMID- 6496947 TI - Sodium sulfite as an antioxidant in the acid hydrolysis of bovine pancreatic ribonuclease A. AB - Treatment of hydrochloric acid with sodium sulfite prior to the acid hydrolysis of bovine pancreatic ribonuclease A has been found to suppress the oxidation of cystine, methionine, and tyrosine without adversely affecting the recoveries of other amino acids. Statistical analysis of the results indicated that the assumption of the independence of the mean and the variance, an assumption commonly used in the evaluation of the effects of various treatments, may not be valid in evaluating antioxidants used in the acid hydrolysis of proteins. PMID- 6496949 TI - Automation of a fluorometric method for the determination of 2-deoxy-D-glucose. AB - A continuous-flow fluorometric procedure for the determination of 2-deoxy-D glucose (2DG) is described. The method utilizes Technicon Autoanalyzer equipment and modules, and is based on the acid-catalyzed condensation of 3,5 diaminobenzoic acid with 2DG. The procedure permits analysis of 20 samples/h, is sensitive to concentrations of 2DG as low as 0.2 mg/100 ml, and requires sample volumes of only 0.25 ml. 2DG can be quantitatively measured in serum samples or tissue extracts without requiring deproteinization. Glucose does not interfere with the assay while 2-deoxy-D-ribose develops a fluorescence which is about 15% of that produced by the same amount of 2DG and is additive when both deoxy sugars are present together. The procedure is accurate, reproducible, and fast, and can be run continuously. PMID- 6496950 TI - Radioimmunoassay for neopterin in body fluids and tissues. AB - Specific antibodies against D-erythroneopterin have been prepared in rabbits using a conjugate of D-erythroneopterin to bovine serum albumin (D erythroneopterinylcaproyl-bovine serum albumin). The antiserum distinguished D erythroneopterin from other pteridines, i.e., three stereoisomers of neopterin, L erythrobiopterin, folic acid, xanthopterin, and four other synthetic pteridines. Using this specific antiserum, a radioimmunoassay for D-erythroneopterin has been developed to measure the neopterin concentrations in urine and tissues. The conjugate of D-erythroneopterin with tyramine (NP-Tyra) was synthesized and labeled with 125I as the labeled ligand NP-[125I]tyra for the radioimmunoassay. The minimal detectable amount of neopterin was about 0.1 pmol. The concentration of total neopterin (neopterin, 7,8-dihydroneopterin, quinonoid dihydroneopterin, and tetrahydroneopterin) in the biological samples was obtained by iodine oxidation under acidic conditions prior to the radioimmunoassay, and that of neopterin plus 7,8-dihydroneopterin by oxidation under alkaline conditions. Total neopterin values in human urine obtained by this new radioimmunoassay showed a good agreement with those obtained by high-performance liquid chromatography with fluorescence detection. With rat tissue samples which contained very low concentrations of neopterin as compared to biopterin, biopterin was simultaneously determined by our previously reported radioimmunoassay, and neopterin values were corrected for the cross-reactivity (0.1%). The neopterin concentrations obtained by this method agreed with the values obtained by the radioimmunoassays for neopterin and biopterin after their separation by high performance liquid chromatography. This very small amount of neopterin, as compared with biopterin, in rat tissues could not be determined by high performance liquid chromatography-fluorometry alone due to the masking of the neopterin peak by a large biopterin peak.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496951 TI - Differential pulse polarographic determination of plasma menadione. AB - A differential pulse polarographic assay for plasma vitamin K3 (menadione) has been developed. Details of the assay are (i) lipid-soluble material is extracted from plasma into ether by the method of Bjornsson et al. [(1978) Thromb. Haemostas. 2, 466-473]; (ii) ether is evaporated under nitrogen and the residue is dissolved in the supporting electrolyte, methanol: 0.2 M borate buffer (9:1), pH 6.8; (iii) current height is measured at -0.32 V vs SCE on the differential pulse polarogram. The lower sensitivity limit of this technique after addition of standard vitamin K3 to plasma is 0.3 microM; the calibration curve is linear from 0.6 through 10 microM. Two patients treated with a single dose of menadiol sodium diphosphate, 20 mg/M2 i.m., achieved measurable plasma vitamin K3 levels at 0.5 to 1.0 h ranging between 0.5 (0.08 micrograms/ml) and 2 microM (0.3 micrograms/ml). PMID- 6496952 TI - Purification of glycogen phosphorylase from small quantities of mouse skeletal muscle. AB - A new approach to the purification of skeletal muscle glycogen phosphorylase is described. The purification scheme is particularly suited to preparation of the enzyme from small amounts of tissue. A combination of dye-ligand chromatography and hydrophobic chromatography yields homogenous enzyme with good recoveries. The purification is rapid and may be completed in a working day. PMID- 6496953 TI - Sources of error in estimating radioactivity in protein from cell cultures by liquid scintillation counting. AB - In this study, several common sample preparation techniques for liquid scintillation counting were critically reviewed. It has been shown that techniques such as NaOH or formic acid solubilization of trichloroacetic acid (TCA)-precipitated proteins led to underestimation of the radioactivity by 20 40%; this loss was not corrected by either internal or external standardization. Hydrolysis of the proteins with 6 N HCl or Pronase significantly increased the recovery of the labeled proteins. Also, 10% of the labeled cell proteins remained on the dish when cells were scraped into buffer; these labelled proteins could be recovered either by in situ hydrolysis with Pronase or by solubilization and scraping in 0.3 N NaOH. These techniques increased the recovered radioactivity by 50-60%, allowing quantitative measurements to be made over a 3-day chase period. A possible mechanism and the implications of this observation were discussed. PMID- 6496954 TI - Evaluation of a dual mass spectrometer system for rapid simultaneous determination of hydrogen-2/hydrogen-1 and oxygen-18/oxygen-16 ratios in aqueous samples. PMID- 6496955 TI - Determination of leukotriene C4 by radioimmunoassay with a specific antiserum generated from a synthetic hapten mimic. PMID- 6496956 TI - Direct comparison of secondary ion and laser desorption mass spectrometry on bioorganic molecules in a moving belt liquid chromatography/mass spectrometry system. PMID- 6496957 TI - Sequential determination of glutamate-oxalacetate transaminase and glutamate pyruvate transaminase activities in serum using an immobilized bienzyme poly(vinyl chloride) membrane electrode. PMID- 6496958 TI - Dehalogenation reactions in fast atom bombardment mass spectrometry. PMID- 6496959 TI - Infertility and chronic prostatitis. AB - Long term treatment of chronic prostatitis with antimicrobials and their influence on semen quality and infertility were studied in 30 men with mean age of 36.7 +/- 6 years. The infection was symptomatic only in 50% of the patients with abnormal prostatic physical findings in 66.7%. Cardinal findings in the spermatogram were leukocytosis in 100% and oligoasthenozoospermia in 66.5% of the patients. E. coli and Staphylococci presented the most commonly isolated bacteria in prostatic secretion cultures. Various treatment schedules, including mostly co trimoxazole, doxycycline and erythromycin, were given alternatively for 6-8 months. Symptoms were cured or improved in 79.7%, with elimination or improvement of abnormal physical findings in 85%, while the isolated pathogens were eradicated in all. Spermatograms were normalized or improved in 70% of the patients, while among them 9 impregnated their wives and in 2 of them twice. It is concluded that male infertility in the presence of semen leukocytosis and oligoasthenozoospermia should be investigated for underlying chronic prostatitis, while whenever proved, long term treatment with the proper antimicrobials not only cures or improves chronic prostatitis, but subsequently cures or improves male infertility. PMID- 6496960 TI - Study of sperm morphologic characteristics in a group of 833 fertile men. AB - For the 13 abnormalities under consideration, the mean percentages were found to be the following: irregular head (15.2), microcephalic (9.8), elongated head (5.9), coiled tail (5.8), bent tail (4.7), thin head (4.6), cytoplasmic remains (3.2), macrocephalic (1.6), short tail (1.1), no tail (0.6), duplicate tail (0.5), duplicate head (0.4), lysis (0.4). In so far as the group studied is representative, the results obtained may be considered as "norms" with the 90th percentiles showing the upper limit of the "normal". The same mean percentages were found by MacLeod and Gold (1951) for the five abnormalities they had identified. The length of abstinence preceding the collection of the ejaculate was found to have no influence on the percentage of abnormal forms. PMID- 6496961 TI - Duration of vitality and migrating ability of human spermatozoa cryopreserved at +4 degrees C. AB - Non-freezing cold storage of sperm may provide a useful means for repeated AIH or AID by using the same semen sample and avoiding expensive and complicated freezing procedures. By a simple method of resuspending sperm in a yolk and glycerol based preserving solution, the samples were kept in a standard refrigerator up to 96 hours. Motility patterns as well as in vitro migration of spermatozoa remained unaltered until 24 hours. After this time however, a rapid deterioration began so that at 48 hours all parameters had decreased with high significance as compared to controls. Between 48 hours and 96 hours the impairment of motility and migration went further, though at a slower pace. PMID- 6496962 TI - Clinical use of the turbidimetric analysis of sperm motility: an update. AB - The turbidimetric method of sperm motility analysis provides a quantitative measure of sperm motility. We have previously reported the methodology by which this method is utilized in routine sperm motility determinations in our Male Fertility Clinic. We have recently observed that the motility of sperm in dialyzed seminal plasma is over double the motility in Lopata's medium. This report provides quantitative evidence that the use of dialyzed seminal plasma in the turbidimetric analysis is significantly superior than the use of Lopata's medium. PMID- 6496963 TI - [The investigation of spermatozoa motility]. AB - The motility of spermatozoa on 324 ejaculates was investigated with the help of two different methods, the sperm motile efficiency (Ishii) and a subjective calculation of the velocity of spermatozoa. Simultaneously the eosin-vitality test was done. There was a very good statistical correlation (alpha = 0,1%) and no difference could be observed among the three methods. Ishii's sperm efficiency will be recommended as a standard. PMID- 6496964 TI - Further studies on testicular lipids and glycogen in human patients with unilateral varicocele. AB - In the present study the lipid and glycogen content of human testis in patients with unilateral varicocele is presented. Eight cases were taken for the present study. Testicular biopsy specimens taken from these patients were analyzed and the normal testis acted as control groups. There was marked increase in total lipids, ester cholesterol and glycerides in the testis of varicocele patients. The abnormal increase observed in estercholesterol may be due to non-utilization of cholesterol esters for androgen biosynthesis. The glycogen level was reduced significantly in the affected testis. Thus, varicocele seem to alter the availability of substrates of energy required for normal functioning of germinal and non-germinal cells which results in defective spermatogenesis and steroidogenesis. PMID- 6496965 TI - Inhibition of glyceraldehyde 3-phosphate dehydrogenase by adenine nucleotides in pachytene primary spermatocytes from rat testes. AB - The effect of adenine nucleotides on the catalytic activity of spermatocyte glyceraldehyde 3-phosphate dehydrogenase (GA3PDH) was studied for its significance to metabolic regulation. In the presence of glucose (10 mM), the ATP level declined whereas the ADP and AMP levels remained unchanged. During incubation with glucose, fructose 1,6-bisphosphate (fruc 1,6-P2) and dihydroxyacetone phosphate (DHAP) were accumulated markedly. GA3PDH was inhibited by ATP (Ki = 2.27 mM), ADP (Ki = 1.21 mM) and AMP (Ki = 0.73 mM) competitively with NAD (Km = 0.24 mM). The results suggest that glycolysis in spermatocytes is regulated by GA3PDH. PMID- 6496966 TI - The effect of seminal plasma on gonadotrophin secretion by sheep pituitary cells in culture. AB - We tested the effect of seminal plasma fractions of pooled normozoospermic and azoospermic seminal plasma on secretion of LH by sheep pituitary cells in culture. From these experiments we conclude that there is activity in seminal plasma (molecular mass 10.000-80.000) which inhibits LH secretion. This activity is not steroid-mediated and is absent in azoospermic seminal plasma. These data support our thesis that LH secretion is not only controlled by testosterone but also by spermatogenesis per se. PMID- 6496967 TI - [Disorders of testis function after high-dose depot testosterone therapy for the treatment of excessive height in adolescents]. AB - Short comment about the side effects of the high-dosage testosterone-depot treatment of tall boys by pediatrics. Concerning the own experiences on adult males with this treatment (permanent azoospermia in cases of oligozoospermia) I strictly reject to practice this therapy. PMID- 6496968 TI - Duration and toxicity of bupivacaine for topical anesthesia of the airway in the cat. AB - To assess bupivacaine as a topical anesthetic of the airway, 0.5 ml of 1, 2, and 4% bupivacaine was sprayed down the trachea of lightly anesthetized cats and the duration of anesthesia, systemic toxicity, and local toxicity was compared to that produced by 4% lidocaine. Two percent bupivacaine suppressed the cough reflex longer than 4% lidocaine with no increase in either local or systemic toxicity. Four percent bupivacaine produced arrhythmias in 5 of 10 cats in two groups and apnea in 4 of 6 cats. This study indicates that 2% would be an appropriate concentration to assess bupivacaine as a topical anesthetic of the airway in humans. PMID- 6496969 TI - Intracranial pressure during tetrodotoxin-induced hypotension. AB - The effect of tetrodotoxin-induced hypotension on intracranial pressure (ICP) was investigated in cats with normal and artificially increased ICP. Cats were anesthetized with intraperitoneal pentobarbital (25-30 mg/kg), intubated, and ventilated with nitrous oxide in oxygen. Mean arterial pressure (MAP), heart rate (HR), and pulmonary arterial pressure (PAP) were continuously recorded. A double 18-gauge needle was inserted into the cisterna magna; ICP was continuously monitored from one needle and the other was used to increase and maintain ICP at 27 +/- 4 mm Hg by infusion of pH-adjusted Ringer's lactate solution. After control measurements were taken, tetrodotoxin (TTX) was given intravenously in each cat when ICP was normal and increased. Injection of 8-16 micrograms TTX (approximately equal to 2-4 micrograms/kg) decreased MAP 40-50% for 8-12 min under both initial ICP conditions. Whether initial ICP was normal or elevated, no significant increase occurred in ICP (0.6 to 1 mm Hg), and cerebral perfusion pressure (CPP) was not jeopardized. When initial ICP was normal, TTX caused a decrease in HR that was statistically but not clinically significant. The change in HR when initial ICP was increased was not statistically or clinically significant. No significant change in PAP was apparent during TTX-hypotension under either initial ICP condition. PMID- 6496970 TI - Hyperbaric bupivacaine for spinal anesthesia in cesarean section. AB - The efficacy and safety of 0.5% hyperbaric bupivacaine (Sensorcaine, Astra) was evaluated in 22 patients undergoing elective cesarean section under spinal anesthesia. The dose varied from 7.5 to 10 mg, (depending on the patient's height) which was significantly lower than previously reported. Patients were placed in head-down tilt immediately after subarachnoid injection. The mean spread of analgesia was to T3, which was reached in 10-15 min. Regression was complete in 258 +/- 16 min. Complete motor paralysis of lower extremities occurred in only two patients. Complete recovery of motor function in all patients was evident in less than 2.5 h. All infants were vigorous at birth and there were no serious maternal complications. The incidence of hypotension was 4.5%, the lowest reported as a consequence of spinal anesthesia in this group of patients. A technique involving the use of reduced doses of hyperbaric bupivacaine (0.5%) in conjunction with head-down tilt appears to be useful for spinal anesthesia for cesarean section. PMID- 6496971 TI - Caudal anesthesia with lidocaine or bupivacaine: plasma local anesthetic concentration and extent of sensory spread in old and young patients. AB - Continuous caudal peridural anesthesia with 2% lidocaine (6 mg/kg) or 0.75% bupivacaine (2.2 mg/kg), both with epinephrine 1:200,000, was studied in two groups of male patients, younger than 40 or older than 55 yr old, respectively. Patients receiving lidocaine in the younger group (n = 6) were 32 +/- 5.2 (mean +/- SD) yr old and weighed 75 +/- 12 kg, while those in the older group (n = 16) were 66 +/- 5.3 yr old and weighed 72 +/- 8.2 kg. Patients receiving bupivacaine in the respective groups were 27 +/- 7.0 yr old (n = 5), and 76 +/- 10 kg compared to 69 +/- 10 yr (n = 14) and 75 +/- 10 kg. Anesthesia was satisfactory in all patients. Extent of sensory anesthesia, peak plasma lidocaine or bupivacaine concentrations, and area under the plasma concentration-time curves were independent of age. No local anesthetic toxicity was observed and peak drug concentrations were below those commonly associated with toxicity. PMID- 6496972 TI - Phenytoin improves hemodynamic tolerance and survival after severe hypoxia. AB - Three groups of 12 rabbits each, anesthetized with ketamine (30 mg/kg, intramuscularly) and spontaneously breathing N2O-O2, were given intravenous injections of either placebo (group 1), thiopental (TP) (40 mg/kg, intravenously; group 2), or phenytoin (PNT) (15 mg/kg, intravenously; group 3). Four minutes later, succinylcholine was given and, while ventilation was controlled with N2O alone, changes in systolic blood pressure (SBP) and heart rate (HR) were measured. Tachycardia (greater than 210 beats/min) occurred in groups 1, 2, and 3 111, 107, and 151 sec later, respectively. SBP decreased below 100 torr at 189, 192, and 362 sec, respectively, and below 30 torr 245, 216, and 433 sec after the onset of hypoxia (P less than 0.05), respectively. Bradycardia (less than 30 beats/min) appeared 248, 219, and 439 sec (P less than 0.05), respectively. The onset of severe bradycardia and hypotension was significantly (P less than 0.05) delayed by PNT but not by TP. All rabbits in the placebo group died, while 3 and 8 of the animals given TP and PNT, respectively, survived; survival rate was significantly (P less than 0.05) increased by PNT but not by TP. Phenytoin appears to sustain cardiovascular function during hypoxia better than thiopental does, but phenytoin may not be more effective than thiopental in increasing survival. PMID- 6496973 TI - The epidural blood patch: are more than two ever necessary? PMID- 6496974 TI - High-frequency jet ventilation for tracheal resection in a child. PMID- 6496975 TI - Neonatal neurobehavioral responses after epidural anesthesia for cesarean section using lidocaine and bupivacaine. PMID- 6496976 TI - Obstetric side brace for the delivery room table. PMID- 6496978 TI - The Lee modification of the Tuohy needle--a useful adjunct to gauging the depth of the epidural space. PMID- 6496977 TI - An unusual cause of failure of anesthetic gas delivery to a patient circuit. PMID- 6496979 TI - Balanced anesthesia does anesthetize. PMID- 6496980 TI - Statistically significant vs clinically significant differences. PMID- 6496981 TI - The effect of halothane, isoflurane, and blood loss on hepatotoxicity and hepatic oxygen availability in phenobarbital-pretreated hypoxic rats. AB - This study evaluated the role of ventilatory and circulatory depression in anesthesia-induced hepatotoxicity in rats. Male Sprague-Dawley rats (181 animals) were pretreated with phenobarbital and exposed to hypoxia (FIO2 = 0.14) for 2 hr. The animals were divided into four groups: group 1 received 1% inspired halothane in the hypoxic gas mixture; group 2 received 1.4% inspired isoflurane and hypoxia; group 3 had 25-30% of their blood volume removed 2 hr before exposure to hypoxia; and group 4 served as a control with no treatment other than hypoxia. Hepatic blood flow was studied using microspheres; oxygen availability to the liver was calculated using values of hepatic blood flow and oxygen content of arterial and portal venous blood; and liver injury was quantitatively evaluated. Ventilation was depressed in rats that received halothane and, to a lesser extent, isoflurane. The lowest portal blood flow was observed in groups 1 and 3. Hepatic arterial blood flow was lowest in group 1 and highest in group 3. There was an inverse relationship between hepatic oxygen availability and severity of histologic lesions. The most severe lesions and lowest oxygen availability was associated with halothane. Hemorrhage and isoflurane were associated with less diminution of oxygen availability and less severe hepatic lesions. The least decrease in oxygen availability and the least severe histologic changes occurred in control rats subjected to hypoxia only. PMID- 6496982 TI - Maternal, fetal, and neonatal effects of lidocaine with and without epinephrine for epidural anesthesia in obstetrics. AB - The effects of epidural lidocaine with and without 1:300,000 epinephrine on uterine activity, progress of labor, fetal heart rate, maternal blood pressure and heart rate, newborn Apgar scores, neonatal acid-base status, and the Neurologic and Adaptive Capacity Scoring System were compared in 30 parturients during labor and delivery. Patients in group I (n = 16) received 1.5% lidocaine with 1:300,000 epinephrine and those in group II (n = 14) 1.5% lidocaine alone. Addition of epinephrine to lidocaine did not have any significant effects on uterine activity, duration of first or second stages of labor, fetal heart rate variability, or the incidence of abnormal fetal heart rate patterns. Maternal heart rate and the incidence of hypotensive episodes did not differ significantly between the two groups of patients. Apgar scores, neonatal acid-base status, and the NACS were equally good in the two groups. Duration of analgesia was significantly longer in group I as compared to group II patients (106.9 +/- 6.6 vs 66.2 +/- 4.4 min, P less than 0.001). Umbilical venous concentrations of lidocaine and umbilical vein to maternal vein ratios of lidocaine were significantly higher in group II patients (P less than 0.05). It is concluded that addition of epinephrine to lidocaine during epidural anesthesia in the normal parturient has no adverse effects on mother, fetus, neonate, or the progress of labor and it significantly prolongs the duration of anesthesia and limits the placental transfer of lidocaine. PMID- 6496983 TI - The influence of diazepam on the serum protein binding of bupivacaine at normal and acidic pH. AB - Since both bupivacaine and diazepam are highly protein bound, it is possible that a drug displacement interaction could occur, resulting in an increase in free bupivacaine concentration that could exacerbate systemic toxicity. This study was undertaken to characterize the serum binding of diazepam and to evaluate any drug displacement interaction between diazepam and bupivacaine. Human serum obtained from venous blood of normal male and female volunteers was used for measurements of protein binding using an Amicon Micropartition System. Bupivacaine protein binding in the presence of 0, 0.5 and 1.5 microgram/ml diazepam was best described by the model for two classes of binding sites. Neither concentration of diazepam significantly altered the capacity or affinity for either class of bupivacaine binding sites when compared to control. Free concentrations of bupivacaine were statistically identical in the presence of both diazepam concentrations. The complete diazepam binding profile in both serum and isolated human serum albumin was best described by a model describing two classes of binding sites. The effect of an acidic pH on bupivacaine was also independent of diazepam concentration. Diazepam protein binding was not affected by a reduction in pH from 7.4 to 7.0. The data reported here suggest no binding displacement interaction exists between bupivacaine and concomitantly administered diazepam. Thus, administration of diazepam during a toxic reaction associated with bupivacaine should not alter free bupivacaine concentration. PMID- 6496984 TI - Cell membrane fusion by chloroprocaine. AB - The cytotoxicity of the local anesthetics chloroprocaine, procaine, and lidocaine was studied in murine and human cells. Murine glial and hepatic cells, and human fibroblasts were individually exposed to chloroprocaine, procaine, and lidocaine in concentrations ranging from 1.6 X 10(-3) M to 0.2 X 10(-3) M. The cells of all three cell lines underwent membrane fusion after exposure to chloroprocaine as indicated by the presence of the high number of multinucleated cells in the cultures. The 0.8 X 10(-3) M concentration was the most fusogenic, and caused multinucleation in 30% of glial and hepatic cells, and in 23% of fibroblasts. Membrane fusion and multinucleation also occurred in mixed human and murine cell cultures that were exposed to 0.8 X 10(-3) M concentration of both commercial and crystalline solutions of chloroprocaine, with a portion of multinucleated cells that was 27 and 17%, respectively. Cell membrane fusion was not caused by procaine, lidocaine, sodium bisulfite (the antioxidant present in the commercial solutions of chloroprocaine), or chloro-aminobenzoic acid and diethylamino ethanol (the two chloroprocaine metabolites). The fusogenic effect of chloroprocaine on cell membrane has not been previously described for any local anesthetic. PMID- 6496986 TI - Renal effects of dopamine. PMID- 6496985 TI - Use of cyclopropane to test generality of anesthetic requirement in the elderly. AB - The minimum alveolar concentration (MAC) of cyclopropane was determined in young (mean age, 32 yr; n = 16) and older (mean age, 81 yr; n = 12) surgical patients. Cyclopropane requirement was 23% lower in the elderly (P less than 0.01). This reduction in anesthetic requirement with age is similar to that reported previously for halothane and isoflurane and supports the thesis of a general effect of age on anesthetic requirement. PMID- 6496988 TI - The hemodynamic consequences of high-dose methohexital anesthesia in humans. AB - The hemodynamic, electroencephalographic (EEG), and metabolic effects of a high dose methohexital anesthetic were examined in eight neurosurgical patients. The patients were studied at rest and at 15-min intervals during a 60-min infusion of the drug, given at a rate of 0.40 mg . kg-1 . min-1 (total dose 24 mg/kg). Ventilation was controlled with oxygen:air (FIO2 = 0.50), and fluid was infused at a rate sufficient to maintain pulmonary capillary wedge (PCW) pressures at control values (8 +/- 2 mmHg, mean +/- SD). Serum methohexital concentrations increased progressively, reaching values of 11.7 +/- 2.9 micrograms/ml at t = 30 min and 18.1 +/- 10.8 micrograms/ml at t = 60 min. Characteristic barbiturate induced EEG changes were noted, with isoelectricity achieved at t = 28 +/- 13 min. Methohexital infusion resulted in significant reductions in arterial pressure (84% of control at t = 60 min), systemic vascular resistances (83% of control at t = 60 min), right and left ventricular stroke work indices (65% and 68% of control, respectively at t = 60 min), and total body O2 consumption (76% of control at t = 60 min). In addition, a progressive dose-related decrease in stroke volume index was noted (50.1 +/- 90 ml X beat-1 X m-2 at t = 0, 40.1 +/- 10.2 ml X beat-1 X m-2 at t = 60 [80% of control]). This occurred in spite of unchanged ventricular filling pressures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496987 TI - The diuretic properties of dopamine in patients after open-heart operation. AB - Dopamine and dobutamine were administered to 12 patients who had undergone open cardiac operations. To eliminate the effects of variation in systemic blood flow upon renal function the drug infusion rates were adjusted to achieve equal cardiac outputs. Under conditions of equivalent systemic pressure and flow, dopamine (5.0 +/- 1 micrograms X kg-1 X min-1) and dobutamine (3.5 +/- 1.8 micrograms X kg-1 X min-1) had similar effects upon glomerular filtration rate (90 +/- 29 vs. 83 +/- 27 ml X min-1 X 1.73 m-2) and effective renal plasma flow (375 +/- 119 vs. 357 +/- 126 ml X min-1 X 1.73 m-2). However, dopamine administration resulted in a significantly greater diuresis (2.8 +/- 2.7 vs. 1.0 +/- 0.3 ml/min), natriuresis (0.32 +/- 0.39 vs. 0.07 +/- 0.10 mEq Na+/min), and kaliuresis (0.15 +/- 0.06 vs. 0.10 +/- 0.03 mEq K+/min) (P less than 0.05). In patients with modest depression of cardiac performance and renal vasoconstriction, dopamine's selective renal vasodilator effects were not evident. Furthermore, these data suggest that dopamine inhibits tubular solute reabsorption directly. Thus, the diuresis and natriuresis that frequently accompany dopamine administration may occur independently of any effects of dopamine upon renal blood flow. PMID- 6496989 TI - The effect of paralysis on oxygen consumption in normoxic children after cardiac surgery. AB - To determine whether paralysis reduces oxygen consumption (V02) after cardiac surgery in infants, the authors measured V02 before and after paralysis in 17 sedated infants who were ventilated mechanically after cardiac surgery. Oxygen consumption was determined as being the difference between oxygen content of inspired and expired gases. The absence or presence of "movement" (breathing or repeated movement of the extremities) before paralysis was noted. For eight infants who did not "move" before paralysis, VO2 was similar before (9.1 +/- 1.2 ml . kg-1 . min-1, mean +/- SD) and after (9.0 +/- 1.5 ml . kg-1 . min-1) paralysis (P = 0.81). However, for nine infants who did "move" before paralysis, VO2 decreased from 9.2 +/- 1.4 ml . kg-1 . min-1 before paralysis to 8.0 +/- 1.4 ml . kg-1 . min-1 after paralysis (P less than 0.05). One infant in each group had an increase in VO2 greater than 10% of the baseline value (i.e., 12% and 14%). In conclusion, if breathing or repeated movement is present before paralysis, paralysis decreases VO2 by 13% in sedated infants after cardiac surgery. If repeated or regular movement is not present before paralysis, paralysis does not decrease VO2. These data suggest that in normoxic patients, muscle paralysis does not significantly alter V02 and therefore should not be used for this purpose. PMID- 6496990 TI - Effects of enflurane and isoflurane on resistance to reabsorption of cerebrospinal fluid in dogs. AB - Using the technique of ventriculocisternal perfusion, resistance to reabsorption of cerebrospinal fluid (Ra) was calculated from determinations of the rate of reabsorption of cerebrospinal fluid (Va) at differing cerebrospinal fluid pressures in dogs. Ra was examined during prolonged anesthesia (5.0-6.0 h) with enflurane (2.2%, end expired) or isoflurane (1.4%, end expired). Compared with previously reported normal values for Ra in dogs (220-224 cmH2O . ml-1 . min), enflurane increased Ra to 274 +/- 4 cmH2O . ml-1 . min (mean +/- SEM), and isoflurane decreased Ra to 104 +/- 1 cmH2O . ml-1 . min. The alterations of cerebrospinal fluid (CSF) dynamics caused by enflurane, namely increase of both Ra and the rate of production of cerebrospinal fluid (Vf), may contribute to the sustained increase of intracranial pressure observed during prolonged anesthesia with enflurane. In contrast, the different alterations of CSF dynamics caused by isoflurane, namely decrease of Ra with no change in Vf, may explain, in part, why minimal increase of intracranial pressure is observed during prolonged anesthesia with isoflurane. Because decreased Ra improves spatial compensation by cerebrospinal fluid volume for increased intracranial pressure, isoflurane may offer an advantage over enflurane in patients at risk because of increased intracranial pressure. PMID- 6496991 TI - Blood pH and brain uptake of 14C-morphine. AB - 14C-Morphine was injected iv in control awake rats or in rats subjected to metabolic alkalosis or acidosis. Ten minutes later, radioactivity was determined within each of seven brain regions, after correction was made for intravascular tracer. In each region, parenchymal radioactivity was correlated positively and significantly (P less than 0.05) with arterial blood pH. Brain radioactivity was twofold to threefold greater in alkalotic rats (mean pH = 7.62) than in acidotic rats (mean pH = 7.16). The results are consistent with the pH-partition hypothesis for drug entry into the brain and indicate that morphine uptake can be increased by elevating the fraction of lipid-soluble uncharged morphine base in blood, by means of alkalosis. The observations may account for an exaggerated morphine-induced analgesia in alkalotic patients. PMID- 6496992 TI - The involvement of endotoxin in halothane-associated liver injury. AB - Since endotoxin, lipopolysaccharides (LPS), have been implicated as a causative factor in the development of hepatic necrosis in rats exposed to hepatotoxic levels of several chemical agents, the role of LPS in the halothane-hypoxia (HH) model of hepatic damage in male Sprague-Dawley rats was investigated. When injected intravenously immediately after halothane anesthesia, a subnecrotic dose of LPS (0.5 mg/kg; Escherichia coli 026:B6) was found to markedly potentiate HH induced hepatic necrosis. Pretreatment of the animals with the antiendotoxin agent, lactulose, prior to exposure to halothane reduced the hepatic damage normally seen from HH. A possible mechanism of LPS-induced potentiation was indicated by changes in hepatic calcium levels at 24 h after treatment. Endogenous LPS may play a role in HH-induced hepatic necrosis, and the mechanism of LPS-induced potentiation may be due to an LPS-related membrane dysfunction. PMID- 6496994 TI - Baroreceptor reflex control of heart rate during morphine sulfate, diazepam, N2O/O2 anesthesia in humans. AB - The effect of morphine, diazepam, N2O/O2 anesthesia on baroreflex control of heart rate in humans was investigated in this study. Group 1 subjects (n = 11) received morphine 0.5 mg/kg, diazepam 0.25 mg/kg, and 70% N2O with O2. Group 2 subjects (n = 10) received morphine 0.75 mg/kg, diazepam 0.25 mg/kg, and 70% N2O with O2. Phenylephrine (the pressor test), sodium nitroprusside (the depressor test), and graded neck suction were employed to alter the stimulation of baroreceptor sites. The pressor, the depressor, and neck suction baroreflex slopes declined significantly in both groups from awake to anesthetized. There was no significant difference in the degree of depression between the two groups for all three tests. Neck suction derived slopes compared favorably to the pressor test slopes (r = 0.70, P less than 0.01). This study indicates that the depression of arterial baroreflex-heart rate responses under morphine, diazepam, N2O/O2 anesthesia is similar to that seen with potent inhalational anesthetics such as isoflurane. Furthermore, there was no difference between the two morphine doses that were studied. PMID- 6496993 TI - Diffusional delay in local anesthetic block in vitro. AB - The diffusion of lidocaine to myelinated and unmyelinated axons was compared on individual afferent fibers of rabbit vagus nerve. The criterion consisted of the time required for more than 95% completion of the asymptotic increase in impulse conduction time produced by a weak, nonblocking concentration of lidocaine. Measurements on sheathed and desheathed nerves for both myelinated and unmyelinated axons detected an apparent but statistically not significant diffusional lag at the perineurial sheath, averaging four minutes in this model; there was no significant difference in the mean time for attainment of criterion in myelinated and unmyelinated axons, which averaged an additional 13 min in both types of fiber. From these observations the authors conclude that lidocaine diffused as readily through the nodal gap to the excitable membrane of the myelinated fiber as through the Schwann cell mesaxon to the unmyelinated fiber. Thus differential diffusion within a nerve seems unlikely to be a contributing factor to clinical differential block. PMID- 6496995 TI - Postthoracotomy pain and pulmonary function following epidural and systemic morphine. AB - Thirty patients undergoing thoracotomy for lung resection were entered in a randomized, double-blind trial comparing the effects of epidural (E) versus intravenous (iv) morphine on postoperative pain and pulmonary function. Postoperatively the patients were given repeated doses of either 5.0 mg of morphine epidurally or 0.05-0.07 mg/kg morphine intravenously until there were no further spontaneous complaints of pain. Two, 8, and 24 h postoperatively, the following indices were measured: linear analogue pain score, somnolence score, vital signs, arterial PaO2, PaCO2, and pH, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and peak expiratory flow rate (PEFR). Patients receiving epidural morphine had significantly less pain at 2 h (P less than 0.01) and 8 h (P less than 0.004) postoperatively. There was no difference in vital signs except for significantly slower respiratory rates at 2 h (P less than 0.04), 8 h (P less than 0.02) and 24 h (P less than 0.01) in the epidural group. No significant differences occurred in the somnolence scores or blood-gas measurements, which were within normal limits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496996 TI - Smoking and anesthesia: preoperative abstinence and perioperative morbidity. AB - Much less is known of the effects of stopping smoking than of continuing to smoke, and many of the studies on smoking cessation are concerned with long-term effects rather than effects within 48 hr. Studies concerned with this period are required, especially in terms of postoperative respiratory morbidity, before an authoritative assessment can be made of the benefits and risks of stopping smoking in the short period before operation. Present studies are convincing that great benefit will accrue in the cardiovascular system, mainly from carbon monoxide and nicotine elimination, after 12-24 h. A few days may greatly improve ciliary beating and 1-2 weeks provide a significant reduction in sputum volume. However, a minimum period of 4-6 weeks would seem appropriate to greatly influence postoperative respiratory morbidity, although the statement that "one needs 4-6 weeks to influence postoperative respiratory morbidity" must not be misapplied and become "there is no point in giving up smoking unless it is 4-6 weeks prior to operation." There are no proven disadvantages to the respiratory system from stopping smoking in the short term, and it seems unwise to sacrifice proven advantages for a theoretic consideration that sputum may become "stickier" and more difficult to clear. Less is known with regard to the time course of offset of smoking effects on drug metabolism and the immune system, although 6-8 weeks would be expected to produce some benefit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6496997 TI - Low molecular weight proteins in human malignant hyperthermic muscle. AB - Malignant hyperthermia (MH) is a pharmacogenetic disorder provoked by volatile anesthetics and depolarizing muscle relaxants. The preoperative diagnosis of MH is difficult because it requires a large muscle biopsy and a laboratory dedicated to such diagnostic studies. The authors performed electrophoresis of six muscles taken from MH patients or their relatives to determine whether the protein composition is different from normal muscle. MH muscle was found to contain large amounts of two low molecular weight proteins (15,000 daltons and 13,500 daltons) that are not present in normal muscle. Although it has not been determined that these differences are specific for MH, this finding eventually might be of assistance in diagnosing MH. PMID- 6496998 TI - Unintentional removal of meningeal tissue with a 25-gauge spinal needle during spinal anesthesia: a case report. PMID- 6496999 TI - Retinal hemorrhage following anesthesia. PMID- 6497000 TI - Respiratory depression following orally administered flunitrazepam for preanesthetic medication in children. PMID- 6497001 TI - Does metoclopramide decrease the volume of gastric contents in patients undergoing cesarean section? PMID- 6497002 TI - Perioperative management of newborn pharyngeal teratomas. PMID- 6497003 TI - Cardiovascular effects of ketamine given to relieve penile turgescence after high doses of fentanyl. PMID- 6497004 TI - Acute intermittent obstruction of a Bjork-Shiley mitral valve: a case report. PMID- 6497005 TI - Activation of epileptogenic activity by etomidate. PMID- 6497007 TI - Timolol and postoperative apnea in neonates and young infants. PMID- 6497006 TI - Precurarization inhibits maximal ventilatory effort. PMID- 6497009 TI - Monitoring respirations with a gauze thread: an ancient and outdated technique. PMID- 6497008 TI - Hepatitis B markers in pediatric anesthesia personnel. PMID- 6497010 TI - On the prevention of hypoxic accidents. PMID- 6497011 TI - A simple device for testing peripheral nerve stimulators. PMID- 6497012 TI - Bupivacaine: cardiotoxicity or anesthetic technique? PMID- 6497013 TI - Does almitrine restore halothane-induced depression of hypoxic respiratory drive? PMID- 6497014 TI - Can we do without O2 analyzers? PMID- 6497015 TI - Infrared heat lamps interfere with pulse oximeters. PMID- 6497016 TI - The "puff technic" for intravenous diazepam. PMID- 6497017 TI - Hydrogen peroxide may cause venous oxygen embolism. PMID- 6497018 TI - Benzodiazepines and polymorphonuclear leukocyte oxidative activity. PMID- 6497019 TI - Pulmonary artery catheter sheath malfunction with sternotomy. PMID- 6497020 TI - Oxygen pressure sensor shutoff valve failure in the Ohio "Wedge" anesthesia machine. PMID- 6497021 TI - Anesthetic management during Nd-YAG laser resection for major transbronchial obstructing tumors. PMID- 6497022 TI - A simple device for filtering mouth-to-mouth resuscitation. PMID- 6497023 TI - Management of children for surgery. PMID- 6497024 TI - Percutaneous radial artery cannulation using a pressure-curve-directed technique. PMID- 6497025 TI - [Anesthesia in the surgical treatment of pheochromocytoma]. PMID- 6497026 TI - [Pulsating perfusion during carbon fluoride oxygenation of blood]. PMID- 6497027 TI - [Effectiveness of total body washout in acute medinal poisoning]. PMID- 6497028 TI - [Ultra-close telemetry for cardiac monitoring in intensive care units]. PMID- 6497030 TI - [Dimexide therapy of septic complications in critical states]. PMID- 6497029 TI - [Long-term artificial pulmonary ventilation in the treatment of a patient with acute myocardial infarction complicated by true cardiogenic shock and pulmonary edema]. PMID- 6497031 TI - [Intensive therapy of hydrogen arsenide poisoning]. PMID- 6497033 TI - [Anesthesia in cheiloplasty in newborn infants]. PMID- 6497032 TI - [Brachial plexus block--ways of improving and the perspectives of its use in current anesthesiology]. PMID- 6497034 TI - [Equipment and methods of conducting selectively regulated artificial ventilation of the lungs]. PMID- 6497035 TI - [Humidification of the respiratory mixture using new Soviet-made humidifiers during long-term artificial ventilation of the lungs]. PMID- 6497036 TI - [Diagnosis and prevention of the accidental introduction of a venous catheter into the right segments of the heart during catheterization of the subclavian vein in children]. PMID- 6497037 TI - [Catheterization of the subclavian veins by the subclavicular and supraclavicular approaches and complications associated with venous puncture and the use of the catheter]. PMID- 6497038 TI - [Hemodynamic disorders and their correction in middle-aged and old patients after operations on the extrahepatic bile duct]. PMID- 6497039 TI - [Urban alternate host cycle of Taenia saginata in Wittstock County, district of Potsdam (East Germany)]. AB - The urban alternate host cycle of Taenia saginata in the county of Wittstock, district of Potsdam (GDR). Investigations of the epidemiology of bovine cysticercosis and human taeniasis were carried out in the county of Wittstock from 1979 till 1980. The analysis was based on the examination of human faeces, sewage and sewage sludge, the registration of infested humans, anticestodica consumption, number of infested cattle, areas for squirting out sewage, fodder supply areas and location of cattle. These data were mapped. There is a direct connection between the prevalence of Cysticercus bovis in more than 50 per cent of the infested cattle of the county of Wittstock and the squirting out of the sewage of the county town. 21 to 27 million Taenia eggs per day get into the waste-water purification plant. The proportion of infested humans and infested cattle is 1: 250 or 1: 290, respectively. The prevalence of adult tapeworms is 0.008-0.18%, and that of cysticerci is 20%. PMID- 6497040 TI - [Occurrence of housedust mites (Astigmata; Pyroglyphidae) in stables]. AB - Occurrence of house-dust mites (Astigmata; Pyroglyphidae) in stables. The house dust mite Dermatophagoides farinae was found in 5 samples derived from a conventional henhouse with fowls and pigeons and from a test animal hutch with rats, mice and rabbits. 63 samples derived from conventional sheds, pigsties and hutches as well as from conventional henhouses and large-scale poultry farms showed negative results. Besides mites of the family Pyroglyphidae mites of the Tyroglyphidae family and/or mucedine were found, which affect the development of mite populations. House-dust mites should be considered in the etiology of allergic diseases of dog, cat and livestock. PMID- 6497041 TI - [Possible role of arthropods in the circulation and distribution of plasmids]. AB - On the possible role of arthropods for the circulation and distribution of plasmids. Arthropods both of synanthropic and remote areas presumably have an indirect medico-epidemiological effect on the circulation and distribution of plasmids. Haematophagous parasites and saprophagous, necrophagous, coprophagous and polyphagous non-parasites seem to be suitable. PMID- 6497042 TI - [Fleas (Siphonaptera) in man. Analysis of findings from 1961 to 1983 in the district of Leipzig (East Germany). 1. Species, sources of infestation and distribution]. PMID- 6497043 TI - [Protozoacidal effect of chlorpromazine]. PMID- 6497044 TI - [Lucilia sericata myiasis (Diptera, Calliphoridae) in gangrene of the foot]. PMID- 6497045 TI - Age-dependent changes of collagen and elastin content in human aorta and pulmonary artery. AB - Collagen and elastin in the arterial wall are thought to show some age-dependent changes, and to relate with development of the arteriosclerotic lesion. Both aortas and the pulmonary trunks were collected from 137 autopsy cases. Biochemical determination of collagen and elastin content was carried out. Collagen and elastin of the aorta and the pulmonary artery showed no significant age-dependent changes. Elastin content of the pulmonary artery increases with age in the adult. This paper seems to be the first report of simultaneous estimation of collagen and elastin content of both the aorta and the pulmonary artery. PMID- 6497046 TI - Ineffectiveness of Ca2+-antagonists nicardipine and diltiazem on experimental atherosclerosis in cholesterol-fed rabbits. AB - There is accumulating evidence that calcium metabolism plays an important role in the pathogenesis of atherosclerosis. The inhibitory effect of nifedipine, a Ca2 antagonist, on experimental atherosclerosis in cholesterol-fed rabbits has been reported, and we examined the anti-atherosclerotic action of nicardipine and diltiazem, similar Ca2+-antagonists, but no inhibitory action was observed. It is necessary to recognize the fact that the sensitivity of rabbits to an anti atherogenic diet shows great individual differences. For the purpose of preventing atherosclerosis due to the abnormality of lipid metabolism the use of Ca2+-antagonist is not warranted at the present stage. PMID- 6497047 TI - Whole blood and red cell ATP content in patients with peripheral vascular disease: the effect of cigarette smoking and oxpentifylline. AB - The relationship between erythrocyte ATP content and the presence of atherosclerotic peripheral occlusive vascular disease was investigated. In 20 elderly patients with severe peripheral vascular insufficiency (10 male, 10 female; age 68.8 +/- 12.5 years; Mean +/- SD) the mean erythrocyte ATP content was 1.57 +/- 0.16 mmol/litre. In a sex and age matched group (69.1 +/- 9.6 years) with no signs or symptoms of peripheral or myocardial ischaemia, erythrocyte ATP content did not differ significantly (1.49 +/- 0.29 mmol/litre). In young healthy volunteers, there was no difference in erythrocyte ATP content between males and females or between cigarette smokers and non-smokers, nor were the values for the young group different from those obtained from the elderly patients. The effect of oxpentifylline administration on erythrocyte ATP levels in patients with peripheral vascular disease was also studied. Administration of oxpentifylline (1.6 g per day in divided doses) over 7 days had no effect on erythrocyte ATP content in 10 patients (5 male, 5 female) with ischaemic lower limbs. These results suggest that measurement of erythrocyte ATP content is unlikely to be a useful index in the assessment of peripheral vascular disease. PMID- 6497048 TI - Pressure rise at arterial bifurcations. AB - The increase in cross-sectional area within an arterial bifurcation is shown to be much larger than that predicted by the conventional area ratio beta. Modified area ratios which better describe this increase are presented and their values are assessed both from theoretical considerations and from physiological data. The results suggest that the pressure rise within an arterial bifurcation may be much more severe than that suggested by the conventional area ratio beta, and that local flow separation may be far more common. These conditions may adversely affect endothelial tissue and orderly flow within the bifurcation region. PMID- 6497049 TI - Current status of the vascular laboratory in the diagnosis of deep vein thrombosis. AB - The frequency of venous disease probably surpasses that of heart disease and stroke. The fallibility of the clinical diagnosis of pulmonary embolism and deep vein thrombosis (DVT) approaches 50% error in both conditions. Because of the serious errors in omission and commission of the clinical diagnosis of venous thrombosis, a variety of noninvasive diagnostic techniques have been developed within the past decade. The purpose of this paper is to analyze these noninvasive venous modalities with more emphasis on what is available in our vascular lab at Charleston Area Medical Center-Charleston Division, West Virginia University Medical Center. PMID- 6497050 TI - Fascial pathways of extravasation of blood in lower abdomen following angiography anatomic and clinical correlation. AB - The extravasation of urine following traumatic rupture of the urethra or periurethral abscess is well known to clinicians. The extravasation of blood following angiography, in the same anatomical space, is rare. Extravasation of fluids in the lower abdomen, groin and external genitalia follows distinct anatomical pathways. This case illustrates the anatomical pathways and emphasizes their clinical importance. PMID- 6497051 TI - Effect of serotonin on albumin and low density lipoprotein uptake in perfused rabbit femoral arteries. AB - Uptake by the arterial wall of plasma constituents has considerable clinical implication; thus, uptake of low density lipoprotein (LDL) plays an important role in the development of atherosclerosis. Serotonin and other vasoactive material may result in changes in the arterial wall leading to increased uptake of albumin or low density lipoprotein. This study was conducted to determine the effect of serotonin (10(-5)M 5-hydroxytryptamine) and serotonin-induced arterial constriction on albumin and low density lipoprotein uptake rates in perfused rabbit femoral arteries. The results show that the presence of serotonin inhibits the rate of uptake of both albumin and LDL. The effect on albumin uptake does not have a direct dose response dependence and is linearly dependent on transmural pressure. In contrast, LDL uptake rates are only slightly affected by pressure. Thus, albumin and LDL uptake processes appear to be due to separate mechanisms. PMID- 6497052 TI - Atherosclerosis and cerebral ischemic attacks: intakes of cerebrography with xenon133 inhaled and platelet tests in the diagnosis, clinical and therapeutic monitoring; the preventive role of dipyridamole. AB - A study of patients to develop the significance of the role of the blood platelets in the recurrence of transient cerebral ischemic attacks in patients with cerebral atheromatous, develop the effectiveness of dipyridamole in the prophylactic therapeutic regimen. In the group treated with dipyridamole, a 76.3% clinical improvement was recorded (mean increases of 11.2 ml/min. and 11.4 ml/min. of the cerebral hemispheric flows), 15.8% of cases stabilized (mean increases of 1.7 ml/min. and 1.2 ml/min.) and 7.9% failures (mean decreases of 10.4 ml/min. and 14.3 ml/min.) of these same flows. The cerebrography with xenon133 inhaled as well as the platelet tests used, constitute unfailing means of diagnosing and monitoring the clinical development. PMID- 6497053 TI - Leg blood flow in intermittent claudication--a comparison between non insulin dependent diabetics and non diabetics. AB - The influence of diabetes on leg blood flow in intermittent claudication has been assessed by comparing the systolic arm-ankle pressure gradient at rest and resistance to blood flow during reactive hyperemia in patients with non-insulin dependent diabetes and non-diabetic controls. Cases and controls were matched for age and sex. Smoking habits, blood pressure, and blood lipids didn't differ in the two groups. Diabetes was associated with a higher resistance to blood flow during reactive hyperemia and a greater arm-ankle pressure gradient at rest. Resistance to blood flow during reactive hyperemia was in the non-diabetics strongly correlated to the arm-ankle pressure gradient at rest (r = 0.84). Corresponding correlation coefficient was in diabetics 0.04. In one of four diabetic legs a high resistance to blood flow during reactive hyperemia didn't correspond to a big arm-ankle pressure gradient. The results in this study support the concept of both macro- and microvascular disease in diabetes. PMID- 6497054 TI - Pulmonary varix. AB - Pulmonary varix is rare, only 53 cases having been reported. A brief review of the literature is given. Because its radiologic appearance may be indistinguishable from mediastinal or pulmonary lesions, pulmonary angiography is necessary to avoid exploratory thoracotomy, mediastinoscopy, and unnecessary antituberculous therapy. PMID- 6497055 TI - Pseudoaneurysm of the left ventricle: diagnosis by gated radioisotope imaging. AB - Because pseudoaneurysms of the left ventricle, although rare, can rupture, their differentiation from true aneurysm is desirable. A case is described in which a pseudoaneurysm was diagnosed noninvasively by means of a gated radioisotope ventriculogram. The diagnosis was made by noting a narrow neck leading to a large chamber. The pseudoaneurysm was successfully excised at surgery. PMID- 6497056 TI - Deep venous thrombosis of the upper extremity five years experience at a university hospital. AB - All patients with deep vein thrombosis of the arm seen at one University Hospital over a 5 year period were reviewed. The 17 cases could be divided into distinct patient groups. The first group (primary thrombosis) consisted of 7 patients primarily healthy young males (mean age 23) who had vocations or avocations which involved vigorous physical activity of the arms. The 10 patients with secondary thrombosis tended to be older (mean age 47.3) and to be ill or hospitalized at the time of onset of their illness. Followup information could be obtained in 9 of the cases and 7 of these patients had persistence in their symptoms consisting of residual discomfort and edema of the involved arm especially after exercise. None of the patients treated with anticoagulation were asymptomatic. The only patients who were symptomatic were one patient who received streptokinase and another who underwent thrombectomy. Three illustrative case studies are included. PMID- 6497057 TI - Lymphocyte alloantigens of the horse. III. ELY-2.1: a lymphocyte alloantigen not coded for by the MHC. AB - A new polymorphic locus of the horse which has several unusual properties is described. The suggested name for the locus is ELY-2. The gene product of one allele at this locus, designated ELY-2.1, has been identified with antisera raised as a result of pregnancy. Antibody to ELY-2.1 was first detected on day 55 after conception in the serum of a mare in first pregnancy. This early onset of antibody is similar to that seen for antibody to ELA antigens, and suggests that the source of the antigenic stimulus may be the tissue of the equine endometrial cups. The antisera identifying ELY-2.1 are cytotoxic and kill all peripheral blood lymphocytes from horses carrying the antigen. ELY-2.1 is a cell surface molecule expressed on lymphocytes, erythrocytes, and platelets. Other cell types have not been investigated. The overall phenotypic frequency of ELY-2.1 in several horse breeds was 16%. The ELY-2.1 antigen is controlled by an autosomal, dominant gene which is not coded by the ELA region (the major histocompatibility complex of the horse), nor is it identical to the ELY-1 locus, which codes for another cell surface alloantigen of equine lymphocytes. Stimulator cells carrying ELY-2.1 did not induce proliferation of ELY-2.1 negative responder cells in mixed cultures of horse lymphocytes. Attempts to raise alloantisera to other alleles of the ELY-2 locus through immunization with lymphocytes were unsuccessful. It is possible that the alternate allele(s) does not code for a gene product which is expressed. The function and biochemical nature of the ELY-2.1 molecule are unknown. PMID- 6497058 TI - Comparison of ELY-2.1 with blood group and ELY-1 markers in the horse. AB - The distribution of ELY-2 was compared to the distribution of blood group factors Aa, Ab, Ac, Ae, Ca, Da, Db, Dc, Dd, De, Df, Dh, Dk, Ka, Pa, Pb, X, Qa, Qc, Ua, and W in 2465 American Standardbred horses and to ELY-1 in 193 American Standardbred horses. The distribution patterns were different in each case. The segregation of ELY-2.1 and factors at the A, C, D, K, P, Q, U and T (W) blood group loci and at the ELA locus indicated that ELY-2.1 is not a product of any of those loci. No segregation data were available for the ELY-1 locus. Family studies indicated that the gene for ELY-2.1 is not sex-linked. PMID- 6497059 TI - Joint report of the Second International Workshop on Lymphocyte Alloantigens of the Horse, held 3-8 October 1982. AB - The Second International Workshop on Lymphocyte Alloantigens of the Horse was held 3-8 October 1982. At this workshop, the 6 specificities identified at the first workshop were confirmed and an additional 5 new specificities were identified and given workshop nomenclature. Four of the new specificities, products of the ELA locus, were named ELA-W7, W8, W9, and W10. An additional specificity, designated ELY-2.1, is the product of a locus independent of the ELA locus. Cell isolation methods were compared at this workshop. Technical variation in methods clearly affected reactivity of many reagents. However, when highly selected reagents were used, antigen assignment did not differ regardless of the cell isolation method. Based on the comparison of methods, isolation procedures in which thrombin was used were more effective than those relying on carbonyl iron or slow centrifugation. PMID- 6497060 TI - Genetic markers in the blood of four Italian horse breeds. PMID- 6497061 TI - Genetic markers in the blood of the Italian standardbred trotter horse. PMID- 6497062 TI - Studies on the nature of the equine protease inhibitors. PMID- 6497063 TI - Urinary proteins: interstrain differences in the laboratory rat. AB - By comparing electrophoretic patterns of urinary proteins from males of different inbred strains and pertinent hybrids, a new polymorphic locus designated Mur-2 has been detected. PMID- 6497064 TI - Abnormal segregation of alkaline ribonuclease genes in cattle. AB - Polymorphism of alkaline ribonuclease in the leucocytes of 76 bulls, 554 cows and their progeny of 556 calves was investigated. All possible genotype matings were examined. Observed offspring genotypes were compared with the expected ratios. Abnormal genotype distribution was noticed: homozygous calves of RNaseB/RNaseB genotype were significantly fewer than expected. PMID- 6497065 TI - Heterogeneity of horse transferrin: the role of carbohydrate moiety. AB - Homozygous horse transferrin (Tf O) is highly heterogeneous. In starch gel electrophoresis it gives at least 9 zones. Two main components (2a and 4b) were purified by rivanol and ammonium sulphate precipitation, DEAE-Sephadex chromatography and SP-Sephadex chromatography. Molecular weights of 75 200 and 80 500 for components 2a and 4b, respectively, were determined by sedimentation equilibrium ultracentrifugation. Amino acid compositions of the two components were similar, and there were no differences in the N-terminus (glutamic acid followed by glutamine) and the C-terminus (valine). Differences were found in carbohydrate composition between components 2a and 4b. Component 2a contained 10 moles of sugar components per mole of protein (4 hexoses, 4 hexosamines and 2 sialic acids), while component 4b contained twice the number of both total carbohydrates and individual sugar components. Carbohydrates were identified as mannose and galactose (ratio mannose: galactose approximately equal to 1.5:1), N acetylglucosamine and N-acetylneuraminic acid. At present it is not clear whether the difference between the two components resides solely in the difference of carbohydrate contents. It is proposed that component 2a has one diantennary glycan, while component 4b has two. PMID- 6497066 TI - The development of asthma after tracheobronchial aspiration of a foreign body. AB - To evaluate whether a tracheobronchial foreign body (TBFB) itself or its removal by bronchoscopy with the patient under general anesthesia predisposed children to asthma, we surveyed 58 children who had a TBFB removed at the Mayo Clinic between 1970 and 1978. A control group included children who had undergone tonsillectomy or adenoidectomy. Asthma developed in four children in each group. Children with a TBFB do not seem to be predisposed to the development of asthma. PMID- 6497067 TI - Chronic urticaria related to sialoadenitis. AB - A 31-year-old black male experienced severe recurrent urticaria and angioedema during meals. An abnormal sialographic pattern indicated submandibular sialoadenitis, and surgical excision of the gland resulted in complete resolution of the urticaria. This report describes the association of sialoadenitis and urticaria and possible mechanisms involved. PMID- 6497068 TI - Safety and efficacy of salbutamol aerosol on Dermatophagoides farinae induced bronchospasm in asthmatic patients. AB - The effects of inhaled salbutamol in bronchial provocation with inhaled house dust mite allergen (HDM) were studied in 20 adult subjects with bronchial asthma and positive skin test to the allergen. There was a significant association between the skin test and the outcome of bronchial challenge, although the magnitude of the skin test reactivity was not significantly correlated with the degree of bronchial reactivity. Metered dose inhaler administration of salbutamol (200 gamma total) was started after antigen produced a fall in mean FEV1 to 31%. Salbutamol treatment returned the FEV1 within 5 min to 66%, and within 45 min to 91% of baseline in all but one patient. It appears that in most asthmatics inhaled salbutamol does significantly and immediately reverse HDM-induced bronchospasm. PMID- 6497069 TI - Stability of Lolium perenne extract. AB - The stability of Lolium perenne extract was studied during a year in different conditions of storage. The changes of allergen activity were measured periodically by both in vivo and in vitro techniques, and structural modifications were examined by polyacrylamide gel electrophoresis and isoelectric focusing. Lyophilised extracts did not show any change and frozen samples retained full activity, but there were slight alterations in the pattern of proteins during the storage period. The activity of refrigerated aqueous extracts (4-6 degrees C) decreased gradually with time, while glycerinated samples at the same temperatures did not lose any of their allergen potency. Room temperature and 40 degrees C were unsatisfactory for aqueous extracts, but less so for preparations that contained 50% glycerol. The presence of the preservative phenol had a significant negative effect on stability at all of the temperatures studied. PMID- 6497070 TI - Serum IgG, IgA, IgM, IgE, salivary IgA levels and lung function in a healthy male population from the Italian Air Force: a preliminary study. AB - The reliability of total IgE quantitation in predicting atopic states was evaluated in a highly homogeneous group of 315 male subjects between 19 and 22 years of age, in apparent good health. A parallel evaluation of the other major Ig classes (serum IgG, IgA, IgM and salivary IgA) and a series of lung function tests were also performed. Forty-eight subjects (15%) referred history of allergy (41 respiratory and seven cutaneous). Twenty-one percent of these had IgE greater than 440 IU/ml, a value reported as abnormally high. No significant association was found between atopy and any of the lung function tests performed. Clinical history or IgE levels were not related to other Ig classes. Conversely, serum but not salivary IgA levels were significantly reduced in tonsillectomized subjects. From the present data it appears that neither IgE determinations nor performing lung function tests can be considered reliable substitutes for an accurate history and evaluation of clinical parameters. PMID- 6497071 TI - [Calculi experimentally obtained in the rat by intrarenal injection of Ureaplasma urealyticum]. AB - Male Sprague Dawley rats have been contaminated with Ureaplasma urealyticum (by injection in their kidney of a 10(8) C.C.U. suspension of micro-organisms of human origin). They produce urinary tract stones similar to the humans ones and composed of struvite crystals (NH4MgPO4, 6H2O). It is concluded that such a model is a very good tool to develop new research on struvite lithiasis. PMID- 6497072 TI - [Changes in the serum protein profile during radiotherapy of the upper respiratory and digestive tracts]. AB - Patients with a cancer of the upper airways or upper gastro-intestinal tract present a state of malnutrition as a result of the disease itself and, more importantly, as a result of its localisation. Loco-regional radiotherapy often leads to an aggravation of this state. The protein profile, consisting of nine serum proteins, was determined each week in 54 patients with cancer of the upper respirato-gastro-intestinal tract receiving radiotherapy. During the course of radiotherapy, the already altered nutritional state of these patients deteriorated further, as shown by a regular and significant downturn in the weight curve. The weekly monitoring of the protein profile showed a gradual and significant decrease in the levels of nutritional proteins (prealbumin, retinol binding protein, transferrin) and immunoglobulins (IgM, IgA) and a small variation in the levels of inflammatory proteins (haptoglobin, orosomucoid, C3 complement fraction, alpha 1-antitrypsin). The protein profile, established on the basis of carefully selected proteins, can provide useful information in the monitoring of a patient's nutritional state. PMID- 6497073 TI - [Simultaneous high performance liquid chromatographic determination of 8 anti epileptics and sedatives in plasma. Use of a radial compression column system]. AB - The authors describe a method of assaying anti-epileptic and sedative drugs by high performance liquid chromatography. This method allows for simultaneous separation and quantification of these drugs (Ethosuximide, Primidone, Phenobarbital, Beclamide, Prominal, Diphenylhydantoin, Glutethimide, Carbamazepine) in a relatively short analysis time, by means of a system of radial compression of the column. The serum is acidified and extracted by ethyl acetate. After evaporation, the residue is taken up in the mobile phase. The various drugs are eluted in a 10 micron Rad-Pak C 18 column with a mobile phase consisting of a mixture of methanol and water with a flow rate of 4 ml/min. The chromatograph is read at 200 nm and the separation is effective in about 16 minutes. The yield is between 75 and 100 per cent and the repeatability of the method is good (C. V. less than 9 per cent). The originality of the method resides in the assay of drugs such as beclamide, methylphenobarbital and glutethimide at the same time as the major anti-epileptics. PMID- 6497074 TI - [Risks of coproculture in parasitology]. PMID- 6497075 TI - [The calculator for the thermodilution measurement of cardiac output: a new Pandora's box?]. PMID- 6497076 TI - [Posttraumatic fat embolism]. AB - Between 1977 and 1982, fifty cases of post-traumatic fat embolism were treated in a general intensive care unit. Average age of patients was 25.5 +/- 13 years; there was no male majority. Mean free interval was 39 +/- 27 h. 12 cases (24%) had single fractures and 38 (76%) multiple fractures. Forty-four patients had a fractured femur. Thirty-two patients presented the complete clinical syndrome with general, respiratory, neurological and cutaneous signs. Thrombocytopaenia and hypocholesterolaemia were the biological signs most often seen. In forty-four patients, orthopaedic treatment consisted of immediate immobilization, usually with traction. Twenty-six patients were reoperated on: intramedullary nail for twenty patients, plate for the other six. Fat embolism appeared in spite of surgery in six cases; it worsened after surgery in six others. Seven patients had per- or postanaesthetic problems. Fourteen per cent of patients died. The decrease in mortality was mainly due to an improvement in mechanical ventilation techniques. Early surgical fixation remained the rule if there was no serious respiratory distress or haemodynamic instability, although it did not seem to change the mortality rate in this group of patients. PMID- 6497077 TI - [Midazolam as an induction agent for surgery of the anterior segment of the eye]. AB - A new water-soluble benzodiazepine, midazolam maleate, was used at a dosage of 0.15 mg X kg-1 to induce general anaesthesia for eye surgery in 30 patients. The following parameters were measured at times C (control), t1, t2 and t3 (2, 5 and 10 min after induction): systemic arterial blood pressure, heart rate, respiratory rate, arterial blood gases and eye tone. Results showed very significant changes in acid-base balance, with an increase in PaCO2 and a significant fall in eye tone; changes in haemodynamic parameters were not significant. Midazolam therefore appeared to be a good drug to use for inducing anaesthesia in eye surgery, particularly in the elderly. PMID- 6497078 TI - [So-called pocket-sized spirometry versus respiratory function tests: a comparative study of vital capacity, forced expiratory volume in 1 second and Tiffeneau's coefficient]. AB - A simplified preoperative respiratory assessment was carried out in order to assess the reliability of a pocket-sized spirometer. 30 patients were each tested using two methods: 1) the traditional extensive laboratory lung function tests and 2) a bedside test using a pocket-sized spirometer, which measured the vital capacity (VC), the forced expiratory volume in 1 second (FEV1), the peak flow (PEF) and the ratio of FEV1 to VC. The correlation between the two series of VC and FEV1 measurements was highly significant (p less than 0.001). Therefore, these two parameters could be considered as reliable when testing was performed at the bedside. However, the sensitivity of the FEV1/VC ratio was decreased; in three of the patients, the significance of this third parameter was not the same with the two methods. Measurements of peak flow were only collected at the bedside, and a statistical comparison was not established. Analysis of this last parameter always allowed us to confirm or not an obstructive syndrome when the values of FEV1 or FEV1/VC were in disagreement. The pocket-sized spirometer would seem to be a simple and reliable means of diagnosing respiratory insufficiency, its type (obstructive or restrictive) and its seriousness. PMID- 6497079 TI - [Intramuscular premedication with midazolam in infants and children]. AB - The useful intramuscular premedication dose of midazolam was determined in 100 children divided up in three age groups: one month to three years, 3 to 10 years, 10 to 15 years. All biometric parameters were normal for the age, and comparable between similar age groups. Haemodynamic and respiratory parameters were not altered by the premedication. The reduction in anxiety, as assessed by the child's behaviour, was good or excellent in more than 85% of cases from all age groups; it was proportional to the dose used. The doses that had, for equivalent reductions in anxiety as assessed by the chi-square test, the least hypnotic effect, were: 0.5 mg X kg-1 before three years of age, 0.4 mg X kg-1 for the 3 to 10 yr olds, and 0.25 mg X kg-1 for the 10 to 15 yr olds. This fall in dose with age, quite usual in paediatrics, was not unexpected. The level of consciousness, one hour after surgery, was always normal. No undesirable side-effect was observed. These results, together with its physical, chemical and pharmacodynamic characteristics, make midazolam a choice drug for intramuscular premedication in children, with a foreseeable use in day-care anaesthesia. The unexpected finding of an age-dependent dissociation between the reduction in anxiety and the hypnotic effect is discussed in the light of a study carried out in the adult and recent data from the literature. PMID- 6497080 TI - [Hypovolemic shock caused by an increase in capillary permeability after cesarean section]. AB - A 24 year old woman was delivered by caesarean section after an uncomplicated full-term pregnancy. Non-specific prodromes appeared 48 h later, with development of a severe shock. After confirmation of hypovolaemia, attention was focused on the abnormal haematological findings (a sharp drop in serum proteins with a rise in haematocrit) which suggested major leakage of plasma. Treatment based on infusions of plasma and albumin failed, and the patient died in a state of anasarca and pulmonary oedema with normal wedge pressure. 18 similar cases have already been published, six of which were in obstetric or surgical patients. After analysing the prodromes and its onset, its pathophysiological mechanisms and treatment are discussed. PMID- 6497081 TI - [Accidental ingestion of a battery]. AB - A case of accidental battery ingestion by a three-year old boy is reported. The possible complications are local (i.e. necrosis of tissues by leakage of the alkaline electrolyte, by electrical injury or by impaction of the battery) and general (mercury poisoning). Large diameter batteries impacted in the oesophagus need prompt removal. When the battery is located in the stomach, two attitudes are discussed: some authors allow it to progress through the gastrointestinal tract spontaneously under radiological control, others recommend rapid removal by endoscopy or surgery in order to avoid the complications above described. PMID- 6497082 TI - [Dissection of the internal carotid artery]. AB - Closed injury of the internal carotid artery is rare, as it represents only 4% of all the lesions affecting the carotid system. Diagnosis of this injury is difficult, the first signs often being missed as they usually occur in severely injured patients, with the neurological signs appearing later. The death rate remains high, and the sequelae very heavy. After a road traffic accident, three patients, all drivers wearing their seat-belts, presented with bone and/or abdominal lesions, a head injury and a left anterolateral flail chest. All three cases showed an unilateral mydriasis; the variations in their conscious levels led to further neurological investigations. The diagnosis was suggested in one patient by computerized axial tomography, and confirmed in all three by carotid arteriography. The results were excellent when early surgery could be performed (2 cases). However, in the absence of surgery, carotid dissection could only be a major contributing factor for the cerebral oedema associated with the previous hemispheric contusion. The mechanism of these carotid injuries would appear to involve rotation and extension or flexion movements of the neck, crushing the internal carotid artery against the transverse processes of the cervical vertebrae or the mandible: a possible part played by the seat-belt would explain the frequent association of the injury with chest trauma. PMID- 6497083 TI - [Technics for artificial ventilation of a single lung during thoracotomy]. AB - Different means of limiting the fall in arterial PO2 produced by single artificial ventilation were studied in 60 patients during thoracotomy. Changing from ventilating both lungs to the one healthy lung in the lateral recumbent position, without modifying tidal volume and frequency, brought about a fall in arterial PO2 from 180 +/- 56 to 67 +/- 40 mmHg. The alveolar to arterial oxygen gradient increased to 110 +/- 45 mmHg (the alveolar oxygen pressure being calculated). Reducing the tidal volume so as to keep the inflation pressure at its initial level did not improve the arterial PO2 but slightly increased the arterial PCO2 (2.3 mmHg). The use of 6 to 8 cm H2O positive end-expiratory pressure did not significantly modify the arterial PO2 or PCO2. Increasing the inspired oxygen fraction from 0.5 to 0.7 increased the arterial PO2 from 100 +/- 89 mmHg to 165 +/- 59 mmHg, whilst the alveolar to arterial oxygen gradient increased to 118 +/- 60 mmHg. Clamping the pulmonary artery increased the arterial PO2 and dual lung ventilation restored it to its initial value. Therefore, the only effective means of increasing oxygenation was to increase the inspired oxygen fraction. Unilateral continuous positive airway pressure was not used so as not to impair surgery. Dual lung ventilation may be necessary if the arterial PO2 remains low. PMID- 6497084 TI - [Tissue necrosis after accidental perivenous injection of potassium chloride]. PMID- 6497085 TI - [Role of hyperventilation in severe hypophosphoremia]. PMID- 6497086 TI - [Blood histamine and aortography]. PMID- 6497087 TI - [Pruritus after spinal anesthesia with pethidine]. PMID- 6497088 TI - Characteristics of protective activity of Mycoplasma hyopneumoniae vaccine. AB - Protective activity of Mycoplasma hyopneumoniae vaccines prepared from whole cells or crude extracts was evaluated in an experimentally induced mycoplasmal pneumonia swine model. Swine were obtained at 7 to 10 weeks of age from a surgically derived herd free of porcine mycoplasmas. Vaccines prepared from whole cells, freeze-thaw-saline solution extract, supernate of culture, or saline wash of cells were treated with 0.15% formalin, incorporated with Freund incomplete adjuvant, and administered IM in 2 doses. Twenty-five to 42 days after the 1st dose of vaccine was given, pigs were challenge exposed intratracheally with supernate of lung homogenate containing only M hyopneumoniae. Necropsies were done 27 to 38 days after challenge exposure. For evaluation of protective efficacy of vaccines, determination of proportion of lung with gross lesions gave better results than histologic, fluorescent antibody or mycoplasmal isolation procedures. Whole cell vaccine containing 10(9) color-changing units of M hyopneumoniae, an amount attainable in log-phase cultures, protected swine against development of pneumonia. Whole cells, supernate of culture, and saline wash of cells induced comparable protection. Protective activity of whole cell vaccine resisted heating at 80 C. Extracts prepared according to a freeze-thaw procedure were variable in protective activity and, in some instances, enhanced lesion development. PMID- 6497089 TI - Immune response of swine vaccinated with a group E Streptococcus whole-culture bacterin. AB - Swine (n = 10) were given a concentrated whole-culture adsorbate bacterin made from group E Streptococcus (GES). Two doses of bacterin were given subcutaneously 3 weeks apart. Control swine (n = 10) were given a blank preparation made from sterile culture medium. Swine were challenge exposed 3 weeks after the 2nd injection of bacterin by being penned continuously for 8 weeks with carrier swine infected with GES. A significant (P less than or equal to 0.009) immune response to vaccination with the bacterin was observed. Vaccinated swine, but not control swine, developed antibodies to an antiphagocytic factor (as detected with bactericidal and long-chain tests) before challenge exposure. Vaccinated swine also developed 51.2% (20 vs 41) fewer abscesses after challenge exposure than did control swine. Control swine developed a greater serologic response to challenge exposure, indicating a more extensive infection with GES. PMID- 6497090 TI - Distribution of innervation and circulation in porcine cervical trachea. AB - The circulation and innervation to porcine cervical trachea were studied in 54 animals in situ. The antemortem response of porcine tracheal muscle was measured isometrically during selective injection of acetylcholine into the cranial thyroid arterial circulation. A predominantly unilateral (70.4%), rather than bilateral (3.7%), arterial circulation was identified; a cranial thyroid artery was not demonstrated in 25.9% of swine, suggesting dominant perfusion from the caudal thyroid circulation. After animals were killed, dye injection through the dominant cranial thyroid trunk demonstrated homogeneous perfusion of the muscle in all instances. In 20 of these animals, the distribution of parasympathetic innervation to porcine tracheal muscle was studied by selective electrical stimulation of the vagus nerves in situ. Tracheal smooth muscle response was measured isometrically, using settings (20 v, 20 Hz) causing maximal contractile force. Bilateral electrical stimulation caused active tracheal tension of 23.2 +/ 1.9 g/cm. Unilateral stimulation of the left vagus nerve caused 17.8 +/- 1.5 g/cm contraction, which was significantly greater than the response caused by selective stimulation of the right vagus nerve (12.1 +/- 1.6 g/cm; P less than 0.001). Innervation to porcine cervical trachea, although bilateral, is derived predominantly from the left vagus nerve; circulation is derived almost always from the left cranial thyroid artery. PMID- 6497091 TI - Persistence of encysted Toxoplasma gondii in tissues of pigs fed oocysts. AB - Ten pigs were fed 100 to 10,000 Toxoplasma gondii oocysts. Two pigs died 7 and 11 days later, and 8 pigs were euthanatized at days 38, 38, 91, 126, 168, 169, 170, and 171. From the euthanatized pigs, portions of 15 organs digested in pepsin-HCl solution were inoculated into mice, as a bioassay for viable T gondii. Such organisms were isolated from the brain and heart of these 8 pigs, from the tongue of 7, from thigh muscles of 5, from the diaphragm of 4, from kidneys, liver, and small intestines of 2, and from salivary glands and eyes of 1 pig; but not from lungs, spleen, spinal cord, mesenteric and prescapular lymph nodes of any pig. Results indicate that T gondii can persist in edible tissues of living pigs for at least 171 days and that heart and brain may be the most suitable porcine tissues for epizootiologic surveys. PMID- 6497092 TI - Serologic analysis of isolates of Pasteurella haemolytica and Staphylococcus aureus from mastitic ewes. AB - Milk samples (10 ml) were collected aseptically from infected and healthy mammary glands of 20 range ewes in the early stages of unilateral acute mastitis. The ewes were on 5 different ranches in the Northern Rocky Mountain region of the United States. The samples were plated on tryptose blood agar and examined for bacteria of possible etiologic significance. Twelve of the 20 ewes were infected with Pasteurella haemolytica, 4 ewes with Staphylococcus aureus, and 1 ewe with both bacteria. Twelve of the P haemolytica infections were in pure culture as were 4 S aureus infections. The 13 isolates of P haemolytica represented 6 different serotypes. Isolates of P haemolytica from ewes on the same ranch were as serologically diverse as were isolates from ewes in different herds. The 5 isolates of S aureus were similar antigenically. Bacterial isolates were not obtained from the milk of clinically healthy mammae. PMID- 6497093 TI - Plasma mepivacaine concentrations after caudal epidural and subarachnoid injection in the horse: comparative study. AB - The venous plasma concentrations of mepivacaine were determined in 7 adult mares (420 +/- 17.1 kg) given an injection of a 2% solution of the hydrochloride at either the sacral (S2-3 to S5-C1) epidural space or the midsacral (S2-3) subarachnoid space. An average dose of 91.4 +/- 15.7 mg (4.6 +/- 0.8 ml) was needed to produce caudal epidural analgesia (CEA) and 26.7 +/- 5.4 mg (1.3 +/- 0.3 ml) to produce caudal subarachnoid analgesia (CSA). Maximal caudal analgesia extended from spinal cord segments S-1 to coccyx during CEA and CSA. The onset of analgesia as measured by response to superficial and deep muscular pinprick stimulations was significantly (P less than 0.05) faster in mares with CSA than with CEA (8.3 +/- 2.4 minutes vs 21.4 +/- 3.8 minutes). The period of analgesia was significantly (P less than 0.05) longer in mares with CEA than with CSA (80.0 +/- 11.5 minutes vs 67.4 +/- 26.3 minutes). The rate of vascular absorption of mepivacaine from the epidural space was significantly (P less than 0.05) faster than from the subarachnoid space. Maximum venous plasma concentrations of mepivacaine were similar (P greater than 0.05) after epidural and subarachnoid injections (0.05 +/- 0.03 micrograms/ml and 0.05 +/- 0.03 micrograms/ml) at the same times after mepivacaine administration (51.4 +/- 33.4 minutes and 53.6 +/- 24.3 minutes).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497094 TI - Usefulness of lymphocyte typing to exclude incorrectly assigned paternity in horses. AB - Lymphocyte typing can be used to detect incorrectly identified parentage of horses. Efficacies of lymphocyte typing to solve paternity questions were calculated using gene frequency estimates of equine lymphocyte antigen (ELA) markers for Thoroughbreds and Standardbreds. Probabilities that ELA typing will detect an incorrectly assigned sire were 68.7% in Thoroughbreds, 67.9% in pacing Standardbreds, and 62.0% in trotting Standardbreds. These calculations demonstrate that ELA typing is among the most efficacious genetic systems for solving paternity questions in horses. Likewise, it could also be effective for blood type identification and solving other questions of parentage in horses. PMID- 6497095 TI - Healing of experimentally induced wounds of mammary papilla (teat) of the cow: comparison of closure with tissue adhesive versus nonsutured wounds. AB - Lacerations were surgically produced on the mammary papillae (teats) in 11 healthy dairy cows (10 Holstein and 1 Guernsey). Chemical restraint and local anesthesia were used before the lacerations were done. Twenty-one lacerations (10 front and 11 rear papillae) were apposed with synthetic adhesives. Eight lacerated papillae (6 front and 2 rear) were allowed to heal without tissue apposition. Healing was evaluated daily by palpation and visual inspection. Histologic and subgross photomycrographies were done at the time of slaughter (13 to 20 days). Of the 21 lacerated wounds apposed with adhesive materials, 17 healed by primary intention (81%). One papillary laceration dehisced on the second day and developed a milk fistula. The remaining 3 wounds which were initially repaired with adhesives were injured during the cows' anesthetic recovery and were reapposed with adhesives. The latter healed, but not as well as did the 17. Clinically, there was no detectable differences between adhesives as concerns healing. Of the 8 controls (papillary lacerations that were not apposed), 3 healed by 1st intention (37.5%). The remaining five (62.6%) healed by 2nd and 3rd intention with fistula formation. When evaluated by subgross photomycrography, 20 wounds (18 glued; 2 controls) were bridged by connective tissue and showed no change in wall thickness. Three papillary lacerations (2 glued; 1 control) showed different stages of bridging with connective tissue and wall thickness. Histopathologic evaluation revealed a marked foreign body response evidenced by giant cell and epithelial macrophages adjacent to all lacerations apposed with adhesives. Tissue alteration varied widely depending on the method of tissue apposition and the tissue adhesive used. PMID- 6497096 TI - Control of bovine coccidiosis with monensin: in nonresistant newborn calves. AB - Newborn Holstein male calves were purchased within 3 days after birth and were removed from the local farms to the Dixon Springs Agricultural Research Center. They were hand-fed for 7 weeks and then weaned to a prepared feed. Eight groups, each of 4 calves, were housed in separate pens. In each of 4 pens (pens 2 to 5), 1 calf was inoculated with sporulated oocysts of Eimeria bovis (and was not medicated); 1 calf was inoculated and given feed with added monensin at the dosage level of 10 g/906 kg of feed; and 2 calves were inoculated and given medicated feed with added monensin at the dosage level of 20 g/906 kg or 30 g/906 kg. In the 4 other pens (6 to 9), the calves were inoculated with E zuernii and otherwise were given feed without or with added monensin as in pens 2 through 5. Another group of 5 calves (all kept in 1 pen), served as noninoculated, nonmedicated controls. At 14 days after inoculations with E bovis, the single calves in each of the 4 pens that were given the nonmedicated feed began to show clinical signs of coccidiosis and discharged increasing numbers of oocysts. The other inoculated calves (given monensin) had fewer clinical signs and discharged fewer oocysts in the feces as the level of medication in the feed increased. The calves inoculated with E zuernii developed only moderately severe infections when compared with those inoculated with E bovis. Inoculated (with E bovis) nonmedicated calves had severe reductions in feed consumption and weight, and 3 of 4 died.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497097 TI - Efficacy of fenbendazole against inhibited larvae of Ostertagia ostertagi in yearling cattle. AB - Efficacy of fenbendazole, at doses of 7.5 and 10.0 mg/kg of body weight, against inhibited early 4th-stage larvae of Ostertagia ostertagi and other nematodes of the abomasum and intestinal tract, was investigated in naturally infected yearling heifers in late May 1982. In Louisiana, this is near the end of the period (March to May) in which maximal numbers of inhibition-prone larvae are acquired. The mean numbers of O ostertagi in 10 untreated control cattle were: adults, 4,880; developing 4th-stage larvae, 12,546; and inhibited early 4th-stage larvae, 167,931. At the 7.5 mg/kg dose level (10% liquid suspension) in 10 cattle, percentage reduction of O ostertagi in comparison with controls was: adults, 95.7%; developing 4th stages, 91.1%; and inhibited 4th stage, 55.0%. Percentage reductions of other genera were as follows: abomasum--Trichostrongylus axei, 99.6%; Haemonchus sp, 95.1%; intestinal tract--Cooperia spp, 97.8%; Trichostrongylus colubriformis, 100.0%; and Oesophagostomum radiatum 4th stage and adults, 100.0%. At the 10.0 mg/kg dose (10% liquid suspension) in 11 cattle, the percentage reduction of O ostertagi in comparison with controls was: adults, 98.6%; developing 4th stages, 92.9%; and inhibited 4th stage, 80.0%. Percentage reductions of other genera were: abomasum--T axei, 99.9%; Haemonchus sp, 98.8%; intestinal tract--Cooperia spp, 99.3%; T colubriformis, 100.0%; and Oes radiatum 4th stage and adults, 100.0%. Variability of efficacy against inhibited larvae was observed, particularly at the 7.5 mg/kg dose; at this dose, 7 of the 10 heifers in the group yielded in excess of 54,000 surviving larvae.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497098 TI - Normal values of the canine M-mode echocardiogram. AB - M-mode echocardiograms were recorded from 40 healthy dogs, awake and unsedated, in left lateral recumbent position. Fifteen echocardiographic measurements were taken and correlated with body weights using linear regression equations. The left ventricular internal dimension in systole and diastole, the left ventricular wall thickness, the aortic root dimension, and the left atrial dimension had high correlation coefficients (r2), ranging from 0.756 to 0.619. The fractional shortening of the left ventricle in systole (39% +/- 6%) and the left atrial to aortic root ratio (0.99 +/- 0.10) were not linearly related to body weights and had constant values. PMID- 6497099 TI - Auditory-evoked response in the clinically normal dog: early latency components. AB - Early latency components (0 to 10 ms) of the auditory-evoked response, which is also called the brainstem auditory-evoked response (BAER), were recorded in 6 clinically normal adult dogs. Each dog responded to suprathreshold monaural clicks with a highly repeatable averaged waveform configuration consisting of 6 to 7 vertex positive waves. Configuration of the canine BAER consisted mainly of waves I, II, III, V, and VI. Wave IV was present in some records, but in most cases, it formed a complex with wave III and was not apparent as a separate wave. After a 90-dB hearing level (HL) stimulus (20/s), the positive peak of wave I in the averaged response appeared at approximately 1 ms after stimulation onset, and subsequent waves were spaced at approximately less than or equal to 1-ms intervals. Amplitudes of these waves were 4.0 microV when measured from positive peak to the following negative trough. Experiments were conducted to determine the effects of varying stimulus intensity (50- to 90-dB HL) on BAER wave amplitude and peak latency in nonanesthetized and anesthetized dogs and to determine the effects of increasing stimulus rate (10 to 50/s) in nonanesthetized dogs. As stimulus intensity was increased in 10-dB steps from 50 to 90 dB and as the stimulus rate remained at 20/s, amplitude increased and latency decreased for all waves (P less than 0.01). When stimulus intensity was held constant at 90 dB and stimulus rate increased from 5 to 50/s, amplitude decreased and latency increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497100 TI - Auditory-evoked response in the clinically normal dog: middle latency components. AB - The middle latency components (6 to 60 ms) of the auditory-evoked response were recorded in clinically normal mature dogs (n = 15 mixed breed). To record the middle latency response (MLR), a series of suprathreshold auditory clicks was presented monaurally to nonanesthetized and anesthetized dogs at a stimulus rate of 5/s. To determine effects of stimulus intensity on wave amplitude and latency in nonanesthetized dogs, clicks were presented at 90-, 70-, and 50-dB hearing level. Filtered electroencephalic activity during the first 100 ms after each click was recorded and averaged digitally for 1,024 consecutive stimuli. The response pattern in the nonanesthetized dog was a repeatable polyphasic configuration characterized by 3 to 4 major waves. Peaks of the waves were labeled, using a method developed in human beings. Mean latency ranges for the positive (P) or negative (N) peaks that comprised the waves across intensity levels were 7.43 to 7.77 ms (No), 11.07 to 11.57 ms (Po), 13.62 to 14.20 ms (Na), 20.04 to 20.68 (Pa), 39.08 to 39.37 ms (Nb), and 54.25 to 55.21 ms (Pb). The only variations in waveform morphologic features were the additional wave formed by peaks Nx (24.80 to 25.94 ms) and Px (30.0 to 30.62 ms), which occurred in 44% of the records, and the missing wave formed by No and Po in 6.6% of the records. Varying the stimulus intensity had no effect (P less than 0.05) on wave amplitude or latency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497101 TI - Effects of spontaneous hyperadrenocorticism on serum thyroid hormone concentrations in the dog. AB - Serum thyroid hormone concentrations were evaluated in 124 dogs with untreated spontaneous hyperadrenocorticism either by measuring basal thyroxine (T4) and triiodothyronine (T3) concentrations (102 dogs) or by assessing the T4 response to exogenous thyroid-stimulating hormone (TSH) administration (22 dogs). Reduced basal serum concentrations of T4 and of T3 were found in 58 (57%) and 53 (52%), respectively, of the 102 dogs with hyperadrenocorticism; of these, 42 dogs had low values for both T4 and T3, 16 had decreased T4 concentrations alone, and 11 had only decreased T3 concentrations. In 20 dogs that had basal serum thyroid hormone concentrations determined before and after control of hyperadrenocorticism, mean concentrations of both T4 and T3 increased significantly (P less than 0.05). Serum T4 and T3 concentrations normalized in all but 1 of the 20 dogs. In the 22 dogs with hyperadrenocorticism given TSH, mean serum concentrations of T4 at both basal and post-TSH administration times were significantly decreased (P less than 0.01) compared with the results obtained in 18 normal dogs. Nevertheless, a significant increase (P less than 0.001) in mean T4 concentration occurred in these dogs; T4 concentrations after TSH was given were at least 2-fold greater than basal values. The T4 response to exogenous TSH was less in the 13 dogs with low basal T4 concentrations than in the 9 dogs that had resting T4 values within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497102 TI - Antimicrobial susceptibility of coagulase-positive staphylococci isolated from Louisiana dogs. AB - Disk diffusion susceptibility tests were done on 1,178 clinical strains of coagulase-positive staphylococci (CPS) isolated from dogs during a 7-year period. Relative decreases of 7% to 33% were found in the percentages of CPS sensitive to 8 antimicrobics. Relative percentages of CPS sensitive to 9 other antimicrobics were increased or decreased less than 5%. Sensitivity to the beta-lactam antibiotics showed the least relative change. Regression analysis demonstrated that the greatest change in percentage sensitivity of CPS occurred to gentamicin and cephalothin and the least change occurred to penicillin and ampicillin. Recent canine clinical isolates of CPS, specifically identified as Staphylococcus intermedius (n = 109), were uniformly sensitive to novobiocin, amikacin, tobramycin, spectinomycin, and amoxicillin-clavulanic acid. Twenty-two isolates were also sensitive to 17 other antimicrobics. Eighty-seven isolates were resistant to 1 or more antimicrobics tested. Resistance was most common to sulfonamides, penicillin G, ampicillin, tetracycline, and streptomycin. Differences in susceptibility results between S intermedius and unspecified CPS were not statistically significant. PMID- 6497103 TI - Direct spectrometric determination of serum bile acids in the dog and cat. AB - Serum bile acid concentrations have been shown to be a predictive indicator of hepatobiliary disease in persons. However, there has been only limited use of bile acid values in the clinical diagnosis of hepatobiliary disease in the dog and cat because of technical difficulties associated with many bile acid assays. A rapid enzymatic method previously developed for the quantitation of 3-hydroxy bile acids in persons has been adapted for use in the dog and cat. Nonsulfated 3 hydroxy bile acids are converted to 3-oxo bile acids by 3 alpha-hydroxysteroid dehydrogenase and reduction of NAD+ to NADH. In a coupled diaphorase catalyzed reaction, H+ is transferred to nitrotetrazolium blue to produce a diformazan dye, which is measured spectrophotometrically at 540 nm. Nonspecific interfering dehydrogenase activities present in the dog and the cat serums were inhibited by heating the serum to 60 C for 30 minutes or by the addition of sodium pyruvate. Standard curves prepared from various serum sodium taurocholate concentrations in dogs and cats are linear to 250 mumol/L. The assay is sensitive for the detection of bile acid concentrations as low as 2.5 mumol/L in sera from dogs and cats. In validation studies quantitative recovery of known concentrations of 7 primary and secondary, conjugated and unconjugated, 3-hydroxy bile acids from pooled canine serum was 95.3 +/- 7.9% (mean +/- SEM) and that from pooled feline serum was 101.4 +/- 8.2%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497104 TI - Radioimmunoassay of conjugated bile acids in canine and feline sera. AB - A solid-phase radioimmunoassay for the measurement of total conjugated bile acids was validated for use in dogs and cats. The method used an 125I-labeled iodoglycocholate tracer and polypropylene assay tubes coated with rabbit antiserum against the major conjugated bile acids. Standard solutions of sodium taurocholate provided with the kit and serial dilutions of canine and feline sera containing low, medium, and high endogenous bile acid concentrations inhibited binding of the [125I]iodoglycocholate tracer to the antibody in a parallel manner; this inhibition indicated specificity of the assay for bile acids in the serum of dogs and cats. Increased serum bile acid concentrations in animals with liver disease confirmed the biologic specificity of the assay in dogs and cats. Accuracy was shown by quantitative recovery of purified sodium taurocholate from canine and feline sera. Intra-assay precision was 7.2% to 17.3% for dogs and 8.5% to 18.5% for cats. Interassay precision was 4.8% to 17.2% for dogs and 3.5% to 11.2% for cats. The sensitivity of the assay in dogs and cats was 0.4 mumol/L. Solid-phase radioimmunoassay is a valid method for the direct measurement of total conjugated bile acids in the dog and cat, and is of value in the diagnosis of hepatobiliary disease in these species. PMID- 6497105 TI - Immunoradiometric assay for quantitation of Dirofilaria immitis antigen in dogs with heartworm infections. AB - An immunoradiometric assay (IRMA) was developed, optimized, and validated for detection of parasite-specific antigen in sera from hosts with filarial infections, using Dirofilaria immitis in dogs as a model. The precision, reproducibility, and parallelism of the IRMA were examined, using precision profile analysis. The IRMA had acceptable precision and reproducibility [less than 15% intra-assay coefficient of variation (CV)] over a working range of 10 to 2,000 ng of D immitis-antigen (AG)/ml. The IRMA parallelism (agreement between dilutions) was acceptable (less than 10% interdilutional CV) with laboratory spiked D immitis AG sera containing no D immitis-antibody (AB). However, it was not acceptable (greater than 20% interdilutional CV) for analysis of sera from naturally infected dogs containing D immitis AB, probably due to dissociation of immune-complexed AG with increasing serum dilution. Nonparallelism limited the accuracy of binding data interpolation from the standard curve. Specificity of the IRMA was enhanced by preabsorption of the radiolabeled detection antibody with Toxocara canis AG before use. Varying amounts of D immitis AG (22 to 1,000 ng/ml) were detected in 42% (20/48) of microfilaremic dogs. The presence of AG specific AB at concentrations as low as 1 microgram/ml reduced the ability of the IRMA to detect D immitis AG. Factors that influence the accuracy and sensitivity of immunoassays for circulating filarial antigens are discussed. PMID- 6497106 TI - Electromyographic and urethral pressure profilometry: assessment of urethral function before and after perineal urethrostomy in cats. AB - Urethral pressure and electromyographic profiles were recorded in 10 healthy adult male cats before and after perineal urethrostomy. There was a significant decrease (P = 0 at 1 week after surgery, P = 0.002 at 3 weeks after surgery) in the mean maximum urethral pressure profile with associated loss of periurethral striated muscle activity. PMID- 6497107 TI - Staphylococcus sciuri subsp lentus associated with goat mastitis. AB - An organism recovered from mastitic milks of goats was identified as Staphylococcus sciuri subsp lentus. Isolation of this organism in pure cultures from individual half-udder samples of 5 goats of 18 affected, confirms that it possesses pathogenic potential. PMID- 6497108 TI - Chlamydia psittaci experimental abortion in goats. AB - To study abortive chlamydiosis in goats, 11 pregnant goats were inoculated intradermally at the 3rd month of pregnancy with 2 X 10(7) or 2 X 10(6) plaque forming units of a strain of Chlamydia psittaci isolated from naturally occurring abortions in goats. The 11 inoculated does aborted 24 to 56 days after they were inoculated and shed Chlamydia. This shedding began at least 9 days before abortion (1 goat) and persisted 12 days after abortion (1 goat). Retained placenta or metritis were observed in 4 of the goats. PMID- 6497109 TI - An ultraviolet-attenuated egg vaccine for swine ascariasis: parameters affecting the development of protective immunity. AB - Pigs inoculated with UV-irradiated Ascaris suum eggs developed immunity against challenge exposure with A suum infective eggs. Trials were conducted to determine the optimal conditions necessary to induce high levels of protective immunity and minimize liver lesions related to larval migration. Protective immunity was defined as the percentage of reduction in the recovery of larvae from the lungs of inoculated pigs, compared with controls, 7 days after challenge exposure with 5 X 10(3) or 10(4) infective eggs. Initial experiments showed that protective immunity was higher in pigs inoculated orally with UV-irradiated eggs than in those inoculated intraperitoneally. The highest level of protection (94%) was obtained by immunization with 5 oral inoculations of 10(4) eggs that had been UV irradiated at total energy doses (ET) of 150, 100, 75, 75, and 75 mu W-min/cm2, respectively. A level of 83% protection was induced with as few as 2 oral inoculations of eggs irradiated at 150 and 75 ET, respectively. However, protection was reduced when pigs received eggs that were irradiated at and above 400 ET. The minimum number of irradiated eggs required to induce significant (P less than 0.05) protection was determined by feeding pigs 10(4), 10(3), or 10(2) eggs irradiated on 3 consecutive weeks at 150, 100, and 75 ET; the levels of protection induced were 94%, 89%, and 83%, respectively. Pigs inoculated with equal numbers of UV-irradiated eggs or normal eggs developed a similar level of protective immunity after challenge exposure. However, worms developing from the inocula were detected in the intestines of some of those pigs that had received normal eggs, but not in those pigs given UV-irradiated eggs. PMID- 6497110 TI - Cross protection in mice and swine immunized with live erysipelas vaccine to challenge exposure with strains of Erysipelothrix rhusiopathiae of various serotypes. AB - Mice and swine immunized subcutaneously with live vaccine prepared from acriflavine-fast attenuated Erysipelothrix rhusiopathiae, strain Koganei (serotype 2), were challenge exposed to virulent strains of E rhusiopathiae of various serotypes. Vaccinated mice did not die after challenge exposure to serotypes 1a, 1b, 2, 3, 5, 6, 7, 8, 9, 11, 12, 15, 16, 18, 19, 21, or N, but 20% to 30% mortality occurred in vaccinated mice challenge exposed to serotypes 10, 14, 20, or 22. Nonvaccinated control mice died after challenge exposure to all serotypes tested. Vaccinated swine challenge exposed to strain 14B (serotype 9) or strain 2179 (serotype 10) developed localized urticarial lesions at the site of intradermal exposure. Vaccinated swine challenge exposed to serotypes 1a, 1b, 2, 5, 8, 11, 12, 18, 19, or 21 did not have clinical signs of acute erysipelas. Nonvaccinated control swine developed acute generalized erysipelas or localized lesions at the site of intradermal exposure. PMID- 6497111 TI - Injection of iron in newborn beef calves: erythrocyte variables and weight gains with newborn-dam correlations. AB - Iron injection in beef calves during the 1st week after birth increased their PCV, hemoglobin (Hb) concentrations, mean corpuscular volumes (MCV), and mean corpuscular Hb (MCH). These increases persisted between weeks 2 and 12. The RBC count during the 1st week after birth had a positive correlation with the PCV and Hb concentrations and a negative correlation with the MCV and MCH. There was a positive correlation between the serum iron concentration of the dams and their MCV and mean corpuscular Hb concentration. There was also a positive correlation between the MCV and MCH of the dam and their calf's MCH. Seemingly, iron injection did not affect weight gain during the first 18 weeks of life. PMID- 6497112 TI - Action of epinephrine on the function of the teat sphincter in the lactating cow. AB - Under continuous IV infusion of oxytocin, milk leakage was elicited in 6 lactating cows with full udders by induction of a vacuum (-30 cm of water) around 1 mammary papilla (teat) with a plethysmographic apparatus. The volumes of milk loss were measured every minute. Epinephrine injected either into the jugular vein (20, 100, and 500 micrograms) or into the external pudic artery (1.5, 7.5, and 37.5 micrograms) induced an increase in milk leakage in 5 cows. This effect could be antagonized by the beta-blocking agent sotalol hydrochloride (0.5 to 4 mg) injected into the external pudic artery. In 1 cow, however, epinephrine given intra-arterially exerted a biphasic effect, small doses inducing stimulation, and large doses evoking inhibition of milk loss. The stimulating effects were blocked by sotalol (2 mg). The inhibiting effects were antagonized by the alpha-blocking agent prazosin (2 mg). PMID- 6497113 TI - An apparatus for quantitative collection of urine from male cattle, sheep, and swine. AB - An apparatus for quantitative collection of urine from male cattle, sheep, and swine was designed. The apparatus was constructed of elastic, waterproof cloth, fabric fastener, and a waterproof bag. The apparatus was lightweight, easily installed on the animal, resulted in no apparent discomfort to the animal, and could be used for extended collection periods. PMID- 6497114 TI - Polyethylene glycol-6000 as a clearing agent for lipemic serum samples from dogs and the effects on 13 serum assays. AB - Polyethylene glycol-6000 (PEG) was evaluated as a clearing agent for lipemic serum from dogs. Effects of PEG-treatment in lipemic and non-lipemic samples were determined for 13 chemical and enzymatic assays (glucose, BUN, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, amylase, total protein, albumin, sodium, potassium, chloride, phosphorus, and calcium). Control samples for lipemic sera were prepared by ultracentrifugation. Treatment with PEG cleared all lipemic samples. Regression lines for all lipemic samples were highly significant (P less than 0.0001) and the SD of the control values around the regression lines were small compared with the mean value for an assay. The technique was simple, quick, and inexpensive. With proper validation, reliable predictions of true serum values could be calculated for lipemic serum samples for all assays studied. PMID- 6497115 TI - Radiologic and anatomic observations of plantar sesamoid bones at the tarsometatarsal articulations of greyhounds. AB - In Greyhounds, 2 plantar sesamoid bones were identified in radiographs taken of the intact tarsus and also of the tarsometatarsal fibrocartilage, that had been dissected free from the joints. Anatomic dissections defined the precise position of each sesamoid. A prominent sesamoid was present on the lateral side of the tarsometatarsal articulation in 50% of the tarsi; it is proposed that this bone be named the lateral plantar tarsometatarsal sesamoid bone. A smaller bone was detected on the medial side of the tarsometatarsal articulation in 27% of the tarsi; it is proposed that this bone be named the intra-articular tarsometatarsal sesamoid bone. PMID- 6497116 TI - Pilot study on the treatment with thioproline of 24 small animals with tumors. AB - Thioproline (thiazolidine-4-carboxylic acid) was administered in a 16-week trial by either IM or subcutaneous routes to 23 dogs and 1 cat with solid tumors (12 animals) and incompletely excised malignant tumors (12 animals). Acute partial responses were observed in 3 of the 12 animals with solid tumors. In a mammary gland carcinoma and oral fibrosarcoma, there was tumor enlargement by the 4th day of drug therapy followed by partial regression. Drug activity appeared to be directed against tumor blood supply. Tumor progression occurred in 11 of the 12 other animals (incompletely excised tumors). Although 4 of 5 dogs with intranasal tumors were alive and relatively free of tumorous signs at 9 months or more after surgical operation was done, there was no microscopic evidence of reverse transformation or cytostatic activity in the 2 intranasal tumors that were reoperated upon. There was no hematologic or biochemical toxicosis noted. Apparent pain from injection and abscess formation were the most frequent complications from parenteral administration and would preclude using this method on a long-term basis. PMID- 6497117 TI - Correction of organophosphate-induced neuromuscular blockade by diphenhydramine. AB - Dogs exposed to topical organophosphate (fenthion) developed decreased plasma and muscle cholinesterase activities. After 2 doses were applied (1 week between doses), plasma concentrations declined 80% and muscle cholinesterase activity was reduced by 56%. Decremental responses to repetitive nerve stimulation developed after fenthion administration. Diphenhydramine, but not placebo, corrected the electrical abnormalities caused by organophosphate application, but without altering plasma or muscle cholinesterase activity. Control dogs housed in the same kennel demonstrated a slight decrease (18%) of plasma cholinesterase, which indicates that there may be potential cross contamination. Diphenydramine may be effective in treating organophosphate-induced neuromuscular weakness which is refractory to other forms of therapy. PMID- 6497118 TI - Hereditary anomaly of neutrophil granulation in Birman cats. AB - A hereditary anomaly of neutrophil granulation in purebred Birman cats was described with respect to genetic, electron microscopic, histochemical, and functional characters. The trait was inherited in an autosomal recessive manner and was prevalent in the population studied. Affected cats had fine eosinophilic granules in the cytoplasm of neutrophils. The granules had normal morphology as determined by electron microscopy and did not stain for acid mucopolysaccharide. Bactericidal activity, phagocytosis, and oxidative function of affected neutrophils were not different from those of unaffected neutrophils. The anomaly was concluded to be an alteration in the content of lysosomal granules with increased affinity for acidic dyes. PMID- 6497119 TI - Spinal-evoked potentials and spinal conduction velocity of the cat: reference values. AB - Spinal conduction velocities of the fastest afferent fibers of the spinal cord were calculated from the onset latencies of averaged evoked responses elicited by stimulation of the tibial nerve sensory afferent fibers and were recorded at various sites on the spinal cord. Locations for stimulation and recording electrodes were identified. Waveforms, mean amplitudes, and duration of the evoked spinal potentials were described. The mean conduction velocity of the spinal cord afferents at T12-T13 was 74.25 m/s with a SD of +/- 9.81 m/s. The mean conduction velocity of the spinal cord afferents, determined at the cisterna magna, was 80.66 m/s with a SD of +/- 11.50 m/s. This is a slight increase over the spinal conduction velocity at T12-T13 (P = 0.05). PMID- 6497120 TI - Feline malignant lymphoma: log-linear multiway frequency analysis of a population involving the factors of sex and age of animal and tumor cell type and location. AB - A method appropriate for the analysis of multiway frequency tables is described. This multivariate approach was used to evaluate the relationship between age, sex, cell type, and tumor location based on information available from 1,733 cases of feline malignant lymphoma. The analysis identified 6 bivariate relationships to be statistically significant, P less than 0.001; there were no significant higher order interactions observed. Emphasis was placed on 3 interactions: age to tumor location, age to sex, and tumor location to cell types. PMID- 6497121 TI - Feline giardiasis: observations on natural and induced infections. AB - The excretion of Giardia sp cysts in the feces of naturally and artificially infected cats fluctuated sporadically, and cysts were undetectable several times during 7 weeks of observation. The mean prepatent period for Giardia infection in 7 cats was 9.6 days (range, 5 to 16 days). The amount of the cyst inoculum did not appear to affect the length of the prepatent period. Six of 11 cats had clinical signs consistent with those of giardiasis. Clinical signs and cyst excretion were eliminated after treatment with metronidazole or furazolidone. Moderate oral or parenteral doses of corticosteroids produced little, if any, alteration in the infection. Postmortem examination of 1 inoculated cat revealed Giardia trophozoites in the jejunum and upper portion of the ileum but not in the duodenum, lower portion of the ileum, cecum, or colon. Giardia cysts isolated from cat feces produced infection in Mongolian gerbils but not in C57BL/6J mice. PMID- 6497122 TI - Tracheal lesions in young turkeys infected with Bordetella avium. AB - Forty-six turkeys were inoculated intranasally with Bordetella avium at 3 days of age. Inoculated and non-inoculated turkeys (n = 72) were necropsied sequentially from post-exposure days (PED) 3 to 53. Tracheal lesions were studied histologically. Mild fibrinopurulent tracheitis, associated with bacterial colonization of ciliated epithelium, was seen at PED 7 to 10. At PED 14 and 21, there were numerous bacterial colonies, loss of ciliated cells, epithelial hyperplasia, depletion of mucus, and diffuse infiltration of lymphocytes and macrophages. At PED 28, the mucosa and tracheal rings were severely distorted. The mucosal epithelium, composed of immature epithelial cells and nononuclear leukocytes, had formed prominent longitudinal folds. Mucous glands were cystic and lined by low cuboidal epithelium. At PED 42 and 53, tracheas appeared normal, except for residual distortion of tracheal rings and shortened luminal epithelium. PMID- 6497123 TI - Plasmid content and pathogenicity of Campylobacter jejuni and Campylobacter coli strains in the pregnant guinea pig model. AB - Strains of Campylobacter jejuni and C coli from human and animal sources were assessed for pathogenicity by their capability to produce abortions in pregnant guinea pigs. The pathogenicity rate varied from 7% to 87% for the C jejuni strains and from 0% to 53% for the C coli strains. Plasmid carriage was not found to correlate with pathogenicity as determined by ability of the strains to produce abortions in the pregnant guinea pig model. PMID- 6497124 TI - Partial purification of extracellular toxic material of fish Vibrio. AB - Hemolytic activity of 3 pathogenic strains, of fish Vibrio commonly associated with vibriosis (V anguillarum NCMB6 and NCMB571 strains, and Vibrio sp N7802 strain) was examined, using chicken and mammalian erythrocytes. Vibrio strains NCMB6 and NCMB571 and their culture filtrates had hemolytic activity against 8 kinds of erythrocytes tested, whereas Vibrio strain N7802 produced only a little amount of hemolysin. Strain NCMB571 culture filtrate and its material partially purified by column chromatography were lethal in mice. From 2 peaks of protein, hemolysin was recovered from the 1st peak, which coincided with toxicity in mice. Heat-inactivation of culture filtrate indicated that hemolytic materials may be thermolabile proteins, but that toxic material may be comparatively thermostable. PMID- 6497125 TI - In vitro propagation of canine distemper virus: establishment of persistent infection in Vero cells. AB - Primary cultures of bovine fibroblast (BF) and canine brain cells, persistently infected with virulent R252-canine distemper virus (CDV), were cocultured with African green monkey (Vero) cells. Transfer of persistent CDV from BF to Vero cells varied inversely with the in vitro passage level (age) of the CDV-infected BF cells. Successful transfer of CDV to Vero cells was signaled by the transient appearance of viral syncytia, rapid spread of viral antigen to all Vero cells in the culture, and by recovery of cell-free Vero-infectious virus in culture fluids. With time, viral cytopathic effects in Vero cells containing CDV disappeared, and the infected lines could not be distinguished from noninfected control Vero cells, except by immunoassay for viral antigen. PMID- 6497126 TI - Cutaneous innervation of the thorax and abdomen of the dog. AB - The anatomy of the cutaneous nerves innervating the canine thorax and abdomen was investigated by gross dissection of 38 dogs. Additionally, the cutaneous areas innervated by the thoracic and abdominal cutaneous nerves were mapped in a 2nd group of 33 barbiturate-anesthetized male dogs, using electrophysiologic techniques. The skin of the thorax was innervated by dorsal cutaneous branches, lateral cutaneous branches, and ventral cutaneous branches of the spinal nerves. The dorsal cutaneous branches were branches of the dorsal primary branches of spinal nerves C6 and T2 through T11. The lateral cutaneous branches were branches of the ventral primary branches of spinal nerves T2 through T12. The ventral cutaneous branches were branches of the ventral primary branches of spinal nerves T2 through T10. The skin of the abdomen was innervated by dorsal and lateral cutaneous branches of spinal nerves T12 through L3 (and occasionally L4). The cutaneous areas of the dorsal cutaneous branches occupied the dorsal half of the scapular and thoracic regions and the dorsal 2/5 of the abdominal region. The cutaneous areas of the lateral cutaneous branches covered the major portion of the ventral half of the thorax and the ventral 3/5 of the abdomen. The cutaneous areas of the ventral cutaneous branches occupied the axilla and the ventral part of the thoracic wall. PMID- 6497127 TI - Effect of ophthalmic prednisolone acetate on the canine adrenal gland and hepatic function. AB - Iatrogenic hypothalamic-hypophysis-adrenal axis suppression occurred in 5 small dogs as a result of ophthalmic instillation of 1% prednisolone acetate. An ophthalmic suspension was applied 4 times a day to each eye, such that 4 mg/day was delivered for 2 weeks followed by 2.67 mg/day for 2 weeks. After treatment week 2, serum cortisol decreased from base-line mean values of 17.66 ng/ml (before ACTH) and 139.16 ng/ml (60 minutes after ACTH) to 3.22 ng/ml (before ACTH) and 13.58 ng/ml (60 minutes after ACTH). After treatment week 4, serum cortisol values decreased to a mean of 1.76 ng/ml (before ACTH) and 4.82 ng/ml (60 minutes after ACTH). Before ACTH cortisol values returned to base line 2 weeks after discontinuing treatment. Values after ACTH administration remained 26% lower than base line (P = 0.0132), although within a normal response range. Hepatic carbohydrate metabolism was altered, allowing marked glycogen accumulation. Marked increases in the blood glucose values after glucagon stimulation testing occurred at 3, 5, 15, 30, and 60 minutes after glucagon administration. The greatest increase corresponded to the 30-minute sample with a mean glucose increase of 112.40 mg/dl from base-line values (P = 0.0022) as a result of the ophthalmic corticosteroid applied. Seemingly, topical ophthalmic corticosteroids have the potential for causing adrenocortical suppression and hepatic metabolic changes. The dosage level of treatment was low enough to avoid major hematologic changes. The exaggerated response to the glucagon tolerance test indicates that this test can be used in detecting hyperglucocorticism. PMID- 6497128 TI - Effects of selenium on polymorphonuclear leukocyte function in goats. AB - Polymorphonuclear neutrophils (PMN) from goats fed selenium-deficient and selenium-adequate diets were tested for their ability to perform (i) random migration under agarose, (ii) leukotaxis toward serum chemotaxins under agarose, and (iii) phagocytosis of opsonized zymosan by chemiluminescence analysis. Function of PMN from goats fed the selenium-deficient diet was severely depressed, and incubation of these cells with selenium resulted in marked functional enhancement. Also, administration of selenium to goats fed the selenium-deficient diet resulted in increased PMN functions. Increase or decrease in PMN function was associated with corresponding alterations in blood, serum, and intracytoplasmic PMN glutathione peroxidase activities. It was concluded that a selenium-inadequate diet fed to goats results in depressed PMN function which is associated with physiologic changes in glutathione peroxidase levels. PMID- 6497129 TI - The importance of dietary antigen in the cause of postweaning diarrhea in pigs. AB - Food was given to pigs before weaning to determine whether a hypersensitive response to dietary antigen might be a predisposing factor to postweaning diarrhea. Small amounts of food increased the severity and accelerated the onset of postweaning diarrhea. Postweaning diarrhea was dependent on the presence within the diet of antigenic material (bovine casein). A weaning diet, containing little antigenic material (hydrolyzed casein), had less effect on sucrase concentration in intestinal brush borders than did diets rich in antigens (native casein). Seemingly, immune-mediated intestinal damage may predispose the pig to postweaning diarrhea. PMID- 6497130 TI - Halothane testing for malignant hyperthermia in swine: dose-response effects. AB - Purebred Pietrain malignant hyperthermia (MH)-susceptible pigs (n = 102) were subjected to halothane (0%, 1%, 2%, 3%, 4%, and 5%) in oxygen. The number of pigs in each group exhibiting muscle rigidity (MH(+) reaction) and the reaction times were recorded, as were the number of deaths resulting from MH. Mortality was not affected by the halothane concentration. However, halothane concentration did markedly affect the number of MH(+) reactions and the reaction times. False negative reactions were apparent in the pigs at halothane concentrations less than 3%. Increasing the halothane concentration incrementally to 5% (from 0%) significantly (P less than 0.05) decreased reaction times between treatment groups. The reductions in reaction times which occurred in the pigs given the 3%, 4%, and 5% halothane concentrations (62.1, 56.2, and 50.05)--although significant (P less than 0.05)--would indicate that 3% halothane would generally be sufficient for MH testing. PMID- 6497131 TI - Effects of furosemide on the plasma and urinary concentrations and the excretion of fentanyl: model for the study of drug interaction in the horse. AB - The effects of furosemide (0.55 mg/kg IV) on the plasma and urinary fentanyl (PFE UFE) concentrations were studied during steady-state conditions. The PFE during the steady-state period was 0.31 +/- 0.027 ng/ml, with no significant changes occurring, even though the rate of excretion of fentanyl (EX) increased during the 1st hour from 112.0 +/- 21.6 to 534.5 +/- 82.9 ng/minute. The EX returned to control levels within 3 hours, as did the UFE. The injection of furosemide increased glomerular filtration rate from 1.97 +/- 0.21 to 3.81 +/- 0.75 ml/kg/min. The fractional reabsorption decreased from a control of 70.3 +/- 6.2% to 25.2 +/- 2.3% during the 1st hour, returning to control levels at 3 hours after furosemide was given. The total body clearance of fentanyl increased slightly during the peak period of diuresis. The return of EX, fractional reabsorption, UFE, and clearance of endogenous creatinine to control levels occurred before the return of urine specific gravity, indicating the ability of the kidney to concentrate fentanyl before its water concentrating capacity had returned. PMID- 6497132 TI - Dexamethasone and prednisolone in the horse: pharmacokinetics and action on the adrenal gland. AB - Pharmacokinetics of dexamethasone and prednisolone were studied in 6 horses given dexamethasone alcohol (IV or IM) or dexamethasone 21-isonicotinate as a solution IV or IM (50 micrograms/kg of body weight), prednisolone 21-sodium succinate IV or IM (0.6 mg/kg of body weight), or prednisolone acetate IM (0.6 mg/kg of body weight). Plasma concentrations were determined using a high-performance liquid chromatographic method. After dexamethasone alcohol (IV) or dexamethasone 21 isonicotinate (IV), the half-life of elimination was similar (53 minutes) for both formulations. After dexamethasone (alcohol and isonicotinate, IM), concentrations were low or nondetected. After prednisolone 21-sodium succinate (IV), the half-life of elimination (99.5 minutes) was significantly (P less than 0.01) longer than that for dexamethasone. After prednisolone 21-sodium succinate (IM), absorption was rapid and bioavailability was high. After prednisolone acetate (IM), absorption was slow and prednisolone was present in plasma for about 7 days. Due to the nonlinearity of prednisolone kinetics, a bioavailability higher than 100% was obtained. The basal plasma hydrocortisone concentration was approximately 70 ng/ml. After dexamethasone (IV or IM), plasma hydrocortisone values decreased after a 2-hour delay and returned to base line after a 3 to 4 day delay. After prednisolone 21-sodium succinate (IV or IM), plasma hydrocortisone decreased immediately (IV) or rapidly (IM) and returned to base line after a 24-hour delay. After prednisolone acetate (IM), plasma hydrocortisone decreased for up to 21 days. PMID- 6497133 TI - Interactions of cold stress and Pasteurella haemolytica in the pathogenesis of pneumonic pasteurellosis in calves: method of induction and hematologic and pathologic changes. AB - Six healthy neonatal calves were chilled with cold water and had focal tracheitis induced by spraying 5% acetic acid into the tracheal lumen. Subsequently, 20 ml of sterile saline solution was injected intratracheally. The effects of these interventions on total and differential white cell counts, plasma cortisol, histamine, and bradykinin, hematocrit, total plasma solids, and indices of the erythrocyte size and hemoglobin content were determined over the subsequent 12 hours. Cold stress increased plasma cortisol levels for less than 1 hour, but did not alter any other variable. This group of calves served as a control group for a second series of neonatal calves which were given 2 X 10(9) organisms of Pasteurella haemolytica intratracheally immediately following an identical period of chilling and acetic acid exposure. Calves given P haemolytica became neutropenic. There were increased numbers of circulating band neutrophils by 12 hours after exposure, and serum cortisol values were maintained at the same or greater than cold stress concentrations for all measurement periods subsequent to exposure. Infected calves had acute fibrinous pneumonia from which P haemolytica was isolated. Contrary to previous reports, these data may indicate a role for the neutrophil in the pathogenesis of early lesions of pasteurellosis. Although the association of circulating corticosteroids with stress and subsequent infection is clear, our data provide no evidence to indicate that circulating histamine or bradykinin are involved in the pathogenesis of the acute lesions of Pasteurella pneumonia. PMID- 6497134 TI - Interactions of cold stress and Pasteurella haemolytica in the pathogenesis of pneumonic pasteurellosis in calves: changes in pulmonary function. AB - Thirteen healthy neonatal Holstein calves were cold stressed twice by hosing with cold water for 20 minutes, 12 hours between hosings. Measurements of the pattern of ventilation [tidal volume (VT), respiratory frequency (f), minute ventilation (VMIN), and functional residual capacity (FRC)], gas exchange properties of the lungs [alveolar ventilation (VA), oxygen uptake (VO2), CO2 production (VCO2), dead space ventilation (VD), dead space/tidal volume ratio (VD/VT), arterial oxygen tension (PaO2), arterial CO2 tension (PaCO2) and alveolar-arterial oxygen difference (AaDO2)] and of the mechanical properties of the pulmonary system [dynamic compliance (Cdyn), pulmonary resistance (RL), and total respiratory system resistance (RRS)] were taken. Calves responded to chilling by increasing VO2 and VCO2 necessitating an increase in VA. This was accomplished by increasing VT with reciprocal decreases in f so that VMIN remained constant. There was no change in Cdyn, RL, or AaDO2. Seven of these 13 calves were then exposed to intratracheal inoculation of 2 X 10(9) organisms of Pasteurella haemolytica, the remaining calves serving as controls. Within 1 hour, calves exposed to P haemolytica had increased VMIN, f, VD/VT, and VD. There was a decrease in PaO2 associated with increased AaDO2, but no change in PaCO2, Cdyn or RL. By 3 hours after inoculation, there were pronounced changes in PaO2 and AaDO2, and Cdyn was reduced below base-line values. By 12 hours after inoculation, calves infected with P haemolytica had increased RL and RRS and PaCO2, in addition to the previously mentioned changes. Data from Pasteurella-exposed calves indicate that gas exchange impairment and peripheral lung injury occur rapidly and that increases in airway resistance develop relatively late in the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497135 TI - Vitamin E requirement of mink with special reference to tocopherol composition in plasma, liver, and adipose tissue. AB - Tissue responses of 4 different tocopherols found in a basal diet (BD) and the effect of 2 physiologic levels of dl-alpha-tocopheryl acetate (25 and 150 mg/kg) on tissue tocopherol content were studied in the mink. The BD contained a total of 7.1 mg vitamin E/kg, with alpha-, beta-, gamma-, and delta-tocopherol in a ratio of 1:0.07:0.55:0.10, respectively. The corresponding ratios in the tissues were: liver, 1:0.04:0.12:0; plasma, 1:0:0.13:0; and adipose tissue, 1:0:0.19:0. After mink were fed diets containing vitamin E, alpha- and gamma-tocopherol were distributed in similar proportions in plasma and liver, but gamma-tocopherol was in a slightly higher proportion in adipose tissue. Addition of 25 or 150 mg/kg of alpha-tocopheryl acetate to the BD decreased the gamma-tocopherol levels in all 3 tissues; this was considered to be a dilution effect of other tocopherols in BD with added alpha-tocopheryl acetate. The beta-tocopherol content in the liver remained unchanged, irrespective of the dietary amount of alpha-tocopheryl acetate. Plasma alpha-tocopherol had a linear relationship to log dietary dose, with an apparent half-saturation of the vitamin E binding capacity at 13 mg vitamin E/kg diet. At the given dietary levels, liver and adipose continued to accumulate alpha-tocopherol. The correlation between total plasma lipids and plasma alpha-tocopherol was significant (P less than 0.001) only in the group fed the BD. Vitamin E analysis of plasma could be used as a routine method for controlling the vitamin E status of mink.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497136 TI - Demonstration of the inclusion appendage of Anaplasma marginale in nymphal Dermacentor andersoni. AB - Dermacentor andersoni nymphs were placed in stockinettes and allowed to feed on a splenectomized calf with experimentally induced anaplasmosis when the parasitemia was 3%-5%. Nymphs were selected on each of the 6 days of feeding and every 5 days from repletion through molting to the adult stage (25 days postrepletion); they were killed and midgut tissues were processed and examined by light and electron microscopies. No stages of A marginale were seen in tissues of feeding ticks. Visualization of individual components of gut contents was difficult owing to presence of the concentrated, electrondense blood meal containing hemoglobin. Inclusion appendages were observed in midgut tissues of nymphs at 5 and 10 days postrepletion, but not at 20 or 25 days. The morphology of the appendages was similar to that described for inclusion appendages commonly associated with anaplasmal inclusions in bovine erythrocytes. Some appendages were free in the lumen of the midgut and occurred either alone or with clusters of small vesicular particles. Occasionally, initial bodies like those generally found in bovine erythrocytes were seen with the appendage, but most of them were swollen and appeared to be degenerating. Frequently, inclusion appendages were observed attached to the luminal surface of the midgut cell membrane by a blunt, electron dense attachment complex. The attachment of the appendage appeared to be extracellular, with the pointed end extending into the lumen. Often, small particles were observed immediately across the cell membrane from where the appendages were attached; the small particles appeared to be generated from the appendage itself and to have passed through the membrane of the midgut cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497137 TI - Serum and cerebrospinal fluid concentrations of immunoglobulin G in Suffolk sheep with scrapie. AB - Determinations were made by laser nephelometry of serum and CSF immunoglobulin (Ig) G concentrations in Suffolk sheep with naturally occurring scrapie. The serum IgG concentrations in 3 sheep with confirmed or suspected scrapie were between 2,140 and 3,290 mg of IgG/100 ml, and the CSF values were between less than 10 and 75 mg of IgG/100 ml. In 8 clinically healthy (control) sheep, serum IgG concentrations were 2,647 to 7,380 mg/100 ml and CSF IgG concentrations were between 0 (undetectable) and 162 mg/100 ml. A sheep with pulmonary adenomatosis had 1,445 mg of IgG/100 ml of serum. The results indicated that neither serum nor CSF IgG concentrations were increased in sheep with naturally occurring infection with scrapie and that the severity of the disease did not correspond with the IgG concentration. PMID- 6497138 TI - Immunogenicity and safety of an attenuated Bordetella bronchiseptica vaccine in pigs. AB - The immunogenicity and safety of an attenuated Bordetella bronchiseptica vaccine for swine atrophic rhinitis (AR) was evaluated in 22 hysterectomy-produced, colostrum-deprived pigs and 18 conventional pigs. None of 8 pigs inoculated at 7 days of age intranasally with greater than or equal to 3 X 10(5) colony-forming units (CFU) of vaccinal strain/pig and 2 of 5 pigs inoculated at 7 days of age intranasally with 3 X 10(4) CFU of the vaccinal strain/pig developed AR after intranasal challenge exposure with a virulent strain at postinoculation week (PIW) 3. The remaining 3 vaccinated pigs and 4 nonvaccinated pigs developed AR. Thirteen pigs were inoculated intranasally with 3 X 10(6) to 3 X 10(9) CFU of the vaccinal strain at 7 days of age. At PIW 12, the pigs were killed and necropsied. None of the pigs had clinical signs of AR and/or pneumonia. Virulence was studied by transmission of vaccinal strain through 3 serial growing passages on the nasal mucosa of a litter of hysterectomy-produced colostrum-deprived pigs. Inoculum (nasal swab samples from 2 pigs 4 days after inoculation with 10(8) CFU of vaccinal strain at 5 days of age) was inoculated into the nasal cavity of 2 nonvaccinated pigs. This procedure was repeated 3 times. After the 1st passage, the vaccinal strain was recovered on postinoculation day 4, but after postinoculation day 4, the vaccinal strain was not recovered until the end of the 3rd passage. Turbinate atrophy or pneumonia was not recognized in these inoculated pigs. The vaccinal strain provided immunogenicity without ill effects. PMID- 6497139 TI - Campylobacter jejuni and Campylobacter coli inoculation of neonatal calves. AB - Three groups of neonatal calves were inoculated orally with pathogenic strains of Campylobacter jejuni or C coli. The calves developed a mild, self-limiting enteritis characterized by thick mucoid feces. Bacteremia and fecal shedding of Campylobacter were sporadic in all inoculated calves. Two groups of calves were killed 1 to 3 weeks after inoculation to study the pathogenesis of infection. Postmortem culture of tissues revealed C jejuni or C coli most frequently in the ileum, cecum, colon, and blood. Clinical or pathologic differences between C jejuni-inoculated and C coli-inoculated calves were minimal. PMID- 6497140 TI - Metabolic responses to fasting and alloxan-induced diabetes mellitus in steers. AB - To induce diabetes mellitus in 8 steers, they were fasted for 96 hours and given 110 mg of alloxan/kg of body weight (IV, in 1 dose) immediately before refeeding. Subsequently, 4 of the steers were treated with insulin (0.1 to 3 U/kg) to control hyperglycemia and 4 were not given insulin. Four control steers were fasted and refed. Fasting increased serum phosphorus, total protein, and bilirubin and decreased serum magnesium and potassium. Refeeding returned serum values of magnesium, potassium, total protein, and bilirubin toward base-line values, regardless of treatment group. However, serum phosphorus remained increased in steers with alloxan-induced diabetes and was not lowered by insulin injections. Sodium and chloride values were depressed in steers with alloxan induced diabetes; these values remained significantly (P less than 0.05) lower than base-line values, even in steers given insulin. Fat infiltration was evident in the pancreas, liver, and to some extent, kidneys of steers with alloxan induced diabetes, but was occasionally present in tissues of steers given insulin. PMID- 6497141 TI - Effect of dietary niacin supplementation on phlorhizin and 1,3-butanediol-induced ketonemia and hypoglycemia in steers. AB - 1,3-Butanediol and phlorhizin were used to induce ketonemia and hypoglycemia in steers. Oral administration of butanediol increased blood beta-hydroxybutyrate (BHB) and plasma nonesterified fatty acids (NEFA) and decreased serum glucose. Subcutaneous injections of phlorhizin, given in addition to butanediol orally, further increased NEFA and BHB concentrations and decreased glucose. Dietary niacin supplementation of steers given phlorhizin and butanediol caused serum glucose concentration to increase and blood BHB and plasma NEFA concentrations to decrease. PMID- 6497142 TI - Effect of dietary niacin supplementation on serum constituents of periparturient dairy cattle. AB - A total of 60 multiparous periparturient Holstein cows were used to determine the differences in serum constituents between cows given supplemental niacin in the diet and cows not given supplemental niacin. Serum inorganic phosphorus concentration was consistently higher (P less than 0.10) and serum potassium, total calcium, and sodium concentrations and alkaline phosphatase activities were consistently lower in cows given supplemental niacin than in cows not given supplemental niacin. Serum chloride, creatinine, and albumin values also tended to be lower in niacin-supplemented cows. Serum total protein tended to be slightly higher in niacin-supplemented cows. There was no consistent difference in urea nitrogen between groups of cows. PMID- 6497143 TI - Bovine pulmonary alveolar macrophages: antemortem recovery and in vitro evaluation of bacterial phagocytosis and killing. AB - A system was developed to recover pulmonary alveolar macrophages (PAM) from living cattle and to evaluate the function of these cells by measuring bacterial phagocytosis and killing. For the collection of PAM, single-tube and telescoped double-tube pulmonary lavage devices were compared. The total recovery, using these systems, was 70 +/- 10.7% of infused fluid, yielding approximately 87% PAM. The total number of cells per collection was approximately 5 times higher with the single-tube device (6.87 +/- 0.78 x 10(7) cell/ml) than with the telescoped double-tube device (1.3 +/- 0.1 X 10(7) cells/ml). Phagocytosis and intracellular killing of Staphylococcus epidermidis and Staphylococcus aureus by PAM in media suspension and by plastic-adherent PAM were evaluated. In addition, different bacteria-to-macrophage ratios were assessed, as well as the intracellular killing of S epidermidis at periodic intervals. Results showed that over a 3-hour period, similar numbers of both bacteria were phagocytized, but intracellular killing of S epidermidis was more efficient than intracellular killing of S aureus. It also was found (i) that suspended PAM and adherent PAM phagocytized similar numbers of bacteria; (ii) that when the bacteria-to-cell ratio was 10:1, the numbers of phagocytized bacteria and intracellular killing were higher than when the ratio was 1:10; and (iii) that killing of S epidermidis by adherent PAM was directly proportional to incubation time. The time that PAM are in culture affects the phagocytosis and killing of intracellular bacteria, as shown by increased phagocytosis and by intracellular killing of S epidermidis by PAM in suspension for 48 hours or plastic adherent for 60 hours after collection. PMID- 6497144 TI - Moraxella bovis hemolysin. AB - Moraxella bovis hemolysin was readily filterable through polycarbonate membrane filters, but not through nitrocellulose filters. The hemolysin was filterable through polycarbonate filters with pore diameters of greater than or equal to 0.015 micron (APD). Of the hemolytic activity of cell-free filtrates, 74% could be pelleted by ultracentrifugation at 100,000 X g for 2 1/2 hours. Hemolytic activity could be demonstrated in preparations of outer membrane fragments isolated from log-phase cultures. Hemolysin in M bovis broth cultures reached a maximum concentration in late logarithmic phase (4.5 hours after inoculation) and declined thereafter. Hemolysin was inactivated by heat, trypsin, formalin, and lyophilization. PMID- 6497145 TI - Canine atopic disease: investigations of eosinophils and the nasal mucosa. AB - Blood eosinophil counts were comparable in dogs with and without canine atopic disease. Eosinophils were not observed in the nasal smears of any of the dogs studied. Of 46 dogs with atopic disease, a significant increase (P less than 0.001) in nasal airway resistance was observed in 2 dogs after nasal provocation with nebulized allergens of grasses and in 1 dog after provocation with summer weed extracts. PMID- 6497146 TI - Inflammation induced by subcutaneous turpentine inoculation of young American alligators (Alligator mississippiensis). AB - Turpentine-induced skin lesions in young American alligators (Alligator mississippiensis) kept at 25 C were used to study inflammatory response in a reptile. Skin harvested at intervals between 4 hours and 30 days after inoculations were done had no gross changes until days 24 to 26, when superficial skin necrosis was evident. Early responses of congestion and dermal edema (4 to 8 hours) were seen by light microscopy, and these were followed by necrosis and granulocyte migration (1 to 3 days). Later, there was predominance of monocytic cells, including vacuolated macrophages (7 to 30 days). Evident at 14 days and prominent by day 30 were central dermal zones of necrotic debris surrounded by orderly palisades of vacuolated multinucleated giant cells and capillary-laden immature fibrous connective tissue. Systemic illness or visceral lesions were not observed. Controls, given inoculations of sterile saline solution, had no gross or microscopic changes. PMID- 6497147 TI - Effect of dexamethasone on babesiasis in hamsters. AB - Three subcutaneous injections of 0.20 mg of dexamethasone/kg of body weight caused a substantial increase in Babesia microti-parasitized RBC of hamsters, indicating that this was a useful method for revealing the presence of latent infections. A relative neutrophilia, lymphocytopenia, and eosinopenia were also seen in the long-term B microti-infected carrier hamsters after 0.20 mg or 0.02 mg of dexamethasone/kg. Noninfected hamsters treated with dexamethasone had a neutrophilic leukocytosis and a transient lymphocytopenia. Spleen to body weight ratios of noninfected hamsters decreased significantly (P less than 0.02) after 4 injections with either dosage level. These ratios did not significantly (P greater than 0.05) decrease in dexamethasone-treated infected hamsters. PMID- 6497148 TI - Science and government. A federal agency perspective. PMID- 6497149 TI - Federal legislation recognizing psychology. PMID- 6497150 TI - Psychology in United States medical schools: 1983. PMID- 6497151 TI - Does chest physical therapy move airway secretions? PMID- 6497152 TI - Tracheal mucus clearance in high-frequency oscillation. II: Chest wall versus mouth oscillation. AB - We compared the tracheal mucus clearance rate (TMCR) in anesthetized dogs during spontaneous breathing (SB), ventilation by high-frequency oscillation at the airway opening (HFO/AO), and ventilation by high-frequency oscillation of the chest wall (HFO/CW). The HFO/AO was carried out by using a piston pump with a high impedance transverse flow at the proximal end of the endotracheal tube; HFO/CW was effected by creating rapid pressure oscillations in an air-filled cuff wrapped around the lower thorax of the animal, causing small tidal volumes at the mouth. The TMCR was measured by observing the rate of displacement of a charcoal marker in the lower trachea; a fiberoptic bronchoscope was used to deposit the marker before each experiment and to relocate it after a 5-min run. In 7 dogs, mean TMCR during control (SB) was 8.9 +/- 3.5 mm/min. At 13 Hz with an oscillatory tidal volume (VTO) of 1.5 ml/kg, mean TMCR was 240% of control with HFO/CW (p less than 0.001) and 76% of control with HFO/AO (NS). During HFO/AO at 20 Hz and a VTO of 3 ml/kg, mean TMCR was 97% of control. We conclude that high frequency ventilation by rapid chest wall compression enhances tracheal mucus clearance when compared with spontaneous breathing, whereas high-frequency oscillation at the mouth does not. PMID- 6497153 TI - The UCLA population studies of chronic obstructive respiratory disease. VIII. Effects of smoking cessation on lung function: a prospective study of a free living population. AB - We evaluated effects of smoking cessation on lung function and respiratory symptoms of residents 25 to 64 yr of age from 3 communities in the Los Angeles area who completed a detailed respiratory questionnaire and measurements of forced expired volumes and flow rates, closing volume, and closing capacity at 2 times (T1 and T2) 5 yr apart. Results were analyzed in 2,401 participants who fit into 4 smoking categories: never smokers (414 males, 737 females); former smokers (294 males; 172 females); quitters between T1 and T2 (106 males, 62 females); and continuing smokers (278 males, 338 females). Covariance analysis was used to determine differences in lung function across smoking categories at T1 and T2 (adjusted for T1 values) and differences in decline in lung function between T1 and T2. Chi-square analysis was used to compare continuing smokers and quitters with respect to changes in respiratory symptoms. In this population, smoking at T1 was associated with impairment in all indexes of lung function evaluated. Smoking cessation led to significant improvement in symptoms of cough, wheeze, and phlegm production, and to significantly less decline in indexes of small airway function during 5 yr compared with measurements in continuing smokers. However, at T2, lung function still was lower among quitters compared with former and never smokers. Forced expiratory volume in one second (FEV1) was marginally improved in women who quit compared with those who continued to smoke.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497154 TI - Lung disease in long-term cigarette smokers with and without chronic air-flow obstruction. AB - Despite the established role of cigarette smoking in the causation of chronic air flow obstruction (CAO), only a small proportion of regular cigarette smokers develop significant clinical disease. We compared emphysema severity as well as pathologic and morphometric features of the peripheral conducting airways and the muscular pulmonary arteries among 3 groups of older subjects. These groups included lifelong nonsmokers (NSM), regular smokers without severe disease (SM), and smokers with an established diagnosis of CAO (SM-CAO). For most pathologic features examined there was an orderly progression in severity when comparing SM to NSM and SM-CAO to SM. Emphysema severity and scores for peripheral airways disease, except for goblet cell metaplasia, better distinguished SM-CAO from SM than did measures of bronchiole lumenal caliber. Within the SM-CAO group, the premortem percent predicted forced expiratory volume in one second (FEV1) correlated significantly with emphysema severity (r = 0.74), with average bronchiole diameter (r = 0.54), with the proportion of bronchioles with diameters less than 400 mu (r = 0.51), but not with any of the scores for bronchiolar disease. However, within this group no morphologic or pathologic feature of the small airways was an independent predictor of ventilatory function beyond that of emphysema alone. When compared with those from NSM, histological sections from SM CAO lungs contained approximately twice as many fully muscularized artery profiles 0 to 300 mu in diameter, the arterial medial muscle layer was doubled in thickness, and the amount of arterial intimal fibrosis was tripled.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497155 TI - Breathing patterns in patients with chronic obstructive pulmonary disease. AB - The respiratory inductance plethysmograph (RIP) was used to record resting breathing for 45 min in 12 patients with stable chronic obstructive pulmonary disease (COPD) and 8 age- and sex-matched control subjects. The COPD group had mean FEV1.0 of 31% predicted (range: 15 to 49%), mean PaO2 of 70 mmHg (56 to 83 mmHg), and mean PaCO2 of 37 mmHg (31 to 47 mmHg). All subjects were studied in the sitting position, and the rib cage (RC) and abdomen (ABD) RIP signals were simultaneously recorded on a polygraph and sampled at 20 Hz by a microcomputer. The summed RC and ABD signals were processed to create a spirogram from which the timing components of the respiratory cycle were subsequently analyzed. The mean number of breaths analyzed per subject was 702 +/- 213 (SD). Mean tidal volumes were identical in both groups. Inspiratory and expiratory times were significantly less (p less than 0.01), and mean inspiratory flow was significantly greater (p less than 0.01) in the COPD group. Frequency and minute ventilation also were significantly greater in the COPD group (p less than 0.005). Variability of breathing pattern, assessed in terms of coefficients of variation, was significantly less for TI, TI/Ttot, and VI in COPD patients than in normal subjects, even after sighs had been excluded from the analysis. We suggest that alterations in breathing pattern and its variability reflect changes in neural control of breathing consequent to disease. PMID- 6497156 TI - The influence of orally administered cimetidine and theophylline on the elimination of each drug in patients with chronic airways obstruction. AB - We studied the effect of cimetidine and theophylline on the metabolism of each drug in 19 elderly patients with stable chronic obstructive pulmonary disease. Each patient received either regular release or sustained release oxtriphylline. Cimetidine was given to some patients in both groups after steady state for theophylline was achieved. Multiple serum theophylline and cimetidine measurements were performed. Cimetidine decreased theophylline clearance by an average of 37.8% (26.2 to 46.7) for regular release and 33.4% (22.2 to 45.0) for sustained release oxtriphylline. The apparent volume of distribution was not changed; however, the half-life for theophylline was increased. As there is a linear relationship between the theophylline clearance before and after the addition of cimetidine and a linear relationship between trough and peak values before and after cimetidine, these 2 relationships may be used to predict clearance values and serum levels after cimetidine treatment when the initial values are known. PMID- 6497157 TI - Dopamine effect on bronchomotor tone in vivo. AB - The effect of increasing doses of dopamine (inhaled or infused) on pulmonary resistance (RL) was measured in 4 normal and in 4 asthmatic subjects. Dopamine, in doses sufficient to raise systolic blood pressure 25 mmHg, did not change RL. However, dopamine, inhaled and infused, significantly decreased histamine-induced bronchoconstriction both in normal and in asthmatic subjects. Thus, we conclude that if dopamine is released by the adrenal medulla during an asthmatic attack, it should have a beneficial rather than a deleterious effect. PMID- 6497158 TI - Epidemiologic study of clinical and physiologic parameters in grain handlers of northern United States. AB - To study the effects of grain dust exposure, we compared respiratory parameters between 310 grain handlers and 237 city workers of comparable age, height, weight, and smoking habits. Both populations resided and worked in the same geographic area of the United States. Information was obtained by questionnaire, interview, and examination. Pulmonary function tests included FEV1, FVC, FEF25 75, Vmax50, CV, delta N2/L, and DLCO. The prevalence of acute work-related and chronic respiratory symptoms, of auscultatory bronchi, and of airways obstruction (FEV1/FVC less than 0.7) were significantly higher (p less than 0.05) in grain handlers than in control subjects. The mean values of all lung functions except CV, delta N2/L, and DLCO were significantly lower in grain workers than in control subjects. The effects of smoking and grain handling on symptom prevalence and lung functions adjusted for age and height, analyzed by logistic regression model, were highly significant (p values ranged from 0.00001 to 0.5) and independent. The odds of having chronic bronchitis or wheezing at work were, respectively, increased 4.4-fold and 4.8-fold by grain handling and by 2.9-fold and 1.9-fold by smoking. Grain handling increased the odds of having airways obstruction 2.6-fold and smoking increased it 2.7-fold. We conclude that grain handlers have a higher prevalence of chronic bronchitis and other respiratory symptoms than do comparable workers who do not handle grain. The effect of grain dust exposure on symptom prevalence is usually greater than that of smoking. Grain handling has an adverse effect on lung function that is of the same or smaller magnitude than that of smoking.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497160 TI - An in vitro gallium-67 lung index for the evaluation of sarcoidosis. AB - In the evaluation of the active alveolitis of pulmonary sarcoidosis, both the proportional lymphocyte count obtained by bronchoalveolar lavage and state of activation of the alveolar macrophage by gallium scanning are required. We injected 6 mCi (200 MBq) of 67Ga intravenously on 24 occasions in 13 patients with biopsy-proved sarcoidosis. Forty-eight hours later, patients were scanned with a rectilinear scanner and the generated scintigrams were evaluated using the NIH index. Seventy-two hours after injection, bronchoalveolar lavage was performed, and venous blood was sampled. The harvested lavage fluid was analyzed for absolute and proportional cell counts, and radioactivity was measured in blood and BAL fluid. An in vitro 67Ga index was generated and expressed as counts/100,000 alveolar macrophages/ml blood (mean, 0.0146 +/- 0.0087 SD). There was a significant relationship between the in vitro index and proportional lymphocyte BAL counts (r = 0.79; p less than 0.002) that was comparable to that obtained using the NIH index (r = 0.74; p less than 0.005). These data suggest that the in vitro index might offer a more objective assessment of 67Ga uptake by the lung, but this would require validation against clinical parameters in a prospective study. PMID- 6497159 TI - Experimental hypersensitivity pneumonitis: lack of tolerance. AB - Most subjects repetitively exposed to agents responsible for hypersensitivity pneumonitis (HP) do not develop persistent or progressive pulmonary inflammation. To determine if immunologic tolerance is associated with resolution of pulmonary abnormalities despite continuing exposure, we examined markers of local immunologic reactivity in a model of HP in rabbits. Rabbits were exposed to Micropolyspora faeni (M. faeni), the agent responsible for farmer's lung disease, with 3 sensitizing and 2, 4, or 8 challenge intratracheal injections. We determined bronchoalveolar macrophage migration inhibition (MMI) induced by M. faeni antigen, mitogen, and antigen-induced lymphocyte proliferation of lymphocytes derived from the lungs and hilar lymph nodes, and the amount of IgG antibody to M. faeni in serum and bronchoalveolar lavage fluid. We found MMI of lavage cells from rabbits exposed to M. faeni. Migration inhibition was dependent on ongoing protein synthesis. Hilar node and pulmonary lymphocytes proliferated upon exposure to M. faeni antigen, and anti-M. faeni antibody was found in serum and lavage fluid from M. faeni-treated rabbits. There were no differences between rabbits challenged 2, 4, and 8 times. We conclude that resolution of pulmonary histologic abnormalities in this model of hypersensitivity pneumonitis is not associated with evidence of immunologic tolerance. PMID- 6497161 TI - Biologically active products of complement and acute lung injury in patients with the sepsis syndrome. AB - To determine if biologically active products of complement appear during sepsis and to establish the relationship of these components to the respiratory and hemodynamic complications of sepsis, we measured C5a des Arg and C3a des Arg (radioimmunoassay), neutrophil chemotaxis, and neutrophil-aggregating activity in plasma obtained from 40 patients at the time sepsis was suspected clinically. Levels of C3a des Arg and C5a des Arg were elevated in 35 and 38 patients, respectively, and in all 25 with positive blood cultures. Highest C5a des Arg levels occurred in patients with hypotension (less than 90 mmHg) and/or acidemia. The C5a des Arg concentrations were significantly higher in patients with than in those without neutrophil-chemotactic activity. Neutrophil-aggregating activity was less sensitive an index of complement activation, as it was positive in only 8 patients and correlated poorly with C5a des Arg and C3a des Arg values. Using a composite scoring system to quantify sepsis-related pulmonary abnormalities, we found that neither biologic nor immunologic assays of complement activation products correlated with the initial severity nor predicted the development or worsening of associated acute lung injury. PMID- 6497162 TI - A successful supervised outpatient short-course tuberculosis treatment program in an open refugee camp on the Thai-Cambodian border. AB - The operation of a tuberculosis treatment program in an open refugee camp of 45,000 refugees on the Thai-Cambodian border is described. Fifty-eight patients received 6 months of supervised daily, outpatient therapy with a protocol employing isoniazid, rifampin, streptomycin, and pyrazinamide. Patient compliance was high, with only 15 of 10,209 patient days being missed, despite a high incidence of minor side effects. Three patients died, 4 defaulted, and 1 moved to another camp for treatment. The therapies of 4 patients were extended because of the need for reduced doses of medications, the development of extrapulmonary disease, treatment failure, and slow resolution of infiltrates on radiographs. There was 1 late relapse. This report demonstrates the feasibility in integrating short-course therapies with program designs to produce high compliance under difficult field conditions. PMID- 6497163 TI - IgG antibody to purified protein derivative by enzyme-linked immunosorbent assay in the diagnosis of pulmonary tuberculosis. AB - We studied the diagnostic utility of an enzyme-linked immunosorbent assay (ELISA) in hospitalized patients with suspected pulmonary tuberculosis (TB). A positive culture for M. tuberculosis identified active disease, and 3 negative cultures and smears defined the negative group. IgG antibody activity was determined by adding a 1:1,000 dilution of serum to plates coated with PPD antigen. Alkaline phosphatase labeled anti-IgG was added, color developed, and an optical density index (ODI) was determined. Twenty-one patients with M. tuberculosis TB had a mean ODI of 0.27, which was higher than 99 patients without TB, ODI 0.10 (p less than 0.001). An ODI of 0.15 or greater was established as a positive ELISA test. For patients with M. tuberculosis TB, the ELISA had a sensitivity of 67 and a specificity of 79%. The first smear had a sensitivity of 57 and a specificity of 99%. With the first smear and the ELISA test results, a combined sensitivity of 86% was achieved. When both ELISA and the first smear were negative (101 cases), active TB caused by M. tuberculosis was found in only three patients (3.0%). PMID- 6497164 TI - Effect of hydralazine on cardiac output and venous admixture in experimental lung injury. AB - The mechanism by which hydralazine increases venous admixture (QVA/QT) in the setting of lung injury was investigated in a canine model of noncardiogenic pulmonary edema. Permeability pulmonary edema was produced by administration of oleic acid, 0.08 ml/kg given intravenously to 9 mongrel dogs. After stabilization of lung injury, hydralazine was administered intravenously in a loading dose of 1 mg/kg and followed by a constant infusion at 0.05 mg/kg/h. To control for the effect of increased cardiac output (QT) on QVA/QT, a balloon catheter was placed in the inferior vena cava, and stepwise inflation of the balloon was used to impede venous return and maintain QT at predrug levels. Prior to inflation of the balloon catheter, administration of hydralazine produced a 51% decrease in total systemic resistance (TSR) and a 23% decrease in mean arterial pressure (Pa). In contrast, pulmonary vascular resistance (PVR) showed no significant change, and mean pulmonary artery pressure (Ppa) increased 47%. Cardiac output increased from 3.4 +/- 0.3 to 5.5 +/- 0.4 L/min (mean +/- SEM; p less than 0.01) after administration of hydralazine, and QVA/QT increased from 23 +/- 7 to 35 +/- 5% (p less than 0.05). Mean arterial oxygen tension (PaO2) showed no significant change. Inflation of the balloon in the inferior vena cava after hydralazine administration reduced QT to 3.1 +/- 0.4 L/min and QVA/QT to 28 +/- 4%. Neither of these values differed significantly from the prehydralazine levels. Similarly, values for Ppa and PVR after hydralazine administration plus balloon inflation did not differ significantly from predrug levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497166 TI - Upper respiratory tract infections and airway reactivity in normal and asthmatic subjects. AB - To assess the effect of an upper respiratory tract infection (URTI) on airway reactivity, histamine inhalation tests (HITs) were performed prospectively in 44 nonsmoking asthmatic (14) and nonasthmatic (30) volunteers. Fifteen of the subjects developed an URTI during the following 4 months. Pulmonary function forced expiratory volume in one second (FEV1), maximal midexpiratory flow rates (MMEFR) and maximal flow at 50% vital capacity (V50), and HITs, were studied at onset and 2, 3, and 4 wk after infection. There were no significant changes in pulmonary function during the total study period. For the 15 subjects, the mean provocative concentration of histamine causing a 20% fall in FEV1, (PC20H) was 8.73 mg/ml prior to onset of URTI, and at 1, 2, 3, and 4 wk after URTI was 7.97, 8.68, 8.13, and 8.61 mg/ml. These were not significantly different for the group as a whole, nor for the subgroups of asthmatics and nonasthmatics. Small changes in PC20H outside the normal range of variability occurred in 5 of 15 subjects. These were short-lived and no predictive factor for change in PC20H was identified in this group. Thus, URTI was not associated with significant changes in PC20H in this group of asthmatic and nonasthmatic subjects. PMID- 6497165 TI - Treatment of shock in a canine model of pulmonary embolism. AB - Despite the high mortality (greater than 30%) associated with hypotension complicating pulmonary embolism, previous studies have not systematically investigated how best to treat shock resulting from pulmonary embolism. In 24 dogs, we measured relevant hemodynamic parameters before and after shock was produced by intravenously injected autologous blood clots. When systemic blood pressure fell to 70 mmHg, dogs were randomly divided into groups and treated blindly for 1 h. All control dogs and all dogs treated with volume and isoproterenol died. In contrast, all dogs treated with noradrenaline were resuscitated and remained hemodynamically stable for 1 h. This effect of noradrenaline was significant (p less than 0.01, Fisher's exact test). Noradrenaline improved right ventricular performance by increasing blood pressure and improving right ventricular perfusion and/or by a direct increase in contractility. We conclude that in a canine model of pulmonary embolism and shock, noradrenaline may be the drug of choice for acute resuscitation. PMID- 6497167 TI - Pathogenesis of pleural plaques. Relationship of early cellular response and pathology. AB - To study the initial pleural cellular response to asbestos and to determine the relationship between this response and the development of pleural plaques, a model of asbestos pleurisy was developed in both normal and nitrogen-mustard treated (neutropenic) New Zealand white rabbits. Animals were rendered neutropenic, as it has been shown that neutropenic rabbits do not develop a macrophage influx in the pleural space after the administration of either BCG or bacteria and that the pathology is different from that in normal rabbits treated in a similar fashion. Intrapleural asbestos induced an exudative effusion in normal animals within 4 h, and there was increased metabolic activity through 120 h, with a fall in pleural fluid pH and PO2 and a rise in pleural fluid PCO2. Neutropenic animals similarly developed an exudative pleural effusion but showed no change in metabolic activity of pleural fluid. Normal rabbits showed a marked cellular influx into the pleural space after asbestos treatment, with a peak total cell count of 27,208/microliters at 24 h; the majority of these cells were polymorphonuclear leukocytes. A macrophage influx occurred at 48 h and peaked at 72 h. By 120 h, lymphocytes were the predominant cell. Nitrogen-mustard-treated animals reached a peak of only 5,442 cells/microliters in the pleural space at 24 h, with a small percentage of polymorphonuclear leukocytes. A macrophage peak did not occur in these animals. There was a marked contrast between groups noted at autopsy. Normal animals developed pleural plaque formation, which was evident by 7 days and completely developed by 1 month.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497168 TI - Ventilation-perfusion relationships during exercise-induced asthma in children. AB - In order to elucidate the mechanisms underlying the hypoxemia associated with exercise-induced asthma (EIA), ventilation-perfusion (VA/Q) relationships were investigated in 11 children with a history of EIA. A virtually continuous distribution of VA/Q ratios was measured by the multiple inert gas technique with the children at rest before and after an exercise test. All children displayed a unimodal distribution before the test. In 4 of the children, the exercise test did not provoke asthma, and the unimodal (VA/Q) distribution was maintained. Of the 7 children who developed asthma, 6 displayed a bimodal distribution. One mode fell within normal VA/Q regions but with increased perfusion to regions with VA/Q ratios of 0.1 to 1, which correlated well to the hypoxemia noted during asthma. The other mode fell within regions with high VA/Q ratios, and the magnitude of the mode correlated to the reduction in FEV1 and PaO2. No one had a shunt or a clearly low VA/Q mode (VA/Q less than 0.1). We hypothesize that the high VA/Q was caused by increased intrathoracic pressure impeding regional blood flow. PMID- 6497169 TI - High living: lessons from extreme altitude. The 1984 J. Burns Amberson lecture. PMID- 6497170 TI - Prospective evaluation of the protected specimen brush for the diagnosis of pulmonary infections in ventilated patients. AB - To determine the relative cultural accuracy of the bronchoscopic protected specimen brush (PSB) in ventilated patients, we compared this method in the same area of the lung with histologic and bacteriologic examinations of pulmonary specimens. The procedures were concluded just after death when the ventilator was still functioning. Samples via the PSB were taken from a branch of the anterior basal bronchus of the left lower lobe, and immediate left thoracotomy was performed to obtain peripheral specimens from the corresponding segment for quantitative cultures. Twenty-six patients were studied; 6 had histologically proved pneumonia. Using quantitative cultures, a correlation was evidenced between PSB and lung cultures, especially in the subgroup of patients who received no antibiotic during the week preceding their death. No pneumonia was observed when PSB cultures isolated no organisms in concentrations greater than 10(3) colony-forming units (cfu) per ml. The PSB cultures at a level of 10(3) cfu/ml identified every patient with histologically proved pneumonia and every microorganism present in concentrations of 10(4) cfu/g or greater in the lungs. Moreover, in the subgroup of patients receiving no antibiotic, only 4 microorganisms were isolated by the PSB in concentrations greater than 10(3) cfu/ml and not found in the lung.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497171 TI - Pulmonary function in insulin-dependent diabetes mellitus with limited joint mobility. AB - Patients with insulin dependent diabetes mellitus (IDDM) and limited joint mobility (LJM) were studied to determine if altered respiratory mechanics were another manifestation of a generalized disturbance in collagen metabolism. Lung volumes and maximal expiratory flow volume curves were measured in 23 patients with IDDM. Patients were divided into 2 groups: (1) 11 without LJM, and (2) 12 with severe LJM. The groups were matched for age, sex, and glycemic control but not for duration of IDDM. In patients with severe LJM, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were significantly decreased (p less than 0.05). Total lung capacity (TLC), thoracic gas volume (TGV) at functional residual capacity (FRC) and residual volume (RV) were also significantly lower (p less than 0.05) in the severe LJM group. There was no evidence of air-flow obstruction in either group. Our results demonstrate an association between severe LJM and a significant decrease in lung volumes. This could be due to decreased lung compliance or restriction of chest wall expansion. PMID- 6497172 TI - The effects of chronic hyperinflation, nutritional status, and posture on respiratory muscle strength in CF. PMID- 6497173 TI - Emphysema and dust exposure in a group of coal workers. PMID- 6497174 TI - Use of spacers to facilitate inhaled corticosteroid treatment of asthma. PMID- 6497175 TI - Regulation of mucociliary transport. PMID- 6497176 TI - Paradox of REM sleep. PMID- 6497177 TI - Second leg ischemia. Lower extremity bypass versus amputation in patients with contralateral lower extremity amputation. AB - Unilateral amputees with second leg ischemia may miss consideration for anything but amputation. Justification for a reconstructive approach for these ischemic second limbs was sought from a retrospective study of 108 patients who underwent lower extremity distal bypass. Risk factors and results were compared for the 12 unilateral amputees and the 96 nonamputees. Age and relative incidence of rest pain, claudication, and tissue loss were not significantly different for the two groups. Diabetes mellitus was present in 41.6 per cent of amputees and 31.3 per cent of nonamputees. Preoperative, average ankle-brachial blood pressure ratios were equal for both groups (0.3). Angiography showed comparable distribution of patients between the two groups with regard to distal run-off vessels. Operative mortality was 8 per cent for amputees and 3 per cent for nonamputees. Cumulative survival at 25 months was 67.5 per cent for amputees and 82.4 per cent for nonamputees. Cumulative patency at 6 months was 71.5 per cent for amputees compared with 63 per cent for nonamputees and at 25 months was 58.5 per cent for amputees and 37.6 per cent for nonamputees (no significant difference). Unilateral amputees appear to have similar risks and results for lower extremity distal bypass as do nonamputees. An independent, aggressive approach for evaluation and surgical revascularization should not be overlooked for the ischemic, remaining lower extremity in the dysvascular unilateral amputee. PMID- 6497178 TI - Lower extremity amputation for peripheral vascular disease. A low-risk operation. AB - Two hundred fifty-three consecutive major amputations of the lower extremity for peripheral vascular insufficiency were performed over a 3-year period. Operative mortality was 0.9 per cent for 113 below-knee and 2.8 per cent for 140 above-knee amputations. Although lower extremity amputation has a reputation for high mortality and morbidity, this is unwarranted; adherence to a protocol of aggressive medical management with timely surgical intervention allows a mortality that is appropriate to the age and general debility of this patient population. PMID- 6497179 TI - A combined study of the strain gauge plethysmography and I-125 fibrinogen leg scan in the differentiation of deep vein thrombosis and postphlebitic syndrome. AB - The fallibility of the clinical diagnosis of deep venous thrombosis (DVT) and postphlebitic syndrome has led to a variety of noninvasive diagnostic modalities, e.g, Doppler ultrasound, plethysmography, and radionuclide phlebography. The purpose of this study is to analyze the value of combined strain gauge plethysmography (SPG) and I-125 fibrinogen leg scanning in the differentiation of DVT and postphlebitic syndrome. Using strain gauge plethysmograph, 600 studies were performed on 502 patients. The maximum venous outflow (MVO) was calculated. An MVO of 20 cm3/100 cm3 of tissue/min or above was considered normal, and MVO of less than 20 cm3 was abnormal. Of those, 150 limbs had I-125 fibrinogen leg scan and venograms. Of 82 normal SPG, when compared with venograms, 75 were normal, five had postphlebitic syndrome, and two had DVT (97.6% true-negative). Sixty eight legs had positive SPG, 46 of which had DVT (67.6% true-positive), 21 had postphlebitic syndrome (30.9%), and one was normal (1.5% false-positive). When rubber tourniquets were placed lightly on each leg between the strain gauge and the thigh cuff, 12 legs changed from positive SPG to negative SPG; 56 legs only had positive SPG. Forty-six of these had DVT (82.1% true-positive), nine had postphlebitic syndrome, and one was normal. When positive SPG was combined with positive leg scan, the accuracy raised to 95.6% (44 of 46 legs). If the SPG was positive but the leg scan was negative, the possibility of postphlebitic syndrome was most likely (8 of 10, i.e., 80%). PMID- 6497180 TI - Long-term results of jejunoileal bypass in the young. AB - Between 1970 and 1975, 16 adolescent patients with a mean age of 17.8 years underwent jejunoileal bypass for exogenous morbid obesity. Their mean preoperative weight was 273.8 lbs. The total weight loss averaged 48 kg per patient. An extended evaluation process was instituted to determine the effectiveness of this procedure. Six of these parameters were the ponderal index (PI), body mass index, Broca's index, the per cent of ideal weight, complications, and diarrhea as a separate complication. A new formula was introduced to interpret weight loss as the percentage of excess pounds lost (PEPL). Three required reestablishment of normal intestinal continuity. There were no deaths in the group. Fifty and 69 per cent experienced excellent weight loss and postoperative PI respectively; excellent results were obtained in 27.5 per cent in both categories. In contrast, 50 per cent had a weight loss less than 100 lbs and 19 per cent a poor PI postoperatively; 13 per cent experienced poor results by both criteria. Linear growth in all patients continued along a normal curve, and their heights were above the mean. PMID- 6497181 TI - The effect of preoperative treatment with cimetidine on postoperative wound sepsis. AB - The results of preoperative treatment of uncomplicated duodenal ulcer patients with Cimetidine are presented. Cimetidine given preoperatively increases the pH of gastric aspirates and alters the bacterial flora of the stomach at the time of operation, resulting in an increased incidence of postoperative wound sepsis. Discontinuing Cimetidine 2 days before surgery is a safe step against the risk wound sepsis. PMID- 6497182 TI - Evaluation of injured intestine with the aid of fluorescein. AB - In an animal model, a new diagnostic use for fluorescein as an aid in determining intestinal viability after blunt trauma, has been evaluated. Areas of traumatized intestine that do not fluoresce are invariably necrotic; fluorescing tissue is always viable. Fluorescein is a simple and rapid means of evaluating traumatized intestine, and it may prove to be a useful adjunct to the clinical examination. PMID- 6497183 TI - The treatment of 179 blunt trauma-induced liver injuries in a statewide trauma center. AB - The records of 179 patients who were admitted to a statewide trauma center with liver injuries from blunt abdominal trauma are reviewed. The overall mortality for the 119 men and 60 women was 35 per cent. The simpler forms of injury (classes 1, 2, and 3) were easily treated and yielded good results, whereas treatment for major injuries, involving lobar destruction and vena caval injury (classes 4 and 5), yielded poor results. Hepatic artery ligation was successful in only 7 of 17 cases, hepatic lobectomy was successful in 3 of 16 cases, and intracaval shunting was successful in both in which it was attempted. Anatomic variation, severity of injury from blunt abdominal trauma, and perhaps rapidity of evacuation combine to give poor results in these injury categories. While 26 per cent of all mortality occurred in patients with severe head injuries, hemorrhage was the most frequent cause of death (49%). In 19 of these 30 patients, the hemorrhage was from the liver. Infection played a significant role in the deaths of 27 patients. In eight of these 27 patients, the infections were related directly to the liver injury. The number of associated injuries per patient appeared unrelated to the overall outcome of the injury. PMID- 6497184 TI - Clinical investigation involving the use of the Haemonetic Cell Saver in elective and emergency vascular operations. AB - Fifty-five patients undergoing elective and emergency vascular operations using the Haemonetic Cell Saver unit were studied. The advantages and complications associated with autotransfusion are reviewed with special emphasis on this new method of blood salvage. Also technical improvements and protocol for use of the Cell Saver are described. PMID- 6497185 TI - The fate of the left kidney after division of its vein. AB - The effect of dividing the left renal vein was studied in Sprague-Dawley rats. Immediately after the left renal vein is divided near the renal hilum, the left kidney becomes markedly edematous and dusky. Twenty-four hours later, the kidney remains edematous and boggy. In contrast, the edema that immediately follows division of the left renal vein adjacent to the inferior vena cava is much less dramatic and virtually resolves within 24 hours. When the left renal vein was divided near the hilum simultaneously with right nephrectomy, all animals died within 48 hours. When the vein was divided adjacent to the vena cava with simultaneous nephrectomy, all animals survived. The effect of dividing the renal vein on perfusion of the left kidney was studied in Sprague-Dawley rats using intra-arterial injection of copper pigment. Division of the left renal vein reduced perfusion of that kidney to 68.9 per cent of control levels. This reduction was demonstrated to be totally reversible within 10 days. PMID- 6497186 TI - The parasacral approach to the rectum. AB - The posterior parasacral approach to the rectum is well-suited to several benign conditions and may occasionally be indicated in malignant rectal disorder. The York Mason modification of the Kraske procedure permits preservation of the sphincters and preservation of anal continence. The procedure is recommended as part of a surgeon's repertoire in operations on the rectum. PMID- 6497187 TI - [Importance of salivary levels of theophylline in monitoring pediatric asthmatic patients]. AB - In order to maintain theophylline serum levels between 10 and 20 mcg/ml., obtaining an average dose of 26.36 +/- 6.42 mg/kg/d (range 11.42 mg/kg/d-48 mg/kg/d), authors have determined average dose of oral theophylline intake needed in a group of 212 infants, 1 to 15 years of age. Statistical analysis of 717 salivary and blood theophylline values simultaneously obtained (both at therapeutic and subtherapeutic levels), was carried out reading a lineal correlation coefficient of 0.93. Correlation that has been sufficiently worked out in many other papers. Once necessary dose for obtaining salivary and blood theophylline therapeutic levels is determined, salivary theophylline concentration may be used as a nonaggressive method control of outpatients, assuring their intake continuity between medical controls and as a good seric level index in a given patient. PMID- 6497188 TI - [Nephropathy in Schoenlein-Henoch purpura. Long-term developmental aspects in 55 cases]. AB - Fifty five patients with Schoelein-Henoch nephropathy were reviewed. These patients were divided into five groups according to the clinical picture initially presented: 1. Hematuria with proteinuria. 2. Hematuria with nephrotic syndrome. 3. Isolated hematuria. 4. Hematuria, nephrotic syndrome and renal failure. 5. Proteinuria. From a histopathological point of view, they were classified into six groups according to ISKDC criteria. A strong correlation was found between clinical presentation and histological lesion. The worst prognosis corresponded to patients with nephrotic syndrome and renal failure, whose biopsy revealed more than 75% of glomeruli with epithelial crescents. PMID- 6497189 TI - [Clinical value of intraesophageal pH measurement in children. Experience in 235 cases]. AB - The intra-esophageal pH test is presented as a diagnostic method and as a control of GER, considering the 24-hour test as the best among all exploratory methods. The authors present 235 studied cases, distributed as follows: a control group of 20 normals, 24 cases explored after surgery, 80 cases of children with recently diagnoses GER or cases of bad response to postural treatment and 111 cases at the end of a favourable postural treatment. The normal quantitative values of 24-hour esophageal monitoring by pH-metry are presented in children and these are compared between the aforementioned groups. A detailed study of these explorations allows the authors to make a quantitative value of GER and to find out which ones of the studied parameters are more reliable for diagnosis (percentage of time under pH less than 4), and which ones indicate the severity of the process (refluxes of more than five minutes) that condition a change of treatment for the patient. Likewise, this study also permits the establishment of a relationship between GER and respiratory symptoms. PMID- 6497190 TI - [Ventriculo-peritoneal shunt, hypovolemic shock and cerebrospinal fluid ascites]. AB - A case of communicating hydrocephalus with excessive amount of choroid plexus confirmed by computerized tomography scan in a five-year-old girl is reported. The child exhibited hypovolemic shock and cerebrospinal fluid (CSF) ascites after ventriculo-peritoneal shunting and relief after ventriculoatrial shunting. Some features suggest overproduction of CSF, with the so-called "third-space" fluid losses, due to sequestration of fluids in the body (peritoneum) that might explain shock. They review 22 cases of CSF ascites reported in the literature. PMID- 6497191 TI - [Right cervical aortic arch: report of 2 cases, one associated with aortic coarctation]. AB - Cervical aortic arch is a rare congenital vascular anomaly. Usually it appears as an asymptomatic pulsatile cervical mass, but symptoms of tracheal and esophageal compression may be present in 25% of the patients. About 40% of cases are associated with vascular or heart abnormalities. Angiography provides definitive diagnosis. Authors report two patients with right cervical aortic arch, one of them associated with aortic coarctation, and review 52 published cases. PMID- 6497192 TI - Hepatojugular reflux: useful in the bedside diagnosis of tricuspid regurgitation. AB - Using phonocardiography and auscultation, we ascertained the presence or absence of hepatojugular reflux and Carvallo's maneuver in three groups of 15 patients. The first group had isolated tricuspid regurgitation; the second, isolated mitral regurgitation; and the third was a control group with no murmurs. The specificity and sensitivity of hepatojugular reflux were 100% and 66%, and those of Carvallo's maneuver were 100% and 80%. All but 1 patient in our series had a positive response to one or the other maneuver (combined sensitivity, 93%). Thus, hepatojugular reflux is a useful adjunct to Carvallo's maneuver in the diagnosis of tricuspid regurgitation. PMID- 6497193 TI - Bromocriptine treatment of prolactin-secreting pituitary adenomas may restore pituitary function. AB - Six men with prolactin-secreting pituitary macroadenomas and deficiencies of pituitary hormones other than gonadotrophins were treated with bromocriptine for 6 months. During treatment the serum prolactin concentration decreased markedly in all six patients, and in four adenoma size decreased and visual function improved. Two patients who were hypothyroid before bromocriptine treatment were euthyroid during the sixth month of treatment, and the one patient who was hypoadrenal before treatment was euadrenal during treatment. Two of the six men who had subnormal growth hormone secretion before treatment had normal growth hormone secretion during treatment. We conclude that pituitary hormonal functions may improve during bromocriptine treatment for prolactin-secreting pituitary macroadenomas. This improvement may result from decompression of other pituitary cells, because correction of hypothyroidism by bromocriptine was accompanied by conversion from an absent to a normal thyrotrophin response to thyrotrophin releasing hormone. PMID- 6497194 TI - Hepatitis B virus infection in the acquired immunodeficiency syndrome. PMID- 6497195 TI - Hypothermia with acute myocardial infarction. PMID- 6497196 TI - Chemotherapy-associated palmar-plantar erythrodysesthesia syndrome. PMID- 6497197 TI - The humanities, science, and the medical curriculum. PMID- 6497198 TI - The periodic health examination and internal medicine: 1984. PMID- 6497199 TI - Diabetic diarrhea and lidamidine. PMID- 6497200 TI - Heparin and thrombocytopenia. PMID- 6497201 TI - Vincristine and Kaposi's sarcoma in the acquired immunodeficiency syndrome. PMID- 6497202 TI - Hodgkin's disease and the acquired immunodeficiency syndrome. PMID- 6497203 TI - Bone marrow in the acquired immunodeficiency syndrome. PMID- 6497204 TI - Hematin-induced hemolysis in acute porphyria. PMID- 6497205 TI - Radiologic methods for estimation of mineral content of bone. PMID- 6497206 TI - Cardiac function in septic shock. PMID- 6497207 TI - Digitalis in congestive heart failure. PMID- 6497208 TI - Precipitation of verapamil in an intravenous line. PMID- 6497209 TI - Vancomycin and cardiac arrest. PMID- 6497210 TI - Cellulitis at vein-donor sites. PMID- 6497211 TI - Paradoxical diaphoresis in cyclobenzaprine poisoning. PMID- 6497212 TI - Schistosomiasis and praziquantel. PMID- 6497213 TI - Cimetidine in recurrent genital herpes simplex infection. PMID- 6497215 TI - Differential diagnosis of elevated intraocular pressure following ocular surgery. PMID- 6497214 TI - Listeria monocytogenes bacteremia in the acquired immunodeficiency syndrome. PMID- 6497216 TI - Automated objective refractometers. AB - We have shown how the modern-day analysis of the aerial image produced by an indirect ophthalmoscope forms the basis for automated objective refraction. Objective automated optometers present with the advantages that they: record rapidly, thereby minimizing the effects of accommodative fluctuation and/or fixation instability, demand only low-level technical skill on the part of the operator, demand little of the patient beyond passive cooperation. Refractive findings obtained using objective automated refractors are counterparts of retinoscopic prescriptions and correlate about as well with subjective findings as do those obtained by the proficient retinoscopist. PMID- 6497217 TI - Experimental subdural retrobulbar injection of anesthetic. AB - Sudden respiratory arrest following retrobulbar block, a complication which has gained increasing attention, is explained by an experimental study in which radiopaque dye was injected into the intraorbital subdural space, as could easily be done in a living patient, and was shown by radiography to diffuse posteriorly along the subdural space to the midbrain surrounding the respiratory center. Clinical implications are discussed. PMID- 6497218 TI - Blepharoptosis as a complication of pregnancy. AB - The complication of blepharoptosis occurred in an otherwise normal pregnancy. Its onset during the sixth month of the pregnancy suggests an etiology related to the increased estrogen levels normally occurring at this time. Infiltration of water molecules into the collagen ground substance of the levator muscle and its tendon is suggested as a possible mechanism of action. Similarities with other conditions in young individuals causing blepharoptosis are discussed. PMID- 6497219 TI - Comparison of manual Goldmann and automated static visual fields using the Dicon 2000 perimeter in the detection of chiasmal tumors. AB - We report that changes in the program (software) operating an automated perimeter (hardware) remarkably improved its ability to produce interpretable diagnostic information. A group of 11 postoperative patients with pituitary adenomas and other chiasmal tumors having stable visual field defects demonstrated by manual kinetic and suprathreshold Goldmann perimetry were re-examined with automated suprathreshold static perimetry performed by the Dicon model 2000 perimeter. During the study a program for two-zone (central and peripheral), three-level suprathreshold static perimetry became available. With optimum test administration and interpretation, the Dicon 2000 perimeter with the two-zone, three-level suprathreshold program can at least equal the performance of an experienced perimetrist using manual Goldmann kinetic and selective static perimetry in the detection of visual field defects resulting from chiasmal tumors. The two-zone, three-level suprathreshold suprathreshold program was superior to a single zone, one-level programs in examining this population. PMID- 6497220 TI - Complications from anterior chamber lenses: report of cases. AB - This is a report of cases of complications from anterior intraocular lenses. Problems discussed include dislocated, misfit, or malpositioned implants and methods of surgical correction. The importance of accurate anterior chamber diameter measurement, flexible anterior chamber lenses, and stability of lens fixation for successful anterior chamber surgery is stressed. PMID- 6497221 TI - Visual evoked potentials in the diagnosis of multiple sclerosis. AB - A three-year collaborative study was done on 96 patients presenting with signs of neurological dysfunction suggestive of multiple sclerosis. All were tested using Visual Evoked Potentials, with the final diagnosis not known to the tester. Patients with bilateral Visual Evoked Potential P1 wave conduction delays were more likely to have a subsequent diagnosis of MS, than those with unilateral delays, or normal VEPs. The average delay between the onset of the first symptom, and a definitive diagnosis of MS was 3.5 years. The most frequent initial symptom was paresthesias of the lower extremities, followed by blurred vision. This study suggests that the presence of Visual Evoked Potential abnormalities may be useful in the longitudinal diagnostic evaluation of patients with a presumptive diagnosis of multiple sclerosis. PMID- 6497222 TI - Anterior radial keratotomy experience in 600 cases of myopia. AB - Surgical results of anterior radial keratotomy in 1,200 eyes are presented. Of the eyes, 55% had an unaided visual acuity of 6/9 or better six months after surgery. An average of 1.90 D of myopia was corrected in these cases. It takes six weeks for the refraction to stabilize and to know the final success of surgery. There was no statistically significant influence of age or sex or preoperative refractive error on the amount of surgically induced change in refraction. The extent of myopia corrected is directly proportional to the change induced in the radius of curvature. The operative and postoperative complications were minimal and did not endanger vision. PMID- 6497223 TI - Amiodarone-induced corneal deposits. AB - Amiodarone, 2-N-butyl-3-(4'diethylaminoethoxy-3',5-diiodobenzoyl)benzofuran, also known as Cordarone, is presently under clinical investigation in the United States. It is an alpha and beta antagonist and is extremely effective in treating otherwise uncontrollable ventricular arrhythmias. To date, 27 patients participating in our ongoing study since 1977 have had corneal deposits. The deposits are in the corneal epithelium basal cell layer, and occur in stages (mild, moderate, and severe), which seem to correlate with dosage and duration of treatment. Vision is rarely diminished by these deposits, and if it is, discontinuation of the drug therapy will cause regression of the deposits with eventual return to normal beginning within two to four weeks but possibly taking as long as 1 1/2 years. The deposits look similar to those seen in chloroquine toxicity and Fabry's glycolipidosis. Other adverse effects reported in the European literature include thyroidopathy, cutaneous pigmentation, and neuromyopathy. PMID- 6497224 TI - Flammability of silicone rubber: an unrecognized hazard. AB - A patient sustained a burn when silicone rubber tubing was ignited by a pencil cautery unit. Unlike polyethylene, silicone rubber does not melt prior to reaching its ignition temperature. The application of heat near or to silicone rubber is to be avoided. PMID- 6497225 TI - Delayed onset of aphakic cystoid macula edema. AB - Cystoid macula edema occurred in both eyes of two patients three years after routine intracapsular cataract extraction. Vitreous adhesion to the cataract wound was noted in all four eyes within eight weeks of surgery. The relatively young age and good health of both patients may explain why their perifoveal capillaries remained competent so long after surgery. PMID- 6497226 TI - Primary congenital eversion of the eyelids. AB - Primary congenital eversion of the upper eyelids is a rare event. This dramatic neonatal disorder is bilateral, self-limited, and seems to be most common in black persons. The etiology is obscure, but difficulty during delivery may be partly causative. The ultrastructure of the affected eyelids is normal. Conservative therapy using dermatologic taping of the eyelids and ocular lubricants to protect the conjunctiva is curative. PMID- 6497227 TI - [Mixed germ cell tumors of the ovary. Clinical and anatomopathologic analysis of 3 cases of mixed tumors composed of dysgerminoma and endodermal sinus tumor treated at the Mangiagalli Clinic 1970-1979]. PMID- 6497228 TI - [Tumors of the endodermal sinus of the ovary. Clinical and anatomopathologic analysis of 3 cases treated at the Mangiagalli Clinic 1970-1979]. PMID- 6497229 TI - [Dysgerminoma of the ovary. Clinical and anatomopathologic analysis of 11 cases treated at the Mangiagalli Clinic 1970-1979]. PMID- 6497230 TI - [Lasers in uterine microsurgery: experimental research]. PMID- 6497231 TI - [Intravenous leiomyomatosis of the uterus]. PMID- 6497232 TI - [Long-term evaluation of the results of a regimen of prevention of cervical carcinoma. Organizational and methodological problems]. PMID- 6497233 TI - [Use of computerized tomography in the staging of endometrial adenocarcinoma at stage I FIGO]. PMID- 6497234 TI - Chevalier Jackson lecture. Respiratory and alimentary relations in staged human embryos. New embryological data and congenital anomalies. AB - The early development of the digestive and respiratory systems is summarized in relation to embryonic staging. It has frequently been emphasized that the digestive and respiratory tubes do not arise from a common chamber, that they pursue separate courses as soon as the lung bud appears, that a mesenchymal septum comes to intervene between them, and that the two tubes rapidly acquire independent outer coats. Some commonly held views such as the supposed caudorostral separation of the trachea from the esophagus, have been shown to be incorrect. These ideas often arose from the use of unstable landmarks during development. It is pointed out that, for 3 weeks after its appearance, the tracheoesophageal separation point remains at a constant level, whereas the tracheal bifurcation descends. The application of valid embryological data to the interpretation of several congenital anomalies has been shown to be of value. Although the modes of origin in some instances are still obscure, considerable advance has been made in understanding the timing of the relevant events. PMID- 6497235 TI - Congenital laryngeal stridor (laryngomalacia): etiologic factors and associated disorders. AB - Congenital laryngeal stridor (CLS) and laryngomalacia are terms used to describe a common disorder characterized by onset, at or soon after birth, of a harsh respiratory sound mostly audible during inspiration. Typically, laryngoscopy reveals flaccid supraglottic structures which tend to prolapse medially toward the glottis during inspiration. Despite reports of this disorder dating back to the mid-19th century, specific etiology and pathogenesis remain nebulous. Analysis of findings in 30 infants indicate that there are often associated manifestations of delayed development in neuromuscular control. Associated findings include gastroesophageal reflux, obstructive and central apnea, hypotonia, failure to thrive, and pneumonitis. A retrospective review of relevant medical literature along with results of laryngeal dissections and analysis of clinical findings in the 30 cases leads to the conclusion that CLS may be a mild form of localized hypotonia rather than an isolated idiopathic type of anatomic abnormality. PMID- 6497236 TI - Posterior cleft larynx associated with hamartoma. AB - Two patients with a thus far unreported unusual lesion of the larynx, a hamartoma in association with an isolated posterior cleft, are presented. Obstruction in association with aspiration of liquids, recurrent bronchitis with pneumonia, and severe obstructive laryngeal disease were cardinal symptoms of this anomaly. One child had 13 pairs of ribs and the other had Opitz-Frias (G) syndrome, a rare genetic disorder. The cases are reviewed in detail, endoscopic findings are described, and the literature and embryology are reviewed. After endoscopic removal of the hamartoma, both children were relieved of the obstruction, thrived, and no longer had recurrent pneumonia. The aspiration of liquid foods continued when fluids were gulped or taken too rapidly. PMID- 6497237 TI - An unusual form of laryngeal paralysis associated with Arnold-Chiari malformation. AB - This paper alerts the otolaryngologist to a previously unreported type of laryngeal paralysis (adductor type) in association with the Arnold-Chiari malformation. A survey of the literature fails to reveal any similar documented cases of absent laryngeal sensory function in association with this neurological defect. All prior reports have dealt with abductor laryngeal paralysis associated with the Arnold-Chiari malformation in which airway obstruction was the predominant laryngeal symptom. In the patient reported here, aspiration was the predominant symptom and was due to total loss of laryngeal sensation. This report describes this patient's clinical findings in detail, reviews the literature, and discusses management. PMID- 6497238 TI - Chondrosarcoma of the larynx. Case report and management philosophy. AB - Of the 250 cartilaginous tumors of the larynx reported in the literature, at least 69 (28%) were chondrosarcomas. Of these, 46 are sufficiently well documented to permit detailed analysis. One new case, previously reported as a benign chondroma, is added here. Initial diagnosis, type of treatment, and ultimate survival of these cases can be analyzed to arrive at a basis for treatment philosophy. PMID- 6497239 TI - Complications associated with a narrow bore nasogastric tube. AB - The use of a new narrow bore nasogastric feeding tube with stylet has resulted in two cases of misplacement with traumatic laceration of the visceral pleura. Diagnoses were made by chest x-ray film, one case immediately and the other 24 hours later. In both cases, the narrow bore tube was inserted asymptomatically by a graduate physician. Detailed case reports of both patients are presented, those patients at risk for abnormal placement of this nasogastric tube are discussed, and new guidelines for safer use are proposed. PMID- 6497240 TI - Spontaneous perforation of the esophagus as a manifestation of dermatomyositis. AB - Spontaneous perforation of the esophagus evolving into a retropharyngeal abscess in a child with severe dermatomyositis is reported. Clinical presentation and successful management are discussed. Aggressive surgical debridement with extensive drainage, multiple antibiotic coverage, and careful steroid management are advocated. The histopathology and clinical presentation of dermatomyositis as a type of polymyositis are discussed as pertinent to the otolaryngologic clinician. The literature is reviewed and results of a retrospective analysis of head and neck manifestations are reported in 50 children with dermatomyositis treated at Children's Hospital, Los Angeles, over the past 20 years. PMID- 6497241 TI - A new pediatric microlaryngoscope. PMID- 6497242 TI - Flexible neonatalscope. AB - Since the introduction of small flexible fiberoptic scopes for the examination of airways, efforts have been made to reduce their size to fit the smallest patients. The first practical scope of this type was the 3.9-mm nasopharyngolaryngoscope introduced in 1975. Modifications over the years have led to the development of the 1.7-mm neonatalscope, primarily designed for the examination of intubated neonates. This neonatalscope has been of great help in determining placement of endotracheal and tracheotomy tubes, as well as in localizing areas of obstruction within the tubes. By means of a special adapter the scope may be used while the patient is on a respirator. Introduction of this new generation of flexible scopes will undoubtedly lead to other valuable and interesting applications of this instrument. PMID- 6497243 TI - Pulmonary arteriopexy to relieve tracheobronchial compression by dilated pulmonary arteries. AB - Adequate treatment of pulmonary artery compression of the tracheobronchial tree requires a high index of suspicion for the diagnosis, precise localization of the sites of airway compromise by bronchoscopy, and accurate identification of the anatomy of the obstructing vascular structures. Surgical correction of this vascular anomaly to relieve airway compression is necessary in many infants and should be performed promptly. Pulmonary artery plication, arteriopexy, or aneurysmorrhaphy is well tolerated and can be dramatically successful in improving airway patency. PMID- 6497244 TI - Pediatric endoscopy: a review of 616 cases. AB - Congenital and acquired lesions of the pediatric airway may lead to significant morbidity and mortality. A review of 616 endoscopic procedures, carried out over a 2-year period, was undertaken. Of these procedures, 270 were diagnostic and 346 were therapeutic. This paper outlines the clinical indications, the role of radiology, and the diagnoses revealed by this retrospective review. Of particular interest was the fact that 11.5% of the patients had lesions in more than one anatomic site in the upper aerodigestive tract. The complications were divided into intraoperative, immediate postoperative, and delayed. In total, there was a 1.6% complication rate. PMID- 6497245 TI - Actinomycosis of the larynx. PMID- 6497246 TI - ENG of the month. Computed tomography and electronystagmography in conflict with minor symptoms and signs. PMID- 6497247 TI - Pathology consultation. Coccidioidomycosis of the larynx. AB - Coccidioidomycosis, while endemic to the American Southwest, may occur in travelers on return to their homes. Usually asymptomatic in human hosts, approximately 40% of infected subjects will have pulmonary signs and symptoms and 2% will have dissemination from the pulmonary foci. The larynx may be secondarily involved or may be the site of sputum inoculation. PMID- 6497248 TI - [Periungual capillaroscopic aspects in Behcet's disease. Apropos of 30 cases]. AB - Nailed capillaroscopy was systematically performed in 30 patients with Behcet's disease to search capillary dystrophies with paradoxal normal number of capillary loops; some indirect signs of microvascular disease were noted: pallor of the background; petechiae; sludge; abnormal visibility of the venous plexus and of irregularly arranged venules. Eight patients had a normal capillaroscopy: thirteen had direct signs of microvalvular abnormalities (nine cases with two direct signs and at least two indirect signs; and four cases with two direct and one indirect, or one direct and three indirect signs). Nine patients had only sludge and/or petechiae. We never observed any abnormality in the number of the capillaries, in the sweat droplets nor in the circulatory speed. Two patients had megacapillaries resembling those seen in scleroderma. The petechiae were observed in 50 p. 100 of the cases. We found no correlation between the capillaroscopic abnormalities and the age, sex, duration of the disease, or ethnic background. However, the presence of aphthosis the day of the capillaroscopy seems to be correlated with the cutaneous microvascular abnormalities. Thus, there exist frequent capillaroscopic abnormalities in Behcet's disease. Although aspecific, they point out the vascular tropism of this disease, resembling that of the vascularite. The prognostic importance of the capillaroscopy in Behcet's disease is under study. PMID- 6497249 TI - [Chronic urticarial eruption with arthritis, papillary edema, and meningoencephalitis of childhood onset]. AB - The authors report on a case of chronic urticarial eruption since infancy in a man who is now 27-year-old; the association of numerous chronic symptoms, principally meningo-encephalitis, polyarthritis, hepato-spleno-adenomegaly allows the authors to compare this case to those described by Prieur and Griscelli in 1981 and 16 others cases found in literature. It appears as a "systemic disease" without biological or immunological markers; it might belong to the group of chronic normocomplementemic vasculitis. PMID- 6497250 TI - [Photoallergy to quinine]. AB - A case of occupational photodermatitis induced by quinin sulphate is reported. Photobiologic investigation disclosed the responsible photoallergin, demonstrated the mechanism to be of the photoallergic type, and proved the active rays to be mostly UVA. It seems that we do not deal with a contact photodermatitis, but with an internal photosensitization induced by absorption or inhalation of quinin powder and possibly excreting during sweating. PMID- 6497251 TI - [Painful piezogenic pedal papules]. PMID- 6497252 TI - [Painful piezogenic pedal papules]. PMID- 6497253 TI - [Painful piezogenic pedal papules]. PMID- 6497254 TI - [Post-kala-azar dermal leishmaniasis or diffuse cutaneous leishmaniasis]. PMID- 6497255 TI - [Hypercalcemic bone metastases of malignant melanoma]. PMID- 6497256 TI - [Neonatal stomach perforations. Apropos of 25 cases]. PMID- 6497257 TI - [Respiratory repercussions of gastroesophageal reflux and cine esophagogastroscintigraphy]. PMID- 6497258 TI - [Viral arthritis in children]. PMID- 6497259 TI - [Noise-induced epilepsy]. PMID- 6497260 TI - [Spitz juvenile melanoma (multiple form)]. PMID- 6497261 TI - [Dissociated humoral IgG and IgA immunodeficiency with increased IgM. Apropos of a case]. PMID- 6497262 TI - [Congenital adenomatoid and cystic malformation of the lung. Anatomic and clinical presentation and discussion of 2 cases]. PMID- 6497263 TI - [Neuroblastic cells during adrenal development]. PMID- 6497264 TI - [Hyperpyretic convulsive crises and malaria in children]. PMID- 6497265 TI - Cranioplasty for traumatic deformities of the frontoorbital area. AB - Cranioplasties of the frontoorbital area pose a major challenge to the surgeon because of the proximity to the globe, the sinuses, and the eyebrows and eyelids. The choice of material for reconstruction includes autogenous and alloplastic materials. A modification of the fixation technique of split rib graft to avoid depression deformities at the periphery of the defect is described. Sixteen patients were reconstructed with different treatment modalities, including the use of alloplastic materials or autogenous bone or a combination of both. The results are reported as are the complications. Limitations encountered with these difficult reconstructions are discussed. PMID- 6497266 TI - Intravenous extravasation injuries: the effectiveness of hyaluronidase in their treatment. AB - This experimental study in the rabbit establishes a reliable model for the production of skin necrosis analogous to intravenous extravasation injuries in humans. The effectiveness of hyaluronidase in reducing the extent of tissue injury is examined, using several different toxic agents. PMID- 6497267 TI - Giant cell tumor of tendon sheath (localized nodular tenosynovitis). AB - Giant cell tumor of tendon sheath (localized nodular tenosynovitis) remains a disease of unknown origin. Thirty-five giant cell tumors of tendon sheath are reviewed in this study. High recurrence rates can be minimized with attention to accurate preoperative diagnosis and aggressive local excision. The removal of portions of tendon sheath, volar plate, periosteum, or joint capsule may be necessary in selected cases. PMID- 6497268 TI - The sonic digitizer: a rapid and accurate method to assess the size of experimental flaps. AB - Two methods for measuring area, the sonic digitizer and the polar-planimeter, were compared for speed, accuracy, and efficiency. The sonic digitizer was significantly (p less than 0.001) faster than the planimeter (97.2 +/- 9.5 versus 206.3 +/- 14.8 seconds per flap) and more efficient. The accuracy of both methods in measuring areas of 5 to 30 cm2 was comparable; however, for areas of 5 to 13 cm2 the sonic digitizer gave more reproducible results (p less than 0.001). These differences were not reflected in the computed rate of necrosis of the present flap model. PMID- 6497269 TI - Nasal physiology. AB - Because injudicious surgery may adversely alter nasal function, those who treat problems of the nose should be aware of nasal physiology. The nose has seven functions: airway, air conditioning, air cleaning, olfaction, phonation, reflex, and secondary sex organ. These are reviewed in detail and their significance to the planning and performance of an aesthetic rhinoplasty, septal surgery, and turbinate surgery appropriately noted. Form and function are related. PMID- 6497270 TI - Steatocystoma multiplex: a case report. AB - A severe case is reported of a rare skin disorder characterized by multiple intracutaneous cystic lesions; the condition is difficult to manage and impossible to cure. The complicating cystic infections that accompany the condition are treated acutely using sound surgical principles, yet long-term management remains a difficult and unsolved problem. Some of the approaches to treatment are discussed. Surgical cures are usually precluded by the extensive nature of the disease. Perhaps most disheartening is the devastating social and psychological damage resulting from the progressive facial and bodily disfigurement, for which there is at present no satisfactory treatment. PMID- 6497271 TI - Diaphragm mobilization for closure of chest wall defects. AB - Locally disseminated breast carcinoma after a simple or radical mastectomy and radiotherapy causes serious surgical problems. Excision of the chest wall obliterates the negative intrapleural pressure, and wound healing within a previously irradiated area is notoriously poor. A new method is described in which the diaphragm is mobilized and reinserted into the defect to allow final resurfacing with a skin graft or locally rotated skin flap. This simple surgical method is advocated when the prognosis is poor and breast reconstruction is not being considered. PMID- 6497272 TI - Sural nerve neurocutaneous cross-foot flap. AB - Managing heel ulcers has proved frustrating because of the tendency for recurrence despite satisfactory use of grafts and flaps. This predisposition for continual breakdown is invariably associated with the loss of sensation. A neurocutaneous cross-foot flap was used to provide coverage and sensation to a heel after a degloving injury. Initially a full-thickness skin graft was used but resulted in a chronic, infected ulcer. Local tissue was not available for coverage. The neurocutaneous flap was based over the distribution of the sural nerve of the opposite foot. After proper delay, the flap was transferred. When the pedicle was divided, the sural nerve was anastomosed to the sural nerve in the recipient leg. This procedure has provided adequate padding and good sensation to the heel, preventing recurrence in this very active patient. PMID- 6497273 TI - An interview with Vahram Bakamjian, M.D.: conducted by William D. Morain, M.D. PMID- 6497274 TI - Surgical anatomy of the upper eyelid fascia. AB - There is a network of fascia in the upper eyelid that serves to transmit and distribute the motor power of the levator palpebrae muscle to the superficial tissues. The architecture of this network was studied intraoperatively. The results demonstrate that there is a superficial fascia under the orbicularis muscle which fuses with the levator aponeurosis at the level of the lid fold. Below the fold, these fascia remain fused or "conjoined." Thus, the fold in the upper eyelid reflects the union of fascia occurring internally and dose not result simply from the levator aponeurosis inserting into the skin. This article describes the anatomy and surgical identification of the upper eyelid fascia. I contend that the fascia constitutes an important internal framework for the upper eyelid, shaping the lid fold while elevating the tarsal plate in perfect synchrony. For the surgeon, visualizing the fascial architecture is a great aid in the correction of a variety of difficult eyelid deformities. PMID- 6497275 TI - Frontalis suspension for blepharoptosis using palmaris longus tendon. AB - In treatment of moderate to severe blepharoptosis in the Oriental, an excellent result can be obtained by frontalis suspension using free palmaris longus tendons. Postoperative functional training is unnecessary. Children of 5 or 6 with congenital upper eyelid ptosis are favorable candidates for correction by this method. In traumatic cases, the operation may be performed about six months after injury. PMID- 6497276 TI - Augmentation mammaplasty: the surgical and psychological effects of the operation and prediction of the result. AB - The aim of this research was to evaluate the effect of augmentation mammaplasty on women and to determine if it is possible to predict which women will benefit most from the operation. Interviews were conducted with both women who were about to undergo augmentation mammaplasty and those who had undergone the surgery. These interviews were compared with interviews from a control group composed of a normally distributed population. The women who apply for augmentation mammaplasty are a homogeneous group who experience their breast problems in a very similar way. Our study revealed that they are distinctly different from the control group in personality and childhood environment. Most of the women were generally satisfied with the operation even though many had complaints about the technical result. Certain behaviors had changed, but despite these positive results these changes were not radical and in reality the improvement was not as the women initially described it. The women's behavior reactions rarely changed enough to become similar to the reactions of the control group. Using a personality test, it is possible to predict which women will benefit most from the operation. When an assessment of psychiatric problems was made using the neurosis scale in a personality test, the women who scored low on a scale of neurotic self-assertion were satisfied with the operation to a greater extent. PMID- 6497277 TI - Management of mandibular fractures in unreliable patient populations. AB - There is a high incidence of complications following treatment of fractures of the dentulous mandible at our institution, which has led us to scrutinize the criteria for maintaining teeth in the line of fracture and to evaluate other factors that may compromise healing of the fractured mandible, especially in an unreliable patient population. We have reviewed the opinions of various authors and agree that management decisions must be individualized. We recommend prompt and stable immobilization, adequate observation, use of a "tickle file" to keep track of missed appointments, and long-acting intramuscular prophylactic antibiotic coverage, all of which will help minimize morbidity associated with teeth in the line of mandibular fractures, especially in high-risk patients. We also recommend extraction of fully or partially erupted third molars in the line of fracture as well as deeply carious teeth, severely mobile teeth, or teeth with half or more of their root surface exposed to the fracture line. Finally, we recommend that intraoral rather than extraoral open reduction be considered when teeth are to be extracted in order to avoid contamination with the extraoral environment, to enhance surgical access, and to lower postsurgical morbidity. PMID- 6497278 TI - Augmentation of temporal area by insertion of silicone plate under the temporal fascia. AB - The Japanese are mesocephalic and their faces tend to look broad when viewed from the front. The main reason for this appearance is the prominent zygoma. The temporal area is closely related to the zygoma, and when this portion of the face is excessively concave, the zygoma stands out and causes the face to appear seedy or older than the actual age. To cure this condition, there have been three conventional operations performed in Japan, which are not without shortcomings. The authors have improved on these methods and have succeeded in solving most of the problems in 21 cases by devising a method in which a soft silicone plate is inserted under the temporal muscle fascia. PMID- 6497279 TI - Efficacy of the carbon dioxide laser in hand surgery. AB - The use of the carbon dioxide laser for minor hand problems is reviewed, and the physiological effects of laser treatment are discussed. Forty-one patients have been treated during a one-year period for warts, nail disorders, and a variety of benign neoplasms. Results of CO2 laser treatment are equivalent to those of other methods with less pain and disability. Future applications of the CO2 laser are discussed. PMID- 6497280 TI - The crane principle revisited: application in the reconstruction of compound frontal defects. AB - An extension of the "crane" principle is presented for use in compound frontal defects, and several case histories are described. The procedure would obviously not be possible if a foreign material had been used for the osseous defects, since take of the skin graft depends on circulation through the autogenous bone graft. PMID- 6497281 TI - Plastic incisions for facial and neck tumors. AB - We review various incisions for treatment of tumors of the face and parotid and submaxillary regions, as well as for radical neck surgery. A contribution to this field is made in the form of facial and cervical incisions that not only provide broad exposure of the region affected by the tumor, but also involve incision traces based on plastic surgery criteria. In this respect, we describe plastic modeling of the facial, submaxillary, and neck contours, resorting to the sternocleidomastoid and trapezius muscles. PMID- 6497282 TI - Lymphangioma of the parotid gland. AB - Parotid gland tumors in infancy and childhood are rarely seen and infrequently documented. Among them, hemangioendothelioma and mixed tumors are the most common. Parotid lymphangioma is very rare. This report presents a case of parotid lymphangioma and discusses the clinical, gross, and histological features, differential diagnosis, and treatment. PMID- 6497283 TI - Aquaplast for nasal splinting. AB - A nasal splint ideally should be sturdy, moldable, light, easy to apply, and inconspicuous. Plaster, dental compound, and aluminum are currently used but each has limitations. We have found that Aquaplast, a material softened by immersion in hot water, more closely conforms to the qualities of the ideal nasal splint. Aquaplast is sturdy, light, thin, very moldable, easy to apply, and allows for passage of air and moisture. PMID- 6497284 TI - Re: Humphrey: invited comment on Pennisi and Capozzi. PMID- 6497285 TI - [Angiography and embolization in the treatment of vascular complications of pelvic injuries]. PMID- 6497286 TI - [Idiopathic ureteral varices in children. Apropos of 4 cases]. PMID- 6497287 TI - [Echography and subdural effusion]. PMID- 6497288 TI - [Diagnostic and therapeutic value of radiologic and scintigraphic studies. Apropos of a case of osteoid osteoma]. PMID- 6497289 TI - [Left eosinophilic colitis. Radiological aspect]. PMID- 6497290 TI - [Symposium on bone tumors. Paris, 10 December 1982]. PMID- 6497291 TI - [Role of surgery in recent traumatic lesions of the upper cervical spine (C1 and C2) in adults]. PMID- 6497292 TI - [Treatment of perforated duodenal ulcers]. PMID- 6497293 TI - [Are there still indications for peripheral intrahepatic cholangio-anastomoses?]. PMID- 6497294 TI - [Emergency colonic surgery. Apropos of a series of 80 ideal mechanical colectomies]. PMID- 6497295 TI - [Surgical diverticular sigmoiditis. Apropos of a series of 117 cases]. PMID- 6497296 TI - [Postoperative abdominal infection. Epidemiological aspects at the Clinical Hospital of Salamanca]. PMID- 6497297 TI - [Gardner's syndrome]. PMID- 6497298 TI - [Transposition of the gluteus minimus in spastic hip. Apropos of 11 cases]. PMID- 6497299 TI - [Cardiac valvular surgery after 65 years of age]. AB - 252 symptomatic patients aged 65-79 underwent surgery between 1970 and 1982 for heart valve lesions. Hospital mortality was 11.8%. Analysis of the short and long term results justifies cardiac surgery in elderly patients with valve disease. PMID- 6497300 TI - [Isolated or combined myocardial revascularization in patients over 65 years of age]. AB - Of a total of 4 952 patients undergoing surgery between 1975 and 1982 for coronary artery disease, 430 (8.7%) were over 65. Single or multiple coronary by pass was carried out in all patients, either alone or in combination with other procedures (aortic valve replacement: 16 cases; mitral: 10 cases; mitral aortic: 3 cases; mitral-tricuspid: 1 case; vascular surgery: 8 cases; aneurysm resection + mitral stenosis: 15 cases). Hospital mortality was 6.9%. Clinical improvement (NYHA), despite the short follow-up, was most considerable: only 6% of the patients failed to show improvement. The risks of surgery are therefore acceptable and, given the high improvement rate, operation is to be encouraged in this age group. PMID- 6497301 TI - [Open-heart surgery in patients over 65 years of age. Lesions encountered and immediate postoperative mortality]. AB - Open heart surgery after 65 is more and more frequent (16% of our surgical cases). Between January 1971 and December 1982, 8 425 open heart operations were performed in this Department, 1 377 of them in patients over 65. Most were cases of aortic valvulitis (620), and calcific aortic stenosis in particular, but also dystrophic aortic insufficiency; 217 patients underwent surgery for mitral valvulitis (rheumatic or dystrophic in origin) and 84 for involvement of more than one valve. Of the 2 440 patients with coronary lesions who underwent surgery, 255 were over 65; beyond this age, a higher rate of association between coronary lesions and valvular disease was found (167 patients undergoing surgery). Surgical mortality (during the first postoperative month) was higher after 65: 11.1% in patients with valve disease, and 11.4% in those with coronary artery disease, whereas in patients under 65 the figures were 6.5% and 4% respectively. On the other hand, in those undergoing surgery for combined valve and coronary disease, mortality over 65 was hardly any higher than under 65 (13.7% as against 10.4%). This justifies screening for coronary artery disease in any candidate for valve surgery aged over 65. These results were achieved thanks to some technical and anaesthetic precautions, and though they may be less satisfactory than those for younger patients, they justify such surgery for all lesions that threaten survival in the short term. PMID- 6497302 TI - [Surgery of calcified aortic stenosis in patients aged 70 and over. Immediate results. Apropos of a series of 229 cases]. AB - 229 patients aged 70 or over with aortic stenosis (AS) underwent surgery between January 1972 and July 1983 (21.8% of 814 cases of AS operated on during the same period). The Bjork Shiley prosthesis was used at the beginning of the series (115 cases, 50.2%), until bioprostheses became the treatment of choice in this age group. Overall operative mortality in the series was 10.9% (25/229). Analysis shows a very marked reduction in recent years: from 15.6% between 1972 and 1977, to 5.8% in 1982-3. Improvement can be attributed in part to the technical progress in myocardial protection. Patient age is a very significant factor in the prognosis. Progress in surgery, together with that in anaesthetics and intensive care, justifies operation in these elderly and incapacitated patients whose general and neurological condition is well preserved. PMID- 6497303 TI - [Cardiac manifestations of Lyme disease. Apropos of 2 cases]. AB - Lyme disease, a well-known entity in the United States, has featured only rarely in the French literature. We report two cases from the Cardiology Department with acute symptomatic atrio-ventricular block. The illness begins with migratory chronic erythema, which is the best marker of the condition. This is followed by neurological, joint and cardiac manifestations. Cardiac involvement consists essentially in A-V block of varying severity, which rapidly regresses. Until the recent discovery of the arthropod vector responsible (Ixodes dammini), the diagnosis was clinical and was confirmed by negative serological results for the other infectious agents. Penicillin and tetracycline are effective at the skin lesion stage. It is important to recognise this condition since there is no case of complete A-V block lasting longer than 2 weeks. PMID- 6497304 TI - [Evaluation of the venotropic effect of chromocarb diethylamine in patients with varices, using 133Xe]. PMID- 6497305 TI - Pharmacodynamic and pharmacokinetic aspects of local anesthetics. AB - The clinically useful local anesthetic agents can be divided chemically into the amino-esters, e.g., procaine, chloroprocaine and tetracaine, and the amino amides, e.g., lidocaine, mepivacaine, prilocaine, bupivacaine and etidocaine. Pharmacologically, these agents can be categorized as agents of low potency and short duration of action, e.g., procaine and chloroprocaine; agents of intermediate potency and duration of action, e.g., lidocaine, mepivacaine and prilocaine; and agents of high potency and long duration, e.g., tetracaine, bupivacaine and etidocaine. The blood level of local anesthetics is determined by the rate of uptake, tissue redistribution, metabolism and excretion. The rate of vascular absorption is a function of the site of injection, dosage, inclusion of a vasoconstrictor in the local anesthetic solution and the specific drug employed. The amino esters are eliminated by means of enzymatic hydrolysis in blood while the amino amides are metabolized primarily in the liver. Among the ester agents chloroprocaine is cleared most rapidly due to its fast rate of hydrolysis. Within the amide series, prilocaine is cleared most rapidly due to its fast rate of tissue redistribution and its rapid hepatic metabolism. Bupivacaine is cleared most slowly due primarily to its decreased rate of hepatic degradation. PMID- 6497306 TI - The role of spinal anesthesia today. PMID- 6497307 TI - Regional anaesthesia and uterine blood flow. AB - Sufficient placental blood flow is mandatory for the well-being of the fetus. The delicate balance between uterine perfusion pressure and uterine vascular resistance can be critically disturbed during epidural anaesthesia. Maternal hypotension is common when extensive block for Caesarean Section is used. If hypotension as well as aortocaval compression is avoided and sufficient preload (Ringer's lactate) is used intervillous blood flow (IBF) will not significantly change. Ephedrine given to prevent or treat maternal hypotension will not adversely effect IBF. Lumbar epidural analgesia used for pain relief during labor (10 ml dose of local anaesthetic (1.a.] will significantly (p less than 0.05) improve IBF in healthy parturients. Epinephrine (less than or equal to 50 micrograms), added to the local anaesthetic, will not decrease IBF. IBF can be severely reduced in pregnancy-induced hypertension (PIH) since the fetus is chronically asphyxiated it is crucial to avoid any further decrease in IBF. Extensive sympathetic blockade (T8) using epidural analgesia (10 ml dose of 1.a.) has been shown to significantly (p less than 0.01) improve IBF in parturients with PIH by decreasing uteroplacental vascular resistance. PMID- 6497308 TI - Toxicity due to local anaesthetics. PMID- 6497309 TI - Regional anaesthesia for children. PMID- 6497311 TI - The scope of epidemiology. PMID- 6497310 TI - Postoperative pain relief and regional techniques. AB - The methods of providing postoperative analgesia by regional anaesthetic techniques with local anaesthetics are outlined. For the use of epidural analgesia, the techniques of inserting an epidural catheter at any level of the spine must be familiar. The block should be regional, restricted to the area of pain and effective at all times after its institution with a minimum of side effects. Bupivacaine is at present the best local anaesthetic and can be administered either as intermittent injections with an interval of 1-2 hours or as a continuous infusion. A dose regimen for thoracic, abdominal, perineal and lower extremity pain is presented. Side effects of the epidural technique and ways to treat and avoid them are discussed. The intercostal nerve block for post thoracotomy and upper abdominal pain is described with special reference to the recent development of the continuous technique with bupivacaine and the cryoanalgesia technique. PMID- 6497312 TI - Analysis of the secular trend and seasonal variation of measles mortality rate in Taiwan. AB - The secular trend and seasonal variation of measles mortality rate in Taiwan from 1959 to 1981 were analyzed through multiple regression analyses. A significant downward trend with a regular two-year cyclic fluctuation was observed before and after the implementation of a mass vaccination campaign, and the difference between odd and even years was greater in later years than in earlier years. There was a characteristic unimodal pattern of seasonal variation which peaked in the months of late spring or early summer, and measles deaths were found more clustered in epidemic years than in nonepidemic years. While 94.3% of the total variation of annual measles mortality rate could be explained by calendar year, two-year cycle, and their interaction; 87.6% of the total variation of monthly measles mortality rate could be explained by calendar year, two-year cycle, month, and the interaction between two-year cycle and month. The implication and application of such multiple regression analysis of temporal components of measles epidemiology are discussed. PMID- 6497313 TI - A cohort study on the causes of death in an endemic area of schistosomiasis japonica in Japan. AB - In order to elucidate the chronic effects of schistosomiasis japonica, a retrospective cohort study was carried out. The mortality experience of 2,067 inhabitants over 30 years old in the endemic area of schistosomiasis in Yamanashi Prefecture were followed up from 1958 to 1982 concerning the underlying cause of death. Total person-years at risk were 18,694.1 for males and 21,524.9 for females. The observed-expected ratio (O/E) was significantly high for cirrhosis of the liver (4.05 for males, 5.53 for females), cancer of the liver (males only, 2.30) and cancer of the colon (females only, 2.25). Increasing O/E values were observed for cirrhosis of the liver and cancer of the colon (females only) in relation to duration of residence in the area before 1957. These results suggest that schistosomiasis japonica is one of the important risk factors for cirrhosis of the liver, cancer of the liver and cancer of the colon. PMID- 6497314 TI - Epidemiological aspects of a poliomyelitis outbreak in Taiwan, 1982. AB - Active surveillance was carried out to examine the epidemiological characteristics of an abrupt outbreak of poliomyelitis after a significant decline in incidence had resulted from a mass vaccination campaign. Through the intensive survey of private and public hospitals, a total of 1,058 paralytic cases were found with a sex ratio of 1.4. While the age-specific attack rate was highest for the age group of less than one year and decreased with increasing age, the age composition did show a greater proportion of higher age groups than in previous outbreaks. Among 901 cases with a known history of vaccination, about half had received no vaccination and only 9.7% had received three or more doses. The outbreak started on May 29th, peaked in late August and ended on November 1st. The epidemic spread from the north through the middle to the south of the island during this period. A simulated epidemic curve based on the Reed-Frost model fitted the observed one fairly well. Attack rates varied from county to county and were significantly associated with the community health status, vaccination coverage, and their interaction. Possible ways to prevent the epidemic are discussed. PMID- 6497315 TI - Diarrhoeal diseases in rural Malaysia: risk factors in young children. AB - A survey was conducted in six selected rural villages to obtain baseline data on socioeconomic status, nutrition, environmental sanitation and behavioural aspects in relation to diarrhoeal diseases, using a standard questionnaire. Subsequent to this, children 0-4 years of age were followed weekly for six months for diarrhoeal disease. Eleven variables representing socioeconomic status, nutritional status, housing condition, environmental sanitation, mother's knowledge and beliefs were investigated using stepwise logistic regression to determine significant predictors of diarrhoeal disease. Children who were below two years of age, living in conditions of poor sanitation and poor quality water supply, whose houses were prone to flooding and who had mothers whose sanitary habits were not influenced by their religious beliefs, were at significantly greater risk of diarrhoeal disease. PMID- 6497316 TI - Present status and future prospects for malaria control in the world. AB - The potential of residual insecticides with their direct action against the sporogonic cycle of plasmodia prompted the idea of possible eradication of malaria. In the early fifties health administrators supported by technicians favoured the control of endemic diseases through "mass campaigns". In such an atmosphere, at the 8th World Health Assembly held in Mexico in 1955 a resolution was adopted urging member states to initiate health programmes aimed at eradicating malaria. Initial spectacular results continued for ten years, but the progress slowed down considerably in the late sixties due to a number of technical, operational and administrative problems encountered in many countries. Nevertheless, malaria was eradicated in 37 countries and territories, thus freeing the population of some 500 million from the risk of infection. During the period 1972-1977 serious resurgence of malaria affected a number of countries in South East Asia, Central America and Turkey. Energetic counter measures have brought down malaria to a level which is far from being under control. At the same time in Africa, south of the Sahara, practically no organised control of malaria is being carried out. While malaria morbidity is rising, the policy of national health administrations is to carry out malaria control applying the strategy of Primary Health Care. However, in view of the multiple difficulties countries are facing much more flexibility and an epidemiological approach are required at this stage. Possible modalities for action are discussed in the paper in more detail. PMID- 6497317 TI - Multiple primary cancers in Singapore 1968-1978. AB - The Singapore Cancer Registry has, since its inception, adopted very strict criteria for the registration of multiple primary cancers. This report covers 121 cases registered from 1968 to 1978, which works out to a proportion of 0.5% of all persons with cancer. The strict criteria has ruled out all second primaries in multicentric foci in the same organs or in bilaterally paired organs, thus accounting for the very small number. There were significantly more females, but no significant differences among the three major ethnic groups. The females were generally younger at first diagnosis (mean 54 years) compared to the males (mean 60 years). The time-interval between diagnoses ranged from 0 to 20 years, with the median at 3 years, the interval being longer in younger patients. Interesting site associations include the kidney-bladder and cervix-lung combinations. PMID- 6497318 TI - Geographical and socio-economic variations in ischaemic heart disease in men in Hong Kong. AB - Variations in Ischaemic Heart Disease mortality in men in Hong Kong were analysed using registered deaths from 1976 to 1981 and the 1981 Census population, and earlier years. Age-specific rates in Hong Kong as a whole are lower than in Britain and in the USA and have changed relatively little over the past ten years. Standardised Mortality Ratios (SMRs) for districts, Proportional Mortality Ratios (PMRs) for occupations, and Direct Age-Standardized Mortality rates were calculated, using the whole of Hong Kong in 1981 as the standard. In 1981 the SMRs for the affluent districts were significantly high while the SMRs of the most rural areas were significantly low. Although the affluent districts had high proportions of non-Chinese deaths, these were not sufficient to explain the high SMRs. In affluent districts there were high proportions of professional, administrative and managerial workers who had significantly high PMRs for Ischaemic Heart Disease. The district SMRs were positively correlated with the proportions of these workers. The conclusion is that in Hong Kong in 1981, higher levels of socio-economic status were associated with higher levels of Ischaemic Heart Disease in men. Further studies are being made, and attention will be paid in risk-factor studies to areas and population groups with higher risks. PMID- 6497319 TI - Lead pollution in Antwerpen, Belgium. AB - Environmental pollution by trace metals was found to be important in the vicinity of a smelter situated in Hoboken, a suburb of Antwerpen, Belgium. Lead content of surface soil ranged from 147-693 ppm, while dust samples contained up to 7% of lead. The annual average ambient air concentration decreased from 3.79 micrograms Pb/m3 in 1974 to 1.25 micrograms Pb/m3 in 1982. Lead deposition in fall-out samples was about 20 mg/m2/day at 500 m from the smelter. In 1978 the mean blood lead level of 11-13 years old children was 26.9 micrograms/100 ml within 1 km from the smelter, compared to 16.3 micrograms/100 at 2.5 km and 11.2 micrograms/100 ml in a rural control group. Younger children even proved to be at higher risk of lead impregnation. Out of 359 children, 3-12 years old, attending schools within 1 km of the smelter, 23 belonged to class III of the CDC risk classification and 3 to class IV. 17 of them showed reduced nerve conduction velocities. The mean dentine lead level of 51 exposed children was 31.94 +/- 6.98 ppm compared to 9.63 +/- 1.50 ppm in an urban control group. A programme aimed at reducing exposure was enforced: reduction of emission and wind blown dust from ore-piles, decontamination of houses and soils, closing down of schools near the smelter, motivation of families for moving away from the area, screening of the children, etc. Although an important reduction of ambient air lead levels could be realized, lead deposition did not decrease significantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497320 TI - The epidemiological approach to cadmium pollution in Japan. AB - The study of health problems due to cadmium pollution in Japan originated from an endemic episode of Itai-itai disease in a rural area in north-central Japan after World War II. The disease was defined as osteomalacia with tubular changes in the kidney and considered to be associated with excess intake of cadmium. This episode motivated the Japanese Government to conduct health examinations on the general population in cadmium-polluted and non-polluted areas throughout the country since 1969. Although Itai-itai disease-like bone changes were rarely found, these studies revealed a higher prevalence of renal tubular dysfunction among elderly people in the cadmium-polluted areas. No significant difference was noted in cancer mortality, but mortality from cardiovascular diseases and all causes tended to be lower in cadmium-polluted areas. Clinical and pathological studies in man as well as experiments on primates have recently been made to elucidate the pathogenesis of Itai-itai disease and the health effects of cadmium. The lack of knowledge on the ecological and biological complex of cadmium resulted in the impediment of studies on this problem. The lesson from this experience is that basic research is essential for promoting the study of pollutants such as heavy metals, though pollution problems usually require urgent solutions. PMID- 6497321 TI - Two examples of environmental problems occurring in remote sparsely populated areas. AB - Studies in two widely separated remote areas are presented. Arsenic from gold mining contaminates the town of Yellowknife, North West Territories, Canada, An electromyographic study was carried out on 517 people in Yellowknife and a control population. Correlations between hair arsenic levels and nerve velocity, although not striking, are noted. Mercury contamination of fish in a pristine environment in Lake Murray, Western Province, Papua New Guinea, is reflected in elevated hair and urine levels in the local inhabitants. An attempt was made to determine the effects of mercury on the people and 40% of those tested had albumen in their urine. The conclusions drawn from these studies are given. The problems imposed on epidemiological studies by remote areas and harsh conditions are suggested. PMID- 6497322 TI - Fluoridation of public water supplies in Singapore. AB - Fluoridation of public water supplies as a means of reducing the prevalence of dental caries was introduced in Singapore in 1956. This paper will describe the fluoridation programme, and discuss its role in the prevention of dental decay. Water fluoridation has been advocated by the World Health Organisation in 1958 when the first report by an expert committee concluded that drinking water containing about 1 ppm. fluoride had a marked caries preventive action, and that controlled fluoridation of drinking water was a practicable and effective public health measure. Today, more than 60 countries serving over 330 million people have drinking water which is fluoridated. In Singapore, public water supplies contain 0.7 ppm. fluoride. The efficacy of this programme is reported in follow up studies. After ten years, mean dmf/DMF reduction of 34.4% was recorded for seven-year old Chinese school children, and 33.6% for the same age group Malay school children. These results are consistent with world-wide studies which show beneficial reduction in carries level in children by 30-80%. Fluoridation of public water supplies is indicated if there is an efficient system of distribution and when there is a moderate-to-high prevalence of dental caries. PMID- 6497323 TI - Perinatal mortality with particular reference to the Singapore situation. AB - Perinatal mortality rates have been gradually declining in all countries. The initial decline mainly resulted from improvements in the late foetal mortality rates. Later with improvements in neonatal care, early neonatal mortality rates also improved. The developed countries have consistently shown better results than the developing countries, an indication of the higher standard of living, general health as well as the delivery of health care in these countries. In the Singapore situation, a rapid improvement in perinatal mortality was initially observed due to improvements in the late foetal mortality, followed later by reduction in the early neonatal mortality due to upgrading of neonatal intensive care. The perinatal mortality rate is lowest in the Chinese compared to the Indians and Malays, most likely due to the dietary practices of the three ethnic groups in Singapore; while the Chinese encourage extra nutrition in the pregnant female, the Malays and Indians tend to practise dietary restriction during this period. The improved nutrition of the pregnant mother is a factor in improving the perinatal mortality. PMID- 6497325 TI - Teaching epidemiology to the medical student. AB - The time allocated to epidemiology in the medical curriculum of most medical schools has increased and its importance has gained more general acceptance. The reason "Why?" epidemiology should be taught is perhaps best given by the World Health Organisation's report that epidemiology should aim to influence the future doctor's attitude to the problems of health and disease in the community by making the student more aware of the scientific approach to those problems. The question "How?" epidemiology should be taught is more difficult and there is evidence, at least from the United Kingdom, that the subject is regarded as both dull and the least difficult of sixteen subjects investigated. The question of whether epidemiology should be taught as a separate discipline or integrated into the curriculum is perhaps best answered by saying both should be done. The methods of instruction vary and a combination of methods is desirable in any course. The relations between epidemiology and other subjects and the place of epidemiology in formal examinations, varies greatly between medical schools. The ideal solutions to these and other problems still lie in the future. PMID- 6497324 TI - Providing primary health care with non-physicians. AB - The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined. PMID- 6497326 TI - Opening address, International Epidemiological Association Regional Meeting, 1983. PMID- 6497327 TI - Epidemiology in occupational health. PMID- 6497328 TI - Contributions and limitations of epidemiological knowledge in occupational health. AB - Although epidemiological principles and methods in occupational medicine have been used for many years, it is only recently that the term "occupational epidemiology" has begun to appear in the field of occupational health. In fact, this is only the 3rd meeting of "occupational epidemiology" of a scientific subcommittee of PCIAOH. Thus, the importance of epidemiology in occupational health has been recognized among not only scientists but other members of the field and by the general public. This is indeed a desirable trend and will promote the practice of occupational health. However, epidemiology is not "almighty", not an absolute science. The misuse of epidemiological results can provide wrong information and may even cause grave confusion and misunderstanding in the protection of the health of workers and relevant legislative action. The use of epidemiology can be broadly categorized as follows: Search for a cause of occupational disease--Cause and-effect relationship of an event among workers: Occupational cancer and other diseases; Industrial injuries; Absenteeism; Detection of subclinical and psychological conditions due to job; and Occupational fatigue. Dose-effect, dose-response relationship of toxic chemicals. Practical application of epidemiological results: Establishment of criteria for the maintenance of health; Industrial hygiene; and Policy making for prevention and compensation--regulation and legislation. There are many problems, issues and conflicts in the uses of occupational epidemiology. These will be discussed in the text. PMID- 6497330 TI - On the problem of controlling confounding in case-referent studies. AB - Individuals in various exposure categories constitute an epidemiological study population and its health experience over time can be taken as the base of the study, which is either open with a turnover of individuals (deaths, migrations etc) or closed, when encompassing only originally defined individuals. In cohort studies all individuals are known in terms of membership and exposure, whereas case-referent (case-control) studies utilize a sample from the base, the referents, for information about the exposed and non-exposed domains of the base, and the referents are a sort of relative denominators for the cases. An association in the base between the exposure and another determinant of the disease means confounding and can be fully accounted for in the cohort approach, but not in the case-referent study as relying on a sample of the base. The reason is that the occurrence of the confounder among the referents is influenced by random variation in the sampling procedure and the referents may therefore not always reflect the true situation with regard to confounding in the base. Computer simulations of the acquisition process of referents illustrate that neither a confounded nor a non-confounded base might always be properly reflected in case-referent data. However, the variation of the confounding rate ratio (the crude rate ratio/SMR) might not be expected to vary by more than about a factor of two. Particularly in nested case-referent studies, a relatively large number of referents helps stabilize the random variation, but only the cohort approach provides full control of confounding, a fact, that becomes the more important, the smaller the effect under study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497329 TI - Strategies for pooling data in occupational epidemiological studies. AB - In occupational epidemiology, most of the populations at risk are of limited size, and therefore pooling of the experience of different groups with similar exposure is desirable. We present and compare five different strategies for pooling of such data, including the "default" strategy of present reporting practices, which have the disadvantage that the experience of many small units is not recorded because of the low statistical power of small populations. A simple summation strategy including cases and controls from diverse groups, while attractively simple, may be fallacious when cases and controls have different proportions which are confounded with the risk ratios. Separate summation of observed and expected numbers of cases avoids the risk of fallacy, but may be unduly influenced by the results in one large plant. A "Clinical Trial" type of strategy in which all of the data are collected by a common protocol and therefore considered as a single data set is administratively complex and does not seem well suited for occupational epidemiology. Probability pooling seems to have attractive features, avoiding most of the disadvantages of the other strategies, and having the added feature that weighting for exposure and duration of follow-up can be included. Probability pooling requires exact probability statements for each study. Examples are given for pooling of data from exposures of operating room personnel to anaesthetic agents, cohorts of workers exposed to asbestos, and cohorts of workers exposed to man-made mineral fibres. A working group is proposed to recommend procedures and to assist in interpreting pooling activities. PMID- 6497331 TI - The mortality odds ratio (MOR) in occupational mortality studies--selection of reference occupation(s) and reference cause(s) of death. AB - In occupational mortality studies, the information on the population at risk is frequently not available. In these circumstances, the rate ratio of interest can be assessed through the mortality odds ratio (MOR), given appropriate selections of reference occupation(s) and reference disease(s). The reference occupation should be chosen with a view to three aspects of validity: (1) comparability of effects, i.e., identity of mortality effects between the index and the reference occupation apart from the effect of the exposure under study; (2) comparability of contrasted populations, i.e., same job entry and exit factors and similar health promotion programmes when related to the mortality under study; and (3) comparability of mortality information, i.e., same diagnostic and certification practices for the cause of death of interest between the contrasted populations. The reference causes of death must also satisfy these requirements with the additions that the exposure under study have no effect on the risk of reference causes of death, and that the accuracy of information about the compared occupations be the same as in the context of the index cause of death. Throughout the discussion, an example of exploring cancer risks among lens manufacturing workers is used. PMID- 6497332 TI - Statistical problems associated with cohort studies of workers in an industry. AB - Risk factors in a working environment are studied mainly by case control studies or cohort studies of workers in several occupational settings. While the cohort studies are by far more powerful in detecting risk factors there are many problems associated with these studies, apart from the high cost and long duration. Some of these problems include the large number of variables involved, the evaluation of missing observations and the resulting bias, problems in selecting appropriate statistical models and analyses as well as identifying the disease subgroup (including loss to follow up). The problems are considered under four groupings: (1) identifying outcome, (ii) missing data, (iii) estimation of work exposure and (iv) statistical analysis. The apparent advantages of retrospective cohort study should be weighed against these problems when deciding on a study design. More appropriate statistical methods, other than SMR and PMR analysis, should be considered while analysing data from such studies. PMID- 6497333 TI - A quantitative evaluation of competing risks in occupational studies. AB - Mortality risk is competing because each individual is subject to several competing causes of death but can only die from one. Adjustment for competing risks will allow more meaningful comparisons of cause-specific mortality of two populations, especially if dying from all other causes is significantly different between the two populations. In this paper, a method has been developed for adjustment of competing causes of death in the calculation of relative risk. It identifies three factors as determining the significance of competing risks: (1) magnitude of the overall mortality risk of the study population; (2) differential risk or adjustment factor for all other causes between two populations; and (3) age interval used in mortality calculation. Thus, the impact of competing risks is increased if the mortality risk of the study population is high, if the differential risk for all other causes is large or if wide age intervals are used in the mortality calculation. An example from refinery cohort data shows that in certain age groups unadjusted for competing risks the relative risk is overestimated by 9%. The impact of competing risks in this particular example is relatively small. PMID- 6497334 TI - Use of questionnaires in occupational studies of pregnancy outcome. AB - Previous studies have demonstrated a high miscarriage risk among women in laboratories and women exposed to anaesthetic gases. Many of these studies have methodological shortcomings. The aim of the investigation was to study the pregnancy outcome, mainly the miscarriage rate in these occupational groups, and to study such potential sources of error as response bias and inaccurate diagnosis. A questionnaire study was performed among women who had worked at a Swedish hospital as well as women employed in laboratories at the University of Gothenburg (U.G.). Reported pregnancies were accepted only if they could be verified in hospital records or if they were anamnestically reported in medical records. Pregnancies among non-respondents were also sought in medical records. All women suffering a miscarriage after exposure to anaesthetic gases reported their miscarriage while one-third of all miscarriages occurring to women who were not exposed during pregnancy were not reported in the questionnaire. Twelve per cent of the miscarriages among laboratory employees at U.G. could not be verified or found anamnestically in medical records. Work with solvents during pregnancy was more frequently reported for these miscarriages as compared to those which were found in medical records. No significantly increased miscarriage risk after exposure to solvents in laboratory work or to anaesthetic gases could be demonstrated after correction for these errors. It is concluded that use of questionnaires as the only source of information in studies of pregnancy outcome could give biased results and should thus be avoided. PMID- 6497335 TI - Epidemiological discovery of occupational cancers. AB - Most occupational hazards of cancer that have been recognized have been discovered as a result of clinical intuition or epidemiological observation. Most could, however, have been avoided if modern laboratory techniques had been used to test the substances used before men and women were deliberately exposed to them. Industry must be expected to use such tests in the future and it is hoped that few occupational hazards of cancer will be introduced. Laboratory studies, however, are not 100% reliable as predictors of human risk and epidemiological observations will continue to be required to: detect existing hazards that have been overlooked, pick up new hazards that were not predicted by laboratory investigation, determine the level of risk that is socially acceptable, if a carcinogenic agent has to be used, and sometimes to demonstrate the safety of an agent that has been suspected of causing a hazard to man on uncertain grounds. The ways in which epidemiological observations can be used for these purposes are discussed. PMID- 6497336 TI - Fibre exposure and mortality from pneumoconiosis, respiratory and abdominal malignancies in chrysotile production in Quebec, 1926-75. AB - To define the relationships between chrysotile exposure in fibre terms and death from specific cancers, and pneumoconiosis, all 11,379 persons born 1891-1920 who had worked in the asbestos mines and mills of Quebec for a month or more before 1967 were followed to the end of 1975. Among the 10,939 men, there had been 4,463 deaths, 634 from these causes. For each death, referents were randomly selected from among men in the cohort born in the same year as the case and known to have survived to a greater age. For each case and his referents, exposures accumulated up to nine years before the death of the case had been obtained as (million particles per cubic foot) x years. Fibre counts were estimated for each work place so that all exposures could be expressed in (fibres/ml) x years. The ratio of the means for all 2,586 accumulated exposures was 3.46 (f/ml)/mpcf. Relative Risks (RR) were related to exposure by matched analysis. For pneumoconiosis and lung cancer, RR = 1 + b.(f/ml).y fitted well, with b estimated as 0.00647 and 0.00038, respectively. For cancers of upper and of lower G.I. tract, severe exposure was associated with elevated RRs, but rather unclearly. For other abdominal cancers, and laryngeal cancer, risks and exposure were not positively associated. The asbestos-smoking interaction in lung cancer was closer to multiplicative than to additive. PMID- 6497337 TI - Asbestosis, the nervous system and cancer. AB - Asbestosis patients have a high cumulative risk of cancer: four of ten asbestosis patients develop cancer. Paraneoplastic involvement of the nervous system, peripheral neuropathy in particular, is often encountered in cancer patients, even at very early stages of the disease. In order to estimate the occurrence of paraneoplastic neuropathy among asbestosis patients, we formed a small cohort (115 asbestosis patients, mean age 56 years, mean duration of exposure to asbestos 21 years) in 1979. Neurological examination revealed slight peripheral neuropathy in 44 (39%) of the patients, 24 (22%) of whom also had central nervous system signs (disturbances in gait and posture, memory and fine movements). The prevalence of peripheral neuropathy among asbestosis patients was higher than among various referent patients (fibrosing alveolitis, diagnosed solvent poisoning and gynaecological carcinoma). No significant differences were found between the patients with and without peripheral neuropathy regarding the following parameters: pulmonary function tests, tumour markers (CEA, ferritin, beta-2-microglobulin), antinuclear antibodies, C3, C4 and circulating immune complexes. Nevertheless, at group level, the asbestosis patients had increased levels of the three tumour markers. Estimates based on the data accumulated so far (10 cancer patients) show that within three years we shall probably have a sufficient number of cancer cases to draw some conclusions about the value of neuropathy in the early diagnosis of occupational cancer. PMID- 6497338 TI - Mortality from nasopharyngeal carcinoma and occupation in men in Hong Kong from 1976-81. AB - A study of deaths from Nasopharyngeal Carcinoma (NPC) among males in Hong Kong from the years 1976 to 1981 was conducted. Variations in NPC mortality among different occupational groups were investigated. The average death rate from NPC among males was 14 per 100,000 in the past ten years which is among the highest in the world. Comparisons using age specific mortality rates and direct age standardized mortality rates between occupational groups revealed increasingly high mortality in agricultural and fishery occupations (p less than 0.01), and being lowest among administrative occupations (p less than 0.05). The ten highest proportional mortality ratios for occupations were calculated and showed significantly high ratios among fishermen, plumbers, welders and fitters. The paper reviewed and discussed the possible reasons for these findings. PMID- 6497339 TI - Cancer incidence in Singapore by occupational groups. AB - Population-based registration of all cancer cases diagnosed in Singapore began in 1968. While most of the basic demographic and clinical data collected are reasonably adequate and accurate, the item on occupation is quite unsatisfactory. Most notifying practitioners either do not state the patient's occupation or use general terms that do not indicate any particular environmental exposure. In spite of the difficulties, some notifications do contain specific information on the occupation. For the period 1968-1977, analyses on cancer incidence in occupational groups were confined to Chinese males aged 35-64. Due to the lack of relevant population data, relative risks were based on the Standardised Relative Proportional Risk (SRPR), standardised for age, dialect group and place of birth. Managers and clerical workers seem to have high SRPRs for cancer of the large bowel, but low SRPRs for cancer of the lung and oesophagus. High SRPRs for lung and oesophagus are seen in some groups of manual workers (e.g., bricklayers, carpenters, transport equipment operators and labourers not otherwise specified). There is also a high SRPR for skin cancer among farmers. PMID- 6497340 TI - Lung cancer among underground workers in the iron ore mine of Kiruna based on thirty years of observation. AB - A previous study showed a three-fold increase in the risk of dying from lung cancer among underground workers in the iron ore mine in Lapland. The present report describes a follow-up covering the period 1971-1980. On the basis of data obtained in both studies an attempt is made to examine the time trend and to estimate the lifetime risk of developing lung cancer from alpha radiation from the decay of radon and its daughter products. The risk of dying from lung cancer among underground workers was seven times the corresponding risk among all other men in the community. The calculated risks for the populations working underground in 1951-1970 and 1971-1980 (ages 30-74 years) were 9.2 and 13.1 cases per 10(6) person-years and working level month respectively. The corresponding calculated risk for ages 50-64 years for 1971-1980, was 22 cases. Based on the accumulated mortality from lung cancer among mine workers exposed to radon underground in 1921-1940, the expected excess number of lung cancers in the population exposed underground in 1951-1980 is 59. So far only a total of seven cases have been observed. PMID- 6497341 TI - A prospective study on early neurotoxic effects of lead. AB - A prospective follow-up study on new lead workers who entered a storage battery factory was carried out between 1975 and 1981. Nerve conduction velocities and psychological performance were recorded before the commencement of exposure and after one, two, and four years of work, respectively. Out of an initial number of 89 workers, 23 were available for the 1-year, 16 for the 2-year and 11 for the 4 year re-examination. The reference group comprised non-exposed workers of a cable manufacturing plant and an electrical power plant. Especially the sensory conduction velocities of the median nerve decreased during the 2-year follow-up. When divided into two groups according to the median Pb-B values (27-30 micrograms/100 ml), the higher exposure group showed slower values for several motor and sensory conduction velocities at the 1- and 2-year examination as compared with the lower group. Also visual intelligence and visuomotor functions had impaired significantly. The learning effect for some psychological tests which was clearly evident among the referents, was almost absent among the lead workers. After four years only 11 lead workers remained. This together with selection in the drop-out, resulted in that the group differences found for conduction velocities and psychological tests did not reach statistical significance anymore. PMID- 6497342 TI - Reproduction and exposure to lead. AB - A study on spontaneous abortions and twinning rate was carried out in a commune with a lead smeltery and in a control commune without a specific source of lead exposure. For a period of 20 years (1961-1980) information on spontaneous abortions was recorded from vital statistics data. Data on twin deliveries were obtained from the birth certificates. The additional information regarding sex of twins, maternal age of delivery and mother's and father's occupations were recorded by an interview. To each twin birth two singleton births were matched by the area of residence and date of birth. Pollution measurements data on lead, zinc and cadmium were also evaluated. The average annual rate of spontaneous abortions in the commune with a lead smeltery was 12/1000 and in the control commune 6.7/1000 fertile women. The cumulative rate of twin births was 2.4/1000 inhabitants in the commune with a lead smeltery and 2.6/1000 inhabitants in the control commune. However, in the commune with a lead smeltery in the area actually exposed to lead the cumulative rate of twin deliveries over 20 years was 1.7/1000 inhabitants and in the rest of the commune it was 2.7/1000 inhabitants. The results indicate a possible interference of lead exposure with reproduction. PMID- 6497343 TI - Prognosis of mercury poisoning in mercury refinery workers. AB - The prognosis of chronic metallic mercury poisoning in two groups of patients from the mercury refinery of a mercury mine was evaluated by reexamination which included an interview, physical and neurological examination and determination of urinary mercury. Group I consisted of 70 male patients, who had been exposed to metallic mercury for 1.6-17.8 years, 15 of whom had been diagnosed 10 years earlier as having severe chronic metallic mercury poisoning, and the rest moderate chronic metallic mercury poisoning. At the time of reexamination, they had been removed from mercury exposure for 2 months-17 years. None of them had been treated with any chelating agent. Group 2 comprised 84 male patients from the same mercury mine, who had been exposed to metallic mercury for 2-10 years after 1962 and had been previously diagnosed as having mild chronic metallic mercury poisoning. They were reexamined after 2 months of hospital admission and chelation treatment with unithiol or sodium dimercaptosuccinate (Na-DMS). Based on clinical evaluation, the condition of the patients in both groups had all improved, even in the severe cases. The overall prognosis of chronic metallic mercury poisoning in mercury refinery workers was encouraging after termination of mercury exposure. Chelation therapy with unithiol or Na-DMS was evidently beneficial for reducing urine mercury and some symptoms, but not for neurological and stomal signs. PMID- 6497344 TI - Congenital malformations, mortality and styrene exposure. AB - The prevalence of congenital malformations among children born to styrene-exposed male and female workers, as well as the mortality of the exposed workers, was studied. A cohort of 2,209 workers (1,698 men, 511 women) was selected from the personnel files of 160 workplaces using styrene in the manufacture of reinforced plastic products. The earliest exposure histories began in 1960, but the majority of workers had been exposed after 1967. The data on children born to the exposed workers were linked with those of the Register of Congenital Malformations. The number of malformations of children born to the workers was, both before and during the styrene exposure, below the expected values. In the cohort there were 37 observed deaths (expected 74.0), six of which were due to cancer (expected 13.0). The cancer sites were the stomach (2 cases), bronchus (1), breast (1), ovary (1), and kidney (1 case). There were no cases of lymphatic or haematopoietic cancer. Most of the cancers appeared after short exposure times and soon after the commencement of exposure. PMID- 6497345 TI - An epidemiological study of lung functions and hearing acuity in Singapore firemen. AB - This study was conducted on 506 firemen in Singapore. Interviews, pulmonary function tests and audiometry were conducted. With regard to pulmonary function, the results showed that forced vital capacity (FVC) increased up to the age of 25 30 years for both Chinese and Malays. Both FVC and forced expiratory volume in one second (FEV1.0) increased with standing height over the whole age range studied. The mean values of FVC and FEV1.0 were higher in Chinese. It was also found that the FEV1 of the subjects in the study showed a greater decline in rate with age than other workers studied by the authors previously. The hearing threshold of 83 fire fighters showed a prominent upward shift of 6-8 KHz at ages 20-30. This upward shift was more pronounced in the right ear. The implications of the findings are discussed and a comparison with results of other similar studies in other countries is made. PMID- 6497346 TI - Sickness absence in a Singapore refinery. AB - Most of the literature on sickness absenteeism is derived from western countries where absenteeism is high and has been rising over the years. Less is known of the situation in the newly developing countries of the east. This paper analyses sickness absenteeism in male industrial employees in a major oil refinery in Singapore in 1982. On average each worker had 5.1 spells and 7.0 working days of absence attributed to illness. Absenteeism increased with age, and shift workers were found to have twice as much sick leave as day workers. However more younger workers had longer durations of absence than older workers. This was because chronic medical conditions more commonly associated with increasing age did not contribute significantly to long spells of absence. A variety of surgical operations, followed by accidents, were the main causes of long absences. The absence rate of 7.0 days per worker was much lower than most of the published data from Europe, and was comparable to two shipyards in Singapore. PMID- 6497347 TI - An analysis of sickness absence and clinic visits among employees of a company in Kuwait. AB - A study was conducted to determine the frequency of clinic visits by, and the incidence and duration of sickness absence among employees of a company in Kuwait. The company employs about 2,000 employees who work in various departments located throughout Kuwait, and have varied access to the company clinic which was established in 1978. During the three year period October 1979 to September 1982, the mean frequency of visits to the company clinic among a selected population of 1,000 employees was about 6 visits per employee per year. No significant difference was found in this frequency between the years, or between different months in the year. However, the distance of the place of work from the clinic, and the nature of work appeared to influence the frequency of clinic visits. Looking at sickness absence among a selected population of 1,750 employees, the mean incidence was about 0.55 percent per working day, and the mean duration of sickness absence was about 4 days per employee per year. This mean duration of sickness absence is very low compared to the average of 19 days' absence in Britain in 1978-79, and earlier European averages ranging between 12 and 21 days; and is possibly influenced by the difference between sick leave regulations in these countries. PMID- 6497348 TI - A study of work injuries in eight Asian countries. AB - This study is based on a survey conducted in Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore, Sri Lanka and Thailand on occupational injuries during the years 1975-1980. The number of work accidents have risen rapidly during this period in all of the 8 countries studied. In the case of Thailand, the total number of work injuries increased four fold from 1975-1978, whereas, in Singapore it has almost doubled in 6 years. The number of permanent disablement nearly trebled in Korea, and the Philippines for the year 1967-1980. The largest percentage of accidents are lost-time injuries in all of the 8 countries. Thailand had a three fold increase in lost-time injuries whilst in Hong Kong the figure doubled. Six out of the 8 countries indicated that the building construction industry had the largest number of fatal accidents, followed by the manufacturing industry. PMID- 6497349 TI - 14th annual meeting of the European Thyroid Association. Rotterdam, 3-7 September 1984. Abstracts. PMID- 6497350 TI - Mutation and selection in the marker (X) syndrome. A hypothesis. AB - Sherman et al. (1984) concluded from a cytogenetic and genetic analysis of families with the marker (X) syndrome that the rate of the mutation leading to this syndrome is extraordinarily high (7.2 X 10(-4) in male germ cells), and that these mutations occur exclusively in male germ cells. It is shown by some model calculations that the empirical evidence can be reconciled with more conventional assumptions on the mutation rate if a moderately increased fertility of clinically unaffected female and possibly male carriers in the past is assumed. Indirect evidence for such an increased fertility can be derived from old reports on higher reproduction of slightly subnormal individuals. On the other hand, complete compensation of gene loss in affected individuals by higher fertility of unaffected carriers appears to be rather unlikely. At present, a moderately high mutation rate--as found, for example, in Duchenne muscular dystrophy or haemophilia A--in combination with a moderately increased fertility of clinically unaffected carriers is the most likely alternative. PMID- 6497351 TI - On the lod score method in linkage analysis. AB - Genetic epidemiology deals with the interaction of environmental and genetic determinants in common diseases. Linkage analysis is an important branch of this field. The current practice of claiming linkage between two genetic loci when the maximum lod score z(theta) exceeds 3 has not received theoretical justification, whether considered as a sequential or as a fixed sample size test. Within the framework of significance testing, Wald's (1947) formulae are not applicable to allow this procedure a sequential interpretation. Considered as a fixed sample size test, we find that a chi 2 approximation would instead be very adequate. Since repeated significance testing is performed on linkage data, the nominal significance level should be more stringent for each test than the overall level. Some recent developments in group sequential trials by Pocock (1977) and in repeated significance testing by Woodroofe (1979) seem to indicate that the critical value of the maximum lod score should lie roughly between 0.9 and 3.3, depending on the maximum number of repetitions anticipated, on whether the significance level is desired to be 0.05, 0.01 or 0.001, and on whether the test is derived from a one-sided or a two-sided consideration. In terms of the group sequential approach, if a maximum of twenty repetitions is allowed, if z(theta) greater than log10 A is considered as a one-sided test and assumed to be symmetric when linkage is absent, then the type I error is approximately given by 1/A. We also treat the confidence interval approach for exclusion of unlikely recombination values. PMID- 6497352 TI - Age-related differences in brain electrical activity of healthy subjects. AB - A combined neurophysiological (electroencephalographic [EEG] and sensory evoked potential) and neuropsychological investigation was performed on 63 healthy men ranging in age from 30 to 80 years. Although alpha frequency diminished slightly with age, neither amplitude nor frequency demonstrated a high age correlation. Alpha blocking, in contrast, did correlate with age, in the direction of reduced alpha reactivity. EEG background activity underwent significant age-correlated change, consisting of reductions in slow activity and augmentation of fast activity, i.e., EEG desynchronization. Previously reported age-related EEG slowing may be related to the presence of disease in the populations studied. Topographic analysis revealed that the greatest change occurred in the temporal lobes. More change was noted either early or late in the age span, suggesting that aging is a nonlinear process. More features were derived from the right hemisphere than from the left, suggesting that the aging process is not completely symmetrical. PMID- 6497353 TI - Brain electrical activity in patients with presenile and senile dementia of the Alzheimer type. AB - Neurophysiological and behavioral data obtained from 9 patients with presenile dementia and 10 with senile dementia of the Alzheimer type were compared with similar data from 25 age- and sex-equivalent controls. Compared with the healthy controls, both patients groups demonstrated increased background electroencephalographic slowing with a reduction in fast activity (synchronization). Topographic analyses of data from electroencephalographic and evoked potential studies indicate that areas of maximal group differences between the presenile patients and their controls include the right posterior temporal and, to a lesser extent, left midtemporal to anterior temporal areas, whereas the maximal differences between the senile patient group and their controls involve the midfrontal and anterior frontal lobes, bilaterally. Moreover, right-sided numerical features derived from topographic maps proved most useful in differentiating the presenile patients and their age-matched controls, whereas bilateral features were more useful in separating senile patients from their controls. These topographic dissimilarities between patient groups suggest that an age-disease interaction exists between patients with presenile and senile dementia of the Alzheimer type. Correlational analyses between neuropsychological test scores and neurophysiological features indicate that increased slowing and decreased fast activity were associated with poorer test performance. PMID- 6497354 TI - Effect of aging on the accuracy of visually guided saccadic eye movement. AB - Changes in oculomotor behaviors with aging were studied in normal young and elderly subjects. Saccadic eye movements induced by presentation of a visual target were analyzed. Elderly subjects commonly showed an elongation of the time to locate the target, accompanied by an increase in reaction times (mean increase, 100 ms) and a decrease in saccadic velocities. The decrease in the velocity was particularly notable when a large-amplitude saccade was executed. In spite of the slowed motor responses, most elderly subjects preserved the function necessary to execute a correct saccade toward the visual target. The saccadic slowing was accompanied by an increase in saccade duration. Although a longer time was necessary for elderly subjects to locate the target, the accuracy of the initial saccades was not different from that of young subjects. One group of elderly subjects showed extremely long reaction times. These subjects, displaying no abnormal neurological symptoms, were not able to locate the visual target with initial saccades. They had to execute multistep saccades typically seen in patients with degenerative neurological diseases. PMID- 6497355 TI - Hereditary dysphasic dementia and the Pick-Alzheimer spectrum. AB - Hereditary dysphasic dementia is described in terms of its clinicopathological, ultrastructural, and transmissibility characteristics. Its mode of inheritance is autosomal dominant, and its clinical manifestations of progressive dementia and severe dysphasic disturbances are expressed in late adulthood. Complete neuropathological examination of four patients reveals findings typical for Pick's disease (asymmetrical focal cerebral atrophy), Alzheimer's disease (profuse neuritic plaques), and paralysis agitans (neuronal depigmentation, depletion, and Lewy body formation in substantia nigra) in addition to a striking but nonspecific spongiform degeneration of superficial cortical layers. This unique combination of gross morphological and histopathological features qualifies hereditary dysphasic dementia as a distinct entity, but its precise relationship to the well-recognized adult cortical dementias has been difficult to establish by conventional classification methods. This disorder and other unusual dementing illnesses may be best considered as part of a Pick-Alzheimer spectrum of cortical neuronal degenerations. PMID- 6497356 TI - Transient visual obscurations with elevated optic discs. AB - The pathogenesis of the transient obscurations of vision that occur with papilledema is a subject of speculation and debate. We present four examples of transient obscurations of vision that were clinically indistinguishable from those of papilledema; they occurred in patients with elevated optic discs from causes not related to increased intracranial pressure. The underlying mechanism for visual obscurations in all of these patients appear to be transient ischemia of the optic nerve head consequent to increased tissue pressure. Axonal swelling, intraneural masses, and increased influx of interstitial fluid may all contribute to increases in tissue pressure in the optic nerve head. The consequent reduction in perfusion pressure renders the small, low-pressure vessels that supply the optic nerve head vulnerable to compromise. Brief fluctuations in intracranial or systemic blood pressure may then result in transient loss of function in the eyes. We postulate that such mechanisms may apply in all cases of optic disc elevation, including papilledema. PMID- 6497357 TI - Conjugate eye deviation after acute hemispheric stroke: delayed recovery after previous contralateral frontal lobe damage. AB - In 42 patients with acute unilateral ischemic or hemorrhagic hemispheric stroke, conjugate eye deviation toward the lesioned side was usually of brief duration. It subsided within 48 hours in 24 patients (57%) and lasted no longer than 5 days in 38 patients (90%). Early disappearance of conjugate eye deviation was an isolated phenomenon and preceded any improvement in the other focal neurological deficits, which persisted in their initial severity. In 6 additional patients with stroke, conjugate eye deviation was remarkably prolonged, lasting from 13 to more than 43 days. In all 6 there was evidence for preexisting damage to the contralateral frontal region. Our study suggests that early recovery of conjugate eye deviation in patients with acute hemispheric stroke may be mediated by the contralateral unaffected frontal eye field. PMID- 6497358 TI - The swine flu incident revisited. PMID- 6497359 TI - Motor signs are infrequent in dementia of the Alzheimer type. PMID- 6497360 TI - Catecholamines and amnesia: the need for psychometric verification. PMID- 6497361 TI - [Pre-exposure to a response, Lubow effect and masking in the learning of bidirectional avoidance]. PMID- 6497362 TI - [Ways of analyzing an unperceived change in 3.0 to 6.6-year-old children]. PMID- 6497363 TI - [Hemispheric specialization and word memory: effects of an interfering task]. PMID- 6497364 TI - [How do the eyes explore written lines?]. PMID- 6497365 TI - [Current age of the menarche in Belgium]. AB - In Belgium, as in most industrialized countries, studies about menarcheal age have shown an earlier physical and sexual maturation. In this paper we will consider the secular trend in menarcheal age over the last twenty years in Brussels. The results concerning menstruation have been obtained in 1980-1982 from 1048 Belgian girls aged between 9 and 17. These girls have very varied socio economic backgrounds, representative of the diversity of social origin in the Belgian population of Brussels (city and suburbs). Our data were collected using the status quo-method and compared with Jeurissen's (menarcheal age in Belgium between 1915 and 1959). Percentiles and probits were used. The lower limit, where 10% of the girls have had their menarches remains more or less constant. Between 1915 and 1959, Jeurissen noted the tendency of the median menarcheal age toward earlier sexual maturation from 14 years 4 months to 13.0. But, for the first time in Belgium, it seems that the median age is stabilized at 13.0 years. However, the higher limit (age, where 90% have had their menarches) is attained at a lower age: 15.0 for girls born between 1950-1954 and 14.0 in our sample. In conclusion, it seems that better conditions of life cause an evolution in the cases of late menarches but have no more repercussions on the median menarcheal age in this Belgian group. PMID- 6497366 TI - [Age of the menarche of girls in Thessaloniki, Greece]. AB - In 1982-1983 a total of 977 girls from Thessaloniki has been investigated for their menarcheal ages, using the retrospective and the status quo methods. 565 of these girls aged between 11 and 18.5 years (age classes 1964-1972) were found to menstruate. The mean menarcheal age amounts to 12.0 years. The results are compared with corresponding data from literature. They confirm a clear secular trend for the menarcheal age in Greek population. PMID- 6497367 TI - "Taco" tongue fold in Seminole Indians. AB - Two Florida Seminole Indians demonstrated the ability to fold the tongue longitudinally, with the open side either to the right or to the left. PMID- 6497368 TI - Heat injury and repair in Campylobacter jejuni. AB - A procedure for detecting and quantitating heat injury in Campylobacter jejuni was developed. Washed cells of C. jejuni A7455 were heated in potassium phosphate buffer (0.1 M, pH 7.3) at 46 degrees C. Samples were plated on brucella agar supplemented with Na2S2O3, FeSO4 X 7H2O, and sodium pyruvate and on a medium containing brilliant green, bile, Na2S2O3, FeSO4 X 7H2O, and sodium pyruvate. Colonies were counted after 5 days of incubation at 37 degrees C in an atmosphere containing 5% O2, 10% CO2, and 85% N2. After 45 min at 46 degrees C, there was virtually no killing and ca. two log cycles of injury. Cells grown at 42 degrees C were more susceptible to injury than cells grown at 37 degrees C. The addition to brucella agar supplemented with Na2S2O3, FeSO4 X 7H2O, and sodium pyruvate of three different antibiotic mixtures used in the isolation of C. jejuni from foods or clinical specimens did not prevent recovery of heat-injured C. jejuni. Cells lost 260 nm of absorbing materials during heat injury. The addition of 5% NaCl or 40% sucrose to the heating buffer prevented leakage but did not prevent injury. Of the additional salts, sugars, and amino acids tested for protection, only NH4Cl, KCl, and LiCl2 prevented injury. Heat-injured C. jejuni repaired (regained dye and bile tolerance) in brucella broth supplemented with Na2S2O3, FeSO4 X 7H2O, and sodium pyruvate within 4 h. Increasing the NaCl in this medium to 1.25% inhibited repair, and increasing it to 2% was lethal. Heat-injured C. jejuni will repair at 42 degrees C but not at 5 degrees C. PMID- 6497369 TI - Mechanisms and pathways of aniline elimination from aquatic environments. AB - The fate of aniline, a representative of arylamine pollutants derived from the manufacture of dyes, coal liquefaction, and pesticide degradation, was comprehensively evaluated by use of unpolluted and polluted pond water as model environments. Evaporation plus autoxidation proved to be minor elimination mechanisms, removing ca. 1% of the added aniline per day. Instantaneous binding to humic components of a 0.1% sewage sludge inoculum removed 4%. Biodegradation of aniline in pond water was accelerated by the sewage sludge inoculum. A substantial portion of the degraded aniline carbon was mineralized to CO2 within a 1-week period, and microbial biomass was formed as a result of aniline utilization. Biodegradation was clearly the most significant removal mechanism of polluting aniline from pond water. A gas chromatographic-mass spectrometric analysis of biodegradation intermediates revealed that the major pathway of aniline biodegradation in pond water involved oxidative deamination to catechol, which was further metabolized through cis,cis-muconic, beta-ketoadipic, levulinic, and succinic acid intermediates to CO2. Minor biodegradation pathways involved reversible acylation to acetanilide and formanilide, whereas N-oxidation resulted in small amounts of oligomeric condensation products. PMID- 6497370 TI - Effect of proteins on reovirus adsorption to clay minerals. AB - Organic matter in sewage, soil, and aquatic systems may enhance or inhibit the infectivity of viruses associated with particulates (e.g., clay minerals, sediments). The purpose of this investigation was to identify the mechanisms whereby organic matter, in the form of defined proteins, affects the adsorption of reovirus to the clay minerals kaolinite and montmorillonite and its subsequent infectivity. Chymotrypsin and ovalbumin reduced the adsorption of reovirus to kaolinite and montmorillonite homoionic to sodium. Lysozyme did not reduce the adsorption of the virus to kaolinite, but it did reduce adsorption to montmorillonite. The proteins apparently competed with the reovirus for sites on the clay. As lysozyme does not adsorb to kaolinite by cation exchange, it did not inhibit the adsorption of reovirus to this clay. The amount of reovirus desorbed from lysozyme-coated montmorillonite was approximately 38% less (compared with the input population) than that from uncoated or chymotrypsin-coated montmorillonite after six washings with sterile distilled water. Chymotrypsin and lysozyme markedly decreased reovirus infectivity in distilled water, whereas infectivity of the virus was enhanced after recovery from an ovalbumin-distilled water-reovirus suspension (i.e., from the immiscible pelleted fraction plus supernatant). The results of these studies indicate that the persistence of reovirus in terrestrial and aquatic environments may vary with the type of organic matter and clay mineral with which the virus comes in contact. PMID- 6497371 TI - Antagonism by gram-negative bacteria to growth of Yersinia enterocolitica in mixed cultures. AB - The inhibition of the growth of Yersinia enterocolitica by other gram-negative bacteria in mixed cultures at 32 degrees C was not the consequence of a depletion in essential nutrients, an unfavorable change in pH or oxygen tension or the production of toxic metabolic products. The inability of Y. enterocolitica to attain its potential maximum population in mixed cultures appeared instead to result from "metabolic crowding," which occurred when the faster-growing antagonistic organism reached stationary-phase density. Lowering the incubation temperature, a technique commonly used in "cold" enrichment for isolation of Y. enterocolitica, tended to equalize growth rates and thereby allowed Y. enterocolitica to achieve a higher population. PMID- 6497372 TI - Dynamics of pollution-indicator and heterotrophic bacteria in sewage treatment lagoons. AB - The spatio-temporal dynamics of pollution-indicator bacteria and aerobic heterotrophic bacteria were studied in the sewage treatment lagoons of an urban wastewater center after 26 months of biweekly sampling at eight stations in these lagoons. Robust statistical methods of time-series analysis were used to study successional steps (through chronological clustering) and rhythmic behavior through time (through contingency periodogram). The aerobic heterotrophic bacterial community showed two types of temporal evolution: in the first four stations, it seems mainly controlled by the nutrient support capacity of the sewage input, whereas in the remaining part of the lagoon, it seems likely that the pollution-indicator bacteria are gradually replaced by other bacterial types that are better adapted to this environment. On the other hand, the pollution indicator bacteria showed an annual cycle which increased in amplitude at distances further from the wastewater source. The main events in this cycle were produced simultaneously at all stations, indicating control of these bacterial populations by climatic factors, which act through physical and chemical factors, and also through other biological components of this ecosystem (phytoplankton and zooplankton). Finally, we use results from this study to suggest a modified design for a future study program. PMID- 6497373 TI - Microbiological contamination of raw materials for large-volume parenterals. AB - A wide range of raw materials used for the production of large-volume parenterals were tested for their content of bacteria, molds, yeasts, and endotoxins. All raw materials were relatively free of microorganisms, although some mannitol samples contained relatively high amounts of endotoxin. The low endotoxin content of the other raw materials did not require the use of depth filters to remove endotoxins to prepare pyrogen-free infusion fluids. PMID- 6497374 TI - Inactivation of Giardia lamblia cysts with ozone. AB - Giardia lamblia cysts were inactivated in water with ozone at pH 7.0 and 5 and 25 degrees C. The concentration-time products for 99% inactivation were 0.53 and 0.17 mg-min/liter at 5 and 25 degrees C, respectively. These products were significantly lower than those reported for chlorine. PMID- 6497375 TI - Superoxide dismutase in ruminal bacteria. AB - Of 13 species of anaerobic ruminal bacteria examined, 11 were found to contain measurable levels of superoxide dismutase activity. Four of five other strict anaerobic species studied for comparison were found to contain superoxide dismutase activity. PMID- 6497376 TI - Purification and characterization of an extracellular H2O2-requiring diarylpropane oxygenase from the white rot basidiomycete, Phanerochaete chrysosporium. AB - An H2O2-requiring oxygenase found in the extracellular medium of ligninolytic cultures of the white rot fungus Phanerochaete chrysosporium was purified by DEAE Sepharose ion-exchange chromatography and gel filtration on Sephadex G-100. Sodium dodecyl sulfate (SDS)-disc gel electrophoresis indicated that the purified protein was homogeneous. The Mr of the enzyme as determined by gel filtration and SDS-polyacrylamide gel electrophoresis was 41,000. The absorption spectrum of the enzyme indicated the presence of a heme prosthetic group. The absorption maximum of the native enzyme (407 nm) shifted to 435 nm in the reduced enzyme and to 420 nm in the reduced-CO complex. The pyridine hemochrome absorption spectrum indicated that the enzyme contained one molecule of heme as iron protoporphyrin IX. Both CN- and N-3 bound readily to the native enzyme, indicating an available coordination site and that the heme iron was high spin. The purified enzyme generated ethylene from 2-keto-4-thiomethyl butyric acid, and oxidized a variety of lignin model compounds, including the diarylpropane, 1-(3'4' diethoxyphenyl)1,3-dihydroxy-2-(4"-methoxyphenyl)propane (I); a beta-ether dimer, 1-(4'-ethoxy-3'-methoxyphenyl)glycerol-beta-guaiacyl ether (V); an olefin, 1-(4' ethoxy-3'-methoxyphenyl)-1,2 propene (III); and a diol, 1-(4'-ethoxy-3' methoxyphenyl)-1,2-propane diol (IV). The products found were equivalent to the metabolic products previously isolated from intact ligninolytic cultures. PMID- 6497377 TI - The primary structure of the COOH-terminal half of cholera toxin subunit A1 containing the ADP-ribosylation site. AB - The sequence of 96 amino acid residues from the COOH-terminus of the active subunit of cholera toxin, A1, has been determined as (sequence; see text) This is the largest fragment obtained by BrCN cleavage of the subunit A1 (Mr 23,000), and has previously been indicated to contain the active site for the adenylate cyclase-stimulating activity. Unequivocal identification of the COOH-terminal structure was achieved by separation and analysis of the terminal peptide after the specific chemical cleavage at the only cysteine residue in A1 polypeptide. The site of self ADP-ribosylation in the A1 subunit [C. Y. Lai, Q.-C. Xia, and P.T. Salotra (1983) Biochem. Biophys. Res. Commun. 116, 341-348] has now been identified as Arg-50 of this peptide, 46 residues removed from the COOH-terminus. The cysteine that forms disulfide bridge to A2 subunit in the holotoxin is at position 91. PMID- 6497378 TI - Regulation of pyruvate oxidation in blowfly flight muscle mitochondria: requirement for ADP. AB - Blowfly (Phormia regina) flight muscle mitochondria oxidized pyruvate ( + proline) in the presence of either ADP (coupled respiration) or carbonylcyanide-p trifluoromethoxyphenylhydrazone (FCCP-uncoupled respiration). There was an absolute requirement for ADP (Km = 8.0 microM) when pyruvate oxidation was stimulated by FCCP in the presence of oligomycin. This requirement for ADP was limited to the oxidation of pyruvate; uncoupled alpha-glycerolphosphate oxidation proceeded maximally even in the absence of added ADP. Atractylate inhibited uncoupled pyruvate oxidation whether added before (greater than 99%) or after (95%) initiation of respiration with FCCP. In the presence of FCCP, oligomycin, and limiting concentrations of ADP (less than 110 microM), there was a shutoff in the uptake of oxygen. This inhibition of respiration was completely reversed by the addition of more ADP. Plots of net oxygen uptake as a function of the limiting ADP concentration were linear; the observed ADP/O ratio was 0.22 +/- 0.025. An ADP/O ratio of 0.2 was predicted if phosphorylation occurred only at the succinyl-CoA synthetase step of the tricarboxylate cycle. Experiments performed in the presence of limiting concentrations of ADP, and designed to monitor changes in the mitochondrial content of ADP and ATP, demonstrated that the shutoff in oxygen uptake was not due to the presence of a high intramitochondrial concentration of ATP. Indeed, ATP, added to the medium prior to the addition of FCCP, inhibited uncoupled pyruvate oxidation; the apparent KI was 0.8 mM. These results are consistent with the hypothesis that it is the intramitochondrial ATP/ADP ratio that is one of the controlling factors in determining the rate of flux through the tricarboxylate cycle. Changes in the mitochondrial content of citrate, isocitrate, alpha-ketoglutarate, and malate during uncoupled pyruvate oxidation in the presence of a limiting concentration of ADP were consistent with the hypothesis that the mitochondrial NAD + -linked isocitric dehydrogenase is a major site for such control through the tricarboxylate cycle. PMID- 6497379 TI - Lapachol inhibition of vitamin K epoxide reductase and vitamin K quinone reductase. AB - Lapachol [2-hydroxy-3-(3-methyl-2-butenyl)-1,4-naphthoquinone] has been shown to be a potent inhibitor of both vitamin K epoxide reductase and the dithiothreitol dependent vitamin K quinone reductase of rat liver microsomes in vitro. These observations explain the anticoagulant activity of lapachol previously observed in both rats and humans. Lapachol inhibition of the vitamin K epoxide and quinone reductases resembled coumarin anticoagulant inhibition, and was observed in normal strain but not in warfarin-resistant strain rat liver microsomes. This similarity of action suggests that the lactone functionality of the coumarins is not critical for their activity. The initial-velocity steady-state inhibition patterns for lapachol inhibition of the solubilized vitamin K epoxide reductase were consistent with tight binding of lapachol to the oxidized form of the enzyme, and somewhat lower affinity for the reduced form. It is proposed that lapachol assumes a 4-enol tautomeric structure similar to that of the 4-hydroxy coumarins. These structures are analogs of the postulated hydroxyvitamin K enolate intermediate bound to the oxidized form of the enzyme in the chemical reaction mechanism of vitamin K epoxide reductase, thus explaining their high affinity. PMID- 6497380 TI - Modulation of the activity of NAD malic enzyme from solanum tuberosum by changes in oligomeric state. AB - The effects of pH, NaCl, and malate2- on the equilibrium between dimeric and higher-molecular-weight forms of NAD malic enzyme from Solanum tuberosum var. Chieftain have been analyzed by monitoring the kinetic changes associated with disaggregation [S. D. Grover and R. T. Wedding (1982) Plant Physiol. 70, 1169 1172]. At pH values above 7.0 the enzyme was disaggregated to the dimeric, high Km(malate) form by preincubation with NaCl, with a half-maximal effect at 25 mM. At low pH the enzyme remained in the low-Km(malate) (tetramer or octamer) form. Malate protected against disaggregation to the high-Km form in preincubation, and this effect was half-maximal at 6 mM. At pH 7.3, in the absence of malate, half maximal disaggregation occurred at 580 nM enzyme. Varying the enzyme concentration in the assay led to kinetic changes which fit equations based on an associating enzyme model [B. I. Kurganov (1967) Mol. Biol. (Moscow) 1, 17-27]. This analysis confirmed that the dimer has intrinsic activity, with Vm somewhat lower than that of the tetramer but a Km(malate) that was 9-fold higher than that of the tetramer. Malate decreased the Kd for disaggregation of the enzyme during assay approximately 20-fold, with a half-maximal effect at 3 to 4 mM. In contrast, high NaCl concentrations in the assay increased the Kd for disaggregation in a manner which was competitive with the effect of malate on Kd. The physiological significance of these aggregation state changes is discussed. PMID- 6497381 TI - Identification of calmodulin-sensitive and calmodulin-insensitive adenylate cyclase in rat kidney. AB - Adenylate cyclase from rat kidney membranes solubilized with Lubrol-PX, was resolved into calmodulin-insensitive and calmodulin-sensitive forms using DEAE Sephacel and calmodulin-Sepharose affinity chromatography. The major fraction, 90% of the activity recovered, did not bind to the calmodulin-Sepharose in the presence of Ca2+, and was insensitive to activation by calmodulin. The calmodulin sensitive enzyme, approximately 10% of the recovered activity, bound to the affinity column and was eluted with buffer containing 2 mM EGTA. In the presence of free Ca2+, calmodulin increased the specific activity of the calmodulin sensitive adenylate cyclase from 15.2 to 60.4 pmol/mg protein-1 min-1. Maximum stimulation occurred at 0.035-0.076 mM Ca2+. The apparent Ka for calmodulin was 8 nM. The calmodulin-mediated increase in activity was inhibited by trifluoperazine, but not by its analog trifluoperazine-5-oxide. In contrast, trifluoperazine did not inhibit the calmodulin-insensitive activity. The GTP analog, guanyl-5'-yl imidodiphosphate, did not activate either fraction. Furthermore, activation by calmodulin did not require the presence of a guanyl nucleotide. The present finding of a calmodulin-sensitive form of adenylate cyclase in kidney raises the possibility that a calmodulin-mediated mechanism is involved in the formation of cAMP in this organ. PMID- 6497382 TI - Anomalous behavior of bovine alpha s1- and beta-caseins on gel electrophoresis in sodium dodecyl sulfate buffers. AB - Electrophoresis in the presence of sodium dodecyl sulfate (SDS) provides a relatively simple means of determining molecular weights of proteins. This technique relies on the validity of a correlation between some function of Mr and the mobility of the protein through the gel matrix. However, bovine caseins (especially alpha s1-casein) have lower mobilities than expected on the basis of their known Mr. The binding of SDS to both alpha s1-casein (Mr 23,600) and beta casein (Mr 24,000) reached a maximum at the slightly low value of 1.3 g SDS/g protein. Gel-filtration chromatography showed, however, that the alpha s1 casein:SDS complex was larger than the beta-casein:SDS complex at pH 6.8 or 7.0, but that they were similar in size at pH 2.9 or 3.0. Circular dichroism spectra indicated that the low helical structure content of both alpha s1- and beta casein increased with the addition of SDS and/or decreasing the pH to 1.5. 13C NMR results showed that SDS bound to alpha s1- and beta-casein in the same way as it did to bovine serum albumin. Either esterification or dephosphorylation followed by amidation of alpha s1-casein increased its mobility in SDS-gel electrophoresis, but neither modification affected beta-casein mobility. These and other results indicate that the low electrophoretic velocity of alpha s1 casein in SDS-gel electrophoresis results from its unexpectedly large hydrodynamic size. This is caused by localized high negative charges on certain segments of alpha s1-casein, which would induce a considerable amount of inter- and intrasegmental electrostatic repulsion, leading to an expanded or extended structure for portions of the alpha s1-casein molecule in the presence of SDS. It is clear that the conformation, and hence the equivalent radius, of an SDS:protein complex is determined by the sequence of amino acids in the protein and that, a priori, it cannot be anticipated that the electrophoretic mobility of such a complex will bear more than a casual relationship to the Mr of the protein. PMID- 6497383 TI - The time course of the interaction of sheep liver cytoplasmic aldehyde dehydrogenase with 2,2'- and 4,4'-dithiodipyridine: a comparison with the action of disulfiram. AB - 2,2'-Dithiodipyridine reacts rapidly with sheep liver cytoplasmic aldehyde dehydrogenase in the presence of NAD +, resulting in activation of the enzyme by 2 to 2.5-fold (when assayed in the usual way). This is followed by the slow loss of most of the enzyme activity during the next few hours at 25 degrees C. 2 Thiopyridone is displaced from the labeled enzyme at approximately the same rate as activity is lost. This is explained in terms of the initial modification of an enzymatic thiol group (giving activation) followed by the reaction of the labeled group with a second enzymatic thiol group, resulting in the formation of a disulfide bond and the inactivation of the enzyme. 4,4'-Dithiodipyridine reacts in a broadly similar way, although both the loss of label and loss of activity are faster and do not correlate with each other as well as for the 2,2' isomer. The results suggest that the dithiodipyridines act to produce the same enzymatic disulfide bond as has been shown to arise from the reaction of the enzyme with disulfiram (a drug used in alcoholism treatment). The implications of the results are discussed with reference to the proposed mechanism of action of aldehyde dehydrogenase. It is concluded that the thiol group initially modified by disulfiram is unlikely to be catalytically essential to the dehydrogenase action of the enzyme. PMID- 6497384 TI - Spectroscopic evidence for anthracenedione antineoplastic agent self-association and complex formation with flavin nucleotides. AB - Dihydroxyanthraquinone (DHAQ) and ametantrone (anthraquinone) are two new anthracenedione antineoplastic agents which were found by proton NMR spectroscopy to self-associate in aqueous media. Self-association was consistent with a bimolecular model, with average association constant values of 3400 and 2900 M-1 determined for DHAQ and ametantrone, respectively. Both anthracenediones interacted with the flavin nucleotides FMN and FAD to produce concentration dependent upfield shifts of the flavin isoalloxazine ring proton signals, as observed by proton NMR spectroscopy. Average association constant values obtained for FMN-DHAQ, FAD-DHAQ, FMN-ametantrone, and FAD-ametantrone complexation were 5100, 2600, 4300, and 1600 m-1, respectively. Optical difference spectroscopy confirmed FMN-DHAQ complexation, which resulted in a hyperchromic, bathochromic shift of the DHAQ spectrum following addition of FMN. These results were consistent with the formation of a pi-pi bimolecular ring-stacking complex. Information obtained on anthracenedione self-association and complexation with flavins may be of consequence in the interpretation of anthracenedione-DNA binding data and flavoprotein-mediated anthracenedione metabolic activation. PMID- 6497385 TI - Malonyl-coenzyme A:isoflavone 7-O-glucoside-6"-O-malonyltransferase from roots of chick pea (Cicer arietinum L.). AB - A malonyltransferase which catalyzes the malonylation of isoflavone 7-O glucosides in position 6 of the glucose moiety using malonyl-coenzyme A as acyl donor has been purified 157-fold from 4-day-old roots of chick pea (Cicer arietinum L.). The enzyme showed a pH optimum of 8.0 and a molecular weight of 112,000. The Km for malonylcoenzyme A was 48 microM and, for the chick pea isoflavones biochanin A and formononetin, 36 and 24 microM, respectively. Various other isoflavone, flavone, and flavonol 7-O-glucosides and chalcone 4'-O glucosides were much poorer substrates. Flavonol 3-O-glucosides and isoflavone 4' O-glucosides were not malonylated by the malonyltransferase. PMID- 6497386 TI - The determination of the separation of tyrosine-99 and tyrosine-138 in calmodulin: radiationless energy transfer. AB - The average separation of the phenolic groups of tyrosine-99 and tyrosine-138 has been measured by radiationless energy transfer between each tyrosine and the nitro derivative of the second tyrosine. A separation of 16.7 +/- 0.7 A was found in the absence of Ca2+ and 15.5 +/- 0.7 A in the presence of Ca2+. PMID- 6497387 TI - A comparison of van't Hoff and calorimetric heats of binding to DNA using an ethidium selective electrode. AB - A liquid membrane electrode selective for ethidium ion was used to measure free ethidium in mixtures with calf thymus DNA. Electrode response was unaffected by variation in ionic strength from 1 mM to 0.5 M, and was not degraded over the temperature range studied. DNA-ethidium binding isotherms obtained with the electrode at 17.4, 25.4, 30.1, and 40.6 degrees C were fitted to a single class of excluded sites model for v ranging from 0.01 to 0.16. van't Hoff analysis of these data yielded delta H = -8300 cal/mol ethidium bound (in 0.5 M KCl, 10 mM Tris buffer, pH 10, 1 mM EDTA). Direct calorimetric measurements of the heat of complex formation led to a value of -7600 cal/mol at 25 degrees C in the same medium; the two results were not significantly different at the 95% confidence level. The agreement supports the validity of the ethidium selective electrode, and illustrates its utility in the study of ligand binding to nucleic acids and related materials. PMID- 6497388 TI - Purification of various forms of elongation factor 1 from rabbit reticulocytes. AB - Previous studies have indicated that the high-molecular-weight form of elongation factor 1 (EF-1H) contained four subunits (alpha, beta, gamma, and delta). Using the conventional methods of gel-filtration and ion-exchange chromatography, various forms of elongation factor 1 (EF-1 alpha, EF-1 beta delta, EF-1 beta gamma delta) have been purified from rabbit reticulocyte lysate. The procedure described allows one to purify these factors from a single batch of lysate in sufficient amounts for physical and biochemical studies. EF-1 alpha is a single polypeptide of Mr 52,000, and has an isoelectric point of 9.1. EF-1 beta delta and EF-1 beta gamma delta are composed of two and three nonidentical polypeptides, respectively, as judged by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. Both proteins can form stable aggregates in native conditions that can reach more than 2,000,000 Da. The isoelectric point for each polypeptide was determined; 5.8 for EF-1 beta, 5.5 for EF-1 gamma, and 4.8 for EF-1 delta. The activity of both proteins was compared on a molecular basis by their ability to stimulate EF-1 alpha in the poly(U)-directed synthesis of polyphenylalanine. On the basis of this assay EF-1 beta gamma delta is slightly more active than EF-1 beta delta. The similarity of the amino acid composition of EF-1 gamma and EF-1 delta and the molar ratio of alpha: beta: gamma: delta in EF-1H of approximately 1:1:0.5:0.5 have led to the conclusion that EF-1 delta is probably a breakdown product of EF-1 gamma, and that the native form of EF-1H probably contains only the alpha, beta, and gamma subunits. PMID- 6497389 TI - Phosphorylation of prostatic nuclear matrix proteins is under androgenic control. AB - Nuclear matrix fraction was isolated from rat ventral prostatic nuclei previously incubated with [gamma-32P]ATP to label nuclear phosphoproteins with 32P. A significant portion of the radioactivity was recovered in the phosphoproteins intrinsic to the nuclear matrix fraction. At 12 h after androgen deprivation (i.e., when a significant portion of the nuclear androgen receptor was known to be depleted), the rate, but not the extent, of phosphorylation of nuclear proteins (predominantly nonhistone proteins) was markedly reduced. Nuclear matrix fraction isolated from such preparations demonstrated a profound reduction in the rate of incorporation of 32P into the matrix-associated proteins without any apparent change in the gel electrophoretic profile of these proteins. The results indicate that the cAMP-independent protein kinase activity which catalyzes the phosphorylation of nuclear matrix proteins is under androgenic control. This may be germane to nuclear matrix-associated initial events in androgen action. PMID- 6497390 TI - Stability of the complex formed between French bean (Phaseolus vulgaris) phenylalanine ammonia-lyase and its transition-state analog. AB - Phenylalanine ammonia-lyase forms trans-cinnamate from L-phenylalanine, and thus stands at a gateway to secondary metabolism in higher plants. L-alpha-Amino-oxy beta-phenylpropanoic acid (L-AOPP), a very effective competitive inhibitor of this enzyme, is most probably a transition-state analog for the elimination reaction. A preparation of phenylalanine ammonia-lyase (PAL), obtained from diluted suspension cultures of French bean cells, was used to investigate the binding of this compound in vitro. After extensive dialysis, the inhibitor remained tightly bound to the enzyme unless both an increased temperature and L phenylalanine were provided, when the spectrophotometer trace of enzyme activity gradually approached linearity. Under such optimal catalytic conditions (37 degrees C; 25 mM L-phenylalanine; pH 8.8), dissociation of the enzyme-ligand complex took place with a half-time of approx 10 min. (This is much longer than reported for the enzyme from maize.) The consequences of these findings are discussed for investigations where L-AOPP is applied in vivo. These experiments have shown that the irreversible binding of the transition-state analog under appropriate conditions (0-4 degrees C, no L-phenylalanine) gave continued protection against attack on the enzyme by an excess of borohydride. By titrating the enzyme with increasing concentrations of analog and measuring the degree of protection afforded, the active-site concentration has been estimated. The turnover number (kcat = 0.8 s-1) given by this novel approach is of the same order of magnitude as previously reported from extensive purification of enzyme from other species. PMID- 6497391 TI - N-malonyltransferases from peanut. AB - Three distinct N-malonyltransferases were purified from peanut seedlings, accepting either anthranilic acid, D-tryptophan, or 3,4-dichloroaniline, respectively, as a substrate. Partially purified malonyl-CoA:D-tryptophan malonyltransferase also catalyzed the formation of the corresponding malonic acid conjugate when 1-aminocyclopropane-1-carboxylic acid was employed as a substrate. These N-malonyltransferases were clearly distinguished from several O malonyltransferase activities also present in the same seedlings. N-Malonic acid conjugates have been previously isolated from peanut either as a natural constituent or after feeding with xenobiotics. By analogy to the results reported with cultured parsley cells, multiple malonyltransferases in peanut may have a role in vacuolar transport. Crude extracts of young peanut seedlings were incapable of hydrolyzing the respective N-malonic acid conjugates. However, dialyzed extracts of older plants released malonic acid from malonyl-1 aminocyclopropane-1-carboxylic acid but not from malonyl-3,4-dichloroaniline, suggesting that some N-malonic acid conjugates may be metabolized in plants which are approaching senescence. PMID- 6497392 TI - Immunochemical evidence for a role of cytochrome P-450 in liver microsomal ethanol oxidation. AB - Antibodies to cytochrome P-450 isozyme 3a, the ethanol-inducible isozyme in rabbit liver, were used to determine the role of this enzyme in the microsomal oxidation of alcohols and the p-hydroxylation of aniline. P-450 isozymes, 2, 3b, 3c, 4, and 6 did not crossreact with anti-3a IgG as judged by Ouchterlony double diffusion, and radioimmunoassays indicated a crossreactivity of less than 1%. Greater than 90% of the activity of purified form 3a toward aniline, ethanol, n butanol, and n-pentanol was inhibited by the antibody in the reconstituted system. The catalytic activity of liver microsomes from control or ethanol treated rabbits was unaffected by the addition of either desferrioxamine (up to 1.0 mM) or EDTA (0.1 mM), suggesting that reactions involving the production of hydroxyl radicals from H2O2 and any contaminating iron in the system did not make a significant contribution to the microsomal activity. The addition of anti-3a IgG to hepatic microsomes from ethanol-treated rabbits inhibited the metabolism of ethanol, n-butanol, n-pentanol, and aniline by about 75, 70, 80, and 60%, respectively, while the inhibition of the activity of microsomes from control animals was only about one-half as great. The rate of microsomal H2O2 formation was inhibited to a lesser extent than the formation of acetaldehyde, thus suggesting that the antibody was acting to prevent the direct oxidation of ethanol by form 3a. Under conditions where purified NADPH-cytochrome P-450 reductase-catalyzed substrate oxidations was minimal, the P-450 isozymes other than 3a had low but significant activity toward the four substrates examined. The residual activity at maximal concentrations of the antibody most likely represents the sum of the activities of P-450 isozymes other than 3a present in the microsomal preparations. The results thus indicate that the enhanced monooxygenase activity of liver microsomes from ethanol-treated animals represents catalysis by P-450 isozyme 3a. PMID- 6497393 TI - Biosynthesis of ascaridole: iodide peroxidase-catalyzed synthesis of a monoterpene endoperoxide in soluble extracts of Chenopodium ambrosioides fruit. AB - Ascaridole, an asymmetric monoterpene endoperoxide with anthelmintic properties, occurs as a major constituent (60-80%) in the volatile oil of American wormseed fruit (Chenopodium ambrosioides: Chenopodiaceae), and as a lesser component in the leaf pocket oil of the boldo tree (Peumus boldus: Monimiaceae). Determination of optical activity and chromatographic resolution of naturally occurring ascaridole, and several synthetic derivatives, showed that both wormseed and boldo produce ascaridole in racemic form. The biosynthesis of ascaridole from the conjugated, symmetrical diene alpha-terpinene (a major component of the oil from wormseed) was shown to be catalyzed by a soluble iodide peroxidase isolated from homogenates of C. ambrosioides fruit and leaves. The enzymatic synthesis of ascaridole was confirmed by capillary gas-liquid chromatography and mass spectrometry of the product, which was also shown to be racemic. Optimal enzymatic activity occurred at pH 4.0 in the presence of 2.5 mM H2O2 and 1 mM NaI. Soluble enzyme extracts were fractionated by gel filtration on both Sephacryl S-300 and Sephadex G-100, and were shown to consist of a high-molecular weight peroxidase component (Mr greater than 1,000,000, 30% of total activity) and two other peroxidase species having apparent molecular weights of 62,000 and 45,000 (major component). Peroxidase activity was susceptible to proteolytic destruction only after periodate treatment, suggesting an association of the enzyme(s) with polysaccharide material. Ascaridole biosynthesis from alpha terpinene was inhibited by cyanide, catalase, and reducing agents, but not by compounds that trap superoxide or quench singlet oxygen. A peroxide transfer reaction initiated by peroxidase-generated I+ is proposed for the conversion of alpha-terpinene to ascaridole. PMID- 6497394 TI - Detection of beta-carbanion formation during kynurenine hydrolysis catalyzed by Pseudomonas marginalis kynureninase. AB - 2-Amino-4-hydroxy-4-phenylbutyric acid has been shown to be formed during the Pseudomonas marginalis kynureninase-catalyzed hydrolysis of kynurenine in the presence of benzaldehyde and pyridoxal phosphate. The formation of 2-amino-4 hydroxy-4-phenylbutyric acid is the first demonstration, to our knowledge, of the controlled trapping of an amino acid beta-carbanion generated either chemically or enzymatically, and is perhaps the best empirical evidence to date that enzyme mechanisms can proceed through a beta-carbanionic intermediate. The lifetime of the beta-carbanionic alanyl intermediate generated by kynureninase is of sufficient duration to allow reaction with benzaldehyde. Other aromatic, but no aliphatic, aldehydes will undergo electrophilic addition with kynureninase generated beta-carbanionic alanyl intermediates to form the corresponding amino acid. PMID- 6497395 TI - Biosynthesis of alkanes by particulate and solubilized enzyme preparations from pea leaves (Pisum sativum). AB - Enzymatic activity responsible for the conversion of fatty acids to alkanes catalyzed by pea leaf homogenate was found to be mainly in the microsomal fraction. This particulate preparation catalyzed alkane formation from n-C18, n C22, and n-C24 acids at rates comparable to that observed with n-C32 acid with O2 and ascorbate as required cofactors. In each case the major alkane contained two carbon atoms less than the precursor acid. Since the preparation also catalyzed alpha-oxidation, it was suspected that some alpha-oxidation intermediate, with one less carbon atom than the substrate acid, might lose another carbon to generate the alkane. Thin-layer and radio-gas-liquid chromatographic analysis of the products generated from [U-14C]stearic acid by the particulate preparation after different periods of incubation showed that, at all time periods, alpha hydroxy C18 acid, C17 aldehyde, and C17 acid were the major products. Since C16 alkane was the major product even after short periods of reaction, the C17 aldehyde might have been the immediate precursor of the alkane. Exogenous labeled C18 and C24 aldehyde were converted to alkanes. The alkane-synthesizing activity was solubilized from the microsomal preparation using Triton X-100. The solubilized preparation was retarded in a Sepharose 6-B column, but the hydrocarbon-forming activity was not resolved from alpha-oxidation. The solubilized preparation produced alkane with two carbon atoms less than the parent acid in a time- and protein-dependent manner. The soluble preparation also required O2 and ascorbate and, like the microsomal preparation, was inhibited by dithioerythritol and metal ion chelating agents. PMID- 6497396 TI - [Mode of action of fluoropyrimidines, in relation to their clinical application]. AB - From results which we obtained in experiments on 5-fluoropyrimidine analogs, it was demonstrated that the mode of action of these compounds was as follows: In human cancer, in contrast to experimental animal tumors, it was demonstrated that thymidine phosphorylase (Thd Pase) activity was dominant compared to that of uridine phosphorylase (Urd Pase). This observation would indicate that 5 fluorouracil (5-FU) was mainly metabolized to produce 5-fluoro-2'-deoxyuridine-5' monophosphate (FdUMP), via 5-flu fluoro-2'-deoxyuridine(FdUR). FdUMP would inhibit DNA synthesis by blocking thymidilate synthetase activity, resulting in the death of cancer cells. Thd Pase activity by which 5-FU is converted to FdUR would participate greatly in the antitumor effect of the compounds because of the fact that FdUR has 1,000 times greater antitumor activity than 5-FU. Moreover, some of the fluoropyrimidines are activated by this enzyme to produce 5-FU. It should be emphasized that Thd Pase activity is higher in tumor tissue than in normal tissues. This finding would mean that the compounds would exert a selective (antitumor) activity on cancer cells. In addition, a clinical trial of fluoropyrimidines showed them to be effective when administered to patients in order to maintain a lower effective level of 5-FU in tumor tissues for a longer period of time. Such experiences would also lend more weight the possible of the mode of action of the of fluoropyrimidines mentioned above. PMID- 6497397 TI - [Cell kinetics and nuclear ploidy pattern in relation to the growth of gastric cancers as analyzed by DNA-RNA cytofluorometry]. AB - We investigated the cell kinetics and nuclear ploidy pattern of human gastric cancers (12 early and 30 advanced cancers) using DNA-RNA cytofluorometry (NIKON SPM-RF1-D) with AO stain. The results showed that the gastric cancers studied could be divided into two main groups on the basis of ploidy pattern determined both by DNA and RNA contents: group I without, and group II with polyploidization. Cells having nuclear DNA contents between 2 n and 4 n were regarded as representing those in the S phase, and it was found that both groups had similar proliferative activity. In group I, cell proliferation without polyploidization seemed to be maintained during tumor growth regardless of the extent of invasion, and the fraction of 2 n cells was 72-94%, compared to 93-99% in control cells from the non-neoplastic gastric epithelium. In group II, however, the extent of polyploidization appeared to be increased in association with both the tumor growth and its invasion into deeper tissues; thus the fraction of 2 n cells was low, ranging from 12 to 79%. Especially, the fraction of 2 n cells in cancers with aneuploid-polyploidization was further decreased to 6-25%. Based on these results, it is hypothesized that, in the early stages of gastric cancers, the cell population may be composed mostly of diploid cells, but with both further tumor development and its invasion, the neoplastic cells may gradually differentiate into two distinct cell populations. PMID- 6497398 TI - [Antitumor activities and mechanisms of action of harringtonine and homoharringtonine]. AB - The antitumor activities and the mechanisms of action of harringtonine and homoharringtonine, alkaloids isolated from cephalotaxus hainanensis Li, were compared to those of vincristine. The results obtained were as follows: Harringtonine and homoharringtonine Significantly inhibited the growth of L1210 cells in culture. The IC50 values were similar to that of vincristine. Harringtonine and homoharringtonine had little effects on changes in the DNA histograms of FL cells at any concentrations, which suggesting that these drugs prolong the duration of each phase of the cell cycle evenly. Harringtonine and homoharringtonine had only a minor effect in arresting P388 cells in mitosis. Harringtonine significantly inhibited the DNA synthesis of P388 leukemia cells in culture, while vincristine weakly inhibited RNA and DNA synthesis. The successive treatment with harringtonine and homoharringtonine were as effective as the successive treatment with vincristine against P388 and L1210 leukemia, while both drugs were ineffective against Lewis lung carcinoma. PMID- 6497399 TI - [Low-dose methotrexate and sequential 5-FU treatment in advanced gastric cancer]. AB - Combination chemotherapy of low-dose methotrexate and sequential 5-FU was given to 16 patients with advanced gastric cancer. Treatment regimen : methotrexate 30 mg/m2 followed 3 hours later with 5-FU, 750 mg and 24 hours later with leucovorin 30 mg/m2. Each drug was administered as a bolus. Treatment was repeated weekly. The median ECOG PS was 3 (range 2-4) and median age was 55.1 years (range 28-87). Of these 16 patients who were evaluated, four had PR, and 5 had MR, giving a response rate of 25%. Of the 7 patients who had been previously treated with a combination of chemotherapy including 5-FU, the figures were 2 PR and 3 MR. This regimen has been well tolerated by the patients. No patient had a WBC nadir of less than 2000 cells/mm3, and no patient had a platelet count nadir of less than one hundred thousand platelets/mm3. No other toxicity was detected. PMID- 6497400 TI - [A phase II study of ranomustine (MCNU) tablets in patients with gastrointestinal cancer--by cooperative study group]. AB - A phase II study of MCNU tablets in gastrointestinal cancer was carried out by the Hanshin MCNU cooperative study group involving 21 institutions. The selection of patients and evaluation of tumor response were based on the Criteria for the Evaluation of tumor Response by Chemotherapy in Solid Tumor Patients by Koyama and Saito. Of 67 patients who were entered into the study, 46 patients were evaluable, and comprised of 27 cases of gastric cancer, 13 of colorectal cancer, 2 hepatoma, and 4 patients suffering from other typas of gastrointestinal cancer. MCNU was administered orally at a dose of 50 mg/body/day for 4-6 days consecutive every 6-8 weeks. Only one partial response was obtained among the rectal cancer patients, with a response rate of 2.3% (1/43) in evaluable patients. Minor responses were obtained in 3 patients including 2 of gastric cancer with liver metastasis and 1 colon cancer with liver metastasis. Major side effects were marrow suppression and gastrointestinal symptoms. The former consisted of mainly leukopenia (15 patients, 30.0%), thrombocytopenia (20 patients, 40.0%), and oligochromaemia (10 patients, 20.0%). The latter consisted of mainly nausea and vomiting (5 patients, 10.0%). PMID- 6497401 TI - [Control of multiple skin and lung metastasis of malignant melanoma by combined DAV and OK-432 chemoimmunotherapy in association with large-scale administration of indomethacin]. AB - Skin metastasis of malignant melanoma has been difficult to control by chemoimmunotherapy. We report a case of melanoma with marked reduction of multiple skin and lung metastasis and an improved cell-mediated immunity using combined DAV (DTIC, ACNU, Vincristine) and OK-432 chemoimmunotherapy in association with doses of indomethacin administered over a long period (250 mg/day, 6 months) to relieve the cancerous pain. PMID- 6497403 TI - [Echocardiographic diagnosis of cardiac tumors]. AB - Primary tumors of the heart are uncommon lesions that can mimic any other type of cardiovascular disease, so such tumors were rarely diagnosed before autopsy until the 1950's. Recent advances in echocardiography have enabled rapid and precise diagnosis of cardiac tumors to be made noninvasively. In diagnosing cardiac tumors by echocardiography, we must recognize fully the anatomical features of the four chambers of the heart. Cardiac tumors can be differentiated from other intracavitary mass lesions and ultrasonic artifacts. In this paper we described the echocardiographic features of cardiac tumors and their differential diagnosis. Present methods cardiac surgery have made the excision of cardiac tumors a safe therapeutic procedure providing an early and precise diagnosis of the cardiac tumor is made by echocardiography. PMID- 6497402 TI - [Effect of etoposide for pulmonary metastases from urogenital tract cancer]. AB - Seven cases with pulmonary metastases from the urogenital tract were treated with VP-16 in either oral doses of 200 mg or intravenous doses of 100 mg for 5 days. Two of 4 cases with transitional cell cancer from the urinary bladder and a case with prostatic adenocarcinoma responded to the treatment. Another 2 cases with adenocarcinoma arising from the kidney showed no response. Leucopenia, thrombocytopenia and alopecia were outstanding side effect. PMID- 6497404 TI - [Results of random screening of possible antineoplastic agents in Japan using mouse cancer. 3]. PMID- 6497405 TI - Pigmented keratoacanthoma. PMID- 6497406 TI - Delayed hypersensitivity in drug-induced toxic epidermal necrolysis. PMID- 6497407 TI - Topical antiseptics. PMID- 6497408 TI - UV-B. Unanswered questions. PMID- 6497409 TI - Scalp reduction surgery. PMID- 6497410 TI - The clinical spectrum of the persistent light reactor. AB - Eight patients had a chronic photodermatitis of five to 19 years' duration. The clinical and photobiological features were consistent with the pattern observed in persistent light reactors. Severity and clinical presentation, however, were quite variable, ranging from a few isolated papules to extensive lichenification involving the entire exposed skin. Three had positive photopatch tests to halogenated salicylanilides, while the remaining five reacted to musk ambrette. Exposure of the uninvolved skin to UV-B or solar-simulated radiation provoked abnormal delayed papular or infiltrated reactions. Histological evaluation of these reactions in three cases disclosed moderate to dense perivascular lymphocytic infiltrates with occasional eosinophils, focal exocytosis, and epidermal spongiosis. We conclude that persistent light reactivity associated with photoallergic contact dermatitis shows a spectrum of disease activity and photosensitivity. Recognition of the subtle forms of this disease is important. PMID- 6497411 TI - Skin markings in the diagnosis and prognosis of cutaneous melanoma. AB - Skin markings and pathologic findings in 105 patients with cutaneous melanoma were reviewed to determine relationship between clinical findings, pathologic findings, and prognosis. Lesions with decreased or absent markings are significantly thicker than those with increased or normal markings and therefore carry a worse prognosis. Loss of skin markings is a late sign of melanoma and should not be relied on as an aid in early diagnosis. PMID- 6497412 TI - Port-wine stains. Morphologic variations and developmental lesions. AB - Studies have shown that port-wine stains (PWSs) probably represent a progressive ectasia of the superficial cutaneous vascular plexus. During examination of approximately 500 patients with PWSs, seven lesions were identified that could be categorized into two groups. In one group (two patients), the typical superficial PWS was accompanied by a proliferation and ectasia of thin-walled vessels in the deeper dermis, subcutaneous adipose tissue, and skeletal muscle (cavernous hemangioma). In the other group (five patients), single or multiple polypoid tumors arose that consisted of a proliferation of vessels with walls of varying thickness, and intervascular stroma (arteriovenous malformation). These tumors appear to arise in both young patients with flat lesions as well as the older patients with pronounced surface irregularities. Two patients were specifically chosen because they represented the typical PWS cobblestone pattern. This vascular abnormality represents a localized exaggeration of the ectasia process. We conclude that a small number of PWSs are associated with an underlying cavernous hemangioma. Furthermore, besides the surface irregularities that characterize the older PWS, de novo vascular tumors arise that can be categorized as arteriovenous malformations. PMID- 6497413 TI - Failure of curettage and electrodesiccation for removal of basal cell carcinoma. AB - Sixty-nine primary basal cell carcinomas were treated by curettage and electrodesiccation three times, and subsequently, excised tissue was analyzed for microscopic persistence of tumor. We found persistent tumor in 33.3% of cases overall. Of 45 lesions on the head, residual tumor was detected microscopically in 46.6%, whereas of 24 lesions on the trunk and extremities, residual tumor was found in only 8.3%. This difference was statistically significant, even though the average precurettage and postcurettage sizes of the lesions in these two groups were comparable. Therefore, we conclude that basal cell carcinomas are more resistant to ablation with curettage and electrodesiccation on the head than on the trunk or extremities. PMID- 6497414 TI - The nails in keratosis lichenoides chronica. Characteristics and response to treatment. AB - Keratosis lichenoides chronica may be seen clinically and histologically as a variant of lichen planus. One in three patients have nail involvement with changes that may superficially resemble psoriasis, but pitting and pustulosis do not occur. Hyperkeratotic hypertrophy of the periungual tissues is a distinctive feature. Psoralens and UV-A therapy as well as etretinate have improved some cases. PMID- 6497415 TI - Essential primary cutis verticis gyrata. Treatment with the scalp reduction procedure. AB - A case of cutis verticis gyrata (CVG) occurred in a patient with no known associated disorders. Under the present classification system, patients with primary CVG are all grouped together. We propose subclassifying patients with primary CVG into two groups: those with associated neurologic and ophthalmologic diseases and those without. Our patient was treated with a scalp reduction procedure. PMID- 6497417 TI - Idiopathic photodermatitis with a positive paraphenylenediamine photopatch test. AB - A 61-year-old man was seen for a long-standing, recurrent eczematous dermatitis that appeared only in the summer. A patch test with ammoniated mercury was positive. Photopatch reactions to caine mix and paraphenylenediamine were positive, and phototesting disclosed an idiopathic photosensitivity to UV-A. Avoidance of sunlight exposure and the use of chemical sunscreening agents prevented further recurrence of the dermatitis. PMID- 6497416 TI - UV radiation and keratosis follicularis. AB - We carried out provocation studies on the lesions of keratosis follicularis by the use of UV radiation. Nonerythema-producing doses of UV-B elicited the lesions in uninvolved skin sites in a 34-year-old man with this disease. The elicited lesions were compatible with those of keratosis follicularis both clinically and histopathologically. Similar irradiation with UV-A produced no visible changes in the test area. PMID- 6497418 TI - Spontaneous partial regression of primary melanoma with death due to metastases. AB - A 42-year-old man had a metastatic melanoma in the brain, but no obvious primary melanoma could be detected. A halo nevus-like depigmented lesion was found on the left side of the patient's back. The histopathologic features of the depigmented lesion were compatible with those of a spontaneously regressed primary lesion of malignant melanoma. Enhanced immune responses to autologous and homologous melanoma cells were not detected when investigated in the late disease stage. Subsequently, the patient died of disseminated melanoma. PMID- 6497419 TI - Pathology quiz case 1. Erythema elevatum diutinum (EED). PMID- 6497420 TI - Pathology quiz case 2. Bowenoid papulosis (BP). PMID- 6497421 TI - Subcutaneous fat necrosis of the newborn. PMID- 6497422 TI - Scleredema adultorum. A case of the recurrent cellulitis syndrome. PMID- 6497423 TI - Ornithodoriasis preceding Borrelia infection. PMID- 6497424 TI - Toe walking and neuromuscular disease. PMID- 6497425 TI - Microcomputers and malformation syndromes. PMID- 6497426 TI - Clinical significance of gastro-oesophageal reflux. PMID- 6497427 TI - Baby of a schoolgirl. PMID- 6497428 TI - Improved sweat test method for the diagnosis of cystic fibrosis. AB - We describe a new technique of collecting sweat for measurement of osmolality and sodium concentrations. Eighty two subjects were studied--39 controls and 43 patients with cystic fibrosis. Adequate amounts of sweat were obtained in 81 subjects and sweat was analysed for both osmolality and sodium concentrations in 73 subjects. The 34 controls gave sweat osmolality and sodium values ranging from 62 to 196 mmol/kg and 9 to 72 mmol/l respectively. The 39 cystic fibrosis patients gave osmolality values ranging from 220 to 416 mmol/kg and sodium concentrations ranging from 60 to 150 mmol/l. Sweat osmolality alone was determined in eight infants under 50 days of age--four later developed the clinical features of cystic fibrosis and four, in whom cystic fibrosis was suspected, were later excluded. Sweat osmolality values in these two groups ranged from 255 to 345 mmol/kg and 87 to 123 mmol/kg respectively. The simplicity of collecting sweat and the measurement of osmolality offer distinct advantages over techniques previously described. PMID- 6497429 TI - Relapsing acute and chronic pancreatitis. AB - Twenty five children with non-traumatic relapsing acute or chronic pancreatitis who had been followed up from five months to seven years were studied. Seven had congenital anomalies, including two with choledochal cysts and four with pancreas divisum. Alcohol related disease was suspected in one child. The importance of diabetes in two patients and a positive family history in a further three is discussed, but in 12 children no association was found. Management was similar to that for adults. Surgical intervention was required in six patients, and percutaneous drainage of pseudocysts in a further three. Outcome has generally been good. PMID- 6497430 TI - Obesity and respiratory symptoms in primary school. AB - The association of weight for height and triceps skinfold with seven respiratory symptoms has been examined using logistic regression analysis in 7800 5 to 11 year old children (6200 in England and 1600 in Scotland). The results support the view that overweight children have a greater liability to some respiratory symptoms than other children. After allowing for age, sex, and social factors, significant (P less than 0.05) or borderline non-significant (P less than 0.1) positive associations were found between weight for height and the prevalence of bronchitis, 'chest ever wheezy', and 'colds usually going to the chest'. This suggests that some respiratory illness can be reduced by preventing children from becoming overweight. If this is correct, more than nutritional gains can be achieved by implementing an effective health education programme on obesity. PMID- 6497432 TI - Weight and water loss in the neonate in natural and forced convection. AB - We describe a simple method of determining weight loss and hence water loss of infants in incubators. Unlike previously reported methods, it does not interfere with the microenvironment surrounding the infant. Weight loss of 16 term and 32 preterm infants was measured in both forced and natural convection. No significant increase in water loss was observed in the term infants but in the preterm infants the mean loss in natural convection was 0.85 g/kg/hour compared with 1.26 g/kg/hour in forced convection: in the most extreme situation it was doubled. This water loss represents a substantial energy loss and suggestions to minimise it are discussed. PMID- 6497431 TI - Sodium homeostasis in term and preterm neonates. III. Effect of salt supplementation. AB - Clinical and biochemical effects of supplementing dietary sodium intake to 4 to 5 mmol(mEq)/kg/day from days 4 to 14 of life were studied in 22 infants of gestational age 27 to 34 weeks. These infants were compared with a group of 24 unsupplemented babies. Supplemented infants lost less weight postnatally and regained birthweight more quickly: their improved weight gain continued after supplementation was stopped. Sodium balance was positive at age 5 to 11 days in supplemented babies but slightly negative in controls. Potassium balance was more strongly positive in the supplemented group. Plasma sodium concentration was higher in supplemented infants during weeks 3 and 4. Hyponatraemia was significantly more common in unsupplemented (37.5%) than supplemented (13.6%) infants. No infant became oedematous, hypernatraemic, or showed evidence of circulatory overload. The incidence of patent ductus arteriosus and necrotising enterocolitis was not increased; no intracranial haemorrhages occurred. Urinary potassium:sodium ratio was lower in supplemented babies than controls suggesting responsiveness of the distal tubule to mineralocorticoids. Providing 4 to 5 mmol(mEq)/kg/day of sodium to infants born before 34 weeks' gestation for the first two postnatal weeks improves growth and biochemical status and causes no undesirable side effects. PMID- 6497433 TI - Handling during neonatal intensive care. AB - The handling received by very low birthweight newborns undergoing intensive care in the first few days of life and the effects of this were studied. Infants were handled an average of 4.3 hours (18%) of the total 24 hour observation time and received a mean 234 handling procedures. Parental handling contributed 35% of the total time but was usually benign except in that it could interfere with the infant's rest. Many procedures were associated with undesirable consequences. Endotracheal suctioning was invariably associated with hypoxaemia and was often carried out more frequently, or took longer, than was optimal. Transcutaneous oxygen monitoring, although considered routine for all intensive care infants, was only carried out for 50% of the observation time and often did not accompany periods of likely intensive handling. Increasing technology in neonatal intensive care often results in increased handling of sick infants. Each new innovation, as well as routine procedures, should be viewed in the light of the continuum of neonatal intensive care events, and handling kept to a minimum. PMID- 6497434 TI - Pilot study of revised stillbirth and neonatal death certificates. AB - Draft revised stillbirth and early infant death certificates were sent with a short questionnaire to certifying doctors for 206 stillbirths and 198 neonatal deaths for which death certificates had been received in the Office of Population Censuses and Surveys over a three week period in 1982. The new certificates complied with the recommendations of the World Health Organisation and asked for details of the cause of death, including separate sections for maternal and fetal conditions. Replies were received for 163 stillbirths and 151 neonatal deaths. Questionnaires were examined clerically and answers and comments analysed. Draft certificates were processed by computer to examine any differences between the causes of death given on the new forms and information given on the original certificates. This testing suggested that revised certificates are acceptable. Extension of the early infant death certificate to cover all neonatal deaths does not seem to create problems and should provide information on the association between maternal conditions and deaths occurring in the second to fourth weeks of life. If the full potential of the new certificates is to be realised, attention needs to be given to the detailed layout of the forms and clearer notes of guidance. Certifiers need to be encouraged to give appropriate details of any obstetric problems. PMID- 6497435 TI - Neonatal and postneonatal mortality in very low birthweight infants. AB - We reviewed 388 very low birthweight infants admitted to this neonatal intensive care unit over a four year period to determine the pattern of neonatal and postneonatal deaths up to age 2 years. Neonatal mortality is no longer an adequate indicator of outcome because deaths arising from perinatal events occur after the first month of life. PMID- 6497436 TI - Functional palatal incompetence in the fetal anticonvulsant syndrome. AB - We report two children with mild mental retardation and appreciable articulation difficulties whose mothers took phenobarbitone and phenytoin throughout their pregnancies. The speech difficulties in both children were due to malfunction of an anatomically normal palate. PMID- 6497437 TI - Subcutaneous emphysema: a new form of self abuse. AB - Subcutaneous emphysema is usually the result of trauma or surgery. We report an unusual case of a disturbed adolescent who presented with cervicofacial emphysema as a result of self abuse. PMID- 6497438 TI - Fibronectin in children with diabetes mellitus. AB - Fibronectin plasma concentrations were determined in 28 children with type I diabetes mellitus and 22 healthy children. No statistically significant difference was observed between the fibronectin concentrations in diabetic and non-diabetic children. Even in children with poor glycaemic control the fibronectin concentrations (glycosylated haemoglobin greater than 10%) were not significantly higher. PMID- 6497439 TI - Gastric trichobezoar associated with transient pancreatitis. AB - A Pakistani girl presented with acute abdominal pain and raised serum amylase and alkaline phosphatase concentrations. She was found to have a gastric trichobezoar with a tail extending to the mid-ileum. The altered biochemical parameters returned to normal after surgical removal of the bezoar. Irritation of ampulla of Vater by the bezoar tail is believed to have caused transient pancreatitis. PMID- 6497440 TI - Transient hyperphosphatasaemia. AB - Transient hyperphosphatasaemia is usually a chance finding arising from the use of biochemical screening profiles. Clinical correlates in cases so far described have been non-specific. PMID- 6497441 TI - Environmental asbestos exposure and cancer mortality. AB - From 1970 to 1980, mortality from cancer of the lung and stomach was analyzed in a town with asbestos deposits and in a town with asbestos processing. The populations of the entire country, the province, the district, and of all communities of the same size and agricultural index were used as references. In the town with asbestos contamination of air and water from natural tremolite deposits and an endemic occurrence of pleural plaques, no increased risk for lung or stomach cancer was found. In the town with asbestos cement production lung cancer rates were lower in males and higher in females, and stomach cancer rates were lower than expected. No significant differences could be attributed to environmental asbestos exposure. PMID- 6497442 TI - Risk factors in male infertility: a case-control study. AB - A case-control study was undertaken to evaluate environmental risk factors potentially involved in male infertility. One hundred twelve azoospermic or oligospermic subjects and 127 controls were interviewed, before sperm count results were available, about coffee and alcohol consumption, smoking habits, x ray exposure, usual sitting posture, drug consumption, other nonoccupational risk factors, socioeconomic status, education level, and occupational history. An unmatched analysis was then conducted. None of the occupational risk factors appeared to be related to azoospermia or oligospermia. A high relative risk was associated with (1) occupation in the radioelectric industry, (2) nonsedentary clerical workers, (3) clerical work in the typographic industry, and (4) occupation in the textile industry, but none of these figures were statistically significant. Because of the population from which cases and controls were drawn, certain occupational risks could not be investigated in this study, e.g., exposure of agricultural workers to chemicals. PMID- 6497443 TI - Outbreak of fatal arsenic poisoning caused by contaminated drinking water. AB - An outbreak of subacute poisoning occurred among nine members of a family; eight were ill with gastrointestinal symptoms, four developed encephalopathy, and two died. Abnormal liver function tests and leukopenia were common laboratory findings. Epidemiologic and environmental investigations traced the source of arsenic exposure to a farm well with water containing 108 ppm arsenic. The soil adjacent to the well was also contaminated with arsenic, possibly from waste pesticide. Presumably, arsenic gained access to the well through obvious leaks in the well's casing. To our knowledge, this is only the second reported outbreak of fatal arsenic poisoning from contaminated drinking water and one of few instances where illness followed exposure to a toxic substance which was disposed of, or possibly disposed of, in an indiscriminate manner. PMID- 6497444 TI - Death certificate case-control study of cancers of the prostate and colon and employment in the textile industry. AB - A case-control study was conducted to investigate possible relationships between employment in the textile industry and cancers of the prostate and colon. Death certificate information on occupation and industry was obtained for 1037 male prostatic cancer cases, 820 male and female colon cases, and matched controls who died during 1970-1978 in South Carolina. Black males were the only race-sex group to show an excess risk of prostate or colon cancer among employees of the textile industry. Nonstatistically significant excesses of prostate cancer were seen in dyeing and finishing businesses and broad woven fabric mills. Overall, there was no strong evidence indicating a relationship between the textile industry and either prostate or colon cancer. It is unlikely that limitations of the data masked real risks since previously reported associations with nontextile industries were confirmed. PMID- 6497445 TI - Workplace injury experience of female coal miners in the United States. AB - Analysis of the 1978-1980 accident history of female coal miners collected by the Mine Safety and Health Administration (MSHA) has identified significant differences in injury severity due to mine type, source and nature of injury, geographic region, age class, and part of body injured. Approximately 4% of all female coal workers were involved in a lost-time accident as compared to 7% for males; female workers lost approximately 1.1 days each as compared to 2.4 days for males; and 0.01% of the female work force were fatally injured as compared to 0.05% among males. Most injuries to both female and male workers involved back sprains. The majority of remaining injuries are sprains and fractures to joints and bones of the limbs. PMID- 6497446 TI - Peripheral vasodilatation following 1,1,1-trichloroethane inhalation: peripheral vessels as a site of action. AB - The effects of 1,1,1-trichloroethane (1,1,1-TCE) inhalation on total peripheral vascular resistance and the possibility of the peripheral vessels being a site of action for 1,1,1-TCE were investigated in anesthetized dogs. In acute inhalation experiments, a decrease in total peripheral vascular resistance was observed following inhalation of 1,1,1-TCE concentrations sufficient to induce systemic hypotension. The threshold concentration of 1,1,1-TCE required to produce a decrease in perfusion pressure of the isolated hindlimb was approximately 0.4 0.5% in inspired air. A dose-response relationship between the decrease in perfusion pressure and 1,1,1-TCE concentration, which exceeded the threshold level, was observed. It is suggested that the decrease in total peripheral vascular resistance is related to systemic hypotension following 1,1,1-TCE inhalation; further, this vasodilator effect may be induced in the peripheral vessels, which is one of the sites where 1,1,1-TCE acts. PMID- 6497447 TI - Lead in umbilical blood, indoor air, tap water, and gasoline in Boston. AB - A strong statistical correlation was found among the monthly averages of lead concentrations in umbilical cord blood (about 500 births/month), indoor air (12 sites/month), and gasoline lead sales between March, 1980 and April, 1981 in Boston. Tap water lead (24/month) variations did not correlate with blood lead in this population. PMID- 6497448 TI - The role of air pollution and other factors in local variations in general mortality and cancer mortality. AB - Age-adjusted indices of female cancer mortality and total male mortality in 31 California countries were correlated with air pollution data and with geographic and socioeconomic data from the 1970 United States Census and elsewhere. Air quality was the worst in those countries where socioeconomic status was highest. Cancer mortality showed positive correlations with air pollution levels. Overall male mortality was lower in the affluent but polluted coastal counties. However, when partial correlation coefficients were calculated, controlling for the confounding variables, both overall male mortality and female cancer mortality showed positive correlations with air pollution indices. Stepwise regression analysis produced similar results. PMID- 6497449 TI - Asthmatics' responses to 6-hr sulfur dioxide exposures on two successive days. AB - Asthmatic volunteers (N = 14) aged 18 to 33 yr with documented sensitivity to sulfur dioxide (SO2) were exposed in a chamber to 0.6 ppm SO2 for 6-hr periods on 2 successive days. Similar exposures to purified air, 1 wk later or earlier, served as controls. Subjects exercised heavily (target ventilation rate 50 L/min) for 5 min near the beginning of exposure (early exercise) and for an additional 5 min beginning after 5-hr of exposure (late exercise). At all other times, they rested. Body plethysmographic measurements and symptom questionnaires were administered pre-exposure, after each exercise period, and hourly during rest. Bronchoconstriction and lower respiratory symptoms were observed during or immediately following exercise--to a slight extent with clean air, and to a more marked extent with SO2. Bronchoconstriction and symptoms were modestly less severe on the second day of SO2 exposure than on the first day, but there were no meaningful differences in response between early and late exercise periods on either day. PMID- 6497450 TI - [A new device for percutaneous nephrostomy guided by one-stage ultrasound]. PMID- 6497451 TI - [Urologic hemangiomas]. PMID- 6497452 TI - [Percutaneous nephrostomy in obstructive anuria]. PMID- 6497453 TI - [Nitrofurantoin in the treatment of recurrent acute cystitis]. PMID- 6497455 TI - [Renal oncocytoma: report of a new case]. PMID- 6497454 TI - [Primary carcinoma of the urethra. Review. I: Carcinoma of the urethra in the male]. PMID- 6497456 TI - [Epidemiology of renal lithiasis: influence of the diet]. PMID- 6497457 TI - [Urinary infections caused by ureolytic diphtheromorphs with false-negative cultures]. PMID- 6497458 TI - [Hypernephroma in horseshoe kidney: apropos of 2 cases]. PMID- 6497459 TI - Prospective study of early rheumatoid arthritis. I. Prognostic value of IgA rheumatoid factor. AB - Thirty-three patients with early arthritis, 28 of whom developed classical/definite rheumatoid arthritis (RA), were followed up for two to four years. Rheumatoid factor (RF) levels of the IgM, IgA, and IgG isotypes were measured in serum and synovial fluid by an ELISA technique developed in our laboratory. All seven patients who presented with raised IgA RF developed erosions of their hands and wrists. This was significantly different from the remaining 26. By contrast none of the five patients who presented with isolated elevation of IgM RF developed erosive disease. The patients with raised IgA RF needed significantly more treatment with 'specific' drugs than the remaining 26. It is suggested that the detection of IgA RF in early RA indicates poor prognosis, justifying a more aggressive treatment at an early stage. PMID- 6497460 TI - Prospective study of early rheumatoid arthritis. II. Association of rheumatoid factor isotypes with fluctuations in disease activity. AB - Thirty-three patients with early peripheral synovitis were followed up for two to four years in order to study the relationship between fluctuations in rheumatoid factor (RF) levels and indices of clinical activity. Twenty-eight of these patients developed classical/definite rheumatoid arthritis (RA). Seventeen patients developed erosive disease of their hands and wrists and thirteen had a positive RF agglutination test. Nineteen patients had raised levels of IgM, RF, IgA, RF, or IgG RF as measured by isotype-specific ELISA techniques. The within patient fluctuations in IgA RF levels correlated significantly with the corresponding fluctuations in grip strength (p less than 0.05), erythrocyte sedimentation rate (ESR) (p less than 0.01), and a composite index of disease activity (p less than 0.02). IgG RF levels were also associated with changes in ESR and grip strength, but IgM RF showed only a weak association with fluctuations in ESR and not with any other clinical parameters. It is suggested that serum IgA RF may be a useful marker of disease activity in rheumatoid arthritis. PMID- 6497461 TI - Clinical judgment in rheumatoid arthritis. III. British rheumatologists' judgments of 'change in response to therapy'. AB - A realistic analysis of the criteria used by rheumatologists in evaluating the progress of patients suffering from rheumatoid arthritis must be based on actual clinical judgments rather than on expressed opinions. A randomly selected 15% sample of British rheumatologists (48) recorded judgements on the progress of 50 'paper' patients, based on data taken from actual patients participating in clinical trials. The rheumatologists differed markedly in their assessments of the progress of disease, with serious disagreements even when only 'clinically important' changes were considered. Some clinicians showed little consistency in their judgments of duplicate cases. Multiple regression analysis of the patient data in relation to the disease assessments provided a model of each clinician's judgment policy. These judgment policy models showed that the differences in clinical assessment were greater than could be explained by the inconsistent application of similar assessment policies, and were a consequence also of differences in the underlying judgment policies themselves. Judgments related more closely to changes in ESR and other process measures than to changes in functional ability. PMID- 6497462 TI - Clinical judgment in rheumatoid arthritis. IV. Rheumatologists' assessments of disease remain stable over long periods. AB - Seven rheumatologists made judgments about the improvement or deterioration of identical sets of 50 'paper' patients on two occasions one year apart. The stability of their judgments over one year (rs = 0.70) compared favourably with the reliability of duplicate judgments on each occasion (rs = 0.76). Multiple regression analysis of the patient data in relation to the disease assessments provided a model of each clinician's underlying judgment policy. The stability of judgments predicted by these policy models was even higher (rs = 0.83). PMID- 6497463 TI - Fibrin(ogen)olysis in polymyalgia rheumatica and temporal arteritis: preliminary findings on association with disease activity. AB - Postulating an increased production of fibrin(ogen)olytic degradation products (FDP) and an abnormality of fibrinogen metabolism in polymyalgia rheumatica (PMR) and temporal arteritis (TA), we studied 16 PMR/TA patients and 10 control subjects using a sensitive radioimmunoassay for a specific type of FDP, namely, fibrin(ogen)-related D-antigen. Median serum D-antigen levels were increased five fold in those 11 PMR/TA patients who were untreated compared with control subjects. In the five PMR/TA patients who were treated with prednisone the median D-antigen levels were not significantly different from those of the healthy controls. D-antigen concentration correlated significantly (r = 0.83) with ESR in the seven untreated PMR patients. In PMR patients prednisone therapy was followed by a reduction of serum D-antigen levels. PMID- 6497464 TI - Antibodies to peptidoglycan in patients with spondylarthritis: a clue to disease aetiology? AB - Although the aetiology of the spondylarthritic diseases, ankylosing spondylitis and Reiter's syndrome, is obscure, a clue to the pathogenesis might be an animal model, adjuvant arthritis. Rats with this disease develop a spectrum of pathology with marked similarity to the spondylarthritides. Since peptidoglycan, a major cell wall component of most bacteria is causally implicated in adjuvant arthritis, we sought evidence that peptidoglycan exposure accompanies both Reiter's syndrome and ankylosing spondylitis. Antibodies to the D-Ala-D-Ala moiety of peptidoglycan were measured by a sensitive and specific ELISA. Antibodies were elevated significantly in patients with ankylosing spondylitis or Reiter's syndrome, but not in patients with rheumatoid arthritis or degenerative joint disease in comparison with normal controls. The findings should be considered preliminary, since only a minority of patients had increased antibody titres. However, the findings are compatible with the hypothesis that peptidoglycan is causally related to spondylarthritis. Antibodies to other moieties in the peptidoglycan molecule might be a more sensitive test for significant exposure. PMID- 6497465 TI - Histopathological and ultrastructural studies of synovium in Milwaukee shoulder syndrome--a basic calcium phosphate crystal arthropathy. AB - Light and electron microscopic study of synovial specimens from four patients with the Milwaukee shoulder syndrome disclosed vascular congestion, villous and focal synovial lining cell hyperplasia, occasional giant cells, and fibrin deposition both within and on the surface of the synovium. Although these changes are non-specific, the finding of basic calcium phosphate crystal aggregates in all four cases and the near total absence of an inflammatory reaction are helpful in distinguishing this condition from other types of arthritis. The focal areas of synovial cell hyperplasia may relate to the powerful mitogenic effect of both synthetic and naturally occurring calcium-containing crystals in concentrations found in the synovial fluid of these patients. PMID- 6497466 TI - Synovial fluid lactate levels in septic and non-septic arthritides. AB - Lactate concentration was studied in 383 synovial fluid specimens from patients with various arthritides. The highest concentrations of lactate occurred in non gonococcal septic synovial fluids. High values were recorded in seropositive rheumatoid arthritis and crystal-induced arthritides, medium values in synovial fluids from seronegative rheumatoid arthritis, seronegative spondylarthritides, gonococcal arthritis and haemarthrosis, and the lowest values in aspirates from osteoarthrotic joints. There was a positive correlation between synovial pH and lactic acid concentration. These data suggest that determination of lactate in synovial fluid can be valuable in the rapid exclusion of septic arthritis. Its value for differentiating between other inflammatory arthritides is discussed. PMID- 6497468 TI - Calcifying supracoracoid bursitis as a cause of chronic shoulder pain. AB - A case of chronic shoulder pain is reported with marked limitation of both active and passive elevations and a normal range of motion of the glenohumeral joint. X ray examination demonstrated cloudy calcification in the coracoclavicular region, presumably indicating calcifying supracoracoid bursitis. PMID- 6497467 TI - Anticardiolipin antibodies: occurrence in Behcet's syndrome. AB - Anticardiolipin antibodies have recently been described in association with arterial and venous thrombosis, and with neurological symptoms, in connective tissue diseases. In a study of 70 patients with Behcet's syndrome 13 patients had these antibodies. Of these 13 patients eight had a history of either retinal vascular pathology, cerebral infarction, or thrombophlebitis. The association of retinal vascular disease and the presence of anticardiolipin antibodies was statistically significant. PMID- 6497470 TI - Rheumatoid arthritis and malignant histiocytosis of the intestine. PMID- 6497469 TI - Transient Brown's syndrome in juvenile chronic arthritis. AB - A 9-year-old boy with systemic juvenile chronic arthritis and Brown's syndrome (limitation of elevation of the adducted eye due to limitation of movement of the superior oblique tendon) is described. The resolution in association with steroid treatment suggested a transient tenonsynovitis involving the superior oblique tendon as the cause. PMID- 6497471 TI - Synovial fluid complement levels in Behcet's disease. PMID- 6497472 TI - Transposition of the great arteries: which operation? PMID- 6497473 TI - Results of the Damus-Stansel-Kaye procedure for transposition of the great arteries and for double-outlet right ventricle with subpulmonary ventricular septal defect. AB - From 1975 through 1982, the Damus-Stansel-Kaye procedure was performed on 20 patients with complete transposition of the great arteries (TGA) and on 4 with double-outlet right ventricle (DORV) and subpulmonary ventricular septal defect (VSD). The patients ranged from 6 days to 20 years old (median age, 13 months). Associated anomalies included atrial septal defect (24 patients), VSD (14), and others (25). Thirteen patients had had palliative operations previously. Of the 14 hospital deaths (58%), 13 occurred among the 17 patients with one or more risk factors: age less than 18 months, weight less than 10 kg, and left ventricular peak systolic pressure less than 75% of systemic pressure. Follow-up ranged from 12 to 87 months (mean, 51 months). One patient died of cardiac failure two years postoperatively, and 2 required conduit replacement at 40 and 50 months because of stenosis. All 9 survivors are free from major symptoms. The Damus-Stansel-Kaye repair is most suitable for patients with TGA or DORV with subpulmonary VSD who are older than 18 months, weight more than 10 kg, and have a "prepared left ventricle," and whose coronary artery anatomy precludes transplantation. PMID- 6497474 TI - Transposition of the great arteries and intact ventricular septum: anatomical repair in the neonate. AB - Fourteen neonates 18 hours to 32 days old with transposition of the great arteries (TGA) and virtually intact ventricular septum (IVS) underwent arterial switch operations under deep hypothermic circulatory arrest. Preoperative left ventricular to right ventricular peak systolic pressure ratios ranged from 0.7 to 1.0 (mean, 0.92), and the echocardiogram showed a centrally positioned ventricular septum in 10 patients and a rightward displaced ventricular septum in 4. One patient died twelve hours after operation. Postoperative complications included bleeding from the left coronary artery-pulmonary artery anastomosis (1 patient), stenosis of the pulmonary artery-aorta anastomosis requiring reoperation (2 patients), transient ST segment and T wave abnormalities consistent with ischemia (3), and development of pathological Q waves suggestive of clinically silent infarction (2). The capacity of the left ventricle in a neonate to effectively take over the systemic circulation was clearly demonstrated. A longer follow-up period is needed to assess late ventricular function, coronary ostial growth, growth of the aorta-pulmonary artery anastomosis, late aortic valve (anatomical pulmonary valve) function before definitive recommendations about the superiority of the arterial switch operation in neonates with TGA plus IVS can be formulated. PMID- 6497475 TI - The questionable role of computed tomography in preoperative staging of esophageal cancer. AB - The findings of computed tomography (CT) in 18 patients with histologically proven esophageal carcinoma were compared with operative and pathological findings. Computed tomography delineated esophageal lesions in 14 of the 18 patients. In 11 patients, CT scanning was found to be inaccurate in assessing tumor involvement of esophageal lymphatic drainage. Nine patients had no abdominal nodal metastasis demonstrated by CT scan. Operative exploration revealed tumor involvement of celiac or left gastric lymph nodes in all of these patients. Two patients' CT scans demonstrated tumor involvement of celiac and left gastric lymph nodes; at operative exploration, these nodes were enlarged, but they were histologically negative for esophageal carcinoma. Operative exploration changed the preoperative TNM classification in 8 of the 11 patients. Review of these data indicates that surgical exploration continues to be the only reliable method of determining the actual extent and often the resectability of esophageal carcinoma. PMID- 6497476 TI - A perspective on chest wall resection in patients with breast cancer. AB - The morbidity from locally recurrent breast cancer or osteoradionecrosis and accompanying infection is substantial. The selective use of surgical resection offers good palliation. Extended full-thickness chest wall resection is facilitated by a variety of techniques available for closure and coverage including use of latissimus dorsi myocutaneous flap, rectus abdominus myocutaneous flap, pectoralis myocutaneous flap, breast flap, and omentum with skin graft. The experience with 43 consecutive chest wall resections in patients with breast cancer affords the opportunity to define indications and contraindications for such palliative procedures. Indications include local symptoms of pain and infection, tumor recurrence refractory to radiation therapy, and infection that precludes chemotherapy. Relative contraindications are pulmonary metastases, bone metastases, hepatic metastases, and malignant pleural effusions. Absolute contraindications are brain metastases, bone marrow involvement, bulky disease in two organs, and breakthrough on multiple chemotherapy regimens. Operative revision was only required in 4 of 43 patients. Minor wound complications occurred in 12 (28%). Three patients who underwent resection for local recurrence have survived 40 months or more free from disease. This procedure provides substantial palliation by relieving pain, controlling infection, removing a weeping wound, and allowing chemotherapy for metastatic disease. In the proper setting, chest wall resection is an important part of the armamentarium for palliation of the patient with breast cancer. It can markedly improve quality of life and occasionally may result in long-term survival. PMID- 6497477 TI - The evaluation of various bioabsorbable materials on the titanium fiber metal tracheal prosthesis. AB - A new type of tracheal prosthesis was studied. It consists of a rigid, porous cylinder of titanium fiber metal coated with a polymer that provides an initial air seal and then is absorbed to permit subsequent fibrous tissue ingrowth and reepithelialization. Fifteen such cylinders measuring 50 mm by 26 mm were coated with one of the following polymers: polycaprolactone 700 (3 coated internally and 3 externally); a copolymer of 75% poly-L-lactic acid and 25% polyglycolic acid (3 coated internally and 3 externally); and polyglactin 910 (3 coated externally). Fifteen kennel-conditioned mongrel dogs, each randomly assigned to one of these five groups, underwent implantation of the prosthesis through a right thoracotomy into a 5-cm defect in the distal intrathoracic trachea. There were no immediate postoperative deaths, and no instances of major air leak from the prosthesis. One animal died after two weeks secondary to a lower respiratory tract infection. Bronchoscopic evaluation revealed varying degrees of tissue ingrowth into the prostheses, with no evidence of infection or distal accumulation of secretions. Histological evaluation showed superior tissue ingrowth and reepithelialization with internally coated prostheses; two out of three polymers gave good results. PMID- 6497478 TI - Prevention of ischemic spinal cord injury following aortic cross-clamping: use of corticosteroids. AB - Prior to proximal aortic cross-clamping, baseline measurements of spinal cord blood flow and function were done. Blood flow was evaluated with radioactive microspheres and function determined by assessment of somatosensory evoked potential (SEP). Group 1 (N = 6) animals had aortic cross-clamping for 5 minutes after ischemic spinal cord dysfunction (SEP loss) was documented. Group 2 (N = 9) underwent aortic cross-clamping for 10 minutes after loss of SEP. Group 3 (N = 6) also underwent 10 minutes of cross-clamping after initial SEP loss, but were treated intravenously with methylprednisolone (30 mg per kilogram of body weight) 10 minutes prior to cross-clamping and again 4 hours postoperatively. After release of the cross-clamp, the animals were allowed to recover and serial evaluations of spinal cord blood flow and neurological status were carried out for seven days. Group 1 animals recovered uneventfully without evidence of neurological injury. Group 2 animals sustained a 67% incidence of permanent spastic paraplegia (p = 0.02 versus Group 1). In contrast, methylprednisolone treated animals sustained no clinically detectable neurological injury (p = 0.02 versus Group 2). Measurements of spinal cord blood flow at the time of SEP loss revealed similar degrees of spinal cord ischemia in all groups. No significant differences were observed in the duration of aortic cross-clamping prior to SEP loss among the three groups. The data indicate that short periods of cross clamping (5 minutes) following SEP loss are well tolerated, whereas longer periods (10 minutes) are associated with a high incidence of paraplegia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497479 TI - Depression of pulmonary metabolic function by cardiopulmonary bypass procedures increases levels of circulating norepinephrine. AB - We measured plasma levels of endogenous norepinephrine radioenzymatically in mixed venous and arterial blood simultaneously sampled from anesthetized dogs before, during, and after 1 to 4 hours of total cardiopulmonary bypass (CPB) or 2 hours of left heart bypass. Prior to bypass, arterial levels of norepinephrine were 0.41 +/- 0.04 ng/ml and pulmonary extraction of norepinephrine was 25 +/- 3% (N = 20). During bypass, norepinephrine levels significantly increased from control to 1.41 +/- 0.15 (1 or 2 hours of CPB; N = 8) and 1.97 +/- 0.30 (3 or 4 hours of CPB; N = 8) or 0.97 +/- 0.29 (2 hours of left heart bypass) ng/ml. Restoration of normal pulmonary blood flow was associated with a rapid and significant decrease in arterial levels of norepinephrine, which, after 1 or 2 hours of CPB or 2 hours of left heart bypass, returned to levels obtained before bypass. However, arterial levels of norepinephrine remained higher than 1 ng/ml in the 3-hour recovery period after prolonged bypass. In these animals, pulmonary extraction of norepinephrine was significantly less than control. These data suggest that the lung's ability to remove norepinephrine is altered by CPB and that the severity of the alterations is directly related to pump time. The impairment in extraction allows higher than normal concentrations of norepinephrine to enter the arterial circulation and may contribute to systemic hypertension after bypass. PMID- 6497480 TI - Surgical approach to corrected transposition of the great vessels and situs inversus [I, D, D] with ventricular septal defect and systemic atrioventricular valve regurgitation. AB - Successful surgical repair of a 4-year-old boy with situs inversus [I, D, D] and corrected transposition of the great vessels (TGV) as well as hemodynamically significant ventricular septal defect (VSD), systemic atrioventricular (tricuspid) valve regurgitation, and atrial septal defect is described. Unique technical aspects of VSD and tricuspid valve repair in association with corrected TGV and situs solitus or inversus are discussed and clarified. PMID- 6497481 TI - Triple diaphragmatic rupture with disruption of the pericardium: pericardial reconstruction by lyophilized dura allograft. AB - A patient is described with the unusual findings of intrapericardial diaphragmatic rupture combined with total disruption of the pericardium and partial abruption of the diaphragm from its costal origin. Through a third traumatic diaphragmal leak, the small intestine had prolapsed intercostally without contact to the pleural space. Surgical repair was done by direct diaphragmatic suturing and lyophilized dura allograft reconstruction of the left pericardial circumference. Postoperatively, atrioventricular block secondary to myocardial contusion necessitated pacemaker implantation. The patient left the hospital five weeks after the injury. PMID- 6497482 TI - Traumatic ventricular septal defect following closed-chest massage: a new approach to closure. AB - A 59-year-old man underwent a quadruple coronary bypass. Nine hours postoperatively, cardiac arrest developed; it was preceded by bradycardia resistant to pacing. Closed-chest massage resulted in a rapid recovery of stable cardiac function followed by the development of cardiogenic shock. A new systolic murmur was appreciated 36 hours following arrest. It was diagnosed at catheterization as a ventricular septal defect that was subsequently found to lie in the posterior ventricular septum, and two operations were necessary to effect closure. The final operation was performed with exposure of the septal defect through the right atrium. Sixteen months after operation, the patient remained well. To our knowledge, this is the first reported instance of a ventricular septal defect occurring secondary to closed-chest massage and also of the closure of a traumatic defect using a right atrial approach. PMID- 6497483 TI - A technique of anastomosis of the right internal mammary artery to the circumflex artery and its branches. AB - A new technique for direct revascularization of the left circumflex artery and its ventricular branches through anastomosis with the right internal mammary artery (RIMA) was applied in 56 patients. Postoperative angiographic studies in 17 patients showed that positioned behind the aorta, the RIMA can reach the circumflex artery with no tension, allowing adequate distal filling. PMID- 6497484 TI - A new scapula retractor for posterolateral thoracotomy. AB - A new retractor is presented for use in performing posterolateral thoracotomy. Its advantages are stabilization of the tip of the scapula and preventing it from protruding over the intercostal space to be incised. PMID- 6497485 TI - Lower esophageal ring. PMID- 6497486 TI - Preoperative spirometry: let's do it! PMID- 6497487 TI - Aortic cannulation with Rubio aortic punch. PMID- 6497488 TI - [An ethical code for experimental research on animals]. PMID- 6497489 TI - [Cardiovascular diseases and society]. PMID- 6497490 TI - [Infant mortality in relation to the mother's health status and occupation of the father, classified for the country and the 3 districts. Introductory studies; findings in the year 1981]. PMID- 6497491 TI - [Demographic development and hospital management]. PMID- 6497492 TI - [The safety of microwave ovens]. PMID- 6497493 TI - [Hypotensive treatment in purely systolic hypertension caused by aortosclerosis: is it illogical with or without evidence of usefulness?]. PMID- 6497494 TI - [Intraventricular conduction block induced by ischemia]. AB - The electrical consequences of experimental acute myocardial ischemia were studied in 50 dogs. The study was performed through unipolar epicardial leads and at different levels of the conducting system; bundle branch and Purkinje fibers. There is evidence that the block takes place at the Purkinje-muscle union or in the muscle-muscle conduction. In none of the experiments the block appeared in any of the components of the conducting system. Also, there is evidence that with severe ischemia muscle recordings disappeared while the Purkinje potentials remained unchanged, this suggests that conducting system cells are more resistant to hypoxia than the contractile cells. Ventricular arrhythmias usually appeared simultaneously with conduction blocks that favored reentries. Arrhythmias were more frequent when the blocks were more accentuated. Our data demonstrates that the conduction disorder precedes in some instances, the positive RS-T displacement and in others it hides the such displacement. It is concluded that the RS-T displacement, the distal conduction block and arrhythmias are manifestations, at different levels, of partial diastolic depolarization induced by acute myocardial ischemia. PMID- 6497495 TI - [Pathogenesis of acute myocardial infarction. I. Complement activation in vivo and development of infarction]. AB - We studied 53 patients within 12 hs from the onset of symptoms of acute myocardial infarction, and 25 healthy controls. We searched for complement split products in plasma treated with EDTA to avoid in vitro complement activation. Therefore the presence of proteolytic degradation products of C3 signals in vivo activation. Sixteen of the 53 cases (30%), had C3 splitting products in EDTA plasma. In contrast only 2 (8%) controls showed C3 splitting products. In vivo complement activation correlated with the severity of the infarction. PMID- 6497497 TI - [Congenital intrathoracic right kidney]. AB - Ectopic intrathoracic kidney is an extremely rare congenital disorder. It is generally asymptomatic, being discovered as incidental finding on a routine chest radiograph. Diagnosis is established by an intravenous pyelogram demonstrating an abnormally shaped excretory system with longer than usual ureters, which also helps to differentiate it from other posterior mediastinal tumors, such as neurogenic masses, including neuroblastoma, ganglioneuroma, neurofibroma, neuroenteric cysts, meningoceles and hernia of the foramen of Bochdalek. PMID- 6497496 TI - [Double-outlet left ventricle]. AB - Two cases of double-outlet left ventricle with ventricular septal defects and pulmonic stenosis are described. Both had atrial situs solitus, one with concordant and another with discordant atrioventricular connections. Considering the clinical behaviour of the malformation, the diagnosis is difficult. Although the echocardiographic findings suggest the abnormality, angiocardiography is the best procedure for the accurate diagnosis. PMID- 6497498 TI - [Report of the Joint Committee of the International Society and Federation of Cardiology and the World Health Organization on the recommendation for the standardization of quantitation of M-mode echocardiography]. PMID- 6497499 TI - Comparative effects of morphine and cyclazocine on gastrointestinal motility in conscious dogs. AB - The effects of intravenous (i.v.) and intracerebroventricular (i.c.v.) administration of two opiate-like drugs, morphine and cyclazocine on gastrointestinal motility were investigated in conscious fasted dogs chronically fitted with strain gauge transducers on the antrum, the jejunum and the colon. Intravenous administration of morphine (100 micrograms.kg-1) induced a disorganization of the cyclic motility of the antrum, a premature phase of regular activity on the jejunum and a stimulation of colonic motility. Intracerebroventricular administration of morphine at a 10 times lower dose induced a short (10-15 min) stimulation of gastric motility followed by a prolonged (2-3 hr) inhibition associated with a disorganization of the jejunal motility and a stimulation of colonic motility. Cyclazocine at the same doses (10 micrograms.kg-1) induced identical effects after administration by i.v. and i.c.v. routes which consisted of an inhibition of gastric and jejunal motility and a stimulation of colonic motility. These results show peculiar motor responses, at each level of the digestive tract, to central and peripheral administration of an opiate-like drug. PMID- 6497500 TI - Flavonoid-induced delay in the small intestinal transit: possible mechanism of action. AB - Three flavonoids viz: gossypin, epicatechin and hydroxyethyl rutosides were evaluated for their effect on small intestinal transit in mice. All the three flavonoids delayed the small intestinal transit in a dose-dependent manner. Naloxone, yohimbine and phentolamine antagonized the inhibitory effect of flavonoids, while it was not altered by prazosin, propranolol, atropine, physostigmine, hexamethonium, pheniramine or metiamide. It is suggested that opiate and alpha-2 adrenergic receptors mediate the flavonoid-induced delay of small intestinal transit. PMID- 6497501 TI - Renal effect of clonidine during acute hypobaric pressure breathing in normal and diabetes insipidus rats. AB - The renal effects of clonidine (100 and 500 micrograms/kg s.c.) during acute hypobaric pressure breathing (i.e. a protocol which induces an increase in intrathoracic blood volume) were studied in normal and diabetes insipidus rats. In normal rats, clonidine enhanced the increase in urine flow and urea concentration elicited by hypobaric breathing without change in urinary creatinine level. By contrast, in Brattleboro diabetes insipidus rats, clonidine reinforced the hypoxia-induced mechanisms: oliguria, decrease in both urinary urea and creatinine excretions. During normobaric and hypobaric conditions in normal rats administration of clonidine induced an increase in electrolytes (Na+, K+, Cl-) excretion. In Brattleboro rats, clonidine potentiated the decrease in electrolytes excretion elicited by the hypobaric pressure breathing. Since the diuretic reflex elicited by the hypobaric pressure breathing is due to an inhibition of vasopressin release, the present data show that clonidine induces an inhibition of vasopressin release. However, it is suggested that beside this property clonidine also possesses direct vasoconstrictor actions during hypobaric pressure breathing. PMID- 6497502 TI - Studies on nifurtimox nitroreductase activity in liver and other rat tissues. AB - Rat liver microsomes exhibit nifurtimox (NFX) nitroreductase activity, which is mostly NADPH-dependent and is completely abolished by heating and under an atmosphere of air. Pure carbon monoxide inhibits for 28% microsomal NFX nitroreductase activity while FAD 1 mM significantly enhances it. Smaller activities than in liver were found in brain, small intestine, testes, lung and heart. Rat liver cytosol also showed NFX nitroreductase activity using either hypoxanthine or N-methylnicotinamide as substrates. These activities were inhibited by allopurinol or menadione respectively. Results suggest that cytochrome P-450, NADPH cytochrome c reductase, xanthinoxidase and aldehyde oxidase are able to reduce NFX nitrogroups in rat liver and other tissues. PMID- 6497503 TI - Effects of the (+/-)-, (+)- and (-)-forms of propranolol, timolol and metoprolol on noradrenergic transmission in the rat isolated right ventricle. AB - The effects of the (+/-)-, (+)- and (-)-forms of propranolol, timolol and metoprolol on noradrenergic transmission have been studied in the rat isolated right ventricle. (+)- And (-)-propranolol (10(-5) M) inhibited the accumulation of radioactivity from [3H]-noradrenaline. The decline in the spontaneous outflow of radioactivity, following loading of the tissue with [3H]-noradrenaline, was reduced by (+)- and (-)-propranolol (10(-5) M), (+)-timolol (10(-5) M), (-) timolol (10(-6) - 10(-5) M) and (+)-metoprolol (10(-5) M). (+)-Propranolol, (+) timolol (10(-6) M) and (+)- and (-)-metoprolol (10(-5) M) increased the decline in outflow of radioactivity evoked by field stimulation in the absence, but not in the presence, of lignocaine (10(-4) M), probably by decreasing nerve excitability. The ability of (-)-propranolol (10(-5) M) to increase the decline in evoked outflow was also reduced in the presence of lignocaine. (+) Propranolol, (+)-timolol and (-)-metoprolol reduced the contractile response to field stimulation by a similar percentage in the absence or presence of lignocaine. The ability of (-)-propranolol and (+)-metoprolol (10(-5) M) to reduce contractile responses was decreased and abolished, respectively, by the addition of lignocaine. Evoked-outflow was not altered but contractile responses were inhibited by (-)-timolol (10(-7) - 10(-5) M) and (-)-metoprolol (10(-5) M). Contractile responses to isoprenaline were not altered by (+)-propranolol, (+) timolol (10(-7) M) and (+)-metoprolol (10(-7) - 10(-6) M). (+)- Or (-) propranolol (10(-7) M) and (+)-timolol (10(-6) M) had no effect on the rate of beating to isoprenaline but reduced the force whereas (+/-)-metoprolol (10(-7) M) had no effect on the force but reduced the rate of beating. The rate of beating and force responses to isoprenaline were reduced by (+/-)-, (+)-, (-)-propranolol (10(-6) M), (+/-)- or (-)-timolol (10(-7) - 10(-6) M), (+/-)-metoprolol (10(-6) M) and (-)-metoprolol (10(-7) - 10(-6) M). The data suggest that, in the rat isolated right ventricle, the (+)-isomers are active constituents of (+/-) propranolol and (+/-)-timolol but not of (+/-)-metoprolol. PMID- 6497504 TI - The effect of calcium-channel-blocking agents on the various types of smooth muscle activation of the isolated rat uterus. AB - Both verapamil and nifedipine were found to inhibit various types of activation of the isolated rat uterus, as for example: tonic and phasic components of contraction produced by KC1 and by oxytocin, phasic components of contraction produced by electrical stimulation and phasic spontaneous rhythmic activity. Presumably, verapamil and nifedipine affect a common pathway in calcium metabolism in all three types of muscle activation. Both verapamil and nifedipine inhibited more the contractile responses to high concentrations of KC1 than the responses to oxytocin, indicating the possibility of KCI and oxytocin acting through different calcium channels. Nifedipine inhibited more the tonic than phasic components of contractions produced by both KCI and oxytocin. It is assumed that two different calcium channels might be implicated in two components of contractions produced by KCI and oxytocin. Phasic components of contraction produced by KCI and by electrical stimulation were almost completely restored by increasing the concentration of calcium in the medium, whereas tonic components were restored only to about 50%. PMID- 6497505 TI - Effects of verapamil on electrophysiological disturbances induced by lysophosphatidylcholine in isolated rabbit hearts. AB - Lysophosphoglycerides such as lysophosphotidylcholine (LPC) have been shown to accumulate in ischemic myocardium and may be important in the genesis of arrhythmias. In this study effects of verapamil on electrophysiological and biochemical derangements induced by LPC were evaluated in Langendorff-perfused rabbit hearts. LPC perfusion (10 microM) produced conduction disturbances and enhanced spontaneous firing concomitantly with increasing potassium and creatine phosphokinase contents in the coronary effluents. Although pretreatment with verapamil (2 microM) did not show any significant effects on the conduction delay and biochemical changes, it suppressed the occurrence of rapid spontaneous firing during LPC perfusion. These results suggest that relatively low concentration of LPC can induce electrophysiological and biochemical derangements comparable to those observed during myocardial ischemia and that verapamil may modify the dysrhythmias induced by LPC. PMID- 6497506 TI - In vivo anti-allergic and bronchopulmonary pharmacology of REV 3164 in rats and guinea-pigs. AB - REV 3164 has been evaluated in a variety of intact rodent models to reveal potential utility in the prophylactic treatment of asthma. REV 3164 was found a potent, orally active inhibitor of rat (IgE) passive cutaneous anaphylaxis (PCA, ED50 = 0.9 mg/kg). By contrast, at 50-200 mg/kg p.o., it did not affect guinea pig (IgG1) PCA. In PCA rats, both REV 3164, 1-36 mg/kg i.p., and the known inhibitor of mast cell mediator release, disodium cromoglycate (DSCG), 2-54 mg/kg i.p., blocked cutaneous wheals caused by i.v. antigen challenge but not by intradermal serotonin or histamine. Neither REV 3164 (0.1-10 mg/kg i.p.) nor DSCG (2-54 mg/kg i.p.) affected Compound 48/80-induced wheals. REV 3164 (0.01-1 mg/kg i.v. or 10 mg/kg i.p.) abolished rat (IgE) passive lung anaphylaxis (PLA, ED50 = 0.05 mg/kg i.v. for inhibition of elevated airway resistance). At 10 mg/kg i.p., REV 3164 did not affect active lung anaphylaxis in guinea-pigs pharmacologically manipulated to enhance the production and action of slow reacting substance of anaphylaxis (SRS-A), nor did it exhibit anticholinergic activity in the rat. REV 3164 (100 mg/kg i.p.) did not protect conscious guinea-pigs from histamine aerosol-induced collapse. It is concluded that REV 3164 is an oral inhibitor of IgE-dependent immediate hypersensitivity in the rat with biological activities in rats and guinea-pigs similar to DSCG. PMID- 6497507 TI - Dulcerozine-induced duodenal ulcers in rats: a simple, highly-reliable model for evaluating anti-ulcer agents. AB - Dulcerozine-induced duodenal ulcers in rats were studied in order to establish the optimum conditions for a routine production of ulcers and to elucidate their possible pathogenesis. Single doses of dulcerozine administered either subcutaneously or orally produced a dose-related duodenal ulceration in rats. The ulcerogenic effect of dulcerozine was most potent when given subcutaneously to 24 hr fasted animals at 300 mg/kg. At this dose, deep or perforating ulcers were consistently produced within 18 hr, but mortality due to general toxicity of the agent was excluded at least up to 48 hr. Feeding of animals resulted in a significant reduction in susceptibility to dulcerozine. An antacid and antisecretory agents prevented dulcerozine-induced duodenal ulceration in a dose dependent manner. Either pylorus ligation or vagotomy completely inhibited duodenal ulceration in response to dulcerozine. In addition, an ulcerogenic dose (300 mg/kg s.c.) of dulcerozine evoked a sustained gastric hypersecretion in pylorus ligated rats. These results suggest that a stimulating action on gastric secretion may be, at least in part, responsible for the ulcerogenic property of dulcerozine. The present study provides a new reliable model for investigations of the pathogenesis and therapy of duodenal ulcer disease. PMID- 6497508 TI - Structural restriction in bile acids and non-ionic detergents for promotion of heparin absorption from rat gastro-intestinal tract. AB - Selected non-ionic surfactants of the polyoxyethylene ether series as well as selected bile acids elicit plasma clearing activity (PC) after oral heparin administration by action on the gastro-intestinal mucosa. Evidence obtained indicates that certain structural characteristics are needed for promoting heparin absorption, since this effect is observed with some but not all non-ionic detergents (cetyl and stearyl ethers but not lauryl) and bile components (deoxycholic, chenodeoxycholic and cholic acids, but not ursodeoxycholic or dehydrocholic acids or lecithin). It is suggested that a specific mechanism of action is involved. PMID- 6497509 TI - Effect of calcium-entry blockers and divalent cations on noradrenaline-induced contractions of the rat anococcygeus muscle. AB - The effect of three calcium-entry blockers and two divalent cations known to inhibit Ca++ entry on noradrenaline (NA)--and potassium (K+)--induced contractions were studied. The organic calcium entry-blockers--diltiazem (2.5 X 10(-7)-2.5 X 10(-6) M), nifedipine (2.8 X 10(-7)-2.8 X 10(-6) M) and flunarizine (2.5 X 10(-7)-2.5 X 10(-6) M) did not significantly (P greater than 0.05) reduce NA (3.75 X 10(-7)-1.2 X 10(-5) M) contractions. However, these concentrations of the calcium entry-blockers significantly (P less than 0.05) reduced K+ (80 mM) induced contractions of the anococcygeus muscle. Both NA- and K+-induced contractions of the anococcygeus muscle were concentration--dependently reduced by the divalent cations manganese (10(-4)-10(-3) M) and cobalt (10(-4)-10(-3) M). It is suggested that while NA-induced contractions are dependent on extracellular calcium, it is quite possible that the agonist NA and K+ activate different Ca++ channels or that the mechanism of activation of the Ca++ channels is different. PMID- 6497510 TI - Effects of organic Ca2+-antagonists on membrane characteristics of nodose ganglion cells in the rabbit. AB - The effects of Ca2+-antagonists, diltiazem, verapamil and nifedipine on excised and superfused nodose ganglia of the rabbit were investigated with intracellular recording techniques. In a Na-free solution, somata of nodose ganglion C-cells were capable of eliciting Ca-spikes which were maintained by a Ca-influx when stimulated by passing currents. At a concentration of 10(-5) M, spike amplitude was inhibited to 24% of control by diltiazem, to 16% by verapamil, and to 13% by nifedipine. In a normal physiological solution, diltiazem at 10(-6) M, verapamil at 10(-6) M, and nifedipine at 10(-7) M reduced the maximal rate of rise and at 10(-7) M produced a reduction of the maximal rate of fall of the action potentials accompanied with a prolonged duration, although the resting membrane potential and the amplitude of the action potentials were not altered. The results reveal membrane characteristics of ganglion cells and suggest that Ca2+ antagonists depress not only Ca-influx but also Na-influx and K-efflux. PMID- 6497511 TI - Inotropic and electrophysiological effects of PY 108-068 on isolated cardiac preparations. AB - The inotropic and electrophysiological effects of PY 108-068 (PY), a new Ca antagonist agent, were studied on isolated atria and guinea-pig papillary muscles. On isolated atria PY produced a dose-dependent decrease in amplitude and rate of spontaneous contractions. This negative inotropic effect was more evident at fast stimulation rates. PY decreased the maximum inotropic and chronotropic responses to isoprenaline and caused a dose-response parallel shift of the Ca dose-response curve. On papillary muscles, PY produced a shortening in action potential duration without changes in the resting potential and the Vmax and amplitude of phase O. PY also produced a dose-dependent decrease in amplitude and Vmax and a shortening of the duration of the slow action potentials elicited by isoprenaline in K (27 mM)-depolarized papillary muscles. These results suggest that in isolated right atria and guinea-pig papillary muscles PY produced a selective inhibition of Ca Influx via the slow inward current. PMID- 6497512 TI - Electromechanical dissociation and possible uncoupling of phosphorylation following tachydysrhythmogenic dose of amrinone in the guinea-pig Langendorff heart preparation. AB - In the guinea-pig Langendorff heart preparation amrinone induced tachydysrhythmia and electromechanical dissociation at 1000 micrograms/ml but not at 50 and 250 micrograms/ml. At 1000 micrograms/ml, the myocardial oxygen consumption was twice the value at equilibration in spite of a very marked fall in contractile force, thus suggesting that amrinone at that toxic dose level uncoupled phosphorylation. Amrinone at 50 and 250 micrograms/ml caused a dose-related reversal of the cardiac depressant effect induced by verapamil suggesting, therefore, that the positive inotropic effect is due at least in part to influx of Ca2+ into the sarcoplasm. It is suggested that the electromechanical dissociation and the possible uncoupling of phosphorylation induced by a toxic dose of amrinone are related to a considerable influx of Ca2+ into the sarcoplasm and the mitochondria. PMID- 6497513 TI - Effects of procaine on the isolated dog coronary artery. AB - In order to search into the mechanism of the potassium contracture of the dog coronary artery the effects of procaine were studied in the isolated smooth muscle preparation of the dog coronary artery. Procaine is a substance which is known to specifically inhibit the calcium-induced calcium release mechanism. A dose-related relaxation of the potassium contracture was observed with procaine. However, the increase in La3+-resistant 45Ca uptake as measured by the Karaki and Weiss' method (1979) was not inhibited. As reported in a previous paper, caffeine induced a phasic contraction of the fully-depolarized preparation in a calcium free EGTA containing medium. Procaine produced a dose-related inhibition of this contraction. These findings suggest that the potassium contracture of the dog coronary artery is dependent on the calcium-induced calcium release mechanism. Since the potassium contracture of this preparation can be relaxed by calcium antagonists, it may be inferred that the calcium influx through the voltage dependent channels may represent the initiation mechanism of the calcium-induced calcium release process. PMID- 6497514 TI - Amyloidosis (AL). An approach to early diagnosis. PMID- 6497515 TI - The diagnosis of Parkinson's disease. PMID- 6497516 TI - Disseminated histoplasmosis in the acquired immune deficiency syndrome. PMID- 6497517 TI - Long-term furosemide treatment in idiopathic edema. AB - Of 12 patients with idiopathic edema, ten patients had received total doses of furosemide of up to about 950 g. A good negative correlation was observed between the creatinine clearance and the duration of daily oral furosemide intake of more than 40 mg, and a highly significant correlation was found between the logarithm of the creatinine clearance and the duration of daily furosemide ingestion. Cessation of furosemide and institution of a sodium-restricted diet was followed by improvement in the creatinine clearance. Three patients had acute renal failure with myoglobinuria. All patients examined showed tubular and/or interstitial changes. This study shows that in idiopathic edema, long-term furosemide treatment gradually impairs renal function, with reversal to a considerable degree after cessation of the drug, and that it causes organic changes in the kidney. PMID- 6497518 TI - Nonarrhythmogenicity of diuretic-induced hypokalemia. Its evidence in patients with uncomplicated hypertension. AB - Twenty patients aged 33 to 69 years with uncomplicated hypertension, no heart disease, and normal stress test results underwent ambulatory ECG monitoring a month after receiving placebo and two and four weeks after hydrochlorothiazide therapy. Serum potassium level (+/- SEM) averaged 4.4 +/- 0.09 mEq/L after the placebo trial and 3.4 +/- 0.07 and 3.0 +/- 0.06 mEq/L after two and four weeks of therapy, respectively. Sixteen patients had no arrhythmias. Four patients had 329 +/- 140 premature ventricular beats (PVBs) while receiving placebo and 341 +/- 203 and 315 +/- 158 PVBs per 24 hours after two and four weeks of therapy, respectively. Thus, patients with uncomplicated hypertension and no arrhythmias before diuretic therapy did not experience arrhythmias as a result of diuretic induced hypokalemia of one month's duration. Patients with low-grade ventricular ectopy (VE) before therapy did not progress to higher grades of VE after diuretic treatment for four weeks. PMID- 6497519 TI - ECG abnormalities in polymyositis. AB - Electrocardiographic abnormalities were found in 25 (32.5%) of 77 patients with polymyositis. Left anterior hemiblock (13.0%) and right bundle-branch block (9.1%) were the most common abnormalities. No association could be found between these defects and clinical activity of polymyositis, severity of duration of disease, or degree of creatine kinase level elevation. Similarly, there was no association with age or the presence of certain clinical conditions such as rash or arthritis. In only two patients, both children, did an ECG abnormality improve with corticosteroid therapy. Three patients with heart block died suddenly. This study points up the need for continual close observation of patients with inflammatory muscle disease, even after apparent remission. PMID- 6497520 TI - Renal tubular handling of potassium in patients with medullary sponge kidney. A model of renal papillectomy in humans. AB - Renal tubular function, with special emphasis on potassium excretion, was studied in three patients with medullary sponge kidney (MSK). Urinary acidification and concentration abilities were impaired, while glomerular filtration rates remained normal. After short-term intravenous (IV) potassium chloride loading, maximal excretion of potassium was lower in the patients with MSK than in the normal controls. The kaliuretic response to IV sodium sulfate and acetazolamide infusion was maintained. The capacity of the kidney to sustain potassium balance under conditions of either long-term potassium loading or depletion was preserved. We have concluded that the medullary and papillary segments of the human collecting duct, have an important role in the handling of short-term potassium loading. The integrity of these segments, however, is not essential for adaptation to prolonged potassium surfeit or dietary depletion. PMID- 6497522 TI - Using Doppler ultrasound to quantify mitral valvular disease. PMID- 6497521 TI - The general medicine clinic. Making the ugly duckling fly. PMID- 6497523 TI - Cardiopulmonary resuscitation (CPR). Patient factors and decision making. PMID- 6497524 TI - Acute deterioration in renal function in patients with preexisting renal insufficiency. PMID- 6497525 TI - The future of geriatrics. PMID- 6497526 TI - Who is a geriatrician? PMID- 6497528 TI - March 1965. PMID- 6497527 TI - Geriatric medicine. PMID- 6497529 TI - Mrs. D. PMID- 6497531 TI - Cerebellar ataxia due to procainamide toxicity. AB - It has become appreciated that drug levels of procainamide hydrochloride needed to suppress inducible ventricular tachycardia by programmed ventricular stimulation exceed the previously published therapeutic range. Cerebellar ataxia developed acutely in a patient receiving high-dose procainamide. This was associated with a marked increase in the serum drug level. Resolution occurred within three days after drug therapy was discontinued. PMID- 6497530 TI - Hepatic amyloidosis. An unusual cause of ascites and portal hypertension. AB - I treated a patient who had amyloidosis with predominantly hepatic involvement and portal hypertension. The main clinical features were hepatomegaly, gross ascites, proteinuria, and elevated alkaline phosphatase levels. Despite permanganate-sensitive AA protein being present in the biopsy specimen, none of the recognized disease entities associated with secondary amyloidosis were found. A review of the literature and the mechanism of portal hypertension in amyloidosis is given. It is suggested that elevated portal pressures may be of greater importance in the pathogenesis of ascites in amyloidosis than has been appreciated. PMID- 6497532 TI - Failure of colchicine in the treatment of Mollaret's meningitis. AB - A 32-year-old man was hospitalized 23 times in 11 years because of attacks of Mollaret's meningitis. Colchicine (0.6 mg twice daily) was administered for 15 months but failed to decrease the severity or the frequency of attacks. The prophylactic efficacy of drugs in Mollaret's meningitis is difficult to assess because episodes are unpredictable and remissions occur spontaneously. There remains no established therapy for Mollaret's meningitis. PMID- 6497534 TI - Hodgkin's disease in the liver without splenic involvement. AB - We encountered an unusual case of Hodgkin's disease disseminating to the liver without splenic involvement. Ours appears to be the first such case reported in which it was possible to rule out any prior inclusion of the spleen. PMID- 6497533 TI - Hydralazine hoarseness. A new appearance of drug-induced systemic lupus erythematosus. AB - Otolaryngologic involvement is rarely a manifestation of drug-induced systemic lupus erythematosus (SLE). Hoarseness developed in a 60-year-old man that was secondary to ulcerated lesions, which involved the epiglottis and aryteno epiglottic folds, with serologic evidence of SLE after he had been treated with hydralazine for six months. Histopathologic study of an epiglottic "pseudotumor" disclosed necrotizing vasculitis. To our knowledge, this is the first reported case of laryngeal involvement as a complication of hydralazine-induced SLE. PMID- 6497535 TI - Hepatitis A-induced remission of minimal change nephropathy. AB - A two-month remission of minimal change disease induced by hepatitis A infection occurred. The remission was substantiated by clinical, biochemical, and pathologic methods. To our knowledge, this is the first such case reported in the literature. PMID- 6497537 TI - Protein catabolism following stroke. PMID- 6497536 TI - Acute multisystem toxicity associated with the use of nonsteroidal anti inflammatory drugs. PMID- 6497538 TI - Cancer in thyroid nodules. PMID- 6497539 TI - [Present status of the research on total artificial heart implantation at Kyoto University]. PMID- 6497540 TI - The mechanism of recurrent vomiting after mild head injury in children. PMID- 6497541 TI - Comparative study of cardioplegia by anoxic arrest and elective fibrillation under extracorporeal circulation using left ventricular function curve. PMID- 6497542 TI - [Serum gastrin level before and after gastrectomy following oral administration of glycine]. PMID- 6497543 TI - [Experimental studies of esophageal cancer. 1. Production and observation of an experimental model of esophageal cancer by Vx2 carcinoma]. PMID- 6497544 TI - [Experimental studies of esophageal cancer. II. Experimental lymphographic study of the esophagus as an aid in the treatment of esophageal cancer]. PMID- 6497545 TI - [Changes of the tumor vessels following intra-arterial infusion therapy using a combination of anti-cancer agents and dexamethasone]. PMID- 6497546 TI - [Correlation between in vitro chemosensitivity of human tumors and the corresponding xenografts in nude mice]. PMID- 6497548 TI - Mechanism of the formation of bilirubin stones. II. Analysis of conjugated and unconjugated bilirubin by high performance liquid chromatography and measurements of calcium ion by ion-selective electrode in bile of patients with gallstones. PMID- 6497547 TI - [Abdominal angiography with a non-ionic contrast medium, iopamidol]. PMID- 6497549 TI - A new double column HPLC method for rapid separation of fatty acids. PMID- 6497550 TI - Three-dimentional histometry of bile ducts in the porta hepatis tissue in cases of biliary atresia. PMID- 6497551 TI - Quantitative analysis of postprandial gastric acid secretion and emptying by measuring gastric pH in dogs. PMID- 6497552 TI - Experimental study on repair of collateral ligament. PMID- 6497553 TI - [Two-dimensional echocardiography and left heart obstruction in the newborn infant. Diagnostic contribution and impact on therapy]. AB - Thirty-nine neonates with left heart obstructions (LHO) were investigated by two dimensional echocardiography (2 D echo). Results of 37 investigations were compared with angiographic data (15 cases) and/or anatomic data (surgery: 20 cases; post-mortem examination: 20 cases). 2 D echo was always performed as an emergency procedure and was interpreted before further hemodynamic investigation. Accurate investigation of the left ventricle and of the aorta (arch and proximal branches) was possible in 38 patients (97%) by combining the supra-sternal and subcostal approaches. The existence of LHO and its localization were correctly predicted by 2 D echo in 37 of 39 cases including: aortic coarctation (Ao co) (23 cases), isolated aortic stenosis (iAo S) (5 cases), interruption of the aortic arch (IAA) (3 cases), hypoplastic left ventricle (6 cases), and ranged LHO (2 cases). In 2 patients, one of whom presented with transposition of the great arteries, a coarctation was overlooked and a false positive (Ao co) was found during the same period in a prospective study of 100 neonates by 2 D echo (sensibility 95%, specificity 99%, predictive value 97%). In all patients, 2 D echo made it possible to establish the associated lesions that could modify therapeutics. In no case was emergency diagnostic surgery necessary and the last 9 patients of this series underwent successful therapeutic surgery only on the basis of echographic data. PMID- 6497554 TI - [Early treatment of congenital hypoplasia of the penis with intramuscular delayed action testosterone]. AB - Three intramuscular injections of 25 to 50 mg of testosterone hexahydrobenzoate were prescribed in 37 boys who presented with hypoplastic penis: 16 with micropenis and normally placed urethra, 21 with hypospadias. Ages ranged from 4 months to 9 years. In almost all children treated between the ages of 6 and 18 months, penis growth became normal for age. Growth and bone maturation were temporarily accelerated but in a parallel fashion, so that this very early androgen-therapy need not reduce the adult height of children thus treated. PMID- 6497555 TI - [Micropenis. Results of treatment with testosterone]. AB - Two groups of children presenting with micropenis (penis length less than or equal to 2.5 cm) were treated according to 2 different therapeutic schedules. The first consisted of the transcutaneous administration of testosterone propionate (4 mg twice a day) and the second of the intramuscular injection of sustained action testosterone enanthate (25 mg every 2 weeks). Only the intramuscular treatment was able to induce a normal and durable penis growth, owing to the hyperplastic action that the testosterone injection exerted on the level of the cellular tissues of the penis. Using testosterone enanthate dosages varying from 25 to 50 mg, the risks for an abnormal acceleration of growth and bone age seem to be minimized. PMID- 6497556 TI - [Final results of treatment with human growth hormone]. AB - The authors report the results of treatment with human growth hormone (hGH) (for 3 1/2 years to 11 3/4 years, mean: 5 years 4 months) in 34 children presenting with complete growth hormone deficiency and an average growth failure reaching 3.9 standard deviations (SD). Treatment was discontinued, after spontaneous or induced puberty, when bone age reached or was beyond 15 years in boys, and 13 years in girls. A partial correction was obtained in almost all cases. However, average height remained at -2.4 SD with respect to age and -1.75 with respect to bone age, reaching normal limits in only half of the patients. School and professional performances were not appreciably different from those which are observed in normal adolescents. Although the acceptance of the diagnosis and therapy was not always good, the medical support associated with the supervision of the treatment seems to have had a favourable psychological effect. PMID- 6497557 TI - [Acromesomelic dysplasia. Apropos of a new case]. AB - The authors report a 4 year 5 month-old Algerian girl with acromesomelic dwarfism. The dwarfism was severe (-6 SD) with kyphoscoliosis at the thoraco lumbar junction induced by major involvement of the spine between D11 and L1. Shortening of the tubular bones was symmetrical, interesting especially the upper limbs, involving middle and distal segments. Intellectual development was normal. The parents were first cousins of normal height, like the 2 younger sisters. PMID- 6497558 TI - [Dystonia musculorum deformans. Elements of a favorable development]. AB - The therapeutic benefits of a concomitant approach to the disease and to the patient's identity experienced by the authors is illustrated by this case of a child presenting with dystonia musculorum deformans and severe disturbances of identity. This work was part of a research program concerning the function of these approaches and the operative modalities of their combinations. PMID- 6497559 TI - [Iconographic rubric: an appendicular coprolith]. PMID- 6497560 TI - [Characteristics of the dietary intake of French children from 3 to 24 months of age. Diet of French infants]. AB - The food consumption of 543 French infants, aged 3 to 24 months, was recorded during a 3 day period. The nutrient intake data were calculated by a computerized food table. The 1981 recommended dietary amounts proposed by the Committee of the Centre National de Coordination des Etudes et Recherches sur la Nutrition et l'Alimentation were used to assess adequacy of intake. Our results showed a great variability between individuals considering the caloric intake. The mean energy intakes were greater than the recommended amounts for the age range of 6 to 12 months: therefore a revision of the recommended amounts appears necessary. A marked decrease of the consumption of infant formulas was noted between 4-5 months (57% of the total energy intake) and 6-7 months (18% of the total energy intake). The consumption of the other baby foods was the highest at 6-7 months (23% of the total energy intake). The probability that a French infant has a protein intake less than the recommended amounts was less than 0.02. This probability was 0.04 for calcium intake and 0.50 to 0.78 for iron intake according to age. An increase of the iron intake from 4-5 months is a justified dietary goal. The mean intake of linoleic acid was the smallest at a mean age of 8 to 12 months and represented less than 2% of the caloric intake. PMID- 6497561 TI - [Chronic cough in schoolchildren from the Bordeaux area. Results on 15000 adolescents]. AB - A large epidemiological survey carried out in the spring of 1981 among the teenagers attending school in Bordeaux and its surroundings enabled us to study the relationship between the history of broncho-pulmonary diseases in childhood and infancy and chronic cough in teenagers. The population consisted of 15,247 pupils (average age, 16.5 years). There were 47% boys. Data collection was carried out by means of self-administered questionnaires filled out in class. Besides socio-demographic information and questions about smoking habits, the pupils answered questions concerning present respiratory symptoms and history of bronchopulmonary diseases before 2 years of age and between ages 2 and 6. A chronic cough was present in 4.3% of the pupils. This proportion was significantly higher in girls, older pupils, smokers, those belonging to lower social classes and asthmatics. The relationships between history of bronchopulmonary diseases during childhood and infancy and present chronic cough were highly significant and remained so after adjustments for confounding factors. This relationship existed also in the sub-population of non-asthmatic pupils. PMID- 6497562 TI - [Evaluation of maternofetal transport by the determination of serum prealbumin in the mother and newborn infant]. PMID- 6497563 TI - [Paraplegia disclosing an intramedullary tuberculoma in a 6-year-old child]. PMID- 6497564 TI - Akathisia with haloperidol and thiothixene. AB - We studied the incidence of akathisia in two populations of newly admitted schizophrenic patients: one group was treated with haloperidol and the other group was treated with thiothixene hydrochloride. Within six hours after taking a 5-mg test dose of haloperidol, 40% of the patients experienced akathisia; during maintenance treatment with 10 mg of haloperidol taken at bedtime, 75% of the patients experienced akathisia by the seventh day. With thiothixene hydrochloride (0.22-mg/kg test dose; 0.44-mg/kg maintenance dose), the respective percentages were 20% and 46%. The akathisia experienced after administration of the test of haloperidol dose was not mild or inconsequential; 28% of the patients experienced moderate, 17% of the patients experienced severe, and 22% of the patients experienced very severe akathisia. Akathisia with haloperidol could not be suppressed completely in half of the patients. Treatment-resistant akathisia was experienced as anxiety and depression. We believe these tallies to be important because akathisia causes much misery and often goes undiagnosed. PMID- 6497565 TI - Schneider's first-rank symptoms of schizophrenia. An association with increased growth hormone response to apomorphine. AB - Growth hormone and prolactin (PRL) responses to 0.75 mg of apomorphine hydrochloride were measured in 19 newly admitted psychotic patients who had been untreated by neuroleptic or antidepressant drugs for at least nine months. We compared hormonal responses between subgroups of patients who were distinguished using the diagnostic criteria of Feighner et al and Spitzer et al, and by the presence or absence of Schneider's first-rank symptoms of schizophrenia. We included nine healthy subjects who were matched by age and sex with the schizophrenic patients. Growth hormone responses to apomorphine were greater in patients with Schneider's first-rank symptoms than in those without first-rank symptoms, and were also greater than in control subjects. Suppression of plasma PRL was also greater in schizophrenic patients than in control subjects. These results support the dopamine hypothesis of schizophrenia. PMID- 6497566 TI - Haloperidol. Plasma levels and prolactin response as predictors of clinical improvement in schizophrenia: chemical v radioreceptor plasma level assays. AB - The relationship between clinical response of schizophrenic patients to haloperidol and (1) blood levels of the medication, determined by both gas-liquid chromatography (GLC) and radioreceptor (RR) assays, or (2) prolactin response to the medication, was examined in an inpatient study using several fixed doses of haloperidol. Regression analysis disclosed a substantial curvilinear relationship between steady-state GLC-determined plasma haloperidol levels and decrease in Brief Psychiatric Rating Scale (BPRS) Psychosis factor scores; however, no substantial relationship was found between clinical response and RR plasma haloperidol levels or serum prolactin response to haloperidol. Our results suggest that steady-state plasma levels of haloperidol determined by the GLC chemical assay are a better predictor of decreases in BPRS Psychosis factor scores than RR assayed plasma haloperidol levels or prolactin response to haloperidol. PMID- 6497567 TI - Vulnerability to schizophrenia. Prediction of adult schizophrenia using childhood information. AB - Forty years ago, Glueck and Glueck studied a group of Boston Inner city children to discover factors relating to delinquency. Detailed information was obtained on 1,000 boys aged 10 to 17 years, 500 "delinquents" and 500 "nondelinquent controls." In follow-up studies of this group, we have found that 24 have a diagnosis of adult schizophrenia. We matched these 24 with 48, who had a nonschizophrenic outcome, on the basis of IQ, ethnicity, age at interview, and original Glueck grouping (delinquent or control). The 72 childhood records were then examined on a blind basis by Independent raters looking for predetermined "indicators of vulnerability to schizophrenia." The total indicator scores were able to differentiate schizophrenic outcome from nonschizophrenic outcome at highly significant levels. A number of the individual indicators were likewise able to predict outcome. Prediction was improved when subjects with the lowest IQs (less than 85) were excluded from consideration. PMID- 6497568 TI - Increased sensitivity to caffeine in patients with panic disorders. Preliminary evidence. AB - The results of a caffeine consumption inventory indicated that patients with panic anxiety disorder, but not affectively ill patients or normal controls, had levels of self-rated anxiety and depression that correlated with their degree of caffeine consumption. In addition, this self-report survey suggested that patients with panic disorder had an increased sensitivity to the effects of one cup of coffee. This apparent sensitivity to caffeine was also documented by the observation that more patients with panic disorder reported the discontinuation of coffee intake due to untoward side effects than controls. These results, based on self-reports, suggest that the hypothesis that patients with panic disorder are more reactive to caffeine should be directly tested using caffeine challenges and that the mechanisms underlying caffeine's effects on anxiety should be further explored. PMID- 6497569 TI - Behavioral effects of caffeine in children. Relationship between dietary choice and effects of caffeine challenge. AB - From a survey of 24-hour caffeine intake of 798 grade-school children (mean age, 10.3 years), 19 "high consumers" (reported intake of 500 mg/day or more) and a matched group of 19 "low consumers" were recruited for a double-blind, placebo controlled, caffeine challenge study. Children received 5 mg/kg of caffeine twice a day or placebo for two weeks each, using a crossover design. While not receiving caffeine, high consumers had higher scores on an anxiety questionnaire and tended to have lower autonomic arousal (less frequent spontaneous skin conductance response and lower skin conductance level). While receiving caffeine, low consumers were perceived by their parents as more emotional, inattentive, and restless, while high consumers were not rated as changed. These differences cannot be attributed to tolerance, withdrawal, or subject selection, and suggest a possible physiological basis in children for dietary caffeine preference. PMID- 6497570 TI - Biological 'markers' for endogenous depression. Effect of age, severity of illness, weight loss, and polarity. AB - The dexamethasone suppression test (DST) can differentiate between endogenous and nonendogenous depression. Similarly, EEG sleep patterns can differentiate primary from secondary depression, and this technique has also been used to make the endogenous-nonendogenous discrimination. However, a number of physiological variables associated with this diagnostic distinction may also affect the DST results and sleep architecture. With the use of multivariate statistical procedures, we found that although age and weight loss affect the results of both tests, both the DST and sleep EEG differentiate endogenous from nonendogenous depression when these variables are taken into account. Severity of illness affected both proposed diagnostic markers, but did not account for the differences between diagnostic groups, alone or when added to the physiological variables. The DST was more sensitive in unipolar than in bipolar endogenous depression, but there were no significant differences in the sleep of unipolar and bipolar patients. PMID- 6497572 TI - Hypothalamic-pituitary-adrenocortical activity in patients with diabetes mellitus. AB - Several clinical and physiologic associations between depression and diabetes mellitus have been reported. In this study, a potential neuroendocrine association was studied by measuring hypothalamic-pituitary-adrenocortical (HPA) axis activity in patients with diabetes mellitus. Plasma cortisol levels and response to dexamethasone administration were determined in 54 diabetics. Twenty three (55%) of forty-two 1-mg dexamethasone suppression tests (DSTs) performed in 34 subjects, with eight repeated tests, and two (10%) of twenty 2-mg DSTs demonstrated a blunting of normal suppression. None of a variety of potential demographic, physiologic, or mood factors predicted nonsuppression. This study replicates prior findings that HPA dysfunction occurs in association with diabetes, and invalidates the use of the 1-mg DST as a diagnostic marker for melancholia in patients with diabetes. PMID- 6497573 TI - Placebo-control groups in the study of outpatient depressives. PMID- 6497571 TI - Abnormal results of dexamethasone suppression tests in nondepressed patients with diabetes mellitus. AB - To investigate the specificity of the dexamethasone suppression test (DST) for the diagnosis of major depression in patients with diabetes mellitus, we administered 1 mg of dexamethasone to 30 nondepressed diabetics and to 58 normal controls at 11 PM. Diabetic subjects received hemoglobin A1 (Hb A1) determinations, the Hamilton Rating Scale for Depression (HRSD), and five to eight blood glucose determinations during the 48 hours surrounding the DST. Results demonstrated a significantly higher rate of nonsuppression (plasma cortisol level, greater than or equal to 5 micrograms/dL) at 4 PM the following day among diabetics (43%) than among controls (7%) but no difference between these groups in the rate of nonsuppression at 8 AM. Plasma cortisol level at 4 PM correlated with Hb A1 level but not with duration of illness, HRSD score, mean blood glucose level, or maximum blood glucose excursion. These results suggest that the results of the DST used as a diagnostic test for major depression must be interpreted with caution in patients with diabetes. PMID- 6497574 TI - Do maladaptive attitudes 'cause' depression: misconception of cognitive theory. PMID- 6497575 TI - Cognition and therapy. PMID- 6497576 TI - Immunogenicity of splenocytes, associated with temporal exposition of D galactosyl residues, in Rauscher leukemia. AB - To prove the existance of specific cellular immunity in leukemia the antigen preparations, obtained from the leukemia spleens and from embryos were studied in electrophoretic mobility test. It was shown that only spleens, which were obtained at days 2 and 3 after virus inoculation, possess the specific antigenic activity. Immunogenicity is associated with D-galactosyl residues, as was shown in the experiments with competitive inhibition by sugars, binding with peanut lectin and isolation of PNL-positive cells. PMID- 6497577 TI - Ultrastructural observations of the stroma of human colon carcinomas with special regard to myofibroblasts. AB - The stroma of 18 human colon carcinomas was studied with regard to the occurrence of myofibroblasts. In addition, we tried to determine if there was any relationship between myofibroblasts and other stromal responses to tumor growth, e.g. immunologic inflammatory reactions or activation of vascular structures. We found myofibroblasts in 13 carcinomas, although only sporadically in 6 of them. In 5 carcinomas these cells were absent. The number of myofibroblasts showed an inverse relation to the quantity of inflammatory cells (mainly lymphocytes, plasma cells and histiocytes). A variable amount of activated vascular structures could be seen in all cases. In 5 tumors many activated vessels showed a multilayered basement membrane. The electron microscopic findings led to the conclusions that myofibroblast proliferation and immunologic inflammation are not positively correlated with each other and that vascular activation does not parallel myofibroblast induction. The significance of the individual components for tumor prognosis is briefly discussed and the need for further work to clarify the role and mode of interaction of the different factors in tumor-induced stromal response is emphasized. PMID- 6497578 TI - [Clinical picture, therapy and prognosis of orolabial cancer with special reference to regional lymphatic drainage]. AB - Upon classification according to the TNM system, most lip carcinomas fell into low T-categories whereas cancers of the oral cavity fell in high T-categories. The proportion of cases with palpable lymph nodes did not differ between the two sites although the extent of the palpation findings (N-category) did differ. In general differences in clinical behavior between the two locations were more apparent when a complex evaluation of all findings was undertaken. Lymph node metastases were divided into two categories whereby a more differentiated calculation of the frequency of metastasis was possible. The interpretability and accuracy of the palpation findings of regional lymph nodes corresponding to the TNM-classification is rather limited with respect to the occurrence of metastases. Patients with fixed lymph nodes or histologically confirmed or clinically certain metastases have a poor prognosis. The frequency of appearence of temporally-determined recurrences and late metastases as well as the average interval until appearence were essentially the same. PMID- 6497579 TI - [Importance of computed tomography in metastatic kidney tumors]. AB - The value of computed tomography for discovery and assessment of primary tumors has been investigated in 54 malignant kidney tumors with already existing distant metastases. The method is compared to the diagnostic data obtained by urography. Computer tomography proved to be the most informative method to examine the state of tumor spreading and, therefore, determines the further diagnostic procedure. PMID- 6497580 TI - [Epidemiology of bronchial carcinoma]. AB - The epidemiological data collected suggest increasing occurrence of bronchial carcinoma throughout the world. The trend in mortality, and incidence if the latter is explored, reveal, with rare exceptions, a still increasing tendency. Separate evidence is presented from epidemiological surveys which suggest rising risk factor prevalence, above all smoking and occupational exposures. Descriptive and analytical epidemiology may considerably contribute to the fight against cancer, in particular to its prevention. Unfortunately, in many European countries no cancer records are maintained even for the most diseminated malignancy, i.e. bronchial carcinoma. PMID- 6497581 TI - [Neoplasms in children in the GDR]. AB - Since its establishment in 1953, the National Cancer Registry of the GDR has collected approximately 10,800 neoplasms which occurerd in children. The present work analyzes neoplasms reported in persons under 15 years old by age, sex and tumor site. Incidence and mortality statistics are presented and compared for successive time periods. PMID- 6497582 TI - [Modification of selected leukocyte functions in albino rats caused by the transplantable Jensen sarcoma and by therapeutic trials of cyclophosphamide and vinblastine, Clostridium butyricum M55 and short-term hyperglycemia]. AB - A significant increase in leukocyte adhesion and agglomeration was observed in white rats with Jensen sarcoma. Glucose induced short-term hyperglycemia temporarily stimulated these leukocyte functions in healthy rats. This effect was not notably influenced by administration of tumorlyzing spores. In contrast administration of the cytostatic agents vinblastine and cyclophosphamide demonstrated dose-related inhibition of leukocyte agglomeration and adhesion. PMID- 6497583 TI - [Increase in serum aldolase caused by bronchial carcinoma]. AB - 13 patients were undergone a resection of their lung tumours. Under operation aldolase were determined in V. pulmonalis, A. pulmonalis and V. basilica. First time it is demonstrated: Human bronchial carcinomas give aldolase in circulating blood. Aldolase-level in V. pulmonalis of carcinoma increases with size and dedifferentiation of tumours. PMID- 6497584 TI - A comparative study of early gastric cancer. AB - Authors provided a comparative study of early gastric cancers (EGC) which were found in the Cancer Research Centre of the Academy of Medical Sciences of USSR (Group A) and in the Central Institute of Cancer Research of the Academy of Sciences of GDR (Group B). The most frequent EGC-type in group B was type II, while types I and III were more frequent in group A. The rate of lymph node metastases in group A was 4,54% versus 16,2% in group B. Multicentric cancers were more often found in group A. These findings strengthen the opinion that early gastric cancer is not a uniform biological entity. Accuracy of x-ray and gastroscopic diagnoses was higher in group A. This fact surely contributes to the better prognosis of early gastric cancer in this group. PMID- 6497585 TI - The cancer registry in cancer control. AB - The sole justification for a cancer registry is that use is made of its data. The information stored and produced by a cancer registry forms the scientific basis for planning and organization of the treatment and prevention of cancer in the community. Its data can also be used in the testing of various hypotheses concerning the aetiology and biology of malignant neoplasms and it may also give rise to various new hypotheses. PMID- 6497586 TI - The role of registration in a nationwide cancer control program in Slovakia. AB - In comparison with the official statistics substantially higher, more reliable and more detailed cancer incidence and mortality rates were ascertained by the National Cancer Registry of Slovakia established in the frame work of a complex cancer control program initiated in Slovakia in 1976. The role of the registry in the evaluation of treatment, planning for material and personal resources, orientation of public education, improved classification of malignancies in childhood, in planning and evaluation of preventive measures as well as its experience with the use of the standard WHO system for cancer registries are described. A more important position for the registry in the continuous evaluation and current orientation of the cancer control program is suggested for the future. PMID- 6497587 TI - [Screening for endometrial carcinoma in a group at risk]. AB - In a population-based study 923 asymptomatic women with diabetes aged 40 to 70 years were investigated by aspiration curettage. The samples were evaluated histologically. During the initial screening 4 histologically proved endometrial cancers were diagnosed. All cancer patients were additionally obese and had hypertension, with one exception they were also nulliparous. During the same period the expected number of cases for all investigated women was estimated to 0,74. The expected number of cases limited to those with diabetes, obesity and hypertension was 0,31; and limited to those with diabetes, obesity, hypertension and nulliparity was 0,1, respectively. Additionally 4 cases of adenomatous hyperplasia of the endometrium were identified. The long-term impact on morbidity and mortality of endometrial cancer within the investigated population at risk cannot be assessed as yet. PMID- 6497588 TI - Light and electron microscopy of bone marrow hemopoiesis in late embryonal and early postnatal mice: a qualitative and quantitative study. AB - Using serial sections of the entire body of late embryonal and early postnatal mice, a morphologic analysis of the bone marrow in the whole skeleton was made qualitatively and quantitatively. Hemopoietic cells in the developing marrow were also examined at the light and electron microscopic levels. Before birth, the bone marrow is quite small in volume. During the first five postnatal days, the marrow shows an approximately 65-fold increase in total volume. At 0-3 days of age, hemopoiesis begins in the marrow throughout the body. Marrow hemopoiesis starts earlier in the rib, scapula, humerus and femur. The development of hemopoiesis proceeds through the following three stages: formation of the marrow cavity, accumulation of neutrophils in the cavity, and appearance of hemopoietic cells. In the bone marrow prior to active hemopoiesis, a majority of cells first appearing are mature neutrophils, among which immature erythroblasts and dark small lymphocytes, although very small in number, are seen. The functional significance of the cells appearing early is discussed in relation to the subsequent events involved in marrow hemopoiesis. In addition the marrow, development of the other blood forming tissues and lymphatic organs is also examined quantitative-morphologically. PMID- 6497589 TI - Quantitative observation of megakaryocytes in the spleen and bone marrow of the mouse: effects of sex, sex hormones, pregnancy and lactation. AB - Megakaryocytes in the spleen and bone marrow of the mouse were quantitatively examined particularly in relation to sex. In the splenic red pulp, megakaryocytes increase equally in number in both sexes in early life until 35 days of age. At 70 and 150 days of age, however, the number of megakaryocytes is significantly greater in females than in males, and thus a significant sex difference is apparent between the sexes. Removal of the testis causes an increase in the number of splenic megakaryocytes. In males, gonadectomized or normal, estrogen induces a marked increase in the number of megakaryocytes, whereas neither testosterone nor progesterone causes significant changes. In females, splenic megakaryocytes show a marked increase during pregnancy. After delivery, they gradually decrease in number. The decrease is more rapid in non-lactating than in lactating mice. In the bone marrow, no significant sex difference is evident in the number of megakaryocytes per unit area. Estrogen causes a significant increase in the megakaryocyte count also in the bone marrow. Based on the results obtained, megakaryocytopoiesis in the hemopoietic tissue was considered from a standpoint of its relation to sex. PMID- 6497590 TI - Scanning and transmission electron microscopy of cysts in the renal cortex of the macaque monkey. AB - Renal cysts in the cortex of the monkey kidney were observed by scanning and transmission electron microscopy, in an attempt to determine the three dimensional structures of the epithelial cells in these cysts. The cysts were composed of a thin wall which limited a large spherical space containing a jelly like substance and some wandering cells. Rudimentary tufts of glomerular capillaries and/or a mound-like swelling were present on the inner surface of the cyst wall, and the inner surface of the cysts was lined with an epithelium with pedicles. The epithelial cells were podocytes, whose surface structure was similar to that on the glomerular capillary in the normal renal corpuscle. The terminal foot processes were characteristically interdigitated not only on the glomerular capillaries, but also on the mound-like swelling and concave surface of the parietal portion of the cyst. A discrete, smooth-surfaced area was found on the side opposite to the glomerulus or swelling. This area was covered by squamous epithelial cells. At the peripheral zone of the smooth-surfaced area, elongated epithelial cells were demonstrated. Our findings indicate that the podocyte layer of the cyst corresponds to the internal leaflet of Bowman's capsule, and the squamous cell layer to the external leaflet. The mound-like swelling covered by podocytes is considered to represent a stage of possible evagination of the tufts of glomerular capillaries. There was no evidence of an opening of the urinary tubule in the cyst wall. PMID- 6497591 TI - Macrophagic ameboid cells in the brain ventricles of the neonatal rat. AB - Scanning electron microscopy revealed numerous macrophagic ameboid cells on the ependymal surface of all brain ventricles in neonatal rats. Macrophagic ameboid cells aggregated in the sulcus medianus of the fossa rhomboidea, the recessus of the cerebral aqueduct and the recessus infundibuli, i.e. the ventromedial floor of the ventricular cavity covered mainly with non-ciliated ependyma. Macrophagic ameboid cells were numerous in the first few days after birth, often intermingling with extravasated erythrocytes. Subsequently, these cells decreased in number until 10 days after birth. Thus, it was rather difficult to find such ameboid cells in the brain ventricles of 21-day-old rats. Intravenous injection of primuline, a fluorescence dye used as a cytoplasmic marker in the previous study, enhanced the appearance of the ameboid cells and caused them to remain longer on the ventricular surface. PMID- 6497592 TI - Ultrastructure of Paneth cells in germ-free rats, with special reference to the secretory granules and lysosomes. AB - Ultrastructure and acid phosphatase activity in Paneth cells, which are thought to play a role in regulation of the intestinal flora, were observed in control and germ-free rats (5 weeks of age, male). Examination of the germ-free rats revealed: secretory granules with coarse and a low-electron dense matrix in the duodenal, jejunal and ileal Paneth cells; numerous and larger lysosomes in ileal Paneth cells; and contact or fusion between the secretory granules and lysosomes in ileal Paneth cells. Acid phosphatase activities in Paneth cells were observed in the GERL of Novikoff (1964) and lysosomes in germ-free as well as control rats. None of the secretory granules showed any acid phosphatase activity. The fact that the lysosomes fused with the secretory granules suggests that the process of crinophagy occurred in the Paneth cells of germ-free rats. PMID- 6497593 TI - Uptake of carbon and polystyrene particles by the sinusoidal endothelium of rabbit bone marrow and liver and rat bone marrow, with special reference to multiparticle-pinocytosis. AB - The endocytosis of tracer particles by sinusoidal endothelial cells was studied in the bone marrow and liver of the rabbit and in the bone marrow of the rat after intravenous injection. The tracer particles used included carbon particles and polystyrene particles of different sizes ranging from 0.11 to 5.7 micron in diameter. The sinusoidal endothelial cells of the rabbit liver and rat bone marrow took up carbon through the formation of bristle-coated vesicles at the luminal surface, but they eventually failed to ingest polystyrene particles of 0.11 micron or larger. On the other hand, the sinusoidal endothelial cells of the rabbit bone marrow took up carbon and polystyrene particles varying from 0.11 to 2.02 micron in diameter. These endothelial cells were found to sequester circulating tracer particles in the cytoplasm through the formation of two kinds of vesicles at the luminal surface: bristle-coated vesicles and "multiparticle pinocytotic vesicles." This special type of pinocytotic vesicle was larger in diameter than the bristle-coated vesicle and variable in size according to the size or amount of the particles to be sequestered. Carbon and 0.11 micron polystyrene particles were taken up by means of both the bristle-coated vesicles and multiparticle-pinocytotic vesicles, whereas particles 0.30 micron in diameter or larger were taken up by the vesicles similar in nature to multiparticle pinocytotic vesicles. A sequence for the morphological events occurring in the formation of multiparticle-pinocytotic vesicles in the sinusoidal endothelial cells of rabbit bone marrow shall be suggested and discussed. PMID- 6497595 TI - Sustained release preparations, XVI: Collagen as a drug carrier. PMID- 6497594 TI - Myelin figures in the basal-granulated cells of human Brunner's glands. AB - Peculiar myelin figures were abundantly found in some basal-granulated cells including S, D1 and I cells in human Brunner's glands. Intense acid phosphatase activity was found in the periphery of the myelin figures, indicating that they were secondary lysosomes or residual bodies. The acid phosphatase activity was also found in some secretory granules. There were some secretory granules which were partly membranous in content, suggesting the initial stage of their degradation into myelin figures. There were also features indicating the fusion of secretory granules with the myelin figures. All these findings suggest that the myelin figures are the products of lysosomal degradation of secretory granules. The rate of occurrence of basal-granulated cells containing myelin figures in Brunner's glands tended to be higher in subjects with duodenal ulcer than in cases of gastric cancer or ulcer. PMID- 6497596 TI - Syntheses and in vitro antimycotic activities of 1-benzyl-3-(1 imidazolylmethyl)indoles. PMID- 6497597 TI - Novel phenanthridine thiosemicarbazone and thiazoline derivatives: syntheses and evaluation for anticancer and antimicrobial activities. PMID- 6497598 TI - Syntheses, structures and antimicrobial properties of some halogenofuroxans and related furazans. PMID- 6497599 TI - Syntheses of some substituted isatin-beta-thiosemicarbazones and isatin-beta hydrazonothiazoline derivatives as potential antiviral and antimicrobial agents. PMID- 6497600 TI - [The anticoagulant 2,5-diarylcyclopent-4-ene-1,3-dione]. PMID- 6497601 TI - Histological results with cement-free implanted hip joint sockets of polyethylene. AB - The histological appearance of the implant-bone boundary in eight preparations from seven deceased patients in whom a polyethylene acetabulum socket had been inserted without cement between 3 weeks and 3 years previously is described. In all cases, a good or excellent clinical result had been present up to death. All sockets were firmly anchored macroscopically in the bone of the acetabulum. Three zones were defined in accordance with the mechanical strain on the surface of the cup: (a) zone of compression; (b) zone of transition in which mainly shear forces act; and (c) zone of decompression, which corresponds to the region below the "equator." It was noticeable that a layer of connective tissue separated the implant from the bone over almost the entire surface. This layer was very thin in the region of the pressure transfer layer, and thicker in the decompression zone. At sites at which pressure and shear forces act a fibrocartilaginous tissue was found, and the "subchondral" bone was only occasionally in direct contact with the polyethylene surface. At some sites, but above all in the region of the compression zone, very tiny particles that were birefringent in polarized light were found. Either these derive from very fine grindings from the prosthesis surface or they are to be interpreted as a result of "biodegradation" of the polyethylene. This observation permits the conclusion that the biocompatibility of the implant can be improved further by coating the polyethylene surface. PMID- 6497602 TI - Rearthroplasty after conventional total hip prosthesis and double-cup prosthesis. A comparative study. AB - Revision of 19 Muller total hip prostheses and 9 ICLH double-cup prostheses is compared. In the Muller group the mean operation time was 186 min, the amount of blood transfused 3526 ml, and the hospital stay 34.9 days. The corresponding figures for the ICLH group were 94 min, 1389 ml, and 25.7 days. Revision of the conventional hip prostheses involved technical difficulties and complications such as femoral fractures and postoperative dislocations, which were not seen in the ICLH group, in which the revision was as easy to perform as the primary operation. The clinical result 6 months after revision was significantly better in the ICLH group. Thus, the double-cup prosthesis provides another possibility for revision. However, a relatively high incidence of early loosening indicates that it should not be used in older patients in whom one would expect a follow-up shorter than the lifetime of a conventional hip prosthesis. PMID- 6497603 TI - The influence of age on the morphology of trochanteric fracture. AB - A series of 127 trochanteric femoral fractures was analyzed with respect to fracture type, age, and bone quality (osteoporosis). There was a continuous decrease in bone quantity (measured as femoral score) with age and a direct relation between bone quality and the severity of the pattern of the trochanteric fracture. The skeletal ageing process starts earlier in women. However, after the age of 85 years the process is more rapid in men. Consequently, the risk of sustaining a trochanteric fracture is greater in men than in women above this age. The increasing age of the population and the longer survival of the oldest people results in more unstable and more comminuted fractures, which have increased by a factor of nearly 3 during the past three decades. PMID- 6497604 TI - Synovectomy as treatment for purulent joint infection. AB - Conventional treatment of pyogenic knee joint infections leads to unsatisfactory results. Through early synovectomy, before cartilage damage and osteoarthritis appear, the infected focus can be "excised." Functional after-treatment avoids cartilage atrophy, wound adhesions, and muscle weakness. The excellent results after 26 knee joint infections confirm this. PMID- 6497605 TI - Rotatory instability of cadaver knees after transection of collateral ligaments and capsule. AB - The importance of the medial and lateral compartment ligaments of the knee in relation to valgus-varus and axial rotation instability was investigated. Mobility patterns were drawn from 20 osteoligamentous knee preparations after successive transections of the structures. Cutting of the medial collateral ligament resulted only in slight valgus instability and modest anteromedial instability. When the medial posterior joint capsule was also cut, both types of instability increased, and moreover, the knee became posteromedially unstable. Cutting of the lateral collateral ligament produced only a little varus instability and anterolateral rotatory instability, but varus instability increased considerably when the posterior lateral capsule was also transected. In this latter situation, even marked posterolateral rotatory instability was found. Isolated transection of the medial or lateral collateral ligament did not cause any major valgus or varus instability, but when the posterior capsule was also transected, a considerable degree rotatory instability could be found even though the cruciate ligaments were intact. PMID- 6497606 TI - The anterior cruciate ligament of the knee: an experimental study of its importance in rotatory knee instability. AB - The importance of the anterior cruciate ligament (ACL) in relation to valgus varus and axial rotation stability in the knee joint was investigated. Mobility patterns were drawn from ten osteoligamentous preparations after successive transection of the two parts of the ACL and the medial (MCL) and lateral collateral ligaments (LCL). The knee joint remained grossly stable after partial injury of the ACL, while sectioning of the entire ACL caused an increase in internal rotation in the extended-semiflexed position. Combined lesions to the ACL and the MCL caused considerable valgus instability increasing with flexion, the joints remaining stable in extension. Moreover, marked anteromedial instability occurred, while only slight posteromedial instability was found. Combined lesions to the ACL and the LCL caused varus instability, worst in the semiflexed position, and a consistent pivot shift in applying a valgus torque in flexion was noted. Moreover, moderate posterolateral instability was found, at its maximum in the semiflexed position. External rotatory stability is secured primarily by the MCL, secondarily by the posterior medial capsule, and finally by the ACL. The existence of lateral pivot shift is proof of damage to the ACL. PMID- 6497607 TI - Surgical treatment of spondylolisthesis by bone grafting and direct stabilization of spondylolysis by means of a hook screw. AB - A new method of treating a spondylolisthesis by means of bone grafting and a special hook screw is reported. With this method, the "restitutio ad integrum" of spondylolysis and at least partial reduction of a grade-I spondylolisthesis can be achieved. The surgical technique is simple. Ten patients in our series of 12 showed good or excellent results. PMID- 6497608 TI - The application of somatosensory-evoked potentials in orthopedic spine surgery. AB - This review will report results and experience gained with intraoperative monitoring SSEP's (somatosensory-evoked potentials) during 61 operations on the spine for correction of scoliotic curvatures. The potentials were elicited by uni or bilateral stimulation of the tibial nerve and recorded from the scalp. Four cases, in which we observed intraoperative or postoperative alterations in waveform or neurologic status, are described. The method is easily applicable, noninvasive, and can--in spite of its sensitivity to environmental influences- well provide information about the neurologic function of the spinal cord. PMID- 6497610 TI - Delayed diagnosis of a spontaneous atlanto-axial rotatory dislocation. AB - Without any known specific cause a 3-year-old boy developed a torticollis. Although the symptoms were treated immediately there was no improvement. Four months later X-rays showed that the dens-atlas distance was enlarged. In spite of this, he was treated by tenotomy and intensive physiotherapy, but the torticollis remained. Two years later a tomogram and a CT showed a complete rotatory dislocation between atlas and axis. At this stage it was impossible to treat the original cause. Physiotherapy was continued to improve the position of the head. PMID- 6497609 TI - On the pathogenesis of spondylosis deformans and arthrosis uncovertebralis: comparative form-analytical radiological and statistical studies on lumbar and cervical vertebral bodies. AB - To investigate the etiopathogenesis of the common clinical symptoms of the lower lumbar spine (LS) and cervical spine (CS) (lower back pain and local cervical spine syndrome), the dimensions of the third to fifth lumbar vertebral bodies (LVB) and the fifth to seventh cervical vertebral bodies (CVB) were studied quantitatively and morphometrically in frontal and sagittal planes, as a function of sex and age, in 105 human cadavers of both sexes aged between 16 and 91 years. The evaluation was done in X-ray pictures of 100-micron-thick polished bone sections with the aid of the Macro Facility of the Leitz Texture Analysis System. In each case, the maximum and minimum heights and widths and depths and the computed differences in heights, widths, and depths were determined. The results were evaluated statistically and compared within and between the two regions of the spine, using regression-correlation analyses. The heights, widths, and depths of the VB are all greater in men than in women; their behavior during ageing is, however, identical for both sexes. The heights of all the VB examined remain constant throughout life after termination of growth. The maximum widths and the width differences reveal an increase in both LVB and CVB in old age. All depth parameters reveal constancy in the case of the LVB but an increase in the case of the CVB in old age. The correlation coefficients of the maximum width of the VB within the spinal regions are very high in the LVB, but lower in the CVB. Between the two regions, in contrast, they are very low. This behavior suggests a superordinate action principle within each of the spinal regions which is based on characteristic anatomical construction and functional stressing. The static stressing of the LVB leads, laterally to disc protrusions. As a result of this, traction forces acting on the weak lateral elements of the anterior longitudinal ligament, stimulate the accretion of spondylotic osteophytes at the point of insertion of the ligament on the vertebral body. Anteriorly, in contrast, the particular strong anterior longitudinal ligament prevents such a remodelling process. Posteriorly, the longitudinal ligament is attached to the intervertebral discs, and can thus not stimulate the vertebral body to produce osteophytes. The dynamic stressing of the CVB leads laterally to friction between the VB in the region of the uncovertebral joints and to the formation of arthrotic osteophytes. Anteriorly, owing to the weak configuration of the anterior longitudinal ligament in this aspect, disc protrusion occur and, subsequently, spondylotic osteophytes accrete. PMID- 6497611 TI - Genu recurvatum: a complication of prolonged femoral skeletal traction. AB - Genu recurvatum is a rare complication of prolonged skeletal traction. The literature reports very few cases, the majority secondary to wire traction applied to the tibia in the treatment of femoral shaft fractures. A case of genu recurvatum in a 12-year-old girl as a complication of prolonged femoral skeletal traction was treated at the Kobe University Hospital. A proximal open wedge tibial osteotomy using iliac bone grafts was the surgical treatment initiated at the time of diagnosis. Follow-up after 1 year showed recurrence of the genu recurvatum. Early surgical intervention, prolonged casting and application of knee orthosis were all contributory factors in the recurrence of genu recurvatum in our patient. It should be emphasized that extreme care should be taken in treating femoral shaft fractures in children, especially those requiring wire traction in the tibia or femur, in order to prevent genu recurvatum. PMID- 6497612 TI - Traumatic dislocation of the hip with separation of the proximal femoral epiphysis. Report of two cases and review of the literature. AB - Traumatic hip dislocation with separation of the proximal femoral epiphysis is a rare injury. Twenty-six observations collected from the literature, together with two further cases presented in this paper, were statistically evaluated. Two types of injury were considered: T1, dislocation with complete separation and displacement of the epiphysis; and T2, dislocation with incomplete separation of the epiphysis. Two main therapeutic protocols had been carried out: restoration of anatomy, supplemented by different means of stabilization; and removal of the epiphysis with or without complementary procedures. Fifteen patients had been followed up for 2 years or more and avascular necrosis had been found in all of them. Leg-length discrepancy also had significant incidence. Eleven patients with T1 injury had been followed up to skeletal maturity: results were fair in four patients and poor in seven. Early surgical restoration of the proximal extremity of the femur, stabilized with Kirschner wires and cast, is the recommended treatment. PMID- 6497613 TI - Posttraumatic bacterial arthritis with luxation of the elbow. A case report. AB - Trauma predisposes an individual to bacterial arthritis. This report describes a case of posttraumatic bacterial arthritis with luxation of the elbow. It was necessary to perform synovectomy as a complement to systemic antibiotic treatment in order to control infection and reduce the dislocation. The use of external fixation is demonstrated. PMID- 6497614 TI - Continuing health professional education: objectives and instructional strategies. AB - The efficacy of continuing health professional education (CHPE) depends upon both the learner and the teacher. The goals of CHPE activities are to improve, enhance, and maintain the learner's professional competence. This article, third in a series of six on CHPE, focuses on two essential components of CHPE program planning: (1) the establishment of clear and concise educational objectives in the learner's language, and (2) the formulation of appropriate instructional strategies for the learner to achieve those objectives. PMID- 6497615 TI - Total contact casting in diabetic patients with neuropathic foot ulcerations. AB - This study investigated total contact casting in the treatment of diabetic foot ulcerations and factors affecting the rate of ulcer healing. Twenty-two diabetic patients with foot ulcerations were rated on the basis of age, weight, ulcer size, and ulcer grade. After treatment with total contact casting, 16 patients (72.7%) healed in an average of 38.3 days, 3 refused treatment, 1 developed a small tibial ulceration, and the remainder were discontinued due to excessive edema. A significant (p less than 0.01) t test for differences between means was calculated comparing ulcer duration prior to casting to healing rate during casting. All patient variables were intercorrelated, and significant (p less than 0.01) intercorrelations among patient variables were as follows: age with grade, 0.58; grade with healing time, 0.49; size with healing time, 0.50; age with ulcer size, 0.36; weight with ulcer size, 0.37; age with healing time, 0.32. A multiple correlation of 0.69 (p less than 0.01) was found for age, grade, size, and weight with healing time. Ulcer grade and size contributed most directly to the total multiple correlation; age contributed equally to size, grade, and healing time; and weight contributed primarily to ulcer size. These results suggest the following: 1) total contact casting is an extremely valuable method of treatment for diabetic foot ulcerations, and 2) when using this treatment technique associated factors (ulcer size, ulcer grade, patient age, patient weight) may be utilized to help predict patient healing. PMID- 6497616 TI - Serum creatinine as an indicator of renal function after spinal cord injury. AB - This study was conducted to determine (1) if serum creatinine levels (SCL) in spinal cord injury (SCI) patients are influenced by neurologic level of lesion, sex, age, or time since injury, and (2) if SC values are a sensitive indicator of renal function (as reflected by renal plasma flow [RPF]) in these patients. The overall SC mean and SD were 0.9 +/- 0.2mg/dl (n = 141). There was no difference in SC values between patients with higher injuries (T-6 or above) and patients with lower injuries (T-7 or below), nor was there any difference between patients with lesions less than 3 months, 10-14, 22-26, 34-38, 46-50, or 58-62 months in duration. Age and gender each accounted for less than 5% of the variation in SC. There was no significant correlation between RPF and SC (unless the patient also had moderate or severe pyelocaliectasis) nor between change in serum RPF (from the previous examination, usually 12 months earlier) and change in SC, suggesting that SCL does not reflect the functional status of the kidney in these patients. PMID- 6497617 TI - Secondary changes in segmental neurons below a spinal cord lesion in man. AB - The function of sensory and motor neurons below the level of a spinal cord injury (SCI) was assessed in 23 patients by recording the nerve conduction velocities and the amplitudes of evoked nerve and muscle compound action potentials for sural and posterior tibial nerves. Sensory and motor conduction velocities were generally normal when obtainable. Two patients had a unilateral reduction in the sural nerve and abductor hallucis muscle compound action potentials which may have been due to peripheral nerve compression. In 11 patients the abductor hallucis muscle compound action potential was below the normal range, while sural nerve action potentials remained within the normal range. Motor unit counts showed a reduction in the number of functioning motor units in these muscles. PMID- 6497618 TI - Arthrographic findings in hemiplegic shoulders. AB - To discover the influence of hemiplegia on arthrographic changes in hemiplegic shoulders, we compared arthrographic findings from paralyzed and nonparalyzed shoulders in 77 patients with hemiplegia. The correlation between arthrographic changes in paralyzed shoulders and characteristics of the hemiplegic condition was also investigated. Hemiplegic changes were considered to be responsible for adhesive changes in affected shoulders because those changes were found in paralyzed shoulders at a statistically significant higher rate (54.6%) than in the nonparalyzed side (32.5%). The occurrence rate of contrast leakage from capsule tear on the subscapular bursa and the bicipital tendon sleeve was higher on the nonparalyzed side than on the paralyzed side. It is suggested that capsular contracture due to hemiplegia prohibits capsular tear during arthrographic maneuvers. No significant difference was found in the occurrence of rotator cuff tear between the paralyzed and the nonparalyzed shoulder. Those changes on the paralyzed side were not correlated with any characteristics of hemiplegics except for shoulder pain prior to the onset of hemiplegia. PMID- 6497619 TI - Quantification of intraoperative somatosensory evoked potential. AB - Cortical (C) and spinal (S) somatosensory evoked potentials (SEP) were measured and quantified in 30 patients undergoing scoliosis surgery during the following periods: I, preincision; II, hypotension; III, instrumentation; IV, postinstrumentation; and V, skin closure. Paired two-tailed t tests were performed on all commonly measured SEP parameters comparing values obtained at periods I and II with each subsequent period. CSEP were obtained with Cz-Fz recording sites of the international 10-20 system while SSEP were obtained with recording electrodes at C7-Fz, following bilateral posterior tibial nerve stimulation at the ankles. From period I, CSEP P1 prolonged significantly across all periods but not from period II to subsequent periods. N1 remained stable from either period I or II until period V when latencies increased. P1-N1 amplitude decreased significantly between period I and other periods until period V when near base value was regained. Compared to period II however, P1-N1 amplitude did not differ significantly until period V when it increased beyond base. CSEP P2 and N2 latencies and amplitudes were less distinct and had high variability under our anesthetic technique which consisted of N2O-O2 and isoflurane 0.25%-0.50%, narcotics, nondepolarizing blocking agents, and induced hypotension. When attainable, they behaved in a similar pattern to the early CSEP. SSEP were obtained in 23 cases. The stability of latencies and amplitudes compared favorably with CSEP P1 and N1. Graphs of relative percent changes were developed for clinical use. It is concluded that the noninvasive monitoring technique described is practical, and that P1 and N1 CSEP and SSEP values are reliable monitoring parameters. PMID- 6497620 TI - Electrodiagnostic values through the thoracic outlet using C8 root needle studies, F-waves, and cervical somatosensory evoked potentials. AB - Mid-humerus cadaver determinations of ulnar F-wave, C7 spinal somatosensory evoked potential (SEP), and modified C8 root stimulation (RS) were performed bilaterally on 20 normal subjects to standardize technique and obtain normal values for the segment from mid-humerus to cervical spine. Our cadaver study shows that the best position for upper extremity measurement of mid-humerus cervical spine distance is at 60 degrees of shoulder abduction, 45 degrees of internal rotation, and at the distance of 35cm, measured by caliper. Using this position and distance the following normal values were obtained: 1) Mid-humerus F wave minimal, maximal, and mean latencies, and minimal nerve conduction velocity (NCV) were 21.8 +/- 1.2msec, 22.3 +/- 1.2msec, 22.3 +/- 1.1msec, and 59.7 +/- 2.4m/sec, respectively. Latency difference between minimal and maximal F-wave was 1.4 +/- 0.4msec. 2) Cervical spine SEP was 5.1 +/- 0.4msec, with left to right difference of less than 0.9msec. 3) C8 RS and mid-humerus ulnar nerve (UN) pick up latency and NCV were 4.9 +/- 0.2msec and 71.4 +/- 2.2m/sec, whereas C8 root pick-up and mid-humerus UN stimulation latency and NCV were 5.2 +/- 0.4msec and 66.9 +/- 5.2m/sec, respectively. To evaluate proximal nerve conductivity through the thoracic outlet, the sequential use of the three modified techniques for 35cm mid-humerus-cervical spine distance is recommended. PMID- 6497621 TI - Functional strapping for incomplete Erb palsy: case report. AB - A simple harness device for the treatment of residual arm posturing in patients with brachial plexus palsy is described. The harness consists of six parts and is made of elastic and cotton webbing. The harness holds the arm in a functional range of movement and permits the patient's hand to be used in bimanual tasks and activities of daily living. The approximate cost of this device is +65, including labor. PMID- 6497622 TI - Subcutaneous hemorrhage in a patient receiving anticoagulant therapy: an unusual EMG complication. AB - A 64-year-old man on chronic anticoagulant therapy underwent electromyography (EMG) and six days later noted a 13 X 8cm ecchymotic region on the right flank and a smaller area of ecchymosis along the lower spine. He was found to have significant subcutaneous bleeding (hematocrit decreased from 43% to 29%), which required a two-unit blood transfusion. In light of the location of the hematoma and the temporal relationship to the EMG, it is proposed that this unusual case represents a significant complication of a usually benign procedure. Clinicians need to be aware of the possibility of such a complication in the anticoagulated patient and of the need for a risk-benefit decision prior to EMG. PMID- 6497623 TI - Isolated proximal musculocutaneous nerve palsy: case report. AB - Isolated musculocutaneous nerve injury is extremely rare. The few reported cases were associated with heavy exercises and violent extension of the forearm. The lesions in those cases were below the coracobrachialis muscle, involving the biceps, brachialis, and cutaneous nerves of the forearm. This patient's lesion was unique, located proximal to the coracobrachialis. There was no antecedent trauma. At follow-up six weeks and four months after onset of symptoms, significant improvement was noted both clinically and electrophysiologically. Musculocutaneous nerve palsy is important to distinguish in certain differential diagnoses, particularly with C5 or C6 radiculopathy and brachial plexus injury. PMID- 6497625 TI - Polytetrafluoroethylene grafts as the first-choice arterial substitute in femoropopliteal revascularization. AB - We studied a series of femoropopliteal bypass operations in which polytetrafluoroethylene (PTFE) grafts were used as the first choice, regardless of the availability of saphenous vein. From Jan 1, 1979 to Dec 31, 1982, 63 PTFE femoropopliteal bypass grafts were placed in 55 patients without exploration of the saphenous vein. Forty-three grafts were placed for limb salvage, and 20 grafts were placed for disabling claudication. Patients were followed up for nine to 53 months (average, 23 months). The operative mortality was 1.8%. There were no infections. The overall patency at 30 months was 76.1%. The 30 months' cumulative patency rate for patients with claudication was 89.3%, and there were no amputations. The cumulative 30-month patency for limb salvage was 70.1%, and there was a limb salvage rate of 81.2%. Because the 30-month results were comparable with reported series using autogenous saphenous vein, we concluded that PTFE conduits may be considered the first-choice arterial substitute for femoropopliteal reconstruction. Until longer follow-ups are available, reversed autogenous saphenous vein should probably be the graft of first choice in younger patients (less than 60 years of age) without coronary artery disease who are undergoing femoropopliteal revascularizations. PMID- 6497624 TI - Preparing for the 1990's: a challenge to the specialty of PM&R. PMID- 6497626 TI - Thoracic aortic injury. A ten-year experience. AB - Between 1974 and 1983, 41 patients arrived alive at Loma Linda (Calif) University Medical Center after sustaining a traumatic disruption of the thoracic aorta. Four patients died during the resuscitation attempts and the 37 patients who survived underwent thoracotomy for attempted definitive repair. There were six hospital deaths (16.22%) among those who underwent definitive repair; associated injuries (mostly orthopedic and neurologic) were contributing factors. Four patients were discharged with spinal cord injuries, two were paraplegic on arrival at the hospital, and two became paraplegic postoperatively (surgical spinal cord injury, 5.41%). Most injuries were distal to the left subclavian artery (97.56%). Cardiopulmonary (left heart) bypass was gradually abandoned in favor of more simple techniques, including ventriculoaortic and aorto-aortic heparinized shunts or a "clamp and sew" method. Experience has demonstrated that most traumatic aortic disruptions can be repaired safely by direct suture technique (without graft interposition) if accomplished during the acute episode. PMID- 6497627 TI - The use of surface oximetry to assess bowel viability. AB - Tissue depends on perfusion, but tissue oxygenation measurements have been impractical. To develop a method for the clinical evaluation of bowel viability, we studied PO2 on the bowel surface (PSO2). The PSO2 was assessed on the stomach and intestine of 11 dogs. Normal small-bowel PSO2 was 44 +/- 11 mm Hg (mean +/- SD). When bowel vasculature was interrupted PSO2 rapidly decreased. Reductions in PSO2 were related to the degree of ischemia produced. Anastomoses were performed on partially devascularized bowel to determine anastomotic viability at various levels of PSO2. The PSO2 measured just prior to anastomosis predicted viability of the anastomoses at 48 hours. Anastomoses below 30% of predevascularization PSO2 necrosed. Between 30% and 50%, one third of anastomoses leaked. At PSO2 values above 50% of initial normal value all anastomoses healed. Surface oximetry allows accurate intraoperative assessment of bowel perfusion. PMID- 6497628 TI - Chronic constipation. Manometric patterns and surgical considerations. AB - We studied 80 children who had severe chronic constipation that was refractory to dietary, medicinal, and psychiatric therapy by means of barium enemas, rectal biopsies, and manometry. Four patients had Hirschsprung's disease and three patients had segmental dilatation of the colon. The remaining 73 patients had radiologically dilated anorectums with inpaction. Only 49 patients underwent rectal wall biopsies. All of the specimens were positive for ganglion cells. Manometric study of the 73 patients showed 18 patients who had elevated internal sphincter pressures with good relaxation following balloon inflation (group A); 45 patients who had normal internal sphincter pressures but no relaxation following balloon inflation (similar to Hirschsprung's disease) (group B); and ten patients who had normal pressures with good relaxation. Twenty-five patients in groups A and B had internal sphincter myectomies. Eight patients resumed normal bowel movements, 11 patients required minimal medicinal help, and two patients' conditions did not improve. Postoperatively, there was a reduction to normal pressure levels in group A patients and relaxation of the internal sphincter in group B patients. PMID- 6497629 TI - The need for arteriography in diabetic patients with gangrene and palpable foot pulses. AB - A group of five diabetic patients had gangrene or failed limited amputations and palpable foot pulses in a total of seven limbs. Because a failure to heal persisted and gangrene progressed, arteriography was performed and disclosed occlusion of all three infrapopliteal arteries. Tibial bypass grafting resulted in complete healing in four of the five patients. The fifth patient refused surgery and died with progressive sepsis. The incidence of this unusual syndrome is unknown, but presumably it is rare. The mechanism of pulse formation in the foot, despite occlusion of the infrapopliteal vessels, is dependent on good flow to the popliteal artery, collateral flow to the rigid distal tibial-peroneal vessels, compliant ankle arteries, and highly resistive distal foot vessels. Although healing of limited amputations is usual in diabetic patients with foot pulses, it is not universal. We recommend that arteriography be performed routinely if gangrene is present and the foot is salvageable, irrespective of pedal pulse status. PMID- 6497630 TI - Determinants of failure in the treatment of ruptured abdominal aortic aneurysm. AB - One must identify those fatal errors in the treatment of patients with ruptured abdominal aortic aneurysms (AAAs) to improve future treatment and reduce mortality. Our vascular registry identified 29 patients with ruptured AAAs who died following admission to the UCLA Hospital, Los Angeles, and the Sepulveda (Calif) Veterans Administration Hospital between 1971 and 1981. Review of the records identified four categories of error that contributed to death. These included failure to proceed with elective aneurysmectomy in 12 patients with known AAAs, error in the diagnosis of aortic rupture that led to delay in getting nine patients to the operating room, intraoperative technical error that produced venous injury in eight patients, and undue delay in anesthetic induction in four patients. Following the outline of a careful treatment approach should further reduce the mortality in the treatment of patients with ruptured AAAs. PMID- 6497631 TI - Peritonitis due to intraperitoneal perforation of infected urachal cysts. AB - Acute bacterial peritonitis due to intraperitoneal perforation of an infected urachal cyst represents a potentially lethal complication of the rare anomalies of the fetal urachus. We report four cases of this disease, including what we believe is the first to have been correctly diagnosed prior to operation. All four patients underwent emergency laparotomy and curative excision of the urachal remnant. Review of our four cases plus seven previously reported cases disclosed the perforated urachal cyst to be predominantly a disease of young males who initially have acute peritonitis but often without specific indication of a urachal anomaly. Bacteriologic examination has identified a wide variety of infecting organisms. Umbilical sinography or abdominal ultrasonography may allow accurate preoperative diagnosis. Broad-spectrum antibiotic coverage and laparotomy are indicated and excision of the entire urachal remnant is consistently curative. PMID- 6497633 TI - Sclerosant treatment of varicose veins and deep vein thrombosis. AB - Impedance plethysmography (IPG) and the Doppler ultrasonographic probe were used to assess whether thrombophlebitis, initiated by injection of a sclerosant into superficial varicose veins, extended to involve the deep veins of the leg. Sixty seven legs were treated with compression sclerotherapy in 50 patients (26 men, 24 women) whose mean age was 53 years. Indications for this therapy were unacceptable appearance (n = 37), pain (n = 13), cramps (n = 11), and stasis ulcer (n = 6). Each leg received an average of six injections (range, three to 11) of 0.5 mL of sodium tetradecyl sulfate. Blood flow in the deep veins was studied immediately before injection of the sclerosant and one week and two weeks afterward. In each leg, no change in either of these studies was found at one and two weeks following injection treatment. In nine extremities, delayed venous emptying was found on IPG. This persisted after sclerosis and was interpreted as evidence of a previous deep vein thrombosis. PMID- 6497632 TI - Large-vessel arterial occlusive disease in symptomatic upper extremity. AB - Subclavian and axillary artery occlusive disease resulted in sufficient upper extremity symptoms to necessitate 30 vascular reconstructions in 28 patients over the past ten years. Female patients predominated, with a ratio of 2.5:1. The average age of the patients was 61 years. The incidence of diabetes mellitus was low (7%). Sixteen of 18 proximal subclavian lesions were on the left side, while more distal lesions were equally distributed on the left and right. Extrathoracic bypasses were used in all cases. Dacron grafts were used in 16 of 17 carotid subclavian bypasses. Autogenous vein grafts were used in 11 of 13 bypasses to the axillary or brachial artery. Concomitant cervicodorsal sympathectomy was done in only four patients. The in-hospital graft patency rate was 93% and the long-term graft patency rate at one year and beyond was 88%. PMID- 6497634 TI - Hamartomas of the spleen. AB - A study of 12 cases of splenic hamartomas, rare benign lesions of the spleen, included one case of spontaneous rupture of a hamartoma that required emergency operation and two cases of hamartomatosis with splenomegaly. An increased incidence of accessory spleens was also noted. Therefore, although rarely symptomatic, hamartomas may occasionally be of clinical importance. Surgeons should be aware of these lesions in the differential diagnosis of splenic tumors that appear as filling defects on scintiscan or as splenic masses on abdominal exploration. Since it may also be a source of spontaneous splenic rupture, it should be considered as one of the rare causes of such an occurrence. PMID- 6497635 TI - Development of gallstone pancreatitis. The role of the common channel. AB - Whether bile reflux through a common channel into the pancreatic duct is a causative factor in the development of gallstone pancreatitis is controversial. To address this issue, we have reviewed a consecutive series of cholecystectomies performed with intraoperative cholangiograms. The cholangiograms and the patients' charts were reviewed independently to determine the incidence of a common channel in patients both with and without pancreatitis and to analyze their clinical courses. The group of patients who had pancreatitis showed a common channel in 19 (90%) of 20 cases, while those patients who did not have pancreatitis showed a common channel in 23 (35%) of 66 cases. The patients who had pancreatitis were less likely to have choledocholithiasis than were those patients who did not have pancreatitis, and these patients were less likely to require exploration of the common bile duct. PMID- 6497636 TI - Carcinoma of the male breast. An update. AB - The majority of reports in the literature that have documented poor survival in men with breast cancer have originated from major cancer centers and military hospitals. In contrast, we reviewed 45 men with breast cancer from seven community-based medical centers. Of the patients who were seen, 55% had localized disease (stage I), 39% had disease that was confined to the axilla (stage II), and 6% had metastatic disease (stage III). The survival data was compared with that of 2,620 women treated during the same time interval. The comparison showed a survival advantage for the men. This variance in survival data obtained from previously published reports may be due to a generally early stage of disease seen in community hospitals as compared with major referral centers. PMID- 6497637 TI - Roentgenographic contrast studies in acute small-bowel obstruction. AB - Plain abdominal roentgenograms are usually adequate for the treatment of patients with small-bowel obstruction. There is a select group of patients who may benefit from a more precise diagnosis or by nonoperative therapy for whom contrast roentgenograms may be helpful. Contrast roentgenograms were performed in 68 (21%) of 327 patients who had nondiagnostic abdominal films, atypical histories or findings, or those in whom nonoperative resolution would be highly desirable. Sixty-eight percent of 48 contrast tracers gave useful information, whereas 75% of 24 contrast enemas were helpful. Contrast material passed through a site of obstruction in 34 patients, yet 13 (38%) still required an operation. Contrast material did not pass in 16 patients and only one avoided a surgical procedure. No difference was noted between barium sulfate or water-soluble contrast material or how it was administered. PMID- 6497638 TI - Splenic salvage using biologic glue. AB - Fibrin sealant (FS) is a biologic adhesive containing highly concentrated human fibrinogen that is effective in the face-to-face sealing of tissues, and in establishing hemostasis. We evaluated FS in 32 experimentally produced splenic injuries in six adult mongrel dogs. Complete hemostasis was achieved in all animals prior to closure. The dogs were reexplored postoperatively at intervals varying from four hours to six weeks (mean +/- SD, 21 +/- 20 days). When the dogs were killed, there was no gross evidence of splenic disruption or recurrent bleeding; all of the spleens had developed well-healed capsules. Histologic examination demonstrated a regenerated fibrous capsule extending over the superficial injuries as well as into the deep injuries, without significant inflammatory response. We conclude the following: that FS provides adequate hemostatic control of superficial and deep splenic injuries, FS has good systemic and local compatibility, it can be applied to bleeding parenchymal wounds, it reduces the need for parenchymal sutures that may be traumatic, and it promotes splenic wound healing. PMID- 6497639 TI - Esophageal perforations. The need for an individualized approach. AB - Since 1971 we have treated 33 patients with esophageal perforation caused by instrumentation in 21 patients, trauma in six, and spontaneous perforation in six. Chest pain, fever, mediastinal air, and an abnormal esophagogram were frequent but not invariable findings. Surgical therapy, consisting of primary repair and drainage in 12 patients, drainage alone in five, esophageal diversion in two, and esophagogastrectomy in one, was initiated within 24 hours in 14 patients, all of whom survived. A delay of more than 24 hours in six patients resulted in 33% mortality. Nine patients with small instrumental perforations were treated successfully with antibiotics alone, while three other patients with late traumatic (n = 2) and spontaneous (n = 1) perforations were treated nonoperatively; all three died. Overall mortality for the series was 15.5%. Except for small contained instrumental injuries, esophageal perforations demand prompt exploration, with primary repair and drainage as the procedure of choice. PMID- 6497640 TI - Complications of renal dialysis access procedures. AB - The complications of 2,179 dialysis access procedures of various types have been reviewed in an effort to determine their possible prevention and management. Scribner arteriovenous shunts or central venous catheters were preferred for temporary dialysis. Infection was a common complication of central venous catheters, but responded well to removal of the catheter. Brescia-Cimino fistulae were preferred for long-term dialysis, but were often not possible because of inadequate veins or the need for relatively urgent hemodialysis. The most useful secondary shunt was the straight forearm synthetic polytetrafluoroethylene (PTFE) graft whose most common complication was thrombosis due to intimal hyperplasia at the venous anastomosis. In most cases, this complication could be corrected by patch grafting or by extension bypass. Infection was infrequent with PTFE shunts and, when localized, was sometimes successfully treated by drainage, antibiotic therapy, and topical povidone-iodine. The principal complications of long-term peritoneal dialysis were peritonitis and tunnel infection that responded to antibiotic therapy and/or removal of the catheter. Compulsive care in access insertion and meticulous management during dialysis has permitted very satisfactory long-term hemodialysis and peritoneal dialysis. PMID- 6497642 TI - Tape closure of skin wounds. PMID- 6497641 TI - Abdominal aortic cross-clamping. Metabolic and hemodynamic consequences. AB - We address the question of whether an oxygen debt develops during a period of abdominal aortic cross-clamping that may explain observed hemodynamic changes. Group 1 received morphine sulfate (1 mg/kg) during induction of anesthesia. Group 2 received same dose of morphine sulfate. Group 3 received 4 mg/kg of morphine sulfate. We measured the oxygen consumption (VO2) and the carbon dioxide production levels (VCO2), as well as hemodynamic and biochemical parameters. In groups 1 and 3, VO2 and VCO2 decreased 10% to 13% following abdominal aortic cross-clamping compared with values measured before cross-clamping. In group 2, VO2 and VCO2 decreased 3% and 7%, respectively. On unclamping, the greatest increase in VO2 was observed in group 3 (26%), while in groups 1 and 2, VO2 rose 18% and 5%, respectively. In all three groups, metabolic changes were not paralleled by hemodynamic or temperature changes. Results indicate that oxygen debt developed during abdominal aortic cross-clamping, but this has no effect on hemodynamic changes seen after unclamping. Higher dosage of narcotic administered during anesthetic induction did not temper increase in metabolic rate observed after unclamping. PMID- 6497643 TI - Inadequacies in a wound infection study. PMID- 6497644 TI - [Effect of graded nitrogen supplements on egg protein synthesis and body protein retention in broiler hens]. AB - In the top laying period (29th/30th week of life) egg protein synthesis and protein retention in the bodies of laying hens were ascertained. Based on egg-N analyses, the relation between N-intake/live weight0.67kg and egg-N discharge/kg LW0.67kg was regressively calculated and described. The subtraction of egg-N discharge/LW0.67kg from N-balance/LW0.67kg made it possible to estimate N retention/LW0.67kg in the body. From the intersection of this curve with the chi axis it follows that the broiler hen meets the N-requirement for maintenance and egg production with a daily consumption of 1,264.7 mg N/LW0.67kg, which corresponds to 15.8 g crude protein, and then neither loses nor retains body protein. At a daily intake of this amount of CP (15.8 g) the broiler hen produces 44.1 g egg per day. An energy intake of more than 70 EFUhen/animal and day resulted in fat retention in the broiler hen. PMID- 6497645 TI - The influence of urea diet supplemented with protected protein on metabolism and wool growth in sheep. AB - The utility of blood meal and formaldehyde treated casein as protein supplements in the nutrition of sheep receiving approximately 50% of their total nitrogen from urea was studied. It was observed that protected protein supplements positively influenced wool growth and quality. On the basis of biochemical analysis of blood the mechanism of this effect is discussed. It seems that small protein supplements (about 6% of the total protein) are not only a source of amino acids in the duodenum but also influence the hormonal control in animals. PMID- 6497646 TI - [Rumen fermentation with special reference to volatile fatty acid production during reproduction. 1. Methods and results of volatile fatty acid levels and production rates in vitro]. AB - The target of the investigations was to register part of the synthesis performance in the rumen of ewes during the complete reproduction cycle. With the help of in-vitro experiments with artificial rumen the concentration and production rates of volatile fatty acids in the rumen fluid were measured. From the experiments the measured data of fertility-accentuated crossbreeding (experiment 1) and crossbreeding (experiment 2) ewes were contrasted. The average concentrations of volatile fatty acids in ewes are 95.4 m mol/l in experiment 1 and 109.2 m mol/l in experiment 2 during the early stage gestation, 121.4 m mol/l in experiment 1 and 99.8 m mol/l in experiment 2 in the last stage stage of gestation, 129.6 m mol/l in experiment 1 and 112.8 m mol/l in experiment 2 during lactation and 106.6 m mol/l in experiment 1 and 112.9 m mol/l in experiment 2 during the dry period. The production rates of volatile fatty acids calculated form their concentration amount to 4.8 m mol/l X h in experiment 1 and 2.6 m mol/l X h in experiment 2 in the early stage of gestation, 3.5 m mol/l X h in experiment 1 and 3.1 m mol/l X h in experiment 2 in the last stage of gestation, 3.2 m mol/l X h in experiment 1 and 2.7 m mol/l X h in experiment 2 during lactation and 3.7 m mol/l X h in experiment 1 and 2.9 m mol/l X h in experiment 2 in the dry period. The correlation between the concentration and the production rate of volatile fatty acids is not significantly negative in either of the ewe experiments. The scattering of the individual values is wide so that the individual influence of the test animals as well as the influence of the in-vitro method used permit the conclusion that a significant statement on the influence of the genotype and the stage of reproduction on the production rates cannot be made. PMID- 6497647 TI - [Oral and intramuscular ferric dextran administration in male rearing calves. 5. Live weight gain during maintenance in fluid feed and weaning ranges]. AB - 195 rearing calves, which immediately after their gathering from various dairy farms had an anaemia frequency of 57.4% and an average age of 22 d and an average live weight of 43 kg, were at random divided into 3 groups and received in addition to the iron in the rations oral (B), intramuscular (C) or no (A) ferridextrane applications during their 56-day stay in the fluid feed range of a rearing farm. The average live weight gain of the calves during these 56 days in groups A, B, and C was 882 +/- 171, 949 +/- 145 and 912 +/- 170 g/d resp. and during the 57-day stay in the weaning range 664 +/- 205, 715 +/- 222 and 670 +/- 226 g/d resp. The significant advantage in the development reached by the calves in group B over those in group A during their stay in the fluid feed range did not get lost after the change to the weaning range. Based on the cost of medicine and on the development of the live weight of the calves in the 3 test groups in the fluid feed and weaning ranges the economic effect of ferridextrane applications was calculated. Under the rearing conditions given, iron intervention proved to be sensible for both health and economic reasons. PMID- 6497648 TI - The influence of liver disease on the methylation of arsenite in humans. AB - The capacity for inorganic arsenic (ASi) methylation in 13 healthy volunteers and in 30 patients with different types of liver disease has been assessed by measuring the amount of unmetabolized ASi, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) excreted in urine within 24 h after the IV injection of 7.14 micrograms/kg ASi. Liver disease does not affect the percent of the injected dose excreted within 24 h but has striking and opposite effects on the proportions of MMA and DMA. MMA excretion is highly correlated with the 14C aminopyrine breath test (r = 0.73; P less than 0.05). The reduction in the proportion of MMA excreted in urine and the increase in that of DMA are similar with regard to sensitivity and specificity for detecting liver impairment. Unlike the 14C-aminopyrine breath test, the inorganic arsenic methylation test offers the advantage of being unaffected by treatment with microsomal enzyme inducers. PMID- 6497649 TI - A method of studying the intestinal absorption of aluminium in the rat. AB - Aluminium (Al) intoxication in dialysis patients is held to be caused not only by Al in the dialysis fluid but also by Al from orally administered phosphate binders. Studies on Al absorption in patients and healthy individuals as well as in animals are still scarce, and do not provide sufficient data to characterize the absorption process. This paper presents a method of studying the process of Al absorption in a perfusion system of rat small intestine in vivo, in combination with a cannulation system of the portal vein for serial blood sampling. Determination of concentrations of an absorbed substance in samples of both the perfusion medium and the portal blood, collected during the perfusion medium and the portal blood, collected during the perfusion period, may clarify the nature of the absorption process. Although this method appears to be useful for the study of the intestinal absorption of any substance, it was adapted for the study of the intestinal absorption of Al compounds. The usefulness of this method for studying Al absorption was demonstrated in an experiment in which Al chloride (0.5 g/l) in buffered media of pH 7.0, 7.5, and 8.0 was perfused through the rat small intestine over a period of at least 30 min. The results of this experiment indicate that a decrease in pH of the perfusion medium leads to an increase in absorption of Al in the portal blood. PMID- 6497650 TI - Regional alterations of brain catecholamines by styrene exposure in rabbits. AB - The regional distribution of dopamine, norepinephrine and homovanillic acid was assessed in adult male rabbits exposed to styrene vapours. The turnover of dopamine and norepinephrine was also measured in several brain regions by the decay in endogenous catecholamines after inhibition of tyrosine hydroxylase by alpha-methyl-p-tyrosine. Styrene exposure produced a marked and dose-dependent decrease in striatal and tuberoinfundibular dopamine, associated with a consistent increase in homovanillic acid content in the same regions. Norepinephrine levels were unaffected by styrene exposure. The observed increase in catabolism of dopamine cannot be explained by the turnover time, which was not significantly different in the exposed as compared to the control rabbits. Competition of a styrene metabolite with dopamine for the vesicular storage capacity or a selective destruction of dopaminergic terminals are suggested as the possible mechanisms for styrene neurotoxicity. PMID- 6497651 TI - Further observations on in vitro and in vivo effects of 2,5-hexanedione on glyceraldehyde-3-phosphate dehydrogenase. AB - The in vitro and in vivo effect of aliphatic diketones has been studied on glyceraldehyde-3-phosphate dehydrogenase (GAPDH) D,L-glyceraldehyde-3-phosphate: NAD oxidoreductase (phosphorylating EC 1.2.1.12 activity). Neurotoxic diketone, 2,5-hexanedione (2,5-HD), but not 2,4-hexanedione (2,4-HD), a non-neurotoxic diketone, inhibited GAPDH in rat bran homogenate preincubated with 25 mM diketones for 20 min. If the preincubation period was increased to 2 h, approximately 25% and 55% inhibition of GAPDH activity was observed with 1 mM and 5 mM 2,5-HD respectively. The inhibition of GAPDH activity was also seen in sciatic nerves but not in the brain or liver homogenates of rats chronically intoxicated with 2,5-HD for 12 weeks. The inhibition of GAPDH by 2,5-HD appears to be selective, and thus confirms earlier data from this laboratory. PMID- 6497652 TI - Influence of exposure mode on vinyl chloride action. AB - Rats were subjected to 4 h continuous or intermittent exposure to vinyl chloride (VC) at different time-weighted average concentrations (15, 50, 150, 500 and 15,000 mg/m3). Hepatic non-protein sulfhydryl content (NPSH) and excretion of thiodiglycolic acid (TdGA) in urine were determined. VC at concentrations from 50 mg/m3 to 15,000 mg/m3 caused a dose-dependent depression of NPSH, but no difference in the magnitude of this depression induced by continuous of VC was noted. At average concentrations of 50 mg/m3 and 150 mg/m3, the urinary excretion of TdGA under continuous exposure did not differ from that under intermittent exposure, whereas at VC concentrations of 500 mg/m3 and 15,000 mg/m3 it was higher following continuous exposure. PMID- 6497653 TI - Reactivators of organophosphate-inhibited cholinesterase. 4-cycloalkylcarbonyl substituted bis-pyridinium monooximes. AB - Two isomeric cyclopentylcarbonyl and two cycloheptylcarbonyl derivatives of 2 hydroxyiminomethyl-1-[3-(1-pyridinio-2-oxapropyl]pyr idinium diiodide and 4 hydroxyiminomethyl-1-[3-(1-pyridinio-2-oxapropyl]pyr idinium diiodide were prepared and characterized by spectroscopic methods. The inhibitory power (I50) of the investigated oximes was determined using purified bovine erythrocyte AChE and human erythrocyte AChE. Percentage of reactivation after 30 min was estimated after inhibition of human erythrocyte AChE by sarin, VX, tabun, soman, and paraoxon. The in intro protective indices (p.i. and P50) against inhibition by soman have been calculated using bovine erythrocyte AChE for p.i. and human erythrocyte AChE for P50. Their I50 for human erythrocyte AChE varied from 1.4 9.8 (10(-4) mol . dm-3) and for bovine erythrocyte AChE in the range of 1.1-17 (10(-5) mol . dm-3). With 2 X 10(-5) mol . dm-3 oximes the percent of reactivation was: 0-17% for paraoxon-inhibited AChE, 9-49% for sarin-inhibited AChE, 16-65% for VX-inhibited AChE, 0-8% for tabun-inhibited AChE, and 0-4% for soman-inhibited AChE. The 2-hydroxyimino derivatives protect human erythrocyte AChE and purified bovine erythrocyte AChE from inhibition by soman. PMID- 6497654 TI - Hypotensive effects of hydroxylamine in intact anesthetized dogs and cats. AB - When given IV in bolus doses to intact anesthetized dogs or cats, hydroxylamine hydrochloride produced transient but precipitous falls in the mean arterial blood pressure in a dose-related manner, as well as a significant methemoglobinemia. The half-time for recovery of the mean arterial pressure was also dose-related. These effects were very similar to those elicited by comparable doses of sodium nitrite, except that the half-recovery time for return to normal blood pressure was somewhat longer with nitrite. Although hydroxylamine has long been known to relax vascular smooth muscle in vitro, we are not aware of previous demonstrations of hypotensive effects in vivo. Acute poisoning by either nitrite or hydroxylamine is apt to result in both an anemic hypoxia due to methemoglobinemia and a stagnat (hypokinetic) hypoxia due to direct vasodilation. Hydroxylamine, but not nitrite, also appeared to stimulate respiration possibly through an effect on the chemoreceptors of the carotid body. PMID- 6497655 TI - Disobutamide-induced cytoplasmic vacuoles in cultured dog coronary artery muscle cells. AB - Smooth muscle cells released by protease from the coronary artery of dogs were cultured in M199 supplemented with 10% fetal calf serum. Cells were grown on glass coverslips to semiconfluence and exposed to disobutamide at 0, 1, 2, 3, 6, 8, and 10 X 10(-4) M for 24, 48, and 72 h, examined in situ by light microscopy, then fixed in 100% methanol, stained with May-Grunwald Giemsa and examined by light microscopy. Cells were also exposed to drug for 24 h, pelleted, fixed and prepared routinely for electron microscopy. Control cells and cells exposed to 6 X 10(-4) M disobutamide were examined. Vacuole formation was dose and time dependent between 2 X 10(-4) M and 10(-3) M. By light microscopy, morphologic alterations induced by the drug were clear cytoplasmic vacuoles in live cells, vacuoles in dead cells and dead cells without vacuoles. Small round vacuoles were an early change. Dark granules were dispersed among the vacuoles. The vacuoles increased in size at higher doses or longer times. Eventually all the cytoplasm was occupied by vacuoles and the cells were enlarged. By electron microscopy, the vacuoles were round, primarily membrane-bound, contained mostly electron-lucent material and occasionally small flocculent bodies. There was vacuolar coalescence. The dose response of vacuole induction in confluent and semiconfluent cells was similar. Cytoplasmic vacuoles without cell death can be induced by disobutamide at 2 or 4 X 10(-4) M during a 3-day exposure. Cell culture is a suitable biological system for studying cytoplasmic vacuoles of the type induced by disobutamide. PMID- 6497656 TI - Comparison of nine strains of influenza C virus in growth characteristics and viral polypeptides. Brief report. AB - Nine strains of influenza C virus were compared in their growth characteristics and viral polypeptides using LLCMK2 cells. The results suggested that influenza C virus undergoes genetic changes like influenza A or B virus. PMID- 6497657 TI - Cross-reactivity between cowpox and vaccinia viruses with monoclonal antibodies. Brief report. AB - Hybridoma cell lines producing monoclonal antibodies against cowpox virus (CPV) and vaccinia virus (VV) were established to examine the specific and cross reactive antigenic determinants of these viruses. Monoclonal antibodies against CPV (LB red strain) and VV (Lister strain and Ikeda strain) were classified into several groups on the basis of the results of immunofluorescence and haemagglutination inhibition tests. It was suggested that the groups defined above include the group of antibodies reacting with each of known major antigens of poxvirus, i.e. nucleoprotein (NP) antigen, heat labile and stable complex (LS) antigen, haemagglutinin (HA), cell surface antigen (CSA) and type A inclusion body (A). PMID- 6497658 TI - The genome of simian hemorrhagic fever virus. AB - Techniques are described for preparing intact Simian Hemorrhagic Fever (SHF) virus RNA. SHF RNA extracted by proteinase K digestion in the presence of sodium dodecyl sulphate (SDS) has a sedimentation coefficient of 49 S compared with a reference figure of 47 S for Sindbis RNA. Purified SHF RNA in cesium sulphate gradient has a buoyant density of 1.63 g/ml similar to that of Sindbis RNA. This result leads to the conclusion that SHF RNA is single stranded. This is supported by results on RNAse sensitivity and analyses on sucrose gradients under different ionic strength conditions. Electrophoresis analyses on both hydroxymethylmercuric acid or formaldehyde containing gels, gave a value of about 5.5 X 10(6) daltons for the molecular weight of SHF RNA. No evidence of subunit structure was found. From these results, we conclude that the SHF virus genome is a single continuous chain of about 15,000 ribonucleotides. PMID- 6497660 TI - Immune adherence hemagglutination test for detection of antibody to respiratory syncytial virus. Brief report. AB - An immune adherence hemagglutination test was established for detection of antibodies to respiratory syncytial virus. The test was shown to be as specific as and much more sensitive than the neutralization and complement fixation tests. PMID- 6497659 TI - Measles virus and inactivated canine distemper virus induce incomplete immunity to canine distemper. AB - Pairs of specific pathogen free dogs were immunized with two injections of heat inactivated canine distemper virus (CDV) or one injection of a live CDV or live measles virus (MV) vaccine. Three unimmunized dogs were used as controls. All 9 dogs were challenged with virulent CDV (Snyder Hill strain). The three unimmunized dogs developed severe signs of disease with a lethal infection in one. The two dogs immunized with live CDV vaccine developed a strong humoral as well as cellular immune response after immunization and were protected against virus replication. Animals immunized with either inactivated CDV or modified live MV failed to develop a measurable cellular immune response after immunization and had a comparatively weak humoral immune response to distemper antigens. They showed mild signs of infection after challenge and responded with strong anamnestic cellular and humoral immunity. The measles vaccine immunized dogs had a moderate serum titer of measles hemolysin-inhibiting antibodies which, after exposure to distemper virus, was boosted to high levels. It is proposed that this response plays a role in the mitigation of the virulent distemper infection in these animals. PMID- 6497661 TI - Pharmacokinetics of theophylline in asthmatic children after multiple oral doses of aminophylline tablets. PMID- 6497662 TI - [Effect of growth on nasal allergy in children]. PMID- 6497663 TI - [Effect of physical training on exercise-induced bronchospasm of institutionalized asthmatic children]. PMID- 6497664 TI - [Study on peripheral blood mononuclear cell subpopulations in children. Part 1. Peripheral blood mononuclear cell subpopulations in healthy neonates, infants, young children and school children]. PMID- 6497665 TI - [Prevalence of Hymenoptera hypersensitivity in residents of 6 towns in Tochigi Prefecture]. PMID- 6497666 TI - [Study on peripheral blood mononuclear cell subpopulations in children. Part II. Peripheral blood mononuclear cell subpopulations in patients with Kawasaki disease]. PMID- 6497667 TI - [A case of status asthmaticus with suspected complication of syndrome of inappropriate secretion of antidiuretic hormone (SIADH)]. PMID- 6497668 TI - [Swimming training in a hot spring pool as therapy for steroid-dependent asthma]. PMID- 6497669 TI - [Long-term effects of residential care for asthmatic children]. PMID- 6497670 TI - [Studies on the effect of beclomethasone dipropionate (BD) on airway hyperreactivity of patients with bronchial asthma]. PMID- 6497671 TI - [Changes of plasma cortisol level in late asthmatic responses]. PMID- 6497672 TI - [Development of satellite-neuron relations in the spinal ganglia of the rat]. AB - Cerebrospinal ganglia of 11-, 13-, 15-, 18- and 20-day-old embryos have been studied light- and electron-microscopically. On the 11th day of anlage the ganglia are presented exclusively as neuroblasts: the satellite-cells are formed later from lemmoblasts that install into the ganglion on the 13th-15th days both from the surrounding mesenchyme and from the developing roots and trunklets of the cerebrospinal nerves. In the ganglion they undergo proliferation and further differentiation. On the 15th day simple satellite-neuron interrelationships are formed: one satellite-cell is tightly connected with perikaryons of some neuroblasts and young neurons. On the 18th day around some neurons a double layered capsule is formed from the satellite-cells. Multilayered tunics are formed only on the 10th-15th day after birth. During the process of the capsule formation an unusual reactive character of the satellite-neuron interrelationships is revealed, it is manifested as, performed by the satellite cells, an active microphagocytosis of the perikaryon cytoplasmic processes and the initial segment of the sensitive neuron main process. In embryogenesis the lemmocyte-axon interrelationships develop earlier than the satellite-neuronal ones. PMID- 6497673 TI - [Ultrastructure of neurons of the myenteric plexus in the normal cat and after temporary circulatory interruption]. AB - Ultrastructural organization of neurons in the myenteric plexus of the cat small intestine has been studied in norm and after the blood stream had been switched off for 4 hours and 1, 3, 7, 30 days after recirculation. Ultrastructural uniformity of perikaryons is noted, therefore it is impossible to reveal electron microscopically neurons with different functional qualities. Four morphological types of preterminal dilatations of axons are revealed. Some neurons demonstrate certain resistance to the four hours' ischemia of the intestine, predominance of reactive processes in most of the cells. Dynamics of destructive and reparative processes are followed in neurons and their processes after recirculation. PMID- 6497674 TI - [Variability of morphologic parameters of individual neurons and neuron clusters in the visceral ganglion of the mollusk Lymnaea stagnalis L]. AB - Quantitative investigations on variability of visual morphological parameters in neurons BB1, BB3-5 and clusters BBb have been performed on the ventral side of the visceral ganglion in 20 molluscs Lymnaea stagnalis L. (height of the shell 45.5-1.3 mm, variation coefficient -2.9%) cought in the same pond and on the same day. Statistical analysis of the data obtained is performed by means of the methods applied for analysing small independent samples. A probability character of visual identification and an essential variability are demonstrated for the parameters of the neuron BB1 (diameter, position, colour), of the number of giant and/or large neurons BB3-5 and the cluster BBb neurons. The variation character of the parameters mentioned is asymmetric. It is possible to speak on a greater determinancy of a preferable gradation of the parameters. The interconnection of the variability and the determinancy of the morphological signs with the identificity and functioning of the neuronal elements are discussed. A suggestion is made that identification of the neurons according to both their morphological and functional criteria, as a whole, can have a probability character. The data considered in the work make doubt the invariance of the neurons studied in the mollusc Lymnaea stagnalis L. PMID- 6497675 TI - [Growth of a graft from the septal region of the brain in the anterior chamber of the eye]. AB - The neural tissue (the hippocamp and septal cerebral area) obtained from rat embryos is transplanted into the anterior eye chamber of mature animals. The developing grafts are sized and measured and light optic microscopy is performed 3-4 months after transplantation. Essential differences in development and organization of the septal cerebral area (SCAG) and the hippocampal (HG) grafts are revealed. The SCAG have a spherical form, a limited contact with the host iris and are vascularized by one--two ingrowing and branching vessels. The HG are elongated in their form, have contacts with the host iris by the wide plane parallel to their long axis and a great number of blood vessels growing into them. The size of the HG is much larger than that of the SCAG. The latter contain diffusely scattered multipolar neurons, while the HG neurons are organized as a layer with their apical dendrites oriented towards the iris. PMID- 6497676 TI - [Prenatal development of the intrinsic nerves of the muscles of the human foot]. AB - Myelogenesis and blood supply of the intraorganic nerves have been studied in 4-6 and 7-9-month-old human fetuses. At first, the intramuscular nerves are presented as very thick fasciculi (the diameter is more than 90), thick (the diameter is from 50 up to 90) and single muddle neural fasciculi (the diameter is from 30 up to 50 mcm). The microcirculatory blood bed is formed at the expense of branches of the blood vessel-satellites and the blood vessels of the surrounding tissues and is carried out, without any interruption, along the whole extent. In 7-9-month-old fetuses the neural apparatus becomes more complex. The number of the middle neural fasciculi appear. On the background of fine neural fibers in the fasciculi a small part of the middle neural fibers appears, and in the musculus flexor digitorum brevis--single thick neural fibers. The intramuscular nerves have their own hemocirculatory bed presented by microvessels that are on the perineurium surface, in its bulck and among neural fibers. PMID- 6497677 TI - [Structure and cellular composition of cubital lymph nodes in the adult human]. AB - The cubital lymph nodes obtained from 32 corpses of mature persons (16-75 years of age) have been studied. Sections 5-7 mcm thick made at the level of the hilus are stained with hematoxylin--eosin, azur II--eosin, after van Gieson and Mallory. When the comparative contents of the connective tissue, cortical and medullary substance are determined, the whole area of the node in the section is taken as 100%. With age, the connective tissue composition (capsules and trabecules) and fat tissue grow in size. During all the age periods the medullary substance predominates over the cortical substance. The amount of the lymph nodules essentially decreases with age. For each age period there is its own specific cytological profile. However, during all the age periods the amount of the small lymphocytes predominates over the contents of the large and middle lymphocytes. PMID- 6497678 TI - [Age and the anatomy of lymph nodule groupings in the human appendix]. AB - The appendices from 121 corpses of persons died at the age 1 day--83 years have been studied. Increase in number and size of the lymph nodules in the appendix wall takes place up to 16 years of age. At the same age there is a certain increase in arrangement density of the lymph nodules from the base of the organ towards its apex. In childhood and adolescent age, in histological sections, the grouped lymph nodules are often arranged in 2-3 layers. The form of the nodules in transversal sections of the appendix in children and adolescents is round, oval and piriform, and at mature age and especially in aged and old persons, most of the nodules are flattened and elongated in transversal direction. The germinative centers are present in most of the lymph nodules in children up to 16 years of age, their number is less in mature persons and they are absent in the nodules in aged and old persons. PMID- 6497679 TI - [Patterns of the structural organization of the fibrous stroma of various human organs]. AB - Fibrillar elements and the ground substance of some human organs have been morphologically studied using light, raster and transmissive electron microscopy. A number of common regularities has been revealed in their structure. The organ specificity in structure of the fibrous stroma is manifested as various degree of one or other common regularities in structure and their certain combinations. PMID- 6497680 TI - [Use of regression analysis and elements of differential calculus in functional morphologic studies]. PMID- 6497681 TI - [Isometric method of analyzing the shape of the hard palate in children during the period of permanent occlusion development]. PMID- 6497682 TI - [Methodologic trends in teaching histology, cytology and embryology in medical universities and in the medical colleges of universities]. PMID- 6497684 TI - The use of topical corticosteroids in dermatology. PMID- 6497683 TI - Prinzmetal's variant angina. PMID- 6497685 TI - Tay-Sachs disease: Part 1. The risk to non-Jews. PMID- 6497686 TI - Fetal echocardiography: new horizons in ultrasound. PMID- 6497687 TI - Heroin: should it be legalized for the treatment of cancer pain? PMID- 6497688 TI - Fluency and fantasy. PMID- 6497689 TI - Case of the month no. 73. Multiple gastric polyps. PMID- 6497690 TI - Private voluntary care for the "Notch Group:" the St. Elizabeth's Clinic experience. PMID- 6497691 TI - A legislative option for coping with the distressed physician. PMID- 6497692 TI - American Medical Association. President's inaugural address. PMID- 6497693 TI - Medical libraries, medicine, and the humanities. PMID- 6497694 TI - [Differential diagnosis of precancerous and cancerous states of the cervix uteri based on the multiparameter analysis of the results of cytological studies]. AB - The problems of the early cytological diagnostics of precancerous and cancerous conditions of the uterine cervix are considered. The algorhithm for a differential diagnostic of borderline conditions in the uterine cervix is presented based on the multiparametric statistical analysis of the morphometric data (surface and perimeter of epithelial cell nuclei). Results are obtained on the semiautomatic cytological analyzer "Integral". The possibility of classification of the early dysplastic epithelial changes (simple dysplasia), advanced dysplasia and cancerous processes in the uterine cervix is shown. The diagnostic errors occur in less than 16% of cases. PMID- 6497695 TI - [Ultrastructural characteristics of the endometrial cells in proliferative-type dyshormonal glandular hyperplasia]. AB - Four morphofunctional cell types are distinguished ultrastructurally in the glandular epithelium of endometrium with dyshormonal glandular hyperplasia of the medium proliferative stage: proliferating, secreting, ciliary, endocrine. The cells of every type may undergo degeneration. The possibility of the cell proliferation with predominantly endocrine differentiation is noted. PMID- 6497696 TI - [Tissue metallosis of the implant bed as a late complication of metal osteosynthesis]. AB - Biopsies of soft tissues of 28 patients taken from the region of metallic construction implantation which were in the host for osteosynthesis from 5 months to 4 years were examined histologically, histochemically and electron microscopically. Control biopsis were taken in 4 patients with false joints of long bones 5 months--1 year after the trauma. It is proven that the signs of the metal corrosion destruction are most frequently observed when complex multicomponential metallic implants prepared from heterogeneous metals are used. Corrosion results in the "metallic" tissue response long after the implantation. This is characterized by the formation of dense fibrillar connective tissue, its focal infiltration with fragments of metallic constructions and the products of their destruction in the form of various metal-protein complexes, syderosis, acute or chronic inflammation as a results of corrosion, metallosis and trauma. Metallosis of tissues in the implant bed is to be considered as a late complication of the metallic osteosynthesis. PMID- 6497697 TI - [Importance of a structural and functional analysis of the fallopian epithelium in tubal pregnancy and endometrial adenocarcinoma]. AB - The structural-functional analysis of the uterine tube epithelium is proposed as an additional indirect index of the ovarian hormonal activity. Several standard types of the tubal epithelium are distinguished (proliferative, secretory, gravidal, non-functional, proliferative-hyperplastic) which are characteristic of certain level of various sex hormones in the woman organism. The control data obtained are used for the evaluation of the hormonal background in women with tubal pregnancy and endometrial carcinoma. The signs of ovarian dysfunction were observed in 55.2 and 43.3% of cases respectively and these symptoms were reflected in the pathogenesis and clinical picture of the diseases studied. PMID- 6497698 TI - [Structural and metabolic mechanisms of placental adaptation]. AB - Ninety-two placentas from patients with late toxaemia of pregnancy were studied by means of histologic, stereologic and enzyme histochemical methods. 32 placentas were from live births and 60 from stillbirths. In the stillbirth series, 31 placentas were from cases of fetal antepartum deaths and 29 from cases of fetal intrapartum deaths. The increase of the microcirculation volume in placental villi and the increase of oxidative enzyme activity in the syncytiotrophoblast, stroma and villi vesel wall are considered as structural and metabolic mechanisms of placenta adaptation. The role of structural and metabolic placenta insufficiency in the pathogenesis of the intrauterine fetal death is discussed. PMID- 6497699 TI - [So-called epithelioid hemangioendothelioma]. AB - Tumour that developed in the armpit of a 52-year-old man was studied by light and electron microscopy. The tumour 3 cm in diameter was firmly attached to the vessel and almost completely obliterated its lumen. Histologically the neoplasm closely resembled the metastasis of mammary gland carcinoma. However electron microscopic examination allowed rejecting the epithelial origin of tumour and suggesting its vascular genesis (so-called "epithelioid hemangioendothelioma"). PMID- 6497700 TI - [Isolated actinomycosis of the spinal cord]. AB - A brief review of the literature on the actinomycosis of the central nervous system and particularly on that of the spinal cord is given. The authors observation concerns a 7-year-old boy with a clinical diagnosis of congenital defect of sacrum, suppuration of dermoid with fistula in the sacral region, epiduritis, cauditis. At the necropsy the actinomycosis of the lower thoracic and lumbar parts of the spinal cord with the involvement of bone and soft tissue in the sacral region and formation of scarring fistula was found. PMID- 6497701 TI - [Case of a pseudoaneurysm of the heart]. AB - Postmortem observation of a false heart aneurysm in a man of 64 is presented. The false aneurysm was located on the posterior surface of the heart and had the appearance of a dome-like protruding sac 16 cm in diameter and 0,3 cm thick, communicating with the left ventricle cavity through a hole 2,5 cm in diameter. The aneurysm wall consisted of hyalinized connective tissue. PMID- 6497702 TI - [Method for determining the age of the fibrin in the disseminated intravascular coagulation syndrome]. AB - Three methods for the detection of generalized intravascular coagulation are proposed. The dyes produced in the USSR are used in these methods: acid red 2C- orange-red-blue method; acid yellow light-proof--picric red-blue method; acid blue-black in the method called red-blue-black. The use of these methods allows one to determine the duration of the fibrin existence in the vessels and to distinguish "young", "mature" and "old" fibrin. PMID- 6497703 TI - [Pathologicoanatomic diagnosis in pediatric practice]. PMID- 6497704 TI - [Veno-occlusive disease of the liver: report of 2 cases in the northeast of Brazil]. AB - Two cases of veno-occlusive disease of the liver (VOD) are reported in eleven and twelve-year-old children. The number of Brazilian cases of this entity amounts to five, with the addition of the present cases. One patient was in a subacute stage (central hepatic fibrosis) and had her diagnosis based on hepatic biopsy and venography; the other one was necropsied in a cirrhotic stage. Aspects concerning differential diagnosis with other regional hepatic disease, as well as the currently known geographic distribution and etiologic possibilities of VOD were reviewed. PMID- 6497705 TI - [Benign tumors of the bile ducts]. AB - Benign neoplasms are rare events in the extrahepatic biliary ducts, and scanty literary references on the subject are available. Four cases of obstructive jaundice caused by benign tumours of the extrahepatic biliary ducts have been reviewed. Two of them have also displayed lithiasis of the gallbladder and common bile duct. In three cases histopathologic confirmation was obtained, in contrast to the remaining case in which only a gross pathologic presumptive diagnosis was possible. Three patients underwent surgical resection, and in one of them hepatojejunostomy was performed. The patient with a presumptive diagnosis of "inflammatory polyp" was not submitted to surgery, due to the special circumstances of the case. The undisturbed follow-up of the four cases attested to the worthiness of the surgical procedures. PMID- 6497706 TI - [Effect of the intake of imbalanced protein on the liver of growing rats]. AB - The goal of the present work was to reproduce in laboratory animals situations frequently observed in low-income population, such as the insufficient energetic ingestion associated with protein sources of inferior quality. Corn was chosen as the protein source of low biological value and casein as the reference protein. The latter was administered in adequate quantity (20%) or equal to that of the corn (10%). Several biochemical parameters and the amounts of DNA, RNA and protein in the liver of rats in a phase of rapid growth were studied. In result, we can attest that the group fed on corn were the most seriously compromised in body weight, liver weight and biochemical parameters with the group fed a restricted diet of corn being the most seriously affected. The results suggest that the alterations caused by ingestion of a balanced diet restricted in quantity were less accentuated that those observed when the diet was of corn "ad libitum". PMID- 6497707 TI - [Bilio-digestive fistulas]. AB - The authors report upon 5 cases of biliary-enteric fistulas, all of them detected preoperatively in a General Surgery Service during a relatively short period of time (6 months). Two cholecysto-duodenal and one cholecysto-ileal fistula were complications of a pre-existent cholelithiasis. A choledocho-duodenal fistula was caused by a penetrating peptic ulcer and a choledocho-colonic fistula was a iatrogenic traumatic one. The review of the literature demonstrates generally a lower incidence of this pathology in different surgical centers, one or two cases a year. More than 50 per cent of the biliary-enteric fistulas were unexpectedly found during operations on the biliary tract or stomach. This forces the surgeon to change his programmed surgical procedure without adequate preoperative preparation. The consequence is a higher morbidity rate in such operations. The continuing refinement of diagnostical procedures have led to a progressive and more frequent preoperative assessment of these fistulas. Adequate diagnostic methods and surgical procedures adopted in different cases of biliary enteric fistulas are discussed, emphasizing the good results obtained and the lower morbidity. PMID- 6497708 TI - Absorption of D-xylose in full term newborns adequate for gestational age: prospective study up to third month. AB - Studies of the D-xylose absorption capacity in newborns are scarce and the results reported are controversial. We evaluated the xylose absorption in full term newborns adequate for gestational age in the first days of life and prospectively up to the third month. D-xylosemia values of the first and second hours at birth and at 3-5 days are significantly lower than on the 15th day at one month and at three months. On the other hand, the values obtained in these last three groups showed no differences among themselves. The comparison of first hour D-xylose values between a control group and those children investigated on the 15th day at one month and at three months, revealed significant differences, but second hour values did not show statistic differences. We concluded that enterocyte absorption capacity is already completely developed at 15 days of life in full term newborns adequate for gestational age. PMID- 6497710 TI - [Clinical conference at the Brazilian Institute for Study and Research in Gastroenterology]. PMID- 6497709 TI - [Fibrocystic disease of the pancreas: a presentation feature. Anatomopathological report]. AB - Five patients with CF (cystic fibrosis) dead between 1974 to 1982 at ages ranging from one to six months are presented. All of them showed edema, hypoalbuminemia and anemia in a severely compromised clinical situation, and failure to gain weight in spite of being breast-fed in the first weeks of life, in four of them. All of them were second or third degree malnourished babies (Gomez classification) at admission. Five children presented edema, two severe, two moderate and one mild. Hematocrit values ranged from 19% to 39% (means 26.4%), and albuminemia from 1.60 to 3.00 g/% (means 2.14 g/%). Two patients presented antecedents of dead brothers. All of them received substitution therapy with pancreatic enzymes. The children dead within seven and seventeen days of admission (means ten days) of broncho-pulmonar disfunction. In this work, we wish to call the pediatrician's attention about the importance of making this diagnostic presumption in the first months of the life. PMID- 6497711 TI - Intracranial abscesses in infancy and childhood: report of 40 cases. AB - Forty cases of brain abscesses in patients under 15 years of age observed between 1960 and 1982 are reported in this study. There has been a progressive decrease in the number of admissions due to that disease. The typical clinical picture was subacute and characterized by intracranial hypertension, fever, alterations in the level of consciousness, seizures and signs of localization in a decreasing order of frequency. Otites and sinusites predominated as primary foci and the most common localizations were frontal and parietal. Electroencephalogram and examination of the cerebrospinal fluid were useful. Currently, computerized tomography is indicated as the test of choice. Thirty-four patients underwent surgeries and the mortality rate was 35.2%. PMID- 6497712 TI - [Simultaneous determination of 4 anticonvulsant drugs by high pressure liquid chromatography (HPLC)]. AB - We describe a sensitive and precise method for the simultaneous high pressure liquid-chromatography determination of phenobarbital, diphenylhydantoin, primidone, and carbamazepine in serum. The drugs are extracted into chloroform, dried and dissolved in the mobile phase. The drugs are eluted from a reverse phase column with methanol/water and detected by their absorption at 214 nm. Concentrations are estimated from their peak heights. The results, when compared with those by enzyme-immunoassay, gave correlation coefficients of 0.990 for phenobarbital, 0.993 for diphenylhydantoin, 0.992 for primidone and 0.994 for carbamazepine. PMID- 6497713 TI - [Diseases and syndromes associated with myasthenia gravis in a group of 304 patients]. AB - Epidemiologic and clinic studies of both diseases and syndromes associated in a group of 304 myasthenic patients were made. A comparative projection between the present cases and those of other authors was presented. PMID- 6497714 TI - [Thyroid diseases and myasthenia gravis]. AB - In a group of 304 myasthenic patients 15 cases with thyropathies were reported: nine with hyperthyroidism, one with hypothyroidism and five with nontoxic goiter. Four patients presented diffuse simple goiter and one a multinodular goiter with normal thyroid function. No patient came from an endemic goiter region, not even familial goiter. The prevalence and influence of hyperthyroidism on myasthenic symptomatology were studied. Our findings suggest that there is no clinical correlation between both myasthenia symptomatology and thyroid dysfunction, neither significant influence on myasthenic symptoms when the endocrine disorders improve. PMID- 6497715 TI - Spinocerebellar degeneration and slow saccades in three generations of a kinship: clinical and electrophysiologic findings. AB - Four members of a family with spinocerebellar degeneration and slow saccadic eye movements are described. Detailed electrophysiological studies revealed abnormalities of neurological pathways not apparent clinically. The patients had slow saccades as measured electrophysiologically, as well as absence of rapid eye movements (REM) despite REM stages of sleep. These studies suggest that although saccadic eye movement and REM are mediated through the pontine paramedian reticular formation, other characteristics of REM sleep are not necessarily mediated through the same neurons. PMID- 6497716 TI - [Muscular hypertrophy in denervation: report of 2 cases with a histochemical and histometric study of normal and hypertrophic muscles]. AB - Report of two adult males, 31 and 24 years-old, with hypertrophy in their left inferior limb, with denervation in the electromyography. Both patients undergone to a muscle biopsy in the normal and in the enlarged limb, which were processed by histochemistry. The mean muscle fiber diameter, percentage of muscle type fibers and atrophy and hypertrophy factors were calculated, as well as histographic fiber analysis. We found rare atrophic muscle fibers and one of the patients had hypertrophy of type II muscle fiber and the other hypertrophy of both types. The calculation of the atrophy and hypertrophy factors, revealed a predominance of type II fiber hypertrophy in both quadriceps of the two patients and type I hypertrophy in one case. A discussion about the factor responsible by the hypertrophy in denervation is made. The possible etiology of one case was a S1 radiculopathy and in the other, a possible motor neuron disease. PMID- 6497717 TI - [Menkes syndrome: review of the pathogenesis apropos of a clinico-pathological case]. AB - The authors report a case of Menkes' syndrome, probably the first one described in Brazil. The patient, a 15-month-old boy, showed pili torti, early progressive psychomotor deterioration and seizures. Serum levels of ceruloplasmin and copper were very low. Neuroradiological and roentgenological examinations revealed diffuse cerebral atrophy, arterial changes and bone abnormalities. At the post mortem examination the more consistent findings were cerebral atrophy, neuronal loss in the thalamus and above all cerebellar cortical lesions. The disease has a sex-linked recessive inheritance and is believed to be caused by an inborn error of copper metabolism, perhaps subordinated to changes of proteins which carry copper to different tissues. The relevant literature in relation to the pathogenesis is reviewed. PMID- 6497718 TI - [Medullary schistosomal granuloma: report of a case]. AB - A case of Schistosomotic granuloma of the spinal cord in a 34 years old man with a primary diagnostic of spinal cord tumor is reported. The diagnostic conditions, the complementary examinations and endemic aspects are commented. The surgical treatment and the results are comparized with literature data. PMID- 6497719 TI - [Brachial plexus neuropathy (amyotrophic neuralgia) and infectious mononucleosis: report of a case]. AB - A case of brachial plexus neuropathy (BPN) associated with infectious mononucleosis (IM) in a 13 year old boy is presented. The essential clinical picture of BPN is discussed and the main points are: acute pain at onset across the top of the shoulder-blade followed by weakness and atrophy on muscles supplied in most cases by superior brachial plexus. The prognosis is good and most patients began to note improvement within months. The main neurological complications of IM are lymphocytic meningitis, peripheral neuropathy and encephalomyelitis and they can occur without any classical findings as pharyngitis, adenopathy or splenomegaly. The association of BPN and IM was described previously in only 7 cases and as the present case all of them had a complete recovery. PMID- 6497720 TI - [Marfan syndrome and giant intracranial aneurysms: report of a case]. PMID- 6497721 TI - [Transient cortical blindness after cerebral angiography: report of a case]. AB - A case of temporary cortical blindness following cerebral angiography is presented and discussed. The etiology of this rare complication is not completely understood. Probably the blindness is secondary to the direct effect of the contrast medium in the blood-brain-barrier in the striate cortex. PMID- 6497722 TI - [A case of bilateral tonic pupil (Holmes-Adie syndrome)]. AB - The authors present a case of bilateral tonic pupil and discuss clinical and physiopathological aspects of this syndrome. They discuss some elements necessary for the understanding of the etiopathogenesis of the disease. PMID- 6497723 TI - Association of Joubert's syndrome with Leber's congenital amaurosis. PMID- 6497724 TI - Homolateral paresis and ataxia. PMID- 6497725 TI - A battered doll. PMID- 6497726 TI - On the notion of doll's eyes. AB - The descriptor doll's eyes is used (and sometimes abused) in reporting clinical signs at the bedside. Originally coined by Bielschowsky, its meaning is often compromised by prior experience with dolls that exhibit human pathology as part of their normal condition. Radiographic examination of antique dolls provides insight into their mechanism of horizontal conjugate gaze, a function rarely encountered in contemporary dolls. PMID- 6497727 TI - Computer-aided assessment of transient ischemic attacks. A clinical evaluation. AB - We developed and evaluated a computer-based system to assist with the difficult problem of assessing the conditions of patients with transient ischemic attacks (TIAs). The program used criteria to classify a patient's illness localize the neurologic deficit, screen for 46 causative or mimicking disorders, recommend additional tests, and suggest management steps. We evaluated this program in 103 patients with TIAs. The TIA program's localization and classification of patients generally agreed with those made by stroke specialists at our institution, demonstrating that computer programs can reproduce the decision criteria of stroke specialists. With revisions, the TIA program or similar systems could be useful for objective disease classification in clinical trials or epidemiologic studies. In contrast, the TIA program's treatment recommendations were often found to differ significantly from the actual treatments administered by non stroke specialists. PMID- 6497728 TI - Small capsular hemorrhages. Clinical-computed tomographic correlations. AB - Ten patients' hemorrhagic capsular lesions were detected by computed tomography (CT). Nine of these ten patients had systemic arterial hypertension. Two patients had prior transient ischemic episodes that were of the same nature and suggested the same vascular territory as the subsequent capsular hemorrhage. All of the patients had the sudden onset of maximal neurologic deficit and none showed progressive worsening. Seven patients had pure motor hemiparesis and three had motor weakness with mild sensory impairment. The CT showed capsular hemorrhage in all cases without extension into the thalamus or basal ganglia. None of the hemorrhages caused mass effect or showed surrounding hypodense rim. In nine cases there was a rapid and complete neurologic improvement and in only one case did the patient show mild residual neurologic deficit. These ten cases emphasize the potential dangers of anticoagulation in patients who have not had a prior CT scan. PMID- 6497729 TI - Ventricular size in patients with presenile dementia of the Alzheimer's type. AB - The computed tomograms (CTs) of eight mild to moderately impaired patients with presenile dementia of Alzheimer's type (aged 53 to 64 years) were compared with scans of ten healthy age-matched controls. Two computer programs and a variety of linear measurements were used to analyze the CTs. A single computerized measure of fluid volume on the slice at the maximum width of the bodies of the lateral ventricles correctly predicts the group membership of 88.89% of the subjects. Computerized measures on other CT slices do not increase discrimination between the groups. Easily performed linear measures correctly predict the group membership of 78.9% of the subjects. Computerized measures of ventricular size may provide highly valuable information for the diagnosis of Alzheimer's disease in the presenile age range. PMID- 6497730 TI - CT density numbers in patients with senile dementia of the Alzheimer's type. AB - The computed tomograms (CTs) of 13 mild to moderately impaired patients with senile dementia of the Alzheimer's type (aged 65 to 82 years) were compared with CTs of 18 healthy age-matched controls. Two computer programs and a variety of linear measurements were used to analyze the CTs. A measure of the mean CT density number of the brain tissue on the slice at the maximum width of the bodies of the lateral ventricles correctly predicts the group membership of 77.42% of the subjects. The addition of a second computerized variable, the fluid volume on the slice at the maximum width of the third ventricle, increased discriminating power to 93.55%. The CT density numbers may provide highly valuable information for the diagnosis of Alzheimer's disease in the senile age range. PMID- 6497731 TI - Metastatic cerebral abscesses due to Hemophilus paraphrophilus. AB - A patient who had a two-month history of nonspecific inflammatory disease experienced symptoms of raised intracranial pressure and meningitis. Computed tomographic scan showed multiple, small ring-enhancing hypodensities consistent with cerebral abscesses. The infective agent proved to be Hemophilus paraphrophilus, a fastidious, particularly slow-growing organism that was identified on blood cultures. An autopsy disclosed disseminated microabscesses and demonstrated typical pathologic changes of endocarditis complicating mitral valve prolapse. PMID- 6497732 TI - A genetic variant of Emery-Dreifuss disease. Muscular dystrophy with humeropelvic distribution, early joint contracture, and permanent atrial paralysis. AB - A 38-year-old woman, a product of consanguineous parents, had been observed to have limited neck flexion and elbow joints contracture since early childhood. In addition, she experienced humeropelvic muscular weakness and atrophy, so that she was unable to walk by age 27. At 34 years of age, she required a permanent pacemaker to treat complete atrioventricular block with ventricular bradycardia. A myocardial biopsy confirmed cardiomyopathy. The clinical features of the present case are similar to those of the Emery-Dreifuss syndrome; however, this case may be inherited through an autosomal recessive trait. PMID- 6497733 TI - Cerebellar hemorrhage complicating methylmalonic and propionic acidemia. AB - Methylmalonic (MMA) and propionic (PPA) acidemias are inherited disorders characterized by a wide spectrum of clinical and biochemical findings. We report the neuropathologic findings in two young infants with MMA and PPA in which death probably resulted from cerebellar hemorrhage. When combined with a previous report of isovaleric acidemia complicated by diffuse subarachnoid and parenchymal cerebellar hemorrhage, it is apparent that cerebellar hemorrhage must be considered in any infant with a fulminating organic acidemia. Rapid neurologic deterioration despite an improvement in acidosis and hyperammonemia is an indication for computed tomography of brain. Surgical evacuation of the blood may improve the chance for survival in this catastrophic illness. PMID- 6497734 TI - Aphasia after left thalamic infarction. AB - We examined a 70-year-old woman who became aphasic after a left thalamic infarction. Computed tomographic scan showed injury that was largely limited to the ventral anterior and rostral ventral lateral thalamic nuclei. Speech was characterized by reduced voice volume, impaired auditory and reading comprehension, perseverations, intermittent use of jargon, fluctuations in the ability to perform confrontation naming, extraneous intrusions, verbal paraphasia, intact repetition skills, and fluent speech that was laconic but grammatically correct. We propose that the deficits after left thalamic injury can be grouped into the following four large clusters: extrapyramidal deficits (decreased or fading voice volume), deficits in lexical access (anomia, verbal paraphasia), deficits in vigilance (neologisms, intrusions, fluctuating performance, jargon, perseverations), and comprehension defects. PMID- 6497735 TI - Downbeat nystagmus with alcoholic cerebellar degeneration. PMID- 6497736 TI - Serum concentrations of propranolol and migraine prophylaxis. PMID- 6497737 TI - Averaging techniques to define the low-amplitude compound motor action potential. PMID- 6497738 TI - Fungus corneal ulcer. PMID- 6497739 TI - Neuroretinal rim area. PMID- 6497740 TI - The status of radial keratotomy in 1984. PMID- 6497741 TI - Classification and incidence of space-occupying lesions of the orbit. A survey of 645 biopsies. AB - Six hundred forty-five consecutive biopsies of orbital lesions performed at a major ophthalmic hospital during a 20-year period were used to develop a comprehensive classification of orbital tumors and pseudotumors, excluding thyroid orbitopathy. Although this series has certain bias, it probably closely parallels the incidence of orbital lesions that would prompt a biopsy in an ophthalmic practice. It is hoped that this review, combined with a familiarity of the signs and symptoms of various orbital lesions, will aid the clinician in the diagnostic evaluation of the patient with an orbital mass. PMID- 6497742 TI - Visual, refractive, and keratometric results of radial keratotomy. One-year follow-up. AB - Ongoing prospective evaluation of radial keratotomy was conducted on 156 eyes of the first 101 consecutive patients. We did a one-year follow-up and compared previously reported six-month findings. All eyes were examined both six months and one year after surgery. Findings obtained by an independent examiner both before and after surgery correlated highly with findings obtained in the surgeon's office. One year after surgery, mean change in spherical equivalent was +4.7 diopters; overall uncorrected distance acuity was 20/20 in 49% of cases and at least 20/40 in 76% of cases. Fifty-eight percent of eyes were within 1.0 D of emmetropia. Visual results showed slight general improvement between six and 12 months; refractive results were stable, except that excessive overcorrection was found to decrease. In this series, radial keratotomy seemed safe and effective one year after surgery. PMID- 6497743 TI - Vitrectomy and intravitreal antiviral drug therapy in acute retinal necrosis syndrome. Report of two cases. AB - Two patients with acute retinal necrosis were treated with vitrectomy, intravitreal infusion of acyclovir, and prophylactic scleral buckling procedures. Both patients have had a uneventful postoperative course and a recovery of visual acuity; follow-up has been at five and 14 months. There has been no sign of toxicity from the intravitreally administered acyclovir by electroretinographic or clinical criteria. PMID- 6497744 TI - Krypton laser trabeculoplasty. A clinical report. AB - Krypton red (647.1 nm) or krypton yellow (568.2 nm) laser trabeculoplasty was performed in 15 phakic eyes of 14 patients. After an average follow-up of five months, these patients had an average drop of intraocular pressure of 8.9 mm Hg. In addition, in eight of these patients studied, argon laser trabeculoplasty was performed in the opposite eye. After an average follow-up of more than five months in these eight patients, the average drop of IOP was 7.2 mm Hg in the eyes with krypton laser trabeculoplasty and 6.8 mm Hg in the eyes with argon laser trabeculoplasty. This preliminary study indicates that laser trabeculoplasty may be effectively performed with krypton wavelengths. PMID- 6497746 TI - Clinical performance of a disability glare tester. AB - A glare tester was described previously and was found, in the presence of cataracts, to be almost twice as predictive as was Snellen measurement for determining visual acuity outdoors. The current study tests the reproducibility of glare test scores and the influence of refractive error and contrast sensitivity on such scores when used in a clinical environment. Although the effects of visual acuity and impaired contrast sensitivity were found to be statistically significant components of glare test scores, the magnitudes of their effects were found to be clinically insignificant. Sequential retesting of physiologically stable eyes or, in the case of progressive cataracts, within intervals short enough to preclude discernible lenticular changes indicated that, for the most part, reproducibility of glare testing was comparable to that of visual acuity testing. PMID- 6497745 TI - Flurbiprofen pretreatment in argon laser trabeculoplasty for primary open-angle glaucoma. AB - We examined the influence of topically administered flurbiprofen sodium 0.03%, a potent prostaglandin inhibitor, on the inflammatory response and intraocular pressure following argon laser trabeculoplasty. Our investigation included one eye of each of 118 patients with primary open-angle glaucoma in whom laser trabeculoplasty was indicated. Sixty-three patients received flurbiprofen and 55 received a vehicle during the two-hour period immediately preceding laser therapy and for one week postoperatively. No significant differences in postoperative IOPs were noted between groups. However, when we considered conjunctival erythema at 24 hours or control of inflammation at the termination of the investigation, the eyes receiving flurbiprofen had less inflammation than did the vehicle treated eyes. PMID- 6497747 TI - Mechanism of tear flow after dacryocystorhinostomy and Jones' tube surgery. AB - In the 42 patients (84 eyes) in this study, 32 eyes had dacryocystorhinostomy (DCR), 15 had Jones' tube insertions, and the remaining 37 were considered controls. All patients were studied using nuclear scanning with computer interfacing quantitative lacrimal scintillography to determine the effects of blinking, respiration, and gravity on their functioning. Tears flowed through DCR openings faster than through the systems of normal patients. Patients with Jones' tubes demonstrated slower flow than in normal patients. The effect of respiration on tear flow was minimal, but blinking and lid function were important. Patients with eyelid laxity may show decreased flow even if the DCR and Jones' tubes are functional. PMID- 6497748 TI - Neurilemoma of the eyelid resembling a recurrent chalazion. AB - A 63-year-old woman was seen with a slowly enlarging mass located on the right lower eyelid, where a "chalazion" had been twice curetted but not studied histologically. An excisional biopsy was performed, and the specimen proved histologically to be a neurilemoma (schwannoma). Although a neurilemoma is extremely rare on the eyelid, this case demonstrates that it should be included in the differential diagnosis of lesions that can clinically masquerade as a chalazion. PMID- 6497749 TI - Lymphomatous optic neuropathy. AB - Optic neuropathy as the first sign of a lymphoreticular neoplasm is rare. A 65 year-old man complained of initially transient and then progressive visual loss in the right eye for two weeks. Computed tomography demonstrated a mass in the region of the intracranial portion of the right optic nerve. Frontal craniotomy was performed and histopathologic examination of the tumor disclosed a granulomatous process. Regrowth of the mass and visual deterioration, despite systemic steroid therapy, prompted surgical reexploration. Histopathologic examination confirmed large cell lymphoma. After local radiotherapy (2,500 rad), the patient is well and free of local or systemic lymphoma one year later. Other reported cases of lymphomatous optic neuropathy are reviewed and the diagnostic difficulties encountered are discussed. PMID- 6497750 TI - Endothelial cell loss following radial keratotomy in a primate model. AB - The effect of radial keratotomy on the corneal endothelium of subhuman primates was studied by serial specular microscopy and histopathology. Fixed-frame analysis of specular micrographs of 13 operated eyes at one month after surgery revealed an endothelial cell loss of 13% (+/- 4%). Follow-up of all 13 eyes for six months disclosed no statistically significant progressive endothelial cell loss. Similarly, no significant loss could be demonstrated in five eyes followed up for 18 months and two eyes followed up four years after surgery. Variable frame analyses of specular micrographs of all 13 unoperated eyes followed up for six months also did not suggest progressive endothelial cell loss following radial keratotomy. Histopathology and ultrastructural studies of corneas undergoing radial keratotomy disclosed no abnormalities suggesting ongoing endothelial cell damage. These findings suggest that radial keratotomy produces an acute postoperative endothelial cell loss that is nonprogressive. Much longer term follow-up with larger numbers of subjects is necessary before the ultimate delayed effects of radial keratotomy on the endothelium can be determined. PMID- 6497751 TI - Metabolic status of fresh v eye-bank-processed corneas. A phosphorus nuclear magnetic resonance study. AB - The concentrations of corneal phosphatic metabolites in fresh and eye-bank processed corneas were measured by phosphorus 31 nuclear magnetic resonance of perchloric acid corneal extracts to determine whether metabolic differences exist between these two corneal preparations. Cat corneas were prepared using an eye bank protocol, including specular microscopic examination and transport to a distant location. Fresh cat corneas were used as controls. The hexose 6-phosphate resonance band, the nucleoside monophosphate band, the phosphodiesters, and adenosine triphosphate of eye-bank-processed corneas were significantly decreased relative to fresh control corneas. Phosphatic metabolites that significantly increased relative to control corneas included inorganic orthophosphate and phosphocreatine. A calculated corneal tissue-energy index was significantly decreased for eye-bank-processed corneas relative to control. This decline demonstrates a compromise in the metabolic energy status of the tissue and is indicative of a diminished ability of the cornea to maintain its complement of high-energy phosphates. PMID- 6497752 TI - Vernal conjunctivitis. Model studies in guinea pigs immunized topically with fluoresceinyl ovalbumin. AB - Repeated topical applications of fluoresceinyl ovalbumin (FL-OA) to the conjunctival sac of guinea pigs sensitized them for conjunctival type 1 hypersensitivity reactions and mast cell degranulation. Guinea pigs infected with Ascaris suum, with high titers of circulating anti-A suum IgE and IgG1 antibody, also produced conjunctival type 1 reactions on topical challenge with A suum antigen. These reactions were no more intense than those of animals topically sensitized and challenged with FL-OA, which in some instances had no detectable serum homocytotropic antibody. Persistently reactive animals that had undergone repeated type 1 conjunctival reactions had histological findings (eg, papillary changes with extensive epithelial eosinophil infiltrates, epithelial thickening or thinning, numerous goblet cells, subepithelial lymphoid cell infiltrates, and new vessel formation) resembling those of human atopic vernal conjunctivitis. PMID- 6497753 TI - Principles of photometry of the papilla. AB - To enhance the qualitative information gained by photographing the optic nerve head, we built a silicon photovoltaic detector (photodiode) in the image plane of a fundus camera (Zeiss). It permitted quantitative evaluation of the relative brightness of the illuminated papilla. Following construction of the device and during the early course of more than 260 measurement sessions (on more than 130 subjects), several heretofore unknown sources of error were encountered and subsequently dealt with, resulting in a margin of error for the entire system of between 0.3% and 1.2%. Pallor of the optic nerve head induced by artificial ocular hypertension can be well reproduced by this method. PMID- 6497755 TI - A mechanical three-step test. AB - A simple mechanical binary search device is described that can be used to perform the Parks' three-step test. Instructions to make the device from light cardboard are provided. PMID- 6497754 TI - Intravitreal expanding gas bubble. A morphologic study in the rabbit eye. AB - The morphologic changes induced by an expanding bubble of perfluoropropane (C3F8) gas in the vitreous body have been studied in the rabbit eye by dissecting microscopy and scanning and transmission electron microscopy. Initial expansion of the gas displaces water from the vitreous; the remaining vitreous forms a compressed layer on the retinal surface. Subsequent absorption and contraction of the gas bubble is associated with gradual detachment of the compressed vitreous from the retina. Eventually, vitreous detachment is complete, except for residual attachments posteriorly to the medullary rays and anteriorly to the ciliary processes. The plane of vitreous separation is predominantly at the anatomic vitreoretinal junction, although scattered islands of outer cortical vitreous are found on the surface of the retina. PMID- 6497756 TI - Cancer and gall stones. Should all stones be removed? PMID- 6497757 TI - Barium enema in the diagnosis of colonic carcinoma. PMID- 6497758 TI - An inter-hospital criteria audit of infection in total hip-joint replacement surgery. PMID- 6497759 TI - The endoscopy explosion. An occasional paper. AB - The endoscopy boom is likely to continue. Major efforts to rationalise the indications and monitor the results are essential. However, "accreditation" of endoscopists is not likely to overcome the problems inherent in the boom. PMID- 6497760 TI - Surgical competence. PMID- 6497761 TI - Australian Medical Association. Statement to the committee of inquiry into rights of private practice in public hospitals public hearing, Melbourne May 15, 1984. PMID- 6497762 TI - Guidelines for delineation of clinical privileges in surgery. PMID- 6497763 TI - Criteria audit of carotid surgery. A co-operative study in 7 teaching hospitals. PMID- 6497764 TI - The natural history of Parkinson's disease. PMID- 6497766 TI - The early diagnosis of Parkinson's disease. AB - Parkinson's disease is characterised by symptoms and signs which relate to tremor, rigidity and bradykinesis. The signs may be mild in the early stages of the disorder but the diagnosis can be established by careful neurological examination directed at proper evaluation of the essential features. The lack of any specific abnormality on special investigation leaves the responsibility for diagnosis with the clinician. PMID- 6497765 TI - Difficulties in long term management of Parkinson's disease. AB - It must be recognised that patients with idiopathic Parkinson's disease will eventually get worse and, where appropriate, realistic prognostications of the future should be conveyed to patients and their responsible relatives. Some 15 per cent of patients will not respond to levodopa. When a patient does not show a significant improvement on therapy a number of important questions should be considered. Is the diagnosis correct? Consider an alternative diagnosis such as progressive supranuclear palsy, drug effect, multi infarct dementia, Alzheimer's disease, striatonigral degeneration, senile or essential tremor and the Shy Drager syndrome which all may be mistaken for Parkinson's disease. Is the patient complying with therapy? Is the dose adequate and the frequency of administration appropriate? Are the symptoms caused by drug therapy? Would the addition of other therapy assist, for example amantadine, anticholinergics or bromocriptine? Is the patient on other drugs which may be contributing to the impaired function? Is the patient depressed? Is there some other underlying condition aggravating the Parkinson's disease? PMID- 6497768 TI - Cricket injuries. AB - English and Australian cricket teams on tour used to travel by ship, and many enjoying shipboard life, reached their destination considerably overweight and thus unfit and vulnerable to injury in their sport. Now they travel by air and most national teams employ a fitness coach to supervise sessions of rigorous exercise before and during the season. However the international cricket season is longer than it was and the incidence of overuse injuries is increasing. PMID- 6497767 TI - The drug treatment of Parkinson's disease. AB - The drug treatment of Parkinson's disease should be tailored to the age of the patient, coexistence of dementia or postural hypotension, duration of the disease process and the emergence of side effects. In the early stages of the disease when disability is minimal, amantadine or anti-cholinergic drugs may suffice. As the patient's lifestyle becomes hampered, levodopa in combination with carbidopa or benserazide is introduced. Mild dopa induced dyskinesia can be ignored but when it is troublesome the dose of levodopa should be reduced. Fluctuations are minimised by giving small doses of levodopa frequently throughout the day or by adding bromocriptine to the drug regimen. Postural symptoms often respond to fludrocortisone and elevation of the head of the bed. In elderly or demented patients anticholinergic drugs and amantadine should be avoided. In these patients small doses of levodopa alone may be preferable to the combined preparations. More effective drugs with fewer side effects are likely to emerge with future successful research into the different types of dopamine receptors and other possible transmitters. PMID- 6497769 TI - Rugby injuries. PMID- 6497770 TI - Common snow skiing injuries. PMID- 6497771 TI - Injuries to the ankle. AB - Injury to the ankle joint is common in athletes. Incorrect management can result in delayed return to sport and persistent impairment of function. PMID- 6497772 TI - Hamstring muscle injuries. AB - Probably the most common lower limb injury in amateur and professional athletics is strain of the hamstring muscles. Its frequent mismanagement stems from the inability of the athlete and his medical advisors to assess accurately the severity of the damage, coupled with the often premature return to competition which can result in a demoralising repeat muscle tear. PMID- 6497773 TI - Exercise for the elderly. AB - Increased physical and mental activity has something to offer all people, including the elderly. The medical profession often regards 'geriatric' as a 'condition' instead of a person with special needs and abilities. The opportunity to promote better health to such people is available: we must aim to add life to years not years to life. PMID- 6497774 TI - The widow's rejection. PMID- 6497775 TI - X-ray quiz. Scleroderma. PMID- 6497776 TI - Strapping of joints. AB - Strapping with adhesive tape plays a significant part in the prevention of joint injuries, particularly at the ankle and hand, and is important during early management of injury and rehabilitation. Recurrence of injury when the athlete recommences training is less likely when supportive strapping is applied. PMID- 6497777 TI - Supportive counselling of parents after a stillbirth. PMID- 6497778 TI - Acquired paternal influence in mice. Altered serum antibody response in the progeny population of immunized CBA/H males. AB - First generation offspring derived from CBA/H males immunized in adult life against rat blood cell antigens displayed altered immune reactivity to rat erythrocytes (RE) as assayed at a single time point after challenge. For the low antigen challenge doses employed (10(6) to 10(7) RE i.p.) the population of test offspring showed a significant enhancement of serum antibody response relative to the control population of progeny of unimmunized males; at higher antigen challenge doses (10(8) RE i.p.) the response in the test progeny population was suppressed. PMID- 6497779 TI - Microsomal protein synthesis and induction of cytochrome P-450 in cirrhotic rat liver. AB - In order to determine whether non-specific defects of protein synthesis account for reduced levels of cytochrome P-450 in cirrhotic liver, total microsomal protein synthesis and response to microsomal enzyme-inducing agents have been examined in rats. Cirrhosis was produced by administration of carbon tetrachloride (CCl4) and phenobarbitone for 10 weeks. Ten days after stopping these agents, cytochrome P-450 levels were 30% lower in cirrhotic liver than in controls (p less than 0.0001). However, total microsomal protein synthesis, determined in vivo by administration of [3H]-leucine, was similar in cirrhotic (1347 +/- 420 dpm/mg protein) and control (1317 +/- 303 dpm/mg protein) liver. Three separate types of microsomal enzyme-inducing agents, phenobarbitone, beta naphthoflavone, and pregnenolone 16 alpha-carbonitrile, were administered to cirrhotic and normal rats. In both groups of animals increases of total cytochrome P-450 and selective changes of cytochrome P-450 isoenzymes (assessed by mixed function oxidase activity towards four substrates) were qualitatively and quantitatively similar. It is concluded that hepatocytes of cirrhotic rat liver synthesize microsomal protein at a normal rate but less of it is cytochrome P-450, and the entire process of enzyme induction is intact. Thus, it appears likely that altered regulation of basal levels of cytochrome P-450 rather than an altered response of the liver is responsible for the lowered cytochrome P-450 content of cirrhotic rat liver. PMID- 6497780 TI - The contribution of inositol exchange to agonist-stimulated breakdown of myo- [2 3H] inositol-labelled phosphatidylinositol in mouse exocrine pancreas. AB - Agonists stimulate the release of myo-inositol from phosphatidylinositol (PtdIns) labelled in vivo with myo-[2-3H] inositol. In the presence of lithium, which inhibits myo-inositol-1-phosphatase, the compound which accumulates following the breakdown of pre-labelled PtdIns is inositol-1-phosphate. This indicates that the agonist-stimulated release of the head group from this lipid is not the result of inositol exchange and is due to phosphodiesterase activity. The total amount of 3H-labelled compounds released from PtdIns in the presence and absence of lithium is the same, which indicates the labelled compounds which are released are not re incorporated. Agonist-induced release of myo-[2-3H] inositol can be used as a reliable indication of PtdIns breakdown in the exocrine pancreas. PMID- 6497781 TI - Analysis of collagen from normal and abnormal human bone. AB - Using cyanogen bromide digestion of bone collagen, we have studied the type of collagen in normal bone, and in samples from patients with Paget's disease of bone, osteomalacia, osteoporosis and renal osteodystrophy. Despite extensive extraction with ethylene diamine tetraacetic acid and guanidine hydrochloride, not all of the glycoproteins could be removed from bone collagen. Upon electrophoresis on sodium dodecyl sulphate polyacrylamide gels, the cyanogen bromide peptides of insoluble bone collagen showed the pattern of type I collagen only in all samples, both normal and abnormal. Amino acid composition of the insoluble collagens and the ratio of hydroxylated and non-hydroxylated amino acids were similar for all adult bone samples. These results suggest that the type of collagen in bone is not altered in the bone diseases examined. PMID- 6497782 TI - Metabolism of exogenous noradrenaline in slices of hypothalamus and caudate nucleus of the brush-tail possum, Trichosurus vulpecula. AB - In the possum, Trichosurus vulpecula, the major catecholamines in the hypothalamus and caudate nucleus are noradrenaline and dopamine, respectively, suggesting that catecholaminergic transmission in these regions is similar to that in eutherian mammalian brain. Comparisons of accumulation and metabolism of 3H noradrenaline by tissue slices of the two regions indicated that in the caudate nucleus there was a seven-fold greater accumulation of unchanged noradrenaline but a lower rate of deamination to the principal metabolite, dihydroxyphenylethylene glycol (DOPEG). Cocaine inhibited DOPEG formation in the hypothalamus but not in the caudate nucleus. To explain these results, it is suggested that in the hypothalamus noradrenaline is taken up by noradrenergic nerve terminals where it undergoes extensive deamination. However, in the caudate nucleus it is taken up by, but not deaminated within, the dopaminergic nerve terminals. In the hypothalamus the presence of a corticosteroid-sensitive O methylating system extraneuronal to noradrenergic neurones was indicated by the inhibitory effect of hydrocortisone on the O-methylation of isoprenaline. The results do not point to any major differences between the metabolism of noradrenaline in metatherian (marsupial) and eutherian brain. PMID- 6497783 TI - Factors influencing the release of noradrenaline from hypothalamic slices of the possum, Trichosurus vulpecula. AB - Slices of hypothalamus of the possum, Trichosurus vulpecula, were incubated with 3H noradrenaline and the subsequent spontaneous and K+-induced effluxes of 3H measured. Unchanged 3H noradrenaline comprised virtually all the K+-induced efflux, indicating that there was little, if any, metabolism of the amine after its release. Receptor-modulation of the K+-induced efflux of 3H was shown by inhibition of this efflux by noradrenaline, clonidine, angiotensin II and leu enkephalin, and by the increase in efflux produced by yohimbine and isoprenaline. It is concluded that, in the possum, the control of spontaneous and K+-induced release of noradrenaline in the hypothalamus is similar to that in eutherian mammalian brain. PMID- 6497784 TI - The isolation of influenza A viruses and paramyxoviruses from feral ducks in New Zealand. AB - Tracheal and cloacal swabs from apparently healthy ducks, gulls, shearwaters and terns in New Zealand were tested for myxoviruses by inoculation into embryonated eggs. Seven influenza A viruses belonging to three antigenic subtypes (H4N6; H1N3; H11N3) and nine paramyxoviruses of two antigenic subtypes (PMV-1; PMV-4) were isolated from feral ducks. The occurrence of the same virus subtypes in birds, including ducks, in other countries suggests that they were introduced into New Zealand by the importation of infected poultry or game birds. Ducks experimentally infected with two of the influenza A virus isolates excreted virus in their faeces for 12 days. Infection with H4N6 subtype prevented reinfection with the same subtype but not with a different one (H11N3). PMID- 6497785 TI - Impaired renal concentrating capacity in the rat after surgical resection of the papilla. AB - Renal cortical and medullary function was examined in rats 4 weeks after surgical resection of the distal portion of the renal papilla had been performed. Glomerular filtration rate (GFR), obtained during the determination of free water reabsorption (TcH2O) at high rates of urine flow, did not differ significantly among controls (1.62 +/- 0.19 ml/min, n = 5), sham operated animals (1.45 +/- 0.16, n = 4) and papillectomized animals (1.49 +/- 0.21, n = 7). Maximum urinary osmolality (Umax) was 2216 +/- 293 mOsm/kg in controls, and was significantly reduced in sham operated (1737 +/- 261, P less than 0.05) and papillectomized animals (889 +/- 143, P less than 0.0001). TcH2O was normal in sham operated animals at high rates of osmolar clearance (Cosm), but was significantly impaired after resection of the renal papilla. These results suggest that removal of the terminal collecting ducts and interruption of nephrons with long loops extending into the papilla impair the maximal generation of solute free water. PMID- 6497786 TI - Artificial rearing of a rusa deer calf (Cervus rusa timorensis) PMID- 6497787 TI - Electrical immobilisation. PMID- 6497788 TI - An epidemiological study of trichostrongylidiasis in dairy cattle grazing irrigated pastures. AB - Trichostrongylid burdens in 1 to 2-year-old dairy heifers were estimated after they grazed with a dairy herd for up to 12 months. Ostertagia ostertagi, Trichostrongylus axei and Cooperia oncophora represented 79.5, 12.7 and 7.8% respectively of all trichostrongylids recovered. The largest burden was 97,000 trichostrongyles with less than 20,000 being the typical burden. Clinical disease was not observed. The strain of O. ostertagi present was capable of inhibition and was not necessarily controlled by anthelmintics. Availability of infective larvae increased with the onset of spring when "modified tracer" calves accumulated up to 30,000 trichostrongyles over intervals of one month. From July to September each year, up to 80% of the Ostertagia burden in these animals were inhibited larvae. Faecal strongyloid egg counts fell from less than an average of 60 eggs per gram to 10 eggs per gram when the heifers were one and 2 years old, respectively. Mature cows continually passed few eggs in their faeces. PMID- 6497789 TI - A survey of hairy shaker disease (border disease, hypomyelinogenesis congenita) in sheep. AB - A survey by mail in 1979 of 995 sheep farmers in Victoria enquiring as to the occurrence of hairy shaker disease (HSD) in lambs on their farms resulted in a 48% response. A total of 17 farms reported the presence of HSD. One hundred and eleven ewes produced lambs with HSD representing a small proportion only of the ewes (0.8%) on these farms and an even smaller percentage of the total ewes (0.03%) in the survey. Abortions were not prevalent on the majority of farms reporting HSD. There was no evidence that HSD was more common in any particular area in Victoria. As was anticipated mucosal disease virus/bovine virus diarrhoea (MDV) antibody was often present in serums from affected sheep. It was concluded that at present, the hairy shaker form of border disease did not appear to be an economically important problem in Victoria. PMID- 6497790 TI - Effects of feeding lupin seed naturally infected with Phomopsis leptostromiformis to sheep and pigs. AB - Lupin seed, 10% of which was naturally infected with Phomopsis leptostromiformis was obtained from 2 different sources and stored either conventionally, or in a warm and humid environment, for 45 weeks. Only very low levels of toxicity were apparent during the storage period and in the warm, humid environment the level of infection of P. leptostromiformis was gradually reduced and eventually eliminated. The 2 batches of infected seed, and non-infected lupin seed, were fed to sheep as sole rations for 40 weeks, or as part of feedlot rations for 10 weeks, and to baconer pigs as part of grower and finisher rations for 16 weeks. In the 40-week feeding trial mild lupinosis developed in sheep fed from one batch of infected seed, but there was no evidence of lupinosis in sheep fed the feedlot rations, or pigs fed the grower and finisher rations. It is suggested that lupin seed with levels of Phomopsis-infection of up to 10% could be safely fed to sheep and pigs under commercial conditions. PMID- 6497791 TI - Coccidiosis associated with post-weaning diarrhoea in beef calves in a dry tropical region. AB - The roles of helminths and coccidia in post-weaning diarrhoea in beef calves in the dry tropics were investigated. Diarrhoea occurred approximately one month after weaning in both anthelmintic treated and untreated calves. The highest numbers of coccidial oocysts were seen 29 days after weaning and 3 necropsies confirmed Eimeria zuernii coccidiosis. In the absence of wet overcrowded conditions, disease may have been precipitated by environmental interactions leading to suppression of host immunity. Other Eimeria identified were E. bukidnonensis, E. wyomingensis, E. bovis, E. auburnensis, E. cylindrica, E. ellipsoidalis and E. subspherica. The last 5 species are believed not to have been previously documented in Australia. The presence of E. canadensis was strongly suspected. PMID- 6497792 TI - Colitis in sheep due to a Campylobacter-like bacterium. AB - Epidemic diarrhoea was observed in approximately 2,000 of 6,700 sheep on 9 farms. The disease, called weaner colitis, caused mortality of 1%, while morbidity varied from 20 to 75%. Colon contents from affected sheep were inoculated into 17 sheep, 13 of which developed diarrhoea 5 to 7 days after inoculation. Naturally and experimentally infected sheep had mild, erosive typhlitis and colitis. Microscopic examination of washed scrapings of colonic mucosa from all affected sheep revealed masses of curved bacteria that were not seen in controls. Electron microscopic examination showed similar bacteria adherent to colonic epithelium of an experimentally infected sheep. Curved, motile bacteria were isolated from 2 naturally occurring cases. One isolate was inoculated into 9 sheep, 2 of which developed diarrhoea. The other isolate was given to 4 sheep without observable effect. The curved bacteria grew only on media containing blood, in an atmosphere of approximately 10% air, 10% CO2 and 80% H2. They were Gram-negative, with a polar flagellum at one or both ends, they did not ferment glucose or give a positive catalase reaction. It is suggested that these bacteria are a new Campylobacter species and that they play a major role in the aetiology of weaner colitis. PMID- 6497793 TI - Hereditary neuraxial oedema in a Poll Hereford herd. AB - Cases of neuraxial oedema in a Poll Hereford herd were investigated and the pedigrees of affected calves determined. In all cases, and over no more than 3 generations, the pedigree led back to a common bull. Analysis of the herd breeding records supported an autosomal recessive mode of inheritance of the disease. Fractures of the femoral heads, acetabular cartilage and/ or bone, or both, were seen in some affected calves. This lesion was probably induced during birth or soon after, and the suggestion is made that such hip lesions could be regarded as highly suggestive of hereditary neuraxial oedmea of Herefords. The majority of calves showed clinical signs at birth, but 2 calves did not develop clinical signs until they were 2 days old. PMID- 6497794 TI - Gastric retention associated with a pyloric mass in two horses. AB - Partial pyloric obstruction causing gastric retention is described in 2 young female horses. Gastric retention was confirmed by contrast radiography of the upper gastrointestinal tract. In both horses a large mass was palpated in the wall of the pyloric antrum at exploratory laparotomy. Post-mortem examination of the first case confirmed that this mass was associated with chronic gastric ulceration. Gastric ulceration was not confirmed in the second case but this horse recovered after the pylorus and duodenum were bypassed by gastro jejunostomy. PMID- 6497795 TI - Attempted induction of premature birth in sheep fed Cupressus macrocarpa. PMID- 6497796 TI - Observations on the short thermal tuberculin test. PMID- 6497797 TI - Appetite and growth of weaner sheep fed oat grain with and without a limestone supplement. PMID- 6497798 TI - Kennel cough and canine adenovirus vaccines in Australia. PMID- 6497799 TI - Tyzzer's disease in foals. PMID- 6497800 TI - Iodine in milk of cows after intrauterine infusion of Lugol's solution. PMID- 6497801 TI - Septicaemia and pneumonia in Mycoplasma capricolum infections of young goats. PMID- 6497802 TI - Correct administration of bovine growth promotants. PMID- 6497803 TI - Skeletal abnormalities in young horses associated with zinc toxicity and hypocuprosis. AB - Four young horses grazing pastures near industrial plants developed illthrift, lameness and skeletal abnormalities characterised by periarticular enlargement of the long bones. The clinical signs and lesions were attributed to hypocuprosis induced by an excessive intake of zinc from pasture. High pasture intakes of iron may have further compounded the problem. PMID- 6497804 TI - Clinical features therapy and epidemiology of tiger snake bite in dogs and cats. AB - Snake bite was diagnosed in 125 dogs and 115 cats over 10 years. Young sporting dogs and young cats were mainly affected. More dogs (48%) were seen in contact with tiger snakes than cats (7%). One hundred and four (84%) dogs and 89 (76%) cats were bitten in the warmer months of the year (October to March). As the incidence rose in September/October, dogs were bitten on days when the temperature was near 20 degrees C or over. The commonest presenting signs were dilated pupils and absences of pupillary light reflex. Dyspnoea, hypothermia, hindleg ataxia and glycosuria were common features in cats. Vomiting, tachypnoea, hyperthermia and complete flaccid paralysis were often seen in dogs. The overall recovery rate after administering antivenene was 90% for cats and 83% for dogs. Death from anaphylaxis as a result of giving antivenene occurred in 3 cats and one dog. Dogs treated soon after being bitten recovered more rapidly. There was no correlation between the bite-to-treatment period and the treatment-to-recovery period for cats. PMID- 6497805 TI - Stress and summer infertility in pigs. AB - A serious year-round fertility problem on a commercial piggery was investigated. The problem was characterised by a high proportion of non-pregnant sows and gilts which showed a delayed return or failure to return to oestrus after a normal mating to a fertile boar. Several factors were identified that we considered to be placing undue stress on the breeding stock from wearning through mating and early pregnancy. When steps were taken to reduce the influence of these stressors there was a marked improvement in the herd farrowing rate. Across all months this improvement was largely due to a reduction in the number of sows showing delayed return or failure to return to oestrus after mating. There were no concomitant changes in other indices of performance. In conclusion this study has shown that stressful factors other than summer heat stress can cause a syndrome of delayed or failure to return to oestrus, this syndrome is commonly and perhaps wrongly called 'summer or seasonal infertility'. When given the appropriate combination and/or intensity of stressful stimuli, it can be manifest at any time of the year. PMID- 6497806 TI - Assessment of a complement fixation test to detect Mycoplasma hyopneumoniae infection in pigs. AB - Serums from pigs slaughtered at abattoirs were tested for evidence of Mycoplasma hyopneumoniae infection using a complement fixation (CF) test which avoids the procomplementary effect of pig serum. To establish a diagnosis of enzootic pneumonia, the lungs from all sampled pigs were examined for pathological and histological changes consistent with the disease and cultures were made for mycoplasmas and bacteria. The study was carried out at Parkville and Bendigo 160 km apart at different times and all serums were tested at both laboratories. The results agreed closely. Thirty-six of 97 pigs at Parkville and 46 of 99 at Bendigo had enzootic pneumonia. About 80% were positive in the CF test. Sixteen per cent of porkers and 36% of baconers gave false negative reactors, that is, a negative test though lesions were present. About 18% to 36% gave false positive reactions but the level in the porkers in the Bendigo group was significantly higher (p less than 0.02). Possible explanations include, for the false negatives, loss of reactivity caused by circulating antigen and for the false positives, cross reacting antibody produced by another infection or failure to appreciate that lesions of EP were present in lungs because either they were not identified as such or they were not detected. The validity of any serological test for this disease cannot be established while there is a possibility that the present methods used for diagnosis, gross and microscopic examination and recovery of M. hyopneumoniae, fail to detect some infected animals. Other criteria may have to be adopted. PMID- 6497807 TI - Experimental ochratoxicosis A in pigs. AB - Ochratoxin A was isolated from a culture of Aspergillus ochraceus grown on a cornmeal substrate. The mycotoxin was added to a grower ration for 14 kg young pigs at 2, 4, 8 and 16 mg/kg and fed to groups of 3 for periods ranging from 6 to 20 days. The highest dose rate group only became sick, with loss of appetite, weight loss, polydipsia, polyuria, proteinuria, glucosuria, elevation of serum creatinine, pale swollen kidneys, renal tubular degeneration and cortical fibrosis. The pigs on the 2 mg toxin/kg of diet appeared unaffected with only slight renal tubular degeneration present in one animal. Feeding diet contaminated with the intermediate doses of 4 and 8 mg toxin/kg diet lead to reduction of weight gain and/or reduced feed intake and feed conversion efficiency as well as mild renal lesions. Ochratoxin A has recently been reported on mould-affected grain in Queensland and some local strains of A. ochraceus in culture have been shown to be able to produce levels of ochratoxin A of up to 4000 mg/kg of substrate. Rare episodes of nephrotoxicity in pigs seen at slaughter in Queensland may thus be due to prior contamination of the diet with ochratoxin A. PMID- 6497808 TI - Johne's disease in sheep. AB - Johne's disease was identified in sheep flocks on 6 farms in one area of the central tablelands of New South Wales. The sources of infection were not determined and no common source of all infections was identified. The disease was not diagnosed in cattle that were run on 4 of the farms. PMID- 6497809 TI - Experimental medication of equine ringworm due to Trichophyton equinum var. autotrophicum. AB - Twelve medicaments were tested for their efficacy in the treatment of Trichophyton equinum var. autotrophicum; povidone iodine, thiabendazole ointment, captan ointment and Burroughs Wellcome Ringworm Ointment gave satisfactory results but their usefulness may be limited for treatment of large numbers of horses. Aqueous washes containing 0.5% hexetidine or 0.3% chloramine-T did not prevent fungi being isolated from lesions for up to 7 days after treatment. Similarly neither etisazole nor thiabendazole suspension prevented fungi from being isolated from lesions for up to 15 days after treatment. Commonly used aqueous solution of 2.5% lime sulphur and 2% captan were least successful, as fungi could still be isolated from lesions for up to 30 days after treatment. The need to treat large numbers of horses may dictate the use of such solutions rather than ointments because of ease of application and cost factors. Treatments consisting of 10% nystatin ointment, 10% iodine fortis, 10% Medol and a proprietary ointment, Queensland Itch Dressing, were not satisfactory. Clinical appraisal and a scratch test must be used together to evaluate progress of treatment. Mass medication of large numbers of horses should be primarily aimed at reduction of spread of infection; normal hair growth should not be used as an indication of the removal of infective agents in the hair as regrowth was altered very little by medication. Hence assessments of cure on the basis of regrowth of hair alone are of dubious value. PMID- 6497810 TI - Serological diagnosis of bovine abortion due to Mortierella wolfii. PMID- 6497811 TI - Elevation of zinc levels of brewer's grains stored in galvanised troughs. PMID- 6497812 TI - Poisoning caused by the combined effects of two phenylarsonic acid growth promotants in pigs. PMID- 6497813 TI - The effect of coat length on the bioavailability of levamisole applied topically to cattle. PMID- 6497814 TI - Marek's disease in sixty week-old laying chickens. PMID- 6497815 TI - Feeding rubberbush (Calotropis procera) to cattle and sheep. PMID- 6497816 TI - Central hemodynamics during zero gravity simulated by head-down bedrest. AB - Central hemodynamics during head-down tilt of -6 degrees lasting for 2 h were studied using catheterization of the pulmonary artery. M-mode echocardiography was performed simultaneously. Significant increases occurred for pressures in the right atrium, pulmonary artery in pulmonary wedge position, and for pulmonary vascular resistance. Cardiac and stroke volume index, heart rate, mean arterial pressure, and total systemic resistance remained constant throughout the exposure time. Constancy was also observed for echocardiographic measures of cardiac dimensions. It is concluded that head-down tilt leads to an increase of preload without any evidence of disturbed left ventricular function. No distinct time course of hemodynamic variables could be seen. Echocardiography proved a useful method to study cardiovascular adaptations during head-down tilting. PMID- 6497817 TI - Sex differences in transthoracic impedance: evaluation of effects on calculated stroke volume index. AB - A recent publication noted that women and men differ in transthoracic impedance (Zo), with women having higher levels, and this might cause underestimation of stroke volume index (SVI) in women when impedance cardiograph (IC) techniques are employed, as Zo is a squared factor in the denominator of the calculation equation. This paper confirmed the observed sex differences in Zo, with women (n = 19) having significantly (p less than 0.0001) higher Zo than men (n = 19) in both seated and supine positions. However, women also had higher dZ/dt (first derivative of impedance signal over time) levels when seated (women: 2.48 +/- 0.58; men: 1.38 +/- 0.35; p less than 0.0001) and when supine (women: 2.62 +/- 0.56; men: 1.58 +/- 0.34; p less than 0.0001). dZ/dt is a factor in the numerator, and, therefore, calculated SVI did not differ across sexes in either position. It was speculated that the Zo difference is due to differences in fat levels. Controlling for percent body fat and subscapula skin-fold differences did not entirely eliminate the sex differences in Zo. However, a group of well trained females tested later (n = 10) showed lower Zo levels (24.8 vs. 28.2) when compared to the original group of 19 women who were not well-trained. Differences may be due to fat/muscle ratio of the thorax. PMID- 6497818 TI - Influence of the chest wall on regional intrapleural pressure during acceleration (+Gz) stress. AB - The purpose of this study was to determine the influence of altered chest wall compliance, chest wall shape, and G-suit abdominal bladder inflation on regional intrapleural pressure (Ppl) during +Gz stress. Experiments were conducted in two species (9 dogs, 10 pigs) so that data relating to a spectrum of chest wall characteristics could be obtained. Anesthetized animals were exposed to +Gz levels ranging from 1 to + 5 Gz. Regional Ppl was monitored at 2-4 sites during spontaneous breathing with and without G-suit abdominal bladder inflation and after removal of active chest wall muscular tone by sacrificing the animal. In the dog, Ppl became more negative in the upper and middle thoracic regions with +Gz stress (-1.63 and -1.66 cm H2O.G-1, respectively), but, in the lower thorax, Ppl increased slightly (0.05 cm H2O.G-1). When active muscular tone was removed, the rate of Ppl change increased in the upper thorax (-2.55 cm H2O.G-1), but not in more dependent regions. In the pig, Ppl became more negative with +Gz stress (upper = -3.3; middle = -1.99; lower = -2.16 cm H2O.G-1), and without active muscular tone, the rate of Ppl change tended to increase in all regions (upper = 4.3; middle = -3.47; lower = -2.97 cm H2O.G-1). With G-suit application in both species, Ppl increased toward or exceeded control values at all levels. Results indicate that chest wall characteristics play a significant role in determining regional Ppl during +Gz stress. PMID- 6497819 TI - Tolerance of the human cervical spine to high acceleration: a modelling approach. AB - A sagittal plane mathematical model for the cervical spine has been used to simulate the neck's response to loads due to high acceleration. The model is capable of simulating the muscular response of the cervical spine and the stress distribution between the joint levels. In order to obtain conservative estimates of the maximum acceleration that the neck can support, the neck was simulated using the assumption that the inertial load is supported primarily by the muscles. It was found that accelerations of up to 30 g can be supported with the appropriate posture and direction of acceleration. Estimates were also obtained using experimental results to approximate the role that the ligaments of the spine play in supporting the load. It was found that accelerations of up to 40 g can be supported for the appropriate posture and acceleration direction. PMID- 6497820 TI - Bubble formation of aqueous humor and lens opacity during chamber flight. AB - A transparent miniature decompression chamber was placed on the stage of a large working zoom-stereo microscope so that the effect of decompression on the frog eye could be microscopically observed and photographed. It was found that chamber flight at a simulated altitude of 66,000 ft (20,117 m) or more caused bubble formation in aqueous humor and lens opacities in some of the experimental animals. On return to ground level, the bubbles either decreased in size or completely disappeared. The cataract could also regress after recompression to 1 atm. Such lens opacities may be termed altitude cataract, instead of asphyxial or anoxic cataract. PMID- 6497821 TI - Stereoscopic cerebral evoked potentials of Air Force pilots and civilian comparison groups. AB - Dynamic random-dot stereograms were presented to Air Force jet pilots (N = 14) through a new visual display system. Games which simulated target-detection exercises were included in the test sequence. Event-related potentials were recorded at scalp sites 01, 02, T5, T6, referenced to an anterior midline site. Comparisons were made where possible with the data from recent studies on three civilian groups. A pattern of response was revealed in the event-related potential measures. In general, left-hemisphere amplitudes exceeded right and the predominant response was recorded at the left-temporal site. Amplitudes of responses in subjects able to describe the stimuli in subjective report (perceivers) exceeded those of non-perceivers. Stimuli with definite boundaries evoked stronger and earlier-latency responses than stimuli with nebulous boundaries. The response patterns of subjects make a contribution to normative data on the cerebral electrical indices of stereoscopic vision. PMID- 6497822 TI - Central nervous reactions to a 6.5-hour altitude exposure at 3048 meters. AB - In this study of CNS reactions to mild hypoxia, 7 subjects were decompressed to the equivalence of 3048 m altitude breathing air, for 6.5 h. On reaching 3048 m, and for every second h thereafter, a battery of neuropsychological tests were administered. In addition, blood and performance measures were sampled and a symptom check list was administered. The performance tests indicated significant effects of hypoxia. In contrast to earlier studies on grade of hypoxia and performance, no relationship between impaired performance and duration of exposure to hypoxia was found. Repeated testing throughout exposure indicated stable individual reactions. Endocrine variables did not support the hypothesis that activation or 'stress' caused the impairment observed. In addition to impaired neuropsychological test performance and impaired task performance, the subjects reported headache, weakness and some dizziness. Comparisons between different tests confirmed previous results showing that mild hypoxia yields varying degrees of impairment on different cognitive functions. PMID- 6497823 TI - Effects of high hydrostatic pressure on catecholamine contents in tissues of the eel acclimatized at two temperatures. AB - Catecholamines (CA) are involved in many adaptative mechanisms of an organism to its environment. In fish, pressure is an environmental factor able to modify these mechanisms of adaptation, and some of the physiological perturbations observed under pressure can be compared to CA unloading. Moreover, the metabolic rate, and probably the CA metabolism of fish, are modified by the ambient temperature. This study has been conducted to measure tissue (brain and heart) CA contents (dopamine, norepinephrine, epinephrine) of eels acclimatized for 15 d at two temperatures, Tw, (15 degrees C or 25 degrees C). The measurements have been made either at atmospheric pressure (1 ATA) or after 60 min at 101 ATA of hydrostatic pressure "per se." The results show that 1) at a given Tw, pressure has no significant effect on tissue CA contents; and 2) there seems to exist a pressure-temperature antagonism concerning dopamine and epinephrine in the brain. It is suggested that this antagonism acts on enzymatic systems involved in the metabolism of these two amines. PMID- 6497824 TI - Physiological and perceptual responses to cyclic heat stress variations. AB - The effect of the time presentation of a given external heat load was examined on five subjects exercising at a constant work load (50 W). The subjects, dressed in briefs, were exposed to cyclic variations for 120 min in air temperatures between 51 degrees C and 23 degrees C, under three different schedules involving heat pulses of 10-min, 20-min and 30-min duration, respectively. The strain induced by each of these conditions was compared in terms of both physiological and perceptual criteria. Results showed that between conditions, there were significant differences in skin temperature levels but not in core temperature levels, body heat storage, or body weight loss. Perception of effort and thermal sensation ratings both exhibited similar changes in all three conditions. Due to the time constant of the sweating response, sweating rates and skin wettednesses at the end of the heat pulses were lower for 10-min heat pulses than for those of 20- and 30-min duration, and these differences were perceived by the subjects. Lower perceived skin wettedness ratings are thus suggested as the main factor to explain why all subjects rated the 10-min heating-cooling cycle as the least strenuous and uncomfortable condition. It is concluded that under the conditions of this study, perceptual criteria associated with physiological criteria represent a useful means of discriminating slight differences in strain. PMID- 6497825 TI - The effects of spectacle frames on field of vision. AB - Spectacle frames with thick frames and wide and low-set temples were obtained from an optical goods distributor. Peripheral visual fields were mapped with a Goldmann Projection Perimeter to determine if there was evidence of a safety hazard. A novel way of displaying visual fields was employed. Frame fronts caused more obstruction than temples, which were not found to be a particular problem. Large lenses and thin frames are still recommended for aviator's spectacles and sunglasses. Unusually wide, solid temples should not be worn while flying or driving. PMID- 6497826 TI - Human factors in aircraft incidents: results of a 7-year study. AB - Human error causes or contributes to considerably over half of all aviation mishaps. This report describes a 7-year study of aircraft incident data conducted in an attempt to further our understanding of the phenomenon of human error. The study of incidents as a surrogate for aircraft accidents is relevant only if incidents constitute a population or universe of which accidents are a subset. This assumption has been examined in a study of over 35,000 reports of aviation incidents collected from 1976-83 by the NASA Aviation Safety Reporting System. One-third of the reports involve conflicts among aircraft. The most common single aircraft anomalies in flight involve altitude or track deviations. The most common controller errors involve failure to coordinate traffic with other elements of the air traffic control system. Analysis of these reports indicates that both human and system factors contributing to human errors can be identified. Many other incidents involve shortcomings specifically of the human, rather than of the system. Failures of control are rare in this series, but failures of decision-making and cockpit resource management are frequent. Boredom, complacency and ennui appear to underlie some failures, while very high workloads are associated with others. These data indicate that at least several categories of aircraft accidents involving operational and human factors are, in fact, subsets of populations of incidents containing the same elements. The environment in which an incident occurs is extremely important in determining its outcome. It is concluded that aviation incident reports are a necessary and important instrument in safety surveillance. PMID- 6497827 TI - The 1980 and 1981 accident experience of civil airmen with selected visual pathology. AB - In studies of the 1974-76 accident experience of U.S. general aviation pilots with static physical defects, those with blindness or absence of either eye had significantly increased rates and ratios. A 1979 study found that 1,140 pilots with aphakia and 173 with artificial lens implants had significantly higher rates, but the monocular pilots did not. The present study examined the 1980-81 accident experience of 4,169 monocular pilots, 1,299 with amblyopia, 969 with aphakia, 285 with lens implants, 118 with a history of diplopia, 1,269 with a tropia, 2,601 with hyperphoria greater than 1 diopter, and 2,711 with esophoria or exophoria greater than 6 diopters by class of medical certificate held. The numbers were too small for statistical treatment, but first- and second-class medical certificate holders, who often have more accidents per 1,000 airmen, consistently had progressively lower accident rates per 100,000 hours. Monocular, aphakic, lens implant, and amblyopic accident airmen had higher accident rates than did the total airman population. PMID- 6497828 TI - Linkage studies on alpha-glycerophosphate and isocitrate dehydrogenases in Aedes albopictus (Diptera: Culicidae). AB - Linkage studies were carried out on alpha-glycerophosphate dehydrogenase (alpha GPDH) and isocitrate dehydrogenase (IDH) in the mosquito Aedes (Stegomyia) albopictus. Only one locus coding for alpha-GPDH was revealed on agar gels by applying adult homogenates. Two loci for IDH were observed using either fourth instar larvae, pupae, or adults. This study was restricted to the more anodal Idh 2 of the two loci, and alpha-Gpdh. Both alpha-Gpdh and Idh-2 encode dimeric enzymes. Thirteen backcrosses indicated that the alpha-Gpdh and Idh-2 loci are arranged in linkage group 2 in the following order: p (pigmented pupa)--(ca. 2 map units)--Wb (white-body)--(7.5-17.8)--Idh-2--(13.1)--alpha-Gpdh. Females exhibited more recombination than males. PMID- 6497829 TI - Enzyme markers in inbred rat strains: genetics of new markers and strain profiles. AB - Twenty-six inbred strains of the laboratory rat (Rattus norvegicus) were examined for electrophoretic variation at an estimated 97 genetic loci. In addition to previously documented markers, variation was observed for the enzymes aconitase, aldehyde dehydrogenase, and alkaline phosphatase. The genetic basis of these markers (Acon-1, Ahd-2, and Akp-1) was confirmed. Linkage analysis between 35 pairwise comparisons revealed that the markers Fh-1 and Pep-3 are linked. The strain profiles of the 25 inbred strains at 11 electrophoretic markers are given. PMID- 6497830 TI - A structural gene (Hdc-s) for mouse kidney histidine decarboxylase. AB - The concentration of mouse kidney histidine decarboxylase (HDC) is modulated by estrogen, testosterone, and thyroxine in a tissue-specific manner. Variation in HDC levels between strains of mice can be used to investigate the genetic regulation of enzyme structure, tissue specific expression, and induction and repression by hormones. Variation in the structure of HDC between different inbred strains of mice affecting its Km for the cofactor pyridoxal-5'-phosphate (PLP) and its heat stability has been discovered. The alternative phenotypes are additively inherited in crosses and the heat stability difference is due to alleles of a single structural gene, Hdc-s, which segregate among the BXD and BXH recombinant inbred strains. The allele Hdc-sb determines the heat-stable phenotype (C57BL substrains), and the allele Hdc-sd the heat-labile phenotype (DBA/2 and C3H/He strains). The alleles of the structural gene cosegregate with alleles of a regulatory gene previously named Hdc (determining kidney enzyme concentration); there were no recombinants among 38 RI strains. Therefore the two loci are less than 0.685 cM apart and comprise part of the HDC gene complex, [Hdc], on chromosome 2 of the mouse. PMID- 6497831 TI - Variation among chicken stocks in the fractional rates of muscle protein synthesis and degradation. AB - Fractional rates (% X day-1) of synthesis and degradation were determined by measuring the output of N tau-methylhistidine (MeHis) in the excreta at 4 and 8 weeks of age in the chicken. At 4 weeks of age, the fractional rate of synthesis of the meat-type stock was twice that of the egg-type stock (White Leghorn), but the fractional rates of synthesis at 8 weeks of age were similar (4.1-5.1% X day 1) among stocks. The fractional rate of degradation (1.3-1.5% X day-1) of the meat-type stock at 8 weeks of age was less than half the rate of the egg-type stock (2.9% X day-1). The fractional rates of synthesis and degradation at 4 weeks of age in the Satsuma native fowl were relatively high compared with those in the other stocks. In particular, the rate of degradation (8.6% X day-1) at 4 weeks of age was approximately twice that of other stocks. These results show that fractional rates of synthesis and degradation of muscle protein in the chicken differ among genetically diverse groups. The effect of changes in rates of synthesis and degradation on the change in fractional growth rate also differed. From regression coefficients (bks . FGR and bKd . FGR) of these rates in skeletal muscle protein on the fractional growth rate, it was recognized that the change in growth rate accompanies the changes in both synthesis and degradation in White Leghorn and commercial broilers but only the change in synthesis in White Plymouth Rock (dw) and Satsuma native fowl. PMID- 6497833 TI - The kinetics and feedback inhibition of cytidine 5'-triphosphate synthetase in wild-type and mutant Chinese hamster cells. AB - The kinetics and cytidine 5'-triphosphate (CTP) feedback inhibition of CTP synthetase in wild-type and four mutants of Chinese hamster V79 cells have been studied. The enzymes of the wild type and three of the four mutants exhibited positive cooperativity with the substrate uridine 5'-triphosphate (UTP). Three of the mutants had Kmapp and S50 values distinctly greater than those of the wild type, while the fourth mutant had values similar to those of the wild type. All four mutants exhibited resistance to CTP feedback inhibition, while the wild type was sensitive to such inhibition. It is postulated that a single mutational event in each mutant had caused a concomitant change of the enzyme in its binding both to the substrate UTP and to the end-product CTP. PMID- 6497832 TI - Pleiotropic mutants of Chinese hamster cells with altered cytidine 5' triphosphate synthetase. AB - Following chemical mutagenesis and multiple-step indirect selection, four clones of Chinese hamster V79 cells were isolated which exhibited auxotrophy for thymidine, deoxycytidine, or deoxyuridine but not for cytidine or uridine. All were resistant to uridine, 3-deazauridine, 5-fluorouridine, thymidine, and cytosine arabinoside at concentrations that were toxic to wild-type V79 cells. The cytidine 5'-triphosphate (CTP) and deoxycytidine 5'-triphosphate (dCTP) pools in the mutants were expanded, but the uridine 5'-triphosphate (UTP) pool either decreased or remained unchanged relative to the wild-type level. Furthermore, since the parental cells appear to be deficient in dCMP deaminase activity and CTP (or one of its metabolites) has been shown to inhibit uridine 5'-diphosphate (UDP) reduction, an elevated CTP level should lead to the observed thymidine auxotrophy. It also explains the joint resistance of mutant clones to thymidine and cytosine arabinoside. The change in the ratio of intracellular dCTP to thymidine 5'-triphosphate (dTTP) may be responsible for the elevation in the rates of spontaneous mutations in these mutants. PMID- 6497834 TI - Zein synthesis in the embryo and endosperm of maize mutants. AB - Zein synthesis in the developing (22 and 50 days postpollination) endosperm and embryo of maize (Zea mays L.) double mutants, brittle-1; opaque-2 and brittle 2;opaque-2, were compared and correlated with sucrose concentration and RNase activity in order to test the hypothesis that high sucrose concentrations may prevent the interaction between zein polyribosomes and endoplasmic reticulum and make the zein mRNAs more susceptible to hydrolysis by high RNase activity, resulting in a severe reduction in zein synthesis. The double-mutant combinations of opaque-2 with each of the starch-deficient mutants, brittle-1 and brittle-2, maintained not only a high sucrose concentration in the endosperm but also a higher RNase activity than either one of the single mutants alone. Consequently, these double mutants severely suppressed the synthesis of two major zein components in their endosperms. In contrast to the endosperm system, embryos of the double mutants produced amounts of zein (and electrophoretic patterns) similar to that of the opaque-2 embryo, and their embryos contained levels of sucrose and RNase activity comparable to that of the o2 and normal control. These results are consistent with the notion that a posttranscriptional degradation of zein mRNAs by RNase, rather than a specific transcriptional block, is involved in the endosperm to suppress zein synthesis in these double mutants. PMID- 6497835 TI - Multiple forms of gamma-butyrobetaine hydroxylase (EC 1.14.11.1). AB - gamma-Butyrobetaine hydroxylase [4-trimethylaminobutyrate, 2-oxoglutarate:oxygen oxidoreductase (3-hydroxylating), EC 1.14.11.1] from human kidney was resolved into three forms by chromatofocusing. After further chromatography on an anion exchanger, each form appeared as a single band on electrophoresis in polyacrylamide gel containing sodium dodecyl sulphate. The isoelectric points of isoenzymes 1, 2 and 3 were 5.6, 5.7 and 5.8 respectively, as estimated by isoelectric focusing. Their specific activities were 17-29 mu kat/g of protein. The concentrations of the three isoenzymes were about equal, possibly slightly lower for isoenzyme 1. The requirement for Fe2+ and the Km values for gamma butyrobetaine and 2-oxoglutarate were about the same for the different enzyme forms. L- and D-Carnitine caused decarboxylation of 2-oxoglutarate to the same extent (8 and 29%) with the three forms. The enzyme forms had the same mass, 64 kDa, as determined by gel filtration in nondenaturing media. The same subunit mass, 42 kDa, was obtained for the multiple forms by electrophoresis in polyacrylamide gels containing sodium dodecyl sulphate. Isoenzyme 2 was resolved into two protein bands by isoelectric focusing in polyacrylamide gels containing urea. Isoenzyme 1 contained only one of these bands and isoenzyme 3 the other. The three enzyme forms of gamma-butyrobetaine hydroxylase thus appear to be dimeric combinations of two subunits differing in charge but not in size. gamma Butyrobetaine hydroxylase from crude extracts of human, rat and calf liver was also separated into multiple forms by a chromatofocusing technique. The isoenzyme pattern was the same in human liver and kidney. The technique used to resolve the mammalian enzymes gave no evidence for the presence of multiple forms of the bacterial enzyme from Pseudomonas sp. AK 1. PMID- 6497836 TI - A computerized approach to the analysis of oligosaccharide structure by high resolution proton n.m.r. AB - The 500 MHz proton-n.m.r. spectra of 21 oligosaccharides, predominantly of the lacto-N and lacto-N-neo series and their derivatives containing non-reducing terminal fucose, sialic acid or N-acetylgalactosamine and reduced-end hexitol or hexosaminitol, were examined with 2H2O as solvent. The chemical-shift data obtained from analysis of the spectra were collated with data from other laboratories who have used 250-500 MHz n.m.r. in the analysis of secreted and chemically synthesized oligosaccharides and of the O- and N-linked chains of glycoproteins. A referenced computer library was constructed that includes the chemical shifts of monosaccharides within oligosaccharide sequences that make up the majority of the carbohydrate structures found in mammalian glycoproteins. Examples are given of the computerized interrogation of this library for the assignment of possible structures of unknown oligosaccharides. PMID- 6497837 TI - Integrated rate equations for enzyme-catalysed first-order and second-order reactions. AB - Generalized rate equations covering all mechanisms giving hyperbolic initial-rate kinetics with stoichiometry A in equilibrium P, A in equilibrium P + Q, A + B in equilibrium P and A + B in equilibrium P + Q were integrated. The results are regular and reasonably economical. PMID- 6497838 TI - Uptake of mannose-terminated glycoproteins in isolated rat liver cells. Evidence for receptor-mediated endocytosis in hepatocytes. AB - Even though most of the hepatic binding capacity for mannose-terminated glycoproteins has previously been shown to reside in the hepatocytes (not in the non-parenchymal cells), detailed evidence for the specific uptake of mannose terminated ligands has been lacking. In the present studies, yeast invertase, a large glycoprotein (Mr 270 000) containing about 50% mannose, was shown to be taken up into hepatocytes by receptor-mediated endocytosis. The uptake was saturable and could be specifically inhibited by mannosides or by a Ca2+ chelator. The asialo-glycoprotein receptor was not involved. The low-Mr (13 000) ligand ribonuclease B, which contains a single high-mannose glycan, was not taken up by hepatocytes; however, it was taken up as fast as invertase by non parenchymal liver cells. After injection of 131I-invertase into a rat in vivo, about one-half of the labelled protein was recovered in the hepatocytes. On a per cell basis, each endothelial cell contained 3-4 times as much radioactivity as did the hepatocytes. On fractionation of hepatocytes in sucrose gradients, invertase showed a different intracellular distribution from that of asialo fetuin, in that invertase moved much faster into that region of the gradient where the lysosomes were recovered. This indicates that invertase and asialo fetuin are not transported intracellularly by identical mechanisms. PMID- 6497839 TI - Formation of bile pigments by coupled oxidation of cobalt-substituted haemoglobin and myoglobin. AB - Treatment of cobalt-substituted haemoglobin and myoglobin with ascorbate and molecular O2 (coupled oxidation) resulted in biliverdin formation from the cobalt(II) derivatives but not from the cobalt(III) derivatives. This was apparently due to the inability of ascorbate to reduce cobalt(III) haemoproteins. Isomer analysis of the biliverdins produced from coupled oxidation of cobalt(II) oxyhaemoglobin suggested that the orientation of the cobalt protoporphyrin IX in the haem pocket differed slightly from that of the haem in native haemoglobin. PMID- 6497840 TI - Conformational changes induced in bovine lens alpha-crystallin by carbamylation. Relevance to cataract. AB - Carbamylation of lens proteins may contribute to cataractogenesis in certain medical conditions where blood urea is elevated for prolonged periods. This paper reports on the effects of carbamylation on the physicochemical properties of one of the major lens structural proteins, alpha-crystallin. In particular it is shown that carbamylation alters the tertiary and secondary structure of the protein, leading to an increased reactivity of protein thiols, resulting in interchain disulphide bonding. PMID- 6497841 TI - Kinetics of protein modification reactions. Plot of fractional enzyme activity versus extent of protein modification in cases where all modifiable groups are essential for enzyme activity. AB - The plot of fractional enzyme activity versus extent of protein modification, for cases where all enzyme modifiable groups of a certain kind are essential for activity, is found to be nearly independent of the number, per enzyme active site, of modifiable groups involved. Such plots usually, by a fallacious extension of the initial portion of the plot on the extent-of-modification axis, are interpreted to mean the modification of one single group per enzyme active site (or per enzyme molecule). The possible relevance of these findings to cases in the literature is discussed. PMID- 6497842 TI - Alpha-tocopherol and phylloquinone as non-competitive inhibitors of retinyl ester hydrolysis. AB - Inhibition of rat intestinal retinyl ester hydrolase by alpha-tocopherol (vitamin E) and phylloquinone (vitamin K1) was non-competitive. Maximum inhibition occurred within 10 min, and, particularly with alpha-tocopherol, was substantially reversible. Consequently, increasing tissue concentrations of retinyl esters, which might occur with advancing age or changes in diet, would not diminish the effects of the inhibitors. These data further support the notion that alpha-tocopherol may, at physiological concentrations, influence the concentration of vitamin A and its ester in tissues. PMID- 6497843 TI - A controversy on the mechanism of autoxidation of oxymyoglobin and oxyhaemoglobin: oxidation, dissociation, or displacement? PMID- 6497844 TI - Biochemical studies on the isolation and characterization of human spleen haemosiderin. AB - Haemosiderin was isolated from thalassaemic human spleens by centrifugation through concentrated KI solutions. A method for solubilizing haemosiderin was developed which leaves the iron oxyhydroxide cores and constituent polypeptides intact, facilitating further purification and analysis. Purified haemosiderin contained no detectable haem, trace amounts of carbohydrate, and iron and phosphorus in a molar ration of 6:1; much of the phosphate may be present as core adsorbed. Several lipids were present, but it is not certain whether these are contaminants or components of the haemosiderin granules. In all preparations examined, a characteristic group of six to seven peptides of apparent Mr 12 900 17 800 were found, with a major band at Mr 14 500 and, in addition, a minor component of Mr 42 000; these peptides co-chromatographed with the cores. Negatively stained electron micrographs suggest that these peptides form an incomplete shell about the cores, consistent with the view that haemosiderin is a proteolytic product of ferritin. PMID- 6497845 TI - Changes in the anti-lipolytic action and binding to plasma membranes of N6-L phenylisopropyladenosine in adipocytes from starved and hypothyroid rats. AB - The anti-lipolytic effect of the adenosine analogue N6-L-phenylisopropyladenosine was studied with rat adipocytes incubated with a high concentration of adenosine deaminase (0.5 unit/ml, approx. 2.5 micrograms/ml) and concentrations of noradrenaline that were equieffective in different physiological states. These studies were performed to compare the fed and starved (24h) states and to compare a hypothyroid state (induced by feeding propylthiouracil + a low-iodine diet) with the euthyroid state. Starvation increased sensitivity of the cells to the lipolytic action of noradrenaline, while decreasing sensitivity to the antilipolytic action of phenylisopropyladenosine. Hypothyroidism resulted in decreased sensitivity to noradrenaline and increased sensitivity to phenylisopropyladenosine. Studies of the binding of [3H]phenylisopropyladenosine to adipocyte plasma membranes indicated heterogeneity of binding sites or negative co-operativity in the binding. Starvation did not change [3H]phenylisopropyladenosine binding to membranes, whereas hypothyroidism caused an unexpected decrease in both the number and affinity of the binding sites. These observations are discussed in terms of the dual regulation of adipose tissue lipolysis by lipolytic and anti-lipolytic agents. PMID- 6497846 TI - Purification and photoaffinity labelling of lipid methyltransferase from rat liver. AB - An enzyme that catalyses the three-step methylation of phosphatidylethanolamine to phosphatidylcholine as well as the methylation of fatty acids and that uses S adenosylmethionine as the methyl donor has been purified about 200-fold from rat liver. Irradiation of the purified enzyme with a short-wavelength u.v. light in the presence of [methyl-3H]8-azido-S-adenosylmethionine followed by electrophoresis results in the incorporation of radioactivity into a single protein band of about 25 kDa. It is concluded that a single catalytic subunit catalyses the conversion of phosphatidylethanolamine into phosphatidylcholine and fatty acid methylation. PMID- 6497847 TI - The capacity of basic peptides to trigger exocytosis from mast cells correlates with their capacity to immobilize band 3 proteins in erythrocyte membranes. AB - The effect of mast-cell-triggering peptides on the rotational properties of band 3, a protein component of the human erythrocyte membrane, was measured by observing flash-induced transient dichroism of the triplet probe eosin maleimide. In the presence of melittin, polylysine and five synthetic peptides, varying degrees of retardation in the rotational motion of band 3 were produced. When placed in order of band 3 immobilizing activity, the peptides formed a series identical with their order of efficacy in releasing 5-hydroxytryptamine from rat peritoneal mast cells. The correspondence in the abilities to immobilize band 3 in the erythrocyte and trigger mast cells is significant because structure activity analyses of the peptides show both processes to have the same cationic, hydrophobic and stereochemical requirements. Probably, the immobilization of band 3 proteins reflects an ability of the basic peptides to aggregate anionic surface moieties, and therefore a similar mechanism is implied in mast-cell triggering. PMID- 6497848 TI - The evolution of enzyme kinetic power. AB - Evolution of the kinetic potential of enzyme reactions is discussed. Quantitative assessment of the evolution of enzyme action has usually focused on optimization of the parametric ratio kcat./Km, which is the apparent second-order rate constant for the reaction of free substrate with free enzyme to give product. We propose that the general form kcat.[E]T/Km (where [E]T is total enzyme concentration), which is designated the 'kinetic power', is the real measure of kinetic/catalytic potential in situ. The standard paradigm of 'perfection' dictates the evolutionary maximum of 'kinetic power' to be k+s[E]T/2, where k+s is the diffusion-controlled rate constant for formation of the ES complex (and, hence, for the overall enzyme reaction). We discuss the role of protein conformational mobility in determining this state of 'perfection', via gating of substrate binding and determination of the catalytic configuration. Going beyond the level of the individual enzyme, we indicate the manner by which the organizational features of enzyme action in vivo may enhance the 'kinetic power'. Through evolutionary 'perfection' of the microenvironment, one finds that the 'kinetic power' of enzymes can be affected by alteration of [E]T as well as the unitary rate constants. At this level of complexity, we begin to realize that the 'kinetic' description of cell metabolism must be supplemented with thermodynamic concepts. PMID- 6497849 TI - Evidence for the reversibility of the acyl-CoA:lysophosphatidylcholine acyltransferase in microsomal preparations from developing safflower (Carthamus tinctorius L.) cotyledons and rat liver. AB - Acyl exchange between acyl-CoA and position 2 of sn-phosphatidylcholine occurs in the microsomal preparations of developing safflower cotyledons. Evidence is presented to show that the acyl exchange is catalysed by the combined back and forward reactions of an acyl-CoA:lysophosphatidylcholine acyltransferase (EC 2.3.1.23). The back reaction of the enzyme was demonstrated by the stimulation of the acyl exchange with free CoA and by the observation that the added CoA was acylated with acyl groups from position 2 of sn-phosphatidylcholine. Re-acylation of the, endogenously produced, lysophosphatidylcholine with added acyl-CoA occurred with the same specificity as that observed with added palmitoyl lysophosphatidylcholine. A similar acyl exchange, catalysed by an acyl CoA:lysophosphatidylcholine acyltransferase, occurred in microsomal preparations of rat liver. The enzyme from safflower had a high specificity for oleate and linoleate, whereas arachidonate was the preferred acyl group in the rat liver microsomal preparations. The rate of the back reaction was 3-5% and 0.2-0.4% of the forward reaction in the microsomal preparations of safflower and rat liver respectively. Previous observations, that the acyl exchange in safflower microsomal preparations was stimulated by bovine serum albumin and sn-glycerol 3 phosphate, can now be explained by the lowered acyl-CoA concentrations in the incubation mixture with albumin and in the increase in free CoA in the presence of sn-glycerol 3-phosphate (by rapid acylation of sn-glycerol 3-phosphate with acyl groups from acyl-CoA to yield phosphatidic acid). Bovine serum albumin and sn-glycerol 3-phosphate, therefore, shift the equilibrium in acyl CoA:lysophosphatidylcholine acyltransferase-catalysed reactions towards the rate limiting step in the acyl exchange process, namely the removal of acyl groups from phosphatidylcholine. The possible role of the acyl exchange in the transfer of acyl groups between complex lipids is discussed. PMID- 6497850 TI - Hordein-gene expression during development of the barley (Hordeum vulgare) endosperm. AB - A previous study [Rahman, Shewry & Miflin (1982) J. Exp. Bot. 33, 717-728] showed differential accumulation of the major storage proteins (called B and C hordeins) in developing endosperms of barley (Hordeum vulgare). To determine how this accumulation is regulated, we have studied mRNA fractions prepared from similar endosperms. Hordein-related mRNA species were detected some days before the deposition of hordeins in vivo. The translation products in vivo directed by polyribosomes, polysomal RNA and total cellular RNA showed similar changes in the proportions of the hordein products to those observed in the accumulations of the proteins in vivo. There was a relative increase in one of the subfamilies of B hordeins (called B1 hordein) and a decrease in the second subfamily of B hordeins (B3 hordein) and in C hordeins. The populations of RNA species related to these three groups of hordeins were studied by 'dot hybridization', with specific complementary-DNA probes for B1-, B3- and C-hordein-related sequences. This showed a 10-15-fold increase in sequences related to the B1 hordein during endosperm development, but only a 4-fold increase in sequences related to B3 and C hordeins. These results indicate that the rates of synthesis of hordeins are related to the abundance of their respective mRNA species. The different results observed for the two subfamilies of B hordeins are of interest, since they indicate differential expression of two subfamilies of genes present at a single multigenic locus. PMID- 6497851 TI - A comparison of the low-density-lipoprotein receptor from bovine adrenal cortex, rabbit and rat liver and adrenal glands by lipoprotein blotting. AB - This paper describes the use of lipoprotein blotting to detect low-density lipoprotein (LDL) receptors in rat and rabbit liver and adrenal glands and in bovine adrenal glands. Using this technique we show that the rabbit and rat liver LDL receptors have Mr values of 128000 and 145000 respectively. Mr values for the rabbit, rat and bovine adrenal receptors are 131000, 142000 and 132000 respectively. Differences between the bovine adrenal and rat liver receptors are not due to differences in the degree of sialylation. Lipoprotein blotting can be used to detect dietary- and drug-induced changes in the concentrations of LDL receptors. When rabbits are fed on a cholesterol-rich diet, liver LDL receptors cannot be detected, consistent with the suppression of hepatic LDL receptors by cholesterol feeding. Pharmacological doses of 17 alpha-ethinyloestradiol cause a marked increase in hepatic LDL-receptor activity in the rat. This is accompanied by a corresponding increase in the number of LDL receptors detected by lipoprotein blotting. The Mr of the induced receptor is identical with that of the receptor from control rats, which suggests that the induced receptors are produced by the same gene as LDL receptors normally present in the liver. PMID- 6497852 TI - The superoxide-generating oxidase of leucocytes. NADPH-dependent reduction of flavin and cytochrome b in solubilized preparations. AB - An NADPH-dependent O2.- -generating oxidase was solubilized from phorbol 12 myristate 13-acetate-activated pig neutrophils by using a mixture of detergents. Recovery of oxidase was approx. 40%. The extract contained cytochrome b-245 (331 pmol/mg of protein) and FAD (421 pmol/mg of protein); approx. 30% of each was reduced within 60s when NADPH was added to anaerobic incubations. Three different additives, quinacrine, p-chloromercuribenzoate and cetyltrimethylammonium bromide, strongly inhibited O2.- generation; they also inhibited the reduction by NADPH of cytochrome b at the same low concentrations. In the presence of p chloromercuribenzoate cytochrome b reduction was strongly inhibited and flavin reduction was less inhibited. A detergent extract prepared from non-stimulated neutrophils also contained flavin and cytochrome b, but its rate of O2.- production was less than 1% of that from activated cells; its initial rate of cytochrome b and flavin reduction was low, although the state of reduction at equilibrium was similar to that of extracts of activated cells. Even in the non activated cell extract the reduction of flavin and cytochrome was made fast and complete when Methyl Viologen was added to the anaerobic incubations. The oxidase was temperature-sensitive, with a sharp maximum at 25 degrees C; temperatures above this caused loss of O2.- generation, and this coincided with loss of the characteristic cytochrome b spectrum, indicate of denaturation of the cytochrome. The cytochrome b formed a complex with butyl isocyanide (close to 100% binding at 10mM); butyl isocyanide also inhibited the oxidase activity of stimulated whole neutrophils (22.5% inhibition at 10mM). Photoreduced FMN stimulated O2 uptake by the oxidase. The results support a scheme of electron transport within the oxidase complex involving NADPH, FAD, cytochrome b-245 and O2 in that sequence. PMID- 6497853 TI - Isolation of cells from rabbit renal proximal tubules by using a hyperosmolar intracellular-like solution. AB - A novel method of isolation of cells from rabbit kidney proximal tubules by using an intracellular-like solution (ICS) and gentle mechanical agitation in the absence of enzymes or chelators is described. Metabolic and functional characteristics of these cells were studied after washing and resuspension in modified Hanks medium, and the results were compared with those obtained in cells similarly prepared in extra-cellular-like solution (ECS). Trypan Blue exclusion and protein content were not different between the two preparations. However, oxygen consumption, ATP content and time- and concentration-dependent rates of uptake of phosphate, alpha-methyl glucoside and L-alanine were severalfold higher in cells prepared in ICS. Na+-dependent uptake of these solutes was 95% and 80% of total uptake in cells prepared in ICS and ECS respectively. Maximum transport rates (Tmax.) of phosphate, alpha-methyl glucoside and L-alanine were significantly higher in cells prepared in ICS. We propose that the use of ICS in the isolation procedure would yield a functionally more viable cell preparation, and therefore provides an ideal model for transport and metabolic studies at a cellular level. PMID- 6497854 TI - Specific inhibition of L-type pyruvate kinase by the triazine dye Procion Blue MX R. AB - Incubation of the triazine dye Procion Blue MX-R with L- and M-type pyruvate kinase resulted in rapid time- and dye-concentration-dependent loss of activity. L-type pyruvate kinase was protected only by a low concentration of Mg2+; this was not the case with the M-type enzyme. Modification of the L-type form resulted in the incorporation of 1.54 +/- 0.057 mol of dye/mol of enzyme subunit in the absence of Mg2+, but only 0.73 +/- 0.024 mol of dye/mol of enzyme subunit in the presence of Mg2+. Tryptic peptide mapping of L-type pyruvate kinase modified in the presence and in the absence of Mg2+ further indicated that there were two sites modified in the enzyme, one of which was protected by Mg2+. The pKa of the nucleophile involved in the modification was calculated to be 7.1, implicating the possible involvement of a histidine residue. L-type enzyme was bound to Sepharose-immobilized Procion Blue MX-R specifically in the presence of Mg2+, whereas binding of the M-type enzyme was Mg2+-independent. The specific interaction of L-type pyruvate kinase with the dye was exploited in the large scale purification of the enzyme and in the isolation of the phosphorylated enzyme. PMID- 6497855 TI - Increased cathepsin D-like activity in cortex, tubules, and glomeruli isolated from rats with experimental nephrotic syndrome. AB - We have examined the activity and distribution of cathepsin D (EC 3.4.23.5), a major renal lysosomal endoproteinase, in the various anatomical and functional areas of normal rat kidney. Cathepsin D-like activities (delta A280/h per mg of protein) in normal rat tissues were: cortex, 0.78 +/- 0.05, n = 37; medulla, 0.62 +/- 0.03, n = 12; papilla, 0.63 +/- 0.04, n = 12; tubules, 0.74 +/- 0.04, n = 28; glomeruli, 0.59 +/- 0.03, n = 28; and liver, 0.41 +/- 0.02, n = 28. Enzyme activity was maximal at pH 3.0-3.5 and inhibited more than 90% by pepstatin (6.7 micrograms/ml), suggesting that the enzyme is cathepsin D. In subsequent experiments we measured cathepsin D-like activity in cortex, tubules and glomeruli isolated from rats with puromycin aminonucleoside (PAN)-induced nephrotic syndrome. Treated animals (15 mg of PAN/100g body wt., intraperitoneally) developed proteinuria beginning 4 days after injection and exceeding 900 mg/24h on day 9. In two separate experiments involving 52 animals we observed a significant increase in cathepsin D-like activity in cortex (+82.7%), tubules (+109.6%) and glomeruli (+54.7%) isolated from PAN-treated rats killed during marked proteinuria (day 9, mean total urinary protein excretion: 937 +/- 94 mg/24h). This increase was observed whether the activity was expressed per mg of DNA or per mg of protein. Increased cathepsin D-like activity was first observed in cortex and tubules coincident with the onset of proteinurea (day 4, mean total urinary protein excretion: 112 +/- 23 mg/24h). In contrast with the significant elevation of renal cathepsin D-like activity, the activity (nmol/h per mg of protein) of alpha-L-fucosidase (EC 3.2.1.51), a non-proteolytic enzyme, was markedly decreased in the identical samples used for the measurement of cathepsin D-like activity: cortex (-46.4%); tubules (-46.1%); and glomeruli ( 38.5%). In addition to changes in renal enzyme activities, PAN-treated rats excreted large amounts of cathepsin D-like activity in their urine (beginning on day 3) compared with nearly undetectable cathepsin D-like activity in the urine from control rats. The significant increases in glomerular and tubular cathepsin D activity may reflect an important role for this enzyme in the pathophysiology associated with PAN-induced nephrotic syndrome. PMID- 6497856 TI - Differential interaction of porphyrins used in photoradiation therapy with ferrochelatase. AB - The mechanism of porphyrin accumulation by tumours is not yet established. If metabolism aids porphyrin elimination, tumours, unlike normal tissues, may not metabolize porphyrins used clinically, such as proto-, haemato-, OO'-diacetyl haemato- and monohydroxyethyl-monovinyl-deutero-porphyrin. Proto-, haemato- and monohydroxyethyl-monovinyl-deutero-porphyrin are substrates for the mitochondrial enzyme ferrochelatase (EC 4.99.1.1), which can form haem analogues from exogenous porphyrins. The Km values for proto-, haemato- and monohydroxyethyl-monovinyl deutero-porphyrin are 11, 22 and 23 microM respectively. However, OO'-diacetyl haematoporphyrin is an effective competitive inhibitor with Ki of 11 microM. Hepatic ferrochelatase specific activity is 5.9 and 5.5 nmol of haem/h per mg of protein respectively in normal Buffalo rat and in those bearing the extrahepatic Morris 7288C hepatoma, and is only 0.13 nmol/h per mg in the hepatomas. Therefore low ferrochelatase activity in cancerous cells may provide one means whereby some porphyrins accumulate in tumours, and the ability of certain porphyrins to act as ferrochelatase inhibitors may provide another. PMID- 6497857 TI - Bilirubin mono- and di-glucuronide formation by purified rat liver microsomal bilirubin UDP-glucuronyltransferase. AB - Highly purified bilirubin UDP-glucuronyltransferase from Wistar-rat liver, when reconstituted with Gunn-rat liver microsomes (microsomal fraction), was able to catalyse the conversion of unesterified bilirubin into both bilirubin monoglucuronide and diglucuronide. Under zero-order kinetic conditions for monoglucuronide formation, the fraction of bilirubin diglucuronide formed by incubation of bilirubin with the reconstituted highly purified transferase accounted for 18% of total bilirubin glucuronides, which was only slightly lower than the fraction of diglucuronides (23% of total bilirubin glucuronides) formed by incubation with hepatic microsomes in the presence of UDP-N-acetylglucosamine or Lubrol. The reconstituted purified enzyme also catalysed the UDP-glucuronic acid-dependent conversion of bilirubin monoglucuronide into diglucuronide and, when bilirubin was incubated with UDP-glucose or UDP-xylose, the formation of bilirubin glucosides and xylosides respectively. These results suggest that a single microsomal bilirubin UDP-glycosyltransferase may be responsible for the formation of bilirubin mono- and di-glycosides. PMID- 6497858 TI - Biliary excretion of metallothionein and a possible degradation product in rats injected with copper and zinc. AB - The concentrations of metallothionein-I (MT-I) and related immunoreactive products in bile from adult female rats were measured by radioimmunoassay. Concentrations in normal animals were 20-30 ng/ml, but increased to 600 and 75 ng/ml after injection of Cu2+ and Zn2+ respectively (3 mg of metal/kg body wt.). However, only 1-2% of the biliary Cu was bound to MT, and less than 1% of the total liver MT in control or Cu2+-injected rats appeared to be secreted in intact form into bile. Other major immunoreactive components in bile from Cu2+-injected rats included an aggregated form of MT-I and a possible degradation product of the isoprotein. PMID- 6497859 TI - Purification and some properties of the D-lactate-2-sulphatase of Pseudomonas syringae GG. AB - A soil bacterium grown on propan-2-yl sulphate as sole source of carbon and sulphur yielded extracts containing an enzyme capable of liberating sulphate from racemic lactate-2-sulphate. The enzyme was purified to homogeneity by a combination of streptomycin sulphate precipitation of nucleic acids, batch treatment with DEAE-cellulose, and chromatography on columns of DEAE-cellulose, Sephacryl S-300 and butyl-agarose. The protein was monomeric with an Mr of 55 000 60 000. The enzyme activity was specific for D-lactate-2-sulphate (Km 6.6 nM; maximal specific activity 14.3 mumol/min per mg of protein) and showed no activity towards the L-isomer. The products of the enzyme's action were inorganic sulphate and D-lactate which were released in equimolar amounts and stoicheiometrically with the amount of ester hydrolysed. No L-lactate was formed. Retention of configuration implied cleavage of the O-S bond of the C-O-S ester link and this was confirmed by 18O-incorporation experiments in which 18O from 18O-enriched water in the incubation medium was incorporated exclusively and quantitatively into inorganic sulphate. Only two other esters (serine-O-sulphate and p-nitrophenyl sulphate) of a total of 29 compounds tested were substrates for the enzyme. D-Lactate, L-lactate-2-sulphate and the substrate analogues glycollate-2-sulphate and butyrate-2-sulphate were significantly inhibitory. PMID- 6497861 TI - An improved procedure for the isolation of intact chloroplasts of high photosynthetic capacity. AB - An improved procedure for the mechanical isolation of chloroplasts of high degree of intactness (90-95%) and photosynthetic capacity (25-50 mmol of O2/s per mol of chlorophyll) is described. The combination of pea plants (Pisum sativum L.) as starting material and the high reproducibility of the procedure readily and cheaply yields reliable intact chloroplasts for photosynthetic studies. PMID- 6497860 TI - Photochemical cross-linking of protein and DNA in chromatin. Synthesis and application of a photosensitive cleavable derivative of 9-aminoacridine with two photoprobes connected through a disulphide-containing linker. AB - A novel cleavable photo-cross-linking reagent, N-(2-methoxy-6-azidoacridin-9-yl) N'-(4-azidobenzoyl)cystamine, for analysis of protein-nucleic acid interactions, has been synthesized. The reagent contains two photosensitive groups that can be activated sequentially. The azidoacridinyl moiety is sensitive to u.v. and visible light (lambda less than or equal to 450 nm), whereas the azidobenzoyl part needs higher-energy light (lambda less than or equal to 350 nm). Furthermore, the disulphide bridge connecting the two photoactive groups can be cleaved by reduction with mercaptans. The reagent is shown to induce cleavable cross-links between all five major histones and DNA in chromatin from Ehrlich ascites cells on activation with long-wavelength u.v. light (lambda greater than 300 nm) at an efficiency of approximately 3% of the added reagent. PMID- 6497862 TI - The computerized derivation of steady-state rate equations for enzyme kinetics. AB - A FORTRAN 77 program is described for the derivation of steady-state rate equations for enzyme kinetics. Input is very simple and consists of the two enzyme forms and the two rate constants for each step in the mechanism. The program may be run interactively or off-line. The results are produced after collecting together the algebraic coefficients of like concentration terms, taking account of sign. A fully interactive BASIC version running on a BBC Microcomputer is also available. Details of the programs have been deposited as Supplementary Publication SUP 50126 (45 pages) with the British Library Lending Division, Boston Spa, Wetherby, West Yorkshire LS23 7BQ, U.K., from whom copies may be obtained as indicated in Biochem. J. (1984) 217, 5. PMID- 6497863 TI - Sickling of sickle erythrocytes does not alter phospholipid asymmetry. AB - Experiments in which phospholipase A2 has been used to examine the accessibility of phospholipids on the surface of sickled erythrocytes and of spectrin-free spicules derived from these cells have shown that accessibility is essentially unchanged compared with oxygenated sickle or normal erythrocytes. These results conflict with the claims of other workers that sickling is accompanied by loss of lipid asymmetry and that spectrin is important in maintaining the normal distribution of phospholipids in the erythrocyte membrane. PMID- 6497864 TI - N-acetylglutamate and urea synthesis. PMID- 6497865 TI - Effect of erythropoietin on the lipid composition of red blood cell membrane. AB - Effect of Ep on [14C]acetate incorporation into different lipid fractions of RBC membranes in starved and phenylhydrazine-treated rats was studied. The incorporation was increased into both neutral and phospholipid fractions on Ep treatment to starved or phenylhydrazine-treated rats. A slight decrease in the ratio of neutral lipid to phospholipid was observed under the influence of Ep in starved rats (23%) or in phenylhydrazine-treated rats (36%). Incorporation of radioactivities into different phospholipid fractions of RBC membrane increased on Ep treatment to starved rats, whereas, the relative percentages of these phospholipids (except LPC) remained more or less unchanged under similar conditions. Phenylhydrazine treatment increased the relative percentage of PC and concomitantly decreased the percentage of Sph. Percentage composition of both these two phospholipids showed a tendency to return to their normal levels on administration of Ep to phenylhydrazine-treated rats. Ep decreased the sigma saturated/sigma unsaturated ratio of fatty acids in PE, PS, and PC of RBC membrane in starved rats. On the other hand, no significant change was observed in this ratio of fatty acids in the phospholipids except Sph of RBC membrane in the presence of phenylhydrazine and Ep. In Sph, the ratio went down under similar conditions. PMID- 6497866 TI - Differences in lipid composition and fluidity of cardiac sarcolemma prepared from newborn and adult rabbits. AB - As the lipid composition of sarcolemma isolated from the rabbit heart changes during ontogeny, the object of this study is to determine if concomitant changes in sarcolemmal fluidity occur. Highly purified sarcolemmal fractions of newborn and adult myocardium were prepared and lipids of those fractions were analyzed. The fluorescence anisotropy of sarcolemmal fractions of both groups was also measured on a fluorometer using 1,6-diphenylhexatriene (DPH) as a probe. Total phospholipid, cholesterol, total fatty acid, and saturated fatty acid contents in the sarcolemmal fraction of the newborn were significantly higher than those of the adult. Total fluorescence intensity at saturating levels of DPH was significantly higher in the sarcolemmal fraction isolated from the newborn compared to the adult, but anisotropy was not significantly different between the newborn and the adult. An Arrhenius plot demonstrated phase transition points at nearly 23 degrees C in both myocardium, but an apparent phase transition at breaking point was not observed in the newborn sarcolemmal fraction. The slight difference in the value of the fusion activation energy above and below the phase transition point was observed between the newborn and the adult. Thus, it is apparent that the changes of sarcolemmal fluidity with age do occur but are smaller than expected, based on the difference in the sarcolemmal lipid composition. PMID- 6497867 TI - A microchamber for polarographic assay. AB - A glass micro-chamber which allows polarographic assay in a volume of 180 microliter is described. The conical shape of this chamber allows efficient mixing with a Teflon magnetic flea. This chamber facilitates the study of the small quantities of mitochondria obtained from human tissue biopsies or animal sources. The polarographic assay of mouse liver mitochondria is described. PMID- 6497868 TI - Comparison of nonenzymatic glycosylation of arterial and venous collagens. AB - The extent of nonenzymatic glycosylation of collagen isolated from sheep carotid arteries and jugular veins was compared. It was found that the level of this modification in the arterial collagen was about 2.7 times higher than that in the venous collagen. Arteriovenous fistulae were established between the common carotid artery and external jugular vein on one side only of six sheep. Sham arteriotomy and phlebotomy were performed on the contralateral vessels. Although there was an increase in the concentration of these ketoamine-linked hexoses in all the tissue samples assayed, a difference of between two- and three-fold was maintained between the arterial and venous tissue. The relationship of this finding to the development of vascular complications and to the level of circulating reducing sugar is discussed. PMID- 6497869 TI - Circannual versus seasonal variations of longitudinally sampled 25 hydroxycholecalciferol serum levels. AB - Seasonal variations in human serum levels of 25-hydroxycholecalciferol (25OHD) have been largely documented in transverse studies of population. But seasonality is not per se a demonstration that 25OHD serum levels fluctuate along the course of year according to a waveform profile with a periodic rhythm. Because of this, we attempted to investigate the possible occurrence of a circannual rhythm for 25OHD serum levels in a longitudinal design, by fitting a 365.25-day cosine curve to temporal biodata recorded in 10 clinically healthy subjects, monthly sampled for RIA determinations of 25OHD. Cosinor procedure statistically validated the occurrence of a circannual rhythm for 25OHD serum concentrations at a highly significant level of probability (P = 0.0015) for null hypothesis amplitude = 0. With 95% of probability, amplitude ranges from 5.0 to 16.5 ng/ml (mean value of oscillation = 10 ng/ml), while acrophase is temporally located from September 14 to December 3 (mean timing = October 21). Yearly, mean values for 25OHD serum concentrations is of 40.3 +/- 5.4 ng/ml as quantified by the line which transversely divides the cosine curve interpolating original biodata. By calculating the band of a complete 12 months variability which includes 90% of the distribution with 90% confidence limits, the circannual chronodesm of 25OHD serum levels has been obtained. Such a chronodesmic sinusoid has been compared to the circannual chronogram. By this comparison, a dissociation between the crest (October) and the peak (August) has been detected. The finding suggests that seasonal variations are superimposed to the circannual rhythm. Seasonal but also circannual changes, thus, characterize the yearly variability of 25OHD serum levels in man. PMID- 6497870 TI - Effect of pyridoxine deficiency on intestinal absorption of calcium and oxalate: chemical composition of brush border membranes in rats. AB - [U-14C]oxalic acid and 45Ca uptake was measured in control and vitamin B6 deficient rats. Calcium and oxalate uptake rates were significantly increased from the intestine of vitamin B6-deficient rats as compared to pair-fed controls. Oxalate uptake in pair-fed control rats follows a passive diffusion. In pyridoxine-deficient rats, the oxalate uptake increases nonlinearly as the oxalate concentration in the incubation medium increased, indicating a two component system--a saturable sodium-independent uptake and a linear nonsaturable passive-diffusion component. The brush border membrane composition reveals that membrane sialic acid, cholesterol, and protein contents were markedly reduced. These aberrations in the chemical composition of brush border membrane may be responsible for the enhanced oxalic acid uptake in vitamin B6-deficient rats. PMID- 6497871 TI - Opposite changes with age in liver and muscle in the mitochondrial and soluble glucose-1,6-bisphosphate and 6-phosphogluconate dehydrogenase. AB - Glucose-1,6-bisphosphate (Glc-1,6-P2), the powerful regulator of carbohydrate metabolism, was markedly decreased in liver of adult rats (2 months of age) as compared to young rats (1-2 weeks of age). This regulator was found to be present in both the mitochondrial and soluble fractions of liver. Its concentration in both these fractions was decreased with age. Concomitant to the decrease in Glc 1,6-P2, which is a potent inhibitor of 6-phosphogluconate dehydrogenase, the activity of this enzyme was markedly increased with age in both the mitochondrial and soluble fractions. However, the increase in this enzyme's activity was more pronounced in the mitochondrial fraction. The mitochondrial enzyme was more susceptible to inhibition by Glc-1,6-P2 as compared to the soluble enzyme, and this may explain the greater enhancement in its activity with age in this fraction. The tibialis anterior muscle exhibited changes with age opposite to those found in liver; Glc-1,6-P2 concentration, in both the mitochondrial and soluble fractions of muscle increased with age, and this increase was accompanied by a concomitant reduction in the activity of the mitochondrial and soluble 6 phosphogluconate dehydrogenase. Similar to liver, the mitochondrial enzyme was more affected by age, as it also exhibited a greater susceptibility to inhibition by Glc-1,6-P2. PMID- 6497872 TI - Alterations in erythrocyte membrane lipids in abetalipoproteinemia: phospholipid and fatty acyl composition. AB - Scanning electron microscopic observation revealed that there were wide variations including typical acanthocytes in morphology of erythrocytes from a patient with abetalipoproteinemia. The erythrocyte membrane phospholipids and cholesterol contents from a patient was higher by 25% compared to an age-matched control subject. Analysis of phospholipid composition of red blood cells showed an increase of sphingomyelin (25.1----30.1%) with a concomitant decrease of lecithin (27.5----21.0%). Thus, the sphingomyelin/lecithin ratio was increased dramatically (0.91----1.43). As for fatty acyl chain composition of main phospholipids, an increased percentage of palmitic acid and docosahexaenoic acid and a decreased proportion of arachidonic acid and lignoceric acid were observed for sphingomyelin. There was an increment of palmitic acid which was accompanied with a decrease of linoleic acid in lecithin. On the other hand, no significant difference was shown in the fatty acid composition of phosphatidylethanolamine and phosphatidylserine plus phosphatidylinositol between a patient and control. PMID- 6497873 TI - Glutathione conjugation of arylnitroso compound: detection and monitoring labile intermediates in situ inside a fast atom bombardment mass spectrometer. AB - The glutathione (GSH) conjugation reaction of the active metabolite of a potent protein-pyrolysate carcinogen, 2-nitroso-6-methyldipyrido[1,2-a:3',2'-d]imidazole (NO-Glu-P-1), occurred in glycerol matrix inside a fast atom bombardment (FAB) mass spectrometer. The short lived GSH-conjugates were detected by in situ FAB analysis. The precursor-product relationship between the conjugates was indicated by following the reaction by measuring [M + H]+ ions of the conjugates. PMID- 6497874 TI - Effect of chromium(III) on poly(dG-dC) conformation. AB - The interaction of chromium(III) with poly(dG-dC) inhibits the B to Z transition and results in the condensation of the polymer at high Cr/nucleotide ratios. At low Cr/nucleotide ratios chromium(III) enhanced the ability of ethanol to induce the B to Z transition of poly(dG-dC). The effects of chromium(III) on the conformation of DNA may be related to the carcinogenicity of chromium compounds. PMID- 6497875 TI - Stereoselective hydroxylation at the aliphatic carbons of 7,8- and 9,10 dihydrobenzo[a]pyrenes by rat liver microsomes. AB - Optically active 7-hydroxy-7,8-dihydrobenzo[a]pyrene and 8-hydroxy-7,8 dihydrobenzo[a]pyrene were identified as two of the major metabolites formed by incubation of 7,8-dihydrobenzo[a]pyrene with rat liver microsomes. Optically active 9-hydroxy-9,10-dihydrobenzo[a]pyrene and 10-hydroxy-9,10 dihydrobenzo[a]pyrene were similarly identified as two of the minor metabolites of 9,10-dihydrobenzo[a]pyrene. The formation of these metabolites was abolished either by prior treatment of liver microsomes with carbon monoxide or the absence of NADPH, but was not inhibited by an epoxide hydrolase inhibitor. The results indicate that the aliphatic carbons of dihydro polycyclic aromatic hydrocarbons may undergo stereoselective hydroxylation reactions catalyzed by the cytochrome P 450 system of rat liver microsomes. PMID- 6497876 TI - Conversion of 1-alkyl-2-acetyl-sn-glycerols to platelet activating factor and related phospholipids by rabbit platelets. AB - The metabolic pathway for 1-alkyl-2-acetyl-sn-glycerols, a recently discovered biologically active neutral lipid class, was elucidated in experiments conducted with rabbit platelets. The total lipid extract obtained from platelets incubated with 1-[1,2-(3)H]alkyl-2-acetyl-sn-glycerols or 1-alkyl-2-[3H]acetyl-sn-glycerols contained at least six metabolic products. The six metabolites, identified on the basis of chemical and enzymatic reactions combined with thin-layer or high performance liquid chromatographic analyses, corresponded to 1-alkyl-sn glycerols, 1-alkyl-2-acetyl-sn-glycero-3-phosphates, 1-alkyl-2-acyl (long-chain) sn-glycero-3-phosphoethanolamines, 1-alkyl-2-acetyl-sn-glycero-3 phosphoethanolamines, 1-alkyl-2-acetyl-sn-glycero-3-phosphoethanolamines, 1-alkyl 2-acyl(long-chain)-sn-glycero-3-phosphocholines, and 1-alkyl-2-acetyl-sn-glycero 3-phosphocholines (platelet activating factor). These results indicate that the metabolic pathway for enzymatic activities: choline- and ethanolamine- phosphotransferases, acetyl-hydrolase, an acyltransferase, and a phosphotransferase. The step responsible for the biosynthesis of platelet activating factor would appear to be the most important reaction in this pathway and this product could explain the hypotensive activities previously described for alkylacetyl-(or propionyl)-glycerols. Of particular interest was the preference exhibited for the utilization of the 1-hexadecyl-2-acetyl-sn-glycerol species in the formation of platelet activating factor. PMID- 6497877 TI - Effect of 5'-methylthioadenosine on induction of murine erythroleukemia cell differentiation. AB - The polyamines putrescine, spermidine and spermine have been implicated in the regulation of proliferation and differentiation. The present study has monitored the effects of 5'-methylthioadenosine, the metabolic product of spermidine and spermine synthesis, on the appearance of a differentiated murine erythroleukemia cell phenotype. The results demonstrate that increasing concentrations of 5' methylthioadenosine (1 X 10(-6) to 5 X 10(-4)M) progressively inhibit murine erythroleukemia cell heme synthesis and hemoglobin production. The results also demonstrate that this inhibition of differentiation is not related to depletion of intracellular spermidine or cytostasis. Since 5'-methylthioadenosine is also a known inhibitor of DNA methylation, this naturally occurring nucleoside may be an intermediate involved in both murine erythroleukemia cell proliferation and differentiation. PMID- 6497878 TI - Incorporation of [18O]water into 4-hydroxybenzoic acid in the reaction of 4 chlorobenzoate dehalogenase from pseudomonas spec. CBS 3. AB - 4-Chlorobenzoate is dehalogenated by 4-chlorobenzoate dehalogenase from Pseudomonas spec. CBS 3 to form 4-hydroxybenzoate. In 18O enriched water the hydroxygroup of 4-hydroxybenzoate is quantitatively labelled with 18O. This result clearly shows, that 4-chlorobenzoate dehalogenase catalyzes the hydrolytic cleavage of the halogen-carbon bond, without the involvement of molecular oxygen, a reaction not yet described. PMID- 6497880 TI - Inactivation of human blood coagulation factor X by chemical modification of gamma-carboxyglutamic acid residues. AB - The inactivation of human factor X by incubation with a reagent known to chemically modify gamma-carboxyglutamic acid to gamma-methylene glutamic acid was studied. Incubation of factor X at pH 5.0 with a preincubated formaldehyde/morpholine mixture (0.9 M/1.0 M) resulted in a progressive decrease in factor X coagulant activity. In the presence of calcium (20 mM) the rate of factor X inactivation was decreased -3-fold. By using [14]C-formaldehyde, modified-factor X (less than 5% residual activity) was found to contain 7 mols of [14]C per mol of protein. Modified-factor X was not activated by Russell's viper venom in the presence of calcium, suggesting that the loss of coagulant activity was related to the inability of modified-factor X to be activated. PMID- 6497879 TI - Enhanced lysosomal phospholipid degradation and lysophospholipid production due to free radicals. AB - To pursue the hypothesis that peroxidized lipids may become preferred substrates for endogenous phospholipases, we injured hepatic lysosomes by adding an exogenous free radical generating system [dihydroxyfumurate + Fe3+-ADP]; this system rapidly lysed hepatic lysosomes at pH 6.0, with maximal changes at 30 min. The production of malondialdehyde [MDA] plateaued rapidly. At 20 min the degradation of phosphatidylethanolamine [PE] was greater than phosphatidylcholine [PC]: 52% and 17%, respectively. Sphingomyelin and neutral lipids did not decrease. Most interesting was the significant increase of lysoPC [329%; p less than 0.05] at 10 min and [381%; p less than 0.01] after 20 min of incubation; lysoPE production became significant [766%; p less than 0.05] at 20 min. This enhanced production of lysoPC and lysoPE suggests a new mechanism to increase the production of amphiphilic lipids during ischemia, that is active at moderately acid pH without added calcium. PMID- 6497881 TI - Estrogen induces secretary proteins in transformed mouse Leydig cell in vivo, but not in vitro. AB - The estrogen-induced proteins were analyzed in one of estrogen responsive mouse Leydig tumors. The incubation of cells freshly prepared from solid tumors with [35S] methionine resulted in the demonstration of estrogen-induced secretary protein with a molecular weight of 34,000. The additional minor estrogen-induced secretary protein (36,000) was also identified. An exposure of these cells to the culture condition for 48 hr caused the loss of their ability to synthesize these secretary proteins even in the presence of estrogen. In contrast, minced tumor tissue was observed to sustain the ability to synthesize these proteins at least for 48 hr. These results would suggest that some cellular arrangement is required for the synthesis of estrogen-induced proteins. PMID- 6497882 TI - Correlation of tumor metastasis with sterol carrier protein and plasma membrane sterol levels. AB - Squalene and sterol carrier protein (SCP) levels and sterol/phospholipid molar ratios of whole cells and plasma membranes were measured in cultured primary tumor and metastatic cell lines. SCP is abundant in all cell lines. However, metastatic lines have significantly lower SCP levels and plasma membrane sterol/phospholipid ratios than do primary lines. The results indicate that extremely malignant, metastatic cells are unable to produce or maintain adequate levels of both SCP and plasma membrane sterols when grown in lipoprotein deficient media. This defect, in vivo, probably causes excess uptake of SCP and lipid. PMID- 6497883 TI - Antibodies against a 23Kd heparin binding fragment of thrombospondin inhibit platelet aggregation. AB - Antiserum against a 23Kd heparin binding fragment of thrombospondin inhibits the aggregation of platelets in response to ADP, collagen or thrombin. The antiserum inhibits the secretion-dependent second phase, but not the primary phase of aggregation of platelets responding to ADP. Although immune serum added during the second phase of ADP-induced aggregation causes some inhibition of secretion, it also causes reversal of aggregation to the level produced during primary aggregation. Since thrombospondin is the endogenous lectin of human platelets, these results support the conclusion that the endogenous lectin mediates, at least in part, the secretion-dependent aggregation of platelets. Our data suggest that the region of thrombospondin which contains the heparin binding domain(s) present in the 23Kd fragment play(s) a critical role in secretion-dependent aggregation of platelets. PMID- 6497884 TI - Estrogen-like effects of combined dexamethasone and tamoxifen in the chick oviduct. AB - The effects of dexamethasone alone on withdrawn chick oviduct weight, DNA, protein content and progesterone receptor concentration were barely detectable, whereas ovalbumin and conalbumin synthesis were increased. When dexamethasone and tamoxifen were combined, a marked increase of total proteins, including egg white proteins, DNA and wet weight occurred. Progesterone receptor also was increased. The most striking result was the stimulation of DNA polymerase-alpha activity by combined dexamethasone and tamoxifen, whereas either compound was completely ineffective. PMID- 6497885 TI - CU(II)-dependent inactivation of Mn-catalase by hydroxylamine. AB - Hydroxylamine is a strong inhibitor of the Mn-catalase of Lactobacillus plantarum in the presence of hydrogen peroxide [Kono, Y., and Fridovich, I. (1983) J. Biol. Chem. 258, 13646-13648]. In the presence of CuCl2 the Mn-catalase was rapidly inactivated by hydroxylamine without the addition of hydrogen peroxide. FeSO4 and MnCl2 were approximately 10% and 4% as effective as was CuCl2. Under anaerobic conditions, the inactivation did not occur. The chelating agents such as EDTA and histidine completely prevent the inactivation. These results indicate that the hydrogen peroxide produced during the autooxidation of hydroxylamine catalyzed by CuCl2 participates in the CuCl2-dependent inactivation by hydroxylamine. PMID- 6497886 TI - Stereospecific incorporation of hydrogens from NADPH in elongation of very long fatty acyl-CoA by swine cerebral microsomes. AB - The elongation of arachidoyl-CoA by swine cerebral microsomes resulted in the production of behenic acid (22:0) and lignoceric acid (24:0) concomitantly. When 4S-[4-2H1]NADPH was used for the elongation of arachidoyl-CoA, the incorporation of two deuterium atoms into 22:0 was observed by the technique of mass fragmentography. Furthermore, the incorporation of four deuterium atoms into 24:0 was also detected. On the other hand, when 4R-[4-2H1]NADPH was used, no deuterium was incorporated into the elongated products. PMID- 6497887 TI - 3-Aminobenzamide does not alter DNA repair in human fibroblasts through modulation of deoxynucleoside triphosphate pools. AB - 3-Aminobenzamide does not deplete cellular purine deoxynucleoside triphosphate pools as do the structurally-related ribonucleotide reductase inhibitors, the hydroxy- and amino-substituted benzohydroxamic acids. Thus, the previously reported ability of 3-aminobenzamide to inhibit de novo synthesis of DNA purines does not appear to be due to a direct effect on pools via inhibition of ribonucleotide reductase. The enhancement rather than inhibition by 3 aminobenzamide of DNA repair in the present studies, however, leaves open the possibility that pool modulation may play a role in cell systems where repair inhibitory effects are seen. PMID- 6497888 TI - Conversion of N6-isopentenyladenine to zeatin by Actinidia tissues. AB - Tissue cultures grown from stem explants of three Actinidia species and a hybrid species rapidly converted N6-isopentenyladenine (i6Ade) to zeatin (io6Ade), a potent hydroxylated cytokinin. Within 24 h on 50 uM i6Ade, callus tissues of A. chinensis x arguta accumulated 83 +/- 6 nmol/g io6Ade which was purified using HPLC and identified by its characteristic UV and mass spectra. Activity converting i6Ade to io6Ade was also demonstrated in stem segments from intact plants where it was low in the tip (3 cm), highest in the region corresponding to rapid leaf growth and very low in the mature stem. Root segments converted i6Ade to io6Ade almost as rapidly as the most active region of the stem while leaf petioles produced little io6Ade. Fruits of A. arguta and A. chinensis produced little or no io6Ade, respectively. PMID- 6497889 TI - Inactivation and affinity-labeling of rat liver iodothyronine deiodinase with N bromoacetyl-3,3',5-triiodothyronine. AB - The thyroid hormone derivative N-bromoacetyl-3,3',5-triiodothyronine (BrAcT3) acts as an active site-directed inhibitor of rat liver iodothyronine deiodinase. Lineweaver Burk analysis of enzyme kinetic measurements showed that BrAcT3 is a competitive inhibitor of the 5'-deiodination of 3,3',5'-triiodothyronine (rT3) with an apparent Ki value of 0.1 nM. Preincubations of enzyme with BrAcT3 indicated that inhibition by this compound is irreversible. The inactivation rate obeyed saturation kinetics with a limiting inactivation rate constant of 0.35 min 1. Substrates and substrate analogs protected against inactivation by BrAcT3. Covalent incorporation of 125I-labeled BrAcT3 into "substrate-protectable" sites was proportional to the loss of deiodinase activity. The results suggest that BrAcT3 is a very useful affinity label for rat liver iodothyronine deiodinase. PMID- 6497890 TI - Blood group A glycolipid (Ax) with globo-series structure which is specific for blood group A1 erythrocytes: one of the chemical bases for A1 and A2 distinction. AB - A new blood group A-active glycolipid fraction, termed Ax, showing a chromatographic mobility between Aa and Ab was found in blood group A1 erythrocytes but not in A2 erythrocytes. Ax was identified by its conversion to "globo H" by alpha-N-acetylgalactosaminidase and by 1H-NMR spectroscopy as GalNAc alpha l----3[Fuc alpha l----2]Gal beta l----3GalNAc beta l----3Gal alpha l--- 4Gal beta l----4Glc beta l----lCer. Globo-H (Fuc alpha l----2Gal beta l--- 3GalNac beta l----3Gal alpha l----4Gal beta l----4Glc beta l----lCer) was found in blood group A, and O but not in A1 erythrocytes. Thus, one of the A1-specific determinants must be an A determinant carried by globo-series structure. PMID- 6497891 TI - Identification of the mRNA coding for prolactin in the human decidua. AB - Total RNAs extracted from amnion, chorion and decidua of the human second trimester placentas were translated in the cell-free translation system, followed by immunoprecipitation with antiserum to human prolactin (Prl) and electrophoresis in sodium dodecyl sulfate slab gel. A single immunospecific protein with an apparent molecular weight of approximately 25,500, about 3000 daltons larger than authentic Prl, was formed only with RNA from decidua, and it competed with unlabeled Prl but not with unlabeled human placental lactogen (hPL) for binding to the antibody. The electrophoretic patterns of the fragments formed by partial enzymatic proteolysis of it and authentic Prl were similar. PMID- 6497892 TI - Cross-linking of bacteriorhodopsin using specific carboxyl modifications and proteolytic cleavage. AB - Specific carboxyl modification of purple membrane using a water-soluble carbodiimide yielded a mixture of oligomers, revealed by gel electrophoresis. Purple membrane pre-treated with papain or trypsin, cleaving the C-terminal tail, showed the same pattern of cross-linked products. Chymotryptic cleavage released amino acids 1-72 (7kD fragment) from the cross-linked products, as it did with native membrane. The tail and helices A and B are not, therefore, involved in carbodiimide-promoted cross-linking. Similar cleavage of a hydrophobic dihydroquinoline-modified sample showed that mainly intra-molecular cross-linking occurs, with little cross-linking between the large and small chymotryptic fragments. PMID- 6497893 TI - Human aglycosyl-IgG exhibits increased hydrophobicity. Binding/fluorescence studies with 8-anilinonaphthalene-1-sulfonic acid (ANS). AB - Human monoclonal, aglycosyl-IgG produced in vitro in the presence of tunicamycin, was compared with its native and acid pH-altered counterparts for their respective abilities to bind the fluorescent hydrophobicity probe, 8 anilinonaphthalene sulfonate. A novel technique based on continuous-flow dynamic dialysis (Sparrow et al., 1982, Anal. Biochem. 123:255-264) allowed binding studies under non-equilibrium conditions. While the native IgG conformation exhibits two, weak ANS binding sites (ca. 10(3) l/mol), aglycosyl-IgG has one weak and one moderate affinity (least squares average Ka = 2 X 10(4) l/mol) site, and the acid conformer binds yet another two ANS molecules with moderate affinity (4 X 10(4) l/mol). Increases in affinity and in the number of sites correlate roughly with increased relative percent fluorescence by conventional fluorimetry. The fluorescence lifetime of ANS bound to altered IgGs is about 10% longer (T2 = 15 nsec by time-resolved fluorimetry) than that for native IgG. All populations also exhibit a rapid decay component (T1 = 3 nsec) analogous to that seen for ANS in 50% aqueous dioxane. Results are discussed in relation to structural role(s) for IgG-linked heterosaccharides. PMID- 6497894 TI - Crystallization of alpha 1-acid glycoprotein. AB - Crystals of alpha 1-acid glycoprotein have been grown reproducibly from delipidated protein in the presence of chlorpromazine. The crystals are large hexagonal prisms of space group either P622 or P6(2)22 and the unit cell dimensions are a = b = 101 A and C = 201 A. The unit cell is very highly hydrated and is nearly 80% solvent. It contains one molecule of protein per asymmetric unit. The crystals diffract only to low resolution, presumably reflecting the extensive hydration and accompanying disorder. PMID- 6497895 TI - The origin of the oxygen incorporated during the dehalogenation/hydroxylation of 4-chlorobenzoate by an Arthrobacter sp. AB - An Arthrobacter sp. has been shown to dehalogenate 4-chlorobenzoate yielding 4 hydroxybenzoate. Experiments with 18O indicate that, in the presence of cell-free extracts, the hydroxyl group which is substituted onto the aromatic nucleus during dehalogenation is derived from water and not from molecular oxygen. Dehalogenation therefore is not catalysed by a mixed-function oxidase; instead a novel aromatic hydroxylase is implicated in the reaction. PMID- 6497896 TI - Structural modifications at the 2'- and 3'-positions of some pyrimidine nucleosides as determinants of their interaction with the mouse erythrocyte nucleoside transporter. AB - Modifications in the sugar moiety of pyrimidine nucleosides may affect their ability to function as permeants of the mouse erythrocyte nucleoside transporter. In this investigation, a number of synthetic uracil and thymine nucleosides which differ from the physiological nucleosides, uridine, deoxyuridine and thymidine, through structural changes at the 2'- and 3'-positions were studied. Interaction of the analogs with the transporter has been assessed in terms of their affinities for an external site on the transporter as well as their abilities to effect trans-acceleration of thymidine efflux. 1-(beta-D-Arabinofuranosyl) uracil (araU) and 1-(beta-D-arabinofuranosyl)thymine (araT) were comparable to thymidine as permeants while nucleosides in which the 3'-hydroxyl was replaced with hydrogen or a halogen had a decreased affinity for the transporter. 3'-Fluoro-3' deoxy-araU weakly accelerated thymidine efflux while its ribo-isomer and the other 3'-halogeno-3' deoxy-arabino analogs as well as dideoxythymidine inhibited efflux. The absence of 2'- and 3'-carbons in acyclothymidine and acyclouridine strongly decreased the affinities of these nucleosides for the transporter; efflux of thymidine was not accelerated in the presence of these compounds. The conformationally constrained cyclic nucleoside 2,2'-anhydro-araU had a very low affinity for the transporter, and influx of the radiolabeled compound could not be demonstrated. The results suggest that modification at the 3'-position, loss of a portion of the sugar ring, and lack of conformational flexibility are factors which decrease the abilities of some pyrimidine nucleosides to function as permeants. It is suggested that combined effects of substituents which play a role in determining nucleoside conformation should be considered in assessing structural requirements for permeants of the transporter. PMID- 6497897 TI - Kinetics and mechanism of in vitro uptake of amino-beta-lactam antibiotics by rat small intestine and relation to the intact-peptide transport system. AB - By utilizing the everted jejunum of rats, the initial uptake rates of several antibiotics were measured over a wide range of concentrations. The uptakes followed mixed-type kinetics involving saturable and non-saturable processes in parallel. The pertinent kinetic parameters for the uptake of each antibiotic were determined. The effect of cephalexin on the uptake of cyclacillin obeyed competitive inhibition kinetics, and the inhibition constant Ki was found to be equal to the Michaelis constant Kt for the uptake of cephalexin itself. In a similar way, the uptake of cephalexin was inhibited by cyclacillin. Uptakes of both cyclacillin and cephalexin were reduced significantly by several metabolic inhibitors. From the effect of temperature on the uptakes of cyclacillin and cephalexin, activation energies of 24.8 and 23.1 kcal/mole were obtained respectively. These results indicate the involvement of an active transport mechanism for cyclacillin and cephalexin. It was found that several dipeptides markedly inhibited the uptakes of cyclacillin and cefadroxil. Furthermore, the uptake of glycylglycine, a typical dipeptide, was inhibited by cyclacillin, cefadroxil, cephalexin, and cephradine. The kinetics of mutual inhibition of the uptakes of cyclacillin and glycylglycine were consistent with competitive-type inhibition. This is the first report which establishes, from a kinetic point of view, the involvement of a common transport system in the in vitro uptakes of the dipeptides and the antibiotics. PMID- 6497898 TI - Sulfation in isolated enterocytes of guinea pig: dependence on inorganic sulfate. AB - Isolated intestinal epithelial cells of the guinea-pig were used to study uptake and metabolism of inorganic sulfate in the jejunum (proximal cells) and ileum (distal cells). Proximal enterocytes accumulated sulfate 1.5-fold and distal enterocytes 3.1-fold. Accumulation was almost linearly related to substrate concentrations up to 5 mM. In proximal cells, despite their lower intracellular sulfate levels, sulfate incorporation into acid-precipitable material and sulfate conjugation of 1-naphthol were faster than in distal cells. Formation of 1 naphthyl sulfate increased with extracellular sulfate concentrations up to 1 and 3 mM sulfate in distal and proximal enterocytes, respectively. The data suggest that the extent of intestinal sulfation of phenolic compounds may be enhanced by oral administration of sulfate. PMID- 6497899 TI - Comparative subcellular distribution of aldehyde dehydrogenase in rat, mouse and rabbit liver. AB - The subcellular distribution of hepatic aldehyde dehydrogenase (ALDH) activity was determined in Buffalo, Fischer 344, Long-Evans, Sprague-Dawley, Wistar and Purdue/Wistar rats. These subcellular distributions were compared to the distribution of mouse and rabbit liver ALDH. For the six rat strains, at millimolar propionaldehyde concentrations, NAD-dependent ALDH activity was associated primarily with mitochondria (51%) and microsomes (30%). At millimolar acetaldehyde concentrations, NAD-dependent ALDH was primarily mitochondrial (up to 80%). Less than 1% of total NAD-dependent aldehyde dehydrogenase was found in the cytosol. The highly inbred Purdue/Wistar line possessed significantly less acetaldehyde-NAD ALDH activity as well as less total NADP-dependent ALDH activity than the other strains. In CD-1 mouse liver, millimolar Km, NAD-dependent ALDH activity was found in mitochondria (60%), microsomes (23%) and cytosol (5%). In rabbit liver, millimolar Km, NAD-dependent ALDH was also distributed among mitochondria (36%), microsomes (19%) and cytosol (28%). At micromolar substrate concentrations, mitochondria possessed the majority of rat, mouse and rabbit liver ALDH activity. In all three species, NADP-dependent ALDH activity was found predominantly in the microsomal fraction (up to 65%). The cytosol possessed little NADP-dependent ALDH in any species. We conclude that there are significant species differences in the subcellular distribution of aldehyde dehydrogenase between rat, mouse and rabbit liver. In all three species, mitochondria and microsomes possessed the majority of hepatic aldehyde dehydrogenase activity. However, the cytosol of mouse and rabbit liver also made a significant contribution to total ALDH activity. For the six rat strains examined, liver cytosol possessed little or no ALDH activity. PMID- 6497900 TI - Effects of propylthiouracil on D-galactosamine hepatotoxicity in the rat. Evidence for a non-thyroidal effect. AB - The cytoprotective effects of propylthiouracil (PTU) were studied in rats treated with the hepatotoxin D-galactosamine (D-GNH2). Five days of PTU pretreatment prior to D-GNH2 caused hypothyroidism and a significant reduction in liver injury as assessed by serum transaminase levels. When PTU was administered as a single dose with D-GNH2, significant decreases in transaminase also occurred at times when thyroid function was unchanged. Furthermore, aminopyrine oxidation showed significant impairment after D-GNH2 and was normalized by one dose of PTU. Further studies were carried out in thyroidectomized rats. PTU caused significant reductions in transaminase levels when given for 5 days pretreatment or as a single dose. Animals receiving pretreatment with PTU plus thyroxine (T4) also had significant decreases in serum transaminase. The antithyroid drug methimazole also had a hepatoprotective effect, while two other potent antithyroid compounds (2-thiouracil and 2-thiobarbituric acid) did not. These data suggest that PTU can protect against liver injury induced by D-GNH2, that the effect is independent of thyroid function, and that this effect is not common to all thiol-containing antithyroid drugs. PMID- 6497901 TI - Effect of nitroheterocyclic drugs on lipid peroxidation and glutathione content in rat liver extracts. AB - Incubation of rat liver cell-free extracts with an NADPH-generating system and with nifurtimox or benznidazole (two nitroheterocyclic drugs used in the treatment of Chagas' disease) produced oxidation of reduced glutathione (GSH) and increased lipid peroxidation, as shown by the generation of thiobarbituric-acid reacting intermediates. Nifurtimox and benznidazole inhibited GSSG-reductase, but not GSH-peroxidase, the former inhibition contributing to GSH depletion. In every case, nifurtimox was more effective than benznidazole. Addition of GSH or free radical scavengers (catalase, superoxide dismutase, mannitol, sodium benzoate or L-histidine) prevented the effect of nifurtimox on lipid peroxidation reactions. These results support the assumption [M. Dubin, S. N. J. Moreno, E. E. Martino, R. Docampo and A. O. M. Dubin, Biochem. Pharmac. 32, 483 (1983)] that, in the rat liver, GSH exerts a protective action against oxygen radicals generated by the nitroheterocyclic drugs. PMID- 6497902 TI - An effect of piretanide upon the intracellular cation contents of cells subjected to partial chronic (Na-K) pump blockade by ouabain. AB - Cultured cells have been used to study the contribution made by the ouabain insensitive but diuretic (piretanide)-sensitive K transport system (so-called cotransport) to the maintenance of intracellular Na+ and K+ contents in normal cells and in cells whose Na-pump sites have been subjected to chronic partial inhibition. In cells which have normally directed gradients of Na+ and K+, chronic incubation in piretanide (10(-4) M) for up to 24 hr has no significant effect on the internal ion contents of HeLa (human carcinoma), MDCK (dog kidney epithelium) or BC3H1 (mouse smooth muscle) cell lines. This observation is consistent with the notion that when the intracellular ion contents are in a normal steady state the net driving force acting upon the diuretic-sensitive K transport (Na + K + Cl cotransport system) is zero or very close to zero. When cells are subjected to chronic partial inhibition of the sodium pump as a consequence of growth in sublethal concentrations of ouabain (10(-9)-3 X 10(-7) M), the number of functional Na-pump sites decreases, the intracellular Na+ content increases and the intracellular K+ decreases in a dose dependent manner. Under these conditions, inclusion of piretanide (10(-4) M) causes a significant retardation of Na+ gain and K+ loss from the cells. This response is of high molar affinity (EC50 = 3-4 X 10(-6) M) and can be obtained with the other loop diuretics, furosemide and bumetanide. The data presented are consistent with the idea that in cells subjected to chronic partial inhibition of the Na-pump, there is a piretanide-sensitive exchange of intracellular K+ for extracellular Na+. Such an effect of the cotransport system would not be predicted on the basis of a tightly coupled electroneutral cotransport of Na+, K+ and Cl- with a stoichiometry of 1Na:1K:2Cl. The data are discussed in relation to the possible role of putative circulating endogenous inhibitors of the Na-pump. PMID- 6497903 TI - Influence of red blood cells, serum albumin, and serum lipoproteins on the clearance of benzo[alpha]pyrene by isolated livers of 3-methylcholanthrene treated rats. AB - Red blood cells, serum albumin, and serum lipoproteins transport benzo[alpha]pyrene and other xenobiotic compounds in the circulation. The distribution of benzo[alpha]pyrene and its metabolites among these blood components was examined, and the effect of their presence in the perfusion medium on the ability of isolated livers from 3-methylcholanthrene-pretreated rats to clear circulating benzo[alpha]pyrene was determined. A large fraction (45%) of the benzo[alpha]pyrene in rat blood was associated with the serum lipoproteins. However, only 8% of the benzo[alpha]pyrene metabolites was associated with this component. Forty to forty-five percent of each was associated with red blood cells. Benzo[alpha]pyrene clearance by isolated rat livers was 1.8 +/- 0.2 ml/min when the medium contained only red blood cells and buffer. Addition of serum lipoproteins or serum albumin increased benzo[alpha]pyrene clearance to 5.1 +/- 0.5 or 8.5 +/- 0.9 ml/min respectively. Appearance of benzo[alpha]pyrene metabolites in perfusions medium and bile was similarly altered by the changes in medium composition. These results indicate that the clearance of benzo[alpha]pyrene by rat liver depends on the composition of the medium perfusing the organ and suggest that alterations in blood components in vivo may influence the metabolic disposition of this carcinogen. PMID- 6497904 TI - Hydrolysis of opioid hexapeptides by carboxypeptidase N. Presence of carboxypeptidase in cell membranes. AB - Carboxypeptidase N, purified to homogeneity from human plasma, rapidly hydrolyzed Lys6- or Arg6-enkephalins when measured by high pressure liquid chromatography. Comparison of the kinetics of hydrolysis of the enkephalin hexapeptides and bradykinin by carboxypeptidase N revealed the following values for the Km and kcat: Arg6-Met5-enkephalin, 49 microM, 1024 min-1; Arg6-Leu5-enkephalin, 57 microM, 375 min-1; Lys6-Met5-enkephalin, 216 microM, 6204 min-1; bradykinin, 19 microM, 58 min-1. Thus, while bradykinin had the lowest Km, the specificity constants (kcat/Km) for all the enkephalin hexapeptides were higher than that of bradykinin due to their high turnover numbers. Preincubation of the enzyme with 0.1 mM CoCl2 increased both the kcat and Km of bradykinin and Arg6-Met5 enkephalin. Similar results were obtained when the above experiments were conducted with the active 48,000 dalton subunit of carboxypeptidase N. Basic carboxypeptidase activity was found in the amniotic fluid, in membrane fractions of various human and bovine tissues, and in cultured cells in the following order of decreasing specific activity: human placental microvilli, human kidney, human amniotic fluid, human lung, bovine lung, bovine pulmonary artery, human foreskin fibroblasts, human pulmonary arterial endothelial cells, and human lung fibroblasts. The membrane-bound carboxypeptidase activity had a neutral pH optimum and behaved similarly to plasma carboxypeptidase N in the presence of various inhibitors and activators. It was different from the carboxypeptidase activity in bovine adrenal chromaffin granules which had an acid pH optimum and was inhibited by sulfhydryl reagents. These studies show that human carboxypeptidase N, an enzyme found in high concentration in blood, readily hydrolyzes Arg6- or Lys6-enkephalins. It could thus control the levels of these peptides if they are released into the circulation from the adrenal gland. In addition, a membrane-bound carboxypeptidase N-like enzyme in various tissues may regulate the local levels of biologically active peptides containing C-terminal basic amino acids such as hexapeptide enkephalins, kinins, anaphylatoxins or fibrinopeptides. PMID- 6497905 TI - The effect of procyanidolic oligomers on the composition of normal and hypercholesterolemic rabbit aortas. AB - Rabbits were fed with normal (group 1 and 2) and cholesterol rich diets (group 3 and 4) concomitantly to a daily peroral administration of 50 mg/kg procyanidolic oligomers (PCO) to groups 2 and 4. After 10 weeks, the cholesterol content of the blood serum and the excised aortic intima-media were significantly higher in groups 3 and 4 than in groups 1 and 2. The DNA, hydroxyproline, uronic acid contents were similar in aortic dry weight basis in all four groups. The intima media samples were extracted successively with 0.15 M NaCl, 0.02 M sodium phosphate pH 7.4 (NaCl extract) and with 4 M guanidinium chloride, 0.05 M sodium acetate pH 5.8 prior (G1 extract) and following (G2 extract) hydrolysis of the collagen with collagenase. The cholesterol contents of G1 extracts were higher in groups 2 and 4 than in groups 1 and 3. The cholesterol content of aortic elastin increased with cholesterol feeding (group 3). With simultaneous administration of cholesterol and PCO the cholesterol content of aortic elastin in group 4 was significantly lower than in group 3. The uronic acid contents increased in G1 extracts and in the collagenase digest with PCO treatment of both normal and hypercholesterolemic rabbits. The ratio of dermatan-sulphate to chondroitin sulphate decreased with hypercholesterolemia (group 3) and with PCO (group 2 and 4). The parallelism between increased cholesterol and uronic acid contents and modified glycosaminoglycan composition in G1 extract, indicate that the interaction of cholesterol with macromolecules of the aorta can be modulated by PCO. This drug modifies the extractibility of aortic cholesterol and glycosaminoglycans and reduces the association of cholesterol to elastin. PMID- 6497906 TI - The reactivation by oximes of phosphonylated acetylcholinesterase: the possible erroneous interpretation of reactivating potency. AB - A comparative study of the reactivation by two oximes of acetylcholinesterase inhibited by several organophosphates has been made, with particular reference to the dependence of the degree of reactivation produced by an oxime (reactivating potency) upon the concentration of inhibited enzyme. In the case of one inhibitor it is demonstrated that the relative reactivating potency of the two oximes can be reversed by a change in experimental conditions. It is concluded that the measurement of the reactivation produced by two or more oximes, particularly when carried out under standardized conditions, is of little value in determining their relative reactivating potencies, and of negligible value in predicting their likely therapeutic effectiveness against organophosphate poisoning. PMID- 6497908 TI - Adriamycin--a potent inhibitor of Ca2+-cardiolipin interaction. PMID- 6497907 TI - Comparison of the binding affinities of five forms of rat glutathione S transferases for bilirubin, sulfobromophthalein and hematin. PMID- 6497909 TI - [Substrate specificity of T4 RNA-ligase. The effect of the nucleotide sequence of the minimum phosphate acceptor on the efficacy of intermolecular ligation]. AB - The 2' (3'),5'-diphosphates of cytidine, uridine, adenosine and the trinucleoside diphosphates, such as NpCpC, NpCpU, NpUpC, NpUpU and ApNpC (where N = U, C, A, G), were used to study the substrate specificity of the T4 RNA ligase. The outcome of ligating various phosphate acceptors to a common phosphate donor was governed not only by nucleotide composition but also the nucleotide sequence of a phosphate acceptor. The effect of the changes in a single position of the phosphate acceptor on the efficiency of the intermolecular ligation cannot be defined independently of the other nucleotide residues. For four examined groups of phosphate acceptors and pCp as a donor, four different ranks were obtained (in order of decreasing reactivity): C greater than A greater than greater than U greater than G (for NpCpC); G greater than U approximately equal to A greater than C (NpCpU); A greater than U greater than C greater than G (NpUpC) and A greater than G greater than C greater than U (NpUpU). The yield of ligation products with various phosphate donors and a common phosphate acceptor significantly depends on the donor structure: pyrimidine phosphate donors are more effective than pAp, while pCp is more effective than pUp. PMID- 6497910 TI - [Study of energy characteristics of 5-fluorouracil analogs by photoionization mass-spectrometry]. AB - The fragmentation pathways of N-1-alkoxyalkyl derivatives of 5-fluorouracil and various analogues of an antitumor drug ftorafur have been examined using a mass spectrometry technique. The ionization and appearance energies for major ions of the compounds under study have been determined on the basis of the ionization efficiency curves obtained using photoionization mass-spectrometry. Different transport forms of 5-fluorouracil have been demonstrated to be similar in the stability of their pseudoglycosidic C-N bond. PMID- 6497911 TI - [Conformation analysis of a mixed hemoglobin-glutathione disulfide]. AB - Theoretical conformational analysis was carried out for a mixed disulfide of hemoglobin with glutathione. The conformational mobility of the beta-subunit C terminal fragment in methemoglobin and deoxyhemoglobin either with free or glutathione-blocked reactive SH-groups was examined. The most stable conformations of the mixed disulfide were delineated. Its spatial structure was shown to be dependent on the hemoglobin state prior to the S-S bond formation: a disulfide made with deoxyhemoglobin had more closely interwoven hemoglobin and glutathione chains than the methemoglobin-derived disulfide. However, in both cases disulfide formation brought about the alterations in the spatial structure of hemoglobin as well as glutathione. The changes in the hemoglobin biochemical properties accompanying the association with glutathione were rationalized in the frames of the mixed disulfide structural analysis. PMID- 6497912 TI - [Analysis of enkephalin conformation using circular dichroism and fluorescence spectroscopy]. AB - Conformation of Leu- and Met-enkephalins and their 17 synthetic analogues was studied by CD and fluorescence spectroscopy both in dioxane and aqueous solutions. The results obtained indicate the beta-turn presence in dioxane solution for the most of the peptides under study. An appreciable percentage of the conformations of this type seems to exist in aqueous solutions as well. PMID- 6497913 TI - [Biologically active loop-shaped analogs of bradykinin and polisteskinin]. AB - The classical methods of peptide chemistry have been employed to synthesize loop shaped derivatives of bradykinin and polisteskinin, Lys-Lys-Lys-[cyclo (9----1 epsilon), Lys1, Gly6]bradykinin and Lys-Lys-Lys-Leu-Arg-Gly[cyclo (9----1 epsilon)Lys1, Gly6] bradykinin. In the course of synthesis, the linear "tail" fragments were attached to partially deblocked cyclopeptide. Protective groups were removed by treating with hydrogen fluoride, the end products were purified using reversed-phase and ion exchange chromatography. Biological experiments in vivo have revealed that the two compounds elicit a prolonged hypotensive effect in rats which is characteristic of cyclic bradykinin analogues. With the latter compound, a decrease in arterial pressure is preceded by a brief hypertensive action. The loop-shaped analogues are slightly myotropic when applied to rat uterus preparations in vitro. PMID- 6497914 TI - [DNA-phospholipid interaction. 31P-NMR study]. AB - The phage T7 DNA complexes with various phospholipids (PL) were studied by 31P NMR at PL/nucleotide molar ratio of 2 : 1. Using a phosphatidylcholine thion analogue, the contributions of PL and DNA into the 31P NMR spectrum of the complex were estimated. It was found that PL-DNA interaction results in partial immobilizing ability of PL depends on their structure, increasing in the following row: phosphatidylcholine-phosphatidylethanolamine less than sphingomyelin less than or equal to ternary mixture of these PL. The data obtained are indicative of nonequivalent binding of DNA with various PL species. PMID- 6497915 TI - [Biotransformation of 1-beta-D-ribofuranosyl-4-methylthiopyrazolo(3,4 d)pyrimidine and its 5'-monophosphate]. AB - 1-beta-D-Ribofuranosyl-4-methylthiopyrazolo(3,4-d)pyrimidine (I) has been converted into its 5'-monophosphate (III) by reacting with POCl3 in trialkyl phosphates or by phosphorylating 2',3'-O-ethoxymethylidene derivative of riboside (I) using 2-cyanoethyl phosphate in the presence of DCC and subsequent removal of blocking groups. Condensation of nucleotide (III) imidazolide with pyrophosphoric acid afforded corresponding 5'-triphosphate. Pools of natural NTPs and riboside (I) phosphates were monitored by HPLC after administering riboside (I), phosphate (III), or 4-methylthiopyrazolo(3,4-d)pyrimidine (II) into mice with leukemia L1210 or after incubating CaOv culture cells with these compounds. Treatment with riboside (I) or nucleotide (III) possessing antileukemic and cytotoxic activites led to much higher level of monophosphate (III), than treatment with biologically inactive base (II). ATP and GTP levels in CaOv cells incubated with (I) or (III) decreased by 60-70%, whereas (II) did not affect NTP pool. Bioactivation of nucleoside (I) into monophosphate (III) proceeds via direct phosphorylation by adenosine kinase. No tranformation of (II) into (I) or (III) occurs under these conditions. PMID- 6497916 TI - [Amino acid sequence of 2 neurotoxins from the scorpion Buthus eupeus venom]. AB - Three polypeptides, M10, M14 and M9, toxic to mammals were isolated from the venom of the Central Asian scorpion Buthus eupeus. All the toxins were shown to be homogeneous according to disc-electrophoresis and N-terminal group analyses. The toxin M9 was digested with trypsin, Staphylococcus aureus proteinase and cleaved with BNPS-skatole. The toxin M14 was subjected to tryptic and chymotryptic hydrolyses. The complete amino acid sequences of the toxins M9 and M14 were established and it was shown that each of them consists of 66 amino acid residues with four intramolecular disulfide bonds. PMID- 6497917 TI - An attempt to predict the response to gold therapy in rheumatoid arthritis. AB - In 54 rheumatoid arthritis patients undergoing conventional chrysotherapy, we prospectively sought predictors of response, using strict clinical and laboratory criteria of improvement. Forty-five patients who completed 6-12 months of therapy were classified into 3 outcome categories: group 0, not significantly improved (18 patients); group 1, improved (18 patients); and group 2, markedly improved (9 patients). Sixty-two entry variables were tested in univariate and multivariate analysis for predictor function. No continuous variable was predictive. The discrete variables HLA-A3 positivity and HLA-DR4 negativity were the best predictors of response to gold. In a multivariate analysis using these 2 univariates (A3 and DR4) plus hemoglobin, we developed a discriminant function that correctly predicted outcome in 21 of 23 patients in groups 0 and 2. We also observed that of 15 DR blank patients (10 of whom were DR4 blank), none entered remission. PMID- 6497918 TI - Small airways function in nonsmokers with rheumatoid arthritis. AB - To evaluate the possible relationship between rheumatoid arthritis (RA) and airways dysfunction independent of cigarette smoking, we studied 19 lifetime nonsmokers with RA and 47 healthy nonsmokers. Ten tests of small airways function were administered to the subjects. In addition, diffusing capacity and static lung compliance were measured, and upstream airway conductance at mid-to-low lung volumes was calculated. Mean values were not significantly lower in the RA group than in the control group in any of the tests of small airways function. Three of the 19 (16%) patients with RA versus 15 of the 47 (32%) control subjects had abnormal findings on greater than 2 tests of small airways function (P greater than 0.1). Although mean diffusing capacity and static lung compliance were both within normal limits in each group, the former tended to be lower, while the latter was significantly lower, in the RA subjects. We conclude that airways dysfunction in RA, if present, is probably related to factors other than the underlying disease; if an association between RA and small airways abnormality is present in some patients, its prevalence is too small to have been detected in our sample. PMID- 6497919 TI - A critical review of compliance studies in rheumatoid arthritis. AB - Nineteen studies of treatment compliance in rheumatoid arthritis (RA) patients have been critically appraised to assess the magnitude and determinants of noncompliance in this population. Deficiencies in study methodology undermined the possibility of firm conclusions on the influence of various factors on compliance in RA populations. Nevertheless, it is apparent that noncompliance with treatments for RA is a major problem that hitherto has not been widely considered. Compliance with prescribed drug regimens varied from 16% to 84% among these studies. With physiotherapy regimens, compliance rates varied from 39% to 65%, while for splint-usage, rates varied from 25% to 65%. No consistent correlation has been demonstrated between compliance and age, sex, treatment side effects, disease severity, or drug dose frequency. Gaps in our present day knowledge have been detailed and the need for further research is outlined. PMID- 6497920 TI - Interstitial lung disease in scleroderma. Analysis by bronchoalveolar lavage. AB - Interstitial pulmonary fibrosis is a common feature of scleroderma (systemic sclerosis) which may result in impairment of pulmonary function and may be a major determinant of morbidity and mortality. Clinicopathologic observations suggest that interstitial and alveolar inflammation may appear prior to fibrosis. Using the bronchoalveolar lavage (BAL) technique, we have characterized the nature of the inflammatory process in the lower respiratory tracts of 19 non smoking scleroderma patients. Eleven of 19 patients (58%) had increased percentages of neutrophils and/or eosinophils in BAL fluid. Five of 10 patients (50%) had elevations of IgG in BAL fluid. The presence of neutrophils was associated with a decreased lung diffusing capacity for carbon monoxide (P less than 0.05) and with more advanced radiographic features of interstitial fibrosis in patients with disease of more than 1 year's duration. This study suggests that scleroderma lung involvement may be characterized by an inflammatory alveolitis and that the presence of such inflammation may relate to the severity of the pulmonary disease. PMID- 6497921 TI - Characterization of a new antigen-antibody system (Su) in patients with systemic lupus erythematosus. AB - A new antigen (Su) from calf thymus nuclear extract that reacts with sera from patients with systemic lupus erythematosus (SLE) is described. Antibodies to Su, demonstrated by immunodiffusion, were most frequently found in patients with a diagnosis of probable or definite SLE. Thirty-seven percent of patients with Su antibodies and a diagnosis of SLE were positive for antinuclear antibodies by indirect immunofluorescence, but lacked specific antibodies previously associated with SLE. Patients with Su antibodies exhibited a higher frequency of Raynaud's phenomenon, but exhibited a lower frequency of malar rash, alopecia, and arthritis when compared with SLE patients in previously published reports. The Su antigen is weakly acidic, heat-stable at 37 degrees C, heat-sensitive at 56 degrees C, resistant to DNase and RNase, but sensitive to trypsin. Its molecular weight approximated 154,000 daltons by Sepharose chromatography. The Su antibody may be associated with a subset of SLE patients with distinct clinical features, and may serve as a serologic marker for patients who are positive for fluorescent antinuclear antibodies but have no other detectable SLE-associated antibodies. PMID- 6497922 TI - Rheumatoid arthritis associated with jejunoileal bypass. PMID- 6497923 TI - Leukemia-associated arthritis: identification of leukemic cells in synovial fluid using monoclonal and polyclonal antibodies. PMID- 6497924 TI - Aseptic necrosis of the talus and calcaneal insufficiency fractures in a patient with pancreatitis, subcutaneous fat necrosis, and arthritis. PMID- 6497925 TI - Digital ulcerations in systemic sclerosis. PMID- 6497927 TI - Hydroxychloroquine in rheumatoid arthritis. PMID- 6497926 TI - Wegener's granulomatosis: onset during puerperium. PMID- 6497928 TI - Comment on Daniels article (Labial salivary gland biopsy in Sjogren's syndrome) PMID- 6497929 TI - Effects of estradiol on myointimal thickenings from catheter injury and on organizing white mural non-occlusive thrombi. AB - The objective of this present study was to determine the effect of estradiol on the organization of white, mural, nonocclusive thrombus produced with a permanent, indwelling catheter in the abdominal aortae of rabbits and on myointimal thickenings produced by catheter injury but with only transient adhesion of platelets and no thrombosis in the thoracic aorta. Estradiol did not significantly alter the weight of thrombus or myointimal thickenings produced nor did it qualitatively or quantitatively alter Evans Blue uptake by the 7-day myointimal thickenings from injury or alter Evans Blue uptake by the 7-day thrombus. DNA synthesis measured in terms of [3H]thymidine incorporation into biochemical extractable DNA and expressed as dpm/mg DNA was 9 519 for the normal rabbit aortic wall without adventitia; 358 261 for myointimal thickenings including underlying aortic wall without estradiol treatment and 196 336 with estradiol; 55 840 for thrombus without estradiol and 55 250 with estradiol. Expressed as dpm/mg delipidated tissue the values were 62 for the normal rabbit aortic wall; 4 590 for myointimal thickenings without estradiol and 2 037 with estradiol; 1 421 for thrombus without estradiol and 1 403 with estradiol. Estradiol was effective in reducing DNA synthesis in the myointimal thickenings from injury but was not effective in reducing DNA synthesis in the 7-day thrombi. Estradiol significantly increased the influx or retention of [14C]cholesterol found at autopsy in both the organizing thrombi and the myointimal thickenings from injury after an oral dose of 14C-labelled cholesterol was administered 4 days prior to autopsy; however, estradiol did not significantly modify the final cholesterol concentration in the lesions. PMID- 6497930 TI - The use of polymorphic DNA and protein markers for the third complement component for determining linkage of familial hypercholesterolaemia. AB - We have used DNA and protein polymorphisms for the third complement component (C3) to assess the potential of DNA markers in the diagnosis and study of familial hypercholesterolaemia (FH), and to confirm the reported linkage between FH and C3. The inheritance of FH and the C3 gene has been studied in 10 families by combining information from both the protein and DNA polymorphisms. Our results confirm that the C3 gene is loosely linked to the gene causing FH (lod score maximum of 2.0) at a recombination distance of 0.15. When these results are combined with previously published data the overall lod score maximum is 4.75 at a recombination distance of 0.2, meaning that the two genes will be inherited together in only about 80% of children. These results confirm that the gene that causes familial hypercholesterolaemia is linked to C3 and is therefore on chromosome 19, but C3 is not close enough to be used as a diagnostic marker. PMID- 6497931 TI - The effect of exercise and hyperlipemic diet on aortic histopathology in the rat. AB - Histological changes in the aorta were used as criteria to assess the effect of treadmill exercise on the development of atherosclerosis in rats consuming a moderately hyperlipemic diet. While grossly visible atherosclerotic plaques were absent, microscopic examination of sections of the abdominal aorta were distinctly different between exercised and sedentary rats. Aortas of sedentary rats fed a diet containing lard and cholesterol had a high degree of plaque development, fat accumulation, mineralization, erosion and necrosis. Aortas of exercised rats fed the same diet had considerably less atherogenic involvement. Both hyperlipemic groups had greater plaque formation than sedentary rats fed a normolipemic diet. In addition, there were marked differences in plasma lipids; exercise ameliorated the diet-induced changes in plasmatic atherogenic lipids. Our results indicate that exercise retards the development of atherosclerosis in rats fed a hyperlipemic diet. PMID- 6497932 TI - Relationship between lipoproteins including HDL subfractions and the intravenous fat tolerance test. AB - There is a positive relationship between the HDL cholesterol concentration and the fractional removal rate k2 of intravenously administered Intralipid, the intravenous fat tolerance test (IVFTT). This relationship was analysed in 22 female and 20 male healthy normolipoproteinaemic volunteers with regard to HDL subfractions. A positive correlation between the IVFTT k2 value and HDL cholesterol (r = 0.40, P less than 0.05) was confirmed. The k2-HDL2 cholesterol relationship was strong and positive (r = 0.56, P less than 0.001), whereas the correlation between HDL3 cholesterol and k2 was negative (r = -0.37, P less than 0.05). These findings extend other observations indicating that HDL2 seems to be the HDL fraction, directly associated with removal of TG-rich particles from the circulation. PMID- 6497933 TI - Computerized edge tracking and lesion measurement in coronary angiograms. A pilot study comparing smokers with non-smokers. AB - Comparison of coronary atherosclerosis change in a pilot angiographic study of retrospectively matched smokers and controls indicates more rapid progression in smokers. The findings indicate the feasibility of small-scale angiographic trials of treatment designed to ameliorate arterial damage in atherosclerotic smokers who cannot quit. PMID- 6497934 TI - Is cutaneous apoprotein B a better discriminator than serum lipoproteins for atherosclerosis? AB - Serum lipids, skin apoprotein B (apo B) and skin cholesterol measurements have been investigated in 2 populations: one with normal coronarography, the other with pathological coronarography. Within these 2 populations there were highly significant differences in serum apo B (P less than 0.001), skin cholesterol (P less than 0.01) and skin apo B (P less than 0.001) levels. Skin apo B is a valuable test because its increase is closely related to the coronary heart disease. From these 2 populations, 2 groups with normal serum apo B (less than 1.3 g/l) were selected and compared. No significant differences in the various serum lipids were observed except for triglycerides (P less than 0.05) and serum apo B (P less than 0.05). However, a very significant difference was noticed in the skin apo B (P less than 0.001). With this cutaneous apo B determination it was possible to foresee coronary heart disease in 75% of patients. This test can be therefore considered useful to predict coronary status. PMID- 6497935 TI - Post-heparin lipolytic activities and alterations of the chemical composition of high density lipoproteins in alcohol-induced type V hyperlipidemia. AB - In order to study the effects of chronic alcoholism, 3 groups of patients were investigated and compared to 10 healthy controls. Group I consisted of 9 heavy drinkers, who exhibited type V hyperlipidemia (HLP) under alcohol intake. Group II consisted of 7 patients, who previously had type V HLP under the influence of alcohol. At the time of the investigation, however, they had ceased alcohol drinking for at least 6 months and were normolipidemic. Group III consisted of 7 heavy drinkers without hyperlipidemia. Compared to controls, group I had significantly decreased plasma concentrations of high density lipoproteins2 (HDL2) and HDL3 (both P less than 0.01); activities of post-heparin lipoprotein lipase (LPL) and hepatic lipase (HTGL) as well were excessively decreased (both P less than 0.01). In group III LPL was also decreased (P less than 0.01), but HTGL was distinctly (P less than 0.01) higher than in controls. No such differences could be demonstrated for the patients of group II. Acute alcohol withdrawal from a patient suffering from alcoholism with HLP led to a sharp increase of LPL with a simultaneous decrease of VLDL within 2 days and a more delayed increase of LDL, HDL2 and HTGL, all reaching normal values within 12 days after cessation of alcohol drinking. With respect to the apolipoprotein (apo) composition of HDL2, patients of group I and group III exhibited a significantly lower percentual content of apo C-I at the expense of a significantly higher content of apo A-II as compared to controls and patients of group II. In group I and II, the percentual content of apo D in HDL2 was significantly higher than in controls and in group III. It is concluded that severe alcohol intake strongly impairs LPL in patients with HLP. The pronounced increase of HTGL in some patients (group III) may protect these individuals from HLP. The increased content of apo D in HDL2 may be a possible primary trait for alcohol-inducible HLP. PMID- 6497936 TI - Serum lipoproteins and proteins after breast cancer surgery and effects of tamoxifen. AB - Serum proteins and lipoproteins were determined in 23 menopausal females after surgery for early forms of breast cancer and the results compared with data from a matched group of randomly selected healthy females. The patients were randomly divided into 2 groups, one serving as a control group, the other receiving 40 mg tamoxifen daily for 2 months. Breast cancer patients were found to have significantly higher concentrations of serum cholesterol than controls (7.90 +/- 1.15 vs. 6.87 +/- 1.18 mmol/l, P less than 0.001), which was the result of a 16% higher concentration in LDL cholesterol (P less than 0.05) and a 13% higher concentration in HDL cholesterol (P less than 0.05). During tamoxifen therapy total TG tended to increase, whereas total cholesterol fell. Significant lipoprotein changes were found in the LDL fraction where LDL-TG increased from 0.46 to 0.56 (P less than 0.01) and LDL cholesterol fell from 5.11 to 4.10 mmol/l (P less than 0.001). During tamoxifen therapy haptoglobin and orosomucoid concentrations fell significantly (P less than 0.01), whereas those of alpha antitrypsin and ceruloplasmin increased (P less than 0.001). Factors such as diet and weight may explain the differences between breast cancer patients and controls. The tamoxifen-induced changes indicate that this anti-oestrogen exerted a mild oestrogen-like effect with regard to protein and lipoprotein metabolism. PMID- 6497938 TI - Dietary proteins and atherosclerosis. PMID- 6497937 TI - The phosphorylation state of casein and its hypercholesterolaemic effect. The role of divalent cations. PMID- 6497939 TI - Apoprotein E-4-like isoprotein in hypertriglyceridaemic patients during acute pancreatitis. PMID- 6497940 TI - HDL cholesterol, LDL receptor activity and response to dietary cholesterol. A reply to the letter of Cortese, Miller, Marenah and Lewis. PMID- 6497941 TI - Surface determinants of low density lipoprotein uptake by endothelial cells. AB - The surface sialic acid content of aortic endothelial cells in vitro was substantially lower in sparse cultures than at confluence. Binding of LDL to endothelial cells did not change at different culture densities and was unaffected by brief pretreatment with neuraminidase to partially remove surface sialic acid residues. In contrast, internalization of LDL declined by a factor of 3 between low density cell cultures and confluent monolayers; neuraminidase pretreatment increased LDL uptake and the effect was most marked (greater than 10 fold) at confluence. Pretreatment with cationised ferritin, which removed most of the surface sialic acid residues as well as glycosaminoglycans, increased LDL internalization by up to 20-fold, again with most effect on confluent monolayers. Thus LDL uptake is inversely correlated with sialic acid content. We conclude that changes in the surface density of sialic acid (and possibly other charged) residues significantly modulate endothelial LDL uptake, and suggest that focal increases in LDL accumulation during atherogenesis may be related to alterations in endothelial endocytic properties at sites of increased cell turnover or damage. PMID- 6497942 TI - Enhanced expression of a high-molecular-weight protein in arteriosclerotic plaques. AB - We report the detection of a high-molecular-weight protein which is present in the 12,000 X g supernatant of arteriosclerotic plaques from the abdominal aortas of cockerels. The protein has a molecular weight of 160-170 kd when resolved via sodium dodecyl sulfate polyacrylamide gel electrophoresis (7.5%) in the presence of beta-mercaptoethanol. Densitometric scans of silver-stained gels indicate that the 160 kd protein is 8-10 times more prominent in plaques than in the underlying artery wall. This protein, which is present in all plaques analyzed to date, can be detected in animals as young as 8 weeks of age. This represents the first demonstration of the elaboration of a unique protein during the early stages of arteriosclerotic plaque development. PMID- 6497943 TI - Identification of the high-risk groups in familial coronary heart disease. AB - Occurrence of coronary heart disease (CHD) was assessed among the sibs of 309 men with fatal or non-fatal CHD, including 126 men who developed the disease before age 46 (young patients), and 183 men who developed it at age 46-55 (middle-aged patients), and among the sibs of 212 reference men. The risk of early onset CHD was about 3 times as great for the sibs of the young as for those of the middle aged patients. The risk was greatest of all, or up to 10-fold over the expected value, for the sibs of those young patients whose father or mother had died of CHD before age 70, but the risk was distinctly increased also for the sibs of the other young patients. By contrast, the sibs of the middle-aged patients carried an appreciably increased risk of early onset CHD only when one of the parents had died from CHD before age 70. Information about the family pattern of CHD is helpful in identifying the individuals at high risk for premature CHD. PMID- 6497944 TI - Reduced incidence of cardiovascular complications and mortality in hyperlipoproteinemia (HLP) with effective lipid correction. The Dresden HLP study. AB - The influence of the efficacy of triglyceride and cholesterol correction on cardiovascular complications and mortality was analysed in a follow-up study with 260 patients with primary HLP (triglycerides before entry greater than 2.9 mmol/l and/or cholesterol greater than 7.8 mmol/l). The follow-up time was 67.4 +/- 27 months. It was hypothesised that reduction of elevated levels of triglycerides and/or cholesterol influenced favourably the incidence of angina pectoris, MI, stroke and total mortality. For ethical reasons, it was not possible to carry out the investigations with a control group. Therefore, we performed an internal comparison of 3 categories of lipid correction achieved during the trial (effective, moderate, insufficient). A substantial improvement of the lipid disorder was obtained by individualizing the therapy. Triglycerides and cholesterol decreased on average by 50% and 20%, respectively. The incidence of MI was 10 times higher than in the general population. With respect to the type of HLP, hypertriglyceridemia revealed a significantly higher incidence of MI compared with hypercholesterolemia and mixed HLP. The therapy variant was only of importance with respect to gallstone diseases accumulating in the CPIB-treated subgroups. We found a majority of cases with newly manifested angina pectoris and stroke in the group with moderate correction of both triglycerides and cholesterol. Patients with effective triglyceride and cholesterol correction suffered less frequently from MI than those with insufficient correction. This was also the case with secondary prevention in cases with MI prior to entry. There was no significant difference in the distribution of lipid categories at entry between those with and without recurrent infarction. In the group without reinfarction, however, the percentage with insufficient control diminished significantly. Associated risk factors such as hypertension, diabetes, smoking and obesity were of minor or no significance. In subjects with effective triglyceride correction, the total mortality was 0.97/1000 treatment months vs. 3.63 in insufficiently treated patients. The figures for MI mortality were 0.36 and 1.91, respectively. PMID- 6497945 TI - Total plasma apo E and high density lipoprotein apo E in survivors of myocardial infarction. AB - Total apo E in plasma and the amount of apo E-HDL were measured in 40 normolipidemic male survivors of myocardial infarction and in 40 controls. LDL-C, Lp(a) and apo B were significantly higher and HDL-C and apo A-I were significantly lower in survivors than in controls. Total plasma apo E did not differ between patients and controls, but HDL-E and the ratio HDL-E/apo A-I were lower in survivors. The data support the view that atherosclerotic patients are often characterized by abnormalities in the concentration and distribution of lipoproteins as well as of apoproteins, even in the presence of normal total plasma lipids. PMID- 6497947 TI - Does nifedipine suppress atherogenesis in WHHL rabbits? AB - The effects of the calcium antagonist, nifedipine, on atherogenesis were investigated in WHHL rabbits, a unique animal model for human familial hypercholesterolemia. Nifedipine, in a daily dose of 40 mg, was fed orally to 9 rabbits over a period of 26 weeks, resulting in serum concentrations of between 740 and 1370 ng/ml. Rabbits were killed at an age of 40 weeks and atherosclerotic plaque formation in various aortic segments was quantified. Atherosclerosis was most pronounced in the aortic arch and the thoracic aorta, plaques covering, respectively, 59 +/- 17% and 17 +/- 9% of total vessel area. These results are similar to those observed in a control group, which received the same diet and no nifedipine and displayed lesions on 62 +/- 19% and 21 +/- 13% of total area of aortic arch and thoracic aorta, respectively. Although variations in plaque area between WHHL rabbits are large and thus preclude the observation of small effects, the efficacy of nifedipine as an anti-atherogenic agent in rabbits with hereditary hypercholesterolemia appears questionable. PMID- 6497948 TI - Alcohol and body weight. PMID- 6497946 TI - Effect of polyunsaturated isocaloric fat diets on plasma lipids, apolipoproteins and fatty acids. AB - The effect of an increased polyunsaturated fatty acid concentration in the diet on the plasma lipoproteins from a normal group of healthy persons and from a group of hypercholesterolemic patients, consuming an isoenergetic and an isocholesterolemic diet, was examined and the changes in the plasma phospholipids were measured. Nine normal and 10 hypercholesterolemic patients were treated with a polyunsaturated diet for 1 month. Controls and hypercholesterolemic patients were screened on their lipid and lipoprotein profiles and their P/S ratio in the diet was calculated and increased with a factor 4. In the control group the P/S ratio was increased from 0.35 to 1.38 and in the hypercholesterolemic group from 0.46 to 1.59. They received the diet for at least 4 weeks before a second analysis of lipids and lipoproteins. The most important results are a decrease of plasma cholesterol, followed by a significant increase of HDL cholesterol. The cholesterol-lowering effect results largely from the plasma LDL decrease, especially in the patient group. Apo A-I is decreased accompanied by a significant increase of the ratio HDL-C/apo A-I. The observed changes are most pronounced in the hypercholesterolemic group. There is no change in apo B but a significant change in the linoleic acid concentration especially in the HDL cholesterol esters. The major phospholipids in plasma are identical in both groups and there is an identical change under the PUFA diet, sphingomyelin is increased and phosphatidylcholine is decreased, which may be related to an increase of the HDL2/HDL3 ratio. PMID- 6497949 TI - Fatal accidental hypothermia and alcohol. AB - A series of 51 fatal cases of accidental hypothermia in northern Sweden has been reviewed. The cases conform well to previous investigations with respect to the mean age of the victims (48 years) and a predominance of males. The cases occurred mainly during the winter months and on Saturdays. Most cases succumbed at temperatures below -10 degrees C. The most frequent necropsy findings were areas of frostbite with purple discoloration of the skin, reddish lividity and superficial erosions of the gastric mucosa. Paradoxical undressing was present in more than half of the cases. About two thirds of the cases were under the influence of alcohol with a mean blood alcohol concentration of 1.6 g/l. Furthermore, at least half of the cases could be considered habitual drunkards. In conclusion, the present series shows two main groups of fatal hypothermia victims: one group of elderly persons, mostly chronic abusers and under the influence of alcohol (approximately two-thirds of the series), and another of younger and sober persons, performing recognised sporting activities (approximately one-fourth of the series). PMID- 6497950 TI - Ethnicity and drinking in northern California: a comparison among whites, blacks and Hispanics. AB - This research reports the drinking patterns and alcohol problems in three ethnic groups of the U.S. population: Whites, Blacks and Hispanics. Respondents were sampled randomly from the general population of three counties of the San Francisco Bay Area, in northern California. Both Black and Hispanic females have higher rates of abstention than White females, but at the aggregate level male's drinking patterns are similar across ethnic groups. However, among males the patterning of drinking and the prevalence of alcohol problems by age change dramatically according to ethnicity. Among White males drinking and problems decrease abruptly from the twenties to the thirties, as has been traditionally found in the U.S. general population. Among Black males the trend is exactly the opposite of that for Whites, while among Hispanic males there also is a decrease but not quite so large as that for Whites, and the frequency of heavy drinking and problems is always higher than for the other two groups. The types of problem reported by respondents do not vary by ethnicity but the sociodemographic correlates of both number of drinks consumed per month and number of alcohol problems do differ among the ethnic groups. Both Hispanics and Blacks have more liberal attitudes toward alcohol use than Whites. These results suggest that Whites, Blacks and Hispanics each have a characteristic way of using alcoholic beverages. The less restrictive views towards alcohol use in the Black and Hispanic culture, as well as the different patterning of drinking and problems by age, are of importance for prevention: Whites, Blacks and Hispanics have different groups of people at risk for developing alcohol problems and prevention should be planned accordingly. PMID- 6497951 TI - Young people, drink and the law: a descriptive study covering two London magistrates' courts. AB - The survey sample consisted of 104 young people between the ages 17 and 25 who appeared in court charged with simple drunkenness, drunk and disorderly and drink and driving charges. Interviewing was carried out in two London magistrates' courts every weekday using a fortnightly rota over a six-month period. The results showed that the majority reported usually drinking in pubs and clubs; lager was the preferred alcoholic beverage. More than half the sample reported drinking in excess of 10 units, often considerably more (one unit = 1/2 pint of beer = 1 single measure of spirits = 1 glass of wine), on a drinking occasion. This rate of consumption was considered moderate drinking by a considerable number who were drinking either almost every day or at least once a week. Responses to a self-administered questionnaire showed that 40% had experienced some degree of psychological or physical dependence during the three months prior to their arrest. Of the sample 67% were surprised by the charge and 70% said that a court appearance would not make them more careful of their alcohol consumption in the future. PMID- 6497952 TI - Alcohol and expectancy--I. Perceived sex differences in the effects of drinking. AB - One hundred undergraduates freely listed the effects of male and female drinking. Results broadly agree with previous research conducted in the U.S.A. Generally speaking, male drinkers, in contrast to female drinkers, are expected to behave unpleasantly. PMID- 6497953 TI - Alcohol and expectancy--II. Perceived sex differences in the role of alcohol as a source of aggression. AB - Previous expectancy surveys associate aggression with male drinking. This study confirms the finding from a reversed standpoint. Students listed the causes of male and female aggression. Males ascribed a greater role to alcohol in aggression per se than did females; they also held narrower sexual stereotypes about causes. PMID- 6497954 TI - Alcohol consumption of undergraduates at Oxford University. AB - At the end of the fourth week of the spring term 1982, 734 female and 754 male undergraduates at Oxford University were sent a questionnaire inquiring about their alcohol consumption. Of the 561 women and 522 men who replied, 80% and 85% respectively had drunk alcohol during the previous four days. The mean consumption over the four days was 8 units (equivalent to four pints of beer) for the women and 15 units (equivalent to eight pints of beer) for the men. Two fifths of the alcohol consumed by women was in the form of wine and three-fifths consumed by men was in the form of beer. Sixteen per cent of female drinkers and 28% of male drinkers did try to limit or cut down their drinking although only four women and seven men consulted a doctor or a counsellor about their alcohol consumption. Student health services should be aware that alcohol may play a part in health or personal problems. Undergraduates might appreciate health education literature on alcohol. PMID- 6497955 TI - Alteration of acetaldehyde metabolism in carbon tetrachloride-intoxicated rat liver: analysis using liver perfusion system. AB - The heptic metabolism of acetaldehyde in carbon tetrachloride (CCl4)-intoxicated rats was studied using a non-recirculating haemoglobin-free liver-perfusion system. Acetaldehyde uptake by the liver from acutely CCl4-treated animals (4.16 mmol/kg,i.p.) at 24 hr after the treatment was not significantly altered, whereas that by the liver from chronically CCl4-treated animals (2.08 mmol/kg,i.p., twice a week, for 8-12 weeks) was decreased by approximately 50% when it was determined in the presence of 0.01-5 mM acetaldehyde. In liver from rats chronically intoxicated with CCl4, the following important biochemical changes were observed: (1) The activity of low Km aldehyde dehydrogenase (ALDH) in hepatic mitochondria was decreased by approximately 75%. (2) The basal levels of the lactate/pyruvate (cytosolic [NADH]/[NAD+]) ratio as well as the beta-hydroxybutyrate/acetoacetate (mitochondrial [NADH]/[NAD+]) ratio were elevated by more than 2-fold. (3) Mitochondrial NADH oxidation was also reduced by approximately 35% of the control level. (4) The basal level of hepatic oxygen uptake was attenuated by approximately 50%, and the infusion of acetaldehyde (0.01-5.0 mM) caused a further decrease in the uptake. (5) The rate of ethanol production from acetaldehyde by the catalytic action of alcohol dehydrogenase was found to be unaltered when low concentrations of acetaldehyde (0.01-0.2 mM) were used, whereas a significant suppression of the rate of ethanol production was detected in the presence of high concentrations of acetaldehyde (0.6-5 mM).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6497956 TI - Heterogeneity of human erythrocyte transketolase: a preliminary report. AB - A modified procedure for the preparation of transketolase from erythrocytes by dialysis and column ion-exchange resin chromatography is described. Changes have been made in the resin used, the column dimensions and the elution procedure so as to separate the enzyme with improved resolution, prepare the apoenzyme free of thiamine pyrophosphate and study the kinetics of its activation or reactivation by the coenzyme. On the basis of the elution profile of the enzyme activity from the chromatographic column, two different samples of the transketolase have been isolated, which differ not only in their isoelectric properties, but also in the proportion of the transketolase present in the apoenzyme form. Not only do the apoenzymes isolated from each of the two fractions differ in the way in which they recombine with thiamine pyrophosphate but kinetic analysis of the results shows that each fraction contains at least two variants of transketolase differing in their affinity for thiamine pyrophosphate. Three, probably four, separate variants have been identified which differ in their affinities for thiamine pyrophosphate over a range greater than 10(4). It is concluded that these two fractions of the enzyme must contain different subsets of the eight isoenzymes of transketolase of differing isoelectric points and that some of these isoenzymes must differ also in their affinity for the coenzyme. The implications of these findings for the Blass and Gibson hypothesis about the pathogenesis of the Wernicke-Korsakoff syndrome are considered. PMID- 6497957 TI - Pre-natal and post-natal effects of alcohol in the rat--I. Changes in body weight and exploratory activity. AB - The effects of chronic alcohol administration during the pre- and/or post-natal period on body weight and on exploratory behaviour in the "open field' apparatus were investigated. Alcohol was administered in increasing concentrations in a milk diet to the dams and/or their offspring so that the mean daily intake exceeded 12 g/kg body wt; this corresponded to a mean blood-ethanol concentration of 3 mg/ml. There was no evidence of malnourishment in the offspring of the alcohol-treated dams nor was there any difference in body wt gain between the offspring treated with the alcohol diet and those receiving an isocaloric diet. An increase in the ambulation score of the offspring exposed to alcohol during the post-natal period was observed and can be attributed to the direct effect of ethanol. No change in the ambulation score was noted in the offspring that had been exposed to alcohol during the pre-natal period. There was no change in the rearing scores of any of the offspring that had been exposed to alcohol during the pre- or post-natal period. PMID- 6497958 TI - Response rates in British general population surveys of alcohol consumption: a comparison. AB - A review of response rates obtained in 17 British general population surveys of alcohol consumption is presented. Response rates ranged between 66.8 and 90% (M = 78.5 +/- 8.0). High response rates were most likely when unlimited visits to establish contact were allowed. It is suggested that expensive efforts to enhance response rates in such studies may be unnecessary. No clear evidence of declining response rates was found. PMID- 6497959 TI - The role of alcohol in unplanned pregnancy. AB - About 25% of all pregnancies are unplanned. While age, marital status, social class and contraceptive practice have all been considered, little attention has been paid to alcohol as a possible aetiological factor. The present study based on a questionnaire was devised to ascertain the role of alcohol in conception. One hundred and sixteen pregnant women participated and these were attending the ante-natal clinic for the first time. In only 2 cases was alcohol thought to be a likely factor in conception although only a few had never consumed alcohol. A further study on 100 clients attending the regional day care abortion unit revealed that less than one tenth felt that alcohol was a factor in the conception. Unplanned pregnancies may result from alcohol consumption in less than 10% of cases, lack of motivation to use some form of contraception would appear to play a more prominent part. PMID- 6497960 TI - Drinking amongst pregnant women: some initial results from a prospective study. AB - A review is presented of the characteristics of the foetal alcohol syndrome (FAS). It is noted that in its most extreme form the FAS encompasses both physical and mental abnormalities. Some of the initial results are briefly presented from the first two phases of a Scottish prospective study. This relates to the patterns of alcohol use and misuse of 1008 pregnant women. These data indicate that self-reported alcohol consumption was slightly but significantly correlated with previous obstetric problems. In addition, a minority of the study group, due to their levels of alcohol consumption, may run an increased risk of giving birth to abnormal offspring. It is concluded that on the basis of current evidence those planning or experiencing pregnancy should be advised not to drink. PMID- 6497961 TI - Foetal alcohol syndrome. AB - Foetal alcohol syndrome (FAS) is the combination of growth retardation, neurological impairment and abnormal facies shown by some infants born to alcoholic women. It seems likely that FAS only indicates a small proportion of the total damage inflicted on the foetus by maternal drinking. Levels of alcohol consumption below the equivalent of 30 ml per day of absolute alcohol probably do not have a significant effect on the foetus. But there is an increased incidence of either growth retardation or behavioural and congenital abnormalities amongst the infants of women who drink heavily in pregnancy but who are not alcoholic. Such children are sometimes described as showing foetal alcohol effects and such effects are probably commoner than complete FAS. The way in which alcohol damages the foetus is unknown. Genetic and nutritional factors in mother or child may determine the response to alcohol. Smoking appears to potentiate the effects of alcohol on the foetus. Drugs may also alter the foetal response to alcohol. The prevalence of children damaged by maternal drinking is impossible to estimate. Foetal alcohol effects overlap with many other congenital and developmental abnormalities. FAS is more common than 1 in 2500 births in Liverpool and may even approach the incidence of 1 or 2 cases per 1000 births seen in U.S.A. and Scandinavia. PMID- 6497962 TI - Moderate drinking during pregnancy and foetal outcome. AB - Although there are many reports of the adverse effects of alcohol on the infant in ancient literature the first modern report was by Sullivan, Physician to Liverpool gaol. He showed an increased incidence of growth retardation and stillbirth in children of alcoholic mothers using their non-drinking relatives as a control. The literature on moderate drinking is contradictory and suffers from poor control of factors known to confound pregnancy outcome such as social class, parity and smoking habit. The other major problem in assessing the effect of moderate drinking is the difficulty in obtaining accurate drinking histories and the many and varied ways in which these are taken. All histories however, should be regarded as an underestimate. Moderate drinking (less than 40 g alcohol/day before and during pregnancy) has been related to growth retardation, a higher incidence of congenital abnormality, poorer behavioural and neurological scores in the newborn. Recent American surveys have shown an increased relative risk of mid-trimester abortion in women who drink more than three times a week in early pregnancy. Recent work in this country has demonstrated a trend toward smaller head circumference and reduced weight in the babies born to mothers consuming more than 100 g alcohol a week in very early pregnancy. The interaction between smoking and drinking is particularly important for this effect. Using logistic regression analysis the effect of drinking and smoking on birth weight can be clearly seen together with the effect of social class. For any impact to be made on this problem educational intervention is necessary before pregnancy is planned, and thus should be directed at pre-conception clinics, family planning clinics and the general practitioner's surgery. PMID- 6497963 TI - Alcohol and the young child. AB - With the increasing availability of alcohol in modern times, the child neglect and abuse portrayed in Hogarth's engraving Gin Lane may once again be witnessed. Reports occur occasionally of alcohol being given deliberately to infants to quieten them, but alcohol poisoning in the slightly older child is not uncommon. The introduction of child-proof containers has altered poisoning figures recently. However, alcohol poisoning tends to occur at ages 3 and 4, that is, about 2 years after the peak of all poisonings in children. This difference may be an indication that alcohol is taken in imitation of parents' drinking, a suggestion which has some support from reported cases of mouthwash poisoning. Holidays and high days where children and alcohol mix, are potentially dangerous periods. Since alcohol poisoning can be fatal, yet if recognised is relatively easily managed, every child with the slightest degree of drowsiness should be suspect until proven or not by blood alcohol. The prevention of alcohol poisoning in the young child consists in protecting the alcohol by lock and key, not setting an example by drinking or gargling in front of children. Many substances such as mouthwash and perfume should also be under supervision. Once actual poisoning has occurred blood sugar is probably more important than the level of blood ethanol and blood sugar levels should be monitored frequently and the child treated with glucose, preferably intravenously. PMID- 6497964 TI - Alcohol abuse in adolescence. AB - Twenty patients between the ages of 11 and 15 years who presented at hospital in 1981 having ingested alcohol were studied. Two were poisoned by another person. The data on the 18 adolescents who poisoned themselves were analysed in detail. Three groups emerged: A--4 patients had drunk alone as an experiment, act of mischief or act of defiance; B--9 patients had been involved in peer group activity; C--5 patients had either made an attempt at suicide or a plea for help. There was a predominance of females. The average age was 13 years 5 months. Most alcohol was obtained from the patients' own homes. The higher-proof beverages caused most problems. Four patients in group C combined alcohol with medicinal drugs and 2 of these had had previous episodes of self-poisoning. No clear evidence of habitual drinking emerged. Only those 8 patients who had emotional or behavioural problems prior to admission were followed up. The importance of the home as a source of alcohol and the pre-existing instability of many of the adolescents indicates that in the management of these young people and in any preventative work the whole family must be involved. PMID- 6497965 TI - Alcohol problems in pregnancy and childhood--where do we go from here? AB - The awareness of potential damage to the foetus caused by maternal drinking during pregnancy creates the need for a planned programme of education for young women of childbearing age. Prevention of foetal damage might best be achieved by commencing the education process with schoolchildren and adolescents but preconception and antenatal clinics must necessarily be 'foci of attention'. Thought must be directed to the content of the material presented and efforts made to tailor the information for target groups. A prime need is the proper instruction of all those who will be involved as educators to ensure a balanced approach. Primary prevention must be the mainstay of our efforts in the management of obstetric, neonatal and developmental problems resulting from alcohol consumption during pregnancy. PMID- 6497966 TI - Whither alcoholism? PMID- 6497967 TI - [The Oral Hydration Service of the Hospital Infantil de Mexico Federico Gomez]. PMID- 6497968 TI - [Rehydration by the oral route in newborn infants dehydrated by acute diarrheal disease]. PMID- 6497969 TI - [Teratomas in children. Study of 44 patients]. PMID- 6497970 TI - [A pilot clinic on sexual orientation and family life for adolescents]. PMID- 6497971 TI - [Oto-palato-digital syndrome and craniopharyngioma. Apropos of a case]. PMID- 6497972 TI - [Subcostosternal diaphragmatic hernia. Presentation of a case]. PMID- 6497973 TI - [Medical procedures for the oral hydration of children with diarrhea]. PMID- 6497974 TI - [Standards of acceptable manufacturing and inspection methods]. PMID- 6497975 TI - Validation of assay methods in pharmaceutical QC. Studies on tiropramide hydrochloride. PMID- 6497976 TI - Quantitative analysis of pharmaceutical products containing tetracycline hydrochloride by computerized dispersive infrared spectroscopy. PMID- 6497977 TI - [Radio-opaque organic iodates in plasma]. PMID- 6497978 TI - [The effect of sodium laurylsulfate on the electrokinetic potential of sulfadiazine particles]. PMID- 6497979 TI - [Morphometric observations on the number of neurons in spinal ganglia]. AB - Nerve cell number has been determined in the thoracic spinal ganglia XVII to XXII of chick embryos of 14-18 days of incubation. It is shown that these ganglia constitute a statistically homogeneous population in respect of the number of their constituent nerve cells. The statistical frequency distribution of the thoracic spinal ganglia according to the number of their neurons is unimodal, but markedly asymmetrical with a distinct positive skewness; the distribution differs significantly (P less than 0.05) from a normal (Gaussian) distribution. PMID- 6497980 TI - [Comparative microscopic anatomy of the urinary bladder of various domestic and wild ruminants]. AB - The Authors focus their interest on the microanatomical differences between urinary bladders of some domestic (sheep and cattle) and wild Ruminantia (roe and chamois). Sixteen urinary bladders of the following species have been studied by Azan, Masson and Weigert staining methods: Three urinary bladders of Ovis aries (L.) and Bos taurus (L.) drawn from animals of both sexes; seven urinary bladders drawn from female of Capreolus capreolus (L.); three urinary bladders from both sexes specimens of Rupicapra rupicapra (L.). It is possible to summarize the data on the compared microanatomy of urinary bladder in the following way: it presents three tunics: mucosa, muscularis and adventitia. The tunica mucosa is composed of lamina propria and transitional epithelium, and presents typical plicae which give a peculiar aspect to the lumen. In roe deer the lamina propria presents several smooth muscle fibers which are organized in an evident "muscularis mucosae" which is absent in all the studied species. The tunica muscularis is composed of two longitudinal (outer and inner) muscle layers and a middle circular layer. In roe this tunica is thicker and more powerful than in other species, and the single layers are more evident because of the presence of many connective septa. The tunica adventitia is composed of loose connective tissue, and some elastic fibers. Unexpectedly, the Chamois, which belongs to wild Ruminants as the roe, does not present a "muscularis mucosae". Therefore the authors suppose that the presence of "muscularis mucosae" in roe could be due to the ethology peculiar of this species which is accustomed to mark the boundary of its territory by staling frequently. PMID- 6497981 TI - [Electrophoresis of liver proteins from the rat under various physiological conditions]. AB - The total protein and glycoprotein in electrophoretic patterns of rat liver endoplasmic reticulum we studied in peculiar physiological conditions as perinatal development, pregnancy and liver rigeneration. Previous work in these experimental systems showed a changed microsome lipid composition and modified activities of some ER membrane bound enzymes. The microsomes obtained from foetal and neonatal liver show a modified electrophoretic pattern of both total protein and glycoprotein of low weight with respect to the adult animal. As to the microsomes of 8h and 12h regenerating liver modifications are observed only in the pattern of glycoprotein in the molecular weight range. PMID- 6497982 TI - [Effect of x-rays on the intracellular transport of thymidine in human lymphocytes stimulated by phytohemagglutinins]. AB - The effect of X-irradiation on thymidine transport in human lymphocytes PHA stimulated was investigated. Mediated transport sistem, the predominant mechanism at low extracellular concentration of thymidine (less than 10(-7) M) in the medium is highly radiosensitive. The transport sistem was damaged considerably by high doses of X-rays (at least until 10 Krad); the decrease of thymidine uptake was a function of the time of incubation after irradiation. It suggest that repair mechanisms are not involved at high doses of X-rays within 120 minutes of incubation. PMID- 6497983 TI - [In vitro conjugation of allyl alcohol and of its metabolites with reduced glutathione]. AB - Hepatic GSH is utilized in conjugation reactions with the chemically-reactive metabolite, thus its measurement is a useful indication of the extent of conjugation. The toxic effect of allyl alcohol on rat livers is related to its conversion into acrolein. The toxicity of acrolein could be related to further metabolic activation into acrilic acid and/or glycidaldehyde. Allyl alcohol may also be converted into glycidol. Since hepatic GSH is an important determinant of allyl alcohol hepatotoxicity, we have studied "in vitro" reactivity of GSH with allyl alcohol, acrolein and glycidol. The addition of these chemicals to incubation mixtures containing liver 105.000 g supernatant fraction, phosphate buffer and GSH leads to GSH consumption, as measured by the Ellman's method. All the compounds examined react with GSH when added to incubation mixtures containing or no SPM. These results seem to indicate that these chemicals react with glutathione either enzymatically or no. PMID- 6497984 TI - Calcium hormones in diabetic pregnancy. AB - To evaluate calcium hormones in diabetic pregnancy, eleven diabetic pregnant women were studied by measuring serum total calcium, phosphorus by conventional methods, and parathyroid hormone, calcitonin and 25-hydroxycholecalciferol, by radioimmunologic methods, serially every four weeks, beginning at 16th week throughout 36th week of gestation. Serum total calcium, phosphorus and parathyroid hormone levels dit not differ between diabetic and non diabetic pregnant women, nor between all pregnant women and age-matched non pregnant healthy women. Serum calcitonin levels, although significantly higher than those of age-matched non pregnant women, did not differ between diabetic and non diabetic pregnant women, maintaining constant with the progression of pregnancy. Serum 25-hydroxycholecalciferol levels, although contained within the normal range, increased significantly in the third trimester of gestation both in non diabetic pregnant women and, even though later, in diabetic pregnant women. PMID- 6497985 TI - [Variations in the catabolism of the acetylcholine receptor during aging]. AB - The time and modalities of degradation of the muscles acetylcholine receptor have been studied by several investigator, both in vivo and in vitro and under normal and pathological condition. The metod employed in this study for assessment of possible changes in the degradation to age involves the valutation of several parameters. These are explained and discussed. The preliminary results show the turnover of the receptor for junction acetylcholine, which is known to be considerably accellerated in conditions such denervation and myastenia, is slowed down during senescence. PMID- 6497986 TI - [Evaluation of the biological compatibility of bioglass with a new experimental model, the fibronectin binding test]. AB - The authors expose their results about the biological compatibility of Bioglass (BG), using a new experimental model; this model implicates the use of Fibronectin (FN), a glycoprotein involved in cellular adhesion. The term Bioglass indicates a family of glasses (of possible use as implants) with the formation of a stable calcium-phosphate film on their surface when in contact with an aqueous environment. Two types of BG, B5 and B6, have been incubated with FN; the first binds three times B6 the FN. The results are discussed considering other preliminary results. PMID- 6497987 TI - [The fibronectin binding test: proposal of an experimental model for the evaluation of the biocompatibility of materials of orthopedic interest]. AB - The Authors expose their experience about a new model for testing the biocompatibility of materials of possible use as implants in surgery. This model uses a glycoprotein, Fibronectin (FN) involved in cellular adhesion; FN was purified from human plasma by affinity chromatography on denatured collagen; the protein obtained by this procedure is about 95% pure. The best value of FN binding was found to be on bioglass B5 whereas in the case of Titanium Alloy and B6 an intermediate value was measured. Results may be discussed considering other preliminary results about cell adhesion. PMID- 6497988 TI - [Effects of vitamin A (retinol), Tioadenolo and a standard diet on the plasma lipid pattern in the rat on an atherogenic diet]. AB - The Authors have examined the action of large doses of vitamin A (2000 U.I./Kg diet) compared with that obtained by administration of a lipid lowering drug (Tioadenolo) and a standard diet in albino rats feed at first an atherogenic diet for 15 days. The "recovering" diets were adminisetred for 15 and 30 days. Serum components were obtained with routine chemical-clinical assay, membrane lipids and related fatty acids by the method of Folch in erythrocytes isolated by the method of Wipple. Both retinol and Tioadenolo lower blood plasma and cell membrane lipids more than a standard diet. PMID- 6497989 TI - [Changes in the metabolism of tryptophan in erythematosus]. AB - An abnormal tryptophan metabolism is present in patients affected by Erithematodes with high excretion particularly of kynurenines and xanthurenic acid. PMID- 6497990 TI - [Tryptophan metabolism in syphilis infections]. AB - Tryptophan metabolism "via kynurenine" is altered in lues: after a load of 50 mg/Kg b.w. of L-tryptophan the urinary excretion of kynurenine, 3 hydroxykynurenine and xanthurenic acid is increased, suggesting a deficiency of vitamin B6. PMID- 6497991 TI - A simple method for isolating osteoblasts from mouse calvaria. AB - A method for isolating osteoblasts from mouse calvaria, based on the capability of these cells to migrate onto plastic substrates, is reported. The osteoblasts migrate from small (1-2 mm2) regularly cut fragments of calvaria directly onto plastic surface as a continuous cellular sheet. Isolated osteoblasts retain a poligonal shape and the ability to initiate bone matrix formation in presence of B-glycero phosphate. The method is simple and provides a large quantity of osteoblasts ready to be used directly without the need of being detached and reseeded. PMID- 6497992 TI - [Relation between acute changes in diuresis and renal prostaglandins. I: Induced hypotonic polyuria]. AB - We have evaluated the effects of indomethacin (I) and of a rich in linoleic acid phosphatidylcholine (E) on the renal function and on the PGE urinary excretion during steady hypotonic polyuria. 5 normal subjects have been studied in the absence of treatment (TA) and after treatment with I, E, E + I. The renal function has been estimated by clearance (cl.) method during hypotonic polyuria induced by oral water loading and i.v. infusion of 5% dextrose solution. The glomerular filtration rate has been estimated by cl. of endogenous creatinine; moreover have been measured the osmotic clearances (Cosm, CH2O), the sodium and potassium clearances (CNa, CK), the mean arterial pressure (PA) and the urinary prostaglandins of E series (PGE) by RIA method. In I condition is observed: a) a trend to a glomerular filtration rate decrement; b) a significant decline of the urinary flow rate, CH2O, UPGV and a significant increment of the urinary osmolarity; c) a trend to an increment of potassium and a decrement of sodium urinary excretions; d) a significant increase of PA. It is possible that the contrary effects observed during the hypotonic polyuria in E condition depend on the stimulating effects of this material on the PG intrarenal synthesis. PMID- 6497993 TI - [Relation between acute changes in diuresis and renal prostaglandins. II. Induced antidiuresis]. AB - We have evaluated the effects of indomethacin (I) and of a rich in linoleic acid phosphatidylcholine (E) on the renal function during in bolo infusion of lysine-8 vasopressin (LVP). 5 normal subjects have been studied in the absence of treatment (TA) and after treatment with I, E, E+I respectively. Two clearance (cl.) periods have been performed in the following time intervals: 0-30 min and 30-60 min after in bolo LVP (1.5 m-U.kg-1) infusion. Have been measured: the urinary flow rate, V, the endogenous creatinine cl., Cc, the osmotic clearances, Cosm, CH2O, the sodium and potassium cl., CNa, CK, the urinary prostaglandins (PG) of E series excretion (UPGV) by RIA method and the mean of arterial pressure (PA). 1) In TA condition LVP decreases V, Cosm, Cc, CH2O, CNa, CK and slightly increases the urinary osmolarity; these effects regress during the interval 30-60 min. 2) In I condition LVP produces a significant increment of PA and prolonged and intensified decrement of Cc, CH2O, V; in this condition the increase of urinary osmolarity is greater than in TA condition. 3) The E-treatment alone does not affect the LVP-induced renal effects; however the enhancement of these effects produced by I is attenuated in the presence of E though UPGV does not differ in I and E+I. PMID- 6497994 TI - [Hemispheric asymmetries in cortical electrical activity during sleep. I]. AB - The hypothesis of a predominance of the right hemisphere in stage REM as compared to NREM has been tested through a spectral analysis of the EEG recorded from left (T3) and right (T4) temporal sites in 5 young healthy right-handed male subjects. Variations in the asymmetry coefficient R - L/R + L in different sleep stages have been analyzed by one way ANOVAs and Sheffe's tests. The hypothesis of a progressive increase in left hemisphere activity throughout different REM cycles as one approaches final awakenings have been investigated by comparing variations in the asymmetry coefficient for epochs of REM and stage 2 NREM sampled in different phases of the REM cycle. EEG results do not support either the hypothesized stage dependent or cycle dependent variation in EEG activity during sleep. We question whether variations in EEG amplitude and synchronization can be used as indices of hemispheric asymmetries during sleep. PMID- 6497995 TI - [The direction of rapid eye movements as an indication of hemispheric asymmetry during REM sleep. II]. AB - The hypothesis of right hemisphere predominance in REM sleep and of an increase in left activity throughout the night have been tested by analyzing the distribution of vertical and of horizontal rapid eye movements (REMs) to the right and to the left during the first and the last REM periods in 5 right-handed subjects. Neither the expected superiority of REMs to the left nor variations along the REM periods were found. For vertical eye movements our data suggest a superiority of upward movements during REM. In waking some empirical evidences suggest a relationship between upward eye movements and right hemisphere functioning although to date no hemispheric model can explain it. PMID- 6497996 TI - Feeding behaviour following substantia nigra and globus pallidus stimulation in chronic cats. AB - It is known that the lesion of the nigrostriatal and pallidofugal systems causes an experimental condition comparable to the hypothalamic sindrome, with severe aphagia and adipsia. It was considered of interest to study the effects of the low frequency long-duration stimulation of the substantia nigra and the globus pallidus on feeding behaviour. Experiments were performed on eight chronic cats with electrodes implanted in SN (pars compacta) and in the GP (pars externa). In the 2 hours of observation the food intake and the number of food-taking acts were calculated. The stimulation was induced continuously in the former hour. The modification in food intake, also on the basis of somatic behavioural observations may be ascribed to motor impairment rather than to involvement of a motivational state. PMID- 6497997 TI - [Activation of the alternative complement pathway by Newcastle disease virus. I) Effect of the virus on the complement system in vivo and in vitro]. AB - The authors have studied the effect of the paramyxovirus of Newcastle disease on the complement system in the mouse. The results obtained show that NDV activate both in vivo and in vitro the alternative complement pathway, suggesting that the intervention of complement system during viral infections represents a general biological phenomenon. PMID- 6497998 TI - A radio-anatomical study in vivo on pancreatic ducts. AB - Pancreatography using fibroscopy is current practice in medicine and contributes to the diagnosis of diseases of the pancreas. The radiographic images obtained generally represent oblique projections which have little in common with classic anatomical diagrams. An analysis of 60 pancreatographic investigations considered normal (out of a series of 400 investigations made on various diseases of the pancreas) has been followed by a comparison between these radiographic results obtained in vivo with diverse anatomical classifications in current use. The conclusion is reached that pancreatography is morphologically reliable and that there is no correlation between the mode of ramification of the ducts and pathological conditions (with the exception of the pancreas divisum and the annular pancreas). PMID- 6497999 TI - Double vertebral artery in an Indian cadaver. AB - Double vertebral artery arising from the first part of the right subclavian artery was found in one of the 80 cadavers. The course and characteristics of the artery are described highlighting the possible applied importance in certain clinical and surgical conditions. PMID- 6498000 TI - Segmental agenesis of the internal carotid artery: angiographic aspects with embryological discussion. AB - The embryology of the internal carotid artery (ICA) shows that this vessel comprises from origin to termination six segments, i.e. cervical, petrous, vertical cavernous, horizontal cavernous, clinoid and cisternal segments. Each of these segments displays a specific course and limits, defined by the origin of the following embryonic arteries: ventral pharyngeal hyoid, mandibular, primitive maxillary, trigeminal, dorsal ophthalmic and ventral ophthalmic. Each segment is independent and may show agenesis. In such cases the internal carotid blood flow (hemispheric arterial supply) is rerouted to afford usual ICA supply distal to the agenetic segment. All congenital anomalies of the ICA can be described and understood on the basis of embryological data. The "aberrant internal carotid" can therefore be identified as a normal vessel. Differentiation can be made between congenital versus acquired absence of the ICA. This type of analysis should allow the clinician to recognize what are normal, albeit rare variations, rather than to mistake them for an abnormal condition requiring treatment. PMID- 6498001 TI - Radiological anatomy of the testicular vein. AB - Based on the study of 400 opacification procedures of the testicular vein performed in the course of exploration of male infertility, the authors describe certain hitherto poorly recognized radio-anatomical features. The normal radiological anatomy and numerous anatomical variations of the testicular venous system are presented. PMID- 6498002 TI - The place of anatomy in the medical curriculum in France: a noble past, a calamitous present, a precarious future. PMID- 6498003 TI - Anatomical basis of the surgical approach to the membranous urethra. AB - The pars membranacea is the short segment of the urethra traversing the floor of the perineum. The main anatomical obstacles encountered in the approach to the membranous urethra are the perineal body posteriorly, and the deep dorsal vein of the penis and preprostatic venous plexus, anteriorly. These obstacles must be borne in mind when performing a surgical approach to the membranous urethra. The perineal body is the main obstacle to the perineal approach and can be avoided by incision of the sagittal raphes (anobulbar and rectourethral raphes) posterior to it and up to the apex of the prostate. When the trans-symphysial or transpubic approach is used, detachment of the suspensory ligament and roots of the penis allows exposure of the preprostatic venous plexus whose inferior part lies over the membranous urethra. PMID- 6498004 TI - Anatomical bases of lateral thoracotomy without muscle transection. AB - The descriptive anatomy of the lateral thoracic wall and the topographical anatomy of the fifth intercostal space are used as bases for the description of the lateral approach to the thoracic cavity without muscle transection, considered by the authors as a "standard" approach to the thoracic cavity. PMID- 6498005 TI - Radiological anatomy of the vascularization of cranial dural arteriovenous malformations. AB - Knowledge of the radiological anatomy of the cranial dural vascularization allows a flexible and appropriate approach to the pretherapeutic investigation of cranial dural arteriovenous malformations. The variability of the origin of these arteries requires that several possible sources of vascular supply be investigated - internal carotid, internal maxillary, ascending pharyngeal, occipital and vertebral - and that each of their meningeal branches be known in detail. Finally, familiarity with the radiological anatomy of these vessels allows one to identify on routine angiography those vessels that may be a source of risk when performing techniques of endovascular therapy (pedicles supplying the cranial nerves, internal carotid and vertebral anastomoses). Each foramen at the base and vault of the cranium contains an artery to the dura mater. Accordingly, very precise topographical study, in particular of the cavernous region, can be made. PMID- 6498006 TI - Pregnancy outcome and health conditions of offspring of self-poisoned pregnant women. AB - Pregnancy outcome of 142 self-poisoned pregnant females is analysed. Thirty three pregnancies were terminated, 13 ended with fetal death. Health conditions of 96 livebirths are demonstrated in detail. PMID- 6498007 TI - Partial deletion of short arm of chromosome 18. AB - Three cases of partial deletion of the short arm of chromosome 18 (pll-pter) are presented. The cytogenetic and clinical features of the patients observed are compared to cases found in the literature. 18p-aberration produces a fairly unique phenotypic alteration, but on the sole basis of the clinical manifestation, without cytogenetic analysis, correct diagnosis cannot be established. PMID- 6498008 TI - Neonatal intensive care does not cause chromosome damage. AB - In three neonatal units a total of 30 gravely ill newborn infants requiring intensive care were investigated cytogenetically. The results were compared with those obtained in 28 matched control neonates. No significant difference in the frequency of chromosome breaks, gaps, satellite associations, and sister chromatid exchange was found between the two groups of neonates. PMID- 6498010 TI - Lymphocyte subpopulations in peripheral blood of small-for-gestational age and appropriate-for-gestational age preterm neonates. AB - The lymphocyte subpopulations were investigated in peripheral blood of small-for gestational age (SGA) and appropriate-for-gestational age (AGA) preterm newborns. In SGA newborns the number and percentage of T lymphocytes were reduced. Among the T lymphocytes, the number and percentage of T helper cells were significantly decreased. The cytotoxic/suppressor T cells were also reduced, but to a lesser extent. PMID- 6498009 TI - Plasma somatomedin activity and nutrition in the newborn infant. AB - Plasma somatomedin activity was measured by postnatal pig cartilage bioassay in 11 full term normal for dates, 10 preterm normal for dates and 5 full term small for dates newborn infants on the 2nd, 5th and 10th day after birth. On day 2 mean somatomedin activity was lower than in the adult in all three groups of infants. After that, a slight but not significant rise in somatomedin activity occurred in the full term but not in the preterm infants. No significant correlation was found between somatomedin activity and calorie, protein, lipid or carbohydrate intake. PMID- 6498011 TI - Zinc, copper, manganese and gold content of the hair of infants. AB - In the hair of 41 normal newborn children the amounts of the trace elements zinc, copper, manganese and gold were followed up longitudinally by neutron activation analysis, the samples being taken on the 1st day of life, between the 63th and 109th days, the 200th and 240 th as well as between the 368th and 478th days of life. In the newborn children no correlations among their hair trace elements themselves and with the duration of normal pregnancy, birth weight, weight percentiles according to Lubchenko et al. [21] and birth length were found. The zinc content of 212 +/- 63 ppm, the copper content of 8.1 +/- 2.3 ppm and the manganese content of 0.211 +/- 0.366 ppm agreed well with values in the literature from different parts of the world. The hair gold content was found to be 0.086 +/- 0.006 ppm. In early childhood the trace element contents do not exhibit any dependence on sex. The investigation of trace elements in the hair of babies resulted in the remarkable observation that in the first three months of life zinc, copper and gold contents shows a considerable increase to multiple levels of the birth values, followed by a decrease. This is important for the interpretation of hair trace element analyses in infants. There are significant positive correlations among zinc, copper and gold contents in hair. It must be emphasized that gold, although classified as a non-essential element, behaves in the hair of infants just like the physiologically important essential trace elements zinc and copper.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498012 TI - [Neuropsychological and electroencephalographic study on the West syndrome and the Lennox syndrome]. PMID- 6498013 TI - [Anatomy of the human fetal brain of 23 weeks' gestation: a comparative study of structural volumes with adult brains]. PMID- 6498014 TI - [Polysomnography on lissencephaly]. PMID- 6498015 TI - [Lacunar infarcts in childhood: clinical and computed tomographic correlations]. PMID- 6498016 TI - [Developmental changes of topographic EEG features in the newborn]. PMID- 6498017 TI - [Anesthesia-induced rhabdomyolysis in a patient with Fukuyama-type congenital muscular dystrophy]. PMID- 6498018 TI - [Two siblings with beta-galactosidase-neuraminidase deficiency (galactosialidosis) developing clinical symptoms in early childhood]. PMID- 6498019 TI - [Linear nevus sebaceous syndrome: report of a case and a review of the literature]. PMID- 6498020 TI - [A computed tomography study of myotonic dystrophy]. AB - Mental symptom is one of the characteristic features in myotonic dystrophy, but documentation of mental signs including pathological changes of the brain has been imprecise. An attempt to show the involvement of the central nervous system by CT scan and EEG has been done in our department. The material consists of 14 patients 10 males and 4 females, from 15 to 50 years of age. CT scan of the 14 patients showed diffuse enlargement of lateral and third ventricles without definite atrophy of cerebral cortex and brainstem. Measurements of various parts of the ventricles showed a difference and an increase with age of values compared with that obtained from 49 neurologically normal persons (P less than 0.01). Main findings of EEG taken from 7 patients were slowing and low voltage of background activity, and 4 patients showed monotonous alpha waves. Both asymmetry and paroxysmal waves were not found. There was no significant correlation between the degree of ventricular enlargement and the frequency of the alpha activity (P greater than 0.05). Our study reveals that the ventricular enlargement is more correlated with aging than the severity of muscle involvement or the degree of mental deterioration. This fact possibly reflects a progressive nature of the pathology of the brain, especially the white matter. PMID- 6498021 TI - [Case of cerebral aneurysm producing the aberrant regeneration of the oculomotor nerve]. AB - We reported a 61-year-old woman who developed the associated movements in oculomotor muscles after the clipping of the IC-PC aneurysm which had produced the oculomotor palsy. It has generally been assumed that the phenomenon is the result of an aberrant regeneration of oculomotor nerve fibers. The sign of the aberrant regeneration may include any of the following: Pseudovon Graefe sign: retraction and elevation of the lid on downward gaze. Gaze lid dyskinesis: elevation of the involved lid on adduction of the eye. Inability to elevate or depress the globe: the globe neither elevates nor depress in up or down gaze. Retraction of the globe: the globe can be seen to retract on vertical movement. Adduction of the involved eye on attempted depression or elevation. Pseudo-Argyll Robertson pupil: the dilated pupil will not react to light but will contract when the medial rectus, inferior rectus, or elevators of the eye are stimulated. Monocular optokinetic response: in testing the vertical optokinetic response, the normal eye responds as usual but the affected eye either remains stationary or will show a slight horizontal nystagmus. All but category 4 were noted in our case. PMID- 6498022 TI - [Development of tetany in siblings suffered from Bartter's syndrome]. AB - The present authors observed and treated a siblings case of normocalcemic tetany, which is considered as belonging to Bartter's syndrome. As far as we know, there are a number of familial cases of tetany in literature, but none of them spreads over more than two generations, so that the tetany appears to be recessive in hereditary characters including our patients. Both of them presented tetanic seizures in the course of Bartter's syndrome and they were regarded as one of various manifestations of the syndrome. In other words, the Bartter's syndrome or the hypopotassemia should be one of the fundamental disorders for developing tetanic symptom. The tetanic symptoms became extinct during the treatment with spironolactone against hypopotassemia. Of the two patients, younger sister had shown an agitated depression developed on her childish and over-sensitive personality, but the depression was improved in parallel to the recovery from tetany and hypopotassemia. Therefore, it appears to be certain that the patients would have some premorbid deviation of personality traits, where symptomatic psychoses could be attributed, in the case of Bartter's syndrome. Generally speaking the psychic disorders, such as personality deviation and psychotic episode, seem to by very important symptoms in patient with Bartter's syndrome as well as in patient with hypocalcemia or hypoparathyroidism. PMID- 6498023 TI - [Clinical studies of meningeal gliomatosis]. AB - Ten (23%) patients out of 43 with malignant glioma developed meningeal gliomatosis during the follow up period of at least one year. The duration between the first surgery and diagnosis of meningeal gliomatosis ranged from one to 78 weeks (median 45 weeks). In younger age group less than 20 years old, 5 (56%) out of 9 patients had meningeal gliomatosis, and on the contrary the incidence was lower in older age group above 20 years old (5 of 34, 15%). Seven (22%) out of 32 male and 3 (27%) out of 11 female patients developed meningeal gliomatosis. The primary tumor location were frontal lobe in 4 cases (including one bifrontal tumor), temporal in 2, parieto-occipital in 1, thalamus in 1, midbrain in 1, and cerebellar hemisphere in 1, respectively. Histologically, 7 tumors were anaplastic astrocytoma, and 3 were glioblastoma. The characteristic neurological findings observed during the course of meningeal gliomatosis were abnormal mental status (80%), cranial nerve palsies (50%), paraplegia (60%), stiff neck (80%), seizure (50%), and respiratory disturbance (80%), CSF cytology was positive in all 9 patients tested. CT scan demonstrated hydrocephalus (70%), and diffuse contrast enhancement of ventricular wall (60%) and basal cistern (10%). In 2 cases, block and irregular filling defect were seen by myelography. Six patients were treated by irradiation to the whole brain and/or spine, and 5, by intrathecal chemotherapy with methotrexate, cytosine arabinoside and bleomycin. However, all patients died of the tumor one to 46 weeks (median 18 weeks) after the diagnosis of meningeal gliomatosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498024 TI - [Brain death in a neurosurgical unit in Japan]. AB - Walker states that the incidence of brain death accounts for approximately 1% of all deaths, so that brain death is a common state. According to Jennett et al, the occurrence of brain death is now a relatively frequent event, with about 4000 cases each year in Britain. But the actual circumstances of brain death can not be discovered from any published report. During the last 11 years (1973-1983) at Kyorin University Hospital, we studied 121 cases diagnosed as brain death according to Japanese criteria. The Japanese criteria requires that the pathology be a gross primary brain lesion, so did not concern ourselves with brain deaths due to secondary brain damage. We analysed the factors associated with brain death, that is the annual incidence, age, sex distribution, primary diagnosis and elapsed time from brain death to cardiac death. The increasing incidence of brain death in the last 5 years is probably due to a rise in severely brain-damaged patients (Table 1). In the age distribution, the high number of patients in their fifties presumably reflects the human age tendency for traumatic and vascular disorders respectively (Fig. 1 and Table 2). The fact that males predominate relates to the greater risk faced regarding cerebral trauma (Table 3). The primary diagnoses were cerebrovascular accidents in 60% of the cases especially subarachnoid hemorrhage in 41%, head injury in 31% and brain tumor in 9% (Tables 4 and 5). The elapsed time from brain deaths is measured from diagnosis of clinical brain death to cardiac asystole (Fig. 2). All patients had final cardiac asystole while still being ventilated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498025 TI - [Potent convulsant effects of a benzodiazepine inverse agonist, methyl beta carboline-3-carboxylate in cats]. AB - The convulsant properties of methyl beta-carboline-3-carboxylate (beta-CCM), which is a homologue of a putative benzodiazepine receptor ligand in the mammalian central nervous system, were examined in cats. Subcutaneous injection of 0.5 mg/kg of the beta-CCM produced various degrees of myoclonic jerks always accompanied by cortical spike burst. Some autonomic symptoms such as tachypnea, hypersecretion of thick mucous saliva, vomiting and mydriasis were also presented. Subcutaneous injection of 1.0 mg/kg of the compound induced a generalized tonic-clonic convulsion. Injection of the same amount of the drug 1 hour later in the same cats failed to provoke a generalized seizure. Repeated injection of the same dose 3 hours later provoked a generalized seizure, but with a longer latency. However, repetition of the experiments 24 hours after or 10 days after the first injection consistently induced the same type of generalized seizure with the same latency as the first injections. These results support the suggestion that the pharmacological effect, especially the convulsive effect, of beta-CCM is dose-related, reversible and reproducible in the same cats and among different cats. Moreover, the postictal refractory period in this model of epilepsy may continue about for 3 hours. PMID- 6498026 TI - [Nuclear magnetic resonance study of the immature rat brain]. AB - Using rat brains, the maturational change on the water contents and on the proton NMR signals were studied in this laboratory. Water contents, the proton longitudinal relaxation time (T1) and the transverse relaxation time (T2) were measured on the samples from gray and white matters, separately. A constant decrease of these parameter values was observed in relation to the development of the brain. Water content of 1 week-old rat was 88.393 +/- 1.19% in the gray matter (G) and 88.63 +/- 1.96% in the white matter (W). These values decreased gradually and reached adult rat level when the animals became 5 weeks old: 81.47 +/- 1.67% in G and 79.45 +/- 2.39% in W. No marked change on the brain water content was observed thereafter, T1 values of immature (one week-old) rat brain were 1.755 +/- 0.088 sec in G, and 1.832 +/- 0.154 sec in W, while T1 values of the adult rat brain were 1.327 +/- 0.043 sec in G, and 1.297 +/- 0.039 sec in W, respectively. A marked difference was observed on the values of T1 between the immature and the adult rats. T2 value of the 1 week-old rat brain was 101.05 +/- 10.20 msec in G, and 102.75 +/- 8.10 msec in W, respectively. T2 of the mature rat brain was 56.90 +/- 2.61 msec in G, and 54.52 +/- 2.35 msec in W, respectively. A statistically significant correlation was proved between the water content and the proton relaxation time (either T1 and T2).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498027 TI - [Minimal-flow xenon and semiclosed circuit anesthesia for computed tomographic measurement of local cerebral blood flow (LCBF)]. AB - For the purpose of decreasing the volume of expensive xenon, anesthesia with minimal-flow xenon and semiclosed circuit were induced for computed tomographic LCBF measurement. Eighteen patients with ischemic cerebral disease were studied. Anesthesia was induced with minimum dose of thiopental, diazepam and fentanyl. Muscle relaxation was obtained by means of pancuronium bromide. Patients were intubated and ventilated mechanically with flows of 6 l/min. O2 for 20 to 30 minutes to eliminate nitrogen from the system. O2 concentrations in semiclosed circuit were monitored throughout the procedures using galvanic battery. Endtidal CO2 tension was also measured for maintaining normocarbia. Blood gas analyses were carried out before xenon inhalation, during xenon inhalation and immediately before stopping inhalation of xenon-oxygen mixture. Xenon inhalation programs were subdivided into three groups, each of them consisted of 6 patients. The formula for calculating fresh gas flow for low flow semiclosed circuit was introduced according to Shimoji's which was based on the original formula of Foldes. O2 concentration in circuit was predicted to be 25%. Mean xenon uptake for initial 20 minutes was predicted to be 125 ml/min. or 360 ml/min. (Formula: see text) (CRO2: O2% in semiclosed circuit. FO2: fresh O2 flow ml/min. FXe: fresh xenon flow ml/min. VO2: oxygen consumption ml/min. VXe: mean xenon uptake ml/min.) The first group started xenon inhalation during pure xenon inflow into semiclosed circuit for two minutes and followed by about 68% xenon in O2 inhalation for 23 minutes. FXe and VXe were fixed at 700 ml/min and 360 ml/min respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498028 TI - Cardiology at the crossroads. PMID- 6498029 TI - Implications of precordial ST segment depression during acute inferior myocardial infarction. Arteriographic and ventriculographic correlations during the acute phase. AB - Thirty two patients presenting with acute transmural inferior wall myocardial infarction underwent cardiac catheterisation and angiography within 12 hours of the onset symptoms. Twelve lead electrocardiograms performed within one hour of catheterisation showed ST segment depression in the anterior precordial leads in addition to inferior wall changes in 17 patients and no ST segment changes in the anterior leads in 15. When the clinical, arteriographic, and ventriculographic variables were compared between the two groups no significant differences were noted with regard to age, sex, risk factors for coronary disease, duration of symptoms before angiography, Killip class, number of inferior leads with ST segment elevation, or initial serum creatine kinase activity. The extent of coronary artery disease as well as the prevalence of severe disease in the left anterior descending artery were similar for both groups. Biplane left ventriculography showed no significant differences between the two groups with regard to global ejection fraction or to the prevalence of posterolateral or anterior segmental wall motion abnormalities. PMID- 6498030 TI - Factors affecting left ventricular function after correction of tetralogy of Fallot. AB - To investigate the possible causes of left ventricular dysfunction after total correction of tetralogy of Fallot, 84 patients, aged 1 1/2 to 16 years, were studied by left ventricular cineangiography both before and a mean of 4.6 months after operation. Left ventricular ejection fraction and mean velocity of circumferential fibre shortening were calculated; using multivariate analysis the results were correlated with age at operation, the degree of hypoxia and polycythaemia before operation, occurrence of hypoxic spells, and the duration of operative procedures (cardiopulmonary bypass and aortic cross clamping). The postoperative left ventricular ejection fraction was decreased slightly or moderately in 46% of patients. The variable most significantly associated with altered left ventricular function was a history of hypoxic spells. Age, the degree of chronic hypoxia, and polycythaemia did not correlate significantly with left ventricular function indices. Although no correlation was found between the duration of cardiopulmonary bypass and left ventricular ejection fraction, bypass times exceeding 120 minutes were associated with decreased ejection fractions; this was statistically significant and independent of the variable "hypoxic spells". Thus repeated episodes of acute hypoxia and long operative procedures appear to have a deleterious effect on left ventricular function in tetralogy of Fallot. PMID- 6498031 TI - Echocardiographic and anatomical correlations in fetal congenital heart disease. AB - In a series of 1600 pregnancies 34 cases of congenital heart disease were correctly identified by fetal echocardiography. In each case echocardiographic diagnosis was confirmed by anatomical study. Termination of pregnancy was done electively in 14 cases: in six because of the identification of a cardiac anomaly and in the remaining eight because of multiple congenital anomalies. The remaining 20 fetuses died subsequently owing either to the complexity of congenital heart disease or to associated extracardiac abnormalities, which were present in more than half the fetuses with congenital heart disease. There were eight errors in interpretation of the fetal echocardiogram. The outcome of the pregnancy was not influenced by the error in any case. Fetal echocardiography can predict correctly structural malformations of the heart. The technique is sufficiently reliable to give an accurate prognosis in early pregnancy and provide the basis for alterations in obstetric management. PMID- 6498032 TI - Mitral valve replacement in the first three months of life. AB - Two infants, aged 2 and 3 months, underwent mitral valve replacement with Bjork Shiley mechanical valves for severe congenital mitral regurgitation not amenable to valve repair. Both infants survived the operation and left hospital taking a low dose aspirin anticoagulant regimen. One child survived for three years without incident, but the other died at 11 months of pneumonia after valve replacement for tissue ingrowth and subsequent thrombosis. PMID- 6498033 TI - Pulmonary vascular disease in different types of congenital heart disease. Implications for interpretation of lung biopsy findings in early childhood. AB - Pulmonary vascular structure was studied by analysing serial reconstructions of the arterial pathways and random sections of tissue in the lungs of 16 children who died with different types of congenital heart disease and pulmonary hypertension. Cases of ventricular septal defect showed an appreciable increase in muscularity of both preacinar and intra-acinar (respiratory unit) arteries, and intimal proliferation was infrequent and mild. By contrast, cases of transposition of the great arteries with ventricular septal defect and atrioventricular septal defect showed an increase in preacinar muscularity, a short heavily muscularised arterial segment containing intimal proliferation at the entrance to the acinus, whereas the intra-acinar arteries beyond showed only a moderate increase in muscularity. In these children who were less than 1 year of age an increase in pulmonary vascular resistance was due to strategically placed small areas of intimal proliferation and not to widespread obliterative pulmonary vascular disease. The study demonstrated and explained differences in the appearance of the peripheral pulmonary arteries in different types of congenital heart disease, which help interpret the findings of lung biopsies. PMID- 6498034 TI - Radionuclide measurement of left ventricular ejection fraction in tricuspid atresia. AB - In 15 patients with tricuspid atresia and one with tricuspid stenosis the left ventricular ejection fraction was measured by equilibrium gated radionuclide angiography and the results compared with those from a control group of 16 patients. The patients with tricuspid atresia had a significantly depressed ejection fraction. Those who had a surgical shunt or who had had pulmonary artery banding had significantly lower ejection fractions than the remainder. There was no significant correlation between the ejection fraction and age, the arterial oxygen saturation, or the haemoglobin concentration. Five patients were also studied during isometric exercise; three had an abnormal response. Volume overload of the ventricle is identified as one cause of the dysfunction, but other factors may be important. Radionuclide angiography offers a non-invasive method of studying ventricular function in this condition. PMID- 6498035 TI - Pulmonary vascular structure in patients dying after a Fontan procedure. The lung as a risk factor. AB - Pulmonary vascular structure was analysed in the lungs of 12 patients who had had a Fontan repair, 11 of whom died. Of the eight patients with a low pulmonary blood flow preoperatively, pulmonary vascular structure was almost normal in seven, but in the remaining patient many intra-acinar arteries contained organised occlusive thrombi. Of the four patients with an increased pulmonary blood flow immediately before operation, there was a significant increase in pulmonary vascular smooth muscle despite three of the patients having had a pulmonary arterial band. The findings suggest that it is more difficult for patients with an increased pulmonary blood flow to fulfil the Fontan criteria for repair, and even when the pulmonary vascular resistance is less than 4 units/m2 there may be significant pulmonary vascular abnormalities likely to increase right atrial afterload and prejudice the outcome of a Fontan repair. PMID- 6498036 TI - Increase in reflex vasoconstriction with indomethacin in patients with orthostatic hypotension and central nervous system involvement. AB - Since indomethacin may be effective in the treatment of orthostatic hypotension, the ability of this drug to increase reflex vasoconstriction was studied in six patients with orthostatic hypotension and in five normal subjects. Reflex forearm vasoconstriction during lower body negative pressure at 20-40 mm Hg was measured before and after indomethacin 50 mg by mouth. In patients with orthostatic hypotension and central nervous system involvement indomethacin increased recumbent blood pressure, resting forearm vascular resistance, and reflex forearm vasoconstriction during lower body negative pressure. The fall in blood pressure with lower body negative pressure was not significantly inhibited by indomethacin, but mean blood pressure during lower body negative pressure was higher after than before indomethacin. Indomethacin did not alter these responses in normal subjects. The increase in reflex vasoconstriction with indomethacin may contribute to its therapeutic effects in the treatment of orthostatic hypotension. PMID- 6498037 TI - Coronary artery obstruction associated with congenital aortic valve disease. AB - Abnormal attachment of the aortic valve caused obstruction to left coronary arterial flow in a young girl, who presented with angina of effort. Aortic valve and root replacement resulted in the patient's effort tolerance returning to normal with resolution of the exercise electrocardiographic and angiographic abnormalities. This case emphasises the importance of an awareness of the existence of such defects and their amenability to surgical correction. PMID- 6498039 TI - Chordal rupture: aetiology and natural history. PMID- 6498038 TI - Aortic root abscess complicating bacterial endocarditis. Demonstration by computed tomography. AB - A 68 year old man with an aortic valve prosthesis was admitted to hospital with Staphylococcus aureus endocarditis. Despite antibiotic treatment he continued to be pyrexial. Computed tomography identified a probable abscess between the root of the aorta and the left atrium. The presence of an abscess in this location was subsequently confirmed at operation. Computed tomography is a useful additional diagnostic method for identifying this potentially lethal complication of bacterial endocarditis. PMID- 6498040 TI - The computer and anaesthesia. PMID- 6498041 TI - A reassessment of the validity of the iso-shunt graph. AB - The iso-shunt diagram was introduced in 1973 to simplify the selection of the optimal inspired oxygen concentration in patients undergoing intensive therapy. A further study of 25 patients in a District General Hospital showed that plots of arterial PO2 against inspired oxygen concentration closely follow predicted iso shunt lines. There was no significant difference in calculated mean values for shunt with inspired oxygen concentrations between 30 and 100%. Results are compared with other studies and it is suggested that some reported discrepancies may be explained by the reduced response of many polarographic electrodes when measuring high values for arterial PO2. PMID- 6498042 TI - Sore throat after intubation of the trachea. AB - Eighty female patients were allocated randomly to groups, divided in three ways, to investigate the effects of using cuffed p.v.c. v. red rubber tracheal tubes, intermittent adjustment of the cuff volume, and humidification of inspired gases on the incidence and severity of sore throat after tracheal intubation. In addition, the influence of the anaesthetist's participation in the trial was studied by assessing sore throat in a further 60 female patients where the anaesthetists were unaware of the trial. There were no significant differences between any of the groups despite using three sensitive methods of assessment. In terms of the simple discrimination between "sore throat" and "no sore throat" the 95% confidence limits of the differences of incidence were generally +/- 15-20%. If there are any real differences produced by these changes, and if any of them were as large as 15% then, to show with 95% confidence that any difference is at least 10%, would require a trial involving about 1400 patients. Retrospective analysis of the results showed no difference between patients who received suxamethonium and those who did not. PMID- 6498043 TI - Gas exchange and haemodynamics during thoracotomy. AB - Cardiac index, systemic and pulmonary arterial pressures, carbon dioxide elimination and ventilation of each lung were studied during thoracotomy. Seventeen patients, placed in the full lateral position, were ventilated mechanically through a Carlens' tube to moderate hypocapnia. Mean cardiac index increased by 12% as the pleura was opened (P less than 0.05), with no further change during surgery on the still ventilated upper lung. Mean arterial pressure was unchanged after opening the pleura, but decreased from 114 +/- 15 mm Hg (mean +/- 1 SD) to 104 +/- 18 mm Hg during surgery on the lung (P less than 0.01). Mean pulmonary artery pressure was unchanged. There was a significant (P less than 0.01) increase in carbon dioxide elimination from the upper lung when the pleura was opened. In addition, the ventilation of this lung increased significantly (P less than 0.05). Mean end-tidal PCO2 of the lower lung increased from 4.1 to 4.2 kPa after opening the pleura, while that of the upper lung increased from 3.0 to 3.6 kPa (P less than 0.01). VD/VT decreased from 43 to 38% as the pleura was opened (P less than 0.01). During surgical handling of the lung, marked decreases in ventilation, compliance, carbon dioxide elimination and end-tidal PCO2 were observed in the upper lung. We conclude that ventilation-perfusion mismatch decreased on opening the pleura, and that neither opening the pleura nor the subsequent lung surgery (both lungs being ventilated) caused any clinically important derangements in haemodynamics or oxygenation. PMID- 6498044 TI - Choice of local anaesthetic drug for extradural caesarean section. Comparison of 0.5% and 0.75% bupivacaine and 1.5% etidocaine. AB - One hundred women undergoing elective lower uterine segment Caesarean section under extradural anaesthesia received either 0.5% or 0.75% plain bupivacaine or 1.5% etidocaine with adrenaline 1:200 000 by random allocation. The time taken to establish satisfactory blockade for surgery was significantly shorter in the etidocaine group compared with either of the bupivacaine groups (P less than 0.001). There were no significant differences in the durations of either analgesia or motor blockade in the three groups. The efficacy of the sensory blockade, measured by the incidence of discomfort during the surgical procedure and the requirements for supplementary analgesia or general anaesthesia, was greater in the bupivacaine groups compared with the etidocaine group. Measurement of plasma bupivacaine concentrations in 34 of the patients revealed significantly increased umbilical venous concentrations at the time of birth in those who received 0.75% bupivacaine (P less than 0.05). There was no advantage in the use of bupivacaine in concentrations exceeding 0.5%. Etidocaine 1.5% may be of some value in situations where minimal delay in establishing adequate extradural blockade for surgery is desirable, but in view of its comparatively poor analgesic effects, routine use is not recommended. PMID- 6498045 TI - Fixation of extradural catheters by means of subcutaneous tissue tunnelling. AB - In 100 patients treated for chronic pain, extradural opioids were administered by means of catheters which were tunnelled subcutaneously. Seventy-three per cent of patients needed only one catheter and 15% had a catheter in place for more than 100 days, the longest being for 434 days. In only 18 patients was the catheter displaced accidentally from the extradural space. There were no instances of extradural infection, although in three patients the tunnel became infected. We conclude that fixation of extradural catheters by subcutaneous tunnelling is a simple method which provides adequate security in clinical practice. PMID- 6498046 TI - Effect of posture on extradural pressure. AB - Extradural pressure was measured in the lateral and the supine positions in three groups of patients using the extradural catheter as a manometer. The groups consisted of 20 pregnant patients at or near term, 10 patients in the period after childbirth and 10 male surgical patients. In every patient, the extradural pressure in the supine position was greater than that in the lateral position. The mean extradural pressures in the lateral and the supine positions were similar in the three groups. It is suggested that the difference between the extradural pressures in the lateral and the supine positions is physiological and occurs irrespective of vena caval compression. Extradural pressure changes are probably the result of postural changes in the cerebrospinal fluid (CSF) pressure. The influence of CSF pressure on extradural pressure was confirmed further by measuring the extradural pressure in the prone position in five pregnant patients. PMID- 6498047 TI - Placental blood flow during caesarean section performed under subarachnoid blockade. AB - Subarachnoid blockade using 0.5% bupivacine after a "preload" of Ringer's lactate solution 1500-2000 ml i.v. was studied in nine patients undergoing elective Caesarean section. Ephedrine infusion 50 mg in 500 ml was instituted at the first signs of maternal hypotension in seven patients. Although significant decreases in mean maternal systolic, mean and diastolic arterial pressures were recorded, the individual decreases in pressure were less than 30 mm Hg in all except two patients. In general placental blood flow did not change, although there was a marked increase in one patient with toxaemia and a decrease in one woman with diabetes mellitus. The babies were unaffected at delivery. Preventive measures, especially the "preload" infusion, are important in the maintenance of adequate placental perfusion in patients undergoing Caesarean section under subarachnoid blockade. PMID- 6498048 TI - Kinetics of thiopentone in relation to the site of sampling. AB - Plasma concentrations of thiopentone were determined at frequent intervals over the first 12 min following injection i.v. in eight patients. Samples of arterial and peripheral venous blood were obtained in all subjects. In six, central venous and in two, internal jugular samples were obtained also. Thiopentone concentrations in arterial and central venous plasma did not differ significantly after 2 min. Differences between arterial and peripheral samples were significant for 2 min although, in some patients, considerable variability persisted for up to 9 min. In both patients from whom jugular venous samples were obtained, the difference between these and the peripheral plasma concentrations was marked. This difference may account for the appearance of acute tolerance. A computer model for this hypothesis is presented. PMID- 6498049 TI - Thiopentone pharmacokinetics in patients with chronic alcoholism. AB - The pharmacokinetics of thiopentone were compared in nine control patients and 10 patients with chronic alcoholism (without signs of cirrhosis or hepatitis) undergoing orthopaedic or abdominal surgery under general anaesthesia. The mean (+/- SD) alcohol intake was 92 +/- 14 litre of ethanol per year in the alcoholic patients and less than 10 litre yr-1 in the controls. Thiopentone plasma concentrations were measured by high pressure liquid chromatography after the administration of a single bolus dose (5-9 mg kg-1). The plasma clearance of thiopentone was significantly increased from 3.7 +/- 0.9 ml min-1 kg-1 in the controls to 5.4 +/- 2.2 ml min-1 kg-1 in the patients with chronic alcoholism. The volume of the central compartment and the total apparent volume of distribution were similar in both groups. The terminal elimination half-life was of 684 +/- 168 min in the alcoholics and did not differ significantly from the value found in the controls (750 +/- 212 min). PMID- 6498050 TI - Pharmacokinetics of lignocaine in children following caudal anaesthesia. AB - The time course of the plasma lignocaine concentration, following caudal anaesthesia, was studied in 11 healthy children (3.5-9 yr). Plasma lignocaine concentrations were measured for up to 6 h after administration (5 mg kg-1). Peak plasma concentration was 2.05 +/- 0.08 micrograms ml-1 and occurred at 28.2 +/- 2.9 min after administration. Pharmacokinetic parameters determined from a two compartmental model were similar to those observed after the i.v. or extradural administration of lignocaine in adults, except for a longer half-life of elimination (155 +/- 32 min). Since the total body clearance of lignocaine was similar in children (15.4 +/- 1.2 ml min-1 kg-1) to that in adults, the longer half-life of elimination was attributed to a larger volume of distribution in the children (3.05 +/- 0.40 litre kg-1). PMID- 6498051 TI - Effect of nitrous oxide on visual, auditory and somatosensory evoked potentials. AB - The effects of 10%, 30% and 50% nitrous oxide on visual, auditory and somatosensory evoked potentials were studied in seven healthy volunteers. The evoked potentials were averaged from the electroencephalogram following repeated peripheral sensory stimulation of the appropriate modality. Latencies and amplitudes of the resulting potentials were measured and compared with control values. In five subjects, increasing concentrations of nitrous oxide were associated with a graded reduction in amplitude of the visual (P less than 0.02) and somatosensory (P less than 0.02) evoked potentials. The latency of the first major negative potential of the visual evoked potential was significantly increased (P less than 0.02). Latencies of brainstem auditory evoked potentials did not alter. In the other two subjects the amplitudes of the visual and somatosensory evoked potentials showed graded increase with decreasing concentrations of nitrous oxide, confirming that the changes are dose related. As nitrous oxide is used almost universally during anaesthesia, these changes must be taken into account when assessing variations observed during operation in anaesthetic-related evoked potential studies. PMID- 6498052 TI - Haemodynamic and cerebral effects of ATP-induced hypotension. AB - Controlled decreases in mean arterial pressure to 20%, 40% and 60% of baseline were produced by the administration of increasing concentrations of adenosine triphosphate (ATP) i.v. in five anaesthetized baboons. Indices of the systemic circulation (arterial pressure, right atrial pressure, pulmonary artery pressures, cardiac output) and of the cerebral circulation (cerebral blood flow, cerebral metabolic rate for oxygen, cerebrovascular reactivity) were obtained as arterial pressure was decreased, and following discontinuation of the infusion of ATP. A neuropathological investigation was undertaken at the end of the experimental procedure. The infusion of ATP produced dose-dependent decreases in systemic vascular resistance and mean arterial pressure (MAP). Cardiac output and stroke volume were maintained close to baseline values, or increased slightly. Cerebral blood flow (CBF) increased initially (48 +/- 4 ml min-1/100 g to 68 +/- 9 ml min-1/100 g) and then decreased progressively as MAP was decreased to 40% and 60% of baseline. Cerebrovascular reactivity was shown to be impaired during, and for up to 90 min following, the administration of ATP. However, there was no morphological evidence of ischaemic cell damage in any animal. Tachyphylaxis was not observed during, and there were no instances of rebound hypertension following, the infusion of ATP. The concentration of uric acid had increased significantly by the 40% decrement in MAP, and remained so 60 min after the restoration of the arterial pressure. PMID- 6498053 TI - Microcomputer-based anaesthetic record system. AB - A system, based on the Apple II microcomputer, has been developed to collect cardiovascular data on-line from a non-invasive arterial pressure monitor. Off line data are entered as far as possible, with a light pen. All information is stored on disc for subsequent analysis. A coloured trend graph can be displayed on the screen. The trend graph and all the information entered off-line can be printed out at the end of the operation to form a complete anaesthetic record. PMID- 6498054 TI - Occurrence of malignant hyperpyrexia in a patient with osteogenesis imperfecta. AB - Probable malignant hyperpyrexia (MH) developed and was successfully treated in a 20-yr-old man during anaesthesia for reduction of a fractured mandible. The sister of this patient had died after an anaesthetic at the age of 14 yr, but malignant hyperpyrexia was not suspected. Subsequent enquiries revealed that the patient and his sister both had osteogenesis imperfecta. This case illustrates the infrequently reported association of malignant hyperpyrexia with osteogenesis imperfecta, and the difficulties in obtaining an adequate personal and family history of previous anaesthetics. PMID- 6498055 TI - Hydrogen bonding in mechanisms of anaesthesia tested with chloroform and deuterated chloroform. PMID- 6498056 TI - The relief of pain. PMID- 6498057 TI - Chronic cerebrovascular disorders: a clinical study with cyclandelate. PMID- 6498058 TI - Peroperative concentrations of ticarcillin in blood, gallbladder wall and bile. PMID- 6498059 TI - The diabetic hand--5 illustrative case reports. PMID- 6498060 TI - Chronic intussusception of Meckel's diverticulum. PMID- 6498061 TI - Response of differentiated but not anaplastic teratoma to interferon. AB - A Phase 2 trial was conducted using intramuscular lymphoblastoid interferon (IFN, Wellcome Research Laboratories), 4 MU per day, in 10 patients with chemotherapy resistant teratomas. There was stabilisation of disease in 2 patients both of whom were in retrospect considered to have had differentiated teratoma at the time of IFN administration. There was progression of presumed active anaplastic germ cell tumour in 8 patients. One of these patients, a 15-year-old boy with biopsy proven differentiated teratoma has received 2 courses of lymphoblastoid IFN and 1 course of recombinant leukocyte A IFN (Roche Products Ltd.) lasting 5 1/2, 8 and 8+ months respectively. He has had a mixed response in his differentiated tumour which on each occasion has been maintained for the duration that he received IFN. Rising HCG levels during his second course of interferon required additional cytotoxic chemotherapy. Lymphoblastoid IFN does not appear to be active against anaplastic germ cell tumours but both lymphoblastoid and recombinant leukocyte A IFN may be useful in the treatment of unresectable differentiated teratoma. PMID- 6498062 TI - Cytotoxic effect of dose and schedule on normal murine hematopoietic progenitor cells following the administration of 4'-deoxydoxorubicin. AB - In an experimental setting, 4'-deoxydoxorubicin (4'-deoxy-DX) shows minimal cardiotoxicity as well as the marked antitumoral activity shown by doxorubicin, its parent compound. In this experimental study, the haematologic toxicity of the new anthracycline was investigated by haematopoietic precursor cell (HPC) assays using in vivo (colony-forming units - spleen, CFUs) and in vitro (CFUc-culture) methods with (C57B1 X C3H)F1 mice. Dose-survival curves and time response of HPC in situ following 4'-deoxy-DX administration were determined. In the time-related experiments, the effects of a single dose, an intermittent treatment (Days 0, 2, and 5) and a prolonged biweekly administration were studied. All dose-survival curves were exponential, with statistically significant differences between the effects on the various cell classes. CFUc appeared more sensitive than CFUs. In time-related experiments, 4'-deoxy-DX toxicity for HPC seemed to be relatively mild. However, CFUc sensitivity was again high in comparison with other populations assayed. In long-term administration, the 4-deoxy-DX effects on the haematopoietic system were also rather slight. PMID- 6498063 TI - Effects of cimetidine and indomethacin on the growth of dimethylhydrazine-induced or transplanted intestinal cancers in the rat. AB - The effects of cimetidine and indomethacin on the growth of dimethylhydrazine induced or transplanted intestinal tumours in the rat have been studied. Cimetidine is a histamine type 2 receptor antagonist and indomethacin is an inhibitor of prostaglandin synthesis. Two models of rat intestinal tumours were used: a colon carcinoma line transplantable in syngeneic animals and intestinal tumours induced by dimethylhydrazine treatment of Sprague-Dawley rats. Cimetidine and indomethacin were given in drinking water, alone or in combination. Cimetidine had no effect on the growth of transplanted colon cancer but significantly increased the incidence of chemically-induced tumours, with a tendency toward more invasive and metastatic tumours than in the control animals. Indomethacin did not significantly modify the incidence or other characteristics of the tumours in any of the models. This result is at variance with a protective effect of indomethacin on chemically-induced rat colon cancer previously reported by others. PMID- 6498064 TI - Oestrogen and progesterone receptors and disease-free interval in primary breast cancer. AB - Oestrogen and progesterone receptor assays were performed in 286 women with primary breast cancer, and the patient group was followed up for a minimum of 24 months. Of the 263 patients belonging to clinical stages I-III and serving as the population used for calculation of disease-free interval only 1.9% received postoperative endocrine treatment and 6.5% chemotherapy. No significant relationship between the presence or concentrations of oestrogen or progesterone receptor and the disease-free interval was observed. It is therefore possible that the positive relationship between these variables reported in some investigations reflects an influence by adjuvant endocrine measures. PMID- 6498065 TI - Cutaneous malignant melanoma in women: exogenous sex hormones and reproductive factors. AB - The roles of exogenous sex hormones and reproductive factors in the causation of malignant melanoma of the skin in women were examined in a case-control study of 276 patients and 276 matched controls in Western Australia. There was no consistent evidence of a relationship between the incidence rates of different histogenetic types of melanoma and age at menarche, duration of menstrual life, degree of obesity, number of pregnancies more than 20 weeks in duration or use of oral contraceptive preparations (OCP). Exposure to OCP was examined separately for different age periods and in different intervals of time before diagnosis; no consistent trend emerged. There was borderline evidence of an association of superficial spreading melanoma with duration of use of unopposed oestrogens. On the basis of seven studies of the relationship of melanoma to OCP published to date, we estimate that the total incidence rate of melanoma in OCP ever-users is unlikely to be increased by more than one third the rate in never-users. PMID- 6498066 TI - Oral contraceptive use and malignant melanoma in Australia. AB - In a case control study of 287 women aged 15-24 years with malignant melanoma and 574 matched controls, findings relating to oral contraceptive use and other hormone use are reported. Ever having used oral contraceptives was not associated with an increased risk of melanoma (relative risk for ever use of the pill = 1.0). Women with melanoma were, however, more likely to have taken oral contraceptives for long periods of time in the past, the relative risk associated with oral contraceptive use for a total duration of 5 years or longer which had begun at least 10 years before the melanoma was diagnosed being 1.5 (95% confidence interval 1.03 to 2.14) This elevated risk persisted after controlling for the reported hair and skin colour, frequency of moles on the body, place of birth, and measures of sunlight and fluorescent light exposure. Cases were more likely than controls to have used hormones to regulate their periods, hormonal replacement therapy and be given hormone injections to suppress lactation, the respective relative risks being 1.9, 1.4 and 1.4, but none differed significantly from 1.0. These findings suggest that prolonged oral contraceptive use may, after a lag of 10 years or so, increase the risk of malignant melanoma. PMID- 6498067 TI - Endometrial cancer following treatment for breast cancer: a case-control study in Denmark. AB - To evaluate the risk of endometrial cancer subsequent to breast cancer, a case control study was carried out in Denmark. Between 1943-1977, 115 cases of histologically confirmed endometrial carcinoma developed more than 3 months after the diagnosis of a primary breast cancer in 51,638 women. A total of 235 breast cancer patients with no second primary cancer were matched to the cases on age, calendar year of diagnosis, and survival with an intact uterus. Identification of cases and controls relied upon records available in the Danish Cancer Registry. Information on risk factors and reproductive histories was abstracted from hospital records. Increased relative risks (RR) for endometrial cancer were associated with menopausal oestrogen use (RR = 4.9), nulliparity (RR = 2.1), late age at natural menopause (RR = 2.9), and pelvic irradiation (RR = 1.4). No association was apparent for drugs used to treat breast cancer. This study indicates that breast and endometrial cancer share several common aetiologic factors and that studies of second primary cancers have the potential to provide information on risk factors other than those associated with therapy. PMID- 6498068 TI - Geographical variations in the incidence of colorectal cancer in Britain. AB - The incidence of colorectal cancer was compared in nine towns in England and Wales, chosen to encompass a range of socio-economic conditions and spread of latitude in the country. Cases were ascertained through pathology records, supplemented by clinical notes. The pattern of variation in incidence was different for men and women. Among men incidences were highest in towns with better socio-economic conditions, whereas among women the trend was reversed. This supports the hypothesis that the dominant aetiological influences causing colorectal cancer differ in the two sexes. Mortality rates did not correlate closely with incidence. This, together with the markedly different patterns of incidence of colorectal cancer and appendicitis in the nine towns, casts doubt on the significance of a reported inverse correlation between regional mortality from colonic cancer and the consumption of pentosic fibre. PMID- 6498069 TI - Comparative levels of tissue enzymes concerned in the early metabolism of 5 fluorouracil in normal and malignant human colorectal tissue. PMID- 6498070 TI - Asbestos, radiation and oncogenic transformation. PMID- 6498071 TI - Limitations of the human tumour xenograft system in individual patient drug sensitivity testing. PMID- 6498072 TI - Comparison of assays used for in vitro chemosensitivity testing of human tumours. PMID- 6498073 TI - Prognostic significance of peritumoral vascular invasion in breast cancer. AB - A prospective study of 232 patients with primary invasive breast cancer (UICC Stages I, II and III) and histologically confirmed axillary node status was carried out to assess the prognostic significance of several readily available clinical and pathological characteristics. In addition to the recognised utility of tumour size and axillary lymph node status, the presence or absence of cohesive clumps of malignant cells in peritumoral vascular spaces (both lymphatic and blood vessels) was found to be prognostically important. PMID- 6498074 TI - Preventive effects of antioestrogen on mammary and pituitary tumorigenesis in rats. AB - Six groups of inbred male Wistar/Furth (WF) rats were castrated at 40 days of age and group I received no further treatment. Groups 3 and 5 received 5.0 mg diethylstilboestrol (DES) pellets. Groups 4 and 6 were given both DES and 5.0 mg anti-oestrogen (antiE) clomiphene citrate pellets. At 50-55 days of age groups 2, 5, and 6 were exposed daily to drinking water containing 5.0 mg N nitrosobutylurea (NBU), for 30 days. None of the castrated rats given NBU alone developed mammary or pituitary tumours (MT, PT). When antiE was administered, both MT and PT incidences were reduced in rats given DES alone or in combination with NBU. Furthermore, in antiE-treated rats receiving DES and NBU the mean number of MT per rat was also significantly decreased. Similarly a marked reduction in the mean pituitary weight was observed in antiE-treated groups. These results indicate that antiE treatment was effective in the prevention of both mammary and pituitary tumorigenesis in rats receiving DES alone or receiving a combination of DES and NBU, and its inhibitory effect on mammary tumorigenesis may be mainly due to competitive antagonism for DES-induced pituitary tumorigenesis by antiE. PMID- 6498075 TI - The effect of vasopressin and hepatic artery ligation on the blood supply to normal and metastatic liver tissue. AB - The effect of low (0.08 microU g-1 body wt min-1) and high (0.16 microU g-1 body wt min-1) rates of vasopressin infusion on blood flow to normal liver tissue and to liver metastases derived from azoxymethane induced colorectal carcinomas was studied in 36 male Wistar rats. Portal venous flow was measured by electromagnetic flowmetry and blood flow to normal and metastatic liver tissue by the clearance of xenon-133 injected directly into the liver parenchyma or metastasis. The low rate of vasopressin infusion decreased portal venous flow but increased blood flow to normal and metastatic liver tissue while at the higher rate of infusion these effects were reversed. Hepatic artery ligation (HAL) immediately following a low rate of vasopressin infusion abolished the observed increase in blood flow to both normal liver tissue and metastases. HAL immediately following the higher rate of vasopressin infusion further reduced blood flow to metastases but did not further alter blood flow to normal liver tissue. HAL prior to the infusion of the vasoactive drug significantly reduced blood flow to metastatic liver tissue, increased portal venous flow and was without effect on blood flow to normal liver tissue. Following HAL, blood flow to metastatic liver tissue was not further altered by either the low or high rates of vasopressin infusion. However, blood flow to normal liver tissue after HAL was reduced by a low rate of infusion of vasopressin and increased by the higher rate of infusion. The results of this study indicate that blood flow to normal or metastatic liver tissue can be increased or decreased by differential rates of infusion of vasopressin. These observations may have important implications in the treatment of liver metastases in man where different rates of vasopressin infusion may potentiate the effects of hepatic artery ligation or cytotoxic therapy. PMID- 6498076 TI - Synergistic growth inhibiting effect of nitrous oxide and cycloleucine in experimental rat leukaemia. AB - Nitrous oxide (N2O) inactivates the vitamin B12-dependent enzyme methionine synthetase with subsequent impairment of folate metabolism and a reduction of cellular proliferation. Indications exist that this effect is antagonized by S adenosylmethionine (SAM), and it was investigated whether combination with an inhibitor of SAM synthesis, cycloleucine, would result in increased inhibition of growth in rat leukaemia model (BNML). Leukaemic growth was compared in untreated rats, in rats treated with either nitrous oxide/oxygen (1:1) or cycloleucine (50 mg kg-1 i.p.), and in rats receiving both agents. Combined treatment resulted in the strongest reduction of leukaemic infiltration in spleen and liver, and this reduction often was more than the added effects of single treatments. Peripheral leukocyte counts were also lowest after combined treatment. The deoxyuridine suppression test, measuring folate-dependent de novo synthesis of thymidine, was more severely disturbed with combined treatment. Levels of vitamin B12 in plasma were reduced in rats receiving N2O, but an increase in plasma folate occurred in all treated rats. These results indicate that a reduction of SAM synthesis by cycloleucine can increase the disturbance of folate metabolism that is caused by nitrous oxide, with a potentiation of the effects on leukaemic growth. PMID- 6498078 TI - A comparison of the expression of the DIDS-binding proteins from normal and tumorigenic human cells. AB - A monoclonal antibody was prepared against DIDS, an inhibitor of anion transport, and used to compare the occurrence and distribution of DIDS-binding sites of tumorigenic and non-tumorigenic human somatic-cell hybrids. The monoclonal antibody (E8) was produced by the fusion of the mouse myeloma (NS-1) with mouse spleen cells and is of the IgG1 subclass. The apparent half-saturation of DIDS for HEp-2 cells is 16 microM and the reaction is rapid. The number of binding sites on tumorigenic and non-tumorigenic hybrid cells was the same. The DIDS binding protein occurs homogeneously on all cells, a characteristic which distinguishes it from the possible tumour antigen recognised by the M/27 monoclonal antibody. PMID- 6498077 TI - Effect of misonidazole pretreatment on nitrogen mustard-induced DNA cross-linking in mouse tissues in vivo. AB - In the present study we have used the alkaline elution technique to study the effect of misonidazole (MISO) on the initial amount of DNA cross-linking in various normal and neoplastic tissues of C3H mice treated with nitrogen mustard (HN2) in vivo. Tissue samples for analysis of the cross-links were prepared 1 h after injection with HN2 to minimize the effect of subsequent repair processes on the yield of lesions. For mice receiving HN2 alone, the greatest level of cross linking was found in spleen and jejunum, with the liver showing the lowest level. In animals that had been pretreated with MISO (1 mg g-1, i.p.) for 0.5 h prior to injection with HN2, the amount of cross-linking in the spleen and jejunum was not affected by MISO; however, in all other tissues that were examined, cross-linking was enhanced by MISO to a varying extent depending on the specific tissue. The greatest enhancement was observed in the liver (X 6) and kidney (X 3.1), both of these tissues showing a greater enhancement than either of the two fibrosarcomas. The potentiation of HN2 cross-linking in a particular tissue correlated well with two cellular processes that are known to be nitroreduction-dependent in vitro, namely, the degree of MISO-induced GSH depletion and the binding of MISO to cellular macromolecules. Thus, the potentiation of cross-linking in normal tissues such as liver and kidney, and by inference in tumours, may be intimately related to the generation and/or accumulation of nitro-reduced MISO metabolites in those tissues. PMID- 6498079 TI - Cancer mortality in small areas around nuclear facilities in England and Wales. AB - Cancer mortality trends were examined for the small areas around fourteen nuclear and five non-nuclear facilities in England and Wales. Using routine OPCS mortality data, standardized mortality ratios (SMRs) for these areas were computed for selected causes of death. Changes in the SMRs were then sought by comparing the SMRs for the five years before the facility opened with the period 10 (in some cases 15) years after start-up, and by computing the weighted regression of the SMRs on calendar year. These analyses indicate no overall pattern of increasing cancer SMRs around nuclear facilities. PMID- 6498080 TI - Different age and sex relationship for cancer of subsites of the large bowel. PMID- 6498081 TI - Cross-resistance to cytotoxic drugs in human glioma cell lines in culture. PMID- 6498082 TI - Interaction of diethylaminoreserpine with cells of a transplantable tumour in vivo. PMID- 6498083 TI - Immunological detection of occult blood in faeces in colorectal cancer. PMID- 6498084 TI - Mast cell degranulation and increased vascular permeability induced by 'therapeutic' ultrasound in the rat ankle joint. AB - Ultrasound at frequencies between 0.75 and 3.0 MHz is widely used in the treatment of musculoskeletal injuries in human and veterinary patients. The mechanisms by which ultrasound affects clinical recovery are, however, incompletely understood. At present no clear rationale has been evolved to guide the selection and use of all the factors comprising the dosage of ultrasound in treatment designed to encourage tissue healing. In the present study applications of ultrasound considered to be therapeutic caused a small but significant increase in vascular permeability in the hindpaw ankles of rats in vivo which was abolished by pre-treatment of the rats with a combination of a histamine H1 receptor antagonist and a serotonin antagonist. Histological sections from rat ankles showed that ultrasound also caused a significant increase in the number of degranulated mast cells above control values. Since mast cells contain histamine, low concentrations of which have been associated with healing, the finding that ultrasound produces mast cell degranulation and evidence of histamine release provides a new direction for investigation of the mechanism of its therapeutic action, and for determination of appropriate regimens of treatment. PMID- 6498085 TI - Reduction of the susceptibility to infective endocarditis with time in animals with endocavitary catheters. AB - In a previous study we showed that the lesions of non-bacterial thrombotic endocarditis induced by means of implantation of a catheter in the left ventricle (LV) of the rabbit, undergo inner connectivization and surface endothelialization, which are completed within 2-3 months. In the present study we have investigated whether these histological changes lead to a variation in susceptibility to infective endocarditis (IE). After studying two control groups, we compared the incidence of IE in four groups of 15 rabbits each, inoculated with Streptococcus mitis I, 10, 35 and 70 days after implantation of a catheter in the LV. The frequency of infection was shown to be progressively reduced from 100% to 26.7%. This demonstrates that endothelialization of the catheter and the sterile vegetations protect the animals from IE. PMID- 6498086 TI - Cellular uptake of clindamycin and lincomycin. AB - Neither clindamycin nor lincomycin killed intracellular Staphylococcus aureus over a 4-h period. Bio-assay of neutrophil sonicates after exposure to antibiotic showed the presence of active clindamycin at approximately 20 times the extracellular concentration. Clindamycin and lincomycin kill staphylococci relatively slowly, particularly in cell culture medium and balanced salt solution. This might account for their failure to kill intracellular staphylococci despite intracellular accumulation. The neutrophil experiments could not be extended to a time period (20 h) over which the antibiotics would kill S. aureus, as the presence of these bacteria within neutrophils for this length of time resulted in considerable cell lysis. PMID- 6498087 TI - Subtotal pancreatectomy in the male Wistar rat. AB - Subtotal pancreatectomy was performed in the male Wistar rat in order to obtain a model for the study of pancreatic regeneration. Adherence to previously published techniques caused an unacceptably high operative mortality due to duodenal necrosis. The operation was modified after a detailed study of the duodenal vasculature was performed and this modification together with meticulous haemostasis enabled the procedure to be performed with an acceptable operative mortality. The procedure ensured that between 73 and 83% of the total pancreatic mass was removed. PMID- 6498088 TI - Gastric mucosal histamine, histamine formation capacity (HFC) and plasma gastrin after cysteamine administration. AB - Cysteamine administration is followed by stomach and duodenal ulcers in rats. We aimed to establish a time relationship between changes in gastric mucosal histamine, histamine formation capacity (HFC) and plasma gastrin after cysteamine administration. Up to 4 h after cysteamine s.c., no ulcers were found. Plasma gastrin rose after cysteamine and was higher than in controls 2h after injection. Mucosal histamine fell after 4h; no other significant changes were found in mucosal histamine and HFC. A direct correlation was found between plasma gastrin and HFC in both controls and after cysteamine. It is suggested that the changes indicate that cysteamine releases gastrin, which increases HFC and thus histamine. The fall in histamine seems to indicate utilization of histamine in acid production. PMID- 6498090 TI - Effect of ultraviolet irradiation on granulocyte chemotaxis and nitroblue tetrazolium reduction activity in healthy individuals. AB - The effects of ultraviolet irradiation on granulocyte chemotaxis and nitroblue tetrazolium reduction activities were studied in healthy volunteers. An increase of polymorphonuclear chemotaxis takes place after five irradiations, while the nitroblue tetrazolium reduction activity remains practically unchanged. PMID- 6498089 TI - Adrenoceptor-mediated responses in human skin studied by iontophoresis. AB - The adrenoceptor-mediated responses in human skin (blanching and erythema) were studied by an iontophoretic technique. It is concluded that the receptors in superficial dermal blood vessels belong to the subclasses alpha 1 and beta 2. PMID- 6498091 TI - Cytogenetic studies in a patient with porokeratosis of Mibelli, multiple cancers and a forme fruste of Werner's syndrome. AB - A 49-year-old man with extensive porokeratosis of Mibelli (PM) developed a squamous cell carcinoma and several carcinomas-in-situ within the lesional skin. The patient also had diabetes mellitus and a short stature with a prematurely aged appearance. The patient's father and two siblings also had PM. The patient died from metastatic squamous cell carcinoma, and at autopsy an adenocarcinoma of the descending colon was also found. Fibroblasts cultured from both the PM affected and unaffected skin showed chromosomal abnormalities and a decreased lifespan. Cellular sensitivity to ultraviolet rays measured by unscheduled DNA synthesis and colony-forming ability were within normal limits. An association with a forme fruste of Werner's syndrome was suspected. PMID- 6498092 TI - Low serum zinc in children with atopic eczema. AB - Serum zinc was measured by atomic absorption spectrophotometry in sixty-five children with atopic eczema and seventy-nine control children. The mean serum zinc of the patients, (11.4 +/- 2.0 mumol/l) was significantly lower than that of the controls (13.7 +/- 2.3 mumol/l, P less than 0.0001). There was no significant correlation between the patients' serum zinc concentration and either the height/weight centile or a subjective assessment of severity and extent of the eczema. Of eleven patients with serum zinc below 10 mumol/l, six had recurrent infections of the skin, a significantly greater proportion than in patients whose serum zinc was 10 mumol/l or above. It is suspected that the decreased plasma zinc concentration in children with eczema is a non-specific consequence of the dermatological disorder, and therefore there is no indication for zinc supplementation. PMID- 6498093 TI - Low-dose oral chloroquine in the treatment of porphyria cutanea tarda. AB - Seven patients with porphyria cutanea tarda received a total of ten courses of low-dose oral chloroquine therapy (125 mg chloroquine phosphate twice weekly). Patients were treated for a mean 14.9 months during which time all went into clinical and biochemical remission. Relapse occurred in four patients on a total of six occasions after a mean 17 months. In four patients there was no relapse after a mean 47.3 months. There were no adverse side-effects from the treatment. Low-dose oral chloroquine therapy appears to be a safe, effective and convenient treatment for porphyria cutanea tarda, although relapses may occur requiring further therapy. PMID- 6498094 TI - Atypical psoriasis of the face and hands after PUVA treatment. AB - In sixty patients with psoriasis, two types of lesions developed after repeated and prolonged courses of PUVA radiation. In sixteen patients, new lesions on the face resembled seborrhoeic dermatitis; in thirteen patients thick plaques on the dorsum of the hands developed insidiously over the years. There was no significant association between the two types of lesions and only the latter were dose-related. The appearance of recalcitrant psoriasis on the face and hands appears to be a complication of PUVA treatment. PMID- 6498096 TI - 'Coudability': a new physical sign of alopecia areata. PMID- 6498095 TI - Pemphigus foliaceus induced by rifampicin. AB - Pemphigus foliaceus was seen in a patient with pulmonary tuberculosis during rifampicin therapy. The skin lesions were eczematoid patches, flaccid bullae and crusted plaques on the trunk and extremities, histologically showing a high epidermal blister with acantholysis. The diagnosis was confirmed by immunofluorescent studies. After the patient discontinued rifampicin, the skin lesions cleared completely within 5 weeks without any systemic medication. PMID- 6498097 TI - Effectiveness of dapsone in Behcet's disease. PMID- 6498098 TI - Treatment of lymphomatoid papulosis with methotrexate. PMID- 6498099 TI - High levels of circulating haemopoietic stem cells in very early remission from acute non-lymphoblastic leukaemia and their collection and cryopreservation. AB - Circulating myeloid progenitor cells (PB CFU-GM) were measured in the peripheral blood of 13 patients with acute non-lymphoblastic leukaemia (ANLL) as they entered first remission. The mean of the recorded peak levels was 2796 X 10(3) CFU-GM/l, representing a 25-fold increase above the mean value in normal subjects. These elevated levels of PB CFU-GM occurred regularly during the very early remission phase when platelet counts rose rapidly. Five of the patients had PB mononuclear cells collected by continuous-flow leukapheresis during this early recovery phase. CFU-GM were assayed as a measure of the number of haemopoietic stem cells in each collection. The cells were concentrated and then cryopreserved in liquid nitrogen. Leukapheresis was also performed on five normal subjects for comparison. Low numbers of CFU-GM were harvested from normal subjects, mean 0.33 +/- 0.06 X 10(4) CFU-GM/kg body weight for each leukapheresis. In ANLL patients entering remission, however, very large numbers of CFU-GM were regularly harvested. A mean of 11 +/- 2 X 10(4) CFU-GM/kg body weight were cryopreserved after each leukapheresis, representing 5 times the number of CFU-GM considered necessary for successful autologous haemopoietic reconstitution. Haemopoietic stem cell viability was assessed after varying periods of cryopreservation. There was no significant stem cell loss after up to 24 months storage. Thus, it is possible to collect and cryopreserve large numbers of CFU-GM and by inference pluripotent haemopoietic stem cells from the peripheral blood of patients with ANLL during very early remission. The possible biological and therapeutic implications are discussed. PMID- 6498100 TI - Cytochemical localization of adenylate cyclase activity in rat bone marrow. AB - The localization of adenylate cyclase (AC) in rat bone marrow was studied at the ultrastructural level using a cytochemical technique with adenosine triphosphate (ATP) as substrate. The strongest precipitate occurred around cytoplasmic membranes of cells of granulocytic lineage. Around cells of erythrocytic lineage, as well as megakaryocytes, lymphocytes and the plasma cells, the granules resulting from the cytochemical reaction revealed various degrees of density. The region within the bone marrow tissue where the cells manifested an increased reaction product was called 'reaction fields'. Most often the 'reaction fields' were formed by maturing cells of the granulocytic and erythrocytic lineages, surrounding the reticular cells. The reaction precipitate was also apparent around the advential and endothelial cells of the sinuses. Mature cells migrating from the bone marrow space to the sinus lumen also showed an intensified reaction product. The causes of such localization of AC were discussed. PMID- 6498101 TI - Isolation of normal human megakaryocytes. AB - This paper reports a simple procedure for obtaining human megakaryocytes with a high purification and high recovery yield. Bone marrow cells, obtained from surgically removed ribs, were separated by a two-step procedure. Initially, a single cell suspension was enriched in megakaryocytes by equilibrium density centrifugation, the low density cell fraction was subsequently layered over a shallow continuous albumin gradient in a glass sedimentation chamber. Megakaryocytes averaged 0.03 +/- 0.02% of all nucleated cells in the starting marrow cell suspension, after this procedure an average 80 +/- 15% of the initial megakaryocyte population was recovered with a purity of 94 +/- 4%. Previous methods, based upon the use of a two-step procedure, are reviewed. The theory of velocity sedimentation is discussed with regard to the differences in the methodology used, which account for the different results I obtained. PMID- 6498102 TI - The anaemia of chronic renal failure in sheep: studies in vitro. AB - The presence of inhibitors which accumulate during uraemia has been postulated as a significant factor in the development of anaemia in chronic renal failure (CRF). To determine whether factors in uraemic serum depress erythropoiesis, samples were obtained from sheep prior to and after surgical induction of CRF. The sera were tested in vitro for their effect on erythroid colony growth. The sheep sera were substituted for fetal calf serum (30% concentration) in cultures of serotype-matched or autologous sheep marrow cells at optimal doses of erythropoietin (Ep). Forty-two paired sera from five animals were tested against normal (22) and uraemic marrow (20). In 7/42 random pairs, erythroid colony growth was decreased by 20% in the presence of uraemic serum when compared to a normal sample from the same animal. In the remainder of the cultures, uraemic sera stimulated or supported erythroid colony growth as well as normal sera. When the results were analysed individually, serum from only one of five animals showed minimal (10%) in vitro inhibition of erythroid colony growth. This study, performed in a prospective manner utilizing compatible target cells, disputes the hypothesis that uraemic toxins significantly inhibit in vitro erythropoiesis. These data correlate with the in vivo response to Ep in this sheep model, and suggest Ep would be effective in treating the anaemia of CRF. PMID- 6498103 TI - Conversion of endogenous cobalamins into microbiologically-inactive cobalamin analogues in rats by exposure to nitrous oxide. AB - Rats were exposed to a mixture of oxygen and nitrous oxide (1/1) for up to 18 d. There was a marked fall in both the serum and liver cobalamin levels. There was a significant rise in the concentration of microbiologically-inactive cobalamins in serum 24 h after exposure to N2O. The proportion of microbiologically-inactive cobalamin in liver increased throughout the period of exposure. We were unable to show a similar effect in sera from patients inhaling N2O for 24 h, nor by exposing rat plasma to N2O for 24 h. It was concluded that microbiologically inactive cobalamins are produced in vivo from endogenous cobalamins and that one form appears to be a product of cobalamin oxidation. PMID- 6498105 TI - Pure white cell aplasia treated by high dose intravenous immunoglobulin. PMID- 6498104 TI - CM Affi-Gel Blue chromatography of human urine: a simple one-step procedure for obtaining erythropoietin suitable for in vitro erythropoietic progenitor assays. AB - A method for both concentrating and purifying human urinary erythropoietin (Ep) using CM Affi-Gel Blue is described. We have found that up to 40 litres of urine can be processed on a 1 litre gel bed of this material. This gives a 25-50-fold purification of Ep with an apparent Ep recovery in excess of 100%. The high recovery of Ep is probably due, in part, to the removal of inhibitors present in the initial urine. By selecting urine that contains high levels of Ep (greater than 0.5 units/ml), it is possible with this method routinely to obtain preparations with specific activities of 100-300 units of Ep per mg protein. Such preparations are noninhibitory when assayed in either short-term suspension cultures or in longer-term methylcellulose cultures at concentrations up to 5-10 units/ml. Similar tests with these same bioassay systems have shown that other non-Ep stimulating factors (i.e. erythroblast enhancing factor (EEF), granulocyte/macrophage colony stimulating factor (GM-CSF) and burst promoting activity (BPA) ) are also not present at detectable levels. In this study we also show that the loss of biological activity which often occurs when partially purified Ep preparations are stored in solution is markedly reduced in the presence of either 1% bovine serum albumin or 0.1% sodium dodecyl sulphate. PMID- 6498106 TI - Mortality and incidence of cancer of workers in the man made vitreous fibres producing industry: an international investigation at 13 European plants. AB - A total of 25 146 workers at 13 plants producing man made mineral fibres (MMMF) in seven European countries (Denmark, Finland, Federal Republic of Germany, Italy, Norway, Sweden, and United Kingdom) were studied in a historical cohort investigation. At 12 of the 13 plants an environmental survey was carried out to determine present day concentrations of airborne man made mineral fibres that showed levels of respirable fibres usually below 1 f/ml and most commonly in the range 0.01 to 0.1 f/ml. Workers were entered into the cohort at the moment of their first employment at one of the 13 factories (which started to operate between 1900 and 1955), and were followed up to at least 31 December 1977. Three per cent of the workers were lost to follow up. National death rates and national cancer incidence rates, where applicable, were used for each of the seven countries for comparison with the workers' cohort. A single death from mesothelioma was reported out of a total of 309 353 person-years of observation. No consistent differences (within and between plants) were noted between observed and expected numbers concerning individual causes of death or individual cancer sites, apart from lung cancer. For this cause a tendency was observed for the standardised mortality ratio (SMR) to increase with time from first employment. When the data from all the plants were pooled a statistically significant raised SMR of 192 (17 observed, 8.9 expected; 95% confidence interval 117-307) appeared in the group with 30 years or more since first employment. The relevance of this finding, to which different factors including uncontrolled confounders such as smoking habits may have contributed, cannot be established at present. The result is suggestive, however, of an increased risk associated with the man made mineral fibres working environment of 30 or more years ago. PMID- 6498107 TI - Scrotal cancer in the West Midlands 1936-76. AB - Between 1936 and 1976, 344 cases of scrotal cancer were registered in the West Midlands Region. There was a considerable increase in the number of registrations after 1955, the figures remaining high until the 1970s since when they appear to be falling towards the low level seen in the early years of registration. By the end of December 1981 250 deaths had occurred. The cause of death was known in 226 cases and of these, 97 (42.9%) were attributed to cancer of the scrotum, 40 (17.7%) to other malignancies, and 89 (39.4%) to other causes, scrotal cancer not being mentioned on the death certificate. The mean age at registration was 59.3 years and at death 66 years. Mean survival was 6.6 years with a five year survival rate of 51%. Survival was shorter in men who presented with palpable lymph nodes and greater in those treated with surgery alone. Occupations were known for all but 28 of the cases and of these, 61.9% had been exposed to mineral oil and a further 7.8% to pitch and tar. Among the occupations with exposure to mineral oil, tool setters and tool fitters accounted for the greatest proportion, 89 men having followed those trades. In 74 cases second primary tumours were registered after the scrotal primary, mostly in the skin and bronchus. There was no relation between the development of second primary tumours and exposure to mineral oil or to pitch and tar. PMID- 6498108 TI - Rice millers' syndrome: a preliminary report. AB - A study was carried out to determine the health effects of rice husk dust in Malaysian rice millers. The study population consisted of 122 male Malay workers from three rice mills, with 42 controls of similar age, sex, ethnic group, and agricultural work background. Interviews using standardised questionnaires, physical examination, total and differential white cell counts, chest radiographs, and lung function tests were performed on each of the millers and the controls. Environmental dust monitoring was also carried out in the three rice mills. Clinical, haematological, and radiological findings suggest that a distinct clinical syndrome seems to be associated with exposure to rice husk dust. The manifestations of this "rice millers' syndrome" include acute and chronic irritant effects affecting the eyes, skin, and upper respiratory tract; allergic responses such as nasal catarrh, tightness of chest, asthma, and eosinophilia; and radiological opacities in the chest, probably representing early silicosis or extrinsic allergic alveolitis. PMID- 6498109 TI - Wheat flour sensitisation and airways disease in urban bakers. AB - A total of 176 bakers and 24 subjects employed as bread slicers and wrappers were studied to examine the effect of occupational category on respiratory symptoms, ventilatory capacity, non-specific bronchial reactivity, and prick skin test responses to wheat and common allergens. Bakers had a greater prevalence of attacks of wheeze and dyspnoea and more frequently considered that work affected their chests than did slicers and wrappers. Bakers with a history of asthma with onset since starting work in a bakery had a greater prevalence of chronic cough and sputum, increased bronchial reactivity, and positive prick skin test responses to wheat and common allergens than other bakers. There was a significant association between the frequency of positive prick skin tests to wheat and common allergens, suggesting that prior atopy facilitates sensitisation to cereal antigens. The frequency of positive prick skin responses to common allergens, however, declined with increasing baking duration whereas the frequency of positive skin responses to wheat increased with increasing baking duration, suggesting that subjects who were sensitised to common allergens were leaving the industry whereas subjects who stayed in the industry increased their risk of developing sensitisation to wheat. Oven handlers had a greater prevalence of attacks of wheeze and dyspnoea and more frequently considered that work affected their chests than either dough makers or general bakers. They also had a greater prevalence of positive prick skin test responses to wheat than dough makers or general bakers. Oven handlers also had a lower mean standardised casual FEV1 than either general bakers or dough makers. Thus oven handlers appear to have a greater risk of developing respiratory allergy and airflow obstruction than bakers in other occupational categories. PMID- 6498110 TI - Comparison of radiographic appearances with associated pathology and lung dust content in a group of coalworkers. AB - The pathology and dust content of lungs from 261 coalminers in relation to the appearances of their chest radiographs taken within four years of death were examined. Radiological opacities of coalworkers' pneumoconiosis were more profuse the more dust was retained in lungs. Among the men who had mined low rank coal- that is, with a relatively high proportion of ash--the increase in profusion was most closely related to the ash component of the dust, whereas in men who had mined high rank coal both coal and ash increased in the lungs in relation to radiological profusion. The fine p type of opacity was found to be associated with more dust and a higher proportion of coal and less ash than the nodular r opacity, and was also more likely to be associated with emphysema. The pathological basis of the different types of opacity found on the radiographs of coalminers related to the number, size, and nodularity of the dust lesions. Larger fibrotic lesions were likely to appear as r opacities, whereas fine reticular dust deposition was most likely to present as p opacities, q opacities showing a mixture of appearances. The study has shown that the composition of dust retained in the lung, as well as its amount, makes an important contribution to the radiographic appearances of pneumoconiosis. In particular, the r type of lesion on the radiograph of a low rank coalminer indicates the possibility of a silicotic like lesion. PMID- 6498111 TI - Cotton induced bronchoconstriction detected by a forced random noise oscillator. AB - Lung function responses to inhaled cotton dust were evaluated in a group of 58 healthy subjects by spirometry (MEFV curves) and forced random noise impedance parameters. Twenty-one of these subjects were also examined by body plethysmography to assess changes in airway resistance (Raw). For the study group as a whole, alterations in lung mechanical function after exposure to cotton dust were detected by maximal expiratory volumes and flows (p less than 0.001) and impedance parameters (p less than 0.01) but not by Raw. Subjects showing responses in MEFV curves also showed increases in Thevenin or effective resistance at low frequencies (R1, R5-9, R5-9/R20-24), suggesting that the limitation of flow occurred predominantly in the peripheral airways. By contrast, non-responders on MEFV measurements were found to have significant increases in effective resistance both at low and at high frequencies (R1, R5-9, R20-24), suggesting a central airways effect. MEFV curve non-responders also exhibited a significantly lower baseline effective resistance profile than MEFV curve responders. The data indicate that under the conditions of the experiment measures of the Thevenin resistance (real part of impedence) by the forced random noise method are reliable indicators of cotton induced bronchoconstriction. Measurement variability, however, suggests that, at present, these are more appropriate for group studies and should remain adjuncts to standard tests of lung function such as spirometry. PMID- 6498112 TI - Acute lung function response to cotton dust in atopic and non-atopic individuals. AB - Acute spirometric responses to inhaled cotton dust were examined in a population of 226 healthy, non-asthmatic adults whose atopic status had been evaluated by skin prick tests to 10 common environmental allergens. Exposure to cotton dust occurred in model cardrooms where elutriated dust levels were carefully controlled (1.02 mg/m3). Atopy, defined as positive prick tests to at least two allergens, was observed in 26% of subjects. Significant forced expiratory volume in one second (FEV1) decrements occurred after exposure to cotton dust independent of atopic status (p less than 0.001). The mean FEV1 decline in atopic subjects, however, was significantly greater than in non-atopic subjects (p less than 0.05). Degree of atopy, as measured by number of positive skin tests, also exhibited a significant association with cotton induced decrements in FEV1 (p less than 0.05). These data suggest that atopy may be an important determinant of the magnitude of the acute pulmonary response to cotton dust. This may reflect the non-specific airways hyperresponsiveness that has been described in non asthmatic, atopic individuals. PMID- 6498113 TI - Acute exposure of symptomatic steelworkers to sulphur dioxide and carbon dust: effects on mucociliary transport, pulmonary function, and bronchial reactivity. AB - Nine steel workers participated in controlled exposures to sulphur dioxide alone and sulphur dioxide plus carbon dust (5 ppm and 10 mg/m3, respectively). All were experiencing work related respiratory difficulties. Bronchial clearance was measured using radioaerosol inhalations and external detection. Results were variable and no statistically significant changes were observed. One asthmatic showed a complete cessation of clearance during exposure to sulphur dioxide and carbon dust. Bronchial reactivity was found to be significantly raised after exposure to sulphur dioxide but equivocal results were found after exposure to sulphur dioxide and carbon dust. Pronounced changes in pulmonary function were seen only in the two asthmatic subjects. They could not tolerate the levels, indicating that these threshold limit values are too high, at least for these individuals who showed much greater sensitivity to the pollutants than the others. PMID- 6498114 TI - Histological types of malignant mesothelioma and asbestos exposure. AB - The Los Angeles County Cancer Surveillance Program abstracts hospital pathology records on almost all cases of cancer occurring in the county. Those cases of pleural and peritoneal mesothelioma that occurred between 1972 and 1978 were identified. Occupational histories were obtained from interviews, and the histopathology of the tumours was reviewed by a member of a mesothelioma reference panel who was unaware of the exposure histories. The relation of asbestos exposure to the three histological types of mesothelioma (epithelial, mesenchymal, and mixed) was studied among the 29 cases for whom occupational histories were available and who were also considered to have histopathology consistent with mesothelioma. The proportion of cases exposed to asbestos was high for both the epithelial (11/17, 65%) and mixed histological types (6/11, 55%). The single case of mesothelioma classified as a mesenchymal type was also exposed to asbestos. Cases who had worked in shipyards were represented in each of the three groups. In cases who had worked in asbestos production and manufacture an exclusively epithelial type of tumour was observed. In cases who had worked as insulators or in heating trades the histological type was predominantly (3/4) mixed. These data do not support the hypothesis that any specific histological type of mesothelioma is especially related to asbestos exposure. PMID- 6498115 TI - n-Hexane metabolism in occupationally exposed workers. AB - Lung uptake and excretion of n-hexane were studied in ten workers in a shoe factory. Simultaneous samples of inhaled and alveolar air were collected with the aid of a Rhan-Otis valve, personal samplers, and charcoal tubes. Alveolar excretion was monitored during a six hour postexposure period. Uptake was calculated from lung ventilation, the retention coefficient, and environmental concentrations. The amount of exhaled n-hexane was calculated from the decay curve. According to the experimental data, alveolar retention was about 25% of the inhaled n-hexane, corresponding to a lung uptake of about 17%. The postexposure alveolar excretion was about 10% of the total uptake. The main metabolites of n-hexane were identified and measured by capillary GC/MS in spot urine samples collected before, at the end, and 15 hours after the same working shift. Urinary concentrations were low, though related to n-hexane in the air. 2,5-Hexanedione in the end of shift samples gave the best estimate of overall exposure. About 3 mg/g creatinine of 2,5-hexanedione would correspond to about 50 ppm of n-hexane in the air (mean daily exposure). PMID- 6498116 TI - Uptake, distribution, metabolism, and elimination of styrene in man. A comparison between single exposure and co-exposure with acetone. AB - Six male subjects were exposed for two hours during light physical exercise to 2.81 mmol/m3 (293 mg/m3) of styrene on one occasion and to a mixture of 2.89 mmol/m3 (301 mg/m3) of styrene and 21.3 mmol/m3 (1240 mg/m3) of acetone on another (combination study). About 68% of the dose (somewhat more than 4 mmol) of styrene was taken up. The arterial blood concentration of styrene reached a relatively stable level after about 75 minutes of exposure of about 18 and 20 mumol/l after the single and combined exposure, respectively. Calculated values of mean blood clearance were 1.9 l/min in the styrene study and 1.6 l/min in the combination study; the half life of styrene in blood was about 40 minutes in both studies. The concentration of non-conjugated styrene glycol increased linearly during exposure and reached about 3 mumol/l at the end of exposure and was eliminated with a half life of about 70 minutes. Styrene-7,8-oxide was detected and quantified in the blood in a complementary study. The half lives for the excretion of mandelic and phenylglyoxylic acid in the urine were about four and nine hours, respectively, in both studies. PMID- 6498117 TI - Biological monitoring of workers exposed to 4,4'-methylenebis (2-chloroaniline) (MBOCA). AB - A biological monitoring programme has been developed for assessing occupational exposure to 4,4'-methylenebis (2-chloroaniline) (MBOCA) in a factory which manufactures polyurethane elastomers. In a systematic programme of biological monitoring over a five year period urinary MBOCA concentrations have been used to provide evidence of absorption of MBOCA. Improvements in the handling and use of MBOCA have coincided with a steady reduction in the urinary MBOCA concentrations. PMID- 6498118 TI - Confidentiality in obstetrics. PMID- 6498119 TI - Prophylactic bromocriptine treatment during pregnancy in women with macroprolactinomas: report of 13 pregnancies. AB - Ten women with a macroprolactinoma had prophylactic bromocriptine treatment during 13 pregnancies in the second and third trimesters. One patient had signs of tumour enlargement during the first trimester, but none of them showed tumour enlargement during prophylactic bromocriptine treatment. Prolactin levels were reduced in both maternal and cord sera, but they were normal in amniotic fluid. All pregnancies progressed to term. Thirteen healthy infants were born without congenital malformations and growth and psychomotor development were normal during the follow-up period (7 months to 5 years). The safety of bromocriptine treatment during pregnancy is discussed and our current policy of management of patients with prolactinomas is outlined. PMID- 6498120 TI - Follow-up study of children whose mothers were treated with warfarin during pregnancy. AB - Twenty-two children whose mothers took the oral coumarin anticoagulant warfarin during pregnancy were seen, to assess their physical and mental development; a comparison was made with matched controls. No significant difference was observed between the study group and controls, nor within the study group according to the period of gestation when their mothers took warfarin. PMID- 6498121 TI - Human placental lactogen in pre-eclampsia. AB - Serum placental lactogen (hPL) was measured in serial blood samples obtained from 663 pregnant women at weekly intervals from 36 to 40 weeks. The group included 231 women with pre-eclampsia. Levels of hPL were significantly elevated in primigravidae with this condition but not in multigravidae. In all groups hPL levels were significantly reduced in association with growth retardation, but the clinical value of this observation appeared to be greater in multigravidae than in primigravidae. It is suggested that in primigravidae with pre-eclampsia maternal hPL levels reflect both the pathology of the disease as well as the condition of the fetus. PMID- 6498122 TI - Effect of short-term maternal exercise on maternal and fetal cardiovascular dynamics. AB - Maternal and fetal cardiovascular dynamics were studied immediately after moderate short-term maternal exercise in 28 healthy nulliparous subjects at between 34 and 38 weeks gestation who were randomly assigned to an exercise group (n = 14) or a control group (n = 14). At the end of the study, data from 11 exercise and 12 control subjects were available for analysis. A significant rise in maternal heart rate and systolic and diastolic blood pressure during exercise was observed. Mean blood flow velocity in the fetal descending aorta as measured by pulsed Doppler ultrasound and fetal heart rate did not show any significant changes. These data indicate that there are no cardiovascular signs of fetal stress immediately after moderate short-term maternal exercise. PMID- 6498123 TI - Merits of an individualized approach to fetal movement counting compared with fixed-time and fixed-number methods. AB - The most commonly employed methods for maternal counting of fetal movements take no account of variation in the level of activity between fetuses. This may result in false alarms or prolonged counting in pregnancies in which perceived movements are infrequent. A new counting method is described in which an individualized hourly rate of perceived movements is first calculated for each patient; then, the time taken to feel this number is recorded each day for the remainder of the pregnancy. The new system is associated with a substantially lower false alarm rate than a system of counting for an hour and continuing for a second hour if the level is low. In comparison with the Cardiff 'count-to-10' method, the amount of time spent counting each day was more uniform and was halved overall. Although this system is more complicated to initiate these clear advantages suggest that it should be subjected to large-scale feasibility trials. PMID- 6498124 TI - Posture in labour: patients' choice and its effect on performance. AB - In a study to assess the influence of maternal posture on the progress and efficiency of labour, 275 parturients were asked to choose between remaining in bed during labour or being ambulant. Among primigravidae in spontaneous labour those who remained ambulant throughout had the shortest labours; they also had shorter labours than others who were only partially ambulant. Analysis of the data, based on original preference, however, suggests that an easy labour allows ambulation rather than vice versa. Radiotelemetry was used to transmit the fetal heart signal in all ambulant patients and provided satisfactory fetal surveillance in both high- and low-risk labours. PMID- 6498125 TI - Peripheral vasomotor control and menopausal flushing--a preliminary report. AB - Menopausal flushing can be considered as an intermittent loss of peripheral vasomotor control. Thermal entrainment testing has been used to assess the degree of peripheral vasomotor control in a preliminary study of seven women receiving oestrogen replacement therapy in the form of percutaneous cream. Significant improvement was demonstrated in the degree of control over a 3-month period in those patients who were symptomatically improved. We suggest that oestrogen exerts an influence on peripheral vasomotor control and flushes and sweats occur when this influence is removed. PMID- 6498126 TI - Serum levels of progesterone and some of its metabolites including deoxycorticosterone after oral and parenteral administration. AB - Single 100-mg doses of progesterone were given orally and as intramuscular injections to four women during the follicular phase of the menstrual cycle. After oral administration serum levels of progesterone increased rapidly to reach luteal phase values (mean maximum level 55.6 nM) within 1-4 h and were still elevated after 12 h. The serum concentrations of 20 alpha-hydroxy-4-pregnen-3-one showed a similar pattern while there were only minor transient changes in 17 alpha-hydroxyprogesterone concentrations. The serum levels of cortisol and 4 androstene-3,17-dione were unaffected. In comparison, after intramuscular administration values two to three times higher than by the oral route were achieved. A significant increase in serum deoxycorticosterone was recorded in all women. The mean ratio between the change in deoxycorticosterone and progesterone was increased after oral administration. Oral treatment with natural progesterone may develop into an attractive alternative to synthetic progestogens but the conversion of progesterone into a potent mineralocorticoid may be a potential disadvantage. PMID- 6498127 TI - The short luteal phase and infertility. AB - The distribution of the length of the luteal phase was investigated in 187 women with regular, apparently ovulatory menstrual cycles of whom 95 had unexplained infertility and the other 92 comprised a group of healthy volunteer subjects. If the short luteal phase is associated with infertility it might be expected to occur more frequently in women with unexplained infertility. A short luteal phase (defined as a luteal phase lasting less than or equal to 11 days) was found in 9% of the infertile group and in 8% of the normal group showing that these cycles do not occur more frequently in women with infertility. PMID- 6498128 TI - Morphological changes in tubal mucosa associated with the use of intrauterine contraceptive devices. AB - We examined the endosalpinx of 28 healthy non-pregnant women, 12 of whom had an intrauterine contraceptive device (IUCD) and 16 of whom had neither an IUCD nor used oral contraceptives. Measurements made on light- and scanning electron micrographs showed that the percentage area covered by ciliated cells was approximately 40% in non-IUCD users and only 20% in IUCD users. PMID- 6498129 TI - Cervical healing and Langerhans' cells. AB - A study of cervical epithelium healing after laser treatment found the early presence of Langerhans' cells. These cells were demonstrated using a histochemical technique for adenosine triphosphatase. The significance of Langerhans' cells in healing epithelium and their probable immunological role is discussed. PMID- 6498130 TI - Invasive cervical cancer in young women. AB - Between 1970 and 1979, 103 women below 35 years of age with invasive cervical cancer were treated at the First Obstetrics and Gynaecology Clinic of the University of Milan. Nine patients were pregnant or less than 3 months postpartum. Estimated 10-year disease-free survival, determined by the life-table method, was 100% in stage IA (37 patients), 79% in stage IB (45 patients), 67% in stage II (15 patients), 0% in stages III (5 patients) and IV (1 patient). Prognosis was also strongly associated with lymph-node involvement, 10-year actuarial survival decreasing from 93% in lymph-node-negative to 44% in lymph node-positive patients (P less than 0.001). The prognostic relevance of the clinical stage decreased after adjustment for lymph-node involvement, but the statistical significance of lymph-node involvement was unaffected when stage was allowed for. In the present series, the estimated 10-year disease-free survival was 80% in patients treated by radical hysterectomy compared with 62% in the group treated by total hysterectomy (stage IB to IV patients only); this difference, however, was not statistically significant when the data were adjusted for clinical stage (P = 0.10). None of the 20 patients with recurrent disease could be managed successfully. PMID- 6498131 TI - Colposcopy in microinvasive carcinoma of the cervix--an enigma of diagnosis. PMID- 6498132 TI - Microscopical studies of necrotising scleritis. I. Cellular aspects. AB - Light and electron microscopy were used to examine tissue excised during surgery from eight patients with advanced destructive scleral disease. These comprised two cases of scleromalacia perforans, three cases of anterior necrotising scleritis alone or in conjunction with other systemic diseases, and three cases in which scleritis developed following ocular surgery. It was not possible to distinguish between these three categories by histological or cytopathological criteria. All showed extensive granulomatous infiltration of the conjunctiva, episclera, and sclera by plasma cells and lymphocytes. Mast cells were abundant throughout these inflamed tissues. Examination of scleral stroma from sites in advance of the granuloma revealed active fibroblastic cells in the absence of other inflammatory cells. Fibroblastic transformation of scleral cells may be one of the earliest events in scleral degradation during necrotising disease. PMID- 6498133 TI - Microscopical studies of necrotising scleritis. II. Collagen degradation in the scleral stroma. AB - Electron microscopy of tissue excised during surgery in eight cases of advanced anterior necrotising scleritis showed degradation of collagen in the scleral stroma by both intracellular and extracellular mechanisms. In the first of these mechanisms cells resembling active fibroblasts and macrophages were observed in the process of phagocytosis of collagen fibrils into vacuoles associated with dense cytoplasmic granules. In the second mechanism collagen fibrils in large areas of the scleral stroma appeared swollen and unravelled, or completely solubilised, without close association with stromal cells. Both activation and degeneration of stromal fibrocytes were evident in zones of extracellular fibril degradation. These changes appeared to take place prior to invasion of the stroma by cells of the granuloma. PMID- 6498134 TI - Surgical management for abnormal head position in nystagmus: the augmented modified Kestenbaum procedure. AB - Patients with nystagmus and an eccentric null point in lateral gaze may assume an abnormal head position to maximise visual acuity. Surgical procedures for this condition can result in significant undercorrection of the head turn. A follow-up of 15 patients for an average of 33 months revealed a sustained improvement in head position with the use of the augmented modified Kestenbaum procedure. PMID- 6498135 TI - Dissociated vertical deviation: evidence of abnormal visual pathway projection. AB - Abnormalities in visually evoked responses have been used to demonstrate abnormal optic nerve fibre projections in human albinos, who have anomalous nystagmoid movements. Using visually evoked potentials we tested the hypothesis that patients with dissociated vertical deviation (another group with anomalous nystagmoid movements) may have abnormal visual evoked responses similar to those of albinos. Patients with dissociated vertical deviation (both unilateral and alternating), patients with congenital esotropia without dissociated vertical deviation, and normal subjects were investigated. The results showed a very high incidence of abnormal visual evoked responses in patients with dissociated vertical deviation, while recordings from the other groups were normal. As well as suggesting the possibility of abnormalities of optic nerve fibre projections, the visual evoked responses showed a marked increase in latency in all patients with dissociated vertical deviation. These results occurred regardless of the visual acuity or amblyopia of the eyes tested. The possible existence of abnormal pathway projection in the presence of dissociated vertical deviation is discussed. PMID- 6498136 TI - Contrast sensitivity and visual disability in chronic simple glaucoma. AB - A battery of vision tests was used to quantify visual defect in a group of 50 patients with chronic simple glaucoma. The vision tests were near and distance visual acuity, visual fields, and contrast sensitivity to static and temporally modulated sinusoidal grating patterns. Of these, static contrast sensitivity function appears to be the most sensitive method of measuring visual defect in glaucoma patients. The visual disability experienced by the glaucoma patients was quantified by means of a questionnaire, and the relationship between perceived visual disability and visual defect was examined. It was found that results from a group of tests, near visual acuity, visual field, and contrast sensitivity measures, are the best predictors of the difficulty experienced by patients in performing visually dependent daily activities. PMID- 6498137 TI - Treatment of chalazions with injection of a steroid suspension. AB - A trial was conducted to compare the efficacy of the treatment of chalazions by injection of triamcinolone acetonide with conventional incision and curettage. Of the 39 injected cases 77% resolved completely, though 54% of the injected cases required a second injection. Of the 30 surgically treated cases 90% resolved, but 27% required a second operation. Injection of chalazions with a steroid suspension is a convenient and reasonably effective alternative to the standard surgical management of this common condition. PMID- 6498138 TI - Intralesional corticosteroid therapy of chalazia: a comparison with incision and curettage. AB - Patients with chalazia were randomly allocated to treatment by intralesional triamcinolone injection or incision and curettage. Incision and curettage resulted in a significantly higher rate of resolution by two weeks after treatment. PMID- 6498139 TI - Spontaneous orbital haemorrhage. AB - A 57-year-old housewife, with controlled hypertension, presented with acute right proptosis and visual loss with external ophthalmoplegia due to spontaneous orbital haemorrhage. Vision and ocular motility were returned to normal by the rapid surgical evacuation of the blood. Acute orbital haemorrhage is an ocular emergency requiring urgent treatment to prevent the usual previously reported outcome of permanent visual loss. PMID- 6498140 TI - Exogenous ocular candidiasis associated with intravenous heroin abuse. AB - Seven young men developed disseminated candidiasis within 10 days of a single episode of intravenous heroin abuse. Sequential development of eye and skin lesions was noted in all cases. The bone or costal cartilage was involved in five. Ocular manifestations of candidiasis included episcleritis, chorioretinitis, and endophthalmitis. A presumptive diagnosis of candida chorioretinitis was established rapidly by culture of Candida albicans from involved skin and costal cartilage. Systemic therapy with amphotericin B plus 5 fluorocytosine resulted in cure of the episcleritis, chorioretinitis, osteomyelitis, costochondritis, and skin infection. Pars plana vitrectomy with local instillation of amphotericin B was required to cure chorioretinitis associated with vitreal extension of infection. PMID- 6498141 TI - Human energy metabolism below, near and above energy equilibrium. AB - Complete 24 h energy and nitrogen balances were measured for fifteen subjects at three levels of energy intake and for two other subjects at two levels of intake. At each level, the fifteen subjects ate diets consisting of fifteen to twenty separate foods for 7 or 8 d. Faeces and urine were collected for the final 4 d. Respiratory gas exchange was measured during the final 72 h while the subjects stayed in an 11 m3 open-circuit respiration chamber, and simulated office or light household work. The energy balance of the other two subjects was determined initially in a similar way when they consumed a diet which was sufficient for energy equilibrium. Subsequently, the measurements were repeated twice at the same high level of metabolizable energy (ME) intake after 4 and 18 d on that diet. Neither energy nor N digestibilities were significantly affected by intake level or subject. Due to relatively small urinary energy losses the ME content of the gross energy increased slightly at the higher intake. Respiratory quotient increased with intake level from 0.78 to 0.87. The efficiencies of utilization of ME were approximately 1.0 for maintenance (from the low to the intermediate intake level) and decreased to about 0.9 for maintenance and energy deposition (from the intermediate to the high intake level). Estimates of daily ME requirements at energy equilibrium were 149 (SD 13) kJ ME/kg body-weight, 432 (SD 33) kJ ME/kg body-weight 0.75 and 204 (SD 22) kJ/kg lean body mass. The former two values were negatively correlated with percentage body fat although not significantly so. ME utilization and heat production of the other two subjects were nearly equal after 6 and 20 d on a diet supplying 1.5-1.7 times the ME needed for energy equilibrium. PMID- 6498142 TI - Short-term dietary selenium restriction in young adults: quantitative studies with the stable isotope 74SeO3(2-). AB - A 45 d metabolic study was carried out in four young adult male North American residents consuming a controlled diet based on an amino acid mixture. During the initial 10 d, total daily selenium intake was adjusted to 107.7 (SE 0.1) microgram/d, which was reduced to 11.4 (SE 0.1) microgram/d for the remaining 35 d. Two doses of a stable isotope (74SeO3(2-)) were administered orally in the post-absorptive state on days 4 and 39 of the study. Se balance (faecal + urinary excretion) as well as stable isotope excretion studies were carried out for the entire 45 d period; blood plasma and erythrocyte Se concentrations were also monitored. Plasma Se concentrations (microgram/ml) fell progressively from the initial value of 0.132 (SE 0.007) to 0.083 (SE 0.008) at the end of the study. The erythrocyte concentrations of Se did not vary in a consistent manner (average value for the entire study 0.147 (SE 0.002) microgram/ml). Faecal excretion of unenriched Se decreased from 66 (SE 6) microgram/d for days 1-10 to 10.2 (SE 0.8) microgram/d for days 14-40. Mean urinary excretions of the unenriched Se were 43.9 (SE 2.8) microgram/d (days 1-10) and 26.9 (SE 4.6) microgram/d (days 14-40). Total balance (intake-faecal excretion-urinary excretion) for unenriched Se was (microgram/d):-18 (SE 7) days 10-19, -17 (SE 2) days 19-39, -5 (SE 1) days 38-45. Fractional absorption of the ingested label was 0.529 (SE 0.032) and 0.542 (SE 0.038) for the Se-adequate and Se-restricted phases of the study. However, urinary excretion of the absorbed label was reduced from 6.57 (SE 0.73)% for day 1 of the Se-adequate phase to only 3.32 (SE 0.26)% for day 1 of the Se-restricted phase. Similar observations were also made for day 7 of each phase. These findings indicate that immediate contribution of ingested Se to the urinary Se pool is small. PMID- 6498143 TI - Nutrient intake of pregnant Asian women at Sorrento Maternity Hospital, Birmingham. AB - The dietary intake of pregnant Asian women (that is originating from the Indian subcontinent) attending Sorrento Maternity Hospital in Birmingham was determined, using the weighed and recall techniques, at five-weekly intervals from 18 to 38 weeks of pregnancy. Mean energy intake of the group was 7.1 MJ (1700 kcal)/d. The intakes of most nutrients were substantially below those consumed by pregnant European women in Britain, a little below those of expectant Pakistani mothers in Islamabad, and about the same as those of expectant East London mothers. Intakes of vitamin D, total folate, vitamin B6, zinc and magnesium were particularly low. These observations suggest that a number of Asian women in Birmingham are likely to experience nutritional stress in pregnancy, and there is some anthropometric and biochemical evidence from Sorrento, published elsewhere (Bissenden et al. 1981), to support this. A possibly beneficial feature of the diet was a low sodium intake (2 g/d). Previous work at this hospital has noted a lower prevalence of hypertension in pregnant Asian women (Wharton et al. 1980; Bissenden et al. 1981). PMID- 6498145 TI - The mode of action of anabolic agents: the effect of testosterone on muscle protein metabolism in the female rat. AB - Testosterone (1 mg/kg body-weight per d) given subcutaneously to female rats increased their growth rate and food conversion efficiency but not their food intake compared with that of the placebo-oil controls. A higher dose of testosterone (10 mg/kg body-weight per d) failed to increase the daily weight gain. The increased growth rate of the testosterone-treated rats appeared to occur in the whole body and not specifically in muscle. There were no significant changes in body composition. The fractional synthetic rate of gastrocnemius muscle protein was higher in the hormone-treated rats than in controls. This contrasts with previous results for the anabolic agent trenbolone acetate and reflects differences in the mode of action of these two different steroids, both with androgenic properties. PMID- 6498144 TI - Subethnic variation in the diets of Moslem, Sikh and Hindu pregnant women at Sorrento Maternity Hospital, Birmingham. AB - The previous paper (Eaton et al. 1984) described the nutrient intake of pregnant Asian women attending Sorrento Maternity Hospital, Birmingham using the weighed and recall methods. The present paper describes the subethnic variation in nutrient intake by comparing the results from Pakistanis, Sikhs, Hindus and Bangladeshis and also describes food eaten by the pregnant women. Generally, Sikhs had the highest intake of most nutrients (mean energy 7.5 MJ (1800 kcal)/d) and the greatest variety of foods; they ate chapatti and paratha but few ate meat. Hindus had a very similar diet but more ate meat, chicken and rice. Pakistanis had an energy intake about 10% below that of the Sikhs and Hindus; meat was eaten, and intake of fruit, and therefore vitamin C, was quite large. Bangladeshis were the smallest women; they had the lowest intake of energy (mean energy 6.5 MJ (1555 kcal)/d) and most nutrients, except for protein, so that 15% of energy was provided by protein. Fish, rice and a low-fat intake were other features of their diet. From a nutritional standpoint, peoples coming from the Asian subcontinent should be divided into subethnic groups; the collective term 'Asian' is insufficient. It is not clear whether these differences have any effect on the life and health of the individuals. Comparison of groups does not suggest an obvious relationship between dietary intake and fetal growth; however, there is other evidence to implicate the possible role of deficiencies of protein, energy, zinc and pyridoxine. The results provide some support for the community nutritional policies of (a) offering vitamin D supplements to all pregnant Asian women and (b) fortifying bread with calcium, thiamin and nicotinic acid. There is probably no need to offer vitamin A and C supplements but they are harmless. Indications for iron supplementation are no different from those for white English women. PMID- 6498146 TI - Magnesium absorption in mature ewes infused intrarumenally with magnesium chloride. AB - The effects of magnesium supplementation on Mg absorption proximal and distal to the pylorus in ewes maintained on a grass diet were investigated using a combination of balance, digesta flow and electropotential measurements. Three mature ewes each received by intrarumenal infusion a supplement of 0, 1, 2 and 3 g Mg/d in sequence over four 10-d periods. Net Mg absorption distal to the pylorus took place down its electrochemical gradient, although the quantity absorbed remained small during the control and first infusion periods. The bulk of Mg absorption occurred before the pylorus and, during the control and first infusion periods, took place against its electrochemical gradient. The net Mg absorption proximal to the pylorus rose with declining efficiency as Mg intake was increased. It is suggested that saturation of the absorption process at this site was occurring. PMID- 6498147 TI - Growth and zinc homeostasis in the severely Zn-deficient rat. AB - Male weanling rats were fed on diets either adequate (55 mg/kg), or severely deficient (0.4 mg/kg) in zinc, either ad lib. or in restricted amounts in four experiments. Measurements were made of growth rates and Zn contents of muscle and several individual tissues. Zn-deficient rats exhibited the expected symptoms of deficiency including growth retardation, cyclic changes in food intake and body weight. Zn deficiency specifically reduced whole body and muscle growth rates as indicated by the fact that (a) growth rates were lower in ad lib.-fed Zn deficient rats compared with rats pair-fed on the control diet in two experiments, (b) Zn supplementation increased body-weights of Zn-deficient rats given a restricted amount of diet at a level at which they maintained weight if unsupplemented, (c) Zn supplementation maintained body-weights of Zn-deficient rats fed a restricted amount of diet at a level at which they lost weight if unsupplemented (d) since the ratio, muscle mass: body-weight was lower in the Zn deficient rats than in the pair-fed control groups, the reduction in muscle mass was greater than the reduction in body-weight. Zn concentrations were maintained in muscle, spleen and thymus, reduced in comparison to some but not all control groups in liver, kidney, testis and intestine, and markedly reduced in plasma and bone. In plasma, Zn concentrations varied inversely with the rate of change of body-weight during the cyclic changes in body-weight. Calculation of the total Zn in the tissues examined showed a marked increase in muscle Zn with a similar loss from bone, indicating that Zn can be redistributed from bone to allow the growth of other tissues. The magnitude of the increase in muscle Zn in the severely Zn deficient rat, together with the magnitude of the total losses of muscle tissue during the catabolic phases of the cycling, indicate that in the Zn-deficient rat Zn may be highly conserved in catabolic states. PMID- 6498148 TI - Undernutrition in sheep. The effect of supplementation with protein on protein accretion. AB - In a comparative-slaughter experiment, individually rationed wether lambs initially of 42 kg were given 235, 362 or 456 kJ metabolizable energy (ME)/kg live weight (LW)0.75 per d as sodium hydroxide-treated barley straw with urea (six lambs per treatment), or NaOH-treated barley straw with urea plus 125 g/d white-fish meal to give 307 or 488 kJ ME/kg LW0.75 per d (seven lambs per treatment) for 92 d. All unsupplemented lambs lost both fat and body protein. The changes in fat were -3.53, -2.75 and -1.40 (SE 0.59) kg (initial value 8.6 kg), and the changes in body protein were -0.47, -0.09 and -0.14 (SE 0.13) kg (initial value 4.9 kg) for the three unsupplemented groups respectively. When supplemented with fish meal, fat was again lost as -1.53 and -0.93 (SE 0.55) kg, but wool-free body protein was increased, and gains were 0.48 and 0.89 (SE 0.12) kg for the two supplemented groups respectively. All animals lost wool-free body energy, total changes being -150, -111, -59 and -49 and -16 MJ respectively. When corrected to an equal ME intake the supplemented lambs, when compared with the unsupplemented lambs, gained (instead of losing) body protein (P less than 0.001) and lost less fat (P less than 0.05). Wool growth did not respond to supplemental protein, but was related to ME intake with an increase of 0.78 g wool fibre for each additional MJ ME. The maintenance requirements of the unsupplemented and supplemented groups respectively were estimated by regression analysis to be 554 and 496 kJ ME/kg LW0.75 per d. The apparent utilization of ME below energy equilibrium (km) was 0.31 (SE 0.08) for the unsupplemented animals, and 0.12 (SE 0.10) for the supplemented animals, well below a km of 0.70 which current UK standards (Agricultural Research Council, 1980) would predict. Most of these differences could be reconciled if basal metabolism was assumed not to be constant. It is concluded that lambs in negative energy balance can continue lean body growth at the expense of body fat, provided sufficient dietary protein is available. It is also concluded that since the animals at the lowest ME intakes required less ME than predicted by current feeding standards, the effect was that it would have been difficult to distinguish between the apparent utilization of ME for maintenance (km) and for fattening (kf). PMID- 6498149 TI - Metabolism of cryptoxanthin in freshwater fish. AB - In search of other provitamins A, the metabolism of cryptoxanthin was studied in several species of freshwater fish, i.e. Channa gachua, Labeo boga (retinol-rich) and Heteropneustes fossilis (dehydroretinol-rich). The fish were either allowed to starve for 20-25 d to make their intestines free from carotenoids and vitamin A or kept on a vitamin-A-deficient diet for 140-150 d to deplete the initial reserve of vitamin A in the livers. Retinol-rich freshwater fish such as C. gachua and L. boga converted cryptoxanthin into retinol and no 3-dehydroretinol or 3-hydroxyretinol could be isolated from those fish that received cryptoxanthin. 3-Hydroxyretinol and 3-dehydroretinol were isolated from the vitamin-A-deficient H. fossilis, a 3-dehydroretinol-rich freshwater siluroid, after the administration of cryptoxanthin. PMID- 6498150 TI - Leucine and isoleucine requirements of the kitten. AB - In separate experiments the isoleucine and leucine requirements of the kitten were determined on the basis of growth and nitrogen retention. The dietary concentrations of isoleucine tested were (g/kg diet) 1.4, 2.2, 3.0, 3.8, 4.6 and 9.0 with adequate (12.0 g/kg diet) leucine. The levels of leucine tested were (g/kg diet) 5.0, 7.5, 9.0, 10.5, 12.0 and 20.0 in diets containing adequate (9.0 g/kg diet) isoleucine. In both experiments six male and six female kittens received each dietary level of isoleucine or leucine for periods of 10 d in a balanced 6 X 6 Latin-square experimental design. Asymptotic curves were fitted to the response relationships and the minimal dietary requirements for maximal response were estimated from the values at 0.95 of the asymptote. On this basis, the requirements for maximal growth were 6.2 g isoleucine/kg and 7.8 g leucine/kg diet. The requirements for maximal N retention were higher; 8.4 g isoleucine and 10.6 g leucine/kg diet. The isoleucine requirements suggested by this method are probably overestimations and might be slightly above 4.6 g/kg diet. Plasma isoleucine and leucine concentrations were not useful in estimating the requirements. Plasma leucine increased rectilinearly with increasing dietary leucine while the response of plasma isoleucine to increasing dietary isoleucine was non-rectilinear. Neither response relationship exhibited a breakpoint at the level of requirement. Below the suggested minimal requirement for leucine there were significant increases in the concentrations of isoleucine and valine in the plasma. Dietary isoleucine below the level of requirement had no effect on plasma valine and leucine. Dietary leucine had no effect on the plasma concentrations of methionine, phenylalanine and threonine, suggesting that the effect of decreasing dietary leucine on plasma isoleucine and valine is a result of decreased oxidation rather than decreased protein anabolism. In a separate experiment six kittens, presented a diet containing 2.2 g isoleucine/kg, developed crusty exudates around their eyes within 27 d and six kittens, presented diets containing 3.8 g isoleucine/kg, showed this clinical sign but with less severity within 47 d. Cultures of conjunctival swabs taken from the most severely affected kittens showed the presence of staphylococcal species, suggesting that in isoleucine-deficient kittens there was impaired resistance to these dermal microbes. PMID- 6498151 TI - Further studies on the effects of the presence or absence of protozoa in the rumen on live-weight gain and wool growth of sheep. AB - Lambs were given a diet of oaten chaff-sucrose-fishmeal (48:48:4, w/w) and either 60 (diet A) or 120 (diet B) g urea/kg sucrose in the diet. All animals were defaunated and half were refaunated. Each group of lambs (faunated and defaunated) was then divided into two groups and given diet A or diet B. Feed intake, wool growth and live-weight change were monitored over a 182 d period. The level of urea supplementation had no effect on wool growth or live-weight gain. Defaunated lambs gained live weight at a higher rate (9%, P less than 0.06) and grew 37% more wool (P less than 0.01) than the lambs with large populations of protozoa in their rumens. PMID- 6498152 TI - The nutritive value of rumen micro-organisms in ruminants. 4. The limiting amino acids of microbial protein in growing sheep determined by a new approach. AB - Four experiments were carried out to identify and quantify the limiting amino acids (AA) in rumen microbial protein (RMP). A method was developed which involved first, an assessment of the efficiency of utilization of absorbed AA nitrogen (U) of RMP, defined as the retention of AA-N from RMP absorbed from the small intestine, and second, addition of a mixture of AA similar to the absorbed AA profile in a quantity defined by the U of RMP and equal to (1-U)/U. Third, it involved removal of each AA in turn and measurement of the resultant N retention. Using this approach it was possible to calculate both the order and extent of AA limitations in RMP. Apart from methionine which was found to be the most limiting AA, only lysine, arginine and histidine reduced N retention when omitted, and accordingly only these AA were limiting in RMP. The method is discussed in detail and the amount of supplementary AA required to utilize RMP fully is calculated. PMID- 6498153 TI - Simulation of the metabolism of absorbed energy-yielding nutrients in young sheep. AB - A mathematical model is described, which simulates the metabolism of absorbed nutrients (amino acids, acetic acid, butyric acid, glucose, lipid and propionic acid) in growing sheep. The basic assumption of the model is that each nutrient is partitioned between synthetic, oxidative or intermediate reactions with rates of reaction which are described using enzyme kinetics. These rates depend on the relationship between maximum reaction rates, constants of affinity and inhibition and the concentrations of metabolites as determined by the model. Synthetic reactions calculate fat and protein deposition while intermediate reactions involve the production of ATP and NADPH. There is a total of twelve state variables and the model, programmed in CSMP and ACSL, is solved by integration of twelve differential equations. The model calculates the efficiency of utilization of metabolizable energy for different nutrient inputs and the results may be interpreted in terms of fluxes through the metabolite pools. Simulations using inputs representing forage- and concentrate-based diets indicated decreased efficiency for the forage at high levels of intake and possible reasons for this were further studied in simulations where the inputs of protein and glucose were varied. PMID- 6498154 TI - Glycosylation and processing of high-mannose oligosaccharides of thyroid stimulating hormone subunits: comparison to nonsecretory cell glycoproteins. AB - Thyroid-stimulating hormone (TSH) subunit glycosylation was compared to that of total cell glycoproteins in mouse thyrotropic tumors. Lipid-linked oligosaccharides, total cell glycoproteins, and TSH subunits were labeled with either [3H]mannose, [3H]galactose, or [3H]glucose in pulse and pulse-chase experiments. The various oligosaccharides were isolated respectively by lipid extraction and mild acid hydrolysis, by selective immunoprecipitation, or by acid precipitation followed by trypsin and endoglycosidase H treatment. The nature of the oligosaccharides was assessed by their migration in paper chromatography, their relative incorporation of different precursors, and also their resistance to alpha-mannosidase. At 60 min, lipid-linked oligosaccharides were found to be composed of Glc3-2Man9GlcNAc2, Man9-8GlcNAc2, and Man5GlcNAc2. At 10 or 60 min of labeling, total cell proteins contained Glc3Man9GlcNAc2, Glc1Man9GlcNAc2, Man9GlcNAc2, Glc1Man8GlcNAc2, Man8GlcNAc2, and Man7GlcNAc2. The largest oligosaccharide, Glc3Man9GlcNAc2, had an unusually long half-life of about 2 h. In contrast, no Glc3Man9GlcNAc2 was found either on TSH + alpha subunits or on free beta subunits isolated either by immunoprecipitation or by sodium dodecyl sulfate gel electrophoresis. Instead, primarily Man9GlcNAc2 was found after a 10 min pulse both on TSH + alpha subunits and on beta subunits. When the pulse was followed by a chase up to 2 h, there was a progressive increase in Man8GlcNAc2 in higher amounts on TSH + alpha-subunit carbohydrate chains than on beta subunits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498155 TI - Long-lived metastable states and hysteresis in the binding of acetylcholine to Torpedo california acetylcholine receptor. AB - Studies of the binding of [3H]acetylcholine to receptor-rich membranes of Torpedo californica electric organ under conditions that normally lead to a state of equilibrium did not give rise to equilibrium binding curves. Instead, the acetylcholine receptor was found to develop very long lived metastable states resulting in hysteresis in binding. Under conditions where the concentration of free [3H]acetylcholine is both less than 0.1 microM and smaller or comparable to the total receptor concentration, the degree of binding of acetylcholine depends on the rate, i.e., the mode, of increasing the acetylcholine concentration (rapid mixing vs. dialysis). The equilibrium positive cooperativity in high-affinity acetylcholine binding previously inferred from the data is deceiving; the curvature in Scatchard representations is a consequence of long-lived nonequilibrium distributions between high-affinity and lower affinity receptor conformers. By manipulation of the experimental conditions, true equilibrium binding, resulting in a linear Scatchard binding curve, was obtained and yielded the apparent equilibrium constant, K = 5 +/- 1 nM at 4 degrees C. The stoichiometry of the high-affinity site associated with this K value was found to be one acetylcholine per receptor monomer (Mr 250 000) when carefully standardized [3H]acetylcholine analyzed for both radiopurity and acetylcholine concentration was used. While our fresh membrane fragments prepared in the presence of 4 mM Ca2+ revealed up to twice as many 125I-alpha-bungarotoxin sites in 0.1% nonionic detergent relative to those assayed in the absence of detergent, nonionic detergent treatment of membrane fragments did not result in any change in total available acetylcholine binding sites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498156 TI - Kinetic studies of prothrombin activation: effect of factor Va and phospholipids on the formation of the enzyme-substrate complex. AB - The kinetic parameters of bovine prothrombin activation by factor Xa were determined in the absence and presence of factor Va as a function of the phospholipid concentration and composition. In the absence of factor Va, the Km for prothrombin increases proportionally with the phospholipid concentration and correlates well with the affinity of prothrombin for the different membranes. Phospholipid vesicles with a high affinity for prothrombin yield low Km values compared to membranes with less favorable binding parameters. At limited phospholipid concentrations, the Vmax of prothrombin activation correlates with the binding affinity of factor Xa for the various phospholipid vesicles. Membranes with a high affinity for factor Xa have high Vmax values, while for membranes with a low affinity a low Vmax is observed. Extrapolation of double reciprocal plots of 1/Vmax vs. 1/[phospholipid] to infinite phospholipid concentrations, a condition at which all factor Xa would participate in prothrombin activation, yields a kcat of 2-4 min-1 independent of the type and amount of acidic phospholipid present in the vesicles. Also, in the presence of factor Va the Km for prothrombin varies proportionally with the phospholipid concentration. There is, however, no correlation between the binding parameters and the Km. Factor Va drastically lowers the Km for prothrombin for vesicles that have a low affinity for prothrombin. Vesicles composed of 20 mol % phosphatidylglycerol and 80 mol % phosphatidylcholine have a Km of 0.04 microM when factor Va is present, compared to 2.2 microM determined in the absence of factor Va.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498157 TI - Stimulation of the glycine cleavage system by short-chain fatty acids in isolated rat liver mitochondria. AB - The effect of short-chain fatty acids on glycine catabolism by the glycine cleavage system was investigated in isolated rat liver mitochondria. Metabolic flux through the glycine cleavage system was monitored by measuring the production of 14CO2 from [1-14C]glycine. Propionate, butyrate, pentanoate, and octanoate, and to a lesser extent acetate, all significantly stimulated 14CO2 production from [1-14C]glycine by isolated rat liver mitochondria maintained in state 4. Concomitant with the stimulation of 14CO2 production was a decrease in the measured intramitochondrial content of NADPH which we have previously demonstrated correlates with the metabolic flux through the glycine cleavage system [Hampson, R.K., Barron, L.L., & Olson, M.S. (1983) J. Biol. Chem. 258, 2993-2999]. The propionate-mediated stimulation of mitochondrial 14CO2 production from [1-14C]glycine was not diminished by the addition of L-carnitine but was abrogated nearly completely by the addition of oligomycin. Incubation of the mitochondria with short-chain fatty acids evoked a large decrease in the measured intramitochondrial ATP content and a large increase in the AMP content. However, manipulation of the intramitochondrial adenine nucleotide profile demonstrated that no direct correlation existed between ATP, ADP, or AMP and 14CO2 production from [1-14C]glycine. These experimental results indicate that short-chain fatty acid oxidation causes the oxidation of the NADP(H) redox couple in isolated rat liver mitochondria, resulting in the stimulation of the metabolic flux through the glycine cleavage system.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498158 TI - Bilayer membranes containing the ganglioside GM1: models for electrostatic potentials adjacent to biological membranes. AB - Although the Gouy-Chapman-Stern theory of the aqueous diffuse double layer describes well the electrostatic potential adjacent to negatively charged phospholipid bilayer membranes, it does not describe adequately the zeta potential of biological membranes: the zeta potential of an erythrocyte is about half the value predicted from the theory by using the known density of negatively charged sialic acid residues. To investigate the factors responsible for this low electrophoretic mobility, we formed membranes from mixtures of the zwitterionic lipid phosphatidylcholine, PC, and the glycolipid galactosyl-N acetylgalactosaminyl(N-acetylneuraminyl) -galactosylglucosylceramide, GM1. This glycolipid differs from phospholipids in two respects. First, the negative charge on GM1 is located about 1 nm from the surface, which tends to increase the electrophoretic mobility of vesicles. Second, the head group of GM1 contains five sugar groups that exert a hydrodynamic drag, which tends to decrease the mobility of the vesicles. In a decimolar monovalent salt solution, where the Debye length is about 1 nm, the electrophoretic mobility of the PC-GM1 vesicles is about half the mobility of PC-phosphatidylserine or PC-phosphatidylglycerol vesicles of equivalent composition. In addition, conductance measurements with planar bilayer membranes as well as 31P nuclear magnetic resonance and fluorescence measurements with sonicated vesicles indicate that the potential at the surface of PC-GM1 membranes is about half the value measured for PC-phosphatidylserine membranes in a 0.1 M monovalent salt solution. PMID- 6498159 TI - Kinetics of phosphatidylcholine and lysophosphatidylcholine exchange between unilamellar vesicles. AB - The rates of exchange of phosphatidylcholine and lysophosphatidylcholine from unilamellar donor vesicles to acceptor vesicles of similar composition were followed in a protein-free system to establish the relationship between the rate of exchange and the aqueous-phase solubility of the lipid. Further, the rate of exchange of dimyristoylphosphatidylcholine (DMPC) between vesicles was examined over a range of temperatures to determine the effect of the lipid phase transition on the rate of lipid exchange. Intervesicular exchange of DMPC is faster than transbilayer exchange; lipid molecules in the outer monolayer of the bilayer exchange with t1/2 = 2.0 h at 37 degrees C. A discontinuity is observed in Arrhenius plots of DMPC exchange; the activation energy over the temperature range 27-45 degrees C is 70 kJ mol-1. The t1/2 for DMPC exchange extrapolated to 24.5 degrees C (the phase transition temperature of the donor bilayer) is 6.5 h and from temperatures below 24 degrees C is 82.6 h. The differences in the thermodynamic parameters of activation for DMPC exchange above and below 24.5 degrees C are 25 kJ mol-1 for the activation enthalpy and 197 J mol-1 K-1 for the activation entropy. These differences are similar to the enthalpy and entropy changes associated with the gel to liquid-crystalline phase transition of DMPC. The rate of exchange of lysopalmitoyl-phosphatidylcholine (LPPC) was difficult to measure since LPPC transfers rapidly to the columns used for separating donor and acceptor vesicles; the t1/2 for transfer is less than 2 min. LPPC at 5 mol % in cholesterol-egg PC vesicles does not affect the rate of cholesterol exchange.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498160 TI - Calcium-promoted fusion of isolated chromaffin granules detected by resonance energy transfer between labeled lipids embedded in the membrane bilayer. AB - Chromaffin granules isolated from bovine adrenal medulla were labeled with small unilamellar vesicles (SUV) made from N-(7-nitro-2,1,3-benzoxadiazol-4 yl)phosphatidylethanolamine and/or N-(lissamine rhodamine B sulfonyl)phosphatidylethanolamine as donor and acceptor fluorophores. Labeling of granules could be followed by the relief of self-quenching experienced when the labels were incorporated into the granule membrane. The mechanism of incorporation seemed to be fusion of the SUV with the granule membrane although transfer of label could not be ruled out. Granule-granule fusion could be detected either by resonance energy transfer from donor to acceptor fluorophores or by donor quenching, in either of two different experimental designs: by a decrease in donor fluorescence and an increase in acceptor fluorescence when donor-labeled granules fused with acceptor-labeled granules or by an increase in donor fluorescence and a decrease in acceptor fluorescence when granules containing both probes fused with unlabeled granules. Fusion of freshly prepared granules could be initiated by millimolar concentrations of calcium; magnesium was less effective. Mg-ATP had no effect. Fusion was inhibited by potassium glutamate and a variety of organic and inorganic cations and anions, which also inhibited granule-granule aggregation to a lesser extent. The conditions for promotion and inhibition of granule-granule fusion were quite different from those reported by Knight and Baker [Knight, D. E., & Baker, P.F. (1982) J. Membr. Biol. 68, 107-140] for exocytosis of granule contents from permeabilized chromaffin cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498161 TI - Local structural changes in tropomyosin detected by a trypsin-probe method. AB - Structural changes in tropomyosin from rabbit skeletal muscle were studied by the tryptic digestion method, which is an application of the quantitative enzyme probe method recently developed by Ueno and Harrington [Ueno, H., & Harrington, W.F. (1984) J. Mol. Biol. 173, 35-61]. Effects of ionic strength, temperature, and an interchain disulfide bond at Cys-190 on the structure of tropomyosin were examined. A region of high susceptibility to trypsin was found to be localized in the middle portion of the molecule, and its susceptibility increased on lowering ionic strength and/or raising temperature. With the introduction of a disulfide bond at Cys-190, cleavage on the N-terminal side of Cys-190 was accelerated. The results suggest that skeletal muscle tropomyosin is flexible in the middle of the molecule in contrast to the flanking N- and C-terminal trypsin-resistant segments. PMID- 6498162 TI - Modulation of actin polymerization by the spectrin-band 4.1 complex. AB - The effect of human erythrocyte spectrin dimer and band 4.1 on the polymerization of actin was studied by two independent methods: by following the increase in fluorescence of actin covalently conjugated to N-pyrenyl-iodoacetamide (pyrenylactin) and by following the increase in light scattered by actin polymers. Both techniques indicated that the complex of spectrin dimer and band 4.1, but neither spectrin nor band 4.1 alone, stimulates the rate of nucleation (decreases the lag phase of polymerization) and stabilizes oligomers of F-actin. While the band 4.1-spectrin complex, but not spectrin alone, had no immediate effect on the rate of polymerization after the lag phase, it eventually decreases the rate of actin filament growth when the molecular ratio of actin-spectrin-band 4.1 approaches the physiological range. The complex has no detectable effect on the critical actin concentration and does not significantly alter the apparent order of the nucleation reaction. PMID- 6498163 TI - Syntheses and configurational analyses of thymidine 4-nitrophenyl [17O,18O]phosphates and the stereochemical course of a reaction catalyzed by bovine pancreatic deoxyribonuclease I. AB - The syntheses of both diastereomers of thymidine 3'-(4-nitrophenyl [17O,18O]phosphate) [( 17O,18O]TpNP) and of thymidine 5'-(4-nitrophenyl [17O,18O]phosphate) [( 17O,18O]NPpT) and the Rp diastereomer of thymidine 3'-(4 nitrophenyl [17O,18O]phosphate) 5'-(4-nitrophenyl phosphate) [( 17O,18O]NPpTpNP) are described. The absolute configurations of the chiral phosphorus atoms have been determined unambiguously by 31P and 17O NMR spectroscopy. The Rp diastereomer of [17O,18O]NPpTpNP was hydrolyzed in the presence of bovine pancreatic deoxyribonuclease I to yield the Rp diastereomer of thymidine 3' [16O,17O,18O]-phosphate 5'-(4-nitrophenyl phosphate), demonstrating that the enzyme-catalyzed reaction occurs by a mechanism in which a single displacement reaction occurs at the chiral phosphorus atom. PMID- 6498164 TI - Reinvestigation of the structure of oxidized and reduced flavin: carbon-13 and nitrogen-15 nuclear magnetic resonance study. AB - Several chemically substituted flavins are investigated in the oxidized and the reduced state by 13C and 15N NMR techniques. The dependence on the polarity of the solvent and on the concentration is studied. In combination with already published results, a semiempirical theory is developed to interpret the chemical shifts in terms of the solution structure of flavins. Where possible, the results are compared with crystallographic and light absorption data. In contrast to common ideas, the solution structure of the oxidized state is not fully coplanar, but the N(10) atom is situated out of plane to a certain degree. Polarizing the flavin by hydrogen bonds in a high dielectric medium moves the N(10) atom into the molecular plane, and the flavin molecule becomes coplanar. In the coplanar molecule, pi electrons are delocalized from the N(10) atom mainly to O(2 alpha) and O(4 alpha). The NMR results show that the solution structure of reduced flavin is mainly governed by sterical hindrance and hydrogen bonds. The findings are in contrast to commonly accepted ideas that reduced flavin is strongly bent. In an apolar solvent, the reduced neutral isoalloxazine is only slightly bent. The formation of hydrogen bonds in a protic solvent of a high dielectric constant decreases the bend. The N(10) atom is now almost fully sp2 hybridized, and the N(5) atom has an endocyclic angle of 115-117 degrees, indicating its predominant sp2 character. The results have several important implications for flavin catalysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498165 TI - Modification of the heme distal side in myoglobin by cyanogen bromide. Heme environmental structures and ligand binding properties of the modified myoglobin. AB - Met, deoxy, and CO forms of myoglobin (Mb) react with a stoichiometric amount of cyanogen bromide (BrCN) to cause substantial changes in the 1H NMR, optical absorption, and infrared spectra. These spectral changes were interpreted as arising from the substantial alterations in the heme environments, most probably due to the modification of the histidine residue at the heme distal side. It is also revealed that the modified Mb does not combine with some exogenous ligands such as CN-, CH3NH2, and O2, although it does with N-3 or CO. These unique ligand binding properties are also discussed with relevance to a role of the distal histidine in stabilizing the coordinated ligand through a hydrogen bond and to a steric constraint. PMID- 6498166 TI - Assignment of 1H NMR resonances of histidine and other aromatic residues in met-, cyano-, oxy-, and (carbon monoxy)myoglobins. AB - The resolved 1H NMR resonances of the aromatic region in the 270-MHz NMR spectrum of sperm whale, horse, and pig metmyoglobin (metMb) have been assigned, including the observable H-2 and H-4 histidine resonances, the tryptophan H-2 resonances, and upfield-shifted resonances from one tyrosine residue. The use of different Mb species, carboxymethylation, and matching of pK values allows the assignment of the H-4 resonances, which agree in only three cases out of seven with scalar correlated two-dimensional NMR spectroscopy assignments by others. The conversion to hydroxymyoglobin at high pH involves rearrangements throughout the molecule and is observed by many assigned residues. In sperm whale ferric cyanomyoglobin, nine H-2 and eight H-4 histidine resonances have been assigned, including the His 97 H-2 resonance and tyrosine resonances from residues 103 and 146. The hyperfine shifted resonances from heme and near-heme protons observe a shift with a pK = 5.3 +/- 0.3 (probably due to deprotonation of His-97, pK = 5.6) and another shift at pK = 10.8 +/- 0.3. The spectrum of high-spin ferrous sperm whale deoxymyoglobin is very similar to that of metMb, which allows the assignment of seven surface histidine H-2 and H-4 resonances and also resonances from the two tryptophan residues and one tyrosine. In diamagnetic sperm whale (carbon monoxy)myoglobin (COMb), 10 His H-2 and 11 His H-4 resonances are observed, and 8 H-2 and 9 H-4 resonances are assigned, including His-64 H-4, the distal histidine. This important resonance is not observed in sperm whale oxymyoglobin, which in general shows very similar titration curves to COMb. Histidine-36 shows unusual titration behavior in the paramagnetic derivatives but normal behavior in the diamagnetic derivatives, which is discussed in the accompanying paper [Bradbury, J. H., & Carver, J. A. (1984) Biochemistry (following paper in this issue)]. PMID- 6498167 TI - Conformational differences between various myoglobin ligated states as monitored by 1H NMR spectroscopy. AB - In paramagnetic metmyoglobin, cyanomyoglobin (CNMb), and deoxymyoglobin, His-36 has a high pK (approximately 8), and the NMR titration behavior of the H-2 resonance is perturbed, due to the presence at low pH of a hydrogen bond with Glu 38, which is broken at high pH. The His-36 H-4 resonance shows no shift with pK approximately 8 because of two opposing chemical shift effects but monitors the titration of nearby Glu-36 (pK = 5.6). In diamagnetic derivatives [(carbon monoxy)myoglobin (COMb) and oxymyoglobin (oxyMb)], the titration behavior of His 36 H-2 and H-4 resonances is normalized (pK approximately 6.8). The very slight alkaline Bohr effect in sperm whale myoglobin (Mb) is interpreted in terms of the pK change of His-36 from deoxyMb to oxyMb and compensating pK changes in the opposite direction of other unspecified groups. In sperm whale COMb at 40 degrees C, the distal histidine (His-64) and His-97 have pK values of 5.0 and 5.9. The meso proton resonances remote from these groups do not show a titration shift, but the nearby gamma-meso proton (pK = 5.3) responds to titration of both histidines, and the upfield Val-68 methyl at -2.3 ppm (pK = 4.7) witnesses the titration of nearby His-64. At 20 degrees C, the latter resonance is reduced in size, and a second resonance occurs at -2.8 ppm, which is insensitive to pH and, hence, more remote from His-64. Both resonances arise from two conformations of Val-68 in slow equilibrium. In oxyMb at 20 degrees C, only the latter resonance is observed, presumably because of the steric restrictions imposed by the hydrogen bond between ligand and His-64 in oxyMb, which is not present in COMb. In oxyMb the pK of His-97 (5.6) is similar to that of the meso proton resonances (5.5) and to the pK of other pH-dependent processes, including the very small acid Bohr effect. It is likely that these processes are controlled by the titration of His-97.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498168 TI - Photochemically induced nuclear polarization study of exposed tyrosines, tryptophans, and histidines in postsynaptic neurotoxins and in membranotoxins of elapid and hydrophid snake venoms. AB - The accessibility of surface tyrosines, histidines, and tryptophans in snake venom neurotoxins (short and long) and in membranotoxins to excited triplet 10 (carboxyethyl)-flavin was studied by photochemically induced dynamic nuclear polarization at 270 MHz. Trp-29 is accessible in the short neurotoxins- erabutoxins a, b, and c and cobrotoxin--and also in the long neurotoxins--alpha cobratoxin and alpha-bungarotoxin. Tyr-25 is practically inaccessible in all neurotoxins. Tyr-39 in cobrotoxin and Tyr-55 in alpha-bungarotoxin are accessible. His-6 (revised sequence) is inaccessible in the erabutoxins while His 26 is only very weakly accessible. His-22 of alpha-cobratoxin is inaccessible as are His-4 and -68 in alpha-bungarotoxin and His-4 of cobrotoxin. His-33 of cobrotoxin is accessible. The rigidity order alpha-bungarotoxin greater than or equal to alpha-cobratoxin greater than or equal to erabutoxins, with respect to the unfolding effect of 7 M urea, was deduced in this study. In the membranotoxins studied (cardiotoxin and its analogues I, II, and IV as well as cytotoxin I and II), the two tyrosines Tyr-25 and Tyr-58 are only weakly accessible. Tyr-14 is completely accessible and so is in all probability Tyr-29. These studies allow deductions to be made about the accessibilities in analogous systems. Thus, the accessibility of His-33 and the inaccessibility of His-4 in cobrotoxin can be used to deduce the conformations of these residues in a large group of neurotoxins including the alpha-toxin of Naja nigricollis, neurotoxin II of Naja naja oxiana, and neurotoxins I and III of Naja mossambica mossambica.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498169 TI - Affinity labeling of the reduced diphosphopyridine nucleotide inhibitory site of glutamate dehydrogenase by 6-[(4-bromo-2,3-dioxobutyl)thio]-6-deaminoadenosine 5' diphosphate. AB - Bovine liver glutamate dehydrogenase reacts covalently with the new adenosine analogue 6-[(4-bromo-2,3-dioxobutyl)thio]-6-deaminoadenosine 5'-diphosphate with incorporation of about 1 mol of reagent/mol of enzyme subunit. Modified enzyme completely loses its normal ability to be inhibited by high concentrations of reduced diphosphopyridine nucleotide (DPNH) (greater than 100 microM), which binds at a regulatory site distinct from the catalytic site; however, the modified enzyme retains its full activity when assayed at 100 microM DPNH in the absence of allosteric compounds. The enzyme is still activated by ADP, is inhibited by GTP (albeit at higher concentrations), and binds 1.5-2 mol of [14C]GTP/subunit. A plot of initial velocity vs. DPNH concentration for the modified enzyme, in contrast to the native enzyme, followed Michaelis-Menten kinetics. The rate constant (k) for loss of DPNH inhibition (as measured at 0.6 mM DPNH) exhibits a nonlinear dependence on reagent concentration, suggesting a reversible binding of reagent (Kd = 0.19 mM) prior to irreversible modification. At 0.1 mM 6-[(4-bromo-2,3-dioxobutyl)thio]-6-deaminoadenosine 5'-diphosphate, k = 0.036 min-1 and is not affected by alpha-ketoglutarate, 100 microM DPNH, or GTP alone but is decreased to 0.0094 min-1 by 5 mM DPNH and essentially to zero by 5 mM DPNH plus 100 microM GTP. Incorporation after incubation with 0.25 mM 6-[(4 bromo-2,3-dioxobutyl)thio]-6-deaminoadenosine 5'-diphosphate for 2 h at pH 7.1 is 1.14 mol/mol of subunit in the absence but only 0.24 mol/mol of subunit in the presence of DPNH plus GTP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498170 TI - Biosynthetic incorporation of fluorescent carbazolylundecanoic acid into membrane phospholipids of LM cells and determination of quenching constants and partition coefficients of hydrophobic quenchers. AB - A fluorescence quenching method was developed for determining partition coefficients and diffusional rates of small molecules in cell membranes. This method involves quenching the fluorescence of carbazole-labeled membranes by hydrophobic molecules that partition into membranes. Cell membrane phospholipids of mouse LM cells in tissue culture were biosynthetically labeled with the carbazole moiety by supplementing the growth media with 11-(9 carbazolyl)undecanoic acid. Plasma membranes, microsomes, and mitochondria were isolated free of nonmembranous neutral lipids, and the incorporation of the fluorescent probe was characterized. Quenching studies of the carbazole moiety by a series of N-substituted picolinium perchlorate salts showed that the carbazole moiety was located in the hydrophobic interior of the membrane bilayer. The carbazole fluorescence also was quenched by the hydrophobic quenchers lindane, methoxychlor, and 1,1-dichloro-2,2-bis(rho-chlorophenyl)ethylene, indicating that these compounds partitioned into the membrane. Stern-Volmer quenching constants determined by fluorescence lifetime and intensity measurements were identical, as expected for dynamic quenching. The effects of different lipid compositions on quenching constants and partition coefficients were determined by comparing different membrane fractions. These parameters also were measured in membranes from cells in which the phospholipid composition was altered by substituting ethanolamine for choline in the growth medium. Changes in the lipid composition produced changes in the bimolecular quenching constants. For example, bimolecular quenching constants for 1,1-dichloro-2,2-bis(rho-chlorophenyl)ethylene were higher in mitochondrial membranes than in plasma membranes and microsomes. They were also higher in dispersions made from membrane phospholipids as compared with intact membranes or total lipid dispersion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498171 TI - Influence of phospholipid peroxidation on the phase behavior of phosphatidylcholine and phosphatidylethanolamine in aqueous dispersions. AB - The influence of oxygen-induced phospholipid peroxidation on the phase behavior of aqueous dispersions of both egg phosphatidylcholine (egg-PC) and egg phosphatidylethanolamine (egg-PE) has been investigated. Phospholipid peroxidation was followed via malondialdehyde formation and analyses of acyl chain compositions. 13C nuclear magnetic resonance spectroscopy (NMR) and the amino-indicating probe trinitrobenzenesulfonic acid were used to study the effect of peroxidation on the chemical structure of hydrated egg-PE. The macroscopic organization of the phospholipids was monitored by 31P NMR and small-angle X-ray diffraction. Differential scanning calorimetry was employed to study the influence of peroxidation on the thermotropic behavior of egg-PE. The results show that egg-PE is more sensitive to the effects of peroxidation than egg-PC. In the latter, no changes in the macromolecular organization were observed. However, peroxidation strongly influenced the polymorphic phase behavior of PE. Initial peroxidation stabilized hydrated egg-PE in a lamellar system up to 70 degrees C, presumably by modification of the head group. Such modifications were confirmed by 13C NMR experiments, which indicated the formation of Schiff bases between PE head groups and aldehydes. Furthermore, quantitative analyses of trinitrobenzenesulfonic acid reactable egg-PE and the corresponding fatty acid compositions revealed the presence of cross-links between the ethanolamine head groups, likely involving the bifunctional malondialdehyde. Prolonged peroxidation of egg-PE resulted in a loss of order in the system, possibly by the formation of intermediate nonbilayer structures. PMID- 6498172 TI - Transmembrane movement of phosphatidylglycerol and diacylglycerol sulfhydryl analogues. AB - Transmembrane movement of phospholipids is a fundamental step in the process of biological membrane assembly and intracellular lipid sorting. To facilitate study of transmembrane movement, we have synthesized analogues of phosphatidylglycerol and diacylglycerol in which a sulfhydryl group replaces a hydroxyl group in the polar head group. A rapid, continuous assay for the movement of phospholipids across single-walled lipid vesicles was developed that exploits the reactivity of these analogues toward 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB), a nonpenetrating, colorimetric, sulfhydryl reagent. In the reaction of DTNB with vesicles containing phosphatidylthioglycerol, a phosphatidylglycerol analogue, two kinetic phases were seen, which represent the reaction of DTNB with phosphatidylthioglycerol in the outer and inner leaflets of the bilayer. Analysis of the slow second phase indicated that the half-time for phosphatidylthioglycerol transbilayer movement was in excess of 8 days. In a similar experiment using dioleoylthioglycerol, a diacylglycerol analogue, the reaction was complete within 15 s. The large difference in translocation rates between these two lipids indicates that the primary barrier to transmembrane movement is the polar head group and implies that phospholipid translocation events in biological membranes may not be unlike those for molecules similar to the polar head groups alone. PMID- 6498173 TI - Association of poly(adenosine diphosphate ribosylated) nucleosomes with transcriptionally active and inactive regions of chromatin. AB - We have investigated whether transcriptionally active or inactive gene sequences are associated in vivo with poly(adenosine diphosphate ribosylated) regions of chromatin. Soluble HeLa cell chromatin derived from nuclei treated either briefly or extensively with micrococcal nuclease was fractionated on an anti poly(adenosine diphosphate ribose)-Sepharose column [Malik, N., Miwa, M., Sugimura, T., Thraves, P., & Smulson, M. E. (1983) Proc. Natl. Acad. Sci. U.S.A. 80, 2554-2558] to obtain fractions that were enriched or depleted in poly(ADP ribosylated) chromatin. DNA obtained from these fractions was then probed for active and inactive gene sequences with a cDNA probe made from total cell mRNA and a probe for the beta-globin gene. Chromatin enriched in poly(ADP-ribosylated) nucleosomes contained both active and inactive gene sequences as detected by the probes and appeared to be more nuclease sensitive than that found in the fraction of chromatin depleted of poly(ADP-Rib). Poly(ADP-ribosylated) chromatin from nuclei digested briefly with nuclease showed an enrichment in both active and inactive genes while that treated extensively with nuclease showed either no enrichment or a depletion of active and inactive genes. Actively transcribed chromatin was digested at a rate several times that of the bulk or inactive chromatin. Nevertheless, the enrichment of active genes in poly(ADP-ribosylated) nucleosomes derived from brief nuclease digestion was greater than that of inactive genes. These results are interpreted as showing that some, but not all, of actively transcribed chromatin contains associated poly(ADP-ribosylated) proteins. However, since poly(ADP-ribosylated) proteins are also associated with inactive genes, the function of this modification cannot be assigned solely to transcription. PMID- 6498174 TI - Carbon-13 nuclear magnetic resonance studies of myocardial glycogen metabolism in live guinea pigs. AB - Myocardial glycogen metabolism was studied in live guinea pigs by 13C NMR at 20.19 MHz. Open-chest surgery was used to expose the heart, which was then positioned within a solenoidal radio frequency coil for NMR measurements. The time course of myocardial glycogen synthesis during 1-h infusions of 0.5 g of D [1-13C]glucose (and insulin) into the jugular vein was investigated. The possible turnover of the 13C-labeled glycogen was also studied in vivo by following the labeled glucose infusion with a similar infusion of unlabeled glucose. The degree of 13C enrichment of the C-1 glycogen carbons during these infusions was measured in heart extracts by 1H NMR at 360 MHz. High-quality proton-decoupled 13C NMR spectra of the labeled C-1 carbons of myocardial glycogen in vivo were obtained in 1 min of data accumulation. This time resolution allowed measurement of the time course of glycogenolysis of the 13C-labeled glycogen during anoxia by 13C NMR in vivo. With the solenoidal coil used for 13C NMR, the spin-lattice relaxation time of the labeled C-1 carbons of myocardial glycogen could be measured in vivo. For a comparison, spin-lattice relaxation times of heart glycogen were measured in vitro at 90.55 MHz. Natural abundance 13C NMR studies of the quantitative hydrolysis of extracted heart glycogen in vitro at 90.55 MHz showed that virtually all the carbons in heart glycogen contribute to the 13C NMR signals. The same result was obtained in 13C NMR studies of glycogen hydrolysis in excised guinea pig heart. PMID- 6498175 TI - 8-Chloroguanosine: solid-state and solution conformations and their biological implications. AB - The three-dimensional structure of 8-chloroguanosine dihydrate was determined by X-ray crystallography. The crystals belong to the orthorhombic space group P2(1)2(1)2(1), and the cell dimensions are a = 4.871 (1) A, b = 12.040 (1) A, and c = 24.506 (1) A. The structure was determined by direct methods, and least squares refinement, which included all hydrogen atoms, converged at R = 0.031 for 1599 observed reflections. The conformation about the glycosidic bond is syn with chi CN = -131.1 degrees. The ribose ring has a C(2')-endo/C-(1')-exo (2T1) pucker, and the gauche+ conformation of the -CH2OH side chain is stabilized by an intramolecular O-(5')-H...N(3) hydrogen bond. Conformational analysis by means of 1H NMR spectroscopy showed that, in dimethyl sulfoxide, the sugar ring exhibits a marked preference for the C(2')-endo conformation (approximately 70%) and a conformation about the glycosidic bond predominantly syn (approximately 90%), hence similar to that in the solid state. However, the conformation of the exocyclic 5'-CH2OH group exhibits only a moderate preference for the gauche+ rotamer (approximately 40%), presumably due to the inability to form the intramolecular hydrogen bond to N(3) in a polar medium. The conformational features are examined in relation to the behavior of 8-substituted purine nucleosides in several enzymatic systems, with due account taken of the steric bulk and electronegativities of the 8-substituents. PMID- 6498176 TI - Temperature and pH dependence of the metarhodopsin I-metarhodopsin II kinetics and equilibria in bovine rod disk membrane suspensions. AB - The kinetics of the relaxation of bleached bovine rod disk membrane suspensions from metarhodopsin I into the equilibrium between metarhodopsins I and II were determined at pHs between 5.9 and 8.1 and at temperatures between -1 and 15 degrees C. From these data, thermodynamic equations were generated by two-way linear regression that simultaneously describe the functional dependence on pH and temperature of the pseudo-first-order and true forward rate constants, the reverse and observed rate constants, and the equilibrium constant. Using these equations, we obtained the thermodynamic parameters and the apparent net proton uptake for the transitions from metarhodopsin I to metarhodopsin II and from metarhodopsin I to the activated intermediate. The reversibility of this equilibrium and the effect of aging of the preparation on the measured rate constants were investigated. PMID- 6498177 TI - Isolation and some properties of macrophage alpha-actinin: evidence that it is not an actin gelling protein. AB - We have isolated an actin-binding protein from rabbit alveolar macrophages which by virtue of its physical properties we classify as a nonmuscle alpha-actinin. The protein consists of two subunits of Mr 103 000 and has a Stokes' radius of 7.26 nm and a sedimentation coefficient of 6.83 X 10(-13) s-1. Under the electron microscope, rotary-shadowed molecules appeared as short rods with an average length of 39.9 nm. We have examined the nature of the interaction of macrophage alpha-actinin with F-actin. The binding of radioiodinated macrophage alpha actinin to F-actin is calcium sensitive. At a low concentration of free calcium (less than 10(-9) M), the binding affinity is 4.2 X 10(6) M-1 and is relatively unaffected by changes in temperature, while in the presence of 0.1 mM Ca2+, binding is reduced more than 5-fold. The stoichiometry of binding suggests that alpha-actinin binds all along the length of the actin filaments. The affinity of 45Ca2+ for macrophage alpha-actinin is 4 X 10(6) M-1 with a capacity of four calcium ions per molecule. Although macrophage alpha-actinin has calcium inhibitable actin gelation activity at 7 degrees C, its effect on the apparent viscosity of F-actin decreases with increasing temperature, and at 37 degrees C, no gel point is observed. Therefore, at the temperature at which macrophages function in vivo, alpha-actinin probably does not promote the isotropic gelation of actin. PMID- 6498178 TI - Molecular basis of the protonophoric and uncoupling activities of the potent uncoupler SF-6847 [3,5-di-tert-butyl-4-hydroxybenzylidene)malononitrile) and derivatives. Regulation of their electronic structures by restricted intramolecular rotation. AB - We reported recently (Yoshikawa, K. and Terada, H. (1982) J. Am. Chem. Soc. 104, 7644-7646) that the potent uncoupler of oxidative phosphorylation SF-6847 [3,5-di tert-butyl-4-hydroxybenzylidene)malononitrile) shows unique intramolecular restricted rotation of the malononitrile moiety. In this study, values for the activation energy Ea of the restricted rotation of SF-6847 derivatives with the same alkyl chain R in both ortho positions of the phenolic hydroxyl group were determined from the temperature-dependent change in the 1H-NMR signals of their aromatic protons. The Ea values of the neutral forms of these derivatives were found to be the same irrespective of R, but those of the anionic forms increased with increase in the alkyl chain length of R. It was found that the restricted rotation of the malononitrile moiety regulates its electron-withdrawing ability in such a way as to keep the acid dissociability of these derivatives similar, overcoming the effect of steric hindrance by R. The protonophoric activity of these derivatives, in a phospholipid bilayer membrane and their uncoupling activity in rat-liver mitochondria were both found to depend on Ea of their anionic forms. The stability of the uncoupler anions regulated by the restricted rotation of the malononitrile group in a nonpolar membrane environment was found to be important for exhibition of these activities. The hydrophobicity of the anionic forms of these derivatives was suggested also to be affected by the intramolecular rotation. PMID- 6498179 TI - Nigericin-induced transient changes in rat-liver mitochondria. AB - Addition of nigericin to mitochondria oxidizing succinate in a choline- and Tris supplemented, low-KCl medium leads to a transient matrix acidification, followed by a return of pHin to values very close to pHout. The initial inhibition of stimulated respiration is gradually relieved as pHin returns to higher values. Matrix realkalinization depends on the operation of the H+ pumps and on the electrogenic influx of cations and efflux of anions. The process leads to replacement of much of the matrix K+ by other cations. Throughout the acidification/realkalinization cycle delta mu H variations, if any, are small, even though there are profound changes in the relative contributions of its two components, delta psi and delta pH. PMID- 6498180 TI - The role of glucose, pyruvate and lactate in ATP production by rat spermatocytes and spermatids. AB - The ATP content of pachytene spermatocytes and round spermatids, isolated from rat testes, was not maintained during incubation of the germ cells in the presence of glucose. Glucose was metabolized via glycolysis at a considerable rate, but the rate of oxidation of the resulting endogenous pyruvate in the mitochondria was too low to support fully ATP production. Exogenous pyruvate (0.25 mM) or exogenous L-lactate (3-6 mM), however, were effective energy substrates. The lactate dehydrogenase reaction in isolated germ cells favoured the rapid conversion of pyruvate to lactate, at the expense of reducing equivalents from mitochondrial NADH. Hence, to support ATP production by the germ cells via mitochondrial metabolism of endogenous pyruvate, a relatively high concentration of exogenous lactate may be essential. In the spermatogenic microenvironment in vivo, such high concentrations of lactate could result from the net production of lactate by Sertoli cells. The mitochondria of the isolated germ cells produced ATP probably at a close to maximal rate, and spermatogenesis therefore may be extremely sensitive to compounds which interfere with mitochondrial energy metabolism and respiratory control. PMID- 6498181 TI - Oxidation-reduction potentials and spectral properties of some cytochromes from Thiobacillus versutus (A2). AB - Cytochromes c-550 (acidic), c-550 (basic), c-551 and c-552.5 from Thiobacillus versutus have been highly purified and characterized. Their spectral properties at 77 K are described. Oxidation-reduction titrations of cytochromes c-550 (acidic) and c-550 (basic) showed them to exhibit Nernst values of n = 1, with single redox centres in the cytochromes, and to have midpoint redox potentials at pH 7.0 (Em,7) of 290 and 260 mV, respectively. Cytochrome c-551 contained two separately titratable redox components, each giving n = 1. The low potential centre (55% of titratable cytochrome) and the high potential centre (45%) had Em,7 values of -115 and +240 mV, respectively. Cytochrome c-552.5 also contained at least two redox centres. One (65% of titratable cytochrome) had n = 1 and Em,7 = 220 mV. The remaining 35% appeared to be a low potential component with an Em,7 possibly as low as -215 mV. the roles of these cytochromes in respiratory thiosulphate oxidation are discussed. PMID- 6498182 TI - Phospholipid composition of dystrophic chicken erythrocyte plasmalemmae. I. Isolation of a unique lipid in dystrophic erythrocyte membranes. AB - Several structural and functional properties are characterized in nucleated erythrocyte plasmalemmae of age- and sex-matched dystrophic (line 413) and normal (line 412) chickens obtained from the University of California at Davis. Plasmalemma purity is assessed through marker enzymes. Significant differences are observed in the phospholipid content between dystrophic and normal chickens. The dystrophic chicken erythrocyte plasmalemma has an increased concentration of phosphatidylserine and a decreased concentration of phosphatidylethanolamine compared with control birds. Also, a measurable and distinct polar lipid, observed only on thin-layer chromatography (TLC) plates spotted with dystrophic preparations, is visualized adjacent to phosphatidylethanolamine. These abnormalities in the dystrophic chicken erythrocyte may signal a general defect in membrane structure for chicken dystrophy. PMID- 6498183 TI - Phospholipid composition of dystrophic chicken erythrocyte plasmalemmae. II. Characterization of a unique lipid from dystrophic erythrocyte membranes as ethanolamine plasmalogen. AB - The phospholipid content of normal (line 412) and dystrophic (line 413) chicken erythrocyte plasmalemmae has been quantified on a developmental basis using sex matched controls. A specific minor phospholipid component, ethanolamine plasmalogen, is identified from dystrophic erythrocyte membrane preparations. To arrive at this identification, data from studies utilizing gas-liquid chromatography, thin-layer chromatography, [14C]ethanolamine incorporation, and biochemical assay for specific organic moieties were correlated. This phospholipid has the potential to alter and regulate membrane fluidity and thus membrane function. The possible presence of significant concentrations of plasmalogen in human dystrophic tissues may serve as a marker for dystrophy and thus be of clinical importance. PMID- 6498184 TI - Cellular mode of serotonin action on Cl- transport in the rabbit corneal epithelium. AB - The present work examines serotonin-induced changes in cell potential difference and barrier resistances in the corneal epithelium in vitro using voltage measuring microelectrodes and related techniques. Component resistances were determined using voltage and resistance profiles of the epithelium before and during the serotonin response. Serotonin, added to the stromal side of the cornea in the presence of nialamide, markedly reduced transcorneal and apical membrane resistances, while basal barrier resistance increased slightly and shunt resistance was unchanged. The marked drop in apical membrane resistance after serotonin treatment reflects an increase in apical membrane chloride permeability, inasmuch as the serotonin-stimulated short-circuit current is indistinguishable from the increase in net chloride flux. Prolonged (more than 1 h) exposure of corneas to serotonin markedly depolarized the epithelial cells and reduced the voltage divider ratio from 12.3 +/- 2.1 to 1.5 +/- 0.5, while not significantly affecting the stimulated short-circuit current. These later effects suggest changes in epithelial ion distribution during long periods of stimulation by serotonin. PMID- 6498185 TI - Kinetics of nucleoside transport in human erythrocytes. Alterations during blood preservation. AB - The transmembrane equilibration of radiolabeled uridine was measured by rapid kinetic techniques in human erythrocytes from freshly drawn blood and in the same cells during conventional storage of the blood as well as in cells from outdated blood. Our results confirm earlier reports that the maximum velocity of uridine equilibrium exchange (Vee) at 25 degrees C is about 30% lower in outdated than fresh red cells, whereas the opposite is the case for the Michaelis-Menten constant for equilibrium exchange (Kee), and that maximum zero-trans efflux (Vzt21) is about 4-times greater than maximum zero-trans influx (Vzt12) in outdated cells (directional asymmetry), whereas they are about the same in fresh red cells. At 25 degrees C, the nucleoside-loaded carrier of fresh cells moves on the average 6-times more rapidly than the empty carrier, whereas the differential mobility of loaded and empty carrier from outdated cells is about 15-fold. Our results also show that greater efflux than influx in outdated cells is not due to a general leakiness of outdated cells, that the differences in kinetic properties of the transporter developed during the first two weeks of blood storage and that the differences are greatly amplified when transport is measured at 5 degrees C rather than 25 degrees C. At 5 degrees C, the loaded carrier from outdated red cells moves about 325-times more rapidly than the empty carrier and maximum zero trans efflux exceeds maximum zero-trans influx about 14-times, whereas the transport of fresh cells exhibits directional symmetry just as at 25 degrees C. The changes in kinetic properties of transport induced by temperature and storage are probably related to structural alterations in the plasma membrane and suggest that the operation of carrier is subject to modification by the membrane environment. Other results show that the kinetics of the sugar transport of human red cells is not affected in the same manner by blood storage as those of the nucleoside transporter. PMID- 6498186 TI - Vesiculation of platelet plasma membranes. Dilauroylglycerophosphocholine-induced shedding of a platelet plasma membrane fraction enriched in acetylcholinesterase activity. AB - Incubation of washed rabbit platelets with suspensions of dilauroylglycerophosphocholine resulted in the shedding of vesicles without causing any appreciable leakage of cytoplasmic marker (lactate dehydrogenase) or organelle marker [( 14C]serotonin). The response was dependent on incubation time, concentration of dilauroylglycerophosphocholine and reaction temperature. Vesicles were separated from platelets and exogenous dilauroylglycerophosphocholine by a series of centrifugation steps. An average diameter of vesicles was 100-200 nm on scanning electron microscopy. Vesicles were enriched 5-fold in plasma membrane marker enzyme, acetylcholinesterase, whereas specific activities of lactate dehydrogenase and intracellular membrane marker enzyme, NADH-cytochrome c reductase were decreased in vesicles. Protein analysis by SDS-polyacrylamide gel electrophoresis showed that actin and actin binding protein were present, while myosin was barely detectable in vesicles. Vesicles contained all phospholipid species of intact platelets and cholesterol but almost 50% of phospholipids in vesicles was dilauroylglycerophosphocholine. The phospholipid to protein ratio in vesicles was about 6.5-times higher than in intact platelets. PMID- 6498187 TI - Partition of parathion in synthetic and native membranes. AB - Partition coefficients of [14C]parathion were determined in several types of membranes. Model membranes of egg phosphatidylcholine, dimyristoyl- (DMPC), dipalmitoyl- (DPPC) and distearoyl- (DSPC) phosphatidylcholines, and native membranes of mitochondria, sarcoplasmic reticulum, brain microsomes, myelin and erythrocytes were investigated. Parathion partition is variable among the membranes under study and depends on temperature and cholesterol content. First order transition of membrane lipids from the gel to the liquid crystalline state is accompanied by a sharp increase in the partition coefficient of parathion. The insecticide is easily accommodated in bilayers of short-chain lipids, since the partitions were 1950, 650 and 270 in DMPC, DPPC and DSPC, respectively, at temperatures 10 degrees C below the midpoint of their transitions. Preferential interaction with short-chain lipids promotes phase separation in heterogeneous bilayers, favouring segregation of lateral domains enriched in insecticide phospholipid complexes. Cholesterol incorporation in membranes prevents the binding of the insecticide either through competition for similar interacting sites or as a consequence of changes in structural organization of phospholipids. PMID- 6498188 TI - Quantitative characterization of the interactions of aldolase and glyceraldehyde 3-phosphate dehydrogenase with erythrocyte membranes. AB - Results of studies on the interactions of aldolase and glyceraldehyde-3-phosphate dehydrogenase with erythrocyte ghosts have been reinterpreted by making allowance for possible multivalency of the enzymes in regard to their interactions with matrix sites. It is shown that the curvilinearity of the experimental Scatchard plots may be attributed fully to the formation of enzyme-membrane complexes in which tetravalent enzyme may form crosslinks between several membrane sites. This interpretation of the results is preferable to earlier analyses based on heterogeneity of membrane sites in that (a) it takes into account the tetrameric nature of aldolase and glyceraldehyde-3-phosphate dehydrogenase, and (b) it is consistent with experimental demonstrations that band 3 protein is the sole site for enzyme interaction with the erythrocyte matrix. The dependence on ionic strength of the intrinsic association constant for either interaction is such that the binding of neither aldolase nor glyceraldehyde-3-phosphate dehydrogenase could be detected at ionic strengths in excess of 0.08 I. This finding is discussed in relation to the claims and counterclaims concerning the physiological significance of these interactions between glycolytic enzymes and erythrocyte membranes. PMID- 6498189 TI - Characterization of the association of Electrophorus electricus acetylcholinesterase with sphingomyelin liposomes. Relevance to collagen sphingomyelin interactions. AB - Electrophorus electricus acetylcholinesterase is a large polymorphic enzyme. Its native forms 18 S, 14 S and 8.5 S possess a tail having a collagen-like structure. It was suggested that this tail is involved in the anchorage of the enzyme at the terminal of the synapse. Watkins et al. [1] showed that all forms of the enzyme having a collagen segment also bind to sphingomyelin liposomes with almost no binding to phosphatidylcholine (PC) liposomes. In agreement with the above results, the binding of acetylcholinesterase reported here was independent of the following liposomal parameters (a) curvature, (b) the physical state of the bilayer, (c) the gel to liquid crystalline phase transition of sphingomyelin, (d) stereospecificity of the sphingomyelin, (e) acyl chain of the sphingomyelin. The binding was reduced with increasing PC content in sphingomyelin vesicles. The binding has no effect on the bilayer integrity. The enzymatic activity can be released from the vesicles by incubation with collagenase. The association of the enzyme with the liposomes had minimal effect on its kinetic parameters (Km, Vmax). The only detectable effect was increasing enzyme stability at low enzyme concentration. This suggested that the binding of the enzyme to sphingomyelin liposomes reduced its surface denaturation. Such association was not unique to acetylcholinesterase since collagen showed similar behavior. Collagen binding to sphingomyelin liposomes was 5-10-times larger than to PC liposomes. The exact details of the interaction of collagen and collagen-like peptides with sphingomyelin bilayers are yet unknown although it differs from the well documented hydrophobic or electrostatic interactions [7]. This work proposes hydrogen bonding as a third mechanism which involves the interface region of sphingolipids molecules and the collagen or collagen-like tail of acetylcholinesterase. This binding is also of interest due to its correlation to the accumulation of sphingomyelin and collagen during aging and the development of atherosclerosis in blood vessels of mammals. PMID- 6498190 TI - A fluorimetric determination of the activity of glycolipid transfer protein and some properties of the protein purified from pig brain. AB - The fluorimetric method of Correa-Freire et al. (Correa-Freire, M.C., Barenholz, Y. and Thompson, T.E. (1982) Biochemistry 21, 1244-1248) to measure glucosylceramide transfer between phospholipid bilayers has been applied to the determination of the activity of glycolipid transfer protein purified from pig brain. The transfer of pyrene-labeled galactosylceramide (PyrGalCer) from donor to acceptor vesicles was measured by a decrease in the intensity ratio of eximer (E) to excited monomer (M). A sensitive determination of the glycolipid transfer activity is possible by the fluorimetric method without separation of the donor and acceptor vesicles. The newly developed fluorimetric assay of glycolipid transfer protein was used to study the effects of N-ethylmaleimide, HgCl2 and sugars on the transfer activity. The treatment with N-ethylmaleimide inactivated the activity to about 40%. The activity was almost completely inactivated by the treatment with HgCl2. Monosaccharides and methyl-alpha-D-glucoside had no inhibitory effect on the transfer activity. A marked and immediate drop of the E/M ratio was observed by the addition of glycolipid transfer protein to vesicles containing PyrGalCer at a protein-to-PyrGalCer molar ratio of 1.56:1. The result suggests a complex formation of glycolipid transfer protein with PyrGalCer. PMID- 6498191 TI - The modulation of the calcium pump of human red cells by Na+ and K+. AB - The sidedness of Ca2+-pump activation by Na+ and K+ was studied by atomic absorption spectrophotometry in human erythrocyte ghosts, which had been prepared in dextran solutions and resealed to alkali cations. When ghosts were incubated in an all-choline medium, the increase in Na+i elicited an inhibitory-stimulatory effect on Ca2+ extrusion. By contrast, only a stimulatory action was induced when choline was replaced by Na+o. A dual effect on active Ca2+ efflux was also produced by increasing K+i or K+o. The biphasic response to the latter, however, was absent from high-K+ ghosts. Furthermore, the stimulation obtained at high K+o was additive to that elicited by K+i. The results suggest that Na+ and K+ stimulate the Ca2+ pump of human red cells through two different mechanisms. The first one appears to be an electric coupling between Ca2+ efflux and the external activating cation. The other seems associated with the molecular reactions of the Ca2+-pump protein. PMID- 6498192 TI - Interaction of influenza virus proteins with planar bilayer lipid membranes. I. Characterization of their adsorption and incorporation into lipid bilayers. AB - Alterations in the surface potential difference (delta U) of asolectin planar bilayer lipid membranes were measured following the adsorption of isolated matrix protein (M-protein) or neuraminidase of influenza virus. The method used was based upon measurement of the bilayer lipid membrane capacitance current second harmonic. The delta U dependence on the M-protein and neuraminidase concentration indicates different mechanisms of adsorption of these viral proteins by the lipid bilayer. The conductance (G0) dependence of the bilayer lipid membrane with different compositions on the concentration of isolated surface glycoproteins, hemagglutinin and neuraminidase, M-protein or neuraminidase was investigated. The change in G0 for M-protein was observed only after adsorption saturation had been achieved. Neuraminidase alone does not affect the membrane conductivity. The surface charge and lipid composition of the lipid bilayer influences the adsorption and incorporation of influenza virus M-protein and surface glycoproteins. The reversibility of protein incorporation into the bilayers was investigated by a perfusion technique. The results show reversibility of surface glycoprotein incorporation while M-protein binding appears to be irreversible. PMID- 6498193 TI - Interaction of influenza virus proteins with planar bilayer lipid membranes. II. Effects of rimantadine and amantadine. AB - The dependence of the surface potential difference (delta U), transversal elasticity module (E1) and membrane conductivity (G0) on the concentrations of the antiviral drugs, rimantadine and amantadine was studied in the planar bilayer lipid membrane system. The method used was based on independent measurements of the second and third harmonics of the membrane capacitance current. The binding constants of bilayer lipid membranes obtained from the drug adsorption isotherms were 2.1 X 10(5) M-1 and 1.3 X 10(4) M-1 for rimantadine and amantadine, respectively. The changes in G0 took place only after drug adsorption saturation had been achieved. The influence of rimantadine and amantadine on the interaction of bilayer lipid membranes with matrix protein from influenza virus was also investigated. The presence of 70 micrograms/ml rimantadine in the bathing solution resulted in an increase in the concentration of M-protein at which the adsorption and conductance changes were observed. The effects of amantadine were similar to those of rimantadine but required a higher critical concentration of amantadine. The results obtained suggest that the antiviral properties of rimantadine and amantadine may be related to the interaction of these drugs with the cell membrane, which can affect virus penetration into the cell as well as maturation of the viral particle at the cell membrane. PMID- 6498194 TI - Identification of membrane proteins of human blood platelets with a hydrophobic photolabel. AB - A photoactivable glycolipid probe, 12-(4-azido-2-nitrophenoxy)stearoyl[1 14C]glucosamine, was used to label proteins and lipids of platelet membranes. The proteins were analyzed by two-dimensional high-resolution gelelectrophoresis. The labeling patterns showed that three membrane proteins were labeled which were not previously identified by ectolabeling (Sixma, J.J. and Schiphorst, M.E. (1980) Biochim. Biophys. Acta 603, 70-83). Analysis of the lipid fraction showed that phosphatidylcholine, phosphatidylethanolamine and phosphatidylserine were labeled by the probe. The distinct labeling of phosphatidylserine strongly suggests that the probe redistributes between the two halves of the bilayer. PMID- 6498195 TI - The mechanism of fluid secretion in the rabbit pancreas studied by means of various inhibitors. AB - In order to increase our understanding of the mechanism of pancreatic fluid secretion we have studied the effects of various transport inhibitors on this process in the isolated rabbit pancreas. In this preparation, a high rate of unstimulated fluid secretion occurs, which probably originates from the ductular cells. Inhibitory are ouabain, furosemide, bumetanide, piretanide, 4-acetamido-4' isothiocyanostilbene-2,2'-disulfonic acid (SITS) and acetazolamide, with their half-inhibitory concentrations: 2 X 10(-6) M (ouabain), 1.3 X 10(-3) M (furosemide), 2.2 X 10(-3) M (bumetanide and piretanide) and 1.4 X 10(-4) M (SITS). With acetazolamide a maximal inhibition of only 20% is found at 10(-3) M. Amiloride (10(-3) M) has no effect on pancreatic fluid secretion. The inhibitory effects on HCO-3 output are always larger and those on Cl- output lower than those on fluid secretion. The results suggest that the ouabain-sensitive (Na+ + K+)-ATPase system provides the energy for a Na+-gradient-driven Cl--HCO-3 exchange transport system, sensitive to the loop diuretics furosemide, bumetanide and piretanide and to SITS. This system would drive the transcellular transport of HCO-3 and secondarily that of cations, Cl- and water. PMID- 6498197 TI - The interaction of adriamycin with cardiolipin in model and rat liver mitochondrial membranes. AB - The interaction of adriamycin with cardiolipin in model membranes and in various membrane preparations derived from rat liver mitochondria was studied and the results are analyzed in the light of a possible specific interaction between adriamycin and cardiolipin. It was found that adriamycin binds to cardiolipin containing model membranes with a fixed stoichiometry of two drug molecules per cardiolipin. Furthermore, the extent of drug complexation by mitochondria and mitoplasts (inner membrane plus matrix) is in reasonable agreement with their cardiolipin content. In contrast, adriamycin-binding curves of inner membrane ghosts and submitochondrial particles reveal considerable association to an additional site, presumably RNA. The evidence for the potential importance of RNA as a target comes from experiments on outer membranes and microsomes which both appear to bind substantial amounts of adriamycin. Removal of the major part of the RNA associated with these fractions by EDTA treatment is accompanied by a dramatic reduction of binding capacity. We propose that endogenous RNA present in mitochondria and mitoplasts is not accessible for adriamycin at low concentrations of the drug due to the presence of an intact lipid barrier. This potential site comes to expression in ghosts and submitochondrial particles, due to the absence of an intact lipid bilayer and due to the inside-out orientation of the limiting membrane, respectively. Electron microscopical studies show that adriamycin induces dramatic changes in mitochondrial morphology, similar to the uncoupler-induced effects described by Knoll and Brdiczka (Biochim. Biophys. Acta 733, 102-110 (1983). Adriamycin has an uncoupling effect on mitochondrial respiration and oxidative phosphorylation. The concentration dependence of this effect correlates with the adriamycin-binding curve for mitochondria which implies that only bound adriamycin actively inhibits respiration. PMID- 6498196 TI - Lipid fluidity and composition of intestinal microvillus membranes isolated from rats of different ages. AB - The lipid composition and fluidity of microvillus (luminal) membranes isolated from the small intestines of Fisher 344 rats aged 6, 17, and 117 weeks were compared. Lipid fluidity, as assessed by the fluorescence anisotropy of 1,6 diphenyl-1,3,5-hexatriene, was significantly greater in rats aged 6 weeks as compared to 17 or 117 weeks. A lipid thermotropic transition was observed at 17.5 +/- 1.3 degrees C in the membranes of the youngest group, approx. 5-6 degrees C lower than that of the older animals. The differences in lipid composition which account for the higher fluidity of the youngest preparations include a decreased cholesterol/phospholipid molar ratio in both the proximal and distal halves of the small intestine and, in the proximal half alone, increases in the lipid/protein ratio and double bond index. The foregoing reduction in cholesterol/phospholipid ratio derives mainly from a higher content of total phospholipid, and the increment in double bond index results from an increase in arachidonic acid residues. The results demonstrate an age-dependent decrease in fluidity of intestinal microvillus membranes in the early post-weaning period in the rat. This pattern was unlike that of the microvillus membrane p nitrophenylphosphatase, whose specific activity declined progressively in the older age groups. PMID- 6498198 TI - Anion exchange in human erythrocytes has a large activation volume. AB - Sulfate equilibrium exchange in human red cells has an activation volume of +150 +/- 20 cm3/mol over the pressure range 0.1 to 83 MPa (15 to 12000 lb/in2) at 30 degrees C. This value greatly exceeds the expected contribution from sulfate binding to the anion exchanger. We suggest that the activation volume reflects conformational changes during the transport cycle. PMID- 6498199 TI - Preferential stimulation of rabbit alpha globin mRNA translation by a cap-binding protein complex. AB - A cap-binding protein complex (Edery et al. (1983) J. Biol. Chem. 258, 11398 11403) is shown here to stimulate preferentially the translation of endogenous alpha versus beta globin mRNA in a rabbit reticulocyte lysate. Several initiation factors (eIF-2, eIF-3, eIF-4A, eIF-4B, eIF-4C, eIF-4E and eIF-5) and elongation factor 1 were found to have no such discriminatory effect. These results are in contrast to several previous reports and demonstrate that the only factor capable of relieving translational competition between alpha and beta globin mRNAs is the cap-binding protein complex. PMID- 6498200 TI - Translation in micrococcal nuclease-treated cell-free extracts from Ehrlich ascites tumor cells. Stimulation by initiation factor eIF-2B. AB - Translation of exogenous mRNAs in micrococcal nuclease-treated extracts from Ehrlich ascites tumor cells is greatly stimulated by the addition of crude initiation factors or initiation factors eIF-2B and eIF-2 containing eIF-2B. The requirement for exogenous eIF-2B in micrococcal nuclease-treated extracts does not result from either loss or enhanced phosphorylation of eIF-2 during incubation. PMID- 6498201 TI - Psoralen-DNA crosslink repair in human lymphocytes. Comparison of alkaline elution with electron microscopy. AB - Much interest has surrounded the question of the removal of psoralen interstrand crosslinks in DNA of eukaryotic organisms. A commonly employed method for the study of psoralen repair is alkaline elution. In this study we have used alkaline elution to assess psoralen crosslink repair in human lymphocytes. The lymphocytes were treated with 8-methoxypsoralen or 4,5',8-trimethylpsoralen and allowed to repair for different periods of time. Analysis by alkaline elution showed elution patterns compatible with crosslink removal. When the crosslink removal under comparable conditions was studied by the use of electron microscopy under totally denaturing conditions, no repair of the crosslinks could be detected. PMID- 6498202 TI - Conformational changes in human urokinase induced by a specific reduction of disulfide bond in Cys-194-Cys-222 associated with exhibition of enzymatic activity. AB - The disulfide bond in Cys-194-Cys-222 of the isolated B chain (UK X B) of human urinary urokinase was selectively carboxamidomethylated (R X CAM-UK X B) after specific reduction with dithiothreitol in the presence of the competitive inhibitor N-alpha-benzoyl-L-argininamide (BzArgNH2) and 0.3 M guanidine with inactivation. There were no differences between UK X B and R X CAM-UK X B in CD spectra of 200-250 nm and infrared spectra in the amide I and II regions, whereas two out of five negative CD bands of 250-310 nm were slightly reduced in R X CAM UK X B. R X CAM-UK X B was more susceptible than UK X B to guanidine denaturation, H-2H exchange in peptide protons and tyrosine-residue ionization. These results indicate that Cys-194-Cys-222 contributes to conformational stabilization against perturbants, but not to static conformation in the resting state, except for a slight disruption in the amino-acid side-chains. BzArgNH2 and 0.3 M guanidine, corresponding to the threshold point toward denaturing transition, enhanced more markedly all the five CD bands of 250-310 nm in UK X B than in R X CAM-UK X B, but did not alter CD spectra of 200-250 nm. The deletion of either BzArgNH2 or guanidine did not induce the inactivation or the cleavage of Cys-194-Cys-222 upon the reduction of UK X B, nor did it induce a marked CD enhancement in the near-ultraviolet upon the addition to UK X B. The results suggest that the BzArgNH2-UK X B interaction enhances the solvent accessibility to the disulfide bond with aid of critical guanidine-denaturation. PMID- 6498203 TI - Interaction of porcine immunoglobulin M with protein A of Staphylococcus aureus. AB - Intrigued by reports that the mitogenic effect of protein A on B lymphocytes was due to a direct interaction of cell surface immunoglobulin with protein A, the binding of 19 S, 8 S, and Fab mu fragments of 125I-labeled IgM isolated from porcine serum was investigated. Approx. 60% of purified 19 S porcine IgM interacted specifically with Protein A-Sepharose. Mild reduction and alkylation of 19 S IgM to yield monomeric IgM did not appear to alter its ability to bind to protein A. Elution of either molecular species of IgM from protein A and subsequent repassage over Protein A-Sepharose resulted in nearly quantitative rebinding of the IgM to protein A. Fab mu fragments prepared by digestion of 19 S IgM with pepsin exhibited binding characteristics similar to that observed for intact and monomeric IgM. These results suggest that: (1) there are at least two populations of porcine serum IgM, one that binds to protein A and one that does not; (2) these populations are not interconverting; (3) the ability of IgM to bind to protein A is not dependent on the 19 S pentameric structure extant in sera, but rather is an intrinsic property of some and not all four chain IgM protomers; and (4) a binding site for protein A on porcine IgM is localized in the Fab mu (including the C mu 2 domain) regions of the molecule. PMID- 6498204 TI - Renal trehalase: two subsites at the substrate-binding site. AB - Phlorizin, phloretin, Tris and beta-methylglucoside are competitive inhibitors, with respect to the substrate trehalose, of purified renal trehalase. Mercuric chloride is a noncompetitive inhibitor. The active site of trehalase was examined further by multi-inhibition kinetic studies involving combinations of inhibitors. Phlorizin vs. phloretin and phlorizin vs. Tris were mutually non-competitive. In contrast, phloretin vs. Tris was mutually competitive. These findings suggest that the binding site of phlorizin to the enzyme differed from that of phloretin or Tris, and that phloretin and Tris might bind at a common site. These findings suggest a model in which trehalase has two binding sites at the substrate-binding site, a phlorizin (glucosyl) and a phloretin (phenyl) binding site, analogous to the model proposed previously for the glucose carrier. In addition, mercuric chloride vs. beta-methylglucoside was mutually competitive, although mercuric chloride and beta-methylglucoside, respectively, were noncompetitive and competitive inhibitors with respect to the substrate. Thus, it is suggested that the substrate binding and the SH-inhibitor binding sites are located very close to each other. PMID- 6498205 TI - On the occurrence of polymers of H1, H1(0) and H5 in extracts of whole tissues. Artificial production during protein preparation. AB - Inspection of preparations of H1, H1(0) and H5 histones made by extraction of whole tissues has shown that dimers and higher polymers of all three of these proteins are present. They may be formed by the cross-linking action of poly(ADP ribose) chains which are linked to some of the protein molecules. Putative dimers and higher polymers were noted in preparations from various tissues and species. However, evidence is presented which suggests that production of these polymers is an artifact of precipitation during the preparation of the proteins, so the significance of the polymers is questionable. PMID- 6498206 TI - Conformational specificity of chymotrypsin toward proline-containing substrates. AB - A number of peptide-4-nitroanilide substrates containing proline within the peptide chain have been synthesized and subjected to chymotryptic hydrolysis. Values of kcat and Km have been obtained from measurements at pH 7.8 and 25.0 degrees C. Kinetic studies at high enzyme concentrations up to 6.0 X 10(-4) mol X 1(-1) have allowed the evaluation of the conformational specificity of chymotrypsin due to the observation of various kinetic phases during the time course of the reaction. When proline occupies the P2 position within the peptide chain, it is shown that the enzyme cleaves only the trans isomer of the substrate. The conformational specificity has also been studied for proline in P4 and P5 positions of the substrate. In some cases, an enzyme-catalyzed hydrolysis of the cis isomer was detected. From the amplitude ratios and the rate constants of the kinetic phases, information about the structural dependency of the cis/trans interconversion could be obtained. Charged residues N-terminal to the isomeric bond are of little influence on either cis/trans ratio or the rate of cis to trans interconversion. Extending the peptide chain N-terminal to the isomeric bond by alanine decreases to a low extent the cis content and increases the rate constant of the trans isomer formation. PMID- 6498207 TI - Mechanism of peroxisomal 24-hydroxylation of 3 alpha,7 alpha,12 alpha-trihydroxy 5 beta-cholestanoic acid in rat liver. AB - We recently showed that the peroxisomal fraction of rat liver has a high capacity to catalyze conversion of 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid into cholic acid and that 3 alpha,7 alpha,12 alpha,24-tetrahydroxy-5 beta cholestanoic acid is an intermediate in this conversion. With use of 2H2O and 18O2, evidence is presented here that the formation of 3 alpha,7 alpha,12 alpha,24-tetrahydroxy-5 beta-cholestanoic acid involves intermediary formation of a delta 24-unsaturate intermediate followed by hydration. PMID- 6498208 TI - Comparison of the hydrolysis of phosphatidylethanolamine and phosphatidyl(N acyl)ethanolamine in Dictyostelium discoideum amoebae. AB - In Dictyostelium discoideum, (N-acyl)ethanolamine glycerophospholipids disappear as the amoebae aggregate, whereas the amount of ethanolamine glycerophospholipids remains relatively constant, suggesting that each type of ethanolamine-containing phospholipid might have a separate metabolic pathway. To study their metabolism, phosphatidylethanolamine and phosphatidyl(N-acyl)ethanolamine containing either [14C]ethanolamine or a 14C-labeled sn-2 fatty acyl group were incubated with D. discoideum homogenates, and the conversion of the substrates into radioactive products was monitored. At pH values 3.8 and 4.5, phosphatidyl(N acyl)ethanolamine was hydrolyzed by a phospholipase A1 to form the sn-2 acyl form of the lipid. Only minor hydrolysis occurred at pH values of 5.2 or higher. (N acyl)Ethanolamine was also released by a phospholipase D type activity at 0.1 the rate of the lysophospholipid formation. Phosphatidyl(N-acyl)ethanolamine was not hydrolyzed to form phosphatidylethanolamine or water soluble components. At pH 7.2 and at the low pH range of 3.8-4.5, phosphatidylethanolamine was hydrolyzed to lysophosphatidylethanolamine, which was then further degraded to water-soluble components. At pH 7.2, a phospholipase A2 initially hydrolyzed the phosphatidylethanolamine, whereas at the low pH range a phospholipase A1 was the most active enzyme. Although both types of ethanolamine-containing phospholipid were hydrolyzed by a phospholipase A1 at the low pH range, phosphatidylethanolamine hydrolysis was more sensitive to inhibition by Trition X 100, and phosphatidylethanolamine was hydrolyzed to water-soluble components, whereas phosphatidyl(N-acyl)ethanolamine was not. At pH 7.2, phosphatidylethanolamine was hydrolyzed, but phosphatidyl(N-acyl)ethanolamine was not hydrolyzed at all. These results indicate that there are separate routes of degradation for the two types of ethanolamine-containing phospholipid in D. discoideum. PMID- 6498209 TI - Studies on enzymes related to diacylglycerol production in activated platelets. II. Subcellular distribution, enzymatic properties and positional specificity of diacylglycerol- and monoacylglycerol-lipases. AB - The subcellular distribution of diacylglycerol- and monoacylglycerol-lipases has been studied in human platelets. Using a fractionation procedure on Percoll gradient (Perret, B., Chap, H. and Douste-Blazy, L. (1979) Biochim. Biophys. Acta 556, 434-446), the enzyme activity displayed the same profile as that of [3H]concanavalin A, a plasma membrane marker. This result was confirmed with highly purified platelet plasma membranes prepared by adsorption onto polyethylenimine-bonded polyacrylamide beads (Kinoshita, T., Nachman, R.L. and Minick, R. (1979) J. Cell Biol. 82, 688-696). Studies with isolated membranes or crude homogenate revealed that the enzyme requires calcium or magnesium and displays an optimal pH of 6.2, showing that it is able to hydrolyse diacylglycerol under conditions where phosphatidylinositol-specific phospholipase C is fully active. Using diacylglycerol labelled in the 1- or 2-position, it was found that the two fatty acids are released at the same rate, which is supported by the lack of monoacylglycerol accumulation and by the observation that monoacylglycerol is hydrolysed at a 20-fold faster rate than diacylglycerol. Increasing concentrations of Mg-ATP promote the conversion of diacylglycerol into phosphatidic acid by diacylglycerol kinase, but only high concentrations become inhibitory for diacylglycerol lipase. These results are discussed in the light of our former hypothesis that arachidonic acid release from platelet phospholipids might occur through the sequential action of a phosphatidylinositol-specific phospholipase C coupled to a diacylglycerol lipase (Mauco, G., Chap, H., Simon, M.F. and Douste-Blazy, L. (1978) Biochimie 60, 553-561). The possible role of this enzyme in the regulation of the activity of protein kinase C is also emphasized. PMID- 6498210 TI - Enhanced turnover of arachidonic acid-containing species of phosphatidylinositol and phosphatidic acid of concanavalin A-stimulated lymphocytes. AB - The incorporation of [32P]orthophosphate into phosphatidylinositol (PI) of pig lymphocytes was markedly increased by stimulation with concanavalin A. The labeling of PI with [3H]glycerol was also enhanced significantly, indicating that both de novo synthesis and recircular system (PI response) of PI were accelerated. This rapid labeling of PI might be related to the rapid breakdown of phosphatidylinositol 4,5-bisphosphate which was observed in various stimulated tissues. Concanavalin A also accelerated the labeling of phosphatidic acid with 32P and [3H]glycerol. To determine the dependence of this phenomenon on the fatty acid composition of both phospholipids, we separated PI and phosphatidic acid into individual molecular species. The predominant molecular species in PI was tetraene (81.6%) and those in phosphatidic acid were monoene (53.0%), diene (15.8%) and tetraene (19.2%), respectively. Interestingly, the incorporation of 32P into arachidonic acid-containing species (tetraene) was most rapidly elevated. On the other hand, the increment of 32P into saturated + monoene, diene and triene was relatively smaller and resembled that of [3H]glycerol. Similarly, the incorporation of 32P into tetraene of phosphatidic acid was preferentially accelerated. This is the first report concerning the metabolism of molecular species of phosphatidic acid in stimulated cells. These results indicate that the PI recirculating system is virtually dependent on tetraenoic species and that the participation of other molecular species is small. The increased de novo synthesis mainly depends upon molecular species other than tetraene. Arachidonic acid-containing species which turn over rapidly via the PI cycle may have an important role in the mitogenic triggering. PMID- 6498211 TI - Glycosphingolipid patterns of rat kidney. Dependence on age and sex. AB - The composition and quantity of glycosphingolipids in kidney from 3-50-week-old male and female rats have been investigated. Glycosphingolipids were separated by high-performance liquid chromatography on a diethylaminoethyl-porous glass and porous glass column followed by high-performance thin-layer chromatography. The quantity of neutral glycolipids in male rat kidney decreased significantly between 3 and 25 weeks; the quantity in 25-week-old kidney became half the quantity found in 3-week-old kidney and remained constant thereafter. The quantity of neutral glycolipids in female rat kidney did not show age-dependent changes. The composition of neutral glycolipids revealed by high-performance thin layer chromatography was constant, regardless of age and sex. Monoglycosylceramide and tetraglycosylceramide were the major compoments at all ages in both sexes. In contrast to the patterns of neutral glycolipids, ganglioside content was higher in female rats than males, and total ganglioside content increased in both sexes with increasing age. The most remarkable change was an increase of disialoganglioside in female rat kidney between 5 and 25 weeks. The ratio of disialogangliosides to monosialogangliosides (D/M value) in female rat kidney increased 4-fold during this period. The ganglioside pattern in female rat kidney was affected by spaying. The quantity of disialogangliosides decreased rapidly on the 7th day after spaying, but the level went back to normal on the 14th day after spaying. The data strongly suggest that sex hormones influence glycosphingolipid synthesis in rat kidney. PMID- 6498212 TI - Evidence of different binding sites for nogalamycin in DNA revealed by association kinetics. AB - The kinetics of association between nogalamycin and DNA have been measured by stopped-flow spectrometry. With a naturally occurring DNA (calf thymus) the reaction profile requires not less than three exponentials for its complete description. By contrast, binding to poly(dA-dT) is fully described by two exponentials which correspond to the two faster components seen with the natural DNA, whereas binding to poly(dG-dC) is a single exponential process whose time constant is about the same as the slowest component measured with calf thymus DNA. In all cases the amplitude of each component in the decay varies considerably with polynucleotide concentration. The results are consistent with a model in which the antibiotic is only able to bind directly to regions of the DNA which are transiently perturbed, probably non-basepaired. As a result, the antibiotic interacts much faster with AT-rich rather than GC-rich DNA sequences, which may provide a basis for its apparent sequence selectivity. PMID- 6498213 TI - 5'-Methylthioadenosine in urine from normal subjects and cancer patients. AB - In an attempt to study, in human body, the metabolism of 5'-methylthioadenosine, a byproduct of the polyamine biosynthesis, we examined whether this nucleoside is excreted into urine, and, if so, whether the amount increases when the synthesis of polyamines increases. We found that 5'-methylthioadenosine is a natural nucleoside in human urine as evidenced by two separate chromatography systems as well as the analysis of the acetylated compound by gas chromatography-mass spectrometry. Preliminary study did not show the elevation of urinary 5' methylthioadenosine level in malignant patients, suggesting that the cleaving enzyme, 5'-methylthioadenosine phosphorylase, very efficiently removes this nucleoside in vivo. PMID- 6498214 TI - Catabolism of polyamines in the rat. Polyamines and their non-alpha-amino acid metabolites. AB - The metabolic fate of stable isotopically labeled polyamines was investigated after their first and second intraperitoneal injection in rats. Using gas chromatographic and mass fragmentographic analyses of acid-hydrolyzed 24-h urines, some aspects of the polyamine metabolism could be elucidated. After the injections with hexadeutero-1,3-diaminopropane, only labeled 1,3-diaminopropane was recovered from the urine samples. The rat injected with tetradeuteroputrescine excreted labeled putrescine, gamma-amino-n-butyric acid, 2 hydroxyputrescine and spermidine, while the urine samples of the rat after the injections with tetradeuterocadaverine contained labeled cadaverine and delta aminovaleric acid. The injections of hexadeuterospermidine led to the appearance of labeled spermidine, isoputreanine, putreanine, N-(2-carboxyethyl)-4-amino-n butyric acid, putrescine, gamma-amino-n-butyric acid, 1,3-diaminopropane, beta alanine and spermine. After the injections with bis(2-carboxyethyl)-1,4 diaminobutane, spermidine, isoputreanine, putreanine, N-(2-carboxyethyl)-4-amino n-butyric acid, putrescine, 1,3-diaminopropane, beta-alanine, 2-hydroxyputrescine and possibly gamma-amino-n-butyric acid were recovered. Clear differences between the metabolism after the first and second injection were noted for putrescine, spermidine and spermine, which is suggestive for enzyme induction and/or the existence of salvage pathways. PMID- 6498215 TI - Purification and characterization of mitochondrial thioesterase from rabbit myocardium and its inhibition by palmitoyl carnitine. AB - Mitochondrial thioesterase from rabbit myocardium was purified to homogeneity by sequential ion exchange, hydroxylapatite, chromatofocusing and gel filtration chromatographies. The purified protein had an apparent molecular mass of 170 kDa. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and subsequent silver staining revealed a single band (Mr 43 000) demonstrating that the protein is a tetramer. The specific activity of the purified thioesterase for palmitoyl-CoA hydrolysis was 1.8 mumol/mg per min. Thioesterase activity was maximal at pH 8 and was activated by Mg2+ but inhibited by Ca2+. Pathophysiological concentrations of L-palmitoyl carnitine (20-400 microM) competitively inhibited enzymic activity. The purified enzyme was also inhibited by high concentrations of substrate (over 20 microM palmitoyl-CoA). PMID- 6498216 TI - Increased lung uptake of liposomes coated with polysaccharides. AB - Liposomes labeled with [14C]coenzyme Q10 in the lipid bilayer were coated with various polysaccharide derivatives, i.e., palmitoyl conjugates of pullulan, pullulan phosphate, amylopectin, amylopectin phosphate and amylopectin sulfate. The kinetics of disposition and the tissue distribution of [14C]coenzyme Q10 after intravenous injection of the liposomes into guinea pigs were investigated. Lung uptake of radioactivity after injection of the O-palmitoyl amylopectin- and O-palmitoyl amylopectin phosphate-coated liposomes was 5- and 3-times higher, respectively, at 30 min after injection than that of the conventional liposomes. For doubly labeled liposomes with [3H]inulin and [14C]coenzyme Q10, the 3H/14C ratios in the lung, spleen and heart were similar to one another. Urinary excretion of [3H]inulin encapsulated in O-palmitoyl amylopectin-coated liposomes was much lower than that of unencapsulated [3H]inulin. These observations suggest that the O-palmitoyl amylopectin-coated liposomes are rather stable in vivo and are taken up into tissues in the intact form. PMID- 6498217 TI - Characterization of highly purified ornithine decarboxylase from rat heart. AB - A highly purified preparation of heart ornithine decarboxylase was obtained from isoproterenol-treated rats. The molecular and catalytic properties of the cardiac enzyme were investigated. The isoelectric point of the enzyme appeared to be 4.9, and the molecular weight was estimated to be 54000 by SDS-polyacrylamide gel electrophoresis. Under nondenaturing conditions, the molecular weight of the partially purified enzyme was 10000-110000 as determined by gel filtration, whereas a significantly lower (Mr approx. 70000) value was obtained for purified ornithine decarboxylase. Both Km for the substrate and Vmax were affected by the dithiothreitol concentration in the assay mixture. In particular, the Km for ornithine was found to be about 0.09 mM in the presence of 2.9 mM dithiothreitol and appeared to decrease at lower dithiothreitol concentrations. The Km for pyridoxal phosphate was about 0.09 microM; putrescine and lysine inhibited the enzyme competitively, with Ki values of 1.3 and 11.7 mM, respectively. The existence of two different forms of ornithine decarboxylase in cardiac tissue was indicated by DEAE-cellulose chromatography. PMID- 6498219 TI - The use of monoclonal anti-Thy1 IgG1 for the targeting of liposomes to AKR-A cells in vitro and in vivo. AB - A number of SH-containing proteins or protein derivatives were coupled to small unilamellar liposomes. These were composed of distearoylphosphatidylcholine (DSPC), dipalmitoylphosphatidylethanolamine (DPPE) and cholesterol (1:1, phospholipid/cholesterol molar ratio) and activated (DPPE moiety) with the heterobifunctional reagents N-hydroxysuccinimide ester of iodoacetic acid (hydroxysuccinimide iodoacetate), N-succinimidyl-4-(2-bromoacetylamino)benzoate (SBAB) or N-succinimidyl-3-(2-pyridyldithio)proprionate (SPDP). DPPE was activated with the reagents before or after its incorporation into liposomes. Protein coupling values varied widely depending on the reagent and the protein used, but were highest in the case of SPDP-activated liposomes and SPDP-modified immunoglobulin G (IgG). Monoclonal anti-Thy1 125I-IgG1-bearing liposomes (SPDP- or SBAB-activated) containing quenched carboxyfluorescein were incubated under a variety of conditions with mouse AKR-A cells expressing the cross-reactive Thy 1.1 antigen. The following observations were made; (a) binding of intact liposomes to the cells at 4 degrees C reached plateau values after about 1 h with at least 70% of the liposomes used being capable of associating with the target cells; (b) binding of liposomes to AKR-A cells was much more pronounced than when using another cell line (EL4-Tc); (c) binding to AKR-A cells could be effected with as little as 1.3 molecules (average) of IgG1 per vesicle; (d) binding was inhibited only modestly by the presence of 50% mouse plasma; (e) stability of IgG1-bearing liposomes in terms of entrapped solute and IgG1 retention in the presence of plasma at 37 degrees C was maintained quantitatively for at least 5.5 h, and by 24 h, 54% of the IgG1 was still associated with the liposomes. AKR mice were injected intravenously with 99mTc-labelled AKR-A cells and 2.5 min later with anti-Thy1 125I-IgG1-bearing liposomes containing quenched carboxyfluorescein and 111In-Ca-DTPA or with similar liposomes devoid of IgG1. In parallel experiments, AKR mice received either of the liposome preparations without previous injection of cells. On the basis of patterns of quenched carboxyfluorescein, 111In and 125I-clearance from the circulation, of 99mTc levels in the blood and of values of 111In in the liver and spleen, it appeared that IgG1-bearing liposomes were capable of binding to their target cells in the vasculature. Such binding accelerated the clearance of interacting moieties (i.e., AKR-A cells and liposomes). The present results suggest that targeting of liposomes to circulating in vivo is feasible. PMID- 6498218 TI - Transmembrane potential of liver mitochondria from hexachlorobenzene-and iron treated rats. AB - The respiratory parameters and the membrane potential of liver mitochondria from rats treated with either hexachlorobenzene, iron or hexachlorobenzene plus iron, to induce experimental porphyria, have been studied. Partial uncoupling of oxidative phosphorylation has been observed in mitochondria from hexachlorobenzene- and hexachlorobenzene plus iron-treated rats. Direct evidence has been presented that this uncoupling is due to the action of pentachlorophenol endogenously formed by metabolism of hexachlorobenzene. No irreversible damage of mitochondria membrane has been revealed under both these conditions. Normal oxidative phosphorylation has been found in mitochondria from rats treated with iron alone. In contrast, they presented an anomalous membrane potential, fully restored by oligomycin. A possible involvement of lipid peroxidation process, induced by iron, in causing these abnormalities has been suggested. PMID- 6498220 TI - Lipid composition of the secretion from human bronchial explant culture. AB - In this study, we identified and quantitated the lipid components in the secretions of human bronchial explants cultured in a serum-free medium over a period of 50 days. Total lipids represented 6% of the dry material. This amount is considerably lower than that reported for 'normal' human sputum and suggests that the latter is contaminated by serum transudates, alveolar secretions, and microorganisms. Such serum-free culture systems are highly suitable to study cell physiology as it relates to human disease. PMID- 6498221 TI - 3T3 fibroblasts release a low-molecular-weight inhibitory peptide of lymphocyte DNA synthesis into serum-free culture medium. AB - 3T3 fibroblasts release a novel factor into serum-free culture medium, which strongly suppressed concanavalin A-induced thymocyte DNA synthesis. This activity was highly purified by gel filtration, ion exchange and thin-layer chromatography and was characterized as a 1 kDa heat-stable peptide. Although this peptide suppressed lymphocyte DNA synthesis when added relatively early after lectin stimulation, the cell viability was not changed significantly. The peptide considerably repressed DNA synthesis of some mammalian fibroblast cells, but malignant-transformed cells were not affected. PMID- 6498222 TI - The effects of colchicine and vincristine on the concentrations of glucose and related metabolites in goat's milk. AB - The effects of colchicine and vincristine on the concentration of glucose and its metabolites in milk were studied following intramammary injection of the alkaloids into one mammary gland of lactating goats. Both alkaloids decreased the rate of milk secretion from the treated gland and produced similar changes in the concentrations of various metabolites in milk. The concentrations of glucose, UDP galactose, galactose, pyruvate and lactate increased, while those of glucose 6 phosphate and phosphoenolpyruvate decreased in milk from treated glands. The rate of milk secretion from the untreated gland increased, along with the concentrations of glucose in the milk. The changes in the concentrations of the metabolites in milk are discussed in relation to possible biochemical changes occurring in the mammary gland during the suppression of milk secretion by the alkaloids. It is suggested that, before alkaloid treatment, the rate of milk secretion was limited by intracellular glucose supply. PMID- 6498223 TI - Hexokinase in developing rabbit erythroid cells. AB - The activity and isozyme distribution of hexokinase were studied in bone marrow cells from normal and anemic rabbits separated by density centrifugation or by unit-gravity sedimentation. The specific activity of the enzyme was found to be about 150-fold higher in the basophilic erythroblasts as compared with the mature circulating erythrocytes. Most of the falls in hexokinase activity take place when the cell completes its final division and matures from the polychromatic stage to the orthochromatic stage. Concomitant with this strong decrease in enzyme activity, qualitative as well as quantitative changes in the hexokinase isozymic pattern become apparent. While in the basophilic and polychromatic erythroblasts the only hexokinase isozyme present is hexokinase type I, the orthochromatic cells also contain hexokinase Ib. This last isozymic form, which increases further at the reticulocyte stage, is also present in the circulating reticulocytes but not in mature red blood cells. PMID- 6498224 TI - Increased activities of liver cathepsins T and D in carbon tetrachloride-treated rats. AB - Changes in activities of a new proteinase cathepsin T as well as some other lysosomal acid proteinases and hydrolases were examined in liver homogenate from rats treated with a single hepatotoxic dose of carbon tetrachloride. The most striking changes were several-fold increases of liver cathepsin T and D activities over their levels in untreated rats 3 days after administration of the agent to rats. Increase of cathepsin T was greater than that of cathepsin D at all doses of the hepatotoxin examined. The activities of N alpha-benzoyl-DL arginine 2-naphthylamide hydrolase, acid phosphatase, beta-galactosidase and beta glucuronidase in poisoned rat liver were unchanged or only slightly increased. Cathepsin T and D activities were less enhanced in mitochondrial lysosomal fractions than in the homogenate, and were greatly elevated in the supernatant fractions of liver from the treated rats. As judged from the molecular weights, the elevated activities of cathepsins T and D in the treated rat liver could be attributable to the two cathepsins themselves and not to other proteinases. Administration to rats of other hepatotoxic agents, thioacetamide and dimethylnitrosamine, also induced the elevation of the two cathepsin activities in liver, but on partial hepatectomy the activities of liver cathepsins T and D did not show such marked increases. Nonparenchymal liver cell fractions were responsible for almost all the increased activities of liver cathepsins T and D. It is possible that cathepsins T and D play a role in the heterolytic breakdown of hepatocyte molecules following CCl4 poisoning. PMID- 6498225 TI - Molecular events involved in the proaggregating effect of heparin on human platelets. AB - Molecular mechanisms underlying the ability of heparin to enhance the platelet aggregating effect of various agonists were studied. Heparin potentiates the aggregating effect of adenosine diphosphate (ADP) and epinephrine, but it is uneffective on the aggregation induced by ristocetin and collagen. Heparin inhibits aggregation induced by thrombin in the presence of plasma, but it is uneffective, or sometimes stimulates aggregation, in the absence of plasma. The effects on the platelet-activating factor- (PAF-acether) induced aggregation are very variable. The late phase of the ADP-induced aggregation is sensitive to proteinase inhibitors, but heparin overcomes this inhibitory effect. Drugs which inhibit remodeling of membrane phospholipids abolish the potentiating effect of heparin, while cyclooxygenase inhibitors do not. The proaggregating effect of heparin subfractions correlates with the lipoprotein lipase activity and, slightly, with the molecular weight, but it does not correlate with the anticoagulant activity. Platelets prelabelled with phosphatidyl[U14C]inositol show a very rapid effect of heparin in triggering phosphatidylinositor breakdown and a cooperative effect with ADP, a known agonist of the 'phosphatidylinositol cycle'. Heparin is also effective in stimulating the labelling of polyphosphoinositides in platelets prelabelled with 32Pi. These results, together with the selective sensitivity to drugs, lead to the conclusion that a stimulatory effect on the very early events of remodeling of membrane phospholipids is involved in the platelet proaggregating effect of heparin. PMID- 6498226 TI - [Effect of pH and the binding anion on In3+-transferrin interaction: spectroscopic study of the perturbed angular correlation of 172-245 keV gamma rays of indium 111]. AB - The formation of ternary complexes, transferrin-anion-In111 has been investigated by means of gamma-gamma coincidence spectrometry of the 172-245 keV rays. The angular correlation between the two gamma-rays emitted in cascade depends on the magnetic and electric fields gradients, consequently the chemical structure of metal holder. Any modification of this structure causes the variation of angular correlation. The study of G22 (infinity) as function of pH (G22(infinity): integrated perturbed angular correlation coefficient) has been performed to turn out the hydrolysis of In111 in aqueous solution, metal complex formation in presence of chelating agents (citric acid and sodium bicarbonate) and the formation of protein-metal complexes. The presence of complexing agents limits the domain of In111 colloid existence and allows fast transfer of ionised indium on the transferrin. Two types of metal-protein interactions has been turn out. The first in the weakly acidic range of pH is characterized by an affinity constant near to this of citric acid. The second lying in neutral and basic range of pH, where the formation rate of transferrin-In111 complex is fast (t less than 500 s). In citrate medium, for pH 6-7,5 the rate of metal transfer on the protein, studied by means of G22 (infinity) = f(t), is function of pH. The binding anion appears as an indispensable element for the formation of protein metal complexes. The In111 previously chelated by 8-Hydroxyquinoline is fixed by the protein if only exits a binding anion in the solution. This mays bring in the formation of an intermediate active state, indispensable step for the ternary complex formation transferrin-anion-In111. PMID- 6498227 TI - Relationship between cell density and prolidase activity in human skin fibroblasts: effects of ascorbate and fructose. AB - To evaluate the influence of cell density on the activity of fibroblast prolidase (EC 3.4.13.9), we determined this activity in sparse and dense cultures. We also investigated, the effects of different concentrations of beta-D (-) fructose and L (+) ascorbate, which both increased cell density at confluency. For a fructose concentration of 25 mM, we observed that in the absence of glucose, intracellular total proteins increased 1.5-fold and prolidase specific activity, 1.8-fold. For ascorbate, a broad optimum concentration was found (range 0.01 - 0.50 mM). Addition to cultures of 0.1 mM ascorbate increased total proteins 1.4-fold, and doubled prolidase activity. This investigation was prompted by our previous results [J. Metab. Dis. 1983, 6, 27-31], confirmed here, and suggesting that increased prolidase activity at confluency was due to a rise in cell density. PMID- 6498228 TI - Zein of maize grain: I--Isolation by gel filtration and characterization of monomeric and dimeric species. AB - Unreduced zein chromatographed on Sephadex G 200 in 8 M urea, on G 100 in 1.5 or 2.5% sodium dodecyl sulfate (SDS) and on hydroxypropylated G 100 in 70% ethanol was resolved into two minor fractions A and B and two major ones D and M irrespective of the medium. The quantitative importance of the fraction M was dependent on the isolation conditions of zein. It decreased from 53% of the proteins contained in ethanolic extract and chromatographed as they were extracted, to 40% of the purified zein. The molecular weight values obtained from SDS-polyacrylamide gel electrophoresis and amino acid compositional data indicated that fractions D and M, as isolated from purified zein in the presence of ethanol, represented respectively dimeric and monomeric forms of a mixture of Mr 22 000 and 24 000 polypeptides with threonine or phenylalanine as NH2-terminal residue. Electrophoretic analysis of selectively carbamylated fraction M on starch gel at pH 3.5 revealed that zein subunits comprised several polypeptides differing in the number and the nature of basic amino acids. At least one of these polypeptides contained one lysyl residue. PMID- 6498229 TI - Zein of maize grain: II--The charge heterogeneity of free subunits. AB - The subunits present as monomers in unreduced zein and isolated as fraction M by gel filtration, were chromatographed on sulfoethyl-cellulose. Three major subfractions were detected and characterized. Each of them, submitted to electrophoresis at pH 3.5, migrated as a single band corresponding to each of the three major electrophoretic forms seen in fraction M at the same pH. The presence of lysine in some polypeptides, suggested by amino acid composition data, was confirmed by electrophoretic analysis of carbamylated subfractions at pH 3.5. At pH 8.9 each subfractions was further resolved into three cationic bands in starch gel and three (or more) anionic bands in polyacrylamide gel. The same fractionation was also obtained by submitting the major electroforms of fraction M, as isolated at pH 3.5, to isoelectric focusing. Based on these observations, the most probable distributions of basic amino acids in subunits detected by electrophoresis at pH 8.9 were specified and compared to those recently published for several zein clones. The presence per polypeptide chain of three carboxyl groups and occasionally of one lysine would be a feature of zein originating from maize hybrid Inra 260. PMID- 6498230 TI - 2-(4-methyl-1-piperazinylmethyl) acrylophenone dihydrochloride: a new antimicrotubular drug. AB - With the relation between chemical structure and pharmacological activity as a guide, we have been for some time synthetizing a wide range of beta-amino-ketone derivatives. One of them, 2-(4-methyl-1-piperazinylmethyl) acrylophenone, MPMAP, possesses antimicrotubular activities. This product inhibits 50% of the microtubule polymerization at a 3.10(-5) M concentration. It does not prevent tubulin paracrystal formation induced by vinblastine, and binding experiments reveal that this product is a weak inhibitor of colchicine binding. The structure of this compound is different from the other antimicrotubular agents and has the advantage of being far less complex, highly soluble and easy to synthesize. Thus, this product and related compounds should be a new tool for the study of antimicrotubular activities and tubulin assembly. PMID- 6498231 TI - Purification and partial characterization of an erythroagglutinin from the hemolymph of scorpion, Heterometrus bengalensis. AB - An erythroagglutinin from the hemolymph of the scorpion, Heterometrus bengalensis, has been purified by gel filtration and ion-exchange chromatography. Its homogeneity has been demonstrated by polyacrylamide gel electrophoresis. The purified agglutinin appears to be a monomeric protein having a possible molecular weight between 146,000 and 148,000. It has no divalent cation requirement for erythroagglutination. The erythroagglutination is not inhibited by saccharides, glycoproteins and mucin. Identical erythroagglutination pattern is obtained with normal as well as neuraminidase treated erythrocytes. PMID- 6498232 TI - Viral neuraminidase and cellular ectosialyltransferase in human lymphoblastoid cells infected with influenza virus. AB - In human lymphoblastoid cells, infected with an influenza virus, Fowl Plague Virus (FPV), glycoproteins (such as secreted IgM) are hyposialylated, through the action of viral neuraminidase. In this study, the modulation of the cellular ectosialyltransferase activity during viral infection was investigated. This activity was detectable in FPV-infected cells, was shown to be 2.5-fold higher than that of uninfected cells, and to be able to restore, at least partially, the level of sialylation of the cell surface acceptors. PMID- 6498233 TI - Resolution of the molecular forms of rat liver glucocorticoid receptor by affinity chromatography on immobilized heparin. AB - Rat liver cytosolic glucocorticoid receptor labelled with [3H] dexamethasone and stabilized with molybdate was bound to heparin-ultrogel and eluted with NaCl or heparin as a single peak of radioactivity. After heat exposure of cytosol, two steroid receptor complexes could be separated by NaCl or heparin. Characterization of the two forms was performed by means of affinity towards isolated nuclei, sucrose gradient centrifugation and gel exclusion high performance liquid chromatography. The results presented here suggest that the two forms eluted from heparin-agarose correspond to the untransformed and transformed states of the glucocorticoid receptor complex. Taken together, these observations argue in favor of heparin-ultrogel as a suitable procedure to study the mechanism of glucocorticoid-receptor transformation. PMID- 6498234 TI - [Effect of papaverine on the absorption and metabolism of 14C- adenosine and 14C adenine in thymocytes]. AB - Some peculiarities of adenosine and adenine nucleotide metabolism in rat thymocytes were investigated. It was shown that the uptake of labelled adenosine or adenine by thymocytes is markedly inhibited by papaverine due to the decrease of the adenylate kinase activity, on the one hand, and to the acceleration of ATP catabolism and inosine and hypoxanthine release into the environment, on the other. ATP catabolism occurs in a special compartment which in [14C] adenosine and [14C] adenine prelabelled thymocytes has a higher specific radioactivity as compared with the whole cell. In [14C] adenine-prelabelled thymocytes and extracellular medium, papaverine does not influence the content but increases the specific radioactivity of adenosine. PMID- 6498235 TI - [Protein of membrane-bound liver ribosomes changing after exposure of an organism to various factors]. AB - Polyacrylamide gel electrophoresis was used to examine the protein composition of membrane-bound ribosomes from mouse liver upon exposure to different influences, e.g., cell transplantation, cold stress, injections of heterogeneous proteins and cytotoxic non-protein substances, etc. Significant changes in the protein (Mr 50 000) structure occurring immediately after the exposure and depending on its nature were revealed. PMID- 6498236 TI - [Changes in the ganglioside composition of various rat organs under the action of thyroid hormones]. AB - The ganglioside content in various organs of the rat were studied under normal conditions and under deficiency of thyroid hormones. The minimal ganglioside content was observed in skeletal muscles, the maximal one--in the brain. Using thin-layer chromatography, it was demonstrated that these organs possess a complex ganglioside composition which differs both qualitatively and quantitatively. Under thyroid hormone excess, the total ganglioside content shows a tendency to increase, while under hormone deficiency--to decrease. The nature of changes in individual ganglioside fractions in various tissues depends on the thyroid hormone content in the organism. PMID- 6498237 TI - [Pyruvate kinase in the bovine adrenal cortex]. AB - Pyruvate kinase from bovine adrenal cortex was purified to an electrophoretically homogeneous state. The molecular weight of the native enzyme is about 230 000, that of one subunit is 57 000. The maximal values of the pyruvate kinase initial reaction rate were obtained in 50 mM imidazole-acetate buffer within the pH range of 6.8 to 7.0. The curve of the initial pyruvate kinase reaction rate versus phosphoenolpyruvate (PEP) and ADP concentrations is hyperbolic and obeys the Michaelis-Menten kinetics with Km for PEP and ADP of 0.055 X 10(-3) M and 0.25 X 10(-3) M, respectively. The enzyme is activated by Mn2+ and Co2+ by 43 and 38%, respectively. IDP, GDP, and UDP may be used as analogs of ADP. The enzyme is not activated by fructose-1.6-diphosphate and is inhibited by L-phenylalanine and ATP. PMID- 6498238 TI - [Several peculiarities of the interaction of troponin T and troponin C of skeletal and cardiac muscle]. AB - Using several independent methods, the interaction between troponin T and troponin C from skeletal and cardiac muscles was studied. It was found that troponin T and troponin C from skeletal muscles form a complex whose stability depends on Ca2+ concentration. Study of interactions between these troponin components demonstrated that both electrostatic and hydrophobic forces are involved in the complex formation. Cardiac troponin T and troponin C weakly interact with each other irrespective of experimental conditions. It was assumed that the weakening of interactions between the components of cardiac troponin is due to structural peculiarities of cardiac troponin T. PMID- 6498239 TI - [Possible participation of a free-radical lipid intermediate in the coupling of oxidation and phosphorylation]. AB - Data shown propose two regimes of lipid radicals and oxygen utilization realized in mitochondrial membranes. The first one--lipid peroxidation, i.e. interaction of lipid radical and oxygen is an empty step. In switching this regime to the functional one lipid peroxidation is inhibited. Setting L. -dependent coupling apparatus on phosphorylation in mitochondria takes place in the presence of ADP and Pi. PMID- 6498240 TI - [Analysis of the plastic properties of the postsynaptic neuron in the sensory motor cortex in response to repeated microphoretic administration of gamma aminobutyric acid]. AB - The absence of habituation effect to the iontophoretic repetitive applications with 120, 30 and 15 seconds intervals of inhibition transmitter--gamma aminobutiric acid (GABA)--in sensomotor cortex neurons has been established. Earlier habituation effect has been discovered under the same experimental conditions during other transmitter administration--acetilcholine. A hypothesis concerning the absence of biological expendiency of habituation in the GABA-ergic system is suggested. PMID- 6498241 TI - Restless kids. PMID- 6498242 TI - Brain energy metabolism and blood-brain barrier permeability in depressive patients: analyses of creatine, creatinine, urate, and albumin in CSF and blood. AB - A reliable method is described using high pressure liquid chromatography to measure creatine, creatinine, and urate in human cerebrospinal fluid (CSF) and blood; albumin was analyzed by routine methods. Creatine and creatinine serve as indices of one aspect of brain energy metabolism, the creatine-creatine phosphate (CrP) shuttle. CSF levels have been adjusted to a set blood level by analysis of covariance. The ratios between CSF and blood concentrations of urate and albumin are two sensitive indices of impaired blood-brain barrier (BBB) function. Analyses were performed on 41 male and 58 female inpatients with RDC major depressive disorders, with a mean age of about 40 years. The CSF creatinine and creatine levels were highly positively age-dependent; this factor as well as possible influences of body habits were removed by way of analysis of covariance from all measures in focus. We describe positive, highly significant correlations between creatinine and monoamine metabolites (HVA and 5HIAA) and purine metabolites (hypoxanthine and xanthine) in CSF, and a strong negative correlation between both BBB permeability measures and the noradrenalin CSF metabolite MHPG. CSF creatinine was negatively linked with suicidal ideation and increased appetite. The BBB tended to be the more permeable the less melancholic the depression. No measure appeared to be dependent on depressive state. Comparisons of depressive subgroups revealed a higher CSF creatinine concentration in sporadic unipolar patients according to Winokur. A particularly wide variance in the albumin ratio was found in pure unipolars. Pure unipolars with an impaired BBB had a more protracted onset, were more suicidal, had a higher erythrocyte sedimentation rate, and lower plasma cortisol levels than those without. Impaired BBB was further linked with a slower EEG rhythm and higher systolic blood pressure. Results suggest significant contributions of brain energy metabolism and deranged BBB permeability in accounting for some aspects of neuronal transmission and modulation as well as the symptomatology of depressive illness. PMID- 6498243 TI - Depression and anxiety inventories, and the dexamethasone suppression test. AB - Twenty-one psychiatric inpatients with prominent depressive symptoms underwent dexamethasone suppression tests and assessment with observer-rated and self-rated anxiety, depression, and somatic symptom inventories. This was done to test the hypothesis that anxiety, more than depression, was related to cortisol nonsuppression seen in psychiatric patients including those diagnosed as having major depressive disorders. Nonsuppressors were significantly more depressed but not more anxious on the symptom inventories. In addition, it was noted retrospectively that the depression symptom inventory scores predicted nonsuppression. Several individual items from the symptom scales which correlated with post-dexamethasone cortisol levels were also identified. PMID- 6498244 TI - A chronobiological study of melatonin and cortisol secretion in depressed subjects: plasma melatonin, a biochemical marker in major depression. AB - The temporal organization of plasma melatonin and cortisol secretion was examined in healthy rested controls and in depressed patients: 11 patients suffering from a primary affective disorder (10 female, 1 male) and 8 male controls were studied over a 24-hr period; blood was collected at 2-hr intervals during the day at 1-hr intervals at night. Plasma melatonin and cortisol levels were determined by radioimmunoassay. In addition, melatonin was determined in plasma sampled at 3 AM in older male controls (n = 8) and in females (n = 10) at ovulation. The controls showed low or undetectable (less than 5 pg/ml) diurnal plasma melatonin levels and a very marked nocturnal rhythm (acrophase: 2.27 AM, mesor: 34.4 pg/ml, amplitude: 58.7 pg/ml). For the three control groups, no significant difference was observed in the nocturnal melatonin peak at 3 AM. The depressed patients also showed a significant melatonin rhythm but with lower amplitude (14.5 pg/ml) and mesor (19.1 pg/ml). The latter rhythm was not significantly phase-advanced with respect to the controls (acrophase at 1.18 and 2.34 AM, respectively). In 9 of the 11 patients, nocturnal melatonin secretion was less marked and frequently associated with hypercortisolemia. An additional episodic melatonin secretion was observed in the late afternoon in only two patients. In depressed patients, there was an increase in the mean cortisol secretion level (mesor at 13.6 micrograms/100 ml against 9.1 micrograms/100 ml in the controls), but the amplitude and the acrophase were not significantly modified. These data are discussed in terms of both the hypothalamus-pituitary-adrenal-epiphysis and aminergic abnormalities. PMID- 6498245 TI - Left hemispheric density deficits in chronic schizophrenia. AB - Regional determinations of mean cerebral tissue density were made for 50 chronic schizophrenics and compared with results in 24 normal controls. When values for corresponding left and right hemispheric regions were compared, 11 of 12 comparisons showed the left regional value to be significantly greater than the right for controls while only 6 of 12 comparisons among schizophrenics showed left values significantly greater than right. These data suggest an overall decreased relative density of the left cerebral hemisphere in schizophrenia. Further implications of the data are discussed. PMID- 6498246 TI - Dexamethasone suppression in major depression. AB - Overnight 1 mg dexamethasone suppression tests were performed on 37 hospitalized patients with unipolar major depression and 13 psychiatric controls: 62% of the depressives and 38% of controls failed to suppress below 6 micrograms/dl of plasma cortisol at least once on the day after dexamethasone. Specificity for depressive diagnosis was only 62% but rose to 100% when a plasma cortisol value of 10 micrograms/dl was used as the criterion for normal suppression. Depressed patients were significantly more likely to show normal suppression if they were under age 65 (56% vs. 24% in the geriatric sample). Other demographic and clinical variables examined in the depressed sample did not assort by suppressor status. PMID- 6498247 TI - Do insomniacs have impaired daytime functioning? PMID- 6498248 TI - Electroacupuncture and ECT. PMID- 6498249 TI - Methadone for depression. PMID- 6498250 TI - Dopamine receptor rhythms. PMID- 6498251 TI - A potent psychotropic. PMID- 6498252 TI - The dexamethasone suppression test: interaction of diagnosis, sex, and age in psychiatric inpatients. AB - A group of 277 semiconsecutive psychiatric inpatients manifesting a depressive affect underwent an overnight 1 mg dexamethasone suppression test (DST) and a semistructured diagnostic interview according to DSM-III criteria. For major depressive syndromes (major depression with and without psychosis, bipolar depressed) the sensitivity of the DST was 63.9%, specificity 73.0%, and diagnostic confidence 72.3%. Additionally, a significant interaction between age and baseline cortisol values and nonsuppression rates was found in depressed males but not in nondepressed males nor in depressed and nondepressed females. The authors discuss the implications of these findings. PMID- 6498253 TI - The modality shift effect in schizophrenia: fact or artifact? AB - We investigated whether the disproportionate slowing of schizophrenic patients on cross-modal relative to ipsimodal sequences in a reaction time task ("modality shift effect") could be attributed to a psychometric artifact, as implied by Chapman and Chapman. Fifteen schizophrenic patients (Research Diagnostic Criteria) and 50 normal controls with no current or past history of psychiatric disorder were tested. Subjects made an identical finger-lift response to brief duration light and sound stimuli of different intensities presented in quasi random order. The major finding was that psychometric artifact could not account for the disproportionate slowing of the reaction time of schizophrenic patients since the reliabilities and variances of the cross-modal and ipsimodal conditions did not differ in normal controls. Furthermore, the modality shift effect was highly significant for reaction times to both sound and light and for all intensities. Findings were the same when the schizophrenic patients were compared to a matched subgroup of slow-responding normal controls. PMID- 6498254 TI - Serum zinc, copper, and ceruloplasmin levels in male alcoholics. AB - Twenty male alcoholics aged 29 to 69 years (mean 45.80 + SD 10.97) were compared with controls for serum zinc, copper, and ceruloplasmin levels. The serum zinc level of the alcoholic patients was significantly lower than that of the control group (t = 3.3005, p less than 0.005). The serum copper and ceruloplasmin levels of the alcoholics tended to be higher than those of the controls, but the difference was not statistically significant. A significantly positive correlation between serum zinc and albumin levels (r = 5.41, p less than 0.01) was also found. The nutritional state of the alcoholics may not be an adequate explanation for their low serum zinc level. It is suggested that further research on alcohol as a toxic agent might focus on trace element-containing enzymatic defects in brain peptides and hormones to promote fuller understanding of the psychopathology associated with alcohol abuse. PMID- 6498255 TI - Anorexia nervosa precipitated by a prepubertal pyometra. AB - A severe pyometra was found in a typical case of anorexia nervosa, with the latter illness apparently precipitated by the former. Compulsory alimentation before and after operation brought some weight gain as well as reversal of dilated cerebral sulci and hypothyroidism, though hypothalamo-pituitary dysfunction persisted. PMID- 6498256 TI - The pattern of polyuria in relation to duration of lithium treatment. PMID- 6498258 TI - CSF probenecid and biogenic amines. PMID- 6498257 TI - The dexamethasone suppression test in patients with postpsychotic depressions. PMID- 6498260 TI - [Initial experiences with higher magnetic flow densities (1.5T and 2.0T) in MR tomography]. PMID- 6498259 TI - [Imaging with nuclear magnetic resonance tomography]. PMID- 6498261 TI - [Algorithms for the generation of tomographic pictures]. PMID- 6498262 TI - Biplane multidirectional angiocardiography: exact orthogonal positioning of the X ray systems (laterally mounted C-arm-L-arm-systems). PMID- 6498263 TI - Intramolecular dynamics of chain molecules monitored by fluctuations in efficiency of excitation energy transfer. A theoretical study. AB - The fluorescence quantum yield of a polymer molecule to which an energy donor chromophore and an energy acceptor chromophore are attached depends on the distance between the donor and acceptor chromophores. If this distance fluctuates with time, the fluorescence intensity is expected to fluctuate as well, and the time course of the intensity fluctuations will be correlated with the time course of the changes in the interchromophore distance. The intensity fluctuations are experimentally measurable if the number of illuminated molecules is small. A theoretical treatment of such fluorescence intensity fluctuations is presented in terms of a parameter that describes the polymer chain dynamics. Computer simulations were performed to illustrate the dependence of the autocorrelation function of the intensity fluctuations on the polymer chain conformation, the interchromophore energy transfer properties, and the macromolecular dynamics. These simulations demonstrate that the intensity fluctuations due to nonradiative energy transfer between chromophores attached to polymer chains can be large enough to be experimentally useful in the study of intramolecular dynamics of macromolecules. PMID- 6498264 TI - Analysis of fluorescence decay kinetics from variable-frequency phase shift and modulation data. AB - Recently it has become possible to measure fluorescence phase-shift and modulation data over a wide range of modulation frequencies. In this paper we describe the analysis of these data by the method of nonlinear least squares to determine the values of the lifetimes and fractional intensities for a mixture of exponentially decaying fluorophores. Analyzing simulated data allowed us to determine those experimental factors that are most critical for successfully resolving the emissions from mixtures of fluorophores. The most critical factors are the accuracy of the experimental data, the relative difference of the individual decay times, and the inclusion of data measured at multiple emission wavelengths. After measuring at eight widely spaced modulation frequencies, additional measurements yielded only a modest increase in resolution. In particular, the uncertainty in the parameters decreased approximately as the reciprocal of the square root of the number of modulation frequencies. Our simulations showed that with presently available precision and data for one emission bandpass, two decay times could be accurately determined if their ratio were greater than or equal to 1.4. Three exponential decays could also be resolved, but only if the range of the lifetimes were fivefold or greater. To reliably determine closely-spaced decay times, the data were measured at multiple emission wavelengths so that the fractional intensities of the components could be varied. Also, independent knowledge of any of the parameters substantially increased the accuracy with which the remaining parameters could be determined. In the subsequent paper we present experimental results that broadly confirm the predicted resolving potential of variable-frequency phase-modulation fluorometry. PMID- 6498265 TI - Resolution of mixtures of fluorophores using variable-frequency phase and modulation data. AB - We measured fluorescence phase shift and modulation data for one-, two- and, three-component mixtures of fluorophores at modulation frequencies ranging from 1 to 140 MHz. These data were analyzed using the least-squares procedure described in the preceding paper (Lakowicz, J. R., G. Laczko, M. Cherek, E. Gratton, and M. Limkeman, 1984, Biophys. J., 46:463-477). Using data obtained at a single emission bandpass, the lifetimes and preexponential factors of two-component mixtures could be easily resolved if the lifetimes differed by a factor of 2. With currently available instrumental stability, three-component mixtures could be resolved when the overall range of decay times was 10-fold, (e.g., 1.3, 4.4, and 12 ns). Measurement of phase and modulation data at several emission wavelengths, where the ratio of the preexponential factors varied, enhanced our ability to resolve closely spaced two and three-component decays. Two-component mixtures could then be resolved if the lifetimes differed by 30% (4.4 and 6.2 ns). Also, the multiple-wavelength data allowed the lifetimes and emission spectra of the three-components of a mixture to be resolved. These results demonstrated that resolution of multiexponential decay laws was possible using frequency-domain phase-modulation fluorometry. PMID- 6498266 TI - Mass-action formulations of monovalent and divalent cation adsorption by phospholipid membranes. AB - An extension of a previous treatment (Cohen, J. A., and M. Cohen, 1981, Biophys. J., 36:623-651) is presented for the adsorption of monovalent and divalent cations by single-component phospholipid membranes, where monovalent cations adsorb with a cation/phospholipid stoichiometry of 1:1 and divalent cations adsorb with stoichiometries of 1:1 and 1:2. Previously the 1:1 and 1:2 binding of divalent cations were assumed to occur by independent, parallel pathways. Here a serial adsorption scheme is considered in which 1:2 binding occurs via reaction of 1:1-bound complexes with adjacent unoccupied phospholipids. This two dimensional lattice reaction is shown to obey a law of mass action, and the mass action equilibrium constant is used to parameterize the adsorption isotherm. This isotherm is shown to be mathematically equivalent to the previous isotherm, although the two formulations differ in the dependence of 1:2 binding on the 1:1 association constant. PMID- 6498267 TI - Neutron scattering shows that cytochrome b5 penetrates deeply into the lipid bilayer. AB - Cytochrome b5 was asymmetrically reconstituted into small lipid vesicles made of a highly deuterated phospholipid. Small-angle neutron diffraction patterns were collected in a series of H2O-D2O mixtures from vesicles consisting of lipid and native or trypsinized cytochrome b5. The second moment of the radial distribution of scattering density in the vesicles was derived from these data and was compared to values calculated from three proposed models, which differ by the degree that cytochrome b5 penetrates the lipid bilayer. The model in which the hydrophobic domain of the protein is distributed across the bilayer agreed most closely with the data. PMID- 6498268 TI - Compensation for resistance in series with excitable membranes. AB - Extracellular resistance in series (Rs) with excitable membranes can give rise to significant voltage errors that distort the current records in voltage-clamped membranes. Electrical methods for measurement of and compensation for such resistances are described and evaluated. Measurement of Rs by the conventional voltage jump in response to a current step is accurate but the measurement of sine-wave admittance under voltage-clamp conditions is better, having about a fivefold improvement in resolution (+/- 0.1 omega cm2) over the conventional method. Conventional feedback of the membrane current signal to correct the Rs error signal leads to instability of the voltage clamp when approximately two thirds of the error is corrected. We describe an active electronic bridge circuit that subtracts membrane capacitance from the total membrane current and allows full, yet stable, compensation for the voltage error due to ionic currents. Furthermore, this method provides not only fast and accurate control of the membrane potential in response to a command step, but also fast recovery following an abrupt change in the membrane conductance. Marked changes in the kinetics and amplitude of ionic currents resulting from full compensation for Rs are shown for several typical potential patterns. PMID- 6498269 TI - Effect of orientational order on the decay of the fluorescence anisotropy in membrane suspensions. A new approximate solution of the rotational diffusion equation. AB - We discussed the time-dependence of fluorescent emission anisotropy of a cylindrical probe in membrane vesicles. We showed that, if the motion of the probe were described as diffusion in an anisotropic environment, it would be possible to determine not only the second-rank but also the fourth-rank orientational order parameter from the decay of the fluorescence anisotropy. The approximations involved were based on an interpolation of short-time and long time behavior of the relevant correlation functions. A general expression was derived for the time dependence of the fluorescence anisotropy in closed form, which applies to any particular distribution model. It was shown to be in good agreement with previously reported results for the cone model and the Gaussian model. Finally, the applicability of the theory to time-resolved and differential phase fluorescence depolarization experiments was discussed. PMID- 6498270 TI - The hill coefficient for the Ca2+-activation of striated muscle contraction. AB - The following arguments are presented for the observation that curves relating free Ca2+ and force development of thin filament regulated myofilaments of skinned muscle fibers have Hill coefficient (n) greater than 4, which is the number of Ca2+ binding sites on troponin: Activation of the myofilaments is a process relaxing to a nonequilibrium steady state or stationary state. Systems operating at nonequilibrium stationary states are known to display Hill coefficients greater than the number of interacting sites and similar results have been obtained for Ca2+ activation of myofilament isometric force. The size of the basic subunit of thin filament regulated muscle may be the entire thin filament rather than seven actins, one tropomyosin, and one troponin. In this case the number of interacting sites may be on the order of hundreds. Hysteresis in the Ca2+ activation of isometric force might result from multiple stationary states and also might give rise to Hill coefficients greater than 4. PMID- 6498271 TI - Thermodynamic properties of purple membrane. AB - We measured the density, expansivity, specific heat at constant pressure, and sound velocity of suspensions of purple membrane from Halobacterium halobium and their constituent buffers. From these quantities we calculated the apparent values for the density, expansivity, adiabatic compressibility, isothermal compressibility, specific heat at constant pressure, and specific heat at constant volume for the purple membrane. These results are discussed with respect to previously reported measurements on globular proteins and lipids. Our data suggest a simple additive model in which the protein and lipid molecules expand and compress independently of each other. However, this simple model seems to fail to describe the specific heat data. Our compressibility data suggest that bacteriorhodopsin in native purple membrane binds less water than many globular proteins in neutral aqueous solution, a finding consistent with the lipid surround of bacteriorhodopsin in purple membrane. PMID- 6498272 TI - On microelectrode ionophoresis. AB - An equation for ionophoresis in large tip microelectrodes is derived from Nernst Planck equations for the general case of a completely dissociated electrolyte. The relation between the release of ions and the applied electric current is mainly determined by two parameters: the transference number of the ions under consideration and the diffusional leak of the microelectrode. Also it is shown how the release of ions is affected by the concentration of the electrolyte within the electrode and that of the external solution. The equation describes the ionophoretic release of polyvalent spermine. In addition, new equations for tip potential and for tip resistance are derived. PMID- 6498273 TI - Voltage-dependent calcium and calcium-activated potassium currents of a molluscan photoreceptor. AB - Two-microelectrode voltage clamp studies were performed on the somata of Hermissenda Type B photoreceptors that had been isolated by axotomy from all synaptic interaction as well as any impulse-generating (i.e., active) membrane. In the presence of 2-10 mM 4-aminopyridine (4-AP) and 100 mM tetraethylammonium ion (TEA), which eliminated two previously described voltage-dependent potassium currents (IA and the delayed rectifier), a voltage-dependent outward current was apparent in the steady state responses to command voltage steps more positive than -40 mV (absolute). This current increased with increasing external Ca++. The magnitude of the outward current decreased and an inward current became apparent following EGTA injection. Substitution of external Ba++ for Ca++ also made the inward current more apparent. This inward current, which was almost eliminated after being exposed for approximately 5 min to a solution in which external Ca++ was replaced with Cd++, was maximally activated at approximately 0 mV. Elevation of external potassium allowed the calcium (ICa++) and calcium-dependent K+ (IC) currents to be substantially separated. Command pulses to 0 mV elicited maximal ICa++ but no IC because no K+ currents flowed at their new reversal potential (0 mV) in 300 mM K+. At a holding potential of -60 mV, which was now more negative than the potassium equilibrium potential, EK+, in 300 mM K+, IC appeared as an inward tail current after positive command steps. The voltage dependence of ICa++ was demonstrated with positive steps in 100 mM Ba++, 4-AP, and TEA. Other data indicated that in 10 mM Ca++, IC underwent pronounced and prolonged inactivation whereas ICa++ did not. When the photoreceptor was stimulated with a light step (with the membrane potential held at -60 mV), there was also a prolonged inactivation of IC. In elevated external Ca++, ICa++ also showed similar inactivation. These data suggest that IC may undergo prolonged inactivation due to a direct effect of elevated intracellular Ca++, as was previously shown for a voltage-dependent potassium current, IA. These results are discussed in relation to the production of training-induced changes of membrane currents on retention days of associative learning. PMID- 6498274 TI - Segmented and "equivalent" representation of the cable equation. AB - The linear cable theory has been applied to a modular structure consisting of n repeating units each composed of two subunits with different values of resistance and capacitance. For n going to infinity, i.e., for infinite cables, we have derived analytically the Laplace transform of the solution by making use of a difference method and we have inverted it by means of a numerical procedure. The results have been compared with those obtained by the direct application of the cable equation to a simplified nonmodular model with "equivalent" electrical parameters. The implication of our work in the analysis of the time and space course of the potential of real fibers has been discussed. In particular, we have shown that the simplified ("equivalent") model is a very good representation of the segmented model for the nodal regions of myelinated fibers in a steady situation and in every condition for muscle fibers. An approximate solution for the steady potential of myelinated fibers has been derived for both nodal and internodal regions. The applications of our work to other cases dealing with repeating structures, such as earthworm giant fibers, have been discussed and our results have been compared with other attempts to solve similar problems. PMID- 6498275 TI - Analysis of lumped and distributed elements models of cut muscle fibers in vaseline or sucrose gap preparations. AB - A general method of finding the time course and the steady state distribution of potential in Vaseline or sucrose gap preparations is given by making use of the linear cable equation. The general solution has been found analytically in terms of its Laplace transform and then numerically inverted. Two particular experimental situations, namely the single gap and the double gap preparations, have been analyzed. The results have been compared with the solutions of the commonly used lumped elements models. While for the double gap no large errors are introduced by the lumped model, for the single gap there are significant differences. The dependence of the voltage distribution on various electrical and geometrical parameters has been examined. It is suggested that the proposed mathematical treatment might be used by experimenters as a reference to assess the validity of simplified lumped models. PMID- 6498276 TI - Kinetics of nucleation-controlled polymerization. A perturbation treatment for use with a secondary pathway. AB - We present a perturbation method for analyzing nucleation-controlled polymerization augmented by a secondary pathway for polymer growth. With this method, the solution to the kinetic equations assumes a simple analytic closed form that can easily be used in fitting data. So long as the formation of polymers by the secondary pathway depends linearly on the concentration of monomers polymerized, the form of the solutions is the same. This permits the analysis of augmented growth models with a minimum number of modeling assumptions, and thus makes it readily possible to distinguish between a variety of secondary processes (heterogeneous nucleation, lateral growth, and fragmentation). In addition, the parameters of the homogeneous process, such as the homogeneous nucleus size, can be determined independent of the nature of the secondary mechanism. We describe applications of this method to the polymerization of actin, collagen, and sickle hemoglobin. We present an extensive analysis of data on actin polymerization (Wegner, A., and P. Savko, 1982, Biochemistry, 21:1909-1913) to illustrate the use of the method. Although our conclusions generally agree with theirs, we find that lateral growth describes the secondary pathway better than the fragmentation model originally proposed. We also show how this method can be used to study the degree of polymerization, the parentage of polymers, and the behavior of polymers in cycling experiments. PMID- 6498277 TI - The somatic shunt cable model for neurons. AB - The derivation of the equations for an electrical model of nerve cells is presented. The model consists of an equivalent cylinder, a lumped somatic impedance, and a variable shunt at the soma. This shunt was introduced to take into account the fast voltage decays observed following the injections of current pulses in some motoneurons and hippocampal granule cells that could not be explained by existing models. The shunt can be interpreted either by penetration damage with the electrode or by a lower membrane specific resistance at the soma than in the dendrites. A solution of the model equations is presented that allows the estimation of the electrotonic length L, the membrane time constant tau m, the dendritic dominance ratio rho, and the shunt parameter epsilon, based only on the measurement of the first two coefficients and time constants in the multiexponential voltage response to injected current pulses. PMID- 6498278 TI - Physical analysis of light-scattering changes in bovine photoreceptor membrane suspensions. AB - We have used electron microscopy and model calculations to analyze the physical basis of light-scattering signals from suspensions of photoreceptor membranes. These signals have previously been used to probe interactions between photoactivated rhodopsin (R*) and the peripheral membrane enzyme, GTP-binding protein (G) (Kuhn et al., 1981, Proc. Natl. Acad. Sci. USA., 78:6873-6877). Although there is no unique physical interpretation of these signals, we have shown in this study that they were qualitatively unchanged when the rod outer segment fragments (containing stacked disks) were fragmented by sonication or osmotic shock to produce spherical disk membrane vesicles. An exact treatment of the scattering process for spherical vesicles enabled us to evaluate the effects of changing membrane thickness, refractive index, or vesicle diameter. We present a particular redistribution of mass upon R*-G interaction that fits the experimental data. PMID- 6498279 TI - Extracellular [K+] fluctuations in voltage-clamped canine cardiac Purkinje fibers. AB - Membrane currents and extracellular [K+] were measured in canine Purkinje strands during voltage-clamp steps to plateau or diastolic potentials. Extracellular [K+] increased during step depolarizations and decreased during step hyperpolarizations. On hyperpolarization, the largest fraction of the K+ depletion occurred during the initial 500 ms of the voltage-clamp step and was correlated with a potassium depletion current, the id. A slower component of the depletion also occurred on hyperpolarization and had a time constant consistent with cylindrical diffusion of potassium within the Purkinje strands. On depolarization, there is an accumulation of K+ that is correlated with the plateau current ix. On termination of depolarizing test pulses, the K+ accumulation decays with a time course similar to the ix tail current. Surprisingly, no accumulation of K+ occurred during the arrhythmogenic transient inward current, TI, suggesting that the selectivity of this current should be reevaluated. PMID- 6498280 TI - Interactions of nucleic acid double helices induced by electric field pulses. AB - Electric field pulses induce a substantial increase of the light scattering intensity of double-helical DNA. The relative change of light scattering and also the reciprocal relaxation time constants under electric field pulses increase with increasing nucleotide concentration. These observations, together with a large difference between dichroism orientation time constants and light scattering time constants under electric field pulses, demonstrate that the main part of the light scattering effect is due not to field-induced orientation but to interactions between DNA helices. From the concentration dependence of the light scattering time constants we obtain, according to an isodesmic reaction model, association rate constants in the range 3 X 10(10) M-1 helices s-1 for DNA with approx. 300 base-pairs. These values are at the limit of a diffusion controlled DNA association and do not show any dependence upon the field strength. The dissociation rate constants kd decrease strongly with increasing field strength E and thus demonstrate that the interactions between the helices are induced by the electric field. This conclusion is consistent with independent measurements which do not reveal any DNA association at zero field strength. The observed linear relation between log(kd) and E2 suggests a field-induced reaction driven by dipole changes. According to this interpretation the change of dipole moment should be in the range of approx. 1400 debye. The dissociation rates for DNA helices with approx. 300 to approx. 800 base-pairs strongly increase with increasing salt concentration (measured in the range 1-5 mM ionic strength), whereas the association rate constants remain virtually unchanged. Measurements of the linear dichroism in the same range of DNA chain length demonstrate that for long field pulses of e.g., 40 microseconds, the amplitude approaches a maximum value and then decreases. The dichroism relaxation curves observed after long field pulses exhibit a component with a positive dichroism and an increased decay time. These observations suggest the formation of a DNA aggregate with an unusual arrangement of the bases. PMID- 6498281 TI - Forward rate constants for receptor clusters. Variational methods for upper and lower bounds. AB - We are interested in the effect of receptor clustering on k+, the diffusion limited forward rate constant for the binding of a ligand to a cell surface receptor. Here we estimate the reduction in k+ when receptors are clustered in various configurations. We obtain two alternative expressions for the flux of ligands into receptors distributed on a surface. Next we show through a variational principle that these provide both upper and lower bounds on the flux when evaluated for trial concentration functions which satisfy only the boundary conditions of the Laplace equation. We use an analogy with electrostatics to calculate rigorous bounds within approx. 10% of the exact result for a variety of planar clusters of hemispherical receptor sites. We also obtain an exact result for the flux into a spheroidal receptor and use this result to obtain bounds on the flux into certain receptor clusters. PMID- 6498283 TI - Twist and writhing in short circular DNAs according to first-order elasticity. PMID- 6498282 TI - Hetero-alpha-helical, two-chain, coiled coils: alpha beta hybrid tropomyosin. PMID- 6498284 TI - Diffusion-controlled protein-DNA association: influence of segmental diffusion of the DNA. PMID- 6498285 TI - Theoretical pi-pi absorption, circular dichroic, and linear dichroic spectra of collagen triple helices. PMID- 6498286 TI - Identification of a new electronic transition in the Z form of poly(dG dC).poly(dG-dC) by infrared absorption and resonance Raman spectroscopy. PMID- 6498287 TI - Calculation of the thermodynamic quantities of solvation for lysozyme and beta lactoglobulin A in guanidinium chloride. PMID- 6498288 TI - Molecular theory of the helix-coil transition in polyamino acids. V. Explanation of the different conformational behavior of valine, isoleucine, and leucine in aqueous solution. PMID- 6498289 TI - Theoretical studies on protein-nucleic acid interactions. I. Interaction of positively charged amino acids with nucleic acid fragments. PMID- 6498290 TI - Theoretical studies on protein-nucleic acid interactions. II. Hydrogen bonding of amino acid side chains with bases and base pairs of nucleic acids. PMID- 6498291 TI - Theoretical studies on protein-nucleic acid interactions. III. Stacking of aromatic amino acids with bases and base pairs of nucleic acids. PMID- 6498292 TI - Resonance Raman spectra of mononucleotides obtained with 266 and 213 nm ultraviolet radiation. PMID- 6498293 TI - Premelting and the hydrogen-exchange open state in synthetic RNA duplexes. PMID- 6498294 TI - Temperature-dependent reversible transition of poly(dCdG).poly(dCdG) in ethanolic and methanolic solutions. PMID- 6498295 TI - DNA gelation in concentrated solutions. PMID- 6498296 TI - Solvation effects on the 31P-NMR chemical shifts and infrared spectra of phosphate diesters. PMID- 6498297 TI - Conformation of control and acetylated HeLa stripped chromatin after reassociation with H1. PMID- 6498298 TI - Characterization of intermediate conformational states in the B in equilibrium Z transitions of poly(dG-dC).poly(dG-dC). PMID- 6498299 TI - Catalytic influence of heparin on auramine O hydrolysis: a basis for differentiating heparin from other glycosaminoglycans based on its properties as a polyelectrolyte. PMID- 6498300 TI - Viscoelasticity of rigid macromolecules with irregular shapes in the limit of overwhelming Brownian motion. PMID- 6498301 TI - A high-resolution 13C-NMR study of collagenlike polypeptides and collagen fibrils in solid state studied by the cross-polarization-magic angle-spinning method. Manifestation of conformation-dependent 13C chemical shifts and application to conformational characterization. PMID- 6498302 TI - Synthesis and beta-conformation of sequential polypeptides containing arginine, histidine, and leucine. PMID- 6498303 TI - Stress relaxation in fine fibrin films: comparison of films prepared with thrombin and ancrod. PMID- 6498304 TI - Conformation of cyclic analogs of enkephalin. II. Analogs containing a cystine bridge. PMID- 6498305 TI - Proton magnetic resonance studies on dermorphin and its peptide fragments. PMID- 6498306 TI - Calorimetric study of 2U:1A three stranded complexes formed between poly(U) and adenine dinucleotides: ApA and diastereoisomers of nonionic adenine dideoxyribonucleoside methyl phosphonate. PMID- 6498307 TI - Quality of diagnoses and cost of managing anemia in four countries. AB - An earlier study of non-hospitalized Swedish patients suggested frequent overprescribing of iron tablets and frequently uncertain diagnoses of iron deficiency. For this reason, a record audit was performed of 202 patients hospitalized because of iron deficiency anaemia or pernicious anemia in an English, a French, three Swedish, and a US teaching hospitals. Results are difficult to interpret because of the limited extent of this study and because differences between hospitals are as great as those between countries. Nevertheless, the Swedish hospital seemed to have 37% longer duration of stays (p less than 0.05), it spent only 16% of the total hospitalization cost for diagnostic studies as compared to 22-35% for the other hospitals, and it had numerically, but not significantly increased percentages both of uncertain diagnoses and of unidentified causes of the iron deficiency. For comparable time periods the hospitals with the longest length of stay also had the highest percentage of uncertain diagnoses (p less than 0.001). After the local publication of the first reports in 1978-1981, an improvement in the percentage of uncertain diagnoses was found in the Swedish hospital, which suggests that quality evaluation can lead to quality assurance. PMID- 6498308 TI - Liver function and medroxyprogesterone acetate elimination in man. AB - Medroxyprogesterone acetate (MPA) elimination rate was investigated in 25 patients with primary biliary cirrhosis, alcoholic cirrhosis and fatty liver. The serum and urine concentrations of MPA were measured by RIA after a single oral administration of the drug. Biochemical liver tests and antipyrine kinetics were determined as indicators of the liver function. The antipyrine test, a reflector of the activity of hepatic drug-metabolizing enzyme system, was impaired only in alcoholics. The results demonstrate that the elimination rate of MPA is reduced in subjects with alcoholic cirrhosis, whereas the values of the patients with fatty liver and primary biliary cirrhosis are in the normal range. The findings show that the MPA elimination is impaired only in cases with far advanced liver disease. PMID- 6498309 TI - Sphenoid sinusitis. AB - We review our clinical experience with infectious sphenoid sinusitis in an effort to characterize the clinical presentation, bacteriology and associated severe complications of this frequently misdiagnosed infection. PMID- 6498310 TI - Carbohydrate-binding properties of lectins: a possible approach to lectin nomenclature and classification. Review. PMID- 6498311 TI - Induction of metallothionein and metallothionein mRNA in rainbow-trout liver following cadmium treatment. AB - A low-molecular-weight cadmium-binding protein was induced in the livers of rainbow trout (Salmo gairdnerii) following a series of intraperitoneal injections of cadmium chloride. The subsequent purification and amino acid analysis of this protein showed it to be a true metallothionein. As in higher organisms, two major forms of metallothionein appeared to be present in the liver following cadmium treatment. Following a similar induction procedure total RNA was also isolated and shown to contain high levels of metallothionein-mRNA activity when assayed in a wheat-germ cell-free translation system. This activity was present in the Poly A+-containing fraction of the total RNA. The bulk of this mRNA activity was shown to be in the 8-10S region of a sucrose gradient. PMID- 6498312 TI - Sequence of ionophore conformational changes induced by a simulated membrane/water interface. AB - We demonstrate how the progressive passage through an interface simulated by a linear increase in dielectric constant may mediate a reversible transconformation of Na+/X537A (lasalocid A) from a cyclic to an extended structure. During the passage through the interface, the complex adopts progressively a more extended conformation favorable to the Na+ complexation or decomplexation at the interface. PMID- 6498313 TI - [Role of the hypophysis in fixing postural asymmetry at the segmental level in hemisection of the spinal cord]. AB - The role of the pituitary in the mechanisms of posttraumatic reorganizations of the segmental apparatus was studied. Hypophysectomized rats failed to demonstrate postural asymmetry after spinal cord hemisection. The lack of asymmetry is connected with a considerable decrease in postural asymmetry factor activity in the cerebrospinal fluid and cerebral tissue. It was established that pituitary tissue is characterized by the maximal level of postural asymmetry factor activity after hemisection. PMID- 6498314 TI - [Lipid peroxidation in experimental myocardial infarct: the action of hyperbaric oxygenation]. AB - Rats with experimental myocardial infarction demonstrated decrease in the activity of superoxide dismutase and catalase and increase in the content of lipid peroxidation (LPO) products and Schiff bases both in and outside the area of necrosis. The combined ischemic damage and hyperbaric oxygenation resulted in the over additive effect of accumulation of LPO products in and outside the area of infarction. The data suggest that it is desirable to use antioxidants during hyperbaric oxygenation. PMID- 6498315 TI - [Dynamics of microcirculatory system recovery in the post-stress period]. AB - Twenty-four-hour immobilization or electric stimulation for 6 h were used in rats as stressors. The first stressor caused more profound and protracted disturbances in the microcirculatory system. The recovery of the microcirculation occurred in 50% of animals by day 6 and in 100% by day 14 after immobilization. The terminal blood flow recovery after 6-hour electric stimulation was seen in a day. Vascular permeability after 24-hour immobilization returned to normal in 24 h, and after 6 h of electric stimulation in 6 h. This process correlated with the morphofunctional status of mast cells and was probably phasic in nature. PMID- 6498316 TI - [2 functions of proteoglycans in erythrocyte aggregation and adhesion]. AB - It has been shown that rabbit red cells treated with formalin form aggregates in the presence of hyaluronic acid (HUA) soluble protein-chondroitin-keratan sulfate (PCKS) and cartilage proteoglycan aggregates (PA) but to a lesser degree than normal red cells. It is suggested that the proteoglycans under consideration can specifically interact with red cells. Aggregation of red cells in the presence of HUA, PCKS and PA is the result of the combined action of these two factors. PMID- 6498317 TI - [Changes in the passive electrical properties of the erythrocytes during hemosorption]. AB - Passive electrical properties of erythrocytes were studied during hemosorption in vivo. It was shown that specific conduction and capacity of the erythrocyte plasma membrane were reduced after hemosorption. Incubation of erythrocyte suspension with free fatty acids resulted in an increase in specific conduction and capacity of the plasma membrane. That effect was eliminated after the passing of erythrocytes through a column with activated charcoal. PMID- 6498318 TI - [Nonenzymatic fibrinolytic reaction to the intravenous administration of small doses of Salmonella endotoxin to rabbits]. AB - Intravenous injection of a low dose of Salmonella endotoxin (10 micrograms/kg bw) into rabbits results in an increase in the non-enzymatic fibrinolytic activity of blood at early stages of a pathological process followed by depression of this response at later stages of the pathology. At higher degrees of non-enzymatic fibrinolysis activation the morphological and ultrastructural changes in renal tissues caused by endotoxin injection are the least pronounced. Intravenous injection of heparin after injection of a lethal dose of Salmonella endotoxin (100-200 micrograms/kg) enhances non-enzymatic fibrinolysis activation and decreases the morphological and ultrastructural lesions in renal tissues. PMID- 6498319 TI - [Dynamics of lymph node function in disordered innervation]. AB - A mechanotron 6MX1C was used to study lymphodynamic indices of the dog popliteal lymph nodes after cutting the ischiatic and femoral nerves in the left limb at 1 week, 3 and 5 months. The lymph nodes of the contralateral limb and the lymph nodes from intact dogs were used as controls. It has been demonstrated that denervation causes acceleration of the periods of the filling and emptying of the lymph nodes both in the denervated and contralateral limbs as compared with the initial period. The amplitude of fluctuations under maximal filling of the lymph nodes decreases significantly at the long-term postoperative periods. The lymphodynamic changes seem to be determined by pathomorphological alterations in lymph node tissues. PMID- 6498320 TI - [Effect of sodium succinate on metabolic and morphological changes in acute cooling]. AB - The effect of sodium succinate preinjection (16 mg/kg) on the resistance of mice to acute low-temperature exposure was studied. The measurements were taken of the changes in blood glucose concentration, of the content in the heart of macroergic compounds and glycogen, and of succinate dehydrogenase activity. Cardiomyocytes were studied by electron microscopy. The data indicate that greater preservation of macroergic compounds and stabilization of the ultrastructure of myocardial mitochondria play a role in the mechanism by which the animals' resistance to intense cooling is increased after sodium succinate injection. PMID- 6498321 TI - [Lipid peroxidation in children with Duchenne's hereditary myopathy]. AB - Eighteen patients aged 4 to 13 years with Duchenne's progressive muscular dystrophy were examined for the content of lipid peroxidation (LPO) products (lowest volatile hydrocarbons) in the exhaled air. The level of LPO products was found to exceed normal 4-fold as compared to the control group including healthy children of the same age. The maximal increase was detected at the early stages of the disease with a rapid progressive degeneration. The role of LPO in the pathogenesis of Duchenne's muscular dystrophy and possible applications of free radical oxidation inhibitors as new effective medicinal tools are discussed. PMID- 6498322 TI - [Effect of adrenaline on kidney lysosome function in rats during prolonged soft tissue crushing]. AB - The total and unsedimentable activity of acid DNase, RNase, phosphatase and arylsulfatases A and B was examined in the rat kidneys during long-term compression of soft tissues in the presence of high excitability of the sympathoadrenal system. Injection of adrenalin to rats with trauma reduced the total activity of DNase, acid phosphatase and arylsulfatases A and B, particularly at the late periods of soft tissue compression, whereas the total activity of acid RNase slightly increased as compared with control. Compression of soft tissues after adrenalin preinjection was accompanied by a substantial rise of unsedimentable activity of the lysosomal enzymes under study in the kidneys. The activity of the enzymes in cytosol progressively ascended as the time of soft tissue injury increased. PMID- 6498323 TI - [A new myofibrillar protein from the skeletal musculature of the rabbit]. AB - A new protein that differs in the molecular mass (78-79 kD) from the known myofibrillar proteins was isolated from metamyosin of rabbit skeletal muscles. Functional properties of the new protein and its role in muscle contraction remain unknown. PMID- 6498324 TI - [Water-soluble proteins of the subesophageal ganglionic complex in the edible snail in the early stages of learning]. AB - During the early stages of conditioned defensive reflex formation, a dramatic increase in the acidic protein concentration can be seen in the snail CNS (the mobility 0.58 in polyacrylamide gel) with reference to water-soluble proteins of the animals' ganglions under study. Such an increase occurs at the time when the majority of neurons are involved in the learning process. The rise of the protein content is also seen upon the snail arousal, 2-6 h after being awake. It is suggested that the high level of the protein correlates with the appearance of the orientation reflexes. At the cellular level this phenomenon appears to be linked with increased excitability of a great number of neurons. PMID- 6498325 TI - [Space-time changes in isocitrate dehydrogenase activity in the rat liver]. AB - The author describes a quantitative histochemical test of NAD- and NADP-dependent isocitrate dehydrogenase (ic-NAD and ic-NADP) activity changes in relation to the time of day and topographic locality in the hepatic lobule. It was established that activity of the enzymes was characterized by monophase circadian rhythms, with the phase of ic-NAD activity observed in the dark period and ic-NADP activity in the light period of day. Rhythmic fluctuations in ic-NAD activity in different regions of the lobule were more synchronized than those in ic-NADP activity. Spatial changes in the activity of both the enzymes were fairly similar, decreasing from the center to the periphery of the lobule up to the end of the median and peripheral area. The changes in ic-NADP activity were more uniform in nature as compared to those seen in ic-NAD. The most demonstrable differences in the activity of both enzymes among adjacent hepatocytes could not be localized to any particular area in the lobule, moving regularly through its areas during the day. Thus, the functional heterogeneity of hepatocytes should be studied, from the standpoint of the activity of the enzymes, in close relation with time and space changes in their metabolism. PMID- 6498326 TI - [Comparative study of the effect of ethacizin and lidocaine on the blood supply and function of the intact and ischemic myocardium]. AB - It has been shown in experiments on cats anesthesized with nembutal that lidocaine (1.0 and 2.0 mg/kg) and etacizine (0.5 and 1.0 mg/kg) decrease heart work and create in the heart muscle a definite oxygen reserve, without exerting any inhibitory effect on myocardial contractile function. The drugs improve the function of the focus of myocardial ischemia, with the effect of etacizine being more lasting. PMID- 6498327 TI - [Effect of dibunol liniment on posttraumatic skin regeneration in mice]. AB - The effect of dibunol liniment (5-50 mg/kg) on excised mouse skin was studied. The liniment caused complete skin regeneration with hair and gland formation in the majority of treated mice. Application of the liniment led to a considerable increase in proliferative activity of skin epithelial cells and inhibition of wound area reduction within the first day of healing as compared with controls. PMID- 6498328 TI - [Daphnia magna Straus as consumers of enteropathogenic bacteria]. AB - The ability of Daphnia magna Straus to digest enteropathogenic bacteria, i.e. Salmonella, Shigella and Yersinia was studied in a series of experiments. High antibacterial activity of Daphnia magna Straus against these enteropathogenic bacteria was demonstrated by bacteriological and radionuclide methods. Thus, on the 3d-5th day of experiment a complete water clearance was observed in experimental flasks where Daphnia were fed Salmonella, Shigella and Yersinia, while attempts to isolate bacteria from these flasks ended in failure. Radionuclide studies disclosed active assimilation of the degradation products of enteropathogenic bacteria by Daphnia throughout the entire experiment. PMID- 6498329 TI - [Role of polypeptide factors of the hypothalamus and epiphysis in regulating the function of stem cell precursors of granulomonopoiesis]. AB - The claster- and colony-formation capacity of the offls--precursors of granulomonopoiesis in 29 normal subjects was studied in a bilayer agar system. Parallel cultures were used to investigate the effects of polypeptide factors of the hypothalamus and epiphysis. It was found that polypeptide factors of the hypothalamus and epiphysis have a regulatory influence on granulomonopoiesis at the level of precursor cells. PMID- 6498330 TI - [Morphological characteristics of a substantia alba lesion of the cerebral hemispheres in newborn infants with periventricular leukomalacia and sepsis]. AB - Neurohistological and electron microscopy studies of the foci of periventricular leukomalacia allowed defining 3 stages in their development: necrosis, resorption and formation of the glial cicatrix or a cyst. Comparative study of the lesions in two groups of neonates (with and without sepsis) showed that sepsis promoted the process persistence and development of new pathological foci. One of the possible pathogenetic mechanisms might be the thrombosis of brain white substance vessels. PMID- 6498331 TI - [Changes in the myocardial ultrastructure of the perfused rabbit heart under hypoxia]. AB - Ultrastructure of rabbit heart left ventricle isolated according to Langendorf was examined under different conditions: in intact animals, during ligation of the coronary artery, and hypoxic heart perfusion. The intact perfused heart showed unmarked exo- and intracellular edema and moderate swelling of the mitochondria. During hypoxic perfusion, marked swelling and destruction of the mitochondria were noted. During ligation of the coronary artery, the heart was characterized by a high degree of mitochondrial heterogenicity. The correlation of the data obtained allowed one to reveal the myocardial adaptive-accommodative mechanism, (intermittent mitochondrial activity) that makes it possible to maintain the heart bioenergetics during coronary artery occlusion at a permanently high level. PMID- 6498332 TI - [New informative index of the functional status of polymorphonuclear neutrophils]. AB - A new test was applied to study the function of polymorphonuclear neutrophils according to their ability to form oreols in a hypertonic medium. During inhibition of neutrophil function in vivo (desympathetization, tumor growth), oreol formation increased. Stimulation of neutrophils in vitro by adding noradrenaline to the incubation medium led to a decrease in their oreol-forming ability. The data obtained enabled the authors to offer the test for detecting the functional activity of polynuclear cells. PMID- 6498333 TI - ras Oncogenes and the molecular mechanisms of carcinogenesis. PMID- 6498334 TI - Fluorescence cytophotometric analysis of megakaryocytic ploidy in culture: studies of normal and thrombocytopenic mice. AB - A system for the accurate and rapid measurement of the ploidy of cultured megakaryocytes derived from megakaryocytic colony-forming cells (CFU-M) has been developed. Thirty thousand murine marrow cells per milliliter were cultured for varying time periods in agar in the presence of horse serum and pokeweed mitogen stimulated spleen cell-conditioned medium (PWM-SCM). To ensure the inclusion of all the megakaryocytic cells in the analysis, entire agar discs were transferred onto glass slides and dried. Cells of the megakaryocytic lineage were identified by staining for acetylcholinesterase (AchE) for two hours. Subsequently, the nuclei of the cells were stained using 1.7 X 10(-5) mol/L chromomycin A3, a specific DNA-binding fluorochrome. Megakaryocytic colonies (greater than or equal to 2 AchE+ cells) were located under transmission light. The fluorescence emission of each cell of the colony was then measured by a photometer interfaced with a computer. The mean fluorescence emission of about 20 random granulocytes per slide was used as a 2N standard. There was no significant cell loss, quenching of fluorescence by AchE staining, or overlapping of colonies or cells. Approximately 100 megakaryocytes per hour could be analyzed. Modal ploidy of cultured megakaryocytes increased from 2N to 32N between days 3 and 6 in culture. Varying concentrations of PWM-SCM from 5% to 20% did not affect the ploidy distribution when examined at day 5. The heterogeneity of the ploidy of cells within colonies increased continuously with increasing cell numbers per colony. Clonal analyses of mean ploidy and ploidy heterogeneity did not show distinct types or classes of colonies; rather, the data show that megakaryocytic colonies are structured as a continuum. An inverse correlation was found between the number of cells constituting the colonies and their mean DNA content. To determine if short-term in vivo exposure of CFU-M to a thrombocytopenic environment could affect the ploidy of their progeny, mice were given rabbit antimouse-platelet serum while control animals were given normal rabbit serum. Twenty-four hours after injection, marrow derived from these animals was cultured. At day 5, the ploidy distributions and ploidy heterogeneity were identical in both treated and control groups. Thus, factor(s) that promote CFU-M proliferation do not affect megakaryocytic endoreduplication, while stimuli that acutely influence megakaryocytic ploidy in vivo do not determine the ultimate ploidy potential of megakaryocytes derived from a CFU-M. PMID- 6498335 TI - Potentiation by red blood cells of shear-induced platelet aggregation: relative importance of chemical and physical mechanisms. AB - Evidence has been reported to indicate that red blood cells (RBCs) may potentiate platelet adherence and platelet aggregation (PAG) in different flow systems in vitro as well as hemostatic platelet plug formation in response to vascular injury. In this study, we demonstrate that RBCs enhance PAG induced by well defined, low-intensity, uniform, laminar shear stress. Potentiation by RBCs of shear-induced PAG was associated with appreciable loss of adenine nucleotides from 14C-adenine-labeled RBCs, the extent of which increased with increasing RBC concentration. The concentrations of RBC-derived ADP measured in the medium after shear, as determined by both high pressure liquid chromatography and the luciferin/luciferase system, were within the range of concentrations of ADP which may trigger PAG or potentiate PAG induced by low concentrations of other platelet agonists in the aggregometer. To assess the relative contribution of chemical (ADP) and physical (platelet surface transport) mechanisms in the RBC-mediated potentiation of shear-induced PAG, aliquots of citrated platelet-rich plasma (C PRP) were exposed to shear stress in the presence of untreated RBCs or RBCs exposed to an antihemolytic concentration (5 mumol/L) of the membrane stabilizing agent, chlorpromazine (CPZ). Potentiation of shear-induced PAG in the RBC-CPZ system was significantly less than that in the untreated RBC system. However, CPZ induced reduction of PAG potentiation was associated with an increase rather than a decrease in loss of adenine nucleotides from RBC. Furthermore, shear-induced PAG in C-PRP as well as ADP- and collagen-induced PAG in C-PRP in the aggregometer was significantly inhibited by 5 mumol/L CPZ, indicating that the observed reduced potentiation of shear-induced PAG by RBCs in the presence of CPZ was due to a direct inhibitory effect of the drug on platelets rather than a reduction of shear-induced liberation of ADP from RBCs. When aliquots of C-PRP were exposed to shear stress in the presence of RBCs completely depleted of ADP by fixation in 1% glutaraldehyde, potentiation of PAG was approximately half of that observed with intact RBCs. These findings indicate that both RBC-derived ADP and RBC-mediated platelet surface transport are involved in the potentiation by RBCs of PAG induced by laminar shear stress. PMID- 6498337 TI - Red blood cell deformability influences platelets--vessel wall interaction in flowing blood. AB - Hematocrit and red cell size are important factors for the transport of blood platelets toward subendothelium in flowing blood. We report that red cell deformability also influences platelet transport. Red cell deformability was estimated with Couette-flow viscosimetry at a shear rate of 130 s-1 and expressed as a 'T' factor--a dimensionless parameter relating the relative viscosity and the hematocrit derived from the relationship: T = (1 - mu -0.4 rel)/H, where mu rel is the relative viscosity and H is the hematocrit. The normal value of T was within a narrow range (0.91 +/- 0.02). Treatment of normal red cells with isoxsuprine and chlorpromazine caused decreased rigidity and decreased T. Cholesterol loading and treatment with diamide increased rigidity and increased T. In vitro perfusion experiments in an annular perfusion system with everted human umbilical arteries were performed with perfusates to which such treated red blood cells were added to investigate their influence on platelet adherence to artery subendothelium. Platelet adherence was well correlated with red cell rigidity, with increased adherence at increased rigidity and vice versa. A change in T of 0.10 corresponded to a change in platelet adherence of approximately 50%. These effects were more pronounced at a wall shear rate of 1,800 s-1 than at 300 s-1. PMID- 6498336 TI - Coagulation Factor IX concentrate: method of preparation and assessment of potential in vivo thrombogenicity in animal models. AB - Thrombosis and/or disseminated intravascular coagulation (DIC) are complications specifically associated with the use of factor IX complex in some patients. Assuming that these complications might result from zymogen overload, we have produced, using diethylaminoethyl (DEAE)-Sephadex (Pharmacia, Piscataway, NJ) and sulfated dextran chromatography, a factor IX concentrate (coagulation factor IX) that is essentially free of prothrombin, factor VII, and factor X. Factor IX specific activity is at least 5 U/mg protein, a 250-fold purification compared to plasma. Amounts of factors II, VII, and X are less than 5 units each per 100 units of factor IX. The concentrate is essentially free of activated clotting factors and contains no added heparin. In the rabbit stasis model, a dose of 200 factor IX U/kg was less thrombogenic than 100 factor IX U/kg of the DEAE-Sephadex eluate from which the concentrate was derived. Infusion of 200 factor IX U/kg did not induce DIC in the nonstasis rabbit model, whereas 100 factor IX U/kg of the DEAE-Sephadex eluate resulted in DIC in this model. Several factor IX lots were found to have shortened nonactivated partial thromboplastin times (PTTs), but were nonthrombogenic in both animal models. These data indicate that coagulation factor IX concentrate is less thrombogenic than factor IX complex. PMID- 6498338 TI - Comparison of hemoglobin Koln erythrocyte membranes with malondialdehyde-reacted normal erythrocyte membranes. AB - Splenectomized patients with hemoglobin (Hb) Koln have rigid RBCs with membrane polypeptide aggregates that are not dissociable with disulfide-reducing agents. Malondialdehyde (MDA) action on normal RBCs produced rigid RBCs with similar nondissociable aggregates. To test the hypothesis that Hb Koln RBC aggregates contained unsaturated MDA-type bonds, we reduced normal control RBC membranes, Hb Koln RBC membranes, and MDA-reacted membranes with [3H]NaBH4. Hb Koln RBC membranes and MDA-reacted membranes both had significantly more 3H incorporation than control membranes. Furthermore, 3H incorporation in both Hb Koln and MDA treated membranes was located in the membrane polypeptide aggregates, presumably saturating the crosslinking bonds. After reaction of RBCs with [14C]MDA, the MDA label was similarly concentrated in the membrane polypeptide aggregates. Normal RBC membranes incubated with MDA were analyzed with and without reduction by NaBH4 prior to amino acid determination by high-performance liquid chromatography (HPLC). Reduction with NaBH4 after MDA treatment decreased the lysyl residues by 33% and the serine by 7% and increased by 10% the methionyl residues, but did not affect 12 other amino acids. Similar changes could be detected in NaBH4-reduced Hb Koln aggregates in methionine and serine content. MDA may also alter protein configuration, as evidenced by an increase in the protease susceptibility of membrane proteins from MDA-treated and Hb Koln RBCs. We conclude that Hb Koln RBC membranes, like MDA-treated membranes, have similar high molecular weight aggregates conferring decreased membrane deformability, [3H]NaBH4-reducible unsaturated bonds, changes in amino acid composition upon reduction, and protease sensitive configurational changes. PMID- 6498339 TI - Characterization of erythrocyte quality during the refrigerated storage of whole blood containing di-(2-ethylhexyl) phthalate. AB - Di-(2-ethylhexyl) phthalate (DEHP) accumulates in blood brought into contact with materials utilizing this compound as a plasticizer. To determine whether this phthalate diester affects red blood cell integrity, we have compared cell morphology, plasma hemoglobin accumulation, micro-vesicle production, and the concentration of intracellular metabolites and electrolytes of erythrocytes from blood stored at 4 degrees C with and without DEHP. When sufficient emulsified DEHP was mixed with blood to give a final concentration of 300 micrograms/mL, plasma hemoglobin accumulation was reduced by an average of 70%, the percentage of cells exhibiting normal morphology was enhanced by at least 20-fold, and the volume of microvesicles released from red blood cells was reduced by 50% after 35 days of refrigerated storage compared to the values obtained from corresponding samples stored without added phthalate. Similar effects were observed regardless of whether blood was stored in nonplasticized polypropylene or tri-(2-ethylhexyl) trimellitate plasticized polyvinylchloride containers and with DEHP solubilized by a variety of emulsifiers. When 300 micrograms/mL DEHP was added to stored blood containing erythrocytes predominantly in the echinocyte conformation, many of the cells reverted to the normal discoid morphology. The addition of this quantity of DEHP to blood had no significant effect on the course of storage induced changes in erythrocyte adenosine triphosphate (ATP), 2,3 diphosphoglycerate (2,3-DPG), sodium or potassium concentrations. The data are consistent with the hypothesis that DEHP inhibits the deterioration of the red blood cell membrane that results from the refrigerated storage of whole blood. PMID- 6498340 TI - Low serum cobalamin in disorders of cobalamin transport. PMID- 6498341 TI - Characterization of single isolated vascular smooth muscle cells from bovine coronary artery. AB - Single smooth muscle cells from bovine coronary artery were obtained by enzymatic digestion. 20.1 +/- 3.2% (mean value of seven experiments) of the dispersed cells were in a relaxed, noncontracted state. These cells responded to electrically induced depolarization with a graded contraction to a maximum shortening of 47.8% of initial length; the corresponding maximum for K+-induced depolarization was 61.7% of initial length. Cells relaxed only a small percentage (approximately equal to 20%) of the amount of shortening, but could be restimulated several times to contract to even shorter lengths. The decrease in mean cell length of dispersed cells exposed to serotonin, acetylcholine, and ergonovine maleate was 21.0, 23.0 and 25.5%, respectively (p less than 0.05). No significant decrease in cell length was obtained with norepinephrine. The ultrastructure of the relaxed cells seemed to be unaltered, suggesting that the accuracy of the physiological results is not impaired by induced structural damage. PMID- 6498342 TI - Effect of sodium gradient on the rate of relaxation of rat mesenteric small arteries from potassium contractures. AB - We have measured the relaxation of rat mesenteric small arteries (internal diameter ca. 200 micron) from a potassium contracture under conditions where the transplasmalemmal sodium gradient was altered. Adjustment of the sodium gradient was made either by exposing vessels to ouabain (1 mM) for different periods to vary the intracellular sodium concentration (Nai), or by varying the sodium concentrations of the relaxation solutions (Nao). Under normal conditions (where we have previously shown Nai is about 19 mM), vessels relaxed completely within 1 min in low sodium solutions (Nao = 25 mM) using either sucrose, choline-Cl or MgCl2 as substitutes. However, the relaxation (measured after 1 min) was reduced when sucrose substitution was used, and further experiments were made using this substitute. Here it was found that exposing vessels to ouabain, for example 90 min (thus increasing Nai to about 73 mM) and then performing the relaxation in a low sodium solution gave only about 50% relaxation after 1 min. Experiments with intermediate sodium concentrations in the relaxation medium showed that reduction to 100 mM had no significant effect on the relaxation, and that it was only below 50 mM that effects were most marked. The effects of altered sodium gradient were eliminated if the calcium concentration of the relaxation medium was zero. The results indicate that under normal physiological conditions, small changes in sodium gradient have little effect on calcium metabolism of rat mesenteric small arteries, but also that under extreme conditions net calcium extrusion does appear to be reduced by a reduced sodium gradient. PMID- 6498343 TI - Autoimmune hemolytic anemia by coexisting anti-I and anti-Fl cold agglutinins. AB - In association with atypical pneumonia, a patient developed acute severe autoimmune hemolytic anemia. Hemoglobin temporarily was only 7.0 g/100 ml, so that the patient needed red blood cell (RBC) transfusion. Hemolysis was found to be caused by high titer cold agglutinins (CA), which occurred transiently during the acute period of the disease. CA of two different specificities, anti-I and anti-Fl, were demonstrated in the patient's serum. Antibodies of the two specificities were clearly separated by absorption/elution experiments using neuraminidase (RDE)-treated RBC. They were distinguished by serologic means: Both anti-I and anti-Fl react more strongly with adult RBC than with newborn and i adult RBC; in contrast to anti-I, anti-Fl does not agglutinate RDE-treated cells. Inhibition experiments showed that I-active substances prepared from papainized RBC exhibited both I and Fl antigenic activity. By RDE-treatment of I-active substances, Fl-activity was markedly reduced, while I-activity was increased. PMID- 6498344 TI - [Use of xenografts for the evaluation of tumor chemotherapy. Application to adjuvant chemotherapy]. AB - Man-mouse xenografts have been widely used to assess the therapeutic activity of carcinostatic drugs on human malignant cells. Xenotransplantation greatly benefited of the use of athymic nude mice and of thymectomized isogenic radiation chimaeras. However xenografts are still frequently rejected and their growth rate remains low at least for the initial passages. In spite of these limitations they constitute an interesting material which retain most of the characteristics of the original tumour. With few exceptions these grafts express the same sensitivity to chemotherapy as the original tumour and they may therefore provide valuable information in this respects. Unfortunately the long delay of about 5 months necessary to establish a transplantable line and to stabilize its growth parameters limits the use of xenografts in adjuvant chemotherapy. Thus the information brought by the xenografts may at best help in modifying the on-going treatment. PMID- 6498345 TI - [Rationalization of adjuvant chemotherapy by induction chemotherapy]. AB - An induction chemotherapy, before any local treatment, allows to precise the chemosensitivity of the primary tumor. These data may help to improve indication and type of a further adjuvant chemotherapy. However there are many biological differences between different sites of the same tumor and along the time, without or after treatment. It is thus impossible to be sure that a chemotherapeutic regimen effective as first treatment on the primary will be equally active on micro-metastases some months later. Many questions in this field will be answered only by controlled studies and careful observations. PMID- 6498347 TI - [Evaluation of prognostic factors in breast cancer]. AB - The survival of the patients with breast cancer depends on many factors. The TNM system, which is the most widely used prognostic system takes into account only the size, and the local extension of the tumor, and presence or not of axillary or supraclavicular lymph nodes. The axillary nodes involvement is the single precise prognostic variable. However, other valuable and important factors are to be considered. As a matter of fact, the growth rate of the tumors, their estrogen and progesterone receptor status, and their histopathological grade may reflect with a better accuracy the tumor biology, and should be integrated among the variables to study before the choice of an adjuvant treatment. PMID- 6498346 TI - [Adjuvant chemotherapy of cancer: immediate costs and long-term risks]. AB - Medical, psychologic, socio-professional and economic side effects of adjuvant chemotherapy are frequent. Some of these are not easily recognized with accuracy. They influence directly the life of treated patients and perhaps later their medical future. They involve the quality of life for cancer patients, after initial curative treatments. Indications for adjuvant chemotherapy cannot be extended without comparative evaluation of their advantages and disadvantages. It is necessary to select patients with the highest probability of improvement in the duration and the quality of life and to give them so active but the least toxic treatments possible. PMID- 6498348 TI - [Adjuvant chemotherapy of cancer of the ovary]. AB - The aim of adjuvant chemotherapy is to cure micrometastatic disease and to prevent relapses after apparently complete surgical exeresis. It is almost always administered after initial surgical treatment, except for stage IA1 malignant epithelial tumours and stage I-II pur dysgerminomas. Chemotherapy combines anthracycline, an alkylating agent, a plant alkaloid and cis-platinum, for 4-8 months. After second-look laparotomy, if no more macro or microscopic tumor have been discovered, adjuvant chemotherapy does not seem necessary. However it is when all residual tumor has been excised or cyto- and/or histologic controls are positive. Optimal schedules are not yet perfectly defined. In some cases, a third look laparotomy should confirm the absence of tumor in order to stop treatment. Side effects (hematologic, gastrointestinal, neurologic, renal) are frequent. It is necessary to recognize patients able to benefit from chemotherapy and to define the least toxic treatment. PMID- 6498349 TI - [Chemotherapy of carcinoma of the upper respiratory and digestive tract]. AB - New regimens of chemotherapy in previously untreated squamous cell head and neck carcinoma yielded a 60 per cent rate of regression in over 50 per cent of patients. Planned radical surgery may be delayed and curative irradiation is often preferred. However, many patients have been excluded for polychemotherapy because of poor general condition. The results of simultaneous perioperative chemotherapy and X-ray therapy are not well known. Adjuvant chemotherapy after initial treatment is difficult to apply and to appreciate for results. Chemotherapy of recurrences is disappointing, even if efficient. Randomised trials are necessary to improve our knowledge in this field. PMID- 6498350 TI - [Adjuvant chemotherapy in cancers of the stomach, pancreas and intestine]. AB - Adjuvant chemotherapy after apparently complete resection of gastrointestinal cancer may be theoretically justified by the high rate of local and metastatic recurrences. However, the results of controlled trials are generally disappointing, even if some of them have recently suggested some hope, chiefly for adjuvant therapy in gastric cancer. Confirmation of these preliminary results is needed before considering adjuvant therapy as routine treatment in digestive tumors. PMID- 6498351 TI - [French oncology: a spatiotemporal general view from a special observation point, the Year Books of Cancer]. AB - The Year Book(s) of Cancer were analyzed to count selected French articles within the 1965-1982 period. A comparison between two periods: 1966-1976 and 1978-1982 shows an increase in French production from 2.3 per cent to 4.6 per cent. Strong sectors are breast, female genital tract, leukemia and lymphoma, radiotherapy, immunology and immunotherapy. This increase in number of selected papers is mostly due to articles published in biomedical French journals in which French language is prevalent. The place of provincial institutions changed from 1/4 in 1965-1976 to 1/2 in 1978-1982. With the same method of analysis, cancerology seems more developed in France than cardiology or endocrinology. This statistic suggests the necessary endeavours to further regularly improve the situation. PMID- 6498352 TI - [Combination of radiotherapy with 5-fluorouracil in advanced cancer of the pancreas]. PMID- 6498353 TI - Stereochemical analysis of the nerve agents soman, sarin, tabun, and VX by proton NMR-spectroscopy with optically active shift reagents. PMID- 6498354 TI - Fluorometric assay for aflatoxins. PMID- 6498355 TI - A gas chromatographic method for determination of 2,4-D residues in urine after occupational exposure. PMID- 6498356 TI - Formalin preservation of avian blood for metal and DDE analysis. PMID- 6498357 TI - Detection of 4-hydroxy-BHT residues in laboratory animals as an indicator of exposure to butylated hydroxytoluene (BHT). PMID- 6498358 TI - High performance liquid chromatographic method for determination of six N methylcarbamates in vegetables and fruits. PMID- 6498359 TI - Impact of chlorine, chlorine dioxide and ozone on the oxidation of NTA during drinking water treatment. PMID- 6498360 TI - Degradation of carbofuran by Azospirillum lipoferum and Streptomyces spp. Isolated from flooded alluvial soil. PMID- 6498361 TI - Partition coefficients as a measure of bioconcentration potential of crude oil compounds in fish and shellfish. PMID- 6498362 TI - Toxicity of the pyrethroid insecticides cypermethrin and WL85871 to the earthworm, Eisenia foetida savigny. PMID- 6498363 TI - Low concentration effects of endosulfan insecticide on reproductive behaviour in the tropical cichlid fish Sarotherodon mossambicus. PMID- 6498364 TI - Acute toxicity of hydrazine hydrate to the fathead minnow (Pimephales promelas) and daphnid (Daphnia pulex). PMID- 6498365 TI - Selenium effects on antennal integrity and chronic copper toxicity in Daphnia pulex (deGeer). PMID- 6498366 TI - Heavy metal levels in Nucella lapillus (Gastropoda: Prosobranchia) from sites with normal and penis-bearing females from New England. PMID- 6498367 TI - Effect of pH on pentachlorophenol toxicity to embryos and larvae of zebrafish (Brachydanio rerio). PMID- 6498368 TI - Hiring during a hiring freeze: the statistical edge. PMID- 6498369 TI - Journal use in a clinical librarian program. PMID- 6498370 TI - [Anthropozoonoses of viral origin]. PMID- 6498371 TI - [Experimental models for the study of viral infections of the nervous system]. PMID- 6498372 TI - Arthroscopy and arthroscopic surgery. PMID- 6498373 TI - Vascular aspects of haemodialysis. AB - Vascular access remains the Achilles heal of haemodialysis. Fistulae are the most effective means of access, but are subject to thrombosis and infection. Bidirectional single-line systems are a useful alternative to shunting in the short-term management of acute renal failure. Attention must be given to the insertion of a patient's first fistula, and to the subsequent care of these access sites. PMID- 6498374 TI - Management of acute viral encephalitis. AB - Effective therapeutic intervention in the natural history of a disorder implies understanding of pathogenesis, accuracy of diagnosis, and the availability of an effective treatment. In viral encephalitis, these are all problematic and, as a result, there is no general agreement on the preferred management strategy. PMID- 6498375 TI - Sensory deprivation and clinical psychiatry. AB - Sensory deprivation as a scientific procedure was conceived in the early 1950s, intensively studied in the early 1960s, and applied in a limited way in the 1970s. From a consideration of the data, it is clear that clinical psychiatry could benefit from its more general application in the 1980s. PMID- 6498376 TI - Oncogenes and human cancer. AB - In the past, the investigation of the causes of cancer has seemed to involve many unconnected disciplines such as tumour virology, chemical carcinogenesis, and chromosomal analysis. Oncogene research has revealed exciting links between these, and the identification of some of the biochemical mechanisms associated with malignant change offers hope for the development of more specific therapies. PMID- 6498377 TI - Clinical applications of oesophageal motility studies? AB - Technological advances in the investigation of oesophageal motility have resulted in progressive awareness of gastro-oesophageal reflux disease and motor disorders of the oesophagus as causes of obscure "noncardiac" chest pain, as well as for unexplained swallowing difficulties. Oesophageal motility studies should also be undertaken before surgery for reflux oesophagitis. PMID- 6498378 TI - Your accounts. Private practice--3. PMID- 6498379 TI - Digital deformities and dental malocclusion due to finger sucking. AB - The habit of finger and thumb sucking in infancy usually ceases spontaneously by the age of 5 years. If the habit is not broken, serious deformities of the digit may appear along with significant disturbance of the dental occlusion. If diagnosed early, the habit can be broken and the threatening disturbances of digital growth and dental occlusion will resolve spontaneously. If not, even more complicated surgical and orthodontic measures may be required. Five such cases are reported. PMID- 6498380 TI - Human bites: a review. AB - Forty-one human bites of the face are presented with a comparative review of earlier published series. Their primary treatment is outlined. The majority of bites presented few initial complications due to the excellent blood supply of the face and the use of prophylactic antibiotics. Secondary reconstruction, however, usually entailed multiple staged operations. PMID- 6498381 TI - Partial thickness scalp grafts: clinical experience of their use in resurfacing facial defects. AB - Partial thickness scalp grafts provide a good cosmetic match for resurfacing small facial defects. The donor site is convenient for harvesting the graft, comfortable for the patient in the post-operative period and heals quickly with few complications. This paper outlines our experience with this procedure. PMID- 6498382 TI - Congenital cranio-facial dysmorphosis associated with Ito's syndrome (incontinentia pigmenti achromians): a case report. AB - The authors describe a child who presented multiple congenital malformations affecting the cranio-facial region and the extremities associated with a rare skin lesion (incontinentia pigmenti achromians). PMID- 6498383 TI - The importance of symmetry in forehead flap rhinoplasty. AB - Five patients who have undergone forehead flap rhinoplasty at the West Midlands Regional Plastic and Jaw Surgery Unit are described. The variations in technique are outlined with particular reference to the symmetrical appearance of the reconstructed nose. PMID- 6498384 TI - Arteriography and selective embolisation in the control of life-threatening haemorrhage following facial fractures. AB - Bleeding after serious facial fractures may be of such life-threatening proportions that it is sometimes impossible to control it by traditional methods. Super-selective arteriography allows accurate localisation of the bleeding site and immediate embolisation of the offending vessel is a highly effective manoeuvre. Two clinical cases are reported. PMID- 6498385 TI - The ulnar artery forearm free flap. AB - The ulnar artery forearm flap is a reliable, versatile and convenient fasciocutaneous flap. Based on the ulnar artery distal to the common interosseous branch it may include muscle (FCU) tendon (PL) and bone (ulna). The arterial and venous anatomy allow a flow-through capability and a reversal of flow which permits its use as a distally pedicled island flap. Many of its properties are shared with the radial flap, but the ulnar flap has further advantages. The donor site is virtually hairless, easily closed even when bone is taken, and is less obvious as it lies on the proximal ulnar aspect of the forearm. The ulnar artery is not reconstituted and in 11 cases there has been no clinical evidence of any circulatory, sensory or motor impairment of the hand. The flap is especially useful in intra-oral reconstruction and has been valuable in the lower leg where it may restore deficient distal circulation. PMID- 6498386 TI - Local transposition of a distally-based island forearm flap to close a complicated excisional wrist defect in a nonagenarian: some anatomical and clinical considerations. AB - A distally based island forearm flap was used in a 93-year-old patient to reconstruct a dorsal forearm defect following tumour resection. Augmentation of the venous out-flow using a microvascular venous anastomosis was required. The expediency and safety with which this island flap can be used is emphasized with a cautionary note on venous drainage. PMID- 6498387 TI - A study of the thickness of uninvolved dermis beneath cutaneous malignant melanoma: the ratio of uninvolved dermis to tumour thickness (DT:TT) as a prognostic index. AB - The histological material from 147 patients treated for clinical stage I primary cutaneous malignant melanoma between 1968 and 1972 was reviewed. All patients had a minimum follow up of 10 years. Measurements were made of the thickness of uninvolved dermis (DT) deep to the tumour and the tumour thickness (TT) itself. The ratio of dermal thickness: tumour thickness (DT:TT) was correlated with clinical progress at follow-up and compared as a prognostic index with tumour thickness alone. The ratio DT:TT was found to be a useful prognostic guide, a value of greater than 2.0 proving to be a very favourable sign. It is suggested that this simple ratio should be routinely reported in all cases of primary cutaneous malignant melanoma to provide an additional index with a view to assessing its value as a prognostic guide. PMID- 6498388 TI - Experience of thin cutaneous melanomas (less than 0.76 mm and less than 0.85 mm thick) in a large plastic surgery unit: a 5 to 17 year follow-up. AB - The detailed histological findings of 728 melanoma patients treated at Frenchay Hospital during the period 1967 to 1978 have been fully reviewed and analysed. Of these, 75 patients with lesions less than 0.76 mm thick and 15 with lesions greater than 0.75 mm and less than 0.85 mm thick have been identified using a computerised data base. The general practitioners of all the patients in the series have been approached and the clinical histories found in nearly every case (69/75 and 15/15) thus providing a follow-up period of 5 to 17 years. A number of fatal melanomata have been found in these two groups. The histopathological features have been related to the known prognosis in an attempt to characterise the lethal lesions. No statistically significant relationship could be found between prognosis and any histological feature, including specifically the amount of regression within the lesion. However, it was found that assessment of the ratio of the uninvolved dermis beneath the tumour to tumour thickness itself might prove helpful in future case evaluation. PMID- 6498389 TI - Long term follow-up in cutaneous malignant melanoma: the relationship of maximal tumour thickness to disease free survival, disease recurrence and death. AB - 284 patients with invasive cutaneous malignant melanoma and known maximal tumour thickness (MTT) were followed up for 10 to 16 years (or to earlier death) following conventional wide margin excision of the primary tumour. Of these 26 (9%) presented with clinical Stage II disease (enlarged regional lymph nodes). The 10 year disease free survival was 45% for clinical Stage I disease, with 5/26 patients with Stage II disease alive 10 years after tumour excision combined with lymph node dissection. Ninety per cent of first tumour recurrences (lymph node or local skin recurrence) occurred within 5 years of primary surgical treatment for clinical Stage I disease, whilst only 63% of deaths from melanoma occurred within this 5 year period. Although maximal tumour thickness is a valuable prognostic guide, cutaneous malignant melanoma remains an unpredictable disease. PMID- 6498390 TI - Skin expansion as an adjunct to reconstruction of the external ear. AB - This case report illustrates the use of a Radovan tissue expander in a patient undergoing reconstruction of the upper two-thirds of the external ear. The expansion facilitated draping of the superior retro-auricular skin over the autogenous costal cartilage framework that was used for the skeletal reconstruction of the ear. PMID- 6498391 TI - Controlled tissue expansion in reconstructive surgery. AB - Controlled soft tissue expansion by encouraging the development of tissues which are ideally matched in colour, texture and hair-bearing qualities to a given donor defect, offers a new, safe and widely applicable technique in reconstructive surgery. Over the past four years we have used this technique to reconstruct "difficult" defects in many parts of the body. When necessary, synthetic implants or bone grafts have been successfully implanted beneath the expanded tissues. PMID- 6498392 TI - Anterior urethral advancement: a one-stage technique for hypospadias repair. AB - This paper presents a new technique of repairing congenital hypospadias by a one stage method using the principle of advancement of the anterior urethra. It can also be applied in the secondary repair of urethral strictures or fistulae. No urinary diversion is necessary. It eliminates the possibility of post-operative urethral stricture or fistula formation which are frequent complications of the more classical procedures and the repair can be completed in one stage. The clinical details of 16 patients in whom this technique was successfully used are presented. PMID- 6498393 TI - A successful case of urethral reconstruction in a child with persistent urethral bleeding due to an extensive cavernous haemangioma. AB - A 10-year-old boy presented with long-standing urethral bleeding from a cavernous haemangioma of the penis associated with Klipper-Weber syndrome. Bleeding was controlled by limited local excision and the urethra was successfully reconstructed with a full-thickness skin graft applied directly on to this cavernous haemangioma. From time to time split-skin grafts have been used to repair the defects following excision of simple haemangiomata but we could find no case report in the literature of a free skin graft applied directly on to a cavernous haemangioma. PMID- 6498394 TI - Repair of a prostato-membranous urethral stricture with a gracilis myocutaneous flap. AB - A one-stage repair was carried out for a prostato-membranous urethral stricture using an epilated gracilis myocutaneous flap. The follow-up has now lasted for 2 years and 6 months. The patient has been continent and able to pass urine with a good stream. This procedure is particularly suitable for reconstruction of the posterior bulbar and prostrato-membranous urethra which is difficult to repair by standard techniques. PMID- 6498395 TI - Lip function: a study of normal lip parameters. AB - This paper presents a study of normal lip parameters in 500 individuals representing both sexes and all age groups. The parameters studied were intercommissural distance at rest and during activity, soft-tissue gape, oral access, elasticity of perioral tissues, and upper and lower sulcus depths as an indication of lip curtain height. The strength of the orbicularis oris was measured using the pommeter (Peri-Oral-Muscle-Meter). Lip sensation was studied by testing two-point discrimination in all four lip quadrants. Statistical analysis revealed results to be significant to a p value of 0.01. PMID- 6498396 TI - Lip function: a study of oral continence. AB - Oral continence is achieved through the harmonious interplay of several factors of which the most important are the lip sensitivity, the strength of the orbicularis oris muscle and the height of the lip curtain. Forty-four persons with varying degrees of oral incontinence and diverse lip disorders were then examined and compared against the normal values. Significantly low values for all three factors found in the orally incontinent patients supported our hypothesis that the normality of these factors is essential for the maintenance of the oral seal. Central causes of dribbling, such as mental retardation and salivary over secretion, irrespective of etiology, are not considered here. PMID- 6498397 TI - Shoulder girdle resection for giant basal cell carcinoma. AB - Forequarter amputation may seem the only surgical option when a tumour of the scapula or its overlying soft tissues invades the bones of the shoulder joint. As illustrated in this case of giant basal cell carcinoma, shoulder girdle (Tikhor Linberg) resection is occasionally, possible, thus preserving a functional arm. PMID- 6498398 TI - The true pectoralis major myocutaneous island flap: an anatomical study. AB - The pattern of blood supply to the clavicular and sternocostal portions of the pectoralis major muscle was studied in the cadaver with X-rays of injected specimens. The major blood supply to the sternocostal part was derived from the pectoral branch, although in about 50% of cases the clavicular branch provided minor contributions. This finding supports the clinical experience that it is safe to isolate the full length of the vascular pedicle, deep to the clavicular portion of the muscle, in the preparation of a pectoralis major myocutaneous flap. PMID- 6498399 TI - The anatomy of the subscapular-thoracodorsal arterial system: study of 100 cadaver dissections. AB - The results of 100 cadaver dissections of the subscapular-thoracodorsal arterial system are presented. These results confirm the anatomical reliability of the thoracodorsal artery and report the consistent presence of a branch of the thoracodorsal artery to the serratus anterior muscle. The branches to serratus anterior were of sufficient dimensions to support either a latissimus dorsi flap or a serratus anterior flap. A direct cutaneous branch from the thoracodorsal artery to the skin of the axilla was identified in only 47% of the dissections. PMID- 6498400 TI - One-stage ante-thoracic reconstruction of the thoracic oesophagus using myocutaneous flaps. AB - An ante-thoracic reconstruction of the thoracic oesophagus was performed by fashioning a skin tube from a skin flap supplied by perforators from the internal mammary vessels. This neo-oesophagus was covered with a trapezius myocutaneous flap and a rectus abdominis myocutaneous flap, in a one stage operation. PMID- 6498401 TI - Q.E.D. flaps (?demonstrandum, disputandum or deprecandum): three useful axial pattern flaps in tropical African surgery. AB - Three axial pattern flaps are briefly reviewed, attention is drawn to a few technical points and their usefulness is stressed within the context of routine surgical work in district hospitals in tropical Africa. PMID- 6498402 TI - Rectus femoris muscle grafts performed with and without vascular anastomosis: an experimental study in the rabbit. AB - To study the effect of vascular repair on muscle transplants, rectus femoris muscles in rabbits were grafted orthotopically with and without microsurgical blood vessel repair. The function and structure of the grafts were evaluated 90 days after operation. Contractile properties were measured in vivo. Muscle biopsies were stained for nerve and motor end-plate regeneration. The twitch tension and maximal tetanic tension returned respectively to 32 +/- 6% and 32 +/- 7% of control values in the vascular transplants. In the avascular transplants twitch tension and maximal tetanic tension were respectively 6 +/- 1% and 8 +/- 1% of control values. Poor regeneration of muscle fibres, infection, fibrosis and immature reinnervation were the reasons for failure of avascular transplants. The avascular muscle grafts had insufficient contractile properties and were more static than dynamic. In conclusion, large avascular muscle grafts should be avoided because of the likelihood of poor revascularisation with extensive ischaemic necrosis, resulting in scar tissue. PMID- 6498403 TI - Prostanoid derivatives in experimental flap delay with formic acid. AB - The physiological changes that allow increased flap survival after flap delay have never been clearly defined. Inflammation has been postulated as a critical factor in flap delay and prostaglandins are known to be mediators of the inflammatory response. To evaluate the role of prostanoid derivatives in experimental flap delay, 0.2% formic acid was injected under the outline of modified McFarlane flaps in 20 rats and saline was injected under the flap outline in 20 control rats. Two weeks later the flaps were raised on all the rats. Average flap survival one week after flap elevation was 65.5% after formic acid delay and 42.9% after saline delay. Biopsies were taken from the flaps both during the delay period and after flap elevation. The specimens were stained for PGE2, PGF2 alpha and thromboxane. Changes noted in the levels of these prostanoid derivatives suggest that they may indeed mediate flap delay. PMID- 6498404 TI - The damaging effect of smoking on digital revascularisation: two further case reports. AB - Two cases are reported in which the smoking of a cigarette on the 5th day after revascularisation of the thumb produced immediate vascular insufficiency in a previously viable digit. PMID- 6498405 TI - The management of the soft-tissue haemangiomatous manifestations of Maffucci's syndrome. PMID- 6498406 TI - Acral lentiginous melanoma: an illustrative case report and brief review of the literature. AB - Acral lentiginous melanoma has not previously been reported in the English literature. It is a rare tumour occurring nearly always on the palmar and plantar surfaces and has only recently been recognised as a separate histological group of melanoma. Diagnosis can be difficult both clinically and histologically, and is often delayed. An illustrative case is presented and the world literature is briefly reviewed. PMID- 6498407 TI - On twisting bandages: an experimental study. AB - Following hand surgery, some surgeons prefer to bandage fingers individually, a technique that involves twisting the material as the dressing is continued onto the palm. A laboratory study was performed to observe changes in tension which occurred when twisting a bandage already under load. Six commonly used types of bandage were studied, each of three standard widths. The rise in bandage tension due to rotation of certain materials may increase tissue pressure to a level at which skin perfusion is significantly impaired. PMID- 6498408 TI - The intra-uterine healing of foetal muscle wounds: experimental study in the rat. AB - This work confirms that foetal wound healing is rapid, occurs without an apparent inflammatory response and takes place without the deposition of collagen. It is shown for the first time that foetal muscle wounds heal by regeneration. This study also shows that, immediately after injury, there is a degeneration of mesenchymal and ectodermal elements in that part of the lip between the wound and the mid line. This degeneration is followed by regeneration of only the mesenchymal elements. PMID- 6498409 TI - The special characteristics of suicide in hospital in-patients. PMID- 6498410 TI - Suicides in Exe Vale Hospital, 1972-1981. PMID- 6498411 TI - Assessment of suicide risk in psychiatric in-patients. PMID- 6498412 TI - Suicide in high buildings. PMID- 6498413 TI - A survey of unexpected deaths among psychiatric in-patients and ex-patients. PMID- 6498415 TI - Schizophrenia in old age (late paraphrenia). AB - Late paraphrenia is the form of expression of schizophrenia in old age. Twenty five patients diagnosed as suffering from the condition were studied, and their symptoms compared with the diagnostic criteria for schizophrenia of Spitzer et al (1975), the Catego system (Wing et al, 1974), Carpenter et al (1973a) and Langfeldt (1960). The study confirms late paraphrenia as one of the schizophrenias, and discusses differences with previous studies. PMID- 6498414 TI - Impact of psychogeriatric day hospital care on the patient's family. AB - The supporters of 129 patients referred for psychogeriatric day hospital care were interviewed and followed-up after three and six months. The majority of their dependents suffered from dementia. Thirty-one per cent were still attending six months later, while 37% had been admitted to institutional care. The most positive effects of day hospital were associated with continued patient attendance, the number of distinct advantages foreseen by the supporter, and the lack of any negative expectations concerning their dependents' adjustment to day care. Positive benefits were also closely associated with reductions in the number of problems faced by the supporter. PMID- 6498416 TI - Schizophrenia and spectral analysis of the visual evoked potential. AB - Power spectral analysis was performed on the visual evoked potentials (VEPs) recorded in response to flashes of different intensity in both unmedicated schizophrenic and normal subjects. At occipital locations (O1, O2), schizophrenics showed less power than normals in the 10-14 Hz frequency range. In the 18-22 Hz range, schizophrenics showed under-activation in the left hemisphere and over-activation in the right. At temporal locations (T3, T4), schizophrenics showed abnormal (left greater than right) hemisphere patterns of activation in 10 14 Hz and 18-22 Hz ranges. There were no group differences in relationships between power and intensity changes at vertex (Cz). The results suggest abnormal cortical-subcortical interactions during analysis of visual information in schizophrenia. PMID- 6498417 TI - The dexamethasone suppression test in psychotic versus non-psychotic endogenous depression. AB - The authors investigated the dexamethasone suppression test (DST) in 93 female patients with primary (endogenous) major depression; in 20 female paranoid schizophrenics, and in 17 healthy females. Depressed patients had a significantly higher rate of abnormal DST response and significantly higher post-dexamethasone serum cortisol levels than schizophrenics and normal controls. The unipolar and bipolar depressives showed a similar profile of DST abnormalities. Depressed patients with psychotic features had a significantly higher rate of positive DST results than non-psychotic patients. PMID- 6498418 TI - The measurement of psychiatric rehabilitation status. A review of the needs and a new scale. AB - The recognition of rehabilitation as a special interest in psychiatry, and its practice by professional teams, raises the need for some uniformity in examining patient outcome. The features required in a scale designed for this purpose are considered and the Morningside Rehabilitation Status Scales, which have been prepared specifically for psychiatric rehabilitation, have their development and use described. They measure the dimensions of dependency, inactivity in occupation and leisure, social integration/isolation, and current symptoms and deviant behaviour. The measures can be expressed as a profile of the dimensions, with the total a measure of overall level of functioning; reliability has been established, and validity assessed. The scales are not difficult to apply when the patients are known to the staff using them. They should be useful to rehabilitation teams for defining the current status of patients, measuring changes produced by rehabilitation programmes, deciding areas where treatment or service deficits may exist which the team should be attempting to remedy, as well as for teaching purposes. PMID- 6498419 TI - A comparative evaluation of two psychiatric day hospitals. AB - Two psychiatric day hospitals were evaluated in terms of the outcomes after three months' attendance by patients. Multiple measures were made using questionnaires, naturalistic observation, and ratings at the start and end of this period, for a total of 83 patients. The results indicated that although both day hospitals were serving similar patient samples, only one was achieving significant clinical improvements; one plausible explanation for the findings was the differences between their respective programmes. The major implication of the result is the need for evaluation of both the outcome obtained by patients following attendance and the therapeutic process by which these outcomes are achieved. PMID- 6498420 TI - Autonomic monitor for electroconvulsive therapy. PMID- 6498421 TI - Relief of diazepam-withdrawal syndrome by shoplifting. PMID- 6498422 TI - ECT, dopamine and delusions. PMID- 6498423 TI - DST in mania:prolonged suppression? PMID- 6498424 TI - Neuroleptic malignant syndrome and heat stroke. PMID- 6498425 TI - Circadian rhythms and psychiatry. PMID- 6498427 TI - Koro. PMID- 6498426 TI - A single-consultation assessment clinic. PMID- 6498428 TI - Recovery of radiologically functionless obstructed kidneys. AB - Eleven patients had radiologically non-functioning and unilaterally obstructed kidneys with normal kidneys on the other side. The kidneys were divided into three groups according to the urinary pH of the obstructed kidney at operation: Group 1 (pH 6.0 or less); Group 2 (pH 6.1-7.1); Group 3 (pH greater than 7.1). The obstruction was corrected in all patients despite the pre-operative radiological findings or the morphological appearance at operation. Radiological recovery was assessed 2 months post-operatively and was found to be good in all patients in Group 1. In Group 2, recovery was good in one patient, moderate in two and absent in one. In Group 3 there was no evidence of radiological recovery in either patient. PMID- 6498429 TI - The evaluation of risk factors in male stone-formers attending a general hospital out-patient clinic. AB - The daily urinary excretion of calcium, oxalate, glycosaminoglycans and uric acid, and the 24-h urinary pH and volume were measured in 61 normal men and in 81 men with a history of renal stone disease. The following features of these data were noted: No significant difference could be demonstrated between the stone formers and normals with respect to any of the variables measured. The values of each of the urinary parameters were positively and significantly correlated with those of at least two other parameters in one or both subject groups. The probability density histograms constructed from the data for each urinary variable in each subject group were unsuitable as the basis for calculation of individual relative risk factors. Thus it was concluded that the data were inappropriate for the calculation of "overall relative probability of forming stones" (P'SF) and that such an index is unlikely to be of use in the assessment and management of stone-formers attending a general hospital out-patient clinic. PMID- 6498430 TI - A prospective study of renal stone recurrences. AB - A simple metabolic investigation was carried out in 54 patients presenting with their first attack of renal stones. In three cases a probable cause for stone formation was found. During the following 8 years 53% of the patients developed recurrences, the risk of which was highest during the first years after the initial attack. Recurrences were more common in males than in females. As a group, patients who were to have recurrences had higher urinary calcium levels but there was a considerable overlap between the two groups. This prospective study confirms the opinion from retrospective evaluation of the natural history of renal stones that recurrences are common. However, they cannot be predicted from standard laboratory findings in individual patients. PMID- 6498431 TI - Biochemical effects in patients with calcium oxalate stone disease during combined treatment with bendroflumethiazide and magnesium oxide. AB - Thirteen patients with calcium oxalate stone disease were treated with 2.5 mg bendroflumethiazide and 200 mg magnesium oxide twice daily for 1 year, and the effects on serum and urine constituents were evaluated. Serum magnesium and potassium decreased, whereas urate increased during treatment. The association of decreased urinary calcium and increased urinary magnesium resulted in a reduced Ca/Mg quotient and apparently a lower risk of forming urine supersaturated with calcium oxalate. Combined treatment with a thiazide and magnesium appears to alter the composition of urine in a way that might be more favourable than treatment with either substance alone. PMID- 6498432 TI - Does calcium contribute to the effectiveness of a coagulum for pyelolithotomy? AB - Adding calcium to a mixture of thrombin and fibrinogen increased the breaking strain of the resultant coagulum by 10-fold, but did not significantly reduce the length to which it could be stretched. There was no detectable change in the time taken for the coagulum to dissolve in urine. Simulation pyelolithotomies were performed on pig kidneys containing ball-bearings which represented calculi. Coagula formed with calcium were significantly more effective at retrieving the ball-bearings than coagula without calcium. It is concluded that the ideal coagulum formula should include 1 mmol of calcium. PMID- 6498433 TI - Infrared spectroscopic studies of renal stones. AB - The chemical composition of 125 urinary stones was determined by means of an infrared spectrophotometric method using the potassium bromide pellet technique. Statistical combinations regarding the chemical composition of the stones are discussed and compared with the findings of other workers. Calcium oxalate was the commonest component of pure as well as mixed stones. PMID- 6498434 TI - Study of the venous phase on renal angiography in cases of renal carcinoma. AB - The venous phase on renal angiography was studied in 65 cases of renal carcinoma. Opacification of the renal vein stem was observed in 33 cases (51%). The visualisation rate of the renal vein was lower in high stage than in low stage tumours but there was no difference between these groups if patients with tumour thrombus of the renal vein were excluded from the high stage group. Renal arteriovenous fistulas were observed in six cases (9%), in three of which tumour thrombus of the renal vein was also seen. The thrombus was discovered at operation in 14 of the 65 cases and it was in 10 of these that the striated vascular pattern was observed on renal angiography. Collateral veins were observed in 15 cases (23%), only five of which had tumour thrombus of the renal vein. PMID- 6498435 TI - Ureteroureteric reflux. Pathological entity or physiological phenomenon? AB - The clinical, urographic and radionuclide examinations of 28 consecutive patients with incomplete duplication of the upper urinary tract are presented. Four possible types of urodynamic abnormality can occur in this condition and 3 of these were found in 8 of the 28 patients. The urodynamics of normal and duplex upper tracts are reviewed and the question of whether the abnormalities represent a pathological process requiring surgery or a harmless physiological variant is examined. PMID- 6498436 TI - Bladder function following spinal cord injury: a urodynamic analysis of the outcome. AB - Repeated urodynamic testing was undertaken on a group of 58 consecutive patients admitted with acute spinal cord injury. Thirty-seven (64%) were able to void satisfactorily spontaneously, whereas 10 required bladder outlet surgery and 11 achieved emptying by either abdominal straining, intermittent self catheterisation or an indwelling suprapubic catheter. The pattern of the initial cystometry soon after injury provided some idea of what possibilities could be expected of subsequent bladder function. Very high detrusor pressures exceeding 80 to 100 cm of water developed in a third of patients with supranuclear lesions. Six patients developed vesicoureteric reflux between 4 and 24 months after injury. PMID- 6498437 TI - Urography and cystoscopy in bladder mucosal abnormality. AB - A prospective study was carried out on 60 patients. The diagnostic usefulness of intravenous urography (IVU) compared with that of cystoscopy in assessing the state of the bladder mucosa was evaluated. Collectively, radiology was as good as cystoscopy in suggesting the final diagnosis of the location and severity of a mucosal lesion. The after-micturition film (AMF) from IVU was the single most informative film which produced correct results in 59 of 60 patients. The full bladder film was the least useful examination and in 45 cases suggested an incorrect or misleading diagnosis. PMID- 6498438 TI - Routine cross-matching is not necessary for a transurethral resection of the prostate. AB - Two hundred and fifty-five consecutive patients undergoing transurethral prostatectomy were studied prospectively to test a policy of not routinely cross matching blood. Blood was ordered only for patients with anaemia, a major medical risk factor, a prostate gland estimated to be greater than 60 g, or the presence of red cell alloantibodies. Of the 203 patients who were "grouped and saved" only, 30 (12%) were subsequently cross-matched and 22 (8.5%) transfused. There were no significant problems as a result of the operation of this policy. The value of these pre-operative criteria for cross-matching was confirmed, apart from the clinical estimation of prostatic size. The use of such a policy could be of significant value to the hospital blood transfusion services. PMID- 6498439 TI - The meatal problem with TUR prostate: the value of post-operative self dilatation. AB - In a preliminary retrospective study, we found that 37% of patients about to undergo a transurethral resection of the prostate had an external meatus too small to admit a 26 F resectoscope sheath. In a prospective study, a formal meatotomy was compared with an Otis urethrotomy for patients with a narrow meatus. This study was stopped because 71% of cases having a meatotomy developed strictures compared with 29% having an internal urethrotomy. In a further study of 59 patients, regular self-dilatation of the cut meatus with a plastic spigot was compared with internal urethrotomy of the meatus alone. Seven per cent of cases having self-dilatation developed strictures compared with 34% having internal urethrotomy. It was concluded that in those patients with a narrow external meatus meatotomy should not be carried out, but self-dilatation following internal urethrotomy greatly reduces the incidence of meatal strictures. PMID- 6498440 TI - Radioimmunoassay for prostatic acid phosphatase in early prostatic carcinoma. AB - A radioimmunoassay procedure has been used to measure prostatic acid phosphatase in the serum of 46 patients with intracapsular carcinoma of the prostate. The results obtained did not differ significantly from those obtained in a control group of similar size. It is concluded that the radioimmunoassay procedure for measurement of prostatic acid phosphatase has no advantage over enzyme activity measurements for the detection of early prostatic carcinoma. PMID- 6498442 TI - Biofeedback: a 5-year review. PMID- 6498441 TI - Factors influencing recurrence of urethral strictures after endoscopic urethrotomy: the role of infection and peri-operative antibiotics. AB - One hundred patients who had undergone 162 urethrotomies were reviewed. Factors which influenced the outcome of the procedure are discussed. Peri-operative infection occurred in 38% of cases and significantly increased the recurrence rate unless the patients were treated with antibiotics. PMID- 6498443 TI - Testicular metastasis from carcinoma of the prostate. PMID- 6498444 TI - Vasocutaneous fistula following scrotal injury. PMID- 6498445 TI - Inverted papilloma of the ureter. PMID- 6498446 TI - Localised primary amyloidosis of the renal pelvis. PMID- 6498447 TI - Spontaneous intraperitoneal rupture of pyonephrosis during pregnancy. PMID- 6498448 TI - Ureterocolic fistula. PMID- 6498449 TI - Long-term survival of patient with carcinoma of penis. PMID- 6498450 TI - Renal fibrolipomatosis simulating renal pelvic tumour. PMID- 6498451 TI - A simple technique for removing the coagulum cast in coagulum pyelolithotomy. PMID- 6498452 TI - Femoropopliteal bypass with a Goretex prosthesis: a long-term follow-up. AB - This report describes a series of 101 femoropopliteal bypasses performed on 85 patients (16 bilateral procedures), in whom a 6 mm diameter polytetrafluoroethylene prosthesis (Goretex) was used. The indication for operation was severe claudication in 58 cases and pregangrene in 43 cases. After one year there was a statistically significant difference between the cumulative patency rates for these two subgroups at 66 and 29 per cent respectively (P less than 0.001). In patients with good 'run-off, i.e. three patent vessels in the lower leg, there was a tendency for the bypasses to remain patent for longer than in patients in whom there were only one or two vessels present (e.g. 58 and 33 per cent respectively at 2 years), although this trend was not statistically significant. At 3 years the cumulative patency rate for the whole group was 36 per cent and for claudicants alone was 48 per cent. PMID- 6498454 TI - Retrorectal abscess: a complication of terminal ileal Crohn's disease. PMID- 6498453 TI - Vascular spasm and gangrene during heparin-dihydro-ergotamine prophylaxis. AB - A case is reported of a multiple trauma victim who developed severe vascular spasm whilst receiving heparin-dihydro-ergotamine thromboembolic prophylaxis which ultimately led to amputation of the right foot. Identification of high risk groups for this complication is attempted from a review of the literature. Treatment should be with intra-arterial or intravenous nitroprusside or nitrates. Little information is as yet available on the use of prostacyclin in this condition. PMID- 6498455 TI - Vascular injury following cardiac catheterization. AB - Fifteen out of 3500 patients undergoing cardiac catheterization sustained arterial injury requiring surgical repair. Seven injuries to the common femoral or profunda femoris arteries presented late as false aneurysms, requiring simple suture repair. Three superficial femoral and four brachial artery injuries presented immediately after catheterization and surgical repair generally required the insertion of a vascular graft. The outcome of surgery was uniformly excellent. Small vessel cannulation is associated with increased likelihood of arterial injury. The common femoral route, with a high puncture site avoiding the superficial femoral or profunda vessels, is to be preferred to the brachial approach. PMID- 6498456 TI - Benign bile duct stricture following cholecystectomy: critical factors in management. AB - Seventy-eight patients with benign bile duct stricture following cholecystectomy were referred for further management over an 8-year period. The majority (58 per cent) had multiple operations before referral. On presentation 90 per cent of patients had abnormal liver function tests, 19.5 per cent a depressed serum albumin, 49 per cent a history of previous major infection, and 14 per cent associated liver disease and portal hypertension. Seventy-two patients (92 per cent) were operated upon: 63 by stricture repair alone, 4 by stricture repair and portal systemic anastomosis, and one by splenorenal anastomosis alone. Of the patients treated by stricture repair alone and no other procedure 90 per cent have a good result with a mean follow-up of 3.3 years, and an operative (30-day) mortality of 3.2 per cent. There were no postoperative deaths in 61 patients in whom stricture repair alone was performed by direct suture techniques, but in the presence of portal hypertension and liver disease the mortality was 27 per cent. Factors influencing a satisfactory stricture repair were the number of previous operations, site of stricture and type of repair. Factors influencing mortality were the number of previous operations, a history of major infection, the site of stricture, pre-operative serum albumin concentration, and the presence of liver disease and portal hypertension. PMID- 6498457 TI - Multiple colonic carcinoid tumours in a child. PMID- 6498458 TI - Anorectal profilometry with the microtransducer. AB - The reproducibility of anal sphincter manometry has been evaluated in 17 patients with a continuous pull-through technique using a miniature transducer mounted on a 2mm diameter Dacron catheter. Comparison was made with a conventional station pull-through technique using a 4mm diameter waterfilled microballoon connected to an external transducer. Parameters measured with the microtransducer (maximum resting pressure, squeeze pressure, functional sphincter length, area under high pressure zone, amplitude of rectosphincteric reflex) showed mean coefficients of variation from 3.2 to 5.7 per cent. Pressures measured with the microballoon were uniformly higher than those obtained with the microtransducer. The functional sphincter length was significantly shorter when measured with the microballoon (P less than 0.001). The microtransducer provides a highly accurate and reproducible method of anorectal profilometry that avoids many of the drawbacks associated with fluid-filled systems. PMID- 6498459 TI - Serum carcinoembryonic antigen and acute phase reactant proteins in the pre operative detection of fixation of colorectal tumours. AB - Fixity of colorectal tumours carries a poor prognosis, but only if it is the consequence of malignant spread. Pre-operative radiotherapy may be beneficial but selection depends on clinical examination which is often inaccurate or impossible. We therefore investigated if serum concentrations of carcinoembryonic antigen and acute phase reactant proteins (APRPS) which may be elevated in patients with colorectal cancer could determine the degree and nature of local spread prior to operation. Carcinoembryonic antigen (CEA), alpha 1 acid glycoprotein (AGP) and C-reactive protein (CRP) were measured pre-operatively in 100 patients with colorectal tumours, 89 of whom had a carcinoma. Thirty-two (36 per cent) were fixed, 18 (56 per cent) by malignancy (FM) and 14 (44 per cent) by inflammation (FI). Levels of CEA, AGP and CRP were all significantly higher in the serum of patients with fixed tumours (P less than 0.05). Concentrations of AGP greater than 1.4 g/l or CRP greater than 15 mg/l were accurate predictors of tumour fixation (specificity 87 and 90 per cent; sensitivity 78 and 78 per cent. CEA appeared more accurate in determining the nature of fixation. A value of greater than 50 ng/ml predicted 82 per cent of FM tumours (specificity 100 per cent; sensitivity 87 per cent). Thus, pre-operative measurement of serum CEA and APRP appear able to predict fixation of colorectal tumours. PMID- 6498460 TI - Evidence for sphincter dysfunction in patients with gallstone associated pancreatitis: effect of ceruletide in patients undergoing cholecystectomy for gallbladder disease and gallstone associated pancreatitis. AB - The functional activity of the sphincter of Oddi complex has been examined by ceruletide manometry in patients undergoing cholecystectomy with a normal peroperative cholangiogram. In Group I (n = 14), which included patients with previous acute cholecystitis/biliary colic, the sphincter activity appeared to be normal and responded to intravenous ceruletide by a marked relaxation with a significant fall in both the infusion and postinfusion pressures. In patients undergoing cholecystectomy for gallstone-associated pancreatitis (n = 8), the sphincter exhibited manometric features of hypotonia with low infusion and postinfusion pressures which were not significantly altered by intravenous ceruletide. PMID- 6498462 TI - Reliability of tests of venous function. PMID- 6498461 TI - Abnormalities of colonic function in patients with rectal prolapse and faecal incontinence. AB - We have investigated changes in colonic motility and anorectal function in 6 continent patients with a rectal prolapse; in 10 incontinent patients with rectal prolapse and in 16 patients with idiopathic faecal incontinence compared with 26 age and sex match controls. A history of incontinence, irrespective of a prolapse, was associated with significantly lower anal squeeze pressures (P less than 0.05), a deficient anorectal angle (P less than 0.05), failure to retain a balloon containing more than 250 cm3 of air in the rectum (P less than 0.01) and increased sigmoid motility (P less than 0.02) compared with controls. By contrast patients with rectal prolapse and no incontinence had normal anal pressures, a normal anorectal angle and normal sigmoid motility, but transit was delayed. These results indicate that abnormal sigmoid motility is commonly associated with faecal incontinence and that slow transit constipation is frequent in patients with rectal prolapse who are continent. PMID- 6498463 TI - Porcine dermal collagen repair of incisional herniae. PMID- 6498464 TI - Intraperitoneal tetracycline and adhesions. PMID- 6498465 TI - Postoperative urinary retention. PMID- 6498466 TI - Pre-operative biliary drainage. PMID- 6498467 TI - Monoclonal antibody immunoscintigraphy for the detection of gastrointestinal tumours. PMID- 6498468 TI - The surgical management of typhoid perforation in children. AB - Typhoid perforation still has a high mortality rate (19-59 per cent) and controversy regarding the management of patients with this complication still abounds. We report our experience of 26 children with histologically proven typhoid perforation with an operative mortality of 9.0 per cent. Timed surgery with ulcer excision, simple two-layer closure of the defect and copious peritoneal lavage were used. PMID- 6498469 TI - Passage of a colon 'cast' following resection of an abdominal aortic aneurysm. PMID- 6498470 TI - Incidence of synchronous and metachronous colorectal carcinoma. AB - Two hundred and twenty-three patients with colorectal carcinoma were treated consecutively at the University Hospital of South Manchester from May 1976 to January 1981. Twenty-four patients (10.7 per cent) were found to have more than one colorectal carcinoma. In 18 patients this was recognized either immediately or within 6 months of the initial diagnosis--synchronous carcinoma. In the other six cases a second carcinoma was found at a later time--metachronous carcinoma. The incidence of synchronous, and consequently the combined incidence of synchronous and metachronous carcinoma, was higher than previously documented. The anatomical distribution of the multiple carcinomas and the sex incidence in these patients was similar to that seen in patients with a single carcinoma of the large bowel. A high association of adenomatous polypi with multiple large bowel carcinomas was observed. The possibility of more extensive colonic resection in the younger patient with a favourable carcinoma is discussed. PMID- 6498471 TI - Improving prognosis for malignant melanoma in Britain. AB - Analysis of a consecutive series of 225 patients with malignant melanoma in Cardiff has shown a 5 year cumulative survival rate of 73.3 per cent. This survival rate is considerably better than those reported in previous British series, equal to the high rates reported in the past from Australia, and far exceeds that of all common internal malignancies. It is suggested that the improving prognosis is associated with more accurate diagnosis and an increasing incidence of superficial spreading melanoma, a type for which earlier diagnosis might be expected to lead to improved prognosis. These facts provide a basis of optimism for future programmes of public and professional education. PMID- 6498473 TI - Cutting corners. PMID- 6498472 TI - Accessory sphincterotomy (endoscopic and surgical) in patients with pancreas divisum. AB - Sixteen patients with the congenital anomaly of pancreas divisum have been treated by enlarging the orifice of the accessory papilla. Attempts to do this at duodenoscopy succeeded in only 5 of 12 patients, and only one had a good clinical result. Sphincteroplasty was performed surgically in seven patients; five had a good or fair result. Most patients with poor results have undergone pancreatic resection. One patient died post-operatively; the remaining 15 divide equally as good (5), fair (5) and poor (5) results at follow-up after periods ranging from 7 months to 5 years. Results appear to be better in patients presenting with recurrent attacks of acute pancreatitis than in those with chronic pain. The preferred management for these patients remains unclear. PMID- 6498474 TI - Cancer of the testis. PMID- 6498475 TI - The management of soft tissue sarcomas. AB - The management of soft tissue sarcomas presents one of the more exciting areas of the application of multimodal therapy for malignancy. Rapid developments have taken place in the understanding of the histogenesis, histopathology, prognostic indicators and treatment approaches. With the combination of local irradiation and adjuvant chemotherapy, limb sparing operations can now be widely advocated with amputation being reserved for proximal difficult lesions. Retroperitoneal sarcomas, however, remain a major challenge with little progress in results of therapy, other than improved operative morbidity in the last 10-15 years. Current prospective, randomized studies of the management policies designed to maximize survival while minimizing morbidity should provide further insights in the near future. Our current and past experience with more than 150 new cases each year allows a brief summary of the understanding and management of these difficult problems. PMID- 6498476 TI - Surgical approaches to thromboembolism. AB - Management of angiographically confirmed pulmonary thromboembolism in 313 patients has been based on a physiological classification system. Patients in shock (Class IV) are managed either by catheter embolectomy (26 patients) with 27 per cent mortality rate or by open embolectomy during active resuscitation (6 patients) with a 33 per cent mortality rate. High-risk patients with transient hypotension (Class III) are managed by anticoagulation and filter insertion. The most common indication for filter placement is a contra-indication to anticoagulation (37 per cent). Filter placement was infrarenal in 268 patients (86 per cent) and intentionally suprarenal in 19 patients (6 per cent). Misplacement has occurred into the iliac veins, renal veins and the heart but has not been seen since the guide wire technique for insertion was developed. The 30 day mortality for patients receiving filters was 14 per cent and due to other disorders. Only one death was suspected from recurrent embolism. One hundred and thirteen venacavagrams at intervals up to 99 months in 110 patients showed long term patency in 97 per cent. Recurrent embolism was seen in five patients (2 per cent) but caused no deaths. PMID- 6498477 TI - Surgical management of reflux-induced oesophageal stenoses: results in 101 patients. AB - One hundred and one patients with benign, reflux-induced oesophageal stenosis were surgically treated at the Mayo Clinic during a recent 6 year period by the author. In 71 patients, the stenosis was readily dilated and treated by a variety of antireflux procedures, depending on presence or absence of oesophageal peristalsis or acquired shortening of the oesophagus. Thirteen additional patients were managed by gastric secretion suppression with duodenal diversion using the Roux-Y principle. Seventeen patients with undilatable stenoses were managed by resection and a variety of reconstructions. The modified Ivor-Lewis procedure with or without thoracotomy was the procedure employed in 12 of the 17 with the remainder managed with either substernal colon or upper digestive secretion suppression-diversion. These 101 operations were accomplished without mortality and all but one patient have resumed an oral diet and returned to their usual occupation. While 91 per cent of the 101 patients are free of reflux symptoms or demonstrable stenosis and are considered improved, only 83 per cent of all patients have "excellent' to "good' late results in terms of both oesophageal and gastrointestinal symptoms. PMID- 6498478 TI - A review of treatment of spinal cord injury. AB - Spinal cord injury remains a devastating event to the person sustaining the injury. Not only the cost of acute and rehabilitation care, but also the loss of productivity of the victims who are often young men injured at a highly productive period of their lives are a costly illness for society as a whole. In the past 20-30 years, there has been continual improvement in the morbidity and mortality from spinal cord injury with the improvement in prevention of a second injury, prevention of secondary renal, pulmonary and cutaneous complications, better techniques for stabilization of the spinal column, and more effective utilization of remaining neurological function with improved rehabilitation therapy. It remains, however, difficult to demonstrate an effect from a wide range of 'acceptable' medical or surgical care on the resultant loss of spinal cord function. The lack of improvement in preventing or reversing the loss of spinal cord function in spite of marked variations in acute spinal cord injury care indicate that acceptable data are still lacking to determine the role of aggressive and conservative management. The need for a more organized approach to the problem is obvious. PMID- 6498479 TI - Surgical treatment for thyroid cancer. PMID- 6498481 TI - Abstracts from the Royal College of Surgeons in Ireland. PMID- 6498480 TI - Current achievements and challenges in adrenal surgery. AB - Adrenal surgery is now done in almost ideal circumstances. Mortality and complications are rare except in Cushing's syndrome. All major adrenal hormones and their stimulators are measurable and discriminating tests abound. Imaging techniques detect small masses. Inhibitors of hormone synthesis and cell receptors allow amelioration of metabolic hazards preoperatively. Primary aldosteronism is first medically controlled, and patients are selected for operation if difficult to control and if the type of disease is responsive to adrenalectomy. Cushing's disease usually requires pituitary adenomectomy, but some of the 15-30 per cent failures, those with ectopic adrenocorticotrophic hormone (ACTH) producing tumours, or adrenal adenomas warrant adrenalectomy. Metabolic hazards are controlled pre-operatively by aminoglutethimide. Benefits of adrenalectomy are uncertain and many challenges remain. Hazards of phaeochromocytomectomy are avoided by pre-operative adrenergic blockade. Myocardial disease warrants delay. Small unilateral lesions of all types are best removed through unilateral approaches. Small masses found on imaging and without apparent effect can be observed. PMID- 6498482 TI - Brain traits through phylogeny: evolution of neural characters. AB - We have previously derived a hypothetical tree of the lines of mammalian descent, based upon a comprehensive numerical taxonomic cross-analysis of primitive and derived states of 15 brain traits in 38 representative species. In this communication we use this tree to describe the probable sequence of changes that have taken place in phylogenetic history. 2 characters proved to be multiply convergent, occurring in parallel in several disparate lines of descent. The remaining 9 characters each appeared in ancestors of one or another of the lineages and characterize related progeny. PMID- 6498483 TI - Regional variations in cortical cholinergic innervation: chemoarchitectonics of acetylcholinesterase-containing fibers in the macaque brain. AB - There are marked regional variations in the laminar distribution and intensity of acetylcholinesterase containing fibers in cortex. These fibers were particularly prominent in the 5 major paralimbic (mesocortical) regions of the brain: the insula, the caudal orbito-frontal cortex, the temporal pole, the cingulate gyrus and the parahippocampal region. Within these 5 areas, the part of cortex which is adjacent to allocortex has the most acetylcholinesterase and there is a gradual decline towards granular isocortex. The primary sensory-motor areas have distinctive laminar patterns of enzyme distribution. For example, primary visual, auditory and somesthetic konio-cortices are characterized by a salient band in layer IV. On the other hand, motor and premotor areas are characterized by a concentration of radially arranged fibers within the deeper layers of cortex. High order sensory association areas throughout the cortical mantle consistently contain the least amount of acetylcholinesterase-positive fibers. It is conceivable that these patterns reflect regional variations in the distribution of cortical cholinergic innervation. The cortical topography of cholinergic markers may be relevant to the biological organization of mood and memory and also to the pathophysiology of Alzheimer's disease and of partial epilepsy. PMID- 6498484 TI - Acute increases in blood pressure cause arousal from sleep in lambs. AB - We did experiments to determine whether or not acute increases in blood pressure would cause arousal from sleep. Nine lambs were studied 3-4 days after a balloon tipped catheter was inserted via the femoral artery into the descending aorta and electrodes for the following recordings were implanted: electrocorticogram, electro-oculogram, electrocardiogram and diaphragm electromyogram. Balloon inflation increased mean arterial blood pressure 27.9 +/- 6.3 mm Hg (mean +/- 1 S.D.) during quiet sleep (QS) and 24.4 +/- 8.9 mm Hg during active sleep (AS). Behavioral arousal occurred from both sleep states but was significantly (P less than 0.05) delayed during active sleep (21.3 +/- 6.7 s) compared to quiet sleep (10.0 +/- 3.3 s). This occurred despite there being a greater percent change in R R interval for a percent change in mean blood pressure during active sleep (2.68 +/- 1.08) than during quiet sleep (1.55 +/- 0.62). The increases in blood pressure did not produce any significant changes in respiratory rate of integrated diaphragm activity. Thus, acute increases in blood pressure are capable of causing arousal from sleep. This finding should be considered when one discusses the possible mechanisms of arousal from sleep during rapidly developing hypoxemia. PMID- 6498486 TI - Miniature synaptic potentials recorded intracellularly from Purkinje cell dendrites in guinea pig cerebellar slices. AB - Intracellular recordings from Purkinje cell dendrites in guinea pig cerebellar slices revealed the existence of miniature spikes with various amplitudes, which were firing apparently without any externally applied stimulations. These spikes were in a hyperpolarizing direction at a resting membrane potential, and their apparent reversal potential was at about -60 mV, indicating their inhibitory nature. Based on the blocking actions of high-Mg2+, tetrodotoxin and amino acid antagonists such as bicuculline etc., these spikes were suggested to be inhibitory synaptic potentials generated by cerebellar interneurons. PMID- 6498485 TI - Bilateral lesions of the dorsolateral funiculus of the cat spinal cord: effects on basal nociceptive reflexes and nociceptive suppression produced by cholinergic activation of the pontine parabrachial region. AB - In cats, bilateral microinjections of the cholinergic agonist, carbachol (0.6 micrograms in 0.2 microliter), into an area surrounding the lateral half of the brachium conjunctivum (BC) produces a non-narcotic suppression of nociceptive responses, as assessed by flexion reflexes (tail-flick and calibrated pinch tests). Bilateral lesions of the dorsolateral funiculi (DLF) of the thoracic spina cord (T2) significantly reduced the magnitude of this nociceptive suppression. Nociceptive suppression following carbachol microinjections into sites along the dorsal aspect of BC was reduced by DLF lesions to a greater degree than nociceptive suppression following injections into sites within or ventral to BC. Relatively superficial DLF lesions produced reductions in nociceptive suppression which were equivalent to reductions induced by deeper lesions. DLF lesions, either superficial or deep, produced equivalent, reliable decreases in tail-flick test assessments of baseline nociceptive thresholds. The magnitude of decreases in baseline nociceptive thresholds produced by DLF lesions was not correlated with the magnitude of reduction of carbachol-induced suppression of nociceptive responses, indicating that DLF lesions suppress anti nociception independent of baseline alterations. These data suggest that non narcotic analgesia produced by cholinergic activation of cells along the dorsal aspect of BC may be predominantly mediated by fibers descending within the DLF. However, results of the retrograde horseradish peroxidase (HRP) tracing studies reported in the present investigation indicate that this pain suppression is probably mediated by polysynaptic pathways since this region dorsal to BC projects neither through DLF nor extra-DLF pathways. Retrograde HRP data show that areas ventral to and including BC projects to the cord via both DLF and extra-DLF pathways. Since DLF lesions were less effective in reducing analgesia attained from ventral compared to dorsal sites, spinal pathways other than DLF may mediate reflex suppression following carbachol microinjection into these more ventral sites. Possible cholinergic contributions to endogenous, non-opiate forms of analgesia are discussed. PMID- 6498487 TI - Auditory space representation in the superior colliculus of the big brown bat, Eptesicus fuscus. AB - The auditory response areas of 123 superior collicular (SC) units of Eptesicus fuscus were studied under free-field acoustic stimulus conditions. A stimulus was delivered from a loudspeaker placed 14 cm in front of a bat. The best frequency of a unit was determined by changing the stimulus frequency until the minimum threshold was measured. A best frequency stimulus was then delivered as the loud speaker was moved across the auditory space to determine the response center of the auditory response area of each unit. The response center was defined as the direction at which the unit had its lowest minimum threshold. The stimulus intensity was then raised 2-20 dB above the lowest minimum threshold of the unit and the response area for each stimulus intensity was determined. The response area of a unit expands with stimulus intensity, but the expansion is not even in all directions. The size of the response area of a unit does not correlate with its minimum threshold, best frequency, or recording depth. Response centers of 7 units were located directly in front of the animal, but most response centers were located in a limited portion of the contralateral auditory space. Although each unit has a response center which is the point of maximal sensitivity, the point-to-point representation of the auditory space is not systematically organized. We suggest that an animal with highly mobile external pinnae may not need an orderly auditory space map in its neural tissue for accurate sound localization. PMID- 6498489 TI - Single neuron activity in dorsolateral prefrontal cortex of monkey during operant behavior sustained by food reward. AB - The activity of 190 neurons was recorded from the dorsolateral prefrontal cortex of monkeys during an operant task that consisted of 3 phases: visual discrimination of food and non-food, bar pressing to gain access to the food and ingestion. In area 8, a fairly large proportion of the 49 recorded neurons responded in both the visual discrimination (37%) and motor initiation (35%) phases. Some functional heterogeneity seems evident within area 8 since visual discrimination responses were rostral, visuokinesis was central and motor initiation was in the caudal bank of the arcuate sulcus. Neurons in area 9 responded primarily (37%) during the bar pressing phase and less during the visual discrimination phase. Neurons in area 10 responded variously during most phases of the task--food discrimination, bar pressing, and ingestion. Neurons in the periprincipal sulcal area usually responded in the visual discrimination phase, but some which did not respond to food presented in front of the subject responded to meaningful visual or auditory cues that were related to food reward. The data suggest that neurons in the dorsolateral prefrontal cortex have multiple functions related to all phases of complex, learned feeding behavior. Functional roles of the prefrontal cortex and the lateral hypothalamus in development of feeding behavior are discussed. PMID- 6498488 TI - Somatosensory evoked potentials and neuraxial blood flow in central nervous system decompression sickness. AB - Seven adult, conditioned dogs were anesthetized with pentobarbital sodium and prepared for measurement of upper lumbar, mid-thoracic and lower cervical spinal evoked potentials (SEPs), cortical evoked potential (CEP), and aortic, right ventricular, and cerebrospinal fluid pressures. Following preparation, one animal was monitored by means of repeated evoked potentials for 2 h, at which time a [14C]iodoantipyrine autoradiographic blood flow study was performed. The 6 other animals were exposed to simulated dives in a compression chamber while anesthesia was maintained through a chamber penetration. These animals developed decompression sickness (DCS) of varying severity upon returning to the surface, and the corresponding decrements in neuronal function of the cord and the brain were measured by means of serial SEP and CEP recording. Following this evoked potential recording, [14C]iodoantipyrine autoradiographic blood flow studies were performed. The results indicated that clear reductions in SEP and CEP amplitude were associated with very low blood flows, which were in the 'neuron-disabling' range. Spinal and cortical somatosensory evoked potentials provide a valuable index with which to monitor and manage a model of spinal cord DCS. PMID- 6498490 TI - Zinc: effect and interaction with other cations in the cortex of the rat. AB - Zinc and other cations were iontophoretically applied to neurones in the frontoparietal cortex of urethane-anaesthetised rats and their effect on the activity of these cells was examined. Slow and often prolonged increases in firing rate occurred in 45.2% of neurones after zinc application and 72.7% after barium. Calcium caused short duration decreases in firing rate in 89.3% of neurones as did manganese (78.6%) cerium (21.9%) and magnesium (33.3%). When applied simultaneously zinc blocked the depressant effect of calcium (in 79.3% of neurones) but not that of manganese or GABA; other ions were ineffective. These results suggest that zinc, which is known to be present in nerve terminals, may modulate neuronal activity. PMID- 6498491 TI - Responses of midbrain raphe neurons to ethanol. AB - The effects of ethanol on single midbrain raphe neurons were studied in the rat. For dorsal raphe neurons, only the units with rhythmic slow firing were consistently inhibited by ethanol. Those units often exhibited periodic cessation of spontaneous discharges in the initial responses, but later showed a dose related slowing of discharge rates. Although median raphe neurons were also inhibited by ethanol, their responses consisted of an early tendency to fire more regularly, and then a decrease in spontaneous activity with bursting discharges. The data indicate that ethanol exerts different modes of inhibition on these two functionally different cell groups in the midbrain raphe complex. PMID- 6498492 TI - Do large diameter cutaneous afferents have a role in the transmission of nociceptive messages? AB - In recent studies, it has been reported that high-frequency stimulation restricted to A alpha beta fibers in man can be perceived as painful and evoke a nociceptive flexion reflex. These results would indicate that some patterns of activity in low-threshold mechanoreceptors can lead to painful sensations. Because of the theoretical importance of this question, the above studies were extended by recording the evoked neural activity with the technique of percutaneous microneurography. Painful sensations and the nociceptive reflex did not appear unless the evoked nerve response contained activity in A delta fibers. The results support the theory that painful sensations occur in normal man only when nociceptor afferents are activated. PMID- 6498493 TI - Effects of tetraethylammonium-chloride and divalent cations on the afterhyperpolarization following repetitive firing in leech neurons. AB - In leech Retzius cells, repetitive activity evoked a prolonged Ca2+-dependent after-hyperpolarization (PAH) (30-60 s) accompanied by an increase in input conductance. PAH persisted in Retzius cells, as well as in nociceptive (N) cells, when Sr2+ but not Mg2+ was substituted for Ca2+. In the presence of tetraethylammonium-chloride (TEA) or Ba2+, PAH was replaced by a Ca2+-dependent, Mg2+-blockable depolarization which was present in the order N greater than R. Careful study of the differences in such phenomena in identified cells may improve our understanding of the differential susceptibility of various neurons to hyperexcitability. PMID- 6498494 TI - A reproducible experimental model of focal cerebral ischemia in the cat. AB - In the past experimental methods used for producing focal cerebral ischemia have had considerable difficulty with regard to reproducibility of the size of the infarcted region. In this study we have developed an experimental model which enables us to consistently produce focal regions of cerebral ischemia (resulting in infarction) which vary little in size in a number of animals. Thirty-seven cats (3-4 kg b. wt.) anesthetized with chloralose and urethane were used. Physiologic monitoring and adjustments maintained arterial blood values as follows: pCO2 27-35 Torr, pO2 100-150 Torr, pH +/- 7.4, glucose 200 mg%, hematocrit greater than 25. The left middle cerebral artery was exposed via a transorbital approach and occluded for 1-2 h with and without left and/or both carotid artery occlusion. Sixteen hours following the ischemic episode, the animals were sacrificed and sections of fresh brain tissue were processed for vital staining using 1% tetrazolium solution. With this method normal brain areas appear dark red, ischemic regions (without infarction) appear gray and irreversibly infarcted areas appear pinkish-white. The volumetric dimensions of the lesioned area were measured using a planimeter. The same tissue was also evaluated histologically by means of standard histopathologic techniques on paraffin-embedded material. Infarcted areas as delineated macroscopically by the tetrazolium correlated well with the light microscopic findings. Ten animals subjected to a 2-h occlusion of the left middle cerebral artery (LMCA) and both carotid arteries resulted in a reproducible infarct which was 3.2 +/- 0.7 ml in volume. This represents 13.3 +/- 2.9% of the total volume of both cerebral hemispheres (above the level of the inferior colliculus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498495 TI - Positive control of target cerebellar cells on norepinephrine uptake in embryonic brainstem cultures in serum-free medium. AB - Brainstem cells from 15-day-old mouse embryos (E 15) grown for 8-10 days in dissociated primary cell culture in serum-free medium show high affinity uptake for [3H]norepinephrine (NE) that is specifically inhibited by desmethylimipramine (DMI), and also show high affinity binding for [3H]DMI. Brainstem cell uptake capacity for NE is increased at least 2-fold when cocultured with target cerebellar or striatal cells of the same embryonic age. The stimulation exerted by the cerebellum appears to be developmentally regulated since more mature cerebella (from 16-17-day-old embryos) exerted a greater stimulation than younger structures (from 14-15-day-old embryos). This stimulatory effect is also correlated with the number of available target sites since increasing the amount of cerebellar cells result in an increased stimulation of uptake capacity. The high affinity binding for [3H]DMI is also enhanced in coculture. The number of noradrenergic neurons, detected by autoradiography, remains unchanged in coculture indicating that added cerebellar cells did not take up NE, suggesting that the number of uptake sites per noradrenergic neuron is increased in the presence of target cells. These results indicate that interactions between afferent and target neurons, which normally take place during in vivo development, also occur in vitro and may result in a modification of neurotransmitter uptake in the afferent neuron. PMID- 6498496 TI - A quantitative Golgi analysis of the postnatal maturation of dendrites in the central nucleus of the inferior colliculus of the rat. AB - In this work, we used Golgi impregnation and computer assistance to analyze the quantitative development of the dendrites of neurons in the central nucleus of the inferior colliculus in the rat from 8 (P8) to 20 (P20) days of age, i.e., during the period of functional maturation of the auditory system. The number and length of the dendritic segments and the number of spines of a total of 516 impregnated cells were studied. The variations of both the mean number of peripheral dendritic segments and the mean dendritic domain area suggest that the dendritic tree of these cells is orientated preferentially in the sagittal plane before the onset of functional maturation, but undergoes a reorientation in the frontal plane during this critical period. The length of dendritic segments varies as a function of both the stage of the period of functional maturation and the order of magnitude of these segments. During the first stage, from P8 to P16, only proximal and intermediate segments lengthen, the distal segments increasing their length later from P16 to P20. The lengthening of the dendritic segments is associated with dramatic reabsorption of the dendritic spines on all dendritic segments and seems closely related to the functional maturation of the auditory pathways. PMID- 6498497 TI - The development of stereociliary bundles in the cochlear duct of chick embryos. AB - The differentiation of hair cell stereociliary bundles was investigated during early stages of embryonic development in the chick cochlear duct. The ultrastructural characteristics of the differentiating stereocilia and the position of the hair cells at the time of their differentiation were determined with scanning (SEM) and transmission (TEM) electron microscopy. Stereocilia were first identifiable with SEM as early as embryonic day 6 (stage 29) in only the distal region of the basilar papilla. By embryonic day 7.5 (stage 32) stereocilia were detected with both SEM and TEM on hair cells located in the distal two thirds of the basilar papilla. Stereociliary bundles were recognizable throughout the entire basilar papilla by embryonic day 9 (stage 35). At this stage the hair cells exhibited a distal-to-proximal gradient in the cell surface area and the number of stereocilia on each hair cell. These results suggest that there is a distal-to-proximal wave of hair cell differentiation which occurs at a very early time period in the development of the chick cochlea. Both the timing and the direction of the stereociliary differentiation contrast with previous ultrastructural reports of avian hair cell development, yet compare favorably with the patterns of functional development in the auditory system. PMID- 6498498 TI - A quantitative comparison of the reactions of retinal ganglion cells to optic nerve crush in neonatal and adult mice. AB - The response of neurons and glia of the ganglion cell layer of the retina to optic nerve crush was studied in adult and neonatal albino mice between 10-85 days post-lesion (dpl). The numbers of ganglion cells and glia surviving optic nerve transection were quantified using Nissl-stained retinal whole mounts. Large and intermediate-sized ganglion cells were more sensitive to axotomy in the optic nerve than small-sized cells. About 80% of the former cells degenerated by 10 dpl in adult mice whilst 90-100% were affected in neonates. 40-60% of the small-sized ganglion cells survived in adults whilst in neonates, although a similar number escaped the effects of axotomy at 10 dpl, by 30 dpl only less than 10% remained. These aspects were reflected in the changes in the relative frequency distribution with time of ganglion cells in normal and lesioned mice. No significant alterations in glial cells in the ganglion cell and fibre layers of the retina were recorded at any time of lesioning the optic nerve. PMID- 6498499 TI - A qualitative comparison of the reactions of retinal ganglion cell axons to optic nerve crush in neonatal and adult mice. AB - The reaction of ganglion cell axons in the mouse retina to optic nerve crush was studied in adult and neonatal albino mice 10-85 days after operation, using silver-stained retinal whole mounts and sagittal sections of retina and optic nerve. In both adult and neonatal animals the majority of neural cells and axons degenerated; surviving neurons had small cell bodies. Degeneration was more marked in neonatal neurons compared to adult neurons. In the adult study, two populations of axonal sprouts growing from the ends of the severed ganglion cell axons were identified. One population, representing the large majority of fibres grew for up to 20 days after operation in the myelinated retinal stump of the optic nerve and then degenerated. A smaller number of axons grew for the whole duration of the study, initially in the inner plexiform area juxtaposed to the non-myelinated optic nerve head and peri-papillary region of the retina, but later invaded the entire retina. In the neonate, no evidence of axonal regeneration was seen, although transient axonal collateral sprouting of surviving ganglion cells occurred. PMID- 6498500 TI - Postnatal development of the inferior olivary complex in the rat. III. A morphometric analysis of volumetric growth and neuronal cell number. AB - The overall volume of the three main inferior olivary (ION) subnuclei increases four-fold between the day of birth (PO) and P21. The rate of this increase is uneven; between P10 and P15 there is an abrupt acceleration which parallels the period of intense synaptogenesis and maturation of the neuropil. The growth of the various subnuclei occurs in an almost synchronous manner. A study discloses that the postnatal volumetric increase is the result of the development of the neuropil and the glial cells. The numerical estimation of neuronal perikarya was made for each ION subnucleus from P0 to P33. However, due to methodological problems, the quantitation becomes reliable only from P5 onwards. From P5 to P8, there is a small (10%) but consistent decrease in the number of olivary neurons, a decrease which is homogeneously shared by the 3 main subnuclei. This phase of reduction in neuronal numbers, indicative of cellular death, is followed by an increase of similar magnitude, between P10 and P15. Since the phase of apparent olivary cell death coincides with the peak of the regression of the multiple innervation of Purkinje cells (PCs) by climbing fibers (CFs), both processes might be interrelated. However, the slight amplitude of the cell death is inadequate to fully explain the whole process of synaptic regression. These results indicate a dual nature of the mechanism underlying the establishment of the one-to-one relationship between CFs and PCs: a small proportion of the regression results from cell death, while the largest proportion must be the result of a loss of collaterals from the olivary axons at the origin of the CFs. The problem of the increase in the number of ION neurons between P10 and P15 is discussed in relation to recent morphometric data indicating a late increase in the number of PCs of the cerebellum. PMID- 6498501 TI - Architectonic and hodological organization of the cerebellum in reeler mutant mice. AB - The architectonic and hodologic organization of the reeler cerebellum has been studied by means of immunohistochemistry, general cell and fiber stains and by horseradish peroxidase and autoradiographic tracing methods. Malposition of Purkinje cells, which varies in degree, is the most salient architectonic anomaly of the mutant cerebellum. Mapping the distribution of Purkinje cells is facilitated by a monoclonal antibody which selectively stains neurons of this class in the cerebellum. Although some Purkinje cells form a normal monolayer, most lie in heterotopic positions within or below the granule cell layer. The major contingent is segregated in subcortical masses in the depths of the cerebellum. Fiber bundles continuous with the cerebellar peduncles run in septa between the subcortical Purkinje cell masses. The distribution of Purkinje cell masses as well as the roof nuclei and areas of normal cortex and fiber bundles are identical from animal to animal. These consistent architectonic variations serve to partition the reeler cerebellum into 7 sagittally oriented compartments: one medial, two intermediate, two lateral and two additional lateral lobular appendages which may correspond to paraflocculus and/or flocculus of the normal cerebellum. The topography of the reeler olivocerebellar, or climbing fiber, system is normal in that the caudal-to-rostral axis of the olivary complex maps onto the medial-to-lateral axis of the contralateral hemicerebellum. The climbing fiber projection in reeler, like that of the normal animal, appears to be organized in parasagittal strips. In the mutant, mossy fibers from the pons and spinal cord project respectively to the lateral and medial cerebellar fields, and overlap in the intermediate compartment. They thus invest different and to a large extent complementary cerebellar territories, which approximate the architectonic divisions. This segregation of the two principal mossy fiber systems is not so marked in the normal cerebellum. In terms of laminar distribution, the pontine projection is distributed principally to the granule cell stratum in the mutant. The reeler spinocerebellar afferents, by contrast, project not only to the granule cell layer but also to the heterotopic Purkinje cells. The present observations suggest that the primary defect in the reeler cerebellum is malposition of Purkinje cells. As appears to be the case during development of the forebrain in reeler, the mutation may affect the terminal phase of migration of Purkinje cells in the cerebellum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6498502 TI - Glycogen, its transient occurrence in neurons of the rat CNS during normal postnatal development. AB - Progressive changes in the postnatal incidence, distribution and duration of glycogen in neurons of the pons, medulla and spinal cord were studied by light and electron microscopy using cytochemical and quantitative methods. Albino rats of 11 ages ranging from newborn to adult were used for this investigation. Methacrylate sections, stained with periodic acid-Schiff-dimedone (PAS) were surveyed to identify nerve cell groups containing the polysaccharide, glycogen. The PAS reaction was positive in neuronal cell groups of the hypoglossal nucleus, the mesencephalic nucleus of V, nucleus ambiguus, the abducens nucleus, the facial motor nucleus and anterior horn cells of the spinal cord. The intensity and duration of the PAS reaction appeared greatest in the hypoglossal nucleus. Neurons of the mesencephalic nucleus of V demonstrated a reaction of moderate intensity and duration. The remaining nerve cell groups exhibited a weak, diffuse reaction of brief duration. Postnatal differences in the incidence and patterns of disposition of glycogen were quantified using ultrathin sections of the hypoglossal nucleus, the site richest in glycogen. The presence of glycogen was verified by the periodic acid-thiosemicarbizide-silver proteinate (PA-TSC-SP) ultracytochemical stain. The incidence of glycogen in neuronal perikarya of hypoglossal nuclei was related to age. All neurons contained some glycogen during the first postnatal week. By 24 days postnatal (dpn), the majority of hypoglossal neurons lacked glycogen and all neurons of adult rats were glycogen free.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498503 TI - Development of dendritic patterns in the lateral geniculate nucleus of monkey: a quantitative Golgi study. AB - Quantitative analysis of dendritic branching patterns was performed in rapid Golgi sections of the lateral geniculate nucleus of Old World monkeys at several ages, using a computer-microscope and a tree-analysing program. In parvocellular and magnocellular multipolar neurons the dendrites were analysed in centrifugal order and according to whether they were intermediate or terminal segments. Between late gestation and birth there is an increase in the mean length of dendrites, and in the total length of dendrites per neuron, more pronounced in magnocellular layers; there follows a progressive decrease in their length until adulthood. However, only terminal dendritic segments are involved in these changes in length. Intermediate segments are shorter and show a more or less constant length throughout life. The final length of a segment seems more determined by it being terminal or intermediate than by its order of branching and there is greater plasticity in the terminal part of the dendritic tree. Magnocellular neurons are characterized by a greater number of both intermediate and terminal segments than parvocellular neurons but not by a greater length of individual segments. This accounts for the greater dendritic length in magnocellular neurons and may offer them a larger surface for synaptic connectivity. PMID- 6498504 TI - Selection of pathways by regenerating spinal cord fiber tracts. AB - We have traced fiber tracts in the regenerating teleost spinal cord and have found that the regenerative capabilities of fiber tracts coming from different parts of the CNS vary considerably. Some descending tracts can regenerate up to 5.6 mm beyond a transection, while other fiber tracts cannot even penetrate the scar tissue. In spite of a great disturbance of their normally ordered pathways as they grow through the lesion site, those tracts which can regenerate can find their appropriate funiculi in the distal spinal cord. PMID- 6498505 TI - Effects of sex steroids on the development of the accessory olfactory bulb in the rat: a volumetric study. AB - The effects of postnatal (on day 1 after birth) male castration and female androgenization on accessory olfactory bulb (AOB) volume were studied. Control males showed greater values than females in AOB volume. Postnatal treatments abolished and inverted these differences. It is suggested that the AOB development is influenced by sex steroids during at least a postnatal period. PMID- 6498506 TI - Tracing of afferent and efferent pathways in the left inferior cardiac nerve of the cat using retrograde and transganglionic transport of horseradish peroxidase. AB - Retrograde and transganglionic transport of horseradish peroxidase (HRP) was used to trace afferent and efferent pathways in the left inferior cardiac nerve of the cat. Cardiac efferent and afferent neurons were located, respectively, in the stellate ganglion (average cell count per experiment:2679) and in the ipsilateral dorsal root ganglia (DRG) from C8 to T9 (average cell count per experiment:213). Labeled cardiac afferent projections to the spinal cord were most dense in segments T2-T6 where they were located in Lissauer's tract and in lamina 1 on the lateral border of the dorsal horn. Labeled afferent axons extended ventrally through lamina 1 into lamina 5 and the dorsolateral region of lamina 7 in proximity to the intermediolateral nucleus. A weak projection was noted on the medial side of the dorsal horn. These sites of termination are similar to projections by other sympathetic afferent pathways (i.e. renal, hypogastric and splanchnic nerves) to the lower thoracic and lumbar spinal cord, indicating that visceral afferents may have a uniform pattern of termination at various segmental levels. This pattern of termination in regions of the gray matter containing spinothalamic tract neurons and neurons involved in autonomic mechanisms is consistent with the known functions of sympathetic afferent pathways in nociception and in the initiation of autonomic reflexes. PMID- 6498507 TI - Age-related changes in cytoplasmic estradiol receptor concentrations in microdissected brain nuclei: correlations with changes in steroid-induced sexual behavior. AB - The purpose of this study was to; determine at what age changes in cytoplasmic estradiol receptors are evident in specific microdissected brain areas of the female rat; assess whether alterations parallel previous changes observed when large brain areas were used for determination of receptor concentrations; and assess whether changes in cytoplasmic estradiol receptors are correlated with changes in steroid-mediated physiological functions. To assess the effects of age on cytoplasmic estradiol receptor concentrations, we used virgin female Sprague Dawley rats at 3-4 months, 7-8 months and 10-11 months of age. They were ovariectomized 7-14 days prior to use to allow maximal translocation of receptors to the cytoplasm. The animals were anesthetized and perfused with a 10% (v/v) solution of dimethylsulfoxide to protect the receptor proteins from the effects of freezing. Brains were removed and frozen. This procedure of freezing the brains caused a minimal (15-18%) loss in the number of receptors and no change in the dissociation constant. Consecutive 300 micron sections were sliced and the following nuclei and brain areas were microdissected: bed nucleus of the stria terminalis, suprachiasmatic-preoptic area, medial preoptic nucleus, periventricular preoptic nucleus, periventricular anterior hypothalamic area, paraventricular nucleus, dorsomedial nucleus, ventromedial nucleus, arcuate median eminence, medial amygdala, and cortical amygdala. The pituitary gland was also removed and analyzed. The cytoplasmic fraction from a tissue pool from 3 animals was prepared and aliquots were incubated with [3H]estradiol at a final concentration of 1.5 nM in the presence or absence of 100-fold excess moxestrol. Receptor-bound [3H]estradiol was separated from free hormone by gel filtration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498508 TI - Midbrain stimulation inhibits tail-flick only at currents sufficient to excite rostral medullary neurons. AB - The effects of midbrain electrical stimulation on the activity of tail-flick (TF) related neurons in the rostral ventromedial medulla (RVM) were studied. Neurons whose activity either decreased (off-cells) or increased (on-cells) immediately prior to TF were examined. Of 31 off- and on-cells, 26 (84%) showed increased activity during midbrain stimulation sufficient to suppress the TF. Furthermore, in 21 of these cells, the threshold for activation was identical to the threshold for TF suppression, and in the other 5 cells the threshold difference was less than or equal to 5 microA. This study provides evidence that off-and on-cells in the RVM mediate the antinociceptive actions of midbrain stimulation. PMID- 6498509 TI - Tail-flick related activity in medullospinal neurons. AB - Using the classification system of Fields et al. 131 neurons in the rostral ventromedial medulla (RVM) of lightly anesthetized rats were divided into 3 groups according to their response during tail-flick (TF) testing: those with an abrupt increase in activity prior to TF (on-cells); those with a sudden pause in activity prior to TF (off-cells); those with no change in activity prior to TF (neutral cells). Collision testing was performed using a cervical spinal cord stimulating electrode to determine whether these neurons projected to the cord. Conduction velocities were determined for all cord-projecting neurons. All 3 cell types projected to the cord and approximately 38% of cord-projecting neurons were flick-related (off-or on-cells). All projecting neurons were within or immediately adjacent to the nucleus raphe magnus. The mean conduction velocity of on-cell axons (17.7 m/s) was significantly greater than that of off-cell axons (10.7 m/s) and neutral cell axons (12.4 m/s). Conduction velocities for all cells were within the range for myelinated axons. These findings support the hypothesis that off-and on-cells in the RVM play a significant role in pain modulation at the spinal cord level. PMID- 6498510 TI - Nigral dopaminergic neurons: differential sensitivity to apomorphine following long-term treatment with low and high doses of amphetamine. AB - Twice daily injections of 1.0 or 5.0 mg/kg D-amphetamine for 6 consecutive days differentially affected the response of dopaminergic neurons in the substantia nigra pars compacta to challenge injections of apomorphine on the following day. Thus, whereas treatment with the high amphetamine dose produced a dramatic shift to the right of the apomorphine dose-response curve, rats treated with 1.0 mg/kg D-amphetamine responded to apomorphine in the same way as saline-treated controls. These results support the view that long-term treatment with relatively high amphetamine doses is required to produce autoreceptor subsensitivity in the substantia nigra. PMID- 6498511 TI - Olfactory bulbectomy prevents the gonadal regression associated with short photoperiod in male golden hamsters. AB - In male rats, pre-pubertal olfactory bulbectomy (BX) unmasks photoperiodic responsiveness so that maintenance of BX animals on short photoperiod results in a pineal gland mediated gonadal regression (Nelson and Zucker, Neuroendocrinology, 32 (1981) 266). The objective of the present study was to determine the effect of BX in Syrian hamsters, a species where short photoperiod alone induces a pineal gland induced testicular regression. Pre-pubertal (25-days old) Syrian hamsters underwent either sham BX, BX, or pinealectomy (PX) plus BX. One half of each group was then placed on an LD 14:10 photoperiod and the other half on LD 6:18. Thirteen weeks later all animals were decapitated. In the animals on LD 14:10, BX resulted in a slight but highly significant increase in testes weight but had no effect on other parameters examined. Sham BX hamsters on LD 6:18 had regressed testes and reduced serum testosterone levels, but these effects of short photoperiod were reversed in BX hamsters, so that the testes and seminal vesicles remained large. In addition, serum LH and testosterone levels were elevated following BX of the animals on LD 6:18. These results indicate that the olfactory bulbs tonically inhibit the reproductive system even in male hamsters maintained on long photoperiod and that olfactory bulbectomy prevents gonadal regression in male Syrian hamsters on short photoperiod, an effect which is the opposite of results obtained in rats on short photoperiod. Elucidation of the neural pathways involved and the nature of the relationship between the olfactory bulb and the pineal gland or photoperiodism remains for further investigation. PMID- 6498512 TI - Depolarization-induced effects of Ca2+-calmodulin-dependent protein kinase injection, in vivo, in single neurons of cat motor cortex. AB - Intracellular injection of calcium-calmodulin-dependent protein kinase followed by depolarization and depolarization-elicited impulse activity increased input resistance of neurons of the motor cortex of cats. Protein kinase alone or depolarization in the absence of protein kinase did not produce this effect. An analogous increase of input resistance can be produced in the type B photoreceptor of Hermissenda by applying protein kinase and sufficient depolarization to increase calcium conductance and internal Ca2+ concentration. Given previous studies linking changes in both types of neurons to the development of conditioning, the results suggest the possibility of shared biochemical steps in mechanisms of neuronal adaptation by vertebrate and invertebrate species. PMID- 6498513 TI - A field-potential study of centripetal and centrifugal connections of the olfactory bulb in the carp, Cyprinus carpio (L). AB - The projection areas of mitral cell axons in the lateral (LOT) and medial (MOT) olfactory tracts and the pathways of two groups of centrifugal fibers (with fast and slow conduction velocities) to the olfactory bulb were studied in the carp using the field potential method. Mitral cell axons of the LOT and those of the MOT projected to the overlapping areas in the bilateral telencephalon and preoptic area (POA), the contralateral MOT, and the nucleus posterior tuberis (NPT) in the diencephalon. However, the precommissural, ventromedial part of the ipsilateral telencephalon received the projection only from mitral cell axons of the MOT, not from those of the LOT. No projection was detected in the contralateral LOT and the contralateral olfactory bulb. The distribution of the fast and slow centrifugal fibers and/or their cells of origin were similar to each other. They were distributed bilaterally in the telencephalon and POA, in the NPT, and contralateral LOT and MOT. These areas overlapped with the projection areas of the mitral cell axons considerably. The results support and extend those obtained from anatomical studies. PMID- 6498514 TI - Veratridine-induced release of acetylcholine from mouse forebrain minces: dependence on the hydrolysis of cytoplasmic acetylcholine for a source of choline. AB - The importance of depolarization induced hydrolysis of cytoplasmic acetylcholine (ACh) in providing choline for the veratridine-and high K+-induced release of acetylcholine was studied in mouse forebrain minces. Results indicated that a loss of hydrolyzable cytoplasmic ACh prior to depolarization reduced the amount of ACh released by veratridine but not the amount released by high K+. The reduction in the veratridine-induced release of ACh did not occur during the first 5 min of incubation. Loss of vesicular ACh prior to depolarization reduced both the veratridine- and K+-induced release of ACh during the first 5 min of incubation. Blockade of extra-cellular choline transport by hemicholinium (HC-3) did not affect the veratridine-induced release of ACh during a 10 min incubation period unless the cytoplasmic pool of ACh had first been depleted and was unavailable as a source of choline. In contrast, HC-3 reduced the K+-induced release of ACh from brain tissue with normal stores of cytoplasmic ACh. These results indicate that both depolarizing agents primarily stimulate the release of preformed ACh from a vesicular fraction during the first 5 min of mince incubation. Thereafter, they both stimulate the release of newly synthesized ACh, however, they differ in one important respect. The principal source of choline for the veratridine-induced release of newly synthesized ACh appears to be the cytoplasmic pool of ACh, whereas the major source of choline for the K+-induced release of newly synthesized ACh appears to be extracellular choline. PMID- 6498515 TI - Dendritic changes in the spinal dorsal horn following transection of a peripheral nerve. AB - In an attempt to examine the morphologic changes which take place in the spinal dorsal horn as a consequence of peripheral nerve injury, the superficial radial nerve was cut and prevented from regenerating in adult cats. In laminae I-V of the 7th cervical segment of spinal dorsal horn at 2 weeks, 1 and 2 months following transection, small and medium-sized dendritic shafts developed membrane bounded cavities. These cavities varied in number and size in each dendrite and were sometimes connected to the agranular reticulum. Large cavities often hollowed out a dendrite, leaving little remaining cytoplasm between the cavity membrane and the plasma membrane. Small and large cavities were frequently found open to the intercellular space. Synaptic glomeruli showed a loss of small dendrites with empty scalloped depressions in the central axonal endings of these structures left exposed to enlarged intercellular spaces. In addition, clusters of many enlarged oval or irregular intercellular spaces were found in the neuropil where many cavitated dendrites were observed. At least some of these intercellular spaces were thought to be derived from the loss of dendrites. From these observations we conclude that small and medium-sized dendrites involute through cavitation and eventually disappear from the spinal dorsal horn when primary input is disturbed by transection of peripheral sensory nerves. PMID- 6498516 TI - Characterization of angiotensin binding to gerbil brain membranes using [125I]angiotensin III as the radioligand. AB - The observation that an Angiotensin II (AII)-sensitive species, the gerbil, exhibited little or no [125I]AII binding to brain membranes led to the hypothesis that AII's central action may be mediated by smaller and/or modified fragments of AII. This possibility was assessed, in part, by examining the ability of gerbil brain membranes to specifically bind [125I]desAsp1 AII (AIII), a heptapeptide fragment of AII. Specific binding was evident throughout the gerbil brain with highest binding in the septum (containing the subfornical organ), anterior ventral third ventricular region, hypothalamus (containing the median eminence), and striatum. This binding was found to possess many of the properties commonly associated with binding to membrane bound receptors. The binding within the circumventricular organs had characteristics that set them apart from the other central nervous tissues examined. Both the olfactory bulb and adrenal gland appeared to have two different angiotensin binding sites. It appears that the binding sites within the brain interact with a product of the metabolism of AIII or AII rather than the peptides themselves. The results suggest that [125I]AIII appears to be a better ligand than [125I]AII in the binding assay because it is more readily degraded to another substance. PMID- 6498517 TI - Seizures produced by pilocarpine in mice: a behavioral, electroencephalographic and morphological analysis. AB - Increasing doses of pilocarpine, 100-400 mg/kg, were given intraperitoneally to mice and the resulting behavioral, electroencephalographic and neuropathological alterations were studied. No behavioral phenomena were observed in mice treated with the lowest dose of pilocarpine. Occasional tremor and myoclonus of hindlimbs were found in animals which received pilocarpine in a dose of 200 mg/kg. At doses of 300, 325 and 350 mg/kg, pilocarpine produced a sequence of behavioral alterations including staring spells, limbic gustatory automatisms and motor limbic seizures that developed over 15-30 min and built up progressively into a limbic status epilepticus lasting for several hours. The highest dose of pilocarpine, 400 mg/kg, was generally lethal to mice. Pilocarpine produced both interictal and ictal epileptiform activity in the electroencephalogram (EEG). The earliest EEG alterations appeared in the hippocampus and then spread to cortical areas. EEG seizures started 10-15 min after injection of large doses of pilocarpine, 300-350 mg/kg. Ictal periods lasted for 1-2 min, recurred every 5-10 min and were followed by periods of depression of the EEG activity. By 30-45 min paroxysmal activity resulted in a status epilepticus. Examination of frontal forebrain sections with light microscopy revealed a widespread damage to several brain regions including the hippocampus, amygdala, thalamus, olfactory cortex, neocortex and substantia nigra. Scopolamine, 10 mg/kg, and diazepam, 10 mg/kg, prevented the development of convulsive activity and brain damage produced by pilocarpine. The results emphasize that excessive and sustained stimulation of cholinergic receptors can lead to seizures and seizure-related brain damage in mice. It is proposed that systemic pilocarpine in mice provides a useful animal model for studying mechanisms of and therapeutic approaches to temporal lobe epilepsy. PMID- 6498518 TI - Cardiovascular and T2-T4 dorsal horn cell responses to gallbladder distention in the cat. AB - Effects of gallbladder distention on blood pressure, heart rate, and T2-T4 dorsal horn cell activity were determined in 18 cats anesthetized with alpha-chloralose. Distention of the gallbladder (10-100 mm Hg) increased blood pressure in 17 of 18 cats, but heart rate was altered in only 2. The gallbladder pressure-blood pressure relation was derived for 11 cats. Pressor responses were greater with greater distending pressures over the gallbladder pressure range of 20-80 mm Hg. The maximum increase in blood pressure was 21 +/- 6 mm Hg at a gallbladder pressure of 80 mm Hg. Effects of gallbladder distention were tested on 64 T2-T4 dorsal horn neurons which met the following criteria: they had a somatic receptive field and were excited or inhibited by electrical stimulation of the left greater splanchnic nerve. In addition, all 64 neurons responded to stimulation of cardiopulmonary sympathetic afferent fibers. Gallbladder distention excited 17 cells and inhibited 9 cells. Responses usually consisted of phasic and tonic components. Significant increases or decreases in cell activity were elicited at a gallbladder pressure of 40 mm Hg. Pressor responses as well as changes in cell activity were abolished or greatly attenuated when both greater splanchnic nerves were sectioned. Vagotomy had no effect. Gallbladder pressure thresholds for a change in blood pressure (27 +/- 3 mm Hg) and cell activity (29 +/- 4 mm Hg) were not significantly different. Cells responding to gallbladder distention were located in laminae IV-VII of the T2-T4 segments. We conclude that gallbladder distention alters cell activity in the upper thoracic spinal cord and increases blood pressure. These findings may explain the phenomenon of chest pain which results from disease of the gallbladder. PMID- 6498519 TI - Binaural interaction effects on the auditory brainstem response of the cat and kitten. AB - The auditory brainstem response (ABR) is a series of volume conducted potentials that can be recorded from the scalp within 10 ms following auditory stimulation. Differences between ABRs evoked with binaural stimulation and those constructed by summing equivalent numbers of monaural stimulation to each ear indicate the presence of binaural interaction for some ABR potentials but not for others. In the present study, ABR binaural interactions were studied in both cats and kittens. Binaural interactions were not seen for waves 1-3 but were present at the latencies of waves 4, 5 and, in most cases, 6. The sound intensities used were selected to insure that acoustic cross-over, i.e. sound presented monaurally to one ear stimulating the other, did not influence binaural interaction effects. Experiments with cats that had been monaurally deafened confirmed that the effects observed were not due to acoustic cross-over. Systematic manipulation of stimulus rate and intensity produced marked changes in the level of binaural interaction. Increases in stimulation rate from 10 to 100 clicks/s reduced binaural interaction for wave 4 and reversed the direction of binaural interaction for wave 5. Wave 6 was not generally present at rates above 10 clicks/s. Reduction of stimulus intensity reduced binaural interaction for wave 4. Binaural interaction effects were at adult levels in kittens of 20 days for waves 4 and 5. Wave 6 was not present until 30 days of age. These data suggest a possible model of the physiological processes producing binaural interaction which is based on occlusion as seen in other areas of the nervous system. In such a model, convergent input becomes more important in driving the generators of some ABR potentials when the system is stressed (as, for example, by increased stimulus rate), than it is when the system is not stressed. PMID- 6498520 TI - Effect of phencyclidine (PCP) on blood pressure and catecholamine levels in discrete brain nuclei. AB - PCP (10 mg/kg, s.c.) causes hypertension that is associated with decrease or tendency to decrease the levels of epinephrine and norepinephrine in the hypothalamus and the brainstem regions. If this represents a decreased catecholaminergic activity, then this may enhance sympathetic activity and contribute to the PCP-induced hypertension. PMID- 6498521 TI - Changes in projection from locus coeruleus to lateral geniculate nucleus following ablation of visual cortex in adult rats. AB - The visual cortex of adult rats was unilaterally ablated. A histofluorescence study revealed an increase of noradrenergic terminals in the lateral geniculate nucleus (LGN) ipsilateral to the decortication, confirming the previous report. Corresponding to this, the frequency for encountering neurons in the locus coeruleus (LC) activated antidromically from the LGN was increased. We suggest that LC neurons whose axon terminals were damaged by ablation of the visual cortex formed new axons or axon collaterals (pruning effect) in the LGN, thus contributing, at least partly, to the increase of noradrenergic terminals therein. PMID- 6498522 TI - [D-Arg]Kyotorphin-induced ipsilateral rotation: evidence for in vivo effects independent of Met-enkephalin release. AB - Kyotorphin (Tyr-Arg) and its stable analogue [D-Arg]kyotorphin were injected into the substantia nigra of rats. Intranigral [D-Arg]-kyotorphin resulted in consistent ipsilateral rotational behavior which was naloxone-reversible. In comparison, intranigral Met-enkephalin induces naloxone-sensitive contralateral rotation. These results indicate a pharmacological effect of [D-Arg]kyotorphin in the substantia nigra that would appear to be independent of Met-enkephalin release. PMID- 6498523 TI - Neurons in the ventral tegmentum have separate populations projecting to telencephalon and inferior olive, are histochemically different, and may receive direct visual input. AB - The connections of the ventral tegmental area (VTA) and medial terminal nucleus (MTN) of the accessory optic system were studied in the albino rat. Using injection of two fluorescent retrograde tracers it was found that individual neurons of the VTA project to frontal cortices or the inferior olive but not both structures. Using combined retrograde fluorescent tracers and glyoxylic acid histochemistry, it was found that although a third of the cells projecting to frontal cortex contained catecholamine, none of the cells projecting to the inferior olive contained catecholamine. Thus, these portions of the ascending and descending VTA systems are independent. In addition, using injections of the anterograde transneuronal tracer [3H]adenosine into one eye, it was found that cells in the VTA, as well as the MTN, contained the tracer. Therefore, there is a basis for direct retino-mesentelencephalic pathways through the VTA. PMID- 6498524 TI - The complex binding of tricyclic antidepressants to rat brain: the case of nortriptyline. AB - [3H]Nortriptyline (NT) binding to rat brain sections was characterized using saturation and competition experiments, quantitative autoradiographic localization and monoaminergic lesions. [3H]NT binding exhibits a saturable component in the nM range (high affinity binding). Final saturation is reached only in micromolar concentrations (low affinity binding). The high affinity binding sites of [3H]NT appear in areas rich in noradrenergic and serotonergic terminals, and are decreased by 6-OHDA and 5,7-DHT lesions, to an extent depending on the brain region and the relative density of noradrenergic and serotonergic terminals there. We conclude that [3H]NT binds with high affinity to both noradrenergic and serotonergic nerve terminals, and with low affinity to other yet uncharacterized entities. This complex binding pattern is compatible with the multiplicity of biochemical, physiological and behavioral effects of NT and tricyclic antidepressants in general. PMID- 6498525 TI - Sprouting and retraction of neurites by undamaged adult molluscan neurons. AB - The present study examined the morphology of an identified molluscan neuron subsequent to exposure of animals to a variety of forms of stress. The neuron exhibited the sprouting and retraction of a single neurite in response to specific forms of animal stress. This new form of neuronal plasticity may provide an insight into the factors regulating adult neuronal morphology. PMID- 6498526 TI - Enhancement of central cholinergic sprouting by prior injury: correlation with endogenous trophic content of hippocampus. AB - Injury to neural tissue elicits the release of neurotrophic substances which support the survival of cultured cholinergic neurons. The aim of the present report was to determine the effect of prior hippocampal injury on the sprouting of mature intrinsic cholinergic septal afferents in vivo. Levels of choline acetyltransferase (CAT) in intrahippocampal iris implants were used as an index of cholinergic regeneration. The results show that prelesioning the hippocampus 1 week prior to insertion of the iris increased CAT levels of implants left for 8 days in situ. Levels of iris CAT were correlated with the trophic content of the surrounding hippocampal tissue. These observations suggest that endogenous trophic factors released as a consequence of neural injury facilitate cholinergic sprouting in vivo. PMID- 6498527 TI - Some effects of sympathetic stimulation and isoprenaline on fatigued tetanic contractions of skeletal muscle in the cat. AB - In anaesthetized cats, stimulation of the lumbar sympathetic trunk inconsistently elicited small increases in the contraction of fatigued Peroneus Longus muscles (Orbeli phenomenon). Facilitation of this anti-fatigue effect was regularly observed following close intra-arterial injection of isoprenaline, a beta adrenergic agonist. Injection of the drug by itself exerted a marked anti-fatigue effect on muscle contraction. PMID- 6498528 TI - Harmaline disrupts acquisition of conditioned nictitating membrane responses. AB - A basic tenet of the Marr-Albus theory of motor learning is that the learning process involves concurrent activation of the climbing fibre and mossy fibre inputs to the cerebellum. This theory was tested by administering harmaline, a drug which causes climbing fibres to fire at their maximal rate of 8-12 Hz, to rabbits during a classical conditioning protocol. Harmaline significantly reduced the proportion of conditioned nictitating membrane responses on each of 4 successive training days. When harmaline was given to already-conditioned rabbits, the proportion of conditioned responses fell sharply to the day 1 level: however, this was still a higher proportion of conditioned trials than that which was seen with naive animals trained for 4 days with harmaline. It is therefore concluded that harmaline disrupts the acquisition of classically-conditioned nictitating membrane responses but does not prevent the expression of an already learnt response. These findings are therefore consistent with the proposal in the Marr-Albus theory that the climbing fibres play an essential part in motor learning. PMID- 6498529 TI - Effect of dopamine receptor blockade or norepinephrine synthesis inhibition on acute, ovariectomy-induced increases in pulsatile luteinizing hormone release in the rat. AB - The initial aim of the present studies was to examine the influence of blockade of dopamine (DA) receptors with pimozide or inhibition of norepinephrine (NE) synthesis with U-14,624 on acute, ovariectomy (OVX)-induced changes in pulsatile LH release. Either treatment instituted at the time of OVX suppressed or inhibited the rapid increase in LH pulse amplitude and frequency normally occurring within 24 hr following ovarian removal on diestrus 1. While administration of pimozide at either 24 hr or 48 hr following OVX suppressed pulsatile LH release by selectively reducing LH pulse frequency, by 8 days following OVX pimozide failed to exert any effect on LH pulse frequency and therefore on pulsatile LH secretion. To determine if there was a transient critical period following OVX of at least 2 days but less than 8 when endogenous DA was excitatory to pulsatile LH release, piribedil (a DA receptor agonist) was given 24 hr following OVX. Rather than increase LH secretion, piribedil markedly suppressed pulsatile LH release indicating that DA does not stimulate LH secretion in acutely ovariectomized rats. These experiments indicate that (1) NE is involved in stimulating the acute, OVX-induced increase that occurs in pulsatile LH release; (2) DA receptor blockade by pimozide has a differential effect on pulsatile LH secretion which depends on the time following OVX when the compound is administered; (3) this differential effect cannot be explained by a transient critical period of a few days duration following OVX during which DA is excitatory to pulsatile LH release. PMID- 6498530 TI - The effect of hypothalamic temperature on the immune response in the rat. AB - To clarify the role of febrile temperatures on the immune system, rats were immunized with sheep erythrocytes and their core temperature was then changed by continuously cooling or heating the preoptic area for five days. Core temperatures of up to 2 degrees C above or below normal were associated with a high titre of antibodies against sheep erythrocytes, whereas larger displacements of core temperature, as well as normal temperature, were associated with a low titre. These results are at variance with the idea that the production of antibodies is proportional to body temperature. It is suggested that the immunostimulation elicited by heating and cooling the preoptic area, and by inference that the immunostimulation associated with fever, could be due to factors other than the change in body temperature. PMID- 6498531 TI - Maintenance of regional chemical integrity for energy metabolites in microwave heat inactivated mouse brain. AB - A method is described in which brain tissue from microwave heat inactivated mouse brain is prepared for microregional energy metabolite analysis. This method permits the sectioning of the tissue into sections 40 microns thick in which layers can be visualized and dissected. Results show no movement or leaching of metabolites from one microregion to another. This method therefore, permits the combined use of the two powerful neurochemical techniques of microwave irradiation for sacrifice and microregional analysis for energy metabolite determination. PMID- 6498533 TI - Steady-state visual evoked responses in anesthetized monkeys. AB - Steady-state stimuli are repeated continuously at a frequency that evokes averaged EEG waveforms with components at a frequency which is the same or some multiple of the stimulus rate. A variety of stimulus parameters are readily manipulated and controlled. We wished to assess the suitability of this approach for animal experimentation, and chose to evaluate steady-state visual evoked potential (VEP) responses to counterphased checkerboard stimuli in anesthetized adult male Rhesus monkeys. Large VEPs were reliably produced over the range of 3 6 Hz reversal rate; at 10 Hz, the VEP spectral power was clearly diminished in all monkeys. At each given reversal rate, monkeys differed substantially in variability and amount (up to 3-fold) of spectral power. These large inter subject differences paralleled what we have seen in similar studies of unanesthetized humans. All monkeys developed large VEPs at the midline, but the topographic distribution of maximum VEP was not uniform; in 3 monkeys the power was much greater over one hemisphere than the other. Fatigue or habituation was not evident; in each monkey, there were usually no significant differences in VEP power over the 3 consecutive 30 sec segments of a given stimulation. We conclude that the anesthetized monkey can be a suitable model for study of steady-state phenomena, as long as the proper stimulus parameters are employed and as long as the level of variance is taken into account. PMID- 6498532 TI - Inhibition of brain acetylcholine biosynthesis by methyldopa in spontaneously hypertensive rats. AB - The formation of 3H-acetylcholine was measured in several brain regions of spontaneously hypertensive (SH) rats following intracerebroventricular injection of 3H-choline. Endogenous acetylcholine (ACh) also was measured and specific activity-time curves for brain ACh generated for control SH rats and for SH rats pretreated with methyldopa (100-200 mg/kg, IV). The relative turnover rates for ACh in several brain regions was estimated from the specific activity-time curves. The turnover rates of ACh in rostral hypothalamus, caudal hypothalamus, medulla oblongata and pons were reduced by 34-54%. Apparently synthesis was inhibited also since methyldopa produced relatively little effect on ACh levels. More rostral brain regions, thalamus-septum, midbrain and striatum, were not significantly affected by methyldopa. Methyldopa also reduced arterial pressure by 53/28 mmHg. The ability of methyldopa to inhibit the function of cholinergic neurons in selective brain regions may be responsible for its common "anticholinergic" side effects. Since centrally-acting anticholinergic drugs reduce arterial pressure in SH rats, it is possible that inhibition of brain ACh synthesis by methyldopa also may contribute to its antihypertensive action in experimental genetic hypertension. PMID- 6498534 TI - Responses of preoptic neurons to stimulation of caudal and rostral brain stem reticular structures. AB - Effect of stimulation (1 Hz) of rostral and caudal brain stem reticular formation was studied on 41 neurons of preoptic area in encephale isole cats. Primary excitation was seen on almost all the 25 neurons influenced by stimulation of either of the areas. Many of these influenced neurons received inputs from both areas and showed poststimulatory oscillations in excitability. The two brain stem reticular structures, which have antagonistic influence on cortical EEG, cortical and subcortical neuronal activity, had identical influence on preoptic area neurons when stimulated at 1 Hz. PMID- 6498535 TI - Cellular mechanisms of acute estrogen negative feedback on LH secretion: norepinephrine, dopamine and 5-hydroxytryptamine metabolism in discrete regions of the rat brain. AB - Rats on diestrous day 1 were ovariectomized (OVX) and killed 10 days later. LH was measured by RIA and the metabolism of NE, DA and 5-HT were assayed concurrently in the suprachiasmatic (SCN), medial preoptic (MPO), dorsomedial (DMN), rostral (ANr) and caudal (ANc) arcuate nuclei as well as the median eminence (ME) utilizing HPLC with electrochemical detection. Serum LH increased 10-12 fold 10 days following OVX compared to diestrous controls. The injection of estradiol benzoate (Eb, 20 micrograms in corn oil/rat, SC) did not affect LH concentrations at 30 minutes but decreased serum LH both 60 and 180 min following its administration. OVX caused an increased NE metabolism (estimated by the concentration of the NE metabolite, 3-methoxy-4-hydroxyphenylethylene glycol) in the SCN, MPO, ME, and DMN and a decreased NE metabolism in the ANc compared to diestrous control values. All of these changes were reversed or attenuated 180 minutes following Eb treatment. Observed changes in the DA and 5-HT neuronal systems were more restricted and less dramatic with the largest effects on DA metabolism occurring in the DMN and ME and the clearest changes in 5-HT metabolism occurring in the MPO, ANr, and ANc. The results demonstrate that the inhibition of LH secretion following the injection of Eb to OVX rats is accompanied by changes in metabolism in NE neurons in preoptic (SCN and MPO) and medial (ME, DMN, and ANc) hypothalamic areas, as well as in DA neurons in the DMN and ME, and in 5-HT neurons in the MPO, ANr, and ANc. PMID- 6498536 TI - 3H-2-deoxyglucose uptake after electrical stimulation of cardioactive sites in anterior medial cortex in rabbits. AB - The anterior medial cortex is an important integrative area for cardiovascular adjustments occurring during learning and conditioning. The autoradiographic 3H-2 deoxyglucose (3H-2DG) method for regional cerebral metabolic activity was used to identify other forebrain regions associated with cardiovascular adjustments elicited by electrical stimulation of anterior medial cortex. Rabbits that received anterior midline stimulation that produced bradycardia and depressor responses showed increased metabolic activity in the ipsilateral mediodorsal (MD) nucleus of the thalamus and the dorsal aspect of the claustrum. Two additional animals with anterior cortical placements in the infralimbic and anterior limbic areas showed ipsilateral increased activity in perirhinal cortex, but more dorsolateral placements in the precentral agranular area did not produce increased perirhinal activity. Control animals did not show this pattern of activity. These data suggest that MD and claustrum participate in a neural circuit which mediates cardiovascular adjustments similar to those elicited by Pavlovian conditioning contingencies. PMID- 6498537 TI - Afferent projections of the cervical vagus and nodose ganglion in the dog. AB - The distribution within the brain stem of the afferent projections of the cervical vagus and the nodose ganglion was studied with horseradish peroxidase (HRP) and HRP-wheat germ agglutinin conjugate. Two to eight days after application of tracer into the cervical vagosympathetic trunk or the nodose ganglion the brain stems and ganglia were perfused and processed by the tetramethyl benzidine method. Vagal afferent fibers entered the lateral medulla as a distinct bundle spatially separate from the vagal efferent rootlets which were caudal and ventral to the afferents. Labeled axons in the solitary tract began to enter the nucleus tractus solitarii (nTS) 4.5 mm anterior to obex and were seen throughout the ipsilateral nTS as far as 3.5 mm caudal to obex. Label density varied within the nTS, with heaviest labeling in the dorsal and dorsolateral portions. Label was also seen in the ipsilateral area postrema (ap) and dorsal motor nucleus of the vagus. Labeled fibers crossed in the commissural portions of ap and nTS to enter the contralateral ap and nTS. PMID- 6498538 TI - Distribution of motoneurons in the brain stem of monkeys, innervating the larynx. AB - Following HRP (Horseradish Peroxidase) injections to cricothyroid muscle, recurrent laryngeal nerve and the vagal nerve at the level of nodose ganglion, labeled motoneurons were found to show a characteristic distribution in the brain stem of the monkey. Cricothyroid motoneurons extended from a level caudal to the facial nucleus to a level caudal to the middle part of the inferior olivary nucleus (IO) and were scattered around the outer area of nucleus ambiguus (Amb). Motoneurons supplying the recurrent laryngeal nerve were found between a level rostral to the middle of IO and its caudal end. Distribution was compact in the lateral part, but was scattered in the dorsomedial part of Amb. On injection of HRP into the nodose ganglion of the vagal nerve, labeled motoneurons were seen in two cell columns: In the Amb and in the dorsal motor nucleus of the vagus. The former extended from the rostral level of IO to the caudal end of IO, also showing connections with the retroambigual nucleus. PMID- 6498539 TI - Anatomical alterations in locus coeruleus neurons in the adult spontaneously hypertensive rat. AB - A golgi-Cox examination of the locus coeruleus in the spontaneously hypertensive rat (SHR) has shown an increase in the number of primary dendritic branches, in the number of secondary branch points, in the mean length of the dendritic branches from the soma to the outer extent of the secondary branches, and in the longest extent of the dendritic domain in comparison with the locus coeruleus in the Wistar-Kyoto normotensive rats at sixteen weeks of age. We suggest that the anatomical changes may provide a substrate for altered afferent relationships in the neurochemical regulation of neurons of the locus coeruleus, although it remains to be shown whether such alterations are related in any way to blood pressure. It appears evident that the altered mechanisms resulting in hypertension in this genetic model are more complex than an anatomical or neurochemical modification in one of the central autonomic nuclei. However, the present finding that anatomical alterations in the dendritic arborizations of a key nucleus such as the locus coeruleus occur, points towards a need for further examination of the interrelationships of specific neurotransmitter systems in this nucleus. PMID- 6498540 TI - Norepinephrine and serotonin in central autonomic nuclei in the spontaneously hypertensive rat and two normotensive control rats. AB - Neurochemical analysis of norepinephrine and serotonin with high performance liquid chromatography with electrochemical detection (LCEC) in several microdissected central autonomic nuclei of 4 week old and 16 week old spontaneously hypertensive rats (SHR), normotensive Wistar-Kyoto rats (WKY), and control normotensive Wistar rats (WIS), revealed some differences among these strains, but only one change that correlated with the hypertensive state. Norepinephrine levels in the 4 week old SHR were greater in the parabrachial nuclei and the dorsal motor nucleus of X than in the WKY, but levels in the WIS normotensive also were greater than in the WKY, and equalled levels in the SHR. In the 16 week old rats, no difference was noted between NE levels in the SHR and WKY strains, but levels in the locus coeruleus and parabrachial nuclei of the WIS were greater than in both the SHR and WKY. Serotonin levels in the 4 week old SHR and WKY rats did not differ, while levels in the paraventricular nucleus, locus coeruleus, parabrachial nuclei, and medullary raphe nuclei of the WIS rat were greater than one or both of these inbred strains. In the dorsal motor nucleus of X in 16 week old rats, serotonin levels were greater in the SHR than in either the WKY or WIS controls, suggesting one possible transmitter action that should be explored further for its potential relationship to the hypertensive state.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498541 TI - Hypothermic effect of 2,4-dinitrophenol infused ICV in the cat. AB - The effects of body temperature and behavior of 2,4-dinitrophenol injected into the cerebral ventricles of the cat was investigated in these experiments. Infused in a volume of 0.1-0.2 ml, 2,4-dinitrophenol produced a dose-dependent fall in body temperature, the duration of which was also dose-dependent. Apart from hypothermia, 2,4-dinitrophenol evoked mydriasis, respiratory irregularities, urination, vomiting, ataxia, muscular weakness, sedation and occasional clonic tonic convulsions. Of all the autonomic effects, the most consistent was the effect on thermoregulation. The possible mechanisms of action in the brain of 2,4 dinitrophenol on the thermoregulatory mechanisms are discussed. PMID- 6498542 TI - [Biometric analysis of the relation between the occurrence of paroxysmal arrhythmias and the phases of the lunar cycle using Poisson's distribution of rare events]. PMID- 6498543 TI - [Sex differences in cardiac resistance to acute ischemia in rats exposed to the effect of chronic hypobaria and physical stress]. PMID- 6498544 TI - [The relative risk of ischemic heart disease, physical performance and prognosis in 40-to-55-year-old males in Bratislava]. PMID- 6498545 TI - [Combination of carbonated baths with potassium-sparing diuretics]. PMID- 6498547 TI - [Circulating immunocomplexes in the blood of patients with essential hypertension and changes after balneologic and climate therapy]. PMID- 6498546 TI - [Prolonged oxygen therapy of inpatients with chronic respiratory insufficiency]. PMID- 6498548 TI - [Changes in the peripheral circulation in persons with hypertensive disease during a stay in the high mountains]. PMID- 6498549 TI - [Reactivity of the cardiovascular system to cold and mental stress in patients with hypertensive disease]. PMID- 6498550 TI - [The diabetes compensation index and its changes during spa therapy]. PMID- 6498551 TI - [Cholesterol esters in the supernatant fraction of the brain of guinea pigs with experimental allergic encephalomyelitis]. PMID- 6498552 TI - [Quantification of PAS-positive substances in the liver cells of newborn infants in the postnatal period]. PMID- 6498553 TI - [Recognition of leukemic malignant lymphoma]. PMID- 6498554 TI - [Morphological development of glomeruli]. PMID- 6498555 TI - [Experience with the surgical treatment of aplastic vagina]. PMID- 6498556 TI - [Damage to the conducting system of the heart in the prenatal diagnosis of complete atrioventricular block]. PMID- 6498557 TI - [Secondary myopathy in Werdnig-Hoffman disease]. PMID- 6498558 TI - [A rare case of suicide with a firearm]. PMID- 6498559 TI - [Esophagogastric heterotopia in the skin of the shoulder]. PMID- 6498560 TI - Effect of plasma fibronectin, macrophages, and glycosaminoglycans on tumor cell growth. AB - Fibronectin (Fn) synergizes with macrophages (M phi) in inducing cytostasis and cytotoxicity of neoplastic cells in culture. Since heparin enhances Fn's opsonic activity in many systems, we investigated its effect on Fn-macrophage synergy in cytostasis. MCG-T14 (a spontaneous mouse mammary adenocarcinoma) cells (4 X 10(4] were added to wells both with and without C. parvum activated M phi monolayers. To these cultures were added increasing concentrations of Fn with or without heparin. Fn synergizes with both M phi S and heparin in inhibiting tumor cell growth. The combined cytostatic effect of Fn, heparin and M phi S is more than additive. In other experiments, MCG-T14 cells were pre-incubated for 2 hr with Fn, washed free of Fn, and treated as above. The results of these experiments were similar to coculture experiments, but the effect of heparin was even more pronounced. Dermatan sulfate and hyaluronic acid had a variable effect on Fn and Fn-macrophage induced cytostasis. PMID- 6498561 TI - [Practice conditions of Italian physicians in the 80s]. PMID- 6498562 TI - [Demography, activity and remuneration of physicians in public hospitals in France]. PMID- 6498563 TI - [Locale and content of physician visits: the point of view of consumers]. PMID- 6498564 TI - [Attractiveness as an indicator of frequentation: study of the case of a mental health canter]. PMID- 6498565 TI - A comparison of pretreatment regimens for minimizing the haemodynamic response to blind nasotracheal intubation. AB - The authors determined the cardiovascular effects of blind nasotracheal intubation in four randomized groups of 25 patients each. After induction of anaesthesia with IV thiopentone 4 mg X kg-1, patients in group A received no pretreatment, while patients in group B received IV lidocaine 1.5 mg X kg-1. Three minutes before induction, patients in group C received 0.25 per cent phenylephrine nasal spray (0.2 mg in each nostril); those in group D received ten per cent lidocaine nasal spray (30 mg in each nostril). After intubation, mean arterial pressures (MAP) were highest in group B (IV lidocaine) patients (p less than 0.05), remaining significantly elevated for 5 min. Conversely, within four minutes after intubation, MAP of group D (ten per cent nasal lidocaine spray) patients were below control (p less than 0.05), and lower than those of any other group (p less than 0.05). MAP of group A and C patients increased after intubation, but not as much as in group B patients (p less than 0.05). There were no adverse effects from the lidocaine nasal spray. Ten per cent lidocaine nasal spray is a safe and effective way to minimize the MAP increases which typically accompany blind nasotracheal intubation in lightly anaesthetized patients. PMID- 6498566 TI - The effect of subarachnoid epinephrine and phenylephrine on spinal cord blood flow. AB - Eighteen mongrel dogs were divided into three equal groups. Spinal cord and spinal dural blood flow in the cervical, thoracic and lumbosacral regions were measured using the radioactive microsphere technique. Measurements were taken before and 10 and 40 minutes after lumbar subarachnoid injection of one of the following: physiologic saline; epinephrine 200 micrograms or phenylephrine 5 mg. No significant change in spinal cord blood flow occurred in any of the groups, nor was there any difference between the groups. Dogs receiving subarachnoid phenylephrine did demonstrate a significant reduction of thoracic dural blood flow at ten minutes. Dogs receiving intrathecal epinephrine or phenylephrine demonstrated a significant reduction in lumbo-sacral dural blood flow at ten minutes after injection. The reduction in dural blood flow was still evident at 40 minutes in dogs receiving phenylephrine. Subarachnoid epinephrine (200 micrograms) and phenylephrine (5 mg) do not effect spinal cord blood flow but do produce regional dural vasoconstriction. PMID- 6498567 TI - Hormonal and haemodynamic responses to upper abdominal surgery during isoflurane and balanced anaesthesia. AB - The purpose of the study was to compare the protective role of different anaesthetic techniques against surgical stress. Sixty patients undergoing elective laparotomy were randomly divided into six groups of ten patients each: Group I was given 0.65 MAC nitrous oxide (66 per cent inspired) and 0.65 MAC isoflurane (0.75 per cent end-expired); Group II was given 0.65 MAC nitrous oxide and 1-1.2 MAC isoflurane (1.2-1.4 per cent end-expired); Group III was given the same anaesthetic management as patients in Group I but with the addition of fentanyl (2 micrograms X kg-1) before the skin incision and 1/8 of the initial dose every 15 minutes during surgery; Group IV was treated as patients in Group I with an additional infusion of lidocaine (30 micrograms X kg-1 X min-1); Groups V and VI were given 0.65 MAC of nitrous oxide and fentanyl, 7.5 and 15 micrograms X kg-1, respectively, before skin incision with 1/8 of the initial dose every 15 minutes during the operation; diazepam, 5 mg IV each hour of surgery, was given to prevent intraoperative awareness. Cortisol concentration was determined by radioimmunoassay method and catecholamines were measured by high performance liquid gas chromatography in blood samples taken at different stages perioperatively. All patients had satisfactory haemodynamic courses of anaesthesia. Statistically significant increases in both epinephrine and norepinephrine concentrations were observed during the immediate postoperative period in Group I patients only. Haemodynamic stability was maintained despite a two- to three-fold increase in cortisol which occurred during the operation and immediate postoperative period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498569 TI - Subarachnoid and epidural anaesthesia for patients with epidermolysis bullosa. AB - Successful anaesthetic management of two patients with severe epidermolysis bullosa was accomplished using subarachnoid and epidural blockade. In order to avoid complications of regional anaesthesia, antiseptic preparation of the skin should not involve scrubbing nor should adhesive tape be used to secure catheters. In addition local infiltration of the skin is best avoided. The potential complications of skin and oral mucosal damage associated with mask or endotracheal inhalation anaesthesia was avoided. PMID- 6498568 TI - Electroconvulsive therapy: physiological and anaesthetic considerations. PMID- 6498571 TI - Three per cent 2-chloroprocaine for caesarean section: appraisal of a standardized dose technique. AB - We evaluated 2-chloroprocaine, three per cent, in 44 women having epidural anaesthesia for Caesarean section. All subjects received a minimum dose of 25 ml (750 mg) in increments designed to allow early recognition of accidental subarachnoid or intravascular injection. Further increments were given as needed to achieve a T5 sensory level or higher. We recorded pulse and blood pressure at two-minute intervals and used a simple pain scale to assess analgesia. Ninety three per cent of subjects had acceptable analgesia. Seventeen mothers required more than 25 ml to attain a T5 level; subjects having a BMI (body mass index) equal to or greater than 35, or over 35 years of age, demonstrated more cephalad spread. Hypotension (MAP 80 per cent of control or less) occurred in 24, mothers (54 per cent), often transiently, but an infused fluid volume exceeding 30 ml X kg-1 at delivery significantly reduced post-delivery hypotension. Nausea and vomiting accompanied the hypotension in 12 mothers. No neonatal depression occurred. We conclude the incremental administration of chloroprocaine, as described, permits safe administration of the drug, with excellent analgesia in most parturients. PMID- 6498570 TI - Isolated regional perfusion; anaesthetic technique, monitoring and blood replacement. AB - Isolated regional perfusion for the treatment of malignant melanoma is an accepted method of treatment. No standard of anaesthetic practice has been established for those individuals. Perioperative records of patients undergoing isolated limb perfusion were studied to determine adequate blood replacement. Records were examined and compared for (1) age, (2) ASA physical status, (3) presence of associated disease, (4) anaesthetic technique, (5) the amount of blood and fluid replacement, (6) preoperative haemoglobin (hgb) and haematocrit (hct) and postoperative serial complete blood counts. Fifteen patients were studied (mean age 53 +/- 16 yrs). Mean blood and fluid replacement was: packed red blood cells; 2.28 +/- 0.82 units, 722 +/- 17 ml of 5 per cent albumin, 1747 +/- 21 ml crystalloid. There were twelve Physical Status Class I or II and three Class III patients. All patients received general anaesthesia. There was a statistically significant difference in the preoperative and postoperative values for haemoglobin and haematocrit (p less than 0.01) with no difference between the postoperative and discharge values. Adequate blood replacement was determined by the equation: (Formula: see text) Extensive invasive monitoring is not routinely required for adequate blood replacement or the detection of leaks between the systemic and isolated circulation. PMID- 6498572 TI - Is it necessary to transport arterial blood samples on ice for pH and gas analysis? AB - We evaluated whether arterial blood samples for pH and blood gas analysis need to be transported on ice. We found that although the changes in pH, pCO2 and pO2 were greater in samples kept at room temperature versus those kept on ice, the difference was probably not of clinical significance until the period of time after arterial puncture exceeded 20 minutes. We recommend that arterial blood samples do not need to be kept on ice if the analysis for pH and gases is performed within 20 minutes of blood being drawn. PMID- 6498573 TI - Cleaning of anaesthesia breathing circuits and tubings: a Canadian survey. AB - A cross-Canada survey of 38 university-affiliated hospitals with over 250 beds was undertaken to examine the procedures for cleaning anaesthetic tubings and circuits. Twenty-eight (74 per cent) hospitals responded. Gluteraldehyde was the most commonly used method (13/28), and pasteurization was the second most used method (9/28). These two methods are described and recommendations are made for basic requirements for disinfection. PMID- 6498574 TI - Internal mis-mating of breathing system components. AB - A patient anaesthetized for bronchoscopy could not be ventilated when components of the breathing system met too closely and prevented the out flow of expired gas. This type of obstruction within the system may occur in the Ayre's T-piece, and when "low dead space" mask angles or co-axial systems are used with "low dead space" tracheal connectors or bronchoscopes. The problem is especially dangerous because it is not easily identified and subjects the patient to a very high airway pressure. PMID- 6498575 TI - Accidental epidural narcotic overdose. PMID- 6498576 TI - A simple wheel guard for anaesthetic gas machines. PMID- 6498577 TI - Effect of halogenated anaesthetics on heart rate changes during reversal of neuromuscular block with glycopyrrolate and neostigmine. AB - The effect of halothane and enflurane on changes in heart rate during reversal of neuromuscular blockade was compared in 48 patients. Premedication and anaesthetic technique was standardized. Either halothane or enflurane was used as the primary anaesthetic. Neuromuscular block was reversed by injection of glycopyrrolate and neostigmine, given either separately or simultaneously. Heart rate changes were significantly different between the halothane and enflurane subgroups. Patients anaesthetized with enflurane showed less fluctuations in heart rate. Simultaneous injection of glycopyrrolate and neostigmine minimized the tachycardia in the halothane subgroups only. PMID- 6498578 TI - Comparative effects of volatile anaesthetic agents and nitrous oxide on human leucocyte chemotaxis in vitro. AB - Infection following surgery is not uncommon. Human leucocytes play a vital role in the body's defense against infection. In order to decrease perioperative morbidity and mortality from infection, it is important to define the comparative effects of different anaesthetic agents on the leucocyte function. Therefore, the effect of equipotent concentrations (MAC 1) of isoflurane, enflurane, halothane, methoxyflurane and 70 per cent nitrous oxide, on the leucocyte chemotactic migration was investigated in vitro. The chemotactic migration of neutrophils and monocytes, with and without equilibration with MAC 1 concentrations of different volatile anaesthetics and 70 per cent nitrous oxide, was compared by using a modification of Boyden's method. Chemotactic migration of both cell types was unaffected by isoflurane, but a significant depression of chemotactic migration was observed with enflurane, halothane, methoxyflurane and nitrous oxide (p less than 0.05). The severity of depression of migration was maximal with nitrous oxide, followed by methoxyflurane, halothane and enflurane in order. It is concluded that equipotent concentrations of various anaesthetic agents produce different degrees of depression of leucocyte chemotactic migration in vitro. PMID- 6498579 TI - The use of propranolol in rapid sequence anaesthetic induction: optimal time interval for pretreatment. AB - Forty patients ASA physical status I-III were selected and divided into four groups. Group I, Control, received saline pretreatment five minutes prior to rapid sequence induction and intubation, while Groups II, III and IV received propranolol 0.01 mg X kg-1 IV two, five or eight minutes prior to induction and intubation. Measurements of heart rate (HR), arterial blood pressure (ABP) were recorded as baseline values and at one, two, five, eight and 20 minutes, and simultaneous venous samples were withdrawn for propranolol levels. Calculated rate pressure product (RPP) showed best haemodynamic control in Group III. Serum propranolol levels were under 5 ng X ml-1 in Group III and undetectable in Group IV. Our data show that the optimal time interval between IV propranolol administration and intubation was five minutes. PMID- 6498580 TI - Lack of tolerance to cyclopropane and cross-tolerance to halothane in rats. AB - Cyclopropane requirement (MAC) in rats was determined before, during, and after repeated exposure to anaesthetic concentrations of cyclopropane and halothane for one hour every day for 20 and 30 days, respectively. MAC values during and after exposure ranged from 93 to 103 per cent (mean = 99 per cent) of control values, which indicates a lack of significant tolerance to cyclopropane or a cross tolerance between cyclopropane and halothane. PMID- 6498581 TI - Oral flunitrazepam in the prevention of local anaesthetic-induced convulsions in mice. AB - The present study determined whether oral flunitrazepam was effective reducing CNS toxicity of lidocaine and bupivacaine. Pretreatment of mice with flunitrazepam, 0.065-0.25 mg X kg-1, significantly reduced or prevented convulsions and mortality induced by lidocaine 106 and 209 mg X kg-1 or bupivacaine 58 and 90 mg X kg-1 injected intraperitoneally. The doses of flunitrazepam used did not cause measurable sedation in mice. The efficacy of oral flunitrazepam in preventing local anaesthetic-induced convulsions is similar to that previously reported by intraperitoneal or intramuscular injections in mice. Flunitrazepam could be useful for oral premedication of patients before regional anaesthesia. PMID- 6498582 TI - Common bile duct pressure in dogs after opiate injection--epidural versus intravenous route. AB - The effect on the common bile duct pressure of epidurally injected morphine and fentanyl, was compared with that of intravenous injections of the same drugs in 12 mongrel dogs. Intravenous injection of morphine (0.1 mg X kg-1) or fentanyl (0.01 mg X kg-1) significantly elevated the common bile duct pressure from 10.48 +/- 0.37 to 21.68 +/- 0.33 cm H2O and from 9.66 +/- 0.33 to 14.14 +/- 0.21 cm H2O respectively. These increases occurred within 4-15 minutes after injection and lasted for about 2-3 hours. When the narcotics in identical dosages were injected epidurally, the common bile duct pressures were unchanged during the four hours of investigation. Further studies are planned to determine whether this beneficial effect of epidural narcotics applies also in the human clinical situation. PMID- 6498583 TI - Dopamine reverses cardiovascular depression of toxic doses of pentobarbitone in dogs. AB - Pentobarbitone, 20 mg X kg-1 IV followed by infusion of 25 mg X kg-1 X hr-1, produced a progressive decrease in mean arterial pressure in dogs from 113 +/- 17 mmHg (SD) after one hour of infusion to 82 +/- 21 mmHg after 3.5 hours and to 49 +/- 22 mmHg after 5.5 hours. EEG silence occurred at 3.6 +/- 0.6 hours. In dogs similarly treated with pentobarbitone, a two hour infusion of dopamine 5 micrograms X kg-1 X min-1 beginning at the time of EEG silence prevented the further decrease in pressure and restored pressure to 87 +/- 18 mmHg. The mechanism for this effect of dopamine was an increase in cardiac output as systemic vascular resistance was unaffected by dopamine. The cardiac output increase was mainly the result of an increase in stroke volume as heart rate increased only slightly. Since reduced stroke volume was the main reason why pentobarbitone lowered blood pressure, the effect of dopamine on stroke volume and thus on blood pressure makes it an appropriate antagonist to the cardiovascular effects of toxic doses of pentobarbitone. PMID- 6498584 TI - Inspired humidity in anaesthesia breathing circuits: comparison and examination of effect of Revell circulator. AB - Humidity levels of respired gases in spontaneously breathing patients were measured with a quadrupole mass spectrometer (Medishield Model MS-2) and compared between various anaesthetic systems during clinical anaesthesia. In studies of high flow rebreathing non-absorption systems the mean inspired absolute humidity averaged approximately 16 mg X l-1 (range 14.7 to 16.1 mg X l-1) compared to a semiclosed circle absorption system (BOC MK III) in which values for absolute humidity varied from 6.8 +/- 5.1 mg X l-1 for children through 9.5 +/- 3.0 mg X l 1 for adults), and the closed circle absorption system in which values of 20.5 +/ 2.3 mg X l-1 were only gradually reached. Addition of a functioning Revell circulator to the circle absorption system provided immediately markedly higher levels of inspired humidity during clinical use, either semiclosed (15.4 +/- 5.1 mg X l-1 in children to 18.8 +/- 2.4 mg X l-1 in adults), or closed (23.3 +/- 1.8 mg X l-1 in adults). These markedly higher inspired levels of absolute humidity were attained during forced circulation of respired gas provided by the Revell circulator without the concomitant disadvantages of rebreathing or the potential hazards associated with some humidifying devices. PMID- 6498585 TI - The reversal of epidural morphine induced somnolence with physostigmine. AB - Two case reports are presented of patients with post-thoracotomy pain treated with epidural morphine who developed somnolence several hours after the procedure. Physostigmine, 1 mg IV successfully reversed the somnolence without any effect on analgesia. PMID- 6498586 TI - Anaesthetic management with morphine in phaeochromocytoma. AB - Morphine was used as the principal anaesthetic agent for five patients undergoing resection of phaeochromocytoma, and changes in plasma catecholamines were monitored. Phenoxygenzamine (0.5 mg X kg-1 X day-1) was orally given one week before operation. After premedication with hyoscine (0.4 mg) and diazepam (20 mg) of meperidine (50 mg), anaesthesia was induced with an infusion of morphine (1 mg X kg-1) over 30 min and maintained with diazepam, nitrous oxide and oxygen. Pancuronium was used as the muscle relaxant. In three of the five patients, blood pressure transiently rose (ranging from 15 to 60 mg) following orotracheal intubation, but vasodilators were not required. In two of the three, plasma norepinephrine increases were 1.1 and 1.3 ng X ml-1. In the other two patients, whose blood pressure was stable, the change in plasma norepinephrine was 0.1 and 0.7 ng X ml-1. After reaching a peak at the time of ligation of drainage vein from the tumour, plasma catecholamines rapidly decreased to the preoperative levels, but the blood pressure was well maintained in all cases. Ventricular arrhythmias did not occur despite the increased levels of endogenous catecholamines. These findings suggest that morphine can be used as an alternative anaesthetic agent during operation for phaeochromocytoma and that exaggerated pressor responses to morphine (when given slowly) seem not to occur in phaeochromocytoma. PMID- 6498587 TI - Intraoperative failure of a Fluotec Mark II vapourizer. AB - A case report describing the failure of a Fluotec Mark II vapourizer to deliver the indicated anaesthetic concentration during surgery is presented. The failure was caused by a broken internal circlip which resulted in most of the fresh gas flow bypassing the vapourizer. The inspired halothane concentration was reduced to 0.1 per cent, irrespective of the vapourizer dial setting. This type of vapourizer failure may be identified by the unusually loose dial on the Mark II vapourizer. The complications resulting from a light level of anaesthesia include awareness, systolic and diastolic hypertension, movement, and their sequelae. PMID- 6498588 TI - Calorimetrical comparison of insulative properties of metalized plastic, clear polyethylene, and polyester blanket. AB - The thermal insulation properties of metalized plastic sheeting (MPS), clear polyethylene sheeting (CPS) and 100 per cent polyester thermal bed blanket (TBB) were tested and compared quantitatively using direct calorimetry. The experiments were carried out on individual subjects sitting in a whole body calorimeter and covered first with a TBB bag up to the neck. Then the three materials were tested, one at a time, over the original TBB up to the neck. The temperature of the calorimeter was set at normal operating room temperature of 18 degrees C. MPS provided the greatest reduction in sensible heat loss (SHL) of all three materials tested. The total SHL saving provided by an MPS over TBB was 29.7 per cent and was statistically highly significantly different from that provided by a CPS or TBB over TBB (the difference is 9.6 and 9.9 per cent, respectively, p less than 0.001 for both). While the SHL saving provided by a CPS over TBB was 20.1 per cent, and a TBB over TBB was 19.8 percent, the difference of 0.3 per cent is statistically not significant (p greater than 0.5). An additional finding was that MPS is electrically conductive on one side. Precautions must be taken when it is used on patients connected to electrical devices. Also, insensible perspiration trapped inside the bag can be as much as 10 g X hour-1 and may become a problem when the patient is wrapped in MPS for an extended period of time. PMID- 6498589 TI - Bradyarrhythmia induced by repeated dose of succinylcholine. PMID- 6498590 TI - Carrier-mediated ion transport in lipid bilayer membranes. AB - The electrical properties predicted by a widely accepted model for carrier mediated ion transport in lipid bilayers are described. The different steps leading to ion transport and their associated rate constants are reaction at the interface between an ion in the aqueous phase and a carrier in the membrane (kRi), followed by translocation of the ion-carrier complex across the membrane interior (kis) and its dissociation at the other interface (kDi) after which the free carrier crosses back the membrane interior (ks). Results on glyceryl monooleate (GMO) membranes for a family of homologue carriers, the macrotetralide actin antibiotics (nonactin, monactin, dinactin, trinactin, and tetranactin) and a variety of ions (Na+, Cs+, Rb+, K+, NH4+, and Tl+) are presented. Internally consistent data obtained from steady-state electrical measurements (zero-current potential and conductance, current-voltage relationship) allow us to obtain the equilibrium permeability ratios for the different ions and show that for a given carrier kRi is relatively invariant from one ion to the other, except for Tl+ (larger), which implies that the ionic selectivity is controlled by the dissociation of the complex. The values of the individual rate constants obtained from current relaxation experiments are also presented and confirm the findings from steady-state measurements, as well as the isostericity concept for complexes of different ions with the same carrier (kis invariant). These also allow us to determine the aqueous phase membrane and torus membrane partition coefficients. Finally, the observed increase in kis from nonactin to tetranactin and, for all homologues, from GMO-decane to solvent-free GMO membranes, together with the concomitant decrease in kDi, can be explained in terms of modifications of electrostatic energy profiles induced by variations in carrier size and membrane thickness. PMID- 6498591 TI - Physical force considerations in model and biological membranes. AB - We have emphasized the general lessons learned by measuring the forces between and within many kinds of phospholipid bilayers. Interbilayer forces within about 30 A separation (1 A = 0.1 nm) are dominated by a strong hydration repulsion that we believe exists for all interacting hydrophilic surfaces. This hydration can be characterized by the polarization properties of water. Its decay with distance is common to all hydrophilic surfaces, while its strength is characteristic of the specific surface groups. Interactions at distances greater than 30 A between surfaces charged by adsorbed ions or by dissociation of surface groups qualitatively follow expectations for electrostatic double-layer forces, but quantitatively reveal an influence by the long-range hydration on electrostatic double layers. Bilayer lateral pressures and compressibilities, measured at thermodynamic equilibrium, are nonlinear and highly dependent on lipid species. Comparison with monolayers is not possible, since the latter are usually metastable states. In applying these results to contact and fusion of phospholipid vesicles, we define weak and strong regimes of interbilayer force, the former being too weak to overcome the hydration barrier. The special case of divalent cation binding with acidic phospholipids provides sufficient attraction to compete with hydration repulsion. However, such attraction will distort vesicles to rupture. Any observed fusion in such systems may be incidental to this destruction. This suggests that the control of biological membrane fusion, divalent cation antagonism, and postfusion stability is lacking in these systems. Biological fusion more likely involves focal biochemical change simultaneous with reduction of the hydration forces. PMID- 6498592 TI - [Molecular interactions in the membranes of visual photoreceptors. Study using mixed monomolecular film]. AB - We have examined the interactions in a mixed monomolecular film between the 11 cis and all-trans isomers of retinal and different saturated and unsaturated phosphatidylcholines and phosphatidylethanolamines. The phase diagrams of the different binary mixtures are drawn using the surface pressure isotherms measured on 10(-3) M phosphate buffer at 21 +/- 1 degree C. Analysis of the results shows that the unsaturated chain phospholipids (dioleoyl L-phosphatidylcholine and dioleoyl L-phosphatidylethanolamine extracted from bovine retinas) and the retinal isomers are miscible at the interface. In addition, the excess free energies of mixing are identical for these mixtures. On the other hand, the saturated phospholipids (distearoyl L-phosphatidylcholine and distearoyl L phosphatidylethanolamine) are not miscible with the retinal isomers under the same conditions. The comparison between the results obtained with the saturated lipid and unsaturated lipid mixtures shows the importance of hydrophobic forces in the thermodynamics of the interactions of these systems. In addition, the isotherms of the mixtures containing phosphatidylethanolamine do not vary with the pH of the subphase in the region studied, pH 5.5 to 8.2. These results raise serious doubts about the existence of a Schiff base between phosphatidylethanolamine and the retinals at the interface. The possible implications of this phenomenon for the disc membrane are analyzed, particularly with respect to the stability of the retinals in vivo. PMID- 6498593 TI - The thermodynamic properties of mixed phospholipid bilayers: a theoretical analysis. AB - A theoretical model is presented with the intention of describing lateral phase separations in binary lipid mixtures in which the acyl chains of the components differ in their length. The model includes explicitly interactions between the acyl chains and between polar heads of the lipid molecules. Phase diagrams and thermodynamic properties of binary lipid mixtures were calculated using a wide range of interaction parameters. It is shown that the occurrence of immiscibility in the gel phase is related to the interactions between the polar heads of the lipid molecules. The calculated results for binary lipid mixtures are compared with the available experimental data. In particular, the calculated specific heat for dilauroyl phosphatidylcholine-distearoyl phosphatidylcholine is in reasonable agreement with experimental results obtained from differential scanning calorimetry measurements. PMID- 6498594 TI - Microtubule associated proteins in microtubule preparations made with and without glycerol. AB - Preparation of microtubule protein in the presence or absence of glycerol results in differences in polymerization properties and content of microtubule associated proteins. The variation in properties appears to result from the reduced proportion of microtubule associated proteins in preparations made with glycerol. I have used the colchicine binding assay to monitor recovery of active tubulin and have found that a single factor can account for the difference. During the in vitro assembly of microtubules from the crude brain homogenate, glycerol promotes polymerization of the bulk of the tubulin, while less than half is incorporated into microtubules in the absence of glycerol. Assembly of partly purified microtubule protein is not enhanced by glycerol however. Microtubule associated proteins present in the crude homogenate are almost completely incorporated into the microtubules regardless of the presence of glycerol, and their high content in glycerol-free preparations appears to be the trivial result of low tubulin recovery. The high affinity of microtubule associated proteins for the assembled microtubules has other consequences for in vitro studies of microtubule assembly, and critical concentration plots to determine the polymerization equilibrium constant can be distorted unless the preparation used has a high content of microtubule associated proteins. PMID- 6498595 TI - The interaction of guanine nucleotides with the adenylate cyclase complex in white adipocyte membranes of lean and obese (ob/ob) mice. AB - The ability of the guanine nucleotides (Gpp(NH)p and GTP-gamma-S) and of fluoride to stimulate adenylate cyclase is equal in the white adipocyte of lean and ob/ob mice. This suggests that the interaction between the guanine nucleotide regulatory component (N) and the catalytic unit of adenylate cyclase is normal. In the membranes from obese mice, the addition of agonist did not diminish the concentration of guanine nucleotide required for half-maximal activation, as it did in membranes from lean mice, indicating that the interaction between the receptor and N may be altered in the obese mouse. GDP-beta-S and GTP were found to be equally potent in inhibiting Gpp(NH)p-activated adenylate cyclase activity in both groups. Experiments with membranes loaded with or depleted of GDP showed that GDP did inhibit the activation of the cyclase under all conditions tested. Although depleting the membranes of obese mice of GDP improved their response to isoproterenol, it did not restore the response to levels seen in the membranes of lean mice. The data show that it is not likely the binding of GDP which limits cyclase stimulation by agonists. The defect must therefore reside in another property of N. PMID- 6498596 TI - The incorporation of [3H]glycerol and 1-[14C]acyl-sn-glycero-3-phosphocholine into different molecular species of phosphatidylcholine in human platelets. AB - The molecular species of phosphatidylcholine which are formed by de novo synthesis and by the acylation of 1-acyl-sn-glycero-3-phosphocholine were characterized and compared in human platelets. For this purpose, intact human platelets were incubated in the presence of [3H]glycerol or 1-[14C]palmitoyl-sn glycero-3-phosphocholine and the newly formed radioactive phosphatidylcholine was isolated by thin-layer chromatography. The labelled phosphatidylcholines were converted to their 1,2-diacylglycerol acetate derivatives and fractionated into their various chemical classes (saturates, monoenes, dienes, trienes, tetraenes, and greater than tetraenes) by argentation thin-layer chromatography. Regardless of the precursor used, the radioactivity distributions among the various classes did not correspond closely to that of the mass. The highest percentage of the radioactivity incorporated from [3H]glycerol was found in the saturates (25% of total), followed closely by the tetraenes (21%) and monoenes (18%), with lesser amounts in the dienes (15%), pentaenes plus hexaenes (14%), and trienes (7%). These results indicate that the de novo pathway is capable of substantial synthesis of tetraenoic (1-acyl 2-arachidonoyl) phosphatidylcholine in human platelets in contrast to previous observations in rat liver. In close agreement with work in rat liver, 59% of the radioactivity in the [14C]phosphatidylcholine derived from 1-[14C]palmitoyl-sn-glycero-3-phosphocholine was found in the tetraenoic species. The present results, together with the existence of phospholipase A2 and acyltransferase activity in platelets, support the potential importance of a deacylation-acylation cycle enrichment of human platelet phosphatidylcholine in arachidonoyl species. PMID- 6498597 TI - Partial resialylation of human asialotransferrin types 1 and 2 in the rat. AB - 125I-labeled asialotransferrin types 1 and 2 were administered in small doses to rats. The protein still in the plasma after 1-12 h was partially repurified and electrophoresed at pH 8.1, together with a transferrin standard that is composed of all six forms of the protein with respect to sialic acid content. The electrophoretic mobility of both asialotransferrins increased with time, type 2 being affected sooner than type 1. The changed mobility was due to increased electronegativity that was fully reversible by treatment of the samples with neuraminidase, thus identifying the underlying cause as partial resialylation. Asialotransferrin incubated in vitro with serum, plasma, or whole blood for 16 h exhibited no change in electrophoretic mobility. In conjunction with an earlier study on asialotransferrin type 3, it was found that the apparent speeds of resialylation of the three asialotransferrins were in the same order as their affinities for the asialoglycoprotein-binding hepatic lectin. This suggests the involvement of an endo- rather than of an ecto-transferase. Transfer of 59Fe from asialotransferrins to the liver was used to monitor the frequency of hepatocyte asialotransferrin interactions. Iron deposition in the liver took place much more rapidly than the appearance of detectable quantities of partially resialylated asialotransferrin molecules in the circulation. It is concluded that each asialotransferrin molecule probably undergoes several passages through the hepatocyte before its glycans become modified. PMID- 6498598 TI - Rapid qualitative changes in mRNA populations in cultured human lymphocytes: comparison of the effects of cycloheximide and concanavalin A. AB - To examine the hypothesis that the stimulation of cultured lymphocytes by lectins involves the inactivation of a protein repressor of putative "activation genes," the effects of a protein synthesis inhibitor (cycloheximide) and a lectin (concanavalin A) were compared. Qualitative changes in mRNA populations were assessed by translating RNA prepared from cycloheximide- or lectin-treated cultures in a rabbit reticulocyte lysate. [35S]Methionine-labelled translation products were analysed by two-dimensional polyacrylamide gel electrophoresis. Cycloheximide increased the radioactive labelling of cultured lymphocytes with the RNA precursor [3H]uridine, as previously reported. This was observed during the first 3 h of culture; thereafter, cycloheximide was inhibitory. The period of increased labelling with [3H]uridine coincided with a period of great increase in mRNA corresponding to an acidic protein of a relative mass of approximately 55 000. This mRNA was not detected in RNA prepared from control cultures, but was one of the most abundant mRNA species detected in RNA prepared from cycloheximide treated cultures. Increases in certain less abundant mRNA species were also noted. However, the mRNAs were not observed in RNA prepared from lectin-treated cultures. If an increase in these mRNAs is important for lymphocyte activation, then the increase must be to an extent not detected by our current methods. PMID- 6498599 TI - The incidence of spontaneous cytogenetic aberrations in lymphocytes cultured from normal humans for 48 and 72 h. AB - Spontaneously occurring cytogenetic aberrations were compared in 48- and 72-h human lymphocyte cultures from a group of 20 normal male volunteers. Mitotic indices for both cultures times were also evaluated. BUdR (5-bromo, 2 deoxyuridine) labelled metaphases from three men were utilized to determine the cell cycle kinetics in the medium used. There was no statistically significant difference between 48- and 72-h cultures among the majority of aberration categories considered. Possibly, the lymphocyte populations at the two different culture times maintained a consistent yield level. Mitotic indices in 72-h cultures were invariably higher than those in 48-h cultures. An overwhelming number of first division metaphases were observed at 48 h of incubation; however, approximately 22% of the lymphocytes did not enter into mitosis until 72 h in culture. A number of difficulties with regard to utilizing BUdR-labelled first division metaphases for cytogenetic analyses are discussed. PMID- 6498600 TI - Inversion polymorphisms in natural populations of Anopheles stephensi. AB - A preliminary survey of natural populations of Anopheles stephensi Liston in Pakistan has uncovered the presence of 16 autosomal paracentric inversions. Twelve previously undescribed inversions were observed in the field populations and an additional new one was seen in a laboratory colony. A comparison of urban and rural populations showed striking differences in the kinds and frequencies of paracentric inversions. PMID- 6498601 TI - Chromosome segregation from cell hybrids. I. The effect of parent cell ploidy on segregation from mouse-Chinese hamster hybrids. AB - To determine whether the dosage of some parental factor influences the direction and extent of chromosome segregation, I have constructed hybrids between polyploid series of mouse and Chinese hamster lines. The input ratio of mouse:hamster chromosomes varied from 3.3 (in hybrids between diploid hamster and polyploid mouse cells) and 0.9 (in hybrids between polyploid hamster and near diploid mouse cells). Mouse chromosomes were retained and hamster chromosomes were lost from all hybrids with input ratios greater than or equal to 1.3; the extent of hamster chromosome loss increased from 25 to 60% as the proportion of mouse chromosomes was increased. Reverse segregation was observed in hybrids in which the ratio was 0.9; hybrids between polyploid hamster and diploid mouse cells retained most hamster chromosomes and lost 52% of mouse chromosomes. I conclude that the direction and extent of chromosome segregation from these hybrids depends on the dosage of some factor contained in the parent cells; because the volumes of polyploid cells are proportional to chromosome number, this factor could be chromosomal, nuclear, or cytoplasmic. Dosage differences should therefore be considered when comparing chromosome segregation from hybrids with cells of the same species combination, but which might differ in chromosome number (e.g., diploid lines and established lines), or cell volume (e.g., cells from different tissues). PMID- 6498602 TI - [Electrophoretic variability in a total of 11 structural sites in murine rodents (Muridae, Rodentia)]. AB - Forty-six rodent species of the Muridae family were submitted to sequential electrophoresis for the study of 11 protein loci, using 12 buffer systems which differed in pH and ionic composition. The complete set of electrophoretic conditions yielded 135 variants of which 68 were detected through a single condition. The twofold increase of revealed variants was essentially limited to intergeneric comparisons because few additional variants within genera were revealed, despite the use of several buffers. These results show that estimation of the degree of genetic differentiation among taxa at a higher level than that of the genus by standard electrophoretic data may, although of current use, lead to erroneous results. PMID- 6498603 TI - Evaluating visual loss with multi-flash campimetry. AB - Multi-flash campimetry is a computer-implemented psychophysical technique that allows temporal resolution to be assessed in 120 points per eye in a half hour. It has previously been reported that the results can serve to distinguish between multiple sclerosis patients and control subjects. We have now used this technique to measure temporal resolution in patients with amblyopia, cataracts, optic neuritis or macular degeneration. Our results indicate that multi-flash campimetry is at least as sensitive to visual loss in patients with amblyopia or cataracts as visual acuity testing with the Snellen chart and kinetic visual field testing with the Goldmann perimeter. Further, multi-flash campimetry may be more sensitive than the other two techniques to subtle residual loss in patients who have had optic neuritis and to early loss in patients with macular degeneration. PMID- 6498604 TI - New polypropylene tube to stent or bypass the lacrimal system. AB - A tube made of polypropylene has been used both as a stent after canalicular reconstruction or repair and as a bypass device to drain tears when the canaliculi have been destroyed. The tube comes in different sizes, can be cut to any length, can be bent to any shape and can easily be flanged at the nasal end by the surgeon. The tube has good capillarity and drains well. There is enough tissue reaction around it so that it will not extrude, yet when it is used as a stent it can easily be removed. PMID- 6498605 TI - Intracranial plasmacytoma associated with multiple myeloma. AB - A 58-year-old man with multiple myeloma presented with a 3-month history of a sensation of occipital pressure, transient blurring of vision and increased bone pain. Funduscopic examination revealed disc swelling, tortuous veins and superficial retinal hemorrhages simulating early hyperviscosity syndrome. Clinical investigation and computerized tomography, however, indicated that an intracranial plasmacytoma was the cause of his papilledema. Cobalt 60 beam therapy and vincristine were added to his treatment regimen. Seven weeks later the intracranial tumour had almost totally disappeared. Symptomatic cerebral compression from an intracranial plasmacytoma associated with systemic disease is uncommon. The diagnosis and management are reviewed. PMID- 6498606 TI - Parable from Quebec, or are we forgetting our basics? PMID- 6498607 TI - Effects of bile and bile salt infusions on renal function in dogs. AB - A previous study in dogs indicated that 4 h of acute biliary obstruction was associated with an increment in the glomerular filtration rate (GFR), renal perfusion, and urinary sodium excretion. These effects could also be transmitted to a "recipient" dog following 2 h of cross circulation. In this study we examined the possible role of bile and bile products in reproducing these effects. The i.v. infusion of 15 mL of undiluted gallbladder bile produced a marked diuresis and natriuresis, while arterial pressure and GFR declined. Bile diluted as much as 1/100 in isotonic saline could produce an effect when infused intravenously. When bile diluted to 1/250 was infused into th left renal artery at 0.5 mL/min, a diuretic and natriuretic response was obtained. GFR and renal blood flow declined with more concentrated solutions, though blood pressure remained normal. Dialysis of bile, or prior incubation with cholestyramine or plasma, failed to uncover a renal vasodilator effect. Following the first two procedures, the diuretic properties of infused bile were lost. The infusion of small amounts of synthetic bile salts (taurocholate or glycocholate) into the left renal artery caused marked increments in urinary sodium excretion without any change in renal hemodynamics. The infusion of bilirubin was without effect on renal function. Taurine and glycine, the amino acids present in the conjugated bile acids, were injected i.v. Both caused marked diuresis and natriuresis, but only glycine increased GFR and renal perfusion. The plasma levels of these substances, however, were unchanged following 4 h of acute biliary obstruction. We conclude that while bile salts probably cause the diuresis of biliary obstruction, the mechanism for the increase in GFR has not yet been identified. PMID- 6498608 TI - Whole body and hindlimb cardiovascular responses of the anesthetized dog during CO hypoxia. AB - To compare with earlier studies of anemic hypoxia obtained by hemodilution, O2 carring capacity was decreased by carbon monoxide (CO) hypoxia. Arterial O2 content was reduced either 50% (moderate CO) or 65% (severe CO). In two groups of anesthetized dogs (moderate and severe CO) hindlimb innervation remained intact while in a third group (moderate CO) the hindlimb was denervated. Measurements were obtained prior to and at 30 and 60 min of CO hypoxia. Cardiac output was elevated at 30 min of CO hypoxia in all groups (p less than 0.01) and in the severe CO group at 60 min (p less than 0.01). Hindlimb blood flow remained unchanged during CO hypoxia in the intact groups. In the denervated group, hindlimb blood flow was greater (p less than 0.05) than that in the intact groups throughout the experiment. A decrease in mean arterial pressure (p less than 0.01) in all groups was associated with a fall in total resistance (p less than 0.01). Hindlimb resistance remained unchanged during moderate CO hypoxia in the intact group but increased (p less than 0.05) in the denervated group. In the severe CO group hindlimb resistance was decreased (p less than 0.05) at 60 min. The results indicate that the increase in cardiac output during CO hypoxia was directed to nonmuscle areas of the body and that intact sympathetic innervation was required to achieve this redistribution. PMID- 6498609 TI - Methyl parathion and fenvalerate toxicity in American kestrels: acute physiological responses and effects of cold. AB - Physiological and toxicological effects of p.o. methyl parathion (0.375-3.0 mg/kg) or fenvalerate (1000-4000 mg/kg) were examined over a 10-h period in American kestrels (Falco sparverius) maintained in thermoneutral (22 degrees C) and cold (-5 degrees C) environments. Methyl parathion was highly toxic (estimated median lethal dose of 3.08 mg/kg, 95% confidence limits of 2.29-4.14 mg/kg), producing dose-dependent inhibition of brain and plasma cholinesterase activity, hyperglycemia, and elevated plasma corticosterone concentration. Brain and plasma cholinesterase inhibition in excess of 50% was associated with transient but pronounced hypothermia 2 h after intubation, although the magnitude of this response was variable. Fenvalerate, at doses far exceeding those encountered in the environment, caused mild intoxication and elevated plasma alanine amino-transferase activity. Cold intensified methyl parathion toxicity, but did not affect that of fenvalerate. Thus, it would appear that organophosphorus insecticides pose far greater hazard than pyrethroids to raptorial birds. PMID- 6498610 TI - Control of right atrial pressure at constant cardiac output suppresses volume natriuresis in anesthetized rats. AB - The blood volume of anesthetized rats was expanded acutely by 33% with donor blood while a caval snare was gradually tightened so that right atrial pressure (RAP) was prevented from rising (n = 6). In control experiments (n = 5) an aortic snare was used to hold mean arterial blood pressure near the values found in the experimental series. However, RAP was allowed to change freely and increased by 1.6 +/- 0.4 mmHg (1 mmHg = 133.322 Pa) during volume expansion. When the two groups were compared, there were no significant differences between their mean arterial blood pressures (near 110 mmHg) or in their cardiac outputs (near 0.25 mL X min-1 X g body weight-1). There were, however, significant differences between their renal responses to the volume load. When RAP was free to change, the rate of volume excretion (V) increased to 30 +/- 15 (SEM) microL X min-1 X g kidney weight-1 (KW) from its control value of 3.49 +/- 0.31 and the rate of sodium excretion (UNaV) increased to 3.59 +/- 0.20 muequiv X min-1 X g KW-1 from its preinfusion value of 0.42 +/- 0.10. When RAP was not allowed to increase during volume loading, V and UNaV did not change from their respective preinfusion values (2.99 +/- 0.46 microL X min-1 X g KW-1 and 0.35 +/- 0.10 muequiv X min-1 X g KW-1). The results imply that during acute blood volume expansion increased central vascular pressure is a prerequisite for the homeostasis of body water and salt. PMID- 6498611 TI - Resonance properties of the human elbow. AB - In normal human subjects, elbow resonance was measured by driving the forearm over a range of frequencies. The relaxed forearm, in a manipulandum with a low inertial moment, had a resonance of 0.068 +/- 0.06 Hz which was remarkably consistent for either sex and over a wide variety of arm sizes. Elbow stiffness, therefore, appears to be well adapted to the forearm moment of inertia. The resonant frequency increased as the elbow muscles were cocontracted, but the amplitude of resonance dropped exponentially because of increased damping. By 25% of maximum electromyogram levels the elbow was critically damped. Comfortable voluntary motion exhibited an amplitude-period relation very similar to that of forearm resonance, suggesting that significant use was made of resonance properties. It was found that the forearm was voluntarily oscillated at its resonant frequency within a specific range, characteristic for the individual. Depending on movement frequency, resonance can provide anything from a major to a negligible contribution to voluntary oscillatory motion. It would greatly increase efficiency of performance when antagonist muscles are kept as relaxed as possible to minimize damping. PMID- 6498612 TI - The effects of hyperoxia on oxygen uptake during acute anemia. AB - The effects of normobaric hyperoxia on the oxygen uptake (VO2) and cardiovascular responses of the whole body and hindlimb during anemia were investigated. Anesthetized, paralyzed dogs were ventilated for 20-min periods with room air (normoxia), 100% O2 (hyperoxia), and returned to room air. Anemia (hematocrit = 15%) was then induced by isovolemic dextran-for-blood exchange and the normoxia, hyperoxia, normoxia sequence was repeated. Whole body VO2 and cardiac output rose following anemia, and then fell (p less than 0.05) with hyperoxia during anemia. These responses were not abolished by beta-blockade with propranolol (1 mg/kg, iv) or bilateral vagotomy. The hindlimb data for blood flow and VO2 were similar in direction to those of the whole body but were more variable. Section of the sciatic and femoral nerves did not appear to have significant effect on the limb responses to hyperoxia. The decrease in whole body and hindlimb VO2 with hyperoxia during anemia may have resulted from a redistribution of capillary blood flow away from exchange vessels in response to the elevated PO2. PMID- 6498613 TI - Effects of the oral hypoglycemic agent methyl palmoxirate on exercise capacity of rats. AB - The effect of the oral hypoglycemic agent methyl palmoxirate (methyl 2 tetradecylglycidate, McN-3716), a selective inhibitor of long chain fatty acid oxidation, on the exercise capacity of normal rats was evaluated. Daily administration of 2.5 mg/kg for 7 days, or of a single dose of 10 mg/kg, of methyl palmoxirate did not affect the ability of rats to perform strenuous exercise of an intensity that caused exhaustion in less than 30 min. The ability to perform prolonged, moderately strenuous exercise of an intensity that could be maintained for more than 60 min was decreased slightly (17%) in the methyl palmoxirate treated rats. This effect appeared to be mediated by a significant reduction in initial liver glycogen content in the methyl palmoxirate treated rats. As a consequence, the methyl palmoxirate treated rats became hypoglycemic during prolonged exercise. Inhibition of fatty acid oxidation in skeletal muscle was minimal. Treatment with methyl palmoxirate protected against the development of exercise-induced ketosis. It appears that the liver is the major site of action of methyl palmoxirate when given in low dosage. PMID- 6498614 TI - Evaluation of topical phenol as a means of producing autonomic denervation of the liver. AB - Topical application of 90% phenol around the bile duct, portal vein, and hepatic artery, as well as along each of the three hepatic ligaments was tested for effectiveness of rapid and chronic denervation in cats. Because phenol produces nonselective nerve degeneration, it was assumed that proof of functional sympathectomy was adequate proof of disruption of parasympathetic and afferent nerves as well. Functional sympathetic neurons were evaluated by measuring physiological responses to direct electrical stimulation of the anterior hepatic plexus. Acute or rapid denervation was assessed by the degree of rise in portal blood pressure produced by nerve stimulation. Complete denervation appeared within 20 min and was still present by 80 min postapplication. Chronic denervation was tested by applying the phenol and recovering the cats for 6-14 days. An equal number (n = 6) of sham-denervated cats were compared. Phenol denervation did not alter basal glucose, insulin or glucagon levels, hematocrit, blood pressure, or hepatic glycogen levels. These variables are a good index of stress and metabolic status. Nerve stimulation in the chronic sham group raised portal pressure, arterial pressure, and blood glucose levels, whereas the chronic denervated group showed no responses. The health of the two groups appeared normal with the sole difference being that the painted tissues were mildly discolored and more adhesions appeared in the phenol-denervated set. Thus phenol is a useful tool for producing hepatic denervation. It is less traumatic, faster, and more certain than surgical denervation. In addition, the hepatic lymphatics can be preserved using the topical application of phenol. PMID- 6498615 TI - Amitriptyline and imipramine inhibit the release of acetylcholine from parasympathetic nerve terminals in the rat iris. AB - The electrically stimulated release of [3H]acetylcholine from the parasympathetic nerve terminals of the rat iris in vitro is increased in a dose-dependent manner by scopolamine but is decreased by the tricyclic antidepressants amitriptyline and imipramine. The increased release in the presence of scopolamine seems to be due to the blockade of a presynaptic muscarinic autoreceptor that, in the drug free state, inhibits the release of acetylcholine. However, at drug concentrations that should have comparable antimuscarinic potency, the antidepressants inhibit the release of acetylcholine. This suggests that the anticholinergic side effects of the antidepressants may be due to the reduced release of acetylcholine from parasympathetic nerve terminals as well as a possible direct postsynaptic muscarinic receptor blocking action. Whatever the mechanism of this action, the antidepressants do not have the same effect as scopolamine at the presynaptic muscarinic autoreceptor in the rat iris. PMID- 6498616 TI - A human cytochrome P-450 characterized by inhibition studies as the sparteine debrisoquine monooxygenase. AB - The present study compares the debrisoquine monooxygenase and the sparteine monooxygenase activities of human liver microsomes. In the presence of 14 competitive inhibitors, apparent inhibition constants (Ki) as determined by these two activities ranged over four orders of magnitude with a correlation coefficient 0.99. These in vitro results represent the strongest evidence to date that the debrisoquine monooxygenase and the sparteine monooxygenase are identical and involve a single isozyme of cytochrome P-450. PMID- 6498617 TI - Transmembrane calcium transport and the activation of cardiac contraction. AB - It has been known for a century that extracellular Ca2+ ions are needed for triggering contraction in the heart. However, the two possible mechanisms of Ca2+ entry into the cardiac cells have only been discovered and investigated recently: these are the voltage-gated Ca2+ channels and the Na+-Ca2+ exchange. This paper reviews the field of the control of cardiac contractility by the sarcolemma and describes various techniques used to study the Ca2+ transport and the corresponding two components of contraction: phasic and tonic tension. The most controversial issue of the past 5 years, attracting the attention of many investigators, is whether or not the Na+-Ca2+ exchange in the heart is electrogenic and voltage-dependent and thus contributes to the beat-to-beat regulation of free intracellular [Ca2+]. This paper concentrates on this controversy and gives an up-to-date view of the major steps in the development of our present concept of this transport and of some of the recent experimental approaches. The contribution of an electrogenic, voltage-dependent Na+-Ca2+ exchange to the regulation of contraction, as well as to cardia electrical activity, is discussed, and the alterations of both of these cardiac functions due to Na+ accumulation intracellularly (owing to various interventions) are described. PMID- 6498618 TI - Calcium and myocardial cell injury. An appraisal in the cardiomyopathic hamster. AB - The heart muscle is very compliant within a wide range of physiologic impulses. The adaptive energy of the myocardium depends, however, upon adequate oxygen supply and the functional state of the plasmalemma. These limitations have been well demonstrated in a number of experimental models with emphasis on the essential role of Ca2+ transmembrane movements for maintenance of heart functions and its viability. This postulate appeared quite important when we found that Ca2+ slow channel blockers could prevent necrotic changes in hamster hereditary cardiomyopathy. However, the effectiveness of beta-adrenoagonists when given in low doses seems more difficult to interpret since these agonists can only promote Ca2+ transmembrane movements. We can only surmise that Ca2+ accumulation in cardiomyopathic hearts does not derive from a primary defect of the plasmalemma but rather from an exhausted hypokinetic state that favours Ca2+ accumulation with progressive deterioration of the structural proteins. It is thus inferred that Ca2+ mediates rather than initiates the degradation process which characterizes this inherited cardiomyopathy. PMID- 6498619 TI - Kainic acid evoked release of D-[3H]aspartate from rat striatum in vitro: characterization and pharmacological modulation. AB - A presynaptic stimulatory action of kainic acid (KA) on the release of glutamate from corticostriatal neurons is thought to contribute to the toxic effect of KA on cell bodies of neurons in the striatum. To characterize the action of KA on the presynaptic amino acid release, its effect was evaluated on the spontaneous efflux of D-[3H]aspartate (D-[3H]Asp), a marker for glutamatergic neurons, from slices of rat striatum in superfusion experiments. In the concentration range 0.5 10.0 mM, KA significantly increased the spontaneous efflux of D-[3H]Asp. Under similar conditions potassium (K+, 25 mM), veratridine, D-aspartic acid (D-Asp), and N-methyl-D-L-aspartic acid (NMDLA) also induced the efflux of the radiolabelled amino acid. The stimulatory effect of KA, like that of K+, was partly calcium dependent. The action of veratridine, D-Asp, and NMDA was not calcium dependent. Tetrodotoxin (TTX) blocked the action of veratridine on D [3H]Asp efflux but did not affect the action of KA. In a sodium-free perfusion medium the action of KA was greatly reduced. Dihydrokainic acid produced an effect on D-[3H]Asp efflux comparable in magnitude with that produced by KA. The latter, at a dose of 5 mM, also stimulated the efflux of D-[3H]Asp from the cortex, hippocampus and the septum but its effect on these regions was weaker than its striatal effect. The action of several agents, which previously have been found to depress transmitter release in other systems and (or) to modify the neurotoxic action of KA in vivo, was evaluated on the KA-evoked D-[3H]Asp efflux from striatal slices.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498620 TI - Indocyanine green pharmacokinetics in the rabbit. AB - In a Latin square design, nine New Zealand white male rabbits (2.8-4.8 kg) each received intravenous indocyanine green (ICG) in doses of 2.5, 12.5, and 25 mg/kg. A period of 4 weeks separated consecutive experiments. A specific high-pressure liquid chromatographic (HPLC) assay and the traditional spectrophotometric (SPEC) method were used to monitor plasma ICG. The analyses demonstrated the ambiguous nature of the SPEC assay, and the HPLC procedure pointed to the presence of an unidentified ICG metabolite. Dose-dependent ICG disposition was evident from the ANOVA of the mean (+/- SD) clearances, namely, 17.09 (7.35), 4.50 (0.82), and 2.27 (0.57) mL X min-1 X kg-1 for the aforementioned doses, respectively. Analysis of variance of the clearances also demonstrated a significant ordering effect suggesting cumulative ICG toxicity. The mean ICG profiles for the three doses accorded with a novel three-compartment model containing two ICG distributional spaces in addition to a compartment (liver) responsible for ICG elimination from the circulation. A saturable uptake process into the eliminating compartment (Vmax = 0.93 mg X kg-1 X min-1; Km = 31.9 mg/L) accounted for the dose-dependent features. Additional studies in four unanesthetized rabbits with chronically catheterized bile ducts revealed no disparity between the SPEC and HPLC analyses of biliary ICG. The mean (+/- SD) ICG recovery in bile following an intravenous dose of about 12.5 mg/kg was 59.8 (16.3)%. PMID- 6498621 TI - Correlation between endogenous noradrenaline and glucose released from the liver upon hepatic sympathetic nerve stimulation in anesthetized dogs. AB - The metabolic role of neurally released noradrenaline (NA) was studied in the liver of anesthetized dogs. Sustained stimulation with various frequencies was directly applied on the anterior plexus of hepatic nerves. Stimulation-induced changes in plasma concentrations of endogenous catecholamines in hepatic venous blood were determined in correlation with concomitant changes in those of glucose (GL). Mean basal values for hepatic venous NA, adrenaline, dopamine, and GL were 0.062, 0.022, 0.032 ng/mL, and 97.9 mg%, respectively. Among these catecholamines, NA was the only one being released significantly during stimulation. While hepatic venous NA increased rapidly during stimulation, being maximum within 3 min, hepatic venous GL increased gradually, reaching a maximum value 5 min after the onset of stimulation. A highly significant correlation (r = 0.90, P less than 0.001) was found between changes in hepatic venous NA and GL concentrations observed during stimulation at various frequencies (2-16 Hz). However, hepatic vasoconstricting responses to stimulation were not correlated with increased hepatic venous GL. An alpha-blockade with phentolamine (2 mg/kg, iv) resulted in diminished release of GL by approximately 50% (P less than 0.05) and reduced hepatic arterial vasoconstriction by approximately 47% (P less than 0.01) upon stimulation (8 Hz, 5 min), even though NA release was markedly enhanced. We conclude that in the dog, NA is the sole catecholamine released within the liver in response to direct hepatic nerve stimulation, and NA thus released mediates the hepatic glycogenolysis via alpha-adrenoceptors. PMID- 6498622 TI - Effects of tetrodotoxin-induced disuse on properties of developing rat gastrocnemius muscle. AB - Our goal was to determine the influence of a complete lack of neuromuscular activity, during a period of rapid muscle growth, on muscle morphology and contractile function. Rats, 21 days old, had one hindlimb paralyzed for a period of 7-9 consecutive days by repetitive implantation of a silastic cuff containing tetrodotoxin (TTX), a specific nerve impulse conduction blocker, around the sciatic nerve. In situ isometric contractile properties of gastrocnemius were measured at 31 days of age, and muscles were subsequently examined histologically. Normal growth during this period resulted in a two- to three-fold increase in muscle weights, mean muscle fiber cross-sectional areas and increases in absolute twitch and tetanic tensions. After inactivity from 21 to 30 days of age, gastrocnemius muscles were smaller, and tetanically weaker, than age-matched controls. The normal cross-sectional area increase of fast-twitch fibers was preferentially affected. Inactive muscles also demonstrated significantly slower twitch responses, had higher twitch:tetanus ratios and relative tensions at 25 Hz than age-matched controls, suggesting a "slower" contractile response. On the other hand, maximum rate of tetanic tension development was elevated. These effects of inactivity appeared to be reversed by resumption of normal activity for 4 days. Neuromuscular inactivity during a relatively short period of rapid muscle growth causes significant muscle morphological and contractile changes, which are most likely reversible. PMID- 6498623 TI - Intestinal absorption of zinc: competitive interactions with iron, cobalt, and copper in mice with sex-linked anemia (sla). AB - Duodenal uptake and transfer of 59Fe and 65Zn and absorptive interactions between iron, zinc, cobalt, and copper were studied in sla mice and in genetically normal Swiss albino control mice. Genetically normal mice with a high iron-absorbing capacity, induced by being fed an iron-deficient diet, showed greater uptake and transfer of 65Zn in duodenum but not ileum, compared with mice with a low iron absorbing capacity. 59Fe transfer from the duodenal mucosa to the body was lower in sla mice compared with controls and bleeding stimulated the capacity to absorb 59Fe less in sla mice relative to normal controls. In contrast, 65Zn transfer in sla was no different from controls and was not stimulated by bleeding in sla or in control mice. Iron or cobalt in a 10-fold molar excess predominantly lowered 65Zn transfer in both sla and controls, but in a study of the effect of zinc on iron transport only the uptake of 59Fe in sla mice was lowered by excess zinc in the perfusate. The effect of added copper on 65Zn transport was paradoxical; in both sla and control mice copper markedly increased 65Zn uptake relative to perfusates containing 65Zn alone, but transfer in normal mice was lowered whereas it was increased in sla animals. The interaction between zinc and iron does not appear to take place at the site of the genetic defect in sla mice. The lesion in iron transport in these mice is likely due to defective binding and transfer sites in the basolateral membrane; these sites are apparently exclusive for iron and not shared by zinc. PMID- 6498624 TI - Renal metabolism and ammoniagenesis during acute respiratory alkalosis in the dog. AB - Acute respiratory alkalosis (blood pH, 7.60; arterial PCO2, 15 mmHg (1 mmHg = 133.322 Pa); plasma bicarbonate, 14 mM) was induced in nine anesthetized dogs by increasing their respiratory rate and depth. Renal glutamine extraction and ammonia production expressed per 100 mL of glomerular filtration rate did not change during acute hypocapnia, whereas arterial glutamine concentration decreased significantly from 0.47 to 0.36 mM. Hypocapnia did not change plasma potassium concentration and its urinary excretion. Acute hypocapnia increased lactate extraction and pyruvate production, whereas citrate extraction and glutamate and alanine production did not change. Citraturia remained minimal. Renal cortical glutamine concentration fell from 0.64 to 0.38 mM during hypocapnia while alpha-ketoglutarate, glutamate, malate, oxaloacetate, and citrate did not change. Lactate concentration rose from 1.1 to 2.0 mM. Glutamine concentration in the liver and muscle decreased following acute hypocapnia. Our data are compatible with the hypothesis that an acute respiratory alkalosis might not result in any change in the hydrogen ion concentration and (or) gradient between the mitochondrial matrix and the cytosol. Consequently, renal glutamine extraction and ammonia production are not reduced, renal cortical concentrations of relevant metabolites in the ammoniagenic pathway are not changed, and renal handling of citrate remains unaffected. PMID- 6498625 TI - Intestinal absorption of free oleic acid in the unanesthetized rat: evidence for a saturable component? AB - The intestinal absorption of free oleic acid at low intraluminal concentrations and the influence of luminal factors on its absorption were studied in the unanesthetized rat. The relationship between oleic acid concentration (30-2500 microM) and its rate of absorptions fitted best to a rectangular hyperbola (y = x/(2.19 + 0.0015x), r = 0.94). Oleic acid's rate of absorption increased as the hydrogen ion and sodium taurocholate concentrations were increased or as the thickness and resistance of the unstirred water layer were diminished or following the addition of lysolecithin. The additions of the artificial detergent Tween-80, or lecithin and linoleic, linolenic and arachidonic acids to the perfusate decreased oleic acid's rate of absorption. It was concluded that oleic acid absorption in this range of concentrations displays apparent saturation kinetics which are due to unstirred layer effects, limited aqueous solubility of oleic acid and possible saturation of cytosol fatty acid binding proteins. Factors which increase oleic acid's protonated concentration or diminish the unstirred layer resistance, enhance its absorption rate, while factors which enhance its micellar solubility or interfere with its transfer out of the cell membrane decrease its overall rate of absorption. PMID- 6498626 TI - Low extracellular Ca2+ and enzyme release in the perfused rabbit heart. AB - Previous studies have shown that the well-oxygenated perfused rabbit heart releases creatine kinase when treated with the calcium antagonist drug verapamil (VER) in a dose-related manner. It is possible that this effect is related to Ca2+ ion deprivation of the sarcolemma. This possibility was explored by perfusing hearts with low Ca2+ (0.5, 0.23, 0.15, and 0 mM) versus a control group (1.27 mM Ca2+) for 60 min. Low Ca2+ perfusion was associated with reduction in the heart rate--left ventricular systolic pressure product and O2 consumption, tendency for the coronary sinus flow to increase, electromechanical dissociation, prolongation of atrioventricular conduction and QT interval, and decrease in myocardial glycogen. Lower total adenosine nucleotides were found only in the 0 mM Ca2+ group. As the Ca2+ concentration was reduced, the hearts lost increasing amounts of creatine kinase, aspartate aminotransferase, and lactate dehydrogenase. These results confirm the importance of Ca2+ ions in contractile and electrical cardiac functions and show that decreased availability of this cation leads to increasing enzyme leakage resembling that seen in VER-treated hearts. PMID- 6498627 TI - Effect of glucocorticoids on testosterone production by porcine Leydig cells in primary culture. AB - For this study, purified immature porcine Leydig cells in primary culture were used. After 2 days of culture, the cells were incubated with dexamethasone (5 X 10(-9), 1 X 10(-7) M) for various periods of time (3-45 h). The media were discarded and treatment was repeated with or without the addition of human chorionic gonadotropin (HCG, 10 mIU/mL) for 3 h. Dexamethasone (10(-7) M) decreased testosterone production of HCG-treated cells (up to 40%) in a time dependent fashion while the lower dose was ineffective. The effect of varying doses (10(-8) and 10(-6) M) of natural glucocorticoids (corticosterone, cortisol) or synthetic glucocorticoids (triamcinolone, triamcinolone acetonide, betamethasone, dexamethasone) and that of a synthetic progestin (R-5020) on cultured Leydig cells was also studied. After 18 h of preincubation, the various synthetic but not the natural steroids nor R-5020, were able to decrease testosterone production of control and HCG-treated cells by 20-40%. Of a number of other hormonal and nonhormonal substances studied at concentrations of 10(-9) 10(-5) M, only lysine8-vasopressin at a concentration of 10(-6) M was able to inhibit testosterone production by these cells. These results indicate that dexamethasone and other synthetic glucocorticoids, and to a lesser degree lysine8 vasopressin, may exert a direct inhibitory effect on testosterone production by purified porcine immature Leydig cells in vitro. PMID- 6498628 TI - Influence of hypercapnia and (or) hypoxemia and metabolic acidosis on sulfamethazine kinetics in the conscious rabbit. AB - The aim of the present study was to determine whether acute changes in blood gases and pH alter sulfamethazine (SMZ) kinetics. Groups of conscious rabbits were exposed for 270 min either to air or to a high CO2 and (or) low O2 atmosphere to produce hypercapnia, hypoxemia, or both. Another group of rabbits received 47 mL/kg of 0.3 M HCl by gavage tube to induce metabolic acidosis. Once the blood gases were stabilized, the rabbits received 20 mg/kg SMZ i.v. Multiple blood samples were drawn for 180 min to assess SMZ kinetic parameters, SMZ protein binding, and blood gases. Fifteen minutes after the administration of SMZ, a suboccipital puncture was performed to determine the concentration of SMZ in the cerebrospinal fluid (CSF). Urine was collected for the first 180 min through a sterile catheter and for the next 21 h in a metabolic cage. Hypercapnia alone did not significantly influence SMZ kinetics. Hypoxemia, hypoxemia combined with hypercapnia, and metabolic acidosis increased the SMZ apparent volume of distribution (V) and total body clearance (CL). This increase in the SMZ V correlated positively (p less than 0.01) to the ratio of SMZ concentration in CSF to SMZ concentration in plasma. The increase in SMZ CL was mainly due to an increase in nonrenal clearance, although a slight increase in SMZ renal clearance was also observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498629 TI - Protein synthesis in compensatory hypertrophy of rat plantaris. AB - Protein synthesis in rat plantaris muscle undergoing surgically induced hypertrophy was studied using a perfused hindquarter preparation. The tissue mass of the hypertrophied muscle increased 11, 33, 33, and 104% at 2, 5, 15, and 50 days postsurgery. Total tissue protein synthesis was unchanged during the early phase but was significantly elevated after 15 and 50 days of work overload. Myosin synthesis was also significantly elevated after 15 and 50 days of hypertrophic growth. Increases in muscle protein content (milligrams per muscle) for each protein fraction examined were temporally in step with the altered synthetic rates. The shift in muscle fibre-type profile from approximately 10% alkaline-labile fibres in the control muscle to about 25% alkaline-labile fibres in the hypertrophied muscle also followed a similar time course. These data suggest that during compensatory hypertrophy, enhanced protein synthesis may be the dominant mechanism for the massive accumulation of muscle protein. However, its contribution to muscle growth does not become evident until about 15 days after the initial growth stimulus. PMID- 6498630 TI - Physiological properties of sympathetic preganglionic neurones in the thoracic intermediolateral nucleus of the cat. AB - Extracellular spikes were recorded from cell bodies of sympathetic preganglionic neurones in spinal segments T1-T3 of the cat. Each neurone was identified by its antidromic response to electrical stimulation of the sympathetic chain and was found in histological sections to lie within the intermediolateral nucleus. Physiological properties studied in detail included basal activity, spike configuration, and latency of antidromic activation. Also studied, in tests with paired stimuli, were the threshold interstimulus interval evoking two responses, as well as changes in amplitude and latency of the second spike which occurred at intervals near this threshold. Approximately 60% of the units studied were spontaneously active, the rest were silent. Spontaneous activity was characterized by a slow (mean = 3.1 +/- 2.6 (SD) spikes/s), irregular pattern of discharge. With approximately one-third of the cases there was a periodic pattern of discharge in phase with oscillations in blood pressure. This correlation of phasic activity suggests that many of the units studied were involved specifically in cardiovascular function. Silent and spontaneously active units could not be differentiated on the basis of latency of antidromic activation or threshold interstimulus interval; mean latency for the two groups was 7.2 +/- 4.9 ms, mean threshold interval was 6.4 +/- 4.7 ms. Thus, with the exception of basal activity, the physiological properties studied failed to indicate more than a single population of neurones. These results therefore suggest that the sympathetic preganglionic neurones in the intermediolateral nucleus subserving varied autonomic functions share overlapping physiological properties, and that functional differentiation of these neurones may be based on differences in synaptic inputs. PMID- 6498631 TI - Effect of 5-isosorbide mononitrate on isosorbide dinitrate-induced relaxation of rabbit aortic rings. AB - The ability of isosorbide dinitrate (ISDN) and its two metabolites, 5-isosorbide mononitrate (5-ISMN) and 2-isosorbide mononitrate (2-ISMN), to relax phenylephrine-contracted rabbit aortic rings was compared. The three organic nitrates demonstrated similar efficacy. ISDN was found to be the most potent (median effective dose (ED50); 1.5 X 10(-7) +/- 1.1 X 10(-7) M), followed by 2 ISMN (ED50, 1.8 X 10(-6) +/- 9 X 10(-7) M) and 5-ISMN (ED50, 8.2 X 10(-6) +/- 3.6 X 10(-6) M). The log dose-response curve of ISDN in rabbit aortic rings was constructed in the absence and presence of three fixed concentrations of 5-ISMN (5 X 10(-6), 10(-5), and 3 X 10(-5) M). No shift in the ISDN dose-response curve at high ISDN concentrations was noted in the presence of 5-ISMN. Using the isobolographic method with fixed ISDN/5-ISMN ratio mixtures, no evidence for an antagonistic effect of 5-ISMN on ISDN-induced vasodilation was obtained. Analysis of the fixed ISDN/5-ISMN ratio mixture responses by the median-effect plot showed no antagonistic effect. It is concluded that in rabbit aortic rings 5-ISMN, the major metabolite of ISDN, is not an antagonist of ISDN at a "nitrate receptor," and no support is provided for the hypothesis that the accumulation in plasma of metabolites (e.g., 5-ISMN) with longer half-lives than the parent drug explains tolerance to organic nitrates. PMID- 6498632 TI - Pharmacological properties of canine intrapulmonary blood vessels. AB - The contractile response of ring segments of large, medium, and small pulmonary arteries and veins of the dog to histamine, norepinephrine, and serotonin have been studied. The maximum contractile response to these drugs was normalized with respect to the maximal response obtained in stimulation with 127 mM K+. The small pulmonary artery was more reactive to histamine, norepinephrine, and serotonin when compared with large and medium pulmonary arteries. The medium and large pulmonary artery showed no difference in reactivity to histamine. However, the mean effective dose (ED50) values for these agonists among the different segments of pulmonary arteries showed no significant difference. The small and medium pulmonary veins demonstrated increased reactivity to histamine, but not norepinephrine and serotonin. The ED50 values also indicated that both small and medium veins were more sensitive to histamine when compared with the large pulmonary vein. The log concentration percent response curves for both small and medium pulmonary veins were displaced leftward (increased sensitivity) with respect to that for the large pulmonary vein. However, the reactivity and sensitivity to histamine between medium and small pulmonary veins were no different. The reactivity and sensitivity of different segments of pulmonary veins to norepinephrine and serotonin showed no significant differences among them. We conclude that histamine and other vasoactive substances, which are directly or indirectly related to mast cell degranulation, exert pharmacological effects on the pulmonary vasculature which possesses differential responsiveness at various levels of the vascular tree. PMID- 6498633 TI - Binding and degradation studies on angiotensin II. AB - 125I-labelled angiotensin II (AII) and [3H]AII showed specific binding to rat mesenteric artery microsomes. The binding in either instance was inhibited by the AII analog saralasin. [3H]AII was not degraded by the microsomes but 125I labelled AII was degraded. Autoradiography of thin layer chromatograms of 125I labelled AII treated with microsomes showed the parent peak (Rf = 0.4-0.45) and a single major degradation product peak (Rf = 0.25-0.30), and [125I]NaI had an Rf value higher than both 125I-labelled AII and its degradation product. Chromatography of unlabelled AII or [3H]AII gave the same Rf value as 125I labelled AII, but unlabelled AIII moved with Rf = 0.55-0.60. The formation of the degradation product was time and membrane concentration dependent. The degradation occurred at pH 6 and 7 but not at pH 8. However, specific binding of 125I-labelled AII was also lower at pH 8. The degradation could not be completely inhibited by the use of crude particulate fractions instead of microsomes, by preparing membranes in presence of protease inhibitors, or by including protease inhibitors and sulfhydryl agents in the assay medium. However, the degradation product neither showed specific binding to the microsomes nor interfered with the specific binding of 125I-labelled AII. Furthermore, the tightly bound material eluted from the microsomes in presence of 0.05 M acetic acid at 0 degree C consisted predominantly of the parent compound. The implications of these findings are discussed both in terms of validity of the binding experiments and possible relationship between the degradation and the receptor binding sites in the membrane. PMID- 6498634 TI - Modulation of myosin isoenzyme populations and activities of monoamine oxidase and phenylethanolamine-N-methyltransferase in pressure loaded and normal rat heart by swimming exercise and stress arising from electrostimulation in pairs. AB - The question of whether the effects of physical exercise on the heart of 15-weeks normotensive and hypertensive rats can be modulated by additional stressors was studied. Intermittent swimming (33-35 degrees C water, maximum 2 X 1.5 h/day, 2-6 weeks) was employed as a model of exercise. Electrostimulation of rats in pairs (maximum 2 X 1.5 h/day, 6 weeks) served as a model leading predominantly to stress. When the above procedures were combined, electrostimulation in pairs was performed in one session and was followed up by swimming. The myosin isoenzyme population was used as a marker of changes in contractile performance of myofibrils. Activities of the catecholamine-degrading enzyme monoamine oxidase (MAO) and the adrenaline-synthesizing enzyme phenylethanolamine-N methyltransferase (PNMT) served to monitor chronic alterations of catecholamine turnover in myocardium. Redistribution in favour of VM-1 (ventricular myosin isoenzyme 1) occurred as early as 2 weeks after the onset of intermittent swimming and was observed under several experimental conditions. The redirection of genetic expression of the isoenzymes was not linked to the presence of an increased ratio of right to left ventricular weight, most probably arising from intermittent hypoxia during drownproofing. The myosin isoenzyme population of swimming spontaneously hypertensive rats (SHR) resembled that of sedentary Wistar rats. The enzyme activities of MAO and PNMT were both significantly reduced following 6 weeks intermittent swimming in Wistar rats and SHR. This can most probably be attributed to the exercise component of swimming which, on average, led to reduced catecholamine turnover in heart. Electrostimulation of rats in pairs for 6 weeks, which resulted in aggressivity and aggressions, did not alter the myosin isoenzyme population in Wistar rats; in SHR, it further augmented the proportion of VM-3 (ventricular myosin isoenzyme 3), which had already increased in the sedentary state. Furthermore, electrostimulation increased PNMT activity, but did not affect MAO activity. Electrostimulation in pairs, followed by swimming, altered the myosin isoenzyme population in the same way as did swimming alone. However, the activities of PNMT and MAO seemed to be governed by the routine involving stress and not by the exercise routine. This demonstrates that stressors supplementing exercise can decisively modify or even prevent reactions of the organism in response to exercise.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6498636 TI - Physiological studies of small mediastinal ganglia in the cardiopulmonary nerves of dogs. AB - Stimulation of the cranial end of a decentralized canine cardiopulmonary nerve results in the generation of a compound action potential which can be recorded at the caudal end. A region has been identified which, on stimulation, produces a compound action potential with complex configuration which is different from simpler wave forms obtained by stimulating 1 mm or more in either the rostral or caudal direction. Histological examination reveals that clusters of neuronal cell bodies are localized to this region of the nerve, whereas none is found to either side. Characteristics of the different wave forms evoked by changing the site of stimulation and reversing the stimulation and recording electrodes provide evidence for the existence of both afferent and efferent synaptic pathways. The compound action potential evoked by the most rostral stimulations and presumed to contain synaptic components was not altered by intravenously administered cholinergic and adrenergic pharmacological blocking agents (hexamethonium, atropine, phentolamine, or propranolol). It was, however, depressed by local injections of chymotrypsin or manganese into the functionally identified transitional region. It is concluded that synapses, which can be activated at relatively high frequencies (1-10 Hz) and may be important for rapidly changing local neural regulation of the heart and lungs, appear to exist within the course of cardiopulmonary nerves. PMID- 6498635 TI - Effect of disulphonic stilbenes on Ca2+ transport in smooth muscle plasma membranes. AB - We studied the effects of two disulphonic stilbenes, 4',4'-diisothiocyano-2,2' stilbene disulphonic acid (DIDS) and 4-acetamido-4'-isothiocyano-2,2'-stilbene disulphonic acid (SITS), on Ca2+ transport by plasma membrane vesicles from the circular muscle of the dog stomach. Both compounds inhibited ATP-dependent Ca2+ uptake and reduce the leak from loaded vesicles. The inhibition produced could not be significantly reduced by either permeant anions or by increasing the level of free Ca2+. The effects of DIDS could be rendered irreversible by incubating the membranes with this agent at 37 degrees C. PMID- 6498637 TI - Specific high affinity binding of the calcium channel antagonist, [3H]nitrendipine, to rat liver microsomes. AB - Some key properties of the binding of [3H]nitrendipine, an analogue of the 1,4 dihydropyridine, nifedipine, to a plasma membrane enriched microsomal fraction from the rat liver are described. Specific binding was saturable, linear with protein concentration, and reversible. The apparent equilibrium dissociation constant, KD, was 4.20 +/- 0.22 nM and the maximum density of binding, Bmax, was 3.02 +/- 0.17 pmol/mg of protein determined from Scatchard analysis of binding at 10 degrees C. Inhibition of binding was specific for dihydropyridines with competitive inhibition being noted with nifedipine and 4-chloronifedipine, as well as BAY K-8644, a calcium channel agonist. A biphasic displacement curve was recorded for methoxy verapamil (D-600), and a triphasic competition curve with lanthanum (La3+), and diltiazem demonstrated competitive kinetics. The high affinity binding site for nitrendipine in the liver, although having some similar properties to those sites described in skeletal muscle, would appear to be distinctive with respect to its unique sensitivity to D-600 and diltiazem. We speculate that this binding site may represent a Ca2+ channel responsible for regulating Ca2+ influx and hepatic glycogenolysis. PMID- 6498638 TI - Excretion of alpha-keto acids by strains of Streptomyces venezuelae. AB - Cultures of Streptomyces venezuelae released acidic metabolites during nitrogen limited growth on glucose. The main products were pyruvic acid and alpha ketoglutaric acid. Variation in the extent of acid production was observed; spores of the parental strain 13s gave approximately 10% of low-producing colonies when plated on acid-base indicator medium. Examination of one low producer, strain PC 51-5, showed that differences in acid production became apparent only in low-glucose media containing manganese. In both strains PC 51-5 and 13s, uptake of alpha-keto-[5-14C]glutaric acid occurred by diffusion and no marked differences in permeability to alpha-ketoglutarate were detected. However, differences were observed in the activity of alpha-ketoglutarate dehydrogenase. In cultures of strain PC 51-5, the specific activity of the enzyme increased throughout growth, whereas in the parental strain activity decreased and could not be detected in older mycelium. Loss of enzyme activity was accompanied by excretion of alpha-ketoglutaric acid and failure to assimilate the product after glucose exhaustion. The results suggest that accumulation of pyruvic and alpha ketoglutaric acids in S. venezuelae cultures grown in glucose-containing media may be due to regulatory suppression of the dehydrogenases by this carbon source. PMID- 6498639 TI - Adsorption of tumorigenic Agrobacterium tumefaciens cells to susceptible potato tuber tissues. AB - Cells of tumorigenic Agrobacterium tumefaciens strain B6 were labeled with [35S]methionine and used to estimate bacterial adsorption to potato tuber discs. After 10 min at pH 7.2, about 5 X 10(5) bacteria adsorb to each 9.0-mm disc. Lengthening the incubation period to 90 min increases adsorption to about 11 X 10(5) bacteria per disc. Bacterial adsorption is reduced under both alkaline and acid pH conditions and increases 2.3-fold if the number of bacterial cells in the inoculum is doubled. Adsorption is increased if citrus pectin, polygalacturonic acid, or demethylated pectin is included in the inoculum; methylated polygalacturonic acid is inactive. The activity of citrus pectin is abolished, however, if the compound is applied to the discs as a pretreatment and then removed prior to inoculation. Lipopolysaccharide preparations from five of six A. tumefaciens strains have no effect on bacterial adsorption. The sixth preparation, from nontumorigenic strain NT-1, reduces adsorption by about 20%. PMID- 6498640 TI - Relationship between group JK corynebacteria and the biotypes of Corynebacterium genitalium and Corynebacterium pseudogenitalium. AB - Twenty-six strains of group JK corynebacteria had the same colonial morphology and biological reactions as the biotypes of the biovars of Corynebacterium genitalium and C. pseudogenitalium. Therefore, group JK corynebacteria can be assigned to the biovars of C. genitalium or C. pseudogenitalium. Although the strains differed in sensitivity to 16 antibiotics tested by Sensi-Discs or by the Micro-Media technique, they are uniformly sensitive to 4-5 micrograms/mL of vancomycin. Medium containing 10 micrograms vancomycin/mL was bactericidal and the killing time was dependent on the concentration. The rate of mutation to resistance to 10 micrograms vancomycin was greater than 1 in 10(10) corynebacteria. Therefore, vancomycin sensitivity is a stable characteristic of these corynebacteria which also indicates that group JK corynebacteria are strains of either C. genitalium or C. pseudogenitalium. Since group JK corynebacteria are considered pathogens, this finding supports the belief that C. genitalium is a pathogen and suggests that some biotypes of the commensal C. pseudogenitalium may infect compromised hosts. PMID- 6498642 TI - Excision of pilonidal sinus as an office procedure. PMID- 6498641 TI - Treatment of colorectal cancer. PMID- 6498643 TI - Incidence of funerals and cancer in Canada. PMID- 6498644 TI - Another use for temporarily placed atrial electrodes. PMID- 6498645 TI - Radionuclide scintigraphy: a valuable diagnostic aid in children with splenic trauma. AB - Preserving the spleen in children with splenic trauma remains a primary concern of surgeons. Nonoperative management has been encouraged in recent years, but this must be balanced against the risk of delayed rupture of the spleen and failure of diagnose other causes of intra-abdominal bleeding. The author reviews his experience over a 10-year period with 36 children who had a diagnosis of ruptured spleen. The role of radionuclide scintigraphy of the spleen has been reviewed recently with particular reference to its influence on the need for laparotomy. The indications for laparotomy and the management of splenic injuries are discussed. In the author's opinion, radionuclide scintigraphy is a valuable diagnostic aid in children with suspected splenic trauma. PMID- 6498646 TI - Localized rigidity and narrowing of the antrum: a cause of gastric outlet obstruction in infancy. AB - In infants with persistent vomiting without bile staining, in whom congenital hypertrophic pyloric stenosis has been excluded, an upper gastrointestinal roentgenogram may show antral obstruction. Of four infants with partial gastric outlet obstruction described by the authors, an antral membrane was demonstrated radiologically in two. Other causes of antral obstruction, such as granulomatous disease, hour-glass deformity of the antrum, cholecystogastrocolic band and antral dysmotility, were considered and excluded as the cause of the vomiting. After medical management failed, gastroscopy revealed a rigid stenotic circumferential area in the antrum in all four infants. An antral membrane was not found. Laparotomy confirmed this finding and a pyloroplasty successfully resolved the symptoms. Localized rigidity and narrowing of the pyloric antrum, masquerading as an antral membrane radiologically, should be considered among the causes of gastric outlet obstruction in infancy. Treatment is determined by the severity of the symptoms. Pyloroplasty is successful when medical management fails. PMID- 6498647 TI - Surgical management of persistent postoperative chylothorax in children. AB - Chylothorax occurring postoperatively in children is found most commonly after cardiovascular operations, but may occur after almost any thoracic procedure. Seven cases of postoperative chylothorax seen at the Children's Hospital of Eastern Ontario in Ottawa from 1976 to 1983 are reported. Two resolved with nonoperative management and five required surgical intervention. The authors discuss the clinical presentation, treatment and outcome. They describe a simple, safe and effective method of ligation of the thoracic duct just above the diaphragm. PMID- 6498648 TI - Pancreatic carcinoma: surgical treatment. AB - There is controversy in the literature over the surgical treatment of pancreatic carcinoma, especially whether gastro-enterostomy should be performed prophylactically when palliative biliary bypass is done. The authors report a retrospective study of 184 patients with pancreatic carcinoma treated at the Hotel-Dieu Hospital in Montreal between 1970 and 1982. Of these, 106 patients had cancer of the head of the pancreas. In this group, 15 had a Whipple procedure. Median survival was 512 days with no 5-year survivors. Forty-nine patients had biliary bypass alone and 3 needed gastroenterostomy later for duodenal obstruction. Eleven patients had both biliary--enteric bypass and gastroenterostomy. Biliary bypass using the common duct gives the same result as that using the gallbladder. Considering their reoperation rate of only 7.3%, the authors do not believe that prophylactic gastroenterostomy is indicated in these patients. PMID- 6498649 TI - Sclerotherapy for esophageal varices: preliminary experience. AB - There has been a resurgence of interest in injection sclerotherapy as a means of controlling and preventing variceal hemorrhage. This report reviews and evaluates the early experience with this procedure at the Toronto General Hospital. From May 1979 to January 1983, 39 patients underwent 73 separate treatment sessions (rigid 23, flexible 50), during active bleeding (3), during hospitalization for variceal hemorrhage but after cessation of bleeding (35) and during elective admission to hospital expressly for sclerotherapy (35). Follow-up was obtained for 38 patients (98%). The overall rate of rebleeding was 27%. Complications occurred in 13 patients (33%). Ten patients died; in 2, death was directly attributable to a complication of sclerotherapy. From this preliminary experience the authors conclude that complications of sclerotherapy are frequent and potentially life-threatening, so more prospective randomized trials are needed before its role in the treatment of bleeding varices is clear. PMID- 6498650 TI - Prophylactic use of antibiotics in pancreatic sepsis: a 25-year reappraisal. AB - The efficacy of antibiotics given prophylactically in cases of acute pancreatitis is controversial. The authors carried out a retrospective review of 528 cases of pancreatitis seen between 1955 and 1980 and noted a marked increase in the number of septic complications and in the mortality related to sepsis. In most cases, infection was due to organisms sensitive to the antibiotics used, suggesting that they are not effective in preventing sepsis. The authors suggest a new approach to prophylactic administration of antibiotics, based on bioactive tissue levels in pancreatitis. PMID- 6498651 TI - Tracheal sleeve pneumonectomy for carcinomas of the proximal left main bronchus. AB - Although most primary cancers of the left main bronchus extending to the carina are inoperable, some patients with such a tumour may benefit from an extended, curative surgical procedure. This type of resection presents specific problems in reconstruction and physiologic management during operation. Between 1977 and 1983, five such patients were managed by left pneumonectomy followed by resection of the carina. They ranged in age from 49 to 65 years. None were irradiated before the procedure. In all cases, an end-to-end anastomosis was made between the right main bronchus and the mediastinal trachea. The high-flow catheter technique was used for ventilation during reconstruction. There were no operative deaths. Excessive bronchorrhea was noted in all patients and was aggravated by left recurrent nerve palsy in two. This report indicates that modern techniques of tracheobronchial reconstruction can be successfully applied in patients with locally advanced carcinoma of the proximal left main bronchus. This type of resection may be the treatment of choice in selected cases. PMID- 6498652 TI - Fracture of the hook of the hamate. AB - Fracture of the hook of the hamate most often occurs in athletes in the hand that holds a club, racket, bat or hockey stick, when the end abuts against the palm of the hand. The authors report six patients with this rare fracture, including the only known case of spontaneous healing. Because this fracture is associated with nonunion, surgical excision of the hook through the fracture site is recommended in most cases. PMID- 6498653 TI - Spontaneous perforation of the common bile duct in infancy detected by 99mTc HIDA scanning. AB - Bile ascites is a rare cause of mild icterus and abdominal distension in the newborn. An indirect inguinal hernia may also occur. The authors report such a case in a 5-week-old infant. Proof was obtained by abdominal ultrasonography followed by scanning with N-(2,6-dimethyl phenyl carboxymethyl) iminodiacetic acid labelled with technetium 99m (99mTc HIDA) and paracentesis. Laparotomy was carried out at 7 weeks of age and the opening in the common bile duct was closed with excellent results. PMID- 6498654 TI - Treatment of femoral fractures with the cast brace. AB - The authors report a retrospective review of 82 patients with femoral fractures treated nonoperatively by skeletal traction and cast bracing at the University of Alberta Hospital between 1975 and 1979. Fractures were classified as stable or unstable and the position of the fracture was assessed at the time of application of the cast brace and at the time of removal, using angulation, shortening and healing time as criteria for classification of results. Satisfactory results were seen in 88% of patients. At the time of cast brace removal, average knee flexion was 97 degrees, thigh atrophy was 2.5 cm and shortening was 1.4 cm. The unsatisfactory results are analysed and a protocol for successful use of the cast brace is suggested. PMID- 6498655 TI - Clinical comparison of Michel and Proximate clips used for abdominal wound closure. AB - For many years Michel clips (Down Surgical, Mississauga, Ont.) have been used to close wounds and results have been good, but several newer clips are now available (e.g., Proximate; Ethicon Sutures Ltd.), which are said to be easier to use and produce a better scar. However, they are much more expensive. The authors carried out a prospective controlled study in which 30 patients with abdominal incisions had half of the skin incision closed with Michel clips and the other half with Proximate clips. They assessed ease of insertion and removal, and appearance of the wound immediately after removal and 2 months later. Ethicon Proximate clips were, in general, slightly easier to insert, less uncomfortable to remove in 8 of the 30 patients and gave a better immediate cosmetic result in 9 patients. However, there was no difference in the appearance of the wound 2 months later. The authors do not consider that Ethicon Proximate clips offer an advantage over the much less expensive Michel clips. PMID- 6498656 TI - Pleuroperitoneal shunt for intractable pleural effusion. AB - Intractable pleural effusion secondary to malignant disease is often managed by thoracentesis or sclerotherapy, painful time-consuming procedures that may be ineffective. An alternative technique is to place a pleuroperitoneal shunt as in a 73-year-old man, described in this paper, who had recurrent right and left pleural effusions secondary to inoperable squamous cell carcinoma of the right lung. In his case, sclerotherapy was not attempted on the left side because a pericardial window was functioning. The left pleural effusion was successfully managed by inserting a pleuroperitoneal (LeVeen) shunt. PMID- 6498657 TI - Supracondylar fractures of the femur: results of treatment of 61 patients. AB - A retrospective study of 61 fractures (60 patients) involving the supracondylar and intercondylar areas of the femur was made. All patients were younger than 60 years and sustained their injuries in motor vehicle accidents. Follow-up was from 1 to 9 years (mean 30 months). Clinical results of operative and nonoperative treatment were compared with respect to knee motion, pain and function. Extra articular (type A) fractures had superior clinical ratings if treated operatively (45% excellent and 30% unsatisfactory). Intra-articular (type B) fractures had a substantial number of unsatisfactory ratings (45%) and results of operative and nonoperative treatment were comparable. Fractures of one condyle only did best with open reduction and internal fixation. Rates of nonunion were low (7%); malunion in varus led to poorer overall function. The most important factor for acceptable function was early knee mobilization. Early motion of the knee and quadriceps rehabilitation are facilitated by operative management or use of the cast brace. PMID- 6498658 TI - Congenital posterolateral diaphragmatic hernia in the adult. AB - Bochdalek's hernia, congenital posterolateral diaphragmatic hernia, is common in children but rarely occurs in adults. The authors report two such adult cases. One of the hernias was on the left and the other on the right. Both patients had gastrointestinal symptoms. The approach was abdominal in one and thoracoabdominal in the other. There were no operative or postoperative complications. The possibility of congenital posterolateral diaphragmatic hernia must be considered in the differential diagnosis of patients who have recurrent gastrointestinal and respiratory complaints. A complete roentgenologic examination is necessary in order to make an accurate diagnosis preoperatively. Because of the danger of strangulation of the hernia, operation should be carried out as soon as the diagnosis is made. PMID- 6498659 TI - Unusual snowmobile injury of the penis: a case report. AB - Snowmobiles have been responsible for a variety of characteristic injuries. The authors report a most unusual injury--degloving of the penis. A 49-year-old man was thrown against the handlebars of his machine. The penis was traumatically circumcised, degloved and forced through the subcutaneous peritoneal tissue to exit through a gash in the left thigh. At operation, the area was debrided and irrigated. The penis was easily returned to its normal position, into the intact but detached penile skin which was then sutured in place. PMID- 6498660 TI - Human bite injuries of the hand. AB - The charts of 24 patients admitted to Victoria Hospital, London, Ontario with human bite injuries were analysed. Two clinical groups were found. One group of patients had evidence of septic arthritis. They required operative treatment and experienced complications. The second group was made up of patients with cellulitis who responded to antibiotic therapy and had an uncomplicated course. No resistance to cephalosporins was found. Patients seen soon after injury without evidence of joint penetration should be managed by irrigation and open management of the wound, immobilization in a hand dressing, elevation, tetanus prophylaxis, oral administration of a cephalosporin and reexamination within 24 hours. Those who fail to respond to this treatment should be admitted to hospital and given antibiotics intravenously. Clinical evidence of septic arthritis warrants early operative incision and drainage combined with antibiotics given intravenously. PMID- 6498661 TI - Improved neurologic function following repair of type I aortic dissection with an intraluminal prosthesis. AB - Repair of type I dissection of the aorta by suturing is often complicated by intraoperative and postoperative bleeding. To avoid these complications, the authors use a sutureless ringed intraluminal prosthesis. They describe the case of a 62-year-old woman who had paralysis of the lower extremities with acute type I dissection of the aorta. Emergency surgical intervention 14 hours after onset of symptoms and repair with the intraluminal graft resulted in minimal aortic insufficiency and almost complete functional recovery. An aggressive surgical approach to patients with profound neurologic deficits due to aortic dissection is justified. Repair with the sutureless intraluminal prosthesis is simple and safe and may allow recovery of neurologic function. PMID- 6498662 TI - Visual hallucinations induced by a sympathomimetic drug. PMID- 6498663 TI - [Esophageal ulcer caused by doxycycline]. PMID- 6498664 TI - Psychosis induced by sustained-release procainamide. PMID- 6498665 TI - Crohn's disease in a mother, father and son. PMID- 6498666 TI - Dirofilariasis presenting as a breast lump (correction) PMID- 6498667 TI - Doll shoes: the cause of behavioural problems? PMID- 6498668 TI - Restoring the balance between research and medical education. PMID- 6498669 TI - The place for more comprehensive institutional geriatric services in the health care system. PMID- 6498670 TI - Tobacco smoke in the workplace: an occupational health hazard. AB - Tobacco smoke, which contains over 50 known carcinogens and many other toxic agents, is a health hazard for nonsmokers who are regularly exposed to it while at work. Involuntary exposure to tobacco smoke annoys and irritates many healthy nonsmokers. Serious acute health effects are probably limited to the one fifth of the population with pre-existing health conditions that are aggravated by exposure to tobacco smoke. The consequences of long-term exposure include decreased lung function and lung cancer. Existing air quality standards for workplaces do not directly specify an acceptable level for tobacco smoke. The evidence on the composition of tobacco smoke and on the health hazards of involuntary exposure suggests that there may not be a "safe" level for such exposure. PMID- 6498671 TI - Tailoring family medicine residency programs to meet community needs. Department of Family Medicine, University of Ottawa. AB - This paper describes how members of the Department of Family Medicine of the University of Ottawa developed lists of problems and procedures common and important in family practice in Canada and, on the basis of these lists, drew up guidelines for content in the 2-year residency program for family medicine. A computerized data retrieval system is used to monitor every resident's practice to ensure that he or she gains appropriate exposure to common problems and procedures. PMID- 6498672 TI - The "new" ampicillins: who needs them? Committee on Infectious Diseases and Immunization, Canadian Paediatric Society. PMID- 6498673 TI - Sources of primary health care for women in an urban centre. AB - Family or general practitioners and obstetrician-gynecologists have the opportunity to provide primary health care to women. Who actually gives this care in a large urban setting was the focus of this study. In the Montreal area 297 women were asked by telephone whether they had an obstetrician-gynecologist and whether they would see another type of doctor for a cold that was not getting better. Overall, 88% of all the women indicated that they would go to a family or general practitioner for such a problem, and of the women who reported receiving some care from an obstetrician-gynecologist 78% also received care from another physician. Of the respondents seeking health care from only one type of doctor, women with English as the mother tongue were significantly more likely to attend an obstetrician-gynecologist, whereas French-speaking women much more often were cared for by family or general practitioners. PMID- 6498674 TI - [Immunologic aspects of 2 modes of prevention of urinary tract infection in children with trimethoprim-sulfamethoxazole]. AB - Two types of prophylaxis of urinary tract infection with trimethoprim sulfamethoxazole (TMP-SMZ) were studied in 72 children with recurrent urinary tract infections or vesicoureteral reflux or both. Daily prophylaxis only was used in 36 children and thrice-weekly prophylaxis only in 25 others, and 11 children received successively both types of prophylaxis. The same dosage was used in all cases: 2 mg/kg of TMP and 10 mg/kg of SMZ, given at bedtime. With daily prophylaxis the infection rate over 556 patient-months was 5.4 cases per 1000 patient-months, compared with 285.4 cases in the year before prophylaxis; side effects were noted in 11% of the patients during treatment. With thrice weekly prophylaxis the infection rate over 381 patient-months was 15.7 cases per 1000 patient-months, compared with 313.6 cases in the year before prophylaxis; only 3% of the patients receiving this treatment had a side effect that was possibly drug-related. These results indicate that effective prophylaxis of urinary tract infection in children can be obtained with these two types of treatment. PMID- 6498675 TI - The warning leak in subarachnoid hemorrhage and the importance of its early diagnosis. AB - A 40-year-old man had a severe headache of sudden onset and progressive palsy of the third cranial nerve from a minor subarachnoid hemorrhage. Despite assessment by two primary care physicians the possibility of serious neurologic disease was not raised and the urgency of the situation not appreciated. Two weeks after the onset of the headache the patient was urgently admitted to hospital at the request of a neuro-ophthalmologist. Cerebral angiography revealed an aneurysm of the posterior communicating artery, which was surgically occluded with a clip. The patient had a satisfactory recovery, with almost complete return of nerve function by the time of discharge from hospital. Such "warning leaks" in subarachnoid hemorrhage are discussed, and a protocol for their assessment is recommended. PMID- 6498676 TI - Hereditary central diabetes insipidus: plasma levels of antidiuretic hormone in a family with a possible osmoreceptor defect. AB - A large Canadian kindred of Irish extraction extending from Quebec to British Columbia with autosomal dominant diabetes insipidus responsive to exogenous antidiuretic hormone (ADH) is described. Out of 121 individuals 34 have been identified as affected in seven generations. The disorder is characterized by variability in age at onset and in severity, and by apparently spontaneous abatement in old age. The affected subjects do not appear to manifest hypertension or its sequelae. In three individuals tested the plasma ADH level was very low in spite of adequate osmotic stimulation. However, the level rose in two of them when they were given furosemide, which suggests an osmoreceptor defect and a normal ADH response to volume change. PMID- 6498677 TI - Congenital temporal triangular alopecia. AB - Congenital temporal triangular alopecia is a form of nonscarring alopecia that, as its name suggests, is present at birth. Four cases are reported. One patient underwent hair transplantation, which was successful and might be useful in other patients. Cases occurring in a father and his son suggest for the first time a genetic link. PMID- 6498678 TI - Musicogenic epilepsy. AB - A case of musicogenic epilepsy is reported in which the seizures were precipitated by singing voices. It was found that some singers' voices were particularly epileptogenic and that some of their songs, but not others, would precipitate a seizure. A study of the "offending" songs and singers did not reveal a common key, chord, harmonic interval, pitch or rhythm, and the emotional feeling or intensity of the music did not seem to be relevant. However, the voices that caused the seizures had a throaty, "metallic" quality. Such a singing voice results from incorrect positioning of the larynx such that it is not allowed to descend fully during singing; consequently, the vowel sounds produced must be manipulated by the lips or jaw to be distinguished. This trait is most common in singers with a low voice range who sing softly and use a microphone. It is not seen in trained operatic or musical theatre singers. The results of repeated testing showed that the seizures in this patient were caused by listening to singers who positioned the larynx incorrectly. PMID- 6498679 TI - Woody Freamo: a perspective on European medical manpower. PMID- 6498680 TI - Ban balance billing? A US federal court says "no". PMID- 6498681 TI - The myths and realities of civil defence. PMID- 6498682 TI - Computers and medicine: the physician on line. PMID- 6498683 TI - Can vitamins prevent neural tube defects? PMID- 6498684 TI - "Wounded healers" can help give hospital patients more humane care. PMID- 6498685 TI - The randomized clinical trial: panacea or placebo? PMID- 6498686 TI - Breast self-examination: importance of technique in early diagnosis. AB - Shortly after diagnosis of breast cancer 416 patients were interviewed about their use of screening procedures and the method of tumour detection. Although 72% reported that they performed breast self-examination (BSE), only 12% actually inspected and palpated their breasts monthly. BSE was not significantly associated with tumour size or involvement of the lymph nodes; however, thorough inspection was associated with smaller tumours, and careful palpation with the absence of palpable nodes. Of those who no longer or never had examined their breasts 40% reported having annual breast examinations by their physician and had significantly smaller tumours than did the others. Most of the women (86%) reported having detected their own tumours, and BSE did not significantly increase the likelihood of self-detection. The frequency of use of screening procedures was similar in a sample of women without breast cancer. PMID- 6498687 TI - Methadone poisoning due to accidental contamination of prescribed medication. AB - Two infants presented with fever and signs of brainstem dysfunction, including impaired consciousness, miosis, absence of oculocephalic responses, respiratory depression and a very peculiar tremor of the tongue and floor of the mouth. They were found to have methadone poisoning caused by accidental contamination of prescribed antibiotics in the same pharmacy, which was a dispensing centre for a methadone maintenance program. They recovered with supportive treatment only. PMID- 6498689 TI - Pleuropulmonary melioidosis in a Cambodian refugee. AB - A 47-year-old Cambodian refugee presented with an acute respiratory illness that featured consolidation of the lower lobe of the left lung and progressive involvement of the adjacent pleura caused by Pseudomonas pseudomallei. Initial difficulty in identifying the organism resulted in an inadequate duration of therapy. Chronic pleural disease followed, and the organism became resistant to many antibiotics during therapy. A diagnosis of pleuropulmonary melioidosis should be entertained and the microbiology laboratory alerted when patients with pneumonia who are from endemic areas are encountered, so that a diagnosis can be made early and the appropriate treatment begun. PMID- 6498688 TI - Urinary schistosomiasis: a report of four cases and a review. AB - Urinary schistosomiasis is a common cause of hematuria in tropical regions, where it most often affects teenage boys. Children presenting with hematuria in the developed world are usually considered to have bacterial cystitis or a structural lesion and are investigated and treated accordingly. The authors report on a family recently returned to Canada from Nigeria in which all four children had urinary schistosomiasis. Nocturnal enuresis was the presenting symptom in the index case; this patient also had hematuria and dysuria. Nocturia occurred in a second child, and the other two children were asymptomatic. All four were cured by a single dose of praziquantel, a new schistosomicide. The life cycle of the causative organism, the clinical manifestations of schistosomiasis, the host response and treatment with praziquantel are reviewed. PMID- 6498690 TI - Strangulated diaphragmatic hernia in a patient with osteogenesis imperfecta. AB - Hernias are common in patients with osteogenesis imperfecta, but to our knowledge there have been no reports of diaphragmatic hernias in such patients. We describe a patient with osteogenesis imperfecta in whom a diaphragmatic hernia contained a strangulated segment of the splenic flexure of the colon. Resection of the necrotic tissue and transverse colostomy resulted in an uneventful recovery. PMID- 6498691 TI - Where is the art in medicine? PMID- 6498692 TI - Information science and the general professional education of the physician. PMID- 6498693 TI - Genetics and a woman's rights. PMID- 6498694 TI - Table-top artificial sweeteners: current use in Canada. PMID- 6498695 TI - Is chronic pain a real condition? PMID- 6498696 TI - Hyperbilirubinemia in Indian newborns. PMID- 6498697 TI - How viruses suppress immunity. PMID- 6498698 TI - Artificial sweeteners are not drugs: where does that leave us? PMID- 6498700 TI - A collaborative report on training in obstetrics and gynecology for family physicians in Canada. Ad hoc committee of the Association of Professors of Obstetrics and Gynaecology of Canada. PMID- 6498699 TI - Excipients and additives: hidden hazards in drug products and in product substitution. AB - The excipients and additives in drug formulations have been described as inert because they do not have an active role in the prevention or treatment of particular ailments. This has led to the misconception among physicians, pharmacists, drug manufacturers and the public that excipients are harmless and unworthy of mention. In fact, pharmacists are allowed to substitute drug formulations, without regard to the excipients, as long as they ensure that the active ingredients in the substitute are the same as those in the formulation prescribed. The inappropriateness of the term inert is becoming increasingly apparent as evidence of adverse reactions--some fatal--to excipients mounts. The likelihood that some "active" constituents, particularly erythromycin, have been blamed for such reactions deserves to be investigated. The public deserves to be better protected. For example, the United States has legislation requiring complete labelling of all food, drugs and cosmetics that incorporate more than one ingredient, no matter how innocuous the constituents are believed to be. In Canada, drug manufacturers are not even required to share this information with physicians or pharmacists when they introduce a new drug or reformulate a product already being marketed, nor are pharmacists required to disclose the contents of formulations that they prepare in the absence of commercially available products. PMID- 6498701 TI - Increased prevalence of mitral valve prolapse in patients with migraine. AB - Patients with classic migraine (69 women and 31 men) selected randomly from a practice list of over 1000 were matched for age, sex and neighbourhood with 100 people who did not have headache problems, and both groups underwent M-mode and two-dimensional echocardiography and clinical examination by cardiologists blinded to the subjects' clinical status. The mean ages were 34.9 +/- 11.3 years for the migraine group and 33.1 +/- 9.9 years for the control group. Definite and possible mitral valve prolapse (MVP), diagnosed according to predefined echocardiographic criteria, were found about twice as often in the migraine group as in the control group (in 15 v. 7 and 16 v. 8 patients respectively); the echocardiograms were definitely normal in 69 migraine patients and 85 controls (chi 2 = 8.39, p less than 0.025). Altogether 25% of the migraine group and 11% of the control group had evidence of MVP from a combination of the echocardiographic and auscultatory findings (chi 2 = 5.72, p less than 0.025). The odds ratio was 2.7, with 95% confidence limits of 1.17 and 6.29. The association between migraine and MVP has implications for the understanding of platelet abnormalities and episodes of cerebral ischemia occurring in both these conditions. PMID- 6498702 TI - Pertussis in a vaccinated 12-year-old girl. AB - Pertussis, though uncommon in people older than 9 years, does occur (in girls and women primarily) and should be considered in the differential diagnosis of persistent cough. Earlier this year in British Columbia a 12-year-old girl contracted the disease, even though she had been fully vaccinated against it at the appropriate ages. The source of her infection was unknown. The clinical picture was classic except that the girl experienced intense headaches, lasting up to an hour, after the episodes of paroxysmal coughing. Canadian physicians and public health practitioners should encourage vaccination against pertussis. PMID- 6498703 TI - Hemolytic anemia following insertion of Ionescu-Shiley mitral valve bioprosthesis. AB - Hemolytic anemia is a relatively common complication after the replacement of cardiac valves with mechanical prostheses; the prevalence rate varies from 38% to 85%, depending on the prosthesis implanted. However, cardiac valves fabricated from biologic material are associated with a reduced incidence of hemolytic anemia, and to the authors' knowledge this report is the first to document hemolytic anemia in a patient who had the mitral valve replaced with an Ionescu Shiley valve. The anemia was not associated with evidence of hemodynamically important mitral regurgitation and was ultimately controlled by iron and folate supplements. PMID- 6498704 TI - MRC's Dr. Pierre Bois: research funding's precarious future. PMID- 6498705 TI - The challenge of training specialists in geriatrics. PMID- 6498706 TI - Canadian psychiatrists consider the plight of the unemployed. PMID- 6498707 TI - Anonymity in medical journals. PMID- 6498708 TI - Special report on medical education. PMID- 6498709 TI - Adverse effects of NSAIDs on renal function. PMID- 6498710 TI - Characteristics of patients found not to have multiple sclerosis. PMID- 6498711 TI - Employment history valued but not recorded by MDs. PMID- 6498712 TI - Electroconvulsive therapy. PMID- 6498713 TI - [Occupational exposure to formaldehyde during pregnancy]. PMID- 6498714 TI - Grading clinical research: a midterm report card. PMID- 6498715 TI - Improving the quality of research published in CMAJ. PMID- 6498716 TI - Differential diagnosis and treatment of the "housebound syndrome". AB - Not all people who become housebound suffer from agoraphobia. Other emotional illnesses can underlie this behaviour. Early diagnosis is important. Some conditions can be treated by family physicians without special training, and some are appropriately treated only in special settings. This paper describes psychiatric disorders that may present as a "housebound syndrome" and outlines the principles of treatment for each. PMID- 6498717 TI - Recent trends in incidence rates of pleural mesothelioma in British Columbia. AB - A total of 64 cases of pleural mesothelioma were reported in British Columbia between 1973 and 1980, 54 in males and 10 in females. There was a significant (p less than 0.05) increase in the incidence among males. The overall incidence rates were 4.9 and 0.9 per million person-years for males and females respectively. The age distribution of the cases was roughly exponential up to age 70 years. Almost all of the cases were clustered in Cowichan Valley, Capital and Greater Vancouver counties, where there was a high level of shipbuilding activity 30 to 40 years ago. The increased incidence in males may be related to this activity, which involved exposure to asbestos. PMID- 6498718 TI - Hepatitis B follow-up among Indochinese refugees. AB - During 1979 and 1980 the Department of National Health and Welfare carried out a survey and later routine testing to determine the prevalence of serologic markers of hepatitis B in Indochinese refugees entering Canada. Between March and July 1981 the hepatitis-B-marker status of 220 selected refugees in the Ottawa-Hull area was reassessed. Overall, 173 (79%) of the participants had the same serologic markers when retested, but in 47 (21%) the markers had changed. The most significant changes were the loss of antigenemia in 22% of those who had been HBsAg-positive and the appearance of evidence of infection in 18% of those who had been seronegative. Most of these changes occurred among persons under 30 years of age, especially females aged 10 to 19 years. PMID- 6498719 TI - Cimetidine-induced psychosis in a 14-year-old girl. AB - A 14-year-old girl presented with hallucinations and bizarre behaviour 3 days following the institution of cimetidine therapy for acute gastritis. She had no history of drug abuse or psychiatric disorders, and physical examination and laboratory investigations yielded no abnormalities. Within 24 hours after cimetidine therapy was discontinued her behaviour returned to normal and the hallucinations stopped. PMID- 6498721 TI - The new Vienna General Hospital: high tech in an old city. PMID- 6498720 TI - Psychiatric manpower in British Columbia. AB - The ideal psychiatrist population ratio of 1:11 000, as accepted by the Ministry of Health in British Columbia and the British Columbia Medical Association, is probably inadequate since it does not take into account increased utilization and demand, the ageing of the population, the reduction in the work week of psychiatrists and the expected absence of of increased productivity of psychiatrists. The increase in utilization and demand reflects treatment of disorders with high prevalence and chronic outcomes whose needs were previously met, rather than psychiatrists "chatting with the worried well", as is sometimes alleged. The concentration of psychiatrists in Vancouver reflects the needs of both tertiary care and migration of psychiatric patients. It is not a local aberration and does not reflect over supply. An adequate psychiatrist to population ratio for large geographic areas is less than 1:10 000. The ratio for urban areas has not yet been determined, but is probably less than half of the overall ratio. In any case, more study of this issue is required before draconian health policy measures are undertaken to solve a perceived problem which may not exist. PMID- 6498722 TI - What's past is prologue. Future issues in public health. PMID- 6498723 TI - Health protection in Canada to the year 2000. PMID- 6498724 TI - A survey of zoonotic diseases and arthropod vectors isolated from live-trapped Norway rats (Rattus norvegicus) in the municipality of Richmond, British Columbia. PMID- 6498725 TI - Viral hepatitis: practical aspects of "in-hospital" infection control. PMID- 6498726 TI - Survey of the use of activated carbon water filters in Canadian homes. PMID- 6498727 TI - [Scientific knowledge and action in Public Health: The role of research in the creation of a health program]. PMID- 6498728 TI - Late effects of adjuvant radiotherapy for breast cancer. AB - Complications requiring in-hospital treatment were observed in 24 of 221 consecutively treated patients (11%) who were followed from 8 to 42 years after postmastectomy irradiation. There were four sarcomas of the treated chest wall, three squamous carcinomas (two in the esophagus), two angiosarcomas of the swollen homolateral arm, nine chronic ulcers, five respiratory insufficiencies, six pathologic fractures of the radiated shoulder or ribs, two fatal cardiomyopathies, one persisting leukopenia with fatal brain abscess, and one severe neurovascular impairment of the arm. In a comparable group of 394 consecutive postmastectomy patients who were not irradiated, one similar event, a myxosarcoma of an unswollen arm, was observed. Only long-term follow-up can determine the ultimate risks of radiotherapy. PMID- 6498729 TI - Intraoperative radiotherapy for advanced carcinoma of the pancreas. AB - A detailed retrospective analysis of the efficacy of intraoperative radiotherapy (IOR) in advanced carcinoma of the pancreas is presented. During a 10-year period from 1973 through 1982, 70 patients with advanced carcinoma of the pancreas were treated by multimodal methods, separate or combined therapy of surgery, IOR, and chemotherapy in two different institutions. Among these, 33 patients underwent IOR, mostly combined with additive surgery. A single dose of 20.1 to 40.0 Gy with 8 to 25 meV electrons was delivered through radiation cones ranging from 6 to 10 cm in diameter. Excellent relief was noticed in 50% of the patients who had complained of pain. Among Stage IV patients, a significant difference of survival rate was observed between IOR and control groups (P less than 0.05); the mean survival time of the IOR group was 4.6 +/- 2.6 (SD) and that of the control group 2.5 +/- 1.4 (SD) months. Intraoperative radiotherapy proved to be effective in prolonging the survival of patients with advanced stage of the lesion. PMID- 6498730 TI - Diagnosis of orbital tumors by aspiration biopsy guided by computerized tomography. AB - Thin-needle aspiration biopsy (TNAB) was performed on 22 patients with orbital tumors. Nine patients were studied before the introduction of computed tomography (CT) and only two cytologic diagnoses could be established. Thirteen aspiration biopsies guided by CT were successful. The technique of the CT-guided TNAB of orbital tumors is described. The cytologic features combined with the clinical data made it possible to diagnose precisely 10 malignant orbital tumors that were either metastatic or primary. Two meningiomas and one abscess were also identified. There were no complications. The TNAB of orbital tumors under CT guidance appears to offer several significant benefits to the patients. PMID- 6498731 TI - Accuracy of chest computerized tomography in detecting malignant hilar and mediastinal involvement by squamous cell carcinoma of the lung. AB - The accuracy of chest computerized tomography (CT) in detecting malignant hilar and mediastinal involvement by squamous cell carcinoma of the lung is examined. The preoperative chest CT scans of 74 patients with pathologically proven squamous cell lung carcinoma were prospectively and retrospectively reviewed. Criteria for the diagnosis of malignant hilar involvement were nonvascular mass enlarging the hilum; local alteration of hilar contour; adenopathy greater than 1 cm; thickened posterior wall of the bronchus intermedius and distal upper lobe bronchi; and bronchial displacement, compression, and obstruction. Criteria for the diagnosis of malignant mediastinal involvement were confluence of tumor with the mediastinum, altered contour of the azygoesophageal recess, thickened posterior wall of the proximal main stem bronchi, and mediastinal adenopathy greater than 1 cm. Calcified hilar and mediastinal nodes were considered benign. Our results, corrected for reader error, were 92% sensitive, 92% specific, and 96% accurate in the hilum and 95% sensitive, 77% specific, and 82% accurate in the mediastinum. These data support a significant role for chest CT in the preoperative staging of non small cell lung carcinoma. PMID- 6498732 TI - The role of luminal contents in radiation enteritis. AB - A guinea pig model was used to evaluate luminal content as a factor in the development of acute radiation enteritis. Surgical bypass of one half of the small bowel created an isolated segment free of luminal contents. Radiation effects on this empty intestine were compared with effects on bowel in continuity, on intestine containing bile only, and on intestine containing pancreatic enzymes plus food. The animals were subjected to a single dose of 1600 rad via an abdominal port and killed 4 days later. Surviving crypts per circumference provided one index of the severity of the injury. Intestinal damage was further evaluated by histologic grading. Surviving crypts were significantly fewer for irradiated segments of bowel containing any of the components of the intestinal stream compared to either nonirradiated controls or irradiated but empty bowel. Histologic scoring revealed a gradation of injury, with progressively more severe damage in empty irradiated bowel, and in intestine containing only pancreatic secretion, bile, and all components of the luminal stream. We conclude that both bile and pancreatic secretions in the lumen enhance acute radiation-induced small-bowel injury. PMID- 6498733 TI - The ability of macrophages from head and neck cancer patients to kill tumor cells. Effect of prostaglandin inhibitors on cytotoxicity. AB - Monocyte-derived macrophages were isolated from the peripheral blood of 39 patients with either squamous cell carcinomas of the head and neck or basal and/or squamous cell carcinomas of the facial areas. Macrophages from 6 of the 27 patients with squamous cell carcinomas of the head and neck were cytotoxic toward the human tumor cells. When indomethacin, a prostaglandin inhibitor, was added to the noncytotoxic macrophages during the cytotoxicity assay, macrophages from 8 of the 27 patients became cytotoxic for the tumor cells. When 12 patients with basal and/or squamous cell carcinomas of the facial areas were studied, the macrophages from 2 of these patients possessed cytotoxic macrophages. In addition, when indomethacin was added to the noncytotoxic macrophages during the assay, the macrophages from two of these patients became cytotoxic. However, it was also noted that 19 of the 39 patients with either squamous cell carcinomas of the head and neck or basal and/or squamous cell carcinomas of the face possessed macrophages that were noncytotoxic toward the tumor cells in the presence and absence of indomethacin. Macrophage-mediated cytotoxicity was also found to be inhibited by factors present in many cancer patients' plasma. Twelve of the 30 patients with squamous cell carcinomas of the head and neck possessed a plasma inhibitory factor capable of suppressing macrophage-mediated cytotoxicity by more than 50%, whereas no plasma inhibitory factor was found in the patients with basal and/or squamous cell carcinomas of the face. In addition, 29 of the 30 patients studied were incapable of killing the tumor cells in vitro either because they possessed nonresponsive macrophages and/or they possessed a plasma inhibitory factor. PMID- 6498734 TI - Familial hemophagocytic lymphohistiocytosis in Israel. II. Pathologic findings. AB - Presented are the pathologic findings in familial hemophagocytic lymphohistiocytosis (FHLH), based on observation of 11 cases from four affected families. The outstanding morphologic feature was a multiorgan involvement with lymphohistiocytic cellular infiltrates. The organs most frequently affected were the bone marrow and lymph nodes and, less frequently, the liver and the brain. The histiocytes in the infiltrates were usually bland and displayed prominent hemophagocytosis. The differential diagnosis of FHLH and the difficulty in distinguishing it from malignant histiocytosis is discussed. In view of the focal distribution of lesions, it is suggested that histopathologic diagnosis of FHLH be made only after evaluation of combined findings in several organs and consideration of the patient's family history as well as the result of the clinical and laboratory investigations. PMID- 6498735 TI - Serum thyroid hormone changes during whole body hyperthermia. AB - In order to elucidate changes in thyroid hormone metabolism during acute heat stress, we measured sequentially serum thyroxine (T4), triiothyronine (T3), and reverse T3 (rT3) levels in 5 patients with neoplasia during treatment with whole body hyperthermia. The core temperature was raised from 37.0 degrees C to 42.0 degrees C over a 2-hour period, maintained at 42.0 degrees C for 2 hours, and then cooled to 37.0 degrees C over 2 hours. This short period of severe hyperthermia produced a fivefold rise in rT3 and a fall in T3 levels to one half of baseline levels. T4 and free T4 levels increased slightly, but thyrotropin (measured in two patients) did not change. These changes in T3 and rT3 levels were detectable at the fourth hour after onset of hyperthermia, were maximal at 24 and 48 hours, and in one patient were uncorrected after 4 days. We conclude that this reciprocal change in T3 and rT3 levels is a response to stress and may represent in part adaptation to a high environmental temperature by the suppression of theromengic T3. Whole body hyperthermia of short duration for cancer therapy produces profound changes in the peripheral degradation of thyroxine, which last for several days. This must be considered in the management of patients receiving hyperthermia, and the technique itself may prove to be a useful model for the study of adaptation to heat stress. PMID- 6498736 TI - Androgen receptors in breast cancer. AB - Androgen receptor assays have been performed on 1371 specimens of histologically confirmed primary and recurrent breast cancer. Forty-two patients who had received tamoxifen as treatment for advanced disease were assessed for objective response. Another 42 patients who had received chemotherapy were similarly studied. Patients with androgen receptor-negative tumors had a significantly poorer response rate to hormone therapy than those with receptor-positive tumors (P less than 0.05). This clinical correlation is supported by survival data of 1181 patients with primary breast cancer which showed that patients with androgen receptor-negative tumors had a highly significant trend toward shorter overall survival than those with receptor-positive tumors (P less than 0.001). Androgen receptor data added significantly to the information provided by estrogen receptor data both in terms of response to hormone treatment and survival. PMID- 6498737 TI - Serum deoxythymidine kinase gives prognostic information in chronic lymphocytic leukemia. AB - A recently developed deoxythymidine kinase assay, utilizing iodine-125-iodo deoxyuridine as substrate and capable of detecting enzyme activity in serum from healthy humans, was used in an investigation of sera from 55 untreated patients with chronic lymphocytic leukemia (CLL). When confined to the study, the patients were classified as having progressive or indolent disease and according to Rai stage. The results showed a significant correlation between serum deoxythymidine kinase activity (S-TK) and disease status, i.e., higher values were found in patients with progressive disease, compared to those with indolent disease. S-TK also correlated with Rai stage. S-TK values of more than 40 times the normal value were found in some patients. All patients with S-TK greater than 8.4 units had a disease that was or became progressive during the observation period. Within the patient group with indolent disease two groups that differed with regard to prognosis could be distinguished according to their initial S-TK values. In longitudinal studies of 18 patients with indolent disease, S-TK was found to exceed 8.4 units only on one occasion during an observation period of up to 68 months. In patients with indolent disease, a transition to progressive disease was parallelled by an increase in S-TK. Studies of S-TK levels in 18 patients receiving treatment showed that S-TK decreased during successful therapy. S-TK was also found to increase when the disease was reactivated. From these results it is concluded that S-TK could be used as a prognostic marker for the individual CLL patient. Furthermore, S-TK seems to be useful for longitudinal follow-up studies of disease status, both in indolent disease and in progressive disease during treatment. PMID- 6498738 TI - A case of large "thymic granuloma". Neoplasm of T-zone histiocyte. AB - An unusual case of classic thymic granuloma is reported. A 16-year-old boy presented with a huge mediastinal mass and the superior vena caval syndrome. Irradiation and combination chemotherapy induced complete remission, despite several episodes of lymph node recurrence. Examination of the first biopsy specimen was considered to indicate a histiocytic tumor or malignant form of eosinophilic granuloma, because of the diffuse proliferation of histiocytes and marked infiltration of eosinophils. Late involvement in the lymph node appeared to have the same histologic characteristics as the mediastinal tumor. Immunohistochemically, the proliferating histiocytes were stained with anti-S100 protein IgG but not with anti-lysozyme or anti-NCA (nonspecific cross-reacting antigen with carcinoembryonic antigen) antibody. These characteristics were similar to those of interdigitating cells in the lymph nodes, thymus, and other lymphoid tissues. The relationship of this case to mediastinal Hodgkin's disease or proliferative disorders of histiocytes is discussed. PMID- 6498739 TI - Mesenchymal chondrosarcoma of the kidney. AB - A case of mesenchymal chondrosarcoma of the kidney, with osseous metastases, is presented in this article, and the clinical, radiologic, and histopathologic features of this uncommon neoplasm are discussed. The addition of this case to those previously reported in the literature brings the total number of reported cases of mesenchymal chondrosarcoma of extraskeletal origin to 42. None of the previously reported cases originated from the kidney. The metastatic pattern of this case illustrates the propensity of mesenchymal chondrosarcoma to metastatize to unusual locations. PMID- 6498740 TI - Superficial cerebral astrocytoma attached to dura. Report of six cases in infants. AB - Reported are six cases of meningocerebral astrocytomas attached to dura, involving the superficial cortex, in infants under 1 year of age. They represent 1.25% of 483 intracranial tumors in infancy studied at the Children's Hospital in the last 12 years. Five were located in the frontal lobes, with variable extension to the parietal or the parietotemporal regions, and one was located in the parietal lobe. They were all composed of a solid portion and one or more cysts, and they measured approximately 6 to 12 cm in diameter. They had spindle cells, some more plump, arranged in areas in a storiform pattern. Tumors were very rich in reticulin fibers, mimicking a mesenchymal tumor. There was very slight pleomorphism. Bizarre giant cells were not observed and lipidization was not a prominent feature. Immunoperoxidase technique was performed in all of them and showed glial fibrillary acidic protein (GFAP) in most of the tumor cells. We believe their origin is from subpial astrocytes. They probably represent a separate entity whose diagnosis cannot be accurately established without immunohistochemical techniques. PMID- 6498741 TI - Invasive thymoma with myasthenia gravis. AB - In 261 surgically treated patients with myasthenia gravis (MG), 26 had an invasive thymoma and 49 had a noninvasive thymoma. Invasive thymoma was seen in 41% of thymomatous MG patients older than 40 years of age, and 28% in patients younger than 40 years of age. Of 19 patients who underwent total or subtotal thymothymomectomy accompanied by irradiation (4000 rad), 17 were still alive on an average 6.5 years after surgery. The deterioration of MG by the irradiation was observed in 7 of 20 irradiated cases. Thus, postoperative irradiation is effective but should be done with attention to the deterioration of MG. The prognosis of MG in patients with an invasive thymoma was poorer than that in patients with a noninvasive thymoma. PMID- 6498742 TI - Breast self-examination among diagnosed breast cancer patients. AB - The practice of breast self-examination (BSE) was explored by personal interview in a sample of women with diagnosed breast cancer. Despite physician recommendations to practice BSE, only 43% of those interviewed were examining themselves regularly, a figure that is little different from that of the general population. Predictors of BSE were age (older women were less likely to practice) and practice of BSE before diagnosis. Factors contributing to nonpractice were judged to be: (1) the patients' beliefs that occasional examinations by physicians are a sufficient substitute for BSE; (2) the patients' perceptions that BSE is discretionary and not truly "medical"; and (3) the fact that BSE may raise patients' anxiety over cancer without affecting its likelihood. It was concluded that the practice of BSE among diagnosed patients could be increased if physicians stress its importance and provide systematic instruction or reinstruction in its practice. PMID- 6498743 TI - Autoimmune hemolytic anemia and dermoid cyst of the mesentery. A case report. AB - An autoimmune hemolytic anemia has been detected in a patient suffering from a dermoid cyst of the mesentery. Early recognition of the teratoma is important, since only removal of the tumor is consistently curative. Investigations showing immunocompetent cells within the cyst's wall lend further support to the contention that the tumor tissue itself produces, for reasons yet unknown, antitumor autoantibodies that could cross-react with the patient's erythrocytes. The role of computerized tomography (CT) in the diagnosis of abdominal teratoma is emphasized, since CT has permitted visualization of the cystic structure of the tumor before the surgical removal of the mass. PMID- 6498744 TI - Risk of large-bowel cancer in synthetic fiber manufacture. AB - In a previous study, the authors found an increased incidence of colorectal cancer among workers in a textile factory producing synthetic fiber. To answer the crucial question of whether the risk is confined to one section of the plant, a case-control study was done. For each of 43 cancers that occurred in the plant between 1965 and 1979, 3 controls were selected at random from company files of 24,270 current and past employees. They were matched for age, date of beginning employment, and duration of employment. Forty-four percent of the cancer patients worked in one of three departments: "extrusion D," "extrusion TM," and "textile," whereas only 21% of the controls worked in one of these departments (P less than 0.005). After 1974, when the peak incidence was observed, 10 of 21 patients had worked in either or both extrusion departments; only 8 of 63 controls had worked in these departments. (P less than 0.002). It took more than 10 years (10 of 33 cases versus 8 of 95 controls; P less than 0.002) before a risk became apparent. According to work areas, the relative risk was increased for those who had worked in building 3, where the extrusion D department was located (P less than 0.02). These results offer a basis for the prevention and surveillance of colorectal cancer in this industry. PMID- 6498745 TI - Multiple primary tumors in association with prostatic cancer. AB - One hundred forty-six patients with clinically nonmetastatic carcinoma of the prostate were treated at Columbia-Presbyterian Medical Center from 1964 through 1976. Of these 146 patients, 24 (16.4%) had developed at least one additional primary cancer. This review contrasts the 122 patients who had a single primary prostate cancer only with the 24 patients who had additional primary carcinomas with respect to age, racial distribution, clinical stage, and prostate cancer histology including Gleason's score, patterns of failure of prostate cancer, and survival data. Local failure and distant failure were less in the multiple primary group. Patients with high Gleason's scores appear to be at greater risk for second primaries. Five-year observed survival (by actuarial life table method) for the single prostate primary group was 76.5%, and 5-year observed survival of the prostate multiple primary group where prostate cancer appeared first was 71%. PMID- 6498746 TI - Papillary adenocarcinoma of the male urethra. Case report and review of the literature. AB - Mucinous papillary adenocarcinoma of the bulbous urethra developed in a 40-year old man with congenital stricture. The tumor appeared as a localized polypoid exophytic mass without evidence of submucosal invasion (Stage 0). The tumor was determined not to be of prostatic origin clinically and by absence of immunoperoxidase staining for prostatic acid phosphatase, prostate specific antigen, and carcinoembryonic antigen. Surgical resection of the urethra revealed extensive squamous and glandular metaplasia (urethritis glandularis) in association with the neoplasm. The mucosa displayed a spectrum of epithelial changes varying from dysplasia to carcinoma in situ, in confirmation of the urethral origin of the tumor. These observations emphasize the close association of metaplastic proliferative lesions and malignancy in the lower urinary tract. PMID- 6498747 TI - Blood-borne spread of a benign giant cell tumor from the radius to the soft tissue of the hand. AB - A unique case of giant cell tumor of the distal epiphysis of the radius that spread to the soft tissue of the hand after an en bloc excision is reported. Three months after the excision, 27 cutaneous-subcutaneous tumoral nodules, ranging from 0.3 to 1.5 cm in diameter, were observed spreading from wrist to fingers on both hand aspects. Microscopically, the tumor tissue displayed the pattern of a benign giant cell tumor. Multiple tumor tissue emboli were lodged in venules of the soft tissue between nodules and in a small vein. The findings suggest that the tumor emboli arrived at the hand through a mechanism of retrograde embolism through the superficial veins. PMID- 6498748 TI - Breast cancer and polyps of the colon. A case-control study. AB - A case-control study was conducted involving 145 patients with breast cancer and 144 controls. A pansigmoidoscopy was performed in each case and control. There was no statistically significant difference in the length of the colon explored (cases, 50.3 cm; controls, 48.9). The odds ratio for adenomatous polyps was 2.65 (confidence limits, 1.56 and 3.74). As adenomas of the colon can be considered as precursors of colon cancer, this study demonstrates new evidence of the close relationship between breast and colon cancer. These results show the usefulness of performing a pansigmoidoscopy in all breast cancer patients and, if positive, the removal of all of the polyps through the colonoscope. PMID- 6498749 TI - Interpersonal linkage among Hodgkin's disease patients and controls in Western Australia. AB - Interpersonal linkages were studied in 178 Hodgkin's disease patients, aged 60 years or younger, who lived in Western Australia between 1964 and 1975, and in their matched controls. Eighty-nine living subjects were interviewed about places and periods of residence, school attendance and employment, and possible linkages were computed based on concurrence of these events. Subjects were also shown the names of all patients and controls and asked to mark the names they recognized, giving details of acquaintanceships. The acquaintanceship method yielded more and the concurrence method fewer case-case links than expected. Little overlap occurred in linkages identified by the two methods. The acquaintanceship method is thought to be the more reliable. Risk factors suggested in the literature were also investigated. Increased risk of Hodgkin's disease in living patients was associated with being unmarried, being born outside Western Australia, smoking cigarettes, and having lived and worked on a farm and worked with animals. These effects did not explain the excess of case-case linkages found by the acquaintanceship method. PMID- 6498750 TI - The occurrence of soft tissue sarcomas in three siblings with Werner's syndrome. AB - Werner's syndrome, a relatively rare and autosomal recessive disorder, is well known to be characterized by a high frequency of malignant neoplasm. The occurrence of familial neoplasm in patients with this condition, however, has been recorded only once before in the literature. Reported are the findings with regard to the occurrence of sarcomas in three siblings with Werner's syndrome. Two of the current three cases were of malignant fibrous histiocytomas, one in a 36-year-old man and one in a 32-year-old woman. The other case was of a leiomyosarcoma in a 26-year-old man. Two of the patients died of the tumors, although the third is still alive. The exact cause of the high incidence of malignant tumor in this family remains unknown, as is still so in other cases of Werner's syndrome. PMID- 6498751 TI - Seasonal patterns in the diagnosis of malignant melanoma of skin and eye in upstate New York. AB - Seasonal patterns in diagnosis were examined for 2403 melanomas of the skin and 238 melanomas of the eye diagnosed among residents of upstate New York State in 1975 to 1979 and reported to the population-based New York State Cancer Registry. The previously reported summer peak in diagnosis of melanoma of the lower extremity in females was confirmed and shown to hold for melanomas diagnosed at both early and late clinical stages; increased recognition of earlier stage melanomas in summer months is an unlikely explanation for this peak. For skin melanomas at other anatomic sites, seasonal patterns by sex and clinical stage at diagnosis were more complex. A previously unreported seasonal pattern was evident for trunk melanomas in males, with a March-April peak. Significant seasonal variations in diagnosis of melanomas of the eye were evident for both males and females, but the seasonal patterns differed between the sexes. Possible explanations for these findings on skin and eye melanomas were discussed with reference to psychosocial and hormonal factors as well as ultraviolet stimulation. PMID- 6498752 TI - Clinical trials for the evaluation of cancer therapy. AB - One of the great advances of the last 50 years has been the introduction of prospective randomized controlled trials into clinical medicine. Those efforts apply the scientific method to clinical problem solving and provide the mechanism for obtaining answers to important clinical and biologic questions that can be obtained in no other way. When properly employed, clinical trials supply definitive information relative to the worth of therapies prior to their widespread use on populations as a whole. They are sophisticated endeavors requiring the interactions of clinicians, investigators, and statisticians as equal partners in a common effort that requires discipline as rigid as that of a laboratory experiment. There are three types or phases of clinical trials conducted on cancer patients; each is directed toward supplying answers to different questions. Phase I trials determine safe dose levels and/or schedules of drugs in humans. They may be aimed at using known drugs in combinations heretofore not tried or at determining the tolerably toxic dose of drugs that have shown benefit in animal models. Efficacy is not a defined goal of Phase I trials. Utilizing schedules and dosages and incorporating limitations discovered in Phase I trials, studies are next conducted that are aimed at determining therapeutic efficacy; i.e., Phase II trials. They are performed on patients of the same tumor type and measurable disease (usually Stage IV). In neither Phase I or II trials is randomization a feature. With demonstration of at least some efficacy in a Phase II trial, a therapy becomes a candidate for full-scale testing and comparison with a currently "standard" therapy in a Phase III trial. This report presents an overview of some of Stages I and II cancer. Comments will be made relative to their rationale, design, conduct, and statistical requirements, as well as ethical considerations, with the hope that more of the current generation of physicians will become aware of their importance and will be stimulated to participate in such endeavors. This overview is not meant for the statistician or for the sophisticate who is well versed in the vast literature that is accumulating in this area. Comments are primarily based upon experiences derived from the clinical trials conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP) for a quarter of a century. Where appropriate, breast cancer will serve as a model for the discussion. PMID- 6498753 TI - Surgical implications for infusion chemotherapy. AB - Technical advances that have provided reliable long-term vascular access are described in the setting of pulse and continuous venous chemotherapy infusion and for regional arterial drug delivery. Despite dramatic improvement in the morbidity of such access procedures, it is important to remember that their value still depends upon the effectiveness of the chemotherapy delivered. PMID- 6498754 TI - The impact of pain on the patient with cancer. AB - Pain is one of the most feared consequences of cancer. Until recently, however, little has been known about its prevalence, severity, and impact on the patient with cancer. The presence of pain, despite efforts to treat it, represents a continued source of frustration for patients, their families, and the health care team. Although often one of the early indicators of the presence of disease, pain is not a significant problem for the majority of patients in the early stages of disease, with 5% to 10% of patients with solid tumors reporting pain at a level that interferes with mood and activity. But when metastatic disease is present, about one in three patients reports significant pain, and our data and those of others indicate that the majority of patients with end-stage disease will report pain of a severity that interferes with several aspects of the patient's quality of life. Site of tumor is also significantly related to the progression of pain. The relationship between pain intensity and depression and anxiety is examined in detail, and the treatment implications of this relationship discussed. Whereas a modest relationship between pain intensity and depression has been found across several studies, the possibility that depression is a causative factor in the pain experienced by the cancer patient may have been overemphasized. Data on the relief of pain in cancer are reported from the perspective of patients as well as the physicians and nurses who treat them. The majority of physicians and nurses specializing in cancer treatment whom we have surveyed believe that cancer patients in general are undermedicated for pain. Patient survey data indicate that only 50% of cancer patients with pain report 70% or greater pain relief with analgesic medication. Although a number of nonsystemic treatments may be useful for cancer pain management (such as nerve blocks, neurosurgery, and behavioral treatments), they are not widely available and there are few controlled studies of their effectiveness. Teaching patients to report the level of their pain on simple pain intensity scales has proven useful in monitoring the effectiveness of pain management, as well as in helping establish pain control goals for the individual patient. PMID- 6498755 TI - Control of cancer chemotherapy-induced nausea and vomiting. AB - With increasingly effective cancer chemotherapy, the control of chemotherapy induced nausea and vomiting has become more important. These unpleasant side effects can be so severe that patients delay or stop potentially curative therapy. Phenothiazines and butyrophenones have been the mainstays of most antiemetic therapy but unfortunately have only partially controlled nausea and vomiting. Recently, renewed interest in the control of nausea and vomiting has led to the introduction of additional classes of agents. Cannabinoids appear to be superior to phenothiazines as antiemetics, but must be given in doses that also cause central nervous system side effects. Metoclopramide, given in high doses (1.0-3.0 mg/kg) has proven to be a major advance in the control of nausea and vomiting induced by cisplatin. Glucocorticoids may be useful, particularly when combined with other agents. There has been recent recognition of the importance of anticipatory nausea and vomiting, and attempts to control this through behavioral modification techniques have met with some success. PMID- 6498756 TI - The role of sexual rehabilitation in the treatment of patients with cancer. AB - The goal of sexual rehabilitation is to restore the patient's ability to engage in intimate interpersonal relationships. It incorporates the restoration of both self-esteem and bodily function. When appropriate and desired, sexual rehabilitation includes restoring the physical ability to engage in sexual activity. Rehabilitation begins at diagnosis and continues throughout therapy. It addresses the specific desires of each patient and incorporates the contributions of every member of a health care team. An adaptation of Annon's PLISSIT model is appropriate to this multidisciplinary, holistic approach. All patients need permission (P) and limited information (LI); frequently, dispelling myths and eliminating ignorance about therapy are enough to enable patients to resume sexual intimacy. Specific suggestions (SS) help patients whose irradiation, hormone therapy, or radical surgery have resulted in physiologic or anatomic alteration to the genitals or the mechanisms of sexual response. Highly skilled professionals provide intensive therapy (IT), which may include surgical reconstruction, implantation of prosthetic devices, or intensive marital and sexual counseling. PMID- 6498757 TI - Treatment alternatives. Head and neck cancers. AB - No tumor system is more amenable to multidiscipline therapy than head and neck cancers. Diagnosis is enhanced by fine-needle cytology, computerized tomography (CT) scan, and tumor markers. Modified surgical techniques, CO2 laser, and immediate myocutaneous flap reconstruction have enhanced surgery. Endocurie therapy, radiosensitizers, and particle therapy supplementation have enhanced radiotherapy. Combination chemotherapy, immunotherapy, prostaglandin synthesis inhibitors, and retinoids have enhanced chemotherapy. Induction chemotherapy followed by surgery with or without postoperative radiotherapy is optimum multidisciplinary therapy. Reduction in exposure to tobacco, alcohol, sunlight, gamma irradiation, occupational toxins, and Epstein-Barr virus, and recognizing high-risk hereditary conditions, can help prevent these cancers. PMID- 6498758 TI - Treatment alternatives. Localized rectal cancer. AB - Cancers that occur in the low or mid rectum, and are superficial and freely movable on the underlying bowel wall, should be considered for local treatment provided they are not anaplastic and are technically accessible to excision. Although a variety of methods have been shown to be effective, we propose that initial local surgical excision as a "total biopsy" is the most rational approach to the management of such lesions. Factors indicating a poor prognosis, including extension through the entire thickness of the bowel wall, incomplete surgical excision, poorly differentiated histologic grading, venous or lymphatic invasion, or colloid type of tumor, can be identified, and more aggressive surgical treatment can be urged. When these factors are absent, the total biopsy then constitutes definitive treatment for this highly selected population. PMID- 6498759 TI - Monoclonal antibodies to breast cancer-associated antigens as potential reagents in the management of breast cancer. AB - Monoclonal antibodies reactive with the surface of human breast carcinoma cells have been generated and characterized. The immunogens used were membrane-enriched fractions of metastatic carcinoma lesions. The various monoclonals were shown to react with previously known as well as with novel tumor-associated antigens (TAAs). The most specific of the latter group is monoclonal B72.3, which is reactive with a 220,000 to 400,000 high-molecular-weight glycoprotein complex found in 50% of human mammary carcinomas and 80% of human colon carcinomas. Monoclonal antibody B6.2, which recognizes a 90,000-d glycoprotein, was radiolabeled and shown to efficiently localize human carcinoma transplants in athymic mice via gamma imaging without the use of second antibody or background subtraction manipulations. F(ab')2 and Fab' fragments were shown to be more efficient for tumor localization than intact immunoglobulin. Whereas the phenomenon of antigenic heterogeneity of tumor cell populations has long been known to exist, this phenomenon was also shown to manifest itself as antigenic modulation, in which specific TAAs can modulate their expression on the cell surface concurrent with different phases of the cell cycle. A phenomenon known as antigen evolution, in which a specific cloned tumor cell population can gradually drift in antigenic phenotype, has also been demonstrated. Recombinant interferon has been employed to (1) enhance the expression of specific TAAs on the surface of tumor cells already expressing the antigen; and (2) induce the expression of specific TAAs on the surface of carcinoma cells not previously expressing the antigen. The clinical implications of such phenomena in gamma scanning for the detection of tumor masses and for tumor immunotherapy are discussed. Methods for circumvention of problems inherent in the clinical use of monoclonal antibodies are also addressed. PMID- 6498760 TI - Intraoperative radiotherapy for intracranial malignancies. A pilot study. AB - Intraoperative radiotherapy (IOR) or "direct view" irradiation permits the delivery of a single exposure of high-energy electrons to a surgically exposed tumor. Surgical exposure permits physical retraction of normal uninvolved tissues away from the IOR beam as well as the accurate assessment of the target volume. IOR represents a "supplement" or "boost" dose to conventional fractionated external beam irradiation that is administered postoperatively. This pilot study represents the clinical experience in the US using IOR for brain tumors. At Howard University Hospital, Washington, DC, 12 patients underwent surgical resection or decompression and 1500 cGy were delivered to the tumor bed intraoperatively. After surgical recovery, 5000 cGy in 25 fractions were delivered to the whole brain and an additional 500 cGy cone-down boost were delivered to the tumor bed. This protocol was best tolerated when the cranial vault was decompressed. Two patients with meningioma are without evidence apparently NED at 8, 11, 12, and 15 months, respectively. A fifth patient died at 8 months NED from an accident. Three glioma patients died with disease at 3, 13, and 15 months, respectively. Two additional patients died 30 days after surgery. Indications, techniques, and clinical findings are presented. PMID- 6498761 TI - Potentiation of differential hyperthermic sensitivity of AKR leukemia and normal bone marrow cells by lidocaine or thiopental. AB - Previous work has utilized spleen colony formation to evaluate the fractional survival of AKR leukemia and normal bone marrow cells after in vitro heat exposure. An inherently greater sensitivity of neoplastic cells to thermal killing, as compared to normal syngeneic stem cells, has been established both at 41.8 degrees C and 42.5 degrees C. Normal bone marrow colony-forming units were assayed in lethally irradiated (750 cGy) mice. Leukemic colony-forming units were assayed in nonirradiated mice. Using this methodology, the authors demonstrated that the differential effect of hyperthermia on AKR murine leukemia and AKR bone marrow cells can be further enhanced by the addition of lidocaine or thiopental to incubation mixtures. These findings may have application to autologous bone marrow transplantation in humans. PMID- 6498762 TI - Phase II study of recombinant leukocyte A interferon (rIFN-alpha A) in disseminated malignant melanoma. AB - Thirty-one patients with disseminated malignant melanoma received intramuscular recombinant leukocyte A interferon (rIFN-alpha A), 50 X 10(6) units/m2 three times weekly for a planned treatment duration of 3 months. Seven objective regressions (23%), which ranged in duration from 3 to 11.2+ months, were observed. Forty-two percent of 12 patients who were fully active (Eastern Cooperative Oncology Group [ECOG] performance score, 0) responded compared to 11% of 19 patients with impairment of performance status (ECOG, 1-3). Prior chemotherapy did not influence response rate. For all patients the median time to progression and of survival was 2 months and 6 months, respectively. Four patients had partial regressions in soft tissue (3, 4.6 months), pulmonary (7 months), and prostatic lesions (3 months). The latter was biopsy-proven and assessed by serial computerized tomography (CT) scans. Three had complete regressions of soft tissue disease (2 patients, 6.4 and 10+ months each), and liver involvement (11.2+ months). The major toxicities were moderate to severe fatigue (87%), anorexia (58%), and confusion (23%). Performance score deteriorated in 84% of patients during the time they were receiving rIFN-alpha A. Among the 13 patients whose tumors did not progress for at least 12 weeks, 7 required dose reductions or termination of treatment due to toxicities. Hematologic and hepatic toxicity was transient and of little clinical significance. The study indicates that rIFN-alpha A has some antitumor activity accompanied by difficult side effects in patients with disseminated malignant melanoma. PMID- 6498763 TI - Postoperative adjuvant irradiation and 5-fluorouracil for adenocarcinoma of the cecum. A pilot study. AB - Twenty-one patients with adenocarcinoma of the cecum were treated in a pilot study between October, 1972 and June, 1982 by right hemicolectomy and received adjuvant postoperative irradiation (40-45 Gy/4-5 weeks) and 5-Fluorouracil (5 FU). There were 15, 4, and 2 patients with Stages (Astler-Coller) B2, C2, and D, respectively. There was no major morbidity nor mortality attributable to the adjuvant therapy. Patients were followed for a minimum of 15 months. Fifteen patients are alive and disease-free, with a median survival of 34 months (range, 17-79). There were no significant differences in the median survival or incidence of distant metastases when the adjuvant therapy group was matched by sex, age, and stage of disease with a group of patients treated by right hemicolectomy alone. There was a lower local failure rate in the adjuvant group compared with the surgery-alone group (5% versus 19%) (P less than 0.2). These data suggest that adjuvant therapy for cecal carcinoma is feasible, safe, and may reduce local failures and possibly improve survival in high-risk patients. It deserves further investigation so that a definite conclusion may be drawn. PMID- 6498764 TI - Management of children with isolated testicular leukemia. AB - Since 1975, nine children with testicular leukemia were treated at the University of Kansas Medical Center on a standard protocol. Six patients presented with overt testicular leukemia and three patients had microscopic testicular leukemia detected on a biopsy done after 3 years of continuous complete remission. All patients had an M1 bone marrow at the time of testicular relapse and one patient had a concomitant central nervous system (CNS) relapse. Therapy consisted of testicular irradiation, CNS chemoprophylaxis, and systemic reinduction chemotherapy. Systemic maintenance therapy after the testicular relapse consisted of 6-mercaptopurine and methotrexate with vincristine/prednisone pulses administered in the same basic dose and schedule as the patient's original maintenance regimen. These nine patients had a mean duration of first remission of 33 months and a mean duration of second remission of 45+ months. Four patients have relapsed (two bone marrow, one CNS, one CNS + bone marrow), but five patients remain in their second complete remission for 33+ to 94+ months from the time of testicular relapse. These results demonstrate that, in some children, testicular leukemia represents a site of temporary drug resistance and long-term second remissions can be obtained (once local disease is controlled) by using the initial maintenance chemotherapy regimen. PMID- 6498765 TI - Effects of sequencing of the total course of combined hyperthermia and radiation on the RIF-1 murine tumor. AB - The optimal sequence for clinical utilization of combined radiotherapy and hyperthermia is not known. The clinical trials have resulted in similar responses whether hyperthermia is given before or after radiation. Moreover, studies addressing the best sequence for an entire course of multifractionated hyperthermia and radiation are lacking. In these experiments, the importance of sequencing of heat and irradiation in a multifractionated treatment regimen in RIF-1 murine tumors was studied. It was observed that a close sequence of heat and irradiation is more beneficial than separate cytotoxic action. When heat and irradiation were given simultaneously, (within 1 hour) 67% to 75% of the tumors were cured. Heat and irradiation given sequentially (the entire course of one following the entire course of the other, each separated by 72 hours) cured 20% of the tumors. No tumors were cured when treated with heat or irradiation alone. The tumor regrowth time (mean tumor doubling time) is much longer in simultaneous treatment than in sequential treatment. It appears that heating first decreases the effectiveness of subsequent irradiation, causing a shorter growth delay than the opposite sequence. Heat alone does not alter the tumor bed permanently, but irradiation seems to do so, resulting in a slower rate of growth upon recurrence. PMID- 6498766 TI - Clinical results of radiofrequency hyperthermia combined with radiation in the treatment of radioresistant cancers. AB - Clinical results of radiothermotherapy applied to 40 radioresistant tumors in 36 patients were reported. Hyperthermia was administered locally using two radiofrequency (RF) capacitive heating equipment systems developed in our institution under the collaboration of Yamamoto Vinyter Co. Ltd. Hyperthermia was given twice weekly immediately after irradiation. Intratumor temperatures of 41 degrees C to 44 degrees C were maintained for 30 to 60 minutes. Radiation doses varied from 32 Gy to 60 Gy. Of the 40 tumors treated, 21 (53%) showed complete response, 16 (40%) partial response, and 3 (7%) no response when the tumor response was assessed by tumor size measurement. Of eight patients who had matched tumors treated with either radiation alone or radiation plus hyperthermia, six patients showed better response in tumors treated with radiothermotherapy than in tumors treated with radiation alone. Skin reactions following radiothermotherapy and radiation alone were comparable. The tumor response was greatly dependent on the tumor size. Greater response was observed in small tumors, although histologic examinations and long-term follow-up studies revealed an excellent effect of radiothermotherapy on the large tumors as well as on the small tumors. Tumor responses correlated with tumor center temperatures but not with histologic features. Our clinical results indicate that RF hyperthermia combined with radiation has a therapeutic benefit in the treatment of radioresistant cancers. PMID- 6498767 TI - Cosmetic results following primary radiation therapy for early breast cancer. AB - In order to assess the cosmetic results of treatment, the results in 239 patients with early breast cancer treated by primary radiation treatment without adjuvant chemotherapy were reviewed. Four patients had bilateral cancers, making a total of 243 breasts available for analysis. Follow-up ranged from 24 to 78 months with a median of 33 months. The parameters measured were breast edema, retraction, telangiectasia, arm edema, and the overall cosmetic appearance. The cosmetic results declined over the first 3 years after treatment, but then stabilized. At 5 years, the overall cosmetic results were judged by physicians as excellent in 77%, good in 9%, fair in 9%, and poor in 5%. A fair or poor cosmetic result was highly correlated with the development of moderate or severe breast retraction. Telangiectasia was uncommonly the only cause of a fair or poor cosmetic result. Breast and arm edema were rarely noted to be significant, but were more common in patients who underwent axillary dissection. In 210 cases, a supplementary boost dose of radiation was delivered to the primary tumor area, and in 33 cases a boost was not used. This boost consisted of an interstitial iridium-192 implant in 204 cases and either high-energy photons or electrons in the remainder. At 4 years, no patient treated without a boost had a fair or poor result compared with 22% who received a boost (P = 0.13). The conclusion is that, in general, primary radiation treatment provides highly satisfactory cosmetic results for patients with early breast cancer. PMID- 6498768 TI - Lymphocyte subpopulations in patients with breast cancer after postoperative radiotherapy. AB - The effects of radiotherapy on the immune competence of patients with mammary cancer was studied using enumeration of the various lymphocyte subpopulations as detected by monoclonal OKT antisera, lymphocyte proliferative responses to phytohemagglutinin, concanavalin A, purified protein derivative to tuberculin (PPD), and serum immunoglobulin levels. The tests were carried out in nine patients with newly diagnosed and operated mammary cancer before and after the radiation therapy, and 6 months later, and in ten patients whose mammary cancer had been diagnosed and treated at least 3 years earlier and who had remained tumor-free. The number of lymphocytes in the peripheral blood and the various T cell subpopulations as well as the OKIa1 cells mostly representing B-cells decreased. The only population increasing were the OKM1-positive cells, mostly representing monocytes and null cells. As also described earlier, the responses to mitogens decreased because of the radiotherapy but recovered, except for the responses to PPD which remained low. PMID- 6498769 TI - Sensitivity of lymphocytes from patients with cancer to x- and ultraviolet radiation. AB - It has been suggested that radiation sensitivity may be increased in certain patients with cancer. Using a high-efficiency limiting dilution cloning technique, the sensitivity to x- and ultraviolet (UV)-radiation of lymphocytes from untreated patients with cancer to that of age-matched controls was compared. Sensitivity to x-radiation in 19 patients with carcinoma and 10 with lymphoma, and sensitivity to UV-radiation in 8 patients with carcinoma and 4 with lymphoma were studied. The proportion of unirradiated lymphocytes forming clones was significantly lower in patients with cancer, particularly lymphoma, but there was no suggestion of increased sensitivity to either x- or UV-radiation in any of the patients studied. PMID- 6498770 TI - Bacteria-associated hemophagocytic syndrome. AB - Histiocytic medullary reticulosis (HMR) was originally defined as a neoplastic disorder. Some cases reported as HMR have been characterized by a systemic proliferation of mature histiocytes showing hemophagocytosis, bone marrow necrosis, pancytopenia, hepatitis, and coagulopathy. Clinically, these patients have fever and constitutional symptoms and often have hepatosplenomegaly and lymphadenopathy. Although there is a high mortality rate, this process appears to be reactive and has been associated with active viral infection. Similar cases have been briefly described that were associated with other agents or disease processes, but concomitant viral infections were not excluded. Three characteristic examples of this hemophagocytic syndrome that were associated with bacterial sepsis are described. Active infection by those viruses that have previously been associated with the syndrome was excluded. It appears that the hemophagocytic syndrome may be associated with various types of active disseminated infections. PMID- 6498771 TI - Colonic carcinoma associated with an abnormal collagen table. Collagenous colitis. AB - A case of cecal adenocarcinoma with the typical histopathologic features of collagenous colitis throughout the resected colon is described in a 67-year-old woman. Collagenous colitis has not previously been reported in association with adenocarcinoma of the colon and the relationship of these findings appears to be unprecedented. A review of 100 randomly selected Duke's B adenocarcinomas of the colon revealed no similar case. PMID- 6498772 TI - Histologic grade and karyotype of immature teratoma of the ovary. AB - Seven cases of ovarian "pure" immature teratoma were encountered in patients 10 to 38 years of age, six cases being in Stage Ia and one case in Stage IIc. The primary tumors and recurrent growth observed in one case were histologically graded from 0 to 3 according to the criteria of Norris et al. Karyotypes of the tumors and the patients were determined using culture and banding techniques. The only nonsurviving case was in Stage IIc. Four primary tumors belonging to grades 0, 1, and 2 showed a normal 46,XX female karyotype and the patients are alive and healthy. Three grade 3 tumors showed various types of karyotype abnormalities (48,XX,+14,+21; 47,XX,+20; 47,XXX). One patient died, one is alive after experiencing a recurrent tumor, and one has only been followed for 22 months. All seven patients had a normal 46,XX female chromosome constitution. Evidence to date indicates that karyotype of ovarian immature teratoma is either normal female 46,XX or a slight deviation from normal. It is postulated that in ovarian immature teratoma normal 46,XX karyotype is an indicator of favorable prognosis, whereas deviations in karyotype suggest a possibility of poor prognosis. PMID- 6498773 TI - Prognostic value of histopathologic parameters in squamous cell carcinoma of the oropharynx. AB - Seventy-seven patients with squamous cell carcinoma of the oropharynx were treated by preoperative radiation therapy (4000-5000 rad) followed by surgical resection. The original biopsy specimens were evaluated for degree of keratinization, nuclear pleomorphism, frequency of mitoses, inflammatory response, vascular invasion, and pattern of invasion. Multivariant analysis (Cox regression model) and life table survival function were used to determine the relative contributions of the clinical and histologic parameters to patient outcome. The results were as follows: (1) large tumor size, nodal metastases, and male sex were found to be predictive of a poorer survival (P = 0.004, 0.0167, and 0.0237, respectively); and (2) an analysis of a combination of clinical and histologic parameters demonstrated that the pattern of invasion was the only histologic factor that was predictive of survival (P = 0.0436). Neoplasms invading as large cohesive aggregates indicated a better prognosis than neoplasms invading as thin, irregular cords or individual cells. Restricting the statistical evaluation to only histologic factors (excluding clinical factors) demonstrated that increased frequency of mitoses also correlated with poor survival (P = 0.0218). Further restriction of the analysis to T2 and T3 neoplasms that have similar survival times indicated that both frequency of mitoses and pattern of invasion were of prognostic value in predicting survival (P = 0.0127 and 0.0168, respectively). PMID- 6498774 TI - Pathologic findings from the National Surgical Adjuvant Breast Project (Protocol No. 4). XI. Bilateral breast cancer. AB - Sixty-six confirmed instances of clinically metachronous second breast cancers were encountered over a 10-year period in 1578 women with invasive breast cancer enrolled in Protocol 4 of the National Surgical Adjuvant Breast Project (NSABP). Seven of the second cancers were in situ, yielding an incidence of 3.7% invasive and 0.5% noninvasive cancers. Except for a peak of 1.75% in the second postoperative year, the annual incidence based on patients at risk was constant and less than 1%. Ninety-three percent of the second cancers occurred within 7 years and 80% within 5 years following mastectomy for the initial primary. All of the second cancers were regarded as being primarily of mammary origin exhibiting either: (1) an in situ component; (2) dissimilar but well-recognized patterns of primary breast cancers; or (3) the appearance of scar cancer, a recently described morphologic feature characteristically observed in some primary breast cancers. A search for factors that might be predictive of bilaterality was performed. Thirty-eight pathologic and eight clinical factors were assessed, including family history. Although the latter was 1.5 to 2 times more frequent in patients with bilateral disease, this estimate was not statistically significant. On the other hand, a statistically significant association with bilateral disease was found when the initial tumor measured more than 2.0 cm, was associated with invasive cancer or proliferative fibrocystic disease, nipple involvement, absent nodal sinus histiocytosis, lobular carcinoma in situ in the vicinity of the dominant mass, or was of the lobular invasive or tubular types. However, the degree of risk of these discriminants was no greater than 2 to 3:1. Despite the clinical scrutiny imposed by the NSABP protocol second tumors measured only 1 cm less than the first, measuring on average 2.4 cm, which reflects the difficulty attendant on the clinical detection of so-called early breast cancers. Yet, no significant difference in pathologic nodal status was noted between the first and second cancers or that of patients with unilateral disease. Furthermore, there was no difference in survival rate between patients who developed a second cancer and those with unilateral disease.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6498775 TI - Hormone receptors in rapidly progressing breast cancer. AB - Biopsy specimens from 85 Tunisian breast cancer patients were compared with those of 95 American breast cancer patients for estrogen receptor (ER) and progesterone receptor (PR) levels. Tunisian patients with rapidly progressing breast cancer (RPBC) had lower ER levels than American patients or Tunisian patients without evidence of RPBC. Lower ER levels in the earliest stage of RPBC, which presents without inflammatory signs, supported epidemiologic and pathologic studies indicating that rapid growth as reported by the patient is an important aspect of RPBC. Low ER levels were generally found in young, premenopausal Tunisian women with advanced RPBC; multivariate analyses suggest that age was the most important correlating factor. In the Tunisian patients, ER levels showed a direct correlation with response to therapy. No consistent relationship between American and Tunisian patients or subgroups was observed for PR levels. These results indicate the need for reevaluating the routine use of oophorectomy in RPBC. PMID- 6498776 TI - Glucose intolerance in sarcoma patients. AB - Twenty-seven otherwise healthy patients with localized sarcoma were examined to determine if glucose intolerance can be detected before the appearance of clinical signs of cachexia. No patient had lost weight or demonstrated severe malnutrition. Fasting plasma samples for glucose, insulin, glucagon, and free fatty acids (FFA) were obtained, and a standard intravenous glucose tolerance test performed. Glucose disappearance rate (K) was calculated between 5 and 60 minutes. K levels were compared to those of normal controls and to those of patients with more extensive cancer (statistics obtained from the literature). Levels for K were compared to tumor volume measurements following surgery. Fasting glucose, insulin, and glucagon levels were normal. Fasting FFA levels were slightly elevated. K levels for sarcoma patients were significantly lower than in control patients (P = 0.04), and higher than in patients with advanced cancer (P less than 0.0001). The subset of patients who weighed less than the ideal had a significantly lower K level than did the rest of the sarcoma population. K levels correlated inversely with tumor volume (r = -0.34; P = 0.04). These data indicate that mild glucose intolerance (reduction in clearance of a glucose load) occurs early in untreated sarcoma patients, is most prevalent in patients who maintain less than the ideal weight, correlates with tumor burden, and occurs before other signs of cachexia appear. PMID- 6498777 TI - Prognostic significance of the depth of invasion relating to nodal metastases, parametrial extension, and cell types. A study of 628 cases with Stage IB, IIA, and IIB cervical carcinoma. AB - Depths of invasion by increments of 5 mm were evaluated as a prognostic factor in 628 patients after radical hysterectomy for Stage IB to IIB cervical carcinoma. Nodal metastases (N) were significantly increased when tumor invasion was deeper than 5, 10, and 30 mm. Parametrial extension (P) was significantly increased with 10-, 15-, and 25-mm invasion. In total, the corrected 5-year survival rates were significantly reduced with 20 and 30 mm invasion. However, survival rates were almost the same in N(-)P(-) cases, ranging from 96% to 100%. Reduction of the survival rates with 20-mm invasion was found in IIB, P(+), or N(-) cases, and with 30-mm invasion in IB, IIB, P(+), or N(+) cases. Subdivision by N or P factors revealed an evidence that in N(+) or P(+) cases, survival of patients with under 10-mm invasion was significantly poorer than that of cases with 10- to 15-mm invasion. These indicate that depth of invasion is a valuable prognostic factor in patients with nodal metastases or parametrial extension. PMID- 6498778 TI - Atypical herpes simplex (HSV) infection in a patient with Hodgkin's disease. AB - An atypical presentation of herpes simplex virus type 1 (HSV-I) in the form of nodular tongue lesions was documented by histologic and immunohistochemical studies in a patient with advanced Hodgkin's disease. This represents yet another manifestation of HSV-I in the immunocompromised host and further emphasizes awareness of the oral complications of cancer chemotherapy. PMID- 6498779 TI - Factors related to patient delay in seeking medical attention for cutaneous malignant melanoma. AB - This study investigated the relationship between patient delay in seeking medical attention and prognostic indicators, tumor characteristics, and demographic and behavioral factors in 106 patients with cutaneous malignant melanoma. Patients with less readily apparent lesions, particularly on the back, had longer delays in seeking treatment, as might be expected. The prognostically unfavorable nodular melanomas were detected more frequently by patients themselves than they were found during visits to physicians for unrelated problems. In terms of behavioral variables, patients with less knowledge of melanoma or its appropriate treatment had significantly longer delays. Patients who minimized the seriousness of their condition were more likely to seek treatment sooner, perhaps because this reduced fear and anxiety about the disease or its treatment. For superficial spreading melanoma, delay was significantly and positively correlated with Clark's level of invasion, and also with tumor thickness when only noncoincidentally diagnosed patients were included; whereas for the nodular type, delay was significantly and positively associated with tumor thickness, whether the patient was coincidentally diagnosed or not. The significance of these findings for early detection, and hence improved prognosis of malignant melanoma, is discussed. PMID- 6498780 TI - The diagnostic value of the hemoccult as a screening test in patients taking anticoagulants. AB - The value of a 3-day Hemoccult II test in the diagnosis of colorectal disease in patients receiving anticoagulant therapy was studied. The influence of rehydration and nonrehydration of the slide was investigated, as well as the reproducibility of positive tests. Eight hundred forty-nine patients on anticoagulant therapy performed three Hemoccult II tests each. One hundred twenty eight (15%) had one or more positive slides, when these were rehydrated. Three patients with carcinoma and 13 patients with adenomas were found among these 128 patients. One hundred twenty-one of these patients performed six duplicate Hemoccult II tests with four samples from each of three consecutive stools. Three of the six slides were rehydrated and three were not rehydrated before development. Forty-one and 23 patients, respectively, showed positive test results. Two of three reinvestigated patients with large bowel carcinoma had positive slides in both of these series. Seven and 2, respectively, of 13 patients with adenomas had positive tests in the second series when the slides were developed with and without rehydration. Thus, the predictive value was low with nonrehydrated slides, and the precision was low when the slides were rehydrated. It is concluded that the sensitivity of a 3-day Hemoccult II test without rehydration is too low to permit its use as a screening method for colorectal neoplasms in patients receiving anticoagulant therapy. PMID- 6498781 TI - Peripheral neuroepithelioma in childhood. AB - Peripheral neuroepithelioma is a rare and controversial neoplasm that may occur at any age. Fifteen of the 38 previously reported cases have involved children from birth to 17 years of age. The authors observed the course of a 3-month-old girl who presented with an enlarging mass in the left arm and manifested hepatic metastases at the time of diagnosis. The urinary level of vanillylmandelic acid (VMA) was moderately elevated. The primary lesion was excised and metastatic foci showed response to a regimen of vincristine, cyclophosphamide, Adriamycin (doxorubicin), and cisplatin. However, tumor recurred in the brain and liver and the child died 14 months after diagnosis. At autopsy, there was no involvement of adrenal glands or sympathetic ganglia and the liver contained numerous involuted lesions as well as active metastases. It is suggested that this is a unique neoplasm, derived from neural crest but distinct from neuroblastoma, which can be characterized by peripheral origin, a histologic pattern of confluent pseudorosettes, and aggressive clinical behavior. PMID- 6498782 TI - Sex differences in the changing anatomic distribution of colorectal carcinoma. AB - The anatomic site distribution of large bowel cancer was studied in 2079 patients between 1967 and 1980. To measure the trend in the localization of the carcinomas, the slope of the regression line of the proportions at each site over the years was computed. The large bowel was divided into five segments: cecum, ascending colon and hepatic flexure, transverse and descending colon, sigmoid and rectosigmoid junction, and rectum. A significant decrease in the proportions of cancer in the sigmoid for both sexes (slope parallel b = -0.89; P less than 0.001) and an increase of cecal cancer (b = 0.54; P less than 0.004) was observed. Sex-specific results indicated the diminishing proportion of sigmoid cancer in men (b = -1.04; P less than 0.004) with an increase in transverse and descending colon cancer proportions (b = 0.52; P = 0.012). In women, a negative slope of -0.74 was not significant for sigmoid cancer, but cancer of the cecum showed an increase in proportions (b = 0.80; P = 0.01). The age distribution indicated a significant decrease in proportion of men older than 80 years and of women in the age group of 40 to 49 years and an increase in women older than 80 years. However, age adjustment did not change any of the previous conclusions. The observed sex differences in the changing distribution within the large bowel over a 14-year period cannot be explained by the improvement of diagnostic tools in the last years. In view of these findings, it is important to evaluate the possible sex-related bias in the application of screening and preventive measures as well as the changes in the ecologic features of the large intestine. PMID- 6498783 TI - Colon carcinoma and diabetes mellitus. AB - A significantly increased occurrence of overt diabetes mellitus was found among colon or rectal carcinoma patients by comparison with that found among lung carcinoma or hip fracture populations in two hospitals. PMID- 6498784 TI - Stage Ib, IIa, and IIb cervix cancer, postsurgical staging, and prognosis. AB - Two hundred fifty-five cases of International Federation of Gynecology and Obstetrics (FIGO) Stage Ib, IIa, and IIb cases of cervical cancer were analyzed following radical surgery with regard to the extent of invasion into vagina, parametria, and pelvic lymph nodes. Restaging was carried out based on the findings. Discrepancies were found between FIGO stages and the actual extent of the disease, particularly in Stage IIb. Among 99 cases of Stage IIb, only 42.4% were correctly staged. The 5-year disease-free survival by FIGO and postsurgical stagings were, respectively: Ib, 88.4% and 87.0%; IIa, 85.2% and 95.0%; IIb, 70.7% and 62.3%. Prognostic significance in the pathologic examination of operated materials was demonstrated when there were deep stromal invasions of cancer cell or parametrial invasions or pelvic lymph node metastases. When cancer was present in both of the parametrium and pelvic lymph nodes, the prognosis of the patient worsened (5-year survival rate, 41.4%). PMID- 6498785 TI - Metastatic patterns of prostatic cancer. Correlation between sites and number of organs involved. AB - Prostatic cancer in 1885 autopsy cases was classified according to the number of organs involved in metastasis, and a comparison was made concerning the frequency of metastasis to the various organs. The frequencies of metastasis to the lungs and para-aortic lymph nodes were low in cases with single-organ involvement (4.6% and 2.3%, respectively), but increased rectilinearly in accordance with the number of organs involved and became high in cases with metastasis to three or more organs (49.1% and 21.8% in total, respectively). On the other hand, the frequencies of local extension to the bladder and invasion of the pelvic lymph nodes were high even in cases with single-organ involvement (34.5% and 9.2%, respectively) and were not significantly changed regardless of the number of organs involved. No significant correlation was seen between pelvic and para aortic lymph node involvement. In cases with single-organ involvement, metastasis to the lumbar spine occurred frequently, but those to the ribs, sternum, and ilium occurred less frequently. There may be multiple metastases in cases with metastases to the para-aortic lymph nodes, sternum, and ilium. The number of metastatically involved organs is useful in analyzing the mode of metastasis. PMID- 6498787 TI - Nonrandom chromosome changes in carcinoma of the cervix uteri. II. Ten tumors in the triploid-tetraploid range. AB - Nonrandom chromosome changes in direct preparations of 10 cervical carcinomas with modal numbers in the range of 60-82 were similar to those found in a previous study on near-diploid tumors: Chromosomes 1 (seven tumors) and 11 (five tumors) were most often involved in structural rearrangements and a small metacentric, often present in duplicate, was seen in six tumors. The appearances of the small metacentric again suggested an origin from a chromosome #4 or #5: either a long arm deletion or a short arm isochromosome; in one tumor, Giemsa-11 banding was more compatible with a #4 than a #5. Chromosome #17 anomalies were probably present in four tumors, and two tumors had markers, probably derived from chromosome #2, containing homogeneously staining regions. PMID- 6498786 TI - Race, poverty, and survival in multiple myeloma. AB - To identify possible interracial differences in the behavior of multiple myeloma, the records of 52 black myeloma patients at Harlem Hospital Center (HHC) and 46 black and 46 white patients at Columbia-Presbyterian Medical Center (CPMC) were reviewed. In addition to clinical variables such as tumor burden, azotemia, and hypoalbuminemia, the effect of poverty on prognosis was examined, using socioeconomic indices from the United States census block group data of each patient. The median survival of CPMC black and white patients was comparable (34 and 29 months, respectively) whereas that of the HHC group was 12 months (Breslow test, P less than 0.0001). Overcrowding and hypoalbuminemia were the most significant prognostic factors by multivariate regression analysis on all 144 patients (P = 0.001); for HHC patients, overcrowding was the single significant variable affecting survival (P = 0.004). By all socioeconomic indices, HHC patients were more impoverished than CPMC patients (P less than 0.001); they also presented with more advanced disease. Race is not a significant prognostic factor in myeloma, whereas the effect of socioeconomic status on survival appears to equal that of previously described clinical features. PMID- 6498788 TI - Quantitative analysis of chromosomal G-bands in human hematopoietic disorders by methotrexate synchronization technique. AB - Chromosomal G-bands in an improved morphology were demonstrated in bone marrow and unstimulated blood cultures from 12 patients with hematopoietic disorders and 1 with another disease. The procedure used was a cell synchronization technique involving methotrexate or cytosine-arabinoside and thymidine release. Quantitative analyses were made comparatively between synchronized and nonsynchronized (control) cultures in each patient. Mitotic indices varied with the individual. The average number of G-bands per haploid set increased statistically in 8 cases, and the count was often over 400. Improved chromosomal banding patterns in the synchronized preparation resulted in easy and precise identification of chromosome rearrangements in three patients with chronic myeloid leukemia (CML), two with acute myeloblastic leukemia (AML), and three with anemias. Normal cells were more frequently observed in synchronized overnight cultures than in control cultures from two patients with an admixture of normal and abnormal metaphases. There was a slight increase in a minor abnormal clone in the synchronized cultures from one patient. These findings indicate that the cell synchronization technique we use is not only useful in improving chromosome morphology, but is also efficient in detecting both normal and abnormal metaphases. PMID- 6498789 TI - Inherited aplastic anemia with abnormal clones in bone marrow and increased endoreduplication in peripheral lymphocytes. AB - Cytogenetic studies in peripheral blood and bone marrow cells from a female patient (aged 31 years) with inherited aplastic anemia and without other congenital anomalies are reported. Endoreduplication was increased in stimulated peripheral lymphocytes in several investigations. Chromosome breaks were shown to be near the control frequency, although chromatid exchange figures and dicentrics were present. Cytogenetic analysis was extended to the three children of our patient. Abnormal clones were detected in bone marrow preparations of our patient in all cytogenetic investigations. At the first examination, two of these clones were prevalent, with their karyotypes being 48,XX, +9, +16 and 46,XX,dup(1)(q24-- -q32),t(17;?)(p12-13;?). The prevailing karyotype after 2 years was 46,XX,t(17;?)(p12-13;?). Involvement of chromosomes #1 and #17 is discussed, taking into account data from the literature concerning several human neoplasias. PMID- 6498790 TI - Major karyotype aberrations, including t(3;12), in a patient with myelodysplastic syndrome. AB - Cytogenetic analysis of bone marrow cells was performed twice on a patient with myelodysplastic syndrome, specifically, refractory anemia with excess blasts. The patient had a progressive course, with transformation toward acute leukemia and death within 3 months. Chromosome analysis showed major karyotype abnormalities, including dir dup (1p), t(3;12), and a unique breakage of a #15 resulting in t(15;18) and dic(15;21). Involvement of #3 and #12 in a translocation has been recently reported, and a comparison with these cases is made with a discussion of the significance. PMID- 6498791 TI - Chromosome 6q- in metastatic melanoma involving the large bowel. AB - Chromosome banding analysis was performed on a metastatic melanoma involving the large bowel. The complex karyotype contains a 6q- chromosome, which has been seen in a variety of other neoplasms. PMID- 6498792 TI - Serum selenium and glutathione peroxidase, and plasma lipid peroxides in uterine, ovarian or vulvar cancer, and their responses to antioxidants in patients with ovarian cancer. AB - The concentrations of serum selenium and plasma lipid peroxides, and the activity of serum glutathione peroxidase (GSH-Px) were measured before any therapy in patients suffering from uterine, ovarian or vulvar cancer, and in association with 1-day combination cytotoxic chemotherapy of ovarian cancer following 1-week supplementation with selenium (96 micrograms/day), vitamin E (300 mg/day), selenium and vitamin E, or placebo. Patients with gynaecological cancer (N = 44) had lower serum concentration of selenium (1.15 +/- 0.04 S.E. mumol/l; P less than 0.05) and serum activity of GSH-Px (404 +/- 13 units/l, P less than 0.01) than the control subjects (N = 56; 1.25 +/- 0.03 mumol/l and 444 +/- 8 units/l, respectively). In association with cytotoxic chemotherapy selenium alone (P less than 0.05), vitamin E alone (P less than 0.05) and both of them together (P less than 0.001) decreased the plasma concentration of lipid peroxides, and the combination of selenium and vitamin E also increased the activity of serum GSH-Px (P less than 0.01). During placebo, cytotoxic chemotherapy did not affect plasma lipid peroxides but it decreased (P less than 0.001) the activity of GSH-Px. Selenium inhibited this effect. Our data suggest that antioxidative mechanisms of patients with gynaecological cancer may be defective and that treatment with selenium and vitamin E results in changes of biochemical factors related to lipid peroxidation. PMID- 6498793 TI - The metabolism of 1-hydroxy- and 2-hydroxy-3-methylcholanthrene by liver microsomes: effect of enzyme inducing agents. AB - The metabolism of both 1-hydroxy-3-methylcholanthrene (1-OH-3-MC) and 2-hydroxy-3 methylcholanthrene (2-OH-3-MC) by rat liver microsomes was investigated. Metabolites were separated by high pressure liquid chromatography (HPLC). Both compounds were shown to be substrates for further metabolism. Metabolism of 1-OH 3-MC gave rise to at least 13 products while 2-OH-3-MC showed the formation of at least 10 metabolites. At least 3 products of the 1-OH-3-MC metabolism are diol derivatives of the substrate. Using 2-OH-3-MC as substrate generated one major diol derivative that represented between 20% and 50% of total metabolite formation. Pretreatment of animals with known microsomal enzyme inducing agents did not result in the expected induction patterns. In some instances, the microsomes from induced animals were less efficient at metabolizing substrate than those from control. The discovery of a major peak from 2-OH-3-MC metabolism is of extreme importance considering the potency of the parent hydroxy compound in tumor initiation studies. PMID- 6498794 TI - Effect of 2-beta-D-ribofuranosylthiazole-4-carboxamide on uptake of nucleosides by cultured L1210 cells. AB - 2-beta-D-Ribofuranosylthiazole-4-carboxamide (TR) at micromolar concentrations reduces salvage of exogenous pyrimidine and purine nucleosides by cultured L1210 cells. Uridine transport into erythrocytes is inhibited 62-69% by 0.5 mM concentration of the drug. Neither the parent drug nor its monophosphate or triphosphate derivatives inhibited uridine/cytidine kinase in vitro. When L1210 cells were washed free of drug prior to incubation with [14C]uridine approximately 50% inhibition of uridine uptake remained. Incubation of L1210 cells with the drug resulted in an increase in the uracil nucleotide pool. These results indicate that TR reduces uridine uptake by L1210 cells via a combination of inhibition at the transport site and inhibition of uridine/cytidine kinase due to an increased uracil nucleotide pool. PMID- 6498795 TI - Effect of prospidine administered at different times of the day on the development and growth of N-nitrosomethylurea-induced mammary tumors in Wistar rats. AB - The chemotherapeutic effectiveness of intraperitoneal administration of prospidine (50 mg/kg per day during the initial 14 days of study) was evaluated, on a circadian basis, on the N-nitrosomethylurea (NMU)-induced mammary tumors in female rats. Untreated rats showed a progressive increase in the mean tumor area and total tumor area/rat. At the end of treatment the average tumor area and total tumor area/rat in the animals treated at 0800, 1400 and 2000 h were significantly lower than the values in the control group by week 2. By weeks 3 and 4 the mean tumor area and total tumor area in all groups of treated rats were significantly lower than those in the untreated animals. The mean tumor area by weeks 5 and 6 in the animals treated at 0800 h were significantly lower than in the group treated at 0200 h, and the mean value by week 6 in the group treated at 1400 h was significantly lower than those from the groups treated either at 2000 h or 0200 h. The mean total tumor area/rat in rats treated at 1400 h was, by week 6, significantly lower than in animals treated either at 2000 h or 0200 h. A transient reduction in body weight was registered at the end of prospidine treatment. PMID- 6498796 TI - Modification of N-methyl-N-nitrosourea initiated carcinogenesis in the rat by subsequent treatment with antioxidants, phenobarbital and ethinyl estradiol. AB - The modifying effects of butylated hydroxyanisole (BHA), sodium L-ascorbate (SA), phenobarbital (PB) and ethinyl estradiol (EE) were studied by their administration to F344 rats subsequent to initiation with N-methyl-N-nitrosourea (MNU), a wide-spectrum carcinogen inducing tumors in many organs. Rats were initially given 4 doses of MNU (50 mg/kg) intraperitoneally within a 2-week period and then placed on a diet containing BHA (1%), SA (5%), PB (0.05%) or EE (0.001%) for 23 weeks prior to killing. Since the experiment was based on a whole body concept of carcinogenesis, all major organs were examined histologically and histochemically for any preneoplastic lesions. BHA enhanced forestomach and urinary bladder carcinogenesis as did SA also for the urinary bladder, whereas PB enhanced the induction of gamma-glutamyl transpeptidase positive (gamma-GT+) foci in the liver and also the incidence of thyroid carcinoma and forestomach carcinoma. In contrast, EE inhibited the induction of thyroid tumors, malignant lymphoma or leukemia. Thus these compounds, when given after initiation of many organs by a single carcinogen, exert an influence on the site of tumor development by, as yet unknown, organotropic modifying effects. PMID- 6498797 TI - Changes in the relative distribution and properties of smooth endoplasmic reticulum subfractions isolated from the livers of rats fed 2 acetylaminofluorene. AB - A marked increase in the amount and relative proportion of fraction II of the smooth endoplasmic reticulum (SER II) and a concomitant decrease in the SER I fraction were observed in the liver of male Sprague-Dawley rats fed diets containing 0.05% (w/w) 2-acetylaminofluorene (AAF) for various lengths of time (3 18 weeks). The amount of rough endoplasmic reticulum (RER), which remained at control levels after 3 weeks of AAF feeding, i.e. before the appearance of hyperplastic nodules (HPN), was clearly decreased after 18 weeks of continuous AAF-feeding (HPN present). When the rats were subjected to 4 or 5 cycles of interrupted AAF feeding, similar increases in SER II were also observed both in the homogenates of HPN-containing livers, as well as in the homogenates of HPN dissected out from the surrounding liver tissue. SER II, the predominant microsomal membrane fraction in the livers of rats fed AAF for 3 weeks, showed the highest level of induction of epoxide hydrolase. A marked elevation of the manganese-dependent enhancement of polysome binding in vitro was also observed in SER II from the livers of AAF-fed rats. PMID- 6498798 TI - Possible pre-dissociation of diorganotin dihalide complexes: relationship between antitumour activity and structure. AB - An examination of crystallographic data has indicated that the structure/activity relationship for diorganotin dihalide complexes is different from that of other metal dihalides, in that the Sn-N bond lengths appear to determine the antitumour activity. PMID- 6498799 TI - Di(2-ethylhexyl)phthalate but not phenobarbital promotes N-nitrosodiethylamine initiated hepatocellular proliferative lesions after short-term exposure in male B6C3F1 mice. AB - The differential effects of short- or long-term exposure to the liver tumor promoters di(2-ethylhexyl)phthalate (DEHP) or phenobarbital (PB) were studied in male B6C3F1 mice. Mice were injected intraperitoneally (i.p.) at 4 weeks of age with N-nitrosodiethylamine (DEN) at a dosage of 80 mg/kg. At 5 weeks of age, the mice were fed diets containing PB or DEHP for periods of from 1 to 168 days and killed at 168 or 252 days. When DEHP was fed at a dietary level of 3000 ppm for 28, 84, or 168 days, or PB was fed in the water at 500 ppm for 168 days, there were significantly increased incidences of mice with focal hepatocellular proliferative lesions (FHPL) as compared with those in mice receiving DEN alone. There was no significant promotion of FHPL when DEHP was fed for 1 or 7 days or when PB was fed for 1, 7, 28, or 84 days. Thus, DEHP was an effective promoter after only 28, 84, or 168 days exposure whereas PB required 168 days of continuous exposure for a promotive effect to be evident. PMID- 6498801 TI - The imaging of small experimental murine tumors grown in the subrenal capsule using monoclonal antibodies. AB - The ability of a "tumor-specific', monoclonal antibody (OX7) and a subclass matched, non-specific, control antibody (anti HRP) to localize in and image small (20-60 mg) murine lymphomas growing in the subrenal capsule of mice was tested. Due to the small tumor size, and its visceral location, the subrenal site of tumor growth represents a model of metastases which may be more clinically relevant to human cancer. The in vivo and in vitro quantitative data (as well as the gamma camera images) support the feasibility of the concept of using monoclonal antibodies for metastatic tumor detection and treatment. PMID- 6498800 TI - Histological comparison of the B16 melanoma and its F1 variant. AB - The B16 malignant melanoma and its F1 variant line were described and compared in syngeneic C57BL/6 mice at short and long term periods after transplantation. No observable differences in gross or histological features were noted. In both lines, liver and lung metastasis was confirmed and kidney colonization proposed. PMID- 6498802 TI - The carcinogenic effect of bis-(2-oxopropyl)-nitrosamine on Sprague-Dawley rats. AB - Sprague-Dawley rats received subcutaneous injections of bis-2-oxopropyl) nitrosamine (BOPN) once weekly for life. The animals developed mainly papillomas and squamous cell carcinomas of the nasal cavity, follicle cell carcinomas of the thyroid gland and papillomas and transitional cell carcinomas of renal pelvis, ureter and urinary bladder. The tumour incidence was 100% in all the 3 treated groups. Survival time, tumour latency and multiplicity showed dose dependency. PMID- 6498803 TI - A carcinogenicity study of styrene-7,8-oxide in rats. AB - Styrene-7,8-oxide (200 mg/kg body wt) was given orally to female BDIV rats on 17th day of pregnancy. Their offspring received 96 weekly doses of styrene oxide (100-150 mg/kg body wt). Following the continuous administration of styrene oxide, an increased incidence, statistically significant, of forestomach tumours was observed in rats of both sexes. The incidence of tumours occurring at other sites was similar in treated and control animals. The present results show that styrene oxide is a direct-acting carcinogen producing benign and malignant tumours of the forestomach. PMID- 6498804 TI - Rapid lipid peroxidation in the nuclear fraction of rat liver induced by a diet deficient in choline and methionine. AB - A diet deficient in choline and methionine, known to produce hepatocellular carcinoma in the absence of any added chemical carcinogen, induced lipid peroxidation in the nuclear fraction of the liver when fed to male Fischer 344 rats. This lipid peroxidation was detected within 1 day of feeding the diet by the appearance of diene conjugates and increased progressively up to 3 days. It was prevented completely by the addition of choline chloride to the diet. The close proximity of DNA may make it a possible target for attack by free radicals. PMID- 6498805 TI - Gossypol inhibits Ehrlich ascites tumor cell proliferation. AB - Neutral gossypol solution injected peritoneally into NMRI mice preimplanted with Ehrlich ascites tumour cell, at a dose of 25-100 micrograms/mouse per day, lengthened the number of survival days of the hosts. This gossypol effect on tumour cell proliferation is concentration dependent. The optimum dose is 100 micrograms. However, at too high a dose, the gossypol caused a body weight loss and the death of the tumour-bearing mice. PMID- 6498806 TI - The effect of deuterium substitution on carcinogenesis by azoxymethane. AB - Azoxymethane was synthesized labeled with deuterium in one or other of the two methyl groups. Groups of 20 male F344 rats were given either 4 mg or 1 mg per week of each of the labeled compounds or of unlabeled azoxymethane each week in drinking water, for 30 weeks, after which the animals were kept until they died. All in the high dose groups died earlier with tumors induced by the treatment than did those in the low dose groups. Azoxymethane itself led to earlier death than either of the deuterium-labeled compounds, and methylazoxymethane-d3 seemed to be the least potent compound. The incidence of liver tumors and of kidney tumors was similar in the groups receiving the same dose of all 3 compounds. However, there were fewer tumors of the colon in animals given methyl-d3 azoxymethane than with the other 2 compounds. These results are consistent with the concept that either methyl group of azoxymethane can be oxidized in the course of activation to a proximate carcinogenic agent for liver, kidney or colon of rats, but that oxidation of the methyl group next to the nitrogen bearing oxygen is more important in the induction of colon tumors. PMID- 6498807 TI - Evidence for a major role of plasma lipoproteins as hematoporphyrin carriers in vivo. AB - Hematoporphyrin (5 mg/ml), administered intravenously to tumor-bearing patients, becomes associated with different serum proteins, including lipoproteins (mainly HDL), globulin and albumin. No residual porphyrin is bound to the two latter classes of proteins after 48 h, whereas the complexation with the lipoproteins appears to be particularly stable probably owing to the hydrophobic nature of hematoporphyrin. The late persistence of hematoporphyrin in serum is due to the binding to the VLDL fraction with special regard to its cholesterol moiety. The importance of hematoporphyrin transport by lipoproteins for the photodynamic therapy of tumors is briefly discussed. PMID- 6498808 TI - Tumour enhancement associated with induction of abscesses in mice bearing a transplantable solid tumour. AB - A model of intraabdominal sepsis in the tumour-bearing host was established in order to study the interactions between host, tumour and infecting organisms. BALB/c mice bearing a transplanted tumour were given an intraperitoneal inoculum containing Bacteroides fragilis, Escherichia coli and bran as an abscess potentiating agent. Tumour-bearing mice formed abscesses which were not significantly smaller than in controls except late in tumour growth. The bacterial contents of the abscesses were not significantly different to controls. In contrast, mice given an abscess-inducing mixture at or near the time of tumour cell inoculation had tumours which were significantly larger than in controls. The mechanism of tumour enhancement is not known. PMID- 6498809 TI - Inhibition of protein synthesis and cell proliferation in cultured human breast cancer cells treated with mitoxantrone. AB - Mitoxantrone suppresses cell proliferation, inhibits protein synthesis and induces ultrastructural alterations in the T-47D and MDA-MB-231 breast cancer cell lines. After 24 h treatment with 10(-9), 10(-7) and 10(-5) M drug and 8 h incubation with [35S]methionine, protein synthesis declined rapidly. While a 10 15% decrease in protein synthesis at 10(-9) M was observed, more than 95% inhibition of protein synthesis occurred at 10(-5) M mitoxantrone in both cell lines. Sodium dodecylsulfate (SDS) gel electrophoresis of labeled proteins revealed no qualitative changes in either cell line. However, only trace amounts of several proteins were present in T-47D cells treated with 10(-5) M drug. At 10(-9) M mitoxantrone had little effect on cell proliferation. At 10(-7) M, 25% and 35% growth inhibition in T-47D and MDA-MB-231 cells was observed, respectively. Cell growth at 10(-5) M was abolished. Cytotoxicity was evident at drug concentrations above 10(-5) M. Ultrastructural alterations in the nucleoli of both cell lines included disintegration and segregation of granular and fibrillar components and the disappearance of nucleolar organizers at 10(-7)-10( 5) M mitoxantrone. PMID- 6498810 TI - Carcinoembryonic antigen production, secretion, and kinetics in BALB/c mice and a nude mouse-human tumor model. AB - Carcinoembryonic antigen (CEA) is currently being used as a target antigen in the radioimmunodetection of cancer. Circulating CEA may adversely affect the outcome of such studies by formation of intravascular immune complexes. The following studies were undertaken to expand our knowledge of the production, secretion, and pharmacokinetics of CEA, since these factors should have a direct bearing on the serum levels of CEA encountered in radioimmunodetection. The production of CEA was assessed in nude mice given implants of the T-380 CEA secreting human colon tumor. Serum CEA rose linearly as the tumors enlarged; however, the concentration of CEA per g of extracted tumor remained constant throughout the weight range studied. The secretory rate of the T-380 tumor was determined by surgically removing all blood flow to the liver and gastrointestinal tract of the nude mouse model. This procedure removes the known sites of CEA degradation. Serum CEA levels rose progressively following surgery, the values being directly related to the tumor size. The secretory rate was also proportional to tumor size but was a constant 13.8 +/- 3.6 (S.D.) ng/g tumor/hr when expressed on a per g tumor basis. To determine if the serum levels of CEA observed in patients could be due to unique differences in the clearance rates of each patient's CEA, serum from three patients with CEA levels of 2150, 709, and 58 ng/ml was administered i.v. to groups of mice at the original and diluted concentrations. The kinetics of all samples followed a single exponential clearance pattern with a half-time of about 2.5 hr. This was dramatically different from the kinetics of tumor-extracted CEA which exhibited a multiexponential pattern, the first component having a half time of 3 min. These data suggest that CEA secreted by a tumor is in some way different from that adhering to the tumor. If the secreted CEA truly has a monoexponential clearance with a fixed rate as the experiments suggest, the absolute values of serum CEA are either entirely a function of the tumor secretory rate, or else the product having the short half-time is not measured in serum samples obtained from patients. PMID- 6498811 TI - Promoting effect of bile acids on the chemical transformation of C3H/10T1/2 fibroblasts in vitro. AB - We studied the effect of bile acids on the chemically induced transformation of C3H/10T1/2 fibroblasts in vitro. Bile acids exerted marked cytotoxicity on the cells at concentrations of greater than 100 microM lithocholic acid or deoxycholic acid, greater than 150 microM chenodeoxycholic acid, and greater than 500 microM cholic acid. N-Methyl-N'-nitro-N-nitrosoguanidine (MNNG) at 13.6 microM showed remarkable cytotoxicity to the cells but produced transformed cell foci in the cultures. When the cells were pretreated with MNNG and then maintained in medium containing bile acids, they showed an increased number of transformed cell foci compared to cells treated with MNNG alone. No promotion was observed in cultures treated first with bile acids and then with MNNG. On the basis of the present data, we conclude that bile acids promote the carcinogenic process of C3H/10T1/2 cells and that such promoting activity is observed not only with secondary but also with primary bile acids. PMID- 6498812 TI - Protection against thermal cell death in Chinese hamster ovary cells by glucose, galactose, or mannose. AB - The addition of D-glucose, D-galactose, or D-mannose to culture medium increased survival of heated Chinese hamster ovary cells in a concentration- and time dependent manner. Heat protection by sugars was not immediate but required prior incubation in the sugar medium before hyperthermia. The degree of heat protection conferred by each sugar and its time dependence differed characteristically: galactose protection appeared rapidly (within 1 hr) and was proportional to the galactose concentration in the medium up to 0.3 M. Glucose and mannose were less effective heat protectors at 0.3 M concentrations when compared with galactose, but cell survival after 40 min, 45 degrees, at concentrations below 0.1 M was similar in the three hyperosmotic sugar media. Heat protection by 0.3 M glucose under hyperosmotic conditions (600 mOSM) became apparent only after a preincubation period of at least 5 hr, 37 degrees. Under isoosmotic conditions (300 mOSM, 10% medium-10 mM morpholinopropanesulfonic acid-250 mM glucose), heat protection by glucose appeared more rapidly (3 hr), but the time dependence of heat protection was not eliminated. Under the same isoosmotic conditions in galactose medium, the survival of heated cells was not measurable. The 45 degrees survival curve in hyperosmotic galactose medium (6 hr, 37 degrees prior to heating, 0.3 M) was characterized by a DO of 10 min (controls, 3 min) and a quasithreshold dose of 17 min (controls, 17.5 min). When galactose-loaded cells were returned to fresh medium, heat protection decayed rapidly; cell survival measured 1 or 6 hr later showed a small degree of residual heat protection. A 5 hr incubation period at 37 degrees in galactose-supplemented medium resulted in a major intracellular accumulation of free galactose with smaller accumulations of glucose, sorbitol, and dulcitol. A similar incubation in glucose medium showed only minor intracellular elevations of polyols or sugars. A flow-cytometric analysis of the age distribution showed that incubation in the sugar-supplemented media slightly reduced the fractional cell population in G1 with concomitant gains in both the S- and G2-phase populations. Thus, heat protection by galactose or glucose is probably neither the result of a redistribution of cells in the cycle, nor does it always require the intracellular accumulation of free sugars and polyols. The greater degree of heat protection by galactose and its rapid manifestation under hyperosmotic conditions may be related to the intracellular accumulation of free galactose and/or its metabolites. PMID- 6498813 TI - Bioconversion and macromolecular binding of 2-amino-4-(5-nitro-2-furyl)thiazole by cultured rat urothelial cells. AB - Bioconversion and binding of 2-amino-4-(5-nitro-2-furyl)-thiazole (ANFT) were examined using cultured rat bladder epithelial cells from weanling male F344 rats. Bladder cells were obtained in large quantities from outgrowths of dissected explants which were grown on collagen gels. Metabolic potential of rat urothelial cells to activate ANFT was evaluated by incubating primary culture cells with [2-14C]ANFT for 48 hr. Metabolites were subsequently analyzed by chromatographic and spectroscopic methods. Thin-layer chromatography of the ethyl acetate:diethyl ether (1:1, v/v) extract of the culture medium revealed two regions of radioactivity with Rf values of 0.12 and 0.60, the former corresponding to ANFT and the latter to one of its metabolites. High-pressure liquid chromatography of the solvent extract revealed two major peaks, with retention times of about 4 and 9 min, corresponding with the metabolite and ANFT, respectively. Low-resolution mass spectrum of the isolated metabolite showed a molecular ion at m/e 181. The metabolite was identified as 1-[4-(2 aminothiazolyl)]-3-cyano-1-propanone based on its chromatographic and spectral characteristics in comparison with the synthetic compound. About 24% of the recovered radioactivity from the culture medium was extractable into the organic phase, a majority of which was identified as 1-[4-(2-aminothiazolyl)]-3-cyano-1 propanone. Analysis of binding to proteins and nucleic acids prepared following exposure of [2-14C]ANFT revealed a 15- and 9-fold greater amount of binding, respectively, in cultures incubated with bladder cells than their corresponding heat-inactivated controls. Furthermore, homogenates of cultured bladder cells reduced ANFT on anaerobic incubation with reduced nicotinamide adenine dinucleotide phosphate to generate 1-[4-(2-aminothiazolyl)]-3-cyano-1-propanone. On reduction of [2-14C]ANFT with rat bladder or liver homogenates, about 23 and 11%, respectively, of the initial amounts of radioactivity were bound to the trichloracetic acid-insoluble fraction. These data demonstrate that rat bladder cells possess the metabolic capability to reduce ANFT and to generate reactive intermediate(s) that bind to cellular macromolecules. PMID- 6498814 TI - Augmented antiproliferative effects of interferons at elevated temperatures against human bladder carcinoma cell lines. AB - The in vitro antiproliferative effects of interferons (IFN) against the human bladder carcinoma cell lines T24, RT4, HT1197, and 647V were evaluated at temperatures ranging from 37-41 degrees. At 37 degrees, the antiproliferative activities of IFN, either naturally produced or produced by recombinant DNA technology, were different against different cell lines. An increase in temperature markedly enhanced the antimitotic effect of IFN for all cells. For example, T24 cells grown at 37 degrees and treated with 200 units naturally produced IFN-alpha or IFN-beta per ml for 7 days were inhibited 50 to 60%. No change in cell proliferation occurred in untreated T24 cells grown at 39.5 degrees. Treatment with 200 units IFN-alpha or IFN-beta per ml at 39.5 degrees inhibited these cells 80 to 90%. Similar results were obtained with IFN produced by recombinant DNA technology and purified to homogeneity. Colony formation by the RT4 cell line, at 37 degrees, was decreased less than 10% with 200 units IFN alpha per ml and 63% by 200 units IFN-beta per ml. At 39.5 degrees, colony formation by untreated RT4 cells was inhibited 48%. Treatment with IFN-beta at 39.5 degrees did not result in an enhancement of the antiproliferative effect; however, treatment with IFN-alpha enhanced the inhibition from less than 10% to 98%. These results suggest that a supraadditive relationship exists between antiproliferative effects of IFN and temperature elevation. The differences seen between IFN-alpha and IFN-beta may be due to the different stabilities of these two molecules. In order to probe the mechanism of the enhanced antiproliferative effect, activity of an IFN-induced enzyme, 2'-5'-oligoadenylate synthetase, was measured. IFN-alpha treatment resulted in significantly greater 2'-5' oligoadenylate synthetase induction at 39.5 degrees than at 37 degrees. Thus, two cellular effects resulting from IFN were augmented by increased temperature. PMID- 6498815 TI - Effects of 1,2-dimethylhydrazine on the number of epithelial cells present in the villi, crypts, and mitotic pool along the rat small intestine. AB - Young adult male rats received 1,2-dimethylhydrazine (25 mg/kg) twice weekly for 2 months and once a week thereafter for up to 6 months. Histological samples of duodenum, jejunum, and upper, mid-, and terminal ileum were prepared from groups killed at each month. Using cell counts, the average number of epithelial cells was determined per representative section of villi and crypts and was used as an index of villus size and crypt size, respectively. The average number of mitotic figures in representative crypt sections was also determined. All three parameters increased during treatment, and the increments showed a specific pattern in relation to time and intestinal region. Mitotic number showed a consistent change all along the small intestine: close to 20% rise by 3 months; decrease to near control level by the fourth month; and a rise thereafter. Probably, a systemic stimulation of mitotic activity by 1,2-dimethylhydrazine took place. The crypt size index changed similarly, showing highly significant correlation with mitotic number. This correlation indicated that average mitotic time and cell cycle time remained unchanged and the number of divisions increased in progenitor cells. Calculations showed that only a fraction of the progenitor cells was involved. These were probably "initiated" cells. There was a net increase of initiated cell numbers with time, but a sharp drop at 4 months indicated that there is a mechanism inducing a regression of the initiated cell population. Villus size increased linearly in the duodenum and jejunum. In the ileum, there was also a net increase but with some initial fluctuation. In general, villus size seemed to increase so as to maintain a fairly stable turnover time. This would mean that the increased mitotic activity was balanced by increasing differentiation. PMID- 6498816 TI - Cross-resistance to rhodamine 123 in Adriamycin- and daunorubicin-resistant Friend leukemia cell variants. AB - Cross-resistance to rhodamine 123 (Rho-123) has been found in Adriamycin (ADM) resistant and daunorubicin (DNR)-resistant Friend leukemia cell variants. Cytotoxicity in sensitive cells correlates with the intracellular amount of Rho 123, as determined by high-pressure liquid chromatography. Differential resistance coincides with Rho-123 accumulation which in sensitive cells was 20 fold higher than in resistant cells after 180 min of treatment. Sodium azide, which has been shown to inhibit ADM efflux and consequently increase drug accumulation in ADM-resistant cells, did not inhibit Rho-123 efflux. The difference in Rho-123 accumulation between sensitive and resistant cells correlates with cytotoxicity, which is in contrast to what has been found in these cells when treated with either ADM or DNR. Moreover, in contrast to the known effects of ADM and DNR on macromolecular synthesis, Rho-123 in sensitive cells was found to inhibit protein synthesis but had no effect on DNA or RNA synthesis. At Rho-123 doses which inhibited protein synthesis, drug localization changed from mitochondrial specific to generalized cytoplasmic. This effect was never achieved in resistant cells, even with prolonged drug exposure. The relevance of these findings is that different mechanisms of resistance to different drug types can be identified in the same cells even though similar resistance occurs. The similarity in resistance need not share a common mechanism. Although the drugs are effluxed more efficiently in resistant cells, the mechanisms for resistance in each case seem to differ. In the case of ADM and DNR, it appears to be multifactorial, whereas with Rho-123, total intracellular accumulation seems to be most important. PMID- 6498817 TI - Stereochemical properties of nucleosides alkylated by activated carcinogens. AB - An initial stage in the mechanism of chemical carcinogenesis by "activated" carcinogenic polycyclic aromatic hydrocarbons is believed to involve alkylation of DNA. However, very high (atomic) resolution studies of alkylated DNA are not technically feasible at this time, and therefore the detailed, high-resolution three-dimensional structures of portions of alkylated DNA have been determined. The initial phase of this study (reported here) has involved the preparation of a series of adenosines and 2'-deoxyadenosines substituted at N6 by related aralkyls of differing carcinogenic potential. We report here the crystal structure determinations of four of these compounds: Compound 1, N6-(anthracenyl-9 methyl)adenosine; Compound 2, N6-(10-methyl-anthracenyl-9-methyl)adenosine; Compound 3, N6-[12-methyl-benz(a)anthracenyl-7-methyl]adenosine; and Compound 5, N6-(10-methylanthracenyl-9-methyl)-2'-deoxyadenosine. Results are compared with those for a previously published analysis Compound 6, N6-[12 methylbenz(a)anthracenyl-7-methyl]-2'-deoxyadenosine. Several results of structural interest have emerged. All five compounds have the syn-conformational relationship between the sugar (ribose or 2'-deoxyribose) and the base (adenine), in contrast to the anti arrangement in B-DNA and in nonalkylated nucleosides. In four of the five compounds, there is an intramolecular hydrogen bond between the 5'-hydroxyl group and adenine. However, in the fifth molecule, this hydrogen bond is not found, and yet the conformation is syn. This indicates that formation of this internal hydrogen bond is not a prerequisite for the adoption of the syn conformation. In general, the overall conformations of all five compounds are similar, the base lying approximately perpendicular to the polycyclic aromatic ring system. The packing of molecules in the unit cell is also of interest because it consists of alternations of adenine and polycyclic aromatic ring systems in columns through the crystal, indicating that this may serve as a model for the interaction with DNA. The oxygen atom of the sugar ring points towards the hydrocarbon ring system of another molecule. It is premature at this stage of our study to speculate as to the effects of alkylation on the conformational properties of either RNA or DNA. The only comment that appears justified is that the propensity of these adducts to adopt the syn-conformation may be indicative of a preference of alkylated DNA for the Z-conformation (even if the form that is initially attacked is B-DNA).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6498818 TI - Variation in capacity for anchorage-independent growth among agar-derived clones of spontaneously transformed BALB/3T3 cells. AB - A subline of cloned spontaneously transformed BALB/3T3 cells had a colony-forming efficiency (CFE) in agar of 5 to 20%. Individual agar colonies isolated and reseeded into agar were not significantly more efficient at initiating colonies than the original unselected subline. Four successive cycles of agar growth and selection also failed to increase the mean CFE in agar. Randomly selected clones isolated on a plastic surface all had the capacity to grow in agar. These results suggest that the failure of the majority of the cells to grow in agar is not the result of an intrinsic or heritable inability to do so. The ability to initiate a colony in agar seems to vary phenotypically from cell to cell. In contrast, agar colonies isolated from some tumor cell lines (originating from related spontaneously transformed 3T3 cells) and reseeded in agar had a higher CFE than the unselected tumor cell lines. In one case, this increased CFE in agar was lost when the cells were passaged on plastic without further selection for agar growth. Thus, expression of the anchorage-independent phenotype may vary, even among related cloned populations of transformed cells. PMID- 6498819 TI - Chromosomal radiosensitivity of human tumor cells during the G2 cell cycle period. AB - Thirteen cell lines derived from human tumors of diverse tissue origin and histopathology were compared with 12 lines of normal skin fibroblasts with respect to chromatid damage induced by 25, 50, or 100 R of X-irradiation during the G2 period of the cell cycle. Only cells in metaphase were examined, and these had been irradiated 1.5 hr before fixation. When irradiated under identical conditions, the tumor cells showed significantly more chromatid breaks and gaps than did the normal cells at all doses tested. The data suggest that the increased G2 chromosomal radiosensitivity of the tumor cells is associated with deficient DNA repair during the G2-prophase period of the cell cycle. PMID- 6498820 TI - Growth enhancement of N-nitrosomethylurea-induced rat mammary tumor cells in soft agar by estrogen or prolactin. AB - Cells obtained from N-nitrosomethylurea-induced rat mammary tumors were grown in vitro using the soft-agar clonogenic assay technique. Their growth was studied in regular media containing serum as well as in media lacking serum, but to which insulin was added. Deletion of serum from the media resulted in a mean decrease of 49% in the number of colonies formed in vitro in 13 of 18 tumors and was without effect in the remaining 5 tumors. The addition of either 17 beta estradiol (10(-8) M) or ovine prolactin (OPRL, 100 ng/ml) to the defined media resulted in an increase in the number of colonies formed in 12 of 18 tumors. The mean numbers of colonies per Petri dish in 17 beta-estradiol- and OPRL-treated Petri dishes were 95 +/- 5.4 (S.E.) and 92 +/- 6.2% of the values seen in serum containing media. Simultaneous addition of both hormones to the defined media resulted in a significant increase in the number of colonies formed which was greater than that seen when either hormone was added separately. Of four tumors where neither hormone influenced colony formation, the addition of both 17 beta estradiol and OPRL resulted in an increase in the number of colonies formed in three tumors. We conclude that the N-nitrosomethylurea-induced mammary tumors can be grown in soft agar using defined media and that their growth can be enhanced by either 17 beta-estradiol or OPRL. These hormones have a synergistic effect on the growth of some of these tumors in vitro. These data are consistent with the known in vivo effects of these hormones on the N-nitrosomethylurea-induced rat mammary tumors. PMID- 6498821 TI - Radioimmunoassay and preliminary pharmacokinetic studies in rats of 5' noranhydrovinblastine (navelbine). AB - The antitumor drug navelbine (5'-noranhydrovinblastine) was converted into a reactive acid azide and covalently coupled to free amino groups of bovine serum albumin. The conjugate was used to raise specific antibodies in rabbits. The acid azide derivative was also reacted with the peptide glycyl-L-tyrosine, and the conjugate was radiolabeled with 125I. The resulting high-specific-activity gamma emitting probe was shown to bind very tightly to anti-navelbine antiserum. Using these reagents, a radioimmunoassay was developed which proved sensitive enough to measure less than 10 fmol of navelbine in serum and which showed little cross reaction with closely related analogues such as vinblastine, vindesine, or 5'-6' secovinblastine. A preliminary pharmacokinetic analysis was performed in rats given navelbine i.v. (dose, 1.2 mg/kg). The radioimmunoassay was used to monitor the plasma concentration decay kinetics after injection. Navelbine systemic clearance was estimated from the area under the concentration-time curves [1.9 +/ 0.5 (S.D.) liters/hr/kg] and was found to be larger than that of vinblastine (1.1 +/- 0.4 liters/hr/kg) measured under similar conditions (dose, 0.6 mg/kg). Terminal half-lives were 8.9 +/- 2.1 hr for navelbine and 8.1 +/- 2.6 hr for vinblastine. This radioimmunoassay will provide a sensitive method with which to monitor plasma levels of navelbine during clinical trials and to further study the relationships between pharmacokinetics, toxicity, and antitumor activity among Vinca alkaloids. PMID- 6498822 TI - Antitumor activity of DL-threo-beta-fluoroasparagine against human leukemia cells in culture and L1210 cells in DBA mice. AB - DL-threo-beta-Fluoroasparagine (DL-threo-beta-F-Asn) inhibited the growth of murine leukemia L1210 cells and three human leukemia cell lines in culture. Fifty % inhibiting dose values ranged between 30 and 50 microM DL-threo-beta-F-Asn. L1210 cells were not sensitive to DL-erythro-beta-fluoroasparagine, DL-threo-beta fluoroaspartic acid, or DL-erythro-beta-fluoroaspartic acid at 300 microM, the highest dose studied. The antileukemia activity of DL-threo-beta-F-Asn was studied in further detail using the L1210 model system. Inhibition of growth in culture was prevented by L-asparagine but not by D-asparagine. Inhibition of growth of L1210 cells incubated for 40 hr in the presence of 300 microM DL-threo beta-F-Asn was reversed after DL-threo-beta-F-Asn removal. Treatment for longer periods of time resulted in cell lysis. DL-threo-beta-F-Asn at doses of 250 mg/kg increased life span in mice bearing L1210 tumors by 60%. These results demonstrate the chemotherapeutic potential of the amino acid analogue DL-threo beta-F-Asn. PMID- 6498823 TI - Esophageal microsomal metabolism of N-nitrosomethylbenzylamine in the zinc deficient rat. AB - Epidemiological studies in China suggest that dietary zinc deficiency and environmental exposure to N-nitrosamine carcinogens, such as N nitrosomethylbenzylamine (NMBA), are among the factors associated with an increased incidence of esophageal carcinoma in humans. NMBA belongs to a class of nitrosamines which require activation by the cytochrome P-450-dependent mixed function oxidases in order to be mutagenic. Rats maintained on a zinc-deficient diet exhibited an increased incidence of NMBA-induced esophageal carcinoma when compared to rats on a control diet. The increased tumor formation was associated with an alteration of the microsomal metabolism of NMBA. Weanling male Sprague Dawley rats were raised on egg protein diets containing 2.3 ppm zinc (low zinc) or 50 ppm zinc (control zinc). Analysis of tissues revealed a rapid decline in the levels of zinc in serum and esophagi of the animals fed the low-zinc diet. Gastric and hepatic zinc content did not differ significantly between the animals fed the low-zinc diet and the animals fed the control zinc diet, even after 6 weeks. Microsomes were prepared from esophageal mucosa, livers, and forestomachs from weanling animals fed these diets for 3 weeks. The rate of formation of benzaldehyde from NMBA by esophageal mucosal microsomes prepared from the rats fed the low-zinc diet was nearly 10-fold higher than that of the rats fed the control zinc diet [0.230 +/- 0.047 (S.E.) versus 0.024 +/- 0.008 nmol/min/mg microsomal protein; p less than 0.001]. The rate of benzaldehyde formation by hepatic microsomes was 0.062 +/- 0.005 nmol/min/mg microsomal protein in the rats fed the low-zinc diet and 0.042 +/- 0.002 nmol/min/mg microsomal protein in the rats fed the control zinc diet (p less than 0.01). The rate of benzaldehyde formation by forestomach microsomes was not detectable in tissue from rats on either diet. This increased rate of NMBA metabolism by esophageal mucosal microsomes from the zinc-deficient rats may explain the increased incidence of esophageal carcinoma in these animals. PMID- 6498824 TI - Induction of DNA strand breaks and cross-links by 2,5-diaziridinyl-3,6 bis(carboethoxyamino)-1,4-benzoquinone in Chinese hamster ovary cells. AB - The DNA-damaging effects of 2,5-diaziridinyl-3,6-bis(carboethoxyamino)-1,4 benzoquinone (AZQ) in Chinese hamster ovary cells were investigated. As determined by alkaline elution, DNA strand breaks were observed in cells treated with 50 microM AZQ for 2 hr. The single-strand break frequency was 31.3 +/- 5.3 (S.D.) rad equivalents. Strand breaks could also be detected at lower drug concentration if proteinase K treatment was included before DNA elution. In comparison, DNA cross-links were apparent in cells treated with as low as 6.25 microM AZQ. The cross-linking frequencies were 39.7, 124.3, 230.3, and 625.1 rad equivalents for 6.25, 12.5, 25, and 50 microM AZQ, respectively. Both DNA-DNA and DNA-protein cross-links in AZQ-treated cells were revealed by the proteinase K assay. The DNA strand breaks induced by AZQ were rapidly rejoined within 1 hr after drug removal. DNA interstrand cross-links increased within the first 6 hr of postincubation and then slightly decreased by 12 hr, and most of the cross links disappeared after cells were allowed to recover for 24 hr. DNA-protein cross-links were immediately formed during the drug treatment period and were gradually decreased after drug removal. PMID- 6498825 TI - Growth-stimulative effect of estrogen on androgen-dependent Shionogi carcinoma 115. AB - The stimulative effect of 17 beta-estradiol on the growth of androgen-dependent Shionogi carcinoma 115 and estrogen receptor in the tumor were studied. The incorporation of 17 beta-[3H]estradiol following a single injection of 17 beta [3H]estradiol into tumor-bearing animals was 5- to 20-fold higher in the tumor than in the spleen and blood. Scatchard plot analyses showed that the tumor cytosol possessed a 17 beta-estradiol-binding site having a high affinity for 17 beta-estradiol [Kd 1.1 +/- 0.1 nM (S.E.)]. Competition experiments demonstrated that the 17 beta-estradiol binding was specific only for estrogenic compounds. Using sedimentation coefficient obtained by high-salt sucrose gradient (4.0S) and Stokes radius obtained by gel chromatography on Sephadex G-200 (46 A), the molecular weight of 17 beta-estradiol-binding component in the tumor cytosol was estimated to be 76,400. In castrated DS mice, a slight but significant increase in growth of s.c. grafted tumors was found by daily s.c. injections of either 17 beta-estradiol or 10 micrograms per mouse of testosterone propionate. Growth of the tumor maintained by 10 micrograms of testosterone propionate was augmented markedly by the addition of 4 micrograms of 17 beta-estradiol, and the growth approached the level induced by 100 micrograms of testosterone propionate. Simultaneous injections of bromocryptine inhibited an increase in 17 beta estradiol-induced prolactin secretion but had no effect on the 17 beta-estradiol enhanced tumor growth. These results demonstrate for the first time the stimulative effect of estrogen on the growth of androgen-dependent Shionogi carcinoma 115. The tumor contains typical estrogen receptor, which might be able to transmit estrogen signal to tumor cell nuclei with regard to tumor growth. PMID- 6498826 TI - Relative contribution of antiproliferative and host immunity-associated activity of mouse interferon in murine tumor therapy. AB - Administration of mouse interferon (IFN; 0.5 to 1 X 10(7) reference units/mg protein) inhibited the growth of Meth A and Meth 1 fibrosarcomas, but to a lesser extent, if at all, the growth of Colon 26 adenocarcinoma in BALB/c mice. The in vitro IFN sensitivity of these three tumors was not consistent with the in vivo therapeutic response in mice bearing these tumors under the present experimental conditions; Colon 26, the most sensitive of the three tumors in the in vitro antiproliferation test, did not respond or responded most poorly to IFN therapy; furthermore, Meth A and Meth 1 tumors responded similarly well to IFN therapy, although there was about a 100-fold difference in their in vitro IFN sensitivity. These results as well as the kinetic analysis of IFN concentrations of the serum of Meth A- or Colon 26-bearing mice did not indicate that the antiproliferative activity of IFN was solely responsible for its in vivo therapeutic effect. In contrast, abrogation of T-cell immunity by alpha mouse thymocyte globulin completely nullified the IFN-dependent therapeutic effect in Meth A-bearing mice. Furthermore, the IFN-dependent therapeutic response in Meth A tumors was much weaker in T-cell-defective BALB/c (nu/nu) mice than that in immunologically competent BALB/c (+/+) mice and was marginal, if present at all, confirming that T-cell immunity was involved in the IFN-dependent therapeutic effect and suggesting that the antiproliferative activity of IFN may only be responsible to a small extent for the therapeutic effect. PMID- 6498827 TI - Serial transplantation to nude mice of an androgen-dependent pilosebaceous tumor developed in Suncus murinus. AB - The pilosebaceous tumor spontaneously developed on the sidegland of an old male Suncus murinus was serially transplanted into male nude athymic (BALB/c-nu/nu) mice. By the 18th generation, tumor growth occurred in about 70% of them. The transplantability of the tumor maintained in these male mice to female or castrated male nude mice was less than 35%. The histological features of the tumor did not differ by the hormonal status of hosts. Tumor growth started later and was slower in females than in males. This androgen dependency seems to be restricted to an initial period of growth, since the transplantability to males was decreased by castration within a week after grafting. The tumors grown in males possessed both cytoplasmic and nuclear androgen receptors and those in females cytoplasmic androgen receptor only. The latter tumors were found androgen sensitive, because treatment with testosterone propionate significantly increased tumor size. In addition, after [3H]-testosterone administration, bound radioactivity was detected in the nuclear fraction from female as well as male hosts. Although the mechanism responsible for the development of these androgen independent sensitive cells is unknown, the variance in transplantability to female hosts suggests that the original tumor was composed of androgen-dependent and androgen-independent cells. PMID- 6498828 TI - Leech salivary gland extract from Haementeria officinalis, a potent inhibitor of cyclophosphamide- and radiation-induced artificial metastasis enhancement. AB - Studies were designed to determine whether salivary gland extract (SGE) from the leech Haementeria officinalis could inhibit enhancement of lung tumor colonization induced by pretreatment of mice with cyclophosphamide (CY) or local thoracic irradiation (LTI). Tumor nodules in the lung were generated by i.v. injections of T241 sarcoma and FSA fibrosarcoma cells into syngeneic C57BL/6 and C3Hf/Kam mice, respectively. CY (200 mg/kg) was given i.p. 1 or 4 days prior to i.v. injection of tumor cells. In other mice, a single dose of 1000 rads of LTI was given 1 day before tumor cells. Three i.v. or i.p. injections of SGE at doses of 600 to 800 micrograms of protein per injection given at 2-hr intervals between 2 hr before and 4 hr after CY, LTI, or tumor cell injection strongly inhibited and, in some cases, abolished the artificial metastasis enhancing effect of CY and LTI. SGE was similarly effective in inhibiting the enhancement of lung colonization when given before or after cytotoxic agents. Using [125I]iododeoxyuridine-labeled tumor cells, it was observed that SGE did not affect the initial lodgement of tumor cells in the lung, but it greatly facilitated their subsequent release from the lung. In normal mice, the SGE was active when given on the day or 1 day before but not when given 4 days before tumor cells. The antimetastatic effect of SGE was ascribed to its anti-platelet aggregating, anticoagulant, and antiproteolytic enzyme activities. PMID- 6498829 TI - Specificity, efficacy, and toxicity of radioimmunotherapy in erythroleukemic mice. AB - Radioimmunotherapy with 131I-labeled monoclonal immunoglobulins was studied using the Rauscher murine erythroleukemia. Tumor-specific monoclonal antibody, nonrelevant monoclonal antibody, F(ab')2 fragments, polyclonal gamma-globulin, and serum albumin were used as carriers of 131I. Therapeutic effects as measured by the reduction in splenomegaly were seen with all the radiolabeled proteins tested, but not with 131I-tyrosine. Dose-response curves showed that about 90% reduction in spleen size occurred at 80 muCi injected per animal, irrespective of whether specific or nonrelevant monoclonal antibody was used. Therapeutic efficacy was affected by the size of the 131I-carrier and could be correlated with half-life of carrier protein in vivo. As expected, increase in the serum concentration of circulating antigen decreased the targeting of the tumor specific monoclonal antibody and also contributed to a shorter half-life for the tumor-specific monoclonal antibody in leukemic animals compared to uninfected controls. This study showed that there was no therapeutic advantage to the use of tumor-specific monoclonal antibody over nonrelevant immunoglobulin as a carrier for 131I in the treatment of murine erythroleukemia and that, although it was extremely effective, radioimmunotherapy with 131I was not specific in this system. PMID- 6498830 TI - Inhibition of transformation of primary rat tracheal epithelial cells by retinoic acid. AB - The effect of retinoic acid (RA) on N-methyl-N'-nitro-N-nitrosoguanidine-induced transformation of primary cultures of rat tracheal epithelial cells was investigated. RA inhibited transformation of rat tracheal epithelial cells by up to 95% at concentrations of 3.3 to 33 nM which did not substantially affect cell survival. The inhibitory effect of RA on transformation was concentration dependent and was also dependent upon timing and duration of treatment. Treatment with RA for only 1 week following N-methyl-N'-nitro-N-nitrosoguanidine exposure diminished the transformation frequency by 30 to 57%, although longer treatment times were more effective. Because RA was able to inhibit transformation effectively at concentrations which were not substantially inhibitory to colony forming efficiency of rat tracheal epithelial cells, the mechanism of inhibition of cell transformation does not seem to be related to cytotoxic effects of RA known to occur at high RA concentrations. PMID- 6498831 TI - Relationship between oxidative metabolism of 2-acetylaminofluorene, debrisoquine, bufuralol, and aldrin in human liver microsomes. AB - The capacity of human liver microsomes from 28 individuals to metabolize debrisoquine and bufuralol, two drugs oxidized polymorphically in humans, as well as the carcinogen 2-acetylaminofluorene (AAF), was determined. In addition, the cytochrome P-450 content and the capacity of these microsomes to carry out the epoxidation of aldrin were measured. Interindividual differences in debrisoquine 4-hydroxylation, bufuralol 1-hydroxylation, and aldrin epoxidation were 12-, 20-, and 2.4-fold, respectively. The metabolism of debrisoquine was not correlated with cytochrome P-450 content (r = 0.26), whereas both the metabolism of bufuralol (r = 0.45; r2 = 0.20) and the epoxidation of aldrin (r = 0.72; r2 = 0.52) were correlated. Rates of debrisoquine and bufuralol metabolism were significantly correlated (r = 0.73), whereas only weak correlations existed between debrisoquine:aldrin (r = 0.49) and bufuralol:aldrin (r = 0.51). Because biphasic kinetics have been observed in human liver microsomes for the 7- and 5 hydroxylation of AAF, two concentrations of this substrate were used. The disappearance of AAF at either 0.37 or 50 microM was not correlated with debrisoquine, bufuralol, or aldrin metabolism. Similarly, at 0.37 microM AAF, no correlation existed between the formation of N-, 1-, 3-, 5-, 7-, and 9 hydroxylation products of AAF and debrisoquine, bufuralol, or aldrin metabolism. At 50 microM AAF, only the 7-hydroxylation of this substrate correlated with bufuralol metabolism (r = 0.47). This lack of, or weak correlation between pathways leading to metabolic activation (N-hydroxylation) or detoxication (C hydroxylation) of the carcinogen AAF and debrisoquine, bufuralol, and aldrin metabolism strongly suggests that different forms of cytochrome P-450 are involved in these pathways. In contrast, exceptionally high correlations (r greater than 0.94) existed between N-OH-AAF:1-OH-AAF. N-OH-AAF:7-OH-AAF, and 7-OH AAF:1-OH-AAF at the low concentration of AAF, and imply that similar forms of cytochrome P-450 produce these metabolites. However, at 50 microM AAF, these correlations are considerably weaker and explain less than 35% of the variance in the data. It is concluded, based on these multiple cross-correlations, that common cytochrome P-450 isoenzymes are involved in the formation of AAF metabolites, while the metabolism of debrisoquine, bufuralol, and aldrin is unrelated to the metabolism of this carcinogen in human liver microsomes. PMID- 6498832 TI - Formation of O6-ethylthioethyldeoxyguanosine from the reaction of chloroethyl ethyl sulfide with deoxyguanosine. AB - O6-Ethylthioethyldeoxyguanosine has been synthesized from 6-chloro-3',5'-di-O acetyldeoxyguanosine and characterized by UV, fluorescence, and mass spectrometry. High-pressure liquid chromatography studies have shown that this modified nucleoside is formed when the one-armed sulfur mustard, chloroethyl ethyl sulfide, reacts with deoxyguanosine. This result supports the hypothesis that the mutagenic effects of the sulfur mustards are caused in part by substitution of the O6-position of deoxyguanosine. PMID- 6498833 TI - Contributions of glycolysis and oxidative phosphorylation to adenosine 5' triphosphate production in AS-30D hepatoma cells. AB - The AS-30D rat hepatoma cell line is characteristic of that class of rapidly growing tumors which exhibit high rates of aerobic glucose utilization and lactic acid production (Bustamante, E., Morris, H.P., and Pedersen, P.L., J. Biol. Chem., 256: 8699-8704, 1981). In this study, we have examined the coupling properties of the mitochondria in intact AS-30D hepatoma cells and the relative contributions of cytoplasmic (glycolytic) and mitochondrial compartments to total cellular ATP production in the presence of glucose and glutamine. All respiration in AS-30D cells was inhibited by inhibitors of mitochondrial electron transport, ruling out significant rates of respiration from other cellular components. Moreover, cellular respiration was found to be coupled to phosphorylation of ADP, as demonstrated by its inhibition by oligomycin and aurovertin, inhibitors of the mitochondrial ATP synthetase (F0F1-ATPase). When intact cells were supplied with glucose as the only added energy source, it was estimated that about 60% of the total cell ATP was derived from glycolysis and 40% from oxidative phosphorylation. Addition of physiological concentrations of glutamine in the presence of glucose had little effect on the relative contributions of glycolysis and oxidative phosphorylation to total cellular ATP production. In the absence of added glucose, glutamine alone could maintain the same ATP production rates by supporting mitochondrial oxidative phosphorylation. It is concluded that, in the AS-30D hepatoma cell line, glucose is the preferred energy source, with the larger portion of ATP production being supplied by glycolytic reactions. Although oxidative substrates such as glutamine can replace glucose in maintaining total cell ATP production, they do not appear to be the major fuel sources when hepatoma AS-30D cells are exposed to concentrations of substrates which occur in vivo. PMID- 6498834 TI - Mechanism of action of arenesulfonylhydrazones of 2-pyridinecarboxaldehyde 1 oxide in L1210 cells. AB - The arenesulfonylhydrazones of 2-pyridinecarboxaldehyde 1-oxide represent a relatively new class of anticancer agents. The biochemical alterations responsible for antineoplastic activity were investigated using the most potent member of this class synthesized to date, the 3,4 dimethoxybenzenesulfonylhydrazone of 2-pyridinecarboxaldehyde 1-oxide (3,4-DSP), as the prototype compound. The primary biochemical lesion observed was the production of DNA single-strand breaks, which were analyzed using alkaline elution methodology. This production of DNA damage required the spontaneous chemical formation of a reactive species; thus, "aging" of a solution of 3,4-DSP prior to exposure of L1210 leukemia cells in culture markedly decreased the production of DNA single-strand breaks. The chemical production of an alkylating species from 3,4-DSP has been proposed to occur by the intramolecular abstraction of the nitrogen proton by the 1-oxide group, followed by release of arenesulfinic acid to form the potent alkylating species, 1-oxidopyridin-2-yldiazomethane. Replacement of the proton by a methyl group, lack of the 1-oxide group, or replacement of the aldehyde proton by a methyl group increases the chemical stability of the arenesulfonylhydrazones. These modifications have been shown in a previous publication (D .A. Shiba, J. A. May, Jr., and A. C. Sartorelli, Cancer Res., 43: 2023-2029, 1983) to lead to (a) an elimination of alkylating activity and (b) a decrease in in vitro cytotoxicity and in vivo anticancer activity. These effects are also accompanied by an inability to produce detectable DNA single-strand breaks. 3,4-DSP caused little or no inhibition of the biosyntheses of DNA, RNA, or protein, as measured by the incorporation of radiolabeled thymidine, uridine, or leucine, respectively, into acid-insoluble material; however, consistent with the production of DNA damage, 3,4-DSP inhibited the normal progression of L1210 cells through the cell cycle after a single treatment in vivo with drug (100 mg/kg). Cells were blocked in the G2-M phase of the cell cycle for 6 to 24 hr after exposure to 3,4-DSP; the cell population recovered by 48 hr after exposure and appeared to be progressing normally through the cell cycle. PMID- 6498835 TI - Effect of estradiol on nonmalignant human mammary cells in primary culture. AB - We have studied effects of estradiol on primary cultures of nonmalignant human mammary tissue collected surgically from fibroadenomas or during reduction mammoplasties. After enzymatic digestion, "organoids" made of epithelial cells organized in ductal or alveolar structure were grown in primary cultures (up to 12 days) on different substrata (glass, plastic, collagen-coated plastic, and floating collagen membranes). Transmission and scanning electron microscopy showed that these organoids were responsive to physiological concentrations of estradiol. Condensed chromatin of epithelial cells became dispersed following estrogen treatment. The plasma membrane of epithelial cells at the surface of the organoids was dramatically modified by estradiol, which increased the number and the length of the microvilli, as observed previously in the MCF7 breast cancer cell line (Vic et al., Cancer Res., 42: 667-673, 1982). This effect was not observed with the same concentrations of progesterone, dexamethasone, dihydrotestosterone, or 1 microM tamoxifen or in fibroblasts of the same tissue, demonstrating that epithelial mammary cells are specifically responsive to estradiol. By contrast, no effect of estradiol could be evidenced on the [35S]methionine-labeled proteins released into the medium by the organoids. The estrogen-regulated protein of Mr 52,000 was not found in the medium after purification by concanavalin A-sepharose or immunoprecipitation with specific antibodies to the Mr 52,000 protein from MCF7 cells. We conclude that nonmalignant mammary cells are responsive to estrogens in primary culture. PMID- 6498836 TI - Prolonged binding of a radiolabeled monoclonal antibody (B72.3) used for the in situ radioimmunodetection of human colon carcinoma xenografts. AB - Monoclonal antibody B72.3 binds to a glycoprotein complex with a molecular weight of 220,000 to 400,000. B72.3 reacts with approximately 50% of human mammary carcinomas and to 80% of the colon carcinomas tested but does not react appreciably with normal mammary tissue, with normal colon, or to a variety of normal adult human tissues tested using immunohistochemical techniques. B72.3 immunoglobulin G was purified and radiolabeled with 125I without significant loss in its reactivity to tumor extracts. The radiolabeled B72.3 immunoglobulin G was shown to efficiently localize human colon carcinoma xenografts in athymic mice. Tumor:tissue ratios of the localized antibody rose over the 7-day period studied, with tumor:liver, tumor:spleen, or tumor:kidney ratios of approximately 18:1 at Day 7 and a tumor:blood ratio of approximately 5:1 at Day 7. Tumor:muscle or tumor:brain ratios rose to over 100:1. The amount of radioactivity in the tumor increased for the first 2 days postinoculation of antibody and stayed constant over a 19-day period of study. Thus, there was no appreciable loss of radioiodine from the tumor over the study interval. No localization was seen in mice bearing a B72.3 antigen-negative human melanoma xenograft or with an isotype-identical control immunoglobulin G in mice bearing colon tumor xenografts. Gamma camera imaging with a pinhole collimator confirmed the ability of the radiolabeled antibody to detect the presence of colon carcinoma xenografts less than 0.5 cm in diameter over a 19-day period. The potential use of this system as a model for radioimmunotherapy will be discussed. PMID- 6498837 TI - Growth inhibition by retinol of a human breast carcinoma cell line in vitro and in athymic mice. AB - Although the anticarcinogenic and antiproliferative effects of vitamin A (retinol) have been extensively studied in vitro, there are few data regarding the response of human tumor cells to this agent in vivo. We have studied the effects of retinol on the human breast carcinoma cell line, MDA-MB-231. Initial in vitro studies on monolayer cultures demonstrated a retinol-induced growth inhibition that was reversible as well as time and dose dependent. A similar dose dependent decrease in tumor cell growth was shown in vivo when BALB/c-nu/nu (athymic) mice were inoculated s.c. with MDA-MB-231 cells and given graded nontoxic doses of retinol intragastrically for 3 weeks. Tumor cells were also inhibited from lung colonization as "artificial" metastatic lesions when injected i.v. into athymic mice following retinol treatment. Spleen cells from these mice were assayed for natural killer cells as determined by their cytotoxic activity on 51Cr-labeled target cells. There was no change in natural killer activity with any dose of retinol. We conclude that retinol has a dose-dependent antiproliferative effect on human breast carcinoma in vivo as well as in vitro. Further, the retinol-induced tumor inhibition seen in T-cell-deficient mice does not appear to be due to enhancement of host immunity and thus may be solely a direct effect of retinol on the tumor. PMID- 6498838 TI - Differentiation-associated cellular complex formation of murine thymocytes with thymic stromal cells. AB - Properties of normal murine thymocytes forming in vitro cellular complexes with thymic epithelial-like stromal cells in the form of pseudoemperipolesis were studied. The complex-forming cells were low-buoyant-density blasts primarily localized to the subcapsular zone. After transition into small cortical lymphocytes, their capacity for complex formation was lost. The complex-forming cells were relatively resistant to cortisone acetate and low-dose (170 rads) whole-body X-irradiation. Their number increased sharply in the early stage of thymic regeneration, corresponding to an increase in the percentage of large thymic lymphocytes 4 to 5 days after cortisone treatment or X-irradiation. However, after the thymus was repopulated with small lymphocytes, the percentage of complex-forming lymphocytes decreased rapidly to the normal level. A possible relationship between a step in thymic leukemogenesis and intrathymic T-cell differentiation is discussed. PMID- 6498839 TI - The aging ACI/Seg versus Copenhagen male rat as a model system for the study of prostatic carcinogenesis. AB - In untreated male ACI/Seg rats, the incidence of microscopic cancer of the ventral prostate is zero below the age of 16 months but increases to greater than 80% by 36 months of age, while the incidence of grossly manifest cancer of the ventral prostate is zero before the age of 20 months and increases to 16% by 36 months of age. In contrast, in untreated male Copenhagen rats, the incidence of microscopic prostatic cancer is only 10%, and the incidence of grossly manifest prostatic cancer is less than 1% even at 36 months of age. Analysis of the relationship between ACI/Seg host age and the incidence of microscopic versus grossly manifest prostatic cancer suggests that microscopic prostatic cancer is the result of a multistep process and that additional events are required for the progression of microscopic to grossly manifest prostatic cancer. Comparison of the serum levels of sex steroid hormones between aging male ACI/Seg and Copenhagen rats reveals substantial differences, suggesting that alterations in the serum testosterone:estrogen ratio may be one of the factors involved in prostatic carcinogenesis in the ACI/Seg rat. Chronic elevation of serum testosterone levels in these male ACI/Seg rats by means of exogenous testosterone treatment alone, however, does not induce the precocious development of microscopic prostatic cancer in young (i.e., less than 1 year of age) animals, suggesting that other factors, in addition to alterations in serum levels of testosterone, are required for prostatic carcinogenesis in the male ACI/Seg rat. PMID- 6498840 TI - Correlation of retinoic acid-enhanced sialyltransferase activity and glycosylation of specific cell surface sialoglycoproteins with growth inhibition in a murine melanoma cell system. AB - Retinoic acid inhibits the proliferation of the murine melanoma clone S91-C-2 cells, enhances the glycosylation of specific cell surface sialoglycoproteins, and stimulates sialytransferase activity. Mutant clones, selected from the S91-C 2 cells for resistance to the growth-inhibitory effect of retinoic acid, were used to explore whether cell surface modulation by retinoic acid is related to growth inhibition. Glycoprotein synthesis was assessed by analysis of [3H]glucosamine incorporation into glycoconjugates, and cell surface sialo- and galactoglycoproteins were analyzed after radiolabeling by the NaIO4:NaB3H4 and the neuraminidase plus galactose oxidase:NaB3H4 methods, respectively. The cells were solubilized and the labeled molecules were separated by polyacrylamide gel electrophoresis and identified by fluorography. Sialytransferase activity was measured in detergent-solubilized cells, using cytidine 5' -monophosphate [14C]sialic acid as a sugar donor and asialofetuin as an exogenous acceptor. The results demonstrated that retinoic acid enhanced [3H]glucosamine incorporation into a Mr 160,000 glycoprotein in the S91-C-2 cells but not in any of the resistant mutant clones, while the pattern of [35S]methionine-labeled proteins was not modified in either the sensitive or the resistant clones. Radiolabeling of a Mr 160,000 sialoglycoprotein on the surface of S91-C-2 and of several retinoic acid-sensitive subclones of S91-C-2 was augmented by retinoic acid. A considerably smaller effect was observed on the labeling of Mr 160,000 sialoglycoprotein on one of the resistant clones, and no significant effect could be detected on the other resistant mutant clones. Sialytransferase activity was increased 2- to 3-fold by retinoic acid in the S91-C-2 cells and in several sensitive subclones, but not in any of the resistant mutant clones. Tetradecanoylphorbol acetate, which inhibits the proliferation of both retinoic acid-sensitive and retinoic acid-resistant cells, failed to increase either sialyltransferase activity or cell surface labeling of sialoglycoproteins. These findings suggest that the ability of retinoic acid to stimulate sialyltransferase activity and glycosylation of cell surface glycoproteins is related to the growth inhibitory effect of this compound. PMID- 6498841 TI - Establishment and characterization of human colorectal cancer cell lines. AB - A protocol for establishment of human colorectal carcinoma cell lines from fresh surgically removed tissues is described. Twelve human colorectal carcinoma cell lines were established from 6 of 18 primary cancers and four of four metastases. Cell lines from concurrent primary tumors and metastases were established from two individual patients. Two primary cancers gave rise to multiple cell lines with differing biological characteristics. Factors contributing to our success appear to be differential selection on the basis of substrate adherence and the timing of passage. The protocol avoids the use of feeder layers or passage through athymic mice. The established cell lines exhibit a range of karyotypes, morphologies, and growth characteristics. PMID- 6498842 TI - Carcinoembryonic antigen-induced release of a suppressor factor from normal human lymphocytes in vitro. AB - Although it is generally accepted that tumor-bearing patients may be immunosuppressed, the mechanism for this effect is unclear. Therefore, we tested the hypothesis that a tumor-associated macromolecule, carcinoembryonic antigen (CEA), could itself suppress lymphocyte function, as quantitated by uptake of [3H]thymidine by lymphocytes stimulated with the plant lectin, phytohemagglutinin. Normal human peripheral blood mononuclear cells, after exposure to CEA for 48 hr, subsequently released a factor in vitro which markedly inhibited phytohemagglutinin-stimulated lymphocytes. In further experiments, this factor release was confirmed to be initiated by CEA and not by a contaminant, and to be induced over a broad range of CEA concentrations (0.2 to 100 ng/ml). Suppression could not be accounted for by factor-associated cytotoxicity toward indicator cells, nor was it secondary to a mixed-lymphocyte reaction, nor could CEA alone (without factor) modulate proliferation. In studies to characterize the factor, its molecular weight was greater than 10,000, its activity was partially denatured by heat and proteases, and the isoelectric point was 3.4. Polyacrylamide gel electrophoresis of an "active" fraction revealed protein bands with molecular weights of 52,000, 77,000, and 171,000. Knowledge of immunomodulatory molecules present in cancer patients may suggest new modalities for therapy. PMID- 6498843 TI - Susceptibility of healed gastric ulcers to chemical carcinogenesis in rats and implications of cellular kinetic changes. AB - The susceptibility of healed, experimental gastric ulcers to chemical carcinogenesis was investigated. Slowly healing gastric ulcers were induced by the acetic acid method in the fundic and pyloric gastric mucosae of inbred male Wistar rats. N-Methyl-N'-nitro-N-nitrosoguanidine (MNNG) was administered in drinking water at a concentration of 50 mg/liter for 360 days after ulcer induction. Twenty-eight adenomatous hyperplasias and six-adenocarcinomas developed in the pyloric mucosae of rats, including five cases of adenomatous hyperplasia which developed in the periphery of the healed ulcer. In contrast, only one adenomatous lesion was found in the regenerated mucosa of the healed pyloric ulcer. No neoplasm was observed in the healed fundic ulcer area. The results demonstrated an increased incidence of neoplasms in the peripheral area of the healed pyloric ulcer and a decreased incidence of neoplasms in the regenerated mucosa within the healed pyloric ulcer scar, although these differences were not statistically significant in comparison with the intact pyloric mucosae of the MNNG-treated rats. Histoautoradiographs of the gastric mucosae demonstrated increased labeling indices in the healed ulcer periphery of the pyloric mucosa and decreased labeling indices in the regenerated mucosa within the healed pyloric ulcer scar of MNNG-treated rats, which might be related to the differential susceptibility of the two regions to gastric carcinogenesis. Intestinal metaplasia preferentially developed near the pyloroduodenal junction in MNNG-treated rats but was not localized in control rats. In the fundic ulcer scar area, an unusual squamous cell metaplasia was observed in one rat. PMID- 6498844 TI - Intestine-like remodeling of adult mouse glandular stomach by implanting of fetal intestinal mesenchyme. AB - A morphogenetic response of adult glandular stomach grown in contact with implanted fetal intestinal mesenchyme has been demonstrated. Mesenchymal tissues from intestines of 14- to 16-day-old BALB/c mouse fetuses were introduced beneath the epithelial layer of glandular stomach in 2-month-old mice and allowed to develop. Three to 4 weeks later, remodeling of the epithelial architecture had occurred; the characteristic glandular pit structure of normal stomach had been replaced by immature villi and crypts composed of mucus-secreting columnar cells more characteristic of intestinal tissues. Chief and parietal cells had disappeared, but neither goblet nor Paneth cells were observed. Such intestine like morphogenesis was not induced by similarly implanted mesenchymal controls from fetal glandular stomach, forestomach, and salivary gland. A possible role of the mesenchymal stroma in the pathogenesis of intestinal metaplasia in stomach is discussed. PMID- 6498845 TI - Heterogeneity in induced heat resistance and its relation to synthesis of stress proteins in rat tumor cell clones. AB - Tumor cell clones isolated from a rat 13762NF mammary adenocarcinoma and its spontaneous metastases were heterogeneous in their survival responses to continuous 42 degrees heating. Clones MTLn3 and MTF7 had similar initial survival responses; they were significantly less sensitive than clone MTC. Following the first decrease in survival, different magnitudes of induced thermal resistance were observed. When ratios of the first and resistant slopes of survival curves were compared (the thermotolerance ratio), the order of induced thermal resistance was MTLn3 greater than MTF7 greater than MTC. These clones were compared for the rates of synthesis of heat stress proteins (HSP). The same four major HSP at Mr 112,000, 90,000, 70,000, and 22,000 were induced or enhanced in all 3 clones. The rates of synthesis of these HSP were analyzed through a unique system of computer-assisted video densitometry and digitization. When all 4 HSP were analyzed as a group, the rates were significantly different (p less than 0.017), and the rank order of rates of synthesis was significant with MTLn3 greater than MTF7 greater than MTC. Induction kinetics of the individual HSP were different. Individually, the HSP at Mr 112,000, 90,000, and 22,000 were synthesized at significantly different rates between clones (p less than 0.001) but the Mr 70,000 HSP was not. Absolute total protein synthesis was highest for clone MTLn3, and MTF7 was higher than MTC but only marginally. Although absolute accumulations of these HSP could not be directly compared between these clones, the higher rates of HSP synthesis in these tumor cell clones correlated with more thermal resistance. These data support the working hypothesis that one or more of these HSP have a direct role in the mechanism(s) for inducing thermal resistance in rat tumor cells, but other factors such as total protein synthesis could modify the complex bio-chemical and phenotypic pathways involved in induced HSP and thermal resistance. PMID- 6498846 TI - A diagnostic-prognostic test for bladder cancer using a monoclonal antibody-based enzyme-linked immunoassay for detection of urinary fibrin(ogen) degradation products. AB - An enzyme-linked immunosorbent assay (ELISA) using a monoclonal antibody was developed to determine the clinical value of urinary fibrinogen/fibrin degradation product levels for the identification and management of patients with bladder cancer. Assays were performed on 286 serial urine specimens from 56 bladder carcinoma patients. Specimens were grouped according to whether the patient had an evident tumor at the time of specimen collection (134 specimens, 41 patients) or was clinically disease-free following treatment (152 specimens, 38 patients). Many patients contributed specimens to both groups as determined by their clinical status at the time of collection. In addition, 45 specimens from 33 patients with inflammation of the urogenital tract and 81 specimens from 19 patients with renal or prostatic cancer were assayed for urinary fibrin degradation products. The ELISA, using a high-sensitivity procedure, identified 83% of the specimens from bladder cancer-positive patients with an overall accuracy with all specimens of 78% and a false-negative rate of 5% for all specimens tested. The high-sensitivity ELISA appeared most appropriate for monitoring bladder cancer patients for recurrence of tumor after surgery. The ELISA using a high-specificity procedure appeared most appropriate for screening. The high-specificity ELISA accurately identified 96% of urine specimens from non bladder cancer patients with a false-positive rate of only 5%. These results demonstrate that the ELISA is an efficient, reliable, quantitative, and noninvasive immunoassay that can be useful both for the identification of bladder cancer patients and for monitoring the course of the disease. PMID- 6498847 TI - Increased androgenic activity and breast cancer risk in premenopausal women. AB - Blood and urine specimens from 27 premenopausal breast cancer patients and 62 healthy controls have been compared with respect to concentration of testosterone and progesterone in blood and of testosterone and androstanediol in urine, measured in the luteal phase of the menstrual cycle. There was a strong positive association between the concentration of the two androgens, either in blood or urine, and breast cancer risk. A strong association was also observed with decreasing levels of progesterone. The association was statistically significant (p for trend less than 0.01) for each hormone; the rate ratios were 10.2 for serum testosterone (highest category), 5.6 for serum progesterone (lowest category), 8.4 for urinary testosterone (highest category), and 5.2 for androstanediol (highest category). The rate ratio for women presenting both high serum testosterone and low progesterone was 21.8 (4.1 to 116.1). Considering the exposure to at least one of three androgens at the highest level and low progesterone, the rate ratio was as high as 90.2 (8.2 to 989.7). This study provides evidence for the hypothesis that increased androgenic activity is an important risk indicator for breast cancer, particularly when associated with anovulation, as indicated by low serum progesterone level. PMID- 6498848 TI - Antitumor activity of macrophages in lung cancer patients with special reference to location of macrophages. AB - Antitumor activity of macrophages from the peripheral blood, pleural cavity, and alveoli of 35 patients with primary lung cancer was examined. Cytostatic activities of peripheral blood monocytes and alveolar macrophages from either tumor-bearing or non-tumor-bearing segments declined in association with metastasis to regional lymph nodes, an increase in tumor size, and the development of pleural invasion. However, no such correlation could be observed between the cytostatic activity of pleural cavity macrophages and the degree of pleural invasion. The cytostatic activity of pleural cavity macrophages was found to be suppressed when the pleural invasion extended beyond the visceral pleura to the neighboring lobe or chest wall. On the other hand, the cytostatic activity of pleural cavity macrophages was markedly augmented when pleural invasion was limited to within the visceral pleura, although it was low in patients with no visceral pleural invasion. These results suggest that the pleural cavity is isolated from sites of systemic immunological response and that systemic immunological response does not strongly affect pleural cavity macrophages. PMID- 6498849 TI - Detection of ganglioside GD2 in tumor tissues and sera of neuroblastoma patients. AB - A murine monoclonal antibody (monoclonal antibody 126) produced against cultured human neuroblastoma cells (LAN-1) was found to be specifically directed to a disialoganglioside (GD2) antigen preferentially expressed on both cell lines and tissues derived from melanoma and neuroblastoma. In enzyme-linked immunosorbent assays, monoclonal antibody 126 failed to react with leukemic and lymphoblastoid cells as well as with a variety of carcinoma and sarcoma cell lines. Immunohistological analysis by the immunoperoxidase technique revealed strong reactivity of monoclonal antibody 126 with frozen and formaldehyde-fixed neuroblastoma and melanoma tissues. Tissues from patients with glioma or with small cell cancer of the lung showed faint staining, whereas those from individuals with sarcoma, lymphoma, and a variety of other neoplasms proved to be negative. Sera of neuroblastoma patients showed significantly elevated GD2 levels compared to normal children (p less than 0.001) and children with other tumors (p less than 0.001) as determined by a quantitative competitive enzyme-linked immunosorbent assay. Furthermore, the GD2 serum level of one neuroblastoma patient, when followed serially, was found to correlate with progression of disease, suggesting the potential usefulness of this assay for the diagnosis and monitoring of neuroblastoma. PMID- 6498850 TI - Phase I and pharmacokinetic studies of high-dose uridine intended for rescue from 5-fluorouracil toxicity. AB - The clinical effects and pharmacokinetics of high-dose uridine were determined in seven patients with advanced-stage cancer and in one healthy volunteer. Uridine was also examined for its effect on 5-fluorouracil toxicity in two patients. Uridine was administered as a 1-hr i.v. infusion at doses of 1 to 12 g/sq m. Plasma and urine samples were analyzed for uridine and uracil using high-pressure liquid chromatography. In 23 courses of uridine alone, the only toxicity observed was transient shivering after one of two courses at 12 g/sq m. This side effect was also seen after administration of uridine (10 g/sq m) during combination with 5-fluorouracil. The pretreatment plasma uridine concentration was elevated from low micromolar to millimolar levels with uridine administration at doses up to 12 g/sq m. Maximal areas under the concentration-time curve were about 5 mmol/liter/hr. Both peak plasma level and area under the curve for uridine increased linearly with dose. Uridine plasma decay curves were biphasic with a terminal half-life of 118 min. Half-life, volume of distribution (634 ml/kg), and total clearance (4.98 ml/kg/min) appeared to be independent of dose. Plasma uracil concentration increased gradually after administration of uridine to plateau levels. Maximal plasma uracil concentrations were about one-tenth that of peak uridine concentrations. The plasma uracil level declined with a half-life of about 40 min after uridine levels decreased to 300 microM. Total urinary excretion of uridine was 24% of the dose, while the amount of uracil recovered in urine was 3.4%. In two patients, uridine rescue was attempted during 5 fluorouracil dose escalation. Uridine at 5 to 6 g/sq m given on 1 or on 2 days after 5-fluorouracil did not prevent myelosuppression and gastrointestinal toxicity associated with increasing plasma concentrations of 5-fluorouracil. These data show that uridine administered as a 1-hr infusion at doses which provide peak plasma uridine concentrations in the millimolar range is well tolerated. Rapid elimination of uridine primarily due to catabolism results in modest exposure to substantially elevated plasma uridine concentrations. Preliminary findings suggest that prolonged treatment with uridine may be required to test its potential to rescue patients from 5-fluorouracil toxicity. PMID- 6498851 TI - American cancer society Phase I trial of naturally produced beta-interferon. AB - Naturally produced beta-interferon was evaluated following i.m. and i.v. administration to 18 patients with advanced cancer. Fever (mean +/- S.E. = 38.1 degrees +/- 1.7 degrees), enhancement of natural killer cell cytotoxicity, and depression of the white blood cell count occurred following a single i.m. injection in the absence of detectable serum antiviral activity. Fever, rigors, and fatigue were dose-limiting toxicities following daily i.v. administration of 10 million units. Tachyphylaxis, as reported following repetitive administration of alpha-interferons, did not occur. Side effects, depression of the white blood cell count, and enhancement of natural killer cell cytotoxicity were similar when beta-interferon was administered daily as a 10-min bolus or as a 6-hr infusion. However, while natural killer cell cytotoxicity increased progressively over 10 days of bolus injections, it was maximal after the initial 6-hr infusion of beta interferon. Administration of 10 million units of beta-interferon divided equally between a 10-min bolus injection and a 3-hr infusion was well tolerated and resulted in high initial peak and lower sustained serum interferon levels. Based on pharmacokinetic criteria, this schedule of administration can be recommended for further study in Phase II trials. However, in light of the biological activity of beta-interferon following i.m. administration, the level of beta interferon in the serum may have limited value as a predictor of antitumor response, toxicity, or biological response modification. PMID- 6498852 TI - Commentary on "clinical predictivity of transplantable tumor systems in the selection of new drugs for solid tumors: rationale for a three-stage strategy. PMID- 6498853 TI - Sensitive radioimmunoassay for cytarabine and uracil arabinoside in plasma. AB - A sensitive and specific radioimmunoassay for cytarabine (ara-C) or uracil arabinoside (ara-U) was established by using [3H]ara-C and anti-ara-C antiserum or [3H]ara-U and anti-ara-U antiserum. The antiserum was prepared by immunizing rabbits with ara-C or ara-U hapten conjugated to human albumin. In the present assay, as low as 2.5 ng/ml (0.01 microM) of ara-C or 5 ng/ml (0.02 microM) of ara U in blood plasma samples could be detected. The cross-reaction of ara-C or ara-U structurally related compounds with each antiserum was so small that the nucleosides could be determined without any purification procedure. The plasma concentration of ara-C and ara-U in mice following oral administration of an antileukemic agent, cytosine arabinoside-5'-stearylphosphate (C18PCA) (100 mg/kg), or ara-C (48 mg/kg) was determined by using this method. In the case of C18PCA administration, ara-C was detectable in blood for at least 24 hours longer than in the case of ara-C administration. This method is suitable for the analysis of ara-C and ara-U, the metabolites of depot drugs of ara-C such as C18PCA. PMID- 6498855 TI - Phase II trial of vinzolidine, an oral vinca alkaloid, in Hodgkin's disease and non-Hodgkin's lymphoma. AB - Vinzolidine, a semisynthetic vinblastine derivative, was tested in an oral formulation in 21 heavily pretreated patients with lymphoma. Partial remissions were seen in four patients with Hodgkin's disease (50%) and in one patient with non-Hodgkin's lymphoma (8%). Significant side effects included neurotoxicity and dose-related myelosuppression. Vinzolidine is an active vinca alkaloid which merits further evaluation in patients with lymphoma, particularly Hodgkin's disease. PMID- 6498854 TI - Evaluation of a sequential 5-FU and hydroxyurea combination in advanced bowel cancer. AB - Twenty-nine patients (two with small bowel cancer and 27 with colorectal cancer) were treated with a sequential 5-FU-hydroxyurea combination following the suggestion of schedule-dependent synergism in experimental systems. No enhanced toxicity was observed, but the response rate was only 4%. Seven additional patients manifested greater than or equal to 50% declines in CEA, but caution must be used in interpreting such changes as antitumor activity. PMID- 6498856 TI - Continuous-infusion vinblastine for treatment of refractory epithelial carcinoma of the ovary: a phase II trial. PMID- 6498857 TI - Hypercalcemic flare with megestrol acetate. PMID- 6498858 TI - alpha-/beta-Triglycidyl-urazol (TGU, NSC 332488, I.N.N.: ANAXIRONE): a new chemotherapeutic agent. AB - Triglycidyl-urazol (TGU) was a rational drug development from the original triepoxide triglycidyl-triazinetrione (TGT). It was selected for further studies because of its superior physico-chemical properties as well as its improved therapeutic range in animals. Like the parent compound, TGU exerts antitumour activity in a wide spectrum of experimental tumours, including those resistant to cyclophosphamide. Its biochemical reactivity is very high, a fact which may contribute to its rapid plasma clearance after parenteral administration. Bone marrow suppression constitutes the dose-limiting toxicity in animals and man with a vague suggestion of cumulative effects. Other toxicities are generally mild and rapidly reversible. The new chemical structure, its reproducible experimental antitumour activity combined with an acceptable and manageable toxicology warranted the introduction of the compound into the clinic. Phase I studies in patients have largely confirmed the predicted toxicities and probable antitumour activity in man (7, 12, 13). Consequently, clinical phase II studies in various tumour types are now under way. PMID- 6498859 TI - Fourier-transform infrared, vibrational circular dichroism of sugars. A spectra structure correlation. PMID- 6498860 TI - The enterobacterial common-antigen, a cyclic polysaccharide. AB - Structural studies of the enterobacterial common-antigen, using chemical methods and fast-atom-bombardment mass spectrometry, indicate that it is a cyclic polysaccharide, composed of four, five, and, to a smaller extent, six trisaccharide repeating-units. In the structure of the antigen, given below, D Fuc4NAc stands for 4-acetamido-4,6-dideoxy-D-galactose. PMID- 6498861 TI - Non-destructive determination of the monosaccharide composition and the structure of the O-specific polysaccharide of Pseudomonas cepacia. PMID- 6498862 TI - Subselective diagnostic and interventional arteriography using a simple coaxial catheter system. AB - A simple, commercially available 6.5-3.0 French coaxial catheter system was used to obtain the subselective catheter position for diagnostic or interventional (drug infusions, embolizations) angiography. The system was employed 81 times in 75 patients without complication. We describe the catheter system, techniques for its use, and its clinical applications. PMID- 6498863 TI - Fogarty catheter complication treated with angiographic techniques: new use for balloon occlusion catheter. AB - Fogarty catheter embolectomy is occasionally associated with complications, including intimal dissection and thrombosis. We report a case of this complication in the iliac artery treated angiographically by thrombectomy with a balloon occlusion catheter. PMID- 6498864 TI - Percutaneous closure of a Blalock-Taussig shunt. AB - The technique used in the percutaneous closure of a Blalock-Taussig shunt in a 4 year-old child is described. After selective catheterization of the subclavian artery leading to the shunt, a spring coil was inserted which completely occluded the shunt. PMID- 6498866 TI - Case report of translumbar renal angiography and embolization. AB - The translumbar approach was used for renal angiography and transcatheter embolization in a patient whose usual sites of vascular entry were not available because of arteriosclerotic occlusive vascular disease. A description is given of the reasons for embolization and the method used. PMID- 6498865 TI - Nonsurgical treatment of childhood hypertension: embolization of an intrarenal aneurysm. AB - Renal artery aneurysms are an unusual cause of renovascular hypertension in children. When present in an intrarenal location, they pose a difficult surgical problem and transcatheter embolization may represent an effective alternative treatment. PMID- 6498867 TI - Blood supply of experimental liver tumors after intraarterial embolization with gelfoam powder and absolute ethanol. AB - Twenty rats with implanted liver tumor were studied. Following baseline angiography, the hepatic artery was embolized with Gelfoam powder or ethanol (n = 12) while the controls (n = 8) did not undergo embolization. Postmortem Microfil perfusion was performed in all livers. Filling of tumor lakes from the portal vein was seen more often in embolized animals than in controls, indicating the potential role of the portal venous system in the supply of dearterialized hepatic tumors. We discuss the possible clinical implication of our results. PMID- 6498869 TI - Unusual right umbilical vein collateral in portal hypertension. AB - Umbilical vein collaterals frequently occur in patients with portal hypertension, with the vessels usually connected to the left portal system. An umbilical vein collateral draining the right intrahepatic portal system was found in a patient with portal hypertension. This observation has not been previously reported and probably represents persistence of the embryonic right umbilical vein. PMID- 6498868 TI - Development of collateral circulation following distal embolization of hepatic artery in pigs. AB - The distal hepatic artery was embolized with black polystyrene microspheres (diameters of 50 +/- 10 mu and 200 +/- 25 mu) in 12 pigs. The animals were reexamined from 1 h to 2 weeks after embolization via hepatic angiography and subsequent injection of Microfil, a silicone rubber compound, into the arterial and portal vascular systems of the liver. Dissection of dehydrated and cleared liver specimens under the stereomicroscope demonstrated the presence of arterial collaterals bypassing embolized vessels within 2-3 days after embolization. Collaterals were noted to develop around occlusions in arteries with inner diameters as small as 100 mu. PMID- 6498871 TI - Case report of a complication of coil placement during transvenous embolization of spermatic veins. AB - Coil embolization of an incompetent spermatic vein of a patient resulted in a complication from the use of a sidehole catheter. Alternative procedures are suggested to avoid the problem. PMID- 6498872 TI - A modified basket for percutaneous stone removals. AB - A modified stone removal basket is described. It has a torquable leading wire attached with a swivel joint to facilitate manipulation through the biliary or urinary tract and has been used to remove stones in 12 patients. PMID- 6498870 TI - Gallbladder varices: a potential collateral pathway in portal hypertension and portal vein occlusion. AB - Varices of the gallbladder were demonstrated angiographically in four patients. One patient who had had a mesocaval shunt developed gallbladder varices as a result of hepatoportal shunting. Three patients had gallbladder varices owing to collateral circulation from portal vein occlusion. PMID- 6498873 TI - Effects of static and rhythmic twitch contractions on the discharge of group III and IV muscle afferents. AB - Although both static and rhythmic twitch contractions of the hindlimb muscles of anaesthetised cats have been shown to reflexly evoke pressor responses, the increase in arterial pressure evoked by the former type of contraction has been shown to be substantially larger than that evoked by the latter. We have therefore recorded the impulse activity of single group III and IV muscle afferents, whose activation reflexly increases arterial pressure, while we both statically and rhythmically twitch-contracted the triceps surae muscles of anaesthetised cats. We found that group III afferents (n = 17) discharged significantly more impulses in response to static contraction than in response to rhythmic contraction. By contrast, group IV afferents (n = 18) fired approximately the same number of impulses in response to the two types of contraction. In addition, we found that many of the group III but only a few of the group IV afferents displayed discharge properties suggestive that these afferents were mechanoreceptors. We conclude that the discharge of group III afferents are likely to be responsible for the difference in the magnitudes of the reflex pressor responses evoked by static and rhythmic contraction. PMID- 6498874 TI - Cardiac valve orifice equation independent of valvular flow intervals: application to mitral valve area computation in mitral stenosis and comparison with the Gorlin formula and direct anatomical measurements. AB - An orifice equation is developed which relates the effective mitral valve area (A), the average mitral valve pressure gradient (dP), the cardiac output (Q) and the heart frequency (f) through considerations of momentum conservation across the mitral valve. The form of the new equation is A = (4.75 X 10(-5)Qf/dP, where A, Q, and dP are expressed in cm2, ml X min-1 and mmHg respectively. Mitral valve areas computed with the new orifice formula are found to correlate with those computed by the Gorlin formula in conditions of equilibrium associated with the resting state at a level of r = 0.95, SE = 0.15 cm2, with autopsy measurements at a level of r = 0.85, SE = 0.18 cm2 and with direct anatomical measurements of excised valves at a level of r = 0.78, SE = 0.41 cm2. The results suggest that the new formula may be considered as an independent orifice equation enjoying a similar domain of validity as the Gorlin formula. The new equation offers the possibility of deriving additional useful haemodynamic relationships when used in combination with established cardiological formulas. PMID- 6498875 TI - Creatine kinase MM isoenzyme subforms in myocardium, cardiac lymph and blood after coronary artery occlusion in dogs. AB - A time-varying pattern of creatine kinase MM (CK-MM) isoenzyme subforms has been found in the blood of patients after acute myocardial infarction, but the site of enzyme modification has not been identified. Therefore, we studied the CK-MM subform patterns in myocardium, cardiac lymph and blood of dogs after coronary artery occlusion. In five conscious dogs, serial blood samples were taken for 72 h after occlusion of the left anterior descending coronary artery. Samples of non infarcted and infarcted myocardium were taken after 72 h. In five other anaesthetised, open-chest dogs, cardiac lymph and blood samples were taken for 6 h after coronary artery occlusion. CK-MM subforms were quantitated by an isoelectric focusing method. Before coronary occlusion, 64% of the total CK activity in blood appeared as the anodal subform CK-MM 1 (pI 6.3); 20% and 9% as the cathodal subforms CK-MM 2 (pI 6.6) and CK-MM 3 (pI 6.9), respectively. However, after 2 h of coronary occlusion CK-MM 2 and CK-MM 3 were increased (38% and 17% of total activity respectively) compared with CK-MM 1. Between 4 h and 10 h, CK-MM 2 and CK-MM 3 decreased as CK-MM 1 increased restoring the control relative activities of subforms. In contrast to the subform changes in blood, CK MM 3 was the predominant subform in both non-infarcted and infarcted myocardium after 72 h of coronary occlusion and in cardiac lymph during 6 h of coronary occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498876 TI - Recovery of myocardial function following brief versus prolonged atrial pacing stress in the presence of coronary artery stenosis. AB - The ability of myocardium distal to a severe coronary artery stenosis to recover from brief (5 min) versus prolonged (30 min) atrial pacing stress was compared in this study. Eight closed chest pigs were prepared with a coronary artery stenosis (82% lumenal diameter reduction) in the left anterior descending artery and ultrasonic length sensors in left anterior descending endocardium. Extent of recovery of systolic function 5 min following a brief (5 min) period of ischaemia induced by rapid (175 to 190 min-1) atrial pacing (AP-1) was compared with that following a prolonged (30 min) period of ischaemia induced by rapid atrial pacing (AP-2). Regional myocardial blood flow (ml X min-1 X g-1) was measured at control, during, and following atrial pacing. Regional shortening (%) distal to the stenosis declined versus control at both 5 min of AP-1 (10.0 +/- 7.3 (mean +/ 1 SD) to 0.6 +/- 0.9, p less than 0.01) and 30 min of AP-2 (6.8 +/- 3.3 to 2.1, +/- 3.5, p less than 0.01). However, within 5 min of discontinuing both brief as well as prolonged pacing, regional segmental shortening (5.7 +/- 3.9 and 7.0 +/- 6.9, respectively) returned to 50 to 70% of initial control levels (10.0 +/- 7.3). Regional shortening was similar 5 min following brief and prolonged stress. Distal left anterior descending zone epicardial regional myocardial blood flow increased (p less than 0.01) versus control at AP-1 (1.05 +/- 0.24 to 1.39 +/- 0.24) and 30 min of AP-2 (0.99 +/- 0.21 to 1.40 +/- 0.23).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6498877 TI - [The subject, methods, modern concept and prognosis in the field of social medicine and the organization of health care]. PMID- 6498878 TI - [New possibilities of securing information in Czechoslovak health research and practice]. PMID- 6498879 TI - [Cybernetic model of emetine kinetics in humans]. PMID- 6498880 TI - [Budgetary stagnation, but acceleration of the program of the World Health Organization]. PMID- 6498881 TI - [Comments on pneumonology workplaces in West Germany]. PMID- 6498882 TI - [The effect of transfer factor on phagocytosis and humoral immunity in children with recurrent otitis media]. PMID- 6498883 TI - [Prenatal therapy of fetal hypotrophy using long-term glucose infusions]. PMID- 6498884 TI - [Symptomatology of esophageal diseases]. PMID- 6498885 TI - [Stenoses of the colon in the colonoscopy picture]. PMID- 6498886 TI - [An experimental model of cancer of the large intestine]. PMID- 6498887 TI - [Acute liver porphyrias. I. Clinical and biochemical findings in 45 patients (1981-1982)]. PMID- 6498888 TI - [Binding of porphyrins to intracellular proteins]. PMID- 6498889 TI - [Principles and practical guidelines for drug dosages in liver diseases. II]. PMID- 6498890 TI - [The ratio of urea nitrogen to total urinary nitrogen in liver diseases]. PMID- 6498891 TI - [Focal liver cirrhosis]. PMID- 6498892 TI - [Surgical treatment of Caroli's disease]. PMID- 6498893 TI - [Treatment of Wegener's granulomatosis]. PMID- 6498894 TI - [The physicians' movement to prevent nuclear war and the organization for signatures on the Amsterdam appeal to stop the nuclear arms race]. PMID- 6498895 TI - [The most important results of the Czech Ministry of Health research plan in 1983]. PMID- 6498897 TI - [Analgesic nephropathy. I. Incidence, etiology, pathophysiology and the pathologico-anatomic picture]. PMID- 6498896 TI - [Analgesics and age. II. Age-determined changes in the effects of mild analgesics]. PMID- 6498898 TI - [Analgesic nephropathy. II. Analgesic nephropathy and analgesic syndrome, diagnosis and treatment]. PMID- 6498899 TI - [Serious adverse reactions after inhalation provocation tests]. PMID- 6498900 TI - [Hormonal contraceptives in female rowers]. PMID- 6498901 TI - [Absorption characteristics of hemoperfusion sorbents of Czechoslovak manufacture for various drugs]. PMID- 6498902 TI - [Drugs and myasthenia gravis]. PMID- 6498903 TI - [Calcium and calciotropic substances in psychiatry]. PMID- 6498904 TI - [Use of calcium channel blockers in psychiatry. Hypothesis and the first results]. PMID- 6498905 TI - [Vasomotor activity of the penis in healthy and sexually dysfunctional men]. PMID- 6498907 TI - [On the "epidemiology" of the use of the term ""borderline states"]. PMID- 6498906 TI - [Types of vasomotor reactions in the penis]. PMID- 6498908 TI - [The palmar total ridge count in the normal population]. PMID- 6498909 TI - [Inhalation scintigraphy of the lungs using diffusible microaerosols]. PMID- 6498910 TI - [Calcitonin--analgesic effect]. PMID- 6498911 TI - [Present views on the problem of coxarthrosis]. PMID- 6498912 TI - [Coxarthrosis from the viewpoint of the rheumatologist]. PMID- 6498913 TI - [Radiography of coxarthrosis]. PMID- 6498914 TI - [Pre-arthrosis conditions of the hip joint in children]. PMID- 6498915 TI - [Conservative treatment in the therapy of coxarthrosis]. PMID- 6498916 TI - [Surgical treatment of arthrosis of the hip joint]. PMID- 6498917 TI - [The total endoprosthesis in the treatment of arthrosis of the hip joint]. PMID- 6498918 TI - [Acquired immunodeficiency syndrome]. PMID- 6498919 TI - [Immunology of systemic connective tissue diseases]. PMID- 6498920 TI - [Role of the immune process in the pathogenesis of interstitial nephritis]. PMID- 6498921 TI - [The significance of age factors for the incidence of monoclonal immunoglobulins in a group of hospitalized patients]. PMID- 6498922 TI - [Multicystic peritoneal mesothelioma]. PMID- 6498923 TI - Role of schistosomiasis in the pathogenesis of glomerular disease in Zimbabweans. PMID- 6498924 TI - Bone marrow rehydration in a busy district hospital paediatric ward. PMID- 6498925 TI - Compliance with anti-tuberculous chemotherapy in Harare City. PMID- 6498926 TI - Tick borne relapsing fever in Tanzanian children. PMID- 6498927 TI - Active cutaneous myiasis: a case report. PMID- 6498928 TI - The ectopic eczema story. PMID- 6498929 TI - Facial temperature in migraine, tension-vascular and tension headache. AB - The relationship between clinical features and changes in the extracranial circulation was studied during 209 separate attacks of headache affecting the anterior part of the head. Extracranial vascular changes were assessed thermographically and by the change in headache intensity when pressure was applied over the superficial temporal and common carotid arteries. In unilateral headaches, increased heat loss from the affected frontotemporal region was observed most frequently in attacks which were temporarily relieved by compression of the superficial temporal artery; thermographic asymmetry disappeared as the headache abated. Although such headaches were associated more frequently with migrainous features than attacks which did not respond to arterial compression, many headaches with clinical features of migraine had no vascular component detectable by thermography or vascular compression. Furthermore, the response to arterial compression was not consistent from one headache to another in the same patient. It was concluded that extracranial vascular changes recur intermittently in headache-prone patients, depending on the severity of pain and association with other features commonly regarded as migrainous. However, there was no clear demarcation point between entities diagnosed clinically as "migraine" and "tension headache". PMID- 6498930 TI - Vascular compression of the C2 and C3 roots--yet another cause of chronic intermittent hemicrania? AB - Two male patients had a history of right-sided headache attacks occurring daily and spreading from the occipital to the frontal region. The attacks were accompanied by ciliary injections on the symptomatic side, increased lacrimation and, in one case, by rhinorrhea. The pain was relieved with vasoconstricting preparations (ergotamine) and provoked with vasodilating medications (nitroglycerine). A selective conduction anaesthesia of the C2 nerve root in one case and of the C2 and C3 roots in the other, temporarily relieved the pain. At operation, vessels were found which compressed these roots. Since decompression of the nerve roots, 3 years and 1 year ago respectively, the patients have remained free of pain. PMID- 6498931 TI - The prevalence of diet-induced migraine. AB - Nineteen percent of about 490 patients with classical or common migraine reported that headaches can be precipitated by chocolate, 18% by cheese and 11% by citrus fruit, and a highly significant majority of these patients were sensitive to all three foods. Twenty-nine percent of the patients reported sensitivity to alcohol; again this was significantly associated with sensitivity to the three food stuffs, though a substantial number of patients were sensitive to alcohol but not foods. Thirty-one percent of 331 female patients believed that oral contraceptives precipitated headaches, but this could not be related to any dietary response. Patients with affected relatives were significantly more likely to report sensitivity to alcohol and chocolate; sensitivity to cheese and citrus fruit was less strongly related, and there was no relationship at all for oral contraceptives. These correlations suggest that food induced headaches are mediated by chemical constituents common to these foods. PMID- 6498932 TI - Cluster headache-like pain caused by an upper cervical meningioma. AB - A 68-year-old man with chronic lung disease suffered from cluster headache (CH) like pain associated with an upper cervical meningioma extending to compress the lower brain stem. The pain disappeared after tumour excision. We suggest that compression of the brain stem and hypoxemia associated with chronic lung disease might have caused the attacks, especially in the early morning when REM sleep hypoxia was prevalent. PMID- 6498933 TI - Chronic paroxysmal hemicrania: lack of pre-chronic stage. AB - Two cases of chronic paroxysmal hemicrania are presented, both with atypical late onset of illness and lack of pre-CPH stage. In one patient the pain attacks were unusually short, and no associated symptoms during the pain attack were observed. However, the positive reaction to indomethacin substantiates the diagnosis of CPH. PMID- 6498934 TI - Intracranial arteriovenous malformation and migraine. AB - To define more closely the clinical relationship between migraine and intracranial arteriovenous malformation (iAVM), the clinical features of 57 reported instances and of 7 personal cases were analysed. Migraine attacks symptomatic of AVM include: late onset, frequent absence of (familial) migraine history, diminution or even inversion of the usual sex-ratio in migraine, brevity of attacks, disruption of the usual sequence of attack symptoms and, finally, unusual or permanent neurologic deficit. An attempt has also been made to clarify the epidemiological relationship. The reported frequency of migraine in cases of AVM, and AVM in cases of migraine is reflected against an inquiry into the number of annually diagnosed cases of AVM in 20 Dutch neurological/neurosurgical centres, covering 12.10(6) inhabitants in 8 of the 11 provinces. The annual incidence of migraine is estimated at 1:3,500 population, that of diagnosed iAVM is 120, i.e. 1:100,000. Coincidental occurrence of the two conditions works out at 1:4 X 10(8) per year. The presented case series of 7 seen in 2 of the 20 centres strongly militates against such a chance hypothesis. PMID- 6498935 TI - Cluster headache and attack-related sweating. PMID- 6498936 TI - Analysis of transferrin recycling in mitotic and interphase HeLa cells by quantitative fluorescence microscopy. AB - Recent findings suggest that membrane vesicle transport during mitosis may be generally inhibited. To test this, we examined the kinetics of uptake and exocytosis of RITC-transferrin in mitotic and interphase HeLa cells. We used quantitative image-intensification fluorescence microscopy to analyze the content of ligands in single cells. This technique was validated by comparison of 3H or RITC-transferrin release from interphase cells determined by microscopy or radiometry. Both methods gave a t1/2 of release of 5-6 min. The uptake of RITC transferrin was depressed in mitotics. More importantly, we monitored the exocytosis of label during mitosis. Labeled mitotics were obtained by the progression of interphase cells into mitosis during a 50 min incubation with RITC transferrin. After 30 min chase with unlabeled transferrin, the intensities of interphase cells approached background, whereas those of mitotic cells remained nearly constant. Thus both exocytosis and endocytosis of transferrin were exocytosis and endocytosis of transferrin were blocked during mitosis. PMID- 6498937 TI - Translocation across Golgi vesicle membranes: a CHO glycosylation mutant deficient in CMP-sialic acid transport. AB - Golgi vesicle membranes from the Lec2 CHO glycosylation mutant translocate CMP sialic acid at only 2% the rate of vesicles from wild-type CHO cells. The deficiency is specific, because vesicles from Lec2 cells can translocate UDP-N acetylglucosamine, adenosine 3'-phosphate 5'-phosphosulfate, and UDP-galactose at rates comparable to those of vesicles from wild-type cells. Complementation analyses show that Lec2 mutants belong to the same genetic complementation group as clone 1021, a CHO mutant of similar phenotype. Both mutants have previously been shown to have a 90% reduction in the sialylation of glycoproteins and gangliosides compared with wild-type cells. However, 1021 cells appear to have normal levels of CMP-sialic acid, sialyltransferase activity, and endogenous acceptors for sialylation. It seems likely that the primary defect in Lec2 and 1021 cells is their inability to translocate CMP-sialic acid across Golgi vesicle membranes. PMID- 6498938 TI - Fibroblast lines expressing activated c-myc oncogenes are tumorigenic in nude mice and syngeneic animals. AB - The influence of c-myc expression on fibroblast growth and morphology was investigated by transfection of c-myc genes linked to viral promoters. No foci were observed after transfection of either NIH/3T3 or Rat 2 cells. Cell lines containing activated c-myc genes were established using SV2-neo coselection and several growth parameters of the cells were studied. The cells showed a slight increase in refractility and formed colonies in soft agar with an efficiency of only 1%-2%. The c-myc-transfected cells grew well in 0.5% serum while the controls did not. The major difference in cell growth noted was that c-myc transfected cells were tumorigenic when inoculated into nude mice or syngeneic rats. Analysis of RNA from the tumorigenic cells showed a level of c-myc expression from the transfected genes that was 2 to 6 fold higher than that from the endogenous gene. The level of c-myc RNA in the fibroblast tumors was similar to that found in mouse plasmacytomas. Expression of the endogenous c-myc gene was unaffected by the transfected genes for subconfluent cells in culture, but the gene was shut off in the nude mouse tumors. These results demonstrate that constitutive c-myc expression leads to tumorigenicity in immortalized cell lines. PMID- 6498940 TI - Cytotic vesicles in myelinated nerve fibres in the human dental pulp, as demonstrated by freeze-fracturing. PMID- 6498939 TI - Reconstitution of the transport of protein between successive compartments of the Golgi measured by the coupled incorporation of N-acetylglucosamine. AB - Transport of the VSV-encoded glycoprotein (G protein) between successive compartments of the Golgi has been reconstituted in a cell-free system and is measured, in a rapid and sensitive new assay, by the coupled incorporation of 3H N-acetylglucosamine (GlcNAc). This glycosylation occurs when G protein is transported during mixed incubations from the "donor" compartment in Golgi from VSV-infected CHO clone 15B cells (missing a key Golgi GlcNAc transferase) to the next, successive "acceptor" compartment (containing the GlcNAc transferase) in Golgi from wild-type CHO cells. Golgi fractions used in this assay have been extensively purified, and account for all of the donor and acceptor activity in the cells. Together with several other lines of evidence, this indicates that the cell-free system is highly specific, measuring only transport between sequential compartments in the Golgi stack. Transport in vitro is almost as efficient as in the cell, and requires ATP and the cytosol fraction in addition to protein components on the cytoplasmic surface of the Golgi membranes. PMID- 6498941 TI - Diamide reversibly induces a stress response in the sea urchin, Arbacia punctulata. AB - Sea urchin blastulae were treated with two concentrations (0.54 and 0.72 mM) of diamide, a sulfhydryl oxidant, after hatching. These treatments increased the relative synthesis of one set of embryonic proteins while decreasing that of another. This was demonstrated by quantitating the incorporation of [35S]methionine into polypeptides separated by 2-dimensional polyacrylamide gel electrophoresis (2D PAGE). These shifts were dose dependent and apparently reversible after the embryos had regenerated reduced sulfhydryls. Those proteins showing increased incorporation migrated at the same position by 2D PAGE as heat shock proteins, suggesting that diamide was inducing a stress response. Diamide also caused some developmental aberrations at low frequency, and reversibly inhibited ciliary beating. PMID- 6498942 TI - Phase-dependent polymerization and depolymerization of actin in Physarum polycephalum nuclei. AB - G- and F-actin contents in physarum polycephalum nuclei isolated during the progress of cell cycle were estimated and compared both by the inhibiting activity of deoxyribonuclease I (DNase I) and by the fractionation on DEAE Toyopearl column chromatography. The inhibition of DNase appeared maximal in late S phase or early G2 phase and decreased to a minimal value in late G2 phase or M phase, while total actin content in a nucleus, which was analyzed by SDS polyacrylamide gel electrophoresis as well as by DNase inhibition assay in the presence of 0.75 M guanidine-HCl, did not show such phase-dependent dynamics through the cell cycle. PMID- 6498943 TI - Different aggregation properties of sea urchin embryonic cells at different developmental stages. I. Stage specificity of aggregation factors solubilized by butanol. AB - Surface proteins solubilized with butanol from purified plasma membranes of sea urchin embryos at different developmental stages were tested for their aggregation promoting activity on dissociated cells. Cells used for the assays were obtained either from blastulae or from embryos at the 16 cell stage. Results show that a strong enhancement of cell aggregation was produced only when extracted proteins and dissociated cells were obtained from embryos at the same developmental stage. PMID- 6498944 TI - Different aggregation properties of sea urchin embryonic cells at different developmental stages. II. Stage specific response to fibronectin and collagen. AB - Fibronectin and collagen were added to cells dissociated from embryos at the blastula and at the 16 cell stages. Both molecules stimulate aggregation of cells dissociated from blastula but they do not affect aggregation of blastomeres dissociated from the 16 cell stage. The stage-specific response to fibronectin and collagen appears to be related to the onset of new functional role(s) of the two molecules at the blastula stage. PMID- 6498945 TI - Cytidine deaminase levels in cultured mammalian cell lines measured by the growth tests and enzyme assays. AB - We developed a test medium for cytidine deaminase in order to examine the distribution of this enzyme in cultured cell lines. The growth of various mammalian cell lines was tested in culture medium containing 2 microM pyrazofurin and 100 microM cytidine. Enzymological assays for the enzyme also were made spectrophotometrically with cell extracts. A good correlation was found between results of cell growth tests and the levels of enzyme activity. Twelve of twenty cell lines were killed in the test medium, but the remaining lines showed good growth. The levels of enzyme activities were lower in the former lines than in the latter. The critical level of enzyme activity required to support cell growth was approximately 30 units per mg protein. These findings indicate that culture medium containing 2 microM pyrazofurin and 100 microM cytidine serves as a test medium for cytidine deaminase. The possibility that the cytidine deaminase may be useful in determining the embryonic origin of cultured cell lines is discussed, based on the growth properties of various cultured cell lines in the test medium. PMID- 6498946 TI - ATP- and calcium-controlled contraction in a saponin model of Physarum polycephalum. AB - Saponin models of the plasmodial strand of Physarum polycephalum were constructed to study how Ca2+ and ATP regulate the generation of tension. ATP-induced isometric tension in a saponin model increased with an increase in ATP concentration until maximum tension (0.3-1.7 mg) was reached at about 1 mM. The sensitivity of the model to ATP was heightened three to five times in a basic solution containing an ATP-regenerating system, the maximum tension (0.3-0.6 mg) being reached at 0.2 to 0.3 mM ATP. Contraction of the model also depended on the Ca2+ concentration irrespective of the presence or absence of the ATP regenerating system. The optimal pCa was 7.0, and tension decreased with a Ca2+ concentration above or below this value. These results indicate that the tension generated in the plasmodial strand of Physarum in vivo may be regulated by ATP and/or Ca2+. PMID- 6498947 TI - Reorganization of membrane cholesterol during membrane fusion in myogenesis in vitro: a study using the filipin-cholesterol complex. AB - Using filipin and freeze-fracture electron microscopy, we examined the distribution of membrane cholesterol during the fusion of myoblasts in vitro. The early stages of fusion were characterized by the depletion of cholesterol from the membrane apposition sites, at which the plasma membranes of two adjacent cells were in close contact. At first, filipin-cholesterol complexes were absent from the plasma membrane of one cell only and were distributed homogeneously on the membrane of the other cell. Eventually, both of the closely apposed membranes became almost completely free the filipin-cholesterol complexes. Membrane fusion took place at several points within the filipin-cholesterol complex-free areas. In later stages, the cytoplasms of the fusing cells became confluent by fenestration of the plasma membranes formed with the filipin-cholesterol complex free regions. Our observations suggest that membrane cholesterol is reorganized at these fusion sites and that fusion initiated by the juxtaposition of the cholesterol-free areas of each plasma membrane of the adjacent cells. PMID- 6498949 TI - Symposium on cardiac rehabilitation. PMID- 6498948 TI - Somatic hybridization between human and mouse lymphoblast cells produced by an electric pulse-induced fusion technique. AB - The technique of electric pulse-induced cell fusion (electro-fusion) was used to obtain heterokaryons between normal human lymphoblasts (HSC93) and mouse leukemic lymphoblasts (MCN151). The two types of cells were brought into contact in the cell suspension by dielectrophoresis with an alternating electric field (0.8 kV/cm, 100 kHz) in the presence of calcium ions and pronase E. Cell fusion was induced by giving two successive electric pulses (3.3 and 5 kV/cm, 10 microsec). Prior treatment of human (but not mouse) lymphoblasts with neuraminidase improved fusion efficiency. Differential staining of the two types of cells with Janus Green and Neutral Red showed that about 40% of the viable fused cells underwent heterokaryonic fusion. We concluded that electrofusion is an efficient method for obtaining heterokaryons from human and mouse lymphoblasts. PMID- 6498950 TI - Early ambulation after myocardial infarction. The in-patient exercise program. AB - At present, the care of patients with myocardial infarction, especially those with few or no complications, is characterized by an abbreviation of the period of bed rest, a decrease in the restriction of activity, earlier resumption of physical activity, and earlier discharge from the hospital for appropriately selected individuals. The physiologic basis for early ambulation is reviewed and a program for rehabilitative physical activity is outlined. PMID- 6498952 TI - [Mercurimetric determination of penicillins. I. Conditions for the titration of natural penicillins in a pyridine solvent medium and its application to drug forms]. PMID- 6498951 TI - Marathon running and immunity to coronary heart disease: fact versus fiction. AB - Marathon runners should not consider themselves immune to either sudden death or coronary heart disease. Further, physicians should not assume that marathon runners cannot have serious cardiac disease. All symptomatic marathon runners should undergo exhaustive cardiovascular evaluation. However, since some runners do not have any premorbid warning symptoms, not even these measures will prevent all cases of sudden death during marathon running. PMID- 6498953 TI - [Controversy in the definition of clearance. II. Methods of derivation and conditions of the validity of the Cl = Vd ke relationship]. PMID- 6498954 TI - [Analytical study of the metabolites of trimecaine]. PMID- 6498955 TI - [Derivatives of nortestosterone metabolites useful in the preparation of immunogens for the radioimmunologic control of doping]. PMID- 6498956 TI - [Mannich's compounds on the basis of benzothiazole as a potential anorectic]. PMID- 6498957 TI - [Biological availability and pharmacological effects of Prazosin VUFB in dogs]. PMID- 6498958 TI - [Use of stabilized human cell lines derived from hematopoietic cells as models for testing cytostatics]. PMID- 6498959 TI - [Use of radiation sterilization for medical material]. PMID- 6498960 TI - [Effectiveness of the modified intrapartum CTG James score. I. Retrospective study]. PMID- 6498961 TI - [Effectiveness of the modified intrapartum CTG James score. II. Prospective study]. PMID- 6498962 TI - [Problems of intrapartum cardiotokographic scoring systems]. PMID- 6498963 TI - [Use of urodynamic testing methods in gynecologic urology]. PMID- 6498964 TI - [The present state of obstetrical psychoprophylaxis in Prague. I. Methods of preparing the patients]. PMID- 6498965 TI - [Hemangioma of the cervix uteri]. PMID- 6498966 TI - [Nuclear magnetic resonance (NMR) and tissue imaging]. PMID- 6498967 TI - [Characteristics of the innervation of coronary vessels in relation to myocardial innervation]. PMID- 6498968 TI - [Development of the coronary arteries and their variability]. PMID- 6498969 TI - [Development of the terminal coronary bed in the ventricular myocardium]. PMID- 6498970 TI - [Functional aspects of the development of coronary circulation]. PMID- 6498971 TI - [Regulation of coronary circulation]. PMID- 6498972 TI - [Neural regulation of coronary circulation]. PMID- 6498973 TI - [The effect of changes in extracellular magnesium on the activity of the smooth muscles of vascular walls]. PMID- 6498974 TI - [Importance of the endothelium in the function of vascular walls]. PMID- 6498975 TI - [Drugs affecting coronary circulation]. PMID- 6498976 TI - [Determination of myocardial perfusion in clinical practice and in experiments on focal ischemia; evaluation of the methods used]. PMID- 6498977 TI - [Risks in chronic circulatory insufficiency of the coronary bed]. PMID- 6498978 TI - [Comparison of metabolic changes in the occlusion of anatomically different sections of the coronary bed]. PMID- 6498979 TI - [The geometry and quantitative structure of consecutive sections of the coronary bed from the viewpoint of potential coronary spasm]. PMID- 6498980 TI - [The work of smooth muscles in the afferent coronary artery in comparison with other arteries of analogous dimensions]. PMID- 6498981 TI - [Induction and elimination of coronary spasm using drugs]. PMID- 6498982 TI - [The oxygen and calcium paradox in cardiac muscle]. PMID- 6498983 TI - [Essential ocular hypertension and the initial onset of open-angle glaucoma]. PMID- 6498984 TI - [Collagen architecture of the trabecular meshwork in the human eye in glaucoma and severe myopia]. PMID- 6498985 TI - [Characteristics of the ultrastructure of connective tissue in the trabecular meshwork of the chamber angle in glaucoma]. PMID- 6498987 TI - [Contribution of computer tomography to the localization of intraocular foreign bodies. Case report]. PMID- 6498986 TI - [Lasers in the treatment of simple glaucoma]. PMID- 6498988 TI - [Surgical treatment and postoperative correction in binocular congenital cataracts]. PMID- 6498989 TI - [Surgical treatment and postoperative correction using gel contact lenses in monocular congenital cataracts]. PMID- 6498990 TI - [Treatment of traumatic cataracts in children]. PMID- 6498991 TI - [Assessment of ability to drive motor vehicles]. PMID- 6498992 TI - [Posterior scleroplasty in the treatment of severe progressive myopia]. PMID- 6498993 TI - [Plastic repair of the eyelid margin by free transfer of a transplant from the opposite eyelid]. PMID- 6498994 TI - [Possibilities of determining the physiological and pathological function of the tonsils by measuring spontaneous superweak radiation]. PMID- 6498995 TI - [Experience with the He-Ne laser in otorhinolaryngology]. PMID- 6498996 TI - [Circumstances and causative factors in injuries of the otorhinolaryngologic organs]. PMID- 6498997 TI - [Closure of the neoglottis phonatoria in deglutition]. PMID- 6498998 TI - [The importance of preoperative arteriography and ligation of the external carotid artery in tumors of the nasopharynx and in epistaxis]. PMID- 6498999 TI - [Surgical treatment of congenital choanal atresia in adults]. PMID- 6499000 TI - [Personal experience with the aspiration of foreign bodies in children]. PMID- 6499001 TI - [Electronystagmographic diagnosis of fixation nystagmus]. PMID- 6499002 TI - [Preventive significance of studying vestibular reactivity and adaptability]. PMID- 6499003 TI - [A look at the present activity of the Otolaryngology Department at the Institute for the Continuing Education of Physicians and Pharmacists in Bratislava]. PMID- 6499004 TI - [Personality in hearing loss]. PMID- 6499005 TI - [Results of measuring superweak spontaneous radiation of benign and malignant tumors in the ORL area]. PMID- 6499006 TI - [Personal experience in the treatment of malignant tumors of the nose and paranasal sinuses]. PMID- 6499007 TI - [Tumors of the nose, nasopharynx and paranasal sinuses in children]. PMID- 6499008 TI - [Osteoplastic surgery of the maxillary sinus]. PMID- 6499009 TI - [Disorders of tongue innervation in microlaryngoscopy]. PMID- 6499010 TI - [Fixation of repositioned nasal bones using a Hexcelite splint]. PMID- 6499011 TI - [Treatment of extensive hemangiomas of the pharynx using cryodestruction]. PMID- 6499013 TI - [Present status and outlook on standardization in audiology]. PMID- 6499012 TI - [Etiological diagnosis of nasal polyps]. PMID- 6499014 TI - [More detailed criteria for distinguishing lymphatic and reticular cells using electron microscopy]. AB - About 100 illustrative cases of malignant lymphoma and non-tumorous lymph node processes studied by electron microscopy were revised. Some distinguishing features were stressed as about nuclear patterns and intercellular relations of basic lymphatic elements. The centrocyte is unique in a fine chromatin pattern of the cleft nuclei and in varied superficial qualities. It tends to form junctions with dendritic cells and bilateral dense bodies remaining from severed cellular projections. The centroblast and immunoblast represent a different structural line related to plasmacytes and macrophages or epitheloid cells. The T-line tends to form characteristic junctions with interdigitating cells as well as dense invaginations of cytoplasmic membrane on the both sides of junctions. There is a limited number of similar junctions with pericytes. Dense bodies produced at the junction of lymphatic and stromal reticular cells are discussed. PMID- 6499015 TI - [Electron microscopy morphometric analysis of the effect of immobilization stress on the structure of the myocardium in rats belonging to 2 age groups]. AB - 13 month-old and 25 month-old Wistar rats were exposed to immobilisation stress and compared with a control group of animals. The most impressive influence was found in mitochondria but there were not any significant changes of myofibrils. The number of mitochondria decreased significantly as well as their relative cytoplasmic volume. Absolute mitochondrial volume increased simultaneously. Difference in age of animals resulted in greater mitochondrial sensibility to stress condition in 25 month-old rats. PMID- 6499016 TI - [Cytological detection of cervical dysplasia and neoplasia]. AB - A total of 7017 women were examined during a year in a specialized dispensary for prevention of cervical cancer and in a department of obstetrics. Diagnosis of PAP III or higher was established in 227 smears, i.e. 3,3% of cases. A correlation of positive cytology with following biopsy was performed. The influence of cervical inflammation and virus lesion on possible modification of suspect cytology was discussed. PMID- 6499017 TI - [Ultrastructural findings in intrahepatic bile ducts in primary biliary cirrhosis]. AB - A lesion of small bile ducts wall in 6 women suffering from primary biliary cirrhosis (stage II, III, IV) included unspecific and progressive epithelial changes (increase of cytoskeleton, filaments, many phagosomes, basement membrane reduplication). Besides in stage II of the disease and in one case of cirrhosis, there were dense deposits in widened basement membrane and periductal macrophages which reminded of the bile. Some biliary canaliculi were dilated in all the cases and their microvilli were partly lost or swollen. PMID- 6499018 TI - [Carcinoma of the hypophysis with acromegaly]. AB - A 38-year old man deceased after being operated on recurring pituitary adenoma removed 13 years ago. Autopsy showed a massive spread of tumour on dura and in subarachnoid space. Growth hormone producing cells were found prevailing in the primary tumour as well as in secondaries by immunohistochemistry and immunofluorescence which concurred with acromegaly. Many cells produced prolactin. The tumour spreading discontinually in subdural and subarachnoid space was taken for a carcinoma. PMID- 6499019 TI - [An aorto-esophageal fistula in a patient with malignant lymphogranuloma]. AB - A 25-year-old man suffering from lymphogranuloma malignum received mediastinal radiotherapy in a dose of 3,380 R (827 mC/1 kg). About 2,5 years later fatal gastro-intestinal haemorrhage occurred from a aortooesophageal fistula. Aortic necrosis of media and intima with G+ cocci was found, as well as adventitial fibrosis with radiation fibroblasts. Assisting mechanisms of aortic damage by therapeutic doses of radiation were discussed. PMID- 6499020 TI - [Mesothelial cyst of the spleen with squamous cell metaplasia]. AB - A cyst of the spleen covered by flat simple epithelium with parts of squamous metaplasia was found in a biopsy of a 14-year old boy. Pathology, origin, and nomenclature of this type of cyst were discussed. PMID- 6499021 TI - [Massive oxalosis of the kidney in association with anesthesia using methoxyflurane]. AB - A 20-year old foreigner suffering from progressive renal insufficiency had a massive renal oxalosis. According to case history and clinical analysis oxalosis proved to occur in relation to methoxyflurane general anaesthesia. PMID- 6499022 TI - [Epileptology. Prognostic expertise]. PMID- 6499023 TI - [Vestibular and neurologic findings induced by long-term exposure to noise and vibration]. PMID- 6499024 TI - [Correlation of CT and EEG findings in brain diseases. Study of 250 patients]. PMID- 6499025 TI - [Autosomal recessive pseudohypertonic muscular dystrophy with mental retardation. Report on 2 siblings]. PMID- 6499026 TI - [Validity of the activation method in the EEG diagnosis of epilepsy]. PMID- 6499027 TI - [Hydantoin atrophy (degeneration) of the cerebellum]. PMID- 6499028 TI - [Interhemispheric subdural hematoma. The clinical, angiographic and scintigraphic picture]. PMID- 6499029 TI - [Comments on the term polyneuritis]. PMID- 6499030 TI - [The present state of gerontopsychiatric care in Czechoslovakia]. PMID- 6499032 TI - [Interaction of knowledge structures as a noetic problem in psychiatry]. PMID- 6499031 TI - [Experience in the use of the dexamethasone suppression test in the diagnosis of depressive states]. PMID- 6499033 TI - [Laws in aggression]. PMID- 6499034 TI - [Lithium and other preventive agents of affective disorders in 1983]. PMID- 6499035 TI - [Comments on the theory of psychosis]. PMID- 6499036 TI - [Paranoid symptoms in functional disorders of the hypothalamus]. PMID- 6499037 TI - [Prognosis in the development of genetic research in mental disorders]. PMID- 6499038 TI - [Dimensions of themes and times in dialogues]. PMID- 6499039 TI - [Automobile accidents as stress situations]. PMID- 6499040 TI - [Effect of hypnosuggestion on the reception and processing of sensory information]. PMID- 6499041 TI - [Research trends in psychiatry]. PMID- 6499042 TI - [Pulmonary fluid as one of the causes of post-partum adaptation disorders]. PMID- 6499043 TI - [Nephrotic syndrome caused by glomerulonephritis in children with a positive finding of HBsAg in the serum]. PMID- 6499045 TI - [Experience in the psychological diagnosis and therapy of minimal brain dysfunction in the preschool age]. PMID- 6499044 TI - [Treatment of chronic recurrent parotitis using bacterial vaccine]. PMID- 6499046 TI - [Obesity in the preschool age]. PMID- 6499047 TI - [Immunoglobulins in the adenoid tissue of children with "spastic bronchitis"]. PMID- 6499048 TI - [Calcium-oxalate urolithiasis in children. (2. Clinical course, therapy, metaphylaxis and prophylaxis]. PMID- 6499049 TI - [Personal experience with the administration of tamoxifen to patients with gynecomastia]. PMID- 6499050 TI - [Ethical problems in neonatal intensive care]. PMID- 6499052 TI - [Genetic factors in the development of duplicate efferent urinary tracts]. PMID- 6499051 TI - [Uncommon causes of ischemic heart disease in childhood]. PMID- 6499053 TI - [Factors of non-specific immunity in a group of children with asthma]. PMID- 6499054 TI - [Congenital hip dysplasia, possibilities of diagnosis and treatment]. PMID- 6499055 TI - [Possibilities of therapy using continuous negative pressure in the neonatal unit]. PMID- 6499056 TI - [Pregnancy in young women with kidney failure]. PMID- 6499057 TI - [Psychological study of children with diabetes]. PMID- 6499058 TI - [Respiratory pauses during sleep in infants]. PMID- 6499059 TI - [New possibilities of the surgical treatment of craniofacial malformations]. PMID- 6499061 TI - [Therapy of renal hypertension in children]. PMID- 6499060 TI - [Anomalous origin of the left branch of the pulmonary artery as a cause of dyspnea in infants]. PMID- 6499062 TI - [When should the acquired immunodeficiency syndrome be considered in children (AIDS)?]. PMID- 6499063 TI - [A view of pediatric cardiology from a community center]. PMID- 6499064 TI - [Post-hepatic portal hypertension]. PMID- 6499065 TI - [Aspects of economic efficiency in the manufacture of pharmaceuticals. Optimalization of the batch size and the batch series in the production of drugs]. PMID- 6499066 TI - [Teaching social medicine in the 6th year of study of general medicine at a medical school]. PMID- 6499067 TI - [Recognizing the effectiveness of health education (II)]. PMID- 6499068 TI - [Establishing the rooming-in system]. PMID- 6499069 TI - [Comments on the process of work motivation as a part of the management of health facilities]. PMID- 6499070 TI - [Global ecological evaluation of the frequency of congenital defects in the district of Prague-West in 1961-1981]. PMID- 6499071 TI - [Physics of energy conservation and the heating of health facilities]. PMID- 6499073 TI - [Management activities by the physician in the system of physician-patient relations]. PMID- 6499072 TI - [Problems of work activity, social contact and outside interests of persons 60 years-old and older with emphasis on single persons]. PMID- 6499074 TI - [Methods of studying and assessing the needs and utilization of health services at the 1st line level and at a polyclinic]. PMID- 6499075 TI - [Establishment of networks of health facilities in large cities]. PMID- 6499076 TI - Reactive products formed by peroxidase catalyzed oxidation of p-phenetidine. AB - The nature of the reactive metabolites formed during HRP/H2O2 catalyzed oxidation of p-phenetidine was investigated. Interaction with DNA measured as the induction of DNA single strand breaks and DNA binding resulted in a time-dependent decrease in the interaction and could be related to the primary oxidation of p phenetidine. Oxygen uptake observed during p-phenetidine metabolism in the presence of GSH also exhibited such a correlation. GSH-conjugate formation and protein binding on the other hand exhibited an initial increase and did not appear to be directly related to primary p-phenetidine oxidation since maximal interaction was obtained when p-phenetidine had been completely metabolized. The GSH-conjugate and protein binding ratio of ring labelled to ethyl labelled p phenetidine of approx. 2:1 indicated that these reactive metabolites(s) may be dimer(s) whose formation presumably involved loss of one ethoxy group of p phenetidine. Accordingly formation of ethanol, indicative of ethoxy group elimination, could be observed during p-phenetidine metabolism. Only one metabolite generated from p-phenetidine oxidation exhibited a concentration dependent binding to protein. This metabolite also reacted with GSH to form water soluble conjugates. Prior reduction of the metabolite by ascorbic acid prevented this conjugate formation. The mass spectral fragmentation pattern of the reactive protein- and GSH-binding metabolite was compatible with the structure N(4 ethoxyphenyl)-p-benzoquinoneimine. PMID- 6499077 TI - The effects of neighboring bases on N-methyl-N-nitrosourea alkylation of DNA. AB - Calf thymus DNA and the synthetic polynucleotides of defined sequence, poly(dG).poly(dC) and poly(dG-dC).poly(dG-dC) were reacted with N-methyl-N nitrosourea (MNU) and the amounts of 7-methylguanine (7-MG) and O6-methylguanine (O6-MG) determined. It was found that the O6-MG/7-MG ratio for DNA was 0.13, for poly(dG).poly(dC) was 0.10, and for poly(dG-dC).poly(dG-dC) was 0.21. From these data, it is evident that the neighboring bases affect the alkylation pattern of guanine by MNU, a finding that can have significant relevance in defining 'hot spots' of alkylation in the genome which may be important in the processes of mutagenesis and carcinogenesis. PMID- 6499078 TI - Relationships between carcinogen metabolism, adduct binding and DNA damage in 3 methylcholanthrene-exposed lung. AB - The extent to which structural damage in DNA, isolated from rats receiving an intratracheal dose of 3-methylcholanthrene (3-MC), was affected by change in microsomal mixed-function oxidase activity, has been examined. Instillation of 3 MC causes a characteristic pattern of structural change in lung DNA as determined by stepwise elution from benzoylated DEAE-cellulose (BD-cellulose). The proportion of lung DNA containing single stranded regions was increased biphasically, relative maxima occurring 14 and 72 h after treatment, the first increase being proportional to the dose of 3-MC. Binding of 3-MC to lung DNA increased progressively for 24 h after treatment and decreased rapidly from 48 h onward. Cytochrome P-450 content of pulmonary, and also of hepatic microsomes from treated animals, was measured. On this basis, 3-MC metabolism was modified, carbon tetrachloride being an effective inhibitor when administered 4 h in advance of treatment whilst maximum self-induction of 3-MC metabolism required 24 h. BD-cellulose analysis of lung DNA of 3-MC-treated rats subjected to inhibiting or inducing treatment suggested that the extent of structural damage was primarily determined by the capacity of lung tissue to metabolise the carcinogen. In particular, inhibition of 3-MC metabolism by prior treatment with carbon tetrachloride prevented production of single stranded regions, whilst modifying 3 MC binding to DNA. The data indicate that structural analysis of DNA is a sensitive means of assessing levels of genomic injury by carcinogens. This procedure may be used to study the effects of complicated treatments, and specifically agents which modify carcinogen metabolism. PMID- 6499079 TI - 13C- and 31P-NMR studies of the conformation of carcinogen-modified nucleic acid dimers. AB - The effect of the carcinogen acetylaminofluorene (AAF) on nucleic acid structure was examined using 13C- and 31P-NMR spectroscopies. Conformational effects were compared in two AAF-modified dinucleoside monophosphates (ApG and GpA) and two AAF-modified deoxydinucleotides (dpApG and dpGpA). Changes in adenine 13C chemical shifts on formation of the AAF-adduct and as a function of temperature provided evidence of base stacking. Differences in fluorene 13C chemical shifts between the AAF-modified dimer and AAF-modified monomer provided evidence of fluorene stacking. The effect of forming the adduct on the phosphate backbone was examined using 31P-NMR. A correlation was demonstrated between the degree of adenine-fluorene stacking on one hand and the change in conformation of the backbone conformation on the other. PMID- 6499080 TI - Antivertigo agents. III. Synthesis of 5,6,7,8-tetrahydro-1,6-naphthyridine methyl homologs. PMID- 6499082 TI - O-Methylation effect on the carbon-13 nuclear magnetic resonance signals of ortho disubstituted phenols and its application to structure determination of new phthalides from Aspergillus silvaticus. PMID- 6499081 TI - Syntheses of 2-mercapto-4-substituted imidazole derivatives with antiinflammatory properties. PMID- 6499083 TI - Chemical modification of sulfazecin. Synthesis of 4-methoxycarbonyl-2-azetidinone 1-sulfonic acid derivatives. PMID- 6499084 TI - Asymmetric alpha-substituted phenethylamines. IV. The synthesis and analgesic activity of optically pure (S) and (R)-1-cyclohexyl- and 1-cyclohexenyl-2 phenylethylamines. PMID- 6499085 TI - Studies on Scutellariae radix. VII. Anti-arthritic and anti-inflammatory actions of methanolic extract and flavonoid components from Scutellariae radix. PMID- 6499086 TI - Stimulation of lipid and sugar metabolism in ginsenoside-Rb2 treated rats. PMID- 6499087 TI - Vibrational test for evaluation of creams. I. The effect of vertical vibration imposed on O/W creams. PMID- 6499088 TI - Effect of convulsions induced by pentylenetetrazole or electricity on the dispositions of creatinine and urea in rats. PMID- 6499089 TI - Interactions of microcapsules with human polymorphonuclear leucocytes. PMID- 6499090 TI - Preparation and evaluation in vitro of polycarbonate microspheres containing local anesthetics. PMID- 6499091 TI - Photochemical nitrosation of phenol in aqueous nitrite solution. PMID- 6499092 TI - (1R,5R,8S,9S)-Deoxyloganic acid from Nepeta cataria. PMID- 6499093 TI - New methods for identification of Alismatis rhizoma by means of electrophoresis, paper partition chromatography, and thin-layer chromatography. PMID- 6499094 TI - Elimination of creatinine following intravenous administration to chronically CCl4-treated rats. PMID- 6499095 TI - Chronic blood vessel catheterization in Gottingen miniature pigs and application to a preliminary bioavailability study of nalidixic acid. PMID- 6499096 TI - Effect of sodium copper chlorophyllin on lipid peroxidation. VII. Effect of its administration on the stability of rat liver lysosomes. PMID- 6499097 TI - Further investigation of peptide antibiotic, hypelcin A: isolation and structures of hypelcins A-I, A-II, A-III, and A-IV. PMID- 6499098 TI - Significance of bile alcohol in urine of a patient with cholestasis: identification of 5 beta-cholestane-3 alpha,7 alpha,12 alpha,26,27-pentol ( beta cyprinol) and 5 beta-cholestane-3 alpha,7 alpha,12 alpha,26-tetrol (27-deoxy-5 beta-cyprinol). PMID- 6499100 TI - [Microcomputers and ophthalmology]. PMID- 6499099 TI - Preparation and characterization of well defined D-erythro sphingomyelins. AB - A simple semisynthetic procedure for the preparation of various D-erythro sphingomyelins (SPMs), differing in their acyl chains, is described. They were prepared by one-step condensation of the desired free fatty acid with sphingosyl phosphorylcholine (SPC) using dicyclohexylcarbodiimide. The D-erythro SPMs were obtained in high purity, high yields and resemble bovine brain SPM in their chromatographic behavior, infrared, circular dichroism (CD) and proton NMR (PMR) spectra as well as in their rate of hydrolysis by Staphylococcus aureus sphingomyelinase. Multilamellar vesicles can be prepared from the semisynthetic SPMs. Their thermotropic behavior is dependent mainly on the acyl chain though it is also affected by the heterogeneity of the sphingosine base composition. Intact sealed small unilamellar vesicles (SUV) cannot be prepared from a single semisynthetic saturated SPM but can be prepared from their mixtures. This acylation procedure can also be applied for preparing simple neutral glycosphingolipids. The sphingolipids prepared by this method can be used to study metabolism, enzymology and physicochemical properties of D-erythro well defined simple sphingolipids. PMID- 6499101 TI - [Computerized medical records and searching]. PMID- 6499102 TI - [Around the microcomputer]. PMID- 6499103 TI - [Daily use of computer science]. PMID- 6499104 TI - [Computer science and visual electrophysiology]. PMID- 6499105 TI - [Electroretinography]. PMID- 6499106 TI - The nature of inherited susceptibility to cancer. PMID- 6499107 TI - Selective distribution of selenium in colon parallels its antitumor activity. AB - Results of epidemiologic and experimental studies suggest that selenium can inhibit the development of tumors. In rats, the administration of selenium decreases the incidence of carcinogen-induced colon tumors; the inhibition is greater in the proximal colon that in the distal colon. We investigated the distribution of selenium in the different segments of rat colon and determined the uptake of selenium in the mucosa and in the muscle layers of each segment. The colon was perfused before removal of the segments to ensure complete removal of blood-borne selenium. We found that the concentration of selenium was greater in the proximal colon than in the distal colon and that within each segment the uptake was higher in mucosa than in muscle. In addition, we determined the level of selenium in blood, serum, and liver at different times after the administration of various doses of selenium. Though the mechanism by which selenium prevents tumor development is unknown, the data indicate a correlation between the uptake of selenium in different segments of colon and inhibition of tumorigenesis. PMID- 6499108 TI - Metabolism of 1-nitro[14C]pyrene in vivo in the rat and mutagenicity of urinary metabolites. AB - The metabolic fate of the bacterial mutagen, environmental pollutant and potential carcinogen 1-nitropyrene (NP) has been investigated in the rat. Over half of an i.p. dose (10 mg/kg) of 1-nitro[14C]pyrene was excreted within 24 h of dosing, 15% of the dose in urine and 40% in the faeces. After 96 h greater than 80% of the dose had been recovered. The urinary and fecal metabolites of NP were separated and quantitated by h.p.l.c., then identified by high resolution gas chromatography/mass spectrometry (h.r.g.c./m.s.) and comparison with synthetic reference compounds, where available. Very little (less than 5%) of the dose was excreted unchanged. Urinary metabolites were all excreted in conjugate form, mainly with glucuronic acid. Among the principal metabolite fractions identified were 3-hydroxy-1-nitropyrene and 8-hydroxy-1-nitropyrene (already known as hepatic in vitro metabolites of 1-nitropyrene) and the hitherto unreported metabolites 6-hydroxy-N-acetyl-1-aminopyrene and 8-hydroxy-N-acetyl-1 aminopyrene. Mutagenic activity was detected, by means of the Ames Salmonella (strain TA 98) plate incorporation assay, in the urine of rats dosed with NP. This mutagenicity, unlike that of NP itself, required exogenous metabolic activation. It was predominantly associated with 6-hydroxy-N-acetyl-1-aminopyrene and with the nitropyrene phenols (specific mutagenicity 600 and 700 rev/nmol respectively in the presence of 0.6 mg of S9 protein per plate). The majority of the residual metabolites were polar, refractory to enzymic hydrolysis, and of low mutagenicity. The major proportion of the 14C in feces was not extractable or amenable to enzymic hydrolysis; the extractable fecal metabolites were similar in nature to those in urine. PMID- 6499109 TI - Methylating and ethylating carcinogens have different requirements for poly(ADP ribose) synthesis during malignant transformation. AB - Transformation of mouse C3H 10T1/2 cells by various alkylating carcinogens can be modulated by inhibiting poly(ADP-ribose) synthesis with a low concentration of 3 amino-benzamide, which induces no additional toxicity or reported side effects. Transformation by methylating agents was decreased by 3-aminobenzamide, whereas transformation by ethylating agents was increased. These results confirm earlier work on transformation by methylating agents, X-rays and u.v. light. Transformation by ethylating agents, however, appears to proceed by a different mechanism. PMID- 6499110 TI - Metabolism of benzo[a]pyrene by cultured human hepatocytes from multiple donors. AB - Primary hepatocyte cultures from six human donors were established and their abilities to metabolize the polycyclic aromatic hydrocarbon carcinogen benzo[a]pyrene (B[a]P) were examined. Cells from each donor were plated at similar densities (1 X 10(7) cells/100 mm dish). All cultures metabolized B[a]P to a significant extent (24-35 nmol in 24 h) and h.p.l.c. profiles of the organic solvent-soluble and glucuronidated B[a]P metabolites were obtained for all donors. The predominant extracellular organic solvent-soluble B[a]P metabolites were the 9,10- and 7,8-dihydrodiols, 9-hydroxy-B[a]P, and a mixture of tetrols, but the general ratios of these metabolites varied widely among the cells from different donors. In contrast, profiles were highly reproducible in cells from the same donor treated with B[a]P at either 8 or 24 h after initial plating. There was less variability in the amounts of specific B[a]P metabolites conjugated to glucuronic acid by cells from various donors. This variability could not be correlated with cell viability or overall levels of B[a]P metabolism. In addition, B[a]P metabolism by fresh and cryopreserved hepatocytes from the same donor was compared. While there was only a small reduction in the level of total B[a]P metabolism after cell freezing, there was a 3- to 5-fold increase in production of B[a]P-7,8-dihydrodiol, found both in the extracellular medium and as glucuronic acid conjugates, by the cryopreserved cells tested. PMID- 6499111 TI - DNA adduct formation, removal and persistence in rat liver during one month of feeding 2-acetylaminofluorene. AB - Male Wistar-Furth rats were fed 0.02% 2-acetylaminofluorene (AAF) for 3 days or 0.02% AAF for 25 days followed by 0.02% [ring-3H]AAF for an additional 3 days. The concentration of hepatic DNA adducts was then monitored by both radioimmunoassay and radiolabeling during 28 days of control diet. This approach allowed comparisons to be made of adduct accumulation, removal and persistence at both the beginning and end of a four week carcinogen feeding period. DNA adduct formation remained constant during the month of AAF administration with an accumulation rate of 157 fmol adduct/micrograms DNA during days 1-3 and days 25 28 of the experiment. Furthermore, the rate of removal of adducts formed during these three day periods was similar when both groups were fed control diets for 28 additional days. Continued AAF administration resulted in a slow accumulation of persistent adducts; thus, 91 +/- 6% of the adducts detected after 3 days of AAF feeding were removed during a subsequent month of control diet, while only 65 +/- 11% of the adducts detected after 28 days of AAF diet were removed when rats were fed control diet for an additional 28 days. In a second experiment, the removal of adducts was compared in animals fed control or AAF diet after previously being fed 0.02% AAF for 17 days. Similar removal curves were observed in both groups; therefore, continued ingestion of AAF did not affect the rate of adduct removal. In both experiments, biphasic repair curves were observed. These data were used to develop a pharmacokinetic model. Two genomic regions were postulated, an area susceptible to fast repair and a region more resistant to the removal of AAF adducts. At equilibrium, which was reached after 2-3 weeks of AAF feeding, the concentration of adducts in each region was similar with approximately 150 fmol adduct/micrograms DNA. Although the total number of adducts formed in the fast repair region during one month of AAF administration was five times greater than in the resistant region, the model predicted that the adducts localized in regions resistant to repair were the persistent adducts detected after one month of control diet. Overall, the removal of adducts formed during chronic AAF feeding was very efficient since greater than 93% of the adducts were removed by the end of a subsequent month of control diet. PMID- 6499112 TI - 32P-post-labelling analysis of DNA adducts formed in the livers of animals treated with safrole, estragole and other naturally-occurring alkenylbenzenes. I. Adult female CD-1 mice. AB - The binding of a series of alkenylbenzenes to liver DNA of adult female CD-1 mice, isolated 24 h after i.p. administration of non-radioactive test compound (2 or 10 mg/mouse), was investigated by a modified 32P-post-labelling assay. The known hepatocarcinogens, safrole, estragole and methyleugenol, exhibited the strongest binding to mouse-liver DNA (1 adduct in 10 000 - 15 000 DNA nucleotides or 200 - 300 pmol adduct/mg DNA after administration of a 10 mg dose), while several related compounds, which have not been shown thus far to be carcinogenic in rodent bioassays, bound to mouse-liver DNA at 3 - 200x lower levels. The latter compounds included allylbenzene, anethole, myristicin, parsley apiol, dill apiol and elemicin. Eugenol did not bind. Low binding to mouse-liver DNA was also observed for the weak hepatocarcinogen, isosafrole. Two main 32P-labelled adducts, which appeared to be guanine derivatives, were detected for each of the binding chemicals on thin-layer chromatograms. The loss of safrole adducts from liver DNA was biphasic: a rapid loss during the first week (t 1/2 approximately 3 days) was followed by a much slower decline up to 20 weeks after treatment (t 1/2 approximately 2.5 months). Adducts formed by reaction of 1'-acetoxysafrole, a model ultimate carcinogen, with mouse-liver DNA in vitro were chromatographically identical to safrole-DNA adducts formed in vivo. Pretreatment with pentachlorophenol, a known inhibitor of sulphotransferases, inhibited the binding of safrole to mouse-liver DNA, providing further evidence that the metabolic activation of the allylbenzenes proceeds by the formation of 1'-hydroxy derivatives as proximate carcinogens and 1'-sulphooxy derivatives as ultimate carcinogens. PMID- 6499113 TI - 32P-post-labelling analysis of DNA adducts formed in the livers of animals treated with safrole, estragole and other naturally-occurring alkenylbenzenes. II. Newborn male B6C3F1 mice. AB - When a series of nine alkenylbenzenes were administered to preweanling male mice, safrole, estragole and methyleugenol induced a significant incidence of hepatic carcinomas, while eugenol, anethole, elemicin, myristicin, dill apiol and parsley apiol did not (Miller et al., Cancer Res., 43, 1124-1134, 1983). Following the protocol used to test seven of these compounds, male C57Bl X C3H/He F1 mice were injected with 0.25, 0.5, 1.0 and 3.0 mumol of a compound on days 1, 8, 15 and 22 after birth, respectively. Groups of mice were killed and their liver DNA isolated on days 23, 29 and 43, and analysed by a modified 32P-post-labelling procedure. Highest levels of adducts were detected with methyleugenol (72.7 pmol/mg DNA), estragole (30.0) and safrole (17.5). After correction for liver growth it was estimated that most of these adducts were still present at 43 days. Significant levels of DNA binding by myristicin (7.8 pmol/mg DNA) and elemicin (3.7) were also found but in the former case the adducts were less persistent. Only low levels of adducts were detected with anethole, dill apiol and parsley apiol (less than 1.4 pmol/mg DNA); no DNA binding was detected with eugenol. Thus, all but one of the alkenylbenzenes studied became bound to newborn mouse liver DNA, but the levels and the persistence of adducts formed by the carcinogenic compounds were greater. PMID- 6499114 TI - Chlorinated ethylenes: their metabolism and effect on DNA repair in rat hepatocytes. AB - The major initial metabolites of the chlorinated ethylenes in hepatocyte suspensions isolated from phenobarbital treated rats were as follows (rates of metabolite production in nmol/10(6) cells/min are given in brackets): vinylidene chloride, dichloroacetic acid (0.015); cis-1,2-dichloroethylene, 2,2 dichloroethanol (0.24); trans-1,2-dichloroethylene, dichloroacetic acid (0.005); trichloroethylene, chloral hydrate (2.7); tetrachloroethylene, trichloroacetic acid (0.08). Comparison of the metabolism of the chlorinated ethylenes by isolated hepatocyte suspensions and hepatic microsomes indicates that the initial products of the three dichlorinated ethylenes from cytochrome P-450 in hepatic microsomes are rapidly and extensively metabolized in the hepatocyte, where the Phase II enzymes are present. In contrast, the initial metabolites of trichloroethylene and of tetrachloroethylene in the two systems are identical. The abilities of the chlorinated ethylenes to induce unscheduled DNA synthesis was assessed in isolated hepatocytes using a method which does not require the blocking of semi-conservative DNA synthesis. Vinylidene chloride, cis-1,2 dichloroethylene and trichloroethylene induced unscheduled DNA synthesis, while trans-1,2-dichloroethylene and tetrachloroethylene did not. PMID- 6499115 TI - Comparative genotoxicity of nitrogen mustard and nor-nitrogen mustard. AB - Nitrogen mustard and nor-nitrogen mustard were investigated in Salmonella typhimurium and human lymphocytes for genotoxicity. Point mutations were assessed using the plate test, the conventional spot test and a method in which the substances were not in direct contact with the microorganisms. Both compounds were active, but nor-nitrogen mustard was far more potent than nitrogen mustard in all bacterial systems. Cytogenetic experiments with human lymphocytes revealed that both compounds induced a dose dependent increase in chromosomal aberrations and sister chromatid exchanges, but that nitrogen mustard was 10 times more potent than nor-nitrogen mustard. Thus, the spectrum of activity for nor-nitrogen mustard and nitrogen mustard differ. Nor-nitrogen mustard was more effective in inducing point mutation damage than nitrogen mustard and a reversal of potency was found for cytogenetic damage. These results indicate that although these two substances induce the same type of DNA lesions the amounts of the different DNA adducts vary. PMID- 6499116 TI - Correlation between O6-methylguanine-DNA-methyltransferase activity and resistance of human cells to the cytotoxic and mutagenic effect of N-methyl-N' nitro-N-nitrosoguanidine. AB - Cells from Gardner's syndrome (GS) and familial polyposis coli (FP) patients, persons with a hereditary predisposition to colon cancer, were compared to those of normal persons for sensitivity to the cytotoxic and mutagenic action of N methyl-N'-nitro-N-nitrosoguanidine (MNNG), a model compound chosen because methylating agents have been implicated in colon carcinogenesis. FP cell line GM2355 and GS cell lines 2938 and GM3948 exhibited normal sensitivity to the cytotoxic and mutagenic effects of MNNG. In contrast, GS cell line GM3314 and cells from an apparently normal fetus GM0011 showed extreme sensitivity to the killing and mutagenic effect of this alkylating agent. To determine if the resistance of the various cell lines to MNNG correlated with their ability to remove methyl groups from the O6-position of guanine, we measured their O6 methylguanine-DNA methyltransferase (MT) activity. The resistant cell lines exhibited normal levels of MT; the sensitive strains showed virtually non detectable levels of this activity. We also compared fibroblasts from a xeroderma pigmentosum (XP) patient (XP12BE, complementation group A), an SV40 virus transformed XP cell line (XP12ROSV) and a normal cell line transformed by this virus (GM637) for their response to the cytotoxic and mutagenic effect of MNNG and for MT activity. XP12BE cells showed normal sensitivity and a normal level of MT; GM637 cells showed an intermediate level of sensitivity and a reduced level of MT activity; XP12ROSV cells were extremely sensitive to the cytotoxic and mutagenic effect of MNNG and showed virtually non-detectable levels of MT activity. The MT did not remove methyl group from O4-methyl-thymine. These results suggest that O6-methylguanine and/or any other adduct repaired by the methyltransferase, is a potentially cytotoxic and mutagenic lesion. They also indicate that the predisposition to colon cancer of FP and GS patients is not necessarily correlated with an increased sensitivity of their fibroblasts to mutations induced by methylating carcinogens. PMID- 6499117 TI - Dose-response studies on promoting and anticarcinogenic effects of phenobarbital and DDT in the rat hepatocarcinogenesis. AB - Possible discrepancy between the dose level required for promoting action, when given after initiation process, and that needed to exert an anticarcinogenic effect when given simultaneously with a carcinogen, of hepatic promoters were investigated in an attempt to obtain a 'practical' threshold dose of promoters. Phenobarbital (PB) and dichlorophenyltrichloroethane (DDT) were used as promoters and 3'-methyl-4-(dimethylamino)-azobenzene (3'-Me-DAB) was used as the carcinogen. Male weanling rats were treated with 600 p.p.m. 3'-Me-DAB for 3 weeks followed by a diet containing a promoter at various dose levels (5-500 p.p.m.), or the animals were treated with a low dose (100 p.p.m.) of 3'-Me-DAB plus a promoter at various dose levels (20-500 p.p.m.). The effects of promoters were measured by scoring size and number of enzyme-altered islands at weeks 12 and 24 of rat age. The promoting effect of PB and DDT was demonstrated in dose-dependent fashion, in the dose range of 10-500 p.p.m. and 20-500 p.p.m., respectively. On the other hand, promoters given simultaneously with a low dose of carcinogen enhanced the carcinogenesis at all the dose levels tested, quite in contrast with their inhibitory effect on carcinogenesis when given together with relatively high doses of carcinogens. PMID- 6499118 TI - Repair of O6-methylguanine in human fetal brain and skin cells in culture. AB - The repair of O6-methylguanine was measured in cell cultures derived from human fetal brain and skin. Cells derived from nine different fetal specimens were treated in culture with N-methyl-N-nitrosourea (MNU). The brain cell cultures used were a mixture of glial and neuronal cell types, while the skin cell cultures were predominantly fibroblasts. The amount of O6-methylguanine initially induced and remaining in cellular DNA was quantitated as a function of time (0-4 h) by h.p.l.c. analysis of the acid hydrolyzates of in vitro alkylated cellular DNA. Very little (less than 10%) of the 7-methylguanine was lost from the DNA of both cell cultures 4 h post-treatment. Approximately 50% of the O6-methylguanine induced in cellular DNA by MNU was lost within 0.7 h in both the human fetal brain and skin cells in culture. Within 4 h, 80% of this methylated guanine was lost. The kinetics for the removal of O6-methylguanine in the brain and skin cells appeared biphasic. A rapid initial phase was followed by a gradual slower phase of repair. These studies indicate that cells derived from human fetal brain and skin exhibit the same degree of proficiency for the repair of the potential pro-carcinogenic O6-methylguanine lesion. PMID- 6499119 TI - The relevance of gap junctions to stage I tumor promotion in mouse epidermis. AB - A previous paper reports that the potent tumor promoter, 12-O tetradecanoylphorbol-13-acetate (TPA), has a time-dependent effect on mouse epidermal gap junctions. A single topical application of 1.0 micrograms TPA results in the absence of gap junctions from mouse interfollicular epidermis between 18 and 30 h post-treatment. This paper describes the dose-dependent effect of TPA on mouse epidermis. Observations indicate that only promoting doses of TPA affect the gap junctions. Similarly, while a low dose of the hyperplasiogenic compound mezerein (1.0 microgram) is ineffective, a higher dose (4.0 micrograms) results in a significant reduction in the gap junction number. One and two applications of TPA had identical effects. The potent inhibitor of both stage I and stage II of tumor promotion, Fluocinolone acetonide, used in combination with TPA, completely suppressed the hyperplasiogenic and the gap junction modulating effects of TPA. Retinoic acid, which inhibits only stage II of tumor promotion, did not influence the gap junction eliminating property of TPA. Tosylphenylalanine chloromethyl ketone which is a mild but specific inhibitor of only stage I of tumor promotion counteracted the action of TPA on gap junctions to some extent, which remained present in smaller numbers than in normal tissue at 24 h after the treatment. These results suggest that gap junctions are essential and specifically relevant to stage I tumor promotion. PMID- 6499120 TI - Promotion of mouse liver neoplasms by the organochlorine pesticides chlordane and heptachlor in comparison to dichlorodiphenyltrichloroethane. AB - The organochlorine pesticides chlordane and heptachlor were demonstrated to be liver neoplasm promoters in mice. Male B6C3F1 mice exposed to diethylnitrosamine (DEN) for 14 weeks followed by 25 weeks on control diet developed a 40% incidence of liver neoplasms whereas those given chlordane or heptachlor afterwards had approximately an 80% incidence of liver neoplasms, as did mice given DDT, a positive reference compound. Mice exposed to DEN also developed neoplasms of the forestomach and lung, but the incidences of these were not increased by chlordane, heptachlor or any other exposure. None of the chemicals given alone for the last 25 weeks of the study increased the incidence of liver neoplasms and none given before DEN produced a syncarcinogenic effect. PMID- 6499121 TI - Repair of chromate-induced DNA damage in chick embryo hepatocytes. AB - The repair of DNA damage caused by chromate was examined in chick embryo hepatocytes. Treatment of chick embryo hepatocytes with 5 microM sodium chromate for 2 h caused the formation of DNA strand breaks, DNA interstrand cross-links, and DNA-protein cross-links. The maximal level of strand breaks and DNA interstrand cross-links was observed immediately after the 2 h chromate treatment. After removal of the chromate, strand breaks and DNA interstrand cross links were completely repaired by 3 h and 12 h, respectively. In contrast, DNA protein cross-links continued to form reaching a maximal level 3 h after chromate removal. Although the level of DNA-protein cross-links decreased at later times, a significant level persisted 40 h after chromate removal. The effect of these persistent DNA-protein cross-links on gene expression was examined by measuring induction of porphyrin accumulation by propylisopropylacetamide and deferoxamine methanesulphonate, a process known to depend on mRNA synthesis. Induction of porphyrin accumulation was decreased immediately following the 2 h chromate treatment. Only partial recovery of induction was observed even 40 h after chromate removal. The effect of chromate treatment on cellular glutathione levels was monitored. No change in cellular glutathione was observed after a 2 h treatment with 5 microM sodium chromate; however, a three-fold increase was observed 12 h after removal of chromate. PMID- 6499122 TI - Enhancement of the mutagenicity of carcinogenic arylamines by ethinyl estradiol. AB - Ethinyl estradiol, the estrogenic component of oral contraceptives, has been shown to enhance the mutagenicity of 2-aminofluorene, 2-acetylaminofluorene, N hydroxy-2-acetylaminofluorene, and N-acetoxy-2-acetylaminofluorene with strain TA 98 of Salmonella typhimurium and various rat liver activating systems. The magnitude of the enhancement of mutation produced by ethinyl estradiol is dependent upon: the type of mixed-function oxidase inducer of the liver activating system; the structure and concentration of the arylamine; the concentration of ethinyl estradiol; and metabolism of ethinyl estradiol to its catechol, 2-hydroxyethinyl estradiol, by the activating system. Moxestrol, a biologically potent estrogenic derivative of ethinyl estradiol which is not metabolized effectively to its catechol by the mixed-function oxidases, does not enhance the mutagenicity of the above arylamines and related compounds. Both 2 hydroxyethinyl estradiol and 2-hydroxymoxestrol enhance the mutagenicity of 2 aminofluorene and 2-acetylaminofluorene. Neither the estrogens nor their catechols are mutagenic by themselves in this system. In the presence of ethinyl estradiol, a marked inhibition of ring hydroxylation of 2-acetylaminofluorene was demonstrated. Since ring hydroxylation is a well established detoxification pathway of arylamine and arylamide metabolism, the enhancement of mutagenicity by ethinyl estradiol may be the result of a net increase in N-hydroxylation of arylamines and arylamides. PMID- 6499123 TI - Metabolic processing of 2-acetylaminofluorene by microsomes and six highly purified cytochrome P-450 forms from rabbit liver. AB - Kinetic analysis of oxidative metabolism of 2-acetylaminofluorene (AAF) was studied in control and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-induced microsomes and with six highly purified cytochrome P-450 isoenzymes from rabbit liver. Kinetic parameters were defined for 7-, 5-, 3-, 1- and N-hydroxylations of AAF. 7-Hydroxylation was best defined by a two enzyme system, displaying a high affinity and relatively low capacity and a low affinity high capacity components in both control and TCDD induced microsomes. All the purified cytochrome P-450 isoenzymes were capable of catalyzing the 7-hydroxylation of AAF and, with the exception of form 4, this was the only oxidation on the AAF molecule catalyzed by these forms. It is probable that forms 1, 4 and 6 accounted for a substantial part (greater than or equal to 25%) of total metabolic capacity corresponding to the high affinity component of 7-hydroxylation, whereas forms 3b and 3c accounted for less than 5% of the metabolic capacity displayed by the low affinity component in control microsomes. However, forms 4 and 6 could account for greater than 90% of the metabolic capacity of the high affinity component of 7 hydroxylation in TCDD microsomes, whereas the form(s) responsible for the metabolic capacity of the low affinity component were not identified. Each of the 1-, 3-, 5- and N-hydroxylations were best defined by a single enzyme system in both control and TCDD microsomes (3- and 5-hydroxylations could not be defined in TCDD microsomes). Close agreements were found between the apparent Km for N hydroxylation in control, TCDD induced microsomes and with form 4. alpha Naphthoflavone inhibited AAF N-hydroxylation to a similar extent in control and TCDD microsomes and in form 4. These date indicate that: a subpopulation of cytochrome P-450 isoenzymes, which includes all the purified P-450 forms tested in the present study, is solely involved in detoxification (i.e., 7 hydroxylation) of AAF, and as such probably behave as a functional unit in vivo; modulation of cytochrome P-450 content by inducers such as TCDD results in emergence of relatively few cytochrome P-450 isoenzymes that can account for most of the oxidative metabolism of AAF; and a single cytochrome P-450 isoenzyme (i.e., form 4) is responsible for catalyzing N-hydroxylation of AAF, the first and the obligatory step in the metabolic activation of this carcinogen. PMID- 6499125 TI - Methylation of DNA in stomach and small intestine of rats after oral administration of methylamine and nitrite. AB - Young adult male Sprague-Dawley rats were given 30 mumol/kg body weight [14C]methylamine hydrochloride and 700 mumol/kg body weight sodium nitrite by oral gavage. DNA isolated from the stomach and from the first 15 cm of the small intestine was methylated, containing 7-methylguanine (7mG) at a level of one 7mG molecule per 5 X 10(6) and 1 X 10(7) nucleotides, respectively. No 7mG was found in the liver at a limit of detection of one 7mG molecule per 2 X 10(8) nucleotides. In a second experiment, the excised stomachs were incubated with deoxyribonuclease before the isolation of the DNA in order to degrade DNA in the lumen and in the uppermost lining cells. This treatment resulted in a 30% decrease in the yield of DNA and a 90% reduction in the level of 7mG formation. The results show that nitrosation of a primary alkylamine yields a precursor of an alkylating agent which has a long enough lifetime to diffuse towards and react with intracellular DNA. A correlation of DNA methylation in the stomach with the corresponding tumor formation by the methylating carcinogen N-methyl-N'-nitro-N nitroso-guanidine was used to estimate the role of DNA damage resulting from endogenous nitrosation of dietary methylamine in man. It was concluded that the risk resulting from this single amine must be negligible but that a similar evaluation of other primary amines is required before the over-all role of primary amine nitrosation in the etiology of human gastric cancer can be assessed. PMID- 6499124 TI - Effect of herbicide 2,4,5-trichlorophenoxyethanol (TCPE) containing dioxin on mutation and induction of sister chromatid exchanges. AB - Previous studies have indicated that both herbicide 2,4,5-trichlorophenoxyethanol (TCPE) and its contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) enhance liver tumor incidence in male Swiss mice in a dose-dependent manner. In this report the mutagenicity of TCPE (containing 0.1 p.p.m. TCDD) in the Salmonella/microsome assay was studied, and the effect of this herbicide on the colony-forming ability and on the frequency of sister chromatid exchange (SCE) in Chinese hamster cells were determined. TCPE (1-500 micrograms/plate) appeared non mutagenic in strains TA 1535, TA 1537, TA 1538, TA 98 and TA 100 either in the absence or presence of S-9 mix from male Wistar rat, male Swiss mouse and male hamster liver pre-treated by Aroclor 1254, using the standard plate incorporation and the pre-incubation assay. Male mouse urine, after a single administration of TCPE to the animal, also proved to be non-mutagenic in strains TA 98 and TA 100. In mammalian cell systems, however, TCPE directly induced a dose related increase in SCE frequency. The dose required to double the control SCE frequency was in the slightly toxic range of the survival curve for TCPE. The cytotoxicity was diminished both in bacterial and mammalian systems in the presence of S-9 mix from male Swiss mouse liver. This S-9 mix strongly reduced SCE frequency induced by TCPE. The induction of SCE observed cannot be attributed to the contaminant TCDD alone, because the SCE production was not influenced by the appropriate low concentration of pure TCDD. PMID- 6499126 TI - O6-Methylguanine-DNA transmethylase converts O6-methylguanine thymine base pairs to guanine thymine base pairs in DNA. AB - O6-Methylguanine lesions in natural and synthetic DNAs were studied as substrates for the O6-methylguanine-DNA methyltransferase in vitro. The results indicate that O6-methylguanine is repaired by this protein when base paired to T as well as to C in double-stranded DNA. The results also indicate that O6-methylguanine is less subject to repair than previously reported when it is in single-stranded DNA and suggest that O6-methylguanine may not be repaired when it is at the 3' terminus. PMID- 6499127 TI - Phototransformation of 2-aminofluorene into N-oxidized mutagens. AB - Exposure to sunlight or artificial sources of near u.v. light transforms 2 aminofluorene into a direct-acting mutagenic agent in the Ames/Salmonella histidine reversion bioassay. H.p.l.c. fractionation indicates that the majority of this mutagenic activity elutes as a single A254 absorbance peak. I.r. spectroscopy of the fractionated active fraction shows the presence of significant quantities of 2-nitrofluorene. The use of a nitroreductase deficient strain of Salmonella, coupled with t.l.c. analysis, however, also indicates the presence of a minor component whose mutagenic and t.l.c. properties are identical with 2-nitrosofluorene. These results implicate a specific mechanism by which aromatic amines can be photo-oxidized to potentially harmful genotoxic agents. PMID- 6499128 TI - N-Nitroso-2-hydroxymorpholine, a mutagenic metabolite of N-nitrosodiethanolamine. AB - N-Nitroso-2-hydroxymorpholine was synthesized from N-(2 hydroxyethyl)aminoacetaldehyde diethylacetal by nitrosation and hydrolysis. It was detected as a metabolite of N-nitrosodiethanolamine in rat hepatic 9000 g supernatant. It was mutagenic toward Salmonella typhimurium TA 1535, with and without activation. The results suggest that N-nitroso-2-hydroxymorpholine, which is formed by metabolic beta-oxidation of N-nitrosodiethanolamine, could be involved in carcinogenesis by N-nitrosodiethanolamine. PMID- 6499129 TI - Independence of myocardial oxygen consumption from pressure-volume trajectory during diastole in canine left ventricle. AB - We have found that myocardial oxygen consumption is linearly correlated with the systolic pressure-volume area in the canine left ventricle. This pressure-volume area is a specific area in the pressure-volume diagram that is circumscribed by the end-systolic pressure-volume relation line, the end-diastolic pressure-volume relation curve, and the systolic segment of the pressure-volume trajectory. This area is equivalent to the total mechanical energy generated by ventricular contraction, consisting of the external mechanical work and the mechanical potential energy. In the present study, we specifically changed the course of the diastolic segment of the pressure-volume trajectory without changing the systolic segment of the pressure-volume trajectory and the systolic pressure-volume area. Although the fractions of external mechanical work and mechanical potential energy in the pressure-volume area were markedly changed, the simultaneously measured left ventricular oxygen consumption remained unchanged. This result indicates that the myocardial oxygen consumption is predominantly determined by the total mechanical energy generated during systole, or the systolic pressure volume area, independent of how the total mechanical energy is converted effectively to external mechanical work during the cardiac cycle. PMID- 6499130 TI - Interaction of canine carotid sinus and aortic arch baroreflexes in the control of total peripheral resistance. AB - Interaction of carotid sinus and aortic arch reflex control of total peripheral resistance was studied in eight dogs anesthetized with sodium pentobarbital and placed on constant flow cardiac bypass. Carotid sinus and aortic arch baroreceptor areas were isolated and separately perfused at controlled pressures. Combinations of carotid sinus and aortic arch pressures were delivered at random in steps of 25 mm Hg over the 50-225 mm Hg pressure range, and systemic arterial pressure was measured. Changes in arterial pressure reflected changes in total peripheral resistance. A multiple linear regression showed that both carotid sinus and aortic arch pressures exhibited a sigmoidal relationship with arterial pressure. Independent of carotid and aortic baroreceptor pressures, arterial pressure was found to be a periodic function of time (period = 2 hours) in all dogs. The average carotid sinus reflex open loop gain was found to be 0.231 +/- 0.092, while average aortic arch open loop gain was 0.141 +/- 0.088. The gain of either the carotid sinus or aortic arch reflex was not influenced by the absolute pressure level of the other receptor area. In a separate series of experiments performed in the same dogs, we tested the hypothesis that a nonlinear temporal summation of the reflex control of total peripheral resistance might exist when the inputs to carotid and aortic baroreceptors are changed simultaneously. With both inputs held at the region of maximum gain, 25 mm Hg step changes were imposed first on carotid sinus pressure, then on aortic arch pressure, and then on both simultaneously. A temporal inhibition of the two reflexes showed that simultaneous excitation of both receptors resulted in a smaller reflex response than the sum of individual responses. PMID- 6499131 TI - The role of vascular capacitance in the coronary arteries. AB - When the left coronary artery was perfused with nonpulsatile pressure, the onset of diastole was accompanied by a capacitance overshoot in flow with an exponential decay back to a steady state. Time constant for that decay ranged from 55 msec when tone was present to 105 msec with maximal dilation. Since the transient resulted from a fall in tissue pressure, this represents an estimation of intramural arterial capacitance only. Transients in perfusion pressure, which would also affect epicardial arteries, yielded similar time constants. We concluded that most of the coronary capacitance resides in the small intramural vessels. Analysis of transients yielded a value for capacitance of between 0.01 and 0.05 ml/mm Hg per 100 g. We then used the data from the transients to construct coronary pressure flow curves which were free of any back flow from capacitance. When coronary tone was present, the curves indicated that flow ceased at 30 mm Hg. With maximal dilation, flow ceased at only 18 mm Hg. Long diastoles in those same hearts indicated that flow ceased at about 10 mm Hg higher pressure. Although capacitance causes critical closing pressure as determined by a long diastole to be artifactually high, critical closing pressure is still appreciable in the heart, and tone dependent. Finally, three computer models were built, one of which included only small vessel capacitances, the second, only vascular waterfalls, and the third, both of the above. Only model 3 was capable of reproducing the flow patterns which were actually seen. PMID- 6499132 TI - Altered control of hindlimb vascular resistance by vagal afferents in spontaneously hypertensive rats. Difference in the early and late stage of hypertension. AB - The aim of this study was to examine whether control of vascular resistance by vagal afferents is altered in the early as well as late stage of hypertension. We examined the effects of vagotomy on hindlimb vascular resistance as well as on arterial baroreflex control of hindlimb vascular resistance in spontaneously hypertensive rats and Wistar-Kyoto rats, 12 and 35 weeks old. Vagotomy in rats with the intact arterial baroreceptors increased hindlimb vascular resistance in all four groups. Hindlimb vascular responses to graded sympathetic nerve stimulation were closely linear up to 6 Hz in all groups, and the slope of the response was approximately 1.4 times steeper in spontaneously hypertensive than in Wistar-Kyoto rats, in both the young and old groups. The increase in hindlimb vascular resistance after vagotomy normalized by the slope of the response to sympathetic nerve stimulation was greater in young spontaneously hypertensive rats than in young Wistar-Kyoto rats, but was less in old spontaneously hypertensive rats than in old Wistar-Kyoto rats. Vagotomy increased the gain of arterial baroreflex control of hindlimb vascular resistance in young spontaneously hypertensive rats, and in two groups of Wistar-Kyoto rats, but not in old spontaneously hypertensive rats. The percent increase in the gain of arterial baroreflex control of hindlimb vascular resistance after vagotomy tended to be greater in young spontaneously hypertensive than in young Wistar-Kyoto rats, but was less in old spontaneously hypertensive than in old Wistar-Kyoto rats. Central venous pressure and left ventricular end-diastolic pressure were higher in spontaneously hypertensive than in Wistar-Kyoto rats in both young and old groups. Left atrial distensibility assessed by obtaining the atrial pressure volume relationship was comparable between young spontaneously hypertensive and young Wistar-Kyoto rats, but was less in old spontaneously hypertensive than in old Wistar-Kyoto rats. These results indicate that vagal afferents exert tonic inhibition on control of hindlimb vascular resistance in spontaneously hypertensive as well as in Wistar-Kyoto rats, and that tonic inhibitory influence of vagal afferents on control of hindlimb vascular resistance is altered in spontaneously hypertensive rats, augmented in young, but attenuated in old, spontaneously hypertensive rats, compared with that in age-matched Wistar-Kyoto rats. It is considered that altered control of vascular resistance by vagal afferents in spontaneously hypertensive rats may result from changes in vagal afferent activity. PMID- 6499133 TI - Cardiovascular effects of leukotrienes in neonatal piglets. Role in hypoxic pulmonary vasoconstriction? AB - We investigated the effects of exogenous leukotriene D4, synthesis inhibitors, and a leukotriene receptor antagonist upon chloralose anesthetized, mechanically ventilated, neonatal piglets with constant left pulmonary blood flow and upon piglets with uncontrolled pulmonary blood flow. Leukotriene D4 (100-10,000 ng, intravenously) caused dose-dependent increases in peak tracheal pressure, pulmonary vascular resistance, and systemic arterial pressure. In a limited number of experiments, cardiovascular responses to exogenous leukotriene C4 were qualitatively similar but quantitatively less than those to leukotriene D4. Neither treatment with diethylcarbamazine or the lipoxygenase inhibitor nordihydroguaiaretic acid, nor with the leukotriene receptor antagonist, FPL55712, altered any baseline cardiovascular parameter measured, suggesting the absence of any influence of leukotrienes on resting hemodynamics. Hypoxia or hypoxia combined with mild hypercapnia caused pulmonary vasoconstriction. Neither treatment with diethylcarbamazine or the lipoxygenase inhibitor nordihydroguaiaretic acid, nor with the leukotriene receptor antagonist FPL55712, altered the pulmonary vasoconstrictor response to hypoxia or combined hypoxia/hypercapnia. We conclude that endogenous leukotrienes do not appear to have an influence on resting cardiovascular function, neither do they appear to be necessary for hypoxic pulmonary vasoconstriction in the neonatal piglet, although exogenous leukotrienes are capable of producing cardiovascular effects. PMID- 6499134 TI - Effects of pericardial effusates of various conductivities on body-surface potentials in dogs. Documentation of the eccentric spheres model. AB - The purpose of this study was to discover the cause and magnitude of changes in the body-surface potentials occurring when: (1) fluids of various conductivity were added to the pericardial sac, or (2) the volume of the blood within chambers of the heart was either increased or decreased. Fluids added to the pericardium were physiological saline, whole-blood, and mineral oil. Magnitudes of body surface potentials were compared to the predictions based on a mathematical eccentric spheres model of the heart and torso developed previously by Rudy and Plonsey. Data demonstrated conclusively that there is a nonlinear relationship between the body-surface potentials and the conductivity of the pericardial layer. This relationship is one in which the body-surface potentials of the anterior chest were found to decrease when conductivity of the pericardial layer was either increased or decreased. These changes in body-surface potentials were caused solely by alterations in the conductivity and volume of the fluid effusate. It was demonstrated that these changes were not caused by any "stretching" or "compression" of the cardiac tissue caused by the altered fluid volumes in and around the heart. Findings were accurately predicted by the eccentric spheres model, thereby confirming the model's usefulness as a predictive instrument. The model provides an explanation for the nonlinear relationship that was exhibited by the data. PMID- 6499135 TI - An analysis of myocardial infarction. The effect of regional changes in contractility. AB - In a preceding paper, we employed an initially spherical, modified membrane model of the infarcted ventricle to investigate the relation between ventricular function and both infarct size and infarct stiffness. In the present paper, we have applied the same model to a set of different questions, namely, the consequences of enhanced or depressed inotropic state within the noninfarcted myocardium. When infarcted ventricles containing up to 41% infarction are examined, stroke volume appears to be relatively insensitive to increases in inotropic state. However, stroke volume falls rapidly when inotropic state is depressed below 80% of normal. For the case of a ventricle with a large, weakly contracting segment which is not totally infarcted, stroke volume is impaired only when the contractility of the weak region is diminished below 50% of normal. Finally, the stress concentration around a region of infarction appears to be dependent more strongly on the inotropic state of the noninfarcted tissue than on the infarct size. PMID- 6499136 TI - Role of glycolytic products in damage to ischemic myocardium. Dissociation of adenosine triphosphate levels and recovery of function of reperfused ischemic hearts. AB - The mechanism of irreversible damage to ischemic myocardium was investigated in the perfused rat heart. The time of transition from reversible to irreversible damage to contractile function was accelerated by accumulation of glycolytic products and increases in extracellular calcium. Both of these effects were largely independent of adenine nucleotide levels in the tissue. With zero coronary flow and 1.25 mM calcium the decrease in ability of the heart to recover ventricular function with reperfusion after 30 minutes of ischemia was directly correlated with accumulation of glycolytic products (as estimated by tissue lactate) during ischemia. The extent of lactate accumulation during ischemia was varied by preperfusing the hearts for 0, 10, or 15 minutes under anoxic, high coronary flow conditions to deplete tissue glycogen prior to ischemia, and by adding lactate back to the perfusate of these hearts during the ischemic period. Recovery of ventricular function was inversely related to tissue lactate during ischemia and varied from 28 to 92%, even though there was little or no change in tissue levels of residual adenosine triphosphate. Increasing extracellular calcium accelerated the time of onset of irreversible damage with little or no change in residual adenosine triphosphate levels. At any given calcium concentration, the time-dependent declines in the ability of the heart to recover ventricular function was also largely independent of adenosine triphosphate levels. These studies suggest a major role of anaerobic glycolytic products (lactate, hydrogen ion, or NADH) in ischemic damage to the heart that is unrelated to loss of tissue adenine nucleotides. With zero or low flow ischemia, this effect may result in irreversible damage to the myocardium before adenine nucleotides are reduced to critically low levels. PMID- 6499137 TI - The effects of shortening on myoplasmic calcium concentration and on the action potential in mammalian ventricular muscle. AB - When cardiac muscle shortens during a contraction, the duration of mechanical activity is abbreviated (shortening deactivation), but the duration of the action potential is prolonged. Neither of these phenomena is fully understood, but both may be related to changes in the myoplasmic free calcium concentration. In these experiments, isolated papillary muscles from cats and ferrets were allowed to contract under various mechanical conditions while myoplasmic calcium was monitored with aequorin, or in parallel experiments the membrane potential was recorded with microelectrodes or a sucrose gap. When shortening occurred, myoplasmic calcium was increased and the membrane potential was more positive than in isometric contractions. The changes in calcium apparently precede the depolarization. We propose that muscle shortening reduces calcium binding to the contractile proteins and leads to a rise in myoplasmic calcium, and that this rise in myoplasmic calcium activates an inward current leading to the observed changes in the action potential. These processes may be important contributory factors in some arrhythmias. PMID- 6499138 TI - Measurement of cytosolic free calcium concentration in isolated rat ventricular myocytes with quin 2. AB - Cytosolic free calcium concentration was determined in isolated ventricular myocytes from adult rats with the calcium-sensitive indicator, quin 2. The fluorescence signal from resting cells indicated that cytosolic free calcium concentration was 181 +/- 18 nM (mean +/- SEM, n = 18). Inhibition of the sodium potassium pump with strophanthidin (0.1 mM) resulted in an increase of cytosolic free calcium concentration from 186 +/- 17 to 736 +/- 129 nM (n = 6). The results indicate that it is possible to measure cytosolic free calcium concentration in cardiac muscle cells that have been isolated enzymatically. Moreover, they confirm the observation that inhibition of the sodium-potassium pump increases cytosolic free calcium concentration, presumably via the sodium-calcium exchange mechanism. PMID- 6499139 TI - Temporal changes in he sympathetic-parasympathetic interactions that occur in the perfused canine atrium. AB - In the isolated, blood-perfused, canine right atrium, stimulation of the intramural autonomic nerves evoked negative chronotropic and inotropic responses. The responses were not maintained at a constant level during tonic neural stimulation, but they tended to drift back toward their control levels. These time-dependent changes in the cardiac responses were more pronounced the higher the frequency of stimulation. After the beta-adrenergic receptors were blocked in half of the preparations, the negative cardiac responses to autonomic neural stimulation were more pronounced, but the time dependency of those responses was less. After the muscarinic receptors were blocked in the other half of the preparations, only positive responses to neural stimulation were observed. These responses faded significantly at a high stimulation frequency (30 Hz), but not at a lower frequency (5 Hz). The cardiac responses to combined autonomic neural stimulation were substantially more negative than the algebraic sum of the individual responses to sympathetic and parasympathetic stimulation. The extent of this interaction was most pronounced near the beginning of stimulation, but it became less pronounced as the stimulation progressed. Hence, the cardiac sympathetic-parasympathetic interactions change appreciably with time during a continuous train of autonomic neural stimulation. PMID- 6499140 TI - Efficacy of left cardiac sympathectomy in the treatment of patients with the long QT syndrome. AB - Ten patients with the long QT syndrome and recurrent syncope and/or cardiac arrest caused by ventricular arrhythmias underwent left stellate (one patient) or left cervicothoracic sympathectomy (nine patients) after failing to respond to high-dose beta-blocker therapy. The syndrome was familial in four and idiopathic in six. All patients had a prolonged resting QT interval (548 +/- 51 msec, mean +/- SD) and corrected QT interval (QTc) (556 +/- 43 msec). After sympathectomy the mean QTc shortened significantly from 556 +/- 43 to 508 +/- 65 msec (p less than .05) but the QTc remained abnormal in all but one patient. Over a mean follow-up period of 38.6 +/- 19 months, eight patients developed recurrent symptoms that included cardiac arrest in three (one fatal, two nonfatal), syncope in four, and presyncope in six. The addition of beta-blockers was ineffective in suppressing the recurrent symptoms. The control of symptoms required more extensive sympathectomy (three patients), chronic atrial pacing (three patients), and implantation of an automatic internal defibrillator (one patient). Only one patient has remained asymptomatic without drug or pacemaker therapy. In conclusion, left cervicothoracic sympathectomy proved inadequate for long-term control of symptoms in most patients with the long QT syndrome. These patients usually required concomitant drugs, more extensive surgery, or long-term cardiac pacing for symptomatic relief. PMID- 6499141 TI - Catheter ablation of the atrioventricular junction: a report of the percutaneous mapping and ablation registry. AB - An international registry was formed to collate data for patients undergoing attempted catheter ablation of the atrioventricular (AV) junction and insertion of a permanent pacemaker. Over the past 2 years, data was submitted for 127 patients who were followed for a mean of 9.9 +/- 8.2 months. The most common arrhythmia treated was chronic or paroxysmal atrial fibrillation or flutter (78 patients, 61%); the remainder had supraventricular tachycardia due to AV node reentry, ectopic atrial tachycardia, or incorporated an accessory pathway. A single shock of 150 to 400 J was effective in producing chronic third-degree AV block in 45 patients while two or more shocks were used in an additional 45 patients. There was no significant difference in the total cumulative energy used in successful and unsuccessful procedures. Immediate complications related to the shock included ventricular fibrillation (one patient), pericardial tamponade (one patient), and transient hypotension (one patient). No chronic sequelae occurred as a result of these complications. Late complications (1 day to 1 month) included ventricular tachycardia (three patients), sepsis involving the pacemaker pocket (two patients), staphylococcal sepsis from temporary pacing catheter (one patient), thrombophlebitis (one patient), thrombosis of the left subclavian vein (one patient), and hemothorax (one patient). Follow-up evaluation revealed chronic third degree AV block in 90 (71%) and AV conduction resumed but no drugs were required for arrhythmia control in eight (6.5%) and arrhythmia control was achieved with previously ineffective drugs in 16 (13%). Thirteen patients (10%) had no improvement and five of these patients underwent cardiac electrosurgery for direct His bundle ablation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499142 TI - Improvement in indexes of diastolic performance in patients with congestive heart failure treated with milrinone. AB - To elucidate the mechanisms by which the new bipyridine inotropic agent milrinone improves cardiac function, we examined multiple indexes of left ventricular diastolic function before and after administration of milrinone to patients with advanced (NYHA class III or IV) congestive heart failure. In 13 patients left ventricular pressure measurements were made with a micromanometer to permit assessment of peak negative dP/dt and the time constant of left ventricular isovolumic relaxation, T, before and after milrinone. In nine patients radionuclide ventriculographic studies were performed during left heart catheterization, allowing calculation of left ventricular peak filling rate, volumes, and the diastolic pressure-volume relationship before and after milrinone. After intravenous administration of milrinone, peak negative dP/dt increased (+ 18%; p less than .01) and T decreased (-30%; p less than .01), while heart rate increased by only 8% (87 +/- 12 to 94 +/- 15 beats/min; p less than .01), left ventricular systolic pressure did not change, and mean aortic pressure fell by 11% (p less than .01). Left ventricular peak filling rate increased (1.2 +/- 0.6 to 1.7 +/- 0.7 end-diastolic volumes/sec; p less than or equal to .02) despite a decrease in left ventricular filling pressure (mean pulmonary wedge pressure 27 +/- 7 to 18 +/- 9 mm Hg; p less than .01). There was a fall in left ventricular end-diastolic pressure (28.6 +/- 6 to 19 +/- 7 mm Hg; p less than or equal to .01), with no significant change in left ventricular end-diastolic volume. This was associated with a downward shift in the left ventricular diastolic pressure-volume relationship in most cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499143 TI - The use of left ventricular end-ejection pressure and peak pressure in the estimation of the end-systolic pressure-volume relationship. AB - The end-systolic pressure-volume relationship (ESPVR) as derived from left ventricular pressure-volume loops has gained increasing acceptance as an index of ventricular contractile function. In animal experiments the ESPVR has been defined as a line connecting the upper left corners of several differently loaded pressure-volume (P-V) loops with a slope parameter Ees and a volume axis intercept parameter Vo. In the clinical setting, several variants of the ESPVR have been determined with use of peak left ventricular pressure, end-ejection pressure, and end-ejection volume. The maximum P-V ratio has also frequently been measured. We attempted to determine which of these alternatives resulted in good approximations of the reference ESPVR in eight isolated canine ventricles that ejected into a simulated arterial impedance system with resistance, compliance, and characteristic impedance. We determined various versions of the ESPVR from the same set of beats quickly obtained with little change in inotropic background. To vary ventricular pressure wave forms, each of the arterial impedance parameters was independently controlled at 50%, 100%, and 200% of normal. Against each of the nine combinations of the impedance parameters four P V loops were obtained under four preloads and from each of the sets of four P-V loops, the reference ESPVR, linear regression of the peak pressure on end ejection volume (ESPVRPP-EEV), and linear regression of end-ejection pressure on end-ejection volume (ESPVREEPV) were determined. In addition, the maximum P-V ratio (MPVR) was calculated for each P-V loop.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499144 TI - Increased vasoconstrictor activity of proximal coronary arteries with endothelial damage in intact dogs. AB - In this study we examined the hypothesis that endothelial damage increases proximal coronary arterial vasomotor tone and sensitivity to vasoconstrictor stimulation. The response of the left anterior descending coronary artery (LAD) (% area change) to serotonin and nitroglycerin were examined in eight anesthetized (Innovar + nitrous oxide), closed-chest dogs by means of quantitative coronary angiography. Dose-response curves of percent change in arterial cross-sectional area for three doses of intracoronary serotonin were examined before and after endothelial damage produced by a balloon catheter in the LAD. Endothelial damage was verified by postmortem scanning electron microscopic examination. Intracoronary injection of 133Xe provided coronary flow data. The damaged segment of LAD showed spontaneous vasoconstriction and further constriction in response to serotonin (33 +/- 5% before and 52 +/- 6% area reduction after damage; p less than .05). Nitroglycerin reversed serotonin induced vasoconstriction in LAD segments without damage but not in the LAD segment with endothelial damage. No significant changes were observed in aortic pressure, and heart rate was kept constant by pacing. Blood flow in the LAD was not affected by endothelial damage itself (control, 2.44 +/- 0.09 ml/min/g; damage, 2.53 +/- 0.22 ml/min/g). Endothelial damage induced spontaneous proximal coronary constriction and diminished the relaxant response to nitroglycerin in the presence of serotonin. These results suggest that focal coronary narrowing that occurs in some patients after provocation with vasoconstrictor agents may be caused by local areas of damaged endothelium. PMID- 6499145 TI - Effects of adenosine and adenine nucleotides on the atrioventricular node of isolated guinea pig hearts. AB - The primary goal of this study was to determine whether the slowing of atrioventricular (AV) conduction by ATP is caused by ATP per se or is mediated by adenosine formed from ATP degradation. We assessed the effects of ATP, beta, gamma-methylene ATP, ADP, AMP, and adenosine on AV conduction time in the isolated perfused guinea pig heart. The cardiac effluent was collected and analyzed for its content of adenine nucleotides and nucleosides. Perfused ATP was rapidly and almost completely broken down to AMP and adenosine; only 2.5 +/- 0.5% of the infused ATP was recoverable in the effluent. A significant correlation was found between the effluent concentration of adenosine and atria-to-His bundle (A H) conduction time. Compounds that altered the effect of adenosine on A-H conduction likewise altered the effect of ATP: (1) aminophylline, a competitive antagonist of adenosine, antagonized the ATP-induced A-H prolongation; (2) adenosine deaminase, the enzyme responsible for the deamination of adenosine to inosine, reduced the effect of ATP by 82%; (3) the adenosine transport blockers NBMPR and dipyridamole markedly enhanced the effect of ATP; and (4) EHNA, an inhibitor of adenosine deaminase, potentiated the effect of ATP. Furthermore, the less hydrolyzable ATP analog, beta, gamma-methylene ATP, was less potent than ATP in causing A-H prolongation. We conclude that the adenosine-like action of ATP on the guinea pig AV node requires that ATP first be degraded to adenosine. PMID- 6499146 TI - Cigarette smoking and cardiovascular diseases. A statement for health professionals by a task force appointed by the steering committee of the American Heart Association. PMID- 6499147 TI - Dynamic mechanisms in human coronary stenosis. AB - At the clinical level, coronary stenoses frequently behave as though the obstruction to flow were variable and not as rigidly fixed as previously imagined. Pressure (energy) lost in flow through a stenosis is the primary determinant of its hemodynamic impact. Ischemic episodes occur when pressure distal to the stenosis falls below that needed to perfuse the subendocardium. Three important properties of the stenosis contribute to variation in its pressure loss. First, loss is proportional to the square of stenosis flow. Thus proper distribution of perfusion is doubly vulnerable to conditions such as exercise, anemia, or pharmacologic vasodilation, which ordinarily increase myocardial blood flow. Second, pressure loss is proportional to the inverse fourth power of minimum lumen diameter. As a result, seemingly small changes in diameter are amplified to large changes in stenosis resistance. Third, a compliant arc of normal arterial wall borders part of the lumen in the majority of coronary lesions. This extremely important morphologic feature of stenoses permits transient variation in stenosis lumen diameter in response to drugs or to variation in endogenous vasomotor activity or intraluminal pressure. Although our understanding is incomplete, many of the clinical features of coronary disease and its pharmacologic responses are explained in terms of these stenosis properties and their interaction. PMID- 6499148 TI - Determinants of survival in patients with congestive cardiomyopathy: quantitative morphologic findings and left ventricular hemodynamics. AB - We analyzed data from 68 consecutive patients with congestive cardiomyopathy to evaluate the prognostic significance of quantitative morphologic findings in left ventricular myocardium as compared with the prognostic significance of left ventricular hemodynamics. Left ventricular endomyocardial biopsy specimens were obtained from all patients during diagnostic heart catheterization. Myocardial fiber diameter, volume fraction of interstitial fibrosis, and intracellular volume fraction of myofibrils were determined by light-microscopic morphometry. All patients had normal coronary arteriograms, but reduced left ventricular ejection fractions. There were 23 deaths during a mean follow-up period of 1124 days. Multivariate regression analysis (Cox model) revealed that left ventricular ejection fraction (p less than .00001) and left ventricular systolic pressure (p less than .01), but not morphometric findings in biopsy specimens, were independent predictors of cardiac death. Thus, morphologic findings in the left ventricular myocardium do not contribute significantly to the prognostic evaluation in patients with congestive cardiomyopathy studied by hemodynamic and angiographic methods. PMID- 6499149 TI - Hemodynamic effects of dynamic exercise in children and adolescents with moderate to-small ventricular septal defects. AB - We studied the hemodynamic effects of dynamic exercise during cardiac catheterization in 35 children and adolescents with small-to-moderate ventricular septal defects. Eighteen of them exercised at 25% and 50% of their maximum workload and 17 exercised at 60%. There was no significant difference between the two groups with respect to age and body mass, height, and surface area. The changes evoked by exercise showed the same pattern at the different workloads, although they were more marked at the higher than at the lower percentage of maximum workload. During exercise the pulmonary vascular resistance did not change, in contrast to the systemic vascular resistance, which decreased. The pulmonary and systemic blood flows both increased, while the left-to-right shunt flow did not change, which led to a decrease of the left-to-right shunt fraction. As the heart rate increased and the shunt flow did not change, the shunt volume per beat decreased during exercise. We conclude that in patients with small-to moderate ventricular septal defects the hemodynamic effects of dynamic exercise are favorable because the normal rise in systemic blood flow occurs without a corresponding increase in left-to-right shunt flow. Consequently, children and adolescents with such defects should not be restricted in their dynamic exercise activities. PMID- 6499150 TI - Quantitative assessment of right and left ventricular growth in the human fetal heart: a pathoanatomic study. AB - We quantitated the growth patterns of the normal fetal heart and the right and left ventricles from postmortem hearts obtained from 55 spontaneously aborted human fetuses from the completion of cardiogenesis to term. Fetal gestational age was assessed by menstrual history of the mother, crown-rump length, head circumference, and body weight and ranged from 8 to 40 weeks. Each heart was perfused and fixed at constant pressure and dissected to obtain right and left ventricular free wall, left ventricular, and total heart weights. Right and left ventricular free wall thicknesses were measured and the respective surface areas were calculated. The changes in each of these parameters with gestational age were examined by regression analysis. Total heart and right and left ventricular wall weights increased linearly with body weight, but exponentially with head circumference, crown-rump length, and menstrual history. Right and left ventricular free wall weights were similar throughout gestation and the percent that each contributed to total heart weight were constant at 29 +/- 2% and 30 +/- 2%, respectively. Right and left ventricular wall thicknesses did not differ significantly, increasing linearly with menstrual age, crown-rump length, head circumference, and body weight from 8 to 40 weeks. The surface areas of the right and left ventricular free walls that we used as an index of changing ventricular architecture were indistinguishable throughout the period of gestation studied.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499151 TI - Alteration of diastolic filling rate during exercise radionuclide angiography: a highly sensitive technique for detection of coronary artery disease. AB - Diastolic and systolic parameters of left ventricular performance were characterized from high-frequency time-activity curves obtained in 10 normal volunteers (mean age 29 +/- 4 yr), in 25 patients with normal coronary arteries, and in 50 patients with coronary artery disease (CAD) at rest and during three stages of exercise radionuclide angiography. In the normal volunteers ejection fraction was 65 +/- 5% (SD) at rest and 78 +/- 5% with exercise (p less than .001). In patients with normal coronary arteries ejection fraction was 64 +/- 5% at rest and 72 +/- 8% with exercise (p less than .0001). In patients with CAD resting ejection fraction was 60 +/- 10% and that during exercise was 61 +/- 13% (p = NS). Peak diastolic filling rate in the first half of diastole, peak systolic ejection rate, and times to peak rates and to end-systole were measured. In the normal subjects resting peak diastolic filling rate was 3.1 +/- 0.6 end diastolic counts/sec and it increased in all subjects with exercise to 3.6 +/- 0.7 (p less than .05). In patients with normal arteries and those with CAD peak diastolic filling rate was 2.3 +/- 0.8 at rest and with exercise this parameter increased to 3.2 +/- 1.1 (p less than .001) in patients with normal arteries and fell to 1.7 +/- 0.6 in those with CAD (p less than .001). Peak systolic ejection rate decreased from 2.5 +/- 0.8 to 1.9 +/- 0.8 with exercise in patients with CAD (p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499152 TI - Intraoperative endocardial mapping during sinus rhythm: relationship to site of origin of ventricular tachycardia. AB - Mapping-guided endocardial resection has proved to be an effective therapy for recurrent sustained ventricular tachycardia. However, some patients cannot be mapped during ventricular tachycardia, so that guidance from findings during normal sinus rhythm would be highly desirable. We examined the frequency, timing, and duration of several abnormal types of electrograms recorded endocardially during sinus rhythm and related these findings to activation mapping during sustained ventricular tachycardia. Thirteen patients with extensive myocardial infarction complicated by recurrent sustained ventricular tachycardia were studied intraoperatively during sinus rhythm and induced ventricular tachycardia with a standardized mapping scheme involving the entire endocardial surface. Fractionated electrograms (multicomponent with amplitude less than 1 mV and duration greater than 50 msec) were recorded in all patients. This type of electrogram could be recorded at up to 36% of mapped sites. Split electrograms (two components separated by isoelectric period) were also frequently seen but involved only a mean of 5.8% of mapped sites. Late electrograms (inscribed entirely after the QRS complex) were only recorded in four of 13 patients at a mean of 5% of mapped sites. The location of these electrograms was related to an arbitrary 8 cm2 zone around the earliest site of endocardial activation recorded during ventricular tachycardia. The longest fractionated electrogram was closely related to nine of 22 morphologies of induced ventricular tachycardia, split electrograms were related to seven of 16 morphologies, and late electrograms to two of four morphologies. We have concluded that extremely abnormal electrograms recorded endocardially during sinus rhythm are widespread in patients with extensive myocardial infarction complicated by ventricular tachycardia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499153 TI - Right ventricular and right atrial collapse in patients with cardiac tamponade--a combined echocardiographic and hemodynamic study. AB - To determine the hemodynamic derangement associated with right ventricular diastolic collapse and to assess the value of right ventricular and right atrial collapse in identifying cardiac tamponade, two-dimensional echocardiograms were recorded simultaneously with measurement of right atrial, pulmonary capillary wedge, intrapericardial, and systemic arterial pressures and cardiac output in 16 patients as they underwent pericardiocentesis. Twelve patients (group I) had evidence of right ventricular or right atrial collapse or both on their echocardiograms and hemodynamic evidence of cardiac tamponade before pericardiocentesis. All hemodynamic parameters improved after pericardiocentesis (p less than or equal to .05). Continuous monitoring during pericardiocentesis in three of these patients showed significant improvement in all parameters except heart rate (p less than or equal to .02) at the point of disappearance of right ventricular diastolic collapse, with further improvement in cardiac output as pericardiocentesis continued (p less than .01). Right atrial collapse persisted after right ventricular collapse disappeared but was no longer present when pericardiocentesis was completed. Three patients (group II) had no right ventricular or right atrial collapse, no hemodynamic evidence of cardiac tamponade, and no improvement in hemodynamic parameters after pericardiocentesis. A single patient (group III) was found to have elevated right heart pressures and right ventricular hypertrophy before pericardiocentesis. Although there was hemodynamic evidence of cardiac tamponade in this patient, there was no evidence of right ventricular or right atrial collapse. In this study, the sensitivity of right ventricular collapse as a marker for cardiac tamponade was 92%, its specificity 100%, its accuracy 94%, and its predictive value 100%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499154 TI - Variation of left ventricular myocardial gray level on two-dimensional echocardiograms as a result of cardiac contraction. AB - Integrated ultrasonic backscatter from normal myocardium has been shown to vary with the phase of cardiac contraction (decreasing from end-diastole to end systole) in previous studies of open-chest dogs. If confirmed, this finding would have important implications for clinical application of ultrasonic tissue characterization. Our hypothesis was that a cardiac cycle-dependent variation in regional average gray level would be detected on analysis of digitized two dimensional echocardiograms. We analyzed echocardiographic images from 16 subjects in whom normal, technically good studies were obtained with a commercial phased-array scanner and a 2.25 MHz transducer. Images from six subjects were digitized from stop-frame photographs and those from 10 subjects were obtained directly in digital format from the scanner. Average gray level was measured in a portion of the left ventricular posterior wall in parasternal long-axis images obtained at end-diastole and end-systole by both photographic and digital-image acquisition. In seven of the subjects from whom digital images were acquired, left ventricular posterior wall gray level and ventricular septal gray level were also evaluated on parasternal short-axis images. In images digitized by the photographic technique, mean posterior wall gray level decreased significantly from end-diastole (175 +/- 5.8 SEM) to end-systole (167 +/- 5.1, p less than .05). Similarly, in images digitized directly, mean posterior wall gray level in the long-axis view decreased from end-diastole (71 +/- 3.4) to end-systole (59 +/ 2.5, p less than .005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499155 TI - A new method to calculate aortic valve area without left heart catheterization. AB - Assessment of the severity of aortic stenosis remains a commonly encountered clinical problem. Noninvasive evaluation has to date not proven sufficiently accurate in most cases to permit clinical decision making in the individual patient. Therefore, cardiac catheterization and measurement of the valve area with use of the Gorlin equation remains the standard approach in patients with suspected aortic stenosis. Doppler ultrasound allows direct measurement of blood velocity in cardiac chambers. This technique was used to study 16 patients with suspected aortic stenosis after cardiac catheterization. Aortic valve area (AVA) was calculated with the equation AVA = CO/(SEP X mean velocity), where CO is cardiac output measured by thermodilution and SEP is the systolic ejection period derived from the Doppler tracings. The resulting value was compared with valve area calculated from cardiac catheterization data and an excellent correlation was noted (r = .99). This study demonstrates that Doppler ultrasound can be used to accurately measure aortic valve area without the need for left heart catheterization. PMID- 6499156 TI - The role of the laboratory in the diagnosis of cystic fibrosis. AB - Laboratory investigations used for detecting cystic fibrosis have been critically reviewed. The sweat test is still the only investigation that can be used for detecting the disease at any age. Trypsin in blood or serum might have the same discriminatory power during the first three months of life and could be used for neonatal screening. There is no immediate prospect for prenatal diagnosis or heterozygote detection. The change of the pattern of plasma proteins in cystic fibrosis is the same as in other chronic disorders with varying clinical intensity. Albumin and alpha-1-antitrypsin may be used to monitor treatment. The plasma concentration of alpha-2-macroglobulin is considerably decreased in many younger patients. PMID- 6499157 TI - Rapid electroenzymatic measurement of lactate in microsamples of spinal fluid. AB - A lactate sensor, which makes possible rapid direct measurement of L-lactate in small samples of spinal fluid, has been developed. This enzyme electrode gives a linear current output as a function of hydrogen peroxide generated by a lactate oxygen oxidoreductase sandwiched between two membranes. The membranes serve to support the oxidase, prevent the diffusion of soluble electroactive species such as urate, ascorbate, and phenolic drugs such as acetaminophen, and to form a diffusion-limited path for the lactate. A 10 or 25 microL sample of spinal fluid is injected into a 350 microL thermostated chamber containing a suitable buffer and the electrode's sensing surface. The method has been tested by analysis of spinal fluid, with amounts of lactate up to 15 mmol/L, by comparison with a photoenzymatic method. A correlation coefficient of 0.999 was found. With a new cellulose ester membrane, acetaminophen levels up to 10 mmol/L did not interfere. A YSI glucose analyzer can be converted to a lactate analyzer by changing the O ring mounted enzyme transducer membrane. PMID- 6499158 TI - Assessment of specific gravity determined by Ames N-Multistix-SG. AB - Specific gravity (SG) was determined in 204 urines by N-Multistix-SG solid phase test strip. Seventy-seven of the urines were from patients with known renal disease or were positive for protein or glucose, or had pH greater than 6.4 (Group I) and were assayed for osmolality, SG by urinometer and refractometer, and several other parameters, intercorrelations were calculated. Osmolality was used as the gold standard. In Group I, correlation of osmolality with N-Multistix SG (r = 0.66) was not significantly different (p greater than 0.1) from that found with SG determined by refractometer (r = 0.72), or urinometer (r = 0.60). The correlation coefficient for 45 N-Multistix-SG values determined by two staff members was 0.91. For the 127 Group II normal urines, the correlation coefficient between Multistix-SG and SG by refractometer was 0.85. Multistix-SG avoids the errors related to large molecules such as glucose and radiographic contrast media seen with SG determined by urinometer and refractometer (uncorrected for glucose) and was found to have comparable accuracy to these two methods when compared with osmolality, in patients with known renal disease or abnormal urinalysis. PMID- 6499159 TI - The effect of storage conditions on ion exchange and affinity chromatographic assays for glycated hemoglobin. AB - Experiments were performed to evaluate the effect on glycated hemoglobin determinations when erythrocytes were stored under various conditions. We studied the influence of time, temperature, glucose concentration, and pH on results obtained by three commercially available column chromatographic procedures designed to quantify glycated hemoglobin. An affinity chromatographic procedure which measures total glycated hemoglobins (GHb) was compared with two ion exchange column methods. One ion-exchange method measures total hemoglobin A1 and the other is purported to measure hemoglobin A1c. Stability studies were performed using specimens from nondiabetics and diabetics, supplemented in vitro with glucose at pH 7.4 and pH 5.0. Results obtained from the A1c and the GHb tests were unchanged over time for samples stored under the described conditions. Erythrocytes were incubated with glucose to produce labile glycated hemoglobin and assayed before and after overnight incubations in saline. These experiments showed that the A1c and GHb assays were unaffected by the presence of labile glycated hemoglobin. Column fractions were analyzed by isoelectric focusing and scanned with a laser densitometer for quantitative assessment of hemoglobin species found in each fraction. These experiments showed that the three column methods measure very different hemoglobin species. Focusing of eluates from the A1 and GHb tests revealed carryover of several hemoglobin species into the measured fractions, while the A1c test was found to be much more specific for HbA1c. Our data suggest that it may be possible to analyze glycated hemoglobins in samples transported to a reference laboratory without special treatment. PMID- 6499160 TI - Serum iron determination using ferene triazine. AB - The synthesis and characterisation of a new colorimetric reagent for iron, 3-(2 pyridyl)-5,6-bis(2-furyl)-1,2,4-triazine are described. Peak assignments and chemical shifts of the high resolution 13C nmr spectrum are given. The reagent forms a tris iron(II) complex with epsilon max of 32000 Lcm-1 mol-1 at 577 nm. The results of precision, linearity and recovery studies for use of the reagent in direct serum iron determinations are reported. Thiourea effectively suppresses copper interference for the serum iron determinations. With the procedure used, the presence of hemolysed cells in the serum had no effect on serum iron levels recorded. PMID- 6499161 TI - The evaluation of five commercial serum cortisol kits regarding precision and accuracy. AB - We evaluated Amerlex (Amersham International), Corti-Shure (Nuclear Medical Laboratories), Gammacoat (Clinical Assays), Coat-A-Count and DPC-direct (Diagnostic Products Corporation) radioimmunoassay kits for determination of cortisol in sera. The between- and within-batch precision (coefficient of variation) ranged between 4.4-12.5% and 3.0-10.9% respectively. No one kit exhibited a clearly better precision throughout the assay range. All kits displayed good sensitivity and parallelism. Cortisol concentrations determined by kit methods, in two assayed control sera, were 3-14% higher than by gas chromatography/mass spectrometry. Coat-A-Count and Gammacoat were technically the simplest assays while Corti-Shure and DPC-direct kits had the best designed standard curves over the diagnostic range. The Amerlex kit had the greatest sensitivity, showed least shift in the dose-response curve between assay and was the only assay that came to equilibrium within the specified incubation time. PMID- 6499162 TI - Are immunoassays for digoxin reliable? AB - The specificity of radioimmunoassay and fluorescence polarization immunoassay procedures for the measurement of digoxin has been assessed. Many steroids and lipids have been found to interfere and give false positive results for digoxin under the conditions of the study. Caution is recommended in the interpretation of digoxin measurements made by immunoassay procedures. PMID- 6499164 TI - Two-dimensional electrophoresis protein mapping. PMID- 6499165 TI - Some perspectives on two-dimensional protein mapping. PMID- 6499163 TI - Clinical evaluation of serum guanase activity in liver diseases. AB - We measured serum guanase (EC 3.5.4.3) activity in patients with various diseases and in healthy controls, and evaluated the clinical usefulness of this enzyme in liver diseases. The reference range, which showed no significant difference between sexes and ages over the range studied, was 0 to 1.8 U/L. The mean guanase activities for patients with various liver diseases, including acute hepatitis, chronic hepatitis, liver cirrhosis, hepatoma and metastatic carcinoma, were above the upper limit of the reference range. In acute hepatitis and metastatic carcinoma of the liver, the activities were especially high. Validity (sensitivity + specificity) of guanase, which in all tests was above 1.66, was compared to that of AST and ALT in liver diseases. With guanase, the highest validity (1.98) was found in acute hepatitis and metastatic carcinoma. Specificity of guanase was 0.98, whereas sensitivity of AST was 1.00 in all diseases. Sensitivity and specificity of ALT were 0.85 to 0.97 in all diseases. As guanase was specific, including this enzyme with other liver function tests, such as AST and ALT, may decrease false-positive results and may be effective for prediction of liver disease. PMID- 6499166 TI - Two-dimensional electrophoresis of proteins from cultured human retinal-pigment epithelial cells: internal references, cataloging, and glycoproteins. AB - Two-dimensional gel electrophoresis of acidic and basic [35S]methionine-labeled polypeptides derived from primary cultures of human retinal-pigment epithelial cells revealed about 850 proteins. By co-electrophoresis with highly purified, evolutionally conserved proteins, alpha-actinin, calmodulin, cytosol retinal binding protein, alpha- and beta-tubulin, and vinculin (mass: 130 000 Da) were tentatively identified in the fluorograms. Quantification of greater than 100 of the excised radioactive spots by liquid scintillation counting revealed an estimated overall gel/gel and donor/donor variation of 40% (SEM, 21%), the latter for data on three to four donors 57 to 81 years old. Therefore, for a difference from normal to be significant (p less than or equal to 0.01), it would, on average, have to exceed 88% of the control mean for that protein. Putative glycoproteins were independently radiolabeled, with tritiated sugars as precursors. Glucosamine was incorporated most rapidly and with the highest specific activity. It labeled about 170 polypeptides. Fucose and N acetylmannosamine, respectively, labeled 74 and 27 polypeptides. The glycoprotein label was maximal in about 16 very acidic proteins with apparent molecular masses between 50 000 and 150 000 Da. Parallel use of both a sugar and an amino acid label facilitates identification of proteins in two-dimensional gels. PMID- 6499167 TI - Quantitative analysis and pattern recognition of two-dimensional electrophoresis gels. AB - We describe a system, both hardware and software, that provides quantitative analysis and data reduction of two-dimensional electrophoresis gels. Image analysis techniques are used to determine spot intensities and to match spot patterns among many gels. A pattern-recognition program is used to extract the useful information contained in the spot lists. The application of this technology to a study of supernates from bacterial cultures is described. PMID- 6499168 TI - A metrological study of autoradiographs from two-dimensional gel electrophoresis. AB - Samples prepared from a single batch of labeled cells were subjected to two dimensional gel electrophoresis and autoradiography. Three factors were varied: total quantity of protein, quantity of labeled protein, and exposure time. The mean background absorbance of the film remained identical (about 0.5 A) for all the treated series, whatever the exposure time and whether or not there were unlabeled proteins in the sample. Hence any spot with a peak A of the same order of magnitude can be seen. The standard deviation was about 0.05 A. Thus, the measurement precision is 2.5% of full scale for digitalization over 0 to 2 A. We derived experimental calibration curves, which are neither linear nor logarithmic because of the film response and which can be used on randomly chosen spots. PMID- 6499169 TI - Identification of coordinate pairs of polypeptides: a technique for screening of putative precursor product pairs in 2D gels. AB - Two-dimensional electrophoresis, combined with computerized quantification of individual proteins, provides a sensitive and accurate approach to detection of small differences in the protein pattern. As an extension of "GELLAB," a data base system for the analysis of two-dimensional electrophoretic gels, we report here on a screening algorithm for detection of certain post-translational modification events. It is based on the assumption that, if there is a post translational modification of a protein in the transition between two functional states of a biological system, in many cases the sum of the protein concentration of a precursor-product pair in one is equivalent to that in the other. In addition to the identification of candidate pairs with a precursor-product relationship, cues to the nature of the post-translational modification that might relate them might also be derived from comparisons of the isoelectric point and apparent molecular mass. This subset of the GELLAB system may be thought of as a screening tool in the search for and investigation of post-translational protein-processing events so that the more time-consuming structural investigations to follow can be performed on a smaller set of proteins. PMID- 6499170 TI - Quality control and technical outcome of ISO-DALT two-dimensional electrophoresis in a clinical laboratory setting. AB - In this paper, we present initial quality-control evaluations for a prototype clinical laboratory, recommendations for clinical and technical data record keeping, and laboratory protocols designed to minimize operator-dependent analytical error in a multi-user environment. These evaluations and recommendations are based on qualitative and semiquantitative two-dimensional electrophoresis studies of the College of American Pathologists' Reference Preparation for Serum Proteins (RPSP). We include the schematic map of RPSP and manually derived estimates of analytical precision for within-run and run-to-run performance with the standard 18 X 18 cm ISO-DALT system. PMID- 6499171 TI - Proteins in normal, irradiated, and postmortem human brain quantitatively compared by using two-dimensional gel electrophoresis. AB - Using a combination of two-dimensional gel electrophoresis (2DE), silver staining, and computerized densitometry, we studied protein patterns in human cerebral cortex: normal fresh-frozen, fresh-frozen but previously irradiated, and post-mortem. The relative molecular mass of the resolved proteins ranged from 14 400 to 100 000, the isoelectric points from 4.75 to 7.0. The pattern of proteins (six of them identified) was essentially the same for all three groups. However, computerized densitometry demonstrated significant alterations in the density of several spots in the irradiated and postmortem groups as compared with the normal controls. Irradiated cortex showed statistically significant changes in only six spots (three increased and three decreased in density); postmortem material showed 20 altered spots (16 diminished and four increased). Evidently normal human cerebral cortex has a consistent protein pattern on 2DE, which is quantitatively (but not qualitatively) altered in irradiated and postmortem material. These findings provide a point of reference against which proteins from abnormal brain material can be compared, both qualitatively and quantitatively. PMID- 6499172 TI - Two-dimensional gel electrophoresis used in neurobiological studies of proteins in discrete areas of the rat brain. AB - Using two-dimensional gel electrophoresis, we studied proteins in the rat brain. The relative amounts of individual proteins differ in discrete areas of the brain, and the concentrations of three different proteins can be altered by chronic administration of desmethylimipramine or reserpine. Brain proteins can be radiolabeled in vitro by incubating samples of fresh tissue with [35S]methionine. We identified several proteins by using immunoblotting and comigration. Finally, we developed a possible animal model for studying proteins related to Alzheimer's disease by depleting the cholinergic innervation to the cortex and the hippocampus. PMID- 6499173 TI - Effect of heat and sodium dodecyl sulfate on solubilization of proteins before two-dimensional polyacrylamide gel electrophoresis. AB - To solubilize biological samples, sodium dodecyl sulfate (SDS) frequently is added and the mixture heated at 70-100 degrees C. However, two-dimensional polyacrylamide gel electrophoresis of a single protein after SDS treatment has not been reported. When rabbit-muscle creatine kinase was so run, we saw considerable difference in the gel staining pattern for the heated and nonheated enzyme dissolved in the SDS solution. After heating for 10 min at 95 degrees C the number of silver-stained spots apparent increased, and staining of several spots intensified. After 60 min, most of the discrete spots disappeared. Evidently the peptide backbone had been hydrolyzed. When the enzyme was simply left at room temperature for four days, the effects were similar. Appearance of new spots and loss of spots apparently are caused by heating alone but are intensified by SDS. Experiments with human serum albumin yielded similar results. PMID- 6499174 TI - Two-dimensional electrophoresis of proteins in human serum: improved resolution by use of narrow pH gradients and prolonged electrophoresis. AB - The limited resolution of serum proteins achieved with a simplified technique of two-dimensional electrophoresis (Clin. Chim. Acta 103: 51-59, 1980) has been improved by using different ampholyte (Ampholine) mixtures in the first dimension, to obtain relatively shallow pH gradients, and prolonged electrophoresis time in the second dimension. The technique has been further simplified, without negative effect, by decreasing the concentration of non-ionic detergent (first dimension), omitting both sodium dodecyl sulfate equilibration and the use of a stacking gel (second dimension), and by using an improved silver staining procedure. Reverse-polarity isoelectric focusing and non-equilibrium pH gradient electrophoresis have been successfully used to resolve the basic polypeptides in serum after deleting sodium dodecyl sulfate from the sample preparation. These combined techniques reveal over 1100 polypeptides in human serum. After immunodeletion of albumin, additional serum polypeptides are seen. Immunodeletion of serum proteins from plasma reveals polypeptides that are relatively specific to plasma. PMID- 6499175 TI - An attempt to resolve all the various proteins in a single human cell type by two dimensional electrophoresis: I. Extraction of all cell proteins. AB - A concept is presented for estimation of the total number of different proteins in a single human cell type (exemplified here by Hep cells) by use of two dimensional electrophoresis (2DE). This concept includes three problems, the first, investigated in this study, being the transfer of all protein species of the cells into a sample useful for separation by 2DE. Five different extraction media containing--in various combinations--urea, Nonidet P-40, Zwittergent, mercaptoethanol, dithiothreitol, and sodium dodecyl sulfate were used step by step in three different extraction procedures to extract the cell proteins. The amount of radiolabeled proteins in each extract was measured. Each extract was subjected to 2DE. From the total mass of cell proteins, 99.99% could be extracted in two steps: 96% were extracted with urea/beta-mercaptoethanol solution, the remaining 4% with sodium dodecyl sulfate/urea/beta-mercaptoethanol solution. A special class of proteins assumed to be present in the latter fraction was not detected. Thus this fraction can be omitted from the further analysis of all cell proteins by 2DE. Protein classes that possibly remain undetected by the described extraction procedures are mentioned. PMID- 6499177 TI - "Map" of proteins resolved from human chorionic villi by two-dimensional electrophoresis. AB - Two-dimensional electrophoresis was applied to specimens of human chorionic villi obtained during the first trimester of gestation, the object being to simultaneously map several hundred polypeptide gene products. Genetically normal specimens were homogenized in a urea-based denaturant and the supernates were electrophoresed with use of the "ISO-DALT" system. Four categories of proteins are distinguished on the map: previously identified proteins present in chorionic villi and other cell types; unidentified proteins present in chorionic villi and other cell types; proteins present in chorionic villi and amniotic fluid but not in other cell types; and proteins probably originating from the amnio-chorionic plate. The reference map for chorionic villi provided in this study may serve as the basis of determining whether genetic analyses conducted in the first trimester accurately represent the fetal genotype. PMID- 6499176 TI - Global approaches to quantitative analysis of gene-expression patterns observed by use of two-dimensional gel electrophoresis. AB - A major difficulty in the use of two-dimensional protein maps to identify and classify cell types is the problem of acquiring, selecting, and analyzing quantitative data on hundreds of protein spots. Here we use methods of multivariate statistics to analyze the differences among a panel of human cell lines, in some cases involving quantitative data on more than 250 proteins. Principal-component and cluster-analysis techniques show that the lines can be easily distinguished, even by using the subset of proteins present in all cells. A preliminary analysis of the protein changes brought about by phorbol ester induced differentiation of the line U937 is included. PMID- 6499178 TI - Two-dimensional gel pattern of proteins synthesized de novo in lymphoid organs of the mouse. AB - Mice were injected intravenously with 1 mCi of [35S]methionine, and serum and tissue were sampled 4 h later. Serum and lymphoid and non-lymphoid tissues had all incorporated enough labeled methionine to allow radiofluorographic detection on two-dimensional gels of proteins synthesized de novo and, by comparing radiofluorographs, we could distinguish spots peculiar to a given tissue from others more ubiquitous. We selected a protein of 17-kDa apparent molecular mass and pl about 4 to demonstrate tissue specificity. All patterns obtained for thymus samples yielded this spot; in all other immunologically relevant sites it was missing or weak. It also was not detected on gels previously obtained from lymphocyte subpopulations biosynthetically labeled in vitro. The labeling method described here will be especially helpful for characterizing cell populations that cannot be radiolabeled under cell-culture conditions. In contrast to detection methods that detect all proteins of a sample, in vivo labeling allows specific recognition of de novo synthesized proteins. Therefore it will facilitate comparison and detection of proteins produced by an animal in response to a given treatment. PMID- 6499179 TI - Two-dimensional electrophoresis used to differentiate the causal agents of American tegumentary leishmaniasis. AB - American tegumentary leishmaniasis is caused by a diverse group of Leishmania classified within two species complexes: L. mexicana and L. braziliensis. Because distinct disease forms are associated with certain species or subspecies, prognosis requires taxonomic identification of the pathogen. Biological criteria allow identification only to the species level; thus, biochemical and immunological markers are eagerly sought. We have used two-dimensional electrophoresis to examine the relationships among reference strains of New World Leishmania and stocks isolated from Colombian patients. The L. mexicana and L. braziliensis species complexes are shown to be extremely disparate, and the relative affinities of the subspecies reference strains and Colombian Leishmania stocks are documented. The latter displayed a variety of patterns--some clearly identifiable with a particular L. braziliensis subspecies reference strain, others intermediate between those of L.b. panamensis and L.b. guyanensis. Such comparisons are useful both in establishing relatedness and identifying subspecies and variant marker proteins, which may have biological significance. PMID- 6499180 TI - A "high-performance" 2D gel scanner. AB - We describe the design principles of a photometric flatbed scanner with a scan area of 250 X 250 mm2, a dynamic range of 4000 gray levels, a signal/noise ratio of 2000/1, a step size of 0.1 mm, and a step frequency of 2000 steps per second. It is controlled by a microcomputer and used to acquire data for quantitative evaluation of gels or chromatograms. The performance of the instrument is demonstrated by the data obtained by scanning gratings, gray step filters, and high-resolution electropherograms. PMID- 6499181 TI - Molecular characterization of an abnormal fibrinogen by two-dimensional electrophoresis. AB - We examined normal and abnormal fibrinogen (fibrinogen "Grenoble") by two dimensional gel electrophoresis to obtain data on possible defects at the molecular level. Fibrinogen Grenoble is characterized by an abnormal rate of fibrin monomer aggregation. The electrophoretic analysis revealed the presence of abnormal gamma chains. Two kinds of gamma chains can be detected in fibrinogen Grenoble: (a) normal gamma chains and (b) gamma chains Grenoble (gamma G) with a greater molecular mass but no modification in isoelectric point. The latter chain can be detected in whole plasma by two-dimensional gel electrophoresis. Metrological analysis was performed in an attempt to quantify observed differences between normal fibrinogen and fibrinogen Grenoble. On use of gels stained either with Coomassie Brilliant Blue or with silver, the partly qualified evaluation gives about 60% normal gamma chain and 40% gamma chain Grenoble. PMID- 6499182 TI - Pouring reproducible gradients in gels under computer control: new devices for simultaneous delivery of two independent gradients, for more flexible slope and pH range of immobilized pH gradients. AB - Recently we described (Electrophoresis 5: 143-147, 1984) a new device for producing density and solute gradients, involving computer-controlled cooperation of stepmotor-driven high-precision burettes, the purpose being to substantially improve reproducibility, flexibility, and documentation of gradients used in gels and in other applications in biochemistry. Here we present the functional principle of three modified and partly alternative devices, based on simultaneous delivery of a density gradient and a non-density gradient. They provide unlimited flexibility of choice for the slope of the non-density gradient, which is stabilized by the density gradient. They seem especially useful for pouring immobilized pH gradients in gels of wide pH ranges (between pH 3.5 and 10) where localized flattening of the gradient is needed to selectively improve resolution. Used in two-dimensional electrophoretic analysis, they should considerably improve control of spot coordinates, standardization of the technique, and interlaboratory data exchange. PMID- 6499183 TI - Advantages of separations on "giant" two-dimensional gels for detection of physiologically relevant changes in the expression of protein gene-products. AB - "Giant" 2-D gel electrophoretic protein separations (Methods Enzymol 91, part I, 190-214, 1983) offer a significant increase in resolving power over the usual methods. The increased capacity (good resolution up to 1 mg and as much as 10 mg of sample can be applied) and the improvement in resolution reveal some 3000 individual proteins when whole-cell extracts from diverse sources are separated on broad-range (pH 4.5-7.5) isoelectric-focusing (IEF) gels, and an additional 2000 when non-equilibrium and lower pH range IEF gels are also run. When applied to several types of steroid target cells, the giant-gel methods have allowed detection, among the minor protein species not resolved on standard-size gels, of a group of rapidly evolving (within the first 30 min or so) adrenal glucocorticoid inductions. These are likely mediators of the characteristic hormone effects. The giant gels have also greatly expanded the range of changes in protein gene-products in response to heat shock, growth factors, and retrovirus-induced malignant transformation, and should substantially enlarge the number of protein polymorphisms useful in genetic studies for linkage mapping. PMID- 6499184 TI - Can pharmacologic hyperprolactinemia and breast-suction induce lactation in women with normal menstrual cycles? AB - Six women--age range 21/24--with regular ovulatory cycles, voluntarily underwent with L-Sulpiride (100 mg/die) from the 5th to the 19th day of the cycle. On the 13th, 14th and 15th day of therapy breast suction by syringe breast-pump was performed on each woman every 6 hours and for 4' from either breast. Milk secretion was poor and showed no noticeable increase in the three days of breast suction. L-Sulpiride-induced hyperprolactinemia combined with nipple stimulation induced increased PRL secretion failed to stimulate milk secretion at a level comparable with physiologic lactation in puerperium. PMID- 6499185 TI - Misinterpretation of fetal heart rate monitoring in case of intrauterine death. AB - Electronic fetal heart rate monitoring has become a routine examination to assess fetal well-being. This report presents an unusual case in which maternal heart rate tachycardia was obtained from a dead fetus and was interpreted erroneously. The dead fetus conducted maternal ECG even through a scalp electrode by amplifying the input signal through the Automatic Control system of the monitoring equipment. The importance of concomitant maternal radial pulse recording or a real time scan is stressed. PMID- 6499186 TI - Conisation as an important point in the diagnosis and treatment of pre-invasive neoplasy. AB - 110 cases of conisation carried out in the Obstetric and Gynecological Clinic of the University of Padua between 1.1.74 and 31.12.82 have been considered. The operations were always performed on completion of diagnostic assertions comprising colpocytology, colposcopy and biopsy, this last undertaken upon indications from both colposcopic and colpo-cytological examinations. The comparison of the histological sample with the serial on the cone, with the cytological, colposcopical and bioptic ones, correspond in the importance of the lesion in almost 90% of cases. The reliability of the diagnosis by the three methods associated and then integrated by the conisation therefore approaches 100%. Prophylaxis carried out in this way allows a personalisation in the operation which, though respecting radicality, must be as non-demolitary as possible. PMID- 6499187 TI - Septic pelvic thrombophlebitis as an enigmatic cause of persistent puerperal fever course of disease diagnosis and treatment. AB - A rare case of septic puerperal pelvic thrombophlebitis is presented. This condition is an uncommon but potentially serious complication of pyogenic pelvic infection. The purpose of this report is to describe a particular form of septic pelvic thrombophlebitis (SPT) that frequently eludes diagnosis because of the absence of positive abdominal or pelvic findings. Our recent experience with this entity is interesting, because of the striking effect of heparin after many days of unsuccessful high dose multiple antibiotic treatment. PMID- 6499188 TI - Colposcopic pictures in cervical intraepithelial neoplasia grade III. AB - This study concerns 414 women affected by cervical intraepithelial neoplasia grade III. In each case we have considered and compared the colposcopic examination and the cyto-histologic type of lesion. Ectopy and/or typical transformation prevail in atypical metaplasia. Leukoplakia has its highest incidence in severe dysplasia, is prominent in severe dysplasia and carcinoma in situ unless these two lesions are combined atypical metaplasia. The mosaic prevails in atypical metaplasia, but appears in a prominent form in carcinoma in situ only, whereas the punctation prevails in carcinoma in situ. When the suspect white areas appear in association their incidence in the various CIN III lesions they do not vary. The red suspect areas are rather infrequent, while the atypical transformation is absent in atypical metaplasia, fairly frequent in carcinoma in situ and prevails significantly in microinvasive carcinoma. PMID- 6499189 TI - Vaginal delivery after previous cesarean section. AB - The Authors evaluate the percentage of vaginal delivery after previous cesarean section, in a group of 57 patients. Results show that 34% of the patients delivered spontaneously, and when recurring causes are excluded the percentage rises to 39%. The Authors conclude that a careful monitoring of labour can prevent unnecessary cesarean section in patients who underwent previous surgical delivery. PMID- 6499190 TI - Decalcifying algodystrophy of the hip in pregnancy. A case report. AB - Description of a case of decalcifying algodystrophy of the hip in pregnancy, an infrequent syndrome of unknown etiology, characterised by pain in the hips, radiographic picture showing demineralization of the head of the femur and of the acetabulum, leaving unchanged the articular rima; generally rapid and with spontaneous regression after delivery. PMID- 6499191 TI - Addisons's disease in pregnancy. AB - The Authors show a rare case of Addison's disease in pregnancy, in a 27 year old patient, under cortisonic therapy. They propose the current diagnostic therapeutic orientations relating to maternal foetal risks. PMID- 6499192 TI - Post cesarean section urinary tract infections, risk factors and prophylactic antibiotic treatment. AB - Two hundred and seventy eight women undergoing Cesarean section were evaluated retrospectively to determine the value of prophylactic antibiotic treatment on post-operative urinary tract infection morbidity. One hundred eight women who received no prophylactic treatment, and ninety eight treated prophylactically with ampicillin and colistin (colliracin). The effect of various obstetrics parameters including parity, previous Cesarean section, duration of labor and maternal anemia on the rate of infection was studied. Significant difference in the rate of infection after the introduction of prophylactic treatment was found. Morbidity rate was reduced to 6.1% in patients treated with ampicillin and collistin compared to 16.1% in the control group (P less than 0.001). The risk group for developing urinary tract infection were those who stayed more than two hours in the delivery room or with hemoglobin blood level less than 12 gr/D.L. PMID- 6499193 TI - Links in the chain: an approach to the treatment of drug abuse on a professional football team. PMID- 6499194 TI - The St. Jude Medical cardiac valve versus the Bjork-Shiley prosthetic valve in the mitral position: a preliminary report. PMID- 6499195 TI - Intractable seizure disorders of childhood. PMID- 6499196 TI - The 1984 JNC report on hypertension (Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure) PMID- 6499197 TI - Pulmonary embolism: a review of 200 cases with emphasis on pathophysiology, diagnosis, and treatment. PMID- 6499198 TI - Progressive facial and cerebral hemiatrophy. PMID- 6499199 TI - Fibrodysplasia ossificans progressiva presenting as fibrous scalp nodules. PMID- 6499200 TI - Congenital lymphedema of genitalia and extremities. PMID- 6499201 TI - Nodular regenerative hyperplasia of the liver: a cause of noncirrhotic portal hypertension. PMID- 6499202 TI - Glucose-6 phosphate dehydrogenase deficiency: an easy and sensitive quantitative assay for the detection of female heterozygotes in red blood cells. AB - Different methods for the quantitative determination of glucose-6-phosphate dehydrogenase (G-6-PD) were compared and one of them found to be highly precise. Maleimide inactivation of 6-phosphogluconate dehydrogenase (PGD) was investigated. It was shown that this inactivation is time-dependent and causes loss of assay precision. The most precise method was adapted to lysates of red blood cells from females, known to be heterozygote for G-6-PD deficiency and from non-deficient males and females. Heterozygote gene carriers were detected at a rate of 97.0%. PMID- 6499203 TI - Determination of 3 methyl-L-histidine in human urine by ion exchange high performance liquid chromatography. Applications to patients in post-operative surgical care. AB - A new chromatographic procedure is proposed for measuring 3 methyl-L-histidine (3 MH) in human urine. The sample was purified on a cation-exchange resin (AGR 50W X4) and analysed by ion exchange high performance liquid chromatography on a PARTISIL 10 SCX Whatman column in UV light at 210 nm within 16 min. This procedure gave similar outputs of 3 MH to those described in human normal urine (mean +/- SEM = 213 +/- 15 mumol X 24 h-1, n = 19). It was used to measure the urinary outputs of 3 MH of five patients admitted to an intensive surgical care unit, for 48, 28, 25, 15 and 10 days, respectively. The urinary outputs of 3 MH were normal or lower than normal. The 10(3) urinary 3 MH/creatinine molar ratios were also calculated; this new 3 MH analysis could help the reanimator to prescribe an adequate nutritional assessment. PMID- 6499204 TI - Increased calcium uptake in the red cells of unsplenectomized patients with hereditary spherocytosis: significant contribution of reticulocytosis. AB - The presence of abnormal calcium (Ca) metabolism in the red cells of hereditary spherocytosis (HS) patients has long been in dispute. Thus, to clarify the discrepancies of experimental results published previously, Ca metabolism in the red cells was investigated in 12 unsplenectomized and 6 splenectomized HS patients. A marked increase of Ca uptake was observed in the ATP-depleted red cells of the unsplenectomized HS patients. The increased red cell Ca uptake was normalized after splenectomy in the same HS patients. The extent of increased Ca uptake was well correlated to the degree of reticulocytosis (p less than 0.001). The observation was confirmed by the fractionation studies of the HS red cells. Ca uptake was not increased in the spherocyte-rich bottom fraction, if reticulocytosis was not present. No significant difference was observed in red cell calcium content between normal and HS patients, neither unsplenectomized nor splenectomized. PMID- 6499205 TI - Biochemical assessment of bone disease in multiple myeloma. AB - In patients with multiple myeloma, with moderate and severe bone disease, the urinary hydroxyproline excretion was disproportionately elevated with respect to the activity of bone isoenzyme of alkaline phosphatase when compared with the relationship between the variables observed in 58 age- and sex-matched controls and in 50 healthy young subjects. A significant positive correlation was found between urinary hydroxyproline excretion and the clinical variables related to the extent of bone involvement in multiple myeloma (X-rays, patient's performance status, anaemia). In 9 out of 13 patients with moderate and severe bone disease the chemotherapy-induced remission was associated with a significant (p less than 0.05) rise in the activity of bone isoenzyme of alkaline phosphatase and decrease (p less than 0.005) in urinary hydroxyproline excretion. In successfully treated patients, the relationship between the biochemical variables indicated increased but proportionate extents of whole-body rates of bone formation and resorption. This was not the case in patients in whom no chemotherapy-induced remission was noted. The simultaneous evaluation of the activity of bone isoenzyme of serum alkaline phosphatase and urinary excretion of hydroxyproline improves the assessment of bone involvement in multiple myeloma and the efficacy of treatment. PMID- 6499206 TI - Studies of the biochemical and immunological properties of human neutrophil alkaline phosphatase with comparison to the established alkaline phosphatase isoenzymes. AB - A range of affinity column chromatographic procedures and various inhibitors have been used to compare human neutrophil alkaline phosphatase with the three established isoenzymes. The column chromatography studies have clearly distinguished neutrophil alkaline phosphatase from the intestinal isoenzyme. Inhibition studies with L-phenylalanine, L-homoarginine and levamisole have revealed a distinct pattern of inhibition for liver, kidney and neutrophil alkaline phosphatase which is quite different from the pattern shown by placental and intestinal alkaline phosphatase. Immunospecificity experiments with a monoclonal antibody raised to human liver alkaline phosphatase have shown that it cross reacts with alkaline phosphatase from kidney, bone and neutrophil. In all studies, neutrophil alkaline phosphatase has virtually identical properties to that of liver, kidney and bone alkaline phosphatase. This is strong evidence that neutrophil alkaline phosphatase is a product of the same structural gene which codes for the liver/bone/kidney group of human alkaline phosphatases. PMID- 6499207 TI - Serum sulfate levels in patients with cystic fibrosis. AB - Patients with cystic fibrosis (CF) secrete copious amounts of mucous material which is viscous, tends to accumulate in the respiratory tract and contains larger than normal amounts of sulfate. The present investigation was designed to measure sulfate levels in the serum of patients with cystic fibrosis by ion chromatography of protein-free serum aliquots. The level of inorganic sulfate in the serum of non-cystic fibrosis pediatric patients averaged 0.29 +/- 0.03 mmol/l while patients suffering from cystic fibrosis had an average serum sulfate value of 0.27 +/- 0.03 mmol/l which was not significantly different from controls. No differences were observed in serum sulfate levels among males and females of either group of patients. There was a tendency for serum sulfate levels to decrease with age, but there was no statistically significant difference in serum sulfate levels between cystic fibrosis patients and normals as a function of age. These findings indicate that the highly sulfated mucoid materials secreted by cystic fibrosis patients are not reflected in abnormal serum sulfate levels. PMID- 6499208 TI - Prolidase deficiency: characteristics of human skin fibroblast prolidase using colorimetric and fluorimetric assays. PMID- 6499209 TI - A new spectrophotometric method for determining triglycerides in serum. PMID- 6499210 TI - Lipid- and lipoprotein values in octo- and nonagenarians free from overt degenerative arterial disease. AB - In any attempt to prevent the development of diseases in which known risk factors are involved, it is important to know the mode of correlation between risk factors and disease development. If the mode is an 'all-or-nothing' one, the maximum safe exposure limit is a vital parameter. If the correlation follows a continuous curve (as is the case in the lipid hypothesis of atherogenesis), a description of the natural distribution of risk factor compared with disease development is of interest. As such data are rare in unselected high-age groups and unknown in the very old without vascular disease, the distributions of total cholesterol and triglycerides, LDL- and HDL-cholesterol in 243 selected persons are communicated. PMID- 6499211 TI - The elucidation of adrenal-cortical status by measuring two-hour urinary-free cortisol levels. AB - Urinary-free cortisol (UFC) measured in 24-h samples has provided unambiguous data regarding adrenal-cortical status, but collection is cumbersome and compliance is a problem. We reasoned that measuring UFC in 2-h samples collected at strategic times would distinguish patients with adrenal-cortical disorders from normal subjects. Patients with Cushing's syndrome demonstrated late P.M. (samples collected between 2000 and 2400 h) 2-h UFC levels that were greater than or equal to 12.0 micrograms/2 h (reference interval for this time period is 0.1 3.2 micrograms/2 h, n = 35). Several patients with various symptoms of Cushing's syndrome displayed late P.M. levels within the reference interval. Those with adrenal insufficiency had morning (collected between 0500 and 0900 h) levels less than or equal to 0.2 microgram/2 h (reference interval 1.7-21.2 micrograms/2 h, n = 37). These data indicate that adrenal-cortical status is reflected by measuring UFC levels in 2-h samples. PMID- 6499212 TI - The effect of D-carnitine on palmitate oxidation in cultured fibroblasts. PMID- 6499213 TI - An evaluation of three commercial methods for the determination of LDL cholesterol. PMID- 6499214 TI - Direct and continuous measurement of Na+ effluxes with an ion-selective electrode of [Na+] in human erythrocytes. PMID- 6499215 TI - A rapid chemiluminescence-based method for the determination of total polyamines in biological samples. PMID- 6499216 TI - Determination of pipecolic acid in human blood plasma by high-performance liquid chromatography. PMID- 6499217 TI - Outdated blood and redundant buffy-coats as sources for the preparation of multiparameter controls for Coulter-type (resistive-particle) hemocytometry. AB - Outdated, buffy-coat depleted, CPDA-1 blood and redundant buffy-coats were used as sources for the laboratory preparation of controls for Coulter-type (resistive particle) hemocytometry. Deteriorated white blood cells and platelets and potentially interfering microaggregates with volumes not exceeding 400 fl are shown to be virtually completely removed by centrifugation and filtration. Addition of fixed red blood cells as white blood cell substitutes and of isolated, fixed platelets enable the preparation of multiparameter controls of short-to-medium-term stability. The availability of these simple, inexpensive controls can contribute significantly to optimal internal quality control in hemocytometry. PMID- 6499218 TI - The significance of total creatine kinase activity and isozyme determinations in cerebrospinal fluid of neurological patients. AB - Total CK activity is often increased in cerebrospinal fluid samples in neurological diseases (35%). These increased levels are frequently caused by CK M chain activity and appear to have no diagnostic relevance. Furthermore, an obvious concentration gradient for total CK activity was often observed in two subsequent tubes from the same lumbar puncture. In this study, CK non-M activity is measured, being the sum of all CK activity not caused by the M-chain. A bioluminescence technique using anti-M-inhibiting antibodies was used for this purpose. In two subsequent tubes from the same lumbar puncture a difference of 8% in CK non-M activity was found. A similar gradient could be observed for total protein. Retrospectively, the correlation between CK non-M levels and the amount of brain tissue damage was studied in 81 neurological patients and in 19 healthy subjects. There was an obvious relation between the extent of brain tissue damage and the CSF CK non-M levels. The clinical results in this study are promising and justify a prospective study of the diagnostic relevance of this parameter in CSF in various patient groups. PMID- 6499219 TI - Analysis of assay errors in drug measurements from the Heathcontrol interlaboratory quality assessment schemes. AB - Measurements of drug concentrations from the Heathcontrol quality assessment schemes were analysed to detect the presence of intralaboratory, interlaboratory, or intermethod errors. We developed weighted least-squares regression procedures as significance tests for evaluating intralaboratory noise, curvature vs linearity, proportional errors and additive errors. The latter intercept test for additive errors was unsatisfactory and an effective alternative based on the difference between measurements and estimates of the true drug concentrations was developed. Significance of residuals was tested against the population noise, which was defined by smooth mathematical functions fitted to the standard deviation (SD) data for the drug samples. We evaluated these tests for 1,647 sets of data. Only small amounts of curvature were present, validating the linear regression approach. Both random and proportional errors were demonstrated. The most frequent errors were additive in nature, components of which were demonstrated to be the result of intermethod differences. PMID- 6499220 TI - Polymeric complexes and fragments of albumin in normal human plasma. AB - Nitrocellulose blots of normal human plasma proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis were examined for polymeric complexes and fragments of albumin using an immunoperoxidase-labelled mouse monoclonal anti human albumin antibody. Under reducing conditions, no polymeric complexes were seen. Under non-reducing conditions, polymeric complexes were detected at the following molecular weights: 210 000, 168 000, 147 000, 132 000, and 110 000. These probably represent both homo- and heteropolymers of albumin. Fresh plasma samples were also analyzed by S-200 chromatography with the same results indicating that detection of polymeric complexes was not an artifact of the sodium dodecyl sulfate-polyacrylamide gel electrophoresis technique. In quantitative terms, polymeric complexes constituted 0.3-2.8% of the total albumin present. Fragments of albumin were also seen in normal human plasma with molecular weights of 45 000, 28 000 and 19 000. These fragments probably represent breakdown products of albumin in normal blood, and they constituted less than 2% of the total albumin present. PMID- 6499221 TI - Hemodialysis does not affect erythrocyte sodium-lithium countertransport. AB - Sodium-lithium countertransport measurements on erythrocytes are currently of interest because some hypertensive subjects and their relatives have abnormally high values. Woods et al [1] reported that red cells taken from dialysis patients after hemodialysis had significantly lower sodium-lithium countertransport than before dialysis. They suggested that sodium-lithium countertransport is influenced by 'a dialyzable plasma factor'. We conducted experiments to further evaluate their observations relating to the 'dialyzable plasma factor'. However, we have been unable to confirm their findings. Neither an effect of hemodialysis on sodium-lithium countertransport in erythrocytes from maintenance dialysis patients nor any effect of dialysis on normal erythrocytes in vitro was evident. Our results do not support the existence of a dialyzable plasma factor affecting sodium-lithium countertransport. PMID- 6499222 TI - Serum creatine kinase activity following a 120-km march. AB - Serum creatine kinase (SCK) was measured in 19 well-trained athletes before, immediately after and 24 and 72 h after a 120-km, non-stop march. The mean level before the march was 97.6 +/- 46.6 (SD), immediately after the march 1072.8 +/- 708 microns/l, and 72 h later 185.6 +/- 106.2 microns/l. It is concluded that elevated SCK levels may persist for 72 h after a long march. PMID- 6499223 TI - Raised CK-MB isoenzyme after exercise in a patient with alcoholic myopathy. AB - The relation between exercise, total serum creatine kinase activity, and serum creatine kinase MB isoenzyme in a patient with alcoholic myopathy was investigated. After a short-term exercise the serum values of creatine kinase MB isoenzyme rose to high levels within hours. This finding is important for obvious differential diagnostic reasons. PMID- 6499224 TI - A new direct radioassay for the determination of true erythrocyte hexokinase activity. PMID- 6499225 TI - Evaluation of the hydroxyproline isomers in blood serum. PMID- 6499226 TI - Comparison of two methods for amniotic fluid cholinesterases identification in the qualitative test for prenatal diagnosis of neural tube defects. PMID- 6499227 TI - Urinary protein determination using Coomassie Brilliant Blue in the presence of sodium dodecyl sulphate. PMID- 6499228 TI - Histamine N-methyltransferase preparation used for histamine assay contains endogenous histamine. PMID- 6499229 TI - Analysis of the fatty acid composition of human serum lipids by high performance liquid chromatography. PMID- 6499231 TI - Meta-iodobenzylguanidine in metastatic phaeochromocytoma. AB - A case of metastatic phaeochromocytoma is presented. Meta-iodobenzylguanidine was used to locate the tumour but failed to show two functioning abdominal metastatic deposits. Although meta-iodobenzylguanidine appears to be highly specific for phaeochromocytoma, a negative scan does not exclude a functioning tumour with confidence. PMID- 6499230 TI - The role of endogenous opioids in the chlorpropamide alcohol flush. AB - The response of plasma immunoreactive met-enkephalin (IR-met-enkephalin) to ethanol (8 g by mouth) after chlorpropamide (250 mg daily for 14 d) was studied in three groups of non-insulin dependent diabetics (a) six diabetics who showed chlorpropamide alcohol flush (CPAF) and in whom the reaction could be blocked by indomethacin, (b) five diabetics who showed CPAF but in whom the flush could not be blocked by indomethacin and (c) five diabetics who did not show CPAF. A rise in plasma IR-met-enkephalin was observed in all three groups. When the two groups of flushers were re-tested with the addition of an infusion of naloxone a rise in plasma IR-met-enkephalin was still demonstrated in both groups regardless of whether the flush was blocked by naloxone. Naloxone blocked the flush only in those six subjects whose flush could be blocked by indomethacin. In five subjects, all flushers, CPAF was tested using intravenous and oral ethanol in doses producing similar plasma ethanol levels. A facial flush was induced by both intravenous and oral ethanol. In three flushers, plasma IR-met-enkephalin levels were measured during CPAF testing with both intravenous and oral ethanol. None showed a rise in plasma IR-met-enkephalin after intravenous ethanol, despite the appearance of a facial flush, whereas all showed a rise after oral ethanol. We therefore conclude that CPAF is unlikely to be caused by a rise in plasma IR-met enkephalin. PMID- 6499232 TI - Recurrence of nontoxic goitre with and without postoperative thyroxine medication. AB - The incidence of postoperative recurrence of nontoxic goitre was evaluated in 175 patients. The average observation period was 8.8 years. Levothyroxine (Eltroxin) had been taken by 104 of these patients as long-term prophylaxis against goitre recurrence. Ten (9.5%) of the 104 had recurrence. The other 71 patients received no or only brief thyroxine medication postoperatively. In this group there were eight recurrences (11.3%). The difference was not significant, nor did the two groups differ significantly in regard to sex and age distribution, pathologic anatomy and observation time. Routine long-term administration of thyroxine after thyroid resection is not justified from the results of this study. PMID- 6499233 TI - Inhibitory effect of cimetidine on L-dopa-stimulated growth hormone release in normal man. AB - Some evidence suggests the existence of a histaminergic influence on GH secretion in animals and man. We used cimetidine, a specific H2-receptor antagonist, to study the possible interference of H2-receptor blockade on plasma GH release by L dopa and on PRL inhibition by L-dopa in normal man. Seven healthy normal male volunteers aged 23-36 years received a single oral dose of L-dopa (500 mg) or an i.v. bolus of cimetidine (300 mg) or both (L-dopa 30 min before cimetidine). Blood samples were taken at various times over 2 h and plasma GH and PRL levels measured. Cimetidine alone did not alter basal plasma GH values; L-dopa elicited the well-known GH releasing effect with peak values at 75 min (15.65 +/- 2.8 ng/ml); cimetidine injected 30 min after L-dopa ingestion significantly blunted the GH response to L-dopa and peak values (4.7 +/- 1.6 ng/ml) were delayed to 105 min. Cimetidine provoked a rapid rise in plasma PRL with the peak value of 15 +/- 3 ng/ml at 15 min, followed by a return to near basal values in 90-120 min. L Dopa completely inhibited the PRL response to cimetidine. We conclude that there is an inhibitory influence of the H2-receptor antagonist cimetidine on GH release by L-dopa. This, together with the action of cimetidine on PRL secretion (with or without L-dopa), suggests a possible antidopaminergic effect of H2-receptor blockade at the level of the central nervous system. PMID- 6499234 TI - Total deficiency of corticosteroid-binding globulin. AB - An obese 15-year-old boy of Jewish Iranian origin who is the offspring of consanguineous parents was found to have very low levels of total cortisol in the plasma. Investigation of the family revealed a complete lack of cortisol-binding globulin (CBG) in the proband and a sister, evidently the first cases of total CBG deficiency to be reported. The parents and a brother were found to have half the normal levels. This study indicates that CBG deficiency, a benign condition, is compatible with a codominant or recessive autosomal trait inheritance. PMID- 6499235 TI - The relationship of plasma ionized calcium to cardiovascular disease endpoint and family history of hypertension. AB - Plasma ionized calcium and total calcium were measured on 271 individuals from 34 Utah pedigrees divided into groups defined by the method of pedigree ascertainment: 1) hypertension clusters, 2) early stroke death clusters and 3) clusters of early heart attack deaths. Normotensive individuals were also categorized by family history of hypertension. Members of stroke cluster pedigrees had higher mean plasma ionized Ca2+ than either hypertension pedigrees (p less than 0.05) or coronary artery disease pedigrees which had the lowest concentrations (p less than 0.001). Within the normotensive group, those subjects with a positive family history of hypertension exhibited significantly higher plasma ionized Ca2+ (2.18 +/- 0.10 (S.D.) mEq/l) than individuals without a family history of hypertension (2.12 +/- 0.08 mEq/l, p less than 0.01). In medicated hypertensives, both ionized (p less than 0.05) and total (p less than 0.01) plasma calcium were higher than calcium levels in the normotensive negative family history subjects. Plasma ionized Ca2+ in the adult normotensives (N = 134) had significant age corrected positive correlations with plasma sodium (r = 0.25, p less than 0.01), potassium (r = 0.29, p less than 0.001) and erythrocyte sodium lithium countertransport values (r = 0.20, p less than 0.05). These findings provide additional evidence that plasma ionized calcium concentrations may be important to help define the heterogeneity of hypertension in adult Americans. PMID- 6499236 TI - Serum concentration of Na, K, Ca, Mg, P, Zn and Cu in patients with essential arterial hypertension. AB - Serum concentration of Na, K, Ca, Mg and inorganic phosphate as well as serum levels of Zn and Cu were determined in control subjects and in patients with essential arterial hypertension (EAH) divided according to the stage of the disease. No significant differences were found between the serum mean levels of Na, K, Ca, Mg, Zn and Cu in controls and in patients with EAH. A significant decrease of the serum Zn was noted in the third stage of EAH. A number of cases with hypomagnesemia and/or hypopotassemia probably caused by a long term uncontrolled therapy was also detected. The concentration of inorganic phosphate was significantly lower in patients with EAH associated with overweight than in hypertensive patients with normal body weight and in controls. It is considered that a sustained study of the complex interrelationship between electrolyte interaction and the functional aspects of the arterial wall could still contribute to a better understanding of pathogenic aspects of EAH and of its complications including those subsequent to modern diuretic therapy. PMID- 6499237 TI - Blood pressure responses to prolonged infusions of adrenaline and noradrenaline in conscious dogs. AB - Adrenaline was infused intravenously into conscious dogs to test whether chronically elevated plasma levels can produce arterial hypertension. Adrenaline infused at 12.5 micrograms/kg/hr from 4 days produced no change in mean arterial pressure (1.1 +/- 2.7 mmHg) despite raising plasma adrenaline concentrations from 49 +/- 20 pg/ml to 1420 +/- 279 pg/ml. Myocardial tissue levels of adrenaline averaged 435 ng/g, compared to 20 ng/g in vehicle infused dogs. Longer infusions of adrenaline (11 days) at doses from 1.25 micrograms/kg/hr to 12.5 micrograms/kg/hr were also without significant effect on arterial blood pressure. In contrast, infusion of noradrenaline at 6.25 micrograms/kg/hr for 11 days produced sustained elevation of mean arterial pressure (11.7 +/- 5.1 mmHg). Although adrenaline infusion alone did not alter arterial pressure, a small rise (5.6 +/- 1.6 mmHg) was measured when the dogs were also given cortisone (50 mg twice daily). These results are therefore not in accord with the hypothesis that increased plasma levels of adrenaline may cause hypertension by activation of pre junctional beta-adrenoceptors. However simultaneous administration of adrenaline and cortisone did elevate blood pressure, indicating that increases in both adrenal cortical and medullary hormones may be required to produce hypertension. PMID- 6499238 TI - Centrally-induced vasopressor responses to ouabain are augmented in spontaneously hypertensive rats. AB - Dihydroxyouabain (ouabain), 1.0-10 micrograms, per rat, injected intracerebroventricularly, produced dose-related vasopressor responses accompanied by corresponding increases in abdominal sympathetic nerve activity in 16 weeks old Wistar (NT) rats anesthetized with urethane. The heart rate then also increased, dose-dependently, to ouabain injected in doses up to 10 micrograms. However, 100 micrograms produced arrhythmia resulting in bradycardia. Pressor effects were appreciable within one minute after the ouabain injection, but did not become maximal until between 7-10 min later. Either the removal of sympathetic vasomotor tone by surgical section of the spinal cord or intravenous pretreatment with a vasopressin antagonist significantly reduced the vasopressor responses in the NT rat. Ouabain, 10 micrograms, injected intraventricularly in 16 weeks old Kyoto Wistar rats produced similar cardiovascular responses to those in the NT rat, but the magnitude of the blood pressure responses, along with the heart rate and sympathetic responses, was larger in SHR than in WKY. These results suggest that dihydroxyouabain acts centrally to elevate the blood pressure by increasing not only the sympathetic discharge but also, perhaps, the secretion of vasopressin. In light of previous studies showing that SHRs exhibit both sympathetic hyperactivity and hypersecretion of vasopressin, the present results suggest that their enhanced responsiveness to ouabain could result from both the sympathetic hyperactivity and an enhanced vasopressin release as a result of the centrally injected ouabain. PMID- 6499239 TI - Melatonin in serum and the pineal of spontaneously hypertensive rats. AB - Involvement of melatonin in the blood pressure regulation as an endogenous central hypotensive factor has been suggested in rats and in man. We studied the relationship between melatonin and the development of hypertension in 5- and 15 week-old spontaneously hypertensive (SHR) and normotensive Wistar Kyoto (WKY) rats, by measuring serum and the pineal concentrations with a sensitive and specific radioimmunoassay coupled with a novel extraction method. Serum melatonin concentration at midnight in young SHR rats was significantly higher than that in age-matched WKY rats (P less than 0.01), whereas it was decreased in the adult SHR (P less than 0.01). No such differences were observed at noon. Pineal content of melatonin at midnight in 5-week-old SHR rats was lower than in age-matched WKY rats (P less than 0.01). These data demonstrate that melatonin in the nocturnal serum of SHR rats is elevated at prehypertensive stage while it is decreased after the development of hypertension. The role of melatonin in the hypertensive process in SHR rats requires further study. PMID- 6499240 TI - The diagnosis and management of psychogenic facial pain disorders. PMID- 6499241 TI - High frequency ventilation in laser surgery of the larynx. AB - For endolaryngeal laser surgery an anaesthetic technique is required which provides the surgeon good access to the larynx. High frequency ventilation of the lungs using a FG 14 insufflation catheter covered by aluminium foil has proved to give a nearly optimal condition for the surgeon, while the fully paralyzed patient is very well ventilated. This has been used in more than 1000 patients, 200 of them have been treated by the laser beam in the airway. A method of total intravenous anaesthesia is described using short acting drugs. This way early awakening after surgery in the airways prevents aspiration of blood or debris into the lungs. PMID- 6499242 TI - The concept of an artificial tympanic membrane. AB - A review is given of the development of the concept of an artificial tympanic membrane. Starting with homologous tympanic membranes we compared biodegradable collagen materials (homologous and heterologous) and biodegradable synthetic materials, poly-glycolic acid, poly-lactic acid and poly-alpha-amino acids. As a non-degradable material microporous PTFE and bisphenol-A poly (carbonate) were investigated. It is concluded that either poly-alpha-amino acid or PTFE with poly alpha-amino acid maybe a suitable material for an artificial tympanic membrane. PMID- 6499244 TI - Chorionic villi sampling under direct vision. PMID- 6499243 TI - The impact of large Y chromosome on pregnancy, foetus and birth. AB - In a current investigation of children born in the Arhus area (Denmark) chromosome examinations were made in 6,691 newborns. Of these children, 170 boys had a large Y chromosome (2.6%). The present material was examined using a bi variate stratified analysis to eliminate social and simple biological factors that could act as confounders. No increased frequency of malformations was found, and birth weight and length was nearly equal in the probands and the controls. A significantly increased frequency of prostaglandin stimulation of labour was found for the mothers of the Yq+ boys. Differences in the frequency of mechanical disproportion or abnormal presentation could not explain this. The Yq+ boys suffered more frequently from intrauterine asphyxia leading to acute Caesarean section. This finding cannot be explained by long-standing placenta problems alone. A possible mechanism which could link these findings together is suggested, and it is concluded that the boys with Yq+ most probably should be regarded as being at a certain risk at the time of birth. PMID- 6499245 TI - Detection of the fragile X chromosome and other fragile sites. AB - To assist in cell sample size selection and detect the fragile X chromosome, statistical tables have been presented. A comparable approach had been suggested earlier for the diagnosis of chromosome mosaicism. The cytologic detection of the fragile X or any fragile site is simply a special case in the detection of mosaicism. Minimum numbers of metaphases are recommended for fragile X analysis to have 95% confidence that the fragile X is not manifest in a given proportion of cells and similar recommendations apply to all other fragile sites. PMID- 6499246 TI - Date of conception and prevention of neural tube defects. AB - The authors studied the time of conception of 280 fetuses and liveborns with anencephaly or spina bifida seen in a French Canadian population during a period of six years. There is an evident seasonal variation in the conception of NTD fetuses. Using a wave statistical model applied to data recorded over a six year period the authors have rejected the "no variation between the six two-month intervals" hypothesis at a P less than or equal to 0.005 level. It is postulated that, in any vitamin intake or environmental program to prevent NTD in families at risk, one must take into account the annual and seasonal variations, ethnic groups identity and the date of conception in the choice of control mothers. PMID- 6499247 TI - The manifestations and natural history of spondylo-epi-metaphyseal dysplasia with joint laxity. AB - Spondylo-epi-metaphyseal dysplasia with joint laxity (SEMDJL) is characterized by severe dwarfism, articular hypermobility and progressive spinal malalignment. The clinical manifestations of 18 affected persons in 13 families of the Afrikans speaking community of South Africa have been analysed and it has become evident that survival into adulthood is unusual. SEMDJL is inherited as an autosomal recessive trait. PMID- 6499248 TI - Fetal mortality in oral cleft families (IX): factors relating to the occurrence of sporadic clefts. AB - Pedigree data on 854 probands with cleft lip and/or cleft palate from the State of Indiana are presented. These include 123 probands with cleft lip alone (CL), 453 with cleft lip and palate (CLP), and 278 with isolated cleft palate (CP). Probands and families were interviewed at the Indiana University Medical Center during the years 1962-1980. Among features of special interest are an excess of bilateral CLP (46% of all CLP cases) and a significantly greater number of older mothers and fathers (over 34 years old) than in the general population. An apparent increase in the proportion of sporadic cases with time may be due to bias in ascertainment. It is suggested that the increased proportions of more severe clefts and older parents are among several factors which contribute to the incidence of fetal mortality in a cleft population. The association of fetal mortality with liability to clefting introduces a more precise way to define a sporadic cleft. That is, a truly sporadic cleft is one conceived as a single occurrence event and has survived to become a liveborn cleft child whereas other apparently sporadic cleft individuals represent the surviving cleft in a sibship in which fetal mortality has eliminated all other cleft offspring already conceived. This observation has applications to the collection and interpretation of genetic pedigree data for clefts as well as many other genetic conditions. PMID- 6499249 TI - Controlled comparison of plasma and serum for cystic fibrosis protein. AB - Investigators who have previously reported attempts to utilize the isoelectric focusing (IEF) method to detect the cystic fibrosis protein (CFP) in blood samples from CF homozygotes and heterozygotes, and normal healthy controls have restricted their evaluations to serum samples. The requirement of using serum and the stringent conditions laid down for the collection, processing, and storage of serum samples have been impediments, however, to the successful use of the IEF method for CFP detection. We now report results obtained from controlled ("blind") comparative analyses of matched serum and plasma samples from CF homozygotes and heterozygotes, and normal healthy controls which indicate that the CFP is present in plasma and that heparinized plasma in particular may be a better fluid than serum for use in future studies on the CFP. PMID- 6499250 TI - Genital anomaly and cardiomyopathy: a new syndrome. AB - Two brothers, products of a consanguineous marriage, had severe hypoplastic genitalia and cardiomyopathy. These findings are similar to those of three other brothers of another consanguineous family who in addition had evidence of mental retardation. These five boys probably represent a previously undescribed syndrome of genetic origin but of poorly understood pathogenesis. PMID- 6499251 TI - The Coffin-Siris syndrome: report of a family and further delineation. AB - The familial occurrence of the Coffin-Siris syndrome, combining a typical facial appearance with hypoplastic or absent fifth finger- or toenails, is reported. The full expression of the syndrome was present in two sisters, and partial clinical manifestations were present in their mentally borderline father. The relevant literature is reviewed, and the relation and confusion with other mental retardation syndromes, mainly the Coffin-Lowry syndrome, is discussed. PMID- 6499252 TI - Duplication in chromosome 15q in a boy with the Prader-Willi syndrome; further cytogenetic confusion. AB - We describe a six-year-old boy with the typical features of Prader-Willi syndrome. Cytogenetic investigation revealed a chromosome aberration that has not been described yet, i.e. a duplication in the proximal half of 15q. Based upon banding-pattern the exact nature of the duplicated part could not be delineated. Both parents had a normal karyotype. Various hypotheses concerning the relationship between Prader-Willi syndrome and various chromosome 15 abnormalities are discussed. PMID- 6499253 TI - Parental determinants of birth weight. AB - As part of a study on causes of variation in birth weight, questionnaire data on parental measures were related to offspring birth weights recorded in the Medical Birth Registry of Norway. A genetic analysis of parent-offspring covariances in birth weight indicated that about 60% of the variance in birth weight could be explained by effects of fetal genes, while no effects of maternal genes were detectable. Multiple regression analysis showed that height and weight of both parents and maternal smoking status were associated with variation in birth weight. Socioeconomic status, educational attainment and paternal smoking habit had no independent effects. The adult, parental variables could only explain 10% of the variation in mean offspring birth weight. PMID- 6499254 TI - Diagnosing of chromosome abnormalities in Denmark. AB - A survey of how frequent chromosome abnormalities are diagnosed in Denmark prenatally as well as postnatally compared with the expected incidence in an 11 year period 1970-1980 has been made from the Danish Cytogenetic Central Register. Ten percent of the expected number of Klinefelter's syndrome, 41% of Turner's syndrome and 10% of other sex chromosome abnormalities in children born between 1970 and 1980 have been diagnosed until January 1, 1983. The total frequency of diagnosed cases with sex chromosome abnormalities is 13% of the expected number. Induced abortion was made in 62% of the cases with sex chromosome abnormalities diagnosed prenatally. Ninety percent of all cases with Down's syndrome were diagnosed by chromosome examination, and 10% were diagnosed prenatally and aborted. During the last part of the period from 1977-1980 this had increased to 20%. Thirty-seven percent of cases with other chromosome abnormalities were diagnosed. Among the expected 4,396 children with chromosome abnormalities to be born between 1970 and 1980, a total of 39% were diagnosed postnatally until January 1, 1983, and 10% were diagnosed prenatally. It is concluded that there is a great need for training consultants in clinical genetics, expansion and further decentralization of cytogenetic service with more cytogenetic laboratories and employment of clinical geneticists in all 14 Danish counties. PMID- 6499255 TI - Long arm deletions of the X chromosome and their symptoms: a new case (bp q24) and a short review of the literature. AB - The clinical and cytogenetic data from a 26-year-old female with del(X)(q24--- ter) are reported. This breakpoint has not been described yet. Besides this report we give a comparative summary of 24 cases from the literature with different deletions of Xq. PMID- 6499256 TI - Oculocutaneous albinism and anterior chambre cleavage malformations. Not a coincidence. AB - We report on 6 patients out of a group of 86 albinos, with an additional eye defect: an anterior chamber cleavage disorder, i.e. a frequency of 7%. Given this high percentage of the coexistence of these two, we believe that this is not a coincidence. PMID- 6499257 TI - Klinefelter syndrome and two fragile X chromosomes. AB - Two fragile X chromosomes were found in 20% of the cells in a moderately mentally retarded patient with Klinefelter syndrome. PMID- 6499258 TI - Autosomal dominant lamellar ichthyosis: a new skin disorder. AB - Lamellar ichthyosis (nonbullous congenital ichthyosis) has been explained as an autosomal recessive trait. We have found an autosomal dominant type of this disorder. Four patients, belonging to three consecutive generations of a family, were affected from birth. The disorder was characterized by large, dark brown scales covering the entire body including flexural folds, palms and soles. X linked recessive ichthyosis was excluded by clinical appearance, pattern of transmission and normal electrophoretic mobility of beta-lipoproteins. Autosomal dominant ichthyosis vulgaris and bullous ichthyosiform erythroderma were excluded by the histological and ultrastructural features. In the absence of a positive family history, this skin disorder would have been taken for autosomal recessive lamellar ichthyosis. This new autosomal dominant type of ichthyosis should be considered for differential diagnosis, when genetic counselling is given in a sporadic case of lamellar ichthyosis. PMID- 6499259 TI - Familial 5p- syndrome. AB - This report concerns a mother and son with a small terminal deletion of the short arm of chromosome 5 (del(5)(qter----p15.1:). Both mother and son had superficial resemblance to patients with classical Cri-du-Chat Syndrome, but lacked the severe mental and growth retardation generally associated with such cases. PMID- 6499260 TI - A supernumerary microchromosome in amniotic cell cultures and talipes equinovarus in a live born female. AB - Amniocentesis for advanced maternal age resulted in the demonstration of a supernumerary microchromosome in the amniotic fluid cells. Cytogenetic analysis of peripheral blood from the female infant revealed a mosaic karyotype 46,XX/47,XX, + marker. The only anomaly noted in the infant was talipes equinovarus. PMID- 6499261 TI - Maternal translocation t(13:18)(q34:q11) and Edward's syndrome in a fetus: 47,xy,t(13:18)(q34:q11) + 18. AB - A 32-year-old woman, who presented with four spontaneous abortions, was found to have a balanced translocation: 46,XX,t(13:18)(q34:q11). In the last pregnancy an amniocentesis was done. Abnormal constitution of the fetus had been detected: 47,XY,t(13:18)(q34:q11) + 18, and an abortion was induced. Examination of the fetal tissue confirmed the finding. The fetus showed the characteristics of Edward's syndrome. Through the patient's pedigree it was discovered that balanced translocation appeared in three generations. PMID- 6499262 TI - Two sibs with bilateral diaphragmatic defect. PMID- 6499263 TI - Birth intervals in oral cleft families. PMID- 6499264 TI - Comment on "Partial trisomy 11q...", report by De France et al. (1984) PMID- 6499265 TI - The fragile X syndrome. A study of 83 families. AB - The present report summarizes the experience on the mar(X) syndrome in a total of 157 male patients (44 prepubertal and 113 postpubertal) ascertained through 83 index patients from 83 families under investigation. In one third of the families pedigree data were consistent with X-linked recessive inheritance. In the further two thirds of the families the presenting symptom was familial mental retardation with a mentally retarded mother, or mental subnormality with hyperkinetic behaviour in the male patient. No more than 60% of the adult males presented the typical clinical triad (mental retardation-long face-megalotestes). The most characteristic finding in the mar(X) boy is the psychological profile with severe hyperkinetism, hypersensitivity, handbiting and autistic features in some of them. In 4 of the 27 large mar(X) pedigrees strong evidence was present of a possible transmission of the mar(X) through normal males. The high incidence of mental subnormality in the female offspring of heterozygote carriers, and the relationship between mental status, phenotype, age and expression of the mar(X) in different culture conditions is discussed. PMID- 6499266 TI - Isochromosome 18q with karyotype 46,XX,i(18q). Cytogenetics and pathology. AB - Cytogenetic and morphological findings of a 20-gestational-week-old female fetus with karyotype 46,XX,i(18q) are reported. The fetus displayed clinical features resembling Edward's syndrome. No characteristic symptoms of monosomy 18p could be observed. PMID- 6499267 TI - Familial occurrence of azoospermia and extreme oligozoospermia. AB - To determine the familial incidence of azoospermia and extreme oligozoospermia (AEO; sperm counts less than 3.10(6)/ml) 147 men with primary AEO were asked, by means of mailed questionnaires, for the occurrence of infertility among their brothers. 119 questionnaires were completed (81%). Out of a total of 163 informative brothers 7 were reported infertile, of whom 3 had a documented AEO. This incidence is probably about double the general population frequency. A familial case of congenital aplasia of the vasa deferentia was found; this has previously been reported to recur in a sibship and may represent a simple inherited disorder. PMID- 6499268 TI - New anomalies found in the 11q-syndrome. AB - The cytogenetic analysis of an infant with multiple congenital anomalies revealed a small deletion of the long arm of one No. 11 chromosome: 46XX del 11 (q23-q25). The main clinical manifestations included: trigonocephaly, flat broad nasal bridge, micrognathia, carp mouth, hypertelorism, low set ears, severe congenital heart disease, anomalies of limbs and external genitalia. In comparison to the previously reported cases of 11q-, the patient presented here had congenital anomalies not described before, including severe affected urogenital system, hypoplasia of the adrenal, accessory spleens and mild hydrocephaly. PMID- 6499269 TI - Interstitial deletion of the long arm of chromosome 6 [del(6) (q16q22)]: case report and review of the literature. AB - Partial monosomy of 6q resulting from an interstitial deletion of bands q16--- q22 was found in a 12-year-old boy manifesting mental retardation, seizure disorder, and dysmorphic features. The correlation of phenotypic expression and specific long arm deletions of chromosome No. 6 is discussed. PMID- 6499270 TI - Weyers acrodental dysostosis in a family. AB - A four generation family with postaxial polydactyly of hands and feet and dental anomalies is reported. Lower and upper incisors were abnormal in shape and number. Additional findings were prominent ear anthelices, hypoplastic and dysplastic nails and mild shortness of stature. Inheritance was dominant with variable expression. It is proposed that the family presents the syndrome of acrofacial dysostosis described by Weyers in 1952. To differentiate it from other acrofacial dysostoses, we suggest naming the condition acrodental dysostosis. PMID- 6499271 TI - Two fertile Turner women in a family. AB - Two fertile women, mother and daughter, both presenting sex chromosomal mosaicism (45,X/46,XX/47,XXX and 45,X/46,Xr(X] are reported. The mechanisms through which a Turner women can eventually be fertile are discussed. PMID- 6499272 TI - Abnormal chromosome in Prader-Willi syndrome. AB - A Prader-Willi Syndrome (PWS) patient was found to have an extra satellite chromosome, smaller than the normal Chromosome 22, in 60% of her metaphases. G- and C-bandings showed that the extra chromosome did not derive from a Chromosome 15 as has been reported in some PWS patients. Because of variation in chromosomal abnormalities in the PWS patients reported, it was concluded that the chromosomal abnormalities found in them may be a secondary phenomenon rather than the cause of PWS. PMID- 6499273 TI - Cytogenetics of Prader-Willi syndrome. PMID- 6499274 TI - A case of green hair--a consequence of exogenous copper deposition and permanent waving. PMID- 6499275 TI - An Irish family with variegate porphyria. PMID- 6499276 TI - White piedra--a case report and review of the literature. PMID- 6499277 TI - Twenty-nail dystrophy of childhood--two cases in one family. PMID- 6499278 TI - Erythema annulare centrifugum and malignant histiocytosis--report of a case. PMID- 6499279 TI - A cutaneous complication of Dorbanex therapy. PMID- 6499280 TI - Tinea capitis--trichophyton violaceum in east London. PMID- 6499282 TI - Changes in the populations of lymphoid cells in human peripheral blood following physical exercise. AB - Marked lymphocytosis occurs after exercise. In a study of healthy volunteers this was dominated by one population lacking T cell and B cell determinants and another expressing the Leu 2a phenotype (cytotoxic/suppressor). Lymphocytes from two individuals were characterised further and a near five-fold increase in cells expressing antigens associated with natural killer (NK) cells (Leu 7 and Leu 11) was noted. In addition, these emergent lymphocytes, unlike most T cells, lacked acid alpha-naphthyl esterase activity. In functional studies, exercise led to significantly greater NK activity but, in spite of altering the distribution of lymphocyte subpopulations, there was no detectable change in the proliferative response to the T cell mitogen, concanavalin A, over a wide range of cell concentration, mitogen dose and time. The numbers of low density macrophages and dendritic cells increased concomitantly with the increase in total lymphocytes. We conclude that exercise increases the proportion of circulating NK cells and cells expressing the Leu 2a phenotype. PMID- 6499281 TI - Flare-up of antigen-induced arthritis in mice after challenge with oral antigen. AB - Mice with unilateral chronic mBSA-induced arthritis were orally challenged with mBSA. Three hours after antigen challenge clear flare-up of the chronic arthritis was demonstrable as detected by an increase in the 99mTc uptake of the knee joint and the reaction continued for at least 2 days. The contralateral non-arthritic knee joint was not affected. The dose of mBSA needed to induce a flare-up in nearly all mice within a group was in the order of 20 mg. After oral challenge with 10 or 5 mg of mBSA the incidence was lower and flare-up reactions were only rarely observed after challenge with 2.5 or 1.25 mg mBSA. Histology of knee joints taken at 24 h after oral challenge of 20 mg mBSA revealed an increase in the number of cells in the infiltrate in the synovial tissue and exudate in the joint space, the most conspicuous sign being the increase of PMN. Passage of macromolecules through the gastrointestinal mucosa may be an important principle in the perpetuation of human chronic arthritis. PMID- 6499283 TI - Cells that mediate NK like cytotoxicity are present in the human delayed type hypersensitivity response. AB - By inducing delayed type hypersensitivity (DTH) responses under previously formed skin blisters we determined that cells which mediate natural killer (NK) like cytotoxicity are present in the DTH response in man. Similar levels of killing were not present in cells obtained from skin blisters not associated with positive DTH responses. The DTH response associated killer cell was found to be a mononuclear cell that had presumably undergone stimulation since it not only killed NK sensitive K-562 cells, but also NK resistant Daudi target cells. PMID- 6499284 TI - Improved standardization in the quantitative estimation of soluble immune complexes making use of an international reference preparation. Results of a collaborative multicentre study. AB - Heat aggregated immunoglobulin G (A-IgG) of restricted size and complement solubilized tetanus toxoid (Te): human anti-Te immune complexes (IC) were sent as coded test samples to eight laboratories for quantitative assessment by different IC assay techniques including C1q solid and fluid phase binding assays, conglutinin binding assay. Raji cell test and particle counting immunoassay. In addition, samples containing the same material at concentrations communicated to the laboratories for the performance of reference curves were included. The investigators were asked to estimate the quantity of A-IgG or Te:aTe in the coded samples by reference to both their own locally produced standards and to the A IgG and Te:aTe reference preparations of known concentrations. When calculated on the basis of locally prepared standards the range of concentrations found by the various laboratories and tests was 20-260 micrograms/ml for A-IgG (actual concentration 50 micrograms/ml) and 32-1,420 micrograms/ml for Te:aTe complexes (actual concentration 40 micrograms complexed antibody/ml). When read on the international candidate reference A-IgG preparation these ranges were 28-800 micrograms/ml and 35-800 micrograms/ml, respectively. The highest standardization efficiency was obtained when the Te:aTe reference curve was used for quantitation: the range of results obtained for A-IgG and Te:aTe coded samples being as narrow as 7-40 micrograms/ml and 34-68 micrograms/ml, respectively. Thus, when the content of the coded samples was estimated on the basis of the Te:aTe reference curves established in the laboratories a narrow clustering of the results was seen. It is proposed that the Te:aTe preparation, which has been found stable during storage for 2 years, could serve as a useful international reference preparation in the field of IC determination. PMID- 6499286 TI - Infections in haematology. PMID- 6499285 TI - Immune abnormalities in patients lacking a lymphocyte surface glycoprotein. PMID- 6499287 TI - Clinical and echocardiographic features of isolated severe pure mitral regurgitation. AB - Recent studies have shown that rheumatic heart disease is no longer the main cause of isolated severe pure mitral regurgitation. In this study, we evaluated various clinical and echocardiographic features found in the syndrome of mitral regurgitation. Our data is consistent with recent reports that mitral valve prolapse and coronary artery disease are now the predominant causes of mitral regurgitation and that rheumatic heart disease is a much less common etiology. In addition, our data suggest that clinical evaluation alone is usually very accurate in identifying the correct etiology. Various clinical and echocardiographic features found in the subsets of acute and chronic mitral regurgitation are described. Specifically, patients with acute mitral regurgitation were more likely to have echocardiographic evidence of segmental left ventricular dysfunction and flail mitral valve leaflet. In chronic mitral regurgitation, atrial fibrillation and left atrial dilatation were more commonly present. Echocardiography was found to be more useful in the detection of the complications of coronary artery disease rather than in identifying its presence. Patients with a New York Heart Association classification of IV and those with echocardiographic evidence of an increased left ventricular endsystolic dimension or left ventricular hypertrophy had a worse prognosis. PMID- 6499288 TI - Global left ventricular function and regional wall motion in pure mitral stenosis. AB - Global left ventricular function (LVF) and segmental wall motion of the left ventricle are registered in 113 patients presenting a pure mitral stenosis (MS) and in a control group of 50 individuals. The segmental wall motion is measured on the end-diastolic-end-systolic frames of the left ventricle, obtained from right anterior oblique (RAO) monoplane cineangiography. Measurement of the segmental wall shortening is performed using the Stanford method. Group 1 includes 68 patients (60% of the total number of patients studied). These patients show no pathological contraction abnormality. In this group, the global LVF is not different from the control group. Group 2 includes 45 patients (40% of the total) for whom contraction abnormalities are present: anterior hypokinesis in 20% of the cases (anterior area mean shortening (AAS) = 18 +/- 8%; p less than 0.001 vs. group 1 and control group), and posterior hypokinesis in 20% of the cases (posterior area mean shortening (PAS) = 9.8 +/- 5.8%, p less than 0.001 vs. group 1 and control group). In this group, global LVF is impaired; ejection fraction (EF) = 0.57 +/- 0.1% (p less than 0.001 vs. group 1); velocity of circumferential fiber shortening (VCF) = 1 +/- 0.3 circ/s (p less than 0.001 vs. group 1); enddiastolic pressure (EDP) = 11 +/- 5 mmHg (p less than 0.01 vs. group 1). Segmental contraction abnormalities appear to be the main factor involved in the global LVF impairment. Segmental wall motion abnormalities could be related to subvalvular fibrosis, or LV filling difficulties, or principally, to a possible interplay between the right and the left ventricles. PMID- 6499290 TI - Elimination of unstable angina by diltiazem under temporary pacing. AB - We describe two patients in whom spontaneous angina following acute myocardial infarction (postinfarction angina caused by coronary artery spasm) and worsening angina were successfully eliminated after clinical dosage of oral diltiazem, while marked sinus node suppression developed and temporary pacing was performed. The patients were females (one was 67 years and one was 64 years old), and had no history of sinus node dysfunction. The occurrence of the adverse effect was not during angina, and the intervals between the initiation of diltiazem and the occurrence were 6 days after 120 mg/day in one patient, and 4 h after a single administration of 60 mg in the other. Diltiazem is also efficacious in the elimination of unstable angina, however one should note that diltiazem may remarkably suppress not only atrioventricular node activity but also sinus node activity in some patients. PMID- 6499289 TI - Echocardiographic evaluation of cardiovascular effects of amrinone. AB - Amrinone, a new inotropic drug, was infused at a dosage of 2.5 mg/kg body weight in 14 patients affected by dilatative cardiomyopathy in New York Heart Association (NYHA) functional class III and IV. Cardiac index, mean arterial pressure, and some echocardiographic parameters were evaluated. Cardiac index (CI) increased from 2.03 +/- 0.24 to 2.82 +/- 0.43 1/min/m2 (p less than 0.001). Fractional shortening (FS) increased from 16.4 +/- 5.2 to 21.5 +/- 5.3% (p less than 0.05). End-diastolic and end-systolic diameters showed a significant reduction. Mean arterial pressure decreased from 90.7 +/- 88 to 87.3 +/- 8.4 mmHg (p less than 0.001), the end-systolic stress (ESS) decreased from 5.8 +/- 1 to 5.2 +/- 1 g/cm (p less than 0.001). Analyzing the relationship between FS and ESS, it was possible in some cases to suppose the presence of an important vasodilator effect of the drug. The afterload in 7 patients was therefore modified before and after infusion of the drug to analyze FS at the same levels of afterload. This was done to evaluate the vasodilator effect of amrinone. Examining the regression line of FS/ESS ratio it was possible to observe a predominant vasodilator effect in some patients, but in most, a sinergic action was noted. This may be useful for chronic treatment of congestive heart failure, reducing amrinone doses, and using it in association with other vasodilator drugs. PMID- 6499291 TI - Secondary mania associated with diltiazem. AB - Diltiazem, a calcium-channel blocker, is an effective antianginal agent, particularly in treating the vasospastic type of angina pectoris. This drug has recently been released for use in the United States. Noncardiac untoward effects of diltiazem are few. We describe a case of mania with psychotic features that occurred while a patient was on diltiazem. PMID- 6499292 TI - The use of calcium gluconate prior to verapamil in infants with paroxysmal supraventricular tachycardia. AB - Verapamil is a useful drug for treating supraventricular tachycardia; however, severe side effects occasionally have been reported in infants. We describe here our experience with the use of a 10 percent solution of intravenous calcium gluconate prior to the use of verapamil in infants with paroxysmal supraventricular tachycardia. In all the attacks verapamil converted the supraventricular tachycardia to sinus rhythm. We feel that calcium gluconate injected previous to verapamil can avoid the negative inotropic effects without interfering with the antiarrhythmic properties of verapamil. PMID- 6499293 TI - Pseudocoarctation of the aortic arch in a patient with Turner's syndrome. AB - Pseudocoarctation of the aortic arch is a rare congenital anomaly which resembles true coarctation by the presence of a narrowing in the descending thoracic aorta immediately distal to the origin of the left subclavian artery. However, it is differentiated from that entity by the absence of a significant hemodynamic obstruction and by the presence of aneurysmal dilatation proximal and distal to the area of narrowing. As a result, the commonly observed clinical findings of coarctation such as a prominent collateral circulation and decreased blood pressure in the lower extremities are not observed. "Kinking" or "buckling" are common adjectives used to describe the roentgenographic appearance of the aortic arch in this condition. The association of various congenital cardiac abnormalities with pseudocoarctation has been reported, and are similar to those commonly seen with true coarctation. We now present the first reported case of pseudocoarctation associated with a probable bicuspid aortic valve in a patient with Turner's syndrome. PMID- 6499294 TI - Staphylococcal abscess complicating endocardial aneurysmectomy. AB - Subendocardial left ventricular aneurysmectomy relieved previously intractable ventricular tachycardia in a 68-year-old man with severe coronary artery disease. Staphylococcal septicemia developed postoperatively; an infected venoclysis site may have provided the portal of entry. Autopsy confirmed staphylococcal abscess at the epicardial aspect of the ventriculotomy, constituting the first reported case, to our knowledge, of this complication following endocardial surgery. PMID- 6499295 TI - Juvenile Alzheimer's disease with myoclonus: amyloid plaques and grumose alteration in the cerebellum. AB - A case of juvenile Alzheimer's disease is reported with onset at 34 years of age, a clinical course of 6 years, had myoclonic jerks, generalized convulsions, dysarthria and ataxic symptoms. The neuropathological examination indicated kuru plaques, amyloid angiopathy and grumose alteration (degeneration) in the dentate nucleus. In this case, the plaques in Alzheimer disease is quite rare. This case also demonstrates the complex interrelationship between Alzheimer's disease and various multisystemic degeneration mainly involving the dentate nucleus. PMID- 6499296 TI - Monoaminergic neurotransmitter systems in presenile Alzheimer's disease and in senile dementia of Alzheimer type. AB - The number of nerve cells was counted in locus caeruleus, dorsal motor vagus, dorsal tegmental nucleus and substantia nigra and the volume of their nucleolus measured in 30 patients with Alzheimer's disease ranging from 48-92 years of age and in 67 control patients without neurological disease. Loss of nerve cells and reduction in nucleolar volume was greatest in the locus caeruleus and these changes were most severely expressed in the younger patients, falling with age such that by 90 years of age the level of damage approached that of old age alone. Less extensive changes were present in the dorsal tegmental nucleus and these were also age dependent in their severity. Moderate damage to the dorsal motor vagus was not age related. Nucleolar volume alone was altered in substantia nigra and then only significantly so in the younger patients. PMID- 6499297 TI - Morphological changes of the isocortex in morbus Parkinson. AB - An increasing number of pyramidal cells in the third layer of the human neocortex with pigment-filled expansions of their proximal axon is correlated with advancing age. Comparison between cases of morbus Parkinson and an age-matched control group reveals that the number of these pathologically altered pyramidal cells is significantly higher in cases of morbus Parkinson than in controls. PMID- 6499298 TI - Preservation of the nucleus X-pelvic floor motosystem in amyotrophic lateral sclerosis. AB - Fourteen cases of amyotrophic lateral sclerosis (ALS) were investigated neuropathologically, emphazising the sacral spinal cord which contains Onuf's nucleus X. The nucleus innervates the pelvic sphincters. In two cases, small striated pelvic muscles were studied. No changes characteristic of ALS were observed in Onuf's nucleus X, not even in 8 cases in which other caudal motoneuron nuclei presented a severe loss of neurons. The striated sphincters proper demonstrated no signs of neurogenic atrophy in contrast to muscles in the limbs. The bulbo- and ischiocavernosus muscles, also supposedly innervated by Onuf's nucleus, were without pathological changes. Moreover, the latter two muscles were found to have a composition very similar to that of the sphincters. This indicates that a characteristic morphology of the nucleus X-innervated muscles exists. A review of the clinical records of all the cases revealed, that although 8 demonstrated severe involvement of the lower extremities, only one presented vesico-rectal dysfunction which could be ascribed to ALS. But even in this case, the pelvic closure mechanisms appeared to be intact. The preservation of continence in ALS is related to the neuropathological findings, and the observations are compared with previous neuropathological studies concerning Onuf's nucleus X as well with experimental studies including this nucleus. It is pointed out that structural and biochemical differences must exist between nucleus X neurons and other motoneurons. PMID- 6499299 TI - The neuromuscular system in patients with anorexia nervosa: electrophysiological and histologic studies. AB - The effects of cachexia on the neuromuscular system were investigated in ten young women with anorexia nervosa and in two patients with hysteric neurosis. Ten women, matched for age and height, served as controls. A neurologic examination was performed on all subjects and sensory and motor neurographic recordings were carried out in the upper and lower limbs. Biopsies from the vastus lateralis muscle were stained for myofibrillar ATPase activity and the size and distribution of both histochemical fiber types (types 1 and 2) were determined. Both types of muscle fibers were found to be significantly reduced in size in the cachectic patients but there was a predominant affection of the type 2 fibers. The average numerical distribution of fiber types was almost identical in the two groups. By subjective evaluation, four of the cachectic patients revealed small groups of angulated atrophic fibers, resembling denervation atrophy. Fiber necroses and other myopathic changes were not seen. Although the nerve conduction velocities (NCV) were within normal range in all cases, the motor NCV was generally slower in the cachectic patients than in the controls. The sensory NCV, on the other hand, was almost identical in the two groups. Five of the patients with anorexia nervosa and both cases with hysteric neurosis had clinical signs of a very mild sensory polyneuropathy. These seven cases had a lower body-mass index than the others and both types of muscle fibers and muscle responses were somewhat smaller in these cases. The sensory NCV did not differ from those of the other patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499300 TI - Polar spongioblastoma of the cervical spinal cord: case report. AB - Polar spongioblastomas are rare, histologically distinctive glial neoplasms that have been reported to involve the brain stem, third ventricle, aqueduct, and fourth ventricle. In this case report we describe a polar spongioblastoma of the cervical spinal cord in a patient who has survived 2 1/2 years without evidence of recurrent neoplasm. PMID- 6499301 TI - Prevalence of coxarthrosis. AB - In a survey of 4027 double-contrast colon roentgenograms, the hip joints were examined and classified with regard to the presence or absence of primary coxarthrosis. The hips were graded according to type and severity of coxarthrosis. The data collection was performed in precisely the same manner as in an earlier study undertaken on 3903 similar examinations that had been performed more than 20 years earlier. During this time period, the prevalence had not changed, nor was there any change in sex ratio or distribution between bilateral and unilateral cases or between types of coxarthrosis. Also, the severity of the coxarthrosis at the time of the examination was approximately the same. A considerable portion of the patients (including those in the present study), about one third, had not been previously diagnosed. In this group, mixed and medial coxarthrosis were more common among men than was lateral coxarthrosis. There was no difference in age or sex between previously diagnosed and undiagnosed groups of coxarthrosis. In the recent study, about one third of the patients had been treated mostly by total hip arthroplasty (THA). In these patients, lateral coxarthrosis was more common. Women were over-represented among the THA cases, even though the coxarthrosis was not more severe. PMID- 6499302 TI - The overall mortality rate in patients with total hip arthroplasty, with special reference to coxarthrosis. AB - The mortality rate was calculated in 1385 patients with total hip arthroplasties compared with the population at risk in the period from 1968 to 1981. In elderly women with coxarthrosis, after the age of 70, the mortality rate decreased after the first postoperative year. There was no such effect in men. In women, there were no changes in mortality rate in those who had had revision operations, whereas in men operated on for coxarthrosis who were over the age of 70, there was an increased mortality rate after the first postoperative year following revision. Patients operated on for complications after hip fracture and/or rheumatoid arthritis had an increased mortality rate after the first postoperative year, including both women and men below age 70. PMID- 6499303 TI - Longitudinal growth rate of the distal tibia and fibula in children. AB - In 61 children (30 boys and 31 girls), the growth rates in the distal tibia and fibula were recorded by use of a roentgen stereophotogrammetric technique. The average observation time was about one year and seven months. The growth rates were correlated with chronologic and skeletal age. Adjusting for skeletal age did not significantly change the average growth rates or the scattering of the values. The mean growth rate and the remaining growth from about nine years of age in the boys and eight years of age in the girls were calculated for separate age groups. In the distal tibia in the boys and the girls, the average growth rate decreases from a plateau of about 11 and ten years of age, respectively. Decreasing growth rates were found somewhat later in the distal tibia than in the distal fibula in both the boys and the girls. The growth rates were close to zero at about the same time in the distal tibia and fibula in both sexes. In determining the remaining growth, the large biologic variability indicates the importance of serial measurements on the individual patient. The individual growth charts, together with clinical and radiographic estimation of maturity, provide a guideline for treatment of a patient with growth disturbance of the distal tibia and fibula. PMID- 6499304 TI - Mobility of the pubic symphysis. In vivo measurements with an electromechanic method and a roentgen stereophotogrammetric method. AB - Mobility of the pubic symphysis can be measured in vivo by two new methods. One is electromechanic (EM), with steel pins inserted into the bone. The other is roentgen stereophotogrammetric analysis (RSA), with tantalum bone markers implanted into the hip bones. With the first method, movements are directly registered with resistive transducers mounted on the pins. With the second method, movements are deduced with kinematic analysis from roentgen stereophotogrammetric measurements of the positions of the bone markers. Both methods have high precision, about 0.1 mm for translations and 0.1 degrees for rotations. The methods were used in two young volunteers, a man and a woman. In provocative tests with identical loading (alternating, active straight-leg raising in the supine position and standing on alternating left or right leg) there was a good correlation between the two methods. The measured values, i.e., translations of up to 2 mm and rotations of up to 3 degrees, form a basis for more comprehensive studies of normal and pathologic mobility of the pubic symphysis. PMID- 6499305 TI - Formation and resorption of bone induced by demineralized bone matrix implants in rats. AB - Demineralized bone matrix was implanted in the abdominal wall of growing rats. 45Ca and 3H-proline were injected 21 days after implantation, and groups of animals were killed at 30 minutes to 16 days. Implants, tibial metaphyses and diaphyses, and incisor teeth were assayed for ash weights and isotope content. The net increase in mineral content was largest in the early phase of bone formation. Three weeks after implantation, the mineral accretion was approximately 10% of tibial metaphyses, or 0.06 mg ash per milligram implanted bone matrix. In both these tissues, the net increase in ash weight was only one fourth of the accretion because of the high rate of resorption. PMID- 6499306 TI - The relation between labor and coxarthrosis. AB - Three hundred thirty-two laborers in a shipyard, all of whom had been working for decades in heavy industry, were compared with regard to the occurrence of coxarthrosis with a similar sized group of white-collar workers and with a random population sample. All three sets of men were of the same age. About one-fourth (the same in all three groups) had been referred for a hip roentgenographic examination at some time over the previous decades. In the group of laborers and their white-collar controls, coxarthrosis occurred in about 3%, with no difference between the two samples. The occurrence was less, but not significantly less, in those men who had been randomly selected from the population. PMID- 6499307 TI - The variation of the Q angle with different positions of the foot. AB - The Q angle (i.e., the angle between the rectus femoris and the patellar ligament) was measured on 34 healthy volunteers by use of three different methods: (1) a photographic method, (2) a direct method with a goniometer on erect persons, and (3) a direct method on subjects in the supine positions. The Q angle was measured with the foot in different positions with regard to inward and outward rotation and pronation and supination. It was found that the Q angle increased as the foot shifted from outward to inward rotation. The Q angle decreased as the foot shifted from pronation to supination. The reproducibility of the photographic method was good and gave basically the same values as the direct method on erect persons. However, these methods gave values different from those of the direct method on the supine person. Consequently, it is necessary to standardize the position of the foot when measuring the Q angle. PMID- 6499308 TI - Shoulder pain and heavy manual labor. AB - The problem of the increasingly common shoulder pain syndromes in industry was investigated by biomechanic and epidemiologic methods. Rotator cuff tendinitis constitutes a major problem in people with arduous occupations, i.e., shipyard welders (prevalence ratio, 18.3%), and steel plateworkers (16.2%). Static work seems to induce symptoms at an earlier age. The clinical diagnosis was supraspinatus tendinitis. The biomechanic studies confirmed the view that the shoulder muscles are heavily loaded when the arm is elevated. Excessive hand tool mass increases the strain markedly in some muscles, particularly the supraspinatus and the infraspinatus. The hypovascularity of the supraspinatus tendon is then likely to be accentuated by high intramuscular pressure that reduces the blood flow through the muscle. The strain on the supraspinatus muscle in overhead work is an important factor contributing to prolonged shoulder disability. An analysis of the distribution of loads imposed on the shoulder in practical working situations can be based on observations of working postures and external forces. PMID- 6499309 TI - Joint debridement in the treatment of advanced hemophilic knee arthropathy. AB - Joint debridement by a meticulous surgical technique has been performed for advanced knee arthropathy in three hemophiliacs between the ages of 22 and 27. The results at follow-up evaluation, ranging from one to five years, have been surprisingly good. The procedure involves comparatively little surgical trauma and appears to have a low rate of complications. Knee joint debridement should be considered in the young hemophilic patient as a means of avoiding or at least delaying more extensive operations such as arthrodesis or arthroplasty. Joint debridement may give the patient years of pain-free, independent, and gainfully employed life with a minimum of surgical trauma. PMID- 6499310 TI - A synopsis of surgery for rheumatoid arthritis (excluding the hand). AB - Over the years, orthopedic surgery has become more involved in the care of the rheumatoid patient. A more active and aggressive attitude by orthopedic surgeons has thrown new light on the handling of the rheumatoid patient. Currently, the surgical treatment of rheumatoid arthritis is evaluated not only by the outcome of a procedure on a single skeletal part but also by the generalized effects of the disease on the activity of the patient and the function of neighboring joints. Soft-tissue procedures, such as synovectomy and release operations, have been beneficial. Prosthetic surgery yields satisfactory results, and every effort should be made to give the rheumatoid patient as long a period as possible with relief of pain and increased mobility. PMID- 6499311 TI - Impaired muscle function with aging. A background factor in the incidence of fractures of the proximal end of the femur. AB - Muscle biopsy material from vastus lateralis musculus quadriceps was obtained during surgery from 43 66-100-year-old female and nine 70-89-year-old male patients with fresh hip fractures. Before the accident, 18 women and two men were clinically healthy, and in the others, one-third had cardiovascular, one-third locomotor, and one-third neurologic disorders. Twelve women lived in institutions. The other women and all of the men lived in their own homes. A striking finding was a more advanced reduction in muscle fiber size in the vastus lateralis, especially in the fast twitch (FT) fibers. The reduction occurred in preaccident clinically healthy fracture patients. With advancing age, the proportions of the slow twitch (ST) and FT fibers remained the same. Well maintained, enzymatic metabolic capacity, moderate neuropathic changes, and absence of myopathic changes indicate that the quality of the muscle tissue is relatively well preserved, even in elderly patients with hip fractures. Muscle fiber atrophy and weakness in muscle strength may be attributable in part to a low physical activity and are possibly reversible with exercise in some individuals. PMID- 6499312 TI - Arthrodesis after failed knee arthroplasty. A nationwide multicenter investigation of 91 cases. AB - Ninety-one patients with attempted arthrodesis after failed knee arthroplasty were identified in a prospective nationwide study of knee arthroplasties performed from October 1975 through January 1982 in Sweden. The study included 43 hinged or stabilized, 34 bi- or tricompartment, and 14 unicompartment endoprostheses. Three-fourths of the failures were caused by infections. At follow-up evaluation, two patients had expired from infection and four patients had amputations. Fusion was achieved in only 50% of 108 attempts in 91 knees. Patients with unstable joints had limited function. The fusion rate was relatively high after unicompartment endoprostheses, in cases with sustained rigid fixation, or in cases where infection was brought under control at arthrodesis. Rigid fixation was best achieved with an external double frame or an intramedullary nail. Repeated attempts were worthwhile. Removal of all foreign material, eradication of the infectious lesion, and an arthrodesis performed in a one- or two-stage procedure with insertion of gentamicin beads seemed to be the best way to combat infection. The treatment of prosthetic failures should be referred to centers with special interest in knee arthroplasty. PMID- 6499313 TI - The geyser sign and torn rotator cuff: clinical significance and pathomechanics. AB - The geyser radiographic sign on shoulder arthrogram is characterized by leakage of dye from the glenohumeral joint into the subdeltoid bursa. The dye outlines the acromioclavicular joint. It is usually an indication of a full-thickness cuff tear of long duration. The clinical occurrence and pathomechanics of this finding indicate that repair is generally difficult. PMID- 6499314 TI - Angiography in Perthes' disease. AB - Angiography may play an important role in the understanding of the cause and treatment of Perthes' disease. Angiograms were performed in 30 patients, including 26 aortographies and six selective angiographies. The major angiographic alterations were: general decrease of blood flow in the affected hip, lack of a patent medial circumflex artery, an atrophic medial circumflex artery or obstruction of its branches, distended vessels in subluxations of the hip joint, and almost complete absence of the obturator artery. These anatomic differences between normal and pathologic hips suggest a deficient blood supply in the affected side and an ischemic epiphysis. Surgical treatment is indicated in cases in which distention of the circumflex vessels is noted and the condition progresses to massive necrosis. There were no differences in circulation of the hip between men and women afflicted with Perthes' disease. PMID- 6499315 TI - Iliacus hematoma and subsequent femoral nerve palsy after penetration of the medical acetabular wall during total hip arthroplasty. Report of a case. AB - Intrapelvic perforation of the medial acetabular wall during total hip arthroplasty is not uncommon but has been associated only rarely with adverse effects. A postoperative iliacus hematoma with secondary femoral nerve palsy occurred in a 61-year-old woman. The patient had been on Coumadin prophylaxis against deep venous thrombosis, but bleeding times were never excessively prolonged. Diagnosis was made by computerized tomographic (CT) scan. Conservative therapy produced resolution of the nerve deficit within eight months. Careful attention to the placement of anchoring drill holes in the acetabulum could have prevented this complication. Iliacus hematoma should be considered in the differential diagnosis of a femoral nerve palsy in the postoperative total hip patient, particularly if anticoagulation is employed. PMID- 6499316 TI - Dual-lock total hip arthroplasty. A preliminary experience. AB - The long-term experience with total hip arthroplasty (THA) has shown an increasing failure rate associated with aseptic loosening of components. A Dual Lock system incorporates features designed to reduce the incidence of loosening. The Dual-Lock THA has a low-profile acetabular component that permits preservation of subchondral bone. The design features a large, collarless, straight-stem femoral component with an interlocking metal-to-bone press fit as the primary form of fixation. In a series of 210 THAs in 180 patients, with follow-up examinations over a period of one to four years, the results were 92% good or excellent. A problem with the press fit is femoral cracking. Subsidence, early loosening, and calcar changes have not been found to a significant degree. Preliminary results with this new design have been encouraging and support the concept of the press fit. PMID- 6499317 TI - Ray resection in the dysvascular foot. A retrospective review. AB - Twenty-nine ray resection amputations of the lower extremity were performed in 25 dysvascular patients during a four-year period. The indications for amputation were localized gangrene, resistant localized osteomyelitis of a metatarsal, or both. Specific criteria included: (1) foot Doppler pressure of 70 mm Hg, (2) ankle-arm Doppler arterial pressure ratio of at least 0.5, (3) lateral ray resection only when healthy tissue margins could easily be produced, and (4) central ray resection only for persistent deep infection resistant to local treatment. Only 31% healed without further amputation or ulceration. Analyzed retrospectively, the results demonstrate that ray resection has a poor potential for success in the presence of "localized" gangrene and is only moderately successful in the treatment of chronic resistant localized infection. PMID- 6499318 TI - Retrieval and analysis of intramedullary rods. A follow-up study. AB - From 1980 to 1983, 16 AO intramedullary femoral rods were retrieved and analyzed clinically, radiographically, and metallurgically. Cracking and/or fracture was observed in four of the 16 specimens. All cracks occurred at the point of maximum stress at the end of the slot. In two cases a structurally weaker weld zone coincided with this location. The weld zone and slot were also found to coincide in five of the uncracked rods. Two of the four cracked rods were removed because of pain, while only three of the 12 uncracked rods caused pain. Structural and material characteristics (i.e., the location of the weld at a point of maximum stress and significant variability in microstructure), rather than surgical technique or time in situ, were found to be responsible for the implant mechanical failures. Improvements should be made in fabrication techniques and material properties. For the present, careful assessment of a painful intramedullary rod and routine removal after healing are advisable. PMID- 6499319 TI - Scoliosis. Experimental and clinical studies. AB - The hypothesis, advanced on the basis of experimental and clinical observations, that asymmetric growth of the ribs may be the primary cause of the thoracospinal deformity at least in some cases of right convex, thoracic, idiopathic scoliosis finds further support in the results of the anthropometric studies referred to below. There is also the possibility that asymmetric growth and more pronounced vascularization of the often larger breast may stimulate enough longitudinal growth at the underlying costosternal cartilage to upset the balance of forces acting on the normal spine. Muscular and other mechanical forces might be responsible for the further development of the deformity. Whether the data and evidence in this article will ultimately support or advance the hypothesis presented above remains to be seen. However, this hypothesis and the observations reported to date would seem to be capable of explaining the main characteristics of at least some cases of thoracic idiopathic scoliosis, i.e., the predominance in girls, the occurrence in the teens, and the predominant right convexity. PMID- 6499320 TI - Can carbon fiber implants substitute for collateral ligament? AB - The biomechanic and histologic changes following replacement of the medial collateral digit of the knee with carbon fiber filament prostheses of varying diameters were studied in young rabbits. Biomechanic testing showed changes with time in the mode of failure and force to failure of the replacements, but the initial differences in the force to failure of the three diameter groups diminished over the 12-week experimental period. Histologic studies with both light and electron microscopy revealed resorption of the carbon fibers and replacement by fibrosed ligaments. There was a correlation between the change in mode of failure and force to failure and increased production, orientation, and organization of new collagen fibrils, as well as simultaneous fragmentation of the carbon fibers. PMID- 6499321 TI - Lumbar intervertebral disc and ligament deformations measured in vivo. AB - The physiologic deformations of the anterior and posterior margins of the annulus fibrosus and the interspinous ligaments were defined in flexion and extension by accurate measurements taken from lateral roentgenograms of the lumbar spines of 11 normal males. The anterior and posterior disc heights were shown to compress and extend up to 35% and 60%, respectively, while the interspinous distance extended up to 369%. In relation to the known mechanical characteristics in vitro, these deformations implied that the soft-tissue elements were lax or in compression during part of the range of motion. Significantly, the interspinous ligament could be active only in the extremes of flexion. These data provide basic information for further studies of the function of the soft parts of the intervertebral joints. PMID- 6499322 TI - Supracondylar fractures of the femur. PMID- 6499323 TI - Epidemiology of hip fractures in Goteborg, Sweden, 1940-1983. AB - A dramatic progressive increase in the incidence of cervical and trochanteric fractures of the proximal end of the femur was observed in Goteborg from 1940 to 1983. From 1965 through 1983, the fracture rate increased by 109%. Only 20% of the increase can be explained by the age factors in the population. With the present trend, which appeared to be validated by the observed fracture rate from 1981 to 1983, the fracture incidence would double in 16 years in men and in 30 years in women. PMID- 6499324 TI - Ender nailing of pertrochanteric fractures. Results at follow-up evaluation after one year. AB - One hundred twenty-seven patients with pertrochanteric femoral fractures were transfixed with the Ender nail. The mean age of the patients was 78.9 years. Thirty-five percent of the fractures were of the stable type, and 65% were of the unstable type. All patients had clinical and radiologic follow-up examinations every three months for one year. Successful closed reduction was achieved in 97.6% of the patients. Perioperative supracondylar femoral fractures occurred in two patients. The overall stay in hospital was 19 days. Technical failures occurred early in five patients, and late manifestations of major technical failures occurred in four patients. The average time to fracture union was 18 weeks. The primary mortality rate was 7%. From one to 12 months, the mortality rate increased to 15%. Of the 108 patients surviving the first year, 86% regained their prefracture activity-of-daily-living status. Ninety-six percent of the surviving patients returned to their prefracture residence, a very satisfactory outcome of a condition often observed as a terminal illness. PMID- 6499325 TI - Hip arthroplasty with an extended femoral stem for salvage procedures. AB - The problem of treatment of a combination of failed hip arthroplasty secondary to resorption, osteoporosis, osteolysis, or fracture is unsolved. Twenty-seven such complicated hips, including four with previous infection, were treated by a femoral prosthesis driven into an intramedullary nail. The goal of stability, allowing immediate mobilization, was attained in virtually all patients. The oldest was 84 years of age and the mean age was 69.3 years. In the early postoperative period, one patient died of pulmonary embolism and one of myocardial infarction. Two infections were treated 25 and 11 months after implantation; these patients were free from pain and showed no signs of loosening of the implant. The mean time in the hospital for the infected patients was 60 days and for the noninfected patients was 23 days. Among 14 patients who were observed for at least ten months after surgery, freedom from pain was achieved in eight, significant alleviation of pain in five, and slight improvement in one. Five patients also became completely free from dependence on walking aids; seven used one or two canes. Two patients were dependent on crutches. Discrepancy in the length of the lower limbs was noted in seven patients. Six patients showed 1 cm shortening and one patient 2 cm. In six patients the Trendelenburg sign was negative, and in only three patients was it clearly positive. The mean Harris Hip Score in 14 patients observed for more than ten months after surgery was 82. Intramedullary nailing combined with a femoral component in total hip arthroplasties, where defects or fractures of the femur have occurred, give good fixation of the implant components and a satisfactory functional result. PMID- 6499326 TI - Musculoskeletal tumor surgery in Goteborg. AB - Careful preoperative planning is of great importance for successful surgical treatment of soft-tissue sarcomas. All means available should be used for determining as exactly as possible the location and extension of the tumor. Based on the observation that malignant soft-tissue tumors usually respect preformed fibrous barriers until a late stage, special surgical techniques have been devised. Some muscles in the body are dispensable and can be removed without significant loss of function. For assessing the prognosis after surgical treatment of soft-tissue sarcomas, a nonparametric multivariate analysis and a long follow-up period are essential. Seven cases of total spondylectomy (removal of one or several entire vertebrae), three cases of extended hemipelvectomy (parts of the adjacent spine included in the specimen), and one case of lumbosacral amputation (hemicorporectomy) are briefly reviewed with recent follow up data. PMID- 6499327 TI - Epidemiology of slipped capital femoral epiphysis in southern Sweden. AB - Five hundred thirty-two cases of slipped capital femoral epiphysis (physiolysis colli femoris--PCF) treated at three orthopedic departments in southern Sweden between 1910 and 1982 were used for epidemiologic studies. Three hundred twenty five cases came from a well-defined area and were used for incidence analyses. During the whole period of investigation, the disease was more common in men than in women. The difference was more pronounced in the earlier years of the investigation and among patients living in the country compared with patients living in the city. The mean age at onset of slipping has decreased in men from 16.0 to 12.7 years and has decreased in women from 12.6 to 11.8 years since the beginning of the century. The left hip is affected more often than is the right, especially in men, but during the past decades there has been a tendency toward equalization. Bilateral slipping was evident in 25.4% of the men and in 17.7% of the women. Men living outside the city were at higher risk for bilateral involvement than were men living in the city. In women, the situation was the opposite. The incidence has followed a periodic pattern with peaks approximately every 20th year. The mean incidence (number of cases/10,000 living born) during the period of growth was 6.1 in men and 3.0 in women. The maximal risk is supposed to be 25.7 in men and 20.5 in women. Men living in the country have always been at higher risk compared with men living in the city. Since the fifties, the incidence in women has also been higher in those living in the country. In women, the incidence was significantly higher between May and August. No seasonal variations were seen in men. PMID- 6499328 TI - Slipped capital femoral epiphysis in southern Sweden. Long-term result with no treatment or symptomatic primary treatment. AB - Forty-nine cases of slipped capital femoral epiphysis or physiolysis colli femoris (PCF) without primary treatment were evaluated 20-60 years after diagnosis by questionnaire and in 44 cases by clinical and radiographic reexamination. The cases represent PCF cases without primary treatment from three different orthopedic centers from 1910 to 1960. Only a few had restrictions in working capacity or social life. Two of these 49 cases have required surgery because of secondary arthrosis, far fewer than were found in a comparable group of cases treated with closed reduction and hip spica. PMID- 6499329 TI - [A clinico-pathological study on multiple system atrophy, with special reference to its striato-nigral lesions and motor neuron involvements]. PMID- 6499330 TI - [Demonstration of central cavity in juvenile type of distal and segmental muscular atrophy of upper extremities]. PMID- 6499331 TI - [A case of Mollaret's meningitis--benign recurrent aseptic meningitis]. PMID- 6499332 TI - [A case of segmental zoster paresis]. PMID- 6499333 TI - [Total ophthalmoplegia and brainstem auditory evoked response abnormalities in a patient with acute phenytoin intoxication]. PMID- 6499334 TI - [A case of myasthenia gravis with malignant thymoma and features of Eaton-Lambert syndrome]. PMID- 6499335 TI - [Clinical study of seven patients with facial diplegia. Its differentiation between Bell's palsy and variant form of Guillain-Barre syndrome]. PMID- 6499336 TI - [The relationship between prognosis and sex and age at onset in amyotrophic lateral sclerosis]. PMID- 6499337 TI - [Lumbosacral radiation myeloneuropathy. Report of a case and effects of prednisolone treatment]. PMID- 6499338 TI - [Age changes in acetylcholine receptor distribution on human skeletal muscle]. PMID- 6499339 TI - [Sibling cases with lipodystrophic skin change, muscular atrophy, recurrent skin eruptions, and deformities and contractures of the joints. A possible new clinical entity]. PMID- 6499341 TI - Program schedule & abstracts presented at the Society of Nuclear Medicine, 25th annual Southeastern chapter meeting. Lexington, Kentucky, November 1-3, 1984. PMID- 6499340 TI - [Study on the pathogenesis of myokymia, hyperhidrosis and increased urinary excretion of catecholamine after thymectomy in Myasthenia gravis]. PMID- 6499342 TI - Program schedule & abstracts presented at the Society of Nuclear Medicine, 9th annual Western regional meeting. Monterey, California, October 11-14, 1984. PMID- 6499343 TI - Prediction of steady-state nortriptyline plasma levels by the repeated one-point method. AB - 10 psychiatric inpatients with a diagnosis of depression were entered into a prospective study to investigate the repeated one-point method as a method of predicting steady-state concentrations for nortriptyline. Four males and 4 females completed all requirements of the protocol. Single plasma concentrations obtained after the first and second daily doses were found to be accurate predictors of the steady-state minimum plasma concentrations. The difference between the measured and the predicted steady-state minimum values ranged from 2.10 to 32.7 micrograms/L with a standard deviation 10.4 and a mean of 10.5 micrograms/L, assuming a normal distribution. The correlation coefficient of predicted versus measured concentrations was 0.946 with 90% confidence limits, ranging from 0.800 to 0.990. The repeated one-point method was found to be an accurate predictor of steady-state minimum plasma concentrations in patients receiving nortriptyline. This method should allow for individual adjustment of dose while minimising the time required to achieve therapeutic, non-toxic plasma concentrations. PMID- 6499345 TI - Chronopharmacokinetic study with prolonged infusion of midazolam. AB - Physiological and temporal variation in the disposition of midazolam has been reported. In order to delineate the underlying mechanisms of these alterations, we infused in 5 healthy male volunteers for 26 hours midazolam at a rate of 0.025 mg/kg/h preceded by a bolus of 0.05 mg/kg. Thus, steady-state conditions were rapidly achieved. Plasma levels of midazolam were monitored on a 2-hourly basis during this period. In addition, the pharmacodynamic response to the new sedative/hypnotic benzodiazepine was characterised by a pencil tracking test, sedation index formed from visual analogue scales, and choice reaction time. In all subjects, small (4 to 16%) but clinically irrelevant fluctuations of steady state plasma concentrations around 45 ng/ml were observed. During the night-time (11pm to 7am) plasma concentrations were slightly (p = 0.074) higher than during the daytime. Total plasma clearance varied from 563 to 823 ml/min. Plasma protein binding of midazolam was time independent. Since in only 1 of 5 subjects was a circadian rhythm observed, fluctuations in plasma midazolam concentrations under controlled and constant conditions are probably not of clinical significance. PMID- 6499344 TI - Tobramycin serum level monitoring in young patients with normal renal function. AB - Five clinical strategies for monitoring serum tobramycin concentrations were compared in a population of children and young adults with normal renal function receiving tobramycin for suspected sepsis. The drug monitoring strategies were evaluated on the basis of the ability of each to predict subsequent drug levels. The strategies included 3 methods requiring assessment of individual drug disposition: (a) measurement of peak drug concentrations after 2 separate doses; (b) a 3-point kinetic study to define distribution volume and elimination rate; (c) a 3-point kinetic study with adjustment of the value for elimination rate to account for deep compartment drug accumulation; and 2 strategies using a fixed dose approach in which prediction of individual levels was made on the basis of mean population kinetic parameters. Although all methods were of similar accuracy, the fixed-dose strategy was the most precise in predicting subsequent serum tobramycin levels (95% tolerance limits = 84-135% of predicted). Poor performance of the other strategies was accounted for by interpatient variability of tobramycin disposition that was small relative to the intrapatient variability in these measurements. We conclude that these strategies for aminoglycoside serum level monitoring, which have proven beneficial in patients with impaired renal function, afford little benefit to children and young adults with normal renal function. Administration of these drugs on a fixed-dose schedule without serum concentration monitoring appears to be warranted in this select population. Alternatively, specific strategies for this population must be developed that consider the small interindividual differences in drug disposition and low incidence of toxicity. PMID- 6499346 TI - Acquired craniofacial features associated with chronic phenytoin therapy. AB - Although the teratogenic effect of phenytoin on the fetus has been well documented, the effect on postnatal facial structure has not been emphasized. The evolution of such changes is illustrated with serial photographs and case histories of five mentally retarded individuals not known to have diagnoses that could account for these dysmorphic features. The intent of this report is to increase awareness of this serious consequence of phenytoin therapy and to stimulate interest in further studies of the phenomenon. The incidence and prevalence, mechanism of production, genetic predisposition, and critical age for development of this effect in patients treated with phenytoin needs to be determined. PMID- 6499347 TI - Circumcision using the Mogen clamp. AB - The purpose of this study was to analyze the results of 313 circumcisions using the Mogen clamp. This procedure was done between 1 day and 2 years of age in all but four patients. The complication rate was low (1.6%). Two patients had local infection, one mild hemorrhage, one concealed penis, and one postcircumcision phimosis. Circumcision using the Mogen clamp is a simple, quick, and safe procedure. PMID- 6499348 TI - Alimentary absorption of gentamicin in preterm infants. AB - Fifty-two preterm neonates receiving oral gentamicin from birth, as prophylaxis against necrotizing enterocolitis (NEC), had serum gentamicin levels measured on the second day of life (52 infants) and on the seventh to tenth days (43 infants). The serum gentamicin concentrations on the second day were 0.5 microgram/ml or less in 21 percent, 0.6 to 1.0 microgram/ml in 15 percent, 1.1 to 2 micrograms/ml in 34 percent, 2.1 to 5 micrograms/ml in 25 percent, and 5 to 7.1 micrograms/ml in 4 percent of the infants. Paired serum gentamicin levels were significantly lower (p less than 0.001) on the seventh to tenth day as compared to the second day. We conclude that preterm infants in the first few days of life absorb orally administered gentamicin. Concomitant use of systemic gentamicin under such circumstances may potentially lead to toxic serum gentamicin concentration. PMID- 6499349 TI - Exclusion of ill children from day-care centers. Policy and practice in New Haven, Connecticut. AB - Despite evidence that children who attend group day-care centers have an increased frequency of infectious illnesses, appropriate criteria for exclusion of ill children from day-care centers have not been defined. Of the 89 licensed day-care centers in the New Haven area, 53 (60%) returned an anonymous questionnaire about their practices in managing ill children. Most of the centers (median size--38) included only children aged 3 to 5 years. The percentage of centers that excluded children with specific signs or symptoms varied from 100% for fever to 30% for either cough or runny nose. Although all of the day-care centers excluded children with fever, the minimum temperature defined as fever varied substantially (median--99.1 degrees F). Most centers (62%) relied on the parents' discretion for allowing an ill child to return to the center. PMID- 6499350 TI - Bretylium tosylate for ventricular fibrillation in a child. PMID- 6499351 TI - Medical responsibility to incarcerated children. PMID- 6499352 TI - Perioperative prophylaxis with cephalosporins. PMID- 6499353 TI - Combined alpha adrenoceptor antagonism and calcium channel blockade in normal subjects. AB - Because both verapamil and prazosin act on peripheral vascular smooth muscle and undergo extensive first-pass metabolism, the possibility of dynamic and kinetic interactions with their concurrent use was investigated. The acute hemodynamic effects of oral prazosin (1 mg), oral verapamil (160 mg), and their combination were evaluated in eight men with normotension. The kinetics of both drugs, alone and in combination, were also assessed. Verapamil did not change blood pressure or heart rate, but prazosin induced a fall in blood pressure, particularly on standing (lowest systolic pressure was 98 mm Hg). The combination of prazosin and verapamil had an earlier, longer, and greater hypotensive effect that was maximal 4 hr after dosing, with a standing systolic pressure of 89 mm Hg. Increases in heart rate were less after the combination (maximum of 102 bpm) than after prazosin alone (maximum of 112 bpm), although there were greater falls in blood pressure with the combination than with prazosin alone. Increases in plasma catecholamine and aldosterone levels and plasma renin activity were greatest with the combination. No differences were found in the kinetics of verapamil when combined with prazosin, but the combination affected prazosin kinetics, with increases in peak prazosin concentrations and AUC. Our data suggest that the greater hypotensive activity of the combination results at least in part from a kinetic interaction that enhances the bioavailability of prazosin, but it is possible that a dynamic interaction at the level of vascular smooth muscle or compensatory cardiac activity also plays a role. PMID- 6499354 TI - Effect of metoclopramide on digoxin absorption from tablets and capsules. AB - The effect of metoclopramide, a drug that increases gut motility, on the consistency of digoxin absorption was examined in 16 healthy men. Each received the following four single-dose digoxin treatments in complete crossover fashion: two 0.25-mg digoxin tablets, alone, and two 0.2-mg digoxin capsules with metoclopramide. Mean serum AUCs over 24 hr (AUC-24) and cumulative urinary digoxin excretion over 48 hr (CUE-48) were of the same order for the tablets and capsules alone treatments. Metoclopramide reduced the mean AUC-24 for tablets from 12.26 +/- 2.70 to 9.38 +/- 3.78 ng X hr/ml (P less than 0.001) and the CUE 48 from 119.0 +/- 22.4 to 97.6 +/- 22.2 micrograms (P less than 0.01). There were no significant differences in mean AUC-24 (12.94 +/- 3.16 and 13.45 +/- 2.33 ng X hr/ml) and mean CUE-48 (117.8 +/- 23.4 and 109.7 +/- 25.0 micrograms) when capsules alone were compared to capsules with metoclopramide. Metoclopramide reduced the time to reach peak concentration for both digoxin dosage forms. The effect of metoclopramide on digoxin absorption is minimized by administration of digoxin in capsules. PMID- 6499355 TI - Verapamil and propranolol in essential hypertension. AB - Twenty-four subjects with mild to moderate essential hypertension completed this 9-wk parallel, randomized, double-blind study of the antihypertensive effects of verapamil (V) (240 to 480 mg%) and propranolol (P) (120 to 360 mg%). V lowered systolic and diastolic blood pressures in all postural positions, with an average reduction of 20/16 mm Hg. With the exception of standing systolic blood pressure, P also lowered systolic and diastolic blood pressures in all postural positions, with an average reduction of 9/11 mm Hg. Differences between V and P were significant only for sitting systolic blood pressure. Heart rate was decreased by P but was not affected by V. The PR interval was prolonged by V. Plasma levels of V and P were directly related to dose. Plasma levels of V were linearly related to those of its major metabolite, norverapamil (r = 0.81). There was no correlation between clinical response and the dose or plasma level of V or P, but all subjects who received 480 mg% V had an average blood pressure reduction of 20/16 mm Hg and plasma levels of the parent drug above 200 ng/ml. V is an effective antihypertensive for mild to moderate essential hypertension. Constipation, pedal edema, and a maculopapular rash were reported as side effects of V. PMID- 6499356 TI - Mephenytoin hydroxylation deficiency in Caucasians: frequency of a new oxidative drug metabolism polymorphism. AB - The ability of normal subjects to hydroxylate mephenytoin (100 mg) or debrisoquine (10 mg) after oral dosing was investigated in 156 unrelated Caucasians living in middle Tennessee. Urinary recovery of 4-hydroxymephenytoin (4-OH-M) and the urinary S:R enantiomeric ratio of mephenytoin measured in an 8 hr urine sample were investigated as phenotypic traits for mephenytoin, and the urinary metabolic ratio of debrisoquine was used to determine the debrisoquine hydroxylase phenotype. Both urinary 4-OH-M and the S:R ratio of mephenytoin discriminated between extensive (EM) and poor (PM) metabolizers of mephenytoin. The frequencies of PMs for mephenytoin and debrisoquine hydroxylation activity were 2.6% and 7.0%. These two defects in oxidative metabolism were not observed in the same subjects, which suggests that 4-hydroxylation of mephenytoin is a new polymorphism independent of that for debrisoquine. PMID- 6499357 TI - L-thyroxine contamination of pharmaceutical D-thyroxine: probable cause of therapeutic effect. AB - Studies have shown that pharmaceutic preparations of the stereo isomers of thyroxine differ with respect to thyromimetic potency and lipid level-lowering effects. We applied a stereospecific assay for dextrothyroxine (DT4) and levothyroxine (LT4) to determine whether the biologic effects observed after the administration of DT4 (Choloxin; Flint Laboratories) resulted from inherent biologic activity of DT4, conversion of DT4 to LT4 in vivo, or LT4 contamination of Choloxin tablets. Choloxin was administered in a dose of 8 mg/day for 5 mo to nine athyreotic subjects who were then treated with pharmaceutic LT4 (Synthroid), 0.2 mg/day for an additional 5 mo. Analysis showed that LT4 contamination of Choloxin tablets ranged from 0.50% to 2.30%. This degree of contamination resulted in physiologically significant doses of LT4 in the 8 mg/day doses of Choloxin. During the treatment with two different lots of Choloxin, serum LT4 accounted for 33% to 53% of the measurable serum total thyroxine. The degree of LT4 contamination in Choloxin tablets was sufficient to account for the observed serum LT4 levels and casts doubt on the conclusions derived from previous studies in which Choloxin was used as the source of "DT4." PMID- 6499358 TI - Evaluation of methods to estimate cigarette smoke uptake. AB - Exposure to tobacco smoke is measured by a variety of invasive and noninvasive techniques. Our purpose was to examine how well some of these measures correlated when obtained simultaneously from the same subjects. On three occasions, six subjects were studied while they were smoking a single cigarette after 24 hr of abstinence. There were positive correlations between increases in heart rate and plasma nicotine concentrations and between percentage carboxyhemoglobin and exhaled carbon monoxide. Although residual cotinine was readily detected in samples of plasma before the subjects smoked, there was an increase in mean levels, with a peak approximately 1 hr after smoking. Urinary concentrations of nicotine, cotinine, and nicotine-1'-N-oxide and thiocyanate levels in plasma and saliva were essentially unchanged by smoking a single cigarette. Data on smoke generation and nicotine retention in cigarette butts correlated poorly with all other measures of smoke uptake. PMID- 6499359 TI - Effect of aminoglutethimide on antipyrine, theophylline, and digitoxin disposition in breast cancer. AB - The influence of aminoglutethimide (AG) on antipyrine, theophylline, and digitoxin kinetics was examined. Antipyrine was given as a single test dose before and after 3 mo of AG treatment, whereas theophylline and digitoxin kinetics were investigated at steady state in patients receiving these drugs therapeutically before and after AG therapy. During AG treatment, mean clearance rates for antipyrine, theophylline, and digitoxin increased by 81%, 32%, and 109%. Together with earlier reports of effects of AG on warfarin and dexamethasone disposition and on its own metabolism, these findings indicate that AG is a potent inducer of drug metabolizing microsomal monooxygenases of the liver. Since many drugs known to be metabolized by this enzyme system are frequently used for concomitant conditions in patients with breast cancer, interactions with AG are to be expected. PMID- 6499360 TI - Vancomycin disposition: the importance of age. AB - We examined the influence of age on vancomycin kinetics in 12 normal healthy men (six young and six elderly) after an intravenous infusion of 6 mg/kg. Serial blood and urine samples were collected for up to 2 days after dosing and were assayed for unchanged drug by a specific radioimmunoassay. Serum concentrations of vancomycin after infusion declined in a multiphasic manner. Both serum and urinary excretion data were simultaneously fit by a three-compartment model with SAAM-27 computer programs. Estimates of mean t1/2 obtained from the terminal phase of the drug disposition profile showed the t1/2 to be longer in the elderly than in the young subjects (12.1 and 7.2 hr). Although there was no change in the initial distribution volume of the central compartment, total systemic and renal clearances were reduced in the elderly and did not correlate with renal function. The increase in the vancomycin volume of distribution at steady state was ascribed to enhanced tissue binding of drug in the elderly, since the mean fraction of vancomycin bound in systemic pool of the young and elderly did not differ (0.53 and 0.56). In-depth analysis of excretion data tends to support suggestions of vancomycin excretion solely by glomerular filtration. Our data strongly suggest the need for adjustment or modification of recommended vancomycin dosing schedules in the elderly. PMID- 6499361 TI - Kinetics of misonidazole enantiomers. AB - The kinetics of misonidazole enantiomers were followed in nine healthy subjects after a single oral dose of racemic misonidazole (1.0 gm/m2). Mean clearance of (+)-misonidazole was 14% greater than that for (-)-misonidazole and mean volume of distribution was slightly greater (3%) for the (+)-enantiomer. After treatment of four of the subjects with cimetidine, there was a small increase in (-) misonidazole distribution volume, but there was no significant change in other kinetic parameters for either enantiomer. Phenytoin (three subjects) and phenobarbital (two subjects) increased the clearance of both enantiomers (the increase was greater for (+)-misonidazole). The use of (+)-misonidazole together with induction of metabolism may reduce the neurotoxicity associated with racemic misonidazole. PMID- 6499362 TI - Prednisolone disposition in obese men. AB - Obesity is accompanied by altered secretion and disposition of sex and glucocorticoid hormones, including cortisol, and also confounds parameter normalization and drug dosage selection relative to body weight. Prednisolone disposition was assessed in eight obese and four normal male subjects after a dose of 33 mg iv. Steroid concentrations were determined by HPLC. Kinetics were related to ideal body weight (IBW) and total body weight (TBW). Uncorrected steady-state volume of distribution (Vss) of total prednisolone was 20% greater in obese subjects (36.7 and 44.1 l). This effect could be described by the relationship: Vss = 0.54 IBW + 0.09(TBW-IBW), with a distribution coefficient of 0.09 reflecting limited prednisolone uptake by fat. Protein binding parameters and albumin and transcortin concentrations were similar between groups. Uncorrected total and free prednisolone clearances (Cl) were increased in obesity (11.1 and 8.3 l/hr total; 65.4 and 46.5 l/hr free). Free prednisolone Cl correlated strongly (r = 0.80) with degree of obesity expressed as TBW/IBW. In the obese, endogenous cortisol concentrations were initially higher before exogenous steroid dosing, were suppressed at an identical rate, and returned to baseline more slowly than in normal subjects. The apparent hypersensitivity of the adrenal gland offsets the increased Cl of free prednisolone in obesity, indicating that weight-proportional dosage adjustments of this steroid in obesity should reflect TBW. PMID- 6499363 TI - Symposium on lip surgery. PMID- 6499364 TI - Our experience with lip reconstruction. A lesson from history. AB - The authors' philosophy in performing labial reconstruction has evolved from unsatisfactory results using classic procedures. Such results prompted attempts with procedures that are both more cosmetic and functional and that give greater emphasis to the restoration of the oral sphincter. PMID- 6499365 TI - Electrical burns of the mouth in children. AB - The acceptable state of the art for commissure electric burns of the mouth in children in the past was to advocate conservative treatment, allowing spontaneous healing to be followed by reconstructive procedures. These statements were made because of the difficulty of assessing the degree of initial injury, the loss of valuable normal tissue in early excision and reconstruction, and the minor role played by infection in healing of local electric burns particularly in this anatomic area. Most authors feel that maximum tissue preservation and functional restoration could best be achieved by delay of surgery until the eschar had separated and the scar had softened. Another school of surgeons believe that scarring, distortion, and secondary infection can be circumvented by timely, early surgical intervention. More recently the fabrication and use of a "dynamic microstomia prevention splint" appears to be beneficial in eliminating the need for or decreasing the degree of surgery in children with electric burns of the commissure of the mouth. PMID- 6499366 TI - Oral splint therapy to manage electrical burns of the mouth in children. AB - Oral electrical burns to the lip commissure are disfiguring injuries for a child. Current treatment includes the use of an orally anchored splint to hold the lip commissures at their correct positions during healing. After wearing an appliance for a period of one year, the burn site is evaluated for the need for corrective surgery (Fig. 9). It has been found that the use of a commissure appliance decreases the need for reconstructive surgery. PMID- 6499367 TI - Genetics of congenital lip defects. PMID- 6499368 TI - Cleft lip repair by a systematic Z-plasty. PMID- 6499369 TI - On the importance of muscle repair in secondary cleft lip deformity. AB - Generally the evolution of cleft lip repair has included a transition from those methods with primary emphasis on the skin design with intricate flaps, going to further elaborations of carefully designed skin and muscle units but with minimal muscle dissection or intentional reorientation, on to those with greater emphasis on extensive muscle dissection with specific realignment of the orbicularis oris muscle. These latter methods assign to the skin a more complementary role in the plan of correction. This article joins others in which it is now felt that extended dissection and surgical reorientation should be done to include associated involved muscles of the lip, nose, and medial face. In particular, attention to the details of muscle repair as completely as possible, extending to the entire oro-naso-facial complex, seems pertinent in the matter of secondary correction of cleft lip deformities. A review of the anatomy involved, certain surgical philosophy, and examples of illustrated cases are included in this article. PMID- 6499370 TI - Human bites of the lip. AB - Human bites of the lips are very common. If less than 10 mm in size, they are treated conservatively and if greater, are treated surgically. Many lip bites are treated immediately, when infection is present, surgery is performed a few days later. PMID- 6499371 TI - Mending lips and closing gaps. AB - Operation PHILPLAST is neither original nor unique. Moreover, it is a tribute to our specialty that many plastic surgeons now unselfishly offer their skills through a multitude of programs in many foreign lands. Some believe that training and service cannot be combined. We strongly disagree. If the time-honored principles of supervision and progressive responsibility are practiced, the results, both educationally and surgically, are spectacular. When plastic surgeons offer their expertise abroad, they become effective ambassadors of good will. Such foreign policy is straightforward and difficult to misinterpret or distort. In the process of operating and teaching, a variety of gaps are closed: in lips, in education, in culture. Giving lip service, we conclude, is not only worthwhile; it is exhilarating. PMID- 6499372 TI - Two useful small flaps for reconstruction of lip and nose. AB - This article presents an extension of known and tried surgical techniques involving muscle flaps with epithelial covering. These extensions of principles represent useful applications either as definitive corrective techniques or as stepping stones to further surgical corrections. It is hoped that the successful use of these techniques in the examples given might prompt further investigation and discussion in areas related to their use. PMID- 6499373 TI - Combined measurement and significance of lipid-bound sialic acid and carcinoembryonic antigen in detection of human cancer. AB - We evaluated the clinical usefulness of lipid-bound sialic acid (LSA) as a "tumor marker" and assessed individual and carcinoembryonic antigen (CEA) in cancer patients. Serum LSA and CEA concentrations were measured by the resorcinol method after total lipid extraction and isolation of the sialolipid fraction, and by Abbott enzyme immunoassay procedures, respectively. Results indicate that the frequency of elevation and mean LSA values were highest in patients with lung cancer (318 mg/liter), intermediate in miscellaneous (210 mg/liter) and colorectal cancers (200 mg/liter), and lowest in breast cancer (175 mg/liter); while mean CEA values were highest in colorectal cancer (162.5 micrograms/liter), followed by lung (33.8 micrograms/liter), miscellaneous (30.3 micrograms/liter), and breast cancers (11.6 micrograms/liter). Statistically, LSA and CEA values for cancer patients were significantly (P less than 0.001) higher than for normal subjects. The combined measurement of LSA and CEA in serum provides better detection potential for cancer patients than either of the two markers alone. PMID- 6499374 TI - Decreased levels of complement components C4 and C2 in lupus erythematosus: genetic defect or complement activation? PMID- 6499375 TI - HLA typing of nonviable tissues with a multiple microabsorption method. AB - HLA typing is usually performed by directly measuring complement-dependent cytotoxicity on viable peripheral blood lymphocytes as target cells. To overcome the limitations inherent to viable targets, absorption inhibition techniques have been developed. The main drawbacks of most of these techniques are, however, that they are not very feasible and require relatively large amounts of absorbing material and rare antisera. Therefore, we adjusted the multiple microabsorption method (MMA) and tested simultaneously for 16 HLA specificities of the A, B, and C locus on 6 different nonviable tissues. The results of the MMA, when compared with those of the usual microlymphocytotoxicity test (LCT) that was run in parallel, correspond in 96% of the 28 comparable antigen pairs. Only one false negative and no false positive result was found. The absorbing quality of the individual organs differed, as was to be expected: lymph node and spleen rank on the top, followed by liver and kidney, whereas brain and muscle show several negative reactions. Altogether, the MMA proves to be a reliable and practical method for typing nonviable tissues, eg, in hematological diseases or in certain forensic situations. PMID- 6499376 TI - Serum immunoglobulin elevations in the acquired immunodeficiency syndrome (AIDS): IgG, IgA, IgM, and IgD. AB - The exact nature of the immune defect in the acquired immune deficiency syndrome (AIDS) is not known. Most studies have focused on abnormal T-cell functions which occur in AIDS. Although polyclonal elevation of serum immunoglobulins is also consistently reported in AIDS, there have been no statistical studies measuring the isotypes (classes) comprising this hypergammaglobulinemia. Quantitative serum immunoglobulin levels of IgG, IgA, IgM, and IgD in patients with AIDS (n = 33) were compared to healthy homosexual (n = 71) and healthy heterosexual (n = 32) controls. Serum IgD levels are increased tenfold in AIDS compared to healthy heterosexuals, and threefold compared to healthy homosexuals. Serum IgA levels are increased more than twofold that of either control group. In contrast, the elevations of IgG and IgM are relatively small and show much greater overlap compared to controls. We conclude from a statistical analysis of the data that these elevations of IgD and IgA are characteristics of AIDS. PMID- 6499377 TI - Simplified screening for immune complexes by laser nephelometry of ultracentrifuged serum. AB - Serum samples were drawn from 14 healthy volunteers after an overnight fast and again after a meal. Each sample was divided into two aliquots. One aliquot was centrifuged at 20,000 rpm for 20 min, and a portion from the middle of the tube was removed by puncturing the tube's side. All samples were then added to cuvettes containing 0.14 M NaCl alone or 1, 2, 3, or 4% polyethylene glycol in 0.15 M KCl. The light scattering of each tube was measured. The centrifuged samples scattered 58% less light than the uncentrifuged controls. The range of values obtained with the centrifuged samples was also smaller as reflected in the standard deviation of the means obtained at each polyethylene glycol concentration. The coefficient of variation for replicate samples ranged from 0 to 16.6% (mean 5.8%), even when samples were processed differently. Storage at 70 degrees C significantly increased light scattering compared to baseline values. Serum samples were drawn from 44 patients with diseases that have been associated with immune complexes. Nephelometry selectively identified some groups of patients as abnormal. We conclude that preparative ultracentrifugation removes much of the background light scattering of serum samples, including that due to lipid, under conditions that do not sediment out immune complexes. Because it measures a physical property of immune complexes, this assay may provide information that is not available from biological receptor-based assays. PMID- 6499378 TI - The evolution of colorectal carcinoma. PMID- 6499379 TI - Priorities for computed tomography in the management of testicular seminoma. AB - A study to assess the role of computed tomography (CT) in the management of testicular seminoma showed that CT was of value in defining the extent of bulky abdominal disease at initial staging. After radiotherapy for Stage IIc disease, relapse by 1 year was common and predominantly extra-abdominal. Mediastinal relapse was detected by CT in the absence of raised serum tumour markers or changes on the chest radiograph. It was concluded that CT should be used at initial staging only to assess the volume of bulk disease shown by lymphangiography, that no benefit seemed to accrue from CT scanning of Stage I and IIa patients and that the follow-up of Stage IIb and IIc patients requires regular CT surveillance in the first year, irrespective of clinical status. PMID- 6499380 TI - The impact of computed tomography on the management of testicular teratoma. AB - A comparison has been undertaken between conventional radiographic imaging and computed tomography (CT) in 35 patients with testicular teratoma as part of an audit of our investigative approach to staging and follow-up. The CT examination included alternate cuts from the carina of the trachea to the lung bases as the thoracic assessment as well as the standard examination of the abdomen. Lymphangiography appeared to detect Stage IIa lesions better than did CT; however, CT was able to define the volume of abdominal disease more accurately. During the follow-up of Stage I patients, CT detected progressive disease in the absence of tumour marker elevation. Such progressive disease presented within 4 months in the majority of cases. The selective thoracic CT scanning conferred no advantage over whole-lung tomography, only one additional lesion being detected in 123 examinations. It is recommended that CT should be reserved for examining the area above the renal hila, for cases where lymphangiography is equivocal or positive, and that CT scanning of the abdomen in Stage I patients not receiving therapy should be repeated every 3 months following orchidectomy for the first year, irrespective of clinical status. PMID- 6499381 TI - Priorities for computed tomography and lymphography in the staging and initial management of Hodgkin's disease. AB - Thirty-five patients with Hodgkin's disease were staged with the aid of chest radiographs, bipedal lymphograms and computed tomography (CT) scans. Computed tomographic findings altered management in only two patients (6%) by indicating enlargement of their radiotherapy fields. After lymphography, five patients (14%) were changed from Stage II (clinical and CT staging) to Stage III, so altering their management. Because either technique may show more extensive disease, CT and lymphography are complementary. Computed tomography should be performed initially. If it reveals no abnormality in the lymphogram area, lymphography, too, should be undertaken. Inverted Y fields are easier to visualise and design from lymphograms than from CT sections. PMID- 6499382 TI - Primary carcinoid tumours of the ileum: the radiological appearances. AB - Primary carcinoid tumours are rarely detected in the small intestine by conventional radiological methods. The radiological features are presented of 11 patients with primary small-intestinal carcinoids, in whom the tumour was demonstrated by the barium infusion technique. In four of these patients the site of the primary tumour was also demonstrated angiographically. We have found these methods valuable in identifying primary carcinoid tumours and consider them to be the investigations of choice in evaluating patients with suspected or established carcinoid syndrome. PMID- 6499383 TI - Patient attitudes towards radiographic examinations involving contrast media. AB - Patient attitudes and responses to radiographic examinations with contrast media were measured by means of a self-administered questionnaire. Forty-seven per cent of patients reported being worried about its unpleasantness and 64% about its possible findings. Men expressed less anxiety about the unpleasantness than women and old people less about the findings than young people. Most patients, but especially those who were worried about the procedure, would have liked more information about why they were having the investigation; worried patients were also more likely to seek non-medical advice. There was, however, no difference between 'worried' and 'non-worried' patients in their understanding of the nature of the investigation. PMID- 6499384 TI - Combinations of laxatives for bowel preparation: are they necessary? AB - To determine whether combinations of saline and surface-acting laxatives have any superior action over saline laxatives alone in cleansing the colon, patients having double-contrast barium enema examinations were randomly allocated to magnesium citrate alone and magnesium citrate with either oral or rectal bisacodyl. The addition of bisacodyl conferred no benefit over magnesium citrate alone. A companion study of magnesium citrate and sodium picosulphate (Picolax) showed no benefit over magnesium citrate alone. It is concluded that it is unnecessary to add a contact or surface-acting laxative to 25 g of magnesium citrate for bowel preparation. PMID- 6499385 TI - A comparison of dilute barium and dilute water-soluble contrast in opacification of the bowel for abdominal computed tomography. AB - Dilute barium was compared with dilute water-soluble contrast medium as an oral preparation for abdominal computed tomography (CT). Patients generally preferred the barium to the water-soluble contrast medium. Both preparations opacified the bowel satisfactorily. Barium caused no streaking artefacts. Dilute barium is the preparation of choice for abdominal CT. PMID- 6499386 TI - Abnormal fat: a useful marker of intra-abdominal disease at computed tomography. AB - Computed tomography (CT) gives unique information about the margins of the intra abdominal organs and the intervening fat and fascial planes. Not infrequently, these planes appear abnormal without any visible underlying cause. We present 85 patients in whom such an abnormality was shown. Although the appearances are non specific, tumour infiltration was the most common cause (57 (70%) out of 82 where the cause is known). Infection, secondary effects of pancreatitis, granulomatous disease, haemorrhage, early ascites or oedema and the effects of radiotherapy should all be considered in the differential diagnosis. PMID- 6499387 TI - Percutaneous drainage of malignant cysts. AB - Five patients who were suffering pain or pressure effects from malignant neoplastic cysts of the gastrointestinal or genito-urinary tract had percutaneous drainage guided by computed tomography. In four patients percutaneous drainage succeeded in relieving symptoms. There was objective relief of pressure effects due to the cyst in three patients, including reversal of renal failure in one patient. The technique failed in the remaining patient due to septation of the cyst. Percutaneous drainage has a limited but important role in the management of patients with advanced cancer when alleviation of pressure effects is required. PMID- 6499388 TI - Prone computed tomography metrizamide myelography: a technique for improved diagnosis of lumbar disc herniation. AB - Computed tomography metrizamide myelography of the lumbar spine in the prone position is advocated for better visualisation of the thecal sac-disc annulus interface. This method allows a more precise diagnosis of disc herniation. Therefore, it is suggested that this technique should routinely be performed prone. In cases where suspended respiration in the prone position is difficult, the same result may be achieved by patient movement before scanning in the supine position. PMID- 6499389 TI - Water-soluble contrast medium in the localisation of cord and dural stab wounds. AB - Two cases are reported of dorsal stab wounds involving the spinal cord. In both cases the site of the dural tear and cord damage were accurately localised by supine screening with water-soluble contrast medium. PMID- 6499390 TI - The value of urethrocystography in the investigation of patients with spinal cord injury. AB - In a review of 127 urethrocystograms carried out on 92 males with spinal cord injury the following conclusions were drawn. (1) In the presence of vesico ureteric reflux or urethral reflux into the male adnexa, bladder outlet obstruction should be suspected. (2) Lesions of the anterior urethra develop easily as the result of indwelling catheterisation in patients lacking sensation. A retrograde urethrogram is necessary to demonstrate these lesions. (3) Severe trabeculation of the bladder wall can be a sign of high-pressure outlet obstruction. (4) Dilatation of the bladder neck in patients with detrusor sphincter dyssynergia may lead to total urinary incontinence after sphincterotomy. (5) Urethrocystography is not a valid investigation to detect bladder stones. PMID- 6499391 TI - Upper urinary tract changes in patients with spinal cord injury. AB - Two hundred and six intravenous urograms on 119 patients with spinal cord injury were reviewed and the findings correlated with the clinical data. Fifty (42%) of 119 patients had pathological changes in their upper urinary tracts. The most common feature was impaired renal emptying. Patients with normal and pathological upper tracts had similar findings according to the number of positive urine cultures during the first post-injury year, but in the follow-up those with pathological urograms showed bacteriuria significantly more often. Febrile urinary tract infections at least once a year were encountered in the follow-up of 40% of the patients with pathological urograms, as compared with 8% with normal urograms. All patients with severe renal changes had impaired emptying from the kidneys. This supports the view that the basic patho-physiological mechanism leading to upper tract deterioration in patients with spinal cord injury is a functional or mechanical obstruction of the lower urinary tract. This should be treated actively before irreversible renal changes develop. PMID- 6499392 TI - Rotatory subluxation of the scaphoid. AB - Rotatory subluxation of the scaphoid is an uncommon abnormality which is not widely understood. It can be difficult to diagnose and, if incorrectly managed, can lead to a severe and disabling radio-carpal arthritis. While complicating many forms of wrist trauma, its place in the lunate-perilunate dislocation spectrum being especially important, the abnormality may occur in the absence of trauma, such as with rheumatoid arthritis; its association with Kienbock's disease is documented in this paper. The mechanisms underlying the subluxation are discussed and the importance of early diagnosis is stressed. Eight cases of rotatory subluxation of the scaphoid are reported to illustrate the presentations, symptomatology and complexities of diagnosis. PMID- 6499393 TI - Lymphatic hypoplasia without lymphoedema. AB - A prospective study of lymph vessel abnormalities in the lower limbs of 744 adult patients without lymphoedema revealed seven patients with lymphatic hypoplasia, a prevalence rate of 0.94% (95% limits of confidence 0.24-1.64%). The prevalence was higher in males (1.1%) than in females (0.5%) but the difference is not statistically significant. This is much higher than any available estimate of the prevalence of primary lymphoedema of the lower limbs and suggests that lymphatic hypoplasia is merely one factor in the aetiology of clinical lymphoedema. PMID- 6499394 TI - Staging laparotomy in Hodgkin's disease. PMID- 6499396 TI - A coalition that works: medical indigent care in Pueblo. PMID- 6499395 TI - Victory in Brighton County Court. PMID- 6499397 TI - Polio survivors find support. PMID- 6499398 TI - Laboratory evaluation of the bleeding patient. AB - The laboratory evaluation of bleeding patients is often inaccurate and incomplete when the history and physical examination are not adequately evaluated. Using such information the next step is to use screening tests to evaluate platelet numbers and function, clot formation and clot stability and then to proceed to appropriate follow-up testing when indicated. In this way the number of tests can be significantly reduced and an accurate diagnosis becomes more likely. PMID- 6499399 TI - Fibrinopeptide A in the diagnosis and treatment of deep venous thrombosis and pulmonary embolism. AB - The assay of fibrinopeptide A (FPA) has stimulated particular interest because of its high sensitivity and unique specificity for the action of thrombin. It has proved to be an extremely useful tool in research studies concerning the pathophysiology of thrombotic disease. Use of FPA in the diagnosis and treatment of deep venous thrombosis and pulmonary embolism is reviewed, and the potential usefulness of measuring FPA in the monitoring of the effectiveness of anticoagulant therapy is discussed. PMID- 6499400 TI - The use of synthetic substrates in the coagulation laboratory. AB - The development and adaptation of synthetic substrates has introduced new concepts and methodologies to the coagulation laboratory. Synthetic substrates offer potentially improved standardization over conventional testing, providing a rapid, sensitive, and specific way to measure enzymes directly. PMID- 6499401 TI - Emotional support providers and psychological distress among Anglo- and Mexican Americans. AB - Accumulating evidence from studies investigating the role naturally-occurring emotional support networks play in remediating psychological distress strongly suggests that such networks buffer personal distress and lessen the need for formal mental health care. Research findings also suggest that reliance on emotional support networks varies across ethnic groups. The present study compared emotional support network characteristics of Anglo-Americans to those of Mexican Americans, in addition to examining the relationship between the reliance on specific support providers and psychopathological symptoms for Anglo- and Mexican Americans. Randomly selected adult Anglo- and Mexican Americans (n = 515) living in one of three suburban communities in Southern California provided responses to a standardized measure of psychological impairment and named those persons on whom they depended in time of personal problems. Both Anglo- and English speaking Mexican American (ES MA) respondents reported significantly larger networks and more cumulative contact and reciprocity with network members than did Spanish-speaking Mexican Americans (SS MA) respondents. Anglos and ES MAs named significantly more friends and neighbors as emotional support providers than did SS MAs. SS MAs, on the other hand, more often depended on extended kin and spouses than did the other two subgroups. Professional caregivers accounted for a very small proportion of responses across the subgroups. The number of friends and neighbors as support providers was significantly and positively correlated with problems of social relations in only the SS MA subgroup. Implications of results for community mental health direct and indirect service components are discussed. PMID- 6499402 TI - A study of mental health administrators and systems utilizing a four-part rural/urban taxonomy. AB - A study of administrators working in public-sector community-level mental health systems was undertaken. Three hundred and fourteen managers representing 109 systems in both urban and rural settings were interviewed, with 91 percent providing completed questionnaires. Multiple discriminant analyses indicated significant differences in perception of ruralness; personal, job, and system characteristics; and nonwork dimensions. Administrators differed in what they did on the job, not in responses (e.g., turnover, stress) to their work. The rural manager seems more a generalist, but other stereotypes of the nature of rural mental health management and managers were contraindicated. Implications of the data and further research are discussed. PMID- 6499403 TI - Staffing patterns in rural health services for children and adolescents. AB - This paper reviews several current human resources issues in delivering mental health services to children and adolescents, focusing primarily on the lack of systematic data regarding staff involved in these programs. Data from twenty counties in rural western Pennsylvania are then presented demonstrating the personal, educational, employment, and caseload characteristics of this group of staff, as well as their primary job functions and areas of job satisfaction. Professional staff were likely to have terminal master's degrees and to work primarily in outpatient services, whereas bachelor's-level staff were more likely to perform "generalist" functions, often without adequate supervision and clinical training. Paraprofessional staff were most numerous in community residential settings and performed a variety of functions. The implications of these findings for services development and staff training are discussed. PMID- 6499404 TI - Correlates of success and lack of success in deinstitutionalization. AB - This is a case study of ninety-two patients served by an outpatient service of a state psychiatric hospital in a rural area in west central New York State. The purpose was to identify variables associated with success (tenure in the community) and lack of success (number of readmissions within last year and five years and one subsequent year). Using a stepwise multiple regression analysis, age and living with others were positively correlated with success and negatively correlated with rehospitalizations within one year. Over a five-year period, affective disorders, inconsistency in taking medication, and having a hobby were correlated with multiple hospitalizations. In the year following data collection, readmissions were related only to inconsistency in taking medication. Mental health practitioners are advised to carefully follow up persons at highest risk of returning to the hospital. PMID- 6499405 TI - Block grants and federal promotion of community mental health services, 1946-65. AB - The current Alcohol, Drug Abuse, and Mental Health block grant program represents a return to the form of federal promotion of community mental health services that existed in the 50s and early 60s. Federal mental health policy during this period is outlined, and associated changes in the number and characteristics of outpatient psychiatric clinics are described. This policy is contrasted with both the CMHC program that succeeded it and the current block grant program. Differences with the earlier block grant suggest that the current one will be minimally effective in maintaining or increasing state support of community-based services. PMID- 6499406 TI - Use of isoelectric focusing of bacterial proteins for characterisation of strains of motile anaerobic "corroding" bacteria isolated from soft tissue infections in cats and dogs. AB - Isoelectric focusing of bacterial proteins in 1 mm thick agarose gels and ultrastructural analysis of cell walls were used to facilitate characterisation of motile "corroding" bacteria from subcutaneous abscesses and pyothorax infections from cats and dogs. Some of the motile "corroding" rods had ultrastructural cell wall features identical with Wolinella recta described from human periodontal pockets. Other strains had the more conventional cell wall ultrastructure of Gram negative bacteria. Isoelectric focusing of bacterial proteins divided the motile "corroding" strains into two groups. These groups correlated with the ultrastructural appearance of the cell walls. It is considered that isoelectric focusing techniques using 1 mm thick agarose gels may provide a more rapid method for ultimate differentiation of these organisms than other methods described so far. PMID- 6499407 TI - Immunizing efficacy of Toxoplasma gondii strains isolated from different hosts. AB - Studies were carried out to determine the fate of virulent Toxoplasma gondii challenge in immune animals. Toxoplasma strains isolated from human, swine, rabbit and cat hosts were used for the primary immunization of mice. Brains were removed at various intervals after the challenge and subinoculated into normal mice. Prior immunization with one of the nine toxoplasma strains enabled the mice either to eliminate or harbour the challenge organisms without loss of virulence. The outcome of challenge infection was dependent on the parasite strain used for the immunization and the time interval between challenge and subinoculation. Mice immunized with strain KSU isolated from a cat eliminated repeatedly administered challenge from 80% of animals. Strain S 162 isolated from a swine eliminated similar challenge from only 20% of animals. The results indicate that the extent of protection against virulent T. gondii can vary widely and is related to the immunogenicity of the original immunizing strain. PMID- 6499408 TI - Effects of tobacco smoke inhalation on the tracheo-bronchial microflora of rats. AB - The purpose of work was to study the effects of tobacco smoke on the airway flora in rats. A study on the regional distribution, total numbers and composition of the flora suggested the following: (a) Subacute smoke exposure intensified the penetration of the flora into deeper, normally sterile portions of the airways. (b) On smoking, the predominantly D. pneumoniae type flora of normal rats was found to shift to a form in which Hemophilus sp. was most frequent. (c) Exposure to low or high nicotine content cigarettes did not particularly modify these results. PMID- 6499409 TI - Immunoregulation of fish nonspecific cytotoxic cell activity by retinolacetate but not poly I:C. AB - Nonspecific cytotoxic cells (NCC) from fish (Ictalurus punctatus) were treated with different concentrations of retinolacetate and poly I:C. Both in vitro and in vivo experiments were conducted. Retinolacetate significantly increased NCC activity against chromium-51 labeled human B-cell lymphoma target cells (NC-37). Preincubation (treatment prior to adding the labeled target cells) of NCC for 4 to 8 h in 10(-3) to 10(-12) M concentration of retinolacetate produced significant increases in NCC activity compared to treatment during the killing assay only. Similar experiments with different concentrations of poly I:C had no NCC augmenting effects when tested by adding poly I:C either during preincubation periods or during the cytotoxicity assay. Retinolacetate probably produces positive modulation of cytotoxicity by increasing the killing effectiveness of individual NCC, rather than recruiting larger numbers of cytolytic cells. In vitro studies were also conducted by injecting catfish (i.p.) with 1 X, 3X and 5X the daily recommended vitamin A dosages and determining NCC activity after 24, 48 and 72 h treatment. The 1X dose significantly increased NCC activity at 72 h. This increase was not transient because NCC activity after 33-37 days' treatment was significantly higher than controls in the 1X, 2X and 3X groups. Intraperitoneal injections of fish with poly I:C produced no significant increases in NCC activity at 24 or 72 h post-inoculation. PMID- 6499410 TI - Localization, isolation and characterization of Mn-superoxide dismutase in bovine adrenocortical cells. AB - Cyanide-insensitive superoxide dismutase activity was present in both cytosol (26%) and mitochondrial (64%) fractions of bovine adrenal cells. The cyanide insensitive superoxide dismutase was isolated from the mitochondrial fraction. It contained 2.2 g atoms of manganese per mol of enzyme. The enzyme had a molecular weight of 82,000 and a subunit molecular weight of 22,000. The isoelectric point, amino acid composition, and spectra of visible and ultraviolet regions were similar to those of the Mn-superoxide dismutase from the other mitochondria. PMID- 6499411 TI - Plasmalogenase activity in normal and dystrophic chicken erythrocytes. AB - The enzyme kinetics for plasmalogenase have been analyzed on a developmental basis and correlated with the presence of ethanolamine plasmalogen (1-alkyl,1' enyl,2-acyl-sn-glycerol-3-phosphoryl-ethanolamine) in dystrophic chicken erythrocyte membranes. At day 15 ex ovo, both dystrophic (Line 413) and normal (Line 412) chicken erythrocyte enriched microsomal preparations manifest high Km forms of plasmalogenase. However, with time, the Km of this enzyme from normal erythrocyte preparations drops significantly whereas the Km of the enzyme from dystrophic preparations remains high. This observation may account for elevated concentrations of plasmalogen observed in dystrophic chicken tissues. PMID- 6499412 TI - Processing of the electroencephalogram in cardiac surgery. AB - The objective of this investigation was to find a method to automatically detect several types of abnormal EEG patterns which occurred during cardiac surgery. The EEGs were analyzed by means of several EEG processing and pattern recognition methods. It was found that a good classification into normal and abnormal EEG patterns was generally obtained if only two EEG features were used. The results of this investigation are of importance for implementing into a computer-based monitoring system for use during cardiac surgery. PMID- 6499413 TI - Finn chamber patch test technique. AB - Proper technique aids reliable patch test results. The Finn chamber volume was determined to be 25 microliters. These studies suggest the optimal volume semi solid test substance to be 12-15 microliters. More than 18-21 microliters caused significant extrusion of test substance and improper adhesive adherence. Finn chamber paper discs used with solutions absorb a maximum of 17.5 microliters test solutions and keep 15 microliters within the chamber. The evaporation rate of aqueous test solutions from Finn chambers was 1 mg/3 min; thus, the chambers should be applied quickly to avoid drying. PMID- 6499414 TI - Patch testing with colophony. AB - Colophony (rosin) has been fractionated into 2 parts, an acidic and a neutral fraction. Routine patch testing with neutral components gives positive reactions at a 40% higher frequency than routine patch testing with colophony (20%) (w/w in pet.). A concentration of 60% colophony is suggested for routine patch testing. PMID- 6499415 TI - Shifts of delayed immune response to persulphates and other allergens. AB - Certain chemicals such as persulphates and formaldehyde are able to induce both immediate and delayed type reactions in the skin. The levels of delayed type response to persulphates (at 48 and 74 h), obtained by epicutaneous tests were subjected to comparative studies of shifts (48 versus 72 h) and statistical analysis. The 95% confidence limit of the mean value of shifts to persulphates was significantly higher than that of a standard routine battery as a whole and, with the exception of formaldehyde, also to that of other individual constituents of this battery. In the case of persulphates, this difference in shifts was due to an extremely low mean value of delayed-type response read at 48 h. The possible underlying mechanisms and the possible limiting role of vaso-active amines in the early evolution of delayed-type response is discussed. PMID- 6499416 TI - The sensitizing capacity of atranorin. AB - The allergenic potential of the aromatic lichen substance atranorin has been investigated by means of the guinea pig maximization test of Magnusson & Kligman. Sensitivity was induced in 30% of the animals, which corresponds to a moderate allergenic capacity (grade III). This is in agreement with the clinically observed frequency of 1.5% among our patients. A modified photoallergy test on the same animals was performed, but irradiation did not increase the number of positive reactions. 4 patients with proven contact sensitivity to atranorin, evernic, usnic or physodic acid, were examined with different dilutions from 0.001 to 0.1%. Irradiation of the test series did not provoke any clear-cut photoallergic reaction. PMID- 6499417 TI - Histological assessment of skin damage by irritants: its possible use in the evaluation of a 'barrier cream'. AB - The histological changes induced by topical application of selected irritants are reported. The possible application of this methodology to the evaluation of the protective value of a silicone-containing barrier cream is discussed. Although this crude method only allows objectivity of the later stages of a toxic reaction, it gives useful information about the potential protective effect of a silicone-containing barrier cream. PMID- 6499419 TI - Contact allergy related to TEA-PEG-3 cocamide sulfate and cocamidopropyl betaine in a shampoo. PMID- 6499418 TI - Purpuric allergic contact dermatitis to epoxy resin. PMID- 6499420 TI - Reading positive patch test reactions. PMID- 6499421 TI - Patch testing in children. (I) Collective test results; skin testability in children. AB - The results of 10 years of patch tests in children with eczema aged between 3 and 16 years are reported. 147 children were tested, of whom 104 (71%) reacted. 334 (6.1%) of 5398 tests were positive and 302 were relevant. 3,539 tests were negative in the 104 children who reacted to at least one substance. 1,525 negative tests were found in 43 children who showed no positive reactions, making a total of 5,064 negative tests among 141 children. The conclusions are: (i) Positive tests are relatively infrequent in children in relation to the large number of tests performed. (ii) The high number of negative results shows that the skin of children can be tested with the concentrations used for adults, and supports the allergic nature of the positive reactions in the series, which were relevant in 90% of the patients. PMID- 6499422 TI - Purpuric vasculitis-like eruption in a patient sensitive to balsam of Peru. AB - A case is reported of secondary dissemination of allergic contact dermatitis in a patient sensitive to balsam of Peru. The primary eruption was located in the face. The secondary lesions appeared as purpuric vasculitis-like eruptions on both legs. Such an unusual manifestation of contact dermatitis may cause considerable delay in establishing the correct diagnosis. PMID- 6499423 TI - Pacemaker contact sensitivity. AB - In a patient who had 4 cardiac pacemakers implanted and removed, pruritus, redness, and swelling of the skin overlying the pacemaker developed at intervals of 6 weeks to 17 months after insertion. Patch testing showed a 2+ reaction to titanium. The positive result of this test, the titanium case of the generator, and the history of multiple local reactions around the generator site pointed toward contact sensitivity to the pacemaker. Although a review of the literature indicates that this problem is rare, it is of extreme importance to the patient with pacemaker contact dermatitis. PMID- 6499424 TI - Patch test allergens in petrolatum: a reappraisal. AB - Patch test materials in petrolatum, from 3 different manufacturers and 14 different types were evaluated by gross and microscopic examination. The allergens were noted to be suspended as particles or droplets in the vehicle. Obvious variations in both size and structure of the included allergen were found with the same chemicals but of different manufacture. Several materials do not meet the pharmaceutical standards which should be requested regarding stability, particle size and packing. A more detailed declaration is proposed. PMID- 6499425 TI - Comparison of methods for the macroscopic assessment of epicutaneous allergic contact reactions in guinea pigs. AB - 40 guinea pigs were sensitised with a 50% solution of 2,4-dinitro-1-chlorobenzene (DNCB) and challenged 14 days later with DNCB 0.05%. Four parameters were determined to evaluate the challenge reaction after 24, 48, 72 and 96 h: (a) intensity of erythema, (b) reaction area (product of the largest diameters of the reaction in vertical alignment), (c) increase in skinfold thickness and (d) reaction volume (product of the reaction area and the increase in skinfold thickness). The test reactions were read blind by 2 independent observers, yielding small but significant differences in all methods except determination of the reaction area. Further statistical analysis revealed a linear correlation between the intensity of erythema and the other 3 parameters determined, as well as between the reaction area and the reaction volume. In contrast, the increase in skinfold thickness did not correlate linearly either with the reaction area or the reaction volume. When the results of the 24- and 48-h readings were compared, the characteristic crescendo reaction of contact allergy was demonstrable by all methods except the determination of the reaction area. After the 48-h reading, a continuous decrease of reactions was found with all methods. It is concluded that the determination of the reaction area and consequently of the reaction volume are not suitable for exact measurement of epicutaneous allergic contact reactions in guinea pigs. The most precise results will be obtained by measuring the increase in skinfold thickness, whereas the determination of the intensity of erythema, which is easier to perform, may be sufficient for many purposes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499427 TI - Sensitivity to woodtar. PMID- 6499426 TI - The sensitizing capacity of multifunctional acrylates in the guinea pig. AB - The multifunctional acrylates used in ultraviolet (UV) curable resins act as cross-linkers and "diluents". They are usually based on di(meth)acrylate esters of dialcohols or tri- and tetra-acrylate esters of polyalcohols. In UV-curable coatings, the most commonly used are pentaerythritol triacrylate (PETA), trimethylolpropane triacrylate (TMPTA) and 1,6-hexanediol diacrylate (HDDA). In other uses, such as dental composite resin materials, the dimethacrylic monomers based on n-ethylene glycol are the most useful. The sensitizing capacity of various multifunctional acrylates and their cross-reactivity pattern have been investigated with the guinea pig maximization test. The tests show that BUDA (1,4 butanediol diacrylate) and HDDA are moderate to strong sensitizers and that they probably cross-react with each other. The n-ethylene glycol diacrylates and methacrylates tested are weak or non-sensitizers. Tripropylene glycol diacrylate (TPGDA) is a moderate and neopentyl glycol diacrylate (NPGDA) a strong sensitizer, whereas neopentyl glycol dimethacrylate is a non-sensitizer. The commercial PETA is a mixture of pentaerythritol tri- and tetra-acrylate (PETA-3 and PETA-4). PETA-3 is a much stronger sensitizer than PETA-4. Simultaneous reactions were seen between PETA-3, PETA-4 and TMPTA. The oligotriacrylate OTA 480 is a moderate sensitizer, but no concomitant reactions were seen with PETA-3, PETA-4 or TMPTA. Of the multifunctional acrylates tested, the di- and triacrylic compounds should be regarded as potent sensitizers. The methacrylated multifunctional acrylic compounds are weak or non-sensitizers. PMID- 6499428 TI - Dermatitis from sodium lauryl sulfate in hydrocortisone cream. PMID- 6499429 TI - Lipstick dermatitis related to castor oil. PMID- 6499430 TI - Contact dermatitis to formaldehyde in fabric softeners. PMID- 6499431 TI - Unexpected cause of IPPD sensitivity. PMID- 6499432 TI - Phototoxicity of a weedkiller: a correction. PMID- 6499433 TI - Estradiol enhances nickel-induced blast transformation. PMID- 6499434 TI - Positive patch test reactions to injectable corticosteroids. PMID- 6499435 TI - The use of cervical caps at the University of California, Berkeley: a survey. AB - A survey of cap use and efficacy of women who initially purchased a cervical cap at the University of California at Berkeley Student Health Service is described. It reports the follow-up of 65 U.C. women students who purchased either Vimule or Cavity-rim cervical caps from May, 1978 through June, 1981 and raises questions about cervical cap use and efficacy. Participants were divided into two groups: regular and irregular users. Of the 33 regular users, 16 experienced unplanned pregnancy during the study. Survival probabilities were 80% at 6 months, 73% at one year and 52% after 2 years. Life table analysis of the 33 regular users indicated a 20% probability of pregnancy in the first 6 months of use, 27% by 1 year and 48% by the end of 2 years. PMID- 6499436 TI - Long-term luteal changes after tubal sterilization. AB - In this study the luteal function was evaluated in 109 subjects 2 to 108 months following tubal sterilization by Pomeroy's technique or laparoscopic tubal rings. Midluteal endometrial biopsies determined by basal body temperature charts were performed and dated in all subjects. Midluteal serum progesterone was estimated by RIA in 40 women. Our results indicated that the mean time which had elapsed since sterilization was significantly shorter in the subjects who revealed luteal defects than in those with normal luteal function. There were no statistically significant differences between the 2 occlusive techniques in terms of poststerilization incidence of luteal defects. PMID- 6499437 TI - Intestinal absorption of ST-1435 in rats. AB - The intestinal absorption of a 19-norprogesterone (ST-1435) was studied in rats after an oral dose of 5 mg ST-1435/kg body weight. Blood samples were collected simultaneously from the portal vein and by cardiac puncture. Plasma ST-1435 concentrations were measured from the samples by radioimmunoassay (RIA). Chromatographic purification of ST-1435 in rat plasma revealed a metabolite cross reacting in the RIA. A peak concentration of 240 ng ST-1435/ml was found in portal plasma 75 minutes after administration, indicating that the steroid is well absorbed from the small intestine. However, in spite of the relatively high dose used, the plasma concentrations of ST-1435 in the systemic circulation remained low and of short duration. Thus, it seems that ST-1435 in hepatic portal blood is extensively taken-up and metabolized by the liver, resulting in low plasma concentrations of ST-1435 in the systemic circulation when the steroid is administered orally. This is also supported by the observation that higher metabolite levels were found in systemic plasma than in portal plasma during the first 90 minutes after administration. This pronounced first-pass effect may also explain why in women oral administration of ST-1435 has failed to result in any biological effect. PMID- 6499438 TI - Biological, microscopic and scanning electron microscopic investigations of the effects of postinor /d-norgestrel/ in rabbits. AB - The contraceptive effect of d-norgestrel given immediately after copulation in various quantities was investigated in rabbits. It was established that the effect is dose-dependent. A correlation was found between the amount of dose administered and the changes taking place on the surface of endometrium. It can be suggested that d-norgestrel alters the surface of the endometrium to such an extent that nidation is unable to take place; therefore, it can be used for postcoital contraception at any time. PMID- 6499439 TI - Lack of tubal occlusion by intrauterine quinacrine and tetracycline in the primate. AB - The effects of slow- and fast-releasing quinacrine pellets and tetracycline tablets on the genital tracts of 20 cynomolgus monkeys was evaluated. After surgical implantation of the pellets, the primates were observed for three months. No signs of toxic effects to the drugs were observed during the three month period and on autopsy. Histopathological evaluation of the fallopian tubes, cervix, ovaries and uterus (except the endometrium) indicated they were all within normal limits. In no case were the uterotubal junctions obstructed. Endometrial changes were more frequent for quinacrine-treated monkeys. The results of the study point to the need for additional research regarding the optimal dose and duration of quinacrine administration. PMID- 6499440 TI - Fibrinolytic activity in plasma and vessels of the hind leg in rats treated with ethinylestradiol and D-norgestrel. AB - The separate effect of ethinylestradiol (4 micrograms/kg b.w./day) and d norgestrel (20 micrograms/kg b.w./day) on the fibrinolytic activity in plasma and in vessel walls of the hind leg was investigated in an experimental study on rats. No hormonal effect on the fibrinolytic activity in plasma was registered. However, a significantly increased fibrinolytic activity in the vessel wall of the distal hind leg was demonstrated in the d-norgestrel-treated rats with plasma levels well below those reported in women using combined contraceptive pills. On the contrary, the fibrinolytic activity of the vessel wall was uninfluenced in the ethinylestradiol-treated rats with plasma levels corresponding to those in women on contraceptive pills containing 30 micrograms ethinylestradiol. PMID- 6499442 TI - IgA mesangial nephropathy. PMID- 6499443 TI - IgA mesangial nephropathy. First international meeting of nephrology on IgA mesangial nephropathy, Milano, October 3-4, 1983. PMID- 6499441 TI - Morbidity risk among young adolescents undergoing elective abortion. AB - A cohort study comparing risks of morbidity at the time of elective abortion between 399 young adolescents aged 17 years or less matched to 399 women aged 20 to 29 years was completed. The study matched for duration of gestation, types of procedure, parity, race, month of procedure, and insurance status. Results indicated a relative risk of post-abortal endometritis for adolescents compared to older women of 2.5 (95% C.L. 1.48, 3.85). The reasons for this difference are unclear. PMID- 6499444 TI - Characteristics of eluted IgA in primary IgA nephropathy. PMID- 6499445 TI - Immunogenetics of mesangial IgA nephritis. PMID- 6499446 TI - Mucosal immunity. PMID- 6499447 TI - Idiopathic IgA mesangial nephropathy: clinical features. PMID- 6499448 TI - Acute renal failure in mesangial IgA nephropathy. PMID- 6499449 TI - Therapeutic perspectives in mesangial IgA nephropathy. PMID- 6499450 TI - Primary IgA nephropathy: prognostic factors. PMID- 6499451 TI - Idiopathic IgA mesangial nephropathy: natural history. PMID- 6499452 TI - IgA nephropathy: natural history and prognostic indices in children. PMID- 6499453 TI - Vessel sclerosis and progression in IgA nephropathy. PMID- 6499454 TI - Relation between proteinuria and morphology in IgA nephropathy. PMID- 6499455 TI - Henoch-Schonlein purpura: clinical presentation. PMID- 6499456 TI - Ultrastructural lesions of Henoch-Schonlein syndrome and IgA nephropathy: similarities and differences. PMID- 6499457 TI - Immunoglobulin A in alcoholic liver disease. PMID- 6499458 TI - IgA mesangial nephropathy in neoplastic diseases. PMID- 6499459 TI - Pathologic conditions associated with IgA mesangial nephropathy: preliminary results. PMID- 6499460 TI - Relevance of an experimental model to clinical IgA nephropathy. PMID- 6499461 TI - Experimental IgA nephropathy. Factors governing the persistence of IgA-antigen complexes in the circulation of mice. PMID- 6499462 TI - IgA mesangial nephropathy 1968-1983. PMID- 6499463 TI - Detection of antigenic substances in patients with IgA nephropathy. PMID- 6499464 TI - The glomerular mesangium. PMID- 6499465 TI - Circulating and mesangial IgA in IgA nephropathy. PMID- 6499466 TI - Presence of specific IgA immune complexes in IgA nephropathy. PMID- 6499467 TI - Macromolecular IgA in the circulation and mesangial deposits in patients with primary IgA nephropathy. PMID- 6499468 TI - Handling of IgA immune aggregates by liver cells. PMID- 6499469 TI - Acute ethylene glycol poisoning. AB - Ethylene glycol, a major constituent of antifreeze, is metabolized by alcohol dehydrogenase to glycoaldehyde, glycolate, glyoxylate, and oxalate. The metabolites of ethylene glycol cause severe metabolic acidosis and central nervous system, pulmonary, and renal damage. Ethanol competes with ethylene glycol as an alternate substrate of alcohol dehydrogenase. Two cases of ethylene glycol poisoning associated with serum concentrations of 59 and 150 mg/dl are reported. One patient was protected from the toxic effects of the metabolites because of concomitant ethanol ingestion. In patients with unexplained anion and osmol gaps, early diagnosis and therapy with ethanol and hemodialysis help prevent the toxic manifestations of ethylene glycol poisoning. PMID- 6499470 TI - High tech/low touch? PMID- 6499471 TI - Tension pneumomediastinum secondary to meconium aspiration syndrome. PMID- 6499472 TI - Hypomagnesemia and citrate toxicity. PMID- 6499473 TI - Terminal weaning. PMID- 6499474 TI - Side-port adaptor for catheter sheath-introducer systems. PMID- 6499475 TI - Detection of blood volume deficits through conjunctival oxygen tension monitoring. AB - Because acute blood loss may produce abnormal tissue perfusion and oxygenation before affecting blood pressure, we measured conjunctival (PcjO2) and arterial (PaO2) oxygen tensions and blood volume in 16 normotensive emergency department patients whose histories were consistent with significant blood loss. All eight patients with measured blood volume less than 85% of normal, as well as two euvolemic patients, had a PcjO2/PaO2 value of 0.57 or less, yielding a sensitivity of 100%, specificity of 75%, and positive predictive value of 80%. Lowering the cutoff point to 0.50 increased specificity and positive predictive value to 100% while reducing sensitivity to 88%. These results demonstrate that the PcjO2/PaO2 ratio is an early, sensitive, and specific indicator of significant blood volume deficit. PMID- 6499476 TI - Noninvasive arterial hemoglobin oxygen saturation versus transcutaneous oxygen tension monitoring in the preterm infant. AB - We found that results from a transcutaneous arterial hemoglobin oxygen-saturation monitor correlated well with those from a co-oximeter. The monitor was not disturbed by differing hematocrit levels, the presence of fetal hemoglobin, or hypotension. We also found that the results of simultaneous transcutaneous arterial hemoglobin oxygen saturation (StcaO2) and transcutaneous oxygen tension (PtcO2) monitoring were predictably correlated over a wide range of hemoglobin saturations in preterm infants. When StcaO2 was between 80% and 95%, PtcO2 was at a safe level of 40 to 80 torr in 94% of the patients studied. StcaO2 monitoring as an index of arterial oxygenation has several advantages for the preterm infant. PMID- 6499477 TI - Continuous monitoring of arterial and tissue PCO2. AB - Catheter-tip sensors used to measure arterial and tissue PCO2 produced a baseline drift less than 2 torr during 1 to 5 h of monitoring. Clot formation during PaCO2 monitoring was avoided by continuous infusion of a small amount of heparin solution around the sensor. PaCO2 sometimes fluctuated periodically during spontaneous breathing but not during mechanical ventilation. Subcutaneous tissue PCO2, monitored by placing the sensor under the skin on the chest, showed an almost parallel movement to PaCO2 with a time delay of a few minutes. This PCO2 sensor was durable and accurate for up to 5 h continuous clinical monitoring. PMID- 6499478 TI - Oxygen transport and utilization in hyperoxia and hypoxia: relation of conjunctival and transcutaneous oxygen tensions to hemodynamic and oxygen transport variables. AB - A device to measure surface oxygen tension of the palpebral conjunctiva (PcjO2) was developed and tested in 12 mongrel dogs subjected to normoxia, hyperoxia, and hypoxia. Intravascular pressure, hemodynamic, and bulk oxygen transport variables were measured simultaneously with PcjO2 and transcutaneous O2 (PtcO2) and CO2 (PtcCO2). PcjO2 closely paralleled PaO2 as the fractional inspired O2 concentration was changed from 0.21 up to 1.0 and down to 0.05; the correlation coefficient, r, was 0.95 for 305 data sets. During hyperoxia there were no significant hemodynamic or bulk O2 transport changes, but during hypoxia, the cardiac output and O2 extraction increased while PaO2, PtcO2 and PcjO2 fell; O2 delivery and O2 consumption were maintained until just before death. PMID- 6499479 TI - Effect of hemorrhagic shock on conjunctival and transcutaneous oxygen tensions in relation to hemodynamic and oxygen transport changes. AB - To evaluate possible physiologic mechanisms in hemorrhagic shock, sequential hemodynamics, O2 transport, conjunctival O2 (PcjO2), transcutaneous blood gases (PtcO2, PtcCO2), and core and conjunctival temperature (Tcore, Tcj) were measured during a control period, after hemorrhage, after reinfusion of the shed blood, and subsequently during terminal normovolemic shock in eight anesthetized dogs. The PtcO2 sensor requires surface heating to 44 degrees or 45 degrees C, whereas the PcjO2 sensor measures surface temperature but does not heat the tissue, thus avoiding heat-induced artifacts. Shortly after onset of hemorrhage, hemodynamic variables, bulk O2 transport, and tissue O2 tensions decreased abruptly. Prolongation of hemorrhage further deteriorated these variables. Reinfusion of the shed blood returned all values except PcjO2 to the normal range. In the terminal stage, all variables except PaO2 again deteriorated; decreased O2 transport impaired oxygen consumption, which in turn reduced both central and peripheral heat production. Lowered oxygen consumption, Tcore and Tcj reflect decreases in total-body and local tissue metabolism. These data are consistent with the concept that tissue O2 tension represents the balance between O2 supply and O2 demand and thus reflects overall O2 metabolism, which may be rate-limited by circulatory deficiencies. PMID- 6499480 TI - Plasma catecholamine and free fatty acid levels during infusion of lipid emulsion in critically ill patients. AB - The fractional elimination rate of exogenous fat, and fat-mobilizing lipolysis in relation to plasma catecholamine (CA) levels were studied in seven ventilator treated ICU patients. Blood levels of CA, triglycerides, cholesterol and free fatty acids (FFA) were also analyzed before and during constant infusion of a soybean oil emulsion (Intralipid). Triglyceride concentrations rose significantly during the infusion. FFA levels also increased significantly within 30 min after the infusion was begun, reflecting fatty acids derived from Intralipid triglycerides. Plasma norepinephrine levels showed large interindividual variations and were inversely related to FFA concentrations. No correlation was found between plasma CA levels and the fractional removal rate of fat. These data suggest a deficiency of substrate in these critically ill patients. PMID- 6499481 TI - Plasma lipid peroxides and alpha-tocopherol in critically ill patients. AB - Plasma lipid peroxide measured as thiobarbituric acid reactive substances (TBARS) and alpha-tocopherol levels in 24 critically ill patients were compared with those of control subjects. The mean plasma alpha-tocopherol level was significantly lower and the mean TBARS level was significantly higher in critically ill patients. Eight ICU patients developed disseminated intravascular coagulation (DIC); the mean TBARS level during DIC was significantly above the mean pre-DIC level. These results indicate that lipid peroxidation may contribute to the development of DIC in critically ill patients. PMID- 6499482 TI - Biases in the measurement of arterial pressure. AB - We compared cuff to simultaneous direct intra-arterial pressure in 26 seriously ill patients, in order to: test the accuracy of oscillometric and auscultatory estimates of direct systolic pressure; test muffling and disappearance of sound as indices of direct diastolic pressure; gain insight into the timing of the different phases of Korotkoff sounds; and assess the local and general effects of cuff inflation on blood pressure. We found that conventional estimation of systolic blood pressure by auscultation of the first Korotkoff sound (K1) underestimates direct systolic pressure by an average of 16 to 17 mm Hg. Oscillometric pressure measurement provides a significantly better estimate than K1 but still underestimates by 7 to 8 mm Hg. These systolic cuff measurements are biased downward from direct values because of local cuff effect and cuff error. Diastolic cuff measurements deviate from direct values primarily because of a local cuff effect which produces an upward bias of 5 mm Hg at the point of sound muffling (K4), and 3 mm Hg at the point where sounds disappear (K5). We recommend oscillometric measurement of systolic pressure and K5 measurement of diastolic pressure as the best indirect estimates of blood pressure in critically ill patients. PMID- 6499483 TI - A simplified acute physiology score for ICU patients. AB - We used 14 easily measured biologic and clinical variables to develop a simple scoring system reflecting the risk of death in ICU patients. The simplified acute physiology score (SAPS) was evaluated in 679 consecutive patients admitted to eight multidisciplinary referral ICUs in France. Surgery accounted for 40% of admissions. Data were collected during the first 24 h after ICU admission. SAPS correctly classified patients in groups of increasing probability of death, irrespective of diagnosis, and compared favorably with the acute physiology score (APS), a more complex scoring system which has also been applied to ICU patients. SAPS was a simpler and less time-consuming method for comparative studies and management evaluation between different ICUs. PMID- 6499484 TI - Use of a needle valve variable resistor to improve invasive blood pressure monitoring. AB - Inaccurate measurements using in-line systems are partly due to the resonance frequency. A variable acoustic resistor designed to change the damping coefficient of these monitoring systems was evaluated under clinical conditions. The device improved pressure transmission characteristics in measurements on 12 of 13 patients. Use of the device and of the bedside step-impulse test for calibration should improve the reliability of in-line blood pressure monitoring. PMID- 6499485 TI - Pressure infusors: variability in delivered infusion pressure. AB - A pressure infusor was used to apply external pressures of 300, 250, 200, and 150 mm Hg to 500-ml plastic bags of saline. At constant applied pressure, 50-ml aliquots of saline were periodically withdrawn. The delivered pressures were less than the applied pressures, and the difference increased as the volume of saline within the bag decreased. This inherent pressure difference should be considered when the system is used with a continuous flush device. PMID- 6499486 TI - Pediatric endotracheal tube designed for high-frequency ventilation. AB - Using pediatric endotracheal tubes (ETs) designed for high-frequency jet ventilation (HFJV), we demonstrated that when the fraction of the ventilatory cycle spent in inflation (Ti) was 0.3 or greater, entrainment of air flow was unaffected by frequencies up to at least 900 cycle/min. Flow through the jet opening was related to drive pressure (PD) at the ventilator, and to the diameter of the external connector to the jet tube in the ET. Maximal entrainment was completed within a 2.5-cm section downstream from the jet opening in these small ETs. When the jet opening was closer than 2.5 cm to the tip, output from the ET was compromised. Pressure measured in the lumen of the ET was most negative at the axial location of the jet opening. Its amplitude at that point reflected a balance between jet-flow velocity (a reflection of PD) and back-pressure (or airway pressure). ET lumen diameter had little effect on entrainment or on total flow through the ET. PD, Ti, and frequency can be regulated to optimize the output for an ET. PMID- 6499487 TI - Burkitt's lymphoma of the stomach. AB - An unusual case of American Burkitt's lymphoma originating in the stomach of an elderly man is presented. Computed tomography revealed diffuse infiltration of the gastric wall by a solid tumor measuring 2.5 to 5.5 cm in thickness. Despite such bulky tumor, however, distensibility of the stomach was preserved because Burkitt's lymphoma does not induce desmoplastic reaction and linitis plastica. PMID- 6499488 TI - Role of computed tomography in symptomatic vertebral hemangiomas. AB - Vertebral hemangioma, although a benign lesion, can result in neurologic deficit. Computed tomography is useful in demonstrating the extension of the hemangioma into the posterior neural arch and epidural space. Computed tomography after intravenous contrast administration is useful in evaluating the vascular nature of the lesion and is a useful technique before surgery or spinal angiography. PMID- 6499489 TI - Case report: CT findings in lumbosacral agenesis. AB - This case describes a newborn paraplegic male with lumbosacral agenesis and related congenital anomalies, including bilateral hip dislocations, arthrogryposis, talipes equinovarus, as well as neurogenic bladder with urine incontinence. An extra-dural tumor, surgically excised and diagnosed as a lipoma, was identified on computed transaxial scans to be adjacent to an abruptly terminating dural sac. Caudal to the sac the scans demonstrated partial fatty replacement of muscle bundles and direct articulation of the iliac wings. A follow-up myelogram delineated the subarachnoid space, but could not distinguish the tumor from a deformed sac secondary to lumbar defects. Computed tomography is thus recommended as part of the general radiologic protocol for fully evaluating the spatial orientation and anomalies of this spinal defect. PMID- 6499490 TI - Pulmonary vein tumor thrombosis and left atrial extension in lung carcinoma. AB - A case of lung carcinoma extending into left atrium through a pulmonary vein and mimicking left atrial myxoma is presented. The localized enlargement of a pulmonary vein is seen as a possible CT sign of pulmonary vein tumor thrombosis. Computed tomography (CT) and echocardiography are complementary in the correct diagnosis of this condition. PMID- 6499491 TI - Abdominal computed tomography scan in acute lupus abdominal serositis. AB - This report demonstrates the value of abdominal computed tomography in the evaluation and management of a patient with abdominal complaints due to systemic lupus erythematosus. PMID- 6499492 TI - Liposarcoma involving the scapula. AB - An unusual case of a soft tissue liposarcoma arising in the upper limb was studied by computed tomography. Computed tomography suggested the diagnosis of myxoid liposarcoma using the criteria of textural inhomogeneity and bony erosion and scalloping of the scapula. PMID- 6499493 TI - Computed tomography evaluation of bilateral bronchostenosis caused by sclerosing granulomatous mediastinitis: a complication of histoplasmosis. AB - A proved case of histoplasmosis with sclerosing granulomatous mediastinitis complicated by severe bilateral bronchostenosis in a 28-year-old woman is reported. The case demonstrates that this relatively benign disease can lead to grave consequences and that computed tomography is extremely useful in the evaluation of this mediastinal lesion, particularly when plain chest radiography is noncontributory. PMID- 6499494 TI - Antibody-dependent cell-mediated cytotoxicity of cryopreserved human monocytes. AB - Human peripheral blood monocytes (PBM) modulate and participate in a variety of host defences. Cryopreservation of PBM has facilitated studies of their function. Peripheral blood samples cleared of red cells and granulocytes by centrifugation over Ficoll-Hypaque were cryopreserved at 1 degree C/min in 10% Me2SO and stored at -150 degrees C. Cryopreserved cells were thawed rapidly, diluted at a constant rate over 10 min with 9 vol of media, and washed twice prior to study. Antibody dependent cell-mediated cytotoxicity (ADCC) activity against anti-D-coated Rh positive erythrocytes of both fresh and cryopreserved PBM was tested and found to be equal (52.5 vs 51%). The myeloperoxidase positive, EA-rosette-positive population in cryopreserved cells was 39% compared with 17% for fresh cells (P less than 0.0001). This difference is due to preferential recovery of cryopreserved monocytes among mononuclear cells. The proportion of cells expressing Fc receptors among the myeloperoxidase-positive mononuclear cell population increased after freezing, suggesting an alteration in membrane structure induced by cryopreservation. It is concluded that PBM can be cryopreserved in Me2SO and that ADCC function is fully retained in the cryopreserved cells. This study along with a previous study (R.S. Weiner and S.J. Norman, J. Natl. Cancer Inst. 66, 255-260, 1981) demonstrate the feasibility of using cryopreserved human PBM for functional studies. PMID- 6499495 TI - Differences in the in vitro growth pattern of fresh and cryopreserved granulo monopoietic precursors. AB - A study of the in vitro growth model of human granulo-monopoietic precursors (CFU GM) before and after cryopreservation using both leukocyte feeder layers and GCT conditioned medium as the source of colony stimulating activity (CSA) is reported. The number of colonies produced with fresh cells was linearly related to the amount of marrow seeded with both CSA sources, whereas after cryopreservation this was true with feeder layers, and with GCT only at relatively high cell concentrations. This might indicate the production of granulopoietic stimulators on the part of a second population that is at least partly resistant to freezing. It seems more likely, however, that these results depend mainly on a sublethal damage to CFU-GM induced by freezing, thus making the cells hyporesponsive to some forms of CSA, such as those contained in GCT conditioned medium. PMID- 6499496 TI - The effect of cooling rate and warming rate on the packing effect in human erythrocytes frozen and thawed in the presence of 2 M glycerol. AB - The effect of hematocrit (2 versus 75%) has been studied on human red blood cells frozen and thawed in 2 M glycerol at a range of cooling rates (0.8-850 degrees C/min) and warming rates (0.1-200 degrees C/min). The data obtained at a hematocrit of 2% agree well with the data of R. H. Miller and P. Mazur (Cryobiology 13, 404-414, 1976). The results at a hematocrit of 75% show a decrease in recovery with increased cell packing, primarily dependent on warming rate at cooling rates less than 100 degrees C/min and on cooling rate at higher cooling rates. Rapid warming reduced the packing effect, whereas cooling faster than 100 degrees C/min accentuated it. It has been argued that these effects are unlikely to be due to modulation of the generally accepted mechanisms of freezing injury, that is, solution effects and intracellular freezing. It has been suggested that they may be explained by effects of cooling and warming rates on the dimensions of the liquid channels in which the cells are accommodated during freezing and thawing. PMID- 6499497 TI - Some functional parameters in the isolated calf liver after hypothermic preservation. AB - The purpose of the experiments presented in this paper was to ascertain the influence of cold preservation on parameters allowing assessment of liver function. All tests were carried out during 6 hr normothermic perfusion of calf liver which had been previously exposed to hypothermic conditions. These conditions were achieved by continuous perfusion of the isolated liver at +15 degrees C for 1-6 hr (dynamic hypothermia) or by preserving the liver in the refrigerator at +4 degrees C from 1 to 168 hr (static hypothermia). The correlation between the type and duration of the preservation procedure and the observed variation of the parameters studied indicates significant advantages in the continuous perfusion method over storage in the refrigerator. PMID- 6499498 TI - Lysosomal enzyme release in hypothermically perfused dog kidneys. AB - This study investigated lysosomal disruption during hypothermic perfusion preservation of kidneys and its possible relationship to viability. The percentage of free and bound enzyme activity was analyzed for three lysosomal enzymes in homogenates made from perfused canine kidney cortex tissue, including beta-glucuronidase, cathepsin-D, and aryl sulfatase. All three enzymes displayed characteristic increases in free enzyme activity (47-68%) throughout 5 days of perfusion preservation. The increased activity obtained at 5 days of preservation was found to indicate "severe" tissue damage, as shown by a similar increase obtained in renal cortex tissue exposed to warm ischemia (37 degrees C) for 4 hr or longer. Aryl sulfatase was found to be the most sensitive indicator of severe damage. Pretreatment of kidney donors with methylprednisolone, a lysosomal stabilizer, was also studied in kidneys exposed to 5 days of perfusion. Pretreatment was found to reduce the percentage of free lysosomal enzyme activity following 5 days (nonviable) of perfusion to those levels normally obtained following 3-day (viable) perfusion. This indicates that methylprednisolone may be useful in modulating the severe disruption of lysosomes induced by long-term preservation. It is concluded that extensive disruption of lysosomes occurs during hypothermic perfusion preservation and may represent one cause for loss of organ viability. PMID- 6499499 TI - The effect of cooling and warming rate on cortical cell function of glycerolized rabbit kidneys. AB - Experiments previously reported (I.A. Jacobsen, D.E. Pegg, H. Starklint, J. Chemnitz, C.J. Hunt, P. Barfort, and M.P. Diaper, Cryobiology 19, 668, 1982) suggested that rabbit kidneys permeated with 2 M glycerol are least damaged during freezing and thawing if they are cooled very slowly (1 degree C/hr). Using similar techniques of glycerolization, cooling, storage at -80 degrees C, rewarming, and deglycerolization, active cell function in cortical tissue slices prepared from such kidneys has now been studied. Oxygen uptake, tissue K+/Na+ ratio after incubation, and slice/medium PAH ratio after incubation were measured. Kidneys cooled at 3.1 degree C/min and warmed at 4.2 degrees C/min gave poor results in the previous studies and the lowest levels of cell function in the present experiments. Kidneys cooled at 1 degree C/hr exhibited degrees of slice function that were dependent on warming rate: warming at 1 degree C/min was better than warming at either 1 degree C/hr or c.20 degrees C/min. These results refine the previously drawn conclusions, (loc cit) and indicate optimal cooling and warming rates for rabbit kidneys containing 2 M glycerol, in the region of 1 degree C/hr cooling and 1 degree C/min warming. These rates are much lower than have hitherto been used by others for any system. Some implications of these findings are discussed. PMID- 6499500 TI - Improved recovery of post-thaw motility and vitality of human spermatozoa cryopreserved in the presence of dithiothreitol. AB - Semen was collected in the laboratory from nine healthy donors. The concentrations and the percentages of live and motile spermatozoa in all semen samples were within the normal range. Each sample was diluted with citrate-egg yolk-glycerol medium with and without 5 mM dithiothreitol (DTT). Samples were frozen in liquid nitrogen vapor (-70 degrees C) for 7 min and subsequently stored in liquid nitrogen. The effect of DTT in cryopreservation of sperm was determined by comparing percentage of motile and live spermatozoa between controls and DTT treated post-thaw samples. Percentage of motile spermatozoa was determined by two techniques, laser Doppler velocimetry (LDV) and light microscopy. The percentage of live spermatozoa was measured by microscopic evaluation after staining with eosin-nigrosin. It was shown that the addition of DTT to the freezing medium significantly improved the recovery of motile and live spermatozoa in the post thaw samples. The mean motility recovery, as measured by LDV, was 44.9% in the controls as compared to 73.9% in the DTT-treated samples. Similarly the mean recovery of live spermatozoa in the controls and DTT-treated samples was 66.5 and 86.6%, respectively. Based on these results, a new hypothesis implicating lipid peroxidation in cryoinjury is proposed. It is also suggested that the use of DTT in the freezing medium may offer an advantage over the commonly used techniques of human sperm cryopreservation. PMID- 6499501 TI - The effect of glycerol concentration and cooling velocity on cryosurvival of ram spermatozoa frozen in straws. AB - The effect of varying the concentration of glycerol from 0 to 16% on the survival of ram spermatozoa frozen at increasing rates of cooling (1-100 degrees C/min) or by direct plunging of spermatozoa in 0.5-ml straws in liquid nitrogen was studied after thawing at a constant rate (in water at 39 degrees C for 30 sec). For each glycerol concentration, the ram spermatozoa tolerated a range of cooling velocities and the best survival rates (percentage motility and rating) were obtained when the glycerol concentration was 4 or 6% and when the rate of freezing ranged from 10 to 100 degrees C/min. No spermatozoa survived in any glycerol concentration following freezing in straws plunged into liquid nitrogen. In general, the range of cooling rates shifts to lower values as the glycerol concentration increases for optimum cryosurvival. However, the toxic effect of increasing the concentration of glycerol over 8% contributes greatly to the gradual decrease in cryosurvival of spermatozoa at these particular concentrations. PMID- 6499502 TI - Cryopreservation of Plasmodium chabaudi. II. Cooling and warming rates. AB - Various cooling and warming rates were investigated to determine the optimum conditions for cryopreserving the intraerythrocytic stages of Plasmodium chabaudi. Infected blood, equilibrated in 10% v/v glycerol at 37 degrees C or in 15% v/v Me2SO at 0 degree C for 10 min, was cryopreserved using cooling rates between 1 and 5100 degrees C min-1. After overnight storage in liquid nitrogen the samples were warmed at 12,000 degrees C min-1. Warming rates between 1 and 12,000 degrees C min-1 were investigated using samples previously cooled at 3600 degrees C min-1. After thawing, the glycerol and Me2SO were removed by dilution in 15% v/v glucose-supplemented phosphate-buffered saline. Survival was assayed by inoculation of groups of five mice each with 10(6) infected cells and the time taken to reach a level of 2% parasitemia estimated. The optimum cooling rate was 3600 degrees C min-1 for parasites frozen using either 10% glycerol or 15% Me2SO; the pre-2% patent periods were 0.90 and 1.01 days above control values (representing survival levels of 21 and 17.5%, respectively). The optimum warming rate was 12,000 degrees C min-1; the pre-2% patent periods were 1.01 and 1.32 days above control values, respectively (18 and 10% survival), for glycerol and Me2SO. With ethanediol (5% v/v) and sucrose (15% w/v) as cryoprotectants the optimum warming rates were also 12,000 degrees C min-1 while the optimum cooling rates were 330 and 3600 degrees C min-1, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499503 TI - A helium gas probe for use in cryosurgery. AB - The design and testing of a prototype cryosurgical probe utilizing helium gas precooled with liquid nitrogen are described. An 8-mm-diameter probe produced an ice ball with a diameter of 28 mm after 10 min freezing using a helium gas flow rate of 42 liter/min. This indicated a surface heat transfer coefficient of 0.34 W/cm2 degrees K and temperature of -138 degrees C at the probe tip. Improved performance figures can be achieved using higher gas pressures and flow rates. A helium gas flow system schematic for use with this new type of cryoprobe is also presented. It is claimed that this system will overcome the problems of developing both multiple-tipped probes and small-diameter needle probes for use in cryoanalgesia. PMID- 6499504 TI - Effect of stage of development on survival of mouse embryos frozen--thawed rapidly. AB - Embryos were recovered on Day 4 of pregnancy from superovulated random-bred OF1 Swiss albino mice. They were classified into four categories based on their stage of development: expanding blastocyst, blastocyst, early blastocyst, and compacted morula. They were then cooled at 2 degrees C/min from -7 to -25 degrees C in a freezing medium containing 1.36 M glycerol and 0.25 M sucrose in phosphate buffered saline (PBS). At -25 degrees C, they were plunged into LN2 and thawed a few hours later in water at 20 degrees C. After washing in PBS, recovered embryos were cultured for 20 to 24 hr and the number of embryos that had developed normally was recorded. The results showed a clear effect of the stage of development on survival. Survival of expanding blastocysts and blastocysts was very low (1.4 and 21.8%, respectively) compared to that of early blastocysts and compacted morulae (69.4 and 73.5%). The more differentiated stage of the blastocyst (two kinds of cells) and the presence of a blastocoelic cavity may explain the differences observed under our cooling conditions. As a further test of viability, 93 blastocysts that had developed in culture for 20 hr from 153 frozen-thawed early blastocysts and compacted morulae (60.8%) were transferred to 8 recipient mice. Seven became pregnant, yielding 38/82 normal live young (46.3%). PMID- 6499505 TI - Cross-cultural aspects of bereavement. II: Ethnic and cultural variations in the development of bereavement practices. AB - Despite a growing interest in bereavement in cross-cultural perspective, few reports have described a comparative analysis of bereavement. By examining the social contexts in the transformations of Western bereavement practices, structures common to bereavement in a range of cultures can be identified. The paper compares the contemporary bereavement practices of several ethnic and cultural groups in North America: Blacks; ethnic Chinese; Southeast Asian refugees; Haitians; Italians; Greeks; and Spanish-speaking groups. Consideration is given to the state of widowhood in different cultural systems. The impact of modernization among traditional societies demonstrates that even though Western technologies are incorporated into the procedures followed by these modernizing societies, the deep cultural code remains intact. Five questions require further clarification: is bereavement an illness, or a rite de passage and a normal life event? How widespread and useful are protective factors, such as group support, that facilitate successful resolution of grief? How effective are mourning practices of various ethnic groups in preventing "bad grief", and might some of these practices be beneficial if taken up by other ethnic groups? How can the Western health practitioner know that a bereaved person from an unfamiliar cultural group is suffering "bad grief"? How acceptable is Western grief counseling to non-Western clients? PMID- 6499506 TI - Health care and health care seeking strategies among Puyallup Indians. AB - This study replicated Kleinman's research on family-based popular health care in Taiwan among the Puyallup Indians of Washington. Standardized interviews were conducted among 80 Puyallup families to determine family health practices and beliefs, and the patterns of referral to professional practitioners. Comparisons are made between the Puyallup and Taiwanese family health care practices and health care seeking processes. The author concludes that the relative absence of folk medicine and the availability of free medical care among the Puyallup are the most important factors causing the variance between the rates of family treatment and the patterns of health care seeking behaviors between the Puyallup and the Taiwanese. PMID- 6499507 TI - Preferences in help-seeking among Chinese students. AB - Chinese university students were asked to indicate their inclination to seek help and the resources for consultation on the 22 problems listed on the Langner Scale. Results showed that the Chinese students were generally not inclined to seek help and when they did, would most often seek help from medical doctors. However, when items were grouped in terms of clinical content, it was found that friends were predominantly preferred for psychological problems while the doctor was preferred for psychophysiological, physiological, and ambiguous problems. More female than male students tended to rely on friends and family members while the reverse pattern was found in the preference for doctors. The mental health professional was rarely cited as a resource for any of the problems. The results provide some explanation for observations made in previous studies on symptom presentation and help-seeking behavior among Chinese psychiatric patients. PMID- 6499508 TI - The role of hallucinogenic drugs and sensory stimuli in Peruvian ritual healing. AB - On Peru's north coast, curanderos perform night-long curing ceremonies in which the mescaline-bearing cactus San Pedro is used. The concept of autonomic nervous system tuning is presented as the best explanation for the overall physiological effect of the ritual. An assessment of the possible therapeutic impact of this condition is provided. Organic response and symbolic message are seen to resonate in the purificatory connotations of the ritual. PMID- 6499509 TI - The pharmacokinetics of the individual constituents of an aspirin-metoclopramide combination ('Migravess'). AB - A study was carried out in 10 healthy volunteers, aged between 22 and 28 years, to investigate the pharmacokinetics of an aspirin-metoclopramide combined preparation compared with those of the individual components given alone. Blood levels were determined before and after administration of a single dose of the three medications given at weekly intervals. No significant difference was found in the bioavailability of either the aspirin or metoclopramide from the combination as compared to the individual components. PMID- 6499510 TI - Long-term treatment with dantrolene sodium of stroke patients with spasticity limiting the return of function. AB - A study was carried out to determine the efficacy and long-term safety of dantrolene in treating stroke patients with spasticity limiting rehabilitation. Fifteen of the 18 patients studied experienced reduction in spasticity and clinical improvement after treatment with dantrolene sodium for 6 weeks. Fourteen of these patients participated in a 6-week, double-blind, placebo-controlled study. The 5 patients who continued to receive dantrolene did not experience clinical deterioration. However, the 9 patients given placebo noted increased deficits. Seven asked that the blind be broken and chose to resume dantrolene therapy. After 6 weeks, 13 of the 14 patients elected to continue on dantrolene (average dose 165.4 mg/day). All continued to improve. Side-effects were generally mild and transient. Although these patients took other drugs concomitantly, no drug interactions were reported. PMID- 6499511 TI - A double-blind comparison of meptazinol versus placebo in chronic rheumatoid arthritis and osteoarthritis. AB - A double-blind, placebo-controlled, between-patient evaluation of the analgesic properties of oral meptazinol was carried out in 60 patients suffering from chronic pain due to rheumatoid arthritis and osteoarthritis. Patients were allocated, at random, to receive either 200 mg meptazinol every 3 to 6 hours as required or identical matching placebo for a total period of 72 hours. Data from 57 patients (30 on meptazinol, 27 on placebo) were suitable for analysis. Pain intensity in five major categories was assessed using a 4-point verbal rating scale by a clinician before the first dose and at the end of the trial period. Patients performed a self-assessment of pain prior to taking the first dose and subsequently at 2,4,24, 48 and 72 hours using 100 mm visual analogue scales and verbal rating scales. The clinician-rated pain scores showed no significant difference between the two groups in initial pain intensity. After 72-hours' treatment , there was a significant (p less than l.01) reduction in pain intensity after 2 hours which was maintained throughout the trial period. There was no significant reduction in pain intensity inpatients taking placebo. Visual analogue scale scores and pain intensity difference scores showed significantly (p less than 0.01) greater reduction in pain intensity at all time points in the meptazinol- treated patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499513 TI - Comparative efficacy of 3-day and 7-day chemotherapy with twice-daily pivmecillinam in urinary tract infections seen in general practice. AB - In a multi-centre general practice study, 183 females suffering from symptoms of acute urinary tract infection were randomly assigned to receive 400 mg pivmecillinam twice-daily for either 3 or 7 days. The clinical response was equally good in both treatment groups with a mean reduction in symptom scores of 88%. Positive pre-treatment bacteriological cultures were obtained from 48 (36%) of the 134 patients for whom data were complete. Bacteriological cure was achieved in all these patients except for 1 in the 3-day treatment group. Pivmecillinam was well tolerated, with side-effects reported by 7 (7%) patients in the 3-day group and 12 (13%) patients in the 7-day group. One patient in the 3 day group and 2 patients in the 7-day group stopped treatment prematurely due to side-effects. PMID- 6499512 TI - Treatment of acute tonsillo-pharyngitis: a comparative study of spiramycin and erythromycin. AB - A comparative study was carried out to determine the clinical efficacy of spiramycin and erythromycin in the treatment of acute tonsillo-pharyngitis. Patients were allocated at random to receive either 500 mg spiramycin 3-times daily for 3 days or 500 mg erythromycin 3-times daily for 5 days. Details were recorded daily by patients of subjective complaints such as fever, sore throat and difficulty in swallowing, and objective signs and symptoms of inflammation were assessed by the physician before and after treatment. Results were analyzed for 32 patients in each group and showed both treatments resulted in a rapid relief of their clinical condition in over 90% of patients. Although all patients showed marked improvements, a few still complained of symptoms at the end of the treatment period. Neither treatment regimen proved adequate for the eradication of the initial pathogen identified from throat swab cultures and leucocytosis persisted in at least 1 patient in each group. Seven patients on erythromycin complained of nausea and/or epigastric pain and 1 patient on spiramycin had urticaria. PMID- 6499514 TI - Serum concentrations and penetration into prostate of mecillinam and ampicillin. AB - The absorption of the two antibiotic pro-drugs pivmecillinam and pivampicillin was investigated in 10 patients with normal or slightly impaired renal function. After a therapeutic dose of 200 mg pivmecillinam plus 250 mg pivampicillin, the mean peak concentration in serum was 2.3 micrograms mecillinam and 5.3 micrograms ampicillin per ml. The elimination half-life was approximately 2 hours for both antibiotics. Consequently, a ratio of 2:5 was maintained in serum during the excretion period and this ratio is within the range where optimal synergistic effect between the two antibiotics against many Gram-negative organisms is most likely to occur. Penetration of mecillinam and ampicillin into the prostate, determined in tissue homogenate obtained from 10 patients undergoing transurethral resection of the prostate showed that the antibiotics penetrated equally well with a serum tissue ratio of approximately 2:1. PMID- 6499515 TI - Enzyme catalysis and control. PMID- 6499516 TI - Kinetic analysis of the specificity of multisubstrate carnitine palmitoyltransferase. PMID- 6499517 TI - GABA and taurine enzymes in mammalian brain. PMID- 6499518 TI - Regulation of gluconeogenesis at phosphoenolpyruvate carboxykinase. PMID- 6499519 TI - Involvement of guanidino groups in anion-binding sites and in enzyme-catalyzed covalent modification reactions. PMID- 6499521 TI - Age-related effects on subunit interactions in rat muscle glyceraldehyde-3 phosphate dehydrogenase. PMID- 6499520 TI - Use of coimmobilized multienzyme systems as models for in vivo processes. PMID- 6499522 TI - Catalysis of methemoglobin reduction. PMID- 6499523 TI - Laser-induced photogeneration of ATP: a new approach to the study of chemical kinetics of muscle contraction. PMID- 6499524 TI - Mechanistic implications of 18O exchange during ATP synthesis in oxidative phosphorylation. PMID- 6499525 TI - Control of forward and reverse electron flow in mitochondria: thermodynamic versus kinetic considerations. PMID- 6499526 TI - Regulation of metabolism in Penicillium charlesii by organic acids: role of L tartaric acid. PMID- 6499527 TI - Palate development: normal and abnormal cellular and molecular aspects. PMID- 6499528 TI - Perioral dermatitis. PMID- 6499529 TI - Another aspect of contrived disease: "dermatitis simulata". AB - Three cases in which innocuous substances were applied to the skin to simulate skin disease are presented herein. We have coined the term "dermatitis simulata" for this previously unrecognized form of contrived disease. PMID- 6499530 TI - Occult eccrine sweat duct hamartoma and cicatricial scalp alopecia. AB - A second case of eccrine ductal proliferation of the scalp which presented as cicatricial alopecia is reported. Histopathology is compatible with a diagnosis of eccrine sweat duct hamartoma. This case seems to establish a rare clinical occurrence of sweat gland cyst formation which microscopically resembles syringoma. PMID- 6499531 TI - Resolution of onychogryphosis. AB - A patient with a leg ulcer and edema of her foot had onychogryphosis. Although onychogryphosis is usually thought of as permanent, correction of the leg ulcer and edema permitted regrowth of a structurally normal nail. PMID- 6499532 TI - Lupus vulgaris responding to double antituberculous therapy. AB - A patient with a 3 by 4 cm ulcerated lesion on the nose and upper lip in whom previous antibiotics and antifungal treatments for a "mixed infection" were of no avail is presented. Her history revealed that she has had pulmonary and pharyngeal tuberculosis and subsequently scrofuloderma of cervical lymph nodes. She eventually responded well to isoniazid, rifampin, and pyridoxine therapy. PMID- 6499533 TI - Pruritus of pregnancy. PMID- 6499534 TI - Dermatologists' referrals of prescriptions requiring compounding. AB - This study surveyed a sample of dermatologists in an effort to determine their assessments of pharmacists' compounding ability. Results indicate that dermatologists refer patients to specific pharmacies perhaps because a high percentage of patients had complained about pharmacists being unable or unwilling to fill compounded prescriptions. Data also indicate a higher level of confidence in the pharmacists' actual practice than in their training for that practice. PMID- 6499535 TI - Depigmentation of the male genitalia. AB - A study of the incidence of depigmentation of the male genitalia in patients attending a dermatology clinic is presented. Of the 5,000 consecutive new male patients examined, thirty-eight patients had white patches on the genitalia, sixteen of which were leukoderma due to post inflammatory hypopigmentation. The remaining twenty-two were classified as vitiligo, with no known cause. PMID- 6499536 TI - Median raphe cyst of the penis. AB - A case of median raphe cyst of the penis in a 7-year-old boy is reported. Although the lesion is rare, characteristic clinical features makes it easy to diagnose median raphe cyst of the penis, which has been mistakenly reported as apocrine hidrocystoma. Surgical excision must be performed to prevent recurrence. PMID- 6499537 TI - Highlights of the 8th Annual Dermatology Seminar. Wailea, Maui, Hawaii, February 10-15, 1984. PMID- 6499538 TI - XIth Postgraduate Seminar in Pediatric Dermatology. Miami, Florida, February 23 26, 1984. Part 1. PMID- 6499540 TI - Enter the pathologist/clinician. PMID- 6499539 TI - Apocrine cystadenoma arising in a nevus sebaceus of Jadassohn. AB - An increased incidence of benign and malignant adnexal tumors has been noted to occur within the nevus sebaceus of Jadassohn. We report a case of a 41-year-old white woman with a blue cyst on her scalp which had recently developed within a congenital "birthmark." Excision of the lesion revealed that the nodule was an apocrine cystadenoma within a nevus sebaceus of Jadassohn. The clinical features of nevus sebaceus with apocrine cystadenoma are discussed and the various tumors which may arise within the nevus sebaceus are reviewed. PMID- 6499541 TI - Peritoneal dialysis and pulmonary function. PMID- 6499542 TI - Cardiac legionellosis. PMID- 6499543 TI - Transbronchial needle aspiration of peripheral pulmonary nodules. AB - To determine the role of transbronchial needle aspiration (TBNA) in the diagnosis of peripheral pulmonary lesions, TBNA was performed in 20 patients who had unexplained nodules (15) or masses (five) and no endobronchial abnormality. The TBNA cytopathology was positive for malignancy in 11 patients, and provided the only diagnostic specimen in seven. The TBNA yield was significantly higher than that of forceps biopsy or bronchial brushing, either alone or in combination (p less than 0.05). The procedure was complicated by pneumothorax in one patient. Transbronchial needle aspiration is diagnostically useful and safe for evaluation of the peripheral pulmonary nodule. PMID- 6499544 TI - COPD prevalence in nonsmokers in high and low photochemical air pollution areas. AB - The prevalence of respiratory symptoms, as ascertained by questionnaire, was evaluated in 6,666 nonsmokers who had lived for at least 11 years in either a high photochemical pollution area (4,379 individuals) or a low photochemical pollution area (2,287 individuals). Of these, 5,178 had never smoked, and none was currently smoking. The risk estimate for "definite" COPD, as defined in this study, was 15 percent higher in the high pollution area (p = 0.03), after adjusting for sex, age, race, education, occupational exposure, and past smoking history. Past smokers had a risk estimate 22 percent higher than never smokers (p = 0.01). Multivariate analysis showed a significant effect of air pollution on the prevalence of "definite" COPD which univariate analysis failed to demonstrate. PMID- 6499545 TI - Comparative predictive value of ST-segment depression or angina during early and repeat postinfarction exercise tests. AB - To determine the relative value of electrocardiographic (ECG) ST-segment depression alone compared to angina alone for predicting multivessel coronary artery disease during early and repeat postinfarction exercise tests, we evaluated 93 postmyocardial infarction patients with modified treadmill exercise tests prior to hospital discharge (mean 14 +/- 2 days), and 36 of these 93 patients with repeat exercise tests at six weeks following infarction. It was concluded that angina alone or angina irrespective of the presence of ST-segment depression are better predictors of multivessel coronary artery disease than ECG ST-segment depression alone, and the persistence of ischemic abnormalities during repeat treadmill exercise tests following infarction is useful for confirming the presence of multivessel coronary artery disease. PMID- 6499546 TI - Lateral position test and quantitative lung scan in the preoperative evaluation for lung resection. AB - The postpneumonectomy FEV1 was predicted in 24 patients with severe chronic obstructive pulmonary disease (FEV1 less than or equal to 2.0 L) and a lung mass using the quantitative lung scan (QLS) and lateral position test (LPT). Although a good correlation (r = .72, p = 0.0006) was found between the FEV1 predicted by QLS and LPT, there was more than 10 percent difference between the result in 59 percent of the subjects. A subgroup of these patients performed multiple (two to five) LPTs, and the results were calculated blindly to assess variability. The variation seen was 14 times greater than in previously reported normal subjects. Calculations suggest that as many as 37 tracings would be needed on each patient to obtain an acceptably low measurement error. Whereas there was a good overall correlation between the predicted postpneumonectomy FEV1 using both methods, the variability found with LPT would suggest extreme caution in its use. PMID- 6499547 TI - Use of oral contraceptives in women with cystic fibrosis. AB - Oral contraceptive pills (OCP) represent the most common contraceptive method among teenagers and young adults. Because many women with cystic fibrosis (CF) are now surviving into childbearing age and are at risk for the complications of pregnancy in CF, oral contraceptive use may be indicated. However, it has been suggested that OCP use by CF patients may be associated with deterioration in pulmonary function. Ten adolescent and young adult women with CF and moderate-to severe obstructive lung disease were studied while taking a combination oral contraceptive pill (Ovral 28). No significant deterioration was found in clinical status or pulmonary function. Careful follow-up should nevertheless be continued to monitor for other adverse effects of oral contraceptive use in CF, such as cholelithiasis. PMID- 6499549 TI - Inspiratory muscle training in clinical practice. Physiologic conditioning or habituation to suffocation? AB - Six healthy volunteers and 19 patients with stable chronic obstructive pulmonary disease underwent a multistage, maximal, ventilatory stress test, ie, serial imposition of increasingly severe resistances to inspiration by means of a commercially available device (Pflex Inspiratory Trainer). Patients consistently underventilated and suffered desaturation during the test; healthy individuals did not. Eight patients completed three weeks or more of daily training stints using the inspiratory resistive device. There was no significant improvement in performance of the test after training. Those individuals whose condition improved showed no discernible change in ventilatory pattern but did suffer further desaturation. PMID- 6499548 TI - Arterial oxygen desaturation following salbutamol inhalation in acute asthma. AB - The practicality and accuracy of a new ear oximeter was evaluated. The SaO2 measured with this instrument correlated significantly with simultaneous SaO2 measurements with another ear oximeter in 12 children (age three months to 20 years) with chronic pulmonary or cardiac diseases (r = 0.93, p less than 0.001), and also correlated significantly (r = 0.96, p less than 0.001) with calculated SaO2 based on blood gas measurements of blood from the left side of the heart obtained during cardiac catheterization. The SaO2 was then measured continuously and readings were taken before and five, 15, and 30 minutes after salbutamol inhalation by face mask in 18 children. Following treatment, mean PEFR increased significantly, and mean SaO2 was significantly lower than preinhalation values at five and 15 minutes postinhalation. At 30 minutes, SaO2 had returned to control values. In nine of 18 subjects, SaO2 fell greater than or equal to 5 percent. This response was not predictable on the basis of different parameters (treatment, heart rate, PEFR). The findings suggest that supplemental O2 may be required during the first 30 minutes posttreatment. PMID- 6499550 TI - Serial studies of pulmonary function in continuous ambulatory peritoneal dialysis. A prospective study. AB - Continuous ambulatory peritoneal dialysis (CAPD) produces a nearly continuous state of iatrogenic ascites which may interfere with respiratory excursions of the diaphragm and compromise ventilatory function. Sitting and supine studies of pulmonary function and arterial blood gas analyses done serially in 13 patients undergoing CAPD showed a significant decline in pulmonary volumes immediately after the institution of CAPD; however, the decline was not accompanied by abnormalities in gas transfer. Pulmonary volumes returned to baseline values within two weeks in all patients, including those with preexisting mild chronic obstructive pulmonary disease (COPD). It is concluded that CAPD does not compromise pulmonary function in patients with normal pulmonary function or in those with mild COPD. PMID- 6499552 TI - Forced random noise resistance determination in childhood asthma. AB - The forced random noise method for measuring respiratory resistance was studied in terms of reproducibility and correlation with spirometry and flow volumes in 30 older children (four to 17 years) with asthma and in 16 infants and children below three years of age. In the 30 older children, the mean value of individual coefficient of variations for three repeated measurements was 7.4 percent. Resistance parameters correlated well with spirometric parameters with all but three correlation coefficients greater than 0.7. In 20 older asthmatic patients, 180 micrograms albuterol caused a significant reduction in resistance in 11 subjects. At the same time, FEV1 increased significantly in nine subjects but showed a paradoxic decrease in five. This paradoxic response is attributed to complex reflexes caused by the maximum inspiration and forced expiration and did not occur with resistance measurements. This method requires little subject cooperation, and therefore, is well suited for infants and children. PMID- 6499551 TI - Pulmonary disposition of moxalactam. AB - Moxalactam is a new synthetic oxa-beta-lactam antibiotic with a broad spectrum of activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria. It has proven clinical efficacy in pneumonia caused by a variety of infecting organisms. Therapeutic concentrations of moxalactam are achieved in most body tissues and fluids, including pleural fluid and sputum. However, assessment of the adequacy of lung tissue levels in pneumonia requires the sampling of material at an alveolar level. We performed bronchoalveolar lavage (BAL) in 13 patients one hour after they had been given moxalactam intravenously in doses ranging from 250 mg to 2 g. Absolute alveolar drug levels ranged from less than 1 to 6 micrograms/ml, and serum levels from 8 to 50 micrograms/ml. When expressed per micromole of creatinine, there was a significant relationship (r = 0.85; p less than 0.01) between serum and alveolar moxalactam levels in those patients in whom the drug concentration could be quantified accurately in BAL fluid. PMID- 6499554 TI - Two-dimensional and pulsed Doppler echocardiographic abnormalities in coronary artery-pulmonary artery fistula. AB - We describe two patients who presented with precordial continuous murmurs which were diagnosed clinically as due to patent ductus arteriosus; however, two dimensional echocardiographic and pulsed Doppler echocardiographic studies showed dilatation of the left main coronary artery with turbulent flow during systole in the lumen in both patients. Subsequent selective coronary angiographic studies showed bilateral coronary artery-pulmonary artery fistula in one patient and left coronary artery-pulmonary artery fistula in the other. This study illustrates that in a patient presenting with a continuous murmur which is suggestive of patent ductus arteriosus, such two-dimensional and pulsed Doppler echocardiographic findings as were seen in our patients should immediately alert the physician that he may be dealing with a case of coronary arterial fistula. PMID- 6499553 TI - Postoperative chest percussion with postural drainage in obese patients following gastric stapling. AB - Vigorous respiratory therapy can prevent the development of postoperative pulmonary complications which occur with increased frequency after upper abdominal surgery. Obesity poses an additional risk factor. To study the effects of postoperative chest percussion with postural drainage (CPT), 53 consecutive patients undergoing Roux-en-Y gastric stapling procedures for treatment of morbid obesity were randomized to two groups. Both received identical postoperative respiratory care, except the study group received additional CPT. It was concluded that the addition of CPT to patients without prior chronic lung disease undergoing upper abdominal surgery caused patient discomfort, increased hospital cost, and failed to affect the incidence of postoperative pulmonary complications. PMID- 6499555 TI - Non-Q wave myocardial infarction. Pathophysiology and prognostic implications. AB - Non-Q wave myocardial infarctions, also known as nontransmural myocardial infarctions or subendocardial myocardial infarctions, have been managed as "mild" coronary events in the past. Substantial evidence now requires modification of this approach. Because of their tendency to be associated with modest cardiac enzyme level elevations, non-Q wave infarcts often result in a favorable early or inhospital prognosis. However, their late complications include recurrent angina, transmural myocardial infarction, and sudden death. Previous myocardial infarction with residual myocardium "at risk" from recurrent ischemia probably bears responsibility for these late complications. Earlier identification of patients at risk and appropriate interventions may improve the long-term prognosis after nontransmural infarcts. PMID- 6499556 TI - Bilateral diaphragmatic densities in a 72-year-old woman. PMID- 6499557 TI - Coronary artery spasm--1984. AB - Coronary artery spasm was virtually unknown not long ago, but the intense, ongoing interest it has generated in the past decade has produced a number of specific diagnostic techniques and therapeutic approaches, as well as considerable insight into mechanisms of coronary vascular tone and various coronary syndromes. There is growing evidence that coronary artery spasm is involved in unstable angina, stable angina, myocardial infarction, and sudden death. It is by no means a benign process and is associated with significant morbidity or mortality if misdiagnosed or untreated. It seems clear that what started as a mere clinical curiosity involving a minority of patients with the so called Prinzmetal's variant angina is snowballing into a major arena for research, diagnosis, and treatment in the field of ischemic coronary artery disease. PMID- 6499558 TI - Irreversible hypercapnia secondary to embolic occlusion of the pulmonary artery. AB - We describe a patient in whom extensive thromboembolic occlusion of the pulmonary arteries led to hypercapnia, in spite of a large increase in minute ventilation. PMID- 6499559 TI - Errant placement of nasoenteric tubes. A hazard in obtunded patients. AB - We describe a case of intubation of both main-stem bronchi with a narrow-bore nasoenteric tube on two separate occasions, with the subsequent development of pleural effusions of enteral solution, in an elderly semicomatose woman with a properly positioned cuffed endotracheal tube. Neither aspiration of fluid from the tube nor propulsion of air with auscultation of gastric borborygmi are positive proof of proper positioning. We recommend that in obtunded patients, especially if there is the possibility of impaired mucosal integrity, appropriate placement of the tube should be confirmed by chest roentgenogram. PMID- 6499560 TI - Essential thrombocythemia and coronary artery disease. AB - An unusual case of essential thrombocythemia in a young man presenting with progressive angina pectoris is presented. Angiography revealed proximal left anterior descending artery stenosis. Successful percutaneous transluminal angioplasty along with antiplatelet therapy and a calcium channel blocking drug have rendered this patient asymptomatic. PMID- 6499561 TI - Fiberoptic bronchoscopy for intraoperative localization of endobronchial lesions and foreign bodies. AB - The use of the fiberoptic bronchoscope for pinpointing a lesion during the course of surgical endobronchial extraction is described. Two cases are outlined: removal of a retained foreign body; and excision of a pedunculated bronchial tumor. The use of a bronchoscope as an aid during thoracotomy for bronchial lesions is emphasized. PMID- 6499562 TI - Respiratory muscle training. PMID- 6499563 TI - Percutaneous needle biopsy of lung lesions. PMID- 6499564 TI - Rhabdomyolysis, acute renal failure and Legionnaires' disease. PMID- 6499565 TI - Recurrent form of amiodarone-induced pneumonitis. PMID- 6499566 TI - Intracranial lipomas, hydrocephalus and other CNS anomalies in oculoauriculo vertebral dysplasia (Goldenhar-Gorlin syndrome). AB - 13 cases of Goldenhar-Gorlin syndrome are presented in which numerous central nervous system anomalies have been found. These include occipital encephalocele, hydrocephalus, aqueductal stenosis, agenesis of corpus callosum, multiple congenital lipomas and many others. Pertinent literature has been reviewed. It is concluded that any part of the central nervous system can be involved in this condition and that careful evaluation is indicated in order to rule out a treatable intracranial anomaly. PMID- 6499567 TI - Germinoma in a boy with precocious puberty: evidence of hCG secretion by the tumoral cells. AB - The present report concerns a 10-year-old boy in whom diabetes insipidus and short stature were the first manifestations of a suprasellar germinoma. Neuroradiological investigations performed when these symptoms appeared were negative. 2 years later, a rapid and early pubertal development was observed and related to secretion by the germinoma of human chorionic gonadotropin (hCG) identified immunohistochemically. This clinical evolution is unusual and indicates that plasma hCG measurements in patients with so-called idiopathic diabetes insipidus can be of clinical value in predicting the presence of an hCG secreting tumor. PMID- 6499568 TI - Interhemispheral neuroepithelial (glio-ependymal) cysts, associated with agenesis of the corpus callosum and neocortical maldevelopment. A case study. AB - Callosal agenesis and interhemispheral cysts containing ependyma, choroid plexus and glial cells are reported in a male infant. To the authors' knowledge this represents the 4th recorded case. Other findings were: nodular neuronal heterotopias with fully differentiated spiny neocortical neurons, widespread neocortical microgyria, cerebellar hypoplasia and bony abnormalities of the foramen magnum and atlas. This study confirms that glio-ependymal cysts are heterotopias of embryonic ventricular epithelium. The existence of more than one type of heterotopia (i.e. neuronal and ependymal) in 1 individual is significant. This indicates an error of cell generation and cell migration affecting the original structure from which both cell types are derived: the embryonic (sub)ventricular zone. PMID- 6499569 TI - Congenital anaplastic ependymoma: a case report of familial glioma. AB - A congenital anaplastic infratentorial ependymoma, occurring in a female infant whose sister also died of brain tumor, is described. The tumor, located in the cerebellum and the fourth ventricle, is characterized by predominantly undifferentiated neuroepithelial cells associated with numerous mitoses, and partially of the cells demonstrating differentiation into ependymal cells and astrocytes. Of special interest is the fact that the elder sister of the patient had also died of a congenital glioma located in the cerebellum and the fourth ventricle, which leads to the discussion about the influences of genetic factors in the development of the familial gliomas as well as about the histogenesis of the tumor examined. PMID- 6499570 TI - Third ventricle choroid plexus papillomas. PMID- 6499571 TI - [Inguinal hernia in children--the first operation]. PMID- 6499572 TI - [Complications following inguinal hernia surgery]. PMID- 6499573 TI - [Ergotamine-induced anal ulcer]. AB - Chronic, extensive anal ulceration following haemorrhoidectomy and excessive application of ergot suppositories was observed in a 61 year old patient, suffering for years. The diagnosis of an anocutaneous ergotism was not arrived at before 10 months, treatment in several hospitals and two operations including a sigmoid colostomy. Complete healing within several weeks ensued from discontinuation of the suppositories. Symptoms, histological features, pathogenesis and therapy are discussed. Two further cases could be observed meanwhile. PMID- 6499574 TI - [Is the treatment of inguinal hernia an operation for beginners?]. AB - The early postoperative results of 1273 operations for inguinal hernia are reported. In addition, the late outcome of 688 operations of patients answering the questionnaires was analysed according to the surgeons stage of training. In group 1, the operator was in the first two years of his training, in group 2, he was older but had not yet achieved his title as a specialist for surgery and in group 3, all are fully trained surgeons. The postoperative complications are distributed equally among the 3 groups. Wound infection was leading in 37% to recurrent inguinal hernia. The overall figure of recurrent inguinal hernia was highest in group 2 with 7.8% (14 out of 179), followed by group 1 with 5.5% (22 out of 399) and group 3 with 4.5% (5 out of 110). Early post-operative recurrence was again highest in group 2 with 7 out of 14 compared with 9 out of 22 in group 1 and 2 out of 5 in group 3. We conclude from these results that inguinal hernia may be performed by a very young surgeon in training; supervision in those who are over the first steps, but have not completed their training has to be intensified and that asepsis has to be observed very carefully. PMID- 6499575 TI - [Prognosticly unfavorable factors in esophageal carcinoma. I. The importance of anamnestic data]. AB - The analysis of data of 121 patients with esophageal carcinoma treated at the Department of Surgery, Landeskrankenhaus Klagenfurt, between 1969 and 1982 revealed that neither sex nor age, environment, delay of treatment or additional disease had any significant influence on survival time. Weight loss, however, significantly shortened survival time (p = 0.0002). In addition, weight loss suggests an advanced tumor stage (p = 0.0279). After curative resection, rate of survival was significantly lower in patients with weight loss (p = 0.042). In the presence of weight loss and additional risk factors resection is probably not indicated. PMID- 6499576 TI - [Nuclear victims]. PMID- 6499578 TI - Local excision and radiotherapy for early cancer of the breast. PMID- 6499577 TI - [Results of a continuous series of 761 invasive breast cancers, 408 followed more than 5 years, treated by partial mastectomy with axillary curettage followed by irradiation]. PMID- 6499579 TI - [Treatment of patients with multiple injuries]. PMID- 6499580 TI - [Proposal for a predictive score of severity in the surgery of retention jaundice]. PMID- 6499581 TI - [The problem of failure in various technics for partial interruption of the inferior vena cava]. PMID- 6499582 TI - Day case surgery. PMID- 6499583 TI - [Treatment of ruptures of the short rotator cuff of the shoulder by simple reinsertion of the supraspinatus without translation. Results of 63 cases]. PMID- 6499584 TI - [Esophagotracheal fistulas during assisted ventilation. Apropos of 13 cases]. PMID- 6499585 TI - [Subcutaneous reservoirs for systemic intravenous or intraportal chemotherapy]. PMID- 6499586 TI - [Unusual late complication of caustic stenosis. Canceration of the cervical esophagus at the level of the ileocoloplasty anastomosis]. PMID- 6499587 TI - [Results of surgical treatment of chronic pancreatitis (95 cases)]. PMID- 6499588 TI - [Cystic lesions of the pancreas in children. Apropos of 7 cases]. PMID- 6499589 TI - [Chronic pancreatitis and pancreas divisum. Apropos of 3 cases treated surgically]. PMID- 6499590 TI - [Ischemic stenosis of the small intestine after surgery of the abdominal aorta. 2 cases]. PMID- 6499591 TI - [Immune behavior in women with operable breast cancer]. PMID- 6499593 TI - [Neurinoma of the abdominal pneumogastric nerve. Apropos of a case]. PMID- 6499592 TI - [Action of the immunoadjuvant P 40 in women with operable breast cancer]. PMID- 6499594 TI - [Peritonitis caused by colonic perforation into a free peritoneum]. PMID- 6499596 TI - Chromosome relationships in the genus Salmo. AB - Chromosome numbers and polymorphisms in rainbow trout, Atlantic salmon, and brown trout are described. The karyotypes of these three species are compared with each other and with those of other salmonid fish from the genera Salmo, Salvelinus, and Oncorhynchus. Karyotype evolution from a postulated ancestral tetraploid is discussed. PMID- 6499595 TI - Chromosomal transplantation. The nuclear transplantation of colchicine-treated cells. AB - Dissociated cells of middle-to-late blastulae were exposed to 0.1 mg colchicine/ml and achieved 92% metaphase arrest. These cells contained a haploid set of Bombina maxima (Anura:Discoglossidae) chromosomes. When transplanted into the enucleated eggs of B. orientalis, some donor cells stimulated development to the late blastula and middle gastrula stages. - Most (17/20) of the embryos resulting from chromosomal transplantation were nonmosaic aneuploids. A high percentage of recipient egg enucleation (93%), the ratio of long-to-short chromosomes, and the presence of species-specific marker chromosomes proved that chromosomes were transplanted from the donor cells. Therefore, metaphase chromosomes lacking intact spindle apparatuses were injected into and incorporated by amphibian eggs. These chromosomes were replicated in all cells of the resulting embryos. The aneuploidy of these embryos is explained by an inability of the recipient egg to locate and replicate many transplanted chromosomes (44%) before first cleavage. PMID- 6499597 TI - Medical teacher and his pedagogical training (experience with Bratislavian system of training the assistants for pedagogical activity in postgraduate education of physicians and pharmacists). AB - System of training the medical teachers for pedagogical activity, used in the Institute for Postgraduate Education of Physicians and Pharmacists (IPEPP) in Bratislava, have not had long tradition as yet. We do not want this training to be understood as universal instruction to prepare the assistants for pedagogical activity, which is in a final consequence always dependent on the concrete conditions and social needs. It should serve as information on one of the possibilities to secure the systematic training of medical teachers for pedagogical activity in postgraduate education of physicians and pharmacists. PMID- 6499598 TI - Contribution to the knowledge on the ultrastructure of marginal gingivae. AB - A total of 51 bioptic specimens of marginal gingivae from young healthy donors were subjected to the light and electron microscopic study. Clinical and morphological findings indicated that the gingiva should be studied as a whole. Description of the healthy epithelium cannot be separated from the knowledge of the actual state of lamina propria mucosae. As healthy can be considered only those gingival specimens, which do not contain any lymphocytes, leukocytes and other cells typical of inflammatory infiltrate, respectively. The epithelial basal membrane is considered as a light microscopic concept. Topographic orientation, particularly in the layers of epithelial cells not connected with lamina basalis or with the surface, presents a problem in electron microscopic examinations. Morphological pendent of mucopolysaccharides can be found in lamina propria mucosae. Hemidesosomal structures of stratum basale of the epithelial layer may reflect physiological requirements counterbalancing the mechanical pulls in a given area. PMID- 6499599 TI - Serum esterase activity during the surgical therapy of bronchogenic carcinoma. AB - Serum esterase activity was estimated in 148 patients with bronchogenic carcinoma and in 19 patients with pulmonary tuberculosis before operation, 1 week and 3 weeks after operation. We failed to prove significant differences between the patients with malignant and nonmalignant lung diseases. We failed also to prove significant differences between the mean esterase activity findings regarding to the extent of surgery. They were identical even of the performed thoracotomy was radical, palliative or explorative. The course of changes in esterase activity findings is quite individual. From the esterase activity we cannot conclude, if the tumor tissue was completely removed or not. PMID- 6499600 TI - Retention of labelled 5-iodo-2-deoxyuridine after intratumorous injection as a possible indicator of the cellular kinetics. AB - On the basis of an experimental model of the Lewis lung carcinoma a possibility was checked of obtaining basic kinetic data about the individual proliferation of tumour cells by a method of measuring the incorporation of labelles 125I 5-iodo-2 deoxyuridine intratumorously with a subsequent measurement of the retained activity in the tumour. These activity, which resides in the tumour for a time longer than 24 hours depends on the fraction of cells, that in the synthetic part of the cell cycle at the time of the injection. PMID- 6499601 TI - New prospects in the conservative treatment of rectal cancer. AB - Conservative treatment of rectal cancer is applicable only to limited tumors that are assumed to have no lymphatic spread; these are well or moderately well differentiated adenocarcinomas confined to the bowel wall, without palpable pararectal metastatic lymph nodes. The experience of intracavitary irradiation (contact x-ray therapy often combined with iridium 192 implant), based on 245 patients followed for more than five years, shows a low rate of local failure (5.3 per cent). The rate of death from cancer is 8.9 per cent and the five-year survival rate is 76 per cent. In patients under 60 years, a perirectal lymphadenectomy should be considered a safety measure. A new approach, based on a combination of external beam irradiation (3000 rads in 12 days), followed by iridium 192 implant two months later, allows the field of conservative treatment in poor-risk surgical patients to be extended without jeopardizing their chance of cure. PMID- 6499602 TI - A comparison of prednisolone enemas with low-dose oral prednisolone in the treatment of acute distal ulcerative colitis. AB - The therapeutic efficacy of prednisolone metasulphobenzoate enemas in the treatment of distal colitis has been compared with that of low-dose oral prednisolone, in a single-blind, cross-over trial. Treatment with steroid enemas resulted in symptomatic and sigmoidoscopic evidence of improvement more frequently than treatment with a dosage of oral steroid calculated to achieve similar plasma prednisolone levels. In addition to demonstrating, for the first time, that prednisolone metasulphobenzoate enemas are effective in the treatment of colitis, this study suggests that their efficacy is due to a local action rather than systemic absorption. PMID- 6499603 TI - The rubber dam as a means to isolate contaminated peritoneal defects after colonic resection. AB - After colonic resections, peritoneal defects exposed to colonic flora and blood may become the seat of localized peritonitis and cause small-bowel adhesions and obstruction. In the past five years, we have seen 14 patients where one or both of these complications was anticipated for one of the following reasons: presence of an abscess cavity, local infection or accidental tear of the colon. In these patients a rubber sheet was stitched to the edges of the peritoneal defect with absorbable sutures and brought out through the abdominal wall. In all patients the rubber dam functioned as a passive drain and as a barrier between the peritoneal defect and the small bowel. Three weeks later the rubber dam was removed by traction. None of these patients developed small-bowel obstruction and no adverse effects from the rubber sheet were seen. The working mechanism of the rubber dam was investigated in female Wistar rats. After removing the peritoneum between the left kidney and pelvis, the defect was covered with a rubber dam. A capsule with a standard solution of Escherichia coli, Bacteroides fragilis, and autoclaved feces was used to initiate peritonitis under the rubber dam. The rubber proved to act as an efficient drain and barrier. No abscesses or small bowel adhesions were seen. In the control group, 75 per cent of the animals died from generalized peritonitis or developed an abscess. PMID- 6499604 TI - Staging of colorectal cancer. The Australian clinico-pathological staging (ACPS) system compared with Dukes' system. AB - A new system, the Australian Clinico-pathological Staging (ACPS) System, has recently been proposed for the recording and reporting of colorectal carcinoma. This system requires the accurate use of precise definitions, cooperation between surgeons and pathologist, and a complete pathology report. It utilizes all information available--clinical, radiologic, operative, pathologic--before a stage is allotted. This contrasts with Dukes' system, which is based solely on the pathologic examination of the resected carcinoma. It allows classifications of all cases of colorectal cancer seen, whether treated by resection, palliative surgery, local excision or not at all. The stage at presentation and the five year survival of 490 patients with colorectal cancer are compared using the ACPS and Dukes' systems. Eighty-four cases were not classifiable under Dukes' system, and there was a significant difference in survival in one of the comparable groups of patients. PMID- 6499605 TI - Prostaglandins in colonic anastomotic healing. AB - In this study we report the effects of flurbiprofen and prostaglandin E2 on anastomotic tensile strength, collagen synthesis, and collagenolytic activity which are in a particularly fine balance in colonic healing. Colonic anastomoses were fashioned in 150 Sprague-Dawley rats which were allocated to receive either 20 mcg prostaglandin E2 in 1 ml saline, 1 ml saline alone (control) intraperitoneally for three days post-operatively, or oral 2.5 mg/kg flurbiprofen daily. Anastomotic bursting pressures, collagen content and collagenolytic activity were measured at three, six, and ten days. It was found that prostaglandin E2-treated animals had significantly weaker anastomoses at three days (102 +/- 6.1 mm Hg; m +/- SEM) compared with the control (126 +/- 7.3; P less than 0.02) or flurbiprofen group (128 +/- 4.6; P less than 0.01) with no differences at six and ten days. Collagen levels were higher in flurbiprofen treated rats at three days (9.7 +/- 0.2 micrograms hydroxyproline/mg tissue) compared with the control (8.1 +/- 0.4 micrograms/mg; P 0.01) or prostaglandin E2 group (7.2 +/- 0.5 micrograms/mg; P 0.001). These differences were unchanged at six days but were not statistically different at ten days. Collagenolytic activity showed no differences in the three groups during the study. It is concluded that flurbiprofen enhances colonic healing with improved collagen synthesis without affecting collagenolytic activity. PMID- 6499606 TI - The risk of developing rectal cancer after colectomy and ileorectal anastomosis in Danish patients with polyposis coli. AB - Fifty-eight Danish polyposis patients had been treated with colectomy and ileorectal anastomosis by the end of 1982. Three of these patients developed rectal cancer despite regular proctoscopic control, but one was probably an overlooked synchronous cancer. The cumulative risk at five and ten years after operation (actuarial method) was 3.5 and 13.3 per cent (95 per cent confidence limits 0-10.3 and 0-70.3 per cent, respectively), which seem to be acceptably low figures. This study supports the assumption that colectomy and ileorectal anastomosis is still the operation of choice in polyposis patients without rectal cancer. PMID- 6499607 TI - Results of Whitehead operation. AB - Eighty-four patients underwent the Whitehead procedure for extensive hemorrhoids. Early postoperative complications, excluding urinary difficulties, developed in six patients. Long-term results were within an acceptable range. PMID- 6499608 TI - Electrophysiologic and manometric assessment of failed postanal repair for anorectal incontinence. AB - The reason for failure to improve fecal incontinence after postanal repair in idiopathic (neurogenic) anorectal incontinence is unknown. The authors have studied 20 patients whose anorectal continence was not improved after Parks' postanal repair. Anorectal manometry, single fiber EMG of the external anal sphincter muscle, and measurements of the pudendal nerve terminal motor latency were studied before and nine months after postanal repair. All 20 patients had evidence of reinnervation within the external anal sphincter muscle before operation; 17 had a raised pudendal nerve terminal motor latency and all 20 had low resting voluntary contraction anal canal pressures. No significant differences were found between the resting, voluntary contraction anal canal pressures and single fiber EMG fiber density values before or after postanal repair. However, a significant increase in the pudendal nerve terminal motor latency was found after postanal repair (P less than 0.001) using a student's paired t test. These results suggest that, in patients who are not rendered continent by postanal repair, a continuing neuropathic process takes place. PMID- 6499609 TI - Cecal volvulus. Low mortality at a city hospital. AB - The case records of 12 patients with cecal volvulus over a 20-year period were reviewed. The patients averaged 46.7 years old; 75 per cent were white and 67 per cent were male. Patients presented with signs and symptoms of intestinal obstruction. Pain and distention were present in more than half of the patients. X-rays assisted in making the diagnosis of cecal volvulus in only five of the patients. Diagnosis was made in the remainder at the time of surgical exploration. At operation, one cecum was necrotic and required resection. Five patients underwent cecostomy, two cecopexy, and four simple detorsion. Post operatively, one patient developed a wound infection. There were no deaths. Follow-up for seven patients averaged 75 months each. One patient who had undergone simple detorsion developed another cecal volvulus. All who were contacted were alive and well. At St. Luke's Hospital, cecal volvulus generally occurs in middle-aged white males. Cecostomy or cecopexy adequately treats cecal volvulus when the cecum remains viable. This study demonstrates that prompt surgical intervention, before strangulation of the colon occurs, results in low mortality even in city hospital patients. PMID- 6499610 TI - The superior mesenteric artery. The critical factor in the pouch pull-through procedure. AB - The critical factor in ileal pouch pull-through operations is the length of the superior mesenteric artery. The pouch must reach the dentate line and have adequate blood supply. A series of cadaver and morgue studies were performed to evaluate the two most popular pouches of the "J" and "S" configurations. The "S" pouch generally reaches 2 to 4 cm more caudad than the "J" pouch. If necessary, however, the "J" pouch can be lengthened 2 to 4 cm by cutting the branch vessel under tension to the pouch, sparing vessels to either side and the marginal arcade. The "S" pouch procedure always sacrifices the ileocecal artery, but the "J" pouch procedure does not necessarily do so. The greatest caudad reach is available when the ileum is cut flush with the cecum. To verify a rule of thumb for reaching the dentate line with the pouch, the length of the superior mesenteric artery (SMA) origin to the inferior margin of the symphysis pubis and the SMA to dentate line were compared. If the tip of the pouch or conduit reached 6 cm below the symphysis pubis, all pouches reached the dentate line. PMID- 6499611 TI - Endobronchial metastasis from colorectal carcinoma. AB - A case report and review of the literature concerning endobronchial metastasis from colorectal carcinoma is discussed. Careful attention to the past history of the patient, presenting symptoms and laboratory evaluation, may lessen the diagnostic difficulty in differentiating a centrally located bronchogenic carcinoma from a metastasis to a major bronchus. In the majority of cases, the primary colorectal tumor will precede the pulmonary abnormality. The most frequently manifested symptoms are cough and hemoptysis. Radiologic findings usually consist of a collapsed lung, lobe or segment secondary to the bronchial obstruction. There appears to be equal predilection for metastatic involvement of either the right or left bronchial segments. Bronchial biopsies and comparison with the previous histology of the primary colorectal tumor are mandatory. PMID- 6499612 TI - Pneumatic perforation of the colon during colonoscopy. Is the hypermobile right colon a risk factor? AB - Perforation of the colon by pneumatic injury during colonoscopy is a rare complication. Intraoperative observations of a patient who developed massive cecal distention, pneumatosis coli and severe pneumoperitoneum during colonoscopy suggest that an isolated, air-trapping colonic segment is a factor in the mechanism of such injury. The possibility that a poorly fixed, hypermobile cecum and right colon predispose to such injury by air insufflation during colonoscopy is discussed. PMID- 6499613 TI - With regard to the anatomic explanation of low rectal anastomotic leakage. PMID- 6499614 TI - An evaluation of combined therapy for squamous cell cancer of the anal canal. AB - Carcinoma of the anal canal develops in the area of the dentate line and is referred to as cloacogenic, transitional, basaloid, epidermoid, and squamous cell cancer. For years, the accepted treatment for these lesions has been abdominoperineal resection. The use of preoperative radiation and chemotherapy was begun by our group in 1972. By 1975, it became apparent that radiation and chemotherapy alone appeared effective enough so that radical operation was not done routinely. An evaluation of the results in 104 patients, 44 of whom were treated by us (the rest of the data was collected by questionnaire), suggests that radiation and chemotherapy alone are at least as effective as radical surgery in most patients with this disease. PMID- 6499615 TI - Sensitivity of hemoccult testing in patients with colorectal carcinoma. AB - This paper is a retrospective study of 100 sequentially selected cases of colorectal carcinoma treated at The Roosevelt Hospital between 1978 and 1983. In 44 of these patients, the admitting physical digital rectal examination was hemoccult-negative (HN). This group of patients showed no significant difference in tumor location, stage, size, or in presenting symptoms when compared with the 56 patients who were found to be hemoccult-positive (HP). It is concluded that a negative stool hemoccult examination should not alter the course of the patient's work-up if any suspicion of colorectal carcinoma exists. Furthermore, hemoccult sensitivity does not appear to be affected by the size, location or Dukes' classification of a colorectal neoplasm. PMID- 6499616 TI - Phantom sensations after excision of the rectum. AB - Forty consecutive patients were questioned after proctectomy to ascertain the presence and characteristics of phantom sensations. Twenty-six (65 per cent) reported the presence of these sensation. Once established, the sensations were permanent in 20 patients; in six, they disappeared after a variable lapse of time. The most frequent sensation was an urge to defecate, which may be very disturbing to the patient. Explanation of the phenomenon usually is sufficient to alleviate anxiety. PMID- 6499617 TI - Conservative management of paraileostomy ulcers in patients with Crohn's disease. AB - Paraileostomy ulcers (PSU) are uncommon after construction of an ileostomy and are difficult to manage. Seventeen patients with Crohn's disease developed 28 parastomal ulcers at least 1.5 cm in diameter from two weeks to seven years after ileostomy construction (mean 45.6 weeks, median 8 weeks). Some patients had multiple episodes of parastomal ulceration. The etiology and clinical features of PSU are discussed. Conservative management included debridement, curettage, unroofing of the ulcer complex, pouching of the stoma with Telfa strips placed in the ulcer base and a conventional appliance or a Perry Model #51 device. Most of the ulcers healed between two and 32 weeks (mean 12.7 weeks, median 8 weeks). In the six patients in whom the ulcers did not heal, Crohn's disease or another ileostomy complication necessitated ileostomy relocation. This conservative management allowed most patients to be treated on an outpatient basis, carrying out their daily tasks and delaying or obviating the need for ileostomy relocations. When required, relocations were done electively. PMID- 6499618 TI - Steroid receptors and the distribution of IR-carcinoembryonic antigen in colonic cancer. AB - Twenty-five colonic cancer tissues were studied for the presence of estrogen and progesterone receptors (ER, PR) and the distribution of immunoreactive carcinoembryonic antigen (IR-CEA). ER and PR were determined in 6 (24 per cent) and 3 (12 per cent), respectively, of 25 patients with colonic cancer. Of the six patients with ER, five were females, four of whom were postmenopausal. Steroid receptors, however, had no correlation with age, tumor localization, stage of disease or IR-CEA. In cancer tissue, IR-CEA in the cytosol fraction was higher than that found in the membrane fraction. In normal colon, however, the concentrations of the two fractions were reversed. Immunohistochemical findings have shown a different distribution of IR-CEA in cancerous and normal colon, and our results demonstrated similar findings by using radioimmunoassay (RIA). PMID- 6499619 TI - Multiple primary malignant tumors involving the large bowel. AB - We reviewed 5680 autopsy protocols in order to determine the frequency of Multiple Primary Malignant Tumors (MPMT) in different organs. The large bowel was the organ most frequently involved, making up to 32 per cent of all MPMT cases. Of 26 patients with colorectal MPMT, six were multicentric in the large bowel, and 20 were associated with extracolonic malignancies. The tissues harboring primary malignancies were, in order of decreasing frequency, liver, lung, and female and male reproductive organs. We compared the exact location of large bowel cancers in patients with and without a prior cholecystectomy; there was no statistically significant difference between the two groups, especially for right sided colonic carcinoma in women. PMID- 6499620 TI - Survival of 727 patients with single carcinomas of the large bowel. AB - The outcome of 727 patients presenting with solitary colorectal carcinoma over a seven-year period is reviewed. Of the patients, 52 per cent were females 45 per cent were over 70 years and 31 per cent had an emergency admission. Of the tumors, 43 per cent occurred in the rectum and 40 per cent were stage D (not treated curatively). Predisposing causes included inflammatory bowel disease (n = 12) and abdominal irradiation (n = 6); associated adenomatous polyps were present in 22 per cent of resection specimens. Hospital mortality rates (20 per cent overall) were adversely affected by emergency admission (36 per cent), age greater than 70 years (29 per cent) and advanced, stage D disease (31 per cent). Corrected overall five-year survival rate was 32 per cent and, after curative resection, 59 per cent. Of patients in whom curative resection included contiguous organs, 47 per cent survived five years. Survival was reduced in patients over 70 years (26 per cent), in emergency admissions (24 per cent), in poorly differentiated tumors (18 per cent), and if tumor fixity was present (14 per cent). Factors contributing to a favorable outlook included a long history (greater than one year) and a tumor situated in the left colon. Recurrence developed in 47 per cent of patients surviving curative resection and was seldom diagnosed at a curable stage. PMID- 6499621 TI - Prospective studies of laboratory and radiologic tests in the management of colon and rectal cancer patients: I. Selection of useful preoperative tests through an analysis of surgically occult metastases. AB - The laboratory and radiologic tests that give useful information in colon and rectal cancer patients over and above that obtained by routine work-up and surgical exploration of the abdomen have not been defined previously. An analysis of surgically occult metastases was used to discover which test would assist in the management of these patients. Occult metastases for radiologic tests were those occurring within one year after resection of the primary tumor; for CEA they were metastases occurring at any time following surgery. Full lung tomography, liver/spleen scan, computerized tomogram of the abdomen, intravenous pyelogram, bone scan, and postoperative baseline CEA greater than 2.5 ng/ml were analyzed. The postoperative baseline CEA was the most sensitive test detecting occult metastases in 57 per cent (12 out of 21) of a high risk patient population. Both postoperative baseline CEA and computerized tomograms of the abdomen had high positive predictive values of 71 and 67 per cent. The negative predictive percentage of computerized tomograms of the abdomen (18 per cent) was lower than that of CEA (21 per cent). In comparing these tests in individual patients with occult recurrence, postoperative CEA and computerized tomograms of the abdomen were seen to be complementary in that approximately 90 per cent of occult metastases were detected when both examinations were used. Computerized tomogram of the abdomen and postoperative baseline CEA are useful in patients with primary colorectal cancer as part of their routine work-up. PMID- 6499622 TI - Constipation. An uncommon etiology. AB - An uncommon cause of chronic constipation is presented in a case report. The patient presented with chronic cough and constipation. Work-up revealed a loop of transverse colon herniated through a right diaphragmatic tear resulting from an old, blunt, abdominal injury. The diaphragmatic hernia was repaired through a right thoracotomy without complications. Diaphragmatic hernia should be ruled out in patients who present with chronic respiratory or vague abdominal symptoms, especially after a history of blunt abdominal trauma. Once the diagnosis is confirmed, expeditious surgical treatment should be undertaken to prevent the development of obstruction or strangulation and its grave consequences. Thoracotomy is the incision of choice, as it affords good exposure for lysis of adhesions, reduction of the hernia, and repair of the diaphragmatic defect. PMID- 6499623 TI - Juvenile versus adult colonic cancer: distinct different etiologic factors? PMID- 6499624 TI - Possible role of mycobacteria in inflammatory bowel disease. I. An unclassified Mycobacterium species isolated from patients with Crohn's disease. AB - A previously unrecognized Mycobacterium species was isolated from two patients with Crohn's disease. The organism is an acid-fast, mycobactin-dependent Mycobacterium that has characteristics which do not conform to any of the presently recognized species. It belongs to the Runyon group III mycobacteria and is most closely related to Mycobacterium paratuberculosis. Animal inoculation revealed pathogenicity for mice when injected intravenously or intraperitoneally, but not for rats, guinea pigs, rabbits, or chickens. The mice developed hepatic and splenic granulomas which contained numerous acid-fast mycobacteria. A 7-day old goat which was inoculated orally with 50 mg of the organism developed both humoral and cell-mediated immunologic responses in two to three weeks and granulomatous disease of the distal small intestine, with noncaseating tuberculoid granulomas in five months. Acid-fast bacilli were not demonstrable in sections of the intestine, but a single organism was seen in each of two microgranulomas of the mesenteric lymph node. The Mycobacterium species was reisolated from the lymph node but not from intestine. Our findings raise the possibility that a Mycobacterium plays an etiologic role in at least some cases of Crohn's disease. PMID- 6499625 TI - Is Crohn's disease a mycobacterial disease after all? PMID- 6499626 TI - Immunological findings in whole and parotid saliva of patients with Crohn's disease and healthy controls. AB - Since oral lesions appear to occur more commonly in patients with Crohn's disease (CD) than in normal controls or patients with ulcerative colitis, it has been suggested that a deficit of locally produced IgA allows the invasion of the oral mucous membrane by antigens and contributes to the production of oral lesions. In connection with this hypothesis, the concentrations of IgA, IgM, and IgG in whole and parotid saliva were investigated by the ELISA technique in 20 patients with CD and 20 healthy subjects matched for dental status. IgA predominated in whole and parotid saliva in both patients and controls, and in both groups whole saliva had higher levels of IgA, IgM, and IgG than parotid saliva did. Compared with the controls, IgA, IgM, and IgG levels were significantly elevated in the whole saliva of CD patients. However, no correlation was found between immunoglobulin levels and age, sex, therapy, duration, localization, or activity of the disease. PMID- 6499627 TI - Relationship between clinical and laboratory parameters and length of lesion in Crohn's disease of small bowel. AB - The correlation of 22 commonly used clinical and laboratory abnormalities with linear extent of the lesion was studied in 70 patients with Crohn's ileitis, 16 of whom had inactive disease and 54 active disease. Extent was measured radiologically using a well-validated double-contrast technique. In the patients with active disease, lesion length was significantly correlated with weight loss, serum albumin, total protein, and serum iron. In the group without active inflammation, pain and abdominal mass were significantly correlated with lesion extent. No correlation was found between linear extent of lesion and the following: an index of inflammatory activity (New Crohn's Disease Activity Index), several acute-phase reactants, and the components of the complete blood count. Only total protein and serum iron had a significant regression coefficient following a procedure of stepwise regression. No mathematical model was found capable of satisfactorily predicting the length of lesion. PMID- 6499628 TI - Achalasia as a risk factor for esophageal carcinoma. A reappraisal. AB - Achalasia has been purported to be a risk factor for the development of esophageal carcinoma. To test the validity of this association at the Yale-New Haven Hospital (YNHH) and its major affiliate, the West Haven Veterans Administration Medical Center (WHVA), two approaches were employed: (1) a prospective study identifying 100 subjects with manometrically documented achalasia for the development of esophageal cancer; (2) a retrospective review of esophageal cancer patients admitted to the YNHH and the WHVA from 1971 through 1981 for any evidence of achalasia. No cases of esophageal carcinoma were identified in the 91 evaluable achalasics. No case of achalasia was found or even suggested in association with the 153 cases of esophageal cancer reviewed. Our findings do not substantiate the association of achalasia and esophageal carcinoma. The clinical implications of this conclusion on surveillance and follow-up of achalasia patients are discussed. PMID- 6499629 TI - Plasma cholecystokinin concentrations in patients with pancreatic insufficiency measured by sequence-specific radioimmunoassays. AB - It has been claimed that plasma cholecystokinin (CCK) concentrations are raised in patients with pancreatic insufficiency. We have measured plasma CCK concentrations in 32 patients with pancreatic insufficiency (22 alcoholic pancreatitis and 10 cystic fibrosis) and in 30 normal subjects by radioimmunoassays using antibodies with different specificities. Antibody 1703 binds to COOH-terminal forms of CCK containing at least 14 amino acid residues and does not cross-react with gastrins. Antibody T204 binds to all CCK-peptides containing the sulfated tyrosyl region and shows low cross-reactivity with sulfated gastrins but no binding to nonsulfated gastrins. Antibody 5135 binds to all COOH-terminal CCK-peptides and shows full cross-reactivity with gastrins. In patients with pancreatic insufficiency, plasma CCK concentrations (1.2 +/- 0.1 pmol/liter, antibody 1703; 2.0 +/- 0.2 pmol/liter, antibody T204; 12.5 +/- 1.4 pmol/liter, antibody 5135) were not significantly different from those in normal subjects (1.1 +/- 0.1 pmol/liter, antibody 1703; 2.2 +/- 0.3 pmol/liter, antibody T204; 10.5 +/- 0.9 pmol/liter, antibody 5135). Furthermore, plasma CCK concentrations in patients with pancreatic insufficiency due to alcoholic pancreatitis (1.2 +/- 0.1 pmol/liter, antibody 1703; 1.9 +/- 0.2 pmol/liter, antibody T204; 14.0 +/- 1.9 pmol/liter, antibody 5135) were not significantly different from those in patients with cystic fibrosis (1.2 +/- 0.2 pmol/liter, antibody 1703; 2.4 +/- 0.4 pmol/liter, antibody T204, 9.1 +/- 1.0 pmol/liter, antibody 5135). Cross-reactivity with gastrin accounted for almost all CCK-like immunoreactivity measured with antibody 5135.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499630 TI - Lack of correlation between serum lipoproteins and biliary cholesterol saturation in patients with gallstones. AB - It has been suggested that elevated serum lipoprotein cholesterol levels may be a determinant of biliary cholesterol saturation and cholesterol gallstone disease. The aim of this study was to correlate serum lipoprotein cholesterol and apolipoprotein levels with biliary cholesterol saturation in patients with gallstones who participated in the National Cooperative Gallstone Study. Baseline serum lipoprotein and biliary lipid levels were studied in 181 of these patients before they received treatment for dissolution of their gallstones. Neither low- or high-density lipoprotein cholesterol nor apolipoprotein levels correlated with biliary cholesterol saturation. This study, therefore, does not support the concept that serum lipoproteins are a determinant of biliary cholesterol saturation. It is possible, however, that a significant effect of lipoprotein levels is obscured by the greater effects of more important determinants of biliary cholesterol saturation. PMID- 6499631 TI - Effect of chenodeoxycholic and ursodeoxycholic acids on isolated adult human hepatocytes. AB - Chenodeoxycholic and ursodeoxycholic are effective cholelitholytic agents, but differ in their side effects. Chenodeoxycholic acid administration induces diarrhea and a transient rise of GOT, which are virtually nonexistent with ursodeoxycholic acid treatment. Lithocholic acid, a bacterial metabolite of chenodeoxycholic acid, has been implicated as a possible hepatotoxin. In the present investigation, the effect of chenodeoxycholic acid or ursodeoxycholic acid and their glycine and taurine conjugates on isolated human hypatocytes was directly assessed. Chenodeoxycholic acid had drastic effects on isolated human hepatocytes by reducing the number of microvilli and disrupting cell membranes. Pronounced release of GOT was observed. In contrast, ursodeoxycholic acid produced only slight morphological changes and enzyme release. Conjugation of each respective bile acids had a moderating effect. PMID- 6499632 TI - Antisecretory activity of fenoctimine in rat and dog. AB - Fenoctimine (4-(diphenylmethyl)-1-[(octylimino)methyl]piperidine) sulfate was evaluated for gastric antisecretory activity in the acute gastric fistula rat and chronic gastric fistula dog. It showed potent gastric antisecretory activity of long duration in the rat, and was more potent on a mg/kg basis than cimetidine. In the dog, fenoctimine showed significant activity against gastrin tetrapeptide, histamine, and bethanechol. It was least potent against bethanechol, indicating a lack of significant anticholinergic activity in the dog at the doses tested. It had a long duration of action in the dog with doses of 6 mg/kg, showing significant activity even at 24 hr. Fenoctimine does not appear to fit the spectrum of activity associated with other known antisecretory agents and may have a unique mechanism of action related to effects directly on parietal cells. PMID- 6499633 TI - In vitro bile acid adsorption by bismuth subsalicylate and montmorillonite. AB - We investigated the capability of Pepto-Bismol and its components (Veegum and bismuth subsalicylate) to sequester bile acids from aqueous solution in vitro and compared it to that of cholestyramine. Through a pH range of 3-9, all substances tested sequestered free and conjugated bile acids in quantities directly related to the concentration of the sequestering agent within the incubation mixture. Veegum was more effective gram for gram than bismuth subsalicylate. Pepto-Bismol, whose sequestering capacity approximated cholestyramine's, absorbed more than either of its components alone. The relationship between Pepto-Bismol's in vitro bile acid binding and its in vivo antidiarrheal properties is unknown. PMID- 6499634 TI - Exercise-induced hypoglycemia following propranolol in a patient after gastric fundoplication surgery. PMID- 6499635 TI - Non-insulin-dependent diabetes (NIDDM) in a newly independent Pacific nation: the Republic of Kiribati. AB - A population-based survey of 2938 subjects has demonstrated a high prevalence of non-insulin-dependent diabetes (NIDDM) in the Micronesian population of Kiribati (formerly the Gilbert Islands). This finding provides further support for evidence from Nauru, Guam, and the Marshall Islands that Micronesians are particularly susceptible to NIDDM. The age-standardized prevalence was over twice as high in an urban, as compared with a rural, sample (9.1 versus 3.0 in men, 8.7 versus 3.3 in women). To test the a priori hypotheses that obesity, reduced physical activity, and a nontraditional diet are associated with NIDDM, indices of these factors were compared in rural and urban subjects. The rural population was found to be leaner, to have a higher estimate of habitual physical activity, and to have a lower percentage of daily energy intake derived from imported foods. Further analysis demonstrated that obesity alone was insufficient to explain the rural-urban difference in prevalence of NIDDM. The multiple logistic regression model demonstrated a significant association between the prevalence of NIDDM and both obesity and urbanization in men. In women, obesity, physical inactivity, and urbanization were all associated with increased prevalence of NIDDM. PMID- 6499636 TI - Association of differing dietary, metabolic, and clinical risk factors with microvascular complications of diabetes: a prevalence study of 503 Mexican type II diabetic subjects. II. AB - The overall prevalences of microvascular complications and their association with dietary, clinical, and metabolic characteristics have been studied in 503 Mexican type II diabetic subjects. Average daily dietary intakes were 1866 kcal, 46.5% as carbohydrate, 13.7 mmol cholesterol, 8.7 g fiber, and a polyunsaturated/saturated fat ratio of 0.98. Prevalence rates of microvascular and metabolic complications were as follows: background retinopathy 12.3%, exudative retinopathy 24.2%, proliferative retinopathy 8.1% (1% blind, 4% able to read large print only), 9.1% of patients had cataract, 15.9% nephropathy, and 40.8% peripheral neuropathy. In addition, 3.6% had experienced transient lower motor neuron facial paralysis and 0.2% oculomotor paralysis. Patients with retinopathy had a longer mean duration of diabetes, were less obese at the time of examination, and had higher initial and mean blood pressures and higher mean fasting blood glucose levels when compared with those without retinopathy. Similar differences were observed between groups with and without nephropathy except that mean blood glucose levels were similar in the two groups. The presence of peripheral neuropathy was associated with longer duration of diabetes, less obesity, higher mean blood pressure and mean blood glucose levels, and lower hemoglobin concentration. Patients treated with diet alone had significantly lower prevalences of all three microvascular complications but they also had significantly shorter duration of diabetes and lower mean blood glucose levels. However, multivariate analyses on the subgroup of 360 patients who had repeated fasting blood glucose measurements for at least 5 yr demonstrated associations between retinopathy and duration of diabetes, mean blood pressure and mean blood glucose, and percent calories from carbohydrate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499638 TI - Verbal fluency and naming performance in type I diabetes at different blood glucose concentrations. AB - The effect of serum glucose alterations on selected verbal skills was examined in a group of diabetic men between 18 and 35 yr of age. An artificial insulin infusion system was used to set and maintain glucose concentrations during testing at each of three levels: hypoglycemia (55 mg/dl), euglycemia (110 mg/dl), and hyperglycemia (300 mg/dl). Subjects were used as their own controls, with performance at euglycemia serving as the comparison standard. A double-blind crossover design was employed as described in Holmes et al. (see ref. 14). Results showed significantly disrupted naming or labeling skills at hypoglycemia, with a trend toward poorer performance at hyperglycemia. During hypoglycemia, rate of responding was slowed from 6% to 18%, compared with euglycemic performance, but accuracy was not impaired. In contrast, word recognition skills were not affected by deviations in glucose. These performance effects were not correlated with duration of disease except for one of the five tests administered. This one exception, on the most difficult task, was less notable than the general finding of no relation between disease duration (from 6 mo to 17.5 yr) and test performance. Thus, in addition to considering long-term consequences of blood glucose alterations, clinicians and diabetic patients may wish to consider acute neuropsychological consequences of disrupted euglycemia. PMID- 6499637 TI - Autonomic neural dysfunction in recently diagnosed diabetic subjects. AB - Because onset of autonomic neural dysfunction in the diabetic syndrome has not been well established, sensitive and quantitative measures of autonomic nervous system (ANS) function were made in 19 non-insulin-dependent (NIDD) and 14 insulin dependent (IDD) recent-onset diabetic subjects. The known duration of diabetes mellitus in the NIDD subjects was less than or equal to 12 mo. The duration in the IDD subjects was less than or equal to 24 mo. RR-variation during beta adrenergic blockade (an index of an ANS reflex involving the cardiac parasympathetic nervous system [PNS] pathway) was smaller than that of control subjects in both NIDD (P less than 0.001) and IDD subjects (P less than 0.01). This PNS abnormality was not likely to be due to volume depletion since acute volume depletion induced by furosemide in six normal subjects (1608 +/- 105 ml, mean +/- SEM) did not change RR-variation. Dark-adapted pupil size after topical PNS blockade (an index of iris sympathetic nervous system [SNS] activity) was also smaller in both groups of diabetic subjects (NIDD, P less than 0.01; IDD, P less than 0.05). Pupillary latency time (an index of an ANS reflex involving iris PNS pathway) was prolonged in the NIDD subjects (P less than 0.005) but was not significantly altered in the IDD subjects. Thus, it would appear that the ANS is impaired soon after the diagnosis of diabetes mellitus. We hypothesize that early impairment of the ANS is common in IDD and NIDD subjects. This finding is consistent with the hypothesis that abnormal carbohydrate metabolism is an important factor in the etiology of diabetic autonomic neuropathy. PMID- 6499639 TI - Accuracy in estimating fasting blood glucose levels by patients with diabetes. AB - This study was designed to assess the accuracy with which diabetic patients can estimate their fasting blood sugars (FBS) and to determine whether experience with self-monitoring of blood glucose improves this ability. Twenty patients with type II diabetes who had no experience with self-monitoring of blood glucose were compared with 17 patients who had been monitoring blood sugar regularly for the previous 8 mo. All patients were asked to estimate FBS immediately before it was measured in the laboratory. Patients were very accurate in estimating their FBS; the average error in estimation was 2 mg/dl, and 65% of patients estimated FBS within 20% of actual FBS. However, there was no evidence that experience in self monitoring of blood glucose improved the accuracy of estimation. Additional studies are needed to determine the types of cues that patients use in estimating blood sugar. PMID- 6499641 TI - Teledyne Sleep Sentry: false security? PMID- 6499640 TI - Development of paper-strip test for 3-hydroxybutyrate and its clinical application. AB - A rapid paper-strip test for the semiquantitating 3-hydroxybutyrate (3-OHBA) has been developed. The color develops within 5 min after applying the serum to the paper strip, and the purple color was read either visually or by reflectance meter. This can detect 3-OHBA levels as low as 0.1 mmol/L up to 2.0 mmol/L. The more concentrated sample can be measured on serial dilution. Clinical usefulness has been tested in a summer camp for insulin-dependent diabetic children as well as in a routine diabetes clinic. Serum 3-OHBA levels ranged from greater than 100 mumol/L to 4 mmol/L in all the subjects before breakfast in a summer camp. In four subjects, 3-OHBA was elevated to the level of 2-4 mmol/L, and only one of these four subjects exhibited ketonuria by nitroprusside test. In a diabetes clinic, a new paper-strip test for 3-OHBA has revealed ketonemia in 34 (74%) of 46 diabetic subjects, while nitro-prusside test revealed ketonemia in only 4 (13%). The present paper-strip test for 3-OHBA is sensitive enough to detect levels as low as 0.1 mmol/L and is clinically useful for rapid detection of ketosis proneness as well as for monitoring of diabetes control. PMID- 6499642 TI - Hypoglycemia associated with trimethoprim/sulfamethoxazole therapy. PMID- 6499643 TI - R-R interval studies: a simple office protocol for evaluation of autonomic neuropathy. PMID- 6499644 TI - [Effect of biopolymers on the properties of water as a factor in the organization of histohematic barriers]. PMID- 6499645 TI - [Innervation of specific skin glands in the rabbit: the cholinergic terminal reticulum]. PMID- 6499646 TI - [Homology of the temperate viruses of a polylysogenic culture of Erwinia carotova 268]. PMID- 6499647 TI - [Study of nucleotide base polyhydrates in a vacuum by low-temperature field mass spectrometry]. PMID- 6499648 TI - [Synthetic genes of peptide hormones. A model gene of human calcitonin]. PMID- 6499649 TI - [Monoclonal antibodies to the nerve tissue growth factor from Vipera lebetina venom]. PMID- 6499650 TI - [Effect of hyperthermia on body temperature and the catecholamine content of the hypothalamus of white rats]. PMID- 6499651 TI - [Effect of the antioxidant dibunol on the composition and lipid peroxidation intensity of the blood of ischemic heart disease patients]. PMID- 6499652 TI - Correlation of benzene metabolism and histological lesions in rainbow trout (Salmo gairdneri). AB - Rainbow trout metabolized benzene to phenol and catechol, and excreted them primarily as glucuronide conjugates. Treatment with benzene or toluene resulted in spleenomegaly that may be a more generalized solvent effect on the circulating RBCs. Anemia was observed only in the benzene-treated animals. This may be a result of decreased erythropoiesis in the head kidney or a direct effect of the principal metabolite (phenol) or its reactive intermediate. Both the spleen and liver metabolized benzene in vitro, while no metabolism was observed in the head kidney or trunk kidney. This fact, along with the observed "covalently" bound material in the liver, spleen, and kidney in vivo, can be interpreted as indicating that a reactive metabolite is formed outside the head kidney and is transported to the head kidney where it results in the observed hematopoietic damage. A similar hypothesis has been suggested for the observed protection by partial hepatectomy against bone marrow effects in mammalian species. The effects observed in trout are similar to those reported for higher mammalian species, but the metabolic profile is simpler, and studies in these animals may shed light on the mechanism of benzene toxicity. The techniques developed for monitoring benzene toxicity in trout can also be used for examining other environmental pollutants that may affect the hematopoietic system of fish. PMID- 6499653 TI - Imipramine-induced syndrome of inappropriate antidiuretic hormone secretion. AB - A case report of imipramine-induced syndrome of inappropriate antidiuretic hormone (SIADH) secretion in a 54-year-old woman is presented along with a review of the literature on antidepressant-induced SIADH. The clinical and laboratory presentation, diagnosis, treatment, and monitoring of antidepressant-induced SIADH also are discussed. PMID- 6499654 TI - Spurious increase in serum creatinine associated with intravenous methyldopate therapy. AB - A patient with subarachnoid hemorrhage treated with intravenous methyldopate experienced a sudden marked increase in serum creatinine. This increase was due to interference by methyldopate in the assay for serum creatinine. By performing in vitro interference studies, we confirmed that methyldopate interferes with the creatinine assay. PMID- 6499655 TI - Rational antimicrobial prophylaxis on a urological ward. AB - The development of a policy for antimicrobial use on a urological ward is presented. The introduction of guidelines for rational antimicrobial use and the monitoring of their effect over a four-year period are described. As a result of the implementation of this policy, a reduction of over 60 percent in antibiotic consumption on the urological ward was achieved. Without interference in the quality of patient care, as determined by the incidence of postoperative wound infections and adverse effects, the overall number of patients treated with antimicrobial agents was reduced 50 percent, but proved to be age dependent. In addition, costs were diminished 20 percent. These results were achieved by intensive collaboration between the Departments of Urology and Clinical Pharmacy. PMID- 6499656 TI - Warfarin dosage following prosthetic valve replacement: effect of smoking history. AB - Warfarin currently is the most widely used agent in the prevention of thrombosis and embolism after prosthetic cardiac valve replacement. Since smoking has been shown to increase the requirement for medications undergoing hepatic metabolism, this study was designed to determine if a correlation exists between smoking history and warfarin daily maintenance dose (DMD) in patients undergoing cardiac valve replacement. Of 200 charts retrospectively reviewed at the New England Medical Center, 174 satisfied the criteria for inclusion in the study (normal hepatic, renal, and hematologic function, and absence of complicating medications). The study population included aortic, mitral, and combined valve replacement. Study groups consisted of 117 nonsmokers (Group A), 23 light smokers (Group B), and 34 heavy smokers (Group C). Thirty-three percent of patients required a low DMD of warfarin (less than or equal to 2.5 mg), 43 percent required a moderate DMD (greater than 2.5-7.5 mg), and 24 percent required a high DMD (greater than 7.5 mg). Each of the subgroups followed a similar pattern. In Group A, there were 31 percent low, 44 percent moderate, and 25 percent high-dose requiring patients. In Group B, there were 48 percent low, 39 percent moderate, and 13 percent high-dose requiring patients and in Group C there were 29.5 percent low, 41 percent moderate, and 29.5 percent high-dose requiring patients. Chi-square analysis did not demonstrate any statistically significant difference between smokers and nonsmokers in regard to daily maintenance warfarin dose (p = 0.5). The study population followed a normal pattern of distribution in regard to warfarin dosage. On the basis of these data we conclude that smoking history does not affect warfarin dose requirement. PMID- 6499657 TI - A utilization review of theophylline assays: sampling patterns and use. AB - Use of the theophylline assay was reviewed for two months in 121 hospital inpatients who received 426 evaluations at a university medical center. Clinicians adapted published audit criteria for the collection and use of theophylline assays. The charts of all patients receiving theophylline were examined daily, and the following data, among others, were collected: pulmonary function tests, arterial blood gases, liver function tests, vital signs, and physician assessments. Only 29.8 percent of the evaluations complied with all criteria. When the audit categories of rational indication, correct performance, and appropriate dosage adjustment were evaluated independently, compliance rates were 69.1, 72.3, and 67.2 percent, respectively. In 171 cases (48.6 percent), the physicians' instructions for the assay were inadequate to ensure proper collection time by the phlebotomist. Hospital laboratory charges for unnecessary, incorrectly performed, or inappropriately used theophylline assays were estimated to exceed +77000 annually. This audit demonstrates the need for a collaborative pharmacokinetics service with reimbursement through the physician billing charge. PMID- 6499658 TI - Pharmacists' views on mandatory patient counseling. AB - A questionnaire was sent to a randomly selected sample of Florida pharmacists to obtain information on the acceptability of mandatory patient counseling. The results of the questionnaire demonstrated that most Florida pharmacists who responded to the survey do not favor a patient counseling regulation. Factors that correlated with a desire for mandatory counseling include: an institutional practice site; assistant director and staff pharmacist position; and a perceived higher income for the patients served by pharmacists. These data indicated that if the mandatory method is selected to stimulate pharmacist-patient interaction, the interrelated issues of reimbursement, facility changes, technician support, patient profiles, continuing education programs, and pharmacists' attitudes toward regulated practice will need to be addressed. PMID- 6499659 TI - Clinical pharmaceutical services in retail practice. I. Pharmacists' willingness and abilities to provide services. AB - The expansion of service levels in traditional community pharmacies in the face of structural and process impediments as well as the lack of reinforcement that would be provided by demand and reimbursement for such services requires a highly dedicated professional. As a result, this research had the goals of investigating the relationship between service provision and pharmacist willingness and competency, and characterizing pharmacists who presently do or do not provide expanded levels of service. A census of South Carolina community pharmacists was carried out using a self-administered, mail questionnaire. Analysis of the 890 responses representing 63.4 percent of the sample revealed that there is a significant relationship between pharmacists' willingness and ability and the extent to which they provide expanded levels of service. Pharmacists providing services were not only more willing and able to do so, but worked longer hours, tended to work in apothecary or independent pharmacies, held advanced degrees, and were more involved in continuing education. The results generally support the hypothesis that both willingness and competency may serve as barriers to the extension of clinical services into traditional community pharmacy settings. PMID- 6499660 TI - Vitamin K deficiency during hospitalization. PMID- 6499661 TI - Verifying aminoglycoside dosing. PMID- 6499662 TI - Comment on ephedrine-phenobarbital formulations. PMID- 6499663 TI - The effectiveness of four education strategies in the elderly. AB - A study was designed for practitioners wishing to provide comprehensive educational services to the elderly. The effectiveness of four methods (i.e., oral instructions alone or in combination with written information, a medication reminder calendar, or a medication reminder package) of changing patient attitudes, drug knowledge, and compliance behavior was measured in 158 ambulatory cardiovascular patients using a randomized, controlled, single-blind design. The results indicate that drug knowledge will most likely be improved by a strategy that provides small amounts of specific information, thereby reducing the possibility of overwhelming the patient. Noncompliance behavior caused by forgetfulness can be best improved by combining a reminder aid with oral reinforcement. The high levels of motivation present in these patients indicate that improving patient attitudes toward medication taking may be unnecessary. PMID- 6499664 TI - The calcium antagonists: an important new group of drugs. PMID- 6499665 TI - Preventing carbon monoxide poisoning in the home. PMID- 6499666 TI - General practitioners and postmarketing surveillance. PMID- 6499667 TI - Acyclovir--an important advance. PMID- 6499668 TI - Oxyphenbutazone eye ointment. PMID- 6499669 TI - [Suicide and weather]. AB - In 151 patients, admitted to an intensive care unit after attempted suicide, the possible influence of weather at the time of the attempt was analysed retrospectively. The "biosynoptic daily analysis" of the German Weather Service provided the weather data. There was a 5% and 1%, respectively, significant level for the positive correlation between the time of the attempted suicide and the weather parameters "stable upslide, labile upslide, fog and thunderstorm" and the summarized parameters "warm air, upslide and weather drier than on the two preceding days". Significantly fewer attempts than expected occurred when the weather description was "low pressure and trough situation, labile ground layer- upslide above" and the summarized parameters "subsidence or downslide motion". Besides the individual factors such as the reaction to conflicts and the spectrum of reactions, exogenous factors like weather must be considered as important for the time of suicidal attempt. PMID- 6499670 TI - [Recurring thrombosis of the subclavian vein during estrogen therapy of prostatic cancer]. AB - A cardiac pacemaker had been implanted in a patient with carcinoma of the prostate because of a sick sinus node. Thrombosis of the left subclavian vein occurred four weeks later. After complete recanalisation following thrombolytic treatment a recurrence of the thrombosis occurred during high-dosage intravenous oestrogen treatment. Continuous increase of prothrombin time was observed during oestrogen administration while the oral anticoagulation had remained unaltered. This indicated increase of synthesis of vitamin-K-dependent clotting factors by the oestrogens. This case demonstrates that in patients with implanted material and oral long-term anticoagulation the indication for oestrogen treatment must be extremely accurately. In every case very close surveillance of coagulation is necessary. PMID- 6499671 TI - [Polymorphous aspects of alcohol-induced hyperlipemia]. PMID- 6499672 TI - [Incidence of malignant neoplasms in West Germany. Cumulative incidences]. PMID- 6499673 TI - [Hyposiderinemia and anemia in Crohn disease]. PMID- 6499675 TI - [Rabies virus in the saliva of infected animals before the outbreak of clinical symptoms]. PMID- 6499676 TI - [Splenic rupture as a consequence of coloscopy]. PMID- 6499674 TI - [The thyrotropic function of the hypophysis and peripheral thyroid hormones after removal of bland and autonomous nodular goiters]. AB - Bilateral subtotal resection or enucleation or unilateral resection was performed in 60 patients (36 with bland nodular goitre, 24 with autonomic adenoma). The thyrotropic pituitary activity and the peripheral thyroid function were examined in all patients preoperatively and followed up for 12 months postoperatively. The results show that all patients with bilaterally resected bland nodular goitre require postoperative administration of thyroid hormone, since enhanced thyrotropic activity is seen not later than three months after surgery. Since thyrotropic function remains normal in unilaterally operated nodular goitre, thyroid hormone administration does not appear generally necessary. In patients with autonomic adenoma there is postoperatively variability of function, independent of the surgical method employed. In view of possible functional recompensation, final decision on the administration of thyroid hormones should not be made before the end of the sixth postoperative month. These results can be considered as guidelines for a differentiated postoperative management. PMID- 6499677 TI - [Diagnostic and prognostic significance of massively increased serum glutamate dehydrogenase activity]. AB - In a retrospective analysis of case reports of 115 patients with glutamate dehydrogenase (GLDH) activity in serum of more than 100 U/l in 1979-1981, the most common causes of this increase were: acute right heart failure (28 patients), protracted septic-toxic circulatory failure (20), obstructive jaundice (18) and severe respiratory insufficiency (16), i. e. diseases causing perfusion or excretion disorders in the liver. The ratio of GLDH activity to transaminase activity provided a reliable separation of acute viral hepatitis, but not of different forms of perfusion disorders. The correlation between GLDH activity and death rate, especially in acute right-heart failure, is of prognostic value. PMID- 6499678 TI - [Rubella encephalitis with unusual course in an adult]. AB - A 35-year-old woman developed neurological signs over several weeks after a symptom-free rubella infection. Rubella encephalitis was diagnosed from a significant rise in rubella virus antibodies and the demonstration of IgM antibodies. Slow improvement in the neurological defects began not earlier than in the 16th week of illness. Severe defects of speaking, reading, writing and calculating as well as mild disorders of affect still persisted eight months after onset of the illness. PMID- 6499679 TI - [Accidental rubella vaccination in pregnancy]. AB - In the Federal Republic of Germany, between 1971 and 1983, 365 women were by chance vaccinated against rubella (Cendehill or RA-27/3-HDC rubella live vaccine) between 3 months before and up to 3 months after conception. The data on these women are compared with similar ones from the USA (1096 women vaccinated with Cendehill, HPV77 or RA-27/3 vaccine within the same time-span in relation to pregnancy). The results indicate that the risk for the child from rubella vaccination of the mother before pregnancy and in the first trimester is minimal. Vaccination during early pregnancy is thus no compelling indication for the termination of pregnancy. However, known pregnancy continues to be a contraindication to rubella vaccination. PMID- 6499680 TI - [Diagnosis in malignant duodenal wall changes]. PMID- 6499682 TI - [Blood pressure characteristics in hypertensive patients in change of environment]. PMID- 6499681 TI - [Cytostatic agent-induced increase of fibrinopeptide A levels]. PMID- 6499683 TI - [Orthograde bowel irrigation using Ringer's lactate solution]. PMID- 6499684 TI - [Survival time and causes of death in dialysis patients]. AB - Renal dialysis was performed, between 1973 and 1983, in 431 patients in terminal renal failure. Of these, 223 (51.7%) are still in treatment, 21 (4.9%) have a functioning transplant. 22 patients (5.1%) have changed to another treatment centre. Three (0.7%) are in uraemia not requiring dialysis. The cumulative survival time for the whole group was 91% at the end of one year, 84% after the second, 78% after the third, 73% after the fourth and 69% after the fifth year. In those over 65 years and those with hypertension or diabetes survival chances were least favourable. Among this group, 5-year survival time was 51, 55 and 46%, respectively. The most frequent cause of death among 162 patients were cardiovascular and cerebrovascular diseases (35 and 23%, respectively). PMID- 6499686 TI - [Diagnostic procedures in gynecomastia]. PMID- 6499685 TI - [Femoral nerve paralysis after vaginal hysterectomy. Its causes and forensic significance]. AB - Paralysis of the femoral nerve following vaginal hysterectomy is a rare peripheral lesion the pathogenesis of which is still under dispute. However, after abdominal hysterectomy it is much more frequent, with a largely clarified aetiology. During 1975 to 1984 three clinically and electrodiagnostically established cases of paralysis of the n. femoralis following vaginal hysterectomy were seen; in one case, paralysis was bilateral. The question whether lesion of the n. femoralis is due to malpractice is still a moot point. PMID- 6499687 TI - [Withdrawal of drugs for the patient's own protection]. PMID- 6499688 TI - [Cholestatic jaundice during flecainide therapy]. PMID- 6499689 TI - [Prevention of motion sickness with a transdermal therapeutic system containing scopolamine. A randomized, comparative double-blind study in the German Federal Navy]. AB - To test the prophylactic value of anti-motion sickness drugs, a randomized double blind trial was undertaken on 46 young, healthy, male volunteer marines. Comparison was made between a transdermal therapeutic system (TTS) containing as the effective agent scopolamine (TTS-scopolamine) and proprietary meclozine tablets. An artificial "sea voyage" served to produce motion sickness, each subject sitting by himself on an artificially tilting "island", on two days for 30 minutes. Without treatment, 19 of the 46 subjects developed symptoms of motion sickness requiring treatment. After administration of TTS-scopolamine or meclozine tablets (double-dummy technique) the motion sickness score was reduced by 89% and 59%, respectively. There was a reduction on the visual analog scale of 98% and 59%, respectively. Probability of error (Fisher's exact probability test) for assuming therapeutic advantage of TTS-scopolamine over meclozine tablets was 13.5%. A pre-set significance level of 5% was thus not reached. This trial shows that TTS-scopolamine, even in a brief exposure, has at least the same effectiveness as meclozine, in addition to avoiding the gastrointestinal tract and maintaining with certainty a constant blood level over three days. PMID- 6499690 TI - [Hypotension and shock in pheochromocytoma]. AB - A 22-year-old woman was admitted to hospital in shock, the admission diagnosis being lobar pneumonia with septic shock. Ultrasound demonstrated a tumour in the region of the left adrenal, but because of the absence of hypertensive symptoms and hypoglycaemia this was interpreted as a non-contributory finding. Despite intensive therapeutic measures the patient died within a few hours. At autopsy a phaeochromocytoma of the left adrenal gland was found. "Catecholamine myocarditis" resulting in acute cardiac failure, was demonstrated histologically. Phaeochromocytoma with predominant adrenaline or dopamine secretions often takes a normotensive or hypotensive course. Sudden excessive catecholamine release can, as in the described case, cause so-called adrenaline shock. The catecholamine induced hypoxic-toxic myocardial changes determine the likely outcome. PMID- 6499691 TI - [Problems of hemostatic therapy after myocardial infarct]. PMID- 6499692 TI - [Plasmapheresis--an enrichment in the therapy of autoimmune endocrinopathies]. PMID- 6499694 TI - Electrolyte disturbances and cardiac risks. Proceedings of a symposium, Amsterdam, 16-17 March 1984. PMID- 6499695 TI - The pathophysiology of potassium and magnesium disturbances. A cardiac perspective. AB - Sodium (Na+) and calcium (Ca++) ions are both involved in the activation of cardiac muscle cells. Na+ ions initially depolarise the cell, and the cell-inward flux of Ca++ ions maintains the plateau phase of the action potential. Ca++ ions trigger the release of more Ca++ ions from the sarcoplasmic reticulum. The free Ca++ ions inside the cell subsequently activate the formation of actomyosin complexes and initiate the contraction. Potassium (K+) and magnesium (Mg++) ions modulate the actions of Na+ and Ca++. Hyperkalaemia lowers the membrane potential, and thereby reduces excitability and conduction velocity. Doubling of the K+ concentration may stop the heart, but slightly increased K+ concentrations may increase the risk of arrhythmia. Hypokalaemia reduces potassium conductance of the muscle cell. Instead of hyperpolarising the cell, as one might expect, the myocardium depolarises in a low-K+ solution. Membrane resistance increases and depolarising currents are insufficiently balanced by K+ conductance changes. In the case of low K+, the cells are unstable and excitability is increased. In addition, hypokalaemia increases the risks of digitalis treatment and enhances the arrhythmogenic effect of digitalis. Although cardiac muscle contains a relatively high concentration of Mg++, the free Mg++ concentration is probably low. Outside the cell, the free Mg++ concentration is about 0.5 to 0.7 mmol/L, and there is probably little or no gradient across the cell membrane. A passive carrier-mediated influx of Mg++ ions balanced by an active countertransport keeps intracellular Mg++ concentrations relatively constant. Membrane permeability is low and Mg++ has little direct effect on the membrane potential.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499693 TI - An epidemiological perspective of sudden death. 26-year follow-up in the Framingham Study. AB - Over 26 years of follow-up of 5209 Framingham subjects there were 147 sudden deaths in men and 50 in women. Half the sudden deaths in men and 70% in women occurred without prior coronary heart disease. The incidence doubled with each decade of age, with women lagging men by 20 years. At any age in either sex the risk varied widely in relation to their risk factor make-up. By incorporating systolic pressure, serum cholesterol, vital capacity, cigarette smoking, relative weight, heart rate and ECG abnormalities into a multivariate formulation, a composite estimate of risk was obtained over a wide range. The multivariate sudden death prediction was as efficient in women as in men, identifying 53% and 42% of the sudden deaths, respectively, in the upper decile of multivariate risk. At any level of multivariate risk, women had only a third of the sudden death incidence of men, suggesting a unique biological resistance to sudden death. Ventricular premature beats, associated with an excess sudden death incidence, often occurred concurrently with ECG evidence of left ventricular hypertrophy, intraventricular block, and nonspecific ECG abnormalities. These associated ECG abnormalities were more highly predictive of sudden death than ventricular premature beats. The key to prevention of sudden death would appear to be reduction of the risk of coronary attacks. Once overt coronary heart disease or cardiac failure appears, the risk of sudden death escalates 9-fold, and at this stage the standard coronary heart disease risk factors have little predictive value. Only ECG abnormalities, arrhythmia and poor cardiac function appear to be predictive. PMID- 6499697 TI - Magnesium in coronary artery disease. AB - Magnesium in coronary artery disease is reviewed with regard to its role in the pathogenesis of arteriosclerosis, coronary spasm, myocardial function, acute myocardial infarction and ventricular arrhythmias. Experimentally, magnesium depletion potentiates and supplementation retards the effect of atherogenic diets. Evidence from human studies is circumstantial. Reactivity of arterial smooth muscle is enhanced by low and suppressed by high magnesium media. Evidence that magnesium depletion may initiate coronary spasm is provided by dog and retrospective human studies. Although experimental magnesium deficiency disrupts myocardial mitochondria, there are no studies which show that magnesium deficiency will lead to cardiac failure or that replacement will improve cardiac function. It is known that an infarcted or ischaemic myocardium loses magnesium and this may be the basis for ventricular arrhythmias. Coronary occlusion in a previously magnesium-depleted heart will result in a larger area of necrosis and ischaemia. The fall in serum magnesium in acute myocardial infarction is probably due to the formation of soap in fat cells undergoing catecholamine lipolysis. Ventricular fibrillation in coronary artery disease will respond to parenteral magnesium, even in the presence of normal serum concentrations. PMID- 6499696 TI - Magnesium deficiency. Causes and clinical implications. AB - The many causes of clinical magnesium deficiency can be placed into 2 categories: diminished intake of magnesium, and enhanced losses of magnesium, either through the gastrointestinal tract or through the kidneys. Examples of the first category include alcoholism, starvation, anorexia due to neoplastic disease and/or chemotherapy. Examples of the second category include severe diarrhoeal states, gastrointestinal fistulae, malabsorption, diuretic therapy and gentamicin therapy. Estimates of the prevalence of clinical hypomagnesaemia range from 6 to 11% in hospitalised patients. Serum predictors of associated clinical magnesium depletion include hypokalaemia (42%), hyponatraemia (23%), hypophosphataemia (22%) and hypocalcaemia (20%). Experimental and clinical observations strongly support the view that magnesium and potassium are closely linked at the cellular level. Magnesium has been demonstrated to be important in cell energetics (Mg++ activated ATPase), in maintenance of the integrity of cell membranes, retardation of cell loss of potassium, as well as enhancing repletion of cell potassium. While translation of these experimental observations into clinical terms encompasses a wide spectrum of illnesses, there is special relevance in considering the role of magnesium in repletion and maintenance of cell potassium in 2 clinical instances: (a) patients treated with digitalis and diuretics; and (b) hypertensive patients. In these types of patients not only potassium but also magnesium should be administered together to avoid the problem of cell potassium depletion and refractory potassium repletion associated with coexisting and uncorrected magnesium depletion. PMID- 6499698 TI - Intracellular magnesium loss after diuretic administration. AB - Diuretic agents influence the renal handling of magnesium, causing increased losses of the ion. Continuing magnesium losses may, in the long term, result in a magnesium deficiency. 296 patients with congestive heart failure or arterial hypertension receiving long term diuretic therapy were studied by skeletal muscle biopsies to assess their magnesium status. 65% of the congestive heart failure patients and 42% of the patients with arterial hypertension were found to have subnormal values for skeletal muscle magnesium. Studies with the potassium sparing diuretics amiloride, spironolactone and triamterene demonstrate that these drugs significantly increase the muscle magnesium content in patients on long term diuretic treatment for congestive heart failure and/or arterial hypertension--in addition to their well known positive effect on potassium balance. PMID- 6499699 TI - Ischaemic heart disease. An epidemiological perspective with special reference to electrolytes. AB - Ischaemic heart disease (IHD) is a major public health problem in most industrialised countries. In the death rates from IHD, marked differences exist between various countries and also between different areas of individual countries. Unfavourable dietary factors appear to play an important role in the aetiology of IHD, and thus differences in dietary habits and the quality of food may be mainly responsible for the geographic differences in the prevalence of IHD. The present liberal use of salt as well as the refining and other industrial processing of food increase the content of sodium and decrease the content of potassium and magnesium in the diet. The high intake of sodium and the inadequately low levels of potassium and magnesium in the diet predispose to the development of arterial hypertension. Since arterial hypertension is a major risk factor of IHD, the distorted electrolyte composition of our present diet can be considered an important aetiological factor of this disease. To decrease the body burden of sodium, diuretic agents are frequently used. Unfortunately, in the presence of the relatively low content of potassium and magnesium in the diet, the diuretic-induced increases in the excretion of these electrolytes commonly decrease the potassium and magnesium levels in the body. The falls in potassium and magnesium may increase the death rate from IHD by predisposing the heart to fatal arrhythmias, and also by other mechanisms. The likelihood of magnesium deficiency also appears to be influenced by the area of residence. The higher than-average death rates from IHD in the so-called North Karelia area in eastern Finland and in some other areas with exceptionally high death rates from this disease may be at least partly due to the very low levels of magnesium in the soil and drinking water. It can be concluded that electrolyte disturbances have important implications in the aetiology and pathogenesis of IHD. PMID- 6499700 TI - Diuretic-induced magnesium losses. AB - Long term administration of common loop or distal tubular diuretics may cause somatic magnesium depletion. The resultant deficiency of Mg++ destabilises the myocardium electrically and is a principal cause of cardiac arrhythmias ascribed to diuretics. The adverse effects of diuretics caused by Mg++ depletion can be avoided by selecting diuretics that do not cause magnesium deficiency, minimising the diuretic dose, supplementation of Mg++ intake, or the concomitant use of a K+ retaining, Mg++-sparing diuretic. PMID- 6499701 TI - The role of potassium in control of blood pressure. AB - Extra potassium intake has been found to be a determinant of blood pressure for epidemiological and experimental reasons. People with hypertension have a small fall in blood pressure with added potassium. Potassium chloride (48 mmol/day) was given to 36 male patients with high blood pressure; 5 did not comply with therapy. In the entire group of patients, potassium chloride had no significant effect on blood pressure, but prevented the rise in blood pressure and pulse rate produced by posture. In patients with a urinary Na+ excretion less than 75 mmol per 10 mmol creatinine, potassium chloride had no effect on supine blood pressure, but prevented the rise in blood pressure and pulse rate with standing. In those on a high sodium intake, potassium chloride lowered both the systolic and diastolic pressures. In sodium-responsive subjects, potassium chloride prevented the rise in blood pressure induced by sodium chloride but had no significant effect on blood pressure when on a low sodium intake. These results indicate that potassium reduces the rise in blood pressure caused by sodium chloride and reduces the increased sympathetic postural response seen in people on a low sodium intake. PMID- 6499702 TI - Sudden death in men with increased risk of myocardial infarction. The MRFIT Programme. AB - The Multiple Risk Factor Intervention Trial (MRFIT) was a randomised clinical trial of the preventability of fatal first heart attacks among middle-aged men at high risk of coronary heart disease (CHD). After screening 361,662 men aged 35 to 57 years, 12,866 men currently free of CHD at the upper end of the risk spectrum on the basis of their levels of serum cholesterol, diastolic blood pressure and cigarette smoking were randomised either to 'special intervention' (SI) or to 'usual care' (UC). Those SI men with a sustained diastolic blood pressure greater than or equal to 90mm Hg (following attempted weight loss, if indicated) received pharmacological treatment in the form of a protocol of 'stepped care'. UC men were referred to their usual source of medical care. At the termination of the study - after 6 to 8 years of intervention - no significant differences in overall deaths from CHD or from all causes were observed between the SI and UC groups. However, among the subgroup of individuals who had both a diastolic blood pressure greater than or equal to 90mm Hg and abnormalities of the resting electrocardiogram at baseline there was an excess of deaths from CHD in the SI group compared with the UC group (36 vs 21), and most of the excess deaths were sudden (20 vs 8). PMID- 6499703 TI - Diuretics and arrhythmias in the Medical Research Council trial. AB - Direct visual interpretation of a daytime and night-time hour of ambulatory ECG recording was possible in 287 of 324 Medical Research Council mild hypertension trial participants. The prevalence of arrhythmias in 103 unselected participants was similar before and 8 weeks after initiation of placebo or thiazide treatment. However, in 164 unselected participants studied during long term therapy (average, 24 months) the prevalence of daytime and night-time ventricular ectopic beats (VEBs) greater than or equal to 5/hour was greater in thiazide recipients (32% and 23%, respectively) than in their placebo counterparts (20% and 9%, respectively). In addition, special VEBs such as multifocal beats, couplets. R-on T beats and bigeminy were more common during long term thiazide (33%) than placebo (15%) treatment. Ventricular ectopic beats greater than or equal to 5/hour and special VEBs were also common (45% and 40%, respectively) in 20 selected hypokalaemic participants studied during long term thiazide therapy. In pooled data, daytime and night-time VEBs were negatively correlated with serum potassium (p = 0.04 and p = 0.03, respectively) but the correlation coefficients were small (r = -0.11 and r = -0.12, respectively). PMID- 6499706 TI - Peripheral vertigo. PMID- 6499704 TI - Ventricular arrhythmias in patients with myocardial infarction and ischaemia. Relationship to serum potassium and magnesium. AB - Alterations in serum electrolytes may frequently accompany ischaemic heart disease. Many of these patients are hypertensive and receive diuretic therapy which results in chronic lowering of serum potassium and magnesium. In addition, acute catecholamine-induced shifts of potassium into cells may also occur in the setting of acute myocardial ischaemia. An association between low serum potassium concentrations and ventricular arrhythmias has been observed by a number of investigators in patients with acute myocardial infarction. The increased frequency of ventricular fibrillation with low serum potassium concentrations is particularly relevant as this arrhythmia is associated with poor prognosis, even in the setting of a coronary care unit. Ventricular fibrillation also occurs with increased frequency in patients with angina who have low serum potassium levels. The possibility that low serum potassium concentrations may be a risk factor in the increased incidence of sudden death in such patients should be considered. Diuretic-induced magnesium deficiency may be yet another factor favouring the emergence of ventricular arrhythmias in patients with ischaemic heart disease. While such electrolyte disturbances do not account for all of the ventricular irritability seen in patients with ischaemic heart disease, they represent easily identifiable and treatable risk factors. Primary prevention of these electrolyte disturbances in patients at risk for coronary ischaemia is recommended. PMID- 6499705 TI - Diuretic-induced hypokalaemia and ventricular arrhythmias. AB - In the past, adverse cardiac effects of potassium depletion in non-digitalised patients and in patients without cardiac disease were considered to be minimal. However, several studies have now demonstrated a significant incidence of ventricular ectopic activity in diuretic-treated patients, particularly in those who become hypokalaemic. Potassium repletion with potassium-sparing diuretics or with potassium chloride supplementation has generally demonstrated a beneficial therapeutic effect in reducing ventricular ectopic activity. However, occasional patients may have persistent ventricular ectopic activity after diuretic therapy which may result from focal myocardial lesions associated with potassium depletion. In addition, factors other than potassium depletion appear to initiate or magnify diuretic-induced ventricular ectopic activity. Thus, to avoid these adverse cardiac effects, normokalaemia should be maintained during long term diuretic therapy. PMID- 6499707 TI - Functional anatomy of balance. PMID- 6499708 TI - The causes of peripheral vertigo. PMID- 6499709 TI - Evaluation of the dizzy patient. PMID- 6499710 TI - The treatment of peripheral dizziness. PMID- 6499711 TI - Frontoethmoid mucocele with CSF leak. PMID- 6499712 TI - The chronology of adipose tissue appearance and distribution in the human fetus. AB - Timing of first appearance and subsequent distribution of adipose tissue were assessed in 488 normal-for-age human fetuses. The sample represented each of the three trimesters of normal pregnancies. Light microscopy showed that adipose tissue first appears and progressively develops from the 14th to 24th week of gestation (100-216 mm crown-rump length) in those areas where it characteristically accumulates after birth. No significant sex differences were found in patterns of early fat deposition. It is suggested that the second trimester of gestation is the critical or key period in fat adipogenesis. PMID- 6499713 TI - Association of syndromes predisposing to low birthweight. AB - In a geographically-defined sample of low birthweight deliveries, the incidence was measured of ante-partum haemorrhage, hypertension, placental insufficiency and premature rupture of the membranes. When more than one of these syndromes was present, a clear pattern of segregation into pairs was noted, ante-partum haemorrhage tending to occur with premature rupture of the membranes, and hypertension with placental insufficiency. PMID- 6499714 TI - Evaluating breast-milk intake by test weighing: a portable electronic balance suitable for community and field studies. AB - A K-Tron Digital Scale (Model DS-1) was used to weigh a group of 52 new born babies. The regression of the weights on true weights obtained with a Sartorius electronic balance 3806MP was 0.9911, with an estimated residual variance of 5.25. With the same babies weighed on a Marsden Weighmaster, the estimated residual variance was 68.93. Data from published studies on other balances are presented for comparison. The K-Tron is a reliable, portable, battery operated balance suitable for measuring milk intake by test weighing in homes or in the field. PMID- 6499715 TI - The bacon Chow study: effects of maternal nutritional supplementation on birth measurements of children, accounting for the size of a previous (unsupplemented) child. AB - Studies on nutritional supplementation of pregnant mothers have observed small but sometimes significant effects on fetal growth. Previously we also reported significant changes in physical resemblance of siblings at birth due to this kind of supplementation, using data collected by the late Dr. Bacon Chow and associates. This suggested that components of variation in physical growth may change as a result of supplementation. To explore this further, we sought the effects of nutritional supplementation on somatic growth, holding constant the birth measurements of a previous (unsupplemented) sibling. Only head circumference at birth came close to showing a statistically significant (P less than 0.06) supplement effect on its mean (+ 0.36 cm) when the measurement of the first infant was held constant. Both increases and decreases in weight for length as assessed by Rohrer's Index (wt/l3) occurred with supplementation. Increases in the index occurred by a significant (P less than 0.01) gain in birth weight (238 g) between 1st and 2nd siblings in the supplement group but not in the placebo group. Decreases in this index resulted from a significant gain in birth length (1.3 cm) in supplemented families with a previous (untreated) sibling having a below average length for average weight. These non-linear effects on somatic growth suggest that responses to maternal nutritional supplementation may be more effective in a subgroup of the population where the normal adaptive responses to low energy protein intakes may have failed or where nutritional conditions over pregnancy may have varied considerably. PMID- 6499717 TI - Organ blood flows of fetal and infant baboons. AB - Baseline values for total and selected regional blood flows are presented for 77 studies of baboons from 92 days of gestation to 61 days of postnatal age. Systemic blood flow rose from 231.3 +/- 21.4 ml/min/kg to 330.4 +/- 122.4 ml/min/kg in late gestation and from 124.0 +/- 29.9 ml/min/kg on day 1 to 162.8 +/- 20.5 ml/min/kg at the 8th week. In both fetal and infant periods, blood flow to brain, heart, kidneys, and gastrointestinal tract changed to reflect both anatomic and functional requirements. When compared to late gestation levels, blood flows on day 1 to brain, myocardium and gastrointestinal tract decreased proportionally to systemic blood flow. In contrast, renal blood flow on day 1 was maintained at the predelivery level and represented about twice the proportion of systemic blood flow of late gestation. The data presented provide a developmental profile of systemic and selected organ blood flows from mid-gestation to the 8th week of postnatal life in the baboon. As such, they may form the basis for further investigation and understanding of perinatal maladaptation from preterm delivery and disease. PMID- 6499718 TI - Intracranial haemorrhage in the preterm sheep fetus. PMID- 6499716 TI - 15-Hydroxyprostaglandin dehydrogenase activity in human fetal kidney tissue. AB - Human fetal kidney tissue was found to be rich in NAD+-dependent 15 hydroxyprostaglandin dehydrogenase (PGDH) activity. The enzyme activity was localized primarily in the medullary portion of fetal kidney. Separated cortical and medullary tissue fragments were maintained in organ culture for up to 9 days. The specific activity of PGDH in cortical tissue was low at the commencement of organ culture and remained low throughout the culture period. The specific activity of PGDH in medullary tissue fell precipitously during the first 48 h in organ culture; thereafter, the specific activity of the enzyme increased steadily during the culture period and reached values of up to ten times that in starting tissue by 6-7 days in organ culture. The decline in specific activity of PGDH in medullary tissue during the first 48 h in culture could be prevented by including inhibitors of lysosomal enzyme activity, i.e., chloroquine or ammonium chloride, in the culture medium. We suggest that human fetal kidney tissue explants in organ culture may be an appropriate model for the study of the regulation of PGDH activity. Such an evaluation of the regulation of PGDH is believed to be of importance since PGDH serves to regulate the levels of and, thence, the action of the biologically active prostaglandins. PMID- 6499719 TI - Early pregnancy screening for intrauterine growth retardation. AB - In a prospective clinical study from Uppsala County, Sweden, in 1980, all pregnancies were screened early in pregnancy for 15 previously reported risk factors for intrauterine growth retardation (IUGR). This risk group (n = 639) was then compared with a randomly selected control group (n = 539). In the risk group, there were increased risks for the delivery of growth retarded infants, low birthweight infants and infants spontaneously delivered as prematures. 30% of the population exhibited risk factors. Smoking was the most important risk factor, 16% of the mothers smoked at least ten cigarettes per day and smoking was the main risk factor in the majority of cases with IUGR. PMID- 6499720 TI - Factors influencing birthweight for gestational age, with special respect to risk factors for intrauterine growth retardation. AB - In a prospective clinical study from an unselected, area-based population, the influence on birthweight for gestational age of different factors was studied, with special respect to 15 risk factors for intrauterine growth retardation (IUGR) recognizable in early pregnancy. In the multiple regression analyses performed, birthweight for gestational age was used as the dependent variable. Only 10% of the variance in birthweight for gestational age could be explained. A correlation was found between the number of risk factors and birthweight for gestational age. Four risk factors had a significant negative influence on birthweight for gestational age: smoking, previous birth of a low birthweight infant, a low prepregnancy weight and addiction. No single risk factor influenced birthweight for gestational age as much as parity. When a risk factor was present the expected increase in birthweight for gestational age with increasing parity did not appear. PMID- 6499721 TI - The postures exhibited by 3-day-old full term neonates. AB - A carefully selected sample of 18 3-day-old full term neonates was videotaped in 3 different positions. The time of taping was controlled for feed interval. These tapes were then analysed for state and posture using a frame by frame facility. Seventy one separate postures were documented and the existence of a 'neutral posture' was noted. These postures will provide a baseline for further work in adult-infant interaction. PMID- 6499722 TI - Cell hydration in the normally grown, the premature and the low weight for gestational age infant. AB - Total body water (TBW), extracellular volume (ECV) and intracellular water (ICW) were measured in a cross-sectional study of 107 infants up to four weeks after birth. Three groups of infants were selected for study: (1) mature normally grown infants, (2) mature low weight for gestational age (LWGA) infants and (3) premature normally grown infants. In the normal mature infants there was no significant change in TBW during the first 6 days after birth but there was a small but significant (P less than 0.02) redistribution of extracellular water into the cells by the sixth postnatal day. This suggests that the normal weight loss in infants after birth is due to a relative starvation rather than cell dehydration. In the LWGA infants, TBW levels were higher than normal and ICW significantly increased. This index of cell mass further increased throughout the 14-day period studied (P less than 0.01) and was the highest of all groups studied. It is argued that the changes are due to cytoplasmic growth. Premature babies (mean weight approximately 2000 g and greater than 30 weeks gestation) had higher TBW values than their mature normally grown counterparts. Hyponatraemia was infrequent and no shift of water into cells was detected. All groups of infants revealed loss of ECV over the first two weeks and in premature infants the loss was commensurate with that of TBW. PMID- 6499723 TI - The body proportions for small-for-dates infants. AB - Measurements of weight, head circumference, crown-heel length, crown-rump length, rump-heel length and limb lengths were made in 514 neonates. From these measurements the differences in trunk and limb growth and their relations with head growth and body weight were examined in small-for-gestation (SGA) and appropriate grown (AGA) infants, and in different ethnic groups. We found that Asian infants had different body proportions from blacks and whites, with shorter trunks and forearms. SGA infants as a whole showed little difference in proportions from AGA infants except in their ponderal indices and the ratio of head size to body weight. However there was a preponderance of thin, relatively well-grown infants among them. When very short SGA infants were compared with AGA infants significant differences emerged, the short infants of all ethnic groups having shorter trunks and forearms in relation to their other measurements. We found no evidence of relative sparing of head growth. The results suggest that infants with prolonged intrauterine growth retardation are most likely to have disturbed skeletal proportions. PMID- 6499724 TI - Acute effect of maternal smoking on the maternal and fetal cardiovascular system. AB - Maternal and fetal cardiovascular dynamics were studied in relation to maternal smoking in 18 healthy nulliparous subjects randomly divided into a smoking (n = 9) and a control group (n = 9) between 34 and 38 weeks of gestation. At the end of the study, data from 7 smokers and 7 controls were available for analysis. A significant rise in maternal heart rate and systolic blood pressure was observed during and following smoking one cigarette. A significant increase in fetal heart rate occurred following smoking, whereas mean blood flow velocity and vessel diameter in the fetal descending aorta as measured by pulsed Doppler and time motion techniques did not demonstrate any significant changes. PMID- 6499725 TI - [Behavior of serum iron levels and total iron-binding capacity following gastrectomy]. AB - Iron and the total iron binding capacity before and after an application of iron per os using the method of atomic absorption were determined in serum of 18 patients with a gastrectomy. The results were compared with a healthy group without a gastrectomy. We could not find significant disturbances of the enteral resorption of iron. But some patients show symptomes of a latent iron deficiency. After an operation the routine substitution of iron per os in patients without the stomach is indicated. PMID- 6499726 TI - [Computer tomogram of changes in pancreatic calcification during pancreatitis]. AB - In 3 patients an increase of pancreatic calcification was observed in the course of 2 months. The increase of the calcification was combined with an improvement of the patient and a decrease of pseudocysts. Therefore the increase of pancreatic calcification was considered as a good sign. After surgical drainage of a pseudocyst one patient showed a decrease of pancreatic calcification in the course of 1 year. In this patient the clinical picture indicated a favourable development. This observation demonstrates that a recovering pancreas may show diminishing calcifications. PMID- 6499727 TI - Remarks on gastroenterologic diagnostics of amoebic liver abscess, peritoneal tuberculosis and tropical splenomegaly. AB - The amoebic liver abscess, the peritoneal tuberculosis and the "tropical splenomegaly" belong to diseases which are frequent in warm countries but single cases appear also in moderate climate by intercontinental communications. False diagnoses especially in the first both can lead to severe rsp. fatal consequenses. Therefore experiences are dealed with, which have been gained within nearly one year in Ethiopia and which shall illustrate the diagnostic procedures under field conditions in warm countries as well as under conditions of modern hospitals in moderate climates. Amoebic liver abscess is quickly detected and confirmed by sonography and immunodiagnostic. Contrary to it in the fields there is the puncture by means of a i. v.-needle often not only the sole diagnostic but also the first and sometimes life-saving therapeutic procedure in advanced cases. It allows X-ray in double contrast technique if equipment is available. In suitable cases such approved technique shall be used also in modern clinics disposing of methods like sonography and computerized tomography. Concerning peritoneal tuberculosis our examinations agreed with the opinion of literature that the laparoscopy seems to be the most suitable method for quickly detection and safe discrimination from decompensated portal hypertension in liver cirrhosis. By the way the "cope needle" are mentioned which is distributed in warm countries for searching for peritoneal tuberculosis by performance of a blind peritoneal biopsy. It is easier than laparoscopy but not so efficient. - In this connection 31 cases examined by laparoscopy are presented in a table in order to give an impression on further indications to laparoscopy existing in such areas of warm countries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499728 TI - [Kinetics of benzo[a]pyrene penetration into the mouse skin after treatment with various phenols]. AB - A mathematical method for the study of benzo(a)pyrene (BP) penetration into the skin of nude mice was elaborated and supported by the experimental data. BP, whose concentration was measured by its fluorescence intensity, was applied to the skin using a "dry" technique. The effect of certain phenols and products of oxybenzene oxidation was studied. It was found that only butylated hydroxytoluene inhibits essentially the rate of BP metabolism. PMID- 6499730 TI - [Neutral DNAse activity in rat tissues in radiation carcinogenesis]. AB - The activity of neutral DNAse and its natural protein inhibitor was determined in the liver, brain and spleen of albino rats with malignant tumours of mammary gland and other organs. The tumours appeared 14-20 months after the irradiation of rats with fast neutrons (0.5-1.0 Gy). It is shown that the activity of DNAse I and its protein inhibitor increases in the liver and brain of tumour-bearing rats, while the enzyme and inhibitor capacity to form the nuclease-inhibitor complex decreases, especially in the liver. It is suggested that the increase in the DNAse activity in the tumour-bearing rats liver is important in the antitumour activity of the organism. PMID- 6499729 TI - [DNA levels in the cell nuclei of nervous system tumors induced by ethylnitrosourea]. AB - Distribution of DNA in cells of 28 primary ethylnitrosourea-induced tumours of the rat nervous system was studied by the Feulgen cytophotometry method. Out of them 20 had paradiploid DNA quantity, 3 tumours--hypodiploid and 4--hyperdiploid content of DNA. A high heterogeneity of the DNA quantity and the absence of expressed modal class were found only in one case. No correlation is found between the DNA distribution in gliomas and the stage of their malignancy. PMID- 6499731 TI - [The effect of antitumor vaccine on the recurrence of solid tumors in mice subjected to surgery]. AB - The frequency of tumour recurrences in A/Sn mice with operated Ehrlich carcinomas and treated with lyophylized antitumour vaccine and trypan blue or both of them was investigated. The tumours in vaccinated mice relapsed by the 47th day after the operation in 10% of cases, in 50% of control animals, the injection of trypan blue increased the tumour recurrences by 20%. The antitumour effect of vaccination is associated with the enhancement of the activity of the cellular and humoral immune systems. The trypan blue inhibition of the macrophage function suppresses the antitumor activity of the immunity cellular components. PMID- 6499732 TI - [Proliferative activity and cytotoxic effect of mouse lymphocytes during the growth of transplanted melanoma B-16]. AB - The PHA stimulated proliferative activity of C57B1 mice lymphocytes and cell mediated cytotoxicity on tumour target cells in vitro were studied during the transplantable melanoma B16 growth. The lymphocyte stimulation was shown to take place in all studied periods of the tumour growth with the exception of the terminal stage. The kinetics of cytotoxic activity during the melanoma B16 growth is characterized by rises and falls in the lymphocyte cytotoxicity. The maximum of proliferative activity of lymphocytes coincides with the minimum of their cytotoxic effect on the tumour cells. PMID- 6499733 TI - [The effect of preparations of microbial glutamin(asparagin)ase on cultured tumor cells]. AB - Glutamin (asparagin)ase from Pseudomonas boreopolis 526 is shown to produce a cytotoxic effect on the human ovary carcinoma cells (CaOv line), Fisher lympholeukemia (L-8 line) and Burkitt's lymphoma cells (P3HR line). A significant inhibition of the DNA synthesis is found in L-8 and P3HR cell lines. The enzyme is less active in the cells of the CaOv line. PMID- 6499734 TI - [Changes in various biochemical indices and ultrastructure of ascites tumors after combined administration of cyclophosphamide and levorin]. AB - The fractional composition of chromatin proteins and an electron-microscopic pattern of cell ultrastructure of the Ehrlich ascite tumours and ascite lymphoma NK/Ly were studied when suppressing their growth by a combined action of cyclophosphane and polyene antibiotic. Changes in the fractional composition of chromatin proteins were found under the effect of levorin. A sharp increase in this effect and summation of heterogeneous morphological changes provoked by each of the preparation occur under a combined application of the preparations. PMID- 6499735 TI - [Comparative evaluation of the lymphocyte blast-transformation reaction induced by various mitogens in the polychemotherapy of patients with breast cancer]. AB - The immunity system condition was studied in 118 patients with breast cancer of stage III who received combination chemotherapy: 91 patients--according to the Cooper scheme and 27 patients--according to CMF scheme. The reaction of lymphocyte blast transformation (LBT) was determined by three mitogens: phytohemagglutinin (PHA "O"), PHA "D" and lipopolysaccharide (LPS). The levels of Ig A, G, M were also determined. A decrease in immunological indices of different degree was observed in all patients. LBT was proved to have a high response to phytohemagglutinin "O" and it is recommended for immunological investigations. No significant changes in the immunological state of LPS were revealed. PMID- 6499736 TI - [The effect of hyperthermia on proliferating and resting HeLa cells]. AB - The action of hyperthermia (42 degrees C, 10-60 min) on HeLa cells was studied at the logarithmic and stationary growth stages. It is shown that changes in the cell number, DNA synthesis, incorporation of 3H-thymidine, and 14C-3-O methylglucose caused by hyperthermia depend on the initial physiological state of cells. PMID- 6499737 TI - [Characteristics of micromethods for the analysis of the in vitro synthesis of antibodies against xenogenic erythrocytes]. AB - In order to choose an optimal assay for screening cell microcultures containing anti-xenogenic erythrocyte antibodies in their supernatants, two microassays were compared: microhemagglutination and hemolytic patch assay. Samples of murine sera, each in both assays, were examined for the antibody titer. It is shown that the sensitivity of the assays is approximately at the same level, as the statistically significant difference in the amount of antibodies evaluated either by hemagglutination or by patch assay was not found. Hence one should not prefer any of the assays from the standpoint of sensitivity, when choosing the screening procedure for hybridomas of lymphoid cell microcultures secreting antibodies against xenogenic red blood cells. PMID- 6499738 TI - [Analysis of the statistical characteristsics of the distribution of NK/Ly lymphoma cells obtained by laser flow cytometry]. AB - Distributions in volumes of NK/Ly ascite lymphoma cells in different periods after inoculation were studied by laser cytometry. With the age of tumour the primary peak of distribution shifts to an area corresponding to large cells, but from the sixth day there appears an additional peak of distribution due to an accumulation of a pool of nonproliferating quiscent G0(R1) cells. The obtained data are in good agreement with results of sedimentation fractionation of NK/Ly lymphoma cells. Discrepancies in statistical characteristics of distributions, found by the both methods, are not more than 20%. PMID- 6499739 TI - [Mechanism of the modifying effect of neuraminidase of the influenza virus on the development of Rauscher leukemia]. AB - It was established that neuraminidase--an immunosuppressive component of influenza virus--stimulated Rauscher leukemia in BALB/c mice. This effect is connected with earlier manifestation of sensitization to embryonic antigens and the appearance of immature PNL+ cells in spleens of infected mice rather than with immunosuppression. The mechanism of cocarcinogenic effect of viral neuraminidase is discussed. PMID- 6499741 TI - [Effect of cryodestruction of Lewis lung carcinoma in mice on the development of metastases]. AB - The effect of the primary tumour cryodestruction on a degree of metastatic spreading in the lungs was investigated in experiments with C57B1/6 mice with Lewis carcinoma of the lungs. It is found that after the tumour cryosurgery there was a less quantity of metastases as compared with operated animals (surgical removal of the tumour or amputation of the limb with the tumour) or with untreated animals. A regular correlation is observed between the degree of metastatic spreading and the efficiency of the primary tumour treatment. The relapse after cryosurgery or surgical removal of the tumour led to an increase in the quantity of pulmonary metastases. PMID- 6499740 TI - [The blastomogenic effect of 249Bk in rats]. AB - It is shown that 249Bk nitrate injected intraperitoneally in a wide range of doses to albino mongrel female rats is preferentially accumulated in the bony tissue (39.8%) and liver (18.4%). Incorporation of 249Bk to rats results in development of osteosarcomas, neoplasms of hemopoietic and lymphoid tissues, mammary tumours, thyroid and pituitary glands. PMID- 6499742 TI - [Electric charge of tumor cells of different karyological structure]. AB - The relation was studied between the density of the electrical charge of the surface (DECS) and the karyological structure of the rat ovary tumour (OT) cells. For this purpose the sedimentation rate and electrical mobility of cells from two OT clones were measured. The OT1 and OT2 clones differed in their modal chromosome numbers (44 and 80-90, respectively). An increase in DECS by 4-5% on the average occurs in cells with the chromosome set close to the tetraploid one. The further increase in the chromosome number to the octaploid one does not change DECS. The results obtained show stability of DECS with significant changes in the structure of the OT cells karyotype. PMID- 6499743 TI - [Effect of ceruloplasmin on the growth of experimental tumors and proliferative activity of cells]. AB - Exogenous ceruloplasmin influence on experimental tumour growth and intensity of normal and malignant cell proliferation in tissue culture was investigated. It was found that ceruloplasmin administration to animals with transplanted tumours caused a 25-50% inhibition of tumour growth. A growth inhibiting activity of ceruloplasmin observed in tissue culture at the concentration of 5 mg/ml was established. It is also shown that ceruloplasmin did not reduce the antitumour effect of cyclophosphamide. PMID- 6499744 TI - [Effect of lofenal on rat embryogenesis]. AB - The embryotoxic and teratogenic effect of lofenal was studied at different stages of embryogenesis of albino rats. Postimplantation death of embryos and foetus anomalies are stated to depend on both the dose of the administered preparation and on the period of embryogenesis. PMID- 6499745 TI - [Possibility of N-dimethylnitrosamine formation after parenteral administration of amidopyrine and nitrite to rats]. AB - The intravenous or intraperitoneal injection of amidopyrine and sodium nitrite to rats induces liver necrosis caused by endogenic synthesis of carcinogenic N nitrosodimethylamine (NDMA). Ascorbic acid, which inhibits this synthesis when injected intravenously, phenobarbital, which is an inductor of enzymatic decomposition when injected intraperitoneally, prevented the formation of necrosis. PMID- 6499746 TI - [Phospholipid composition of tumors and homologous tissues of rats exposed to dimethylnitrosamine]. AB - Quantitative changes in phospholipid spectra of blood serum, liver, kidneys and tumour tissues were determined at different stages of carcinogenesis induced by nitrosodimethylamine in rats. It was established that tissue of kidney tumours differs from homologous tissue only in the total amount of phospholipids as well as of cardiolipin phosphatidylethanolamine, phosphatidylserine and sphingomyelin. Essential changes were revealed in the phospholipid spectrum of blood serum and liver of tumour-bearing rats. The inverse correlation was found in phosphatidylethanolamine and phosphatidylserine amount in these tissues. PMID- 6499747 TI - [The origin of 5 S DNA from tumor ascitic fluid]. AB - Certain properties of DNA from chromatin mononucleosomes of the normal rat liver were compared with those of 5 S DNA from the ascitic fluids of human and animal tumours. Both DNA proved to be identical by their electrophoretic mobility in 8% PAAG and by characteristic violet tinge when stained with methylene blue. Thermal and alkaline denaturation causes less degradation of mononuclesome DNA than 5 S DNA. It is shown that 5 S DNA of ascitic fluid of Ehrlich ascite tumour of mice hybridizes with a higher amount of mouse genome DNA restricts. An assumption is advanced that 5 S DNA is either a product of chromatin decay to mononucleosomes or a product of extracopial synthesis and is delivered to ascitic fluid surrounding the tumour cells as a result of activation of Ca, Mg-dependent endonuclease of the latter. PMID- 6499748 TI - [Effect of levorin on RNA synthesis in Ehrlich ascites carcinoma cells]. AB - The polyene antibiotic levorin had no effect on the incorporation of 14C-uracil into the pool of intracellular free nucleotides in Ehrlich ascites tumour cells. RNA synthesis was inhibited by the antibiotic only at the late stages of incubation, evidently, due to earlier disturbances of the protein synthesis and in cell energetics. PMID- 6499749 TI - [Selective inhibition by chloramphenicol of protein biosynthesis in ascites tumor cells]. AB - Chloramphenicol in a dose of 50-200 micrograms/ml sharply inhibits the incorporation of 14C-labelled amino acids into proteins of ascites Zajdela hepatoma cells while it has no effect on protein biosynthesis in rat liver cells. In vivo chloramphenicol selectively inhibits this process in ascites tumour cells of rat Zajdela hepatoma and mouse Ehrlich carcinoma and hepatoma 22a, without inhibiting the process in various organs of tumour-bearing animals. The inhibition of labelled amino acid incorporation into nuclear and especially nuclear matrix proteins is more pronounced than into the whole tissue. A certain degree of inhibition was revealed in liver cells as well. PMID- 6499750 TI - [Cytogenetic characteristics of the leukemia L1210 strain in the development of drug resistance]. AB - The dose and schedule dependent resistance occurred at the 17th (L1210/D1) and 27th (L1210/D2) generations during leukemia L1210 transplantation by the cells treated with suboptimal diazane doses. With growth of the resistance to diazane the selection of modal cell class with 39 chromosomes took place while in the parent leukemia line the modal cell class consists of the cells with 40 chromosomes. No reliable differences were observed in G-banded karyotypes between the resistant subline L1210/D1 and the parent line L1210. When the resistant sublines were transplanted without supporting the diazane doses no restoration of the leukemic cells sensitivity to the drug was observed (the time of observation for L1210/D1 was 92 transplantation generations and for L1210/D2-48 generations). The changed number chromosome characteristics remained the same in this case. PMID- 6499751 TI - [Effect of bone marrow cells on the clonal growth of granulocyte-macrophage precursors in a soft agar]. AB - The granulocyte-macrophage colony stimulating effect of bone marrow cells is shown to be less intensive than the stimulating effect of feeding leukocytes. It is supposed that these two stimulating substances activate different progenitor populations. Stimulating effect of mixture consisting of leukocytes and bone marrow cells are very close to that of bone marrow cells alone. Leukemic bone marrow cells demonstrate the least colony stimulating ability. PMID- 6499752 TI - [Functional and histochemical parameters of the neutrophil state in patients with malignant tumors]. AB - A functional state of neutrophils was studied by their ability to chemotaxis and phagocytosis as well as their enzymatic activity (myeloperoxidase, acid and alkaline phosphatase, glycogen, cation proteins) of 13 patients with malignant neoplasms in dynamics (before and 2 weeks after the radical operation) was studied. Decreasing of all investigated parameters before the operation and significant increasing of chemotaxis and phagocytosis after the operation were revealed. PMID- 6499753 TI - [Effect of interferon on cell cycle phases in cultured human tumor cells]. AB - The action of homological and heterological (pig) leukocytic interferon on cell cycle kinetics of cultivated human tumour cells (lines HeLa, CaOv) and diploid strain was studied by flow cytofluorimetry. The cells of HeLa line and dFch strain demonstrated low sensitivity to interferon administration. The cells of interferon-sensitive line CaOv reacted by the change in cell cycle kinetics (arrest in G2/M). The action of heterological interferon on sensitive cells was similar to that of homological one. PMID- 6499754 TI - [The pituitary-adrenal system in cancer of the esophagus and stomach]. AB - Excretion of corticosteroids, levels of 11-OCS in blood plasma, tests with dexasone and clinical evaluation of the pituitary-adrenal system function were studied in 354 patients with carcinomas of the esophagus and proximal stomach division. Some degree of hypocorticism with a decrease in the 11-OCS level in blood plasma and lowered excretion of corticosteroids in the urine were found in 71% of patients. These variations are accompanied by lowered hypothalamus sensitivity to dexasone. Similar disturbances though less pronounced are determined in the precancerous states and in the remote periods after operation. PMID- 6499755 TI - [Growth kinetics of HeLa tumor cells during subculturing after irradiation with low-intensity red light in the stationary growth phase]. AB - The curves of relative growth rate of HeLa cells were studied after their irradiation at the stationary growth phase (He-Ne laser, lambda = 632.8 nm, D = 100 J/m2) and reinoculation to the fresh medium in different periods after the irradiation. The irradiation evokes changes in cells of the stationary phase which are realized in subcultivation. When the interval between irradiation and inoculation is short (5 min), the cell growth is inhibited; when the interval becomes longer (up to 4 h), the cell growth in the exponential phase increases. In the HeLa cell culture with the stimulated growth only a part of cells are able, to reach the stationary growth phase. PMID- 6499756 TI - [Experimental study of the need for the dearterialization of tumors]. AB - The influence of local ischaemia on the tumor growth rate and the character of metastases of Walker's carcinosarcoma-256 (WCS-256) and carcinoma RS-1 was studied in 168 male rats of Wistar line. The authors observed the dependence between the quantity of tumour cells in peripheral blood both under normal conditions and under local ischaemia in the tumour area. The efficiency of the produced ischaemia was controlled by the polarographic methods. The local ischaemia decreases grafting of tumours, reduces the growth rate and formation of the regional and distant metastases and decreases the quantity of the tumour cells in the peripheral blood. PMID- 6499757 TI - [Various structural-functional characteristics of erythrocyte membranes in malignant growths]. AB - Changes in the acetylcholinesterase activity, thermal and osmotic stability of erythrocyte membranes of the cancer patients are found as compared with this activity of erythrocyte membranes of donors. No differences were detected in the rate of phosphate anion transfer through the erythrocyte membranes in the examined persons. The data obtained show that the development of malignant tumours is followed by the changes in the structural and functional state of surface components of erythrocyte membranes. PMID- 6499758 TI - [French empiric criteria for psychoses. I. Situation of the problem and methodology]. AB - The French classification of mental disorders is a simple nomenclature which provides no definitions nor any other information concerning the categories. The present study describes the methodological guidelines of a nation-wide investigation that was initiated to establish empirical operational definitions for schizophrenia and other non-affective psychoses of classical French nosology. PMID- 6499759 TI - [The matter of tardive dyskinesia]. PMID- 6499760 TI - 1-(o-Chlorophenyl)-1 (p-chlorophenyl)2,2,2-trichloroethane induces functional progestin receptors in the rat hypothalamus and pituitary gland. AB - A recent report suggests that estrogen induction of hypothalamic progestin receptors is not a prerequisite for the facilitation by progesterone of female sexual behavior in rats. Progesterone was found to facilitate sexual behavior despite no apparent induction of progestin receptors by 1-(o-chlorophenyl) 1-(p chlorophenyl)2,2,2-trichloroethane (o,p'-DDT). To investigate these findings further, ovariectomized rats were treated with daily injections of o,p'-DDT for 3 days, followed by progesterone on day 4. Daily injections of 400 mg o,p'-DDT/kg resulted in activation of lordosis in 50% of the animals; injections of 200 mg/kg were ineffective. Cytoplasmic and nuclear progestin receptor levels in the mediobasal hypothalamus-preoptic area and pituitary gland were then determined in similarly treated animals. Because competition assays revealed that o,p'DDT interacts with progestin-binding sites in vitro, residual o,p'-DDT was removed from the cytosol fraction before assay. o,p'-DDT treatment increased the level of cytoplasmic progestin receptors by 43% compared with that in oil-injected controls. Progesterone administration to DDT-treated rats resulted in a 137% increase in the level of nuclear progestin receptors relative to levels observed in animals receiving no progesterone. These findings contradict a previous report using o,p'-DDT and support the hypothesis that estrogen-induced progestin receptors are required for the facilitation of sexual receptivity by progesterone. PMID- 6499761 TI - Development of thyroid hormone dependence for growth in the rat: a study involving transplanted fetal, neonatal, and juvenile tissues. AB - The role of thyroid hormones (TH) in the growth of rat tissue of different ages was investigated in a transplant system. Paws from 14- to 15-day-old fetal rats or pieces of xiphoid cartilage from 18- to 20-day fetuses and 2-, 9-, or 30-day old rats were transplanted under the kidney capsule of control or thyroidectomized (TX) syngeneic adult female hosts and grown there for 11 days. Paw transplants grew equally well, and tissue differentiation was similar in control and TX hosts. The degree of ossification was measured by a histometric procedure and was found to be equivalent in paws that developed in situ until 4 days postpartum and in paw transplants of equivalent age grown for 11 days on the kidneys of euthyroid or TX hosts. These results show that growth and differentiation of the skeletal and other tissues of the paw are not dependent on TH during the transplant period, which encompassed the equivalent of the late fetal and first few days of neonatal life. Transplanted xiphoid cartilage was used to analyze growth and the development of TH dependence of a differentiated tissue which is relatively uniform in animals of different ages. In control and TX hosts, the growth capacity of transplanted xiphoids declined progressively with increasing donor age. The tissue also showed an age-related increase in dependence on TH for growth. The xiphoid transplants from the fetal rats grew equally well in the euthyroid and hypothyroid hosts, but those from 30-day-old rats showed a near-total dependence on TH for growth. Overall, the results indicate that rat supportive tissues begin to develop a dependence on TH for growth during the second week postpartum. PMID- 6499762 TI - Relationship between urinary dopamine production and natriuresis after acute intravascular volume expansion with sodium chloride in dogs. AB - The role of renal production of dopamine in mediating the natriuretic response to acute vascular volume expansion was investigated. The effect of infusion of 0.9% saline (30 ml/kg X h) over 2 h on urine excretion of sodium and catecholamines, as well as other hemodynamic and renal function parameters, was examined in seven dogs during control and carbidopa (1 mg/kg every 8 h for 24 h before saline infusion) treatment periods. Acute vascular volume expansion with saline resulted in a rise (P less than 0.01) in the renal excretion of dopamine and a depression (P less than 0.01) in renal excretion of norepinephrine which paralleled the natriuretic response to saline infusion. Epinephrine excretion was not altered by saline infusion. Carbidopa treatment was not associated with changes in left ventricular filling pressure, arterial blood pressure, glomerular filtration rate, renal blood flow, renal excretion of norepinephrine or epinephrine. However, carbidopa eliminated the increase in renal production of dopamine and markedly attenuated the natriuretic response to saline infusion. Since carbidopa blocks tissue conversion of dopa to dopamine, it appears that renal production of dopamine is an important mechanism mediating the natriuretic response to acute volume expansion. PMID- 6499763 TI - Effect of actinomycin D on iodide transport in FRTL-5 thyroid cells. AB - TSH-induced I- uptake in FRTL-5 thyroid cells requires new protein synthesis. During the induction of I- uptake, which takes nearly 60 h to reach its maximum, two waves of protein synthesis can be identified: one during the first 8 h and another after 24-30 h, each involving different proteins. Cycloheximide (CH) added during the first 10 h of a 48-h incubation with TSH completely inhibits the induction of I- uptake; 58% inhibition is observed with CH added at 24 h; no inhibition is observed when CH is added 36 h after TSH. Like CH, actinomycin D (ActD), added at the beginning of the 48-h period, inhibits TSH induction of I- uptake; partial inhibition (83%, 72%, and 28%) is observed when ActD is added at 1, 5, and 10 h, respectively. Treatment with ActD at 24 h (ActD-treated cells), however, paradoxically increases I- uptake (1.8- to 3.5-fold over the control value). The characteristics of I- uptake in ActD-treated cells are the same as those in untreated cells; both are Na+ dependent and can be inhibited in a comparable manner by anions. Kinetic measurements of I- transport indicate that ActD increases the rate of I- influx (2-fold or greater increase in maximum velocity without a significant change in Km), with only minor changes in I- release. Enhanced I- uptake in ActD-treated cells is inhibited by the simultaneous (24-h) administration of CH, indicating that protein synthesis is required for the late ActD effect. Despite an overall 2-fold decrease in protein synthesis in cells treated with ActD at 24 h, the synthesis of individual proteins maximally induced by TSH during the first 8 h is increased, whereas that of some proteins maximally synthesized after 24-30 h is markedly reduced. The present data indicate that TSH-induced I- uptake in FRTL-5 cells involves a regulatory action of TSH that operates at the mRNA level. PMID- 6499764 TI - Free thyroid hormones in altricial (ring doves) versus precocial (Japanese quail) development. AB - Ring doves (altricial development) and Japanese quail (precocial development) were used as models to compare differences in serum free hormone concentrations and the binding of thyroid hormones to serum protein fractions in adults, and the pattern of free thyroid hormones in the serum of altricial vs. precocial young. Total and free hormones were determined directly by RIA; free hormones also were determined by equilibrium dialysis. Binding protein fractions were identified by electrophoresis of serum preincubated with labelel hormones. Albumin bound the largest proportion of T4 in serum to both species; albumin also bound the largest proportion of T3 in doves, but globulin bound the largest proportion in quail. There were significant differences between species in the proportional binding of both thyroid hormones by different protein fractions at physiological pH. Electrophoretic separations at alkaline pH significantly altered hormone binding by different protein fractions from that at physiological pH. These data explain some conflicting results in the literature on thyroid hormone-binding proteins in different species. Free T4 and free T3 were below the sensitivity limits of the assays during the perinatal period in doves. After hatching, serum free T4 rose more rapidly than total T4. After day 12, hormone concentrations decreased, with a proportionately greater change in free T4 than in total T4. Serum free T3 concentrations were variable, but did not change significantly during development. These results demonstrate that the pattern of serum free thyroid hormones, like that of total hormones, is markedly different in altricial than in precocial development. PMID- 6499765 TI - Bovine luteinizing hormone iodinated at alpha Tyr21, alpha Tyr92, or alpha Tyr93 retains specific binding activity. AB - It has previously been shown that as the extent of iodination or nitration of LH is increased, receptor-binding activity is lost. To determine whether this loss is attributable to modification of a specific tyrosine, we located iodotyrosines in only those iodinated molecules that retained specific binding activity. Iodinated bovine LH (*bLH) with intact binding activity was separated from *bLH lacking activity by binding to and elution from receptors. Gel exclusion chromatography of tryptic peptides and microsequenator analysis of tryptic glycopeptides showed that iodotyrosine was present at each of the only readily accessible residues in intact hormone: alpha Tyr21, alpha Tyr92, and alpha Tyr93. Loss of activity with increased modification could not be explained by subunit dissociation, hormone aggregation, or degradative release of radioactive residues. These results together with the previous finding that those molecules of *bLH that can bind specifically to receptors do so with an apparent Ka indistinguishable from that of unmodified hormone show that any one of the residues, alpha Tyr21, alpha Tyr92, or alpha Tyr93, can be iodinated without an effect on binding and suggest that none of these residues interacts directly with receptor. They further suggest that it is modification of more than one tyrosine in the same molecule which negatively affects binding. We discuss how modification of two tyrosines might decrease binding activity when modification of any one has no observable effect. PMID- 6499766 TI - Effect of sodium concentration on aldosterone secretion by isolated perfused canine adrenal glands. AB - Small changes in sodium concentration [( Na]) are not generally considered to have a major direct effect on aldosterone secretion. However, a marked disruption in the renin-aldosterone relationship has been observed in a variety of hypernatremic and hyponatremic states. Therefore, we evaluated the hypothesis that small changes in [Na] have a potent direct effect on angiotensin II- and potassium-stimulated aldosterone secretion. The left adrenal gland, abdominal aorta, and surrounding periadrenal tissue were surgically isolated from mongrel dogs and perfused with Ringers bicarbonate solution at a pressure of approximately 57 mm Hg. Infusion of a KCl test solution at the beginning and end of most experiments produced similar increases in aldosterone secretion, thus documenting the stability of these preparations. After a stable response was established to either a low dose of angiotensin II or a small increase in perfusate [K], the [Na] was changed by adding or removing NaCl. Changing perfusate [Na] from 152 to 139 mM during the infusion of either angiotensin II or potassium caused 20- to 25-fold increases in aldosterone secretion. Increasing perfusate [Na] from 145 to 152 mM inhibited aldosterone secretion to a greater extent during stimulation by lower doses (40-50 pg/ml) than by higher doses (80 100 pg/ml) of angiotensin II. These data demonstrate that during moderate stimulation by angiotensin II or potassium, small changes in [Na] have a powerful inverse effect on aldosterone secretion by a direct action on the canine adrenal gland. PMID- 6499767 TI - Developmental changes in the luteinizing hormone secretory pattern in peripubertal female rhesus monkeys: comparisons between gonadally intact and ovariectomized animals. AB - Developmental changes in LH release patterns were observed longitudinally in female rhesus monkeys at 10-65 months of age. The average ages of menarche and first ovulation in this experiment (n = 14) were 31.1 +/- 2.6 and 47.0 +/- 2.6 months (mean +/- SE), respectively. To assess the ovarian influence on developmental changes in LH, data were simultaneously obtained from neonatally ovariectomized animals at similar ages. The estimation of circulating LH was made with RIA as well as biological assay. During the prepubertal period (10-20 months of age), basal LH was very low, and there was no circadian fluctuation of LH in gonadally intact monkeys. During the early pubertal stage (20-30 months of age), before menarche, basal LH levels started to increase, and a circadian LH rhythm (nocturnal increases) appeared. At the midpubertal stage (30-50 months of age), a period between menarche and first ovulation, basal LH levels further increased, and the circadian LH rhythm was maximal. At the late pubertal stage (50-60 months of age), a period after the first ovulation during which the animals were not able to reproduce fully as adults, basal LH declined, and the circadian rhythm diminished. Similar but more exaggerated developmental changes in basal LH and the circadian fluctuation of LH were observed in females ovariectomized neonatally. Basal LH levels at 10-20 months were as low as those in intact animals with no circadian rhythm present. During the early pubertal period, a circadian fluctuation appeared at the time when a slight increase in the basal LH level occurred. Furthermore, the amplitude of circadian fluctuation (the difference between morning and evening LH values) increased linearly with the increase in basal LH during the midpubertal stage. These LH parameters in ovariectomized animals reached their peaks at 40-44 months, an age before the first ovulation in intact animals. As basal LH levels declined during the late pubertal stage to postpubertal stage, circadian fluctuation disappeared. The results suggest that the increase in LH output and concomitant circadian fluctuations occur in close association with the pubertal process, and this change in LH release is not dependent on the presence of the ovary. Therefore, we suggest that alteration of the LHRH release pattern during maturation, as reflected by LH release, rather than resetting of the gonadostat, is the key factor involved in the mechanism of the onset of puberty. PMID- 6499768 TI - Posterior hypothalamic lesions advance the onset of puberty in the female rhesus monkey. AB - The effects of experimental lesions in the posterior hypothalamus and the anterior hypothalamus on menarche and first ovulation were examined in nonhuman primates. With the aid of x-ray ventriculography, bilateral lesions were made by passing a radiofrequency current through a thermister electrode in the posterior hypothalamus (n = 7) or the anterior hypothalamus (n = 6) of female rhesus monkeys at 18 months of age. Four animals that received sham lesions as well as four normal females of a similar age served as controls. All animals were caged individually and examined daily for vaginal bleeding and sex skin color change. Developmental changes in gonadotropins, ovarian steroids, body weight, and nipple size were monitored throughout the experiments. The time of first ovulation was determined by laparoscopic observation of the newly formed corpus luteum and by the level of circulating progesterone. Histological examination confirmed that the bilateral lesions in the hypothalamus were approximately 2-3 mm in diameter and overlapped midline. Primary sites of posterior hypothalamic lesions included the premamillary area and the posterior nucleus, while the infundibular nucleus and the median eminence were entirely spared. The posterior lesions encroached upon the mamillary nuclei caudally in most cases and upon the ventromedial nucleus rostrally in some cases. Primary sites of anterior hypothalamic lesions included the medial preoptic area, the periventricular preoptic nucleus, and the anterior hypothalamic nucleus. Partial lesions of the diagonal bundle of Broca, the medial preoptic nucleus, and the paraventricular nucleus were also detected. Posterior hypothalamic lesions advanced the ages at menarche (22.2 +/- 1.3 months; P less than 0.001) and first ovulation (40.7 +/- 2.7 months; P less than 0.05) compared to those of control animals (menarche, 30.3 +/- 3.1; first ovulation, 51.2 +/- 3.3 months). The body weight at menarche of these lesioned animals (2.62 +/- 0.11 kg) was smaller (P less than 0.05) than that of controls (3.14 +/- 0.20 kg), but the body weight at first ovulation of lesioned animals (4.36 +/- 0.28 kg) was not different from that of controls (4.57 +/- 0.13 kg). Hormonal and physical changes during maturation, i.e. an increase in circulating estradiol and growth in nipple size before menarche and first ovulation, occurred earlier in the lesioned animals and the growth spurt before first ovulation not only began earlier but also attained mature levels several months earlier than that in control animals.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6499769 TI - Effects of luteinizing hormone withdrawal on Leydig cell smooth endoplasmic reticulum and steroidogenic reactions which convert pregnenolone to testosterone. AB - Depletion of endogenous LH with sc implants of testosterone-17 beta-estradiol (T E) caused a reduction in the Leydig cell smooth endoplasmic reticulum (SER) over a 10-day treatment period. Decreases also occurred in some, but not all, of the testicular steroidogenic reactions responsible for the conversion of pregnenolone (PREG) to testosterone. The conversions of progesterone (PROG) to 17 alpha hydroxyprogesterone, 17 alpha-hydroxyprogesterone to androstenedione, and androstenedione to testosterone were significantly correlated (P less than 0.05) with the loss of Leydig cell SER. In contrast, the testicular conversion of PREG to PROG in rats deprived of endogenous LH for up to 10 days was identical to that in intact controls. Similar results were obtained when rats were hypophysectomized for 10 days. These results indicate that the Leydig cell enzyme activities responsible for converting PREG to PROG are distributed in the Leydig cell SER fraction which remains in Leydig cell cytoplasm 10 days after LH withdrawal, and thus, the bulk of these enzyme activities are sequested in a SER compartment that is resistant to LH withdrawal. PMID- 6499770 TI - Daily afternoon administration of melatonin does not irreversibly inhibit sexual maturation in the male rat. AB - Previous studies from our laboratory demonstrated that daily afternoon melatonin injections from 20-40 days of age inhibited sexual development of young male rats, whereas in adult animals, similar injections had no effect. The present study was designed to determine more precisely the critical age period during which melatonin exerts its inhibiting effect and to see whether spontaneous sexual maturation resumes after discontinuation of melatonin administration at 45 days of age or even during continuous administration of melatonin until 115 days of age. Sexual maturation was evaluated using weights of seminal vesicles and testes; plasma levels of testosterone, FSH, and LH; pituitary contents and concentrations of FSH and LH; and, finally, pituitary content of GnRH receptors. Administration of melatonin to young male rats from 20-30 days of life had the same inhibitory effect on sexual maturation at 40 days as melatonin injections from 20-40 days. In contrast, administration of melatonin from 30-40 days only slightly decreased plasma testosterone concentration, weight of seminal vesicles, and pituitary GnRH receptor content. Melatonin administration from 38-40 days had no effect. Daily melatonin administration from 20-45 days of age was followed by resumption of sexual maturation, as observed at 70 days. The recovery was complete by 80 days of age when all of the parameters studied reflected complete sexual maturation. Finally, in rats treated continuously with melatonin from days 20 until 115, sexual maturation occurred but was delayed by about 20-30 days. Beginning of sexual development was observed at 60 days of life, and full development was attained only at 100 days. These data confirm that melatonin delays sexual maturation in the young male rat when administered daily in the afternoon. They demonstrate that this inhibitory action of melatonin is most critical between 20 and 30 days of life and is reversible regardless of whether melatonin administration is discontinued after 45 days of life. The suppression of the pubertal peaks of pituitary GnRH receptor number and pituitary and plasma FSH concentrations in treated rats suggests that melatonin interferes with the pubertal increase in GnRH secretion. In conclusion, these reversible effects of melatonin suggest that this pineal indolamine represents an important factor for the timing of sexual maturation. PMID- 6499771 TI - Absence of biological effects of oxidized parathyroid hormone-(1-34) in dogs and rats. AB - Recent studies have shown that oxidation of bovine PTH-(1-34) [bPTH-(1-34)] with H2O2 abolished the vascular effects of PTH in rats and dogs, but the hypercalcemic effect of the oxidized PTH was preserved in the Japanese quail in vivo. These observations seem at variance with previous studies from our laboratory in the isolated perfused canine tibia preparation in which no uptake of immunoreactive PTH or stimulation of cAMP release was demonstrated during infusion of oxidized bPTH-(1-34). The present studies examine the skeletal and renal effects of oxidized PTH-(1-34) in rats and dogs in vivo. Oxidation of PTH with H2O2 reduced its activation of adenylate cyclase by 95% in dog renal cortical membrane. Awake normal dogs were studied before and during the infusion of bPTH-(1-34) or oxidized PTH-(1-34) (4 U/kg X h). With active PTH, ionized Ca+2 rose in each dog (range, 0.7-1.5 mg/dl), while with oxidized PTH, Ca+2 remained within 0.1 mg/dl of the baseline values. Fractional excretion of PO4 rose from 1.58 +/- 0.6% to 29.5 +/- 2.5% with active PTH and from 1.4 +/- 0.4% to 5.7 +/- 1% with oxidized PTH. The latter did not differ from the value in vehicle-infused dogs. Further studies were performed in 30 acutely parathyroidectomized rats. Plasma Ca+2 rose from 8.2 +/- 0.1 to 9.0 +/- 0.3 mg/dl with active PTH (20 micrograms/kg), fell to 7.7 +/- 0.2 with oxidized PTH, and fell to 7.3 +/- 0.3 mg/dl with vehicle. In parathyroid-intact rats plasma Ca+2 increased by 0.9 mg/dl whether given active PTH, oxidized PTH, or vehicle. We conclude that oxidation of bPTH-(1-34) results in loss of both the renal and skeletal effects of PTH in vivo in rats and dogs. PMID- 6499772 TI - Reversible denaturation of the estrogen receptor and estimation of polypeptide chain molecular weight. AB - The estrogen receptor protein loses its ability to bind to estrogens upon denaturation with sodium dodecyl sulfate and 2-mercaptoethanol. Binding activity is recovered at 60-80% efficiency upon removal of the denaturants, equilibration with 6 M guanidine hydrochloride, and dilution into buffer containing estrogen. Renatured receptor is similar to native receptor in affinity for 17 beta estradiol and ability to bind DNA. Detection of receptor activity after sodium dodecyl sulfate-polyacrylamide gel electrophoresis of uterine or pituitary cytosol or of uterine nuclear extracts reveals a single unique polypeptide species of 65,000 mol wt. PMID- 6499774 TI - Phospholipid-sensitive Ca2+-dependent protein kinase system in testis: localization and endogenous substrates. AB - The presence and localization in pig and rat testes of phospholipid-sensitive Ca2+-dependent protein kinase (PL-Ca-PK) and its substrates were investigated. PL Ca-PK activity was found in the testis total particulate fraction and epididymal fluid, but little in the testis total particulate fraction and epididymal fluid, but little in the testis cytosol and matured spermatozoa obtained from the epididymis. Similarly, at least three endogenous substrates (83,000, 33,000, and 26,000) and five substrates (greater than 100,000, 83,000, 60,000, 43,000, and 19,000) for PL-Ca-PK were detected in the testis total particulate fraction and the epididymal fluid, respectively, but little or no substrates were observed in the testis cytosol and matured spermatozoa. The three substrates detected in the total particulate fraction were also observed in the testis nuclear fraction. In rat testis, PL-Ca-PK activity was detected in the total particulate fraction of germ cells. The results suggested that PL-Ca-PK system might be important in membrane- or subcellular organellar-associated functions in testis. PMID- 6499773 TI - Squamous carcinoma model of humoral hypercalcemia of malignancy. AB - Squamous carcinomas are the most common cause of humoral hypercalcemia of malignancy (HHM) in humans. To develop an animal model of this syndrome, CD-1 female mice were painted with dimethylbenzanthracene, which produced cutaneous squamous carcinomas in the majority of those painted. Greater than 90% of tumor bearing mice developed a syndrome of hypercalcemia, hypophosphatemia, hypercalciuria, elevated plasma 1,25-dihydroxyvitamin D, normal immunoreactive PTH, elevated urinary cAMP, and accelerated bone resorption compared to control mice. Tumor excision reversed the hypercalcemia and hypophosphatemia, and autopsies revealed no evidence of skeletal or other metastases. Dietary calcium restriction did not affect the hypercalcemia in tumor-bearing mice. Extracts of tumor tissue contained potent bioactivity paralleling that of bovine (b) PTH in a PTH-sensitive canine renal cortical adenylate cyclase assay. The activity was trypsin sensitive and partially inhibitable by Nle, Tyr bPTH amide. The activity coeluted with chymotrypsinogen (mol wt, 25,700) on Sephacryl S-200 chromatography, well ahead of bPTH. This is the first description of an animal squamous carcinoma that produces HHM. With the exception of elevated plasma 1,25 dihydroxyvitamin D levels, the syndrome precisely mimics that seen in human HHM. The presence of a biologically active protein larger than PTH in tumor extracts, similar to that extracted from human tumors, suggests a common mode of pathogenesis. This model should be useful in further studying the pathophysiology of HHM. PMID- 6499775 TI - Hormonally sensitive esterase activity in the mouse uterus results from uptake of plasma esterase. AB - Mouse uterine homogenates contain an estrogen-sensitive serine esterase (hydrolase II). In immature animals, hydrolase II levels increase rapidly after the administration of estradiol. However, stimulation of de novo synthesis in the uterus has not been demonstrated. In this communication we show that hydrolase II activity in the uterus results from uptake of an esterase from the blood. We describe the purification of this protein from mouse plasma and discuss some of its properties. It appears to be similar if not identical to a sexually dimorphic plasma esterase called albumin esterase or esterase 1 by others. Consistent with this, hydrolysis of estradiol valerate and beta-alanine nitrophenyl ester by either uterine homogenates or purified esterase 1 was blocked by heating or by incubation with diisopropyl flurophosphate or antibody to esterase 1. Levels of the plasma esterase (esterase 1) were 50% higher in adult female mice than in adult males. Levels in juvenile males were in between those in the adult males and females. No significant changes in esterase 1 plasma levels in any group were detected after 4 days of treatment with either testosterone or estradiol. Like the uptake of other plasma proteins, estrogen-stimulated uterine uptake of the plasma esterase was inhibited by prednisolone, but not by puromycin. Using immunoprecipitation of [35S]methionine-labeled esterase 1 prepared in a cell-free translation system, mRNA specific for esterase 1 was found in mouse liver, but not in mouse uterus. Although the natural substrate for esterase 1 (or hydrolase II) is not known, both the purified enzyme and uterine homogenates were able to hydrolyze the valerate ester of estradiol, but not the stearate ester. However, estradiol esters are not necessarily the natural substrates of esterase 1, as only the long chain fatty esters of estradiol are reported to occur in vivo. PMID- 6499776 TI - Effect of neonatal gonadectomy and administration of testosterone on coital masculinization in the ferret. AB - Male ferrets castrated on postnatal day 5 displayed significantly lower levels of neck gripping, mounting, and pelvic thrusting behavior than groups of males castrated on postnatal days 20 or 35 when tested in adulthood after treatment with testosterone (T). Administering a high dosage of T via sc Silastic capsules to ovariectomized female ferrets over postnatal days 5-20 caused a significant enhancement of all three parameters of masculine coital behavior and ossification of clitorides, in comparison with control females that received no exogenous hormone neonatally. A lower dosage of T given to other ovariectomized females over the same neonatal period caused only slight coital masculinization even though the plasma concentrations of T achieved in females with this particular implant were somewhat higher than the levels normally present in gonadally intact male ferrets at any time between postnatal days 5 and 40. Administration of high and low dosages of T to ovariectomized females over days 20-35 failed to cause any coital or genital masculinization. The results suggest that T acts in the male ferret brain between postnatal days 5 and 20 to cause coital masculinization. The sensitivity of the male brain to T during this period may, however, normally be enhanced by the action of T or some other hormone before day 5. PMID- 6499777 TI - An increase in single unit activity of the medial basal hypothalamus occurs during the progesterone-induced luteinizing hormone surge in the female rhesus monkey. AB - Accumulated evidence from our laboratory indicates that a positive feedback effect of progesterone (P) occurs at the hypothalamic level. The present study in female rhesus monkeys examined the effects of P on single unit activity of neurons in the hypothalamus and on LH release. Single unit activity was recorded by inserting a flexible stainless steel electrode into the hypothalamus of the monkey, which was restrained in a chair under light ketamine sedation. The firing rate of the single unit activity of the ventral hypothalamus (1.5 +/- 0.2 spikes/sec; n = 57) in ovariectomized estrogen-primed monkeys was slow and was slower in the ventral hypothalamus than in the dorsal hypothalamus (6.2 +/- 0.8 spikes/sec; n = 80). P injection resulted in a dramatic increase in unit activity of the ventral hypothalamus (4.7 +/- 0.6 spikes/sec; n = 111), but not of the dorsal hypothalamus (5.3 +/- 0.7 spikes/sec; n = 72), and induced a concomitant release of LH. Both increases in circulating LH and unit activity of the ventral hypothalamus were significantly correlated over time (P less than 0.02). In contrast, oil injections induced neither change. Therefore, in the rhesus monkey, P seems to activate neural substrates in the ventral hypothalamus to promote the release of LHRH and, subsequently, LH. PMID- 6499779 TI - Specific binding of calcitonin to rat liver plasma membranes. AB - The binding of human calcitonin (CT) was investigated in the plasma membrane fraction obtained from normal rat liver. The liver plasma membrane bound 125I labeled [( 125I]) human CT, with increasing concentrations of the plasma membrane protein from 4.6-80 micrograms/ml, in a both time and temperature dependent manner. Specific binding of [125I] human CT was competitively inhibited by concentrations of unlabeled homologous hormone more than 0.05 nM. Half-maximal inhibition of specific binding was observed with 0.5 nM human CT. Scatchard analysis of the data suggested the presence of one class of binding site with an apparent affinity constant of 4.08 X 10(9)M-1. The binding of human CT was highly specific; half-maximal inhibition of binding was observed with 100 nM synthetic [Asu1,7] eel CT, ACTH having no effect in this system. These results demonstrate that specific binding receptor sites for CT are present in the plasma membrane of rat liver, compatible with the CT function in these cells. PMID- 6499778 TI - Transformation of highly purified avian progesterone receptor. AB - Transformation of the avian progesterone receptor to the nuclear form was studied using highly purified receptor preparations. The progesterone receptor was purified to near homogeneity in the presence of 10 mM sodium molybdate by affinity chromatography on deoxycorticosterone-Sepharose followed by DEAE Sephadex chromatography. This latter step resolved the receptor into two 8S forms, I and II. Receptor transformation was measured by the binding of receptor to the polyanion resins (DNA-cellulose, phosphocellulose, or ATP-Sepharose) and to isolated nuclei and by the change in sedimentation coefficient from 8S to 4S. Molybdate was removed from the purified receptor preparations by agarose gel filtration. This step resulted in transformation of a major portion of receptor, as indicated by the above criteria. The extent of transformation was enhanced slightly by further incubation of the receptor in 0.2 M KCl. Control samples, which contained 10 mM molybdate, remained nontransformed, as tested by sedimentation or binding analysis. However, receptor transformation could not be reversed by adding molybdate back to transformed receptor. Although transformation of both receptor components I and II was observed, the extent of component I transformation was generally 2- to 5-fold greater than that of component II. About 50-90% of component I could be converted to a form that bound DNA-cellulose, ATP-Sepharose, and phosphocellulose. Since the progesterone receptor is a phosphoprotein, 32P-labeled receptor was tested for any loss of phosphate during transformation or receptor inactivation by incubation at 37 C. No observable loss of 32P occurred with either treatment. Our results show that transformation of the 8S receptor components I and II can be achieved in the absence of other cytosolic factors. PMID- 6499780 TI - Family history of Japanese patients with non-insulin-dependent diabetes. Different implications of diabetes in parents and in siblings. AB - The family history of diabetes in parents and siblings was analyzed in relation to the age of onset and previous obesity in patients with non-insulin-dependent diabetes mellitus (NIDDM). The frequency of a positive family history of diabetes in parents was higher in patients with the onset of diabetes earlier than 40 years of age than in those who developed diabetes after 50 years of age (32% vs 12%, p less than 0.001). The frequency of a positive family history in siblings was about 20% and fairly constant in patients who became diabetic after 30 years. The prevalence of diabetes in siblings was higher in patients with diabetic parents than in those without diabetic parents (p less than 0.001). The higher frequency of diabetes in parents of young-onset patients remained significant even in a comparison of patient groups of similar ages (50-59 years) at the interview. Patients with definite obesity in the past had a significantly lower frequency of family history of diabetes in parents (p less than 0.001), and a lower prevalence of diabetes in their parents (p less than 0.001) and siblings (p less than 0.05) than did patients without obesity. The frequency of patients who had diabetic siblings did not differ between obese and lean groups. These data suggest that implications of the presence of diabetes in parents and in siblings are different in family history studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499781 TI - The antiproliferative effect of rat hypothalamic extract. PMID- 6499782 TI - Metoclopramide stimulation of prolactin secretion in women during puerperal lactation. PMID- 6499783 TI - The effect of metoclopramide on serum thyrotropin level in various stages of hypothyroidism. PMID- 6499784 TI - Effect of chronic exercise on certain aspects of hormonal function in obesity. PMID- 6499785 TI - Effects of steroid androgens on the uptake and distribution of zinc in slices from human prostates. AB - Slices of human hyperplastic prostates were superfused with magnitude of [6 5Zn] Cl2 in the absence or in the presence of testosterone or 5 alpha - dihydrotestosterone or 5 alpha-androstane-3 alpha, 17 beta-diol. Uptake of magnitude of [6 5Zn] Cl2 was not significantly changed by steroid androgens but the binding of magnitude of [6 5Zn] to the citrate of prostatic cytosol was generally significantly decreased by the tested steroids. The 5 alpha-reduced androgens were more efficient that testosterone in decreasing bound zinc levels and increasing free zinc concentrations. Implications of these findings on the metabolism and differentiation of prostatic cells are discussed. PMID- 6499786 TI - Analysis and properties of the cytosolic estrogen receptor from rat thymus. AB - The equilibrium association constant, KA, and the number of receptor binding sites, Bmax, that characterize the estrogen receptor present in rat thymus were determined using five different methods of data analysis on binding data obtained using a dextran-coated-charcoal assay. The methods of data analysis consisted of fitting the binding data directly to the hyperbolic binding function, fitting the data to the Lineweaver-Burk, Scatchard, and Woolf transforms of the hyperbolic function, and the direct linear plot method of Eisenthal--Cornish-Bowden. The Woolf and Eisenthal--Cornish-Bowden methods gave identical results indicating that added estradiol caused a decrease in KA (competitive inhibition) and a marked decrease in Bmax (noncompetitive inhibition). The Scatchard analyses gave only a very qualitative indication of this trend, while the Lineweaver-Burk analyses gave no indication of any such systematic trend. The results from the computationally more difficult fits to the hyperbolic binding equation were in agreement with the Woolf and Eisenthal--Cornish-Bowden results. Thus, the cytosolic thymus estrogen receptor from the rat shows both competitive and noncompetitive inhibition in the presence of endogenous or exogenous estradiol. PMID- 6499787 TI - A new paradigm is needed in toxicology evaluation. PMID- 6499788 TI - The effect of female strain on identification of male mice carrying reciprocal translocations. AB - Chemicals capable of inducing heritable chromosomal effects may be detected by the mouse heritable translocation test, which is based on the detection of a specific type of transmissible abnormality, namely, reciprocal translocation. Since mice carrying such a chromosomal abnormality usually have reduced fertility, they may be identified on the basis of fertility data. In the present study, the efficiency of two female strains for identifying CD-1 male translocation heterozygotes was examined. Thirty-three 10-wk-old CD-1 male mice were injected IP with triethylenemelamine (0.025 mg/kg/day) 5 days a wk for 5 wk. The treated males were then mated to untreated CD-1 females for 2 wk to produce progeny. The F1 males were raised to maturity, tested for fertility by using two female strains (CD-1 and B6C3F1), and analyzed cytogenetically. The cytogenetic analysis confirmed that 41 males were translocation heterozygotes and 125 were normal. Examination of the fertility data showed that in the test with CD-1 females all translocation heterozygotes were identified but 19 normal mice were identified as potential translocation carriers because of decreased fertility. In the test with B6C3F1 females, five translocation heterozygotes were not identified on the basis of fertility data, and 11 normal mice were misclassified as potential translocation carriers. PMID- 6499789 TI - Calibration of the maize yg2 assay using gamma radiation and ethylmethanesulfonate. AB - A standard protocol for the yellow-green-2 (yg2) forward mutation assay in Zea mays is proposed. A detailed calibration of the assay using 137Cs gamma rays and ethylmethanesulfonate (EMS) was conducted. Gamma ray-induced mutant sectors in leaves 4 and 5 exhibited one-hit kinetics. The radiation doses ranged from 25 to 500 rads. The mean induced mutation rate per rad of gamma radiation was 4.54 X 10(-6). This value was constant for the primordial cells of leaves 4 or 5. The induction of forward mutation by EMS also exhibited one-hit kinetics in the concentration range 0.25-20 mM (0.33-23.54 mumol EMS/kernel). The mean induced mutation rate per mM EMS was 1.79 X 10(-4), and the mean induced mutation rate per mumol of EMS per kernel was 1.52 X 10(-4). Using the induced mutation rates for gamma radiation and EMS, the rad equivalent was calculated. One rad of gamma radiation is equivalent to the exposure of a 2.53 X 10(-5) M EMS solution or to 2.99 X 10(-8) mol of EMS per kernel. PMID- 6499790 TI - Detoxification of nitrosamides and nitrosocarbamates in blood plasma and tissue homogenates. AB - Nitrosamides and nitrosocarbamates exhibit relatively high mutagenic activity in Salmonella when compared with nitrosoureas. This high activity can be accounted for by activation of nitrosamides and nitrosocarbamates by cellular thiols, predominantly reduced glutathione, that are present intracellularly at concentrations in the millimolar range. In striking contrast to the in vitro mutagenicity tests, a number of studies have indicated that nitrosamides and nitrosocarbamates are less potent than nitrosoureas when tested in vivo in model systems such as the mouse. We extend here previous studies [Aukerman et al, 1983] that demonstrate striking chemical decomposition and inactivation of mutagenic activity of nitrosamides and nitrosocarbamates during exposure to murine blood plasma. Plasma glutathione concentrations are inadequate to account for the rapid inactivations noted. Furthermore, the predominant inactivating species is heat sensitive, nondialyzable, and is greater than 25,000 daltons in size as judged by ultrafiltration experiments. Serum albumin has some inactivating capacity at the concentration found in undiluted plasma and could account for the very low but significant inactivating capacity of human plasma. On the other hand, serum albumin lacks the potency necessary to account for the extremely high levels of inactivating activity observed in rodent and rabbit plasma. Elsewhere we present evidence that carboxylesterase activity is the predominant inactivating species in mouse plasma [Aukerman et al, 1983; Aukerman, 1983; Brundrett and Aukerman, 1984]. Mouse liver, large intestine, kidney, and stomach have more activity per milligram protein under the assay conditions used than plasma itself. Rat liver S9 is also active at enhancing the decomposition of nitrosamides and nitrosocarbamates; most of this inactivating capacity resides in the microsomal fraction. The relatively rapid detoxification of these N-nitroso compounds by plasma and other tissues of rodents has important implications regarding the utility of rodents in assessment of tumorigenicity and/or antitumor activity of these classes of drugs in other animal species. Tests with Salmonella may be of use in estimating relative levels of protection that vary widely among mammalian species. PMID- 6499791 TI - Chromosomal and biochemical studies on the effect of kat extract on laboratory rats. AB - Kat is being used extensively in many countries as a central nervous system stimulant. The effect of three doses of crude kat extract on chromosomal division and abnormalities in bone marrow, as well as on DNA, RNA, and total protein content in brain and liver was studied in laboratory rats in order to test the possible mutagenicity of the drug. Kat was given as a single subcutaneous injection at 0.05 (usage dose), 0.52 (intermediate dose), and 1.00 (sublethal dose) g/kg body weight. Animals were sacrificed at 6, 24, and 48 hr after treatment. Also, some animals were exposed subacutely for 5 consecutive days with sacrifice occurring 6 hr after the last injection. The mitotic index was reduced by all treatments, with the greatest effect occurring in the subacute treatment. Chromosomal abnormalities were induced by kat at all three doses, administered acutely or subacutely. The significant chromosomal aberrations were in the form of gaps, breaks, centromeric attenuations, and centric fusions. The concentration of DNA, RNA, and total protein in liver and brain decreased at all doses, with the greatest decrease occurring after subacute treatment. These findings suggest that kat has a profound effect on cell proliferation, on chromosomal abnormalities, and on DNA, RNA, and total protein synthesis. PMID- 6499792 TI - Chemicals showing no evidence of carcinogenicity in long-term, two-species rodent studies: the need for short-term test data. AB - Studies to determine the performance of short-term tests (STT) in predicting chemical carcinogenicity are frequently characterized by a poor representation of noncarcinogens among the test chemicals. As a result, the performance of several STT is well characterized with carcinogenic chemicals, but the ability of the tests to discriminate between carcinogens and noncarcinogens is largely unknown because of the shortage of test results for noncarcinogens. A list of 70 chemicals that have been tested by the National Cancer Institute or the National Toxicology Program in long-term rodent carcinogenicity studies and that have yielded no evidence of cancer induction in male and female rats and mice is presented. The list helps document the shortage of STT results of noncarcinogens and provides a potential source of chemicals for consideration in future studies designed to assess the ability of STT to predict chemical carcinogenicity. PMID- 6499793 TI - Review of glycol ether and glycol ether ester solvents used in the coating industry. AB - Ethylene oxide-based glycol ether and glycol ether ester solvents have been used in the coatings industry for the past fifty years. Because of their excellent performance properties (evaporation rate, blush resistance, flow-out and leveling properties, solubility for coating resins, solvent activity, mild odor, good coupling ability, good solvent release) a complete line of ethylene oxide-based solvents of various molecular weights has been developed. These glycol ether and glycol ether ester solvents have better solvent activity for coating resin than ester or ketone solvents in their evaporation rate range. The gloss, flow and leveling, and general performance properties of many coating systems are dependent on the use of these products in the coating formula. Because of the concern about the toxicity of certain ethylene oxide-based solvents, other products are being evaluated as replacements in coating formulas. PMID- 6499794 TI - Effects of ethylene glycol monomethyl (EGME) and monoethyl (EGEE) ethers on the immunocompetence of allogeneic and syngeneic mice bearing L1210 mouse leukemia. AB - The effect of ethylene glycol monomethyl ether (EGME) and ethylene glycol monoethyl ether (EGEE) on cell-mediated immunity was evaluated by an allograft rejection assay. Allogeneic B6C3F1 (C57BL/6 X C3H) mice were given oral doses of 600, 1200, or 2400 mg/kg/administration of EGEE or 300, 600, 1200 mg/kg/administration of EGME on days -12 through -8 or cyclophosphamide (Cy) at 180 mg/kg by the IP route on day -1. Untreated controls were given oral doses of water on days -12 through -8 and -5 through -1. On day 0, the mice were challenged with 1 X 10(2), 3 X 10(3), and 1 X 10(5) or 3 X 10(6) L1210 cells by the IP route. Syngeneic CD2F1 (Balb/c X DBA/2) mice were challenged with 1 X 10(5) L1210 cells on day 0 and were treated on days 1 to 5 and 8 to 12 with the same dosages of EGME and EGEE used for the B6C3F1 mice. Water-treated syngeneic mice died with a median survival time (MST) of 8.0 days. There was no effect on the MST of syngeneic mice treated with either EGME or EGEE, indicating no direct antitumor effect of the compounds. All allogeneic mice receiving either water or Cy and challenged with 3 X 10(6) tumor cells, died with ascites. However, when mice were treated with EGME or EGEE and challenged with 3 X 10(6) tumor cells, no more than one animal per group died. This would indicate that there was a prophylactic action of the compounds or that the immune system was stimulated. Blood smears of allogeneic mice were made for differential counts the last day of drug dosing, the day of death where possible, and on survivors at day 43 post tumor implantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499796 TI - Developmental effects after inhalation exposure of gravid rabbits and rats to ethylene glycol monoethyl ether. AB - The effects of ethylene glycol monoethyl ether (EGEE) were determined on development in utero. Pregnant New Zealand White rabbits were exposed to air or 160 or 617 ppm EGEE for 7 hr/day from 1 to 18 days of gestation (dg). Virgin Wistar rats were exposed to 150 or 649 ppm EGEE or air 5 days/week for the 3 weeks immediately preceding their breeding. Sperm-positive rats were subsequently exposed to air or 202 or 767 ppm EGEE for 7 hr/day from 1 to 19 dg. Group sizes were 29 to 38 per concentration for both species. Pregestational exposure of rats had no effect on mating success, and there was no effect of EGEE exposure on establishment of pregnancy in either species. Rabbits exposed to the both concentrations had decreased food intake and depressed weight gain. Exposure related mortality occurred in the 617 ppm EGEE group of rabbits. The only toxic sign seen in rats was reduced weight gain after exposure to 767 ppm EGEE. Exposure induced high embryomortality at maternal toxic concentrations in rats and rabbits, while lower levels induced fetal growth retardation in rats but not in rabbits. Gestational exposure increased the incidence of anomalies and variations; these were primarily of soft tissues in rabbits and of skeleton in rats. Thus, significant evidence of terata, fetal growth retardation and embryomortality were induced in rabbits and rats at levels that were below or similar to those that induced maternal manifestation of toxicity. These data implicate EGEE as a teratogen. PMID- 6499795 TI - Interruption of cell-cell communication in Chinese hamster V79 cells by various alkyl glycol ethers: implications for teratogenicity. AB - Intercellular communication most likely plays a significant coordinating role in morphogenesis. Blockage of a specific type of intercellular communication, that mediated by gap junctions, has been proposed as a mechanism of action of some teratogens. Several glycol ethers have recently been shown to be teratogenic in laboratory animals. Because these compounds are negative in genotoxic assays, it is suggested that they may act by nongenetic, perhaps membrane-mediated mechanisms. In the present study several structurally related alkyl glycol ethers were examined for their ability to block junction-mediated intercellular communication. Interruption of intercellular communication was measured in vitro by an assay that depends on the transfer of metabolites via gap junctions, i.e., metabolic cooperation. All compounds tested--ethylene glycol (EG), ethylene glycol monomethyl ether (EGME), ethylene glycol monoethyl ether (EGEE), ethylene glycol monopropyl ether (EGPE), and ethylene glycol monobutyl ether (EGBE)--were able to block metabolic cooperation in vitro. The potencies of the compounds were inversely related to the length of the aliphatic chain, the dose required for maximum blockage increasing as the aliphatic chain shortened. Some differences in the maximum amount of blockage were detected, but these were not consistent and hence were not considered significant. Cytotoxicity, as measured by cell survival, was also related to the structure of the compound, generally increasing with increased length of the aliphatic chain. There were structurally related differences in the concentration ranges over which the compounds were effective.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499797 TI - Developmental toxicity and structure/activity correlates of glycols and glycol ethers. AB - In recent years, the National Toxicology Program (NTP) has selected numerous glycol ethers for testing in routine laboratory mammals to ascertain the magnitude of their ability to injure the conceptus. From the lists available of ongoing and projected NTP test chemicals, a series of glycol ethers was selected for examination in vitro in the hydra assay. Also tested were additional chemicals of similar molecular configuration and/or composition. This short-term screening test placed the 14 glycols and glycol ethers tested into a rank order sequence according to their degree of hazard potential to developmental biology, i.e., their ability to interfere with the developmental events characteristic of all ontogenic systems. They were ranked according to the difference between the lowest dose or concentration overtly toxic to adults (A) and the lowest concentration interfering with development (D) of the artificial embryo of reaggregated adult hydra cells and the A/D ratio. Published data from mammalian studies were available for a few of the test chemicals, and in each instance the hydra assay was in direct agreement with the outcomes reported of the more elaborate and standard animal tests. Ethylene glycol and ethylene glycol monomethyl ether were shown by both standard evaluations in mammals, and by the hydra assay, to disrupt embryos only at or very near to their respective adult toxic doses, whereas the mono-ethyl ether perturbed development at approximately one-fifth of the lowest dose overtly toxic to adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499798 TI - Results of testing fifteen glycol ethers in a short-term in vivo reproductive toxicity assay. AB - Fifteen glycol ethers were investigated for their potential to cause adverse reproductive toxic effects using an in vivo mouse screening bioassay. Pregnant mice were orally dosed once per day on days 7 through 14 of gestation at concentrations causing 0 to 41% maternal mortality. Reproductive endpoints included pup survival in utero (percent of live litters/pregnant survivors), pup perinatal and postnatal survival (number of live pups per litter, number of dead pups per litter, and pup survival to 2.5 days of age), and pup body weight statistics (weight at birth and weight at 2.5 days of age). The study was conducted in two phases: a dose range-finding phase using nonpregnant female mice, and a definitive reproductive phase using time-mated mice. The range finding phase sought to identify, for each chemical, the maternal LD10 as the target dose. However, based upon reproductive phase results, such an exact dose was impractical to achieve. Thus, a range from the LD5 to the LD20 was considered a sufficient challenge dose that would not affect results due to high mortality, i.e., greater than the LD20. Glycol ethers were assigned to groups having different priorities for further testing based upon whether a sufficient challenge dose was administered and the degree of effects recorded for each chemical.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499799 TI - Toxicities of ethylene glycol and ethylene glycol monoethyl ether in Fischer 344/N rats and B6C3F1 mice. AB - The toxicities of ethylene glycol (EG) and ethylene glycol monoethyl ether (EGEE) were studied in Fischer 344/N rats and B6C3F1 mice. In a 13-week study, EG was administered in feed to groups of 10 rats and 10 mice of both sexes at dose levels of 0 (control), 0.32, 0.63, 1.25, 2.5 and 5.0%. Kidney/body weight ratios were elevated in the 2.5 and 5.0% dose groups of male and female rats relative to controls, while serum urea nitrogen and serum creatinine levels were elevated in the two highest dose groups of male rats. Toxic nephrosis and crystal deposits in renal tubules were observed in the 2.5 and 5.0% dose groups of male rats. Crystals were also observed in brains of male rats in the 5.0% dose group. Nephrosis was the only lesion observed in female rats (5.0% dose group). Mild, compound-related lesions were seen in kidneys (nephrosis) and livers (centrilobular degeneration) of male mice in the 2.5 and 5.0% dose groups. There were no adverse effects observed in female mice. Groups of 50 rats and 50 mice of both sexes were administered EGEE by gavage in a 2-year study at dose levels of 0 (control), 0.5, 1.0 and 2.0 g/kg body weight. Testicular atrophy was observed in male rats that died early in this study and in the medium- and high-dose male mouse groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499800 TI - Subchronic inhalation toxicology of ethylene glycol monoethyl ether in the rat and rabbit. AB - The subchronic inhalation toxicology of ethylene glycol monoethyl ether (EGEE) was evaluated in rats and rabbits using a 13-week exposure regimen. Groups of 20 rabbits (10 M, 10 F) and 30 rats (15 M, 15 F) were exposed to a vapor of 25 ppm, 100 ppm, or 400 ppm, 6 hr/day, 5 days/week. The control groups received air only. Physical examinations and body weight measurements were conducted on all animals pretest and weekly throughout the study. Ophthalmoscopic examination was performed pretest and at termination. Evaluation of hematology and clinical chemistry was conducted on 10 animals per sex per group from each species after 13 weeks of study. Histopathological changes were assessed for all animals from the high-dose and control groups. In addition, selected tissues were examined from all animals from the mid- and low-dose groups. Both species exhibited an increased incidence of lacrimation and mucoid nasal discharge, but the response was not consistently dose-related. Rats exposed to EGEE showed no compound related effects except for a decrease in pituitary to body weight ratio for high dose males and a decrease in absolute spleen weight for all female animals. The spleen to body weight ratio was also less than controls for the females in the low- and high-dose groups. Pathological changes supportive of these organ weight changes were not observed. The rabbit is the more sensitive species to the subchronic toxicological effects from EGEE. Mean body weight values for low- and high-dose animals were decreased; the mid-dose animals, however, showed no change.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499801 TI - Comparative acute and subchronic toxicity of ethylene glycol monopropyl ether and ethylene glycol monopropyl ether acetate. AB - The acute toxicity of ethylene glycol monopropyl ether (EGPE) and ethylene glycol monopropyl ether acetate (EGPEA) was determined in a series of standardized tests. The oral LD50 in rats was 3089 and 9456 mg/kg EGPE and EGPEA, respectively. Skin irritation was slight following an occluded single dose application of either compound to the guinea pig abdomen. The dermal LD50 for guinea pigs was 1 to 5 mL/kg and greater than 20 mL/kg EGPE and EGPEA, respectively. EGPE produced a very weak positive sensitization response in one of five guinea pigs. No positive response was elicited when 10 guinea pigs were similarly challenged with EGPEA. EGPE produced transient moderate to severe eye irritation in rabbits while EGPEA produced slight eye irritation. Subchronic toxicity was determined in a series of oral and inhalation studies. Groups of 10 male rats were dosed with 15, 7.5, 3.75 or 1.88 mmole/kg EGPE and 30, 15 or 7.5 mmole/kg EGPEA by gavage 5 days/week for 6 weeks. Hemoglobinuria was seen at least once at all dose levels of both compounds. EGPE had little effect on feed consumption or body weight gain, while body weight gain was reduced in the two high dose groups exposed to EGPEA and feed consumption was reduced at all dose levels. Hematologic changes were seen at all dose levels of both compounds. Absolute and/or relative spleen weights were increased at all but the lowest EGPE dose level and at all EGPEA dose levels. Gross and histopathologic examinations revealed significant effects on the spleen of animals exposed to EGPE and on the spleen, liver, kidney and testes of animals exposed to EGPEA. The no-observed effect level (NOEL) for splenic changes was 1.88 mmole/kg EGPE. A NOEL for hematology was not established. The NOEL for liver and testicular changes were 15 and 7.5 mmole/kg EGPEA, respectively while a NOEL for hematologic, splenic and renal changes was not established. Groups of 10 rats (5M, 5F) were exposed to 800, 400, 200 or 100 ppm EGPE or EGPEA 6 hr/day, 5 days/week for a total of 11 exposures. Body weight gains in all exposure groups were comparable to controls. Hemoglobinuria was seen only after the first or second exposure in males and females exposed to 800 ppm EGPE and in males exposed to 400 ppm EGPE. Males and females exposed to 800 ppm EGPEA and females exposed to 400 and 200 ppm EGPEA also exhibited hemoglobinuria.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6499802 TI - Pulmonary and percutaneous absorption of 2-propoxyethyl acetate and 2-ethoxyethyl acetate in beagle dogs. AB - A comparison was made of the absorption and elimination rates of 2-propoxyethyl acetate (PEA) and 2-ethoxyethyl acetate (EEA) following inhalation, dermal application or IV administration. Male beagle dogs were exposed to 50 ppm PEA or EEA for 5 hr, and breath samples were collected during the exposure and a 3-hr recovery period. Both compounds were rapidly absorbed through the lungs. After 10 min of exposure, the concentrations of the parent compounds in the expired breath were 5 to 10 ppm (80-90% absorption) and reached plateau values at about 3 hr of 13 ppm for PEA (74% absorption) and 16 ppm for EEA (68% absorption). Post exposure breath samples declined exponentially to 0.5 ppm and 2 ppm after 3 hr for PEA and EEA, respectively. Expired concentrations of PEA were slightly, but significantly (p less than 0.025), lower than those of EEA at corresponding times during the exposure. After IV dosing with 1 mg/kg [ethyl-1,2-14C]PEA, the urine contained 61% and 88% of the dose in 4 and 24 hr, respectively. [14C]EEA was eliminated more slowly, with 20% and 61% of the dose appearing in the urine in 4 and 24 hr, respectively. Blood elimination half-lives were 1.6 hr for [14C]PEA and 7.9 hr for [14C]EEA. Only trace amounts of 14CO2 (less than 1%) or volatile materials (less than 0.1%) were detected in the expired air with either compound. For studies of percutaneous absorption, [14C]PEA or [14C]EEA was added to undiluted compound and applied in a glass cell to a shaved area on a dog's thorax for 30 or 60 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499803 TI - Acute and subchronic toxicity of ethylene glycol monobutyl ether. AB - The available information on the acute and subchronic toxicity of ethylene glycol monobutyl ether is reviewed. Data from animal studies have been examined from the standpoint of dose-response relationships and the sensitivity of various animal species, including man, to the effects of this chemical. In view of recent findings with other chemically related glycol ethers, particular attention has been given to possible adverse effects on blood and testicular tissue. In evaluating the hazard that this chemical may pose to man, consideration has been given to likely routes of exposure and its irritant properties. It is concluded that the available information continues to support the current ACGIH TWA8-TLV of 25 ppm with a STEL of 75 ppm. PMID- 6499804 TI - Absorption of some glycol ethers through human skin in vitro. AB - To assist evaluation of the hazards of skin contact with selected undiluted glycol ethers, their absorption across isolated human abdominal epidermis was measured in vitro. Epidermal membranes were set up in glass diffusion cells and, following an initial determination of permeability to tritiated water, excess undiluted glycol ether was applied to the outer surface for 8 hr. The appearance of glycol ether in an aqueous "receptor" phase bathing the underside of the epidermis was quantified by a gas chromatographic technique. A final determination of tritiated water permeability was compared with initial values to establish any irreversible alterations in epidermal barrier function induced by contact with the glycol ethers. 2-methoxyethanol (EM) was most readily absorbed (mean steady rate 2.82 mg/cm2/hr), and a relatively high absorption rate (1.17 mg/cm2/hr) was also apparent for 1-methoxypropan-2-ol (PM). There was a trend of reducing absorption rate with increasing molecular weight or reducing volatility for monoethylene glycol ethers (EM, 2.82 mg/cm2/hr; 2-ethoxyethanol, EE, 0.796 mg/cm2/hr; 2-butoxyethanol, EB, 0.198 mg/cm2/hr) and also within the diethylene glycol series: 2-(2-methoxyethoxy) ethanol (DM, 0.206 mg/cm2/hr); 2-(2 ethoxyethoxy) ethanol (DE, 0.125 mg/cm2/hr) and 2-(2-butoxyethoxy) ethanol (DB, 0.035 mg/cm2/hr). The rate of absorption of 2-ethoxyethyl acetate (EEAc) was similar to that of the parent alcohol, EE. Absorption rates of diethylene glycol ethers were slower than their corresponding monoethylene glycol equivalents. Combination of intrinsic toxicity and ability to pass across skin contribute to assessment of hazards of contact with undiluted glycol ethers. PMID- 6499805 TI - Further studies on the toxicology of the glycol ethers with emphasis on rapid screening and hazard assessment. AB - The discovery that ethylene glycol monomethyl ether (EGME) could affect the testis and the developing fetus in laboratory animals prompted further work to understand the effect of EGME and to examine additional glycol ethers to see if they showed EGME's reprotoxicity. Propylene glycol monomethyl ether (PGME) was shown not to cause testicular atrophy or to affect the development of rats at 600 ppm by inhalation, whereas EGME caused testicular atrophy at 300 ppm and showed teratogenic potential at 100 ppm. Diethylene glycol monomethyl ether (diEGME) was found to show no teratogenic potential when administered subcutaneously in rats at up to 1000 microL/kg, whereas EGME had effects at 40 microL/kg. EGME has been shown to cause effects on the testis in rats after a single exposure to 600 ppm or above for 4 hr. The effects can be seen as little as 24 hr after exposure. Ethylene glycol monoethyl ether (EGEE) also causes a reduction in testicular weight following a single exposure to saturated vapor for 3 hr (17 mg/l), but ethylene glycol monoisopropyl ether (EGPE) at 15 mg/l and ethylene glycol monobutyl ether (EGBE) at 4 mg/l showed no effect on the testis. PMID- 6499806 TI - Testicular toxicity produced by ethylene glycol monomethyl and monoethyl ethers in the rat. AB - Ethylene glycol monomethyl ether (EGME) and ethylene glycol monoethyl ether (EGEE) were administered orally to young male rats at doses varying from 50 to 500 mg/kg/day and 250 to 1000 mg/kg/day for EGME and EGEE, respectively, for 11 days. At sequential times animals were killed and testicular histology examined. The initial and major site of damage following EGME treatment was restricted to the primary spermatocytes undergoing postzygotene meiotic maturation and division. EGEE produced damage of an identical nature, but a larger dose was required to elicit equivalent severity (500 mg EGEE/kg being approximately equivalent to 100 mg EGME/kg). Additionally, within the spermatocyte population, differential sensitivity was observed depending on the precise stage of meiotic maturation: dividing (stage XIV) and early pachytene (stages I-II) greater than late pachytene (stages VIII-XIII) greater than mid-pachytene (stages III-VII). Equivalent doses of methoxyacetic acid (MAA) and ethoxyacetic acid (EAA) gave injury similar to the corresponding glycol ether. When animals were pretreated with inhibitors of alcohol metabolism followed by a testicular toxic dose of EGME (500 mg/kg), an inhibitor of alcohol dehydrogenase (pyrazole) offered complete protection. Pretreatment with the aldehyde dehydrogenase inhibitors disulfiram or pargyline did not ameliorate the testicular toxicity of EGME. In mixed cultures of Sertoli-germ cells, MAA and not EGME produced effects on spermatocytes analogous to that seen in vivo, at concentrations approximately equivalent to steady-state plasma levels after a single oral dose of EGME (500 mg/kg). It would seem likely that a metabolite (MAA or possibly methoxyacetaldehyde) and not EGME is responsible for the production of testicular damage. PMID- 6499807 TI - Spermatotoxicity associated with acute and subchronic ethoxyethanol treatment. AB - Investigations of the male reproductive toxicity of ethoxyethanol (ethylene glycol monoethyl ether) have been restricted exclusively to histopathological assessments of the testes. The present study consisted of two experiments designed to document the spermatotoxicity of ethoxyethanol (EE) as reflected in evaluations of ejaculated rat semen. The basic strategy involved the evaluation of individual ejaculates recovered from the genital tract of a female rat prior to exposure of the males to EE. Repeated assessments of the ejaculate were made during the experimental phase according to specified protocols. Adult Long-Evans hooded male rats received 0, 936, 1872 or 2808 mg/kg (PO) of EE for five consecutive days. Semen evaluations were then conducted at weeks 0, 1, 4, 7, 10 and 14 after exposure. Males in the highest two dose groups showed declines in sperm counts by week 4 and were essentially azoospermic by week 7. At this time, males receiving the lowest dose of EE also exhibited decreases in ejaculated sperm counts. An increase in abnormal sperm shapes was also observed. Over the ensuing weeks all males exhibited varying degrees of recovery as reflected by increasing ejaculated sperm counts. In a second experiment, males were treated with 0 or 936 mg/kg of EE daily (5 days/week) for 6 weeks with semen evaluations conducted weekly. By week 5, sperm counts were significantly depressed and there was an increase in the number of abnormal shapes. Sperm motility was depressed by week 6. The temporal trends seen in these experiments suggested a differential sensitivity of the spermatocyte stage to EE toxicity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499808 TI - Ethylene glycol monomethyl ether and propylene glycol monomethyl ether: metabolism, disposition, and subchronic inhalation toxicity studies. AB - Short-term and subchronic vapor inhalation studies have shown that there are pronounced differences in the toxicological properties of ethylene glycol monomethyl ether (EGME) and propylene glycol monomethyl ether (PGME). Overexposure to EGME has resulted in adverse effects on testes, bone marrow and lymphoid tissues in laboratory animals. PGME does not affect these tissues, and instead, overexposure to PGME has been associated with increases in liver weight and central nervous system depression. EGME is primarily oxidized to methoxyacetic acid in male rats, while PGME apparently undergoes O-demethylation to form propylene glycol. Since methoxyacetic acid has been shown to have the same spectrum of toxicity as EGME in male rats, the observed differences in the toxicological properties of EGME and PGME are thought to be due to the fact that the two materials are biotransformed via different routes to different types of metabolites. PMID- 6499809 TI - Analyses of ethylene glycol monoalkyl ethers and their proposed metabolites in blood and urine. AB - Glycol ethers are known to produce embryotoxic and teratogenic effects in a variety of animal species. In addition, testicular edema and tubular atrophy have been reported. The health effects of this class of compounds are not known in humans, despite the fact that these solvents are widely used in industry. In order to evaluate potential effects in humans, it is first necessary to estimate exposure in the workplace (environmental monitoring). However, in the case of glycol ethers traditional air monitoring may be ineffective because of the low volatility of these solvents and the possible significant exposure via the skin. Biological monitoring can be used to estimate glycol ether uptake by all routes of exposure. The compounds can be measured in blood or their metabolites quantitated in urine. These procedures are suggested for measuring 2 methoxyethanol, 2-ethoxyethanol and 2-butoxyethanol in blood. In addition, tentative procedures have been developed to measure the oxidized acidic metabolites, methoxyacetic acid and ethoxyacetic acid in urine as possible indices of exposure. All procedures have detection limits of less than 11 parts per million. These procedures are ready to be validated in workers exposed to these solvents. PMID- 6499810 TI - Developmental toxicity of ethylene glycol monopropyl ether acetate (EGPEA) in the rat. AB - Pregnant rats were exposed by inhalation to vapor concentrations of 100, 200, 400 or 800 ppm of ethylene glycol monopropyl ether acetate on days 6 through 15 of gestation. Concentrations of 400 and 800 ppm reduced the feed intake, mean body weight and red blood cell counts. Mean corpuscular volume and mean corpuscular hemoglobin were increased. Clinical signs of toxicity included lethargy and red discolored urine in the dams exposed to 400 or 800 ppm. The incidence of resorptions was significantly increased and the mean fetal body weight was reduced in litters of dams exposed to 800 ppm. Reproductive indices were not affected. Examinations at cesarean section revealed no major external malformations. Internal soft tissue examinations revealed three fetuses with a cardiovascular defect consisting of a right-sided aortic arch. Two of these fetuses were from dams exposed to 800 ppm, while the third was from a control litter. Skeletal examinations revealed no major skeletal malformations, while minor rib anomalies were slightly increased in litters from dams exposed to 400 or 800 ppm of ethylene glycol monopropyl ether acetate. The incidence of common skeletal variants was slightly increased at 200 ppm. PMID- 6499811 TI - Reproductive toxicity of the industrial solvent 2-ethoxyethanol in rats and interactive effects of ethanol. AB - The solvent, 2-ethoxyethanol, induced complete embryomortality in pregnant rats exposed to three times the current Federal permissible exposure limit (PEL). Following exposure to ethoxyethanol at a concentration only one-half the current PEL, the offspring evidenced behavioral and neurochemical deviations from controls. Subsequent studies found that ingestion of ethanol with concomitant inhalation of ethoxyethanol vapors early in pregnancy appeared to reduce the number of both behavioral and neurochemical deviations found for ethoxyethanol. In contrast, the concomitant exposure to ethanol and ethoxyethanol later in gestation potentiated the behavioral and neurochemical effects of ethoxyethanol. This research indicates that the industrial solvent 2-ethoxyethanol presents an occupational reproductive hazard and raises the issue of the importance of an interaction of social habits with occupational exposure to such hazards. The results would suggest that occupational physicians should advise pregnant workers in the chemical industry of the adverse effects of ethanol during pregnancy and of the possible interactions with other chemicals and should encourage them to be especially cautious with ethanol consumption since they may be at greater risk. PMID- 6499813 TI - 1,1-Dichloroethylene: an apoptotic hepatotoxin? AB - Within 2 hr after 1,1-dichloroethylene administration, the following phenomena occur in livers of fasted rats: dilation and disruption of bile canaliculi, plasma membrane invagination and loss of microvilli, cytoplasmic vacuolation, and loss of density in mitochondrial matrices. Early, selective loss of enzyme activities was localized by histochemical staining to bile canalicular, and inner and outer mitochondrial membranes. Biliary permeability to inulin increased, a change suggestive of the breakdown of junctions between hepatocytes. Endoplasmic reticulum and lysosomes appeared spared. In addition, scattered, individual hepatocytes exhibited changes characteristic of apoptosis by 2 hr: chromatin aggregation and margination, nucleolar coarse granulation and enlargement, rounded blebs and proturberances on cell surfaces, and the separation of these cells from surrounding parenchyma. In contrast, evidence of plasma membrane leakiness to K+, Ca2+ and soluble cytoplasmic enzymes was not detected until after 2 hr. Based on these observations, we propose that 1,1-dichloroethylene may initiate apoptosis-like cell degradation in selected parenchymal cells prior to or coincident with centrolobular necrosis. PMID- 6499812 TI - Comparative inhalation teratogenicity of four glycol ether solvents and an amino derivative in rats. AB - Previous research demonstrated the inhalation teratogenicity of the solvent 2 ethoxyethanol in rats and rabbits. As this is one of a class of widely used industrial solvents, we investigated the teratogenicity of five structurally related compounds. Each chemical was vaporized and administered to approximately 15 pregnant rats in one to three concentrations for 7 hr/day on gestation days 7 to 15, and dams were sacrificed on day 20. Fetuses were individually weighed, and two-thirds of them were fixed in Bouin's solution and examined for soft-tissue anomalies. The other one-third were fixed in alcohol, stained with Alizarin Red and examined for skeletal defects. Data were analyzed on a litter basis; three solvents were compared with a pooled group (N = 34) of sham-exposed controls, and the remaining two were compared with a group of 15 controls. At concentrations which were apparently not maternally toxic, 2-methoxyethanol was highly embryotoxic, producing complete resorptions at 200 ppm; increased resorptions, reduced fetal weights and skeletal and cardiovascular defects occurred at both 100 and 50 ppm. 2-ethoxyethyl acetate at 600 ppm induced complete resorption of litters; 390 ppm reduced fetal weights and induced skeletal and cardiovascular defects, but only a single defect was observed at 130 ppm. 2-Butoxyethanol evidenced slight maternal toxicity at 200 ppm but produced no increase in congenital defects at that concentration. Neither 2-(2-ethoxyethoxy)ethanol (100 ppm) nor 2-methylaminoethanol (150 ppm) was maternally toxic or embryotoxic. In summary, shorter alkyl chained glycol ethers produced greater embryotoxicity than those having longer chains, and the ester produced effects equivalent to the ether, both patterns predictable from the biochemical literature. PMID- 6499814 TI - Assessment of the role of calcium ion in halocarbon hepatotoxicity. AB - Halogenated hydrocarbons (CCl4, BrCCl3, 1,1-dichloroethylene, bromobenzene) cause a wide spectrum of dysfunction and injury in liver cells. An early effect of CCl4, BrCCl3, and 1,1-dichloroethylene is destruction of the Ca2+-sequestering ability of the endoplasmic reticulum, and it has been suggested that this lesion leads to subsequent disruption of other cell functions. Work to test this hypothesis has begun in this and other laboratories. While it appears that redistribution of intracellular Ca2+ does occur following these agents, the importance of this in cell injury is not fully resolved. Current results suggest Ca2+ redistribution may be involved in some cases (e.g., surface blebbing caused by bromobenzene), but not in others (e.g., inhibition of lipid secretion by CCl4). PMID- 6499816 TI - Ethylene glycol monoethyl ether and ethylene glycol monoethyl ether acetate teratology studies. AB - An inhalation teratology study was conducted in rats at 10, 50 and 250 ppm ethylene glycol monoethyl ether (EGEE) and in rabbits at 10, 50 and 175 ppm EGEE. This study was designed to supplement a study conducted for NIOSH which showed teratogenic effects in rats at 200 ppm EGEE and in rabbits at about 160 ppm EE. In this study, EGEE was found not to cause teratogenic effects at concentrations up to and including 250 ppm in rats and 50 ppm in rabbits, while 175 ppm EGEE was considered to be a marginal effect level for teratogenic effects in rabbits. Fetotoxicity was observed at 250 ppm EGEE and possibly at 50 ppm EGEE in rats. An inhalation teratology study using ethylene glycol monoethyl ether acetate (EGEEA) has been conducted in rabbits at 25, 100 and 400 ppm. There was evidence of teratogenicity (vertebral malformations) at 400 ppm EGEEA and slight fetotoxicity at 100 ppm; 25 ppm was a no effect level. PMID- 6499815 TI - Quantitative studies on the in vitro metabolic activation of dimethylnitrosamine by rat liver postmitochondrial supernatant. AB - The metabolic activation of dimethylnitrosamine (DMN) to mutagenic and/or cytotoxic intermediates in vitro has been characterized and the relationship between DMN demethylase and ethoxyresorufin-O-deethylase (EROD) or ethylmorphine N-demethylase (EMND) has been evaluated. A mammalian assay system which uses the postmitochondrial supernatant (S-15 fraction) prepared from a rat liver homogenate as an enzyme source and V79 Chinese hamster cells as targets for chemically induced damage was used. The enzyme pattern of the S-15 fraction was altered by pretreatment of experimental animals in vivo and/or by the use of enzyme inhibitors in vitro. The results of these studies indicate that the concentration of S-15 fraction in the reaction mixture can markedly influence the degree of DMN-induced cytotoxicity when it is metabolized in vitro and that the degree of DMN-induced cytotoxicity and mutagenicity are linearly related. The degree of cytotoxicity and mutagenicity induced in V79 cells by DMN does not correlate with EROD activity (a measure of 3-methylcholanthrene-inducible mixed function oxidases) nor with EMND activity (a measure of phenobarbital-inducible mixed function oxidases) in the S-15 fraction. PMID- 6499817 TI - Behavioral teratology of ethylene glycol monomethyl and monoethyl ethers. AB - A recent addition to the field of teratology has been the inclusion of functional assessment techniques of offspring after prenatal exposure to exogenous agents. The present paper reviews the behavioral teratogenic effects of ethylene glycol monomethyl ether (EGME, 2-methoxyethanol) and ethylene glycol monoethyl ether (EGEE, 2-ethoxyethanol). Groups of 15 pregnant Sprague-Dawley rats were exposed via inhalation to 25 ppm EGME or to 100 ppm EGEE on gestation days 7 to 13 or 14 to 20. An equal number of sham-exposed controls were included for both periods of gestation. The only effect noted in the maternal animals was a slightly prolonged gestation in the group exposed to 100 ppm EGEE on days 14 to 20. Litters were culled to four female and four male pups on the day of birth. Pups of each sex from all litters were tested on a variety of behavioral tasks (including tests of neuromuscular ability, activity, and learning ability) extending from postnatal days 10 to 90. In addition, brains from newborn and from 21-day-old offspring were removed and analyzed for concentrations of the neurotransmitters acetylcholine, dopamine, norepinephrine, and 5-hydroxytryptamine (serotonin). Both the behavioral testing and the neurochemical evaluations revealed functional alterations in the litter groups experiencing prenatal exposure to EGME and EGEE at concentrations which produced no observable effects in the maternal animals. PMID- 6499819 TI - Summary of CMA glycol ether research activities. PMID- 6499818 TI - Teratologic evaluation of ethylene glycol monobutyl ether in Fischer 344 rats and New Zealand white rabbits following inhalation exposure. AB - Timed-pregnant Fischer 344 rats and New Zealand White rabbits were exposed to ethylene glycol monobutyl ether vapors by inhalation on gestational days 6 through 15 (rats) or 6 through 18 (rabbits) at concentrations of 0, 25, 50, 100 or 200 ppm. The animals were sacrificed on gestational day 21 (rats) or 29 (rabbits). In rats, exposure to 200 or 100 ppm resulted in maternal toxicity (clinical signs, decreased body weight and weight gain, decreased absolute and relative organ weights, decreased food and water consumption and evidence of anemia), embryotoxicity (increased number of totally resorbed litters and decreased number of viable implantations per litter) and fetotoxicity (reductions in skeletal ossification). No increase in fetal malformations was observed in any exposure group relative to controls. At 50 or 25 ppm, there was no maternal, embryo or fetal toxicity (including malformations) in rats. In rabbits, exposure to 200 ppm resulted in maternal toxicity (apparent exposure-related increases in deaths and abortions, clinical signs, decreased weight during exposure and reduced gravid uterine weight at sacrifice) and embryotoxicity (reduced number of total and viable implantations per litter). No treatment-related fetotoxicity was seen. No treatment-related increased in fetal malformations or variations were seen at any exposure concentration tested. There was no evidence of maternal, embryo, or fetal toxicity (including malformations) at 100, 50 or 25 ppm in rabbits. PMID- 6499820 TI - Developmental toxicity of four glycol ethers applied cutaneously to rats. AB - Previous NIOSH studies demonstrated the embryo- and fetotoxicity and teratogenicity of ethylene glycol monoethyl ether (EGEE) applied to the shaved skin of pregnant rats. In the present study ethylene glycol monoethyl ether acetate (EGEEA), ethylene glycol monobutyl ether (EGBE), and diethylene glycol monoethyl ether (diEGEE) were tested in the same experimental model, using distilled water as the negative control and EGEE as a positive control. Water or undiluted glycols were applied four times daily on days 7 to 16 of gestation to the shaved interscapular skin with an automatic pipetter. Volumes of EGEE (0.25 mL), EGEEA (0.35 mL), and diEGEE (0.35 mL) were approximately equimolar (2.6 mmole per treatment). EGBE at 0.35 mL four times daily (approximately 2.7 mmole per treatment) killed 10 of 11 treated rats, and was subsequently tested at 0.12 mL (0.9 mmole) per treatment. EGEE- and EGEEA-treated rats showed a reduction in body weight relative to water controls that was associated with completely resorbed litters and significantly fewer live fetuses per litter. Fetal body weights were also significantly reduced in those groups. Visceral malformations and skeletal variations were significantly increased in EGEE and EGEEA groups over the negative control group. No embryotoxic, fetotoxic, or teratogenic effects were detected in the EGBE- or diEGEE-treated litters. PMID- 6499821 TI - Ethylene glycol monomethyl ether (EGME) and propylene glycol monomethyl ether (PGME): inhalation fertility and teratogenicity studies in rats, mice and rabbits. AB - A combined dominant lethal-fertility study was conducted in which male and female Sprague-Dawley (CD) rats were exposed to 0, 30, 100 or 300 ppm of ethylene glycol monomethyl ether (EGME) vapor for 6 hr/day, 5 days/week for 13 weeks and then mated to untreated counterparts. Among males, fertility was completely suppressed after exposure to 300 ppm. A partial restoration of reproductive function was evident following 13 weeks of recovery. No treatment-related reproductive effects were observed among males exposed subchronically to 100 ppm, or among females exposed to 300 ppm or below of EGME. Studies to assess the effects of inhaled EGME on embryonal and fetal development were also conducted in Fischer 344 rats, CF-1 mice, and New Zealand White rabbits. Rats and rabbits were exposed to concentrations of 0, 3, 10 or 50 ppm for 6 hr/day on days 6-15 or 6-18 of gestation, respectively. Exposure of rabbits to 50 ppm resulted in significant teratologic effects, an increased resorption rate, and decreased fetal body weight. Slight fetotoxicity in the form of skeletal variations were observed among rats exposed to 50 ppm. Exposure of pregnant mice to 0, 10, or 50 ppm for 6 hr/day on days 6-15 of gestation resulted in slight fetotoxicity at 50 ppm. No significant treatment-related effects were observed at 10 ppm of EGME or below in any of the species tested. Separate groups of pregnant rats and rabbits were exposed to 0, 500, 1500 or 3000 ppm of propylene glycol monomethyl ether (PGME) during organogenesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499823 TI - Reproductive toxicity of ethylene glycol monoethyl ether tested by continuous breeding of CD-1 mice. AB - The reproductive toxicity of ethylene glycol monoethyl ether (EGEE) was evaluated in the Fertility Assessment by Continuous Breeding protocol. Both male and female CD-1 mice were given 0, 0.5, 1.0 or 2% EGEE in the drinking water and were housed as breeding pairs continuously for 14 weeks. Significant adverse effects on fertility were seen at 1 and 2% but not at 0.5%. After the continuous breeding phase of this test was completed, treated males were housed with control females and treated females with control males and fertility and reproduction were compared to the corresponding pairs of control male and control female mice. Both males and females from the 1 and 2% groups were affected. Testicular atrophy, decreased sperm motility and increased abnormal sperm were noted in the treated males, but no specific anomalies were detected in the females. PMID- 6499822 TI - Experimental studies on toxicity of ethylene glycol alkyl ethers in Japan. AB - Past studies on the toxicological effects of ethylene glycol alkyl ethers as well as the recent data on these chemicals in Japan are reviewed. Only a few researchers have participated in the study of ethylene glycol alkyl ethers in Japan. The effects of ethylene glycol alkyl ethers on testis and embryotoxic effects of ethylene glycol monomethyl ether (EGM) have been studied, as has the teratogenicity of ethylene glycol dimethyl ether (EGdM). Studies on ethylene glycol alkyl ethers and related compounds administered to mice by oral gavage revealed the occurrence of testicular atrophy and decreased white blood cell count by EGM, EGdM, ethylene glycol monomethyl ether acetate, ethylene glycol monoethyl ether and ethylene glycol monoethyl ether acetate, and the toxicity was related to their chemical structure. On the other hand, ethylene glycol, ethylene glycol monopropyl ether, ethylene glycol monobutyl ether, ethylene glycol monophenyl ether, ethylene glycol monoacetate or ethylene glycol diacetate showed no such an effect. Studies on EGM using hamsters or guinea pigs revealed the occurrence of testicular atrophy similar to that observed in mice. In regard to the methyl ethers of other glycols, there is no convincing evidence that propylene glycol monomethyl ether, diethylene glycol monomethyl ether or diethylene glycol dimethyl ether causes testicular atrophy in mice. Teratological studies of EGM and EGdM revealed embryotoxic effects in mice. PMID- 6499824 TI - Measuring exposures to glycol ethers. AB - In 1981, NIOSH began investigating the potential reproductive health effects resulting from exposures to a class of organic solvents known generically as glycol ethers (GE). This research was begun as a result of the NIOSH criteria document development program which revealed little data available on the health effects of glycol ether exposure. Toxicologic research was begun by NIOSH and other researchers which suggested substantial reproductive effects in animals. These animal data motivated a study of human exposures in the occupational setting. In 1981 and 1982 NIOSH conducted several walk-through surveys which included preliminary measurements of exposures in a variety of industries including painting trades, coal mining, production blending and distribution facilities, aircraft fueling, and communications equipment repair facilities. The human exposure data from these surveys is summarized in this paper with most results well below 1 parts per million (ppm) and only a few values approaching 10 ppm. Blood samples were collected at one site resulting in GE concentrations below the limit of detection. Exposures to airborne glycol ethers, in the industries investigated during the collection of this data, revealed several problems in reliably sampling GE at low concentrations. It became apparent, from the data and observations of work practices, that air monitoring alone provided an inadequate index of GE exposure. Further field studies of exposure to GE are anticipated, pending location of additional groups of exposed workers and development of more reliable methods for characterizing exposure, especially biological monitoring. PMID- 6499825 TI - Comparative study of cystine clearance in cystinotic and I-cell fibroblasts upon exposure to cystine dimethyl ester. AB - I-cell fibroblasts can accumulate cystine at levels comparable to those seen in homozygous cystinotic fibroblasts. Cystine accumulation in cystinosis is accounted for cystine clearance defect in situ. To unravel the question whether the same clearance defect or two different mechanisms cause cystine accumulation in I-cell disease, we used the cystine loading technique upon exposure of skin fibroblasts to radioactive cystine dimethyl ester. Normal, cystinotic and I-cell fibroblasts were exposed to radioactive cystine dimethyl ester, and the clearance of the generated radioactive cystine was measured. Cystinotic cells showed a marked defect in cystine clearance in situ, as compared to normal fibroblasts. In I-cell fibroblasts, we observed slow hydrolysis of cystine dimethyl ester to cystine, indicating low esterase activity, but no defect in clearance of the generated cystine. Cysteine production from the exogenous cystine dimethyl ester, presumably by cytoplasmic hydrolysis of the generated cystine, is normal in I cell fibroblasts. Thus, our results indicate that, unlike cystinosis, there is no cystine clearance defect in situ for cystine in I-cell disease, and probably unrelated mechanisms cause cystine storage in cystinosis and I-cell disease. PMID- 6499826 TI - Chromatographic resolution and characterization of different casein phosphatase activities from the cytosolic compartment of rat erythrocytes. AB - Casein phosphatase activity in the cytosol of erythrocytes, taken from 1-month old rats, is associated with three chromatographically distinct peaks: E1, E2 and E3. The dominant molecular form was E3 phosphatase, molecular weight 180,000 dalton, which increased in the cytosol of erythrocytes as compared to the value found in the same compartments of reticulocytes. The enzyme had the pH optimum at 6.5 and seemed to be positively cooperative with respect to substrate and negatively cooperative with respect to pyrophosphate, the most potent inhibitor. E1 and E2 casein phosphatases seem to be remnant activities in erythrocytes as compared to the values found in the cytosol of reticulocytes. PMID- 6499827 TI - Age dependency of serum acid phosphatase in controls and Gaucher patients. AB - Serum acid phosphatase activity has been used as a complementary test for the diagnosis of Gaucher's disease. This study suggests that phosphatase activity is age dependent. The use of controls in the patients' age is strongly recommended. PMID- 6499828 TI - The measurement of effort. PMID- 6499829 TI - Evaluation of responses to broad-band whole-body vibration. PMID- 6499830 TI - An amphipathic sulphated glycoconjugate of Leishmania: characterization with monoclonal antibodies. AB - A major glycoconjugate of Leishmania tropica major identified by two monoclonal antibodies was shown to be an externally oriented, amphipathic membrane antigen shed into the culture medium in which the parasites grow. This molecule could be labelled metabolically with [3H]glucose, [3H]galactose, [32P]phosphate and [35S]sulphate. It migrated as a polydisperse band upon electrophoresis in SDS polyacrylamide gels, spanning the region of the gel corresponding to an apparent mol. wt. of 20 000-67 000 daltons. An apparently identical family of molecules could be labelled on the surface of living promastigotes using galactose oxidase and [3H]-sodium borohydride. This molecule was shown to be released into the supernatant over a period of several hours. Detection of the 3H- or 35S-labelled molecule required several days exposure of autoradiographs, but a novel blotting technique using nitrocellulose coated with monoclonal antibody allowed rapid detection of the molecule in charge shift electrophoresis, Western blotting and dot blotting. The electrophoretic mobility of the glycoconjugate in agarose relative to its mobility in Triton X-100 was increased in the presence of deoxycholate, and decreased in the presence of cetyl trimethyl-ammonium bromide, indicating amphipathic properties consistent with insertion into the lipid bilayer of the membrane. Using the dot-blotting technique the glycoconjugate was detected in all virulent and avirulent clones of LRC-L137 and in two additional isolates of L. tropica major (LRC-L287 and LRC-L251), but not in L. donovani or L. mexicana, consistent with the previously described specificity of the antibodies. However, the general approaches used in this paper showed that L. donovani (LRC-L52) and L. mexicana (LRC-L94) synthesize a similar, but antigenically distinct glycoconjugate. PMID- 6499831 TI - The Drosophila position-specific antigens are a family of cell surface glycoprotein complexes. AB - Position-specific (PS)1 and PS2 monoclonal antibodies bind non-uniformly to the mature wing imaginal disc of Drosophila with respect to the boundary separating the dorsal and ventral developmental compartments. PS1 antibodies preferentially recognize dorsal cells, PS2 antibodies ventral cells. Antibodies of the two classes extract distinct sets of glycoproteins from an imaginal disc lysate. PS3 antibodies bind to both dorsal and ventral disc cells and extract both PS1 and PS2 glycoprotein sets together with an additional component. We show that the PS antigens are related multimeric glycoprotein complexes on the cell surface. PS3 antibodies recognize a glycoprotein present in all complexes, while PS1 and PS2 antibodies recognize unique components of their own complexes. Spatial and temporal correlations suggest the molecules may have a function in development. PMID- 6499832 TI - Analysis of the distribution of charged residues in the N-terminal region of signal sequences: implications for protein export in prokaryotic and eukaryotic cells. AB - A statistical analysis of the distribution of charged residues in the N-terminal region of 39 prokaryotic and 134 eukaryotic signal sequences reveals a remarkable similarity between the two samples, both in terms of net charge and in terms of the position of charged residues within the N-terminal region, and suggests that the formyl group on Metf is not removed in prokaryotic signal sequences. PMID- 6499833 TI - Is actin a transcription initiation factor for RNA polymerase B? AB - We have previously reported that two fractions derived from HeLa cell S100 extracts, the heparin flow-through and the heparin 0.6 M KCl eluate are required in vitro for efficient and accurate transcription by RNA polymerase class B (II). We have further purified a factor present in the heparin flow-through fraction, which markedly stimulates specific transcription catalyzed by the heparin 0.6 M KCl eluate. We report here that some of the properties of the stimulatory factor present in our most purified fractions are strikingly similar to those of actin. We demonstrate also that this factor acts at the pre-initiation level of the transcription reaction. PMID- 6499834 TI - Control of pT181 replication I. The pT181 copy control function acts by inhibiting the synthesis of a replication protein. AB - pT181 is a fully sequenced 4.4-kb 20 copy Tcr plasmid from Staphylococcus aureus. Its replication system involves a unique unidirectional origin embedded in the coding sequence for a plasmid-determined protein, RepC, that is required for initiation. When joined to a 55 copy carrier plasmid, pE194, pT181 excludes autonomous isologous replicons by inhibiting their replication. Two types of spontaneous pT181 copy mutants have been isolated, one that eliminates sensitivity to this inhibition and another that does not. A spontaneous 180-bp deletion, delta 144, eliminates both the inhibitory activity and sensitivity to it. This deletion increases copy number by 50-fold and RepC production by at least 10-fold. It is located directly upstream from the repC coding sequence and the deletion-bearing plasmid supports the replication of inhibitor-sensitive plasmids in cells containing active inhibitor. This effect is probably due to the overproduction of RepC by the delta 144 plasmid. On the basis of these results, it is suggested that RepC synthesis is negatively controlled by an inhibitor that is encoded directly upstream from the repC coding sequence and acts as a tareget set in the same region. It is likely, therefore, that pT181 replication rate is determined by the level of RepC. PMID- 6499835 TI - Three-dimensional structure of bovine pancreatic DNase I at 2.5 A resolution. AB - The three-dimensional structure of bovine pancreatic deoxyribonuclease I (DNase I) has been determined at 2.5 A resolution by X-ray diffraction from single crystals. An atomic model was fitted into the electron density using a graphics display system. DNase I is an alpha, beta-protein with two 6-stranded beta pleated sheets packed against each other forming the core of a 'sandwich'-type structure. The two predominantly anti-parallel beta-sheets are flanked by three longer alpha-helices and extensive loop regions. The carbohydrate side chain attached to Asn 18 is protruding by approximately 15 A from the otherwise compact molecule of approximate dimensions 45 A X 40 A. The binding site of CA2+ deoxythymidine-3',5'-biphosphate (Ca-pdTp) has been determined by difference Fourier techniques confirming biochemical results that the active centre is close to His 131. Ca-pdTp binds at the surface of the enzyme between the two beta pleated sheets and seems to interact with several charged amino acid side chains. Active site geometry and folding pattern of DNase I are quite different from staphylococcal nuclease, the only other Ca2+-dependent deoxyribonuclease whose structure is known at high resolution. The electron density map indicates that two Ca2+ ions are bound to the enzyme under crystallization conditions. PMID- 6499838 TI - Penicillin-resistant Streptococcus pneumoniae meningitis successfully treated with vancomycin. PMID- 6499837 TI - Immunological aspects of humidifier fever. AB - An epidemiological investigation was made of eight employees working in a defined section of an office building who complained of febrile reactions accompanied by respiratory tract symptoms and fatigue. Culture of the water from the humidifier for their section yielded strains of Pseudomonas acidovorans and an unidentified Pseudomonas species. In vitro studies showed that these strains activated the alternative pathway of the complement system in Mg-EGTA supplemented serum, as evidenced by properdin depletion and conversion of C3-proactivator (Factor B) and C3. Whereas the employees with symptoms had significantly reduced properdin values during the symptomatic phase, a slight C3 conversion and antibodies to Pseudomonas spp., staff working in another part of the building with a different ventilation system did not. It was concluded that staff with humidifier fever symptoms had been exposed to Pseudomonas spp. through the faulty ventilation system, and their symptoms were most likely a result of complement activation. PMID- 6499836 TI - Use of histone antibodies for studying chromatin topography and the phosphorylation of chromatin subunits. AB - Polyclonal and monoclonal antibodies specific for histones as well as sera directed against synthetic peptides of histones were used to probe the topography of chromatin subunits. In native chromatin, the regions corresponding to residues 130-135 of H3 and 6-18 of H2B were found to be exposed and able to interact with antibodies whereas the regions 26-35 and 36-43 of H2B and 80-89 and 85-102 of H4 were not. In vitro phosphorylation of H3 and H5 in native chromatin or of H3 in H1/H5-depleted chromatin led to a marked drop in the binding of antibodies specific for residues 130-135 of H3 and 6-18 of H2B. Phosphorylation of H1/H5 depleted chromatin also altered the degree of exposure of certain H2A epitopes but it did not affect the surface accessibility of residues 1-11 of H2B. PMID- 6499839 TI - Abdominal infections caused by Streptococcus pneumoniae. PMID- 6499840 TI - Antibiotic sensitivity of "Campylobacter pylori". PMID- 6499841 TI - Legionnaires' disease in north-western Greece. PMID- 6499842 TI - Does the occurrence of plasmids in Campylobacter jejuni and Campylobacter coli isolates correlate with antibiotic resistance? PMID- 6499843 TI - L-Lactate dehydrogenase from Thermus caldophilus GK24, an extremely thermophilic bacterium. Desensitization to fructose 1,6-bisphosphate in the activated state by arginine-specific chemical modification and the N-terminal amino acid sequence. AB - Heat-stable and fructose-1,6-bisphosphate-activated L-lactate dehydrogenase (EC 1.1.1.27) has been purified from an extremely thermophilic bacterium, Thermus caldophilus GK24 [Taguchi, H., Yamashita, M., Matsuzawa, H. and Ohta, T. (1982) J. Biochem. (Tokyo) 91, 1343-1348]. N-terminal sequence analysis of the first 34 amino acids of the enzyme indicates that the N-terminal arm region (first 1-20 residues) known for the vertebrate L-lactate dehydrogenases is completely missing in the T. caldophilus enzyme, while there is a high homology of sequence between the regions which are considered to be part of the NAD-binding domain. The C terminal amino acid of the enzyme was phenylalanine. Analysis of the amino acid composition showed that T. caldophilus enzyme contained much more arginine and fewer lysine than other bacterial and vertebrate L-lactate dehydrogenases. On modification reaction with 2,3-butanedione in the presence of NADH and oxamate, an enhanced activity of the T. caldophilus L-lactate dehydrogenase was obtained independently of fructose 1,6-bisphosphate, and the modified enzyme was desensitized to fructose 1,6-bisphosphate. Amino acid analysis indicated that such a desensitization in the active state was caused by the modification of only one arginine residue per the enzyme subunit. Desensitization of the enzyme was inhibited in the presence of fructose 1,6-bisphosphate. A similar desensitization was observed using 1,2-cyclohexanedione instead of 2,3-butanedione. The enzyme was irreversibly modified with 2,3-butanedione and characterized. The irreversibly modified enzyme also showed an enhanced activity independently of fructose 1,6-bisphosphate, and its pyruvate saturation curve was similar to that of the native enzyme measured in the presence of fructose 1,6-bisphosphate. Fructose 1,6-bisphosphate, which increases the thermostability of the native enzyme, did not affect that of the modified enzyme, while thermostability of the modified enzyme slightly decreased. Amino acid analysis indicated that only the arginine content was decreased by the modification. These results show that arginine residue(s) exist in the binding site for fructose 1,6-bisphosphate on the enzyme, and that the arginine residue(s) play some important role in the allosteric regulation of the enzyme activity. PMID- 6499844 TI - Characterization of the transcription products of glyceraldehyde 3-phosphate dehydrogenase gene in HeLa cells. AB - We have partially purified the messenger RNA coding for glyceraldehyde-3 phosphate dehydrogenase (GAPDH, EC 1.2.1.12) from HeLa cells and obtained a cDNA clone containing part of its sequence. Using this clone to probe electrophoregrams of RNA transferred to nitrocellulose, we have investigated the characteristics of nuclear and cytoplasmic transcripts in these cells. In the cytoplasm, nature GAPDH mRNA was detected in Northern blots as an intense band, apparently unique, of approximately 1400 nucleotides. The half-life of this mRNA was determined both from the decay kinetics, after a chase with actinomycin D, and from the labeling kinetics during an accumulation experiment. Both kinds of experiments yielded a half-life value of about 8 h, while the accumulation experiment indicated that steady-state GAPDH mRNA amounted to about 1.6% of cytoplasmic poly(A)-rich RNA. Much longer species, likely to be restricted to the nucleus, were also detected in RNA extracted from total cells. At least three discrete species of 1600, 4000, 5800 and 6800 bases were observed above a trailing background extending up to about 8000 bases. This value is commensurate with a functional size of the GAPDH transcription unit in the order of 13000 bases, which we determined by measuring the size of the ultraviolet inactivation target. Until direct evidence can be obtained at the genomic level, the present results provide the first clue to the existence of introns, presumably at least four, in a GAPDH gene from a higher eucaryote. PMID- 6499845 TI - pH-induced co-operative effects in hysteretic enzymes. 1. A theoretical model of a new type of co-operative behaviour controlled by pH. AB - A new model which provides an explanation for pH-induced co-operativity of hysteretic enzymes is proposed. The essence of the model is that a region, or a domain, of the enzyme undergoes a spontaneous 'slow' conformational change which does not affect the geometry of the active site. The region which undergoes this spontaneous conformational transition bears an ionizable group. Kinetic co operativity occurs if the pK of this ionizable group changes upon this conformational transition. Thus co-operativity does not arise from a distortion of the active site. An interesting prediction of the model is that at 'extreme' pH values co-operativity must be suppressed. Although the kinetic equation pertaining to the model is of the 2:2 type, co-operativity is not maximum or minimum at half-saturation of the enzyme by the substrate, as occurs with 2:2 binding isotherms. A new index of maximum or minimum kinetic co-operativity, whether this extreme occurs at half-saturation or not, has been proposed which allows the change of kinetic co-operativity to be followed as a function of pH. It is believed that this model will be useful in explaining the behaviour of enzymes attached to biological polyelectrolytes, such as membranes or cell envelopes. PMID- 6499846 TI - The action of anoxia and cyanide on glycogen breakdown in the liver of the gsd/gsd rat. AB - Perfusion of normal rat livers under anoxic conditions or the addition of KCN to aerobic perfusions activated phosphorylase and stimulated glycogen breakdown and glucose output. Livers from rats with a deficiency of liver phosphorylase kinase (gsd/gsd) showed a much smaller activation of phosphorylase with anoxia or KCN and produced glucose at about half the rate of normal livers. The increase in phosphorylase a in gsd/gsd livers was insufficient to account for the increase in glucose output. The addition of KCN to normal hepatocytes, activated phosphorylase and stimulated glucose output almost as effectively as glucagon. Hepatocytes from gsd/gsd rats showed only a very small increase in phosphorylase a on the addition of KCN, and glucose output did not increase. We conclude that in the perfused liver, anoxia and KCN stimulate glycogen breakdown and glucose output, at least in part, by a mechanism that does not involve conversion of phosphorylase b to phosphorylase a. In isolated hepatocytes KCN stimulates glucose output only by increasing the content of phosphorylase a. PMID- 6499847 TI - Glucose-6-phosphate dehydrogenase. A transferred nuclear Overhauser enhancement study of NADP+ conformations in enzyme-coenzyme binary complexes. AB - The conformation of NADP+ in glucose-6-phosphate-dehydrogenase--NADP+ binary complexes has been investigated using proton-proton transferred nuclear Overhauser enhancement measurements to determine interproton distance ratios between bound NADP+ protons. The enzymes from Saccharomyces cerevisiae (brewer's yeast and baker's yeast) and Hansenula jadinii (Candida utilis, Torula utilis) form binary complexes with NADP+ in which the glycosidic bond of the adenine moiety is in the anti conformation whereas that of the nicotinamide moiety exists as a syn (69-70%)/anti (30-40%) mixture. The enzymes have similar subunit sizes (Mr approximately 58 000) and it is shown that they bind NADP+ in essentially similar conformations. Inactivation of the baker's yeast enzyme with acetylsalicylic acid caused little if any alteration in the conformation of bound NADP+, and the presence of NADP+ during inactivation afforded very little protection to the enzyme. Inactivation rates were, however, lower in the presence of glucose 6-phosphate. It is concluded that the epsilon-amino group of the lysine residue that is acetylated during the inactivation reaction with acetylsalicylic acid is not necessary for binary complex formation between the enzyme and NADP+, but that it is situated in a part of the molecule affected by formation of the enzyme--glucose-6-phosphate complex. The implication of the findings for the catalytic process, and related evolutionary aspects, are discussed briefly. PMID- 6499848 TI - The nature of the interaction of eukaryotic initiation factor 2 with double stranded RNA. AB - In addition to binding messenger RNA molecules at specific sequences, eukaryotic initiation factor 2 (eIF-2) also binds to double-stranded RNA (dsRNA). The dsRNA is a powerful inhibitor of initiation of eukaryotic translation, causing the inactivation of eIF-2, but in the presence of certain mRNA templates, dsRNA fails to establish inhibition. Such mRNA templates bind to eIF-2 with higher affinity than does dsRNA, while globin mRNA, a template sensitive to inhibition, binds with lower affinity. Here, the nature of the interaction between dsRNA and eIF-2 was studied by examining both the binding of eIF-2 to Penicillium chrysogenum dsRNA molecules carrying 32P label at their 5' ends, and the ability of eIF-2 to protect such label against pancreatic ribonuclease digestion. The results reveal binding sites for eIF-2 at the 5' ends, as well as throughout internal regions of the dsRNA molecule. At least 15 molecules of eIF-2 can be accommodated on a 3000 base molecule of P. chrysogenum dsRNA. eIF-2 protects a 105-base-pair 5'-terminal fragment in dsRNA against digestion, but exhibits no noticeable preference for the 5' ends. By contrast, eIF-2 fails to protect label at the 5' ends of denatured dsRNA molecules, even though it binds to them at internal sites more avidly than to native dsRNA. Binding of eIF-2 to dsRNA is not restricted to specific sequences: eIF-2 binds with equal affinity to the synthetic dsRNA sequence, poly(rI . rC). The data support the interpretation that eIF-2 recognizes the A conformation in dsRNA rather than sequence. Apparently binding of eIF-2 at sites spaced 200 base pairs apart prevents relaxation of the intervening length of the double helix, thereby stabilizing the dsRNA molecule against ribonuclease attack. These results show that, even though dsRNA and mRNA compete in their binding to eIF-2, the structural features recognized by eIF-2 in these RNA species are distinct. PMID- 6499849 TI - RNA and ribosomal protein patterns during aerial spore germination in Streptomyces granaticolor. AB - Disruption of the external sheath of Streptomyces granaticolor aerial spores and subsequent cultivation in a rich medium result in a synchronous germination. This method was used to analyze RNA and protein patterns during the germination. The germination process took place through a sequence of time-ordered events. RNA and protein synthesis started during the first 5 min and net DNA synthesis at 60-70 min of germination. Within the first 10 min of germination, synthesis of RNA was not sensitive to the inhibitory effect of rifamycin. During this period rRNA and other species including 4-5-S RNA were synthesized. Dormant spores contained populations of ribosomes or ribosomal precursors that were structurally and functionally defective. The ribosomal particles bound a sporulation pigment(s) of the melanine type. The ribosomal proteins complexed to the pigments formed insoluble aggregates which were easily removed from the ribosomes by one wash with 1 M NH4Cl. During the first 10 min of germination, pigment(s) were liberated from the complexes with the ribosomes and protein extracts of the washed ribosomes had essentially the same pattern as the extracts of ribosomes of vegetative cells. These structural alterations were accompanied by enhancement of the ribosome activities in polypeptide synthesis in vivo and in vitro. When the spores were incubated with a 14C-labelled amino acid mixture in the presence of rifamycin, only three proteins (GS1, GL1 and GS9) were identified to be radiolabelled in the extracts from the washed ribosomes. These experiments indicate that liberation of the sporulation pigment(s) from the complexes with ribosomal proteins and assembly of de novo synthesized proteins and proteins from a preexisting pool in the spore are involved in the reactivation of the ribosomes of dormant spores of S. granaticolor. PMID- 6499850 TI - The interaction of mitochondrial transhydrogenase with derivatives of coenzyme A. AB - The 2,4-dinitrophenyl derivative of dephospho-CoA and the 7-nitrobenzofurazan-4 yl derivative of CoA are competitive inhibitors (Ki 3 microM and 2.6 microM respectively) of mitochondrial transhydrogenase with regard to NAD+ and NADPH respectively. The 7-nitrobenzofurazan-4-yl derivative of dephospho-CoA is a competitive inhibitor with regard to both transhydrogenase substrates with the same Ki equal to 0.3 microM. The pattern of transhydrogenase inhibition with the 7-nitrobenzofurazan-4-yl derivative of dephospho-CoA indicates that one molecule of the inhibitor binds simultaneously to both the NADP(H) and the NAD(H) binding sites of the enzyme. This result is evidence of the short distance between the NADP(H) and the NAD(H) binding sites. PMID- 6499851 TI - Unreliability of conventional visual electrocardiographic monitoring for detection of transient ST segment changes in a coronary care unit. AB - Visual monitoring at the central station of coronary care units (CCUs) may not adequately assess the presence and frequency of transient asymptomatic ST segment changes in patients with unstable angina. We have performed continuous 24-h electrocardiographic recordings over a total period of 50 days in 10 patients admitted to our CCU with frequent attacks of angina at rest. Over the corresponding period, at the central monitoring station (6 beds), the nursing staff detected only 31 transient ischaemic episodes (27 with ST elevation, 4 with depression, 9 of which were asymptomatic). By contrast the retrospective analogue analysis of tapes identified 213 ischaemic episodes: 143 with ST elevation (greater than or equal to 0.2 mV) and 70 with ST depression (greater than or equal to 0.2 mV); usual CCU monitoring failed to report changes during 13 episodes (8 with ST elevation, 5 with depression) accompanied by anginal pain. When the tapes were played back in real time on a CCU monitoring scope, a cardiologist (who had the option of interrupting the play-back whenever tired) recognized 48% of the episodes when presented in groups of 4 and randomly positioned on the screen together with 2 other electrocardiographic tracings not related to the study; he recognized 92% of the episodes when only one ECG was presented on the screen. Thus conventional visual monitoring in a CCU considerably underestimates the incidence of transient ischaemic ST segment changes, some of which were accompanied by pain. This low rate of detection is the result of the presentation on the central monitoring station of several ECGs and of fatigue. PMID- 6499852 TI - The QRS morphology in post-myocardial infarction ventricular tachycardia. A study of 100 tracings compared with 70 cases of idiopathic ventricular tachycardia. AB - A hundred tracings of ventricular tachycardia (VT) belonging to 85 patients with myocardial infarction (MI) were compared with 70 cases of incessant, benign, idiopathic VT. The two groups of tracings differed in terms of QRS axis, most often normal in idiopathic VT (75%) and outside normality in MIVT (74%). The sum of QRS amplitude in unipolar limb leads was greater in idiopathic VT (4.3 +/- 1.3 mv, mean +/- S.D.) than in MIVT (2.6 +/- 0.8 mv, P less than 0.001). The QRS width was also different: 135 +/- 11 ms in idiopathic VT vs. 171 +/- 32 ms in MIVT (P less than 0.001). The QRS morphology in MIVT was characterized by the presence of a QR pattern in leads other than VR, or a QS pattern in V5-V6. These two aspects were constantly absent in idiopathic VT, and they were present in 89% of MIVT. In only 38 MIVT tracings were the ECG signs of MI observed in the same leads during sinus rhythm and during VT. In 51 MIVT tracings the location of the MI indicated by the VT tracing differed from that displayed in sinus rhythm. Rather than indicating an extension of the infarcted area not apparent in the tracings in sinus rhythm, such a discrepancy suggests that the QRS pattern during VT strongly depends on the point of origin of the VT. Conversely, this explains why the morphology of the QRS is an unreliable means for localizing the VT origin if the location of the MI is not taken into account. We conclude that both factors should be taken into consideration, and this might theoretically permit a better though complex approach to the VT origin in coronary heart disease using surface tracings. PMID- 6499853 TI - New electrocardiographic criteria for inferior myocardial infarction. AB - The sensitivity of existing electrocardiographic (ECG) Q-wave criteria for inferior myocardial infarction (IMI) is poor. New criteria were developed after prospective analysis of the ECGs of 300 consecutive subjects undergoing cardiac catheterization (group 1). These criteria were then prospectively tested in a second group of 300 consecutive subjects undergoing cardiac catheterization (group 2). Only patients with left bundle branch block were excluded from both groups. In each group, IMI subgroups were defined on the basis of angiographic inferior wall motion abnormalities associated with a 70% or greater stenosis of the supplying coronary artery. All subjects who did not satisfy these angiographic criteria were included in the non-IMI subgroups. The new ECG criteria defined in the group 1 subjects were: 'Q' waves in one or more of the ECG leads 2, 3, or a VF, where 'Q' waves are those at least 30 ms in duration (onset to nadir) or those with a Q:R ratio at least 1:4, provided the QRS amplitude is greater than or equal to 0.5 mV. The ECG pattern 'Q3qF', where 'q' waves are those not satisfying either of the above, is excluded from these criteria. When tested in the group 2 subjects, the proposed criteria were significantly (P less than 0.001) more sensitive (68%) than those of the New York Heart Association (28%), though less specific (84% versus 97%, P less than 0.001). Of 300 ECGs analysed by two independent observers, disagreements as to the diagnosis by the proposed criteria were encountered in 19 cases (6%). PMID- 6499854 TI - Flecainide: one-year efficacy in patients with chronic ventricular arrhythmias. AB - During a one-week short-term in-hospital period, 60 patients with chronic ventricular arrhythmias were treated with 200 mg flecainide twice a day. Flecainide reduced premature ventricular complexes (PVCs) by more than 85% without causing important side-effects in 47 patients, who entered a one-year follow-up period and were followed with bimonthly 24-h ECGs. Median PVC-frequency remained reduced by more than 99% during the follow-up period. Repetitive ventricular beats and ventricular tachycardia were present in 83% and 42% of patients, respectively, before flecainide. During follow-up, these arrhythmias were seen in less than 32% and less than 10% of patients, respectively, at each 24-h ECG. Furthermore, the mean number of hours with repetitive ventricular beats and ventricular tachycardia remained reduced by more than 76% and more than 79%, respectively, throughout the follow-up period. Ventricular arrhythmias remained suppressed despite a gradual reduction in flecainide dosages (to a median of 300 mg day-1) and flecainide plasma levels. In nine out of 47 patients, an increase in ventricular arrhythmias above baseline values on one or more occasions was observed. During a flecainide withdrawal period, a 65-fold increase in median PVC frequency was observed and ventricular tachycardia reappeared in 18 patients. Subjective side-effects were acceptable except for two patients. During the follow-up period, one patient developed reversible heart failure and sinus node dysfunction. During the total study period, four patients, with either severe coronary artery disease (2) or cardiomyopathy (2) developed lethal arrhythmias (3) or ischaemic events (1). We conclude that prolonged flecainide treatment is effective in a high proportion of patients with chronic ventricular arrhythmias. In some patients an arrhythmogenic effect may occur. PMID- 6499855 TI - Permanent cardiac pacing in congenital heart disease: a follow-up study of 20 patients. AB - Sinus nodal dysfunction (SND) and complete heart block (CHB) in congenital heart disease (CHD) are commonly associated with congestive heart failure, syncopal attacks, and sudden death. Permanent cardiac pacing (PCP) is required to avoid these manifestations which are frequently associated with a high rate of complications, particularly in the younger age group. Twenty patients with CHD aged 4 months to 46 years underwent pacemaker implantation. Twelve (60%) were less than 20 years of age. CHB was present in 15 patients: in 10 it developed 1 week to 11 years following surgery, in two it was congenital, and in three patients it developed spontaneously with previous conduction disturbances. SND was present in 5 patients: it was congenital in two patients and developed post operatively in three. Seventeen patients are alive and no syncopal attacks or bradyarrhythmias were recorded 2.5 to 12.5 years following the initiation of PCP. Improvement in the cardiac output was noted in most patients with heart failure. The three patients who died had adequately functioning pacemakers. Only nine re implantations were needed, seven of them in adult patients after closure of an atrial septal defect. Our experience indicates a favourable outcome for patients with CHD needing PCP. PMID- 6499856 TI - Evaluation of potential adverse effects of sodium nitroprusside during pacing induced myocardial ischaemia in man. AB - To elucidate the potential harmful effects of sodium nitroprusside (NP) on myocardial ischaemia, eleven patients with coronary artery disease were studied before and during two doses NP infusion. The infusion rates were adjusted to reduce systolic aortic pressure by 10-20 mmHg and to between 100 and 110 mmHg. Myocardial haemodynamic and metabolic measurements were undertaken in sinus rhythm and during pacing-induced angina pectoris. The procedure was repeated at the low and high dose NP using the same pacing rate. One patient did not develop ischaemia and was excluded. Low dose NP reduced ischaemia slightly, whereas the higher dose had no effect despite falling indices of cardiac work. The oxygen uptake was maintained except at high dose treatment during pacing due to an increased catecholamine stimulation. The transmural perfusion gradient was unchanged at low dose NP, but fell at the higher dose suggesting reduced perfusion of ischaemic tissue. High dose NP also decreased coronary arteriolar resistance considerably which may have induced a coronary 'steal' effect. Thus, NP may induce adverse haemodynamic and metabolic changes which counteract the beneficial actions of the drug on ischaemia when used in high doses and in patients without heart failure. PMID- 6499857 TI - 2D echocardiographic diagnosis of total anomalous pulmonary venous connection of the infradiaphragmatic type. AB - In two newborn infants with infradiaphragmatic total anomalous pulmonary venous connection the common pulmonary vein was visualized with 2D echocardiography. The transducer was placed in the subcostal region so as to image the descending aorta and the vertebral column. Apart from the aorta and the inferior vena cava a third vessel was identified, lying anterior to the aorta, the proximal part lying behind the left atrium, the distal part curving anterior in the liver, the distal end being distended. These findings are highly characteristic and diagnostic for total anomalous pulmonary venous connection of the infradiaphragmatic type. PMID- 6499858 TI - Isolated chylopericardium due to lymphangiomatous dysplasia of the thymus. AB - In this paper we present the case of an 18-year old asymptomatic woman whose routine chest radiograph revealed an enlarged cardiac silhouette which was caused by a chylopericardium due to a lymphangioma of the thymus. PMID- 6499859 TI - Angina, coronary risk factors and coronary artery disease in patients with valvular disease. A prospective study. AB - The relationship between coronary risk factors and coronary artery disease in patients with valvular heart disease was studied prospectively in 387 consecutive patients undergoing routine coronary arteriography prior to valve replacement. Coronary artery disease was as common in patients with mitral valve disease (31.9%) as in those with aortic valve disease (26.8%). Although it occurs more frequently in patients with angina (45.7%) significant coronary artery disease is found in 19.2% (47 of 245) of those without angina (P less than 0.001), suggesting that the presence of angina alone is an unreliable indicator of significant coronary disease. The prevalence and severity of significant coronary artery disease increases progressively as the number of coronary risk factors also increase (P less than 0.001) but the prevalence is low (3%) in patients in whom both angina and coronary risk factors are absent. These findings suggest that preoperative coronary arteriography might be omitted in this latter group of patients. PMID- 6499860 TI - Therapeutic use of adenosine for terminating spontaneous paroxysmal supraventricular tachycardia. AB - Intravenous adenosine proved effective in eight out of ten episodes of acute spontaneous supraventricular tachycardia. AV node blockade induced by adenosine occurred 20 s after injection, and disappeared very quickly. Side-effects were transient and never serious. Therefore, it is thought that adenosine can be proposed safely for the short-term treatment of supraventricular tachycardia. Because of the different mechanisms of action, the specific side-effects observed after ATP administration are unlikely to be encountered. PMID- 6499861 TI - Isolated systolic hypertension and its relationship to the risk of myocardial infarction, cerebrovascular disease and death in a middle-aged population. AB - The prevalence of hypertension in general and of those complications associated with isolated systolic hypertension (at least 165 mmHg systolic and less than 95 mmHg diastolic pressure) were assessed in a random sample of 3888 men and 4336 women aged 30-59 years at the beginning of the study. The prevalence of isolated systolic hypertension was about 5% both in men and women aged 30 to 49 years; in those aged 50 to 59 years the prevalence was 7% in men and 13% in women. Systolic hypertension was associated with an increased risk of acute myocardial infarction (AMI), cerebrovascular stroke and death both in men and women in the seven-year follow-up period. The relative risk of AMI in men and women with isolated systolic hypertension was 1.65 (P less than 0.05) and 0.87, respectively, and the relative risk of stroke 0.57 and 1.29, respectively. Isolated systolic hypertension is not uncommon in the middle-aged population and its impact on cardiovascular complications seems to be significant not only on the elderly but also in the middle-aged. PMID- 6499862 TI - Acute haemodynamic and myocardial metabolic effects of intravenous urapidil in severe heart failure. AB - The acute haemodynamic and myocardial metabolic effects of intravenous urapidil were evaluated in 12 patients with severe congestive heart failure due to coronary heart disease. Urapidil was given intravenously (0.5 mg kg-1 min-1 as a bolus) followed by infusion at a rate of 4 micrograms kg-1 min-1 for 120 min. Following urapidil administration, cardiac index increased by 29%, mean pulmonary artery wedge pressure fell by 35% and systemic vascular resistance by 33%. The fall in mean arterial pressure was moderate. No significant alterations in coronary sinus blood flow, myocardial oxygen consumption and myocardial lactate extraction occurred. No untoward effect was observed. This study shows that intravenous urapidil produces beneficial haemodynamic effects without a deleterious effect on myocardial metabolism in patients with heart failure due to coronary heart disease. PMID- 6499863 TI - A comparison of the Naughton and modified Bruce treadmill exercise protocols in their ability to detect ischaemic abnormalities six weeks after myocardial infarction. AB - Symptom-limited Naughton and modified Bruce treadmill exercise protocols were compared in 20 patients to assess their ability in detecting additional ischaemic abnormalities six weeks after myocardial infarction. Eleven patients had a result indicating reversible myocardial ischaemia on both tests while the other nine had no ischaemic abnormality during either of the two protocols. The only significant difference between the two protocols was the longer exercise duration resulting from the Naughton protocol (17.3 +/- 5.0 vs. 14.8 +/- 2.8 mins, P less than 0.01). The mean maximum heart rates, rate-pressure products and achieved workloads did not differ significantly. We conclude that even though the Naughton protocol resulted in a significantly longer mean maximum exercise duration, the protocols were equally effective in detecting additional ischaemic abnormalities six weeks after myocardial infarction. PMID- 6499864 TI - Right and left ventricular ejection fraction and left ventricular volume changes at rest and during exercise in normal subjects. AB - The effect of exercise upon right and left ventricular ejection fractions (RVEF and LVEF) as well as the changes upon left ventricular end-diastolic and end systolic volume indices (LVEDVI and LVESVI) were investigated. Twenty-two normal subjects were studied at rest and during upright submaximal exercise. RVEF was determined using a first-pass method. LVEF was measured using multiple gated blood pool imaging. During the exercise test ECGs remained normal. HR and BP increased significantly (P less than 0.01). RVEF increased from 44% +/- 4 (mean +/- SD) to 60% +/- 6 (P less than 0.001). LVEF increased from 62% +/- 6 to 76 +/- 5 (P less than 0.001). A wider scatter was observed in delta RVEF than in delta LVEF. There was a 14% increase in LVEDV-index and a 14% decrease in LVESV-index (P less than 0.001). A multiple regression analysis with delta RVEF as the dependent variable and delta HR, delta systolic BP, delta LVEF, delta LVEDV-index and LVESV-index as independent variables showed a significant correlation between delta RVEF and delta LVEF and delta systolic BP (P less than 0.05). Our data provide insight into the mechanisms by which the pump performance is increased in normal subjects. The central mechanisms observed are the Starling effect and an increase in contractility of the myocardium. This is connected in the general circulation to an increase in afterload, indicating a redistribution of blood from the vascular beds to the muscles and to the heart. PMID- 6499865 TI - Reference ranges of echocardiographic measurements in the Dutch population. AB - Reference ranges for echocardiographic measurements were determined in 609 healthy Dutch subjects, using height, weight, age, sex, RR-interval and blood pressure (in adults only) as determinants. End-systolic as well as end-diastolic measurements of the aortic root as well as left ventricular inner diameter, posterior and septal thickness were taken, as was the left atrial end-systolic diameter. Multiple linear regression was performed of the form: M = A.(age)B.(height)C.(weight)D.(RR-interval)E.(sex)F. The residuals were calculated in order to determine the percentile limits by means of linear interpolation. Sex and weight were significant determinants in all the echocardiographic parameters studied. The results were presented twofold, with a simple version for males and females separately, using only weight as a determinant and allowing graphical presentation, and secondly a complex version taking into account all determinants, which can only be solved with help of a calculator. PMID- 6499866 TI - Evolution in the treatment of arrhythmias. 22-23 September 1983, Brighton, U.K. PMID- 6499867 TI - Medical versus surgical treatment of tachydysrhythmias. AB - Traditionally, surgical therapy for tachydysrhythmias has been reserved for drug refractory cases. Accordingly, there has been no study comparing medical with surgical therapy in similar groups of patients. Recent developments in surgical therapy for supraventricular and ventricular tachydysrhythmias have resulted in lower morbidity and mortality with good surgical success. In most patients with the Wolff-Parkinson-White syndrome, accessory pathway division can be performed with very low mortality and high chance for success, obviating the need for lifelong drug therapy. Similarly, in patients with life-threatening ventricular tachydysrhythmias, several operative techniques including the encircling endocardial ventriculotomy and subendocardial resection offer an alternative to therapy which often requires frequent dosing with one or more medications, each associated with a significant incidence of adverse effects. These newer operative techniques for both supraventricular and ventricular tachydysrhythmias are challenging the widely held concept that surgery should be reserved only for patients with drug-refractory tachydysrhythmias. PMID- 6499868 TI - Secondary preventive trials with antiarrhythmic agents: are we asking the right question? PMID- 6499869 TI - Automatic analysis of ambulatory ECG records. AB - Fully automatic or semi-automatic analysis of ambulatory ECG records is a method of dealing with the enormous processing problems posed by 24 h surface ECG recording. Successful automation of 'book-keeping' and event detection has been realized, but automation of event diagnosis and presentation of the final report remains problematic. To date, the reliable detection of ventricular ectopic complexes has received much emphasis, but many other features which may reflect the arrhythmia substrate are not routinely analysed. Future developments may require consideration of this area. Regardless of the recording and analysis system, and regardless of the application, human involvement with data interpretation remains indispensable. PMID- 6499870 TI - Induced arrhythmias in clinical decision making. PMID- 6499871 TI - Problems in the treatment of re-entrant arrhythmias: general considerations. PMID- 6499872 TI - Pharmacology of antiarrhythmic drugs for the clinician--medical emergencies and chronic treatment. AB - Optimal treatment with antiarrhythmic drugs poses difficulties both in acute and chronic treatment situations. Knowledge of clinical pharmacology is helpful in both respects in order to obtain rapid antiarrhythmic activity with minimal side effects. The pharmacokinetic and pharmacodynamic profiles of antiarrhythmic drugs show marked interpatient variations which are influenced by age and disease. Therapeutic monitoring of drug concentrations is therefore helpful to ensure optimum therapeutic levels, to reduce the risk of side-effects, to detect non compliance, and to define therapeutic failure. PMID- 6499873 TI - Pre- and in-hospital antiarrhythmic prevention of ventricular fibrillation complicating acute myocardial infarction. AB - Prehospital prevention of primary ventricular fibrillation using 300 mg lidocaine intramuscularly seems to be ineffective in view of the rather low plasma lidocaine levels obtained with this regimen. Preliminary results of 400 mg lidocaine administered by paramedics using an automatic injector are encouraging. In-hospital prevention of primary ventricular fibrillation can be achieved by routine administration of intravenous lidocaine in rather high dosages provided that adequate measures are taken. When, however, recurrent attacks of primary ventricular fibrillation supervene, repeated defibrillation seems to be preferable rather than continuous institution of various antiarrhythmic drugs. PMID- 6499874 TI - Myocardial scintigraphy with 99mTc-tris-DMPE in man. AB - Cardiac scintigraphy was performed in six patients with a documented previous myocardial infarction, in one patient with mitral regurgitation, and in four healthy volunteers following administration of 99mTc-tris-DMPE. An intense early blood pool phase permitted gated blood pool scintigraphy and left ventricular ejection fraction calculation. A myocardial phase 12-14 h later permitted myocardial perfusion imaging. The rest myocardial perfusion image quality with 99mTc-tris-DMPE appeared to be superior to the resting image quality obtained with 99mTc-dichloro-DMPE but was inferior to the resting image quality obtained with 201Tl. PMID- 6499875 TI - Effect of therapy on 24-h subcutaneous blood flow in the leg in patients with severe ischemia. AB - The effect of vascular surgical reconstruction or Buerger's exercises upon average subcutaneous blood flow for a 24-h period was studied in 14 patients with severe leg ischemia due to occlusive arterial disease. Blood flow was estimated proximally in the calf and in the foot by a 133Xe washout technique. Seven patients underwent vascular surgery. Postoperatively subcutaneous blood flow increased in the calf and the foot in all patients except one in whom a decrease in blood flow in the foot was seen. In this case a decrease in systolic blood pressure occurred following the operation. Buerger's exercises did not alter subcutaneous blood flow either in the calf or in the foot in the seven patients studied. Buerger's exercises seem to be of no value for these patients. The measurement of blood flow in subcutaneous tissue over a period of 24 h seems to be a useful test of the effect of different treatments. PMID- 6499876 TI - The utility of radionuclide myelography and cisternography in the progress of cerebrospinal fluid leaks. AB - Three cases of CSF leaks that did not communicate with the body surface were diagnosed and followed using radionuclide myelography or cisternography. The utility and advantages of this definitive diagnostic method are discussed. PMID- 6499877 TI - Scintigraphic localization of a disseminated malignant pheochromocytoma with the use of 131I-meta-iodobenzylguanidine. AB - Preliminary clinical studies with 131I-meta-iodobenzylguanidine, a newly synthesized radiopharmaceutical and guanethidine analog capable of imaging the adrenal medulla, have led to the identification of a case of disseminated malignant pheochromocytoma with the localization of brain and bone metastases. The result is of particular interest as the symptomatology in this case appeared rather equivocal and various investigations had led to a completely different diagnosis. This new scintigraphic technique has proved to be safe, specific and noninvasive, and it may have a clinical application as a complementary or alternative technique to conventional diagnostic tests. PMID- 6499878 TI - 131I uptake in a benign serous cystadenoma of the ovary. AB - A patient with well-differentiated thyroid carcinoma had a whole body scan using 5 mCi 131I which demonstrated abnormal uptake of 131I in a palpable pelvic mass. Approximately 24 years ago the patient had a total thyroidectomy followed by 131I treatment. The histologic examination of the mass was consistent with serous cystadenoma of the ovary. No thyroid tissue or teratoma was identified. The mechanism for the unusual uptake of 131I in a benign ovarian tumor is not clear, and the differential diagnosis of metastatic thyroid cancer is briefly reviewed. PMID- 6499879 TI - [The Strauss-Carpenter Scale: evaluation of its prognostic value for the 5-year outcome of schizophrenic patients]. AB - An adequate prognosis of schizophrenic psychoses cannot be made on the basis of single variables. Therefore prognostic scales combining prognostically relevant items should be tried. The prognostic value of the scale of Strauss and Carpenter, the predictive accuracy of which has been described in the Anglo American literature, was tested in a 5-year follow-up study on patients with schizophrenic or similar psychoses. A high correlation was found between the total score and all outcome criteria. Although many single items reached a high prognostic relevance, the total score of the scale was superior. PMID- 6499880 TI - [Life change events preceding acute psychiatric diseases]. AB - A sample of 112 psychiatric inpatients were examined in comparison to 70 somatic inpatients with respect to the question, how frequent psychiatric diseases were in correlation with stressful life-events. There were significant discrepancies concerning life-event stress between the diagnostic subgroups. The life-event stress was most important in the neurotic patients, also patients suffering from endogenous psychoses, especially schizophrenics, showed an increased life-event stress. Different methods (objective stress scores suggested by Paykel, self rating scores concerning negative experiences, and a synthesis between these two methods) led to similar results. Experiences, rated positive by the patients, showed no correlation with psychiatric diseases. PMID- 6499882 TI - Statistical manoeuvres in the dark. Remarks on "An operationalized multisymptomatic model of neuroses (OMMON): toward a reintegration of diagnosis and treatment in behaviour therapy" by I. Hand and W. Zaworka. PMID- 6499881 TI - [Dexamethasone suppression test: a biologic marker of endogenous depression?]. AB - In the past few years there have been numerous publications, which have stressed the value of the Dexamethasone Suppression Test (DST) as a diagnostic marker of endogenous depression. Our own studies in 333 psychiatric inpatients and 121 healthy subjects did not reveal a differential diagnostic use for the DST. This result is in good agreement with recent results published in the literature. Our own data demonstrate, however, that intervening variables, such as severity of illness, weight loss, sleep disturbances, situational stress, drug and alcohol withdrawal and the pharmacokinetics of dexamethasone, have an important influence on the DST results, regardless of the diagnostic classification. PMID- 6499883 TI - Importance of laboratory clinical investigation in the diagnosis of immune vasculitis with neurological manifestation. AB - In this study 23 cases of immune vasculitis with predominance of neurological symptoms were analysed. Besides patient history and neurological examination, myelotomy is the most relevant means of diagnosis in immune vasculitis. For this reason myelotomy should be integrated in routine diagnostic methods if the diagnosis immune vasculitis is discussed. Other laboratory parameters have no great relevance in the diagnosis of immune vasculitis. A higher specificity of antibody tests, especially in the case of ANA, might be able to replace myelotomy in the diagnosis of immune vasculitis. The relevance of laboratory parameters in the diagnosis of immune vasculitis in neurological patients was examined. PMID- 6499884 TI - Prognosis and outcome in a cohort of patients with non-affective functional psychosis. AB - Over a period of 3 years since the first in a lifetime onset of an episode of non affective functional psychosis a cohort of 82 Dutch patients was studied at set intervals with regard to prognosis and outcome. Prognostic statements on remission, relapse, duration of episode, length of stay in hospital, and occupational, family and overall social adjustment were checked against actual outcome after 1 year. In general, the research team of three psychiatrists, a psychologist and a sociologist began quite optimistically, but became slightly more pessimistic with time. However, their predictions proved hardly better than chance statements. The team appeared to be more pessimistic about the diagnosis of schizophrenia than about that of reactive psychosis, although they were not correct with one diagnostic category more often than with the other. PMID- 6499885 TI - Placement decisions revisited: IQ doesn't always tip the scale. PMID- 6499886 TI - Matching technology to content and learners: a case study. PMID- 6499887 TI - An investigation of mainstream teacher time spent with students labeled learning disabled. PMID- 6499888 TI - Integration of severely handicapped students and the proportion of IEP objectives achieved. PMID- 6499889 TI - Alternatives to age for assessing occupational performance capacity. AB - For the past four decades, the assessment of performance of older workers has commanded considerable discussion but limited systematic investigation from industrial gerontologists. Progress has not been substantial; only recently have they concerned themselves with the legal implications of various personnel assessment strategies. This report is thus a critical examination of the concept of functional age in both psychological and legal arenas. Criticisms of this approach as well as litigation that has arisen from the difficulty of measuring older worker performance via functional age strategies receive special attention. It is suggested that intrinsic attributes serve as the basis for determination of the competence of both older and younger workers. PMID- 6499890 TI - Longitudinal trends in track and field performances. AB - Previous investigation of aging effects in track and field performances has relied on cross-sectional data. In the present study, the shapes were examined of longitudinal performances on age curves from 81 older, elite, male athletes. The mean duration of the longitudinal span was 5.3 years, and performances were obtained from six events. The prediction made was that the performance on age curves would be curvilinear in shape: attenuated decline was predicted for the early portion of the longitudinal span, due to the effects of accumulated training. After quantification of the curves by application of a second-order polynomial model, the prediction was borne out by overall analysis of the equation coefficients. Other findings indicated discrepancies in the shape of the curves between the long jump and running events, and a failure to obtain effects owing to the ages of athletes. PMID- 6499891 TI - Age differences in attributions to causality: implications for intellectual assessment. AB - Negative attributions and failure expectations held by elderly test-takers may be confounding ability-extraneous variables and thus may contribute to lowered intellectual performance. The present study, using the contextualistic model, examined these confounds through experimental manipulation of causal attributions to test outcome in younger and older individuals. Eighty females (40 elderly; 40 younger) were exposed to noncontingent failure (unsolvable test items) and received a verbal massage stating their failure and relating it to either their ability, effort, or no cause. A fourth group exposed to identical failure was not given feedback. Subjects in all four groups for both ages were then administered three solvable intelligence sub-tests: Reasoning, Hidden Patterns, and Paper Folding. Older subjects exhibited significantly lower success expectations and performed more poorly on all three tests. Also, older and younger subjects, in the absence of suggested causal ascription, showed differential performance in the Paper Folding Test. Younger subjects with no experimenter-given cause for failure exhibited facilitation of performance while older subjects' performances, under the same conditions, showed deficits. Results are discussed in reference to attributional style research and the contextualistic viewpoint. PMID- 6499892 TI - Age-related metabolic modifications in male F344 rats. AB - Basal metabolic rate, basal colonic temperature, and response to intraperitoneal injection of tryamine were examined in three age groups: young (3 months), adult (12 months), and old (24 months) of male Fischer 344 rats. Basal metabolic rate of sedentary male F344 rats decreased significantly between 3 months (21.5 ml O2 X kg-1 X min-1) and 1 year (19.4 ml) of age and continued to decrease in the oldest animals (19.0 ml). The decrease between 1 and 2 years was not statistically significant. Basal colonic temperature showed a step-wise significant increase with age. Mean colonic temperature was 36.7 degrees C at 3 months, 37 degrees C at 1 year, and 37.5 degrees C at 2 years. Higher optimal doses of tyramine were required for 1- and 2-year-olds than for 3-month-olds. The optimal dose was 2 mg X kg-1 for 3-month-olds and 5 mg X kg-1 for 1- and 2-year olds. Although the optimal dosages were the same for the 1- and 2-year-olds, 2 year-olds had lower peak response and the response was slower than for the 1-year olds. PMID- 6499893 TI - Social housing of rats: life-span effects on reaction time, exploration, weight, and longevity. AB - Sprague-Dawley rats were housed throughout their lives either in group cages or singly in standard laboratory cages. Locomotor activity was observed at selected ages and, in addition, operant conditioning procedures were used with an extensively trained subset of the animals to study reaction time and fixed ratio responding. The major effect of prolonged isolation was to induce timidity and inactivity during open field and emergence tests. Responding by isolates was depressed relative to socially-housed animals at 13 and 19 months of age although the higher levels of the social animals progressively declined during tests at 19 and 25 months. By comparison, neither housing condition nor age (7 to 25 months) systematically influenced the well-practiced operant responses (response rates, postreinforcement pauses, reaction times, foreperiod responses). A serendipitous finding was that isolated animals tended to die at earlier ages, an outcome that may be related to the fact that isolates also tended to weigh more throughout the experiment. PMID- 6499894 TI - Papaverine disposition in cardiac surgery patients and the effect of cardiopulmonary bypass. AB - Cardiac surgery involving cardiopulmonary bypass (CPB) causes substantial physiologic changes which may potentially alter the pharmacokinetic properties of drugs used during and after the procedure. Studies with fentanyl have implied a relationship between prolonged elimination half-lives following CPB and decreased liver perfusion during and after the procedure. To further test this hypothesis, the effects of CPB on the pharmacokinetics of papaverine, a coronary vasodilator currently being added to the cardioplegic solution to prevent vasospasm, were studied. The drug was given to two groups of patients, one (n = 6) undergoing surgery with and one (n = 5) without CPB, the latter serving as controls. Plasma papaverine concentrations declined biexponentially in the control patients with a mean elimination half-life of 1.30 +/- 0.25 h, total plasma clearance of 13.8 +/- 3.75 ml/min/kg, volume of distribution of 1.52 +/- 0.45 l/kg and volume of distribution, steady-state, of 0.992 +/- 0.530 l/kg. For the CPB group, only half life was estimated, and averaged 2.77 +/- 0.28 h, significantly greater (p less than 0.01) than that in the controls. These results further confirm the increased half-lives seen with other hepatically cleared drugs following CPB and have implications in the clinical management of patients given drugs eliminated in this manner. PMID- 6499895 TI - Crossover comparison of moxonidine and clonidine in mild to moderate hypertension. AB - The antihypertensive effect of moxonidine X HCl X H2O (MOX) was compared with that of clonidine X HCl (CLON) in a randomized double-blind crossover study in 20 hypertensive outpatients (BP range 154-178/96-108 mmHg). After 2 weeks without antihypertensive medication, either MOX 0.2 mg daily or CLON 0.2 mg daily was given and the dose was titrated until the diastolic blood pressure fell below 90 mmHg. The first treatment period was continued for 2 weeks and, after crossover without a wash-out period, it was followed by the second treatment for a further 2 weeks. Within the first 4 days of administration 0.2-0.4 mg of either agent caused a significant decrease in BP (p less than 0.001) from a mean of 166/100 mmHg to 149/86 mmHg after CLON (approx. -10/-14%), and 163/99 mmHg to 146/84 mmHg after MOX (approx. -10/-15%). No significant difference in the fall in BP or pulse rate was detected between the two drugs. In the mean daily dose of 0.3 mg both drugs showed the same antihypertensive activity, but on CLON a higher incidence of side effects (p = 0.003) was noted, and after discontinuation of therapy a more rapid rise in BP (systolic BP p less than 0.01, diastolic BP p less than 0.02) was found. 17 patients on CLON complained of side effects, especially tiredness and dry mouth, whilst only 6 patients on MOX were affected (p = 0.003). PMID- 6499896 TI - Clinical pharmacological studies with the vasodilator endralazine in patients with renal impairment. AB - The influence of renal impairment on the pharmacokinetics of endralazine was studied in 12 patients; 4 patients on regular haemodialysis therapy (creatinine clearance less than 5 ml/min) and 8 patients with varying degrees of renal impairment (creatinine clearance 11-52 ml/min). Following an oral dose of 10 mg endralazine the mean terminal elimination half-life (beta t1/2) in the dialysis sub-group was prolonged at 7.1 h (range 3.3 to 14 h), compared to 3.6 h in the other renal patients (and compared to 2.3 h in hypertensive patients with normal renal function). After one week's therapy with 10 mg B.D. endralazine in the 8 patients with moderate renal impairment there was a significant increase in beta t1/2 to 8.6 h but there was no significant change in the area under the drug concentration-time curve and no evidence of drug accumulation. In this study those patients with the poorest renal function had the longest beta t1/2 after acute dosing. There was a significant correlation between creatinine clearance and acute beta t1/2 but there was considerable variability in individual patients and, even with severe degrees of renal impairment, major dose adjustments do not appear necessary. PMID- 6499897 TI - Actions and interactions of acetylsalicylic acid, salicylic acid and diflunisal on platelet aggregation. AB - Acetylsalicylic acid (ASA) is increasingly employed in the secondary prophylaxis of thromboembolic diseases, due to its capacity to inhibit platelet aggregation. The anti-aggregatory effect of ASA on platelets can be inhibited in vitro by a high concentration of salicylic acid (SA). SA is generated in vivo upon ASA administration, and the SA thus formed might impair the antiplatelet effect of ASA. To assess this possibility, the platelet response to ASA was tested in healthy volunteers before and after medication for 1 week with ASA 1 g t.i.d., with SA 1 g t.i.d., and with the SA derivative diflunisal 0.5 g b.i.d. Pre medication test doses of 1 g ASA always inhibited platelet aggregation in vivo. Neither treatment with SA nor diflunisal, producing plasma steady-state concentrations of about 1.0 and 0.35 mmol/l, respectively, inhibited platelet aggregation. Nor did administration of SA, diflunisal or ASA itself impair the anti-aggregatory effect of a fresh test dose of ASA. ASA inhibited platelet aggregation in vitro at 0.03 mmol/l, whereas SA and diflunisal failed to impair platelet aggregation until concentrations exceeding 2.0 and 0.5 mmol/l, respectively, were reached. These findings make it unlikely that SA formed upon administration of ASA would impair the anti-aggregating capacity of ASA. PMID- 6499898 TI - Increased metabolism to dihydrodigoxin after intake of a microencapsulated formulation of digoxin. AB - A capsule preparation containing small, enteric-coated granules of digoxin was developed to prevent acid hydrolysis of the drug in the stomach and to diminish the variation in plasma glycoside concentration during the intervals between doses. The absorption and metabolism of tritiated digoxin after a single oral loading dose of this formulation (Formulation C) were compared to those after ingestion of a digoxin solution (Formulation S) by 8 healthy men. Drug concentrations were measured by radioimmunoassay (RIA) and liquid chromatography (LC). The percentage of the digoxin dose excreted in the urine during 72 h, as measured by RIA, was significantly lower after the capsule (20.5 +/- 2.0% vs 36.2 +/- 3.0% after S, mean +/- SEM) but total urinary radioactivity after the two treatments was similar (C 35.3 +/- 5.2 and S 41.2 +/- 2.6%; p greater than 0.05). The discrepancy was mainly due to significantly greater excretion of dihydrodigoxin after the capsule (m 12.8%, range 0-28.6% of the dose) than after the digoxin solution (m 5.4%, range 0-14.5%). Dihydrodigoxin was not measured by the RIA. The recovery of hydrolysis metabolites (LC) was greater during the first 24 h after S (2.3 +/- 0.6% vs 0.9 +/- 0.3% after C; p less than 0.05). The peak plasma concentration of digoxin (RIA) was significantly reduced and delayed after intake of C (2.5 +/- 0.4 nmol/l at 3.8 +/- 0.3 h vs. 8.3 +/- 0.8 nmol/l at 0.9 +/ 0.1 h after S), and so was the shortening of electromechanical systole at 1.5 h, 2.5 h, and 3 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499900 TI - Pharmacokinetics of metoprolol in healthy, elderly, non-smoking individuals after a single dose and two weeks of treatment. AB - The effect of long-term treatment on the absorption and disposition of metoprolol has been evaluated in 8 healthy, non-smoking, elderly individuals (mean age 74.5 years) and in a control group of 8 healthy, young individuals. Two trace doses of [3H]metoprolol were given i.v., first concomitantly with a single oral 50 mg dose of cold metoprolol, and second, with the morning dose after 2 weeks of treatment with 50 mg b.d. In the elderly, the mean AUC increased by about 45% (p less than 0.05) over the treatment period, while in the control group the mean AUC was 18% greater (p less than 0.05) on Day 14 than on Day 1. In the elderly, changes both in pre-systemic elimination and in total body clearance accounted for the elevation of the AUC, whereas reduced first-pass effect appeared to be the major cause of the increased steady-state plasma level in the control group. With the exception of the volume term, V beta, the pharmacokinetic parameters were not significantly different between the elderly and the young individuals. For this reason, almost identical steady-state plasma levels were attained in the two groups. The results suggest that age-related physiological changes may have some minor effects on the pharmacokinetics of metoprolol, and also that the changes do not lead to significantly altered plasma concentrations compared to those in young individuals. PMID- 6499899 TI - Ethanol-induced inhibition of hepatic uptake of propranolol in perfused rat liver and in man. AB - Studies were conducted to determine the mechanism whereby ethanol alters the hepatic disposition of propranolol. In eight isolated perfused rat livers, ethanol (mean = 40.1 mmol/l diminished the clearance of dl-propranolol (1.93 +/- 0.43 to 1.24 +/- 0.22 ml/min/g liver, p less than 0.05); increased its t1/2 (12.8 +/- 1.5 to 20.7 +/- 3.25 min, p less than 0.01); and decreased the proportion metabolized (68.7 +/- 4.7% to 34.3 +/- 10.3%, p less than 0.01). These results suggest that ethanol could substantially increase the oral bioavailability of propranolol in humans. However, in normal human volunteers administered 80 mg of propranolol orally, alone, or preceded and followed by ethanol to maintain breath ethanol concentrations of 800-1000 mg/l, increases in propranolol AUC were smaller than anticipated. Seven subjects had increases in free propranolol AUC0 8h (32%, range: 12-61%) (p less than 0.05), while total propranolol AUC0-8h increased by a mean 22% (range: -4-+49%). Propranolol free fraction varied with time and was higher after ethanol (mean = 0.090 vs 0.084) (p less than 0.077). The extent of the propranolol-induced slowing of heart rate was not influenced by ethanol (mean decrease from baseline of 13 bpm at peak propranolol effect vs 9 bpm without ethanol); mean heart rates following propranolol with ethanol were higher at all times (mean of 7.5 bpm) (p less than 0.001) than after propranolol alone. Ethanol inhibits the hepatic oxidative metabolism of propranolol in vitro; however, any effect on heart rate of higher concentrations of propranolol induced by ethanol in humans is offset by the cardio-acceleratory effect of ethanol. PMID- 6499901 TI - Pharmacokinetics of meptazinol after single and multiple oral administration to elderly patients. AB - Oral administration of meptazinol (200 mg Meptid) to male and female geriatric patients (greater than 70 years) resulted in rapid absorption, with peak drug concentrations at 0.5 to 3 h after dosage. Subsequent elimination also proceeded rapidly with a half-life of 3.39 h (+/- 0.26 SEM) after a single dose and 4.97 h (+/- 0.80 SEM) after 13 consecutive 6-h doses. These values were not statistically different. There was no accumulation of meptazinol above that expected from the single-dose kinetics. Plasma protein binding of meptazinol was 33.8% (+/- 0.74 SEM). No sex difference was apparent in any of the pharmacokinetic parameters determined. Comparison of these results with those obtained in an earlier study in young volunteers showed that although the half life of meptazinol was somewhat longer than the value of 2 h seen in the young, peak plasma concentrations after single and multiple dosing were similar for both age groups, implying that clearance remained largely unaltered. It was concluded that there was no pharmacokinetic basis for recommending a reduction in dosage when treating elderly patients with oral meptazinol. PMID- 6499902 TI - Effect of cimetidine on the metabolism of cholephilic dyes in Gilbert's syndrome. AB - The metabolism of indocyanine green, bromsulphophthalein and bilirubin was studied before and after a treatment for 2 weeks with cimetidine 1.0 g/day in 12 subjects with Gilbert's syndrome. There was no effect on the plasma clearance of indocyanine green and bromsulphophthalein, on the maximal biliary excretion capacity of bromsulphophthalein, on serum bilirubin concentrations or on the biliary metabolites of bromsulphophthalein and bilirubin. It is concluded that in Gilbert's syndrome two weeks of treatment with cimetidine had no effect on liver blood flow or on conjugation mechanisms which were independent of cytochrome P450. PMID- 6499903 TI - Drug utilization in paediatrics: non-medical factors affecting decision making by prescribers. AB - The study was done to show that in certain areas of paediatric pharmacotherapy unexpected discrepancies may arise between accepted therapeutic principles and the actual behaviour of a prescribing doctor. The first example was of a great reduction in penicillin use in a university teaching hospital after certain therapeutic accidents: in one year, there were 2 fatal cases of rhabdomyolysis due to use of procaine benzyl-penicillin. Other antimicrobial drugs inferior to penicillin, such as lincomycin and sulphonamides, replaced penicillins. The second example showed the inverse relationship between the use of antitussives and other drugs in symptomatic treatment of respiratory diseases in outpatients and inpatients; the pressure of unduly optimistic expectations of therapy imposes a high prescribing rate of these drugs in the outpatient population, in contrast to hospitalized patients, whose doctors, being spared such pressure, prescribe antitussives far less often. The third example demonstrates the possibility of inadequate education in the use of antimicrobial drugs. Although doctors from regional hospitals receive their training at an university hospital, they tend to prescribe chloramphenicol ten times more per bed-day than their colleagues in an university hospital. In terms of the cost/effectiveness ratio, a high prescribing rate of cephalosporins is not economically favourable in a university teaching hospital. It is also shown that studies of drug utilization in children are feasible if age--appropriate adaptation of the statistical value expressed as the defined daily dose is performed. The adaptation was evaluated by comparing pharmacy-based drug consumption data expressed in "paediatric defined daily doses", with actual days of treatment with particular drugs, i.e. data from patient records for 244 beds in the University Teaching Hospital. PMID- 6499904 TI - Lack of effect of haemodialysis on mebendazole kinetics: studies in a patient with echinococcosis and renal failure. AB - The effect of haemodialysis on mebendazole kinetics has been studied in a patient receiving both mebendazole therapy and haemodialysis. The procedure of haemodialysis did not influence the plasma concentration-time profiles or the mean daily plasma levels. The arterio-venous difference in the dialyser was negligible and no mebendazole could be detected in the dialysate. Protein binding of mebendazole was 90% before dialysis and 88% during dialysis and not significantly different from the binding in patients without renal disease (91.4 +/- 1.9%, n = 22). PMID- 6499905 TI - Pharmacokinetics of oral indoramin in elderly and middle-aged female volunteers. AB - Indoramin was administered as a single 50 mg oral tablet to 5 elderly (aged 68-71 years) and 6 middle-aged (aged 46-55 years) healthy female volunteers. The mean half life of indoramin in elderly subjects (14.7 +/- 4.8 h, mean +/- SEM) was statistically significantly longer than that seen in middle-aged subjects (5.1 +/ 1.0 h). The mean plasma concentrations of indoramin and mean area under the plasma concentration/time curve were also greater in elderly than in middle-aged subjects, although this did not achieve statistical significance. In many elderly patients, therefore, a reduction in dosage may be required due to the apparent reduction in clearance of indoramin. However, because of the wide inter-subject variability observed in the oral pharmacokinetics of indoramin, individual titration of indoramin dosage in all patients may be desirable. PMID- 6499906 TI - Influence of antacids on the bioavailability of trimoprostil. PMID- 6499907 TI - The D segment defines the T15 idiotype: the immunoresponse of A/J mice to Pneumococcus pneumoniae. AB - In the immune response of BALB/c mice (Igha) to Pneumococcus the majority of antibodies express the idiotype of the myeloma protein TEPC 15 (T15). In contrast mice of the A/J strain (Ighe) do not express this idiotype. Using (BALB/c X A/J)F1, F2 or backcross mice it could be shown that in allotype heterozygous animals (Igha/e) Pneumococcus pneumoniae preferentially stimulates B cells expressing a heavy chain (H) encoded by genes in the BALB/c H chain gene complex. Phosphorylcholine (PC)-specific hybridoma lines were established from BALB/c and A/J spleen cells and idiotypically analyzed using monoclonal antibodies (mAb) specific for the T15 idiotopes 32/65, 10/13, 16/13 or 21A5. Whereas the majority of the BALB/c PC-binding mAb express these idiotopes, only some of the A/J mAb are positive for one or the other of the idiotopes formed by the variable (V) regions of the H and the light chain of the myeloma protein T15. However, 80% of the A/J PC-binding hybridoma proteins were bound by the anti-idiotopic mAb 21A5. This mAb is specific for a determinant partially formed by the C alpha and partially by the V regions of the myeloma protein T15. The mRNA of one of these T15- A/J PC-binding hybridoma lines was sequenced. VH and V kappa were identical with sequences found for BALB/c T15-like antibodies. The sequence of the D segment was structurally very different. The importance of the D segment in the dominant expression of the T15 idiotype is discussed. PMID- 6499908 TI - Beneficial effect of cyclosporin A on the lymphocytic choriomeningitis virus infection in mice. AB - The effect of cyclosporin A on the course of lymphocytic choriomeningitis virus infection in mice was investigated. Evidence is presented that administration of this immunosuppressive drug spares a majority of lethally infected mice. This beneficial effect is different from the one obtained with other treatments leading to the abolition of T cell functions. Surviving animals rapidly eliminate the virus and produce high titers of neutralizing IgG antibodies. PMID- 6499909 TI - Responses of isolated canine intermediate auricular arteries to 5 hydroxytryptamine and methysergide. AB - The responses of the isolated canine intermediate auricular arteries to 5 hydroxytryptamine (5-HT), methysergide, norepinephrine (NE) and potassium chloride (KCl) were examined by means of the 'cannula inserting' method. 5-HT produced dose-dependent vasoconstriction more potently than did NE. The effect was blocked by methysergide, i.e. a small dose of methysergide competitively inhibited the 5-HT-induced effect, and a large amount of methysergide inhibited it non-competitively. The 5-HT-induced constriction was slightly but significantly suppressed by phentolamine in doses which markedly blocked NE induced effects. KCl-induced effects were not significantly affected by methysergide and phentolamine treatment. Methysergide induced vasoconstriction by itself in about half out of all preparations. In cases in which methysergide induced vasoconstriction, the dose-response curves were bell-shaped and the constriction became smaller with large doses. At small doses, methysergide induced reproducible vasoconstriction but at large doses it readily caused tachyphylaxis. The methysergide-induced constriction was not blocked by 1 microgram of phentolamine which inhibited NE-induced constriction. It is concluded that the canine intermediate auricular artery is very sensitive to 5-HT and methysergide, and that the action of 5-HT may partially involve alpha adrenergic mechanisms. PMID- 6499910 TI - Naltrexone-reversible effects of flunitrazepam on locomotor activity and passive avoidance behaviour in mice. AB - Some behavioural effects of flunitrazepam were investigated in two sets of experiments in C57BL/6 mice. In the first set, flunitrazepam administration (0.025 or 0.05 mg/kg) enhanced the locomotor activity of mice. In the second set, memory impairments were observed following posttraining (immediately or 30 min, but not 60 min) treatment with the drug (0.05 mg/kg). All effects were antagonized by a per se ineffective dose of naltrexone (0.5 mg/kg for the activity, 0.1 mg/kg for the memory experiments), suggesting the involvement of opioid receptors. The results are discussed on the basis of recent evidence suggesting a link between benzodiazepine and opiate mechanisms of action. PMID- 6499911 TI - Acute systemic and regional haemodynamic profile of prazosin in conscious hypertensive rabbits. AB - We used the radioactive microsphere technique to study the acute systemic and regional haemodynamic effects of prazosin (0.01, 0.03 and 0.10 mg/kg i.v.) in conscious hypertensive rabbits. The alpha 1-adrenoceptor antagonist decreased arterial blood pressure dose dependently and increased the heart rate. There was a reduction in stroke volume which resulted in a significant fall in cardiac output at the highest dose of prazosin. Due to the prazosin-induced vasodilatation in the kidneys, intestines and bones, the blood flow to these tissues was not reduced despite the decrease in cardiac output. In contrast, a reduction in the blood flow to the skeletal muscles, skin and, at the highest dose, to the heart, brain and stomach followed prazosin administration. In conclusion, the selective vasodilatation produced by prazosin causes a redistribution of the cardiac output at the expense of vital organs such as the brain, and this finding may possibly explain the symptoms related to the "first dose phenomenon" of prazosin in man. PMID- 6499912 TI - Nifedipine on cardiovascular leukotriene D4 actions in the anaesthetized dog. AB - Open-chest dogs were used to study the effects of intracoronary leukotriene (LTD4; 0.5 microgram/kg) on haemodynamics, coronary blood flow in the left circumflex artery and coronary resistance in the absence or presence of nifedipine (10 micrograms/kg, i.v.). LTD4 increased ventricular filling pressure by 133% (P less than 0.001), the S-T segments and coronary resistance by 490% (P less than 0.001) and abolished coronary flow for 3 min. Nifedipine pretreatment inhibited the cessation of coronary flow. No change in filling pressure and no ischemia signs in the peripheral ECG were noted. However, nifedipine did not inhibit the LTD4-induced decrease in left ventricular dP/dtmax. Haemodynamic LTD4 actions thus could be partially reversed by i.v. nifedipine, suggesting that leukotriene effects on the coronary and peripheral circulation are mediated by calcium release. PMID- 6499913 TI - Effect of strychnine on the contractile response of rat vas deferens. AB - Strychnine at concentrations of 0.1 approximately 1.0 microM induced supersensitivity of rat vas deferens to alpha-agonists but not to other stimulants. Strychnine-treatment resulted in an increase in the number of alpha adrenoceptors, determined by measuring the binding of [3H]prazosin. Glycine did not have any significant effect on the contracture and did not antagonize the action of strychnine. Thus, specific supersensitivity of alpha-adrenergic system was induced by treatment with low concentrations of strychnine. PMID- 6499914 TI - Increased behavioural response to 5-methoxy-N,N-dimethyltryptamine but not to RU 24969 after intraventricular 5,7-dihydroxytryptamine administration. AB - Chemical lesioning of the 5-hydroxytryptamine neurones in the brain with 5,7 dihydroxytryptamine (200 micrograms i.c.v., 14 or 21 days previously) resulted in an enhanced behavioral response following administration of the 5 hydroxytryptamine receptor agonist 5-methoxy-N,N-dimethyltryptamine (2.5 mg/kg). The increase in the behavioural response showed a positive correlation with the decrease in whole brain 5-hydroxytryptamine levels. In contrast, there was no increase in the hyperlocomotion produced by the 5HT1 receptor agonist RU-24969 (3.5 mg/kg). The results are discussed in relation to the proposed 5 hydroxytryptamine receptor subtypes. PMID- 6499916 TI - Autoradiographic demonstration of 5HT1 binding sites in the primate basal nucleus of Meynert. PMID- 6499915 TI - Diazepam-stimulated increases in the synaptosomal uptake of 45Ca2+: reversal by dihydropyridine calcium channel antagonists. AB - Pharmacologically relevant concentrations of benzodiazepines have previously been reported to increase 45Ca2+ uptake into synaptosomes. This observation, coupled with the recent report that nifedipine may block the hypnotic effect of flurazepam, led us to study the effects of nifedipine and nitrendipine on 45Ca2+ uptake into synaptosomes. Diazepam (1 microM) significantly increased the uptake of 45Ca2+ to a crude synaptosomal fraction (P2) prepared from rat cerebral cortex and depolarized with 55 mM K+. Nifedipine (1 microM) did not alter the uptake of Ca2+, while nitrendipine (1 microM) reduced uptake by 37%. Both nifedipine and nitrendipine completely antagonized the ability of diazepam to increase 45Ca2+ uptake following K+ depolarization. These observations support the notion that the pharmacologic actions of benzodiazepines may be mediated through effects on a calcium channel. PMID- 6499917 TI - Increased sensitivity of rabbit carotid body chemoreceptors to dopamine after chronic treatment with domperidone. AB - An increase in specific dopamine D2 receptor binding sites was observed in membranes prepared from the carotid bodies of rabbits treated for 8 weeks and then withdrawn for 4-9 days from the D2 antagonist domperidone (2-5 mg/kg per day). Recordings of chemoreceptor afferent discharge from the carotid body also revealed that this change in receptor density was accompanied by an increased sensitivity to the chemodepressant effects of exogenous dopamine. The chemoreceptor responsiveness of the carotid body to hypoxia is blunted in rabbits treated chronically with domperidone, but this can be restored to normal by an acute dose of the D2 antagonist. These experiments provide evidence that is compatible with a chemo-inhibitory role for endogenous dopamine in the rabbit's carotid body. Furthermore, these results suggest that the carotid body provides a useful model for the functional studies of dopamine D2 receptors. PMID- 6499918 TI - Behavioural and convulsant actions of two methyl esters of beta-carboline-3 carboxylic acid in photosensitive baboons and in DBA/2 mice. AB - The proconvulsant and convulsant actions of methyl 6,7-dimethoxy-4-ethyl-beta carboline-3-carboxylate (DMCM) and of methyl-beta-carboline-3-carboxylate (beta CCM) have been evaluated in two animal models of reflex epilepsy, the photosensitive baboon, Papio papio, and the audiogenic seizure prone DBA/2 mouse. In baboons, myoclonic responses to photic stimulation are markedly enhanced 1 min after DMCM, 0.25 mg/kg i.v. In the absence of photic stimulation DMCM, 0.5 mg/kg i.v. induces a single brief tonic clonic seizure within 10-90 s. beta-CCM, 0.025 0.05 mg/kg i.v. similarly enhances myoclonic responses to photic stimulation. Generalised seizures occur without photic stimulation 0.5-3 min after beta-CCM, 0.1-0.2 mg/kg. Pretreatment with the excitatory amino acid antagonist, 2-amino-7 phosphonoheptanoic acid (2-APH), 110 mg/kg i.v., prevents the generalised seizures induced by DMCM, 0.5 mg/kg, but not those induced by beta-CCM, 0.1-0.2 mg/kg. In DBA/2 mice beta-CCM and DMCM are indistinguishable in potency as convulsants (ED50 values for clonic seizures: 4.4 and 4.6 mg/kg i.p. respectively) and as proconvulsants (ED50 values for facilitation of clonic seizure responses to an 83 dB sound stimulus: 0.25 and 0.23 mg/kg). Pretreatment with 2-APH gives equipotent protection against audiogenic seizures induced by beta-CCM, 1 mg/kg or DMCM, 1 mg/kg. The differences in relative potency of beta CCM and DMCM in the two species are probably accountable for in terms of differing metabolism. A differential action of the two beta-carbolines on receptor subtypes, with enhancement of excitatory amino acid release playing a more important role in epileptogenesis after DMCM, is proposed. PMID- 6499919 TI - Seizure thresholds and their postictal changes in audiogenic seizure (AGS) susceptible rats. AB - The convulsive thresholds for bicuculline and electroshock seizures were studied in audiogenic seizure (AGS)-susceptible and control rats. Electroshock seizure thresholds, determined as the amperage necessary to cause tonic extension of the hindlegs in 50% of the rats (CC50 = convulsive current fifty) were markedly lowered in rats of two stocks, bred for AGS susceptibility. During the clonic phase of electroshock seizure the bicuculline threshold was slightly lowered but started to rise after the convulsion had ceased. After 5 min, the threshold was significantly elevated and the maximal increase was reached in 15 min. In control rats the level normalized curvilinearly within an hour, but in AGS rats it decreased more slowly and was still elevated after 90 min. After an audiogenic seizure, the threshold for bicuculline-induced seizures in AGS rats also rose significantly but declined rapidly after having reached a maximum at 15 min. This rise in seizure threshold for bicuculline might indicate a postictal change in GABAergic transmission. PMID- 6499921 TI - Attenuation of pharmacological effects and increased metabolism of phencyclidine in morphine tolerant mice. AB - Mice were used for a study of the interaction between morphine and phencyclidine (PCP) in relation to lethality, motor incoordination, locomotor activity and rearing, together with the half-life of PCP, following continuous administration of morphine by pellet (75 mg base) implantation for 72 h and after removal of the pellets for 6 and 24 h. PCP induced motor incoordination and suppressed locomotor activity and rearing; these effects were enhanced in morphine 'pellet-implanted' mice and were attenuated in morphine 'pellet-removed' groups. The enhancing effect of morphine on the PCP responses was attributable more to the presence of residual morphine than to the alterations in its disposition. The morphine induced increase in locomotor activity and analgesia was attenuated in PCP (40 mg/kg per day i.p. for 5 days) tolerant mice. The rate of decay of PCP in serum and brain or morphine pellet-implanted animals was not different; however, in the 24 h 'pellet-removed' group, the rate of decay of PCP was increased. The results indicate that there is a two-way cross-tolerance development between PCP and morphine. The phenomenon appears to involve both dispositional and functional adaptation mechanisms. PMID- 6499920 TI - Cardiovascular characterization of UL-FS 49, 1,3,4,5-tetrahydro-7,8-dimethoxy-3 [3-][2-(3,4-dimethoxyphenyl)ethyl] methylimino]propyl]-2H-3-benzazepin-2-on hydrochloride, a new "specific bradycardic agent". AB - UL-FS 49, a chemical congener of AQ-A 39 with structural similarities to verapamil, decreased the rate of spontaneously beating guinea-pig atria at much lower concentrations (effective concentration 30%, EC30 = 0.030 microgram/ml) than it decreased the contractility (2.5 Hz; EC30 = 108 micrograms/ml) and maximal driving frequency (EC30 = 11 micrograms/ml) in electrically driven atria. In comparable experiments AQ-A 39 was much less effective, the EC30 for the negative chronotropic effect being 0.61 microgram/ml. In rabbit aortic strips in the presence of 43 mM K+ and 1.8 mM Ca2+, UL-FS 49 relaxed contraction by 30% at 15 micrograms/ml. In contrast to UL-FS 49, several "Ca2+-antagonists" elicited aortic relaxation at lower concentrations than bradycardia. In anaesthetized cats (n = 6) 0.3 mg/kg i.v., UL-FS 49 increased the cardiac cycle length by 56 +/- 3.5% (S.E.), there were slight or no changes in blood pressure and ECG intervals PQ and QRS. ST and the effective refractory period (ERP), as determined by R triggered extrastimuli in the right ventricle, were prolonged by 28 +/- 3.1% and 24 +/- 2.5% respectively. At comparable increases in cycle length AQ-A 39 prolonged ST and ERP significantly more than UL-FS 49. In isolated guinea-pig atria UL-FS 49 antagonized the carbachol-induced bradycardia; a 10-fold shift of the dose-response curve (CA10) was achieved with 11.3 micrograms/ml and the CA10 for AQ-A 39 was 1.7 micrograms/ml. In conscious dogs UL-FS 49, 1 mg/kg i.v., decreased the heart rate without changes in blood pressure. This was observed in dogs with both genuine sinus rate and heart rate elevated by either atropine or hydralazine. The bradycardic effect was positively correlated with the control heart rate. In conclusion, sinus bradycardia was the most prominent action of UL FS 49 in isolated preparations as well as in intact animals. In comparison to its congener AQ-A 39, UL-FS 49 was more potent in lowering heart rate but less effective in prolonging repolarization time and in anticholinergic activity. It thus represents a new specific bradycardic agent. PMID- 6499922 TI - Correlation of [3H]5-hydroxytryptamine (5HT) binding to brain stem preparations and the production and prevention of myoclonus in guinea pig by 5HT agonists and antagonists. AB - In guinea pig brain stem preparations [3H]5-hydroxytryptamine (5HT) bound specifically to both high and low affinity sites, but specific [3H]spiperone binding was low and could not be consistently detected. This indicates a prevalence of 5HT-1 type receptors in this tissue. High affinity-specific [3H]5HT binding was more potently displaced by indole-containing 5HT agonists than by piperazine-containing 5HT agonists. This agreed with the observation that indole containing, but not piperazine-containing compounds induced dose-dependent myoclonus in guinea pigs which originates from brain stem. The capacity of indoleamine antagonists to displace [3H]5HT-specific binding from guinea pig brain stem was similar to their reported potency in displacing [3H]5HT from 5HT-1 receptors. The [3H]5HT-labelled binding site in guinea pig brain stem is a 5HT-1 receptor and appears to be responsible for the induction of indoleamine-dependent myoclonus. PMID- 6499923 TI - Synthesis and biological activity of carboxy verapamil, a new derivative of verapamil. AB - New analogues of the calcium antagonist verapamil (alpha-isopropyl-alpha-[(N methyl-N-homoveratryl)-gamma-aminopropy l] -3,4-dimethylphenyl acetonitrile) were synthesized. Carboxy verapamil (alpha-isopropyl-alpha-[(N-methyl-N-homoveratryl) gamma -aminopropyl]-3,4-dimethylphenyl acetic acid) was prepared by hydrolysis of the nitrile group of verapamil. Derivatives of carboxy verapamil could be synthesized by coupling substituents onto the carboxylic acid moiety. All syntheses can be prepared on a microscale. The biological activity of carboxy verapamil was compared with that of verapamil by testing their ability to block the isoproterenol-induced slow action potential (APs) in guinea pig papillary muscle. Carboxy verapamil was about 10-fold less potent than verapamil in blocking the slow APs. The IC50 for carboxy verapamil was about 6 X 10(-6) M. Furthermore both drugs had a similar frequency dependency. The effects of carboxy verapamil were rapidly reversed upon washout, suggesting that this drug may act on the external surface of the myocardial plasma membrane. In contrast, verapamil induced effects are slowly reversed upon washout and it may exert is primary effects on the inner surface of the plasma membrane. Carboxy verapamil, because of its dipolar charge character may not readily penetrate into myocardial cells. PMID- 6499925 TI - Antagonism by ketanserin of 5-HT-induced vasoconstriction unmasks a 5-HT-induced vasodilation. AB - The effect of ketanserin on the action of 5-hydroxytryptamine (5-HT) and noradrenaline has been studied using the rat isolated perfused mesentery preparation. Both 5-HT and noradrenaline produced constriction in the mesenteric vessels. The responses to 5-HT and noradrenaline were greater in tissues from hypertensive animals. Responses to 5-HT were abolished by 1 nM ketanserin. Ketanserin was found to be a competitive antagonist of the noradrenaline-induced constrictions (pA2 = 7.5). In partially constricted tissues, 5-HT induced vasoconstriction and vasodilation. In the presence of ketanserin the vasoconstriction was reduced and the 5-HT-induced vasodilation was potentiated. The amount of potentiation of the 5-HT-induced vasodilation by ketanserin was similar in tissues from normotensive and hypertensive rats. It is suggested that the 5-HT-induced vasoconstriction is mediated by activation of 5-HT2 receptors. In the presence of ketanserin, the 5-HT2 receptor mediated vasoconstriction is antagonized, unmasking a 5-HT-induced vasodilation. PMID- 6499924 TI - Blockade by antidepressants and related compounds of biogenic amine uptake into rat brain synaptosomes: most antidepressants selectively block norepinephrine uptake. AB - Inhibitor constants (Ki's) for blocking uptake of [3H]norepinephrine, [3H]serotonin, and [3H]dopamine into synaptosomal preparations of rat brain were determined for 25 antidepressants and putative antidepressants, some neuroleptics, stimulants, antihistamines and other monoamines. With Ki's we could directly and definitively compare the relative potencies of a drug at the three processes. Eighteen or 72% of the antidepressants (including tertiary amine tricyclics) were more potent at blocking uptake of norepinephrine than at blocking uptake of serotonin. Considering all three biogenic amines, 17 antidepressants were selective for blocking [3H]norepinephrine uptake, one (bupropion) was selective although weak for blocking [3H]dopamine uptake, and the remainder were selective for blocking [3H]serotonin uptake. The neuroleptics chlorpromazine and promazine were relatively potent at blocking uptake of [3H]norepinephrine and some tricyclic antidepressants (notably, trimipramine and butriptyline) were very weak at blocking any biogenic amine uptake. PMID- 6499926 TI - Effects of fentanyl on a bradykinin-induced excitatory cardiac reflex in the anaesthetized rat. AB - A reflex increase in arterial blood pressure and heart rate was elicited by application of epicardial bradykinin (4 X 10(-8), 2 X 10(-7), 10(-6) g/ml) in pentobarbital-anaesthetized, thoracotomized rats. The influence of the opioid fentanyl and the tranquilizer diazepam on this increase was then investigated. When fentanyl (2.2 micrograms/(kg X min] was infused i.v. during periods of bradykinin application, a highly significant suppression of the excitatory reflex resulted. Epicardial bradykinin (10(-6) g/ml) induced an increase in mean arterial blood pressure of 25.3 +/- 3.5 mm Hg during the control period and of 6.8 +/- 1.4 mm Hg during fentanyl infusion. The corresponding changes in heart rate were +20.8 +/- 4.7 beats/min during the control period and +1.9 +/- 1.3 beats/min during fentanyl infusion. When cardioacceleration was induced by the carotid occlusion reflex, fentanyl antagonized this effect too. The effect of fentanyl was entirely neutralized by injecting naloxone (30 micrograms/kg i.v.) prior to application of the former. Diazepam had no influence on the bradykinin induced reflex. The results support the view that morphinoceptors may modulate the excitatory cardiac reflex induced by epicardial application of the algesic bradykinin in the rat. PMID- 6499927 TI - Tetrodotoxin-resistant response to nicotine in rabbit bronchial preparation. AB - The mode of action of nicotine was studied in a rabbit bronchial preparation. Nicotine (3 X 10(-5)-10(-3) M) produced a phasic contraction. No inhibitory response to nicotine was observed. The contractile response to nicotine was inhibited by hexamethonium, pentolinium and atropine but not by tetrodotoxin. Nicotine increased the efflux of tritium from preparations which had been labelled with [3H]choline. Tetrodotoxin did not inhibit the nicotine-evoked tritium release from the bronchial preparation. The results indicate that the release of acetylcholine evoked by nicotine was not influenced by tetrodotoxin in this preparation, and that the nicotine-induced response may be produced mainly through a sodium action potential-independent process. We could not rule out a contribution by acetylcholine released from the acetylcholine store in the smooth muscle in the contractile mechanisms for nicotine. PMID- 6499928 TI - Subarachnoid injection of salmon calcitonin does not induce analgesia in rats. AB - It has been proposed that the polypeptide calcitonin (CT) occurs in the central nervous system and may have a neuromodulatory role in endogenous pain relief pathways. However, recent results suggest that CT is not present in the central nervous system. Intrathecal (IT) injection of CT on the lumbar enlargement of rats caused a reversible increase of the hindpaw lick latency in the hot plate test. No analgesia was observed with the vocalization test to electrical stimulation of the tail. In contrast 10 micrograms morphine hydrochloride IT caused analgesia in both tests. It is concluded that IT CT does not cause analgesia, but has a reversible blocking effect on motor responses. PMID- 6499929 TI - Ketanserin alters [3H]serotonin uptake and release in rat hypothalamus. AB - Ketanserin, a serotonin2 receptor antagonist, evoked a dose-related non-calcium dependent release of tritium from slices of rat hypothalamus preloaded with [3H]serotonin. Concentrations of 1, 5 and 10 microM ketanserin caused a 0.5%, 64% and 110% increase, respectively, in tritium release. Chlorimipramine, a potent inhibitor of the serotonin uptake mechanism, did not alter the spontaneous release of tritium. In addition, 5 microM ketanserin reduced high affinity uptake of 0.1 microM [3H]serotonin into rat hypothalamus slices by 36%. These data suggest ketanserin possesses 'amphetamine-like' releasing activity and an uptake inhibitory action on serotonin nerve terminals. Both of these properties could mask 5-HT receptor antagonism in vitro and in vivo. PMID- 6499930 TI - Estrogens antagonize apomorphine-induced yawning in rats. AB - The administration of a small dose of apomorphine (50 micrograms/kg s.c.) induced repeated episodes of yawning in male rats. Short-term (3 days) treatment with 17 beta-estradiol antagonized apomorphine-induced yawning in male rats. Moreover, apomorphine induced yawning much less effectively in female than in male rats. These results suggest that both endogenous or exogenously administered estrogens induce subsensitivity of the DA receptors mediating yawning in rats. PMID- 6499931 TI - A dopamine D2 receptor photolabel: azidoclebopride. PMID- 6499932 TI - [The effect of the age factor on open-field behavior in rats]. AB - We examined the age-related behavior under open-field conditions using 925 Wistar Imamichi rats of both sex ranging 21 to 695 days old. The mean score of ambulation and rearing increased between 28-56 days old, and both decreased after those ages. The coefficients of variation were stable and kept minimum values between 28-98 days old. Other parameters, except for ambulation and rearing, did not show the age-related change. Each parameter was divided into 3 one-minute values in order to detect the change in minutes after exposure in open-field conditions. The chronological change in each behavioral parameter has its own specific pattern regardless of age and sex. Namely, it has been proved that a rat has an invariable natural behavioral pattern with regard to a time course in open field conditions. It is important to detect a change of chronological pattern in each parameter, because an abnormal subject would be identified by an appearance of change in the chronological pattern. Sexual difference also was identified in all ages. It is necessary to evaluate separately parameters depending on sexual difference. PMID- 6499934 TI - Changes of bone marrow cell and peripheral blood cell counts in newborn mice. AB - Differential bone marrow cell and peripheral blood cell counts in new-born mice from zero to twenty-one days of age were investigated. In the bone marrow, erythroblasts rapidly increased whereas granulocytic cells decreased with time. The G/E ratio was 6.7 on day zero and 0.5 on day four, and as the G/E ratio of adult mice is normally from 0.8 to 2.4, these values would be the highest and lowest respectively for the whole life span of a mouse. In the peripheral blood, MCV decreased each day, closely matching the changes in the Price-Jones curves. The results of erythrocyte area measurements indicate that the larger the erythrocyte area, the earlier in days of age it disappeared and the shorter its life span. PMID- 6499933 TI - [Morphological observations on the cranial and facial bones of the crab-eating monkey]. AB - Forty seven skulls of the crab-eating monkey (Macaca fascicularis) were investigated for their morphological characteristics. Five of them were disintegrated into component bones by the use of the papain. Each cranial and facial bone of this species resembled that of the rhesus monkey (M. mulatta) in its general morphology. Some obvious differences, however, were noticed in the detailed structure of the skulls between these two species. The uncinate process of the ethmoid bone was found in the rhesus monkey but was not found in the crab eating monkey. The intrajugular process of the temporal and occipital bones was present in the crab-eating monkey but absent in the rhesus monkey. The nasal process of the incisor bone was sutured with frontal bone in the rhesus monkey but was not sutured with that bone in the crab-eating monkey. PMID- 6499935 TI - Assessment of mouse strain on bacterial translocation from the gastrointestinal tract. AB - The translocation of indigenous bacteria from the gastrointestinal tract to the mesenteric lymphnodes was compared in ten strains of mice. Indigenous Escherichia coli were cultured from the mesenteric lymphnodes of only two of the six mouse strains examined. Thus, spontaneous translocation of indigenous enteric bacteria across the intestinal barrier did not occur to any significant extent in any of the mouse strains examined. Since bacterial overgrowth in the gastrointestinal tract promotes bacterial translocation, bacterial translocation was tested in ten mouse strains including B10 series after antibiotic-decontaminated and subsequent colonization with streptomycin-resistant E. coli C25. E. coli C25 populated the ceca of the mice at levels of 10(8) to 10(9) per gram and translocated to 90-100% of the mesenteric lymphnodes with mean of 10(1.13) to 10(1.86) per mesenteric lymphnode. However, there were no significant differences between mouse strains as to the translocation incidence or the numbers of viable E. coli C25 per mesenteric lymphnode. Thus, genetic differences between mouse strains did not influence bacterial translocation from the gastrointestinal tract to the mesenteric lymphnodes. PMID- 6499936 TI - [A problem on the uric acid value of rats for clinical evaluation]. AB - Routine monitoring on levels of serum uric acid in the rats has been widely employed as an important factor in the nucleic acid metabolism, despite of the presence of the uricase in them. In this paper, it is confirmed that the levels of allantoin in serum and urine of the normal rats were higher than those of uric acid. Therefore, the concentration of allantoin in serum and urine of the rats with abnormal nucleic acid metabolism caused by adenine administration were measured. The results indicated that the value of serum allantoin was more sensitive to abnormal nucleic acid metabolism. PMID- 6499937 TI - [Giardiasis in guinea pigs: a case report]. AB - During the quarantine of 15 guinea pigs acquired from a breeder in February 1983, several became weak and moribund, and one died. A tremendous number of Giardia sp. bodies were detected from stamp smear preparations of the duodenal contents of some necropsied animals in this group. Histopathological examinations of the intestine revealed slight inflammatory changes and cystic enlargement of the crypts in the duodenal and jejunal mucous membranes. From these findings and the fact that other major pathogenic organisms were not detected, this disease was diagnosed as giardiasis in guinea pigs. PMID- 6499938 TI - Pathology of vaginal atresia in BALB/cA-nu/+ and BALB/cA-nu/nu mice. AB - Vaginal atresia was observed with 5.8% morbidity (58/998 females) in adult BALB/cA-nu/+ and -nu/nu mice. Twenty-seven of the diseased mice were pathologically examined. In the affected mice, the vaginal orifice failed to open even 2 months of age and the perineal region was swollen, being scrotum-like. In addition, an increase of the follicle and a decrease of the corpus luteum were noticed in the ovary. This disorder was regarded as a malformation concerned with a heredity. PMID- 6499939 TI - [The present status of animal models for human diseases in Japan (1983)]. PMID- 6499940 TI - Arginase as one of the inhibitory principles in the density-dependent as well as plasma membrane-mediated inhibition of liver cell growth in vitro. AB - Liver cells isolated from the adult rat livers under mild conditions were preincubated for 1 day with Williams medium E (WE) containing serum, dexamethasone and insulin, and then the cells (monolayered) were incubated for 2 3 days with WE (1 ml) containing only insulin to measure DNA synthesis and/or mitosis. DNA synthesis of cultured liver cells was dependent on cell densities within a region from 0.1 X 10(6) to 1.0 X 10(6) nuclei/dish (Falcon, diameter 35 mm). The addition of EGF from the beginning of preincubation stimulated DNA synthesis (or replication) as well as cell proliferation in vitro, but the density-dependent inhibition of DNA synthesis was observed similarly in the presence of EGF. In contrast to the low and high density cultures, DNA synthesis in the intermediary density cultures was enhanced by enlarging the medium volume or by adding ornithine (arginase inhibitor). DNA synthesis in low density cultures was inhibited by liver plasma membranes in a concentration-dependent fashion. The inhibition of DNA synthesis by liver plasma membranes in low concentrations (less than 30 micrograms protein/ml) was reduced by adding either extra arginine or ornithine. DNA synthesis of cultured liver cells (low density) was inhibited by replacing arginine in WE with equimolar ornithine and urea or by adding a commercial arginase (bovine liver). These, together with earlier findings indicating the presence of arginase in liver plasma membranes (outer leaflet), seem to support the idea that arginase may be involved in density dependent as well as plasma membrane-mediated inhibition of DNA synthesis of cultured liver cells. However, this does not exclude possible involvement of other inhibitory principle(s), such as direct cell-to-cell or cell-to-plasma membrane interactions, especially in higher cell densities or larger plasma membrane concentrations. PMID- 6499941 TI - Receptor-mediated delivery of photoprotective agents by low-density lipoprotein. AB - Low density lipoprotein (LDL) has been used to deliver toxic molecules to cells by receptor-mediated endocytosis. In these studies, the cholesteryl ester core of LDL was replaced with a lipophilic, toxic molecule. We now report that photoprotective azo dyes can be stably incorporated into LDL, and that this reconstituted LDL protects cells from the photosensitizing action of pyrene methanol (PM) in a receptor-dependent process. The photoprotective action of the azo dye is due to its ability to scavenge singlet oxygen that is produced by the photosensitive agent in response to UV light. PMID- 6499942 TI - Changes in calmodulin level after fertilization and during first cleavage in the egg of the urodelan amphibian Pleurodeles waltlii. AB - We report three significant calmodulin rises related to Pleurodeles waltlii egg fertilization and following developmental events. These elevations are correlated to the major obvious Ca2+-dependent events: Na+-H+ exchange, activation of NAD kinase, triggering of cortical reaction, resumption of meiotic division II, initiation of DNA synthesis and regulation of cell division. Therefore, it is suggested that alterations in calmodulin level in fertilized egg may be part of the Ca2+-dependent regulatory mechanisms which turn on metabolisms, initiate development and govern cell cleavages. PMID- 6499943 TI - Effects of extracellular calcium and magnesium on junctional intercellular communication in human fibroblasts. AB - The role of extracellular calcium and magnesium in intercellular communication via permeable junctions was studied by measuring metabolic co-operation between ASS- and ASL- human fibroblasts. Communication through pre-existing junctions was not affected by the removal of extracellular calcium and magnesium from the medium. On the other hand, the establishment of communication through new permeable junctions, when ASS- and ASL- cells were mixed, was dependent on the presence of extracellular calcium and magnesium. PMID- 6499944 TI - Characterization of lamin proteins in BHK cells. AB - Lamins are structural proteins found in rat liver nuclear envelope and are major constituents of the nuclear matrix. 2-D gel electrophoresis indicates that BHK cell nuclear matrix is composed of four major proteins (62 kD, 68 kD, 70 kD and 72 kD). Three of these proteins are very similar to lamins A, B and C of rat liver nuclear envelope according to their molecular mass and isoelectric points. An anti-serum specific to BHK matrix proteins has been raised. On 2-D immunoblot, this serum detects all the 62, 68 and 72 kD polypeptide isovariants but only one of the two isovariants of the 70 kD polypeptide. Rat lamins A, B and C react with the anti-BHK matrix serum. However, when a monoclonal antibody to rat liver lamins A, B and C is used (Burke, B, Tooze, J & Warren, G, EMBO j 2 (1983) 361 [23]), only the 72 kD (lamin A-like) and the 62 kD (lamin C-like) BHK polypeptides are detected. Our results suggest that although a strong similarity exists between BHK and rat lamins, there is no identical cross-reactivity between the two species. PMID- 6499945 TI - A subset of non-histone nuclear proteins reversibly stabilized by the sulfhydryl cross-linking reagent tetrathionate. Polypeptides of the internal nuclear matrix. AB - When rat liver nuclei are isolated in the presence of the irreversible sulfhydryl blocking reagent iodoacetamide, digested with DNase I and RNase A, and extracted with 1.6 M NaCl, nuclear envelope (NE) spheres depleted of intranuclear material, as analysed by thin-section electron microscopy, are obtained. Two-dimensional isoelectric focusing (IEF)/SDS-PAGE and non-equilibrium pH gradient electrophoresis (NEPHGE)/SDS-PAGE reveal that the predominant polypeptides are lamins A, B and C. Nuclei isolated in the absence of sulfhydryl blocking reagents yield salt- and nuclease-resistant structures which contain sparse but demonstrable intranuclear material. A number of non-histone polypeptides are seen in addition to the lamins. Nuclei treated with the sulfhydryl cross-linking reagent sodium tetrathionate (NaTT) yield, after exposure to nucleases and 1.6 M NaCl, nuclear matrix-like structures containing an extensive intranuclear network and components of the nucleolus in addition to the NE. Increased amounts of the non-lamin, non-histone polypeptides are recovered with these structures. Subsequent treatment of these NaTT-cross-linked structures with reducing agents in 1.0 M NaCl selectively solubilizes the intranuclear components but leaves the nuclear envelope apparently intact. The lamins remain sedimentable and are virtually absent from the soluble (intranuclear) material. Instead, the major solubilized polypeptides are (a) 68 and 63 kD polypeptides which migrate in the vicinity of lamins B and C, respectively, but are distinguishable from the lamins by immunoblotting and by uni-dimensional peptide mapping; (b) a series of basic 60-70 kD polypeptides (pI greater than 8.0) which are not recognized by anti lamin antisera; (c) an acidic (pI 5.3) 38 kD polypeptide; and (d) a number of high molecular mass (greater than 100 kD) polypeptides. These observations not only suggest a convenient method for fractionating matrix structures from rat liver nuclei into biochemically and morphologically discrete components, but also identify a subset of major non-lamin, non-histone nuclear polypeptides (comprising approx. 20% of the total nuclear protein) whose intermolecular interactions can be reversibly stabilized apparently by intermolecular disulfide bond formation by NaTT. PMID- 6499947 TI - Cell division cycle in mammalian cells. VIII. Mapping of G1 into six segments using temperature-sensitive cell cycle mutants. AB - The G1 blocks in three temperature-sensitive (ts) Syrian hamster cell-cycle mutants have been mapped in relation to other G1 landmarks. Two mutants reported here, ts-559 and ts-694, show defective progression only in G1. When shifted from the permissive temperature of 33 degrees C to the non-permissive temperature of 39 degrees C, G1 cells of these two mutants show no further cell cycle progression, while cells in S, G2 and mitosis progress through the cell cycle but become blocked after entering G1. The two mutants complement each other, and also complement the previously reported mutant ts-550C with blocks in both G1 and G2 of the cell cycle. The locations of the G1 blocks in both ts-559 and ts-694 are before the hydroxyurea arrest point. The G1 ts point in ts-694 is prior to the isoleucine deprivation and serum starvation points, while the G1 block in ts-559 is after the serum starvation point but before the isoleucine block. Other G1 block points which have been reported are in mutants of different species and isolated in different laboratories, causing difficulties for relative positioning of the blocks in G1. The mutants for mapping in this study have been isolated from the same cell line. The G1 ts arrest points of ts-559 and ts-694, and that found in ts-550C, together with nutritional deprivations and metabolic inhibitors, provide seven reference points which divide G1 into six segments, each of which is bracketed by two adjacent points: mitosis, ts-694 block, serum starvation arrest point, ts-559 block, isoleucine deprivation arrest point, ts 550C block, hydroxyurea or excess-thymidine arrest segment. PMID- 6499948 TI - Density-dependent regulation of growth in somatic hybrids between normal Chinese hamster fibroblasts and V79-8 (G1-) cells. AB - The purpose of this work was to determine the relationship between the presence of a G1 period in the mitotic cycle and a cell's ability to respond to density dependent regulation of growth (DDR). Somatic hybrids were obtained between normal fibroblasts from newborn Chinese hamsters, which show a strong response to DDR, and V79-8 Chinese hamster cells, which are insensitive to DDR. Two variant V79-8 sublines were used, one reported to lack a G1 period (G1-) and the other with a G1 period (G1+). Fourteen hybrid clones were isolated in selective medium and analysed for growth properties and cell cycle parameters; their hybrid nature was supported by chromosome counts. All hybrid clones, irrespective of whether a V79-8 G1- or G1+ cell was one of the parents, showed pronounced DDR and had G1 periods of various lengths. Previous experiments had shown the absence of G1 to be dominant in somatic hybrids between V79-8 G1- and G1+ cell lines. Our results may mean that the G1- property provided by V79-8 is unable to overcome the very long G1 of normal fibroblasts, or in cells that can be arrested in G1 in response to DDR, some function prevents the dominant effect of the G1- cell on at least part of the G1 period. PMID- 6499946 TI - Pyruvate regulation of growth and differentiation in primary cultures of rat tracheal epithelial cells. AB - These studies examined the effect of exogenous pyruvate on the growth and differentiation of primary cell cultures of rat tracheal epithelial cells. The cell cultures were derived from outgrowths of tracheal explants, and require pyruvate for survival and growth in the presence of 10% FBS. In pyruvate supplemented (2 mM) medium, the number of cells attached to the dish increased rapidly, while exfoliation of cells into the medium as well as formation of cornified envelopes were relatively low. The growth response to pyruvate was concentration-dependent in these cell cultures. In the absence of pyruvate, the extent of terminal differentiation to keratinization gradually increased. This was characterized by a cessation of growth after one week, and an increase in exfoliation until all cells had sloughed from the dish. Accompanying these changes was a marked increase in the formation of cornified envelopes. Cells undergoing DNA synthesis were present throughout 2 weeks of culture in pyruvate deprived medium, even as the total number of cells was diminishing. Several compounds, including other 2-oxocarboxylic acids, were ineffective growth substitutes for pyruvate. These results indicate that the requirement for pyruvate is quite stringent in these cultures and that one way pyruvate promotes the growth of tracheal epithelial cells is by inhibiting terminal differentiation. PMID- 6499950 TI - A gene function required for cell cycle progression during the G1 portion of the cell cycle and for maintenance of macronuclear DNA synthesis in Paramecium tetraurelia. AB - The ccl mutation in Paramecium tetraurelia reversibly and rapidly blocks cell cycle progression and DNA synthesis at the restrictive temperature. Progression through the cell cycle is blocked during both the G1 and S portions of the cell cycle, while at the restrictive temperature there is neither residual cell cycle progression nor induction of excess delay of subsequent cell cycle events. DNA synthesis activity is reduced to 50% of the normal level in about 5 min and is completely blocked at 30 min after a shift to restrictive temperature. On return to permissive conditions, DNA synthesis is reactivated with similar kinetics. PMID- 6499949 TI - Isolation of hemopoietic pluripotent stem cells from spleens of thiamphenicol pretreated mice. AB - The present report describes the bulk isolation of pluripotent stem cells (PSC) (assayed as day-9 CFU-S, colony-forming-units-spleen). As starting material, spleens, highly enriched with PSC, were used from mice that were bled and treated with thiamphenicol (TAP). In subjecting the spleen cells to a two-stage centrifugal elutriation procedure and a subsequent Percoll gradient centrifugation stage a 30-fold enrichment in the CFU-S concentration was achieved. The splenic PSC seeded with a characteristic low efficiency in the spleens of irradiated mice (f = 2%). Correcting the colony number for this, we obtained a cell mixture consisting of 88% PSC, contaminated with 4% committed precursor cells and about 10% ganuloid cells. PMID- 6499951 TI - Catecholamine concentrations in tears. AB - Lacrimal fluid from 17 healthy volunteers was analysed for catecholamines using a radioenzymatic assay. Significant concentrations of norepinephrine (mean = 4.4 nmol l-1) and epinephrine (mean = 3.7 nmol l-1) were detected in some of the subjects. Dopamine was not detected in the tears of any of the subjects. The possible significance of catecholamines in tears in relation to corneal physiology and intraocular pressure is discussed. PMID- 6499952 TI - Intraocular pressure, ocular toxicity and neurotoxicity after administration of cannabinol or cannabigerol. AB - Cannabinol or cannabigerol was administered to cats topically in doses of 250, 500 and 1000 micrograms as a single drop or chronically via osmotic minipumps (20 micrograms hr-1) over a period of 9 days. While cannabinol had a modest effect on intraocular pressure after a single dose, it caused a more significant reduction in ocular tension during chronic administration. Cannabigerol had similar effects, but the magnitude of response to its chronic administration was greater. Cannabinol but not cannabigerol caused conjunctival erythema and hyperemia. After systemic administration of cannabinol (20, 40 or 80 mg kg-1) to rats, 8-13 Hz polyspike discharges appeared in the electrocorticogram during wakefulness and during rapid eye movement sleep episodes. Cannabigerol (10, 30 and 100 mg kg-1) lacked this effect. These results indicate that chronic administration of these cannabinoids lowers ocular tension considerably. Like marihuana and delta-9 tetrahydrocannabinol, cannabinol produced both ocular toxicity and neurotoxicity. As cannabigerol lacked these toxicities, it appears that the ocular hypotensive effect of this cannabinoid is somewhat dissociable from both the adverse central and ocular effects accompanying marihuana intake. PMID- 6499953 TI - Pyridine nucleotides in normal and cataractous human lenses. AB - The levels of NAD+, NADH, NADP+ and NADPH have been determined in each cortex and nucleus of about 80 normal and cataractous human lenses and in a small number of calf, rabbit and rat lenses. Cataractous lenses had lower levels of all nucleotides than the normal lenses but no progressive decreases were associated with the development of nuclear colour, or with cortical, diabetic, traumatic and steroid cataracts. It was concluded that a lack of reduced pyridine nucleotides was not responsible for a decrease in the ability of the lens to protect itself against oxidative damage. PMID- 6499954 TI - The active and passive transport of water across the corneal endothelium. AB - The relationship between hydrostatic pressure and water flow across the corneal endothelium of the rabbit was determined at 2 degrees C and 34 degrees C and in each case the layer behaved as if it had a constant leak resistance; the value of the resistances was proportional to the viscosity of water at the temperature in question. Superimposed on this passive flow there appeared to be an active transport of water of 67 microns hr-1 in the warm preparation which completely disappeared when it was cooled. PMID- 6499955 TI - The purification and properties of human lens glutathione reductase. AB - A very simple and rapid method for the purification of human lens glutathione reductase has been developed. The method involves only two steps--affinity chromatography on 2',5'-ADP-Sepharose 4B and gel filtration on Sephacryl S-200. With whole lenses, the purification achieved is over 18000-fold and 80% of the activity in the tissue homogenate is recovered as an enzyme with a specific activity of 218 IU/mg-1. Glutathione reductase was purified from the nucleus and cortex of type I cataractous human lenses and the properties of the two enzymes were compared. No differences could be detected between these enzymes in their specific activities, molecular weights, pH-activity profiles, heat labilities, reactivity towards various substrates and kinetic parameters (Vmax and Km) for glutathione, NADPH2 and NADH2. Therefore, it was concluded that specific alterations in the properties of nuclear glutathione reductase were not responsible for the decreased ability of the lens nucleus to protect itself against oxidative insults. Several different glutathione reductase preparations were examined for their ability to cleave mixed disulphides of lens proteins and glutathione. Only crude tissue extracts (wheat germ and whole lens) were able to cleave the mixed disulphides: no activity was observed with purified lens or yeast glutathione reductases. Therefore, it was concluded that glutathione reductase does not cleave mixed disulphides. PMID- 6499956 TI - Degradation of glycosaminoglycans by extracts of calf vitreous hyalocytes. AB - The ability of extracts of calf vitreous hyalocytes to catalyze the degradation of glycosaminoglycans was studied by incubation with radioactively labeled substrates. The degradation of the polymeric substrates to lower molecular weight products was assayed by three methods: (1) paper chromatographic separation of low molecular weight, mobile digestion products from undigested, high molecular weight material which remains at or near the origin; (2) loss of the ability of the glycosaminoglycan to be precipitated by cetylpyridinium chloride; (3) gel chromatography to separate low molecular weight digestion products, which appear in the retarded volume, from undegraded, high molecular weight material, which is eluted in the void volume. The acidic pH optimum of the reaction suggests a lysosomal origin of the enzyme activity. PMID- 6499957 TI - Guinea-pig ocular nerves contain a peptide of the cholecystokinin/gastrin family. PMID- 6499958 TI - Developmental changes in the blood-ocular barriers in chicken embryos. AB - Changes in the permeability characteristics of the developing chicken eye were studied using light and electron microscopy. Chicken embryos from 6-19 days of gestation (E9-E19) and within 1 day of hatching (P1) were injected intravascularly with horseradish peroxidase (HRP) and examined 1 and 5 min after injection. Within 1 min of injection there was focal accumulation of horseradish peroxidase reaction product (HRP-RP) at the angle of the anterior chamber in embryos up to E15. By 5 min post-injection the HRP diffused into the anterior and posterior chambers and vitreous body; and extended posteriorly into the developing uveal tract. No leakage was detected in the E19 or older animals. In the posterior segment of the eye prior to E12, HRP from the adjacent connective tissues diffused into zone III of the optic nerve. After E12 the developing meninges prevented the influx of the HRP. At the level of the lamina cribosa HRP permeated zone II up to E19 after which only 25% of the animals examined showed HRP-RP in this area. In zone I in all ages examined no HRP-RP was detected 5 min after injection. Developing blood vessels in the deep iris stroma, optic nerve and pecten remained impermeable even as they grew, while the choroidal vessels were consistently leaky. This study suggests: (1) that proteins from the vascular system reach the intraocular chambers before E19; (2) that the leakage occurs from vessels located in the uveal tract adjacent to the angle; (3) that the permeability of the optic nerve depends on the development of the meninges and the border tissues associated with the lamina cribosa; and (4) that the growing blood vessels in the developing eye have permeability characteristics similar to those found in mature vessels. PMID- 6499959 TI - Immunochemical characterization and quantitative distribution of crystallins in the epithelium and differentiating fibre cell populations of chick embryonic lens. AB - Lenses from 19-day chick embryos are fractionated by a double punch method to obtain the epithelium-annular pad complex (EP), outer fibres (OF), middle fibres (MF) and central fibres (CF). Water-soluble crystallins are characterized by SDS PAGE, isoelectric focusing (IEF) and two-dimensional IEF-SDS PAGE. Crystallins are also characterized by immunoelectrophoresis (IE), rocket IE, IEF immunoblotting, and quantified by two-dimensional antigen-antibody crossed electrophoresis using antibodies to total 19-day embryonic as well as adult crystallins. In the adult lens, alpha-, beta- and delta-crystallins are 19%, 67% and 14%, respectively, while these are present at concentrations of 9%, 27% and 64%, respectively, in 19-day embryonic lens. In absolute amounts, delta crystallin increases only by 1.23-fold between 19-day embryonic age and 6 months post-hatching, while total lens protein increases 12.5-fold. The predominance of delta-crystallin in central fibres, located along the optical axis, suggests that this protein is of embryonic origin. delta-Crystallin from fibres is electrofocused as 12 distinct molecular classes (pI 5.2-5.42) which react against anti-delta-crystallin on an immunoblot. Of these, the three most anodal species are not detected in EP. Fibres contain 50 000, 48 000 and 45 000 dalton delta crystallin subunits while only 50 000 and 48 000 dalton subunits are present in EP. PMID- 6499960 TI - Longitudinal (T1) relaxation times of phosphorus metabolites in the bovine and rabbit lens. AB - Longitudinal (T1) magnetic relaxation times for the major phosphorus-containing metabolites present in the bovine and rabbit lens under organ culture conditions and in the bovine and rabbit globe have been determined. Significant differences in T1 for the major phosphorus metabolites in each case are observed, as well as for the same metabolite in the two species examined. Species-dependent lens hydration may account, in part, for these differences. Because of the requirement for rapid repetitive pulsing for the attainment of optimum signal collection efficiency by the Fourier transform nuclear magnetic resonance method, significant differential saturation of metabolite resonance intensities occurs in circumstances where appreciable differences in T1 relaxation times are present, which, unless corrected, leads to erroneous determinations of relative metabolite levels. The net effect of assessing relative metabolite levels in terms of the percentage of total phosphate signal, without a correction for T1 discrimination, is to underestimate metabolites with a long T1 (sugar phosphates) and overestimate those metabolites with a short T1 (ATP). Individual metabolite T1 discrimination factors are calculated from integrated areas of spectra acquired using short and long repetition times as well as from metabolite T1 values. They are then employed, for the first time, for the correction of 31P-NMR spectra of bovine and rabbit lenses. Corrected spectra provide relative metabolite levels for lenticular ATP which are in excellent agreement with values determined by chemical and enzymatic assays. PMID- 6499961 TI - Urea cycle enzymes in retina, ciliary body-iris, lens and senile cataracts. AB - Carbamylation of lens proteins induced conformational changes and may play a role in the development of cataracts in uremic patients. Thus, the activities of the urea cycle enzymes: carbamyl phosphate synthetase I, ornithine transcarbamylase, argininosuccinate synthetase, argininosuccinase and arginase, were determined in lens, retina and ciliary body-iris of calf and rabbit. No ornithine transcarbamylase activity was found in ciliary body-iris, lens and retina of calf and rabbit whereas carbamyl phosphate synthetase I, argininosuccinate synthetase, argininosuccinase and arginase activities in calf lens were 5.02 +/- 0.21, 9.50 +/- 0.29, 9.17 +/- 0.16 and 6.32 +/- 0.19 [mumol (g protein)-1 hr-1], respectively. Except arginase, the activities of carbamyl phosphate synthetase I, argininosuccinate synthetase and argininosuccinase in lens were 30-50% of the values in retina or ciliary body-iris. The Km for each of the substrates was obtained for argininosuccinate synthetase, argininosuccinase and arginase of calf lens. Activities of carbamyl phosphate synthetase I, argininosuccinate synthetase, argininosuccinase and arginase in clear human lenses, aged 67-87 years, were 0.11 +/- 0.01, 0.67 +/- 0.01, 0.20 +/- 0.01 and 0.58 +/- 0.03 (mumol lens-1 hr-1), respectively. Two-fold increase in the activity of arginase was found in senile cataracts, but all other enzymes had 36-87% decreases in activities. It is likely that the rise in arginase activity in cataracts could facilitate polyamine synthesis through ornithine and ornithine decarboxylase and additional formation of cyanate, a carbamylating compound, both of which have been implicated in cataract formation. Further, decreased activities of argininosuccinate synthetase and argininosuccinase together with increased arginase activity could lead to the depletion of arginine in senile cataracts. PMID- 6499962 TI - Cytofluorometric nuclear DNA determinations on human corneal endothelial cells. AB - In order to investigate polyploidization of human corneal endothelium, nuclear DNA cytofluorometry was performed. Touch smears of 31 human corneal endothelium taken from 21 autopsies and 10 donor eyes were fixed with absolute methanol and subsequently stained by the pararosaniline-Feulgen nuclear reaction. The optimum condition for Feulgen hydrolysis of the specimens was determined, and all smears were hydrolysed in 1 N HCl for 5 min at 60 degrees C. After the Feulgen reaction, the pararosaniline-DNA fluorescence was measured with an epi-illumination cytofluorometer (Olympus AH-QRFL). Polyploid nuclei, which are the result of abortive cell division after DNA synthesis, appeared with DNA contents of tetraploid (19 cases) and octaploid (two cases) classes. All other nuclei had DNA quantities within the range of the diploid class. Nuclei containing DNA between diploid and tetraploid amounts were not found. It was concluded that most human corneal endothelial cells are of post mitotic Gl population but that a few are in the generative G0 phase. PMID- 6499963 TI - Age-related changes in the canal of Schlemm. AB - A quantitative study of semi-thin sections through Schlemm's canal from 44 human eyes was undertaken. It was shown from counts of endothelial nuclei that the cell population decreased with age. The decrease in cell population was estimated from linear regression equations to be in the order of 430 cells per year for the whole canal and 320 cells per year for the canal's inner wall. Evidence was provided which indicated that counts of the giant vacuoles also decreased with age. PMID- 6499964 TI - Enterosorption in prolonging old animal lifespan. AB - The effect of repeated courses of enterosorption upon the mean and maximal lifespan and some functional and metabolic indices was determined in 28-month-old Wistar rats. Significant increase of mean and maximal lifespan of old rats was noted at certain regimens of enterosorption. The experimental animals demonstrated less marked age-related structural and ultrastructural changes in the liver, kidneys, myocardium, intestines, pancreas, as compared with control animals. Enterosorption leads to a reduction of pentobarbital-induced sleep, decrease of content of cytochrome P-450, blood cholesterol and triglycerides, cardiac and cerebral tissue cholesterol, total lipids, liver cholesterol and triglycerides. Enterosorption was found to increase the RNA and protein biosynthesis in the liver, kidneys and adrenals of old animals. PMID- 6499965 TI - Age-related changes of ascorbic acid content of liver and brain of common Indian toad, Bufo melanostictus. AB - Ascorbic acid content reaches a peak level in liver in group III male toads and then declines significantly. But there is no significant age-related change in ascorbic acid in the brain of male toads or in liver and brain of female toads. Sex comparison indicates that in females the content declines in the liver of age group III and increases in age-group II, and there is an increase in the brain of age-group III females over their male counterparts. PMID- 6499966 TI - Effect of aging on the storage and catabolism of vitamin A in mice. AB - In A/J mice, the mean total storage of vitamin A in the liver increased from birth to a maximum at 216 days, and then decreased at 644 days. The rate of deposition of intraperitoneally injected 11,12(3)H2-retinyl acetate in micellar form into stored retinyl ester in the liver was inversely related to the age of the mice, whereas rates of excretion of radioactive metabolites in the urine and feces were not systematically affected by age. The percent storage of a dose of radioactive vitamin A and the ratio of the amount stored to that excreted were higher in very young mice than in older mice. Vitamin A reserves in old mice (644 days), although lower than in adult mice (approximately 200 days), were still high and fully adequate to meet nutritional needs. PMID- 6499967 TI - Effect of mating status on Drosophila virilis lifespan. AB - Mating status markedly affected the lifespan of Drosophila virilis flies but the effects of virginity on lifespan were different between the sexes. In all cases lengthening of female lifespan and shortening of male lifespan were observed as an effect of virginity. Lifespan was also affected either by the population density or by the sex ratio per culture. At a sex ratio (proportion of females) of 0.5, lifespan was constant in both sexes irrespective of the population density and females lived significantly longer than males. At high (0.9) and low (0.1) sex ratios mean lifespan did not differ between sexes, but it was longer at high sex ratios than at low ones. A negative correlation between mean lifespan and the number of males per vial was revealed for both sexes. Effects of mating on egg-laying activity were also analyzed. Although the number of eggs laid during the first 20 days period after eclosion was greater in mated females than in unmated virgin females, lifetime egg production was not always larger in the former than in the latter. No particular relationship between egg-laying activity and female lifespan was proven. The lifespan of D. virillis flies seemed to be determined by complex interactions between both sexes, in which the sexual activity of males may play the most important role. PMID- 6499968 TI - Metabolic profiles of rats of different ages. AB - Urine samples from 6- to 31-month-old male Fischer F344 rats were analyzed using a high performance liquid chromatograph and a unique computer-based data analysis and quality control system in order to discover substances that could be used as markers in the aging process. Metabolic profiles of the organic acids from these urines yielded 42 peaks whose areas could be measured reliably. Of the 42 peaks, 10 were found by analysis of variance to vary significantly (p less than 0.05) with age. Rats from the four ages could also be distinguished using a multivariate statistic (discriminant analysis). PMID- 6499969 TI - Functional properties of auditory-nerve fibers during postnatal development in the kitten. AB - The discharges of the auditory-nerve fibers were studied in kittens between 2-40 days of age. Up to the 10th postnatal day, fibers could be divided into two main categories: fibers with spontaneous activity (SA) that respond to sound and fibers without SA but with evoked responses. A third, smaller, category, fibers having neither SA nor evoked activity, was also present. The development of SA comprises two phases. The first, lasting from birth up to the third postnatal week, shows a relatively fast increase and the second, lasting up to adulthood, a slower increase. Typical tone burst responses can be recorded at the end of the first postnatal week. Thereafter reactivity steadily increases especially after the 10th postnatal day. In young animals, rate level function is characterized by a steep segment with a low dynamic range followed by a decrease in activity that lasts until the end of the second week. At this point adult-like functions may be observed, although maximal firing still increases for some weeks. Tuning curves and threshold sensitivity tend to develop inversely at corresponding frequencies. Fibers with low characteristic frequencies reach adult threshold before that of high frequency fibers and high frequency fibers reach adult tuning before low frequency fibers. A comparison of auditory-nerve fiber activity in kittens show that maturation of most functional characteristics lasts several weeks after birth and in some cases continues after the first postnatal month. PMID- 6499970 TI - Iso-frequency 2-DG contours in the inferior colliculus of the awake monkey. AB - Tone bursts produced bands of selective 2-[14C]-deoxyglucose labelling in the inferior colliculus (IC) of the awake monkey. Low tone frequencies produced labelling in dorsal regions and high tone frequencies produced labelling in ventral regions. The position of the bands coincided with the position of a single unit with a characteristic frequency, which was the same as the frequency producing the labelling. These findings indicate that the bands of labelling represent iso-frequency contours in IC. The iso-frequency contours extended across most of the nucleus and were oriented from dorsomedially to ventro laterally at 20-30 degrees from the horizontal and became more vertical anteriorly. The width of the contours was as narrow as 200 micron, suggesting that the contours might represent 2 or 3 overlapping cellular laminae. PMID- 6499971 TI - The influence of display characteristics on active pursuit and passively induced eye movements. AB - A series of experiments has been conducted on human subjects to examine the effect of the movement of small targets located in the peripheral visual field on oculomotor response. Subjects were presented with either a single centrally positioned target or a pair of targets displaced at angles of +/- 5 degrees, +/- 10 degrees and +/- 20 degrees from centre. Target movement was in the horizontal plane, the paired targets always moving in unison. The stimulus waveform consisted of either a sinusoidal or random target motion encompassing a frequency range from 0.1 to 4 Hz with an angular displacement of +/- 3.5 degrees. Subjects made two types of response. First they were instructed to follow the single target or the centre point of the paired targets. In this 'active' pursuit condition the gain of slow-phase eye velocity progressively decreased as the moving targets were moved from the central position to the most peripheral location (+/- 20 degrees). Secondly, subjects were required passively to ignore the target movement by staring blankly ahead. During this 'passive' response nystagmic eye movements were induced for which the slow-phase eye velocity also decreased with increasing target eccentricity, but the gains were always less than those induced during 'active' pursuit. The frequency characteristics of the 'passive' response were very similar to those of the 'active' response, breaking down at frequencies beyond 1 Hz. The ability to suppress the 'passive' response was also investigated by the presentation of a tachistoscopically illuminated earth-fixed target. The response was found to decline as the interval between presentations of the fixation target was decreased from 3000 ms to 100 ms. It is suggested that the 'passive' response originates from a basic velocity drive to the oculomotor system resulting from image movement across the retina. This velocity drive may be cancelled with adequate fixation but must be enhanced to accomplish desired eye velocity during active pursuit. PMID- 6499972 TI - From activity to rest: gating of excitatory autogenetic afferences from the relaxing muscle in man. AB - The changes in reflex excitability of the motoneurones to the soleus (Sol) muscle occurring during and after voluntary releases of various duration from a constant plantar-torque level in isometric or isotonic conditions have been investigated in normal humans by means of the H-reflex and T-response. The amplitude of both reflexes during the release phase attains values lower than control (obtained in resting conditions) even in the presence of force and EMG activity; the maximal inhibition is reached at the end of the release; the reflexes recover gradually to control values over several seconds. The more abrupt is the release, the more inhibited is the reflex and the shorter is the time to recovery and vv. These results apply both in isometric and isotonic conditions. Activation of the antagonist muscles, sometimes occurring at the end of the fastest release, does not contribute to the H-reflex inhibition. Tonic isometric contractions and relative releases have also been evoked by the tonic vibration reflex (TVR). The H-reflex during the TVR-induced contractions were lower than control values, at variance with those obtained during the voluntary contractions, but their amplitudes during the releases had similar values and time-courses in both conditions, pointing to a common involved inhibitory mechanism. Any voluntary ballistic or ramp contraction taking place after a preceding release, in the period in which the H-reflexes were still inhibited, was not apparently influenced, despite the fact that H-reflexes evoked during the release conditioned ramp contractions were significantly lower than when evoked during control ramps of similar characteristics. The results are discussed in terms of a premotoneuronal, possibly presynaptic, inhibitory mechanism. PMID- 6499973 TI - An HRP study of the cat's spinal respiratory motoneurones during postnatal development. AB - The localization and morphology of spinal respiratory motoneurones (phrenic and intercostal) were studied in the cat by retrograde labelling using Horseradish Peroxidase (HRP), at different stages of postnatal development. At birth, the distribution of the phrenic and intercostal motoneurones in the cervical and thoracic ventral horn, respectively, is similar to that observed in adult animals. At birth, the phrenic and intercartilaginous motoneurone somata have respectively 60% and 40% of their adult volume, appearing much more developed than the motoneurones involved in the motor control of limbs. During postnatal development, the phrenic and intercartilaginous motoneurones undergo a characteristic sagittal elongation without evident modification along their transverse axes. From birth, the ratio of the somatic volume to that of its corresponding motor column markedly decreases inside of the phrenic column compared to the data obtained in the limb's muscle motor columns by other authors. Similar determinations in intercostal motor columns give intermediate values between those obtained from the phrenic column and from the motor system. These results indicate that the motoneurones innervating the respiratory muscles have some specific features of development. PMID- 6499974 TI - Inspiratory on-switch evoked by mesencephalic stimulation: activity of medullary respiratory neurones. AB - The activity of medullary inspiratory and expiratory neurones was studied in urethan-chloralose anaesthetized cats during stimulus-evoked inspiratory phase (inspiratory on-switch). All neurones were characterized according to their axonal destination (i.e. bulbospinal neurons or vagal motoneurones) or the absence of such axonal projections (i.e. propriobulbar neurones), and to their location in the dorsal or ventral respiratory nuclei. The inspiratory on-switch effects were elicited during expiration (E phase) by brief tetanic electrical stimulation (50 to 100 ms duration; 0.5 mA; 300 Hz) delivered to the mesencephalic periaqueductal central gray and the adjacent reticular formation. The evoked inspiratory effects observed on the phrenic nerve discharge consisted of: an immediate response (latency 20 +/- 5 ms) of stable duration related to the stimulus (primary response: Prim.R.), a delayed response (patterned response: Patt.R.) appearing after a latent period (silent phase: Sil.P.) of 100 ms maximal duration. The later the stimulus in the E phase, the longer was the duration of the Patt.R. (300 to 1000 ms). The stimulation evoked an earlier activation of the inspiratory bulbospinal neurons (latency 12 +/- 6 ms) than that obtained in the phrenic nerve (Prim.R.). Hence, the Prim.R. originated from the bulbospinal pathway and not from a pathway directly impinging on the motoneurones. Conversely during stimulation very few inspiratory propriobulbar neurones were activated and no expiratory neurone discharged. During the phrenic Sil.P., 46% of the inspiratory bulbospinal neurones continued to discharge with a firing rate lower than that during the stimulus train, while most of the inspiratory propriobulbar and expiratory neurones were not active. During the Patt.R. all inspiratory bulbospinal neurones discharged early and were strongly activated whatever the Patt.R. duration whereas the expiratory neurones were not active. Inspiratory propriobulbar neurones were either not recruited or recruited later, and the number of active neurones increased as the duration of the Patt.R. lengthened. Our results suggest that the eliciting of the stimulus-evoked inspiration (Patt.R.) primarily depends on the activation of the inspiratory bulbospinal neurones. These neurones therefore would not only be the output neurones of the medullary respiratory centres, but they would serve other roles such as building up of the excitation in other respiratory neurones, thus acting as a component of the inspiratory ramp generator. PMID- 6499975 TI - Inputs from the olfactory bulb and olfactory cortex to the entorhinal cortex in the cat. I. Anatomical observations. AB - The spatial organization and laminar distribution of projections from the olfactory bulb and the anterior (PPCa) and posterior (PPCp) divisions of the prepiriform cortex to the entorhinal cortex were studied with anterograde (3H leucine) and retrograde (WGA-HRP) tracing techniques. After 3H-leucine injections into the olfactory bulb transported labeling was seen over the lateral entorhinal area, except its most medial part, and over the rostral part of the medial entorhinal area. The labeling covers exclusively layer Ia. The lateral and medial entorhinal areas are also reached by fibers from the prepiriform cortex. The projection to the medial entorhinal area has not been described previously. Following injections of 3H-leucine into the PPCa transported labeling is present over the entire expanse of the entorhinal cortex and is located over layer Ib with the greatest density in its superficial part. Injections of 3H-leucine into the PPCp give rise to transported labeling over much of the entorhinal cortex. No labeling was found over the most medial parts of the medial subdivision (VMEA) of the lateral entorhinal area and the medial entorhinal area. Labeling occupies layer Ib, especially its middle part, and layers II and III. Both PPCa and PPCp appear to project most heavily to the dorsal (DLEA) and ventral (VLEA) subdivisions of the lateral entorhinal area. From the retrograde experiments it can be inferred that cells of layers II and III of the PPCa project predominantly to the DLEA, whereas those of the PPCp project predominantly to the VLEA. The MEA receives its heaviest projection from layer II of both PPCa and PPCp.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499976 TI - The position sensitivity of retinal X- and Y-cells in cats. AB - We have devised a measure of a retinal ganglion cell's sensitivity to changes in the spatial position of a grating stimulus. At maximum, this relative position sensitivity is a scaled product of the stimulus spatial frequency and the cell's fundamental component of response to that spatial frequency. We obtained the relative position sensitivity as a function of spatial frequency for 13 X-cells and 14 Y-cells. X-cell functions peak at significantly higher spatial frequencies than do those of Y-cells. At their peaks, X-cells display significantly higher values of relative position sensitivity than do Y-cells. However, Y-cells have higher position sensitivity at lower spatial frequencies, but exhibit less of a range of variation from maximum to minimum than do X-cells. These results are consistent with a hypothesis that Y-cells provide the crucial substrate for form vision at lower spatial frequencies, while X-cells are important for details carried by the higher spatial frequencies. PMID- 6499977 TI - Is there a retinopetal system in the rat? AB - The centrifugal innervation of the retina was reinvestigated in albino and pigmented rats with intraocular injections of horseradish peroxidase (HRP), radioactive wheat germ agglutinin (WGA) and proline. No labeled cells were found in the brains injected with HRP and proline, except some eye muscle motoneurons in one case apparently involving orbital contamination from the injection. In the cases injected with WGA and having a survival time of at least two days cells were labeled in the lateral mesencephalic tegmentum, ventral to the parabigeminal nucleus and in the periaqueductal gray. Both these findings are most likely due to transneuronal anterograde-retrograde transport of the tracer through the superior colliculus. The results yielded no compelling evidence for the existence of a direct retinopetal pathway in the rat, which is in contrast to a recently claimed retinal projection originating from the pretectum. Special attention was paid to the labeling in the lateral mesencephalic tegmentum, an area giving rise to retinal projections in various submammalian species. This finding is discussed with regard to the possibility that also in the rat the lateral tegmentum exerts an early influence on visual input, but at the "higher" collicular level and not at the "original" retinal one. PMID- 6499979 TI - Compensatory motor function of the somatosensory cortex for dysfunction of the motor cortex following cerebellar hemispherectomy in the monkey. AB - Electrical activities of the motor and somatosensory cortices preceding visually initiated hand movements were recorded with electrodes chronically implanted on the surface and at 2.5-3.0 mm depth in the cortex of monkeys, and changes in field potentials in these cortices after cerebellar hemispherectomy were observed for many weeks. As previously reported, a unilateral cerebellar hemispherectomy including the lateral and interpositus nuclei eliminates the cerebellar-mediated superficial thalamo-cortical (T-C) responses recorded in the forelimb motor cortex contralateral to the hemispherectomy. These T-C responses normally precede the hand movement, and the operation results in the delay of movement initiation. The electrodes in the forelimb area of the contralateral primary somatosensory cortex showed an enhancement of superficial T-C responses of the somatosensory cortex for 30-40 days after the operation. The enhanced potentials preceded the delayed movement as do the cerebellar-mediated superficial T-C responses of the motor cortex in normal situations. Local cooling of the somatosensory cortex following the cerebellar hemispherectomy disturbed the reaction time movement for a few weeks after the operation. This effect was rarely encountered in normal monkeys. The present study suggests the compensatory motor function of the somatosensory cortex for the dysfunction of the motor cortex in early weeks after cerebellar hemispherectomy. PMID- 6499978 TI - The isthmus-tegmentum complex in the turtle and rat: a comparative analysis of its interconnections with the optic tectum. AB - Injections of horseradish peroxidase, wheat germ agglutinin and various amino acids into the optic tectum in both the turtle and rat, and into the nucleus isthmi magnocellularis (IsM) in the turtle were used to analyse the connections of the isthmus-tegmentum complex. The connectivities and the selective retrograde transport properties in certain tectal pathways were taken as a basis to define more accurately isthmus-tegmentum complex subdivisions. There were several main findings. In the turtle the projection from the tectum to the IsM originated in the stratum griseum periventriculare, whereas the projection from the IsM to the tectum terminated in the superficial tectal layers (both projections homolateral). The terminations of the pathway from IsM to tectum were not uniformly distributed throughout the tectal surface; rather, alternating zones of high and low termination density along the lateral dimension were observed. The turtle nucleus isthmi parvocellularis, receiving a few tectal fibers and afferents from the ipsilateral IsM, gave rise to a bilateral tectal projection. Evidence was obtained for a crossed collicular projection to the rat parabigeminal nucleus (Pbg) in addition to the established uncrossed one. GABA was retrogradely transported from the optic tectum to the Pbg in the rat, and to the dorsolateral mesencephalic tegmentum and the IsM in the turtle. After glycine injections into the optic tectum, the dorsomedial peri-parabigeminal tegmentum was retrogradely labeled in the rat, and the IsM in the turtle. An attempt was made to outline the parallelism between the organizations of the isthmus tegmentum complexes in the turtle, pigeon and rat. It was concluded that some basic features in the inter-connectivity of the isthmus-tegmentum complex and other parts of the visual system have been preserved in evolution, despite the apparent loss of the isthmo-retinal projection in mammals. PMID- 6499980 TI - Cortical connections of the anteromedial extrastriate visual cortex in the rat. AB - Efferent and afferent connections of the visually responsive cortex (area anteromedial, AM) located in the anterior portion of area 18b were studied with degeneration and horseradish peroxidase (HRP) methods following small lesions and HRP injections into this area. Degenerating axons, terminals and retrogradely HRP labeled neurons were observed in a broad region of the cortex including areas located lateral, medial and anterior to the striate cortex. The main finding of this study is that connections of area AM with area 18a are distributed in discrete patches whose arrangement is similar to that of the lateral extrastriate visual areas postulated in previous physiological and anatomical reports. These results thus suggest that visual area AM is reciprocally connected with visual areas in area 18a. Area AM is also connected with other regions within area 18b, thus supporting the notion advanced by recent studies that area 18b contains more than one visual area. A weak afferent connection to area AM from the dorsal lateral geniculate nucleus of the thalamus was noted. Previously described connections of area 18b with areas 8 and 29 as well as with the lateral and latero-posterior thalamic nuclei were confirmed in the present study. PMID- 6499981 TI - Roles of glabrous skin receptors and sensorimotor memory in automatic control of precision grip when lifting rougher or more slippery objects. AB - To be successful, precision manipulation of small objects requires a refined coordination of forces excerted on the object by the tips of the fingers and thumb. The present paper deals quantitatively with the regulation of the coordination between the grip force and the vertical lifting force, denoted as the load force, while small objects were lifted, positioned in space and replaced by human subjects using the pinch grip. It was shown that the grip force changed in parallel with the load force generated by the subject to overcome various forces counteracting the intended manipulation. The balance between the two forces was adapted to the friction between the skin and the object providing a relatively small safety margin to prevent slips, i.e. the more slippery the object the higher the grip force at any given load force. Experiments with local anaesthesia indicated that this adaptation was dependent on cutaneous afferent input. Afferent information related to the frictional condition could influence the force coordination already about 0.1 s after the object was initially gripped, i.e. approximately at the time the grip and load forces began to increase in parallel. Further, "secondary", adjustments of the force balance could occur later in response to small short-lasting slips, revealed as vibrations in the object. The new force balance following slips was maintained, indicating that the relationship between the two forces was set on the basis of a memory trace. Its updating was most likely accounted for by tactile afferent information entering intermittently at inappropriate force coordination, e.g. as during slips. The latencies between the onset of such slips and the appearance of the adjustments (0.06-0.08 s) clearly indicated that the underlying neural mechanisms operated highly automatically. PMID- 6499982 TI - Cell populations of the ganglion cell layer: displaced amacrine and matching amacrine cells in the pigeon retina. AB - The proportion and size distribution of ganglion and non-ganglion cells in the ganglion cell layer of different areas of the pigeon retina was examined in whole mounts of the retina by retrograde axonal transport of horseradish peroxidase (HRP) from large brain injections. A maximum of 98% of cells were labelled in the red field and a maximum of 77% in the peripheral yellow field. Unlabelled cell bodies were 30% smaller than labelled ganglion cells and had a mean diameter of 6.2 microns and a size range of 4 to 9 microns. The morphology of cells in the ganglion cell layer was examined by Golgi staining of retinal whole-mounts. Small glia, displaced amacrine and ganglion cells were found. Displaced amacrine cell bodies were about 30% smaller than ganglion cells and their size distribution was similar to the unlabelled cells in HRP preparations. Displaced amacrine cells had small rounded cell bodies (mean diameter 6.2 microns) increasing in size with eccentricity, and a unistratified dendritic tree of fine, nearly radial, varicose dendrites in sublamina 4 of the inner plexiform layer. They had elliptical dendritic fields (mean diameter 66 micron) aligned parallel to the retina's horizontal meridian. A population of amacrine cells was found with somas at the inner margin of the inner nuclear layer and soma and dendritic morphology matching those of displaced amacrines. These amacrine cells had unistratified dendritic trees at the junction of sublaminae 1 and 2 of the inner plexiform layer. Pigeon displaced amacrine cells and their matching amacrines are similar to starburst cells of the rabbit retina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6499983 TI - Inhibitory contours in the inferior colliculus as revealed by the 2-deoxyglucose method. AB - 2-Deoxyglucose experiments were carried out during which tone bursts were presented to one ear of cats, while white noise bursts were presented to the other ear. Autoradiography revealed that the tones had produced clear bands of reduced labelling in the ipsilateral inferior colliculus, in addition to the expected band of increased labelling in the contralateral inferior colliculus. The positions of the bands or contours appeared to be organized tonotopically into iso-frequency inhibitory contours. PMID- 6499984 TI - Autogenic and nonautogenic sensorimotor actions in the control of multiarticulate hand movements. AB - Human subjects were trained to generate rapid movements of the thumb and index finger and produce a controlled pinch contact force. When unanticipated loads were applied to oppose thumb flexion movements, the desired pinch contact force was achieved by compensatory adjustments of both the thumb and the index finger flexor muscles. The nonautogenic finger muscle responses were (1) at latencies of 60 to 90 ms, (2) manifest the first time a load was introduced, and (3) absent for thumb loads introduced during a task not requiring coordination of thumb finger actions. These intermovement sensorimotor mechanisms may reflect a general task-dependent process contributing to coordination of multiarticulate movements. PMID- 6499985 TI - Ensemble reactions of neurons in the reticular formation of the cat- categorization of inputs and temporal influences. AB - A method of recording ensemble reactions of reticular neurons was applied in anesthetized cats to obtain information about categorization of inputs and the influence of the time factor upon a pattern of responses, reactions to stimulus intensity changes and to complex stimuli, and temporal influences with their relation to plastic changes induced by iterative stimulation. In spite of some variability of the pattern of responses evoked in the reticular formation (RF) by electrical stimulation of the same source, reactions of the parenchyma of the RF differentiate heterotopic stimuli; reactions evoked from receptor areas situated closely to each other exhibited a similar pattern whereas less resemblance was found in the case of responses evoked from sources with a heterosegmental projection and from contralateral sources. Stimulus intensity changes did not influence substantially the pattern of recordings in the RF. The noticeable effect resulting from the increase of stimulus intensity was enlargement of responses. A complex stimulus (two heterotopic stimuli applied simultaneously) was manifested by a reaction which, in comparison with reactions evoked from each of both sources separately, had a different pattern. A trend of changes in the size of responses evoked in the RF by continuous stimulation (60 stimuli, 0.3 Hz) was observed only in some cases. Abrupt alterations of the stimulation rate (0.3 Hz in equilibrium 1 Hz, 0.3 Hz in equilibrium 2 Hz) resulted in a prompt change in responses. With constant stimulation conditions, this activity was fairly constant with an absence of trends. Persistent changes were observed only in a minority of cases. The neuronal apparatus of the RF computes ongoing effects on the basis of ability to discriminate different inputs and to readily change its function. The extent to which the RF holds information about the antecedent "history" of its functioning and the extent to which intrinsic mechanisms of the RF by itself are responsible for behavioral habituation remains problematical. PMID- 6499986 TI - Chlordimeform produces profound, selective, and transient changes in visual evoked potentials of hooded rats. AB - Rat visual function was tested after acute exposure to chlordimeform (CDM), a formamidine insecticide/acaricide. Adult male Long-Evans rats were surgically implanted with epidural recording electrodes overlying visual cortex and tested 1 week later. Pattern reversal-evoked potentials (PREPs), flash-evoked potentials (FEPs), and FEP recovery ratios were measured after acute CDM administration. Averaged recordings obtained during 200 reversals of a black-and-white square wave grating comprised the PREPs, and those obtained during 128 paired strobe lamp flashes comprised the FEPs. In the first study, which examined dose-response relationships, i.p. injections of 0 (saline), 5, 15, or 40 mg/kg CDM-HCl were administered 30 min prior to testing. The PREP amplitudes showed large dose related changes in the CDM-treated rats. PREP N1P1 and P1N3 peak-to-peak amplitudes increased more than 200% in the 40 mg/kg group. In contrast, FEP amplitudes and FEP recovery ratios were unchanged by CDM. Both PREP and FEP peak latencies were increased by CDM in dose-related fashions. In the second study, which examined the time course of CDM action, PREPs and paired-pulse FEPs were recorded 3, 6, and 24 h after dosage with either 0 or 40 mg/kg CDM. All evoked potential changes were large at 3 and 6 h, but had returned to control values by 24 h. In summary, acute exposure to CDM temporarily increased both the amplitude and latency of PREPs, but only the latency of FEPs. PMID- 6499987 TI - Monosynaptic activation of long descending propriospinal neurons from the lateral vestibular nucleus and the medial longitudinal fasciculus. AB - In decerebrate cats long descending propriospinal (LDP) neurons were recorded extracellularly in the cervical enlargement. They were identified antidromically by spinal cord stimulation at the L1-L2 level. Inputs to these cells were tested by stimulating the medial longitudinal fasciculus (MLF) 5 to 6 mm rostral to the obex, the lateral vestibular nucleus (LVN), the upper MLF 1 mm caudal to the trochlear nucleus, and the medial vestibular nucleus (MVN), all on the ipsilateral side. Action potentials were elicited in 44% (64/144) of LDP neurons in the ventral horn (laminae VII, VIII) at a segmental latency of 1 ms or less following brain stem stimulation. This was considered to be a monosynaptic latency. The most effective stimulation sites were the MLF and the LVN. MLF stimulation accounted for about two-thirds of the monosynaptically elicited action potentials and LVN for about one-third. Another 22% of LDP neurons responded at longer latencies, but some of those responses may also have been monosynaptic. Stimulation of the upper MLF and the MVN were much less effective, indicating that the MLF input was predominantly from fibers originating in the medullary and/or pontine reticular formation. PMID- 6499989 TI - Lateral entorhinal cortical kindling can be established without potentiation of the entorhinal-granule cell synapse. AB - Kindling is an animal model of epilepsy which involves a permanently enhanced neuronal response to an electrical stimulus. It has been proposed that long-term potentiation (LTP) of excitatory synaptic transmission is the cellular basis of kindling. Therefore, LTP was examined in the monosynaptic projections from the lateral entorhinal cortex (LEC) to dentate granule cells (DG) in unrestrained, unanesthetized rats kindled via the LEC. Population excitatory postsynaptic potentials (pEPSPs) were recorded from the granule cells before, during, and after kindling of the LEC. Controls were unkindled rats recorded during the same time period as the experimental rats. No consistent changes were found in plateau pEPSP amplitudes or initial slopes although kindling via the LEC proceeded through the typical stages. There was also no significant change in the stimulus intensity needed to elicit a 50% maximal or "plateau" pEPSP. Thus, whereas kindling was indeed established by stimulation of the LEC, there was no evidence of LTP detected in the granule cell response either during the development or after completion of kindling. Either LTP does not underlie the mechanism of kindling via this pathway or it occurs in different brain regions receiving LEC input. PMID- 6499988 TI - Neocortical asymmetry and open-field behavior in the rat. AB - The total volume of the neocortex in each cerebral hemisphere was measured in male and female rats that had been exposed to one of two early experience treatments and subsequently tested behaviorally. Rats were either handled in infancy and raised in enriched environments or not handled in infancy and raised in standard lab cages. In adulthood they were tested in the open field for activity, for initial direction of movement out of the start box, and for laterality of wall-hugging behavior. Early experience did not have an effect on neocortical asymmetry, but a gender difference was disclosed. The right neocortex of males was larger than the left by a mean of 1.5%. Females rats did not show a significant asymmetry, although when asymmetry was present it was in favor of the left side. Cortical asymmetry correlated with open-field behavior. The degree of activity decreased with increasing neocortical asymmetry, and an interesting gender effect was present. Also, there was a positive correlation between neocortical asymmetry and direction of wall-hugging behavior, but only in animals with volume differences of less than 1%. These findings represent the first documentation of behavioral correlations with anatomic brain asymmetries in nonhuman species. PMID- 6499990 TI - Development and maturation of postural reflexes in normal kittens. AB - In order to evaluate neurologic development, postural reflexes were tested in normal kittens from birth through 7 weeks of age until stable adult patterns of performance were attained. These reflex tests included: body and air righting, visual placing, chin placing, tactile placing, hopping, and locomotion. A protocol for scoring responses was designed for each individual reflex to differentiate their progression. The first reflexes to mature were visual placing, chin placing, and body righting which attained a maximal score during the 3rd week of life. This was followed by maturation of the forelimb hopping reflex and independent locomotion during the 4th week. Forelimb tactile placing responses, hind limb hopping reflexes, and air righting developed by the 5th week. Hind limb tactile placing responses were the last to mature. They became fully expressed in the 6th week. The pattern of ontogeny of these reflexes proceeded in a cephalocaudal direction. This is in agreement with earlier observations of others who correlated the maturation of reflex responses in kittens with myelination in the central nervous system. PMID- 6499991 TI - Epileptogenic effects of electrolytic lesions in the hippocampus: role of iron deposition. AB - Small, anodal electrolytic lesions in the dorsal hippocampus were produced in rats, and continuous electrographic records were made from contralateral hippocampal electrodes for as long as 48 h following the lesion. Intense spontaneous epileptiform activity was observed, which developed from isolated spiking and spindling, to phasic spike trains, recurrent paroxysmal discharges and, in some cases, continuous ictal activity lasting to 7 h. Spontaneous clonic convulsions were observed in two cases. Epileptiform activity usually subsided after 12 h, but electrographic abnormalities such as spontaneous spiking and high amplitude spindling persisted as long as 12 days. Such effects were reliably produced with iron-depositing lesions using stainless-steel electrodes, but not with platinum electrodes, suggesting that ionic deposition is critical for the lesion-induced seizure development. These results pose interpretive difficulties for the use of ion-depositing lesions in the study of limbic brain function. PMID- 6499993 TI - Cerebellar vermis involvement in monkey saccadic eye movements: microstimulation. AB - The cerebellar vermis (lobules V to VII) was focally stimulated (maximum current = 300 microA) through microelectrodes in alert monkeys trained to fixate on visual targets located at different positions in the eye movement field. Microstimulation of this area evoked saccades whose direction and amplitude were dependent on the spatial locus of the vermal point stimulated and on the position of the eye at the time of stimulation. Stimulation evoked saccades on most (70%) of the electrode penetrations. By alternatively stimulating and recording through the electrode as it advanced through the depth of the vermis, it was possible to map the threshold for evoking saccades along a penetration as well as to ascertain the type of tissue (white matter or Purkinje cell layer) situated at the stimulation points. On penetrations where saccades were evoked, there was generally one (90%) and sometimes two (10%) low-threshold region(s). These low threshold regions were located in fiber tracks and not in the Purkinje or other cellular layers of the cerebellar cortex. The direction and size of the evoked saccades were dependent on position of the eye in the orbit. At a few sites, even the presence or the absence of an evoked saccade depended on the initial eye position. Postsaccadic drifts after termination of evoked saccades were also a common feature (50% of the tracks) associated with vermal microstimulation. The presence or absence as well as the direction of the postsaccadic drift were also dependent on initial eye position. These observations suggest that the vermal stimulations evoked saccades by the antidromic activation of mossy fiber afferent inputs that emanate from the brain stem saccadic burst generator. Furthermore, stimulation in this manner would actually bypass the cerebellar circuitry and produce saccades without the usual modifying influence of the cerebellum. PMID- 6499992 TI - L-dopa-induced locomotor-like activity in ankle flexor and extensor nerves of chronic and acute spinal cats. AB - The ability of L-DOPA and nialamide to produce locomotor-like rhythmic discharges (fictive locomotion) in hind limb nerves of acute and chronically spinalized and paralyzed cats was examined. Ankle flexor and extensor nerves of chronic cats exhibited pharmacologically induced alternate bursts of activity that had significantly shorter cycle times and burst durations than those produced in ankle flexor and extensor nerves of acutely prepared cats. Furthermore, prior to pharmacologic activation, both ankle flexor and extensor nerves of chronic preparations frequently exhibited spontaneous alternate bursts of activity. Neuronal discharges from nerves of chronic preparations, both prior to and after pharmacologic activation, exhibited much greater variability in both cycle time and burst duration compared with those observed in acute preparations. PMID- 6499994 TI - Can Ib axons be selectively activated by electrical stimuli in human subjects? AB - A tendon-vibration technique, used to raise the electrical threshold of muscle spindle Ia afferent fibers above that of Golgi tendon organ Ib afferent fibers in animals, was tested on human subjects. After prolonged tendon vibration, electrical stimulation of the posterior tibial nerve was ineffective or markedly less effective in eliciting Hoffmann (H-) reflexes in the soleus muscle at previbration threshold intensities. With stimulus intensity held constant at values between 1.0 to 1.4 X threshold, postvibration H-reflex myoelectric amplitudes returned to previbration values usually within 60 min. However, at higher electrical stimulus intensities (1.8 X threshold), postvibration H-reflex amplitudes were produced at or near previbration values irrespective of postvibration recovery time; in contrast, initial postvibration tendon tap reflexes were potentiated. Findings suggest that it is indeed possible to selectively activate Ib afferent fibers in humans by electrical stimuli. PMID- 6499995 TI - Impaired lordosis response in golden hamsters with lesions in the ventromedial midbrain. AB - Lesions in the ventromedial midbrain tegmentum of female golden hamsters produced various degrees of impairment of the lordosis response to male hamsters or manually delivered somatic stimuli. The most severe deficits were produced by anterior lesions, whereas larger, more posterior lesions sometimes produced no lordosis impairment. In tests where lordosis was not completely eliminated, the lesions tended to impair maintenance rather than elicitation of lordosis, thus constituting a different behavioral effect from that associated with deep tectal or central gray lesions in this species. PMID- 6499996 TI - Leishmania tropica: protective response in C3H mice vaccinated with excreted factor crosslinked with the synthetic adjuvant, muramyl dipeptide. AB - Excreted factor, an immunosuppressive, acidic polysaccharide released by promastigotes of Leishmania tropica major in culture, was chemically crosslinked to the synthetic adjuvant muramyl dipeptide via the bifunctional imidoester dimethyladipimidate and poly-L-lysine. This conjugate, an uncrosslinked mixture of the components, or each of the components alone were injected one to three times into different groups of 8- to 12-week-old C3H mice. The mice were challenged 2 weeks after the last injection with 2 X 10(6) promastigotes of L. t. major in the base of the tail. For the next 5 weeks, the animals were monitored for number of parasites and size of the lesion which developed at the site of the challenge. Mice receiving one intraperitoneal injection of the conjugate were partially protected against challenge. Treated animals had higher initial parasite numbers but showed a more rapid clearing of the parasites. Furthermore, the treated animals developed smaller lesions that healed quicker than did those of the control groups. Multiple injections, or injection into a footpad, rather than intraperitoneally, reduced the ability to elicit a protective response. On the other hand, muramyl dipeptide injected into a footpad was partially protective. Antibody production to excreted factor, which was measured by indirect hemagglutination of sensitized erythrocytes, was detected after challenge in mice which had received conjugate or conjugate components. A delayed hypersensitivity reaction (measured by skin testing) was not detected in any of the groups prior to challenge. PMID- 6499997 TI - Taenia taeniaeformis: characterization of larval metabolic products and growth of host gastric cells in vitro. AB - Development of larvae of the cestode parasite Taenia taeniaeformis in the liver of rats induces gross hyperplasia of the gastric mucosa and excessive mucus production in the stomach without any direct contact with the stomach. Because the taeniid larvae are known to elaborate excretory-secretory (E-S) product in vivo and in vitro, the product was analyzed further, and its effects on cultured rat and dog stomach cells were investigated. In vitro E-S product contained less negatively charged glycosaminoglycan than either heparin or chondroitin sulfate, and proteins of various molecular weights. It stimulated the growth of both rat and dog stomach cells at concentrations of 3-9 micrograms protein/ml culture medium. At a concentration of 30 micrograms protein/ml culture medium, it stimulated hexosamine production in the cells up to 20 times, and multiple intracytoplasmic granules were found in both rat and dog cultured cells by light and electron microscopy. These results suggest that larval E-S product may be involved in the induction of gastric hyperplasia and hypermucus secretion. PMID- 6499998 TI - Fasciola hepatica: collagen deposition and other histopathology in the rat host's bile duct caused by the parasite and by proline infusion. AB - Bile ducts were examined histochemically to compare the effects of proline infusion with Fasciola hepatica implantation in rats. After 3 weeks of infusion or implantation, both proline and F. hepatica produced increases in the luminal perimeter and collagen content of the bile duct. However, the effect of the parasite was significantly greater than that of proline, and the parasite produced significant increases in the bile duct wall. These results corroborate earlier biochemical and histological studies indicating the important role of proline in the enlargement of the bile duct in fascioliasis. PMID- 6499999 TI - Schistosoma mansoni: ultrastructure of adults from mice treated with oxamniquine. AB - The in vivo effects of a single oral dose (50 mg/kg) of oxamniquine on the ultrastructure of Schistosoma mansoni were investigated. In male worms, severe disruption of the tegument and gastrodermis took place, and extensive extracellular spaces developed between the cells of the internal tissues. Elimination of the damaged worms was associated with complete tegumental breakdown and encapsulation by host cells. A small proportion of females showed similar drug-induced changes and were also eliminated. In the residual females, no drug-induced morphological damage was observed even after a second dose of oxamniquine. However, these females became much reduced in size, and regression of the organs of the reproductive system took place. It is suggested that such regressive changes resulted from discontinued male stimulation rather than the direct effect of oxamniquine. PMID- 6500000 TI - Caenorhabditis elegans and Panagrellus redivivus: enzyme-mediated modification of chemotaxis. AB - Treatment with mannosidase or sialidase completely inhibited chemotactic responses of Caenorhabditis elegans wild type, C. elegans mutants CB1377 (daf-6)X and CB1379 (che-3)I, and Panagrellus redivivus to a source of attractants. Trypsin (EC3.4.21.4) caused a partial reduction in the level of chemoresponse. Normal chemotaxis was renewed within 20 hr following exposure to the enzymes. Other enzymes tested had no effect. Experimental and supporting evidence is presented that behavioral modification resulted from functional impairments to receptors located within chemosensory sensilla. PMID- 6500001 TI - Schistosoma haematobium: amoscanate and adult worm ultrastructure. AB - Amoscanate, when administered orally as an aqueous or "formulated" preparation, induced pronounced ultrastructural abnormalities in male and female Schistosoma haematobium. Higher dose levels of the aqueous suspension (300 mg/kg body wt) had to be administered to achieve the full range of effects induced by formulated doses of 2.5-8 mg/kg body wt. Worms were recovered from hamsters between 1 and 120 hr after treatment. Although the amount of amoscanate-induced damage varied considerably between worms, an overall pattern of damage emerged. Initially, 1 hr after treatment, amoscanate caused tegumental vacuolation and oedema. As the drug treatment period was extended to 24 hr, blebbing, exudation, collapse of sensory organelle bases, and abnormal mitochondria became increasingly evident. With exposure to higher drug doses (50-300 mg/kg body wt), the tegument became further distorted with the appearance of necrotic structures and myelin whorls, which appeared to represent various stages in lysosomal formation and digestion. Eventually, erosion of surface layers resulted in the breakdown of tegumental integrity. The caeca and vitellaria were also adversely affected by drug treatment. Basal vacuolation and the formation of myelin whorls occurred in the gastrodermis. In the mature S4 vitelline cells, coalesced vitelline droplets and myelin whorls were evident. PMID- 6500002 TI - Schistosoma mansoni: differences in acetylcholine, dopamine, and serotonin control of circular and longitudinal parasite muscles. AB - The physiological and pharmacological properties of circular and longitudinal somatic musculature in adult male Schistosoma mansoni were compared using cut muscle sections. Carbachol reduced tone in both circular and longitudinal muscle, but was without effect on circular muscle bathed in high Mg2+, indicating that cholinergic receptors were not associated with circular muscle membrane. 5 Hydroxytryptamine (5-HT) induced rhythmic contractile activity in both sets of muscle. It decreased muscle tone in circular muscle but increased the tone of longitudinal muscle. Metergoline blocked 5-HT effects on both sets of muscle. 5 HT continued to be effective on both sets of muscle bathed in high-Mg2+ medium, indicating that serotonergic receptors were present on both circular and longitudinal muscle membranes. Dopamine decreased both circular and longitudinal muscle tone. Its effects on circular muscle were still present after exposure to high Mg2+, but its effects on the longitudinal muscle were significantly reduced, leading to the conclusion that dopaminergic sites were probably associated with circular muscle membrane but not that of longitudinal muscle. Also, spiroperidol blocked stimulus responsiveness of the circular muscle but not that of the longitudinal muscle. From these studies it appears that there are significant physiological and pharmacological differences between circular and longitudinal muscles in the adult male schistosome. PMID- 6500003 TI - Hymenolepis microstoma: mouse strain differences in resistance to a challenge infection. AB - Antibody responses and host resistance to the tapeworm, Hymenolepis microstoma, were investigated using AKR/J and C3HeB/FeJ strains of mice. AKR mice were significantly more resistant than controls to a secondary infection following exposure to a 3-, 21-, or 40-day primary infection. During a primary infection, intestinal anti-worm antibody responses measured by an enzyme-linked immunosorbent assay were elevated in the more resistant AKR strain, whereas serum antibody titers did not differ between the two strains. However, during a secondary infection, serum IgA titers were higher in AKR mice than C3H mice. Suppression of the serum IgA anti-worm response by oral administration of lipopolysaccharide also suppressed resistance to a secondary infection. Intraperitoneal immunization with worm antigen resulted in a minor degree of protection in AKR mice. This protection was associated with increased intestinal antibody titers compared to mice not demonstrating protection. These results suggest that the protective responses observed in AKR mice relative to C3H mice reflect differences in mucosal antibody responses to H. PMID- 6500004 TI - Tritrichomonas foetus: localization of filipin-sterol complexes in cell membranes. AB - The polyene antibiotic, filipin, was used as a probe for the detection of sterols in the freeze-fractured plasma membrane and the flagellar membranes of the pathogenic protozoa, Tritrichomonas foetus. A homogeneous distribution of filipin sterol complexes was seen throughout the plasma membrane, and the membrane of the three anterior and the one recurrent flagella. No or very few filipin-sterol complexes were observed in some specialized regions such as the base of the flagella (necklace), the portion of the recurrent flagellum, and that part of the cell body to which the flagellum was attached. The density of filipin-sterol complexes varied from one cell to the other. In some cells, about 205 complexes/micron 2 were seen. A larger number of filipin-sterol complexes were observed on both faces of the membrane of cytoplasmic structures, probably corresponding to vacuoles. No complexes were seen in the nuclear membrane and in the membrane of the endoplasmic reticulum. Very few or no complexes were observed in the membrane of the hydrogenosomes. Treatment of living cells with filipin induced aggregation of filipin-sterol complexes at some points of the plasma membrane. PMID- 6500005 TI - Paracelsin; characterization by NMR spectroscopy and circular dichroism, and hemolytic properties of a peptaibol antibiotic from the cellulolytically active mold Trichoderma reesei. Part B. AB - Paracelsin, a hemolytic and membrane active polypeptide antibiotic of the peptaibol class which is excreted by the mold Trichoderma reesei, was obtained by a simplified and rapid isolation procedure utilizing hydrophobic adsorber resins. Investigation by 13C nuclear magnetic resonance spectroscopy and circular dichroism revealed considerable helical portions in solution, and the very recently accomplished sequence determination of paracelsin allows the discussion of the results with regard to the closely related analogues, alamethicin and suzukacillin. A selective cleavage of the peptide was achieved by careful treatment with various acids, and a buffer of pH 8.25 and of high ionic strength made possible the quantitative determination of the C-terminal phenylalaninol released by means of ion-exchange chromatography. The significance of the production of paracelsin and related mycotoxins of the peptaibol class, exhibiting various kinds of biological activity, is discussed with respect to the extensive effort being made towards biotechnological applications of species, strains and cellulolytically highly active mutants of the fungus Trichoderma. PMID- 6500006 TI - The effects of caffeine on physiological functions and mental performance. AB - Polygraphic monitoring of several physiological variables was done throughout an experiment investigating the effects of caffeine on mental performance. The experiment started with a mental maze learning task. Then the subjects were given the test beverages according to the group design (CC group (N = 16): 300 mg caffeine in decaffeinated coffee, DC group (N = 16): decaffeinated coffee, WW group (N = 8): warm water, and NB group (N = 8): no beverage). The experiment continued with a letter cancellation task which was followed by a second mental maze learning task. The caffeine treated subjects differed from the other groups by increased regularity of letter cancellation performance, as indicated by decreases in intraindividual variance. They also differed from the other groups by a slight but significant acrodermal vasoconstriction. No intergroup differences were obtained for mental maze learning, heart rate, respiration, muscle tension, and skin conductance. The results suggest therefore that the drug at this dose level improves behavioral routine and speed rather than cognitive functions and that the vegetative side effects are minimal. PMID- 6500007 TI - Sex differences in human circadian rhythms: intrinsic periods and sleep fractions. AB - The period of freerunning circadian rhythms is significantly shorter and the fraction of sleep is significantly larger in human females than in males, as long as the rhythms run internally synchronized. The sex difference in the period could be a property either of the whole circadian system or of only one of the oscillators in a multi-oscillator system. The sex difference in the sleep fraction could be a fixed property of the sleep-wake rhythm or could depend on interactions in the multi-oscillator system. To investigate these questions, a sample of 33 long-term experiments, in which the rhythms ran internally synchronized in one section and internally desynchronized in another section, were analyzed. The periods of rhythms in rectal temperature were different in females and males during internal synchronization, but became identical during internal desynchronization. In contrast, sex differences in sleep-wake periods were more pronounced when the rhythms were desynchronized than when they were internally synchronized. This result provides evidence that the sex difference in periodicity is a property only of the sleep-wake rhythm; the intrinsic periods of temperature rhythms are identical in females and males, whereas those of sleep wake rhythms are distinctly shorter in females than in males. In the state of internal synchronization, the joint period is a compromise between the intrinsic periods of the rhythms involved, and therefore it shows a small but significant sex difference. Moreover, the transition from internally synchronized to desynchronized rhythms is combined with a highly significant reduction in the sleep fraction, which is considerably greater in females than in males. These results suggest that the occurrence of internal desynchronization strongly affects the sleep-wake rhythm, and that the influence of rhythm disorders is considerably greater in females than in males. PMID- 6500008 TI - Immune-mediated glomerulonephritis induced by mercuric chloride in mice. AB - The BALB/c mouse developed mesangial deposits of immune constituents and light microscopical changes characteristic of immune complex glomerulonephritis after 8 weeks' treatment with mercuric chloride given by s.c. injection. There were no signs of linear of granular immune deposits along the glomerular capillary basement membrane after 2 or 8 weeks. The antigen could not be identified. No antibodies to nuclear or renal structures were found. Using a histochemical method (silver amplification) mercury was detected by light and electron microscopy in tubular and glomerular structures. Mercury was present in secondary lysosomes of the mesangial cells after eight weeks of mercury poisoning. PMID- 6500009 TI - Effects of pre- and post-irradiation glucan treatment on pluripotent stem cells, granulocyte, macrophage and erythroid progenitor cells, and hemopoietic stromal cells. AB - Glucan, a beta-1,3 polyglucose, was administered to mice either 1 h before or 1 h after a 650 rad exposure to cobalt-60 radiation. Compared to radiation controls, glucan-treated mice consistently exhibited a more rapid recovery of pluripotent stem cells and committed granulocyte, macrophage, and erythroid progenitor cells. This may partially explain the mechanism by which glucan also enhances survival in otherwise lethally irradiated mice. PMID- 6500010 TI - Liver function during chronic renal failure in rabbits. AB - In rabbits with chronic renal insufficiency the prothrombin index was increased by 25% and the alanine aminotransferase activity decreased by 20%; the results of other routine tests of hepatic function were not affected. The galactose elimination capacity was decreased by 12%, whereas the body clearance of antipyrine was unchanged. No change in hepatocytic structure was found. PMID- 6500011 TI - Partial purification and some characteristics of hamster molar alkaline phosphatase. AB - A rapid 3-step method is given to purify partially hamster molar alkaline phosphatase. Molecular weight was 50,200 and isoelectric point 3.7. The alkaline phosphatases in the mesenchymal and ectodermal parts of the tooth are probably identical. PMID- 6500012 TI - Fluid and protein clearance in the rat endometrium. Part I: Ultrastructural proof of the absence of an intrinsic lymphatic system from the rat endometrium. AB - An integrated histological and ultrastructural study of the endometrial microcirculation in rats reveals that lymphatic capillaries are absent from the superficial uterine mucosa. Blood capillaries are fenestrated, and their basement membrane may be poorly developed. PMID- 6500013 TI - Fluid and protein clearance in the rat endometrium. Part II: Ultrastructural evidence for the presence of alternative, non-lymphatic clearance mechanisms in the rat endometrium. AB - In the rat endometrium, resident macrophages and exudate phagocytes ensure proteolysis by means of phagocytosis, macro- and micropinocytosis. Using exogenous tracer particles no ultrastructural evidence could be obtained for the occurrence of endometrial prelymphatics. It is suggested that the free tissue fluid may be drained via the fenestrated (probably venous) blood capillaries. PMID- 6500014 TI - Ethanol diminishes the toxicity of the mushroom Amanita phalloides. AB - Survival of mice after lethal doses of a lyophilizate from Amanita phalloides ('death cap') was markedly increased by single doses of ethanol applied 30 min before or 5 min after the mushroom. Hepatic histopathological damage (confluent necrosis) was largely prevented. Acute, but not chronic, consumption of ethanol may thus influence favorably the outcome of death cap poisoning and should be taken into consideration in the evaluation of therapeutic measures. PMID- 6500015 TI - Tissue-specific induction of intestinal glutathione S-transferases by alpha beta unsaturated carbonyl compounds. AB - Glutathione S-transferase activity in rat intestinal mucosa was increased by the injection of alpha beta-unsaturated carbonyl compounds such as phorone and diethylmaleate, but that in the liver and kidney was not. Since the administration of cycloheximide completely blocked the increase of the enzyme activity by phorone, the increase of the activity may be due to de novo synthesis rather than enzyme activation. PMID- 6500016 TI - Tetracyclines inhibit parathyroid hormone-induced bone resorption in organ culture. AB - Several tetracyclines (minocycline, doxycycline, tetracycline), in levels approximating physiologic concentrations, were found to inhibit parathyroid hormone-induced bone resorption in organ culture; the specificity of this effect was demonstrated by comparison with other (non-tetracycline) types of antibiotics. The ability of tetracyclines to inhibit bone resorption is consistent with the recent proposal by Golub et al. that these antibiotics can inhibit mammalian collagenolytic enzymes by a mechanism unrelated to the drug's antibacterial efficacy, a property which could be therapeutically useful in diseases characterized by excessive collagen breakdown. PMID- 6500017 TI - Age-related changes of the pattern of non-histone proteins in active and condensed fractions of mouse liver chromatin and hepatocarcinoma. AB - Electrophoretic analysis of histones and non-histone acid-soluble proteins in active (nuclease sensitive) and inactive chromatin from liver of young and old CBA mice and in age-related hepatocarcinomas showed a higher ratio of NHP:histones in active chromatin in old cells. Some liver- and hepatoma-specific fractions of non-histone proteins have been identified as chromatin matrix proteins. PMID- 6500018 TI - Dark exposure inhibits the mitotic activity of thyroid follicular cells in male mice with intact pineal. PMID- 6500019 TI - American household structure in transition. AB - The number of U.S. households rose by 58 percent between 1960 and 1983, with nontraditional household types accounting for most of the increase. Whereas the number of households containing married couples with children younger than 18 rose by only four percent over the period, one-parent households increased by 175 percent; one-person households, by 173 percent; and households composed of unmarried couples, by 331 percent. In 1983, households maintained by married couples constituted six in 10 U.S. households; the second most common household type--adults living alone--accounted for about one-quarter of all households. Lone parents living with their children represent nearly one in 10 households. Almost all of these parents are women--of whom two-thirds are separated or divorced, one-quarter have never been married, and fewer than one in 10 are widows. Among adults living alone, women aged 45 and older predominate; but the rate at which the practice has been adopted since 1960 has been greatest among those under age 45. Most of the growth in the number of one-person households occurred during the 1970s. The increase in cohabitation--most of it also in the 1970s--has similarly been concentrated in the younger age-groups. The living arrangements of children younger than 18 have changed accordingly over the two decades. Since 1960, the number of children living with two parents has declined by nearly one-fifth, and the number living with one parent--generally the mother- has more than doubled.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500021 TI - Abortion: understanding differences. PMID- 6500020 TI - The effectiveness of family planning clinics in serving adolescents. AB - Data from surveys conducted by The Alan Guttmacher Institute (AGI) in 1981 have been used to create three indicators of the effectiveness of family planning clinics in serving teenagers: the mean delay between first intercourse and first clinic visit (which for teenage clinic patients is 13.2 months); teenage patient retention (67 percent; and the average excess of patient satisfaction over dissatisfaction with clinic policies and services (33 percent). Clinics run by Planned Parenthood are more effective than other types of facility, according to the mean delay indicator, whereas other clinics, such as those associated with community action programs and neighborhood health centers, rank highest in levels of patient satisfaction and patient retention. All three measures indicate that clinics serving 1,000-2,499 family planning patients per year are more effective in serving teenagers than either smaller or larger clinics, and that nonmetropolitan clinics are more effective in providing services than those in cities. Regression analysis shows that clinic administrators might take a number of actions to shorten the mean delay among teenagers between first intercourse and first clinic visit. These include offering community education programs for teenagers, enlisting the support of local churches, developing relationships with local youth groups, opening the clinic during evenings and weekends, accepting more teenagers as walk-in patients and locating a clinic in or near neighborhoods where many teenagers live. Two of the same factors--developing an active relationship with youth groups and opening the clinic to teenagers on evenings and weekends--were also found to be particularly effective in keeping teenagers as clinic patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500022 TI - The Adolescent Family Life Act and the promotion of religious doctrine. PMID- 6500023 TI - Global politics in Mexico City. PMID- 6500024 TI - Absorption, distribution, excretion and metabolism of domiodol. PMID- 6500025 TI - Release of osmotically active drugs from silicone rubber matrixes. PMID- 6500026 TI - Kinetics of the harmaline oxidation by peroxodisulfate. PMID- 6500027 TI - [Analysis of the changes in the mass of the internal organs in a toxicological experiment]. AB - The authors describe a method for the evaluation of the changes in the mass of the animals' internal organs in a toxicological experiment. The method is based on the use of a regression analysis. The method permits evaluating the action of a factor on the mass of the organs, with the exception of the effect of a change in the body mass in an experiment and initial weigh heterogeneity in animal groups. PMID- 6500028 TI - [Use of the human lymphoid Raji-line cell culture in tests of the toxicity of perfluorocarbon emulsions and their separate components]. AB - The possibility has been shown of utilizing the culture of human lymphoid Raji cells as a highly sensitive object for toxicity testing of perfluorocarbon emulsions and their components. It has been disclosed that cytotoxicity of perfluorocarbon emulsions is primarily determined by its stabilizers--proxanoles. Theoretically, the cultures of animal cells are considered to be useful for toxicological studies. PMID- 6500029 TI - [Effect of sex steroids on the fetus in the perinatal period]. PMID- 6500030 TI - [Effect of etimizol on age-related characteristics of the formation of the conditioned passive avoidance reaction]. AB - The authors have demonstrated the effect of ethimizol on the processes of training and consolidation, the duration of memory traces, and process of reproduction in adult and old mice and rats. It has been found that ethimizol in doses of 1.5-5 mg/kg facilitates the formation of passive avoidance behavior in old animals difficult to be trained and raises the duration of storing the reflex formed in both the age groups. The improvement of reproduction of passive avoidance behavior after ethimizol administration has been discovered to be characteristic for old animals. PMID- 6500031 TI - [Hydrochlorides of N-hydroxyalkyl-alpha-piperidine carboxylic arylamides possessing antiarrhythmic activity]. AB - It has been demonstrated in experimental arrhythmias of animals (aconitine one in rats, strophanthine in guinea-pigs, creation of an "ectopic focus of excitation" in cats by electric stimulation) that new compounds, the derivatives of piperidine carboxylic acids, possess antiarrhythmic activity. In doses of 6-23 mg/kg, the compounds under study prevented the development of the mixed type arrhythmia induced by intravenous injection of aconitine, prolonged the time of survival and prevented the animals' death during intravenous injection of the arrhythmogenic doses of strophanthine, prolonged the refractory period, and increased the threshold of ventricular fibrillation in cats. As regards the power of the antiarrhythmic effect, the compounds under study--hydrochlorides of arylamides of N-hydroxyalkly-alpha-piperidine carboxylic acids--approach lidocaine, yield to marcaine, and exhibit a broader range of therapeutic action. PMID- 6500032 TI - [Effect of clofelin and apressin on blood circulation and metabolic indices of the brain]. AB - Experiments on cats were made to study the effects of clopheline (5-6 and 10 micrograms/kg) and apressin (1 mg/kg) on the time-course of changes in the cerebral circulation, total arterial and venous pressures, oxygen and glucose concentrations, pH in the arterial and venous blood. It was discovered that clopheline and apressin appreciably reduce the total blood pressure and minimize the volumetric velocity of the cerebral circulation. Brain oxygen and glucose consumption was found to be reduced under the effect of these drugs. PMID- 6500033 TI - [Effect of heparin on the aggregation function of thrombocytes]. AB - It has been demonstrated in experiments in vitro that addition of heparin to platelet enriched plasma potentiates the ADP-induced platelet aggregation and that heparin itself can provoke aggregation of platelets. Heparin exerts an inhibitory action on the thrombin-induced aggregation, which seems likely to be associated with its inhibitory effect on thrombin, an inducer of aggregation. It has been discovered that heparin action on the hemostasis is determined by its concentration. The doses under 0.05 U/ml enhance the ADP-induced platelet aggregation and accelerate the time of blood coagulation, whereas the doses from 0.3 to 2 U/ml exert a more powerful effect on aggregation, inhibiting blood coagulation. PMID- 6500034 TI - [Effect of sodium oxybutyrate on the development of uterine hyperactivity]. AB - Chronic experiments on ovariectomized rabbits were made to study the effect of sodium hydroxybutyrate, a gamma-hydroxybutyric acid derivative, on the myometrium. The mechanical distension of the uterine horn provoked hyperactivity. The dopamine agonist levodopa dramatically potentiated the mechanical hyperactivity of the rabbit uterus. Sodium hydroxybutyrate (800 mg/kg i.v.) significantly inhibited the mechanical and levodopa uterine hyperactivity. The most powerful inhibitory action was produced on the levodopa hyperactivity. Sodium hydroxybutyrate can be regarded as a potential gravidoprotector. It may be assumed that the dopaminergic system is involved in the development of the myometrium hyperactivity. The GABA-ergic mechanisms are likely to play a definite role in the reduction of uterine contractility. PMID- 6500035 TI - [Effect of cimetidine on the gastric evacuatory function in peptic ulcer patients]. AB - A modified x-ray method was used in 28 patients with peptic ulcer of the duodenum to examine, at an interval of 3 days, the rate of evacuation from the stomach of radiographic contrast capsules ingested together with trial food intakes. Assay of the rate of evacuation from the stomach of the radiographic contrast capsules demonstrated that as compared to controls (without cimetidine), a single oral intake of 200 micrograms cimetidine exerts a statistically significant stimulating effect on evacuation from the stomach of the capsules taken with both semolina and appropriate breakfast. The stimulating effect of cimetidine manifested itself commonly 1 h after food intake. It is suggested that dramatic inhibition of hydrochloric acid secretion plays an important role in the mechanism of the stimulating action of cimetidine, as a result of which the inhibitory enterogastral reflex that regulates gastric evacuation is put out of service. PMID- 6500037 TI - [Acetylation of sulfanilamide substances in toxic lesions of the liver]. AB - In experimental toxic hepatitis induced by injection of CCl4 into rats, the rat blood and urine content of acetylated sulfamonomethoxine diminishes, the acetylation of sulfamonomethoxine and norsulfazole in an isolated stomach of the rat reduces, and acetylation of sulfamonomethoxine is inhibited by rat liver and small intestine homogenates. This confirms that different types of pathology (infectious and non-infectious) provoke the same line of changes, namely the reduction of acetylation of sulfanilamide substances in the body. CCl1 decreases sulfamonomethoxine acetylation by a mixture of the mitochondria and microsomes of the rat liver, i. e. eliminates the synergistic effect characteristic for intact rats. The reduction of acetylation recorded at different levels of the organization of the living systems--bodily, organ and subcellular ones--is accounted for by the lowering of the acetylcoenzyme A content in the tissues. One of the reasons for reduction of acetylation during the CCl4-induced liver injury lies in the impairment in the liver cells of the interaction between the mitochondria and endoplasmic reticulum. PMID- 6500036 TI - [Effect of sodium oxybutyrate on metabolic indices in ischemic hypoxia of muscle tissue]. AB - It has been demonstrated in experiments on rats with an ischemized hind limb that sodium hydroxybutyrate promoted activation of glucose-6-phosphate dehydrogenase of the pentosophosphate cycle, prevented the changes in the content of lactic acid and activity of lactate dehydrogenase in the ischemized muscle, interfered with the development of metabolic acidosis during devascularization of the ischemized limb. PMID- 6500038 TI - [Influence of retinol acetate and carbon tetrachloride on the transplacental carcinogenic effect of N-nitrosoethylurea]. AB - The influence of high doses of retinol acetate (RA) fed with the diet and carbon tetrachloride (CCl4) injected intraperitoneally into rat offspring on transplacental carcinogenic effect of N-nitrosoethylurea (NEU) was studied. Neither RA nor CCl4 affected significantly the development of the nervous system and kidney tumors induced transplacentally by NEU. CCl4 did not induce liver tumors either under these conditions. Obviously, it is rather difficult to modify the transplacental carcinogenesis. PMID- 6500039 TI - [Gametotoxic action of oxytetracycline on the early antenatal oogenesis of mice in in vivo and in vitro experiments]. AB - Examination of the histological sections of mouse ovaries in the antenatal period following oxytetracycline treatment during proliferation of oogonia has shown the adequacy of some indicators obtained in experiments in vivo and in vitro (the index of sexual cells, the mitotic index of oogonia, the index of pathological mitoses of oogonia). The gametotoxic action of the drug manifested itself in a significant increase of the pathological mitoses of oogonia. PMID- 6500040 TI - [Postnatal development of rat progeny after antenatal nicotine exposure]. AB - The authors studied the effect of a chemically pure nicotine on the development of the first-generation progeny after subcutaneous injection of the drug into female rats throughout the entire pregnancy. The drug was injected daily with a four-hour interval, the total doses being 5; 1,5 and 0.4 mg/kg (1/5, 1/20 and 1/70 of the LD50). Following nicotine treatment in doses of 5 and 1.5 mg/kg the survival rate and body mass of the progeny were found to be lowered. The disorders identified in the functions of the nervous system (behavioral reactions) and cardiovascular system (blood pressure, heart rate) were ascertained to be dependent on the drug dose and sex of experimental animals. PMID- 6500041 TI - [Effect of phenobarbital, hexamidine and benzonal on the toxicity of dioxidine]. AB - It has been shown in experiments on rats that phenobarbital, hexamidine and benzonal administered in doses producing the induction of liver microsomal enzymes reduce the total toxic action of dioxydin and pathological alterations in the adrenals induced by dioxydin. A possible mechanism of the effect under consideration is discussed. PMID- 6500042 TI - [Detoxification of portal system blood in the combined treatment of peroral poisonings]. AB - A combined method for body detoxification including extracorporeal purification of the blood outflowing from the intestine with sorbents and emergency evacuation of the small intestine contents by means of a tube was employed in acute experiments on dogs after oral administration of the lethal doses of veronal. Tht use of the method interferes with the poison supply from the gastrointestinal tract to the systemic blood flow, thereby leading to acceleration of body detoxification. PMID- 6500043 TI - [Use of antioxidants for preventing the hepatotoxic effect of acrylonitrile]. AB - The authors examined the possibility of using antiooxidants in the chemoprophylaxis of poisonings with alkylating chemical compounds. It was demonstrated that vitamin E, ionol and low-molecular thiols (cystein, glutatione and unithiol) prevent the increased permeability of plasma membranes and impairment of the protein-synthesizing function of the endoplasmic reticulum of hepatoytes in acute and chronic acrylonitrile poisoning. PMID- 6500044 TI - Antimycotic action of some amino-N-(5-pyrimidinyl)benzenesulfonamides. AB - 2-, 3- and 4-amino-N-(6-amino-1,4-dihydro-4-oxo-2-mercapto (or alkylthio)-5 pyrimidinyl)benzenesulfonamides were synthesized and biologically tested on different strains of Candida albicans and Candida tropicalis. Some of the 4 aminoderivatives were also tested for antibacterial properties on numerous bacterial strains. Antimycotic activity of 4-amino compounds, expressed as MIC, is around 50 micrograms/ml and higher than that of both 2-amino- and 3 aminoderivatives. In all these compounds alkyl chain length does not seem to have any notable effects on biological activity, an exception being made for some aralkyl compounds. Antibacterial activity of 4-aminoderivatives is very low for all strains tested. PMID- 6500045 TI - [Synthesis and analgesic activity of 4-(3-oxo-1,2-benzoisothiazoline-2 yl)phenylalkanoic derivatives]. AB - The synthesis of a new series of 4-(3-oxo-1,2-benzisothiazolin-2 yl)phenylalkanoic compounds and some of their functional derivatives is described. The compounds, on the basis of data obtained from 1,2-benzisothiazolin 3-one derivatives, were biologically examined mainly for their antiphlogistic and analgesic actions. Results obtained, in analyzing the relationship between structure and pharmacological actions, suggest that both 4-(3-oxo-1,2 benzisothiazolin-2-yl)-phenyalkanoic acids and o-sulphobenzimido alkanoic esters are endowed with pain-killing effects comparable in potency and efficacy with phenylbutazone. PMID- 6500046 TI - [Compounds with presumable antitumor activity. III. 1-Substituted N,N'-di-2 pyrimidinyl (or pyrazinyl)methylenediamine]. AB - A series of 1-substituted N,N'-di-2-pyrimidinyl (or pyrazinyl)methylenediamines were synthesized as potential antitumor agents. The compounds were tested on lymphocytic murine leukemia P 388. The active 1-(2-chlorophenyl)-N,N'-(2 pyrazinyl)methylenediamine (IX) was also tested on other experimental tumors. PMID- 6500047 TI - Structure identification of rifampicin N-oxide. AB - 1H- and 13C-N.M.R. spectra, in addition to previous physicochemical data, confirm the structure of rifampicin N-oxide and indicate that the oxygen atom is bonded to the piperazine N--CH3 group. PMID- 6500048 TI - Purification and characterization of a hormone-like factor which inhibits cholera secretion. AB - A factor which inhibits intestinal hypersecretion induced by cholera toxin was studied. The factor was extracted from intestinal mucosa or pituitary gland of pig. It has an isoelectric point of pH 4.7 +/- 0.1 at 10 degrees C and showed a weak affinity to dextran gel and a strong affinity to agarose gel. From agarose gel the factor was eluted with high concentrations of D-galactose or alpha-methyl D-glucose, while D-glucose and lactose were less effective. After purification more than 2000 times by isoelectric focusing and gel chromatography, the factor was shown by SDS-polyacrylamide gel electrophoresis to be a protein consisting of subunits of molecular mass 30, 17 and possibly 15 kDa. PMID- 6500049 TI - Tyrosine sulfation: a post-translational modification of proteins destined for secretion? AB - Protein sulfation was studied in germ-free rats by prolonged in vivo labeling with [35S]sulfate. Specific sets of sulfated proteins were observed in all tissues examined, in leucocytes, and in blood plasma. No protein sulfation was detected in erythrocytes. Analysis of the type of sulfate linkage showed that sulfated proteins secreted into the plasma contained predominantly tyrosine sulfate, whereas sulfated proteins found in tissues contained largely carbohydrate sulfate. This implies some kind of selection concerning the intracellular processing, secretion, turnover or re-uptake of sulfated proteins which is responsible for the enrichment of tyrosine-sulfated proteins in the plasma. PMID- 6500050 TI - Identification and purification of a 36 kDa bile acid binder in human hepatic cytosol. AB - We recently purified two closely related 33 kDa proteins from rat hepatic cytosol, designated bile acid binder I and II, which selectively bind bile acids with comparable affinity as glutathione S-transferase B. This work has now been extended to human liver in which we have identified a similar cytosolic binding activity in the 30-40 kDa fraction from gel filtration. Subsequent chromatofocusing and hydroxyapatite chromatography resulted in the isolation of a homogeneous monomeric protein of 36 kDa. The binding affinity of this protein for lithocholate using the displacement of 1-anilino-8-naphthalenesulfonate (ANS) was 0.1 microM, whereas human hepatic glutathione S-transferases purified from glutathione affinity chromatography demonstrated no competitive displacement of ANS. PMID- 6500051 TI - Hypomethylation of DNA in meiotic and postmeiotic rooster testis cells. AB - To study whether changes in methylation of DNA are related to the structural and functional changes that chromatin undergoes throughout rooster spermatogenenis, we analyzed, by high-performance liquid chromatography, the 5-methylcytosine content of DNA purified from rooster testis cell nuclei at successive stages of the cell differentiation process. The DNA of meiotic and postmeiotic cells appears partially under-methylated, containing approximately 30% less methylcytosines than the DNA obtained from premeiotic and somatic cells. PMID- 6500052 TI - Lysosomal thyroid hormone 5'-deiodinase. AB - Lysosomes prepared from rat liver and kidney after loading with the detergent Triton WR-1339 show membrane-bound 5'-deiodinase activity with marked specificity for 3,3',5'-triiodothyronine (reverse T3), lesser activity with respect to thyroxine (T4) and almost none towards 3,3',5'-triiodothyronine (T3). The enzyme is thiol dependent and shows maximal catalysis at pH 7.2. As many of the states known to alter thyroid hormone levels also affect lysosomal function, inhibition of the lysosomal 5'-deiodinase leading to an increase in intracellular reverse T3 may be an initiating mechanism for thyroid hormone change. PMID- 6500053 TI - Vitamin K-dependent carboxylation: inhibition by a peptide containing 4-methylene glutamic acid. AB - The peptide Boc-4-methylene Glu-Glu-Val has been synthesized and shown to be a strong inhibitor of the vitamin K-dependent carboxylation catalyzed by a detergent solubilized rat liver microsome preparation. The inhibition is apparently competitive with respect to the substrate peptide and non-competitive with respect to HCO3-. PMID- 6500054 TI - Specific interactions of liposomes with PMN leukocytes upon incorporating tuftsin in their bilayers. AB - Incorporation of tuftsin derivatives, Thr-Lys-Pro-Arg-NH-C18H37 or Thr-Lys-Pro Arg-NH-(CH2)2-NH-COC15H31, into an egg phosphatidylcholine/cholesterol liposome bilayer led to significantly enhanced binding of the liposomes to PMN leukocytes at 37 degrees C but not at 0 degree C. Under identical conditions, no such enhanced binding of the liposomes was observed with erythrocytes and lymphocytes. These results demonstrate that grafting of tuftsin on the liposome bilayer enables the liposome to recognize specifically the PMN leukocytes and to deliver its contents to these cells. PMID- 6500055 TI - Reoxidation and renaturation studies on the main toxin of Naja naja samarensis. AB - The main toxin of Naja naja samarensis is a very small and rigid protein (Mr 6850, 8 cysteines). When fully reduced, it regains its native conformation by a mechanism involving a rapid cysteine oxidation and a slower, less temperature dependent disulfide exchange. In a native-like form of the protein we observed a population whose cysteines were incompletely reoxidized. When intermediates with blocked cysteines were incubated with oxidized and reduced glutathione, the percentage of native-like molecules increased. These findings suggest a multiple folding pathway. PMID- 6500056 TI - Chemically induced antioxidant-sensitive respiration. Relation to glutathione content and lipid peroxidation in the perfused rat liver. AB - The interrelations between the hepatic chemically induced antioxidant-sensitive respiration and the contents of malondialdehyde (MDA) and of reduced glutathione (GSH), were studied in the isolated hemoglobin-free perfused rat liver. Antioxidant-sensitive respiration was induced by the infusion of agents such as ethanol, iron, xanthine or t-butyl hydroperoxide, or by phenylhydrazine pretreatment in vivo. The development of this respiratory component occurred concomitantly with high levels of MDA in the perfused livers, while those of GSH were diminished. PMID- 6500057 TI - Phosphorylethanolamine--the major constituent of the phosphomonoester peak observed by 31P-NMR on developing dog brain. AB - 31P-NMR spectra of newborn dog brains exhibit a prominent phosphomonoester (PME) peak (6.78 +/- SD 0.05 ppm from phosphocreatine peak), similar to those of human neonates. Studies were undertaken to identify the chemical constituents of this peak. Brains of puppies were funnel frozen for methanol-HCl-perchloric acid extraction after in vivo 31P-NMR spectra were taken. The pK of the major component of the PME region in the NMR spectrum of extract was 5.4, corresponding to that of phosphorylethanolamine (PEt). Addition of PEt increased the major peak on the PME region over a wide range of pH, while addition of phosphorylcholine or ribose 5-phosphate yielded distinct peaks. We suggest that the major constituent of phosphomonoester peak of 31P-NMR spectra of newborn dog brain is phosphorylethanolamine. Biochemical mechanisms relevant to changes of phosphorylethanolamine during brain development are discussed. PMID- 6500058 TI - XANES study of iron displacement in the haem of myoglobin. AB - The XANES (X-ray absorption near edge structure) spectra of deoxy human adult haemoglobin (HbA) and myoglobin (Mb) have been measured at the wiggler beam line of the Frascati synchrotron radiation facility. The XANES are interpreted by the multiple scattering cluster theory. The variations in the XANES between HbA and Mb are assigned to changes in the Fe-porphyrin geometry. PMID- 6500059 TI - Incorporation of chromaffin granule membranes into large-size vesicles suitable for patch-clamp recording. AB - Incubation of chromaffin granules with excess liposomes at pH 6.0 resulted in the formation of cell-size structures, which were purified by centrifugation on sucrose gradients. Experiments with fluorescein-labeled granules indicated incorporation of granule membrane to these structures. The preparation contained various vesicular structures with a diameter up to 15 micron. The largest elements were studied by the 'patch-clamp' technique. 'Cell-attached' and 'whole cell' recordings indicated the presence of currents corresponding to unitary conductances ranging from 100 to 500 pS. PMID- 6500060 TI - Assignment of the Fe-N epsilon (His) stretching mode in the resonance Raman spectra of a monomeric insect cyanomethaemoglobin. AB - Resonance Raman (RR) spectra of the monomeric cyanomethaemoglobin CTT III from insect larvae of Chironomus thummi thummi are shown for the range of 200-550 cm 1. By iron and cyanide isotope exchange a line varying between 307 cm-1 for 57Fe 13C15N and 311 cm-1 for 54Fe-12C14N, has been assigned to the Fe-N epsilon stretching mode of this haem complex. The substitution of 54Fe for 57Fe has no effect on the Fe-C = N bending mode whereas it affects the Fe-CN stretching mode. PMID- 6500061 TI - Glycogen metabolism: a 13C-NMR study on the isolated perfused rat heart. AB - Glycogen synthesis from D-[1-13C]glucose was observed in the perfused rat heart by 13C-NMR spectroscopy at 62.9 MHz. The glycogenogenesis was stimulated by pretreatment of the animals with isoprenaline. Whereas in hearts from control rats the incorporation of D-[1-13C]glucose into the glycogen remained below the detection threshold, 5 min proton-decoupled 13C-NMR spectra revealed, in hearts from treated rats, a significant labelling of the glycogen within the first minutes of the perfusion and a further linear increase of the glycogen resonance for up to 25 min. This model was used to monitor the appearance of 13C-labelled lactate during ischemia. PMID- 6500062 TI - Chemiluminescent assay of lipid peroxide in plasma using cytochrome c heme peptide. AB - A convenient assay specific to lipid hydroperoxide in plasma is presented. Cytochrome c heme peptide obtained from Saccharomyces was found to emit a strong chemiluminescence with any hydroperoxide, but not with TBA-reactive substances. The benefit of measuring this luminescence using photon counting is discussed with respect to in vivo lipid peroxidation. PMID- 6500063 TI - In vitro enzymatic methylation of DNA substituted by N-2-aminofluorene. AB - Both the initial velocity and the overall methylation of DNA substituted by aminofluorene, by a rat liver DNA(cytosine-5-)-methyltransferase, are increased as compared to native DNA. The Km and Vmax of the modified DNA for the enzyme increase as a function of the extent of modification. The carcinogen may induce a secondary structure favouring the 'walking' of the enzyme along the DNA. The hypermethylation caused by this carcinogen could have a significance in gene activity, cellular differentiation and cancer induction. PMID- 6500064 TI - Does the complex of aminoacyl-tRNA synthetases and tRNA-modifying enzymes prevent miscoding? AB - Several aminoacyl-tRNA synthetases of higher eukaryotes have always been found as multienzyme complexes. There are indications that these complexes can be associated with some tRNA-modifying enzymes. The function of such complexes is unclear. I have noticed that 6 out of 7 aminoacyl-tRNA synthetases most commonly occurring in complexes correspond to a group of tRNAs which must always contain a modified U in the first position of their anticodons. A hypothesis is proposed according to which association of 6 aminoacyl-tRNA synthetases with U-modifying enzymes can protect a cell from miscoding. PMID- 6500065 TI - Mechanism of foetal wastage following immunoneutralization of riboflavin carrier protein in the pregnant rat: disturbances in flavin coenzyme levels. AB - Immunoneutralization of maternal RCP results in a greater than 90% decrease in the content and the incorporation of [2-14C]riboflavin into embryonic FAD as well as a percentage redistribution of both embryonic FMN and riboflavin. This is unaccompanied by any discernible changes in flavin distribution pattern in the maternal liver. Embryonic alpha-glycerophosphate dehydrogenase and NADPH cytochrome c reductase register significant decreases in activities in the RCP antiserum-treated rats. These alterations readily explain the arrest of foetal growth culminating in pregnancy termination in the antiserum-treated animals. PMID- 6500066 TI - History and status of the area postrema. AB - The history of morphological and functional studies on the area postrema (AP) is traced for significant landmarks from 1896, when its name was conferred by Retzius, to 1960 when the foundation of inquiry had become firmly set. A comparative anatomical survey of the medulla oblongata identifies the AP in mammals and birds but not in amphibians and lower phyla even though other members of the so-called circumventricular organ system are represented in the more ancient creatures. Existence of the AP in reptiles is insufficiently documented. The transition from water- to land-dwelling animal life affords propitious neural remodeling for the emergence of the AP in evolving species. No vital role is known to be served by the AP. Nonetheless, its physical interposition between the blood and cerebrospinal fluid and its shared functions with the nucleus tractus solitarii indicate a capability for widespread somatovisceral influence in response to particular perturbations. It is suggested that the diverse systemic expressions of postremal activation are encompassed in the general syndrome of nausea and vomiting. PMID- 6500067 TI - The structure of the mammalian area postrema. AB - The area postrema in mammals other than rodents and lagomorphs is a bilateral mound of gelatinous-appearing tissue that protrudes into the caudal fourth ventricle on either side of the obex. In rodents and lagomorphs it is a single midline structure at the apex of the calamus scriptorius. The vasculature is derived mainly from the posterior inferior cerebellar arteries and consists mainly of sinusoidal capillaries. It appears to constitute a portal system, at least in the rat. Many of the capillaries are fenestrated, and many large perivascular spaces with both vascular and parenchymal basal laminae are present. The cell population is composed of flattened ependymal cells exhibiting microvilli, and of small neurons, normal astrocytes, glialoid cells, and a very few oligodendroglia. Mast cells are occasionally present. The glialoid cells appear to be the predominant cell type and exhibit great numbers of vascular podia. Axodendritic synapses are numerous and axosomatic synapses are occasionally seen in the parenchyma. Synaptic vesicles are mainly of the clear cored type but large dense-cored vesicles are commonly observed in some axon terminals. PMID- 6500068 TI - Participation of the area postrema in cardiovascular control in the dog. AB - Investigations have demonstrated that the pressor effects of low-dose intravertebral angiotensin II (Ang II) in the dog are mediated by the area postrema (AP). Chronic ablation of the AP has been shown to produce both mild hypotension and blunting of the pressor effects of peripherally administered Ang II, which suggests a tonic influence by this structure on the regulation of blood pressure. These findings motivated a correlated series of neurophysiological and anatomical studies to characterize further the AP pressor pathway. The pressor response to electrical stimulation of the AP was shown to be mediated by increased central sympathetic outflow, as shown previously for the response to intravertebral Ang II, and unopposed by the central nervous system baroreflex pathways. Neuroanatomical investigations demonstrated a three-layer structure in the dog's AP, with efferent projections into the medial nucleus tractus solitarii bilaterally. These studies have provided new evidence about the functional and structural mechanisms by which the AP participates in cardiovascular regulation. PMID- 6500069 TI - Localization of neurally mediated arrhythmogenic and coronary vasoconstrictor properties of digitalis. AB - Studies of the cardiotoxicity of digitalis have revealed an appreciable role of the autonomic nervous system in modulating these toxicities. Neuraxis transection experiments and studies with digitalis compounds that fail to enter the central nervous system suggest that centers localized to the floor of the fourth cerebral ventricle play a substantial part in neural arrhythmogenic effects of the digitalis glycosides. Stimulation of the area postrema (AP) in animals partially digitalized, but not otherwise manifesting ventricular arrhythmias, elicits ventricular tachycardia. Neuraxis transection experiments and studies with a charged digitalis derivative also suggest localization of the coronary vasoconstrictive properties of digitalis to the AP. The results suggest that this region of the brain stem is sensitive to neurally active substances that cause peripheral sympathetic effects of considerable consequence. PMID- 6500070 TI - Area postrema: part of the autonomic circuitry of caloric homeostasis. AB - Investigations in which lesion techniques are used suggest a role for the area postrema (AP) in caloric homeostasis. Ablations of the AP in rat are associated with temporary hypophagia, hypodipsia, and rapid body weight loss. This is followed by a steady period of relatively normal eating and drinking and body weight gain. This steady period is characterized specifically by lowered body weight maintenance levels, overingestion of palatable foods, and attenuated taste aversion learning and glucoprivic feeding. These effects cannot be attributed simply to lesions of central terminations of gustatory and visceral afferents. The AP may be involved in feeding behaviors that are triggered by chemical signals in the blood or cerebrospinal fluid. In addition, the AP along with the adjacent nucleus tractus solitarii (NTS) seems to be part of the central autonomic system subserving caloric homeostasis; this system includes the lateral hypothalamus, which has a well-documented role in energy balance. The contribution of the AP along with the NTS must be considered with respect to their relationship to other structures within this system. PMID- 6500071 TI - Area postrema and adjacent solitary nucleus in water and energy balance. AB - Lesions of the area postrema (AP) and immediately adjacent nucleus tractus solitarii cause a syndrome of permanent weight loss with little disruption to behavioral controls of body weight regulation. There is also a permanent polydipsia and elevated salt appetite, which appear to be secondary to deficits in renal conservation of water and sodium. Neuroanatomical studies indicate that the immediately adjacent solitary nucleus and AP are sites of termination of visceral afferents from abdominal organs and the destination and origin of distant central afferent and efferent connections. PMID- 6500072 TI - Crystallization of substrate and product analog complexes of tryptophanyl-tRNA synthetase. AB - We have prepared crystals of tryptophanyl-tRNA synthetase from Bacillus stearothermophilus complexed to tryptophan (type II*), and to tryptophanyl-3'(2') ATP (type IV). The latter compound is a product analog, enzymatically synthesized by acyl transfer of tryptophan from the tryptophanyl-5'-AMP intermediate to a second molecule of ATP. It resembles the 3'-terminal fragment, tryptophanyl 3'(2')-adenosine, of Trp-tRNATrp. Both crystal forms diffract to high resolution. Although both forms are grown from 2 M K2HPO4, they are dramatically different in the shape of the unit cell and in space group symmetry. Type II* crystals are monoclinic (space group P21). However, low-resolution reflections obey the symmetry of space group P321, which indicates both the existence and the location of noncrystallographic symmetry in the monoclinic unit cell. Type IV crystals belong to space group P41212 (or its enantiomorph) and the unit cell is elongated along the fourfold screw axis. Analysis of molecular packing suggests that intermolecular contacts in the two crystal types are very different. Thus, the two structures may exhibit conformational differences related to catalysis by this enzyme. Solution of type II* and type IV crystal structures may provide representations resembling a Michaelis complex and an acyl transfer product complex. PMID- 6500073 TI - Cell culture mutants as aminoacyl-tRNA synthetase complex probes. AB - A number of Chinese hamster ovary cell culture mutants have been characterized by us for their high-molecular-weight aminoacyl-tRNA synthetase (aaRS) complexes. The results all support a model of aaRS complex function wherein the high molecular-weight complexes form aminoacyl-tRNA by utilizing extracellular amino acids immediately on their transport and before they have equilibrated with the internal pool. The low-molecular-weight aaRS forms exclusively utilize amino acids from only the intracellular pool. PMID- 6500074 TI - Sequential events in calmodulin on binding with calcium and interaction with target enzymes. AB - khe conformational and functional events in calmodulin (CaM) are disproportionate to the mean saturation by Ca2+. The enhancement of intrinsic tyrosine fluorescence closely follows the appearance of species CaM X Can greater than or equal to 1; the exposure of the hydrophobic patch at the surface of CaM coincides with the appearance of CaM X Can greater than or equal to 2. For the activation of four different target enzymes, i.e., brain phosphodiesterase and adenylate cyclase, red blood cell Ca,Mg-ATPase, and skeletal muscle phosphorylase b kinase, CaM X Can greater than or equal to 3 is required. The different enzymes have the same affinity for the active species. The direct interaction of CaM with Ca2+ and phosphorylase b kinase has been analyzed according to the theory of energy coupling: whereas the first two stoichiometric calcium-binding constants in the complex are not significantly different from those of free CaM, the third Ca2+ binds with an affinity at least 10(6)-fold higher to enzyme-bound CaM than to free CaM, which corresponds to a free energy coupling of -7 kcal/mol CaM. The similarities in the activation mechanism of different enzymes suggest the existence of one unique CaM-binding domain. The characteristics of the interaction between CaM and melittin, a small amphiphatic cytotoxin, led us to propose melittin as a model for such a CaM-binding domain. PMID- 6500075 TI - The fetus is a graft, both biologically and legally. PMID- 6500076 TI - Three years of in vitro fertilization at Norfolk. AB - During the 3 years from 1981 to 1983, 319 consecutive patients in 560 cycles were treated in a program of in vitro fertilization at Norfolk. All patients were stimulated by human menopausal gonadotropin supplemented by human chorionic gonadotropin. There were transfers in 429 cycles, resulting in 105 pregnancies. Over the 3-year span, the pregnancy rate by cycle was 19%; by transfer, 25%; and by patient, 33%. PMID- 6500078 TI - Immunoreactive relaxin surge in the peritoneal fluid of women during the midluteal phase. AB - Relaxin was assayed in the peritoneal fluid (PF) of 176 women with normal ovulatory cycles. Validation of the assay in this fluid was carefully established. Relaxin was rarely detected before day 20 of the cycle. From days 21 to 24, all samples contained detectable concentrations of the peptide, ranging between 75 and 775 pg/ml. Apparition of relaxin in the PF was not directly related to the ovulatory follicular rupture. It was also delayed, compared with the postovulatory rise of plasma and peritoneal progesterone. Relaxin is thus present in the PF only during the period propitious to human embryo implantation. PMID- 6500077 TI - Evidence of chlamydial infection in infertile women with and without fallopian tube obstruction. AB - This study investigates the prevalence of Chlamydia trachomatis antibodies in 164 infertile women who underwent diagnostic laparoscopy and dye insufflation as part of routine infertility investigations. C. trachomatis antibodies were found in 36 (22%) of 164 infertile women, which was significantly more than the prevalence of antibodies in a control group (22 of 200, 11%). C. trachomatis antibodies were found in 25 (35.7%) of 70 infertile women who had laparoscopically verified peripheral tubal disease. This was significantly more than the prevalence of C. trachomatis antibodies in infertile women with normal fallopian tubes (6 of 52, 11.5%). The prevalence of C. trachomatis antibodies in infertile patients with laparoscopically verified cornual disease was similar to those without cornual disease. C. trachomatis was not isolated from any of the patients studied. This study confirms that past chlamydial salpingitis is associated with the development of peripheral fallopian tube obstruction with resultant infertility. PMID- 6500079 TI - Correlation and comparison of Nb2 lymphoma cell bioassay with radioimmunoassay for human prolactin. AB - Serum samples from groups of men and women with normal and elevated prolactin (PRL) levels were assayed by radioimmunoassay (RIA) and by Nb2 lymphoma cell bioassay (BA) for the presence of PRL. Because the Nb2 lymphoma cells respond to both PRL and growth hormone, BA for PRL activity was carried out before and after neutralization of growth hormone in the serum samples. There were excellent correlations between RIA and BA both in euprolactinemic (r = 0.7587; P less than 0.002) and hyperprolactinemic (r = 0.9558; P less than 0.001) subjects. On an absolute basis, RIA and BA values were similar in the euprolactinemic group (6.6 +/- 0.8 versus 6.2 +/- 1.0), whereas in the hyperprolactinemic group, RIA values were significantly higher than the BA results (89.41 +/- 22.4 versus 62.1 +/- 21.2). The two assay systems also appeared to correlate better in women who were hyperprolactinemic, with obvious menstrual cycle disturbances, than in hyperprolactinemic women without menstrual cycle disturbances. PMID- 6500080 TI - Semen selenium and human fertility. AB - Selenium (Se) was measured in the semen of 125 men from couples consulting for infertility. A mean concentration of 71.3 +/- 29.7 ng/ml of semen was found, with a range of 7 to 230 ng/ml. More than 85% of the Se is in the seminal plasma. There was a significant positive correlation between sperm count and semen Se. Sperm motility was maximal at semen Se levels ranging between 50 and 69 ng/ml; above and below this range, motility was decreased and the incidence of asthenospermia was high. This result suggests an optimal range for semen Se. A follow-up of 4.5 to 5 years after the initial assay of Se revealed that low semen Se levels (less than or equal to 35 ng/ml) were associated with male infertility. A Se level between approximately 40 and 70 ng/ml was optimal for reproductive performance (high pregnancy rate and low abortion rate). Semen Se levels greater than or equal to 80 ng/ml were associated with a high abortion rate and signs of ovarian dysfunction in the partner (both partners usually have the same diet and environmental exposure). These results attest to the role of Se in human reproduction, a well-established fact in several animal species. The semen Se level appears to be a useful indicator of Se status versus reproductive function. Further studies are warranted concerning the general aspects of metabolism and mechanism of action of Se in infertile couples before any therapeutic modification of intake of this element can be contemplated. PMID- 6500081 TI - Suppression of basal luteinizing hormone concentrations by melatonin in postmenopausal women. PMID- 6500082 TI - Tuboovarian autoamputation and infertility. AB - Asymptomatic or undiagnosed tuboovarian autoamputation in teenagers may have its impact on fertility later in life. Two cases are presented with infertility following unilateral adnexal autoamputation. The importance of awareness for possible subtorsion or torsion of adnexa in childhood and adolescence and its impact on fertility are discussed. PMID- 6500083 TI - Peritoneal fluid prolactin in infertile women with endometriosis: lack of evidence of secretory activity by endometrial implants. AB - To evaluate the functional status of endometriotic implants, a luteal secretory product of endometrium, PRL, was measured in the PF of 27 infertile women with endometriosis, 13 infertile women without endometriosis, and 11 fertile women undergoing elective sterilization. PF PRL concentrations and PF/plasma PRL ratios were similar in all the groups and did not vary with the menstrual cycle or the stage of endometriosis. These data demonstrate that the ectopic endometrium in infertile women with endometriosis does not secrete PRL in amounts sufficient to elevate PF concentrations and suggest that the infertility observed in these women is probably not dependent upon the secretory activity of endometriotic implants. PMID- 6500084 TI - [Responses of different hypothalamic structures to stimulation of the viscero caudal region of the nucleus of a the solitary tract of the medulla oblongata]. AB - Responses of single units of anterior, ventromedial, lateral and posterior hypothalamus to stimulation of the caudal viscero-receptive region of nucleus tractus solitarius were recorded in anesthetized and immobilized cats. The patterns of the responses were mainly excitatory in all structures under study. The highest degree of reactivity was found for units in the lateral and posterior hypothalamus. According to the latency of the evoked discharges three types of responses were revealed: short (6-12 msec), middle (13-22 msec) and long-latency (22-60 msec) responses. At relatively low frequencies of stimulation the reproducibility was rather poor. Possible projections from nucleus tractus solitarius to the hypothalamus are discussed. PMID- 6500085 TI - [Effect of partial deprivation of slow-wave sleep on the structure of the sleep wakefulness cycle]. AB - In cats, partial (35% and 55%) deprivation of slow-wave sleep by way of inducing fragments of isolated EEG wakefulness in response to electrical stimulation of brain-stem activating structures, was shown to lead to an enhancement of behavioral sleep and reduction of paradoxical sleep. The reduction of paradoxical sleep is particularly obvious if the deprivation of slow-wave sleep is induced by fragments of behavioral wakefulness. In these situations no rebound of paradoxical sleep is observed in post-deprivation period. The causal interrelationships and interdependence of different phases of the sleepwakefulness cycle as well as interaction of EEG and behavioral mechanisms of sleep and wakefulness, are discussed. PMID- 6500086 TI - [Use of focused ultrasound for local effects on deep brain structures]. AB - The possibilities of the ultrasound technique for local destruction of certain brain areas, for reversible alteration of functional state of the c.n.s. structures and for study of structural-functional interrelationships in the brain are discussed. PMID- 6500087 TI - [Functional status and ultrastructure of the smooth muscle coat of arteries]. AB - The ultrastructure of smooth-muscle sheath of the rabbit ear artery was studied in situ with the blood flow preserved both in contracted and in relaxed states. In the latter state a decrease in the volume of smooth-muscle cells and a relative increase of interfellular space were revealed. These findings suggest a redistribution of fluid in the artery wall during contraction and relaxation which can be important for transport of substances in the vascular wall. In relaxation of smooth-muscle cell such phenomena as desaggregation of thick myosin myofilaments, considerable reduction of the micropinocytose apparatus, shifting of contractile elements to the cell's central zone, partial discomplexation of the endoplasmatic reticulum, were revealed. Possible mechanisms of the ultrastructural changes and their functional role are discussed. PMID- 6500088 TI - [Role of sympatho-activating structures of the ventrolateral surface of the medulla oblongata in vasomotor regulation]. AB - In anesthetized cats, the cold block or coagulation of intermediate zones of the bulbar ventro-lateral surface (BVLS) resulted in profound decrease of the blood pressure (BP) level. The descending tonic activation of spinal vasomotor mechanism in formed by spontaneous discharges of antidromically identified output sympatho-activating neurons with mean firing rate about 14.4/sec. After coagulation of the intermediate zone, pressure reflexes of the BP and late somato sympathetic response in white rami disappear whereas the spino--bulbo--spinal somato--somatic reflex remains unchanged. The reflex discharges of single sympatho--activating neurons were within the time limits of the late somato- sympathetic response and followed by the silent period. The preferable inhibition of the long-latency white rami discharges elicited by BVLS stimulation arise 200 250 msec after R-wave of the ECG. The inhibition of long-latency discharges was observed during the increase of the BP level induced with vasoconstrictor drugs. The intermediate zone structures of BVLS seem to play the key role in supporting of the BP level and organization of pressure reflexes. These structures are suggested to be the actual elements of the bulbar vasomotor center. PMID- 6500089 TI - [New electrophysiologic data on localizing visual representation in the limbic area of the neocortex]. AB - In the limbic part of the rat neocortex, afferents from the retino-geniculo cortical and retino-tecto-thalamo-cortical visual subsystems converge to the area 29. A specific feature of the area 29 responses to stimulation of thalamic visual nuclei (the LGB and the postero-lateral nucleus) involves gradualness of their appearance during rhythmic stimulation. The responses have an initial negative phase, are resistant against nembutal, have a short and stable latency, their neuronal reaction being phasic in nature and showing dependence on physical parameters of stimulation. These intermediate type reactions possess features of both specific and unspecific responses of the neocortex which seems to be characteristic of the area 29 function. PMID- 6500090 TI - [Interrelation of cortical and autonomic processes in regulating functional states of the human brain]. AB - Under normal and disturbed autonomic regulation, the co-ordination of behavioral, neurodynamic and peripheral indices of the brain functional state was studied during mental activity. Different course of cortical processes was revealed depending on autonomic and emotional components of mental strain. The significance of central autonomic regulation of the brain functional state for optimal mental activity, is discussed. PMID- 6500091 TI - [Postsynaptic potentials of the motor neuron of the facial nerve nucleus evoked by stimulation of the cerebellar nuclei]. AB - Synaptic processes induced in the facial motoneurons by stimulation of the red nucleus and the cerebellar interpositus and dentate nuclei were studied in anesthetized and immobilized cats. The stimulation of the red nucleus evoked monosynaptic EPSPs in the motoneurons whereas oligo--and polysynaptic EPSPs were recorded in response to the stimulation of the interpositus and dentate nuclei. Based on the experiments with the lesion of the red nucleus, a conclusion was drawn about its participation in the mechanisms and pathways of the cerebellar influence on the facial motoneurons. PMID- 6500092 TI - [Individual characteristics of the behavior, learning and adaptation of rats exposed to extreme conditions]. AB - Techniques of open field, instrumental food conditioning and acute hypoxic hypoxia were used in experiments on white rats which had been divided into three groups: low--(I), middle--(II) and high-entropy (III). The III group rats were characterized by high motor activity, various postures and states which seemed to account for fast instrumental conditioning of these rats. Rats of the II and III groups (67% of all the rats) proved most resistant against hypoxia and therefore more adaptable to extreme factors. PMID- 6500093 TI - [Asymmetry of the interaction of transcallosal and thalamocortical flows in the sensorimotor cortex]. AB - The interaction between transcallosal potentials and responses to stimulation of the contralateral sciatic nerve was studied in symmetrical areas of the cat sensorimotor cortex. The interacting responses and the resulting EPs were characterized by a functional interhemisphere asymmetry of an individual form. In transcallosal conditioning with 10-ms interstimuli intervals, the positive components of the EPs prevailed in the left hemisphere. The characteristics of the interhemisphere asymmetry were determined by the animal sex: the spatial- temporal interaction of the flows had different features in different hemispheres, was characterized by unequal markedness of asymmetry of the EP components as well as by opposite character of the asymmetry in animals of different sex. The characteristics of the EP interhemisphere asymmetry seem to be determined by an interaction of dominant foci occurring under these conditions in each of the hemispheres. PMID- 6500094 TI - [Shifts in spatial synchronization potentials of the rabbit cortex evoked by the administration of noradrenaline to the visual area]. AB - Application of noradrenaline to the visual cortex of alert rabbits led to a general brief increase of the distant potential synchronization in the visual and motor areas as well as to a local rather steady (5-10 min) synchronization between the processes in the visual cortical area. Later a similar and even more obvious increase occurred between bioelectrical processes in the sensorimotor cortex. The synchronization increase seems to be favourable for excitation transmission. PMID- 6500095 TI - [Characteristics of the response of the white rami communicantes to stimulation of different sections of the amygdaloid body]. AB - Electrical responses in L2-L3 white rami to stimulation of cortico-medial, baso lateral and central amygdaloid nuclei were studied in anesthetized and immobilized cats. The stimulation evoked a similar pattern of sympathetic discharge mostly consisting of a wave with a mean latency of 69.04 +/- 1.31 ms. No strict topographical location of sympatho-activating structures was found in different areas of the amygdala. In simultaneous recording of arterial BP and amygdalo-sympathetic discharges, 10-sec period of tetanic (100/sec) stimulation of the amygdalo led to a short-latency component facilitation or appearance, the late component of the amygdalo-sympathetic discharge being depressed. The duration of the latter inhibition corresponded to the period of the BP reaction and therefore was of a baroreceptor origin. Possible mechanisms of amygdaloid regulation of the activity of sympathetic preganglionic neurons are discussed. PMID- 6500096 TI - [Asymmetry of motor function in the forelimbs of cats]. AB - 82% of cats revealed natural domineering of forelimbs forming in early ontogenesis movements of different degrees of complexness in conditions of equal input signals so both hemispheres. Among these animals 75% appeared to be "right pawed". This phenomenon points out an initial, apparently hereditary interhemisphere asymmetry of functional state of the brain motor structures. PMID- 6500097 TI - [Mechanism of static temperature sensitivity in spontaneously active neurons of the marine mollusk Aplysia]. PMID- 6500098 TI - [Role of the interstitial fluid in regulating osmotic homeostasis during postnatal development]. PMID- 6500099 TI - [Changes of intrauterine pressure in progesterone-treated ovariectomized rats during the second half of pregnancy]. AB - Pregnant rats were ovariectomized on day 14 of pregnancy (sperm = day 1) and daily injected with 4 mg progesterone. The intrauterine pressure and volume of the conceptus with placenta of these rats and intact normal pregnant rats were measured every morning between day 14 and 20 of pregnancy. The average volume of the conceptus in both groups increased at an almost constant rate until day 18 of pregnancy and rapidly between day 19 and 20 of pregnancy. The intrauterine pressure of ovariectomized progesterone-treated rats increased in parallel with the volume of the conceptus until day 19 of pregnancy, suggesting a deficiency in plasticity of the uterine wall. The pressure, however, decreased significantly between day 19 and 20 of pregnancy in spite of the rapid increase of the conceptus volume. In the control rats, the intrauterine pressure gradually decreased during the second half of pregnancy, whereas the conceptus volume increased. The results suggest that estrogen secreted from the ovaries during the second half of pregnancy prevents the rise of the intrauterine pressure by improving the plasticity of the uterus. Furthermore, it could be considered that the decrease of the intrauterine pressure between day 19 and 20 of pregnancy in ovariectomized progesterone-treated rats may be caused by the estrogenic action of androgens secreted from the placenta in late pregnancy. PMID- 6500100 TI - [The measurement of dializable free testosterone]. AB - Non-protein bound testosterone is considered to represent an active androgen in blood, and it reflects in androgenicity. We measured the dializable free testosterone (AFT) in various disorders. The values of plasma testosterone (T), fractional free testosterone (%FT) and AFT were 560 +/- 151 (mean +/- SD) ng/dl 1.9 +/- 0.4% and 10.7 +/- 3.3 ng/dl in normal males (n = 43, aged 25-58), 51 +/- 12 ng/dl, 1.2 +/- 0.3% and 0.6 +/- 0.2 ng/dl in normal females (n = 30, aged 21 41), and 63 +/- 26 ng/dl, 0.6 +/- 0.3% and 0.4 +/- 0.2 ng/dl in pregnancy (n = 20, second and third trimester), respectively. Those values in normal females and pregnancy were significantly lower than those in normal males (p less than 0.001). In male, the concentrations of T and AFT in patients with primary (n = 43, aged 18-50) and secondary hypogonadism (n = 16, aged 22-66) were significantly decreased (p less than 0.001 vs normal males), respectively. The plasma concentration of total testosterone (T) was increased 1032 +/- 269 ng/dl in chronic hepatitis (p less than 0.001) (n = 21, aged 28-52) and 1455 +/- 366 ng/dl in hyperthyroidism (p less than 0.001) (n = 44, aged, 18-52). However, %FT in those disorders was significantly decreased 1.2 +/- 0.3% in chronic hepatitis (p less than 0.001) and 0.8 +/- 0.3% in hyperthyroidism (p less than 0.001), and plasma levels of AFT in both disorders were not different as compared with that in normal males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500101 TI - [The parathyroid function in patients with hyperthyroidism]. AB - The parameters of calcium metabolism were determined in 22 patients with untreated hyperthyroidism (5 males and 17 females) and 5 control subjects. Hypercalcemia was found in the patients with hyperthyroidism in comparison with the control subjects (serum Ca: 10.0 +/- 0.56 vs. 9.0 +/- 0.18, p less than 0.001 and Ca++: 5.1 +/- 0.28 vs. 4.6 +/- 0.15 mg/dl, p less than 0.001, mean +/- SD). Although the urinary excretion of calcium was decreased in many patients, abnormalities of phosphate metabolism were not found in this study. The parameters of bone resorption, urinary hydroxyproline, serum alkaline phosphatase and acid phosphatase, were increased in all patients with hyperthyroidism. Serum immunoreactive PTH was decreased (0.23 +/- 0.05 vs. 0.29 +/- 0.05 ngEq/ml, p less than 0.05). In vitamin D metabolites, 25-OH-D did not differ from the control (16.9 +/- 7.76 vs. 17.9 +/- 5.52 ng/ml), 1,25-(OH)2D showed a tendency to decrease (32.6 +/- 19.53 vs. 37.2 +/- 13.75 pg/ml) and 24,25-(OH)2D was obviously increased (5.57 +/- 3.582 vs. 1.73 +/- 0.619 ng/ml, p less than 0.001) in the hyperthyroid patients. Thus, the parathyroid function was suppressed in the patients with hyperthyroidism, and hypercalcemia in hyperthyroidism was suggested to be due to the direct action of thyroid hormone upon the bone. PMID- 6500103 TI - The pertussis controversy. Part one--the problem. PMID- 6500102 TI - Traumatic intercostal arterio-venous fistula with pseudoaneurysm: a case report. PMID- 6500104 TI - Drug distribution and the physician's responsibilities. PMID- 6500105 TI - Cost of DPT vaccine. PMID- 6500106 TI - Beer drinkers' hyponatremia: a hypoosmolality syndrome. PMID- 6500107 TI - Acute rheumatoid pleurisy with effusion and demonstration of a rheumatoid nodule in the pleura. PMID- 6500108 TI - The volunteer physician program of the Lake Placid Olympic Training Center. PMID- 6500109 TI - Impressions of health and medicine in Tibet. PMID- 6500110 TI - [Dermatomyositis--immunology, clinical course, pathologic anatomy and therapy]. PMID- 6500111 TI - [Preliminary findings on suprapharmacologic steroid therapy in autoimmune diseases]. PMID- 6500112 TI - [Photochemotherapy and activity of lysosomal enzymes in the serum of psoriasis patients]. PMID- 6500113 TI - [The clinical relevance of the SPHA test for the demonstration of IgM in syphilis diagnosis. Report on 3 years' experiences]. PMID- 6500115 TI - [Basic instruments for dermato-surgical procedures]. PMID- 6500114 TI - [Neuroblastoma--the 2d most frequent malignant tumor in childhood. An overview based on a case report]. PMID- 6500116 TI - [Coincidence of multiple tumors in the sacral region]. PMID- 6500117 TI - Malignant melanoma associated with mycosis fungoides. AB - 2 cases of malignant melanoma in 2 male patients, 68 and 63 years old, associated with mycosis fungoides and parapsoriasis en plaques, respectively, are reported. The parapsoriasis later on developed into mycosis fungoides. A pathogenetic linkage based on decreased cellular immunity in mycosis fungoides is suggested. PMID- 6500118 TI - [Lichen aureus]. AB - A 21-year-old male patient with lichen aureus on the lower extremities is described. The clinical and histological features of this rarest of the pigmented and purpuric eruptions consisting of lichenoid papules and plaques are discussed. PMID- 6500119 TI - Erythema multiforme--response to corticosteroid. AB - We studied the response to treatment in 25 patients with erythema multiforme minor, 13 of whom were given corticosteroid while 12 were not. Apart from a shorter duration of fever, the steroid-treated group did not respond better than the non-steroid treated group. PMID- 6500120 TI - Phlebotomy treatment in porphyria cutanea tarda combined with beta-thalassaemia. AB - In 74 patients with porphyria cutanea tarda, 11 (14.9%) cases of beta thalassaemia were found. The incidence of beta-thalassaemia in porphyrics is not greater than in non-porphyrics and it seems that beta-thalassaemia is not a factor triggering the development of porphyria cutanea tarda. The phlebotomy treatment is also a convenient method for porphyria cutanea tarda combined with beta-thalassaemia. PMID- 6500121 TI - Failure of mexiletine to relieve severe pruritus. AB - Mexiletine, an antiarrhythmic drug with pharmacological properties similar to lidocaine, was tested for antipruritic effect in 4 patients with severe pruritus. Although the plasma levels were within the therapeutic range for antiarrhythmic effects, a consistent relief of pruritus could not be found. PMID- 6500122 TI - Mycosis fungoides with monoclonal gammopathy, hypereosinophilia, and hyper-IgE. AB - A 61-year-old female with a well-established Mycosis fungoides also had a marked hypereosinophilia, a monoclonal gammopathy IgGk type, and an elevated IgE level. Such unusual association of abnormalities of the immune system in a given Mycosis fungoides patient has not been described before in the absence of any other underlying cause. PMID- 6500123 TI - An epidemic study of molluscum contagiosum. Relationship to swimming. AB - The incidence of molluscum contagiosum (MC) in children attending 15 public elementary schools and 9 kindergartens in Chigasaki City was studied by questioning their parents. Special attention was paid to the relationship between MC and swimming, and the incidence of MC in the swimming group was twice as high as that of the nonswimming group. This study also revealed that the predilection for lesions was the side of the trunk and the axillae. PMID- 6500124 TI - An early picture of Pagetoid reticulosis. AB - A 26-year-old woman developed a verrucous papule on the dorsum of the right hand during the treatment of housewive's hand dermatitis. Histological and ultrastructural study showed a typical appearance of Pagetoid reticulosis (Woringer-Kolopp disease). PMID- 6500125 TI - Prurigo nodularis associated with malabsorption. AB - The case of a 72-year-old female with a syndrome of malabsorption associated with prurigo nodularis is reported. The patient had been suffering from these disorders for 16 years. The pathological alteration of her malabsorption syndrome was an idiopathic sprue. 5 months after treatment with gluten-free diet supplemented with vitamins and iron, the disappearance of the clinical and analytical alterations was complete. PMID- 6500126 TI - [Clinical demonstrations of the Dermatology Clinic of the University of Bern]. PMID- 6500128 TI - [Presentation of clinical cases of the University of Geneva Clinic]. PMID- 6500127 TI - [Demonstration of the Dermatology Clinic of the University of Zurich]. PMID- 6500129 TI - [Demonstration of the Dermatology Clinic of the University of Basel]. PMID- 6500130 TI - Multicentric reticulohistiocytosis. AB - A case of multicentric reticulohistiocytosis in a 49-year-old man associated with polymyositis is presented. The clinical features along with the light and electron microscopic studies are commented. Partial improvement of the skin lesions was achieved after treatment with azathioprine but the patient's general condition remained unchanged. PMID- 6500131 TI - Phylogenetic diversification of immunoglobulin VH genes. PMID- 6500132 TI - Sialic acid binding lectins in the serum of American spiders of the genus Aphonopelma. AB - Multiple lectins were detected in the serum of three American species of the genus Aphonopelma (A. chalcodes, A. cochise and A. chiricawa) through tests of agglutination and crossed absorption with a panel of untreated and enzyme treated of vertebrate erythrocytes. Hemagglutination-inhibition experiments showed that a fraction of A. chalcodes serum lectins bind sialic acids and sialoconjugates although other related carbohydrates as N-acetyl-D-glucosamine and 2-keto-3 deoxyoctonate also are recognized. Results of these studies extend our observations about the presence of sialoconjugate binding lectins in members of the Chelicerata to species from the Order Araneae. At the present time the Chelicerata (horseshoe crabs, scorpions, whip scorpions and spiders), would constitute the only group of high taxonomic rank which includes species that exhibit certain common patterns in the specificity of their humoral lectins. PMID- 6500133 TI - Crustacean defense strategies II. Recognition, clearance, accumulation and externalization of soluble foreign proteins by the mud-crab Scylla serrata. AB - The Defense reactions of Scylla serrata have been investigated by challenging crabs with two metalloproteins, horse radish peroxidase (HRP:M.W. 40,000) and hemoglobin (Hb:64,000). The defense response analyzed include 1) recognition of foreign proteins; 2) clearance from the haemocoel; 3) accumulation in tissues and 4) externalization. Protein clearance was similar to dye clearance in several respects: 1) clearance rate increased with higher a) molecular weight and concentration and b) at night and 2) decreased with crab size. HRP clearance rate was significantly increased after repeated injections of HRP but not saline. Clearance was not enhanced after repeated injections of Hb. About 70% of HRP accumulates in gills within 2 hours after injection, when there were no signs of HRP accumulation in the hepatopancreas. But about the same percent of injected Hb accumulated in both gills and hepatopancreas after 2 hours of injection. When 300 ug HRP declined in gills after 8 hour, similar amounts of HRP accumulated in the hepatopancreas. Moreover when 325 ug of Hb was lost from gills after 4 hours, the hepatopancreas accumulated about 300 ug, suggesting that foreign proteins may undergo antigenic alteration in the gills prior to mobilization to the hepatopancreas. There is no evidence of degradation of proteins in gills. When HRP and Hb level declined in the hepatopancreas, the levels of these proteins increased in gut contents indicating externalization of injected proteins via gut. PMID- 6500134 TI - Immunocompetent cells requisite for graft rejection in Lineus (Invertebrata, Nemertea). AB - Antecerebral ends from donors of one Lineus species (L. sanguineus) were grafted onto bispecific recipients previously constructed from two other Lineus species (denoted L. ruber----L. lacteus because the anterior component of chimeras was from L. ruber and the posterior component was from L. lacteus) and onto monospecific controls. Histological examination of areas where the tissues from L. sanguineus and L. ruber had been brought into contact by grafting always showed, at early stages, (6 to 20 days postgrafting), a great deal of difference depending upon whether the recipients were monospecific L. ruber or bispecific L. ruber----L. lacteus: only in grafts onto the former was there lysis of gland cells, connective tissue, muscular fibers, and finally epidermis. We attribute this lytic process to a strongly and rapidly cytotoxic action of lymphocyte-like cells from the L. ruber intestinal segment and the absence of lysis during the same stage in grafts onto composite recipients and monospecific L. lacteus to weak, delayed actions of immunocytes from the L. lacteus intestinal segment. Subsequent phagocytosis of material from lysed cell of grafts in the process of being rejected was effected by wandering amebocytes usually involved in destruction of degenerating "self" components, as in oosorption and resorptive processes after fasting. This work supports the existence of immunocytes at an early phylogenetic level. PMID- 6500135 TI - Isolation, characterization and functional assessment of a hemagglutinin from the plasma of Biomphalaria glabrata, intermediate host of Schistosoma mansoni. AB - An agglutinin from the plasma of Biomphalaria glabrata, vector of Schistosoma mansoni, has been isolated and partially characterized. Its isolation is a simple two-step process, yielding an essentially pure preparation that can then be manipulated free from other plasma components. It is a large glycoprotein (10(6) daltons), found in four of the five snail strains tested, and possesses affinity for galactose-type sugar residues. Based upon criteria such as molecular weight, carbohydrate and erythrocyte specificity, physical stability and anatomical source, this agglutinin is considered to be distinct from others reported from this mollusc. Involvement of the agglutinin in the host-parasite interaction is discussed. PMID- 6500136 TI - Endocytosis of a mannose-terminated glycoprotein and formaldehyde-treated human serum albumin in liver and kidney cells from fish (Salmo alpinus L.). AB - The uptake and degradation of a mannose-terminated glycoprotein, yeast invertase, in char (Salmo alpinus L.) tissue was studied after intravenously injection of the 125I-labelled protein. 125I-labelled formaldehyde-treated human serum albumin (fHSA) and native HSA was also injected for comparison. Labelled invertase was rapidly cleared from blood and at about the same rate as labelled fHSA (at 8 degrees C). Approximately 50% of the initial concentration remained in blood 15 min after the injection of the ligands. Acid soluble degradation products appeared in the circulation about 60 min after the injection of the proteins. 125I-labelled invertase was recovered in the liver, pronephros and kidney. The clearance of labelled invertase from blood and the uptake in the organs were inhibited by co-injection of excess unlabelled invertase. fHSA was taken up in the pronephros and kidney tissue, while HSA was not taken up in any organs. In vitro degradation of the labelled ligands was studied in isolated pronephros cells, which had taken up the proteins in vivo. The degradation of invertase in isolated cells was partly inhibited by ammonium chloride. Ammonium chloride and chloroquine inhibited degradation of fHSA, but not leupeptin. These results together suggest that invertase and fHSA were taken up in the organs described by the receptor-mediated endocytosis. The degradation was partly or wholly lysosomal. PMID- 6500137 TI - Random and directed migration of trout (Salmo gairdneri) leukocytes: activation by antibody, complement, and normal serum components. AB - Purified peripheral blood leukocytes from rainbow trout (Salmo gairdneri) were used in experiments to determine whether these cells are capable of random or directed leukotaxis in response to immunologically important mediators. Leukocyte migration was assessed by the use of microporous filter penetration assays and migration-under-agarose tests. Leukocyte migration rates were enhanced in filter penetration assays by the presence of antigen-antibody-complement complexes, and chemotactic migration was observed in migration-under-agarose tests as a response to whole trout serum. Trout leukocytes thus altered normal migratory activities in response to chemical changes in their immediate environment. The role of complement in chemotaxis may be similar in fish and mammals. PMID- 6500138 TI - Nonspecific cytotoxic cells in fish (Ictalurus punctatus). III. Biophysical and biochemical properties affecting cytolysis. AB - Nonspecific cytotoxic cells (NCC) from the catfish (Ictalurus punctatus) may comprise a population of cells that are responsible for cellular immunity in the fish. NCC kill a wide variety of transformed target cells, and previous studies have indicated that NCC share properties with mammalian natural killer cells. In the present study, many biophysical and biochemical properties of NCC were defined. NCC were nylon wool nonadherent and adherent. NCC activity was also enriched in plastic nonadherent cells. NCC were nonphagocytic (for carbonyl iron), and they did not bind to Sephadex G-10. Characterization of NCC by density gradient centrifugation indicated that they comprise a relatively homogenous population of cytolytic cells that band at 45.5% Percoll. Moderate to high doses (500-2500 R) of X-irradiation produced a stimulatory effect on NCC lysis of labeled target cells. Additional studies indicated that a soluble suppressor protein in catfish serum (CFS) regulated NCC activity. This S. aureus protein A binding component isolated from CFS suppressed NCC activity. Analysis by SDS-PAGE indicated that the soluble regulatory protein had properties similar to immunoglobulin. These data indicate that NCC share some biophysical properties with mammalian natural killer cells. In addition, NCC appear to be under partial cell regulation by a radiation sensitive suppressor cell and also by a soluble regulator serum immunoglobulin component. PMID- 6500139 TI - Structural and functional analysis of spontaneous anti-nitrophenyl antibodies in three cyprinid fish species: carp (Cyrinus carpio), goldfish (Carassius auratus) and tench (Tinca tinca). AB - High spontaneous anti-trinitrophenyl (TNP) activities were found in three Cyprinid fish species: Carp (Cyprinus carpio), Goldfish (Carassius auratus) and Tench (Tinca tinca). The molecules involved, isolated by affinity chromatography on dinitrophenyl-lysine Sepharose (DNP-lysine-Sepharose), had the main characteristics of a high molecular weight immunoglobulin (IgM-like). Affinity measurements were performed on natural anti-DNP/TNP antibodies isolated from nine individual tench sera, using the inhibition of DNP-T4 bacteriophage inactivation technique. The antibodies analysed were more specific for TNP than for DNP. No activity was found against paranitrophenyl hapten. Affinities were all very low, even for TNP. In the three species, natural anti-DNP/TNP antibodies constitute as much as 11 to 16% of the total immunoglobulin concentration. This high level of nitrophenyl-binding serum immunoglobulins either suggests the existence of a particular regulatory mechanism in fish or reflects a generally low antibody diversity in these species. PMID- 6500140 TI - Morphometric analysis of thymic medullary non-lymphoid cell changes during postnatal development. AB - Thymic non-lymphoid cells have been shown to influence the differentiation of T lymphocytes. Large numbers of non-lymphoid cells are concentrated in the thymic medullary zone. A morphometric analysis of these cells in the medulla identified little change in their absolute number and volume density during thymic development in the rat. Expansion of thymic medullary volume with age was documented by planimetry. Several subtypes of medullary non-lymphoid cell were identified by electron microscopy, including both squamous and cystic epithelial cells, interdigitating cells and macrophages. Changes in their relative proportion during development were determined with the percentage of squamous epithelial cells declining, interdigitating cells increasing and the other cell types exhibiting little change. Subcellular evidence of secretory activity was sought by analysis of changes in the volume density of organelles in each of the non-lymphoid classes. Cystic enlargement in epithelial cells and a decrease in the volume density of macrophage inclusion bodies were noted but no clear morphometric trend could be correlated with increased secretory activity expected in the developing endocrine thymus. PMID- 6500141 TI - Analytical study of lectins in Squilla mantis L. (Crustacea stomatopoda) using monoclonal antibodies. PMID- 6500142 TI - Differential polymorphism of the amphibian MHC. PMID- 6500143 TI - The antibody responses to sheep red blood cells of the red-tailed hawk and great horned owl. PMID- 6500144 TI - Identification and treatment of a lethal nematode (Capillaria xenopodis) infestation in the South African frog, Xenopus laevis. PMID- 6500145 TI - Ciliogenesis following salpingostomy of rabbit hydrosalpinges. AB - Twenty-five artificially induced hydrosalpinges were studied in New Zealand white rabbits. Hydrosalpinges had been created after 2-16 wk occlusion of both the fimbrial end and the ampullary isthmic junction (A.I.J.), using either Ethilon 8/0 or tantalum clips. Their diameters ranged from 4 to 12 mm, being larger in the clipped oviducts. In hydrosalpinges larger than 6 mm diameter, a salpingostomy was done and ampullary biopsies were taken and prepared for scanning electron microscopy, and 1-micron sections and ultrathin sections for transmission electron microscopy. The changes observed were those found in previous work (Vasquez et al., 1981). Post-salpingostomy biopsies were taken from 10 patent oviducts at different intervals of time, ranging from 2 days to 8 wk. Ciliogenesis was observed between the 2nd and 3rd wk after salpingostomy. PMID- 6500146 TI - Is term breech presentation in primigravida an absolute indication for cesarean section? AB - Excessive perinatal loss is associated with breech presentation, this loss being accounted for by prematurity, congenital anomalies and birth trauma. In the endeavor to exert an effect on two of these problems, cesarean section has been resorted to increasingly. We have compared two management regimes of primigravida term breech presentation corresponding to two 4-yr periods. During the first period every case was evaluated carefully and, if no other pathology was found, a trial vaginal delivery was allowed. During the second period all the cases were delivered by elective cesarean section. Of the 108 cases of the first period, 46 delivered vaginally and 62 underwent cesarean section. 119 cases were scheduled for abdominal delivery during the second period. Immediate infant outcome for each group was determined by the 1 and 5 min Apgar scores. Analysis of 5 min Apgar scores demonstrated no significant differences in immediate outcome between infants delivered vaginally and by cesarean section. Fetal morbidity related to birth trauma was higher in the vaginal delivery group but there were no perinatal deaths. Maternal morbidity was observed only in the cesarean section groups. This study suggests that properly selected primigravid term breech infants could be delivered vaginally without increased perinatal mortality and with immediate outcomes comparable to those found with cesarean section. PMID- 6500147 TI - Maternal blood pressure response to the intravenous administration of pethidine promethazine during labor. AB - A double blind study on the effect of an intravenous injection of a combination of 75 mg pethidine and 25 mg promethazine was conducted on 200 women during normal deliveries. Four groups of 50 women each received injections of pethidine and promethazine, promethazine alone, pethidine alone and normal saline. In the pethidine-promethazine group there was a significant elevation in blood pressure in the first 10 min following the injection as compared with the other groups. The mean (+/- S.D.) systolic blood pressure after the injection was 143.2 +/- 14.3 mmHg as compared with 118.9 +/- 8.4 mmHg before the injection, and the mean diastolic blood pressure as 96.9 +/- 8.4 mmHg after the injection as compared with 77.7 +/- 9.3 mmHg before the injection. 25 mg promethazine alone caused slight elevation in blood pressure which was further increased by combination with pethidine. The clinical significance of these observations is discussed. PMID- 6500148 TI - Gallbladder function and maternal bile acids in intrahepatic cholestasis of pregnancy. AB - Ultrasonic measurement of the gallbladder volume was taken in 8 nonpregnant, healthy women, in 7 women with normal pregnancies and in 7 women whose pregnancies were complicated by intrahepatic cholestasis of pregnancy, in the fasting state and 30, 60, 120 and 180 min after a test meal. At the same time the serum concentrations of cholic acid and chenodeoxycholic acid were measured. The fasting and ejection volumes of the gallbladder in cholestasis of pregnancy were greater than in normal pregnancy. The fasting volume of the gallbladder was greater, but the ejection volume smaller in normal pregnancy than in nonpregnant women. No difference in the ultrasonic appearance of the intra- and extrahepatic bile ducts was found between the groups. Serum bile acids were increased in cholestasis of pregnancy and did not display any decreasing tendency after the postprandial rise during the following 3 h. The results indicate that in cholestasis of pregnancy the gallbladder function and the enterohepatic circulation of bile acids are different from normal pregnancy. This may be associated with the great tendency to gallstones in these women. The large size of the gallbladder in cholestasis of pregnancy has differential diagnostic importance in the ultrasonic evaluation of a pregnant woman with liver disease. PMID- 6500149 TI - Perinatal complications of gestational diabetes: the influence of the timing of the diagnosis. AB - One hundred and thirty-nine single pregnancies complicated by gestational diabetes (GD) were reviewed. All pregnancies were treated by dietary counselling and insulin was restricted to those who presented an abnormal fasting or postprandial glycemia. Obstetrical and neonatal morbidity were evaluated according to the timing of the diagnosis of GD. Preterm labor, preeclampsia, cesarean section, macrosomia, depressed apgar at 1 min and hyperbilirubinemia were more frequent when the diagnosis was made later. Neonatal hypoglycemia was statistically more frequent among the infants of the insulin-treated mothers compared to those of the diet-treated mothers. Our data suggest that early diagnosis of GD might be important to reduce perinatal morbidity further. PMID- 6500150 TI - The L/S ratio in vaginally collected amniotic fluid: a misleading result in a breech presentation. AB - A case is reported in which serial L/S ratios, determined from fluid samples collected vaginally after premature rupture of the membranes, led to a grossly erroneous conclusion of fetal pulmonary immaturity. The fetus was in breech presentation, and in retrospect several 'amniotic fluid' samples consisted largely of fetal urine. Determination of the creatinine concentration of suspect samples should permit distinction to be made between mixed amniotic fluid and fluid containing a disproportionately large amount of fetal urine when the possibility of this error exists. PMID- 6500152 TI - Sirenomelia ('mermaid'). AB - A case of sireniform malformation in a 17-wk-old fetus is described. In addition to the characteristic fusion of the lower limbs, there were also severe malformations of the urogenital system and lower intestinal tract. The essential features and various theories of genesis are discussed. The cases so far described in literature are reviewed. Ultrasound can be very useful in early detection of this deformity, because defective movements of the single lower limb and the typical medial position of the fibulae can be seen. PMID- 6500153 TI - Experimental hydrosalpinx and salpingostomy in rabbits. AB - In 137 oviducts of New Zealand white rabbits different kinds of occlusion techniques were tested to induce hydrosalpinges. In 99 oviducts ligatured or clipped both at the fimbrial end and at the ampullary-isthmic junction 67 hydrosalpinges were achieved, whilst in 34 oviducts ligatured or clipped only at the fimbrial end one hydrosalpinx occurred. Most severe histological changes were seen after double clipping. Ligation of the blood vessels to and from the ampulla of 4 oviducts caused no hydrosalpinx formation. After cuff salpingostomy a higher number of patent oviducts was found than after double-loop salpingostomy. PMID- 6500151 TI - An unusual course of prolactinoma during two consecutive pregnancies. AB - A hyperprolactinemic woman, who had been operated upon twice, in two consecutive pregnancies, because of progressive deterioration of a pituitary tumor, is presented. This case demonstrated the unpredictable behavior of pituitary tumors in pregnancy. PMID- 6500154 TI - Progesterone and pH levels in breech deliveries at term. AB - Umbilical cord vein and artery blood samples were taken at birth from 26 cases of breech presentation delivered vaginally or by caesarean section. All babies were full term and there were no congenital abnormalities. The blood samples were analysed for pH level and progesterone concentration. The cord artery pH was found to correlate strongly with the cord vein progesterone concentration. The cord vein progesterone correlated strongly with the cord artery concentration, showing fetal abstraction of progesterone. PMID- 6500155 TI - Prophylaxis of thrombosis in antithrombin III-deficient women during pregnancy and delivery. AB - Prophylactic treatment of two asymptomatic antithrombin III (AT III) -deficient women with oral anticoagulants and heparin during pregnancy and after delivery appeared to be feasible. Oral anticoagulants caused no change in plasma AT III levels in either woman. A high dose of heparin intravenously in one of them caused a strong reduction in the AT III level which was corrected by infusion of AT III concentrate during delivery. A low dose of heparin subcutaneously in the other caused no significant change in plasma AT III levels. There is probably no need for AT III substitution during an uncomplicated pregnancy. PMID- 6500156 TI - Immature teratoma with gliomatosis peritonei associated with pregnancy. AB - Immature teratoma is a malignant form of teratoma that contains immature structures resembling those of the embryo. It is rare and accounts for less than 1% of all ovarian cancers. It occurs most frequently in young women but it is very rarely reported in association with pregnancy. PMID- 6500157 TI - Obstetrical complications in a patient with the Marfan syndrome. AB - A case history of a pregnant patient with the Marfan syndrome is presented. During pregnancy regular echocardiographic examinations were performed, showing a slight increase in the aortic root diameter 1 month after delivery. The hydroxyproline content of the amniotic fluid appeared to be significantly elevated; however, the baby did not seem to be affected by the Marfan syndrome. After delivery we noted a recto-vaginal perforation, which has not been described in deliveries of Marfan patients before. Pregnancy in a Marfan patient is a hazardous situation, with a 10-40% fatal outcome according to the literature. Regular echocardiographic control is necessary to evaluate the cardiac risk. PMID- 6500158 TI - Amyloidosis development in LLC mice. AB - Using electron microscopy and the protein A-gold labelling technique we studied amyloidosis in the LLC mice, an inbred strain developing amyloidosis spontaneously. We found that the reticular cells lining around the sinuses in the red pulp of the spleen were converted to amyloid. Evidence suggests that the amyloid originates in the cells themselves. The process of amyloid formation is discussed. PMID- 6500159 TI - Relationship between karyotype of tissue culture lines and tumorigenicity in nude mice. AB - There are many factors, other than the absence of an immune response, that are responsible for the successful transplantation of xenografts to nude mice. We have defined, in this study, the relationship between karyotype and transplantability of xenografts into nude mice, using a library of 85 tumor and normal tissue culture lines. Each of these lines had been previously passaged in tissue culture for more than 10 generations. 53 of these 85 lines were classified as diploid, whereas 32 lines were classified as heteroploid. These tissue culture lines were transplanted to groups of 4-10 unmanipulated and antilymphocyte serum (ALS)-treated nude mice and serially monitored for 12 weeks. Only 19% of the diploid lines were successfully transplanted into unmanipulated nude mice, and only 30% were successfully transplanted into ALS-treated nude mice. In comparison, 50% of the heteroploid lines were successfully grafted into unmanipulated nude mice, and a total of 60% were successfully transplanted into ALS-treated nude ice. 12 of the 53 diploid lines can be classified as being pseudodiploid on the basis of rearranged chromosomes or other minor karyotype anomalies. 8 of these 12 pseudodiploid lines were successfully transplanted into nude mice, further strengthening the relationship between abnormal karyotype and transplantability. Tumor karyotype is an additional parameter which should be added to the variables involved in the successful transplantation of tumors to nude mice. PMID- 6500160 TI - Characterization of human bone marrow long-term cultures. AB - In an attempt to more closely simulate the native hematopoietic environment, human bone marrow bony matrix was cultivated in long-term human bone marrow cultures. Sternal bone marrow curettings (i.e., 'bony matrix') were cultured with and without autologous bone marrow single cell suspensions. Fresh media were provided at weekly intervals and the 'harvested' cells were assayed for CFU-gm (i.e., the granulocyte-macrophage precursor). Bone marrow bony matrix alone was not competent to maintain CFU-gm production, although early in the culture nucleated cells and CFU-gm were recruited from the bony matrix. A dose of 850 rad of X-radiation to the bone marrow matrix damaged the hematopoietic growth promoting effects of the adherent cell layer, which was, however, rapidly reconstituted by an inoculation of intact autologous bone marrow cells. Additional investigations revealed that, whereas the addition of hydrocortisone to this culture system did not alter the maintenance of CFU-gm, recharging the cultures with fresh autologous marrow maintained CFU-gm for 10 weeks. These data indicate that human bone marrow stroma is more sensitive to X-irradiation in vitro than in vivo, and the bone marrow hematopoietic microenvironment provided by its bony matrix seemed to be less effective in vitro than in vivo with respect to the maintenance of hematopoietic precursor cells. PMID- 6500161 TI - Fc receptors on lymphocytes and K cells. PMID- 6500163 TI - Isotope specificity in the binding of mouse immunoglobulins to brush borders isolated from the neonatal mouse small intestine. PMID- 6500162 TI - The monocyte binding domain(s) on human immunoglobulin G. PMID- 6500164 TI - The relationship between the immune system and mucus in the protection of mucous membranes. PMID- 6500166 TI - Sulphinpyrazone in cardiovascular elderly azotemic patients: a proposal of a 'guided' incremental dose schedule. AB - Renal tolerability of a guided incremental dose schedule of sulphinpyrazone was evaluated in an open study of 2-month duration, performed in twenty-one cardiovascular elderly azotemic patients (thirteen males, eight females; mean age: 79 years, S.D.: 7 X 3 years). Starting dosage was 200 mg per day; daily dosage was then increased, every 4 days, by 200 mg or kept constant for another 4 days, according to each patient's basal renal function, up to the maintenance dose: 800 mg/day. Eighty-one per cent of the patients followed a successful incremental pathway, 9% kept a constant daily dosage of 200 mg for 8 days, reaching then the maintenance daily dose without any problems. Nine per cent withdrew at 200 mg/day because renal function deteriorated at two consecutive visits. Renal function of the patients who completed the study significantly improved (two-way ANOVA, p less than 0.01). General tolerability was good. The proposed incremental dose schedule of sulphinpyrazone can be successfully used in the treatment of cardiovascular elderly azotemic patients. PMID- 6500165 TI - The insulin receptor-kinase complex: an integrated system for transmembrane hormone signalling. PMID- 6500167 TI - Hypotensive effect of the association atenolol-chlorthalidone in hypertensive diabetics. AB - The authors conducted a clinical investigation in twenty-five patients affected with essential hypertension of mild or moderate grade associated with type II diabetes mellitus, the purpose being to assess the effect of 8 weeks of combined treatment with atenolol (100 mg) and chlorthalidone (25 mg) on arterial blood pressure, heart rate, and glycaemia. It is, indeed, generally known that both beta-blockade agents and diuretics can interfere with carbohydrate metabolism. The results indicate that 92% of the patients treated in this trial had significant reduction of systolic and diastolic blood pressure readings, in the absence of bradycardia or other adverse effects. Glycaemia values were lower at the end of treatment, probably as a result of better diet control during the trial, as suggested by the general tendency to body-weight reduction. PMID- 6500168 TI - Effects of long-term ticlopidine treatment on platelet function and its tolerability in cerebrovascular disease. AB - A trial was performed on thirty-two patients with cerebrovascular disease (transient ischaemic attack and stroke) to assess the effect of ticlopidine, a new inhibitor of platelet aggregation, on some platelet functions and coagulation, and its safety in long-term use (6 months). The results show that ticlopidine was highly effective in inhibiting ADP-induced platelet aggregation, platelet adhesiveness and circulating platelet aggregates, but it had no effect on fibrinogen levels. No serious side-effects were observed. Ticlopidine may therefore prove to be a useful antiplatelet drug in the management of patients with cerebrovascular disease. PMID- 6500169 TI - Comparative evaluation of antipyretic activity of ibuprofen and aspirin in children with pyrexia of varied aetiology. AB - The antipyretic activity of ibuprofen and aspirin was compared in sixteen children with pyrexia due to upper respiratory tract infection and in twelve with fever due to other causes. All 28 children received ibuprofen (7 mg/kg of body weight) and aspirin (15 mg/kg of body-weight) in a single dose on 2 consecutive days in a crossover manner. Rectal temperature was recorded prior to and at regular intervals up to 8 hours after drug administration. Analysis of the results indicate that ibuprofen and aspirin effectively lower temperature and the two drugs are comparable in their antipyretic activity. In conclusion, significant antipyretic activity, good tolerance profile and availability in syrup form make ibuprofen a useful substitute for aspirin in children with fever. PMID- 6500170 TI - Deiodination of T4 to T3 and rT3 by microsomes from normal human thyroid tissue. AB - An enzyme system capable of monodeiodinating T4 to T3 and to rT3 in a microsomal fraction of normal human thyroid tissue is characterized. The pH optimum for 5' monodeiodination of T4 to T3 was around 7.0 The Km (apparent) for the conversion of T4 to T3 was 5.7 mumoles/l. PTU, ipodate and rT3 inhibited T4 deiodination to T3. The rT3 inhibition was of the partial competitive type. rT3 accumulation could not be detected at pH 7.4 or lower. At higher pH values rT3 could be measured in the incubates; however, the concentration was much lower than that of T3. The pH optimum was 9.0. Added rT3 disappeared rapidly at pH 7.4. The results suggest a high affinity of the 5'-deiodinase in human thyroid tissue for rT3, as has previously been described in the rat, but in contrast to our previous findings in dog thyroid and liver. Using tissue from 3 highly differentiated thyroid medullary carcinomas, deiodination could not be demonstrated, while it was normal using paraneoplastic thyroid tissue from the same patients. This suggests that the deiodinases studied originated from the follicular and not the C-cells of the thyroid. PMID- 6500171 TI - Effect of extracellular matrix on PC 12 cell shape and dopamine processing. AB - Substrates of various origins can affect the morphology, growth and functional properties of many cell types. PC 12 cells (a clonal line of rat pheochromocytoma) synthesize, store and secrete dopamine as well as other transmitters. These cells are rounded and loosely attached when cultured on plastic, but flatten and spread extensively when cultured on an extracellular matrix secreted by bovine corneal endothelial cells. We determined that spontaneous dopamine release into culture medium was significantly higher from cells which were flattened on matrix, and that the cellular content of dopamine was less than in cells which were maintained on plastic. The higher levels of medium dopamine in matrix cultures were not due to an increase in cellular attachment or growth as determined by [3H]thymidine incorporation. A variant of PC 12 cells which is flat on plastic showed no change in cell shape or dopamine release when plated on matrix. These experiments suggest that extracellular matrix promotes a change in cell shape and that this change in the physical arrangement of these cells alters their release and storage of dopamine. PMID- 6500172 TI - Activation of Manduca sexta corpora allata in vitro by a cerebral neuropeptide. AB - When an in vitro assay system and radioimmunoassays specific for juvenile hormones (JH) I and III were used to probe the effect of co-incubating pupal brains with last instar larval corpora allata (CA) from the tobacco hornworm, Manduca sexta, a selective activation of JH III synthesis by the CA was observed. This homolog-specific activation suggested the presence of an allatotropic factor for the synthesis of JH III (JH III ATF), and its presence was demonstrated by the ability of a postmicrosomal supernatant of a day 0 pupal brain homogenate to activate the CA in vitro in a dose-dependent manner. This moiety appears to be a protein, based on its heat lability and protease sensitivity, and has an apparent molecular size of 40 kD and an isoelectric point of 5.5 JH III ATF activity is localized in specific neural tissues of the day 0 pupa, the brain and first three abdominal ganglia, with the brain containing 4 times the activity in the ganglia. The existence of this factor suggests that JH III synthesis by the CA of Manduca is regulated by a neuropeptide. PMID- 6500173 TI - Rise and fall of protein phosphorylation during meiotic maturation in oocytes of Sabellaria alveolata (polychaete annelid). AB - Incorporation of [32P]phosphate into proteins was monitored, in preloaded Sabellaria oocytes, during meiosis. After a fourfold increase during the transition from prophase to metaphase I, the incorporated radioactivity decreased steadily by 25% during completion of meiosis, while it slowly increased in metaphase I-blocked oocytes. Measurements of the amount and specific activity of nucleotide pools showed no variation, while total alkali-labile protein-bound phosphate was found to increase and then decrease during meiosis. Autoradiography of sodium dodecyl sulfate slabgels showed that some proteins have peculiar phosphorylation-dephosphorylation kinetics. The changes in the level of phosphorylation of proteins may be related to similar changes in maturation promoting factor (MPF) activity. PMID- 6500174 TI - Disease expression in +-/+- ----mdg/mdg mouse chimeras: evidence for an extramuscular component in the pathogenesis of both dysgenic abnormal diaphragm innervation and skeletal muscle 16 S acetylcholinesterase deficiency. AB - Homozygous mdg/mdg mice die at birth and express a syndrome of abnormalities, the most striking of which is a gross failure of skeletal muscle development. Recently, additional abnormalities in the development of nerve-muscle relationships have been recognized; in particular, on muscle fibers within the diaphragm, motor end plates are inappropriately dispersed and, in all muscles, there is a paucity of the 16 S form of acetylcholinesterase (AChE). These abnormalities could result entirely as secondary consequences of the primary muscle defect or from expression of the mdg defect in additional cell types, e.g., motor neurons. To determine if the muscle genotype alone is responsible for these defects in dysgenic mice, chimeras composed of both dysgenic and normal cells have been investigated. Different glucosephosphate isomerase variants existed in the mdg/mdg and normal cells comprising these chimeras and the mutant, normal, or mosaic genotypes of chimera diaphragm and skeletal muscle was estimated by measuring the relative proportions of each isozyme. In two chimeras, the diaphragm innervation pattern was revealed by AChE cytochemistry and in both, discrete regions of abnormally dispersed and normally restricted motor end-plate zones were observed. No correlation between these patterns of innervation and the assessed genotype of the muscle fibers existing in each area was observed. The relative 16 S AChE content in the limbs of four chimeras was found to range from 2.5 to 42.0%. Here also, no correlation between 16 S AChE content and the muscle genotype was observed. The results of these investigations are not consistent with a model of mdg/mdg pathogenesis in which only the skeletal muscle is primarily affected; an extramuscular deficiency responsible for at least part of the full mdg/mdg syndrome is therefore suggested. PMID- 6500175 TI - Formation of pattern in regenerating tissue pieces of Hydra attenuata. III. The shaping of the body column. AB - Excised pieces of hydra body tissue of varying size and shape regenerate into cylinders with a head and foot at opposite ends. The numbers of cells along the axial and circumferential dimensions were determined before, during, and after regeneration. The main process in shaping the excised tissue into a body column was found to be a rearrangement of the cells. When regenerates of different size were measured, the proportions of the body columns were found to vary, such that the smaller the animal the squatter the body column was. The presence of the head in regenerates was necessary for the formation or maintenance of the cylindrical shape, while the size of the head determined the proportions of the cylinder. The formation of a gradient of adhesivity induced by the developing head is suggested as the basis for the rearrangement of the cells into the cylindrical form. PMID- 6500176 TI - Stepwise commitment of blast cell fates during the positional specification of the O and P cell lines in the leech embryo. AB - The o and p bandlets of the leech embryo are parallel columns of ectodermal blast cells which are identified by their relative positions, and which during normal embryogenesis follow distinct developmental pathways. A previous study showed that o blast cells are initially capable of following either the O or P pathway, and suggested that commitment to the O pathway depends upon interaction with the adjacent p bandlet. To better understand the nature and timing of this interaction we examined the fate of o blast cells whose p blast cell neighbors had been selectively ablated by photoexcitation of a fluorescent lineage tracer. If an o blast cell has not yet begun its secondary divisions, its normal commitment to the O pathway can be effectively prevented by ablation of the adjacent p bandlet. Comparing the outcome of progressively later lesions reveals that the progeny of the o blast cell become committed to the O pathway in a series of three discrete steps, and that these steps occur around the time of the first three blast cell divisions. Each of the three events affects a different subset of elements within the blast cell clone, and apparently commits those elements to either the O or P pathway depending upon the presence or absence of the other bandlet. These changes in blast cell fate are coextensive with the lesion along the bandlet's length, suggesting that the interaction of the two bandlets is localized to neighboring cells. PMID- 6500177 TI - Modulation of nonglobin mRNA levels in erythropoiesis. AB - During erythropoiesis, the decrease of complexity of a RNA population is an important process as is globin mRNA accumulation. To determine the sequential control process of gene expression, many genomic clones which express in mouse reticulocytes were obtained and used for the titration of each mRNA level in the different stages of erythroid cells. The level of mRNAs of rt-clones decreases depending on the maturation of erythroid cells, and the coordinated and sequential control of this level is likely to be one of the factors affecting this process. PMID- 6500178 TI - Hyaluronidase activity in embryonic chick heart muscle and cushion tissue and cells. AB - Hyaluronidase activity was compared in embryonic chick cardiac cushion and noncushion segments, as well as in cultures of mesenchyme derived from cardiac cushion endocardium (cushion tissue-enriched cultures) and in cultures of myocardial cells at stages critical to heart valve and septum development. Enzyme levels were higher in both heart tissue regions at periods of active cushion tissue mesenchyme migration than after migration ceases, and higher in the cushion region than in the noncushion region at both periods. Hyaluronidase was measured in cells and medium in both types of cultures, with five times greater activity found in the myocardial cultures. The cardiac hyaluronidase from cells and medium of both culture types had an estimated molecular weight of 41,000 to 44,000 and degraded hyaluronate and, to a lesser degree, chondroitin sulfate, at an acidic pH optimum. Ion-exchange chromatography demonstrated that in both culture types, a proportion of the secreted enzyme was more acidic than that found in the cell layer. These studies indicate the potential for hyaluronate degradation by the major cell types present in the developing heart at early stages and that the enzyme responsible is probably a lysosomal enzyme. Therefore, hyaluronate internalization is a likely requirement for degradation, and thus, the turnover of hyaluronate in developing heart valves is more complex than the extracellular degradative process suggested by histochemical data. PMID- 6500179 TI - Morphogenetic tissue interactions during posterior commitment in palleal buds of the polystyelid ascidian, Polyandrocarpa misakiensis. AB - The development of chimeric double-anterior and double-posterior buds in the polystyelid ascidian, Polyandrocarpa misakiensis, was studied. Bud pieces used were allowed to develop for various time periods before the fusion operation. One day double-half buds developed into complete zooids with normal anteroposterior polarity. In these cases, the bud half whose site of origin on the parent was higher (more posterior) than the partner formed the posterior organ, the digestive tract, of a resultant zooid. Two-day double-posterior buds developed into biposterior zooids that had two digestive tracts, whereas 2-day double anterior buds still underwent pattern regulation in the same manner as 1-day buds (23-24 degrees C). Bianterior zooids could only be induced from 3-day double anterior buds, suggesting that the anterior determination occurs later than the posterior determination. Next, a 3-day posterior half was combined with a 1-day posterior half from a higher site. Though "high-level" tissue has a high potential for posterior differentiation, the 1-day bud half failed to form the digestive tract. This result suggests that the 3-day bud half has acquired the ability to inhibit the formation of additional posterior structures. The kinetics of posterior-forming activity of developing bud pieces was measured using a 12-hr bud piece of the highest level as a probe. The activity increased with increasing developmental time, and the increase was accompanied by posterior inhibition activity. Buds of different positional levels showed different time courses of these activities. The results of this study show that the posterior end is the dominant region of developing ascidian buds. PMID- 6500180 TI - Temporal separation of the migration of distinct myogenic precursor populations into the developing chick wing bud. AB - The developing chick limb bud contains several stage-specific populations of muscle colony-forming (MCF) cells. The cell lineage relationships of these populations are not completely understood, but previous studies have suggested that there may be at least two myogenic precursor populations present in the limb bud. To investigate the heterogeneity of the precursor population, the migration of myogenic precursor cells into the wing anlagen was stopped at various times by grafting stage 15-18 wing buds to the flank or chorioallantoic membrane regions of host embryos. The grafted wings were subsequently assayed for the various MCF cell populations. The data provide further support for the existence of two distinct myogenic precursor populations that migrate into the wing anlagen at different times; precursors to early MCF cells are present by stage 15, whereas precursors to late MCF cells are not present until the end of stage 16. The fact that wing buds which are grafted to a foreign location at stage 15 exhibit exclusive development of early MCF cells suggests that late MCF cells are not direct cell lineage descendants of either the early-type precursors or early MCF cells. PMID- 6500181 TI - Rescue of blocked cells by reinnervation in denervated forelimb stumps of larval Ambystoma. AB - Cells of amputated, denervated larval Ambystoma forelimbs dedifferentiate and enter the cell cycle but do not subsequently proliferate sufficiently to form a blastema. The denervated limb stump resorbs slowly until reinnervation stimulates regeneration. We used this system to investigate the fate of cells in denervated limbs which undergo early but limited cycling in response to amputation. In Experiment 1, cells were labeled with [3H]thymidine (3H-T) on Day 4 postamputation (PA)/Day 3 postdenervation (PD). Labeled cells were still present on Day 7 PA, but were less frequently observed on Day 13 PA when the limbs were reinnervated and beginning to regenerate. In Experiment 2 we denervated 1 day preamputation to obtain earlier reinnervation and prevent loss of Day 4 PA labeled cells. Cells labeled with 3H-T on Day 4 PA/Day 5 PD were present throughout the denervation period and most were still present on Day 13 PA. Little or no mitotic activity was found among the labeled cells after the initial round of cycling. The apparent cell cycle block was released upon reinnervation on Days 12 and 13 PA when cycling resumed. Labeled mitotic figures were present on Day 13 PA, and the mitotic index of the labeled population increased as a result of reinnervation. These results demonstrate that blocked cells are rescued by nerves, re-enter the cell cycle, and thus contribute to the reinnervation blastema. PMID- 6500182 TI - Axon growth from limb motorneurons in the locust embryo: the effect of target limb removal on the pattern of axon branching in the periphery. AB - Metathoracic limb buds have been unilaterally ablated from locust embryos at 25 to 30% of embryonic development and the effect of this operation on the axon morphology of the motorneuron fast extensor tibiae (FETi) observed at later embryonic stages. In control embryos this neuron sends a single axon out the main leg nerve, nerve 5, to the extensor tibiae muscle in the femur. In limb ablated embryos the axon of FETi is found in a wide variety of aberrant peripheral nerve pathways and projects to a wide range of foreign muscles. There is a degree of apparent selectivity, but no rigid hierarchy, in the choice of pathway and muscle made by FETi. A high degree of variability is found between one embryo and another in the extent and pattern of axon branching. The axon of FETi is generally found in pathways that correspond to nerves in control embryos but on occasion grows along novel routes. An anteriorly directed dendritic branch, seldom seen in control FETi neurons, is frequently seen in experimental FETis. These findings are discussed in terms of the rules for specific axon growth in normal development. PMID- 6500183 TI - Migration of I-cells from ectoderm to endoderm in Hydra attenuata Pall (Cnidaria, Hydrozoa) and their subsequent differentiation. AB - The cellular composition of isolated ecto- and endoderm of the gastric column of Hydra attenuata Pall were recorded qualitatively and quantitatively. The endoderm contains a small population of I-cells ("basal cells") which give rise to the endodermal neurons. The recombination of live ecto- and endoderm, one of which had previously been [3H]thymidine labeled, revealed that the endodermal I-cells and their neural derivatives originate from ectodermal I-cells which migrate across the mesoglea. No other cell types were found to pass from one cell layer to the other. The experiments support the idea that the endodermal gland cells constitute an autoreproductive cell line independent of the pluripotent I-cells. PMID- 6500184 TI - Guidance of optic axons in vivo by a preformed adhesive pathway on neuroepithelial endfeet. AB - Antibodies against the neural cell adhesion molecule (NCAM) were used in vivo both to localize NCAM antigenic determinants in developing tissues of the chicken visual system and to perturb cell-cell adhesion during growth of optic fibers to the tectum. The immunohistochemical studies revealed a staining pattern on neuroepithelial cells which coincided with certain regions of the presumptive route for optic axons, not only with respect to the overall pathway from the eye to the tectum, but also in the preferential distribution of the antigen on the marginal endfeet which are contacted by optic axon growth cones. The antibody perturbation studies, which involved intraocular injection of anti-NCAM Fab at embryonic Day 3.5, demonstrated that inhibition of NCAM-mediated adhesion results in a dramatic distortion of growth cone-neuroepithelial cell relationships and consequently of the optic pathway. Together, these studies suggest that guidance of optic axons along the margin of the brain is at least in part influenced by a preformed adhesive pathway on neuroepithelial cells associated with NCAM antigens. PMID- 6500185 TI - Breathing, sleep, and diabetic autonomic neuropathy. AB - Sudden, unexplained deaths are relatively common in diabetic autonomic neuropathy. As disturbed autonomic function has been associated with sleep apnea, and sleep apnea with sudden death, we recorded breathing patterns, arterial oxygen saturation, and EEG during sleep in 8 male diabetic subjects with severe autonomic neuropathy and 8 age-matched, male diabetic subjects without autonomic neuropathy. None of the patients with autonomic neuropathy had more than 11 apneic episodes per night, and there were no significant differences between the two groups in the number of sleep apneas, the duration of individual apneic episodes, the total duration of irregular breathing during sleep, or the duration and quality of sleep. The arterial oxygen saturation when awake and the lowest arterial oxygen saturation during sleep were also similar in both groups. Thus, diabetic patients with severe autonomic neuropathy have normal breathing patterns and oxygenation during sleep, and it is unlikely that sleep apnea causes these unexpected deaths. PMID- 6500186 TI - Genetic control of pathogenesis of diabetes in C3H mice. Influence of the major histocompatibility complex. AB - Inbred strains of genetically diabetic (db/db) male mice with H-2b haplotype were heretofore found resistant to the diabetogenic action of the db mutation, whereas C3HeB/FeJ-db/db males with H-2k haplotype were susceptible. To determine whether the major histocompatibility complex was linked to diabetes predisposition, we mated C3H.SW/SnJ females (H-2b haplotype) with C3HeB/FeJ- +/db males, identified the +/db heterozygotes in the F1 generation (all H-2b/H-2k), and intercrossed these to produce F2 db/db male offspring that were classed and studied according to the three segregating H-2 genotypes. We found an accelerated diabetes pathogenesis in terms of early onset of severe hyperglycemia, destruction of pancreatic beta cells, and mortality that was not linked to H-2. Of 9 F2 male diabetics with H-2b/H-2b genotype, 14 with H-2b/H-2k genotype, and 5 with H-2k/H 2k genotype, all showed a more severe syndrome than did the grandparental-type C3HeB/FeJ-db/db males. We conclude that on the C3H inbred background, the major histocompatibility complex is not a major background modifier of the diabetes syndrome. The complexity of the results suggests residual non-H-2-related genetic variance between the two grandparental C3H stocks, with C3H.SW/SnJ females possessing diabetes susceptibility factors apparently lacking in C3HeB/FeJ (a stock bred to be free of the milk-borne mouse mammary tumor virus). Since C3H.SW/SnJ females transmitted to F2 males unknown diabetogenic factor(s) that did not appear to segregate, inheritance of a virus was suggested.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500187 TI - The effects of acute and chronic diabetes on myocardial metabolism in rats. AB - This study examined how the duration of experimentally induced diabetes affects myocardial metabolism. Both acutely (2-day) and chronically (30-day and 90-day) streptozocin (STZ)-diabetic rats exhibited hyperglycemia and hyperketonemia, while hyperlipemia was evident only in the chronically diabetic rats. The activity of succinate dehydrogenase was lower, whereas that of 3-hydroxyacyl-CoA dehydrogenase was higher in the hearts of chronically diabetic rats. Although myocardial concentrations of glucose-6-phosphate, glycogen, and triacylglycerols were elevated in diabetes, the patterns of alterations differed between acute and chronic diabetes. The fructose-1,6-diphosphate/fructose-6-phosphate ratio declined progressively after STZ administration, which was not accompanied by a reciprocal increase in citrate levels, although citrate concentrations were elevated. Impaired glucose oxidation was more severe in the freshly isolated heart cells from 30-day than from 2-day diabetic rats. For a given substrate concentration, the oxidation rates of palmitate and 3-hydroxybutyrate were markedly reduced in myocytes from 30-day diabetic rats. However, they were similar to or even higher than the rates found in their control counterparts under conditions that reflected the respective in vivo concentrations of the substrates. Incubating isolated myocytes from 2-day diabetic rats in the presence of insulin only partially restored the impaired glucose oxidation. Insulin administered to the animals 4 h before the experiments restored the impaired glucose oxidation by the cells. Insulin in vitro or single injection in vivo had little or no effect on glucose oxidation in isolated myocytes from 30-day diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500188 TI - Impaired auditory brainstem-evoked responses in insulin-dependent diabetic subjects. AB - Auditory brainstem-evoked responses (ABR) were recorded from the scalp of 30 normoacoustic insulin-dependent diabetic subjects, aged between 15 and 41 yr (29 +/- 7 yr). Three different stimulus repetition rates (11, 37, and 87 cps) were used. The results were compared with those obtained from 20 age- and sex-matched, normoacoustic control subjects. In diabetic patients, metabolic control (mean daily plasma glucose, glycosylated hemoglobin) and the presence of retinopathy, nephropathy, and somatic neuropathy were also investigated. The latencies (ms) of ABR waves were significantly impaired in diabetic subjects as compared with normals. Peripheral transmission time (wave I) and central transmission time (waves I-V) were also significantly delayed in diabetic subjects. Moreover, by increasing stimulus repetition rates, a significant increase in waves I-V shift was observed in diabetic patients. ABR impairment was not related to glucose balance, to the duration of diabetes, or to the presence of the diabetic retinopathy, nephropathy, and somatic neuropathy. In conclusion, diabetic neuropathy is characterized not only by somatic and autonomic nerve dysfunctions, but also by the early involvement of the central nervous system (CNS). ABR recording can represent a useful, noninvasive, simple procedure to detect both acoustic nerve and CNS damage. PMID- 6500189 TI - Hypoglycemic brain injury in the rat. Correlation of density of brain damage with the EEG isoelectric time: a quantitative study. AB - Thirty-eight male Wistar rats were exposed to insulin-induced hypoglycemia resulting in periods of cerebral isoelectricity ranging from 10 to 60 min. Plasma glucose levels during cerebral isoelectricity ranged from 0.12 mM to 1.36 mM. Control rats were injected with insulin, but hypoglycemia was terminated with glucose at the stage of large delta-wave EEG slowing. After recovery, the rats were allowed to wake up and survive for 1 wk. The number of dying neurons was assessed with acid-fuchsin/cresyl-violet-stained, whole-brain, subserial sections using direct visual counting of acidophilic, cytoclastic neurons. Brains from control rats that were not allowed to become isoelectric showed no dying neurons. Ten minutes of cerebral isoelectricity produced very minimal brain damage. The density of neuronal necrosis was positively related to the number of minutes of cerebral isoelectricity up to the maximum examined period of 60 min, but showed no correlation with the blood sugar levels. The cerebral cortex, hippocampus, caudate nucleus, spinal cord, and, to a lesser extent, cerebellar Purkinje cells were affected. The distribution of neuronal necrosis was not identical with that seen in ischemia, but, rather, suggested a CSF-borne neurotoxin operant in contributing to the pathogenesis of neuronal necrosis in hypoglycemic brain damage. Neuronal death does not occur in hypoglycemia unless the EEG becomes isoelectric, whatever the blood sugar level. Serious brain damage does not occur until electrocerebral silence has been established for at least several minutes. Neuronal death accelerates after 30 min of EEG isoelectricity in the rat.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500190 TI - Effect of tolbutamide on myocardial metabolism and mechanical performance of the diabetic rat. AB - Exposure of the isolated, glucose-perfused rat heart to buffer containing 0.4 mM tolbutamide resulted in significant changes in both energy metabolism and myocardial contractility. In the nondiabetic, tolbutamide mediated only small increases in mechanical function at low atrial filling pressure, but this effect increased with increasing preload. By contrast, the stimulation of mechanical function resulting from exposure of the diabetic heart to tolbutamide was independent of preload. As a result, the tolbutamide-mediated, positive inotropic effect in the diabetic heart was greater at lower, but not higher, preload values than the effect in the nondiabetic. Moreover, the changes in energy metabolism initiated by tolbutamide were considerably larger in the diabetic. The most prominent effect was the mobilization of glycogen by tolbutamide in the diabetic, which was considerably greater than that observed in the nondiabetic. The drug also enhanced glucose utilization. The net effect of sulfonylurea exposure was to shift from preferential use of fatty acids as an energy source for contraction to use of glucose. Since the most prominent effect of the drug in the diabetic was the stimulation of glycogenolysis, it is concluded that tolbutamide can dramatically alter the metabolism of a tissue without acting through insulin. PMID- 6500191 TI - Muscle protein turnover in the perfused hindquarters of lean and genetically obese-diabetic (db/db) mice. AB - The stability of the perfused mouse hindquarter was assessed for a period of 5 h, and the preparation shown to remain stable for metabolic studies over this time period. Muscle protein synthesis and degradation rates in lean and diabetic-obese (db/db) mice were measured using the in situ perfused hindquarter preparation. The rates of protein synthesis were 48% lower in the muscles of intact db/db mice than in the lean controls when expressed per gram TCA precipitable protein and 46% lower when expressed per gram dry weight. Adrenalectomy, which has been shown to restore the lean body mass of the db/db mice to normal, had the effect of returning protein synthesis rate in muscle of db/db mice to lean control values. Insulin at a dose of 1 mU/ml stimulated protein synthesis in lean mice only, showing that the process of protein synthesis in the db/db mice is also insensitive to insulin. Measurements of the rates of degradation of muscle protein showed no differences between lean and db/db mice. These findings suggest that the decreased lean body mass of db/db mice is the result of a defect in protein synthesis rather than due to altered degradation. PMID- 6500192 TI - Long-term outcome of acute necrohemorrhagic pancreatitis. A 4-year follow-up. AB - This long-term follow-up of 27 patients treated with conservative surgery for necrohemorrhagic pancreatitis (NHP) showed that an almost complete recovery of the exocrine function is achieved within 4 years after discharge, while about half of the patients presented still abnormal endocrine function. The morphological sequelae, pointed out by endoscopic retrograde pancreatography in almost 50% of the cases, remained unchanged during the follow-up period. Therefore, these data seem to exclude an evolution of NHP towards chronic pancreatitis. PMID- 6500193 TI - Biliary excretion of cobalamin and cobalamin analogues in man. AB - Using dialysis, gel filtration, isoelectrofocusing and radioaffinity assay, we studied the unsaturated and saturated binders of bile and the biliary concentration of cobalamin (Cbl) and Cbl analogues compared to the corresponding serum concentrations in 7 choledochodomized patients. Bile contained a single saturated or unsaturated R binder with a molecular mass of about 120,000. Differences in the isoelectrofocusing pattern were observed between unsaturated and saturated R binders and could correspond to two secretion origins, mucosal secretion and hepatocyte clearance, respectively. The concentration of total corrinoids is about 4 times higher in bile than in serum, and this could be explained by a hepatic clearance of serum Cbl analogue-R binder complexes, as previously described in the rabbit. Moreover, the enterohepatic circulation of Cbl seems likely in healthy individuals since the saturated biliary R binder is degraded by pancreatic juice. PMID- 6500194 TI - Amitriptyline-induced fulminant hepatitis. AB - The authors report the case of a patient who received amitriptyline on 2 occasions. On both occasions, she had fever and jaundice. On the second episode, hepatitis was severe with hepatic encephalopathy, ascites, increased prothrombin time, and massive hepatic necrosis. After interruption of the drug administration, the patient made a slow but complete recovery. PMID- 6500195 TI - Acoustic immittance measures: terminology and instrumentation. AB - After a varied history over the past 15 years, basic acoustic immittance measures now include certain physical measures and certain physiological measures. This article reviews current concepts in the terminology and the instrumentation used for these basic measures. It is designed to provide an understanding of standard acoustic immittance measures and a framework for interpreting the results of special acoustic immittance procedures discussed in this issue. PMID- 6500196 TI - Acoustic reflex averaging. AB - Signal averaging techniques have been applied to acoustic reflex measurement in order to meet the need for better temporal resolution and more accurate threshold delineation. We describe an approach to reflex measurement based on a signal averaging technique designed to examine both threshold and suprathreshold characteristics of the acoustic reflex. Results indicate that: (1) many supposed reflex threshold and latency aberrations are actually amplitude aberrations that are inappropriately classified because of instrumentation constraints; (2) reflex amplitude and waveform morphology can be recorded with appropriate fidelity using a signal averaging technique; (3) problems due to absolute amplitude variability can be minimized by using an index technique to assess amplitude relationships; (4) amplitude indices are sensitive indicators of neural pathology; (5) signal averaging and suprathreshold measurement of reflex amplitude and waveform morphology promise to enhance the sensitivity of acoustic reflex measurement. PMID- 6500197 TI - Acoustic immittance testing of the Eustachian tube. AB - The pathophysiological relationship of Eustachian tube dysfunction to middle ear effusion is widely accepted. Several techniques have been developed for utilizing the clinical measurements of acoustic immittance to assess the ventilatory status of the Eustachian tube. This article describes the array of procedures currently in use as well as a selection of procedures being developed for clinical assessment of the Eustachian tube. Most studies in this area have concentrated on measurements of normal function. Clinicians and researchers are encouraged to increase the application of these techniques in order to broaden the data base that is currently available concerning normal and pathological function. PMID- 6500199 TI - 125I-glucagon-degrading activity in acid-saline extracts of rat salivary gland. AB - The antibody-binding ability of the glucagon-like substance in rat submaxillary gland acid saline extract was examined by affinity chromatography, and the biological activity studied using the isolated liver perfusion method. We found that the glucagon-like substances in acid saline extract could not be bound to anti-glucagon antibody and that the gel-filtration peak on ultrogel AcA 54 could increase neither glucose nor cyclic AMP output from isolated perfused rat liver. Furthermore, the radioactivity peak of 125I-glucagon on Bio Gel P-6 column chromatography moved from its original position and eluted in later fractions after incubation with an acid saline extract of the submaxillary gland. In consequence, there was 125I-glucagon degrading activity in the submaxillary gland, but no glucagon-related peptide. Therefore, it is suggested that the glucagon-like substance, which has been reported in acid saline extract of the rat salivary gland, may be an artifact due to tracer degrading activity. PMID- 6500198 TI - Alloxan effects on mitochondria: study of oxygen consumption, fluxes of Mg2+, Ca2+, K+ and adenine nucleotides, membrane potential and volume change in vitro. AB - Isolated mouse liver mitochondria incubated with alloxan showed stimulated resting (state 4) respiration with succinate, and inhibited resting respiration with pyridine-linked substrates, whereas active (state 3) respiration was decreased with both kinds of substrates. The effects were dependent on the concentration of alloxan, on the energy state, and on transport of inorganic phosphate and uptake of Ca2+. Using succinate as substrate, the effects of alloxan on endogenous Mg2+, K+ and adenine nucleotides, uptake of K+, accumulated Ca2+, membrane potential and volume were studied in liver mitochondria, and in addition efflux of endogenous K+ and accumulated Ca2+ were investigated in mouse islet mitochondria. High concentrations of alloxan (greater than or equal to 3 mmol/l) induced efflux of endogenous Mg2+, K+ and adenine nucleotides, efflux of accumulated Ca2+, inhibition of uptake of K+, loss of membrane potential, and swelling. Low concentrations of alloxan (less than 3 mmol/l) had similar effects only in the presence of added Ca2+ and inorganic phosphate. The influence of potentially protective agents was studied mainly with regard to alloxan induced swelling. Complete or partial protection was offered by antimycin A, malonate, La3+, Ni2+, ruthenium red, mersalyl and N-ethylmaleimide, suggesting requirement for energized transport of Ca2+ and uptake of inorganic phosphate. The start of the respiratory changes, decrease of membrane potential and loss of Mg2+ preceded the release of accumulated Ca2+, which occurred in parallel with efflux of K+ and swelling. The loss of Ca2+ in association with swelling agrees with data previously obtained using qualitative and quantitative electron microscopy and X ray microanalysis of islet beta cells from alloxan-treated mice.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500201 TI - Human proinsulin standards. AB - Two new batches of pancreatic human proinsulin have been compared with biosynthetic human proinsulin. Standards of these three proinsulin preparations were made on the basis of quantitative amino-acid analyses and compared in two proinsulin radioimmunoassays with a proinsulin standard prepared 14 years ago. The curves of the new standards were superimposable. However, they differed considerably from the curve of the old standard which proved to be only one-third of the strength of the new standards, thereby leading to a threefold over estimation of proinsulin concentrations when the old standard is used. We conclude that the new standards should replace previously used standards. PMID- 6500200 TI - Ultrastructure of heart muscle in short-term diabetic rats: influence of insulin treatment. AB - The ultrastructure of myocardium was examined in short-term diabetic rats. Morphometric analysis showed the volume of myocytic mitochondria, sarcoplasmic reticulum and lipid droplets to be significantly increased compared with those of control animals. Further measurements of mitochondria and sarcoplasmic reticulum indicated that the augmentation of these compartments was accountable by the enlargement of pre-existing mitochondria, which were swollen, and of pre-existing tubules of sarcoplasmic reticulum, the lumen of which was dilated. After insulin treatment the morphological changes were returned to normal which indicates that they were not due to the toxic effect of streptozotocin but were caused by the diabetic state per se. This suggestion is further supported by the finding that experimentally induced metabolic acidosis without diabetes did not cause any morphologically detectable changes in the heart muscle. It is concluded that short-term diabetes in the rat causes mitochondrial swelling, dilatation of sarcoplasmic reticulum and accumulation of lipid in cardiac myocytes, and that these changes are preventable with insulin treatment. We suggest that insulin may have an important role in the maintenance of metabolism in heart muscle. PMID- 6500202 TI - Influence of Concanavalin A on 3-O-methylglucose uptake in cultured chick embryo fibroblasts. Evidence for differences related to the age of embryos. AB - Concanavalin A (Con A) was found to inhibit hexose uptake in cultured fibroblasts derived from 8-day chick embryos and to stimulate this process in those derived from 16-day embryos. Con-A effects depended on the duration of contact with cells and lectin and were inhibited by alpha-methylmannopyrannoside. Con A was shown to mask about 70% of the hexose carriers in both 8- and 16-day embryo fibroblasts. Lectin altered the hexose uptake very rapidly. Con A only modified the Vmax of the uptake system and did not alter the Km. This indicates that either the number or mobility of hexose carriers were modified by Con-A treatment. The differential effect of lectin could be due to a modification of the hexose-carrier mobility during the embryonic differentiation of fibroblasts. Secondary effects may affect cell growth. PMID- 6500203 TI - Epithelio-mesenchymal interface and fibronectin in the differentiation of the rat mesonephric and paramesonephric ducts. AB - The distribution of fibronectin and the morphological differentiation of the genital ducts was studied in rat fetuses at ages from 15 to 21 days. Fibronectin was localized with the peroxidase-antiperoxidase and avidin-biotin method at the electron- and light-microscope level. In 15-day-old male and female fetuses, fibronectin was localized as a continuous lamella around the mesonephric duct and as a discontinuous lamella around the paramesonephric duct. During the differentiation of the female paramesonephric duct, the fibronectin layer became continuous and remained so after the age of 16 days. The fibronectin layer of the male mesonephric duct remained continuous at all ages. The accumulation of mesenchymal cells on the outer surface of the female mesonephric duct and the concomitant detachment of the fibronectin layer around the duct suggests that mesenchymal regulation plays a role in the regression of the mesonephric duct. In the regressing male paramesonephric duct fibronectin was simultaneously lost in the condensed periductal mesenchyme, the places of epithelio-mesenchymal contact, and the epithelial cytoplasmic protrusions towards the mesenchyme. Ultrastructurally, fibronectin was localized in the basal laminae, on the cell membrane in contact with the extracellular material, and on the surface of the fibrillar and flocculent extracellular material. In addition to auto- and heterophagy, epithelio-mesenchymal interactions seem to play an important role in the regression of the genital ducts, although in different ways in males and females. The present results give additional support to the theory of the possible migration of epithelial cells into the surrounding mesenchyme during the regression of the paramesonephric duct. PMID- 6500204 TI - Changes in the expression of blood-group carbohydrates during oral mucosal development in human fetuses. AB - The distribution of the blood-group antigens A, B, H type 2 (A and B precursor), and N-acetyllactosamine (H-type-2 precursor) was studied in human fetal oral mucosa from 30 fetuses. Epithelium was examined from the lip, the alveolar ridge and the hard palate in fetuses representing development from week 10-20 in utero. The blood-group carbohydrate chains were examined in tissue sections by immunofluorescence microscopy. The A- and B-blood group antigens were detected by human blood-group sera, and antigen-H type-2 chains and N-acetyllactosamine were detected by murine monoclonal antibodies. Regional differences in the expression of oral epithelial blood-group carbohydrates occurred during the fetal period. In the labial epithelium that remained unkeratinized, blood-group antigens A and B were present throughout the entire period of fetal development on the cell surface of the spinous and superficial cells, antigen H type 2 was present on parabasal cells, and N-acetyllactosamine was present on basal cells. In the epithelia of the alveolar ridge and the hard palate, the initial uniform staining for blood-group antigens A and B only occurred in the upper cell layers and changed to include a patchy reaction of single cells in the spinous cell layer. The distribution of antigen H type 2 changed simultaneously to include parabasal cells and the entire spinous cell layer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500205 TI - Inducer-dependent phenotypic divergence in an embryonal-carcinoma cell line. AB - In monolayer cultures, embryonal carcinoma (EC) cells from the cell line Nulli SCCl can be induced to differentiate at high efficiency by exposure to either retinoic acid or hexamethylenebisacetamide. Depending on which inducing agent is used, two distinct differentiated phenotypes result. These phenotypes resemble two of the earliest differentiated derivatives of the cells of the inner cell mass of a mouse blastocyst, i.e., parietal and visceral endoderm. Both differ from EC cells as well as from each other on the basis of their morphology, antigenic expression, secretion of plasminogen activator, and protein-synthetic profiles. PMID- 6500206 TI - [Hematocrit level in patients with acute myocardial infarct]. PMID- 6500207 TI - [Arrhythmia during dialysis. Dynamic electrocardiographic study]. PMID- 6500208 TI - [Role of ultrafiltration in the treatment of congestive cardiac decompensation in uremic patients]. PMID- 6500209 TI - [Smoking and acute myocardial infarct in the aged]. PMID- 6500210 TI - [Diabetes and acute myocardial infarct in the aged]. PMID- 6500211 TI - [Epidemiologic considerations of risk factors in clinical cases of cerebrovascular and coronary atherosclerosis pathologies]. PMID- 6500212 TI - [Type II diabetes and ischemic cardiopathy. Clinical results and possible pharmacologic interference in treatment with fendiline]. PMID- 6500213 TI - [Antihypertensive action and tolerance of alphamethyldopa and hydrochlorothiazide in fixed association versus single alphamethyldopa administration]. PMID- 6500214 TI - [The apex cardiogram in normal aged subjects]. AB - In 25 healthy subjects aged 60-88 years (mean 74.5) and in 20 healthy subjects aged 16-32 years (mean 23.6) apexcardiographic indices were studied as a function of age. The apex cardiograms (ACG) were obtained using a non-calibrated displacement transducer. With the help of an interactive computer program, 17 ACG indices of systolic and diastolic function were computed. The indices were divided into 2 groups (according to the nomenclature proposed by their Authors): a) systolic indices: electromechanical ventricular interval q-C, systolic upstroke time C-E, time from the beginning of ventricular depolarization to the peak of the first ACG derivative q-dA/dt, time from the onset of systolic slope to the peak of first ACG derivative C-dA/dt, ejection fraction according to Antani et al. 1979 E.F.; b) diastolic indices: electromechanical atrial interval P-a, atrial wave length d.a., height of atrial wave as percent of total ACG deflection a/H, height of atrial wave as percent of total diastolic deflection a/D, ratio of the diastolic wave to the total ACG height D/H, total rapid filling cR, early filling period EFP, rapid filling period RFP, total apexcardiographic relaxation time TART, duration of diastolic period A2-C, total apexcardiographic relaxation time index TARTI and diastolic amplitude time index DATI. Several diastolic indices (a/D, a/H, TART, electromechanical atrial time) were markedly higher (p less than 0.001) or lower (TART and DATI, p less than 0.001) in the older group. Systolic indices showed less significant differences: the electromechanical interval lengthened in the older group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500215 TI - [Depression of the ST segment in precordial derivations: prognostic value in inferior myocardial infarct]. AB - We have assessed the prognostic significance of ST segment depression in the anterior precordial leads in patients with an acute inferior infarction. Eighty four patients with ST segment depression greater than or equal to 1 mm in at least 2 chest leads (Group A) and 82 patients without ST depression (Group B), all admitted to the hospital within 24 hours from the onset of an acute inferior myocardial infarction, were evaluated. Patients with an old infarction, those with intraventricular conduction abnormalities or other causes that could modify the ST segment were excluded from the study. The number of patients affected by complications during the hospital stay was significantly higher in group A (54 patients of group A vs 27 of group B, p less than 0,001). Death, left ventricular failure, ventricular arrhythmias were considerably higher in group A. Moreover we observed that the persistence of the ST segment depression for more than 24 hours identified a subgroup of patients with a very strong risk of complications, particularly death and left ventricular failure. The follow up after 3-6 months, however, did not show any significant difference in both groups. In conclusion, from our study it appears that patients with an inferior infarction precordial ST segment depression have a graver prognosis in the acute phase while their mid term fate does not seem to be influenced by the presence of this electrocardiographic abnormality. PMID- 6500216 TI - [Left ventricular function in patients under peritoneal dialysis treatment]. AB - M-Mode echocardiogram and systolic time intervals were obtained in 24 patients with end-stage chronic renal failure before and after peritoneal dialysis in order to evaluate their left ventricular function. Before dialysis 9 patients (group A) showed an echocardiographic pattern of dilated cardiomyopathy, i.e. increased left ventricular end-diastolic dimension (EDD) and volume (EDV), reduction of fractional shortening (FS%), of circumferential fiber shortening (Vcf) and of ejection fraction (EF). Seven patients (group B) had the morphological and functional features of asymmetric septal hypertrophy: ratio of interventricular septum to posterior wall thickness (IVS/PWT) greater than 1.3, reduced EDD and EDV. Eight uraemics (group C) had no specific feature of cardiac disease, but only aspecific echocardiography signs of myocardial derangement. Peritoneal dialysis appeared to be associated with gradual improvement of the contractile state in group A patients, with reduction in echocardiographic asymmetric septal hypertrophy in group B uraemics, and with an aspecific increase in cardiac performance in group C patients. It is concluded that: end-stage chronic renal failure may have echocardiographic pattern of dilated or asymmetric hypertrophic cardiomyopathy; peritoneal dialysis significantly improves the morphological and functional derangements of both clinical conditions. PMID- 6500218 TI - [Mechanisms of control in scientific research]. PMID- 6500217 TI - [Spontaneous microcavitations in the right cardiac chambers. Microcavitations in the right sections]. AB - Spontaneous echocardiographic contrast has been occasionally detected in the left ventricle of patients with mitral valve prosthesis. Only one case has been so far described in which spontaneous microbubbles have been detected in the right ventricle. We report the clinical and echocardiographic findings of five patients in whom spontaneous echocardiographic contrast was detected in right cardiac chambers: one patient had pulmonary embolism, three patients had mitral valve disease and tricuspid regurgitation, one patient had a congestive cardiomyopathy. These microbubbles can be produced by gas development due to lateral pressure drop secondary to tricuspid regurgitation or to gas absorbed from the intestine, that reach the heart through shunts between the portal and the systemic veins. PMID- 6500219 TI - [Use of sympathomimetic amines in the newborn infant: our experience]. PMID- 6500220 TI - [Aortic insufficiency caused by valvular dysplasia in childhood. Apropos of 3 cases]. AB - Three patients whose aortic incompetence (A.I.) was recognized in childhood, have had an angiographic study 10, 9 and 4 years, respectively, following the first clinical diagnosis of their valvular disease. A.I. was related, in all three cases, to a dysplastic valve ("floppy valve syndrome"); in none of them was there an abnormal dilatation of ascending aorta. In our opinion, the absence of an abnormal aortic root dilatation separates our cases from those in whom aortic regurgitation is part of Marfan's syndrome, either in its full form or in the "forme fruste". From the clinical viewpoint, the presence of a normal ascending aorta could explain the mild course of these cases, as compared to the rapid progression observed in Marfan's syndrome. In the attempt to differentiate the two types of dysplastic valvular disease from an etiologic viewpoint, we suggest that the basic problem in our patients could be an alteration of the valvular connective tissue development, rather than a genetic disorder, like the one possibly responsible for Marfan's syndrome. PMID- 6500221 TI - Conversion of longstanding atrial flutter to sinus rhythm and transient complete A-V block following oral administration of verapamil. Report of a case. AB - In a patient with ischaemic heart disease chronic atrial flutter reverted to sinus rhythm during treatment with oral Verapamil, given at dosage of 240 mg once a day in order to prevent spontaneous angina. Such an unexpected event was accompanied by a remarkable sinus node depression and by a transient complete a-v block, that gradually subsides leaving a slight permanent a-v conduction delay. Either a higher bioavailability of the drug or an extremely increased sensitivity of the receptors can explain such a marked electrophysiological effect at a moderate drug dosage. PMID- 6500222 TI - [Corrected transposition of the great vessels in the adult. Presentation of a case simulating ischemic cardiopathy]. AB - We report the clinical and laboratory findings in a 58 years old woman with corrected transposition of the great arteries (CTGA), who that presented typical angina pectoris. The diagnosis of ischemic heart disease was supported by the history of a previous myocardial infarction. Other findings were a systolic murmur of mild mitral regurgitation, left bundle branch block and enlarged left ventricle on the chest X-ray. Cardiac catheterization showed a corrected transposition of the great arteries (L-malposition with situs solitus); left and right coronary arteries were free of luminal stenosis. We suggest therefore that anginal chest pain may be due to myocardial ischemia induced by discrepancy between myocardial oxygen consumption and coronary blood flow. This complication may occur in patients with corrected transposition of great arteries surviving in adulthood. PMID- 6500223 TI - [Isolated straddling tricuspid valve. Presentation of 2 cases operated on successfully]. AB - During the period May 1977-September 1983 in the Department of Cardiac Surgery of Massa Hospital two patients with isolated straddling tricuspid valve were studied with cardiac catheterization and selective angiocardiography and subsequently underwent surgical correction. The first patient, a 38-month-old white boy presented with "complete straddling" according to Bharati and Lev classification; the second, a 39-month-old white boy presented with "peripheral straddling". In both cases at surgery the ventricular septal defect was closed with a Teflon patch, sparing the chordae tendinae and the "straddling" papillary muscle. Both patients survived operation. The first one developed a complete atrioventricular (A-V) block with a ventricular rate which never was below 80 beats/min, during the 30 days of in-hospital observation. No permanent pacemaker was therefore inserted. The follow-up controls (39 and 79 months respectively) shows both patients to be hemodynamically and functionally well. PMID- 6500224 TI - Exertional hypotension after myocardial infarction. AB - A retrospective study was conducted on 488 patients admitted in our rehabilitation center after a recent acute myocardial infarction. Purpose of the study was to assess the incidence and prognostic value of exertional hypotension in these patients. Of 488 patients admitted to the study 33 (6%) were found to have exertional hypotension; 14 patients had an inferior myocardial infarction, 18 patients had an anterior myocardial infarction, 3 patients had a history of previous myocardial infarction. In the follow-up period (28.3 +/- 13.2 months) the worse prognosis (death or pulmonary oedema) was associated with the presence during exercise of hypotension, ST segment elevation in leads were Q waves were present and no ST depression in other leads. In conclusion, recent anterior myocardial infarctions associated with hypotension and ST segment elevation during exercise appear to be at risk for future cardiac events. PMID- 6500225 TI - Comparative efficacy of nicardipine, a new calcium antagonist, versus nifedipine in effort stable angina. AB - The relative efficacy of nicardipine and nifedipine was examined in a double blind randomized trial. We studied 12 patients with chronic effort angina who had reproducible chest pain and greater than or equal to 1.5 mm of ST-segment depression on treadmill exercise testing performed before and after 1-week control period of single-blind placebo administration. Subsequently over a 9-week period, nicardipine 20 mg or nifedipine 10 mg or an identical placebo four times a day, was administered in a randomized double-blind crossover fashion. Treadmill exercise testing was performed at the end of each 3-week period. Both nicardipine and nifedipine reduced the frequency of anginal attacks and trinitrate consumption. Compared with placebo both drugs caused a comparable increase of the total duration of exercise (p less than 0.05 placebo versus nicardipine; p less than 0.01 placebo versus nifedipine) and of the time to the onset of angina (p less than 0.05 placebo versus nicardipine; p less than 0.01 placebo versus nifedipine) and to the appearance of 1.5 mm ST depression (p less than 0.05 placebo versus nicardipine; p less than 0.01 placebo versus nifedipine). Moreover 4 patients no longer had angina with either drug and only 1 patient with placebo. Both drugs increased resting heart rate and reduced systolic blood pressure at resting (p less than 0.01) and submaximal exercise (p less than 0.01). Peak heart rate, systolic blood pressure and rate-pressure product were similar with placebo, nicardipine and nifedipine. No important side effects were observed with either drug. We conclude that nicardipine and nifedipine produce similar haemodynamic and clinical effects in patients with stable angina. PMID- 6500226 TI - Ejection fraction and regional wall motion at rest and during stress in the diagnosis of coronary artery disease. AB - Stress radio nuclide ventriculography is used to determine ejection fraction and changes in regional wall motion for the detection of ischemia-induced left ventricular dysfunction in patients with coronary artery disease. We have evaluated the relative sensitivity of regional wall motion and of ejection fraction during hand-grip and cold pressor test, in 21 patients with angina pectoris and documented coronary artery disease at angiography. Regional wall motion appeared a more sensitive index than global ejection fraction producing only two false negative cases. Ejection fraction showed great variability among the patients during both hand-grip and cold pressor test. This might be explained by the fact that both tests do not produce a sufficient degree of ischemic stress on the left ventricle. Hand-grip and cold pressor tests appear useful alternative to dynamic exercise in the diagnosis of coronary artery disease being also safe and simple to perform. PMID- 6500227 TI - Regional myocardial performance before, during and after coronary occlusion. AB - The effects of transient coronary occlusion upon segment length and intramyocardial pressure were studied in seven open-chest dogs. The subendocardial and subepicardial layers in the territory of the left anterior descending coronary artery were instrumented with pairs of ultrasonic crystals and miniature pressure probes. During coronary occlusion, systolic subendocardial pressure decreased from 194 +/- 11 to 141 +/- 12 mmHg (p 0.001) and systolic subepicardial pressure from 82 +/- 7 to 62 +/- 12(p 0.05). Systolic shortening was abolished in both layers. During reperfusion, systolic subendocardial pressure reached 242 +/- 22 mmHg (p 0.05) and systolic subepicardial pressure 100 +/- 10 mmHg (p 0.05). Early during reperfusion a transient overshooting was also observed in subendocardial and subepicardial systolic shortening. The observations of this study are consistent with the hypothesis that unrestricted reperfusion is associated with an overshooting in regional myocardial contractile performance. PMID- 6500229 TI - Integration of v-rasH does not necessarily transform an immortalized murine cell line. AB - Plasmids containing v-rasH and Ecogpt were constructed, and used to transfect two established cell lines of mouse origin, NIH3T3 cells and m5S cells. After transfection, most NIH3T3 cells, which are resistant to mycophenolic acid, showed phenotypes characteristic of neoplastic transformation, whereas no mycophenolic acid-resistant m5S cells showed these phenotypes; integration of functionally intact v-rasH in immortalized murine cells is not sufficient for neoplastic transformation in m5S cells. The resistance to the transformation was probably due to a lower level of the v-rasH gene transcripts in m5S cells. PMID- 6500228 TI - [Guidelines for the performance of pharmacologic tests in the diagnosis and evaluation of ischemic cardiopathy. II. Study Group for the Functional Evaluation and Rehabilitation of the Cardiopathy Patient]. PMID- 6500230 TI - Amplification of the c-myc oncogene in human stomach cancers. AB - Amplified c-myc oncogene was found in the DNAs of 2 of 11 human stomach cancers transplanted into nude mice; the amplification was 8- to 10-fold in one tumor and 13- to 15-fold in the other. Both tumors in which the c-myc oncogene was amplified were poorly differentiated adenocarcinomas, but there was no clear-cut correlation between the histological types or growth rates of the tumors and amplification of the c-myc oncogene. No amplification of the c-myc gene was detected in DNAs from 4 cultured stomach cancer cell lines, 19 primary stomach cancers or 11 metastases to lymph nodes from human stomach cancers. PMID- 6500231 TI - Effects of 12-O-tetradecanoylphorbol-13-acetate on carcinogenesis in the heterotopically transplanted rat urinary bladder. AB - 12-O-Tetradecanoylphorbol-13-acetate (TPA), a potent promoter of mouse skin carcinogenesis, was tested for possible tumor-enhancing effects on urinary bladder carcinogenesis using the heterotopically transplanted bladder (HTB) model. Weekly administration of TPA at 1.0 microgram/week to N-methyl-N nitrosourea-initiated HTBs did not increase tumor incidence, but instead, resulted in a significantly high incidence of nodulopapillary hyperplasia, an early neoplastic lesion, suggesting possible tumor enhancement by TPA. In addition, administration of a high dose of TPA with or without a carcinogen treatment led to the development of numerous finger-like epithelial projections on the luminal surface of the HTBs. Evidence indicates that epithelial projections are formed as a result of proliferation of intermediate cells. Whether these structures evolve into true neoplastic lesions is at present unknown. PMID- 6500232 TI - Effects of three sweeteners on rat urinary bladder carcinogenesis initiated by N butyl-N-(4-hydroxybutyl)-nitrosamine. AB - The effects of three sweeteners, sodium saccharin, aspartame and stevioside, on urinary bladder carcinogenesis in rats initiated by N-butyl-N-(4 hydroxybutyl)nitrosamine (BBN) were evaluated. Male F344 rats were given 0.01% BBN in their drinking water for 4 weeks and then the test sweeteners in their diet for 32 weeks. All surviving rats were sacrificed after 36 weeks, and examined histologically. Treatment with sodium saccharin significantly increased the incidence and extent of preneoplastic lesions, papillary or nodular (PN) hyperplasia, in rats treated with BBN for 4 weeks. Administration of 5% aspartame or 5% stevioside in the diet did not, however, affect the incidence or extent of PN hyperplasia in BBN-treated rats. No preneoplastic or neoplastic lesions of the urinary bladder were observed in rats treated with the test sweeteners only. The results with sodium saccharin were consistent with those in our previous experiments. The data also suggest that aspartame and stevioside do not promote bladder carcinogenesis. PMID- 6500233 TI - Promoting activities of butylated hydroxyanisole, butylated hydroxytoluene and sodium L-ascorbate on forestomach and urinary bladder carcinogenesis initiated with methylnitrosourea in F344 male rats. AB - The promoting effects of butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT) and sodium L-ascorbate on two-stage carcinogenesis initiated with methylnitrosourea (MNU) in F344 male rats were investigated. Animals were given injections of MNU (20 mg/kg ip) twice a week for 4 weeks, and then basal diet containing 2% BHA, 1% BHT or 5% sodium L-ascorbate for the next 32 weeks. Administration of BHA, BHT or sodium L-ascorbate in the diet significantly increased the incidences per group and numbers per rat of papilloma and papillary or nodular hyperplasia of the urinary bladder, and BHA and BHT also increased the number of cancers per rat. Furthermore BHA significantly increased the incidences of cancer and papilloma in the forestomach of rats initiated with MNU, whereas treatment with BHA alone was associated with papilloma but no carcinoma development in the rat forestomach. The incidence of adenoma, but not adenocarcinoma, of the thyroid was significantly increased by treatment with MNU plus BHT. These results show that BHA, BHT and sodium L-ascorbate have promoting activities on urinary bladder carcinogenesis in rats initiated with MNU, and that BHA also has a promoting effect on forestomach carcinogenesis after initiation with MNU. PMID- 6500234 TI - Gonadal neoplasms in largemouth bass, Micropterus salmoides and Japanese dace (ugui), Tribolodon hakonensis. AB - Massive abdominal enlargement was observed at relatively high incidence in two species of fish kept in two public aquariums for several years. Three seminomas, one dysgerminoma and two fibromas were found in 14 largemouth bass, Micropterus salmoides, kept in a public aquarium for over 80 months. Four seminomas and one nephroblastoma were found in 24 Japanese dace (ugui), Tribolodon hakonensis, kept for more than 57 months in two different aquariums. The seminomas in M. salmoides showed rapid growth, and the affected fish died within a few months. At necropsy, a single large tumor, measuring 10.5-12.0 cm, was found in the abdominal cavity. The seminomas in T. hakonensis were single or multiple tumors, measuring 2.0-4.5 cm in diameter. Histologically, these seminomas were composed mainly of a typical germ cells similar to those in human seminomas or embryonal carcinomas. A nephroblastoma in one T. hakonensis showed extensive metastases to various organs. The cause of these tumors is unknown, but the prolonged longevity of fish kept under artificial conditions may have enhanced their development. PMID- 6500235 TI - Spontaneous tumors of the nervous system and associated organs and/or tissues in rats. AB - Spontaneous tumors of the nervous system and associated organs and/or tissues in 346 male and 346 female F344/DuCrj rats and 200 male and 177 female Slc:Wistar rats were examined. The main neurogenic tumors observed were gliomas and neurinomas, which were detected in both strains of rats. Out of 7 gliomas, 6 were found in the brain and 1 in the spinal cord, and out of 4 neurinomas, 2 were in the trigeminal nerves and the other 2 were in the spinal nerves. In addition, other types of tumors (2 granular cell tumors in the brain, 1 pinealoma, 3 ganglioneuromas in the adrenal gland, 1 undifferentiated carcinoma in the nasal cavity and 1 chordoma in the posterior neck region) were observed. PMID- 6500236 TI - Clonal origin of spontaneous multiple mammary tumors in mice with cellular mosaicism. AB - The clonal origin of spontaneous multiple mammary tumors in mice was examined. For this purpose, hybrid female mice (Pgk-1b/Pgk-1a), F1[SHN(Pgk-1b) X C3H/He (Pgk-1a)], with X-chromosome inactivation mosaicism with regard to the phosphoglycerate kinase (PGK)-1 isozyme together with a high incidence of spontaneous mammary tumors were constructed. Thirty-seven of 45 mammary tumors (82%) in mosaic mice had a single phenotype of PGK, indicating monoclonal origin. The multiple mammary tumors formed in these mice varied in PGK type, indicating independent cellular origins. PMID- 6500238 TI - Candidiasis-induced esophageal strictures. AB - Candidiasis of the esophagus progressing to hard fibrosed strictures of the esophagus in 2 patients is reported. Both patients had deficient immunologic systems and received extended courses of broad-spectrum antibiotic therapy for control of sepsis. The strictures were progressive despite adequate antifungal therapy and several attempts at dilatations and necessitated visceral esophageal substitution as definitive surgical therapy. PMID- 6500237 TI - Binding of bile acids with rat colon and resultant perturbation of membrane organization as studied by uptake measurement and 31P nuclear magnetic resonance spectroscopy. AB - The mode of interaction of deoxycholate (DOC) or lithocholate (LC) with F344 rat colon was examined by measurements of uptake, 31P nuclear magnetic resonance (NMR) spectroscopy and observation of morphological changes. DOC as well as LC was taken up by the colon in a nonsaturable manner with respect to concentration and time, up to 30 min. None of several metabolic inhibitors reduced the uptake of the bile acids, nor did pretreatment of colon segments with chloroform methanol (2:1, (v/v), heat or trypsin. Further, the bile acids were not transported by the colon against concentration gradients, and they were bound to both the mucosa and serosa equally. From these findings, it is concluded that the bile acids are transported in a passive manner, and no specific receptor for them is contained in colonic mucosa. The uptake of the bile acids by the colon varied with temperature and was related to the fluidity of the colonic membranes. The extent of uptake of dehydrocholate and taurocholate, which do not induce ornithine decarboxylase (ODC) activity, was almost the same as that of LC. The 31P NMR spectra of the colonic mucosal cells indicated that the proportion of the bilayer structure is increased by 0.5 mM DOC. Among a variety of bile acids examined, the extent of membrane alteration was in parallel with the extent of ODC induction. Treatment of the colonic mucosa with 0.5 mM DOC caused marked degeneration of the surface but not the deeper layers of the mucosa. Thus, physiological concentrations of bile acids influence the membrane organization of the colonic mucosa in a nonspecific manner that is possibly related to the tumor promoting activity. PMID- 6500239 TI - Radiation-induced esophageal carcinoma. AB - Radiation-induced carcinoma of the esophagus is rare and only 8 cases have been reported since 1957. This article presents 2 additional patients in whom esophageal carcinoma developed in segments previously exposed to large therapeutic doses of irradiation. The first patient had received 5,000 rads to her mediastinum and the second patient 3,200 rads to her neck region. The latent intervals were 11 years and 30 years, respectively. PMID- 6500240 TI - Giant fibrovascular polyp of the esophagus. AB - Fibrovascular polyp (FVP) of the esophagus is a benign intraluminal tumor that consists primarily of loose connective tissue with numerous vessels and can attain vast dimensions. Symptoms are commonly dysphagia, vomiting, and weight loss. Small polyps can be removed endoscopically, but larger masses should be excised surgically because of the potential for hemorrhage. This case report illustrates the characteristic features of this unusual disease. PMID- 6500241 TI - Gastric involvement in abdominal wall hernias. AB - Six cases of abdominal wall hernias involving the stomach are reported. Three of the hernias were incisional, 2 were epigastric, and 1 was umbilical. All the patients were middle-aged or elderly women. In 2 cases, the gastric herniation produced gastric outlet obstruction with resulting severe dehydration and electrolyte disturbances. Radiographically, the abnormality involved deformity of the stomach with shortening in the frontal views. Lateral profile views were essential in demonstrating the cause of this deformity. In 5 cases, there was mesenteroaxial torsion of the herniated stomach so that the efferent limb of the hernia was superior to the afferent limb. Two of these were associated with obstruction which developed at the neck of the efferent limb. PMID- 6500243 TI - Gastrogastric intussuscepting leiomyomas. AB - Two cases of gastrogastric intussusception of leiomyomas are presented. Intussusception of a fundal mass into the gastric antrum can cause a confusing appearance on the double-contrast barium study. Intermittent intussusception was seen on fluoroscopy in 1 case. PMID- 6500242 TI - Suture line ulceration: a complication of gastric partitioning. AB - Gastric partition with formation of a proximal pouch by staples and reinforced sutures is a well-accepted operation for obesity. Experience at this institution has included 2 cases of ulcers occurring at the partition line, a complication not well-described previously. These ulcers were located on the lesser curvature, appeared benign, and were characterized by chronic, severe pain. A suture associated with the ulcer was demonstrated endoscopically in 1 patient, although it could not be removed perorally. PMID- 6500244 TI - Suprahepatic gallbladder: a rare congenital anomaly. AB - The authors report a case of suprahepatic gallbladder associated with hepatomegaly. The ectopic gallbladder was visualized by sonography, computed tomography, and endoscopic retrograde cholangiography. PMID- 6500245 TI - Flattened fundus sign of the septate gallbladder. AB - The fundus of a normal gallbladder is rounded. Any deviation from this configuration should prompt a search for the nonfilled segment of a septate gallbladder. Three illustrative cases are presented in which the initial observation of a flat fundus led to further evaluation and visualization of the remaining portion of a septate gallbladder. PMID- 6500246 TI - Small bowel length measured by radiography. AB - The jejunoileal length was measured on double-contrast small bowel enema radiographs, obtained from 10 patients who had been investigated for abdominal pain. Previous endoscopic and radiologic examinations had excluded lesions of the upper and lower GI tract. The length of the small bowel ranged from 230 to 370 cm, with an average length of 280 cm. PMID- 6500247 TI - Severe allergic reaction: an unusual complication of barium enema. AB - This article describes a severe allergic reaction to a barium sulfate compound used during double-contrast colon examination. This unusual complication is probably induced by chemical agents used as additives in the commercially available barium preparations. The pertinent literature is briefly reviewed. PMID- 6500248 TI - Colonic malacoplakia. AB - Malacoplakia is an uncommon, pathologically distinct, granulomatous disease most frequently found in the urinary tract. Malacoplakia of the colon may cause abdominal pain, diarrhea, rectal bleeding, and fever. Radiographic features are variable and include polyps, bulky masses, mucosal ulcerations, and fistulae. PMID- 6500249 TI - Brachycolon in the differential diagnosis of colitis. AB - The authors present an illustrative case of progressive and severe shortening of the colon complicating chronic ulcerative colitis. The term brachycolon is defined and proposed as a useful differential diagnostic sign of ulcerative colitis. PMID- 6500250 TI - Carcinoma of the hepatic flexure with proximal lymphatic invasion mimicking Crohn's disease. AB - A case of carcinoma of the hepatic flexure with ileocolic lymphangitic spread that simulates Crohn's disease is reported. Careful evaluation of the primary lesion should give the key to the diagnosis. PMID- 6500252 TI - Hippocampal slice (K+)e: depth profiles and changes induced by stimulation or anoxia. AB - In an attempt to develop a technique which would allow early assessment of the functional state of explanted brain tissue, (K+)e was measured in the CA1 region of rat hippocampal slices using K+-selective microelectrodes. In slices (450 micron) maintained at the boundary between the incubation medium and 95% O2/5% CO2 atmosphere, (K+)e was highest (up to 25-30 mmol/l) immediately below the exposed surface and gradually decreased with depth to (K+) of the bathing fluid (5 mmol/l). (K+)e below the exposed surface remained high throughout the 2 h of incubation. In submersed slices, (K+)e was the highest in the center of the slice (200 micron, 10 mmol/l) and decreased towards both surfaces. During 2 h incubation, (K+)e decreased in the center of the slice to 6 mmol/l in viable preparations remaining high in the deteriorating ones. Electrical stimulation of Schaffer's collaterals (15 V; 0.2 ms; 10 Hz) increased (K+)e of viable slices 200 micron below the surface by 2-3 mmol/l. Similar but slower (K+)e changes were elicited by brief (3 min) anoxic episodes (perfusion with incubation medium equilibrated with 95% N2/5% CO2). It is concluded that submersed slices have a more uniform (K+)e profile as compared to the exposed ones and that low (K+)e in the early phase of incubation is a good predictor of slice viability. PMID- 6500251 TI - Tuboovarian abscess simulating giant colonic diverticulum. AB - The plain abdominal film finding of a large air-filled cavity has a differential diagnosis that includes giant colonic diverticulum, volvulus, giant Meckel's or other small-bowel diverticulum, emphysematous cystitis, vesicoenteric fistula, bowel duplication, and mesenteric cyst. The case presented here expands this differential diagnosis to include tuboovarian abscess with fistulous communication to the bowel. PMID- 6500253 TI - Specific phosphorylation of nuclear non-histone proteins of rat liver after thyreoidectomy and T4 treatment. AB - The effect of thyroxine (T4) on phosphorylation of non-histone proteins in rat liver nuclei was studied. Non-histone proteins obtained by extracting liver nuclei with 0.4 mol X l-1 KCl from normal (N), hypothyroid (Tx) and Tx rats treated with T4 (100 micrograms kg-1 B.W.), respectively, were incubated with 32P ATP at 30 degrees C for 5 min followed by sodium dodecyl sulfate-gradient polyacrylamide gel electrophoresis and autoradiographic analysis. Endogenous phosphorylation in Tx rats was decreased. In T4 treated Tx rats phosphorylation of some proteins was recovered, however the 84 X 10(3) mol wt protein was not completely recovered. Phosphorylation of nuclear nonhistone proteins was not altered by the addition cAMP into the incubation. These findings show that in vitro phosphorylation of non-histone proteins of the rat liver nuclei occurs in some specific fractions which may be thyroid hormone dependent. PMID- 6500254 TI - On the interaction of histones with polyanions. AB - Histones precipitate from a solution of 0.14 mol/l NaCl with increasing concentrations of the polyanions polypentosesulphate; dextran sulphate; inorganic polyphosphate; heparin; or copolymer ethylene-maleic acid forming complexes from which histones cannot be extracted by 0.25 mol/l HCl. Affinities of the histone classes for polypentosesulphate appeared in the order from greatest to least: H4 approximately H3 greater than H2A greater than H2B greater than H1. At increased concentrations of most polyanions studied, the complexes of histones with polyanions remained partially soluble. Complexes of histones with all polyanions used were completely soluble in 2% SDS electrophoresis buffer, in 0.14 mol/l NaCl buffered at pH 12, and in 2 mol/l NaCl buffered at pH 7.2. Solubilisation of the complex polypentosesulphate-histone in 2 mol/l NaCl proved to be due to its dissociation. PMID- 6500255 TI - Topological properties of the molecular electrostatic potential as a tool for prediction of biological activity. AB - The paper is an attempt to reveal a relation between the structure and biological activity. Topological properties of molecular electrostatic potentials were investigated. These properties are represented by tree graphs. Based on known experimental data concerning biological activity of a series of various compounds, a relation between the biological activity and the characteristics of the tree graph was searched for. Such a relation might be used to predict biological activity of compounds other than investigated. Characteristic graphs are presented enabling prediction of activity of compounds. PMID- 6500256 TI - Caenorhabditis elegans deficiency mapping. AB - Six schemes were used to identify 80 independent recessive lethal deficiencies of linkage group (LG) II following X-ray treatment of the nematode Caenorhabditis elegans. Complementation tests between the deficiencies and ethyl methanesulfonate-induced recessive visible, lethal and sterile mutations and between different deficiencies were used to characterize the extents of the deficiencies. Deficiency endpoints thus helped to order 36 sites within a region representing about half of the loci on LG II and extending over about 5 map units. New mutations occurring in this region can be assigned to particular segments of the map by complementation tests against a small number of deficiencies; this facilitates the assignment of single-site mutations to particular genes, as we illustrate. Five sperm-defective and five oocyte defective LG II sterile mutants were identified and mapped. Certain deficiency-by deficiency complementation tests allowed us to suggest that the phenotypes of null mutations at two loci represented by visible alleles are wild type and that null mutations at a third locus confer a visible phenotype. A segment of LG II that is about 12 map units long and largely devoid of identified loci seems to be greatly favored for crossing over. PMID- 6500257 TI - Multiple-locus heterozygosity and the physiological energetics of growth in the coot clam, Mulinia lateralis, from a natural population. AB - The relationship between individual energy budgets and multiple-locus heterozygosity at six polymorphic enzyme loci was examined in Mulinia lateralis. Energy budgets were determined by measuring growth rates, rates of oxygen consumption, ammonia excretion and clearance rates. Enzyme genotypes were determined using starch gel electrophoresis. Growth rate and net growth efficiency (the ratio of energy available for growth to total energy absorbed) increased with individual heterozygosity. The positive relationship between observed growth and multiple-locus heterozygosity was associated with a negative relationship between routine metabolic costs and increasing heterozygosity. Reduction in routine metabolic costs explained 60% of the observed increased growth of more heterozygous individuals. When routine metabolic costs were standardized for differences in feeding rates, these standard metabolic costs explained 97% of the differences in growth rate. Lower standard metabolic costs, associated with increasing heterozygosity, have been proposed as a physiological mechanism for the relationship between multiple-locus heterozygosity and growth rate that has been reported for a variety of organisms, ranging in diversity from aspens to humans. This study demonstrates that reduction of standard metabolic costs, at least in clams, accounts for virtually all of the differences in growth rate among individuals of differing heterozygosity. PMID- 6500258 TI - Ethylnitrosourea mutagenesis and the isolation of mutant alleles for specific genes located in the T region of mouse chromosome 17. AB - Ethylnitrosourea mutagenesis of spermatogonia in male mice is very efficient and makes it practical to isolate new desired mutant alleles by subsequent progeny screening. This is demonstrated for three genes in the t region of chromosome 17. The first, a mutation designated t-int, interacts with the dominant mutation, T (Brachyury), to produce a tailless mouse. Previously, mutant alleles of the t-int gene were available only in t haplotypes, where they are part of a t chromatin block within which recombination with wild-type chromosomes is inhibited. In addition to t-int, new mutations at the quaking and tufted loci were obtained, as well as at several loci not on chromosome 17, e.g., an X-linked lethal that causes a mottled phenotype in the heterozygote and four new mutant W alleles on chromosome 5. In the experiment, an average of one fertilizing spermatozoan in 1500 was mutant at a given locus and an average of one male in five was able to sire mutants at that locus. PMID- 6500259 TI - Additive by additive variance with inbreeding and linkage. AB - Two-locus coancestries, which provide the coefficients of the additive by additive component in the variance and covariance of relatives for a quantitative trait, were formulated generally in terms of two-locus probabilities of identity by descent for combinations of parental and recombinant gametes. Explicit expressions, with linkage, were developed for all relatives of self fertilization, for selfed and outbred relatives and for full and half sibs from unrelated inbred parents. The relative effect of linkage on the two-locus coancestry decreases rapidly as inbreeding and relatedness of the relatives increase. It was concluded that the error caused by ignoring linkage would probably be small in the estimation of genetic variances or in the projection of selection response with self-fertilization. PMID- 6500260 TI - The cohesive population genetics of molecular drive. AB - The long-term population genetics of multigene families is influenced by several biased and unbiased mechanisms of nonreciprocal exchanges (gene conversion, unequal exchanges, transposition) between member genes, often distributed on several chromosomes. These mechanisms cause fluctuations in the copy number of variant genes in an individual and lead to a gradual replacement of an original family of n genes (A) in N number of individuals by a variant gene (a). The process for spreading a variant gene through a family and through a population is called molecular drive. Consideration of the known slow rates of nonreciprocal exchanges predicts that the population variance in the copy number of gene a per individual is small at any given generation during molecular drive. Genotypes at a given generation are expected only to range over a small section of all possible genotypes from one extreme (n number of A) to the other (n number of a). A theory is developed for estimating the size of the population variance by using the concept of identity coefficients. In particular, the variance in the course of spreading of a single mutant gene of a multigene family was investigated in detail, and the theory of identity coefficients at the state of steady decay of genetic variability proved to be useful. Monte Carlo simulations and numerical analysis based on realistic rates of exchange in families of known size reveal the correctness of the theoretical prediction and also assess the effect of bias in turnover. The population dynamics of molecular drive in gradually increasing the mean copy number of a variant gene without the generation of a large variance (population cohesion) is of significance regarding potential interactions between natural selection and molecular drive. PMID- 6500261 TI - Detection of nonrandom association of alleles from the distribution of the number of heterozygous loci in a sample. AB - The distribution of the number of heterozygous loci in two randomly chosen gametes or in a random diploid zygote provides information regarding the nonrandom association of alleles among different genetic loci. Two alternative statistics may be employed for detection of nonrandom association of genes of different loci when observations are made on these distributions: observed variance of the number of heterozygous loci (s2k) and a goodness-of-fit criterion (X2) to contrast the observed distribution with that expected under the hypothesis of random association of genes. It is shown, by simulation, that s2k is statistically more efficient than X2 to detect a given extent of nonrandom association. Asymptotic normality of s2k is justified, and X2 is shown to follow a chi-square (chi 2) distribution with partial loss of degrees of freedom arising because of estimation of parameters from the marginal gene frequency data. Whenever direct evaluations of linkage disequilibrium values are possible, tests based on maximum likelihood estimators of linkage disequilibria require a smaller sample size (number of zygotes or gametes) to detect a given level of nonrandom association in comparison with that required if such tests are conducted on the basis of s2k. Summarization of multilocus genotype (or haplotype) data, into the different number of heterozygous loci classes, thus, amounts to appreciable loss of information. PMID- 6500262 TI - The genetic analysis of quantitative trait differences between two homozygous lines. AB - Previous maximum likelihood methods to analyze quantitative data on two inbred parental strains, their F1 and backcross generations are extended in three directions: (1) a method is suggested to transform the data to better satisfy the assumptions of normality and homoscedasticity; (2) the likelihoods are modified to allow for litter correlations and heteroscedasticity and (3) allowance is made for the incorporation of F2 data. The problem of making a choice among a set of simple genetic hypotheses is further discussed. PMID- 6500263 TI - Population bottlenecks and nonequilibrium models in population genetics. I. Allele numbers when populations evolve from zero variability. AB - A simple numerical method was developed for the mean number and average age of alleles in a population that was initiated with no genetic variation following a sudden population expansion. The methods are used to examine the question of whether allele numbers are elevated compared with values seen in equilibrium populations having equivalent gene diversity. Excess allele numbers in expanding populations were found to be the rule. This was true whether the population began with zero variation or with low levels of variation in either of two initial distributions (initially an equilibrium allele frequency distribution or initially with loci occurring in only two classes of variation). Although the increase of alleles may persist for only a short time, when compared with the time which is required for approach to final equilibrium, the increase may be long when measured in absolute generation numbers. The pattern of increase in very rare alleles (those present only once in a sample) and the persistence of the original allele were also investigated. PMID- 6500264 TI - Alcohol and the elderly. PMID- 6500265 TI - Management of constipation in the elderly. AB - In the elderly, the history--including dietary habits, onset, duration, and change in bowel pattern--is very important. Recent changes could suggest bowel disease such as carcinoma or a disordered metabolism. If the defecation stimulus is repeatedly denied by voluntary contraction of the external anal sphincter, the normal defecation reflex may be blunted and, in time, completely lost. PMID- 6500267 TI - Some observations of a geropsychiatrist on the value of house calls. PMID- 6500266 TI - Arthritis self-management: a study of the effectiveness of patient education for the elderly. PMID- 6500268 TI - Reconstructing the social world at 60: older Cubans in the United States. PMID- 6500269 TI - Health service implications of folk healing among older Asian Americans and Hawaiians in Honolulu. PMID- 6500270 TI - Reciprocity as a coping strategy of the elderly: a rural Irish perspective. PMID- 6500272 TI - Job turnover and job satisfaction among nursing home aides. PMID- 6500271 TI - An exploration of stressful life events, illness, and coping among the rural elderly. PMID- 6500273 TI - The gerontology alcohol project: a behavioral treatment program for elderly alcohol abusers. PMID- 6500274 TI - The alcoholic elderly client: assessment of policies and practices of service providers. PMID- 6500275 TI - Continuity and change in the labor force activity of recently widowed women. PMID- 6500276 TI - Attitudes of health care providers toward elderly patients with normal aging and disease-related symptoms. PMID- 6500277 TI - Lifetime risk of nursing home residency. PMID- 6500278 TI - 37th annual scientific meeting of the Gerontological Society of America. November 16-20, 1984, San Antonio, Texas. Abstracts. PMID- 6500279 TI - [Uncomplicated pregnancy and paroxysmal nocturnal hemoglobinuria. Study of 4 patients]. PMID- 6500280 TI - [Systemic lupus erythematosus and pregnancy. Study of 44 patients]. PMID- 6500281 TI - [Ectopic pregnancy and hysterectomy]. PMID- 6500282 TI - [Conjugal sterility caused by severe infundibulo-ampullar lesion]. PMID- 6500283 TI - [Chlorpromazine in the emergency management of the acute arterial hypertension of pregnancy]. PMID- 6500284 TI - [Expert hygienic evaluation of plans and estimates and its role in preventive sanitary control]. PMID- 6500285 TI - [Evaluation of total vibration load and various medico-biological factors for predicting the time of onset of vibration disease in miners]. PMID- 6500286 TI - [Comparative evaluation of various methods of treating miners with vibration- and noise-induced diseases]. PMID- 6500287 TI - [Correction of microcirculatory disorders in vibration disease]. PMID- 6500288 TI - [Silver: various aspects of its toxicokinetics]. PMID- 6500289 TI - [Effect of refined copper and lead aerosols on immunological indicators in workers]. PMID- 6500290 TI - [Estimation of the levels of noise load in agricultural machine operators]. PMID- 6500291 TI - [Effect of vibration and noise on the functional state of an operator]. PMID- 6500292 TI - [Treatment of vibration disease in coal miners by hyperbaric oxygenation]. PMID- 6500293 TI - [Objective evaluation of neurocirculatory asthenia and psychoemotional disorders in patients with vibration disease]. PMID- 6500294 TI - [Use of enzymes for the correction of immunologic deficiency states in vibration disease]. PMID- 6500295 TI - [Evaluation of the effect of noise by the sound level]. PMID- 6500296 TI - [Effect of low-frequency acoustic fluctuations on various components of the erythrocyte membrane in vitro]. PMID- 6500297 TI - [Problem of dispensarization in occupational pathology]. PMID- 6500298 TI - [Determination of the maximum permissible exposure level of dust from carbon fibrous materials in the air of a work area]. PMID- 6500299 TI - [Improving working conditions of women engaged in hosiery production]. PMID- 6500300 TI - [Toxicology of trimethylbenzoles]. PMID- 6500301 TI - [An electroconductometric gas analyzer]. PMID- 6500302 TI - [Hygienic standardization of vibration]. PMID- 6500303 TI - [Current problems in the industrial hygiene of women in light of the realization of the Food Program of the USSR]. PMID- 6500304 TI - [Prospects for the hygienic improvement of tractors and self-propelled agricultural machinery]. PMID- 6500305 TI - [Nonspecific esterase activity in the blood lymphocytes of persons in contact with benzene vapors and its homologs]. PMID- 6500306 TI - [14C-trinitrotoluene kinetics in rats in various routes of uptake]. PMID- 6500307 TI - [The status and dynamics of occupational morbidity in agriculture in the Ukrainian SSR in the last 20 years]. PMID- 6500308 TI - [Dispensary care for female workers in a rural locality]. PMID- 6500309 TI - [Characteristics of the effect of dusts from mixed feeds of various compositions on the body]. PMID- 6500310 TI - [Experimental establishment of the maximum permissible concentration of 3,4 dichlorobutene-1 in the air of a work area]. PMID- 6500311 TI - [Experimental establishment of the maximum permissible concentration of para nitrobenzoylchloride in the air of a work area]. PMID- 6500312 TI - [Industrial hygiene problems in the manufacture of coating sheets from the wastes of picture tube production]. PMID- 6500313 TI - [Determination of gamma-butyrolactone in the air]. PMID- 6500314 TI - [Co-teratogenic effect of microwave radiation]. PMID- 6500315 TI - [Properdin levels in the amniotic fluid, maternal venous and umbilical cord blood serum in complicated pregnancy]. PMID- 6500316 TI - [Lysosomal protease activity and protein degradation in the amniotic fluid]. PMID- 6500317 TI - [Fetal echocardiography. 5. Quantitative evaluation of selected hemodynamic indicators in fetuses with asymmetrical intrauterine growth retardation]. PMID- 6500318 TI - [Changes in serum ferritin levels in normal pregnancy]. PMID- 6500319 TI - [Possibility of using surgical conization in the treatment of early invasive cervical cancer]. PMID- 6500320 TI - [Colposcopic evaluation of the state of the cervix uteri after amputation of the uterine body]. PMID- 6500321 TI - [Incidence of malignant genital and breast neoplasms in Cracow 1976-1979. II. Diagnostic principles and therapeutic methods]. PMID- 6500322 TI - [Physiopathological basis of disorders of homeostasis in parturients in relation to the degree of their physical capacity and development of fetal risk conditions]. PMID- 6500323 TI - [Coexistence of a giant ovarian tumor and full-term pregnancy]. PMID- 6500324 TI - [N-acetyltransferase activity in human placentas from different stages of pregnancy]. PMID- 6500325 TI - [Effect of electromagnetic radiation in the fetal period on the survival of mouse offspring after experimental viral and bacterial infection or exposure to X rays]. PMID- 6500326 TI - [Colposcopy in inflammatory changes of the cervix uteri]. PMID- 6500327 TI - [Cryotherapy of cervical lesions]. PMID- 6500328 TI - [Indications for bromocriptine treatment of various forms of infertility in women and men]. PMID- 6500330 TI - [Free fatty acid levels of the blood of parturients as an indicator of energy metabolism in physiological labor]. PMID- 6500329 TI - [Value of the colposcopic diagnosis of decidual ectopy in early pregnancy]. PMID- 6500331 TI - Relative growth between femur and tibia in the German cockroach, Blattella germanica. AB - Femur and tibia length of fore, mid, and hindleg, and head width were measured throughout larval stages up to the adult in both sexes. All the leg segments showed positive allometric growth against head width. Postero-anterior and disto proximal growth gradients along the body and leg axes were detected. Total length of femur and tibia of foreleg in a particular instar was nearly equal to that of midleg in the preceding instar, and to that of hindleg in the instar before the preceding instar. Ratio of tibia length to femur length was high in hindleg, intermediate in midleg, and low in foreleg. The ratio increased as the stage advanced in mid and hindleg. Correlation coefficients between any two of the 12 leg segments, femur and tibia of both sides of the body, were calculated in every instar up to the adult stage. In all the three kinds of legs, the values between femur and femur, and tibia and tibia, of opposite side of the body were higher than those between femur and tibia of the same leg. It was also revealed that foreleg correlated more closely to midleg than to hindleg, and midleg, more closely to hindleg than to foreleg. PMID- 6500332 TI - Effect of age on the accumulation of lung protein following unilateral pneumonectomy in rats. AB - The effects of unilateral pneumonectomy (PNX) on the net synthesis of right lung protein were investigated in vivo using three groups of rats with body weights (BW) ranging from 85 to 330 g. These data were compared to those from sham operated and normal growing control animals. After PNX, both the 2-day lag prior to the compensatory increase in right lung mass (LW) and the subsequent rate of increase in LW and LW/BW ratio were independent of two-fold differences in the basal rate of lung growth. In all PNX groups, both right LW and LW/BW reached control values for both lungs, but in the older rats the time required for complete compensation was extended from 5 days to 12 days. The rate of net accumulation of right lung protein increased two-fold in the youngest PNX rats and 6 to 8-fold in the older animals, but when these changes were normalized to the protein content of the remaining tissue, the older rats appeared to respond to PNX less efficiently. Increased tissue levels of RNA and the resulting increased capacity of the lungs for protein synthesis could account for the accelerated rate of gain in right lung protein following PNX in both adult and young animals. PMID- 6500333 TI - Quantitative genetics and the evolution of ontogeny. II. Genetic and environmental correlations among age-specific characters in randombred house mice. AB - In this study, phenotypic, genetic, maternal and residual environmental correlations among all pairs of six ages (17, 24, 31, 38, 45 and 52 days) were calculated for each of five morphometric characters (body weight, head length, trunk length, trunk circumference, and tail length) in ICR randombred house mice. The maternal correlations between ages averaged nearly unity for all characters, and the overall level (and integration, I) of the genetic correlations (mean level = 0.82, mean I = 0.85) was greater than that for the residual environmental correlations (mean level = 0.26, mean I = 0.32). The patterns of the phenotypic and genetic correlations were similar, with the highest correlations being between contiguous ages and a relatively smooth decrease in correlations for increasingly distant ages. Nearly all of the genetic covariation among ages was explained by the first (average = 86%) and second (average = 14%) components derived from principal components analysis of the genetic correlations. Genes with basically equal pleiotropic effects presumably generated the first component, genes with different effects among ages the second component. From the patterns of genetic correlations, it is predicted that direct selection on any given age would result in a moderate, positive response at most other ages, with more change in the height relative to the shape of the growth curve for each characteristic. PMID- 6500334 TI - Influence of fasting and refeeding high forage and all-concentrate diets on beef heifers. AB - An 88% forage diet (F) and a corn-based all-concentrate diet (C) were fed to compare the influence of prior diet and rumen microbial inoculation on dietary intake and ruminal fermentation of heifers allowed to consume their diet ad libitum after a 4-d fast. Twelve ruminal-fistulated Angus heifers averaging 265 kg body weight were fed F ad libitum for 28 d, fasted for 4 d and refed F ad libitum for 21 d (period 1). After 21 d of refeeding, the heifers were fasted for 4 d and then fed C ad libitum for 60 d (period 2). After 60 d, the heifers were fasted for 4 d and refed C ad libitum for 35 d (period 3). The rumens of six heifers were inoculated (1) at the end of each fast with 2 l of ruminal fluid from two ruminal fistulated donor steers fed the corresponding postfast diet ad libitum. Six heifers were uninoculated (UI). The most severe digestive disturbance associated with any of the treatments was reduced feed intake. During the first week of refeeding the I heifers consumed more feed than UI heifers. Regardless of treatment 2 wk or more were required for heifers to return to before fast intake levels. If ruminal glucose accumulated to 10 mg/100 ml in the rumen for more than 7 h, then ruminal lactate accumulated to higher concentrations and for longer periods of time. Ruminal lactic acid accumulation is considered to be one of the main causes for reduced feed intake. When heifers were switched from F to C, they did not overeat to the point of causing complete feed refusals on subsequent days. However, even at low intakes, a reduction in feed intake occurred. PMID- 6500335 TI - Reference curves for biceps, triceps, subscapular and suprailiac skinfolds in Dutch children from 7-14 years. AB - Box-Cox transformation of skinfold measurement data from the Nymegen Growth Study produced reference curves for biceps, triceps, subscapular and suprailiac skinfolds and their sums with an acceptable Gaussian distribution at all ages. The population sample, resulting in 1850 skinfold measurements for boys and 2250 for girls by a single observer, was obtained by random selection and can be considered as representative for The Netherlands. The Gaussian distribution after Box-Cox transformation allows the use of standard deviation scores. Seven percentile curves are presented for boys and girls of 7-14 years of age. PMID- 6500336 TI - The nerve endings of the glycogen body of embryonic and adult avian spinal cord: on the existence of two different varieties of nerve fibers. AB - The innervation of the enigmatic glycogen body in both embryonic and adult spinal cords in Gallus domesticus was investigated using frozen sections stained with the Del Rio Hortega silver method and the procedure of Cajal. Two distinct types of neural terminals were found, one appearing to be sensory associated with neurovascular glomi and the other related to the periependimary glycogen cells. The presence of nests of argentaphin cells indicates the probability of a neurosecretory function. PMID- 6500337 TI - [Coronary-left ventricular fistulas in heart aneurysms]. PMID- 6500338 TI - [The surgical treatment of supravalvular aortic stenosis]. PMID- 6500339 TI - [Selection of patients with vasospastic angina pectoris for surgical treatment]. PMID- 6500340 TI - [Clinical and hemodynamic evaluation of phonocardiographic data after mitral valve bioprosthesis]. PMID- 6500341 TI - [Morphological evaluation of late results of closure of the lumen of subclavian pulmonary anastomoses with a porolone plug in tetralogy of Fallot]. PMID- 6500342 TI - [Variants of pulmonary sequestration in developmental defects]. PMID- 6500343 TI - [Diagnosis of agenesis and aplasia of the lung]. PMID- 6500344 TI - [Diagnosis and treatment of small peripheral chondromatous hamartomas of the lungs]. PMID- 6500345 TI - [State of the cardiovascular system in patients before and after transpericardial operations on the bronchi]. PMID- 6500346 TI - [Segmental lung resection in disseminated destructive forms of tuberculosis]. PMID- 6500347 TI - [Massive blood loss in intrathoracic operations]. PMID- 6500348 TI - [Special instrumental methods of conservative treatment of pleural empyema]. PMID- 6500349 TI - [Zonal rheography in the complex evaluation of pulmonary function before surgery]. PMID- 6500351 TI - [Surgical treatment of true cysts of the thymus gland]. PMID- 6500350 TI - [Use of a hemostatic preparation amifer in operations on the lungs]. PMID- 6500352 TI - [A method of cross bronchospirography]. PMID- 6500353 TI - [Non-clostridial anaerobic infection in patients with lung abscesses]. PMID- 6500354 TI - [Left-ventricular aneurysm in a child]. PMID- 6500356 TI - [Circular resection of the trachea in Boeck's sarcoidosis]. PMID- 6500355 TI - [Case of successful replacement of an earlier implanted xenoaortic prosthesis in Ebstein's anomaly]. PMID- 6500357 TI - [Rupture of the left main bronchus at the level of lobar bronchi]. PMID- 6500358 TI - [Annuloplasty of the left atrioventricular orifice with a knitted supporting ring in rheumatic mitral valve insufficiency]. PMID- 6500359 TI - [Transpericardial occlusion of the left main bronchial stump 19 years after pneumonectomy]. PMID- 6500360 TI - Second European symposium on gastrointestinal motility. Oxford, 5-7 September 1984. Abstracts. PMID- 6500361 TI - Surface morphology of the gastroduodenal mucosa in duodenal ulceration. AB - Endoscopic biopsies from the duodenal cap and prepyloric areas of 25 patients have been examined with the scanning electron microscope. Eleven patients had duodenal ulceration. Bacteria are related only to the surface of gastric type epithelial cells whether these cells are located at areas of gastric metaplasia in the duodenal bulb or in the pre-pyloric region of the stomach. The bacteria are not associated with the surface of intestinal type epithelial cells. The bacteria are absent from the biopsies of those patients with a normal stomach and duodenum. Of those patients with duodenal ulceration, 73% have bacteria related to the epithelial surface. The bacteria are of two morphological types - a kidney shaped bacillus and an S-shaped bacillus. PMID- 6500362 TI - Action of FPL 52694 on gastric acid secretion in the healthy human stomach. AB - In a double blind crossover experiment in 16 healthy male volunteers, the effects of oral FPL 52694 and a matching placebo upon pentagastrin stimulated gastric acid secretion, gastric mucosal histamine content, and gastric mucosal mast cell count were compared. There was a significant increase in acid secretion, and a fall in tissue histamine and the mast cell count after treatment with the placebo. All these changes were inhibited by FPL 52694, and there was a significant difference between the effects of this compound and the placebo in all three parameters. It is concluded that FPL 52694 caused significant inhibition of acid secretion, and that the likely mechanism of action is by stabilisation of mast cells and inhibition of histamine release. PMID- 6500363 TI - Endoscopic pancreatic and biliary manometry in pancreatic, biliary, and papillary disease, and after endoscopic sphincterotomy and surgical sphincteroplasty. AB - Endoscopic manometry was used to measure pancreatic duct, common bile duct, pancreatic duct sphincter and bile duct sphincter pressures in 43 healthy volunteers and 162 patients with a variety of papillary, pancreatic and biliary disorders. Common bile duct pressure was significantly raised after cholecystectomy, with common bile duct stones and papillary stenosis but pancreatic duct pressure only in papillary stenosis. After endoscopic sphincterotomy mean common bile duct pressure fell from 11.2 to 1.1 mmHg and pancreatic duct pressure from 18.0 to 11.2 mmHg. Distinct pancreatic duct sphincter and bile duct sphincter zones were identified as phasic pressures of 3 12 waves/minute on pull-through from pancreatic duct and common bile duct to duodenum. Pancreatic duct sphincter pressures were higher with common bile duct stones and stenosis whereas bile duct sphincter pressures were higher in pancreatitis and stenosis. Bile duct sphincter activity was present in 60% of patients after surgical sphincteroplasty but 21% of patients after endoscopic sphincterotomy. Endoscopic manometry facilitated the diagnosis of papillary stenosis, has allowed study of papillary pathophysiology and has shown a functional inter-relationship between the two sphincteric zones. PMID- 6500364 TI - Clustering of adenomas in the large intestine. AB - In a necropsy study of 68 men and 36 women with single or multiple adenomas of the large intestine the distribution of all adenomas within the bowel in individual patients was examined. Each adenoma was recorded both by its distance in centimetres from the caecal pole and by the intestinal segment in which it was found. Adenomas in individual patients were shown to occur significantly closer together than expected from the general distribution of adenomas within each age group. The statistically significant, but not very strong effect of clustering may be caused by the existence of one or more fields of the large intestine specific to individuals who have a higher than average propensity for neoplastic development. PMID- 6500365 TI - Intracellular electrical activity in circular muscle of canine colon. AB - In vivo and extracellular in vitro studies of colon muscle have led to a great deal of disagreement on the characteristics of slow wave activity. As intracellular recordings of electrical activity in single cells give clear records which are easier to analyse, we used this method to study the slow wave activity of the circular muscle of three different parts of the canine colon. Mucosa was removed from segments of proximal, mid and distal canine colon and specimens from each segment were mounted in an organ bath perfused with oxygenated Krebs' solution. Membrane potential, amplitude and frequency of slow waves were measured using intracellular electrodes. Slow wave activity was present at a single, continuous frequency of 4-6 cpm in the circular muscle at all the sites studied in canine colon. There was no significant frequency gradient along the colon: the membrane potential and amplitude of slow waves did not differ significantly in the three parts of the colon. PMID- 6500366 TI - Contribution of low level HBV replication to continuing inflammatory activity in patients with anti-HBe positive chronic hepatitis B virus infection. AB - The relationship between the histological diagnosis and serological and tissue markers of HBV replication in 41 Greek and 29 British patients with chronic HBV infection were studied. All the nine Greek and 13 British patients who were HBeAg positive had HBV-DNA in serum and HBcAg expression in the hepatocytes. The majority (73%) of these patients had active liver disease. Forty seven per cent of the Greek and 19% of the British patients who were anti-HBe positive continued to display HBcAg in the liver with or without HBV-DNA detected in serum. All but three of these patients had persistently active liver disease. Continuing inflammatory activity in the liver, however, was also found in 31% of anti-HBe positive patients who had no evidence of HBV replication. In these patients, other factors such as delta agent, NANB viruses, alcohol abuse or an autoimmune reaction initiated by HBV may be contributory. PMID- 6500368 TI - Severe intestinal involvement in Wegener's granulomatosis. AB - A case of Wegener's granulomatosis is described, in which the presentation was blood stained mucus diarrhoea. Severe ileal, caecal, and rectal involvement improved rapidly after treatment with cyclophosphamide, azathioprine, and prednisolone. Although intestinal disease is an uncommon feature of Wegener's granulomatosis, both in our own experience (four of 45 cases) and in the literature, this diagnosis should be considered in view of the response to appropriate therapy. PMID- 6500369 TI - Weight loss caused by a thalamic astrocytoma. AB - We describe a case presenting as weight loss without neurological signs, caused by a thalamic astrocytoma. PMID- 6500367 TI - Delta agent infection in acute hepatitis and chronic HBsAg carriers with and without liver disease. AB - Hepatitis B virus (HBV) is a major cause of chronic liver disease in southern Italy. In the same area superinfection with the delta agent is endemic. To assess the prevalence of delta infection in a large population of patients with acute and chronic HBV related liver disease and to look for differential features among delta infected and uninfected subjects sera from 592 consecutive HBsAg positive patients were tested for the delta/anti-delta system by RIA. In no case was delta Ag found in serum. The prevalence of anti-delta was low in acute hepatitis (6.6%) and in asymptomatic carriers (6.4%) but raised in chronic active hepatitis with or without cirrhosis (52.3%). A decrease in frequency of anti-delta was seen in inactive cirrhosis (38.8%) and in hepatocellular carcinoma (11.9%). A younger mean age of delta-infected subjects was observed in each type of chronic liver disease. Our data confirm that delta agent superinfection is definitely associated with severe chronic active liver disease. The difference in age between anti-delta positive and negative patients suggests that delta infection accelerates the natural history of HBV related liver disease. PMID- 6500370 TI - Long term prognosis of Crohn's disease with onset in childhood and adolescence. PMID- 6500371 TI - Presidential address: 15th annual meeting, Society of Gynecologic Oncologist (1984). The gynecologic oncologist: issues of the eighties. PMID- 6500372 TI - The prognostic significance of carcinoembryonic antigen determinations in patients with adenocarcinoma of the cervix. AB - Pretreatment levels of carcinoembryonic antigen (CEA) correlate well with the extent of disease in squamous cell and adenocarcinoma of the cervix. These two tumor types, however, have significantly different capacities for CEA release. The prognostic significance of pretreatment CEA determinations in squamous cell cancers is restricted to a subpopulation of these tumors and low values are equivocal. The present paper reports a long-term follow-up of 54 patients with adenocarcinoma of the cervix, all stages. It was found that no patient, regardless of stage, with an initial value over 15 micrograms/liter survived the disease. In the range between 5 and 15 micrograms/liter the recurrence rate was 67%. Patients with initial values under 5.0 micrograms/liter had an estimated 5 year survival of 90% in contrast to 11% if pretreatment values were over this limit. In Stage I, only 1 out of 8 patients with pelvic lymph node metastasis had a pretreatment value under 5.0 micrograms/liter. CEA determinations are of definite value in the planning of treatment and follow-up of patients with adenocarcinoma of the cervix. PMID- 6500374 TI - Survival and recurrence patterns in the radiation treatment of carcinoma of the vagina. AB - Fifty-three patients with invasive cancer of the vagina were treated with a curative course of radiation at Tufts New England Medical Center between September 1958 and December 1979. There were 37 patients with "primary" carcinoma of the vagina and 16 with metastatic disease to this site. The treatment comprised an integration of teletherapy and intracavitary/interstitial therapy. The 5-year relapse-free survival for primary vaginal carcinoma was 88% for Stage I, 44% for Stage II, 35% for Stage III, and 0% for Stage IV. Patients with metastatic disease had an overall 5-year survival of 63%. There was local recurrence in 35% of the patients with primary and 19% with metastatic vaginal carcinomas. The incidence of local recurrence appeared to be increased with higher grade pathology, lesions other than vault carcinomas, and lesions involving the entire length of the vagina. Due to immediacy of adjacent structures in the high dose volume, complications excluding those patients with persistent recurrent disease were somewhat high (11%). PMID- 6500373 TI - Malignant epithelial tumors of the ovary in childhood: a clinicopathological study of 13 cases in Great Britain 1962-1978. AB - The clinicopathological features of 13 childhood epithelial malignancies of the ovary occurring in Great Britain in the 17-year period 1962-1978 are presented. The majority (10 cases or 77%) were mucinous neoplasms; tumors of borderline malignancy constituted 45% of the total number. These results differ substantially from incidence rates encountered in ovarian neoplasia in adults and suggest that some childhood mucinous neoplasms may be monophyletic teratomas. PMID- 6500375 TI - Synchronous carcinomas of the uterine corpus and ovary. AB - The coexistence of carcinoma in the endometrium and ovary is a relatively uncommon but not rare occurrence. In general it has not been possible to determine which, if any, of these tumors represent metastases from endometrium or ovary or separate primary neoplasms, and gynecologists are unable to agree upon appropriate therapy. Twenty-four women with synchronous carcinomas of the ovary and endometrium in whom disease was confined to the pelvis, diagnosed at the Milton S. Hershey Medical Center between 1970 and 1982, were identified. Thirteen women had typical endometrial adenocarcinoma and endometrioid carcinoma of the ovary (Group A), two had unusual variants of endometrial carcinoma and a similar appearing tumor in the ovary (Group B), and nine had typical endometrial adenocarcinoma with carcinomas in the ovary of differing histologic appearance (Group C). There was no significant difference in survival between women in Groups A and C (77 and 56%, respectively, mean follow-up approximately 40 months). However, deep myometrial invasion (outer third) provided a statistically significant indicator of poor prognosis (77% with deep invasion vs 17% with superficial invasion recurred or died of disease P less than 0.05, chi 2 test). PMID- 6500376 TI - The subrenal capsule tumor implant assay as a predictor of clinical response to chemotherapy: 3 years of experience. AB - The clinical response to chemotherapy of a series of female patients with advanced pelvic malignancies was compared to the response of their tumors to the same agents in the murine subrenal capsule implant assay. A total of 194 different patients were studied in 242 different assays; 89.3% of the assays were evaluable. There were 83 prospective assays (assays performed before the patient received the chemotherapy) of 66 different patients for which clinical correlations were available. In these assays the sensitivity (frequency of positive test results in responding patients) was 85.0%, the specificity (frequency of negative test results in nonresponding patients) was 57.1%, and the efficiency (percentage correctly classified) was 63.9%. There were 100 retrospective assays (assays performed after the patient had been treated with the chemotherapy) of 69 different patients for which clinical correlations were available. In these assays the sensitivity was 66.7%, the specificity 70.7%, and the efficiency 70.0%. Thirty-one of the patients had both prospective and retrospective assays. There were 59 patients for whom the clinical response to chemotherapy could not be determined. It is believed that the clinical utility of the SRC assay has been validated by the good prospective sensitivity of the assay. PMID- 6500377 TI - Estrogen-producing Sertoli cell tumor of the ovary--a case report. AB - Estrogen-secreting Sertoli cell tumor of the ovary is rare. The few cases reported were characterized by metrorrhagia suggesting the hyperestrogenic state. An additional case of Sertoli cell tumor is reported in which the clinical picture is of secondary amenorrhea followed by metrorrhagia. The endocrinological status was investigated by hormonal assays showing a high level of estradiol, which was consistent with endometrial biopsy. A review of the literature together with a discussion on the histogenesis and diagnosis of the tumor is presented. PMID- 6500378 TI - Carcinoma of the uterine cervix and schistosomiasis in West Africa. AB - Schistosomiasis of the uterine cervix is the most common form of genital schistosomiasis, and is most frequently associated with Schistosoma haematobium infection. Cervical schistosomiasis assumes medical importance because clinically it may be mistaken for cervical malignancy. Additionally, it has been proposed that cervical schistosomiasis may lead to the development of cervical carcinoma. In this regard, a patient having squamous cell carcinoma of the cervix in association with cervical schistosomiasis is described, and the recent literature discussing this relationship is reviewed. PMID- 6500379 TI - A patient with situs inversus totalis and embryonal carcinoma of the ovary. PMID- 6500380 TI - Evaluation of an automated prothrombin assay using a chromogenic substrate. AB - The performance of a commercially available assay for the determination of prothrombin by a chromogenic substrate method has been evaluated for use on an automated clinical analyser. The method was rapid and simple; accuracy, precision and sensitivity were satisfactory, while carry-over was negligible. Determinations were performed on 170 plasma samples from patients on long-term oral anticoagulant therapy, using the automated amidolytic method; comparison of the prothrombin levels with results obtained by the prothrombin time and Thrombotest methods provided highly significant correlations. PMID- 6500381 TI - Influence of sex, blood group, secretor character, smoking habits, acetylsalicylic acid, oral contraceptives, fasting and general health state on blood coagulation variables in randomly selected young adults. AB - Blood samples were drawn from 129 randomly selected young adults. Intake of acetylsalicylic acid (ASA), contraceptive drugs, smoking habits and health state were registered. Males had significantly higher systolic blood pressure, shorter bleeding time and lower VIII:C. Smoking was only correlated to some variables assessed in the female group. Users of oral contraceptives smoked more, had a shorter bleeding time and higher fibrinogen levels. Factor VIIIR;Ag was elevated only in female smokers with blood group non-O. Non-secretors had shorter bleeding times and a tendency towards higher VIIIR:Ag. PMID- 6500382 TI - Low molecular weight (LMW) heparin derivatives in experimental extra-corporeal circulation (ECC). AB - Low molecular weight (LMW) heparin has been shown to prevent experimental venous thrombosis. In order to investigate its biological action and its potential use in open heart surgery, we have conducted an experimental study using extracorporeal circulation (ECC) in sheep as an experimental model. 18 sheep were randomly selected to receive either LMW heparin (2 mg/kg), high dose heparin (HD; 160 U/kg), or low dose heparin (LD; 60 U/kg). The HD heparin yielded the same circulating anti-activated factor X (anti-Xa) activities as the LMW heparin and the LD heparin yielded the same anti-thrombin activity. LMW heparin and HD heparin were both effective in preventing blood clotting in the ECC circuit, demonstrating the antithrombotic activity of the LMW heparin. Clotting in the circuit was observed following LD heparin administration showing that the efficacy of LMW heparin does not only rely upon its weak anti-activated partial thromboplastin time (APTT) and anti-thrombin activity. Fibrinogen, fibrinogen degradation products (FDP), factor V (FV), platelet count, antithrombin III (AT III), fast acting antiplasmin (AP) were evaluated during and after ECC. The defects in hemostasis were similar in the three groups. Conclusions were: (1) heparin chain depolymerization diminishes the anti-APTT activity without altering the anti-thrombotic property; (2) LMW heparin is an effective alternative to heparin in cardiac surgery; (3) the absence of postoperative circulating anti APTT activity might be associated with a reduced incidence of hemorrhagic complication, but we were not able to demonstrate it. PMID- 6500383 TI - A simple quantitative estimate of the function of radiolabelled platelets. AB - The function ex vivo of autologous platelets, labelled with 111In, was evaluated at various times following injection by comparing the retention on foreign surfaces of radioactivity with the retention of total platelets (represented almost entirely by unlabelled and therefore unmanipulated platelets) after the application of fresh un-anticoagulated whole blood to (a) filter paper and (b) glass bead columns. Relative retentions were similar for the two materials, with labelled platelet retention being about 80% that of native platelet retention. Prior to injection, when labelled platelets were returned to an excess of freshly drawn whole blood, retention of radioactivity was greater than that of native platelets with a ratio significantly greater than that seen with labelled platelets tested ex vivo. Filter paper retention provides a simple technique which may be useful for the evaluation of labelled platelet function as a function of platelet age and also, with further standardisation, as an inexpensive rapid test of unlabelled platelet function. PMID- 6500384 TI - The effects of high doses of aspirin and related benzoic acid derivatives on arterial thrombosis in male rats. AB - The antithrombotic effects of four compounds structurally related to aspirin (acetylsalicylic acid, ASA) were examined in a rat model of arterial thrombosis and compared to ASA. ASA had antithrombotic activity, but only at high doses (200 mg/kg), when carotid artery thrombosis was induced 15 min after intravenous drug administration. Lower doses were associated with augmented thrombus formation in some animals. 2-Propionyloxybenzoic acid, which has in vitro activities similar to ASA, caused similar in vivo effects, but was antithrombotic at 100 mg/kg. 3 Propionyloxybenzoic acid, which augments platelet function in vitro, and 3 methylphthalide, which inhibits biphasic adenosine diphosphate-induced platelet aggregation, had no statistically significant effects. 2-Acetoxybenzoic acid, which is a weak platelet aggregation and prostaglandin biosynthesis inhibitor, had antithrombotic activity at 100 and 200 mg/kg and was not associated with augmented thrombosis at lower doses as found with ASA. The pattern of antithrombotic activity of this series of compounds does not reflect in vitro effects on prostaglandin biosynthesis and indicates alternative mechanisms of antithrombotic activity. PMID- 6500385 TI - Molecular exchange between blood and in vitro thrombi. AB - Uptake of radioiodinated Lys-plasminogen (125I-PLG), albumin (125I-ALB), and tritiated water (3H-H2O) by in vitro thrombi and interchange of these molecules with blood in an in vitro perfusion system were investigated. The radioisotopes were taken up by thrombi either by incorporation during formation in radiolabelled blood or by perfusion of preformed nonradioactive thrombi in radiolabelled blood. Release of the radioisotopes into a perfusion medium of nonradiolabelled blood was then monitored over a 120-min period. The small molecules of 3H-H2O were rapidly released from the thrombi and achieved equilibrium with the perfusion medium by 120 min in that the specific radioactivity (cpm/mg) of the thrombi equalled that of the medium. The larger molecules of 125I-PLG and 125I-ALB were more slowly released and did not reach equilibrium with the perfusion medium over the period studied. Release of 125I ALB was intermediate between that of 3H-H2O and 125I-PLG. The greater retention of 125I-PLG by the thrombi was consistent with the high binding affinity of plasminogen for fibrin. The demonstrated movement of these radioisotopes between medium and thrombus suggests that thrombi exist in blood in a dynamic state of flux, exhibiting a fluid exchange of molecules between the interstitial compartment of the thrombus and blood. PMID- 6500386 TI - [Electroencephalographic picture in children with reading and writing disabilities in the light of the Bender-Koppitz test and anamnestic data]. PMID- 6500387 TI - [Various anatomopathological aspects of post-traumatic and postoperative bone infections]. PMID- 6500388 TI - [Intraoperative bone infections: the most common clinical forms]. PMID- 6500389 TI - [Combined antibacterial, anticoagulative and fibrinolytic treatment of patients with bacterial osteomyelitis]. PMID- 6500390 TI - [Our experience with the treatment of chronic osteomyelitis using gentamicin beads "Septopal"]. PMID- 6500391 TI - [Analysis of infectious complications after bone surgery]. PMID- 6500392 TI - [Wound infection in orthopedic surgery]. PMID- 6500393 TI - [Analysis of intraoperative infection risk factors in orthopedic surgery]. PMID- 6500394 TI - [Our experience with the treatment of bacterial infections of long bone shafts]. PMID- 6500395 TI - [Treatment of bacterial infection of bone tissue]. PMID- 6500396 TI - [Bone felon as a complication of suppurative inflammation of the soft tissue of the fingers]. PMID- 6500397 TI - [Nonspecific inflammation in the locomotor system]. PMID- 6500398 TI - [Reaction of mesenteric microcirculation during functional hyperemia of the intestine]. PMID- 6500400 TI - [Psychological characteristics of women with postpartum hypothalamic disorder]. PMID- 6500399 TI - [Morphological studies of the oral cavity of rats after the administration of selenium]. PMID- 6500401 TI - [Effect of physical exertion on heart muscle metabolism in disorders of thyroid function]. PMID- 6500402 TI - [Study on the neuro-behavioral development in rats treated neonatally with drugs acting on the autonomic nervous system]. AB - The drugs used were pargyrine, methamphetamine, reserpine, norepinephrine, epinephrine, propranolol, chlorpromazine, 6-hydroxydopamine, haloperidol, pilocarpine, neostigmine and atropine. The body The weight gain of pups receiving reserpine, chlorpromazine, 6-hydroxydopamine and pilocarpine was significantly inhibited. The mortality of pups given reserpine was significantly increased. The behavioral development of righting reflex, cliff drop avoidance and negative geotaxis of rats given reserpine, propranolol, 6-hydroxydopamine and haloperidol was significantly retarded in comparison with that of control pups. Spontaneous motor activity measured by Animex was increased in pups receiving norepinephrine, epinephrine, chlorpromazine, reserpine, propranolol and atropine. Furthermore, pharmacological challenge by the injection of methamphetamine exhibited an accentuated response to an increase in spontaneous motor activity in pups exposed to chlorpromazine, reserpine, propranolol, 6-hydroxydopamine and atropine. These findings suggest that an increase in spontaneous motor activity may be induced by the developmental impairment of central catecholamine mechanisms, especially the noradrenaline nervous system. Delayed latency, decreased rearing and preening of pups receiving propranolol were observed on the open field test. The conditioned avoidance responses using the shuttle box revealed deficits in acquisition of avoidance learning of rats given haloperidol, 6-hydroxydopamine and propranolol, suggesting that the learning deficits may be due to the developmental impairment of catecholamine mechanisms, especially the dopamine nervous system. PMID- 6500403 TI - [Role of taurine in neutrophil function]. AB - The influence of taurine on neutrophil phagocytic and bactericidal capacities and lysosomal enzyme-releasing ability was evaluated in the present study using neutrophils obtained from casein-elicited rat peritoneal exudates. Taurine was dissolved in drinking water at a concentration of 0.3%, and the solution was given to rats for 1-21 days (460 mg/kg/day). Taurine concentration in the serum increased with the term of its administration, while in the neutrophils, it increased significantly after administration for 1 or 3 days. When administered for 7 or 10 days, however, no difference was noted from the control group, but then the concentration remarkably increased after 21 days of administration. The bactericidal capacity of the neutrophils against Escherichia coli was strengthened as their concentration of taurine increased; phagocytic capacity was also strengthened. The release of myeloperoxidase following phagocytosis of yeasts increased with administration, while the release of beta-glucuronidase, lysozyme and lactate dehydrogenase, which are induced by N-formylmethionyl-leucyl phenylalanine, were inhibited. The hypotonic hemolysis of erythrocytes was also inhibited. Taurine decreased the fluorescence depolarization of diphenylhexatriene, indicating an increase in membrane fluidity. These results suggested that taurine strengthens both phagocytic and bactericidal capacities of neutrophils by increasing the fluidity of neutrophil membrane and membrane stability and thus plays an important role in the mechanism of host defense. PMID- 6500404 TI - [Effects of idebenone (CV-2619) on neurological deficits, local cerebral blood flow, and energy metabolism in rats with experimental cerebral ischemia]. AB - Improvement of energy metabolism in ischemic cerebral tissue benefits the therapy of occlusive cerebrovascular lesions. In the present study, the effects of 6-(10 hydroxydecyl)-2, 3-dimethoxy-5-methyl-1, 4-benzoquinone (idebenone, CV-2619) on neurological signs, local cerebral blood flow, and cerebral energy metabolism were assessed in stroke-prone spontaneously hypertensive rats (SHRSP) with bilateral carotid artery occlusion (BCAO). Pretreatment with CV-2619 (10-100 mg/kg, p.o.) for three or ten successive days delayed the onset of ischemic seizure (acute stroke) and prolonged survival time in the SHRSP. When the compound (100 mg/kg, i.p.) was given once 30 min after BCAO, it exerted similar ameliorating effects on the neurological deficits. When CV-2619 (100 mg/kg for 3 days) was given orally, it did not inhibit a decrease in regional cerebral blood flow induced by the carotid artery occlusion. However, the same treatment markedly inhibited increases in lactate content and lactate/pyruvate ratio and a decrease in ATP content in the cerebral cortex. In addition, the compound showed no effect on cerebral blood flow in normal rats. These results suggest that CV 2619 has an ameliorating effect on neurological deficits related with cerebral ischemia, and this effect is mediated by improved cerebral energy metabolism. PMID- 6500405 TI - [Effects of ritodrine hydrochloride on motor nervous system and central nervous system]. AB - Pharmacological effects of ritodrine hydrochloride (ritodrine), a beta 2 adrenoceptor agonist, were investigated in comparison with that of isoxsuprine hydrochloride (isoxsuprine) on the motor nervous system and the central nervous system. Ritodrine (1-30 mg/kg, i.v.) suppressed spontaneous movements in mice, rats and dogs. The animals became slightly sedative and immobile. Ritodrine caused an increase of water intake and vomitting in dogs. These fingings were recovered in 3-5 hr. Isoxsuprine showed similar effects on general behaviour, but the depressive action was more potent than that of ritodrine. Ritodrine slightly suppressed exploratory behaviour in high dose, but had little effect on emotional behaviour. Ritodrine had no effects on conditioned avoidance response, tremor, motor coordination, thiopental induced sleeping time and few types of convulsions. Ritodrine showed no analgetic effects or muscle relaxant actions. Isoxsuprine, in high dose, suppressed motor coordination and showed ataxia. Ritodrine slightly raised body temperature and dose-dependently suppressed hypothermia and ptosis induced by reserpine. Ritodrine (1-10 mg/kg, i.v.) caused a slight resting pattern of spontaneous EEG in rabbits. On the other hand, arousal responses evoked by auditory stimulation, photic stimulation or electrical stimulation of mesencephalic reticular formation were unaffected by ritodrine at any doses used. These results suggest that ritodrine shows little effect on the motor nervous system and central nervous system, and its effects may be nonspecific. PMID- 6500407 TI - Interbirth intervals in a captive group of Japanese macaques. AB - Interbirth intervals in a captive group of Japanese macaques were found to be shortened and inconsistently affected by stillbirth and infant loss within 6 months of life. The reduction in the length of the interval between successive births was in all probability the result of shorter periods of lactation and larger amounts of body fat stored by the well-nourished females of the study group. PMID- 6500406 TI - Mechanisms of antibacterial immunity of mucous membranes. AB - A survey based on both literary data and the authors own results, concerning the mechanisms of sIgA-mediated antibacterial immunity, is presented. Secretory IgA is characterized as a specific component of the immune system of mucous membranes, which can recognize harmful bacterial and distinguish them from indigenous microflora physiologically colonizing the mucous membranes, to fix them to the mucous membrane surface and to direct further factors, such as mucin, lysozyme, etc. (which form the effector component of the mucous membrane immunity system) for their final inactivation and neutralization. PMID- 6500408 TI - Life history of Hanuman langurs (Presbytis entellus). Reproductive parameters, infant mortality, and troop development. AB - Longitudinal data of reproductive parameters from two langur troops (Presbytis entellus) at Jodhpur, Rajasthan, India, are presented. Females can reach menarche at approximately 29 months of age and conceive about 5 months later. Gestation length is about 200 days, average cycling length is 24 days, and mean interbirth interval 15.3 months. Postpartum amenorrhea, which ranges from 80-140 days will be reduced to 23-80 days in cases of stillbirths or early losses of infants, a fact that bears consequences in regard to the discussion of infanticide and reproductive advantage. Troop development showed distinct differences in two neighboring troops, especially in number of surviving female infants until sexual maturity. Both troops taken together, 77.9% of the newborns reached the infant-II stage (6 months), 59.3% survived until their mother's next infant (average, calculated for the mean birth interval of 15.3 months), and only 35.9% completed the 2nd year of life. PMID- 6500409 TI - Old age and its behavioral manifestations: a study on two species of macaque. AB - Observations from two studies on the behavior of stumptail and Japanese macaques revealed that old females were generally less active and involved in fewer social interactions than young adult females. Old females typically avoided or maintained sufficient distance from others to decrease the possibility of interaction, but were neither excluded from social interactions nor out-competed in rank-related situations. The data strongly suggest that the old females selectively withdrew from social interactions and maintained their rank over younger members of the group. Three possible explanations are discussed for the differences in behavior between old and young adult macaque females. (1) Old females with older offspring are less likely to interact with others than old females with younger offspring; (2) old females obtain fewer benefits from social interaction than young adult females, and (3) older females have less energy to disburse for social interaction due to physiological deterioration. The age of the youngest offspring did not account for the decline in social interactions among old females. It was concluded that active withdrawal from social interactions on the part of old females is likely to be the result of both a decrease in the benefits obtained from sociality and an overall physiological deterioration. PMID- 6500410 TI - Achilles tendon repair with an absorbable polymer-carbon fiber composite. AB - Twenty-seven patients were surgically treated for Achilles tendon rupture using a composite implant. The implant is ribbon-like in configuration and composed of filamentous carbon fiber coated with an absorbable polymer. When used to secure an Achilles repair, the implant acts as a scaffold for the regrowth of collagenous tissue. Rapid attachment of host tissue assures good, early repair strengths which allows for a more vigorous rehabilitation program. Fourteen patients have at least 9 months of follow-up (average follow-up, 14.4 months) and have been objectively and subjectively evaluated on a temporal basis for return of function. To date, complications have been minimal. Results have been very encouraging with 90% return of function at 18 months. PMID- 6500412 TI - Correction of clawtoes by the Girdlestone-Taylor flexor-extensor transfer procedure. AB - Several techniques have been suggested for correction of clawtoe deformities in the lateral toes, ranging from multiple arthrodesis of the interphalangeal joints to phalanx resections, partial or total amputation of the impaired toes. An evaluation of the flexor-extensor transfer procedure is the basis of this study. Between 1977 and 1983, 39 feet were operated on in 31 patients, presenting a wide variation in etiology, degree of deformity, and symptoms. Average age at the time of surgery was 57.5 (16 to 80). All of the patients were available for recall and were able to return for an interview and examination. Average length of follow-up was 38 months (range, 10-80 months). The report includes a general discussion of the deformities, description of the operative technique, and the results obtained in our series. Assessment emphasized a subjective report including patient satisfaction, cosmetic result, relief of pain, and objective examination to evaluate the presence of recurrent callosities, range of movement at the metatarsophalangeal joint, and degree of residual passive mobility of the toes. Reduction of metatarsalgia and callosities with improved shape of the toes was achieved in most cases. Our experience indicates that the treatment can be recommended for use in the elderly, too, in appropriate cases. Radical procedures are rarely accepted for cosmetic as well as for functional reasons. PMID- 6500411 TI - The subtalar joint: embryology and morphology. AB - Several different aspects of the subtalar joint are studied. Embryology indicates that it is a recently acquired structure. The anterior subtalar joint does not have a uniform morphology, and it has been subdivided into three anatomical descriptions (ovoid, bean, and two part). To correct the confusion found in other papers, we intend to clearly describe the anatomy of the ligaments. The form and function of the retinacula, cervical ligament, and ligament of the canal are studied. The microscopic anatomy of ligaments is studied, dealing specifically with their innervation and the structure of their fibers. PMID- 6500413 TI - Plantar fascitis--early blood pool images in diagnosis of inflammatory process. AB - Bone scintigraphy is of diagnostic value in stress fractures where radiography may not be helpful. Obtaining early blood pool images during scintigraphy for suspected stress fractures may help to identify soft tissue inflammation (plantar fascitis) when delayed images are normal. PMID- 6500414 TI - A new radiological technique for the forefoot. AB - Based on a study of 50 subjects seen at the University of Rochester Medical center, a new axial weightbearing radiological technique of the forefoot is described. The technique is simple, inexpensive, and easily reproducible. It has the advantage of not distorting the forefoot, relationships, unlike currently employed techniques. Since it is performed under weightbearing conditions, the results correlate closer to clinical situations. The subjects under this study, which excluded those with neuromuscular or malalignment problems, were found to fall into two categories: the pain-free and callous-free feet group, who have a well defined arch in the forefoot, and the group of subjects with pain and/or callous under the forefoot, who have a depressed arch. There is also a statistical significance between the relative heights of the tibial and fibular sesamoids. A new classification for hallux valgus based on observations of this technique is proposed. PMID- 6500416 TI - [Contusion injuries of the posterior eye segment]. PMID- 6500415 TI - Myxoid chondrosarcoma of the os calcis: a case report. AB - This case report of a myxoid chondrosarcoma of the os calcis is presented because of its rarity. The clinical, roentgenographic, and pathological features are discussed, and the difficulty in diagnosis is elaborated. PMID- 6500418 TI - [Trauma and herpes]. PMID- 6500417 TI - [Reconstructive surgery of the extraocular muscles]. PMID- 6500419 TI - [Electroretinographic findings in perforating injuries by intraocular foreign bodies]. PMID- 6500420 TI - [Keratitis caused by rice husks--an important cause of blindness in developing countries]. PMID- 6500421 TI - [Long-term nystagmographic study following craniocerebral trauma]. PMID- 6500422 TI - [Congenital corneal opacity caused by hyperplasia of Bowman's membrane]. PMID- 6500423 TI - [Ophthalmologic and pathologico-anatomic findings in cercoid lipofuscinosis]. PMID- 6500424 TI - [Plasma exchange treatment in chronic uveitis]. PMID- 6500425 TI - [Significance of normal lipid transport in the anterior eye segment for the transparency of cornea and lens]. PMID- 6500426 TI - [Free and bound SH groups in bovine lenses of different ages and in various lens parts]. PMID- 6500427 TI - [Effect of PUVA treatment on the eye lens of psoriasis patients]. PMID- 6500428 TI - [Initial experiences with a controlled flow phacoemulsification instrument]. PMID- 6500429 TI - [Direct cyclopexy following operative and traumatic cyclodialysis]. PMID- 6500430 TI - [Reactive changes in pars plana incisions]. PMID- 6500431 TI - [Diascleral infrared coagulation of the retina?]. PMID- 6500432 TI - [Reliability of objective determination of VEP vision in diseases of the anterior eye segment, retina and optic nerve]. PMID- 6500433 TI - [Detection of stereopsis by recording of visual evoked cortical potentials]. PMID- 6500434 TI - [Development of peripheral visual acuity in the infant]. PMID- 6500435 TI - [Technic and results of inferior oblique advancement in incomitant strabismus (the A phenomenon)]. PMID- 6500436 TI - [Development of binocularity and the most frequent causes of disorders in infants]. PMID- 6500437 TI - [Pain as a psychological problem]. PMID- 6500438 TI - [Differential therapy of deep vein thromboses]. PMID- 6500439 TI - [New alternatives to surgical stone removal from the kidney]. PMID- 6500440 TI - [Reckoning without Alzheimer. Onset of treatment]. PMID- 6500441 TI - [The importance of peripheral venous diseases. Incidence and risk factors]. AB - Comprehensive epidemiological studies in the last few years came concordantly to the conclusion, that peripheral venous diseases have a considerable social medical importance. 70% of the adult population have some kind of alteration in the veins, 15% of which are serious. The main risk factors were the branch and trunk varices. Important risk factors were generally age and familial predisposition; apart from these, there were also relations between the existence of hernias (male), of flatfootedness and splayfootedness (female) and the practice of a "standing" career (male) and overweight (female). The female sex, positive auto-anamnesis relating to venous diseases, surgical interventions, pregnancy and lying-in proved to be important risk factors or indicators for deep phlebothromboses. The administration of a primary or if necessary a secondary prophylactic treatment should be given bearing these factors in mind. PMID- 6500442 TI - [Vascular diseases and occupation. Incidence and significance of circulatory diseases in occupational medicine]. AB - The high incidence and socio-medical significance of vascular diseases--which often manifest during the working lifetime of the patient--mean that doctors in occupational medical practice have more and more frequently to deal with these lesions, irrespective of whether they are causally linked to the patient's occupation or not. For diseases of the circulatory system usually have a direct effect on the patient's efficiency and fitness for work. Depending on the localisation of the lesion, certain precautionary measures may be needed at work, or it may no longer be possible for the affected person to carry out certain jobs -or at least not without risk. This applies not merely to arterial, but also to venous and lymphatic diseases. Further, there are a number of recognised occupational diseases that manifest, or may manifest, as circulatory disorders. A range of occupation-related effects or exposures of a physical, chemical or possibly immunological-allergic nature can lead to vascular lesions including premature attrition of the vascular system. The early detection and prevention of circulatory disorders may become a major task of occupational medicine in the future. PMID- 6500443 TI - [Drowning, swimming pool death and other emergencies related to swimming]. AB - In the Federal Republic of Germany, some 700 people drown every year. Of particular importance is the so-called swimming bath black-out that occurs while swimming under water, which must always be avoidable when the causes are known and appropriate precautionary measures taken. Of life-saving importance in a case of drowning is the rapid and proper use of first aid. The severe pulmonary injury induced by freshwater or salt water aspiration urgently requires the treatment of the victim in an intensive care unit of a hospital, even after successful resuscitation. PMID- 6500444 TI - [Control of the position of central venous catheters by intracardial ECG. A presentation of the method and its advantages compared to roentgen control]. AB - It is obligatory to control the localization of a central venous catheter. We describe a simple own method for controlling the correct position of a central venous catheter electrocardiographically. The reported method is accurate and inexpensive. PMID- 6500445 TI - [Split tetanus vaccine. Studies on its efficacy and tolerance as compared to adsorbed vaccine]. AB - A tetanus split vaccine consisting of the purified C fragment of tetanus toxin was compared with normal adsorbed toxoid vaccine with respect to local reactions and immunogenicity. Altogether, 200 volunteers with primary vaccination against tetanus were vaccinated. Local reactions were studied in 170 persons, the immune response in 87. Immunogenicity, expressed as mean conversion factor, was identical for both groups. Local reactions, including frequency, duration and intensity of symptoms, were reduced by 60% in the subjects given split vaccine. In both groups a positive correlation between preimmunization antibody titer and the mean extent of the local reaction was observed. PMID- 6500446 TI - [Immune reactions after allogeneic small bowel transplantation. Graft rejection and graft versus host reaction in the rat model]. AB - Small bowel transplantation is characterized by the specific immunological problem of graft versus host reaction (GVHR) which appears in addition to rejection reaction. GVHR is induced and maintained by the immunocompetent cells of the graft. In order to clarify the basic mechanisms of these interfering reactions heterotopic accessory small bowel transplantations in the rat were carried out. Immunological reactions were estimated by assessment of mortality rates of recipients, histological examinations, and measurement of cytotoxic T cell reactivity within the graft and recipient. The strength of the rejection reaction depends on the degree of histoincompatibility between donor and recipient, and the length of the graft. The expression of GVHR is also dependent on the histoincompatibility of the donor and the amount of lymphatic tissue grafted within the small intestine. The GVHR shows a characteristic time course, peaking 20 days after transplantation. GVH-T-cell-reactivity can be found in different lymphatic compartments of the graft and recipient. GVHR causes autoimmune reactivity within the recipients. These results clarify basic immunological mechanisms of rejection and GVHR thus providing an indispensable condition for clinical small bowel transplantation. PMID- 6500447 TI - [Varicose vein drugs--new attempts at objectivation of the effects of therapy]. AB - The ultrasound Doppler examination has proved itself to be a very promising non invasive method for the trials of vein medication under defined test conditions. In patients with postthrombotic syndrome the medium blood stream velocity in the V. femoralis increased on the diseased side two hours after oral application of a high-dosed combination of ruscogenin, trimethyl-hesperidin-chalkon and ascorbic acid (1 X 6 capsules Phlebodril) by the mean of 24%. If one observes the quotients from the middle arterial inflow and venous outflow velocity in the femoral vessels, in order to comprehend the relation between both these necessarily correlated hemodynamic parameters, one sees that this quotient shows a decrease after medication of 40%, which was significant on the 5% level. Corresponding drug effects in the early phase after getting upright could also be proved. The importance of these results, which are from an acute trial, must still be tested in a practical long-term therapy. PMID- 6500448 TI - [Chemotherapy of malignant tumors, vomiting and nausea--what to do?]. AB - Very marked nausea and vomiting are the most frequently observed side effects of modern cytostatic agents, and make it necessary to include powerful anti-emetic drugs in any oncological chemotherapeutic concept. The selection of suitable anti emetics, however, often proves difficult. The reasons for this are discussed. A number of important basic rules that should be observed with any anti-emetic treatment are proposed. Finally, a standardised stepwise anti-emetic plan is suggested for discussion. PMID- 6500449 TI - [Non-operative percutaneous cholecystostomy in acute postoperative cholecystitis]. AB - Seriously ill patients with acute postoperative cholecystitis are at high risk from emergency cholecystectomy. A case is presented which shows that non operative percutaneous cholecystostomy may improve the patient's condition. With continuous percutaneous drainage of the infected bile and selective antibiotic treatment, the patient's condition can be stabilized so that all the necessary preparations for elective cholecystectomy can be made. PMID- 6500450 TI - [Cryosurgical treatment of benign skin tumors. Experiences in the practice of a general physician]. AB - The frequency of the occurrence of predominantly benevolent dermatomas in a medium-sized general practice is reported; whereby mainly warts (verrucae vulgares) are dealt with. The treatment of these types of dermatomas by means of cryosurgery is presented, the results are evaluated and the procedure--suitable for a general practice--is described. PMID- 6500451 TI - [Hemorheologic therapy in peripheral arterial occlusive disease]. AB - In view of current knowledge drug treatment of peripheral arterial occlusive disease is required at stage IIb in most cases. Angiological diagnostic procedures should be conducted to determine the location and extent of occlusion as well as to evaluate the blood fluidity. Rheological therapy is indicated in cases of microangiopathy, inoperable macroangiopathy, pre- and postoperative treatment of macroangiopathy and macroangiopathy after angioplasty or fibrinolysis. Drug treatment is administered according to clinical status and rheological parameters. The main emphasis in therapy includes hemodilution, reducing the fibrinogen concentration and improvement of blood fluidity. The findings of hemodilution therapy with various hydroxy-ethyl starches as well as a monotherapy with naftidrofuryl are presented and discussed. PMID- 6500452 TI - [Partial liver resections with various laser types. Functional and morphologic results of an experimental study]. AB - In an experimental study, partial liver resections were performed with a Nd-YAG laser as well as with the combination of a CO2- and Nd-YAG-laser to prove the simultaneous cutting and hemostatic effect. Sufficient cutting efficiency could be achieved with a high power Nd-YAG-laser providing a mean output of more than 70 W; especially with a Nd-YAG-laser working with an unstable resonator due to a decreased spot size as used in the combined laser system. PMID- 6500453 TI - [Spinal shock in traumatic lesions of the cervical spinal cord. 2 cases]. AB - The spinal syndrome following traumatization of the cervical spine is associated with a typical accident mechanism and predisposing conditions within cervical spine. Two Patients with this syndrome are presented, and the treatment and the need to prevent complications are discussed. Both patients were largely rehabilitated, one returning to work after one year. PMID- 6500454 TI - [Late sequelae after subarachnoid hemorrhage. A retrospective study of 104 patients 5 years after the acute occurrence]. AB - 104 patients who had survived an subarachnoidal bleeding were followed up, an additional CT scan being employed in 80 of them. Of permanent disabilities, the most important is cerebral insufficiency. Three-quarters of the patients did not achieve complete rehabilitation, the prognosis being significantly dependent upon the severity of the initial phase. 75% of the patients revealed ventricular dilations that correlated neither with the severity of the acute phase of the subarachnoidal haemorrhage, nor with the permanent functional losses. Progression of hydrocephalus communicans over the long term following subarachnoidal bleeding is unlikely; the cerebral insufficiency does not progress. PMID- 6500456 TI - [Tobacco, alcohol and drug consumption of the working population in Switzerland]. AB - In a study in Switzerland we checked the consumption of tobacco, alcohol and medicaments of 1033 women and 1260 men engaged in 44 factories in Switzerland. Cigarettes smoked 54% of the women, but only 44% of the men in the age from 20 35. No alcohol drank 10% of the feminine and 4% of the masculine employees. At the time of the study 27% of all women and 16% of all men took medicaments of any kind, but only one third of all were prescribed by a doctor. PMID- 6500455 TI - [Treatment of tuberculosis of the wrist. 89 long-term course studies and presentation of the current therapeutic concept]. AB - The decrease in the incidence of tuberculosis may today readily result in a lack of attention being paid to the extrapulmonary forms of this disease in the differential diagnosis of bone changes. Today massive joint destruction can be prevented with the aid of anti-tuberculous chemotherapy, the early establishment of the diagnosis (for example arthrotomy) and surgical intervention (synovectomy or excision of focus, osteosynthesis). On the basis of our patients treated between 1947 and 1982 we describe the diagnostic and therapeutic procedures followed over the last decades. The results are discussed. Our present therapeutic concept is explained. PMID- 6500457 TI - [Cryopreservation of human parathyroid tissue. Effect of in vitro secretory behavior and morphology]. AB - The effects of cryopreservation on in vitro secretion and on the survival rate of parathyroid cells were investigated, in order to find possible causes for the frequent failure of autologous, human parathyroid tissue. A reduction in the hormone secretion or an influence on the secretion could be excluded. The freezing procedure, however, leads to a partial necrosis of the tissue. Similarly good results, as in the replantation of fresh tissue, can be achieved by compensating the necrotic cells using more particles. PMID- 6500458 TI - [Fenoterol in chronic obstructive bronchitis--comparison of the efficacy of various application forms. Advantages and disadvantages of metered dose inhalers with a small or large expander and a mechanical atomizer]. AB - After an initial inhalation of 1,25 mg fenoterol in 2 ml 0,9% NaCl by means of Pari Privat randomized on the following two days, two groups of ten respectively eleven patients with relatively stable respiratory tract obstruction were tested for the reversibility of the obstruction with a metered dose inhaler as follows: Group 1 (10 patients) received the metered dose inhaler with a small expander alternatively on even days and on the odd days without the expander. Group 2 (11 patients) received the metered dose inhaler with the large expander (130 mm X 35 mm) alternatively on the even days and with the small expander (100 mm X 30 mm) on the odd days. All patients showed a significant improvement of the bronchial obstruction regardless of the type of inhalation. Auxiliary appliances (inhalation appliances, expanders for the metered dose inhaler) are therefore only necessary, when the patients cannot cope at all or cannot cope optimally with the simple metered dose aerosol. PMID- 6500459 TI - [Pneumologic emergency conditions in geriatrics. With special reference to risk factors]. AB - Acute respiratory failure is a common life-threatening condition in old age. Structural alterations, progressive loss of lung functional reserves and weakening of pulmonary defense mechanisms are the main factors responsible. The aging lung itself contributes only little to the increased risk, but if combined with chronic lung disease, such as bronchitis, asthma, fibrosis, tuberculosis, pneumoconiosis, severe deterioration of lung function may occur. In many cases, respiratory failure results from an accumulation of the following factors: aging lung, chronic lung disease, cor pulmonale, acute complication. Today, chronic obstructive lung disease (COLD) is one of the most important conditions leading to ventilatory failure in the elderly. Carcinoma of the lung and other manifestations of malignant diseases may also be important. Treatment of the acute respiratory failure in the elderly must include three components: 1. treatment of the acute complication triggering the crisis, 2. treatment of the underlying chronic disease, 3. treatment of concomitant extrapulmonary diseases. After recovery, special attention must be directed towards preventing repeated respiratory failure. PMID- 6500460 TI - [Limited indications for glycoside therapy in pediatrics?]. AB - Owing to its positive inotropic action, digitalis is indicated in congestive heart failure; because of its effect on AV conduction it can also be used in arrhythmias. However the nature of the dysrhythmia and the underlying causes of congestive heart failure and arrhythmia need to be further differentiated. Any underlying disease (e.g. renal failure) must be treated primarily. Also, the value of inotropic agents in obstructive lesions needs to be considered. In cardiac arrhythmias digitalis can elicit potentially dangerous arrhythmias owing to AV block. Shortening of the refractory period of "bypass tracts" and by changing automaticity in autonomic focus atrial tachycardia. The possibility of interactions with such commonly used antiarrhythmic drugs as quinidine and amiodarone must be considered. All patients receiving digitalis should be carefully followed and monitored using physical examination, ECG, echocardiographic assessments and digitalis blood level determinations. PMID- 6500461 TI - [Age and sex dependence of tubular kidney clearance in childhood]. AB - Nuclear medicine methods have gained wide-spread use for quantitative determination of renal function, but normal values related to age and sex are often not available, especially in children. Since pediatric clearance studies in our clinic are carried out routinely by means of I-123-OIH (ortho-iodo hippurate), OIH-clearance determinations were performed in 33 children considered to have normal renal function. Within the investigated age of 3,5-15 years no significant correlation of tubular renal clearance with age and no difference between both sexes was found, the mean value +/- SD being 577 +/- 88 ml/min/1,73 m2 surface area. Comparing all age related values known from literature, our values from children and adults fit in quite well. PMID- 6500462 TI - [A new technic for the sealing of a frontobasal cerebrospinal fluid fistula. Experiences with a hardening alcoholic protamine solution]. AB - Fractures of the frontal base of the skull are often accompanied by rhinoliquorrhea. To prevent infections of the brain they must always be closed surgically. We report on a new method of closing the dura mater defect using an alcoholic prolamine solution, which hardens within a few minutes. After 40 to 90 days the mass has been replaced by connective tissue. We describe our experience with 24 patients who were successfully operated on using this method and followed up for two years. PMID- 6500463 TI - [Where does the responsibility of the physician for lending aid end?]. PMID- 6500464 TI - [INSERM--the elite of medicine and health research]. PMID- 6500465 TI - [Quality assurance and quality control of blood pressure measurements. Experiences with the Munich blood pressure study]. AB - More than 12 000 blood pressure measurements were taken in the Munich Blood Pressure Study (MBS). The reliability of these blood pressure measurements is reported. After consideration of possibilities for systematic and random measurement errors we present methods used in the MBS to control and assess the quality of the blood pressure readings over a long period of time: measures for standardizing the recording conditions and procedures; training and testing of the field staff using audio tape-recording and simultaneous measurements with a double stethoscope; analysis of inter- and intraobserver-variation relative to that of reference measurements; analysis of observer preferences for certain terminal digits. With the application of these methods one can indeed successfully reduce observer variability to a tolerable amount even over a considerable period of time. PMID- 6500466 TI - [Determination of progesterone in serum. Clinical significance in early pregnancy]. AB - The aim of the study was to define the limits of normal and subnormal function of the corpus luteum of pregnancy. Between the 5th and 10th week of gestation blood samples were taken from 149 women and progesterone was measured by RIA. 50 women with normal pregnancies had progesterone values ranged from 10-48 ng/ml (M: 21,9 ng/ml +/- 8,5 sd). 26 women with bleedings in early pregnancy (threatened abortion) had significantly lower progesterone values (M: 17,0 ng/ml +/- 8,3 sd, range: 5-38 ng/ml serum). All 26 pregnancies ended with a living child. The 74 women with complicated early pregnancy showed a wider range: 2-120 ng/ml serum (M: 20,7 ng/ml +/- 15,2 sd). All 74 women delivered a living child. Progesterone serum values below 10 ng/ml prior to 10 weeks of gestation indicate subnormal corpus luteum function. We therefore perform hormone treatment in patients with bleedings in early pregnancy only if subnormal progesterone values are found. PMID- 6500467 TI - [Methodologic studies of the activation and inhibition of thrombin]. AB - Conventional analysis methods of prothrombin and thrombin are not able to measure thrombin generation and inhibition quantitatively and specifically, neither analyses of the interactions of plasmatic coagulation with vessel wall components and platelet substances are possible until now. Therefore, photometric and micro coagulation methods have been developed for quantitative and specific analyses of thrombin generation and inhibition. The following reagents were used: plasma prothrombin, thrombin, which is generated in plasma, human factor Xa, human fibrinogen, a chromogenic substrate, phospholipids and calcium. To confirm the validity of the methodology various examples of application are demonstrated: the analysis of carboxylated and non-carboxylated prothrombin in human hepatic cells, the analysis of the thrombin generation and inhibition induced by endothelial cells and smooth muscle cells and the proof of a reduced platelet factor 3 availability in patients with various platelet aggregation defects. PMID- 6500469 TI - [Acronyms of English language terminology in cardiology]. PMID- 6500468 TI - [Effect of diet on lithogenic and inhibitory substances in the urine]. AB - A standard diet is the pre-condition for an accurate investigation of the causes of stone formation reasons in recurrent stone-formers, since the uncontrolled influences of individual diets on the composition of the urine can thus be eliminated. In patients kept on a standardized diet intake a steady state (balance of excretion of lithogenic substances) is obtained after about 5 to 7 days. Because it must be assumed that brief excretion and concentration peaks are very much more frequently the cause of nucleation, the determination of the circadian rhythm of lithogenic substances is most important. On the basis of our investigation results, an "investigation programme in stages" for research into the causes of stone formation is recommended. PMID- 6500470 TI - [Diffusion of tetroxoprim and sulfadiazine in the cerebrospinal fluid of neurosurgery patients]. AB - Two studies were conducted in neurosurgical patients to establish cerebrospinal fluid (CSF) and plasma levels of tetroxoprim (TXP) and sulphadiazine (SDZ) following the oral administration of co-tetroxazin in a standard dosage regimen. Both TXP (0,62-0,42 micrograms/ml) and SDZ (2,5-4,5 micrograms/ml) adequately penetrated into the CSF, resulting in concentrations above the MICs for most relevant pathogens. In relation to the respective plasma levels and under steady state conditions, CSF-availability is 37,5% for TXP and 31,8% for SDZ. PMID- 6500471 TI - [Combined fluoride/calcium therapy of osteoporosis]. AB - In a prospective study 26 patients with primary or steroid-induced osteoporosis were treated for 15 months with a combined fluoride and calcium preparation. X ray pictures showed no further aggravation or improvement in 70% of the cases. Bone mineral measurements of the axial skeleton showed no further bone loss in 38% and an increase in bone mineral mass in 54%. Improvement of subjective symptoms was observed in 92%. Recalcification began as expected after nine to twelve months of treatment. PMID- 6500472 TI - [Is there still a soul? Thomas Aquinas and modern psychiatry]. AB - The various solutions that have been proposed with respect to the body-mind problem can be more or less regarded as variations on three traditional models. Since the time of Descartes the philosophical position of hylomorphism has been almost forgotten and the influence of the dualist point of view has also been greatly reduced. In contrast, reductionism in the form of materialistic monism has gained immense popularity, especially in psychiatric circles. The present paper summarizes these different approaches but primarily focuses on certain aspects of a modified form of hylomorphism as developed by Thomas Aquinas. These latter considerations are then drawn upon as the basis for a critique of Kurt Schneiders so-called aristotelean-scholastic or metagenic interpretation with regard to the endogenous psychoses. PMID- 6500473 TI - [Borderline--a diagnostic entity?]. AB - In the last years, there has been considerable controversy as to whether the term "borderline" should be introduced into psychiatric diagnostic nomenclature to designate psychiatric disorders not classifiable as psychoses, neuroses or traditional forms of personality disorders. Whereas many psychiatrists, especially those who are psychodynamically oriented, have been using this term for a long time, the more phenomenologically oriented psychiatrists refuse to do so while pointing to its lack of clear-cut definitions and its confusing abundance of meanings. The definitions of the term "borderline" used in the various "borderline" -concepts are reviewed. Some authors (Knight, Kety et al.) consider "borderline schizophrenia" to be a subgroup of schizophrenic psychoses. Others (Klein, Stone) take "borderline" disorders as a heterogeneous group of psychiatric illness encompassing especially some atypical affective disorders. Thirdly the concepts of those authors who conceive "borderline" as a distinct diagnostic entity are reviewed: Kernberg's "Borderline personality organization", Grinker's "Borderline syndrome", Gunderson and Singer's "Borderline personality disorders", Spitzer and Endicott's "Borderline (unstable) personality disorder" and "Schizotypical personality". The "borderline" definitions of all concepts are examined as to whether they fulfil the requirements of a "useful" (according to Kendell) diagnostic category, i.e. whether they yield reliably defined diagnostic criteria, and whether they can be validated by genetic and biological studies, therapy response, and long-term studies. It is pointed out that attempts have been made to establish operationally defined diagnostic criteria for some of the "borderline" concepts, but that research aiming at their validation is still in an initial stage. PMID- 6500474 TI - [Correlation of computer tomographic findings and psychologic test results in patients with craniocerebral injury]. AB - 102 Patients with severe head injuries were examined using computed tomography and psychological tests in the rehabilitation phase. Significant correlations were found between the psychological test results on the one hand and cortical atrophia demonstrated by computed tomography as well as the transverse diameter of the third ventricle on the other. The index of cella media and the contusions of differing localisation did not show any significant correlation with the psychologic test results. Professional re-integration could be most clearly placed in relation to the duration of disease, the intellectual capacity, and irreversible changes of personality; however, there was but little relation to the findings obtained via computerized tomography. PMID- 6500475 TI - [Attitudes and beliefs of medical and psychology students with regard to treatment with psycholtropic drugs]. AB - Attitudes and assumptions of medical and psychology students in regard to psychotropic medication were assessed my means of a content analytic method. The students were in clinical training. Psychology students were compared with medical students. Attitudes related to psychopharmaca were compared with those related to antiepileptics. Results show that psychopharmaca are mainly criticized, that judgments are based on misinformation and presented with much emotional commitment. Negative judgements also generalize on the prescribing physicians. Consequences for the education of students are discussed. PMID- 6500476 TI - [Long-term follow-up study of gastric and duodenal ulcers]. PMID- 6500477 TI - [An epidemiologic study of hepatitis B virus in Yaeyama, Okinawa]. PMID- 6500479 TI - [ST vector changes in ischemic heart diseases: studies in China]. PMID- 6500478 TI - [Clinical evaluation of continuous monitoring of mixed venous oxygen saturation in critically ill patients]. PMID- 6500480 TI - Left ventricular function and myocardial structure in aortic valve disease before and after surgery. AB - 47 patients with aortic valve disease were studied by left ventricular micromanometry and cineangiography before and 18 months after successful valve replacement. There were 27 patients (17 with aortic stenosis, ten with aortic insufficiency) with moderate hypertrophy (angiographic mass less than 180 g/m2) and 20 patients (ten with aortic stenosis, ten with aortic insufficiency) with severe hypertrophy (angiographic mass greater than or equal to 180 g/m2). In the patients with moderate hypertrophy ejection fraction was slightly although not significantly smaller than in 14 controls. Peak systolic circumferential wall stress was, however, significantly increased. In the patients with severe hypertrophy ejection fraction was significantly decreased although afterload was similar to that in the patients with moderate hypertrophy. This indicated a depressed contractile state in the patients with mass exceeding 180 g/m2. After surgery peak systolic wall stress returned to normal levels in both groups. Among the patients with severe preoperative hypertrophy only the patients with aortic stenosis showed a normal ejection fraction after surgery, whereas in the patients with aortic insufficiency ejection fraction improved but remained depressed compared to the controls. In a second study, comparison of left ventricular function with myocardial structure (endomyocardial biopsies) was carried out in 30 patients with aortic valve disease (group 1: 18 with aortic stenosis, group 2: twelve with aortic insufficiency). Both groups were restudied 18.8 and 17.4 months, respectively, following successful aortic valve replacement. Preoperative biplane ejection fraction (60 and 57%), angiographic mass (183 and 186 g/m2), muscle fibre diameter (31.1 and 30.8 mu), interstitial fibrosis (17.1 and 17.4%) and left ventricular fibrous content (31.0 and 32.2 g/m2) were similar in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500481 TI - The value of rest and exercise radionuclide ventriculography as compared to echocardiography and angiography in the detection of left ventricular dysfunction in patients with chronic aortic regurgitation. AB - Symptomatic patients with chronic aortic regurgitation and a left ventricular ejection fraction greater than 0.50, or forward cardiac index greater than 2.5 l/min/m2 at rest, have a much better survival rate than those with a depressed ejection fraction or cardiac index following aortic valve replacement. The annual mortality rate is approximately 2% for those with well preserved ventricular function versus 10% for those with depressed ventricular function at rest. This is in striking contrast to the situation that exists in patients with aortic stenosis, where the long-term survival is similar for those with a normal or depressed left ventricular ejection fraction or cardiac index at rest. Therefore, it would seem to be important to detect incipient left ventricular failure in patients with chronic aortic regurgitation and to intervene surgically before the left ventricular dysfunction becomes irreversible. In patients with a normal left ventricular ejection fraction at rest, maximal supine bicycle exercise testing with radionuclide ventriculography defines a group of patients with truly normal ventricular function (ejection fraction increases by greater than 0.05 ejection fraction units at peak exercise), and a group with incipient left ventricular dysfunction earlier than previously described variables (i.e., left ventricular ejection fraction at rest less than 0.50, left ventricular end-systolic volume index greater than 90 ml/m2, left ventricular end-systolic dimension greater than or equal to 5.5 cm, left ventricular shortening fraction less than or equal to 25%), and generally before the onset of symptoms. PMID- 6500482 TI - Diastolic function in aortic valve disease: techniques of evaluation and pre /postoperative changes. AB - Passive diastolic properties of the left ventricle are determined by several factors intrinsic or extrinsic to the ventricle. In patients with myocardial hypertrophy due to longstanding pressure or volume overload increased muscle mass and structural alterations of the myocardium are responsible for changes in passive elastic properties. Evaluation of diastolic function includes determination of ventricular (= chamber) and myocardial (= muscle) stiffness from simultaneous pressure-volume and stress-strain relations during passive diastolic filling. The slope of the pressure-volume relationship is equal to the constant of chamber stiffness and the slope of the stress-strain relationship equal to the constant of myocardial stiffness. Passive diastolic properties were determined in ten control patients and 21 patients with aortic valve disease before and 17.5 months after successful valve replacement. Ten patients presented with severe aortic stenosis, five patients with combined valve lesions and six patients with severe aortic insufficiency. Simultaneous high-fidelity pressure measurements and M-mode echocardiography were carried out in all patients. Myocardial stiffness was calculated from a viscoelastic stress-strain relationship using a nonlinear curve-fit program. Standard hemodynamic measurements showed a significant decrease in pressure and volume overload after successful valve replacement. Left ventricular muscle mass index decreased in all three groups significantly after surgery, whereas systolic ejection fraction remained unchanged pre /postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500483 TI - Left ventricular function in mitral valve disease. AB - Approximately one-third of all patients with mitral stenosis can be found to have an impaired left ventricular ejection fraction attributable to a reduction in preload subsequent to inflow obstruction, that is, with a lack of adequate Frank Starling compensation together with increased afterload, rather than to an impairment of left ventricular function. The left ventricular function is, thus, generally not a factor exerting influence on the natural history of mitral stenosis or on the surgical results. The easy unloading of the left ventricle via both aortic and mitral valves during systole is the hallmark of chronic mitral regurgitation. The volume overload in mitral regurgitation leads to eccentric hypertrophy of the left ventricle while the mass-to-volume quotient remains within normal limits. There is an increase in compliance. Since left ventricular pressure and radius decrease rapidly due to the regurgitation, the myocardial wall stress of the left ventricle at the end of systole is reduced. Even in the presence of substantially reduced contractility, however, the left ventricular function appears adequate. If the left atrium is distensible enough to act as a buffer against backward transmission of the left ventricular systolic pressure, the patient may have only mild symptoms in spite of severe regurgitation. At end systole, due to the diminished afterload, near normal volumes are reached such that, in association with an increased end-diastolic volume, an increased stroke volume and normal ejection fraction are present. In many patients with decreased contractility, the end-systolic volume may be slightly or moderately increased but, generally, the ejection fraction remains satisfactory at values in excess of 50%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500484 TI - [Function of the right ventricle in mitral valve defects before and after surgical correction]. AB - To ascertain whether surgical correction of mitral valve lesions can lead to postoperative improvement of right ventricular function, investigations were carried out in 17 patients with mitral valve disease, clinical severity grade III and IV, before and at an average of 18 months postoperatively. Six subjects without heart disease served as controls. Preoperatively, all patients underwent catheterization and cineangiographic evaluation of both the right and left ventricles. The right ventricular ejection fraction (RV-EF) was also determined from the radionuclide ventriculogram before and after the surgical intervention (closed mitral commissurotomy in five patients and mitral valve replacement in twelve). The patients were studied at rest and during bicycle ergometry in the supine position. As compared with control subjects, before surgery at rest, patients with mitral valve disease had significantly higher values for mean left atrial pressure (22 +/- 7 vs 8 +/- 2 mm Hg), mean pulmonary artery pressure (39 +/- 17 vs 17 +/- 5 mmHg), pulmonary arteriolar resistance (361 +/- 260, increased 5-fold, vs 69 +/- 27 dyn . s . cm-5) and right ventricular systolic pressure (55 +/- 20 vs 24 +/- 6 mmHg) while the values for right ventricular end-diastolic pressure, mean right atrial pressure, left ventricular end-diastolic pressure and left ventricular systolic pressure did not differ (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500485 TI - [Radiation exposure and radiation risk in angiocardiography in adults]. AB - In 100 patients, the X-ray exposure during routine angiocardiography was measured from which calculations were performed for the integral dose (the energy transferred to the body by the exposure), the mean body dose and the radiation risk (according to ICRP 26, 1977). Fluoroscopy contributed 21% and angiocardiography 79% of the total exposure. The mean body dose was 0.9 rd. The average of the area-dose product was 10,200 Rcm2 with a skin exposure in the central beam of 36.1 rd. The genetic risk (probability of X-ray-induced mutation in progeny) is 1 : 75,000 after average exposures and 1 : 7,700 at maximal doses. The somatic risk (probability of X-ray-induced lethal disease) in the patients studied is 1 : 11,000 after average exposures and approximately 1 : 4,400 at maximal doses. The genetic and somatic risks, thus, are small as compared with those of cardiac catheterization and contrast angiocardiography. PMID- 6500486 TI - On the effect of glucagon on mitochondrial calcium retention in isolated hepatocytes. AB - Exposure of isolated hepatocytes to glucagon for 45 min caused a 2.5-fold increase in the time (Ca2+ retention time) for which mitochondria subsequently isolated from the cells retained a load of exogenous Ca2+ before its spontaneous release. Half maximal effect of glucagon was observed at a concentration of 0.6 nM. An increase in the Ca2+ retention time was observed after 30 but not 15 min exposure of cells to the hormone. Incubation of hepatocytes with dexamethasone, epinephrine, vasopressin, dibutyryl cyclic AMP or 8-bromo cyclic GMP also induced an increase in mitochondrial Ca2+ retention time. The effect of glucagon was associated with an increase in cellular cyclic AMP and was inhibited by puromycin, cycloheximide and cordycepin, but not by actinomycin D or chloramphenicol. Puromycin caused only a small inhibition of the stimulation by glucagon of mitochondrial pyruvate carboxylation. It is concluded that the effects of glucagon on mitochondrial Ca2+ retention require nuclear DNA-directed protein synthesis and differ, in this respect, from the rapid-onset effects of the hormone on other mitochondrial properties, including pyruvate carboxylation. PMID- 6500487 TI - Enhancement in cholesterol-esterase activity and lipolysis due to 17 beta estradiol treatment in rat adipose tissue. AB - The effects of 17 beta-estradiol and testosterone administration on cholesterol esterase, lipoprotein lipase activities and adrenalin-induced lipolysis were examined in rat adipose tissues with the change in serum lipid level. The administration of 17 beta-estradiol (500 micrograms/kg, 2 or 4 weeks) to male rats significantly reduced the body weight, and markedly increased serum cholesterol, triacylglycerols and phospholipids. Cholesterol esterase activity was significantly enhanced in the epididymal adipose tissue from estradiol treated rats and the effect was greater with duration of the treatment. In contrast, lipoprotein lipase activity was markedly reduced. Testosterone reduced cholesterol esterase activity in the parametrial adipose tissue through the treatment with 500 micrograms/kg for 6 weeks, but it did neither influence serum lipids nor lipoprotein lipase activity. Basal lipolysis and adrenalin-induced lipolysis were also significantly enhanced in the epididymal adipose tissue from the male rat treated either with 7 mg/kg estradiol 12 h ahead or with 500 micrograms/kg estradiol for 2 weeks. These results indicate that estradiol exerts strong effects on metabolism of the adipose and these effects seems to be mediated through cyclic-AMP. An alteration of adrenergic functions by gonadal steroids might be intervened. PMID- 6500488 TI - In vitro and in situ skeletal muscle pyruvate dehydrogenase activity in adrenalectomized and glucocorticoid treated rats. AB - Skeletal muscle glucose oxidation is significantly reduced and alanine release enhanced in adrenalectomized rats after short-term glucocorticoid treatment. A possible site of regulation is the pyruvate dehydrogenase complex. Pyruvate dehydrogenase activity was measured in vitro in extracts of the gastrocnemius muscle of normal, adrenalectomized and short-term glucocorticoid treated rats by the p-nitroaniline-arylamine-acetyltransferase method and in situ in non recirculating perfusions of isolated hindlimbs with physiological pyruvate levels and tracer doses of [1-14C] pyruvate by measuring the off-kinetic of 14CO2 wash out in the effluent. Neither method showed a direct influence of glucocorticoids on skeletal muscle pyruvate dehydrogenase activity. PMID- 6500489 TI - Somatomedin, transferrin and amino-acids in serum following injection of human growth hormone in children with growth disease. AB - 17 children with growth retardation (12 with idiopathic hypopituitary dwarfism, 2 with craniopharyngioma and 3 constitutionally short) were studied for three days following a single intramuscular injection of human growth hormone. Somatomedin activity was bioassayed using both sulphate incorporation into chick embryo cartilage and thymidine uptake by human lectin-activated lymphocytes. In hypopituitary patients it showed a significant response, maximal 24 hours after the injection, and significantly correlated for the two bioassays. The aminoacid content of the incubation medium used for thymidine bioassay appeared as an important factor: both glutamine and nonessential aminoacids are required to obtain significant stimulation by low serum concentrations, thus increasing the sensitivity of the assay but reducing the differences between normal and hypopituitary sera. Transferrin levels in serum were significantly lower in hypopituitary dwarfs. They did not rise in the three days following hGH. Aminoacid levels were lower in idiopathic GH deficient patients than in other groups, and did not show short term increase in the fasting samples collected after hGH administration. PMID- 6500490 TI - Mortality and renal failure in the streptozocin-alloxan diabetic dog attributed to contamined alloxan preparations. PMID- 6500491 TI - Effect of secretin and test meal on parathyroid hormone secretion in normal man and in primary hyperparathyroidism. PMID- 6500492 TI - Glucosylated plasma protein injection does not produce glomerular basement membrane thickening. PMID- 6500493 TI - Iodide-induced disappearance of thyroid follicles in cultured cells. PMID- 6500494 TI - First clinical observations with hPTH(1-38), a more potent human parathyroid hormone peptide. PMID- 6500495 TI - Intravenous glucose tolerance tests in the New Zealand strains of mice. AB - Intravenous glucose tolerance tests (I.V.G.T.T.) were carried out in fasting NZO, NZB and NZB/W mice. NZO and NZB mice exhibited an impaired rate of glucose decay, while NZB/W mice cleared glucose very rapidly. The possibility that autoimmune processes are responsible for the glucose intolerance observed in NZO and NZB mice is discussed. PMID- 6500496 TI - Renal control of cephalic and intestinal removal of glucagon in the anesthetized dog. AB - The extraction of plasma glucagon during intravenous infusion of exogenous hormone has been measured in the head, gastrointestinal tract or kidney of dogs submitted to binephrectomy or to sham surgery. A significant glucagon extraction was demonstrated not only in the kidney, but also in the head and in the portal area; moreover, plasma glucagon extraction by the head and by the bowel were significantly reduced, after binephrectomy, by 55 and 46 per cent, respectively. Changes in blood flow are unlikely to be involved to explain these phenomena. Therefore, a control by the kidney of the peripheral removal of plasma glucagon is suggested, the mechanism of which remains hypothetical. PMID- 6500497 TI - Urinary immunoreactive pancreatic polypeptide in normal subjects. PMID- 6500498 TI - Suppression of plasma prolactin in a patient with a pinealocytoma. AB - Plasma growth hormone (HGH), prolactin (PRL), luteinizing hormone (LH), thyroid stimulating hormone (TSH), cortisol and melatonin were determined during a 24 h period in a pubertal boy with a pinealocytoma. All hormone concentrations were normal with respect to age and time of day, with the exception of PRL which was undetectable. After subtotal removal of the tumor, basal PRL was still undetectable, but could be stimulated moderately by insulin-induced hypoglycaemia or TRH. PMID- 6500499 TI - The effect of zinc ion on adenylate cyclase in rat testicular tissue. PMID- 6500500 TI - Sex difference in cholesterol esterase activity in rats adipose tissues and changes of the activity following orchiectomy and ovariectomy. AB - Sex differences in cholesterol esterase activity and changes in the activity in response to orchiectomy and ovariectomy were investigated in rat adipose tissue in association with serum lipid levels. Cholesterol esterase activity in the parametrial adipose tissue was 65% higher than that in the epididymal adipose tissue, but there were no sex differences in the activity of subcutaneous and perirenal adipose tissue. Pre- and post-pubertal orchiectomy resulted in a marked enhancement of cholesterol esterase activity, whereas ovariectomy significantly reduced the activity. Serum cholesterol and triacylglycerol levels were elevated through orchiectomy but ovariectomy had no effect. These results suggest that cholesterol esterase activity in the adipose tissue around sexual organs is regulated by gonadal hormones and that the increase in serum cholesterol due to orchiectomy is unlikely to be related to the change in the enzyme activity. PMID- 6500501 TI - Arginase activity during pregnancy and lactation. AB - Arginase activity in liver, kidney, small intestine and stomach of pregnant and lactating rats as well as their plasma levels have been measured. Late pregnancy as well as weaning induced a parallel increase in enzyme activity that is not reflected in the circulating urea levels. The arginase activity changes have been related to known changes in feeding and nitrogen handling patterns as well as to hormonal variations. PMID- 6500502 TI - The effect of adrenaline pretreatment on the in vitro generation of 3,5,3' triiodothyronine and 3,3',5'-triiodothyronine (reverse T3) in rat liver preparation. AB - The effects of adrenaline (A) on liver T3 and rT3 neogenesis from T4 were studied in Wistar rats. The animals were implanted subcutaneously either with A or placebo (P) especially coated tablets which linearly released the hormone. The serum A values 6 hrs after implantation of 7.5, 15.0 and 45.0 mg tablets were 6.5 +/- 1.31, 6.8 +/- 1.8 and 16.4 +/- 1.9 ng/ml, respectively vs 4.4 +/- 2.5 ng/ml seen in P pretreated group. The output rates of A were 0.11 (7.5 mg), 0.18 (15 mg) and 0.52 microgram/ml (45 mg). The pretreatment with A led to hyperglycemia and the "low T3 syndrome". Neogenesis of T3 from T4 in medium containing liver microsomes of P pretreated rats was 5.49 +/- 0.25 pmol of T3/mg protein/min and decreased in A pretreated rats to 3.82 +/- 0.17, 3.12 +/- 0.27 and 3.06 +/- 0.11 pmol of T3/mg of protein/min. Neogenesis of rT3 from T4 in microsomes from P group was 1.52 +/- 0.09 pmol rT3/mg protein/min and increased after A to 2.71 +/- 0.11, 2.60 +/- 0.21 and 2.21 +/- 0.34 pmol of rT3/mg protein/min thus showing no dose dependency. Enrichment of microsomes medium with cytosol either from P or A pretreated rats had no effect on T3 generation thus excluding effect of A on cytosolic cofactor. Although cytosol further increased rT3 neogenesis this was seen regardless of whether cytosol was obtained from A or P implanted rats. It is concluded that A decreases the activity of T4-5'-deiodinase in liver, and possibly increases the activity of T4-5-deiodinase. PMID- 6500503 TI - HLA antigens in Wolfram's syndrome. PMID- 6500504 TI - Effect of dopaminergic agents on the secretion of gastrointestinal immunoreactive glucagon in depancreatized dogs. PMID- 6500505 TI - Is paranodular, grossly normal thyroid tissue from patients with non-toxic nodular goitre really normal? PMID- 6500506 TI - Effect of trifluoperazine on the adrenaline stimulated glycerol release in vitro. PMID- 6500507 TI - Hepatitis B markers in United States drug addicts with special emphasis on the delta hepatitis virus. AB - Hepatitis B virus and hepatitis delta virus co-infection in drug addicts has been well described in Europe, the latter agent appearing to have been introduced there in the mid-1970's. Currently, similar data are scanty among United States addicts. We therefore reevaluated 99 drug addicts from three different geographic locations in the United States who had participated in a Veterans Administration Cooperative Study between 1972 and 1975. Almost all were asymptomatic, and all had been subjected to liver biopsy because of prolonged aminotransferase abnormalities. Stored sera were tested for antibody to hepatitis delta antigen (anti-HD) by radioimmunoassay and available liver biopsies examined for hepatitis delta antigen (HDAg) by immunofluorescence. Overall, 19.2% were HBsAg positive, 9.1% HBeAg positive, 90% anti-HBc positive and 10.1%, positive for anti-HD. Anti HD was identified in 42.1% of addicts who were HBsAg positive and in 3.3% who were anti-HBs positive. No correlation was found between HBeAg and anti-HD, but anti-HD was present significantly more frequently in those with chronic active hepatitis than in those with chronic persistent hepatitis. We conclude that hepatitis delta virus infection is common in HBsAg-positive drug addicts in the United States dating back to at least 1972 and probably earlier. PMID- 6500508 TI - Detection of anti-HBc IgM following prednisone treatment in patients with chronic active hepatitis B virus infection. AB - The effect of a short course of prednisone therapy on serum IgM type antibody to the hepatitis B core antigen (anti-HBc IgM) was studied in 14 male patients with chronic active type B hepatitis. Eleven patients (78.5%) became positive for serum anti-HBc IgM either during or shortly after prednisone withdrawal. Detection of anti-HBc IgM correlated with an increase in hepatitis B virus specific DNA-polymerase activity and was followed by a rise in serum transaminase levels. Six patients with histologic evidence of cirrhosis developed anti-HBc IgM which lasted six or more months after prednisone therapy and had a rapid onset of hepatic decompensation manifested by encephalopathy with ascites and/or variceal bleeding. In 17 untreated chronic active type B hepatitis patients who served as controls, anti-HBc IgM was detected at low levels in only a single serum sample from each of two patients during the same observation period. PMID- 6500509 TI - Basement membrane production by hepatocytes in chronic liver disease. AB - The immunohistologic distribution of fibronectin, laminin, type IV collagen and whole basement membrane was evaluated in liver biopsies from patients with chronic active liver disease. Fibronectin was consistently increased in the areas of piecemeal necrosis, portal tracts and fibrous septa. Laminin was not detected in normal liver parenchyma. In contrast, laminin positive linear basement membrane structures were prevalent in portal tracts, fibrous septa and the peripheral sinusoids of cirrhotic nodules. In areas of piecemeal necrosis, the hepatocytes, single or assembled in "rosettes", were frequently underlined by linear deposits of laminin and type IV collagen. This immunoreactivity was often polarized, being confined to the stromal side of liver cells, while the parenchymal side was negative for both proteins. Electron microscopy revealed a typical basement membrane in corresponding areas. Hepatocytes normally do not produce a basement membrane, but do so following chronic injury. We suggest that the polarized basement membrane accumulation by hepatocytes is a hallmark of hepatocyte regeneration following damage. PMID- 6500510 TI - The fate of polymeric and secretory immunoglobulin A after retrograde infusion into the common bile duct in rats. AB - In the rat, plasma IgA is rapidly endocytosed by hepatocytes and translocated to the bile via a receptor-mediated vesicular transport system which appears to remain intact even during cholestasis. During the latter phenomenon, there is an accumulation of secretory IgA (sIgA) in plasma. These data suggest that biliary IgA can be regurgitated into the plasma compartment. The present study was designed to determine the location and mechanism(s) by which this might occur. 125I-labeled human polymeric IgA (pIgA) or sIgA was infused retrograde into the rat common bile duct at a flow rate of 20 microliter per min (5 to 10 micrograms per min pIgA; 7 micrograms per min sIgA) over 1 hr. Blood and liver samples were collected 10, 30 and 60 min, and radioactivity determined. Radioactive label appeared in the blood by 10 min and increased linearly with time. By 30 min, however, the liver had reached saturation. All of the label found in the blood was intact starting material, i.e., pIgA or sIgA. Electron microscopic autoradiography analysis clearly demonstrated the presence of grains in vesicles in hepatocyte pericanalicular cytoplasm, as well as in vesicles near the sinusoidal plasma membrane. No grains were observed associated with bile duct or ductule epithelium at any time period. Further, there was no grain accumulation near the parenchymal cell intercellular spaces indicating that paracellular flow plays little or no role in large protein regurgitation. In addition, by 60 min, there were grains associated with Kupffer cells. These data provide the first evidence that hepatocytes, during times of elevated biliary pressure can readily transport macromolecules from bile to plasma via nonreceptor-mediated membrane limited vesicles. PMID- 6500511 TI - Effects of propranolol on azygos venous blood flow and hepatic and systemic hemodynamics in cirrhosis. AB - The effects of propranolol on blood flow through gastroesophageal collaterals and on systemic and hepatic hemodynamics were investigated in 23 cirrhotic patients with portal hypertension. Gastroesophageal collateral blood flow was evaluated by the measurement of azygos venous blood flow by continuous thermal dilution. Azygos venous blood flow was markedly increased in these patients (544 +/- 48 ml per min, as compared with 132 +/- 18 ml per min in subjects without portal hypertension (p less than 0.001). Propranolol at doses achieving effective beta blockage (83 +/- 5 mg) (mean +/- S.E.M.) markedly reduced azygos venous blood flow (to 354 +/- 34 ml per min, p less than 0.001). Reduction of azygos venous blood flow (-34.2 +/- 3.6%) was significantly greater (p less than 0.01) than reductions in cardiac output (-22.6 +/- 1.9%), hepatic venous pressure gradient ( 11.5 +/- 2.4%) and hepatic blood flow (-13.4 +/- 7.4%). The hemodynamic effects of propranolol were not related to plasma norepinephrine levels. Reduction of gastroesophageal collateral blood flow may be the mechanism by which oral propranolol therapy reduces the risk of repeated episodes of variceal bleeding in cirrhotic patients with portal hypertension. PMID- 6500512 TI - The nicotinic acid test in constitutional conjugated hyperbilirubinemias and effects of corticosteroid. AB - The nicotinic acid test was performed in 5 patients with Dubin-Johnson syndrome, 5 with Rotor syndrome and 13 with Gilbert's syndrome. The increment in serum bilirubin concentration and bilirubin retention 5 hr later differed; the proportion of conjugated bilirubin in the increment of total bilirubin in Dubin Johnson and Rotor syndromes was greater than in Gilbert's syndrome. These observations suggest that the nicotinic acid test reflects, in part, impaired biliary excretion of conjugated bilirubin. The results did not differentiate the two conjugated hyperbilirubinemias. The nicotinic acid test was also performed before and after corticosteroid treatment in four patients with Dubin-Johnson or Rotor syndrome. Although serum total and unconjugated bilirubin concentrations were reduced by corticosteroids, no significant change occurred in the parameters of the nicotinic acid test, suggesting that corticosteroids may enhance uptake of bilirubin without significantly altering biliary excretion of conjugated bilirubin. PMID- 6500513 TI - Culture-negative neutrocytic ascites: a variant of spontaneous bacterial peritonitis. AB - A review of the medical records of patients diagnosed as having "spontaneous bacterial peritonitis" (SBP) revealed 18 episodes of culture-negative neutrocytic ascites (CNNA) in 17 patients. The following criteria were all required in order to qualify for this diagnosis: (i) an ascitic fluid neutrophil count greater than 500 cells per mm3; (ii) negative ascitic fluid culture (5); (iii) absence of an intraabdominal source of infection; (iv) no antibiotic treatment within 30 days, and (v) no evidence of pancreatitis. Five patients had positive blood cultures. Two patients with CNNA had SBP in the past, and two other patients, who survived the episode of CNNA, subsequently developed SBP. Clinical signs and symptoms of patients with CNNA were not different from those of 32 patients with 33 episodes of culture-positive SBP. The mortality of CNNA (50%) was not different from that of SBP (70%). Because of the high mortality and because of the similarity of CNNA to SBP, it is presumed that many patients with CNNA have bacterial infection of their ascitic fluid, and it is recommended that they be treated with antibiotics. PMID- 6500514 TI - Morphologic features of the liver in abetalipoproteinemia. AB - Liver tissue of a newly diagnosed 30-year-old patient with abetalipoproteinemia was studied by light and electron microscopy. Despite accumulation of large quantities of lipid droplets in hepatocytes, the lobular architecture remained intact, and there was no fibrosis. Acanthocytes were readily identified in sinusoids by scanning electron microscopy. Profiles of rough endoplasmic reticulum, smooth endoplasmic reticulum and Golgi apparatus appeared normal by transmission electron microscopy. Lipid droplets were not bound to membranes and were not associated with the endoplasmic reticulum or Golgi apparatus. In abetalipoproteinemia, these morphological features are consistent with defective apolipoprotein B synthesis. This prevents assembly of lipoproteins that can be secreted through the normal intracellular communicating tubular network and, consequently, fat accumulates in the cytoplasm of the hepatocytes. PMID- 6500515 TI - Chronic advanced liver disease and impotence: cause and effect? AB - The prevalence of impotence is increased in males who chronically abuse alcohol. Further, impotence may occur in the absence of liver disease in such men. In contrast, no data is available concerning the prevalence of impotence in nonalcoholic men with advanced liver disease. To investigate the relationship between alcohol and impotence in cirrhotic men, a self-administered questionnaire was completed by male alcoholic cirrhotics admitted to the medical service as well as by nonalcoholic cirrhotic liver transplant candidates admitted to the medical and surgical services of Presbyterian-University Hospital. Each participant was asked whether or not he had experienced impotence and if so, to report the frequency and duration of his impotence. The frequency of impotence was recorded on a weighted scale with four gradations: 4 = always; 3 = usually; 2 = sometimes; 1 = seldom. In addition, measures of hepatic injury and function as well as measures of the functional integrity of the hypothalamic-pituitary gonadal axis for each subject evaluated were obtained. Fourteen of the 20 alcoholics with cirrhosis and 10 of the 40 nonalcoholic liver transplant candidates with cirrhosis reported a history of impotence. The association between impotence and alcohol abuse was significant. The impotence index developed by multiplying the frequency by the duration of impotency for each individual demonstrated a more severe degree of impotence in the alcoholics as compared to the nonalcoholics (p less than 0.01). The alcoholics also had lower plasma levels of testosterone and greater plasma levels of gonadotropins as compared to the nonalcoholics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500516 TI - Renal tubular damage depresses renal uric acid excretion in primary biliary cirrhosis. PMID- 6500517 TI - Hemoglobin of the adult white stork (Ciconia ciconia, ciconiiformes). The primary structure of alpha A- and beta-chains from the only present hemoglobin component. AB - The hemolysate obtained from erythrocytes of the adult White Stork (Ciconia ciconia) contains only one hemoglobin component, identified to be HbA. The complete primary structures of alpha A- and beta-chains are presented. The minor hemoglobin component HbD with alpha D-chains usually present in adult avian species was not detected by the White Stork. The sequence was determined by automatic Edman degradation of tryptic peptides and in the case of beta-chains additionally of the C-terminal peptide obtained by chemical cleavage at the Asp Pro bond. Homologous comparison with the Greylag Goose (Anser anser) hemoglobin showed that the alpha A-chains differ by 23 amino-acid exchanges, the beta-chains by 17. Four of the substitutions in the alpha A-chains are in the alpha 1 beta 1 contact points, one in the alpha 1 beta 2-contacts and one in the amino acids near the heme. The amino-acid substitutions of the White Stork hemoglobin as compared to the other avian hemoglobins are discussed. We suggest that alpha D chain is persistence of an embryonic gene. PMID- 6500518 TI - Bile secretion in hemoglobin-free perfused rat liver. AB - Hemoglobin-free perfused rat liver was demonstrated to be a suitable experimental model in studying bile secretion. Bile flow slowly decreased to more than 3 h of perfusion. Despite differences in metabolic states, the bile flow was the same in the recirculating as in the nonrecirculating mode of perfusion. Sulfobromophthalein stimulated bile flow at high rates of infusion. In bile, the ratio conjugated to unconjugated sulfobromophthalein also increased with sulfobromophthalein infusion rate. The access of [14C]insulin, [14C] sucrose, and inorganic [32P] phosphate from perfusate into bile was restricted. Bile flow, secretion of taurocholate and sulfobromophthalein, and bile pressure are compared with values from anesthetized animals and from isolated livers perfused with medium containing erythrocytes. PMID- 6500520 TI - Community services and the issue of "over census". PMID- 6500519 TI - Isolation of acid-resistant urinary trypsin inhibitors by high performance liquid chromatography and their characterization by N-terminal amino-acid sequence determination. AB - Two crude fractions of acid-resistant trypsin inhibitors (apparent molecular masses 44 and 20 kDa, respectively) were prepared from human urine by gel permeation chromatography. From both preparations the pure inhibitors were isolated by high performance liquid chromatography (HPLC). Their N-terminal amino acid sequences were determined and compared with those of HI-30 and HI-14 as isolated by reversible binding to either immobilized trypsin or immobilized chymotrypsin. The N-terminal amino-acid sequence of the high-molecular mass inhibitor UI-I isolated by HPLC was identical with those of HI-30 and UI-C-I isolated via immobilized trypsin or chymotrypsin, respectively. The low-molecular mass inhibitors UI-II and UI-C-II differ from HI-14 by the N-terminal extension Glu-Val-Thr-Lys-when obtained by HPLC or by the extension Thr-Lys-when obtained via immobilized chymotrypsin, respectively. The comparison of these N-termini with the amino-acid sequence of HI-30 (Ala1-...-Val16-Thr-Glu-Val-Thr-Lys-HI-14) defines the low molecular urinary trypsin inhibitors as proteolytic degradation products of the high-molecular urinary inhibitor. Proteolysis may occur at different bonds. The existing discrepancies in molecular architecture and in molecular masses of the urinary trypsin inhibitors are discussed. PMID- 6500521 TI - Ethical considerations in research on methadone in the treatment of schizophrenia. PMID- 6500522 TI - Changing staffing patterns in community mental health centers. AB - During the last 15 years, there have been apparently contradictory criticisms of staffing patterns, and hence of care provided, in community mental health centers (CMHCs). To test their hypothesis that heterogeneity among CMHCs is responsible for the variety of criticisms, the authors examined staffing patterns in CMHCs between 1973 and 1981, dividing the centers into groups by organizational type. They found major differences in staffing between different types of centers, and between groups of centers added to the CMHC program during different time periods. The authors discuss the criticisms leveled at CMHCs in view of their findings, and suggest the research that is needed to clarify the differences between various types of CMHCs. PMID- 6500523 TI - The remedicalization of community mental health. AB - Although the number of full-time psychiatrists working in community mental health centers has generally declined, success in retaining psychiatrists varies throughout the country. According to one study, centers that were the most successful in retaining psychiatrists were those in which psychiatrists devoted more time to clinical care and were more directly involved in outpatient work. Facing accelerated competition from nonmedical providers, psychiatrists must reassess their position in community mental health. The author discusses strategies to remedicalize community services, such as specialized programs that offer training in forensic, geriatric, and child psychiatry. PMID- 6500524 TI - How community mental health centers are coping. AB - Many community mental health centers have had to operate with less funding in the past several years, especially since the advent of block grant funding. Evidence is now accumulating that some centers have had to decrease their overall level of services and staffing. Others have attempted to adjust by increasing their clinician caseloads, closing their satellite facilities, and de-emphasizing services that fail to generate adequate fees and third-party reimbursements, such as consultation and education, partial hospitalization, and programs for children and the elderly. In contrast, and partly as a result of the increased authority of the states over the community mental health centers program, services for the severely and chronically mentally ill appear to be receiving higher priority. This development will require that centers improve their access to the general health care sector, maintain and improve their relationships with academic institutions, and increase the number, responsibilities, and rewards of the psychiatrists they employ. PMID- 6500525 TI - A preliminary assessment of the impact of block grants on community mental health centers. AB - Federal block grants to states implemented under the Reagan administration were designed to shift governmental responsibility to state and local levels. Focusing on the impact of block grants on community mental health centers, the authors consider whether states have the revenue and managerial capacity to administer block grant programs and whether they are willing to address equity issues related to access to services for low-income citizens. They report data from 36 centers in eight states showing that a majority are now receiving lower levels of federal funding and that many have reduced staffing and services as a result. To counteract the loss of federal funds, centers have increased fees and have taken steps to develop services geared toward the private sector. The authors discuss the effect of such changes on the centers and the implications for the centers' low-income clientele. PMID- 6500526 TI - Reevaluating the work of a community mental health center: the care of chronic patients. AB - Traditional forms of data-gathering have tended to underrepresent the care that community mental health centers provide to the more chronic, or seriously ill, patients. Using an alternative data-gathering method based on accumulated direct patient contacts, the authors illustrate how traditional data sets based on discharged patients and active patients yield very different views of the types of patients served and intensity of services received. Only by examining resource utilization among patients in both data sets were the authors able to show their center's extensive commitment to more chronic patients. PMID- 6500527 TI - Geographic patterns of funding for community mental health centers. AB - The author examines geographic patterns of funding for community mental health centers (CMHCs) between 1965 and 1980. Using data from the National Institute of Mental Health, he discusses the evolution of CMHC funding patterns and correlates state per capita funding within three time periods with indexes of social and financial well-being and innovativeness. The author concludes that although redistributing resources from richer to poorer states was not a major aim of the community mental health centers legislation, CMHC funding both nationally and within states was at least moderately redistributive. PMID- 6500528 TI - Gold Award: individualized treatment for substance abusers. Alcohol and Drug Abuse Unit, Southeast Louisiana Hospital, Mandeville, Louisiana. PMID- 6500529 TI - Nurse-psychotherapists: whom do they treat? PMID- 6500530 TI - Mobile medical screening teams for public programs. PMID- 6500531 TI - Alzheimer's disease. PMID- 6500532 TI - Diagnosis and disposition. PMID- 6500533 TI - Cost control's impact pervades '84 news. PMID- 6500534 TI - Multis' 1984 growth: small in numbers, large in impact. PMID- 6500535 TI - Trustees saw raised expectations; PR and lobbying roles grew in 1984. PMID- 6500536 TI - Medical staff changes 'largest in 20 years'. PMID- 6500537 TI - Suppliers squeezed by shorter stays and lower demand. PMID- 6500538 TI - Freestanding emergency and surgery centers proliferate. PMID- 6500540 TI - PPS prompts home care rise; few hospice benefit takers. PMID- 6500539 TI - PPO networking up; HMOs grow 15 percent. PMID- 6500541 TI - Utilization drop prompts layoffs; labor balks at bearing the brunt. PMID- 6500542 TI - Health care stocks, bonds suffered; creative financings appeared in '84. PMID- 6500543 TI - Hospital marketing came of age this year. PMID- 6500544 TI - Exclusive-source contracts among year's top legal issues. PMID- 6500545 TI - Hopes of earlier diagnosis spur research, despite costs. PMID- 6500546 TI - A review of health care television programming. PMID- 6500547 TI - Morality dissected: a plea for reform of current policies with respect to autopsy. PMID- 6500548 TI - A study of tumor progression: the precursor lesions of superficial spreading and nodular melanoma. AB - Six evident lesional steps of tumor progression form the neoplastic system that affects the human epidermal melanocyte: 1) the common acquired melanocytic nevus; 2) a melanocytic nevus with lentiginous melanocytic hyperplasia, i.e., aberrant differentiation; 3) a melanocytic nevus with aberrant differentiation and melanocytic nuclear atypia, i.e., melanocytic dysplasia; 4) the radial growth phase of primary melanoma; 5) the vertical growth phase of primary melanoma; and 6) metastatic melanoma. The common acquired melanocytic nevus is viewed as a focal proliferation of melanocytes, destined in most instances to follow a programmed pathway of differentiation that leads to disappearance of the nevus. If the pathway of differentiation is not followed, characteristic lesions result, and such lesions are regarded as the formal histogenetic precursors of melanoma. Such a developmental flaw is termed aberrant differentiation, and the resultant precursor lesion is designated melanocytic dysplasia. The vast majority of melanocytic nevi showing melanocytic dysplasia are terminal lesions that do not progress to melanoma. If melanoma is to develop via a precursor lesion, however, the nevus with melanocytic dysplasia is that precursor. When melanomas do develop, they develop focally within the precursor. The resultant primary melanoma itself does not follow a pathway of inexorable expansion of a population of melanoma cells in space and time. Rather, primary melanomas, with the exception of nodular melanoma, also evolve in a stepwise fashion. The first step, termed the radial growth phase, is characterized by the net enlargement of the tumor at its periphery, along the radii of an imperfect circle. Tumors in this stage of development show a characteristic pattern of growth within the epidermis and a distinctive form of invasion of the papillary dermis. Such melanomas are not associated with metastasis, and it is hypothesized that such tumors do not have competence for metastasis. For a melanoma to acquire competence for metastasis it must progress to the next step of tumor progression--the vertical growth phase. This lesional step is characterized by the appearance of a new population of cells within the melanoma, not an expansion of the cells forming the pre-existing radial growth phase. The net growth of the cells of the vertical growth phase is perpendicular to the directional growth of the radial growth phase. As a rule, the cells of the vertical growth phase grow in an expansile fashion, expansile as a balloon expands: a growth form characteristic of metastases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6500549 TI - Peliosis-like ultrastructural changes of the hepatic sinusoids in human chronic hypervitaminosis A: report of three cases. AB - In addition to hypertrophy of Ito cells and perisinusoidal fibrosis, previously unrecognized ultrastructural abnormalities of the hepatic sinusoids were observed in three patients with chronic hypervitaminosis A: 1) large areas of communication between the sinusoidal lumina and the perisinusoidal spaces, allowing extravasation of blood cells; 2) marked dilation of the perisinusoidal spaces; and 3) swelling and clarification of endothelial cells. Most of these changes, along with some other sinusoidal barrier alterations previously reported in chronic hypervitaminosis A (i.e., bleb formation on the sinusoidal membrane of the hepatocytes and the presence of multiple cellular layers lining the sinusoids), are strikingly similar to those observed in peliosis hepatis. The present findings suggest that sinusoidal barrier abnormalities might constitute a major event in the pathophysiology of vitamin A-induced liver injury as well as of peliosis hepatis. PMID- 6500551 TI - Nodular mediastinal amyloidosis. AB - A 67-year-old woman presented with supraclavicular lymphadenopathy, a large mediastinal mass, marrow plasmacytosis, and paraproteins, including free lambda light chains, in the serum and urine. Biopsies of the lesions demonstrated nodular amyloidosis, which was confirmed by ultrastructural and cytochemical analyses. Immunoperoxidase staining indicated that the amyloid was composed of lambda light chains. Nodular mediastinal amyloidosis is a rare manifestation of amyloidosis and appears to be a form of immunocytic amyloidosis. PMID- 6500550 TI - Morphologic and morphometric analyses of muscle in the neonatal myotonic dystrophy syndrome. AB - Autopsy studies of three premature siblings who died soon after birth with the neonatal myotonic dystrophy syndrome revealed pulmonary hypoplasia and congenital pleural effusions. Neither of these findings has been described previously in this condition. New ultrastructural findings include focal diaphragmatic myofiber degeneration and necrosis, which were attributed to over-stretching of the fetal diaphragm. In addition, abnormally small stores of free and intravesicular glycogen were observed in skeletal muscle fibers. The morphometric features of control fetal and neonatal skeletal muscle were recorded for comparison with muscle fiber measurements in the three infants. Fiber diameters in the latter were much smaller than expected for body weights. The morphologic and morphometric findings support the concept that fetal muscle maturation is severely retarded in this syndrome. PMID- 6500552 TI - Membranoproliferative glomerulonephritis and amyloidosis. AB - The first known case of membranoproliferative glomerulonephritis co-existing with amyloidosis is reported. The question of whether the amyloidosis was secondary to the glomerulonephritis or whether primary amyloidosis co-existed with membranoproliferative glomerulonephritis is addressed. PMID- 6500553 TI - Villous papilloma of the gallbladder in association with leukodystrophy. AB - A 2-year-old girl with metachromatic leukodystrophy had an unusual papilloma of the gallbladder. The association of metachromatic leukodystrophy and gallbladder disease in children is recognized. The striking anemone-like configuration of this tumor is remarkably unlike those of other papillomas described in the literature. PMID- 6500554 TI - Intraductal breast papilloma with squamous metaplasia in Peutz-Jeghers syndrome. PMID- 6500555 TI - Complementation analysis in lymphoid cells from five patients with different forms of maple syrup urine disease. AB - The possibility of genetic heterogeneity in maple syrup urine disease was investigated by measuring branched-chain ketoacid dehydrogenase in polyethylene glycol-induced heterokaryons of lymphoid cells. The lymphoid cell lines from five patients with varying forms of the disease were established after incubation with Epstein-Barr virus. The results suggested that there are at least two genetic complementation groups in the disease. PMID- 6500557 TI - The gene for human fibroblast interferon (IFB) maps to 9p21. AB - The interferons have been classified into alpha, beta, and gamma (leukocyte, fibroblast, and immune). We used a human genomic clone for beta 1 interferon IFB to determine the gene copy number in two patients with unbalanced rearrangements of 9p. Our results provide evidence for regional assignment of this gene to 9p21. PMID- 6500556 TI - HLA as a marker of the hemochromatosis gene in Sweden. AB - The frequency of HLA-A3 and HLA-B14 antigens was found to be significantly (P = less than 0.0001) higher in a series of 50 unrelated and unselected Swedish patients with idiopathic hemochromatosis (IH) than in controls, being 66% and 32% for A3 and 22% and 2% for B14. The haplotype A3B14 was associated with the highest risk in this material (relative risk 23.4). One family with this haplotype was traced back to the end of the seventeenth century. The pattern of HLA antigens associated with IH in Sweden shows remarkable similarity to those reported from England and Brittany. PMID- 6500558 TI - A unique electrophoretic slow-moving glucose 6-phosphate dehydrogenase variant (G6PD Asahikawa) with a markedly acidic pH optimum. AB - A new glucose 6-phosphate dehydrogenase (G6PD) variant associated with chronic nonspherocytic hemolytic anemia was discovered in Japan. The patient showed hemolytic crises after upper respiratory infections. The enzyme activity was about 3.8% of the normal. The partially purified enzyme revealed slow anodal electrophoretic mobility, high Km NADP, marked thermal-instability, and increased affinity for a substrate analogue (deamino-NADP). A particular characteristic of this enzyme was a biphasic pH curve with a greatly increased activity at low pH values. From these results, this variant was clearly different from hitherto observed G6PD variants, and was designated G6PD Asahikawa. PMID- 6500559 TI - The mode of inheritance of psoriasis: evidence for a major gene as well as a multifactorial component and its implication for genetic counselling. AB - Complex segregation analysis of Lomholt's family data on psoriasis on the Faroe Islands gave evidence for an additive major gene with gene frequency of 0.07 and penetrance 0.12 and 0.44 in the heterozygote and in the homozygote, respectively. In addition, there was a multifactorial component with heritability 0.87. The implications of these findings for genetic counseling are discussed and analytical risk figures are presented for chosen pedigrees. PMID- 6500561 TI - The phenotypic effects of small, distal Xq deletions. AB - The effects of small, distal Xq deletions (Xq26----qter) have been reviewed in light of three cases of our own and five from the literature. The symptoms caused by such deletions range from apparently none through irregular menstruation to secondary amenorrhea (or premature menopause) to primary amenorrhea. That the abnormal chromosome has any effects when it is inactivated may best be explained by one or by a combination of the following hypotheses. (1) the Xq-chromosome might exert an effect during development when cells in which it is active compete with cells in which it is inactivated, assuming that the inactivation of the two X chromosomes is originally random. (2) a more probable hypothesis is that there is a position effect when a break has occurred in the critical region Xq13----q27 which apparently must be intact in both X chromosomes to allow normal development of the ovaries. (3) this position effect might, in turn, affect the oocytes (and thus the ovary) after the inactive X chromosome is reactivated before meiosis or the deletion as such might have a direct effect on the ovaries. PMID- 6500560 TI - Pure monosomy and trisomy 2q24.2----q3105 due to an inv ins(7;2)(q21.2;q3105q24.2) segregating in four generations. AB - An inv ins(7;2)(q21.2;q3105q24.2) was found to segregate through four generations of a family. Adjacent-1 segregation aneusomies were ascertained in five patients: three monosomics and two trisomics; and the corresponding syndromes were delineated. The comparative analysis between these and other previously described 2q aneusomic individuals led to the conclusion that a large cleft between first and second toes is a constant feature in monosomy 2q24----q31. No other trait could plausibly be mapped. Risks of 7.9 to 31.6% for aneusomic children and of 26.3% for abortion were estimated in the present family. PMID- 6500562 TI - Segregation of two independent chromosomal translocations in one family. AB - A family with two independent reciprocal translocations t(3;19) and t(16;22) is described. The proband, a 4-week-old male, was phenotypically conspicuous with multiple congenital anomalies. Cytogenetic examination revealed a balanced reciprocal translocation (3;19) and a supernumerary small marker chromosome. His mother carried two balanced reciprocal translocations, the one found in the proband and a reciprocal translocation (16;22). The maternal grandmother and a maternal uncle were identified as carriers of a single translocation (16;22). The findings in the family members permitted the identification of the proband's marker chromosome as a derivative chromosome 22 resulting in partial trisomy 16 and 22. PMID- 6500564 TI - Genetic polymorphism of complement C6 and haplotype analysis between C6 and C7 in a Japanese population. AB - Genetic polymorphism of C6 in the Japanese population has been described using polyacrylamide gel isoelectric focusing electrophoresis followed by the electrophoretic blotting technique, and haplotype analysis between C6 and C7 has also been investigated. In 565 plasma samples five different common patterns and three rare variant patterns were observed, and these were controlled by autosomal codominance at a single locus with three common and one rare alleles. These alleles were designated C6*B, C6*A, C6*B2, and C6*M, and gene frequencies were estimated to be 0.50265, 0.43186, 0.06018, and 0.00531 for C6*B, C6*A, C6*B2, and C6*M, respectively. It is noteworthy that C6*B2 has a polymorphic frequency in the Japanese population. The distribution of phenotypes fitted the Hardy-Weinberg equilibrium. Two combinations between C6 and C7 alleles, namely C6B-C7B and C6M C7B, were shown to be in significant positive linkage disequilibrium. The presence of allelic combinations showing linkage disequilibrium suggests the close proximity between the C6 and C7 loci. PMID- 6500565 TI - Development and behavior of synaptonemal complexes in human spermatocytes by light and electron microscopy. AB - We describe in this paper the human male synaptic cycle using light and electron microscopy and the distribution of cells in the different stages of prophase I. The pattern of chromosome pairing and synapsis is an important tool to determine accurately whether a given synaptic behavior in infertile or sterile men is really abnormal or not. The relationship of prepachytene to pachytene cells is also important for the diagnosis of the different types of meiotic arrest at the primary spermatocyte level. PMID- 6500566 TI - The identification of a DNA polymorphism of the alpha fibrinogen gene, and the regional assignment of the human fibrinogen genes to 4q26-qter. AB - We have identified a common restriction fragment length polymorphism of the alpha fibrinogen gene with the enzyme TaqI. This polymorphism is probably due to a single base change that creates or destroys a TaqI recognition site about 1000 basepairs from the 3' end of the alpha fibrinogen gene. The frequency of the rare allele in 83 unrelated healthy individuals is 0.33. We have used in situ hybridisation of the alpha fibrinogen cDNA to localise the gene on chromosome 4q29-31. We have confirmed this regional localisation by restriction fragment detection in a human X Chinese hamster somatic cell hybrid which contains a translocated human chromosome 4 with a breakpoint at 4q26. The alpha, beta, and gamma fibrinogen genes are all present on human chromosome 4q26-qter. PMID- 6500567 TI - Distal duplication 14q: report of three cases and further delineation of the syndrome. AB - Three cases of distal duplication 14q are presented. The first two cases are cousins in a kindred segregating a balanced translocation t(14;18)(q31;q23). The third case resulted from a maternal translocation t(14;18)(q24;p11). By review of these cases and those previously reported, a distal duplication 14q syndrome is further delineated. Common features include postnatal growth retardation, mental retardation, hypotonia, microcephaly, slanted palpebral fissures, ocular hypertelorism, sparse eyelashes and eyebrows, nasal dysmorphism, tented lip, micrognathia, posteriorly rotated ears, and minor skeletal anomalies. PMID- 6500569 TI - The two apolipoprotein loci apo A-I and apo A-IV are closely linked in man. AB - In man the closely linked genes for the apolipoproteins A-I and C-III have been assigned to chromosome 11. Linkage studies performed in a Norwegian family with a mutant apoA-I gene established a close linkage between the loci for apoA-I and apoA-IV. For both sexes combined, the peak lod score was 3.01 at a recombination fraction of 0 = 0.00. Thus this study adds the locus of apoA-IV to the previously reported apolipoprotein gene cluster on chromosome 11. The previously unidentified polymorphic serum protein, USP1, is by immunochemical and electrophoretical methods identified as apoA-IV. ApoA-IV typing should be a valuable tool in elucidating the genomic organization of chromosome 11. PMID- 6500568 TI - The association of the nucleolus and the short arm of acrocentric chromosomes with the XY pair in human spermatocytes: its possible role in facilitating sex chromosome acrocentric translocations. AB - Sex vesicle-nucleolus association was observed in 12% of zygotene and pachytene human spermatocytes using Giemsa and NOR-silver stained preparations. The silver positive area of the nucleolus, corresponding to the nucleolus organizer (NOR), was usually close to the XY pair. C-banding frequently showed the terminal chromomere, formed by the condensed short arm of an acrocentric bivalent, attached to the sex vesicle. When a nucleolus produced by transcription of rDNA was connected to the short arm, it seemed to be secondarily associated with the sex vesicle. Non-transcribed ribosomal genes, which did not form a nucleolus, were revealed by in situ hybridization. Autoradiographs showed the rDNA containing short arm of acrocentric bivalents associated with the sex vesicle in 18% of spermatocytes. The difference with the frequency of nucleolus-XY pair association was partially explained by the presence of inactive ribosomal genes. Moreover, electron microscopy showed that the dimensions of the newly formed nucleoli at early zygotene did not exceed 0.5 micron; they can be missed in light microscope investigations. From early zygotene to late pachytene, close relationships were observed between the sex vesicle chromatin and that of the associated acrocentric bivalent, especially in the short arm region. These relationships might explain the frequent involvement of acrocentrics in Y autosome and X-autosome translocations occurring during male meiosis. PMID- 6500571 TI - Folic acid and chromosome breakage. II. A methionine effect similar to that in fragile X expression. AB - The absence of folic acid results in an increase in spontaneous chromosome breakage in the presence of, but not in the absence of, methionine. This is similar to the methionine effect seen in studies of the fragile X chromosome. The results support the idea that fragile sites and at least some types of spontaneous chromosome breaks may share a common mechanism. PMID- 6500572 TI - Gene frequencies of S-adenosylhomocysteine hydrolase (SAHH) in a Japanese population. AB - Genetic polymorphism of S-adenosylhomocysteine hydrolase (SAHH) was investigated in a total of 214 red blood cell samples from unrelated Japanese using the starch gel electrophoresis and the enzyme-specific staining procedures. Three common phenotypes were observed which corresponded to SAHH 1, SAHH 2-1, and SAHH 2, controlled by two alleles, SAHH*1 and SAHH*2. The estimated gene frequencies of SAHH*1 and SAHH*2 in Japanese were 0.953 and 0.047, respectively. This result was not different from European samples reported by Bissbort et al. (1983). PMID- 6500570 TI - Electrophoretic variants of blood proteins in Japanese. III. Triosephosphate isomerase. AB - A total of 15,387 individuals living in Hiroshima and Nagasaki, of whom 10,864 are unrelated, were examined for erythrocyte triosephosphate isomerase (TPI) by starch gel electrophoresis using TEMM buffer, pH 7.4. Four kinds of new variants, one having a cathodal migration and three having anodal migrations, were encountered in this population. These variants were further characterized by starch gel electrophoresis using tris-EDTA buffer, pH 9.3, and isoelectric focusing. An anodally migrating allozyme TPI 2HR1 exhibited markedly decreased enzyme activity, as evaluated by the staining intensity of the variant bands. The level of TPI activity in erythrocytes from this individual with the phenotype TPI 1-2HR1 was about 60% of the normal mean. Family studies confirmed the genetic nature of all the variants. PMID- 6500573 TI - Trisomy 14 by paternal origin. PMID- 6500574 TI - Increased sister chromatid exchanges in human cell lines characterized by monosomy X or structural abnormalities of the X chromosome. AB - In the present investigation we test the hypothesis that deficiencies of the X chromosome affect sister chromatid exchange (SCE) frequencies in human fibroblast cell lines. Our results show increased mean SCE frequencies in cell lines with abnormalities of the X chromosome: 45,X; 46,X,del(X) (q13), 46,X,del(X)(p11), and 46,X,i(Xq); control cell lines were 46,XX. In only one abnormal line [46,X,del(X)(p11)] was the increase not significant after correcting for multiple comparisons. If SCE formation is replication-dependent, the increased SCE frequencies might merely reflect the prolonged cell cycle we reported previously in cell lines with X chromosome abnormalities (Simpson and LeBeau 1981). Other explanations for differences between cell lines are possible, e.g., that deleted loci on the X chromosome affect cellular uptake of bromodeoxyuridine (BrDU). However, specific mechanisms were not explored directly. PMID- 6500563 TI - Cystic kidneys. Genetics, pathologic anatomy, clinical picture, and prenatal diagnosis. AB - According to the classification of Osathanondh and Potter of cystic kidneys we give an overview of the different types of cystic changes taking genetic aspects into account. Usually pathoanatomic types do not represent genetic entities: All type I kidneys are transmitted in an autosomal recessive way with varying clinical symptoms; in rare cases they even present in adults. The relationship to "congenital hepatic fibrosis", "cystic liver", and to the "Caroli syndrome" is discussed. Type II kidneys are usually not genetic in origin; but they may occur as part of several syndromes. Rarely genetic factors might contribute to type II kidneys that may present as familial cases of Potter syndrome ("renal non function syndrome"). Type IV kidneys, although different in their pathoanatomic picture can be regarded according to a common pathogenetic theory as part of the spectrum of malformations as in type II. Therefore the genetic interpretation of type II kidneys also applies to type IV lesions. Type III kidneys include autosomal dominant polycystic kidney disease. This type may already present in childhood; the first prenatal diagnosis by ultrasonography is described in detail. Furthermore type III changes are part of syndromes or non-hereditary malformation complexes, and often present only as mild manifestations. Diseases with isolated involvement of the medulla (juvenile nephronophthisis/medullary cystic disease) or cortex are described as part of the differential diagnosis, they are heterogeneous and genetically only partly understood. Syndromes with cystic kidneys are reviewed as well as the possibilities of prenatal diagnosis of cystic diseases. Reliable prenatal diagnosis is only possible in type II, and possible in some of the other types. The nosology is improved if genetic information is taken into account. PMID- 6500575 TI - The frequency of 47,+21,47,+18, and 47,+13 at the uppermost extremes of maternal ages: results on 56,094 fetuses studied prenatally and comparisons with data on livebirths. AB - We examined the proportions (or so called "rates") of fetuses with 47,+21, 47,+18, or 47,+13 diagnosed prenatally in women at the upper extremes of age. Our analysis was prompted by results from a large scale European study of amniocentesis which indicated that after increasing exponentially from age 35 years, the proportions of the autosomal trisomies reached a peak at a specific age and then leveled off or declined at the upper end of the age range. We analyzed North American data on 56,075 fetuses studied because of no known cytogenetic risk factor (aside from maternal age). This is the largest series to date. For 47,+21, the data from amniocentesis studies provide no evidence for any drop in the rate of change of proportion with maternal age up to 49 years. There is, if anything, a trend in our data to a steepening in the exponential rate of change at the upper extreme of age (above 46 years). Data from livebirths on the Down syndrome phenotype are at least consistent with an exponential rate of increase in proportion affected up to age 49 years. For 47,+18 our data from prenatal diagnoses are more consistent with an exponential increase up to age 43 years and a level proportion (or "rate") after that. For 47,+13 no cases were observed above age 42 years, consistent with the drop in proportion affected above this age observed in the European series. We emphasize the possible effect of sampling fluctuation and reporting error upon these apparent trends. PMID- 6500576 TI - Human genes for glutathione S-transferases. AB - The tissue distribution of different glutathione S-transferases (GST) is analysed by electrophoresis. The existence of GST"e" (erythrocyte), GST3, GST1, and GST2 is confirmed. GST"e" the fastest and most thermolabile of different GST analysed is observed only in erythrocyte cells. GST3 which migrates more slowly than GST"e" is present in all tissues and cells analysed, excepted for erythrocyte cells in which only GST"e" is observed. GST1 presents a polymorphism with four phenotypes, 1, 1/2, 2, and 0 controlled by three alleles 1, 2, and 0 (null). With the sample of 56 livers analysed the different frequencies obtained are 9%, 5%, 43%, 43% for the phenotypes 1, 1/2, 2, and 0 respectively and 0.074 (p), 0.279 (q), 0.647 (r) for the alleles, 1, 2, and 0 (null). GST2 presents variant patterns due probably, in the majority of cases, to post-synthetic modifications rather than allelic variation. Two new GST are described, GST4 and GST5. GST4 abundant in muscle tissue is a dimeric protein. GST4 forms with GST1 a heterodimeric band. GST5 is observed in brain homogenates. For the chromosome localization the results obtained by man (leucocytes)-mouse somatic cell hybrid analysis indicate that the gene for leucocytes GST is on chromosome 11. This gene is the structural GST3 gene. PMID- 6500577 TI - Studies on chiasma frequency and distribution in two fertile men carrying reciprocal translocations; one with a t(9;10) karyotype and one with a t(Y;10) karyotype. AB - The frequency and distribution of chiasmata was investigated in two fertile carriers of reciprocal translocations, one with a 46,XY,t(9;10)(p22;q24) karyotype and one with a 46,X,-Y,+der(Y),t(Y;10)(q12;q24) karyotype. In both cases the chromosomes involved in the translocation showed an increase in chiasma frequency in comparison to karyotypically normal controls and in both cases this increase was localised, affecting only one interstitial segment of each translocation quadrivalent. In the t(9;10) case chiasmata appeared in substantial numbers in a novel location, the proximal two thirds of 9p, while in the t(Y;10) case chiasmata appeared in a conventional location, the medial region of 10q, but at an increased frequency. Furthermore there was evidence for inter-chromosomal effects in the t(9;10) case. PMID- 6500578 TI - Separation of retinoblastoma and esterase D loci in a patient with sporadic retinoblastoma and del(13)(q14.1q22.3). AB - A chromosome 13 deletion in a patient with sporadic retinoblastoma appears to have separated the loci for retinoblastoma and esterase D. This study indicates that: (1) the retinoblastoma locus is distinct from the esterase D locus; and (2) the linear order of these genes is centromere-esterase D-retinoblastoma. PMID- 6500579 TI - A new alpha 2HS-glycoprotein allele (AHS*5) in two Japanese families. AB - Serum specimens of two unrelated Japanese males had a new variant of the alpha 2HS-glycoprotein phenotypes. They had unusual bands designated AHS 5. Family studies indicated that the new variant phenotypes were determined by a new allele, AHS*5, in combination with a common allele AHS*1 or AHS*2, and that the new allele had an autosomal codominant inheritance with other AHS alleles. The frequency of the new alpha 2HS-glycoprotein allele, AHS*5, is 0.0005. PMID- 6500580 TI - Origin of extra chromosome in Patau syndrome. AB - Five live-born infants with Patau syndrome were studied for the nondisjunctional origin of the extra chromosome. Transmission modes of chromosomes 13 from parents to a child were determined using both QFQ- and RFA-heteromorphisms as markers, and the origin was ascertained in all of the patients. The extra chromosome had originated in nondisjunction at the maternal first meiotic division in two patients, at the maternal second meiosis in other two, and at the paternal first meiosis in the remaining one. Summarizing the results of the present study, together with those of the previous studies on a liveborn and abortuses with trisomy 13, nondisjunction at the maternal and the paternal meiosis occurred in this trisomy in the ratio of 14:3. This ratio is not statistically different from that inferred from the previous studies for Down syndrome. These findings suggest that there may be a fundamental mechanism common to the occurrence of nondisjunction in the acrocentric trisomies. PMID- 6500581 TI - Partial trisomy 18 due to a maternal translocation t(9;18). PMID- 6500582 TI - Prenatal diagnosis by trophoblast sampling. PMID- 6500583 TI - Influence of fusion cell ratio and cell plating density on production of human human hybridomas secreting anti-DNA autoantibodies from patients with systemic lupus erythematosus. AB - The utilization of one human lymphoblastoid cell line in fusion experiments with peripheral blood lymphocytes from patients with systemic lupus erythematosus (SLE) has made it possible to define efficient and reproducible conditions for the production of anti-DNA-secreting human-human hybridomas. This investigation, using the human lymphoblastoid cell line GM 4672 fused in the presence of 44% polyethylene glycol with lymphocytes from SLE patients, demonstrated a maximal yield of 22.8% hybridomas, 17% of which produced anti-DNA antibodies. We were able to define, in two independent laboratories, that the maximal yield of hybridomas occurred when the lymphocyte to GM 4672 cell ratio was 1:1 and cells were seeded in 2.0 ml wells at a concentration of 4 X 10(5) cells/well. This report demonstrates the reproducibility of human-human hybridoma production with the GM 4672 cell line and the establishment of efficient conditions for the production of anti-DNA autoantibodies from SLE patients. PMID- 6500585 TI - Two new monoclonal antibodies to human monocytes and granulocytes: isolation of membrane antigens and lack of effects of antibodies on leukocyte functions in vitro. AB - Mice were immunized with purified human monocytes or granulocytes obtained by leukapheresis and isolated on dextran gradients or by countercurrent centrifugation-elutriation. A monoclonal antibody, Mo95, was generated in response to monocytes and was found to react strongly with monocytes, large granular lymphocytes (LGL), granulocytes, eosinophils, and some myelomonocytic leukemia cells, but not with normal T or B lymphocytes, platelets, red cells, or leukemic cell lines. Mo95 is an IgG1 antibody, which precipitated a 95 kD molecular weight antigen. Addition of the Mo95 antibody to monocytes in the absence of complement did not inhibit lysozyme secretion nor did it affect superoxide production, C3b-rosetting, nitrotetrazolium blue reduction, phagocytosis, or chemotactic responses. A second antibody, PMN70, was found to react exclusively with granulocytes and not with monocytes, lymphocytes, LGL, platelets, red cells, or any of the myelomonocytic, T-cell-derived or B-cell derived leukemic cell lines tested. The PMN70 antibody immunoprecipitated a 70 kD molecular weight antigen found only on mature granulocytes. Mo95 and PMN70 appear to be distinct from five other tested monoclonal antibodies reactive to monocytes and/or granulocytes on the basis of the fluorescent cell sorter and immunoprecipitation studies performed. PMID- 6500584 TI - Monoclonal antibodies to human colorectal tumor-associated antigens: improved elicitation and subclass restriction. AB - Monoclonal antibodies to tumor-associated antigens (TAA) of human colorectal cancer were elicited using immunosorbents of lectins combined with peripheral protein extracts of xenografted colon adenocarcinoma. This method of immunization was compared with whole cells from surgical specimens and to crude membranes from xenografted tumors. The immunosorbent immunogens were superior to the other immunogens in three ways: (1) the number of hybrids reactive with colon tumor cells or extracts, but not with lymphoid cells or extracts, (2) the number of stable hybrids after cloning, and (3) the number of hybridoma clones reactive with tissue sections of colon tumors, but not normal colonic mucosa. In addition, lectin immunosorbents elicited primarily IgG antibodies, especially IgG3, with almost 50% of the clones of interest reacting to seemingly less immunogenic glycoproteins. The improved elicitation of monoclonal antibodies to TAA by the use of lectin immunosorbents and peripheral protein extracts has considerable potential for generating reagents useful in diagnosis and therapy of human tumors. PMID- 6500586 TI - Elimination of mycoplasma, bacteria, and fungi contaminants of hybridoma cultures by intraperitoneal passage in the mouse. PMID- 6500587 TI - Establishment of monoclonal anti-Nk-1.1 antibody. PMID- 6500588 TI - Simulated and experimental studies of temperature elevation around electrosurgical dispersive electrodes. PMID- 6500589 TI - Investigation of fertility and in utero effects in rats chronically exposed to a high-intensity 60-Hz electric field. PMID- 6500591 TI - Data reduction of body surface potential maps by means of orthogonal expansions. PMID- 6500590 TI - Estimation of QRS complex power spectra for design of a QRS filter. PMID- 6500592 TI - R-wave detection in the presence of muscle artifacts. PMID- 6500593 TI - The linear homeomorphic saccadic eye movement model--a modification. PMID- 6500594 TI - On the normalized slope descriptor method of quantifying electroencephalograms. PMID- 6500595 TI - Evaluation of light-emitting diodes for whole blood oximetry. PMID- 6500596 TI - Dielectric properties of solid tumors during normothermia and hyperthermia. PMID- 6500597 TI - Culture conditions induce the appearance of immortalized C3H mouse cell lines. AB - Mouse fibroblasts were cultured by three different procedures: (a) changing the 0.2 ml/cm2 of growth medium every 2nd d and seeding 1 X 10(5) cells/cm2 after confluency; (b) changing the 0.4 ml/cm2 of growth medium only at subculture performed at confluency by a 1:2 split and keeping the bottles incubated on a rocking platform; (c) the same as Method b but keeping the bottles stationary throughout culture. By Method a no lines were immortalized over 36 experiments whereas Method b gave 1/4 immortalized lines and Method c gave 10:12 immortalized lines. Cells always went into crisis at the 9th to 11th doubling. Immortalized lines had a tetraploid DNA content. PMID- 6500598 TI - Species specificity affects the choice of S9 preparations for use in the hamster embryo cell transformation system. AB - Before their use as a source of carcinogen-activating enzymes in the hamster embryo cell transformation assay, liver, kidney, lung, and small intestine S9 fractions from Syrian golden hamsters and Sprague-Dawley rats were evaluated for toxicity to hamster embryo target cells. Sprague-Dawley rat liver and kidney S9 were highly toxic to the hamster embryo cells (90 to 100%). When retested at lower concentrations these tissue fractions were still quite toxic (up to 75%). In contrast, hamster liver and kidney S9 were considerably less toxic (14 to 25%). The S9 preparations were also evaluated for their ability to metabolize N-2 acetylaminofluorene to 2-aminofluorene and N-hydroxy-acetylaminofluorene, products that transform hamster embryo cells. Large amounts of N-hydroxy acetylaminofluorene were formed in the presence of preparations from hamster liver and small intestine, whereas kidney and lung S9 fractions were considerably less active. No detectable levels of N-hydroxy-acetylaminofluorene were formed after incubation of N-2-acetylaminofluorene with any of the rat S9 preparations. High levels of deacetylase activity were found in hamster liver and small intestine S9 fractions, at least eightfold higher than those obtained from equivalent rat preparations. Hamster kidney and lung S9 fractions showed low levels of deacetylase activity. There was no detectable activity in equivalent preparations from rats. When tested with N-2-acetylaminofluorene in the hamster embryo cell clonal transformation system, transformed colonies were obtained with hamster liver S9, with and without an external NADPH-generating system. PMID- 6500599 TI - Optimization of the culture medium composition for the antibody response of mouse spleen cells. AB - The Mishell-Dutton culture system for in vitro primary antibody response of mouse spleen cells was used to optimize the amino acid composition of RPMI 1640 media. Each of the 20 amino acids was tested over a broad range of concentrations always leaving the remaining 19 amino acids unaltered (i.e. at the formula recommended concentration). In several instances, higher plaque-forming cell responses were obtained with an amino acid concentration that was either higher or lower than that recommended: (a) the optimum concentration for valine, glutamine, and lysine lies considerably above the recommended one, (b) the optimum concentration for leucine as well as for several other amino acids lies below the recommended concentration, and (c) the optimum concentration for arginine corresponds exactly to the recommended concentration. The second round of optimization, i.e. combining of two conditions that individually yielded an improved response often caused a decrease of response. The possibility is discussed that for an optimal response a ratio of two or several amino acids rather than the absolute concentration of any one amino acid is of importance. PMID- 6500600 TI - Enhancement of rat ACT-1 tumor clonogenicity by xenogeneic mouse macrophages. AB - In vitro growth of rat atriocaval epithelial tumor cells (ACT-1) was enhanced by the inclusion of xenogeneic mouse adherent peritoneal exudate cells (PECs) in a two-layer soft agar system. A linear relationship was found between the number of cells plated and the number of colonies when ACT-1 tumor cells were plated at plating densities of between 1 and 5 X 10(5) cell/60 mm plate (r = 0.9, P less than 0.001). Inclusion of irradiated PECs in the bioassay for tumor stem cells resulted in a two and a half-fold increase in colony formation in three separate experiments (P less than 0.001). PMID- 6500601 TI - Effects of cardioactive drugs on the beating activity of myocardial cell cultures isolated from offspring of trained and untrained pregnant rats. AB - Primary cultures of beating myocardial cells were obtained from 5-d-old offspring of trained (T) and untrained (UT), pregnant, Sprague-Dawley rats. The myocardial cells from the T and UT groups were evaluated for their beating responses to three cardioactive drugs: verapamil (V), isoproterenol (ISO), and propranolol (PRO). The myocardial cell cultures from the UT group showed complete loss of beating when the calcium (Ca++) antagonist, V, was added to the cultures for 1 h or more; the T group was able to show some beating at comparable concentrations and durations of exposure with V. The beta agonist, ISO, markedly stimulated the beating rate of both the T and UT groups, but the beating rates were higher in the UT group at comparable concentrations and durations of exposure than with the T group. When the cultures were pretreated with the beta blocker, PRO, before treatment with ISO, a concentration inhibitory effect on the beating rate was observed in both groups. However, the T cultures were more sensitive to the inhibitory effects of PRO. These results demonstrate that primary cultures of rat myocardial cells isolated from the offspring of trained and untrained pregnant rats show differential beating responses to three well-known cardioactive drugs. PMID- 6500602 TI - Differentiation-arrested rat fetal lung in primary monolayer cell culture. IV. Paradoxical effect of a "fetal" pO2 on precursor incorporation into phospholipids and hormone responsiveness. AB - Differentiation-arrested lung cell cultures were developed from fetal rats of various gestational ages. In contrast to previously published observations with cultures in a pO2 of approximately 142 mm Hg, cultures developed in a pO2 of approximately 30 mm Hg, close to the normal fetal arterial pO2, have improved plating efficiency and a slightly increased growth rate. They did not, however, show gestation-dependent increases of choline incorporation into phospholipids, nor did immature lung cell cultures respond to dexamethasone or triiodothyronine, singly or in combination, by increased choline incorporation into saturated lecithin. The incorporation of choline and glycerol into lipids suggested a mature rate of lipid synthesis by immature cultures at a pO2 approximately 30 mm Hg, despite preservation of an immature morphology. Electron microscope observations revealed no gross differences between immature cultures developed at either pO2. The cellular mechanisms underlying these differences are unclear but suggest that oxygen tension may significantly influence results obtained with in vitro studies of lipid synthesis by immature lung. PMID- 6500604 TI - Isolation and culture of the terminally differentiated adult mammalian ventricular cardiac muscle cell. AB - We have carried out systematic studies to optimize and standardize methodology to isolate and culture the adult rat ventricular cardiac muscle cell. Four hearts were perfused simultaneously with a calcium-free medium containing collagenase. The ventricular tissue was then minced and further digested to liberate individual cells. Approximately 16 million rod-shaped muscle cells were obtained. The plating efficiency has been greatly improved by culturing the cells in a conditioned medium prepared from a rabbit corneal cell line. This medium also contained added fetal bovine serum, essential and nonessential amino acids, vitamins, insulin, transferrin, and 25 trace minerals. The culture flasks were precoated with rat-tail collagen. Fibroblast contamination was virtually eliminated by including cytosine arabinoside in the medium during the first 7 d of culture. After this time the cells could be cultured in the absence of serum in a chemically defined medium composed of MEM, vitamins, nonessential amino acids, and trace minerals. They continued to contract spontaneously and do well in this medium for at least 3 d thereafter. This improved methodology resulted in a reproducible culture system with improved plating efficiency. It provided a new and unique system to study the structure and function of the adult mammalian ventricular cardiac muscle cell. PMID- 6500603 TI - Cell injury of cultured rat myocardial cells after reoxygenation of hypoxic cultures in the presence and absence of calcium. AB - Primary cultures of rat myocytes were deprived of oxygen (approximately 5 mm Hg, pO2) for 2 h in the presence or absence of calcium and were subsequently incubated for different time periods under normoxic (approximately 120 mm Hg, pO2) conditions. Myocyte calcium content was determined at the end of the oxygen free period and after repletion of oxygen. Lactate dehydrogenase (LDH) release from the cells into the medium was used as an index of cell injury. Cultures deprived of oxygen in the absence of calcium showed a significant decrease in myocyte calcium content at the end of the oxygen-free period. However, the calcium content of myocyte cultures deprived of oxygen in the presence of calcium did not change significantly. The enzyme release of both groups of oxygen deprived cultures was similar to that of controls. A progressive increase in myocyte calcium content was observed 5, 10, 15, and 30 min after repletion of oxygen in both groups. Reoxygenation of cultures subjected to hypoxia in the presence of calcium caused minimal LDH leakage. However, major enzyme release was observed 30 min after oxygen repletion in cultures previously subjected to hypoxia in a calcium-free environment. The present study shows that reoxygenation injury is more severe in myocyte cultures previously deprived of both oxygen and calcium than in cultures deprived of oxygen in the presence of calcium. PMID- 6500605 TI - Calcium regulation of normal human mammary epithelial cell growth in culture. AB - The concentration of Ca++ in culture media profoundly affected the growth and differentiation properties of normal human mammary epithelial cells in short-term culture. In media where Ca++ was above 0.06 mM, longevity was limited to an average of three to four cell divisions. The extended growth fraction (those cells able to divide more than once) was only approximately 50% and diminished to zero quickly with time. Stationary cells inhibited from dividing appeared differentiated in the formation of lipid vacuoles and accumulation of alpha lactalbumin. Growth of stationary cultures could be reinstituted in about half the cells, either by disruption and transfer or by a reduction in Ca++ to less than 0.08 mM. The reduction of Ca++ to levels below 0.08 mM extended the longevity of normal cells to eight to nine divisions. The extended growth fraction was 100%. Under these conditions, cells did not differentiate. The effects of Ca++ on growth and differentiation were specific (Mg++ and Mn++ variations were without effect) and reversible and in many respects resembled Ca++ effects on epidermal cells. One major difference is that the dual pathways of growth and differentiation in mammary cells were controlled by glucocorticoid and insulin. Based on the kinetics of the reversible Ca++-induced coupling and uncoupling of proliferation and the program of differentiation, we proposed that Ca++ may be an essential trigger for cell divisions that commit a mammary cell to differentiate progressively in a permissive hormonal milieu. PMID- 6500607 TI - Sensitivity of human pancreatic carcinoma cell line (MIA PaCa-2) to Bisantrene and Theprubicin in vitro. AB - We tested the effect of Bisantrene (BS) and Theprubicin (THP-ADR) on cell growth of a human pancreatic carcinoma cell line (MIA PaCa-2). After 1 h exposure ID50 of BS or THP-ADR was 3 X 10(-7) and 5 X 10(-8) M, respectively. Increasing the exposure time from 1 h to continuous exposure for 5d resulted in 11-fold decrease in ID50 for BS and a 6-fold decrease for THP-ADR. Both drugs inhibited [14C]thymidine incorporation to the same extent and caused an accumulation of cells into G2 + M phase of the cell cycle. PMID- 6500608 TI - Modulation of differentiation in vitro. II. Influence of cell spreading and surface events on myogenesis. AB - We examined the influence of attachment and spreading on myogenesis by adding polylysine-covered beads at different times after plating the cells on a plastic substratum. We show that polylysine per se acting on the cell surface can modulate myogenesis independently of cell spreading. Thus cell shape would not be the limiting factor for the division and differentiation of L6 myoblasts. Multinucleation of the cells was found to be first enhanced by the addition of polylysine-covered beads to replicating myoblasts, although the final percentage of fusion attained by these cultures was lower than in the controls. A similar phenomenon was observed concerning myosin synthesis. No such effect could be observed when the beads were added to a nonfusing mutant or to fibroblasts. Our results show that this phenomenon is specific. We postulate that some of the surface molecules necessary for this process appear on myoblasts shortly before they fuse. PMID- 6500606 TI - Elevated overall rates of transmethylation in cell lines from diverse human tumors. AB - In a study of a diverse set of human tumor cell lines previously shown to all have a defect in methionine metabolism (Stern, P. H., Wallace, C.D. and Hoffman, R.M., J. Cellular Physiology 119, 29-34, 1984), we demonstrate in this report that all have enhanced overall rates of transmethylation compared to normal human fibroblasts. Transmethylation rates were measured by blocking S adenosylhomocysteine hydrolase and measuring the AdoHcy which accumulates as a result of transmethylation. The enhanced transmethylation rates may be the basis of the above-mentioned defects in methionine metabolism previously reported in human tumor cells, including the basis of the inability of the majority of the tumor cells to grow when methionine is replaced by homocysteine. The excess and unbalanced tRNA methylation observed for the last 25 years in many types of cancer may be at least in part explained by our results of elevated rates of overall transmethylation in cancer cells. The alteration of such a fundamental process as transmethylation in cancer may be indicative of its importance in the oncogenic process. PMID- 6500609 TI - Comparative use of fructose and glucose in human liver and fibroblastic cell cultures. AB - The effect of fructose as a substitute for glucose in cell culture media was investigated in human skin fibroblast and liver cell cultures. Cells were grown for between 2 and 10 days in identical flasks in four different media, containing 5.5 mmol X 1-1 and 27.5 mmol X 1-1 glucose and fructose, respectively. In the presence of fructose, cell growth was stimulated, but less in liver cells than fibroblasts. At Day 6, increases were observed in [3H]thymidine incorporation, protein levels, and amino acid consumption, and a reduction was noted in ATP levels. In media containing 5.5 mmol X 1-1 glucose or fructose, consumption of fructose was four times lower than that of glucose at Day 3 and did not rise until Day 6. In fructose media, the lactate production was very low (four to five times less than that of glucose) and the pH values were always higher. Some findings were different for the fibroblasts and liver cells, owing to the specific characteristics of these two cell types in culture; this applied especially to the effects of glucose and fructose concentrations of 27.5 mmol X 1 1. Several possible explanations for the stimulation of cell growth in fructose medium were discussed. PMID- 6500610 TI - A serum-free culture system for studying solute exchanges in the choroid plexus. AB - Organ cultures of choroid plexus tissues from the lateral ventricle of juvenile rats have been maintained for periods up to 7 wk in a chemically defined, serum free media. Of several media and various supplements evaluated, the best growth and survival was obtained with the Pasadena Foundation for Medical Research-4 media supplemented with three hormones: epidermal growth factor, insulin, and hydrocortisone. Autoradiographic studies demonstrated that the epithelial cells incorporated [3H]leucine and [3H]thymidine indicating active protein and DNA synthesis, respectively. The organ cultures were characterized by bulbous, vesicular outgrowths from the choroidal villi explants. The fluid-filled lumina of the vesicles reached diameters of 900 microns and were easily accessed by micropipettes. The walls of the vesicles were composed of single layers of epithelial cells in which the ultrastructural features in the in vivo tissue were well maintained. The in vivo polarity (apical end toward the media and basilar end of the cells toward the luminal cavity) was also maintained. This morphologically stable in vitro system seems to be a promising model for investigation of secretory mechanisms of choroidal tissue. PMID- 6500611 TI - Changes in serum influence the fatty acid composition of established cell lines. AB - The fatty acid composition of different kinds of commercially available serum used to supplement cell culture media differs widely. As compared with fetal bovine serum, horse and bovine calf serum have a very high content of linoleic acid (18:2) and are low in arachidonic acid (20:4). (Fatty acids are abbreviated as number of carbon atoms:number of double bonds). Swine serum contains substantial amounts of both 18:2 and 20:4. Only fetal bovine serum contains more than 1% docosahexaenoic acid (22:6). Considerable differences in fatty acid composition occur when cells are grown in media containing any of these different serum supplements. The 18:2 and 20:4 content of 3T3 mouse fibroblast phospholipids is highest when the medium contains horse serum, intermediate with bovine calf serum, and lowest with swine or fetal bovine serum. Likewise, the highest phospholipid 18:2 content in Madin-Darby canine kidney cells (MDCK) occurs when the medium contains horse serum. With MDCK cells, however, growth in swine serum produces the highest 20:4 content. The 3T3 cell phospholipids accumulate more than 1% 22:6 only when the medium contains fetal bovine serum, whereas in no case do the MDCK cell phospholipids accumulate appreciable amounts of 22:6. The fact that the cellular fatty acid composition is likely to change should be taken into account when changes are contemplated in the serum used to grow established cell lines. PMID- 6500612 TI - Right ventricular infarction in acute inferior wall infarction. Importance of right precordial electrocardiography. PMID- 6500613 TI - Right ventricular anomalous muscle bundle: clinical, electrocardiographic, haemodynamic and angiocardiographic features. PMID- 6500614 TI - Instantaneous death. PMID- 6500615 TI - Two dimensional echocardiographic study of left ventricular false tendons--an assessment of its incidence and clinical importance. PMID- 6500616 TI - Diagnostic utility of epicardial atrial wires after open heart surgery. PMID- 6500617 TI - Clinical, bacteriological and immunological correlationship of rheumatic activity. PMID- 6500618 TI - Serum protein bound fucose in cardiovascular disorders. PMID- 6500619 TI - His bundle electrocardiography (HBE) and spatial vectorcardiography in left bundle branch block. PMID- 6500620 TI - Prevalence of hypertension in a closed urban community. PMID- 6500621 TI - Single right coronary artery and atherosclerosis. PMID- 6500623 TI - Measurement of electrical axis of heart: a new approach. PMID- 6500624 TI - [Disseminated Kaposi-sarcoma within the framework of acquired immunodeficiency syndrome]. AB - A 37-year-old homosexual man suffering from AIDS (= Acquired Immune Deficiency Syndrome) is described. This man died from disseminated Kaposi-sarcomas about one year after establishing the diagnosis. PMID- 6500622 TI - A rare case of an adult with mitral, pulmonary and tricuspid valve stenosis with an interatrial communication and acquired cyanosis. PMID- 6500625 TI - Depression of lymphocyte traffic in sheep by induced systemic arterial hypotension and by acute arterial occlusion. AB - Shock and arterial insufficiency have been observed to be associated with increased levels of sepsis and mortality. As the vast majority of small recirculating lymphocytes reach lymph nodes in arterial blood, the haemodynamic components of lymph node function would appear to be of importance. Lymphocyte traffic in sheep, as mirrored by the output of lymphocytes into the efferent lymph of popliteal lymph nodes, obtained by chronic cannulation of efferent lymphatics, was found to be sharply depressed both by intravenous nitroprusside infusion induced systemic arterial hypotension and by acute femoral arterial ligation on the side of the study node. In the nitroprusside infusion induced arterial hypotension studies, the depressions in lymphocyte traffic were closely related to the depressions in systemic arterial blood pressure. Excellent colateral circulation and compensatory physiological mechanisms in the sheep limited the duration of these depressions in lymphocyte traffic. PMID- 6500627 TI - The role of the lysosome in natural killing: inhibition by lysosomotropic vital dyes. AB - Recent evidence has indicated the importance of lysosomes in natural killing (NK). The lysosomotropic dye neutral red, at concentrations greater than 2 X 10( 5) M, inhibits NK activity of large granular lymphocytes (LGL). Inhibition is at the level of effector cell activity rather than target cell susceptibility. Neutral red inhibits NK activity without affecting the viability of the effector cell population or the response of lymphocytes to the mitogen, phytohaemagglutinin (PHA). While the mechanism of this inhibition is unknown, neutral red-treated peripheral blood lymphocytes (PBL) do not suppress untreated effector cell populations. Furthermore, neutral red does not influence the binding of effector cells to target cells. Since natural killing by neutral red treated PBL recovers slowly upon incubation of the cells at 37 degrees, inhibition is not due to selective toxocity. Trypan blue, another frequently used lysosomotropic vital stain, has no effect when effector cells are pretreated with 10(-3) M dye for 30 min or less. However, effector cells first treated with neutral red lose red granular staining following treatment with trypan blue for as little as 10 min at room temperature. Natural killing by neutral red pretreated PBL also recovers more quickly following brief incubation with trypan blue. Treatment of effector cells with trypan blue and neutral red simultaneously prevents accumulation of neutral red in cytoplasmic granules and subsequent inhibition of NK. PMID- 6500626 TI - Production of a lymphocyte proliferation potentiating factor by purified polymorphonuclear leucocytes from mice and rabbits. AB - Highly pure polymorphonuclear leucocytes (PMN) were prepared from peritoneal exudate cells which were induced by an i.p. injection of casein into C3H mice and rabbits. The PMN were tested for the production of a lymphocyte proliferation potentiating factor with various stimulations in vitro. In both animal species, the purified PMN from the inflammatory site 3 hr after injection (3-hr PMN) produced the factor upon stimulation with kaolin, while the purified PMN from the lesion 24 hr after injection (24-hr PMN) did not. The 3-hr PMN produced the potentiating factor during a relatively earlier period after in vitro stimulation with kaolin. Protein synthesis inhibitors did not inhibit the factor production, suggesting the release of a preformed factor from 3-hr PMN. The effect of kaolin did not appear to be simply due to its cytotoxicity, because the release was dependent on the metabolism of 3-hr PMN and not parallel with 51Cr-release from the PMN. The factor produced by mouse PMN had an MW of about 15,000-25,000; it consisted of two isoelectrophoretically distinct factors, i.e. pI 9.4 and 5.4. The rabbit PMN factor was slightly smaller (MW ranging between 10,000 and 20,000) than the mouse PMN factor and was composed of three pI species, i.e. 7.2, 5.4, and 4.5. PMID- 6500629 TI - H-2-controlled, dose-dependent suppression of the response that expels adult Trichinella spiralis from the small intestine of mice. AB - H-2 congenic strains of mice expressing the H-2k, H-2q or H-2f haplotype were tested for their ability to expel Trichinella spiralis from the gut following infection with either 100, 150, 200, 400, 500, or 600 L1 infective larvae. H-2q and H-2f mice expelled worms more quickly than H-2k mice when 100-200 L1 larvae were given, but this H-2-controlled effect was much reduced when mice received 400 L1 larvae, and completely eliminated when 500 or 600 L1 larvae were given. The observed dose-dependent delay in the expulsion response was paralleled by a concurrent suppression of lymphocyte responsiveness. Lymphocytes from H-2q mice infected with 100-200 L1 larvae incorporated more [3H]thymidine than did cells from H-2k mice. However, this H-2-controlled difference was not apparent in cells from mice receiving 400-600 L1 larvae. The strongest proliferation response in each case was associated with mice infected with the smallest number of worms. Since strains of mice expressing H-2q or H-2f alleles were suppressed at high doses to a much greater extent than were mice expressing H-2k, H-2 genes must influence this dose-dependent response. Many earlier studies, which failed to demonstrate marked H-2 effects on immunity to T. spiralis, employed infective doses which are shown here to be preferentially suppressive to otherwise resistant strains of mice. PMID- 6500628 TI - Source of IgA in tears of rats. AB - The purpose of the present study was to determine whether IgA in rat tears originates from serum and/or local synthesis. To examine the first possibility, we compared the IgA levels in serum and tears of rats with a portacaval anastomosis. This operation induced a chronic and progressive elevation of polymeric IgA concentrations in serum. By 8 weeks after surgery, serum IgA levels in 'portacaval' rats were 20-fold higher than those of sham-operated or intact controls. In contrast, IgA levels in tears of 'portacaval' rats did not increase after surgery, despite the availability of free secretory component (SC) in tears. The lack of correlation between tear and serum IgA concentrations resulted in a significant decrease in the tear IgA/serum IgA ratio after anastomosis surgery. To assess whether tear IgA might be derived from local synthesis, we cultured various ocular tissues from male rats in the presence or absence of cycloheximide, an inhibitor of protein synthesis. Incubation of exorbital (lacrimal) glands resulted in the accumulation of substantial quantities of IgA in the culture medium. This accumulation was significantly reduced by the presence of cycloheximide. In contrast, cycloheximide had no effect on the amounts of IgA in cultures of 'lids', Harder's glands and globes. These results indicate that IgA in rat tears originates from local synthesis and not from serum transfer. Furthermore, our findings suggest that the rat exorbital gland is responsible for the synthesis and secretion of tear IgA. PMID- 6500630 TI - Hybridoma autoantibodies to erythrocytes from NZB mice and the induction of hemolytic anemia. AB - We established two clones of monoclonal hybridoma, from a non-immunized NZB mouse, which produce IgM class hemagglutinating autoantibodies reactive with the exposed murine erythrocyte autoantigens. Absorption studies revealed that one monoclonal antibody exhibits cross-reactivity to chick erythrocytes and mouse liver, and the other antibody to rat erythrocytes and mouse brain. Optimal temperatures for the hemagglutination were 22 degrees C with the former and 4 degrees C with the latter. The specificity and nature of the autoantibodies are apparently distinct from any of the erythrocyte autoantibodies described to date in NZB mice, anti-X, anti-HB, anti-HOL or anti-I antibodies. Implantation of these hybridoma cells in BALB/c mice induced autoimmune hemolytic anemia associated with a marked splenomegaly. These findings provide evidence that the erythrocyte autoantibodies in NZB mice are more heterogenous than generally assumed and suggest that varieties of erythrocyte autoantibodies may be involved in the development of a naturally occurring hemolytic disease in NZB mice. PMID- 6500631 TI - Monoclonal antibodies (IgM) against a murine carcinoma, Lewis lung carcinoma (3LL): production, purification and in vitro selectivity. AB - C57BL/6 mice were immunized against a syngeneic murine carcinoma, Lewis lung carcinoma (3LL). Monoclonal antibodies were prepared by fusing spleen cells of immunized mice with SP2-O-Ag mouse myeloma cells. Hybridoma clones producing anti 3LL antibodies were selected on the basis of a solid-phase radioimmunoassay. Two clones were selected and subcloned to give the 5B5 and the 6B6 hybrid lines which were found to secrete IgM monoclonal antibodies. Large quantities of monoclonal antibodies were purified from ascitic fluids by gel filtration chromatography. Specificities of these antibodies were tested on 3LL tumor cells, 3LL metastases, lymphoid cells and leukemic L1210 cells. The 5B5 IgM monoclonal antibody was found to be selectively directed against primary tumor cells and metastatic cells. PMID- 6500632 TI - EL-4 and macrophages: generation of chemotactic monokines. AB - Various effects of EL-4 lymphoma supernatant fluids on macrophages were studied. Macrophages migrate under agarose to medium conditioned by the EL-4 cell line for up to 40 h. EL-4 conditioned medium after 67 h contained dialyzable migration inhibitors. In addition, upon direct treatment with the EL-4 supernatant, macrophages took on a more elongated or polarized morphology as compared to control medium or another tumour cell line conditioned medium. A 2 h treatment of macrophages with the EL-4 culture supernatant was sufficient to trigger the production and/or release of chemotactic monokines. These monokines were chemotactic for both PMNs and macrophages. In addition, a prior state of activation of the macrophage does not appear to be necessary for the production and/or release of the chemotactic monokines since resident as well as stimulated peritoneal macrophages are equally effective. PMID- 6500633 TI - Increased serum IgG levels in essential hypertension. AB - Serum IgG levels were significantly increased (P less than 0.001) in 33 (20 male and 13 female) essential hypertensive cases (mean = 2083.87 +/- 99.94 mg/dl) when compared to 30 (15 male and 15 female) random normotensive control subjects (mean = 993.84 +/- 72.25 mg/dl). Of the 33 cases, 12 (36.3%) were familial and the rest were sporadic. No significant difference was observed in the IgG levels between familial and sporadic cases. Similarly, no significant difference was found between male and female hypertensive patients both in the familial and the sporadic group or between smokers and non-smokers. However, the levels of IgG were found to be increased in the initial stages of onset of the condition (duration of less than 1 yr). The present study supports the probable involvement of immunological responses in essential hypertension. PMID- 6500634 TI - Inhibitory effect of tumour cells on leukocyte motility. AB - Hep-2 cells inhibit the random migration of human polymorphonuclear leukocytes in a tumour cell-leukocyte microenvironmental model, which is a special form of co migration. The inhibition is indomethacin-sensitive. It is very likely that prostaglandins, produced as a consequence of interaction between tumour cells and leukocytes, are the mediators of this phenomenon. The tumour-induced inhibition of leukocyte motility may represent a tumour-protective mechanism. PMID- 6500635 TI - Enhancement of base hexose-monophosphate shunt activity of human polymorphonuclear leucocytes by human beta-interferon. AB - The effect of human fibroblast interferon (HuIFN-beta) on the HMP shunt activity of human polymorphonuclear leucocytes (PMNLs) was examined. HuIFN-beta caused an increase in the base level of the HMP shunt activity. No significant increase was observed in the same PMNLs stimulated with opsonized zymosan. The augmentation of this property, generally associated with antimicrobial and cytotoxic properties of the PMNLs, may be of potential importance in host defences against microbial and malignant diseases. PMID- 6500637 TI - Height-weight relationship during growth in healthy Indian males. PMID- 6500636 TI - A new lymphocyte surface antigen (Ly-m31) controlled by a gene closely linked to the Akp-2 locus on mouse chromosome 4. PMID- 6500638 TI - Impact of physical environment on the prevalence of intestinal helminthic infestation in under five children. PMID- 6500640 TI - Measles vaccine--feasibility, efficacy and complication rates in a multicentric study. PMID- 6500639 TI - Indian childhood cirrhosis: a search for cause and remedy. PMID- 6500641 TI - Sister chromatid exchange and mitotic index of cultured lymphocytes in patients with measles. PMID- 6500642 TI - Significance of meconium during labour and its correlation with umbilical cord blood studies. PMID- 6500643 TI - Hepatic involvement in childhood tuberculosis. PMID- 6500644 TI - Simple tests in amniotic fluid for evaluation of gestational age. PMID- 6500645 TI - A study of perinatal mortality rate from rural based Medical College Hospital. PMID- 6500647 TI - Streptococcal pharyngitis: clinical clues in diagnosis. PMID- 6500646 TI - Incidence, mortality and bacteriological profile of septicemia in pediatric patients. PMID- 6500648 TI - Hypospadias repair--a new modification of Thiersch-Duplay urethroplasty. PMID- 6500649 TI - Child psychiatric disorders--a definition. PMID- 6500650 TI - Attention deficit disorder and hyperkinesis. PMID- 6500651 TI - Childhood psychiatric disorders with physical manifestations. PMID- 6500652 TI - Measurement of intelligence and its usefulness. PMID- 6500654 TI - Femoral lateral epiphyseal hypoplasia as a cause of unilateral genu valgum. PMID- 6500653 TI - Patterns of childhood psychiatric disorders in India. PMID- 6500655 TI - Primary hyperlipoproteinemia type I. PMID- 6500656 TI - Hypoparathyroidism simulating brain tumor--an unusual presentation. PMID- 6500657 TI - Two siblings with unilateral renal agenesis. PMID- 6500658 TI - Relationship of glucose-6-phosphate dehydrogenase with structural development and growth of human foetal cornea. PMID- 6500659 TI - Coloboma of lens. PMID- 6500660 TI - Bilateral acute lacrimal sac abscess in a newborn infant. PMID- 6500661 TI - Beetle injury of cornea. PMID- 6500662 TI - Franceschetti's syndrome with bilateral atresia of lower puncta and canaliculi. PMID- 6500663 TI - Multifocal primary malignant melanoma of conjunctiva. PMID- 6500664 TI - Euryblepharon. PMID- 6500665 TI - Bickerstaff's encephlitis following acute haemorrhagic conjunctivitis. PMID- 6500667 TI - Structural changes in vitreous in aphakic eye. PMID- 6500666 TI - Orbital glioma. PMID- 6500668 TI - Decompression of the perioptic meninges for relief of papilloedema in benign intracranial hypertension. PMID- 6500669 TI - Effect of methyldopa on brain cholinergic neurons involved in cardiovascular regulation. A study in conscious spontaneously hypertensive rats. AB - Chemical stimulation of brain cholinergic neurons in many species can produce hypertension. Recent studies in this laboratory have demonstrated that clonidine inhibits this central cholinergic pressor response by inhibiting the biosynthesis of brain acetylcholine. This study was designed to determine whether methyldopa, like clonidine, could inhibit brain cholinergic neurons involved in cardiovascular regulation in freely-moving spontaneously hypertensive rats (SHR). Intravenous (i.v.) injection of methyldopa (50-200 mg/kg) produced a dose-related fall in blood pressure (29/15-54/33 mm Hg) in SHR. Intracerebroventricular (i.c.v.) injection of hemicholinium-3 (HC-3) in SHR evoked a fall in arterial pressure through inhibition of acetylcholine synthesis. Doses of HC-3 (10 micrograms, or 15 micrograms, i.c.v.) and methyldopa (50 mg/kg, i.v.) were administered to produce small reductions in arterial pressure in SHR (7-14 mm Hg diastolic, respectively). When the two agents were injected simultaneously, however, a greater than additive response was obtained (p less than 0.05). Central injection of echothiophate (a long-acting cholinesterase inhibitor) to potentiate brain cholinergic activity resulted in a sustained hypertensive response (greater than 40 mm Hg) in SHR for at least 150 minutes. Simultaneous injection of or pretreatment with methyldopa (100 mg/kg, i.v.) inhibited the pressor response to echothiophate over a time course similar to its antihypertensive response in untreated SHR. Methyldopa, however, was completely ineffective in altering the hypertensive response to central injection of carbachol (1 microgram, i.c.v.). This difference in methyldopa susceptibility between the indirect-acting (echothiophate) and direct-acting (carbachol) cholinergic agonists may be related to an inhibiting effect of methyldopa on brain acetylcholine release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500670 TI - Increased susceptibility to osmotic disruption of the blood-brain barrier in chronic hypertension. AB - We examined the effects of chronic hypertension and acute reduction of arterial pressure on the susceptibility of the blood-brain barrier (BBB) to disruption. The BBB was disrupted with an intracarotid injection of 1.6 M arabinose in spontaneously hypertensive rats (SHR), stroke-prone SHR (SHRSP), and normotensive Wistar-Kyoto (WKY) rats. Permeability of the BBB was determined from the ratio of 125I-albumin in brain to 125I-albumin in blood. When the BBB was intact, permeability was less than 0.4%. After hypertonic arabinose, permeability of the BBB was greater (mean +/- SE) in SHRSP (17.6% +/- 1.6%) and in SHR (21.1% +/- 3.1%) than in WKY (10.3% +/- 2.4%) (p less than 0.05). When arterial pressure of SHRSP was reduced acutely with nitroprusside before arabinose, the BBB permeability to albumin was not reduced (21.5% +/- 1.5%). In other rats, we examined survival after osmotic disruption. In SHRSP, 14 of 15 rats died within 1 day after osmotic disruption with marked cerebral edema. In WKY, four of 15 rats died (p less than 0.05 vs SHRSP). When arterial pressure of SHRSP was reduced before arabinose, mortality was reduced to six of 15 (p less than 0.05 vs untreated SHRSP). We conclude that the BBB in SHRSP has enhanced vulnerability that is detrimental to survival. Reduction of arterial pressure improves survival in SHRSP without affecting BBB permeability to albumin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500671 TI - Attenuated arteriolar dilator responses to calcium in genetically hypertensive rats. AB - Vascular responses to calcium were studied in 14 genetically hypertensive (GH) rats of the New Zealand strain and 16 weight- and age-matched normotensive parent strain control rats under chloralose-pentobarbital anesthesia. Calcium (chloride or gluconate) in an isosmolar solution was infused intraarterially into the hindlimb vascular bed which was vascularly isolated, innervated, and pump perfused (blood, 1 ml/min). Increases in limb plasma calcium concentrations up to 30 mEq/liter decreased limb vascular resistance, with no evidence for vasoconstriction. In GH rats decreases in limb vascular resistance in response to increments in limb plasma calcium concentrations of 3.6 to 10.8 mEq/liter were significantly (p less than 0.02) attenuated compared to age-matched controls. When responses in GH were compared to weight-matched controls, similar trends toward attenuation reached significance (p less than 0.02) at Ca2+ increments of 10.8 mEq/liter. In eight other GH rats, we measured total serum calcium concentrations and found them reduced (4.94 +/- 0.08 mEq/liter), especially as compared to values in eight rats of an unrelated Wistar strain (5.42 +/- 0.04 mEq/liter; p less than 0.05). These experiments provide evidence that, over physiological ranges, calcium relaxes arteriolar smooth muscle in rats and that this vasodilation is attenuated in genetically hypertensive rats. Thus, both the lower serum levels of calcium and the attenuated responses to calcium may contribute to the elevated peripheral vascular resistance and hypertension in these rats. PMID- 6500672 TI - Sympathetic activity and cardiac adrenergic receptors in one-kidney, one clip hypertension in rats. AB - The activity of the sympathetic nervous system, as measured by levels of plasma and cardiac catecholamines and catecholamine metabolites and the function of cardiac alpha- and beta-adrenergic receptors, was evaluated at 3 days and 4 weeks after induction of one-kidney, one clip hypertension (1K1C) in the rat. At 3 days, the plasma level of norepinephrine (NE) was lower in the 1K1C group than the control group (p less than 0.01), whereas epinephrine (E) and the metabolites dihydroxymandelic acid (DOMA), dihydroxyphenylglycol (DOPEG), and normetanephrine (NMN) were similar in both groups. In addition, cardiac content of catecholamines, their metabolites, and adrenergic receptors were similar in both groups. At 4 weeks, plasma levels of NE and DOPEG were lower (p less than 0.01), whereas levels of DOMA and NMN were higher (p less than 0.02 and p less than 0.001, respectively) in the 1K1C group than the control group. Cardiac content of NE (p less than 0.01), and DOPEG (p less than 0.05) was significantly lower, whereas DOMA and NMN were significantly higher (p less than 0.01) in the 1K1C group as compared to controls. In addition, cardiac density of both alpha- and beta-adrenergic receptors was reduced in the 1K1C group, whereas receptor affinities were unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500673 TI - Chronic angiotensin II infusion decreases renal norepinephrine overflow in conscious dogs. AB - Sympathetic nerve activity and in particular renal sympathetic nerve activity were monitored in six conscious dogs subjected to 6 days of intravenous angiotensin (ANG II) infusion (20 ng/kg/min). This was accomplished by measurement of both arterial and renal venous plasma catecholamine concentration. During the initial 4 hours of ANG II infusion, mean arterial pressure (MAP) increased 35 +/- 8 mm Hg from a control value of 101 +/- 4 mm Hg. Although there were no significant changes in arterial plasma norepinephrine (NE) concentration at this time (control = 148 +/- 40 pg/ml), arterial plasma epinephrine (E) concentration increased threefold (control 42 +/- 15 pg/ml). After 24 hours of ANG II infusion, MAP remained elevated (132 +/- 5 mm Hg), but plasma E concentration returned to control levels. From Days 2 through 6 of ANG II infusion, MAP was elevated approximately 40 mm Hg, but there were no chronic increases in either arterial plasma E or NE concentrations. In contrast to arterial plasma catecholamine concentration, renal vein plasma NE concentration (control = 216 +/- 27 pg/ml) actually decreased during both the acute (122 +/- 12 pg/ml) and chronic (103 +/- 26 pg/ml) phases of ANG II infusion. Moreover, renal NE overflow (renal venous plasma NE concentration-arterial plasma NE concentration X effective renal plasma flow), an index of renal sympathetic nerve activity, was depressed during the chronic phase of ANG II hypertension. These results, therefore, do not support the contention that the sympathetic nervous system mediates the hypertension produced by elevated plasma levels of ANG II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500674 TI - Hemodynamic characterization of hypertension induced by chronic intrarenal or intravenous infusion of norepinephrine in conscious rats. AB - The present study was designed to determine the hemodynamic changes underlying the hypertension induced by chronic intrarenal infusion of norepinephrine (NE) in conscious rats. NE was infused for a 5-day period intrarenally with osmotic minipumps via a chronic catheter in the right suprarenal artery at rates of 4 and 36 micrograms . kg-1 . hr-1 or intravenously at a rate of 36 micrograms . kg-1 . hr-1. Control rats received a 1 microliter . hr-1 intrarenal infusion of pyrogen free 0.9% NaCl. In separate experiments, short-term effects were measured continuously during a 22- to 24-hour intrarenal infusion of 4 and 36 micrograms NE . kg-1 . hr-1 or intravenous infusion of 36 micrograms NE . kg-1 . hr-1. Intrarenal infusion of NE produced a more pronounced long-term hypertensive effect than infusion of the same dose intravenously. This hypertension was characterized by a rapid and sustained increase in total peripheral resistance index (TPRI). Despite of the initial renal vasoconstriction, specifically produced during the first 24 hours of intrarenal NE application, cardiac index (CI) in parallel to stroke volume index (SVI) decreased significantly during intrarenal as well as during intravenous NE infusion. Furthermore, no signs of sodium retention were observed. Both rates of intrarenal NE infusion have been shown previously to produce a significant long-term increase in plasma potassium concentration, and the present study indicates that this is presumably the result of decreased urinary potassium output. It is concluded that chronic hypertension produced by intrarenal or intravenous infusion is not volume-dependent. The relatively greater increase in TPRI during intrarenal NE infusion is attributed to vascular wall receptor sensitization by increased plasma potassium levels resulting from effects of intrarenally present NE on tubular cation exchange mechanisms. PMID- 6500675 TI - Blood pressure, lanthanum-, and norepinephrine-induced mechanical response in thoracic aortic tissue. AB - The responses of isolated thoracic aortic rings to 10(-5) M norepinephrine (NE) and 5 mM lanthanum chloride (La3+) were compared in tissues from 6- to 8-week-old and 12- to 16-week-old rats. Twelve strains of rats were selected: spontaneously hypertensive (SHR), Wistar-Kyoto (WKY), genetically related outcross F1 and F2, backcross BC1(S) and BC1(W), and Wistar, SHR/Wistar, and Wistar/WKY crosses, Sprague-Dawley (SD), and also Dahl salt-sensitive (DS) and salt-resistant (DR) rats. The La3+ response, expressed as the percentage of the maximal response to NE, demonstrated both age and blood pressure (BP) components in the SHR, WKY, F1, F2, and BC rats; however, when the La3+ response was expressed as mg force/mg tissue, no significant differences within these same groups were noted. The magnitude of the NE response in the same group of rats was inversely related to the BP of the 12- to 16-week-old animals (r = -0.45), and was not affected by treatment of the animal from conception with alpha-methyldopa. Aortic tissues from DS, but not DR or SD rats, demonstrated a response to La3+ which increased with the BP of the rat. This was not observed in prehypertensive DS rats and was prevented by the control of hypertension with either hydrochlorothiazide or MK 421 (a converting-enzyme inhibitor). We conclude that the reduced NE response in aortic tissues from SHR and related hypertensive rats reflects an inherent defect in the vascular smooth cell of the rat and is unaffected by BP control with antihypertensive drug therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500676 TI - Hypertension-producing factor in serum of hypertensive Dahl salt-sensitive rats. AB - To investigate whether serum in hypertensive Dahl salt-sensitive rats (S rats) contains a hypertensinogenic substance, we examined the effects of repeated injections of serum from such S rats on blood pressure (BP) and pressor responses. Serum was collected from either hypertensive or normotensive S rats (fed an 8% or 0.11% NaCl diet, respectively) and injected into uninephrectomized recipient S rats for 2 weeks (0.45 ml, twice a day, i.v.). Serum from hypertensive rats injected for 14 days significantly increased BP by 14 mm Hg (143 vs 129, p less than 0.05), pressor responses to angiotensin II (ANGII) by 45% (p less than 0.005), pressor responses to norepinephrine (NE) by 38% (p less than 0.025), and Na concentration in the aortic wall of recipient rats by 5.9% (p less than 0.05), compared to the effects of the injection of serum from normotensive S rats. These results imply that hypertensive S serum contains a hypertensinogenic substance and that this serum factor produces a mild hypertension in the recipient rats and also contributes importantly to the hypertension in donor S rats. Dahl salt-resistant rats (R rats) on either 8% or 0.11% NaCl had normal BP. Their sera produced no differences in BP or in pressor responses in recipient rats. Hence 8% NaCl, which produced no hypertension, also induced no hypertensinogenic serum factors in R rats. We sought to determine whether nephrectomy would alter these humoral factors. The BP averaged 139 mm Hg in rats receiving normotensive sham-nephrectomized S serum vs 154 in those receiving hypertensive sham-nephrectomized S serum, 15 mm Hg higher (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6500677 TI - Red cell cotransport activity and sodium content in black men. Relationship to essential hypertension. AB - Furosemide-sensitive sodium and potassium cotransport and intracellular sodium content ([Na]i) were measured in erythrocytes (red blood cells, RBCs) from a population of 90 adult black men with and without essential hypertension (EH). The mean values for sodium cotransport activity, expressed as furosemide sensitive Na efflux (mmol/liter RBC/hr), were not significantly different among the EH patients and two control groups, normotensive subjects with a positive history (N+) and those with a negative family history (N-) for hypertensive disease (EH: 154 +/- 123, n = 53; N+: 167 +/- 93, n = 12; and N-: 207 +/- 142, n = 20; all values are means +/- SD). The mean [Na]i 9.66 +/- 3.02 mmol/liter RBC (n = 56) for the EH group was greater than the mean value for the N- control group (7.96 +/- 1.97, n = 20; p less than 0.05). The N+ group also displayed a higher mean [Na]i (10.38 +/- 3.18, n = 12; N+ vs N- p less than 0.01). Although there was substantial overlapping of [Na]i values between the groups and no clear dividing line, the distribution curve of the [Na]i values in EH was skewed toward higher concentrations than in N-. Nevertheless, we must conclude that erythrocyte cotransport and [Na]i are not clinically useful in the identification of EH in black men. PMID- 6500678 TI - Effect of dietary sodium reduction on red blood cell sodium concentration and sodium-lithium countertransport. AB - A randomized, crossover trial was carried out on the effect of moderate sodium reduction on red-blood-cell sodium metabolism. The participants were healthy high school students (mean age = 16 years, n = 33). Changes in sodium-lithium countertransport and intracellular sodium concentration were evaluated 24 days after a decrease in dietary sodium from approximately 110 to 40 mEq per day. Dietary sodium restriction had no significant effect on either sodium-lithium countertransport or intracellular sodium concentration. PMID- 6500681 TI - Accelerated hypertension in a 64-year-old white woman. PMID- 6500680 TI - Renal and systemic hemodynamics in sustained essential hypertension. AB - Cardiac output (CO), renal blood flow (RBF), calf blood flow (CBF), and hepatic blood flow (HBF), glomerular filtration rate (GFR), and dopamine beta hydroxylase (D beta H) activity were studied in 198 men (67 normotensive controls and 131 hypertensive patients) of the same age with sustained uncomplicated essential hypertension. In the hypertensive men, the RBF and the RBF/CO ratio were significantly decreased (p less than 0.001). The RBF and RBF/CO ratio were negatively correlated with age (p less than 0.01), blood pressure (p less than 0.01), and D beta H activity (p less than 0.01). None of these relationships were observed with CBF and HBF. The observed decreases in RBF and the RBF/CO ratio in hypertensive men were reversed after administration of clonidine and alpha methyldopa (p less than 0.01), but not after administration of propranolol. The study provides evidence that the reduction of renal perfusion in essential hypertension is partly reversible and related to an abnormality in the adrenergic system control. PMID- 6500679 TI - Interrelationships between blood pressure, sodium, potassium, serum cholesterol, and protein intake in Japanese. AB - Interrelationships among blood pressure (BP), sodium (Na), potassium (K), dietary protein, and serum cholesterol level (Chol) were examined in 62% (1120) of 1818 Japanese inhabitants of both sexes aged over 30 years who lived in a rural village in Japan. Fasting single-spot urine specimens were collected in the morning to measure Na, K, urea nitrogen (UN), inorganic sulfate (SO4), and creatinine (Cr). The Cr ratios of Na, K, UN, SO4, Na/K, and SO4/UN were analyzed by multiple regression analysis to determine independent associations with BP together with age, obesity index, hematocrit (Hct), Chol, triglyceride (TG), and fasting serum glucose level (Glu). Except for Na/Cr in men, Na/Cr and Na/K were found to be independently and positively related to BP, particularly to systolic BP (SBP). In contrast, K/Cr and SO4/UN (an index related to the dietary score of sulphur-containing amino acids derived mainly from animal protein) were both negatively associated with SBP, and UN/Cr (an index of total protein intake) was positively associated with SBP in men. Chol was linked to BP negatively in men but positively in women. Age, obesity index, TG, and Hct were generally positively and significantly related to BP in both sexes. The results confirmed on epidemiological grounds the positive link of Na and the negative link of K to BP within a single population in Japan. They further suggest, although only in men, that there is a negative relationship of Chol and dietary animal protein with BP. PMID- 6500682 TI - Abstracts of the Council for High Blood Pressure Research. 38th annual fall conference and scientific sessions. October 10-12, 1984. Cleveland, Ohio. PMID- 6500683 TI - Bulbospinal serotonin pressor pathways and hypotensive action of methyldopa in the rat. AB - The administration of methyldopa (200 mg/kg i.p.) induced a green fluorescence typical of catecholamine fluorescence, in regions of the brain stem which coincided with all the major serotonin cell groups, including the B1, B2, and B3 cell groups in the medulla. Prior administration of 5,7-dihydroxytryptamine (5,7 DHT), a neurotoxin relatively specific for serotonin neurons, prevented the appearance of this methyldopa-induced fluorescence. Electrical stimulation of the ventrolateral medulla in areas that coincided with the lateral elements of the B1 and B3 serotonin cell groups evoked pressor responses recorded via cannulae in the abdominal aorta. The pressor responses were frequency-dependent and could be markedly attenuated by prior administration of 5,7-DHT either intracerebroventricularly (i.c.v.) or directly into the cervical cord to ablate descending serotonin nerve fibers. Microinjection of methyldopa (4-16 micrograms) directly into the region of the B1 and B3 cells in the ventrolateral medulla evoked a dose-dependent fall in arterial pressure observed for 4 hours. Here too, prior administration of 5,7-DHT either intracerebroventricularly or directly into the cervical cord largely prevented the hypotensive action of the microinjections of methyldopa. The administration of 5,7-DHT produced a highly selective depletion of serotonin stores without reducing the concentrations of norepinephrine. These experiments suggest that the activity of serotonin nerves descending into the spinal cord from the B1 and B3 cells in the ventrolateral medulla serves to elevate or maintain arterial pressure. They also suggest that these descending serotonin neurons may contribute to the hypotensive action of methyldopa. PMID- 6500684 TI - Fifteen-year survival of patients beginning treatment with methyldopa between 1962 and 1966. AB - The 15-year survival of a group of 205 patients who started treatment in the period 1962 through 1966 and who received methyldopa for two-thirds or more of the time has been investigated. At entry these patients had severe hypertension with an average pretreatment pressure of 216/126 mm Hg. Twenty-one percent had retinal hemorrhages, cotton-wool spots, or papilledema. Blood pressure showed a large fall in the first year, followed by a small, progressive, further fall up to the sixth year. After 5 years of treatment the blood pressure averaged 144/90 mm Hg in men and 151/91 mm Hg in women. The average daily dose of methyldopa was approximately 1500 mg and changed little over the 15-year period. Survival was analyzed by life tables. Approximately 81% of men and women aged 30 to 49.9 years at entry were still alive 10 years later. In the age group 60 to 69.9 years, 53.8% of men and 63.2% of women were still alive 10 years later. Seventy-nine of the patients died during the follow-up period, 89% from cardiovascular or renal disease. Ischemic heart disease (40%) was the major cause of death, followed by stroke (19%). No patients died from drug toxicity. PMID- 6500685 TI - Planning for rural health. PMID- 6500686 TI - Percentile and normal distribution of blood pressure in population and determination of cut off values. PMID- 6500688 TI - Anaemia in tribals of Adhaura, Rohtas, Bihar. PMID- 6500687 TI - The impact of rural health services in Agra sub division. PMID- 6500689 TI - Sero-prevalence of porcine brucellosis in Assam. PMID- 6500690 TI - Influence of steroidal and nonsteroidal sex hormones on host resistance in mice: increased susceptibility to Listeria monocytogenes after exposure to estrogenic hormones. AB - Subchronic exposure to pharmacological levels of estrogenic compounds, including 17 beta-estradiol, diethylstilbestrol, and alpha-dienestrol, significantly increased the mortality of B6C3F1 female mice after Listeria infection. Compounds with little estrogenic activity, including 5 alpha-dihydrotestosterone, progesterone, zearalenol, and corticosterone, did not alter Listeria-related mortality. Estrogen-induced alterations in resistance were inhibited by both adult thymectomy and the estrogen antagonist tamoxifen. Estrogen exposure depressed the accumulation of monocytes and lymphocytes at infective foci. Significantly elevated numbers of bacteria were observed in infective foci of estrogen-treated mice later in the infection when bacteria were nearly eliminated from untreated animals. These results indicate that estrogen-induced suppression of Listeria immunity is partially mediated by the thymus, probably through receptor events which may ultimately suppress the activation of T cell-dependent defense mechanisms. This may be partially reflected by the inability of estrogen exposed mice to eliminate Listeria cells or to accumulate mononuclear effector cells at infective foci at the same rate as controls. PMID- 6500691 TI - Toxicity of staphylococcal toxic shock syndrome toxin 1 in rabbits. AB - Strains of Staphylococcus aureus associated with toxic shock syndrome produce toxic shock syndrome toxin 1 (TSST 1), which is lethal to conventional rabbits and acts synergistically with gram-negative lipopolysaccharide. The lethal effect of TSST 1 was examined in specific-pathogen-free rabbits on the basis that these rabbits, being less colonized by gram-negative bacteria, would be less susceptible than conventional animals. Although there was no significant difference in mortality between specific-pathogen-free and conventional rabbits in response to 100 micrograms of TSST 1, there was a difference in response between Dutch belted rabbits and New Zealand white rabbits. Both specific pathogen-free and conventional New Zealand white rabbits were more susceptible to TSST 1 than the Dutch belted strain. Pretreatment of conventional New Zealand white rabbits with polymyxin B neutralized the lethal effect of TSST 1. PMID- 6500692 TI - Correlation between toxin binding and hemolytic activity in membrane damage by staphylococcal alpha-toxin. AB - The binding of Staphylococcus aureus alpha-toxin to rabbit and human erythrocytes was studied by hemolytic assays and sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting. Hemolytic assays showed that toxin binding to 10% cell suspensions at neutral pH was very ineffective in the concentration range 3 X 10(-8) to 3 X 10(-7) M (1 to 10 micrograms/ml), and less than 5% of added toxin became cell bound. However, binding was augmented as toxin levels were raised, abruptly increasing to 50 to 60% at 2 X 10(-6) to 3 X 10(-6) M (60 to 100 micrograms/ml). When rabbit erythrocytes were lysed with 1 to 5 micrograms of toxin per ml, both monomeric and hexameric forms of the toxin could be detected on the membranes by sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting. In contrast, human erythrocytes treated with 1 to 6 micrograms of toxin per ml did not lyse, and membrane-bound toxin was not detectable. When toxin concentrations were raised to 30 to 100 micrograms/ml, human erythrocytes also lysed and toxin hexamers became membrane bound in comparable amounts as on rabbit cell membranes. Lowering the pH led to a marked increase in susceptibility of human, but not rabbit erythrocytes towards alpha-toxin. When human cells were lysed at pH 5.0 with 5 micrograms of toxin per ml, membrane-bound hexameric toxin became detectable. The demonstrated correlation between the presence of hexameric, cell-bound toxin and hemolytic activity supports the channel concept of toxin-mediated cytolysis. The results also show that toxin binding does not exhibit overall characteristics of a simple receptor-ligand interaction. PMID- 6500693 TI - Differential cytotoxic effects of toxins A and B isolated from Clostridium difficile. AB - Toxin A and toxin B preparations of Clostridium difficile have been shown to affect metabolic functions of intact HeLa cells with different kinetics. The cytotoxins were purified from dialyzed filtrates of C. difficile strain VPI 10463 by hydrophobic interaction chromatography and ion-exchange chromatography and were concentrated by dialysis or by ultrafiltration. The toxins, which are immunologically unrelated, were analyzed by polyacrylamide gel electrophoresis and by immunochemistry with the Western blot technique. Toxin A was resolved into one major cytotoxic protein and a minor, rapidly migrating species that did not comigrate with toxin B. Toxin B was resolved into one major and three minor cytotoxic proteins. One protein comigrating with toxin A had no cytotoxic activity. The highly purified toxin A at 1.0 mg/ml caused loss of intracellular K+ and inhibition of protein synthesis in HeLa cells within 1 h. These effects correlated with morphological changes indicating cytotoxicity. At lower protein concentrations of toxin A (10- to 100-fold less), however, cytotoxic effects were seen at 120 min, whereas no changes in K+ levels or protein synthesis were yet evident. The toxin B preparation, 1,000-fold more toxic than toxin A, was diluted to equivalent cytotoxicity as measured in the overnight assay. Toxin B caused loss of K+ and inhibition of protein synthesis well after cytotoxic morphological changes were complete. In contrast, at higher protein concentrations (2- to 2,000 fold more), intracellular K+ was lost completely by 120 min. The effects on cell rounding and protein synthesis were incomplete at 120 min, but increased with the toxin B concentration. PMID- 6500694 TI - Estrogens inhibit mycelium-to-yeast transformation in the fungus Paracoccidioides brasiliensis: implications for resistance of females to paracoccidioidomycosis. AB - Evidence that disease due to the thermally dimorphic fungus Paracoccidioides brasiliensis occurs post-puberty predominantly in males led us to hypothesize that hormonal factors critically affect its pathogenesis. We show here that estrogens inhibit mycelial- to yeast-form transformation of P. brasiliensis in vitro. Transformation of three isolates was inhibited to 71, 33, and 19% of the control values in the presence of 10(-10), 10(-8), and 10(-6) M 17 beta estradiol, respectively. The synthetic estrogen diethylstilbestrol was active but less potent than estradiol, whereas testosterone, 17 alpha-estradiol, tamoxifen, and corticosterone were inactive. This function was specifically inhibited, since yeast-to-mycelium transformation, yeast growth, and yeast reproduction by budding were unaffected by 17 beta-estradiol. Of note is the fact that mycelium-to-yeast transformation occurs as the first step in vivo in the establishment of infection. The cytosol of the three isolates studied possesses a steroid-binding protein which has high affinity for 17 beta-estradiol. We believe that this binding protein represents a P. brasiliensis hormone receptor which can also recognize mammalian estrogens. We hypothesize that the ability of estrogen to decrease or delay mycelium-to-yeast transformation at the initial site of infection contributes to or is responsible for the marked resistance of females, and that the binder described is the molecular site of action. PMID- 6500695 TI - Comparative observations of fever and associated clinical hematological and blood biochemical changes after intravenous administration of staphylococcal enterotoxins B and F (toxic shock syndrome toxin-1) in goats. AB - The present investigation was undertaken to examine the characteristics of purified toxic shock syndrome toxin-1 (staphylococcal enterotoxin F) given intravenously to dwarf goats (dose, 0.02 to 20 micrograms kg-1). Rectal temperature, heart rate, rumen motility, plasma zinc and iron concentrations, and certain other blood biochemical and hematological values were studied and compared with the changes seen after intravenous administration of staphylococcal enterotoxin B (dose, 0.02 to 0.5 micrograms kg-1). Similar changes such as fever, tachycardia, inhibition of rumen contractions, drop in plasma zinc and iron concentrations, lymphopenia, and a decrease in serum alkaline phosphatase activity were observed. In contrast to the effects of toxic shock syndrome toxin 1, staphylococcal enterotoxin B induced colic, watery diarrhea with pseudomembranes, hemoconcentration, and a more pronounced increase in blood urea nitrogen. The results obtained demonstrate that (i) in the goat staphylococcal enterotoxin B is much more potent than toxic shock syndrome toxin-1 and (ii) the goat is a useful model to study the gastro-intestinal effects caused by staphylococcal enterotoxin B. The present finding that no clear relationship could be found between the temperature response and the alterations in zinc and iron levels in plasma support the theory that the febrile reactions and the changes in plasma trace metals are mediated by different polypeptides released by activated macrophages. PMID- 6500696 TI - Isolation and identification of two hemolytic forms of streptolysin-O. AB - Streptolysin-O was isolated from culture supernatants of group-A beta-hemolytic streptococci (Richards strain) by ammonium sulfate and polyethylene glycol precipitation, DEAE-ion exchange chromatography, preparative isoelectric focusing, and chromatography on Sephacryl S-300. Two forms of the toxin possessing similar hemolytic capacity were identified. The native toxin was a single polypeptide chain devoid of amino sugars with a sedimentation coefficient of 3.9S and a molecular weight of 69,000, and was isoelectric at pH 6.0 to 6.4. Partial degradation of the native toxin occurred during the isolation procedure, yielding a hemolytically active polypeptide with a molecular weight of 57,000 and a pI of 7.0 to 7.5. Both forms of the toxin generated the typical, heterogeneous, open and closed ring-structured channels in erythrocyte membranes. Structural considerations indicated that between 25 and 100 monomer toxin molecules constituted the individual ultrastructurally recognizable channels. Hemolytic titrations indicated that the presence of 70 to 125 toxin molecules per erythrocyte was required to generate an average of one functional lesion per cell. The data are consistent with the concept that one or very few streptolysin O channels will cause hemolysis. PMID- 6500697 TI - Cloning of enterotoxin gene from Aeromonas hydrophila provides conclusive evidence of production of a cytotonic enterotoxin. AB - Culture filtrates of two Aeromonas hydrophila strains which were isolated from patients with diarrhea and assumed to be causative agents of the infections were shown to contain enterotoxic, cytotoxic, and hemolytic activities. Modest heat treatment of the filtrates inactivated the cytotoxic and cytolytic activities, but not the enterotoxic activity. The construction of cosmid gene banks in Escherichia coli of DNA from both A. hydrophila strains demonstrated that the determinants of the three activities are located on three different segments of the A. hydrophila chromosome. Both heated culture filtrates of A. hydrophila and nonheated filtrates of an E. coli clone containing the A. hydrophila enterotoxin gene provoked fluid accumulation in the rabbit ileal loop and suckling mouse models and caused elongation of Chinese hamster ovary cells. Differences in the responses of the models to the A. hydrophila enterotoxin and to the heat-labile and heat-stabile toxins of E. coli indicated that the former is distinct from the latter two types of toxin. These results constitute conclusive evidence for the production by A. hydrophila of a cytotonic enterotoxin that is distinct from the A. hydrophila cytotoxin and hemolysin and known E. coli enterotoxins. PMID- 6500698 TI - Penicillin-induced lysis of Streptococcus mutans. AB - Treatment of Streptococcus mutans GS-5 cells with concentrations of penicillin G within a relatively narrow range resulted in substantial lysis. This penicillin induced lysis was dependent upon cell density and pH of the lysis medium. Other oral streptococci (Streptococcus sobrinus, Streptococcus rattus, and Streptococcus cricetus) also demonstrated substantial levels of penicillin induced lysis under appropriate conditions. Lesser degrees of lysis were seen in a related organism, Streptococcus ferus. PMID- 6500699 TI - Effect of thioglycolate on phagocytic and microbicidal activities of peritoneal macrophages. AB - Brewer thioglycolate-elicited mouse peritoneal macrophages were as active as resident peritoneal macrophages in the phagocytosis of opsonized Staphylococcus epidermidis but were unable to kill ingested microorganisms. This decreased functional activity was restricted to Brewer thioglycolate-elicited macrophages, since peritoneal macrophages elicited with NIH thioglycolate, alone or supplemented with agar and methylene blue, were as active as resident peritoneal macrophages. No effect of agar on the functional activities of macrophages was observed. A defective intracellular killing by peritoneal macrophages due to Brewer thioglycolate was seen only after an intraperitoneal injection with thioglycolate, not after in vitro incubation of resident macrophages with thioglycolate. The results of this study show that, depending on the kind of thioglycolate used, the functional characteristics of elicited macrophages may alter. However, none of the forms of thioglycolate investigated induced the recruitment of activated macrophages. PMID- 6500700 TI - Lipopolysaccharide hyperreactivity of animals infected with Trypanosoma lewisi or Trypanosoma musculi. AB - Rats and mice infected with Trypanosoma lewisi and Trypanosoma musculi, respectively, showed hyperreactivity to lipopolysaccharide (LPS) from gram negative bacteria. Fatal shock could be precipitated with a dose of LPS 100 to 1,000 times less in infected compared with noninfected animals. In trypanosome infected rats and mice, extensive liver damage was evident after LPS challenge. These animals showed a pronounced hypoglycemia, marked elevation of blood aspartate transaminase level, and diffuse severe degeneration and total depletion of glycogen in hepatocytes. Only minor changes were observed in noninfected animals given the same dose of LPS. No mononuclear phagocytic cell infiltration was observed in the liver of infected animals. The most striking change was the great increase in size and the probable increase in phagocytic activity and number of sinusoidal Kupffer cells. We suggest that elevated Kupffer cell activity in trypanosome-infected animals may play a role in LPS-induced hepatotoxicity. PMID- 6500701 TI - In vitro effects of natural killer cells against Paracoccidioides brasiliensis yeast phase. AB - Recently, data have been reported suggesting natural killer (NK) cells may function in natural resistance against a fungus, Cryptococcus neoformans. The primary objective of this study was to examine the reactivity of murine splenic cells against another fungus, Paracoccidioides brasiliensis. Levels of NK activity in effector cell pools were varied by: (i) removing nylon wool-adherent cells, (ii) fractionating splenic cells on Percoll discontinuous gradients, (iii) using old and young effector cell donor mice, (iv) using donors from different strains, and (v) pretreating donors with NK-augmenting and -depressing agents. The various effector cell pools were simultaneously used in the 4-h 51Cr release assay with YAC-1 targets to determine the NK reactivity and in the in vitro growth inhibition assay against P. brasiliensis yeast phase targets. In each case, the level of NK reactivity correlated with the ability of the effector cells to inhibit the in vitro growth of P. brasiliensis. NK activity and P. brasiliensis growth-inhibiting ability could be augmented by fractionation of splenic cells through nylon wool or Percoll gradients. The effector cells responsible for the NK activity and P. brasiliensis growth inhibition were characterized as being nylon wool nonadherent, being found in the low-density fractions from Percoll discontinuous gradients, and having no detectable Thy-1 antigen or immunoglobulin but having asialo GM1 on their surface. These data support the contention that NK or NK-like cells are responsible for limiting the in vitro growth of P. brasiliensis. PMID- 6500702 TI - Presence of toxic shock toxin in toxic shock and other clinical strains of Staphylococcus aureus. AB - Toxic shock toxin (TST), also known as pyrogenic exotoxin C (Schlievert et al., J. Infect. Dis. 143:509-516, 1981) and staphylococcal enterotoxin F (Bergdoll et al., Lancet i:1017-1021, 1981), was purified from toxic shock strains of Staphylococcus aureus by preparative isoelectric focusing and by chromatofocusing. Neither method produced an absolutely pure protein as determined by silver staining of sodium dodecyl sulfate-acrylamide gels, although chromatofocusing was the better method of the two. Three molecular weight variants of the protein were found in the two toxic shock syndrome strains that were studied, regardless of the purification method that was used. An isoelectric point of 7.15 and molecular weights of 21,400, 22,100, and 23,200 were determined for the different forms of the protein from electrophoresis data. A sedimentation coefficient of 2.3S was determined by sucrose gradient centrifugation, and a Stokes radius of 2 X 10(-7) cm was determined by gel filtration. An average molecular weight of 18,900 for all of the TST forms was calculated from these data by the Stokes-Einstein equation. A survey for TST in 32 control and 46 toxic shock strains of S. aureus by isoelectric focusing and by agarose gel double immunodiffusion with specific rabbit antiserum revealed that the isoelectric focusing method tends to overestimate the number of TST-positive strains because of the detection of non-TST, neutral staphylococcal proteins. Based on immunodiffusion data, the association of TST with toxic shock strains was found to be 100% in vaginal isolates and 62% in non-vaginal isolates. In the control strains, TST was found in 16% of the vaginal strains and 23% of the non-vaginal strains. The value of this toxin as a marker for toxic shock and its relationship to the pathogenesis of this disease are discussed. PMID- 6500703 TI - Human phagocyte interactions with the Lyme disease spirochete. AB - The interaction between human polymorphonuclear leukocytes and monocytes and the Lyme disease spirochete was investigated by incubating phagocytes with microorganisms adherent to plastic or glass surfaces. Both cell populations readily phagocytized and killed spirochetes, and antibodies facilitated but were not essential for phagocytosis. PMID- 6500704 TI - Primary sequence of the alpha-toxin gene from Staphylococcus aureus wood 46. AB - The complete DNA sequence of a cloned alpha-toxin gene from Staphylococcus aureus was determined. The amino acid sequence of the alpha-toxin protein, predicted from the DNA sequence, was described and compared with published data. The primary product of the cloned alpha-toxin gene contained a 26-amino-acid leader sequence which possessed characteristic features of a signal sequence involved in secretion. The mature alpha-toxin protein had a molecular size of 33,000 and contained only three short regions of high hydrophobicity in addition to a number of short, weakly hydrophobic regions. PMID- 6500705 TI - Binding of pseudomonal leukocidin to rabbit polymorphonuclear leukocytes. AB - The leukocytotoxic toxin pseudomonal leukocidin, produced by Pseudomonas aeruginosa, was radioiodinated with chloramine-T reagent. Binding of [125I]leukocidin to rabbit polymorphonuclear leukocytes was found to be concentration dependent at 37 degrees C. A Scatchard plot of binding data was linear, indicating that leukocidin binds to a single population of sites. The dissociation constant, KD, was calculated from the Scatchard plot to be 2.5 X 10( 7) M, and the number of binding sites per leukocyte was approximately 4.4 X 10(5). Unlabeled leukocidin or antileukocidin antibody reduced the binding of [125I]leukocidin to the leukocytes. A leukocidin-binding protein was extracted from rabbit polymorphonuclear leukocytes with Triton X-100 and purified by leukocidin-Sepharose 4B affinity column chromatography. Approximately 60 micrograms of binding protein was obtained from 8.1 mg of material extracted from the leukocytes. The binding protein had a molecular weight of about 50,000 as shown by sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis and staining with silver nitrate. Under nondenaturing conditions, its molecular weight was also about 50,000, as shown by gel filtration-Sephadex G-200 chromatography. The 50,000-dalton protein purified in this way from rabbit polymorphonuclear leukocytes competitively inhibited the binding of leukocidin to leukocytes and inactivated leukocidin activity. With equimolar amounts of the 50,000-dalton protein and leukocidin, up to 90% inactivation of leukocidin was observed. PMID- 6500706 TI - Resistance of Actinobacillus actinomycetemcomitans and differential susceptibility of oral Haemophilus species to the bactericidal effects of hydrogen peroxide. AB - We compared the sensitivities of oral and nonoral isolates of Actinobacillus actinomycetemcomitans, Haemophilus segnis, H. aphrophilus, and H. paraphrophilus to the bactericidal action of reagent hydrogen peroxide (H2O2). Susceptibility to a range of H2O2 concentrations (10(-6) to 10(-3) M) was assessed by incubating bacterial suspensions for 1 h at 37 degrees C in the presence of H2O2 and plating on chocolate agar to determine the concentration of H2O2 that would produce a 50% reduction in CFU (50% lethal dose). As a group, A. actinomycetemcomitans was more resistant to H2O2 than the oral haemophili, and H. aphrophilus was much more sensitive than all other organisms tested. The range of 50% lethal dose values for A. actinomycetemcomitans was between 8.5 X 10(-5) and 10(-3) M H2O2 or above. In contrast, H. aphrophilus exhibited 50% lethal dose values from below 1 X 10( 6) to 3.4 X 10(-4) M H2O2. The resistance of A. actinomycetemcomitans to H2O2 may be sufficient to protect these organisms from direct H2O2-mediated killing by host phagocytes. PMID- 6500707 TI - Variation in periodontal floras. AB - Statistical analyses indicated (i) that the floras of individual samples taken from the depth of sulci with nickel-plated Morse 00 scalers were highly reproducible and representative of the flora present at any given time, (ii) that the different compositions of floras of different people with similar clinical signs were statistically highly significant, and (iii) that floras of different affected sites may differ significantly in some (two of three) people at any one time or may differ from week to week in other people (one of three). Thus the flora composition of individual sites appears to be in dynamic flux, probably in response either to environmental changes or to host responses. There was no evidence that double sampling per se (two single passes with 00 scalers) changed the composition of the flora. Repeat samples taken after 1 week were slightly more similar to the initial samples than were samples taken after 3 weeks. PMID- 6500708 TI - Enhanced susceptibility of male rabbits to infection with a toxic shock strain of Staphylococcus aureus. AB - Artificial infection chambers in rabbits were infected with a toxic shock strain of Staphylococcus aureus in an attempt to determine the nature of the enhanced virulence of toxic shock strains relative to non-toxic shock strains of staphylococci. The results showed that rabbits immunized with either neutral or acidic proteins were protected from the lethal effects of these infections. Male rabbits were found to be significantly more susceptible to these infections than female rabbits. Castration rendered both sexes equally susceptible to lethal infections. Numerous tissues from all infected rabbits were examined histologically, and most of the pathological findings involved lymphoid tissue. Of special interest was the observation that unprotected male rabbits which died had evidence of lymphoid depletion and that surviving rabbits, both male and female, usually manifested lymphoid hyperplasia. No other pathological response was noted which would characterize these infections, but immunized rabbits had a diminished level of thymic cortex involution that was not different between the sexes. PMID- 6500709 TI - Longitudinal investigation of bacteriology of human fissure decay: epidemiological studies in molars shortly after eruption. AB - In the present investigation, the proportions of Streptococcus mutans, lactobacilli, Streptococcus sanguis, veillonellae, and an unidentified actinomyces-like organism in dental plaque on occlusal fissures of first mandibular molars were monitored at 6-month intervals over a 3-year period in 368 children who were initially in grades 1 or 2. Teeth destined to become decayed exhibited a significant increase in the proportions of S. mutans from 6 to 24 months before the diagnosis of dental decay. Lactobacilli were sporadically detected but when present were associated with dental decay. Children whose teeth exhibited the greatest number of decayed surfaces had, at all time periods, significantly higher proportions of S. mutans than did children who were caries free. Many teeth had high proportions of S. mutans at their entry into the study. About 10% of the monitored teeth erupted during the period of observation, and in these teeth both S. mutans and lactobacilli could be significantly associated with decay. In these newly erupted teeth S. mutans outnumbered lactobacilli by ca. 20 to 1. S. sanguis, veillonellae, and the unidentified actinomyces-like organism could not be associated with the development of decay. These findings strongly implicate S. mutans and possibly lactobacilli as dental pathogens and suggest that if decay is to be controlled by strategies based upon a S. mutans infection, then the various tactics used probably will have to be performed on primary teeth, as these teeth are the most likely sources of infection for the permanent teeth. PMID- 6500710 TI - Production and partial characterization of a Vibrio fluvialis cytotoxin. AB - Conditions are described for the production of an extracellular cytotoxin or CHO cell-killing factor by Vibrio fluvialis, a recently recognized enteric pathogen. The cell-killing factor was ammonium sulfate precipitable, heat labile, and inactivated by proteases, and had an isoelectric point (estimated by sucrose density gradient electrofocusing) and an apparent molecular weight (estimated by gel filtration) of ca. 4.8 and 12,200, respectively. The culture supernatant fluids also possessed hemolytic and phospholipase A2 activities; however, they were separable from cell-killing factor activity by gel filtration. The substance(s) possessing the hemolytic and phospholipase activities coeluted when fractionated by gel filtration with Sephacryl S-200 (apparent molecular weight of ca. 34,500) and had isoelectric points of ca. 4.4 and 4.5, respectively. PMID- 6500711 TI - Distribution of oral Haemophilus species in dental plaque from a large adult population. AB - The periodontal status of maxillary first molars in 284 young adults demonstrating near-health to early disease was evaluated, and supragingival and subgingival plaque samples were collected. Plaque samples were processed anaerobically, enumerated microscopically for bacterial morphotypes, and cultivated on various media to enumerate the microflora. Although haemophili were ubiquitous (recovered in 98.5 and 96.2% of the supragingival and subgingival plaque samples, respectively), 50% of the respective samples had proportions of less than or equal to 1.5% and less than or equal to 0.33% total Haemophilus spp. based on total cultivable microflora. To study the distribution of Haemophilus spp., 377 colonies were identified from modified chocolate agar (selective for oral haemophili) from 14 supragingival and corresponding subgingival samples from 14 subjects. The most prevalent species, Haemophilus parainfluenzae, was found in significantly higher proportions, based on total haemophili on modified chocolate agar, in supragingival and subgingival samples from teeth with shallower probing depths (less than or equal to 3.0 mm) versus deeper probing depths (greater than or equal to 3.0 mm). Additional statistically significant findings included Haemophilus segnis in higher proportions in supragingival samples from deeper sites, Haemophilus aphrophilus in higher proportions in subgingival samples from deeper sites, and Haemophilus paraphrophilus in higher proportions in subgingival samples from shallower sites. Scatter diagrams illustrating the bivariate distributions of proportions of haemophili with proportions of dark-pigmented Bacteroides spp., spirochetes, and streptococci demonstrated that high proportions of haemophili were never recovered from sites with high proportions of Bacteroides spp. or spirochetes. All levels of haemophili, however, were recovered from sites with all levels of streptococci. Two potential systems for interpreting haemophili data were hypothesized for predicting periodontal probing depths. There was highly significant agreement between the two systems. Small but statistically significant correlations were found between the gingival index, probing depth, and attachment level, and proportions of total Haemophilus species in the respective samples. PMID- 6500712 TI - Immunological relationship between anionic antimicrobial proteins from caries free individuals and known salivary antimicrobial factors. AB - We examined whether the anionic inhibitory proteins identified in mixed saliva from certain caries-free individuals are fragments or degradation products of recognized salivary antimicrobial factors. In the experiments reported here, the anionic inhibitory proteins did not produce precipitin reactions with antisera to any of the established salivary antimicrobial factors examined. Additionally, native, heat-treated, or urea-denatured known salivary antimicrobial factors did not react with the antiserum to the anionic inhibitory proteins. However, the antiserum to the anionic inhibitory proteins was found to be reactive with a protein concentrate from mixed saliva or from separate submandibular and parotid secretions from a number of different donors, as well as with a purified protein fraction containing the homologous anionic inhibitory proteins. These findings suggest that the anionic inhibitory proteins represent intact and unique salivary proteins and not the degradation fragments of salivary antimicrobial protein factors within the oral environment. PMID- 6500713 TI - Role of specific antibody in interaction of leptospires with human monocytes and monocyte-derived macrophages. AB - It has previously been shown that human neutrophils ingest and kill nonpathogenic Leptospira biflexa in the absence of serum but that pathogenic Leptospira interrogans is not ingested by neutrophils even in the presence of normal serum. We extended this study by examining the interactions of human monocytes and monocyte-derived macrophages with pathogenic L. interrogans (serovar icterohaemorrhagiae) and evaluating the opsonizing effect of serotype-specific immune serum on the phagocytosis of pathogenic leptospires by monocytes and neutrophils. Leptospires were incubated with monocytes in pellets at 37 degrees C in 5% CO2. No ingestion or killing of pathogenic leptospires occurred when 10% normal serum was used. However, when the pathogenic leptospires were pretreated with serotype-specific immune serum, monocytes or neutrophils in pellets ingested 96% of the organisms and killed 94% of those ingested. Microscopic observations of the interaction confirmed that phagocytosis of the opsonized pathogenic leptospires by monocytes, monocyte-derived macrophages, and neutrophils had occurred. The opsonizing effect of specific antibody may play an important role in the mechanism of host defense against leptospirosis. PMID- 6500715 TI - Neutrophil migration in vitro and in vivo during hypothermia. AB - The effect of hypothermia on pig leukocyte migration in vitro and in vivo was studied. Neutrophil chemotaxis in vitro under agarose was significantly impaired at 29 degrees C (2.7 +/- 0.6 [mean +/- standard error]; 37 degrees C, 7.1 +/- 1.1). Leukocytes isolated from hypothermic pigs and tested at 37 degrees C migrated normally (7.8 +/- 0.6). Neutrophil and monocyte migration in vivo was markedly reduced at 29 degrees C. Reduced inflammatory responses may contribute to increased infections during hypothermia. PMID- 6500714 TI - Identification and properties of distinct sucrose and glucose phosphotransferase enzyme II activities in Streptococcus mutans 6715g. AB - We investigated phosphoenolpyruvate-dependent phosphotransferase system enzyme II activities for sucrose and glucose in Streptococcus mutans 6715g. Two integral membrane proteins, enzyme IIscr and enzyme IIglc, each specific for its sugar substrate, sucrose or glucose, were identified by their abilities to catalyze specific sugar:sugar-phosphate exchange reactions. Some of the properties of these two transport proteins are also presented. PMID- 6500716 TI - Specific mediation of cellular immunity to Toxoplasma gondii in somatic cells of mice. AB - Lymphocytes from mice immunized against Toxoplasma gondii protected T. gondii infected macrophage and kidney cell cultures. After contact with antigens, supernatants of such immune lymphocytes, also contained a factor protective for T. gondii-infected macrophages and kidney cells. Supernatants were protective only when the lymphocytes and kidneys cells were isogeneic. Protection was specific in that supernatants from only T. gondii-immune, but not Besnoitia jellisoni-immune, lymphocytes provided protection against toxoplasmosis. Sixteen to 24 h were required for an appreciable amount of protective factor to be secreted; a similar absorption time was necessary for kidney cells to be protected. Peritoneal lymphocyte lysates, prepared as transfer factor, contained protective substances with a potency similar to that of lymphocyte supernatants, which were also strain restricted in their effect. PMID- 6500717 TI - D-Alanyl-substituted glycerol lipoteichoic acid in culture fluids of Streptococcus mutans strains GS-5 and BHT. AB - The content and D-alanyl ester complement of lipoteichoic acid from stationary phase culture filtrates of Streptococcus mutans (strains BHT and GS-5; serotypes b and c) were determined chemically and serologically. A third less lipoteichoic acid was obtained from strain GS-5 than from strain BHT. This lipoteichoic acid had an increased mobility on immunoelectrophoresis after exposure overnight at pH 8 and a 10-fold greater content of alanine per mole of glycerol. PMID- 6500718 TI - Histological and immunopathological studies of delayed hypersensitivity reaction to tuberculin in mice. AB - At 4 to 6 weeks after intravenous infection with 2 X 10(4) CFU of dispersed Mycobacterium bovis bacilli (BCG), C3H/HeNCrIBR and C57BL/6NCrIBR mice exhibited a strong reaction to purified protein derivatives, as evaluated by the increase in footpad swelling at both 24 and 48 h after local antigenic challenge. However, histological studies of the footpad skin demonstrated a prominent perivascular infiltration with polymorphonuclear cells at 6 and 24 h after purified protein derivative challenge, whereas mononuclear cells represented the majority of infiltrating cells only at 48 h. An immunopathological study of the footpad skin showed granular deposits of immunoglobulins and complement in vascular walls and perivascular tissues at 6 and 24 h. These results demonstrate that the footpad swelling observed 24 h after the antigenic challenge is caused by an Arthus-type reaction, whereas that caused by cell-mediated immunity appears at 48 h. Hence, delayed hypersensitivity must be evaluated at 48 and not 24 h after challenge. PMID- 6500719 TI - Adjuvant properties of hydrophobic derivatives prepared from L-tyrosine. AB - The capacity of various N-acyl, O-acyl, amide and ester derivatives of L-tyrosine to promote the induction of antibodies to grass pollen extracts has been studied in guinea pigs. Antibody production was generally found to be enhanced when these derivatised materials were used as adsorbate vehicles compared with either L tyrosine or simple aqueous presentations. Increases in alkyl chain length were found to parallel increased adjuvant activity. Unlike L-tyrosine, however, these hydrophobic materials tended to produce tissue lesions in experimental animals at concentrations which displayed apparent adjuvant advantages. PMID- 6500720 TI - Standardization of allergens. Qualitative definition of house dust mite extracts following electroblotting and detection of components with antibody and lectin probes. AB - Components of an extract of Dermatophagoides pteronyssinus were electrophoretically separated, transferred to nitrocellulose membranes, and then probed with a variety of antibodies and lectins. Using mite-allergic human sera as the first antibody source, IgE-binding components were identified. Binding patterns by monoclonal and heterologous sera were also obtained. The method is suitable for the qualitative, and ultimately the quantitative, characterization of allergen extracts. The electroblotting procedure employing specific probes, therefore, promises to be a valuable aid for allergen standardization. PMID- 6500721 TI - Chemotaxis in experimental syphilis. AB - Peritoneal exudate leukocytes from normal and Treponema pallidum-infected rabbits were examined for their chemotactic response to various chemoattractants and treponemal preparations. Leukocytes from normal and infected animals responded well to bacterial and serum-derived chemoattractants. Suspensions of washed Treponema phagedenis biotype Reiter but not T. pallidum exerted significant chemotactic activity. Cells from rabbits infected for greater than or equal to 7 days demonstrated increased locomotion, suggesting the possibility of increased random motility. PMID- 6500722 TI - Effects of FPL 55712, ETYA and aminophylline upon Ascaris-induced bronchoconstriction in cynomolgus monkeys. AB - Dose-related impairment of pulmonary functions was induced in artificially respired, anesthetized cynomolgus monkeys by inhalation of aerosolized Ascaris antigen (AA) in ascending doses. The effects of pharmacologic agents were assessed by increases in threshold Ascaris dose (TAD). TAD were defined as the doses of AA needed for 20% increase in pulmonary resistance and 15% decrease in compliance. Inhaled FPL 55712, an SRS-A antagonist (1.24 mg through-the-valve dose; TTVD), and 5,8,11,14-eicosatetraynoic acid (ETYA), an inhibitor of lipoxygenase and cyclooxygenase (1.0 mg TTVD) resulted in significant increases in the geometric means of TAD for changes in compliance (p less than 0.01). The effects of both agents upon resistance were of borderline significance. Orally administered aminophylline (30 mg/kg) had no significant effect upon mean TAD for resistance or compliance. The activities of FPL 55712 and ETYA suggest that spasmogenic leukotrienes are involved in the pulmonary allergic reactions in cynomolgus monkeys. PMID- 6500723 TI - On the determination of 99Tc in environmental waters. AB - In this paper we propose a search for 99Tc in flocs from water treatment plants. We show that preconcentration of 99Tc from environmental waters is a very advantageous method because of the high volumes involved. A radiochemical method is adapted in these kinds of samples, and 99Tc is identified in them by a previously published method. A typical value found is 0.56 +/- 0.26 mBq/g, where 1 g dry floc should be related to many liters of water. PMID- 6500724 TI - 99Tc in surface air samples during the years 1965-1967. AB - In this work, 99Tc activities in atmospheric filters taken during the years 1965, 1966 and 1967 are measured on a monthly or bimonthly basis. The results show a clear yearly pattern of the activities with a maximum below 3 mBq/1000 m3 at the end of each summer, probably related, in a non trivial way, to meteorological factors. Our atmospheric 99Tc data add a more detailed structure to previously published fallout curves. PMID- 6500726 TI - Uremic myopathy. PMID- 6500725 TI - The use of C-18 SEP PAK cartridges to simplify routine production of 2-deoxy-2 [18F]fluoro-D-glucose. AB - The synthesis of 2-deoxy-2[18F]fluoro-D-glucose has been simplified by the use of C-18 SEP PAK cartridges. The fluorinated sugar produced from the reaction of acetyl hypofluorite and tri-acetyl glucal (TAG) was extracted from the neutralized reaction mixture with C-18 SEP PAK cartridges. The product was washed off the cartridge with diethyl ether and hydrolyzed by HCl. After hydrolysis the product was purified by passage through ion retardation resin, alumina and another C-18 cartridge. The radiochemical purity was 98% and the radiochemical yield was 28%, decay corrected to EOB, with a total synthesis time of 50 min from EOB. PMID- 6500727 TI - Maintenance hemodialysis in end-stage lupus nephritis. PMID- 6500728 TI - The importance of divalent ions to blood pressure regulation during hemodialysis. PMID- 6500729 TI - Reproductive capacity in female patients on chronic hemodialysis. PMID- 6500730 TI - Pathology of endocrine organs in chronic renal failure--an autopsy analysis of 66 patients. AB - Gross and microscopic findings at autopsy are reported in 66 patients with end stage renal disease (ESRD). Nineteen patients received renal transplant, and 47 were maintained on chronic dialysis. Thyromegaly was seen in over half of the dialysis patients and in a third of the transplant recipients. The mean weight of the thyroid gland in the two groups was similar (26.2 +/- 4.5 g in the transplant group and 27.2 +/- 6 g in the group on dialysis). The parathyroid glands were hyperplastic in 10/11 dialysis patients (91%), but of normal size in 78% of the transplant recipients. Adrenal gland atrophy was common in the transplant group, probably reflecting adrenal suppression by glucocorticoids. Seminiferous tubular atrophy was observed in 12/16 dialysis patients and small testes were noted on gross examination in 50% of the transplant recipients. Prominent autopsy findings were goiter, parathyroid gland hyperplasia, and testicular atrophy. Following transplantation parathyroid gland hyperplasia declined, whereas goiter and testicular atrophy appeared to persist. PMID- 6500731 TI - Visual function in diabetic patients undergoing dialysis: comparison of peritoneal and hemodialysis. AB - A prospective, uncontrolled study was designed to evaluate the changes in visual efficiency among insulin-requiring diabetic patients undergoing peritoneal and hemodialysis. Of the 112 patients (63% adult onset and 37% juvenile onset diabetics) studied chronologically, 63% were treated with hemodialysis and 37% with peritoneal dialysis. The mean distribution of sex, age, observation period and initial visual function were the same in the peritoneal and hemodialysis subpopulations, but more juvenile onset diabetics were treated with peritoneal dialysis. Preservation of vision correlated well with overall blood pressure control in all dialysis groups. Loss of vision was independent of the dialysis modality, of glucose control, and of the type of onset of diabetes. PMID- 6500732 TI - In vitro study of combined convection- diffusion mass transfer in hemodialysers. AB - Clearance measurements have been obtained for urea, Vit B12 and myoglobin by simultaneous hemodialysis and ultrafiltration (UF) techniques, using various commercially available hemodialysers. The experimental results confirm that the overall clearance is less than the clearance of each process occurring separately due to interaction between convection and diffusion. Adequate urea clearance (100 ml/min) can be obtained either by using high ultrafiltration (60 ml/min) with low dialysate flow rate (70 ml/min) or moderate ultrafiltration (less than 30 ml/min) with higher dialysate flow rate (120 ml/min). The comparison of experimental clearance with the predictions of theoretical model (1) for urea are found to be in good agreement for dialysate flow rates of more than 300 ml/min and for smaller dialysate flow rates the predicted clearances are higher than measured ones. An approximate correlation for the overall clearance is CL = CLD + QF/2 where CLD is the dialytic clearance and QF the UF flow rate. PMID- 6500733 TI - Heparin for hemodialysis: practical guidelines for administration and monitoring. AB - Anticoagulation of extracorporeal circuit still represents a major problem for hemodialysis units. Uraemic patients are at risk of hemorrhages, so anticoagulant could increase such a risk. On the other hand clotting of extracorporeal circuit may complicate inadequate heparin administration or hemostatic activation by the foreign surfaces. In this article we propose a simple standard for heparin administration and monitoring which allows the theoretical best anticoagulation for extracorporeal circuit. Our data also indicate that the effect of our proposed schedule is not influenced by the type of membrane or dialyser used. PMID- 6500735 TI - A comparative flow study of the Omniscience and the Bjork-Shiley cardiac valve prostheses. AB - The pressure-flow rate characteristics of two new convex-concave pivoting disc prosthetic heart valves are evaluated in vitro. The Omniscience and Bjork-Shiley prostheses are chosen since both use curved occluders with similar dynamic function, but with different occluder curvature and eccentricity. The Omniscience prosthesis is shown to have consistently less pressure loss, and therefore less energy loss, over a range of steady state and pulsatile flow rates. The enhanced flow characteristics of the Omniscience valve are attributed to the larger opening angle of the occluder, the method of retaining the occluder, in the valve frame, the smaller curvature of the occluder, the smaller pivot-axis eccentricity, and the smaller profile thickness of the occluder. The valves are also tested in the closed position, with steady state pressure gradients causing leakage or backflow. This data is compared with the pulsatile pressure-flow rate data to gain insight into the nature of regurgitation. The total regurgitation of the pivoting disc valves are thought to be strongly dependent upon both the maximal opening angle of the occluder and the radial clearance between the disc and the valve orifice. Both the Omniscience valve and the Bjork-Shiley valve are found to have nearly equal volumes of total regurgitation. PMID- 6500734 TI - Central retinal vein thrombosis in hemodialysis patients. PMID- 6500736 TI - Hydrogels: a carrier of bioactive agents. PMID- 6500737 TI - Plasma exchange in myasthenia gravis. AB - Results obtained with P.E. therapy on 19 myasthenic patients are reported. 15 of them improved during treatment and 4 remained unchanged. We believe P.E. is an useful therapy in M.G. because it produces a rapid improvement in most patients. PMID- 6500738 TI - Plasma exchange in radiculopolyneuropathies. AB - The AA. report the results obtained with Plasma Exchange (P.E.) therapy on 24 cases of polyradiculoneuritis; eleven patients had typical Guillain-Barre Syndrome (G.B.S.) ten suffered from a chronic progressive form and three were affected by a relapsing form. The acute patients were selected according to criteria established by the NNCDS Committee (1978) while guidelines laid down by Pineas & Load (1978) were followed in choosing chronic cases. Patients with G.B.S. had four sessions of P.E. at intervals of one or two days while those with chronic forms of polyradiculoneuritis had a total of 6 sessions spaced one to three days apart. P.E. produced no apparent change in chronic progressive patients but two out of three cases with the chronic relapsing form showed rapid and steady improvement resulting in complete cure within a few months. Nine of the eleven G.B.S. patients showed after only one or two sessions a clear and rapid improvement which led to a complete cure within a matter of weeks. The remaining 2 cases showed only partial improvement at first and remained stationary thereafter. The findings confirm the usefulness of P.E. in acute and chronic relapsing radiculopolyneuritis. However, potential side effects and the procedure's high cost suggest that its use should be limited to carefully selected cases, and in particular to those involving respiratory disorders. PMID- 6500739 TI - Precursor lesions of oesophageal cancer in a low-risk population in China: comparison with high-risk populations. AB - An endoscopic survey was undertaken in Jiaoxian, People's Republic of China, a population at low risk for oesophageal cancer, to determine the prevalence of precancerous lesions of the oesophagus, and this rate was compared with the prevalence observed previously in high-risk populations in Iran and Linxian, China. The study involved 252 subjects whose exposure to suspected risk factors was determined by a questionnaire and all of whom underwent physical examination and oesophagoscopy, including cytology and biopsy. Chronic oesophagitis, with endoscopic and histologic characteristics similar to those observed in the high risk populations of Iran and Linxian, was found in 28% of the study subjects compared to 80% in Iran and 65% in Linxian. Oesophagitis accompanied by atrophy of the epithelium was found in 0.4% compared to 10.5% in Iran and 10.8% in Linxian. No case of dysplasia was diagnosed in Jiaoxian while this condition was diagnosed in 4% of the subjects examined in Iran and in 8% of those in Linxian. The findings suggest that these lesions are in fact precancerous. Vitamin analysis showed that riboflavin deficiency was widespread in Jiaoxian, as in Iran and Linxian, but was more severe in Linxian than in Jiaoxian. No significant difference was found in the mean levels of retinol, beta-carotene and zinc between the two populations. PMID- 6500740 TI - Alcohol, smoking, social and occupational factors in the aetiology of cancer of the oral cavity, pharynx and larynx. AB - A case-control study of 374 patients with primary epithelial cancers of the oral cavity, oro- and hypopharynx, and larynx is reported, the controls being patients with selected other cancers, matched for age and sex. Of all eligible patients, 93% were interviewed. Increased risks were seen with alcohol consumption and, less strongly, with smoking, which for all sites could be adequately fitted by either a multiplicative or an additive model. However, the site-specific relationships were different, alcohol consumption being significantly associated only with oral cavity, pharyngeal and extrinsic laryngeal tumours, and smoking only with intrinsic laryngeal tumours. Increased risks were associated with low socio-economic status, the unmarried state, and poor dental care. No significant associations were seen with specific occupational exposures. PMID- 6500741 TI - Detection of an interferon antagonist, sarcolectin, in human sarcomas and muscles. AB - In a variety of human sarcomas we detected the presence of a sarcolectin which reversed an established antiviral protection induced by interferon (IFN). For the same protein concentration, this biological activity was significantly increased when compared to that of normal muscles. All the biological characteristics were comparable to those of a sarcolectin found in hamster tissues; namely the capacity to agglutinate cells and its inhibition by specific sugars, migration in sodium dodecyl sulfate gel, and pepsin, heat and sodium dodecyl sulfate stability. Except for its anti-IFN function and cell agglutinating activity, the biological significances of this sarcolectin is presently poorly understood. PMID- 6500742 TI - Occupational formaldehyde exposure and increased nasal cancer risk in man. AB - A comprehensive data linkage system for the detailed investigation of occupational cancer has newly been established in the Danish Cancer Registry, providing employment histories back until 1964. Based on this system a study of 839 cases of cancer of the nasal cavities, sinuses and rhinopharnyx and 2,465 cancer controls diagnosed in Denmark during the period 1970-1982 was conducted. Histories of exposure to formaldehyde, wood-dust and 10 other specified compounds or procedures, were assessed by industrial hygienists unaware of the case-control status of the cancer patients under study. Some 4.2% of the male and 0.1% of the female controls had been exposed to formaldehyde. A statistically significant excess risk (p less than 0.05) for carcinoma of the nasal cavity and sinuses among males with a history of exposure to formaldehyde (RR = 2.8), wood-dust (RR = 2.5) and paint lacquer and glue (RR = 2.1) was found. When adjustment was made for wood-dust exposure the relative risk associated with formaldehyde was reduced to 1.6, which is not significantly in excess of 1.0, although still compatible with a 3- to 4-fold increase in risk using conventional 95% confidence limits. The joint action of exposure to wood-dust and formaldehyde was in accordance with an additive effect. The excess risk of sino-nasal cancer with exposure to paint, lacquer and glue remained statistically elevated after adjustment for contemporary exposure to wood-dust and formaldehyde. PMID- 6500744 TI - Heat-shock proteins produced by two human melanoma cell lines: absence of correlation with thermosensitivity. AB - Two human melanoma cell lines, extremely different in their thermal sensitivity, were pulse-labelled with (35S)-methionine after 60 min of exposure at 42 degrees C. For both cell lines, fractionation of the intrinsically labelled proteins by polyacrylamide gel electrophoresis (PAGE) showed increased labelling of a polypeptide band of Mr 72,000, along with a slight reduction of overall protein synthesis. By two-dimensional electrophoresis, the Mr 72,000 band resolved into multiple pattern components of the same size but differing in isoelectric points. The absence of qualitative and quantitative differences between the two melanoma cell lines indicates that the different thermal sensitivities are unrelated to their ability to express the heat-shock proteins. PMID- 6500743 TI - Differential growth response of normal human diploid fibroblasts and in vitro transformed human fibroblasts in serum-free defined culture medium. AB - Two neoplastic human cell lines, WI-38 CT-1 and SUSM-1, which were transformed in vitro with gamma rays and 4-nitroquinoline 1-oxide, respectively, grew continuously in a serum-free defined medium. The defined medium used was a 1:1 mixture by volume of Dulbecco's modified Eagle's medium and Ham's F12 (DF) supplemented with 0.1% bovine serum albumin fraction V, 10 micrograms/ml of transferrin, 1 microgram/ml of insulin, and 5 micrograms/ml of oleic acid. In the case of SUSM-1, 100 micrograms/ml of fetuin were added to cultures when the cells were subcultured. Under these conditions the growth rates of the two transformed human cell lines were almost the same as those in a DF medium containing 10% fetal bovine serum (FBS). In addition, the defined medium permitted the cells to grow indefinitely without a lag period when they were transferred from serum containing medium into this defined medium, indicating that no selection or adaptation of the cells had occurred. Interestingly, these cell lines did not require for their growth any polypeptide growth factors such as epidermal, platelet-derived or fibroblast growth factors. On the other hand, the control WI 38 cells stopped growing in the defined medium after about 2 divisions. Another control normal cell strain of fibroblasts derived from a human embryo showed a decreased growth rate in the defined medium as compared with that in the DF medium with 10% FBS. These results suggest that the defined medium described here is useful for the selective growth of human cells transformed in vitro after treatment with carcinogens from an untransformed cell population. In addition, the defined medium for transformed human cells should contribute to studies on their growth mechanisms. PMID- 6500745 TI - Immune rejection mechanisms in murine leukemia. I. Timing of tumor cell rejection process relative to the development of humoral and cell-mediated cytotoxic immune responses. AB - Studies were undertaken to investigate the relationship between cell-mediated and humoral immune responses in the rejection of L1210/MTX-Rev (LR) leukemia cells in CD2F1 mice. The anti-LR antibody (humoral) response was defined by both its cytotoxic antibody titer and isotype composition, assessed by a complement dependent cytotoxicity assay and radioimmune assay, respectively. The cytotoxic thymus (T)-derived lymphocyte response in the spleen was quantitated by 125I release by 125I-IUdR-labelled target cells. Analysis of the sera of tumor-bearing mice indicated that the LR leukemia cells elicited a wide spectrum of anti-tumor antibody isotypes. In mice that mounted a rejection response, the IgM anti-LR response was transient, while in those that did not, the IgM response persisted. Antibody titers for all isotypes remained low until the onset of LR rejection. At that time, high titers of IgG anti-LR antibodies, predominantly of the IgG2a subclass, were detected in sera of tumor-free mice. Thus, the LR rejection response coincided best with the appearance of high titers of IgG2a anti-LR antibodies. A single i.p. injection of viable LR cells elicited a potent cell mediated immune response; neither the appearance nor the magnitude of the cell mediated immune response as measured in the spleen correlated well with the onset or the strength of the LR rejection response in the peritoneal cavity. The LR peritoneal cell population grew unabated in the presence of an intense spleen cell-mediated immune response, and the rejection process began at a time when little cellular immunity could be detected. These results suggest that in the rejection response IgM antibodies contribute little, if any, to the process, and the role of cytotoxic T lymphocytes is questionable (uncertain). The rejection of LR cells appears to be primarily mediated by IgG2a antibodies. PMID- 6500746 TI - Suggestive evidence that the highly metastatic variant ESb of the T-cell lymphoma Eb is derived from spontaneous fusion with a host macrophage. AB - Two lines of evidence are reported which suggest that the highly metastatic variant ESb of the T-cell lymphoma Eb is derived from spontaneous fusion with a host macrophage. Firstly, ESb cells are shown to express the macrophage differentiation antigen Mac-1 which was not found on Eb cells or on any other tumor cells tested except the macrophage tumor line Pu5. Secondly, the progression from low to high metastatic capacity could be reproduced in vitro following hybridization of thioguanine-resistant Eb cells (EbTGR) with syngeneic bone-marrow-derived macrophages. Two HAT medium-selected hybrid tumor lines (Eb F1 and Eb-F2) could be established. They were found to express cell surface markers of both parental lines: T lymphoid differentiation antigens from T lymphoma and macrophage antigens (Mac-1, class II MHC antigens) from the normal cell fusion partner. The antigens were identified on the hybrids and subclones thereof by means of monoclonal antibodies and 3 different detection assays: cytofluorography, complement-dependent cytotoxicity and immunoprecipitation followed by gel electrophoresis. Animals inoculated s.c. with the parental line EbTGR developed local tumors but not metastases and survived for more than 40 days. In contrast, animals inoculated similarly with Eb-F1 or Eb-F2 cells quickly developed metastases in visceral organs and died as early as 10-14 days following inoculation. In many but not all respects, the in vitro-derived T-lymphoma macrophage hybrids resembled the spontaneous in vivo-derived variant ESb. These findings, together with the presence of Mac-1 antigen on ESb cells, suggest (1) that ESb variant cells may be derived from spontaneous fusion with a host cell, most likely a macrophage and (2) that somatic cell fusion may be an important mechanism of genetic rearrangements leading to metastatic variants. The new highly metastatic tumor lines which were developed under well-defined in vitro conditions, and their subclones, may become very useful tools for studying the contribution of specific genetic traits and of membrane-related structures to various steps of the metastatic process. PMID- 6500747 TI - Human tumor xenografts transplanted under the renal capsule of conventional mice. Growth rates and host immune response. AB - The growth of 29 different human tumor lines under the renal capsule of immunocompetent mice was investigated. The tumors, previously established in athymic mice, included malignant melanomas, colon carcinomas, soft-tissue sarcomas, lung cancers and a mammary carcinoma. The growth rates of 17 tumors, measured repeatedly over a period of several years, were highly reproducible. The different grafts exhibited distinctly different and individual growth rates for up to 6 days. In animals pretreated with an immunosuppressive dose of cyclophosphamide, the growth rate was the same as in non-pretreated animals, but the growth continued for several more days. In the case of 9 different grafts, the subrenal growth rates were compared with those observed when the same tumors were growing subcutaneously in athymic, nude mice. The relative growth rates of the different tumors were practically the same in the two systems. The results indicate that the growth conditions under the renal capsule permit the grafts to express their inherent growth potentials and that the subrenal grafts do not represent a selected sub-population of the tumor cells. The extent of infiltration of the grafts by mouse inflammatory cells was measured by flow cytometry on single-cell suspension as well as by quantitative analysis of serial histological sections. In most cases the mouse cells occupied 15-25% of the total graft volume on day 6. The results indicate that the effect of mouse cell infiltration on the growth of established tumor lines is slight and that it is unnecessary to use athymic mice as host animals when testing new investigational drugs by the SRC assay. The use of established tumor lines in the SRC assay in immunocompetent mice may be useful also in the study of factors influencing the anti-cancer activity of current drugs. PMID- 6500748 TI - Use of oral verapamil in long-term treatment of neonatal, paroxysmal supraventricular tachycardia. A pharmacokinetic study. AB - Efficacy and pharmacokinetics of verapamil were studied in two neonates affected by supraventricular paroxysmal tachycardia, under maintenance treatment with the drug. Verapamil proved to be fully effective in suppressing arrhythmic episodes at the daily doses of 1.5 mg/kg four times a day in case 1 and of 2 mg/kg in case 2. The results of plasma half-life of the drug, calculated in a dose interval, were 3.14 hr and 2.10 hr, respectively. In patient 2, doses less than 0.95 mg/kg four times a day did not produce detectable drug plasma levels, while a further stepwise increase of dose up to 2 mg/kg four times a day produced a steep rise in trough concentration. So, in view of this dose-concentration relationship, caution is recommended in adjusting verapamil oral dosage. PMID- 6500749 TI - Absent pulmonary valve syndrome with associated anomalies of the pulmonary blood supply. AB - We report four cases of so-called absent pulmonary valve syndrome associated with absence or anomalous origin of the left pulmonary artery. The fate of the patients with this condition appears to be affected mainly by the occurrence of pulmonary complications (three of our patients died of pulmonary causes, two of them after surgery). The proper timing of corrective surgery is still uncertain. Preoperative investigations should strive to obtain a clear-cut identification of the pulmonary arteries, particularly the left one or, in its absence, of the anomalous vascular supply to the lung. Right ventriculography, as employed by us, is insufficient. Pulmonary angiography, aortography and pulmonary vein "wedge" angiography may be needed. PMID- 6500750 TI - Tricuspid atresia with overriding imperforate tricuspid membrane: an anatomic variant. AB - An anatomical study of 34 specimens presenting with tricuspid atresia, in which particular emphasis was devoted to the atrioventricular junctional area, revealed 5 cases with an imperforate valve. In 1 heart the valve was completely committed to the right ventricle. In the other 4, however, the membrane was related not only to the right ventricle but also to the left ventricle. A hypoplastic right ventricular inlet portion was found in these 4 specimens. In 2 cases the tricuspid membrane overrode an inconspicuous inlet septal defect. In the other 2 hearts, as studied macroscopically, no defect was present underneath the membrane, which was connected to both right and left ventricles. These 4 specimens also had other ventricular septal defects. In classical tricuspid atresia, characterized by absence of the inlet portion of the right ventricle, the inlet septum is absent. In contrast, these 4 hearts did have an hypoplastic inlet septum. PMID- 6500751 TI - Streptokinase thrombolysis in experimental coronary artery thrombosis: pattern of reflow and effect of a stenosis. AB - We studied recanalization of an obstructed left circumflex coronary artery by streptokinase in open-chest anesthetized dogs. Thrombotic occlusion was induced by a 100 microA anodal current selectively delivered to the intimal surface of the vessel. Intracoronary streptokinase (50,000 U) or saline was infused over a 50-min period beginning at either 30 min or 90 min after occlusion. Continuous recordings were made of antegrade circumflex flow and regional myocardial function, which was quantitated using sonomicrometer crystals in the regions of the left anterior descending and circumflex coronary arteries. In some experiments a fixed stenosis, having no effect on mean circumflex coronary artery blood flow, was placed at the site of subsequent thrombus formation. The presence of a stenosis decreased the weight of occlusive thrombi obtained from nonreperfused saline controls by 40% and increased the proportion of animals successfully reperfused by streptokinase from 13 to 76%. Streptokinase reduced thrombus mass by 44% in animals recanalized in the presence of the stenosis. On the average, reflow was established after 26 min of streptokinase infusion, was less in magnitude than pre-occlusion flow, and was unstable and intermittent, being marked by frequent reocclusions. Initiating treatment at 30 min or 90 min post-occlusion did not influence characteristics of the reflow. Return of myocardial contractility in the ischemic bed was not detected during the immediate reperfusion period in the majority of these experiments. PMID- 6500752 TI - Echocardiographic diagnosis of cardiac embolus. AB - We describe a case of thromboembolism to the right atrium, diagnosed echocardiographically. The thrombus subsequently embolised to the pulmonary arteries with survival of the patient. PMID- 6500753 TI - Mitral valve aneurysm revealed by cross-sectional echocardiography in a patient with mitral valve prolapse. AB - We report a cerebral ischemia in a 23-year-old woman, in whom a mitral valve aneurysm with thrombotic masses was diagnosed by cross-sectional echocardiography. A prolapsing mitral leaflet was also visualized. PMID- 6500754 TI - Does role dictate response of chiefs and chairmen? PMID- 6500755 TI - Measurement of urinary thiamine propyl disulfide metabolites as an index of liver function. AB - Thiamine propyl disulfide (TPD) was orally administered in patients with liver disease to measure the main metabolite, 2-hydroxypropyl methyl sulfone (2HPMS), in urine, for the test of liver function. The amount of urinary excretion of 2HPMS decreased in proportion to the degree of severity of liver disease, with intimate correlation with various tests reflecting hepatic reserve function (p less than 0.01). Phenobarbital (PB), one of the inducers of hepatic microsomal drug metabolizing enzymes scarcely influenced the results of this test. In patients with ordinary liver disease without remarkable disturbance of intestinal absorption and renal excretory function, this method appears to be clinically applicable. PMID- 6500756 TI - Adverse drug reactions (ADRs) in patients with heart diseases. Comparison between patients without and with heart failure. AB - Adverse drug reactions (ADRs) may be more frequent in patients who present some diseases. By means of an intensive prospective drug surveillance work, 492 patients with heart diseases, hospitalized at the Department of Medicine of the Clinical Hospital of the University of Chile, were studied in order to determine the frequency and characteristics of ADRs. ADRs were significantly more frequent in patients with heart failure (HF) (30.0%) than in those without HF (22.7%)(p less than 0.05). Patients presenting HF developed more metabolic disturbances than patients not presenting HF (p less than 0.001). Furosemide was the most frequently used drug in both groups, but treatment with it was longer in patients with HF who presented a significantly higher frequency of adverse reactions to this diuretic (p less than 0.05). 89.9% of ADRs in patients without HF and 93.8% of ADRs in those with HF, were dose-related effects. Analyses of some predisposing factors to ADRs, such as age, number of drugs administered, duration of hospitalization, ADR or allergy histories and presence of a renal failure, did not explain differences found between ADRs in patients without and with HF. These findings suggest that heart failure may be a determinant of frequency and characteristics of ADRs. PMID- 6500757 TI - The kinetics of bupivacaine (Carbostesin) plasma concentrations during epidural anesthesia following intraoperative bolus injection and subsequent continuous infusion. AB - Plasma levels of bupivacaine were measured in 25 patients undergoing major abdominal surgery. The pharmacokinetic analysis of these data shows: (1) under a short term treatment, i.e. in the initial phase where multiple injections are given, the kinetic properties are in accordance with linear kinetic theory. The data can best be fitted to a two-compartment-model. (2) under a longterm treatment, i.e. infusion for more than 50 h, a very high accumulation occurs in contradiction to this theory. Therefore, the calculation of plasma levels from initial kinetic data is not feasible. PMID- 6500758 TI - Comparative bioequivalence study of furosemide in human volunteers. AB - A double-blind cross-over randomized clinical study with two different brands of furosemide was carried out in sixteen normal volunteers. The study indicated that the two brands were biologically equivalent. PMID- 6500759 TI - Differences in steady-state plasma levels between aminophylline and theophylline sustained-release micropellets after repeated circadian dosing. AB - In a randomized double-blind, cross-over study, theophylline plasma levels were compared over 24 hours after repeated administration of aminophylline and theophylline sustained-release formulations to 12 healthy volunteers. Although both preparations were capsules containing micropellets, and although they were administered in an identical circadian dosing scheme (1 capsule at 8:00 a.m., 2 capsules at 10:00 p.m.), marked differences in theophylline plasma levels were found. Whereas the aminophylline micropellets (Euphyllin CR 350) resulted in the clinically desired concentration/time profile with highest theophylline plasma levels between 2:00 a.m. and 6:00 a.m., theophylline micropellets failed to do so. Apart from differences in the in-vitro release at low pH-values, this may be due to differences in solubility between aminophylline and theophylline, which become clinically relevant in the supine position at night. PMID- 6500760 TI - Chronobiological approach to the treatment of essential hypertension: preliminary data. AB - The effect on bioperiodic parameters of hypertension elicited by the beta blocking agent mepindolol, administered as a single dose of 10 mg at 8 a.m. vs 10 mg at 8 p.m., was evaluated in this study. Circadian blood pressure monitoring was performed in age-matched patients with essential hypertension after a two week wash-out period with placebo and four weeks treatment. Patients were randomly allocated to one of the two treatment groups. Standard blood chemistry and electrocardiogram were performed at the beginning and end of the treatment period. Statistical analysis of blood pressure circadian rhythm characteristics (mesor, amplitude, acrophase) showed a significant decrease of mesor of systolic and diastolic blood pressure in both groups. Values of the mesor were not significantly different between the two groups. Interestingly, changes of acrophase and amplitude induced by the drug were different in regard to the time mepindolol was administered. Side effects were generally mild. PMID- 6500761 TI - Propranolol kinetics: use of automated liquid chromatography. AB - Concentrations of propranolol in plasma or cerebrospinal fluid can be reliably quantitated using liquid chromatography with fluorescence detection. After addition of pronethalol as internal standard, alkalinized samples are extracted with hexane:isoamyl alcohol (98:2); the organic extract is separated, evaporated to dryness, reconstituted in mobile phase (acetonitrile:water:acetic acid, 30:69:1), and chromatographed on a reverse-phase C-18 column. Effluent is monitored with fluorescence detection at excitation and emission wavelengths of 235 and 335 nm. The simplified extraction procedure plus an automatic injection system allows one person to analyze up to 100 samples per day. Sensitivity limits are .5 ng of propranolol per ml of sample, and the method is applicable to experimental and clinical pharmacokinetic studies. PMID- 6500762 TI - Assessment of daily iron doses administered to patients with chronic blood loss. AB - In chronically bleeding patients the hemoglobin concentration in blood (Hb) increases after iron therapy. The iron dose necessary for the maintenance of Hb is proportional to blood loss. A simple method for determining blood loss in chronically bleeding patients is introduced. The amount of iron necessary for an increase of Hb is needed for determination of the daily blood loss. A good correlation between calculated and required iron dosage was found for 14 out of 16 chronically bleeding patients. The calculated dose determined for one patient was below the required value; for the other patient only a slight difference was noted. PMID- 6500763 TI - The effect of antacid and aspirin on the bioavailability of isofezolac in man. AB - Bioavailability of isofezolac, a new non-steroid anti-inflammatory drug, with or without antacid and aspirin coadministration was investigated in 6 healthy volunteer. Each subject received, in random order, isofezolac (50 mg) alone or associated with aspirin (1 g) or phosphalugel (11 g aluminum phosphate). Isofezolac plasma concentrations were salicylic acid by spectrofluorimetric method. Plasma protein binding of drugs was studied by dialysis equilibrium method. During the absorption phase isofezolac plasma levels were slightly decreased in association with isofezolac-aspirin, but bioavailability of isofezolac was not modified. Time to peak of isofezolac was comparable in the three treatments, as was the case with plasma half-lives. Aluminum phosphate did not modify isofezolac availability. Plasma protein binding of isofezolac was very high (99%) and did not influence salicylic acid binding. PMID- 6500765 TI - On a nonparametric test of location. AB - The aim of this paper is to give some corrections to the article of Matos and Heppes "A simple nonparametric procedure: the Maximin-test", published in 1981, volume 19 of this journal. PMID- 6500764 TI - Drug interaction between chlorpropamide and non-steroidal anti-inflammatory drugs, ibuprofen and phenylbutazone. AB - Diabetics well controlled on chlorpropamide received, in randomized manner either 1200 mg of ibuprofen or 300 mg of phenylbutazone per day for rheumatic pains, for a period of 4 weeks. Fasting and postlunch, whole blood, true sugars (FBS and PLBS) were estimated at weekly intervals. Subjects taking phenylbutazone showed reduction in FBS values throughout the treatment; the reduction became statistically significant at the 3rd and 4th week. Clinical hypoglycemia, however, was not observed. The FBS values returned to pretreatment levels after stopping phenylbutazone. No significant reduction was seen in FBS in subjects taking ibuprofen. There was no significant change in PLBS values in either group. PMID- 6500767 TI - Sotalol-induced prolongation of the Q-T interval and attacks of unconsciousness. AB - A case history is reported of a patient who had several episodes of unconsciousness (because of ventricular extrasystole) while on antiarrhythmic and antihypertensive therapy consisting of quinidine (200 mg b. i. d.), sotalol (80 mg b. i. d.) and hydrochlorothiazide (50 mg g. d.). The syncopal attacks continued after discontinuation of quinidine but ended when sotalol was replaced by metoprolol and later on by verapamil. Marked prolongation of the previously normal Q-Tc interval (up to 0.71 s) was observed during the therapy with sotalol alone or combined with quinidine. The syncopal attacks were preceded by feeling of cardiac arrhythmia and they were most likely caused by torsade de pointes tachycardia. The prolongation of the Q-Tc interval by sotalol alone or combined with quinidine was obviously related to the tendency to cardiac arrhythmia and consequent episodes of unconsciousness. PMID- 6500766 TI - Pharmacokinetic and pharmacodynamic effects of furosemide in patients with impaired renal function. AB - Three groups of patients with kidney diseases were investigated: I. creatinine in serum less than 100 mumol/l, II. creatinine in serum 100-250 mumol/l, III. creatinine in serum greater than 250 mumol/l. After intravenous injection of 40 mg and 80 mg furosemide, serum concentrations and urinary excretion of the unchanged drug were measured fluorometrically. Moreover, urinary excretion of water, electrolytes, creatinine and urea nitrogen were estimated in order to check the pharmacodynamic effect of the drug. The pharmacokinetic parameters calculated were similar in group I and II. In group III t 1/2 was prolonged, renal clearance of furosemide was diminished. The diuretic effect of furosemide was noticeable during the first 4 hours following the injection of 40 mg in all 3 groups. Doubling the dose did not enhance the effect. Creatinine and urea nitrogen excretion in urine were not influenced by furosemide. PMID- 6500768 TI - Fate of orally given isosorbide dinitrate in cirrhotic patients. AB - In 5 out of 7 patients with cirrhosis and extensive shunting, plasma concentrations of isosorbide dinitrate after oral administration of 10 mg of the substance were markedly higher than those found in subjects without hepatic disease. The explanation could be a higher bioavailability and/or a lower systemic clearance, due to shunting and hepatic cell dysfunction. The difference was confirmed by the calculation of the areas under the concentration-time curves. PMID- 6500769 TI - Combined drug therapy--cholestyramine and compactin--for familial hypercholesterolemia. AB - Combined drug therapy with cholestyramine and compactin was found to be extremely effective against heterozygous cases of familial hypercholesterolemia. With a single drug regimen, compactin at a dosage of 15 mg/day produced a cholesterol reduction of 23% (70 mg/dl) in cases of combined hyperlipidemia, while twice the dosage (30 mg/day) was needed to produce a comparable effect with heterozygous familial hypercholesterolemia. When compaction was combined with cholestyramine (in a 4 g dose three times a day), the cholesterol-lowering effect of compactin was strongly improved with heterozygous familial hypercholesterolemia; half the dosage of compactin was enough to produce the additive effect compared with the effect produced by each single drug regimen. PMID- 6500770 TI - The absolute bioavailability of a new pediatric sustained release theophylline tablet, when given as whole or divided tablets. AB - Absorption characteristics and absolute bioavailability of a new sustained release theophylline tablet for pediatric use were investigated in seven volunteers, both after administration of whole tablets and tablets broken into four equal parts. An intravenous infusion of 200 mg theophylline (as aminophylline) was also administered to the same panel of subjects. Theophylline plasma concentrations were measured frequently during a period of 33 h post dosing. Both after intake of the whole and the broken tablets steadily increasing theophylline plasma concentrations were found. The maximum concentration was found after 5.2 +/- 0.6 h (mean +/- S.D.) and 5.3 +/- 2.2 h and measured 2.00 +/- 0.28 mg.1-1 and 2.46 +/- 0.60 mg.1-1, respectively. The absorption process continued for a considerable period. As a consequence the theophylline plasma concentrations remained above 75% of the maximum value during a period of 8.9 +/- 2.1 h and 8.6 +/- 2.0 h. The absolute bioavailability of the whole tablets was 91.8 +/- 24.7% and that of the broken tablets was 95.8 +/- 9.7%. PMID- 6500771 TI - A combination of cefuroxime and N-acetyl-cysteine for the treatment of maxillary sinusitis in children with respiratory allergy. AB - Twenty-four atopic children with allergic rhinitis, asthma and maxillary sinusitis were treated with a combination of cefuroxime 50-80 mg/kg/day and N acetyl-cysteine 15-25 mg/kg/day administered intramuscularly for 10 days. The efficacy of the treatment was judged on the basis of radiological and clinical evolution. The treatment was effective in 95.8% of the children, and 37.5% of them were able to reduce their treatment for asthma. None of the patients suffered severe side effects. The data obtained confirm that appropriate treatment of the sinusitis frequently results in a significant improvement of the asthmatic condition. PMID- 6500772 TI - Multiparametrical approach to fog-challenge-induced bronchial hyperreactivity in asthmatics--protective effects of salbutamol plus beclomethasone dipropionate. AB - A multiparametrical method was used in order to evaluate the characteristics of fog-challenge-induced bronchoreactivity. The effects of the bronchial stimulation were measured by means of spirometrical tests; determination of ventilatory resistances using a new method by interruption and rapid analysis of the expiratory gases, CO2 and He, according to the "multiple single breath" method. The protective efficacy of salbutamol and the salbutamol plus beclomethasone dipropionate combination was evaluated. The results obtained indicate that the combination exerts a greater protective effect, probably related to the stabilizing action of beclomethasone on the bronchial mucosa. PMID- 6500773 TI - Cerebral antioedematous effect of Teproside and of some vincamine derivatives. AB - Alkyltin compounds are known to produce in the rat a selective oedema of the CNS, especially of the white matter. Vincamine and vincamine derivatives, among which Teproside is the most potent, are able to prevent the occurrence of such an oedematous reaction whereas xanthine derivatives and papaverine fail to prevent this oedema. It is suggested that there may be a potentiation of the effect of vincamine by the xanthine part of the Teproside chemical structure. PMID- 6500774 TI - Vincamine TPS activity on glycoconjugate metabolism of the brain: effect on lysosomal enzymes. AB - The effect of vincamine TPS intraperitoneal injection on brain lysosomal enzyme activity is reported. After acute drug administration, an activation of almost all enzymes was found, confirming the "vasometabolic" effect of this drug. PMID- 6500775 TI - Pharmacokinetic study of vincamine teprosilate. AB - The results obtained by the authors in the pharmacokinetic study of vincamine teprosilate after oral and i.v. administration to young healthy volunteers and after oral administration to patients aged 68 to 84 years are presented. The description of the assay for each administration route is reported in the protocol. Plasma levels of vincamine teprosilate were assayed by reverse phase HPLC with spectrofluorimetric detection. The data obtained after i.v. administration made it possible to define the pharmacokinetic model and to estimate parameters. Concentration-time data were adapted to a biocompartmental open model with alpha value of 2.9080 and beta value 0.1047. In oral administration, the overlapping of the fast disposition phase and the absorption phase led to an apparent monocompartmental fit; in both young and aged volunteers, the absorption rate constants as well as the elimination rate constants were calculated. In both groups no significant differences in tmax values were found and no latency period was noticed . Cmax values were similar in both groups of patients; the lower distribution volume in aged volunteers compared to younger ones contributed to this finding. Differences in absorption rate constants in aged and young volunteers (0.53 h-1 and 0.73 h-1 respectively) are analysed. Vincamine teprosilate bioavailability after oral administration was found to be 20 +/- 5%. Possible vincamine teprosilate dose dependence kinetics are suggested. PMID- 6500776 TI - Pharmaco-EEG study on vincamine and on teproside in patients with chronic cerebrovascular disease. AB - Pharmaco-EEG is a technique used in diagnostic and in neuropharmacological research. Correlations between the ageing brain and EEG spectral analysis have been discovered (1-5). Typical EEG findings of multi-infarct dementia, senile dementia and chronic cerebrovascular disease have been reported by several authors. Using this methodology, it is possible to know if a drug crosses the blood brain barrier, the period of drug action and the drug-induced enhancement or inhibition of cerebral bioelectrical activity. It is also possible to ascertain the pharmacological class of a drug through a comparison between it and another that is well known. The authors have studied the pharmaco-EEG effects of teproside and vincamine in two groups of subjects affected by chronic cerebrovascular disease. The first group (8 patients, mean age 58.3 years) were treated with vincamine 15 mg i.v. EEG spectral analysis was performed using a Hewlett-Packard 5423 A analyser with centro-occipital derivations. EEG registrations were executed by using an epoch of 5 min at times- 15, 0, +15, +45, +60, and +120 min with drug administration at zero time. In a chronic study, after a three day wash-out period, teproside 240 mg/os/day was administered to the first group, while vincamine 60 mg/os/day and 120 mg/os/day was administered to the second group. Subjects were studied with EEG spectral analysis by using the same methodology at baseline and after 10 and 20 days of treatment. The two drugs induced an enhancement of cerebral bioelectrical activity by an improvement of alpha waves mean relative power, by a shifting toward rapid rhythms of dominant frequency and by a decrease of delta and theta waves mean relative power. With the dosages used teproside appeared to be more active than vincamine. PMID- 6500777 TI - Acute i.v. vincamine teprosilate administration: quantified investigation in elderly subjects. AB - The EEG changes in elderly subjects with chronic cerebrovascular disorders (CCVD) are well known and have been described by many authors. Vincamine teprosilate (Teproside), a drug supposed to act on the electrical activity of the brain, has the properties of modifying and, to some extent, improving age-related changes. Ten subjects, whose age ranged from 60 to 70 years, underwent the trial. Each received 1 ampoule i.v. of the active drug and 1 ampoule of placebo (or vice versa) after a 48-hour wash-out period, according to a double-blind randomized schedule. EEG recordings were performed at time 0 and then 30 min, 1 h, 2 h, and 4 h after injection. A double effect of vincamine teprosilate could be observed at the quantified EEG: 1) an early effect, i.e., an improvement of the EEG pattern within the first hour following administration; and (2) a slow-occurring effect that prevented negative EEG modifications from taking place at the fourth hour following administration. PMID- 6500778 TI - Evaluation of the effect of vincamine teprosilate on behavioural performances of patients affected with chronic cerebrovascular disease. AB - With a view to determining the efficacy of Teproside versus placebo in patients affected with cerebrovascular disease, 30 subjects, selected at the Montescano Medical Rehabilitation Centre, were randomly divided into two groups of 15 subjects each. After a two-week wash-out period, the first group was treated with placebo and the second with vincamine teprosilate (Teproside) at 120 mg daily, both for a period of 90 days. The assessment of each patient took place in two stages, one at the beginning and one at the end of treatment. It was performed according to both clinical criteria (including an interview with the patient and his family) and neuro-psychological criteria (memory tests, perceptive-spatial and logical functions tests). The data obtained showed a significant improvement of the behavioural performance, the mnemonic ability and the perceptive-motor activity in the Teproside group treated. PMID- 6500779 TI - Characterization of the delayed hypersensitivity response to a protein antigen in the mouse--I. Kinetics of reactivity and sensitivity to classical immunosuppressants. AB - Several parameters of the delayed hypersensitivity response (DHR) to a protein antigen, keyhole limpet hemocyanin (KLH), were investigated. Female B6C3F1 mice were sensitized with KLH suspended in either complete Freund's Adjuvant (CFA) or sterile saline. When the mice were sensitized twice, the magnitudes of these responses were equivalent as measured by a radioisotopic procedure reflecting the influx of monocytes. With only a single sensitization, there was a 37% decrease in the response of CFA-treated mice and a dramatic (82%) decrease in the response of saline-treated mice. Utilizing two sensitizing injections in male CD-1 mice, the kinetics of the responses were determined to be equivalent regardless of whether KLH was suspended in CFA or saline in that both responses were persistent for up to 5 weeks between the second sensitization and challenge. Ear thickness in CFA-treated mice was twice that of the saline-treated mice at 1, 3 and 5 weeks. This increased swelling was not due to an increase in the vascular permeability as measured by the extravasation of a radiolabelled protein. There was a marked increase in the total area of fibrin in both sensitized groups when compared to unsensitized mice; but no difference between the groups. The sensitivity of these responses to immunosuppressants was determined in male CD-1 mice exposed subchronically (14 day) to dexamethasone (DEX) and cytoxan (CTX). There was a marked increase in the suppression by DEX in mice sensitized to KLH in saline as compared to mice sensitized to KLH in CFA. In contrast, the sensitivity to suppression by cyclophosphamide was not affected by the presence of CFA. PMID- 6500780 TI - In vivo effects of ovalbumin-conjugated muramyl peptides on the anti-ovalbumin IgE and IgG responses in mice. AB - The effects of pretreatments of BALB/c mice with several conjugates of MDP and MDP-Lys to ovalbumin before immunization with ovalbumin (OA) were tested on the anti-OA IgE responses. Pretreatment with MDP-Lys-OA, but not with MDP-OA, induced an inhibition of the anti-OA primary and secondary responses, as measured by passive cutaneous anaphylaxis (PCA) and also by mast cell degranulation. The inhibition by pretreatment with MDP-Lys-OA was obtained whether it was administered in Freund's incomplete adjuvant (FIA) or in saline. This IgE suppression was accompanied by an enhancement of IgG2a and IgG2b anti-OA antibodies, with no change in the specific IgG1 levels. Loss of antigenicity of OA, detected by the lack of degranulation of peritoneal mast cells sensitized by IgE anti-OA, was observed in the MDP-Lys-OA but not in the MDP-OA conjugates. This loss of antigenicity appears to correlate with the ability of the conjugate to induce suppression of the specific IgE response. PMID- 6500781 TI - Increase of natural killer (NK) activity of mouse lymphocytes following in vitro treatment with cytosine-arabinoside. AB - The in vitro influence of cytosine-arabinoside (Ara-C) on mouse NK activity was studied treating effector cells, target cells or effector and target mixture with graded concentrations of the drug. Ara-C increased the NK efficiency of mouse splenocytes without enhancing the susceptibility of target cells or the cytolytic events when added to effector-target mixture. This phenomenon was confirmed with splenocytes collected from congenitally athymic (nude) or conventional donors of different ages, untreated or depressed or boosted for NK activity by various agents. In addition Ara-C increased the NK activity of spleen cells of nude mice deprived of nylon-adherent cells, and did not affect suppressor cells capable of inhibiting the lytic phase of NK process. The drug was able to significantly augment the binding ability of spleen cells to the NK-sensitive YAC-1 target. It was concluded that Ara-C would increase the efficiency of natural cytotoxicity presumably through a direct influence on effector lymphocytes. PMID- 6500782 TI - Prevention and treatment of L1210 mouse leukemia by immunization with xenogenized tumor cells combined with immunostimulation by the P40 fraction of C. granulosum and chemotherapy. AB - The effect on L1210 leukemia in mice of immunostimulation, in combination or not with chemotherapy with either daunorubicin or mitomycin, was studied. Immunostimulation with the immunomodulator P40 isolated from C. granulosum, together with xenogenized syngeneic tumor cells (GA-L1210-Tet: L1210 tumor cells inactivated with glutaraldehyde and coupled with tetanus toxoid), on days -14 and -7 before and days 2 and 9 after tumor inoculation, resulted in significant increase of the mean survival time as compared to control group with or without chemotherapy. Administration of P40 or P40 + GA-L1210-Tet cells, before or before and after inoculation of L1210 cells partly inactivated in vitro with antineoplastic agents, leads to a marked prolongation of mean survival time and to inhibition of ascitic tumor growth in a high percentage of mice. About 50% of the mice treated with P40 + GA-L1210-Tet cells and surviving the first challenge were resistant to rechallenge, providing that P40 + cells were reinjected before the second challenge, whereas all mice treated with P40 alone and surviving the first inoculation, were susceptible to rechallenge. The major conclusion is that treatments of combining chemotherapy, active immunization and nonspecific immunostimulation in the applied sequence are more effective than single treatments for control of L1210 mouse leukemia. PMID- 6500783 TI - Business as usual: heroin distribution in the United States. AB - This article criticizes the predominant analysis of heroin use as a social aberration and argues instead that the normal structure and functioning of U.S. capitalism generate both the market for the drug and the industry which supplies it. The structure of the distribution industry is much like those for comparable legal goods, but with distinctive features which provide reduced risk for dealers and long-term stability for the industry as a whole. The expansionary dynamic of the industry and the key role of syndicates in it are analyzed. The heroin industry is deeply integrated into the economy, and far-reaching social and economic change will be necessary if heroin use is to be significantly reduced. PMID- 6500784 TI - Nestle and breast vs. bottle feeding: mainstream and Marxist perspectives. AB - The breast vs. bottle feeding issue has sparked a controversial debate. Mainstream analysis of the problem shows that arguments made by the business community, as represented by the Nestle Corporation, do not withstand examination of the evidence. For example, it cannot be substantiated that women begin formula feeding because they have entered the labor force. Mainstream studies of cost effectiveness further indicate that bottle feeding is a drain on the incomes of impoverished Third World families and nations. Marxist analysis gives a very different perspective. Nestle represents 19th century capitalist development and the Industrial Revolution, and 20th century imperialism, neocolonialism and monopoly capitalism. Its motive has been capital accumulation and expansion. To increase surplus value appropriation, capitalism must devalue the household (subsistence) economy in which women enjoyed considerable status. Women also produce the most fundamental commodity for capitalism-laborers; therefore, the biological connection must be masked and controlled for the benefit of capital. Thus, as the capitalist mode of production has developed, women have been removed from important roles in production and reproduction. Coupled with the ascendancy of science, expertism and public health imperialism, breast feeding in any market economy becomes nearly impossible. As women internalize the values of capitalist ideology, they elevate "man-made" marketed commodities over subsistence goods such as breast milk. PMID- 6500785 TI - The politics of stress: the case of air traffic control. AB - Analysis of the 1981 Professional Air Traffic Controllers Organization strike suggests that workers who employ the concept of stress to describe undesirable job conditions risk unexpected negative consequences. In deciding not to make subjective claims that can only be addressed in political terms, workers necessarily appeal to outside experts to provide scientific, objective descriptions of job conditions. Unfortunately, different experts define stress in strikingly different ways, allowing for a kind of shell game in which the very existence of stress can become problematical. In addition, the stress experts have been unable to offer more than weak data to support the theories that link difficult working conditions to pathological outcomes. Thus workers are likely to lose labor disputes that depend on the stress discourse. A major reason for such an outcome is that job conditions, as part of the social world, lend themselves poorly to a form of inquiry designed to investigate the physical world. PMID- 6500786 TI - Women's health groups: alternatives to the health care system. AB - This article describes an empirical study of 28 alternative women's health organizations. These organizations were formed by women who rejected the existing institutions of health care, especially the nature and quality of reproductive health services. The study examined their philosophy of health care, the range of services provided and the characteristics of women who use them, their internal organization in terms of the distribution of power and authority, and the problems and challenges involved in their existence. Implications and impacts resulting from their continuing existence into the 1980s on the delivery of health care for women are addressed. PMID- 6500788 TI - Responses of maximal aerobic power and capacity to aerobic training. AB - The purpose of this experiment was to investigate the individual differences and the specificity in the response of maximal aerobic power (MAP) and capacity (MAC) to a 20-week aerobic training program. Twenty-four subjects (25 +/- 4 years), ascertained as sedentary, including 13 women and 11 men, participated in this study. MAP was determined with a progressive maximal ergocycle test, while MAC was computed as the total work output accomplished during a 90-min maximal ergocycle test. A modified bicycle ergometer allowed the exact measurement of the distance and the load for the computation of the work performed during MAC. The aerobic training program enhanced mean MAP/kg and MAC/kg by 33% and 51%, respectively. Although MAP/kg response to training was similar in both sexes, there was a sex difference in the response of MAC/kg, men improving 50% more than women. Individual differences in the response to the standardized training program were considerable with training gains ranging from 5% to 88% for MAP/kg and from 16% to 97% for MAC/kg. Correlations between training increments in MAP/kg with those in MAC/kg were rather low ranging from 0.28 to 0.44. These results indicate that there is a sex difference in the trainability of aerobic capacity, but not of maximal aerobic power, under the same 20-week aerobic training program. Moreover, large individual differences in the response to similar aerobic training are observed in sedentary persons, suggesting that certain genotypes are more sensitive to training than others. Finally, there is a high level of specificity in the response to training of the power and of the capacity of the aerobic energy metabolism. PMID- 6500787 TI - The role of medicine in the decline of hypertension-related mortality. AB - Mortality trends are often cited to justify public health priorities and to legitimate professional activities. For example, the decline of cardiovascular disease mortality in recent decades has been cited frequently as affirmation of the proper conduct and direction of medical and public health research. In this paper, the hypothesis that medical intervention is the major cause of hypertension-related mortality declines is reviewed. Evidence relevant to the "medical hypothesis," including mortality data and patterns of antihypertensive drug development and treatment, is presented. While it is clear that factors other than medical intervention must have played the major role in hypertension related mortality trends for most of the period of the decline, much scientific literature increasingly promotes the view that medical intervention is the crucial factor in mortality trends. The role of the medical hypothesis in supporting status quo political and economic interests is discussed, and alternative explanations for mortality trends are considered. PMID- 6500789 TI - Bicycle ergometry and speed skating performance. AB - A comparison between maximal power output during cycling and skating was made, and correlates of skating performance with bicycle performance and skating technique were investigated. Twenty-five well-trained speed skaters performed two bicycle tests and a 500-m and 1500-m ice skating race. The power (P) during skating is calculated from ice and air friction losses: at 500 m P500 = 344 +/- 60 W and at 1500 m P1500 = 283 +/- 65 W. Stroke frequency and pre-extension knee angle as principle determining factors of P were determined. The two bicycle tests (of 30" and 2'30" duration, maximal performance) yield P30C = 875 +/- 86 W and P2.30C = 420 +/- 52 W with VO2max = 4.76 +/- 0.45 l/min. The highest correlate of P500 as well as of P1500 appeared to be P30C, respectively, r = 0.78 and r = 0.85. Correlation coefficients between the power during skating and P2.30C or VO2max have a value of about 0.6. If the stroke frequency and P30C are correlated with the power during skating, then high multiple correlation coefficients are obtained: at 500 m R = 0.85 and at 1500 m R = 0.90. The correlation of P30C suggests that the interindividual differences of skating performance at 500-m and 1500-m distances can be attributed substantially to differences in anaerobic power. Yet, the predictive value of the bicycle test for speed skating performance is low. The difference observed between maximal power output during cycling and skating is discussed. PMID- 6500790 TI - Variations of serum testosterone concentrations after physical exercises of different duration. AB - Serum testosterone concentration was determined before and after physical activities of different duration. The subjects under study were: (1) 7 competitive walkers before and after a 20-km race (average race time 1 h 30 min); (2) 9 middle-distance runners before and after 1-h training; (3) 16 marathon runners before and after a marathon run (average running time 2 h 33 min); (4) 30 ultramarathon runners before and after a 107-km race (average running time 14 h). Serum testosterone increased by 51.8% (NS) in competitive walkers, by 38.2% (P less than 0.05) in middle-distance runners, and by 44.9% (P less than 0.01) in marathon runners; it decreased by 31.9% (P less than 0.001) in the ultramarathon runners. These findings, and similar variations of serum testosterone observed in an ultramarathon runner during a 6-h training session, suggest that serum testosterone increases during physical activities lasting up to 3 h and decreases to or even below the pre-exercise values for longer physical efforts. The possible mechanisms responsible for these differences are discussed. PMID- 6500791 TI - Muscle morphology and metabolic potential in elite road cyclists during a season. AB - The purpose of this investigation was to study muscle adaptation to high endurance performance. Muscle biopsies were taken from the m. vastus lateralis of 23 road cyclists, and their VO2 max was measured repeatedly during the season. At the beginning of their training season, VO2 max was 56 (37-66) ml X min-1 X kg-1 in competitive amateurs and 71 (64-76) ml X min-1 X kg-1 in elite professionals. Muscle capillary density determined at the same time was correspondingly roughly 30% higher in elite than in competitive cyclists while muscle enzyme activities (CS, HAD, and HK) were 30%-60% higher and LDH 50% lower in elite compared to competitive cyclists. Some elite cyclists were retested 5 months later when each of them had completed more than 15,000 km of bicycling during training and competition. During this period VO2 max remained unchanged, and the same was true for capillary density, while muscle enzyme activity (CS, HAD, and HK) increased 40%-70%, and LDH slightly decreased. The present results suggest that there may not be a close coupling between whole body VO2 max and the oxidative capacity of a local muscle group. Rather, the changes in muscle enzyme activities may be of importance for the regulation of muscle metabolism enhancing the endurance capacity. It is suggested that capillary density of the working muscles is of significance for VO2 max. PMID- 6500793 TI - Cervical injury from skiing. AB - A retrospective study of 18 patients with cervical spine injuries from skiing accidents is presented. Four patients were treated surgically because of instabilities. Twelve patients had associated head injuries, two of whom were operated on. One patient died from severe craniocervical injury caused by collision with another skier. The causes of the cervical spine injuries are analyzed and the possibilities for preventing them are presented. PMID- 6500792 TI - Maximal and submaximal oxygen uptakes and blood lactate levels in elite male middle- and long-distance runners. AB - Physiological characteristics of elite runners from different racing events were studied. Twenty-seven middle- and long-distance runners and two 400-m runners belonging to the Swedish national team in track and field were divided, according to their distance preferences, into six groups from 400 m up to the marathon. The maximal oxygen uptake (VO2 max, ml X kg-1 X min-1) on the treadmill was higher the longer the main distance except for the marathon runners (e.g., 800-1500-m group, 72.1; 5000-10,000-m group, 78.7 ml X kg-1 X min-1). Running economy evaluated from oxygen uptake measurements at 15 km/h (VO2 15) and 20 km/h (VO2 20) did not differ significantly between the groups even though VO2 15 tended to be lower in the long-distance runners. The running velocity corresponding to a blood lactate concentration of 4 mmol/l (vHla 4.0) differed markedly between the groups with the highest value (5.61 m/s) in the 5000-10,000-m group. The oxygen uptake (VO2) at vHla 4.0 in percentage of VO2 max did not differ significantly between the groups. The blood lactate concentration after exhaustion (VO2 max test) was lower in the long-distance runners. In summary, the present study demonstrates differences in physiological characteristics of elite runners specializing in different racing events. The two single (but certainly inter related) variables in which this was most clearly seen were the maximal oxygen uptake (ml X kg-1 X min-1) and the running velocity corresponding to a blood lactate concentration of 4 mmol/l. PMID- 6500794 TI - Total rupture of pectoralis major muscle in athletes. AB - Total rupture of the pectoralis major muscle is rare. It may follow a severe trauma or strenuous athletic exercise or performance. Five cases of total rupture of the pectoralis major muscle treated in athletes are reported. Two of them had made an extremely exerted effort in weight lifting, one was injured during a parachute landing, one was tackled in an ice hockey match, and one injured his pectoralis major muscle while pushing himself up from a swimming pool. In two cases the diagnosis was made early and in three cases 2-4 months after the injury. All of the patients were male and were treated successfully with surgery. Later they were able to exercise their sports. The weight lifters did not go on with competitive sports. PMID- 6500795 TI - Lupus miliaris disseminatus faciei. PMID- 6500796 TI - A clinical and mycologic study of tinea corporis and pedis in Puerto Rico. AB - A study of the causative agents of tinea corporis and pedis in Puerto Rico in 1982 disclosed four different dermatophytes from a total of 97 cases. Among the total of 49 fungus specimens collected in tinea corporis, the mycologic flora consisted of four different fungus species: Trichophyton rubrum, 42 isolates (85.7%); Epidermophyton floccosum, 4 (8.1%); Trichophyton mentagrophytes, 2 (4%); and Microsporum ferrugineum, 1 (2%). Among the total of 48 fungus specimens collected in tinea pedis, the mycologic flora consisted of 3 different fungus species as follows: T. rubrum, 35 isolates (72.9%); T. mentagrophytes 8 (16.6%); and E. floccosum, 5 (10.4%). Trichophyton rubrum caused 77 of 97 fungal isolates (79.3%). One surprising finding was the isolation of M. ferrugineum in a case of tinea corporis, documenting the first autochtonous case of this species in the island. This dermatophyte had previously been known only in Japan and adjacent areas of the Far East, Southern Europe, and Africa. PMID- 6500797 TI - Psoriasis verruciformis. PMID- 6500798 TI - Sporotrichoid Mycobacterium marinum infection. Report of a ten-year case. PMID- 6500799 TI - Familial benign chronic pemphigus appearing as leukoplakia of the vulva. PMID- 6500800 TI - Surface morphology of ovarian mesothelium (surface epithelium) and of other pelvic and extrapelvic mesothelial sites in the rabbit. AB - The morphology of the ovarian mesothelium (surface epithelium) and of other pelvic and extrapelvic mesothelia was investigated in the rabbit by use of scanning electron microscopy. Villous processes of varied architectural complexity and surface epithelial crypts were found in the ovary but not in the mesothelial linings of the oviduct, uterus, liver, or pelvic and abdominal walls. Both ovarian and extraovarian mesothelial cells possessed abundant microvilli. Fully developed individual cilia and ciliary tufts were seen exclusively in ovarian mesothelia, while abortive or blunted cilia were rarely seen in pelvic but not in extrapelvic mesothelia. A distinct transition in surface configuration was present in contiguous mesothelia. In fact, ovarian mesothelia containing numerous villous processes, crypts, and cuboidal to low columnar cells merged with oviduct and fat mesothelia displaying only flat or low cuboidal cells. Villous processes were often lined by a stratified or pseudostratified epithelium and this histology resembled that of ovarian surface papillomas. Processes were more numerous in smaller ovaries than in larger ovaries where interstitial tissue and corpora lutea were prominent. This study underscores the unique architecture and morphogenetic behavior of the ovarian mesothelium. It also suggests that local factors and/or reproductive patterns may have a role in regulating the growth and development of this important ovarian component. PMID- 6500802 TI - Well-differentiated ovarian Sertoli-Leydig cell tumors: a clinicopathological analysis of 23 cases. AB - Twenty-three well-differentiated Sertoli-Leydig cell tumors of the ovary, which occurred in patients from 18 to 61 years of age (average 34.5 years), are reported. There was definite evidence of androgen production in 40% of the cases and suggestive evidence in an additional 10%. One post-menopausal patient presented because of vaginal bleeding. The tumors were all Stage Iai and ranged from 1.5 to 10 cm (average 5 cm) in diameter. They were typically solid, lobulated, and yellow, yellow-tan, or white. Follow-up of 6 months or more was available for 21 patients. One of them died of breast carcinoma and another of colonic carcinoma without evidence of spread of their ovarian tumor; the remaining 19 were alive and well from 1 to 23 years (average 6 years) postoperatively. PMID- 6500801 TI - Minimal deviation endocervical adenocarcinoma: clinical and histologic features, immunohistochemical staining for carcinoembryonic antigen, and differentiation from confusing benign lesions. AB - Thirteen patients with a diagnosis of very well-differentiated endocervical adenocarcinoma were studied in order to characterize the histological and immunohistochemical features of minimal deviation adenocarcinoma (MDA). Five of these patients had neoplasms composed of structures almost identical to normal endocervical glandular patterns. These five neoplasms, representing MDA, were characterized by a haphazard proliferation of both large, claw-shaped glands, and smaller, slit-shaped, pointed glands. Focal mild cytologic atypia was identified in each case. Immunohistochemical stains displayed focal cytoplasmic carcinoembryonic antigen (CEA) in each neoplasm. Two of the five patients with MDA died of their neoplasms; both presented with advanced disease. Three well differentiated adenocarcinomas lacked the deceptively bland appearance of MDA. Two of these three well-differentiated endocervical adenocarcinomas also contained CEA. Atypical endocervical gland proliferations originally diagnosed as MDA in five patients were reclassified as benign lesions on the basis of histologic pattern, findings after subsequent surgical procedures, and benign subsequent clinical courses. Of these five benign lesions, only reserve cell hyperplasia was found to contain CEA. Minimal deviation adenocarcinoma should be distinguished from the more common well-differentiated endocervical adenocarcinoma and from atypical benign lesions. Criteria for these distinctions are presented. While the histological appearance of an endocervical gland proliferation is the paramount basis for identifying an MDA, immunohistochemical staining represents a useful diagnostic aid. PMID- 6500803 TI - Postmenopausal ovarian follicle cyst: an unusual cause of estrogen excess. AB - Six years after menopause, a 61-year-old woman complained of enlarging, tender breasts. The serum follicle-stimulating hormone level was 62 mIU/ml; the serum estradiol value was 91 pg/ml; and challenge with progesterone, 100 mg i.m., induced withdrawal bleeding. Histologic examination of a hysterectomy with bilateral salpingo-oophorectomy specimen showed proliferative endometrium and an involuting, luteinized follicle cyst of the left ovary. A follicle cyst causing symptomatic hyperestrogenism after a menopause documented by biochemical tests has not been previously reported. PMID- 6500804 TI - Mixed tumors of the vulva: clinical outcome and pathology. AB - Two cases of mixed tumors or pleomorphic adenomata of the vulva are reported with histologic description and clinical follow-up of 2 and 5 years. Only five other cases have been documented previously in the literature: four benign and one malignant. This rare tumor must be considered in the differential diagnosis of a solid vulvar tumor. PMID- 6500805 TI - Improved synthesis and resolution of beta-(3-pyridyl)-DL-alpha-alanine. AB - beta-Benzamido-alpha-(3-pyridyl)-DL-alpha-alanine hydrochloride was synthesized from 3-pyridinecarboxyaldehyde via the azlactone which was hydrolyzed to the acrylic acid before hydrogenation. The methyl ester was effectively resolved with subtilisin. The optical purity of the D-isomer was established, since the D isomer was used in synthesis of antagonists of the luteinizing hormone releasing hormone. PMID- 6500807 TI - A potential function for conformational analysis of proteins. AB - We have devised a residue-residue potential function for low resolution protein conformational calculations. The interactions between residues near in sequence maintain correct secondary structure, while the long-range terms in the potential govern the larger packing features and overall globularity. The short-range terms were calculated by comparing the observed distributions of distances between C alpha atoms in 35 protein crystal structures to the expected distributions and assigning the discrepancies to a Boltzmann distribution due to an effective potential. Long-range terms were adjusted to ensure that the crystal structure of bovine pancreatic trypsin inhibitor has a lower total energy than perturbed conformations of the same molecule. Thus the empirical potential function implicity contains solvation and conformational entropy effects along with the usual Van der Waals and electrostatic energies. Extensive testing of the potential on trypsin inhibitor and other proteins establishes that it is generally applicable to small proteins, it does not attempt to compress or expand the conformations found by X-ray crystallography, standard secondary structural features are maintained under the potential, and there are so many local minima that local minimization can be trusted to return a perturbed structure to the native conformation only if they differ initially by less than 1 A. PMID- 6500806 TI - Cooperative interactions in neurophysin-neuropeptide hormone complexes. Analytical affinity chromatography of native and covalently-modified neurophysins. AB - The structural interdependence between neurophysin (NP) self-association and ligand binding surfaces has been studied by analytical affinity chromatography of several NP sequence variants and derivatives on Met-Tyr-Phe-aminobutyl-agarose and bovine NP-II Sepharose. Elutions of radiolabeled NP's from both matrices show that hybrid dimers can form between major bovine NP's (I and II, or VLDV- and MSEL-NP's, respectively), as well as between human and bovine NP's, with affinities close to that for homologous dimer formation. Such evidence supports the view that the region of NP involved in NP-NP contact is composed primarily of conserved structural elements of the protein. NP antibodies which recognize surfaces close to or in the NP-NP contact region have been detected by their effects on bovine NP-II elution on NP-II Sepharose. Elutions of [3-nitro-Tyr 49] BNP-II from Met-Tyr-Phe-aminobutyl-agarose showed that nitration has little effect on the chromatographic properties of NP-II. This evidence substantiates previous arguments (Angal, S. & Chaiken, I.M. (1982) Biochemistry 21, 1574-1580) that the chromatographic behavior of native NP's on the affinity matrices is an expression of the interdependence of NP self-association and ligand binding surfaces and not due to bivalent peptide binding by NP monomer. The affinity chromatographic properties of NP derivatives, including bovine NP-II photolabeled in the ligand binding site and tryptic fragments of bovine NP-I (NP-I-(9-93) and [des 19-20] NP-I-(9-93)), support the view that the surfaces for ligand binding and NP-NP contact are conformationally linked. The data argue that conformational changes that ensue upon noncovalent ligand binding and lead to enhanced NP self association cannot occur favorably with the protein modified by either covalent ligand attachment or limited amino-terminal proteolysis. PMID- 6500808 TI - Hepatitis B mediated glomerulonephritis in children. AB - Forty nine children with hepatitis B virus-mediated glomerulonephritis (GN) were observed during the last 11 years. Boys were more frequently affected than girls, the ratio being 38 : 11. Young infants (1 to 5 years of age) predominated in the group. The incidence of membranous form of glomerulonephritis was high (34 out of 44 kidney biopsy cases, 77%), the rest of patients showing mesangiocapillary GN-8 (18%) and mesangial proliferative GN-2 (5%). The disease proved to be self limiting. Immunosuppressive or indomethacin treatment did not modify the course and outcome of the disease. Liver disease in these patients often persisted after the resolution of glomerulonephritis. PMID- 6500809 TI - Hemodiafiltration versus hemodialysis in children. AB - A total of 6 anuric children have been suitable treated with HD for 12 months and subsequently with HDF for 12 other months. Session time, tolerance and quality of epuration are compared in HD and HDF. Hemodiafiltration combining hemodialysis and hemofiltration in the same treatment time realizes in a short time (about 50% of hemodialysis session time) an optimal epuration with a good tolerance in children. PMID- 6500810 TI - Outcome of pediatric patients with end-stage renal disease in Switzerland 1973 1982. AB - The annual incidence of end-stage renal disease (ESRD: 1.32 patients aged 1/2-16 years per million population or 6.5 per million children of same age) and the causes have remained remarkably constant over the last 15 years in Switzerland. 58 patients (69%) were treated by dialysis and/or renal transplantation. The overall survival rate was 77% at 5 years and 65% at 10 years. 26 untreated patients (31%) died of uremia. They had not been treated despite existing facilities for the following reasons: Young age (7 of the 8 patients being less than 2 years old), psychosocial reasons (6), severe mental retardation (6) and associated problems (6). It is estimated that even in the future 20% of all pediatric patients with ESRD will be considered unsuitable for therapy by dialysis and renal transplantation. PMID- 6500811 TI - Screening for bacteriuria in healthy Japanese school children. AB - Bacteriuria was screened among 28,202 healthy school children, 14,575 boys and 13,627 girls by dipstick and dipslide methods and also by pour plate culture method. Prevalence of bacteriuria was 0.06% in boys and 0.54% in girls after third screening. A high rate of false negative results with dipstick test and a high rate of false positive results with dipslide culture method using Microstix 3 were observed. About 60% of screened children continued to have bacteriuria persistently for 9 months after third screening followed by monthly urine culture. Anomalies of urinary tract were detected in 9 of 26 children with persistent bacteriuria. PMID- 6500812 TI - Treatment of critical neonatal edema with hemo-ultrafiltration. AB - Three neonates with extreme edema associated with cardiovascular and renal insufficiency were treated with hemo-ultrafiltration for removal of critical edema fluid. In each patient peritoneal dialysis had not been effective in expedient fluid removal. Ultrafiltration was accomplished by occlusion of the proximal dialysate portal of a Travenol EX12-11, 0.8 m2 dialyzer and the application of vacuum suction to the distal portal. Blood flow ranged from 10-25 ml/min. The rate of ultrafiltration averaged 0.57 ml/kg/min resulting in losses of 4-16% of body weight. Episodes of hypotension were associated with too rapid ultrafiltration rate and not total volume removed. All patients tolerated the procedure. Two of the three patients demonstrated improvement in blood pressure, oxygenation and urine flow following the ultrafiltration. Ultrafiltration in the newborn may be a useful therapeutic procedure when conventional treatment fails. PMID- 6500814 TI - Normal limits for renal mobility in children. AB - The range of vertical renal mobility measured in the recumbent and erect positions was established in 309 children (232 girls) with normal renal function, ages 2.5 to 15 years, hospitalized because of urinary tract infections. It was found that the degree of renal mobility changed nonsignificantly with age, ranging between 12 and 19 mm approximately. In girls ages 12 to 15 years, the mean renal mobility was greater ranging from 21 mm (left kidney) to 23 mm (right kidney). Excessive renal mobility (calculated in mm as kidney mobility greater than 2 SD over the mean value in a particular age group) was found in 13 patients (4.2% of the studied children) 11 of which were girls. The right kidney alone was involved in 76.9% of these cases. A statistically significant correlation was found between the age, body weight, and height of these patients and the degree of right kidney mobility. Since nephroptosis of the right kidney has also been reported, mainly in adult women, the obtained results suggest that this abnormality is constitutional rather than acquired in adult life. PMID- 6500813 TI - Anaphylactoid purpura: hypertension with minimal urinary abnormalities. AB - We wish to draw attention to a case of hypertension in a child with anaphylactoid purpura, but with minimal urinary findings. Early recognition and effective antihypertensive therapy for short periods of time prevent potential complications. The wide spectrum of presentations, the epidemiological features, the diagnostic work-up and the role of the primary care physician are also reviewed. PMID- 6500815 TI - Renal infarction--a rare complication of Schonlein-Henoch syndrome. AB - The case of a 12 yr. old girl, presenting with left flank pain, macrohematuria due to left renal arterial thrombosis, is described. Subsequent appearance of purpura, G.I. bleeding, arthritis suggested the diagnosis of Schonlein-Henoch syndrome, which was confirmed by negative serology and contralateral renal biopsy. Major arterial thrombosis, as seen in this patient, is an extremely rare presenting symptom of Schonlein-Henoch syndrome. PMID- 6500817 TI - Gonorrhea in a five year-old boy with hematuria. AB - A case of hematuria due to gonorrheal infection occurring in a 5 year-old child is described. Since venereal disease in a prepubertal child may reflect sexual abuse, all cases of prepubertal gonorrhea should be carefully investigated. PMID- 6500816 TI - A case of congenital nephrotic syndrome associated with partial deficiency of lecithin cholesterol acyltransferase (LCAT) and hypothyroidism. AB - The case of a 3 year-old boy with congenital nephrotic syndrome is reported, in whom decreased LCAT activity and hypothyroidism were also present. Renal biopsy confirmed a diffuse proliferative glomerulonephritis with a large number of foam cells in the capillary lumen of the glomerulus and the interstitium, which stained positively with acid phosphatase indicating the presence of macrophage with phagocyted lipid vacuole. The histological picture was similar to that of familial LCAT deficiency, but the reported case is one of secondary LCAT deficiency as a result of urinary loss of the enzyme. Replacement therapy with thyroid hormones resulted in improvement in growth and development. PMID- 6500818 TI - Drugs in the rehabilitation of the elderly. PMID- 6500819 TI - Therapy after stroke: amounts, determinants and effects. AB - This report investigates the amounts of physiotherapy and occupational therapy given to acute stroke patients over the first 6 months, the factors that determine how much therapy a patient receives, and the effects of therapy upon outcome. The study is based on 162 acute stroke patients referred to a stroke rehabilitation unit. In this group the average daily rate of treatment during active rehabilitation, for both therapies combined, was 46 minutes, with a maximum of 42 minutes a day for physiotherapy and 48 minutes a day for occupational therapy. The major factors associated with the amount of therapy given related to the severity of the stroke: more therapy was given to those with lower initial functional ability, worse sitting balance, or greater loss of use of arm or leg. This association with severity probably accounts for the association between therapy and shoulder disease. A minor factor governing the amount of therapy given was the patient's degree of recovery: those who recovered less well received more therapy. It was not possible to demonstrate a specific beneficial effect of therapy. PMID- 6500820 TI - Speech disability in children: some general considerations. AB - Difficulties of definition are discussed with reference to overlap between phonological and phonetic disorders. Aspects of delayed speech are described and a brief account is given of deviant speech. Current patterns of management are considered. PMID- 6500821 TI - Speech--language rehabilitation for children in Switzerland. AB - Speech therapy for children is well known in Switzerland, but not all regions get the same supply. The average age of children who receive speech therapy is 7.9 years. This late beginning of treatment leads to longer duration of therapy. Therapy costs are shared by various institutions, to a wide extent by the Schweizerische Invaliden-Versicherung. The public has to be further informed about the meaning of speech and language rehabilitation. PMID- 6500822 TI - The communication status of older people: differentiation and rehabilitation. AB - The communication integrity of the older individual is subject to many influences. Understanding and management of the elderly communication-handicapped can prove difficult because of the problems of differential diagnosis. The role of the speech therapist is acknowledged in acute geriatric rehabilitation but is not immediately associated with psychogeriatric care. The laws of language deterioration appear to apply irrespective of aetiology. Standard linguistic rehabilitation techniques may be equally applicable in both geriatric and psychogeriatric care. PMID- 6500824 TI - Sedation in brainstem response audiometry. AB - In many children, sedation is virtually essential for reducing myogenic interference during brainstem response (BSR) audiometry. The most widely accepted sedative for young children is chloral hydrate. Children who are tired before the sedation is given fall asleep much more quickly with sedation, and in turn, require fewer doses of chloral hydrate. Instructing the parents to keep the child tired has produced significant increases in percent of those sleeping after the first dose (z = 2.08, P less than 0.05). PMID- 6500823 TI - Adenoid hypertrophy and nasal mucociliary clearance in children. A morphological and functional study. AB - The authors have studied nasal mucociliary function and adenoid surface characteristics in a group of 86 children, aged between 4 and 10 years, divided in two groups according to the presence or absence of clinical, instrumental and rontgenographic signs of nasal obstruction due to hypertrophied adenoids. Each group was divided into 3 age-related subgroups (group I: 4-5 years; group II: 6-7 years; group III: 8-10 years). A population of normal adults was chosen both for functional and ultrastructural characteristics. Nasal mucociliary clearance velocity values were evaluated by means of the saccharine method and the surface characteristics of the adenoid tissue by means of scanning electron microscopy. The data obtained show that the nasal mucociliary function is generally reduced in children but, while in the group with poorly developed adenoids an early and progressive improvement can be observed, the children with severely hypertrophied adenoids show an impaired function up to 10 years, without age-related improvements. At almost 10 years, children with poorly developed adenoids reach normal adult clearance values. These functional data can be related to the surface characteristics of adenoid tissue. In fact, while poorly developed adenoids are characterized by a compact layer of ciliated cells, severely hypertrophied adenoids are characterized by a metaplasic epithelium, with almost complete loss of cilia. Such findings, which are probably due to the inflammatory events frequently complicating adenoid hypertrophy, could explain, together with the obstructive effects, the impairment of the nasal mucociliary clearance in childhood. PMID- 6500825 TI - Laryngotracheoesophageal cleft in a newborn. AB - A case of laryngotracheoesophageal cleft in a newborn is presented. A newborn presenting with respiratory distress underwent contrast radiographic studies, direct laryngoscopy, bronchoscopy, and esophagoscopy, demonstrating a complete laryngotracheoesophageal cleft, esophageal diverticulum and microgastria. Attempts to maintain an adequate airway by ligation of the salivary ducts and ligation of the distal esophagus were unsuccessful. Continued biliary drainage per endotracheal tube postoperatively afforded a presumptive diagnosis of bronchobiliary fistula. The child expired on its fourth day of life. A review of the literature and modalities of therapy for these rare and unusual combinations of foregut anomalies is discussed. This is the first reported case of a newborn with the combination of laryngotracheoesophageal cleft, bronchobiliary fistula, microgastria and esophageal diverticulum. PMID- 6500826 TI - Saccular cyst of the larynx in infants. AB - A saccular or congenital cyst of the larynx is a mucus-filled dilatation of the laryngeal saccule and can distort the aryepiglottic fold, the false cord or the laryngeal ventricle. The most common symptom of the laryngeal cyst is respiratory distress with inspiratory stridor and the diagnosis can usually be made by laryngoscopy. Treatment includes incision and drainage together with extirpation of the cranial wall of the cyst through a laryngoscope. Sometimes tracheostomy is also needed. Usually there are no complications afterwards and the development of these infants is perfectly normal. Our 3 cases and clinical features of this very unusual disorder are presented. PMID- 6500827 TI - Otosclerosis in a black child: diagnostic acoustic impedance studies. AB - Otosclerosis classically describes an osteodystrophic change in the bony labyrinth and stapes footplate, of autosomal dominant inheritance, reported rare under the age of 5, extremely "rare" in the Oriental and Black race, "non existent" in the American Indian, and with a clinical incidence of 5 per 1000 Caucasians. The differential diagnosis of a non-effusion conductive hearing loss in a child should include otosclerosis, congenital malleus or footplate fixation, tympanosclerotic fixation, congenital cholesteatoma, lysis of the incus long process, Paget's disease, osteogenesis imperfecta, and fibromuscular hyperplasia of the renal artery. Presented is a case report of a 14-year-old black male with bilateral clinical otosclerosis and a persistent stapedial artery. Preoperative multiple-frequency tympanometry and Zwislocki acoustic reactance and resistance analysis demonstrated absence of the "W" resonance pattern on high-frequency tympanometry and the classic friction and stiffness patterns of otosclerotic fixation. Repeat multiple-frequency tympanometry testing post-stapedectomy demonstrated prosthesis articulation. Prosthesis position can be monitored postoperatively by these acoustic impedance studies. PMID- 6500828 TI - Salivary gland choristoma of the middle ear. AB - A 5-year-old female with a so-called "salivary gland choristoma" in the middle ear is reported, believed to represent the nineteenth such case in the literature. The nineteen cases are reviewed. The only consistent symptom was deafness. Aural discharge, tinnitus and otalgia occurred occasionally. The findings included a middle ear mass, conduction deafness and sometimes facial and external ear developmental disorders. At surgery a lobulated firm mass in the posterosuperior tympanum was usually found, being mobile and often pedunculated from a dehiscent part of the horizontal facial nerve. Ossicular and outer ear developmental abnormalities were common. PMID- 6500829 TI - Ozena as presenting symptom of a rare and severe genetic disease: hypohidrotic ectodermal dysplasia. AB - Ozena is quite a common clinical finding in ENT practice in many countries, but even if the pathological picture is clear, its etiology is unknown. We report on two young females in which ozena was the presenting symptom of a rare and severe genetic disorder (hypohidrotic ectodermal dysplasia, HED). Etiopathogenetic theories on ozena and genetic problems of HED are discussed. PMID- 6500830 TI - Auditory evoked potentials in senescent forgetfulness. AB - Two evoked potential (EP) techniques and the selective reminding test were employed to investigate an apparently benign forgetfulness in seven elderly subjects and seven age-matched elderly subjects with normal memory. EPs were also recorded in a group of seven young adults. Latency of the P3 component, which has been demonstrated to increase in primary degenerative dementia, displayed the normal age-related variation in both elderly groups, but did not differ between the forgetful subjects and the elderly controls. Further, no difference in the recovery cycle of the EP, as measured in a two tone stimulation paradigm, was present between forgetful and elderly control groups. Reexamination of memory after nearly a year disclosed no evidence of deterioration in either elderly group. These findings suggest that senescent forgetfulness, as defined herein, may be a nonprogressive memory disorder. PMID- 6500831 TI - Cerebral functional asymmetry and MBD children: a synergistic deficit of hemispheres? AB - The functional cerebral organization of minimal brain-damaged (MBD) children was studied by testing tactile-visual matching of concrete objects. The results revealed that left hand performance was significantly better than the right in the MBD children while normal controls showed no hand difference, and overall performance level was poor for MBD children. These findings are consistent with the view that tactile matching of concrete objects requires hemispheric synergy and that MBD children lack this synergy. PMID- 6500832 TI - Movement-related potentials during development: a replication and extension of relationships to age, motor control, mental status and IQ. AB - Three age groups of normals (children, preadolescents, and adults) and a group of mentally retarded adults performed a noncued button press task from which averaged movement-related potentials (MRPs) were derived. MRP wave shapes replicated our previously reported modal waveform types, except for the preadolescents, who showed no modal MRP. The normal groups showed a developmental shift in the prevalence of waveforms with the retarded differing from normal adults. The modal child waveform had a large amplitude positive-negative-positive form; the retarded had a uniphasic positive form; while normal adults showed the usual negative form. Major MRP types among children could not be attributed to differences in sampling or number of the trials averaged, or to trial-to-trial MRP variability. Background EEG activity did not differ in different modal MRP types. Modal child MRPs showed an initial peak positivity at Fz, and a late peak at Cz. The retarded had a sustaining central positivity developed by midepoch. MRP positivity and negativity were related to age, inhibition of extraneous eye movement (EM), and IQ. In children, greater cognitive proficiency is associated with adult-like MRP. The results suggest that positivity, in part, reflects a subject's efforts at inhibiting movement extraneous to the instructed task. PMID- 6500834 TI - Retinol and retinyl ester in separated structures of the guinea pig inner ear. AB - Chemical separation of different vitamin A derivates in inner ear extracts was performed by means of high pressure liquid chromatography (HPLC) with fluorescence and UV detection. For more accurate site identification the membranous cochlea was dissected and the basilar membrane, the spiral ligament and the stria vascularis were isolated for analysis. Retinyl esters were found in the basilar membrane at a concentration of 11.4 +/- 5.9 micrograms/g dry weight, a high concentration compared with that in other tissues of other organs. The spiral ligament contained retinyl esters at a lesser concentration and no retinyl esters were found in the stria vascularis. Retinol was not detected in the spiral ligament or basilar membrane but was found in the stria vascularis at a concentration of 1.2 +/- 0.8 micrograms/g. Retinyl palmitate and retinyl stearate were identified. This investigation shows that vitamin A forms retinyl esters with long-chain fatty acids in the basilar membrane in high concentrations relative to other organs and in greater quantity than in other sites in the inner ear. PMID- 6500833 TI - Flash induced nystagmus (FIN) in the rabbit: input-output relations. AB - Flash-induced nystagmus (FIN) was elicited by monocular flicker-stimulation at 20 40 Hz. It was found more often in albino than in pigmented rabbits. Slow phase velocity (SPV) showed a gradual increase, then a steady-state level in most animals and an after-response after cessation of stimulation. incremental and decremental phase mainly showed an exponential change in SPV. Apparent time constants were in the range of 5-40 sec. Simultaneous recording of both eyes revealed greater velocity and amplitude of both phases of FIN in the stimulated eye. FIN can be specified as a type of nystagmus that is evoked by monocular essentially open-loop stimulation of the crossed ("subcortical") visual pathway. Direction-selective elements in the retina may play a specific role and their predominant orientation gives rise to nystagmus in adducting direction in the flicker-stimulated eye as if it were exposed to optokinetic stimulation in the temporonasal direction. PMID- 6500835 TI - Concentration of vitamin A in the liver of foetuses and infants dying of various causes in Brasilia, Brazil. AB - The vitamin A concentration in liver samples taken at autopsy from the central portion of the right lobe of 57 infants 0-1 year old was determined by a dual spectrophotometric and colorimetric assay. Death was due to respiratory disease (30%), complications of premature birth (16%), infections (14%), hemorrhage (14%), pneumonia (10%), cerebral edema (7%), and miscellaneous causes (9%). Gross malnutrition was noted in only 2 of these children. The median vitamin A concentration was 61 micrograms of retinol/g liver, with a range of 6-293 micrograms/g. The percent distribution of liver vitamin A levels in micrograms/g was: less than 5 (0%); 5-10 (7%); 10-20 (5%); 20-40 (16%); 40-80 (42%); 80-120 (14%); greater than 120 (16%). The mean liver level in 9 stillborn full-term infants (60 micrograms/g) was markedly lower than in 7 stillborn premature infants (125 micrograms/g). The median value for 22 infants from indigent families (54 micrograms/g) was lower than that of 35 infants from non-indigent families (65 micrograms/g). By applying the criteria that liver reserves of vitamin A less than or equal to 5 micrograms retinol/g of liver indicate a high risk of vitamin A deficiency and those less than 20 micrograms retinol/g of liver denote an inadequate reserve, no infant was at high risk but 12% had insufficient reserves. PMID- 6500836 TI - Relationships between vitamin A and vitamin E in the chick. AB - Plasma levels of vitamins A and E were analysed during the dietary administration of two levels of vitamin A (10 000 or 50 000 IU/kg) in combination with four levels of supplemental vitamin E (0, 50, 100, or 150 mg/kg) and with or without a supplement of oil to the diet. Tocopherol levels in plasma were markedly decreased by the higher vitamin A supplementation. In contrast, the various vitamin E intakes had no influence on plasma retinol levels. The addition of oil to the diet did not affect this interaction. The absorption, distribution and elimination of labeled 3H-dl-alpha-tocopheryl acetate after an oral or intravenous administration, in combination with a high oral dose of vitamin A (100 000 IU/chick), were studied. The high oral single dose of vitamin A reduced the levels of radioactivity in all the analysed tissues and organs, when both vitamins were administered orally. However, vitamin A did not affect distribution and elimination of radioactivity, when an interaction in the gastro-intestinal tract was avoided by different routes of administration. PMID- 6500837 TI - Measurements of B1, B2, B6 status in children and their mothers attending a well baby clinic in Bangkok. AB - The status of thiamin, riboflavin and pyridoxine in 717 healthy children aged 1 60 months and 569 mothers aged 16-45 years attending a well-baby clinic in Bangkok were determined by using the erythrocyte enzymes, transketolase, glutathione oxidoreductase, aspartate aminotransferase and measuring the degree of stimulation with the coenzymes thiamin pyrophosphate, flavin adenine dinucleotide and pyridoxal phosphate respectively. Cut-off points for the upper limit of the normal ranges for the respective activation coefficients were established from the data obtained. PMID- 6500838 TI - Urinary thiamine excretion after oral physiological doses of the vitamin. AB - Urinary thiamine excretion has been measured in healthy subjects after oral physiological doses of the vitamin. There was a highly significant correlation between the oral dose and the urinary excretion. However, there was considerable overlap between the baseline values and the urinary excretion following doses up to 1000 micrograms. It is recommended that repeated daily measurements are made to differentiate baseline excretion from that recorded after oral physiological doses. This study may have relevance to the monitoring of dietary fortification programmes with thiamine. PMID- 6500839 TI - Thiamine pyrophosphate determination in whole blood and erythrocytes by high performance liquid chromatography. AB - A sensitive method for the measurement of thiamine pyrophosphate in whole blood and erythrocytes, using a straight-phase high performance liquid chromatography (HPLC), is described. The method was based on sample extraction with trichloracetic acid, conversion of the vitamer to the corresponding high fluorescent thiochrome ester, and separation and measurement of the derivative by HPLC. Evidence for reproducibility and accuracy of the assay is presented. Data indicating the thiamine pyrophosphate levels to be expected in blood and erythrocytes of healthy humans are included. PMID- 6500840 TI - Effects of riboflavin administration on the phospholipid metabolism of rat liver impaired with carbon tetrachloride. AB - This study was undertaken to investigate the effects of riboflavin administration on the phospholipid metabolism of rat liver impaired with carbon tetrachloride. Although the specific radioactivity in the CCl4 group decreased, the groups pretreated with riboflavin, especially B2-butyrate group, were prevented a decrease of 32P incorporation into total phospholipid in liver. The percentage of 32P incorporation into phosphatidylcholine in both mitochondria and microsomes was increased by the administration of riboflavin. PMID- 6500841 TI - Effects of pregnancy and riboflavin deficiency on some aspects of iron metabolism in rats. AB - Using female Norwegian hooded rats on controlled dietary intakes we have looked at the effects of pregnancy, and of riboflavin status, on levels of circulating iron, hepatic ferritin, iron stores and iron mobilisation in vitro from ferritin. Results suggest that pregnancy, and rapid growth, increase the demand for iron turnover, and deplete ferritin stores, and that riboflavin deficiency may impair iron mobilisation for these purposes. PMID- 6500843 TI - Quantitative and qualitative effects of N10-methylfolate on high-affinity folate binding in human leukocytes. AB - N10-methylfolate acted as a potent competitive inhibitor of high-affinity [3H] folate binding in human leukocytes, while methotrexate had no effect. Furthermore, folate binding changed into a non-cooperative type in the presence of N10-methylfolate. Hence, in qualitative and quantitative respects, the substrate specificity characteristics of leukocyte folate binding resemble those of other high-affinity folate binding systems. PMID- 6500842 TI - Evaluation of pyridoxine intake and pyridoxine status among aged institutionalised people. AB - The vitamin B6 status of 60 institutionalised elderly subjects (group A: 31 men, mean age = 77 yr and 29 women, mean age = 84 yr) and 41 healthy young adults (group B or control group: 18 men, mean age = 30 yr and 23 women, mean age = 27 yr) was evaluated using erythrocyte aspartate aminotransferase activity coefficient (alpha EGOT) and plasma pyridoxal phosphate (PLP) level (vitamin B6 deficient subjects = alpha greater than 2.0 and PLP less than 80 nmol/l). The kilocalorie, protein and pyridoxine intakes were also estimated. Regarding calories and protein, the diets may be generally considered satisfactory in respect to the French 1981 RDA. The mean dietary intake of vitamin B6 was less than 2 mg/day in all groups. Ninety per cent of the aged, 80 per cent of females in group B in contrast to 56 per cent of males in group B consumed less than their individual vitamin B6 requirements as determined by a probability method. As the incidence of vitamin B6 biochemical deficiency was much higher in the group A (71% for males and 86% for females) than in the control group (11% for males and 30% for females), it is concluded that the high incidence of biochemical vitamin B6 deficiency noted in the aged appeared more relevant from an altered metabolism of the vitamin than from a too low energy intake. Supplements with high doses of vitamin B6 to aged subjects caused a significant decrease in alpha EGOT and a significant increase in PLP levels. PMID- 6500844 TI - Prevention of thrombocytic defects in the br/br rabbit with folic acid and vitamin B12: analogy with the T.A.R. syndrome in humans. AB - Brachydactylia in the rabbit results from in utero haemorrhages leading to necrosis and post-natal amputations. Foetal liver study on day 14 to 16 of gestation, the critical period for thrombosis, reveals abnormalities of haematopoietic tissue. We observe a rarefaction of erythropoietic tissue and a defect of the megakaryocytic series resulting in erythrocyte macrocytosis and thrombopenia. Vitamin treatment (Folic acid + vitamin B12) administered to pregnant females prevents the above disorders and lead to production of mature forms in all the haematopoietic series. The T.A.R. syndrome (thrombocytopenia with absent radii) in humans, presents similarities with the physiological and clinical description of the br/br rabbit. Consequently, our research concerning the br/br foetuses seems to be a model for the study of several types of brachydactylia in humans either due to a vitamin deficiency or not. PMID- 6500845 TI - Lipid composition of the brain in the cobalamin inactivated fruit bat Rousettus aegyptiacus. AB - The fruit bat Rousettus aegyptiacus, when exposed to nitrous oxide (N2O) for 8-10 weeks develops cobalamin deficiency and neurological impairment leading to ataxia and death. We report the lipid composition of cerebral tissue of control animals and impaired animals following exposure to N2O, with or without dietary folic acid supplements. There were no statistically significant differences in the concentrations of total lipids, phospholipid, glycosphingolipid, plasmalogen and cholesterol between the different groups, although the ratio of choline phosphoglyceride to ethanolamine phosphoglyceride in N2O exposed animals was slightly lower than in controls. Bats exposed to N2O showed slightly higher levels of the fatty acid linoleate (18:2) in their phosphatidylethanolamine relative to arachidonate (20:4) compared with controls. This increase tended to be more pronounced in the bats receiving dietary folic acid supplements (but p greater than 0.05). PMID- 6500846 TI - Pantethine and pantothenate effect on the CoA content of rat liver. AB - The role of pantethine as a precursor of CoA in rat liver has been examined. It has been demonstrated that pantethine induces a significant increase in the total CoA content both in perfused liver and in liver homogenate, while it fails to affect the mitochondrial CoA content when added to isolated mitochondria. Pantethine is more efficient than pantothenate in inducing the synthesis of CoA in rat liver, even in the presence of added cysteine. The possible metabolic implications are discussed. PMID- 6500848 TI - An in vitro effect of ascorbate on the spontaneous reduction of sodium nitrite concentration in a reaction mixture. AB - Nitrite is known to react with free amines to form nitrosamines which may have carcinogenic activity. The present study provides evidence showing that addition of ascorbic acid in a reaction mixture results in a spontaneous decrease in nitrite concentration. The nitrite lowering effect of ascorbic acid appears to correlate with the rate of oxidation of the vitamin to dehydroascorbic acid, suggesting that ascorbic acid may be involved in the reduction of nitrite to nitrogen oxide. PMID- 6500847 TI - Excretion of organic acids associated with biotin deficiency in chronic anticonvulsant therapy. AB - Urinary organic acids, known to be elevated in children with biotin deficiency, were determined in 7 epileptics under long-term therapy with anticonvulsants and in three controls. Four patients administered phenytoin, primidone, phenobarbital, or carbamazepine, alone or in combination, had reduced plasma biotin levels (less than 250 ng/l) and an elevated excretion of certain organic acids indicating a possibly decreased activity of propionyl CoA carboxylase (3-OH propionate, methylcitrate) and 3-methylcrotonyl CoA carboxylase (3 methylcrotonate and the glycine conjugate, 3-OH-isovalerate). Two epileptics receiving sodium valproate alone had normal circulating biotin levels and no changes in level of the investigated urinary acids were found. These findings indicate that the reduced biotin levels seen in epileptics receiving other anticonvulsants than sodium valproate lead to an elevated excretion of certain organic acids in urine. PMID- 6500849 TI - The effects of various levels of ascorbic acid intake upon growth and organ weights of guinea pigs. AB - The purpose of this study was to evaluate the systemic effects of varying levels of orally administered ascorbic acid during wound healing in guinea pig oral mucosa. Forty five Murphy/Hartley guinea pigs were randomly placed into four groups and fed an ascorbic acid deficient diet for 2 weeks. Each group of animals then received a daily oral supplement of the following doses of ascorbic acid: 0.5 mg, 5.0 mg, 50 mg, and 250 mg. All animals were weighed twice a week. Twenty eight days later, a standardized wound was made in the premaxilla. On day 35, all animals were sacrificed. Blood samples were evaluated for levels of ascorbic acid. Thirty nine samples showed insignificant levels of vitamin C, 32 of which showed no ascorbic acid. Organ to body weight ratios were calculated and compared. Spleen to body weight ratios were not affected by different ascorbic acid levels. High levels of ascorbic acid caused a significant increase in adrenal gland to body weight ratios. Varying the levels of ascorbic acid did not affect growth prior to surgical wounding. Increased levels of ascorbic acid enhanced body weight recovery post surgically. PMID- 6500850 TI - Effect of large intake of ascorbic acid on urinary and plasma oxalic acid levels. AB - Blood samples form ten healthy subjects, who had been ingesting 3-10 g of ascorbic acid for at least two years, were collected. The ascorbic acid and oxalic acid levels in the plasma of these subjects were measured. The concentrations of oxalic acid in these plasma samples are within the range of plasma oxalate levels of human subjects who were not ingesting ascorbic acid supplements. Large quantities of ascorbic acid (10 g/day) were administered to healthy human subjects. Daily urinary samples of these subjects were collected before and during treatment. Urinary ascorbic acid and oxalic acid levels of these samples were measured. Among the six subjects tested, five experienced no significant change on urinary oxalate excretion. Urinary oxalate level of one subject was significantly elevated upon the large intake of ascorbic acid. But the increased daily excretion of oxylate in this subject is within the changes in urinary oxalate content from consuming normal diets. PMID- 6500851 TI - Effect of maternal dietary selenium intake on selenium levels in breast milk. AB - The average dietary selenium intake in Finland is naturally low, approximately 30 micrograms/d, when domestic grain is exclusively consumed. Selenium concentrations were determined in 46 individual breast milk samples collected after 1, 2, and 3 months of lactation in 1980, when the average Finnish dietary selenium intake was approximately 50 micrograms/d due to consumption of high selenium US grain. Selenium concentrations were characterized by a pattern of slight decline with advancing stages of lactation: 11.8 +/- 1.7 micrograms/l (n = 13), 10.9 +/- 1.9 micrograms/l (n = 18) and 10.0 +/- 1.9 micrograms/l (n = 15) at 1, 2 and 3 months post partum, respectively. This pattern, however, contrasts strongly to that found in a 1976 set of breast milk samples: 10.7 +/- 1.6 micrograms/l (n = 13) and 5.8 +/- 1.2 micrograms/l (n = 13) at 1 and 3 months post partum, respectively. The dietary selenium intake of the subjects was determined to be 33 +/- 13 micrograms/d during the course of lactation. Analytically, the results of these studies are analogous, as the same investigator determined both sets of samples by exactly the same analytical procedure. PMID- 6500852 TI - Selenium concentration in maternal and umbilical cord blood, placenta and amniotic membranes. AB - The selenium concentration of maternal and umbilical cord whole blood was determined by atomic absorption spectrophotometry in 21 parturients at term. Six placental and amniotic membrane tissue specimens were also investigated. The mean selenium concentrations in the maternal (0.73 +/- 0.15 mumol/l) and umbilical cord blood (0.77 +/- 0.18 mumol/l) were similar and without significant correlation. Placental (2.24 +/- 0.20 mumol/kg wet weight) and amniotic membrane tissue specimens (2.32 +/- 0.54 mumol/kg wet weight) also contained similar concentrations of selenium which were about 3 times higher than those in the maternal and umbilical cord blood. Low whole blood selenium concentration in Finnish parturients may be a sign of deficient nutritional intake of selenium during pregnancy. The relatively high concentration of selenium in the placenta and amniotic membranes on the other hand suggest that metabolically active organs are being provided primarily with this essential trace element. PMID- 6500854 TI - Provitamin A carotenoids from green leaves can restore vitamin A deficiency induced lesions in lung lipids in chicks. PMID- 6500853 TI - Effects of a purified diet enriched with animal protein on female rats. Preliminary report. AB - On account of many epidemiological data showing a definite correlation between mortality from heart disease and animal protein content in the diet, the effect of a 60 days purified diet enriched with casein and lactalbumin has been studied in rats. Although the experimental time was rather short, histological study of the organs has shown morphological alterations of liver, adrenal glands, heart, gastrocnemius muscle and kidney. Determination of some haematic parameters have revealed that from 15th day of diet glucose and triglycerides begin to increase moderately but significantly while azotemia is definitely high only after the 60th day. No changes vice versa were observed of cholesterol, creatinine and electrolytes level. PMID- 6500855 TI - Vitamin B6 supplementation during pregnancy and the vitamin-B6-status of the reproductive product. PMID- 6500856 TI - Biotin levels in plasma of patients with Friedreich ataxia and other spinocerebellar degenerations. PMID- 6500858 TI - Nutrition symposium 1984. Zurich, March 30, 1984. Abstracts. PMID- 6500857 TI - Ascorbic acid status of running and sedentary men. PMID- 6500860 TI - A note on the incidence of Trichophyton mentagrophytes infection in pigs and its zoonotic importance. PMID- 6500859 TI - An epidemiological survey of human sera for antibodies to Toxoplasma gondii in two states of Nigeria. AB - Sero-epidemiological survey of 34 blind people, 26 abattoir workers and 117 others to detect antibodies to Toxoplasma gondii was conducted. Only 15% of the blind people had positive levels of agglutinins in their sera. 42% of the abattoir workers and 25% of other donors were also serologically positive. While Toxoplasmosis is zoonotic, it does not seem that the disease was responsible for the blindness among the group that we have studied. PMID- 6500862 TI - Rabies in Ghana, West Africa. AB - Ghana, like many West, Central and East African countries is an edemic area for rabies. Between 1977 and 1981, despite yearly vaccination programmes of dogs and human being population at risk in 1977, the incidence of rabies is still high. A total of 752 canine and 102 human rabies were reported and confirmed. Hospital case reports of 8 persons that died of the disease confirmed all known facts about rabies except seasonality. Finally, the need for a nationwide effort to control, if not erradicate, the disease by mass vaccination of dogs is highlighted. PMID- 6500861 TI - Tick-borne rickettsioses in Pune district, Maharashtra, India. AB - An extensive study on tick-borne rickettsioses in the Pune district of Maharashtra revealed that Indian tick typhus exists as a zoonosis, which only occasionally causes disease in man. By sero-conversion in guinea pigs, presumptive isolates of Rickettsia conori and Coxiella burnetii were recovered from 4 of the 11 species of ticks examined. Boophilus microplus and Rhipicephalus haemaphysalis were found to be harbouring R. conori whereas C. burnetii was isolated from Haemaphysalis intermedia and Hyalomma hussaini in addition to the above mentioned 2 tick species. Complement fixation tests carried out on sera from various species of rodents and gerbils revealed the presence of antibodies against the R. conori antigen in the sera of Rattus blanfordi, R.r. rufescens and Suncus murinus. In the case of large mammals, similar antibodies were detected in the sera from dog, cow, horse and sheep. C. burnetii infection was found to exist in both the sylvan and domestic cycle, as evidenced from the involvement of ticks, large and small mammals and man in its natural history. PMID- 6500863 TI - Brucellosis in Uganda. AB - The paper reviews the present situation of brucellosis in Uganda and indicates that the infection is much more widespread than was hitherto considered. Positive agglutinin reactors among the unselected hospital patients in the zone of endemicity occupy 18-24%. The serology against bovine brucellosis in the newly established dairy farms and ranches shows 18.1% positive. PMID- 6500864 TI - Viral zoonoses in Nigeria: (I) Rabies. PMID- 6500866 TI - Ocular manifestations of diabetes. PMID- 6500865 TI - Rabies in Oyo State, Nigeria; 1971-1982. AB - Epidemiologic data gathered from recorded sources in Oyo State, Nigeria, indicates that people are at 2.1 times greater risk there than in Africa generally and 56 times greater than in the United States of America of dying from rabies. Women older than 30 years of age comprised 45% (5/12) of the analyzable rabies cases from 1971 to 1979. Two of these 12 cases were contracted from cat bites and both of these cases were women. The reason for the high rate of rabies in Women (7/12), especially older women, is not known although this may relate to their socio-economic role in this part of Nigeria. Nor is it understood why women are more likely to be bitten by rabid cats. Eighty-seven percent of rabid animals were dogs. Males were at greater wisk of being bitten by an animal than were females at a ratio of 1.8 to 1, but 57% of male and 49% of female bite victims were 14 years of age or lress. Women 35-39 years old were bitten more frequently than would be expected from the dminishing rate displayed with increasing age, and this may explain, at least partially, their involvement in fatal rabies. There were an average of 45 to 50 cases of animal bites reported in Oyo State each month from January 1978 through December 1981, and a drastic rise was seen in January through April of 1980. There was not a parallel increase in human rabies during this 4 month period, however. A wildlife reservoir for rabies was not evident from the Oyo State data and it must be presumed that dogs are the maintenance reservoir for the virus. Questionnaire surveys were not useful during this study, but personal interview and trace-back efforts to gather information were valuable. These latter efforts suggest that rabies is more prevalent than existing records indicate, probably by a factor ranging from 2 to 6 or more. Rabies control in Oyo State will require recording and systematic reporting of human and animal cases to develop meningful programs. These all in turn revolve around the societal recognition and determination to cope with the problem. PMID- 6500868 TI - Electrophysiological testing in diabetic eye disease. PMID- 6500869 TI - Extraocular muscle palsies in diabetes mellitus. PMID- 6500867 TI - The diabetic cornea. PMID- 6500870 TI - Diabetic vitrectomy. AB - Diabetic vitrectomy is usually performed to remove vitreous blood or to relieve traction of the macula. In addition to removing vitreous opacities and severing all anteroposterior connections of the posterior hyaloid face with a cutting and sucking probe, tangential traction in and around the macula is eliminated by sectioning preretinal membranes with intraocular scissors. Complications are significant in terms of both their incidence and their consequences. They include choroidal or subretinal infusion, peripheral and posterior retinal breaks, intraoperative bleeding, and neovascular glaucoma. Proper management can minimize the occurrence and adverse effects of these complications. If prognostic factors are favorable, visual improvement occurs in 78 to 59% of eyes postoperatively. Preoperative iris neovascularization, florid proliferative diabetic retinopathy, long-standing detachment of the macula, and iatrogenic retinal breaks are all correlated with significantly lower success rates. Three independent studies have shown that if visual improvement is present 6 months postoperatively, the results are usually long-standing [2, 8, 20]. PMID- 6500871 TI - Optic disc edema. PMID- 6500872 TI - The effects of surgery on the circadian rhythms of cortisol. AB - The circadian rhythms of plasma cortisol levels are studied extensively. Frequent sampling techniques are used to examine the effects of surgical trauma on the circadian pattern of plasma cortisol in man. Five patients were studied, 48 hours before and 48 hours after major surgery. The normal preoperative cortisol rhythms of these patients did not disappear after surgical trauma but they were significantly phase-shifted. In addition, the mean cortisol concentrations were significantly elevated and the intracircadian cycles suffered complex changes in the postoperative period. PMID- 6500873 TI - Septic shock in colony bred puppies versus random source puppies. AB - Many shock studies utilize unconditioned random source animals. To determine whether unconditioned random source dogs and colony bred dogs differ in response to septic shock, the following experiment was undertaken. Colony bred puppies and unconditioned random source puppies were pretreated with methylprednisolone and were subject to live E. coli induced septic shock. Resuscitation was carried out with Ringer's lactate and 5% albumin. Cardiac output dropped to less than 50% of control values in all animals. The colony bred puppies maintained a significantly higher cardiac output and pulse pressure and required a longer time for their cardiac output to decrease to 50% of control levels than did the unconditioned animals. In addition, the serum acid phosphatase rose significantly (indicating cellular damage) in the unconditioned group and did not change in the colony bred dogs. Marked hyperglycemia occurred in the unconditioned puppies whereas only a mild decrease in serum glucose was seen in the colony bred animals. These data indicate that extreme caution should be exercised in interpreting the physiological response of the unconditioned animal to experimental septic shock. PMID- 6500874 TI - Restoration of blood 2,3-diphosphoglycerate levels in multi-transfused patients: effect of organic and inorganic phosphate. AB - Blood stored in acid-citrate-dextrose (ACD) shows a progressive decrease in 2,3 diphosphoglycerate (DPG) content. Since the decrease in DPG increases hemoglobin oxygen affinity, which in turn may reduce tissue and venous PO2 and peripheral oxygen delivery, many efforts have been made to preserve or restore DPG levels in stored blood. An in vivo rejuvenating technique, employing fructose-1,6 diphosphate (FDP) at a mean dosage of 1 mmol kg-1 day-1 of phosphate, to increase the DPG circulating level in multi-transfused patients is proposed. Eighteen patients, who received at least one-third of their estimated blood volume (3990 +/- 480 (SEM) ml of ACD stored blood) in blood transfusion, were treated: nine with inorganic phosphate, and nine with FDP. Basal DPG was very low in both groups: 12.61 +/- 1.34 (SEM) and 10.42 +/- 0.98 (SEM) mumol g-1, respectively (normal value is 14.5 mumol g-1, at pH 7.40). However, DPG values increased significantly and promptly in patients receiving FDP, whereas in cases of inorganic phosphate administration, it was not significantly raised over the basal value until the third day. Phosphatemia remained normal and constant with FDP, but it rose significantly on the third day of treatment with inorganic phosphate. FDP appears to consistently and rapidly increase DPG levels after transfusion with blood stored in ACD, and to be particularly safe. PMID- 6500875 TI - Chronic dissecting aorta aneurysm: a medical or surgical disease? AB - The surgical results obtained in 40 cases of chronic dissecting aorta aneurysm are reported and compared with the results obtained in medically treated cases. Improved results with improved surgical techniques are described and the superiority of surgical treatment as opposed to medical treatment is stressed. Although mortality is decreasing, it is still very high and many surgical problems remain unsolved. PMID- 6500876 TI - Fetomaternal outcome in pregnancies after total correction of the tetralogy of Fallot. AB - Nine pregnancies in five women after total correction of the tetralogy of Fallot (TOF) are reported. In four women, further corrective operations were necessary in order to achieve class I functional capacity. Our management of the patients during pregnancy, labor and puerperium is described, and some simple rules are stressed. We suggest that improved feto-maternal outcome, in our series, may be related to the recorrective surgery of residual defects after one stage total correction of TOF, as well as to close surveillance by monitoring of perinatal and hemodynamic aspects of these patients. PMID- 6500877 TI - Amebic liver abscess. AB - 50 patients, with ages ranging from eight to 55 years, suffering from amebic liver abscess (ALA), have been studied. 90% of these patients were males. The abscess was located in the left lobe of the liver in nine cases and involved both lobes in four cases. In 17 patients, the abscess had already ruptured at the time of admission and, in four cases, it was about to rupture. In seven patients the diagnosis of ALA could only be made on laparotomy. The treatment is primarily conservative; antiamebic drugs, antiobiotic supportive therapy and aspiration of the abscess. Twenty-seven patients required surgery in the form of laparotomy and drainage of empyema. The preoperative use of antiamebic drugs directly influenced the results of surgery. Five patients died. None of them had any antiamebic treatment preoperatively and in 80% of these the diagnosis was only made after laparotomy. PMID- 6500878 TI - Inflammatory pancreatic masses. AB - An epigastric lump was found in 24 out of 55 cases of acute pancreatitis. Phlegmon was seen in 18, pseudocysts in five and abscess in one. These lumps present difficult diagnostic and management problems. Close monitoring of the signs and symptoms should serve as a guideline for rational medical or/and surgical management, especially in our country. PMID- 6500879 TI - Chronic pancreatic pleural effusions and ascites. AB - The occurrence of pleural effusion or ascites, secondary to internal pancreatic fistula, is a rare clinical syndrome and diagnosis is, therefore, often missed. The fluid accumulation has been attributed to disruption of the pancreatic duct or to rupture of a pseudocyst. In a 20 year period, 106 patients were hospitalized in the department of surgery, CHUV, with a diagnosis of chronic or chronic relapsing pancreatitis, and 77 with that of pancreatic pseudocyst. During this time, five patients with chronic pancreatic and pleural or peritoneal effusions have been observed. These five cases present a good pattern of the possible causes and evolution of the disease. Wirsungography is of great value for the surgical management of these patients, allowing the right technique to be chosen for each particular case. Surgery caused disappearance of the effusions in our five patients. PMID- 6500880 TI - Surgical treatment of biliary complications from calcifying chronic pancreatitis. AB - Obstructive jaundice in patients with chronic pancreatitis still constitutes a surgical problem deserving the attention of many specialized centers throughout the world. Out of a series of 149 patients operated upon for chronic pancreatitis, 45 (30.2%) with common duct stricture secondary to pancreatic disease have been studied in this series. Eleven patients (24.4%) had transient jaundice, eleven (24.4%) persistent cholestasis and six patients (13.3%) presented cholestasis with cholangitis. Seventeen patients (37.7%) were considered to have asymptomatic biliary tract stenosis. In 37 patients, pancreatic and biliary tract surgery were performed at the same time. There were two postoperative deaths (4.4%) and the late mortality was 9.3%. Choledochojejunostomy was preferred in the treatment of biliary stricture associated with pancreatitis. Cholecystojejunostomy provides inadequate biliary decompression and should not be used in the treatment of these patients. When a pancreatojejunostomy needs to be performed in association with biliary tract decompression, a double intestinal loop technique should be used because it is associated with less morbidity and mortality. PMID- 6500881 TI - Typhoid bowel perforation: a review of 264 cases. AB - Two-hundred and sixty-four patients with typhoid perforation of the bowel, who were admitted to our department during a five-year period (1978 to 1982) were reviewed. Most of the patients presented with advanced peritonitis, severe dehydration, toxemia and gross malnutrition. History and clinical examinations were sufficient for the diagnosis of these patients. Operative management was found to be far better than conservative treatment which was associated with a very high mortality. The best morbidity and mortality levels were obtained in patients who received thorough peritoneal lavage, intravenous Metronidazole, hyperalimentation and blood transfusion. The single layer suture technique was found more effective in reducing the incidence of postoperative fecal fistula than the double layer technique. PMID- 6500882 TI - The surgical management of Crohn's disease of the colon. AB - The authors analyze their experience in the management of 64 cases of Crohn's disease, located in the colon in 47 cases. The clinical and therapeutical aspects are discussed with particular attention to the surgical problems for which even today there is no general consensus of opinion especially when the colon is involved. PMID- 6500884 TI - Management of the perineal wound after rectal excision for carcinoma. AB - Two methods of treating the perineal wound after proctectomy are compared. One hundred and eleven patients had a Miles operation for rectal cancer: in 81 the perineal wound was left open, in 30, primary suture and suction were performed. A significant (p less than 0.001) decrease in the mean (+/- s.d.) duration of the postoperative period was observed after primary suture: 22 +/- 1.7 days, as compared with 44 +/- 2.2 days after healing by second intention. The occurrence of wound infection was similar in the two groups, whereas in 15 per cent of the patients treated without direct closure, a perineal sinus persisted. According to these data, primary closure seems to be very satisfactory in the management of the perineal wound after excision of the rectum. PMID- 6500885 TI - Diaphragmatic hernia as a complication of the Heimlich maneuver. PMID- 6500883 TI - The anterior resection operation revisited. AB - In a ten-year clinical experience (1966-1976) with anterior resection of the rectum and rectosigmoid colon, automated Russian and American anastomosing instruments were used. Results of operation in 123 cases of benign and malignant colonic disease show a nil mortality and no serious morbidity. The technique described establishes a colorectal mechanical anastomosis without the need of preliminary purse-strings and with peritonealization of the staple line for added safety. PMID- 6500886 TI - Stomach strangulated in inguinal hernia presenting with hematemesis. AB - A case of inguinal hernia containing stomach and presenting with hematemesis is reported. Initial conservative treatment was followed by elective surgery and was successful in this case. The possibility of strangulated stomach as part of the contents of inguinal hernia should be borne in mind in cases of very large hernia, presenting with hematemesis. PMID- 6500888 TI - More on congenital diaphragmatic hernia in the adult. PMID- 6500887 TI - Surgical applications of laser in neurosurgery. PMID- 6500889 TI - Herpes simplex virus-induced cell surface protrusions. AB - Cell surface alterations following herpes simplex virus infection were studied by scanning electron microscopy at different times after infection of chick embryo fibroblasts and Vero cells. Beginning at 4 h, an increasing number of cells showed numerous microvillus protrusions 0.12-0.18 micron in diameter and 0.3 micron in length. These structures could also be stained on Vero cells with fluorescent phalloidin, indicating the presence of filamentous actin within them. At 12 h, the number of chick embryo fibroblasts with virus-induced microvillus like structures began to decrease. There was an increase in virus titer in the medium beginning at 24 h, and it was therefore considered unlikely that the microvilli induced earlier had any function in virus release. Similar to poxvirus induced microvilli formation, DNA and protein synthesis inhibitors prevented the induction of microvilli, indicating the involvement of a late viral function. N1 isonicotinoyl-N2-3-methyl-4-chlorobenzoylhydrazine inhibited the formation of herpesvirus-induced microvilli in chick embryo fibroblasts but not in Vero cells. As this inhibitor had no effect on virus replication in either cell type, it is likely that the inhibition of microvillus formation was due to an anticellular activity of the drug. PMID- 6500890 TI - Coronary artery disease--risk factors. PMID- 6500891 TI - Clinical presentation of sex chromosomal anomalies. PMID- 6500893 TI - Non-operative removal of retained bile duct stones--the removal of seventy-one stones in thirty-one patients. PMID- 6500892 TI - Level of education, coronary risk factors and cardiovascular disease. PMID- 6500894 TI - Mortality in a general hospital and urban air pollution. PMID- 6500895 TI - Severe tetanus in a narcotic addict. PMID- 6500896 TI - Long-stay patients in acute general hospitals. PMID- 6500897 TI - The laser in surgery. PMID- 6500898 TI - Are simple striate cells analysers of visual signals both in spatial position as well as in spatial frequency? AB - According to a modern view, simple cells of the cat striate cortex are considered to operate as a part of Fourier analysis system thus leading to the idea that the operational mechanism of the visual cortex is concerned with the analysis of spatial frequencies. Nevertheless if simple cells are really concerned only with the analysis of spatial frequencies there should exist a strict relationship between their spatial frequency selectivity and the spatial organization of their receptive fields. This is because it is the spatial organization of the spatial frequency detector i.e. the cell's receptive field that determines the cell's spatial frequency selectivity. Since the quantitative analysis of the spatial organization of simple cell receptive fields has shown that the receptive fields of these cells are made up of two to four antagonistic subregions it follows that striate simple cells are concerned with the analysis of only a selected range of spatial frequencies. Therefore striate simple cells must be considered analysers of visual signals both in spatial frequencies as well as in spatial positions. PMID- 6500899 TI - Ataxic hemiparesis: further CT confirmation of an old localizing hypothesis. AB - 4 cases of ataxic hemiparesis syndrome are supported by CT proof of a lesion confined to the posterior and superior part of the internal capsule, near the corona radiata. The site of lesion is usually held to be the basis pontis and rostral midbrain. We intend to furnish further evidence in support of an old hypothesis incriminating the corona radiata-internal capsule. PMID- 6500900 TI - Roving lateral eye movements in coma. A clinical-pathological study. AB - Five patients in deep coma due to extensive supratentorial lesions presented roving lateral eye movements (ping-pong gaze), distinguished by the fact that the eyes, after moving to one extreme of gaze, returned to the midline instead of to the opposite extreme. The phenomenon was reported recently by Reynard et al. PMID- 6500902 TI - Effectiveness of bornaprine on parkinsonian tremor. AB - The effectiveness of Bornaprine on parkinsonian tremor was evaluated in a single blind study of medium-term treatment. 25 patients were treated with rising doses of Bornaprine per os, one week at each dose-level. The dose at which Bornaprine was most effective was 8 mg daily and its action at this dose was mild but statistically significant. The drug was generally well tolerated in patients with idiopathic parkinsonism, but transient confusion developed in a few patients with secondary parkinsonism. PMID- 6500901 TI - Failure of carbamazepine to prevent clonazepam withdrawal status epilepticus. AB - We describe two patients in whom clonazepam withdrawal status epilepticus occurred in spite of therapeutic levels of carbamazepine in plasma and cerebrospinal fluid. The failure of carbamazepine to prevent clonazepam withdrawal status epilepticus is discussed. PMID- 6500904 TI - Non-acid gastroesophageal reflux. Detection and evaluation by means of combined esophageal and gastric pH-monitoring. AB - One hundred and fifteen partially-gastrectomized patients were submitted to combined gastric and esophageal pH-monitoring with the aim of studying non-acid gastroesophageal reflux (GER). Since the detection of non-acid GER seems to be linked to the possibility of detecting entero-gastric reflux, only those patients (61) in whom entero-gastric reflux could be evaluated were considered. 37.7% of the patients showed non-acid GER according to the personal definition of such a reflux (any sudden esophageal pH change of 0.5 or more with earlier or simultaneous entero-gastric reflux). On the contrary, with De Meester and coworkers' criteria, only 21.3% of the patients were considered alkaline refluxers. Slight symptoms and slight endoscopical/histological changes were present in 20-30% of both non-refluxers and refluxers (whichever method of GER evaluation was considered). Therefore, correlations between GER and symptoms, endoscopical changes and manometric findings seemed poor using either method of GER evaluation. However, since the theoretical basis of combined gastric and esophageal pH-monitoring seems correct and the application of new techniques and the development of the parameters of "normality" can hopefully increase our understanding, the routine use of gastric and esophageal pH-monitoring should not be abandoned. PMID- 6500903 TI - Possible effectiveness of plasmapheresis on the neurological complications in a case of acute intermittent porphyria. AB - A 56 year old woman with acute intermittent porphyria presented mainly motor polyneuropathy, ophthalmoparesis of probable supranuclear origin and a mild organic brain syndrome. The neurological complications gradually cleared during a course of plasmapheresis. The fairly rapid improvement could conceivably have been fortuitous but it may well have been due to plasmapheresis. PMID- 6500905 TI - Intracolonic by-pass: a new technique to prevent anastomotic complications in colon and rectal surgery. AB - A new technique, the "intracolonic bypass" designed to prevent anastomotic complications after colonic and rectal resections is reported. It consists of a latex tube fixed to the intestinal wall above the anastomosis, which prevents the fecal stream from reaching the anastomotic site. The tube is retained until complete healing of the anastomosis and then excreted spontaneously through the anus. This new and simple technique avoids the disadvantages of a temporary diverting ileostomy or colostomy. PMID- 6500906 TI - The importance of endoscopy in the diagnosis of neoplasms associated with diverticular disease of the colon, and its effect on surgical treatment. AB - The results of fibercolonoscopy performed in 149 patients with clinical and or X ray appearances of diverticular disease are reported. Examination could not be completed in 16 per cent of patients because of impassable strictures in the left colon. Concurrent lesions were diagnosed in 69 per cent, and carcinoma was found in 6 per cent. The respective role of endoscopy and radiology are compared in the diagnosis of polyps, strictures, and cancer, coexisting with diverticulosis. It is concluded that colonoscopy is always indicated in diverticulosis with symptoms because it often provides a precise differential diagnosis thus obviating useless operations. Surgery is essential when impassable strictures prevent colonoscopy because the underlying conditions always require surgical treatment. PMID- 6500907 TI - Aneuploidy of lymphocytes in familial polyposis coli. AB - The "in vitro" aneuploidy of peripheral lymphocytes in 13 members of a family affected by familial polyposis coli and in 5 patients affected by familial adenomatosis and belonging to other two families, was examined. The increase in aneuploidy of lymphocytes was significant only in 6 of the 13 members of the family (2 affected by polyposis and 4 not affected) and in all 5 patients with polyposis. Aneuploidy could be, for these reasons, a marker for polyposis. PMID- 6500908 TI - Peristomal hernia following end-colostomy: a conservative approach. AB - Available data from follow-up of 183 patients who survived abdominoperineal excision for cancer of the rectum are reviewed. Sixteen patients developed a peristomal hernia, but none required surgical correction for over 20 years of observation. An additional group of 50 long-survivors has been recently examined to verify whether our restrictive surgical indications are adequate. Seven of these patients presented with a hernia, but none suffered obstructive symptoms and surgery was judged unnecessary in every case. Thereby, in our view, the benign evolution of peristomal hernias support a conservative approach based on a confident observation, control of the diseases which increase the abdominal pressure, and hernia compression by a colostomy belt. PMID- 6500909 TI - Indications, procedures and results in the surgical treatment of hyperthyroidism: a follow-up of 336 cases. AB - A personal experience with the surgical treatment of hyperfunctioning thyroid diseases from 1970 throughout 1982 is reported. Data on 336 controlled cases are analyzed. The series reported is homogeneous as for indications, surgical procedures, pre and postoperative management. Total lobectomy has proved to be the therapy of choice for uninodular lesions: all followed patients (208) are euthyroid. Subtotal or "near-total" thyroidectomy was curative in 71,8% of multinodular and basedowified goiters, as well as in Graves' disease. For the latter, indications of total thyroidectomy in selected cases are being evaluated. Further studies to complete the follow-up of the series are in progress. PMID- 6500910 TI - Thyrotoxicosis and thyroid cancer: a report on eight operated cases. AB - Eight cases of hyperthyroidism and thyroid cancer, representing 0.96% of overall hyperfunctioning thyroid diseases (835), surgically treated are reported. Clinical and pathological data, and type of treatment are summarized. The etiopathogenic hypotheses about possible relations between thyrotoxicosis and thyroid cancer are discussed. In the presence of thyrotoxicosis, preoperative diagnosis of thyroid cancer is rather difficult, but awareness of the potential association and careful examination of any suspect nodularity make it possible to recognize minimal malignant foci and adequately treat them with total thyroidectomy and, when required, modified neck dissection. PMID- 6500911 TI - Extra-adrenal pheochromocytoma with reversible renal artery stenosis. AB - A rare case of extra-adrenal pheochromocytoma occurring in the aorto-caval space and responsible for right artery stenosis, is described. The pheochromocytoma was excised and the blood flow in the renal artery restored. The heightened blood pressure, of dual origin, returned to normal after the operation. Three years after surgery the patient was normotensive and urinary catecholamines and Plasmatic Renin Activity (P.R.A.) were normal. PMID- 6500912 TI - Metabolism and nutrition in surgical sepsis. AB - The treatment of sepsis involves, in addition to the aggression of the septic focus by antibiotic and surgical means, the support of physiological functions, in particular the metabolic-nutritional support. The Authors base the description of the relevant aspects of metabolic-nutritional support in sepsis on the results of studies performed in their Clinical Research Center and in other Centers. PMID- 6500913 TI - Allocation of resources: the artificial heart. An NIH panel's early warnings. PMID- 6500914 TI - The artificial heart: questions to ask, and not to ask. PMID- 6500915 TI - The social context of workplace screening. PMID- 6500916 TI - Life as a work of art. PMID- 6500917 TI - Autonomy's temporary triumph. PMID- 6500918 TI - Autonomy: a moral good, not a moral obsession. PMID- 6500921 TI - Which clients should a sheltered workshop serve? PMID- 6500919 TI - The biological limits on autonomy. PMID- 6500922 TI - A community of givers, not takers. PMID- 6500923 TI - Organ procurement: it's not in the cards. PMID- 6500920 TI - Redefining parenthood and protecting embryos: why we need new laws. PMID- 6500925 TI - Care of the elderly and chronically ill. PMID- 6500924 TI - Ethical and practical public relations for the physician. PMID- 6500926 TI - Trace metals and atherosclerosis. PMID- 6500927 TI - The relationship between nurse staffing policies and nursing budgets. PMID- 6500928 TI - For-profit hospitals: American and foreign comparisons. PMID- 6500929 TI - Hospital work stoppages--the legal basis and the legal response. AB - Unlike other industries, hospitals are entitled by law to at least ten days' notice of any strike, picketing or concerted refusal to work. By asserting this right, they may plan for continued operation and the continued care of their patients. PMID- 6500930 TI - How to create more humane and productive health care environments. AB - Value-based leadership--linking "managership" and leadership approaches--is needed to meet today's ever-proliferating challenges to the fundamental philosophy and mission of health care organizations. To work, however, it requires important changes from everyone in the organization. PMID- 6500931 TI - The pharmaceutical industry's experiment with a consumer advisory panel: an inside view. AB - Over the past decade, knowledgeable and organized consumers, government regulation and old-fashioned competition have pushed industries into experiments to involve consumers in decision making. The drug industry's consumer advisory panel was one such attempt--on the whole, a productive one. PMID- 6500932 TI - HCMR interviews physician administrator leaders. Interview by Michael J. Enright. AB - This interview departs from HCMR's usual format, interviewing several leaders in health care administration for their ideas on current economic pressures, the impact of competition and joint ventures, attitudes toward equity and capital formation, and competition between the interest of clinical medicine and the cost of care. The physician administrators interviewed hold senior administrative positions: Charles Edwards, President and Chief Executive Officer of Scripps Clinic and Research Foundation; Robert A. Henry, President and Chief Executive Officer of Swedish-American Corporation; William S. Kiser, Chairman of the Board of Governors at Cleveland Clinic Foundation; W. Eugene Mayberry, Chairman of the Board of Governors at Mayo Clinic; and Ronald P. Kaufman, Vice-President for Medical Affairs of George Washington University Hospital. All are members of the Board of Regents or Fellows of the American College of Physician Executives. PMID- 6500933 TI - [Cutis laxa. Classification, clinical aspects and molecular defects]. AB - Cutis laxa summarizes a heterogeneous group of diseases which are characterized by loose skin. An additional to the clinical variants of cutis laxa, a brief review of the elastin pathway is given and possible defects in cutis laxa are discussed. PMID- 6500934 TI - [Congenital reticular ichthyosiform erythroderma]. AB - A 57-year-old female patient has had generalized cutaneous lesions since birth. Clinically there are patch- and band-like areas of erythrokeratotic and pigmented skin in reticular arrangement. The most important histological findings are band like parakeratosis, psoriasiform acanthosis, vacuolization of the keratinocytes in the upper layers of the epidermis with a high frequency of binuclear cells, and deposits of amyloid in the dermis. Ultrastructurally, the formation of perinuclear shells built from a three-dimensional network of fine filaments is the most peculiar finding. Binuclear cells are frequently found from the first suprabasal layers. Oedematization of the perinuclear cytoplasm within the shells finally leads to vacuolization of the uppermost granular cells. The horny layer is parakeratotic and contains debris of nuclei and lipid vacuoles. In the clinically normal appearing skin within the reticular network, keratinization occurs in a completely normal fashion. In spite of a good response to retinoid treatment, perinuclear shells and binuclear cells remain demonstrable in involved regions. The clinical, histological and ultrastructural peculiarities of this case suggest the diagnosis of a special type of congenital disturbances of keratinization, which can be clearly distinguished from the well-known ichthyosiform dermatoses and other inborn errors of keratinization. PMID- 6500935 TI - [Partial lipodystrophy syndrome (Dunnigan type)]. AB - Special forms of partial lipodystrophy, which in contrast to the progressive lipodystrophy of Barraquer-Simons spare the face, have been reported by Dunnigan and Kobberling. Lipodystrophy of the Dunnigan type affects the trunk and limbs; in lipodystrophy of the Kobberling type the loss of subcutaneous fat is restricted to the extremities. The following case report deals with the main clinical and laboratory findings in lipodystrophy of the Dunnigan type. PMID- 6500936 TI - [Glossitis in the area supplied by the chorda tympani nerve in peripheral facial paralysis. Early symptom of the Melkersson-Rosenthal syndrome?]. AB - The case is reported of a patient with incomplete peripheral facial palsy. In addition to hyperacousia and gustation disturbance, he presented with signs of glossitis limited to the region supplied by the chorda tympani. Clinical and laboratory investigations excluded the possibility of a viral infection. Possible connections between this combination of symptoms (apparently "idiopathic" facial palsy and regional glossitis) and the Melkersson-Rosenthal syndrome are discussed. PMID- 6500937 TI - [2 basaliomas of the lower leg in a 60-year-old female--one of them simulating ulcus cruris]. AB - We report on a 60-year-old female patient with an ulcer on the left lower leg, which was treated for 2 years without success. Histologically, a biopsy specimen showed a partly fibrotic and partly solid basal cell epithelioma. When all of the patient's skin was examined, a small skin-colored nodule was found on her right lower leg that histologically also turned out to be a basal cell epithelioma. The patient had no history of predisposing factors like exposure to arsenic or actinic skin damage. Our case is compared with the literature and briefly discussed. PMID- 6500938 TI - Regulatory implications of radiation dose-effect relationships. AB - Risk estimators for ionizing radiation at low doses are dependent upon the assumptions and mathematical relationships which are used for extrapolating the risk estimates obtained at high doses and high dose rates to low doses and dose rates. Much of the current controversy regarding the potential effects of low level ionizing radiation centers upon the choice of the dose-effect relationship used for this extrapolation. The linear dose-rate independent nonthreshold relationship has, until recently, been used almost exclusively for this purpose. It is generally assumed that, if the risks from low-level radiation are much higher than currently estimated from the linear extrapolation, then radiation protection standards should be lowered. Conversely, if the risks are about the same or lower than current estimates, the standards might be raised or be maintained at the current levels. This reasoning is based upon considering only the risk to the individual. If the potential impact on the exposed population is also considered, different conclusions are warranted. Consideration of the collective dose impact shows that if models such as the dose-squared model, D2, were valid, then the potential risks at low doses would be substantially less than predicted by the linear model. However, under these circumstances, it would be advisable to reduce individual doses, even at the expense of increasing the collective dose. This could be done, for example, by drastically lowering the existing dose limits. On the other hand, if a fractional power model, D1/m, was valid, spreading the dose over a large number of people could greatly increase the potential health impact. For this case, exposing fewer workers to higher individual doses might be the strategy to minimize collective risk. Linear quadratic and linear models differed only by a factor of 3 at low doses. For both of these models both the individual and collective dose (and risk) are important. PMID- 6500939 TI - Evaluation of internal control measurements in radioassay. AB - The internal quality control measurements a laboratory makes are repetitive measurements monitored to see whether their variability and conformance to known values are within acceptable limits. These measurements provide a reasonably large volume of quality control information quickly. Evaluation of measurement quality requires pre-established analytical criteria. The most important of these criteria is the acceptable standard deviation of each type of measurement. This paper presents a method for calculating acceptable standard deviations, as a function of radionuclide content, by combining counting statistics and manipulation/calibration error. It includes the treatment of blank variability when it is beyond random variability. Control charts are used as the primary way of presenting data for evaluation. The paper also presents criteria for judging the acceptability of a set of replicate measurements, based on the number that are outside present levels, such as two-sigma levels. In addition, a procedure for applying chi-square tests to data accumulated over a period of time is given. PMID- 6500940 TI - Uptake of 244Cm, 238Pu and other radionuclides by trees inhabiting a contaminated flood plain. AB - The plant uptake of 244Cm, 137Cs, 238Pu and 90Sr was measured for trees in a flood plain forest whose soils were contaminated by aqueous discharges from a nuclear-fuel chemical separations facility. Uptake of the naturally occurring radionuclide 226Ra was also measured. The relative availability of the nuclides was 238Pu less than 244Cm less than 137Cs less than 226Ra less than or equal to 90Sr. The concentration ratios for 238Pu and 244Cm, 3 X 10(-4) and 3.6 X 10(-3), respectively, were similar to those reported for other plant-soil systems. The ratios for 137Cs and 90Sr, 0.11 and 3.9, were similar to those reported for other southeastern soils. However, the ratio for 226Ra, 2.1, was greater than that normally reported. These ratios, which were determined in the field, were generally similar to those reported for greenhouse studies on the same soil. PMID- 6500941 TI - Radon concentrations inside public and commercial buildings in the Pittsburgh area. AB - Radon concentrations in ambient air from numerous schools, stores and other public and commercial buildings in the Pittsburgh, PA, area were measured by grab sampling. This is more appropriate than using long-term integrating monitors because of the correlation between times of occupancy and Rn levels. Results indicate that Rn concentrations in these buildings are nearly an order of magnitude less than in homes, and not much higher than outdoors. Variations among sites is also much less than for homes, probably because there is less variability in ventilation and building maintenance practices. Colleges and universities have somewhat higher Rn levels and a larger degree of variability than commercial buildings or hospitals. There was no indication of higher Rn levels in cold weather than in warm weather, or of correlations with the age of the building. PMID- 6500942 TI - Environmental effects of natural radionuclides from coal-fired power plants. AB - The assessment of the environmental effects of natural radionuclides contained in fly ash released from a coal-fired power plant was carried out and the following results were obtained. Mean concentrations of U, Th and K in 28 kinds of domestic and foreign coals were 1.0 ppm, 3.3 ppm and 2300 ppm, respectively. A good correlation between U and Th concentrations appears evident. Natural radionuclide concentrations of bottom and fly ashes were approximately equal in both ashes, and the values were the same as those calculated by concentration in coal divided by ash content. Release rates of 40K and radionuclides of each decay chain of U or Th were evaluated in the range of 2 to 40,000 pCi/sec for model coal-fired power plants of 1000 MW and 250 MW. The natural radionuclide concentration in air in a plume at the maximum concentration point was 5 X 10(-9) to 5 X 10(-3) pCi/m3, and these values were below 1/200 of those of natural origin. PMID- 6500943 TI - Disposition and effects of 85Kr in pregnant rats. AB - Pregnant rats were housed in 85Kr atmospheres at 10, 15, or 20 days of gestation (dg) and killed after 4 hr of exposure to 37-40 nCi/ml. The 85Kr was present in the components of the fetoplacental unit (FPU) at concentrations (nCi/g) equivalent to approximately 2% of the concentration (nCi/ml) in the exposure atmosphere. Tissue distribution of 85Kr and the distribution of radiation dose did not suggest any unusual hazard to the fetus associated with exposure of pregnant animals. This conclusion was tested using 5-day exposures to a 1000-fold increased concentration: 40 muCi/ml. The main effects observed in pregnant rats exposed to 85Kr from 7-12 or 12-17 dg (estimated radiation dose of 5 X 10(3) rad to maternal lung and 5 X 10(5) rad to maternal skin surface) were deaths, impaired weight gain and skin lesions. Secondarily, the maternal toxicity led to indications of embryotoxicity, although the incidence of malformations was not increased by the estimated 50-rad dose to the FPU. PMID- 6500944 TI - Ingestion pathway factor in dose assessment for annual airborne releases of radioactivity. AB - An analytic model is derived for use in a simplified assessment of the committed effective dose equivalent to the public due to routine airborne releases of radioactive materials. The model uses the dosimetry in ICRP Publication 30 and determines the ratio of the committed effective dose equivalent (CEDE) via a specified ingestion pathway relative to that CEDE by inhalation per annual airborne release of a radionuclide. This ratio is defined as the ingestion pathway factor (IPF) and is shown to depend upon the radionuclide annual limits of intake, the atmospheric deposition velocity, and an ingestion parameter, the effective contamination intake area. The IPF values are tabulated for several radionuclides. These resultant IPF values often exceed unity, suggesting that the ingestion path is often the critical or limiting pathway for off-site CEDE to an individual. An application of this assessment is demonstrated in a review of a hypothetical nuclear facility to determine the appropriate extent of radiologic effluent and environmental monitoring at the facility. PMID- 6500945 TI - Observations on very long-term removal of uranium compounds. PMID- 6500946 TI - Radioactivity in books produced during the last 50 years. PMID- 6500947 TI - Dose estimation to the infant from breast milk following intraperitoneal administration of chromic phosphate 32P for the treatment of early ovarian cancer. PMID- 6500948 TI - Automated source wells for instrument calibration. AB - Microcomputer automating of a source well provides improved accuracy, precision and efficiency for calibrating portable instruments. Furthermore, correction for temperature, atmospheric pressure and radioactive decay can be made automatically. PMID- 6500949 TI - Calculation of 90Sr and 89Sr concentrations in environmental samples using a generalized linear system. PMID- 6500950 TI - Estimation of mean organ doses in diagnostic radiology from Rando phantom measurements. PMID- 6500951 TI - Quality assurance in nuclear medicine: a computerized approach. PMID- 6500952 TI - Distribution of 253Es in juvenile miniature swine. PMID- 6500953 TI - Radon exhalation: moisture and temperature dependence. PMID- 6500954 TI - The effects of water acidity and seasonal variability on the distribution of 241Am in the freshwater snail Lymnaea stagnalis L. PMID- 6500956 TI - Deep-ocean radioactive waste disposal. PMID- 6500955 TI - Iodine-129 in ovine thyroids from England. PMID- 6500958 TI - Evaluating the impact of certificate-of-need regulation using measures of ultimate outcome: some cautions from experience in Massachusetts. AB - Prior evaluations of certificate of need (CON) have concluded that such regulation did little to reduce the level of hospital capital investment. These studies, however, failed to examine the underlying patterns of hospital investment behavior onto which CON was imposed and further neglected to determine the lag period that separates the introduction of regulation and the appearance of outcomes actually attributable to the presence of CON. This article addresses these two issues by using rate-setting data to examine the details of hospital capital investment across the whole voluntary hospital industry in one state- Massachusetts--both before and after the introduction of certificate of need. Massachusetts voluntary hospitals were found to devote most of their capital expenditures to the construction of major new inpatient facilities built in cycles of 14 years average duration throughout the post-World War II period. The date of completion of such a facility proved to be the major determinant of a hospital's capital expenditure pattern over time, and hospitals of similar teaching status and geographic location showed considerable synchrony in the construction of such facilities. At least in Massachusetts, the introduction of certificate-of-need regulation coincided with but was not responsible for the conclusion of a major construction peak among nonteaching hospitals and the beginning of such a peak among teaching hospitals, greatly complicating the evaluation of actual CON effects. Further, capital expenditures actually approved by CON did not appear until the third year of program operation, and even five years post-CON, the majority of hospital capital expenditures reflected projects approved in the first year of regulation, a period during which the program had neither the expert staff nor extensive review capacity that characterized CON function in later years. These findings hold implications for the evaluation of CON effectiveness and, indeed, for the future existence of certificate of need. PMID- 6500957 TI - The effect of hospital characteristics and organizational factors on pre- and postoperative lengths of hospital stay. AB - To determine reasons for variations in length of stay (LOS) for surgical patients, a comprehensive statistical model was specified and estimated using 1978 discharge abstract data from New Jersey. The model distinguished preoperative LOS from postoperative LOS, and analyzed differences in the impacts of each determining factor on each segment of a hospital stay. The model included a large set of control variables, but the focus of discussion in this article is on factors which reflect the preferences, policies, and organizational routines of hospitals. The empirical findings suggest strategies that hospital managers and regulators can use for reducing average LOS. For example, afternoon admissions often result in extra preoperative days of care even after adjusting for severity of illness. Apparent scarcity of posthospital care in New Jersey also seems to translate into longer hospital stays. Using a comprehensive model and a large, reliable data set, the analysis confirms many hypotheses concerning reasons for LOS variation that have been suggested by earlier research. However, the analysis also raises questions concerning the interpretation of other earlier findings. PMID- 6500959 TI - The decision process used for hospital bond rating--and its implications. AB - Investigation of the process of hospital bond rating related the ratings assigned by Moody's and Standard and Poors to indicators of hospital financial condition (such as debt per bed and peak debt coverage), institutional factors (including size, occupancy, and local market competition), indenture provisions (such as reserves), and contextual factors. The criteria used by Moody's and Standard and Poors to rate hospital bonds were revealed to be similar, but not identical. Criteria used in the bond rating process have several important implications: the rating approach provides strong financial incentives for increases in hospital size and complexity, for example, and hospitals that rely on extensive amounts of public financing appear to be penalized in the rating process. PMID- 6500960 TI - Cost implications of hospital unionization: a behavioral analysis. AB - The growth of unionization among hospital workers was sharply accelerated by the 1974 amendments to the National Labor Relations Act covering voluntary hospital workers. With continuing inflationary pressures in the hospital sector, the cost implications of the recent and projected growth of hospital unions is of some concern to policymakers. This article presents estimates of union cost impacts based on data from hospitals in Maryland, Massachusetts, New York, and Pennsylvania. Cross-sectional regressions with data for 1975 yield positive union impacts of 3.3 percent on total costs, 4.1-5.9 percent on cost per case, and 6.1 percent on cost per day. Reestimation of the model with data on changes over the 1971-1975 period yields similar results. We also find that the cost impact of unionization varies with the pattern of coverage (being lower for service employees and RNs) and with the extent of cost-based reimbursement. This suggests that future cost impacts of union growth may be moderated as prospective payment systems for hospitals become more widespread. PMID- 6500961 TI - [Clinical aspects of fertility disorders in the male caused by antispermatozoa antibodies]. PMID- 6500962 TI - [Indications and results of testicular biopsies in infertility]. PMID- 6500963 TI - [Fertility and adnexitis in the male]. PMID- 6500964 TI - [Role and detection of genitourinary inflammations in male infertility]. PMID- 6500965 TI - [Revascularization surgery versus prosthetic surgery in vascular impotence. Indications, operative methods, after care]. PMID- 6500966 TI - [Reanastomosis following vasectomy]. PMID- 6500967 TI - [Homologous insemination in retrograde ejaculation]. PMID- 6500968 TI - [Practical urinary calculus diagnosis. Experiences and consequences after 3 years]. PMID- 6500969 TI - [Iatrogenic lesions of the ureter: immediate or delayed treatment?]. PMID- 6500970 TI - [Bilateral ureteral obstruction following aortofemoral bypass. Presentation of a case]. PMID- 6500971 TI - [One-stage posterior urethroplasty by resection anastomosis. Long-term results]. PMID- 6500972 TI - [Survival and morbidity following combined treatment of cancer of the bladder]. PMID- 6500973 TI - [Cystic kidney diseases and kidney tumors]. PMID- 6500974 TI - [Improvement in teaching endoscopic interventions in the development of video recording systems]. PMID- 6500975 TI - [Urodynamics of the ileal conduit in adults]. PMID- 6500977 TI - [The approach in urology--the lumbar approach]. PMID- 6500976 TI - [Follow-up study of 247 vasectomies]. PMID- 6500978 TI - [Retroperitoneal access by the transthoracic approach]. PMID- 6500979 TI - [Transpubic and perineal operative approach]. PMID- 6500980 TI - [Parasacral approach to the urologic organs and the pelvis]. PMID- 6500981 TI - [The extended Gibson incision as an approach in nephroureterectomy]. PMID- 6500982 TI - [A wing-shaped pararectal incision in tumor nephrectomy]. PMID- 6500983 TI - [Transthoracic retroperitoneal approach in urology]. PMID- 6500984 TI - [Experiences with a modification of Nagamatsu's extrapleural thoracoabdominal approach]. PMID- 6500985 TI - [Indications, technic and results in dorsal kidney exposure]. PMID- 6500986 TI - Separation of the tryptic peptides and cyanogen bromide fragments of the human embryonic zeta chains of hemoglobin in Portland I and II by reverse phase high performance liquid chromatography. AB - The amino acid compositions of tryptic peptides and cyanogen bromide fragments of the purified zeta chain of Hb Portland I (zeta 2 gamma 2) and Hb Portland II (zeta 2 beta 2) have been determined. The hemoglobins were obtained from blood from neonates with hydrops fetalis due to homozygous alpha-thalassemia. The globin chains, tryptic peptides and cyanogen bromide fragments were all separated by reverse phase high performance liquid chromatography (HPLC). Several different types of C-18 columns were used with two different developer systems. The tryptic peptides of aminoethylated zeta chain were separated using an ammonium acetate acetonitrile gradient. An aqueous trifuoroacetic acid-1-propanol developer gradient was used for the separation of cyanogen bromide fragments. Of the seventeen tryptic peptides obtained, two (zeta T10a and zeta T10b) resulted from the unusual cleavage of a Tyr-Ile peptide bond. This was observed even when using TPCK treated trypsin. From this study and results of others, it can be deduced that trypsin will hydrolyze the Tyr-X bond provided either Ala or Ile is bonded to the N-terminal side of Tyr and Ile, Leu, or Gly is bonded to the C-terminal side of the Tyr residue. PMID- 6500987 TI - Asymmetric hybrids formed with hemoglobin British Columbia (alpha 2 beta 2101Glu- --Lys). AB - Whole blood and purified hemoglobins from a patient heterozygous for Hb British Columbia were studied with various types of electrophoresis. Isoelectric focusing of whole blood in cylindrical polyacrylamide gels showed 3 major hemoglobin species at equilibrium: Hb A, Hb British Columbia, and an unidentified Hb with an isoelectric point of 7.15. In addition, a transient asymmetric hybrid band was observed between Hb A and Hb British Columbia; it had disappeared at equilibrium. Hb A2 was never present. Isoelectric focusing of purified Hbs A2 and British Columbia in various proportions, and gel permeation chromatography of them in equal amounts, indicated that the pI 7.15 component was a very stable hybrid. This hybrid was recovered from thin-layer isoelectric focusing in agarose. Electrophoresis on agar at pH 6.0 showed 3 hemoglobins: A2, British Columbia, and one of intermediate migration. On cellulose acetate at pH 9.2, only the 2 parent Hb components, A2 and British Columbia were seen. Thus, the single Hb recovered from agarose is probably the asymmetric hybrid alpha 2 delta beta British Columbia. PMID- 6500988 TI - High pressure liquid chromatographic separation of the labile aldimine (pre hemoglobin AIc) and the stable Hb AIc. PMID- 6500989 TI - Purification and properties of hemoglobin Miyashiro. PMID- 6500990 TI - Interaction between Hb S and Hb Hope in a Cuban family. PMID- 6500991 TI - Hemoglobin Lille [alpha 74 (EF3) Asp----Ala]: the first instance in China. PMID- 6500992 TI - Peroxisomes in sebaceous glands. IV. Aggregates of tubular peroxisomes in the mouse Meibomian gland. AB - The occurrence of peroxisomes, their morphogenesis during the process of sebaceous transformation and their spatial relationship to the endoplasmic reticulum and lipid droplets were investigated by light and electron microscopy after visualization of the peroxidatic activity of catalase using an alkaline diaminobenzidine medium. The morphological alterations of peroxisomes display a characteristic sequence: During cellular differentiation, a remarkable proliferation of exclusively tubular, diaminobenzidine-reactive peroxisomes occurs. As maturation proceeds, an extensive elongation of tubular peroxisomes is seen. Concomitantly, they are densely packed in a regular, hexagonal arrangement and both the diameter and the catalase content gradually decreases. The most conspicuous feature of mature glandular cells are numerous highly organized aggregates of tubular, almost unstained peroxisomes with a diameter of 50 nm, arranged in a hexagonal pattern. They resemble adjacent tubular profiles of smooth endoplasmic reticulum. However, membrane continuities between these two compartments were never observed. During lethal disintegration peroxisomes subsequently decrease in number, probably by rapid sequestration within autophagolysosomes. The role of tubular peroxisomes in the biosynthesis of wax esters in the mouse Meibomian gland is discussed. PMID- 6500993 TI - Light- and electron-microscopic studies on acetylcholinesterase activity in Auerbach's plexus of the developing rat colon. AB - The distal portions of rat colon from 14-, 16-, 18-, and 21-day fetuses, newborns, and adults were histochemically examined for acetylcholinesterase (AChE) activity by light and electron microscopy. The specificity of AChE activity in Auerbach's plexus was confirmed by specific and/or nonspecific cholinesterase inhibition tests. Enzyme activity was first detectable after 18 days of gestation and became stronger with age. The reaction product was demonstrated by electron microscopy in and between the plasma membranes of the nerve fibers and their terminals. Ganglion cells also showed positive activity in the plasma membrane, nuclear envelope, and rough endoplasmic reticulum. The distribution pattern of the reaction product in fetal and newborn rat colons was basically the same as in adult rat colon. Therefore, the localization of AChE activity is considered to be a good marker for identifying premature ganglion cells in Auerbach's plexus, and the degree of AChE staining is a good indication of the degree of maturation of the plexus. PMID- 6500994 TI - Fully automated and fast image analysis of autoradiographs with a TAS-Leitz. Determination of size, Feulgen fluorescence and grain counts of individual nuclei and their evaluation by a simplified cluster analysis. AB - A fully automatic analysis system based on television image analysis was developed to measure simultaneously three parameters in individual nuclei of microscopic autoradiographs prepared from mouse jejunal crypt cell squashes and ascites tumor cell smears: size, Feulgen fluorescence and reflection from silver grains. A dark light camera with an image intensified silicon tube (RCA-ISIT), an automatic scanning stage and an autofocus device were fitted to a Leitz-TAS microscope. The camera permitted localization of Feulgen stained nuclei and measurement of area and light intensity by means of incident of light fluorescence in the red. After automatic changes of the Opak-illuminator silver grains were determined by means of polarized incident light reflected from the grains in the blue. A 25 X oil objective (aperture 0.75) yielded sufficient resolution for measurements. The nadir between the proportions of labeled and unlabeled nuclei was calculated from the data of one specimen on a PDP-computer using a new algorithm based on the minimal variance of the logarithm of reflected light per nucleus. Labeling indices determined by visual grain counting and by automatic analysis of the autoradiographs were well correlated (r = 0.87 to 0.92). Visual grain counts/nucleus and reflected light/nucleus correlated well when individual nuclei were compared (r = 0.92 to 0.97) or means of labeled nuclei of various specimens prepared during a 5 year period (r = 0.90 to 0.93). Quenching of nuclear Feulgen fluorescence was minimal. The optimal labeling range is 30-100 grain counts/nucleus. The time interval between measurements of two specimens was 25 min for a squash of approximately 350 crypt cells within a 3 mm X 3 mm field, and 20 min for a meandering scan with 1,000 ascites tumor cells. PMID- 6500995 TI - Fluorescence histochemical study on the noradrenergic control to the anterior column of the spinal lumbosacral segments of the rat and dog, with special reference to motoneurons innervating the perineal striated muscles (Onuf's nucleus). AB - The organization of noradrenergic fibers in the lumbosacral anterior column of rats and dogs was examined in detail using a modification of a highly sensitive glyoxylic acid fluorescence histochemical method. In both rat and dog, there were greater concentrations of fluorescing noradrenergic fibers around the motoneurons innervating the perineal striated muscles (Onuf's nucleus) than around other motoneuronal groups. The preferential accumulation of noradrenergic fibers in Onuf's nucleus may indicate that the noradrenergic neuron system in the spinal cord of rodents and carnivores is closely related to the functional peculiarities of the perineal striated muscles, including the external anal and urethral sphincter muscles. PMID- 6500996 TI - Effect of hydrocortisone on immunohistochemically demonstrable phenylethanolamine N-methyltransferase in cultures of embryonic and postnatal superior cervical ganglia. AB - Pre- and postnatal superior cervical ganglia of the rat were cultured in Rose chambers for 1-7 days with or without hydrocortisone. Phenylethanolamine-N methyltransferase (PNMT) was demonstrated by indirect immunofluorescence technique. In cultures without added hydrocortisone, no cells or fibres showed PNMT-immunoreactivity, without regard to the time in culture or the developmental stage at the time of explantation. The first PNMT-immunoreactive cells in hydrocortisone-containing cultures appeared 3 days after the explantation of E14 ganglia, or 1 day after the explantation of E15 ganglia, i.e. at the developmental stage E16-E17. The cultures of neither E14 nor E15 ganglia showed marked fibre growth from the PNMT-immunoreactive cell bodies. On the other hand, in the hydrocortisone-containing cultures of newborn or postnatal rats, there was extensive nerve fibre formation from the PNMT-immunoreactive cells in the course of the culture. PNMT-immunoreactive cells did not appear in hydrocortisone containing cultures of ganglia taken from rats older than 17 postnatal days. PMID- 6500997 TI - Energy dispersive X-ray analysis of tissue gold after silver amplification by physical development. AB - Rats were treated intraperitoneally with the gold-containing compounds sodium aurothiomalate (Myocrisin), sodium aurothiosulfate (Sanocrysin), and aurothioglucose. Using stem energy dispersive X-ray analysis, gold and silver were shown to be located at the same point in lysosomes of proximal tubular cells of the kidney, in hepatocytes and in macrophages of lymph glands, spleen and liver. This result indicates that, after exposure to ultraviolet radiation, chemically bound tissue gold is transformed to metallic gold that subsequently can catalyze the reduction of silver ions to silver when subjected to physical development, i.e. exposed to a photographic developer containing silver ions in addition to the reducing molecules. PMID- 6500998 TI - Isolation, culture, and preliminary characterization of ellipsoids (sheathed capillaries of Schweigger-Seidel) of the pig spleen. II. An enzyme histochemical study of in vitro cultivated ellipsoids. AB - Whole isolated ellipsoids (sheathed capillaries of Schweiger-Seidel) of the pig spleen were explanted in Medium 199 containing 20% fetal calf serum or horse serum respectively. Cultures were kept in a gas phase of 5% carbon dioxide in air at 37 degrees C. After about 4 days in culture the outgrowth of two morphologically different cell types was apparent. Small cells of fusiform or stellate morphology displayed high activity of acid phosphatase. N-acetyl-beta glucosaminidase and beta-glucuronidase activity were also detectable. Furthermore these cells were highly reactive for unspecific esterase and gamma-glutamyl transpeptidase activity. Endogenous peroxidase activity was present in the cytoplasm and in the perinuclear space. Stellate cells therefore are thought of as ellipsoid macrophages. Additional observations reported are the expression of Fc-receptors on stellate cells. They triggered the phagocytosis of opsonized test particles. The second cell type showed fibroblastic morphology. The large well spread cells did exhibit low activities of acid phosphatase and N-acetyl-beta glucosaminidase. The other enzyme activities examined were not detectable. The nature of these cells is not well understood at present. Most likely they are constituents of the framework of the ellipsoids. No transitions between stellate cells and fibroblastic cells were found. PMID- 6500999 TI - Localization of alpha-tubulin immunoreactivity to cerebellar Bergmann glia with the TU 01 antibody. AB - The TU 01 antitubulin antibody specific for alpha-tubulin was demonstrated, by light- and electron-microscopic immunocytochemistry, to stain selectively the Bergmann glia of rat cerebellum. Within the glial cells and their fibres the microtubules, the smooth endoplasmic reticulum, the outer mitochondrial membranes and the ribosomal rosettes of the cell body were decorated by the antibody. The high selectivity of this antibody is discussed in terms of tubulin microheterogeneity. PMID- 6501001 TI - Uniformity of increase in pulmonary diffusing capacity during submaximal exercise in normal young adults. PMID- 6501000 TI - Distribution of fluorogenic monoamines in the gastrointestinal muscularure of Helix pomatia. AB - By the use of a glyoxylic acid induced fluorescence method an intensive green fluorescence characteristic to catecholamines was observed on nerve fibres with varicosities, nerve bundles and perykaryons on wholemount stretch preparates of snail's gut. Considering the distribution of the fluorescent nerve elements and also the fluorescence intensity a decreasing gradient was revealed from the fore gut through the stomach to the hind-gut. PMID- 6501003 TI - Molecular mechanism of hexane neuropathy: significant differences in pharmacokinetics between 2.3-, 2.4-, and 2.5-hexanedione. PMID- 6501002 TI - Applicable conditions for alleviation of subjective and cardiovascular loads in the local cold tolerance test. PMID- 6501004 TI - Electrocorticogram (ECoG) and auditory evoked potential (AEP) in rats intoxicated with lead acetate. PMID- 6501006 TI - Effect of 54Mn and lead interaction on their binding with tissue proteins: in vitro studies. PMID- 6501005 TI - A study of cognitive functions in DDT sprayers. PMID- 6501007 TI - A procedure for determining volatile solvents in mouse whole body. PMID- 6501008 TI - A new method for determination of vanadium. PMID- 6501009 TI - [Surgery of thyroid cancer]. AB - Cancer of the thyroid is a rare malignant tumour in all parts of the world. The diagnosis is established by the clinical findings, thyroid scan, ultrasound, needle biopsy cytology. Solitary, solid tumours on ultrasound and scan have an increased risk of cancer, especially if these lesions show a further tendency to increase in size, despite sufficient suppressive treatment with thyroxine. In these cases the risk of cancer is more pronounced in nonendemic areas in men, in recurrent goitres, patients with a history of radiation of the neck during childhood, and with solitary lumps under 20 years and over 60 years of age. The surgical treatment includes lobectomy on the involved side and subtotal resection of the opposite lobe. Total thyroidectomy is generally used only for medullary carcinoma. In the future, a more selective surgical approach seems to be justified in thyroid cancer because of its varying malignancy. Close cooperation between the surgeon, the pathologist, the radiologist and the endocrinologist is essential in such circumstances. The prognosis of thyroid cancer is influenced by the histological type, the stage of the tumour, and the age of the patient. The prognosis is excellent in tumours limited to the thyroid gland and in those of papillary type or follicular type with little vascular invasion. Undifferentiated tumours always have a bad prognosis. PMID- 6501011 TI - [Flexible fiber endoscopy in ENT]. AB - The range of visual examination and therapeutic procedures in the field of ear, nose and throat surgery has been expanded by the combination of the flexible fiberscope with the rigid telescope. The following are the advantages of the flexible fiberscope: 1. Increased accessibility, 2. less patient discomfort, 3. easier insertion technique, 4. low incidence of the accidental injuries, 5. simplified documentation by photography. In addition, these procedures can be performed on a routine and outpatient basis. PMID- 6501010 TI - [Madelung's disease--the problem of treating benign growths of the adipose tissue]. AB - Symmetric, sometimes monstrous fat deposits occur in this rare benign disease. They can extend from the neck to the shoulders and from the mandible to the clavicle. The authors have treated 3 patients during the last 4 years. One of them was sent as an inpatient with the diagnosis of lymphadenitis. The aetiology is unknown. Some metabolic disorders (gout, diabetes mellitus, hypertriglyceridemia) are discussed as causes. Alcoholism seems to be an important factor. Surgical removal of the fat deposits is the therapy of choice despite the tendency to recur which is described in the literature. PMID- 6501012 TI - [Functional complications following supraglottal laryngectomy]. AB - 85 patients who had undergone supraglottic laryngectomy was necessary including the removal of one arytenoid cartilage or one vocal cord which was replaced by a thyroid cartilage graft. The latter group had greater difficulty in learning to swallow, a longer stay in hospital, more deaths as a result of lung infection, and an increased incidence of later lung infection. PMID- 6501013 TI - [Partial resection of laryngeal cancer. Follow-up study of 133 patients from 1961 to 1975]. AB - We were able to carry out a partial resection on 133 (35.1%) of 379 patients with glottic and supraglotic tumours. The results are discussed and compared with the literature. PMID- 6501014 TI - [Uncommon injuries of the larynx following intubation. Recurrent paralysis, torsion and luxation of the cricoarytenoid joints]. AB - 19 laryngeal injuries are reported. 16 were secondary to orotracheal intubation and 3 were sequelae of gastroscopy, laryngoscopy and a nasogastric tube. In 6 patients, the trauma followed prolonged nasotracheal intubation, 10 cases followed a single endotracheal intubation. The main symptom was hoarseness. In 6 cases dislocation of an arytenoid cartilage was diagnosed, in 1 case a vocal cord paresis and in the other cases contusion or distortion of the arytenoid joint. In the cases of subluxation the arytenoid cartilage was dislocated posterolaterally, with the cord in the abducted position. For treatment we recommend closed reduction and injection of Cortison-Crystal-suspension into the joint. The outcome is good after single endotracheal intubation, but bad in prolonged nasotracheal intubation because of ankylosis of the cricoarytenoid joint. PMID- 6501015 TI - [Extensive submucosal hematomas in the pharyngo-laryngeal region in a female patient with tonsillitis during marcumar treatment]. PMID- 6501016 TI - McKusick's dwarfism and resistant Hodgkin's disease. PMID- 6501017 TI - Somatic dysfunction associated with pulmonary disease. PMID- 6501018 TI - Transcatheter ablation of renal tumors. PMID- 6501019 TI - Primary ovarian pregnancy: report of a case. PMID- 6501020 TI - Benign ureteral tumors: report of a case and review of the literature. PMID- 6501021 TI - Accessory muscle activity during sleep in chronic obstructive pulmonary disease. AB - Hypoventilation contributes to oxyhemoglobin desaturation during rapid-eye movement (REM) sleep in patients with severe chronic obstructive pulmonary disease (COPD). Due to hyperinflated lungs these patients have mechanically impaired diaphragms and increased activity of other inspiratory muscles while awake. We speculated that rib cage (RC) inspiratory muscles might lose activity during REM, thereby contributing to hypoventilation. We therefore recorded scalene (SCA) and sternocleidomastoid (SCM) electromyorgrams in six subjects with severe COPD. SCA activity decreased 76% (P less than 0.001), from non-REM (NREM) to tonic REM and decreased an additional 17% during phasic REM. SCM activity was much more variable during NREM but when present also decreased during REM. SCA activity correlated strongly with RC excursion. SCA and SCM activity, RC excursion, estimates of minute ventilation, and oxyhemoglobin saturation all decreased in parallel. Expiratory activity of the SCA and SCM, present during wakefulness and NREM, disappeared during REM. We conclude that loss of inspiratory activity of rib cage muscles during REM causes chest wall distortion and hypoventilation in patients with severe COPD. Loss of expiratory activity of these muscles may contribute to a decrease in end-expiratory volume and thereby to a deterioration of pulmonary gas exchange. PMID- 6501023 TI - Endurance training in older men and women. I. Cardiovascular responses to exercise. AB - The effects of prolonged endurance training on maximal O2 uptake capacity (VO2max) and its determinants were studied in 11 older individuals (63 +/- 2 yr). The subjects were evaluated before training, after 6 mo of low-intensity (LI) training, and after an additional 6 mo of higher intensity (HI) training. VO2max was 25.4 +/- 4.6 ml X kg-1 X min-1 before training, 28.2 +/- 5.2 ml X kg-1 X min 1 after LI training (P less than 0.05), and 32.9 +/- 7.6 ml X kg-1 X min-1 after HI training (P less than 0.01), with an overall increase of 30%. The increase in VO2max in response to training appeared to be mediated primarily through an increase in maximal arteriovenous O2 difference (P less than 0.01), with little augmentation of maximal cardiac output (Q) (P greater than 0.05). At the same absolute work rates, stroke volume was higher (P less than 0.05); heart rate (HR), blood pressure (BP), and systemic vascular resistance were lower (P less than 0.05); and Q and arteriovenous O2 difference were unchanged after training. At the same relative work rates, arteriovenous O2 difference was higher (P less than 0.01); BP and systemic vascular resistance were lower (P less than 0.05); and HR, Q, and stroke volume did not change significantly. These findings show that older individuals can adapt to prolonged endurance training with a large increase in aerobic power. PMID- 6501022 TI - Differential effects of sauna-, diuretic-, and exercise-induced hypohydration. AB - The physiological effects on submaximal and maximal exercise of three methods commonly used by athletes for achieving rapid weight loss were determined by measuring cardiorespiratory variables in 62 nonendurance athletes. A mean weight loss of 4.1% was achieved by those who followed either a sauna (SAU), diuretic (DIU), or exercise (ACT) protocol, compared with the average weight loss of 1.2% in the control group. At maximal exercise O2 consumption, O2 pulse, blood lactate concentration, and work load decreased in SAU and DIU groups relative to the ACT group, whereas only a few differences were observed at the aerobic threshold. Weight loss achieved over a 48-h period was less detrimental to an athlete than was a more rapid (24-h) weight reduction achieved through sauna bathing or the use of diuretics. We conclude that not only the quantity of weight loss but also the method itself may limit physical performance. PMID- 6501024 TI - Endurance training in older men and women II. Blood lactate response to submaximal exercise. AB - Seven men and four women (age 63 +/- 2 yr, mean +/- SD, range 61-67 yr) participated in a 12-mo endurance training program to determine the effects of low-intensity (LI) and high-intensity (HI) training on the blood lactate response to submaximal exercise in older individuals. Maximal oxygen uptake (VO2max), blood lactate, O2 uptake (VO2), heart rate (HR), ventilation (VE), and respiratory exchange ratio (R) during three submaximal exercise bouts (65-90% VO2max) were determined before training, after 6 mo of LI training, and after an additional 6 mo of HI training. VO2max (ml X kg-1 X min-1) was increased 12% after LI training (P less than 0.05), while HI training induced a further increase of 18% (P less than 0.01). Lactate, HR, VE, and R were significantly lower (P less than 0.05) at the same absolute work rates after LI training, while HI training induced further but smaller reductions in these parameters (P greater than 0.05). In general, at the same relative work rates (ie., % of VO2max) after training, lactate was lower or unchanged, HR and R were unchanged, and VO2 and VE were higher. These findings indicate that LI training in older individuals results in adaptations in the response to submaximal exercise that are similar to those observed in younger populations and that additional higher intensity training results in further but less-marked changes. PMID- 6501025 TI - Pressure effects and uptake of platelet-activating factor in isolated rat lung. AB - The aim of this study was, first, to examine pressure effects of platelet activating factor (PAF) on pulmonary vasculature and bronchi in isolated perfused and ventilated rat lungs and, second, to investigate pulmonary uptake of tritium labeled PAF injected into the pulmonary artery. Four different perfusates were used: Krebs-Ringer solution (KRS) and KRS with 0.2, 2.0, and 4% albumin. In the KRS, perfusion and inflation pressure increased by 100 and 47%, respectively, after 100 micrograms PAF. By increasing the albumin concentration, the pressure effects were reduced significantly (P less than 0.01). These changes were paralleled by increasing tritium outflow rates (15.9 +/- 3.6, 49.7 +/- 12.5, 78.3 +/- 8.7, 87.8 +/- 2.6%, respectively). Comparable changes in tritium outflow rates (19.2 +/- 3.9, 38.2 +/- 7.2%) occurred when tracer amounts of labeled PAF were injected, but, in KRS with 2.0 and 4.0% albumin, tritium outflow was significantly lower (52.8 +/- 8.0 and 60.8 +/- 11.8%, respectively). Pressure effects are related to extraction rates. Both pressure effects and extraction rates depend on binding to the albumin in the perfusion medium used. PAF might act on smooth muscle tissue of the pulmonary vasculature. Inflation pressure increases are probably due to concomitant occurrence of edema. PMID- 6501026 TI - Heat exchange during upper- and lower-body exercise. AB - This study examined evaporative and dry heat exchange during upper- and lower body exercise. Four male subjects performed arm-crank or cycle exercise at the same O2 uptake level (approximately 1.6 l/min) in an environment facilitating dry heat exchange [radiative and convective (R + C)] [ambient temperature (Ta) = 18 degrees C, dew-point temperature (Tdp) = 14 degrees C] and an environment facilitating evaporative heat loss (Esk) (Ta = 35 degrees C, Tdp = 14 degrees C). (R + C) was determined from the torso with a net radiometer and from the limbs with heat flow discs, whereas Esk was determined from the torso and limbs by ventilated dew-point sensors. In both environments neither esophageal temperature nor mean skin temperature were different between exercise types (P greater than 0.05). Torso (R + C) was significantly (P less than 0.05) greater during arm crank than during cycle exercise in both environments. Torso Esk, as well as arm (R + C), and arm Esk were not different (P greater than 0.05) between exercise types in each environment. Leg (R + C) was greater (P less than 0.05) during cycle than during arm-crank exercise in the 18 degrees C environment, whereas leg Esk was greater (P less than 0.05) during cycle than during arm-crank exercise in the 35 degrees C environment. These data indicate that to compensate for greater torso sensible heat loss during upper body exercise lower body exercise elicits additional (R + C) or Esk from the legs. The avenue for this compensatory sensible and insensible heat loss depends upon the differential heat transfer coefficients which influence tissue conductivity and mass transfer. PMID- 6501027 TI - Mean airway pressure and alveolar pressure during high-frequency ventilation. AB - Studies and applications of high-frequency ventilation (HFV) are often performed under conditions of controlled mean airway pressure (Paw). In the present study we tested the assumption that controlling Paw adequately controls lung volume during HFV by investigating the relationship between a reliably measured Paw and the mean alveolar pressure (Palv) of the lungs during HFV of healthy dogs. We minimized the errors of Paw measurement due to the Bernoulli effect and various technical factors by appropriate choice of transducers, amplifiers, and measurement site. Palv was estimated by clamping the ventilator tube during oscillation and measuring the equilibration pressure of the lung and airways. Paw and Palv were determined as functions of frequency (8-25 Hz), tidal volume (60-90 ml), Paw (-5 to 12 cmH2O), and position of the animal (supine vs. lateral). We found that Paw could significantly underestimate Palv and that the degree of underestimation increased at higher frequencies, larger tidal volumes, and lower Paw. Shifting the animal from the supine to the lateral position greatly accentuated this effect. The elevation of Palv above Paw was seen to be a function of mean flow and largely independent of the frequency-tidal volume combination which produced the flow. A possible explanation of this pressure difference is that it results from differences in inspiratory and expiratory airway impedances, which in turn depend on airway geometry, compliance, lung volume, and expiratory flow limitation. PMID- 6501028 TI - Inspiratory flow pattern in humans. AB - The theoretical estimation of the mechanical work of breathing during inspiration at rest is based on the common assumption that the inspiratory airflow wave is a sine function of time. Different analytical studies have pointed out that from an energetic point of view a rectangular wave is more economical than a sine wave. Visual inspection of inspiratory flow waves recorded during exercise in humans and various animals suggests that a trend toward a rectangular flow wave may be a possible systematic response of the respiratory system. To test this hypothesis, the harmonic content of inspiratory flow waves that were recorded in six healthy subjects at rest, during exercise hyperventilation, and during a maximum voluntary ventilation (MVV) maneuver were evaluated by a Fourier analysis, and the results were compared with those obtained on sinusoidal and rectangular models. The dynamic work inherent in the experimental waves and in the sine-wave model was practically the same at rest; during exercise hyperventilation and MVV, the experimental wave was approximately 16-20% more economical than the sinusoidal one. It was concluded that even though at rest the sinusoidal model is a reasonably good approximation of inspiratory flow, during exercise and MVV, a physiological controller is probably operating in humans that can select a more economical inspiratory pattern. Other peculiarities of airflow wave during hyperventilation and some optimization criteria are also discussed. PMID- 6501029 TI - Dynamic maintenance of end-expiratory lung volume in full-term infants. AB - We recorded airflow, tidal volume, respiratory muscle electromyogram (EMG), and chest wall configuration in eight normal newborn infants to investigate the determination of end-expiratory lung volume (EEV). The expiratory flow-volume representation was nearly linear and EMG evidence of respiratory muscle activity was absent during the latter part of expiration in both supine and upright postures, consistent with passive expiration. Occasional breaths were associated with marked retardation of expiratory airflow (braking). During unobstructed apnea, expiration proceeded to the relaxation volume (Vr) with no change in slope of the flow-volume curve. During breathing, EEV was greater than Vr observed during apnea. We calculated the difference between EEV and Vr estimated by extrapolation of the linear portion of the expiratory flow-volume curve as 14.4 +/- 5.4 ml (supine) and 11.8 +/- 2.4 ml (upright). When infants were tilted from supine to upright, expiratory duration (TE) and the expiratory time constant (tau) increased significantly. Since the increases in tau and TE offset each other, the EEV-Vr difference was similar in both postures. We propose that while braking plays a major role in the early part of expiration, as long as the final portion of expiration is passive, the dynamic maintenance of EEV above Vr depends on the relative values of tau and TE. Expiratory braking mechanisms interact with the passive mechanical properties of the respiratory system to modulate the balance between tau and TE. These mechanisms provide a neonatal breathing strategy to maintain EEV above a low Vr until the chest wall stiffens with maturity. PMID- 6501030 TI - Respiratory activity of posterior cricoarytenoid muscle and vocal cords in humans. AB - We examined the respiratory activity of the posterior cricoarytenoid muscle (PCA) simultaneously with the movements of the vocal cords during tidal breathing and panting in four normal seated subjects. A bipolar electrode was constructed to record the surface electromyogram (EMG) of the PCA. The glottis was visualized with a fiberoptic bronchoscope, and the glottic image was recorded simultaneously with tidal volume and a digital time marker on video tape. During quiet breathing the integrated EMG signal (EPCA) showed consistent phasic variations in each subject. The inspiratory onset of EPCA in the four subjects preceded inspiratory flow by 170 +/- 80, 650 +/- 310, 130 +/- 80, and 130 +/- 90 ms (mean +/- SD), respectively. This lead time of the PCA was similar to that between the onset of glottic widening and inspiration in each subject. The proportion of each cycle during which EPCA increased (the duty cycle) was 31 +/- 3% (mean +/- SE), whereas the inspiratory portion of the respiratory cycle constituted 37 +/- 2% (mean +/- SE), respectively. The duty cycle of the PCA remained relatively constant in the same subject on different days. During panting at functional residual capacity, the EPCA increased to 142 +/- 11% of the peak activity recorded during the preceding control breaths. This was accompanied by a sustained increase in the glottic width to 91 +/- 9% of the peak value in the preceding breaths. These results confirm the role of the PCA as a principal abductor of the vocal cords and indicate a temporal relationship between PCA activation and the inspiratory phase of the respiratory cycle during tidal breathing in humans. PMID- 6501031 TI - Influence of blood flow on cutaneous permeability to inert gas. AB - A thermally regulated Plexiglas chamber was designed for investigation of transcutaneous diffusion of N2 and helium (He) in the human hand. Influence of cutaneous blood flow in this process was studied simultaneously with gas diffusion measurements. Changes in cutaneous blood flow (Q, in ml X min-1 X 100 ml tissue-1) were effected by altering ambient temperature (T) from 20 to 40 degrees C (Q = 0.08 X 100.07T). We found that the rate of inert gas diffusion through human skin, expressed as conductance (G, in ml STPD X h-1 X m-2 X atm-1), increases exponentially as a function of blood flow, and was indistinguishable between He and N2 (G = 21.19 X 100.0124Q). The permeability, diffusion coefficient per unit diffusion distance (D/h, in cm/h), also rose exponentially as a function of blood flow. But permeability for He (D/h = 0.1748 X 100.0203Q) was greater than that for N2 (D/h = 0.1678 X 100.0114Q). As cutaneous blood flow rises, because of increased temperature, the apparent diffusion distance falls linearly for both N2 and He. The change is more prominent for He than for N2 diffusion. Estimated replacement time for the body stores of N2 by transcutaneous diffusion alone was shortened from 26.8 h at 31 degrees C to 15.1 h at 37 degrees C. It is suggested from this study that beneficial results may be derived during decompression procedure 1) by maintaining an appropriate transcutaneous pressure gradient of inert gases, and 2) by elevating ambient temperature. PMID- 6501032 TI - Mechanical properties of pleural membrane. AB - The pleural membrane is modeled as a planar collection of interconnected randomly oriented line elements. By assuming that the line elements follow the strain field of a continuum, a strain-energy function is formulated. From the strain energy function, an explicit stress-strain equation for large deformations is derived. In the linear approximation of the stress-strain equation the shear modulus and the area modulus of the membrane are respectively found to be 2.4 and 2.8 times the tension at the reference state. The stress-strain equation for large deformations is used to predict the displacement field around a circular hole in pleura. Good agreement is found between these predictions and measurements made on ablated pleura from dog lungs. From these theoretical and experimental results the conclusion is drawn that the pleura has a significant role in carrying shear forces and maintaining the lung's shape. PMID- 6501033 TI - Gas transport and pulmonary perfusion during high-frequency ventilation in humans. AB - Regional pulmonary 133Xe clearances, regional 133Xe washins, regional distribution of pulmonary blood flow, and pulmonary gas exchange were determined during high-frequency small-volume ventilation (HFV, oscillation frequencies 12 or 18 Hz, stroke volumes 1.2-0.8 ml/kg) in six healthy anesthetized-paralyzed volunteers lying supine. Adequate pulmonary gas exchange was maintained by HFV; the efficiency of oxygenation during HFV did not differ significantly from that during conventional mechanical ventilation at similar mean lung volumes. During HFV regional pulmonary clearances and washins of tracer gas were different among regions. Apical nondependent lung regions cleared faster and had greater regional longitudinal gas conductances than did basal nondependent or dependent regions. The vertical gradient for pulmonary perfusion was preserved during HFV. Apparently the rate of interregional gas mixing is small during HFV at 12 and 18 Hz in anesthetized-paralyzed humans. PMID- 6501034 TI - Respiratory changes in parasternal intercostal length. AB - In an attempt to understand the role of the parasternal intercostals in respiration, we measured the changes in length of these muscles during a variety of static and dynamic respiratory maneuvers. Studies were performed on 39 intercostal spaces from 10 anesthetized dogs, and changes in parasternal intercostal length were assessed with pairs of piezoelectric crystals (sonomicrometry). During static maneuvers (passive inflation-deflation, isovolume maneuvers, changes in body position), the parasternal intercostals shortened whenever the rib cage inflated, and they lengthened whenever the rib cage contracted. The changes in parasternal intercostal length, however, were much smaller than the changes in diaphragmatic length, averaging 9.2% of the resting length during inflation from residual volume to total lung capacity and 1.3% during tilting from supine to upright. During quiet breathing the parasternal intercostals always shortened during inspiration and lengthened during expiration. In the intact animals the inspiratory parasternal shortening was close to that seen for the same increase in lung volume during passive inflation and averaged 3.5%. After bilateral phrenicotomy, however, the parasternal intercostal shortening during inspiration markedly increased, whereas tidal volume diminished. These results indicate that 1) the parasternal intercostals in the dog are real agonists (as opposed to fixators) and actively contribute to expand the rib cage and the lung during quiet inspiration, 2) the relationship between lung volume and parasternal length is not unique but depends on the relative contribution of the various inspiratory muscles to tidal volume, and 3) the physiological range of operating length of the parasternal intercostals is considerably smaller than that of the diaphragm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501036 TI - Estimation of rat thermoregulatory ability based on body temperature response to heat. AB - A new simple but general estimation method for survival time in a hot environment is presented in this study. Even in heat-tolerant rats showing a triphasic heat response, an accurate estimation of survival time (ST) is possible. Rat groups, which included some heat-tolerant individuals, were exposed to 42.5 degrees C, 40% rh. Colonic temperature (Tco) was measured continuously by copper-constantan thermocouple. The ST (Y) of male and female rats were expressed as a linear function of time (X) until the Tco of 42.5 degrees C was reached: Y = 0.976X + 30.6 and Y = 0.968X + 31.6, respectively. A Tco of 42.5 degrees C at rest was just below the maximum survivable body temperature and above the steady-state equilibrium Tco levels during the second phase of the triphasic heat-response curve. Heat-tolerant individuals showed lower equilibrium temperatures than heat intolerant rats. All 140 rats survived the Tco of 42.5 degrees C and lived for more than 8 wk, thus enabling them to be used for future experiments on thermoregulation. The heat survivors were able to reproduce, and their genetically controlled offspring could be used for thermoregulatory experiments. PMID- 6501035 TI - Cigarette smoke-induced bronchoconstriction in dogs: vagal and extravagal mechanisms. AB - We reassessed the severity of cigarette smoke-induced bronchoconstriction and the mechanisms involved in anesthetized dogs. To evaluate the severity of smoke induced bronchoconstriction, we measured airway pressure and airflow resistance (Rrs, forced oscillation method). We studied the mechanisms in other dogs by measuring airway pressure, central airway smooth muscle tone in tracheal segments in situ, and respiratory center drive by monitoring phrenic motor nerve output, including the role of vagal and extravagal nerves vs. the role of blood-borne materials during inhalation of cigarette smoke. Rrs increased more than fourfold with smoke from one cigarette delivered in two tidal volumes. About half the airway response was due to local effects of smoke in the lungs. The remainder was due to stimulation of the respiratory center, which activated vagal motor efferents to the airway smooth muscle. Of this central stimulation, about half was due to blood-borne materials and the rest to vagal pulmonary afferents from the lungs. We conclude that inhalation of cigarette smoke in dogs causes severe bronchoconstriction which is mediated mainly by extravagal mechanisms. PMID- 6501037 TI - High-speed bubble-segmented blood sampler for the rat. AB - An arterial blood sampler for use in the conscious rat is described. With this apparatus it is possible to obtain small (10 microliter) whole-blood or plasma samples as frequently as 1/s and to derive accurate arterial time-concentration curves in the first 60-120 s after compounds are injected for regional blood flow or pharmacokinetic measurements. The blood is withdrawn from an implanted arterial catheter into polyethylene tubing at a constant rate while bubbles are introduced at regular intervals via a side channel into the column of blood. Although some dispersion of blood samples occurs as the tubing is traversed, this can be mathematically corrected. However, correction is unnecessary if the information of interest is the area under the time-concentration curve. PMID- 6501038 TI - Sensitivity and specificity of the computational model for maximal expiratory flow. AB - The computational model for forced expiratory flow from human lungs of Lambert and associates (J. Appl. Physiol.: Respirat. Environ. Exercise Physiol. 52: 44 56, 1982) was used to investigate the sensitivity of maximal expiratory flow to lung properties. It was found that maximal flow is very sensitive to recoil pressure and airway areas but not very sensitive to lung volume, airway compliance, and airway length. Linear programming was used to show that a given air flow-pressure curves was compatible with a fairly wide range of airway properties. Additional data for maximal flow with a He-O2 mixture narrowed the range somewhat. It was shown that the flow-pressure curve contains more information about central than peripheral airways and that information about the latter is obtainable only from flows at recoils less than 2 cmH2O. Parameter ranges compatible with individual flow-pressure curves showed differences that demonstrated that such curves give some indication of individual central airway properties. PMID- 6501039 TI - Pulmonary function changes after 1 h continuous heavy exercise in 0.21 ppm ozone. AB - Prediction equations developed from previous ozone (O3) exposure studies suggested that athletes exercising at near competitive intensities would be subject to alteration of pulmonary function during exposure to relatively low concentrations of O3. Accordingly we exercised seven trained athletes for 1 h at 75% of maximal O2 consumption in both room air and a 0.21 ppm O3 environment. Pulmonary function tests, including forced expiratory maneuvers and maximum voluntary ventilation (MVV), were performed prior to and immediately following the 1-h test. Significant decreases in forced vital capacity (FVC, -7%), forced expired volume in 1.0 s (-15%), forced expiratory flow over the midhalf of FVC ( 18%), and MVV (-17%) were recorded following O3 exposure. The magnitudes of these changes are similar to those observed in subjects performing moderate intermittent exercise for 2 h in a 0.24 ppm O3 environment. Symptoms reported following O3 exposure included laryngeal and/or tracheal irritation and soreness and chest tightness on taking a deep breath. The observed alterations in lung functions in these subjects indicate that individuals performing heavy continuous exercise are more likely to be affected by lower O3 levels. PMID- 6501040 TI - Reaction to equine sarcoid therapy. PMID- 6501041 TI - Protecting eyes. PMID- 6501042 TI - ECG of the month. Congestive cardiomyopathy. PMID- 6501043 TI - Efficacy of primidone in dogs with seizures unresponsive to phenobarbital. AB - Fifteen epileptic dogs had been treated with high dosages of phenobarbital but had not achieved adequate control of their seizures. Their treatment was switched to comparable and higher dosages of primidone. Serum concentrations of phenobarbital were measured in all dogs before and after primidone therapy was initiated, to ensure that the primidone dosage achieved comparable or higher values when derived from primidone. Only one dog experienced improvement in seizure control, indicating that there is no advantage to the use of primidone over the use of phenobarbital for the control of seizures in most dogs. PMID- 6501044 TI - Cost comparison of anesthetic regimens in the dog and cat. AB - Comparative costs of anesthetic regimens for the dog and cat were calculated. Various combinations of currently popular sedatives, tranquilizers, and anti muscarinics (preanesthetic drugs), and anesthetic induction and maintenance drugs were studied. The preanesthetic drug affected overall anesthetic cost through its own cost, its effect on the amount of anesthetic drug necessary for intubation, and its effect on the amount of anesthetic necessary to maintain anesthesia. The combination of acetylpromazine-thiamylal-halothane was the least expensive regimen for both the dog and cat, whereas drug combinations that included isoflurane as the maintenance drug were the most expensive. In the cat, induction of anesthesia by use of N2O, O2, and halothane in a plexiglas chamber was more expensive than by the use of thiamylal. PMID- 6501045 TI - Pathogenesis of canine aural hematomas. AB - Morphologic examination of 3 ears from 2 dogs with aural hematomas revealed that the hematomas had developed within the pinnal cartilage. The cartilage had fractured from perichondrium to perichondrium and in some areas clefts had formed within the cartilage. Cartilage fracture could have resulted from wave motions set up in the pinna during head shaking. An explosive burst of head shaking exceeding a critical head velocity or a more gentle but sustained head shaking establishing a sinusoidal wave motion within the ear could have caused cartilage fracture. PMID- 6501046 TI - Effect of epididymitis on semen quality of rams. AB - To better document the detrimental effect of ram epididymitis (RE) in large range flocks, a study was conducted to determine the correlation of palpable RE lesions and semen quality. Presence of leukocytes in the semen of rams affected with RE also was evaluated and found to correlate positively with RE lesions and inversely with semen quality. Rams with palpable RE lesions usually produced semen of reduced quality; however, some affected rams did produce good quality semen. The mean scrotal circumference varied significantly when rams were analyzed by breed, but not when grouped by RE status or classified by semen quality. PMID- 6501047 TI - Use of protein-to-creatinine ratio in a single urine specimen for quantitative estimation of canine proteinuria. AB - The daily excretion of urinary protein was evaluated in 8 conditioned research dogs and in 10 hospitalized, proteinuric dogs, using 24-hour urine collections. Concurrent with each 24-hour urine collection, a 5- to 10-ml urine specimen was obtained during midday. The ratio of urine protein to urine creatinine concentration was determined from the single urine specimen for each dog. Linear regression analysis was used to calculate the correlation between that ratio and the 24-hour urinary protein loss (mg/kg of body weight). The coefficient of determination was significant (r2 = 0.95, P less than 0.0001). Determination of the protein-to-creatinine ratio in a single urine specimen was found to be a sensitive, rapid, and dependable diagnostic technique for detection and quantitative estimation of proteinuria. PMID- 6501048 TI - Effect of yohimbine on xylazine-ketamine anesthesia in cats. AB - Xylazine and ketamine are an anesthetic combination used in feline practice for routine surgical procedures. In a controlled study, we evaluated the effects of yohimbine, an antagonist of xylazine, on the anesthesia induced by this anesthetic combination in cats. Two intramuscular doses of xylazine and ketamine (2.2 mg of xylazine/kg plus 6.6 mg of ketamine/kg and 4.4 mg of xylazine/kg plus 6.6 mg of ketamine/kg) caused approximately 60 and 100 minutes of anesthesia, respectively, in control cats. When yohimbine (0.1 mg/kg) was given intravenously 45 minutes after ketamine administration, the cats regained consciousness within 3 minutes. They were ambulatory 1 to 2 minutes after regaining consciousness. Yohimbine also reversed the bradycardia and respiratory depression elicited by xylazine-ketamine. The results indicated that yohimbine may be useful for controlling the duration of xylazine-ketamine anesthesia in cats. PMID- 6501049 TI - Patterns of cutaneous anesthesia associated with brachial plexus avulsions in the dog. AB - Patterns of cutaneous anesthesia were determined in 4 dogs referred for evaluation of brachial plexus trauma. Using these patterns in conjunction with other clinical and electrophysiologic data, avulsion of spinal nerve roots contributing to the brachial plexus (brachial plexus avulsion) was diagnosed in each case. Two of the 4 dogs had avulsions of the C7-T1 nerve roots and the T2 branch to T1. One dog had C7 and C8 nerve root avulsion, and one had avulsion of the C8 and T1 nerve roots and the T2 communicating branch to T1. Each dog had a distinct pattern of cutaneous anesthesia. PMID- 6501050 TI - Nontraditional treatment of mycosis fungoides in a dog. AB - A 14-year-old Dachshund with plaque-stage mycosis fungoides was treated and kept free of lesions for 25 months, using combination drug therapy of a placental lysate and low-dose prednisone. Mycosis fungoides has a poor prognosis and has had a history of poor response to treatment. Placental lysate with low-dose prednisone may offer an alternate therapeutic regimen in this disease. PMID- 6501051 TI - Cacao bean shell poisoning in a dog. AB - Cacao bean shells contain potentially toxic quantities of theobromine, a xanthine compound similar in effects to caffeine and theophylline. A dog, which ingested a lethal quantity of garden mulch made from cacao bean shells, developed severe convulsions and died 17 hours later. Analysis of the stomach contents and the ingested cacao bean shells revealed the presence of lethal amounts of theobromine. PMID- 6501052 TI - Spinal cord medulloepithelioma in a dog. AB - Medulloepithelioma, an embryonal neural tumor, was diagnosed in a 6-month-old Bullmastiff. Clinical signs of incomplete, upper motor neuron, transverse myelopathy involving the hindlimbs were observed on examination. Myelography was required to identify the cause of clinical abnormality. The tumor involved the L1 spinal cord segment. PMID- 6501053 TI - Disseminated protothecosis in a dog. AB - A dog with forelimb lameness, bilateral retinal detachment, and hemorrhagic diarrhea, died. Necropsy demonstrated multifocal lesions in the skeletal musculature, myocardium, liver, thyroid glands, kidneys, eyes, and brain. Microscopically, the lesions contained numerous organisms and minimal cellular infiltrates. The morphologic and cultural characteristics of the organisms were similar to prototheca. The organisms in tissue sections reacted positively for Prototheca zopfii, using an indirect fluorescent antibody technique. PMID- 6501054 TI - Malignant melanoma in a goat. AB - Malignant melanoma was identified in a crossbred goat. It involved the coronary band area and the medial claw of the right hindfoot, which was removed surgically. The goat was reexamined 1 month after tumor removal and found to have widespread metastases with concurrent neurologic signs. PMID- 6501055 TI - Employment, starting salaries, and educational indebtedness of 1984 graduates of US veterinary medical colleges. PMID- 6501056 TI - What is your diagnosis? Intramural mass in the proventriculus. PMID- 6501057 TI - Ultraviolet-absorbing intraocular lenses. AB - Chemical analysis of the ultraviolet-absorbing materials in American Medical Optics, Cilco, and Optical Radiation Corporation intraocular lenses is reported. Clinical considerations are discussed, and the absence of any long-term safety and effectiveness data is noted. PMID- 6501058 TI - Cataract extraction and diabetic retinopathy. AB - A prospective study of the effect of cataract extraction and intraocular lens implantation on insulin-dependent diabetics is presented. Cataract extraction was performed on 138 patients with diabetic retinopathy. The patients were randomly selected for intracapsular or extracapsular extraction and for the administration of topical indomethacin or placebo. In a second group, 103 diabetic patients received intraocular lens implants, which were anterior-chamber-angle fixated, iris supported, iridociliary sulcus supported, or placed in the capsular bag. Random selection determined who among the extracapsular cases would have on-the table capsulotomy or six-month-postoperative capsulotomy. The study indicated that a greater progression of diabetic changes occurred in both the posterior and the anterior segment of the eye after intracapsular extraction than after extracapsular extraction, especially if the capsulotomy was performed six months postoperatively. Furthermore, the study indicated that in-the-bag implantation without on-the-table capsulotomy was a safe procedure; anterior-chamber-angle fixated lenses exhibited a higher incidence of diabetic changes in the anterior and posterior segments than the other lenses. PMID- 6501059 TI - Operating microscope light-induced retinal injury: mechanisms, clinical manifestations, and preventive measures. AB - Experimental and clinical evidence of light-induced retinal injury associated with the operating microscope is reviewed. The mechanism of photochemical injury is discussed, as well as the concept of reversible phototoxic insults. Factors that influence retinal recovery and measures that can be taken by the surgeon to reduce light exposure to the retina are also discussed. PMID- 6501060 TI - Secondary IOL power calculations: a comparison of regression formula and refraction method in accurate prediction of emmetropia. AB - A retrospective review of 51 secondary intraocular lens (IOL) implantations was made to determine the relative accuracy of the SRK regression formula and the refraction method described by Holladay in preoperative prediction of emmetropic IOL power. The regression formula accurately predicted emmetropia within 1 diopter (D) in 63% of patients; the refraction method accurately predicted within 1 D in only 26% of cases. The emmetropic power predicted by the two formulas differed by at least 1 D in 76% of patients. Precise measurement of preoperative variables is imperative to ensure accurate prediction of emmetropic IOL power in the patient considered for secondary implantation. PMID- 6501062 TI - Rapid fibrosis of ORC Stableflex haptics. PMID- 6501061 TI - Automated perimetry--Part II. PMID- 6501063 TI - Local anesthesia for cataract surgery. PMID- 6501065 TI - Use of anterior lens after ECCE. PMID- 6501064 TI - Glistenings in injection-molded lens. PMID- 6501066 TI - Artifacts on SEM study of eye tissues. PMID- 6501067 TI - Perspex CQ grade for IOLs. PMID- 6501068 TI - Direct measurement of the capsular bag. AB - Direct measurement of the capsular bag was performed after extracapsular cataract extraction on 49 cadaver eyes. These lenses had a collapsed bag size of 10.32 +/- 0.42 mm. PMID- 6501069 TI - The capsule coupeur for automated anterior capsulectomy. AB - We present a mechanical automated anterior capsulectomy device that can operate from its own power source or from several pre-existent automated cataract and vitreous surgical systems. PMID- 6501070 TI - Two-way irrigating needle for cortical cleanup. AB - A 23- or 25-gauge two-way, irrigating-aspirating needle is described. The needle has the shape and conformity of the Simcoe needle, as well as the practical gravity infusion of the Pearce/McIntyre needle. PMID- 6501071 TI - An instrument for irrigating the nucleus in extracapsular surgery. PMID- 6501072 TI - Syringe holder for anterior chamber irrigation/aspiration. AB - A syringe holder that allows one-handed control of irrigation/aspiration of the anterior chamber is described. PMID- 6501073 TI - Use of the piezo-electric gun to remove surface charge from intraocular lenses. PMID- 6501075 TI - Personal characteristics of health professionals: can they be changed by an educational program? AB - The objectives of many graduate programs in the health sciences include the development of various personal characteristics, attitudes, and beliefs. A study was carried out to assess whether personal characteristics of graduate students could be affected by program participation and, if so, which specific personal characteristics could be changed. Three attitude tests were administered to three consecutive classes of mature health professionals, using a repetitive pre-post design. Results showed no difference from pre- to posttesting on the California Personality Inventory; a positive difference on one main scale and two subscales of the Personal Orientation Inventory (inner directedness, flexibility in application of values, and self-acceptance); and a negative difference on the Health Professional Survey (attitude toward working in teams). These findings suggest that many personal characteristics deemed important by program planners in the health sciences may more appropriately be criteria for admission than objectives of the program. PMID- 6501074 TI - Directions in ophthalmic laser development. PMID- 6501076 TI - Constructing the cost of health professions education. AB - Pressures at the national, state, and institutional levels are forcing health professions education administrators to justify their budget requests. Because unit cost studies traditionally used by higher education have proved unsatisfactory, program constructed cost models have been developed. The advantages of the model for administrators lie in the fact that any input unit of the model can be adjusted and the effects of that adjustment can be measured against the cost per student. In times of budget restrictions, these adjustments permit administrators to model various combinations of student enrollment, faculty involvement, class size, and basic program structure to obtain the optimal education experience from available resources. The model is applied by way of example to all nonbaccalaureate dental hygiene education programs in the United States. PMID- 6501077 TI - The Queens Modified Area Health Education Center. PMID- 6501078 TI - Selection of medical technology students in a hospital-based program. AB - This article describes a process for selection of medical technology students into a hospital-based program. The process uses a weighting method for selection criteria and numerical ranking of applicants by a point system. Tools developed by the selection committee are discussed: Pre-Interview Rating Form, Interview Rating Form, Interview Rating Form Score Sheet, and Interview Questions Sets. The structured selection interview is described in detail. The process might easily be adapted to other hospital-based allied health programs. PMID- 6501079 TI - Clinical supervision: Guidelines for managing the problem student. AB - Most allied health education programs require students to satisfactorily complete clinical affiliations before entering their professions. However, few guidelines are given to the clinical supervisor on managing the "problem student," the student with marked skill or personality deficiencies. The concrete procedures in this article can help reassure the supervisor that this complex situation is being handled as fairly as possible and that the student is being given reasonable opportunities to demonstrate needed capabilities. Furthermore, adherence to these procedures protects the supervisor from possible student initiated legal action and protects the profession from unqualified practitioners. PMID- 6501080 TI - A teleconference course for clinical laboratory personnel: a pilot project. AB - This article describes a pilot project teleconference course offering made possible through inter-institutional and intra-institutional cooperation. A continuing education program for clinical laboratory personnel was planned and delivered in six locations in northwest Illinois using teleconference equipment and a telelecture delivery mode. The program was evaluated by two techniques, a videotape interview with participants at one site and a mailed post-program form. Both evaluation methods are described. The evaluation results indicated that the majority of participants were receptive to the new instructional mode and would recommend it to their professional peers. PMID- 6501081 TI - Developing and negotiating transfer agreements in allied health. AB - The Kentucky Council on Higher Education has developed a statewide articulated system for allied health education. The articulated system permits entry and exit of prepared professionals at a variety of levels. The six disciplinary clusters included in the system are clinical laboratory sciences, dental auxiliaries, dietetics/nutrition, rehabilitation therapies, radiological sciences, and respiratory therapy. Competency-based education was used as the theoretical framework for developing and negotiating transfer agreements. Types of agreements included the block credit transfer agreement and the course specific transfer agreement. Agreements were negotiated between education systems and between specific programs/institutions. To date, approximately 30 transfer agreements have been negotiated. The process for negotiating transfer agreements included the following sequence: identify programs, develop a theoretical articulation model, rank order transfer agreements, determine the type of agreement, review respective curricula, determine the existing amount of transferable coursework, draft a pre-articulation agreement, schedule a meeting between faculty and administrators to discuss the agreement, and secure authorizing signatures on the final transfer agreement. Facilitators and barriers to negotiating agreements are discussed and recommendations offered for others who may be interested in developing transfer agreements. PMID- 6501082 TI - Fibroblast androgen receptors in patients with genitourinary anomalies. AB - The etiology of certain disorders of sexual differentiation is unclear. The authors have examined the hypothesis that hypospadias and other disorders compatible with a defect in androgen action, such as cryptorchidism, micropenis, chordee/penile torsion, and ectopic testis, might be explained by androgen receptor abnormalities. Therefore, 25 subjects were studied who were selected only because they had one of these developmental defects, together with a predominantly male phenotype, and no readily ascertainable explanation for the defect. Four of these subjects had mixed gonadal dysgenesis with multiple genito urinary anomalies. They were included for comparative purposes, since there is no evidence for androgen resistance in this disorder. Patients with testicular regression syndrome (gross testosterone deficiency), impaired testosterone biosynthesis (relative testosterone deficiency), 5 alpha-reductase deficiency (altered T/DHT ratio), and a family history or endocrine profile suggestive of androgen resistance, were all excluded from evaluation. Androgen receptor content (R0) and binding affinity (Kd) were measured in 26 genital or pubic skin fibroblast strains cultured from 25 affected patients using a dispersed, whole cell assay at 22 C. There was no difference in the mean androgen receptor content (approximately 10,000 sites/cell) or binding affinity (approximately 1 nM) between the patients' fibroblasts and those from 26 fibroblast strains established from 26 normal males. Moreover, there were no differences in the nuclear uptake of [3H]dihydro-testosterone into dispersed, intact fibroblasts incubated at 37 C when 11 patient and seven normal male fibroblast strains were compared.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501083 TI - Monolateral tubulovasostomy. Report of four cases. AB - After conventional vasoepididymostony, the epididymal lumen may become occluded or obstructed, resulting in recurring azoospermia. Recently, two-layer direct anastomosis has been advocated on the basis of experimental models of tubulovasostomy performed in rats. Monolateral tubulovasostomy was performed in four cases under 16-40 times magnification. Nylon or 11/0 Vycril was used as suture material for the internal layer of the anastomosis, and 10/0 Ethilon was used for the external layer. After three and six months, semen samples were evaluated for sperm count and motility. The presence of spermatozoa in all the samples confirmed 100% patency of the duct. Three patients had a number of spermatozoa compatible with fertility, and one pregnancy occurred. PMID- 6501085 TI - The effects of ethylene glycol monomethyl ether on testicular histology in F344 rats. AB - Ethylene glycol monomethyl ether (EGME) has been found to produce testicular atrophy in experimental rodents. The studies that follow were designed to determine the testicular cell type(s) most susceptible to EGME administration. For histologic studies, F344 rats were gavaged with 150 mg/kg/day of EGME 5 days per week, and serially sacrificed. In sections from perfusion-fixed tissue, necrotic changes were observed in some meiotic and premeiotic spermatocytes 24 hours after a single dose. Also, nuclear condensation was seen in occasional early pachytene spermatocytes. These effects were magnified after two doses; there were more necrotic pachytene and meiotic spermatocytes than necrotic stage I pachytene spermatocytes. By day 4, testes from all treated animals were affected; there was a pronounced maturation-depletion effect, seen as the absence of round spermatids from tubules in stages I to III. These effects continued to develop at days 7 and 10, leaving only Sertoli cells, spermatogonia, and late stage spermatids populating the epithelium. Other animals were treated similarly, but subject to efferent duct ligation 16 hours prior to sacrifice. Fluid production, as judged by weight gain in the testes after efferent duct ligation, was unaffected by EGME treatment. Analysis of the fluid collected at the rete testis indicated that there was no treatment-related change in the relative amounts of androgen binding protein. The data indicate that the spermatocyte is the primary target cell for the histologic effects of EGME in the testis of F344 rats. PMID- 6501084 TI - Fetal irradiation increases androgen production by dispersed leydig cells of the rat. AB - Damage to the seminiferous epithelium of the rat has been shown to decrease the concentration of serum testosterone. In these animals, compared to controls, the structure of the Leydig cells suggests hyperactivity. In an attempt to understand the functional changes at the Leydig cell level, we measured in vitro androgen production by whole testes, testicular fragments, and Leydig cell preparations. The androgen production of adult rats that had received 1.6 Gy of gamma radiation on day 20 of gestation was compared to that of nonirradiated controls. Leydig cells obtained from fetally-irradiated adult rats demonstrated increased basal (1.3 X) and LH-stimulated (4.4 X) testosterone production and increased hCG binding (4.8 X) per histochemically identified Leydig cell, as compared to cells obtained from nonirradiated control animals. Although the irradiated testicular tissue showed an increased responsiveness per mg/tissue compared to controls, basal and stimulated in vitro testosterone production per irradiated testis calculated from this data was diminished because of the five-fold decrease in testis size. In addition, the circulating levels of testosterone were reduced in irradiated animals. We suggest that fetal irradiation is associated with an increase of hCG binding and testosterone production per Leydig cell, and a decrease in the number of these Leydig cells per testis. PMID- 6501086 TI - Effects of long- and short-term vasectomy on structural and functional parameters of the rat. AB - The effects of vasectomy were examined by comparing various parameters from sham operated and vasectomized rats that had undergone surgery at 90 days of age and were killed at 190 or 390 days of age. Significant alterations in the vasectomized rats from sham rats included: testicular and epididymal hypertrophy, formation of pathologic vas deferens granulomas, decreased total serum protein, lowered alpha-globulin levels as shown by serum electrophoresis, and increased sperm agglutinin antibody titers. For vasectomized rats, the differential white blood cell count showed increased numbers of neutrophils and large lymphocytes and decreased numbers of small lymphocytes and basophils. Both the number and extent of many vasectomy-induced alterations were greater in long-term vasectomized than in short-term vasectomized rats. PMID- 6501087 TI - Lysinomicin, a new aminoglycoside antibiotic. II. Structure and stereochemistry. AB - The structure of lysinomicin, a new aminocyclitol antibiotic, was established as 3-epi-2'-N-(L-beta-lysyl)-4',5'-didehydro-6'-de-C-methylfortimi cin B (1) on the basis of spectral evidence and chemical degradation of the antibiotic. In the course of the degradation of 1, three additional compounds with interesting biological properties were obtained: 3-epi-2'-N-(L-beta-lysyl)-6'-de-C methylfortimicin B (4), 3-epi-4',5'-didehydro-6'-de-C-methylfortimicin B (6) and 3-epi-6'-de-C-methylfortimicin B (7). PMID- 6501088 TI - Studies on new antiplatelet agents, WS-30581 A and B. AB - WS-30581 A and B are antiplatelet agents produced by a strain of Streptoverticillium waksmanii. The compounds were purified by solvent extraction and column chromatography, and identified as new pimprinine analogs on the basis of their physico-chemical properties. The producing organism produced pimprinine along with these compounds. Pimprinine and the two new analogs have potent inhibitory effects on platelet aggregation. PMID- 6501089 TI - Studies on an antibiotic, albocycline VII. Minor components of albocycline. AB - As an approach to the search for new potentially useful macrolide antibiotics, we explored the minor components of albocycline (ALB) from the culture broth of Streptomyces bruneogriseus. Eight minor components were isolated and their structures were confirmed as 1 approximately 8. Unexpectedly, they were not glycosidic compounds but only oxidation or reduction products of ALB. Three or four of them will serve as a useful intermediate to introduce amino sugar moiety into ALB skeleton. PMID- 6501090 TI - Isolation of L-cycloserine from Erwinia uredovora. AB - An antibiotic which seems to be a cell wall synthesis-inhibitor was isolated from a bacteria strain identified as Erwinia uredovora. The antibiotic was identified with L-cycloserine from its physico-chemical properties. This is the first example for isolation of L-cycloserine as a microbial product. PMID- 6501091 TI - Novel rifamycins. IV. 3-Aminomethylazinomethylrifamycins, a new class of rifamycins, endowed with remarkable antibacterial activity. PMID- 6501092 TI - The synthesis and antitumor activity of N-glycosyl derivatives of daunorubicin. PMID- 6501093 TI - Interspecific protoplast fusion among macrolide-producing streptomycetes. AB - From auxotrophic and idiotrophic mutants of Streptomyces fradiae (tylosin producer) and Streptomyces sp. AM 4900 (pikromycin producer) or Streptomyces narbonensis (narbomycin producer), prototrophic fusants were obtained at a low frequency by the protoplast fusion technique. In the cross of S. fradiae 261-27E (mycaminose-idiotroph, ilv) and Streptomyces sp. AM 4900 N3-4, (pikronolide idiotroph, arg), an unstable prototrophic fusant, strain No. 14, produced a macrolide antibiotic which was not produced by the wild type, parent strains, and the productivity was lost within a few times transfer. It was concluded that the fusant was not a recombinant, but a heterokaryon. On the other hand, relatively stable fusants were obtained from the cross of S. fradiae TBM (mycaminose idiotroph, met) and S. narbonensis NA12US3 (narbonolide-idiotroph, his, str) at a frequency of 3.2 X 10(-5). One of the prototrophic fusants produced narbomycin, which is believed to be due to a result of interspecific recombination. PMID- 6501094 TI - Activity of rapamycin (AY-22,989) against transplanted tumors. AB - Rapamycin exhibits activity against several ascites and solid transplantable tumors; it is slightly active to inactive against leukemias. On a weight basis, rapamycin was less active than 5-fluorouracil, cyclophosphamide and adriamycin, but rapamycin's maximal activity against Colon 38 tumor was similar to that of 5 fluorouracil and cyclophosphamide. Its activity was such that it significantly inhibited tumor growth at any stage of development. In the active dose range, rapamycin appeared less toxic than the other drugs. In the Colon 38 tumor model, rapamycin at a given dose exhibited the same activity when administered ip, iv, im and sc; upon oral administration, its activity was reduced but not abolished. Rapamycin was compatible with 5-fluorouracil and cyclophosphamide. The sequential treatment 5-fluorouracil-rapamycin-cyclophosphamide was superior to the sequence 5-fluorouracil-adriamycin-cyclophosphamide in protecting Colon 38 tumor-bearing mice. 29-Demethoxyrapamycin exerted only marginal activity against P388 lymphocytic leukemia; it was inactive against B16 melanocarcinoma and Colon 38 solid tumor. PMID- 6501095 TI - Mycoversilin, a new antifungal antibiotic. III. Mechanism of action on a filamentous fungus Trichophyton rubrum. AB - Mycoversilin is active against filamentous fungi, being specifically inhibitory to Trichophyton rubrum, minimum inhibitory concentration being 15 micrograms/ml. Mycoversilin inhibits sporulation to the extent of 28.5% even at the growth inhibitory concentration whereas inhibition of spore germination requires higher concentration. It has no effect on radial growth. Further it shows no action either on the release of UV absorbing materials or on the respiration of T. rubrum. However, the antibiotic inhibits in vivo synthesis of protein fairly strongly, DNA moderately and RNA slightly at the minimum inhibitory concentration. Cell-free protein synthesis is also strongly inhibited, the site of action being the inhibition of leucyl-tRNA formation by the antibiotic which has no action on leucine activation. PMID- 6501096 TI - Enhancement of mouse immune system by pyrrolomycin B. AB - Pyrrolomycin B enhanced both humoral immune response and delayed-hypersensitivity against sheep red blood cells in mice. In spleen cell culture it was a weak inhibitor of mitogenesis. However, in combination with concanavalin A, there was stimulation of mitogenesis in spleen cell culture. Pyrrolomycin B also enhanced phagocytosis of yeasts by peritoneal macrophages after in vivo administration to mice. Thus, pyrrolomycin B, formerly isolated as an antibiotic agent, is an immunopotentiator possibly acting on the membrane of lymphocytes or macrophages. PMID- 6501098 TI - Chemical modification and antitumor activity of herbimycin A. 8,9-Epoxide, 7,9 cyclic carbamate, and 17 or 19-amino derivatives. PMID- 6501097 TI - Isolation and structural determination of siderochelin C, a fermentation product of an unusual Actinomycetes sp. PMID- 6501099 TI - The structure of paulomycin. PMID- 6501100 TI - Stereospecific C6-hydroxyethylation of the penicillin nucleus. PMID- 6501101 TI - Biosynthesis of the glycocinnamoylspermidine antibiotic, cinodine. AB - The biosynthesis of cinodine from a combination of 14C- and 13C-labeled precursors has been investigated. Tyrosine was shown to be incorporated efficiently into the cinnamoyl moiety and glucosamine was found to be the origin of the three carbohydrate moieties. The relationship between the substrate dose and the enrichment of the labeled antibiotic has been elucidated so that it is possible to predict both the specific activity and the yield of the antibiotic obtained from the labeled substrates. PMID- 6501102 TI - Chemical modification of tylosin. Thioether derivatives of tylosin and demycarosyltylosin. AB - Thioether derivatives of tylosin and demycarosyltylosin were synthesized by Michael-type addition of thiol to C-11 of the enone moiety on the aglycone. Some of tylosin derivatives were effective to macrolide resistant Staphylococcus aureus, and their in vivo activities were same or superior than that of tylosin. PMID- 6501103 TI - Pharmacokinetics of rifapentine, a new long lasting rifamycin, in the rat, the mouse and the rabbit. AB - A study on the pharmacokinetics of rifapentine, a new long-lasting rifamycin, has been carried out in the rat, the mouse and the rabbit. The investigation was made using either radioactive or unlabelled rifapentine and both the total 14C and the unchanged compound were assayed. In the rat, the overall evidence obtained was: the oral absorption of rifapentine into central compartment, due to its poor water solubility, appears to be dose-dependent with a satisfactory oral absorption (84%) after a dose of 3 mg/kg, lower (65%) after 10 mg/kg; the antibiotic undergoes rapid liver uptake while it diffuses into the tissue compartment more slowly, with particular affinity for the adrenals, pancreas and kidneys; concentrations higher than in plasma were also measured in the lungs; elimination of rifapentine from the blood and tissue compartments suggests a non linear capacity-limited kinetics where the terminal elimination phase has monoexponential course. Terminal plasma half-life ranged between 14 and 18 hours; the compound is eliminated mainly via the bile with the feces (92% of dose). In mice rifapentine shows a kinetic profile resembling that obtained in rats, whereas in rabbits is metabolized and/or eliminated much more rapidly with a half life of only 1.8 hours. PMID- 6501105 TI - Biosynthesis of the spermidine moiety of glycocinnamoylspermidine antibiotic cinodine. PMID- 6501106 TI - The absolute structures of THP-adriamycins. PMID- 6501104 TI - Studies on the biosynthesis of pentalenolactone. VII. Isolation of pentalenolactones P and O. PMID- 6501107 TI - A novel phenazine antifungal antibiotic, 1,6-dihydroxy-2-chlorophenazine. Fermentation, isolation, structure and biological properties. AB - A novel, solvent extractable, antibiotic complex has been purified from the fermentation broth of an unusual member of the genus Streptosporangium. Two of the major components were isolated from the complex by alumina column chromatography. One of the components was identified as a previously reported compound, 1,6-dihydroxyphenazine. The other component was a novel chlorine containing phenazine, 1,6-dihydroxy-2-chlorophenazine, which exhibited broad spectrum antifungal activity in vitro against dermatophytes and Candida. PMID- 6501108 TI - Empedopeptin (BMY-28117), a new depsipeptide antibiotic. I. Production, isolation and properties. AB - Empedopeptin is a new antibiotic produced by empedobacter haloabium nov. sp. (ATCC 31962). It is a water-soluble depsipeptide antibiotic containing eight amino acid residues and a C14-fatty acid moiety in the molecule. Although structurally unrelated, empedopeptin and vancomycin have similar antimicrobial spectra against aerobic and anaerobic Gram-positive bacteria including antibiotic resistant strains. Empedopeptin is highly active in vivo in mice against systemic infections of Staphylococcus aureus, Streptococcus pyogenes and Clostridium perfringens. Empedopeptin is not absorbed orally. PMID- 6501109 TI - Empedopeptin (BMY-28117), a new depsipeptide antibiotic. II. Structure determination. AB - Structure of a new antibiotic, empedopeptin, has been determined. It is a cyclic depsipeptide composed of two mol of D-serine and one mol each of beta hydroxytetradecanoic acid, L-arginine, D- and L-proline, L-3-hydroxyproline and D and L-beta-hydroxyaspartic acid. The sequence of these moieties was established by partial hydrolysis and mass spectral analysis of the antibiotic. PMID- 6501110 TI - Structural investigation of the antibiotic sporaviridin. X. Isolation and characterization of components of N-acetylsporaviridins. AB - Isolation and characterization of the major components of N-acetylsporaviridins, a derivative obtained by treatment of sporaviridins with acetic anhydride in methanol were carried out. The isolation procedure as shown in Scheme 1 gave successfully six components whose molecular weights are all about 2,200. Each component was suggested to be a glycosidic compound consisting of a macrocyclic lactone, one of viridopentaoses, a D-glucose and an N-acetyl-L-vancosamine by various spectral data. PMID- 6501111 TI - Cochlear deoxyglucose uptake: relationship to stimulus intensity. AB - The relationship between stimulus intensity and the uptake of 2-deoxyglucose (2 DG) in the cochlea of the gerbil was studied using an autoradiographic technique. In silence, incorporation of labeled 2-DG into stria vascularis and the spiral ligament was significantly higher than for other inner ear structures. With increasing intensity of noise exposure, 2-DG uptake in the spiral ganglion and VIIIth nerve increased dramatically when compared to the lateral wall structures. In contrast, relative 2-DG uptake in the organ of Corti was much less affected by noise exposure. Only at 105 dB SPL, the highest intensity tested, was a modest but statistically significant increase observed in the sensory epithelium. The small change in relative 2-DG uptake observed in the organ of Corti during acoustic stimulation is consistent with Davis' (1965: Quant. Biol. 30, 181-190) battery model of the cochlear transduction process. Alternatively, a larger change may have occurred, but been restricted to a small portion of the epithelium, such as one or both populations of hair cells. PMID- 6501112 TI - The human medial geniculate body. AB - The medial geniculate body in non-human species is divided into several parts, each with a different structure, physiological organization, and pattern of connections. Which parts of the human medial geniculate body and which types of neurons might be homologous to those of other species is unknown, and the object of the present study. The cytoarchitecture, fiber architecture, and neuronal organization of the adult human medial geniculate body were studied in Nissl, Golgi, and other preparations. Three divisions, comparable to those in other mammals, were described. The ventral division had a bimodal distribution of somatic sizes in Nissl material which, in Golgi impregnations, may correspond, respectively, to a larger neuron with bushy dendrites and a tufted branching pattern, and a smaller stellate cell with a radiating, spherical dendritic field. The large neurons formed clusters surrounded by a particular pattern of neuropil which, together, constituted fibro-dendritic laminae whose long axis was oriented medio-laterally in parallel sheets or rows. The dorsal division was dominated by small and medium-sized somata representing at least three populations of neurons in the Golgi preparations. The large stellate cell had a radiate dendritic field and a dichotomous branching pattern; an equally large neuron with an elongated, multiangular perikaryon and bushy dendritic arbors forming tufts also occurred. Blended among these larger neurons were many smaller cells with tiny, flask shaped, round, or drumstick-like perikarya, limited dendritic fields and thin dendrites, and poorly developed stellate or bushy dendritic configurations. In the medial division, larger somata were more common than in the other medial geniculate divisions, but small cells were present in considerable numbers. The fiber architecture and the different kinds of neurons distinguished the three major divisions and the nuclei within them. Thus, the ventral nucleus had long fascicles of axons running parallel to the dendrites of bushy neurons, while the marginal and ovoid nuclei had a different organization. The dorsal division had a more diffuse, irregular arrangement of thinner axons interspersed among bundles of coarser fibers, whereas the medial division was traversed by many coarse preterminal axons passing laterally and dorsally from the brachium of the inferior colliculus; these imparted a striated pattern to the neuropil. Regional variation in cytoarchitecture and the fiber plexus defined several nuclei in each subdivision, except in the medial division, where the density of the staining made further subdivision impossible.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6501113 TI - Rapid and short-term adaptation in auditory nerve responses. AB - The peristimulatory adaptation of auditory nerve responses in Mongolian gerbil was studied. Constant-intensity tone bursts were used as stimuli. The time decay of the firing rate following the response peak at stimulus onset was described by fitting two exponentially-decaying components and a constant term to the resulting peri-stimulus-time histograms. The slower (short-term) component had an amplitude which was proportional to the driven-steady-state rate (the portion of the constant term in excess of the spontaneous rate). The short-term time constant was on the order of 60 ms and was independent of intensity. The rapid component grew more quickly with intensity and exhibited a greater dynamic range than did the short-term and steady-state components. The time constant of the rapid component was on the order of 1-10 ms, and decreased with increasing intensity in most units. At a constant intensity above unit threshold, the rapid time constant measured at CF was larger for units with low characteristic frequency (CF) than for units with high CF. These results indicate that as intensity increases, the auditory nerve fiber responds more vigorously and with greater time resolution to the onset of tonal stimuli. PMID- 6501115 TI - Measurement of the combination tone 2f1-f2 using two-tone forward masking and compound action potential responses. AB - The presence of the 2f1-f2 combination distortion tone generated when two tones are presented to the cochlea, can be detected using a two-tone complex to forward mask a probe tone. The combination tone is the effective masking agent and the amplitude of the compound action potential response to the probe tone reflects the degree of masking. Excitation patterns, frequency relationships and intensity functions that are obtained with this procedure are consistent with previously published data. PMID- 6501114 TI - The auditory neurophonic: basic properties. AB - In anesthetized cats an AC signal or neurophonic can be recorded from the auditory nerve and from the scalp when the cochlea is stimulated with low frequency tones. This study examines some of the basic properties of the auditory neurophonics. The auditory nerve signal, termed the auditory nerve neurophonic (ANN), was differentially recorded with a pair of platinum-iridium ball electrodes placed on either side of the auditory nerve as it exits the internal meatus. The signal recorded from the scalp, termed the frequency following response (FFR), was recorded with silver wire. For purposes of comparison the round window-recorded cochlear microphonic was also examined under identical stimulus conditions. Several measures of the response to acoustic stimulation were taken for each recording configuration. Among these were total response amplitude as a function of stimulus level, spectral component amplitude and phase as a function of stimulus level, fundamental component amplitude as a function of stimulus frequency, response amplitude as a function of time after stimulus onset, response amplitude as a function of forward masker intensity. By all these measures the neurophonic responses are signals that are distinct from the CM and share many of the properties of single units in the auditory nerve. In addition, micro-injections of kainic acid into the cochlear nucleus leave these responses largely unaffected, while tetrodotoxin injections into the cochlea greatly diminish both neurophonic responses, while leaving the CM largely intact. From these results, we conclude that at stimulus levels below 90 dB SPL the ANN is almost entirely neural in origin, while the FFR is certainly largely neural, that is, that both responses are quite distinct from the CM. We also conclude that they represent a spatial summation of neural activity in the auditory nerve, probably arising from the phase-locked response of single units to low frequency stimuli. In addition to demonstrating that the neurophonics are neural responses, we have begun the process of relating their properties to the distributed phase locked activity in the auditory nerve. PMID- 6501116 TI - Support of cochlear metabolic and ion transport processes solely by perilymphatic perfusion. AB - Morphologic considerations would seem to suggest that the cochlear duct could not be maintained in a fully functional state in the absence of a blood supply. We found, however, that perilymphatic perfusion could be used as a substitute for the normal vascular circulation. The criteria used to determine cochlear function included (1) normal endocochlear potential, (2) normal net secretory flux of rubidium (as a tracer for K), and (3) normal levels of ATP in both the organ of Corti and the stria vascularis. All criteria were satisfied by our perfusion regimen. PMID- 6501117 TI - Heat injury and recovery of Streptococcus faecium associated with the souring of chub-packed luncheon meat. AB - The presence of NaCl in the heating medium provided some protection from lethal heat damage for cells of a Streptococcus faecium strain isolated from luncheon meat whereas the presence of NaNO2 either alone or in addition to NaCl, had no significant effect on cell survival. Subsequent recovery and growth of heat damaged cells was retarded by the presence of NaCl. When NaNO2 was present in addition to NaCl the inhibitory effect of the latter was reduced. These principal components of the luncheon-meat-cure are apparently opposed in their activities on post-heating recovery and growth of Strep. faecium. Product stability, i.e. duration of the lag before growth occurs, is directly related to the severity of the heat treatment and to the concentration of NaCl in the product. Therefore the resistance of pasteurized chub-packed luncheon meat to streptococcal spoilage during storage at temperatures conducive to microbial growth results from a prolonged heat-induced salt-maintained pre-growth adjustment phase rather than to any inherent inhibitory property of the luncheon meat to the growth of non-heat damaged Strep. faecium cells. PMID- 6501118 TI - Vibrio anguillarum: influence of temperature, pH, NaCl concentration and incubation time on growth. AB - An analysis of the effect of growth conditions on the growth (O.D. values) of five Vibrio anguillarum strains showed that the optima were as follows: pH 7, temperature 25 degrees C, NaCl concentration 2%, and O.D. estimates increased with the incubation time. The independent parameters, as well as their interactions significantly influenced the growth of Vibrio anguillarum (P less than 0.0001). Only the strain-salinity interaction was not always statistically significant. A restriction of the parameters to a level relevant for Danish marine recipients showed that pH and NaCl concentration (salinity) might be of minor importance while the temperature was always of high significance. The possible impact of these observations on local conditions is discussed. PMID- 6501119 TI - Allogenic succession of marine bacterial communities in response to pharmaceutical waste. AB - Vibrio spp. predominated in the culturable bacterial community of surface waters of the Puerto Rico Trench at the site of disposal for nearly ten years of pharmaceutical wastes. In this area and surrounding waters as far as 1000 km north of the dumpsite and south into the Caribbean Sea, Vibrio spp. comprised up to 100% of the culturable bacteria, with Acinetobacter spp. being the second most prevalent group. Pseudomonas spp., reported to be common in these waters a decade earlier, were virtually absent from all samples examined during a three year study involving 9 cruises. Staphylococcus spp. were also found in water samples collected within the dumpsite. Using cultures isolated from surface water samples collected at the dumpsite, laboratory experiments confirmed that pharmaceutical waste can enrich for Vibrio spp., in preference to Pseudomonas spp., with growth of the strains proportional to the amount of waste added. PMID- 6501120 TI - The adhesion of coagulase negative staphylococci to human skin and its relevance to the bacterial flora of milk. AB - Twenty-eight isolates of coagulase negative staphylococci were obtained from nipple swabs provided by one non-lactating woman and five nursing mothers. All but two of these isolates were shown by scanning electron microscopy to adhere to the surface of human skin. Experiments with frozen sections of human skin confirmed and extended these results by showing that isolates exhibited one of three patterns of adhesion, suggesting that there are three different adhesion receptors on epidermal cells. It is proposed that adhesion of staphylococci to the nipple and areolar epidermis provides a mechanism whereby large numbers of bacteria, nourished by residues of milk and saliva, are maintained on the surface of the skin. PMID- 6501121 TI - Changes in metabolism of the rumen bacterium Streptococcus bovis H13/1 resulting from alteration in dilution rate and glucose supply per unit time. AB - Streptococcus bovis H13/1 was grown in a glucose-limited chemostat. A concomitant increase in dilution rate and glucose supply per unit time caused both an increase in lactate production per mole of glucose fermented and a linear increase in growth yield over the dilution rate range 0.052 to 0.141/h. When the dilution rate was increased with no change in glucose supply per unit time there was a reduction in lactate production and an increase in that of acetate and ethanol coinciding with a non-linear increase in growth yield. YMaxglu = 38.6 and a maintenance coefficient, ms = 0.290 mmol/l glucose/g cells/h were calculated. The results also suggested an interaction between the formate and CO2 pools. PMID- 6501122 TI - Outpatient intravenous antibiotic therapy. PMID- 6501123 TI - A survey of antibiotic use in Harare primary care clinics. AB - A survey of antibiotic prescribing by nurses in primary care clinics was carried out in Harare, Zimbabwe. Of 1000 patients surveyed 543 were treated with antibiotics. Respiratory and soft tissue infections were the commonest reasons for prescribing an antibiotic. Procaine penicillin was the commonest antibiotic used. Because of the design of the survey audit of antibiotic use was difficult but antibiotic use was deemed inappropriate in 12.3% of patients. Viral upper respiratory tract infections accounted for the largest single source of error. The large (23.1%) assessor disagreement illustrates the difficulties encountered when applying accepted guidelines for antibiotic use to developing countries. The disagreements were consistent and highlight areas for local research and debate. The overall standard of antibiotic prescribing by ancillary medical staff is good. Clearly outlined policies, continuing education and permanent staff contribute to this. PMID- 6501124 TI - Impact of single dose as compared to three dose prophylaxis with latamoxef (moxalactam) on the colonic microflora in patients undergoing colorectal surgery. AB - Twenty patients undergoing colorectal surgery were given an initial dose of 2 g latamoxef (moxalactam) parenterally at the induction of anaesthesia. Ten of the patients received two subsequent doses at 8 h intervals. A series of serum and faecal specimens were taken for analysis of latamoxef concentrations. Tissue samples from intestinal mucosa and peritoneal fat were also taken at surgery. The mean serum peak level was 119.8 +/- 10.7 mg/l. The mean half life was 2.8 h and the mean area under the serum concentration curve was 345.0 +/- 25.7 mg h/l. The concentrations in intestinal mucosa were high when the tissue was removed within 4 h after the administration of latamoxef (22.6 +/- 1.7 micrograms/g, mean +/- S.E.). The concentrations declined when the tissues were removed later (7.8 +/- 0.7 micrograms/g). The content of latamoxef in peritoneal fat varied, range 0.8 23.4, mean 8.5 +/- 1.4 micrograms/g. Measureable levels of latamoxef in faeces were found in all patients except one. The values varied between 0.2 to 23.0, mean 8.9 +/- 1.5 micrograms/g. Faecal samples were also collected during the investigation period for cultivation of aerobic and anaerobic bacteria. The aerobic bacteria-streptococci, enterococci and enterobacteria--were suppressed significantly during the prophylaxis period. Among the anaerobic bacteria--cocci, lactobacilli, bifidobacteria, clostridia, bacteroides and fusobacteria--decreased markedly during the same period. After two weeks the microflora was normalized in all patients. There were no differences between the patients receiving one dose of latamoxef and those receiving three doses. No postoperative infections occurred. PMID- 6501125 TI - Temocillin bile levels. PMID- 6501126 TI - Aminoglycoside pharmacokinetics. PMID- 6501127 TI - Recent developments in the field of phosphonic acid antibiotics. PMID- 6501128 TI - A simple method for the identification of aminoglycoside-modifying enzymes. AB - In order to study the correlation between the presence of aminoglycoside modifying enzymes in bacteria and the susceptibility of these bacteria to aminoglycosides, 133 resistant strains were collected, representing the most frequently occurring modifying enzymes in clinical isolates today. Enzymes in these resistant strains were identified by the determination of substrate profiles for eight different aminoglycosides in vitro. Thirteen different enzymes or combinations of enzymes appeared to be present in this collection, whereas in seven cases the resistance appeared to be non-enzyme-mediated. The enzyme activities were not reflected in the bacterial susceptibility data for each antibiotic. Cluster analysis of the combined sensitivity data, with biochemical enzyme analysis as a guideline, proved to be unsatisfactory for the identification of aminoglycoside-modifying enzymes in clinical isolates. Much better results were obtained with a stepwise determination scheme. This method relies upon inhibition zone diameters around commercially available sensitivity discs for six aminoglycoside antibiotics. These zone diameters are compared with empirically established critical values, which are characteristic of an enzyme or group of enzymes. By this procedure proper identification of the enzyme(s) proved to be possible in 84% of the 133 resistant strains. For the evaluation of the method 100 consecutively isolated aminoglycoside resistant clinical isolates were analysed by means of the stepwise scheme and the biochemical method. Results were identical for 97 of the 100 strains. PMID- 6501129 TI - In-vitro synergy testing of triple antibiotic combinations against Staphylococcus epidermidis isolates from patients with endocarditis. AB - In-vitro synergy testing was performed against ten blood or valve isolates of Staphylococcus epidermidis taken from patients with endocarditis. A three dimensional microtitre checkerboard method was used for evaluation of vancomycin rifampicin-gentamicin. The triple combination of vancomycin plus rifampicin plus gentamicin was found to be synergistic in 70% of the isolates. Vancomycin plus rifampicin was not synergistic. Oral agents including dicloxacillin, rifampicin, and fusidic acid were also evaluated. Four methicillin-resistant isolates were relatively resistant to dicloxacillin (MIC greater than 0.79 mg/l) but all four isolates were susceptible to fusidic acid alone and rifampicin alone. The triple combination of dicloxacillin plus fusidic acid plus rifampicin was found to be synergistic in 50% of the isolates and generally superior to any two-drug combination raising the possibility of an effective oral combination of antibiotics. PMID- 6501130 TI - The in-vitro susceptibility of the Bacteroides fragilis group to amoxycillin clavulanic acid. AB - The susceptibility to amoxycillin-clavulanic acid of 150 strains belonging to the Bacteroides fragilis group was tested by both disc diffusion and agar dilution methods. On the basis of minimum inhibitory concentrations (MICs), at least 99% of the isolates were sensitive to this agent. However, problems encountered with the disc diffusion method suggest that at present it is unsatisfactory for assessing the in-vitro activity of amoxycillin-clavulanic acid against this group of organisms. PMID- 6501131 TI - Chemoprophylaxis for bacterial endocarditis--a survey of current practice in London. AB - 1820 medical and dental practitioners were circulated with a questionnaire regarding their use of antibiotics to prevent bacterial endocarditis. The response rate was 48.2%. Analysis of results suggests that antibiotics are believed to prevent endocarditis and are in common use for this purpose. However, the regimes used differ markedly from published current recommendations. Different antibiotics that are often inactive against the likely infecting organisms are used or, where recommended antibiotics are used, the doses are often inadequate. The timing of administration of prophylaxis also usually differs from current recommendations with antibiotics being prescribed for unnecessarily long periods. Patient abnormalities and procedures for which prophylaxis is given are generally in line with those considered to predispose to endocarditis. It appears that communication problems between doctors and dentists regarding the use of prophylaxis are less of a problem than previously thought. PMID- 6501132 TI - Inactivation of netilmicin and amikacin by intact or disrupted leucocytes. AB - The bio-inactivation of netilmicin and amikacin by binding with intact and disrupted human normal leucocytes was compared. Even after prolonged incubation of the aminoglycosides with intact cells, no binding could be demonstrated. On the other hand, partial binding of netilmicin and amikacin by disrupted leucocytes occurred: a linear relationship between the logarithm of the initial number of cells and the degree of binding of the drug was observed. The decrease in biological activity occurred rapidly in the presence of disrupted cells and remained unchanged during the next 18 h. PMID- 6501133 TI - Do we need the third-generation cephalosporins? AB - Third-generation cephalosporins have been available for the past 5 years. The continued increase in resistance of bacteria to older antimicrobial agents and the safety profile of a number of the third-generation agents have established situations in which these compounds are useful. Upper respiratory infections such as epiglottitis, lower respiratory tract infections due to Enterobacteriaceae are examples of illnesses in which third-generation cephalosporins would be preferred to older drug programmes. Bone and joint infections due to Enterobacteriaceae can be treated with third-generation cephalosporins with less risk of toxicity than that associated with aminoglycoside use. But this is an area in which resistance may develop. Meningitis in the elderly due to Escherichia coli or Klebsiella pneumoniae are best treated with cefotaxime and the third-generation cephalosporins are alternative therapy for neonatal and the other forms of meningitis except Listeria or Pseudomonas. These drugs have proved extremely useful in treatment of penicillinase-producing Neisseria gonorrhoeae. Hospital acquired urinary tract infections in the elderly can be treated with these agents since they provide excellent urinary levels and have a low risk of nephrotoxicity. The need for third-generation cephalosporins in gynaecological and intra-abdomonal infections is less clear. Selected patients will benefit from their use. Closer attention to the excellent in vitro activity and pharmacological activity of third-generation cephalosporins should establish other areas of need for these compounds, but it will be necessary to follow closely the development of resistance to these compounds since species such as Enterobacter, Serratia and Citrobacter can become resistant. PMID- 6501134 TI - Basic principles in the use of prophylactic antibiotics. AB - The prophylactic administration of antibiotic to the surgical patient is generally indicated whenever complicating infection of the incision or coelom to be violated is associated with a significant morbidity and/or mortality rate. For maximal benefit, antibiotic must be in the tissues at risk just prior to and throughout the entire period of bacterial contamination. When a parenteral route for delivery is uncertain, as in the case of shock or a burn wound, then topical application becomes a practical alternative. Only hospital surveillance, however, can dictate which patients and which surgical procedures warrant prophylactic antibiotic. Intelligently implemented, such a preventive programme can reduce significantly total expenditure for surgical health care. PMID- 6501135 TI - Survey of the phenotypes of susceptibility to beta-lactams in Enterobacteriaceae at the Pitie-Salpetriere Hospital. AB - The phenotypes of susceptibility to ampicillin, carbenicillin, cephalothin, cefamandole, cefoxitin and cefotaxime were determined by the disc-diffusion method in 10,994 Enterobacteriaceae consecutively isolated from in-patients during 18 months. The susceptible phenotypes were much more frequent among Escherichia coli, Proteus mirabilis and Klebsiella (67.4 to 84.8%) than among Serratia, Enterobacter and Citrobacter (8.8 to 35.5%). In all species the most common resistance phenotypes were to ampicillin and carbenicillin: E. coli (28%), Pr. mirabilis (15.2%), Klebsiella (23.8%), indole-positive Proteus (33.3%), Serratia (74.4%), Enterobacter (61.4%) and Citrobacter (74.8%). Among E. coli 4.6% of the strains were resistant to ampicillin and cephalothin but susceptible to carbenicillin. Among E. coli, Pr. mirabilis and Klebsiella the strains susceptible only to cefotaxime represented 0.3 to 5% and no cefotaxime-resistant strain was isolated; whereas among Serratia, Enterobacter and Citrobacter the former represented 28.3 to 58.3% and the latter 7.5 to 18.5%. Some important differences in the distribution of the phenotypes according to the type of ward were observed. PMID- 6501136 TI - Effect of antibiotic use on the incidence of cephalosporin resistance in two Australian hospitals. AB - The incidence of resistance of Gram-negative bacteria to three generations of cephalosporins was surveyed in two large hospitals with widely differing rates of cephalosporin usage. Overall resistance (MIC greater than 5 mg/l) of Enterobacteriaceae to cefotaxime in the hospital using large amounts of cephalosporins was 4% compared with 0.7% in the other. Enterobacter species accounted for most resistant isolates and resistant Enterobacter cloacae replaced sensitive strains in four patients given cefotaxime in 1983. The distribution of species colonizing intensive care areas was similar in both hospitals with cephalosporin-resistant Pseudomonas aeruginosa and Acinetobacter calcoaceticus predominating. PMID- 6501137 TI - The use of injectable antibiotics in two general hospitals. AB - Injectable antibiotic use in Nottingham has shown a change in the past 3 years: the quantity of cefotaxime and cefuroxime prescribed by the end of 1983 was double that of aminoglycosides. The majority (69%) of use of the newer cephalosporins is for prophylaxis. This significant increase in use of cephalosporins has not been accompanied by an increase in bacterial resistance to cefuroxime or cefotaxime. However, these two agents cause the majority of toxin positive antibiotic-associated diarrhoea in Nottingham hospitals. PMID- 6501138 TI - The wobble rule. PMID- 6501139 TI - Specificity and purification of antibodies to adenylic acid. AB - Anti-adenylate antibodies were elicited in rabbits using a conjugate of adenylic acid and bovine serum albumin as immunogen. The specificity of the antibodies was determined by monitoring the inhibition of the binding of [3H]AMP to the antibodies by various nonradioactive nucleic acid components, using a nitrocellulose filter assay. The antibodies were found to be directed against the whole molecule of AMP. They were reactive to polyadenylic acid, RNA, and denatured DNA. The hapten-specific antibodies were isolated by employing an AMP AH-Sepharose affinity column. PMID- 6501140 TI - Rapid modulation of platelet aggregation in plasma by oxygenated sterols. AB - The effect of oxygenated sterols on platelet aggregation induced by thrombin and ADP has been studied. All oxygenated sterols tested with a hydroxyl group on the side chain enhanced thrombin-induced aggregation at 25 microM. In the case of ADP induced aggregation, however, only 22S-hydroxycholesterol[(22S)-5-cholestene-3 beta,22-diol] enhanced the aggregation, and 22R-hydroxycholesterol[(22R)-5 cholestene-3 beta,22-diol], 24S-hydroxycholesterol[(24S)-5-cholestene-3 beta,24 diol], and 25-hydroxycholesterol[5-cholestene-3 beta,25-diol] inhibited it. These effects were observed within 10 min after the addition of oxygenated sterols to platelet suspensions in plasma. PMID- 6501141 TI - Simultaneous determination of thiamine and riboflavin in foods by liquid chromatography. AB - Recent methods for determination of thiamine (thiochrome) and riboflavin by liquid chromatography (LC) are outlined and discussed, and a new method allowing the simultaneous determination of these 2 vitamins by using a single fluorescence detector is described. This system involves an ODS 5 micron ultrasphere column and a pH 7.5 mobile phase composed of 0.005M tetrabutyl ammonium phosphate in methanol-water (20 + 80). PMID- 6501142 TI - Determination of folacin in foods and other biological materials. AB - The objective of most methods for determination of folates in foods and other biological materials is to estimate the total folacin content of the sample. Because folacin comprises a diverse group of related compounds exhibiting similar biological activity, the analytical method must be capable of measuring all of the folates. Methods have been developed for separation of folates in their monoglutamyl form by using anion-exchange, paired-ion reverse phase, or conventional reverse phase liquid chromatography (LC). The application of these separations to determination of folates in foods and other biological materials has been limited largely by the need for development of adequate preparative methods and sufficiently sensitive and specific detection procedures. Although LC with ultraviolet absorption detection has been successful in certain limited applications, the development of fluorometric detection methods has permitted LC determination of folates in a wide range of materials. Tetrahydrofolic acid and its substituted derivatives are detected by monitoring their native fluorescence in an acid mobile phase, while folic acid and certain other folates are measured by using an oxidative post-column fluorogenic derivatization system. Methods also have been developed for determination of the polyglutamyl chain length distribution of folates in biological materials. In total, these procedures permit a direct determination and characterization of folacin compounds. PMID- 6501143 TI - Some effects of replacement of metaphosphoric acid/acetic acid solvent system with trichloroacetic acid in microfluorometric determination of vitamin C. AB - Trichloroacetic acid (TCA) is suggested as a substitute for the metaphosphoric acid/acetic acid (HPO3-HOAc) solvent system in the AOAC microfluorometric determination of vitamin C. Comparative advantages of TCA are easier handling, greater stability, and the approximate 10-fold increase in sensitivity. For both solvent systems, the influence of acid concentration on fluorescence is described. TCA provides maximum fluorescence enhancement at pH 5.5-6.0. PMID- 6501144 TI - Rapid determination of color additives, using the C18 cartridge. AB - A reliable method has been developed for the rapid separation and identification of the 7 permitted FD&C dyes (Red Nos. 3 and 40; Blue Nos. 1 and 2; Yellow Nos. 5 and 6; Green No. 3) and the recently banned FD&C Red No. 2 in foods. The colors are separated by using the C18 cartridge, and their identity is confirmed by spectrophotometry. PMID- 6501145 TI - Quantitative amino acid analysis of feedstuff hydrolysates by reverse phase liquid chromatography and conventional ion-exchange chromatography. AB - Corn, soybean meal, and isolated soybean protein samples were acid-hydrolyzed and analyzed for amino acid content by reverse phase liquid chromatography (LC) and by conventional ion-exchange chromatography (IEC) using an amino acid analyzer. The former method employed pre-column derivatization with orthophthalaldehyde (OPTA)/ethanethiol and fluorescence detection. In the LC procedure, glycine and threonine were not resolved, and proline and cyst(e)ine were not detected. In general, amino acid values obtained by LC and IEC compared closely within and across feedstuffs, and both agreed well with published amino acid composition data. The notable exceptions were aspartic acid, glutamic acid, and alanine. Results of this study suggest that reverse phase LC with pre-column OPTA derivatization can be applied to accurately measure primary amino acids in individual feedstuffs. PMID- 6501146 TI - Forage nitrate analysis: laboratory performance study. AB - Four forage samples were analyzed by 16 laboratories for KNO3 content. Individual reported KNO3 values varied widely for each sample; coefficients of variation for the 4 samples were 36.0, 51.0, 12.8, and 55.0%. Recovery of KNO3 from the spiked sample averaged 105%. The analytical results, as a group, were unacceptable both statistically and for use in feeding recommendations. Three values reported could have resulted in feeding potentially toxic forage to livestock. PMID- 6501147 TI - Liquid chromatographic determination of zoalene in medicated feeds. AB - A rapid, reliable separation and quantitation of zoalene (3,5-dinitro-o toluamide) from feeds is accomplished by using reverse phase liquid chromatography (LC) and ultraviolet detection. An extraction technique which is similar to the present AOAC official colorimetric method is used before chromatographic analysis. This extraction is followed by an activated alumina cleanup and LC to separate zoalene from feed matrix. The methodology was applied to a variety of spiked feed matrices, and yielded good recoveries. Liquid chromatographic results were shown to correlate with colorimetric determinations. PMID- 6501148 TI - Modified flotation technique for quantitative determination of mite populations in feedstuffs. AB - Modifications are described to a previously published technique for quantitative determination of mite populations in animal feedingstuffs. In the modified method, the oil phase is kerosene instead of a mixture of kerosene and tetralin (1 + 1), and aqueous industrial methylated spirit is substituted for aqueous ethanol in the aqueous phase. Emulsion formation at the interface is considerably reduced by incorporating a pre-extraction stage. Examination of mites on the filter paper is made easier and quicker by staining them with Phloxin B. Trials carried out with known numbers of mites in samples of dairy feed concentrates indicate mean recoveries of 84-96% throughout the range tested. The results show that the accuracy of the technique is not affected by the level of infestation. PMID- 6501149 TI - Simple, rapid method for determination of total extractable fat in canned pet foods. AB - The rapid column method described, unlike AOAC method 7.056, determines both neutral ("crude") and total fat in canned pet foods, and uses nonflammable solvent mixtures and simple laboratory equipment. Neutral fat values are obtained by eluting the column with dichloromethane, whereas total fat values are determined by using dichloromethane-methanol (9 + 1). For 7 samples analyzed in triplicate, fat ranged from 2.9 to 10.8%. Neutral fat values by the dry column method were significantly lower (P less than 0.05) than were those by 7.056 (6.29 vs 6.49), although these differences were practically unimportant. Total fat determinations by the dry column method and by 7.056 yielded overall means of 7.40 and 6.49%, respectively. The 0.91% mean difference is significant (P less than 0.01) and represents a more complete extraction of polar lipids by the proposed method. PMID- 6501151 TI - Gas chromatographic determination of residues of bromopropylate and two of its degradation products in honey. AB - An analytical procedure is described for determination of residues of bromopropylate (BP) and its main degradation product 4,4'-dibromobenzophenone (BBP) in honey. The method also allows the determination of 4,4'-dibromobenzilic acid (BBA), a potential intermediate to BBP. The method involves dissolution of the honey in water and separation of BP and BBP from BBA on a partition column. BP and BBP are further cleaned up and separated on a silica gel column and determined by gas chromatography (GC) with electron capture (EC) detection. BBA is oxidized with potassium dichromate to BBP, which is partitioned into dichloromethane and further cleaned up on a silica gel column before determination by GC with EC detection. The method is sensitive to 0.02 mg BP or BBP/kg and 0.023 mg BBA/kg honey. PMID- 6501150 TI - Extraction of organic acids by ion-pair formation with tri-n-octylamine. Part V. Simultaneous determination of synthetic dyes, benzoic acid, sorbic acid, and saccharin in soft drinks and lemonade syrups. AB - Synthetic dyes, benzoic acid, sorbic acid, and saccharin are extracted simultaneously from soft drinks with 0.01M tri-n-octylamine at pH = 5.5 and are back-extracted to an aqueous phase with 0.1M sodium perchlorate. The perchlorate solution is injected directly into the reverse phase liquid chromatographic system which permits the separation of all the substances investigated. Forty-six commercial samples of soft drinks and 11 lemonade syrups were analyzed. All samples conformed to the legal prescriptions. PMID- 6501152 TI - Recent advances in cleanup of fats by sweep co-distillation. Part 2. Organophosphorus residues. AB - This paper describes the isolation of 5 organophosphorus residues in beef fat by a commercial sweep co-distillation unit (Unitrex). The operating conditions specified 223 degrees C and nitrogen flow at 230 mL/min. Recoveries of chlorpyriphos, monodechlorchlorpyriphos, bromophos-ethyl, debromobromophos-ethyl, and ethion ranged from 84 to 99%, with coefficients of variation between 3 and 5%. PMID- 6501153 TI - Gas chromatographic and mass spectrometric determination of ametryn and its N dealkylated products. AB - Gas chromatographic and mass spectrometric properties of ametryn and its N dealkylated products were studied to establish the potential use in a recently reported method describing the residue analyses of these compounds by gas chromatography with N-P detection. Electron impact mass spectra show base peaks at the molecular ion (M+), and methane chemical ionization mass spectra give base peaks at (M + 1) ion for all the compounds studied. Characteristic mass spectral fragmentations of ametryn, GS-11354, GS-11355, and GS-26831 are presented. Combined gas chromatography-mass spectrometry rather than gas chromatography alone provides unambiguous residue characterization. The technique also allows quantitation of ametryn and its N-dealkylated products that cochromatograph with interfering materials present in a complex substrate. PMID- 6501154 TI - Determination of captan, folpet, and captafol in fruits and vegetables, using two multiresidue methods. AB - Two multiresidue methods, the Mills method and the Luke et al. method, are widely used for the determination of pesticides in foods. These methods were evaluated for the determination of the fungicides captan, folpet, and captafol in selected fruits and vegetables. The analytical behavior of standards through these methods was investigated first. Recoveries from apples, strawberries, lettuce, and tomatoes fortified with these compounds at levels of 0.2-5.9 ppm were then obtained. The analytes were quantitated by gas chromatography with electron capture detection, using a column of 5% SP-2401 on 100-120 mesh Supelcoport. Recoveries of captan, folpet, and captafol from fortified crops ranged from 69 to 78, 90 to 93, and 67 to 83%, respectively, by the Mills procedure and from 87 to 102, 81 to 106, and 91 to 109%, respectively, by the Luke et al. method modified to include additional solvent elution of the optional Florisil column. PMID- 6501155 TI - Liquid chromatographic determination of phenol and cresols in total particulate matter of cigarette smoke. AB - The phenol and cresol contents of the total particulate matter of tobacco smoke can be conveniently determined. A simple extraction procedure using 1N base is followed by partial neutralization with glacial acetic acid and elution of hydroxybenzenes from an end-capped reverse phase liquid chromatographic column. The procedure is rapid (20 min/sample after the initial extraction), precise (+/- 10% relative standard deviation), accurate, and convenient. Normally, 12 or fewer cigarettes are needed for a single measurement. PMID- 6501156 TI - Separation and analysis of pilocarpine, isopilocarpine, and pilocarpic acid by reverse phase liquid chromatography: collaborative study. AB - A method for separating and determining pilocarpine and 2 degradation products was developed and subjected to collaborative study. Pilocarpine, isopilocarpine, and pilocarpic acid were isolated on a reverse phase liquid chromatographic phenyl bonded column and detected by UV spectrophotometry at 220 nm. Nine collaborators received commercial samples labeled to contain 2, 1, and 0.5% pilocarpine and a 2% practice sample. The collaborative results for pilocarpine were excellent; coefficients of variation ranged from 3.20 to 4.10%. The method was adopted official first action for determination of the active component, pilocarpine, in the presence of isopilocarpine and pilocarpic acid. Although quantitative results for the degradation products were not as good, the method is suitable as a limits test for these substances. PMID- 6501157 TI - X-ray powder diffraction data for selected drugs: furosemide, hydrochlorothiazide, naproxen, naproxen sodium, propranolol hydrochloride, and the halopheniramine maleates. AB - X-ray powder diffraction data for 9 commonly used drug substances are reported. The data for furosemide, hydrochlorothiazide, propranolol hydrochloride, dexchlorpheniramine maleate, and brompheniramine maleate have been indexed by reference to published crystal structure data. The racemic modifications of propranolol hydrochloride and brompheniramine maleate are shown to exist as racemic compounds rather than racemic mixtures. PMID- 6501158 TI - Identification of a propantheline analog in propantheline bromide tablets. AB - A major impurity in a sample of propantheline bromide tablets has been identified as 9-hydroxypropantheline on the basis of the proton magnetic resonance (PMR) and mass spectra (MS). This identification was confirmed by methanolysis of the tablet extract, which yielded a mixture of methyl xanthanoate and methyl 9 hydroxyxanthanoate. A liquid chromatographic (LC) procedure is described which will permit quantitation of 9-hydroxypropantheline bromide in the presence of propantheline bromide, xanthone, and xanthanoic acid. PMID- 6501159 TI - Difference spectrophotometric estimation of santonin. AB - Santonin gives a characteristic alkaline vs acidic difference spectrum. This was used for its estimation in pharmaceuticals and in the crude drug. Santonin was first extracted and purified through a specific partition procedure; then the difference absorbance was measured either at the maximum, 285 nm, or the minimum, 242 nm. The percentage of santonin can be calculated either by reference to the difference absorbance of a reference santonin sample, treated similarly, or by making use of the determined absorptivity. Measurement at the maximum is advisable, especially when the crude drug is assayed, because natural contaminants may interfere with the difference absorbance at the minimum. PMID- 6501160 TI - Comparison of helium leak test and vacuum leak test using canned foods: collaborative study. AB - Two can leak tests were compared by 7 collaborators. In the helium leak test, pressurized helium is applied to the outside of the container, and a headspace gas sample from the can is then analyzed for the presence of helium. The vacuum test is described in the Bacteriological Analytical Manual. Ninety No. 303 cans of creamed-style corn, green beans, carrots, fruit cocktail, and whole-kernel corn were shipped in 3 groups. Two groups of 30 cans had 10 dented flat cans, 5 flat controls (nondented), 10 dented swollen cans, and 5 swollen control cans (nondented). The third group had 10 dented swollen cans and 5 swollen control cans. Of 600 cans analyzed, 37 (6.2%) were deleted from the analysis because results were not available for both tests. One laboratory was constrained by scheduling to analyze 15 of 45 swollen cans. The helium leak test found 12 (13%) positives of 92 nondented swollen cans. One pressurization test yielded 7 of those 12 positives. Of the 400 dented cans sent as possible leakers, the helium test found 267 positives, and the vacuum test found 181. Five of the 7 analysts had significantly (alpha = 0.05) higher percent positive helium results. One analyst found more leakers by the vacuum leak test. Both tests found fewer positives in the swollen dented cans than in the flat dented cans. After exposure to pressurized helium, all cans with greater than 8 psi headspace pressure were positive helium leakers. The method was adopted official first action. PMID- 6501161 TI - Gas chromatographic determination of clopidol in chicken tissues. AB - A method has been developed for the determination of clopidol residues in chicken tissues. After extraction and cleanup, clopidol is esterified in a 2-phase system to clopidol propionate, which is determined by gas chromatography. The 2-phase system includes, in addition to the clopidol dissolved in methanol, aqueous borax solution, hexane, propionic anhydride, and pyridine. Use of these reagents precludes the use of explosive or carcinogenic chemicals in the derivatization step, and the method is therefore suitable for routine laboratory analysis. Levels of 0.5 ppb clopidol in tissue can be determined. PMID- 6501162 TI - Liquid chromatographic determination of carbadox, desoxycarbadox, and nitrofurazones in pork tissues. AB - A liquid chromatographic (LC) method has been developed for the determination of carbadox, desoxycarbadox, and nitrofurazones in the 10-40 ppb range in pork muscle, liver, and kidney tissues. Tissues were homogenized in absolute ethanol, and the homogenates were treated with metaphosphoric acid and reduced in volume by rotovaporization. Hexane was added to the concentrates, which were then centrifuged to remove fat. After addition of KH2PO4 to the aqueous phase and extraction with ethyl acetate, the extracts were passed through alumina columns before analysis by reverse phase LC. Overall average recoveries (10-40 ppb range) for carbadox and desoxycarbadox from spiked tissues were 53% +/- 13.6 and 61% +/- 7.2, respectively; overall average recoveries for nitrofurazone and furazolidone were 43% +/- 7.3 and 77% +/- 10.9, respectively. Before these optimum determinations, degradation by even minimal incandescent light was found to reduce recovery especially of desoxycarbadox. The results of this photochemical degradation are reported and briefly discussed. PMID- 6501163 TI - Inter- and intra-laboratory variability in rat growth assays for estimating protein quality of foods. AB - Protein efficiency ratio (PER), relative PER (RPER), net protein ratio (NPR), relative NPR (RNPR), and nitrogen utilization (NU) methods were investigated in an interlaboratory rat growth study. Six collaborating laboratories studied 7 protein sources (ANRC casein; minced beef; soya assay protein, SAP; pea flour; whole wheat flour, WW; rapeseed protein concentrate, RPC; and egg white solids, EW), and their 10 supplementary or complementary mixtures (casein + Met, SAP + Met, pea flour + Met, WW + Lys, WW + casein, WW + beef, WW + SAP, WW + pea flour, WW + RPC, WW + EW). Test protein(s) were added at the 8% level (N X 6.25). Casein + Met was used as the reference protein. Interlaboratory variation (estimated as between-laboratories coefficients of variation) of PER (up to 17.2%) was greater than that of RPER (up to 14.9%), NU (up to 9.5%), NPR (up to 7.0%), and RNPR, which had the lowest variability (up to 4.7%). In most cases, intralaboratory variation (estimated as within-laboratories coefficients of variation) for all the methods was less than 5%. PMID- 6501164 TI - Quantitative gas chromatographic headspace determination of choline in adult and infant formula products. AB - A gas chromatographic headspace method has been developed for the determination of choline in liquid and powder formula products. Choline undergoes the Hofmann elimination reaction during a 24 h, 120 degrees C alkaline digestion. Volatile trimethylamine (TMA) is produced and equilibrates between the liquid and vapor phase (headspace). A 50 microL headspace sample is chromatographed on a 28% Pennwalt 223-4% KOH column, with flame ionization detection. Choline is indirectly quantitated by comparing sample TMA peaks with peaks for a reference standard. Ethyl ether is used as an internal standard. Compared with previous methods, this procedure offers improved precision (7.7-9.6% relative standard deviation (RSD], accuracy, and specificity of both free and bound forms of choline. Estimated analysis rate using manual injection is 160 samples/week, requiring 35 work-hours. Automation of this procedure, using a commercially available headspace analyzer, resulted in a further improvement in precision (1.60-6.91% RSD) and a throughput of 400 samples/week. PMID- 6501165 TI - Inductively coupled plasma emission spectroscopic determination of nine elements in infant formula: collaborative study. AB - Results from a collaborative study of a method for the determination of 9 elements in infant formula, using inductively coupled plasma emission spectroscopy, are reported. Six collaborators analyzed 6 infant formulas for native and spiked levels of Ca, Cu, Fe, Mg, Mn, P, K, Na, and Zn. The within laboratory and between-laboratory coefficients of variation were generally (69 of 108 samples) below 9% for all elements determined in all samples. Most of the average recoveries of the elements from spiked samples ranged from 90 to 105%. The method has been adopted official first action for determining Ca, Cu, Fe, Mg, Mn, P, K, Na, and Zn in infant formula. PMID- 6501166 TI - Determination of pantothenic acid, biotin, and vitamin B12 in nutritional products. AB - Until recently, liquid chromatographic (LC) methodology for pantothenic acid, biotin, and B12 (cyanocobalamin) has been only marginally successful. These vitamins are difficult to determine by conventional LC techniques and UV detection at 254 or 280 nm, because either the chromophore is inadequate for detection or interference from co-eluting vitamins is overwhelming. Biotin and B12 are usually present in pharmaceutical products at concentrations 100-1000 times lower than other commonly occurring water-soluble vitamins. Co-extraction of all water-soluble vitamins results in gross interferences, especially in LC when the interfering vitamins co-elute with biotin or B12. In addition, pantothenic acid and biotin are colorless in solution and do not exhibit strong UV absorption above 240 nm. As a result, they must be quantitated either by using a low UV wavelength for detection or by derivatizing the vitamin to obtain an adequate chromophore. A description of procedures for LC determination of pantothenic acid, panthenol, cyanocobalamin, and biotin in pharmaceutical products is presented. Pantothenic acid has been measured by using both a derivatization technique and low UV wavelength detection. Biotin has been quantitated by using low UV wavelength detection. The limitations of these techniques are also discussed. Chromatographic separation of cyanocobalamin is complicated by co-eluting vitamins such as riboflavin. It is detected by using the 546 nm wavelength where riboflavin does not interfere. PMID- 6501167 TI - Liquid chromatographic determination of vitamin B-6 in foods. AB - Chromatographic analysis for vitamin B-6 in complex samples imposes certain requirements on the analyst, who must extract completely the bound, unstable vitamers without loss, remove interfering compounds, and provide clean extracts for analysis. The analyst also has to contend with the problems inherent in all methods, such as sample collection, storage, preparation, and homogenization. However, chromatography provides a means of identifying and quantitating all forms of the vitamin, and thus provides the possibility of addressing the problem of the bioavailability of specific vitamers. It also allows automation, which is absolutely essential in coping with the large numbers of samples that are generated in areas such as quality control. These factors are all addressed here, and chromatographic results for various meat and other food products are presented to illustrate the variations in vitamin content that occur from sample to sample, the agreement with microbiological results, and that liquid chromatography (LC) has come of age in dealing with complex biological samples, such as food and food products. PMID- 6501168 TI - Effect of subject effort on pulmonary function measures: a preliminary investigation. PMID- 6501169 TI - Serum theophylline levels in young children receiving a sustained-release theophylline tablet. AB - This study indicates that a sustained-release tablet may be used in certain young children on an every-12-hr dosing schedule with acceptable serum theophylline fluctuation. Many young children are able to swallow the tablet and dosing increments are convenient. PMID- 6501170 TI - Pulmonary function testing: use of the peak expiratory flow rate in an out patient or office setting. AB - Thus, the weekly use of peak expiratory flow rate measurements in an out-patient office setting, for the purpose of generating multiple, serial, repetitive measurements to serve as a data base for a particular patient, will from time to time provide useful information helpful in the decision-making process pertaining to therapy. The peak expiratory flow rate maneuver is said to produce information referable primarily to the larger airways (although to a certain extent a patient restricted by inability to take a deep breath may also produce a decreased peak expiratory flow rate measurement), and it is certainly true that other measurements such as complete spirometry, FEV1, FEV25-75, or FEF75-90, or various gas exchange procedures will often produce information more accurately and precisely pertaining to the pulmonary status of an individual patient at any given point in time. However, the relative lack of expense and the ease and convenience of use of the peak expiratory flow rate meters currently available render this particular maneuver quite useful in following patients in an outpatient setting. This usefulness derives both from the patient's familiarity with the maneuver and therefore its ready availability for use during an acute process, as well as from the multiplicity of data serially derived forming a data base against which to compare the patient with himself at any given point in time, with the result that, under acute circumstances, when more frequent pulmonary function testing measurements are necessary, the patient's response to bronchodilator treatment can be assessed not only with respect to the severity of the ongoing acute process but also in terms of his performance when well. PMID- 6501171 TI - Realistic expectations: a look at childhood asthma in the 1980s. PMID- 6501172 TI - Receptors and deceptors in asthma. PMID- 6501173 TI - Bleeding following snake-bite. PMID- 6501174 TI - Primary pathological fibrinolysis in saw-scaled (Echis carinatus) viper bites. PMID- 6501175 TI - Chemotaxis as a viable tool to delineate immunodeficiency. PMID- 6501176 TI - Non-organic dyspepsia: a controlled clinico-psychiatric study. PMID- 6501177 TI - Blood urea in myocardial infarction. PMID- 6501178 TI - Hepatic involvement in tropical pulmonary eosinophilia. PMID- 6501179 TI - Status of zinc in pulmonary tuberculosis. PMID- 6501180 TI - Acute idiopathic ophthalmoplegias (a prospective study of eighty cases). PMID- 6501181 TI - Thrombolytic therapy in acute myocardial infarction. PMID- 6501182 TI - Chronic persistent diarrhoea. PMID- 6501183 TI - Accidental poisoning by Canavalia virosa. PMID- 6501184 TI - Actinomycosis. PMID- 6501185 TI - CT scan detection on focal haemorrhage in subthalamic nucleus in hemiballismus. PMID- 6501186 TI - Prolonged 'in situ' stage in oesophageal carcinoma. PMID- 6501187 TI - Congenital adrenal hyperplasia with hypoglycaemia. PMID- 6501188 TI - Acute cerebellar ataxia with opsoclonus. PMID- 6501189 TI - Loperamide versus copamide. PMID- 6501190 TI - Hepatitis surface antigen in hepatic disorders with reference to its subtypes. PMID- 6501191 TI - Single dose bedtime phenobarbitone therapy in epilepsy. PMID- 6501192 TI - Connective tissue diseases versus overlap syndrome. PMID- 6501193 TI - Spectrum of acute poisoning in adults (10 year experience). PMID- 6501194 TI - Studies on noncoronary cardiac complications of diabetes mellitus. PMID- 6501196 TI - Metabolic effects of salbutamol in bronchial asthma. PMID- 6501195 TI - Electrocardiographic changes in acute severe asthma. PMID- 6501197 TI - Serum mucoproteins in amoebic liver abscess. PMID- 6501199 TI - Plasma exchange. PMID- 6501200 TI - Empyema. PMID- 6501198 TI - Leucine aminopeptidase in gastrointestinal cancers. PMID- 6501201 TI - Pancytopenia and D.I.C. in disseminated tuberculosis. PMID- 6501202 TI - Tricuspid valve endocarditis. PMID- 6501203 TI - Electrocardiographic changes in Vibrio parahaemolyticus infection. PMID- 6501204 TI - Primary haemangiopericytoma of lung. PMID- 6501205 TI - Ventricular fibrillation and cardiac arrest due to neem leaf poisoning. PMID- 6501206 TI - Unusual reaction to B.C.G. PMID- 6501207 TI - Marrow toxicity of dipyrone. PMID- 6501208 TI - [Radiotherapy of epitheliomas of the cervical stump. Apropos of 110 cases treated between 1956 and 1975]. PMID- 6501209 TI - Survey of the published RBE values of the californium-252 emission: influence of dose rate. PMID- 6501210 TI - Tumourectomy and telecobalt radiation as the treatment of "small" carcinomas of the breast. Experience with 101 patients. PMID- 6501211 TI - Primary epidermoid epithelioma of the upper mediastinum. PMID- 6501212 TI - Bacteriophage-induced acidic heteropolysaccharide lyases that convert the acidic heteropolysaccharides of Rhizobium trifolii into oligosaccharide units. AB - Acidic heteropolysaccharide lyases from lysates of phages 4S and BY15 grown on Rhizobium trifolii 4S and R. trifolii 0403, respectively, were used to analyze the capsular and excreted extracellular acidic polysaccharides of R. trifolii 0403. The activities of the enzymes as measured by viscometry were enhanced by the addition of calcium. The oligosaccharide products obtained by depolymerase digestion of the polysaccharides isolated from cells grown on agar plates for 5 days were isolated by gel filtration and had a glycosyl composition of glucose, galactose, glucuronic acid, and alpha-linked 4-deoxy-L-threo-hex-4 enopyranosyluronic acid in an approximate molar ratio of 5:1:1:1. This latter component was identified by 1H-nuclear magnetic resonance spectroscopy and confirmed by UV spectroscopy, ozonolysis, and its reactivity with thiobarbituric acid. The oligosaccharide had glucose as the reducing terminus, 4-deoxy-L-threo hex-4-enopyranosyluronic acid as the enzymatically generated nonreducing terminus, and galactose as the terminus of the branched chain. The noncarbohydrate components of the oligosaccharides were acetate, ketal-linked pyruvate, and ether-linked 3-hydroxybutyrate. The mode of action of the enzymes was by beta-elimination from a uronic acid residue with concomitant loss of the glycosyl component substituted at C-4. The 235-nm absorbing properties of the resulting terminal unsaturated sugar were used to study the kinetics of depolymerization of the capsular and excreted extracellular acidic polysaccharides, using the enzyme from phage BY15. The two substrates exhibited different kinetics of depolymerization, and the oligosaccharide products differed in the amount of noncarbohydrate substituents, indicating that the acidic capsular and excreted extracellular polysaccharides from 5-day-old cultures of R. trifolii 0403 were different. PMID- 6501213 TI - Stimulation of clover root hair infection by lectin-binding oligosaccharides from the capsular and extracellular polysaccharides of Rhizobium trifolii. AB - A polysaccharide depolymerase isolated from the phage lysate of Rhizobium trifolii 4S was used to fragment capsular polysaccharides (CPS) and extracellular polysaccharides (EPS) of R. trifolii 0403 into oligosaccharides. These products were analyzed for clover lectin (trifoliin A)-binding ability, effect on infection of white clover root hairs, and changes in glycosyl and noncarbohydrate composition with culture age. The oligosaccharides from CPS of cultures grown on agar plates for 3, 5, and 7 days exhibited lectin-binding ability at levels similar to those of the corresponding intact CPS. The intact EPS did not bind to clover lectin, although the oligosaccharide fragments from EPS did. In contrast, oligosaccharides from deacetylated CPS had less than half the lectin-binding ability of the native polysaccharide substrate. The CPS from 5-day-old cultures, its corresponding oligosaccharide fragments, and the oligosaccharide fragments of EPS from 5-day-old cultures, all at a concentration of 2.5 micrograms per seedling, stimulated infection thread formation in root hairs of clover seedlings inoculated with R. trifolii 0403. Thus, this bacteriophage-induced polysaccharide depolymerase converted the acidic CPS and EPS of R. trifolii 0403 into biologically active oligosaccharides capable of binding trifoliin A and stimulating root hair infection. The amount of the noncarbohydrate substitutions (pyruvate, acetate, and ether-linked 3-hydroxybutyrate) in the CPS oligosaccharides changed with culture age as shown by 1H-nuclear magnetic resonance spectroscopy. The binding of trifoliin A, therefore, appears to be sensitive to changes in the degree of substitution of noncarbohydrate substitutions in the CPS of R. trifolii 0403. PMID- 6501214 TI - Carbon monoxide-dependent methyl coenzyme M methylreductase in acetotrophic Methosarcina spp. AB - Cell extracts of acetate-grown Methanosarcina strain TM-1 and Methanosarcina acetivorans both contained CH3-S-CoM methylreductase activity. The methylreductase activity was supported by CO and H2 but not by formate as electron donors. The CO-dependent activity was equivalent to the H2-dependent activity in strain TM-1 and was fivefold higher than the H2-dependent activity of M. acetivorans. When strain TM-1 was cultured on methanol, the CO-dependent activity was reduced to 5% of the activity in acetate-grown cells. Methanobacterium formicicum grown on H2-CO2 contained no CO-dependent methylreductase activity. The CO-dependent methylreductase of strain TM-1 had a pH optimum of 5.5 and a temperature optimum of 60 degrees C. The activity was stimulated by the addition of MgCl2 and ATP. Both acetate-grown strain TM-1 and acetate-grown M. acetivorans contained CO dehydrogenase activities of 9.1 and 3.8 U/mg, respectively, when assayed with methyl viologen. The CO dehydrogenase of acetate-grown cells rapidly reduced FMN and FAD, but coenzyme F420 and NADP+ were poor electron acceptors. No formate dehydrogenase was detected in either organism when grown on acetate. The results suggest that a CO-dependent CH3-S-CoM methylreductase system is involved in the pathway of the conversion of acetate to methane and that free formate is not an intermediate in the pathway. PMID- 6501215 TI - Purification and properties of glutamate synthase from Bacillus licheniformis. AB - Glutamate synthase [L-glutamate:NADP+ oxidoreductase (transaminating); EC 1.4.1.13](GltS) was purified to homogeneity from Bacillus licheniformis A5. The native enzyme had a molecular weight of approximately 220,000 and was composed of two nonidentical subunits (molecular weights, approximately 158,000 and approximately 54,000). The enzyme was found to contain 8.1 +/- 1 iron atoms and 8.1 +/- 1 acid-labile sulfur atoms per 220,000-dalton dimer. Two flavin moieties were found per 220,000-dalton dimer, with a ratio of flavin adenine dinucleotide to flavin mononucleotide of 1.2. The UV-visible spectrum of the enzyme exhibited maxima at 263,380 and 450 nm. The GltS from B. licheniformis had a requirement for NADPH, alpha-ketoglutarate, and glutamine. Classical hyperbolic kinetics were seen for NADPH affinity, which resulted in an apparent Km value of 13 microM. Nonhyperbolic kinetics were obtained for alpha-ketoglutarate and glutamine affinities, and the reciprocal plots obtained for these substrates were biphasic. The apparent Km values obtained for glutamine were 8 and 100 microM, and the apparent Km values obtained for alpha-ketoglutarate were 6 and 50 microM. GltS activity was found to be relatively insensitive to inhibition by amino acids, keto acids, or various nucleotides. L-Methionine-DL-sulfoximine, L-methionine sulfone, and DL-methionine sulfoxide were found to be potent inhibitors of GltS activity, yielding I0.5 values of 150, 11, and 250 microM, respectively. GltSs were purified from cells grown in the presence of ammonia and nitrate as sole nitrogen sources and were compared. Both yielded identical final specific activities and identical physical (UV-visible spectra, flavin, and iron-sulfur composition) and kinetic characteristics. PMID- 6501216 TI - Oxidation and dehalogenation of 4-chlorophenylacetate by a two-component enzyme system from Pseudomonas sp. strain CBS3. AB - In cell-free extracts from Pseudomonas sp. strain CBS3 the conversion of 4 chlorophenylacetate to 3,4-dihydroxyphenylacetate was demonstrated. By Sephacryl S-200 chromatography two protein fractions, A and B, were obtained which both were essential for enzyme activity. Fe2+ and NADH were cofactors of the reaction. NADPH also activated the enzyme, but less effectively than NADH. FAD had no influence on enzyme activity. 4-Hydroxyphenylacetate, 4-chloro-3 hydroxyphenylacetate, and 3-chloro-4-hydroxyphenylacetate were poor substrates for the enzyme, suggesting that these substances are not intermediates of the reaction. We therefore suggest that the reaction proceeds via a dioxygenated intermediate. PMID- 6501217 TI - Aromatic acids are chemoattractants for Pseudomonas putida. AB - A quantitative capillary assay was used to show that aromatic acids, compounds that are chemorepellents for Escherichia coli and Salmonella sp., are chemoattractants for Pseudomonas putida PRS2000. The most effective attractants were benzoate; p-hydroxybenzoate; the methylbenzoates; m-, p-, and o-toluate; salicylate; DL-mandelate; beta-phenylpyruvate; and benzoylformate. The chemotactic responses to these compounds were inducible. Taxis to benzoate and m toluate was induced by beta-ketoadipate, a metabolic intermediate formed when benzoate is dissimilated via enzymes specified by chromosomal genes. Benzoylformate taxis was induced by benzoylformate and L(+)-mandelate. Taxis to mandelate, benzoylformate, and beta-phenylpyruvate was exhibited by cells grown on mandelate, but not by cells grown on benzoate. Cells grown on benzoate were chemotactic to benzoate, the toluates, p-hydroxybenzoate, and salicylate. These results show that P. putida synthesizes at least two distinct chemoreceptors for aromatic acids. Although DL-mandelate was an effective attractant in capillary assays, additional experiments indicated that the cells were actually responding to benzoylformate, a metabolite formed from mandelate. With the exception of mandelate taxis, chemotaxis to aromatic acids was not dependent on the expression of pathways for aromatic degradation. Therefore, the tactic responses exhibited by cells cannot be attributed to an effect of the oxidation of aromatic acids on the energy metabolism of cells. PMID- 6501218 TI - [14C]methylammonium transport by Frankia sp. strain CpI1. AB - We describe an NH4+-specific transport system in the N2-fixing symbiotic actinomycete Frankia sp. strain CpI1. [14C]methylammonium was used as an NH4+ analog. No specific transport process was detected when cells were grown on high concentrations of NH4+. A transport system with a high affinity for CH3NH3+ was synthesized after 3 to 4 h of nitrogen starvation. Methylammonium transport was not significantly inhibited by a variety of amino acids, primary amines, and polyamines. Ammonium completely eliminated CH3NH3+ transport. The Km for CH3NH3+ transport was around 2 +/- 1.8 microM with a Vmax of 4 to 5 nmol/min per mg of protein. The electron transport inhibitors cyanide and azide eliminated uptake, as did the uncoupler carbonyl cyanide-m-chlorophenylhydrazone. The sulfydryl reagent p-chloromercuribenzoic acid and the heavy metal thallium also inhibited uptake, suggesting the presence of an NH4+-specific permease. Concentration of CH3NH3+ across the membrane was demonstrated by conducting uptakes at low temperature to slow the metabolism of CH3NH3+ by glutamine synthetase. At 7 degrees C most of the label was concentrated inside the cells in a form that could be chased from the cells by adding excess NH4+ to the medium. At 30 degrees C most of the label was present as an impermeant metabolite. Thin-layer chromatography of cell extracts confirmed that the radioactivity inside the cells was mainly in the form of CH3NH3+ at 7 degrees C but was present as an unidentified metabolite at 30 degrees C. These studies demonstrate that Frankia sp. strain CpI1 has a high-affinity NH4+ transport system that is synthesized in response to NH4+ starvation. PMID- 6501219 TI - Anthranilate hydroxylase from Aspergillus niger: new type of NADPH-linked nonheme iron monooxygenase. AB - Anthranilate hydroxylase from Aspergillus niger catalyzes the oxidative deamination and dihydroxylation of anthranilic acid to 2,3-dihydroxybenzoic acid. This enzyme has been purified to homogeneity and has a molecular weight of 89,000. The enzyme is composed of two subunits of 42,000 with 2 gram-atoms of nonheme iron per mol. Fe2+-chelators like alpha,alpha'-dipyridyl and o phenanthroline are potent inhibitors of the enzyme activity. Absorption and fluorescence spectra of the enzyme offer no evidence for the presence of other cofactors like flavin. Flavins and flavin-specific inhibitors like atebrin have no effect on the activity of the enzyme. The enzyme incorporates one atom of oxygen each from 18O2 and H218O into the product 2,3-dihydroxybenzoic acid. Based on these studies, it is concluded that anthranilate hydroxylase from A. niger is a new type of NADPH-linked nonheme iron monooxygenase. PMID- 6501221 TI - Effect of culture pH on the D-alanine ester content of lipoteichoic acid in Staphylococcus aureus. AB - The lipoteichoic acid in Staphylococcus aureus growing at high pH values contained very little alanine ester, showing that high overall levels of substitution were not essential for growth. The low alanine content could have resulted from a progressive loss due to base-catalyzed hydrolysis of the labile ester linkages. PMID- 6501222 TI - TOL plasmid can prevent induction of chemotactic responses to aromatic acids. AB - Growth conditions that elicited positive chemotaxis to benzoate and m-toluate in TOL- Pseudomonas putida cells failed to elicit taxis to these compounds in TOL+ cells. The inability of TOL+ cells to respond to these aromatic acids appears to be due to the preferential expression of TOL-encoded genes for aromatic degradation over chromosomally encoded genes. Expression of chromosomal genes for aromatic degradation is required for cells to form beta-ketoadipate, the inducer of benzoate and m-toluate taxis. PMID- 6501220 TI - Isolation of a novel protein involved in the transport of fructose by an inducible phosphoenolpyruvate fructose phosphotransferase system in Streptococcus mutans. AB - Fructose transport in Streptococcus mutans LG-1 is mediated by at least two distinct phosphoenolpyruvate fructose phosphotransferase systems. One system is constitutive and consists of membrane components enzyme II as well as enzyme I and heat-stable protein. The other system is inducible and requires, in addition to enzyme I and heat-stable protein, a soluble substrate-specific protein for catalytic activity. This protein factor, designated IIIfru, was purified by DEAE cellulose chromatography, hydroxylapatite chromatography, molecular sieving on Sephadex G-75, and preparative electrophoresis. The purified preparation showed only one protein band, with a molecular weight of 12,600, on sodium dodecyl sulfate-urea-polyacrylamide gel electrophoresis, on gel electrophoresis with the discontinuous buffer Tris-glycine, and after electrofocusing in gel (pI congruent to 3.7). The molecular weight of the native protein determined by gel filtration at 4 degrees C was 51,000. Immunodiffusion experiments performed with immunoglobulins prepared against the purified IIIfru from S. mutans LG-1 suggested that other S. mutans strains possessed a IIIfru. No precipitin bands, however, were detected with extracts from S. salivarius, S. sanguis, S. lactis, S. faecalis, Staphylococcus aureus, Bacillus subtilis, Lactobacillus casei, and Escherichia coli. PMID- 6501223 TI - Isolation and characterization of Pseudomonas putida PpF1 mutants defective in the toluene dioxygenase enzyme system. AB - Pseudomonas putida PpF1 degraded toluene via a dihydrodiol pathway to tricarboxylic acid cycle intermediates. The initial reaction was catalyzed by a multicomponent enzyme, toluene dioxygenase, which oxidized toluene to (+)-cis 1(S),2(R)-dihydroxy-3-methylcyclohexa-3,5-diene (cis-toluene dihydrodiol). The enzyme consisted of three protein components: NADH-ferredoxintol oxidoreductase (reductasetol), ferredoxintol, and a terminal oxygenase which is an iron-sulfur protein (ISPtol). Mutants blocked in each of these components were isolated after mutagenesis with nitrosoguanidine. Mutants occurred as colony morphology variants when grown in the presence of toluene on indicator plates containing agar, mineral salts, a growth-supporting nutrient (arginine), 2,3,5 triphenyltetrazolium chloride (TTC), and Nitro Blue Tetrazolium (NBT). Under these conditions, wild-type colonies appeared large and red as a result of TTC reduction. Colonies of reductasetol mutants were white or white with a light blue center, ferredoxintol strains were light blue with a dark blue center, and strains that lacked ISPtol gave dark blue colonies. Blue color differences in the mutant colonies were due to variations in the extent of NBT reduction. Strains lacking all three components appeared white. Toluene dioxygenase mutants were characterized by assaying toluene dioxygenase activity in crude cell extracts which were complemented with purified preparations of each protein component. Between 40 and 60% of the putative mutants selected from the NBT-TTC indicator plates were unable to grow with toluene as the sole source of carbon and energy. This method should prove extremely useful in isolating mutants in other multicomponent oxygenase enzyme systems. PMID- 6501224 TI - Glucose-6-phosphate dehydrogenase deficiency in pleiotropic carbohydrate-negative mutant strains of Rhizobium meliloti. AB - Several mutant strains of Rhizobium meliloti isolated after nitrosoguanidine mutagenesis were selected as unable to grow on mannose. Some of them also failed to grow on glucose, fructose, ribose, and xylose but grew on L-arabinose, galactose, and many other carbon sources. Biochemical analysis demonstrated that the mutants lacked NAD- and NADP-linked glucose-6-phosphate dehydrogenase activities that reside on a single enzyme species. One such mutant was found to accumulate glucose-6-phosphate, and this could partially explain the inhibition of growth observed on mixtures of permissive and nonpermissive carbon sources. Symbiotic properties remained unaffected in all these mutants. PMID- 6501225 TI - Increase of translatable mRNA for major microsomal proteins in n-alkane-grown Candida maltosa. AB - In an n-alkane-assimilating Candida sp., transfer from glucose- to n-alkane containing medium induced changes in the microsomal proteins, and several distinctive polypeptides were demonstrated in the solubilized microsomal fraction derived from n-alkane-grown cells. Long-term-labeling and pulse-labeling experiments in vivo demonstrated the synthesis of the specific microsomal polypeptides. The polypeptides were synthesized as in vitro translation products directed by polyadenylated RNA extracted from n-alkane-grown cells. Two major polypeptides were partially purified from the microsomal fraction from n-alkane grown cells, and antiserum was prepared in a rabbit. Immunoprecipitation of these two polypeptides was accompanied by an increase in the amount of translatable mRNA. The molecular weights of the polypeptides derived from long-term-labeling, pulse-labeling and in vitro translation experiments appeared to be identical. PMID- 6501226 TI - Microcinematographic analysis of tethered Leptospira illini. AB - A model of Leptospira motility was recently proposed. One element of the model states that in translating cells the anterior spiral-shaped end gyrates counterclockwise and the posterior hook-shaped end gyrates clockwise. We tested these predictions by analyzing cells tethered to a glass surface. Leptospira illini was incubated with antibody-coated latex beads (Ab-beads). These beads adhered to the cells, and subsequently some cells became attached to either the slide or the cover glass via the Ab-beads. As previously reported, these cells rapidly moved back and forth across the surface of the beads. In addition, a general trend was observed: cells tethered to the cover glass rotated clockwise around the Ab-bead; cells tethered to the slide rotated counterclockwise around the Ab-bead. A computer-aided microcinematographic analysis of tethered cells indicated that the direction of rotation of cells around the Ab-bead was a function of both the surface of attachment and the shape of the cell ends. The results can best be explained by assuming that the gyrating ends interact with the glass surface to cause rotation around the Ab-beads. The analysis obtained indicates that the hook- and spiral-shaped ends rotate in the directions predicted by the model. In addition, the tethered cell assay permitted detection of rapid, coordinated reversals of the cell ends, e.g., cells rapidly switched from a hook-spiral configuration to a spiral-hook configuration. These results suggest the existance of a mechanism which coordinates the shape of the cell ends of L. illini. PMID- 6501227 TI - Genetic system of Schwanniomyces alluvius determined by diad analysis of fusion products. AB - The genetics of Schwanniomyces alluvius, a yeast that secretes alpha-amylase, were investigated. No mating types have been detected in this haploid organism. Hybrids were produced by protoplast fusion, and these were subjected to diad analysis by using two-spored asci. Results showed that the diploidy introduced by cell fusion persists through successive spore generations. It was concluded that in this organism, sporulation is preceded by the fusion of mitotic products, regardless of the ploidy of the latter. Routine procedures for constructing novel strains would, no doubt, be hampered by this failure of the sporulation process to restore haploidy. Nevertheless, chromosomal instability of hybrids, as indicated both by heterogeneity of fusion products and by a high frequency of morbidity among their segregants, may permit the use of classical genetic techniques for strain construction. PMID- 6501228 TI - Assimilation of chlorinated alkanes by hydrocarbon-utilizing fungi. AB - The fatty acid compositions of two filamentous fungi (Cunninghamella elegans and Penicillium zonatum) and a yeast (Candida lipolytica) were determined after the organisms were grown on 1-chlorohexadecane or 1-chlorooctadecane. These organisms utilized the chlorinated alkanes as sole sources of carbon and energy. Analyses of the fatty acids present after growth on the chlorinated alkanes indicated that 60 to 70% of the total fatty acids in C. elegans were chlorinated. Approximately 50% of the fatty acids in C. lipolytica were also chlorinated. P. zonatum contained 20% 1-chlorohexadecanoic acid after growth on either substrate but did not incorporate C18 chlorinated fatty acids. PMID- 6501229 TI - Simple, rapid, and quantitative release of periplasmic proteins by chloroform. AB - We introduce a method by which periplasmic proteins can be released rapidly, simply, and quantitatively by treating cells with chloroform. All the amino acid binding proteins tested maintained their activity during chloroform treatment. This method makes practical the analysis of the periplasmic protein complement of a large number of strains. PMID- 6501230 TI - Identification of a phosphoenolpyruvate:fructose 1-phosphotransferase system in Azospirillum brasilense. AB - An inducible phosphoenolpyruvate:fructose phosphotransferase system has been detected in Azospirillum brasilense, which requires a minimum of two components of the crude extracts for activity: (i) a soluble fraction (enzyme I) and (ii) a membrane fraction (enzyme II). The uninduced cells neither show any uptake of fructose nor express activity of either of these two enzyme fractions. C-1 of fructose is the site of phosphorylation. This phosphotransferase system does not accept glucose as a substrate for phosphorylation. PMID- 6501231 TI - Alteration of Streptococcus pneumoniae membrane properties by the folate analog methotrexate. AB - The antifolate compound methotrexate (MTX) is toxic to the gram-positive bacterium Streptococcus pneumoniae. Interaction of MTX with this bacterium resulted in an increase in the electric transmembrane potential (delta psi) and enhanced the delta psi-dependent uptake of isoleucine and MTX. In contrast, delta psi-independent uptake of glutamine was not changed. Folate, a nontoxic analog of MTX, did not exhibit these membrane effects, nor did it prevent the effect of MTX, suggesting that the NH2 in position 4 of the pteridine ring of the MTX molecule is involved in the MTX response. A strain bearing the nonsense mutation amiA9, selected for MTX resistance, did not exhibit increased membrane potential after MTX pretreatment. This suggests that MTX interacts with a specific membrane component in S. pneumoniae. A resulting change in ion permeability could lead to changes in the magnitude of the delta psi. The MTX-sensitive component is altered or absent in mutant amiA9. PMID- 6501232 TI - Cell wall and phospholipid composition and their contribution to the salt tolerance of Halomonas elongata. AB - The salt-tolerant bacterium Halomonas elongata makes a variety of physiological adaptations in response to increases in the salt concentration of its growth medium. The cell walls become more compact and internally coherent. The overall lipid pattern shows an increased amount of negatively charged lipids. In addition, the peptidoglycan composition of H. elongata, although not changing in response to increased NaCl, contains the hydrophobic amino acid leucine which is unique among bacterial species. The results suggest that H. elongata is able to live in a wide variety of salt concentrations because it alters its cell physiology in ways which increase both structural integrity and the amount of less-mobile, "structured" cell water, making the cells less susceptible to NaCl induced dehydration. PMID- 6501233 TI - Biochemical and immunological properties of Coxiella burnetii cell wall and peptidoglycan-protein complex fractions. AB - Coxiella burnetii morphological cell types were fractionated into large-cell variant cell walls, two fractions of small-cell variant cell walls, and one fraction of small-cell variant whole cells. Based on the contents of peptidoglycan (PG)-constituents and the yields of the sodium dodecyl sulfate insoluble PG-protein complex (PG-PC) from cell walls, the fraction of large-cell variant cell walls contained significantly less PG than did the fraction of small cell variant cell walls. The yields of PG-PC from the fractions of large-cell variant cell walls and small-cell variant cell walls were 2 and 32%, respectively. These results indicated that the PG of the large-cell variant cell walls may be partially digested by PG-lytic enzymes or incompletely synthesized, whereas the small-cell variant cell walls appeared to have intact PG. Proteins associated with PG-PC were resistant to proteolysis by trypsin, protease VI, and proteinase K. Saturated and unsaturated fatty acids were detected in whole cells and cell walls but not in PG-PC, which contained a 3-deoxy-D-mannooctulosonic acid-like component that is also present in phase I lipopolysaccharide. Immunogenicity of the fractions was tested by measuring the temporal sequence of phase II and phase I antibody responses in vaccinated rabbits. Both phase II and phase I antibody responses were demonstrated with all fractions except the sodium dodecyl sulfate supernatant of the small-cell variant cell walls, whereas PG-PC elicited a pure phase II antibody response up to 29 days postvaccination. The immunogenicity of these fractions may reflect a quantitative difference in antigen concentration or may be due to a qualitative difference in phase II and I determinants. PMID- 6501235 TI - Speculations on the cause(s) of alcoholism. PMID- 6501234 TI - Sensitivity of Coxiella burnetii peptidoglycan to lysozyme hydrolysis and correlation of sacculus rigidity with peptidoglycan-associated proteins. AB - The protease-resistant proteins associated with the peptidoglycan (PG) of the phase I small-cell variant Coxiella burnetii were either partially released from the PG by boiling the PG-protein complex (PG-PC) in sodium dodecyl sulfate containing 2-mercaptoethanol and EDTA or totally released by 1 N NaOH hydrolysis at 23 degrees C. An 18,300-dalton protein was released from the PG-PC under reducing conditions, whereas 1 N NaOH treatment extracted PG-associated proteins without apparent dissolution of the PG. Purified PG was composed of muramic acid, glucosamine, glutamic acid, alanine, and meso-diaminopimelic acid in a molar ratio of 0.9:0.9:1.0:1.4:1.0. Lysozyme hydrolysis of cell walls, PG-PC, and purified PG caused an increase in reducing groups which correlated with roughly 60 to 100% digestion of disaccharides. There was no significant decrease in turbidity during lysozyme hydrolysis of cell walls and PG-PC; however, hydrolysis of purified PG caused about 90% decrease in turbidity. Approximately 60% of the meso-diaminopimelic acid groups of PG were not susceptible to dinitrophenylation, thus, demonstrating an apparent contribution of PG-associated proteins, rather than cross-linkage between peptides, to sacculus rigidity of cell wall and PG-PC. This association of PG and protease-resistant covalently bound proteins may be important structural and functional determiners of resistance to both environmental conditions and intracellular digestion of C. burnetii by eucaryotic cells. PMID- 6501236 TI - Parental mental illness and psychiatric disorders in "at risk" children. AB - Data are reported from psychiatric evaluations of a large group of communication disordered children and their parents who presented to a community speech clinic. Systematic psychiatric evaluations involving the use of standardized interviews, questionnaires, and DSM-III diagnostic criteria reveal that approximately 50% of the children have definable DSM-III psychiatric disorders and approximately the same percentage of children have at least one psychiatrically ill parent. Comparisons of children with psychiatrically ill parents and children with psychiatrically well parents show that parental psychiatric disorder is associated with increased psychopathology in the children. However, other factors, particularly psychosocial stress, are more strongly correlated with the presence of childhood psychopathology. There are few correlations between the types of parental psychiatric disorders and the types of childhood disorders. PMID- 6501237 TI - Yohimbine and the model anxiety state. AB - Ten subjects were treated with 30 and 60 mg oral doses of yohimbine hydrochloride or placebo under controlled clinical conditions to determine if such doses would create a "model anxiety state." Some evidence of anxiety was found on various rating scales, especially after the 60 mg dose. However, maximum anxiety produced by this dose of the drug exceeded that which occurred during placebo testing in only 5 of the 10 subjects. The 60 mg dose produced substantial increases in systolic blood pressure and less increase in diastolic blood pressure and pulse rate. It was concluded that yohimbine does not produce a very good model of anxiety. PMID- 6501239 TI - "Trick" movements in facial dystonia. AB - Two patients with facial dystonia (blepharospasm and/or oromandibular dystonia) presented with an unusual "trick" movement. Both patients were able to inhibit blepharospasm and oromandibular dystonia by vocalizations including singing, reading, and speaking spontaneously. The significance of "trick" movements in facial dystonia is discussed. PMID- 6501238 TI - Serum imipramine concentrations lower than plasma values. AB - In 10 patients, a comparison of serum and plasma concentrations of imipramine and desipramine, using B-D tiger-top and green-top tubes, respectively, showed the serum levels to be significantly lower. Since such differences can influence evaluations of patients' dose schedules, it is important to ascertain the type of sample being used by the laboratory. PMID- 6501240 TI - Spontaneous hypnotic age regression: case report. AB - Age regression--reliving the past as though it were occurring in the present, with age appropriate vocabulary, mental content, and affect--can occur with instruction in highly hypnotizable individuals, but has rarely been reported to occur spontaneously, especially as a primary symptom. The psychiatric presentation and treatment of a 16-year-old girl with spontaneous age regressions accessible and controllable with hypnosis and psychotherapy are described. Areas of overlap and divergence between this patient's symptoms and those found in patients with hysterical fugue and multiple personality syndrome are also discussed. PMID- 6501241 TI - Lithium and carbamazepine. PMID- 6501242 TI - Slow-release methylphenidate: problems when children chew tablets. PMID- 6501243 TI - Amantadine in the neuroleptic malignant syndrome. PMID- 6501244 TI - Profile of the pathological gambler. AB - Pathological (compulsive) gambling is a serious emotional and social problem that has existed for centuries but has only recently been recognized as a distinct diagnostic entity that can be effectively treated. The development and progression of pathological gambling are outlined. The progression of the disorder through three identifiable phases leads to predictable complications. The treatment of the gambler within the framework of Gamblers Anonymous and/or by mental health professionals is described. PMID- 6501245 TI - Psychiatric disorders in opioid-dependent patients. AB - An examination of substance abusers in contemporary practice reveals a high frequency of psychiatric disorders. In some cases, these probably represent preexisting conditions, but in others the disorder may be initiated or aggravated by the biologic and social consequences of substance abuse. The severity of a patient's psychiatric disorder is predictive of response to substance abuse treatment. A high proportion of affective disorders has been found among opioid dependent patients; these are responsive to psychotherapy and to antidepressant treatment with doxepin. Careful psychiatric diagnosis in the management of substance abuse can discriminate those patients who are likely to require psychotherapy or psychoactive medication from those who may do well with standard drug counseling alone. PMID- 6501246 TI - Synthesis and evaluation of 19F labeled sulfonyl fluorides as probes of protease structure: alpha-chymotrypsin. AB - Active site Ser-195-fluorine-labeled derivatives of alpha-chymotrypsin were prepared from a series of N-(trifluoromethylphenyl)-fluorosulfonylphenyl carboxamides whose synthesis is described. The six new 19F spin labels varied in the position of the -CF3 substituent (o-, m-, and p-) and the fluorosulfonyl substituent (m- or p-). The chemical shifts of these covalently bound analogs of "tosyl-chymotrypsin" were each uniquely sensitive to their environment in the catalytic center as evidenced by differences in resonance line position for each label. Upon titrating these derivatives with the reversible competitive inhibitor, indole, a downfield shift was observed (with all but one label), which could be fit in each case to an apparent dissociation constant for indole binding. Indole binding to the p-sulfonyl derivatives was essentially unaltered from that for the native enzyme, while the m-sulfonyl derivatives required some additional free energy of binding to saturate the enzyme. The results are consistent with a partial embedding of the phenylsulfonyl moiety in the aromatic specificity pocket. PMID- 6501247 TI - Binding and cytotoxicity of Ricinus communis lectins to HeLa cells, Sarcoma 180 ascites tumor cells and erythrocytes. AB - The binding of Ricinus communis lectins to HeLa cells, Sarcoma 180 ascites tumor cells and human erythrocytes was studied in detail. Scatchard plots of binding of 125I-lectins to these cells gave biphasic lines except for HeLa cells at 0 degree C. The association constants of lectins for the three cell types at 37 degrees C were lower than those at 0 degree C. The numbers of total binding sites were estimated to be 7 to 16 X 10(7) per HeLa cell, 3 to 4 X 10(7) per Sarcoma 180 ascites tumor cell and 0.4 to 1 X 10(6) per erythrocyte. A fraction, 16 to 27% of the total amount of cell-bound lectin at 37 degrees C, appeared to be bound irreversibly as judged by non-removal on washing with 0.1 M lactose, whereas no lectin was irreversibly bound at 0 degree C. In the case of erythrocytes, no lectin became irreversibly bound even at 37 degrees C. The toxicity of lectins on HeLa cells and Sarcoma 180 ascites tumor cells was investigated. The toxicity of ricin D was 50 times for Sarcoma 180 ascites tumor cells and 140 times for HeLa cells as much as that for castor bean hemagglutinin. As to the sensitivities of both cell types to these lectins, it became apparent that Sarcoma 180 ascites tumor cells were more susceptible than HeLa cells. PMID- 6501248 TI - Electron transfer reactions of chemically modified plastocyanin with P700 and cytochrome f. Importance of local charges. AB - Chemically modified spinach plastocyanin, in which negatively charged carboxyl residues are replaced with positively charged amino residues, has been prepared. Four distinct species of chemically modified plastocyanin, having 1 to 4 mol of modified carboxyl residue per mol of plastocyanin, could be separated by ion exchange chromatography on DEAE-Sephacel. The rate of electron transfer from reduced cytochrome f to oxidized singly substituted plastocyanin was 30% of that of the native unmodified plastocyanin, and the reaction rate decreased further with increasing number of modified carboxyl residues. These results indicate the importance of electrostatic interactions between the negative charges on plastocyanin and the positive charges on cytochrome f in this reaction. Since the overall net charge of cytochrome f is negative at neutral pH, the positive charges on cytochrome f involved in the reaction should be localized ones. On the other hand, the rates of electron transfer from reduced singly and doubly substituted plastocyanin to photooxidized P700 in the P700-chlorophyll alpha protein complex were similar to that of native plastocyanin, which suggests that these carboxyl residues have only a minor role in the electron transfer to P700. Although divalent cation is essential for the electron transfer from native plastocyanin to P700 at neutral pH, the triply substituted plastocyanin could donate electrons to P700 even without MgCl2, and the rate of this reaction reached the maximum at a low concentration of MgCl2 (less than 2.5 mM). The modification of four carboxyl residues per plastocyanin molecule activated this reaction to the maximum level without MgCl2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501249 TI - Isolation and characterization of halorhodopsin from Halobacterium halobium. AB - Chromoprotein of a light-driven chloride pump, halorhodopsin (HR), was isolated from Halobacterium halobium L-33, which contains HR and "slowly cycling rhodopsin like pigment" (SR) but lacks bacteriorhodopsin (BR). The isolation was run in the presence of more than 2 M NaCl, which was required to preserve this halophilic retinal protein. Cell envelope vesicles were washed with Tween-20 to remove 80% of the proteins. The residual membranes were solubilized with 0.5% C12E9, which had little effect on the photochemical activities of HR and SR. HR was purified by passing it through a hydroxyapatite and then a phenyl-Sepharose column in 2 M NaCl and 0.5% C12E9. The absorption maximum of HR was 578 nm and the ratio of absorbance at 280 nm to 580 nm was 1.52. The apparent molecular weight of HR was 20,000 on polyacrylamide gel electrophoresis in the presence of SDS. The characteristic, bilobed CD spectrum of HR in the visible region suggested that HR exists as an oligomer in both its membrane-bound and isolated forms. PMID- 6501250 TI - Oxidation and oxygenation of L-amino acids catalyzed by a L-phenylalanine oxidase (deaminating and decarboxylating) from Pseudomonas sp. P-501. AB - A number of L-amino acids and derivatives were tested as substrates for the purified Pseudomonas L-phenylalanine oxidase. The reaction products of these amino acids were analyzed by high performance liquid chromatography and the kinetic properties of the reactions were partially characterized. In addition to L-phenylalanine, L-tyrosine, DL-o-tyrosine, DL-m-tyrosine, p-fluoro-DL phenylalanine and beta-2-thienyl-DL-alanine served as substrates for both oxidation and oxygenation catalyzed by the enzyme. On the other hand, L methionine and L-norleucine were enzymically converted to the corresponding alpha keto acids with the consumption of oxygen and with the formation of ammonia and hydrogen peroxide in stoichiometric amounts. Kinetic studies showed that the Km values for oxidation and oxygenation of L-phenylalanine by the enzyme were 2.04 mM and 1.96 mM for oxygen, and 13.3 microM and 11.1 microM for L-phenylalanine, respectively. omega-Phenyl fatty acids such as phenylacetic acid, 3 phenylpropionic acid and 4-phenylbutyric acid were competitive inhibitors of the enzyme towards L-phenylalanine. Both oxidation and oxygenation of L-phenylalanine by the enzyme were also inhibited by phenylacetic acid competitively. PMID- 6501251 TI - Acetylcholinesterase release from mammalian erythrocytes by phosphatidylinositol specific phospholipase C of Bacillus thuringiensis and characterization of the released enzyme. AB - The mode of acetylcholinesterase release from mammalian erythrocyte membranes by the action of phosphatidylinositol(PI)-specific phospholipase C of Bacillus thuringiensis was studied. As regards intact erythrocytes, a larger amount of acetylcholinesterase was released from sheep or bovine erythrocytes than from horse erythrocytes. From horse erythrocyte ghosts, acetylcholinesterase was more easily released than from intact cells. Bovine erythrocyte acetylcholinesterase released by PI-specific phospholipase C was purified by column chromatography on DEAE-cellulose, affinity gel and Sepharose 6B, to a homogeneous state, as indicated by polyacrylamide gel electrophoresis, with a recovery of 39%. Also, bovine erythrocyte acetylcholinesterase was solubilized by Triton X-100 and partially purified. The properties of these acetylcholinesterase preparations obtained by the action of PI-specific phospholipase C and/or Triton X-100 were studied in detail. On elution from the Sepharose 6B column, Triton X-100 solubilized acetylcholinesterase was eluted at the void volume while the enzyme obtained by further treatment with PI-specific phospholipase C was eluted in the region corresponding to M.W. 250,000. Furthermore, the heat stability of acetylcholinesterase purified after solubilization with PI-specific phospholipase C was higher than that of the Triton X-100-solubilized acetylcholinesterase. The close association and direct interaction of PI with acetylcholinesterase in the erythrocyte membrane was suggested by the above results. PMID- 6501252 TI - Characterization of nitrite reductase from a denitrifier, Alcaligenes sp. NCIB 11015. A novel copper protein. AB - A copper-containing dissimilatory nitrite reductase [nitric-oxide: ferricytochrome c oxidoreductase, EC 1.7.2.1] was purified from a denitrifier, Alcaligenes sp. NCIB 11015, by ion-exchange chromatography on CM-cellulose, gel filtration on Sephadex G-150, and adsorption on hydroxyapatite. The preparation was homogeneous by SDS-polyacrylamide gel electrophoretic criteria, and its enzymatic activity increased considerably by freezing (at -20 degrees C) and thawing. The enzyme consists of two subunits with a molecular weight of 37,000, and the isoelectric point and redox potential are 8.4 and +260 mV (pH 7.2), respectively. The EPR spectrum and copper analysis clearly indicated that the enzyme contains two type I copper atoms per molecule but no other types of copper. This is the first blue copper protein that exhibits catalytic activity despite possessing only type I copper. PMID- 6501253 TI - DNA polymerases of Chlorella. II. Characterization to distinguish the two enzymes. AB - Previously, we reported two DNA polymerases (DPols), Pol I and Pol II, in the unicellular green alga, Chlorella (Aoshima, J., Nishimura, T., & Iwamura, T. (1982) Cell Struc. Funct. 7, 71-86). Changes in their activities during the cell cycle either in the normal and drug-inhibited courses indicated that Pol I and Pol II functioned to replicate nuclear and chloroplast DNAs, respectively. In the present work, we have examined their enzymic properties to characterize and distinguish them further. A number of inhibitors commonly used for such studies were also tested to determine their effects and the results were analyzed by use of the simple and useful "Tamiya plot." We have also analyzed the data obtained in inhibitor studies on various eukaryotic DPols in the literature using the Tamiya plot, and the results will be presented elsewhere (Iwamura, T. & Aoshima, J. (1984) J. Biochem. in press). Comparisons of the algal DPols with mammalian enzymes as regards enzymic properties and inhibition modes have led us to conclude that: [1] the algal two DPols are significantly different from each other, despite having many similarities to each other: [2] they are related in properties to any of the three mammalian DPols-alpha, -beta, and -gamma; Pol I (n DPol) was a little more like alpha than Pol II (ch-DPol), which in turn more akin to gamma. This feature was quantitized by using vectors in a three-dimensional alpha-beta-gamma-space. Another peculiar feature derived from the Tamiya plot of the inhibitions by araCTP and aphidicolin (both being competitive with cCTP) has led us to propose a specific allosteric role of cCTP in the reaction mechanism besides its role as one of the substrates. PMID- 6501254 TI - Isolation and amino acid sequence of SAP-1, an acidic protein of human whole saliva, and sequence homology with human gamma-trace. AB - A low-molecular-weight acidic protein was isolated from human whole saliva by DE32 column chromatography and designated as SAP-1. The amino acid sequence was determined by conventional methods to be (sequence in text). The protein consisted of 113 residues and the calculated molecular weight was 12,552. Computer analysis revealed the presence of 54% sequence homology between SAP-1 and gamma-trace, a basic microprotein present in cerebrospinal fluid and in urine of patients with renal failure. PMID- 6501255 TI - Proton nuclear magnetic resonance studies of mammalian metallothioneins. AB - Proton nuclear magnetic resonance studies of various mammalian metallothioneins are described. Metallothioneins-1 and 2, isolated from rat and rabbit, and also metallothionein-2, from humans, were investigated. Proton NMR spectra showed that mammalian metallothioneins containing Cd have similar tertiary structures regardless of their sources. On the other hand, metallothioneins containing both Cd and Zn have a slightly different conformation from those containing Cd alone. Almost all methyl resonances of Cd-metallothioneins were assigned to those of Met, Ile, Leu, Val, Thr, and Ala residues by NMR double resonance techniques, pH titration, and the spectral comparison of these metallothioneins. alpha-Proton resonances of Ala residues were classified into two groups, one of which arose around 4.1 ppm, the other around 4.4 ppm. Moreover, the number of alpha-proton resonances around 4.1 ppm and 4.4 ppm agreed with the number of Ala residues in the COOH-terminal and NH2-terminal domains of the metallothionein, respectively. This finding suggests that the chemical shift values of alpha-protons of Ala residues are reflective of the domain structure of the metallothioneins. PMID- 6501256 TI - Photocross-linking from SH1 of the myosin heavy chain to light chains through the dinitrophenyl group attached to SH1. AB - Trinitrobenzene selectively dinitrophenylates SH1, a specific thiol in the myosin heavy chain which contains 1 mol of this cysteinyl residue. When the SH1-DNP myosin thus obtained was irradiated with a mercury lamp, a cross-linked product was formed with a molecular weight of about 220K daltons. It was shown that this product was composed of both heavy and light chains by fluorescence labeling of the heavy chain at SH2, another specific thiol, and immune reaction using an anti light chain antibody, respectively. PMID- 6501257 TI - Isolation of cytochrome P-450 highly active in prostaglandin omega-hydroxylation from lung microsomes of rabbits treated with progesterone. AB - Two forms of cytochrome P-450, designated as cytochrome P-450p-1 and cytochrome P 450p-2, were separated and purified to specific contents of 8.2 and 8.9 nmol/mg of protein, respectively, from lung microsomes of rabbits treated with progesterone. Cytochrome P-450p-1 and cytochrome P-450p-2 migrated as single polypeptide bands with molecular weights of 49,000 and 52,000, respectively, on SDS-polyacrylamide gel. Their CO-reduced difference spectral peaks were at 451.5 and 450 nm, respectively. Cytochrome P-450p-1 catalyzed the N-demethylation of benzphetamine, O-demethylation of p-nitroanisole, and O-deethylation of 7 ethoxycoumarin, whereas no activity was observed with cytochrome P-450p-2. On the other hand, cytochrome P-450p-2 catalyzed the omega-hydroxylation of prostaglandin E1 (PGE1), prostaglandin E2 (PGE2), and prostaglandin A1 (PGA1) with turnover rates of 9.0, 7.5, and 5.0 nmol of product/min/nmol of cytochrome P 450, respectively, as well as the omega- and (omega-1)-hydroxylation of palmitate and myristate with turnover rates of 27.7 and 16.4 nmol products/min/nmol of cytochrome P-450, respectively. This cytochrome showed a greater affinity for prostaglandins (PGs) than for fatty acids. These reactions were absolutely dependent on cytochrome P-450p-2 and NADPH-cytochrome P-450 reductase, and stimulated by addition of phosphatidylcholine and cytochrome b5. Cytochrome P 450p-2 is thought to be a new form of cytochrome P-450 induced by progesterone treatment in rabbit lung microsomes. PMID- 6501258 TI - Isolation and characterization of N-long chain acyl aminoacylase from Pseudomonas diminuta. AB - N-Long chain acyl aminoacylase II (Enzyme II) catalyzing the hydrolysis of N-long chain acyl amino acids was purified about 2,000-fold from the cell extracts of Pseudomonas diminuta with 1.8% of activity yield. The purified enzyme was homogeneous on polyacrylamide gel electrophoresis and the molecular weight was 220,000. Enzyme II differed from N-long chain acyl aminoacylase I (Enzyme I) in molecular weight, in substrate specificity, and in behavior toward temperature and pH. Enzyme II showed broader substrate specificity than Enzyme I and catalyzed the hydrolysis of lipoamino acids containing various amino acid residues, although Enzyme I was almost specific to the lipoamino acids containing L-glutamate. The extent of hydrolysis by Enzyme II reaction varied depending on the kinds of lipoamino acids and were: 100% for palmitoyl-L-glutamate, 91% for myristoyl-L-glutamate, 85% for lauroyl-L-glutamate, 54% for lauroyl-L-aspartate, 28% for stearoyl-L-glutamate and 17.5% for lauroyl-glycine. PMID- 6501259 TI - Heterogeneity of free valine pools for protein synthesis on free and membrane bound polysomes in rat liver. AB - When rat liver was pulse-labeled with [3H]valine in vivo, the nascent peptide on membrane-bound polysomes was found to be more highly labeled than that on free polysomes. Nascent peptides were purified from both classes of polysomes and, after hydrolysis, the amino acids were reacted with 14C-labeled 1-fluoro-2,4 dinitrobenzene. The specific activity of [3H]valine was determined from the [14C] dinitrophenyl-[3H]valine after purification by two-dimensional thin layer chromatography. With this approach we found that the specific activity of [3H]valine in the nascent peptide of membrane-bound polysomes was more than twice that of free polysomes. Moreover, when rats were pretreated with a lysosomal protease inhibitor, the differences between the specific activities of valine in nascent peptides of the two classes of polysomes tended to decrease. Our results indicate the existence of two distinct pools for valine used for protein synthesis in liver cells; one serves as a precursor for the synthesis of secretory proteins on membrane-bound polysomes and the other as a precursor for the synthesis of intracellular proteins on free polysomes. PMID- 6501260 TI - Effect of valinomycin on membrane vesicle aggregation of porcine intestinal brush borders. AB - It has been found in the brush border membrane vesicles from porcine small intestine that valinomycin causes vesicle aggregation and that Ca2+-induced aggregation of the vesicles is saturably stimulated in the presence of valinomycin. The apparent half-maximal concentration of valinomycin required to enhance the Ca2+ effect on the membrane aggregation is approximately 40 microM. Results of a fluorometric study using 1-anilino-8-naphthalene sulfonate (ANS) showed that the addition of valinomycin to the membranes induces slight decreases in the ANS-binding affinities for the membranes in the presence and absence of Ca2+. On the other hand, measurements of the incorporation rate of 1,6-diphenyl 1,3,5-hexatriene (DPH) into the vesicles and of anisotropies of DPH-labeled membranes suggested that the lipid organization of the membranes was not altered upon the addition of valinomycin. From these results, it was suggested that the valinomycin effect on the membrane aggregation is mainly related to the nature of the membrane surface charge. PMID- 6501261 TI - Proton correlation NMR studies of metabolism in Rhodopseudomonas palustris. AB - A 1H correlation NMR study is reported, on the metabolism of a photosynthetic bacterium, Rhodopseudomonas palustris, in dark and light anaerobic conditions. Alkali treatment as well as sonication of the cells were employed to follow the process of accumulation and decomposition of poly-beta-hydroxybutyrate (PHB) which is the reserve material for the bacterium. It was shown that synthesis of PHB from trans-crotonate proceeds in the granules of the cells. It was also demonstrated that under anaerobic light conditions photometabolism and glycolysis generally compete with concomitant synthesis and decomposition of PHB, respectively, and that glycolysis gradually replaces photometabolism with aging of the cells. In contrast, glycolysis is always predominant in the dark and PHB is primarily used as the carbon source. It was observed that photo-induced transport of beta-hydroxybutyrate through the membrane occurs when photometabolism and glycolysis are equally active in the light. The implications of this observation are briefly discussed. PMID- 6501262 TI - Thin-layer chromatography of hyaluronate oligosaccharides. AB - Odd- and even-numbered hyaluronate oligosaccharides with N-acetylglucosamine, glucuronic acid, or 4,5-unsaturated glucuronic acid at their nonreducing ends were separated by thin-layer chromatography, using silica gel and a solvent system of isopropanol-water (66 : 34) containing 0.05 M NaCl. In the isopropanol system, small amounts of electrolytes were necessary for the resolution of each oligosaccharide. PMID- 6501264 TI - Rat pancreatic phospholipase A2: purification, characterization, and N-terminal amino acid sequence. AB - Phospholipase A2 was purified from rat pancreas by heat treatment of the homogenate and the sequential use of DEAE-Sepharose chromatography, CM-Sepharose chromatography, and reverse-phase high-performance liquid chromatography (HPLC). Prophospholipase A2 was not separated from the phospholipase A2 by CM-Sepharose chromatography under the conditions used, but it was well resolved by the reverse phase HPLC. The enzyme was homogeneous on sodium dodecyl sulfate-polyacrylamide gel electrophoresis and on analytical HPLC, and its molecular weight was estimated to be 14,000. The enzyme specifically hydrolyzed an acylester bond at the sn-2-position of the phospholipid examined. The purified enzyme has a pH optimum in the range of pH 9.5 to 10.5 and requires the presence of Ca2+ (3 mM) and sodium deoxycholate (0.1%) for optimum activity. The amino acid sequence of the first 32 residues in the N-terminal region of the enzyme was determined. The sequence revealed a marked homology with those of pancreatic phospholipases A2 of man, pig, ox, and horse, and porcine intestinal phospholipase A2 reported previously. PMID- 6501263 TI - Studies on phospholipase A inhibitor in blood plasma. I. Purification and characterization of phospholipase A inhibitor in bovine plasma. AB - Phospholipase A inhibitor was found in bovine, human and porcine plasma. The inhibitor was purified about 300-fold from bovine plasma by ammonium sulfate fractionation, DEAE-cellulose chromatography, Sephadex G-200 gel filtration and anti-BSA antibody-agarose column chromatography to remove albumin. The purified material was homogeneous as judged by immunoelectrophoresis and 0.7% agarose-2% polyacrylamide gel electrophoresis. The inhibitor suppressed not only rat and human plasma phospholipase A2 activity, but also purified Mamushi (Agkistrodon halys blomhoffi) venom phospholipase A2-II. Bovine plasma inhibitor was shown to be a lipoprotein containing phosphatidylcholine, sphingomyelin, cholesterol ester, and triacyl glycerol as major lipid components. The molecular weight of the native inhibitor was nearly the same as that of bovine plasma high density lipoprotein (HDL) when determined by the gel filtration method. The molecular weights of two subunits of the inhibitor observed on polyacrylamide gel electrophoresis in the presence of SDS were about 10K and 42K. The anti-inhibitor antiserum obtained from rabbits immunized with the highly purified inhibitor cross-reacted with bovine plasma alpha-lipoprotein (HDL). The lipid composition of the inhibitor was similar to that of HDL, but apoinhibitor and apoHDL were different in molecular weight and solubility in various buffers. PMID- 6501265 TI - Characterization of sulfoglycosphingolipids by direct probe electron impact mass spectrometry. AB - Novel mono- and bis-sulfoglycolipids, monosulfogangliotriaosylceramide, bis sulfogangliotriaosylceramide, and bis-sulfogangliotetraosylceramide, were recently isolated from rat kidney. These sulfoglycolipids and their partially- or fully-desulfated products were characterized by direct probe electron impact mass spectrometry as permethylated derivatives. The fragment ions obtained from permethylated-fully-desulfated-remethylated glycolipids included ions containing up to four monosaccharides plus C-1 and C-2 of acylated sphingoids as well as those plus C-1 to C-3 of acylated sphingoids. By the use of trideuteriomethyl iodide instead of methyl iodide in the remethylation step after desulfation, the sequences of the monosaccharides containing the sulfate ester were established. When the sulfate ester was present, the intensity of the ions derived from the carbohydrate moiety was much weaker in comparison to that of those from the permethylated-fully desulfated derivative. Instead, the intensity of the fragments from the ceramide moiety was very strong in the presence of the sulfate ester. PMID- 6501266 TI - Purification of NADPH-dependent enoyl-CoA reductase involved in the malonyl-CoA dependent fatty acid elongation system of Mycobacterium smegmatis. AB - NADPH-Dependent enoyl-CoA reductase [EC 1.3.1.8] was purified to homogeneity, for the first time, from the crude extract of Mycobacterium smegmatis. The molecular weight of this enzyme was estimated to be around 32,000 using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The purified enzyme reduced 2-trans hexadecenoyl-CoA (Km value, 100 microM) and -eicosenoyl-CoA (Km value, 83 microM) almost equally well in the presence of NADPH as a sole electron donor. The Km value for NADPH was 34.5 microM. When NADP3H was incubated with 2-eicosenoyl-CoA and the purified enzyme, the sole tritiated product was arachidate. This enzyme was almost inert to enoyl-CoAs with chains less than 12 carbon atoms long. The purified enzyme still retained FMN, which was detectable by acid ammonium sulfate and was essential for full activity of the enzyme. The enzyme was sensitive to SH reagents such as N-ethylmaleimide and monoiodoacetamide but was not sensitive to isonicotinamide hydrazide. Anti-NADPH-dependent-enoyl-CoA-reductase rabbit serum was found to inhibit the activities of both the reductase and the malonyl-CoA dependent fatty acid elongation system, supporting the involvement of the reductase in this elongation system. PMID- 6501267 TI - High molecular weight calcium binding protein in the microsome of scallop striated muscle. AB - In the microsome of scallop adductor striated muscle, 30K, 55K, 90K, and 360K proteins were detected as calcium binding proteins by 45Ca autoradiography on the transferred nitrocellulose membrane after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE). The 360K protein was directly extracted with Triton X-100 from the whole homogenate of striated portion of scallop adductor muscle and purified through DEAE cellulose and hydroxyapatite column chromatography. This purified scallop high molecular weight calcium binding protein (SHCBP) showed a faster mobility in SDS PAGE in the presence of Ca2+ than in its absence. The decrease of tryptophan fluorescence had a half maximum near pCa 7 and was slightly co-operative with Mg2+. UV absorbance was slightly increased with Ca2+. The CD spectrum also changed with Mg2+ and Ca2+. These results reflect that this SHCBP binds calcium ions under near physiological conditions. SHCBP-like high molecular weight calcium binding proteins were also detected in the smooth muscle portion of adductor muscle and branchiae of scallop by 45Ca autoradiography, but not in liver. The adductor muscle of clam had a high molecular weight calcium binding protein whose molecular weight was a little smaller than that of SHCBP. The foot of turban shell had the same molecular weight calcium binding protein as SHCBP. Stains-all, a cationic carbocyanine dye, which has been reported to stain calcium binding proteins blue, stained SHCBP blue. The spectrum of SHCBP stained with Stains-all was very similar to that of calsequestrin. Although the function of SHCBP is still unknown, it might be expected to correspond to calsequestrin of vertebrate skeletal muscle, a calcium sequestering protein, in the sarcoplasmic reticulum. PMID- 6501269 TI - Induction of rat hepatic alkaline phosphatase and its appearance in serum: electrophoretic characterization of liver-membranous and serum-soluble forms. AB - Simultaneous bile duct ligation and colchicine injection (2 mg/kg body weight) in rats caused a remarkable induction of alkaline phosphatase in the liver. Concomitantly, a marked elevation of the enzyme activity occurred in the serum, and three activity peaks (peaks I, II, and III) were separated by Sephadex G-200 gel filtration. By several criteria for alkaline phosphatase isoenzymes it was determined that the liver-derived enzyme was distributed in peak I (30% of total serum activity) as a vesicle-bound form and in peak II (65%) as a soluble form, while the intestinal enzyme was contained in peak III (5%). The serum alkaline phosphatase in peaks I and II was compared with the liver enzyme extracted from plasma membrane with n-butanol. Under non-reducing conditions, the soluble form of peak II showed an electrophoretic mobility different from that of the liver enzyme; in the presence of sodium dodecyl sulfate the serum-soluble form migrated a little more slowly than the liver one, while in the presence of Triton X-100 the former migrated much faster than the latter. The sedimentable fraction of peak I was found to contain two forms corresponding to the serum-soluble and liver-membranous forms. Neuraminidase treatment of these two forms reduced their mobilities but did not abolish the relative difference in their mobilities on gel electrophoresis in the presence of either Triton X-100 or sodium dodecyl sulfate. Under reducing conditions, however, each form (which was dissociated into single subunits) migrated with an identical mobility on sodium dodecyl sulfate gel electrophoresis. These results suggest that the hepatic alkaline phosphatase exists as conformationally different forms in the serum and the liver membrane (even solubilized), but the difference is no longer preserved after their denaturation into subunits. PMID- 6501268 TI - Stage-specific polypeptides in the developing mouse brain as demonstrated by two dimensional gel electrophoresis. AB - Protein alterations during the development of the mouse brain were studied by two dimensional gel electrophoresis. A protein spot with a molecular weight (MW) of 68,000 and pI value of 5.6 was found in the brain of the 11th day of gestation. Between the 12th and the 14th day of gestation, spots with the same MW and lower pI values appeared progressively. Neuraminidase digestion converted the pI of these acidic spots to 5.6. Thus, increased sialylation appeared to occur during this period. This class of molecules became hardly detectable on the 15th day, and disappeared completely after the 16th day. Analogous spots were present in the heart, liver, and stomach of the embryos, although the increased sialylation was not observed in the liver. No adult organs so far examined showed these spots. On the other hand, two polypeptides (MW 55,000, pI 4.7, and 53,000, pI 4.6) appeared in the brain on the 13th day of gestation and persisted throughout the fetal period. After birth, they became hardly detectable. Furthermore, a spot (MW 48,000, pI 4.8) became newly detectable in the brain 4-5 weeks after the birth. PMID- 6501271 TI - Creators of works and their commissioning parties: the new copyright law. AB - This article is the first in a series which will deal with: a) the rights of the creators of literary and artistic works as they are affected by the provisions of the 1978 revised copyright law (CLRA), b) the relationship between creators and their publishers or other commissioning parties, and c) the knowledge and experience required to cope with these factors. The reference to creators, in terms of creators' rights, includes many disciplines: writers, artists, photographers, composers, sculptors, and many others including those of us who produce educational and public relations materials in the field of medicine. PMID- 6501270 TI - The environment of the high-affinity cation binding site on actin and the separation between cation and ATP sites as revealed by proton NMR and fluorescence spectroscopy. AB - The lanthanide ions Lu3+ (diamagnetic) and Gd3+ (paramagnetic broadening probe) were used to displace Ca2+ from the high-affinity cation binding site on G-actin. The effects of these higher-affinity ions on the proton nuclear magnetic resonance spectrum of actin were recorded. The aliphatic proton envelope in the Gd-actin sample exhibited a complex array of changes due to the proximity of Gd to several aliphatic residues. No such changes were observed in the diamagnetic Lu-actin control spectrum. By contrast, the aromatic proton envelope remained largely unaffected in both Gd-actin and Lu-actin samples. However, the adenosine moiety on the actin-bound ATP became increasingly mobilized without the triphosphate chain being released from the ATP binding site. Maximum adenosine mobilization occurred with approximately 1 mol of lanthanide ion bound per mol of actin. The absence of changes in the aromatic proton envelope suggests that the high-affinity cation binding site is in a region well removed from the adenosine moiety of bound ATP as well as any aromatic side-chains. The separation of the ATP and cation sites was further explored using the fluorescent ATP analogues FTP and epsilon-ATP. Tb3+ bound to the high-affinity cation site was found to be separated by 16 A from the FTP chromophore bound to the nucleotide binding site on actin. Since this distance is greater than can be accommodated on a model of the Tb-ATP complex, we conclude that the sites are physically separate. This conclusion was further reinforced by experiments involving the quenching of epsilon-ATP fluorescence by Mn2+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501272 TI - Cancer education via video-teleconferencing: an assessment of participant responses. AB - Two one-hour video-teleconferences on pediatric oncology were presented to a targeted statewide audience of cancer care providers and other professionals who work with pediatric cancer patients in the hospital, community, and home. Participant responses to a post-broadcast questionnaire addressing program content, process, and context were then assessed. Of the 203 participants, 87.8% agreed that the program content would be useful to their practice, and 94.3% agreed they would recommend video-teleconferencing as an effective method for continuing cancer education. PMID- 6501273 TI - Phosphorylation of RNA polymerase I augments its interaction with autoantibodies of systemic lupus erythematosus patients. AB - Purified RNA polymerase I was phosphorylated by the endogenous protein kinase or dephosphorylated by alkaline phosphatase and used as antigen in a radioimmunoassay with sera from systemic lupus erythematosus patients or serum from an immunized rabbit. Enzyme incubated in the absence of ATP or phosphatase served as control. Three to seven times more of the autoantibodies in the patients' sera reacted with phosphorylated RNA polymerase I than with control enzyme. The reactivity of the dephosphorylated enzyme with lupus autoantibodies was only 50-60% of that observed with control enzyme. Neither phosphorylation nor dephosphorylation of the enzyme had an effect on its reaction with the rabbit antibodies. The effect of phosphorylation on the reaction of each RNA polymerase I subunit (S1-S8; Mr = 190,000-17,000) with the patients' antibodies was determined by an immunoblot procedure following resolution of the subunits on polyacrylamide gels. Prior phosphorylation of the enzyme resulted in a dramatic increase in binding of each patient's antibodies to all polymerase subunits with the exception of S4. Anti-S4 antibody was not detected with either phosphorylated or control enzyme. Strikingly, antibodies in each patients' sera reacted with S6 only after its phosphorylation. Similarly, anti-S5 antibodies in the serum of one patient were only detected with phosphorylated RNA polymerase I. The present data suggest that at least a significant fraction of the anti-RNA polymerase I autoantibodies in the sera of systemic lupus erythematosus patients might be directed against phosphorylated sites on the enzyme and that phosphorylation may have a role in the production of this and other autoimmunogenic nuclear components which are hallmarks of this disease. PMID- 6501274 TI - Cross-linking of histone H5 in hen erythrocyte nuclei. AB - Following treatment of hen erythrocyte nuclei with dimethyl 3,3' dithiobispropionimidate, dimers between histones H1a, H1b, and H5 were extracted with 5% perchloric acid. They resolved electrophoretically into four sub-bands and these were identified by non-reducing/reducing gel electrophoresis. The H5-H5 homodimer species was purified by gel electrophoresis and was treated sequentially with BrCN and dithiothreitol. The pattern of resulting fragments indicates that cross-links were mainly formed between the COOH-terminal portions and at a significantly lower frequency between the COOH-terminal and the NH2 terminal portions. PMID- 6501275 TI - Hybridization studies of chicken liver fatty acid synthetase. Evidence for the participation in palmitate synthesis of cysteine and phosphopantetheine sulfhydryl groups on adjacent subunits. AB - Enzymatically inactive variants of chicken liver fatty acid synthetase have been prepared by specific chemical modification of the active cysteine SH group with iodoacetamide, and the phosphopantetheine SH group with chloroacetyl-CoA. Hybridization of each of these variants with the unmodified enzyme yielded (modified)-(unmodified) hybrid dimers which possessed 50% synthetase activity. A 50% active (iodoacetamide-modified)-(chloroacetyl-CoA-modified) hybrid dimer was also demonstrated by recombination of these variants with each other. These results indicate that the two functional sites on the synthetase are independently active, and that each is comprised of a cysteine SH group from one subunit and a complementary phosphopantetheine SH group from the other subunit as depicted by the head-to-tail arrangement proposed by Wakil and co-workers (Wakil, S. J., Stoops, J. K., and Joshi, V.C. PMID- 6501276 TI - Direct observation of glycogenesis and glucagon-stimulated glycogenolysis in the rat liver in vivo by high-field carbon-13 surface coil NMR. AB - High-field 13C surface coil nuclear magnetic resonance has been employed to investigate glucose and glycogen metabolism in rat liver in vivo. Natural abundance and isotopically enriched proton-decoupled 13C NMR experiments were conducted at 90.56 MHz on a standard commercial spectrometer utilizing a laboratory-built high-sensitivity double-resonance coaxial coil probe. At variance with a previous preliminary report, natural abundance spectra of the liver in vivo from a rat fed ad libitum reveal resonances of substantial intensity from hepatic glycogen with approximately 10 min of signal averaging. The response of hepatic glycogen levels to an intravenous injection of the hormone glucagon was continuously monitored through the glycogen C-1 carbon resonance intensity; this revealed an average 60% depletion of hepatic glycogen stores in vivo within approximately 1 h. In a complementary study utilizing fasted rats, 100 mg of D-[1-13C]glucose (90% enriched) was administered via a peripheral vein injection and continuously monitored by 13C NMR with 3-min time resolution as it was incorporated into hepatic glycogen. The C-1 carbon resonances of hepatic glucose and glycogen are well-resolved in vivo enabling the time course for the relative change in concentration for both metabolites to be established simultaneously. The 13C label incorporated into the glycogen pool reaches a steady-state level in approximately 40 min. PMID- 6501277 TI - Stimulation of glycogenolysis and platelet-activating factor production by heat aggregated immunoglobulin G in the perfused rat liver. AB - Infusion of heat-aggregated immunoglobulin G (IgG) into perfused livers from fed rats resulted in a dose-dependent but transient stimulation of hepatic glucose output. Oxygen consumption and lactate production by the liver also were stimulated, while the lactate/pyruvate ratio of the effluent perfusate was increased. Upon return of hepatic glucose output to the basal rate following immune aggregate stimulation, a second infusion of immune aggregate caused little or no increase in glucose output, indicating desensitization of the response. Infusion of immune aggregate into rat livers also resulted in the appearance of platelet-activating factor activity in the effluent perfusate. Synthetic platelet activating factor or acetylglyceryl ether phosphorylcholine (AGEPC) has been demonstrated to be a potent glycogenolytic agonist in the perfused liver (Buxton, D.B., Shukla, S. D., Hanahan, D. J., and Olson, M.S. (1984) J. Biol. Chem. 259, 1468-1471). The glycogenolytic response of the liver to immune aggregate infusion was not desensitized by prior infusion of AGEPC. Co-infusion of the cyclooxygenase inhibitor indomethacin prevented the immune aggregate-induced glycogenolytic response but had no effect on AGEPC-stimulated hepatic glucose output. It is suggested that the mechanism by which aggregated IgG activates hepatic glycogenolysis requires the synthesis of AGEPC by the liver by a pathway which involves the metabolism of arachadonic acid. PMID- 6501278 TI - Identification of methylphosphomannosyl residues as components of the high mannose oligosaccharides of Dictyostelium discoideum glycoproteins. AB - Lysosomal enzymes isolated from the slime mold Dictyostelium discoideum bind to the mannose 6-phosphate receptor which is present in many mammalian cells. While binding to the receptor suggests that the slime mold enzymes possess the same mannose 6-phosphate recognition marker as their mammalian counterparts, initial structural studies of the phosphorylated oligosaccharides have indicated that the phosphate is attached to high mannose-type units via an unusual phosphodiester linkage (Freeze, H.H., Yeh, R., Miller, A.L., and Kornfeld, S. (1983) J. Biol. Chem. 258, 14874-14879). To identify the components of the phosphodiester group we have isolated the phosphorylated high-mannose oligosaccharides from D. discoideum AX3 cells labeled with [2-3H]mannose or [6-3H]glucosamine and from the differentiation medium of unlabeled cells. The major phosphorylated species contain one or two phosphodiester groups and an average of 6 or 7 mannose residues. The phosphodiesters are relatively stable to both acid and base hydrolysis, but upon strong acid hydrolysis (conditions that completely hydrolyze the oligosaccharide) mannose 6-phosphate residues are liberated. Through a combination of techniques, including fast atom bombardment and direct chemical ionization mass spectrometry, it is shown that the mannose 6-phosphate residues of the intact oligosaccharide are diesterified to methyl groups. This indicates that slime mold possesses a different biosynthetic pathway for the formation of phosphorylated high mannose-type oligosaccharides than is utilized by higher organisms. PMID- 6501279 TI - Three forms of thiol proteinase inhibitor from rat liver formed depending on the oxidation-reduction state of a sulfhydryl group. AB - Three forms of a thiol proteinase inhibitor were isolated from rat liver cytosol. The monomeric inhibitor (pI 5.2) (TPI-1) formed a complex with cathepsin H even in the absence of reducing agents. The inhibitor with pI 5.0 (TPI-2) was inactive in the absence of reducing agents but was converted to an active inhibitor on addition of reducing agents such as dithiothreitol, GSH, cysteine, or 2 mercaptoethanol. The dimeric inhibitor (TPI-D) with an intermolecular disulfide bridge was also inactive and was converted to the active monomeric inhibitor on addition of dithiothreitol. TPI-2 is most likely a mixed disulfide with glutathione. One (Cys-3) of two cysteine residues exposed on the surface of the molecule of TPI-2 is involved in the formation of a mixed disulfide, and the other cysteine residue (Cys-64) is buried in the molecule. The activity of rat liver thiol proteinase inhibitor may possibly be regulated by formation of a protein mixed disulfide or by reduction of the mixed disulfide. PMID- 6501280 TI - Lipid composition and physical state effects on cellular cholesteryl ester clearance. AB - The influence of lipid composition and physical state on the rate of cholesteryl ester clearance from cytoplasmic inclusions has been investigated. Our findings demonstrate that the increased rate of clearance correlates with an increased cellular triglyceride content and a more fluid cholesteryl ester physical state. Cultured rat hepatoma cells were induced to accumulate esterified cholesterol in a smectic liquid-crystalline state by exposure to free cholesterol-rich phospholipid dispersions. Addition of cis-unsaturated fatty acids to this loading medium (either oleate, linoleate, linolenate, or eicosadienoate) resulted in a substantial increase in cellular triglyceride content (greater than 7 times non fatty acid-treated), cellular cholesteryl esters in a liquid state, and a rate of cholesteryl ester clearance twice that of control (approximately 34% versus 17% in 12 h). In studies with oleic acid, storage of cellular cholesteryl esters in a liquid state was found to be dependent on the presence of triglycerides, and the rate at which these cells hydrolyzed cholesteryl esters was proportional to triglyceride levels. Cells exposed to either linoleic or linolenic acid hydrolyzed cholesteryl esters at the faster rate, but in contrast to findings with oleate and eicosadienoate, the storage of cholesteryl esters in a liquid state may also be a consequence of the modified fatty acyl composition of the cholesteryl esters themselves. Addition of a saturated fatty acid (palmitate) or a fatty acid with a trans-double bond (elaidate) to the cholesterol loading media had little effect on cellular triglyceride content, cholesteryl ester physical state, or the rate of cholesteryl ester clearance. PMID- 6501281 TI - Measurement of plasma membrane and mitochondrial potentials in sea urchin sperm. Changes upon activation and induction of the acrosome reaction. AB - The relationship between the plasma membrane potential and activation of sperm motility and respiration, or induction of the acrosome reaction, was explored in sperm of the sea urchin Strongylocentrotus purpuratus. Plasma and mitochondrial membrane potentials were estimated by measuring the uptake of [14C]thiocyanate ( [14C]SCN-) and [3H]tetraphenylphosphonium ( [3H]TPP+) in intact sperm and sperm made permeant with digitonin. Mitochondrial potentials up to-185 mV were found, consistent with data for TPP+ uptake into mitochondria from other cell types. Values for TPP+ uptake corrected for mitochondrial accumulation and estimates of SCN- uptake both indicated that the plasma membrane potential was about -30 mV for actively respiring sperm in seawater and about -60 mV for quiescent sperm in Na+-free seawater. Activation of sperm motility and respiration induced by Na+ increased the intracellular pH and caused a depolarization of both the plasma membrane and mitochondrial potentials. However, membrane potential depolarization did not occur when the activation was induced by increased extracellular pH or by the peptide speract, although activation was always linked to increased intracellular pH. The acrosome reaction, on the other hand, was always associated with sperm plasma membrane potential depolarization, whether it was induced by the physiological effector from the egg surface or by several artificial triggering regimens. Thus, activation of respiration and motility is primarily controlled by increased intracellular pH (Christen, R., Schackmann, R. W., and Shapiro, B. M. (1982) J. Biol. Chem. 257, 14881-14890), whereas the acrosome reaction also requires depolarization of the plasma membrane potential. PMID- 6501282 TI - Ricin B chain and discoidin I share a common primitive protein fold. AB - The galactoside-binding B chain of the cytotoxic protein ricin is apparently derived from a conservative exon-sized 40-residue peptide which is repeated four times in the molecule. A very similar peptide can also be seen in the amino acid sequence of the slime mold lectin discoidin I, which itself appears to be the product of a gene duplication. There is presently no chemical or structural evidence concerning the function of this peptide region. Nevertheless, the size of this unit, its prominence in the structure of ricin B chain, and its apparent conservation in carbohydrate-binding proteins from widely divergent organisms suggest that it may represent an extremely ancient galactoside-binding exon unit. PMID- 6501283 TI - The characterization of high-affinity binding sites in rat brain for the mast cell-degranulating peptide from bee venom using the purified monoiodinated peptide. AB - The preparation of a pure, monoiodinated derivative of mast cell-degranulating peptide (MCD peptide), the mast cell-degranulating peptide from bee venom, has enabled us to identify binding sites in rat brain membranes that have a high affinity and specificity for this peptide. These binding sites are evenly distributed throughout the brain and copurify with synaptic membranes. Saturation binding curves, determined by rapid centrifugation or filtration assays, indicate a single population of sites with a concentration of 200 fmol/mg membrane protein in partially fractionated, lysed brain membranes. Dissociation constants of 150 and 140 pM were calculated for the iodinated and native peptides, respectively. These binding sites are probably associated with the neurotoxic action of MCD peptide in the central nervous system. No similar binding sites have been identified in peripheral tissue preparations, and other polycationic mast cell degranulating agents including compound 48/80 show no such specificity. Specific modification of the primary amines, arginine residues, or disulfide bridges of MCD peptide results in a complete loss of binding activity. Other components of bee venom show specificity for the MCD peptide-binding site, suggesting that a class of neurotoxins in bee venom (possibly including secapin and tertiapin, but not apamin) share the specific action of MCD peptide on the central nervous system. PMID- 6501284 TI - The gene for the adenovirus 2 hexon polypeptide. AB - The nucleotide sequence of the gene for the adenovirus type 2 hexon has been determined. The hexon polypeptide consists of 967 amino acid residues and has a molecular weight of 109,058. Several tentative parts in the previously reported amino acid sequence were resolved from the DNA sequence. The existence of regions with unusual properties in the hexon protein was confirmed, including a region consisting of 16 consecutive acidic residues in the N-terminal part of the protein. In conjunction with previously published sequences and sequences reported in the accompanying papers (Alestrom, P., Akusjarvi, G., Lager, M., Yeh Kai, L., and Petterson, U. (1984) J. Biol. Chem. 259, 13980-13985; Roberts, R. J., O'Neill, K. E., and Yen, C. E. (1984) J. Biol. Chem. 259, 13965-13975) a complete sequence of the 35,937-base pairs-long adenovirus type 2 genome can now be reconstructed. PMID- 6501285 TI - The adsorption of prothrombin to phospholipid monolayers quantitated by ellipsometry. AB - We investigated by means of an automated ellipsometer the calcium-dependent binding of prothrombin from a buffer solution to monolayers of dioleoylphosphatidylserine (DOPS) and dioleoylphosphatidylcholine (DOPC) deposited on chromium slides. This technique allows direct measurements of bound and free protein concentrations and is not hampered by calcium-induced aggregation of vesicles. For pure DOPS a dominant class of binding sites exists with a dissociation constant, Kd = (6 +/- 2) X 10(-10) M (mean +/- S.D.) and maximal binding of prothrombin, gamma max = 0.26 +/- 0.03 micrograms/cm2. Incorporation of a small fraction of DOPC in the monolayer causes a large decrease in the binding affinity with a pronounced biphasic behavior of the binding curve. For monolayers consisting of 20% DOPS and 80% DOPC the binding curve becomes monophasic with Kd = (1.6 +/- 0.6) X 10(-7) M and gamma max = 0.22 +/- 0.03 micrograms/cm2. The procoagulant activity of the monolayers was tested by measuring the generation of thrombin after addition of prothrombin and activated coagulation factors X and V. The thrombin-generating capacity of monolayers and single-bilayer vesicles is comparable but is apparently diffusion limited in the monolayer system. The calcium-dependent formation of stacked multilayers according to the Blodgett technique appeared to be strongly influenced by the DOPS/DOPC ratio in the phospholipid monolayer. From these results it is concluded that for pure DOPS monolayers high-affinity prothrombin phospholipid and phospholipid-phospholipid interactions exist which are radically disturbed when the monolayer contains more than 20-30% of DOPC. PMID- 6501286 TI - Interaction of charged amphiphiles with Na+-Ca2+ exchange in cardiac sarcolemmal vesicles. AB - We have investigated the interaction of several charged amphiphiles with the Na+ Ca2+ exchange mechanism in a highly purified preparation of canine cardiac sarcolemmal vesicles. In all cases, the hydrophobic part of the molecule was an unbranched alkyl group. All anionic lauryl derivatives stimulated (by up to 100%) the initial rate of Na+-Ca2+ exchange in the order lauryl sulfate greater than dodecyl sulfonate greater than lauric acid. All cationic lauryl derivatives (dodecylamine, dodecyltrimethylamine, laurylcholine) were potent inhibitors of Na+-Ca2+ exchange (approximately 50% at 20 microM amphiphile). The effects of the charged amphiphiles on Na+-Ca2+ exchange were not secondary to altered passive ion permeabilities or to altered membrane surface potential. The anionic compound lauryl sulfate stimulated sarcolemmal Na+-Ca2+ exchange activity by increasing the apparent affinity of the exchanger for Ca2+. In contrast, cationic dodecylamine did not change the apparent Km (Ca2+) and acted as a noncompetitive inhibitor of Na+-Ca2+ exchange. The effectiveness of the amphiphiles could be varied by altering the length of the alkyl chain. The more hydrophobic the molecule (i.e. the longer the alkyl chain), the more potent was the stimulation or inhibition of Na+-Ca2+ exchange. This implies that the amphiphiles most probably become embedded in the membrane lipid bilayer to exert effects on Na+ Ca2+ exchange. The Na+-Ca2+ exchange mechanism is more sensitive to the charged amphiphiles than are other sarcolemmal transport mechanisms. We have previously suggested (Philipson, K. D., and Nishimoto, A. Y. (1984) J. Biol. Chem. 259, 16 19) that negatively charged phospholipids could stimulate Na+-Ca2+ exchange activity. We propose that the charged amphiphiles modulate Na+-Ca2+ exchange activity by acting as phospholipid analogues. The amphiphiles are useful tools for studying the interaction of the Na+-Ca2+ exchange mechanism with the lipid bilayer. PMID- 6501287 TI - Allosteric activation of rat liver microsomal 3-hydroxy-3-methylglutaryl coenzyme A reductase by nicotinamide adenine dinucleotides. AB - NADH and NAD+ are neither substrates nor inhibitors of 3-hydroxy3-methylglutaryl coenzyme A (HMG-CoA) reductase in concentrations up to 1 mM. Addition of either NADH or NAD+ enhanced the activity of rat liver microsomal reductase, yet NADH failed to affect the activity of the freeze-thaw solubilized enzyme. The degree of enhancement of enzyme activity by NADH decreased as GSH concentration in the assay increased. Addition of 500 microM NADH to the assay converted the sigmoidal (Hill coefficient = 2.0) NADPH-dependent kinetic curve of the microsomal reductase into Michaelis-Menten kinetics (Hill coefficient = 1.1). Furthermore, the kinetic curves were shifted to the left, resulting in an up to 35% decrease in the concentration of NADH required to obtain half-maximal velocity (S0.5) in the presence of 500 microM NADH. Again, this effect of NADH was diminished as GSH concentrations increased. These results demonstrate that NAD(H) is an allosteric activator of HMG-CoA reductase. These results also indicate that HMG-CoA reductase has NAD(H) binding site(s) distinct from the catalytic NADPH site(s). PMID- 6501288 TI - Destruction of acetylcholine receptor by decaying 125I-alpha-bungarotoxin. AB - Decay of 125I in 125I-alpha-bungarotoxin bound to detergent-solubilized acetylcholine receptor from Torpedo californica electric tissue results in the inactivation of virtually all of the directly occupied and of the second toxin binding sites. This finding establishes the usefulness of 125I-labeled ligands for binding-site multiplicity analysis of proteins. PMID- 6501289 TI - Effect of base sequence on in vitro protein-chain termination. AB - It has been proposed that the sequences surrounding nonsense codons determine the efficiency of protein-chain termination. To test this hypothesis, the termination factor, RF-1, was purified to near homogeneity and was used to examine the specificity of in vitro prokaryotic termination as a function of the nature and number of bases adjacent to UAA. Oligomers with different nucleotide sequences surrounding UAA were synthesized and their conformation was analyzed by NMR spectroscopy. The activity of these oligomers in RF-1-dependent termination was assayed by the release of analogues of peptides, N-acetyl or N-formyl-methionine, that were bound to ribosomes as N-acetyl or N-formyl-Met-tRNAfMet with either AUG or AUG covalently linked to another oligoribonucleotide. In the former case, a second oligomer was added to stimulate release. When added to the AUG-bound intermediate, UAAUAA was 5-fold less effective in stimulating release of N-acetyl Met by RF-1 than were UAA, UAAN (where N is any base), UAAUGA, or UAAUAG. Oligomers AUGUAA, AUGUUAA, and AUG(U)mUAA18-25 (where m = 1-5) stimulated release by RF-1, whereas AUGCUA, AUGCUAA, and other control polymers were inactive. The data suggest that recognition of UAA depends, at least in part, on the nature of the bases surrounding UAA. A loosely stacked conformation of UAA in the short messengers favors termination, whereas nucleosides which encourage strong base stacking restrict release. PMID- 6501290 TI - Tropomyosin heterogeneity in human cells. AB - Tropomyosin preparations from human platelets, human peripheral blood leukocytes from normal individuals and from a patient with chronic lymphocytic leukemia, human lymphoblastoid cells (GM607), human epithelial cells, and human skin fibroblasts have all been found to contain more than one protein when analyzed by two-dimensional gel electrophoresis. Although the lymphoid cell preparations consistently contain two proteins of almost identical molecular weight (Mr = 30,000), the platelet, epithelial cell, and fibroblast preparations contain two or more major proteins with molecular weights between 31,000 and 36,000, in addition to a major protein at 30,000. All of these proteins have characteristics in common with tropomyosin including slightly acidic isoelectric point (approximately pH 4), stability to heat and organic solvents, association with the cytoskeleton, and reactivity with antibody against skeletal muscle tropomyosin. The nonmuscle tropomyosin-like proteins were compared with tropomysins from human skeletal, cardiac, and smooth muscle by peptide mapping after partial proteolysis. The results showed one of the non-muscle proteins to be identical to the major smooth muscle tropomyosin in human uterus (myometrium) and another to be similar but not identical to skeletal muscle alpha-tropomyosin. The remainder of the proteins with tropomyosin characteristics was unique to non muscle cells. In all, nine distinct human proteins with characteristics of tropomyosin are described. Charge variants of two of these proteins have been described previously. PMID- 6501292 TI - Anaerobic expression of maize fructose-1,6-diphosphate aldolase. AB - The anaerobic proteins of maize are a set of 10 major and 10 minor polypeptides selectively synthesized in anaerobic seedling roots. 1) Anaerobiosis resulted in the selected labeling of a protein which bound to Blue Sepharose and was eluted by fructose 1,6-diphosphate. 2) This protein elicited antiserum which recognized a single protein with molecular weight of approximately 40,000. 3) By Western blot analysis, this antiserum recognized a maize fructose-1,6-diphosphate aldolase purified to homogeneity. We show that two major anaerobic proteins of maize, ANP35.5 and ANP33A, correspond to a cytoplasmic fructose-1,6-diphosphate aldolase. PMID- 6501291 TI - Human placenta type V collagens. Evidence for the existence of an alpha 1(V) alpha 2(V) alpha 3(V) collagen molecule. AB - Human type V collagen was purified from placenta and found to contain alpha 1(V), alpha 2(V), and alpha 3(V) chains in varying ratios. Using any of three independent nondenaturing methods (phosphocellulose chromatography, high performance ion-exchange chromatography on IEX-540 DEAE, and ammonium sulfate precipitation), this preparation could be resolved into two fractions. Analysis of the two fractions by sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicated that one fraction contained alpha 1(V) and alpha 2(V) in a 2:1 ratio and the other contained alpha 1(V), alpha 2(V), and alpha 3(V) in a 1:1:1 ratio. When the crude placental type V collagen was electrophoresed under nondenaturing conditions, two bands were observed, one co-migrating with purified (alpha 1(V]2 alpha 2(V) and the other co-migrating with the fractions containing alpha 1(V), alpha 2(V), and alpha 3(V) chains in a 1:1:1 ratio. Electrophoresis in a second dimension under denaturing conditions confirmed that the fast-migrating band contained (alpha 1(V]2 alpha 2(V) and that the slow-migrating band contained the three chains in equimolar ratio. CD spectra of the two fractions and resistance to trypsin-chymotrypsin digestion confirmed that the two fractions contain triple helical collagen. Thermal denaturations were monitored by the changes in CD signal at 221 nm. The two fractions purified by ammonium sulfate precipitation melted at 39.1 and 36.4 degrees C for the (alpha 1(V]2 alpha 2(V) and alpha 1(V) alpha 2(V) alpha 3(V) fractions, respectively. Trypsin cleavage of these two native fractions at temperatures near melting produced completely different fragmentation patterns, indicating different partial unwinding sites of the alpha 1(V) and alpha 2(V) chains in the two preparations and thus different molecular assemblies. Our data demonstrate the existence of two different molecular assemblies of type V collagen in human placenta consisting of (alpha 1(V]2 alpha 2(V) and alpha 1(V) alpha 2(V) alpha 3(V) heterotrimers. PMID- 6501293 TI - Localization of the active site and phosphorylation site of Acanthamoeba myosins IA and IB. AB - The 130- and 125-kDa heavy chains of Acanthamoeba myosins IA and IB were radioactively labeled at either the regulatory phosphorylation site or the catalytic site and then subjected to controlled proteolysis by either trypsin or chymotrypsin. The labeled and unlabeled peptides generated during the course of proteolysis were identified by autoradiography and Coomassie Blue staining after separation by electrophoresis on sodium dodecyl sulfate-polyacrylamide gels. The relative positions of the phosphorylation and active sites could be deduced. The catalytic site of myosin IA is most probably within 38 kDa of one end of the 130 kDa heavy chain, and the phosphorylation site, which can be no more than 40 kDa away from the catalytic site, would then be between 38 and 78 kDa of that same end of the heavy chain. Possibly, the phosphorylation site is further restricted to the region between 38 and 64 kDa from the end of the heavy chain. The catalytic and phosphorylation sites of myosin IB are both contained within a segment of 62 kDa at one end of the 125-kDa heavy chain and are within 40 kDa of each other. The phosphorylation site may be restricted to a small segment between 60 and 62 kDa from one end of the heavy chain which would limit the possible position of the catalytic site to the region between 20 and 60 kDa of that end. PMID- 6501294 TI - Localization of a light-chain binding site on smooth muscle myosin revealed by light-chain overlay of sodium dodecyl sulfate-polyacrylamide electrophoretic gels. AB - The interactions of smooth muscle myosin and its light chains have been examined by incubating sodium dodecyl sulfate-polyacrylamide gels of myosin with radioactively labeled regulatory or essential light chains. The technique involves sodium dodecyl sulfate-polyacrylamide gel electrophoresis and fixation with methanol and acetic acid followed by an extensive series of washes. The gel is incubated overnight with labeled light chains in the presence of bovine serum albumin and then washed extensively to remove unbound protein. Following staining and destaining, the gel is autoradiographed to reveal which protein bands have bound light chain. The myosin heavy chain was able to rebind labeled regulatory or essential light chains despite the harsh procedure described above. By fragmenting the myosin heavy chain proteolytically, we were able to determine the binding site for both types of light chains to be within the 26,000-Da COOH terminal segment of smooth muscle subfragment 1 (S-1) or the 20,000-Da COOH terminal segment of skeletal muscle S-1. The extent of binding was 0.1-0.4 mol of light chain/mol of S-1 heavy chain. No binding was observed to portions of the myosin molecule which do not contain this segment such as myosin rod, light meromyosin, S-2, or the NH2-terminal 75,000-Da segment of S-1. PMID- 6501295 TI - The distribution of H1 histone is nonuniform in chromatin and correlates with different degrees of condensation. AB - Salt induces aggregation of large chromatin fragments maximally at 150-200 mM NaCl. The soluble fragments are depleted of H1 histones while the aggregated fragments are enriched. H1 histones did not equilibrate between the soluble and insoluble chromatin fractions when they were recycled through the process of salt induced aggregation. The chromatin fragments that resisted aggregation retained more H1c subtype than they did H1 ab, correlating with previous results which showed complexes of H1c with DNA resisted salt-induced aggregation much more than complexes of DNA with other subtypes. The chromatin that was soluble at physiological concentrations of NaCl was DNase I sensitive and enriched in acetylated core histones. We conclude that H1 histone is nonuniformly distributed in chromatin in a stable pattern that probably correlates with the different degrees of condensation known to exist in vivo. PMID- 6501296 TI - Gamma-carboxyglutamate in a neuroactive toxin. AB - The venom of a fish-hunting cone snail (Conus geographus) contains a novel toxin, the "sleeper" peptide, which induces a sleep-like state in mice when injected intracerebrally. We demonstrate that this peptide contains 5 mol of gamma carboxyglutamate (Gla) in 17 amino acids. The amino acid sequence of the sleeper peptide is Gly-Glu-Gla-Gla-Leu-Gln-Gla-Asn-Gln-Gla-Leu-Ile-Arg-Gla-Lys-Ser-Asn NH2. PMID- 6501297 TI - Identity of acyl group conformations in the active sites of papain and cathepsin B by resonance Raman spectroscopy. AB - Resonance Raman spectroscopic data provide conclusive evidence for the existence of an acyl-enzyme intermediate during the reaction of a thionoester substrate, N methyloxycarbonylphenylalanylglycine methyl thionoester (CH3OC(=O)-Phe-NHCH2C(=S) OCH3), with cathepsin B from porcine spleen. The resonance Raman spectrum of CH3OC(=O)-Phe-NHCH2C(=S)S-cathepsin B, where the thiol S is from the active-site cysteine residue, is compared to that of the corresponding papain acyl-enzyme. Within the limits of experimental error (+/-2 cm-1 for peak positions), there are no detectable spectral differences. Since the resonance Raman spectrum is sensitive to the torsional angles in the glycinic bonds and the cysteine linkages, the conformations are identical in those parts of the acyl-enzymes where chemical transformation occurs. A conformational analysis of the model compound CH3OC(=O)-Phe-NHCH2C(=S)SC2H5 demonstrates that the dithioacyl group in both dithioacyl-enzymes is present as a single population of a form known as conformer B. Conformer B is characterized by a small torsional angle about the glycinic NHCH2-CS(thiol) bond such that the nitrogen and S (thiol) atoms are in close contact. This conformer is widespread among the dithioacyl intermediates of plant cysteine proteinases, and it is apparent that the same chemistry is retained in a mammalian cysteine proteinase. Steady-state kinetic parameters are also reported for CH3OC(=O)-Phe-NHCH2C(=S)OCH3 reacting with papain and cathepsin B. The similarity of the Kcat values, 0.53 and 1.15 s-1, for papain and cathepsin B, respectively, provides further evidence for a conserved deacylation process. PMID- 6501298 TI - Actin and tropomyosin variants in smooth muscles. Dependence on tissue type. AB - Actin was found to be the major source of myofibrillar protein heterogeneity in smooth muscles. Three isoelectric variants, alpha-smooth muscle (alpha-SM), beta non-muscle (beta-NM), and gamma-actins (gamma-SM and gamma-NM) were measured in 15 different smooth muscles, alpha-SM and gamma-actin contents displayed an inverse relationship in a given smooth muscle, some of which contained primarily alpha-SM actin while gamma-actins dominated in others. alpha-SM actin and gamma actin distributions were tissue-specific, independent of species. A greater proportion of alpha-SM actin appears to be associated with tissues having a high degree of tonic activity. beta-Nonmuscle actin was a significant, and relatively constant, component of all smooth muscle tissues. The high NM-actin content of these tissues may reflect the importance of proliferative, synthetic, or secretory activities in smooth muscle, because the alpha-SM actin disappeared in tissue culture with a time course paralleling the modulation of phenotype from a contractile to a proliferative cell. Two tropomyosin subunits were present in approximately equal amounts in all smooth muscle tissues studied. One tropomyosin subunit exhibited identical mobility on two-dimensional gel electrophoresis, while the other was characterized by some species-specific variation which was unrelated to actin variant distribution. No variants of the 20,000-dalton regulatory light chain of myosin were observed. These results suggest that SM specific actin variants are associated with functional diversity among smooth muscles. PMID- 6501299 TI - Novel reactivity of cytochrome P-450-CAM. Methyl hydroxylation of 5,5 difluorocamphor. AB - The interaction of the camphor hydroxylating P-450 isolated from Pseudomonas putida grown on camphor (P-450-CAM) with 5,5-difluorocamphor, a substrate analog in which the two methylene hydrogens at the normal site of hydroxylation have been replaced with fluorine, has been examined. This compound binds tightly to the enzyme with a dissociation constant and UV-visible absorption spectrum identical to that observed with d-camphor. In the presence of the reconstituted P 450-CAM system, 5,5-difluorocamphor is metabolized at a rate approximately one third the rate of the physiological substrate, d-camphor, resulting in the formation of a hydroxylated product with a molecular weight of 204 as well as a minor (less than 3%) hydroxylated product of molecular weight 184. Isotopically labeled molecular oxygen (18O2) is incorporated into the major product while labeled oxygen from water (H218O) is not incorporated, clearly indicating that the hydroxyl oxygen originates from dioxygen. Proton NMR characterization (400 MHz) of the major product has led to its assignment as 5,5-difluoro-9-hydroxy camphor, with supporting structural evidence provided by the mass spectral fragmentation pattern. The formation of 9-hydroxylated product represents the first example of methyl hydroxylation catalyzed by cytochrome P-450-CAM, indicates a change in regio-selectivity when the normal site of reaction is blocked, and supports the hypothesis that the delivery of the oxygen atom occurs from the exo side of the camphor molecule. PMID- 6501300 TI - Ultrasensitivity in biochemical systems controlled by covalent modification. Interplay between zero-order and multistep effects. AB - A previous analysis of covalent modification systems (Goldbeter, A., and Koshland, D. E., Jr. (1981) Proc. Natl. Acad. Sci. U. S. A. 78, 6840-6844) showed that steep transitions in the amount of modified protein can occur when the converter enzymes are saturated by their protein substrate. This "zero-order ultrasensitivity" can further be amplified when an effector acts at more than one step in a monocyclic or multicyclic cascade of covalent modification. We analyze the limitations of the latter "multistep ultrasensitivity" and show how it can combine with the zero-order effect to enhance the sensitivity of biochemical systems controlled by covalent modification. PMID- 6501301 TI - Molecular structure of trimethylamine dehydrogenase from the bacterium W3A1 at 6.0-A resolution. AB - An electron density map of trimethylamine dehydrogenase has been calculated at 6.0-A resolution. Protein phases were based on two isomorphous mercury derivatives with similar binding properties, and on anomalous scattering measurements. The map has been averaged about the noncrystallographic 2-fold axis, plotted on transparent sheets and used to construct a wooden model. The elipsoidal dimer has a large inter-subunit interface. Each subunit appears to contain three closely associated domains with the iron-sulfur cluster located between two of them. The map suggests an alpha/beta-structure for two of the domains and a large helix content for the third. PMID- 6501302 TI - DARPP-32, a dopamine- and adenosine 3':5'-monophosphate-regulated neuronal phosphoprotein. I. Amino acid sequence around the phosphorylated threonine. AB - DARPP-32 (dopamine- and cyclic AMP-regulated phosphoprotein, Mr = 32,000) is a major endogenous cytosolic substrate for dopamine- and cyclic AMP-stimulated protein phosphorylation in neurons of the basal ganglia of mammalian brain. It shares many properties with phosphatase inhibitor 1, a substrate for cyclic AMP dependent protein kinase, and with G-substrate, a substrate for cyclic GMP dependent protein kinase. We have, therefore, undertaken an analysis of the amino acid sequence around the site at which purified DARPP-32 is phosphorylated by the catalytic subunit of cyclic AMP-dependent protein kinase. The results indicate that DARPP-32 is phosphorylated at a single threonine residue contained in the sequence Arg-Arg-Arg-Pro-Thr(P)-Pro-Ala-Met-Leu-Phe-Arg. This sequence was obtained by automated solid phase sequencing of two overlapping tryptic phosphopeptides and one overlapping chymotryptic phosphopeptide which were purified by reverse-phase high-performance liquid chromatography. A 9-amino acid sequence containing the phosphorylatable threonine residue in DARPP-32 shares 8 identical residues with a sequence containing the phosphorylatable threonine residue in phosphatase inhibitor 1, and shares 5 identical residues with the two identical sequences surrounding the 2 phosphorylatable threonine residues in G substrate. These observations support the view that DARPP-32, inhibitor 1, and G substrate are members of a family of regulatory proteins which are involved in the control of protein phosphatase activity by both cyclic AMP and cyclic GMP, but which differ in their cellular and tissue distributions. PMID- 6501303 TI - DARPP-32, a dopamine- and adenosine 3':5'-monophosphate-regulated neuronal phosphoprotein. II. Comparison of the kinetics of phosphorylation of DARPP-32 and phosphatase inhibitor 1. AB - DARPP-32 (dopamine- and cyclic AMP-regulated phosphoprotein, Mr = 32,000) is a cytosolic neuronal phosphoprotein enriched in dopamine-innervated brain regions which, in its phosphorylated form, acts as an inhibitor of protein phosphatase 1. We have compared the phosphorylation of purified DARPP-32 with that of purified phosphatase inhibitor 1, a widespread inhibitor of protein phosphatase 1. Purified cyclic AMP-dependent protein kinase and cyclic GMP-dependent protein kinase each catalyzed the maximal incorporation of 0.9-1.1 mol of [32P]phosphate/mol of DARPP-32 or phosphatase inhibitor 1, with phosphorylation occurring on threonine residues. Evidence for the existence of a single phosphorylation site in each substrate protein was obtained by two-dimensional thin-layer phosphopeptide mapping of thermolytic digests. Initial rate studies of the phosphorylation of DARPP-32 yielded an apparent Km of 2.4 microM and a kcat of 2.7 S-1 for the catalytic subunit of cyclic AMP-dependent protein kinase, and an apparent Km of 5.4 microM and a kcat of 2.3 S-1 for cyclic GMP-dependent protein kinase. These in vitro results are compatible with a physiological role for the phosphorylation of DARPP-32 by either protein kinase in vivo. Similar studies with phosphatase inhibitor 1 yielded an apparent Km of 5.0 microM and a kcat of 1.4 S-1 for the catalytic subunit of cyclic AMP-dependent protein kinase, and an apparent Km of 25.0 microM and a kcat of 1.2 S-1 for cyclic GMP-dependent protein kinase. A synthetic nonapeptide, corresponding to the phosphorylation site of DARPP-32, was phosphorylated with apparent Km values of 1.12 mM and 1.86 mM and kcat values of 0.22 S-1 and 3.4 S-1 for cyclic AMP-dependent and cyclic GMP-dependent protein kinase, respectively. PMID- 6501304 TI - Renal glutathione transport. Characteristics of the sodium-dependent system in the basal-lateral membrane. AB - Na+-dependent GSH transport in basal-lateral membrane vesicles from rat kidney exhibited saturation kinetics while Na+-independent flux increased linearly up to 10 mM GSH. Inhibitor studies showed that GSH transport was not dependent upon the catalytic activity of gamma-glutamyltransferase. K+, choline and NH+4 ions did not stimulate GSH transport, but Li+ partially substituted for Na+. Na+-dependent GSH transport was inhibited by other gamma-glutamyl amino acids. The membrane also showed Na+-dependent transport of glutathione disulfide (GSSG) and gamma glutamylglutamate. These results show that specificity resides in the gamma glutamyl moiety and suggest that this system may be a general transport system for gamma-glutamyl compounds. Results from four types of experiments showed that Na+-dependent GSH transport was electrogenic. Transport was stimulated by negative and inhibited by positive valinomycin-induced K+ diffusion potentials; the transport rate was influenced by the anion component of the Na+ salt in the order NaSCN greater than NaCl greater than Na2SO4; analysis of the Na+ concentration dependence indicated coupling of at least 2 Na+/GSH; comparison of GSH-dependent Na+ transport and Na+-dependent GSH transport gave a Na+:GSH stoichiometry of 2:1. Thus, energy is coupled to the transport of GSH in the form of the cellular Na+ gradient and the membrane potential. This system, if it functions in vivo, can act as a mechanism for extraction of GSH from the renal circulation. PMID- 6501305 TI - Dimer-monomer dissociation of human hemoglobin A. AB - Isolated 3H-labeled human hemoglobin alpha chains were incubated with unlabeled carbonmonoxyhemoglobin A for 72 h in 0.01 M potassium phosphate, pH 7.0, at 25 degrees C. Following separation of the free alpha chain monomers and Hb A (alpha 2 beta 2) tetramers by electrophoresis on cellulose acetate strips or by chromatography on DEAE-cellulose columns, analysis of radioactivity showed a slow transfer of 3H-labeled alpha chains into Hb A. Separation of the globin chains of the isolated [3H] Hb A on a CM-cellulose column in 8 M urea showed that the radioactivity was in structurally intact alpha chains. Gel filtration of a reaction mixture on Sephadex G-75 in the presence of 0.15 M NaCl showed that the 3H-labeled alpha-chains in Hb A were an integral part of, and not nonspecifically adsorbed to, the tetramer. These results indicate that the free 3H-labeled alpha chain monomers were incorporated into Hb A by exchange with pre-existing unlabeled alpha chain subunits according to the scheme, alpha 2 beta 2 in equilibrium 2 alpha beta in equilibrium 2 alpha + 2 beta. The rate constant for the dissociation of alpha beta dimers to alpha and beta monomers, the rate limiting step in this exchange reaction, was 4.0 (+/- 0.7) X 10(-3) h-1. PMID- 6501306 TI - The regulation of acetoacetyl-CoA synthetase activity by modulators of cholesterol synthesis in vivo and the utilization of acetoacetate for cholesterogenesis. AB - [3-14C]Acetoacetate, injected subcutaneously into rats, was rapidly incorporated into hepatic cholesterol and fatty acids. Injection of radiolabeled acetoacetate, acetate, or glucose resulted in the preferential incorporation of acetoacetate into cholesterol. The postmitochondrial supernatant of a rat liver homogenate has the capacity to synthesize radiolabeled sterols from [3-14C]acetoacetate, and this capacity surpasses its capacity to utilize [1-14C]acetate. The activity of acetoacetyl-CoA synthetase, a cytoplasmic enzyme that activates acetoacetate, was found to be highly regulated by modulators known to affect the activity of 3 hydroxy-3-methylglutaryl-CoA reductase and/or cholesterol biosynthesis in liver and adrenals of adult rats. Acetoacetyl-CoA synthetase activity was depressed by feeding cholesterol or mevalonate administration and was enhanced by the addition to the diet of mevinolin and/or cholestyramine. The activity of acetoacetyl-CoA synthetase in adrenals was enhanced by treatment of the animals with 4 aminopyrazolopyrimidine. These changes in activity of acetoacetyl-CoA synthetase were in synchrony with changes in the activities of 3-hydroxy-3-methylglutaryl CoA synthase and 3-hydroxy-3-methylglutaryl-CoA reductase. The evidence suggests that the regulation of acetoacetyl-CoA synthetase activity and the utilization of acetoacetate for lipogenesis is closely linked to the regulation of cholesterogenesis. PMID- 6501307 TI - The molecular species distribution of platelet-activating factor synthesized by rabbit and human neutrophils. AB - In this study, the molecular species distribution of 1-O-alkyl-2-acetyl-sn glycero-3-phosphocholine (platelet-activating factor) synthesized by rabbit peritoneal and human peripheral neutrophils was examined. Radiolabeled platelet activating factor synthesized from [3H]acetate by neutrophils stimulated with ionophore A23187, opsonized zymosan, or N-formyl-methionyl-leucyl-phenylalanine was separated into the individual molecular species on the basis of length and degree of unsaturation of the 1-O-alkyl chain using reverse-phase high performance liquid chromatography. The predominant alkyl chains in the labeled platelet-activating factor synthesized by ionophore- or zymosan-stimulated rabbit cells were 15:0 (4%), 16:0 (43%), 18:0 (11%), and 18:1 (26%). This is in contrast to the alkyl chain distribution of the widely accepted precursor of platelet activating factor, 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine, present in the cell. The major alkyl chains contained in the labeled platelet-activating factor synthesized by ionophore-, zymosan-, or N-formyl-methionyl-leucyl-phenylalanine stimulated human neutrophils were 16:0 (40%), 17:0 (8 and 5%; two isomers), 18:0 (16%), and 18:1 (18%). As found with the rabbit cells, this distribution differs from the alkyl chain content of 1-O-alkyl-2-acyl-sn-glycero-3-phosphocholine in human neutrophils, which contains less than 1% of each 17:0 isomer. We demonstrate here that the platelet-activating factor synthesized by rabbit peritoneal and human peripheral polymorphonuclear neutrophils is heterogeneous and that some selectivity exists in the choice of the 1-O-alkyl-2-acyl-sn-glycero 3-phosphocholine precursor for platelet-activating factor synthesis in these cells. It also appears that the molecular species distribution of platelet activating factor is independent of the stimulus used to elicit its synthesis. PMID- 6501308 TI - The activation of rat liver phenylalanine hydroxylase by limited proteolysis, lysolecithin, and tocopherol phosphate. Changes in conformation and catalytic properties. AB - Pure phenylalanine hydroxylase from rat liver can be activated by limited proteolysis with alpha-chymotrypsin. As with most other types of activation of this enzyme, including activation by exposure to lysolecithin, the increase in activity is expressed in the presence of the naturally occurring pterin cofactor, tetrahydrobiopterin, but not in the presence of synthetic pterin cofactors such as 6-methyltetrahydropterin. With the chymotrypsin-activated enzyme, we have demonstrated directly, using circular dichroism measurements, that the activated enzyme differs in conformation from the native enzyme. In addition to chymotrypsin, trypsin and a mixture of rat liver lysosomal proteases can also activate phenylalanine hydroxylase. The latter finding raises the possibility that activation of the enzyme by limited proteolysis may be a physiologically important process. In experiments carried out with phenylalanine in which all five hydrogens on the aromatic ring have been replaced with deuterium, and in the presence of tetrahydrobiopterin, we have been unable to detect a kinetic isotope effect with either the native hydroxylase or with the hydroxylase activated by limited proteolysis, or by exposure to lysolecithin. By contrast, with both native and activated enzymes, a small isotope effect was detected when 6 methyltetrahydropterin was used as the pterin cofactor. PMID- 6501309 TI - Sodium-dependent transport of inorganic sulfate by rabbit renal brush-border membrane vesicles. Effects of other ions. AB - A Na+ gradient (extravesicular greater than intravesicular) increased the rate of inorganic sulfate (SO24-) uptake into renal brush-border membrane vesicles and energized the transient accumulation of the anion against its concentration gradient, indicating a secondary active transport system. Stimulation of SO24- uptake was specific for Na+. The anions, SO23-, S2O23-, SeO24-, MoO24-, CrO24-, and WO24-, but not HPO24-, cis-inhibited and trans-stimulated SO24- uptake, suggesting that these divalent anions shared the SO24- carrier. The Na+/SO24- co transport and Na+. The apparent Km for SO24- was 0.6 mM at 100 mM Na+. The relationship between Na+ concentration and rate of SO24- uptake was sigmoidal. From a Hill analysis of the data a [Na+]0.5 of 36 mM and an n value of 1.6 were calculated. Comparisons of the effects of a K+ diffusion potential (inside positive), of a H+ diffusion potential (inside negative), of Na+ salts of anions of different conductances on the Na+-dependent uptakes of SO24- and D-glucose, and of the responses of a membrane potential-sensitive fluorescent probe concomitant with the uptakes indicate that Na+/SO24- co-transport was electroneutral. The simplest stoichiometry consistent with an electroneutral mechanism would be the co-transport of two Na+ and one SO24-. Na+ gradient dependent SO24- uptake was enhanced by intravesicular Cl-. cis-Cl- inhibited the efflux as well as the influx of SO24-. These findings suggest that Cl- was an inhibitor of SO24- transport. Intravesicular K+ stimulated Na+ gradient-dependent SO24- uptake. The co-transport of Na+/SO24- appeared not to be coupled to the transmembrane flux of K+. It is hypothesized that the co-transport system contained an internal site activated by K+. PMID- 6501310 TI - A prostaglandin omega-hydroxylase cytochrome P-450 (P-450PG-omega) purified from lungs of pregnant rabbits. AB - Cytochrome P-450-dependent prostaglandin omega-hydroxylation is induced over 100 fold during late gestation in rabbit pulmonary microsomes (Powell, W.S. (1978) J. Biol. Chem. 253, 6711-6716). Purification of cytochromes P-450 from lung microsomes of pregnant rabbits yielded three fractions. Two of these fractions correspond to rabbit lung P-450I (LM2) and P-450II (LM5), which together constitute 70-97% of total cytochrome P-450 in lung microsomes from nonpregnant rabbits. The third form, which we designate rabbit cytochrome P-450PG-omega, regioselectively hydroxylates prostaglandins at the omega-position in reconstituted systems with a turnover of 1-5 min-1. Titration with purified pig liver cytochrome b5, demonstrated a 4-fold maximum stimulation at a cytochrome b5 to a P-450 molar ratio of 1-2. Rabbit lung P-450PG-omega formed a typical type I binding spectrum upon the addition of prostaglandin E1 with a calculated K8 of 1 microM, which agreed reasonably well with the kinetically calculated Km of 3 microM. Cytochrome P-450PG-omega was isolated as a low-spin isozyme with a lambda max (450 nm) in the CO-difference spectrum distinguishable from P-450I (451 nm) and P-450II (449 nm). Sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis demonstrated that although purified P-450PG-omega had a relatively low specific content (12.1 nmol mg-1), it appeared homogeneous with a calculated minimum Mr of 56,000, intermediate between rabbit LM4 and LM6. When lung microsomes from pregnant and nonpregnant rabbit were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, a protein band, with a Mr identical to P-450PG-omega, was observed in the pregnant rabbit, whereas this band appeared to be very faint or absent in microsomes from the nonpregnant rabbit. Purification of cytochromes P-450 from nonpregnant rabbit lung yielded only P-450I and P-450II. P-450PG-omega appears to be a novel rabbit P-450, possessing high activity towards omega-hydroxylation of prostaglandins, and is greatly induced during pregnancy in rabbit lung. PMID- 6501311 TI - Genetic analysis of adenine metabolism in Leishmania donovani promastigotes. Evidence for diploidy at the adenine phosphoribosyltransferase locus. AB - Mutant promastigotes of Leishmania donovani deficient in adenine phosphoribosyltransferase (AP-Rib transferase) have been isolated in medium containing 4-aminopyrazolopyrimidine. The generation of AP-Rib transferase deficient mutants occurred in two discrete steps. In the first step, clones were isolated with 50% of wild-type levels of AP-Rib transferase activity. These cells were reselected, and colonies totally deficient in AP-Rib transferase were isolated. Wild-type and AP-Rib transferase-deficient cells contained equivalent amounts of other enzymes essential to adenine metabolism such as adenine deaminase and hypoxanthine-guanine phosphoribosyltransferase. Partially and totally AP-Rib transferase-deficient cells exhibited intermediate and complete resistance to cytotoxic adenine analogs, respectively. Nevertheless, wild-type and mutant cells could salvage adenine and utilize adenine as a purine source equally efficiently, suggesting that the adenine deaminase-hypoxanthine-guanine phosphoribosyl-transferase pathway plays an important role in promastigote adenine metabolism. Kinetic and thermal inactivation studies of purified AP-Rib transferase and isoelectric focusing of crude extracts from wild-type and partially AP-Rib transferase-deficient cells suggested that the latter cells possessed wild-type AP-Rib transferase activity at half the amount found in wild type parental cells. These data suggest that L. donovani possesses two copies of the AP-Rib transferase structural gene and that these organisms might be diploid for the AP-Rib transferase locus. PMID- 6501312 TI - Transfer of cholesterol from its site of synthesis to the plasma membrane. AB - We have followed the transfer of newly synthesized cholesterol to the plasma membrane in cultured fibroblasts using cholesterol oxidase as a probe. Since the enzyme has access only to the plasma membrane in intact cells, it permits the discrimination of cell surface and endogenous cholesterol. Cholesterol synthesized from radiolabeled acetate was transferred to the plasma membrane in a strictly first order fashion with a half-time of 1-2 h at 37 degrees C. The rate of transfer was similar in rapidly growing and confluent cells and was not affected by preincubating the cells in lipoprotein-deficient serum which greatly stimulated cholesterol synthesis. We used equilibrium density gradient centrifugation of homogenates from cholesterol oxidase-treated cells to examine further the distribution of newly synthesized cholesterol between cellular pools. We identified membrane fractions enriched in newly synthesized cholesterol yet inaccessible to cholesterol oxidase. The cholesterol in these membranes eventually moved to the plasma membrane. The movement of exogenous radiocholesterol from the plasma membrane to the cell interior also was examined by this method. No detectable transfer was observed over several hours, during which time endogenous cholesterol moved to the plasma membrane. We conclude that the transfer of newly synthesized cholesterol to the plasma membrane is a vectorial process and is not mediated by a simple diffusional equilibrium. PMID- 6501313 TI - The thermal depolymerization of porcine submaxillary mucin. AB - The time dependence of the molecular weight, radius of gyration, and hydrodynamic size distribution for porcine submaxillary mucin (PSM) in solution have been studied using static and dynamic light scattering. The weight average molecular weight (Mw) of PSM in 6 M guanidine HCl, pH 7, is initially 3 X 10(6) and decreases with time in three phases: rapidly from 3-2 X 10(6), less rapidly from 2-0.9 X 10(6), and slowly below 0.9 X 10(6). The rates of decrease are much greater at pH 2. The energy of activation associated with each phase is 20 kcal/mol, which is similar to that reported for peptide bond cleavage at an aspartic acid residue. Addition of mercaptoethanol to PSM in 6 M guanidine HCl leads to a rapid decrease in Mw to 0.9 X 10(6), followed by a very slow further decrease. These results suggest that native PSM consists of subunits (Mw = 0.9 X 10(6] that are linked by disulfide bonds to form dimers (Mw = 2 X 10(6] and then higher aggregates. This cross-linking appears to occur at unglycosylated regions of the protein core, which are believed to be richer in aspartic acid than the rest of the molecule. PMID- 6501314 TI - Low-density lipoprotein receptor binding determinants switch from apolipoprotein E to apolipoprotein B during conversion of hypertriglyceridemic very-low-density lipoprotein to low-density lipoproteins. AB - Using thrombin and trypsin as probes, we determined: first, that low-density lipoprotein (LDL) receptor binding determinants switch from apolipoprotein (apo) E to apo-B within the very-low-density lipoprotein (VLDL) Sf 20-60 region of the metabolic cascade from VLDL1 (Sf 100-400) of hypertriglyceridemic (HTG) human subjects to LDL. Second, two different conformations of apo-E exist in HTG-VLDL Sf greater than 60, one accessible (greater than or equal to 1 mol/mol of particle) and one inaccessible (1-2 mol/mol) to both thrombin and the LDL receptor; normal VLDL (Sf greater than 60) have only the inaccessible conformation and therefore do not bind to the LDL receptor. Third, thrombin degrades apo-B into large fragments, three of which have electrophoretic mobilities similar to B-48, B-74, and B-26; this, however, has no effect on apo-B mediated receptor binding. Fibroblast studies showed that thrombin could abolish receptor uptake of HTG-VLDL1 and HTG-VLDL2 (Sf 60-100), had little or no effect on HTG-VLDL3 (Sf 20-60), and no effect on uptake of intermediate-density lipoprotein (IDL) or LDL. Trypsin abolished the binding of HTG-VLDL1 and HTG VLDL2, reduced that of HTG-VLDL3, but had little to no effect on IDL or LDL binding. Immunochemical techniques revealed that thrombin cleaved some apo-E into the E-22 and E-12 fragments; after trypsin treatment no apo-E was detected in any HTG-lipoprotein. Normal VLDL subclasses contained less apo-E than the corresponding HTG-VLDL subclasses and it was not cleaved by thrombin. Apo-B immunoreactivities of VLDL subclasses were not significantly changed after treatment with thrombin, although thrombin cleaved some of the B-100 of each VLDL subclass, and all apo-B in IDL and LDL, into 4-6 major large fragments. Trypsin converted all of the apo-B of each lipoprotein into smaller fragments (Mr less than 100,000). We conclude that apo-E of the thrombin-accessible conformation mediates uptake of HTG-VLDL1 and HTG-VLDL2 but that apo-B alone is sufficient to mediate receptor binding of IDL and LDL; the switch from apo-E to apo-B as the primary or sufficient binding determinant occurs within the VLDL3 (Sf 20-60) region of the metabolic cascade, where receptor binding first appears in VLDL subclasses from normal subjects. PMID- 6501315 TI - Growth-related expression of a double-stranded RNA-dependent protein kinase in 3T3 cells. AB - Cultured mouse 3T3-F442A and 3T3-C2 fibroblasts exhibit a transient double stranded RNA (dsRNA)-dependent phosphorylation of a 67,000-dalton protein (67K) without prior treatment with interferon (IFN). This phosphoprotein is similar but not identical to the dsRNA-dependent eukaryotic initiation factor-2 (eIF-2) alpha protein kinase (dsI), which regulates protein synthesis in rabbit reticulocytes. We have studied the relationship between cell growth and phosphorylation of the 67K protein (designated 3T3-dsRNA-dependent eIF-2 alpha kinase). A low level of dsRNA-dependent phosphorylation of 3T3-dsI was detectable in extracts prepared from cells not treated with IFN and grown at a low cell density. The phosphorylation of dsI and the phosphorylation of a 38K protein identified as the alpha-subunit (38K) of 3T3-eIF-2 (eIF-2 alpha) occurred concomitantly; the levels of these phosphorylations confluent and thereafter decreased markedly. Treatment of cells with IFN at all stages of growth resulted in an increase in phosphorylation of dsI. 3T3-F442A and 3T3-C2 fibroblasts were found to produce and secrete IFN at levels sufficient to induce an elevated dsI activity. PMID- 6501316 TI - Structures of the neutral oligosaccharides isolated from A-active human gastric mucin. AB - Alkaline borohydride reductive cleavage of the mucin, purified from gastric aspirates of the secretors with blood group A, resulted in a heterogeneous population of neutral (79.7%) and acidic (20.3%) oligosaccharide alditols. Nine oligosaccharides (I-IX), ranging from 6 to 15 sugar units, have been purified from the neutral oligosaccharide fraction. Based on the results of immunological assays, sugar composition, degradation with specific exoglycosidases, and methylation analyses, we propose the following structures for these oligosaccharides: (sequence in text) PMID- 6501317 TI - Characterization of a glycosphingolipid antigen defined by the monoclonal antibody MBr1 expressed in normal and neoplastic epithelial cells of human mammary gland. AB - The antigen defined by a monoclonal antibody, MBr1, was found to be expressed in normal human mammary gland epithelia and human mammary carcinoma cells (Menard, S., Tagliabue, E., Canevari, S., Fossati, G., and Colnaghi, M. I. (1983) Cancer Res. 43, 1295-1300). The antigen has been isolated from breast cancer cell line MCF-7, which was used as immunogen, and its structure was determined by methylation analysis, NMR spectroscopy, direct probe mass spectrometry, and enzymatic degradation as identified below. Fuc alpha 1----2Gal beta 1----3GalNAc beta 1----3Gal alpha 1----4Gal beta 1----4Glc beta 1----1Cer The antibody cross reacted weakly with fucosylasialo-GM1 (IV2FucGg4), which shares the same terminal sequence, Fuc alpha 1----2Gal beta 1----3GalNAc, with this antigen. However, various other structures, including lacto-series H structure (Fuc alpha 1----2 Gal beta 1----4/or 3GlcNAc beta 1----3Gal), did not show any reactivity with this antibody. Therefore, this antigen represents a blood group H antigen with a globo series structure which is abundant in human teratocarcinoma (Kannagi, R., Levery, S. B., Ishigami, F., Hakomori, S., Shevinsky, L. H., Knowles, B. B., and Solter, D. (1983) J. Biol. Chem. 258, 8934-8942), although its presence must be limited in normal adult human tissue. PMID- 6501318 TI - Inhibitory effect of 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole on a protein kinase. AB - The adenosine analog 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole (DRB) inhibits specific in vitro transcription initiation by RNA polymerase II. We report here that DRB inhibits a protein kinase present in an extract of HeLa cells and does not inhibit other protein kinases contained in the same extract. The protein kinase affected by DRB is cyclic AMP independent, prefers acidic protein substrates such as casein and phosvitin, and utilizes GTP as the phosphate donor almost as effectively as ATP in the phosphotransferase reaction. The DRB-sensitive protein kinase is also stimulated by polyamines and inhibited by quercitin and heparin. The biochemical and chromatographic properties of this enzyme correspond to those characteristic of casein kinase II. In HeLa cells, DRB is able to inhibit in vivo phosphorylation on some nuclear proteins. In HeLa cell extracts, in vitro phosphorylation of several proteins by [gamma-32P]GTP is inhibited by DRB. This protein kinase has a DRB sensitivity profile identical to the one previously reported for specific in vitro transcription by RNA polymerase II in a whole-cell extract (Zandomeni, R., Mittleman, B., Bunick, D., Ackerman, S., and Weinmann, R. (1982) Proc. Natl. Acad. Sci. U.S.A. 79, 3167-3170). Thus we suggest that this protein kinase mediates DRB inhibition of specific RNA polymerase II transcription in vivo and in vitro. PMID- 6501319 TI - Interferon-induced proteins. Purification and characterization of a 15,000-dalton protein from human and bovine cells induced by interferon. AB - Human interferons induce a protein of 15,000 daltons in human and bovine cells. This protein is located in the cytoplasm in a soluble form and is induced by concentrations of interferon which induce the antiviral state. Messenger RNA prepared from interferon-treated human and bovine cells contains a mRNA which yields on translation in vitro a protein similar in size to the 15-kDa protein induced by interferon in vivo. The human protein has been purified to homogeneity from interferon-treated human cells by ion-exchange chromatography and reverse phase high-performance liquid chromatography. A comparison of the peptides generated by V8 protease from the human and bovine 15-kDa proteins reveals that the two proteins are similar but not identical. PMID- 6501320 TI - Structural features required for the reactivity and intracellular transport of bis(3,5-dibromosalicyl)fumarate and related anti-sickling compounds that modify hemoglobin S at the 2,3-diphosphoglycerate binding site. AB - Bis(3,5-dibromosalicyl)fumarate (I) reacts preferentially with oxyhemoglobin to cross-link the two beta 82 lysine residues within the 2,3-diphosphoglycerate (DPG) binding site and as a result markedly increases the solubility of deoxyhemoglobin S. The cross-link acts by perturbing the acceptor site for Val 6 within the sickle cell fiber (Chatterjee, R., Walder, R. Y., Arnone, A., and Walder, J. A. (1982) Biochemistry 21, 5901-5909). In the present studies we have compared a large number of analogs of I to determine the structural features of the reagent required for specificity and for transport into the red cell. Both electrostatic and hydrophobic interactions contribute to the binding of these compounds at the DPG site. The optimal position for the negatively charged groups on the cross-linking agent for productive binding is adjacent to the ester as in the original salicylic acid derivatives. There is a direct correlation between the reactivity toward hemoglobin and the hydrophobicity of the substituent attached at the para position. Phenyl and substituted phenyl derivatives as in the analgesic, antiinflammatory drug diflunisal are particularly effective. These groups probably interact with hydrophobic residues of the amino-terminal tripeptide and the EF corner of the beta chains adjacent to the DPG binding site. Although bis(3,5-dibromosalicyl)fumarate is very reactive toward hemoglobin in solution, it is much less effective in modifying hemoglobin within the red cell. The reaction with intracellular hemoglobin was shown to be limited by competing hydrolysis of the reagent catalyzed at the outer surface of the erythrocyte membrane. Inactivation of the red cell membrane acetylcholinesterase with phenylmethylsulfonyl fluoride did not inhibit this reaction. Introduction of a single methyl group onto the carbon-carbon double bond of the fumaryl moiety decreases the lability of the ester 10-fold, due to steric effects, and allows the reagent to be taken up by the red cell and modify intracellular hemoglobin. The kinetics of transport of the methylfumarate derivative, bis(3,5 dibromosalicyl)mesaconate, are first-order, consistent with passive diffusion. The attachment of larger alkyl groups onto the cross-link bridge further enhances the transport of the reagent into the red cell. The solubility of deoxyhemoglobin S cross-linked with the butylfumarate derivative was found to be increased by almost 10% compared to the original fumarate diester.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6501321 TI - Characterization of apolipoprotein A-IV complexes and A-IV isoforms in human lymph and plasma lipoproteins. AB - We have isolated and characterised A-IV apolipoprotein (apo-A-IV) from human lymph and plasma by immunoabsorbance chromatography and two-dimensional electrophoresis. Two different apo-A-IV-containing lipoproteins were isolated from four different sources, human lymph triglyceride-rich fraction (TRL), lymph lipoprotein-deficient fraction (LDF), plasma high-density lipoprotein (HDL), and plasma lipoprotein-deficient fraction (LDF). The lipoprotein complexes obtained from lymph TRL and plasma HDL were similar and contained apo-A-IV, apo-A-I, and small molecular weight peptides (apo-C or -A-II). The second lipoprotein complex was isolated from lymph LDF and plasma LDF, and contained apo-A-IV, apo-A-I, and a peptide of Mr = 59,000. The lipid composition of the lipoprotein complexes varied according to the source: triglyceride predominating in lymph TRL and phospholipid and cholesteryl ester from the other sources. Free cholesterol was conspicuously present in very small amounts. Using two-dimensional electrophoresis and immunoblotting techniques, eleven isoproteins of apo-A-IV were identified (pI-4.98, 5.06, 5.10, 5.15, 5.20, 5.22, 5.25, 5.30, 5.34, 5.42, and 5.48). The isoprotein pattern of lymph TRL and plasma HDL was similar, but that of lymph and plasma LDF were different patterns. These results suggest that apo-A-IV associated with d less than 1.21 lipoproteins and apo-A-IV present in LDF may be in metabolically separate lipoproteins and may have different physiological roles. PMID- 6501322 TI - Evidence for a folded conformation of methionine- and leucine-enkephalin in a membrane environment. AB - Transfer of an aqueous-soluble peptide hormone or neurotransmitter such as [Met]- or [Leu]enkephalin (Tyr1-Gly2-Gly3-Phe4-Met5(Leu5)), to the lipid-rich environment of its membrane-embedded receptor protein may convert the peptide into a ("bioactive") conformation required for eliciting biological activity. We have examined by high-resolution nuclear magnetic resonance (NMR) spectroscopy the conformational parameters of free enkephalin in aqueous solution versus those of enkephalin bound to lysophosphatidylcholine micelles using two approaches: 1) exchange rates, line broadening, coupling constants, and chemical shift changes of enkephalin backbone peptide N-H protons were measured for free and membrane bound peptide in H2O (360 MHz, pH 5.6, 20 degrees C). A selective upfield shift observed for the Met5(Leu5) N-H proton upon lipid binding was interpreted in terms of its incorporation into an intramolecular H-bond. 2) 13C chemical shift changes induced by the shift reagent praseodymium nitrate (Pr(NO3)3) were compared in the presence and absence of lipid micelles. Significant changes occurring in Gly2 carbon atoms in membrane-bound enkephalin suggested the relative proximity of this residue to the Pr3+ atom (bound to the Met5(Leu5) COOH terminal carboxylate 4 residues away). These combined results, in conjunction with studies on the specific interactions of enkephalin substituents with the micelles (Deber, C. M., and Behnam, B. A., (1984) Proc. Natl. Acad. Sci. U. S. A. 81, 61-65) suggest that enkephalin folds into an intramolecularly H-bonded beta turn structure (with an H-bond between Gly2 C = O and Met5 NH) in the lipid environment. Such folding could facilitate the positioning of strategic residues in vivo as the hormone diffuses toward its receptor. PMID- 6501323 TI - Selective intracellular degradation of fibrinogen and its reversal in cultured hepatocytes. AB - Primary monolayer cultures of chick embryo hepatocytes were employed in pulse chase experiments to examine plasma protein synthesis and secretion. The fates of [35S]methionine-labeled fibrinogen and transferrin were monitored in cell extracts and in spent culture media. It was found that hepatocytes, which were maintained in the absence of added hormones or serum, released into the medium virtually all of the label of transferrin but only 30% of the label in fibrinogen. The remainder of the labeled fibrinogen was retained by the cells, gradually disappearing in a manner suggestive of its intracellular degradation. To stimulate fibrinogen production on as many levels as possible, fetal bovine serum was added to the medium of the cultured cells. Serum elicited an increase in the level of fibrinogen mRNA which was accompanied by a 7-fold increase in the rate of fibrinogen synthesis as well as the complete release of fibrinogen label, resulting in an overall 20-fold enhancement in the hepatocellular output of this protein. Thus, both the amount of fibrinogen synthesized as well as the amount ultimately secreted are subject to modulation by the hepatocellular environment. PMID- 6501324 TI - Passive and active components of the internal moment developed about the ankle joint during human ambulation. AB - The internal moment developed about a joint during a functional activity is the result of contraction of muscles and the visco-elastic properties of the joint and its surrounding soft tissues. In this study, the contribution of each one of these mechanisms to the total internal moment developed about the ankle joint during human level walking was assessed. The results indicate that during normal level walking the internal moment about the ankle is mainly due to contraction of muscles surrounding the joint. The contribution of the passive component was found to be negligible. These results, however, were found to be different for the pathological case tested. The results indicated that in a subject with a mild equinus ankle deformity, a substantial portion (21%) of the total internal moment was contributed by the passive resistance of the joint and its surrounding structures. PMID- 6501325 TI - Detection of stimulated back muscle contractions by moire topography. AB - The ability to treat scoliosis via surface stimulated trunk muscle contractions is now being evaluated at several treatment centers. In order to make biomechanical analysis of the procedure, so that the technique can be used optimally, data are needed to quantify the muscle contractions and structural changes by different electrode locations. This paper presents the use of a modified shadow moire technique to quantify geometric changes resulting from electrical stimulation applied to the surface of the back in a healthy subject. PMID- 6501326 TI - Muscular synergism--I. On criteria for load sharing between synergistic muscles. AB - The use of optimization techniques to predict individual muscle forces in redundant biomechanical systems implies the formulation of a criterion for load sharing between the muscles. In part I of this paper, the characteristics and performance of several linear and non-linear criteria reported in the literature have been compared for static-isometric knee flexion. The results show that linear criteria inherently predict discrete muscle action (orderly recruitment of muscles) whereas non-linear criteria can predict synergistic action. All criteria predict that relatively more force is allocated to muscles with large moment arms. When muscle stresses (or ratios of muscle force to maximum muscle force) are used as the decision variables in the objective function, then relatively more force is allocated to muscles with large maximum possible force as well. Future formulations of the optimization should consider the differences in fiber type composition among the muscles. Such an approach is presented in part II of the paper. PMID- 6501327 TI - Muscular synergism--II. A minimum-fatigue criterion for load sharing between synergistic muscles. AB - P6new physiological criterion for muscular load sharing is developed. The criterion is based on the assumption that the endurance time of muscular contractions is maximized, hence muscular fatigue is minimized. The optimization problem is cast in the form of a linearly constrained, non-linear MINIMAX optimization. The new method predicts that: (1) there is synergistic muscle action, (2) muscle force increases non-linearly with external force (load), (3) relatively more force is allocated to muscles that have a large maximum force (large muscles), (4) relatively more force is allocated to muscles with a high percentage of slow-twitch fibers (muscles that are fatigue-resistant), (5) the load sharing does not depend on the moment arm of the muscles (although the absolute force levels do depend on this variable). The predicted load sharing between two cat muscles during standing and walking is in good agreement with direct force measurement data from the literature. PMID- 6501328 TI - A technique for estimating mechanical work of individual muscles in the cat during treadmill locomotion. AB - Mechanical work, the product of force and length change, was assessed in selected hindlimb extensors of two adult cats during three different speeds of unrestrained treadmill locomotion. Forces were measured using implanted transducers placed on the soleus (SOL) and medial gastrocnemius (MG) tendons. A three dimensional technique of muscle length estimation using high speed cinematography was found preferable to either two dimensional or trigonometric measurements derived from anatomical and kinematic parameters. Length excursions increased in both muscles as treadmill speed increased. However, at all speeds of locomotion, the uniarticular SOL exhibited a greater range of motion than the biarticular MG. Increases in treadmill speed resulted in higher peak forces in the MG and constant or slightly lower peak forces in the SOL. These speed dependent changes in length and force resulted in higher total positive work, lower total negative work, and higher net work for both muscles with increasing speeds. These data illustrate the importance of three-dimensional kinematics in determining changes in muscle length and describe the relative force and work changes in a slow and fast ankle extensor with changes in speed of locomotion. PMID- 6501330 TI - Osteochondritis dissecans of the femoral condyles. AB - Because the results of treatment of osteochondritis dissecans of the femoral condyles are still not consistently satisfactory, we reviewed the cases of eighty three patients (ninety-five knees) with osteochondritis dissecans who were followed for two to thirty-one years to identify factors that may influence treatment and long-term prognosis. Of the eighty-three patients, sixteen had only non-surgical treatment, sixty-five had only surgical treatment, and two had non surgical treatment of one knee and surgical treatment of the other. Of the twenty two knees (eighteen patients) that were treated non-surgically, fifteen were treated before and seven were treated after distal femoral epiphyseal closure. Of the seventy-three knees (in sixty-seven patients) that were treated surgically because of persisting symptoms, twenty-three were treated before epiphyseal closure and fifty, after closure. At follow-up, each knee was given a rating of excellent, good, fair, poor, or failure, and a corresponding point score. Seventy seven per cent of the knees in the surgical group and 82 per cent of those in the conservatively treated group were rated either excellent or good. The average scores in both groups were higher in knees in which the osteochondritic defect was small and was treated before epiphyseal closure, and in knees in which the fragment healed as compared with the ones from which the fragment was removed. We found that knees with osteochondritis dissecans of the femoral condyles that had no other abnormal physical findings or functional disability responded well to conservative treatment before epiphyseal closure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501329 TI - Prefabricated functional braces for the treatment of fractures of the tibial diaphysis. AB - We have reviewed our experiences with prefabricated functional braces in the treatment of diaphyseal tibial fractures. The braces were developed in an attempt to reduce the occasional technical difficulties encountered with the use of custom-made braces. Between January 1979 and July 1983 we treated 625 diaphyseal tibial fractures. One hundred and eighty-six patients (29.8 per cent) were lost to follow-up, the braces had to be discontinued in thirty-eight (9.2 per cent), and ten fractures (2.5 per cent) failed to unite. We conducted careful radiographic and clinical analyses of the remaining 391 patients. Two hundred and fifty-seven (65.7 per cent) of the fractures were closed and 134 (34.3 per cent) were open. Three hundred and fifty-seven (91.2 per cent) of the patients had ten millimeters of final shortening or less, and 306 (78.3 per cent) had a final angulation of 5 degrees or less. The average time from injury to bracing was 3.9 weeks (range, one to twelve weeks) for the closed fractures and 5.0 weeks (range, one to twelve weeks) for the open fractures. These findings appear to support our concept that function of the extremity is beneficial to osteogenesis and that many diaphyseal tibial fractures can be satisfactorily stabilized in prefabricated functional braces. These braces also have the advantage of not immobilizing the adjacent joints and they permit the gradual restoration of weight-bearing. PMID- 6501331 TI - Nuclear magnetic resonance imaging in Legg-Calve-Perthes disease. AB - We employed nuclear magnetic resonance imaging in the evaluation of fourteen children with Legg-Calve-Perthes disease, and found that it accurately identified infarction of the femoral head and, with appropriate techniques, could produce an arthrogram-like image of the hip without the use of ionizing radiation or injection of a contrast agent. Partial saturation-recovery and inversion-recovery pulse sequences with two-dimensional Fourier transformation produced the best results. Nuclear magnetic resonance scanning provides a noninvasive method for the study of the contours of the hip joint, and may give clearer insight into the pathophysiology of infarction and revascularization. PMID- 6501332 TI - Extra-abdominal desmoid tumors. AB - One hundred and ninety-four patients with extra-abdominal desmoid tumors, most of them in the extremities, have been treated at the Mayo Clinic. One hundred and thirty-two patients (68 per cent) experienced a recurrence at an average of 1.4 years after the first treatment. A greater tendency for recurrence was evident in female patients, in patients who were more than thirty years old, in certain anatomical locations (especially the foot and calf), and most importantly after treatment by intralesional or marginal excision. In view of the excellent prognosis for survival, we recommend wide local excision when anatomically feasible or marginal excision and postoperative radiation therapy when function of the extremity would be severely compromised if excision with wide margins were done. A recurrent lesion that does not appear to be growing should be followed until evidence of growth of the lesion precipitates a secondary wide excision. PMID- 6501333 TI - Digital nerve-grafting for traumatic defects. Use of the lateral antebrachial cutaneous nerve. AB - We used segments of the lateral antebrachial cutaneous nerve to graft defects in forty-two digital nerves in thirty-five patients. Age was a more important prognostic indicator for functional sensibility than either the length of the nerve graft or the time-interval from injury to grafting. The younger patients did better. A battery of eight tests was used to determine functional sensibility scores. All patients improved and 40 per cent had completely normal sensibility. PMID- 6501334 TI - The incidence of fabellae in osteoarthrosis of the knee. AB - I examined radiographs of the knees of 600 men to determine the incidence of fabellae in radiographically normal knees as compared with knees with primary osteoarthrosis. At least a unilateral fabella was present in 106 (35 per cent) of 300 patients with primary osteoarthrosis of the knee. In an age-matched group of 300 patients with radiographically normal knees, only forty-four (15 per cent) had a fabella. The presence of a fabella may represent an atavistic pattern, and the fact that knees with primary osteoarthrosis are more likely to contain a fabella raises the question of whether an atavistic pattern predisposes a knee to osteoarthrosis. PMID- 6501335 TI - An objective criterion for scoliosis screening. AB - A specially designed inclinometer has been used to measure one part of the clinical deformity (asymmetry of the trunk) that is seen in scoliosis. This objective measurement provides one good guideline that can effectively determine, in surveys of children, whether or not further orthopaedic evaluation is needed. A minimum significant angle of trunk rotation of 5 degrees was shown by computer analyzed data from 1,065 patients to be a good criterion for identifying curvatures of 20 degrees or more. The specificity of scoliosis screening in this manner has a projected false-negative rate of 0.1 per cent and a high degree of sensitivity. The method is simple, reliable, and inexpensive. It is easily taught to lay personnel who can be employed in scoliosis screening procedures. PMID- 6501336 TI - The comparative value of bone scintigraphy and computed tomography in determining bone involvement by soft-tissue sarcomas. AB - In seventeen patients with a soft-tissue sarcoma, bone scintigrams were found to be more useful than computed tomograms for evaluating bone involvement. The scintigrams had higher predictive value and higher sensitivity, as there were no false-negative or false-positive scintigrams, while there were three false positive computed tomograms. Accurate scintigraphy requires the use of high resolution static gamma-camera images that show the tangential relationship between tumor and bone. The images that are usually made in surveying the skeleton for metastatic disease--routine whole-body bone scans, or even gamma camera images that provide only anterior and posterior views--are inadequate. They did not demonstrate the true relationship of the tumor to bone in the patients in this study when activity within the tumor itself was superimposed over bone. In such patients, properly selected oblique views sometimes showed that the tumor was clearly separate from normal bone activity. Determination of the relationship of the soft-tissue tumor to bone is an important part of the accurate anatomical staging that is required to select appropriate surgical management. PMID- 6501338 TI - Free microvascular epiphyseal-plate transplantation. An experimental study in dogs. AB - To evaluate the feasibility of transplanting vascularized epiphyseal plates while maintaining normal growth in the recipient site, twenty-two puppies from known, large breeds were divided into one control and three experimental groups of four animals each and one long-term group of six animals. The control group underwent insertion of a radiopaque marker in the fibular metaphysis bilaterally, and, in addition, a fibular osteotomy was performed on one side. In the experimental groups, a fibular switch was carried out, selecting one fibula as a vascularized graft and the other as a non-vascularized graft. Both the controls and the experimental groups were evaluated using serial roentgenograms, histological examination, fluorescent bone-labeling, and microangiography. One week, six weeks, three months, and seven months postoperatively, animals from each group were killed. Continuous growth was observed in the vascularized epiphyseal transplants and in the controls, with no statistical difference noted, whereas the non-vascularized transplants exhibited considerably less or no growth. Vascularized transplants demonstrated an average 21.2-millimeter increase in length while non-vascularized transplants showed a 6.6-millimeter increase. Histological examination, fluorochrome bone-labeling, and microangiography confirmed the continued viability of the vascularized epiphyseal transplants in contrast to the non-vascularized transplants. PMID- 6501339 TI - Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion. AB - Rotational subcapital osteotomy of the humerus for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion was performed first by us in 1964 as a trial. From 1967 through 1981, 207 rotational humeral osteotomies were performed. Follow-up was possible on 180 of these shoulders. The over-all redislocation rate was 5.7 per cent and the rate of non-traumatic redislocation, 1.1 per cent. Limitation of motion of more than 10 degrees was present in only 3.9 per cent, the maximum limitation of external rotation being 15 degrees in one patient. The average loss of external rotation was less than 5 degrees, without noticeable diminution of power or function in most patients. The results as graded by a standard rating scale were good to excellent in 90 per cent, fair in 3 per cent, and poor in 7 per cent of the patients. The fair and poor results were due to redislocation, delayed union or non-union, post-traumatic arthritis, and over-rotation at the osteotomy site. Reoperation was necessary in two patients with a non-traumatic recurrence, in six patients with delayed union or non-union, and in one patient with excessive rotation at the osteotomy site. Plate removal was performed one to two years postoperatively in 107 of the 180 shoulders. Of the 321 recurrent dislocations seen over the fourteen-year period, 65 per cent were associated with a moderate to severe posterior-superior impression fracture of the humeral head (Hill-Sachs lesion).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501337 TI - Ankle and knee position as a factor modifying intracompartmental pressure in the human leg. AB - The objective of this study was to examine the effect of position of the knee and ankle on intracompartmental pressures in the leg. Slit catheters were introduced bilaterally into all four muscle compartments of the lower extremities of six healthy volunteers. Intracompartmental pressures were monitored with the catheters while the ankle joint was passively held in full dorsiflexion, full plantar flexion, or neutral with the knee flexed 90 or 10 degrees or fully extended. Statistical analysis revealed that intracompartmental pressure increased significantly in all four compartments when the ankle was passively dorsiflexed. Pressure in the superficial posterior and lateral compartments was dependent on knee position and in the deep posterior and anterior compartments it was independent of knee position. In addition, pressure in the deep posterior compartment decreased significantly when the ankle was placed in full plantar flexion, and that finding was independent of knee position. Anterior compartment pressure was not significantly elevated by full passive plantar flexion of the ankle. PMID- 6501340 TI - Roentgenographic demonstration of instability of the shoulder: the apical oblique projection. A technical note. PMID- 6501341 TI - Anterior-posterior stiffness and laxity of the knee after major ligament reconstruction. AB - We recorded anterior-posterior force-versus-displacement curves at 20 and 90 degrees of flexion preoperatively and three years after major ligament reconstruction in patients with documented absence of the anterior cruciate ligament. Patients who had an extracapsular stabilization procedure alone showed no significant changes in laxity or stiffness of the injured knee in either position of flexion. Those who underwent reconstruction of the absent anterior cruciate ligament utilizing the middle or medial one-third of the patellar ligament in addition to the extracapsular procedure showed a significant decrease in anterior laxity and increase in anterior stiffness of the injured knee at 20 degrees of flexion. These changes in stability were not observed at 90 degrees of flexion. Six patients with a cruciate substitution had improved laxity and stiffness values at one year postoperatively which were unchanged at three years. At three-year follow-up the increases in activity scores, decreased feelings of giving-way and pain, and elimination of the pivot shift were comparable in both groups of patients. PMID- 6501342 TI - The gluteus medius-tensor fasciae latae myocutaneous flap for infected girdlestone procedures. Report of two cases. PMID- 6501343 TI - Intra-articular drug abuse. Case report. PMID- 6501344 TI - Familial bilateral proximal femoral focal deficiency. Report of a kindred. PMID- 6501345 TI - Quadriplegia after minor trauma in the Klippel-Feil syndrome. A case report and review of the literature. PMID- 6501346 TI - Tibial fracture through a traction-pin site. A report of two cases. PMID- 6501347 TI - Cervical vertebral-costal process (costovertebral bone)--a previously unreported anomaly. A case report. PMID- 6501348 TI - Solitary intraosseous lymphangioma. A case report. PMID- 6501349 TI - Condensing osteitis of the clavicle. A case report. PMID- 6501351 TI - The treatment of reflex sympathetic dystrophy syndrome. PMID- 6501350 TI - Antimicrobial therapy of childhood skeletal infections. PMID- 6501352 TI - The efficacy of free tissue transfer in the treatment of osteomyelitis. PMID- 6501353 TI - Arthroscopic surgery. PMID- 6501354 TI - The resolution of protrusio acetabuli treated with Ring's hip prosthesis. AB - Seven hips with protrusio acetabuli which showed complete or partial resolution of the protrusion after replacement with Ring's prosthesis are reported. It is suggested that this prosthesis offers a simple and effective method of treating painful protrusion into the pelvis; it allows healing of the medial wall of the acetabulum while avoiding many of the hazards of other methods of treatment. PMID- 6501356 TI - Closed intramedullary rodding for osteogenesis imperfecta. AB - Three cases of severe osteogenesis imperfecta are reported. Each was treated by closed intramedullary rodding, combined with osteoclasis to correct deformity. Operation was performed within a few months of birth. Both tibiae and both femora were stabilised in one operation, using x-ray image intensification to monitor placement of the rods. The technique used to insert the rods is described. The procedure appeared to be entirely satisfactory in reducing the incidence of fractures and it allowed the affected infants to be handled much more easily. PMID- 6501355 TI - Intramedullary cancellous bone block to improve femoral stem fixation in Charnley low-friction arthroplasty. AB - In order to improve the fixation of the stem in primary Charnley low-friction arthroplasty, the medullary canal was routinely closed off with a cancellous bone block. A prospective study of 611 consecutive arthroplasties were carried out between 1 and 5 1/2 years (average 2 years and 9 months) after operation. There were two cases of radiological loosening of the stem, both of which could have been avoided. Five other patients showed demarcation of the bone-cement junction at the calcar; two of these are considered to be "at risk" of loosening. There was no evidence of radiological loosening of the stem in 604 cases and the method is recommended for routine use in primary total hip arthroplasty. PMID- 6501357 TI - Walking ability after transplantation of the iliopsoas. A long-term follow-up. AB - Of 47 patients with spina bifida who had had transplantation of the iliopsoas more than 10 years previously, 32 (68%) were community walkers, 3 were household walkers and 12 were non-walkers. Comparison with other published reports showed that, at the very least, the patients reviewed had not had their walking ability jeopardized by the inevitable loss of hip flexor power. Furthermore, all but three of the community walkers were able to climb and descend stairs. There was a high proportion of non-walkers in those patients whose operation had been performed in the first year of life and such early surgery is no longer recommended. We also found that the pre-operative assessment of muscle power had, in some patients, been inaccurate. Finally, we found that, at review, the power of the transferred muscles was poor, suggesting that transplantation is beneficial because it achieves permanent and major reduction in hip flexor power; this usually prevents recurrent hip flexion deformity and dislocation. PMID- 6501358 TI - The arthroscopic treatment of chondromalacia patellae. AB - Three hundred and nineteen patients who had chondromalacia patellae and persistent patellofemoral pain after six months of conservative management underwent arthroscopy and arthroscopic surgery. The results in four aetiological groups were reviewed at one year and five years after operation. Morbidity was minimal. Lavage produced early remission in all groups. Shaving offered a particular advantage in the post-traumatic group. Lateral release plus shaving and lavage was beneficial in the group with maltracking patellae and in half of the idiopathic group. In the group with unstable patellae, lateral release produced good results in only one in four patients. In conclusion, we consider that arthroscopic surgery has a useful role to play in the management of chondromalacia patellae. PMID- 6501359 TI - Replacement of the anterior cruciate ligament by an allogeneic tendon graft. An experimental study in the dog. AB - The revascularisation and remodelling of allografts used to replace the anterior cruciate ligament in the canine knee were studied by microangiographic, histological and biomechanical methods. The 26 allografts were obtained from the patellar tendons of other dogs and were stored by deep freezing. In a control study a strip of patellar tendon from the same leg was used as an autologous free graft. Microangiography showed that the allografts had been revascularised from the sixth postoperative week, and had later developed an intrinsic vascular pattern similar to that of a normal anterior cruciate ligament. Histologically, the allograft regained a fibrous framework similar to that of a normal ligament, and showed no evidence of immunological rejection. Biomechanical tests on the allograft replacements showed that their mean maximum tensile strength at 30 weeks was about 30% of that of the control ligaments. There were no significant differences between the mechanical properties of the allografts and the autografts. PMID- 6501360 TI - Unicompartmental arthroplasty of the knee. A follow-up of 3 to 9 years. AB - A retrospective review of medial compartment arthroplasty in 22 patients (22 knees) is reported. The operations were performed between 1973 and 1978. Eighty six per cent were rated good or excellent using the knee rating system devised by the Hospital for Special Surgery, New York. Excellent or good results were achieved in six patients who had previously had a high tibial osteotomy. At the time of follow-up significant loosening had not occurred, although progression of patellofemoral disease was noted. This study supports the promising results reported for unicompartmental resurfacing arthroplasty in the elderly. PMID- 6501361 TI - Mechanical factors in the incidence of knee pain in adolescents and young adults. AB - Mechanical abnormalities of the patellofemoral joint are among the many causes that have been suggested for adolescent knee pain. This study seeks to identify these factors. Measurements of joint mobility and lower limb morphology were made on 446 pupils at a comprehensive school, 136 of whom had suffered knee pain in the previous year. The pupils with symptoms enjoyed sporting activities significantly more than their symptom-free contemporaries. Joint mobility, the Q angle, genu valgum and anteversion of the femoral neck were not significantly different between those pupils with and those without anterior knee pain. Data on lower limb morphology of normal adolescents are presented. Examination of 52 hospital outpatients aged 13 to 36 years with anterior knee pain produced results comparable with those for the pupils. It is concluded that chronic overloading, rather than faulty mechanics, is the dominant factor in the genesis of anterior knee pain in adolescent patients. PMID- 6501362 TI - Talectomy for club foot in arthrogryposis. AB - Talectomy was performed on 10 patients (15 feet) for club foot deformity in arthrogryposis multiplex congenita. These were reviewed after an average follow up of eight years. At follow-up nine feet were plantigrade, and six had less than 15 degrees residual equinus at the ankle. All the feet were asymptomatic but had mild residual adduction of the forefoot and marked stiffness of the hindfoot. Seven feet developed spontaneous bony ankylosis in the tibiotarsal joint. The common technical errors were incomplete removal of the talus and incorrect positioning of the calcaneus in the ankle mortise. PMID- 6501364 TI - A simple method of arthrodesis of the first metatarsophalangeal joint. AB - Eighty-seven feet have been reviewed after arthrodesis of the first metatarsophalangeal joint stabilised by chromic catgut. Radiological union was present in 90% of patients at the mean review time of six years. Twenty-four patients had significant metatarsalgia before operation and only two failed to improve afterwards. Excellent or good subjective results were reported in 94% of patients at review. Chromic catgut is advocated as a simple and effective method of stabilising an arthrodesis of the first metatarsophalangeal joint. PMID- 6501363 TI - The pulseless club foot. AB - Previous reports have suggested that the blood supply derived from the anterior tibial artery is absent or markedly diminished in 85% of severe, untreated club feet. To investigate these claims, we used a Doppler technique to study the arterial pulses in 40 children with 63 club feet. In feet with mild or moderate deformities the anterior tibial pulse was always present; in feet with severe deformities it was absent in two out of 30 feet in children under three years and in seven out of 18 feet in children over three years. These results confirm that the incidence of pulselessness increases with the severity and duration of deformity, but not to the extent previously suggested by angiographic studies. The significance of these findings is discussed. PMID- 6501365 TI - Disc space narrowing and the lumbar facet joints. AB - Cadaveric lumbar spine specimens of "motion segments", each including two vertebrae and the linking disc and facet joints, were compressed. The pressure across the facet joints was measured using interposed pressure-recording paper. This was repeated for 12 pairs of facet joints at four angles of posture and with three different disc heights. The results were that pressure between the facets increased significantly with narrowing of the disc space and with increasing angles of extension. Extra-articular impingement was found to be caused, or worsened, by disc space narrowing. Increased pressure or impingement may be a source of pain in patients with reduced disc spaces. PMID- 6501366 TI - The use of nuclear magnetic resonance in the diagnosis of lateral canal entrapment. AB - The use of nuclear magnetic resonance (NMR) in the diagnosis of radicular pain due to lateral canal stenosis in 21 patients is reported. NMR was able to distinguish normal intervertebral discs from degenerate discs, and NMR evidence of reduction of epidural fat was more reliable than radiculography in identifying lateral root entrapment. NMR is an important advance in the investigation of lumbar radiculopathies. PMID- 6501367 TI - Intra-operative awakening to monitor spinal cord function during scoliosis surgery. Description of the technique and report of four cases. AB - We used a modification of the wake-up test to monitor spinal cord function in 102 consecutive scoliotic patients undergoing Harrington instrumentation. Four patients were found to have a neural deficit when they were awakened during the operation. Three recovered immediately after partial release of the distracting force; one required immediate removal of the rod and was left with a slight neural deficit. Using our method, we have encountered no problem in performing the wake-up test, although attention is drawn to the difficulty in repeating the test if the patient is re-anaesthetised with diazepam. There were no false negative results in this series. PMID- 6501369 TI - The operative treatment of scapular fractures. AB - Fractures of the scapula occur mainly from direct trauma involving considerable violence and associated injuries of the shoulder and thorax are common. In most cases early functional treatment gives good or excellent results. Operative treatment may, however, be indicated, especially with displaced intra-articular fractures, fractures of the glenoid rim associated with humeral head subluxation, or unstable fractures of the scapular neck. Between 1967 and 1981, we treated 37 such fractures by open reduction and stable osteosynthesis. We were able to follow up 33 cases (89%), of which 21 (64%) had complete functional recovery. The other 12 had varying degrees of pain, loss of mobility, and weakness. Overall, however, 79% of the patients had good to excellent results. PMID- 6501368 TI - Acquired spondylolysis after spinal fusion. AB - Spondylolysis occurring after a spinal fusion is considered to result from operative damage to the pars interarticularis on both sides. Fourteen cases are reported, and compared with the 23 cases which have previously been published. The defects are usually recognised within five years of fusion, and usually occur immediately above the fusion mass. Other contributory causes may be: fatigue fracture from concentration of stress; damage and altered function of the posterior ligament complex; and degenerative disc disease immediately above or below the fusion. Fusion technique is critical, since virtually all cases occurred after posterior interlaminar fusions. This complication is easily overlooked in patients with recurrent back pain after an originally successful posterior spinal fusion. PMID- 6501370 TI - The Stanmore total elbow replacement for rheumatoid arthritis. AB - Between 1970 and 1982, 50 total elbow replacements were carried out for rheumatoid arthritis using the Stanmore prosthesis. A long-term follow-up of the 44 elbows available for review is presented. Thirty-four of these (77%) had good results, five were fair, and five were poor. The complications and limitations are discussed. PMID- 6501371 TI - Surface replacement of the elbow in rheumatoid arthritis. Early results with the Wadsworth prosthesis. AB - Fifteen patients with rheumatoid arthritis had 19 elbow arthroplasties with the Wadsworth type of surface replacement prosthesis. After a follow-up period averaging 30 months, 11 patients with 15 elbow arthroplasties were entirely satisfied with their freedom from pain and range of movement. Radiologically, however, the humeral component was loose in 10 of the 19 elbows and the ulnar component in 5. Two patients had reoperation, one to remove a prosthesis for early deep infection and one to exchange a humeral component which was loose. The risk of mechanical loosening is reduced by accurate positioning of the humeral component, but there is a high potential for failure. Changes in the design of the prosthesis and better instrumentation for alignment of the components are desirable. Prosthetic replacement of the elbow should still be regarded as experimental. PMID- 6501372 TI - A wrist-powered hand prosthesis. AB - This paper describes a prosthesis for patients who have had a partial amputation of the hand, or who have congenital absence of all or part of the hand. The prosthesis incorporates a new concept whereby the grip is operated by flexion and extension of the wrist. A covering for the prosthesis has been developed using a silicone polymer which produces a lifelike flexible glove. Thirteen patients have so far been fitted with this type of prosthesis, which can give good function and cosmesis. PMID- 6501373 TI - Late surgical decompression for compartment syndrome of the forearm. AB - Two cases are reported of the late diagnosis of compartment syndrome secondary to alcohol and drug overdose. Surgical decompression at two and a half days and at six days, respectively, produced worthwhile recovery. Other reports are reviewed and a case is made for the value of decompression even when performed late, and for delayed and minimal excision of apparently necrotic muscle. PMID- 6501375 TI - Chondrosarcoma in fibrous dysplasia of the pelvis. A case report and review of the literature. AB - Malignant transformation of fibrous dysplasia to chondrosarcoma is rare. We report a case in which malignancy developed in an area of fibrous dysplasia in the ilium. We believe this to be the second reported case at this site. Treatment was by excision of the hemipelvis including the ala of the sacrum. A review of the literature is presented. PMID- 6501374 TI - Development of the iron-cored electromagnet for the treatment of non-union and delayed union. AB - The development of the iron-cored electromagnet as a stimulator of bony union is described. In a clinical trial extending over eight years, 80 patients were treated for various forms of failed union. Their results are presented, as well as tentative conclusions regarding the indications and efficiency of the method. The latest, fully-portable apparatus is described. PMID- 6501376 TI - Open flexor tenotomy for hammer toes and curly toes in childhood. AB - Sixty-two children were reviewed between 3 and 14 years (average 9.8 years) after flexor tenotomy for curly toes or hammer toes. No patients were aware of loss of flexor power in the toes. In only 5% of 188 toes was the operation unsuccessful. When the cause of failure was identifiable it proved to be that the scar crossed one or more flexor creases. None of the operated toes had an abnormally extended posture; only one toe was stiff and this resulted from tethering by a scar. It is concluded that open flexor tenotomy is an effective method for correcting curly toes and hammer toes in childhood. Pre-operative assessment must demonstrate that the resting length of the flexor tendons is unduly short, and that this shortening is the only cause of the deformity. PMID- 6501377 TI - Medicine and nuclear war: a challenge of unprecedented proportions. PMID- 6501378 TI - The Gordon Richards Memorial Lecture 1983: radiotherapy and proctology. AB - Radiation treatment is playing an increasing role in the management of patients with ano-rectal carcinoma. This role may be categorized as a) adjuvant therapy of rectal cancer, b) definitive irradiation of rectal cancer, and c) radiotherapy of carcinoma of the anal canal. Preoperative irradiation according to a well-planned protocol is able not only to decrease the incidence of local failures but also to convert some tumors, initially suitable for AP resection, into a conservative procedure. Applied to selected cases, intracavitary irradiation can control limited rectal cancer with a rate higher than other conservative methods (series of 231 cases followed more than five years). Carcinoma of the anal canal should not be treated by radical surgery or by external beam irradiation alone. New approaches based on combined procedures such as cobalt-60 and iridium-192 implant, with or without chemotherapy, demonstrated a substantial improvement in five-year survival rates in a series of 100 cases. Proctology represents for the radiation oncologist an experience which is both gratifying and full of promise. PMID- 6501379 TI - Clinical problems associated with dosimetry of 125-iodine for cancer of the prostate. AB - Dosimetry and clinical data for iodine-125 prostatic seed implants in 63 patients were retrospectively studied to evaluate the methods of calculating the effective implant activity. Our protocol called for 10 000 cGy to the periphery of the prostate from 125I and 4 000 cGy to the whole pelvis in 20 fractions from supervoltage. Most procedures used seed strengths of 20.35 to 21.09 MBq (0.55 0.57 mCi). The average number of seeds lost per patient was 2.1 without prior transurethral prostatic resection (TURP), and 5.6 with prior TURP. Specific precautions are recommended to minimize seed loss. In a 3 cm diameter gland with uniform seed distribution, the periphery received 10 000 cGy, while the central 2 cm diameter core received 20 000 cGy. Near the periphery there was a rapid decrease in dose averaging 1 390 cGy per millimeter radially. Because of this rapid fall-off, it may be misleading to specify the dose in cGy only. It is recommended that the total 125I activity per implant also be specified in the same way as mghr-of-radium-equivalent for cancer of the cervix. Recommended total activities needed for implantation in various prostate gland sizes are given. PMID- 6501380 TI - Double blind study of the toxicity of intrathecal iopamidol and metrizamide in lumbar myelography. AB - Water-soluble contrast agents (metrizamide) provide a finer myelographic assessment of the spinal neuroanatomical structures but at the expense of some occasional toxic side effects. Iopamidol, a new non-ionic water-soluble agent, has been submitted to clinical trial by the authors in their respective institutions. The combined results indicate better tolerance to this new agent with fewer side effects and those of lesser severity. PMID- 6501381 TI - Intracranial metrizamide following myelography. AB - Twenty patients were studied by cranial computed tomography within 24 hours of myelography with metrizamide (Amipaque) to determine the intracranial manifestations of the use of this nonionic water soluble contrast medium. The findings ranged from relative hypodensity of the white matter due to ventricular opacification and gray matter penetration of metrizamide, to apparent trans ependymal migration of the contrast agent resulting in what we have termed "pseudohydrocephalus." Trans-ependymal migration in normal humans has not been previously described. We were unable to establish precise radiologic correlates with the neurologic complications which some of the patients developed. PMID- 6501382 TI - Prone and supine views in double-contrast knee arthrography. AB - The addition of supine views to the standard double-contrast (DC) knee arthrogram with the patient prone can be useful (a) to diagnose meniscal tears not seen otherwise, (b) to provide a second look at an equivocal meniscal lesion, and (c) to enhance subject contrast in the presence of residual joint effusion, or when opaque medium has not adequately coated the interior surfaces of a large joint. In a prospective study of 137 patients, 30 meniscal tears were diagnosed, two of which were visible only on the supine films. PMID- 6501383 TI - Pneumoarthrography: reemphasis of a neglected technique. AB - Pneumoarthrography is a diagnostic method with which the arthrographer can confidently diagnose common joint abnormalities. Pneumoarthrography is especially applicable when it is necessary to avoid injection of iodinated contrast material and may be used in any situation where it is advisable to limit contrast associated pain, inflammation, or synovitis. We report four patients who had pneumoarthrograms because of contrast sensitivity and illustrate the examination quality and diagnostic efficacy achieved. PMID- 6501384 TI - The radiographic features of epidemic and sporadic Q fever pneumonia. AB - Radiographic dissimilarities exist between the chest radiographs of patients with epidemic and sporadically-occurring Q fever pneumonia. Chest radiographs of 25 patients with Q fever pneumonia were retrospectively assessed, and demonstrated previously unreported differences between these two broad groups. Differing strains of Coxiella burnetii, or varying doses of the pathogen, are postulated as the pathogenetic mechanisms for the observed discrepant findings. PMID- 6501385 TI - Canadian diagnostic radiology manpower 1982. AB - By accurate count there were 1 417 Canadian diagnostic radiologists in active practice in 1982 compared with 1 293 in 1977. Between 1966 and 1975 an average of 69 were certified each year by the Royal College of Physicians and Surgeons of Canada, while between 1970 and 1979 the number had fallen to an average of 59, with about four more entering practice following certification in Quebec or by recognition of American or British qualifications. The age of radiologists has risen and a larger proportion are women. Comparison with other data indicates that Canadian radiology manpower is now in balance. Continuation of manpower monitoring is necessary as a potential shortage of radiologists may occur because of the reduced number being trained, of physician immigration restrictions, of moderately less career-time in the work force on the part of women radiologists, of further advances in imaging technology, and of the demands of interventional radiology. PMID- 6501386 TI - The modified Simmons catheter: experience and complications. AB - The use of the modified Simmons catheter in a selected group of patients over 60 years old, where difficult catheterization was expected, is described. The ease of reforming the loop of the catheter and the ease with which tortuous brachiocephalic vessels are catheterized leads to the recommendation that this catheter should be used routinely in cerebral angiography where ectasia of the arteries is expected. PMID- 6501387 TI - Removal of intravascular foreign bodies using modified Grollman catheter and Dormia basket. AB - A modified Grollman catheter and a Dormia basket offer a simple method for removal of intravascular foreign bodies in about 30 minutes. This technique minimizes the likelihood of damaging the intimal wall or heart valves while allowing excellent maneuverability. PMID- 6501388 TI - The chest radiograph in the diagnosis of atypical nephritis due to infectious mononucleosis. AB - A four-year-old boy developed oliguria, proteinuria and hypocomplementemia, without hematuria, in the course of proven infectious mononucleosis. A chest radiograph revealed a mild cardiomegaly, prominent pulmonary vasculature and pleural fluid. These abnormalities were compatible with acute glomerulonephritis and were in support of this clinical diagnosis in spite of the absence of hematuria. PMID- 6501389 TI - Neonatal neuroblastoma presenting with respiratory distress. AB - We describe two patients to illustrate that neonatal respiratory distress can be associated with airway compression from an intrathoracic neuroblastoma. The clinical features can be either life-threatening from the time of birth or so mild as to escape detection in the immediate newborn period. PMID- 6501390 TI - Necrotizing sarcoid-like granulomatosis: radiologic-pathologic correlation. AB - Necrotizing sarcoid-like granulomatosis is one of five forms of pulmonary disease characterized histologically by angiitis and granulomata formation. Although there have been several reports of the clinical and pathological characteristics of the disease, there has been little reported radiographic correlation. We present two patients with necrotizing sarcoid-like granulomatosis with radiographic and pathologic correlation. The radiographic finding of diffuse lesions, either bilateral nodules or nodular densities with or without cavitation, should prompt definitive diagnostic evaluation. Tissue diagnosis is imperative as necrotizing sarcoid-like granulomatosis has a relatively good prognosis when compared with other similar granulomatous diseases. PMID- 6501391 TI - Plain film manifestations of retrocrural disease. AB - The following plain film findings of retrocrural disease were demonstrated by two patients: a) silhouetting, by a soft-tissue density, of a previously seen inner margin of the crus, b) lateral displacement of the crus, c) lateral deviation of the inferior portion of the paraspinal line, and d) abrupt obliteration of the upper portion of a well defined crus. PMID- 6501392 TI - Angiographic demonstration of an aorto-left renal vein fistula. AB - The unusual complication of an atherosclerotic abdominal aneurysm rupturing into a retro-aortic left renal vein is presented. Angiographic findings and the anatomic variations of the left renal vein are discussed. PMID- 6501393 TI - Percutaneous drainage of a psoas abscess in a young child. AB - Percutaneous drainage of abdominal and retroperitoneal abscesses has become a widely practiced alternative to surgery in selected patients. Although such techniques and results have been widely reported in adults, these series do not include reports of percutaneous drainage of a psoas abscess in a young child to emphasize that interventional radiologic techniques can be effective even in very young children. PMID- 6501394 TI - Occlusion of femoropopliteal bypasses (Biografts). AB - In a series of 225 femoropopliteal bypasses with a Biograft (1978-1983) there were 57 failures due to occlusion of the graft. The main cause was progressive atherosclerotic disease. Inflow obstruction occurred 12 times and outflow obstruction 27 times. Biograft-related causes were kinking of the graft in 7 and distal anastomotic stenosis in 11 cases. Forty nine of the 57 failures were submitted to reoperation. Inflow obstructions were corrected easily. Outflow obstructions were corrected with a jump graft in most of the above-knee cases. Outflow obstructions in the below-knee cases were difficult to correct. Thrombectomy and endarterectomy were successful on a few occasions. After occlusion of the Biograft due to kinking, a simple thrombectomy was always sufficient. Stenosis of the distal anastomosis made a patch angioplasty necessary. The 49 reoperations were initially successful in 38 patients (77%). Major amputation of the leg after an unsuccessful reintervention was necessary in 5 cases. PMID- 6501395 TI - Direct femoral artery pressure measurement at rest and during reactive hyperemia in the evaluation of the aorto-iliac segment. AB - Direct femoral artery pressure (FAP) studies with reactive hyperemia (RH) were performed on 39 extremities which underwent a proximal or distal reconstruction for angiographically multilevel disease. The half-year clinical results were correlated with the FAP studies. A second group of patients underwent FAP studies and angiography and both studies were correlated. The conclusions from the studies are in the first place that FAP studies with RH are an accurate way to assess the aorto-iliac segment without giving any complications; secondly that observation of single plane angiography tends to overestimate aorto-iliac disease. Finally, criteria are proposed which can help in the clinical decision whether to perform a distal or a proximal reconstruction in multilevel atherosclerotic disease. PMID- 6501396 TI - Subclavian-external carotid bypass. AB - Subclavian to external carotid artery bypass was performed to improve collateral flow to the brain in three patients with symptomatic cerebral ischemia from common-internal carotid occlusion. Stenosis of the contralateral carotid in the neck or intracranial internal carotid arteries was also present. There was significant neurological improvement without complications in the three operations. Saphenous vein was used for the bypass and graft patency was confirmed by intra or postoperative arteriography in all cases. PMID- 6501397 TI - Influence of the rupture site of abdominal aortic aneurysms with regard to postoperative survival rate. AB - This study presents an analysis of the influence of the site of rupture of abdominal aortic aneurysms on the postoperative survival rate. A series of 226 patients, who underwent emergency operations for ruptured aneurysms, is examined. The three most important methods of rupture are: (1) Retroperitoneal rupture: this type is associated with a very high mortality (52.8% in our experience), which reaches almost 75% when the posterior parietal peritoneum tears and massive intraperitoneal bleeding occurs. This mortality is related to the amount of blood loss, hypovolemic shock, the number of transfused blood units and, especially, to increasing renal insufficiency. (2) Rupture into the inferior vena cava: in this event the mortality rate it less severe (38.4% in our experience) and it is mostly related to the occurrence of an high output cardiac failure, as well as to oliguria or anuria following renal venous hypertension. (3) Enteric rupture: this is, in our experience, the most uncommon event. It carries a high mortality rate (50%). The copious bleeding, which is unrestricted in hollow organs, explains the dangerous hypovolemic shock, while massive blood reabsorption from the enteric tract leads to a renal insufficiency. PMID- 6501398 TI - Aorto-enteric fistulae: spontaneous and after aorto-iliac operations. AB - Ten case of arterio-enteric fistula are presented, 3 spontaneous and 7 following surgery on the aorta. In the majority of cases "herald bleeding" allows enough time to study the patient. Spontaneous fistulae are very rare and their diagnosis can be very difficult if the aneurysm is not palpable. In any case of gastrointestinal haemorrhage in a patient who has undergone an aortic operation an A-E fistula will be suspect. The only useful diagnostic procedure is gastroduodenoscopy which usually does not show any organic cause for the bleeding. Arteriography seems only a dangerous waste of time: emergency explorative laparotomy, if a fistula is suspected, is surely harmless and preferable. The only sure surgical technique consists in removal of the prosthesis followed by an extra-anatomic by-pass. PMID- 6501399 TI - The advantage of the thoraco-retroperitoneal approach for aortorenal bypass grafting. AB - Postoperative angiographic studies after aortorenal saphenous vein bypass grafting have revealed a high incidence of graft dilatation and aneurysms. The aortorenal bypasses in all these series were performed via the transabdominal approach which gives an angle of at least 90 degrees between the graft and aorta. The routine approach in the present study has been the thoraco-retroperitoneal one which has been used since more than 20 years in 189 patients. In 13 of them an aortorenal saphenous vein bypass was performed. The saphenous vein was sutured into the aorta above the orifice of the renal artery giving an acute angle of about 45 degrees. This angle gives much more favourable hemodynamic conditions including less turbulence. All the patients survived the operation and were followed for a mean period of 5 years. Two of the patients were hypertensive because of stenosis of the opposite renal artery. Eight patients are normotensive and three patients are improved. Renal arteriograms performed 4 to 13 years postoperatively in five of the patients showed excellent conditions without any dilatation of the graft. The thoraco-retroperitoneal approach gives a very good access to the entire renal artery and permits an aortorenal bypass with an angle which causes a minimum of turbulence. PMID- 6501400 TI - Renal complications to left renal vein ligation in abdominal aortic surgery. AB - Postoperative renal complications have been investigated in 31 patients subjected to left renal vein ligation during abdominal aortic surgery (11 ruptured and 18 non-ruptured aneurysms, 2 occlusive diseases). A marked increase in s-creatinine values was found in all patients after left renal vein ligation. The increase was significantly longer (p less than 0.01) and higher (p less than 0.005) as compared with control patients subjected to abdominal aortic surgery without ligation of the left renal vein. A sustained increase in postoperative s creatinine values was found in 6 patients, one of whom had a total loss of left kidney function. Left-sided nephrectomy was necessary in 2 patients to control bleeding from the kidney. Acute haemorrhagic infarction and subinfarction of the left kidney were seen in 2 patients. A restricted application of left renal vein ligation during abdominal aortic surgery is recommended. PMID- 6501401 TI - Prophylaxis against infection during vascular surgery. AB - The authors report their incidence of infection after vascular surgery (7 infections in 1,687 operations = 0.4%). They did not find any infections after surgery of the aorto-iliac-femoral tract (768 operations). The authors ascribe these good results to not using alloplastic grafts below the inguinal ligament. PMID- 6501402 TI - Left ventricular aneurysm: preoperative factors and postoperative results. AB - Among twenty-three patients who underwent surgery for left ventricular aneurysm, the operative mortality, hospital death and late mortality were 0, 1 (4%) and 1 (4%), respectively. Preoperative hemodynamic and radiographic factors were compared between those cases treated with intraaortic balloon pumping (IABP) because of postoperative low cardiac output syndrome (LCOS) and those cases without IABP. Employment of concomitant coronary revascularization and the factors related to myocardial protection showed no significant difference between the two groups. Moreover, there were no differences in preoperative hemodynamic parameters such as cardiac index, stroke volume index and overall left ventricular ejection fraction (EF). However, the EF of the contractile segment (CSEF) and functional parameters calculated by geometric method were well preserved in the non-IABP group. From these data, we concluded that patients who showed a CSEF of less than 45%, a left ventricular aneurysm volume index of more than 55 ml/M2 and a percent change of short axis diameter in contractile segment of less than 20 percent were more susceptible to LCOS after resection of left ventricular aneurysm. PMID- 6501403 TI - Serum thiocyanate levels in subjects who halve their cigarette consumption. AB - The serum thiocyanate levels were measured in sixteen volunteers who smoked their own brands of cigarettes normally. When their cigarette consumption was reduced by half, the serum thiocyanate levels remained unaltered. The most likely explanation of this finding is that the volunteers changed their inhalation behaviour. PMID- 6501404 TI - Aortoatrioplasty with double valve replacement for infective endocarditis. AB - This is a report of a patient with active infective endocarditis involving both aortic and mitral valve annuli. A new surgical technique which was necessary to replace the infected valves is described in detail. This may be regarded as an application of the Manouguian technique to infective endocarditis. PMID- 6501405 TI - The preoperative use of intraarterial thrombolysis for a thrombosed popliteal artery aneurysm. AB - A case of a thrombosed popliteal artery aneurysm with clot in tibial vessels is presented. Preoperative low dose intraarterial thrombolytic therapy lysed the clot and allowed for a successful surgical repair. PMID- 6501406 TI - Intraluminal thrombus from a kink at the distal end of a carotid aneurysm. AB - We describe a patient who had an intraluminal thrombus arising from a kink at the distal end of a carotid aneurysm. He had suffered two strokes both treated with heparin prior to surgery. His carotid aneurysm was replaced using saphenous vein placed over a Javid shunt. PMID- 6501407 TI - Osteoclast formation from mononuclear phagocytes: role of bone-forming cells. AB - In a previous study, using co-cultures of embryonic bone rudiments stripped of periosteum, and mononuclear phagocytes of various sources, we found that multinucleated mineral-resorbing osteoclasts developed in vitro from radiosensitive mouse bone marrow mononuclear phagocytes (BMMP). (Burger, E. H., J. W. M. van der Meer, J. S. van de Gevel, C. W. Thesingh, and R. van Furth, 1982, J. Exp. Med. 156:1604-1614). In the present study, this co-culture technique was used to analyze the influence of bone-forming cells on osteoclast formation and bone resorption by BMMP or peritoneal exudate cells (PEC). BMMP or PEC were co-cultured with liver or dead bone, i.e., in the presence or absence of liver bone-forming cells. Mineral resorption and osteoclast formation were monitored via 45Ca release from prelabeled live or dead bone followed by histology. Osteoclasts developed from precultured BMMP as indicated by [3H]thymidine labeling, but only in live and not in dead bone. They formed readily from BMMP but only erratically, and after a longer culture period, from PEC. Macrophages from BMMP and PEC invaded live and dead bone rudiments but did not resorb the intact mineralized matrix. In contrast, ground bone powder was resorbed avidly by both cell populations, without formation of osteoclasts. We conclude that live bone-forming cells are required for osteoclast formation from progenitors. Live bone is only resorbed by osteoclasts, and not by macrophages. Osteoclast progenitors are abundant in cultures of BMMP but scarce in PEC, which makes a direct descendance of osteoclasts from mature macrophages unlikely. PMID- 6501409 TI - Legionella pneumophila inhibits acidification of its phagosome in human monocytes. AB - We used quantitative fluorescence microscopy to measure the pH of phagosomes in human monocytes that contain virulent Legionella pneumophila, a bacterial pathogen that multiplies intracellularly in these phagocytes. The mean pH of phagosomes that contain live L. pneumophila was 6.1 in 14 experiments. In the same experiments, the mean pH of phagosomes containing dead L. pneumophila averaged 0.8 pH units lower than the mean pH of phagosomes containing live L. pneumophila, a difference that was highly significant (P less than 0.01 in all 14 experiments). In contrast, the mean pH of phagosomes initially containing live E. coli, which were then killed by monocytes, was the same as for phagosomes initially containing dead E. coli. The mean pH of L. pneumophila phagosomes in activated monocytes, which inhibit L. pneumophila intracellular multiplication, was the same as in nonactivated monocytes. To simultaneously measure the pH of different phagosomes within the same monocyte, we digitized and analyzed fluorescence images of monocytes that contained both live L. pneumophila and sheep erythrocytes. Within the same monocyte, live L. pneumophila phagosomes had a pH of approximately 6.1 and sheep erythrocyte phagosomes had a pH of approximately 5.0 or below. This study demonstrates that L. pneumophila is capable of modifying the pH of its phagocytic vacuole. This capability may be critical to the intracellular survival and multiplication of this and other intracellular pathogens. PMID- 6501408 TI - A Chinese hamster ovary cell mutant with a heat-sensitive, conditional-lethal defect in vacuolar function. AB - We describe a mutant derived from Chinese hamster ovary cells that is offt sensitive for viability and for resistance to certain protein toxins. This mutant, termed G.7.1, grows normally at 34 degrees C but does not grow in Dulbecco's modified Eagle's medium at 39.5 degrees C. However, when this medium is supplemented with FeSO4, the mutant cells will grow at the elevated temperature. At 39.5 degrees C, G.7.1 cells acquire resistance to diphtheria toxin, modeccin, and Pseudomonas aeruginosa exotoxin A, all of which are protein toxins that require endocytosis and exposure to a low pH within vesicles before they can invade the cytosol and kill cells. The properties of mutant G.7.1 could result from a heat-sensitive lesion that impairs vacuolar acidification. We assayed the ATP-stimulated generation of pH gradients across the membrane of vesicles in cell-free preparations from mutant and parental cells by the partitioning of acridine orange into acidic compartments and found that the acidification response of the mutant cells was heat-labile. Altogether the evidence suggests that G.7.1 cells contain a heat-sensitive lesion that impairs vacuolar acidification and that they fail to grow in normal medium at 39.5 degrees C because they cannot extract Fe+3 from transferrin, a process that normally requires exposing transferrin to a low pH within endosomal vesicles. PMID- 6501410 TI - Retrieval of lysosomal membrane and acid phosphatase from phagolysosomes of Paramecium caudatum. AB - Little is known about the fate of lysosomal membrane in phagocytic cells. Because the age of the digestive vacuoles in Paramecium caudatum can be easily determined, we have been able to study the dynamic membrane events in the older vacuoles. Late in the phagolysosomal stage (DV-III) the vacuole membrane undergoes a burst of tubule formation. The tubules expand into vesicles which have characteristics resembling lysosomes in both thin sections and freeze fracture replicas. The tubules also contain acid phosphatase activity when they arise from acid phosphatase-reactive vacuoles. We conclude that after active digestion lysosomal membrane is retrieved in whole or in part along with some membrane-associated hydrolases. A logical extension of these results is that the lysosome-like vesicles, after being recharged with hydrolases by fusing with primary lysosomes, are recycled back to DV-II for reuse. PMID- 6501411 TI - Synthesis of cartilage matrix by mammalian chondrocytes in vitro. III. Effects of ascorbate. AB - Chondrocytes isolated from bovine articular cartilage were plated at high density and grown in the presence or absence of ascorbate. Collagen and proteoglycans, the major matrix macromolecules synthesized by these cells, were isolated at times during the course of the culture period and characterized. In both control and ascorbate-treated cultures, type II collagen and cartilage proteoglycans accumulated in the cell-associated matrix. Control cells secreted proteoglycans and type II collagen into the medium, whereas with time in culture, ascorbate treated cells secreted an increasing proportion of types I and III collagens into the medium. The ascorbate-treated cells did not incorporate type I collagen into the cell-associated matrix, but continued to accumulate type II collagen in this compartment. Upon removal of ascorbate, the cells ceased to synthesize type I collagen. Morphological examination of ascorbate-treated and control chondrocyte culture revealed that both collagen and proteoglycans were deposited into the extracellular matrix. The ascorbate-treated cells accumulated a more extensive matrix that was rich in collagen fibrils and ruthenium red-positive proteoglycans. This study demonstrated that although ascorbate facilitates the formation of an extracellular matrix in chondrocyte cultures, it can also cause a reversible alteration in the phenotypic expression of those cells in vitro. PMID- 6501412 TI - Identification and isolation of endothelial cells based on their increased uptake of acetylated-low density lipoprotein. AB - Acetylated-low density lipoprotein (Ac-LDL) is taken up by macrophages and endothelial cells via the "scavenger cell pathway" of LDL metabolism. In this report, aortic and microvascular endothelial cells internalized and degraded 7-15 times more [125I]-Ac-LDL than did smooth muscle cells or pericytes. Bound [125I] Ac-LDL was displaced by unlabeled Ac-LDL, but not unmodified LDL. The ability to identify endothelial cells based on their increased metabolism of Ac-LDL was examined using Ac-LDL labeled with the fluorescent probe 1,1'-dioctadecyl 3,3,3',3'-tetramethyl-indocarbocyanine perchlorate (Dil-Ac-LDL). When cells were incubated with 10 micrograms/ml Dil-Ac-LDL for 4 h at 37 degrees C and subsequently examined by fluorescence microscopy, capillary and aortic endothelial cells were brilliantly fluorescent whereas the fluorescent intensity of retinal pericytes and smooth muscle cells was only slightly above background levels. Dil-Ac-LDL at the concentration used for labeling cells had no effect on endothelial cell growth rate. When primary cultures of bovine adrenal capillary cells were labeled with 10 micrograms/ml of Dil-Ac-LDL for 4 h at 37 degrees C, then trypsinized and subjected to fluorescence-activated cell sorting, pure cultures of capillary endothelial cells could be obtained. Utilizing this method, large numbers of early passage microvascular endothelial cells can be obtained in significantly less time than with conventional methods. PMID- 6501413 TI - Biosynthesis of the D2-cell adhesion molecule: post-translational modifications, intracellular transport, and developmental changes. AB - Posttranslational modifications and intracellular transport of the D2-cell adhesion molecule (D2-CAM) were examined in cultured fetal rat neuronal cells. Developmental changes in biosynthesis were studied in rat forebrain explant cultures. Two D2-CAM polypeptides with Mr of 187,000-210,000 (A) and 131,000 158,000 (B) were synthesized using radiolabeled precursors in cultured neurons. A and B were found to contain only N-linked complex oligosaccharides, and both polypeptides appeared to be polysialated as determined by [14C]mannosamine incorporation and precipitation with anti-polysialic acid antibody. The two polypeptides were sulfated in the trans-Golgi compartment and phosphorylated at the plasma membrane. D2-CAM underwent rapid intracellular transport, appearing at the cell surface within 35 min of synthesis. A and B were shown to be integral membrane proteins as seen by radioiodination by photoactivation employing a hydrophobic labeling reagent. In rat forebrain explant cultures, D2-CAM was synthesized as four polypeptides: A (195,000 Mr), B (137,000 Mr), C (115,000 Mr), and a group of polypeptides in the high molecular weight region (HMr) between 250,000 and 350,000. Peptide maps of the four polypeptides yielded similar patterns. Biosynthesis of C and HMr increased with age, relative to A and B. A and B were sulfated in embryonic brain, however, sulfation was not noticeable at postnatal ages. Phosphorylation, on the other hand, of A and B was observed at all ages examined. We suggest that D2-CAM function may be modified during development by changes in the relative synthesis of the different polypeptides, as well as by changes in their glycosylation and sulfation. PMID- 6501414 TI - Pericellular coat of chick embryo chondrocytes: structural role of hyaluronate. AB - Chondrocytes produce large pericellular coats in vitro that can be visualized by the exclusion of particles, e.g., fixed erythrocytes, and that are removed by treatment with Streptomyces hyaluronidase, which is specific for hyaluronate. In this study, we examined the kinetics of formation of these coats and the relationship of hyaluronate and proteoglycan to coat structure. Chondrocytes were isolated from chick tibia cartilage by collagenase-trypsin digestion and were characterized by their morphology and by their synthesis of both type II collagen and high molecular weight proteoglycans. The degree of spreading of the chondrocytes and the size of the coats were quantitated at various times subsequent to seeding by tracing phase-contrast photomicrographs of the cultures. After seeding, the chondrocytes attached themselves to the tissue culture dish and exhibited coats within 4 h. The coats reached a maximum size after 3-4 d and subsequently decreased over the next 2-3 d. Subcultured chondrocytes produced a large coat only if passaged before 4 d. Both primary and first passage cells, with or without coats, produced type II collagen but not type I collagen as determined by enzyme-linked immunosorbent assay. Treatment with Streptomyces hyaluronidase (1.0 mU/ml, 15 min), which completely removed the coat, released 58% of the chondroitin sulfate but only 9% of the proteins associated with the cell surface. The proteins released by hyaluronidase were not digestible by bacterial collagenase. Monensin and cycloheximide (0.01-10 microM, 48 h) caused a dose-dependent decrease in coat size that was linearly correlated to synthesis of cell surface hyaluronate (r = 0.98) but not chondroitin sulfate (r = 0.2). We conclude that the coat surrounding chondrocytes is dependent on hyaluronate for its structure and that hyaluronate retains a large proportion of the proteoglycan in the coat. PMID- 6501415 TI - Sorting of an apical plasma membrane glycoprotein occurs before it reaches the cell surface in cultured epithelial cells. AB - In Madin-Darby canine kidney (MDCK) cells (a polarized epithelial cell line) infected with influenza virus, the hemagglutinin behaves as an apical plasma membrane glycoprotein. To determine biochemically the domain on the plasma membrane, apical or basolateral, where newly synthesized hemagglutinin first appears, cells were cultured on Millipore filters to make both cell surface domains independently accessible. Hemagglutinin in virus-infected cells was pulse labeled, chased, and detected on the plasma membrane with a sensitive trypsin assay. Under all conditions tested, newly made hemagglutinin appeared simultaneously on both domains, with the bulk found in the apical membrane. When trypsin was continuously present on the basolateral surface during the chase, little hemagglutinin was cleaved relative to the amount transported apically. In addition, specific antibodies against the hemagglutinin placed basolaterally had no effect on transport to the apical domain. These observations suggested that most newly synthesized hemagglutinin does not transiently appear on the basolateral surface but rather is delivered directly to the apical surface in amounts that account for its final polarized distribution. PMID- 6501416 TI - Adhesion of platelets to laminin in the absence of activation. AB - The binding of platelets to components in the subendothelial matrix is an initial event in hemostasis and thrombosis. The glycoprotein components of the matrix are considered important in this interaction. Of these, collagen binds and activates platelets and induces their aggregation. In this study we demonstrate that substrate-bound laminin causes time- and concentration-dependent adherence of human platelets to the substrate. The binding of platelets to laminin was found to be similar in some respects, but different in others, to their binding to surfaces coated with fibronectin or collagen. The binding of platelets to laminin or fibronectin was not associated with their activation under conditions in which type I collagen activates the platelets as measured by [14C]serotonin secretion. Platelets bound to laminin and fibronectin differed in their appearance; they remained rounded on laminin whereas they flattened completely on fibronectin. Binding of platelets to fibronectin, but not laminin, is inhibited by a recently described peptide (Pierschbacher, M., and E. Ruoslahti, 1984, Nature (Lond.), 309:30-33) containing the cell-attachment tetrapeptide sequence of fibronectin, which suggests that separate receptors exist for laminin and fibronectin. These studies establish laminin as a platelet-binding protein and suggest that laminin can contribute to the adhesiveness of exposed tissue matrices to platelets. Since laminin and fibronectin do not activate platelets, whereas collagen does, and laminin differs from fibronectin in that it does not induce spreading of the attached platelets, all three proteins appear to confer different signals to the platelets. Some of these may be related to platelet functions other than those necessary for the formation of a hemostatic plug. PMID- 6501417 TI - Diffusion coefficient of fluorescein-labeled tubulin in the cytoplasm of embryonic cells of a sea urchin: video image analysis of fluorescence redistribution after photobleaching. AB - The diffusion coefficient of tubulin has been measured in the cytoplasm of eggs and embryos of the sea urchin Lytechinus variegatus. We have used brain tubulin, conjugated to dichlorotriazinyl-aminofluorescein, to inject eggs and embryos. The resulting distributions of fluorescence were perturbed by bleaching with a microbeam of light from the 488-nm line of an argon ion laser. Fluorescence redistribution after photobleaching was monitored with a sensitive video camera and photography of the television-generated image. With standard photometric methods, we have calibrated this recording system and measured the rates of fluorescence redistribution for tubulin, conjugated to dichlorotriazinyl aminofluorescein, not incorporated into the mitotic spindle. The diffusion coefficient (D) was calculated from these data using Fick's second law of diffusion and a digital method for analysis of the photometric curves. We have tested our method by determining D for bovine serum albumin (BSA) under conditions where the value is already known and by measuring D for fluorescein labeled BSA in sea urchin eggs with a standard apparatus for monitoring fluorescence redistribution after photobleaching. The values agree to within experimental error. Dcytoplasmtubulin = 5.9 +/- 2.2 X 10(-8) cm2/s; DcytoplasmBSA = 8.6 +/- 2.0 X 10(-8) cm2/s. Because DH2OBSA = 68 X 10(-8) cm2/s, these data suggest that the viscosity of sea urchin cytoplasm for protein is about eight times that of water and that most of the tubulin of the sea urchin cytoplasm exists as a dimer or small oligomer, which is unbound to structures that would impede its diffusion. Values and limitations of our method are discussed, and we draw attention to both the variations in D for single proteins in different cells and the importance of D for the upper limit to the rates of polymerization reactions. PMID- 6501419 TI - Tubulin dynamics in cultured mammalian cells. AB - Bovine neurotubulin has been labeled with dichlorotriazinyl-aminofluorescein (DTAF-tubulin) and microinjected into cultured mammalian cells strains PTK1 and BSC. The fibrous, fluorescence patterns that developed in the microinjected cells were almost indistinguishable from the pattern of microtubules seen in the same cells by indirect immunofluorescence. DTAF-tubulin participated in the formation of all visible, microtubule-related structures at all cell cycle stages for at least 48 h after injection. Treatments of injected cells with Nocodazole or Taxol showed that DTAF-tubulin closely mimicked the behavior of endogenous tubulin. The rate at which microtubules incorporated DTAF-tubulin depended on the cell-cycle stage of the injected cell. Mitotic microtubules became fluorescent within seconds while interphase microtubules required minutes. Studies using fluorescence redistribution after photobleaching confirmed this apparent difference in tubulin dynamics between mitotic and interphase cells. The temporal patterns of redistribution included a rapid phase (approximately 3 s) that we attribute to diffusion of free DTAF-tubulin and a second, slower phase that seems to represent the exchange of bleached DTAF-tubulin in microtubules with free, unbleached DTAF-tubulin. Mean half times of redistribution were 18-fold shorter in mitotic cells than they were in interphase cells. PMID- 6501420 TI - Paramecium secretory granule content: quantitative studies on in vitro expansion and its regulation by calcium and pH. AB - Ca2+-dependent secretion in Paramecium involves the exocytic release of a paracrystalline secretory product, the trichocyst matrix, which undergoes a characteristic structural change from a highly condensed storage form (Stage I) to an extended needle-like structure (Stage III) during release. We studied trichocyst matrix expansion in vitro to examine factors regulating the state of secretory organelle content. A new method for the isolation of membrane-free, condensed (Stage I) trichocyst matrices is described. These highly purified, condensed matrices were used to develop a rapid quantitative, spectrophotometric assay for matrix expansion to examine factors regulating the Stage I and Stage III transition. Expansion from Stages I to III was elicited in vitro by addition of Ca2+ and we found that at neutral pH, expansion required a Ca2+ concentration slightly above 10(-6)M. Previous studies indicate that calmodulin (CaM) antagonists inhibit matrix expansion in vivo. However, in vitro matrix expansion is normal even when trichocyst matrices are preincubated in CaM antagonists before stimulation. Thus, matrix components themselves are unlikely to be the site of CaM antagonist action in vivo. In vitro matrix expansion is also modulated by pH. Decreasing pH to 6.0 inhibits expansion, i.e., expansion requires higher Ca2+ concentration. Conversely, increasing pH to greater than 7.0 promotes expansion, allowing it to occur at a lower Ca2+ concentration. The pH sensitivity of the Ca2+ binding sites of the matrix suggests that, in vivo, the interior of the trichocyst vesicle may be maintained at an acidic pH. Exposure of cells to acridine orange, a fluorescent amine that accumulates in acidic intracellular compartments, leads to its uptake and concentration within trichocysts. Thus intratrichocyst pH appears to be acidic in vivo and may serve as a regulatory or "safety" mechanism to inhibit premature expansion. PMID- 6501418 TI - Spindle microtubule dynamics in sea urchin embryos: analysis using a fluorescein labeled tubulin and measurements of fluorescence redistribution after laser photobleaching. AB - The rate of exchange of tubulin that is incorporated into spindle microtubules with dimeric tubulin in the cytoplasm has been measured in sea urchin eggs by studying fluorescence redistribution after photobleaching (FRAP). Dichlorotriazinyl amino fluorescein (DTAF) has been used to label bovine brain tubulin. DTAF-tubulin has been injected into fertilized eggs of Lytechinus variegatus and allowed to equilibrate with the endogenous tubulin pool. Fluorescent spindles formed at the same time that spindles were seen in control eggs, and the injected embryos proceeded through many cycles of division on schedule, suggesting that DTAF-tubulin is a good analogue of tubulin in vivo. A microbeam of argon laser light has been used to bleach parts of the fluorescent spindles, and FRAP has been recorded with a sensitive video camera. Laser bleaching did not affect spindle structure, as seen with polarization optics, nor spindle function, as seen by rate of progress through mitosis, even when one spindle was bleached several times in a single cell cycle. Video image analysis has been used to measure the rate of FRAP and to obtain a low resolution view of the fluorescence redistribution process. The half-time for spindle FRAP is approximately 19 s, even when an entire half-spindle is bleached. Complete exchange of tubulin in nonkinetochore spindle and astral microtubules appeared to occur within 60-80 s at steady state. This rate is too fast to be explained by a simple microtubule end-dependent exchange of tubulin. Efficient microtubule treadmilling would be fast enough, but with current techniques we saw no evidence for movement of the bleached spot during recovery, which we would expect on the basis of Margolis and Wilson's model (Nature (Lond.)., 1981, 293:705)- fluorescence recovers uniformly. Microtubules may be depolymerizing and repolymerizing rapidly and asynchronously throughout the spindle and asters, but the FRAP data are most compatible with a rapid exchange of tubulin subunits all along the entire lengths of nonkinetochore spindle and astral microtubules. PMID- 6501421 TI - Movement of a karyophilic protein through the nuclear pores of oocytes. AB - It has recently been shown that large karyophilic proteins are transported across the nuclear envelope in amphibian oocytes. In consideration of this, the present experiments were performed to identify the specific sites within the envelope through which transport occurs and determine if molecular size is a limiting factor in the transport process. The following experimental procedure was employed: Colloidal gold particles, varying in size from approximately 20 to 170 A in diameter were coated with nucleoplasmin, a 165,000-mol-wt karyophilic protein, which is known to be transported through the envelope. The coated gold particles were microinjected into the cytoplasm of Xenopus oocytes, and the cells were fixed 15 min and 1 h later. The intracellular localization of the gold was then determined with the electron microscope. It was found that nucleoplasmin coated particles readily enter the nucleus. On the basis of the distribution of the particles associated with the envelope, we concluded that transport occurs through the nuclear pores. Furthermore, the size distributions of the gold particles present in the nucleus and cytoplasm were not significantly different, indicating that the envelope does not discriminate among particles with diameters ranging from 50 to 200 A (the dimensions including the nucleoplasmin coat). Colloidal gold coated with trypsin-digested nucleoplasmin (which lacks the polypeptide domain required for transport) or exogenous polyvinylpyrrolidone were largely excluded from the nucleus and showed no evidence of transport. PMID- 6501422 TI - Acyl-Coa oxidase and hydratase-dehydrogenase, two enzymes of the peroxisomal beta oxidation system, are synthesized on free polysomes of clofibrate-treated rat liver. AB - We investigated the site of synthesis of two abundant proteins in clofibrate induced rat hepatic peroxisomes. RNA was extracted from free and membrane-bound polysomes, heated to improve translational efficiency, and translated in the mRNA dependent, reticulocyte-lysate-cell-free, protein-synthesizing system. The peroxisomal acyl-CoA oxidase and enoyl-CoA hydratase-beta-hydroxyacyl-CoA dehydrogenase 35S-translation products were isolated immunochemically, analyzed by SDS PAGE and fluorography, and quantitated by densitometric scanning. The RNAs coding for these two peroxisomal proteins were found predominantly on free polysomes, and the translation products co-migrated with the mature proteins. As in normal rat liver, preproalbumin and catalase were synthesized mainly by membrane-bound and by free polysomes, respectively. mRNAs for a number of minor 35S-translation products also retained by the anti-peroxisomal immunoadsorbent were similarly found on free polysomes. These results, together with previous data, allow the generalization that the content proteins of rat liver peroxisomes are synthesized on free polysomes, and the data imply a posttranslational packaging mechanism for these major content proteins. PMID- 6501423 TI - Segregation of the polypeptide translocation apparatus to regions of the endoplasmic reticulum containing ribophorins and ribosomes. I. Functional tests on rat liver microsomal subfractions. AB - A preparation of rat liver microsomes containing 70% of the total cellular endoplasmic reticulum (ER) membranes was subfractionated by isopycnic density centrifugation. Twelve subfractions of different ribosome content ranging in density from 1.06 to 1.29 were obtained and analyzed with respect to marker enzymes, RNA, and protein content, as well as the capacity of these membranes to bind 80S ribosomes in vitro. After removal of native polysomes from these microsomal subfractions by puromycin in a buffer of high ionic strength their capacity to rebind 80S ribosomes approached levels found in the corresponding native membranes before ribosome stripping. This indicates that in vitro rebinding of ribosomes occurs to the same sites occupied in the cell by membrane bound polysomes. Microsomes in the microsomal subfractions were also tested for their capacity to effect the translocation of nascent secretory proteins into the microsomal lumen utilizing a rabbit reticulocyte translation system programmed with mRNA coding for the precursor of human placental lactogen. Membranes from microsomes with the higher isopycnic density and a high ribosome content showed the highest translocation activity, whereas membranes derived from smooth microsomes had only a very low translocation activity. These results indicate the membranes of the rough and smooth portions of the endoplasmic reticulum are functionally differentiated so that sites for ribosome binding and the translocation of nascent polypeptides are segregated to the rough domain of the organelle. PMID- 6501424 TI - Segregation of the polypeptide translocation apparatus to regions of the endoplasmic reticulum containing ribophorins and ribosomes. II. Rat liver microsomal subfractions contain equimolar amounts of ribophorins and ribosomes. AB - Ribophorins I and II, two transmembrane glycoproteins characteristic of the rough endoplasmic reticulum (ER) are thought to be part of the translocation apparatus for proteins made on membrane bound polysomes. To study the stoichiometry between ribophorins and membrane-bound ribosomes we have determined the RNA and ribophorin content in rat liver microsomes or in microsomal subfractions of different density (i.e., ribosome content). The specificity of antibodies against the ribophorins was demonstrated by Western blot analysis of rat liver rough microsomes separated by 2-dimensional gel electrophoresis. The ribophorin content of microsomal subfractions was determined by indirect immunoprecipitation and for ribophorin I by a radioimmune assay. In the latter assay a molar ratio of ribophorin I/ribosomes approaching one was calculated for total microsomes as well as in the gradient subfractions. We therefore suggest that ribophorins mediate the binding of ribosomes to endoplasmic reticulum membranes or play a role in co-translational process which depend on this binding, such as the insertion of nascent polypeptides into the membrane or their transfer into the cisternal lumen. PMID- 6501425 TI - Shape changes in human erythrocytes induced by replacement of the native phosphatidylcholine with species containing various fatty acids. AB - Phosphatidylcholine-specific transfer protein from beef liver has been used to replace native phosphatidylcholine (PC) molecules from intact human erythrocytes by a variety of PC species differing in fatty acid composition. These replacements changed neither the total phospholipid content of the membrane, nor the composition of this fraction in terms of the various phospholipid classes. The morphology of the erythrocyte was not modified when native PC was replaced by 1-palmitoyl,2-oleoyl PC, 1-palmitoyl,2-linoleoyl PC, egg PC, or PC isolated from rat liver microsomes. Replacement with the disaturated species 1,2-dimyristoyl PC, 1,2-dipalmitoyl PC, and 1,2-distearoyl PC resulted in the formation of echinocytes and, at higher levels of replacement, in spheroechinocytes. Echinocyte-like erythrocytes were also observed after replacement with 1 palmitoyl,2-arachidonoyl PC, whereas stomatocytes were formed upon replacement with PC species containing two unsaturated fatty acids, e.g., 1,2-dioleoyl PC and 1,2-dilinoleoyl PC. The observations show that the erythrocyte membrane structure and the overall discoid cell shape of the human erythrocyte are optimally stabilized by PC species that contain one saturated and one mono- or diunsaturated fatty acid, and that the cell tolerates only limited variations in the species composition of its PC. PMID- 6501426 TI - MAP 4: a microtubule-associated protein specific for a subset of tissue microtubules. AB - The cytological distribution of microtubule-associated protein 4 (MAP 4) (L. M. Parysek, C. F. Asnes, J. B. Olmsted, 1984, J. Cell Biol., 99:1309-1315) in mouse tissues has been examined. Adjacent 0.5-0.9-micron sections of polyethylene glycol-embedded tissues were incubated with affinity-purified MAP 4 or tubulin antibodies, and the immunofluorescent images were compared. Tubulin antibody labeling showed distinct microtubules in all tissues examined. MAP 4 antibody also labeled microtubule-like patterns, but the extent of MAP 4 reactivity was cell type-specific within each tissue. MAP 4 antibody labeled microtubules in vascular elements of all tissues and in other cells considered to have supportive functions, including Sertoli cells in the testis and glial elements in the nervous system. Microtubule patterns were also observed in cardiac, smooth, and skeletal (eye) muscle, podocytes in kidney, Kuppfer cells in liver, and spermatid manchettes. The only MAP 4-positive cells in which the pattern was not microtubule-like were the principal cells of the collecting ducts in kidney cortex, in which diffuse fluorescence was seen. MAP 4 antibody did not react with microtubule-rich neuronal elements of the central and peripheral nervous system, skeletal muscle from anterior thigh, liver parenchymal cells, columnar epithelial cells of the small intestine, and absorptive cells of the tubular component of the nephron. These observations indicate that MAP 4 may be associated with only certain kinds of cell functions as demonstrated by the preferential distribution with microtubules of defined cell types. PMID- 6501427 TI - Differential proliferative responses of cultured Schwann cells to axolemma- and myelin-enriched fractions. I. Biochemical studies. AB - Cultured rat Schwann cells were treated for 72 h with axolemma- and myelin enriched fractions prepared from rat brainstem. [3H]Thymidine was added to the cultures 48 h before the termination of the experiment. Although, both fractions produced a dose-dependent uptake of label into Schwann cells, the shape of the dose response curves and rates at which [3H]thymidine was incorporated were different. The axolemma-enriched fraction produced a sigmoid dose response curve with a Hill coefficient of 2.05. The dose response curve for myelin rose sharply and saturated at a level that was approximately 50% of the maximal response observed with axolemma. Schwann cells that had been treated with axolemma exhibited little change in the rate of [3H]thymidine incorporation from 36-72 h after the addition of the membranes. In contrast, Schwann cells accumulated label three times faster during the 48-72-h period following the addition of myelin to the cultures when compared with the rate during the preceding 12-h interval. Furthermore, the mitogenic activity of the myelin-enriched fraction was decreased by the addition of ammonium chloride, a lysosomal inhibitor, whereas the activity of the axolemmal fraction was not impaired. PMID- 6501428 TI - Lateral diffusion of wild-type and mutant Ld antigens in L cells. AB - We have compared the lateral diffusion of intact transmembrane proteins, wild type H-2Ld antigens, with that of mutants truncated in the cytoplasmic domain. Diffusion coefficients and mobile fractions were similar for all molecules examined, from wild-type Ld antigens with 31 residues on the cytoplasmic side of the plasma membrane to mutants with only four residues in the cytoplasmic domain. This result limits ways in which the lateral diffusion of a major histocompatibility antigen, a transmembrane protein, can be constrained by interactions with other molecules. PMID- 6501429 TI - Cell cycle regulation by environmental pH. AB - Purified populations of quiescent human tumour cells were isolated from plateau phase cultures of PMC-22 cells by centrifugal elutriation. Dilution into fresh medium resulted in these quiescent cells entering S phase exponentially with a t1/2 of 12 hr, after a 18-20-hr lag period during which cellular RNA content increased. Subsequent studies showed that recruitment of quiescent cells into the cell cycle could be regulated by extracellular pH. When exponentially growing PMC 22 cells were exposed to acidic extracellular pH levels, three growth patterns were observed: 1) Normal growth between pH 7.2 to pH 6.8; 2) A reduction in growth rate associated with accumulation of cells with a G1 DNA content between pH 6.7 and 6.4 (this was also shown to occur in a number of other tumour cell lines); 3) Non-cell-cycle-phase-specific arrest of growth at pH levels less than 6.3. Further studies with purified quiescent cell populations showed the possible existence of a pH-dependent restriction point in the G1 phase of these tumour cells. The implications of these observations to tumour biology are discussed. PMID- 6501431 TI - Role of membrane potential in the regulation of lectin-induced calcium uptake. AB - Incubation of lymphocytes with mitogenic lectins triggers Ca2+ uptake. This increase in free cytoplasmic Ca2+ is postulated to be an important signal in the initiation of DNA synthesis. Transmembrane fluxes of monovalent ions and changes in membrane potential are also associated with lectin-induced activation of lymphocytes. We have examined the relationship between extra-cellular monovalent ion substitution, the associated electrical potential changes (measured with cyanine dyes), phytohemagglutinin-induced Ca2+ uptake (measured with Quin-2) and proliferation in human T cells. The results show that (1) the magnitude of the increase in free cytoplasmic Ca2+ concentration is correlated with the extent of the lymphoproliferative response, (2) lectin-induced Ca2+ fluxes are sensitive to membrane potential, decreasing with depolarization, and are likely conductive, and (3) the presence of extra-cellular Na+ during incubation with phytohemagglutinin is not essential to mitogenic triggering. PMID- 6501430 TI - Splenic erythroblasts in anemia-inducing Friend disease: a source of cells for studies of erythropoietin-mediated differentiation. AB - Splenic erythroblasts obtained from mice during the acute disease caused by either the polycythemia-inducing (FVP) or anemia-inducing (FVA) strain of Friend virus were examined for their degree of terminal differentiation. Morphology, benzidine staining, and heme synthesis kinetics showed that many erythroblasts from FVP-infected mice were undergoing terminal differentiation, while few erythroblasts from FVA-infected mice showed evidence of terminal differentiation. When cultured in methylcellulose medium, splenic erythroblasts from FVP-infected mice completed differentiation without the addition of erythropoietin (EP) to the medium. However, splenic erythroblasts from FVA-infected mice underwent terminal differentiation in vitro only when EP was added to the medium. From spleens of FVA-infected mice, a population of large, immature-appearing erythroblasts was obtained by separation with velocity sedimentation at unit gravity. Serial studies of the separated erythroblasts which were cultured with EP showed that despite some heterogeneity in their proliferative capacity, they were relatively homogeneous in their degree of differentiation in that they had not begun to synthesize heme or globin. Morphological changes and syntheses of heme and globins were monitored during terminal differentiation induced in vitro by EP. The accumulation of immature erythroblasts in vivo, their responsiveness in vitro to EP, and availability of large numbers of cells (10(8) or more) make the splenic erythroblasts of FVA-infected mice an ideal population of cells with which to study EP-mediated terminal differentiation. This erythroblast population should permit the biochemical and molecular studies in erythroid differentiation which heretofore had to be done with chemically induced erythroid differentiation in continuous cell lines. PMID- 6501432 TI - Phorbol esters inhibit the binding of low-density lipoproteins (LDL) to U-937 monocytelike cells. AB - The present study demonstrates that U-937 monocytelike human cells possess specific LDL receptors. 125I-LDL binds at 4 degrees C on the cell surface. The bound molecules are releasable by heparin. The reaction requires Ca2+ and the binding sites are sensitive to proteolysis. Unlabeled LDL compete with 125I-LDL, whereas HDL are ineffective. At 37 degrees C, LDL are internalized and degraded by a chloroquine-sensitive pathway. Tumor-promoting phorbol esters inhibit the binding of 125I-LDL to its receptor on U-937 cells. This inhibition exhibits temperature, time, and concentration dependence. At 37 degrees C, inhibition is 50% at 5 X 10(-9) M of TPA. After removal of phorbol esters, treated cells recover their 125I-LDL-binding activity in 60 min. The inhibitory activities of various phorbol esters are proportional to their tumor-promoting activities. Inhibition appears to be due to a reduction in the number of available LDL receptors rather than a decrease in receptor affinity. PMID- 6501433 TI - Effects of ethidium bromide on cells of the cockroach central nervous system. AB - The effects of ethidium bromide were tested on isolated cockroach interganglionic connectives, either with the perineurium intact or desheathed. Intact connectives showed small, reversible depolarizations in response to 25 mM-ethidium. Desheathed connectives showed much larger, concentration-dependent depolarizations and the membrane potentials repolarized only slowly after washing out ethidium. The ethidium-induced depolarization could be blocked by raising the K concentration in the salines and was also shown to be reduced by rubidium, caesium, ammonium and ouabain. These treatments also reduced the degree of staining of nerve cords by ethidium, which was demonstrated to enter the cells. PMID- 6501434 TI - Distribution of protein sulphydryls and disulphides in fixed mammalian chromosomes, and their relationship to banding. AB - Fixed mammalian mitotic chromosomes, when stained with a variety of sensitive, sulphydryl-specific fluorochromes directly or following reduction of disulphide groups, show uniform fluorescence. Thus sulphydryl and disulphide groups are uniformly distributed along the length of the chromosomes, and do not show patterns related to chromosome bands. Performance of G- or C-banding procedures oxidizes sulphydryls to disulphides, but does not produce an inhomogeneous distribution of these groups. Cross-linking sulphydryl groups has no effect on G , C- or Q-banding of chromosomes. Thus there appears to be no connection between chromosome bands and the distribution or state of oxidation of sulphur in chromosomal proteins. PMID- 6501435 TI - Lesions induced in DNA by ultraviolet light are repaired at the nuclear cage. AB - In mammalian cells, S-phase DNA synthesis occurs at sites fixed to a sub-nuclear structure, the nuclear matrix or cage. This is an ordered network of non-histone proteins, which maintains its essential morphology even in the absence of DNA. We show here that unscheduled DNA synthesis following exposure of HeLa cells to ultraviolet light also takes place at this sub-structure. We also show that ultraviolet irradiation grossly reorganizes nuclear DNA, arresting S-phase synthesis at the cage and leaving the residual synthesis highly localized. PMID- 6501436 TI - Permeability properties of mammalian cell nuclei in living cells and in vitro. AB - The present study evaluates the role of the nuclear envelope in mammalian cells by applying two different approaches using either intact cells of mouse liver or isolated nuclei. In one approach the nuclei were studied with microelectrodes. The transmembrane voltage drop produced by passing current through an impaling microelectrode was measured with a second impaling microelectrode. In the second approach, the permeability of the nuclear envelope was studied by injection of a series of fluorescent probes. Lucifer Yellow CH and a variety of exogenous proteins labelled by conjugation with Lucifer Yellow VS were delivered into either the cytoplasm or the nucleus in situ. The fluorescence of the probe was followed either with a video camera or photographically. The results agree with the idea that the mammalian nuclear envelope is permeable to rather large molecules. Molecules with estimated radii below 2.4 nm seem to exchange rapidly, whereas molecules with estimated radii of 2.8 nm or above are excluded. The low electrical resistance of the envelope yields an estimate of pore radius, in the range of 3.4-6.5 nm. PMID- 6501437 TI - Effect of substrate composition on bone resorption by rabbit osteoclasts. AB - Slices of human femoral cortical bone were prepared with a carborundum wheel. Osteoclasts were isolated from neonatal rabbit long bones and incubated on either untreated, demineralized or anorganic preparations of these bone slices. Anorganic bone showed extensive tracts of uninterrupted surface excavation after incubation, while untreated bone tended to show discontinuous excavations of smaller total volume; demineralized bone was not resorbed. The endosteal surface of adult rat calvaria was also used as a substrate for osteoclastic bone resorption. The endosteal surface was exposed and rendered acellular, and was used either without further treatment or after incubation in collagenase. Bone resorption occurred only in those calvaria pre-treated with collagenase. These experiments imply that osteoclastic contact with bone mineral rather than the endosteal surface is the stimulus that initiates bone-resorptive behaviour in osteoclasts. The mechanism by which osteoblasts induce osteoclastic bone resorption may be through the known ability of osteoblasts to secrete collagenase, which, by digestion of the unmineralized lamina limitans of endosteal surfaces, exposes bone mineral to osteoclastic contact. PMID- 6501438 TI - Reduction in the mitochondrial membrane potential of Toxoplasma gondii after invasion of host cells. AB - The membrane potential of Toxoplasma gondii, an obligatory intracellular protozoan parasite, was monitored with the cationic permeant fluorescent dye rhodamine 123 (R123). Fluorescence microscopy revealed R123 to be partitioned predominantly in a restricted part of the parasite, which consisted of twisted or branched tubules, or of granular bodies. These structures were frequently connected to each other. The dye retention by these structures was markedly reduced by treating R123-labelled parasites with the proton ionophore, carbonylcyanide m-chlorophenylhydrazone, the potassium ionophore, valinomycin and the inhibitor of electron transport, antimycin A. Thus, these structures are regarded as the parasite mitochondria. Another cationic fluorescent dye, rhodamine 6G, stained the parasite mitochondria, whereas a negatively charged fluorescent dye, fluorescein, and the neutral compounds, rhodamine 110 and rhodamine B, did not. This fact indicates that R123 monitored the parasite mitochondrial membrane potential. T. gondii-infected 3T3 cells were also stained with R123. In contrast to the mitochondria of extracellular parasites, those of intracellular parasites failed to take up the dye. The absence of fluorescence in intracellular parasites persisted until the infected host cells ruptured and liberated daughter parasites 1 day after infection. Parasites, liberated from the host cells, either spontaneously or artificially by passing the infected cells through a 27G needle, regained the ability to take up the dye. After direct microinjection of R123 into the vacuole in which the parasite grows and multiples, the dye appeared in the host-cell mitochondria but not in the parasite's mitochondria. Thus, we conclude that the mitochondrial membrane potential of T. gondii was reduced after invasion of host cells by the parasite. PMID- 6501439 TI - Glial toxin effect on protein synthesis in an insect connective. AB - Analysis of electron autoradiographs from the nerve cord of the insect, Periplaneta americana (L.) shows a significant incorporation of 3H-labelled protein in the axons. The axonal activity is greatly reduced after treatment of the cord with the glial toxin ethidium bromide. This is interpreted as substantiating the possibility that adaxonal glia can transfer proteins to the axons. PMID- 6501440 TI - Adhesion of neutrophil leucocytes under conditions of flow. AB - By passing a suspension of polymorphonuclear leucocytes through a parallel-plate chamber their adhesiveness can be assessed by scoring the number of cells trapped on the lower plate, and the fluid shear stress can be defined for a given flow rate. Since the adhesiveness of the cell at the instant of collision must exceed the distractive shear if the cell is to stop, the kinetics of cell accumulation provide a measure of the adhesiveness of the leucocytes and the adhesive interaction can be quantified. This measure of adhesion does not suffer from the complication that the force required to remove the cells from the surface will be greater if the cells have the opportunity to spread before the distractive force is applied. The assay is described in detail and the results of modifying the surface of the flow chamber and altering the composition of the suspension medium are used to illustrate the method. Plasma proteins generally seemed to reduce the adhesiveness of neutrophil leucocytes, whether they were present as a coat of adsorbed protein or in the suspension medium during perfusion. Neutrophil leucocytes, unless suspended in relatively high concentrations of plasma, were considerably more adhesive than other cells that have been tested in this assay system. PMID- 6501441 TI - Physiologic neuroanatomy: new brain imaging methods present a challenge to an old discipline. PMID- 6501442 TI - Intercorrelations of glucose metabolic rates between brain regions: application to healthy males in a state of reduced sensory input. AB - We use a correlational analysis of regional metabolic rates to characterize relations among different brain regions. Starting with rates of local glucose metabolism (rCMRglc) obtained by positron emission tomography using [18F]fluorodeoxyglucose, we propose that the strength of the association is proportional to the magnitude of the correlation coefficient. Partial correlation coefficients, controlling for whole brain glucose metabolism, are used in the analysis. We also introduce a graphical technique to display simultaneously all the correlations, allowing us to examine patterns of relations among them. The method was applied to 40 very healthy males under conditions of reduced auditory and visual inputs (the "resting state"). Dividing the brain into 59 regions, and keeping only those partial correlation coefficients significant to p less than 0.01, we found the following: (a) All regions were significantly correlated with their contralateral homologues. For the most part, the largest partial correlation coefficients were between homologous brain regions. (b) Generally, the pattern of significant correlations between any two lobes in the left hemisphere did not differ statistically from the corresponding pattern in the right hemisphere. (c) Strong correlations were observed between primary somatosensory areas and premotor association areas. Correlations between these association areas and primary visual and auditory regions were not statistically significant. (d) Significant correlations between inferior occipital and temporal areas were found. Metabolic rates in the superior part of the occipital lobe were not correlated significantly with metabolic rates in regions of the temporal lobe, nor with metabolism in the parietal lobe. (e) As a whole, there were numerous correlations among frontal and parietal lobe regions, on the one hand, and among temporal and occipital lobe regions, on the other, but few statistically significant correlations between these two domains. We relate our results to various aspects of known brain anatomy, physiology, and cognitive functioning. PMID- 6501443 TI - Effects of bradykinin on permeability and diameter of pial vessels in vivo. AB - The effect of bradykinin on the permeability and vasomotor response of pial vessels has been studied to enhance our understanding of the pathophysiological role of the kallikrein-kinin system in cerebral tissue. Intravital fluorescence microscopy of the pia arachnoidea was conducted using Na+-fluorescein, FITC dextran, and FITC-albumin as low and high molecular weight blood-brain barrier indicators. Massive arterial dilatation evolved immediately upon administration of bradykinin by superfusion of the exposed cerebral surface. An increase of the arterial diameter by 40% was the maximal response found at bradykinin concentrations of 4 x 10(-5) M. Arterial dilatation became attenuated with continuous superfusion of the preparation with bradykinin. In pial veins, a moderate reduction of the vessel diameter was observed, however, only after prolonged superfusion of the preparation. Bradykinin led to selective opening of the blood-brain barrier for Na+-fluorescein at superfusate concentrations of greater than or equal to 4 x 10(-7) M, but not for FITC-dextran or FITC-albumin. Topical administration of l-isoproterenol (10(-4) M) was found to prevent extravasation of Na+-fluorescein in the presence of bradykinin concentrations of 4 x 10(-6) M. Protection of the blood-brain barrier by isoproterenol was not observed when higher concentrations of bradykinin were employed. Intracarotid infusion of bradykinin were employed. Intracarotid infusion of bradykinin led also to a selective opening of the blood-brain barrier for Na+-fluorescein, but not for FITC-dextran or FITC-albumin. In contrast to superfusion, this route of administration did not induce changes of the vasomotor behavior of the arteries or veins. Additional experiments with B1-agonists and -antagonists suggest that bradykinin causes the openings of the blood-brain barrier th rough an interaction with B2-receptors on endothelial cells, and arterial dilatation via interaction with B2-receptors on vascular smooth muscle cells. Our findings support the concept that the release of kinins in the brain during an acute cerebral lesion mediates secondary damaging processes by the enhancement of blood-brain barrier dysfunction. PMID- 6501444 TI - Effects of anoxia on cerebral blood flow in the rat brain: evidence for a role of adenosine in autoregulation. AB - The purpose of these experiments was to determine the utility of a new method for monitoring CBF using a venous outflow technique with an extracorporeal circulation and to examine the effects of agents that potentiate or antagonize the actions of adenosine on the blood flow response to brief periods of anoxia. The results demonstrate the ability of the new technique to detect the increases in CBF in response to anoxia. Caffeine, an adenosine antagonist, reduced the intensity and duration of the anoxia-induced hyperemia. Dipyridamole and papaverine, inhibitors of adenosine uptake, potentiated the increase in CBF during anoxia. The results support the hypothesis that adenosine plays an important role in regulating CBF during anoxic episodes. PMID- 6501445 TI - Effect of middle cerebral artery compression on pial artery pressure, blood flow, and electrophysiological function of cerebral cortex of cat. AB - In 20 cats, the left middle cerebral artery was gradually compressed with a microdriven vascular occluder implanted by a transorbital approach. Pial artery pressure, cortical blood flow, segmental vascular resistance, electrocorticogram, and cortical steady potentials were measured in the territory of the left middle cerebral artery and correlated with the degree of vascular stenosis. Pial artery pressure began to decrease when the lumen of the middle cerebral artery was reduced to 200 micrometers. Cortical blood flow and EEG power declined when pial artery pressure fell below 35-40 mm Hg; cortical steady potential started to shift toward negativity at a pressure below 25-30 mm Hg; and both hemodynamic and electrophysiological changes were maximal at a pressure below 10 mm Hg. When the vascular occlusion was released within 5 min after the onset of ischemia, a pial artery pressure of only 18 mm Hg was necessary to restore normal blood flow. After 1-h occlusion, normalization of flow occurred at a pressure of 30 mm Hg. Since this pressure is still substantially below normal pial artery pressure, no reflow does not seem to be of significance in this experimental situation. PMID- 6501446 TI - Spectrum of altered reactivity of isolated cerebral arteries following subarachnoid haemorrhage--response to potassium, pH, noradrenaline, 5 hydroxytryptamine, and sodium loading. AB - The circular contractile responses to various stimuli have been measured in segments of cerebral arteries (both middle cerebral and basilar) taken from dogs either 3 or 7 days following the cisternal injection of autologous blood under anaesthesia. The maximum contractile response to 5-hydroxytryptamine was increased significantly 7 days following subarachnoid haemorrhage; the response to noradrenaline also increased but not significantly at 7 days. The contractile response to a raised extracellular potassium concentration (25 and 100 mM) was slightly depressed by 7 days, and the response to a fall in extracellular pH was depressed by 43% both 3 and 7 days following subarachnoid haemorrhage. The ability of these arteries to handle a sodium load was also assessed. The arteries were sodium loaded for various periods of time in mock cerebrospinal fluid with a zero potassium concentration. On transfer to 25 mM potassium solution, the duration but not the magnitude of the initial relaxation phase prior to a final contraction was greater with increasing time spent in the zero potassium solution. Both the magnitude and the duration of this relaxation phase, which reflect in part the ability of the vascular smooth muscle to extrude the sodium load, were increased in arteries following subarachnoid haemorrhage when compared with control arteries. These results demonstrate that the altered reactivity of cerebrovascular smooth muscle following subarachnoid haemorrhage persists in vitro and is more than simply an enhanced response to biogenic amines. PMID- 6501447 TI - Effect of prolonged and intermittent hypoxia on some cerebral enzymatic activities related to energy transduction. AB - The adaptation to repeated, alternate normobaric hypoxic and normoxic exposures (12 h/day, for 5 days) and to pharmacological treatment was evaluated by studying the specific activities of some enzymes related to cerebral energy metabolism. Measurements were carried out on (a) the homogenate in toto, (b) the purified mitochondrial fraction, and (c) the crude synaptosomal fraction in different areas of rat brain--cerebral cortex, hippocampus, corpus striatum, hypothalamus, cerebellum, and medulla oblongata. The adaptation to intermittent normobaric hypoxic-normoxic exposures was characterized by significant modifications of some enzyme activities in synaptosomes (decrease of cytochrome oxidase activity in the hippocampus, corpus striatum, and cerebellum; decrease of malate dehydrogenase activity in the cerebellum) and in the purified mitochondrial fraction (increase of succinate dehydrogenase activity in the corpus striatum). Daily treatment with three doses of naftidrofuryl (10, 15, and 22.5 mg/kg i.m.) modified some enzyme activities affected or unaffected by intermittent hypoxia and, particularly, decreased acetylcholinesterase activity. PMID- 6501448 TI - Cerebral transit of an intravascular tracer may allow measurement of regional blood volume but not regional blood flow. PMID- 6501450 TI - [Osteoid osteoma of the toes. Apropos of 2 cases]. AB - Two patients presented with osteoid osteomas of the distal phalanx of a toe. A review of documented cases provided data on the characteristic features of these lesions. Diagnosis and treatment, in all cases, were ensured by excision biopsy, enabling a permanent cure to be obtained with a minimum of mutilation. PMID- 6501449 TI - [Post-traumatic hemarthrosis of the knee. Diagnostic steps and value of arthroscopy]. AB - The authors report their experience of the arthroscopic diagnosis of acute traumatic hemarthrosis of the knee. They point out the value of testing stability under anaesthesia. A very important laxity, according to severe damage of peripheric structures and cruciate ligaments, need surgical repair. Otherwise, in all cases with minor instability, arthroscopy is very useful: some arthrotomies are so avoided, some associated lesions were diagnosed. Any way arthroscopy is reported to allow adequate treatment of traumatic hemarthrosis of the knee. PMID- 6501451 TI - [Arteriovenous fistula of the left renal pedicle detected 30 years after nephrectomy]. AB - The authors report a case of arterio-venous fistula of the left renal pedicle, thirty years after nephrectomy. The diagnosis was made by the clinical signs and thrill, and by the cardiac hypertrophy. It was confirmed by angiography. Treatment was surgical, complete removal of the fistula. PMID- 6501452 TI - [A new material and a simplified technic for treatment of recurrent or nonrecurrent bilateral hernias by the preperitoneal or subperitoneal approach]. AB - Difficulties arise during surgical treatment of recurrent or non-recurrent bilateral hernia, the use of a median approach alone requiring the insertion of prosthetic material. Recurrence can be avoided if the material is reliable, and there is no risk of its migration or displacement. This applies to crinoplates, which allow the positioning of a relatively rigid but supple material of a size adapted to the pathological inguinal orifices, ensuring perfect reliability of this finally fairly simple operation. The use of two separate plates allows rapid surgery and a short incision, avoiding suprapubic eventration. The fact that the cord pierces the previously drilled plate prevents fixation and any risk of displacement, principal cause of recurrences. Excellent results without recurrence, and total lack of septic complications, were obtained in 200 cases operated upon by this method. PMID- 6501454 TI - [Splenic rupture in chronic pancreatitis. Study of 2 cases and review of the literature]. AB - The authors have observed 2 new cases of splenic rupture due to pancreatic pseudocyst and have made a review of the literature on the subject (40 cases). The clinical, diagnostic and therapeutic approaches of this rare but sometimes dramatic complication of chronic pancreatitis have been analyzed. Diagnosis should be suspected in the case of abdominal pain, mass and anemia in the male subject with previously known chronic pancreatic or alcoholic disease. Sonography completed by either angiography or CT scan if time permits are the best diagnostic methods. Ideal management should include treatment (excision or drainage) of the pseudocyst and splenectomy. PMID- 6501455 TI - [Surgical timing in acute lithiasic cholecystitis]. AB - Acute cholecystitis is a surgical disease. However, if the operative indication is strict and univocal, the timing of operation still debatable. The purpose of this study of 343 calculous acute cholecystitis is to point out the marked tendency of the early surgical therapy. Such attitude may be encouraged by the observed change on roentgenographic studies' strategy (gallbladder opacification supplemented by echography) and the obtained good results. PMID- 6501453 TI - [Verifying the function of hepaticojejunostomies by scintigraphy of the bile ducts]. AB - Thirty six hepatobiliary scintigraphies with 99mTc-Dimethyl IDA were performed in thirty patients with an hepaticojejunostomy one month to ten years after surgery. Twenty patients underwent surgery for biliary disease and ten for duodenal or pancreatic disease. In most cases (twenty three), the radionuclide study has been systematically performed to assess the scintigraphic pattern of a normal hepaticojejunostomy. In seven cases this pattern was abnormal. Four times the biliary enteric anastomosis was involved. Three times it showed an abnormal liver morphology. After an hepaticojejunostomy, hepatobiliary scintigraphy seems to be the only examination providing dynamic information for the biliary enteric anastomosis and the intestinal loop. But it sometimes is difficult to analyse in all cases, it must be the screening test in patients when symptoms occur after hepaticojejunostomy; but a percutaneous transhepatic cholangiogram cannot always be avoided. PMID- 6501456 TI - [Rupture of the bile ducts in closed abdominal injuries]. AB - A further case of rupture of the biliary pathways from a closed injury to the abdomen is reported. The exceptional nature of the lesion was further evidenced by the delay in diagnosis of this rupture: on the 45th day after the injury. Reports in the literature describe the most frequent characteristics of such lesions: affecting young adults they are usually the result of road accidents, they are diagnosed at a late stage due to lack of information from complementary examinations, and they raise problems related to the choice of therapy. PMID- 6501457 TI - [Surgical treatment of fractures of the long bones in children. Interference between osteosynthesis and the physiological processes of consolidation. Therapeutic indications]. AB - Flexible medullary nailing is an excellent method when operative treatment of fractures in children is indicated. It is a new biomechanical concept using prebent flexible rods introduced in the medullary canal through a metaphyseal area. This method can be used in all types of Femoral, Tibial, Humeral or fore arm fractures. In Each case, the operative technique is described. This closed surgical procedure has a low complication rate (no sepsis, no delayed union, no length discrepancy). Early mobilization is often possible and cast is not necessary. PMID- 6501458 TI - [Suction drainage in general and digestive surgery. Apropos of the use of Reliavac material]. AB - The authors studied fifty cases of suction drainage by a new "Reliavac" procedure in general and digestive surgery. They stress its autonomy of function, the absence of inoculation of bacteria and its effectiveness. PMID- 6501460 TI - Cognitive bases of lexical development: object permanence and relational words. PMID- 6501459 TI - [Gastric rupture in status asthmaticus]. PMID- 6501461 TI - Semantic and cognitive development in 15- to 21-month-old children. PMID- 6501462 TI - Higher pitch in BT is not universal: acoustic evidence from Quiche Mayan. PMID- 6501463 TI - Environmental correlates of individual differences in language acquisition. PMID- 6501464 TI - Learning about points of view: spatial perspective and the acquisition of 'I/you'. PMID- 6501466 TI - Learning how to ask: patterns of inversion in yes-no and wh-questions. PMID- 6501465 TI - Patterns of vowel modification in mother-child speech. PMID- 6501467 TI - Preschool children's comprehension of agency. PMID- 6501468 TI - Productivity and memory for newly formed words. PMID- 6501469 TI - The association between comprehension of spoken sentences and early reading ability: the role of phonetic representation. PMID- 6501471 TI - Children's interpretation of referential ambiguities and pragmatic inference. PMID- 6501470 TI - Blind children's language: resolving some differences. PMID- 6501472 TI - Combining two-term relations: evidence in support of flat structure. PMID- 6501473 TI - The acquisition of infinitival complements: a reply to Bloom, Tackeff & Lahey. PMID- 6501474 TI - Lexical development in second language acquisition: initial stages in Japanese child's learning of English. PMID- 6501475 TI - Effects of contamination on ion mobility detection after gas chromatography. AB - The ion mobility detector is a device that can be used for the selective, ultratrace detection of organic compounds after capillary gas chromatography. It is the only gas chromatographic detector which does not require heteroatomic compounds for selective response, yet concern is often expressed over its quantitative capabilities. Being a secondary ionization device, competitive charge transfer reactions from unseparated compounds or detector gas contamination may decrease the accuracy of measurement. This paper investigates the effects of both electronegative and electro-positive contaminants on the detector's response. In general, it was found that contamination of the detector did affect response but no more severely than in conventional detectors such as the electron-capture detector or the flame ionization detector. PMID- 6501476 TI - High-performance liquid chromatographic separation of the enantiomers of anti inflammatory 2-arylpropionates: suitability of the method for in vitro metabolic studies. AB - The enantiomers of 2-phenylpropionic acid, 2-(2-naphthyl)propionic acid, 2-(4 biphenyl)propionic acid and six anti-inflammatory congeners were separated by high-performance liquid chromatography via their diastereoisomeric derivatives with (S)-(-)-1-phenylethylamine. In agreement with a general rule, the diastereoisomers derived from the (R)-acids are less polar and elute first. Structural factors influencing the resolution are discussed. Good calibrations were obtained for R/S ratios and total (R + S) concentrations of flurbiprofen and naproxen added to inactivated rat liver preparations. The method is suitable for in vitro metabolic studies of chiral 2-arylpropionates. PMID- 6501477 TI - Reversed-phase ion-pair liquid chromatographic determination of chlorophacinone residues in animal tissues. AB - A sensitive and specific high-performance liquid chromatographic method for the identification and quantitation of chlorophacinone in animal tissues has been developed. Residues were extracted with chloroform-acetone (1:1, v/v). Clean-up of extracts was accomplished with a combined gel permeation-adsorption chromatographic procedure using Bio-Beads SX-3 and incorporating an on-line Sep Pak silica cartridge. Residues were determined by ion-pair liquid chromatography, with the tetrabutylammonium ion as counter-ion, using a fixed-wavelength UV detector at 280 nm or a diode array detector at 285 nm. Recoveries from spiked liver tissue were around 90% at levels from 0.05 to 1 mg kg-1. A detection limit of 0.001 mg kg-1 could be achieved in animal tissues. The diode array detector confirmed identification by matching spectra for residues down to 0.1 mg kg-1 and below this level by multi-wavelength monitoring. PMID- 6501478 TI - High-performance liquid chromatographic methods designed for metabolic studies of the proallatocidin precocene II. PMID- 6501479 TI - Separation and purification of several anabolics present in bovine urine by isocratic high-performance liquid chromatography. PMID- 6501480 TI - Two-dimensional thin-layer chromatographic identification of twelve 1,4 benzodiazepines. PMID- 6501481 TI - Determination of 4-aminophenol in water by high-performance liquid chromatography with fluorescence detection. PMID- 6501482 TI - High-performance liquid chromatographic analysis of the products of enzymatic lactose hydrolysis. PMID- 6501483 TI - Simultaneous determination of maleic acid and timolol by high-performance liquid chromatography. PMID- 6501484 TI - Fluorescence detection of picomol amounts of the phenylthiohydantoin derivative of histidine in thin-layer chromatography. PMID- 6501485 TI - High-performance liquid chromatography systems for the separation of local anaesthetic drugs with applicability to the analysis of illicit cocaine samples. AB - Two high-performance liquid chromatography (HPLC) systems are presented which are suitable for the separation of local anaesthetic drugs. An octadecyl-silica column is used with aqueous methanolic eluents (15 and 50% respectively) containing n-hexylamine-orthophosphoric acid buffers and data for 36 compounds are given. The HPLC systems have application for the identification of unknown drugs in this class while the first eluent (15% methanol, pH 2.5) is particularly useful for the examination of illicit cocaine samples because it gives good separation of common adulterants and impurities. PMID- 6501486 TI - High-performance liquid chromatography retention data for 84 basic drugs of forensic interest on a silica column using an aqueous methanol eluent. AB - High-performance liquid chromatography retention characteristics have been measured for 84 basic drugs of forensic interest using a silica column with a methanol-aqueous ammonium nitrate eluent. The drugs are from two classes of major interest, namely, the narcotic analgesics (including antagonists, metabolites and analogues) and drugs structurally and pharmacologically related to amphetamine. PMID- 6501487 TI - Identification of meibomian gland lipids by gas chromatography-mass spectrometry: application to the meibomian lipids of the mouse. AB - Methods are described for the structural determination of the constituent alcohols, steroids and fatty acids from meibomian gland esters. The compounds, obtained from hydrolysed extracts, were separated and quantified as trimethylsilyl and methyl ester-trimethylsilyl derivatives by fused-silica capillary column gas chromatography. Structural information relating to the position of chain branching and the position of double bonds in the aliphatic chains of the acids and alcohols was obtained from the mass spectra of a number of other derivatives. Thus pyrrolidide-trimethylsilyl and picolinyl ester trimethylsilyl derivatives provided information on both branching and unsaturation. The double-bond position in unsaturated fatty acids was also examined by use of trimethylsilyl derivatives of the derived glycols. The positions of chain branching of the alcohols were determined by the spectra of their acetate and nicotinate derivatives and by their gas-liquid chromatographic retention times. In meibomian gland lipids from the mouse, cholesterol was the major constituent; alcohols from the n-, iso-, anteiso- and unsaturated series were present with iso-C26 and anteiso-C27 being the most abundant. Mono unsaturated fatty acids belonged mainly to the omega 9 series and saturated acids belonged to the iso-, anteiso- and n-series. Several 1,2-diols were also identified. The most abundant of these had iso-C16 and iso-C20 chains. GC-MS studies on the intact wax esters showed them to be composed of the branched-chain alcohols and both branched-chain and unsaturated acids. PMID- 6501488 TI - The use of steroid profiling in the resolution of pregnenolone metabolites from porcine testicular preparations. AB - The behaviour of 22 steroids has been examined by capillary gas chromatographic profiling, and the identities of the steroids confirmed by mass spectrometry and their relative retention times. Five pairs of steroids have been separated: 5 alpha-androstane-3 alpha,17 beta- and -3 beta,17 beta-diols; 5-androstene-3 beta,17 alpha- and -3 beta,17 beta-diols; pregnenolone and 3 beta-hydroxy-5,16 pregnadien-20-one; progesterone and 4,16-pregnadiene-3,20-dione; 17 hydroxypregnenolone and 5-pregnene-3 beta,20 beta-diol. 5 alpha-Androst-16-en-3 beta-ol and 5,16-androstadien-3 beta-ol (as trimethylsilyl-, tert.-butyl dimethylsilyl- and chloromethyldimethylsilyl ethers) were only partially resolved but could be well separated on thin-layer plates of Kieselgel that had previously been dipped in AgNO3 solution. The profiling method was successfully applied to the separation of pregnenolone and its metabolites in porcine testicular incubation extracts. PMID- 6501490 TI - Ultra-violet visualization of inorganic anions by reversed-phase ion-interaction chromatography; factors that control retention and selectivity. AB - This paper describes the development and characterization of a separation and detection system for the analysis of mixtures of UV-transparent inorganic anions. Retention and separation occurs when a hydrophobic, positively charged paired-ion chromatography (PIC) reagent or an ion-interaction reagent (IIR) is added to the mobile phase of a reversed-phase system. Detection of UV-transparent ions results from a perturbation of the distribution equilibria of the UV-absorbing IIR upon injection of the sample ions. The effect of factors such as the concentration and nature of the buffer, co-ions and IIR as well as an organic modifier are described. The major advantages of this method are that the system is nearly completely nonspecific, the separation system takes advantage of highly efficient reversed-phase columns, rapid separations of 4-6 anions in approximately 6-7 min and good sensitivity with detection limits of less than 1 nmole injected. In addition, no special equipment is required to perform ion analysis by this technique. Only conventional high-performance liquid chromatography pumps, detectors and reversed-phase columns are required. PMID- 6501489 TI - Isolation and structural studies of porcine, ovine and murine thymosin beta 4 by high-performance liquid chromatography. AB - Rapid high-performance liquid chromatographic (HPLC) procedures have been used to isolate and characterize thymosin beta 4 from different species. Crude extracts termed thymosin fraction 5A were prepared from porcine and ovine thymus glands as well as murine spleen. Each fraction 5A preparation was then fractionated by HPLC on a muBondapak C18 reversed-phase column. Porcine and ovine thymus fraction 5A, and murine spleen 5A, each yields a predominant peak at a retention time similar to that of bovine thymosin beta 4. Amino acid analysis as well as HPLC tryptic peptide mapping of these peaks indicate that they have homologous sequences to bovine thymosin beta 4. Chromatographic analysis of fresh murine thymus and spleen tissues also revealed protein peaks at the position of bovine beta 4, suggesting that thymosin beta 4 is the native protein present in the animal tissues. PMID- 6501491 TI - Purification of a cholecystokinin fragment peptide in the horizontal flow-through coil planet centrifuge. PMID- 6501492 TI - High-performance liquid chromatographic analysis of estradiol valerate testosterone enanthate in oily formulations. PMID- 6501493 TI - Structural influences on the amperometric detection of opiates in high performance liquid chromatography. AB - The oxidation reactions of a series of opiates occurring at a glassy-carbon electrode in amperometric high-performance liquid chromatographic detection has been investigated. A structure-reactivity correlation has been drawn for morphone, morphinan and benzomorphan derivatives. Polarography and hydrodynamic voltammography were used to show the importance of phenolic groups to this reaction. Acyl substitution on the phenol did not prevent amperometric detection. PMID- 6501494 TI - High-performance liquid chromatography of retinals, retinols (vitamin A1) and their dehydro homologues (vitamin A2): improvements in resolution and spectroscopic characterization of the stereoisomers. AB - A study of mobile phases for the improved high-performance liquid chromatographic resolution of retinal, 3-dehydroretinal, retinol and 3-dehydroretinol stereoisomers is described. By using 1-octanol as a phase modifier in n-hexane, the simultaneous separation of a complex mixture of vitamin A1 and A2 isomers was satisfactorily achieved, while the separation of the corresponding aldehydes required a ternary mixture of 2-propanol, dioxane and n-hexane. All peaks were spectroscopically characterized by recording their UV spectra, which are reported together with comparative tables of the absorbance maxima of the stereoisomers. PMID- 6501495 TI - Experimental observations of the hydrodynamic behavior of solvent systems in high speed counter-current chromatography. I. Hydrodynamic distribution of two solvent phases in a helical column subjected to two types of synchronous planetary motion. AB - Hydrodynamic distribution of two-phase solvent systems in a rotating helical column subjected to centrifugal fields produced by two different types of synchronous planetary motion has been studied by the use of the combined horizontal flow-through coil planet centrifuge. With continuous elution of the mobile phase, the simpler type of motion resulted in low retention of the stationary phase in the column whereas a more complex motion, which produces a quasi-radial centrifugal field varying in both intensity and direction, yielded high stationary phase retention for commonly used solvent systems having a wide range of hydrophobicity. These solvent systems display highly complex modes of hydrodynamic interaction in the coil according to their particular physical properties. PMID- 6501496 TI - Experimental observations of the hydrodynamic behavior of solvent systems in high speed counter-current chromatography. II. Phase distribution diagrams for helical and spiral columns. AB - Extensive studies have been performed on hydrodynamic distribution of two immiscible solvent phases in helical and spiral columns by means of coil planet centrifugation. Under the Scheme IV [see Fig. 1 in Y. Ito, J. Chromatogr., 301 (1984) 377] planetary motion, the two phases display unilateral distribution in the coil, i.e., one phase travels toward the head and the other phase toward the tail. This hydrodynamic trend is sensitively affected by various factors such as physical properties of the solvent system, helical diameter of the column, revolutional radius, etc. Phase distribution diagrams obtained from a set of conventional two-phase solvent systems under various experimental conditions provide extremely useful information for both basic hydrodynamic studies and practical application in high-speed counter-current chromatography. PMID- 6501497 TI - Experimental observations of the hydrodynamic behavior of solvent systems in high speed counter-current chromatography. III. Effects of physical properties of the solvent systems and operating temperature on the distribution of two-phase solvent systems. AB - Statistical studies were made to correlate the hydrodynamic behavior of two-phase solvent system in counter-current chromatography (CCC) to their physical properties including interfacial tension, viscosity, and the difference in density of the two phases. Settling time measured under unit gravity provided a reliable numerical index for the hydrodynamic behavior of the solvent systems in a centrifugal force field. Viscosity and settling time were strongly correlated (correlation coefficient, r = +0.88) while interfacial tension (r = -0.65) and phase density difference (r = -0.45) showed moderate and weak correlation, respectively. Studies of the effect of temperature on settling time as well as a preliminary apparatus operated at higher temperature show that raising the temperature will improve the performance of high-speed CCC. PMID- 6501498 TI - Sequence analysis of derivatized peptides by high-performance liquid chromatography-mass spectrometry. AB - N-Acetyl-N,O,S-permethylated derivatives of oligopeptides were analyzed by high performance liquid chromatography-mass spectrometry (HPLC-MS) using a moving belt interface. A heated-gas nebulizer was employed for sample deposition, thus permitting the effective use of a water-methanol gradient covering the range from 5% to 95% water at mobile phase flow-rates of 0.5 ml/min. We demonstrate in this paper that it is possible to sequence the octapeptide derived from the C-chain of glucagon by HPLC-MS analysis of a permethylated enzymatic hydrolysate of this peptide using overlap information from the mass spectral patterns. Moreover, it is shown that peptides not readily amenable to analysis by gas chromatography-MS can be analyzed using this approach. Preliminary results suggest that N-acetyl methyl ester derivatives of oligopeptides may in specific cases also be a useful alternative for HPLC-MS analysis of complex oligopeptide mixtures. PMID- 6501499 TI - Improved analysis of acephate and methamidophos in biological samples by selective ion monitoring gas chromatography-mass spectrometry. PMID- 6501500 TI - New ion-pair reagent for the high-performance liquid chromatographic separation of B-group vitamins in pharmaceuticals. PMID- 6501501 TI - Analysis of flumethasone pivalate formulations by high-performance liquid chromatography. PMID- 6501502 TI - Improved chromatographic procedure for determination of 9-(N methylaminomethyl)anthracene isocyanate derivatives by high-performance liquid chromatography. PMID- 6501503 TI - Selective liquid chromatographic isolation and gas chromatographic-mass spectrometric analysis of ketonic bile acids in faeces. AB - A method is described for the separation of ketonic from non-ketonic bile acids. Oximes are prepared from the methyl esters and are subjected to chromatography on the lipophilic strong cation exchanger sulphohydroxypropyl Sephadex LH-20 (SP-LH 20) in the H+ form. Three fractions are obtained which contain non-ketonic compounds, compounds having a 7- or 12-oxime but no 3-oxime group, and compounds having a 3-oxime group. These groups can be analysed as trimethylsilyl ethers by gas chromatography and gas chromatography-mass spectrometry by using fused-silica capillary columns with SE-30 as the stationary phase. The method was applied to the analysis of bile acids in faeces. The major 3-oxo acids found were 3-oxo-5 beta- and 12 alpha-hydroxy-3-oxo-5 beta-cholanoic acids. Smaller amounts of 3,12 dioxo-5 beta-cholanoic acid were present and 3-oxo-5 alpha-cholanoic and 3-oxo-4 cholenoic acids were also identified, but could not be quantified. Semiquantitative analyses indicated that bile acids with a 3-oxo group may constitute 1-20% of the corresponding 3 alpha-hydroxy bile acids. PMID- 6501504 TI - High-performance liquid chromatography of amino acids in urine and cerebrospinal fluid. AB - Two different methods for analyzing amino acids by reversed-phase high performance liquid chromatography (HPLC), both of which can separate D- and L- stereoisomers, have been used for studying the amino acid composition of cerebrospinal fluid (CSF) and urine. One method, by which Dns derivatives of amino acids are separated as mixed chelate complexes with Cu(II) and a single stereoisomer of a second amino acid, was used to analyze CSF. CSF contains ca. 10 mumole/l per amino acid, compared to 100 mumole/l in serum. The high sensitivity of fluorescence detection enabled complete analysis, starting with 50 microliter of fluid. The second method, which uses lower concentrations of both the copper and the second amino acid and detects amino acids by the change in absorbance of the copper complex, was used to measure the urine concentration of the lysine metabolite, pipecolic acid (piperidine-2-carboxylic acid), a secondary amino acid that is difficult to detect by the more usual detection methods. Our procedure involves passing urine through a cation-exchange column, collecting the fraction containing pipecolic acid, and chromatographing it on a reversed-phase HPLC column with a mobile phase containing L-aspartame and Cu(II). To assess the utility of the method, urine samples from a patient given loading doses of D- or L-isomers were analyzed. When either isomer was administered, both D- and L isomers were detected, but in different proportions. Varying proportions and concentrations of both isomers were also detected in the urines of patients with hyperpipecolatemia from different metabolic abnormalities. PMID- 6501505 TI - Trace analysis of organic compounds by high-performance liquid chromatography with photoionization detection. AB - Photoionization detection (PID) has now been successfully interfaced with modern high-performance liquid chromatography (HPLC) to provide a new "hyphenated" technique, HPLC-PID. This method is compatible with reversed-phase HPLC solvents and conditions, as well as with certain organic solvents used in normal-phase liquid chromatography. The HPLC-PID interface consists of a variable-ratio eluent splitter, operated inside a heated oven, which vaporizes both analytes and mobile phase prior to introduction into the detector. Depending on the energy (eV) of the photoionization detector lamp, most of the solvents commonly used in reversed phase liquid chromatography are compatible with long-term, on-line, real-time, continuous photoionization detector operation. Virtually all organic classes now detectable by gas chromatography-PID can also be detected by HPLC-PID, but with somewhat poorer detection limits. In certain instances, minimum detection limits are in the 5-500 ng/injection range. The HPLC-PID system appears ideal for aromatic or aliphatic amines, substituted hydrocarbons, and certain other classes of organic compounds. Various applications of HPLC-PID, under reversed-phase conditions are illustrated and discussed. PMID- 6501506 TI - Branched-chain alpha-keto acid analysis in biological fluids: preparative clean up by anion-exchange and analysis by capillary gas chromatography. AB - A method is given for the quantitative analysis of the alpha-keto derivatives of the branched-chain amino acids in physiological fluids. A sample containing alpha ketovalerate and alpha-ketocaproate as internal standards is passed through a weak anion-exchange resin at neutral pH. After washing the resin with distilled water, the alpha-keto acids are eluted with 4 M hydrochloric acid--ethanol (50:50). Quinoxalinol derivatives are prepared directly in the eluent, extracted with methylene chloride, and trimethylsilylated. Separation of the derivatives is by capillary gas chromatography on a 30 m fused-silica SE-30 column. Chromatographic separation is superior to that reported for packed column methods, thereby permitting the use of alpha-ketovalerate and alpha-ketocaproate as internal standards. PMID- 6501507 TI - Automated high-performance liquid chromatographic assay for monitoring caffeine and its metabolites in biological fluids of monkeys consuming caffeine. AB - A recently reported high-performance liquid chromatographic procedure, using a 5 micron C18 reversed-phase column to separate and quantitate caffeine and seven of its metabolites was modified for use with an automatic sampler to allow the continuous analysis of a large number of samples of various biological fluids obtained from monkeys consuming caffeine. The sensitivity for most metabolites was in the range of 0.1-0.3 microgram/ml from a 0.1 ml sample. The repeatability of the method regarding within-day variations was excellent and the absolute retention time for eight standards differed by less than +/- 0.03 min. Excellent repeatability in the day-to-day assay, with almost quantitative recoveries, was found for most of the analyzed compounds in various biological fluids. The standard deviation for the quantitation of all standards was in a range of 0.41 2.01 micrograms/ml, with the standard error less than 0.02. Using this method an analytical chemist could process between 40 and 60 samples of biological fluids in 24 h. The main metabolite of caffeine in the plasma of the monkey was theophylline, while theophylline and 1,3-dimethyluric acid were the major metabolites in urine. A close correlation was observed for the pattern of metabolites found in plasma and milk. PMID- 6501508 TI - Measurement of tyramine in human plasma, utilising ion-pair extraction and high performance liquid chromatography with amperometric detection. AB - An assay for plasma tyramine has been developed which uses ion-pair extraction, reversed-phase ion-pair high-performance liquid chromatography and amperometric detection. Tritiated tyramine is used as the internal standard. The method can measure down to 0.5 ng/ml of tyramine in 1 ml of human plasma and is thus suitable for monoamine oxidase inhibitor studies involving oral dosing with tyramine. PMID- 6501509 TI - Determination of tiapamil and of its two main metabolites in plasma and in urine by high-performance liquid chromatography. AB - Selective high-performance liquid chromatographic methods for the determination of tiapamil and its two main metabolites in plasma and urine are described. Tiapamil together with its metabolites is extracted at alkaline pH into dichloromethane. Separation is carried out using normal-phase high-performance liquid chromatography with ultraviolet detection (278 nm). The unchanged drug and the desmethyl metabolite are analysed simultaneously. The second metabolite is analysed separately under more polar conditions. The sensitivity limits are 50 ng/ml for tiapamil, 100 ng/ml for the desmethyl metabolite and 75 ng/ml for the second metabolite, using 0.5 ml of plasma. The sensitivity limits in urine are 100 ng/ml for all three compounds using a 0.5 ml specimen. The method has been applied to the analysis of human plasma and urine after intravenous (70 mg) and oral (400 mg) administration of tiapamil. PMID- 6501511 TI - Determination of misonidazole and desmethylmisonidazole in plasma by high performance liquid chromatography with reductive electrochemical detection. AB - A reversed-phase high-performance liquid chromatographic method with reductive mode electrochemical detection was developed for the determination of misonidazole and desmethylmisonidazole in plasma. A thin-layer amperometric detector with glassy carbon working electrode was used to detect the nitroimidazoles at a potential of -0.60 V. The calibration curves were linear. The within-day and day-to-day coefficients of variation were below 3% for plasma misonidazole concentrations of 6-60 mg/l and 1-15 mg/l for desmethylmisonidazole. Electrochemical detection limits were between 2 and 4 pg, which is about 10-20 times lower than that obtained by detection at 323 nm. Limits of quantitation of the nitroimidazoles in plasma were in the order of 1-2 micrograms/l. Under the described conditions other nitroimidazoles and nitro compounds can also be detected with ultimate sensitivity by reductive mode electrochemical detection. PMID- 6501510 TI - High-performance liquid chromatographic separation of cadralazine from its potential metabolites and degradation products. Quantitation of the drug in human plasma and urine. AB - The chromatographic behaviour of cadralazine and its potential metabolites and degradation products with respect to pH, buffer molarity and composition of eluent is described. A selective method with an adequate sensitivity for the determination of the drug in human plasma and urine is also reported. The method includes extraction of biological fluids with chloroform and the analysis of extracts on a reversed-phase column with isocratic elution and detection at 254 nm. The method has been applied to the analysis of plasma and urine of a patient administered a single oral dose of 30 mg of cadralazine. PMID- 6501512 TI - alpha-Alkyl-alpha-arylacetic acid derivatives as fluorescence markers for thin layer chromatographic and high-performance liquid chromatographic assay of amines and alcohols. AB - Activated R,S-benoxaprofen is described as a new reagent for fluorescent derivatization of drugs with primary or secondary amino groups or with hydroxyl groups. Separation of the reaction products is demonstrated by thin-layer chromatography and high-performance liquid chromatography. The sensitivity of the detection is in the picomole range. Derivatization procedures can be easily and rapidly performed. PMID- 6501513 TI - Mass spectrometric determination of N-hydroxyphenacetin in urine using multiple metastable peak monitoring following thin-layer chromatography. AB - This work describes a method for the quantitative determination of the labile, toxic N-hydroxy metabolite of phenacetin in urine. A thin-layer chromatography step was used for the preliminary purification of extracts, and the specificity of the assay was based on the monitoring of specific metastable decompositions in a forward geometry double-focussing mass spectrometer, in a manner analogous to conventional tandem mass spectrometry. This precluded the need for a gas chromatographic separation, thus minimizing thermal decomposition which can occur with these compounds, as well as enabling very rapid analyses. PMID- 6501514 TI - High-performance liquid chromatographic determination of (Z)-and (E)-urocanic acid in human skin. PMID- 6501516 TI - Determination of plasma phenytoin by capillary gas chromatography with nitrogen phosphorus detection and with selective ion monitoring. PMID- 6501515 TI - Determination of morphine in serum and cerebrospinal fluid by gas chromatography and selected ion monitoring after reversed-phase column extraction. PMID- 6501517 TI - Effect of sodium dodecyl sulphate on the extraction of ubiquinone-10 in the determination of plasma samples. PMID- 6501518 TI - High-performance liquid chromatographic determination of nitrazepam and its metabolites in human urine. PMID- 6501519 TI - High-performance liquid chromatographic determination of nifedipine in plasma. PMID- 6501520 TI - Separation of haem compounds by reversed-phase ion-pair high-performance liquid chromatography and its application in the assay of ferrochelatase activity. AB - The separation of haems and porphyrins was achieved in a reversed-phase ion-pair high-performance liquid chromatography system using tetrabutylammonium hydrogen sulphate as the pairing ion. The concentration of methanol and pH in the mobile phase were determinative parameters for the elution pattern of the compounds. Two isocratic systems--one for the assay of protohaem IX and one for deuterohaem IX- were developed. The chromatographic systems were applied to the assay of ferrochelatase activity in mitochondria using either protoporphyrin or deuteroporphyrin as the substrate. The ferrochelatase activity was also measured in reticulocytes, which contain high levels of endogenous haem. PMID- 6501521 TI - Sorption of organic compounds from urine in mutagenicity testing: choice of sorbent. AB - The choice of sorbents for urine mutagenicity testing was investigated. 14C Labelled compounds were dissolved in urine and extracted from it by sorption with seven different sorbents singly or in combination. The compounds were desorbed with acetone. Sorption was examined under various experimental conditions. Except for two strong ionic compounds satisfactory extraction was achieved with a combination of three sorbents: Amberlite XAD-2, XAD-7, and Sep-Pak Silica. Filtration of the urine or contact of it with the walls of the experimental equipment could lead to substantial losses. Implications of these results for urine mutagenicity testing and possibilities for further optimization of the method are discussed. PMID- 6501522 TI - Gas--liquid chromatographic evaluation of lofemizole in biological samples for pharmacokinetic investigations. Comparison of two analytical methods. AB - The present paper reports the analytical conditions allowing lofemizole, a new non-steroidal anti-inflammatory drug, to be evaluated in biological fluids for pharmacokinetic and bioavailability investigations. The first approach led to an N-methyl derivative of lofemizole which could be successfully analysed by gas- chromatography employing a flame-ionization detector, reaching a sensitivity of 2 micrograms/ml. The second approach led to the N-(2-chlorobenzoyl) derivative of lofemizole which was suitable for pharmacokinetic investigation using gas--liquid chromatography with electron-capture detection, and reaching a much higher sensitivity of 10 ng/ml of plasma. Recovery of the extraction, reproducibility and specificity were all satisfactory with both methods. Since the first method employing flame-ionization detection was suitable for pharmacokinetic investigations in animal species, this paper describes both methods on a comparative basis. PMID- 6501524 TI - Digoxin and metabolites in urine: a derivatization--high-performance liquid chromatographic method capable of quantitating individual epimers of dihydrodigoxin. AB - A high-performance liquid chromatographic method is described for the determination of digoxigenin, digoxigenin monodigitoxoside, digoxigenin bis digitoxoside, digoxin, and dihydrodigoxin as the 3,5-dinitrobenzoyl esters. The method is applied to a 10 ml urine sample by adding digitoxigenin as internal standard, extracting with methylene chloride, derivatizing with 3,5 dinitrobenzoyl chloride in pyridine, chromatographing with a normal-phase system and detecting at 254 nm. Derivatized digoxigenin, digoxigenin mono- and bis digitoxoside, and digoxin each yielded one symmetrical peak with the limit of sensitivity of the method being approximately 100 ng/ml. Analysis of a commercially obtained sample of dihydrodigoxin resulted in two well-separated, symmetrical peaks that represent the two epimers of derivatized dihydrodigoxin. Data indicate rapid and complete esterification of all primary and secondary alcohol moieties in the various molecules and the derivatives are shown to be stable in chloroform for at least four days. The procedure appears to be suitable for metabolic investigations and as a prototype for future analytical developments. PMID- 6501523 TI - Gas chromatographic determination of pentoxifylline and its major metabolites in human breast milk. AB - A method has been developed for determination of the xanthine drug, pentoxifylline, and three of its metabolites (a secondary alcohol and two carboxylic acids) in human milk. The method requires pre-extraction with hexane to remove lipids followed by extraction with dichloromethane or dichloromethane isopropanol (4:1). Absolute extraction recoveries were between 76-90%. Pentoxifylline and its alcohol metabolite (as the trifluoroacetate) and the carboxylic acid metabolites (as ethyl esters) were measured in separate gas chromatographic steps using a nitrogen detector. Determinations of pentoxifylline and its three metabolites were 96-99% accurate and standard deviations of 5-10% were observed for samples at or above the lower practical sensitivity limit (10 ng/ml) for the assay. Pentoxifylline and its metabolites were stable in breast milk for three weeks when stored at -15 degrees C. PMID- 6501525 TI - Routine determination of eight common anti-epileptic drugs and metabolites by high-performance liquid chromatography using a column-switching system for direct injection of serum samples. AB - A simple and rapid high-performance liquid chromatographic method for determining eight common anti-epileptic drugs and metabolites in serum is described. A column switching system including one analytical column and two precolumns for sample enrichment offers the possibility of directly injecting patients' sera without any pretreatment. The two precolumns are alternately switched over to avoid time loss in analysis due to the sample washing step. The samples are flushed with dilute phosphoric acid, as the purge liquid, onto the precolumns which consist of very short cartridges (length 0.5 cm) filled with spherical ODS silica gel (particle size 30 micron). The retained substances are carried over, after purification, onto the analytical column in the same direction of flow as in the flushing step. A mixture of acetonitrile and phosphoric acid--sodium phosphate buffer solution is thereby used as solvent for the gradient elution. The separation was carried out using an analytical column, which was filled with ODS material of particle size 5 micron. PMID- 6501526 TI - Canavanine analysis of alfalfa extracts by high performance liquid chromatography using pre-column derivatization. AB - The purpose of this project was to isolate and quantitate canavanine in three different alfalfa samples because it has been hypothesized that alfalfa and therefore canavanine ingestion may exacerbate systemic lupus erythematosus (SLE) in humans. Ten alfalfa tablets were ground into a fine powder, and 100 mg was extracted for canavanine. The extracted canavanine was derivatized prior to quantitation by high performance liquid chromatography. The canavanine content of alfalfa tablets averaged 25.3 and 33.8 micrograms/g depending on lot number and extraction method. Because ten alfalfa tablets are recommended daily, this would provide approximately 0.18 mg of canavanine. Whether daily ingestion of canavanine exacerbated SLE in two patients consuming 15 and 8 alfalfa tablets (0.27 and 0.15 mg, respectively) is uncertain and warrants further investigation. PMID- 6501527 TI - Direct separation of enantiomer of ephedrine and some analogues by reversed-phase liquid chromatography using (+)-di-n-butyltartrate as the liquid stationary phase. AB - A new chromatographic technique for the separation of enantiomers of beta aminoalcohols is presented. A chiral complexing agent, (+)-di-n-butyltartrate (DBT), is used as liquid stationary phase, adsorbed on Phenyl Hypersil. The solutes are eluted with phosphate buffer solutions containing hexafluorophosphate as the counter ion. The resolution of the enantiomers is based on a stereoselective complex formation between DBT and the ion pairs. Separation factors of 1.1 to 1.2 are obtained for ephedrine and norephedrine. The influence of sample structure of some analogues on stereoselectivity is demonstrated. PMID- 6501528 TI - Determination of pentachlorophenol and 2,3,4,6-tetrachlorophenol in human urine by high resolution gas chromatography. AB - A method for the determination of pentachlorophenol, 2,3,4,6-tetrachlorophenol, and their salts or hydrolyzable biological conjugates in urine, water, serum, or fish tissue is reported. The method utilizes fused silica capillary gas chromatography (GC) with electron capture detection of the free phenols following hydrolysis and extraction into toluene. A recovery standard (4-chloro-2 nitrophenol) and an internal standard for GC (1-nitro-2,3,5,6-tetrachlorobenzene) are used to monitor recovery and GC performance. The detection limit for TCP and PCP is 0.5 ppb and the precision observed for each sample in the 1- to 100-ppb range is between 3 and 12% relative standard deviation for both components. PMID- 6501529 TI - A study of transacetylation between 3,6-diacetylmorphine and morphine. AB - Interaction between some of the constituents of illicitly prepared heroin results in the formation of 6-acetylmorphine. Such interactions have been observed during the gas chromatographic examination of heroin. An explanation of these reactions is proposed. Attempts to block the formation of 6-acetylmorphine were not successful, although the problem is minimised by using the lowest temperature consistent with satisfactory chromatography. PMID- 6501530 TI - HPLC analysis with fluorometric detection of vitamin C in food samples. AB - A high performance liquid chromatographic (HPLC) procedure has been developed for the analysis of ascorbic acid and dehydroascorbic acid in complex matrices. Separation is accomplished with an anion-exchange resin and fluorescent detection is achieved through post-column inline chemistry, involving oxidation of ascorbic acid to dehydroascorbic acid followed by reaction with o-phenylenediamine to form a fluorescent product. Lower limits of detection for both forms of vitamin C are well below the levels found in the usual food sources of this vitamin. The extraction procedures developed yield clean samples for analysis with minimal loss of the vitamers during the analytical procedures. Recoveries are in the range of 90-107%. The results obtained with this HPLC procedure agree well with those obtained with a modified version of the classical procedure of Deutsch and Weeks. A variety of foods including fruit juices, vegetables, and fruits were analyzed. PMID- 6501532 TI - Detection of traces of formaldehyde in pure air by gas chromatography and helium ionization detection. AB - The sensitive helium ionization detector (HID) was used for the direct determination of ppm to ppb levels of formaldehyde in air. Two methods to generate formaldehyde in an air stream were evaluated. The first method utilized a paraformaldehyde permeation tube and the second utilized a motor driven syringe and a dilute solution of formaldehyde. The two methods were evaluated using gas chromatography with HID and spectrophotometry. The paraformaldehyde permeation tube generates only about 60% of the theoretical value, while the motor driven syringe was accurate for levels below 2 ppm; however, at a concentration of 13 ppm or above, oligomers or other chemical forms of CH2O are formed to decrease the concentration of gaseous CH2O produced. PMID- 6501531 TI - High pressure liquid chromatographic assay for mexiletine in serum. AB - A highly sensitive, rapid, and specific high pressure liquid chromatographic assay for the analysis of the antiarrhythmic agent mexiletine is reported. The method involves extraction of mexiletine with organic solvent followed by analysis using fluorescence detection. The minimum measurable limit is 1 ng and inter- and intra-day coefficients of variation are less than 5.8%. The method is useful for pharmacokinetic studies and routine serum monitoring of mexiletine. PMID- 6501533 TI - Quantitative investigation of rapid injector port derivatization of amphetamine using trifluoroacetic anhydride with packed and capillary column GC and GC/MS methods. AB - Direct injector port derivatization of amphetamine through coinjection of sample with trifluoroacetic anhydride was quantitatively investigated and found to be a rapid and more sensitive alternative to longer solution-based derivatization procedures. Under optimum conditions determined in this work, limits of detection were 1 ng using gas chromatography with flame ionization detection and 1 pg using single ion monitoring of ion 140.0 amu (M-91+) in gas chromatography/mass spectrometry methods. The previously reported derivatization period of over 12 hr was greatly reduced using instantaneous derivatization with a 100- to 1000-fold increase in limits of detection. Effects of inlet temperature, mass of trifluoroacetic anhydride, and column pre-treatment on chromatographic performance are reported. Application to analysis of serum from amphetamine-dosed rats was used for comparison to accepted solution-based derivatization. PMID- 6501534 TI - Specificity and sensitivity of the IgM capture immunoassay: studies of possible factors inducing false positive or false negative results. AB - The specificity and sensitivity of the IgM-capture immunoassay (IgM-CI) were evaluated for detection of rubella specific IgM and hepatitis B core (HBc) specific IgM. For rubella specific IgM, antibodies bound to the solid phase were detected by haemadsorption and for HBc specific IgM, by using HBc antigen (HBcAg) and radiolabelled IgG anti-HBc. Rheumatoid factor (RF) was found to interfere in the test for HBc specific IgM because IgM-RF bound to the solid phase reacted with aggregated radiolabelled HBc specific IgG. This false positive reaction did not occur when radiolabelled F(ab')2 was used instead of the whole IgG molecule. HBcAg purified from biological fluids might be coated with host IgG and under these conditions, HBcAg could react with RF. It was also demonstrated that high levels of IgG antibodies could interfere with IgG anti-mu coated-surface by means of non-immunological protein-protein interactions. In fact, IgG did not interfere in the rubella assay, whereas it did in the very sensitive anti-HBc test. To prevent this false-positive reaction, different dilution media were tested. Only the addition of non-specific IgG and fetal calf serum (FCS), to the dilution medium, seems to improve the specificity of the test. Furthermore, in order to decrease this non-specific IgG-IgG interaction and an occasional prozoning phenomenon, the dilution of serum to be tested was taken into account. Parameters considered to decrease sensitivity were also studied. RF, anti-F(ab')2 antibodies and non-specific IgM did not decrease significantly the sensitivity of the assay. PMID- 6501536 TI - The molecular mass of adenovirus type 5 as determined by means of scanning transmission electron microscopy (STEM). AB - The mass of adenovirus type 5 was determined by means of computer-assisted scanning transmission electron microscopy (STEM). Arithmetic mean of 157 +/- 10(SD) X 10(6) daltons and mode between 160 and 170 X 10(6) daltons compare favourably with previously reported data. The advantages of the STEM-procedure over the physical and chemical techniques are: low amounts of purified virus particles are needed; visual control of the physical state of virus particles; no need to know the chemical composition or protein concentration of the virus sample. PMID- 6501535 TI - Comparison of mice and cell cultures for the isolation of tick-borne viruses. AB - Three methods of isolating viruses from 10 tick pools were compared; none of the methods produced all 13 of the viruses isolated (7 viruses of the bunyaviridae and 6 orbiviruses). Inoculation of homogenised ticks into various cell lines was the most successful, yielding 11 virus isolations. Only 2 tick homogenates induced overt signs of infection following intra-cerebral inoculation of 2-day old mice. However, when inoculated mouse brain was passaged in various cell lines, 8 of 12 isolations were made. The rates of success of the 3 methods of virus isolation appeared to vary according to the type and titre of the virus in the tick pool. PMID- 6501537 TI - Esophageal cancer in relation to cigarette and alcohol consumption. AB - Cigarette smoking and alcohol consumption both associate, at the individual level, with esophageal cancer; the basis of these associations is explored. Secular (temporal) trends in England and Wales, from 1911 to 1980, show that death rates from esophageal cancer correlate positively with alcohol consumption but negatively with average rates of cigarette smoking. The details suggest that alcohol helps to cause esophageal cancer through an indirect precipitating action. This hypothesis is tested, and loosely corroborated, by using the sex- and age-patterns of esophageal cancer in England and Wales and in U.S. Whites to infer the sex- and age-patterns of alcohol consumption by the victims of the disease. Genetic predisposition, alcohol consumption around 2-3 years before death and a proximal precipitator all appear to have a causal role. PMID- 6501539 TI - Benign breast disease, oral contraceptive use, and the risk of breast cancer. PMID- 6501538 TI - Recent life events in school children: race, socioeconomic status, and cardiovascular risk factors. The Minneapolis Children's Blood Pressure Study. AB - During a study of children's blood pressure, recent life events were measured to determine their occurrence in elementary school children and to determine their relationship to blood pressure and other possible precursors of adult hypertension. Data about life events for a one-year period were obtained from a stratified sample of 1505, 6- to 9-year-old children enrolled in Minneapolis public schools. Children's age and sex were not related to life events. Parental education, employment, and income were related to the child's life event frequency. Indian and black children tended to experience significantly more undesirable life events than white children. Life events frequency was not related to baseline or to follow-up blood pressure or to obesity or other risk factors for adult hypertension. PMID- 6501540 TI - Evaluation of hospice activities. PMID- 6501541 TI - An evaluation of a new patient compliance index using plasma propranolol levels. AB - Propranolol levels in plasma were studied in relation to dose prescribed in order to assess poor compliance with antihypertensive treatment. Fifty consecutive ambulatory patients (36-81 years) having hypertension, including 19 with azotemia, were investigated. Patient interviews using questionnaires and chart reviews were used to evaluate compliance. A composite Compliance Index was calculated for each patient. Individual oral doses of propranolol ranged from 20 to 160 mg. Subsequent plasma levels were determined by high performance liquid chromatography. Good correlation between last oral dose (mg) per body weight (kg) and log plasma propranolol levels were observed in patients whose compliance indices were above the mean for this sample (r = 0.74, p less than 0.01), when blood pressure control was satisfactory (r = 0.66) or excellent (r = 0.78), and when serum creatinines were greater than or equal to 1.4 (r = 0.76, p less than 0.001). Poor correlations between dose and propranolol levels suggest poor compliance with treatment. PMID- 6501542 TI - Cohort and period effects in peptic ulcer mortality from Japan. AB - Japan's death rate from gastric ulcer is far higher than that in any other country. The time pattern of peptic ulcer mortality between 1937 and 1980 was analysed in order to find out whether gastric ulcer in Japan, compared with Europe, shows other epidemiologic features which may indicate a different type of gastric ulcer disease. The age-adjusted death rates of both ulcer types and sexes have continuously decreased. In spite of the much higher death rates in the years 1937-80, the mortality of gastric ulcer shows a similar cohort phenomenon both in Japan and in Europe. The Japanese generations born in the last quarter of the 19th century ran the highest risk of dying from peptic ulcer and carried it throughout their lives. The cohorts with a high risk for duodenal ulcer lag 10 yr behind those with a high risk for gastric ulcer. Male and female cohorts with the highest risk were born at the same time. The cohort effects of both ulcer types are superimposed by period effects. The most obvious period effect during 1946-50 is seen in the short-timed increase of the death rates in all age groups, both sexes, and both ulcer types. The similarities between Japan and Europe suggest that worldwide, at the same time, the same environmental factors have precipitated the risk of dying from gastric and duodenal ulcer. PMID- 6501543 TI - The results of logistic analyses when the variables are highly correlated: an empirical example using diet and CHD incidence. AB - We provide an example which includes highly correlated variables in multivariate logistic analyses relating four nutrients to the incidence of coronary heart disease in 10 years for over 7000 men. Paradoxical results occur for both the inferences to be drawn and variable selection. Different models exist which show that any particular variable both is and is not related significantly to coronary heart disease incidence, and step-up and step-down variable selection algorithms provide drastically different results. PMID- 6501544 TI - Empiric comparison of multivariate analytic techniques: advantages and disadvantages of recursive partitioning analysis. AB - The recent ready availability of recursive partitioning analysis has provided medical investigators with an alternative to the usual parametric multivariate techniques. We believe that recursive partitioning analysis has several distinct advantages: it provides a simple and intuitive method for classifying subjects, it is designed to identify synergistic interactions among factors, it may identify nonlinear relationships with the endpoint, it provides a simple format for constructing homogeneous risk strata, and it considers prior probabilities and penalties for misclassification in its variable selection process. Conversely, parametric multivariate techniques have several advantages over recursive partitioning analysis: they may be better at finding predictive factors during the later stages of the selection process, they may be less subject to the problems of multiple testing and over-training, and they may be better able to account for the full predictive power of a continuous factor. Although neither type of technique is better in all situations, we believe that recursive partitioning analysis will often be the preferred multivariate method and is especially useful for identifying interaction terms that may then be included in parametric multivariate analyses. PMID- 6501547 TI - The effects of physician communications skills on patient satisfaction; recall, and adherence. AB - An understanding of means to improve patient adherence to the therapeutic regimen is a subject of increasing concern in medical care. This study examined the effects of physician interpersonal skills and teaching on patient satisfaction, recall, and adherence to the regimen. We studied the ambulatory visits of 63 patients to five medical residents at a teaching hospital in Baltimore. It was found that quality of interpersonal skills influenced patient outcomes more than quantity of teaching and instruction. Secondary analyses found that all the effects of physician communication skills on patient adherence are mediated by patient satisfaction and recall. These findings indicate that the physician might pay particular attention to these two variables in trying to improve patient adherence, and that enhancing patient satisfaction may be pivotal to the care of patients with chronic illness. PMID- 6501545 TI - The determination of the incidence of acute myocardial infarction from hospital morbidity records. AB - A method for estimating the incidence of acute myocardial infarctions (AMI) from routinely collected hospital morbidity records is presented. The method is based on a review of a sample of routinely collected statistics on hospital diagnoses and the subsequent estimation of the "sensitivity" and "positive predictive value" of hospital diagnoses of AMI. The incidence estimate of AMI is a function of the total number of hospital diagnoses of AMI, the "sensitivity", the "positive predictive value", the proportion of cases of AMI treated at home, and the proportion dying prior to hospital admission. Such estimates may be a practical alternative to community registers for monitoring the incidence of AMI. PMID- 6501546 TI - The clinical utility of the dementia rating scale for assessing Alzheimer patients. AB - Community residing patients with mild (n = 18) or moderately severe (n = 16) Alzheimer's disease and controls (n = 23) were given Mattis' Dementia Rating Scale (DRS) and a brief measure of confrontation naming selected from the Boston Naming Test (BNT). The DRS was shown to be a reliable and clinically useful measure of mental status in patients with Alzheimer's disease. The DRS subscales and the BNT had excellent internal consistency reliabilities and the total DRS score (TDRS) was shown to be generally unrelated to gender and education. Among the dementia patients, performance on the TDRS was significantly associated with functional competence. The two dementia samples had similar profiles on the DRS and BNT, with the mild subjects performing significantly better than the moderately severe subjects on each measure. Extending the range of DRS subscales would improve this measure's utility as an evaluation instrument. PMID- 6501548 TI - Estimating the utility of matching in case-control studies. AB - The estimation of the utility of matching in completed case-control studies is examined. The utility is defined in terms of providing an estimate of a more valid odds ratio than the crude odds ratio, and in providing a more efficient study than an unmatched study with a stratified analysis. Methods are given to estimate the utility of frequency-matching in a completed study where the cases and controls are matched into broad strata such as age or decade of birth. An example from the literature demonstrates the technique. Since the proposed analysis requires knowledge of the proportions of individuals in the study population associated with each stratum, it is recommended that estimates of these proportions be given in the results of frequency-matched case-control studies. For pair-matching where each pair is regarded as defining its own stratum (such as with neighborhood or friend controls) it is shown to be impossible to estimate the utility of the matching from a completed study. In particular, it is incorrect for either frequency- or pair-matching to try to estimate the utility of matching by performing an unmatched analysis on a completed case-control study. PMID- 6501549 TI - Is borderline fasting hyperglycemia a risk factor for cardiovascular death? AB - The majority of previously reported studies of borderline hyperglycemia as a risk factor for cardiovascular disease are based on post-challenge glucose levels, are limited to men, and show either no significant association or a possible threshold effect. In order to determine whether fasting plasma glucose (FPG) in the normal range (less than 140 mg/dl) predicts mortality, we prospectively studied a geographically defined Southern California community of 3625 nondiabetic men and women aged 40-79, 99.5% of whom were followed for 9 years. Levels of FPG were significantly associated with levels of most heart disease risk factors. After adjusting for these risk factors, FPG, analyzed either as a continuous or categorical variable, was independently and significantly associated with all-cause, cardiovascular and ischemic heart disease mortality in men in proportional hazard models. An excess of all-cause mortality with the highest levels of FPG (130-139 mg/dl) was the only statistically significant association seen in women. The absence of a significant linear association in women may reflect true sex differences or a lack of power owing to the relatively small numbers of deaths in women. The independent linear glucose mortality association in men found here differs from previous studies, and may reflect both the larger number of events and the use of FPG, which has less intra-individual variability and less potential for misclassification bias than post-challenge glucose. PMID- 6501550 TI - Data bases, data banks and data dredging: the agony and the ecstasy. PMID- 6501551 TI - [A histopathological study on autopsy cases of non-thrombotic non-occlusive acute myocardial infarction and related cardiac diseases due to coronary insufficiency]. PMID- 6501552 TI - Stimulation of the raphe nuclei produces EEG spikes in the hippocampus of the normal rabbit. PMID- 6501553 TI - An electron microscopic study on the regeneration of the curetted tracheal mucosa in rats. PMID- 6501554 TI - [Platelet lipid peroxides in acute cerebral vascular disease]. PMID- 6501555 TI - [Effects of water soluble iodinated contrast media on microcirculation in the rat mesenterium and liver]. PMID- 6501557 TI - [A psychosomatic approach to patients with so-called unidentified gastrointestinal syndrome in fluoroscopic examination of the gastrointestinal tract]. PMID- 6501558 TI - The treatment of acute attack of primary angle-closure glaucoma by pilocarpine ocusert system. PMID- 6501556 TI - [A histo-pathological study on the myocardial lesions in KK mice, with special reference to the causative factors and prevention of deterioration of the disease condition]. PMID- 6501559 TI - Plasma norepinephrine levels among patients with acute head injury. HPLC and clinical application (VI). PMID- 6501560 TI - Effects of the muscular dysgenesis gene on developmental stability in the mouse mandible. AB - Muscular dysgenesis (mdg) is an autosomal recessive gene in mice affecting primarily the skeletal musculature. mdg/mdg mice exhibit developmental arrest of myogenesis and degenerative changes in all skeletal muscles. In addition, there are pronounced abnormalities in skeletal traits, including the shape of the skull and mandible. Herein, we examine the phenotypic consequences of a single mdg allele in the heterozygous condition (+/mdg) on the size, shape, and developmental stability in 14 osteometric traits from the mouse mandible. Developmental stability in the mandible is measured by fluctuating asymmetry in bilateral traits. There are no statistically significant differences in the size or shape of the mandible between +/+ and +/mdg mice. However, compared to +/+ mice, +/mdg individuals exhibit less developmental stability for several mandible traits. The more unstable traits include height at the mandibular notch, height at the incisive process, condyloid width, height and area of the coronoid process, and size of the tooth-bearing region. All of these latter traits are closely associated with areas of muscle attachment and/or the muscular dysgenesis phenotype, suggesting that the presence of a single mdg allele is sufficient to alter developmental pathways. Traits not showing significantly increased instability in +/mdg mice bear no clear relationship to either muscle attachment areas or to the mdg/mdg phenotype. PMID- 6501561 TI - Roentgencephalometric measurements in trisomy 8 mosaicism: report of three cases. AB - Roentgencephalometric anomalies in three cases of Warkany syndrome (trisomy 8 mosaicism) are described. These include asymmetry of the mandible with a wide gonial angle and a high and narrow symphysis; SNA (anteroposterior position of maxilla) and SNB (anteroposterior position of mandible) values indicate a backward position of the mandible. Other findings point to a disturbance in the vertical growth of the facial skeleton. These measurements may explain at least part of the facial phenotype and may aid in diagnosis, especially in those cases with an uncertain clinical diagnosis and "normal" karyotype in peripheral blood lymphocytes. PMID- 6501562 TI - Early hypercementosis and arrested dental eruption: heritable multiple ankylodontia. AB - This study describes arrested posterior permanent tooth eruption in association with hypercementosis, reduction of the periodontal ligamental space, and bony ankylosis. The severe dental malocclusion occurred in four members of the same family and it appears to have an autosomal dominant mode of inheritance. PMID- 6501563 TI - Neutrophil-endothelial cell interactions. Modulation of neutrophil adhesiveness induced by complement fragments C5a and C5a des arg and formyl-methionyl-leucyl phenylalanine in vitro. AB - Neutrophil adherence to vascular endothelial cells is the initial event in the emigration of neutrophils through blood vessel walls to tissue sites of inflammation; this process is attributed to the generation of extravascular chemotactic factors. To investigate the effect of chemotactic factors on neutrophil adherence to endothelium, we developed a sensitive, reproducible in vitro microtiter adherence assay. Base-line nonstimulated adhesion of human neutrophils to cultured human umbilical vein endothelial cell monolayers was 35.2 +/- 0.9%, which is equivalent to three to four neutrophils per endothelial cell. Addition of either purified complement fragment C5a des arg, or formyl-methionyl leucyl-phenylalanine (FMLP), in concentrations ranging from 10(-10) to 10(-6) M, increased neutrophil adherence to endothelium in a dose-dependent manner. Purified C5a and C5a des arg were essentially equal in their ability to enhance neutrophil adherence, in contrast to the previously described greater in vitro potency of C5a compared with C5a des arg in stimulating neutrophil chemotaxis and enzyme release. Nonstimulated neutrophils adhered preferentially to human endothelial cells compared with fibroblasts or smooth muscle cells, suggesting that endothelial cells may make a unique contribution to the base-line adhesive interaction. However, chemotactic factors appear to enhance neutrophil adherence to endothelium by exerting an effect primarily on the neutrophil. In the presence of chemotactic factor, neutrophils adhered equally well to different cell types or to protein-coated plastic. Pretreatment of endothelial cells with chemotactic factor for as long as 4 h failed to increase subsequent neutrophil adherence. In contrast, pretreatment of neutrophils with chemotactic factor increased adherence to endothelium. Chemotactic factor-stimulated neutrophil adherence to endothelium occurred rapidly (within 2 min), diminished upon removal of stimulus, but could be rapidly and maximally restimulated upon readdition of the original dose of chemotactic factor. Thus, adherence to endothelium stimulated by chemotactic factor would appear to be a dynamic neutrophil response capable of rapid modulation, possibly important to the ability of neutrophils to adhere to and then migrate through vessel walls to localize at sites of inflammation. PMID- 6501565 TI - Effect of acetazolamide on cerebral blood flow and cerebral metabolic rate for oxygen. AB - The aim of this study was to evaluate the effect of acetazolamide on cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2). CBF, arterial and jugular venous partial O2 pressure, partial CO2 pressure, pH, and O2 saturation percentage were measured in six patients before and 3 and 20 minutes after intravenous administration of 1 g of acetazolamide. CBF was measured by the intracarotid 133xenon injection technique. In addition, changes in CBF were estimated from the arteriovenous oxygen content difference. CBF increased in all patients after acetazolamide, by approximately 55 and 70% after 3 and 20 min, respectively. The CBF changes were of the same order whether calculated from the 133Xe clearance or from the arteriovenous oxygen differences (A-V)O2. CMRO2, calculated from (A-V)O2 differences and CBF, remained constant. Except for an increase in the venous oxygen saturation, the blood gases remained constant. Acetazolamide, in a dose sufficient to inhibit the erythrocyte carbonic anhydrase (EC 4.2.1.1), thus induced a rapid and marked increase in CBF, leaving CMRO2 unchanged. This effect of acetazolamide on CBF is probably explained by a decrease in brain pH rather than by brain tissue hypoxia due to inhibition of oxygen unloading in the brain capillaries. PMID- 6501564 TI - Familial apolipoprotein AI and apolipoprotein CIII deficiency. Subclass distribution, composition, and morphology of lipoproteins in a disorder associated with premature atherosclerosis. AB - Lipoprotein classes isolated from the plasma of two patients with apolipoprotein AI (apo AI) and apolipoprotein CIII (apo CIII) deficiency were characterized and compared with those of healthy, age- and sex-matched controls. The plasma triglyceride values for patients 1 and 2 were 31 and 51 mg/dl, respectively, and their cholesterol values were 130 and 122 mg/dl, respectively; the patients, however, had no measurable high density lipoprotein (HDL)-cholesterol. Analytic ultracentrifugation showed that patients' S degrees f 0-20 lipoproteins possess a single peak with S degrees f rates of 7.4 and 7.6 for patients 1 and 2, respectively, which is similar to that of the controls. The concentration of low density lipoprotein (LDL) (S degrees f 0-12) particles, although within normal range (331 and 343 mg/dl for patients 1 and 2, respectively), was 35% greater than that of controls. Intermediate density lipoproteins (IDL) and very low density lipoproteins (VLDL) (S degrees f 20-400) were extremely low in the patients. HDL in the patients had a calculated mass of 15.4 and 11.8 mg/dl for patients 1 and 2, respectively. No HDL could be detected by analytic ultracentrifugation, but polyacrylamide gradient gel electrophoresis (gge) revealed that patients possessed two major HDL subclasses: (HDL2b)gge at 11.0 nm and (HDL3b)gge at 7.8 nm. The major peak in the controls, (HDL3a)gge, was lacking in the patients. Gradient gel analysis of LDL indicated that patients' LDL possessed two peaks: a major one at 27 nm and a minor one at 26 nm. The electron microscopic structure of patients' lipoprotein fractions was indistinguishable from controls. Patients' HDL were spherical and contained a cholesteryl ester core, which suggests that lecithin/cholesterol acyltransferase was functional in the absence of apo AI. The effects of postprandial lipemia (100-g fat meal) were studied in patient 1. The major changes were the appearance of a 33-nm particle in the LDL density region of 1.036-1.041 g/ml and the presence of discoidal particles (12% of total particles) in the HDL region. The latter suggests that transformation of discs to spheres may be delayed in the patient. The simultaneous deficiency of apo AI and apo CIII suggests a dual defect in lipoprotein metabolism: one in triglyceride-rich lipoproteins and the other in HDL. The absence of apo CIII may result in accelerated catabolism of triglyceride rich particles and an increased rate of LDL formation. Additionally, absence of apo CIII would favor rapid uptake of apo E-containing remnants by liver and peripheral cells. Excess cellular cholesterol would not be removed by the reverse cholesterol transport mechanism since HDL levels are exceedingly low and thus premature atherosclerosis occurs. PMID- 6501566 TI - Role of phorbol diesters in in vitro murine megakaryocyte colony formation. AB - In vitro megakaryocyte differentiation is regulated by two activities: a megakaryocyte colony-stimulating activity (Mk-CSA), which is required for proliferation, and an auxiliary factor, megakaryocyte potentiating activity, which plays a role in later differentiation events. Tumor-promoting phorbol esters alter many cellular differentiation-related events. Thus, it was hypothesized that phorbol esters may bring about megakaryocyte differentiation in vitro. 4 beta-Phorbol 12-myristate 13-acetate (PMA), when co-cultured with a source of Mk-CSA, stimulated a threefold increase in colony numbers. Co-culture of PMA and megakaryocyte potentiator activity did not stimulate colony formation, thus eliminating any action of PMA as an Mk-CSA. The direct effect of PMA on the formation of megakaryocyte colonies was established by (a) the function of PMA as a megakaryocyte potentiator in serum-free experiments, (b) the ability of PMA to stimulate megakaryocyte colony formation using bone marrow cells depleted of populations known to produce potentiating activity, (c) the inability of bone marrow adherent cells previously treated with phorbol, 12,13-dibutyrate (PDBu) to augment megakaryocyte colony formation, and (d) the ability of PMA to induce the growth of immature megakaryocytes into large single megakaryocytes. Structure:activity experiments resulted in equivalent activities for PMA and PDBu, whereas the nontumor promoter phorbol 12,13-diacetate and phorbol itself lacked activity. The observations in this study indicate that phorbol esters can bring about megakaryocyte differentiation, and during colony formation, can induce effects identical to those brought about by biological sources of megakaryocyte potentiator activity. PMID- 6501567 TI - Correction of hypokalemia corrects the abnormalities in erythrocyte sodium transport in Bartter's syndrome. AB - In Bartter's syndrome, the defective renal tubular transport has been postulated to be a manifestation of a more generalized membrane abnormality. To explore this possibility, sodium concentration, ouabain-sensitive (pump transport), ouabain resistant but furosemide-sensitive (Na-K-Cl cotransport), and ouabain- and furosemide-resistant (passive transport) 22Na effluxes were measured in erythrocytes obtained from nine patients with Bartter's syndrome before and during correction of hypokalemia. Intracellular [Na+] in erythrocytes obtained from nine patients with Bartter's syndrome was significantly (P less than 0.001) higher than that in 30 normal controls (11.8 +/- 1.8 vs. 7.3 +/- 1.4 mmol/liter cells). Pump transport and Na-K-Cl cotransport 22Na effluxes were significantly (P less than 0.01) increased, whereas the rate constant for these effluxes as well as for passive 22Na efflux did not differ from normal. Correction of hypokalemia and maintenance of a normal serum potassium decreased intracellular [Na+] to 8.2 +/- 1.8 mmol/liter cells, a normal value, and corrected the ouabain sensitive and furosemide-sensitive 22Na effluxes. The results indicate that exposure of erythrocytes to a low potassium environment is responsible for the high intracellular [Na+] and, in turn, the high sodium efflux in Bartter's syndrome. The normal sodium efflux observed during correction of hypokalemia and the consistently normal rate constants for all three efflux parameters measured suggest that intrinsic sodium transport processes in erythrocytes are normal in Bartter's syndrome. PMID- 6501568 TI - Role of thrombospondin in platelet aggregation. AB - Thrombospondin (TSP), the major alpha-granule protein of human platelets, binds to the activated platelet surface upon platelet stimulation. TSP has hemagglutinating (lectin-like) activity and forms a specific complex with fibrinogen. Based on these observations, it was postulated that the interaction of TSP and fibrinogen on the activated platelet surface may be an important step in the platelet aggregation process. To test this hypothesis, monospecific, affinity-purified anti-TSP Fab fragments were prepared and their effects on platelet aggregation and platelet fibrinogen binding were studied. Anti-TSP Fab caused significant interference with thrombin- and collagen-induced platelet aggregation, as monitored by both turbidometric aggregometry and particle counting measuring the disappearance of single platelets. Phase-contrast microscopy revealed that anti-TSP Fab caused a marked decrease in platelet macroaggregates and an increase in microaggregates and nonaggregated single platelets. Anti-TSP Fab did not affect the initial phase of ADP-induced platelet aggregation but caused rapid platelet disaggregation with the abolition of the secondary phase of aggregation. The effect of anti-TSP Fab was not mediated by a direct inhibition of platelet secretion. The effect of anti-TSP Fab on specific binding of labeled fibrinogen to thrombin-stimulated platelets was also studied. Anti-TSP Fab caused a marked decrease in the affinity of fibrinogen binding to the receptors on the activated platelet surface. Kinetic analyses revealed significant displacement of labeled fibrinogen by unlabeled fibrinogen in the presence of anti-TSP Fab, suggesting that TSP serves to stabilize fibrinogen binding to the activated platelet surface and reinforces the strength of interplatelet interactions. It is proposed that platelet aggregation is a dynamic, multistep process, governed initially by the platelet membrane glycoprotein IIb/IIIa-fibrinogen interaction, with the TSP-fibrinogen interaction playing an important role in determining the size and reversibility of platelet aggregates. PMID- 6501569 TI - Comparative effects of cholestanol and cholesterol on hepatic sterol and bile acid metabolism in the rat. AB - Large amounts of cholestanol, the 5 alpha-dihydro derivative of cholesterol are found in tissues of patients with the rare inherited sterol storage disease cerebrotendinous xanthomatosis. Although small amounts of cholestanol are present in virtually every tissue of normal man, little is known about its metabolism and effect on cholesterol and bile acid formation. The purpose of this study is to investigate the absorption and metabolism of cholestanol and its early effects on hepatic morphology and on the rate-limiting enzymes of cholesterol and bile acid biosynthesis. After 2 wk on a diet supplemented with 2% cholestanol, total liver sterol content increased by 48% (3.26 vs. 2.20 mg/g), and resulted in a significant rise in hepatic cholestanol concentration to 1.4 mg/g. However, cholestanol was less efficiently absorbed from the intestine than cholesterol and interfered with cholesterol absorption. Furthermore, hepatic hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase activity rose 2.6-fold (from 150.3 to 397.0 pmol/mg per min) during cholestanol feeding, and was associated with a marked proliferation of the smooth endoplasmic reticulum of the centrilobular areas. In addition, significant amounts of allocholic acid (16%) and allochenodeoxycholic acid (5%) were formed from cholestanol and excreted in the bile. These results show that cholestanol is absorbed from the intestine, interferes with cholesterol absorption, and is deposited in the liver. However, in contrast to cholesterol, cholestanol feeding was associated with a marked elevation of HMG-CoA reductase activity. Thus, despite structural similarity between cholesterol and its 5 alpha-saturated derivative, cholestanol does not exert feedback inhibition on hepatic cholesterol biosynthesis. PMID- 6501570 TI - Effects of platelet depletion on the unanesthetized sheep's pulmonary response to endotoxemia. AB - The effect of platelet depletion on the unanesthetized sheep's pulmonary response to endotoxemia was studied in eight unanesthetized sheep. Platelets were depleted with rabbit anti-sheep platelet antibodies (APA). Bolus injections of APA alone caused marked pulmonary hypertension (PPA increased from 21 +/- 2 to 62 +/- 5 cm H2O +/- SE) and alterations in lung mechanics (dynamic compliance of the lung [Cdyn] decreased to 38.5 +/- 4.6% and resistance to air flow across the lung [RL] increased to 705 +/- 162% +/- SE of control), which were attenuated by pretreatment with meclofenamate. It was possible to deplete platelets before endotoxemia through a slow continuous infusion of APA without altering base-line values of the measured variables. Platelet depletion did not significantly attenuate the alterations in pulmonary hemodynamics, lung mechanics, lung fluid and solute exchange, or the normal increase in lung lymph concentrations of thromboxane B2 or 6-keto-PGF1 alpha observed following endotoxemia in the sheep. We conclude that normal circulating platelet counts are not required for the full expression of the sheep's response to endotoxemia. PMID- 6501571 TI - Differential acute effects of aldosterone, dexamethasone, and hyperkalemia on distal tubular potassium secretion in the rat kidney. AB - To determine the specific effects on renal potassium transport of acute elevations in plasma aldosterone, dexamethasone, and potassium concentrations, we studied adrenalectomized rats prepared such that each factor could be varied independently. Clearance data alone could not be used to deduce the underlying tubular transport effects, however, since infusion of each of these agents was associated with a marked change in urinary flow rate, which may itself have influenced potassium excretion. We therefore used a technique of continuous microperfusion, in vivo, of single superficial distal tubules to evaluate potassium secretion at constant luminal flow rate during each experimental maneuver. Acute aldosterone infusion was associated with a 90% stimulation of potassium secretion by microperfused tubules. However, total kidney sodium excretion and urinary flow rate were markedly reduced, and these factors opposed the direct tubular action of aldosterone, resulting in no net change in the amount of potassium excreted into the final urine. Conversely, dexamethasone had no direct effect on potassium secretion by single microperfused tubules, but it caused a sharp increase in urinary flow and sodium excretion, and secondarily enhanced urinary potassium excretion by 50%. Hyperkalemia per se stimulated renal potassium excretion both via a direct tubular effect and by increasing urinary flow rate. We conclude that urinary potassium excretion after infusion of each of these agents represents the net result of direct tubular effects and secondary flow-mediated changes. PMID- 6501572 TI - Nonenzymatic addition of glucocorticoids to lens proteins in steroid-induced cataracts. AB - A frequent manifestation of long-term glucocorticoid administration is the occurrence of posterior subcapsular cataracts. The molecular basis for this effect has not yet been elucidated. The addition of prednisolone to the rat lens in culture results in a time- and concentration-dependent lens opacification that correlates with the formation of covalent prednisolone-lens protein adducts. Prednisolone adduct formation was analyzed by [3H]prednisolone incorporation and by immunoprecipitation with antiserum specific for proteins modified by the nonenzymatic addition of prednisolone. In the rat lens, these adducts were localized in both the water-soluble and urea-soluble lens protein fractions. Gel electrophoresis and fluorography revealed that the most extensively modified proteins were two crystallins subunits. Lens proteins from 33 normal and cataractous human lenses were fractionated and analyzed for the presence of prednisolone-protein adducts by competitive radioimmunoassay. Adducts were detected only in those samples derived from glucocorticoid-induced cataractous lenses. We conclude that elevated glucocorticoid levels lead to the formation of glucocorticoid-lens protein adducts both in vitro and in vivo. Lens protein modification by glucocorticoids may lead to sufficient biochemical or structural alterations so as to result in cataract formation. The ability of glucocorticoids to form adducts with proteins in vivo also may play a role in some of the other toxic manifestations of long-term glucocorticoid therapy. PMID- 6501573 TI - Protective effect of intrarenal calcium membrane blockers before or after renal ischemia. Functional, morphological, and mitochondrial studies. AB - The present study examined whether a pre- or postischemic infusion of verapamil (V) or a postischemic infusion of nifedipine (N), drugs which block calcium (Ca++) influx across plasma membranes, provides protection against ischemic acute renal failure (ARF) in dogs. Renal hemodynamics and excretory function were examined 1 h (initiation phase) and 24 h (maintenance phase) after a 40-min intrarenal infusion of norepinephrine (NE). In each case, the uninfused contralateral kidney served as control. Four groups were studied: (a) dogs receiving NE alone; (b) dogs receiving an intrarenal infusion of V for 30 min before NE (V + NE); (c) dogs in which intrarenal V was infused for 2 h, beginning immediately after completion of NE infusion (NE + V); and (d) dogs in which intrarenal N was infused for 2 h, beginning immediately after completion of NE infusion (NE + N). Glomerular filtration rate (GFR) in the NE kidneys, as assessed by inulin clearance, at 1 and 24 h averaged 2.4 +/- 1.1 and 5.0 +/- 2.0 ml/min, respectively, as compared with control kidney GFRs of 28.0 +/- 3.5 and 43.8 +/- 5.0 ml/min, respectively (both at least P less than 0.01). In the V + NE group, GFR at 1 and 24 h averaged 15.0 +/- 5.5 and 31.0 +/- 4.5 ml/min, respectively, both at least P less than 0.05 as compared with values from NE kidneys. GFRs in the NE + V group averaged 15.0 +/- 2.4 and 16.3 +/- 3.6 ml/min at 1 and 24 h, both at least P less than 0.02 as compared with values from NE kidneys. GFR in the NE + N group averaged 18.6 +/- 6.0 ml/min at 24 h (P less than 0.05 as compared with GFRs in the NE kidneys). In addition, function of cortical mitochondria (Mito) was examined at the end of the 40-min NE infusion and after 1 and 24 h of reperfusion in the NE alone and NE + V groups. Mito respiration, assessed by acceptor control ratios, was reduced at each period in the NE alone kidneys. After 24 h, these Mito had accumulated Ca++ and exhibited reduced Ca++ uptake and increased Ca++ release rates. Mito from NE + V kidneys respired normally, did not accumulate Ca++, and exhibited no alterations in Ca++ uptake or release. Light and electron microscopy also demonstrated morphological protection of V against tubular necrosis and cell injury. Mito from the NE + N kidneys also respired normally and did not accumulate significant amounts of Ca++. The results of the present studies therefore demonstrated that chemically dissimilar calcium entry blockers exert substantial functional, cellular, and morphological protection against experimental ischemic ARF. These findings are compatible with the hypothesis that increased cytosolic Ca++ is critically important in the maintenance of renal vasoconstriction and the development of cellular necrosis with subsequent tubular obstruction in NE-induced ischemic ARF. V or N may provide protection against renal injury by retarding any increase in cytosolic Ca++ in renal vasculature and epithelium. PMID- 6501574 TI - Electrical charge of the antigen determines intraarticular antigen handling and chronicity of arthritis in mice. AB - We studied the influence of antigenic charge on the handling of intraarticular antigen by the joint and on the ability of the antigen to induce chronic arthritis. Three different antigens were used: anionic native bovine serum albumin (BSA), and charge modified BSA made cationic (pI 8.5) either by methylation (mBSA), or amidation (aBSA). 125I-labeled antigen was injected into the knee joints of nonimmune mice and of mice immunized with antigen in Freund's complete adjuvant. Intraarticular antigen retention of the cationic antigens mBSA and aBSA was significantly increased compared with native BSA, both in immune and non-immune mice. In vitro studies indicated the electrostatic character of the binding of the cationic antigens to joint tissues and confirmed the large difference in antigen retention of the antigens found in vivo. A 100-fold amount of cationic antigen could be bound to non-cartilaginous collagenous tissue of the joint compared with antibody-mediated trapping of native BSA, and for hyaline articular cartilage, this difference was even greater. In immunized mice, chronic arthritis only developed after intraarticular injection of the cationic antigens. This phenomenon was apparently related to increased retention of mBSA and aBSA compared with BSA, since delayed hypersensitivity and humoral immunity were comparable for the three antigens used. Our data indicate that antigenic charge is an important determinant of antigen handling by the joint and, in addition, support the concept that the development of chronic arthritis depends on the amount of antigen retained in the joint. PMID- 6501575 TI - Examination of transepithelial exchange of water and solute in the rat renal pelvis. AB - Severance of the ureter beyond the renal papilla causes a fall in urinary osmolality, which suggests that exchange of water or solute between urine and renal parenchyma normally occurs in the intact renal pelvis. We examined water and solute flux in the renal pelvis with micropuncture and microcatheterization techniques. Four groups of antidiuretic rats were studied. Group I (n = 17) underwent micropuncture through the intact contracting ureter. Urine samples were obtained at the papillary tip, and in the pelvis beside the base of the extrarenal papilla. Urinary osmolality at the base, 880 +/- 97 mosmol/kg H2O (mean +/- SE), was less than that at the tip, 1,425 +/- 104 mosmol/kg H2O (P less than 0.005). In group II (n = 24), samples were analyzed for inulin and osmolality. In 15 rats (group IIA), comparison was made between base and tip samples. In the other nine animals (group IIB), comparisons were made among base, tip, and bladder samples and urea was also measured. In group II (A and B combined) urine-to-plasma (U/P) osmolality was lower at the base, 4.31 +/- 0.27, than at the tip, 6.08 +/- 0.23 (P less than 0.001), and U/P inulin was lower at the base, 192 +/- 25, than at the tip, 306 +/- 16 (P less than 0.001). In group IIB, the bladder urine had a lower U/P osmolality, 5.27 +/- 0.25, than the tip, 6.01 +/- 0.31 (P less than 0.02). The U/P urea was 59 +/- 10.6 (base), 98 +/- 9.4 (tip) (base vs. tip, P less than 0.05), and 81 +/- 6.5 (bladder, P less than 0.005, compared with tip). In group III (n = 8), samples were obtained by microcatheter from the fornices, the deepest intrarenal extensions of the pelvis, and compared with samples at the tip. Urinary osmolality was lower in the fornix, 646 +/- 106 mosmol/kg H2O, than at the tip, 1,296 +/- 99 mosmol/kg H2O (P less than 0.001). Similarly, U/P inulin was lower in the fornix, 48 +/- 14, than at the tip, 128 +/- 12 (P less than 0.001). The lower U/P inulin in the pelvic urine is the result of either the addition of fluid to the pelvis, or the backleak of inulin across the epithelium lining the pelvis. To verify that the pelvic epithelium was impermeable to inulin, in group IVA (n = 4) the left renal pelvis was superfused with a solution of chemical inulin. Cumulative absorption of inulin from the left kidney was 0.15 +/- 0.08% of that superfused. Using [14C]inulin in group IVB (n= 3), similar results were obtained (0.05 +/- 0.02%). These findings indicate that in the renal pelvis, fluid is added to urine after it emerges from the collecting ducts. We suggest that reflux of hyperosmotic urine over the renal papilla creates a transepithelial gradient for the flux of water into the pelvis. A model that incorporates diffusive and convective forces for water and solute transport is proposed to account for these findings. PMID- 6501576 TI - In vivo influx of free and esterified plasma cholesterol into human aortic tissue without atherosclerotic lesions. AB - In order to determine the in vivo influx of plasma cholesterol into human aortic intimamedia tissue, specimens of the ascending aortic wall without visible atherosclerosis were obtained from patients undergoing aortic valve replacement. Before the operation the patients were intravenously injected with autologous plasma in which the lipoproteins were labeled with radioactive cholesterol. The influence of the duration of the exposure time (0.3-114 h) and of the distribution of radioactivity between free and esterified cholesterol in plasma on the amount of radioactivity found in the arterial wall was studied by the simultaneous use of 3H- and 14C-cholesterol. It was shown that the influx of free and esterified cholesterol into the intima-media layer of the tissue could be calculated from a set of linear equations that relate the labeled sterols in the tissue to the average specific activities in plasma. In nine patients between 50 and 70 yr of age with 4.2-5.9 mM total cholesterol in plasma, the influx of free cholesterol and of esterified cholesterol was 1.2-8.8 and 1.0-12.5 nmol X cm-2 X d-1, respectively. Both hydrolysis and esterification of the sterol fractions in the aortic tissue and exchange of free cholesterol between the plasma lipoproteins and the tissue were demonstrated. The cholesterol content of the intima-media layer was 0.6-2.3 mumol X cm-2. This corresponds to the influx of esterified cholesterol during a period of only 0.1-3.5 yr, which is short compared with the lifespan of the patient. Our data thus suggest that removal of esterified cholesterol from aortic tissue without visible atherosclerosis represents a major importance for the cholesterol concentration in the tissue. PMID- 6501577 TI - Iron and copper promote modification of low density lipoprotein by human arterial smooth muscle cells in culture. AB - Modification of low density lipoproteins by human arterial smooth muscle cells was characterized by increased electrophoretic mobility and increased content of malondialdehyde-like oxidation products reactive with thiobarbituric acid. Lipoprotein modification was promoted by micromolar concentrations of iron or copper in the culture medium and was metal ion concentration- and time-dependent. The ability of diverse media to promote smooth muscle cell-mediated low density lipoprotein modification correlated with their iron concentration. Therefore, metal ion concentration of culture media contributes substantially to low density lipoprotein modification in vitro. Human monocyte-derived macrophages took up and esterified the cholesterol from modified low density lipoprotein more extensively than from native low density lipoprotein. Metal ion-mediated modification of low density lipoprotein may be a contributing factor to the pathogenesis of arteriosclerosis. PMID- 6501578 TI - Base rate data for the WAIS-R: test-retest stability and VIQ-PIQ differences. AB - The data analyzed were the 14 WAIS-R scores from each of the individuals who comprised the WAIS-R standardization sample. Examined was the individual VIQ-PIQ difference from only the initial examination of each of the 1880 subjects, as well as the test-retest change in each of the 14 WAIS-R scores for each of the 119 subjects who were retested. The results revealed that, although the WAIS-R has excellent psychometric reliability as reflected in its standard error of measurement of a VIQ-PIQ difference and its impressively high test-retest Pearson r values, the actual magnitudes of the differences between the VIQ and PIQ assessed in a single examination, or the magnitudes of gain or loss in the 14 scores on retest, for some of these normal individuals were sufficiently high that such base-rate data should be routinely considered by clinical neuropsychologists and other practitioners. PMID- 6501579 TI - Dissociation between the processing of affective and nonaffective faces: a case study. AB - In this report we describe a patient with a right-hemisphere lesion who showed a dissociation between the processing of affective and nonaffective faces. Although he performed normally on neutral facial tasks, he was impaired in naming and pointing to facial expressions. This dissociation is discussed in terms of four possible mechanisms: (a) a high-level visuoconfigurational defect; (b) an associative agnosic type of defect for facial expressions; (c) a specific "activation" defect; and (d) a visual-verbal disconnection resulting in an anomic type of defect for facial expressions. PMID- 6501580 TI - Classification of dementia patients by a WAIS profile related to central cholinergic deficiencies. AB - Sixty-two patients were classified as having Alzheimer-type dementia (AD) or multi-infarct dementia (MID) on the basis of clinical criteria. Protocols from the Wechsler Adult Intelligence Scale (WAIS) were scored according to a formula reported by Fuld to reflect the effects of scopolamine administration in young adults. The formula correctly classified 13 of 23 AD patients and 37 of 39 MID patients. The formula was similar to Wechsler's deterioration quotient, which produced a greater number of false positives. The formula did not appear to be biased by age, sex, or severity of impairments. Results suggest that the neuropsychological investigation of AD which emphasizes the deficiencies in cholinergic neurotransmission may be a fruitful avenue of further investigation. PMID- 6501582 TI - Methodological considerations in the use of attribute variables in neuropsychological research. AB - This paper examines the conceptual and statistical difficulties created when neuropsychological research uses attribute variables in traditional orthogonal experimental designs. It is argued that attribute variables, as a result of their statistical and theoretical nonindependence, break the underlying assumptions of these traditional designs, and may lead to incorrect inferences being drawn. These difficulties are illustrated in a consideration of the typical use of analysis of variance designs, matched groups designs, and the analysis of covariance. Finally, a plea is made for the explicit consideration of the assumptions underlying the design models used in neuropsychological research, and a suggestion is made regarding the more appropriate use of correlational techniques in neuropsychology. PMID- 6501581 TI - Cued recall in amnesia. AB - Use of a search procedure to control processing during learning results in apparently normal cued recall by some amnesic patients with impaired free-recall learning. This suggests that their ability to encode and retrieve may be relatively intact when they are induced to carry out effective processing during learning. When processing is controlled during learning, cued recall should be useful for neuropsychological evaluation of residual learning and memory capacity. PMID- 6501584 TI - Florida Kindergarten Screening Battery. PMID- 6501583 TI - Luria left in the lurch: unfulfilled promises are not valid tests. AB - The Luria-Nebraska Neuropsychological Battery (LNNB) remains the subject of controversy among neuropsychologists. Substantial criticisms of a theoretical and applied nature have called into question its research basis as a clinical tool. In response to this, Stambrook (1983) has concluded that further research on the LNNB by neuropsychologists is required. The present commentary disputes this need, pointing to the test author's and publisher's primary responsibility for such research. Tests or batteries may be dropped from one's clinical practice without invoking an obligation on the part of neuropsychology. PMID- 6501585 TI - Effect of chemotherapy on the histological appearances of testicular teratoma metastatic to the lung: correlation with patient survival. AB - We report on 20 patients with teratoma of the testis metastatic to the lungs who underwent surgical enucleation of the pulmonary metastases. Seven patients showed predominantly undifferentiated tumour in the pulmonary metastases; six of these died within 26 months, while the seventh was lost to follow up. Four patients showed only scarring or total necrosis of their pulmonary lesions. These patients all received full courses of chemotherapy before surgery and are alive and well with no evidence of recurrence up to four years after diagnosis. In nine patients the pulmonary nodules consisted entirely of well differentiated tissues of benign appearance, sometimes resembling primary pulmonary adenochondromas. These patients also received full courses of chemotherapy before surgery; one died of disseminated disease but the other eight are all alive and well with survival intervals of up to 14 years after presentation. These findings show that following chemotherapy, necrosis and differentiation of teratomatous pulmonary metastases signify a good prognosis. PMID- 6501586 TI - Penetration of the left ventricular myocardium by benign peptic ulceration: two cases and a review of the published work. AB - Two cases of penetration of the left ventricular myocardium by benign peptic ulcer are reported. Twenty five similar cases in the world published work are reviewed. The condition is only possible when there are fibrous adhesions between the stomach and diaphragm and the pericardium. In addition, the left lobe of the liver may be small. Alternatively, an ulcer within a hiatus hernia may erode into the left ventricle. PMID- 6501587 TI - Traumatic subarachnoid haemorrhage: an alternative source. AB - Traumatic subarachnoid haemorrhage is known on many occasions to result from a blow on the neck rupturing the vertebral artery within the cervical spine. On some occasions, however, no such damage to the artery in the neck can be found to account for the haemorrhage. Some cases are described in which the source of haemorrhage was rupture of the vertebral artery within the skull close to the basilar artery. The reason why rupture should occur at this site is discussed. PMID- 6501588 TI - Mucosal flora of the small intestine and the effect of preoperative antibiotics. AB - Samples of mucosa from the small intestines of 100 patients undergoing intestinal surgery were examined bacteriologically. Sixty four patients had received chemotherapy, 12 for more than 24 h before operation. Most of the jejunal samples were sterile unless there was a carcinoma, previous surgery, or potential intestinal stasis. Ileal mucosa was more likely to contain intestinal organisms. Most of the strains isolated were sensitive in vitro to the antibiotics given in vivo, but short term treatment may not have allowed sufficient time for the treatment to have become effective. The findings suggest that antibiotics are not needed for most operations on the duodenum or jejunum but may be required for operations on the ileum. PMID- 6501589 TI - Postmortem radiographic, histological and bacteriological studies of terminal respiratory infections and other pulmonary lesions in hospital and non-hospital necropsies. AB - One lung from 109 unselected hospital and 43 unselected non-hospital necropsies was studied using postmortem radiography with histological verification. Signs of acute bacterial infection, including bronchiolitis or bronchopneumonia, were present in 42.2% of the hospital necropsies and infection was the immediate cause of death in 8.3%. There was only one case of incipient bronchopneumonia among the non-hospital necropsies. Emphysema was the most common other pulmonary lesion in both groups. Gram negative bacteria were found significantly more often in the bronchial mucus of lungs with any pulmonary lesion, particularly those with signs of bacterial infection, than in the bronchial mucus of morphologically normal lungs in both groups of patients. In addition, the frequency of infections was associated with length of stay in hospital. This may reflect the prevalence of Gram negative infections in hospitals. PMID- 6501590 TI - Comparison of a latex agglutination test with other serological tests for the measurement of antibodies to Toxoplasma gondii. AB - One hundred sera from 49 patients with glandular toxoplasmosis were examined by a latex agglutination test, the dye test, an indirect haemagglutination test, and a double antibody sandwich enzyme linked immunosorbent assay (ELISA) for antitoxoplasma IgM. The results support previous findings that the dye test, indirect haemagglutination test, and latex agglutination test measure different antibodies to Toxoplasma gondii. In early glandular toxoplasmosis, when specific IgM was detected, the titres of both the latex agglutination test and the indirect haemagglutination test were lower than the dye test. Repeat specimens from 11 of the patients showed four cases in which the latex agglutination test titres never exceeded 1/256, whereas both the dye test and the indirect haemagglutination test showed significant titres and specific IgM was detected in every case. We conclude that the latex agglutination test should not be used as a substitute for the dye test in the serological diagnosis of glandular toxoplasmosis. All sera giving a positive latex agglutination test result should be referred for further tests. A combination of the dye test and double antibody sandwich ELISA gives the most reliable serological diagnosis of early glandular toxoplasmosis. PMID- 6501591 TI - Endocarditis caused by Rothia dentocariosa. AB - A case of infective endocarditis caused by Rothia dentocariosa is described in a 53 year old man with a history of rheumatic fever. R dentocariosa is a component of the oral microbiota and has only rarely and recently been recognised as a human pathogen. In this patient the oral flora was the probable source of infection, with a broken molar tooth providing the probable avenue for infection. PMID- 6501593 TI - High incidence of group C streptococci isolated from throat swabs. PMID- 6501592 TI - Necrotising fasciitis caused by Vibrio vulnificus. AB - A case of necrotising fasciitis caused by Vibrio vulnificus is described. The need for early recognition and aggressive surgical treatment are highlighted, and the necrotising infections due to V vulnificus described in the published work are reviewed. PMID- 6501594 TI - Serum creatine kinase isoenzyme levels in patients with cerebral tumours. PMID- 6501596 TI - A nonlinear analysis of phonological disability. AB - In the spirit of Gandour (1981) a reanalysis is presented of the speech of a 6-yr old language delayed child, Rosey, whose phonologic disorder has been discussed by Grunwell (1982). A revealing account of the data can be given by adopting a nonlinear framework; specifically, recent amendments to Goldsmith's (1976) theory of autosegmental phonology. This analysis borrows from autosegmental accounts of Arabic morphology, reduplication, and Kikuyu tone shift (all of which are briefly described). The processes postulated to explain the "deviant" pattern of data, hence, are all well motivated from the grammars of other languages. The analysis is contrasted with a "classical" (SPE) generative analysis and, thus, provides indirect evidence in favor of autosegmental theory over the classical theory. At the same time, the position of such phonologic analyses in psycholinguistic models of acquisition is briefly discussed. PMID- 6501595 TI - Fundamental frequency and intensity measurements in laryngeal and alaryngeal speakers. AB - Fundamental frequency measurements and voice sound pressure levels were examined in 10 tracheoesophageal, 10 esophageal, and 10 laryngeal speakers during three phonation tasks. The results indicated that tracheoesophageal speakers had a fundamental frequency approximately 25 Hz higher than esophageal speakers. Intensity levels for laryngeal and tracheoesophageal speakers were similar. Discussion includes support for this new voice restoration technique. PMID- 6501598 TI - Production of /s/ as a function of word frequency, phonetic environment, and phoneme position. AB - The effects of word frequency, phonetic environment, and phoneme position on the production of /s/ in words by 50 phonologically impaired children were examined. Results indicated that: word frequency of occurrence did not significantly affect the rate of misarticulation; phonetic environments were significantly related to articulation errors; and positional variations were significantly different, prevocalic /s/ was easiest, followed by postvocalic and initial consonant clusters. These results are compared with previous studies, and the implications for management are discussed. PMID- 6501597 TI - A second look at tests of speech-sound discrimination. AB - This study is an extension of an earlier study conducted by Bountress and Laderberg (1981), which compared the performances of a group of children on two tests of speech-sound discrimination, the Wepman test and Goldman-Fristoe Woodcock test. The present study consisted of two treatments: The dual administration of the Boston University Speech Sound Discrimination Test and Wepman, and the Boston and Goldman-Fristoe-Woodcock to two groups of 25 children. An analysis of the results of the two treatments indicated that, as was the case in Bountress and Laderberg's original research comparing the Wepman and Goldman Fristoe-Woodcock, neither the Boston or Wepman nor the Boston or Goldman-Fristoe Woodcock comparisons provided evidence that they are comparable measures of speech-sound discrimination. The results of both studies are analyzed, and implications are discussed. PMID- 6501599 TI - The projection of the supramammillary nucleus to the hippocampal formation: an immunohistochemical and anterograde transport study with the lectin PHA-L in the rat. AB - The organization and possible neurotransmitter specificity of a projection from the lateral supramammillary nucleus to the hippocampal formation has been examined with immunohistochemical and axonal transport methods in the adult male rat. Experiments with the retrograde tracer true blue indicate that neurons throughout the rostrocaudal extent of the nucleus are labeled after injections in either dorsal parts of the dentate gyrus and Ammon's horn, or the entorhinal area, although cells labeled by the entorhinal injections tended to occupy more ventral parts of the nucleus. Combined immunohistochemical-retrograde transport studies showed that a small number (less than 5%) of cholecystokinin immunoreactive neurons in the caudal tip of the supramammillary nucleus project to the hippocampal formation, as do some (5-10%) vasoactive intestinal polypeptide (VIP)-immunoreactive neurons throughout the nucleus. Anterograde transport studies with the lectin phaseolus vulgaris leucoagglutinin (PHA-L) indicate that fibers from the supramammillary nucleus innervate all parts of the hippocampal formation. Many varicose fibers with terminal boutons were observed in the granular and molecular layers of the dentate gyrus, throughout the molecular layer of field CA3 of Ammon's horn, and in the pyramidal layer and stratum oriens of subfield CA3a. Only scattered fibers were found in fields CA1 and CA2. Apparent terminal fields were also observed in superficial parts of the molecular layer, and deep parts of the pyramidal layer, of the subiculum, in the deepest layer of the presubiculum and parasubiculum, and in all layers of the entorhinal area. PMID- 6501600 TI - Localization of sympathetic postganglionic and parasympathetic preganglionic neurons which innervate different regions of the dog heart. AB - The locations of sympathetic postganglionic and parasympathetic preganglionic neurons projecting to the heart have not yet been clearly established. Therefore, aliquots of horseradish peroxidase (HRP) were injected into specific regions of the heart, intraventricular cavity, pericardial sac, aortic arch, and the skin in 27 dogs. Following injections into the heart, aorta, or pericardial sac, retrogradely labeled neurons were present in the greatest numbers in the middle cervical ganglia bilaterally. Labeled neurons were located in the cranial poles of the stellate ganglia bilaterally and occasionally in the superior cervical ganglia. Labeled cells were also found in small ganglia located along cardiopulmonary nerves. Injections of HRP into specific areas of the heart did not result in labeling of cells in specific loci of the thoracic or cervical sympathetic ganglia. When the ansae were cut on one side, no labeled cells were found in the ipsilateral stellate ganglion or upper thoracic chain. Following injections into the skin of the left elbow or left cranial nipple, labeled cells were found in the stellate ganglia and the sympathetic chain and in one case in the middle cervical ganglion as well. These data suggest that postganglionic sympathetic neurons which project efferent axons to a specific cardiac region are not located in a specific region of a sympathetic ganglion or a specific sympathetic ganglion. Rather, neurons in one region of a sympathetic ganglion project axons to widespread areas of the myocardium. Sympathetic postganglionic neurons in the stellate ganglion or sympathetic chain project their axons to the heart via the subclavian ansae or interganglionic nerves, not via nerves arising directly from the sympathetic chain. Small numbers of labeled neurons were found in the medulla oblongata, thus indicating that in comparison to sympathetic postganglionic neurons relatively few preganglionic parasympathetic neurons project directly to the heart. When labeled cells were present in the medulla, the majority were located in the ventrolateral nucleus ambiguus. PMID- 6501601 TI - Rules for retinotectal terminal arborizations in the goldfish optic tectum: a whole-mount study. AB - Retinal axons were labeled in the retina and optic nerve with horseradish peroxidase and traced in tectal whole-mounts. The typical network formed by retinal fibers in the five retinorecipient layers of tectum is illustrated in camera lucida drawings. Three size classes of terminal arbors were identified in the Stratum fibrosum et griseum superficiale (SFGS)-ca. 34 X 52, ca. 103 X 150, and ca. 158 X 274 micron. Terminal arbors are flattened and occupy three sublayers of SFGS. Passing an HRP-coated needle through the optic nerve labeled ganglion cells in retina and axons and terminal arbors in tectum. Terminal arbors of axons that originated in retinal annuli lay in distinct annular regions in SFGS, with old generations from central retina lying central to younger generations from peripheral retina. The tectal annuli were concentric with one another and agreed with the retinotopic map as it had been described before. The youngest terminal arbors from peripheral retina were next to the path of their fascicle along the tectal periphery, connected to their fascicle by short, centrally directed extrafascicular axons. The oldest terminal arbors from central retina were caudally displaced from their rostral fascicle of entrance, at the end of long, caudally directed extrafascicular axons. Terminal arbors from intermediate retina occupied intermediate positions in the tectum. Rostrally, they arose from centrocaudally directed extrafascicular axons but caudally from axons of various orientations. Terminal arbors arising from those extrafascicular axons exhibited different orientations and shapes depending on their tectal position. The spatial order of intratectal paths and terminal arbor sites, and the variability of terminal arbor orientation and shape, are consistent with an earlier model on shifting retinotectal terminals (Easter and Stuermer, '84). PMID- 6501602 TI - Topographical organization of the inferior collicular projection and other connections of the ventral nucleus of the lateral lemniscus in the cat. AB - The topographic distribution of projections from the ventral nucleus of the lateral lemniscus (VNLL) in the cat was investigated with the autoradiographic tracing method. The origin of minor projections was verified by retrograde tracing methods. Small injections of tritiated leucine were placed in restricted zones of VNLL. A major afferent fiber system to the inferior colliculus was labeled in all cases. From the injection site labeled fibers coursed through and around the nuclei of the lateral lemniscus to enter the ipsilateral inferior colliculus. Regardless of the position or small size of the injection, labeled fibers distributed widely in the inferior colliculus. Fibers ended in the central nucleus and deeper layers of the dorsal cortex in most cases. There was also labeling in the ventrolateral nucleus, but very few fibers ended as lateral as the lateral nucleus. A small number of labeled fibers passed from the inferior colliculus into the nucleus of the brachium of the inferior colliculus and adjacent tegmental areas. Some labeled fibers entered the commissure of the inferior colliculus where they were traced into the dorsal cortex and rostral pole of the inferior colliculus on the side contralateral to the injection site. Though the projections labeled in individual cases were similar in their divergent pattern within the central nucleus of the inferior colliculus, specific variations in the pattern were found. The dorsal zone of VNLL projected more heavily to the deeper layers of the dorsal cortex and an adjacent field in the central nucleus than the other zones. Dorsal injections in the middle zone of VNLL, on the other hand, labeled the medial part of the central nucleus more heavily, whereas ventral injections in the middle zone resulted in heavier lateral labeling. The ventral zone of VNLL projected heavily to a central field in the central nucleus. In addition to this major afferent system of VNLL to the inferior colliculus, a smaller descending projection was found. The descending projection ended mainly in the dorsomedial periolivary region and ventral nucleus of the trapezoid body. However, in some cases a few fibers were traced to the cochlear nuclei. Finally, we observed projections to the medial geniculate body from the dorsal and ventral zones of VNLL that ended diffusely in the medial division of the medial geniculate body. Possibly some fibers from the dorsal zone contribute to a broader projection of the lateral tegmentum to the dorsal division of the medial geniculate body. PMID- 6501603 TI - Projections to the cardioinhibitory region of the nucleus ambiguus of rat. AB - The nucleus ambiguus is a brainstem structure which sends projections through the vagus nerve to the viscera, primarily heart, lung, and gut. The anatomical relationship between the nucleus ambiguus and other brain structures has not been elucidated nor has the cardiac region been identified physiologically in rats. We have attempted to clarify which areas of the nucleus ambiguus are cardioinhibitory and to determine other regions of the brain which send direct projections to this physiologically identified cardiac region. Stimulating electrodes were positioned stereotaxically in the medulla of anesthetized rats. Small currents were passed through the electrodes to locate regions in the ventrolateral medulla which slowed heart rate. In each rat, the area found was small (less than 200 micron in diameter), very specific, and located in the rostral portion of the nucleus ambiguus. Micro-quantities of horseradish peroxidase were then iontophoretically ejected into this brainstem area; 24-72 hours following the HRP injection, the rats were processed for HRP reaction product using the tetramethybenzidine method. The major brain area which sent projections to the rostral nucleus ambiguus was the ipsilateral medial subnucleus of the solitary tract. A few labeled cells were found in the ipsilateral ventrolateral subnucleus of the solitary tract, parabrachial complex, the paraventricular nucleus of the hypothalamus, and the contralateral nucleus ambiguus. Control injections in reticular areas surrounding the rostral nucleus ambiguus showed no label in the medial solitary nucleus. PMID- 6501604 TI - Reduced effects of monocular deprivation on a population of A-laminae neurons in the cat's dorsal lateral geniculate nucleus. AB - The generation of nerve cells for the cat's dorsal lateral geniculate nucleus takes place between embryonic day (E) 22 and E32. Neurons generated before E28 exhibit a full range of soma sizes and morphological features, whereas neurons generated after E28 have only smaller somata and a more limited array of morphological features. We measured the effects of monocular deprivation on neurons in the cat's dorsal lateral geniculate nucleus that were generated at different times, with birthdates defined by injections of 3H-thymidine. Whereas populations of nerve cells generated before E28 exhibit changes in cell size that are, on average, typical of those seen in monocularly deprived cats, populations of nerve cells generated after E28 are, on average, less affected by visual deprivation. PMID- 6501605 TI - The effects of partial retinal lesions on activity and size of cells in the dorsal lateral geniculate nucleus. AB - The nasal parts of the adult cat retina were photocoagulated. In the dorsal lateral geniculate nucleus (dLGN) the projection of the remaining innervation was shown by anterograde transport of 3H-proline after eye injections. The neuronal activity was measured from single cells across the border region between innervated and deafferented parts of layer A of the dLGN contralateral to the lesions. A gradual decrease from normal light-excitability to total inexcitability was observed over a range of 300 micron. The perikaryal cell sizes measured in the same part of the dLGN displayed a concomitant decrease. Blockage of the afferent impulses by chronic application of tetrodotoxin did not change the results, suggesting that it is the loss of connections, not the loss of activity, that produces the transneuronal atrophy in the adult cat dLGN. PMID- 6501606 TI - Thalamocortical and other synapses involving nonspiny multipolar cells of mouse SmI cortex. AB - Golgi-impregnated and -deimpregnated neurons having somata in layer IV of mouse posteromedial barrel subfield (PMBSF) cortex were identified with the light microscope and then extensive portions of them were examined with the electron microscope. Dendrites of nine nonspiny multipolar cells and eight of their cell bodies were reconstructed from serial thin sections to determine the numbers and types of symmetrical, asymmetrical, and thalamocortical synapses they formed. Results of this analysis show that cells of the same general morphological class may form widely different patterns of synaptic connections: some nonspiny multipolar cells had dendrites that formed a high proportion of their synapses with thalamocortical axon terminals, whereas dendrites belonging to other cells formed only very small proportions of thalamocortical synapses. A similar diversity characterized the synaptic connections of cell bodies: some formed more symmetrical than asymmetrical synapses, others the reverse. Some formed high proportions of thalamocortical synapses, others much less. Comparisons of thalamocortical synaptic input to cell bodies and dendrites showed that one cell formed about the same proportions of thalamocortical synapses with its cell body as with its dendrites. For two other cells the proportions of thalamocortical synapses formed with their somata was about double that formed with their dendrites. The remaining five cell bodies examined formed far higher proportions of thalamocortical synapses than did their dendrites. That different nonspiny multipolar cells form such contrasting synaptic patterns suggests that included within this morphological classification are cells which are likely to have very different functional roles. PMID- 6501607 TI - 2-Deoxyglucose labelling of the infrared sensory system in the rattlesnake, Crotalus viridis. AB - Infrared (IR) responsive nuclei in the rattlesnake Crotalus viridis were identified by using 14C-2-deoxyglucose (2DG) and autoradiography. Following 2DG intracardial injection, the IR-sensitive pit organ was stimulated periodically with an IR stimulus for 5 hours. The nucleus of the lateral descending trigeminal tract (LTTD, the primary IR sensory nucleus) was labelled heavily with 2DG. Labelling was bilateral, but somewhat heavier ipsilateral to the stimulated pit organ. The nucleus reticularis caloris (RC, the secondary nucleus of the IR system) was lightly labelled ipsilaterally. The middle laminae of the contralateral optic tectum (which contain IR-responsive units) were distinctly labelled; the corresponding layers of the ipsilateral tectum were lightly labelled. A subcerebellar nucleus not known to be part of the IR system was heavily labelled bilaterally. No consistent labelling was found in the diencephalon or telencephalon. Since units in the LTTD do not respond to stimulation of the contralateral pit yet the LTTD is labelled with 2DG when there is contralateral pit stimulation, several controls were carried out. Unilateral injection of 3H-proline into LTTD revealed no projection to the contralateral LTTD. In a monocularly, visually stimulated animal with both pits occluded, the LTTD still showed heavy but equal 2DG labelling bilaterally. In addition, the outer layers of the contralateral optic tectum were heavily labelled. No 2DG labelling of the LTTD was obtained when branches of the trigeminal nerve innervating the LTTD were previously cut. These results suggest that much of the 2DG labelling in the LTTD is due to spontaneous ongoing activity from the pit organ rather than from IR evoked activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501608 TI - Cell death during differentiation of the retina in the mouse. AB - A reproducible pattern of cell death associated with differentiation of the retina in mice was analyzed quantitatively by microscopy. Cell death occurs primarily during the first 2 weeks after birth and is essentially complete by the end of the third week. Death of individual cells involves nuclear condensation and pyknosis (apoptosis), followed by phagocytosis of the cellular remains by adjacent cells or motile phagocytes. From birth through 4 days, an increasing incidence of cell death is observed among ventricular cells. Ganglion cell degeneration is prominent during the first 11 days, peaking on days 2-5. Many presumptive amacrine cells die within the inner plexiform and inner nuclear layers, particularly between 3 and 8 days. Among adjoining bipolar and Muller cells, degeneration reaches a peak at 8-11 days. On day 5, formation of the outer plexiform layer separates the rods into two groups. Rod nuclei situated on the inner side of that layer immediately move across it to enter the outer nuclear layer, but numerous cells die during nuclear migration. Sporadic death of rods continues during the following 2 weeks. Cell death associated with cell differentiation (histogenetic death) is considered to represent a normal developmental process. Possible mechanisms resulting in cell degeneration are discussed. It is suggested that genetically regulated cell death serves to fine tune neuronal networks during the terminal stages of development. PMID- 6501609 TI - The postnatal development of the tract of Lissauer in the rat. AB - This study determined the numbers of axons in the tract of Lissauer of the S2 segment of rat spinal cord during postnatal development. One day after birth there were an average of 39 myelinated and 9,520 unmyelinated axons in this pathway. These numbers changed steadily to the 722 myelinated and 2,759 unmyelinated axons that characterize the adult. Thus there was a 20-fold increase in myelinated axons but a threefold decrease in total axons in this pathway from birth to adulthood. The axonal changes occurred so long after the changes in the number of cells that give rise to these axons that the axonal changes were almost certainly not due to the death of their parent neurons. We do not yet understand the mechanisms that control axonal numbers in this pathway, but in our opinion these mechanisms are as important as those that control neuronal numbers in considerations of the development of the nervous system. PMID- 6501610 TI - The non-pyramidal cells in layer III of cat primary auditory cortex (AI). AB - The form and location of non-pyramidal neurons in layer III of the primary auditory cortex (AI) of adult cats is described in Golgi, Nissl, and other material. The cells were compared to the profiles of retrogradely labeled, commissurally interconnected cells. A principal finding is that certain non pyramidal and pyramidal cells project interhemispherically to AI; a second conclusion is that the retrogradely labeled commissural cells form small clusters or narrow strips separated by unlabeled patches even after massive injections in the opposite AI. The non-pyramidal cells of origin have not yet been conclusively identified, but they must include one (or more) of the following six types of cells observed in Golgi-impregnated material: tufted or bitufted cells with a radially elongated dendritic arbor; sparsely spinous stellate neurons with thin, smooth dendrites and vertically disposed axonal branches; small stellate cells with varicose dendrites, a restricted dendritic field, and a profusely branched local axon; bipolar neurons with long, thin dendrites; medium-sized multipolar cells with radiating, sparsely branched dendrites; and small stellate neurons with smooth dendrites and a tiny dendritic field. These non-pyramidal cells are found throughout layer III but are more numerous in the upper part, layer IIIa, where they mingle with the small pyramidal neurons. As a rule the axonal branches of non-pyramidal cells are more numerous than those arising from layer III pyramidal neurons, and although they have many axonal collaterals, most project locally and vertically in narrow radial strips. In contrast, pyramidal cell axons have ascending and descending components which invade large, lateral territories in many cortical layers. Layer III non-pyramidal neurons are similar to those in layer IV in certain respects, although their dendritic fields are more spherical and less tufted than those of layer IV cells, and their axons have more local, limited targets. These axons appear to contribute but little to the conspicuous, lateral fiber striae in layer III. The primary intrinsic targets of non-pyramidal cell axons appear to be the apical dendrites of medium-sized and large layer III pyramidal cells, and recurrent branches to the parent cell; their fine, distal branches fortify the vertical plexus in layer III, and certain axons may descend into layer IV. Since layer III in AI receives both commissural and thalamic input, it is possible that these parallel, afferent channels are to some degree segregated, and to some degree convergent, onto particular types of cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6501611 TI - Prevention of skin disease. PMID- 6501612 TI - Prevalence, morbidity, and cost of dermatologic diseases. PMID- 6501613 TI - Dermatologic needs in drugs and instrumentation. PMID- 6501614 TI - Vitiligo. PMID- 6501615 TI - Computed tomography of craniofacial fibrous dysplasia. AB - We present five patients with fibrous dysplasia: two monostotic affecting the maxilla, two craniofacial, and one disseminated. Computed tomography was extremely useful for demonstrating the gross bony changes as well as anatomical detail with preservation of the cranial exit foramina. These findings correlate with the lack of significant neurological deficits. The information obtained on CT may be useful for cosmetic reconstructive surgery and debulking procedures. PMID- 6501616 TI - Computed tomography with metrizamide myelography to define the extent of spinal canal block due to tumor. AB - In five patients with complete spinal block due to tumor, CT was used to show the upper level of the block. In each case metrizamide myelography demonstrated the lower level of the block, but not enough metrizamide leaked past the block to allow myelographic identification of the upper level. However, the subarachnoid space both below and above the level of the block was clearly outlined by metrizamide on CT in each case. PMID- 6501617 TI - CT assistance for fluoroscopically guided transthoracic needle aspiration biopsy. AB - Five cases are presented that illustrate the utility of obtaining limited CT prior to fluoroscopically guided biopsy in patients who have lung or mediastinal lesions that cannot be adequately localized by chest radiography. Each case describes a unique setting in which the CT images facilitate accurate and safe biopsy needle placement. The rare requirement for biopsy using CT alone, which can be considerably more time consuming, is emphasized. PMID- 6501619 TI - Postsurgical evaluation of hydatid disease with CT: diagnostic pitfalls. AB - Forty-five patients having previously undergone surgical removal of hydatid cysts were examined for recurrence using CT. Recurrence of hydatid disease was demonstrated in 11 patients. At the site of surgical cyst evacuation, cyst-like structures (pseudocysts) were demonstrated in 15 patients. Although pseudocysts were smaller than the original cysts and demonstrated a flattened appearance and a thicker wall, differentiation from recurrent viable hydatid cysts was difficult. Five of the pseudocysts had attenuation values between 10 and 35 HU, and eight had attenuation values close to that of fat (- 20 to - 100 HU). The findings of this study may be important in the follow-up of patients with hydatid disease. PMID- 6501618 TI - Esters of iopanoic acid as liver-specific CT contrast agents: biodistribution and CT evaluation. AB - The synthesis and preliminary biodistribution data for a series of sterol-like esters of iopanoic acid having potential value as liver-specific CT contrast agents are described. Structural modification of the sterol portion of the iopanoate ester afforded a group of compounds that displayed tissue specificity similar to cholesteryl iopanoate, the prototype ester of this series, but were rapidly cleared from the target tissues after hydrolysis. From the biodistribution data, the most promising of these agents, pregnenolone iopanoate (PI), was evaluated by CT in rabbits receiving a radiologic dose equivalent to 30 mg I/kg. The hepatic parenchyma was enhanced within 2 h of infusion to a maximal level of 31 HU above precontrast values. Hepatic CT attenuation returned to normal within 24 h. However, CT performed after PI infusion into Vx2 tumor bearing rabbits failed to provide superior images compared with those acquired following bolus administration of urographic contrast. PMID- 6501621 TI - Perirenal cobwebs: the expanding CT differential diagnosis. AB - Although initially described as representing collateral venous structures, perirenal cobwebs may be due to a variety of benign and malignant conditions. Six representative cases illustrating the broad differential diagnosis are presented. PMID- 6501620 TI - Xenon/CT blood flow mapping of the kidney and liver. AB - A noninvasive technique for measuring blood flow by xenon-enhanced X-ray transmission CT has been developed and reported quite extensively in recent years. In this method nonradioactive xenon gas is inhaled, and the temporal changes in radiographic enhancement produced by the inhalation are measured by sequential CT. Time-dependent xenon concentration within various tissue segments is used to derive local blood flow maps. The method has been amply discussed in relation to assessment of local cerebral blood flow. Its application to other body organs is explored in this paper, in which results from six preliminary blood flow studies in the liver and kidneys of nonhuman primates are reported. Blood flow in renal cortex ranged from 150 to 280 ml/100 cc/min and hepatic tissue perfusion from 80 to 120 ml/100 cc/min. The advantages and limitations of the method in such applications are discussed. PMID- 6501622 TI - Computed tomography of benign angiomatous lesions of the extremities. AB - Thirteen patients with benign angiomatous lesions of the extremities were evaluated by CT. The relationship of the lesion to specific muscle groups and fascial planes was defined better by CT than on plain radiography or angiography. Computed tomography without contrast enhancement demonstrated well circumscribed masses of lower attenuation value than the surrounding muscle. Eight of the 11 patients who received intravenous injection of contrast material showed characteristic punctate or curvilinear structures within the mass, which had attenuation values similar to normal blood vessels. The characteristic CT features of benign angiomatous lesions of the extremities are presented. PMID- 6501623 TI - Computed tomography in tarsal coalition. AB - The limitations of routine radiography of the feet in demonstrating tarsal coalitions are well known. Even with the use of multiple projections of the foot, tarsal coalitions may escape detection. Computed tomographic examinations of the feet were performed in persons suspected of having tarsal coalitions. The CT images were obtained in both the longitudinal and axial axes of the foot. Results of these examinations suggest the longitudinal projection to be most helpful in demonstrating talonavicular coalitions and the axial projection in demonstrating talocalcaneal coalitions. The history, pathology, and other imaging modalities of tarsal coalitions are reviewed. PMID- 6501624 TI - Comparison of X-ray film and photographic paper in recording CT images. AB - Because of a potential film cost savings of approximately 35% using photographic print paper instead of X-ray film in recording CT images, a comparison was undertaken of these hard copy recording methods. One hundred consecutive CT examinations were reviewed on the scanner display console and recorded on X-ray film and photographic print paper using a multi-imager camera. Hard copy images were compared for diagnostic adequacy. X-ray film adequately recorded the pathology in all cases. Photographic paper adequately recorded the pathology in 97% of cases. In 26% of cases X-ray film was felt to better display the CT diagnosis whereas in 2% of cases photographic paper better displayed the CT diagnosis. Test phantom scans recorded on both media showed no observable difference in spatial or contrast resolution. PMID- 6501625 TI - A postprocessing dual energy technique for vertebral CT densitometry. AB - The influence of the fat content in the cancellous bone on CT densitometry was measured on the excised vertebrae from 42 elderly human subjects. Using single energy CT, the decrease of the measured mineral content was 12% for a fat content of 10% by volume at a mean mineral content of 100-110 mg/cm3. Using a dual calibration at 85 and 130 kVp with reference to K2HPO4 for mineral and to alcohol for fat, our experiment showed that the mineral content of the vertebra can be measured with an accuracy of 6% referred to the ash-weight. PMID- 6501626 TI - Demonstration of the fetal cardiovascular system by MR imaging. AB - Magnetic resonance is potentially a second imaging modality that can be used to study the fetal cardiovascular system. Magnetic resonance imaging to date has not been associated with any harmful effects and, since it does not involve ionizing radiation, we are evaluating its role in fetal imaging. We report a case in which this modality showed the unique features of the cardiovascular system. PMID- 6501627 TI - Aqueductal stenosis: demonstration by MR imaging. AB - A case of nontumorous stenosis of the aqueduct of Sylvius is presented, demonstrating the superiority of sagittal magnetic resonance imaging over other imaging modalities in identifying this disorder. PMID- 6501628 TI - Meckel's cave epidermoid with trigeminal neuralgia: CT findings. AB - An epidermoid tumor of Meckel's cave was found in a middle-aged woman with trigeminal neuralgia. On CT the lesion had negative attenuation numbers of fat and extended from an expanded Meckel's cave through the porous trigeminus into the ambient and cerebellopontine angle cisterns. Surgical excision provided relief of the patient's trigeminal neuralgia. PMID- 6501629 TI - High resolution computed tomography in neonatal nasopharyngeal teratoma. AB - A case of neonatal teratoma of the nasopharynx associated with polyhydramnios and respiratory distress is presented. Surgical excision was carried out after preoperative evaluation with high resolution CT. Computed tomography is valuable in distinguishing a teratomatous tumor and in searching for intracranial extension and malignant characteristics. PMID- 6501630 TI - Computed tomography of aneurysmal bone cyst of the L1 vertebral body. AB - A 31-year-old woman with an aneurysmal bone cyst of the L1 vertebral body proved by biopsy and studied by plain lumbar spine roentgenography, radionuclide studies, myelography, and CT is presented. The unusual location of involvement of the vertebral body alone and the difficulty in differential diagnosis between aneurysmal bone cyst and benign giant cell tumor are discussed. PMID- 6501632 TI - CT appearance of multifocal hepatic steatosis. AB - The CT appearance of focal and diffuse fatty infiltration of the liver has been described in recent radiologic literature. Previous reports of focal steatosis have emphasized the differential diagnosis of the solitary lesion. We report a case of multifocal hepatic involvement and describe a new radiologic sign that is useful in differentiating this process from neoplasia. PMID- 6501631 TI - Computed tomography of spontaneous osteoporotic sacral fractures. AB - Spontaneous osteoporotic sacral fractures are an uncommon entity. They are difficult to image on plain films. Clinically, they may be confused with metastatic disease. A peculiar H-shaped uptake pattern on bone scan should suggest the condition, and CT can then demonstrate the fracture. In this case this combination of radionuclide scan and CT permitted differentiation of a sacral fracture from presumed bony metastases. PMID- 6501633 TI - Xanthogranulomatous cholecystitis mimicking carcinoma of the gallbladder: CT findings. AB - The CT findings in a case of xanthogranulomatous cholecystitis are reported. Irregular thickening of the gallbladder wall and poorly defined borders of the underlying liver and the adjacent duodenum suggested a tumorous lesion. PMID- 6501634 TI - Limitations of computed tomography in the recognition of delayed splenic rupture. AB - Delayed splenic rupture is a rare but life threatening complication of abdominal trauma. A case is reported in which initial evaluation by CT did not show hemoperitoneum or splenic laceration in a patient who ruptured his spleen 10 days following the initial injury. The limitations of current diagnostic methods are reviewed. PMID- 6501635 TI - Contrast medium pooling in cystic renal carcinoma: CT findings. AB - This case report describes a serendipitously diagnosed renal carcinoma in a transplant donor. Computed tomography was instrumental in establishing the true nature of this mass based on its ability to demonstrate pooling of contrast material and staining of discrete septae on dynamic postcontrast scans. PMID- 6501636 TI - Notching of the ureter: CT demonstration of periureteral collaterals. PMID- 6501637 TI - Community care for late adolescents. AB - This paper describes supportive accommodation for late adolescents in Cambridge provided by the Castle Project in conjunction with the Young People's Psychiatric Service. It outlines the characteristics of young people referred to the Project over the first years of its existence, their lengths of stay and next moves, and suggests that there are members of two groups, those with schizophrenic-type disorders and those with pronounced antisocial behaviour, who present long-term problems of care and accommodation and whose needs are not yet catered for appropriately. PMID- 6501638 TI - Adults' perceptions of the economic socialization of children. AB - This study was concerned with the determinants of adults' beliefs in the economic socialization of children through the use of pocket money (allowances). Over 200 adults completed a questionnaire on their beliefs concerning, for instance, how much and how often children should be given pocket money, as well as such things as whether they should be encouraged to work for it, save it, etc. The independent variables included the subjects' age, sex, education, voting pattern, religion, occupation and whether or not they were parents. The results showed that whereas there were few age or sex differences, the socio-economic class of the adults, and the fact that they did or did not have children did discriminate between the responses of the subjects. Findings were discussed in terms of the literature of economic socialization. PMID- 6501639 TI - Diminished responsibility as a mitigating circumstance in juvenile offenders' legal judgments. AB - The legal judgments of 20 juvenile offenders and 20 non-offenders were examined for three types of crimes: assault, arson and treason. Mitigating circumstances cast in the form of an inability to control events consisted of brain damage, passion and economic need, in contrast to a situation in which no mitigating circumstances were offered. The results indicated that despite the often-made legal argument, neither group regarded passion and economic need as circumstances warranting the reduction of sentencing. Compared to the non-offender group, offenders rated brain damage as less mitigating. While non-offenders rated passion and economic need more severely than brain damage, offenders' ratings of the three circumstances did not differ significantly. The findings are discussed in terms of perceptions of control and structural-developmental approaches to socialization. PMID- 6501640 TI - A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders. AB - Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group. PMID- 6501641 TI - Evaluating the systematic use of humor in psychotherapy with adolescents. AB - Adolescents often experience psychological difficulties associated with the demands and changes of puberty. Humor can be an effective response to express troublesome emotions associated with aggression. Self-descriptions of an adolescent client demonstrate the value of a controlled use of humor in individual psychotherapy for certain persons in this developmental age period. PMID- 6501642 TI - Parental influence on adolescents' imagination. AB - It was hypothesized that a permissive democratic parental attitude towards childrearing and favorable accepting attitude towards children's imagination are conducive to the development of their adolescent children's imaginative ability. It was also hypothesized that the mothers' role is more crucial than that of the fathers. The subjects were 104 adolescent Israeli boys and girls and their parents. The subjects were administered four scales of the Imaginal Processes Inventory and the Children's Report of Parental Behavior Inventory. The parents filled out a questionnaire devised to study their attitude to children's imagination. The first two hypotheses were not confirmed. The data point in the opposite direction as regards the first hypothesis. There was partial conformation for the third hypothesis. The data were also discussed in relation to healthy and neurotic daydreaming. PMID- 6501643 TI - Adolescent fantasy and self-fulfillment: the problem of female passivity. AB - A detailed analysis is reported of essays written by teenagers from two independent schools (120 of each sex) in response to the opening sentence: "Today is my eightieth birthday and I look back to the day I left school." Predictably the girls were orientated toward marriage and family life, and were somewhat less career-minded than the boys. They were also less politically aware, and saw hobbies as a luxury for their retirement and not as an integral part of life. Essentially they differed from the boys in being ready to live through others rather than on their own terms. These findings are interpreted in the light of Freud's distinction between passivity and the pursuit of a passive aim, which may call for well directed activity. PMID- 6501644 TI - Characterization of lactogenic hormone binding to membranes from ovine and bovine mammary gland and liver. AB - Binding of radiolabeled human growth hormone, bovine prolactin, and ovine prolactin to membranes prepared from ovine and bovine mammary gland and liver was studied. Of these lactogenic hormones, human growth hormone exhibited the greatest total and specific binding capacity to either liver or mammary membranes. Characterization of binding assay conditions of human growth hormone indicated: that divalent ions (calcium or magnesium) were required for maximal binding, that binding was time dependent and saturable, that specific binding was proportional to the quantity of membrane protein assayed, and that bound radiolabeled human growth hormone was displaced similarly with either nonradiolabeled bovine prolactin or ovine prolactin. Interpretation of computer analysis of Scatchard plots derived from displacement curves indicated heterogeneous binding sites in liver and mammary membranes. Mean apparent dissociation constants of the high affinity binding sites ranged from 2.7 to 5.4 X 10(-9) M in mammary and liver membranes, respectively. Compared with mammary membranes from nonlactating ewes, specific binding of human growth hormone was increased 50% on day 100, 190% on day 130 of gestation, and 296% on day 60 of lactation. We conclude that radiolabeled human growth hormone can be used as a probe to measure lactogenic hormone binding sites in liver and mammary membranes from cows and sheep. PMID- 6501645 TI - Blood constituents in lactating Holstein cows influenced by hematocrit, sampling site, and diet protein and calcium. AB - Constituents were measured in jugular vein (days 0, 4, 14, 28, 43, 72, and 151 of lactation) and internal iliac artery and mammary vein (days 28, 72, and 151 of lactation) blood of 24 Holsteins. Six diets of grain:corn silage-urea contained percents of protein and calcium: 12, .6; 12, .9; 15, .6; 15, .9; 15, .6; 15, .9. Grain contained urea (diets 3, 4) or soybean meal (diets 5, 6). All cows were fed diet 3 the first 4 wk of lactation; then four cows were assigned to each of six diets. In jugular blood, calcium and phosphorus were lower on day 0. Hydroxyproline and ketone bodies peaked and magnesium was minimal on day 4. Hematocrit, urea nitrogen, and free fatty acids decreased with lactation. Jugular blood from younger cows had less ketone bodies, free fatty acids, and magnesium and more hematocrit, hydroxyproline, and phosphorus. Sampling site had arterial venous differences for each constituent, with venous differences for hematocrit, free fatty acids, calcium, phosphorus, and magnesium. Hematocrit decreased with diets 1, 2, 3, 4, or .6% calcium. With a common hematocrit (36%) and change from baseline (day 28), urea nitrogen was less with 12% protein or .6% calcium. Phosphorus and magnesium decreased with 15% protein. More constituents were required from diet and tissues to maintain concentrations in blood as hematocrit decreased, indicating the importance of dietary calcium and protein concentration and quality. PMID- 6501646 TI - In vitro hepatic gluconeogenesis during experimental ketosis produced in steers by 1,3-butanediol and phlorizin. AB - Adaptations of in vitro incorporation of gluconeogenic substrates into glucose and adaptations of metabolite concentrations of liver to subcutaneous phlorizin and dietary 1,3-butanediol were examined for liver samples from dairy steers. Later, the same adaptations were examined after 6 days of feed restriction. Feeding 1,3-butanediol significantly decreased conversion of carbon-14 of lactate and propionate to glucose and to carbon dioxide. There were no changes of concentrations of hepatic glycogen or triglyceride, and increases were only minor for beta-hydroxybutyrate concentration. Both phlorizin, with or without 1,3 butanediol, and feed restriction significantly increased rates of carbon incorporation into glucose from aspartate, lactate, and propionate but did not change rates of oxidation to carbon dioxide. Phlorizin had no effect on hepatic glycogen or triglyceride concentrations, but feed restriction decreased liver glycogen and increased triglyceride concentrations. Changes associated with either phlorizin treatment or feed restriction are consistent with a decreased ratio of insulin to glucagon of blood plasma. When combined, phlorizin and 1,3 butanediol seem to have some utility for developing a ketosis model. PMID- 6501647 TI - Plasma and liver metabolites and glucose kinetics as affected by prolonged ketonemia-glucosuria and fasting in steers. AB - For 28 days, four steers received 1,3-butanediol, which causes ketonemia, and phlorizin, which causes glucosuria. Steers also were fasted for 9 days. Effects of treatments on concentrations of metabolites in blood and liver and on kinetics of glucose metabolism were determined. Treatments were: control, control with dietary butanediol plus injected phlorizin, and fasting. Fasting caused hypoinsulinemia and decreased liver glycogen by 60%. Butanediol plus phlorizin and fasting caused 18 and 19% decreases of plasma glucose and 2.5- and 6-fold increases of free fatty acid concentrations in blood plasma. Glucose irreversible loss averaged 371, 541, and 182 g/day during control, butanediol plus phlorizin treatment, and fasting. Butanediol plus phlorizin increased liver ketone body concentrations, caused glucosuria, ketonuria, and ketonemia, but did not affect insulin, glucagon, or growth hormone concentrations in plasma or triglyceride and glycogen contents in liver. Steers given butanediol plus phlorizin did not show all the usual signs of lactation ketosis, but the treatment still offers promise for studying causes and effects of ketosis. PMID- 6501648 TI - In vitro hepatic gluconeogenesis and ketogenesis as affected by prolonged ketonemia-glucosuria and fasting in steers. AB - Both 1,3-butanediol, which causes ketonemia, and phlorizin, which causes glucosuria, were given to four steers for 28 days to determine effects of prolonged ketonemia and glucosuria on in vitro hepatic gluconeogenesis and ketogenesis. Treatments were: control ration; control with butanediol plus phlorizin; and fasting for 9 days. Liver slices, obtained by biopsy, were incubated with carbon-14 substrates. Substrate converted to glucose [mumol/(h X g liver)] during control, butanediol plus phlorizin, and fasting averaged 2.34, 7.21, and 12.00 for propionate; .99, 3.80, and 12.26 for lactate; .30, .76, and 2.20 for alanine; and 2.06, 5.37, and 5.78 for glycerol. Omission of calcium++ eliminated increases of gluconeogenesis caused by butanediol plus phlorizin and by fasting. Ketone bodies, octanoate, and bovine serum albumin did not affect glucose production markedly. Stearate inhibited gluconeogenesis during all periods except fasting. Production of beta-hydroxybutyrate [mumol/(h X g liver)] during control, butanediol plus phlorizin, and fasting averaged 2.07, 4.27, and 3.25 from butyrate and .06, .27, and .02 from palmitate. Results demonstrate that the gluconeogenic capacity of bovine liver is responsive to physiological and nutritional status. PMID- 6501650 TI - Effect of protein on nutrient digestion and milk production by Holstein cows. AB - Four multiparious Holstein cows fitted with ruminal and duodenal cannulae were in a 4 X 4 Latin square experiment to assess effects of increasing dietary protein on ruminal blood and duodenal traits, milk production, and nutrient digestion. Protein percents of 13, 15, 17, and 19 dry matter were achieved by rolled barley replaced with 0, 12, 24, and 36% rapeseed (canola) meal in pelleted concentrate mixtures. Increasing dietary protein concentration increased ruminal ammonia nitrogen, urea nitrogen in blood serum, and concentration of duodenal total, nonammonia, and feed nitrogen. Highest microbial nitrogen concentration was in cows fed the 15% protein diet; ruminal ammonia nitrogen was 6 mg/100 ml at this percent of protein. Cows fed 13% protein lost body weight (.43 kg/day), whereas those at 15, 17, and 19% protein gained .59, .38, and .59 kg/day. Efficiency of conversion of feed protein to milk protein declined, but digestibility of dry matter, organic matter, and nitrogen was improved with increasing dietary protein. From the traits measured, 15% crude protein appeared to be optimum for cows producing an average of 28 kg milk per day. PMID- 6501649 TI - Effect of ruminal ammonia-nitrogen concentration on protein degradation in situ. AB - Two experiments were conducted to determine the effect of ruminal ammonia nitrogen concentration on rate of ruminal protein degradation. In Experiment 1, four Holstein steers were fed a basal diet of corn grain and corn silage at hourly intervals. Continuous intraruminal infusions of solutions containing sodium bicarbonate and either sodium chloride or ammonium chloride resulted in ruminal ammonia-nitrogen concentrations that averaged 4.8 and 17.3 mg/dl. Ruminal fluid pH, fluid volume, and turnover rate of fluid and molar percentage of acetate, propionate, and butyrate were similar across treatments, reflecting steady state conditions. Rates of nitrogen and dry matter disappearance from polyester bags containing soybean protein supplements with 10.2 or 50.1% soluble nitrogen were not affected by increase of ruminal ammonia-nitrogen concentrations from 4.8 to 17.3 mg/dl. In Experiment 2, Holstein steers were fed twice daily a basal diet of urea-supplemented corn grain and corn silage. Polyester bags containing soybean protein supplements were placed in the rumen at -4, 0, or 4 h with reference to feeding and incubated from 1 to 12 h. Peak ruminal ammonia nitrogen concentrations occurred during different periods of incubation for each treatment. Ruminal ammonia-nitrogen concentrations ranged from 3 mg/dl at 6 h postfeeding to 46 mg/dl at 1 h postfeeding. Nitrogen and dry matter disappearance rates during 0 to 1 and 1 to 12 h of incubation did not differ among treatments. PMID- 6501651 TI - Nutritional chloride deficiency in early lactation Holstein cows. AB - Beginning 1 wk postpartum, weekly changes of feed and water intake, body weight, milk production, and electrolyte concentrations in serum, saliva, urine, milk, and feces were observed for 8 to 11 wk. Three dietary treatments differing in sodium chloride and sodium bicarbonate supplementation but containing equal sodium concentrations were used. Dietary chloride percents were low .10%, medium .27%, and high .45%. Consistently changes were significant for feed and water intake, body weight, milk production, and electrolyte concentrations in serum, urine, milk, and feces of cows fed the low chloride diet. By wk 8, body weight had declined from 575.0 +/- 56.7 to 476.7 +/- 54.3 kg, and daily milk production decreased from a peak of 27.7 +/- 2.4 to 19.2 +/- 3.9 kg for cows fed the low chloride diet. Serum chloride decreased from 106.0 +/- 2.8 to 75.5 +/- 6.7 meq/liter during the same time. Cows on the low chloride diet developed clinical signs of a deficiency characterized by depraved appetite, lethargy, hypophagia, emaciation, hypogalactiae, constipation, and cardiovascular depression. Metabolic alterations could be summarized as a severe primary hypochloremic, secondary hypokalemic, metabolic alkalosis. PMID- 6501652 TI - Water dynamics of dairy cattle as affected by initiation of lactation and feed intake. AB - Effects of lactation and feed intake on sizes and half-lives of body water pools were investigated in four Holstein cows in a thermoneutral environment. Various markers were administered, on average, 24 days prepartum (Period 1, feed intake fixed to average of consumption after offered at a rate ensuring 10% refusal), 24 days postpartum (Period 2, restricted to intake in Period 1), and 42 days postpartum (Period 3, feed again offered at a rate ensuring 10% refusal). Total body water decreased from period 1 to 2; however, it did not change as a percent of body weight. Estimated body water half-lives and fluxes for the three periods were 7.5, 3.7, and 2.9 days; and 42, 66, and 87 liters/day. Increased water intake during lactation closely matched water secreted in milk. Empty body water, estimated by a two-compartment, four-parameter model, as a percent of body weight did not change across periods. Lactation and increased feed intake decreased half life of body water. Plasma volume increased as a percent of body weight because of loss of body weight in early lactation; however, extracellular volume tended to decrease with body weight. Initiation of lactation and feed intake during lactation affect water dynamics of the dairy cow. PMID- 6501653 TI - Reproductive performance of crossline and pureline dairy heifers. AB - Data of 2779 purebred and crossbred heifers collected from five research stations of Agriculture Canada were used to study additive and nonadditive genetic effects on ages at first heat and at first breeding and conception rate at first service. Of these heifers, 2378 heifers had information on ages at first conception and at first freshening, days from first service to conception, and gestation length. The model included station, year of birth, sire, breed additive, maternal, and heterosis effects where sire effects were treated as random. Station differences were a significant source of variation for all reproductive traits. Year of birth had significant effects on four of seven reproductive traits. Breed additive effects for all genetic groups were not significant except for Finnish Ayrshire and American Holstein. No significant maternal effects were detected. Of 21 combinations of heterosis effects, six combinations showed significance. Partial regression coefficients ranged from negative to positive, suggesting that breed additive, maternal, and heterosis effects could increase or decrease for each percent increase of genetic contribution, depending upon the trait, breed group, and type of inheritance. PMID- 6501654 TI - Estrus detection and subsequent reproduction in dairy cows continuously housed indoors. AB - Records (1554) from 961 cows continuously housed indoors in two types of barns were analyzed for occurrence and detection of estrus and subsequent reproduction. Variables, percentage of cows observed in estrus by 55 days postpartum, days to first recorded estrus and first service, conception rates, service intervals, days open, and services per conception were analyzed by least squares procedures for year of calving, month of calving, genetic line, barn-type-parity subclasses, and interaction of month by line. A higher percentage of multiparous cows in the tie-stall barn (60%) were observed in estrus by 55 days postpartum than those in the loose-housing barn (50%). Days to first recorded estrus and to first service, 54 and 81, were less for tie-stall cows than for loose-housing cows, 66 and 91. Conception rates at first service and overall conception, 54 and 91%, were higher for tie-stall cows than for loose-housing cows, 42 and 80%. A higher percentage of primiparous cows (69%) was in estrus by 55 days than multiparous cows (55%). Days to first estrus and first service were less for primiparous cows, 47 and 70, than multiparous cows, 60 and 80. Days open were less for primiparous cows. Primiparous cows required 1.9 services per conception compared with 1.7 for multiparous cows. PMID- 6501655 TI - Lactational response to a feed supplement containing fermentation products, cobalt, dextrose, and lactose. AB - A feed supplement containing dried microbial fermentation products, cobalt, dextrose, and lactose was fed at 15 g per cow daily to 10 lactating Holstein cows in a switchback experiment with three periods of 5 wk each. Cows averaged 80 days postpartum and produced from 28 to 45 kg daily at the beginning of the experiment. Throughout the 15-wk experiment, cows were fed a 19% crude protein concentrate mix at 1 kg per 3 kg milk produced, 2.3 kg alfalfa hay daily, and corn silage for ad libitum intake. Milk production and composition were similar when supplemented or unsupplemented diets were fed. Means with and without feed supplement were: milk, 28.1 and 28.2 kg/day; fat, 3.57 and 3.55%; protein, 3.07 and 3.08%; and total solids, 12.28 and 12.18%. Daily consumption of dry matter as concentrate (10.4 and 10.2 kg), hay (2.1 and 2.1 kg), and corn silage (8.4 and 8.4 kg) was similar with or without the additive. Estimates of cobalt content of diets fed indicated that cows were consuming more than adequate amounts of cobalt without the supplement. Under conditions of this experiment, there was no advantage for feeding this supplement. PMID- 6501656 TI - Selenium content and glutathione peroxidase activity in tissues of the dairy cow after short-term feeding. AB - The effect of selenium and vitamin E on concentrations of selenium and selenium dependent glutathione peroxidase in tissues of dairy cows was studied. Selenium (5 mg/day) and vitamin E (2 g/day) were supplemented for 10 days in a 2 X 2 factorial arrangement. Selenium supplementation increased content of selenium in whole blood, plasma, ovary, and liver and increased activity of selenium dependent glutathione peroxidase in liver. Activity of selenium-dependent glutathione peroxidase in follicular fluid was closely correlated with selenium dependent glutathione peroxidase in plasma. Significant activity of selenium dependent glutathione peroxidase was detected in luteal tissue of the ovary. Relationships were linear between content of selenium and selenium-dependent glutathione peroxidase in ovary, uterus, and adrenal tissues. PMID- 6501658 TI - Assessment of acute pain and anxiety in children and adolescents by self-reports, observer reports, and a behavior checklist. PMID- 6501657 TI - Ruminal bypass of drinking water in lactating cows. AB - Drinking water that does not equilibrate with ruminal fluid, i.e., bypasses the rumen, was studied qualitatively and quantitatively in eight rumen-fistulated lactating Holstein cows. Decreased temperatures in the sulcus omasi and abomasum shortly after initiation of drinking indicated that water had bypassed the rumen. Recovery of a water-soluble marker, included in drinking water offered after water was withheld for 4.5 or 9 h following feeding, was used to estimate ruminal bypass. For respective treatments, 18 and 5% of drinking water was calculated to have bypassed the rumen. Ruminal bypass in lactating cows drinking relatively large amounts of water could affect comparisons of water intake with total ruminal fluid outflow as measured by dilution of a water-soluble marker. Drinking water should not be assumed to equilibrate with ruminal fluid. PMID- 6501659 TI - Cognitive-behavioral and pharmacologic interventions for hyperactive boys: comparative and combined effects. PMID- 6501661 TI - Boys who fight at home and school: family conditions influencing cross-setting consistency. PMID- 6501660 TI - Effects of age and Ritalin dosage on the mother-child interactions of hyperactive children. PMID- 6501662 TI - Reliability and validity of a scale for rating memory impairment in hospitalized amnesiacs. PMID- 6501663 TI - A psychoeducational approach to the treatment of depression: comparison of group, individual, and minimal contact procedures. PMID- 6501664 TI - Prison inmates' explanations for interpersonal violence: accounts and attributions. PMID- 6501665 TI - Behavioral control of exercise in sedentary adults: studies 1 through 6. PMID- 6501666 TI - Variations in the reported age of a patient: a source of bias in the diagnosis of depression and dementia. PMID- 6501667 TI - Metabolic consequences of dieting and exercise in the treatment of obesity. PMID- 6501668 TI - Crime specialization, seriousness progression, and Markov chains. PMID- 6501669 TI - MMPI discrimination of defensive and nondefensive felony sex offenders. PMID- 6501670 TI - Age and sex differences in the mental health of older persons. PMID- 6501671 TI - Effects of caffeine withdrawal on nocturnal enuresis, insomnia, and behavior restraints. PMID- 6501672 TI - Preventing medical noncompliance in the outpatient treatment of bipolar affective disorders. PMID- 6501674 TI - Empirical development of an MMPI subscale for the assessment of combat-related posttraumatic stress disorder. PMID- 6501673 TI - Predictive validity of the child abuse potential inventory. PMID- 6501675 TI - Depression as measured by the DSM-III and the Beck Depression Inventory in an unselected adult population. PMID- 6501676 TI - Teachers' assumptions regarding the severity, causes, and outcomes of behavioral problems in preschoolers: implications for referral. PMID- 6501677 TI - Effect of compliance for chronic asthmatic children. PMID- 6501678 TI - A multiple-choice test to measure social skills in delinquent and nondelinquent adolescent girls. PMID- 6501679 TI - Standard errors for short forms of Wechsler's intelligence scales with deviant subjects. PMID- 6501681 TI - Prediction of dissimulation on the MMPI in a clinical field setting. PMID- 6501680 TI - Treatment and generalization effects of cognitive-behavioral and goal-setting interventions with aggressive boys. PMID- 6501682 TI - Estimating full scale IQs from short forms of Wechsler's scales: linear scaling versus linear regression. PMID- 6501683 TI - New concepts and techniques in hair transplantation and alopecia reduction. PMID- 6501684 TI - Punch transplantation in "early" androgenetic alopecia. AB - Despite the prognostic difficulties that punch transplanting into areas of "early" androgenetic alopecia presents, this approach has many advantages for most patients. Technical considerations as well as five case histories are presented here. PMID- 6501685 TI - How to obtain the "perfect" plug. AB - In order to obtain the "perfect" plug, distortion of the skin produced by the punch must be eliminated by reducing the pressure exerted. This can be accomplished by using a power-driven, exquisitely sharp punch and by proper saline infiltration. Other factors are also reviewed. PMID- 6501686 TI - Transplanting temporal points, sideburns, and feminine hairlines. PMID- 6501687 TI - Single-hair transplantation for hairline refinement: a practical solution. AB - Patients with dark, straight hair and light skin often demonstrate an unnatural abruptness of the hairline following traditional methods of hair transplantation. A rapid, practical technique of harvesting grafts of only one and two hairs from standard 4-mm grafts, for the purposes of "softening" the hairline, is described. Recipient sites are made with a 16-gauge angiocath, not a scalpel, for diminished bleeding and, it is hoped, more accurate placement of the graft. PMID- 6501688 TI - Alopecia reduction by scalp expansion. AB - Areas of alopecia may be eliminated by scalp expanders. This is accomplished by subgaleal placement of soft tissue expanders under normal scalp adjacent to defect. Subsequent inflation and advancement of the expanded scalp resurfaces the defect with an excellent aesthetic result. PMID- 6501689 TI - Hair transplantation with microsurgical free scalp flap. AB - The operative procedure of microsurgical free scalp flap is described. The importance of the natural hair direction on the grafted scalp to obtain a natural appearance after the hair transplantation is emphasized. PMID- 6501690 TI - The Y-shaped pattern of alopecia reduction and its variations. AB - The Y-shaped alopecia reduction is used less frequently than indicated. This article outlines the advantages of this pattern, describes the technique of excision in detail, discusses the many variations possible, and advocates greater utilization of this procedure. PMID- 6501691 TI - Scalp kinetics in multiple excisions for correction of male pattern baldness. AB - The author placed tattoo marks in the scalp in a certain pattern in seven patients with male pattern baldness to ascertain the complex movement of the scalp due to serial longitudinal midline excision of the bald area. PMID- 6501692 TI - Phosphine fumigation of thick-film polyethylene food bags and laminated film food packets. PMID- 6501693 TI - Efficacy of pirimiphos methyl as a larvicide or adulticide against insecticide resistant and susceptible mosquitoes (Diptera: Culicidae). PMID- 6501694 TI - Response of German cockroach (Orthoptera: Blattellidae) populations to a frequency sweeping ultrasound-emitting device. PMID- 6501695 TI - [Comparison of rapid test systems for detecting the carcinogenic and mutagenic activity of chemical compounds]. PMID- 6501696 TI - [Combined action of nonuniform microwave (2.4 GHz) and gamma irradiation on the hemato-encephalic barrier in the rat]. PMID- 6501697 TI - The timing of articulatory gestures: evidence for relational invariants. AB - In this article, we examine the effects of changing speaking rate and syllable stress on the space-time structure of articulatory gestures. Lip and jaw movements of four subjects were monitored during production of selected bisyllabic utterances in which stress and rate were orthogonally varied. Analysis of the relative timing of articulatory movements revealed that the time of onset of gestures specific to consonant articulation was tightly linked to the timing of gestures specific to the flanking vowels. The observed temporal stability was independent of large variations in displacement, duration, and velocity of individual gestures. The kinematic results are in close agreement with our previously reported EMG findings [B. Tuller et al., J. Exp. Psychol. 8, 460-472 (1982)] and together provide evidence for relational invariants in articulation. PMID- 6501698 TI - Learning to detect auditory pattern components. AB - Listeners' abilities to learn to hear all the details of an initially unfamiliar sequence of ten 45-ms tones were studied by tracking detection thresholds for each tonal component over a prolonged period of training. After repeated listening to this sequence, the presence or absence of individual tones could be recognized, even though they were attenuated by 40-50 dB relative to the remainder of the pattern. Threshold-tracking histories suggest that listeners tend to employ two different learning strategies, one of which is considerably more efficient. Special training by reducing stimulus uncertainty and extending the duration of the target component was effective in increasing the rate of threshold improvement. Strategies acquired with the first pattern studied generalized to new sequences of tones. The possible implications of these results for the perceptual learning of speech or other auditory codes are discussed. PMID- 6501699 TI - Predicting frequency selectivity in forward masking from simultaneous masking. AB - Measures of frequency selectivity from forward masking suggest sharper tuning than those from simultaneous masking. To account for this result, various interpretations involving additional tuning mechanisms have been proposed. In the present study, it is shown that a simple multiplicative relation between on frequency forward and off-frequency simultaneous masking predicts this result quite well. The relation assumes that changes in masking produced by separating the masker from the signal in frequency, in time, and in both frequency and time are related to one another by Weber's law. The accuracy of the predictions suggests that the limits of auditory frequency selectivity are already established in simultaneous masking and that special interpretations involving additional tuning mechanisms are not required to account for the difference between simultaneous and forward measures. Implications for a dB scale of masking are discussed. PMID- 6501700 TI - The relations among critical ratios, critical bands, and intensity difference limens in man. AB - Band-narrowing estimates of the critical bandwidth (CB) are consistently larger than critical-ratio (CR) estimates for the same signal frequency. Bilger [in Hearing and Davis: Essays Honoring Hallowell Davis, edited by S.K. Hirsh et al. (Washington U.P., St. Louis, 1976), p. 191] proposed that this difference could be accounted for by reference to intensity-discrimination performance [CR(Hz)/CB(Hz) = delta I/I]. To test this hypothesis, band-narrowing, critical ratio, and intensity-discrimination data were collected for four normally hearing, well-trained listeners. Signal frequency was 2000 Hz and two noise levels were used: 20 and 50 dB N0. The relations proposed by Bilger among critical-bandwidth estimates from band-narrowing experiments, critical-ratio estimates from pure-tone detection in wideband noise, and intensity discrimination for a critical-band-wide noise in wideband noise are not supported by the results of individual listeners, or results averaged across listeners. PMID- 6501701 TI - Refining the measurement of psychophysical tuning curves. AB - Four experiments were performed in an attempt to refine the measurement of psychophysical tuning curves (PTCs). PTCs were determined using sinusoidal signals and narrow-band noise maskers, in both simultaneous and forward masking. In experiment I a fixed low-level notched noise was gated with the masker in order to restrict off-frequency listening and to eliminate "confusions" between the signal and masker in forward masking. In contrast to previous work, this procedure produced PTCs with similar round tips in both simultaneous and forward masking. The PTCs differed mainly in that the high-frequency skirts were steeper in forward masking. Experiment II compared PTCs with and without an additional notched-noise masker, for a number of signal levels. The notched noise had the effect of broadening the tips of the PTCs, this effect being greater in forward masking than in simultaneous masking. With increasing signal level the high frequency skirt of the PTC became slightly steeper, and the low-frequency skirt slightly shallower. Experiment III studied the effect of signal duration on PTCs determined in simultaneous masking. Duration had little effect when off-frequency listening was restricted with a fixed notched-noise masker, but had a substantial effect in the absence of such a masker. Experiment IV studied the effect of signal delay in forward masking. When off-frequency listening was restricted and the signal levels adjusted to produce similar masker levels at threshold for each delay, the shape of the PTC was not affected by delay. It is concluded that, when PTCs are determined in the presence of notched noise, suppression is probably responsible for most of the differences between simultaneous and forward masking. Previous work may have overestimated the influence of suppression, because it did not control off-frequency listening and/or provide appropriate detection cues in forward masking. PMID- 6501702 TI - Frequency discrimination in quiet and in noise for signals with triangular spectral envelopes. AB - The just-noticeable-difference in frequency (jndf) for complex signals with triangular spectral envelopes is found to depend on the envelope slope. For shallow slopes (less than 140 dB/oct), jndf increases with decreasing slope. Addition of noise also impairs frequency discrimination within a region of about 20 dB above masked threshold. This is found for both maskers used: a wideband noise and a narrow-band masker which is below the signal in frequency. When wideband noise is used, frequency discrimination of complex signals with shallow slopes deteriorates more rapidly with decreasing signal-to-noise ratio than it does when the signals have steep spectral slopes. PMID- 6501703 TI - Evidence for a reappraisal of the psychophysical selective adaptation paradigm. AB - The human psychophysical adaptation literature infers the existence of channels in the auditory system sensitive to frequency modulation (FM) from selective increases in FM detection thresholds following adaptation with FM stimuli. Using this psychophysical paradigm to characterize the attributes of feature-sensitive channels requires knowledge of the phenomenon's stability over repeated testing. In this study FM detection thresholds were measured in human subjects with continued testing over numerous sessions. During adapting intervals within the sessions either FM upsweeps or silence was presented. Exposure to FM upsweeps initially resulted in an increase in FM detection thresholds by a factor of 2 to 3 relative to those measured following silence. These initial threshold elevations decreased markedly with repeated testing (more than five 30-min experimental sessions). Final threshold differences between adapted and nonadapted conditions approached zero. In one subject, such asymptotic threshold values were regained in a single session, after a 4-month hiatus. The findings suggest multiple determinants of the selective adaptation function, as well as a reevaluation of inferred mechanisms. PMID- 6501704 TI - Predicting the subjective response to nonsteady vibration based on the summation of subjective magnitude. AB - A purpose of this study was to determine the values of exponents of psychophysical functions for the discomfort produced by whole-body vertical vibration. In addition, the applicability of a method of predicting the average stimulus intensity of a stimulus the intensity of which varies with time was investigated. The first experiment investigated the effect on discomfort of the duration of vibration (for durations of 2, 5, 10, 20, and 50 s) and of the vibration acceleration magnitude [for 0.5, 0.75, 1.11, 1.67, and 2.5 ms-2 (rms) at 8 Hz]. The magnitude estimation method was used. The results show that the logarithm of the magnitude estimates is in linear proportion to both the logarithm of the acceleration and the logarithm of the duration. The values of exponents for acceleration and duration were 0.96 and 0.56, respectively. In the second experiment, the point of subjective equality of each of 16 nonsteady vibrations was measured and compared with the stimulus intensity predicted by means of the method proposed by the authors. Good agreement was found between the measured and predicted stimulus intensity and it was confirmed that the predicting method could be applied to vibration as well as to noise. PMID- 6501705 TI - Effect of the temporal pattern of a given noise dose on TTS in guinea pigs. AB - To show the effect of the temporal pattern of acoustic stimulation on TTS 15 min, guinea pigs were subjected to isoenergetic noises with the same spectrum. The exposures in a first experimental series were continuous noises and noise bursts. The continuous noise was presented with different durations and levels but always with the same energy. The noise burst stimulation consisted of a constant number of bursts with different interstimulus intervals. Both duration and repetition rate were shown to affect the TTS 15 min measured for these isoenergetic stimuli. A duration of 225 to 1800 s and a repetition rate of one per second produced the greatest TTS 15 min. In a second experimental series continuous noise and acoustic impulses with the same spectrum and 100-Hz repetition rate were presented at different levels. In this case the waveform of the stimulus (phase spectrum) was shown to have an effect on TTS 15 min. PMID- 6501706 TI - Community response to noise: is all noise the same? AB - There have been nearly a dozen papers published in the last 5 years which compare community response to noise from several different sources such as road and rail traffic. This paper draws on those and other studies to address three questions. First, is the variation in results simply due to random sources or measurement error, such that use of an "average" dose-response curve is appropriate, or is there some identifiable systematic variation? Second, what characteristics of the noise or community might lead to systematic variation, if there is any? Third, under what conditions is it reasonable to use an average function, even if there are systematic variations? Both of the first two questions receive only tentative answers on the basis of available studies. Although the evidence shows different functions for different sources (e.g., rail and road noise), for different types of one source (e.g., air carrier airports and general aviation airports), and even for different studies at the same location (e.g., Heathrow), the evidence is not sufficiently strong to totally reject the idea that all of this is just random variation about an "average" response. As yet, there is no clear identification of what acoustical or community factors explain the differences in response, so it is sensible simply to use the type of source (i.e., road, rail, or air traffic noise) to categorize the differences. The answer to the third question, then, is that an "average" dose-response curve is useful in the face of limited information--that is, when we cannot specify precisely the conditions calling for different functions. PMID- 6501707 TI - Heat generated by ultrasound in an absorbing medium. PMID- 6501708 TI - Place-of-articulation information in the closure voicing of plosives. PMID- 6501709 TI - Spontaneous narrow-band oto-acoustic signals emitted by human ears: a replication. PMID- 6501710 TI - Proceedings and abstracts of the sixty-second annual meeting of the American College Health Association. Atlanta, Georgia, 1984. PMID- 6501711 TI - Communication is our future. PMID- 6501712 TI - Medicine in institutions of higher education: a transatlantic view. PMID- 6501713 TI - The nonmedical use of amphetamines among the college age group: recent research concerning epidemiology and toxicity. PMID- 6501714 TI - Resolution on alcohol marketing on campus. PMID- 6501715 TI - Morphologically distinct sustained ventricular tachycardias in coronary artery disease: significance and surgical results. AB - One hundred patients with drug-refractory recurrent sustained ventricular tachycardia associated with coronary artery disease who underwent mapping directed subendocardial resection for ventricular tachycardia were retrospectively evaluated with respect to a number of morphologically distinct tachycardias on a 12 lead electrocardiogram. Of 91 operative survivors, 18 patients had only one configuration of tachycardia, whereas 73 (81%) had multiple distinct tachycardia configurations; 36 had multiple configurations clinically. Patients with multiple clinical configurations had a longer mean HV interval (65 +/- 11 versus 53 +/- 10 ms, p less than 0.005) and a higher failure rate of surgery alone (47 versus 25% for single clinical tachycardia, p less than 0.05). The 13 patients whose multiple clinical tachycardias originated in disparate sites in the heart (greater than 5 cm between sites of origin) were less often cured by surgery alone than were those whose multiple tachycardias originated in the same or adjacent sites (83 versus 38% failure rate of surgery alone, p less than 0.05). On the basis of mapping data, multiple configurations of ventricular tachycardia appear to originate in the same or adjacent sites in the majority of patients, although in 16% of patients with multiple tachycardias, the tachycardias originate at widely separated sites. PMID- 6501716 TI - Role of two-dimensional echocardiography in the prediction of in-hospital complications after acute myocardial infarction. AB - To evaluate prospectively the prognostic value of two-dimensional echocardiography after acute myocardial infarction, two-dimensional echocardiography was performed on 61 consecutive patients who were admitted to the hospital with this condition. A left ventricular wall motion score index was derived from analysis of regional wall motion; an index of 2.0 or more within 12 hours of admission identified patients at high risk for pump failure, malignant ventricular arrhythmia or death. These complications occurred in 24 of 27 patients with an initial wall motion score index of 2.0 or more, but in only 6 of 34 with an initial index of less than 2.0 (p less than 0.0005). Of the 47 patients who were in Killip class I on admission, complications developed in 11 (79%) of the 14 with an initial index of 2.0 or more, but in only 6 (18%) of the 33 with an initial index of less than 2.0. After acute myocardial infarction, early determination of the wall motion score index by two-dimensional echocardiography is useful for identifying patients at high risk for complications and is especially valuable in the subset of patients who initially seem to be in stable condition as judged from clinical variables. PMID- 6501718 TI - Blood pressure in survivors of myocardial infarction. The Coronary Drug Project Research Group. AB - The prognostic significance of blood pressure elevation and its associated characteristics in patients recovered from myocardial infarction was studied in the placebo group (n = 2,789) of the Coronary Drug Project. Age, relative body weight, heart rate and ST depression on the electrocardiogram were important positive correlates of hypertension measured at baseline. The relation of uric acid and elevated plasma glucose levels to increased blood pressure could be partially explained as side effects of thiazide diuretic therapy. A "high normal" baseline blood pressure best predicted the development of hypertension among survivors of myocardial infarction. Both combined systolic and diastolic hypertension and isolated systolic hypertension were adverse prognostic factors. Changes in blood pressure, including the prognostic implications of a decrease in pressure, were also analyzed in the subset of patients who sustained a recurrent nonfatal myocardial infarction. Decreases in systolic (mean 7.9 mm Hg) and diastolic (mean 3.6 mm Hg) blood pressure were sustained in this subset. Patients whose blood pressure decreased after recurrent myocardial infarction tended to have higher mortality rates than those of comparable patients whose blood pressure increased or remained unchanged. PMID- 6501717 TI - Temporal evolution of the human coronary collateral circulation after myocardial infarction. AB - An analysis of the coronary collateral circulation in a consecutive series of 116 postinfarction angiograms from patients with persistent 100% occlusion of their infarct artery is reported. Patients were classified into four groups according to the interval between acute infarction and angiography. Of 42 patients studied within 6 hours of infarction (Group I), 52% had no evidence of any coronary collateral development as compared with only 8% (1 of 16 patients) studied 1 day to 2 weeks after infarction (Group II). Virtually all patients studied beyond 2 weeks after myocardial infarction (14 to 45 days, Group III) and later than 45 days (Group IV) had visible collateral flow. Angiographically "well developed" collateral channels were seen in only 16% of Group I patients compared with 62, 75 and 84% of patients in Groups II to IV, respectively. Of six patients studied twice, on the day of the infarction and 2 weeks later, only one patient had collateral vessels on the day of infarction, whereas all six patients did at follow-up study. Group I patients were studied as part of a randomized acute myocardial infarction reperfusion trial, whereas the other patients were referred for angiography primarily because of post-infarction ischemia. Within the limitations imposed by the patient selection process, it is concluded that well developed coronary collateral vessels are rarely present at the time of infarction. After infarction, they develop rapidly and are generally demonstrable within 2 weeks. It may also be inferred that the preservation of ischemic myocardium by well developed coronary collateral vessels at the time of myocardial infarction may be an uncommon occurrence. PMID- 6501719 TI - Diagnosis of constrictive pericarditis by two-dimensional echocardiography: studies in a new experimental model and in patients. AB - The purpose of this study was to determine the value of two-dimensional echocardiography in detecting constrictive pericarditis. Serial two-dimensional echocardiography was performed in eight closed chest conscious dogs with experimental constrictive pericarditis, using a new model that creates constrictive pericarditis by the introduction of a pericardial irritant mixture. Constrictive pericarditis was confirmed in these dogs by cardiac catheterization and pathologic examination. Four patients with constrictive pericarditis and three patients with restrictive cardiomyopathy (amyloidosis) were also studied. Analysis of short-axis two-dimensional echocardiograms was performed to determine the frame by frame change in left ventricular cavity areas throughout diastole. Curves of diastolic left ventricular cavity area change versus percent duration of diastole were constructed for each animal and human subject. Pericardial thickness was measured at various gain settings on two-dimensional and M-mode echocardiograms and at post-mortem examination. In dogs with constrictive pericarditis, the echocardiograms seriously overestimated and correlated poorly with pathologic measurements of pericardial thickness. In dogs after constrictive pericarditis developed, 69 +/- 11% (mean +/- SD) (range 50 to 84) of cavity area change occurred in the initial 30% of diastole compared with 35 +/- 7% (range 20 to 45) in control two-dimensional echocardiograms (p less than 0.001). Four patients with constrictive pericarditis showed similar accelerated cavity expansion in early diastole, but three patients with cardiac amyloidosis showed more variable left ventricular diastolic expansion rates. It is concluded that two-dimensional echocardiograms can demonstrate characteristic diastolic filling abnormalities in constrictive pericarditis, but cannot accurately measure pericardial thickness. PMID- 6501721 TI - Is peripheral arterial pressure a satisfactory substitute for ascending aortic pressure when measuring aortic valve gradients? AB - Substitution of peripheral arterial pressure for ascending aortic pressure is a common but poorly validated practice in the assessment of aortic valve gradients by catheterization. The accuracy of this practice was assessed by comparing the left ventricular-ascending aortic mean gradient in 26 cases of aortic stenosis with the left ventricular-femoral artery gradient, both with and without compensation for temporal delay in femoral artery pressure. Aligned left ventricular-femoral artery gradients (matching upstrokes to compensate for peripheral time delay) underestimated the left ventricular-ascending aortic gradient by 10 mm Hg (range 0 to -17). Unaltered simultaneous left ventricular femoral artery gradients overestimated the left ventricular-ascending aortic gradient by an average of 9 mm Hg (range +1 to +18). For both peripheral techniques, the error was relatively constant throughout the range of aortic valve gradients. The most accurate estimate of both aortic valve gradient and area was obtained by averaging the gradients and areas derived from aligned and unaltered left ventricular-peripheral arterial simultaneous tracings. Although only occasionally critical for clinical decision-making, these errors may be overwhelming in certain types of research applications, such as comparisons of valve prosthesis gradients and serial evaluations of aortic stenosis. An additional source of error is a coexistent peripheral arterial gradient that was present in 21% of otherwise technically suitable patients in the screened study group. PMID- 6501720 TI - Bromocriptine treatment of digitalis-induced ventricular tachyarrhythmias: studies in a canine model. AB - Ventricular tachyarrhythmias associated with digitalis toxicity are believed to be due, in part, to cardiac glycoside-mediated increased central sympathetic neural activity. Because dopaminergic receptor agonists reduce sympathetic outflow, this study assessed effectiveness of the available dopaminergic agonist, bromocriptine, in slowing or terminating ouabain-induced ventricular tachycardia in anesthetized dogs. In all experiments, ouabain was administered intravenously (20 micrograms/kg body weight bolus injection, followed by 2.5 micrograms/kg per min infusion) until the onset of stable ventricular tachycardia. Of seven untreated dogs (Group 1), ouabain-induced ventricular tachyarrhythmias resulted in ventricular fibrillation in three, while in four dogs tachycardia persisted without significant change in rate until the study was terminated. Fourteen dogs (Group 2) received bromocriptine, either 30 micrograms/kg (Group 2A) or 50 micrograms/kg (Group 2B), after the onset of ventricular tachycardia. Tachycardia slowed in all 14 dogs and terminated with resumption of sinus rhythm in 8 of the 14. In all six dogs pretreated with the peripheral dopaminergic antagonist domperidone (Group 3), bromocriptine, 50 micrograms/kg, slowed ventricular tachycardia and in three of the six, tachycardia terminated. In contrast, of five dogs pretreated with haloperidol, a central and peripheral dopaminergic receptor antagonist (Group 4), bromocriptine, 50 micrograms/kg, failed to slow ventricular tachycardia in three, and two of the three developed ventricular fibrillation. In summary, the dopaminergic receptor agonist, bromocriptine, presumably acting at central dopaminergic receptor sites, consistently slowed and in most cases reversed ouabain-induced ventricular tachycardia in a canine model. PMID- 6501722 TI - Repair of anomalous origin of the left coronary artery in the infant and small child. AB - Anomalous origin of the left coronary artery from the pulmonary artery is associated with myocardial infarction, left ventricular dysfunction, mitral valve dysfunction and, occasionally, intracardiac congenital abnormalities. A technique that utilizes a flap of the anterior wall of the pulmonary artery to serve as a neocoronary artery to direct aortic flow from a created aortopulmonary window to the pulmonary artery orifice of the anomalous left coronary artery was used in five patients aged 2.5 months to 4.75 years. Two patients were less than 4 months of age at operation. There was one death 2 days after operation and one late death. The two youngest patients required mitral valve replacement. Two of the three surviving patients are well at follow-up at 7 to 44 months. One patient has been lost to follow-up study. One patient had postoperative catheterization which showed an intact repair. The pulmonary artery neocoronary procedure is applicable to infants and small patients with anomalous origin of the left coronary artery from the pulmonary artery. PMID- 6501723 TI - Two-dimensional echocardiographic assessment of pulmonary artery and aortic arch anatomy in cyanotic infants. AB - To determine the feasibility and accuracy of noninvasive assessment of pulmonary artery and aortic arch anatomy, a prospective two-dimensional echocardiographic evaluation was performed in 20 consecutive cyanotic infants before cardiac catheterization and angiography. The echocardiographic assessment was correct with the following frequency: detection of left aortic arch in 13 of 13 infants, detection of right aortic arch in 7 of 7, identification of patent ductus arteriosus in 13 of 13 (one false positive finding), identification of a right pulmonary artery in 20 of 20, identification of a left pulmonary artery in 19 of 20, identification of the confluence of the right and left pulmonary arteries in 19 of 20 and identification of a main pulmonary artery in 14 of 16 (two false positive diagnoses by echocardiography). Echocardiographic estimates of arterial diameters were slightly smaller than those obtained by angiography. Mean vessel size (echocardiographic/angiographic diameter) was as follows: transverse aortic arch 8.6/10.6 mm, main pulmonary artery 5.7/6.3 mm, right pulmonary artery 4.1/4.2 mm and left pulmonary artery 4.2/3.9 mm. It is concluded that although two-dimensional echocardiography tends to underestimate vessel size, the qualitative assessment is adequate for planning a systemic to pulmonary artery anastomosis in selected infants with cyanotic forms of congenital heart disease. PMID- 6501724 TI - Renal hemodynamic effects of vasodilation with nifedipine and hydralazine in patients with heart failure. AB - The central and renal hemodynamic effects of nifedipine were evaluated in nine patients with severe chronic congestive heart failure. Oral nifedipine (34 +/- 22 mg, mean +/- standard deviation) was associated with a decrease in systemic vascular resistance from 1,748 +/- 436 to 1,321 +/- 302 dynes . s . cm-5 (p less than 0.001) and mean arterial blood pressure from 96 +/- 11 to 87 +/- 6 mm Hg (p less than 0.05) and with an increase in cardiac output from 4.2 +/- 1.1 to 4.9 +/ 1.2 liters/min (p less than 0.001). Although renal vascular resistance decreased from 11,988 +/- 2,256 to 10,286 +/- 3,011 dynes . s . cm-5 (p less than 0.05), no significant change was seen in renal blood flow (599 +/- 120 to 640 +/- 162 ml/min), glomerular filtration rate (62 +/- 18 to 62 +/- 17 ml/min), filtration fraction (18 +/- 5 to 17 +/- 6%), the ratio of renal/systemic vascular resistance (7.0 +/- 1.0 to 7.9 +/- 1.8) and the ratio of renal blood flow/cardiac output (0.15 +/- 0.02 to 0.13 +/- 0.03). Intravenous hydralazine (10 +/- 5 mg), given to eight of the patients in a randomized crossover design, resulted in a larger increase in cardiac output than did nifedipine (38 +/- 7 versus 19 +/- 10%, p less than 0.001) and in an increase in total renal blood flow from 570 +/- 152 to 645 +/- 174 ml/min (p less than 0.001). Renal vascular resistance decreased from 12,080 +/- 2,934 to 10,153 +/- 2,372 dynes . s . cm-5 (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501725 TI - Dissociation of atrial electrograms by right and left atrial pacing in patients with atrioventricular reciprocating tachycardia. AB - Seventeen patients had atrioventricular (AV) reciprocating tachycardia incorporating an AV bypass tract as the retrograde limb of the tachycardia circuit. High right atrial pacing during tachycardia dissociated the low septal right atrial electrogram in four of seven patients with a left free wall bypass tract, neither of two patients with a right free wall bypass tract, four of six patients with a posteroseptal bypass tract and both patients with an anteroseptal bypass tract. Pacing from the coronary sinus during tachycardia dissociated the atrial electrogram recorded at the os of the coronary sinus in no patient with a left free wall bypass tract, both patients with a right free wall bypass tract, two patients with a posteroseptal bypass tract and one patient with an anteroseptal bypass tract. These findings suggest two distinct inputs to the AV node, with the left-sided input being part of the tachycardia circuit in patients with a left free wall bypass tract and the right-sided input being part of the tachycardia circuit in patients with a right free wall bypass tract. However, in some patients with a septal bypass tract, neither the right- nor the left-sided atrial input appears to be a necessary link in the tachycardia circuit. PMID- 6501726 TI - Doppler echocardiography and computed tomography in diagnosis of left coronary arteriovenous fistula. AB - A 37 year old man with recurrent episodes of endocarditis was found to have a large left coronary arteriovenous fistula communicating with the right atrium. The origin and termination of the fistula were identified using computed tomography and two-dimensional Doppler echocardiography. Coronary angiography confirmed the diagnosis and the patient underwent a successful operation. PMID- 6501727 TI - Two-dimensional echocardiographic detection of right-sided cardiac intracavitary thromboembolus with pulmonary embolism. AB - Five patients with pulmonary embolism, in whom right-sided intracardiac thromboembolus was detected by echocardiography and confirmed by either angiography, surgery or postmortem examination, are described. One of these patients died from massive pulmonary embolism after right heart catheterization. In two patients treated medically, either partial or total lysis of the thromboembolus was demonstrated echocardiographically; in another two patients, the right atrial thromboembolus was successfully removed surgically. Typical locations and echocardiographic characteristics of right-sided thromboemboli are described. The potential usefulness of two-dimensional echocardiography in both the diagnosis and the management of patients with right-sided intracardiac thromboembolism is discussed. PMID- 6501728 TI - Extensive endocardial mapping during sinus rhythm and ventricular tachycardia in a patient with arrhythmogenic right ventricular dysplasia. AB - A 38 year old man with arrhythmogenic right ventricular dysplasia underwent electrophysiologic study with extensive endocardial mapping of the right ventricle. During sinus rhythm, markedly reduced amplitude with or without prolonged duration was noted in multiple electrograms of the right ventricle. Delayed activation of the right ventricular outflow tract electrogram was present. Two clinical types of ventricular tachycardia with a left bundle branch block configuration and either an inferior or a superior axis were induced by ventricular stimulation. Endocardial activation sequence during the tachycardias suggested that the tachycardia with an inferior axis originated near the infundibulum, while that with a superior axis originated near the midinferior area of the right ventricle. Both areas have been previously shown to be frequently impaired in right ventricular dysplasia. PMID- 6501729 TI - Pericardial mesothelioma masquerading as a benign pericardial effusion. AB - A 53 year old asymptomatic man presented with a primary pericardial mesothelioma masquerading as a benign pericardial effusion. Although M-mode echocardiography showed an echo-free space, two-dimensional echocardiography and thoracic computed tomography demonstrated that the suspected effusion was caused by a mass surrounding the heart. Newer noninvasive techniques can be valuable for the early detection of pericardial tumor. PMID- 6501730 TI - Asymptomatic aneurysm of the interatrial septum. AB - A case of interatrial septal aneurysm discovered by two-dimensional echocardiography and confirmed by ultrasound contrast technique is described. Previous reports are reviewed, emphasizing the differential diagnosis, prognosis and recommendations for follow-up. PMID- 6501731 TI - Coronary thrombosis and subsequent lysis after a marathon. AB - A patient who developed an acute anterior myocardial infarction after completion of a marathon is presented. Coronary angiography performed 5 hours after the onset of symptoms showed occlusion of the left anterior descending coronary artery and nonocclusive thrombus in the proximal right coronary artery. Repeat angiography 10 days later showed complete resolution of thrombosis in both arteries. The relation between marathon running and coronary thrombosis is discussed. PMID- 6501732 TI - Acute coronary thromboembolization in unstable angina without subsequent myocardial infarction. AB - A 58 year old man underwent coronary arteriography for unstable angina. During the catheterization, distal embolization of a nonoccluding intracoronary thrombus formed at the site of a subtotal atherosclerotic occlusion of the left anterior descending coronary artery and was documented angiographically. This event, which appears unique, was not associated with subsequent myocardial infarction or any apparent morbidity. PMID- 6501733 TI - A new double coronary artery anomaly: the right coronary artery originating above the coronary sinus giving off the circumflex artery. AB - This is the first reported case of a coronary artery anomaly in which the right coronary artery originates above the left sinus of Valsalva and also gives off the circumflex system. Use of the aortogram and careful inspection of the ventriculogram in the right anterior oblique view were most helpful in recognizing the anomaly. The potential pathologic significance of the anomaly and pitfalls of misdiagnosis are discussed. PMID- 6501734 TI - Transmural versus Q wave infarction. PMID- 6501735 TI - Intimal flap prolapse in aortic dissection. PMID- 6501736 TI - Assessment of magnesium and aluminum in erythrocytes by the laser microprobe mass analyzer (LAMMA). AB - The erythrocyte magnesium content was determined using two different analytical systems (atomic absorption spectrometry and the laser microprobe mass analyzer) with specimens from 18 patients with normal renal function and from 10 patients with chronic renal insufficiency. There was a good correlation (r = 0.73) between the two analytical systems. Additionally, the laser microprobe mass analyzer was used to determine the aluminum content of plasma and erythrocytes in specimens from patients who ingested moderate quantities of aluminum hydroxide for several months. Results showed a significant elevation of the plasma aluminum concentration, but a normal erythrocyte aluminum content. The laser microprobe mass analyzer may be useful in studies of mineral metabolism in humans. PMID- 6501737 TI - Nutrition and the elderly: a general overview. AB - Throughout adult life, there is progressive alteration in body composition and tissue function. There is loss of lean body mass, notably by muscle, with a gain in body fat. We do not know whether nutritional factors affect these gross changes. In the case of loss of bone density (osteoporosis), however, there is evidence that the process is retarded by raising the intake of calcium and by exercise. Aging also adversely affects tissue function at the level of the whole organ and tissue as well as at the cellular and subcellular level. Animal models show similar age-related changes, and demonstrate further that alterations in nutrient intake or exercise can alter the rate of loss of tissue and cellular function. In addition to the effects of adult aging on tissue function, certain chronic diseases and disabilities are related to aging. These conditions include atherosclerosis, hypertension, coronary thrombosis, cancer, etc. Both human epidemiological studies and animal experiments on aging suggest strongly that nutrition plays a role in the onset and development of these conditions. There is a need for more accurate assessments of the nutrient needs of people over 65 years of age. A few selected nutrients are discussed. Studies of energy intake during adult life show a progressive reduction with increasing age, due mainly to reduced physical activity. Vitamin C levels in the white blood cells of elderly women can be half those of young adults; these respond to supplementary vitamin C without evidence of clinical benefit. Nitrogen balance studies suggest that the allowance of protein for older adults is not less than for young. Finally, surveys of elderly in whole populations and in selected groups show that, by the nutritional standards of young adults, there may exist a significant amount of malnutrition in people as they grow old, though we do not know whether this affects rate of loss of tissue function with age. PMID- 6501738 TI - Reference values and age-related trends for arm muscle area, arm fat area, and sum of skinfolds for United States adults. AB - Age- and sex-specific percentile distributions for mid-upper arm muscle area (AMA), mid-upper arm fat area (AFA), subscapular skinfold thickness, and sum of triceps and subscapular skinfold thickness for United States adults (18-74 yr) were developed from cross-sectional data collected by the National Center for Health Statistics (NCHS) during the Health and Nutrition Examination Survey, 1971 1974 (NHANES I). Sample weighting factors were applied to the data to assure the production of the identical data set used to calculate weight-for-height percentiles by NCHS. Smoothed curves developed from the percentile distributions for AMA and AFA are also presented. Arm muscle area and AFA were calculated from the Health Examination Survey of 1960-1962 (HES) which made possible an age cohort analysis for age-related changes and secular trends. Secular differences were found for arm muscle area for both men and women, while men differed little in fat-related anthropometric parameters. The secular change in arm fat area for women could be explained by the greater amount of fat that surrounded a larger arm, since the ratio of AFA to AMA did not change between the two surveys. Age cohort analysis revealed increases in AMA with age rather than the apparent decrease observed for the older age groups in the cross-sectional data. Reference values developed from the most recent cross-sectional data are the most appropriate for the nutritional assessment of United States adults, because each age cohort can be seen to display different anthropometric characteristics as well as age-related changes in these parameters. PMID- 6501739 TI - Uncovering the "fine details" of pollen allergen transport. PMID- 6501740 TI - Elevated IgG immune complexes in children with atopic eczema. AB - The levels of serum IgG complement-fixing immune complexes were studied in 20 children with atopic eczema and in 10 children with allergic rhinitis as control subjects with the use of a Raji cell assay. Immune-complex levels were strikingly elevated in those with eczema, 50 +/- 10 SE micrograms/ml, compared to control subjects 11 +/- 9 micrograms/ml (p less than 0.0047), the latter falling within the range for nonallergic subjects. Levels tended to be higher in those subjects with more severe eczema, but there was no statistically significant correlation, nor were levels correlated with serum IgE. Sucrose-density gradient analysis demonstrated the immune complexes to be present in two peaks, 8 to 10S and 21S or higher. High-molecular-weight IgG immune complexes that are complement-fixing may promote the characteristic pruritus of eczema by formation of anaphylactic complement fragments and the release of inflammatory substances from cutaneous mast cells, as well as contributing to the impaired cell-mediated immunity associated with the disease. PMID- 6501741 TI - Airborne ragweed allergens: association with various particle sizes and short ragweed plant parts. AB - These investigations were undertaken to size airborne particles by use of a high volume sampler and to measure the short ragweed allergen activity of airborne particles of different sizes. We found both in vitro and in vivo short ragweed allergen activity in particles of all size ranges including greater than 6, 3 to 6, 1.8 to 3, 1 to 1.8, and 0.3 to 1.0 micron in diameter. Furthermore, we investigated various parts of the short ragweed plant as possible sources of allergen. Plant parts collected before, during, and after the pollination season demonstrated significant in vitro and in vivo allergen activities. We demonstrated allergen activity in various plant parts, especially the inflorescence, as late as November 30. Appreciable ragweed allergenic activity was also associated with particles less than 1 micron in diameter. Collectively, these observations suggest persistent ragweed plant debris in different sized particles as a source of allergen in the air before and after the ragweed pollination season. This may contribute to out-of-season symptoms observed in highly ragweed-sensitive individuals. PMID- 6501742 TI - Characterization of the late response in exercise-induced asthma. AB - Nine young adult subjects who developed asthma after a standard treadmill exercise test were studied. Pulmonary function tests were performed before and after exercise and serially for at least 6 hr afterwards. The subjects performed pulmonary function tests while breathing room air and after breathing an oxygen helium mixture with each test. Although pulmonary function returned to normal within 3 hr after exercising in all subjects, eight of the nine had late asthmatic reactions 3 to 5 hr afterward. In general the late response was less severe than the initial response. Two subjects, however, noticed clinical asthma. In the immediate response, eight of the nine subjects were helium "responders," suggesting that the immediate response involved both large and small airways. In the late response, seven of eight subjects were helium "nonresponders," suggesting that the late response occurred primarily in small airways. PMID- 6501743 TI - Theophylline increases serum uric acid levels. AB - The present study was undertaken to investigate the effect of theophylline on serum uric acid and then to elucidate the mechanisms of action of theophylline as a cause of hyperuricemia. There was a significant increase of serum uric acid levels in male asthmatic patients who received theophylline compared to male control subjects without theophylline (6.3 +/- 0.4 mg/ml, mean +/- SEM, versus 4.3 +/- 0.2 mg/ml, p less than 0.01). A significant correlation of serum levels of uric acid and theophylline was demonstrated in asthmatic patients who received 200 to 400 mg sustained-release theophylline (male group, r = 0.480, p less than 0.001; female group, r = 0.398, p less than 0.01). Intravenous administration of aminophylline in three healthy adult male patients did not inhibit uric acid clearance, suggesting that inhibition of excretion of uric acid by theophylline is unlikely. Theophylline slightly inhibited hypoxanthine guanine phosphoribosyltransferase activity in human erythrocyte lysates at concentrations over 5 mM that is considerably more than therapeutic concentrations of theophylline as determined by the conversion of [14C]hypoxanthine to [14C]inosinic acid. Theophylline caused a moderate inhibition of [14C]hypoxanthine uptake by K-562 cells (approximately 50%) at 10mM that is over 100 times as high as those achieved clinically. Further studies remain to be performed to elucidate the exact mechanisms of theophylline-induced hyperuricemia. PMID- 6501744 TI - Spontaneous and provoked resistance to isoproterenol in isolated human bronchi. AB - Cumulative concentration-response curves to isoproterenol were constructed in 74 preparations of human airways (group A) contracted with acetylcholine (80% of maximal contraction). In 52 bronchi (group A1), the maximal relaxation to isoproterenol represented at least 70% of the acetylcholine contraction (average 98% +/- 3) and the mean concentration (+/- SD) causing 50% of the relaxation (EC50) was 6.0 X 10(-8)M +/- 0.8. Resistance to isoproterenol (significant decrease of the maximal relaxation and right shift of the concentration-response curve) was provoked in 25 preparations by incubating them with isoproterenol (concentration 100 times higher than the individual EC50) for 30 min. The response to isoproterenol remained stable over the same time interval in eight control preparations. Incubation with isoproterenol did not modify the relaxing response to theophylline (n = 8). Indomethacin had no effect on the resistance provoked by isoproterenol incubation (n = 11). Incomplete relaxation to isoproterenol (maximal relaxation averaging 47% +/- 2 of the acetylcholine contraction) was observed in 22 preparations (group A2; mean EC50 = 1 X 10(-6)M +/- 0.2, significantly different [p less than 0.001] from group A1). Such preparations could be completely relaxed by theophylline (n = 7). For the whole group A, a significant negative correlation was found between isoproterenol EC50 and the magnitude of the maximal relaxation to isoproterenol (expressed as percent of acetylcholine contraction). There was no significant correlation between acetylcholine EC50 and isoproterenol maximum relaxation. Spontaneous resistance to isoproterenol was neither related to the technique of isoproterenol administration (cumulative versus noncumulative; n = 11) nor the magnitude of acetylcholine contraction (70% and 95% of maximal contraction; 14 bronchi, group B). PMID- 6501745 TI - Recurrence of allergic bronchopulmonary aspergillosis after seven years of remission. AB - A staging system has been presented previously to assist in the evaluation and management of allergic bronchopulmonary aspergillosis (ABPA). One of these stages is a remission stage in which patients are free from pulmonary infiltrates. It had been uncertain whether patients with ABPA in remission were at risk for recurrences. We now present a patient in whom recurrence of ABPA developed after 7 yr of remission that demonstrates that patients with ABPA are at risk for recurrences for a prolonged period of time. PMID- 6501746 TI - Recent developments in the management of patients with atopic dermatitis. AB - Management of most patients with AD should be directed toward basic therapy- lubricants, moderate potency topical steroids, and antihistamines. Only the severe or unresponsive patient should be considered for management with some of the techniques that have been discussed previously. In part, this is because the addition of extra therapy will substantially decrease long-term compliance, increase the cost of medical care, and produce a dissatisfied patient. There are, however, definite situations in which dietary manipulation, topical and systemic antiseptics, dietary supplementation, and ultraviolet light may be useful. The uses of environmental control, biofeedback, and coal tar were not discussed but may also be useful in certain situations. Finally, all physicians should realize that Herpes simplex infection in patients with AD can be a serious and sometimes life-threatening problem. Rapid, accurate diagnosis is the key to effective management with the newer anti-viral agents. PMID- 6501747 TI - Macrophage-derived chemotactic factors and allergic asthma. PMID- 6501748 TI - Influenza A virus enhances the human polymorphonuclear leukocyte chemoluminescence response without effecting inhibition by trifluoperazine. AB - Influenza A virus has been demonstrated to enhance superoxide generation and chemoluminescence (CL) in human polymorphonuclear leucoytes (PMNs) under in vitro conditions. Although the mechanisms of virus-enhanced neutrophil activity is not established, calmodulin concentrations are known to increase in some virus transformed cells. In the following experiments, we evaluated the PMN response to the calmodulin-inhibitor trifluoperazine (TFP) after an incubation with influenza A virus. Human PMNs were isolated from whole blood and were incubated with either influenza A virus (at 50% egg-infective dose per 1 leukocyte) or noninfected allantoic fluid. After incubation with influenza virus, the CL response of isolated PMNs to opsonized zymosan particles was measured. The influenza virus treated PMNs had a mean (+/- SEM, n = 16) increase in light emission of 59.5 +/- 7.7%. TFP, in concentrations of 6 micron, 8 micron, and 10 microM, inhibition of CL was similar in influenza virus and allantoic fluid-treated neutrophils. These data suggest that, although the influenza A virus enhanced the PMN "respiratory burst" to opsonized zymosan particles, it did not alter the cell response to one calmodulin inhibitor, TFP. PMID- 6501749 TI - Dermal hypersensitivity reactions to imported fire ants. AB - A survey of suburban residents of New Orleans, La., revealed that 58% of the individuals who responded had been stung by imported fire ants (IFA) within the previous year. More than half of the patients stung had dermal reactions that were distinct from the previously reported reactions to IFA in that immediate wheal-and-flare reactions evolved into pruritic, edematous lesions that persisted about the developing pustule for 24 hr or more. Twenty-one volunteers were stung with live IFA, and the course of the reactions was observed. Nine developed persistent reactions after stings. These reactions could be reproduced by the intradermal injection of IFA--whole body extract in only four of these nine subjects. Biopsy specimens of sting reactions at 6 hr demonstrated the reactions to be "late phase reactions" characterized by dense fibrin deposits like those previously noted in dermal reactions to ragweed and insulin. Eosinophils were present in the sting-associated pustules only in individuals who developed late phase reactions. These data demonstrate that late-phase reactions occur commonly to IFA stings and that this form of insect hypersensitivity may not always be diagnosed by skin testing with whole body extract. PMID- 6501750 TI - Exposures to pathogenetic fungi in a voluntary hospital. PMID- 6501751 TI - Effect of interviewer recording practices on nutrient intake--Bogalusa Heart Study. AB - Recording practices of interviewers who independently collected dietary recalls from children for the same 24-hour eating period were analyzed. For each duplicate pair, three aspects of recording were examined: name of foods, quantity assessed from child, and food identification number selected prior to nutrient analysis. There was a 76% agreement on recorded food names. For those matched foods, 87% were assigned the same food identification numbers. Differences regarding quantities of foods were greatest for liquids, meats, and sweets. Recalls were analyzed for nutrient content on the computerized Extended Table of Nutrient Values. A paired t-test statistic showed significant sequence effect, with total energy, sugar, fat, and unsaturated fat higher for the first interview. Significant differences in nutrient intake were noted for the interviewer pair with highest percentage of foods differing by name. After-school snack assessment was the most variable eating occasion. Entry-level criteria for trained interviewers are proposed to establish standardized interviewing techniques when applying the 24-hour recall tool to child respondents. PMID- 6501752 TI - Selection and quantification of typical food portions by young adults. AB - This study was designed to assess (a) the amount of food young adults selected as an average portion and (b) the accuracy with which they could, without the assistance of food models or probing by an interviewer, describe the amount in quantifiable terms. One hundred and forty-seven adults between 18 and 30 years of age selected average portions of either breakfast or lunch items and then described the amount. Selected amounts of butter on toast, sugar on cereal, milk as a beverage, and tossed salad corresponded closely with generally accepted standard portion sizes. For dry cereal, orange juice, tuna salad, and fruit salad, selected portions were above accepted standards, but the portion for salad dressing was below the standard. Men almost consistently selected larger portions than did women. The ability to describe the amount chosen without the aid of measuring devices was poor, with from 8% to 68% of respondents being able to estimate individual items within +/- 25% of actual amount; from 0 to 67% overestimated portion size by more than 51%; and from 0 to 25% underestimated by more than 51%. The results suggest a need to provide respondents with help in estimating portion sizes or to develop alternative methods of assessing dietary intake that do not assume an ability to describe portion size accurately. PMID- 6501753 TI - Physical measurements of 9- to 12-year-old children in Kansas. AB - Measurements of height, weight, triceps, skinfold, and arm circumference were obtained from 3,231 Kansas children 9 to 12 years old as part of the Nutrition Education and Training Needs Assessment Project. Data were collected in 97 schools randomly selected throughout the state. Participating fifth grade students were divided equally between boys and girls; approximately 95% were Caucasian, 3.4% were black, and the remainder were from other ethnic groups, a profile similar to that of the Kansas population. Girls and boys in the study sample tended to be taller and to weigh more than girls and boys of similar age in national studies. Because of adolescent growth spurts, which differ among individuals, the data would need to be interpreted with caution if individual students' growth patterns were being assessed. Kansas girls and boys also tended to have larger triceps skinfold and arm fat area measurements than their counterparts in the NHANES I study. Those data, coupled with the tendency toward greater weight, suggested a greater incidence of overweight among Kansas children than among elementary school children nationally. PMID- 6501754 TI - Nutrient intakes of female adolescents from eight southern states. AB - Nutrient intakes were calculated from two 24-hour recalls for 1,247 adolescent black and white girls. Whites consumed more vitamins E, C, and B-12, niacin, folacin, calcium, phosphorus, magnesium, and zinc and had higher intakes per 1,000 kcal of those nutrients, protein, vitamin D, and iron than blacks. Intakes of calcium (whites) and magnesium (both races) decreased with age. Urban girls consumed more energy and magnesium than rural ones. Folacin intake increased with income. Folacin intakes were most frequently below 67% RDAs, followed by intakes of iodine, vitamin D, iron, calcium, vitamin B-6, zinc, magnesium, and vitamin A. The majority of diets met or exceeded RDAs for protein, vitamins E, C, and B-12, riboflavin, and thiamin. Intakes are reported for most nutrients for which safe ranges have been set. PMID- 6501755 TI - The fitness opportunity for dietetic educators and practitioners. AB - This article describes an academic experience in developing the nutrition component of a community fitness program. It illustrates how the role modeling of faculty and students can lead to the creation of new positions in nontraditional settings. Information is based on the involvement of the Coordinated Undergraduate Program (CUP) at Viterbo College, LaCrosse, WI, in the LaCrosse Exercise Program at the University of Wisconsin-LaCrosse. Included are (a) a rationale for involvement in exercise programs; (b) a perspective on attitudes, knowledge, and skills required for practice in a fitness environment; and (c) suggestions on possible curriculum components applicable to a fitness program that incorporates a nutrition emphasis. PMID- 6501756 TI - The nutrition care profile: an aid to delivery of quality nutrition care in a small community hospital. AB - In an effort to improve nutrition care in a small community hospital with one registered dietitian (R.D.), a system using a nutrition care profile (NCP) and a certified dietetic assistant (C.D.A.) was developed. The NCP includes criteria recognized in the literature or through clinical experience to be indicators of nutrition care needs. The profile is completed by the C.D.A. and reviewed by the R.D., who determines priorities for the patient's nutrition care needs. The NCP has proved to be an effective and efficient tool for prioritizing and systematizing follow-up of nutrition care needs. Indeed, because the NCP form is itself so effective as a follow-up tool for dietary records, the R.D. has found she must make a conscious effort to document nutrition care in the medical record. PMID- 6501757 TI - Biochemistry for dietetic students: course content and format. AB - This article presents the results of a survey of the 251 undergraduate dietetic programs for course content and level of the biochemistry course most frequently used to satisfy competencies in biochemistry under Plan IV of the ADA in 1979-80. It showed that a common core of information was stressed by all biochemistry instructors, but there was great variability in content and level of material covered and the textbook chosen, depending on whether the biochemistry course was offered to dietetic majors only, in classes with other nonchemistry majors, or in classes with chemistry majors. Variability was also seen in the time allotted for biochemistry--39 to 280 hours (total lecture and required laboratory hours); laboratory requirements--only 71%; and departmental affiliation of the instructor -17 different departments, primarily of chemistry (80%), biology (8%), and home economics (4%). Topics given greatest emphasis were descriptive ones, such as definitions, simple structures, and reactions of intermediary metabolism in general terms. Topics given least emphasis were those involving mechanistic and quantitative biochemistry, such as respiratory quotient (RQ), enzyme kinetics, calculations of energy from fat and carbohydrates, and specific structures of vitamins, ketones, and metabolic intermediates. The lack of communication between biochemistry and nutrition instructors and the great differences in the preparation of dietetic majors in biochemistry are sources of concern. PMID- 6501758 TI - Validated foodservice training manual for supervisors with limited experience. AB - The objective of this research project was to develop a useful, validated training manual to be used by supervisors in small foodservice operations and government-funded nutrition programs that do not have access to the services of a registered dietitian. The accuracy of the content was critiqued by an expert panel. The pilot phase was conducted at one congregate dining site to assess and revise problems involving evaluation design. The model phase evaluated the trainer's ability to use the manual and the worker's knowledge and performance as a result of training. Foodservice workers' scores after training were significantly higher than scores before training (p less than .01). Performance evaluations 4 weeks after training showed a significant positive change in work behavior (p less than .001) over evaluations before training. At 8 weeks a return to pretraining behavior was observed. The project showed that regular in-service training sessions conducted in short segments that are inexpensive and continuous would be valuable in any foodservice operation with limited access to dietitians. Benefits from such training include improved efficiency of food preparation and service, better quality of products produced, increased cost-effectiveness, and higher employee morale. PMID- 6501759 TI - Patterns of nutrition concerns and dietary constraints among adult women. PMID- 6501760 TI - The Metropolitan Height-Weight Tables: perspectives for use. AB - It must be remembered that ideal body weight is an abstract rather than an absolute concept. Height-weight tables are merely gross estimates. Nutrition is a multifaceted issue, as is client assessment, especially in the area of weight management. Health care professionals should use height-weight tables with caution and in conjunction with other parameters to assist in nutritional status assessments. PMID- 6501761 TI - Raising the image of the R.D. through public relations: nutrition month all year. PMID- 6501763 TI - Fogarty table corrected. PMID- 6501762 TI - Glycemic effects of carbohydrates. PMID- 6501764 TI - Quality of ambulatory care of the elderly: an analysis of five conditions. AB - Twelve hundred twenty-six (1,226) persons representative of the noninstitutionalized United States population aged 65-74 years were interviewed and examined as part of the 1971-1975 Health and Nutrition Examination Survey (HANES). Using information available in the HANES data base, standards for what could be considered minimally acceptable care were developed for five tracer conditions. Rates of "deficient" care were: angina, 46 percent; dyspnea on exertion, 78 per cent; hypertension, 26 per cent; hearing impairment, 61 per cent; depression, 80 per cent. Deficient care was analyzed by gender, race, income, locale, and self-rated health status. Only low income emerged as a consistent risk factor for deficient care, with the relative odds for deficient care for poor patients as compared with non-poor patients ranging from 2.7 to 5.6 (P less than 0.05) for four of five conditions. A subgroup analysis attempted to determine whether deficiencies were caused by limited access to physicians, underreporting of symptoms, or barriers that occurred after presenting complaints to a physician. The analysis revealed that for three of four symptomatic conditions, the poor and non-poor patients were equally likely to report their symptoms, whereas the poor were more likely to receive "deficient" care after presenting complaints to physicians. The ramifications of these findings as they pertain to the present situation are discussed. PMID- 6501766 TI - Thompson Award lecture. Lessons learned from editing a geriatrics journal. PMID- 6501765 TI - Computerized data base for evaluation and follow-up of demented outpatients. AB - In the course of evaluating and following more than 600 geriatric outpatients referred to a subspecialty clinic because of cognitive impairment, standardized computer-compatible evaluation and follow-up forms were developed, as well as a computerized data base. The forms cover medical, neurologic, psychiatric, psychometric, and clinical laboratory examinations; they help health professionals to perform thorough, standardized, and efficient examinations focused on those characteristics relevant to dementias. The computerized data base facilitates follow-up and other clinical studies. This article presents both the forms and their translation into query-language terminology. PMID- 6501767 TI - Clinical geriatric research: still in adolescence. AB - Clinical investigators face formidable methodologic and ethical challenges in the study of elderly people. To define problems specific to geriatric research the fundamental elements of clinical research are outlined and considerations important to a geriatric study population are identified. Because of the underestimated biologic variation of elderly people, the evaluation of new interventions in one older population may be difficult to generalize to all older people. Inasmuch as older people represent a study population with a lifetime of cumulative exposures for various diseases such as cancer, historical cohort studies are particularly suitable research designs. Despite these advantages, the retrospective study of certain interventions research designs. Despite these advantages, the retrospective study of certain interventions in older people, for example cardiopulmonary resuscitation, requires thoughtful attention to avoid strong and often subtle selection biases. Issues of informed consent and the presence of multiple, comorbid illnesses, especially relevant to clinical trials, are problematic in studying geriatric conditions. Recently, instruments measuring function and disability have been used extensively by investigators in geriatric research, but the precise way to quantify these observations remains controversial. Testing artifacts may be considerably greater in older persons than in many of the populations in which the instruments have been validated. Finally, certain statistical assumptions and inferences may be inappropriate in the study of older people. PMID- 6501768 TI - Falls and mobility in late life: an ecological model. PMID- 6501769 TI - A personal history of experience with a geriatric day care hospital: its initiation, development, function, and effectiveness. PMID- 6501770 TI - Cerebral metastases mimicking depression in a "forgetful" attorney. PMID- 6501771 TI - Subtalar joint subluxation. PMID- 6501772 TI - Computed tomography scanning of the subtalar joint. PMID- 6501773 TI - Evaluation of cefadroxil and cephalexin in oral prophylaxis of postoperative sepsis. PMID- 6501774 TI - Cutaneous Pressure Plethysmography (CPP). Quantitative assessment of skin perfusion. PMID- 6501776 TI - Ankle joint arthrodesis or implant arthroplasty. A report of two cases. PMID- 6501775 TI - Podiatrist-patient interaction during routine podiatry visits. PMID- 6501777 TI - Radiographic Visual Bisector. A new measuring device. PMID- 6501778 TI - Case comparisons of arch-area arteriovenous fistula and cavernous hemangioma. PMID- 6501779 TI - Tarsal coalitions: rare or not. PMID- 6501780 TI - Pediatric history form. PMID- 6501781 TI - Orthotic treatment of feet having a high oblique midtarsal joint axis. PMID- 6501782 TI - [Atlas of head anatomy in the neuro-ocular plane]. AB - The "Atlas of cross-sectional orbito-cephalic anatomy in the neuro-ocular plane" does exist (now in press). The authors submit the main clinico-anatomical correlations observed. We will remind you that the "neuro-ocular plane" (N.O.P.) is defined as the C.T. plane of cephalic orientation comprising "both lenses, optic nerve heads and optic canals in the primary position of gaze". The more informative anatomical, radiological and anthropological data that could derive from the N.O.P. are stressed; first, we will evaluate the validity of our work and the problems we had while building the atlas; then we will describe briefly the position of this cephalic orientation plane as compared to other planes (specifically the anthropological baseline, the orbito-meatal line, the vestibular orientation etc...) previously described. Finally, we will end our discussion by giving the anatomical correlations obtained in the N.O.P.: this plane would best include all the visual pathways starting "from the cornea to the calcarine fissure"; it would also reflect the same orientation of the temporal horn of the lateral ventricle as well as the orientation of the lateral fissure. Much more, the orthogonality of this cephalic orientation to the direction of the brainstem is demonstrated, enhancing the accuracy of the three dimensional approach in the evaluation of the orbito-cephalic anatomy and diseases, as actually completed with C.T. and N.M.R. imaging, at the Centre National d'Ophtalmologie des XV-XX in Paris. PMID- 6501783 TI - [Frontal osteoma with orbital extension. Apropos of a case]. AB - Fronto ethmoidal osteoma are rare slow growth benign tumors. Exceptional ophthalmological and neurological complications can occur. The authors report a case of 32 years old man with eye compression by a giant frontal sinus osteoma. This lesion was responsible for a vertical diplopia and moderate proptosis. Plain skull X-Ray show a well defined opacity filling the whole left frontal sinus and C.T. scan delimited precisely orbital extension. Neurosurgical exposure enabled a complete extraction of the tumor and satisfying recovery. The authors have compared this case to those described in literature and insist on the importance of the pre-operative C.T. scan. PMID- 6501784 TI - [Causes of blindness in Zaire]. AB - From 50.000 patients treated at Eye Department of University Hospital of Kinshasa (Zaire), 944 or 19% were registered legal blind. The male-to-female ratio was 2/1 and 24% of legal blind were in the age group of 0-19 years corresponding to preschool and school period. Blindness incidence increased with advancing age. Glaucoma (31%) was by far the commonest cause of blindness in our sample and in all age groups. Cataract (18,4%) and optic atrophy (16,3%) respectively came in the second and the third position. Only cataract not treatable surgically was considered. Onchocerciasis (4,9%) appeared in the fourth position but this evaluation is a minimal one because Kinshasa is situated far away from some important endemic areas and villages. Onchocerciasis was absent among legally blind younger than 20 years, its importance increased with advancing age. Trachoma is unknown in Zaire and was absent from our list of blinding ocular diseases. Xerophthalmia and keratomalacia in its typical form was rarely a cause of blindness. The common blinding affections in developed countries such as, senile macular degeneration, hereditary chorioretinal dystrophies, diabetic retinopathy are poorly represented in our statistics. Some prophylactic and therapeutic suggestions are given: Persons with glaucoma are generally examined very late, and are difficult to be treated by either rigorous application of current miotics or surgical techniques for glaucoma. Pilocarpine with high concentration (4%, 6%) alone or associated to Timolol gives usually rather good tonometric results. Filtering operations for glaucoma (Elliot trepanation, trabeculectomy) can improve or stabilize the glaucoma but in some cases no improvement is noted.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501785 TI - [Verrucous-form dermatosis papulosa nigra of the eyelid]. PMID- 6501786 TI - [Allergic granulomatous nodule of the conjunctiva]. AB - Six cases of conjunctival allergic granulomatous nodules are reported. This benign lesion was described by Ashton and Cook in 1979. It is commonest in children and young people. Clinically it consists of one or more raised yellow nodules beneath the epithelium of the bulbar conjunctiva. Histologically these nodules consist of an amorphous eosinophilic material surrounded by epithelioid and giant cells arranged in a palisade; often some eosinophils are found in the inflammatory reaction. In the absence of surgical intervention these lesions can disappear spontaneously or after corticotherapy in a few weeks or months. According to Ashton and Cook these granulomas show the histologic feature of the Splendore Hoeppli phenomenon, that is, a giant cell and eosinophilic granulomatous reaction to an antigen-antibody precipitate in relation to parasite or fungi. In two cases Ashton and Cook found fragments of nematode larvae but usually no foreign bodies or parasites are identified in the lesions. PMID- 6501787 TI - [A new ophthalmologic refractometer assisted by a microprocessor]. AB - A new, automated, objective refractometer has been developed in which the examiner looks at the ophthalmoscopic image, while a microprocessor analyzes the data automatically. The results can be displayed as well as printed. The reliability and accuracy of this instrument were evaluated. For spherical or cylindrical powers, 80 to 85% of the refractometer measurements differed from those of subjective refraction by only 0.50 diopter or less. For cylinder axis of eyes with 1.5 diopters or more of astigmatism, the automated and subjective refractions differed by no more than 5 degrees. PMID- 6501788 TI - [Antibiotic therapy in ophthalmology]. AB - Eye drops containing antibiotics are more and more numerous, we prescribe them more and more frequently. We found it interesting first to gather in six lists all antibiotics used locally in ophthalmology and to study for everyone its bacterial spectrum. After that we see which bacteria are most frequently met by ophthalmologists and when (presurgery examination, conjunctivitis, blepharitis, chalazion, meibomianitis, sty, corneal ulcer, lens infection). All this helps the ophthalmologist to choose the antibiotic he prescribes before the bacteriological specimen, with high confidence. At last, we sum up the little that is presently known about penetration of antibiotics into the eye. PMID- 6501789 TI - [Plea for a definition of visual acuity]. PMID- 6501790 TI - Detection and occurrence of pentachlorophenol residues in chicken liver and fat. AB - A method for the detection of pentachlorophenol (PCP) residues in chicken liver and fat is presented. A detection limit of 0.002 mg/kg was achieved. Recoveries from liver and fat were in the range 82-88% and 95-97%, respectively. Low level residues of PCP were found in all 1072 liver and 723 fat samples. These levels were less than 0.010 mg/kg in 92.7% of the fat and 75.6% of the livers. Only 0.75% of the liver samples had PCP levels greater than 0.1 mg/kg. None of the more toxic impurities of PCP were detected in the chicken tissues. PMID- 6501791 TI - Nontransmission of deoxynivalenol (vomitoxin) to milk following oral administration to dairy cows. AB - The absorption of deoxynivalenol (DON; vomitoxin), a trichothecene mycotoxin produced by Fusarium species, was studied in the dairy cow. Serum and milk DON levels were quantitated following a single oral dose of 920 mg DON to each of two lactating cows of similar weight. Maximum blood levels for the two animals following DON administration were 200 and 90 ng/ml serum, occurring at times 4.7 and 3.5 hr, respectively. By 24 hr after dosing only trace levels (less than 2 ng/ml) were still detectable. DON in its conjugated form accounted for 24-46% of the total levels present in serum. Free and conjugated DON were also present in cow's milk, but only extremely low amounts (less than 4 ng/ml) were detected. Detection of DON was carried out utilizing Sep-Pak C18 extraction cartridges for isolation, with additional purification of the sample achieved by passing the extract through a short charcoal/alumina column. The extract was then reacted with N-heptafluorobutyrylimidazole prior to quantitation of the resulting DON tris-heptafluorobutyrate derivative by combined gas chromatography-quadrupole mass spectrometry, using multiple selected ion monitoring. Detection limits were as low as 1 ng/ml (1 ppb). PMID- 6501793 TI - Organochlorine residues in shellfish from Maryland waters, 1976-1980. AB - Shellfish samples, including the American oyster (Craessostrea virginica), the soft shell clam (Mya arenaria), the hard shell clam (Mercenaria mercenaria) and the blue crab (callinectes sapidus), were taken from the Maryland section of the Chesapeake Bay and its tributaries over a five year period (1976-80) and analyzed to determine residue levels of various organochlorine pesticides. Qualitative and quantitative information was obtained for a variety of polychlorinated hydrocarbons. The purpose of this study includes the establishment of baseline values for levels of shellfish contamination, utilization of the data as an indicator of probable levels of water and sediment contamination in the vicinity of the sampling site and ensurance that shellfish harvested for human consumption are within U.S. Food and Drug Administration guidelines for organochlorine contamination. All mean values and virtually all individual values were within FDA guidelines. PMID- 6501792 TI - Trace metal residues in shellfish from Maryland waters, 1976-1980. AB - Levels of seven heavy metal residues, arsenic, cadmium, chromium, copper, lead, mercury and zinc were monitored in samples of the American oyster (Crassostrea virginica), the soft shell clam (Mya arenaria), the hard shell clam (Mercinaria mercinaria) and the blue crab (Callinectes sapidus). Samples were taken from the Maryland section of the Chesapeake Bay and its tributaries over a five year period (1976-80). This study was undertaken to provide an estimate of a baseline for values of trace heavy metals. Also, the oyster, being a non-mobile filter feeder, provides information regarding the level of metal residues in its environment (water and sediment), because heavy metal uptake is related to the surrounding metal concentrations. Additionally, this type of monitoring program is essential to ensure that shellfish sold for human consumption are within safe limits established for toxic substances by the United States Food and Drug Administration. Results of the study are consistent with data from previous years and no statistically significant year-to-year trends were observed over the period of the investigation. PMID- 6501795 TI - Management of flexor hallucis longus tendon injuries. AB - Acute trauma is being seen with increasing frequency by the podiatric surgeon. Tendon pathology may be obvious, as noted through impaired function of a part, or it may be more subtle, suggesting merely localized tenderness. Lack of appropriate management of such injuries can result in major biomechanical alterations. This author describes flexor hallucis longus tendon injuries and their follow-up care. PMID- 6501794 TI - Peroneus tertius reconstruction for flexible clawtoes associated with cavus deformity: a preliminary report. AB - Numerous procedures and techniques are used to correct clawtoe deformity. This paper reports on a new method of correcting clawtoe deformity surgically. Treatment of this condition is not new, and a survey of the literature is offered initially. The theory behind the tendon transposition is discussed and symptoms associated with this deformity are outlined. Variations of this new procedure are listed and illustrated clinically. The authors recommend the peroneus tertius redirection and/or reconstruction procedure as the most adequate way of reducing clawtoe deformity associated with flexible cavus foot. PMID- 6501796 TI - Improved salvage of the foot with arterial reconstruction. AB - The majority of lower extremity amputations performed today are for occlusive vascular disease, whether associated with diabetes or not. Arterial reconstruction, utilized before definitive amputation for ischemia, may permit a more distally located amputation than would have been possible without the bypass. A case history is presented and pertinent literature reviewed. PMID- 6501797 TI - Rheumatoid nodulosis in the foot: a variant of rheumatoid disease. AB - Rheumatoid nodulosis is a relatively benign variant of rheumatoid disease. This entity has been previously ignored in the medical literature. Confusion with other diseases that can produce nodules is not infrequent. A discussion of this entity, as well as a case report, will be presented. PMID- 6501798 TI - Reese Osteotomy Guide System. AB - This paper has been developed to provide surgeons with a new technique called the Reese Osteotomy Guide System. This technique allows surgeons to perform and determine osteotomies with more precision, resulting in better bone healing, greater stability, and more predictable results. PMID- 6501799 TI - Hallux varus--a study of thirty cases. AB - Although both congenital and acquired hallux varus have been described, the deformity has been considered uncommon. Contrary to this belief, we noted that it is fairly common in the unshod population. Analysis of 30 cases shows that congenital hallux varus is the most common type encountered and it is of three types, namely: primary, secondary, and teratogenic. The congenital primary and secondary varieties are apparently easy to treat in infancy, but if left untreated, they progress with age in unshod persons. The more severe grades of hallux varus are associated with medial deviation of the lateral toes. Hallux varus occasionally develops in unshod persons during the fourth, fifth, or sixth decades of life. This is referred to as the idiopathic hallux varus of middle age. The length of the first metatarsal, the first intermetatarsal angle, and the shape of the first metatarsal head appear to have no bearing on the causation of hallux varus. The progression of the deformity in congenital cases and the de novo development of the deformity in middle age appear to be related to the failure to use footwear. PMID- 6501800 TI - Achilles tendon hypercholesteremic xanthoma. AB - A case report of bilateral Achilles tendon xanthomatosis is presented. The literature is reviewed and the systemic condition discussed. Treatment consisted of surgical excision of the offending masses and medical management of the hyperlipidemic state. Follow-up results were excellent. PMID- 6501801 TI - The use of prophylactic antibiotics in clean podiatric surgery. AB - The presence of a postoperative wound infection after clean podiatric surgery may predispose the patient to a prolonged, often nonambulatory, convalescent period. Although the incidence of postoperative infection after elective podiatric surgery is small, a protocol to govern the use of prophylactic antibiotics has been developed in order to achieve their maximum benefits with a minimum of risk. Indications for chemoprophylaxis have been divided into two groups: specific operative procedures that may warrant antibiotic intervention and patients who present with specific risk factors. Additionally, it has been suggested that single dose prophylaxis is preferable to multiple dose administration. PMID- 6501802 TI - Simultaneous radioimmunoassay for plasma arginine-vasopressin and oxytocin using DEAE Sephadex A 25 extraction. AB - A sensitive and specific radioimmunoassay method for simultaneous measurement of plasma arginine vasopressin (AVP) and oxytocin (OT) has been developed utilizing an extraction technique on DEAE Sephadex A25. This procedure resulted in mean recoveries of 70.7% (AVP) and 65.4% (OT) in the peptide range of 5 to 100 pg/4 ml. The sensitivity of the assay is 0.5 pg/tube for AVP and 2 pg/tube for OT. The lower limit of detection for plasma extracts was 1.2 pg AVP/ml and 5 pg OT/ml plasma. Employing this method in normal human non smokers and ad libitum fluid the basal levels (mean +/- SE) of plasma AVP are 3.5 +/- 0.2 pg/ml in males and 4.6 +/- 0.4 pg/ml in females and the basal concentrations of plasma OT are 5.1 +/ 0.3 pg/ml in males and 5.4 +/- 0.3 pg/ml in females. Dehydration and water loading produced significant changes in plasma AVP and OT concentrations and a significant correlation exists between plasma AVP and plasma (r = 0.96, p less than 0.001) and urinary (r = 0.84, p less than 0.01) osmolality, but not between plasma OT concentrations and plasma (r = 0.11, NS) and urinary (r = 0.27, NS) osmolality. These results suggest that a wide range of physiological and pathophysiological changes in plasma AVP and OT can be simultaneously measured by the extraction procedure and the radioimmunoassay described. PMID- 6501803 TI - The behavior of the triiodothyronine/thyroxine (T3/T4) ratio in normal individuals, and its implications for the regulation of euthyroidism. AB - In order to examine the significance of differences in the triiodothyronine/thyroxine (T3/T4) ratio in the control of euthyroidism in a normal population, we measured the serum T3, T4 and FT4 index (FT4I) in 121 healthy men and 68 women. The correlation between T3 and T4 was poor (r = 0.24), suggesting that most of the natural variation in T3 among normal individuals occurs independently of the T4 level. There was, however, a strong inverse correlation (r = 0.59, p less than 0.001) between T3/T4 ratio and FT4I. This correlation reflected a constancy in mean T3 at different levels of T4 such that the T3 changed by only 0.35 nmol/l (22%) throughout the range of normal T4. Furthermore, the T3/T4 ratios of 48 hypothyroid individuals with subnormal T4 represented a simple extension of the relationship found in the healthy individuals, indicating that the rise in T3/T4 classically associated with falling T4 in primary hypothyroidism is merely part of a continuous process of change which begins in euthyroidism. It is proposed that the relationship between T3 and T4 is finely controlled in healthy individuals in such a way that differences in hormone activity due to the wide range of serum T4 among normals may be buffered by systematic adjustment of the T3/T4 ratio. Those with the highest T4 appear to maintain euthyroidism with a minimal T3/T4 ratio. The remainder, with T4 levels towards the lower limit of normal, are subject to a progressive increase in the T3 fraction and may depend on it to remain euthyroid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501805 TI - High serum calcitonin levels in heroin addicts. AB - An involvement of calcitonin in the mechanism of pain perception has recently been hypothesized. In order to collect information about the relationship between this hormone and well known analgesic substances such as opioids, we have studied the serum levels of calcitonin in a group of heroin addicts, finding higher average concentrations than in normal subjects of matched age and sex. In these addicts there were no severe signs of impaired renal or hepatic function, or alterations of the serum levels of calcium and phosphate. So we think that opioids, in a direct or indirect way, can stimulate the secretion of calcitonin. PMID- 6501804 TI - The effects of oral clonidine on the growth hormone level in acromegalic patients. AB - The effects of the noradrenergic agent clonidine on GH secretion of the adenohypophysis were studied in 10 healthy volunteers and 11 acromegalic patients. Orally administered clonidine led to a considerable serum human growth hormone (GH) level increase in the healthy individuals. In the acromegalic patients the clonidine resulted in a slight, but not significant GH increase. These results support the findings that the mechanism of noradrenergic regulation of serum GH secretion is impaired in acromegaly. PMID- 6501806 TI - Circadian variation in plasma dopamine levels in man. AB - Nocturnal and daytime recumbent secretory patterns of norepinephrine, epinephrine and dopamine were determined at 30 min intervals in 9 normotensive males. Plasma levels of dopamine as well as those of norepinephrine and epinephrine followed a circadian pattern in these recumbent males. Plasma levels of dopamine were more closely related to clock time (r = -0.54, p less than 0.001) than either norepinephrine or epinephrine levels. As for norepinephrine and epinephrine, the sleep period in all 9 males was characterized by a paucity of dopamine secretory peaks as well as lower mean dopamine levels than during the awake state. There was a strong relationship between the circadian changes in plasma dopamine levels and those of norepinephrine (r = 0.92) and epinephrine (r = 0.78) throughout the 24-h period of recumbency. These interrelationships are consistent with a common regulatory mechanism governing the sleep/wake and/or rest/activity in plasma catecholamine levels. PMID- 6501807 TI - Parathyroid localization in primary hyperparathyroidism: double-tracer scintigraphy and venous sampling techniques combined. A first evaluation. AB - The authors report their first experience with two techniques for preoperative localization of hyperfunctioning parathyroid glands: double-tracer (99mTc-201Tl) scintigraphy and venous sampling from thyroid veins. Nineteen patients affected by primary hyperparathyroidism were examined by both methods and subsequently submitted to surgery. Scintigraphy showed a sensitivity of 77.3% while the positivity of sampling was 63.6%; with the two techniques combined a correct localization was obtained in 90.9% of all cases. The authors emphasize the usefulness of both methods combined for locating enlarged hyperfunctioning parathyroids. PMID- 6501808 TI - Pituitary thyrotroph hyperplasia mimicking prolactin-secreting adenoma. AB - A 32-year-old woman with persistent postpartum galactorrhea, hyperprolactinemia and a sellar configuration compatible with pituitary adenoma underwent transsphenoidal surgery. Mild hyperthyroidism had been suspected clinically preoperatively and thyroxine plus cortisol therapy was given. Morphological features of pituitary thyrotroph hyperplasia were present as shown by light microscopy, immunoperoxidase staining and electron microscopy. The thyrotroph hyperplasia was secondary to primary hypothyroidism as demonstrated by the TSH response to TRH stimulation and subsequent suppression with thyroid hormone treatment. Although prolonged severe hypothyroidism has been reported to cause pituitary enlargement, this is the first case of thyrotroph hyperplasia with detailed morphologic study of the surgically-removed adenohypophysial tissue. The presentation of this patient calls attention to the possibility of mistaking pituitary enlargement due to primary hypothyroidism for a prolactinoma. PMID- 6501809 TI - The correlation of serum amiodarone levels with abnormalities in the metabolism of thyroxine. AB - Amiodarone, a widely used iodine-containing antiarrhythmic drug, has been shown to divert the peripheral metabolism of T4 towards rT3 than T3. In this prospective study we correlated the concentration of the peripheral thyroid hormones in serum with that of amiodarone. Fifteen euthyroid volunteers were studied, 5 men and 10 women, with a mean age of 64.2 yr, who suffered from various cardiac arrhythmias (atrial fibrillation or multiple ventricular extrasystoles). Serum amiodarone, T4, T3, rT3 and TSH were determined before and 3, 7, and 14 days after the administration of 400-600 mg amiodarone/day. There was a small increase in serum T4 and a suggestive decrease in serum T3. The increase in serum rT3 was significant, with p less than 0.05 for 3 days, p less than 0.01 for 7 days and p less than 0.005 for 14 days. There was a significant correlation between the level of serum amiodarone and the rise in serum rT3 (r = 0.385, p less than 0.05). The rise in rT3 is the main thyroid abnormality after amiodarone administration and may be used as a rough index of the serum concentration of this drug. PMID- 6501810 TI - Effect of hypoxia on the excitability of two cranial reflexes in unanaesthetized fetal sheep. AB - In fetal sheep acute hypoxia causes a decreased incidence of breathing movements and motor activity, and the excitability of polysynaptic reflexes in the hindlimbs is depressed. To determine whether this inhibitory effect extends to other areas in the fetal CNS, we have studied the effect of hypoxia on two reflexes with cranial pathways. The digastric (jaw opening) reflex was elicited by stimulation of the dental nerve through a pair of stainless steel electrodes implanted into the mandible (4 fetuses). The thyroarytenoid muscle of the larynx was reflexly activated by stimulation of the superior laryngeal nerve by a cuff electrode (4 fetuses). Low level stimulation at 1.5-2 X threshold was repeated at approximately 2 min intervals for 3-4 h; the stimulation did not alter the pattern of electrocortical activity, breathing movements, or cause arousal. The amplitude of the digastric reflex was greatest during low voltage electrocortical activity; conversely, the amplitude of the thyroarytenoid reflex was greatest during high voltage electrocortical activity. Isocapnic hypoxia lasting 30-60 min (16 trials), in which the PaO2 was reduced to 12-14 mmHg, did not reduce the amplitude of either reflex. The reduction of thyroarytenoid reflex amplitude which normally occurred during low voltage electrocortical activity was not present during hypoxia. These experiments show that the inhibitory effects of hypoxia on spinal reflexes, breathing movements and motor activity do not include these cranial pathways. PMID- 6501811 TI - Sleep does not affect the cardiovascular response to alveolar hypoxia in lambs. AB - We investigated the effect of sleep on the cardiovascular response to alveolar hypoxia in seven lambs aged 17 to 21 days. Each lamb had previously been anesthetized and instrumented for measurements of electrocorticogram, electro oculogram, nuchal and diaphragm electromyograms, pulmonary blood flow (electromagnetic flow transducer), aortic and pulmonic blood pressures. The lambs were allowed to recover from surgery at least three days before they were studied. Measurements were made during a 1-min control period and during an experimental period of alveolar hypoxia (FIO2 0.10) during quiet wakefulness, quiet sleep and active sleep. Alveolar hypoxia produced similar increases in cardiac output, heart rate, mean aortic and pulmonic blood pressures and a similar decrease in systemic vascular resistance during the three behavioral states. These data provide evidence that sleep does not affect the integrated cardiovascular response to arterial chemoreceptor stimulation in lambs. PMID- 6501812 TI - The blood supply to the abdominal organs of the fetal guinea-pig. AB - Guinea-pigs near term of pregnancy were anaesthetized with diazepam and sodium pentobarbitone. A fetus was exposed and the vitelline artery catheterized to measure blood pressure and heart rate or to render a reference sample of blood for the determination of organ blood flow by the microsphere technique. The radioactive microspheres were injected through a catheter in the right atrium. Mean arterial blood pressure was 4.0 kPa and heart rate was 261 beats min-1. The liver, spleen, pancreas and gut receive most of their blood supply from the same trunk as the vitelline artery. The sample from this vessel was also used to calculate blood flow to the adrenal glands, kidneys, urogenital tract, and placenta, assuming even mixing of microspheres and blood in the abdominal aorta. Umbilical blood flow, corrected to a fetal weight of 100 g, averaged 7.5 ml min 1. The adrenal glands, which are known to increase their cortisol secretion near term, had a very high rate of perfusion. If the microspheres were injected in the umbilical vein, almost all were trapped in the liver, confirming the absence of a ductus venosus in the guinea-pig fetus. Most of these microspheres were found in the quadrate lobe of the liver. Hepatic arterial blood flow was also unequally distributed, with more than two-thirds going to the right lobe of the liver. Although the distribution of portal venous blood flow is not known, it is evident that different areas of the liver are presented with blood of greatly varying oxygen saturation. PMID- 6501813 TI - Pre-parturitional changes in serum prolactin, placental lactogen, growth hormone, progesterone, and corticosterone in the C3H/HeN mouse. AB - Pre-parturitional changes in serum prolactin, placental lactogen, growth hormone, progesterone, and corticosterone in the C3H/HeN mouse are described. Serum prolactin concentrations display an apparent biphasic pre-parturitional increase. Both serum placental lactogen and growth hormone concentrations are elevated during the second half of pregnancy. Serum placental lactogen concentrations remain elevated until parturition, whereas serum growth hormone concentrations decline on the last two days of pregnancy. Serum progesterone and corticosterone concentrations are elevated during the latter half of pregnancy and decline on the day preceding parturition. PMID- 6501814 TI - Nutrient and waste product concentration differences in upper and lower body arteries of fetal sheep. AB - Well oxygenated blood returning from the placenta is preferentially shunted into the left side of the fetal heart and the ascending aorta. This results in higher oxygen saturation in arterial blood supplying the fetal upper body than in blood supplying the lower body. Since the placenta is also the site of nutrient and waste exchange, we evaluated differences in arterial concentrations of nutrients and waste products in fetal upper and lower body. Studies were carried out on ten, chronically catheterized, third trimester, fetal sheep. Blood samples, drawn simultaneously from the carotid and femoral arteries, were analyzed for glucose, oxygen saturation, oxygen content, total amino acids, lactate, urea nitrogen, and hydrogen ion concentration. Carotid arterial blood had higher levels of glucose (1.4 +/- 0.1 mg/dl (SEM); P less than 0.001), of alpha-amino nitrogen (0.4 +/- 0.1 mg/dl, equivalent to amino acid concentration difference of 2.5 mg/dl, P less than 0.025), of oxygen saturation (9.9 +/- 0.5%, P less than 0.001), and of oxygen content (1.0 +/- 0.1 ml/dl; P less than 0.001). Carotid values exceeded femoral by an average of 10% for glucose, 4% for amino nitrogen, 29% for oxygen saturation and 23% for oxygen content. Carotid arterial blood had lower urea nitrogen, (-0.5 +/- 0.2 mg/dl; P less than 0.05) and hydrogen ion (-1.1 +/- 0.1 nM/L; P less than 0.001) concentrations, but these differences averaged only 2% between vessels. Lactate concentration in the carotid and femoral arteries was the same. Fetal glucose and oxygen levels were closely related.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501815 TI - Simultaneous classical and El Tor cholera in Bangladesh. PMID- 6501816 TI - The invasion of epithelial cell lines and the intestinal epithelium of infant mice by Campylobacter jejuni/coli. PMID- 6501817 TI - A new enterotoxin produced by Vibrio cholerae O1. PMID- 6501818 TI - Acute segmental enteritis. PMID- 6501819 TI - Significance of stool toxin determination to Clostridium difficile diarrhoea. PMID- 6501820 TI - Serotype prevalence and antibiotic susceptibility of Shigella strains isolated in Malaysia during 1980 and 1981. PMID- 6501821 TI - Protozoal, bacterial and viral diarrhoea: a common mechanism. PMID- 6501822 TI - Classical vs El Tor cholera: a prospective family study of a concurrent outbreak. PMID- 6501823 TI - Shigellosis in Ethiopia. I. Prevalent Shigella serogroups and serotypes. PMID- 6501824 TI - Campylobacter enteritis in Japanese children. PMID- 6501825 TI - Community-operated treatment centres prevented many cholera deaths. PMID- 6501826 TI - X-ray-negative dysphagia: is endoscopy necessary? AB - We reviewed our experience with patients with symptoms of dysphagia to determine whether endoscopy increased the chance of finding esophageal carcinoma when barium studies of the esophagus were normal. Endoscopy reports from 1974 to 1982 identified 195 patients with x-ray-negative dysphagia. In no patient was esophageal carcinoma found endoscopically. When patients with hiatal hernia (22) or endoscopic Grade I or II esophagitis (52) were excluded, only eight patients were found to have an endoscopic abnormality not demonstrated previously by x ray. In addition, 56 cases of esophageal carcinoma seen at our institution over the same period all showed abnormal barium esophagrams at the time of presentation. We conclude that endoscopy to exclude esophageal carcinoma in patients with dysphagia is not as necessary as claimed, at least when adequate barium studies of the esophagus are normal. PMID- 6501827 TI - The role of pancreatobiliary duct anatomy in the etiology of alcoholic pancreatitis. AB - We determined the types of pancreatobiliary ductal anatomy in 58 chronic alcoholic patients with and without pancreatitis at ERCP. Twenty-four of 28 patients (86%) with pancreatitis had separately opening common bile ducts and pancreatic ducts, while only six of 30 patients (20%) without pancreatitis had this finding. We conclude that a separate channel configuration is an inherited predisposing factor to alcoholic pancreatitis. As both chronic alcohol ingestion and separately opening bile and pancreatic ducts have been associated with ductal epithelial hyperplasia, the pathogenesis of alcoholic pancreatitis may be by way of duct obstruction produced by cell hyperplasia. PMID- 6501828 TI - Hepatobiliary disease that precedes ulcerative colitis. AB - There is a variable temporal relationship between the presenting symptoms of inflammatory bowel disease and associated hepatic disease: hepatobiliary disease may precede, occur with, or occur many years after the onset of the bowel disease. We describe six patients in whom hepatobiliary disease of initially obscure origin preceded the development of inflammatory bowel disease. The colitis which subsequently developed in these patients was symptomatically mild. In our series, there was a high prevalence of sclerosing cholangitis. We conclude that in patients with chronic hepatobiliary disease of obscure origin, evaluation should include detailed questioning about bowel symptoms and routine sigmoidoscopy to screen for subclinical colitis. If a diagnosis of colitis is made in such a patient, endoscopic retrograde cholangiography may be indicated to evaluate the biliary tree for sclerosing cholangitis. PMID- 6501829 TI - Protracted epigastric pain and vomiting as a presentation of thyrotoxicosis. AB - Apathetic thyrotoxicosis is frequently difficult to recognize and can imitate a variety of diseases. A patient with a severe thyrotoxic state is reported, who presented with protracted epigastric pain and vomiting. Hyperthyroidism should be considered in patients with such prolonged and unexplained symptoms. PMID- 6501830 TI - Dysphagia as a primary manifestation of hyperthyroidism. AB - A 69-year old woman suffered from severe dysphagia, abdominal pain, and weight loss. The dysphagia was accompanied by nasal speech, nasal regurgitation of food, weakness, and wasting of the proximal muscles of the upper and lower girdles. Laboratory data revealed T3 sephadex uptake 65.2%; T4 15.1 mcg%; and T3 250 ng%. Treatment with antithyroid medication reversed the manifestation of all the symptoms, including dysphagia. Cine-studies revealed esophageal motor dysfunction as the cause of the dysphagia. Hyperthyroidism is a rare, but treatable cause of unexplained dysphagia. PMID- 6501831 TI - Basal cell carcinoma of the anus: clinical and pathological distinction from cloacogenic carcinoma. AB - A 54-year-old man developed basal cell carcinoma of the anal verge. This extremely rare tumor behaves rather innocently, whereas cloacogenic carcinoma of the anus, which resembles it histologically, metastasizes early and often proves fatal. Clinical and histopathologic characteristics of the two anal neoplasms are tabulated to facilitate differential diagnosis, and thereby promote their very different therapies. PMID- 6501832 TI - Reduction of portal vein pressure with the enlargement of portal-systemic shunts: observation made in one patient. AB - Whether portal vein pressure is reduced as spontaneous portal-systemic shunts are enlarged has long been disputed. We measured portal vein pressure directly by percutaneous transhepatic catheterization in one patient with cirrhosis at a 4 year interval, and demonstrated a significant reduction in portal vein pressure that had occurred along with enlargement of a collateral paraumbilical vein and splenorenal shunt during this period. PMID- 6501833 TI - Significance of serum aminograms in diagnosis and prognosis of liver diseases. AB - The diagnosis, prognosis, and treatment of various liver diseases are still frequently equivocal despite the various liver function tests and invasive procedures presently available to the clinician. The introduction of the Beckman Amino Acid Analyzer Model 119 Cl, greatly facilitated the determination of the individual amino acids in serum and cerebrospinal fluid, and the data thus obtained seem to help in the differentiation of some of the commoner types of liver disease. These data indicate that changes in the concentration of some of the aromatic amino acids (AAA) and branched chain amino acids (BCAA) are helpful in the diagnosis, evaluation of the severity of the hepatic morphologic changes, and prognosis of the type of liver disease. Moreover, the ratio between the AAA and the BCAA seems to be indicative of certain liver diseases. We describe the alterations in the amino acid patterns which may help in the diagnosis, prognosis, and treatment of patients with certain types of liver disease. PMID- 6501834 TI - Incidence and significance of a widened esophageal hiatus at CT scan. AB - We studied the anatomy of the esophageal hiatus using axial CT scans in 320 patients. Normally, the diaphragmatic crura are tightly opposed and closely related to the esophagus. Widening of the esophageal hiatus is readily demonstrated by CT as a separation of the diaphragmatic crura and an increased distance between the crura and esophageal wall. The incidence of widening increases with age, lending support to the hypothesis that the abnormality is acquired. In 100 patients who also had barium studies of the upper gastrointestinal tract, a sliding hiatus hernia was found in 37/43 (86.4%) patients who had a widened esophageal hiatus shown by CT. In 26 of 37 (70.2%) patients, the hernia was demonstrated on CT as a pseudomass usually filled with contrast material lying within and/or above the esophageal hiatus. Small hiatus hernias were shown without a widened esophageal hiatus in only two patients. PMID- 6501835 TI - Informed consent--beware. PMID- 6501836 TI - Colonoscopic removal of a "pop-up meat thermometer" from the sigmoid colon. PMID- 6501837 TI - Widowhood, health, and friendship support in later life. PMID- 6501838 TI - Self-assessments of health by the elderly: the impact of informal assistance. PMID- 6501839 TI - Pathways to adolescent drug use: self-derogation, peer influence, weakening of social controls, and early substance use. PMID- 6501840 TI - Coping and defense: constellations vs. components. PMID- 6501841 TI - The analysis of relationships involving dichotomous dependent variables. PMID- 6501842 TI - Evaluation of the febrile child under 2 years of age. AB - Unlike older children and adults, fever in young children may reflect serious underlying disease despite the lack of associated findings on physical examination. Laboratory examinations may provide important information in the management of these children. The recent literature suggests a systematic approach to the evaluation and management of the young febrile child. PMID- 6501843 TI - Case report: common femoral artery occlusion following blunt trauma in a child. AB - Vascular injury from blunt trauma is infrequently seen in children unless associated with major trauma. This case report is an example of a significant vascular injury in the setting of minor trauma. The consequences of missing such an injury as well as some of the difficulties encountered in establishing the diagnosis are discussed. PMID- 6501844 TI - Seizures in the alcohol-dependent patient: a diagnostic and therapeutic dilemma. AB - Seizures are a common occurrence in patients who are dependent on alcohol. Diagnosis of the etiology of seizures in the alcohol-dependent patient is a difficult diagnostic problem. This paper reviews the diagnostic and therapeutic approach to seizures in the alcohol-dependent patient in the emergency department. PMID- 6501845 TI - Digital intubation. AB - Digital tracheal intubation provides a safe and efficient method of intubation when the conventional methods of endotracheal intubation are impractical or impossible. Because of difficulties encountered in the field with oral or nasal intubation, a more efficient method was sought. After paramedics were taught tactile intubation on mongrel dogs and human cadavers, the procedure was used on 66 patients in the field over a period of 20 months. Fifty-eight patients were intubated successfully using this method. In 27 of these patients, delay in airway control would have resulted if not for the institution of digital intubation. In seven cases digital intubation was unsuccessful and the patients had to be intubated by other methods. Digital tracheal intubation is a safe, rapid method of intubation and should be considered when other methods prove difficult or impossible. PMID- 6501846 TI - The modified odontoid view: an alternative visualization of the atlantoaxial joint. AB - The sensitivity of the cross table lateral view (CTLV) alone, as a determinant in the radiographic disposition in patients with cervical spine fracture/dislocation has been challenged. A cervical spine trauma series that includes the CTLV, the anteroposterior view (APV), and the open-mouth view (OMV) has been suggested. Whereas the CTLV and APV present no difficulty, the OMV is often not possible in the uncooperative or unconscious patient, or in those patients with rigid forms of neck support. The modified odontoid view (MOV) can replace the OMV in these patients. The MOV allows for satisfactory visualization of the C1/C2 complex and is easily obtained as a portable technique. In addition, it requires neither patient cooperation nor neck movement. The technique is described and its interpretation reviewed. PMID- 6501847 TI - A case of fatal strychnine poisoning. AB - Although rare today, poisoning from strychnine, both intentional and accidental, still occurs. A fatal case of self-poisoning with a strychnine preparation is presented. The case illustrates the dramatic presentation of strychnine poisoning, its rapidity of action, and the need for early aggressive treatment. The discussion centers on the pharmacokinetics, the mechanism of action, the signs and symptoms, and the treatment of poisoning from strychnine. The need for rapid diagnosis and the current recommended therapy for this poison are discussed. PMID- 6501848 TI - Planning for emergency ambulance service systems. AB - The application of a computer model to evaluate ambulance deployment configurations in an urban ambulance service is described. A planned expansion of the Boston Emergency Ambulance Service was accomplished using computer projections. The use of analytic models in the planning and implementation of an Emergency Medical Services (EMS) system allows for greater understanding of the interactions between various performance measures, facilitating the effective and cost-efficient allocation of resources. PMID- 6501849 TI - Progressive medical care in disaster situations: a critical evaluation of the current situation in the Netherlands. AB - An overview of the plan for medical response in the event of a disaster in the Netherlands is presented. An idealized evaluation of the response capability, as well as the probable actual ability, is reviewed. The plan involves a response to the disaster site by teams comprising a surgeon, anesthesiologist, and two specially trained nurses from 1 or many of 20 participating hospitals as well as an ambulance response from associated district ambulance posts. An overview of disaster management in general is presented. PMID- 6501850 TI - The specialty of emergency medicine. AB - We have focused on those features of emergency medicine that distinguish it as a separate and independent specialty. We have emphasized rapidity and efficiency in approach to emergency patients with chief complaint, set of vital signs, and general appearance, mandating an appropriate history, physical examination, and generic differential diagnosis. The most serious illness (not the most probable) is considered first and the patient protected against the morbid complications of the most serious disease(s). We have pointed out that the development of a rapid rapport with patients, prioritization of care between patients and even between organ systems in a single patient, and a breadth and depth of expertise and technical skills in dealing with the initial presentation of a variety of common acute illnesses are intrinsic to emergency medicine. It is true that emergency physicians and other physicians overlap at times with regard to each of these characteristics. However, as a whole, these facets define a constellation of special expertise. The key to the specialty of emergency medicine is the ability to successfully manage the acute deterioration and pathophysiology of any life or limb threat. There are many technical skills pertinent to this management which are often shared with other disciplines, but the judgment required to manage this acute deterioration, in fact, defines the specialty of emergency medicine. PMID- 6501852 TI - Emergency ambulance service systems. PMID- 6501851 TI - Emergency health care providers. PMID- 6501853 TI - Fever and the young child. PMID- 6501854 TI - Parasitological and pathological observations on schistosomiasis in sheep in Senegal. PMID- 6501855 TI - The presence of Angiostrongylus cantonensis in Viti Levu, Fiji. AB - Wild rats and molluscs were examined for Angiostrongylus cantonensis infection on Viti Levu, Fiji. A. cantonensis were recovered from 29.6% (16/54) of Rattus rattus and 59.5% (25/42) of R. exulans. A. cantonensis-like larval nematodes were found in all of four slugs, Laevicaulis alte, and ten of 20 unidentified land snails. The larvae developed to adult A. cantonensis in the pulmonary arteries of laboratory rats 40 to 42 days after ingestion. This is the first record of A. cantonensis in Fiji. PMID- 6501856 TI - The possible role of slugs (Agriolimax spp.) in the transmission of infective larvae of Cooperia oncophora. PMID- 6501857 TI - Infectivity, growth and development of Echinostoma revolutum (Trematoda) in the domestic chick. AB - Infectivity, growth and development were studied in 23 one-day-old domestic chicks each fed 25 pre-selected metacercarial cysts of Echinostoma revolutum. All chicks were infected at necropsy one to 44 days post-exposure with one to 18 flukes/chick. From the 575 cysts fed to chicks, 145 (25%) flukes were recovered from the ileum, caeca, rectum-cloaca and bursa of Fabricius. Length measurements on 113 uncurled flukes fixed in hot alcohol-formalin-acetic acid showed that worms grew slowly to 1.0 mm by day 3, rapidly to 6 mm by day 14, and less rapidly to 9 mm by day 36. Worms became ovigerous by day 9. As worms aged in the chick, the body length increased relative to the width, the acetabulum shifted more anteriad and the size of the excretory bladder increased. PMID- 6501858 TI - Induction of host resistance to Brugia pahangi in jirds (Meriones unguiculatus) protected by chemoprophylaxis. AB - Jirds were given a chemoprophylactic inoculation of flubendazole (FMBZ) and then five injections of infective larvae of Brugia pahangi whilst still protected by the FMBZ. When the drug was thought to be non-effective the jirds (and controls) were given a challenge infection of B. pahangi larvae. By comparison with control jirds the treated-infected-challenged jirds had 40% fewer adult worms. The control treated-challenged jirds contained mostly sterile female worms showing that they were still partially protected by FMBZ but worms numbers were not significantly reduced as compared with untreated controls. PMID- 6501859 TI - Studies of Angiostrongylus cantonensis in two experimental hosts. AB - Lung infection with Angiostrongylus cantonensis was established in experimentally infected Indian soft-furred rats (Millardia meltada) and Indian spiny mice (Mus platythrix). Pulmonary arterial migration occurred earlier (at day 20 after infection) in M. meltada than in Wistar rats. M. meltada and M. platythrix could serve as useful animal models for comparative studies of mechanisms determining host specificity of A. cantonensis. PMID- 6501860 TI - Intestinal absorption of glucose in rats after continuous challenge with larvae of Nippostrongylus brasiliensis. AB - The rate of glucose absorption and metabolism and the associated fluid transfer of the small intestine of rats was measured in vitro using an everted sac technique after daily doses of 0, 5, 25 or 225 infective larvae of Nippostrongylus for periods of one to five weeks. Though there were occasional significant changes in the physiology of the intestine there were no obvious patterns or trends with respect to time at any infection level. This differs from the response after a single infection. The possible role of immune adaptation and reduced immunogenicity of the worms during repeated infections is considered. PMID- 6501861 TI - Observations on the infectivity and fecundity of a Sudanese isolate of Schistosoma bovis in albino mice. AB - A Sudanese isolate of Schistosoma bovis from experimentally infected sheep was found to be highly pathogenic to albino mice. Eggs were first found in the livers 42 days after exposure. The distribution of eggs in the liver and small and large intestines changed little during the course of infection. Results are compared with others using an Iranian isolate of S. bovis, which causes only a mild infection, and S. mattheei. PMID- 6501862 TI - Entrance of cholera enterotoxin subunits into thymus cells. AB - Analysis of the staining of cholera enterotoxin on the surface of cells with specific antibodies against each subunit of cholera enterotoxin, using a fluorescence-activated cell sorter and electron microscopy, showed that not only subunit A but also subunit B penetrates the cell membrane. The detection of subunits inside the cell was facilitated by the use of saponin, an agent that increases membrane permeability. PMID- 6501863 TI - Identification of glycoprotein storage diseases by lectins: a new diagnostic method. AB - The specific diagnosis of glycoprotein storage diseases is made by demonstrating a deficiency in enzyme activity or an elevation of undegraded oligosaccharides in cells or body fluids. Prospective sampling and expensive specialized biochemistry, which is also time consuming, are required for such studies. We used lectin reagents on paraffin-embedded tissue sections to identify the specific sugars in undegraded stored substances. We studied 22 cases of glycoprotein storage diseases and differentiated histochemically between alpha- and beta-mannosidosis, fucosidosis, and sialisidosis. Cells affected with alpha mannosidosis stained with Concanavalia ensiformis (Con A), Triticum vulgaris (WGA), and succinyl-WGA (S-WGA), while beta-mannosidosis cells did not stain with any of the lectins used. In fucosidosis the affected cells stained with Ulex europeus-I (UEA-I), while sialisidosis-affected cells stained with WGA, and in three cases with Arachis hypogea (PNA). This study indicates that lectin histochemistry provides a reliable specific diagnostic pattern for some glycoprotein storage diseases using a simple and inexpensive method. PMID- 6501864 TI - Histochemical detection and quantification of macrophages in rhesus and cynomolgus monkey atherosclerotic lesions. AB - A detailed histochemical study of the macrophage involvement during experimental atherogenesis in rhesus and cynomolgus monkeys was performed. Aortic, carotid, and femoral artery lesions were examined in both species after 4, 8, and 12 months of atherogenic diet feeding. Macrophages were identified and quantified in the atherosclerotic lesions using acid lipase, acid esterase, beta-galactosidase, and cytochrome oxidase histochemical procedures. Morphometric quantitation revealed that the cynomolgus monkey arterial lesions were larger and consistently demonstrated a greater number of cells with characteristics of macrophages in the intimal, medial, and adventitial portion of the arteries when compared to the primarily intimal rhesus monkey lesions. Biochemical assays of aortic samples for acid lipase and acid esterase activity also showed consistently higher activities in the cynomolgus samples when compared to the rhesus samples. Average serum cholesterol levels were higher in the cynomolgus monkeys than in the rhesus monkeys, but the differences in the arterial lesions still existed when animals with overlapping cholesterol levels were compared. Macrophages and their associated activities predominated in experimental cynomolgus monkey atherosclerosis when it was compared to the rhesus disease process, which may be an explanation for some of the differences in atherogenesis reported in these two species. PMID- 6501865 TI - Hypotensive effects in cats caused by horseradish peroxidase mediated by metabolites of arachidonic acid. AB - Horseradish peroxidase (HRP) given intravenously was shown to possess a marked hypotensive effect in cats. The effect was not noticeably influenced by antihistamines. Indomethacin and acetylsalicylic acid completely blocked the hypotensive effect of HRP. It is concluded that the effect of HRP on blood pressure is due to stimulation of the synthesis of metabolites of arachidonic acid. PMID- 6501866 TI - Afferent connections of the nucleus posterior thalami in the rat, with some evolutionary and functional considerations. AB - The afferents to the nucleus posterior thalami were investigated in the rat using the methods of retrograde and anterograde transport of horseradish peroxidase (HRP). The main afferents arise from the following structures: sensorimotor cortex, zona incerta, thalamic ventrobasal complex, pretectum, intermediate and deep layers of the superior colliculus, nucleus suprageniculatus, nucleus ruber and perirubral area, mesencephalic reticular formation, nucleus interstitialis of Cajal, nucleus tegmenti pedunculopontinus, nucleus reticularis pontis, sensorial and spinal tract trigeminal nuclei. There is some confusion about the anatomical localization and appellation of the posterior thalamic region among mammals. In most of them, however, the pattern of afferents to this area appears to be relatively homogeneous. We conclude that the projections to the thalamic posterior nucleus of the rat are similar to those reported in other mammals. This nucleus has been suspected of playing a role in the processing of somaesthetic or visual informations. On the basis of the multimodal nature of its afferents, a specific role of this nucleus is excluded. Instead, a non-specific function of modulation or integration is suggested. PMID- 6501867 TI - Astroglial-axonal interrelationship during regeneration of the optic nerve in goldfish. A freeze-fracture study. AB - The cytoplasmic membranes of astrocytes in the regenerating optic nerve of the goldfish were investigated by means of freeze-fracture technique. In contrast to avian and mammalian astrocytes the astrocytes in the fish white matter do not reveal the characteristic orthogonal particle assemblies. Whereas astrocytes hitherto were believed to be interconnected mainly by gap junctions, astrocytes in the optic nerve of the goldfish are additionally interconnected by prominent desmosomes and large tight junctions. The tight junctional strands are frequently intercalated by gap junctions. Astroglial membrane domains, which are directly juxtaposed to untreated myelinated optic fibers, are longitudinally deformed. The distance of these longitudinal grooves corresponds to the caliber of fibers associated with them. The intramembranous particles in these membranous domains are distributed randomly. During optic nerve regeneration, membranes of astrocytes associated with regenerating, still unmyelinated fibers are either longitudinally deformed or smooth. If deformed according to the axonal course the membrane shows a non-random distribution of intramembranous particles; if smooth, the membrane shows a random distribution of its particles. The non-random particle distribution in the astrocytic P-face is characterized by an impoverishment of particles along the concave groove and an enrichment of particles along the convexe bulge which corresponds to the wedge between two associated axons. This phenomenon is restricted to the regeneration period and disappears some weeks after recovery of vision. Then the astrocytic membranes which are associated to regenerated fibers are undulated nevertheless revealing a random particle distribution. It is suggested, that these findings reflect a glial-neuronal interrelationship characterized by the neuron as inductor and the glial cell as responder to axonal signals. The astroglial response to axonal signals would include the formation of attractive glial channels. The working hypothesis is proposed that the presence of orthogonal particle assemblies could contribute to a disturbed astroglial response in the mammalian central nervous system. PMID- 6501868 TI - Quantitative analysis of synaptic boutons on motoneurons of rhesus monkey spinal cord after chronic deafferentation due to cerebral lesions. AB - The motoneurons in the lateral nucleus of the anterior horn of the rhesus monkey cervical enlargement were reconstructed by light microscopy of semi-thin sections of 2 micro in thickness which were cut serially, alternately with ultra-thin sections for electron microscopy. Four single neurons were reconstructed with a computer graphic system, and simultaneously the synaptic boutons on the soma and each dendrite of single reconstructed neurons were analyzed quantitatively by electron microscopy. The synaptic boutons were classified into 4 types on the basis of the shape of the synaptic vesicles. The F-type boutons with flattened vesicles, S-type with spherical vesicles, G-type with cored vesicles and large L type boutons with smaller and polymorphic vesicles, were almost identical to the boutons categorized by Bodian (1966b). The F-type boutons represented the major type in terms of the covering ratio and synaptic population. The S-type boutons tended to occur more frequently on dendrites. The motoneurons of the same region were also investigated in a similar manner after chronic deafferentation by the ablation of the upper extremity area of the left cerebral cortex. F-type of boutons were significantly increased, especially on the dendrites, compared with the synaptic distribution of the normal motoneurons. PMID- 6501869 TI - Comparison of brain structure volumes in insectivora and primates. V. Area striata (AS). AB - Volumes of the area striata (area 17, Brodmann) were measured in 44 species of Primates and Scandentia and some of its laminar components in 25 species. The relative size (expressed by size indices) is on the average distinctly larger in simians than in isoponderous prosimians. The average dimensions of increase are 2.5 times for total area striata (ASV), 3.4 times for white matter (ASW), 2.35 times for grey matter (ASG), 1.9 times for lamina 1 (ASG 1) and 2.4 times for laminae 2-6 (ASG 2-6). The high increase of the white matter and the low increase of lamina 1 both correspond to similar results on the total neocortex (Frahm et al., 1982). The molecular layer (ASG 1) is on the average about 12% of the total area striata grey (ASG). The visual cortex thus has a narrower molecular layer than the neocortex as a whole, in which an average of 14% was found. The size indices of man are within the simian range and generally slightly above the simian average. Tree shrews have relatively small visual cortices, but reach into the lower part of the prosimian range. For Insectivora, ASG volumes were estimated from CGL volumes. According to these estimates, the relative ASG size is about 1/90 in shrews, about 1/40 in tenrecs and about 1/10 in hedgehogs that of isoponderous prosimians. In the European hedgehog, the area striata is about 12% of the total neocortex, a value similarly to that found in area measurements by Brodmann (1913). The relative size of the area striata is discussed with regard to functional, ecoethological and phylogenetic considerations. With increasing body weight, the increase in the visual structures, both cortical and non-cortical, is weak when compared with other brain parts and body organs (strongly negative allometry). PMID- 6501870 TI - Topographical differences of carboxylic esterases in the rhombencephalon and mesencephalon of the turtle (Lissemys punctata granosa). AB - The present contribution deals with histochemical mapping of acetylcholinesterase, butyrylcholinesterase and non-specific esterase in the rhombencephalon and mesencephalon of the turtle (L. punctata). The study reveals that all the neurons of this species are strongly positive for AChE, irrespective of their sensory or motor nature. The enzyme is localized in cell bodies and dendritic processes, while the axons are completely negative. Thus its presence in the fibrous components is not seen except in the superficial layers of optic tectum. Non-specific esterase activity is quite prominent in all the neurons, while the neuropil is weakly positive in most of the nuclei with a few exceptions. The blood vessels are strongly positive throughout the area. In sharp contrast to these enzymes. BChE is completely missing in all the constituents. PMID- 6501871 TI - Topography of cells responding with long latencies to flashes and cells projecting to layer I of area 17 in the rat dorsal lateral geniculate nucleus. AB - After deposition of horseradish peroxidase (HRP) crystals on the surface of cortical area 17 in 7 adult Wistar albino rats only relay cells were found to be labelled retrogradually in the caudal two thirds of the dorsal lateral geniculate nucleus (dLGN). From these results it can be concluded that cells projecting to the cortical layer I are concentrated in this part of the nucleus. Single cell recordings in the rat dLGN have shown that cells responding to light stimuli with long latencies are very frequent in this part of the dLGN, likewise. These findings support the idea that W-cells dominate in the caudal region of the rat dLGN, which is characterized by a population of relatively small geniculo cortical relay neurons (GCR-neurons). PMID- 6501872 TI - Ultrastructural and quantitative investigations of the spinal ganglia neurons after ligation of the abdominal aorta. AB - The structural changes in spinal ganglia neurons of dogs subjected to repeated 40 minute ligation of the abdominal aorta with 1-6 day survival were studied by means of electron microscopy and morphometry. The endoplasmic reticulum shows marked changes with a decrease of bound ribosomes as well as a reduction of the membranous component, especially in the peripheral zone of cytoplasm. There were frequently noticed local deposits of filamentous material. Qualitative and quantitative changes had the same time course, culminating on the second to third day of survival. Later [6 days] some signs of neuronal recovery can be observed. PMID- 6501873 TI - Use of an ammonia electrode to study bacterial deamination of amino acids with special reference to D-asparagine breakdown by campylobacters. AB - A method using an ammonia electrode is being developed for investigating the deamination of amino acids and amides by bacteria. Application of this method to Campylobacter jejuni and C. coli has led to the demonstration of D-asparaginase activity in some strains. This has allowed the subdivision of both species into D asparaginase-positive and -negative biotypes. Even though the method is in the developmental stage, it was found to be generally reproducible and easy to perform. Areas for further improving the procedure have been identified. The ammonia electrode offers the theoretical possibility of investigating the breakdown of any amino acid by bacteria. It thus opens up a new and practical approach for separating species and strains, particularly in those bacterial groups that are difficult to subdivide by conventional means. PMID- 6501874 TI - Surveillance of hepatitis B virus infection in Scotland, 1973-1982. AB - Since 1973 epidemiological surveillance of laboratory-confirmed hepatitis B virus infection has been undertaken in Scotland. During the ten-year period, 1973-82, 2893 persons with laboratory evidence of infection were reported and the number increased by almost threefold between the beginning and the end of this time. Males accounted for 66% of the patients and intravenous drug abuse was the most commonly encountered risk factor. The low risk to laboratory staff is confirmed, but among National Health Service hospital staff nurses accounted for 54% of those reported. PMID- 6501876 TI - Distribution of influenza viruses in Northern Greece during 1972-1983. AB - Observations on the circulation of influenza viruses in Northern Greece during the winters of 1972/3 to 1982/3 are presented. Influenza A viruses were detected every winter with the exception of those of 1973/4 and 1981/2, when neither type A nor type B was isolated. The strains of type A isolated during the study period were similar to those circulating world-wide over the same time scale. Influenza B viruses were isolated only during the winters of 1972/3 and 1979/80; influenza A viruses were also circulating in the community at those times. The B strains detected were similar to those recorded world-wide during the period of study. PMID- 6501875 TI - A comparison of three vaccines against respiratory syncytial virus in calves. AB - An inactivated vaccine against respiratory syncytial virus (RSV) was compared with two live vaccines. The inactivated (GC) vaccine consisted of glutaraldehyde fixed bovine nasal mucosa cells persistently infected with RSV and emulsified with oil adjuvant. The live vaccines were a modified virus (MV) derived from a bovine strain of RSV and a temperature-sensitive mutant (ts-1) derived from a human strain. The GC vaccine was inoculated subcutaneously into 12 calves and the live vaccines intramuscularly into eight calves each. Nine unvaccinated calves acted as controls. The vaccines were administered in two doses 3 weeks apart and all calves were challenged intranasally with 2 X 10(7) p.f.u. of bovine RSV 3 weeks after the second dose. At the time of challenge calves given GC, MV and ts 1 vaccines had mean serum neutralizing antibody titres of 25, 19 and 2 respectively; mean titres of IgG1 antibody by radioimmunoassay were log10 4.5, 1.3 and 2.6 respectively and mean zone areas by single radial haemolysis (SRH) were 107, 27 and 36 mm2 respectively. Eleven of 12 calves given GC vaccine were completely protected against challenge but all control animals and those given the two live vaccines were infected. The mean peak titre of virus in nasal swabs of control calves was 3.0 log10 p.f.u./ml and the mean duration of virus shedding was 6.8 days. Both these parameters were significantly reduced in animals given MV and ts-1 vaccines: mean peak titres were 2.1 and 2.4 log10 p.f.u./ml and mean duration of shedding was 3.4 and 3.3 days respectively. Thus, protection correlated better with RSV antibody detected by radioimmunoassay and SRH than with neutralizing antibody. These results are discussed in relation to the possible mechanism by which protection was mediated. PMID- 6501877 TI - Isolation of an English uukuvirus (family Bunyaviridae). AB - A virus of the Uukuniemi serogroup was isolated from various organs of a moribund kittiwake (Rissa tridactyla) and from ticks (Ixodes uriae) that were feeding on the bird. The kittiwake was found on Marsden beach, north-east England. This is the first virus in the family Bunyaviridae to have been isolated in England and only the second English arthropod-borne virus after louping ill virus, family Togaviridae (Smith & Varma, 1981). The possibility of infection of humans by uukuviruses is discussed. PMID- 6501878 TI - Epidemiological investigations on Campylobacter jejuni in households with a primary infection. AB - Fifty-four Rotterdam patients in which a primary infection with Campylobacter jejuni had been detected (index patients) were compared with 54 control subjects with regard to the consumption and preparation of foods 7 days before onset of illness and the keeping of pet animals. Significantly more index patients than controls had eaten chicken meat (47 v. 29; P = 0.0002), particularly at barbecues (14 v. 2; P = 0.0015). Marginally more index patients had eaten pork (47 v. 39; P = 0.048) or inadequately heated meat (13 v. 8), though in the last case numbers were too small to be statistically significant. The consumption of beef or mutton and outdoor eating (other than at barbecues) were essentially the same in both groups. There was no significant association with the keeping of pet animals, although a few more index patients had cage birds than controls (18 v. 12). Twenty-one (15%) of 136 household contacts of index patients also suffered from diarrhoea during the same period. Circumstantial evidence pointed to a common source of infection with the index patient in 13 instances (nine households) and probable intrafamilial spread of infection in six instances. Campylobacters were isolated from one of 110 swabs of kitchen work surfaces and eight of 107 swabs taken from lavatory bowls in index households. PMID- 6501879 TI - A search for the source of Campylobacter jejuni in milk. AB - Samples of milk from 1501 cows with mastitis were negative for Campylobacter jejuni. The faeces of 74 healthy Friesian cows were screened for C. jejuni: 13% of the samples were positive during the summer when the cows were on pasture, and 51% were positive in the winter when the cows were housed. Positive samples contained on average 1 X 10(4) campylobacters per g faeces. It is concluded that faecal contamination rather than udder infection is the means by which campylobacters enter milk and thereby infect man. PMID- 6501880 TI - Induction in rats of serum agglutinins to Eubacterium, Peptostreptococcus and Coprococcus species by the faecal flora from patients with Crohn's disease and healthy subjects. AB - Sera from patients with Crohn's disease more often than those from other subjects contain agglutinins against anaerobic coccoid rods, identified as Peptostreptococcus productus, Eubacterium contortum (two strains) and Coprococcus comes. The presence of antigens of the four coccoid rods in faeces of patients with Crohn's disease and healthy subjects was investigated by inoculation of rats with faecal suspensions. Antigens of the coccoid rods were detected in faeces from both patients with Crohn's disease and healthy subjects. PMID- 6501881 TI - Legionella pneumophila in aerosols from shower baths. AB - Routine examination of the water system in an establishment where showers were used by staff after work or leisure activities revealed the presence of Legionella pneumophila. Descaling and steaming cleared the system but six months later recolonization was found to have occurred. L. pneumophila was isolated from air samples collected in the shower room whilst the shower was in operation. No clinical cases have occurred. Serological examination of those using the showers throughout the six month period together with a control group showed no evidence of infection. PMID- 6501882 TI - The carriage of Corynebacterium suis in male pigs. AB - This investigation was designed to determine the prevalence of Corynebacterium suis in the preputial diverticulum of pigs of various age groups, located in different parts of the U.K., and to demonstrate whether the organism is transmissible between male pigs. C. suis was isolated from almost 90% of 224 adult males, distributed among 25 pig units in widely separated regions of the country and in 96% of 66 pigs aged 5-6 months originating from six different herds in East Anglia. The rate of isolation of C. suis from younger pigs depended, at least in part, on the system of husbandry practised. Thus, in one herd, A, in which young pigs were maintained in comparative isolation, none of 26 pigs aged 5-8 weeks harboured C. suis; however, in the same herd, the organism was isolated from 77% of 64 pigs aged 9-15 weeks which were in close contact with male pigs aged up to 6 months. In another herd, B, in which individual litters were housed in the same pen from birth to 5 months of age, C. suis was isolated once from only one of 36 pigs in the age range 5-17 weeks, sampled on two occasions, with an interval of 5 weeks between each sampling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6501883 TI - ELISA plaque assay for the detection of antibody secreting cells: observations on the nature of the solid phase and on variations in plaque diameter. AB - This report examines the basis for variations in the size and number of ELISA plaques detected in vitro. The nature and concentration of antigen used to coat the solid phase is shown to be critical, high concentrations of polymerized antigen being optimal for low molecular weight proteins, while coating conditions for high molecular weight multideterminant antigens are similar to conventional liquid ELISA. Variations in plaque diameter are shown to reflect maturational changes in the immune response, and probably indicate differences in the affinity of antibody being secreted within a population of plasma cells. PMID- 6501884 TI - A microenzyme-linked immunosorbent assay for urinary albumin, and its comparison with radioimmunoassay. AB - Interest in early albuminuria ('microalbuminuria') has intensified recently, particularly in the area of diabetes. We describe a sandwich type enzyme-linked immunoassay for urinary albumin and compare it with a conventional radioimmunoassay (RIA) using the same commercial antiserum. The assay ranges for ELISA and RIA were 7.5-500 micrograms/l and 20-5000 micrograms/l respectively and the corresponding sensitivities were 1.5 ng and 2.0 ng. The correlation coefficient between ELISA and RIA in the measurement of albumin in overnight urine samples from 74 children was r = 0.89 (P less than 0.001). ELISA has several practical advantages over radioimmunoassay, and we believe it has the potential to replace RIA in the screening and study of albuminuria. PMID- 6501885 TI - A microELISA Raji cell assay to detect immune complexes. AB - The Raji cell assay to detect immune complexes has been modified to a microtiter ELISA system. Raji cells were fixed to microplate wells, then reacted with serum samples or aggregated human IgG. Horseradish peroxidase-conjugated anti-human IgG was used to detect bound complexes. There was a linear relationship between aggregated IgG added and optical density reading, with less than 2 micrograms/ml of aggregated IgG readily detected. When applied to human serum this technique gave results comparable to those obtained with the standard Raji cell assay. The Raji micro-ELISA is simpler to perform than the standard assay, is equally reliable, and avoids the hazards of radioactivity. PMID- 6501886 TI - Specificity of cholecystokinin antibody may influence choice of tracer for radioimmunoassay. AB - When CCK33 was iodinated at His 20 with lactoperoxidase, the labelled hormone was less immunoreactive under radioimmunoassay conditions than CCK39 which is readily iodinated at Tyr 1. Since the difference in immunoreactivities could not be due to different degrees of oxidative damage, the regional specificity of the assay antibody (UT122, from the laboratory of J.C. Thompson, University of Texas) was re-examined. A synthetic parital sequence, CCK33 6-16, which had similar conformation to the same sequence in the intact peptide, as shown by CD analysis, was devoid of immunoreactivity. Results with sulphated and non-sulphated C terminal octapeptides of the hormone, CCK8 (CCK33 27-33), indicate limited dependence of the C-terminal region for binding to antibody. Thus, the lower binding with 125I-CCK33 than with 125I-CCK39 indicates that His 20 is an important feature of the immunogenic site and that the iodine atom is large enough to cause steric hindrance. This explains why the method of iodination might have to be varied depending on the regional specificity of antibodies. PMID- 6501888 TI - Measurement of primary in vivo IgM- and IgG-antibody response to KLH in humans: implications of pre-immune IgM binding in antigen-specific ELISA. AB - The antigen Keyhole Limpet Hemocyanin (KLH) is often used to test the primary in vivo antibody response capacity in humans. However, measurement of IgM anti-KLH antibodies in ELISA is complicated by the presence of natural antibodies in human serum. This problem occurs particularly at low antibody levels, i.e. after immunization with low doses of antigen and, under these conditions, it was found to be impossible to assess a dose-response curve by immunizing a series of individuals with different suboptimal doses of KLH. This problem was circumvented by choosing conditions for minimal binding of pre-immune IgM and to correct for such binding. Although signal-to-background ratios were markedly improved by modifying the ELISA conditions, pre-immune IgM still showed binding to KLH due to interaction with polysaccharide determinants. This non-specific binding was correlated with the total IgM content of the samples. When anti-KLH activities before and after immunization were expressed relative to total serum IgM, a significant correction was achieved, resulting in a diminished inter-individual variability with respect to both pre-immune and post-immunization values. As with IgG-class antibodies to KLH, virtually no binding was observed in pre-immune sera. After expression of the anti-KLH response as a ratio between the post immunization and pre-immunization titres, a dose of 50 micrograms was found to be sufficient to evoke a detectable IgG-antibody response in the 10 subjects tested. To elicit a positive IgM response, a minimal dose of 250 micrograms was required. PMID- 6501887 TI - Purification of monoclonal antibodies to human alkaline phosphatases by antigen immunoaffinity chromatography: comparisons of their molar binding values. AB - Antigen-immunoaffinity chromatography has been used to purify monoclonal antibodies to human alkaline phosphatases. The binding of the purified antibodies to various alkaline phosphatases was tested utilizing an electrophoretic titration assay. The results indicate that binding differences among the various ALPs seen with several of the antibodies are due to antigenic differences in the molecular structure of the enzymes. We define a molar binding value as the minimum molar concentration of antibody necessary to complex all of the ALP in a standard reaction mixture. These values varied widely, indicating marked differences in the avidities of the different antibodies. PMID- 6501889 TI - Non-specific binding of heat-aggregated IgG to histone detected by ELISA. AB - Anti-histone antibodies are currently detected by micro ELISA in systemic lupus erythematosus sera from humans, mice and dogs. Here we show that the control heated sera may bind non-specifically to the whole histones and histone fractions. The heated immunoglobulins binding to histones are mainly IgG and to a lesser extent IgA, but never IgM. These false positive ELISA reactions occurred only with aggregated IgG which binds to histones via Fc; IgM rheumatoid factor prevented their fixation. Immune complexes do not seem to interfere significantly in the detection of anti-histone antibodies with the ELISA test. PMID- 6501890 TI - Prevention of bridge binding effects in haptenic immunoassay systems exemplified by an iodinated radioimmunoassay for melatonin. AB - Antisera used in immunological assay systems for small molecular weight substances are routinely prepared by coupling the hapten to a carrier protein via a chemical linker. Often this bridge is partly recognized by the antibody, resulting in reduced sensitivity when an identically structured tracer (e.g. iodine-labelled) is used. Historically, the problem was solved by changing the linking structures in the tracer. An alternative way is exemplified by the development of a very sensitive and specific iodinated radioimmunoassay for melatonin. This new approach involves the design of a linkage identical in the tracer and the antigen that is both very short and closely resembling the structure of the analyte itself. PMID- 6501891 TI - Human monocyte adherence measured by the nylon fibre microcolumn technique. AB - A simple rapid method for the measurement of human monocyte adherence using nylon fibre microcolumns is described. The kinetics indicate the optimal contact time to be 30 min for monocytes, compared with 10 min for neutrophils. The optimal temperature is 37 degrees C; significantly low values were obtained for 4 degrees C and 45 degrees C, while intermediate values were obtained for 25 degrees C. Monocyte adherence was more sensitive to inhibition by fluoride than cyanide, suggesting that energy for adherence is mainly derived from the glycolytic pathway. The addition of phorbol myristate acetate enhances monocyte adherence. Significant decay in monocyte adherence occurred after isolation from whole blood for 24 h or longer. PMID- 6501892 TI - Kawasaki disease or mucocutaneous lymph node syndrome. Has it a microbial aetiology? PMID- 6501893 TI - Campylobacter enteritis among immunocompromised patients. PMID- 6501894 TI - Kawasaki disease: a report of 26 patients. AB - Twenty-six patients suffering from Kawasaki Disease (24 from the U.K. and two from the Netherlands) were reported and their details documented on a questionnaire returned by members of the British Society for the Study of Infection between 1981 and 1983. Seventeen of the children (65.4%) were presumed British extraction. The male:female ratio was 1.6:1.0 and their mean age 3.38 years. No seasonal variation was noted. The clinical and laboratory findings are detailed. Little evidence of infection was discovered. Two patients, both British, died of myocardial infarction (7.7%). Four of the 24 survivors had evidence of coronary artery abnormalities making a total of six (23.1%) of the total series of 26 patients to have coronary artery disease demonstrated. Of the three patients (11.5%) given corticosteroids, two died. The significance of these findings is briefly discussed. PMID- 6501895 TI - A comparison of biotypes and serotypes of Campylobacter sp. isolated from patients with enteritis and from animal and environmental sources. AB - The origin of sporadic campylobacter infections has been investigated by means of a collaborative study. From a total of 1152 cases reported in North West England in 1982, Campylobacter strains isolated during one month in each quarter of the year were biotyped and serotyped. For comparison, 875 strains of Campylobacter isolated from environmental and animal sources were similarly examined. Most strains from human beings were Campylobacter jejuni; about half of them were of three serotypes. Those serotypes commonly found in human infections were frequent among strains isolated from environmental and animal sources. PMID- 6501896 TI - Disseminated histoplasmosis. AB - A case of chronic disseminated histoplasmosis, presenting 16 years after returning to Scotland from West Bengal, is reported. The difficulties and pitfalls in diagnosis and management are emphasised. PMID- 6501897 TI - Pasteurella multocida infections in West Suffolk. AB - During the 3-year period 1980-1982, Pasteurella multocida was isolated from 19 patients, each with a history of animal contact. One patient, a slaughterman, whose exposure was occupational, developed meningitis. These case reports illustrate unusual features of human infections with this zoonotic pathogen. PMID- 6501898 TI - Salmonella osteomyelitis in a patient with systemic lupus erythematosus. AB - This paper describes a case of osteomyelitis due to Salmonella bovis morbificans in a patient with systemic lupus erythematosus (SLE) on long-term corticosteroid therapy. Although the organism was susceptible in vitro to chloramphenicol, ampicillin and co-trimoxazole, therapy with any of these drugs became impossible due to severe allergic reactions. A prolonged course of trimethoprim coupled with surgical debridement cured the lesion. The serum concentration of trimethoprim 24 hours after administration of a single oral dose of 300 mg was over four times the minimum inhibitory concentration (MIC) of the Salmonella sp. involved. These results indicate that trimethoprim may be effective in the treatment of Salmonella osteomyelitis. PMID- 6501900 TI - Infectious disease units. PMID- 6501899 TI - Clinically apparent rubella reinfection. AB - We report two cases of rubella reinfection in apparently immunocompetent young women. In both cases rubella-specific IgG had been detected on two occasions prior to an illness clinically diagnosed as rubella. Rubella-specific IgM was detected by various techniques in samples of serum collected at the time of the illness. PMID- 6501901 TI - Group G streptococcal septicaemia: clinical observations and laboratory studies. AB - The clinical features of Group G streptococcal bacteraemia in nine patients are reported. The serious nature of many of these infections was striking, with major embolic complications in all three patients with endocarditis. In this hospital, Group G streptococcal bacteraemia is now more common than that caused by Streptococcus pyogenes. Laboratory investigations included serotyping and antimicrobial susceptibility testing. Although the strains isolated were found to be sensitive to a broad range of agents, tolerance was observed to a varying extent with penicillin, erythromycin and vancomycin. The clinical significance of this observation remains to be determined. PMID- 6501902 TI - Pneumococcal serotyping and antigen detection in pneumococcal pneumonia of adults. AB - A retrospective study of 125 patients presenting to the City Hospital, Edinburgh, with proven pneumococcal pneumonia showed that pneumococcus serotype 3 remains the most prevalent and that since 1970 the distribution of serotypes has remained virtually constant. The frequency of diagnosing pneumococcal pneumonia is increased by the use of countercurrent immuno-electrophoresis (CIE) of sputum. In this series, 25 per cent of patients with negative sputum culture but radiological evidence of pneumonia, were diagnosed by means of this method, which was overall more helpful in making the diagnosis than blood cultures. All nine deaths in this series were in those over 65 years of age. PMID- 6501903 TI - Bacteraemia among children in hospital--a four year prospective study. AB - The incidence of bacteraemia in children (excluding newborn babies) admitted to a general hospital during the period 1978 to 1981 was 3.2 patients per 1000 admissions. Of the total, nosocomial bacteraemia comprised 0.7 patients per 1000 admissions. Analysis of some probable risk factors showed that the chance of acquiring bacteraemia in the first year of life was 6.8 times that for older children, the difference being statistically significant (P less than 0.001). The male to female ratio was 1.7: but this difference was not statistically significant. Overall the case mortality rate was 4.5%. For nosocomial bacteraemia the rate was much higher (14.3%) than that of community acquired bacteraemia (1.9%) with a risk of dying 7.5 times greater (P less than 0.01). Of the pathogens isolated 71.2 per cent were Gram-negative, Escherichia coli being the most common followed by Salmonella typhi. Among the Gram-positive organisms isolated, as well as overall, the pneumococcus was the most common pathogen. Pneumonia and gastroenteritis were the underlying conditions most often found. Since the pneumococcus was the most common pathogen, and in all of our patients originated in the community, physicians who treat in out-patient clinics as well as emergency rooms should be aware of this and look especially for the early symptoms and signs of disease likely to be caused by this organism. PMID- 6501904 TI - Hypothesis: cryptosporidiosis in human beings is not primarily a zoonosis. PMID- 6501905 TI - Lack of effect of influenza and pneumococcal vaccines on anticoagulation by warfarin. AB - The effects on anticoagulation of a purified trivalent sub-unit influenza vaccine and a 14-valent pneumococcal vaccine were investigated in a single-blind controlled study involving 69 well-stabilised warfarin recipients. There were no clinically or statistically significant alterations of anticoagulant control in vaccine recipients as compared with controls at 2, 7 and 21 days after vaccination. On the basis of these data, concern about warfarin-vaccine interaction should not deter practitioners from immunising warfarin recipients against influenza or infection with Streptococcus pneumoniae. PMID- 6501907 TI - Influenza B virus infection complicated by pneumonia, acute renal failure and disseminated intravascular coagulation. AB - The case is presented of a 14-year-old boy in whom influenza B virus infection caused pneumonia, acute renal failure and disseminated intravascular coagulation (DIC). Survival was achieved by prompt treatment of DIC with clotting factors and heparin. DIC should be diligently sought in severe viral infections because appropriate therapy may be life-saving. PMID- 6501906 TI - Granulomatous hepatitis in Yersinia enterocolitica bacteraemia. AB - Bacteraemia caused by Yersinia enterocolitica was associated in a 60-year-old diabetic man with right upper-quadrant abdominal tenderness and abnormal liver function tests. Biopsy of the liver demonstrated granulomas with acute necrosis. To the authors' knowledge, this is the first report of granuloma formation in the human liver associated with this infection. Yersinia enterocolitica should therefore be added to the list of organisms associated with granulomatous hepatitis in human beings. PMID- 6501908 TI - Chronic carriage of hepatitis B surface antigen following acute hepatitis B infection. PMID- 6501909 TI - [Organ donors: survey of 1000 persons]. AB - According to the french law, organs may be removed from all persons who have not, prior to their death, notified their opposition. The survey shows that 56% had not heard of the law, although 77% were willing to donate. There were marked differences in the answers of the different social groups, the lower groups being less informed and more reserved towards the idea of organ donation. The women asked were less willing than the men to donate their own organs or those of their families, and yet they said they had given more thought to this problem. Finally, although this survey was carried out in an area where there been widespread information on the subject, 94% considered that the public were not sufficiently informed. It is true that, of the 20% against donation, only 1 in 10 knew the practical possibilities for refusal. Could we not envisage a system, as exists in other countries, whereby the acceptance or refusal is mentioned on the identity card? We know in advance that 77% would be willing to donate. PMID- 6501910 TI - Ureteropelvic junction obstruction in children with renal ectopy. AB - Of 49 children with renal ectopy, 25 (51%) had hydronephrosis on excretory urography. Dilatation of the renal pelvis was the result of primary ureteropelvic junction obstruction (17 children), significant vesicoureteral reflux (6 children), or extrarenal pelves and calices with renal malrotation producing apparent ureteropelvic junction obstruction (2 children). Vesicoureteral reflux was a common finding in these patients, occurring in 52% of those with crossed renal ectopy and in 70% of those with pelvic kidney. The need for surgical intervention results from either (1) ureteropelvic junction obstruction secondary to high insertion of the ureter on the renal pelvis or (2) vesicoureteral reflux secondary to aberrant migration of the lower ureter. Most children with renal ectopy and ureteropelvic dilatation require surgical reconstruction at the renal level. In selected patients, ureterocalicostomy is an attractive alternative to conventional pyeloplasty and appears to afford improved drainage with superior results. PMID- 6501911 TI - Air embolism, a new complication of percutaneous nephrolithotomy. What are the implications? AB - We report a single case of air embolism following air pyelography in a patient undergoing percutaneous nephrolithotomy. The significance of this finding and the implications for gas nephroscopy and the use of irrigants, stone solvents, coagulants and local anaesthetics are discussed. PMID- 6501913 TI - Beta adrenoceptor blockade in the treatment of female urinary stress incontinence. AB - Previous pharmacologic studies have shown that the adrenergic system has a definite role in urinary continence. For this reason sympathomimetic agents have been used to treat stress urinary incontinence. Similarly, beta adrenoceptors blockade has been shown to be of value in achieving continence in a small group of patients. This study presents the successful results of using a beta blocker (Propranolol) in the treatment of 23 female patients suffering from stress urinary incontinence. The enhanced urodynamic response shown, particularly in the erect position, to this drug could be due to the unopposed effect of alpha adrenoceptors following beta adrenoceptors blockade, thus suggesting the presence of significant numbers of such beta adrenoceptors in the female bladder outlet and proximal urethra. PMID- 6501912 TI - [Sarcomatoid carcinoma of the kidney]. AB - Sarcomatoid renal carcinoma is an uncommon renal malignancy with an aggressive biological behaviour and very poor survival rate. We treated lately 4 patients, three of which died shortly after the operation. The case reports are presented and the histology and the clinical implications are discussed. PMID- 6501914 TI - [Vaginal approach to non-irradiated vesicovaginal fistula]. AB - We herein report our experience in the transvaginal repair of 30 consecutive cases of non-radiated Vesicovaginal Fistulae. The new principles applied include: early surgery as soon as the fistula is recognized, no excision of the fistulous tract to avoid retraction and bleeding of the margins as well as to provide protection of the ureteric orifices, closure of the intact fistula in two layers, rotation and advancement of the vaginal flap to cover the fistula avoiding overlapping of suture lines, and finally assurance of adequate bladder decompression with both a suprapubic tube and an urethral catheter. In the followup period of 6 to 72 months, we experienced a 94% success rate at primary repair with only two failures which are now dry after subsequent trans-vaginal closure. In spite of size, location or proximity to the ureteric orifices, the vaginal approach has proved to be amenable in all cases with minimal discomfort for the patient, a shorter hospital stay and equal or even better results than the more extensive abdominal approach. PMID- 6501915 TI - Unusual clinical presentation of metastatic prostatic carcinoma in elderly patients. AB - Three elderly patients with unusual symptoms of metastatic prostatic carcinoma are presented. The first patient suffered from recurrent acute renal failure, the second presented with induration of penis, and in the third patient an acute onset of paraparesis was the presenting symptom of prostatic cancer. The incidence of such symptoms is reviewed and the importance of early diagnosis and therapy is discussed. PMID- 6501916 TI - Efficacy of dry powders from Bacillus sphaericus: RB 80, a potent reference preparation for biological titration. PMID- 6501917 TI - Chronobiological aspects of the host-parasite relationships between Biomphalaria glabrata and Schistosoma mansoni: cercarial production and infectivity, and growth kinetics of the host. PMID- 6501918 TI - Purification of the toxic protein from Bacillus thuringiensis serotype 10 isolate demonstrating a preferential larvicidal activity to the mosquito. PMID- 6501919 TI - Defense reactions of mosquitoes to filarial worms: comparative studies on the response of three different mosquitoes to inoculated Brugia pahangi and Dirofilaria immitis microfilariae. PMID- 6501920 TI - Defense reaction of mosquitoes to filarial worms: role of the microfilarial sheath in the response of mosquitoes to inoculated Brugia pahangi microfilariae. PMID- 6501921 TI - Histopathological effects of bisazir and triphenyl tin chloride on the ovary of Periplaneta americana (Blattaria: Blattidae). PMID- 6501922 TI - UV irradiation and cutaneous vitamin A: an experimental study in rabbit and human skin. AB - The effect of UV irradiation on the concentration of cutaneous retinoids (retinol and 3-dehydroretinol) in rabbit skin in vivo and in human skin in vitro was investigated. Irradiation with 4 different narrow-wavelength bands produced dose dependent reductions of retinol in epidermis and dermis. The maximal effect was obtained at 334 nm, a wavelength which coincides with the absorption maximum for retinol in organic solutions. 3-Dehydroretinol was not reduced to the same extent as was retinol. In human skin the photodecomposition of retinol was most extensive in epidermis and progressively less so in dermis, presumably reflecting the extent to which 334 nm radiation penetrates the tissue. The regeneration of cutaneous retinol took over a week in the rabbit. The nutritional and biologic implications of the UV-induced reduction of cutaneous retinol remain to be established. PMID- 6501923 TI - Factor XIII inhibits epidermal cell migration in vitro. AB - The effect of a factor XIII preparation on active epidermal cell migration in vitro has been studied using both floating and attached types of human skin explants in short-term maintenance cultures. In both types of experiment the factor XIII preparation proved to have an inhibitory effect on epidermal cell migration in a dose-dependent fashion. This effect was shown to be independent of both the presence of fibrin and the concentration of calcium ion in the medium. The preparation also showed inhibition of the proliferation of epidermal cells in cell culture. PMID- 6501925 TI - Curbside consultation in infectious diseases: a prospective study. AB - This study prospectively evaluates curbside (unofficial, informal) consultation (CSC) directed to the hospital-based Infectious Disease Consultation Service (IDCS) in a 1,000-bed university-affiliated, general teaching hospital. Official consultation (OC) was neither solicited nor discouraged. During a one-year period, the IDCS was consulted officially about 532 patients (503 inpatients, 29 outpatients) and unofficially about 269 patients. Only 31 (11.5%) of the 269 CSCs subsequently resulted in OCs. Problems discussed during a CSC ranged from simple to complicated and life threatening, with pneumonia, hepatitis, and syphilis being the illnesses most frequently discussed. Forty-two percent of the CSCs were sought by the internal medicine housestaff, whereas approximately 29% were sought by internal medicine staff physicians. It may be concluded that a CSC in infectious diseases is common, that it sometimes involves complicated and/or life threatening illnesses but usually does not result in a subsequent OC, and that it requires a considerable expenditure of time by the Infectious Disease Service. A CSC may also involve the exchange of inaccurate or insufficient information between inquiring physicians and the Infectious Disease Service. PMID- 6501924 TI - Histologic changes produced by 2,3,7,8-tetrachlorodibenzo-p-dioxin in the skin of mice carrying mutations that affect the integument. AB - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) produces epidermal hyperplasia and hyperkeratosis, squamous metaplasia of the sebaceous gland, and keratinized cyst formation in 8 strains of mice with the recessive mutation, hairless (hr/hr). The extent of these histologic changes is dependent on the genetic background. No cutaneous lesions are produced in haired (hr/+) mice. In examination of mice with 7 other mutations affecting the integument, TCDD produced similar histologic skin changes in cryptothrix, nude, plucked, and atrichosis; a marginal squamous metaplasia of sebaceous glands in Repeated epilation, and had no effect in fur deficient and Naked mutants. These genetically determined epidermal responses are discussed in light of the mechanism of action of TCDD. PMID- 6501927 TI - Live attenuated influenza A virus vaccines in children: results of a field trial. AB - One hundred three young children were inoculated intranasally with either influenza A/California/10/78 cold-recombinant vaccine (10(6.7) 50% tissue culture infective doses [TCID50] per child), CR-37 (H1N1), or influenza A/Washington/897/80 cold-recombinant vaccine (10(6.5) TCID50 per child), CR-48 (H3N2). The vaccine was well tolerated. Of the 51 children vaccinated with CR-37 (H1N1), 45 were initially seronegative for this virus; 33 of the 45 became infected with the vaccine virus, as indicated by a fourfold rise in antibody titer or by shedding of vaccine virus. Of the 52 children vaccinated with CR-48 (H3N2), six were initially seronegative and all were infected; 46 were initially seropositive and 25 of these children developed fourfold rises in antibody titer. An outbreak of influenza A (H3N2 type predominated) occurred in Huntington one to three months after the children were vaccinated. Significantly fewer febrile illnesses occurred in the CR-48 (H3N2) vaccine group than among the CR-37 (H1N1) vaccine group. Hemagglutination inhibition antibody (titer, greater than or equal to 1:32) to H3N2 was significantly associated with protection from illness and infection with influenza A/H3N2. PMID- 6501926 TI - The use of an antibiotic order form for antibiotic utilization review: influence on physicians' prescribing patterns. AB - An antibiotic order form was implemented for all inpatient antibiotic orders at an 800-bed hospital in April 1981 to provide an ongoing, concurrent audit of antibiotic use. The prescribing physician provided the clinical indication for the antibiotic order, and individual patient treatment courses were identified. During the 25-month study period, cephalosporins, penicillin plus ampicillin, and aminoglycosides accounted for 44%, 22%, and 17% of all treatment courses, respectively. Sixty-nine percent of first-generation cephalosporin treatment courses were for prophylaxis, whereas the remaining antibiotics were used for either empirical therapy or documented infection in 56%-79% of cases. After the introduction of the antibiotic order form, there was a significant decline in both the number of antibiotic treatment courses (P = .025) and the percentage of patients receiving any antibiotic (P = .007). We conclude that a specialized antibiotic order form is an effective method for antibiotic utilization review and can have a significant impact on a physician's prescribing patterns. PMID- 6501929 TI - Studies of echovirus-12 in volunteers: determination of minimal infectious dose and the effect of previous infection on infectious dose. AB - A two-part study of echovirus-12 was done in volunteers. In the first part the human infectious dose of the virus was determined in 149 healthy adults with undetectable serum antibody, each of whom drank 0-330,000 plaque-forming units (pfu) of virus in 100 ml of nonchlorinated water. Infection was defined as fecal shedding of virus or significant (fourfold or greater) increases in serum antibody titer. The HID50 (i.e., the dose required for infection of 50% of the volunteers) was 919 pfu. Through statistical analysis of the data by probit transformation, a 1% human-infectious dose of 17 pfu was predicted. These results were used in the second portion of the study to determine the effect of previous infection on the infectious dose. Previously infected volunteers (those with neutralizing serum antibody) were given a dose of echovirus-12 (1,500 pfu) that had been found to infect 60% of persons with undetectable serum antibody. The presence of serum antibody caused no significant change in the percentage of volunteers infected by this dose. Furthermore, the concentration of serum antibody did not affect the rate of infection or the duration of viral shedding. These results indicate that previous infection with echovirus-12 does not provide lasting protection against reinfection. PMID- 6501928 TI - Avian-human reassortant influenza A viruses derived by mating avian and human influenza A viruses. AB - Reassortant influenza A viruses were produced by mating an avian virus (A/Mallard/NY/78, A/Mallard/Alberta/78, or A/Pintail/Alberta/79) with a wild-type human influenza A virus. From each mating a reassortant virus was obtained that contained the genes coding for the hemagglutinin and neuraminidase surface antigens of the human influenza A wild-type virus and the six other RNA segments ("internal genes") of the avian influenza A virus parent. The avian-human reassortant influenza viruses produced resembled their avian virus parent in that they produced plaques on MDCK monolayers at 42 C, a temperature restrictive for the human influenza viruses. In the trachea of squirrel monkeys, each avian-human reassortant influenza virus was as restricted in its replication as was its avian influenza virus parent. Thus, one or more of the six internal genes of each avian parent virus was responsible for restriction of the reassortant virus in monkeys. The A/Washington/80 X A/Mallard/NY/78 reassortant virus retained its phenotype of restricted replication in monkeys after five serial passages in vivo. It also failed to transmit to cagemates or induce resistance to wild-type virus challenge, and it did not initiate a systemic or enteric infection. These findings form the basis for evaluation of these attenuated avian-human reassortant influenza A viruses as live attenuated vaccines for humans. PMID- 6501930 TI - Frequency and duration of patient-observed recurrent genital herpes simplex virus infection: characterization of the nonlesional prodrome. AB - For assessment of the natural history of patient-observed episodes of genital herpes, 32 patients with culture-proven, recurrent herpes were studied during 340 disease episodes for approximately seven and one-half months. Prodromes were experienced by 29 patients (90.6%) in 201 episodes (59.1%). Nonlesional prodromes were observed in 67 episodes (19.7%) and occurred at least once in 14 patients (43.8%). Vesicles were more likely to occur in men, wet ulcers in women. When all episodes were considered, the time to total healing was 5.65 +/- 3.73 days. Excluding episodes of nonlesional prodrome, the time to total healing was 6.83 +/ 3.7 days. Nonlesional prodromes occur commonly and usually resolve without therapy. Recurrent disease as observed by the patient is shorter than recurrent disease as observed in the clinic; this observation may affect the outcome of patient-initiated therapeutic trials. PMID- 6501931 TI - Distribution and spread of colonic lesions in shigellosis: a colonoscopic study. AB - In a study of the distribution and severity of colonic lesions in patients with shigellosis, colonoscopy was performed for 33 men with this disease. All 33 patients had inflammatory lesions in the rectosigmoid area; in 18 (55%) the lesions extended to the splenic flexure, in 14 (42%) the disease extended to the distal transverse colon, in nine (27%) the area of involvement included the proximal transverse colon, and in five (15%) pancolitis was evident. In most patients lesions were continuous and diffuse, with the intensity of inflammation decreasing in a proximal direction. Biopsied samples from proximal lesions usually showed less severe inflammation than did those from more distal lesions. Aphthoid erosions, which have not previously been described in shigellosis, were observed in five patients. Proximal colitis was associated with diarrhea of four or more days' duration (P less than .01, Fisher's exact test). These findings indicate that the rectosigmoid is the most frequently and most severely affected area of the colon in shigellosis and suggest that during the course of shigella infection, colonic lesions extend in a proximal direction. PMID- 6501932 TI - A whole-blood lymphocyte stimulation test for the diagnosis of human tularemia. AB - A whole-blood lymphocyte stimulation test was used in the diagnosis of 200 cases of tularemia. Ninety-one of the patients involved had ulceroglandular infection, 81 had pulmonary infection, 13 had glandular infection, four had oropharyngeal infection, and one had oculoglandular infection. The clinical picture was obscure in the remaining 10 cases. Results of the lymphocyte stimulation test became positive in 21.3% of cases during the first week, when an agglutinating titer of greater than or equal to 1:80 was found in 2.1% of patients. During the second week, these proportions were 96.8% and 53.3%, respectively. In only one patient with tularemia (0.5%) did the stimulation test result remain negative, and only one (0.5%) of the 211 control patients had a positive result in the first test. The development of cell-mediated immunity followed the same pattern in patients with ulceroglandular tularemia as in those with pulmonary tularemia. PMID- 6501933 TI - Observations on the measurement and evaluation of endotoxemia by a quantitative limulus lysate microassay. AB - A quantitative microassay for bacterial endotoxin in whole blood, based on Limulus amebocyte lysate gelation and involving the use of a chromogenic substrate, was studied. The lower limit of detection was 10 pg/ml, and the mean level of recovery from plasma spiked with 1 ng of endotoxin/ml was 0.93 ng/ml. At clinically significant levels endotoxin was more easily recovered from plasma than from serum. Platelet binding had no adverse effect on the assay. Despite the use of conventional methods for the removal of nonspecific activators and inhibitors, simultaneous assay of six specimens spiked with the same amount of endotoxin resulted in variation in recovery by greater than 100%. These experiments may explain in part the conflicting results of studies of endotoxemia in humans. PMID- 6501934 TI - An outbreak of mouth ulcers in an institution for mentally retarded persons. PMID- 6501935 TI - Yersinia enterocolitica septicemia during long-term immunosuppressive treatment. PMID- 6501936 TI - Serum lipids in patients with leptospirosis. PMID- 6501937 TI - Caterpillar infestation in a diabetic patient. PMID- 6501938 TI - Intestinal parasites in Haitian entrants. PMID- 6501939 TI - Genetic control of neutralizing antibody response to mouse interferon in rats. AB - Various strains of rats were immunized weekly with mouse interferon (IFN containing both IFN-alpha and IFN-beta). Their sera were examined for the ability to neutralize the antiviral activity of IFN in a microtiter assay. DA and ACI (RT 1a), BN (RT-1n), and WF (RT-1w) strains of rats produced anti-IFN antibodies after a minimum of four inoculations. In contrast, neither Lewis (RT-1l) nor Buffalo (RT-1b) strains of rats produced any detectable anti-IFN antibodies even after 12 weekly inoculations of IFN. This lack of responsiveness could not be overcome by immunization in the presence of Freund's complete adjuvant. The genetic basis of this difference in antibody response was examined using F1 and back-cross generations of rats. Both (ACI X LEW) F1 and (LEW X ACI) F1 rats produced titers of anti-IFN antibody intermediate to the parental strains. No maternal or paternal effects were observed. Results from the back-cross generation of F1 rats to the parental strains suggested that although the major histocompatibility complex may be a factor in control of this response, other genes are also involved. PMID- 6501940 TI - Antiproliferative activity of human interferons against ovarian cancer cells grown in human tumor stem cell assay. AB - Fresh biopsies from 14 of 22 (64%) ovarian carcinomas cultivated in the human tumor stem cell assay (HTSCA) were sensitive (greater than 70% inhibition in cell growth) to human interferons (HuIFNs). To achieve 70% inhibition of colony growth, 500 units/ml of a naturally produced IFN-alpha or IFN-alpha A were required in 71% of the sensitive specimens. The antiproliferative potencies of five IFNs were evaluated including two native alpha IFNs, two highly purified cloned subtypes of IFN-alpha, IFN-alpha D and IFN-alpha A, and one native fibroblast-derived beta interferon (IFN-beta). The antiviral activity of the IFN alpha as determined by a human cell target correlated with their relative antiproliferative action. IFN-alpha D had minimal inhibitory effect at the highest concentration tested, while three IFN-alpha with high antiviral activities were equivalent with respect to growth inhibition in the HTSCA. Although instability could not be eliminated as a contributing factor, IFN-beta had significantly less growth inhibitory potency for cells from ovarian cancers when compared simultaneously with native IFN-alpha in the human tumor stem cell assay (HTSCA). Assuming direct antiproliferative effects are primary, future clinical trials evaluating IFN-alpha in ovarian cancer may require high titers of IFN. PMID- 6501941 TI - Interferon-mediated protein kinase activity in different fractions of mouse L-929 cells. AB - The interferon (IFN)-mediated protein kinase activity in extracts from mouse L 929 cells is manifested by the phosphorylation of an endogenous 67 kD molecular weight (mw) protein in the presence of double-stranded (ds) RNA. This protein kinase activity can also be assayed after partial purification on poly(I) X poly(C)-Sepharose under phosphatase-free conditions. By the use of this latter technique, here we investigated the distribution of the protein kinase activity in different cellular compartments. Most of the protein kinase activity is found in the post-ribosomal supernatant (S100) fraction, while a small portion of it is associated with the ribosomal salt wash (RSW: 0.5 M KCl eluate of ribosomal pellet) and nuclear fractions. These results are in contrast to several observations in the literature in which the protein kinase activity is thought to be associated with the ribosomal pellet. This controversy results from the conditions used for assay of the protein kinase activity. In fact, when the kinase is assayed in crude extracts supplemented with dsRNA, very little kinase activity is detectable in the S100 fraction compared to the RSW fraction. The S100 fraction contains a high level of phosphatase(s) activity which interferes with the protein kinase assay and might account for the misinterpretation observed in the literature. Some recent results have implicated a correlation between the dsRNA-dependent protein kinase responsible for the phosphorylation of the 67 kD protein and a polyamine-dependent protein kinase which phosphorylates a similar molecular weight protein, subunit of ornithine decarboxylase (Orn Dcase). Here, we show that Orn Dcase does not bind to poly(I) X poly(C)-Sepharose and polyamines do not substitute the requirement of dsRNA for the phosphorylation of the 67 kD protein. PMID- 6501942 TI - Use of 125I-interferons in pharmacokinetic and tissue distribution studies. AB - The in vivo fate of radiolabeled recombinant human leukocyte A interferon (125I rIFN-alpha A) and intramolecular hybrid A/D (125I-rIFN-alpha A/D Bgl) were studied, following iv injection into CD1 mice. Trichloroacetic acid (TCA) precipitable radioactivity, as well as antiviral activity, were measured in sera and several organ extracts. The results obtained by bioassay were very similar to those obtained by measuring the TCA precipitable radioactivity. The kidney and liver showed preferential uptake of these 125I-IFNs. These studies indicate the feasibility of using radioiodinated IFNs in tissue distribution and pharmacokinetic evaluations. PMID- 6501943 TI - Effects of interferon alpha on the sheep erythrocyte "receptor" of human lymphocytes. AB - The percentage of peripheral blood lymphocytes (PBLs) which formed rosettes with sheep erythrocytes declined from 62 +/- 2% to 29 +/- 4% (p = 0.001) when PBLs were incubated 18 h at 37 degrees C. In the presence of alpha interferon (IFN alpha), a dose-dependent increase occurred in the percentage of sheep erythrocyte binding PBL at the end of incubation compared with PBL incubated without IFN alpha. Change in the number of sheep erythrocyte "receptors" (SER) probably did not account for the observed modulation of rosetting capacity, since the frequency and density of an SER-associated determinant (T11, as defined by immunofluorescence flow cytometry using the monoclonal antibody OKT11A) was unaffected by incubation with or without IFN-alpha. Treatment of PBL, control or IFN-alpha-treated, with neuraminidase (0.4 u/ml), restored rosetting capacity to levels characteristic of freshly prepared PBL. Neuraminidase did not affect rosetting or T11 expression by freshly prepared PBL, nor did it affect T11 expression on PBL cultured with or without IFN-alpha. We thus postulated that steric interference with SER function by sialic acid residues might result from de novo protein synthesis and glycosylation at the cell surface. Inhibition of either protein glycosylation by tunicamycin or protein synthesis by cycloheximide prevented the incubation-induced depression of rosetting capacity. IFN-alpha may modulate functional expression of SER and other surface receptors by altering cell-surface glycoprotein composition and distribution. PMID- 6501944 TI - Enhancement by phorbol esters of cell growth inhibiting action of interferon. AB - When human transformed RSa cells were treated simultaneously with potent tumor promoter 12-O-tetradecanoyl-phorbol-13 acetate (TPA) and interferon (IFN) (20-100 IU/ml) at the concentration which suppresses the multiplication of cells slightly, distinct synergistic suppression of cell growth was observed. Synthesis of DNA in these cells was reduced in proportion to the concentration of IFN and it was more strongly reduced by combined treatment with IFN and TPA. When IFN was pretreated with anti-IFN serum, such synergistic effect was not observed. Highly purified IFN (specific activity, 2 X 10(8) U/ml) together with TPA elicited almost the same synergistic effect on RSa cells. Similar concentration of phorbol 12,13-didecanoate (PDD) also produced synergistic effects with IFN on RSa cells. In contrast, phorbol (PHR), which lacks tumor promoting activity, did not produce such synergistic effects even at a concentration of as high as 500 ng/ml. In the case of HeLa cells and IFN-resistant IFr cells, only an additive effect was observed. Effect of TPA on the antiviral action of IFN against VSV was tested and there was almost no influence of TPA on IFN action. In accordance with these results, 2-5A synthetase activity was not induced by TPA treatment and the level of enzyme action did not change significantly by the combined treatment with TPA and IFN. PMID- 6501945 TI - Antiproliferative effect of natural beta interferon on fresh tumor cells analyzed in a clonogenic assay. AB - Natural beta interferon (beta IFN), derived from diploid fibroblasts, has been evaluated for its antiproliferative activity using a panel of twelve different histologic types of fresh human tumor cells. Thirty-nine percent (9/23) of the tumors showed a 70% or greater decrease in colony formation following exposure to 500 international reference units per ml of natural beta IFN, a concentration which is in the clinically achievable range. Interesting, is that leiomyosarcoma, a tumor relatively resistant to conventional chemotherapy, was uniformly sensitive (3/3) to natural beta IFN. Indeed, the antiproliferative activity of beta IFN was consistently superior (in 19/20 comparative assays) to the other conventional chemotherapeutic drugs evaluated for leiomyosarcomas. This study, which suggests that natural beta IFN exhibits significant antiproliferative activity on a variety of fresh human tumor cells, may be useful in orienting clinical trials with natural beta IFN (still in limited supply because of its unique physicochemical nature) to the more susceptible human malignancies. PMID- 6501946 TI - [Surgical treatment of infective endocarditis]. PMID- 6501947 TI - [Hemodynamic changes of left atrial myxoma by the operation]. PMID- 6501948 TI - [The effect of myocardial temperature on experimental myocardial protection]. PMID- 6501949 TI - [Interrupted aortic arch: the clinical study on factors influencing to improve surgical survivals]. PMID- 6501950 TI - [Surgical treatment and prognosis of thymoma: analysis of 117 cases]. PMID- 6501951 TI - [Mitral valve replacement in a case of Ehlers-Danlos syndrome]. PMID- 6501952 TI - [A case of flow reversal and thromboexclusion by ascending aorta-bilateral femoral artery bypass and permanent aortic clamp for extreme type of DeBakey III dissecting aneurysm]. PMID- 6501953 TI - [Needle in the left ventricle: report of a case with successful removal]. PMID- 6501954 TI - [The tracheal resection associated with subtotal esophagectomy for carcinoma of the esophagus--using intrathoracic application of the latissimus dorsi muscle flap]. PMID- 6501955 TI - [Successful surgical repair for ruptured dissecting aneurysm of descending thoracic aorta with severe hemorrhagic shock]. PMID- 6501956 TI - [A successful emergency operation in a patient with late active bioprosthetic valve endocarditis occurring 4 years later following Bentall's operation and mitral valve replacement]. PMID- 6501958 TI - [Chylothorax following median sternotomy for congenital heart disease]. PMID- 6501957 TI - [A case of juvenile aneurysm of the descending aorta with aberrant right subclavian artery]. PMID- 6501959 TI - [A trial case of fibrous sarcoma occurring after surgery to invert sternum]. PMID- 6501960 TI - [Clinical experiences of long time extracorporeal circulation with newly designed assist device]. PMID- 6501961 TI - [Ventricular volume of single ventricle before and after aortopulmonary shunt operation]. PMID- 6501963 TI - [Evaluation of surgical treatment for metastatic lung tumor]. PMID- 6501962 TI - [Surgical treatment of thoracic aortic aneurysm]. PMID- 6501964 TI - [Abstracts of papers presented at the 57th annual meeting of the Japanese Biochemical Society. 6-8 October 1984, Tokyo]. PMID- 6501965 TI - [Studies on the relationship between quantitative histometry and obstetric complications]. AB - Quantitative histometry of the placenta seems to make it possible to correlate the histopathological changes with various obstetric complications and disorders more precisely. In the present paper, the relationship between the histopathological changes in the placenta and the obstetric complications was investigated by quantitative histometry based on the standardized categories with uncomplicated normal cases as the controls. Among the obstetric complications, special emphasis has been placed on the pregnancies complicated by toxemia of pregnancy and diabetes mellitus. The obstetric disorders of postmature pregnancy and prolonged delivery have also been related to the quantitative histometry. It was revealed that the cytotrophoblast proliferation associated with the formation of syncytial knots was a very common finding both in toxemia and in these obstetric disorders. However, there was a great difference between the two in that impairment of the vasculature was highly specific in the placentae in the case of toxemia. The most conspicuous histopathological change recognized in the placentae due to diabetes was villous edema, which would be due to the osmotic imbalance. However, it is so unusual to find cases complicated by severe diabetes that typical villous edema is rarely observed. The quantitative approaches in the field of histopathology may leave some problems in that the specimens taken from the organ could not always be representative of the whole organ. However, quantitative histometry based on the fairy standardized categories has been shown to offer more promising information on the relationship between the histopathological changes in the placentae and the obstetric disorders. PMID- 6501966 TI - [Effects of autonomic blockades, beta-adrenergic agent and cholinergic agent on the FHR variability of "Shiba goats"]. AB - The effects of atropine, propranolol, isoproterenol and acetylcholine on the fetal heart rate variability were studied using chronically prepared fetal goats. When atropine, propranolol and atropine-propranolol were injected the STVs decreased by 45.2%, 43.2% and 57.3%, respectively; LTVs also decreased by 72.3%, 52.2% and 73.3%, respectively. STVs and LTVs increased by 39.5% and 34.5% with the injection of isoproterenol, and decreased by 27.6% and 22.7% with acetylcholine. These results suggest that FHR variability represents a change in the heart rate due to reciprocal innervation of adrenergic and cholinergic systems; moreover, the activity of the heart itself exerts some influence on variability. It is also suggested that LTV more strongly reflects autonomic nervous tone whereas STV more strongly reflects heart activity. PMID- 6501967 TI - [A morphological study on the placenta in toxemia of pregnancy]. AB - The morphological changes in 64 placentas in toxemia of pregnancy were studied by means of histological (HE, Azan and PAM stains) and morphometrical methods. The author tried to compare these results with inter-typical differences in toxemia classified into H, P and PH type according to the main symptoms, and examined the influence of these results on fetal development. The histological findings were as follows: In comparison with the inter-typical differences, fibrin deposition, damaged basement membrane and swelling of the endothelial cells of villous capillaries were conspicuous in P and PH types. However, prominent syncytial knots, stromal fibrosis and villous atrophies were main findings in H type. The morphometrical findings were as follows: On evaluation of the results of the point count method, both the intervillous space and the volume of the terminal villi decreased in proportion to the degree of toxemia. On evaluation of the results obtained with the Digigramer-G (Mutoh Kohgyo Co. Ltd., Tokyo), the cross sectional area of terminal villus, the area of the capillary lumina and the number of capillaries per villus showed the same tendency as the results obtained with the point count method. Thus the severity of morphological changes in the toxemic placenta correlated with the extent of fetal development. PMID- 6501968 TI - [Estrogen biosynthesis in human uterine myoma tissue. The distribution of androstenedione aromatase activity in uterine myoma tissue]. AB - Although it is well known that the development of uterine myoma is influenced by estrogen, the details of its remain unknown. In this study, estrogen biosynthesis (androstenedione aromatase activity) was investigated in the myoma tissue (the central, surface and middle parts of the tumor) and in the myometrial tissue of the same uterus (5 cases). The tissue homogenate (500 mg w. w.) was incubated with [6,7-3H]-androstenedione (100pmol) and NADPH (1.5mg) at 37 degrees C for 1h in air. After stopping the enzyme reaction with ethyl acetate, [4-14C]-estrone and [4-14C]-estradiol-17 beta (10,000dpm, 250 micrograms, respectively) were added to the incubated sample. The sample extracted with ethyl acetate was subjected to Bio-Rad AG1-X2 column, thin layer chromatography and co crystallization to constant specific activity and 3H/14C ratio. Estrogen formed in the incubated sample was calculated from the 3H/14C ratio of the final crystal. The myoma tissues (14 samples) converted from androstenedione to estrone (36-466 fmol/h/g), while the myometrial tissues of the same uterus did to a lesser extent (22-78 fmol/h/g), while the myometrial tissues of the same uterus did to a lesser extent (22-78 fmol/h/g). Thus, aromatase activity was significantly higher in the myoma tissue rather than in the myometrial tissue of the same uterus. Less estradiol was formed than estrone in both tissues. The distribution of aromatase activity in the tumor was also investigated, and it was found that the enzyme activity tends to become greater away from the center and towards the surface of the tumor. These results suggest that aromatase activity for androgen contributes to the development of uterine myoma. PMID- 6501969 TI - [The evaluation of uterine endocervical lesions by cervicoscopy of lateral view type (clinical advantages for reduction of traditional surgical management of uterine cervical cancer)]. AB - In this study an attempt was made to examine uterine endocervix by contact pan endomicroscopy of the lateral view type (we call it cervicoscopy). Its clinical advantages are also investigated. 127 cases of uterine cervical neoplasms (including CIN) were examined to detect whether or not neoplastic foci existed in the cervical canal. It was found that vascular morphological configurations could be clearly observed. These findings are classified into several categories according to their morphological characteristics. It was found that there are many green asparagus-like vessels and/or root-like vessels in invasive foci but few in CIN foci. 56% of CIN foci, and 90% of advanced foci of endocervix were accurately diagnosed from the abnormal vascular findings. On the basis of what is described above, we examined the endocervical lesions from 40 conization candidates. 19 cases (48%) of the candidates were omitted because of negative advanced findings which were confirmed histopathologically afterwards. It suggested that a reduction in the number of conization candidates will be made possible with this new clinical examination. PMID- 6501970 TI - [Hemodilution and anemia in pregnancy and fetal development]. AB - The relation between hemodilution or anemia of pregnancy and fetal development was studied in 350 pregnant women who were delivered of full term singleton infants and were without any complications except iron deficiency anemia. The mean birth weight of the infants whose mother's hematocrit levels were 28.0-31.9% in 28-32 weeks' gestation was significantly higher than those of infants whose mother's hematocrits were 32.0-35.9% and 36.0-39.9%. There was also observed the same relation between birth weights and mother's hematocrits in 36-37 weeks' gestation. The incidence of small for dates infants was not significantly different between pregnant with different hematocrits. The iron deficiency anemia of pregnancy had no adverse effects on fetal development. It was suggested that hemodilution of pregnancy had an important physiological role in improving placental microcirculation to accelerate fetal development. PMID- 6501971 TI - [The influence of maternal oxygen inhalation for 30 to 60 minutes on fetal oxygenation]. AB - Healthy parturients with uterine displacement received oxygen inhalation before and during spinal anesthesia for elective cesarean section. Oxygen was administered through a mask (group OH2 : 20 cases) or via a nasal cannula (group OH1: 20 cases) for 33 to 69 minutes. All patients were in the right lateral position prior to spinal block and were in the left tilt after the anesthesia. The fetal blood-gas values were relatively evaluated among the OH2, OH1 and OH groups which received oxygen via a cannula for 9 to 17 minutes. The maternal artery PO2 values for the OH2 group (the mean: 491.7 +/- 61.4mmHg) were significantly higher than those for the OH1 and OH groups (244.5 +/- 28.0 and 225.0 +/- 62.9mmHg, respectively). The umbilical vein PO2 (46.1 +/- 7.5mmHg) and SO2 (87.6 +/- 6.3%) of the OH2 group were also significantly greater than those of the other groups (PO2: 36.1 +/- 4.1mmHg, SO2: 77.3 +/- 6.0% in the OH1 group and PO2: 37.5 +/- 6.4mmHg, SO2: 77.6 +/- 10. 3% in the OH group, respectively). The Apgar scores and both the maternal and fetal acid-base values for all groups were excellent. The umbilical vein to artery PO2 and SO2 gradients of the OH2 group were significantly greater than those of the other groups. It is emphasized that maternal hyperoxia with uterine displacement improves fetal oxygenation without adversely affecting the fetal acid-base state, even if it is excessive and maintained for 60 minutes. PMID- 6501972 TI - Role of the pituitary and conceptuses in the regulation of the luteal steroidogenesis in the mid-pregnant rat. AB - Effects of hypophysectomy or reduction of the conceptus number on luteal steroidogenesis were studied in the pregnant rat. On day 7 of pregnancy (day 1 = day of insemination), the number of conceptuses was adjusted to one by aspirating all but one conceptus from the uterus. Another group of rats received hypophysectomy on day 12 of pregnancy. On day 15 of pregnancy, the weights of the corpora lutea (CL), serum progesterone levels, and luteal concentrations of cholesterol, pregnenolone, and progesterone were determined. The aspiration group showed significant a decrease in the weight of the CL and in the serum progesterone level compared with those of the hypophysectomy or control group. However, there were no significant changes in the luteal concentrations of cholesterol, pregnenolone or progesterone. On the other hand, hypophysectomy caused a significant decrease in the luteal concentration cholesterol, whereas no change was observed in the weight of the CL, serum progesterone level or the concentrations of pregnenolone or progesterone in the CL. These results indicated that in mid-pregnancy the pituitary regulated the uptake or storage of cholesterol of the CL, while the placental hormones regulated the serum progesterone level mainly by affecting the growth of the CL. PMID- 6501973 TI - Acute effects of mercuric compounds on preimplantation mouse embryos in vitro. AB - The effects of mercuric compounds on the proliferation and protein synthesis of mouse blastocysts were examined in vitro by treating the embryos with methylmercury (MMC) or mercuric chloride (MC). Late blastocysts were exposed to various concentrations of mercuric compounds for 24 hr. and incubated for another 24 hr. in a mercury-free medium. The protein synthesis of the mercury-treated blastocysts was measured by counting the incorporation of L-[35S]methionine into the acid-insoluble protein fraction of a cell. 0.1 microM of MMC was equivalent to 20 microM of MC with regard to the inhibitory effect on proliferation, and equivalent to 2 to 5 microM of MC after 24 hours' culture, and 10 to 20 microM after 48 hours' culture with regard to the inhibitory effect on protein synthesis of the blastocysts. The results showed that MMC was approximately 200 times more toxic than MC with regard to cell number proliferation, and 20 to 50 times so with regard to protein synthesis capability. PMID- 6501974 TI - Metachronous multiprimary carcinomas of the ovary and endometrium. PMID- 6501975 TI - [The 25th annual report of the Uterine Cancer Registry Committee. Results of the treatment of uterine cancer during 1968-1977]. PMID- 6501976 TI - [Committee report on the medical licensure system in Japan--1984]. PMID- 6501977 TI - [Committee report on nutrition and metabolism in gyneco-obstetrics-- abnormal glucose metabolism in pregnancy, with special reference to the diagnosis of diabetes mellitus in pregnancy]. PMID- 6501978 TI - [Distribution of trabecular microfractures in the proximal femur--with the epiphyseal scar as a landmark]. AB - The distribution of the trabecular microfractures in normal human proximal femora was investigated to see whether they were related to the femoral neck fracture of the elderly. In this study the epiphyseal scar was employed as an anatomical landmark in the proximal femur, since the authors' observation suggested that it remained throughout life and was located in constant connection with the margin of the articular cartilage. The medial aspect of the proximal femur was divided into three anatomical zones, which were called epiphyseal, subepiphyseal and subcapital ones, respectively. There were two areas in which trabecular microfractures concentrated; one was about the lateral end of the epiphyseal scar and another the subepiphyseal zone. Few microfractures were noted on the principal compressive trabeculae. A femoral neck fracture of the elderly usually provides a fracture line running from the lateral end of the epiphyseal scar down to the subcapital zone. Thus the fracture takes place just within the area of concentration of trabecular microfractures laterally, whereas it passes caudad to the medial group of microfractures. The authors hypothesize that the trabecular microfractures arising about the lateral end of the epiphyseal scar may have an etiological significance for the femoral neck fracture, in contrast that those in the subepiphyseal zone may not. PMID- 6501979 TI - [The value of computed tomography in the diagnosis of the rotator cuff tears and bone and soft tissue tumors]. AB - This report consists of 2 parts. Part I: The usefulness of computed tomography (CT) in the diagnosis of rotator cuff tear was assessed. The rotator cuff could not be visualized in detail by CT unless introduction of contrast material into the joint cavity was performed. CT arthrography was performed on 21 cases of rotator cuff tears. The most detailed information was obtained when a relatively low concentration of contrast material (3.25% Angiografin) was filled in the joint cavity, and when the shoulder joint was rotated to the maximum outwards at the side. CT arthrography proved to be the most reliable method for assessing the extent and portion of the rotator cuff tears, so that it demonstrated conclusive evidence of diagnosis and management in 89% of patients studied. Part II: The usefulness of CT in the diagnosis of bone and soft tissue tumors was assessed. CT examination provided unique preoperative information which could imagine a more precise histological characteristics and anatomical localization of the lesion. Contrast enhancement (CE), when used, proved to be helpful in predicting the nature of tumors. The CE by intra-arterial infusion, or intravenous bolus injection of contrast material during the scan was more useful than that by intravenous drip infusion of the material. The information regarding change of tumor size, CT number and CE were appropriate indicators which directly corresponded to responsiveness of the tumor to the chemotherapy and radiotherapy performed. Preoperative ABC classification of the tumor by information regarding its size, location, definition and anatomical relation of tumors to vital structures (neural, vascular, and visceral) was done by using CT. The classification clearly corresponded to the status of patients regarding the treatment required for the patients. PMID- 6501980 TI - [Symbrachydactyly--a roentgenographic and clinical study of 126 cases]. AB - One hundred and twenty-six cases of symbrachydactyly were analyzed roentgenographically and clinically. This curious anomaly of the hand is sporadic and of unknown etiology. It is predominantly one-sided, either isolated or combined with ipsilateral pectoral muscle defect (fifty-one cases). On X-ray pictures, the skeletal abnormalities of the hands ranged from mild involvement featured with hypoplastic or aplastic middle phalanges to the most severe involvement in which all the phalanges were missing, providing a continuous spectrum. Even in the mildly affected hands hypoplasia involves all the phalanges and metacarpals, most severely in the middle phanges followed by distal, proximal phalanges and metacarpals in turn. The forearms and arms are less affected than the hands. The tendency is observed in the severely affected hands. In the most severely affected hand all the digits are missing, but there exist several finger buds which carry often nail rudiments. Synostosis is seen in the remaining hypoplastic metacarpals often and in carpals infrequently. Although remarkable shortening and curving forearm bones are observed often, the humeral involvement remains mild. Abnormalities of muscles and tendons are frequently observed in the hand and forearm. The anomaly is classified roentgenographically into three types: Type I (brachydactyly type) which is featured with fingers having three or two phalanges (fifty-four hands), Type II (partial ectrodactyly type) in which one to four digits have only one phalanx or none(thirty-nine hands), and Type III(total ectrodactyly type) in which all the digits have only one phalanx or none (thirty-five hands). The symbrachydactyly seems to be caused by a extensive defect in an undifferentiated mesenchyme of the arm bud at about developmental stage 16, which may later cause a failure of separation of skeletal and muscular tissues of the hand and forearm or an arrest in their development. PMID- 6501981 TI - [A study on the enhancement of pulmonary metastasis by intra-arterial adriamycin in Lewis lung carcinoma]. AB - Intra-arterial adriamycin was shown to enhance the spontaneous production of pulmonary metastases from the primary subcutaneous tumor in mice. This enhancement of metastasis was not observed in mice treated with adriamycin intravenously. These results suggest that the enhancement of metastasis is induced by vascular damage in tumor tissue under a high concentration of adriamycin. PMID- 6501982 TI - [A quantitative morphologic study of cancellous bone--comparative study between physiological and pathological bone loss in autopsy cases]. AB - The morphologic measurement of bone volume was made by using the lower lumbar vertebrae of 905 cases which were selected from 1,200 consecutive autopsy cases. The tendency and the degree of bone loss, under various pathological conditions and for aging, were compared and examined. Microscopic specimens of the lumbar vertebrae without bone marrow were used as source material and the dimensional ratios of the trabecular bone were calculated by video image processor (VIP). It is already well known that disappearance of transverse trabeculae first occurs in the progress of osteoporotic change, but in this study no clear difference appeared in the comparison of the dimensional ratios between the transverse and vertical trabeculae. On comparison between males and females in the control group, the loss of bone volume in females starts in the fifth decade with a rather rapid progress, while it starts gradually from the sixth decade in males. As regards the group with the diseases compared, the loss of bone volume appears very high for every age with high dose steroid hormone therapy and chronic renal failure but the group characterized by hypertensive vascular disorders showed an insignificant difference in comparison to the control group. In the group with malignant tumors, with liver cirrhosis and with heavy drinkers, the loss of bone volume appears to be considerable in younger individuals but no difference from the controls could be found in older individuals. In the group with diabetes mellitus, the bone volume appears to a high degree in younger individuals and the loss of bone volume makes for an accelerated increase in older individuals. This tendency is very different from the other diseased group. It can be considered that the mechanism of bone loss is accelerated with aging and various pathological factors together. PMID- 6501983 TI - [Experimental studies of osteochondral allografts]. AB - It is important to know the possibilities of allogenic transplantation of the joint in the present modes of the artificial joint replacement. In order to clarify the fate of osteochondral allograft, an experimental study of fresh "shell" transplantation was made on the femoral head of the dogs. Fifteen adult mongrels, around 15 kg in weight, were used as a recipient, and the same number as a donor. Special instruments of the same sized male and female reamer were made to cut an osteochondral shell with 2 to 4 mm thickness. Transplanted animals were killed at the interval from 2 weeks to 3 years. Femoral heads from the transplanted side and the opposite side for control were observed by histo morphometric techniques. Usual decalcified sections were stained with H-E and safranin-O to observe the articular cartilage, and undecalcified ground specimens were made to understand the remodeling of the subchondral bone. The underlying subchondral bone was completely remodeled by 1 year, the grafted shells were well adapted and fixed to the host bone. Although a number of cartilage cells on the superficial layer were decreased from an early stage, the whole articular cartilage could possess its original thickness and well functioned for three years. However, in some animals, the pannus formation and chondrolytic reaction which is thought to be an immunological rejection were observed at the margin of the grafted articular cartilage. This experiment has demonstrated that allogenic osteochondral graft with 2 to 4 mm thickness was very successful even on the femoral head, and clinical trials might be expected if the histocompatibility of the tissue is settled. PMID- 6501984 TI - [Double contrast arthrography of the shoulder joint]. AB - The shoulder joint consists of the soft as well as the hard components. Therefore, the shoulder arthrography is a very important diagnostic tool. Although both positive and negative contrast arthrography have been critically studied, there has been little literature on the double contrast arthrography. The purpose of this paper is to determine the standard technique of the double contrast arthrography, to describe arthrographic findings and to assess its clinical effectiveness of this method. Firstly, the author macroscopically examined the anatomical specimens and molded the interior of the joints with Mercox in the various arm positions. From this experiment, the author correlated the anatomical structures with the shadows on the double contrast arthrogram. Secondly, the arthrography was performed in the normal young adults to determine the ideal volume of the contrast media and the standard positioning of roentgenography. The standard findings were obtained from the arthrograms of normal adults. Thirdly, the author performed the double contrast arthrography to the various shoulder disorders based on the previous experiments to determine the effectiveness of this method. It was concluded as follows pertaining to the double contrast arthrography of the shoulder: The ideal volume of the contrast media is the combination of 1.0-1.5 ml of 76% Urografin and 10-12 ml of room-air. The minimal standard projections needed are antero-posterior views in internal and external rotation, scapular Y view in standing position and axillary view in supine position. This method provides many informations about the interior of the joint and enables us to build up three-dimensional image. This is best indicated to examine the anatomical changes in the disturbance of the anterior capsular mechanism. PMID- 6501986 TI - [Natural courses of coxarthrosis and indication of rotational acetabular osteotomy]. AB - Many factors may influence the development of the secondary osteoarthritis which might have originated from congenital dislocation, subluxation, or acetabular dysplasia of the hip. Accurate prediction of the development of osteoarthritis may be essential to initiate a proper treatment for those patients. We studied whether various acetabular indices could serve as the parameters in predicting the future degenerative changes. Our findings indicated that those indicators did not suggest the future course of the development of osteoarthritis. However, osteoarthritis may appear in younger ages when CE angle is extremely low. And the assessment of the hip congruity has an important factor in predicting any osteoarthritic changes. In those cases, the deranged anatomy of the hip must be corrected to prevent further development of osteoarthritis. There is a wide range of choices for the operative treatment of the dysplastic hip. We are doing the uniquely designed acetabular osteotomy since 1968. This procedure, rotational acetabular osteotomy, is basically the same as Wagner's spherical acetabular osteotomy, or Eppright's dial osteotomy, in which a circumacetabular osteotomy is also done. This operation is indicated for those patients whose hips show such incongruity that degenerative arthritis is inevitable, or in the early stage of degenerative arthritis. We discussed the indications of rotational acetabular osteotomy, by comparing clinically and roentgenologically with the cases in which natural courses were followed up for a long time. PMID- 6501985 TI - [Clinical study of cross-reinnervation in obstetrical paralysis]. AB - It is known that cross-reinnervation occurs when regenerating nerve fibers recombine in brachial plexus injury, especially in obstetrical paralysis. This cross-reinnervation causes abnormal contraction in many muscles simultaneously during voluntary movement. To date, however, little has been reported on its pathophysiology, severity and prognosis. In order to clarify these problems, 362 cases of obstetrical paralysis were studied clinically and electromyographically, and abnormal muscle contractions during voluntary movement were analyzed. The results are as follows; Cross-reinnervation is seen in most cases which have suffered from transection or severe injury near the transection of the nerve fibers (including that in the neural tube), and which have got recovery better than manual muscle testing grade (2) "poor". Cross-reinnervation is caused by cross-reinnervation of nerve fibers which regenerate in the wrong muscles. Muscle contraction occurring in many muscles simultaneously is different from co ordinate movement. Other paradoxical muscle action is found besides that of contraction. Cross-reinnervation can be classified into the following types by the muscle groups showing the contraction. Deltoid m., biceps brachii m. type, Deltoid m., biceps brachii m., triceps brachii m. type, Biceps brachii m., triceps brachii m. type, Deltoid m., biceps brachii m., triceps brachii m., forearm mm. type, Deltoid m., biceps brachii m., forearm mm. type, Biceps brachii m., triceps brachii m., forearm mm. type, Triceps brachii m., forearm mm. type. Abnormal muscle activity caused by cross-reinnervation is found from 4-6 months after nerve recovery from Wallerian degeneration, and it does not improve, but physical therapy or operative treatment can bring improvement in daily activities. Clinical severity of cross-reinnervation is correlated to the severity of paralysis and in proportion to the ratio of normally recovered nerve fibers and cross-reinnervated nerve fibers. It suggests that cross-reinnervation is caused by the discordant recovery from injury of nerve fibers in the brachial plexus. The site of cross-reinnervation depends on the severity of paralysis. Usually it spreads from the 5th and 6th cervical nerve roots to the upper trunk, medial trunk, posterior cord and lastly to the lower trunk and medial cord, determined by the severity of paralysis. This agrees with the way of spreading of obstetrical paralysis. PMID- 6501987 TI - [Variations in spinal cord blood flow in stepwise spinal cord impaction injury]. AB - Referring to the experimental study on acute spinal cord injury, it is known that gray matter falls into an ischemia after injury, but opinions have not been unanimous whether or not the white matter falls into ischemia or hyperemia. The blood flow through the white matter varies according to the severity of the injury and degree of resultant paraplegia. Using rabbits, the authors carried out a series of experimental acute spinal cord impaction injury giving impactions at different strength stepwise, i.e., 400, 300, 200 and 100 gcf (g X cm X force) respectively at the 9th thoracic level of the spinal cord. Thus, upon observation of the paralysed levels and measurement of variable spinal cord blood flows according to the hydrogen clearance method, it was concluded as follows: In the 400 and 300 gcf impaction groups a complete paraplegia was observed with a decrease of spinal cord blood flow both in the gray and white matters. In the 200 gcf group mainly incomplete paraplegia was occurred, and while gray matter showed ischemia, white matter showed indefinite response consisting of both ischemia and hyperemia. In the 100 gcf impaction group the gray matter fell into ischemia, but white matter showed a biphasic increase of blood flow. From the above results it was noted that upon impaction causing complete paraplegia spinal white matter shows ischemia and upon impaction giving transient paraplegia blood flow increases. Ischemia thus does not appear to be a common behavior of spinal cord blood flow spinal cord injury. PMID- 6501988 TI - [Experimental study of vascularized fibular grafting including the epiphyseal growth plate--autogenous orthotopic grafting]. AB - Advancements of microsurgery opened up a new horizon in various facets of surgery. Vascularized bone grafting is one of them and promised viable bone grafting with superb results. Whether this bone grafting along with the epiphyseal growth plate yields continuous bone growth is a matter of great concern and the purpose of the present study. Thirty-nine puppies were used for the experiment, and they were divided into two groups. The proximal portion of the fibula was resected with the popliteal artery and vein including their branches to the epiphysis and the metaphysis, and then, the fibula was returned to the original place and fixed with two Kirschner wires. In group 1, the artery and vein were anastomosed with 10-0 Nylon sutures under operative microscope. In group 2, the bone was treated in a same fashion, but without vascular anastomosis. The roentgenological and histopathological changes were sequentially studied in the both groups. Results were summarized as follows: In group 1, 13 dogs were followed until the epiphyseal closure completed. In two dogs, the treated fibula was of equal length with the non-treated opposite fibula, whereas in five dogs there was slight hypogrowth (average 1.8 mm) and in six dogs there was slight overgrowth (average 2.2 mm). Otherwise, The roentgenological appearance was essentially normal. There was no significant difference in the histopathology of the epiphyseal plates in the treated and the non-treated fibulas. In group 2, all the treated fibulas failed to show epiphyseal growth. Roentgenologically destruction and absorption appeared as early as in the first and second week postoperatively, followed by a fracture line through the metaphysis with displacement and nearly complete absorption of the grafted bone. Histopathological findings consisted of early destruction of the growth plate and early necrosis of the bone marrow as well as the bone trabeculae of the epiphysis, metaphysis and diaphysis. Some reparative new bone formation was noted in the grafted area. In conclusion, the results of the experiment showed the possibility of normal bone growth when a bone is grafted with its epiphyseal growth plate provided the vascular supply to them is reconstructed. PMID- 6501989 TI - Defects in the growth plate of brachypodism in mice--light and electron microscopic findings and cell proliferation by the method of tritiated thymidine autoradiography. AB - The basic defect of the human chondrodystrophies with normal chondro-osseous histopathology is speculated to be quantitative decrease in the rate of ossification. Homozygous brachypodism (brp/brp), chondrodystrophic mutant in mice, is characterized by shortening long bones. The light and electron microscopic observations of the growth plate were essentially normal. The method of tritiated thymidine autoradiography showed that the rate of chondrocyte division in the mutant growth plate was decreased. These findings show that the failure of chondrocytes to divide at a normal rate can produce the growth disturbance of bone without abnormal chondro-osseous histopathology. PMID- 6501990 TI - [Results of radiation therapy of squamous cell carcinoma of the vagina]. PMID- 6501992 TI - [Flow cytometric analysis of cellular transport of adriamycin]. PMID- 6501991 TI - [Hormonal profiles and structures in normal women and in patients with benign and malignant breast diseases]. PMID- 6501994 TI - Chronic pain: when aspirin doesn't work. PMID- 6501993 TI - [Anti-metastatic effect of tumor necrosis factor (TNF)]. PMID- 6501995 TI - Diagnosis and management of endometriosis. PMID- 6501996 TI - Hemostasis: a practical diagnostic approach. PMID- 6501998 TI - Comment on increased erythrocyte susceptibility to lipid peroxidation in myeloproliferative disorders. PMID- 6501997 TI - Potential role of parathyroid hormone as an inhibitor of erythropoiesis in the anemia of renal failure. AB - Patients with varying degrees of renal insufficiency and patients with end-stage renal disease receiving continuous ambulatory peritoneal dialysis or regular hemodialysis therapy were studied to assess the independent relationship between serum parathyroid hormone concentration, and both severity of anemia and degree of serum inhibition of erythropoiesis. In patients with renal insufficiency not receiving dialysis, a significant curvilinear relationship between serum parathyroid hormone and creatinine concentrations was present (r = 65, p less than 0.001). Serum parathyroid hormone (by radioimmunoassay) also correlated with hematocrit level (r = -0.54, p less than 0.001) and degree of serum inhibition of in vitro erythroid progenitor cell growth in fetal mouse liver cultures (r = 0.45, p less than 0.001). However, multiple linear regression analysis revealed that after controlling for the effect of creatinine, m-parathyroid hormone is no longer a significant predictor of hematocrit level or erythroid progenitor cell growth. On the other hand, when a restricted population of patients with creatinine values between 1 and 4 mg/dl was analyzed separately, controlling for the effect of creatinine, there was still a significant correlation between hematocrit level and m-parathyroid hormone, but no such relationship was seen when participants with parathyroid hormone levels of less than or equal to 1000 pg/ml were analyzed. No significant correlation was seen between hematocrit level or inhibition of erythroid colony growth and serum parathyroid hormone concentrations in patients receiving either regular hemodialysis or continuous ambulatory peritoneal dialysis. In 13 patients given regular hemodialysis studied before and after parathyroidectomy, there was no significant change in serum erythropoietin (by radioimmunoassay) or serum inhibition of erythropoiesis, although hematocrit levels increased in six of the 13 patients. The 1-34 human parathyroid hormone, 1-84 bovine parathyroid hormone, and 1,25 dihydroxycholecalciferol had no effect on in vitro erythroid burst-forming unit growth. Parathyroid hormone (8 mu/ml) inhibited and 1,25-dihydroxycholecalciferol (4.0 ng/ml) stimulated erythroid colony-forming unit growth only in the absence of exogenous erythropoietin in culture. In summary, it was not possible to demonstrate a significant relationship between serum parathyroid hormone levels and anemia or inhibition of erythropoiesis in patients with uremia either before starting dialysis or after receiving long-term dialysis treatment.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6501999 TI - Abnormal plasma fibronectin levels in patients with proteinuria. AB - We measured plasma fibronectin levels in 21 patients with severe proteinuria secondary to primary renal disorders and compared those results with values obtained in 77 healthy volunteers and 15 patients with chronic renal disease but minimal proteinuria. Seventeen of the 21 patients with proteinuria (81%) demonstrated plasma fibronectin concentrations greater than 2 SDs above control values. Fibronectin levels in the group with chronic renal disease did not differ from normal values. In the group with proteinuria, plasma fibronectin levels were inversely correlated with total serum protein and serum albumin concentrations but were not correlated with the degree of proteinuria, serum creatinine level, or histologic diagnosis of kidney disease. The possible relevance of these findings to the hypercoagulable state of the nephrotic syndrome is discussed. PMID- 6502000 TI - Elevated granulocyte strontium in inflammatory arthritides is related to the inflammatory activity. AB - Total cellular strontium and calcium were measured by the nuclear microprobe technique. Increased mass fraction of both elements was found in granulocytes isolated from patients with active rheumatoid arthritis and other kinds of inflammatory arthritides. Increased granulocyte calcium but only marginally elevated granulocyte strontium was demonstrated in patients with scleroderma. The granulocyte accumulation of strontium and calcium seems to be linked to the degree of inflammatory activity, because the granulocyte content of both elements was positively correlated to the plasma concentration of acute-phase proteins. Corticosteroid therapy induced a marked reduction of granulocyte strontium but a more modest decrease of granulocyte calcium. The serum levels of strontium and calcium were within the normal ranges in all patients and were not significantly altered by corticosteroids. PMID- 6502001 TI - Amniotic fluid activates complement. A role in amniotic fluid embolism syndrome? AB - A 30-year-old woman died with massive pulmonary microvascular leukostasis immediately after cesarean hysterectomy. We postulated that this might have resulted from amniotic fluid embolization and, therefore, tested amniotic fluids as activators of granulocytes and the plasma complement system. Normal human amniotic fluid failed to aggregate granulocytes, provoke a respiratory burst, or attract the cells chemotactically. However, amniotic fluid activated complement when incubated with normal plasma. The ability to activate complement resided in lipid-rich particulate material in the fluid, and activation proceeded mainly (but probably not exclusively) via the alternative complement pathway. Amniotic fluids varied widely in their ability to activate complement, with the most potent samples derived from women with distressed pregnancies. Plasma samples from donors also varied widely in their ability to be activated by amniotic fluid, and many of the most activatable plasma samples derived from gravid women. We propose that amniotic fluid embolization can, like "shock lung" syndrome, have a leukostatic early phase, and that complement and granulocyte activation on embolization of amniotic fluid can contribute to the pulmonary collapse characteristic of that syndrome, especially when a potently activating fluid is combined with a potently activatable plasma. PMID- 6502002 TI - Effects of iron loading and bacillus Calmette-Guerin on a glycoprotein recognition system on rat hepatic sinusoidal cells. AB - Experiments were performed to determine the effects of agents that modify Kupffer cells on the mannose-N-acetylglucosamine-glycoprotein receptor on hepatic sinusoidal cells. Cells were prepared by collagenase liver perfusion, centrifugation on Percoll gradients, and centrifugal elutriation. The uptake of 125I-labeled agalacto-orosomucoid (125I-AGOR), an N-acetylglucosamine-terminated glycoprotein, was greatest (53% of total uptake) by elutriator fractions containing equal proportions of endothelial and Kupffer cells ("mixed cell" fraction). Uptake was specific and time and concentration dependent. The apparent Km (0.4 mumol/L) and the patterns of inhibition by monosaccharides were similar in all the elutriator fractions, suggesting that only one class of receptor was present. The highest apparent maximal velocity (18 pmol/hr/5 X 10(6) cells) was found in the mixed cell fraction, indicating this fraction contained the highest proportion of receptor-bearing cells. Latex (0.8 micron) and bacillus Calmette Guerin pretreatments did not influence the hepatic uptake of the glycoprotein in vivo. Iron sorbitol significantly reduced hepatic glycoprotein uptake and caused a twofold increase in the proportion of the ligand remaining in the circulation. Uptake of 125I-agalacto-orosomucoid by cells from latex-treated rats was similar to controls, but uptake by bacillus Calmette-Guerin-treated rat cells was only 25% of control uptake. This was related to a marked increase in sinusoidal cell number caused by bacillus Calmette-Guerin. In contrast, iron sorbitol caused a selective suppression of 125I-agalacto-orosomucoid uptake (10% of control uptake) by cells in the mixed cell fraction. This study showed that maximal uptake of 125I-agalacto-orosomucoid was by elutriator fractions containing equal proportions of endothelial and Kupffer cells and that iron sorbitol suppressed ligand uptake by these cells, possibly by influencing the mannose-N acetylglucosamine receptor on Kupffer cells. PMID- 6502003 TI - Model prediction of plasma volume change induced by hemodialysis. AB - We simulated the change in plasma volume by hemodialysis by combining two models for transcapillary and transcellular fluid exchange. Model predictions of the plasma volume change were found to be in good agreement with the measured values in five patients who were studied during 4-hour hemodialysis at a constant ultrafiltration rate of 0.5 L/hr using three different dialysate sodium concentrations: 7% below, 7% above, and equal to the predialytic serum concentration. The measurements and model predictions indicate that the decrease in plasma volume is smaller in high sodium dialysis than in normal and low sodium dialyses. Because model predictions were consistent with measurements, this model should be useful in clinical practice to quantitatively analyze the change in plasma volume during hemodialysis and to relate it with hypovolemic hypotension. PMID- 6502004 TI - Opsonic activity of immunoglobulin prepared for intravenous use. AB - The opsonic activity of two immunoglobulin preparations modified for intravenous infusion was tested against Streptococcus pneumoniae types 3, 7F, and 14 and two strains of Staphylococcus aureus by polymorphonuclear leukocyte uptake of 3H thymidine-labeled bacteria. Reduced and alkylated immunoglobulin (Chem-IgG) and immunoglobulin prepared by chromatography with diethylaminoethyl-Sephadex (DEAE IgG) were evaluated with and without complement and compared with the opsonic activity of immune serum globulin and heated pooled human serum. Opsonic activity of DEAE-IgG was greater than that of Chem-IgG and equivalent to the activity of immune serum globulin and pooled human serum against S. aureus 502A and type 3 pneumococcus. Both intravenous immunoglobulins had lower opsonic activity than either pooled human serum or immune serum globulin against type 14 pneumococcus. There were no differences in antibody avidity for pneumococcal antigen among the immunoglobulins tested. All four opsonins had similar opsonic activity against the protein A-deficient S. aureus Wood 46. Modification of immunoglobulin for intravenous infusion by chemical alteration may adversely affect opsonic activity by changing the Fc portion of the antibody molecule. PMID- 6502006 TI - Techniques and results of microsurgical vasectomy reversal. PMID- 6502005 TI - Relationship between morphologic characteristics of sickle cells and method of deoxygenation. AB - The relationship between the morphologic characteristics of sickle erythrocytes and the method of deoxygenation was studied using rectangular glass capillary tubes (0.05 X 0.5 X 50 mm). Deoxygenated blood samples were anaerobically collected into the tubes and directly observed under a microscope. A high yield (90%) of sickled red blood cells was observed if the sample was deoxygenated slowly with nitrogen gas. However, rapid deoxygenation by sodium dithionite resulted in low percentages of sickling and high percentages of irregularly shaped cells (mosaic cells). Mosaic cells were also formed upon rapid deoxygenation with nitrogen gas and thus appear to result from the precipitation of intracellular deoxygenated hemoglobin S. Only 20% of the mosaic cells converted to sickle cells with prolonged incubation at 37 degrees C. However, if the mosaic cells were cooled, desickled, and deoxygenated again slowly by nitrogen gas, most could be converted to typical sickle-shaped cells. Further studies on the comparison of sodium dithionite and sodium metabisulfite as reducing agents showed that sodium dithionite reduced intracellular hemoglobin rapidly, and sodium metabisulfite reduced it slowly. This difference explains the high yield of sickling with sodium metabisulfite compared with sodium dithionite. PMID- 6502007 TI - The psychometric assessment of children with learning disabilities: an index derived from a principal components analysis of the WISC-R. PMID- 6502008 TI - Multiple indexes of test scatter on the Kaufman Assessment Battery for Children. PMID- 6502009 TI - LD as they see it: perceptions of adolescents in a special residential school. PMID- 6502010 TI - Anxiety and self-concept of learning disabled children. PMID- 6502012 TI - The effects of two prepractice procedures on oral reading. PMID- 6502011 TI - Family interaction and learning disabilities. PMID- 6502013 TI - Performance of good and poor readers on cognitive tasks: changes with development and reading competence. PMID- 6502014 TI - School problems and other factors in childhood headache syndromes. PMID- 6502015 TI - Learning disabilities and the near future. PMID- 6502016 TI - Reflections in a jaundiced eye. PMID- 6502017 TI - [Transcutaneous measurement of the partial pressure of the oxygen. Theoretical bases and hemodynamic significance]. AB - Transcutaneous measurement using a modified Clark type electrode actually measures the amount of oxygen diffusing through the skin, i.e. the transcutaneous oxygen flow (tc O2). The latter depends on arterial partial oxygen pressure, local blood flow, diffusion of oxygen in tissues and local oxygen consumption. In this study, tc O2, cutaneous blood flow (133-xenon) and pedal systolic blood pressure were measured simultaneously on the foot. In normal subjects, there was a good correlation between tc O2, perfusion pressure (r = 0.89) and local blood flow (r = 0.77). Tc O2 passively depends on perfusion pressure, because local heating induced an inhibition of vasomotricity. In patients with severe ischemia (stages 3 and 4), there was a lack of correlation between local blood flow measured by 133-xenon clearance and tc O2. This may be explained by variations of partition coefficient from patient to patient, which introduce a bias in blood flow calculation. Furthermore, tc O2 may constitute an index of nutritional blood flow, while 133-xenon clearance measures total blood flow. PMID- 6502018 TI - [Chronology of vascular access in hemodialysis. Apropos of 244 accesses in 150 hemodialysis patients]. AB - Out of an experience of 244 vascular access in 150 patients the authors try do find the best chronology of the angioaccess procedures. 68% of the patients see their need in vascular access definitely resolved by the first classical forearm internal arterio-venous fistula and everything must be done in the dialysis population to avoid the failure of the fistula. This would lead to internal shunt procedures using graft materials of which we know the limited potency, leading to periodic operations. Emergency situations are approached by use of the femoral vein catheterization for hemodialysis. Only the impossibility of femoral or jugular catheterization would lead to the use of the external A.V. Shunt which would be placed on the leg to preserve the vessels of the arms. For some patients the repeated failure of the successive A.V. fistula and shunts have drived us towards either peritoneal dialysis or "hemasite" vascular access system. PMID- 6502020 TI - [Early rehabilitation of vascular amputees. Value of the multipurpose prosthesis]. AB - After a recall of surgical indications and of technical points of the lower limbs amputations in arteriosclerosis disease, the authors report their experience of early rehabilitation. They define the aims of the rehabilitation and the means to reach it. Among these, a multipurpose prosthesis made by them, authorized their patients to an early walk training. The results are analysed with 86 patients rehabilitated in 2 years by this method. They have 49 good results/51 with amputation below the knee, 31 good results/35 with femoral amputation. The mean age of the patients is 72. PMID- 6502019 TI - [Iliac-femoral artery involvement in relapsing polychondritis]. AB - A patient presenting a relapsing polychondritis with ruptured iliac arterial aneurysm and lower limbs arteritis is described. The analysis of the results compared with the literature's cases confirm the no response for surgical and medical treatments. PMID- 6502021 TI - [Leiomyosarcoma of the femoral vein. Apropos of a case]. AB - A 51 years old woman developed an edema of the right lower limb. Phlebographic examination revealed an occlusion of the femoral vein. This was a tumor at operation. A leiomyosarcoma was diagnosed by microscopic study. The authors emphasize the difficulty of diagnosis, value of phlebography and discuss the treatment. PMID- 6502023 TI - [Symposium on aneurysmal disease. General remarks]. AB - After defining the limits of the subject to be discussed, the principal generalities are mentioned, based on reports of studies in the literature and the replies supplied by 22 teams to a survey conducted at the time of this report. Localizations of the aneurysms, the age and sex of patients, and the physiopathology and pathogenesis, still incompletely understood, are then outlined. PMID- 6502022 TI - [Coarctation of the aortic isthmus. Apropos of a case treated successfully]. AB - The authors report and discuss the rare case of a female patient age 55 years, with a atherosclerotic stenosis of the aortic isthmus with hypertension. The lesion was resected using partial veno arterial bypass with a dacron graft, literature on this case is reviewed. PMID- 6502024 TI - [Atheromatous aneurysms and those caused by media dystrophy (the aorta and arteries of the limbs)]. AB - Pathologic study of lesions involves atheromatous aneurysms initially, with analysis of particular features related to localization and to microscopic changes. Discussions then concern media dystrophy localized to the proximal aorta and to the limb arteries, with a description of macroscopic and of optical and electron microscopy findings. PMID- 6502025 TI - [Aneurysmal diseases. Clinical aspects]. AB - Various features related to anatomoclinical findings are discussed, including extension of aortic aneurysms to the iliac arteries, the different iliac artery localizations, bilateral and multiple lesions. The general course and natural history of aneurysmal disease are then described, together with essential diagnostic and investigational features. PMID- 6502026 TI - [Value of x-ray computed tomography in abdominal aorta pathology]. AB - Computed tomography allows positive diagnosis of aneurysms of all morphological types, and is invaluable for detection of possible extensions and complications and for follow up of both operated and non-operated cases. The CT scan also plays a crucial role for differential diagnosis of dissections, collateral artery aneurysms and tumoral lesions of the retroperitoneal space. PMID- 6502027 TI - [Angiography in aneurysmal disease]. AB - The various angiographic techniques available are described, with emphasis on retrograde catheterization. Complications and results supplied by angiography in the investigation of aneurysms are outlined, and indications for the use of this method studied in relation to its use in 80 cases. Results of this analysis provide data on the reliability of angiography and enable definition of the choice of patients and the angiographic procedures that should be used. PMID- 6502028 TI - [Treatment of aneurysmal disease]. AB - The technique used for an isolated lesion, involving an emptying-graft procedure, is discussed initially, together with particular features related to proximal and distal lesions. The treatment of multiple aneurysms is then evoked, including the attitudes necessary when confronted with either atheromatous disease or aneurysmal polydystrophy. PMID- 6502029 TI - [Aneurysmal disease. Results of treatment]. AB - Immediate and long-term results in the principal sites involved: abdominal aorta, and iliac, femoral and popliteal arteries, are explored successively, and are compared with the principal results reported in the literature. Multiple localizations in the aorta are discussed with respect to the problems they raise, in the light of the personal experiences of the authors. PMID- 6502031 TI - Stochastic models of tumor growth and the probability of elimination by cytotoxic cells. AB - The probability of tumor extinction due to the action of cytotoxic cell populations is investigated by several one dimensional stochastic models of the population growth and elimination processes of a tumor. The several models are made necessary by the nonlinearity of the processes and the different parameter ranges explored. The deterministic form of the model is T' = gamma 0T - k'6T/(K1 + T) where gamma 0, k'6 and K1 are positive constants. The parameter of most import is lambda 0 = gamma 0 - k'6/K1 which determines the stability of the T = 0 equilibrium. With an initial tumor size of one, a (linear) branching process is used to estimate the extinction probability. However, in the case lambda = 0 when the linearization of the deterministic model gives no information (T = 0 is actually unstable) the branching model is unsatisfactory. This makes necessary the utilization of a density-dependent branching process to approximate the population. Through scaling a diffusion limit is reached which enables one to again compute the probability of extinction. For populations away from one a sequence of density-dependent jump Markov processes are approximated by a sequence of diffusion processes. In limiting cases, the estimates of extinction correspond to that computed from the original branching process. Table 1 summarizes the results. PMID- 6502032 TI - Health care issues on the Hill: working toward solutions. PMID- 6502033 TI - Child abuse: the hidden crime. PMID- 6502030 TI - A four-state cross bridge model for muscle contraction. Mathematical study and validation. AB - A mathematical model of contracting skeletal muscle is studied. The model is composed by an elastic element (SE) in series with a contractile element (CE) that describes the cross bridge kinetics with a formulation derived by that proposed by Eisenberg and Hill (1978). An analytical study of the system of nonlinear partial differential equations of the model allows the existence and the uniqueness of the solution to be proved. A suitable approach to the numerical solution is defined and a series of numerical tests are performed. These tests lead to select an appropriate set of parameters and allow to compare model predictions and experimental observations on frog skeletal muscle. PMID- 6502034 TI - The Morehouse perspective on physician manpower needs in Georgia. PMID- 6502035 TI - Enhancement of cardioplegic myocardial protection with calcium entry blockers. PMID- 6502037 TI - SCAMC conference on computer applications in medical care. PMID- 6502036 TI - An information system for head and neck tumors: optimal use of abstracting and retrieval resources. AB - This report describes a symbiotic interaction between a hospital tumor registry and the physicians in a medical school department of otolaryngology. The tumor registry is responsible for collecting central registry data, entering both central registry and department-specific data, performing routine data maintenance functions, and tracking the patients over time. The departmental physicians collect site-specific data and, after entry into a computer-based data base management system, can access the information without intermediaries and at their convenience. The result is a comprehensive information resource for head and neck cancer. The development of a medical subspecialty information system, as a satellite to the central registry mechanism, is noteworthy in its low cost, frequent physician use, better patient tracking, improved patient care, and increased clinical relevance of registry activities. A subtle but pervasive benefit is the increased sense of mission experienced by all concerned. PMID- 6502038 TI - Evaluation tools for hospital computer equipment and systems. AB - The size and scope of this study for 1983 has been only briefly described by the few summary results that we have been able to put within this single article. Thousands of pages of data exist describing and detailing the complete statistical base of information that now exists on hospital data processing over the past 3 years. One need no longer guess or approximate what the industry is doing. Quantitative data are now available that we hope will lead to good decisions, good products, and good services. The 1982 and 1983 data base is now complete, along with the statistical analysis of information. The 1984 survey is now being distributed, and results should be complete in early 1985. For companies that are involved in this industry, the survey produces 11 volumes of information that are called Market Reports. For hospitals primarily concerned about the acquisition of equipment, there exist 8 volumes covering the major systems areas. For further information on these documents or any of the data elements contained within the survey, please address your questions to the Medical Systems Division at the University of Florida, Gainesville, Florida. PMID- 6502039 TI - The value of battery testing in the clinical laboratory: a PERT network case study. AB - This paper presents procedures for battery testing for the diagnosis and monitoring of treatment of patients' bleeding disorders. Specifically, it describes the testing performance for a group of bleeding disorders, disseminated intravascular coagulation (DIC). The value of three battery-testing procedures is examined by using a PERT technique, based on the clinical data obtained from the Saint Louis University Hospitals. The study reveals that a grouping of test procedures provides better patient care and improved utilization of clinical laboratory, while reducing the operational costs. PMID- 6502041 TI - Measuring the productivity of a hospital's clinical laboratory. AB - Productivity and productivity improvement are popular topics. People generally agree about the need to improve productivity in this country, yet there is little consensus as to how to achieve productivity improvement or how to measure this improvement. Furthermore, there is misunderstanding regarding the relationships among productivity, profitability, and price recovery. This paper defines and examines these relationships. These concepts are used to evaluate the productivity of a hospital's pathology laboratory. The distinction is made between income statement analysis and the potential role of productivity measurement. The analysis demonstrates that although profitability is declining, productivity improvement is making a positive contribution to profitability. On the other hand, the decline in price recovery more than eliminates the positive contribution of productivity improvement to profitability. This approach is perhaps one of the first serious attempts to measure the productivity of knowledge workers in a service organization. PMID- 6502040 TI - Optimum distribution of diagnostic-specific technology. AB - Recognizing that the suboptimal allocation of plant assets contribute to the inflationary pressures in the health industry, this paper employs the principles of goal programming to develop a model for distributing diagnostic-specific technology among potential recipients in a given geographic region. The model allocates diagnostic-specific equipment so as to ensure that the provision of the related service satisfies the health needs of the population at risk, the capacity to provide the service in the region and in the hospital is optimal, the service is provided at minimum cost, and access to the equipment is satisfactory. An application and the practical implications of the model are also explored. PMID- 6502042 TI - A computerized review of the prehospital care rendered to EMS cardiac patients: validation and application. AB - A computerized system of evaluating the prehospital EMS care being rendered to cardiac patients is reviewed. The primary component of the evaluation methodology presented is a computer language called PROTO. PROTO is used to evaluate the process of prehospital EMS care that was rendered to cardiac patients. Previously developed protocols of care are applied by means of PROTO to the case records of patients in three EMS districts in the southeastern part of the United States. Comparisons of PROTO's evaluations and those made by a review team consisting of two physicians and an RN are presented. Applications of PROTO's case evaluations are reviewed. PMID- 6502044 TI - Managing patient receivables: a technical note. AB - This paper focuses on the patient receivables of the hospital and employs a Markov process to estimate the timing of cash receipts, the magnitude of cash receipts, and losses that are attributable to bad debts, courtesy discounts, and the provision of charity care. Further, the usefulness of the model in the day-to day management of patient receivables is also explored. PMID- 6502043 TI - An integrated surgical suite management information system. AB - The operational aspects, application areas, and results achieved from an integrated surgical suite management information system are described. The system, which has been operating within Henry Ford Hospital in Detroit, Michigan, for 4 years, captures comprehensive data for each surgical episode, performs extensive edits on these data to assure data base integrity, and utilizes this data base in multiple applications. These applications include fixed-format reporting for medical staff and management; ad hoc retrieval capabilities to support research, education, and decision making; and linkage to other hospital systems to reduce both data redundancy and paper flow. PMID- 6502046 TI - Vascular surgical data registries for small computers. AB - Recent designs for computer-based vascular surgical registries and clinical data bases have employed large centralized systems with formal programming and mass storage. Small computers, of the types created for office use or for word processing, now contain sufficient speed and memory storage capacity to allow construction of decentralized office-based registries. Using a standardized dictionary of terms and a method of data organization adapted to word processing, we have created a new vascular surgery data registry, "VASREG." Data files are organized without programming, and a limited number of powerful logical statements in English are used for sorting. The capacity is 25,000 records with current inexpensive memory technology. VASREG is adaptable to computers made by a variety of manufacturers, and interface programs are available for conversion of the word processor formated registry data into forms suitable for analysis by programs written in a standard programming language. This is a low-cost clinical data registry available to any physician. With a standardized dictionary, preparation of regional and national statistical summaries may be facilitated. PMID- 6502045 TI - Dissemination of computer skills among physicians: the infectious process model. AB - While the potential utility of computer technology to medicine is often acknowledged, little is known as to the best methods to actually teach physicians about computers. The current variability in physician computer fluency implies there is no accepted minimum required level of computer skills for physicians. Special techniques are needed to instill these skills in the physician and measure their effects within the medical profession. This hypothesis is suggested following the development of a specialized course for the new physician. In a population of physicians where medical computing usage was considered nonexistent, intense interest developed the following exposure to a role model having strong credentials in both medicine and computer science. This produced an atmosphere where there was a perceived benefit in being knowledgeable about the medical computer usage. The subsequent increase in computer systems use was the result of the availability of resources and development of computer skills that could be exchanged among the students and faculty. This growth in computer use is described using the parameters of an infectious process model. While other approaches may also be useful, the infectious process model permits the growth of medical computer usage to be quantitatively described, evaluates specific determinants of use patterns, and allows the future growth of computer utilization in medicine to be predicted. PMID- 6502047 TI - National health insurance: a new imperative. AB - When viewed from the perspective of the policy analyst, observed inequities in the access to health services and the rising costs of physician and hospital care are among the most important issues confronting the American health delivery system. Recognizing that publicly financed health insurance programs result in a more equitable distribution of medical services, this paper focuses on the components of a national health insurance scheme that not only offers a comprehensive range of benefits but also employs prospective payment and a set of financial incentives to control the costs of care provided by physicians, hospitals, and other health facilities. The national health insurance program proposed in this paper is designed to eliminate or reduce unwarranted expenditures on plant and equipment; the responsibility for approving and funding capital acquisitions is also regarded as an integral component of the program. PMID- 6502048 TI - Estimating supply requirements for implementing a laboratory information system. AB - The implementation of a new laboratory information system requires the total commitment of all laboratory personnel. Difficulties both within and external to the lab are to be expected as the lab and the hospital staff learn to use the system. Proper planning prior to implementation will avert additional problems that can arise due to an inadequate supply inventory. The purpose of this paper is to discuss methods of estimating supply requirements, as well as to point out other operational considerations related to system start-up. PMID- 6502049 TI - Temporal evolution of body surface map patterns following acute inferior myocardial infarction. AB - We studied the evolution of body-surface potential map (BSPM) patterns in 32 patients following first acute inferior myocardial infarction. Initial BSPMs were obtained at a mean of 79 hours post-infarction; follow-up BSPMs, a mean of eight months post-infarction. Temporal area-of-difference maps, constructed by subtracting initial from follow-up group-mean BSPMs, revealed reciprocal changes over the superior and inferior torso for both Q-zone and ST-segment time-integral distributions. The temporal changes in Q-zone patterns were small but definite: over the inferior torso there was a relative gain in Q-zone values and, over the superior torso, a relative decrease. In contrast, there were marked spatial and quantitative changes of ST-segment distributions during the follow-up period. Over the superior torso, particularly anteriorly, there was a gain in ST-segment values; over the inferior torso, a decrease. With the small temporal changes in Q zone time-integral distributions, individual Q-zone maps continued to reflect a pattern of inferior myocardial infarction at follow-up. In contrast, the marked temporal changes in ST-segment time-integral distributions resulted in individual map patterns at follow-up that were nearly indistinguishable from normal ST segment maps. The relatively small changes in depolarization time-integral patterns during the early post-infarction period suggest that the Q-zone patterns of the acute phase of myocardial infarction reflect near-irreversible or completed myocardial damage. The marked normalization of repolarization time integral patterns during the recovery phase suggests, however, that there are also considerable areas of myocardium-at-risk during the early phase of the infarction process which stabilize with time. PMID- 6502050 TI - The spectrum of right bundle branch block as manifested in electrocardiographic body surface potential maps. AB - A wide spectrum of types of right bundle branch block (RBBB) were studied utilizing the body surface potential maps (BSPMs) of 37 children. Although the spectrum varied from very advanced RBBB to minimal partial RBBB, a common diagnostic feature was the absence of evidence for right ventricular breakthrough in the maps of all patients. Evidence for left ventricular breakthrough was usually seen, the exceptions being five patients with partial RBBB and one of 29 with advanced RBBB. The appearance of evidence for activation of the right ventricle by way of the septum was late in onset. In addition, especially in advanced RBBB, the BSPM pattern reflecting right ventricular activation was prolonged in such a manner that it appeared that utilization of right ventricular Purkinje tissue was minimal and inefficient. The BSPMs during ST-T, which were of inverse polarity, reflect repolarization that is determined by the sequence of depolarization to a greater degree than in the normal. In general, the more extensive the surgery, the more advanced the RBBB (as reflected in the BSPM), although there were exceptions. The one parameter that linked all patients with RBBB together was the absence of evidence for right ventricular epicardial breakthrough. PMID- 6502051 TI - Intracardiac electrography in patients before and after surgical repair of secundum atrial septal defect. AB - Nine patients (mean age 32 years, range 9-58) with a secundum atrial septal defect (ASD) were investigated by intracardiac electrography before and, on an average, 14 months after circumclusion of the defect. Postoperatively, four patients developed atrial fibrillation or flutter requiring treatment. After the repair, sinus node recovery time and the H-V interval increased significantly. The P-A interval, the A-H interval, sinoatrial conduction time, and the effective refractory period of the atrium (ERPA) remained unchanged. In the patients who developed atrial tachyarrhythmias, the mean preoperative ERPA was significantly longer than in the remaining patients; in patients with ERPA less than 220 ms, no atrial arrhythmias occurred. Our findings suggest that circumclusion of a secundum ASD has a sustained deleterious effect on sinus node function and His Purkinje conduction. Preoperative determination of ERPA might be of value for the prediction of postoperative atrial arrhythmias in patients submitted to ASD repair. PMID- 6502052 TI - Ventricular fibrillation and transient arrhythmias after defibrillation in patients with acute myocardial infarction. AB - Ventricular fibrillation (VF) and transient arrhythmias after defibrillation were analyzed from the recordings of 28 patients containing at least one episode of ventricular fibrillation. An R-on-T extrasystole initiated VF in 60% of the episodes. Other initiating factors were a late premature beat (24%), stable ventricular tachycardia (VT) (7%), accelerating idioventricular rhythm (5%) and cardioversion of VT (5%) with a sinusoidal waveform. After the initiating beat, in most cases, evidence was found of a transient ventricular tachycardia which then deteriorated into VF. With a stable VT this may occur after a long time; in the case of apolymorphic VT (with changing amplitude) it generally occurred within 30 s. The main transient arrhythmias generated by circulatory arrest during VF and by the defibrillation shock were: total arrest, total AV-block and/or bradycardia. The combination of a longer duration of VF and a high energy level generally resulted in an increase in the duration of these arrhythmias (P less than 0.01, N = 30). Comparison of episodes of VT and VF recorded in a single patient also shows that arrhythmias are more unfavourable and of longer duration after VF than after VT. These data emphasize fast defibrillation, initially with stored energy levels less than 250J. PMID- 6502053 TI - Relation between QT interval and heart rate. applications and limitations of Bazett's formula. AB - We studied the relationship between QT interval and RR interval when the heart rate was changed by atrial pacing, atropine, isoproterenol, and exercise in nine healthy adult males. The following results were obtained: (1) QT shortening with an increase in heart rate was minimal in atrial pacing and an equation QT = k4 square root RR was obtained from the QT-RR relationship during atrial pacing (r = 0.64, p less than 0.001); (2) shortening of QT with shortening of RR was least in atrial pacing; (3) during recovery from exercise it was largest and almost coincident with Bazett's formula; (4) Bazett's formula, therefore, is clearly applicable in the evaluation of ECGs recorded at rest or after exercise; (5) Bazett's formula can not be applied in the evaluation of an effect of some drug or maneuver on the QT when such a drug or maneuver can affect both the QT and the RR directly. The RR-dependent QT change can be estimated from the equation QT = k4 square root RR and the difference between a measured QT and the estimated RR corrected QT would be a genuine effect of the drug or maneuver on the QT at that heart rate. We conclude that atropine, isoproterenol and exercise actually shorten the QT interval. PMID- 6502055 TI - Latent abnormalities of sinus node function in patients with organic heart disease and normal sinus node on clinical basis. AB - Sinus node (SN) function was analyzed in 22 patients (mean age: 46.2 +/- 12.9 years) with organic heart disease and normal SN on clinical basis (group I) and in 20 normal subjects (mean age: 43.9 +/- 15.6 years), (control group). Sinus cycle length (SCL), corrected sinus node recovery time (CSRT) and sinoatrial conduction time (SACT) were analyzed. After the control study, autonomic blockade (AB) was induced by i.v. propranolol (0.2 mg/Kg) and atropine (0.04 mg/Kg). Measurements of SCL, CSRT and SACT were then repeated. The mean SCL values were very similar in the two groups during the control state and after AB. There were no significant differences in SACTs between the two groups during the control state or after AB. On the contrary, the CSRT of group I was significantly longer than that of control group during the control state (344.8 +/- 78.9 versus 262.2 +/- 46.3 msec, P less than 0.001) and after AB (238.9 +/- 72.8 versus 166.8 +/- 39.3 msec, P less than 0.001). The analysis of real depression of SN automaticity (CSRT minus SACT) in the two groups shows that prolongation of CSRT in group I during the control study and after AB is related to an intrinsic abnormality of SN automaticity; on the contrary, no dysfunctions of the autonomic nervous system appear. These data indicate that the intrinsic abnormality of SN automaticity represents the earliest involvement of the SN in subjects with organic heart disease and normal SN on clinical basis, although this conclusion is speculative and requires experimental verification. PMID- 6502056 TI - Ventricular fibrillation: the importance of being coarse? AB - Ventricular fibrillation (VF) has been classified electrocardiographically as "fine amplitude" or "coarse amplitude" VF. It has been suggested that coarse VF represents increased "synchronization" of myocardial activation which could result in lower thresholds for defibrillation. To test the "synchronization" differences between coarse VF and fine VF, we induced VF in ten normal anaesthetized dogs. Standard limb lead and His bundle electrograms were recorded simultaneously with 12 bipolar epicardial electrograms (eight dogs) and six lead ECG (two dogs). Activation "synchronization" was assessed by calculating the standard deviations (SD) of electrogram activation times during one coarse VF and one fine VF cycle. Less synchronization during VF was indicated by a 50% larger SD (CVF: 29.3 +/- 1.1 msec, FVF: 32.6 +/- 1.6 msec) compared to ventricular pacing (21.2 +/- 1.6 msec) and 500% larger than sinus rhythm (6.5 +/- 0.5 msec). Coarse VF and fine VF did not differ. In addition, the 6-lead ECG recorded during early VF had episodes of coarse VF and fine VF occurring simultaneously. The amplitude of all electrograms diminished over 15 minutes until only fine VF could be recorded. We conclude that coarse VF does not reflect greater synchronization of activity than fine VF early in fibrillation (five minutes). Rather, differences are due to lead orientation. Later in the fibrillation bout, fine VF probably reflects metabolically induced degeneration of cellular excitability. PMID- 6502054 TI - The timing of ventricular premature complexes initiating chronic ventricular tachycardia. AB - Prematurity index (PI), defined as the ratio of the coupling to QT intervals of isolated ventricular premature complexes (VPC) and those initiating ventricular tachycardia (VT) on 24-hour ambulatory ECG recording, was examined in 496 episodes of VT occurring in 122 patients. The PI of VPC initiating VT was less than 1 in only 62 (13%) of the VT episodes and occurred in 14 patients. Although the range of PI was similar for isolated VPC and those initiating VT, for individual patients the PI of VPC initiating VT was significantly longer than the PI of isolated VPC (P less than 0.01). This relationship was not affected by age, sex, presence of absence of heart disease, or drug therapy. The coupling interval of the first VT complex was longer than the first interectopic interval of the VT (VT1-VT2) in 88 (72%) patients; and, the VT1-VT2 interval correlated strongly with the average R-R during VT (r = 0.75), (p less than 0.001). The VT was irregular in 48 patients with 300 episodes of VT. Irregularity of the VT was significantly associated with shorter duration of VT (p less than 0.05). These results show that, for individual patients, the PI of VPC initiating VT tends to be longer than that of isolated VPC, and that the rate of VT is usually predictable from the duration of the first interectopic interval of the VT. These results may have mechanistic implications. PMID- 6502057 TI - Correlation between the direction of the interventricular septum estimated with transmission computed tomography and the initial QRS vectors. AB - A correlative study was performed to relate the interventricular septal angle (As degrees) evaluated by transmission computed tomography to the azimuth of initial QRS vectors in 52 patients. Patients were divided into five groups: RV volume overloading (RVO), RV pressure overloading (RSO), LV volume overloading (LVO), LV pressure overloading (LSO), and normal control with no cardiopulmonary disease. For measurement of As degrees, the leftward and forward directions were designated as zero and 90 degrees, respectively. The mean value of As degrees was significantly smaller in RVO (14.4 degrees) and RSO (41.1 degrees) than in normal controls (50.4 degrees) and in LVO (53.2 degrees). The mean value of the azimuth of the initial 12-msec instantaneous QRS vectors (H 12 degrees) was significantly smaller in RVO (80.5 degrees), RSO (81.7 degrees), and LSO (81.3 degrees) than in normal controls (113.8 degrees and in LVO (113.7 degrees). A significant linear correlation was shown between As degrees and H12 degrees in a combined group consisting of RVO, LVO, and normal controls (r = 0.70, p less than 0.001), and also in another combined group consisting of RSO, LSO, and normal controls (r = 0.52, p less than 0.01). It was concluded that the orientation of the interventricular septum was one of the major determinants of the direction of initial QRS vectors, especially in patients with ventricular volume overload or without cardiopulmonary disease. PMID- 6502058 TI - Thyroid hormone binding in rat liver cytosol. AB - Binding of 3,5,3'-tri-iodothyronine (T3) and thyroxine (T4) to components of perfused rat liver supernatant fraction and isolated liver cell cytosol was studied. Of the four binding fractions in supernatant (X, A, Y and Z) separable by gel chromatography, both T3 and T4 bound preferentially to the A-fraction, which was shown to contain albumin as the major binding protein. When cytosol prepared from isolated cells was examined, T4 was again bound mainly in the A fraction; however, T3 was observed to bind predominantly in the Y-region. Hormone binding to soluble protein in the latter system is thought to reflect the pattern in vivo, better than does binding in supernatant, although the possibility exists that the concentration of albumin observed in cytosol may be artificially high due to transfer of membrane-bound albumin during cell disruption. Nevertheless, albumin (possibly derived from more than one intracellular source) is capable of binding T4 in vivo. The presence of this protein within the hepatocyte may thus contribute to the high T4 binding capacity of the liver compared to other tissues. PMID- 6502059 TI - Brain sites involved in the regulation of growth hormone secretion in the young male domestic fowl. AB - To study brain sites involved in the regulation of GH secretion in the domestic fowl, lesions were placed in and around the hypothalamus of 1-week-old cockerels. Circulating concentrations of GH were then measured at weekly intervals for 4 weeks after the placement of lesions. At the termination of the experiment, histological procedures were used to determine the exact site of the lesion in each bird. Although a fair degree of overlap existed between the lesion sites leading to stimulation and those causing an inhibition of GH secretion, a clear distinction could be made in the overall distribution of stimulatory and inhibitory sites of GH control. A high concentration of lesion sites resulting in GH decline (presumed GH-releasing factor-rich areas) appeared to reside in the general area of the ventromedial and the arcuate nucleus of the hypothalamus. Lesion sites causing a GH rise (presumed somatostatin-rich areas), on the other hand, seemed to have a more caudal distribution. In addition, some evidence of an anterior hypothalamic distribution of these presumed 'somatostatin' neurones was observed. These agree with the existing immunohistochemical data on the distribution of somatostatin and constitute experimental evidence for localization of presumed GH-releasing factor sites within the avian brain. PMID- 6502060 TI - Influence of lighting cycles on daily rhythms in concentrations of plasma tri iodothyronine and thyroxine in intact and pinealectomized immature broiler hens (Gallus domesticus). AB - The effects of pinealectomy on the daily rhythms of concentrations of tri iodothyronine (T3) and thyroxine (T4) were investigated in sexually immature female chickens exposed to 21-, 24- and 27-h cycles of light and darkness, or to extended periods of light or darkness for more than 24 h. In pinealectomized and control birds, rhythms in levels of plasma T3 and T4 were entrained by all lighting cycles and decreased in amplitude or disappeared in continuous light or darkness. In pinealectomized and control birds held on 21-h (11 h light:10 h darkness; 11L:10D) and 24-h (14L:10D) lighting cycles, the peak of the T4 rhythm coincided with, or lagged, the trough in the rhythm of T3 while in birds held on a 27-h (14L:13D) lighting cycle, the peak of the T4 rhythm preceded the trough in the rhythm of T3. Pinealectomy resulted in significant effects on the phases or amplitudes of rhythms of T3 or T4 in all lighting schedules except 4L:20D. However, these effects were not consistent in direction between experimental groups and were, therefore, of doubtful physiological significance. Pinealectomy increased the mean level of plasma T4 in birds exposed to continuous light or darkness or to 4L:20D. A corresponding reduction in mean levels of plasma T3 was seen in birds exposed to continuous light or darkness. It is concluded that under the lighting conditions investigated pinealectomy had no clear effect on the phases or amplitude of daily rhythms of levels of T4 or T3. However, after the effects of the feeding pattern on thyroid hormone rhythms imposed by the lighting cycle were removed by placing birds in constant lighting conditions, pinealectomy appeared to exert an inhibitory action on thyroid function. PMID- 6502061 TI - Conversion and release of an intermediate in vasopressin-neurophysin biosynthesis in the guinea-pig. AB - Guinea-pig neural lobes contain appreciable amounts of neurophysin with a glycopeptide extension (NPGP) which may represent a partially processed form of the arginine vasopressin (AVP) precursor. We have now studied the turnover and release of the NPGP component using a combination of in-vivo radiolabel incorporation and high pressure liquid chromatography. Measurement of the neural lobe content of 35S-labelled peptides at various times after hypothalamic injection of [35S]cysteine demonstrated that the oxytocin-related products accumulated more rapidly than the AVP-related products. The relative amounts of [35S]cysteine incorporated into NPGP and the AVP-related neurophysin (NPavp) changed markedly with time after in-vivo labelling. In-vitro incubation of neurosecretory granules prepared from neural lobes 4h after radiolabel injection produced a time- and temperature-dependent conversion of NPGP to NPavp. Incubation at 37 degrees C for 4h produced a 30% decrease in [35S]NPGP with a concomitant increase in [35S]NPavp, whilst there were no changes in the other 35S labelled components. In-vitro stimulation of radiolabelled neural lobes by 56mM K+ evoked a Ca++-dependent release of NPGP as well as the other expected neurosecretory components, and the amount of NPGP released reflected its neural lobe content. We conclude that the NPGP component found in guinea-pig neural lobes is a biosynthetic intermediate, most of which is further processed to NPavp. However, some NPGP may also be secreted from the neural lobe in an intact form. PMID- 6502063 TI - Sex differences in plasma concentrations of steroids during the sensitive period for brain differentiation in the zebra finch. AB - Changes in plasma concentrations of sex steroids were examined in male and female zebra finch chicks during the sensitive period for differentiation of sexually dimorphic brain nuclei associated with the control of song. Using a chromatographic separation procedure and radioimmunoassay, androstenedione, testosterone and 5 alpha-dihydrotestosterone were detected in plasma at relatively high concentrations immediately after hatching. There were no sex differences in concentrations of these androgens. An oestrogen, oestradiol-17 beta, which is known to differentiate the song-control system, is raised specifically in the circulating plasma of male zebra finch chicks, and not in females. The surge in oestradiol, which occurs during the first week after hatching, coincides with the period when capacity for differentiation of the song system is maximal. Exposure of the male brain to oestradiol-17 beta could trigger neuronal differentiation. PMID- 6502062 TI - Secretion of oxytocin and milk removal as affected by milking cows with and without manual stimulation. AB - Milking cows with a 1-min manual stimulation (treatment 1) and without any udder preparation (treatment 2) was compared by application of an improved, highly sensitive radioimmunoassay for oxytocin and recordings of milk-flow curves. Both treatments caused the release of oxytocin, but treatment 2 generally seemed to be less efficient. Milking characteristics supported the advantage of manual stimulation; milk yield and milk flow were significantly higher, while 'machine on' time was shorter. This clearly indicates the importance of the right timing of release of oxytocin before commencement of milking. Substitution of stimulation by an i.v. injection of 0.5 i.u. oxytocin (treatment 3) resulted in milking parameters very similar to those of treatment 2. This implies that manual stimulation has other effects besides the secretion of oxytocin which are also responsible for optimal milk removal. PMID- 6502064 TI - Acute inhibition of rat myometrial responses to oxytocin by tamoxifen stereoisomers and oestradiol. AB - The non-steroidal antioestrogen tamoxifen (trans-1-(4-beta dimethylaminoethoxyphenyl)-1,2-diphenylbut- 1-ene), widely used in the treatment of breast cancer, and its oestrogenic cis-isomer rapidly inhibited contractile responses of isolated rat myometrium to supramaximal concentrations of oxytocin (1.28 X 10(-6) mol/l). Both compounds were effective at concentrations comparable with the plasma concentrations of tamoxifen reached in therapy (i.e. 5 X 10(-7) to 5 X 10(-6) mol/l). Inhibition was too rapid in onset (less than 3 min) to involve changes in RNA transcription and protein synthesis, and was not prevented or reversed by the addition of oestradiol to the bath. We conclude that the inhibition did not involve the classical oestrogen receptor pathway. Oestradiol 17 beta at concentrations above 10(-6) mol/l also inhibited the myometrium and potentiated the effects of the anti-oestrogens. Our experiments suggest that the anti-oestrogens and oestradiol act via a similar route with tamoxifen having an equilibrium affinity approximately tenfold greater than that of oestradiol. PMID- 6502065 TI - Studies on inhibin-like peptide in gastric juice and serum of patients with duodenal ulcers. AB - Immunoreactive inhibin-like material (ILM) was measured by radioimmunoassay in serum and gastric juice samples of 23 fasting normal men and 23 men with duodenal ulcers (DU). Concentrations of ILM in gastric juice and serum of patients with DU were significantly higher than those in normal men (P less than 0.01). A strong positive correlation (r = 0.894) was observed between pH and ILM levels in gastric juice of normal men but not in patients with DU. Inhibin-like material in the gastric juice had a chromatographic profile similar to that of human seminal plasma. PMID- 6502066 TI - The oestrogenicity of equol in sheep. AB - The effects of intramuscular injection of synthetic racemic equol (+/- 3-(4 hydroxyphenyl)-3,4-dihydro-2H-1-benzopyran-7-ol) into wethers have been examined with respect to maintenance of plasma level, teat growth rate and the activity of the respiratory enzyme glucose-6-phosphate dehydrogenase. At a dose rate of 1.03 mmol/day a steady rise in 'total' (free plus conjugated) equol in plasma occurred to 1.78 mumol/l in 4 days. A dose rate of 2.07 mmol/day produced only a further slight increase in plasma equol. At a lower dose rate of 0.52 mmol/day the plasma concentration reached 0.62 mumol/l in 2 days and this was not exceeded thereafter. At the dose rate of 1.03 mmol/day over 7 days significant increases in teat length and glucose-6-phosphate dehydrogenase activity occurred but no significant changes were observed at the dose rate of 0.52 mmol/day. It appears that threshold levels of intake of equol which maintain a plasma level of about 1.65 mumol/l are needed for oestrogenic effects to become apparent within a relatively short time. Administration of 1.03 mmol/day over 5 days to ovariectomized ewes produced significant increases in uterine weight equivalent to those produced by 92 nmol stilboestrol dipropionate. Thus stilboestrol was apparently 56 000 times more potent than racemic equol. PMID- 6502067 TI - Effects of search cost on foraging and feeding: a three-component chain analysis. AB - An experiment determined whether pigeons minimize number of key pecks per food delivery and maintain their baseline intake of food while key pecking on a three component chain schedule. Pigeons at either 80% or 100% body weight obtained all their food during baseline and contingency sessions. During baseline sessions, pecks on the left and center keys had no consequences; each peck on the right key activated the feeder. During contingency sessions, pigeons key pecked on a three component chain schedule simulating components of a foraging chain. In the search component either 3, 9 or 15 key pecks (varied parametrically across blocks of sessions) on the left key produced a stimulus on the middle key, indicating an encounter with either the low-cost prey (3 key pecks) or an equally probable high cost prey (21 key pecks). In the procurement component the pigeon pecked either: (a) the left key once, thus returning to the search component, or (b) the middle key either 3 or 21 times, which activated the right response key. In the handling component one peck on the right key operated the feeder. The pigeons always procured the low-cost prey and minimized the number of key pecks per hopper by procuring the high-cost prey when the search-cost ratio was high (15 key pecks) but not when it was low (3 key pecks). All pigeons maintained their baselines of eating during contingency sessions by key pecking more frequently and eating more efficiently. The 80% body-weight birds produced higher overall rates of key pecking and eating. These results have implications for ecological theories of optimal foraging and for psychological theories of learned performance. PMID- 6502068 TI - Discriminability of frequency of food or stimulus presentations in variable-time schedules. AB - Pigeons responded in a two-alternative forced-choice task in which reinforcement was dependent upon the frequency of events that occurred in an immediately preceding schedule sample. On a given trial the events were either brief food presentations or brief visual and auditory stimulus changes. High levels of stimulus control were obtained by food-presentation schedules only. Discriminative control by frequency or stimulus change was absent. Stimulus control by food frequency was decreased by the imposition of a delay period between the schedule sample and the choice. Moreover, stimulus control by food frequency was related to the ratio of food-presentation schedule pairs when novel schedules were presented in a transfer test. PMID- 6502070 TI - Fibre order in the normal Xenopus optic tract, near the chiasma. AB - In juvenile Xenopus retinotopic fibre order in the optic tract near the chiasma was investigated by labelling small groups of optic fibres from peripheral retina with HRP. This selective fibre labelling with HRP was combined with autoradiography following administration of tritiated thymidine to the eye, so that the HRP-labelled fibres could be located within the borders of the optic tract. Fibres arising from the periphery of all four retinal quadrants were superficially located in the optic tract near the chiasma, with dorsal retinal fibres showing the greatest tendency to travel deep in the diencephalon. Retinal lesions closer to the optic nerve head labelled fibres which ran deeper in the optic tract. Near the chiasma, fibres from ventral retina tended to group rostrally while fibres from dorsal retina tended to group caudally. However, no obvious localization of fibres arising in temporal or nasal retina was seen in the lower optic tract. PMID- 6502069 TI - Optimization versus response-strength accounts of behavior. AB - Pigeons were run in both single-key and concurrent-key experiments in which, over most of the range of response rates, an increase in response rate gave rise to a continuous decrease in reinforcement rate. In spite of the fact that a low response rate would have produced a high reinforcement rate, all birds responded at relatively high rates, thus keeping reinforcement rates substantially below the maximum possible. In the concurrent-key experiment, in addition to responding at relatively high rates, the birds' ratios of responses approximately matched the corresponding ratios of obtained reinforcers. The results are inconsistent with most theories of optimal performance, which assume that organisms behave in ways that either maximize reinforcement value or minimize deviations from a free behavior point. On the other hand, the results are consistent with the assumption that reinforcement strengthens the tendency to respond. PMID- 6502071 TI - Patterns of cell division during visual streak formation in the frog Limnodynastes dorsalis. AB - The site and extent of cell division were determined in midlarval tadpoles, animals at metamorphic climax and 2-month juvenile Limnodynastes dorsalis using untreated animals and those injected with colchicine or [3H]thymidine shortly before sacrifice. Mitosis was restricted to the ciliary margin at all stages and there were significantly more dividing cells nasally and temporally than dorsally and ventrally. In animals injected with [3H]thymidine and killed at a subsequent stage, labelled cells were grouped at a distance from the ciliary margin and were more frequent in nasal and temporal than in dorsal and ventral retina. These results suggest that differing extents of mitosis around the ciliary margin, reflected in the number of cells entering the ganglion cell layer, may largely underlie the postmetamorphic formation of a visual streak observed using wholemounts. PMID- 6502072 TI - The early development of mystacial vibrissae in the mouse. AB - The initial generation of the pattern of mystacial vibrissae (whiskers) in the mouse is described. The maxillary process is present in 10-day embryos but has a relatively flat surface. Beginning at approximately 11.5 days, the first sign of vibrissal development is the formation of ridges and grooves on the maxillary and lateral nasal processes. The first vibrissal rudiment to form subsequently appears posterior to the most ventral groove on the maxillary process. It is the most ventral whisker of the posterior, vertical row. The next few rudiments appear: dorsal to the first, also in the vertical row; and anterior to the first, on the ventral-most ridge and in the groove beneath it. Formation of vibrissal rudiments continues in a dorsal and anterior progression usually by an apparent partitioning of the ridges into vibrissal units. The hypothesis that this patterning of mystacial vibrissae might be determined by the pattern of innervation in the early mouse snout was investigated. Nerve trunks and branches are present in the maxillary process well before any sign of vibrissal formation. Because innervation is so widespread there appears to be no immediate temporal correlation between the outgrowth of a nerve branch to a site and the generation of a vibrissa there. Furthermore, at the time just prior to the formation of the first follicle rudiment, there is little or no nerve branching to the presumptive site of that first follicle while branches are found more dorsally where vibrissae will not form until later. Thus, a one-to-one spatial correlation between nerve and follicle sites also appears to be lacking. The developmental changes in ultrastructure within the neurites of the trunks and branches as well as the apparent rearrangements of the nerve trunks suggest that early innervation of the snout is a labile phenomenon and that the vibrissal pattern begins to be established before the neural pattern is completely developed. The results indicate that vibrissal pattern formation is likely to be a complex process relying on the interplay of the cells and tissues involved, rather than on unidirectional instructions from neurons to other cell types. PMID- 6502073 TI - Initial phases of the rat testis differentiation in vitro. AB - Rat gonadal primordia with their supporting mesonephroi were explanted in vitro at the undifferentiated stage (12 days 16 h after fertilization), at the outset of testicular differentiation (13 days 9 h) or when already containing seminiferous cords. The younger foetuses were sexed with the sex chromatin test in the amniotic membrane. The basal medium was CMRL 1066 and the culture period, 1 to 4 days. Testicular differentiation resulted from the appearance of large clear cells, the primordial Sertoli cells, and from their aggregation into seminiferous cords. Addition of 15% foetal calf serum to the medium prevented the differentiation of seminiferous cords, but large clear cells appeared. In testes from 14- or 15-day-old foetuses, the seminiferous cords disintegrated under the influence of serum. The serum did not prevent the differentiation of Sertoli cells, but impaired organogenesis or maintenance of the early seminiferous cords. The results support previous histological observations on the initial stages of testicular differentiation. PMID- 6502074 TI - Motor innervation of proximally rotated chick embryo wings. AB - Chick embryo wing buds were rotated close to the lateral edge of the somites at stage 19, prior to limb innervation. Despite the abnormal orientation of the resulting limb, the motor pools to biceps and triceps were largely normal, as judged by electrical stimulation and horseradish peroxidase labelling just prior to hatching. The only abnormalities were a few caudal motoneurons innervating biceps and a few rostral motoneurons innervating triceps. This distribution is similar to that seen normally in young embryos before the completion of motoneurons death and it is suggested that the rotation may be keeping alive motoneurons which otherwise would die. The morphology of the brachial plexus supplying rotated wings was abnormal. It is concluded that axons growing into the limb bud from the spinal cord can compensate for reversal of both the limb axes and selectively innervate appropriate muscles. The result is consistent with others in which proximal reversal of one limb axis alone produced normal innervation. PMID- 6502076 TI - Regeneration and pattern formation in planarians. I. The pattern of mitosis in anterior and posterior regeneration in Dugesia (G) tigrina, and a new proposal for blastema formation. AB - Mitotic activity during regeneration in the planarian Dugesia (G) tigrina shows a biphasic pattern, with a first maximum at 4-12 h, a second and higher maximum at 2-4 days, and a relative minimum in between. The first peak is mainly due to pre existing G2 cells entering mitosis shortly after cutting, whereas the second maximum is due to cells that divide after going through the S period from the onset of regeneration. From a spatial point of view, the highest mitotic values are found in stump (postblastema) regions near the wound (0-300 micron), though regions far from it also show increased mitotic values but always lower overall values. As regeneration continues the postblastema maximum shifts slightly to more proximal regions. In contrast, no mitosis has been found within the blastema, even though the number of blastema cells increases steadily during regeneration. The results suggest that blastema in planarians forms through an early accumulation of undifferentiated cells from the stump to the base of blastema. The results obtained demonstrate that blastema formation in planarians occurs through mechanisms somewhat different to those shown to occur in the classical epimorphic models of regeneration (Annelida, Insecta, Amphibia), and suggest that planarian regeneration could represent an intermediate stage between morphallactic and epimorphic modalities of regeneration. PMID- 6502075 TI - Intercellular relationships during cavitation of aggregates of extraembryonic endoderm cells from gastrulating chick embryos. AB - Extraembryonic endoderm cells from gastrulating chick embryos undergo epiboly and change from a multilayered cell group to a single cell layer surrounding the yolk. Single cell suspensions from this cell layer can aggregate in vitro to form aggregates that cavitate. To study the stages of cavitation aggregates were harvested after different times in culture, and fixed and processed for light and electron microscopy. In aggregates harvested at 75 min of culture cell contact consisted of areas of parallel and close membrane apposition and interdigitation. Desmosomes were occasionally observed. Aggregates in the early stages of cavitation (24 h) contained numerous intercellular spaces bordered by irregularly shaped cells which appeared to be digesting their yolk and releasing material extracellularly. Long cytoplasmic projections were extended into these spaces. In addition to regions of parallel membrane apposition and interdigitation, desmosomes and adherens junctions were observed. Cells closer to the periphery of the aggregates displayed fewer cell projections and also showed signs of release of material extracellularly. After 48 h of culture, a single smooth-walled central cavity was present and cells still exhibited signs of extracellular release of material. These same cell shapes and intercellular junctions were also observed when area opaca tissue dissected from gastrulating embryos was examined. Aggregates of different sizes were created and cultured. The results suggest that a critical tissue mass may be important for cavitation. PMID- 6502077 TI - Changes in hair growth characteristics following the wounding of vibrissa follicles in the hooded rat. AB - The effect on hair growth of wounding the lower region of whisker follicles, and in particular the dermal papilla, with sharply pointed tungsten needles was studied in adult hooded rats. Following injury hair growth ceased, but was subsequently resumed. While it might have been anticipated that follicle wounding would have a negative effect on whisker length, regular postoperative length measurements revealed that in follicles where cellular material was not displaced from the follicle by the original manipulation, 50% of the subsequent hairs produced were longer than their counterparts on the opposite side of the face, with 25% shorter and 25% with their length unchanged. In every case increased hair length was achieved by a prolongation of the growing period of the hair. Growth rate, when altered, was reduced. These results suggest that the factors which control the duration of the hair cycle and fibre growth rate are independent in vibrissa follicles. Since removal of most of the epidermal component by plucking of the hair just prior to injury produced equivalent hair length increases, this implicated the proximal dermal components as being mainly responsible for the observed changes. PMID- 6502078 TI - Histological studies of the effects of wounding vibrissa follicles in the hooded rat. AB - The effects of wounding the lower region of rat vibrissa follicles with a sharp tungsten needle were examined histologically, both shortly after injury and up to one year postoperatively. Following cell damage in the dermal papilla component hair growth ceased, and resumption of fibre production was always preceded by dermal papilla reformation. This papilla healing and regeneration was not associated with the production of scar tissue. In follicles undergoing no cell displacement during wounding (an effect associated with the growth of longer than normal hairs) dermal papillae were reformed from the residual papilla cell population, with recruitment of cells from surrounding mesenchyme. Follicles plucked just prior to wounding revealed little or no original epidermal matrix three days later, confirming that dermal components were primarily affected. Papilla cell counts performed on follicles which had consistently produced longer hairs gave no indication of increased papilla cell numbers. Follicles which underwent displacement of cellular material and displayed distortion of normal follicle morphology shortly after wounding (effects associated with the production of shorter than normal hairs) also revealed abnormalities at long-term biopsy. Moreover these follicles often had a history of altered fibre characteristics from one postoperative generation to the next. It is concluded that gross morphological disruption of the normal cellular relationships in the lower follicle results in a series of reorganizational difficulties with each recurring phase of the hair cycle. PMID- 6502079 TI - Holistic health care: neither new nor coherent. PMID- 6502080 TI - Screening for gestational diabetes--analysis by screening criteria. AB - A previously studied glucose screening test for gestational diabetes was evaluated by six screening test criteria for appropriateness and cost effectiveness as a widespread screening tool. The test consisted of a serum glucose level in a pregnant patient one hour after 50 g of a glucose solution was ingested. Determination was made of price per case detected and of the number of cases missed when using this test or the oral glucose tolerance test on all prenatal patients or on a selected subset of patients. Screening all pregnant patients aged over 25 years for gestational diabetes with the one-hour glucose screening test is recommended. The need for further evaluation of the sensitivity of this screening test is discussed. PMID- 6502081 TI - Patients' willingness to take risks in the management of pharyngitis. AB - Choosing a management plan for pharyngitis involves considering the risks and benefits of alternatives. Using a sick-day equivalent scale, this study examined patients' willingness to be ill with pharyngitis compared with their willingness to risk two outcomes: a penicillin reaction and rheumatic fever. On average, patients preferred 1.5 to 2.5 days of illness with pharyngitis over risking a 5 percent chance of developing a mild penicillin reaction. Willingness to risk the outcomes decreased with increasing probabilities of their occurrence. Subjects were more willing to risk a penicillin reaction than rheumatic fever. Healthy subjects receiving sick pay were more willing to risk varying probabilities of a mild penicillin reaction than subjects not receiving sick pay. Patients ill with pharyngitis, however, were not more willing to take similar risks if they received sick pay. Illness may, therefore, modify some aspects of risk-taking behavior. It is reasonable to conclude that some patients with pharyngitis would prefer early antibiotic treatment for the chance of earlier recovery over waiting for throat culture results despite the risk of a penicillin reaction. PMID- 6502082 TI - Stridor in childhood. AB - The acute onset of stridor in a young child usually represents viral croup, particularly during the fall and early winter. If the clinical picture is entirely consistent with this diagnosis and gas exchange is maintained, management with cool mist at home is appropriate. Rapid deterioration is unusual in viral croup; however, if obstruction is prolonged or becomes unusually severe, racemic epinephrine aerosols, hospitalization for careful observation, a brief course of corticosteroid therapy, and, rarely, endotracheal intubation may be required. Many of the other causes of acute stridor in childhood represent true pediatric emergencies: epiglottitis, foreign body aspiration, bacterial tracheitis, allergic airway edema, and retropharyngeal abscess, all requiring management with a consultant. Chronic stridor in infancy most often represents laryngomalacia, a developmental abnormality of the laryngeal cartilage which usually resolves by the second year of life and rarely requires specific treatment. Other causes of chronic stridor in childhood include subglottic hemangioma, vocal cord paralysis, and a long list of abnormalities. In the older child with chronic stridor or in the infant whose clinical picture is unusual for laryngomalacia, airway roentgenograms, barium studies, or laryngoscopy/bronchoscopy should be obtained to establish the definitive diagnosis. PMID- 6502083 TI - Provider continuity and control of hypertension. PMID- 6502084 TI - Herpetic whitlow in family practice. PMID- 6502085 TI - Use of psychologic testing in characterizing the frequent user of ambulatory health care services. PMID- 6502086 TI - Cardiac output and tissue blood flow in the abalone, Haliotis cracherodii (Mollusca, Gastropoda). AB - Little is known about the characteristics of hemolymph (blood) flow in animals with open circulatory systems. We measured cardiac output and blood flow to specific tissues in the black abalone, Haliotis cracherodii, a gastropod mollusk. The use of thermodilution allowed us to make repeated measurements of cardiac output and cardiac stroke volume over relatively short time intervals (5-10 heart beats) in resting, unrestrained abalone while disturbing the animals minimally. Anatomical studies of the abalone circulation showed that the arterial system terminated in small diameter (approaching 10-20 micron in some cases) lacunar tissue spaces. Because of this, we used radioactive microspheres (which must be trapped in the tissue vasculature) to measure blood flow rates to selected tissues. The major findings of our study were that 1) cardiac output in the black abalone ranged from about 100 to 150 ml X kg-1 X min-1, and was highly correlated with body size; 2) weight-specific cardiac stroke volume was about 5 ml X kg-1, considerably larger than that of a mammal; 3) tissue blood flow rates ranged from 10 ml X 100 g-1 X min-1 (foot muscle) to 80 ml X 100 g-1 X min-1 (nephridial tissue), similar to typical tissue blood flow rates in mammals. Our data suggest that the blood in the abalone is directed to the tissues not in proportion to percent total body weight the tissues represent (as might be expected in an open vascular system), but apparently in proportion to tissue metabolic rate. PMID- 6502087 TI - Ascites tumor fluid and bovine serum albumin as supplements in presomite mouse embryo cultures. AB - The growth of presomite mouse embryos in culture was studied using mouse Ehrlich ascites tumor fluid and bovine serum albumin as supplements to the tissue culture medium. The best development was observed with a mixture of 10-20% ascites fluid and 2% bovine serum albumin. During 48 h of culture under these conditions, embryos grew from egg cylinders to complex structures with neural folds and other organ rudiments. Most embryos had beating hearts, numerous pigmented red blood cells, and a fused chorioallantoic placenta. The results suggest that factors in ascites fluid support differentiation and growth of mouse embryos. Addition of bovine serum albumin was also beneficial for development. Differential sister chromatid staining of cultured embryos showed that ascites fluid increased the rate of cell proliferation as compared with medium containing bovine serum albumin alone, or bovine serum albumin and fetal calf serum. These results with abundant and readily available supplements may facilitate certain studies of mouse embryo development. PMID- 6502088 TI - Electrical stimulation of the starfish's radial nerve in vitro induces the release of a gonadotrophin. AB - In starfish a neuropeptide responsible for the induction of ovulation and the reinitiation of meiotic maturation in fully grown oocytes appears to be released from the radial nerves at the time of spawning. The objectives of this investigation were to determine if the radial nerve would release this gonadotrophin when electrically stimulated in vitro and to locate other possible sources of this factor. Electrical stimulation of radial nerves isolated from the starfish, Pycnopodia helianthoides, resulted in the release of the gonadotrophin. Significant amounts of this neuropeptide were detected neither in other tissues of the starfish nor in mammalian nervous tissue. PMID- 6502089 TI - Regulation of the permeability of the medaka fish embryo chorion by exogeneous sodium and calcium ions. AB - We questioned if the optically transparent noncellular chorion, or egg envelope, which encapsulates the entire medaka fish (Oryzias latipes) embryo might in some way constitute a permeability barrier to high concentrations of the diuretic called amiloride. More specifically, we questioned if removal of cations from the exogenous environment of the medaka embryo might make the chorion more permeable to amiloride and thereby make the fish embryos more sensitive to the inhibitory and lethal effects of this drug. To test this question, chorion-encapsulated medaka embryos were exposed to: deionized-distilled water, to Yamamoto-Ringer's (Y-R) solution, to Yamamoto-Ringer's containing choline chloride as a substitute for NaCl, and to isotonic NaCl solution in the presence of and in the absence of amiloride. Briefly, the prediction that the medaka embryos would be most sensitive to amiloride's inhibitory effects in distilled water was confirmed. Further studies showed that the presence of Na+ or of Ca2+ alone in the culture solution gave partial protection against the lethal effects of the amiloride. Electron probe X-ray microanalysis studies indicated that addition of Ca2+ and other cations to the culture solution caused the concentrations of cations to increase in the chorion, and that increase was correlated to a visible decrease in the permeability of the chorion to the amiloride. This decreased permeability of the chorion apparently protected the embryo from the amiloride. The decreased permeability of the chorion to amiloride, which occurred in the presence of the cations present in Y-R solution, was found to be reversible once the cations were washed from the chorion. Key words medaka, chorion, Na+, Ca2+ permeability, x-ray microanalysis, Oryzias latipes, egg envelope. PMID- 6502090 TI - Reproductive development of female Schistosoma mansoni (Digenea: Schistosomatidae) following bisexual pairing of worms and worm segments. AB - Maturation and maintenance of normal reproductive function in female Schistosoma mansoni require a permanent association with the male, but the nature of this relationship is not well understood. The regional localization of a stimulatory factor in the male and its target in the female were investigated. Unisexual female and mature male worms were transected into segments of various lengths. Various combinations of transected male and female segments and intact worms were transferred to the mesenteric veins of recipient hamsters and were also maintained in vitro. In hamsters and in vitro, pairing took place between intact worms of each sex and segments of the other, and between segments of both sexes. The majority of female worms and segments so paired showed some reproductive development, as assessed by vitelline gland differentiation. In intact unisexual females paired with small male segments, vitelline gland development was limited to that portion of the worm that had been held by the male. Worm segments continued to display normal body contractions throughout 24 days of in vitro maintenance and morphological integrity was retained. It is concluded that 1) in the absence of a functioning gut, worm segments can survive for prolonged periods on nutrients absorbed through the tegument; 2) worm pairing, male stimulation, and the female developmental response are independent of central nervous control by the cerebral ganglia; 3) males have no centralized localization for the female stimulating factor; 4) vitelline gland differentiation in the female requires local stimulation through male contact, and this is not propagated throughout the worm. PMID- 6502091 TI - Antagonistic effects of estradiol dipropionate and progesterone on the histology of the vagina and uterus of the mouse. AB - Administration of estradiol dipropionate (20 micrograms/day; 7 days) to ovariectomized mice caused heavy epithelial proliferation and intense cornification in the vagina and cellular as well as glandular proliferation in uterine tissues. Endometrial hypertrophy with cystlike appearance of uterine glands was seen in response to a long-term (14 days) administration of estradiol dipropionate. Daily injection of progesterone (2 mg; 7 days) to ovariectomized mice resulted in desquamating mucosa, without any trace of vaginal cornification, and the presence of dense uterine connective tissue in the stromal region with typical uterine glands. However, treatment of estradiol depropionate in combination with progesterone at 1:100 dose ratio for 7 days produced vaginal histology similar to that in proestrus and uterine histology equivalent to the ovariectomized condition. The results revealed that progesterone antagonized the estrogenic effects and also that estradiol dipropionate antagonized the effects of progesterone. The effects of the two female sex steroids (estradiol dipropionate and progesterone) in vivo appeared to be more potent in the uterus than in the vagina. PMID- 6502092 TI - Catalase, glutathione peroxidase, and superoxide dismutase in the rete mirabile and gas gland epithelium of six species of marine fishes. AB - Rete mirabile and gas gland epithelium from the swim bladders of six species of marine fishes were assayed for catalase, glutathione peroxidase, and superoxide dismutase activity. Correlation of the results of these assays with measurements of the concentration of oxygen in the lumen of the normal steady state swim bladders revealed that swim bladders in species containing higher levels of oxygen also exhibited higher levels of superoxide dismutase activity in the rete mirabile/gas gland epithelium region. There appeared to be no correlation between oxygen concentration and the level of catalase or glutathione peroxidase activity. Induction of the inflatory reflex in Opsanus tau by a single deflation of the swim bladder resulted in an increase in the percent of oxygen in the swim bladder lumen 18 to 24 hours later, but this was not accompanied by any significant increases in antioxidant enzyme activity. Swim bladders that were deflated three times at 24-hour intervals showed further increases in oxygen concentration at the end of the 72-hour period but no alteration in superoxide dismutase activity. PMID- 6502093 TI - Earthworm leukocyte interactions during early stages of graft rejection. AB - The earliest phase of graft rejection in earthworms, the recognition of foreign tissue antigens, has been subjected to analysis by confronting host leukocytes with foreign erythrocytes. Only rabbit and rat erythrocytes significantly prevented healing of allografts when grafts were transplanted and erythrocytes injected simultaneously. In contrast, autografts and allografts transplanted on worms injected 1 or 2 days before grafting were never affected. Since earthworms readily produce higher titers of erythrocyte agglutinins at 24 h postinjection than at later times, we propose a hypothetical scheme of earthworm leukocyte interactions that may occur during the early phases of graft healing and of agglutinin synthesis. PMID- 6502094 TI - Identification, synthesis, and characterization of the yolk polypeptides of Plodia interpunctella. AB - The mature eggs of Plodia interpunctella were found to contain four major polypeptides. These yolk polypeptides (YPs) were found to have approximate molecular weights of 153,000 daltons (YP1), 69,000 daltons (YP2), 43,000 daltons (YP3), and 33,000 daltons (YP4) as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). In addition, we found YP1 was resolved by a 5% polyacrylamide gel into two separate polypeptides of 153,000 and 147,000 daltons. All of the YPs could be labeled in vivo or in vitro with [35S] methionine. Yolk peptide 1 and YP3 were synthesized by fat body of pharate adult and adult females and secreted into the hemolymph. Yolk peptide 2 and YP4 were synthesized and secreted into incubation medium by ovaries that contained vitellogenic oocytes, but these polypeptides were not found in the hemolymph. Fat bodies of males synthesized and secreted an immunoprecipitable polypeptide similar to YP3 as well as immunoprecipitable polypeptides larger than 200,000 daltons that had no counterparts in the oocytes. Peptide mapping by protease digestion showed each YP to be cleaved into unique fragments, suggesting that no precursor-product relationship exists between the YPs. Ion exchange chromatography and gel permeation chromatography separated that yolk proteins into two groups with approximate molecular weights of 462,000 and 264,000 daltons. By resolving these peaks on SDS-PAGE, it was found that YP1 and YP3 formed the 462,000-dalton yolk protein and YP2 and YP4 formed the 264,000-dalton yolk protein. PMID- 6502095 TI - Identification and characterization of glycoproteins secreted by the skin of the day 16 fetal mouse. AB - The secretion of tissue-specific proteins during mouse skin development, was investigated by incubating day 16 fetal skin explants in the presence of [35S]methionine and analyzing the medium electrophoretically. The medium was found to contain five proteins, which could be classified into two groups according to molecular weight. The kinetics of release of these proteins indicated that they were specifically secreted and not released by cytolysis. Mapping of the proteins by partial proteolytic digestion revealed that although the digestion patterns between the two molecular weight groups were different, within each group similar patterns were seen, suggesting that they were structurally related. Incubation in the presence of tunicamycin resulted in the decrease in molecular weight of the secreted proteins, indicating that the proteins were glycosylated. The results suggest that the two groups of structurally related glycoproteins were secreted by the peridermal layer of the fetal skin. PMID- 6502096 TI - A nerve-conditioning lesion accelerates limb regeneration in the newt. AB - A nerve-conditioning lesion induced sustained acceleration of limb regeneration. Newt limb nerves were subjected to a conditioning lesion by unilateral axotomy at the elbow 2 weeks prior to amputating both limbs above the elbows. Limbs on the side that had received a conditioning lesion began the regeneration process 3-4 days earlier than contralateral controls and this difference was observed up to recognizable digit formation. Limb buds on the conditioned sides had a twofold greater axonal density than contralateral counterparts at 2 weeks after amputation. Since limb bud formation is dependent on a sufficient quantity of axonal regrowth, accelerated limb regeneration is apparently due to accelerated reinnervation. PMID- 6502097 TI - Closure of the squid cornea: a muscular basis for embryonic tissue movement. AB - The squid cornea is derived from epithelial tissue behind the eyeball. The future cornea is pulled over the developing eyeball by contraction of muscle cells which develop just behind the leading edge. Treatment with cytochalasin B or colchicine does not stop this embryonic tissue movement, suggesting that the muscle is the main motive force in corneal closure. PMID- 6502098 TI - Retinoic-acid-induced pattern completion in regenerating double anterior limbs of urodeles. AB - The effects of retinoic acid on the regeneration of double anterior lower arms in the adult newt, Notophthalmus viridescens, were investigated. Normally, double anterior lower arms regenerate a hypomorphic, symmetrical pattern of structures, which are distally complete; and double anterior upper arms regenerate a hypomorphic, symmetrical but distally incomplete pattern of structures. In limbs with a normal anteroposterior axis, the major effect of retinoic acid is to alter the proximodistal (PD) positional value of cells local at the amputation level to a much more proximal value, thereby creating duplications in the regenerate of structures proximal to the amputation plane (Thoms and Stocum, '84). Therefore, we predicted that double anterior lower arms treated with retinoic acid would regenerate like double anterior upper arms. However, in a substantial number of cases, each half of these double anterior lower arms regenerated a limb that was complete in the anteroposterior (AP) axis, with asymmetry corresponding to the half of origin. In addition, these regenerates were serially duplicated in the PD axis. These results indicate that retinoic acid can posteriorize the positional value of midline cells, leading to restoration of normal AP pattern, when the set of posterior-half positional values is removed from the cross section of the limb. PMID- 6502099 TI - The effects of Janus Green B on the temporal and spatial pattern of feather germ morphogenesis. AB - The normal timing and appearance of feather germs was perturbed by injecting the dye Janus Green B into the amniotic fluid of chick embryos at late stage 28, prior to the first appearance of feather germs. This treatment prevented feather germ morphogenesis in some regions while elsewhere it delayed normal morphological development. The Janus Green B effect lasted for approximately 98 hours. Feather regions, which normally form epidermal placodes during the period of treatment, showed the longest delays in subsequent feather germ formation and were the most likely to remain featherless. These results suggest that the epidermal placode stage is critical for feather germ formation. Janus Green B appears to prevent feather germ morphogenesis by interfering with development prior to this critical stage. Since severely affected regions fail to recover their capacity to form feather germs, even after the period of sensitivity to the dye, a limited period of competence is suggested for feather germ formation. PMID- 6502100 TI - Cell death in cultured dorsal and ventral chick wing bud epithelia. AB - We have examined the fate of cultured stage 20 and 25 dorsal and ventral wing bud epithelia and have found evidence that the requirements of apical ectodermal ridge and nonridge limb ectoderms for in vitro survival are different. As previously reported for the apical ectodermal ridge (Boutin and Fallon, '84), dorsal and ventral ectoderms were extensively necrotic after 12 hours of culture in serum-containing medium. The survival of dorsal and ventral limb epithelia at 18 hours was not improved by a collagen substratum, 10% Nuserum, epidermal growth factor, nerve growth factor, multiplication-stimulating activity, insulin, or insulin, transferrin, and selenium. This is in contrast to our observations on the ridge which remains vital for at least 24 hours in insulin or insulin, transferrin, and selenium. PMID- 6502101 TI - Evidence that the ectoderm is the affected germ layer in the wingless mutant chick embryo. AB - We grafted normal flank ectoderm to the denuded presumptive wing bud mesoderm of stages 14-15 wingless embryos. When this was done, the wingless wing bud mesoderm was capable of inducing a ridge in the grafted ectoderm, maintaining that ridge, and growing out to form a wing. However, when stage 17-18 wingless wing bud mesoderm was combined with a normal leg bud ectodermal jacket, the recombinant bud failed to grow out to form a wing (Zwilling, '56a; and this report). When normal ectoderm was first grafted to a wingless host at stages 14-15, and the resulting stage 18 wing bud was removed and then the mesoderm recombined with a normal ectodermal jacket, the double recombinant bud could form a distally complete wing. However, these wings had some deficiencies compared to similar double recombinants made with normal mesoderm. These results show, first, that the ectoderm is affected by the wingless gene and, second, that there may be a prelimb bud stage interaction between wingless ectoderm and mesoderm such that, by stage 17, the wingless mesoderm becomes defective as a result of the ectodermally expressed mutation. Deficiencies in wingless mesoderm double recombinants indicate that the mesoderm may be sensitive to manipulation, possibly because the ectoderm has affected the mesoderm to some extent before stage 14. We believe it is not possible to determine the affected germ layer in wingless after the limb bud arises. However, after using the prelimb bud recombinant technique which we have designed, it becomes apparent that the ectoderm is affected by the wingless gene. PMID- 6502102 TI - Histogenesis in 11-day mouse embryo limb buds explanted in organ culture. AB - Fore- and hindlimb buds from 11-day mouse embryos with 40 to 52 somites (including the four occipital pairs) were explanted in organ culture and submitted to systematic histological analysis. Chondrogenesis occurs normally in culture in all preskeletal rudiments which were already represented by condensed blastemas before explantation. In the proximal territories, the progress of cartilage differentiation occurs according to the normal pattern and can be revealed histologically much earlier than in bulk preparations. In all explanted hindlimbs as well as in forelimbs from embryos with less than 50 somites, a primary coalescence occurs between the IId and IIId digital rays, leading to various fusions from soft tissue syndactyly to oligosyndactyly. This is the result of two combined unfavorable effects of the culture conditions: the lack of simultaneous volumetric growth of the foot- or handplate, which normally would provide the necessary space for the laying down of a pentadactylous pattern, and a loss of cells resulting from abnormal cell death affecting selective mesodermal sites in the zeugopod and in the marginal subridge area, the latter being more severely affected in hindlimb buds. Several observations suggest that the preferential sensitivity of the marginal mesoderm might be related to early changes in the apical ectoderm, which itself becomes excessively necrotic and rapidly looses its pseudostratified configuration. The forelimb buds from embryos with 50 somites and more usually develop a pentadactylous pattern with a better individuation of digital structures. In all explants, the prospective mesoderm of digit I exhibits stronger regulatory tendencies. PMID- 6502103 TI - Uptake and distribution of exogenous serum proteins in the cultured rat embryo. AB - Head fold stage rat embryos were cultured on a medium consisting of adult rat serum for 48 hr. During the final 10 or 20 hr of culture [35S]-methionine was added to the medium. Sera from visceral yolk sac blood vessels, exocoelomic cavity fluid, and amniotic sac fluid were analyzed by SDS-polyacrylamide gel electrophoresis followed by Amido Black staining and fluorography. Amido Black staining showed bands in all three embryonic fluid compartments which migrated at rates comparable to transferrin, alpha-fetoprotein, albumin, IgG, and hemoglobin. Fluorography, however, showed that radioactivity was restricted to alpha fetoprotein, IgG, and hemoglobin. This suggested that at least some transferrin and albumin were transferred intact from the exogenous medium to the embryonic fluid compartments. PMID- 6502104 TI - The motion of floating and submerged objects in the Chattahoochee River, Atlanta, GA. AB - Two mannikins, one designed to float and one designed to sink, were used to examine the ways in which human bodies move in a river. The floating mannikin was used to examine the movement of a body floating downstream on the surface and to determined the flow patterns of surface currents through bends in the Chattahoochee River in Atlanta, GA. The submerged mannikin was constructed to have a specific gravity of a deceased person (over a range of specific gravities) and was used to examine the motion of a body immediately upon entering the water. The submerged mannikin also was used to examine motion along the bottom of the river. Floating objects near each bank of the Chattahoochee River were found to remain along their respective banks as they moved downstream through the bends in the river. No mechanisms of transport from one bank to the other in the bends was found. The movement of a submerged dummy only occurred at very high river flows. The dummy remained stationary at the place where it reached the bottom for tests over a wide range of specific gravities and a moderate range of flow levels. A discussion of the river conditions (for example, bottom topography, bottom composition, flow rates, and hydraulics) is included. The results of the experiments offer initial guidelines and principles that can be used by officials and agencies involved in the search, rescue, and recovery of bodies in most rivers. PMID- 6502105 TI - Improved recovery and stability of ethanol in automated headspace analysis. AB - Solutions are reported here for two problems in automated headspace gas chromatographic analysis for ethanol. The first is the catalytic oxidation of ethanol by oxyhemoglobin, a process that is limited only by the amount of oxygen in the sealed vessel. This reaction is prevented by the addition of sodium dithionite. The other problem, the lack of a suitable salting-out agent, led to the selection of ammonium sulfate, which improved recovery of ethanol as well as enhancing method precision. A procedure incorporating these improvements is described. PMID- 6502106 TI - The determination of sex from forcibly removed hairs. AB - The determination of sex from forcibly removed hairs in forensic science laboratories has, in the past, been based almost entirely on the presence or absence of the Y chromosome in the cells of the hair root sheath. Since the human male genotype is XY and the female is XX, a technique was devised that permits root sheath cells to be stained sequentially for the Y and then the X chromosome using quinacrine mustard. Following staining, the Y and the X chromosome fluorescence were observed, at pH 5.5 and 3.0, respectively, by epifluorescence. The X and Y chromosome counts obtained for a single hair root specimen were reported as a Y-X (Y minus X) score. The results reported show that specimens from males gave positive Y-X score while specimens from females gave negative Y-X scores. Results of an age study and blind trials were also reported. PMID- 6502107 TI - Clarifying the role of forensic anthropologists in death investigations. AB - Although their customary role is the identification of decomposed human remains, forensic anthropologists are frequently called upon to provide evidence for or to testify about the circumstances that surrounded a particular death. The literature is ambiguous and contradictory about the role of anthropologists in death investigations. Relying upon traditional distinctions, we present three cases that illustrate the presence of evidence for "manner of death" on decomposed remains. Then we argue that evidence for vital reactions, necessary for the determination of "cause of death," rarely if ever survives skeletonization, and while forensic anthropologists can be expected to provide evidence for the determination of manner of death, they are unlikely to contribute to the discovery of its cause. PMID- 6502108 TI - Discriminant function sexing of the tibia. AB - The objective of the study was to test whether the shaft dimensions of the tibia were as sexually dimorphic as those of the femur and to develop a new sex determination technique from the tibia. Stepwise discriminant function subroutine based on a sample of 159 tibiae of blacks and whites of both sexes of the Terry Collection was employed for the study. Osteometric measurements included were the length, proximal and distal breadths, the circumference of the nutrient foramen and of the smallest shaft regions, and anteroposterior and transverse diameters at the nutrient foramen levels. The results indicated that in all dimensions proximal epiphyseal breadth and the minimum circumference were the variables selected by the stepwise function in blacks and that all but the transverse diameter participated in the function in whites. Average accuracy of sex determination was 87.3% for whites and 90.0% for blacks. For both races proximal epiphysis was a better indicator of sex differences than the remaining dimensions. While the study provided statistically reliable results sexual dimorphism was observed to be race dependent. This was especially true for blacks who provided higher prediction accuracy and more dimorphism than whites. Thus it was suggested that determination of sex required a consideration of not only growth related sex differences, and physical activity, but also the genetic (racial) nature of a population. PMID- 6502109 TI - Age estimation from the rib by phase analysis: white males. AB - The determination of age at death is an important part of physical and forensic anthropology. Techniques now in use vary from direct observation of a bone to microscopic examination of a given segment. This study introduces the sternal end of the rib as a new site for age estimation by direct observation. The sample consisted of 118 white male ribs of verified age, sex, and race. The ribs were assigned to one of nine phases (0 through 8) based on changes noted at the costochondral junction. These included the formation of a pit, its depth and shape, configuration of the walls and rim surrounding it, and the overall texture and quality of the bone. Statistical analysis indicated that these changes were age related. It was further revealed that metamorphosis was most rapid and uniform from the mean age of 17 to 28 years (Phases 1 through 4). The rib morphology was more varied after age 39 (Phase 5) resulting in a wider range for the predicted age. Our study concluded that the sternal rib end may yield a similar degree of accuracy to the pubic symphysis and perhaps better than that for cranial sutural closure. Our technique also enables the forensic scientist to use the rib for corroboration with age estimations obtained by traditional methods. PMID- 6502111 TI - Competence to proceed: a functional and context-determinative decision. AB - Legally, the defendant's competence at any stage of criminal proceedings is defined in terms of the test set forth in Dusky v. United States, a test establishing minimum rationality as the basis for determining mental competence. A number of investigators have attempted to devise testing instruments to assist clinicians in applying this test to individual defendants being examined for competence. Competence, however, is both context-determinative and functional in nature. The evaluator must insist on being given specific information relating to the functions that the defendant is expected to perform. The evaluator must then assess the defendant's measurable skills in the light of those specified functions and articulate his findings to the court in terms of the skills and functions rather than in terms of conclusory legal labels. Competence is then best determined by the court as a legal, not a mental, health decision under the somewhat nebulous but nonetheless appropriate criterion of "fundamental fairness" in the light of the defendant's mental state. PMID- 6502110 TI - Neuropsychological performance of sexual assaulters and pedophiles. AB - Persons who had been arrested for sexual assault were administered the Luria Nebraska Neuropsychological Battery and the results compared to a group of normal controls. The sexual assaulters performed significantly worse on 7 of the 14 scales of the battery. The data were then broken down into three groups: (1) those who had forcibly assaulted postpubescent victims, (2) those subjects who had sexually molested a prepubescent child, and (3) normal controls. A discriminant analysis correctly classified 68% of the subjects on the basis of their neuropsychological performance alone. PMID- 6502112 TI - A deaf sex offender. AB - Sex offenders are common among deaf criminals seen for psychiatric evaluation. This has previously been attributed to discretionary handling of deaf criminals within the criminal justice system. The author presents the case of a deaf sex offender which illustrates discretionary handling, but which also suggests altered psychosexual development. He then discusses several characteristics in the development and lives of deaf people that may contribute to an altered psychosexual development and an increase likelihood of committing sex offenses. PMID- 6502113 TI - Atherosclerotic coronary artery disease and "low" levels of carboxyhemoglobin; report of fatalities and discussion of pathophysiologic mechanisms of death. AB - Levels of carboxyhemoglobin that would ordinarily cause little or no noticeable symptoms or other effects proved fatal in individuals suffering from atherosclerotic coronary artery disease. All such deaths that occurred in the Cuyahoga County during a period of 23 years were studied. The pathophysiologic mechanisms that may be operative in these deaths are discussed. The importance of being aware of this fact, while one determines the cause and manner of such deaths, is stressed. PMID- 6502114 TI - Postmortem methemoglobin concentrations and their significance. AB - Small concentrations of methemoglobin are present in the blood of normal individuals. Increased concentrations of methemoglobin can be formed by the action of certain chemicals or drugs, or in individuals with specific genetic defects. There is little information available concerning the validity of postmortem methemoglobin concentration as an indicator of antemortem methemoglobinemia. We measured blood concentrations of methemoglobin in 49 autopsy specimens. We conclude that postmortem methemoglobin concentrations are not valid indicators of antemortem methemoglobinemia. PMID- 6502115 TI - The role of the forensic scientist in the application of chemical tests for alcohol in traffic law enforcement. AB - The role and ethical responsibilities of the forensic scientist are reviewed. The context of this discussion includes the application and support of chemical tests for alcohol statutes in the United States adversary system of justice. The goal of this review is to stimulate awareness among the various participants (that is, scientist, prosecutor, defense counsel, judges, and law enforcement officials) in traffic law enforcement situations. Their mutual understanding and cooperation is essential to the effective and efficient use of chemical test procedures. The relative scientific weight that should be given to blood, breath, and urine tests for alcohol is presented. PMID- 6502116 TI - The detection of protein p30 in seminal stains by means of thin-layer immunoassay. AB - The detection of p30 by means of an indirect thin-layer immunoassay (TIA) is described. Extracts from 20 samples can be analyzed in approximately 2 h with a detection limit of approximately 50 ng. The p30 protein was detected in seminal stains which had been stored at room temperature for six months and at 130 degrees C for 4 h. Blood, saliva, urine, perspiration, and tears did not interfere with the method. The reliability of the method was demonstrated in a blind study. PMID- 6502117 TI - Gm(11) grouping of dried bloodstains. AB - An absorption inhibition method for the detection of gamma marker Gm(11) in dried bloodstains is described. Particular reference is made to the association of Gm(11) with Gm(-1, -2). When a dried bloodstain fails to inhibit anti-Gm(1) and anti-Gm(2), this may represent a true Gm(-1, -2) result or there may be insufficient material to inhibit either antibody. The detection of Gm(11) in a bloodstain extract provides an objective means of confirming the apparent absence of Gm(1) and Gm(2) as representing a true Gm(-1, -2) result. This antigen compares very well with other blood group systems with regard to the amount of bloodstain required for analysis and its stability. No evidence is available for preferential loss of Gm(1) and Gm(2) relative to Gm(11) in dried bloodstains. PMID- 6502118 TI - Tissue distribution of lidocaine after fatal accidental injection. AB - The accidental death of a 64-year-old heart patient as a result of the injection of an incorrect dose of lidocaine is presented. The attending nurse inadvertently administered an intravenous bolus of 10 mL of 20% lidocaine (2g). The patient should have received 5 mL of 2% lidocaine (0.1 g). Such iatrogenic overdoses of lidocaine arise from confusion between prepackaged dosage forms. Lidocaine concentrations (mg/L or mg/kg were: blood, 30; brain, 135; heart, 106; kidney, 204; lung, 89; spleen, 115; skeletal muscle, 20; and adipose, 1.3. The results indicate that even during cardiopulmonary resuscitation as much as 38% of the administered dose of lidocaine may be found in poorly perfused tissue such as skeletal muscle and adipose. PMID- 6502119 TI - Toxicologic studies in a fatal overdose of 2,4-D, mecoprop, and dicamba. AB - A suicidal poisoning committed by a 61-year-old woman, who ingested an unknown quantity of Killex, containing in aqueous solution 100 g/L of (2,4 dichlorophenox)acetic acid (2,4-D), 50 g/L of mecoprop, and 9 g/L of dicamba as amine salts is described. Quantitation of chlorophenoxy acids was performed by extraction from an acidified mixture and concentration before high performance liquid chromatography analysis. All three herbicides were separated in a phosphate buffer/acetonitrile mixture at 280 nm on a RP-8 column. Concentrations of herbicides found were: in blood--520-mg/L 2,4-D, 530-mg/L mecoprop, and 170 mg/L dicamba; in urine--670-mg/L 2,4-D and 520-mg/L mecoprop; in bile--340-mg/L 2,4-D, 530-mg/L mecoprop, and 140-mg/L dicamba; and in liver--540-mg/Kg 2,4-D, 500-mg/Kg mecoprop, and less than 100-mg/Kg dicamba. Liquid chromatography was found to be a reliable method for herbicide quantitation in biological tissues and fluids. The technique offered definite advantages over ultraviolet spectrophotometry and avoids the derivatization requirement for gas chromatography. PMID- 6502120 TI - A fatality involving phentermine. AB - A case is presented where phentermine, a sympathomimetic amine used as an anorectic drug, is believed to have significantly contributed to the death of an individual in whom other drugs were also found. Blood, urine, and tissue concentrations of phentermine are reported and compared to other cases in the literature. PMID- 6502121 TI - Suicide by the use of a chain saw. AB - The paper describes a case of suicide by the use of a chain saw. Visceral and tissue damage caused by vibrations are documented in occupational medicine, but fatal damage is not often seen at autopsy. This paper gives an account of the damage to viscera and tissues that has been noted when strong vibrations of low frequency have been directed to the body for a very short time with fatal result after a few minutes survival time. PMID- 6502122 TI - Metropolitan Forensic Anthropology Team (MFAT) case studies in identification: 2. Identification of a Vietnamese trophy skull. AB - A Vietnamese trophy skull, apparently a victim of the Vietnam war, was recently received for analysis in a New York State homicide case. The skull, which is well preserved except for the missing mandible and maxillary dentition, is compared to trophy skulls of Japanese military personnel, also brought back to the United States by American soldiers following wartime duty in Asia. PMID- 6502123 TI - Discussion of "Datura stramonium: a fatal poisoning". PMID- 6502124 TI - Suicide and the computer age. PMID- 6502126 TI - 10th meeting of the International Association of Forensic Sciences, Oxford, England, 18-25 September 1984. Abstracts. PMID- 6502127 TI - [Our experience with the Bakamjian delto-pectoral flap]. PMID- 6502125 TI - Ethanol, marijuana, and other drug use in 600 drivers killed in single-vehicle crashes in North Carolina, 1978-1981. AB - Although the use of ethanol, marijuana, and other drugs may be detrimental to driving safety, this has been established by direct epidemiological evidence only for ethanol. In this study, the incidences of detection of ethanol (and other volatile substances), delta-9-tetrahydrocannabinol (THC), barbiturates, cocaine and benzoylecgonine, opiates, and phencyclidine were determined in an inclusive population of 600 verified single-vehicle operator fatalities that occurred in North Carolina in 1978 to 1981. The incidence of detection of amphetamines and methaqualone were determined for drivers accepted for study during the first two years (n = 340) and the last year (n = 260), respectively. Blood concentrations of 11-nor-deta-9-tetrahydrocannabinol-9-carboxylic acid (9-carboxy-THC) were determined in THC positive drivers. EMIT cannabinoid assays were performed on blood specimens from all drivers accepted for study during the third year, and the feasibility of using the EMIT cannabinoid assay as a screening method for cannabinoids in forensic blood specimens was investigated. The incidence of detection of ethanol (79.3%) was far greater than the incidences determined for THC (7.8%), methaqualone (6.2%), and barbiturates (3.0%). Other drugs were detected rarely, or were not detected. Blood ethanol concentrations (BECs) were usually high; 85.5% of the drivers whose bloods contained ethanol and 67.8% of all drivers had BECs greater than or equal to 1.0 g/L. Drug concentrations were usually within or were below accepted therapeutic or active ranges. Only a small number of drivers could have been impaired by drugs, and most of them had high BECs. Multiple drug use (discounting ethanol) was comparatively rare. Ethanol was the only drug tested for that appears to have a significantly adverse effect on driving safety. PMID- 6502128 TI - [Epidermoid carcinoma of the respiratory-digestive tract in women (excluding the esophagus)]. PMID- 6502129 TI - [Epithelioma of the oropharynx: therapeutic results after only external irradiation]. PMID- 6502130 TI - [Tympanic retraction bags]. PMID- 6502131 TI - [False obstructive osteoma of the external auditory canal (fibrous dysplasia of the tympanic ring)]. PMID- 6502132 TI - [Naso-sinus involvement of occupational origin]. PMID- 6502133 TI - Active ion transport in the renal proximal tubule. I. Transport and metabolic studies. AB - Various aspects of the interrelationship between ion transport and cellular metabolism were investigated using a suspension of rabbit cortical tubules that were mainly proximal in nature. Using the intact tubules, the compartmentation of K within the renal cell was studied by performing 42K uptake studies. The oxygen consumption (QO2) of the tubules was measured under similar conditions, as well as when the Na pump was stimulated by increasing Na+ entry with nystatin. In addition, the state 3 rate of respiration was measured when the mitochondria of digitonin-permeabilized tubules were stimulated by ADP. At 37 and 25 degrees C, a single-compartmental uptake of 42K was observed, which suggests that extracellular K+ communicates with a single compartment within the renal cell. Between 37 and 15 degrees C, the ouabain-sensitive QO2 and the initial 42K uptake rate were parallel in an Arrhenius-type plot, which indicated that active ion transport and oxidative phosphorylation remain tightly coupled within this temperature range. At all temperatures between 37 and 15 degrees C, nystatin stimulated the QO2, which demonstrates that the entry of Na+ into the renal cells was rate limiting for active Na+ transport throughout this temperature range. Between 37 and 20 degrees C, the nystatin-stimulated QO2 was nearly equal to the state 3 rate of respiration, which suggests that active ion transport may be limited by ATP availability under these conditions. At 15 degrees C, nystatin addition stimulated the QO2 well below the state 3 respiratory rate. PMID- 6502134 TI - Characterization of Peptostreptococcus asaccharolyticus glutamate dehydrogenase purified by dye-ligand chromatography. AB - Glutamate dehydrogenase (L-glutamate:NAD+ oxidoreductase (deaminating); EC 1.4.1.2) has been purified from Peptostreptococcus asaccharolyticus in a single step using dye-ligand chromatography. The enzyme (GDH) was present in high yields and was stabilized in crude extracts. A subunit molecular weight of 49000 +/- 500 was determined by SDS polyacrylamide gel electrophoresis and six bands were obtained after cross-linking the subunits with dimethyl suberimidate. This bacterial GDH was predominantly NAD+-linked, but was able to utilize both NADP+ and NADPH at 4% of the rates with NAD+ and NADH, respectively. An investigation of the amino acid specificity revealed some similarities with GDH from mammalian sources and some clear differences. The values of apparent Km for the substrates ammonia, 2-oxoglutarate, NADH, NAD+ and glutamate were 18.4, 0.82, 0.066, 0.031 and 6 mM, respectively. The P. asaccharolyticus GDH was not regulated by purine nucleotides, but was subject to strong inhibition with increasing ionic strength. PMID- 6502135 TI - Purification, characterization and immunological properties of the serotype specific capsular polysaccharide of Pasteurella haemolytica (serotype A1) organisms. AB - The serotype-specific capsular polysaccharide from two strains of Pasteurella haemolytica serotype A1 organisms was purified and characterized by chemical analysis and NMR spectroscopy. The polymer has the structure----3)-O-(2-acetamido 2-deoxy-4-O-acetyl-beta-D-mannopyranos yluronic acid)-(1----4)-O-(2-acetamido-2 deoxy-beta-D-mannopyranose)-(1----. The polysaccharide was immunogenic (able to evoke production of antibodies) for sheep but not for rabbits. Immuno electron microscopy studies using the Protein A-gold technique showed the polysaccharide to be peripherally located on the bacterial surface. Reduction, oxidation and de O-acetylation of the polymer did not appear to alter its immunological precipitability with specific antiserum, but all three treatments destroyed its ability to adhere to sheep erythrocytes at neutral pH. De-N-acetylation of the polymer destroyed both immunological precipitability and erythrocyte adherence. PMID- 6502136 TI - Polar lipid and isoprenoid quinone composition in the classification of Staphylococcus. AB - Representatives of 13 species of Staphylococcus were examined using a small-scale procedure for the sequential extraction of isoprenoid quinones and polar lipids. Menaquinones were the only isoprenoid quinones found in the 77 test strains which were divided into three groups based upon the predominant isoprenologue detected: (i) S. hyicus subsp. hyicus, S. sciuri subsp. lentus and S. sciuri subsp. sciuri contained unsaturated menaquinones with six isoprene units; (ii) S. capitis, S. cohnii, S. epidermidis, S. haemolyticus, S. hominis, S. hyicus subsp. chromogenes, S. intermedius, S. saprophyticus, S. simulans, S. warneri and S. xylosus contained unsaturated menaquinones with seven isoprene units and (iii) S. aureus contained unsaturated menaquinones with eight isoprene units and varying amounts of the corresponding lower isoprenologue. All of the organisms contained very similar polar lipid patterns consisting of diphosphatidylglycerol, phosphatidylglycerol, beta-gentiobiosyl diacylglycerol and a number of glycolipids and phospholipids. One of the glycolipids was chromatographically indistinguishable from beta-gentiotriosyl diacylglycerol. Lysylphosphatidylglycerol was a major component in S. aureus and S. intermedius but was usually present in minor amounts in the coagulase-negative strains. The polar lipid data underline the homogeneity of the genus Staphylococcus and distinguish staphylococci from aerobic, Gram-positive cocci and from the phylogenetically related aerobic, endospore-forming bacteria. Menaquinone composition can also be used to separate staphylococci from other aerobic, Gram positive cocci. PMID- 6502137 TI - Isolation of a motile mycoplasma from fish. AB - For the first time a mycoplasma has been isolated from fish. The organism, designated strain 163K, was isolated on modified Hayflick medium under aerobic conditions at 25 degrees C from the gills of a tench (Tinca tinca L.). It showed the characteristic features of mycoplasmas. In addition it was flask-shaped with a distinct head-like structure and was able to attach to inert surfaces and living cells. The most interesting property of the organism was its ability to show fast gliding motion. Movement was only in the direction of the head-like structure and was not interrupted by resting periods. PMID- 6502138 TI - Genome analysis of influenza C viruses isolated in 1981/82 from pigs in China. AB - The genomes of influenza C viruses isolated from pigs in Beijing, China during 1981/82 and of human influenza C virus strains isolated between 1947 and 1981 were analysed by comparison of RNA migration patterns on gels and by two dimensional oligonucleotide (ON) mapping. The genomes of the pig isolates were closely related to one another, though in part distinguishable by point mutations. They were similar to but more distantly related to the genomes of human influenza C viruses. The genome of the C/pig/Beijing/10/81 isolate differed from that of the C/pig/Beijing/32/81 isolate obtained on the same day at the same place by a number of mutations which were all located in RNA segments 1 and 2 as shown by ON mapping. This result suggests that the two isolates are genetically related by a reassortment event which is likely to have occurred in nature. The question whether or not pigs are a natural reservoir for human influenza C viruses cannot be answered at present. PMID- 6502139 TI - Polypeptide synthesis in MDCK cells infected with human and pig influenza C viruses. AB - MDCK cells were infected with six human influenza C virus strains (isolated between 1947 and 1981) and seven pig influenza C virus strains (isolated in 1981 and 1982) and the virus-specific polypeptides were compared by SDS-polyacrylamide gel electrophoresis and one-dimensional peptide mapping. The major structural polypeptides, i.e. glycoprotein (gp88), nucleoprotein (NP), and membrane protein (M), and one non-structural polypeptide were identified in all strains by radiolabelling infected cells with [35S]methionine. No differences in the electrophoretic migration of the M proteins or NS proteins were observed. The two earliest human isolates, C/Taylor/1233/47 and C/Great Lakes/1167/54, had faster migrating NP proteins, and another human strain, C/Georgia/1/69, displayed a faster migrating gp88. Minor differences in the one-dimensional peptide maps produced by partial digestion of the M proteins with V8 protease were observed between the human and pig isolates, while more marked differences were noted in the peptide maps of the glycoproteins of the C/Georgia/1/69, C/Yamagata/10/81 and C/Yamagata/11/81 viruses compared to the other human strains and the pig strains. The overall conclusion is that the proteins of human influenza C viruses isolated over a 35 year period and those of recent pig influenza C virus isolates are highly conserved. PMID- 6502140 TI - Recovery of host cell protein synthesis during infection with a temperature sensitive mutant of Newcastle disease virus. AB - When chick embryo fibroblasts infected with high multiplicities of a non revertible temperature-sensitive (ts) mutant (ts53) of Newcastle disease virus (NDV) at the permissive temperature (34 degrees C) and incubated to allow the appearance of virus-induced proteins were shifted up to and incubated at the non permissive temperature (42 degrees C), analysis of [3H]leucine-labelled proteins by SDS-PAGE revealed a marked increase in cellular protein synthesis and a decline in viral synthesis, with an eventual return to an apparently uninfected state. Mutant ts53 apparently ceased to suppress cellular protein synthesis, and translation of viral proteins was markedly inhibited. This was not observed in ts+-infected cells, or in ts53-infected cells maintained at the permissive temperature. Recovery from the infected state was inhibited by actinomycin D at any stage, but was not prevented by cycloheximide present immediately before and during temperature shift-up. Mutant ts53 was shown to be RNA- at 42 degrees C, although viral mRNAs synthesized at 34 degrees C are shown to be present throughout host recovery but in an inactive state. PMID- 6502141 TI - Human spumavirus replication in human cells. AB - It was previously reported that the replication of the human syncytium-forming virus (HSFV), a spumavirus, occurred only in fibroblast-like cell lines (human fetal diploid lung #645 [HFDL]) but not in epithelial-like lines (recovered amnion) [RA]. Factors that may be involved in such a phenomenon were the subject of this investigation. While both permissive (HFDL) and nonpermissive (RA) cell lines supported the replication of several representative animal viruses and adsorbed HSFV equally well, immunofluorescent staining of HSFV antigens revealed markedly fewer fluorescing cells in nonpermissive cultures. Infectious center assays of infected nonpermissive cells indicated the formation of significantly fewer infectious centers. The rate of DNA synthesis was markedly greater in the permissive cell lines. In addition, in the permissive cell line, the amount of proviral DNA revealed by the Hirt procedure and isopycnic banding in CsCl was significantly increased and was infectious as determined by the calcium phosphate DMSO transfection assay. These results indicate that resistance of HSFV infection in nonpermissive cell cultures is probably an intracellular event. PMID- 6502142 TI - Etiopathogenetic aspects of hepatitis A II. Specific and nonspecific humoral immune response during the course of infection. AB - The anti-HAV humoral immune response in the IgM, IgA, and IgG classes was analyzed weekly in 35 patients with clinically overt hepatitis A during the time of their hospitalization and 2-3 years afterward. In parallel, the dynamics of total immunoglobulins and complement C3 component (C3) levels were determined. The results suggest that the appearance of class-specific anti-HAV is compatible with the course of primary humoral immune response, with IgM and IgA anti-HAV, providing immunity in the early and intermediate phases of the infection, and IgG anti-HAV, providing immunity in the later phase. The overall appearance of anti HAV, total immunoglobulins, and C3, do not support the view that liver injury is mediated by the humoral immune mechanisms. Instead, the hepatocyte damage is probably caused by direct viral cytotoxicity. This hypothesis is supported by a case of hepatitis A in a patient under immunosuppressive treatment. PMID- 6502143 TI - EKG of the month. When normal isn't "normal". Sinus tachycardia. PMID- 6502144 TI - A survivor of Ewing's sarcoma. PMID- 6502145 TI - An assessment of Louisiana's current physician manpower planning activities. PMID- 6502146 TI - The use of soft tissue expansion in reconstructive surgery. PMID- 6502147 TI - Sociobiology and antisocial personality. An alternative perspective. AB - The clinical characteristics of antisocial personality disorder are well defined, but poorly explained in developmental or etiological terms. After reviewing basic tenets of sociobiology, a theory of the etiology of antisocial personality is developed. Predictions that flow from this etiological theory are compared with published data for the disorder. These comparisons suggest that sociobiological theory provides a powerful and predictive etiological hypothesis for antisocial personality disorder. Social and clinical implications and avenues for future study of antisocial personality are suggested, as are potential relationships of this theoretical approach to other psychopathological conditions. PMID- 6502148 TI - Relationship of sex and the effects of unilateral lesions on the Wechsler Intelligence Scales. Further considerations. AB - Previous studies of sex differences in the effects of unilateral lesions were critically reviewed. New data were included in a review of 28 samples of patients with unilateral right or left cerebral lesions. The results reveal that the relationship of sex to the magnitude of Verbal vs. Performance IQ discrepancy is equal for both right and left lesion samples, and accounts for approximately 15 per cent of the variability among samples. The data are discussed in regard to potential clinical utility of a patient's sex in the interpretation of IQ score discrepancies. PMID- 6502149 TI - Cognitive style, cortical function, and electroconvulsive therapy. AB - Performance on the rod and frame test (RFT) was measured over three separate occasions in three groups of 20 depressive patients and a nonpatient control group. Depressive patients were selected into three groups according to whether they had been prescribed one of three forms of treatment: bilateral electroconvulsive therapy (ECT), nondominant unilateral ECT, or a course of antidepressant drugs. The RFT was administered on three occasions: before treatment, 1 week after completion of treatment, and at 3 months follow-up. The control group received no treatment, but were tested at comparable periods. The RFT was scored as mean absolute error and also as separate frame-dependent, rod dependent, and constant error components. All depressive groups showed improved error measures post-treatment. The two ECT groups showed less frame dependence post-treatment than the drug group. The group receiving bilateral ECT showed a greater decrease in the mean error of performance than the unilateral group. Right-sided unilateral ECT affected frame dependence in patients who were initially frame independent, rather than in those who were initially frame dependent. The results indicated that the effect of ECT may depend on a patient's initial pretreatment cognitive style. PMID- 6502150 TI - Cross-national reliability study of a schedule for assessing personality disorders. AB - The inter-rater reliability of a schedule used to assess personality disorders was examined. The Personality Assessment Schedule (PAS) involves an interview with both the patient and a close informant and the ratings for the informant are given most weight in the final scoring. Videotaped interviews with 23 psychiatric patients, most of whom had a clinical diagnosis of personality disorder, and a close informant were scored by seven raters, four in the United Kingdom and three in the United States. Overall inter-rater reliabilities (using the intraclass correlation coefficient, RI) were generally good to excellent for each of the 24 personality variables tested, ranging between .66 and .94 for informants and between .51 and .91 for subjects. Corresponding reliability coefficients for overall mean PAS scores were .82 and .75, respectively. Consistent with these findings, there was little bias between the scores of American and British raters, although there was some tendency for American raters to score higher for the trait of eccentricity and lower for the trait of conscientiousness than was true for British raters. There was less bias for informants' ratings than for those of subjects. In a second set of analyses, it was shown that inter-rater reliability levels (using the Kappa statistic) were also good to excellent (.6 to .8) for the categorical diagnosis of personality disorder. These results, taken together, demonstrate that abnormal personality can be reliably assessed by both British and American raters. PMID- 6502151 TI - Estimating the prevalence of school refusal and school-related fears. A Venezuelan sample. AB - This study investigated the prevalence of school refusal and school-related fears in a sample of 1034 Venezuelan children from 3 to 14 years of age. Fear surveys were administered to children older than 9 years and to the younger children's parents. In addition, parents and teachers completed questionnaires regarding the children's other behavior problems, and teachers reported on the children's school achievement and attendance. Although a significant proportion (17.7 per cent) of the children expressed intense fears of school, only rarely were such fears combined with high absenteeism or with parents' or teachers' reports of school refusal problems. School refusal prevalence was calculated using six different fear and absenteeism criteria. When refusal was defined by agreement among all information sources, prevalence was .4 per cent, which is comparable to rates reported in other countries using similar criteria. However, the data indicate that there are various degrees of school aversion and refusal. PMID- 6502152 TI - Medical school pressures and their relationship to anxiety. AB - This study examined the relative importance of medical school pressures according to their relationship with symptoms of anxiety, as evaluated by a standardized/normative measure of anxiety. As many as 206 (34 per cent) of the total sample (N = 605) of students reported symptoms of anxiety above the median of a normative population of psychiatric outpatients. Using multiple regression, six medical school experiences significantly accounted for 36 per cent of the variance in anxiety scores. These included: perceived threat, mastering knowledge, anonymity, little time for personal activities, peer competition, and long hours. These results are important for two reasons. Contrary to the traditional belief that stressful experiences are necessary for future medical practice, research suggests that stress and anxiety are major causes of cognitive dysfunction. The identification of those experiences that are most anxiety provoking should help therapists and educators to develop intervention strategies in order to reduce anxiety and increase the quality of medical education. PMID- 6502153 TI - Effects of subliminal activation of Oedipal fantasies on competitive performance. A replication and extension. AB - A subliminal psychodynamic activation experiment was conducted in which the effects of five subliminal stimuli were sought on the dart-throwing performance of male subjects. The stimuli consisted of the following messages, each accompanied by a congruent picture: BEATING DAD IS OK, BEATING DAD IS WRONG, BEATING HIM IS OK, BEATING HIM IS WRONG, and PEOPLE ARE WALKING. The first two stimuli were intended to activate competitive motives within the context of the Oedipus complex; the next two, competitive motives outside that context; and the last was intended as a control stimulus. BEATING DAD IS OK led to greater dart throwing accuracy than each of the other four conditions, which in turn did not differ from each other. This finding replicated a result reported by Silverman, L. H., Ross, D., Adler, J., and Lustig, D. (J. Abnorm. Psychol., 87: 341-357, 1978) and is in keeping with the formulation that the activation of oedipal motives can affect competitive performance. Neither a subject variable (fear of success) nor the differential effects of two experimenters was found to interact with stimulus conditions in affecting dart scores. PMID- 6502154 TI - MMPI characteristics of borderline personality inpatients. AB - MMPI (Form R) profiles of psychiatric inpatients (N = 45) meeting DSM-III criteria for borderline personality disorder were compared with chronic schizophrenic inpatients (N = 48) and with inpatients with acute psychotic illness (N = 20). Profile shape was similar among the three groups, although the borderline sample showed significantly higher elevations on four of the 10 clinical scales--Depression, Hysteria, Psychopathic Deviate, and Psychasthenia- when compared to the chronic schizophrenic cohorts. The borderline sample showed only one significant deviation on the clinical scales when compared to the acute psychotic sample as evidenced by a higher elevation on the Psychopathic Deviate scale. Clinically, the borderline MMPI responses suggest features of irritability, hostility, and resentfulness. On the validity scales, the borderline sample showed a significantly lower score on the L scale when compared to both comparison groups, although all of the groups' L scale scores were within conventional limits. While significant differences between groups did not emerge on the F scale, the borderline sample attained a clinically elevated score suggestive of weakened ego defenses and unconventional thinking. Analysis was also performed of a composite measure of psychoticism probability (the Goldberg Index) between groups. While the borderline and acute psychotic samples showed Goldberg indices suggestive of increasing likelihood for psychotic illness, the chronic schizophrenic group yielded a Goldberg Index significantly greater than both of the other groups, thus confirming the validity of the hypothesis. Finally, the MMPI borderline profiles were also compared to previously published norms of borderline outpatients and veteran borderline inpatients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502155 TI - Psychological aspects of essential blepharospasm. AB - Evaluation of 20 essential blepharospasm patients by using structured interview and psychological testing (MMPI, Rorschach) revealed characteristic pathological personality patterns in all cases. Recent losses or life change, marital conflict, and specific precipitating events were common. Test findings indicated unexpressed hostility, denial, and repression in a majority of women. Three of five men showed evidence of depression. This initial systematic investigation of psychological factors in blepharospasm supports the hypothesis that neurological and psychogenic factors may interact etiologically. The data suggest that personality, recent stress, and precipitating events warrant both clinical assessment and controlled research to determine the specificity and prevalence of these findings. PMID- 6502156 TI - Quantitative effects of a neurotoxin upon serotonin levels within tissue compartments of the medicinal leech. AB - The serotonin (5-hydroxytryptamine, 5-HT) content of tissue compartments in the medicinal leech, Hirudo medicinalis, was measured by means of high-pressure liquid chromatography coupled with electrochemical detection (HPLC-EC). Each segmental ganglion contains 21.3 +/- 2.9 (9) pmol 5-HT [X +/- SEM (N)]. The pharynx contains 7.1 +/- 1.1 (9) pmol 5-HT/mg wet weight; the salivary glands 3.2 +/- 0.9 (10), ventral body wall 2.0 +/- 0.2 (11), and vasofibrous tissue 1.2 +/- 0.2 (11). The blood of hungry leeches contains 8.7 +/- 1.9 (7) nM 5-HT while that of well-fed leeches is 2.2 +/- 0.4 (6) nM. Leeches were injected with the cytotoxic analog of serotonin, 5,7-dihydroxytryptamine (5,7-DHT) producing selective lesions of the peripherally projecting serotonin-containing neurons, and which in turn abolished their feeding behavior. The serotonin content of the pharynx and ganglia of these toxin-treated leeches were lowered significantly. The serotonin levels within the body wall and salivary glands were not altered significantly by the toxin treatment, but the levels within the vasofibrous tissue and blood were elevated substantially. PMID- 6502157 TI - Endogenous burst capability in a neuron of the gastric mill pattern generator of the spiny lobster Panulirus interruptus. AB - The gastric system of the lobster stomatogastric ganglion has previously been thought to include no neurons capable of endogenous bursting. We describe conditions under which one of the motorneurons, the CP cell, can burst endogenously in a free-running manner in the absence of other phasic network activity. Isolated preparations of the foregut nervous system were used, and the CP bursting was either spontaneous or was activated by continuous stimulation of an input nerve. Three criteria were applied to establish the endogenous nature of such burst generation in CP: absence of phasic input, reset of the bursting pattern by pulses of current in a characteristic phase-dependent manner, and modulation of burst rate by sustained injected current. (1) The firing of other cells which are known to be related synaptically to CP was monitored in nerve records. These other cells were either silent or fired only tonically. Cross correlograms showed that CP bursting was not ascribable to phasic activity in these other network cells. (2) A depolarizing current pulse of sufficient strength injected intracellularly between bursts triggered a burst prematurely and reset the subsequent rhythm. A hyperpolarizing pulse during a burst terminated it and reset the subsequent rhythm. Reset behavior was similar to that described for other endogenous bursters. (3) Application of a positive-going ramp current initially caused an increase in burst rate, as described for other endogenous bursters. However, further depolarization caused a slower burst rate due to lengthening of the individual bursts, although mean firing frequency continued to increase throughout the range tested. Such free-running endogenous repetitive bursting appeared to result from the CP's ability to produce slow regenerative depolarizations ("plateau potentials"). When bursting was present, so was the plateau property, as determined by I-V analysis and by the ability of brief current pulses to trigger and terminate bursts. The previous inability to observe endogenous bursting in preparations with central input removed may be due to the usual absence of the plateau property in such preparations. CP bursting during normal gastric mill rhythms, while underlain by plateau potentials, is strongly controlled by network interactions. CP appears not to be well placed in the network to be considered a source of normal gastric rhythmicity. Nevertheless, endogenous bursting in CP may explain some of the partial gastric rhythms seen in behavioral studies, and illustrates one way that cellular properties might contribute to rhythmic behaviors. PMID- 6502158 TI - Proprioceptor distribution and control of a muscle reflex in the tibia of spider legs. AB - In spiders, retrograde cobalt staining was used to clarify the distribution and detailed innervation of the three types of proprioceptors in the tibio-metatarsal leg joint: internal joint receptors, lyriform slit sense organs, and cuticular spines and hairs. The axons of all these receptors run in just two lateral, ascending nerves, which had previously been associated only with the internal receptors. Each nerve contains several hundred axons ranging in diameter from 0.1 micron to ca. 10 micron. Each slit of the four tibial lyriform organs is innervated by two bipolar sensory neurons. The lateral nerves are entirely sensory and run just beneath the cuticle, a convenient site for electrophysiological recording. We demonstrate simultaneous nerve and muscle recordings from intact spiders; these, in combination with selective sensory ablations, show that a resistance reflex in the flexor metatarsi muscles is elicited by internal joint-receptor units. PMID- 6502159 TI - The absolute configuration on the chiral nitrogen atom of proline residue in the metal complexes of oligopeptides. AB - The CD spectra of the Cu(II) and Ni(II) complexes with peptides containing N terminal L-proline residue are discussed. The formation of the absolute configuration on the bound proline nitrogen is observed in all studied complexes and its contribution to the chiralooptical properties is easily seen in CD spectra. PMID- 6502160 TI - Trace metal uptake in liver cells. 1. Influence of albumin in the medium on the uptake of copper by hepatoma cells. AB - Cultured rat hepatoma cells (HTC-cells) were used to study the transfer of copper from a well-defined medium to and across the cell membrane and particularly the role of albumin in this process. HTC-cells, maintained in a minimal salt-glucose medium, accumulated far more copper than when maintained in the same medium, but supplemented with albumin. In the latter case, the Cu uptake strongly depended on the molar Cu/albumin ratio. The results suggest a role of albumin in the uptake of trace metals. The results indicate the presence of two types of binding sites for copper on the cell membrane. The sites of the first type bind copper very strongly and are probably responsible for the uptake of copper under physiological conditions. Their number was estimated to be about 10(6) per cell. Those of the second type only bind copper when the molar Cu/albumin ratio exceeds a value of about 1, i.e., under extreme, unphysiological conditions. Furthermore, the results suggest a direct interaction of the Cu-albumin complex with these strong binding sites as a first step in Cu uptake processes. PMID- 6502161 TI - Enzymatic reduction of synthetic polymer-bound hemin derivatives: efficient method to prepare a heme-oxygen adduct in cooled aqueous medium. AB - Synthetic polymer-bound hemin (iron(III) protoporphyrin IX) derivatives were effectively reduced by ferredoxin and ferredoxin-NADP reductase system. The resultant polymer-bound heme (iron(II) protoporphyrin IX) derivatives formed oxygen adducts with a lifetime of ca. 1 hr in aqueous solution at -30 degrees C. The reduction rate is discussed in terms of the structure of the hemin derivatives. PMID- 6502162 TI - Distribution and chromium-binding capacity of a low-molecular-weight, chromium binding substance in mice. AB - The distribution of low-molecular-weight, chromium-binding substance (LMWCr) and high-molecular-weight, chromium-binding substance (HMWCr) in the organ cytosol were analyzed by means of Sephadex G-25 gel filtration, after a single i.p. injection of K2Cr2O7 (280 mumol, Cr/Kg) to mice (male dd, 23 +/- 2 g). The amount of Cr in LMWCr per mouse was highest in the liver (83 micrograms), followed by those in the kidney (10 micrograms) and other organs (3-1 micrograms), with lesser amounts of Cr in HMWCr in all the organs. In these organs LMWCr was found to bind 3-28 times the amount of Cr to that in the in vivo binding after the in vitro incubation with K2Cr2O7 at 37 degrees C, showing a high Cr binding capacity of the substance. No inductive formation of LMWCr was observed in the liver even after daily repetitive administration of Cr (150 mumol/Kg, 4 days). Time course studies on the liver and the kidney of mice injected with K2Cr2O7 showed no difference in the accumulation of Cr in LMWCr and in the ratio of Cr in LMWCr to that in HMWCr between the organs at intervals of from 5 min to 24 hr after the injection. The comparative affinity of Cr(III) for LMWCr and for the serum proteins decreases in the order LMWCr, transferrin, albumin. The transfer of Cr from LMWCr to albumin and vice versa was almost negligible. However, significant amounts of the metal transfer was found from LMWCr to transferrin and vice versa, and from albumin to transferrin. These findings suggest that LMWCr is distributed widely in the body and it quickly binds invaded Cr in stable form at an organ site, especially in the liver, with participation of albumin or/then transferrin. This supports the hypothesis that LMWCr plays a large role in Cr detoxification. PMID- 6502164 TI - Behavioural manifestations of third ventricular colloid cysts. AB - Three patients with third ventricular colloid cysts manifested disturbances of memory, emotion and personality in the absence of hydrocephalus. All three patients demonstrated significant improvement following removal of the tumours. The symptoms and signs associated with these neoplasms may be attributed to compression or vascular compromise of the diencephalon with disorder of major limbic system structures. Tumour removal should be undertaken in patients with symptoms even in the absence of hydrocephalus, and ventricular shunting may be inadequate as a sole therapeutic measure. PMID- 6502163 TI - A suprasellar subarachnoid pouch; aetiological considerations. AB - A child with hydrocephalus treated by a valved shunt was reinvestigated after developing a shunt infection. A pouch was discovered invaginating the floor of the third ventricle and filling slowly with CSF from the region of the interpeduncular cistern. Histology and mechanisms of this pouch formation are discussed. PMID- 6502165 TI - Cortisol production during high dose dexamethasone therapy in neurological and neurosurgical patients. AB - Simultaneous plasma dexamethasone and cortisol levels were followed at intervals over 8 hour periods on 40 occasions in 19 subjects who received regular high dosage dexamethasone therapy (rarely less than 12 mg a day) for various neurological and neurosurgical conditions. Lower dexamethasone doses (for example 2 mg daily for 2 days) normally suppress adrenal cortical production of cortisol to below 50 micrograms/l for at least 8 hours. However, in 12 of the 35 studies that did not take place at the first steroid dose or in subjects taking second daily bolus steroid dosage such suppression was not present 8 to 12 hours after dexamethasone intake, though it was shown that dexamethasone could suppress cortisol production in all these cases. Failure of maintained suppression despite the high steroid dose appeared to be related to rapid elimination of dexamethasone. These findings may help explain the relative rarity of adrenal failure in clinical neurological practice after high dosage steroid therapy is ceased. PMID- 6502166 TI - Phenytoin impairs the bioavailability of dexamethasone in neurological and neurosurgical patients. AB - Plasma concentration-time data after oral and intravenous administration of dexamethasone have been subjected to pharmacokinetic analysis in six neurological or neurosurgical patients taking the steroid with phenytoin, and in nine patients (one studied twice) taking dexamethasone without phenytoin. An additional patient was studied before and during phenytoin intake. Apparent volume of distribution was similar in the two groups, but the group treated with phenytoin had an almost statistically significantly shorter dexamethasone mean terminal half-life, an approximately trebled mean plasma clearance, and a mean oral bioavailability of the steroid of only 33%, compared with a mean 84% oral bioavailability in those not receiving phenytoin. To achieve a given plasma dexamethasone concentration, patients treated with the steroid and phenytoin may need oral dexamethasone doses several times those required by patients not receiving phenytoin. PMID- 6502167 TI - Neurophysiological changes following traumatic spinal lesions in man. AB - Neurophysiological observations were made on normal subjects and on 57 patients who had had injuries to the spinal cord. The amplitude of the muscle compound action potential (M response) recorded from triceps surae in response to supramaximal stimulation of the tibial nerve was reduced in the patients indicating that there are changes in motor units below the level of a spinal lesion in man. In the patients who were clinically spastic it was found that: (1) The proportion of the triceps surae motoneuron pool reflexly activated either by tapping the Achilles tendon or by stimulating the tibial nerve just below the threshold of the alpha motoneuron axons (H reflex) was greater than in normal subjects. This can be explained by an increase in the excitability of central reflex pathways. (2) Vibration of the tendo Achilles depressed the H reflex less effectively than in normal subjects. This may indicate altered transmission in the premotoneuronal portion of the H reflex pathway. (3) The H reflex elicited 50 and 100 ms after a standardised conditioning stimulus to the tibial nerve and expressed as percentage of the unconditioned reflex was greater than in normal subjects. This could reflect a change in the excitability of motoneurons or of interneurons. PMID- 6502168 TI - Action of tizanidine on responses of forearm flexors and extensors to torque disturbances. AB - The effects of tizanidine on the electromyographic responses of forearm flexors and extensors to torque disturbances were studied in normal subjects. Tizanidine had a strong depressive action on all the reflex responses, and on muscle background activity. It is concluded that the action on reflexes is not specific, but secondary to decreased spinal cord excitability. PMID- 6502169 TI - Lack of correlation between delayed traumatic intracerebral haematoma and disseminated intravascular coagulation. AB - The relationship between delayed traumatic intracerebral haematoma and disseminated intravascular coagulation was investigated. Eighteen patients with delayed traumatic intracerebral haematoma were selected as the study subjects from 268 consecutive patients with head trauma and compared with another two groups of patients with closed head injury (20 cases) and with multiple injuries (24 cases). All cases had six laboratory studies for disseminated intravascular coagulation for 7 days. The results revealed no different clotting abnormalities among the three groups. From the laboratory point of view, it could be concluded there was no essential relationship between disseminated intravascular coagulation and the appearance of delayed traumatic intracerebral haematoma. PMID- 6502170 TI - Rapid development of hyponatraemia during low-dose carbamazepine therapy. PMID- 6502171 TI - High density lipoprotein cholesterol in transient global amnesia. PMID- 6502172 TI - Proceedings of the Society of British Neurological Surgeons. Belfast, 5-6 April 1984. Abstracts. PMID- 6502173 TI - The temporal aspects of prognosis in epilepsy. AB - A major reason for the conflicting views concerning prognosis in epilepsy has been the failure to account for the temporal aspects of seizure relapse and remission. In this paper prognostic studies in a variety of areas are reviewed to emphasise this point. Most traditional studies (including studies of withdrawal of medication) show a generally poor prognosis for epilepsy. These have been hospital-based and, as such, inevitably over-represent patients with chronic epilepsy. Investigations (both hospital and community based) of patients from the onset of seizures show a much better prognosis, and most patients suffer only a small number of seizures in total over a relatively short period of time and then remit. The longer the epilepsy is active the less likely is eventual remission, but once remission is achieved it is usually permanent. The traditional view of epilepsy as a chronic condition with a continuing tendency to relapse is therefore not tenable for the majority of patients. The patterns of epilepsy are established relatively early in its course in most cases, and long term prognosis might therefore be predictable within a few years of the onset of seizures in most patients. Prior to the introduction of effective treatment, it was said that epilepsy rarely remitted, and it is possible that early treatment may actually improve long term prognosis. PMID- 6502174 TI - The treatment of severe dystonia in children and adults. AB - Twenty-three children (aged less than 18 years) and 17 adults with severe widespread dystonia were treated with high doses of benzhexol (up to 130 mg daily introduced slowly over many weeks). Children tolerated higher doses (median 30 mg/day) than adults (median 20 mg/day). 52% of the children gained useful benefit, many (43%) without unwanted side effects. Such an approach was less successful in adults; 41% gained benefit, but only 35% had no side effects. Twelve adults with severe axial dystonia, and two children with life-threatening generalised dystonia were treated with a combination of a low constant dose of tetrabenazine to which were added pimozide and benzhexol as necessary. The dose of tetrabenazine was aimed at 75 mg daily; pimozide was increased (6 to 25 mg/day) until the dystonia was relieved or Parkinsonism and other side-effects prevented further increments; if necessary benzhexol (6 to 30 mg/day) then was added to control side-effects and to provide additional benefit. 75% of the adults with severe axial dystonia, and one of the two children with life threatening generalised dystonia gained useful benefit from this regime. It is concluded that high dose benzhexol is the present first treatment of choice for children with severe dystonia, and is worth a try in adults but with less expectation of success. When benzhexol treatment alone fails in adults with severe disabling axial dystonia, or in children with life-threatening generalised dystonia, combined therapy with tetrabenazine, pimozide and benzhexol may give valuable symptomatic relief. PMID- 6502175 TI - Recognition memory in Parkinson's disease. AB - On four tests of visual recognition memory Parkinsonian patients obtained normal scores, both immediately and after a delay. They also resembled controls closely in nearly all characteristics of memory. Their performance did not correlate with age, motor disability or disease duration. Parkinson's disease does not, therefore, affect this kind of memory. PMID- 6502176 TI - Chronic encephalomyelitis presenting as chronic progressive myelopathy. AB - Chronic progressive myelopathy is a clinical entity with few neuropathological studies. The most frequent diagnosis in necropsied cases is multiple sclerosis. A case of chronic progressive myelopathy is described with a 16-year course in a woman who was 28 years old at the onset of the disease. At necropsy, there was chronic inflammation in the central nervous system with predominant involvement of the spinal cord with diffuse myelin loss and axonal degeneration. PMID- 6502177 TI - Prediction of delayed cerebral ischaemia after subarachnoid haemorrhage by computed tomography. AB - Computed tomography was performed in 100 patients within 4 days of aneurysmal subarachnoid haemorrhage. The CT appearances have been divided into five grades by the thickness and extent of the subarachnoid blood. Delayed cerebral ischaemia occurred in 62.5% of patients with most blood on CT, in 33.3% of those in the next grade and in none of the other grades with less amounts of blood. The outcome from delayed ischaemia was worse in those with most CT blood. PMID- 6502178 TI - Amyloid angiopathy and lobar cerebral haemorrhage. AB - Seven cases of lobar cerebral haemorrhage due to amyloid angiopathy were found among 60 necropsy cases of intracerebral haemorrhage. Clinically five patients were demented and two had hypertension. Immediately after the onset of stroke there was a high incidence of headache and vomiting, followed by nuchal rigidity. Amyloid angiopathy was most prominent in the cerebral cortex and the leptomeninges. Senile plaques were noted in all cases. One should suspect that a haemorrhage may be due to amyloid angiopathy, when lobar cerebral haemorrhage occurs in an aged, normotensive patient with or without dementia. Surgical evacuation of the haematoma is inadvisable, because of the diffuse nature of amyloid angiopathy, high recurrence rate and less tendency to cause brain stem compression. PMID- 6502180 TI - Remission in spasmodic torticollis. AB - In 26 patients with spasmodic torticollis followed up for a median period of 12 years, the frequency of sustained remission was 23%, the median duration of remission was 8 years and duration of torticollis before remission 3 years. These results are more favourable than stated in the literature and should be taken into consideration before recommending surgical treatment. PMID- 6502179 TI - Adult form of Leigh's disease: a clinico pathological case with CT scan examination. AB - The clinical and pathological findings of a 31-year-old woman, in whom the diagnosis of Leigh's disease was made, are reported. CT scan examination with contrast enhancement showed symmetrical areas of low density, in both thalami, anterior limbs of internal capsules and corpus callosum. Longstanding chronic lesions involved the optic chiasma and the cerebral peduncles and consisted of myelin loss, status spongiosus, astrocytic gliosis and marked capillary proliferation. The neurons were spared. In the basal ganglia, internal capsules and corpus callosum, these lesions were more recent and consisted of focal necrosis, perivascular oedema and few lymphocytic perivascular cuffings. PMID- 6502181 TI - Progressive supranuclear palsy and In111-DTPA cisternography. AB - Three cases of progressive supranuclear palsy are reported in which In111-DTPA cisternography showed slow diffusion, ventricular reflux and failure of isotope clearance. The clinical diagnosis of progressive supranuclear palsy was confirmed histologically in two of these patients. The possible causes of the cisternographic changes and their relationship to the changes of CSF dynamics in progressive supranuclear palsy are discussed. PMID- 6502182 TI - Fluctuation of arterial blood pressure during end-of-dose akinesia in Parkinson's disease. AB - The supine and erect arterial blood pressure and pulse rate were measured in 13 patients with Parkinson's disease, chronically treated with levodopa and peripheral decarboxilase inhibitors presenting with or without On-Off phenomenon (end-of-dose akinesia). In the patients with dose-related response fluctuations the mean systo-diastolic blood pressure, both supine and erect, was found significantly higher during the Off phase as compared to the On phase and to that of the control group (patients with stable clinical response). The mean diurnal "excursion" of systo-diastolic supine and erect blood pressure in patients with On-Off phenomenon was significantly larger than in the control group. Although the clinical implications of such findings remain to be established, the results of this study indicate that arterial blood pressure fluctuations are a definite autonomic component of end-of-dose akinesia. PMID- 6502183 TI - Clinico-anatomical correlations in uncomplicated stroke. AB - A method for making clinico-anatomical correlations by computer superimposition of brain maps derived from CT scan images, described in a companion paper, was tested in 19 patients with an uncomplicated left hemiparesis due to acute stroke. Eight patients with an isolated left hemiparesis had small lesions in the most rostral part of the right internal capsule. The composite lesion maps of 11 patients whose left hemiparesis was complicated only by spinothalamic sensory loss showed a larger area of damage more caudally in the posterior part of the posterior limb of the capsule, abutting the thalamus. The close correlation between the results obtained by this method and those obtained in previous clinico-pathological studies of patients with uncomplicated strokes, confirms the validity of this mapping technique. PMID- 6502184 TI - A microcomputer assisted method for obtaining composite pictures of focal brain damage. AB - A method used to produce composite drawings of superimposed areas of brain infarction is described. The method uses a microcomputer interfaced to a digitising pad and linear plotter. Areas of brain damage are drawn on standardised maps, digitised, manipulated in computer memory, and summated using computer graphics facilities. The composites show the position of brain damage in groups of patients as a contour map of the extent of lesion overlap. The method can be used to study neurological and neuropsychological deficits using CT-scan, or other imaging techniques. Deep and superficial lesions may be displayed equally well. PMID- 6502185 TI - Cerebral convulsion after enfluran anaesthesia and occupational exposure to tetrahydrofuran. PMID- 6502186 TI - Glue sniffing and movement disorder. PMID- 6502187 TI - Evaluation of effect of levamisole on feline mammary cancer. AB - Seventy-three cats with untreated malignant mammary tumors (64 with adenocarcinoma, 9 with carcinoma in situ) were selected for study. All cats were clinically staged and stratified on the basis of tumor volume. Following radical mastectomy, the cats were randomized for treatment with either levamisole or placebo. There was no significant difference in either survival time or recurrence rate between the levamisole and placebo groups. The most significant prognostic factor was tumor volume: Cats with small tumors had a significantly enhanced survival time (p = 0.00006) and lower recurrence rate (p = 0.00004). Breed of cat was also an important prognostic factor; the domestic short-haired cats had a significantly (p = 0.038) longer survival time than the cats of other breeds. PMID- 6502188 TI - Emergence of papovavirus in long-term cultures of astrocytes from progressive multifocal leukoencephalopathy patients. AB - Primary and secondary cell cultures of brain tissue from two fatal cases of progressive multifocal leukoencephalopathy (PML) were closely monitored by light and electron microscopy and immunochemical labelling for glial fibrillary acidic protein. Although the cell cultures appeared heterogeneous and sometimes included fibroblasts, most of the cells were glial and many were identified as astrocytes by their morphology and immunochemical label. In long-term primary cultures four to four and a half months old and subcultures after many passages, focal cytopathic effect was noted in many cells. At the same time, papovavirions appeared in the nuclei of degenerating cells. However, the identity of these cells could not be established. Also, consistently present in the cultures were large atypical and pleomorphic cells that were likewise morphologically and immunochemically identified as astrocytes. Complete formed virions consistent with papovavirus appeared in the nuclei of some of these cells after several cell passages. The emergence of the virus in these cultured astrocytes supports the recently held notion that there may be in PML an abortive, or nonpermissive, papovavirus infection of this cell type which is believed to undergo cell transformation. PMID- 6502189 TI - Synaptic neurochemical alterations associated with neuronal degeneration in an inherited cerebellar ataxia of Gordon Setters. AB - Canine Inherited Ataxia (CIA) is an autosomal recessive cerebellar disease of Gordon Setters associated with degeneration of Purkinje and granule cells. To define specific biochemical correlates of neuronal loss, synaptic neurochemical parameters were measured in three cerebellar regions (vermis, "pars intermedia," and hemisphere) at early and late stages of this disease. At one and a half years of age, affected dogs showed the most severe lesions in the "pars intermedia," with a 39% decrease in the number of Purkinje cells and a 29% decrease in granule cells. Neurochemical measurements demonstrated decreased [3H]muscimol binding and elevations in norepinephrine concentration (248% above control) and [3H]glutamate receptor binding (118% above control). At five years of age, reduction of Purkinje cells in the three cerebellar regions ranged from 65 to 91% while loss of granule cells was between 13 and 53%. [3H]Muscimol binding remained low throughout the cerebellum (38 to 59% of control) and norepinephrine concentration and [3H]glutamate binding were markedly reduced from the levels observed at one and a half years. Glutamate decarboxylase activity, [3H]QNB binding and GABA concentration were relatively unaffected. Our results indicate that neurochemical parameters associated with cerebellar neuronal systems demonstrate specific alterations in a chronic degenerative disorder. This study also indicates the importance of evaluating neurochemical measurements with regard to both spared and degenerating neuronal systems and emphasizes the role of compensatory neurochemical alterations in cerebellar degenerative disorders. PMID- 6502190 TI - Astrocytic proteins in the dorsal and ventral roots in amyotrophic lateral sclerosis and Werdnig-Hoffmann disease. AB - Abnormalities were detected by two-dimensional gel electrophoresis in the protein composition of both the dorsal and ventral roots of three of six patients who succumbed to amyotrophic lateral sclerosis (ALS). The abnormalities consisted of a cascade of acidic protein spots on silver-stained gels which were shown by immunoblotting to react with an antiserum to human glial fibrillary acidic protein (GFAP). They were found distal to the normal central nervous system/peripheral nervous system (CNS/PNS) transition zone and were undetected in cervical and lumbar root segments taken at the same distances from the spinal cord of eight control patients. Similar changes were observed in the dorsal and ventral roots of one patient with Werdnig-Hoffmann disease (WHD), while a second patient with WHD had the changes in only the ventral roots. The abnormalities probably reflect the presence of radicular glial bundles, which are pathological extensions of glial cells into the spinal roots, indicating that subclinical changes occurred in the sensory nerves of the affected ALS and WHD patients. While no other qualitative abnormalities were noted on gels of ALS and WHD spinal roots, some quantitative changes may be present. PMID- 6502191 TI - Generation of anencephaly: 1. Aberrant neurulation and 2. Conversion of exencephaly to anencephaly. AB - An experimental model for anencephaly was used to focus on two important aspects of the development of anencephaly: neurulation and conversion of exencephaly to anencephaly. Vitamin A was administered to pregnant rats on gestational days nine and ten. The animals were killed on successive gestational days to allow study of the development of anencephaly. The scanning electron microscope revealed filopodia and lamellopodia as the predominant mode of initial neural fold contact in the controls. Intertwining and overlapping of filopodia and lamellopodia with fusion of the adjacent cutaneous ectoderm completed neurulation. In embryos developing anencephaly, filopodia and lamellopodia never made contact above the cervical region and exencephaly resulted. The first evidence of the conversion of exencephaly to anencephaly was profound, labyrinthine expansion of the extracellular space of the telencephalic mantle. In spite of normal vascular patency and intact vessel walls, the exencephalic malformation spontaneously disintegrated, converting the lesion to anencephaly. The causes for tissue disintegration other than infarction must be considered in reconstructing the pathogenesis of anencephaly. PMID- 6502192 TI - Effects of radiotherapy on the astrocytomatous areas of malignant gliomas. AB - Little is known of the histological effects of radiation on low grade astrocytomas, whereas the clinical efficacy of radiotherapy on these tumors is still a matter of discussion. Since it is difficult to have large series of autoptic brains harboring astrocytomas, the wide astrocytomatous areas of conventionally irradiated secondary glioblastomas have been studied in whole mount preparations. It was assumed that these areas were already present at the time of irradiation. In these areas no histologic changes referable to 'short term' effect of radiation have been found. When the astrocytomatous areas were located in the white matter, they were affected by chronic edema, which usually occurs in periglioblastomatous tissue. In one case necrotic foci in the astrocytomatous areas were interpreted as anaplastic foci damaged by radiation; radiotherapy of astrocytomas might therefore result in the eradication of undetected anaplastic foci. PMID- 6502193 TI - Removable high intensity iridium-192 brain implants. Technique and in vivo measurements in canine brain. AB - A preclinical evaluation of the technical details and dosimetry for temporary high intensity 192Ir brain implants is presented. The canine brain was used for this quality assurance study in which direct in vivo dose measurements were done by thermoluminescent dosimetry (TLD rods). Precise and reproducible positioning of the TLD rods and 192Ir ribbons were assured by simple accessories which can be utilized in the clinical situation. The neurosurgical procedure for this non routine interstitial implant of the brain, suitability of type and size of afterloading cannulas and facility for firmly anchoring them to the scalp, and comparison of measured doses with computer-predicted values are details assured by the canine study. Agreement between the in vivo determination and computer generated doses was consistently in the range 2-5%. Data derived from this preclinical evaluation are currently used in both stereotactic and non stereotactic brain implants at our institution. Details are presented for the implant procedure, dose measurements and brachytherapy planning for multiple ribbons. The latter incorporates direct interaction on computed tomography (CT) images for a hypothetical patient case. PMID- 6502194 TI - Local blood flow in Walker 256 metastatic brain tumors. AB - Local blood flow (F) in metastatic Walker 256 (WL-256) brain tumors produced by the intracarotid artery injection of WL-256 tumor cells in rats was measured using 14C-iodoantipyrine and quantitative autoradiography. Blood flow was variable in the tumors; the overall range was 2 to 222 ml hg-1 min-1 and the maximum range in an individual tumor extended over 150 ml hg-1 min-1. Small tumors had mean blood flows similar to surrounding brain. Medium to large tumors had significantly lower flows; the lowest values were usually measured in necrotic or cystic regions, although low values (less than 20 ml hg-1) were also measured in some viable-appearing tumor regions. Blood flow was significantly reduced in brain adjacent to medium and large but not small tumors. A global depression of brain and tumor blood flow was measured in two animals with hydrocephalus and the largest tumor burden. The blood flow patterns of the WL-256 metastatic tumor model are not uniquely different from other brain tumor models although some individual differences exist. PMID- 6502195 TI - Local blood-to-tissue transport in Walker 256 metastatic brain tumors. AB - Local blood-to-tissue transfer constants (K) in metastatic Walker 256 (WL-256) brain tumors produced by the intracarotid artery injection of WL-256 tumor cells in rats were measured using 14C-alpha-aminoisobutyric acid and quantitative autoradiography. Small compact and diffuse infiltrative intraparenchymal tumors had values of K similar to that of contralateral nontumorous brain tissue. Medium and large tumors, meningeal metastases and intraventricular tumors had higher K values (5 to 30 fold) than contralateral nontumorous brain tissue indicating that intraparenchymal tumor size and location in meningeal and choroidal tissue influence the permeability of tumor capillaries. The local intratumor values of K varied considerably in these tumors and this variability of K correlated to only a few specific histopathologic features of the tumors. The value of K abruptly decreased at the tumor-brain interface when this interface was sharply defined, indicating that the metastatic tumors have only a small effect on the permeability of adjacent brain capillaries. Low blood-to-tumor transport of water soluble drugs will significantly affect drug concentrations in the tumor and the tumor-drug exposure. PMID- 6502196 TI - Medulloblastoma metastatic to the marrow. Report of four cases and review of the literature. AB - Medulloblastoma is a malignant cerebellar tumor seen primarily in the pediatric age group that has a known ability to metastasize extraneurally. The skeleton is the most common site of extraneural metastases, but metastases to the bone marrow can also occur. Four cases of medulloblastoma metastatic to the marrow are reported. In addition, 31 cases from the medical literature are reviewed. Clinical features include bone tenderness, cytopenias and elevated serum alkaline phosphatase and lactic dehydrogenase levels. Skeletal involvement, especially of the pelvic bones, is frequently seen radiographically. Weight loss, soft tissue masses and a requirement for blood transfusion are also associated features. Marrow biopsy specimens are characterized by the presence of a small cell tumor often with fibrosis, necrosis and osteoblastic activity. The symptomatic response to chemotherapy is rapid, but chemotherapy resistance appears quickly. Only 1 in 4 cases diagnosed antemortem in this review lived for more than a year. We conclude that marrow aspiration and biopsy are indicated in the evaluation of patients with medulloblastoma and may serve to diagnose the cause of cytopenias, to verify extraneural spread and to provide prognostic information. PMID- 6502197 TI - Sequential CT scanning in radiation myelopathy. AB - Myelography is usually normal in radiation myelopathy. Occasionally it may show an enlarged spinal cord with block or a spinal cord of reduced size. It is assumed that the enlargement of the spinal cord is transitory, occurs in early stages of radiation myelopathy and is due to oedema, whereas atrophy is seen in later stages of the disease. This assumption however has not been clearly established by sequential radiological examinations. The purpose of this case report is to demonstrate such changes by repeated X-ray investigations. PMID- 6502198 TI - Glial repair in an insect central nervous system: effects of surgical lesioning. AB - Surgical lesioning of central nervous connectives in the cockroach (Periplaneta americana (L.], although causing only local glial damage, resulted in complex and prolonged cellular changes. An early response to mechanical disruption was the appearance of granule-containing cells within the damaged perineurium, among adjacent, undamaged, perineurial cells, and between glial processes deep within the connectives. These cells, which were strikingly similar to hemocytes, were clearly involved in phagocytic activity and persisted in the damaged regions for more than a month after lesioning. There was only a slow restoration of organized perineurial glia and re-establishment of the blood-brain barrier, as indicated by the exclusion of an extracellular tracer, ionic lanthanum. These observations contrast with the speedy, ordered repair of the neuroglia observed following selective glial disruption and suggest that undamaged axons and/or the extracellular matrix exert a profound influence on the mechanisms of glial repair. PMID- 6502199 TI - Glial repair in an insect central nervous system: effects of selective glial disruption. AB - In vivo application of ethidium bromide to cockroach central nervous connectives caused extensive disruption of the neuroglia within 24 hr. Axonal conduction persisted following treatment with the glial toxin. A consistent feature of glial damage and repair was the prominent involvement of granule-containing cells. These cells (which were never seen in control cords) shared a number of cytological features with hemocytes that were seen adhering to and penetrating the neural lamella, in the early stages of glial damage. The granule-containing cells appear to serve dual functions: phagocytosis and structural repair. After 48 hr, granule-containing cells, or their processes, formed layers at the periphery of the connectives. By 4 to 6 days after treatment, the peripheral cells had assumed the morphological characteristics of normal perineurial cells and by 28 days were indistinguishable, ultrastructurally, from those of the perineurium of normal, untreated animals. These structural changes paralleled the re-establishment of the normal permeability properties of the blood-brain interface revealed by the exclusion of an extracellular tracer, ionic lanthanum, and electrophysiological observations. PMID- 6502200 TI - Adaptive plasticity in the primate spinal stretch reflex: evidence for a two phase process. AB - Monkeys can slowly increase or decrease the amplitude of the purely spinal, largely monosynaptic portion of the response to sudden muscle stretch, the spinal stretch reflex (SSR), when confronted by a task requiring such change (Wolpaw, J.R., V.A. Kieffer, R.F. Seegal, D.J. Braitman, and M.G. Sanders (1983) Brain Res. 267: 196-200; Wolpaw, J.R., D.J. Braitman, and R.F. Seegal (1983) J. Neurophysiol. 50: 1296-1311). Change occurs without alteration in initial muscle length or in background activity of agonist, antagonist, or synergist muscles. This study uses composite curves to describe in detail the development of SSR amplitude change. It reveals important, previously unexpected features of this development. SSR increase or decrease appears to occur in two distinct phases. Phase I, a nearly immediate 8% change, occurs within the first 6 hr. Phase II, a 2%/day change, continues for at least 2 months. Although phase II is much slower than phase I, its final magnitude is far greater. Phase I indicates a nearly immediate change in suprasegmental influence of the segmental arc of the SSR. Because stretch onset time is unpredictable and the SSR occurs before any other possible response, this change in descending activity must be tonic; it must be present continually, day after day, for the 5 to 7 hr/day the animal spends at the task. Phase I produces a rapid and significant increase in reward probability. Thus, it may be readily interpreted as an example of operant conditioning, provoked by the reward contingency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502201 TI - Automatic gain control in the bat's sonar receiver and the neuroethology of echolocation. AB - The sensitivity of the echolocating bat, Eptesicus fuscus, to sonar echoes at different time delays after sonar emissions was measured in a two-choice echo detection experiment. Since echo delay is perceptually equivalent to target range, the experiment effectively measured sensitivity to targets at different ranges. The bat's threshold for detecting sonar echoes at a short delay of only 1.0 msec after emissions (corresponding to a range of 17 cm) was 36 dB SPL (peak to peak), but the threshold decreased to 8 dB SPL at a longer delay of 6.4 msec (a range of 1.1 m). Prior research has shown that, at even longer delays (corresponding to ranges of 3 to 5 m), the bat's threshold is in the region of 0 dB SPL. Contractions of the bat's middle ear muscles synchronized with the production of echolocation sounds cause a transient loss in hearing sensitivity which appears to account for the observed echo detection threshold shifts. The bat's echo detection thresholds increase by approximately 11 dB for each reduction in target range by a factor of 2 over the span from 17 cm to 1.1 m. As range shortens, the amplitude of echoes from small targets also increases, by 12 dB for each 2-fold reduction in range. Thus, when approaching a target, the bat compensates for changes in echo strength as target range shortens by changing its hearing threshold. Since this compensation appears to occur in the middle ear, the bat regulates echoes reaching the cochlea to a stable amplitude during its approach to a target such as a flying insect. In addition to this automatic gain control linked to target range, the bat aims its head to track a target's position during approach, thus stabilizing echo amplitude even if the target's direction changes. We hypothesize that the bat's directional emissions, directional hearing, middle ear muscle contractions, and head aim response collectively create a three-dimensional spatial tracking filter which the bat locks onto targets to stabilize echo amplitudes during interception of prey. We further hypothesize that this regulation, which cancels echo amplitude changes caused by the target's changing spatial position, leaves the bat free to observe echo amplitude changes caused by the target's own actions, such as insect wing beats. Elimination of spatially dependent echo amplitude changes removes the cause of potentially troublesome changes in neural response latency and keeps stimulation from echoes in the "tip" region of auditory nerve fiber tuning curves.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6502202 TI - Posture control and trajectory formation during arm movement. AB - One hypothesis for the generation of spatially oriented arm movements by the central nervous system is that a desired joint position is determined by the ratio of the tensions of agonist and antagonist muscles. According to this hypothesis, the transition between equilibrium states should be solely a function of the contraction time of the motor units and the mechanical properties of the arm. We tested this hypothesis in intact and deafferented rhesus monkeys by holding the forearm and measuring the accelerative transient after release of the forearm and by directly measuring the time course of the increase in torque during the movement. Both methods indicated an average time of 400 msec for attaining peak torque in a movement with a duration of 700 msec. In addition, by displacing the arm from its normal trajectory during the movement, we observed that the arm returned neither to the initial nor to the final equilibrium positions, but to points intermediate between them. We conclude that the processes underlying trajectory formation must be more complex than a simple switch between one equilibrium position and another. PMID- 6502203 TI - An organizing principle for a class of voluntary movements. AB - This paper presents a mathematical model which predicts both the major qualitative features and, within experimental error, the quantitative details of a class of perturbed and unperturbed large-amplitude, voluntary movements performed at intermediate speed by primates. A feature of the mathematical model is that a concise description of the behavioral organization of the movement has been formulated which is separate and distinct from the description of the dynamics of movement execution. Based on observations of voluntary movements in primates, the organization has been described as though the goal were to make the smoothest movement possible under the circumstances, i.e., to minimize the accelerative transients. This has been formalized by using dynamic optimization theory to determine the movement which minimizes the rate of change of acceleration (jerk) of the limb. Based on observations of muscle mechanics, the concept of a "virtual position" determined by the active states of the muscles is rigorously defined as one of the mechanical consequences of the neural commands to the muscles. This provides insight into the mechanics of perturbed and unperturbed movements and is a useful aid in the separation of the descriptions of movement organization and movement execution. PMID- 6502204 TI - Transient membrane shedding in Limulus photoreceptors: control mechanisms under natural lighting. AB - Photoreceptors of the Limulus lateral eye shed their light-sensitive membranes (rhabdoms) in a burst early each morning when the animal is maintained in natural lighting. This shedding burst produces a cloud of multivesicular bodies which coalesce and migrate away from the rhabdom. Within 24 hr, these gradually collapse to combination bodies and ultimately to lamellar bodies. Light initiates the burst of shedding. If animals are maintained in darkness beyond their normal dawn, the shedding burst is delayed until the first onset of light. We have not been able to produce a second burst of membrane shedding within one 24-hr period. Efferent optic nerve activity generated by a circadian clock in the brain primes the shedding burst. At least 3 hr of efferent activity in darkness must precede light onset to prime membrane shedding; however, the efferent fibers need not be active when the light-initiated burst occurs. Chronically blocking the efferent input to the retina abolishes the shedding burst. The burst of membrane shedding is robust and short-lived. Within 15 min of light onset the area of photosensitive membrane decreases by about 70%, and within an hour the rhabdom returns to essentially its preburst size. At other times in the diurnal light cycle, the size of the rhabdom undergoes significant variations which are not abolished by blocking the efferent input. Apparently the daily burst of shedding overlays a second cycle of membrane metabolism that is not controlled by efferent optic nerve activity. PMID- 6502205 TI - Neuronal responses of the rabbit cerebellum during acquisition and performance of a classically conditioned nictitating membrane-eyelid response. AB - Neuronal activity was recorded from regions of the cerebellar cortex and dentate interpositus nuclei during learning and/or performance of a classically conditioned nictitating membrane (NM-a third eyelid)/eyeblink response in the rabbit. It was found that neurons located within restricted portions of the ansiform lobule and anterior lobe cortical regions and of the dentate interpositus nuclei respond in relation to the performance of the learned eyeblink response. Furthermore, chronic recordings from the dentate-interpositus nuclei revealed that these responses develop in close relation to the learning of the conditioned eyeblink response. Stimulation of the dentate-interpositus nuclei through the recording electrodes in some cases yielded eyelid closure and NM extension in both trained and untrained animals. Lesion of the axons of the dentate-interpositus nuclei (superior cerebellar peduncle), a manipulation which is known to abolish the learned eyeblink response, abolished the stimulation effect. We have previously reported that lesions of the dentate-interpositus nuclei cause abolition of the learned eyeblink response. In the present study, we report that lesions of the regions of cerebellar cortex projecting to the dentate interpositus nuclei do not permanently abolish the conditioned response, although the amplitude-time course of the learned response could be affected. These results, together with results of other studies, demonstrate that the medial dentate and/or lateral interpositus nuclei are active during learning and performance of the conditioned eyeblink response, are capable of producing this learned response, and are essential for the learning and retention of the conditioned eyeblink response. Therefore, the medial dentate and/or lateral interpositus nuclei are a part of the essential neuronal circuit involved in the learning and production of the classically conditioned eyeblink response in the rabbit. PMID- 6502206 TI - The spatial control of ganglionic neurite growth by the substrate-associated material from conditioned medium: an experimental model of haptotaxis. AB - Techniques are described for forming on the culture substrate a narrow pathway of material derived from medium conditioned by embryonic non-neuronal cells. There is a precise correlation between the known location of the pathway and the spatial distribution of neurites extended from whole ciliary ganglia or dissociated neurons grown on the patterned substrate. When individual growth cones moving on the pathway contact one of its edges, they turn sharply so as to remain on the pathway. This turning response is not simply due to a physical barrier to movement across the edge, since growth cones can cross onto the pathway when entering from the adjacent untreated substrate. The strong preference for neurites to maintain contact with the pathway also is not simply a result of their inability to survive or elongate outside of the pathway, since neurites from whole ganglia elongate readily on other regions of the substrate, although their growth is then undirected. Direct contact with the pathway is required for these directive effects, and there is no indication that the material bound to the substrate diffuses off and exerts its effects at a distance. The neurite-guiding activity is found in partially purified fractions of conditioned medium which also contain a substrate-bound inducer of neurite outgrowth. It is possible that both activities may be due to the same components of conditioned medium. These results suggest that ciliary ganglion growth cones are able to detect specific components of conditioned medium on the substrate and respond to their presence by changing their direction of movement so as to remain in contact with these components.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502207 TI - Is cerebellar granule cell migration regulated by an internal clock? AB - We have studied the time course of migratory behavior of cerebellar granule cells in the microwell tissue culture system. [3H]Thymidine served as a marker for particular granule cell generations. When cultured 4 hr after [3H]thymidine injection for 6 days in microwell cultures, labeled granule cells were seen to migrate along fiber bundles expanding between reaggregates called "cables" for 3 to 4 days. After 5 and 6 days in vitro the percentage of labeled non-migrating cells found in clusters in reaggregates and on cables increased considerably. Whereas unlabeled cells continued to migrate. Comparable results were obtained when granule cells developed in vivo for various times after label and their developmental state was determined in vitro. Cells from cerebellar populations labeled 1 to 4 days before culture maintained their ability to migrate in vitro, even after granule cells had entered the internal granule cell layer. In contrast, the percentage of migrating cells labeled 5 and 6 days before culture was reduced significantly. The results suggest that the time span of granule cell migration is predetermined intrinsically rather than by external signals. PMID- 6502208 TI - Regional changes in brain glucose metabolism reflect cognitive impairments in aged rats. AB - Aged rats (22 to 24 months) and young control rats (3 months) were tested in a battery of behavioral tests which included tests of learning, place navigation, sensorimotor integration, motor coordination, activity, and exploration. Following testing all animals were analyzed in an unanesthetized state for their local glucose utilization. Significant differences in glucose utilization were found between the aged and young groups on some behaviors and in some brain regions. There was considerable variability in the aged group in both their behavioral performance and their glucose utilization scores; thus, attempts were made to determine whether the variability in the degree of impairment within any particular behavioral test was correlated to the regional glucose utilization scores in any of the 45 brain regions analyzed. In two of the behavioral tests employed (i.e., one for learning and one for place navigation), the decline in performance correlated significantly with the decrement in regional glucose utilization. Moreover, the performance in these two tests showed significant correlation with glucose use in only five regions (dentate gyrus, medial septum diagonal band area, hippocampal CA1, hippocampal CA3, and prefrontal cortex). These results show that the learning impairments in the aged rats are related to the extent of decrease in glucose utilization in restricted areas of the limbic system. In addition, the results show that the individual rats within an aged rat population develop cognitive impairments to a variable degree and that the aged rats with the most pronounced learning impairments are the ones exhibiting the most severe functional decrements, in terms of glucose utilization, in the septohippocampal system and the prefrontal cortex. This suggests that aging rats may be interesting not only for the study of the normal aging process, but also as a model of dementia. PMID- 6502209 TI - Activity and the formation of ocular dominance patches in dually innervated tectum of goldfish. AB - This study tested (1) whether blocking impulse activity in both eyes of fish with one tectum prevents the formation of ocular dominance patches, (2) whether areas receiving a high density of innervation from one eye receive a low density from the other, and (3) whether there is an electrophysiological correlate to the anatomical patches. One tectum was removed in goldfish so that the optic nerve fibers from both eyes would compete for synaptic space in the remaining tectum. The terminal arbors from the two projections initially overlapped but by 50 to 60 days segregated into ocular dominance patches, demonstrated by labeling both projections, the normal one with horseradish peroxidase and the regenerating one with tritiated proline radioautography. Alternate sections were processed for radioautography and histochemistry. All projections were drawn by "blind" observers using a camera lucida and were fully reconstructed. Both the level of patchiness within each projection and the correspondence of patches and holes between the two projections were quantified from these reconstructions. Binocular tetrodotoxin (TTX) injections from 18 to 75 days after surgery significantly reduced patchiness, as compared to controls injected with citrate-Ringers solution. When the binocular block was continued until 95 days, segregation was still significantly reduced relative to controls. These results support a hypothesis for an activity-dependent mechanism of segregation of ocular dominance patches. In controls but not TTX-blocked fish, there was a significant tendency for high density areas in one projection to receive a lower density projection from the other eye, and vice versa. However, the two projections were not entirely complementary. Survival of control fish for an additional 5 months resulted in more sharply defined patches but no increase in complementarity. Recordings of field potentials evoked by shocking either optic nerve demonstrated an electrophysiological correlate to the anatomical patches in single tectal fish. Large field potentials from one eye were generally associated with small potentials from the other eye, and vice versa. When the recording sites were marked with electrolytic lesions, there was a direct and significant correlation between the magnitude of the field potentials and the density of the anatomical ocular dominance patches. PMID- 6502210 TI - Binding of the nicotinic cholinergic antagonist, dihydro-beta-erythroidine, to rat brain tissue. AB - The nicotinic cholinergic antagonist, dihydro-beta-erythroidine, binds to two sites in rat cortical membranes with dissociation constants of 4 and 22 nM and respective apparent Bmax values of 52 and 164 fmol/mg of protein. Binding to the higher affinity site, defined by the use of 2 nM [3H]dihydro-beta-erythroidine, was saturable, reversible, and susceptible to protein denaturation. Binding was highest in the thalamus and lowest in the spinal cord and showed preferential enrichment in a synaptosomal subfraction of rat brain. Nicotine displaced [3H]dihydro-beta-erythroidine in a stereospecific manner, the (-)-isomer being approximately 6 times more potent than the (+)-isomer. The alkaloid nicotinic agonists, cytisine and lobeline, were potent inhibitors of binding, while acetylcholine in the presence of the cholinesterase inhibitor di isopropylfluorophosphate was equipotent with (+)-nicotine. Binding was also inhibited by the muscarinic ligands, arecoline, atropine, and oxotremorine. The nicotinic antagonists mecamylamine, hexamethonium, and pempidine were essentially inactive in displacing [3H]dihydro-beta-erythroidine. These findings indicate that dihydro-beta-erythroidine binds to a nicotinic recognition site in rat brain which is neuromuscular, rather than ganglionic, in nature and that such binding is similar in several respects to that seen with nicotinic agonists. Whether such binding is to a nicotinic, as opposed to nicotinic cholinergic, recognition site or to a "common" nicotinic/muscarinic site is an issue that requires further study. PMID- 6502211 TI - Naloxone increases electrophysiological measures of selective information processing in humans. AB - The effects of the opiate antagonist naloxone on electrophysiological measures of human selective attention were examined utilizing a paradigm which dissociates selective information processing from any concurrent processes of general arousal that may be present. Subjects were injected with naloxone (2 mg, i.v.) or placebo prior to performing a three-channel selective listening task. The measure of selective attention was the difference between the auditory event-related potential (AERP) to a sequence of tones when they were attended and to the same sequence of tones when they were ignored. Typically, the AERP to attended channel tones is more negative, and this increased negativity is designated the attention effect. In this study, naloxone produced a significant augmentation of the AERP attention effect at frontal electrode sites, primarily by decreasing the negativity of AERPs to inattended tones. Naloxone had no effect on the AERPs from the undistracted and divided attention tasks or on the sensitivity of the AERP to a physical parameter of stimulus presentation, interstimulus interval. The effects of naloxone on selective attention appear to be independent of any alterations in arousal, as the drug had no effect on autonomic measures, reaction times, or auditory sensitivity, and the attention changes could be dissociated from any naloxone-induced alterations of mood. These data indicate that naloxone can have the specific effect of increasing AERP measures of selective information processing, thus suggesting a role for endogenous opioid peptides in the regulation of auditory selective attention in humans. PMID- 6502212 TI - Microcircuitry of bipolar cells in cat retina. AB - We have studied 15 bipolar neurons from a small patch (14 X 120 micron) of adult cat retina located within the area centralis. From electron micrographs of 189 serial ultrathin sections, the axon of each bipolar cell was substantially reconstructed with its synaptic inputs and outputs by means of a computer controlled reconstruction system. Based on differences in stratification, cytology, and synaptic connections, we identified eight different cell types among the group of 15 neurons: one type of rod bipolar and seven types of cone bipolar neurons. These types correspond to those identified by the Golgi method and by intracellular recording. Those bipolar cell types for which we reconstructed three or four examples were extremely regular in form, size, and cytology, and also in the quantitative details of their synaptic connections. They appeared quite as specific in these respects as invertebrate "identified" neurons. The synaptic patterns observed for each type of bipolar neuron were complex but may be summarized as follows: the rod bipolar axon ended in sublamina b of the inner plexiform layer and provided major input to the AII amacrine cell. The axons of three types of cone bipolar cells also terminated in sublamina b and provided contacts to dendrites of on-beta and other ganglion cells. All three types, but especially the Cb1, received gap junction contacts from the AII amacrine cell. Axons of four types of cone bipolar cells terminated in sublamina a of the inner plexiform layer and contacted dendrites of off-beta and other ganglion cells. One of these cone bipolar cell types, CBa1, made reciprocal chemical contacts with the lobular appendage of the AII amacrine cell. These results show that the pattern of cone bipolar cell input to beta (X) and probably alpha (Y) ganglion cells is substantially more complex than had been suspected. At least two types of cone bipolar contribute to each type of ganglion cell where only a single type had been anticipated. In addition, many of the cone bipolar cell pathways in the inner plexiform layer are available to the rod system, since at least four types of cone bipolar receive electrical or chemical inputs from the AII amacrine cell. This may help to explain why, in a retina where rods far outnumber the cones, there should be so many types of cone bipolar cells. PMID- 6502213 TI - Perturbation of the direction of neurite growth by pulsed and focal electric fields. AB - We have studied the orientation of neurite growth in the culture of embryonic Xenopus neurons in response to three types of extracellular electric fields: spatially uniform pulsed fields, focally applied steady (DC) fields, and focally applied pulsed fields. Under uniform pulsed fields, neurites showed a preferential orientation toward the cathode pole of the field in a manner similar to that previously found for DC fields. The extent of neurite orientation depended upon the duration, amplitude, and frequency of the pulse but appeared to be similar to that produced by a uniform DC field of an equivalent time-averaged field intensity. For square pulses of 5 msec duration, the minimal amplitude and frequency required to produce a detectable orientation of neurite growth over a period of 24 hr were 2.5 V/cm and 10 Hz, which correspond to a time-averaged field intensity of 125 mV/cm. Steady or pulsed focal fields were applied by passing a current through a micropipette placed near the growth cone of the neurite. Fields of negative polarity (current sink) were found to attract the growth cone, whereas fields of positive polarity (current source) were found to deflect the growth cone away from the pipette. The threshold DC current density needed at the growth cone to perturb its direction of growth within 15 min was 0.2 to 2 pA/micron2 (or 3 to 30 mV/cm); and for focal pulsed currents (pulse duration 5 msec), a typical combination of minimal pulse amplitude and frequency was 4 pA/micron2 and 10 Hz. This threshold focal current is similar to that which occurs at the synaptic cleft during active synaptic activity. PMID- 6502214 TI - Horizontal cells of the mouse retina contain glutamic acid decarboxylase-like immunoreactivity during early developmental stages. AB - We have used an antiserum to L-glutamic acid decarboxylase ((GAD), a synthesizing enzyme for gamma-aminobutyric acid (GABA)) to localize putative GABAergic neurons in the developing C57BL/6J mouse retina. At early developmental stages (embryonic day 17 to postnatal day 3), strong GAD-like immunoreactivity is detectable in cell bodies located within the neuroblastic layer. These cells have relatively large cell bodies and extend several sturdy processes which are oriented radially at these early stages. We have identified these cells as horizontal cells. In addition, cell bodies adjacent to the inner plexiform layer and both diffuse and punctate structures within the inner plexiform layer proper have weak GAD-like immunoreactivity at this time. By postnatal day 6, GAD-positive horizontal cell processes begin to form a horizontal network in the newly formed outer plexiform layer. Immunolabeling of amacrine cell bodies and of punctate structures in the inner plexiform layer becomes much stronger at this time, reaching a maximum staining intensity during the second postnatal week. After postnatal day 12, GAD like immunoreactivity of the horizontal cells begins to decline; in 4-week-old mice the horizontal cells are no longer detectably labeled by this GAD antiserum. At the same time, the GAD-like-immunoreactive material in the inner plexiform layer becomes stratified, forming distinct layers. Amacrine cells and the inner plexiform layer remain GAD positive into adulthood. PMID- 6502215 TI - The discharge characteristics of vagal cardiac neurons during classically conditioned heart rate change. AB - Classically conditioned heart rate change in the pigeon has been developed as a vertebrate model system for cellular analysis of associative learning. One aspect of this development involved characterizing in detail the "final common path" for the conditioned response, the "cardiac motoneurons." With this as a foundation it has been possible to investigate the discharge properties of these motoneurons during acquisition of the conditioned heart rate response, and in this paper we report such data for the vagal (parasympathetic) component of the conditioned response. The activity of single neurons was recorded in the intermediate zone of the dorsal motor nucleus of the vagus of the pigeon. Antidromic activation confirmed that these cells gave rise to efferent axons in the vagus nerve and allowed their classification on the basis of conduction velocity into three groups: A, B1 (cardiac), and B2 units. B1 and B2 units had low levels of irregularly maintained activity, whereas A units discharged more regularly at higher frequency. B1 units had a weak cardiac rhythm, no respiratory rhythm, and showed decreased discharge in response to visual stimulation or foot-shock. These stimulus-evoked decreases in the activity of cardiac cells were accompanied by increases in heart rate. B2 units were unresponsive to both visual stimulation and foot-shock, whereas A units were unresponsive to visual stimulation but possibly responsive to foot-shock. The activity of vagal cardiac neurons was recorded during or after classical conditioning (paired lights and foot-shocks) or sensitization (unpaired lights and foot-shocks) to characterize discharge changes associated with conditioned cardioacceleration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502216 TI - Effects of dopamine antagonists on receptive fields of brisk cells and directionally selective cells in the rabbit retina. AB - The effects of dopamine antagonists on the extracellularly recorded activity of ON- and OFF-center brisk ganglion cells and ON-OFF directionally selective ganglion cells in the rabbit retina were investigated. Haloperidol, fluphenazine, and cis-flupenthixol, infused in the arterial system supplying the eye, produced similar effects. In general, these drugs reduced the antagonistic surround responses of brisk ganglion cells, reduced the sustained excitation of the center response of ON-center brisk-sustained cells, reduced the leading edge response of ON-OFF directionally selective cells to moving light stimuli along with any sustained excitation to stationary light stimuli, and affected the spontaneous activity of the cells. These drug effects appear to be due to a blockade of D-1 (adenylate cyclase-linked) receptors and not to D-2 receptors. Neither S sulpiride nor metoclopramide, two specific D-2 antagonists, had much effect. The findings are the first to describe the functional effects of dopamine antagonists on single cells in the mammalian retina and on ganglion cell activity in the vertebrate retina. PMID- 6502217 TI - The effects of nerve growth factor and its antiserum on the postnatal development and survival after injury of sensory neurons in rat dorsal root ganglia. AB - Nerve growth factor (NGF) is known to be essential for survival and maintenance of sympathetic ganglia and of embryonic sensory ganglia of neural crest origin. The present study examined the physiological and pharmacological roles of NGF in the postnatal development of sensory neurons in the dorsal root ganglion (DRG). In contrast to what is generally stated in the literature, administration of NGF antiserum to newborn rats for a period of 7 days resulted in a significant (approximately 20%) reduction of neuronal number in the lumbar DRG. Size spectrum analysis of surviving neurons revealed a shift toward larger sizes, presumably due to a preferential loss of small cells. The number of neurons in the L5 DRG was studied at various times after unilateral sciatic nerve crush in 1-day-old rats. Axotomy resulted in a substantial loss (40 to 50%) of neurons in the immature DRG. Administration of NGF antiserum to animals with axotomized DRG did not increase cell death when compared with the axotomized controls. However, the number of neurons in the antiserum-treated ganglia decreased by the same percentage (20%) when compared with the control serum-treated ganglia before and after axotomy. Treatment with NGF initially prevented the loss of neurons in the axotomized DRG. However, some neurons died during the first week despite continued NGF administration; and, subsequent to NGF withdrawal, neuronal number decreased to the same level as in control animals. Thus, removal of exogenous NGF resulted in the death of the sensory neurons which had been maintained.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502218 TI - Novel organization of microtubules in cultured central nervous system neurons: formation of hairpin loops at ends of maturing neurites. AB - Using the high voltage electron microscope, we have examined cultured embryonic neurons in order to understand better the organization of microtubules in developing neurites. We found that, in embryonic chick retina neurons, microtubules were abundant in the ends of neurites and showed an unusual pattern of organization. Most striking was the presence of microtubule loops; after entering the flattened region of a growth cone, microtubules frequently made tight 180 degrees turns. Occasionally these looping microtubules re-entered the neurite and returned in the direction of the cell body. Positive identification of the loop structures as microtubules was made by specific immunocytochemical labeling. Quantitative analysis showed that more than half of the retina neurons that were dissociated on embryonic day 8 and kept in culture for 4 to 6 days (E8C4 and E8C6) contained at least one microtubule that made a 180 degrees turn at flat regions along or at the tips of neurites. The area within the loops typically contained larger membranous organelles, whereas only small vesicles were seen outside the loops. Fine filaments were seen to interconnect the loops at various places, suggesting the possibility that they played a role in maintaining the shape of microtubule loops. Examination of other neurons showed that tight microtubule loops were prominent in chick spinal cord neurons, but they were rarely seen in neurons of the sympathetic ganglia or dorsal root ganglia or in NG108-15 cloned cells. Developmentally, no loops were observed in E8C1 retina neurons, but retina neurons dissociated from older embryos (12 days) did show loops after 1 day in culture; these data suggest that microtubule loops may be abundant around embryonic day 12 to 13 in the chick retina. The possible significance of this unusual microtubule organization to the control of neurite growth and bidirectional transport is discussed. PMID- 6502219 TI - Dopamine reduces slow outward current and calcium influx in burst-firing neuron R15 of Aplysia. AB - Dopamine's effect on calcium influx into the bursting neuron, R15, of Aplysia californica was tested by tail current measurements and by measurement of absorbance of intracellular Arsenazo III, a calcium-sensitive indicator. Slow outward tail currents were elicited by subthreshold depolarization in voltage clamp and were demonstrated to be dependent upon transient increases in intracellular calcium activity, (Ca)i), using calcium-free seawater, calcium blockers (Mn2+ and La3+), and intracellular injection of EGTA. Dopamine reduces these tail currents as it reduces the slow inward current. Next, the transient elevations of (Ca)i accompanying subthreshold depolarization were measured directly in Arsenazo III-loaded neurons. Dopamine did not reduce the rise in (Ca)i measured in the soma during depolarization. However, when absorbance of the axodendritic region was monitored, dopamine did reduce calcium influx. Voltage monitoring in the axon indicated that the reduced calcium influx could not simply be ascribed to altered space clamp. In keeping with the apparent axodendritic location of dopamine action, isolation of the soma by ligation of the axon markedly reduced the dopamine response. Dopamine seems to reduce calcium influx into R15, but this effect is topographically limited to nonsomatic membrane, an area of the neuron not usually monitored in optical studies of (Ca)i. PMID- 6502220 TI - Patterns of synaptic input to layer 4 of cat striate cortex. AB - Although cells in layer 4 of cat striate cortex represent the first stage in the cortical processing of visual information, they have considerably more complicated receptive field properties than the afferents to the layer from the lateral geniculate nucleus. In considering how these properties are generated, we have focused on the intrinsic cortical circuitry, and particularly on the projection to layer 4 from layer 6. Layer 6 pyramidal cells were injected with horseradish peroxidase and examined at the light and electron microscopic level. The labeled axon terminals were found to form asymmetric synapses and to show a strong preference for contacting dendritic shafts. Serial reconstruction of dendrites postsynaptic to labeled layer 6 cell axon terminals showed that a large proportion of the postsynaptic dendrites belonged to smooth and sparsely spiny stellate cells, suggesting a selective innervation of these cell types. In contrast, the geniculate projection to layer 4 made synapses primarily with dendritic spines and, as a result, the large majority of terminals ended on spiny cells. Since smooth and sparsely spiny stellate cells are thought to mediate inhibition within the cortex, we suggest that one effect of the layer 6 to layer 4 projection could be to contribute to inhibitory features of the receptive fields of layer 4 cells. PMID- 6502221 TI - Dye coupling in hypothalamic slices: dependence on in vivo hydration state and osmolality of incubation medium. AB - Electrotonic coupling is one mechanism which may coordinate the electrophysiological activity of a population of neurons. By measuring the incidence of dye coupling, we have investigated whether conditions that stimulate hormone secretion by hypothalamic magnocellular neuroendocrine cells affect coupling between these neurons. Neurons in the magnocellular regions of the paraventricular nucleus (PVN), in slices prepared from normally hydrated or chronically dehydrated male rats, were intracellularly injected with the fluorescent dye Lucifer Yellow CH. The dye coupling index (DCI), the ratio of the number of dye-coupled neurons to the total number of filled cells, was determined for each treatment group. The DCI for slices from dehydrated animals incubated in 310 milliosmoles/kg of medium (0.121) was significantly lower than that for slices for hydrated animals incubated in medium of the same osmolality (0.333). This decrease was reversed when slices from dehydrates were incubated in medium having an osmolality of 340 milliosmoles/kg (DCI = 0.307). There was also evidence for an interaction between slices incubated in the same chamber: the DCI in slices from dehydrated animals was significantly higher (0.475) when slices from normally hydrated rats were also present in the incubation chamber. Based on these data and on cited evidence, we suggest that the osmolality of the extracellular fluid and the local concentration of sex steroid hormones may influence dye coupling in the PVN. PMID- 6502222 TI - Nerve growth factor-mediated induction of choline acetyltransferase in PC12 cells: evaluation of the site of action of nerve growth factor and the involvement of lysosomal degradation products of nerve growth factor. AB - In previous experiments it has been demonstrated that nerve growth factor (NGF), subsequent to its binding to specific membrane receptors, is internalized. Ultrastructurally, this internalized NGF is localized in membrane-confined compartments which ultimately fuse with lysosomes. The present experiments were designed, first, to evaluate whether a very small but functionally important portion of the internalized NGF might reach the free cytoplasm (and subsequently the nuclear chromatin) and might be responsible for the induction of choline acetyltransferase (ChAT) in PC12 cells. Second, we investigated whether a lysosomal proteolytic degradation product of NGF might act as a second messenger in the NGF-mediated ChAT induction. In one series of experiments, guinea pig erythrocyte ghosts, loaded with NGF (or NGF antibodies), fluorescein isothiocyanate-coupled bovine serum albumin, and/or horseradish peroxidase (HRP) were fused with PC12 pheochromocytoma cells. Electron microscopy showed that [125I]NGF and HRP reaction product were located throughout the cytoplasm and the nucleus but did not penetrate membrane compartments such as the endoplasmic reticulum, the Golgi complex, the perinuclear space, or mitochondria. Biochemically, NGF injected into the cytoplasm did not produce an induction of ChAT, whereas NGF acting via cell surface receptors resulted in a 2-fold increase in ChAT. Conversely, injection of NGF antibodies did not prevent the receptor mediated ChAT induction. In a second series of experiments, the half-life of internalized NGF was increased from 40 min to 24 hr by the administration of leupeptin, a protease inhibitor which is accumulated in lysosomes. However, the NGF-mediated ChAT induction was not affected by this treatment. It is concluded that NGF itself does not act directly on cytoplasmic or nuclear target sites, nor is a proteolytic degradation product of NGF responsible for the NGF-mediated ChAT induction. Thus, NGF must act via a second messenger mechanism, the nature of which remains to be established. PMID- 6502223 TI - Correlation between growth form and movement and their dependence on neuronal age. AB - Neurites of superior cervical ganglion neurons from embryonic, perinatal, and adult rats extended at different rates when placed in tissue culture on similar collagen substrata. Using high resolution cinematography and a time-lapse video recording system, we concluded that these differences arise from variations in individual growth cone behavior. Growth cones of embryonic and perinatal neuronal origin exhibited high peak rates of advance and filopodial and lamellipodial excresences. Perinatal cones differed from embryonic ones in that they were somewhat larger, advanced in straighter paths, and retracted less, consequently translocating at 14 to 29 microns/hr compared with 8 to 22 microns/hr for embryonic cones (ranges of 4-hr means). The growth cones of neurons obtained from adult rats had scant cytoplasm and short branched filopodia, lacked definitive lamellipodia, and traversed the terrain at 4 to 13 microns/hr due to lack of high peak rates of advance and more time spent in stationary or minimal advance phases. Periodic pauses lasting 10 to 20 min, occurring every 20 to 90 min, interrupted the forward advance of growth cones of all ages. During pauses or slow forward movement, the growth cone displayed numerous filopodia whereas, during brief episodes when embryonic and perinatal growth cones moved at peak rates of 200 microns/hr or more, the cone periphery was predominantly lamellipodial. We conclude that the predominance of a lamellipodial or filopodial conformation correlates with the rate of growth cone advance and that age dependent variations in neurite extension rates are related to differences in growth cone form and pattern of translocation. This is the first documentation of differing behavior of single growth cones of neurons of varying developmental ages in culture. PMID- 6502224 TI - Effects of inferior temporal lesions on discrimination of stimuli differing in orientation. AB - Monkeys with inferior temporal (IT) cortex lesions were compared with normal and operated control monkeys on a series of two-choice visual discrimination problems. In some problems, the discriminanda were different patterns or objects whereas, in other problems, the discriminanda were identical patterns or objects presented in different orientations. The animals with IT lesions were significantly impaired in learning to discriminate the different patterns and objects; however, they were not impaired in learning to discriminate stimuli which differed only in orientation by 60 degrees or more. These results help to specify further the role of the IT cortex in visual associative learning by demonstrating that there are some types of visual discriminations which are not sensitive to IT lesions. PMID- 6502225 TI - Localization, chromatographic characterization, and development of somatostatin like immunoreactivity in the guinea pig retina. AB - We have studied the anatomical localization, chromatographic properties, and development of somatostatin-like immunoreactivity (SLI) in the guinea pig retina. The majority of guinea pig retinal SLI in the adult and fetus eluted similarly to somatostatin-28 by gel filtration and high pressure liquid chromatography. This represents a higher ratio of somatostatin-28-like material to total SLI than had been observed in retinal extracts from most other animal species. Somatostatin like-immunoreactive cells and fibers were localized using two antisera in cryostat-sectioned and flat mounted retinae. Distribution of cells and fibers differed uniquely from that in other species previously reported. Reactive perikarya were located only in the far peripheral region: in the innermost layer of the inner nuclear layer (INL), in the inner plexiform layer (IPL), and in the ganglion cell layer. Reactive fibers were prominent in the IPL and nerve fiber layer (NFL) in both the peripheral and central retina. Less frequently, processes were observed between the NFL and IPL, between the IPL and INL, and, rarely, in the outer plexiform layer and outer nuclear layer. Small numbers of reactive fibers were found in the optic nerve and disc. These observations suggest that processes of intrinsic (amacrine or associational ganglion cells) and projection neurons (true ganglion cells or efferent fibers) containing SLI are intermingled in the guinea pig retina. SLI, quantified by radioimmunoassay, was present in the developing retina as early as the 6th week of gestation (full term is 10 weeks). Immunohistochemically detected somatostatin-like-immunoreactive elements were seen first at 2 weeks before birth, coincident with the onset of the period of most rapid increase in levels of assayed SLI. Somatostatin-like-immunoreactive peptides reached two-thirds of adult levels by birth. PMID- 6502226 TI - Blockade of long-term potentiation in rat hippocampal CA1 region by inhibitors of protein synthesis. AB - Long-term potentiation (LTP) in the hippocampus has attracted attention as a model of neuronal plasticity in the central nervous system. Although accumulating evidence associates protein synthesis with LTP, there is no direct proof that protein synthesis is actually required for the production of LTP. Therefore, we have examined the ability of some inhibitors of protein synthesis to modify LTP in the CA1 region of the rat hippocampal slice. Incubation for 30 min in the presence of emetine, cycloheximide, or puromycin decreased the frequency of occurrence of LTP in field CA1 elicited by repetitive stimulation of the Schaffer collaterals. This blockade was dose dependent and correlated with the ability of individual inhibitors to inhibit incorporation of [3H]valine into proteins. LTP blockade was irreversible for the irreversible inhibitor emetine and was reversible for the reversible inhibitor cycloheximide. Blockade of LTP required a substantial preincubation period to be effective. Even at the highest concentration of emetine used to block LTP, no effect on any intracellularly recorded membrane properties was observed. In contrast, the protein synthesis inhibitor anisomycin was unable to block LTP. Puromycin aminonucleoside, a structural analogue of puromycin which is inactive in inhibiting protein synthesis, was ineffective in blocking LTP. These experiments demonstrate that a variety of protein synthesis inhibitors are able to block the production of LTP in field CA1, suggesting the necessity for a set of newly synthesized or rapidly turned over proteins for hippocampal LTP. PMID- 6502228 TI - Saccular aneurysm associated with segmental duplication of the basilar artery. A morphological study. AB - Saccular aneurysm associated with segmental duplication (also called "fenestration") of the basilar artery is an anomaly that results from an embryonic fault. Reports of the treatment of the aneurysmal component have only recently appeared in the neurosurgical literature, and little has been written on the morphology of this anomaly. This study answers the need for information about its structure to the extent permitted by the examination of a single specimen. The specimen was obtained at postmortem examination. A cast of its interior features was made with a synthetic rubber. After the cast was removed, the entire anomaly was serially sectioned for histological study. Defects in the wall of the basilar artery were seen microscopically at each end of the fenestration. At the extensive proximal defect, a saccular aneurysm arose that bulged into the window between the two limbs of the segmental duplication and also presented dorsally and ventrally. It had fatally ruptured. The manner in which the fenestration was formed by intraluminal septa was also revealed. PMID- 6502227 TI - Cell-cell interactions of isolated and cultured oligodendrocytes: formation of linear occluding junctions and expression of peculiar intramembrane particles. AB - Oligodendrocytes were isolated from lamb brain. Freshly isolated cells and cultured cells, either 1- to 4-day-old unattached or 1- to 5-week-old attached, were examined by thin section and freeze-fracture electron microscopy. Freeze fracture of freshly isolated oligodendrocytes showed globular and elongated intramembrane particles similar to those previously described in oligodendrocytes in situ. Enrichment of these particles was seen at sites of inter-oligodendrocyte contact. Numerous gap junctions and scattered linear tight junctional arrays were apparent. Gap junctions were connected to blebs of astrocytic plasma membrane sheared off during isolation, whereas tight junctions were facing extracellular space or blebs of oligodendrocytic plasma membrane. Thin sections of cultured, unattached oligodendrocytes showed rounded cell bodies touching one another at points without forming specialized cell junctions. Cells plated on polylysine coated aclar dishes attached, emanated numerous, pleomorphic processes, and expressed galactocerebroside and myelin basic protein, characteristic markers for oligodendrocytes. Thin sections showed typical oligodendrocyte ultrastructure but also intermediate filaments not present in unattached cultures. Freeze-fracture showed intramembrane particles similar to but more numerous, and with a different fracture face repartition, than those seen in oligodendrocytes, freshly isolated or in situ. Gap junctions were small and rare. Apposed oligodendrocyte plasma membrane formed linear tight junctions which became more numerous with time in culture. Thus, cultured oligodendrocytes isolated from ovine brains develop and maintain features characteristic of mature oligodendrocytes in situ and can be used to explore formation and maintenance of tight junctions and possibly other classes of cell-cell interactions important in the process of myelination. PMID- 6502229 TI - Surgical experiences with giant intracranial aneurysms. AB - A series of 35 patients with 36 giant aneurysms is presented. Thirteen patients presented following subarachnoid hemorrhage (SAH) and 22 with evidence of a space occupying lesion without recent SAH. The preferred technique of temporary trapping of the aneurysm, evacuation of the contained thrombus, and occlusion of the neck by a suitable clip is described. The danger of attempted ligation in atheromatous vessels is stressed. Intraoperatively, blood pressure was adjusted to keep the general brain circulation within autoregulatory limits. Direct occlusion of the aneurysm was possible in over 80% of the cases. The mortality rate was 8% in 36 operations. Six percent of patients had a poor result. Considerable improvement in visual loss was evident in six of seven patients in whom this was a presenting feature, and in four of seven with disturbed eye movements. PMID- 6502230 TI - The prognosis in subarachnoid hemorrhage of unknown etiology. AB - The mortality rate, risk of rebleeding, relevant subjective and objective symptoms, and daily functional capacity after a verified subarachnoid hemorrhage (SAH) of unknown etiology were evaluated in 44 patients treated during a 5-year period (1978 to 1983). A vascular basis for the SAH had been excluded by bilateral carotid and vertebral angiography and computerized tomography. The patients were interviewed at a follow-up examination from 3 to 64 months (median 36 months) after the bleed. The results revealed a 5% mortality rate and a 7% risk of rebleeding. Persisting headache and fatigue were found in 40% of patients, 29% had mild demential symptoms, and 5% had persisting and severe objective neurological symptoms. None had developed epilepsy. A normal daily functional capacity was enjoyed by 84%, while 14% had a moderate reduction in these functions, but were independent of help from other persons. One patient (2%) was not fully assessed. PMID- 6502231 TI - Study of the posterior circulation in moyamoya disease. Clinical and neuroradiological evaluation. AB - Eighty-two cases of cerebrovascular moyamoya disease were studied by cerebral angiography and computerized tomography. Occlusive lesions were demonstrated not only in the anterior circulation but also in the posterior circulation, and they were associated with the development of an abnormal vascular network (moyamoya vessels). Although occlusive lesions do occur in the vertebrobasilar system, the vertebrobasilar system also acts as a source of collateral channels to the anterior circulation in this disease. PMID- 6502232 TI - Dissecting aneurysm of the vertebral artery. Report of seven cases and angiographic findings. AB - Seven cases of dissecting aneurysm of the vertebral artery, all appearing to be of fusiform type, are reported. Clinically, all seven cases initially showed symptoms of subarachnoid hemorrhage; however, three of these were associated with Wallenberg's syndrome. The characteristic angiographic findings in these cases were: 1) retention of contrast medium in the aneurysm; 2) the presence of a true (vertebral artery) and false (arterial wall) lumen in the late arterial and/or venous phase; and 3) irregular arterial narrowing proximal and/or distal to the aneurysm. Autopsy findings of one patient supported the angiographic findings. Recently, reports of fusiform aneurysms associated with subarachnoid hemorrhage have been increasing. As dissecting aneurysms are found in the fusiform group, it is very important to analyze serial angiograms in order to choose a method of surgical treatment. PMID- 6502233 TI - Localization of function in the excision of lesions from the sensorimotor region. AB - A method is described which utilizes the recording of somatosensory evoked responses and cortical stimulation to localize the sensorimotor area under general anesthesia. It has been used in 31 patients who had lesions located in or near the somatosensory or motor gyri. Twenty-six of these patients had a tumor, and the remaining five had a tuberculoma, cysticercoid cyst, thrombosed arteriovenous malformation, cystic infarct, and astrocytic proliferation, respectively. Case histories of selected patients are briefly reported to demonstrate how the method can be used to improve the safety of surgical excisions in the sensorimotor area. The neurological results are discussed in relation to recent physiological studies, demonstrating multiple and spatially separate, sensory and motor representations of the body in the somatosensory and motor gyri. PMID- 6502234 TI - Phase II evaluation of dibromodulcitol in the treatment of recurrent medulloblastoma, ependymoma, and malignant astrocytoma. AB - The authors have conducted a Phase II trial to evaluate orally administered dibromodulcitol in the treatment of 40 evaluable patients with recurrent medulloblastoma, ependymoma, and malignant astrocytoma. Ten of 20 patients harboring medulloblastoma responded to therapy with a median time to tumor progression (MTP) of 40 weeks, and four of 20 patients had no sign of progression of disease 4 years after treatment was begun. The MTP for all 12 patients with ependymoma was 30 weeks. Nine of these 12 patients had stabilization of their disease with an MTP of 67 weeks; three of these 12 patients had no signs of progression for 1 to 3 years after treatment was begun. Of six patients harboring supratentorial gliomas, none responded to dibromodulcitol. Two patients, one with a primitive neuroectodermal tumor and the other with a metastatic carcinoma of the breast, had stabilization of disease for more than 4 and 2 years, respectively. PMID- 6502236 TI - Sterile shunt malfunction. A scanning electron microscopic perspective. AB - Recently, a delayed hypersensitivity reaction to silicone plastics has been demonstrated in some patients with breast and joint implants and subcutaneously injected silicone. In this study, the authors examined the internal surface of shunting systems to evaluate the cellular response to implanted silicone plastic. The distal peritoneal tubing from 20 patients with ventriculoperitoneal shunts was examined with a scanning electron microscope. Twelve tubes were removed because of documented distal shunt malfunction and eight for an elective lengthening procedure. Cultures of all tubing were negative. The catheters removed for malfunction contained a variety of cells: sometimes in clumps, sometimes associated with platelets and densely adherent to the silicone tubing wall. In several shunts, giant cells were seen with multiple foot processes adherent to the internal silicone surface. The internal surface of the tubing of two malfunctioning shunts was embedded in electron microscopy plastic and studied with transmission electron microscopy. The cells proved to be neutrophils with no evidence of silicone granules inside the cell bodies. The shunts removed for elective revision showed only a few cells, and those were never associated with platelets. There was proteinaceous material scattered on the internal surface of the tubing, but the cellular response was markedly different from that in malfunctioning shunts. The authors postulate that the findings in malfunctioning shunt tubing represent a delayed hypersensitivity to silicone similar to that seen with other types of silicone implants. PMID- 6502235 TI - Factors causing acute shunt infection. Computer analysis of 1174 operations. AB - A series of 1174 operations performed on 802 hydrocephalic children was analyzed in an effort to find the factors causing acute postoperative infection. Culture of the cerebrospinal fluid (CSF) samples during the operation was positive in 33 cases. These cases were excluded from the series. Ninety infections were observed in the remaining 1141 operations, an overall rate of 7.9%. Most of these infections were meningitis (56 cases). Staphylococcus epidermidis was the bacterium most frequent identified (44%). Statistically significant relationships were found between shunt infection and the following factors: 1) age: infection was 2.6 times as frequent before 6 months than after 1 year of age (p = 0.03); 2) poor condition of the skin; 3) presence of intercurrent seats of infection at the time of surgery; 4) type of operation: the rate of infection was 8.4% in primary shunt insertions, 5% in shunt revisions, and 17.5% in reinsertions following shunt removal for infection (p = 0.0001); 5) end of the shunt requiring revision: an infection rate of 7.7% followed revision of the ventricular catheter alone, and 2.6% followed revision of the other end alone (p = 0.012); and 6) postoperative wound dehiscence or scalp necrosis. The surgical team involved was poorly correlated with the rate of infection (p = 0.12). No statistically significant relationships have been found between infection and 1) etiology of hydrocephalus: 2) sex; 3) recent neurosurgical operation before the shunt procedure; 4) preoperative presence of an external drainage tube or CSF fistula; 5) lumbar or ventricular taps, or ventriculography; 6) number of previous operations performed on the shunt; 7) time (month and year) of operation; or 8) sugar level and cell count in the CSF. PMID- 6502237 TI - Immunosuppression by phenytoin: implication for altered immune competence in brain-tumor patients. AB - This investigation was conducted to examine the immunosuppressive potential of phenytoin in vivo and to document a correlation between phenytoin therapy and depressed lymphocyte responsiveness to mitogens. It was thought that phenytoin, the most widely used anticonvulsant agent, may play some role in the immunosuppression seen in brain-tumor patients. The effect of phenytoin on mitogen-stimulated lymphocyte function was evaluated by tritiated (3H)-thymidine incorporation and lymphocyte nuclear size distribution. Lymphocytes from either phenytoin-treated or normal rabbits were incubated for 90 hours in culture medium in the presence of three mitogens: phytohemagglutinin (PHA), concanavalin A (Con A), and pokeweed mitogen (PWM). Significant suppression of mitogen-induced activation of the lymphocytes from treated animals was demonstrated. The present studies suggest a possible connection between phenytoin therapy and altered immune competence in brain-tumor patients. PMID- 6502238 TI - Role of surgery in hypertensive intracerebral hematoma. A comparative study of 305 nonsurgical and 154 surgical cases. AB - The indications for surgery in hypertensive intracerebral hematoma are still controversial. The reason for this may be: 1) lack of adequate and comparable data in conservative and surgical therapy from the same institution; 2) lack of adequate close follow-up monitoring over an extended period of time; or 3) lack of proper classification of hematomas for comparison of results from different institutions. The authors have treated 459 cases of hypertensive intracerebral hematoma between October, 1975, and July, 1983. The hematomas have been classified according to their mode of extension on computerized tomography. The long-term outcome was assessed on the basis of activity of daily living. Putaminal hematomas were classified as mild, moderate, severe, and very severe. In general, there was no significant difference in outcome between the surgical and nonsurgical cases; however, the outcome in the moderate and severe hematomas was found to be a little better for the surgical cases in some restricted areas. Thalamic and pontine hemorrhages were classified as mild, moderate, or severe. If the hematoma is localized to the thalamus or pons, and if it extends to the midbrain, there is no indication for surgery; however, in patients with moderate hematomas, the prognosis showed a variable outcome, and the indications for surgery were questionable. In cerebellar hematomas, the authors propose that even a hematoma with a diameter greater than 3 cm might show a good outcome with nonsurgical therapy. PMID- 6502239 TI - Transuncodiscal approach to dumbbell tumors of the cervical spinal canal. AB - A combined anterior and lateral approach to the anterior cervical spinal canal with fusion was performed on five patients with cervical dumbbell-shaped tumors. The procedure consists of anterior discectomy and ipsilateral uncectomy, and removal of the posterolateral corners and posterior transverse ridges of the upper and lower vertebral bodies at the level of the tumor. In the case of a large tumor in the spinal canal, additional removal of a limited segment from the lateral part of the vertebral body was performed. The bone defect was filled with a T-shaped iliac bone graft. Two vertebral bodies were fused in each case. The highest level of the operation was C-2 and the lowest was T-1. The authors believe that any cervical dumbbell-shaped tumor below the C-2 level can be removed via an anterolateral approach as long as no more than three levels of the spine are involved. PMID- 6502240 TI - Diagnosis of superior sagittal sinus thrombosis by computerized tomography. Report of two cases. AB - Superior sagittal sinus thrombosis was diagnosed on computerized tomography (CT) scanning and was subsequently confirmed by angiography in two patients. Small ventricles and filling defects occurring within the sinus (the empty triangle sign) appeared to be highly suggestive of superior sagittal sinus thrombosis, and the association was confirmed angiographically. Potential pitfalls in the CT diagnosis of local obstruction of cerebral venous outflow are described and correlated with the natural history of the disease. The need for improved awareness of the CT appearance of occlusive disease of the dural venous sinuses is stressed. PMID- 6502241 TI - Thoracic disc herniation associated with papilledema. Case report. AB - The occurrence of papilledema in a patient with progressive spastic paraparesis due to herniation of the T11-12 intervertebral disc is reported. The papilledema resolved following discectomy. The association and possible pathogenetic mechanisms between spinal cord lesions and signs of raised intracranial pressure are reviewed. PMID- 6502242 TI - Parailiac ectopic bone after Cloward procedure. Case report. AB - A rare case of parailiac ectopic bone formation 10 years after a Cloward procedure is presented. Dystrophic calcification of a previous hematoma or deposit of bone dust were considered to be the origin of this unusual complication. PMID- 6502243 TI - Occlusion of the great vein of Galen associated with a huge meningioma in the pineal region. Case report. AB - The authors report a case in which the great vein of Galen was occluded during removal of a huge meningioma in the pineal region. The patient recovered satisfactorily without any serious neurological deficits after the operation. Preoperative angiography had shown marked stenosis of the great vein of Galen and anastomoses between the deep and the superficial venous systems. Occlusion of the great vein of Galen may be well tolerated in particular cases if this vein is already compromised. PMID- 6502244 TI - Multiple fusiform intracranial aneurysms following curative radiation therapy for suprasellar germinoma. Case report. AB - A 17-year-old girl died from the rupture of a large fusiform aneurysm of the terminal internal carotid artery. Autopsy revealed three other fusiform aneurysms originating from major cerebral arteries clearly within the ports of previously administered telecobalt radiation therapy. Five years prior to her death, a suprasellar germinoma was partially removed and the area was treated by radiation therapy via three ports. The original arteriograms showed a normal vascular tree. Repeat arteriograms, 3 years and 8 months before her death, demonstrated the aneurysms. The development of aneurysms following radiation damage of the arteries has been reported previously, but not in intracranial vessels. PMID- 6502245 TI - Anti-siphon device in shunt therapy. PMID- 6502246 TI - Interhemispheric subdural hematoma. PMID- 6502247 TI - Anatomy of the tentorial arteries. PMID- 6502248 TI - Reliability of ICP measuring devices. PMID- 6502249 TI - Management of Klippel-Feil syndrome: correction. PMID- 6502250 TI - Residency training in neurological surgery, 1934-1984: evolution over 50 years of trial and tribulation. The 1984 AANS presidential address. AB - The President of the American Association of Neurological Surgeons (AANS) reviews formal neurosurgical training in the United States from its inception with one program in 1934 to 1984, with 94 programs and 650 residents. He reports on the 1st year's experience with a national neurosurgical residency matching plan. He presents realistic remedies for today's professional liability dilemma and analyzes socioeconomic factors that have led to the complex challenges facing neurosurgeons in this decade, relating the importance of the AANS mission and goals in resolving these issues. PMID- 6502251 TI - An analysis of "ablation of thyroid remnants" with I-131 in 511 patients from 1947-1984: experience at University of Michigan. AB - Between January 1947 and June 1983, 511 patients were given treatment doses of I 131 after surgery for thyroid cancer in the presence of I-131 uptake in thyroid remnants. Thirty-four patients were removed from the study leaving 462 patients with a 99% follow-up at 1 or more yr, with a mean follow-up of 15 yr. Of 267 patients with radioiodine uptake confined to the thyroid bed, 233 (87%) had ablation from the first dose of I-131 ranging from 100 to greater than 200 mCi. The higher the percent uptake, the more difficult it was to achieve ablation. In the percentages of successful ablation, there were no significant differences between I-131 doses of: 100-149 mCi, 150-174 mCi, 179-199 mCi, and 200 mCi or more. The 100-149 mCi ablative dose may furnish "adjuvant" therapy for occult metastases. PMID- 6502252 TI - Accuracy and precision of regional multiharmonic Fourier analysis of gated blood pool images. AB - In order to estimate the precision and accuracy of parameters derived from segmental multiharmonic Fourier analysis of gated blood-pool images, a Monte Carlo computer noise simulation was tested on five sample regional time-activity curves. The first three Fourier harmonics were retained and the precision and accuracy of parameters of ventricular function were calculated, varying the ejection fraction, segment size, and framing rate. Precision improved with higher ejection fraction, higher counts per frame, or higher framing rate. There was no change in precision as the framing rate changed at fixed total counts. Accuracy changed little with changing framing rate. Thus, for segmental analysis there is no advantage to using a higher framing rate. Regions five or more pixels in size are recommended for reliable results. This study provides useful information for the optimization of acquisition and processing conditions for regional gated blood-pool analysis. PMID- 6502253 TI - Tc-99m diphosphonate and sulfur colloid uptake by the spleen in sickle disease: interrelationship and clinical correlates: concise communication. AB - To determine the clinical significance of splenic uptake in bone scintigraphy and functional asplenia on the radionuclide liver-spleen image, bone and spleen scintigrams of 38 patients with sickle cell disease were reviewed. Eighteen underwent bone and liver-spleen studies, 15 had only bone images, and five had only liver-spleen studies. Sixteen of 33 who had bone scintigraphy showed splenic uptake, but the frequency of homozygous sickle cell (SS) disease was not greater than heterozygous sickle cell disease (S-hetero) in this group. SS patients with splenic uptake of Tc-99m diphosphonate had significantly fewer painful crises of the abdomen and extremities, and fewer inpatient and outpatient hospital visits than SS patients whose bone imaging did not visualize the spleen. Functional asplenia on liver-spleen images (16 cases) was seen only in SS disease. One SS patient, age 8, still had a spleen capable of phagocytizing colloid. PMID- 6502254 TI - Tc-99m RBC blood-pool imaging demonstrates umbilical vein in portosystemic shunt. AB - Dynamic hepatic scintigraphy in a patient with longstanding ethanolism revealed hepatofugal drainage of the liver area. That this pathway represented the umbilical vein was shown by subsequent blood-pool images. The umbilical vein drained the left portal vein into venous channels in or near the anterior abdominal wall. These channels proceeded through epigastric vessels into the right femoral/iliac venous system. The umbilical vein may serve as a shunt from the portal system to the systemic circulation in cases of portal hypertension. Blood-pool imaging has a potential role in clarifying possible venous channels identified by hepatic scintiangiography, and can suggest the presence of portal hypertension when these vessels are visualized. PMID- 6502255 TI - The synthesis of 2-[F-18]fluoro-2-deoxy-D-glucose using glycals: a reexamination. AB - The reaction of [F-18]F2 with D-glucal in water proceeds sufficiently mildly at room temperature to present marked regiospecificity. After hydrolysis, analysis by Fourier-transform 19F-NMR showed the product to consist of a mixture of 2 fluoro-2-deoxy-D-glucose (2-FDG) and 2-fluoro-2-deoxy-D-mannose (2-FDM) in a 2:1 ratio, respectively. The presence of the mannose isomer has been revealed by extension of the 19F-NMR analyses to other literature methods for 2-FDG synthesis involving the electrophilic fluorinating agent acetyl hypofluorite. Reaction of acetyl [F-18] hypofluorite, prepared by the reaction of [F-18]F2 with solid sodium acetate trihydrate, with the appropriate glycal/solvent combination, followed by hydrolysis, has led to production of [F-18]2-FDG with a radiochemical purity of 95%. PMID- 6502256 TI - Development of a model system to evaluate methods for radiolabeling monoclonal antibodies. AB - We have developed a model system that can be used to evaluate methods for radiolabeling monoclonal antibodies. In this system, dinitrophenyl (DNP) is used as a model antigen, and HDP-1 (a monoclonal antibody specific for DNP) is used as a model monoclonal antibody. DNP-coupled agarose beads are injected into the femoral veins of rats, after which they localize in the animals' lungs. Radiolabeled antibody can then be injected and its biodistribution monitored. We describe here the development and initial testing of the model with radioiodinated antibody. PMID- 6502257 TI - A versatile computer simulation of the left ventricle. AB - A versatile mathematical simulation of a beating left ventricle, as seen in a gated cardiac blood-pool study, is described. The basic model consists of a fifth degree polynomial rotated about its long axis. Motion is mimicked by sinusoidally varying the lengths of the long and short axes. The quality of clinical images is simulated through addition of Poisson noise and camera blur, determined from the measured line-spread function for Tc-99m. To achieve added realism, the modeled ventricle can be inserted in place of the patient's actual ventricle in clinical images. The dimensions, activity, and ejection fraction can all be adjusted. In addition, regional wall-motion abnormalities can be generated in any of the walls. To illustrate applications of the model in testing and evaluating cardiac computer programs, the performances of two ejection-fraction programs are compared, and use of the model in evaluating digital filtering algorithms is discussed. PMID- 6502258 TI - Effects of characteristic x-rays on assay of I-123 by dose calibrator. AB - Large differences in dose-calibrator readings are obtained if "high-purity" I-123 is assayed in different containers. Large correction factors are necessary for assaying another isotope of iodine, I-125, in a dose calibrator, because of absorption of the low-energy (28.4-keV, weighted mean) emissions. We found that up to 70% of the dose-calibrator response to I-123 can be due to characteristic x rays with energies exactly the same as those emitted by I-125, and that dose calibrator response to I-123 is also strongly affected by the absorption properties of the vial. An appropriate method to define I-123 activity uses a gamma camera with a medium-energy collimator to establish correction factors for dose-calibrator assay of I-123 in different containers. Correction factors for a plastic syringe and a thick-wall glass vial, were determined using this method. Measurement of I-123 activity in a copper absorber will eliminate the response to x-rays, and the gamma camera is useful in establishing the necessary correction factors. PMID- 6502259 TI - The relationship of instrument parameters to performance within a survey peer group. AB - Using simulators of transmission imaging, an interlaboratory survey assessed the discriminatory performance of 86 subscribers, each of whom imaged a liver phantom in anterior and right lateral projections. Analysis was by receiver operating characteristic (ROC) with Az, the area under the ROC curve, used as a measure of accuracy unconfounded by decision bias. Az values were then defined as the dependent variable in a statistical model that related performance to several instrument design and operating parameters. Six of 14 postulated parameters explained approximately half of observed subscriber variability. These were: year of camera manufacture or upgrade, number of photomultiplier tubes, collimator type, total counts collected, use of a Co-57 disk source for imaging the phantom, and computer processing of the image. The findings confirm previous inferences drawn from controlled intralaboratory experimentation, but hitherto unsubstantiated by clinical imaging data. PMID- 6502260 TI - Uniformity correction and quality control in scintillation cameras. PMID- 6502261 TI - Re: Activity and protein levels in studies of monoclonal antibody imaging. PMID- 6502262 TI - Lactation increases the efficiency of energy utilization in rats. AB - The possibility that lactation increases the efficiency of energy use was investigated by comparing energy expenditure on activity and maintenance in virgin and lactating rats fed either ad libitum or restricted amounts of food. Energy expenditure was determined, by difference, in a nutrient balance study. Lactating rats fed ad libitum expended 34.9% less energy on activity and maintenance than did control animals. Of this change, 82% was specifically associated with lactation, but the remaining 18% was associated with the negative energy balance that occurred during lactation. Lactating rats fed restricted amounts of food expended less energy on activity and maintenance than did virgin rats fed at the same level of restriction, but this change was associated with increased negative energy balance and not specifically with lactation. These results indicate that the efficiency of energy use is increased substantially during lactation in the rat, regardless of the level of energy intake, and that mechanisms associated with negative energy balance play an important role in the change. PMID- 6502263 TI - The effects of xylitol on gastric emptying and secretion of gastric inhibitory polypeptide in the rat. AB - The effects of xylitol on the rate of gastric emptying and plasma gastric inhibitory polypeptide secretion in the rat were studied to relate xylitol adaptation to these phenomena. Male Sprague-Dawley rats, weighing about 250-270 g, were either gradually adapted to 20% xylitol diets or given a basal diet. The animals were, after a 24-hour fast, given a 1.2 g/kg body weight dose of xylitol or glucose either alone or with a 99mTc-tin colloid marker to study gastric emptying by using a gamma camera. Blood was taken from the tail vein, and plasma was analyzed for immunoreactive gastric inhibitory polypeptide by using a double antibody radioimmunoassay. Xylitol adaptation did not appear to have any effect on the secretion of gastric inhibitory polypeptide. However, adaptation of rats to 20% dietary xylitol appeared to change the rate of gastric emptying by decreasing it. Therefore, it was concluded that gastric emptying plays a role in the adaptation to high xylitol doses while gastric inhibitory polypeptide appears not to be involved. PMID- 6502264 TI - Phenylalanine and tyrosine requirements of immature beagle dogs. AB - Experiments were conducted with immature Beagle dogs to determine the dietary requirement for phenylalanine. With purified L-amino acid diets the requirement for this aromatic amino acid to optimize growth, feed efficiency and nitrogen balance was found to be 0.8%. Dietary limitations in the quantity of phenylalanine resulted in an increase in plasma and urinary urea. Breakpoint analysis of plasma phenylalanine concentrations also indicated a dietary requirement of 0.8%. The present data indicate that the dietary requirement for phenylalanine can be met by supplying approximately 195 mg per 100 kcal metabolizable energy or 518 mg per kilogram body weight per day. In a separate study, tyrosine was found to meet approximately 46% of the phenylalanine requirement of the immature dog. Consumption of diets containing tyrosine in the presence of optimal phenylalanine did not further stimulate growth, feed efficiency or nitrogen balance. PMID- 6502265 TI - Choline uptake by isolated enterocytes of guinea pig. AB - Isolated intestinal epithelial cells of guinea pig were employed to study choline transport. Uptake by cells from the whole length of the small intestine was saturable with an apparent Km value of 119 microM and Vmax of 208 pmol/(mg protein X minute). The compound was taken up by ileal cells about three times faster than by jejunal cells. Antimycin A reduced the rate of uptake more than 50%. Inhibition of the (Na+ + K+)-ATPase by ouabain or replacement of Na+ in the medium by K+ decreased the rate of uptake. The results indicate that choline is absorbed in the jejunum and ileum of guinea pig mainly by an Na+-dependent carrier mechanism. PMID- 6502266 TI - Effect of rumen-protected methionine on plasma free amino acids and production by dairy cows. AB - The effectiveness of an encapsulated rumen-protected methionine compound (RPMet) for delivering methionine postruminally and its effect on plasma amino acid concentrations, milk production and milk composition were evaluated. Thirty multiparous Holstein cows in early lactation were randomly assigned to five levels of RPMet. RPMet was supplied at 0, 550, 1100, 1650 or 3300 mg/kg of concentrate resulting in an intake of 0, 6.9, 12.9, 19.6 or 40.2 g of supplemental DL-methionine/day for each cow. The basal diet was alfalfa bromegrass hay and a 15.8% crude protein corn- and soybean meal-based concentrate mixture. The experiment was divided into pretreatment and treatment periods, each consisting of 21 days. Feed intake and milk production were measured daily, milk composition weekly and plasma amino acid concentrations twice daily on days 17 and 20 of the pretreatment period and on days 4, 10 and 21 of the treatment period. RPMet was effective in delivering methionine postruminally, which increased concentrations of methionine in plasma. Dry matter intake, milk production, milk composition and body weight were not significantly affected by RPMet. PMID- 6502267 TI - Effect of level of dietary protein and total or partial starvation on catalase and superoxide dismutase activity in cardiac and skeletal muscles in young rats. AB - In cells the level of potentially toxic superoxide radical (O2-) is controlled by superoxide dismutase (SOD); the level of hydrogen peroxide (H2O2), also potentially toxic, is controlled by catalase and glutathione peroxidase. To study the effects of altered food intake or dietary protein content on SOD and catalase in cardiac and skeletal muscles, young rats were fed ad libitum diets containing 3, 6 or 25% casein or were subjected to total or partial food restriction (resulting in similar body weight losses). Rats fed a diet containing 3 or 6% casein had much lower growth rates than those fed 25% casein, but the muscle catalase activities were similar in all three groups. Catalase activities in muscles of rats whose food intake was restricted were twice those in rats fed ad libitum. Rats fed ad libitum had higher muscle SOD activities at 41 days of age than did 25-day-old rats, irrespective of the amount of dietary protein or the rate of growth. Twenty-five-day-old rats whose food intake was totally restricted for 2 days had skeletal muscle SOD activities similar to the higher activities seen at 41 days of age in ad libitum-fed rats, but SOD activity in the heart was unchanged after food restriction. The responses of catalase and SOD in muscles differ from the responses reported for these enzymes in liver and erythrocytes when food intake or dietary protein is altered. PMID- 6502268 TI - Effect of caloric restriction during pregnancy on maternal and fetal body composition in the obese Sprague-Dawley rat. AB - The effects of 15, 30 or 50% caloric restriction during pregnancy on maternal and fetal compartments was determined in obese Sprague-Dawley rats. Pregnant and nonpregnant animals were assigned on a weight basis to one of the dietary treatments. All nutrients, except calories, were fed at levels to meet dietary requirements. Animals were killed on day 20 of treatment and fetuses were taken by Caesarian section. Pregnant animals achieved positive weight gain during 20 days of gestation at all levels of caloric restriction. Nonpregnant animals lost body weight when calories were restricted by 30 and 50%. Number of fetuses, fetal body nitrogen, and pup weight were not statistically different (P less than 0.05) among groups. Animals fed the 30 and 50% calorie-restricted diets showed a significant (P less than 0.05) decrease in total-body fat. Percent carcass protein tended to increase as dietary caloric restriction increased. The fetal compartment was apparently not affected by maternal caloric restriction up to 50% during pregnancy provided that all other nutrients were supplied in adequate amounts. Maternal stores were adversely affected at levels of 30 and 50% caloric restriction. PMID- 6502269 TI - Protective effect of taurine, zinc and tocopherol on retinol-induced damage in human lymphoblastoid cells. AB - Cultured human lymphoblastoid cells exposed for short times to retinol and retinoic acid, undergo a time- and dose-dependent decrease in viability, accompanied by cell swelling. The presence of taurine (5-20 mM) and zinc (50-100 microM) protected cells from retinol-induced injury. Taurine 20 mM and zinc 100 microM added simultaneously abolished cell swelling and increased cell viability from 7 to 55%. Tocopherol (200 microM) was also effective in protecting these cells from retinol. The three compounds together afforded complete protection. The effects of retinol and of taurine, zinc or tocopherol seem to be unrelated to lipid peroxidation. A membrane stabilizer action is proposed as the mechanism underlying the protective effect of taurine and zinc or of tocopherol. PMID- 6502270 TI - Maternal organ distribution of cardiac output in the diet-restricted pregnant rat. AB - Maternal organ distribution of cardiac output was measured with 15-micron diameter, radioactively labeled microspheres in ad libitum-fed or 50% diet restricted, term pregnant rats, and in ad libitum-fed nonpregnant rats. The diet restricted dams had a 33% lower total cardiac output than the ad libitum-fed dams, but it was not significantly different from that of the nonpregnant rats. Placental blood flow in the diet-restricted rats was 30% lower than that in the ad libitum-fed rats. Except for a higher blood flow to the pancreas and a lower blood flow to the uterine tissue, blood flows to the other organs of the diet restricted dams were not significantly different from those of ad libitum-fed pregnant dams. Blood flows to the lungs, small intestine and ovaries of the diet restricted pregnant rats were higher than those in the nonpregnant rats. Dietary restriction resulted in a decreased percentage of the cardiac output being distributed to the pregnant uterus and an increased percentage to the hepatic portal circulation, thus maintaining a liver blood flow similar to that in nonpregnant rats. Thus, maternal liver blood flow, rather than that to the placentas, is protected during malnutrition. PMID- 6502271 TI - The effects of zinc deficiency on turnover of cadmium-metallothionein in rat liver. AB - The object of this experiment was to determine the effects of Zn deficiency on the turnover of Cd-induced metallothionein (MT) in rat liver. Male rats were fed a purified Zn-deficient or Zn-adequate diet. After 13 days, the rats were given three daily injections of Cd2+ totaling 1.5 or 3.0 (Zn-deficient) and 3.0 or 6.0 (Zn-adequate) mg Cd/kg body weight. The MT was labeled by injecting the rats with [35S]cystine 2 hours after the final Cd injection. One, 3 or 5 days after labeling, the rats were killed, and their livers were assayed for MT 35S and metal content. The metal composition of MT (mole %) was 41-42% Cd, 51-54% Zn and 4-7% Cu in the Zn-adequate groups and 64% Cd, 27-31% Zn and 6-9% Cu in the Zn deficient groups. The half-lives of Cd-induced MT in the Zn-deficient rats were 2.6 days (1.5 mg Cd/kg) and 2.8 days (3.0 mg Cd/kg). In the Zn-adequate rats, the half-lives were 3.6 days (3.0 mg Cd/kg) and 3.1 days (6.0 mg Cd/kg). The half lives of general, soluble hepatic proteins were 4.1 to 4.3 days in all groups. Despite the stabilizing effect of the higher Cd content, the half-life of hepatic MT in the Zn-deficient rats was significantly shorter than in the Zn-adequate rats. These results indicate that hepatic MT degradation is faster in Zn deficient animals. PMID- 6502272 TI - The effect of depot parenteral zinc on copper metabolism in the rat. AB - The effect of depot parenteral injections of zinc (110 mg Zn/kg body weight) on copper metabolism in young, male rats was investigated. Individually caged rats, fed known amounts of stock diet and deionized-distilled water, were injected s.c. weekly for the first 4 weeks and biweekly for the next 17 weeks with zinc in sesame oil or the oil vehicle only. No significant differences in body weight, hemoglobin, hematocrit and fecal copper excretions were observed between treatments. However, 2 weeks after the initial injections, urinary copper excretion was elevated in the zinc-injected animals and remained elevated throughout the rest of the study. Plasma copper concentrations were significantly higher in the zinc-injected animals from week 2 to 8 of the study, and plasma zinc concentrations of these injected animals were elevated (P less than 0.05) from week 2 and throughout the remainder of the study. Zinc concentrations were significantly higher in the liver, heart, kidney and spleen (P less than 0.05) and copper concentrations were lower in the liver (P less than 0.07), kidney and spleen (P less than 0.05) of zinc-injected animals compared to the vehicle treated control animals. The data indicate that when zinc is administered by a non-gastrointestinal route, the fecal excretion of copper, the major route of copper excretion, is not altered. Thus, a negative copper balance is not initiated by high levels of zinc administered by the depot technique, in contrast to the negative copper balance stimulated by the gastrointestinal administration of zinc. PMID- 6502273 TI - Effects of dietary calcium and fat on cholesterol in tissues and feces of young goats. AB - To examine the effects of amount of calcium and type of fat in the diet on distribution of cholesterol in plasma, several tissues and feces, 4-week-old goats (6 females and 18 males) were fed isocaloric diets consisting of goat milk supplemented with cholesterol and 1) soybean oil, 2) tallow, 3) soybean oil and CaCO3 or 4) tallow and CaCO3 for 20 weeks. Plasma cholesterol increased initially in all animals; plasma and lipoprotein cholesterol concentrations, however, were not affected by dietary fat or calcium. Goats fed CaCO3 excreted more calcium and ash in their feces and had greater cholesterol and fat concentrations in their livers. Neutral steroid, but not bile acid, excretion was greater in soybean oil fed goats than in goats fed tallow. Soybean oil-fed goats had greater cholesterol concentrations in the viscera (minus liver) and tended to have greater cholesterol concentrations in the carcass and whole body. Aortas of soybean oil fed goats exhibited greater fat deposition. In summary, dietary fat, but not calcium, significantly altered cholesterol disposition in young goats by affecting cholesterol deposition in tissues and excretion in feces, without a concomitant change in plasma cholesterol. PMID- 6502274 TI - The utilization and safety of isomeric sulfur-containing amino acids in mice. AB - Growth assays on a synthetic amino acid diet fed to mice showed that substituting D-methionine for the L-isomer resulted in a dose-dependent relative weight gain reaching approximately 76% when D-methionine was fed at a level equivalent to that optimal for the L-form. L-Cysteine and L-cystine stimulated growth in the presence of suboptimal levels of L-methionine, but D-cystine was growth depressing. L-Cystine is at least equally efficient in stimulating growth in the presence of D-methionine as in the presence of the L-isomer. Compared to a suboptimal (25% of maximum) level of L-methionine alone, supplements to this level L-methionine by N-acetyl-L-cysteine produced a weight gain of 214%; L cysteine, 178%; L-cysteic acid, 154%; DL- + meso-lanthionine, 127%; L-cysteine sulfinic acid, 113%; D-cysteine, 76%; and S-methyl-L-cysteine, 13%. The observed growth-depressing effect of D-cysteine, D-cystine and S-methyl-L-cysteine at a concentration no greater than that optimal for methionine implies that these three sulfur-containing amino acids may be toxic. The results are discussed in terms of known and postulated transamination and transsulfuration pathways that govern the biological utilization of isomeric sulfur-containing amino acids and derivatives. PMID- 6502275 TI - The influence of diet on the regression of the Walker carcinosarcoma 256 in rats. AB - Regression of the Walker carcinosarcoma 256 has been observed in rats inoculated with 10(4) viable tumor cells. The regression was found to be affected by dietary composition. Tumors in rats fed a commercial laboratory diet (CLD) regressed after a 9-day initial growth period while tumors in rats fed a purified diet high in free fatty acids continued to grow. Diets with 20% corn oil promoted tumor regression, but rats fed diets containing 20% free fatty acids from corn oil had tumors that continued to grow. The nonsaponifiable fraction (NSF) of corn oil appeared to promote tumor regression when this fraction was added to diets containing corn oil fatty acids. At the end of the experiment (14 days), the tumors of rats fed a free fatty acid diet weighed 13-17 g. The tumors of rats fed CLD, corn oil diet and the corn oil free fatty acid diet plus the NSF of corn oil weighed 1-5 g. These results indicate that something in the NSF of corn oil was associated with the regression of the tumor. However, the nature of the dietary components promoting tumor regression, and the host response to those components, have not been determined. PMID- 6502276 TI - Effects of dietary calcium, phosphorus and magnesium on intranephronic calculosis in rats. AB - The effects of varying dietary levels of calcium, phosphorus and magnesium on the incidence and severity of intranephronic calculosis were studied. Renal calculi were induced by feeding female rats the AIN-76TM semipurified diet for 4 weeks. During this time period, dietary levels of 350, 450 or 550 mg calcium per 100 g diet did not influence the occurrence of urolithiasis. Increasing dietary magnesium levels from 50 to 350 mg was beneficial in preventing the occurrence of calculi if the diet contained 400 mg or less phosphorus. The protective effects of dietary magnesium were counteracted when dietary phosphorus levels were increased from 400 mg to 550 or 700 mg. If the dietary content of phosphorus and magnesium permitted the formation of renal calculi, the severity of the condition was also influenced by the dietary level of calcium. Some animal groups fed semipurified diets did not have microscopic or radiographic evidence of renal calculi but were found to have significantly elevated renal calcium values. It was suggested that these animals might be in a precalculus-forming state. PMID- 6502277 TI - Effect of diet and intranephronic calculosis on bone modeling and parathyroid volume in rats. AB - The effects of diet and intranephronic calculosis on bone modeling parameters and parathyroid volumes in the rat were studied. Bone chemical analyses and histomorphometric evaluation indicated that a modified AIN diet, containing minimal required levels of calcium, phosphorus and magnesium, was not nutritionally adequate. Although the mineral content of the modified AIN diet barely met the demands for normal bone modeling, both the AIN-76TM and modified AIN diet caused intranephronic calculosis. Nephrolithiasis was not observed in rats fed a natural-product diet. After 10 days, the medullary cavity size and the index of resorption were slightly greater in rats fed the calculogenic diets, but these effects were not evident at 9 weeks. A slight but highly significant difference in the bone magnesium content was observed between rats fed the semipurified and natural-product diets. At 9 weeks, the parathyroid volumes were slightly increased in rats fed the AIN-76 diet compared to rats fed the natural product diet. It was concluded that differences in dietary content that promote or inhibit intranephronic calculosis do not alter intestinal absorption as much as they influence molecular and cellular events occurring after absorption. PMID- 6502278 TI - Brain mRNA translatability in rats: changes during long-term dietary restriction in the developmental period of life. AB - We studied the effects of graded dietary restriction on the amount and translatability of messenger RNA (mRNA) molecule coding for brain proteins during the developmental period of life. Control experiments were performed on newborn, 1-, 3-, 6- and 27-week-old rats, whereas the dietary restriction studies, involving 10, 30 or 50% food deprivation, were conducted on weanling rats for periods of 3 or 24 weeks. Graded dietary restriction for 3 or 24 weeks caused a progressive reduction of the amount and translatability of mRNA in the rat brain. Complementary DNA (cDNA) probe and hybridization studies with [3H]cDNA revealed that food deprivation elicited a shorter species of mRNA or shorter sequences of the same species of mRNA coding for brain proteins and that not all polyadenylates mRNA [poly(A)+ mRNA] sequences found in control rats were present in the dietary-restricted animals. Furthermore, it appeared that food deprivation produced a shorter species of pre-mRNA via decreased polynucleotide elongation. The mRNA content of 27-week-old rat brains increased 12.5 times in comparison to newborns, representing an augmentation that was progressive and related to the developmental period of life of the animals. The translatability of mRNA was enhanced in the brain of 3-week-old rats, as compared to 1-week-old pups, and did not show any change thereafter. From these studies, it can be concluded that graded dietary restriction considerably modified the metabolism of mRNA in the rat brain, whereas minor alterations occurred during the developmental period of life in control animals. PMID- 6502279 TI - Thermogenesis in thyroidectomized, protein-malnourished rats. AB - To determine the requirement of thyroid hormones for the expression of diet induced thermogenesis (DIT) in the protein-malnourished rat, groups of male weanling Sprague-Dawley rats were thyroidectomized (Tx) or left surgically intact, and fed isoenergetic diets containing normal (22%, control) or decreased (8%, protein malnourished, PM) casein for 8 weeks postweaning. Half the Tx rats of either group received thyroxine (T4) replacement. Weight gains were least in PM-Tx rats, intermediate in control-Tx, PM and PM-Tx + T4, and greatest in control and control-Tx + T4 groups. Interscapular brown adipose tissue (IBAT) weight and brown adipocyte diameter were similar in control and PM rats and were greater in both Tx groups. Brown adipocyte diameter was normal but IBAT greater in both Tx + T4 groups. Both resting (ROC) and minimal (MOC) oxygen consumptions were increased in PM rats after 7 weeks, but the differences between ROC and MOC were similar in both dietary groups. MOC and ROC were decreased following Tx and became normalized in both Tx groups with T4. The effects of norepinephrine (100 micrograms/kg body weight, s.c.) on MOC were markedly reduced in both Tx groups and were normal after T4 replacement. These observations indicate that the increased thermogenesis observed in the protein-deficient rat is due to a thyroid dependent increase in MOC, and that the thyroid hormones are required for the sympathetic-dependent component of DIT and total thermogenesis in the protein malnourished rat model. PMID- 6502281 TI - Medical records and confidentiality. PMID- 6502280 TI - Relationships between composition and cellular uptake of lipoproteins from normal and hyperlipemic swine. AB - Young male swine fed a high fat, 1% cholesterol diet for 6 weeks developed a hyperlipemia accompanied by alterations in the composition of the very low density, intermediate density and low density lipoproteins (VLDL, IDL, LDL). High density lipoprotein (HDL) composition remained relatively constant. In addition to compositional analysis, determination of sedimentation coefficients indicated the LDL of hyperlipemic animals was of slightly larger size. The in vitro cellular uptake of normal swine and human 125I-labeled LDL by cultured human fibroblasts was similar in time- and concentration-dependent studies. The receptor-mediated uptake of normal swine 125I-labeled LDL, as well as IDL and VLDL, was significantly greater than that of hyperlipemic swine lipoproteins. Nonspecific uptake of normal and hyperlipemic 125I-labeled LDL was similar, as determined in studies with mutant receptor-negative familial hypercholesterolemic fibroblasts. It is hypothesized that the size of the lipoprotein particle may be a determinant in cellular uptake by physically limiting the number of particles that bind to the receptor site for uptake by the cell. PMID- 6502282 TI - Testicular cancer risk in agricultural occupations. PMID- 6502284 TI - Reduced disability and health care costs in an industrial fitness program. AB - A prospective longitudinal study of a group of participants in an industrial physical fitness program during a five-year period compares the disability and major medical costs incurred by the subjects before and after entry into the program. The members of the cohort were employees of an insurance company; most were well educated and held sedentary, white-collar jobs. Participation was voluntary and without financial incentives. The group experienced 45.7% reduction in major medical costs in the postentry year, rather than the expected inflationary increase. There was a reduction of 20.1% in the average number of disability days, and a 31.7% reduction in direct disability dollar costs in the one-year postentry period. The average combined savings per participant were $353.38; the average operational cost was $120.60. Results suggest that work-site wellness programs can make a substantial contribution to the reduction of health care and disability costs. PMID- 6502283 TI - Multiple indicators of stress in an 'active' job--cardiothoracic surgery. AB - Eight members of a cardiac surgery team were monitored for a variety of stress indicators. These included self-reports of felt stress, observations of behavior related to ECG activity, and measurements of urinary cortisol and 3-methoxy-4 hydroxy-mandelic acid (VMA). Observations were made on 12 separate days spread over a 3-month period. Results indicate moderate to low levels of perceived stress with high levels of satisfaction and high levels of support. ECG data showed wide individual variation; heart rates even during operations were not excessively high (mean, 100 beats per minute). VMA levels were within the normal range. Cortisol levels were above the normal range on 72% of measurements and mean levels were positively related to length of experience. Days when self perceived stress was reported were associated with higher levels of cortisol but not of VMA. The study failed to support predictions about responses to "active" jobs derived from Karasek's job-strain model. PMID- 6502285 TI - A mortality study of men exposed to elemental mercury. AB - A cohort of 2,133 white males who were exposed to elemental mercury vapors between 1953 and 1963 was followed up through the end of 1978. Death certificates were obtained for 371 of the 378 workers who were reported by the Social Security Administration to be deceased. The mortality experience of this group was compared with the age-adjusted mortality experience of the U.S. white male population. Mortality has not been studied previously in assessing the long-term health effects of mercury exposure. Standardized mortality ratios (SMRs) were calculated for a comparable unexposed worker population to determine the mortality patterns among workers at the same plant who were not involved in the mercury process. Statistically significant excesses of deaths from cancer of the lung (SMR = 1.34; 71 observed, 52.9 expected) and cancer of the brain and other CNS tissues (SMR = 2.30; 13 observed, 5.65 expected) were observed among the plant workers who were not involved in the mercury process. An excess of deaths from cancer of the lung was also observed among the mercury workers (SMR = 1.34; 42 observed, 31.36 expected), although the elevation of this SMR was not statistically significant. Since excesses of lung cancer were evident in both groups of workers, it is unlikely that they are related to the mercury exposure and more probable that they are due to some other factor present in the plant or to some life-style factor prevalent among the plant workers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502286 TI - The impact of health and safety committees. A study based on survey, interview, and Occupational Safety and Health Administration data. AB - In a study conducted to determine if the existence of a joint labor-management health and safety committee (HSC) was correlated with either the number of Occupational Safety and Health Administration (OSHA) complaints or hazardousness, as measured by OSHA serious citations, virtually no effect could be detected in a sample of 127 Massachusetts manufacturing firms. At a sample of 13 firms, interviews of HSC members were conducted. Committee attributes and perceptions about committee effectiveness were compared with the number of OSHA complaints and serious citations. There were fewer complaints and fewer serious citations at firms with HSCs that were perceived as effective. Results of the study suggest that the objective attributes of the committee may be less important to its success than the commitment of management and labor to solving workplace safety problems. PMID- 6502287 TI - The effects of leaks in spirometers on measurements of pulmonary function. The implications for epidemiologic studies. AB - Although the effects of spirometric leaks on forced expiratory tracings have been noted in retrospect in epidemiologic studies, the present study was designed to examine the effects of leaks of known size on the tracings of subjects with varying degrees of airway obstruction. Such information is needed to assess the potential impact of spirometric leaks on epidemiologic studies using existing spirograms collected in the absence of spirometer leak tests. Spirometric leaks of 5 to 9, 22 to 30, 34 to 46, 69 to 97, and 150 to 190 ml/s were produced by drilling holes of five sizes into spirometer mouthpieces. Eight subjects were studied, of whom five had FEV1/FVC of 0.70 or greater ("normal"), and three had FEV1/FVC of less than 0.70 ("obstructed"). Although leaks of 34 to 46 ml/s or less were found to be invisible in the forced expiratory tracings, they caused statistically significant (p less than .05) FVC decrements in all eight subjects, with a mean decrement of -0.35 l in the normal subjects and -0.79 l in the obstructed subjects. In contrast, the 34 to 46 ml/s leaks caused no significant FEV1 decrements in seven of the eight subjects. Since marked FVC decrements occurred even with the smaller leaks, the FVC should not be analyzed in epidemiologic studies in the absence of frequent, documented leak tests. However, the present study indicates that the FEV1 may be robust enough for analysis if recorded in the presence of small spirometric leaks. PMID- 6502288 TI - Distal ulnar neuropathy in meat packers. An occupational disease? AB - Distal ulnar neuropathy at the wrist level was observed in three meat packers. The diagnosis was confirmed electromyographically, by follow-up, and with surgical exploration. Compression neuropathy of the distal ulnar nerve has been a well-recognized occupational hazard and is cause by chronic and repeated compression of the ulnar nerve at the level of Guyon's canal; pathogenetic mechanisms differ from those observed in the more common carpal tunnel syndrome. PMID- 6502290 TI - Surgery in the obese patient. Review of complications secondary to obesity. PMID- 6502289 TI - Mortality among pulp and paper workers. AB - Mortality among 2,113 U.S. and Canadian members of the Pulp, Sulfite, and Paper Workers' Union, 1935 through 1964, was studied using a proportionate mortality analysis. Mortality due to gastric cancer was found to be elevated in all jurisdictions, but only in mills using sulfate or sulfite pulping. An excess of mortality due to kidney cancer was limited to mills in Oregon and Washington. Excesses of deaths due to leukemia, Hodgkin's disease, and lymphosarcoma were observed only in mills in Oregon, Washington, and Wisconsin and the province of Quebec. Based on small numbers, excesses of deaths due to cancers of rectum, pancreas, kidney, and lymphosarcoma were seen primarily among sulfite process workers, while Hodgkin's disease deaths occurred primarily in sulfate (kraft) process workers. These findings suggest that cancer mortality in pulp and paper workers may be related both to pulping process and to tree species processed. PMID- 6502291 TI - Treating colds and flu the Chinese way (2). PMID- 6502292 TI - Nephrostolithotomy. A new operation. PMID- 6502293 TI - Treating colds and flu the Chinese way (1). PMID- 6502294 TI - Management of esophageal rupture and perforation. PMID- 6502295 TI - Histomorphometric analysis of sclerotic bone from idiopathic myeloid metaplasia (nine cases). AB - The osteosclerosis of idiopathic myeloid metaplasia was investigated by a histodynamic study of undecalcified bone from nine patients. In all cases osteosclerosis resulted from woven bone formation. In moderate osteosclerosis only intrabecular woven bone was observed, with osteoclastic hyperresorption, hyperosteoidosis with many osteoblasts, and an increased calcification rate. This may represent an early stage of the disease, osteosclerosis resulting from increased bone remodelling, with woven bone formation by osteoblasts. However, in extensive osteosclerosis both intratrabecular and medullary woven bone was observed, with moderate osteoclastic hyperresorption, hyperosteoidosis without osteoblasts and a very low calcification rate. The latter pattern could correspond to an advanced stage, and could result from stromal bone formation without osteoblasts. The classical histodynamic profile of osteomalacia was sometimes observed. The link between bone pain and possible osteomalacia remains vague. PMID- 6502296 TI - Persistence of inert macromolecules (Imposil) in the rat mesangium and glomerular functional disturbance. AB - Imposil iron-dextran is an inert tracer that has been used to study mesangial uptake and clearance of macromolecular material from the glomerular circulation. Such a tracer may be a useful marker of altered mesangial function in animals with some forms of glomerulonephritis. We have studied mesangial handling of intravenously injected Imposil (50 mg/100 g body weight) in normal rats by light, immunofluorescence and electron microscopy for up to 3 months. Mesangial cell uptake was maximal at 48-54 h. Extrusion and drainage of tracer to the vascular pole and distal tubule was evident at 3 days but iron was still present in mesangial cells at 3 months. Possible functional renal impairment resulting from persistent mesangially sequestered tracer was examined by measuring daily urine protein and iron excretion. A possible relationship between failure of mesangial cells to eliminate inert tracer and increasing glomerular permeability is demonstrated, suggesting that Imposil and similar inert macromolecules cannot be used for long-term studies of mesangial function. PMID- 6502298 TI - Endothelial cell changes in acute hepatitis. A light and electron microscopic study. AB - Hepatic endothelial cells were studied by light and electron microscopy in 48 patients with acute hepatitis due to virus infection or drug idiosyncrasy. Light microscopy revealed cell swelling and appearance of dense refractile intracytoplasmic granules staining with the amylase PAS reaction and for iron by Perls' method. They were orcein-negative. These cells, regarded as 'activated' endothelial cells, were found throughout the parenchyma, especially in the classical form of acute hepatitis. In acute hepatitis with bridging, panacinar or periportal necrosis, activated endothelial cells were prominent in the necrotic areas. They were constantly seen lining newly formed capillaries in these sites. By electron microscopy, the intracytoplasmic granules had the characteristics of primary or secondary siderosomes. In areas of capillarization, basement membrane material was seen on the aspect of the activated cells facing the space of Disse. Activated endothelial cells may play a part in protecting hepatocytes from injury. PMID- 6502297 TI - Alterations in the biophysical properties of the human endothelial cell plasma membrane induced by a chemotactic tripeptide: correlation with enhanced adherence of granulocytes. AB - Human umbilical vein endothelial cells in monolayer culture were used to study the effects of the chemotactic tripeptide, N-formylmethionylleucylphenylalanine (FMLP), on structure and function of the endothelium. Endothelial cell morphology was unaffected by concentrations of 10(-8)-10(-4)M. No effect on endothelial cell proliferative capacity, as measured by the DNA content of cultures, was seen at the FMLP concentrations studied (10(-8)-10(-6)M). Using fluorescent molecular probes to investigate FMLP-induced alterations in membrane structure, it was shown using the monomer-excimer method with pyrene decanoic acid that FMLP caused a marked restructuring of the plasma membrane. This took the form of a restriction of the surface available to the lipophile reporter molecules, probably caused by a molecular reorganization of the membrane protein component. Experiments with diphenylhexatriene indicated that FMLP did not make the plasma membrane of the endothelial cell more fluid. Concomitant with these changes in the physical properties of the membrane, an FMLP-induced increase in granulocyte adherence to the endothelial cells was observed. A theoretical model is presented correlating granulocyte adherence with the lateral mobility of lipids in the endothelial cell membrane. The significance of the FMLP-induced increase in granulocyte adherence to endothelial cells for the pathogenesis of sepsis is discussed. PMID- 6502299 TI - Microbial causes of neonatal conjunctivitis. AB - We assessed the microbial causes of neonatal conjunctivitis by comparing 55 infants with purulent conjunctivitis and 60 healthy control infants. A mean of greater than 5 leukocytes per 1000X microscopic field was seen in Gram-stained smears obtained from the more inflamed eye in 77% of 30 untreated patients but none of 57 controls. Pathogens isolated more often from untreated patients than from controls included Haemophilus spp. (17% vs 2%, P = 0.01), Staphylococcus aureus (17% vs 2%, P = 0.01), Chlamydia trachomatis (14% vs 0%, P = 0.01), enterococci (8% vs 0%, P = 0.05), and Streptococcus pneumoniae (11% vs 2%, P = 0.06). One or more of these pathogens were isolated from the conjunctivae in 58% of patients and 5% of controls (P less than 0.001). Bacterial morphology seen on smear correlated with the pathogens cultured. Isolation of Haemophilus spp. or S. pneumoniae was associated with dacryostenosis. We conclude that several microbial pathogens are implicated in neonatal conjunctivitis. These organisms have differing susceptibilities to antimicrobial agents, so culture and sensitivity testing are required as a guide to therapy. PMID- 6502300 TI - Role of aluminum hydroxide in raising serum aluminum levels in children undergoing continuous ambulatory peritoneal dialysis. AB - Serum aluminum concentrations were measured in 16 children undergoing continuous ambulatory peritoneal dialysis after 7.9 +/- 2.1 (mean +/- SE) and 16.6 +/- 2.3 months of therapy, when the estimated simultaneous oral Al intake from Al hydroxide gels was 98 +/- 20 and 104 +/- 32 mg/kg/day, respectively. Serum Al concentrations were 55.2 +/- 11.4 and 59.8 +/- 10.4 micrograms/L, respectively, compared to 8.2 +/- 1.1 micrograms/L in normal children (P less than 0.001). Serum Al levels correlated with oral Al intake (r = 0.86, P less than 0.001) and inversely with body weight (r = -0.68, P less than 0.01) and age (r = -0.67, P less than 0.01). The youngest patient with the highest serum Al concentrations (208 and 174 micrograms/L) and greatest Al intake (310 and 192 mg/kg/day) had bone biopsy features characteristic of aluminum-related bone disease. Thus, higher aluminum intake per kilogram body weight given to young children is likely to raise the serum Al levels and increase the risk of osteomalacia. Aluminum containing antacids should be used with caution in infants and young children with renal failure. PMID- 6502301 TI - Comparison of continuous cycling peritoneal dialysis with continuous ambulatory peritoneal dialysis in children. AB - The clinical courses in 10 pediatric patients undergoing CAPD for 15.0 +/- 2.8 months and subsequently CCPD for 9.3 +/- 3.2 months were evaluated. During CAPD patients received four or five daily exchanges, and during CCPD five 2-hour nocturnal cycles over 10 hours plus a diurnal dwell. The only significant biochemical difference during CAPD compared with CCPD was the serum creatinine concentration (9.7 +/- 1.0 mg/dl vs 10.8 +/- 0.9 mg/dl, P less than 0.01). The peritonitis rate was one episode every 10.7 patient months during CAPD, compared with one episode every 8.5 patient months during CCPD. There were 21 episodes of exit site infection during CAPD versus 17 during CCPD. Mechanical complications included five ventral hernias in three patients and six peritoneal leaks in three patients during CAPD; two patients had two hernias and two patients had two peritoneal leaks during CCPD. Our results indicate adequate control of the biochemical abnormalities of uremia with CCPD, with the exception of the serum creatinine concentration. PMID- 6502302 TI - Peritonitis with continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis. AB - The frequency and cause of peritonitis in 18 children receiving continuous ambulatory peritoneal dialysis (CAPD) and nine children receiving continuous cycling peritoneal dialysis (CCPD) are described. Cumulative CAPD and CCPD experience demonstrated 58 episodes of peritonitis in 294 patient treatment months (one case per 5.1 patient treatment months). Total hospitalization for the treatment of peritonitis was 0.18 days per patient treatment month. Life table analysis revealed no significant difference in the peritonitis-free "survival" between the two modalities. Gram-negative organisms accounted for a significantly increased percentage of the peritonitis in CAPD compared with CCPD (65% vs 17%) (P less than 0.001). Thirty-seven percent of the gram-negative infections in the CAPD population were in children with nephrostomies. Factors predisposing to peritonitis were identified in 76% of cases occurring with CAPD. Peritonitis remains the major contributor to the morbidity associated with peritoneal dialysis, regardless of the technique. The resultant frequency of hospitalization is not prohibitive. Attention to the "high-risk" pediatric patient and education directed at several well-recognized predisposing factors may yield improved results. PMID- 6502303 TI - Transfusion-associated acquired immune deficiency syndrome in infants. AB - Two preterm infant boys not known to be at risk developed clinical, laboratory, and pathologic features of acquired immune deficiency syndrome (AIDS) after receiving multiple blood transfusions in the neonatal period. Their clinical courses were characterized by failure to thrive, recurrent otitis media, hepatomegaly, and fatal interstitial pneumonia. Laboratory evaluation revealed progressive lymphopenia, reversed T helper/suppressor ratios, increased percentages of B-lymphocytes, decreased lymphoproliferative responses to mitogens, hyperimmunoglobulinemia, and high levels of circulating immune complexes. At postmortem examination thymic involution, lymphocyte depletion in spleen and lymph nodes, and micronodular mineralization in the central nervous system were seen. The findings were not specific for other known congenital immune deficiencies and were most indicative of AIDS. The lack of other risk factors suggests transmission of AIDS via blood transfusions in the neonatal period. PMID- 6502304 TI - Four siblings with similar malformations after exposure to phenytoin and primidone. AB - Four siblings exposed to phenytoin or primidone or both in utero are reported. Each has craniofacial features consistent with fetal hydantoin syndrome. Two of the siblings were exposed to primidone alone, indicating that phenytoin and primidone may have similar teratogenic effects. PMID- 6502305 TI - Erythropoietin and the anemia of prematurity. PMID- 6502306 TI - Abnormal TSH regulation, pseudotumor cerebri, and empty sella after replacement therapy in juvenile hypothyroidism. PMID- 6502307 TI - Observations on the evolution and treatment of idiopathic infantile hypercalcemia. PMID- 6502308 TI - Isolated elevation of serum alkaline phosphatase. PMID- 6502309 TI - Immune thrombocytopenia associated with acute nonlymphocytic leukemia. PMID- 6502310 TI - Spasmus nutans associated with optic gliomas in infants. PMID- 6502311 TI - Prevention of bronchopulmonary dysplasia by administration of bovine superoxide dismutase in preterm infants with respiratory distress syndrome. AB - The effectiveness of bovine superoxide dismutase (SOD) in the prevention of bronchopulmonary dysplasia was evaluated in a prospective double-blind controlled study in 45 neonates (mean gestational age 28.7 weeks, mean weight 1154 gm) with severe respiratory distress syndrome. All were ventilator dependent with FiO2 greater than or equal to 0.7 at 24 hours of age. Either bovine SOD (0.25 mg/kg) or saline solution was administered subcutaneously every 12 hours according to random selection until patients could be maintained in room air without ventilatory or continuous positive airway pressure (CPAP) support. SOD levels were detected in all patients given treatment. Mean peak values at 4 hours after dose ranged from 0.15 micrograms/ml (dose 1) to 0.45 micrograms/ml (dose 10). The drug was well tolerated, and no side effects were detected. Among the 31 survivors (SOD 14, placebo 17) radiologic evidence of BPD was significantly less in patients given SOD (3/14 vs 12/17, P = 0.008). Clinical signs of bronchopulmonary dysplasia (wheezing, pneumonia) were less in patients given SOD (3/14 vs 11/17, P = 0.019). Patients given SOD required fewer days of CPAP (P less than 0.003). There were no differences in days of O2 therapy, intermittent positive pressure breathing, or incidence and severity of patent ductus arteriosus or intraventricular hemorrhage. This preliminary study suggests that SOD may be helpful in reducing the severity of bronchopulmonary dysplasia in infants with respiratory distress syndrome. PMID- 6502312 TI - Anemia of prematurity: determinants of the erythropoietin response. AB - This study was undertaken to determine the factors that are important in determining the erythropoietin response in low-birth-weight infants during the period of so-called anemia of prematurity. In the first weeks of life oxygen consumption in a group of 21 infants gradually increased as hemoglobin level fell. The magnitude of the erythropoietin response inversely varied with the central venous oxygen tension (P-vO2) (r = -0.55, P less than 0.001). When the P vO2 declined to less than 30 torr, erythropoietin values were uniformly increased above the "normal" range (defined as the values associated with P-vO2 greater than 38 torr). Erythropoietin values varied inversely with hemoglobin but in general did not exceed the values observed for normal adult men. The erythropoietin values in the infants were remarkably lower at any given hemoglobin level when compared with those of older children with anemia resulting from bone marrow failure. In general, elevations of erythropoietin were seen when the hemoglobin concentration declined to less than 10.0 gm/dl. Change in heart rate did not appear to be a reliable indicator of the presence of anemia; rather, it correlated best with oxygen consumption. PMID- 6502313 TI - Decreased response of plasma immunoreactive erythropoietin to "available oxygen" in anemia of prematurity. AB - Erythropoietin, hemoglobin, hematocrit, oxygen affinity (P50), and reticulocyte counts were measured weekly starting at 1 week of age in 10 very-low-birth-weight infants and on a single occasion in 15 healthy men. In the adults, "available oxygen" (derived from oxygen carrying capacity and P50) averaged 13.1 ml/dl blood and the mean erythropoietin level was 15.2 mU/ml. Erythropoietin levels in the infants were inversely related to concentration of hemoglobin, P50, and available oxygen. However, despite the much lower mean "available oxygen" of 9.3 ml/dl in the infants compared with that in adults (P less than 0.001), the mean erythropoietin value of 8.2 mU/ml in the infants was less than in adults (P less than 0.001). Furthermore, the erythropoietin response to decreased "available oxygen" was lowest in the least mature infants. VLBW infants often develop clinical evidence of hypoxia during the anemia of prematurity. The relatively low erythropoietin levels in relation to "available oxygen" are compatible with a decreased erythropoietin response to hypoxia compared with that in adults. Such a difference in response could be a contributing factor to the anemia of prematurity. PMID- 6502314 TI - Necrotizing enterocolitis can be caused by polycythemic hyperviscosity in the newborn dog. AB - Although necrotizing enterocolitis has been associated with polycythemia in human infants, a causal relationship has not been established. Forty-six unanesthetized puppies were studied (age 6 to 14 days). Normovolemic polycythemia (Hct 0.70) was induced in 19 pups by exchange transfusion with 75 ml/kg packed red blood cells. Hypervolemic polycythemia (Hct 0.70) was induced in 14 pups by transfusion with 50 ml/kg RBC. Thirteen pups received exchange transfusion with whole blood and served as controls (Hct 0.40). Gross autopsy was performed on all pups 24 hours after transfusion or at death. Necrotizing enterocolitis was defined as areas of violaceous discoloration of the bowel associated with blood in the intestinal lumen. Although lesions appeared throughout the bowel in some pups, involvement of the distal small bowel was most common. Diagnosis was confirmed by microscopic examination. Both gross and microscopic lesions appeared similar to those in necrotizing enterocolitis in human infants. The disorder was seen in 11 of 19 pups with normovolemic polycythemia, eight of 14 pups with hypervolemic polycythemia, and only one of 13 control animals (P less than 0.01). Polycythemia can cause necrotizing enterocolitis in the newborn dog. PMID- 6502315 TI - Thermal support for the very-low-birth-weight infant: role of supplemental conductive heat. AB - Heated water pads were placed underneath very-low-birth-weight preterm infants receiving care under overhead radiant warmers with plastic heat shields to evaluate the effects on their thermal environments. The electrical input (watts) to the overhead warmer was monitored and temperatures at various locations in the environment and on the infants were recorded. The electrical input to the radiant warmers decreased significantly (P = 0.0015) with the introduction of the heated water pads. Several of the temperatures recorded during the study also showed significant changes, including increased abdominal skin temperatures in these prone infants (P = 0.007) and decreased back-to-abdomen skin temperature gradients (P = 0.007). Less marked changes included higher mattress or pad temperatures (P = 0.019), lower ambient air temperatures within the plastic heat shields (P = 0.022), and increased infant foot temperatures (P = 0.036). We believe that conduction has a significant influence on the thermal environment of the VLBW infant cared for under an overhead radiant warmer and that the use of a heated water pad can markedly alter heat transfer. The impact of conduction appears to have been previously underestimated. PMID- 6502316 TI - Human milk lactobezoars. PMID- 6502317 TI - Study of fenfluramine in outpatients with the syndrome of autism. AB - Fenfluramine was administered to 14 outpatient children with the syndrome of autism to determine whether previously produced decreases in blood serotonin concentrations and clinical improvements could be reinstituted. A double-blind medication-placebo crossover design was used. Each patient received fenfluramine 1.5 mg/kg daily (0.75 mg/kg twice daily) for 8 months, followed by placebo for 2 months. Blood serotonin levels promptly fell approximately 49% regardless of baseline levels. Clinical improvement returned, and on some scales gains after 8 months exceeded those noted after only 4 months of treatment. Significant correlations emerged among the amount of clinical response, initially high verbal IQs, and low blood serotonin concentrations. Compliance was excellent, and no clinically relevant side effects or weight changes occurred. It appears that fenfluramine is effective in ameliorating specific symptoms in certain autistic patients. The extent and mechanism of its action remain to be discovered. PMID- 6502318 TI - Cloxacillin absorption and disposition in cystic fibrosis. AB - Because of reports of lowered antibiotic serum concentrations in patients with cystic fibrosis (CF), a bioavailability and pharmacokinetic study of cloxacillin was conducted in 12 control and 16 patients with CF after intravenously and orally administered doses of cloxacillin 25 mg/kg. The patients had mild to moderate CF and were in stable condition. Significantly lower serum concentrations in CF were a result of a 78% increase in total body clearance (P less than 0.005) and a 38% increase in the apparent volume of distribution (P less than 0.025). The bioavailability in CF (0.50) was not significantly different than in controls (0.38), but more variability was seen in the group with CF. After the intravenously given dose the fraction of cloxacillin excreted in the urine unchanged was similar in controls (0.644) and patients with CF (0.547). Compared with that in the control subjects, the mean renal clearance in patients with CF was 30% greater (P less than 0.10) and the nonrenal clearance was 144% greater (P less than 0.07). Enhanced nonrenal clearance explains most of the demonstrated difference between serum concentrations in controls and patients with CF after identical weight-adjusted doses. The data suggest enhanced cloxacillin biotransformation in CF. PMID- 6502319 TI - Encephalopathy in childhood secondary to aluminum toxicity. PMID- 6502320 TI - Accidental bromocriptine ingestion in childhood. PMID- 6502322 TI - Lateral decubitus position and pulmonary interstitial emphysema. PMID- 6502323 TI - WARNING: new umbilical catheter. PMID- 6502321 TI - Nasal septal perforation associated with topical corticosteroid therapy. PMID- 6502324 TI - Pancuronium administration and immediate hypoventilation. PMID- 6502325 TI - Kabuki makeup syndrome (Niikawa-Kuroki syndrome) in Europe. PMID- 6502326 TI - Apnea and bradycardia during feeding. PMID- 6502327 TI - Otitis and breast-feeding. PMID- 6502328 TI - Erratum: values for plasma glycerol, FFA, and triglycerides. PMID- 6502329 TI - Assessment of growth in short children. PMID- 6502330 TI - Brain calcification in stressed neonates. PMID- 6502331 TI - Hematuria and magnesium deficiency. PMID- 6502332 TI - DHPR deficiency in Italy. PMID- 6502333 TI - Risk factors for microwave scald injuries in infants. AB - An infant sustained second- and third-degree scald burns of the oropharynx from drinking formula heated in a microwave oven. The circumstances leading to the scald injuries were recreated. Factors contributing to the injury included the volume of formula, the initial temperature of the formula, and the temperature gradient between the liquid core and the bottle surface after microwave heating. These studies indicate that infant formula should be warmed only with extreme care in microwave ovens and should be tested for suitability of temperature prior to feeding. PMID- 6502334 TI - Button battery ingestion: assessment of therapeutic modalities and battery discharge state. AB - Button batteries immersed in a simulated gastric environment (0.1N hydrochloric acid) demonstrated less crimp dissolution (corrosion of the metal can) after the addition of neutralizing doses of eight of nine antacids tested. Of 64 ingestion episodes in dogs, clinical manifestations of button battery-induced injury were limited to a single animal developing guaiac-positive stools. Endoscopic lesions included only mild gastritis, occurring with a frequency comparable to that observed in dogs prior to battery ingestion. After ingestion blood mercury levels were not significantly elevated. Crimp dissolution was absent in discharged cells, implying a decreased risk of electrolyte leakage or subsequent tissue injury in patients who ingest spent cells. No protective effect of metoclopramide, cimetidine, or magnesium citrate could be demonstrated in the canine model. PMID- 6502336 TI - Intracranial hemorrhage and vitamin K deficiency in early infancy. AB - We report late-onset (1/2 to 6 months of age) intracranial hemorrhage related to vitamin K deficiency in 32 breast-fed infants, 31 of whom received no prophylactic vitamin K at birth. Computerized tomography showed mild to severe intracranial hemorrhage. Most (90.6%) had subarachnoid hemorrhage, either alone or in combination with subdural hemorrhage (37.5%), parenchymal hemorrhage (31.3%), or intraventricular hemorrhage (12.5%). In three (9.4%) the infratentorial region was involved. PMID- 6502335 TI - Iron deficiency in infants: the influence of mild antecedent infection. AB - In this study of 467 healthy term infants seen for routine 1-year health maintenance examination, we determined the influence of mild prior infection on the concentration of hemoglobin and other laboratory evidence of iron deficiency. In addition we studied the Hgb response in 261 infants randomized to receive a 3 month course of treatment with either iron or placebo. Infants who had had one or more clinic visits because of infection during the previous 3 months or who were reported as not being entirely well during the past month or who had an elevated sedimentation rate were more likely to have anemia or "low normal" Hgb, higher erythrocyte protoporphyrin and serum ferritin values, and lower serum iron concentration than infants who had been well. Hgb response greater than or equal to 1 gm/dl after iron treatment occurred more commonly in infants who had had prior visits because of infection. The results indicate that upper respiratory and other mild antecedent infections commonly predispose to iron deficiency (probably because of a decrease in iron absorption). PMID- 6502337 TI - Ventricular arrhythmias and mitral valve prolapse in childhood. AB - Although ventricular arrhythmias are well described in adults with mitral valve prolapse, this association remains controversial in children. To assess the incidence of ventricular premature complexes (VPCs), 103 consecutive children with mitral valve (MV) prolapse confirmed by echocardiography were evaluated prospectively by treadmill exercise and ambulatory ECG. A group of 50 normal children with clinical, ECG, or echocardiographic evidence of heart disease who had undergone treadmill exercise and ambulatory ECG served as controls. In the group with MV prolapse, 16 patients had VPCs with treadmill exercise and 39 had VPCs on ambulatory ECG. High-grade ventricular ectopy (multiform VPCs, couplets, or ventricular tachycardia) was recorded in four patients with MV prolapse during treadmill exercise and in eight during ambulatory ECG. In contrast, no control patient had a single VPC in response to treadmill exercise and only four control patients had rare uniform VPCs on ambulatory ECG. Neither physical examination findings, standard ECG results, nor symptoms could be correlated with VPCs in the patients with MV prolapse. Although the prognostic implications of these findings are uncertain, this study demonstrates that potentially serious ventricular arrhythmias are frequently observed in children with MV prolapse. PMID- 6502338 TI - Meningitis caused by multiply antibiotic-resistant viridans streptococci. AB - Two patients are described with meningitis caused by multiply antibiotic resistant strains of viridans streptococci; both isolates were resistant to penicillin (MIC greater than 3 micrograms/ml) (4.8 U/ml) and to several other antimicrobial agents. Our findings underscore the importance of doing in vitro sensitivity testing with clinical isolates of viridans streptococci to determine appropriate therapy for infected patients. Multiply antibiotic-resistant strains of viridans streptococci have also been recently isolated in the same populations in South Africa in which the prevalence of resistant Streptococcus pneumoniae is high. Therefore, isolation of resistant clinical strains of viridans streptococci may suggest the need for in vitro surveillance of emerging antibiotic resistance in both streptococcal species. PMID- 6502339 TI - IgG subclasses in nonallergic children with chronic chest symptoms. AB - Immunoglobulin and IgG subclass measurements were made on sera from 37 children thought to have asthma whose chronic chest symptoms were unexplained by allergy. There was a higher proportion of low or low-normal levels of IgG subclasses 1, 2, and 4 in these children than in normal children. Those who had low serum IgG values on initial measurement had a higher proportion of low or low-normal levels of IgG1, IgG2, and IgG4; those who had normal IgG values had a higher proportion of low or low-normal levels of IgG2 and IgG4. Thus a normal serum concentration of IgG did not exclude the possibility of an abnormal level of IgG2 or IgG4. Our experience suggests that abnormal levels of IgG subclasses might play an etiologic role in the chronic chest symptoms in some of these children. PMID- 6502340 TI - Evaluation of a serum IgA-class reticulin antibody test for the detection of childhood celiac disease. AB - Serum IgA class reticulin antibody (RA) was found in 28 (97%) of 29 children with flat small bowel mucosa, and in low titer in four (2%) of 245 with normal or near normal mucosa on small intestinal biopsy. Thus the sensitivity of the IgA-RA fluorescent antibody test for screening of celiac disease was 97% and the specificity 98%. IgA-RA was superior to IgG-RA for the detection of celiac disease. During follow-up of patients receiving a gluten-free diet, the IgA-RA rapidly decreased and in most cases disappeared within a year, suggesting that the test may be useful for clinical follow-up of celiac disease as well. PMID- 6502341 TI - Role of reovirus type 3 in persistent infantile cholestasis. AB - The relationship between reovirus type 3 and persistent infantile cholestasis was studied by measuring antibody to the virus in the sera of affected and control babies younger than 1 year of age. One hundred sixty-seven infants were divided into four groups: those with extrahepatic biliary atresia, idiopathic neonatal hepatitis, or other cholestatic disorders, and controls. When available, maternal sera obtained simultaneously with infant sera were also studied. The results indicate that 62% of babies with extrahepatic biliary atresia and 52% of infants with idiopathic neonatal hepatitis have reovirus 3 antibodies. In contrast, less than 12% of either normal infants or babies with other cholestatic disorders have antibodies. These observations suggest that perinatal infection with reovirus type 3 may serve as an initiating event in the genesis of two closely related forms of infantile obstructive cholangiopathy: extrahepatic biliary atresia and idiopathic neonatal hepatitis. PMID- 6502343 TI - Hypertension as the major problem of idiopathic arterial calcification of infancy. AB - We describe two infants with severe hypertension associated with idiopathic arterial calcification of infancy. In both children, blood pressure control was refractory to aggressive antihypertensive therapy. There was radiologic and laboratory evidence of renovascular disease requiring the use of specific renin antagonists and later nephrectomy, resulting in moderate improvement of hypertension. Although on occasion there is a familial incidence, in the vast majority of cases the diagnosis hinges on a high index of suspicion. PMID- 6502342 TI - Enzyme replacement therapy for infantile hypophosphatasia attempted by intravenous infusions of alkaline phosphatase-rich Paget plasma: results in three additional patients. AB - After biochemical and radiographic studies, enzyme replacement therapy in three patients with the infantile form of hypophosphatasia was attempted by weekly intravenous infusions of bone alkaline phosphatase-rich (BAP) plasma from patients with Paget bone disease. Subsequently, circulating BAP activity was substantially increased in each patient, and in one was maintained in the normal range for nearly 2 months. Despite partial or complete correction of the deficiency of circulating BAP activity, we observed no radiographic evidence for arrest of progressive osteopenia or improvement in rachitic defects in any of the patients. Failure of infants with hypophosphatasia to show significant healing of rickets on correction of circulating BAP activity supports the hypothesis that this isoenzyme functions in situ during normal skeletal mineralization. PMID- 6502344 TI - Oral electrolyte/glucose solutions: 1984. PMID- 6502345 TI - Severe vitamin K deficiency in breast-fed infants. PMID- 6502346 TI - Lymphoid interstitial pneumonia in juvenile rheumatoid arthritis. PMID- 6502347 TI - Lyme myocarditis diagnosed by gallium scan. PMID- 6502348 TI - Spontaneous dissecting aneurysm of the ductus arteriosus in an infant with Marfan syndrome. PMID- 6502349 TI - Intelligence and personality characteristics in adults with untreated atypical phenylketonuria and mild hyperphenylalaninemia. PMID- 6502350 TI - Early onset of essential fatty acid deficiency in patients with cystic fibrosis receiving a semisynthetic diet. PMID- 6502351 TI - Episodic weakness in pyruvate decarboxylase deficiency. PMID- 6502352 TI - Septo-optic dysplasia with digital anomalies. PMID- 6502353 TI - Neutropenia in high-risk neonates. AB - To determine the usefulness of neutrophil values in diagnosing neonatal sepsis among infants at risk of neutropenia, we evaluated the pattern of sequential absolute total and immature neutrophil counts and the immature to total neutrophil (I:T) proportion over the first 5 days of life in infants with sepsis (n = 13), asphyxia neonatorum (n = 12), or delivered of mothers with pregnancy induced hypertension (PIH) (n = 20), comparing values to references ranges previously reported by us. Neutropenia was initially present in 67% and 50% of infants with asphyxia and those whose mothers had PIH, respectively, and persisted through the first 3 postnatal days. In contrast, infants with sepsis were less likely to be neutropenic initially (38%), and neutropenia did not persist after 36 hours of age. Elevated values for the total immature neutrophil count and I:T proportion were much more likely to occur in infants with sepsis (46% and 61%, respectively) than in infants of mothers with PIH (4% and 12%) or those with asphyxia (13% and 22%). The importance of considering the perinatal history as well as the differential neutrophil count in the evaluation of neonatal neutropenia is demonstrated. PMID- 6502354 TI - Difficulty in achieving therapeutic serum concentrations of salicylate in Kawasaki disease. AB - We investigated 49 children (33 boys), mean (+/- SD) age 2.6 +/- 1.8 years (range 8 months to 8 years), who had Kawasaki disease treated with acetylsalicylic acid (ASA) 30 to 180 mg/kg. There was good correlation between salicylate doses and serum concentrations (r = 0.69, P less than 0.01); however, large variability existed. With doses less than 80 mg/kg/day there was not a single therapeutic salicylate serum concentration (greater than 20 mg/dl). In children receiving 100 to 110 mg/kg/day 55% of the serum concentrations were subtherapeutic. The same pattern persisted with doses greater than 120 mg/kg/day; however, 28% of levels were in the toxic range (greater than 30 mg/dl). There was no evidence of salicylate poisoning in the group; three children receiving greater than 100 mg/kg/day had aspirin-induced gastritis. An additional four children, studied prospectively, received ASA 80 to 180 mg/kg/day. The fraction absorbed was 14% to 60%, which may be compared to a normal 85% to 90% absorption. Salicylate renal clearance in these children (7.3 to 21 ml/kg/hr) was lower than in hyperthermic children. Their steady-state serum salicylate concentrations were subtherapeutic (7 to 11.5 mg/dl). The high ASA dose needed to overcome the impaired absorption should be accompanied by frequent monitoring of levels because of the unpredictable changes in absorption. PMID- 6502355 TI - Parelaphostrongylus andersoni (Nematoda: Protostrongylidae) and P. odocoilei in two cervid definitive hosts. AB - Infectivity (as percentage of initial dose), location, orientation, and productivity (as maximum weekly larval output) of adult Parelaphostrongylus andersoni Prestwood, 1972 and P. odocoilei (Hobmaier and Hobmaier, 1934) were compared in white-tailed deer (Odocoileus virginianus) (WTD) and mule deer (Odocoileus hemionus) (MD). Fourteen WTD and 10 MD were exposed to third-stage larvae of P. andersoni or P. odocoilei. Infectivity was 20% and 31%, respectively, in 7 WTD and 4 MD exposed to P. andersoni and 45% in 6 MD exposed to P. odocoilei. No nematodes were recovered from 7 WTD exposed to P. odocoilei. Nematodes were usually found in pairs, although the sex ratio was 3 females: 2 males in all deer. Most adults (greater than 90%) were located in connective tissue within skeletal muscles of the host. Distribution among muscles varied with total number recovered and, perhaps, time after exposure. Productivity was 1,834 larvae/gram and 2,630 larvae/gram, respectively, in 8 WTD and 3 MD exposed to P. andersoni and 0.9 larvae/gram and 15,103 larvae/gram, respectively, in 7 WTD and 5 MD exposed to P. odocoilei. The data were similar for P. andersoni infections in the 2 deer species but markedly different for P. odocoilei in these hosts. These results represent the first experimental demonstration of infection of mule deer with P. andersoni, and illustrate its potential occurrence in these hosts in wild populations. PMID- 6502356 TI - The effect of halofuginone, Wellcome 993 C, oxytetracycline, and diminazene diaceturate on Babesia equi-infected lymphoblastoid cell cultures. AB - The efficacy of halofuginone (DL-trans-7-bromo-6-chloro-3,3-(3-hydroxy-2 piperidyl) acetonyl-4-(3H) quinazolinone), Wellcome 993 C (2-hydroxy-3-cyclohexyl 1,4-naphthoquinone), and oxytetracycline, all of which have been shown to have a schizonticidal effect in the treatment of bovine theileriosis, and the babesicidal drug diminazene diaceturate, were tested against the schizont stages of Babesia equi in cell culture. The in vitro test system measured DNA synthesis in treated and untreated cell lines. Halofuginone (0.02 microgram/ml) and Wellcome 993 C (5 micrograms/ml) suppressed the incorporation of tritiated thymidine by more than 80%. Oxytetracycline was less effective, while diminazene diaceturate showed no notable effect. The insufficient schizonticidal activity may explain the failure of diminazene diaceturate to cure B. equi infections. Schizonticidal drugs either alone, or in combination with known babesicidal drugs, should be tested in the chemotherapy of B. equi infections. PMID- 6502358 TI - Trypanosoma brucei-induced blockage of expulsion of Echinostoma revolutum and of homologous E. revolutum resistance in mice. AB - Experiments were designed to study the effect of Trypanosoma brucei on the expulsion of Echinostoma revolutum and on the development and maintenance of homologous E. revolutum resistance in the mouse. T. brucei given 3, 2, and 1 wk before and 1 wk after infection with E. revolutum completely inhibited the expulsion of the E. revolutum worm burden for a period of at least 6 wk following infection, and T. brucei given 2 or 3 wk after infection with E. revolutum conferred a significant delay in the expulsion of the E. revolutum worm burden. T. brucei given 1 wk before and 1 wk after a primary E. revolutum infection blocked completely the resistance of the mouse to a homologous E. revolutum challenge given 2 wk after the primary infection. A similar blockage of resistance to a homologous challenge was experienced by mice given T. brucei 3 wk after the primary E. revolutum infection and challenged following another 2 wk. The mechanisms underlying the T. brucei-induced interference with the expulsion of E. revolutum and with the development and maintenance of homologous E. revolutum resistance in mice are presumably immunologically mediated. PMID- 6502357 TI - Gender-specific and pair-dependent glycoprotein antigens of Schistosoma mansoni. AB - Gender-specific and pair-dependent glycoprotein antigens of Schistosoma mansoni have been identified. Concanavalin A-binding glycoproteins of unisexually-and bisexually-reared male and female worms were labeled in vitro with 35S-methionine or 125iodine, and the two-dimensional maps of their polypeptides compared. The total protein compositions of male and female worms were very similar. In contrast, the patterns of glycoproteins immunoprecipitated by antisera from mice chronically infected with only male, only female, or both male and female worms were distinctive, indicating that the immune response elicited by the glycoproteins of male and female S. mansoni varied with the type of infection. Radioiodinated cercarial and egg proteins were also studied. Several polypeptides of cercariae and eggs, and 11 of 32 antigenic worm glycoproteins were recognized only by the antiserum from bisexually-infected mice, not by the antisera from unisexually-infected mice. These pair-dependent antigens may be relevant to the immune mechanisms involved in pathogenesis and resistance to reinfection. PMID- 6502359 TI - Leishmania tropica: quantitation of in vitro activity of antileishmanial agents by Giemsa staining, viability, and 3H-formycin B incorporation. PMID- 6502360 TI - Brugia lepori sp. n. (Filarioidea: Onchocercidae) from rabbits (Sylvilagus aquaticus, S. floridanus) in Louisiana. AB - Brugia lepori sp. n., a filarial nematode from the abdominal lymphatics and subcutaneous tissues of rabbits (Sylvilagus aquaticus, S. floridanus), from St. Tammany Parish, Louisiana, is described. Brugia lepori is of moderate size (males 12 to 19 mm, females 39 to 45 mm) and within the genus most closely resembles Brugia beaveri of the raccoon, from which it can be distinguished by its larger size, smaller spicules, and smaller microfilaria which has a shorter cephalic space. Brugia lepori is only the second species of Brugia described from North America and the third species reported from the Western Hemisphere. PMID- 6502362 TI - Cryopreservation of Schistosoma mansoni sporocysts. PMID- 6502361 TI - The role of prostaglandins in cercarial (Schistosoma mansoni) response to free fatty acids. AB - In examining the structure-activity relationship of a diverse group of chemicals reported to prevent cercarial penetration after topical application, we noticed a moiety that was common to free fatty acids and prostaglandins. Because unsaturated fatty acids have been reported to stimulate cercarial penetration, we hypothesized that cercarial stimulation by skin and fatty acids may invoke prostaglandin mechanisms in cercariae, skin, or both. Thus we compared the stimulation of cercariae by a series of essential and nonessential fatty acids and demonstrated an inhibition of this response by ibuprofen and aspirin, known cyclo-oxygenase inhibitors, and by 13-azaprostanoic acid, a potent antagonist of the thromboxane/endoperoxide receptor. These data led us to postulate a major role for prostaglandins in the cercarial penetration response. PMID- 6502363 TI - Immune rejection of Trichinella spiralis infective larvae in the guinea pig. PMID- 6502364 TI - Effects of nylon wool purification on infectivity and antigenicity of Eimeria falciformis sporozoites and merozoites. PMID- 6502365 TI - Diagnostic morphology of the third-stage larvae of three species of Parelaphostrongylus (Nematoda, Metastrongyloidea). PMID- 6502366 TI - Urinary bile acids: a noninvasive measure of liver function and bile acid metabolism? PMID- 6502367 TI - Site of temperature recording and bilirubin metabolism in the newborn. PMID- 6502368 TI - IgA antigliadin antibodies in celiac and inflammatory bowel disease. AB - Antibodies against gliadin of the IgA class were assessed with an enzyme-linked immunosorbent assay technique in children with celiac disease, healthy blood donors, and adult patients with active Crohn's disease or ulcerative colitis. Significantly higher antibody values were found in celiac children during gluten challenge and during the first 3 months on a gluten-free diet, compared with the findings in the healthy blood donors. The patients with active Crohn's disease had significantly higher levels of IgA antibodies to gliadin than the controls did. Although the highest values were found in patients with celiac disease on a gluten-containing diet, the difference between the means of these two groups was not statistically significant. No correlation was found between disease activity in ulcerative colitis and antibody values. The present results support the view that high levels of IgA-class antibodies against gliadin are indicative of small intestinal disease, especially celiac disease. The variability of the levels of antibodies found among the patients suggests that not only the amount of gluten in the diet but also other factors are important. PMID- 6502369 TI - Gastric motility in premature infants fed two different formulas. AB - The effect of two different formulas on gastric contractions was investigated in 10 preterm infants, of mean birth weight 1,149 g and mean gestational age 30.5 weeks, who were being advanced from a 20 calorie per ounce formula (Enfamil) to a 24 calorie per ounce formula (Similac Special Care 24). The neonates were fed by gravity with a feeding tube on a 2-h schedule. The orogastric tube was connected between feedings to a pressure transducer and recorder system upon which pressure waves reflecting gastric contractions were recorded. In the 1st h after feeding there were significantly fewer gastric contractions with 24 calorie than 20 calorie formula. The mean intensity of the gastric contractions per minute of contraction time was significantly less in the 1st h after feeding with the 24 calorie compared with the 20 calorie formula. In the 2nd h after feeding these values were similar. Gastric contractions are decreased with 24 calorie formula compared with 20 calorie formula during the 1st h after feeding. This difference in contractions may influence tolerance to different formulas. PMID- 6502370 TI - Timing of the gut closure. AB - This study was designed to establish whether the starting time of breast-feeding (BF) may have affected gut closure for macromolecules during the earliest postnatal period. An increase of serum IgA concentrations was taken as the index of gut permeability to macromolecules. In 14 neonates, BF started 1-6 h after birth and continued every 3 h during the next 38-48 h; in 19 neonates, it started 12-15 h after birth, continuing in the following 34-46 h; and in 20 neonates, BF started at the age of 24-29 h and continued during the next 18-36 h. Serum IgA concentrations were measured before and after the period of BF using the method of single radial immunodiffusion on commercial plates. In neonates in which BF started earlier, serum IgA concentrations fell significantly (p less than 0.001) until the 3rd day of life. This suggested an early gut closure, caused either by some colostral factor(s) or, perhaps, by some other mechanism which prevented further macromolecular absorption. In 11 of 20 neonates in which BF started after 24 h of life, even though in this group of babies, it was of the shortest duration, serum IgA concentrations increased significantly (p less than 0.001), suggesting that if BF is postponed, a spontaneous gut closure may not take place within the first 30 h of life. PMID- 6502371 TI - Urea utilization by the intestinal flora, of infants fed mother's milk and a formula diet, as measured with the 15N-tracer technique. AB - 15N-Incorporation by intestinal bacteria was measured under different feeding conditions in 16 infants after a single oral loading of 165 mg [15N2]urea X kg-1 body weight as a tracer. In five subjects on a mother's milk diet, the 15N-excess in the isolated intestinal bacteria was 1.08 (0.17-1.85) atom-%. The mean 15N excess in the intestinal flora of five formula-fed subjects did not differ significantly from these values [0.63 (0.17-1.05) atom-%]. A trend to a higher incorporation of 15N from labeled urea by the intestinal flora was seen in four infants, who were adapted to an increased nutritional urea supply on a special formula, containing 14 g of milk protein, 80 g lactose, 36 g fat, and 0.35 g urea X L-1. The same observation was made in two infants with chronic renal failure. The incorporation of urea nitrogen by the putrefactive intestinal flora of infants on a formula diet as well as by the bifidobacterial flora of those on mother's milk feeding indicates the utilization of ureas as a source of bacterial protein and nucleic acid synthesis. The adaptive usage of urea for the bacterial metabolism can be considered as a sign of supportive detoxification by the intestinal flora. PMID- 6502372 TI - Breast milk volume and composition during late lactation (7-20 months). AB - Breast milk composition of 119 samples collected by 46 women during months 7-20 of lactation was compared with composition of 101 samples collected at 4-6 months. Breast milk intake of 10 infants was determined by test-weighing for 1 or more months during months 7-16 of lactation. Longitudinal decreases in milk concentrations of zinc, copper, and potassium, previously documented for the first 6 months, continued into the second 6 months, while protein, iron, and sodium concentrations showed no further decline. Lactose, fat, calcium, and magnesium concentrations were similar to those in earlier stages of lactation. Weaning was associated with significant changes in milk composition: When milk volume fell below 300 ml/day, there was an increase in protein and sodium and a decrease in lactose, calcium, and zinc. Breast milk intake of infants not supplemented with cow's milk or formula averaged 875 ml/day (93% of total energy intake) at 7 months and 550 ml/day (50% of total energy intake) at 11-16 months. Total energy intake increased from 610 to 735 kcal/day, but energy intake per kilogram remained constant at a relatively low 70-79 kcal/kg/day. Our results suggest the need for further studies of nutrient intake and requirements of breast-fed infants during late lactation. PMID- 6502373 TI - Rectal or axillary temperature measurement: effect on plasma bilirubin and intestinal transit of meconium. AB - Physiologic jaundice (5-6 mg/100 ml plasma bilirubin) is common and considered normal in newborn infants during the first week postbirth, but is considered abnormal in older infants. Early meconium passage correlates with lower plasma bilirubin concentrations. Rectal stimulation during rectal temperature measurement may aid passage of meconium containing potentially toxic, absorbable bilirubin. In this study, 100 clinically normal infants were assigned randomly to groups for rectal or axillary temperature measurement. The time of first meconium passage, time of first all-yellow stool, and total plasma bilirubin were compared between groups. Bilirubin was measured during metabolic screening at 48-80 h postbirth (mean 69 h in both groups). By this time 30 infants in the rectal group, but only 17 in the axillary group, had passed yellow stools (p = 0.011). The rectal group had lower mean (+/- 1 SD) bilirubin (5.5 mg/100 ml +/- 2.7 vs. 6.5 +/- 3.0, p = 0.042), and a trend toward earlier first meconium (5.9 h +/- 5.0 vs. 7.3 +/- 5.9, p = 0.096). For clinically normal infants in the first 48-80 h postbirth, these data suggest that rectal stimulation accompanying rectal temperature measurement enhances intestinal bilirubin excretion because of more rapid meconium passage. PMID- 6502374 TI - The vitamin status of low birth weight infants and their mothers. AB - The levels of vitamins A, E, B1, B2, folate, and B12 were measured in maternal blood, cord blood, and in 5-day neonate capillary blood samples. Twenty-six infants and their mothers served as controls and were compared with 32 low birth weight (LBW) infants. LBW infants showed significantly lower levels of vitamins A, E, B2, and folate than the controls. The folate status of mothers of LBW infants was significantly lower (7 +/- 1.8 ng/ml) than that of control mothers (21 +/- 0.8 ng/ml). PMID- 6502375 TI - Growth and biochemical response of premature infants fed pooled preterm milk or special formula. AB - This study compared growth of a group of very low birth weight infants fed a formula specifically developed for such infants (Formula) with another group fed expressed breast milk (EBM). The Formula contained 2.4 g/dl of protein (lactalbumin:casein ratio, 60:40); 4.1 g/dl of fat (40% medium-chain triglycerides); 8.8 g/dl of carbohydrates; and 81 kcal/dl, with more calcium, phosphorus, and electrolytes than are in human milk. Premature babies with birth weights between 1,200 and 1,500 g and gestational age less than 36 weeks were eligible for the study and were fed either pooled EBM or Formula until they reached a weight of 1,800 g. Twenty infants fed EBM and 19 infants fed Formula completed the trial. Weight gain was faster in the Formula-fed infants after a caloric intake of 100 kcal/kg/day was achieved (Formula 27.7 g/day vs. EBM 17.2 g/day; p less than 0.001). Time to reach 1,800 g was 27 days for the Formula group and 39 days for those on EBM (p less than 0.001). Increments in head circumference and skinfold thickness were also greater in the Formula-fed group. Laboratory studies in the two groups of infants showed higher alkaline phosphatase levels, which were not due to vitamin D deficiency, in the EBM-fed infants. PMID- 6502376 TI - Total lipid content and fatty acid composition of preterm human milk. AB - The total lipid content and fatty acid composition of preterm human colostrum and milk were analyzed from aliquots of 24-h collections of colostrum, transitional milk, and mature milk obtained from 21 women who had delivered premature infants with a mean birth weight of 1,049 +/- 38 g (mean +/- SEM) and a mean gestational age of 29 +/- 0.4 weeks. The total lipid content increased significantly with time of lactation (p less than 0.001), from 1.99 +/- 0.25 g/dl in colostrum to 3.89 +/- 0.28 g/dl in mature milk. With respect to the fatty acid pattern, the percentages of 12:0 and 14:0 increased significantly (p less than 0.001), while those of 16:0 (p less than 0.05) and 18:1 (p less than 0.001) decreased significantly with time of lactation. The percentages of 10:0, 16:1, 18:0, 18:2, and 18:3 did not vary significantly with the duration of lactation. Similar compositional changes have been described in term human colostrum and milk as the duration of lactation progresses. PMID- 6502377 TI - Heart rate and sleep time: their relationship with growth and adiposity in male infants. AB - In a clinical trial based on the direct relationship between heart rate activity and energy expenditure during awake and asleep states, 21 healthy 18-month-old infants had their heart rate monitored over a period of 24 h and correlated with their nutritional intake, growth parameters, and measurements of adiposity (fat cell size and skinfold thickness). Infants with higher 24-h and asleep heart rates had smaller fat cells (r = -0.50) and skinfold thickness (abdominal r = 0.70, suprailiac r = -0.80, triceps r = -0.67). Infants with higher relative weight had higher heart rates during awake periods (r = 0.60). Infants sleeping for longer periods had higher weight gain velocity from birth (r = 0.51) and higher relative weight (r = 0.54). This study demonstrates the heart rate activity and duration of sleep are related to growth and adipose tissue deposition during infancy. PMID- 6502378 TI - Chronic propranolol treatment affects parietal cells of the developing rat gastric mucosa. AB - The nonselective beta-adrenoceptor antagonist propranolol (0.3 mg/kg body weight) was given to rats, twice daily, from the day of birth to 5 weeks of age. The animals were then killed, and sections from gastric mucosa were prepared for light and electron microscopy. Propranolol treatment significantly reduced the thickness of the mucosa as compared with that of the controls. The parietal cell volume density and the number of parietal cells were markedly decreased following propranolol. The volume density of lamina propria and of other epithelial cells in the gastric mucosa were not significantly different from the control group. The secretory canaliculi of the parietal cells seemed markedly increased, indicating enhanced secretory activity. These findings suggest an important role for the adrenergic-sympathetic system in the development of parietal cells in the maturing gastric mucosa. PMID- 6502379 TI - Gastric handling of medium-chain triglycerides and subsequent metabolism in the suckling rat. AB - We have previously shown that preduodenal lipases account for 50% of the lipolytic capacity of 14-day-old rats. The present investigation was designed to study the kinetics of and optimal conditions for absorption of fat in the stomach of suckling rats and its subsequent distribution in the body. After the simultaneous instillation of medium-chain triglycerides (MCT) containing 1.25 microCi 2,3-[3H]trioctanoate and of long-chain triglycerides containing 1.25 microCi 1-[14C]glycerol trioleate into the stomach ligated at the pylorus, we were able to show that gastric absorption of fat is limited to MCT. Two and a half minutes after injection, 88.6% of the radioactivity in the wall of the stomach was associated with free fatty acids, proving that lipolysis had preceded the absorption of the majority of the MCT. The remainder of the radioactivity was found in mono-, di-, and triglycerides as well as with cholesterol ester and phospholipids. In the plasma, peak radioactivity was attained within 2.5 min and a steady state ensued which lasted at least 30 min. Over this time period, specific radioactivity continued to rise in the liver, suggesting that hepatic uptake proceeded at the same rate as gastric absorption. Uptake could also be demonstrated in the three other organs tested, the lungs, the heart, and the kidneys. Absorption of MCT at pH 3 was only 20% of absorption at pH 6, which is the physiological pH in the suckling rat stomach within the first 10 min after a feed. Both at pH 3 and at pH 6, the addition of sodium taurocholate increased absorption of MCT over threefold. It is likely that the absorption of MCT by the stomach is a physiological event in the suckling rat. PMID- 6502380 TI - Effects of intrauterine malnutrition on brain free amino acids of young rats, after nutritional recovery during lactation period. AB - The effect of protein-calorie malnutrition during gestation on the brain amino acids of rat pups was studied following nutritional recovery during lactation. The brain amino acids of rat pups born to dam rats malnourished during gestation were studied after these rat pups received proper nutrition during lactation. Pregnant rats were fed a 1% protein diet with total caloric intake restricted to half that of controls. After birth, the offspring of rats fed on deficient diets were nurtured up to the 28th day postpartum by foster mothers receiving adequate diets. At this time, the offspring were killed. The control group consisted of offspring from pregnant rats fed a diet with adequate protein (21%) and calories during the entire gestation and lactation period. Quantitation of brain amino acids in the pups at 28 days postpartum showed lower concentrations of essential and nonessential amino acids in the rats malnourished during gestation. Concentrations of histidine, glycine, and alpha-aminobutyric acid were all reduced. These findings demonstrate that the brains of rat pups malnourished during gestation show persistent decreases in specific brain amino acids after adequate postpartum nutrition. PMID- 6502381 TI - Successful surgical resection of an hepatic gastrinoma in a child. AB - An 8-year-old boy with persistent duodenal ulceration was found to have hypergastrinaemia due to a solitary hepatic gastrinoma. Surgical resection has been followed by total clinical remission for a period exceeding 2 years. PMID- 6502382 TI - Splenic cyst presenting as a gastric mass. AB - A 14-year-old girl with bulimia was found to have an apparent submucosal mass of the gastric cardia by upper gastrointestinal series and endoscopy. At laparotomy the mass was found to be a 5 cm in diameter subcapsular serous splenic cyst compressing the stomach but not attached to it. The clinical and diagnostic features of this unusual lesion are reviewed, with particular emphasis on the endoscopic findings. PMID- 6502383 TI - Aeromonas hydrophila colitis in a child. AB - A 5-year-old girl presented with chronic bloody diarrhea. Evaluation including sigmoidoscopy, rectal biopsy, and barium enema was consistent with the diagnosis of ulcerative colitis. Culture of the stool grew Aeromonas hydrophila. A. hydrophila colitis may be more common than presently realized. PMID- 6502384 TI - Chronic diarrhea and failure to thrive in an infant with Campylobacter jejuni. AB - We report the case of an infant with chronic diarrhea and failure to thrive. Campylobacter jejuni was isolated from stools and treatment with erythromycin resulted in eradication of infection and prompt resolution of symptoms. A 22 month-old girl was referred to our University Hospital because of weight loss and chronic diarrhea, which did not respond to repeated dietetic trials that excluded milk, gluten, and other foodstuffs. Microscopic examination of the jejunal biopsy specimen revealed a mild degree of partial mucosal atrophy with inflammatory infiltrates in the lamina propria without any hallmarks of celiac disease. Repeated stool cultures on Butzler medium were positive for C. jejuni. This finding was associated with a high titer of specific serum antibodies. Erythromycin therapy without any other form of therapy led to prompt improvement, and the patient reached her "own" 50th centile as weight/height ratio. The aim of this report is to alert pediatric gastroenterologists of the possibility that Campylobacter may be associated with chronic diarrhea and failure to thrive. PMID- 6502385 TI - Are antigliadin antibodies specific for celiac disease? PMID- 6502386 TI - Cholesterol and other sterols in human milk. PMID- 6502387 TI - The pancreas in cystic fibrosis. An update on ontogeny and physiology, on alterations of function and structure, and on the treatment of pancreatic insufficiency and malnutrition. PMID- 6502388 TI - Pancreatic lipase, colipase, and cystic fibrosis. PMID- 6502389 TI - Intraduodenal events in cystic fibrosis. PMID- 6502390 TI - What do children with cystic fibrosis eat? PMID- 6502391 TI - A rational approach to meeting macro- and micronutrient needs in cystic fibrosis. PMID- 6502392 TI - The pancreas, nutrition, and cystic fibrosis: how do we ask the right questions? PMID- 6502393 TI - The role of biogenic amines in the regulation of exocrine gland function: a possible mechanism for the pathogenesis of cystic fibrosis. PMID- 6502394 TI - Pancreatic insufficiency in cystic fibrosis: result of defect in ontogenesis of the exocrine pancreas. PMID- 6502395 TI - Structural and developmental abnormalities of the exocrine pancreas in cystic fibrosis. AB - Normal infants from 32 to 54 weeks post-conceptional age show a clear pathway of development in the exocrine pancreas, involving differentiation of acinar tissue, reflected by increased acinar to connective tissue volumes. In contrast, an abnormal pattern of development has been found in cystic fibrosis. Early signs of a deficiency in exocrine tissue at 32-38 weeks post-conceptional age suggest that there is a lack of normal maturation of pancreatic exocrine tissue that occurs in utero, with a degenerative process supervening after birth. The volumes of the acinar and duct lumen is markedly increased, up to 10 fold normal volume in cystic fibrosis subjects. However, the lumenal changes are not a function of age. Accumulation of secretory material in the duct is a characteristic feature in cystic fibrosis and may cause dilation of the duct and acinar lumen and degradation of acini. Alternatively, the greater volume and lack of direct relationship to exocrine acinar volume may reflect a persistence of the fetal pattern of pancreatic development in cystic fibrosis. The diagnosis of cystic fibrosis within the first few months of life is difficult when based on conventional or subjective histologic criteria. By quantitative microscopy of the pancreas, an objective approach is available that clearly distinguishes cystic fibrosis from control subjects. In this retrospective survey, 93% of cystic fibrosis infants were discriminated from normals; only 2 of 30 cases (70%) were not clearly differentiated from controls. As a genetic disorder, the manifestation of cystic fibrosis would be expected to result in pancreatic dysfunction in utero. Other predisposing factors, however, may be involved in the pancreatic lesions such as obstruction of the pancreatic duct, failure in the synthesis or secretion of pancreatic enzymes or abnormal mucus production in the intestine. Further ultrastructural and functional investigations will be important to understand the underlying defect in cystic fibrosis. PMID- 6502396 TI - Immunoreactive trypsin in cystic fibrosis. AB - Since the first observation in 1979 that CF infants have elevated blood IRT, studies in various centres have enabled us to more fully understand the importance of this phenomenon. There is increasing evidence to show that mass newborn screening for CF using the IRT assay is practical and is capable of detecting essentially all CF newborns at a cost comparable to existing screening programs for other disorders such as Hypothyroidism. Although the elevated IRT levels seen in infancy in CF soon decrease, IRT levels in older CF patients appear to quite closely reflect the capability of that patient to secrete pancreatic enzymes and can be helpful in separating CF patients whose ability to secrete enzymes is preserved, from those with diminished exocrine pancreatic function. In all CF patients there appears to be an altered relationship between pancreatic exocrine secretion and circulating IRT levels as compared to control patients. This is probably one further manifestation of a secretory obstructive defect which although not uniformly severe, is common to all CF patients. PMID- 6502397 TI - Pancreatic function testing in cystic fibrosis. AB - None of the currently available clinical techniques for measuring pancreatic function in patients with CF can be considered "ideal". The "direct" pancreatic stimulation test provides the most information and remains the only truly accurate test of exocrine function, particularly in those individuals with pancreatic sufficiency. The invasive, complex nature of the pancreatic stimulation tests precludes its use as a routine method of assessing pancreatic function in all patients and limits its value for monitoring function in those individuals who are expected to deteriorate with time. Many of the indirect tests of pancreatic function are of value for identifying CF patients with complete pancreatic insufficiency who may require therapy with pancreatic enzyme supplements and fat soluble vitamins. However, none of the currently available "indirect" tests of exocrine function are sensitive enough to evaluate or monitor CF patients with pancreatic sufficiency. Blood tests, capable of measuring pancreatic enzymes in the circulation, such as immunoreactive trypsinogen, may be of value for monitoring pancreatic function in patients with CF, but further longitudinal studies are necessary to fully evaluate this approach. More sophisticated "indirect" tests of exocrine pancreatic function are vitally needed to facilitate adequate assessment of this important digestive organ in patients with cystic fibrosis. PMID- 6502398 TI - Improved prognosis in CF patients with normal fat absorption. AB - CF patients with normal fat absorption, as a group, have lower mean sweat chloride levels, maintain better pulmonary function and weight for their age, and appear to survive longer than CF patients with steatorrhea. The prognostic advantage for CF males in general is not seen in the pulmonary function data for patients with normal fat absorption, but may be reflected in the smaller number of females in this group. Males in both groups are clearly better at maintaining good weight than are females. Whether this means that nutritional intervention can improve pulmonary course or that other factors (genetic, endocrinological, environmental) dictate nutritional and pulmonary state, as well as sex differences, remains to be shown. Non-steatorrheic patients are far less likely than steatorrheic patients to have Pseudomonas infecting their lungs. This is a significant prognostic advantage since the progressive lung disease and eventual mortality of most CF patients can be charted by their acquisition of P. aeruginosa and the increasing frequency of exacerbation and attempts to eradicate this organism. CF has been called a lethal genetic disease because affected homozygotes did not generally survive to procreate. However, increasing numbers of young women with CF are surviving to an age where pregnancy and child-rearing are options for them. The majority of patients who reach this stage with sufficiently good health to embark on a pregnancy are patients with normal fat absorption. They also appear to be more likely to remain well throughout pregnancy and as young mothers. There is no doubt that CF patients with normal fat absorption have a better prognosis than those with typical CF malabsorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502399 TI - Social factors associated with adolescent obesity. PMID- 6502400 TI - The role of social support in parental adjustment to pediatric cancer. PMID- 6502401 TI - Preparation of well children in the classroom: an unexpected contrast between the academic lecture and filmed modeling methods. PMID- 6502403 TI - Differential outcomes associated with early medical complications in premature infants. PMID- 6502402 TI - Cognitive development in the failure-to-thrive infant: a three-year longitudinal study. PMID- 6502404 TI - Hypermetropia in accommodative esodeviation. AB - Contradicting earlier doctrine, several studies have indicated that hypermetropia in childhood increases over the first seven years of life, and decreases thereafter. No clear consensus exists as to these characteristics in patients with accommodative esodeviation. In 68 subjects (136 eyes), the mean annual change in hypermetropia up to the seventh birthday was an increase of +0.19 +/- 0.36 D. Subjects whose accommodative deviation deteriorated showed changes similar in magnitude. The corresponding mean annual change in a previously reported age-matched series unselected for strabismus was +0.28 D. Hypermetropia in accommodative esodeviation showed a mean annual decrease between ages 7 and 13 years of -0.18 +/- 0.25 D. The corresponding finding in the general childhood population was -0.22 D. While clinically important individual departures from these results do occur, an accelerated rate of increase in hypermetropia is not characteristic of most cases of either controlled or of deteriorated accommodative esodeviation. PMID- 6502405 TI - Coats' disease: a study of 62 histologically confirmed cases. AB - We studied 62 eyes submitted to the Armed Forces Institute of Pathology (AFIP) from 1958 through 1980 that satisfied our criteria for the histologic diagnosis of Coats' disease. Our histopathologic definition of Coats' disease was the presence of a primary vascular lesion consisting of retinal telangiectasia with leakage of plasma to form intraretinal and subretinal exudates. In the cases we reviewed, Coats' disease occurred more frequently in boys, it usually affected only one eye, and was generally detected in the first decade of life. In 52 cases (79%) the clinical manifestations, strabismus and leukokoria, were thought to be caused by retinoblastoma. Angle closure glaucoma was present in 36 cases (58%). In all but one of the cases studied, the lesion was located peripheral to the equator. We further identified diffuse involvement of capillaries in the peripheral retina using trypsin-digest preparations. Associated histologic findings included: rubeosis iridis, cataract, vitreous neovascularization, and nodules resulting from fibrous metaplasia of the retinal pigment epithelium. These fibrous nodules typically occurred in the macular area and occasionally contained calcium or bone. PMID- 6502406 TI - Ocular torsional movements in humans with normal and abnormal ocular motility- Part I: Objective measurements. AB - Using a corneal marker and cinematography, we analyzed ocular torsional movements during forced head tilt in three patients with superior oblique palsy before and after ipsilateral inferior oblique recession and compared them to those of normal subjects. As the head is tilted in normal subjects, the eye lags behind the head in a slow rolling movement. Periodic rapid wheel-like movements occur in the direction of head tilt which do not completely allow the eye to catch up with the head. This results in a partial compensatory intorsion on ipsilateral head tilt and extorsion on contralateral head tilt. In patients with superior oblique palsy, the rapid extorsional movement on ipsilateral head tilt is greater and faster than in the normal, but becomes slower after inferior oblique recession, indicating it comes from the overacting inferior oblique. The rapid intorsional movement seen during contralateral head tilt is absent in patients with superior oblique palsy, but appears in a diminished form after inferior oblique recession. PMID- 6502408 TI - The role of retinal cryopexy in the management of experimental perforation of the eye during strabismus surgery. AB - In order to investigate the role of retinal cryopexy in the management of accidental perforation of the globe during strabismus surgery, the retinas of 30 rabbit eyes were perforated with a needle simulating the clinical incident. Ten of these eyes received no further treatment, ten eyes were treated with moderate transscleral cryopexy of the surrounding retina, and the remaining ten eyes were treated with excessively heavy cryocoagulation. The incidence of secondary retinal detachment was identical in the first two groups of rabbits, while it was markedly increased in those rabbits treated with excessively heavy transscleral cryopexy (P less than .01). Based on these findings and a review of the literature, recommendations are made for the management of accidental perforation of the globe during strabismus surgery. PMID- 6502407 TI - Anterior segment ischemia following strabismus surgery. AB - Anterior segment ischemia (ASI) is a potentially blinding complication of extensive eye muscle surgery. Eyes have been described with this complication following surgery on as few as two rectus muscles, especially in patients with thyroid dysfunction or other medical illnesses. In an attempt to assess the risk of ASI, we have reviewed the records of 34 eyes in 26 patients who underwent surgery on three or four rectus muscles. Seven eyes of six patients with thyroid ophthalmopathy which underwent two-or three-muscle surgery were also studied. Evidence of clinically significant ASI was apparent in only one patient during a follow-up period of seven months to eleven years. This case was mild and no visual loss resulted. Our findings suggest that surgery on three or four rectus muscles in healthy patients is probably safe when performed in a staged fashion. PMID- 6502410 TI - Botulinum injections for strabismus. PMID- 6502409 TI - Botulinum injections for strabismus. PMID- 6502411 TI - Role of the neural crest in anterior segment development and disease. AB - Certain eye and associated systemic developmental anomalies are apparently related by virture of a common neural crest origin. The development of the anterior segment is extremely complex and is dependent upon the presence or absence of certain local factors (including extracellular matrices and glycoproteins), inductors, receptors, and specific time sequencing. Understanding anterior segment anomalies and their systemic associations requires an understanding of neural crest proliferation and migration patterns; and they may be unified under the designation of neurocristopathies. Goldenhar's syndrome, not previously considered a neurocristopathy, may be considered one on the basis of the relationship between clinical findings and neural crest embryology. PMID- 6502412 TI - Binocular diplopia associated with retinal wrinkling. AB - Four patients with retinal wrinkling and epiretinal membrane formation presented with a unique clinical syndrome consisting of comitant, small angle hyperdeviations with intractable vertical diplopia, and unstable single vision with a failure to respond to conventional prism therapy. The pathophysiology underlying this presentation appears to be the establishment of a rivalry between central and peripheral fusional mechanisms due to mechanical macular distortion. PMID- 6502413 TI - Clinical evaluation of the Nidek AR auto refractor. PMID- 6502414 TI - The clinical usefulness of the visual evoked response. PMID- 6502415 TI - The clinical usefulness of the visual evoked response. PMID- 6502416 TI - Total colon aganglionosis--a new operation. AB - The colon-conserving concepts described by Martin in total colonic aganglionosis all presuppose that the distal end of the bowel is secured at the anus by the method of Duhamel. Many surgeons prefer a modification of the endorectal operation popularized by Soave when treating shorter segment Hirschsprung's disease. By combining the principles of the two methods we have evolved a technique in which the colon is anastomosed to the ileum using the GIA stapler. However, the anastomosis is commenced about 10 cm proximal to the distal cut end of the ileum, having first pulled the distal 10 cm through the muscular cuff of the rectum in the manner described by Soave. A temporary ileostomy is made. This method has been used clinically in two cases with gratifying results. By the use of this new technique the increase in absorptive area is achieved. At the same time the advantages of the endorectal pull-through operations are not compromised by any rectorectal dissection. PMID- 6502417 TI - The clinical relevance of certain observations on the histology of the thyroglossal tract. AB - A study of all patients operated on with a clinical diagnosis of midline neck cyst at the Children's Hospital of Eastern Ontario confirms our impression that certain important facts regarding the microanatomy of thyroglossal duct cyst and its associated tract are the subject of a number of misconceptions entrenched both in surgeon's minds and in some standard reference texts. Our own observations and a review of the literature dating back to Sistrunk's own original contribution in 1920 lead us to emphasize the following: (1) thyroglossal duct cysts seldom have an intact lining; (2) the thyroglossal duct is frequently multiple and arborizes; (3) its course is always anterior to the hyoid bone; (4) it is seldom discernible to the naked eye and it is futile to attempt to dissect it out at operation. By the same token, a full Sistrunk procedure must be done even if the tract is not seen; and (5) deep cervical dermoid cysts may mimic thyroglossal duct cyst when firmly fixed to the hyoid bone, but the presence of sebaceous material in the cyst will identify it as a dermoid because thyroglossal duct cysts do not undergo keratinizing squamous metaplasia. PMID- 6502418 TI - Hydrometrocolpos in neonate due to distal vaginal atresia. AB - Hydrocolpos is the result of vaginal obstruction and can become an emergency in the newborn period. The treatment of imperforate hymen is well defined, but the treatment of vaginal atresia is more complex. We encountered two cases of hydrocolpos secondary to distal vaginal atresia, that were operated on in the first days of life. One baby had distal atresia without persistance of urogenital sinus. Surgery combining abdominal perineal approaches and a posterior vaginoplasty was carried out. The second baby had hydrocolpos with persistance of urogenital sinus. Drainage through the sinus was unsuccessful because the baby developed sepsis by trapping urine in the uterus. Finally an abdominoperineal vaginal pull-through was successfully done. The embryology and literature are reviewed. The classification, indications and surgical technique are discussed. PMID- 6502419 TI - Blunt hepatic trauma in children: experience with operative and nonoperative management. AB - Between 1974 and 1982, 32 children were treated for blunt hepatic trauma. Twenty three injuries were secondary to motor vehicle accidents. Twenty-three patients had associated injuries. The hepatic injury was treated surgically in 18 patients. Urgent surgery for massive bleeding was required in 7 patients; 8 underwent laparotomy for continued bleeding after initial stabilization; 2 underwent laparotomy for marked abdominal tenderness, and 1 for an expanding hepatic hematoma. Various excisional, debridement, suture, and drainage procedures were employed. Seven patients died, 5 from uncontrollable bleeding and 2 from associated severe head injury. The eleven survivors did well. The only postoperative complications were two wound infections. Fourteen patients were managed nonoperatively. Liver scan provided the diagnosis in all. Five of these patients required blood transfusion, and the mean volume of transfusion was 33cc/kg. The hospital courses in all cases were uneventful, and there were no late complications. A follow-up liver scan was obtained in 11 patients, showing resolution of the injury in all. We conclude that laparotomy is necessary for hepatic injury when it is associated with continuous massive bleeding. Hemodynamically stable patients can be managed nonoperatively, even when the blood-transfusion requirements are significant. PMID- 6502420 TI - Cystic duplications of the esophagus and neurenteric cysts. AB - This paper reviews the past 25 years of experience with these lesions at The Hospital for Sick Children, Toronto, during which 19 infants and children were treated. There were 8 females and 11 males. Nine of these patients were under 1 year of age at presentation, 5 were between the ages of 1 and 10 years, 5 were older than 10 years. Eleven presented with symptoms referrable to the chest, and six with predominantly neurological symptoms. Two asymptomatic children were referred because of chest masses found incidentally on chest x-rays. Fifteen chest masses were noted; the other four had neurological symptoms only. Fourteen of these 19 lesions had associated vertebral anomalies. Nine patients underwent myelograms and 8 abnormalities were demonstrated, 2 of which were neurologically asymptomatic. Four patients had both myelographic abnormalities and mediastinal masses. Two out of three technetium scans were positive. Fourteen thoracotomies and six laminectomies were carried out. Nine of the 15 chest masses contained gastric mucosa including 2 which had perforated. None of the intraspinal masses contained gastric mucosa. The long-term survival was 95%. In this series, intraspinal anomalies co-existed with mediastinal masses in almost 25% of patients and were often initially asymptomatic. It is recommended that myelography be carried out in all patients with cystic duplications of the esophagus who have vertebral anomalies. Technetium scans may be useful if the diagnosis is obscure. PMID- 6502421 TI - The diagnosis of foreign body aspiration in childhood. AB - A 10-year experience with the treatment of 157 children for foreign body aspiration is reviewed. The object of the review is to examine diagnostic accuracy and to differentiate between the clinical features of patients diagnosed early (within 24 hours) and late (beyond 24 hours) following the onset of symptoms. Diagnostic accuracy was found to be high. In 83.5% of patients the combination of clinical and radiologic signs correctly disclosed the site of foreign bodies within the tracheobronchial tree. In 80% of patients there was a history of witnessed choking, however, only 46% were diagnosed early. The diagnostic triad of wheezing, coughing, and decreased breath sounds was more common in late diagnoses (47%) than in early diagnoses (31%). The triad was incomplete in 61% of all patients. Radiologic findings were normal in one third of the patients diagnosed early and revealed atelectasis or consolidation in one half of those diagnosed late. With early diagnosis endobronchial inflammation was absent in 56% of patients compared with severe inflammation in 36% of late diagnoses. Right-side foreign bodies were more common (56%) and were diagnosed early 50% of the time compared with left-side foreign bodies which were diagnosed early only 35% of the time. Two thirds of tracheal and bilateral foreign bodies were diagnosed early compared with only one third of peripheral foreign bodies. This review indicates that most children with foreign body aspiration were diagnosed accurately. Although diagnoses can be made early; more than half of the patients were diagnosed late when there was evidence of significant airway obstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502422 TI - Urokinase in the treatment of occluded central venous catheters in children. AB - Urokinase was used to clear occluded silastic central venous catheters in 14 pediatric patients. The catheters, which had been placed into a neck vein and tunnelled out through the skin of the anterior chest wall, were being used for either long-term parenteral nutrition or chemotherapy. Occluded catheters that could not be cleared by simple flushing with heparinized saline were filled with a solution of urokinase, which was left in place for 2 hours before the catheter was flushed a second time. Twenty-one occluded catheters were managed in this way over a period of 14 months. There were no allergic reactions or bleeding complications. Twelve of the 21 occluded catheters were immediately cleared. Three catheters ruptured during attempted flushing maneuvers but were patent after repair. Two catheters remained partially occluded. Only four catheters were removed because of persistent occlusion. When simpler techniques fail, urokinase instillation appears a safe and effective alternative to the more common practice of removing occluded central venous catheters in children. PMID- 6502423 TI - Segmental dilation of the colon: a rare cause of chronic constipation. AB - Segmental dilation of the colon is a rare entity. It should be considered in any young patient with chronic constipation. The clinical picture and radiographic examination are indistinguishable from Hirschsprung's disease and the rectal biopsy is of paramount importance. This disease can be cured by resection of the dilated segment. PMID- 6502424 TI - Colectomy and endorectal ileal pull-through with lateral ileal reservoir for ulcerative colitis and polyposis in children. AB - Nineteen children with chronic ulcerative colitis refractory to medical therapy and one with multiple polyposis, all under 20 years of age, underwent total colectomy, mucosal proctectomy, and endorectal ileal pull-through with ileoanal anastomosis at the UCLA Medical Center during a 4 1/2-year period (mean age, 14.4 years). Seventeen patients underwent second-stage closure of the ileostomy with construction of a side-to-side isoperistaltic ileal reservoir (mean, 6 months) after the ileal pull-through operation. The anastomosis extended over a 20- to 30 cm distance and the lower end was placed within 6 to 8 cm of the ileoanal anastomosis. Transient reservoir inflammation, which occurred in more than half of the patients, was reduced by the use of oral Metranidazole and was rare 6 months postoperation. Cuff abscess in one patient did not respond to long-term antibiotics and required ileostomy as well as eventual takedown of the reservoir. Two patients developed obstruction of the ileum below the reservoir due to an extended distance between the reservoir and anal anastomosis, requiring transient ileostomy. Fourteen of the 17 children who have undergone lateral reservoir construction have achieved a good-to-excellent result, with complete continence and an average of five stools per 24 hours after 6 months. Seven of the 14 now participate in competitive athletics. Three children await construction of the reservoir. PMID- 6502425 TI - The lessons of 40 bladder extrophies in 20 years. AB - A personal series of 42 consecutive unselected bladder extrophies over a 20-year period is critically analyzed. The incidence is calculated as 1 in 25,000 live births. Four died unoperated of multiple anomalies and two died following surgery. Of the remaining 36, cosmetic closure was possible in 34. Most closures were done at about 1 year, though 1 month of age is now preferred. Iliac osteotomy has been abandoned. Further staged surgery using Young-Dees bladderneck reconstruction and ureteric reimplant high in the bladder has been used in 11 selected cases. It has been effective in five but there have been three bilateral ureteric obstructions in small bladders. Twelve patients are under 5 years of age and considered too young for definitive evaluation. Of 22 patients available for close analysis, three and possibly four will be acceptably dry. Twelve have had colon or ileal loop diversion and a further two are awaiting diversion. Three are wet. On our experience we hope to successfully reconstruct about one in five unselected extrophies. For the remainder, ureteric transplant into an isolated colon loop offers the most options for the future. The selection of cases and criteria of continence in young children are important considerations in assessing results. PMID- 6502426 TI - Surgical problems in patients with VATER-associated anomalies. AB - From 1960 through 1980, 14 patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) with two or more other associated anomalies of VATER have been seen. Seventy percent of patients were preterm or low in birth weight. In addition to the esophageal abnormality, vertebral anomalies were found in 7 patients, anorectal anomalies in 11, limb anomalies in 9 and renal anomalies in 9 patients. Three patients had associated duodenal atresia and 4 had cardiac anomaly. Eight patients are dead, 5 are living, and 1 is lost to follow-up. Six of the eight deaths occurred during 1960 to 1970. Preliminary gastrostomy was done in all patients. Primary esophageal repair was carried out in 9 patients--5 died and 4 survived. Three patients had delayed esophageal repair and two of these patients survived. Cervical esophagostomy was done in one patient with EA without TEF after unsuccessful repeated bouginage for elongation of the upper esophageal pouch. Three of the survivors showed growth retardation--below 5th percentile. Aggressive nutritional support and management of chronic problems related to the anomalies are important. PMID- 6502427 TI - Thyroglossal-duct lesions in childhood. AB - A retrospective review of 300 cases of thyroglossal duct lesions is presented, with emphasis on reasons for misdiagnosis and recurrence. Of 28 cases misdiagnosed, 20 presented in atypical sites. The recurrence rate after Sistrunk's operation was 5% but no special features could be identified to explain these recurrences. While previous surgery does reduce the chance of success, inflammation does not seem to affect the recurrence rate. PMID- 6502428 TI - Morphologic findings of chest deformities in children corresponding to the Willital-Hummer classification. AB - The clinical classification of funnel and pigeon chest deformities can be subclassified by means of special measurements of the chest. This simple technique makes it possible to differentiate sternocranial, sternocaudal, infrasternal, symmetrical, and asymmetrical marginal and peripheral deformities. This further classification also includes deformities of the vertebral column and deviatory development. The exact analysis of the abnormal chest in three different planes can be performed by means of external chest-wall measurements. PMID- 6502429 TI - Left ventricular hypoplasia in congenital diaphragmatic hernia. AB - Quantitative anatomic study of the hearts of eight infants with left-sided congenital diaphragmatic hernia (CDH) has revealed significantly decreased cardiac mass, due to hypoplasia of the left atrium and ventricle and interventricular septum. These morphologic deficiencies may be a result of compression of mediastinal structures by herniated abdominal viscera during prenatal life. Left ventricular hypoplasia is likely to be an important factor in the pathogenesis of cardiac insufficiency in patients with left CDH. PMID- 6502430 TI - The use of a lateral skin-flap perineoplasty in congenital anorectal malformations. AB - A lateral skin-flap perineoplasty has been used in 15 patients born with an absent anal canal. The aim behind the introduction of this modification was the prevention of mucosal prolapse. On early assessment, this has been achieved in 11 of the cases. This represents a 50% improvement on our previous results. PMID- 6502431 TI - Acute scrotal swelling in children. AB - We have found that the blanket philosophy of emergency scrotal exploration in all cases of acute scrotal swelling in boys results in an unacceptably large number of unnecessary explorations. The use of specific aspects of the clinical examination, in conjunction with the radioisotope testicular scan in selected instances, has guided our management of 150 consecutive boys presenting with acute scrotal symptoms. PMID- 6502433 TI - Fatal hepatoadrenal necrosis in the neonate associated with echovirus types 11 and 12 presenting as a surgical emergency. AB - Two neonates presented to our service with suspected intraabdominal surgical emergencies. Both subsequently were found to have hepatoadrenal necrosis due to overwhelming echoviral infection. Echovirus types 11 and 12 were isolated postmortem. The latter virus has not been associated previously with fulminant neonatal illness. PMID- 6502432 TI - The early evaluation of survivors after extracorporeal membrane oxygenation for neonatal pulmonary failure. AB - Excluding mortality data, there is little information regarding patients' development after extra corporeal membrane oxygenation (ECMO). In six of nine neonates surviving ECMO for predictably fatal pulmonary failure, examination 15 to 21 months afterward showed (1) physical growth and development, normal in six; (2) chest x-ray, normal pulmonary parenchyma; (3) average arterial blood gases, PO2 80, Pco2 35, pH 7.35; (4) echocardiogram, normal, without evidence of pulmonary hypertension; (5) cerebrovascular dopplers, normal ophthalmic artery flow in five patients, retrograde in one; (6) CT scan, EEG, neurologic survey, normal in five, cerebral atrophy in one patient who had an air embolus during decannulation; (7) psychologic examination, normal in all. This early evaluation of ECMO survivors should encourage its further application in those newborns who would otherwise die. PMID- 6502434 TI - Mallory-Weiss syndrome in a 10-month-old infant requiring surgery. AB - Mallory-Weiss syndrome is infrequent in children. Intractable hemorrhage requiring surgery has been reported in only one 6-year-old child in the English literature. We present a case of intractable hemorrhage from a Mallory-Weiss lesion in a 10-month-old infant requiring surgery. The incidence, etiology, diagnosis, and treatment of Mallory-Weiss syndrome in children is discussed in relation to this case. PMID- 6502435 TI - Splenic hemorrhage in a neonate of a mother on anticonvulsant therapy. AB - A 24-hour-old male infant was referred to the Eastern Maine Medical Center (EMMC) because of pallor, lethargy, and abdominal distention. Diagnostic abdominal paracentesis revealed free blood. At surgery hemisplenectomy removed the damaged part of the spleen followed by complete recovery of the infant. A liver-spleen scan, performed before discharge, revealed normal uptake in the remaining portion of the spleen. PMID- 6502436 TI - String placement and progressive dilatations in the management of high membranous rectal atresia. AB - A newborn with rectal atresia underwent a sigmoid colostomy followed by fluoroscopic placement of a string across the membrane. Progressive dilatations were done until normalization of the rectal canal occurred at 4 months. At 6 months, the colostomy was closed. Although moderate sigmoid dilatation persisted initially, the boy is now developing well and has a normal stooling pattern 3 years following the last procedure. The technique demonstrates the feasibility of high rectal-membrane management without excision. PMID- 6502437 TI - Uterine contractions during pregnancy. AB - The principal function of muscular tissue is contraction. This is also true for the uterus this function begins with sexual maturation. During pregnancy special conditions are brought about by the increasing distention of the uterine cavity. For clinical practice, external tocography is of importance for the recognition of uterine motility Data in the literature on the normal frequency of contractions during pregnancy vary greatly and caused us to study this topic. Moreover, most cases of prematurity independent of other causes suppose a prematurely increased uterine motility. In order to register this activity a portable recording apparatus was developed. We studied in particular the question for how long and how often uterine contractions should be recorded. A one hour daily recording was found to be sufficient. In order to gain information on the average number of contractions it suffices to record during one week. In 26 healthy primiparous and 28 multiparous women the number of contractions from the 25th to 41st gestation week was recorded. A notable finding was the frequency peak about the 32nd week. The number of pregnancy contractions as a sole parameter for the recognition of impending premature delivery is not sufficient. However, the information may be important when taking in conjunction with the previous history and the state of the cervix. We considered tocolysis indicated when as a weekly average there are more than two contractions per hour with beginning cervical dilation or more than three contractions per hour regardless of cervical findings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502438 TI - Heart rate variability and electrocardiogram changes in the fetal lamb during hypoxia and beta-adrenoceptor stimulation. AB - Hypoxic changes in the ST waveform of the fetal electrocardiogram (FECG), with elevated T waves as the main response, have earlier been described in the fetal lamb as mediated via the beta-adrenoceptor cells, initiated by catecholamine release. A similar background to the increase in fetal heart rate variability (FHRV) during hypoxemia has been suggested. The aim of the present study was to elucidate this question and also to compare FHRV and changes in the ST waveform of the FECG as indicators of fetal distress. Twenty-six acutely exteriorized mature lamb fetuses were submitted to periods of graded hypoxemia. Fetal blood gases were measured and oxygen content was calculated. The FHRV was analyzed by a computer program and calculated as the differential index (DI) and the interval index (II). Eighty seconds of the recorded ECG coinciding in time with each fetal blood sample were analyzed using a PDP 11/40 minicomputer. The ECG signal was sampled at a rate of 1250 samples per second giving a resolution in time of 0.8 msec. Each QRS complex was detected with a semi-automatic program using a cross correlation algorithm. QRS complexes that by the program were signalled to be doubtful were visually examined and either rejected or approved. Hence, the resulting list of R-R intervals was practically free from artefacts. From this list of R-R intervals the DI and II were computed according to YEH et al. [30]. Hypoxemia resulted in initially strongly increased DI from 3.1 +/- 2.5 to 17.7 +/ 13.8 (p less than 0.001) and in II from 1.88 +/- 0.65 to 3.77 +/- 2.06 (p less than 0.001) (Fig. 1). Obviously the change in oxygen content per se was strongly associated with the variability indices, as we found a strong correlation between delta oxygen content/min and delta DI/min (r = 0.81). In five fetuses the effect of prolonged hypoxemia on DI was studied (Fig. 2). After the initial rise from 1.6 +/- 1.1 to 31.2 /+- 9.0 (p less than 0.02) DI decreased to 19.4 +/- 20.7. A regression analysis showed a strong connection between DI and PaO2, (n = 93, T = 5.34), whether there was no relation between DI and pH (T = - 1.85). There is strong evidence that hypoxemia and asphyxia induce an increase in the concentration of catecholamines in fetal blood [2, 23].(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6502439 TI - Glycosylated hemoglobin (HbA1) and hemoglobinopathies in pregnancy. AB - Glycosylated hemoglobin (HbA1) is considered to be representative of prior blood glucose levels and is being used in pregnant and nonpregnant diabetic patients as a possible index of both long and short-term glucose-control. Factors other than blood-glucose concentration have been reported to affect its value. Variant hemoglobin is one of them. HbA1 and blood-glucose levels were measured in pregnant patients at high risk for diabetes for screening for abnormal carbohydrate metabolism. HbA1 was measured by cation exchange column chromatography and glucose was measured by hexokinase reaction. The mean HbA1 in patients with normal blood sugars was 6.17 +/- 0.6 percent. A value of HbA1 of less than 5 percent as measured by cation exchange column chromatography was highly predictive (P less than 0.001) of hemoglobinopathies (S or C). The mean HbA1 of randomly selected matched patients with "normal" Hb was 5.94 +/- 0.72 percent. In patients with thalassemia, HbA1 values as measured by cation exchange column chromatography were elevated despite normal carbohydrate tolerance. While interpreting the results of HbA1 in the management of pregnant diabetics, the above fact should be kept in mind. PMID- 6502440 TI - Glycosylated hemoglobin (HbA1), glucose tolerance and neonatal outcome in gestational diabetic and non-diabetic mothers. AB - Glycosylated hemoglobin (HbA1) was determined in three subject groups: 69 non diabetic mothers who were delivered of normal weight infants at term (Group I), 33 non-diabetic mothers who were delivered of macrosomic infants (greater than 4000 g) at term (Group II), 51 gestational diabetics in the 3rd trimester--before onset of the diabetes therapy (Group III). In all three groups diagnostic assessment of glucose regulation was done by means of the oral glucose tolerance test during the 3rd trimester. Glycosylated hemoglobin was assayed by cation exchange chromatography in small disposable columns. The mean values and standard deviations of HbA1 were 6.51 +/- 0.46% in Group I, 6.59 +/- 0.42% in Group II and 7.11 +/- 0.56% in Group III. Between the HbA1 values of Group III (gestational diabetes) on the one hand and those of the non-diabetic groups I and II on the other, there were highly significant differences (p less than 0.001; x2-test). HbA1 values above 7.4%--i.e. above mean + 2 s. d. of HbA1 in the non-diabetic mothers--were with 95% probability abnormal and indicative of gestational diabetes. HbA1 values between 7.0% and 7.4% were suspected of impaired glucose tolerance and gestational diabetes respectively. Between the HbA1 levels in the non-diabetic groups and those in the gestational diabetic group there was a vast zone with overlapping values. HbA1 data situated in this transitional area could be found both in non-diabetic subjects and also in those with abnormal glucose regulation. HbA1 values below 6.0% excluded gestational diabetes or otherwise impaired glucose tolerance with a high degree of probability. PMID- 6502441 TI - Severe neonatal anemia possibly caused by spontaneous cephalic version, with excellent outcome--a case report. AB - A 29-year-old primipara with breech presentation had a spontaneous cephalic version a few days before her admission. She was hospitalised because of a sudden decrease in fetal movements perceived. During labour a sinusoidal fetal heart rate pattern was observed. The mother gave birth to a strikingly pale 3250 g weighing boy. His APGAR score was 1/5/6. Cord hemoglobin was 2.9 g/dl and an acid elution test showed the presence of 9.1% fetal red cells in the maternal circulation. Following a transfusion of packed cells and total blood, the babies hemoglobin rose to above 10 g/dl. On the second day of life he developed an acute functional renal failure which responded well to fluid restriction and furosemide administration. Upon discharge, 10 days after birth, the physical and neurological examination were normal. At present time the child is two years old and thriving well. Anemia in the newborn due to occult blood loss may be the result of bleeding of the fetus into the maternal circulation. The incidence of a massive transplacental blood loss is increased by traumatic amniocentesis, by external cephalic version and during cesarian section. As illustrated by the present case, spontaneous cephalic version may possibly account for another cause of feto-maternal transfusion resulting in severe neonatal anemia. Severe anemia at birth secondary to an acute and massive feto-maternal hemorrhage is commonly associated with a poor prognosis. Under such conditions immediate re-expansion of the blood volume proved to be life saving. PMID- 6502443 TI - On the renaissance of personality assessment and personality theory. AB - Both personality assessment and personality theory have experienced a significant decline in the past two or three decades, giving way to alternate professional interests by some, and being attacked as both empirically unsupportable and devoid of conceptual merit by others. Several tangible signs suggest that a resurrection is underway owing to position reversals by former critics, the changing character of patient populations, refinements in personality-oriented psychometric techniques, the refurbishing of analytic, interpersonal, and learning theories of personality, and the central role assigned personality disorders in the multiaxial format of the DSM-III. Looking toward the future, the paper proposes a series of comprehensive and parallel diagnostic criteria for the personality disorders to be included in either DSM-IIIR or DSM-IV. PMID- 6502442 TI - Treatment of intrauterine supraventricular tachycardia with digoxin and verapamil. AB - Intrauterine fetal supraventricular tachycardia (ISVT) is a rare condition which is connected with organic heart disease in only 4-10 per cent. However, neonatally these children develop heart failure in a high frequency (62 per cent). Intrauterine digitalization has been suggested as treatment, especially if the fetus is preterm. Fetal therapeutic concentrations might demand doses inconvenient to the mother. We hereby report one case of intrauterine SVT in the 26th gestational week treated with a standard dose of digoxin resulting in subtherapeutic umbilical digoxin levels. When no consistent influence on fetal heart rate could be seen, verapamil (80 mg x 3) was added to the treatment. A reversion of the tachycardia and the fetal ECG changes was achieved within two days. The verapamil treatment could be withdrawn after ten days, while the digoxin treatment was continued. An initial discrete heart enlargement also was reversed by the treatment. The delivery in gestational week 38 was uneventful and the child did well. A neonatal ECG showed a sinus rythm interfoliated with supraventricular extrasystoles. No signs of organic heart disease have appeared. When last seen at nine months of age, the ECG was normal and digoxin had been discontinued without recurrence of tachycardia. PMID- 6502444 TI - Sweet sorrow: the color-shading response in an adult cystic fibrosis population. AB - Research on the color-shading response on the Rorschach has been limited previously to its use as a predictor of suicide. The theoretical understanding of this response was addressed by some of the major Rorschach authors. Adult cystic fibrosis patients were administered a battery of psychological tests, including the Rorschach. While these patients face a premature death, none of these patients were suicidal. A higher than usual incidence of color-shading responses occurred. Rapaport's hypothesis that the color-shading response is an expression of a simultaneously conflicting emotion, or similar to "sweet sorrow," was suggested as a possible hypothesis. PMID- 6502445 TI - Discriminating between alcoholic and nonalcoholic blacks and whites on the MMPI. AB - The purpose of the present study was to investigate the influence of race (black, white) on the MMPI performance of alcoholic and nonalcoholic inpatients. Subjects were 73 (27 black, 46 white) male alcoholic inpatients and 73 (27 black, 46 white) male nonalcoholic psychiatric inpatients. While black and white alcoholics failed to differ on the MMPI, white alcoholics presented as less disturbed and black alcoholics as less defensive and distressed, compared to their respective nonalcoholic counterparts. Furthermore, only white alcoholics were accurately identified by the MMPI 2-4/4-2 high-point pair combination and only white alcoholics achieved more high-point pairs containing Scale 4 relative to nonalcoholic controls. PMID- 6502446 TI - Multidimensional assessment of depression. AB - A brief version of the Multiscore Depression Inventory was evaluated. Good coefficient alpha and test-retest reliabilities were obtained for the total score and the subscales. Two factor analyses were reported which appear to justify the use of a multiscore approach for at least 8 of the 9 subscales: helplessness, energy level, guilt, social introversion, cognitive difficulty, irritability, pessimism, and low self-esteem. Sad mood apparently overlapped with energy level on one analysis (replicating findings with the 118-item Multiscore Depression Inventory), and with self-esteem on the second analysis. Normative data are provided on diverse samples totaling 849 subjects. PMID- 6502447 TI - MMPI substance abuse scales on drug addicts with and without concurrent alcoholism. AB - The range and utility of the MMPI-derived MacAndrew Alcoholism Scale (MAC) and the Heroin Addiction Scale (He) was assessed with a large sample of drug addicts with and without concurrent alcoholism. Results indicated that addicts with a co existing alcohol problem obtained higher MAC scores than addicts without a current alcohol problem. Opiate abusers scored higher on the MAC than non-opiate abusers. No such effects were observed with the He scale. The MAC is a particularly robust scale that taps generic substance abuse and may even be sensitive enough to detect alcoholism in drug addicts. PMID- 6502448 TI - Assessment of violence potential using measures of anger, hostility, and social desirability. AB - The assessment of violence potential was studied using the following scales: The Novaco Anger Inventory, the Buss-Durkee Hostility Inventory, the MMPI Hostility Control Scale (Hc), the MMPI Overt Hostility Scale (Ho), and the Marlowe-Crowne Social Desirability Scale. The five measures were evaluated for their ability to discriminate between violent and nonviolent criminals, and between criminal and normal population samples. Normative data was collected for 204 adult male felons. A correlation matrix presents interrelationships among the five scales. A comparison of mean scale scores between violent and nonviolent groups resulted in a significant discrimination in the expected direction for all but the Hc scale. A discriminant analysis procedure applied to individual items from the Novaco Anger Inventory resulted in the selection of 25 variables which identified violence prone individuals with 90% accuracy. Clinical implications are noted and recommendations for future research are made. PMID- 6502449 TI - [Synthetic studies on some biologically active alkaloids starting from dihydropyridinones]. PMID- 6502450 TI - [Cation selectivity of bovine red blood cell membrane estimated by means of TNS fluorescence measurement]. PMID- 6502452 TI - [Pharmacological analysis of the traditional Chinese prescription "goreisan ryo"]. PMID- 6502453 TI - [Determination of adriamycin and its metabolites in biological samples using high performance liquid chromatography. I. Analysis of serum and plasma by direct injection method]. PMID- 6502451 TI - [On the source and evaluation of benzoin]. PMID- 6502454 TI - [Determination of adriamycin and its metabolites in biological samples using high performance liquid chromatography. II. Analysis of tissues by extraction method]. PMID- 6502455 TI - [Determination of microgram amounts of heavy metals in organic substance by X-ray fluorescence spectrometry: application to the determination of heavy metal contents in crude drugs]. PMID- 6502456 TI - [Simultaneous determination of trapidil and its metabolites in serum by high performance liquid chromatography]. PMID- 6502457 TI - [Behavioral and pharmacological studies of spontaneous motor activity of mice by the wheel-cage method]. PMID- 6502458 TI - [Studies on the synthesis of antiulcer agents. I. Synthesis and antiulcer activity of imide derivatives]. PMID- 6502459 TI - [Studies on the synthesis of antiulcer agents. II. Synthesis and antiulcer activity of cyclic carbamate derivatives]. PMID- 6502460 TI - [Studies on the synthesis of antiulcer agents. III. Synthesis and antiulcer activity of 2,4-oxazolidinedione derivatives]. PMID- 6502461 TI - [Analysis and properties of condensed phosphates for medicinal and food additives]. PMID- 6502462 TI - [Effect of Panax notoginseng on experimental disseminated intravascular coagulation (DIC)]. PMID- 6502463 TI - [Induction and potentiation of phagocyte-mediated tumor lysis by chemotherapeutic drugs for cancer]. PMID- 6502464 TI - [Determination of nifedipine in human plasma by gas chromatography equipped with flame thermionic detector (FTD)]. PMID- 6502465 TI - [Combined bactericidal effect of chlorhexidine and diluted ethanol]. PMID- 6502466 TI - [Kinetics of the thermal transition of carbamazepine polymorphic forms in the solid state]. PMID- 6502467 TI - [Studies on chemical protectors against radiation. XXIII. Radioprotective activities of ferulic acid and its related compounds]. PMID- 6502468 TI - [Pharmacological studies on saiko-prescriptions. VI. Effect of shosaiko-to on liver injury induced by D-galactosamine in rats]. PMID- 6502469 TI - [Determination of saikosaponins in Chinese medicinal extracts containing Bupleuri radix]. PMID- 6502470 TI - [Change of serum chromium level in chronic hemodialysis patients]. PMID- 6502471 TI - [The coronary vasodilatory and hypotensive effects of 3,3',4,5' tetrahydroxystilbene and its derivatives]. PMID- 6502472 TI - Disopyramide pharmacokinetics and bioavailability following the simultaneous administration of disopyramide and 14C-disopyramide. AB - The pharmacokinetics and bioavailability of total (bound plus unbound) and unbound disopyramide were compared following the simultaneous administration of an oral dose of disopyramide and an intravenous dose of 14C-disopyramide in five normal volunteers and in 11 patients with congestive heart failure. The binding of disopyramide varied between 60 and 92% in patients and between 81 and 88% in normal subjects at postequilibrium drug concentrations of 10(-7) M. The binding of disopyramide to serum protein was concentration-dependent in all study subjects at serum concentrations achieved following drug administration. The association constant for the first binding site in serum from normal subjects and patients averaged 8.7 X 10(5) M-1 and 4.4 X 10(5) M-1, respectively (p less than 0.05). The unbound clearance of disopyramide averaged 277 ml/min and 209 ml/min in normal subjects and in patients (p less than 0.05). When normalized for body weight, the unbound clearance between patients and normal subjects was not significantly different. The elimination half-life of unbound concentrations in normal subjects and in patients averaged 4.9 and 6.1 h, respectively (p less than 0.05). The clearance and elimination half-life of total disopyramide was the same in both groups. Although the bioavailability of disopyramide averaged 0.85 in both groups, it was more variable in patients owing to the variability in the fraction of the dose absorbed. The unbound renal clearance and volume of distribution at steady state of disopyramide was related to cardiac index. The ratio of elimination half-lives of total and unbound disopyramide was related to the extent of serum protein binding. PMID- 6502473 TI - Lack of influence of an intensive antacid regimen on theophylline bioavailability. AB - We examined the influence of a large-volume, therapeutic antacid regimen, administered for three full days, on the steady-state bioavailability of a conventional-release and sustained-release theophylline product, Aminophyllin and Theodur, respectively. Nine stable asthmatics voluntarily completed a four-phase investigation requiring a total stay of 12 days in the Clinical Research Unit. The treatments consisted of administration of the formulations mentioned with and without antacids to each patient in a randomized sequence. Four patients participated in an additional phase where antacids were administered q2h around the clock for three days. After coadministration of theophylline plus antacids for two days, theophylline therapy was discontinued while numerous blood samples were obtained over 22 hr and analyzed for theophylline content via radioimmunoassay. Antacids had no predictable, consistent influence on theophylline absorption rate as determined by the absorption rate constant, the time to maximal theophylline concentration, or the lag time for theophylline absorption. Antacids had no detectable influence on theophylline elimination half life and had no consistent, statistically significant effect on the extent of theophylline bioavailability, according to measurements of maximal concentration, AUC measured over the appropriate steady-state dosing interval, or elimination rate adjusted AUC. The substantial intraindividual changes for all parameters of theophylline bioavailability that occurred for control and treatment phases likely represent spontaneous, random between-day variability in theophylline disposition independent of antacid administration, as evidenced by the comparability of the percent coefficient of variation for parameters of bioavailability across all phases. Our data demonstrate that therapeutic antacid administration has no effect on steady-state theophylline bioavailability and does not alter the intrinsic variability in theophylline absorption. Based on the results of our data, it is unlikely that a clinically significant (greater than 20%) decrease in theophylline absorption would occur in any patient treated intensively with antacids concurrently. PMID- 6502474 TI - Effects of chlorpromazine on the disposition and beta-adrenergic blocking activity of propranolol in the dog. AB - The effects of chlorpromazine (100 mg p.o., 2 hr before propranolol) on the disposition and beta-adrenergic blocking actions of both intravenous (6 mg) and oral (40 mg) propranolol were studied in the dog. Chlorpromazine pretreatment significantly reduced (69%) the oral clearance of propranolol, resulting in significant increases in propranolol bioavailability (159%), and in the total beta-adrenergic blocking activity (111%) after the oral dose. The increase in the total beta-adrenergic blocking activity of oral propranolol after chlorpromazine pretreatment was mostly due to an increased contribution from the parent compound; the apparent activity from active propranolol metabolites was not affected by chlorpromazine. Chlorpromazine pretreatment had no significant influence on the systemic clearance, elimination half-life, apparent volume of distribution, and plasma binding of propranolol, or on the apparent hepatic blood flow. After intravenous propranolol, chlorpromazine pretreatment had no effect on either the total amount of beta-adrenergic blocking activity or the amount of activity attributable to active metabolites. The decreased oral propranolol clearance by chlorpromazine was seen as a shift to the left in the propranolol dose vs. AUC relationship, eliminating the apparent nonlinear kinetic behavior of oral propranolol, and reducing the apparent oral threshold dose. Chlorpromazine's major, if not only, effect on propranolol disposition was to reduce the presystemic elimination of propranolol, possibly through inhibition of its metabolism via a pathway other than ring oxidation. PMID- 6502475 TI - The design of pharmacokinetic experiments for model discrimination. AB - The need for objective design of pharmacokinetic experiments aimed at model discrimination is argued. A sequential design strategy based on information theory is outlined. The characteristics of this strategy and its applicability to pharmacokinetic experiments is examined by means of computer simulated experiments. The limitation of the technique are discussed and alternative approaches outlined. PMID- 6502476 TI - Triprolidine radioimmunoassay: disposition in animals and humans. AB - A hapten derivative of triprolidine, bearing an acrylic acid side chain ortho to the pyridine ring nitrogen atom, was synthesized and coupled to bovine serum albumin. Immunization of New Zealand White rabbits with the resulting drug protein conjugate resulted in the production of antisera capable of binding a radioiodinated tyramine conjugate of the triprolidine hapten derivative at high antiserum dilutions (1:70,000-1:150,000). These antisera were used to develop a radioimmunoassay (RIA) for triprolidine in human plasma with a sensitivity limit of 0.1 ng/mL (0.01 ng of actual mass). The known hydroxymethyl and carboxyl metabolites of triprolidine cross-reacted weakly (less than 2 and less than 0.05%, respectively) with this antiserum. The RIA could be used for the direct analysis of triprolidine in human and rabbit plasma, but not for rat or dog plasma, presumably due to the presence of other interfering substances (possibly metabolites). The validity of the RIA procedure in human plasma was demonstrated by comparative analysis of a number of samples by quantitative TLC (r = 0.985, slope = 1.076). The assay was employed to describe the pharmacokinetics of triprolidine in the rabbit (t 1/2, beta = 1.7 h). The assay had adequate sensitivity to detect low circulating drug concentrations in humans after therapeutic oral doses and also substantiated previous disposition experiments with triprolidine in humans (t 1/2, beta = 2.27 h). TLC analysis demonstrated that the absolute oral bioavailability of triprolidine (1-mg/kg dose) in the dog was low (4%). A comparison of triprolidine pharmacokinetic parameters in dogs, rabbits, rats, and humans revealed considerable similarity in elimination characteristics in these species. PMID- 6502477 TI - Novel approach to zero-order drug delivery via immobilized nonuniform drug distribution in glassy hydrogels. AB - A novel approach to zero-order drug delivery from glassy hydrogel matrices via an immobilized, sigmoidal, initial drug distribution has been developed. The method utilizes a controlled-extraction process on initially dry, drug-loaded hydrogels to generate an inflection-point-containing drug concentration profile followed by a vacuum freeze-drying step to rapidly remove the swelling solvent and immobilize in situ a nonuniform drug distribution. The drug release from such a system generally exhibits typical zero-order characteristics similar to that of a membrane-reservoir device. However, a saturated reservoir of active ingredient as in the membrane-reservoir device is not required because the constant release is achieved via an initially nonuniform concentration distribution instead of the constant activity in a reservoir. The applicability of the present concept and process has been demonstrated experimentally with the release of oxprenolol hydrochloride from hydrogel beads based on 2-hydroxyethyl methacrylate polymerized with a polymeric cross-linking agent. PMID- 6502479 TI - Drug permeation through human skin II: Permeability of ionizable compounds. AB - The aim of this study was to establish whether ionized as well as un-ionized forms of certain 4-oxo-4H-1-benzopyran-2-carboxylic acids (chromone-2-carboxylic acids) with pKa values less than 2 permeated through excised human skin and, if so, to determine the permeability coefficients of the permeating species. The permeation properties of four carboxylic acids were studied as a function of concentration over the pH range 5-7 at 37 degrees C with plexiglass diffusion cells. Plots of J/CA- (the total flux due to un-ionized and ionized species obtained under steady-state conditions per unit concentration of ionized drug in the donor compartment) against CH3O+ resulted in straight-line relationships. The intercepts of these plots were shown to equal PA-, whereas the slopes multiplied by the Ka values of the compounds equalled PHA, the permeability coefficients of the ionized and un-ionized species, respectively. With all four compounds, both species were found to permeate skin, although the permeability coefficients of the un-ionized species were approximately 10(4) greater than those for the ionized species. It was demonstrated that the relative contributions of the ionized and un-ionized species to the total flux, as well as the total flux, vary significantly, depending on the pH of the drug solution in the donor cell. This may provide a means of controlling the flux of these and similar compounds through human skin. PMID- 6502478 TI - Kinetics of drug action in disease states III: Effect of pregnancy on the relationship between phenytoin concentration and antiseizure activity in rats. AB - The purposes of this investigation were to determine the effect of pregnancy on the susceptibility of female rats to experimentally induced seizures and on the relationship between serum phenytoin concentration and antiseizure activity. Pregnant rats (on the 18th day of gestation) were more susceptible than nonpregnant female rats to seizures produced by maximal electroshock or by a body weight-based dose of pentylenetetrazol. There was no apparent difference between pregnant (20th day of gestation) and nonpregnant rats in the relationship between seizure protection (percent of animals protected) and the serum concentration of total (free plus protein-bound) phenytoin. The relationship between concentration and effect was essentially the same 20 min after an injection of phenytoin and 2 h after the start of a constant-rate infusion preceded by a loading dose of the drug. Since the protein binding of phenytoin is appreciably decreased in late pregnancy, the serum concentration of free phenytoin required for seizure protection tended to be higher in pregnant than in nonpregnant rats. This may be due to the increased susceptibility of pregnant rats to seizure stimuli. PMID- 6502480 TI - Adsorption of phosphate by aluminum hydroxycarbonate. AB - Phosphate is specifically adsorbed by aluminum hydroxycarbonate by anion ligand exchange. IR analysis indicated that phosphate exchanged with specifically adsorbed carbonate. Adsorption is favored by low pH and is inversely related to particle size. Adsorption of phosphate decreases the rate of acid neutralization of aluminum hydroxycarbonate. The results are applied to the treatment of hyperphosphatemia and hypophosphatemia. PMID- 6502482 TI - Preparation and biodistribution of 99mTc-labeled tyramine iminodiacetic acid. AB - The synthesis and biodistribution properties of 99mTc-labeled N-substituted tyramine, [N-(4-hydroxyphenethyl)iminodiacetic acid] are described. Tissue distribution studies in rats were indicative of high hepatic and kidney extraction, accompanied by rapid plasma and urinary clearance and minimal biliary excretion. These findings were substantiated by organ image analysis. The preliminary data indicate that this labeled material may represent a new class of radiopharmaceuticals for the evaluation of hepatic and renal functions. PMID- 6502481 TI - Pharmacokinetic study on the mechanism of tissue distribution of doxorubicin: interorgan and interspecies variation of tissue-to-plasma partition coefficients in rats, rabbits, and guinea pigs. AB - The mechanism of interorgan and interspecies variations in the tissue distribution of doxorubicin was studied in rats, rabbits, and guinea pigs. The permeation properties of doxorubicin were investigated by using isolated rat erythrocytes as a model membrane. A significant dependency of the uptake rate constant on medium pH was observed, suggesting that only un-ionized doxorubicin is diffusible through the plasma membrane. The values of plasma unbound fraction (fp) of doxorubicin were 0.344 for rats, 0.415 for rabbits, and 0.529 for guinea pigs. The tissue DNA concentrations of rats were larger than those of rabbits and smaller than those of guinea pigs in corresponding organs or tissues. An in vitro organ model that described the distribution behavior of doxorubicin in the whole body was constructed, and an equation was derived to estimate the tissue-to plasma partition coefficients, (Kp) from in vitro experiments. The in vitro Kp values showed comparatively good agreement with the in vivo Kp values for the various organs or tissues in all three species. Doxorubicin is exclusively bound to the nuclei in the cells. The variation of the Kp values in different organs depended on the amount of nuclei per gram of tissue. The primary determinant of the interspecies variation in the Kp values was the difference in tissue DNA concentrations among rats, rabbits, and guinea pigs, and a secondary determinant was the difference in fp values. PMID- 6502484 TI - In vitro adsorption-desorption of phenethylamines and phenylimidazoles by a bentonite and a resin. AB - The adsorption of phenethylamines (dextroamphetamine, phentermine, mephentermine, diethylpropion), choline, and phenylimidazoles (levamisole and imazalil) was examined in vitro in aqueous solutions on bentonite and on lewatite at 25 degrees C. An ion-exchange mechanism prevails for lewatite and for bentonite up to 0.8 mEq X g-1. The organic cations are more strongly adsorbed on bentonite than on lewatite. On bentonite, the selectivity of adsorption follows the order: primary less than secondary less than tertiary phenethylamines. An interlamellar monolayer is formed. All drugs, except choline and imazalil, are adsorbed in excess of the cation exchange capacity of bentonite without observable Cl- adsorption and pH changes. Desorption is reversible for lewatite and partially irreversible for bentonite. PMID- 6502483 TI - Enhanced rectal absorption of [Asu1,7]-eel calcitonin in rats using polyacrylic acid aqueous gel base. AB - The effects of polyacrylic acid aqueous gel on the absorption of rectally administered [Asu1,7]-eel calcitonin, a calcitonin analogue, were investigated in rats. The [Asu1,7]-eel calcitonin (1 U/kg) was given into the rectal loop in gel bases at various pH (5.5-8.5) and polyacrylic acid concentrations (0.01-1.0% w/v). The maximum hypocalcemic effect was obtained in approximately 30 min after administration of the analogue in a 0.1% w/v polyacrylic acid gel base at pH 5.5. The plasma calcium level decreased by approximately 18% from the initial level. Rectal administration in vehicles such as polyethylene glycol 1000, triglyceride fatty acid mixture base, or saline solution had little or no hypocalcemic effect at a dose of 5 U/kg. The results indicated that a polyacrylic acid aqueous gel base significantly improved the absorption of this analogue. Furthermore, rectal administration in a polyacrylic acid gel base (0.1% w/v; pH 5.5) required a dose 35 times greater than an intravenously administered dose to achieve an equivalent hypocalcemic effect. PMID- 6502485 TI - Radioimmunoassay for the sulfoxide metabolite of trifluoperazine and its application to a kinetic study in humans. AB - Antibodies were produced in rabbits immunized with 10-[[3-[4-(2-carboxyethyl)-1 piperazinyl]-propyl]]-2 -trifluoromethyl-10H-phenothiazine sulfoxide-bovine serum albumin conjugate. The subsequently developed radioimmunoassay (RIA) procedure enables, for the first time, the quantitation of the sulfoxide metabolite of trifluoperazine in the plasma of humans after administration of therapeutic doses of trifluoperazine, in which 60 pg of the sulfoxide metabolite in 200 microL of plasma can be measured with a CV of less than 3%. Similar results were obtained by this assay with or without a benzene extraction step and also in the presence or absence of a large excess of trifluoperazine and suspected major metabolites of trifluoperazine. This RIA procedure, together with a previously developed RIA for trifluoperazine was used to directly determine plasma concentrations of trifluoperazine and its sulfoxide metabolite after administration of a single, low, oral dose of trifluoperazine to five healthy volunteers. The rapidly appearing, relatively high concentrations of the sulfoxide metabolite are indicative of presystemic sulfoxidation. The mean plasma elimination half-life for the sulfoxide metabolic of trifluoperazine was 5.8 +/- 1.3 h. PMID- 6502487 TI - Stereospecific fluorescence high-performance liquid chromatographic analysis of warfarin and its metabolites in plasma and urine. AB - A stereospecific assay for the simultaneous determination of the enantiomers of warfarin and its major metabolites, 6- and 7-hydroxywarfarin and warfarin alcohols, in plasma and urine was developed. Involved in this determination was the formation of diastereoisomeric esters with carbobenzyloxy-L-proline, separation by normal-phase high-performance liquid chromatography, and detection by fluorescence after postcolumn aminolysis with n-butylamine. The determination limit for any enantiomer is in the order of 50-100 ng. The method was applied to the analysis of the enantiomers of warfarin and metabolites in plasma and urine of human subjects receiving racemic drug. The results for warfarin enantiomers are comparable with those obtained by an MS method, involving administration of a synthetic pseudoracemate [12C(R), 13C(S)]warfarin. In addition to all known metabolites, the detection of 7-R-hydroxywarfarin indicates that 7-hydroxylation is stereoselective rather than stereospecific. PMID- 6502486 TI - Evaluation of diethyl malonate as a simulant for 1,2,2-trimethylpropyl methylphosphonofluoridate (soman) in shower decontamination of the skin. AB - A shower decontamination bench model has been used to assess quantitatively the importance of several variables (water pressure and temperature, surfactant concentration in the decontamination fluid, nozzle type, and shower time) on decontamination of nontoxic chemical warfare-agent simulants diethyl malonate and thickened diethyl malonate from pig skin in vitro. Diethyl malonate was validated as a simulant for 1,2,2-trimethylpropyl methylphosphonofluoridate (soman) by comparison of the skin penetration and decontamination of radiolabeled diethyl malonate to the radiolabeled phosphonofluoridate in shower decontamination trials of pig skin in vitro. Percutaneous penetration of diethyl malonate was significantly greater than that of the phosphonofluoridate during the 15-min period after application. However, both were less than 0.1% of the applied dose. Showering or thickener had no significant effect on the percutaneous penetration of diethyl malonate or the phosphonofluoridate. Most of the phosphonofluoridate removed by showering or scrubbing the skin was inactivated. The quantity of intact 1,2,2-trimethylpropyl methylphosphonofluoridate that penetrated through the skin was below the detection limit of the enzymatic analysis. There was no statistically significant difference between the phosphonofluoridate and diethyl malonate in efficacy of shower decontamination. The presence of thickener did not have a significant effect on decontamination efficacy. PMID- 6502488 TI - Bioavailability of digoxin capsules and tablets: effect of coadministered fluid volume. AB - The effect of different coadministered fluid (water) volumes on the consistency of digoxin absorption was studied in 16 male volunteers. Each volunteer received four single-dose treatments (two 0.25-mg digoxin tablets with 30- and 240-mL of water and two 0.2-mg digoxin capsules with 30- and 240-mL of water). Digoxin present in serum and urine samples collected for 48 h after dosing was quantified by RIA. Treatments were compared by evaluating the following model-independent pharmacokinetic parameters: maximum serum concentration (Cmax); time of maximum serum concentration (tmax); area under the serum concentration-time curve for 0 12 h (AUC0-12); cumulative urinary excretion for 0-48 h (CUE48). No significant differences were found between dosage form (tablets versus capsules) and coadministered water volume (30 mL versus 240 mL) for any of the parameters. For both fluid volumes the AUC0-12 and Cmax were significantly larger (p less than 0.01) and the tmax significantly shorter (p less than 0.01) for the capsules than for the tablets. The volume of coadministered water had no effect on the amount of digoxin absorbed from either dosage form. PMID- 6502489 TI - Inhibition of human polymorphonuclear leukocyte cell responses by ibuprofen. AB - The stimulation of cell swelling, cell aggregation, polymorphonuclear leukocyte locomotion, and lysosomal enzyme release in response to chemoattractant were all inhibited by ibuprofen, a nonsteroidal anti-inflammatory agent. The dosages needed to induce 50% inhibition (ID50) were 5.9, 7.6, 60, and 95 micrograms/mL, respectively. Aside from the differences in ID50, there was also a difference in the degree of maximum inhibition (Imax) of the complement C5a-stimulated responses observed, so that at achievable serum drug concentrations of 20-50 micrograms/mL, inhibition of 67-78% for cell swelling, 69-82% for cell aggregation, 20-35% for migration response, and 17-38% for lysosomal enzyme release were demonstrated. Also observed were a minor stimulatory effect on nitroblue tetrazolium reduction and an inhibitory effect on the ability to kill Staphylococcus aureus, but only at very high concentrations (approximately 2 mg/mL). PMID- 6502491 TI - Determination of the ionization constants of compounds which precipitate during potentiometric titration using extrapolation techniques. AB - It is shown that the ionization constants of diacidic compounds can be determined by utilizing potentiometric titration data, even when a precipitate forms during the titration. The two methods presented are particularly useful for compounds for which the pK alpha values are close together. A third method is presented which can be used with monoacidic compounds or compounds for which the pK alpha values are far apart and form a precipitate during the titration. Four symmetrical diacidic compounds were studied which had similar pK alpha values, and one compound was studied which had pK alpha values that were far apart. Comparison of the second pK alpha of the latter compound with that previously reported determined by a spectrophotometric procedure showed excellent correlation. PMID- 6502490 TI - Preparation of spherically agglomerated crystals of aminophylline. AB - The spherically agglomerated crystals of aminophylline (theophylline ethylenediamine complex) can be compounded directly into pharmaceutical formulations without further processing, e.g., granulation. Such crystals were prepared by mixing theophylline and ethylenediamine in a partially miscible solvent system, i.e., organic solvent-ethanol-water. The organic solvents used were chloroform, 1-hexanol, isopropyl acetate, isobutyl acetate, isoamyl acetate, benzene, toluene, n-hexane, or n-heptane. Spherical crystallization depended upon the solubility of theophylline in the solvent mixture. The resultant agglomerated crystals were identical with the theophylline-ethylenediamine complex by IR, X ray, and differential scanning calorimetry analyses, and was the alpha-, beta-, or gamma-form when the water of crystallization was less than or equal to 0.5, 1.0, and 2.5 mol, respectively. When the amount of ethylenediamine used was less than 1.1 mL (0.0165 mol), the resultant agglomerated crystals were converted to anhydrous theophylline by washing with ethanol. When water was added to the system (greater than or equal to 0.3 mL, i.e., 0.0167 mol), water was occluded in the resultant agglomerates as water of crystallization. Ethylenediamine content in the agglomerated crystals could be controlled by changing the amount of ethylenediamine added in the crystallization solvent. PMID- 6502492 TI - Degradation of fenprostalene in polyethylene glycol 400 solution. AB - The kinetics of degradation of fenprostalene (I) in polyethylene glycol 400 solution was examined using HPLC. The degradation of I at 80 degrees C was shown to depend on the presence of oxygen and a large number of polar products were produced, as evidenced by using 3H-labeled I. Evidence that autoxidation of the polyethylene glycol 400 was concurrent with degradation of I was found from a drop in the apparent pH. Antioxidants were very effective in retarding the rate of degradation in the presence of oxygen. Degradation of I in polyethylene glycol 400 appears to arise from a reaction between the drug and reactive peroxide intermediates formed through air-oxidation of polyethylene glycol 400. This is supported by the finding that I reacts exclusively by a slow transesterification reaction in diethylene glycol, a solvent that is stable to autoxidation. PMID- 6502493 TI - Distribution and elimination of coated polymethyl [2-14C]methacrylate nanoparticles after intravenous injection in rats. AB - Surfactant-coated polymethyl [2-14C]methacrylate nanoparticles had significantly different time-course distribution patterns in rats than noncoated and albumin coated particles. Blood concentrations of poloxamer 188-coated particles were 70 fold higher after 30 min, and the particles persisted at higher levels in the circulation for up to 2 h. The initial and final liver levels were significantly lower (38% after 30 min, 51% after 7 d) and spleen levels were significantly higher (21% after 30 min, 23% after 7 d) than non-coated particles (74% in the liver and 5% in the spleen after 7 d) and the albumin-coated particles (84% in the liver and 5% in the spleen after 7 d). Specific activity was somewhat higher for the surfactant-coated particles in other organs such as the lungs, kidneys, testicles, ovaries, and lymph nodes. The bovine serum albumin sorption behavior of polymethyl methacrylate nanoparticles was followed under various conditions, and adsorption was found to increase with increasing protein concentration and increasing temperature, reaching a maximum at the isoelectric point of pH 4.9 after approximately 12 h of incubation. The zeta potential of the particles decreased with increasing pH, and the change was more pronounced with the albumin coated particles. PMID- 6502494 TI - Oral and intravenous pharmacokinetics of milrinone in human volunteers. AB - Thirty-nine healthy men received milrinone either orally or intravenously in two separate double-blind, placebo-controlled studies. The mean bioavailability, based on the area under the plasma concentration versus time curves, was 0.92. The plasma data for those subjects in the intravenous study were described by an open two-compartment model with a mean (+/- SD) apparent first-order terminal elimination rate constant (beta) of 0.86 (+/- 0.23) h-1, which corresponds to a half-life of 0.8 h. In the intravenous study, the renal clearance and total body clearance were 21.1 and 25.9 L/h, respectively. The corresponding values in the oral study were 23.8 and 29.7 L/h. Between 79.9 and 84.5% of the total doses were recovered in the urine samples taken at 0-24 h. PMID- 6502495 TI - Crystallinity and dissolution rate of tolbutamide solid dispersions prepared by the melt method. AB - The influence of cooling rate of solid dispersions prepared by the melt method was studied by X-ray diffraction and scanning electron microscopy. Tolbutamide was the model drug investigated, and the carriers included urea and polyethylene glycol 6000. Slow-cooled urea dispersions of tolbutamide demonstrated a complete lack of crystallinity, suggesting the formation of an amorphous material. The rapidly cooled dispersion showed peaks for urea and an absence of drug in the X ray pattern, suggesting that a true molecular dispersion was formed. The X-ray patterns of rapid- and slow-cooled dispersions of tolbutamide and polyethylene glycol 6000 demonstrated that a physical mixture of drug and carrier resulted from both methods of dispersion preparation. PMID- 6502497 TI - Absolute intramuscular, oral, and rectal bioavailability of alizapride. AB - A study was designed to estimate the absolute bioavailability of alizapride after intramuscular injection, oral administration as a solution or a tablet, and rectal administration as a suppository compared with that after intravenous injection. A balanced incomplete block-design trial was adopted. The intramuscular injection and the tablet administration showed identical results with those of the intravenous injection. On the contrary, the oral solution and the rectal suppository dosage forms gave lower absorption values, i.e., 75 and 61% of the dose administered was absorbed, respectively. PMID- 6502496 TI - A high-performance liquid chromatographic method for the simultaneous determination of nicardipine and its pyridine metabolite II in plasma. AB - A rapid and specific method in which reverse-phase high-performance liquid chromatography (HPLC) with UV detection was used for the simultaneous determination of nicardipine and its pyridine metabolite II in human plasma is described. Nicardipine, its pyridine metabolite II, and the internal standard were extracted from plasma and partially purified by acid-base partitioning. Final purification and quantitation were achieved by HPLC by using a reverse phase column and a UV detector (254 nm). The extraction efficiencies for nicardipine and its pyridine metabolite II from 1 mL of plasma were 77.4 and 81.1%, respectively. The sensitivity of the assay was 5 ng/mL for both nicardipine and its pyridine metabolite II, and the linear concentration range of the assay was 5-150 ng/mL for both compounds. The low coefficients of variation (less than or equal to 5%) for samples spiked with nicardipine and its pyridine metabolite II in this concentration range demonstrate good reliability and reproducibility of the assay. The HPLC procedure has been validated by comparison with a GC-electron-capture detection (ECD) procedure, which gives the combined concentration of nicardipine-its pyridine metabolite II (total) and with an HPLC/GC-ECD procedure, which gives the concentration of its pyridine metabolite II. All three methods, which were developed in our laboratory, were used to analyze nicardipine and its pyridine metabolite II in specimens of plasma from subjects treated with nicardipine hydrochloride. Good correlations were found for concentrations of nicardipine, its pyridine metabolite II, and nicardipine plus the metabolite determined by these three procedures. The HPLC procedure is suitable for use in pharmacokinetic studies following administration of nicardipine hydrochloride to humans. PMID- 6502498 TI - Kinetic study of the polymorphic transformations of phenylbutazone. AB - The polymorphic transformations of phenylbutazone from metastable forms alpha and beta to stable form delta were studied quantitatively at four temperature and five humidity levels by X-ray powder diffractometry. The transformation of form alpha conformed with the Avrami-Erofe'ev kinetic model and form beta conformed with apparent first-order kinetics. In the two transformation systems, the induction periods depended on the storage conditions and were prolonged with lowering of temperature and humidity. The transformation rate of form alpha was not affected by humidity, whereas that of form beta increased according to a rise in humidity. The temperature dependency of the transformation rate constant was remarkable. The Arrhenius treatment was applicable to the beta----delta transformation at low temperatures. The overall half-life, including induction period, revealed that form alpha was more stable than form beta under any storage condition. A good linear relationship existed between the induction period and the transformation rate constant, irrespective of the storage conditions. The scanning electron photomicrographs of forms alpha and beta demonstrated that acicular crystals of form delta grew as the transformation progressed. This could be confirmed as the change in particle diameter of the samples. PMID- 6502499 TI - Quantitation of flecainide acetate, a new antiarrhythmic agent, in biological fluids by gas chromatography with electron-capture detection. AB - A sensitive and selective gas chromatographic (GC) method for the quantitation of flecainide acetate, a new antiarrhythmic agent, was developed. The unchanged drug and internal standard were separated from biological fluids by a sequence of solvent extractions and then the drug was derivatized. The pentafluorobenzamide derivatives were chromatographed on a 3% SP-2250 glass column and detected with a nickel-63 electron-capture detector. By this method, greater than or equal to 12.5 ng of flecainide/mL can be quantitated in a 1-mL sample of plasma, saliva, or urine. The intraday precision, expressed as the RSD, at plasma levels of 12.5, 25, 50, 100, 200, 300, 400, and 600 ng/mL was 3.4, 6.2, 5.3, 6.4, 1.0, 1.6, 2.0, and 0.5%, respectively; the accuracy, expressed as relative error at these levels was -24.6, -6.9, -6.0, +0.6, +3.8, -0.3, +2.4, and -1.4%, respectively. The interday precision at these levels was 13.8, 13.0, 5.7, 7.6, 8.3, 6.1, 9.0, and 5.4%, respectively. Several other antiarrhythmic agents and one beta-blocker, which might be administered concurrently with flecainide acetate, do not interfere with the assay. PMID- 6502500 TI - Kinetic steric factors and connectivity indices. AB - In this study the relationships between previously reported connectivity indices described by Kier and Hall and steric contributions to the rate constants for several series of reactions are examined. Rate data were examined for four different series of reactions, which were chosen to represent a range of different reaction mechanisms and transition-state structures. For sterically controlled reactions, the relative rates of series of substrates can be correlated either with the connectivity indices of the substrates themselves or with the changes in the indices that accompany formation of transition states. As expected, the significant indices in the correlations are of the cluster and path cluster types. The connectivity indices should be useful descriptors in helping relate equilibrium properties, chemical reactivities, and pharmacological data to one another. PMID- 6502501 TI - Relationship between refractive index and dry-substance content for lactulose syrups. AB - The relationship between the refractive index and the dry substance content of lactulose syrups of different compositions was investigated. It was found that, for a concentration range of 55-75% of dissolved carbohydrates, the sucrose tables can be used after correction by a factor of 0.97. PMID- 6502503 TI - Liquid crystals as a potential ointment vehicle. AB - A lecithin-water lyotropic liquid crystal was used as an ointment vehicle for a hydrocortisone formulation. The hydrocortisone was soluble in the liquid crystalline phase up to 5% by weight. The diffusion coefficient determined for the hydrocortisone in the liquid crystalline phase was 5.5 X 10(-9) cm X s-1, which is four magnitudes higher than the corresponding value for skin. PMID- 6502502 TI - Hypolipidemic activity of phthalimide derivatives V: Reduced and hydrolytic products of simple cyclic imides. AB - A series of cyclic imides and related compounds have previously been shown to possess hypolipidemic activity at the low dose level of 20 mg/kg/d. Hydrolytic and reduced products of the cyclic imides were synthesized and examined to discern if possible metabolic products were the active chemical species of these hypolipidemic agents. Phthalimide proved to be the most active cyclic imide tested. Unfortunately, the new products did not, in general, improve hypolipidemic activity in rodents. The exceptions were piperidine which demonstrated improved hypotriglyceridemic activity, and 3,4,5,6 dibenzohomopiperidin-2-one, which demonstrated improved hypocholesterolemic activity compared to phthalimide. PMID- 6502504 TI - Determination of ibuprofen in capillary and venous plasma by high-performance liquid chromatography with ultraviolet detection. AB - A high-performance liquid chromatographic (HPLC) method is described which determines ibuprofen in human capillary or venous plasma. Ibuprofen plus the internal standard, flurbiprofen, were extracted from acidified plasma with pentane-ether, back-extracted into base, and then extracted into the pentane ether solution after acidification of the aqueous phase. A reverse-phase octadecylsilane column with acetonitrile-water-phosphoric acid as mobile phase and UV detection provided a quantifiable peak for 1 microgram/mL of ibuprofen in 0.1 mL of plasma. Capillary and venous plasma level curves were virtually superimposable after administration of 400 mg of ibuprofen to four normal volunteers. No ibuprofen was detected in the saliva of the subjects. PMID- 6502505 TI - A new method for high-performance liquid chromatographic determination of drotaverine in plasma. AB - A sensitive, specific high-performance liquid chromatographic procedure was developed for the determination of plasma drotaverine levels. Basic plasma samples were adjusted to pH 1.5 and extracted with chloroform. HPLC [n-heptane dichloromethane-diethylamine (50:25:2)] on a microporous silica column, with a variable-wavelength UV detector set at 302 nm allowed the measurement of drotaverine at the 50-ng/mL level. The utility of this method for determination of drotaverine in dog and rat plasma was demonstrated. PMID- 6502506 TI - Relationship of morphine-induced miosis to plasma concentration in normal subjects. AB - The relationship between morphine plasma concentration and pupil diameter was evaluated 2-10 h following intravenous administration of morphine sulfate (10 mg). Seven healthy male volunteers received 10 mg of morphine intravenously following pretreatment for 4 d with either cimetidine (300 mg po four times a day) or placebo in a single blind, balanced crossover study. Pupil diameters were measured directly from contact prints using calipers and a photographed millimeter scale. Cimetidine pretreatment had no significant effect on pupil size either before or after morphine administration or on morphine pharmacokinetics. The relationship between morphine plasma concentration (2-10 h postdose) and pupil diameter was evaluated from the pooled data from both morphine treatment periods by perpendicular least-square regression. In each individual, a strong relationship existed between morphine plasma concentrations and pupil diameter (r = -0.76 to -0.91; p less than 0.05). Weaker correlations for both pupil diameter (r = -0.65; p less than 0.0001) and the absolute change in pupil diameter from baseline (r = 0.72; p less than 0.0001) for the grouped data probably reflect intersubject variation in morphine sensitivity. Thus, the miotic response to an intravenous dose of morphine varies in proportion to morphine plasma concentration. PMID- 6502507 TI - Evidence favoring the venous equilibrium model for hepatic clearance of (S)-(--) propranolol. PMID- 6502508 TI - Method for determination of first-pass metabolism in human skin. PMID- 6502509 TI - Area under blood level versus time curves at steady state for daily dosing at unequal dosing intervals. PMID- 6502510 TI - Determination of selective and nonselective compounds for the 5-HT 1A and 5-HT 1B receptor subtypes in rat frontal cortex. AB - Recent studies indicate that there are multiple subtypes of the 5 hydroxytryptamine 1 (5-HT1) receptor. Previously, we provided evidence consistent with the finding that multiple states of the 5-HT1 receptor are present when the binding of [3H]-5-HT is measured in the absence of guanine nucleotides. When 1 mM GTP was present in the [3H]-5-HT receptor binding assay, the high affinity state was eliminated. As the presence of multiple states of a receptor complicates the interpretation of the inhibition of [3H]-5-HT binding caused by serotonin agonists and antagonists, we examined the ability of a series of these drugs to compete for 15 nM [3H]-5-HT binding in the presence of 1 mM GTP in the rat frontal cortex. Eight agonists and five antagonists showed selectivity for the two subtypes of the 5-HT1 receptor, whereas three agonists and four antagonists showed the same affinity for these two receptors subtypes. Most of the compounds examined exhibited only a modest 10- to 30-fold degree of selectivity. However, 1 (m-trifluoromethylphenyl) piperazine and 5-methoxy-3-(1,2,3,6-tetrahydro-4 pyridinyl)indole were about 65-fold selective and spiperone was over 100-fold selective for one of the receptor subtypes. The subtype specificity of the selective compounds was determined using either spiperone, a selective 5-HT 1A compound, or 1-(m-trifluoromethylphenyl)piperazine, a selective 5-HT 1B compound, to preferentially inhibit one of the receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502511 TI - Suppression of humoral antibody production by exposure to 1,2,3,6,7,8 hexachlorodibenzo-p-dioxin. AB - The day 4 IgM antibody (AB) response to sheep red blood cells was suppressed in adult female B6C3F1 mice subchronically (14 day) exposed to 1,2,3,6,7,8 hexachlorodibenzo-p-dioxin (1,2,3,6,7,8-HCDD) at concentrations reflecting the levels of this dioxin isomer as a contaminant in technical-grade pentachlorophenol. Hepatic microsomal parameters were also measured in these mice and indicated the characteristic induction of mixed-function oxidase enzyme activities, particularly aryl hydrocarbon hydroxylase. The response to sheep red blood cells was also suppressed when measured in vitro by culturing the antigen with spleen cells from a second group of mice subchronically exposed to 1,2,3,6,7,8-HCDD. Enumeration studies with fluorescent-labeled antisera in these animals indicated a dose-related suppression in the number of T-lymphocytes with no effect on B-lymphocytes. 1,2,3,6,7,8-HCDD directly suppressed several in vitro AB responses when added to cultures of spleen cell suspensions from untreated B6C3F1 mice. The rank order of sensitivity was determined to be: polyclonal AB response to LPS greater than or equal to T-independent AB response to DNP-Ficoll greater than T-dependent AB response to sheep red blood cells. Subsequent studies indicated that the suppression by 1,2,3,6,7,8-HCDD could be produced after only a 30-min preincubation. The suppression of all in vitro AB responses was abolished when the dioxin was preincubated with a metabolic activation system: crude liver homogenate (B6C3F1 mice pretreated with the mixed-function oxidase inducer; Aroclor 1254) plus NADP and isocitrate. The suppression of the T-dependent AB response was still evident when the metabolic activation system was heat inactivated (as verified by an inability to activate cyclophosphamide) prior to the preincubation. PMID- 6502512 TI - Nicotinic acid, free fatty acids and myocardial function during coronary occlusion and reperfusion in the dog. AB - The effect of nicotinic acid on regional myocardial blood flow, percentage of segment shortening and myocardial uptake of free-fatty acids during a 15-min occlusion of the left anterior descending coronary artery and 3-hr reperfusion period was compared to a saline-treated control group. Nicotinic acid (2.4 mumol/kg/min i.v.) was infused 30 min before and throughout the occlusion period. Heart rate, arterial blood pressure and left ventricular systolic and end diastolic pressures were not different during occlusion and reperfusion in the nicotinic acid or saline-treated groups. However, left ventricular dP/dt, an index of global myocardial function and percentage of segment shortening in the ischemic region were greater during occlusion and reperfusion after nicotinic acid. Even though myocardial blood flow was unaltered in the normal or ischemic region during nicotinic acid infusion, subendocardial blood flow during reperfusion was enhanced significantly when compared to the control group. Nicotinic acid also decreased free-fatty acid uptake by the heart during occlusion which returned gradually to the pretreatment control during 3 hr of reperfusion. Thus, the improvement in percentage of segment shortening, dP/dt and subendocardial blood flow during reperfusion may be related to the ability of nicotinic acid to reduce free-fatty acid uptake by the heart during coronary occlusion. PMID- 6502513 TI - Classical genetic analysis of nicotine-induced seizures and nicotinic receptors. AB - C3H/2lbg mice are more sensitive to nicotine-induced seizures than are DBA/2lbg mice. There are also differences in alpha-bungarotoxin (alpha-BTX) binding in the hippocampus and midbrain of these two strains, with the C3H mice having greater binding. Because alpha-BTX and nicotine appear to bind to nicotinic receptors in the central nervous system, it is possible that there may be a relationship between seizure sensitivity after a nicotine dose and nicotinic receptor concentration. To examine this relationship, a classical cross producing F1, F2 and backcross (F1 X C3H and F1 X DBA) generations from these two strains was utilized. Dose-response curves for nicotine-induced seizures were constructed for both parental strains and all crosses derived from them. Nicotinic receptors were also measured in three brain regions: cortex, midbrain and hippocampus. Both DL [3H]nicotine and alpha-[125I]BTX were used to measure nicotinic receptors. The pattern of results for the six generations for alpha-BTX binding in the hippocampus paralleled that for seizure sensitivity. These results suggest that strain differences for both seizure sensitivity and receptor concentration in the hippocampus may be due to allelic differences at a single autosomal locus, with dominance for low seizure susceptibility and fewer alpha-BTX receptors. PMID- 6502514 TI - Characterization of stress-induced potentiation of opioid effects in the rat. AB - This study was designed to evaluate systematically the effects of stress on actions of exogenously administered opioids. Dose- and time-dependent analgesic (tail-flick) and thermic (core body temperature) effects of morphine and methadone were determined in unstressed rats and in rats exposed to the stress of restraint or a cold environment. To assess the role of the pituitary adrencortical axis in stress-opioid interactions, tests were performed in hypophysectomized and pituitary-intact rats. The analgesic effect of morphine was greater in all stressed groups than in unstressed controls and was greater still in all groups of hypophysectomized rats than in corresponding groups of intact animals. The analgesic effect of methadone was also greater in all groups of stressed as compared to unstressed rats but was not modified by hypophysectomy, in contrast to the situation with morphine. The effects of both opioids on body temperature varied quantitatively and qualitatively as a function of dose, conditions under which the animals were tested and presence or absence of the pituitary gland. Doses that increased temperature in unstressed pituitary-intact rats decreased temperature in unstressed hypophysectomized rats and in all stressed rats. Brain and plasma levels of morphine were comparable in stressed and unstressed pituitary-intact rats, but were significantly higher in unstressed hypophysectomized animals. Thus, hypophysectomy-induced potentiation of the analgesic effect of morphine is probably due to pharmacokinetic factors whereas stress-induced potentiation of opioid analgesia appears to be a distinct phenomenon, one that is independent of the pituitary-adrencortical axis and general for the pharmacologic class of morphine-like drugs. The well-documented hypothermic response of restrained rats to doses of opioids that increase or have no affect on the body temperature of unrestrained animals appears to represent another example of stress-induced potentiation of opioid effects. PMID- 6502515 TI - Lead accumulation by rat renal brush border membrane vesicles. AB - Pb++ accumulation by rat renal cortical brush border membrane vesicles was evaluated by in vitro incubation with rapid filtration technique. Pb++ uptake was time- and concentration-dependent, with apparent saturation of binding sites at 100 to 200 microM (5 sec initial rate experiments). Equilibrium binding studies (60-min incubation) showed that the ratio of bound Pb++ to free Pb++ was constant at 1.25 +/- 0.07 between 0.01 to 10 microM Pb, with decreasing bound to free ratios at higher concentrations. Osmotic experiments showed that Pb++ uptake was due primarily to membrane binding rather than intravesicular accumulation. Electrochemical gradients of NaCl, KCl or protons did not increase vesicle uptake of Pb++. Incubation of vesicles with a number of amino acids did not stimulate Pb++ uptake although two (cysteine and glutathione) and the chelators EDTA or ethylene glycol bis(beta-aminoethyl ether)-N,N'-tetraacetic acid) completely blocked this process. Competition studies with a number of other metals (at 10 microM and 1 mM) showed that only Sn++ or Sn +, La , Fe++ or Fe and Cu++ produced significant reductions in Pb++ uptake whereas Mg++, Ca++, Zn++, Cd++ and Hg++ were without effect on this process. Release of 203Pb from preloaded vesicles was accelerated in the presence of either cysteine or Sn +. Prior in vivo exposure to Pb (3 mg of Pb/kg i.v.) reduced Pb uptake to 70% of that of vesicles prepared from control animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502516 TI - Loperamide: blockade of calcium channels as a mechanism for antidiarrheal effects. AB - The antidiarrheal opiates loperamide, fluperamide, diphenoxylate and fetoxylate inhibited binding of [3H]nitrendipine to membranes from guinea-pig cerebral cortex with Ki values of 0.5 to 10 microM. Loperamide and fluperamide reversed the tiapamil elicited lowering of [3H]nitrendipine binding with IC50 values of 0.2 to 0.5 microM, indicating a verapamil-like action of these drugs. An oral dose of 1 mg/kg of loperamide reduced gastrointestinal motility and gave concentrations of 0.45 +/- 0.19, 0.38 +/- 0.22 and 0.49 +/- 0.25 microM in the duodenum, jejunum and ileum, respectively. The apparent Ki for loperamide in preventing calcium-induced contractions of guinea-pig ileum depolarized with 80 mM potassium was 0.10 microM. We propose that calcium channel antagonism is responsible at least in part for the antidiarrheal actions of loperamide and related agents. Evidence includes the calcium antagonist actions of loperamide at antidiarrheal doses, the constipating effects of certain calcium antagonists and the failure of opiate antagonists to prevent some intestinal effects of loperamide. PMID- 6502518 TI - Phenobarbital in the genetically obese Zucker rat. I. Pharmacokinetics after acute and chronic administration. AB - The pharmacokinetics of the enzyme inducer, phenobarbital, was evaluated in genetically obese and lean Zucker and lean Sprague-Dawley rats. The volume of distribution of phenobarbital in obese Zucker rats was larger (0.416 liter) than for lean Zucker (0.299 liter) or Sprague-Dawley rats (0.312 liter). Standardizing the volume of distribution for total body weight in the obese and lean Zucker and lean Sprague-Dawley rats resulted in similar volume terms. Intra- and inter strain differences in phenobarbital clearance were observed between the obese and lean Zucker (11.9 and 14.1 ml/hr, respectively) and lean Sprague-Dawley rats (23.0 ml/hr). Greater differences in phenobarbital clearance were observed when clearance was corrected for body weight. Whether comparing the absolute or standardized pharmacokinetic data, lean and obese Zucker rats will exhibit 2- to 3-fold higher phenobarbital plasma concentrations after administration of a standard 75- to 100-mg/kg enzyme-inducing regimen relative to Sprague-Dawley rats. Pharmacokinetic parameters from the single dose study were used to calculate appropriate phenobarbital doses (21-58 mg/kg/12 hr) to achieve similar steady-state phenobarbital plasma concentrations after chronic oral administration in all three groups of rats. Steady-state phenobarbital clearance values were not significantly different from clearance values after single dose administration in each group of rats. The dramatic intra- and inter-strain alterations in phenobarbital disposition demonstrated in this study explain the high mortality reported in Zucker rats after administration of traditional enzyme induction doses of phenobarbital. Differences in phenobarbital disposition should be considered in enzyme induction studies. PMID- 6502517 TI - Porcine systemic and regional organ blood flow during 1.0 and 1.5 minimum alveolar concentrations of sevoflurane anesthesia without and with 50% nitrous oxide. AB - Effects of sevoflurane anesthesia on organ blood flow were examined in nine healthy isocapnic pigs using 15-mumol diameter radionuclide-labeled microspheres that were injected into the left atrium. Minimum alveolar concentration (MAC) of sevoflurane required to prevent 50% of the pigs from responding by gross purposeful movement to a noxious stimulus was found to be 2.66 +/- 0.20%. Hemodynamic measurements were made on each pig during the following five conditions: awake (control); 1.0 MAC of sevoflurane anesthesia; 2.66% (1.0 MAC) sevoflurane + 50% N2O anesthesia; 1.5 MAC of sevoflurane anesthesia; and 3.99% (1.5 MAC) sevoflurane + 50% N2O anesthesia. Dose-related decrease in cardiac output, mean aortic pressure and left ventricular work occurred with sevoflurane anesthesia but heart rate was unchanged. Addition of 50% N2O to either of the pre established sevoflurane concentrations did not change heart rate or the cardiac output, but with 3.99% sevoflurane mean aortic pressure decreased further. Unlike isoflurane and halothane which increase porcine brain blood flow, cerebral blood flow decreased to a similar level with both levels of sevoflurane anesthesia. Whereas cerebellar perfusion was unaltered with both levels of sevoflurane anesthesia, brain-stem blood flow decreased to a similar level from the control value. However, during 3.99% sevoflurane anesthesia, brain-stem blood flow exceeded that at 2.66% sevoflurane anesthesia. Addition of N2O to pre-established concentrations of sevoflurane increased regional brain blood flow but cerebral and brain-stem blood flow exceeded awake value only during 2.66% sevoflurane + 50% N2O anesthesia. Transmural myocardial blood flow decreased in a dose dependent manner during sevoflurane anesthesia but the subendocardial/subepicardial perfusion ratio remained at control value.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502519 TI - Phenobarbital in the genetically obese Zucker rat. II. In vivo and in vitro assessments of microsomal enzyme induction. AB - In vivo and in vitro alterations in drug metabolism and the extent of enzyme induction of the hepatic microsomal cytochrome P-450 system were evaluated in obese and lean Zucker and lean Sprague-Dawley rats. Phenobarbital enzyme-inducing regimens were administered p.o. to achieve similar steady-state phenobarbital plasma concentrations. Control rats received p.o. placebo solution. No significant intra- or inter-strain differences in antipyrine clearance (milliliters per hour) or apparent volume of distribution (liters) were observed between the placebo-treated lean Sprague-Dawley, lean Zucker and obese Zucker rats. Intra- and inter-strain differences in hepatic microsomal protein and cytochrome P-450 content were observed. Compared to placebo, antipyrine clearance (milliliters per hour) after chronic phenobarbital pretreatment was increased in the Sprague-Dawley (198%) and lean Zucker rats (131%), but not significantly altered in the obese Zucker rats. Similarly, increases in hepatic weight, whole liver microsomal protein and cytochrome P-450 content were also observed in the Sprague-Dawley (34, 124 and 352%, respectively) and the lean Zucker rats (24, 96 and 249%, respectively). However, no significant alterations in these parameters were observed in the obese Zucker rats after phenobarbital treatment. Results from these in vivo and in vitro studies implicate alterations in drug metabolism and genetic differences in cytochrome P-450 content in Zucker rats relative to the Sprague-Dawley strain. Obese Zucker rats failed to exhibit a significant induction response after phenobarbital pretreatment. PMID- 6502520 TI - Inhibitory effect of unconjugated bile acids on the enterohepatic circulation of methotrexate. AB - The effect of unconjugated cholic and deoxycholic acids on intestinal and hepatic transport and bile secretion of methotrexate was studied using everted sacs of rat proximal jejunum and isolated perfused rat liver. Cholic and deoxycholic acids competitively inhibit the mucosal-to-serosal transport of methotrexate (Ki, 0.08 and 0.06 mM, respectively). Cholic and deoxycholic acids also decrease intestinal tissue content of methotrexate in a concentration-dependent manner. Structural and functional damage to the intestinal mucosa does not occur in tissue treated with 0.1 mM and lower concentration of deoxycholic acid as assessed by histological studies, transmural potential difference measurements and the release of the cytoplasmic marker enzyme, lactate dehydrogenase. In the isolated liver, cholic and deoxycholic acids inhibit the uptake, retention and biliary secretion of methotrexate. At 1 mM cholic and deoxycholic acids, 72 and 80% inhibition in liver uptake and 93 and 99% inhibition in bile secretion of 1 microM methotrexate are observed, respectively. These studies demonstrate that unconjugated bile acids inhibit the enterohepatic circulation of methotrexate by impairing its intestinal transport and hepatic uptake and retention and biliary secretion. PMID- 6502521 TI - Behavioral effects of caffeine, N6-(L-phenylisopropyl) adenosine and their combination in the squirrel monkey. AB - The behavioral effects of caffeine, N6-(L-phenylisopropyl)adenosine (PIA) and the two drugs in combination were studied in squirrel monkeys. Monkeys responded by pressing a lever under different schedules of reinforcement involving either food or electric shock. The effects of caffeine depended primarily on the type of schedule that controlled responding and were largely independent of the type of consequent event. When responding was maintained at high rates under fixed-ratio schedules of either food presentation or stimulus-shock termination, caffeine (1 56 mg/kg) typically decreased responding in a dose-dependent manner. When responding was maintained at moderate rates under fixed-interval schedules involving either event, intermediate doses of caffeine (3-10 mg/kg) slightly increased responding, whereas higher doses decreased responding. When responding was maintained under a fixed-interval schedule of stimulus-shock termination and concurrently suppressed by response-produced shock, intermediate doses of caffeine (3-30 mg/kg) markedly increased responding. PIA (0.03-1 mg/kg) only decreased responding under all schedules. Caffeine (1-30 mg/kg) antagonized the rate-decreasing effects of PIA under each schedule. PIA (0.03-1 mg/kg) reduced or eliminated the rate-increasing effects of intermediate doses of caffeine under the fixed-interval schedules but did not attenuate the rate-decreasing of high doses of caffeine under any schedule. Thus, the rate-increasing and rate decreasing effects of caffeine differed in their susceptibility to modification by PIA. PMID- 6502522 TI - Possible role of calmodulin in the control of lysosomal enzyme release from human polymorphonuclear leukocytes. AB - Human polymorphonuclear leukocytes (PMNs) were found to contain a mean +/- S.E.M. of 21.7 +/- 7.9 ng of immunoreactive calmodulin (CaM)/10(6) PMNs, which represents 0.032 +/- 0.001% of the total cellular protein. The functional role of CaM in the control of lysosomal enzyme release from human PMNs was investigated using several CaM antagonists. Trifluoperazine (TFP) (10(-6)-2 X 10(-5) M), pimozide (10(-6)-1.5 X 10(-5) M), chlorpromazine (CPZ) (10(-5)-10(-4) M) and promethazine (2 X 10(-5)-10(-4) M) inhibited in vitro lysosomal enzyme release from human PMNs induced by immunological (serum-treated zymosan, concanavalin A and formyl-L-methionyl-L-leucyl-L-phenylalanine) and nonimmunological (Ca++ ionophore A23187) stimuli. Trifluoperazine sulfoxide (TFP-S) and chlorpromazine sulfoxide (CPZ-S), which have very low affinity for CaM, had practically no inhibitory effect on lysosomal enzyme release. The inhibitory effect of TFP could be made irreversible by irradiating the cells with UV light. A sulfonamide derivative, W-7, N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (10(-5)-2 X 10(-4) M), which selectively binds to CaM, inhibited the release of lysosomal enzymes from PMNs. In contrast, the chloride-deficient analog, W-5, N (6-aminohexyl)-1-naphthalenesulfonamide hydrochloride, which interacts only weakly with CaM, had practically no inhibiting effect. The IC50 for enzyme release by a series of eight CaM antagonists was closely correlated (r = 0.89; P less than .001) with their affinity for binding to CaM, supporting the concept that these agents act by binding to CaM and thereby inhibiting lysosomal enzyme release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502523 TI - Neonatal exposure to cadmium alters the responses of the hepatic monooxygenases to phenobarbital and to cadmium in adult male rats. AB - The effects of a single dose of Cd (1.27 mg/kg), within 6 hr of birth, on the hepatic monooxygenase system of the immature and the adult rat were investigated. Cd, administered neonatally, affected neither the basal enzymatic activities nor the levels of the electron transport components in either 8- or 60-day-old rats. However, it increased the loss of cytochrome P450 (by 28%) and elevated the inhibition of both ethylmorphine demethylase (by 28%) and aniline hydroxylase (by 32%) beyond that caused by Cd (1.27 mg/kg) administered to the 60-day-old adult. The greater inhibition of the demethylase and the hydroxylase in the rats (pre )treated at birth was abolished when the activities were expressed per nanomole of cytochrome P450. This suggests that the increased sensitivity of Cd resides in the cytochrome P450. The decrease in the activity of NADPH cytochrome c reductase caused by treating 60-day-old rats with Cd was not affected by a previous exposure to Cd in the neonatal period. Similarly, compared to normal controls, Cd given neonatally did not alter the induction of aniline hydroxylase by phenobarbital (50 mg/kg/day/4 days) in the 60-day-old rat. However, the induction responses of cytochrome P450 and the reductase were attenuated 19 and 14% while those of ethylmorphine demethylase and hexobarbital hydroxylase were decreased by 28 and 17%. The activities of the latter two enzymes did not differ between control and cadmium groups when expressed either in terms of cytochrome P450 or NADPH cytochrome c reductase. This suggests that neonatally administered Cd depresses their induction through the cytochrome and/or the reductase. PMID- 6502524 TI - Biodegradable microspheres. I. Duration of action of dextranase entrapped in polyacrylstarch microparticles in vivo. AB - Dextranase was entrapped in polyacryl starch microspheres of different compositions by emulsion polymerization. After i.v. injection in mice and rats, the particles were removed from the blood circulation by macrophages of the reticuloendothelial system. In these cells, the particles are accumulated in the lysosomes. The degradation of different 14C-labeled microparticles and their entrapped dextranase was followed in an isolated lysosomal fraction in vitro and in liver and spleen after i.v. injection in mice. The duration of entrapped dextranase in vivo was followed directly, i.e., by an enzyme assay, and indirectly by following the decrease of a stored material, [3H]dextran in the liver. The degradation of the entrapped enzyme was dependent on the composition of the particle matrix. More cross-linked spheres could better protect the entrapped enzyme in vitro and in vivo. The half-life of free dextranase in the lysosomal fraction was estimated to be about 4 hr, whereas the duration of entrapped dextranase in the liver was at least 48 hr, as measured with [3H]dextran. Finally, the effect of entrapped and free dextranase on an artificially induced storage disease was studied. The stored [3H]dextran was eliminated completely when dextranase was used in microparticles, whereas free dextranase had no effect in vivo. PMID- 6502525 TI - The 61st annual meeting of the Physiological Society of Japan. Gunma, March 28 30, 1984. Abstracts. PMID- 6502526 TI - Development of Caryospora simplex (Apicomplexa: Eimeriidae) from sporozoites to oocysts in human embryonic lung cell culture. AB - Leighton tubes containing monolayers of human embryonic lung cells were inoculated with 70,000 or 30,000 sporozoites of the viperid coccidium Caryospora simplex and examined at 1, 2, 4, 6, 8, 10, 12, 14, 16, and 18 days post inoculation (PI). By day 1 PI, sporozoites had penetrated cells and were within parasitophorous vacuoles. Most sporozoites became spherical and then underwent karyokinesis several times between days 2 and 6 PI. Mature Type I meronts were found on days 6-16 PI and contained 8 to 22 short, stout merozoites. Mature Type II meronts were present on days 10-18 PI and contained 8 to 22 long, slender merozoites. Developing gamonts (undifferentiated sexual stages) were observed on days 14 and 16 PI. Mature micro- and macrogametes and thin-walled unsporulated oocysts were present on days 16 and 18 PI. Attempts to sporulate oocysts in tissue culture medium or in a 2.5% (w/v) aqueous solution of K2Cr2O7 at 25 degrees C and 37 degrees C were unsuccessful; only a few oocysts developed to the contracted sporont stage. Four Swiss-Webster mice injected intraperitoneally with merozoites obtained from Leighton tubes on day 10 PI did not acquire infections. This is the second coccidium reported to complete its entire development, from sporozoite to oocyst, in cell culture. PMID- 6502527 TI - New observations on gametogenesis, fertilization, and zygote transformation in Plasmodium gallinaceum. AB - The ultrastructure of the sexual stages of Plasmodium gallinaceum during gametogenesis, fertilization, and early zygote transformation is described. New observations are made regarding the parasitophorous vacuole (PV) of gametocytes and the process of emergence in male and female gametocytes. Whereas female gametocytes readily disrupted both the PV membrane and host cell plasmalemma during emergence, male gametocytes frequently failed to break down the plasmalemma of the host cell. New observations and hypotheses are presented on the behavior of the male gamete nucleus. Following fertilization, the male nucleus appears to travel through a channel of endoplasmic reticulum in the female gamete before fusing with the female nucleus at a region in which the nuclear envelope is thrown into extensive convoluted folds. Polarization of the zygote nucleus, in association with the appearance of a perinuclear spindle of cytoplasmic microtubules, preceded all other changes in the developing zygote. After nuclear polarization becomes apparent, electron-dense material is deposited beneath the zygote pellicle, and a canopy is formed which eventually extends over the entire apical end of the developing ookinete. As the apical end begins to extend outward, polar rings, micronemes, and subpellicular microtubules become visible in this portion and a "virus-like" inclusion known as a crystalloid is formed in the posterior portion of the zygote. When female gametes are prevented from being fertilized, the cytoplasm at 24h after gametogenesis is devoid of most of those organelles found in the developing zygote or the mature ookinete. The cell is surrounded only by a single membrane. Although at various points beneath the membrane there are deposits of electron-dense material reminiscent of those deposited in the zygote, no further development of ookinete structures takes place in the unfertilized female gamete. PMID- 6502528 TI - Trypanosoma lucknowi, a new species of trypanosome from Macaca mulatta with observations on its fine structure. AB - Trypanosoma lucknowi n. sp. was isolated in culture from one of 126 Macaca mulatta originating from the vicinity of Lucknow, Uttar Pradesh, India. Trypanosoma lucknowi is distinctive because of the large number of epimastigotes and trypomastigotes which, in culture, exhibit no movement or only a slight bending of the flagellar end. This limited motility coincides with a free flagellum which is either completely absent or rudimentary. The microorganism is cloned readily, and the description is based upon such cultures. Trypanosoma lucknowi shows pronounced differences from other trypanosomes of South Asian macaques and from "aflagellar" African trypanosomes. The ultrastructural demonstration of a cytostome and contractile vacuole suggests ultimate grouping with stercorarian trypanosomes. A 3-D reconstruction of the flagellar pocket/cytostome region is included. PMID- 6502529 TI - Regulatory devices in metabolism and medicine. The Humphry Davy Rolleston lecture 1983. PMID- 6502530 TI - Clinical pharmacology in practice. PMID- 6502531 TI - The inadequacies of information on current drug therapy in out-patients' records. PMID- 6502532 TI - Ethnic minorities and health. PMID- 6502533 TI - Cancer in blacks, whites and Asians in a British hospital. PMID- 6502534 TI - The autopsy, past and present. PMID- 6502535 TI - The autopsy and clinical diagnosis. PMID- 6502537 TI - Immediate reconstruction following maxillectomy. PMID- 6502536 TI - Sleep apnoea in myxoedema. PMID- 6502538 TI - Residual forefoot adduction in treated congenital talipes equinovarus. PMID- 6502539 TI - Cryosurgery for ingrowing toenail. PMID- 6502540 TI - Duodenal tuberculosis. PMID- 6502541 TI - Biliary complications of hepatic hydatid disease. PMID- 6502542 TI - Glucagon in operative cholangiography. PMID- 6502543 TI - Antibiotic peritoneal lavage in childhood appendicitis. PMID- 6502544 TI - A needle for transbronchial aspiration cytology. PMID- 6502545 TI - A modified bone clamp. PMID- 6502546 TI - Abdominal cystic hygroma. PMID- 6502547 TI - Meconium ileus equivalent. PMID- 6502548 TI - An audiometric survey of Royal Artillery gun crews following "Operation Corporate". AB - An Audiometric Survey was carried out on two batteries of 4 Fd Regt RA (n-84) who were exposed to massive levels of impulse noise during "OP CORPORATE". A control group (n-30) was obtained from the remaining battery which did not serve in the Falklands, and it was matched well in age, service and job. They completed a questionnaire, were physically examined and had an audiogram using the MAICO M26 computer audiometer. Results were related to PULHEEMS standards and compared. No subject in the control group was classed below H2 but in those exposed, 17 were H3 or worse. This is significant (p 0.01 for 1 df) but the significance is attenuated medically and statistically. No significant correlation was found between type of ear defender and degree of protection. The survey showed that sufficient numbers had been affected to necessitate a full examination of all troops who fought in East Falkland. PMID- 6502549 TI - Army amputees from the Falklands--review. PMID- 6502550 TI - Medical training for peace and war. PMID- 6502551 TI - First and second line treatment in the Falklands Campaign. A retrospective view. PMID- 6502552 TI - Operation corporate--the Sir Galahad bombing. Woolwich Burns Unit experience. AB - During Military Operations in the South Atlantic to recover the Falkland Islands in 1982, the troopship Sir Galahad was bombed. Initial treatment of the injured in field medical units was followed by transfer to the hospital ship SS Uganda and evacuation to the United Kingdom where 48 patients were treated in the Burns and Plastics Unit, Queen Elizabeth Military Hospital, Woolwich. The treatment of these patients is described and the management of war burns discussed. PMID- 6502553 TI - Sepsis in soft tissue limbs wounds in soldiers injured during the Falklands Campaign 1982. AB - The factors related to the development of sepsis in the soft tissue limb injuries sustained by soldiers during the Falklands Campaign have been assessed. Delay in surgery and delay in antibiotic administration are the most important factors, and where delay in surgery is inevitable, delay in antibiotic administration assumes an even greater importance. PMID- 6502554 TI - The psychologist's contribution to primary care: a reappraisal. AB - Developments over the past few years necessitate a reappraisal of the way in which clinical psychologists can best contribute to primary care. Up until now, psychologists have concentrated on those problems which are their concern within psychiatric hospitals. In addition, they have largely adopted a specialist model of service which may not be in the best interests either of primary care or of clinical psychology. If their manner of working is to change, it will be important for psychologists to overcome the developing stereotype of their role. This might involve explicitly negotiating project-orientated commitments which respond to particular priorities in different settings. PMID- 6502556 TI - The general practitioner in the inner city: a survey of a London health district. AB - A survey of general practitioners in Tower Hamlets health district in London is reported. The findings indicate a caring and concerned group of doctors who are working under considerable difficulty. The pattern of general practice in this district is dissimilar to the rest of the country, with infrequent use of attached staff, poor accommodation, more single-handed practices, and a predominance of elderly doctors trained overseas and either approaching or beyond conventional retirement age. Some suggestions are made towards the future development of the family doctor service. PMID- 6502555 TI - General practitioner's care of the elderly: studies of aspects of workload. AB - This paper reports trends in the volume and nature of general practitioners' contacts with the elderly patients on their NHS lists in Dundee during the 1970s. It forms part of a larger project involving 32 general practitioners collaborating in a continuing study concerning the introduction of the first health centre in Dundee.During the decade contacts with the elderly increased as a proportion of the general practitioners' total work, broadly commensurate with the increase in Dundee's elderly population. Indirect contacts, mainly reissue of prescriptions for longterm medication, showed a greater proportional increase than direct consultations. Home visiting of the elderly remained relatively constant, while house calls to other age groups declined. Hospital referrals remained a small proportion of the general practitioners' work. Entry into a health centre was not associated with obvious changes in patterns of workload.If more might be done in planning and implementing changes in care of the elderly at general practice level, such changes should be the result of consensus among the professionals concerned, and should take account of the views of recipients of care. PMID- 6502557 TI - The importance of tuberculin retesting in the adult community at risk. AB - Tuberculosis immunization status was assessed in 2,501 individuals seeking employment in a district general hospital between January 1979 and December 1981. For 587 (23 per cent) of the employment seekers there was no evidence of BCG vaccination and nor were any of them aware of having had a tuberculin skin test at school. Tuberculin skin tests (Heaf's test) on these 587 individuals showed no reaction in 163 (28 per cent) and a strong (grade 4) reaction in 50 individuals. Only five of the individuals with grade 4 reaction to Heaf's test needed chemotherapy. During the same period, 43 patients with tuberculosis were in contact with 1,568 members of the hospitals's staff.The management of occupational contact is described and the need to rescreen the population at risk is discussed. PMID- 6502558 TI - Compiling a practice disease register--the prevalence of incidental problems. AB - This paper presents the results of a five-year survey in a general practice of the annual incidence and prevalence rates of selected major chronic medical problems presented to, and recognized by, the family doctors. These rates are compared with figures from the second national morbidity survey, 1970-71. The difficulties of defining some of these diseases accurately and of avoiding systematic errors in morbidity recordings are also discussed. PMID- 6502559 TI - Psychotropic drug prescribing. AB - This study was based on the recording of psychotropic drug prescribing over two weeks by 269 doctors using practice activity analysis (PAA) data sheets. The overall mean rates for patients receiving one or more psychotropic drugs were 17.5 per 1,000 list size and 130 per 1,000 consultations; and for prescriptions issued the rates were 20.6 per 1,000 list size and 153 per 1,000 consultations. Recorders were classified into five categories ;low' to ;high', by the volume of prescribing and this paper is concerned with the comparison between them. Between the high and low categories there was a twofold difference in the prescribing of new prescriptions, a fourfold difference for continuing prescriptions and a tenfold difference for repeat prescriptions; 51 per cent of all prescriptions were issued as ;repeats'.Other features of prescribing have been studied in each of the categories. Prescribing rates vary little with workload. Increasing trends are evident from the low to high categories for the use of polytherapy and for the proportion of elderly persons who received prescriptions; the proportion of male patients (28 per cent) was consistent in all categories. The relative proportion of prescriptions by drug group (tranquillizers, antidepressants and hypnotics) was reasonably uniform in all categories. PMID- 6502560 TI - Chronic or recurrent cough in children--a presentation of asthma? AB - Thirty-five children between the ages of one year and 11 years who presented with chronic or recurring cough over a two-year period were treated for asthma. They were given bronchodilator syrup for a trial period of one month. All the children improved symptomatically.It is suggested that any child with a persistent cough or recurring cough should be given bronchodilator syrup even in the absence of wheeze and particularly when there is a family history of asthma. This might result in the early diagnosis of unrecognized asthma and help to reduce the amount of unnecessary antibiotics and cough linctus that these children receive. PMID- 6502561 TI - Change the rules for clinical trials in general practice. PMID- 6502562 TI - General practitioners and terminal care--the future. PMID- 6502563 TI - Practising prevention: sport for all. PMID- 6502565 TI - Open University course--topics in drug therapy. PMID- 6502564 TI - The place of the day release course in vocational training. PMID- 6502566 TI - Smoking and malignant disease: a general practice study. AB - This study, involving a practice population of 7,200 patients, compared the smoking habits of patients suffering from malignant disease (excluding skin cancer) with the smoking habits of controls matched for age and sex. Patients with malignancies were found to smoke more heavily than their controls; this difference was particularly marked between the younger patients and their controls. Data on the most prevalent malignancies (carcinomata of the breast, cervix, rectum, colon and bladder) revealed that this tendency to heavier smoking was more marked in patients with neoplasia of cervix or bladder than in patients with breast or colorectal neoplasms. The age of these patients at diagnosis was reviewed in relation to smoking habits. Although the numbers were small, it appeared that patients who smoke present at an earlier age than non-smokers, except in cases of neoplasia of the cervix.These results seem to justify further general practice studies into the links between smoking and malignant disease. PMID- 6502567 TI - Contraceptive attitudes and practice in women choosing sterilization. PMID- 6502568 TI - Response of patients and doctors to the 1983 'pill scare'. AB - The immediate response of patients and doctors to the recent adverse publicity about the combined oral contraceptive ;Pill' were studied in two separate locations: a major family planning clinic and a large provincial health centre. Consultations arising from anxiety about the Pill were less than the general practitioners had anticipated but extra sessions were required at the family planning clinic to cope with the increased demand. Differences in the responses of doctors were observed both within and between the two locations. Doctors at the family planning clinic were more likely to change the brand of Pill, whereas doctors at the health centre were more likely to offer reassurance only. The respective roles of primary care teams and family planning clinics in the provision of a comprehensive contraception service to the community are discussed. PMID- 6502569 TI - Episiotomy: who gets one and why. AB - Data was collected about the mother, the infant and the pregnancy in women who had an episiotomy performed at delivery, and those who did not, in one district hospital and two community hospitals. Factors predisposing mothers to episiotomy were sought and compared in the different hospitals. Traditional indications for episiotomy, such as a large baby and a small mother, were found to be less important than the occurrence of fetal distress, prolongation of the second stage of labour and the presence of pupil midwives at delivery. Current practice in the use of episiotomy is discussed. PMID- 6502570 TI - The reactions of patients to a video camera in the consulting room. AB - In a general practice survey of reactions to the presence of a video camera in the consulting room 13 per cent of patients refused to be filmed, and 11 per cent of those who did consent disapproved of recording. Patients were more willing to express their reservations about video recording if asked to fill in a questionnaire later at home rather than immediately at the surgery. Patients with anxiety, depression, or problems relating to the breasts or reproductive system were more likely to withhold consent. Patients were less likely to refuse video recording of their consultation if they were asked by the doctor for their verbal permission as they entered the consulting room rather then if they were asked to sign a consent form. Only a small minority of the patients who refused to be filmed felt that this refusal had affected their consultation with the doctor. PMID- 6502571 TI - Latest views on pill prescribing. PMID- 6502572 TI - A survey of psychiatrists in primary care: the silent growth of a new service. PMID- 6502573 TI - Death certificates in Jerusalem: sources of information about cause of death. PMID- 6502574 TI - Ultrasound therapy for herpes zoster pain. PMID- 6502575 TI - Monoclonal antibodies to human sperm antigens--II. AB - As part of our continuous effort to elucidate the biochemical and immunological nature of human sperm surface antigens, monoclonal antibodies to human spermatozoa were generated by improved hybridoma techniques. Following immunizations with the membrane fraction of human spermatozoa and cell fusions, hybrid cells were cultured in a semi-solid HAT-selection medium to maximize the number of monoclones recovered. Subcultures were made in liquid phase 7 to 10 days after cell fusions by removing colonies from the initial medium. Based on the results of screening by microplate enzyme-linked immunoassay, 143 of 552 initial clones were found to secrete antibodies to human sperm antigens. More than one-hundred independently derived hybrid cell lines were established. Using indirect immunofluorescent procedures, 62 cell lines were shown to produce antibodies to surface antigens of human spermatozoa. Unique sperm antigens that react with monoclonal antibodies were identified by the SDS gel/protein blot radioimmunobinding method. Sperm agglutinating and immobilizing antibodies were exhibited by 4 and 15 hybrid cell lines, respectively. Fourteen of the monoclonal antibodies also exhibited cross-reactivity with methanol-fixed sperm cells of the rabbit or mouse or both whereas a reaction was not seen with viable sperm of these species. Generation of monoclonal antibodies against a wide spectrum of human sperm antigens should facilitate future investigations regarding immunologic-associated human infertility and fertility control. PMID- 6502576 TI - In search of early pregnancy factor: characterisation of active polypeptides isolated from pregnant ewes' sera. AB - Further biochemical characterisations of the 20 kd and 67 kd EPF active polypeptides from pregnant ewes' sera are described. Both polypeptides are shown to possess compact, disulphide linked domains which are almost totally resistant to proteolytic attack without prior reduction. In contrast to previous reports on the influence of ammonium sulphate on the expression of EPF activity, neither the biochemical nor the activity characteristics of either polypeptide is changed by ammonium sulphate fractionation. In addition, direct comparative studies have been performed which clearly distinguish the EPF active polypeptides from the known ovine hormones, prolactin, placental lactogen and growth hormone. PMID- 6502577 TI - Menorrhagia. A symposium. PMID- 6502578 TI - Muscle innervation of the gut: structure and pathology. PMID- 6502580 TI - Psychiatry for all. PMID- 6502579 TI - Embolizing techniques in urology. PMID- 6502581 TI - Computed tomographic scanning in rectal carcinoma. AB - Computed tomographic (CT) scanning has been used to assess the extent of local spread in 85 patients with rectal carcinoma. In 37 patients with carcinoma of the rectum who were scanned before surgery, good correlation was found between the extent of local invasion, as assessed by scanning, and that demonstrated at operation by histological assessment. Scanning is not a reliable method for assessing regional lymph node involvement. Forty-eight patients presented with recurrent rectal carcinoma after previous rectal excision (30 patients after abdominoperineal and 18 patients after anterior resection). CT scanning was shown to be a valuable tool in establishing the diagnosis of recurrent tumour. Most of these patients have spread which precludes further curative surgery. CT may identify those patients who have a resectable recurrence, but is especially valuable in planning radiotherapy which may be used for palliation. PMID- 6502582 TI - Cardiopulmonary resuscitation: a survey of standards among junior hospital doctors. AB - The theoretical knowledge of cardiopulmonary resuscitation of 50 junior hospital doctors was examined, and an attempt made to assess their practical ability to manage a collapsed patient. Major defects were found in both the doctors' theoretical knowledge and their practical abilities. Only 8% were able to manage a cardiopulmonary arrest adequately. Suggestions are made as to how standards might be improved. PMID- 6502583 TI - Psychological factors in recovery from myocardial infarction: preliminary communication. AB - A small consecutive series of 27 myocardial infarction patients were interviewed at approximately 10 and 40 weeks after infarction to obtain data concerning the psychological aspects of rehabilitation. The results emphasized the need for consistency in imparting information and advice, and suggested the value of joint cardiological and clinical psychological assessment where patients fail to make expected progress. They pointed to a simple framework for intervention which is capable of further development and evaluation. PMID- 6502584 TI - Pesticide residues in food--a toxicological view: discussion paper. PMID- 6502585 TI - Exertional angio-oedema. PMID- 6502586 TI - Fatal accidental ingestion of Clinitest in adult. PMID- 6502588 TI - Dental education in Portugal. PMID- 6502587 TI - Penile ulcer in Crohn's disease. PMID- 6502589 TI - Synthesis and antifungal activity of (E)-N-(6,6-dimethyl-2-hepten-4-ynyl)-N methyl-1-naphtha lenemethanamine (SF 86-327) and related allylamine derivatives with enhanced oral activity. AB - The allylamine derivatives are a new class of synthetic antifungal agents inhibiting fungal squalene epoxidase. A new subclass, which features an acetylene group conjugated with the allylamine double bond, is characterized by enhanced antifungal activity, especially on oral treatment of guinea pig dermatophytoses. Increased branching of the alkyl group next to the triple bond led to the tert butylacetylene derivative SF 86-327, a compound with strikingly increased activity in vitro and in vivo, which is now under clinical evaluation. Versatile synthetic routes, comparative biological data, and structure--activity relationships are presented. PMID- 6502590 TI - Synthesis and evaluation of furan, thiophene, and azole bis[(carbamoyloxy)methyl] derivatives as potential antineoplastic agents. AB - A series of bis(hydroxymethyl)-substituted heterocycles were synthesized and converted to the corresponding bis(methylcarbamate) derivatives. The heterocyclic systems studied were based on 2-phenyl-3-methylfuran (2-4), 1-phenylpyrazole (5 7), 1-phenyl-5-methylpyrazole (9-11), 1-phenyl-5-methylthiophene (13), 1-phenyl 1,2,3-triazole (14), 3-phenylisoxazole (15), 3-phenylisothiazole (16), 2 phenylthiazole (17), and 2-phenyloxazole (18). None of the bis(carbamates) prepared was active against murine P388 lymphocytic leukemia. Pyrrole bis(carbamates) 20 and 21, which exhibited antileukemic activity, also showed reactivity toward 4-(p-nitrobenzyl)pyridine while the inactive bis(carbamates) were unreactive in the 4-(p-nitrobenzyl)pyridine assay. PMID- 6502591 TI - [(Aminomethyl)aryloxy]acetic acid esters. A new class of high-ceiling diuretics. 1. Effects of nitrogen and aromatic nuclear substitution. AB - A series of Mannich bases and aminomethyl derivatives of ethyl [2,3-dichloro-4-(4 hydroxybenzoyl)phenoxy]acetate were synthesized and tested for saluretic and diuretic activities. The effects of nitrogen and aromatic nuclear substitution, reorientation of the aminomethyl group relative to that of the phenolic hydroxyl group, and replacement of either the phenolic hydroxyl or the aminomethyl group by other functional groups are described. Ethyl [2,3-dichloro-4-[3-(aminomethyl) 4-hydroxybenzoyl]phenoxy]acetate (27) was found to be a very potent, high-ceiling diuretic. PMID- 6502593 TI - Novel pyrimidine and 1,3,5-triazine hypolipidemic agents. AB - New compounds were synthesized by changing the substituents of a trisubstituted pyrimidine, i.e., [[4-chloro-6-[(2,3-dimethylphenyl)amino]-2-pyrimidinyl]thio] acetic acid, a potent hypolipidemic agent, impaired, however, by a marked hepatomegaly-inducing effect. The structural variations led to the subsidence (14b, i.e., 4-chloro-2-(dimethylamino)-6-[(2,3-dimethylphenyl)amino]pyrimidine) or to the reduction (18b, [[4-chloro-6-[(2,3-dimethylphenyl)amino]-2 pyrimidinyl]amino] acetic acid) of said untoward effect but still maintained the hypolipidemic effect that, although markedly decreased, still proves significant for serum cholesterol and triglycerides (18b) or for serum triglycerides only (14b). PMID- 6502592 TI - [(Aminomethyl)aryloxy]acetic acid esters. A new class of high-ceiling diuretics. 2. Modifications of the oxyacetic side chain. AB - The discovery of high-ceiling natriuretic activity from a series of aminomethyl derivatives of ethyl [2,3-dichloro-4-(4-hydroxybenzoyl)phenoxy]acetate prompted our continued investigation of this new class of (aryloxy)acetic acid diuretics. Systematic alteration of the oxyacetic side chain has shown that the carboxylic acid function is the active species in vivo and that the ethyl ester group serves as a prodrug to enhance oral absorption. Side-chain functional groups that are incapable of generating the carboxylic acid in vivo failed to impart diuretic activity to the target compounds. Additional side-chain modifications including homologation, methyl substitution, and heteroatom replacement are also described. Ring annelation of the oxyacetic side chain to a dihydrobenzofuran-2-carboxylic acid produced compound 32, which displayed the highest level of saluretic activity for this series. PMID- 6502594 TI - Effects of volume and surface property in hydrolysis by acetylcholinesterase. The trimethyl site. AB - beta-Substituted ethyl acetates, XCH2CH2OCOCH3, have been prepared, and their hydrolysis by acetylcholinesterase has been studied. Log of enzymic reactivity, normalized for intrinsic reactivity in hydrolysis by hydroxide, log (kcat/Km)n, rises linearly with increasing refraction volume, MR (or RD25), for substrates with beta-X = H, Cl, Br, CH3CH2, (CH3)2CH, (CH3)2S+, (CH3)3N+, and (CH3)3C. Larger substituents may be accommodated, (CH3)3Si and (CH3CH2)3N+, with no further increase in rate. Substrates with beta-substituents CH3S, CH3S(O), (CH3)3N+(OH), and CH3S(O2) are less reactive than consistent with the relation with MR by factors of 5-40, indicating that hydrophobic surface and desolvation of the substrate--enzyme interface may be necessary for maximum reactivity correlated with MR. Values of log (kcat/Km)n for substrates with beta substituents X = CH3S, Cl, Br, CH3CH2, (CH3)2CH, (CH3)3C, and (CH3)3Si rise linearly with increasing hydrophobicity, pi, but reactivity of substrates with X = (CH3)3N+ and (CH3)2S+ are more reactive than consistent with a relation to pi by factors of 300 and 40 and with X = CH3S(O2), CH3S(O), and (CH3)2N+(OH), by factors of 7-100. Reactivity appears related to (i) volume of the beta substituent and its fit in its subsite, which is trimethyl rather than anionic, and (ii) the hydrophobicity of its surface. PMID- 6502595 TI - Peptide sweeteners. 6. Structural studies on the C-terminal amino acid of L aspartyl dipeptide sweeteners. AB - Stereochemical and structural aspects of the variations in the C-terminal residue of L-aspartyl-L-phenylalanine methyl ester have been investigated. Novel configurational analogues such as L-aspartyl-D-alanine benzyl ester and L aspartyl-D-alpha-aminobutyric acid benzyl ester were found to be sweet. In addition, chiral and achiral alpha, alpha-dialkylglycine and alpha aminocycloalkanecarboxylic acids were incorporated into the dipeptides. The L aspartic acid based dipeptide derivatives of alpha-aminoisobutyric acid methyl ester, alpha-aminocyclopropanecarboxylic acid methyl ester, alpha aminocyclobutanecarboxylic acid methyl ester, and alpha aminocyclopentanecarboxylic acid methyl ester are sweet. Dipeptides with alpha aminocyclohexanecarboxylic acid methyl ester and alpha aminocycloheptanecarboxylic acid methyl ester are bitter, whereas the analogues with alpha-aminocyclooctanecarboxylic acid methyl ester, alpha, alpha diethylglycine methyl ester, and alpha-aminoisobutyric acid benzyl ester are tasteless. Aspects on chirality and effective volume of the C-terminal residue are discussed and correlated with taste. PMID- 6502596 TI - Peptide sweeteners. 7. Taste relationships of trifluoroacetyl-L-aspartylanilides. AB - A series of analogues of trifluoroacetyl-alpha-L-aspartylanilides substituted at various positions on the aromatic ring was synthesized and tasted. The position of the substitution is essential for the nature of the taste response. The results clearly establish the close relationship between sweet and bitter taste for these compounds. Combined electronic and topochemical contributions are discussed. PMID- 6502597 TI - A substituent constant analysis of the interaction of substituted naphthalene monoimides with DNA. AB - In a continuing analysis of substituent effects in intercalator-DNA interactions, an unsubstituted naphthalene monoimide, with a 3-(dimethylamino)propyl group on the imide nitrogen has been prepared along with 3- and 4-nitro- and 3- and 4 amino-substituted derivatives. These derivatives allow an evaluation of the importance of the Hammett substituent constant and of the substituent position on the binding of naphthalene monoimides to DNA. Viscosity and spectrophotometric analyses indicate that all five compounds bind to DNA by intercalation. The 4 nitro compound gives a smaller viscosity increase and binds only approximately one-third as strongly as the 3-nitro derivative. It is postulated that this difference is due to the significant angle that the 4-nitro group makes with the intercalated monoimide ring system. The 3-NO2 group can assume a coplanar configuration with the monoimide ring system, allowing more favorable interactions with DNA base pairs, larger viscosity increases, and stronger binding to DNA. The binding constants of the 3-substituted monoimides are in the order 2 greater than 4 greater than 1 and, thus, do not follow a substituent constant pattern. The Tm values from thermal melting of DNA, on the other hand, are in the order 2 greater than 1 greater than 4, suggesting that the enthalpy contributions are significantly different for the binding of the three compounds to DNA. van't Hoff plots support this finding and indicate that both enthalpy and entropy contribute significantly to the binding free energy of 1 and 2 while the binding of 4 is primarily an enthalpic process. Plots of Tm and 65 degrees C log K values as a function of substituent constant for 1, 2, and 4 are linear. CPK model building studies suggest that 4 can form a hydrogen bond with the 5' diester oxygen of the sugar-phosphate backbone of DNA in an intercalation complex. This would lead to more favorable energetics of binding but a loss of mobility and/or available binding configurations with a resulting enthalpy entropy compensation in the binding free energy of 4. This series of compounds dramatically illustrates the steric and hydrogen bonding complexity that can arise in attempts to design drugs to favorably interact with a DNA intercalation site as a potential bioreceptor. PMID- 6502598 TI - Bulky amine analogues of ketoprofen: potent antiinflammatory agents. AB - Replacement of the carboxyl group of 2-(3-benzoylphenyl)propionic acid (Ketoprofen) with various bulky amines has produced a series of highly active antiinflammatory agents that have reduced intestinal ulcerogenicity and have better therapeutic ratios in the 21-day adjuvant arthritis assay in rats than currently marketed nonsteroidal antiinflammatory drugs. Activity is maintained on reduction of these 2-(3-benzoylphenyl)propyl bulky amines to the corresponding alcohols or methylene analogues, on conversion of the ketone function to a primary amine or oxime, and on introduction of a 4-halo substitutent (Cl or F) on the terminal aromatic ring. Removal of the alpha-CH3 group greatly reduces the antiinflammatory activity of the series. These compounds have been synthesized by the reductive amination of 2-(3-bromophenyl)propionaldehyde with the respective amine followed by lithiation of this product and condensation with the appropriate benzonitrile. PMID- 6502599 TI - Azasteroids as inhibitors of rat prostatic 5 alpha-reductase. AB - A series of A-ring heterocyclic steroids has been prepared and tested for inhibition of rat prostatic steroid 5 alpha-reductase in vitro. Strikingly high inhibitory activity was found with a group of 17 beta-substituted 4-methyl-4-aza 5 alpha-androstan-3-ones. These compounds were prepared from 3-keto-delta 4 precursors by oxidative (O3 or NaIO4-KMnO4) A-ring cleavage followed, in turn, by ring closure with an amine and hydrogenation over platinum catalyst. Other A-ring azasteroids were made by Beckmann rearrangement of oximes of 2-oxo-A-nor, 3-oxo- and 4-oxo-5 alpha-androstanes. An A-nor-2-oxo-3-azasteroid was prepared by oxidative decarbonylation of a precursor 2,3-dioxo-4-azasteroid with m chloroperbenzoic acid. A-ring modifications of the 4-azasteroids included delta 1 unsaturation, 2- and 4-substituents, and 3-carbonyl replacements. Side chains at the 17-position were varied with an emphasis on carboxylate derivatives (salts, esters, and amides). PMID- 6502600 TI - C(2)-Methylation abolishes DA1 dopamine agonist activity of 2-amino-6,7-dihydroxy 1,2,3,4-tetrahydronaphthalene (6,7-ADTN): steric intolerance by the receptor. AB - The synthesis of 2-amino-2-methyl-6,7-dihydroxy-1,2,3,4-tetrahydronaphthalene is reported. This compound did not produce vasodilation in the dog renal artery and was inactive as a DA1-type dopamine agonist. This is in contrast to the 2 nonmethylated homologue 6,7-ADTN, which is a potent DA1 agonist. High-field 1H NMR studies of the O,O-dimethyl ethers for both compounds as their free bases in chloroform-d revealed that the 2-methyl homologue probably exists as a rapidly equilibrating mixture of conformers; it seems likely that it can adopt the active conformation proposed to be required by the dopamine receptor. The lack of activity is therefore attributed to the steric effect of the 2-methyl group, consistent with explanations offered by others that the dopamine receptor cannot tolerate alkylation at the alpha side-chain carbon. PMID- 6502601 TI - N2-(4-Substituted-2,6-dichlorophenyl)-N1,N1-dimethylformamidines as antihypertensive and diuretic agents. AB - The synthesis of a series of N2-[4-[(arylmethyl)amino]-2, 6-dichlorophenyl]-N1,N1 dimethylformamidines that caused marked blood pressure lowering and/or diuresis in spontaneously hypertensive rats (SHR) is reported. Diuretic activity was not always associated with acute antihypertensive activity. Central nervous system effects, most notably sedation, were observed. Compound 9d, which lowered arterial blood pressure 37 mmHg in SHR when dosed at 100 mg/kg, was further evaluated in chronic hypertensive dogs because of apparent minimal CNS effects. A reduction in arterial blood pressure of 32 mmHg at 1.0 mg/kg during a 6-h postdosing interval was observed. This response was unrelated to alpha- or beta adrenergic blockade, angiotensin I antagonism, or neuronal or ganglionic blockade. CNS effects were also observed. PMID- 6502602 TI - A potent multisubstrate analogue inhibitor of human thymidylate synthetase. AB - The synthesis of an 8-deazafolate analogue of the intermediate in the methylation of 2'-deoxyuridylate is described. Alkylation of diethyl 5,6,7,8-tetrahydro-8 deazafolate with 3'-O-acetyl-5-(bromomethyl)-2'-deoxyuridine 5'-[bis (trichlorethyl) phosphate], followed by removal of the trichloroethyl groups with a Zn/Cu couple and mild saponification, gave the target inhibitor N-[4-[[[2-amino 3,4,5,6,7, 8-hexahydro-4-oxo-5-[(2'-deoxyuridin-5-yl)methyl]-pyrido[3,2-d] pyrimidin-6-yl]methyl]amino]benzoyl]-L-glutamic acid 5'-monophosphate. The free nucleoside and the 5'-(methyl phosphate) diester were similarly prepared. Each of these reactions yielded a pair of diastereoisomers about C-6 of the reduced deazafolate in approximately a 1:1 ratio. These diastereoisomeric mixtures were evaluated as inhibitors of thymidylate synthetase derived from human tumor (HeLa) cells. The 5'-monophosphate was a potent inhibitor, competitive with respect to both 2'-deoxyuridylate (Ki = 0.06 microM) and tetrahydrofolate (Ki = 0.25 microM). In contrast, the nucleoside and the nucleotide methyl ester were poorer inhibitors by more than 3 orders of magnitude, attesting to the importance of the anionic function at the nucleoside 5'-position in the affinity of an inhibitor for the enzyme active site. PMID- 6502603 TI - 1-Aryl-3,3-dimethyltriazenes: potential central nervous system active analogues of 5-(3,3-dimethyl-1-triazeno)imidazole-4-carboxamide (DTIC). AB - A series of 19 aryldimethyltriazenes were synthesized as potential central nervous system (CNS) active analogues of 5-(3,3-dimethyl-1-triazeno)imidazole-4 carboxamide (DTIC). The compounds were screened in mice against both intraperitoneally (ip) and intracerebrally (ic) implanted L1210 leukemia. Select compounds were further screened against ic implanted ependymoblastoma, and one compound was additionally screened against ic implanted B16 melanoma. Although several compounds were as effective as DTIC at prolonging the life span of mice bearing ip implanted L1210 leukemia, only 4-(3,3-dimethyl-1-triazeno)benzamide (DTB) and 4-(3,3-dimethyl-1-triazeno)benzoic acid (DTBA) were significantly active against the ic implanted tumor. DTB, unlike DTIC, was equally effective against both the ip and the ic implanted tumor, clearly indicating that it penetrated into the CNS in therapeutic concentration. DTB was also active against ic implanted ependymoblastoma and ic implanted B16 melanoma. Aryldimethyltriazenes, particularly DTB, may have a role in the treatment of tumors metastatic to the CNS. They may also be effective against primary brain tumors. PMID- 6502604 TI - Bis(m-nitrophenyl) and bis(p-nitrophenyl) esters and the phosphorodiamidate of thymidine 5'-phosphate as potential sources of intracellular thymidine 5' phosphate in mouse cells in culture. AB - Thymidine 5'-phosphate (TMP) derivatives with masked phosphate groups were synthesized in tritiated form from [methyl-3H]thymidine. They were of interest as models for 5' nucleotide derivatives that might be able to permeate mammalian cells and then liberate intracellular antimetabolite 5' nucleotides by loss of the masking groups. Mouse L fibroblasts were grown in vitro in the presence of 1 mM 5'-amino-5'-deoxythymidine, which was found to suppress greater than 99% of cellular thymidine kinase activity while inhibiting the rate of cell division by only 30%. The TMP derivatives were less effective than thymidine in labeling the deoxyribonucleic acid (DNA) of the L cells. The labeling was inhibited 95-99% by 5'-amino-5'-deoxythymidine, indicating that it represented incorporation into DNA of [3H]thymidine formed from degradation of the test compounds. No evidence was obtained that the compounds acted as sources of intracellular TMP by cell permeation followed by loss of phosphate blocking groups. Similar studies yielded no evidence that the bis(m-nitrophenyl) ester of TMP produced intracellular TMP by that route in the LM(TK-) strain of L cells that are genetically deficient in thymidine kinase. PMID- 6502605 TI - Folate antagonists. 22. Antimalarial and antibacterial effects of 2,4-diamino-6 quinazolinesulfonamides. AB - The synthesis and antimalarial activity of a series of 2,4-diamino-6 quinazolinesulfonamides (III) is described. Chlorosulfonation of 2,4 quinazolinediamine affords the 6-sulfonyl chloride, which upon treatment with the appropriate amine produces the desired products. Alternatively the sulfonyl chloride could be introduced by diazotization of the corresponding amine followed by treatment with SO2 in the presence of CuCl2. Although substantial antimalarial activity was demonstrated for several members of this class, studies were discontinued in light of the potency of related series. PMID- 6502606 TI - Tetrahydropyrrolo[1,2-a]quinoxalines and tetrahydropyrrolo[1,2-a]pyrido[3,2 a]pyrazines: vascular smooth muscle relaxants and antihypertensive agents. AB - A series of tetrahydropyrrolo[1,2-a]quinoxalines and tetrahydropyrrolo[1,2 a]pyrido[3,2-a]pyrazines were synthesized and tested for their ability to relax K+-depolarized aortic smooth muscle and antihypertensive activity. It was shown that compounds producing the most relaxation of aortic smooth muscle (5-[2,6 dimethoxyphenyl)methyl]-1,2,3,3a-tetrahydropyrrolo[1,2-a] quinoxalin-4(5H)-one and 5-[(2,6-dimethoxyphenyl)methyl]-5,6,6a,7,8,9-hexahydropyrrolo[1,2- a] pyrazine, 10 and 19, respectively) demonstrated the least hypotensive activity. Those compounds that were the most effective hypotensive agents (6a,7,8,9 tetrahydro-5-(phenylmethyl)pyrido[3,2-a]pyrrolo[1,2-a]++ +pyrazin- 6(5H)-one and 6a,7,8,9-tetrahydro-5-(4-pyridinylmethyl)pyrido[3,2-e]pyrrolo [1,2-a]pyrazin 6(5H)-one, 12 and 13, respectively) displayed little vascular smooth muscle relaxant activity. PMID- 6502607 TI - Bis(3,5-diisopropylsalicylato)copper(II), a potent radioprotectant with superoxide dismutase mimetic activity. AB - Superoxide disproportionation may partially account for the noteworthy radioprotectant activity of bis(3,5-diisopropylsalicylato)copper(II) [CuII(3,5 dips)2]. Groups of mice treated with CuII(3,5-dips)2 3 or 24 h before exposure to a lethal dose of gamma-radiation had survival rates of 33% and 58%, respectively. These results suggest that copper complexes might be developed for protection of normal tissues in association with cancer radiotherapy and protection against occupational exposures to hazardous radiation. PMID- 6502608 TI - Synthesis and antitumor activity of tropolone derivatives. AB - Treatment of tropolones with benzaldehyde diethyl acetals gave monotropolone (12) and bistropolone (13) derivatives at the benzylic position, whereas the related 1 ethoxyisochroman and the diethyl acetals of crotonaldehyde and cinnamaldehyde gave only the monotropolone derivatives (5, 10, or 11). The monotropolone derivatives (5, 10, 11, and 12) had poor potency against P388 leukemia in mice, but the bistropolone derivatives (13 and 14) showed significant potency and prolongation of life. PMID- 6502609 TI - The replication of two California serogroup viruses in a cell line from the mosquito Aedes triseriatus (Diptera: Culicidae). PMID- 6502610 TI - Ecdysteroids in the American dog tick, Dermacentor variabilis (Acari: Ixodidae), during different periods of tick development. PMID- 6502611 TI - Studies on Papua New Guinea chiggers (Acari: Trombiculidae). XII. A new species of Gahrliepia from the Long-footed Melomys. PMID- 6502612 TI - Dispersal and gonotrophic age of Culicoides variipennis (Diptera: Ceratopogonidae) at an isolated site in southwestern Virginia, USA. PMID- 6502613 TI - Seasonal dynamics of Ornithodoros (Pavlovskyella) erraticus (Acari: Ixodoidea: Argasidae) and the spirochete Borrelia crocidurae in Egypt. PMID- 6502614 TI - Genetics of speciation in the Aedes (Stegomyia) scutellaris group (Diptera: Culicidae). 3. The genetic relationship of Aedes cooki with Aedes kesseli. PMID- 6502615 TI - Juvenile hormone I effects on the camel tick, Hyalomma dromedarii (Acari: Ixodidae). PMID- 6502616 TI - Dermacentor (Indocentor) atrosignatus (Acari: Ixodoidea: Ixodidae): identity of male and female. PMID- 6502618 TI - Two cases of human myiasis caused by Phaenicia sericata (Diptera: Calliphoridae) in Chicago area hospitals. PMID- 6502617 TI - Induction of apolysis and cuticle formation in female Ornithodoros parkeri (Acari: Argasidae) by hemocoelic injections of beta-ecdysone. PMID- 6502619 TI - Comparative studies on the karyotypes of Leptotrombidium deliense, L. fletcheri, and L. arenicola (Acari: Trombiculidae). PMID- 6502620 TI - The tergal pigmentation patterns of Culicoides variipennis and Culicoides furens (Diptera: Ceratopogonidae). PMID- 6502621 TI - Identification by electrophoresis of Culex adults (Diptera: Culicidae) in light trap samples. PMID- 6502622 TI - The laboratory biology of the sand fly Lutzomyia anthophora (Diptera: Psychodidae). PMID- 6502623 TI - Evaluation of commercial and experimental repellents against Xenopsylla cheopis (Siphonaptera: Pulicidae). PMID- 6502624 TI - Sequential sampling to determine the minimum number of host examinations required to provide a reliable flea (Siphonaptera) index. PMID- 6502625 TI - Experimental murine typhus infection in the cat flea, Ctenocephalides felis (Siphonaptera: Pulicidae). PMID- 6502626 TI - Follicular development and parity in phlebotomine sand flies (Diptera: Psychodidae). PMID- 6502627 TI - A new species of Gahrliepia (Acari: Trombiculidae) from a Shrew-hedgehog (Insectivora) in China. PMID- 6502628 TI - Efficacy of permethrin as a repellent and toxicant for personal protection against the Pacific Coast tick and the Pajaroello tick (Acari: Ixodidae and Argasidae). PMID- 6502629 TI - Genetic variation in an urban population of Aedes aegypti (Diptera: Culicidae). PMID- 6502630 TI - Identification of arthropod blood meals using rubidium as a marker: a preliminary study. PMID- 6502631 TI - Mosquito engorgement on normally defensive hosts depends on host activity patterns. PMID- 6502632 TI - Ixodes dammini (Acari: Ixodidae) and other ixodid ticks collected from white tailed deer in New Jersey, USA. I. Geographical distribution and its relation to selected environmental and physical factors. PMID- 6502633 TI - Utilitarianism. PMID- 6502635 TI - In defence of situational ethics, the NHS and the permissive society. AB - Dr Adrian Rogers delivers a three-pronged assault on the concepts of 'situational ethics'; the eleemosynary principles underlying the National Health Service, and the permissiveness of modern society. I hold strong, and largely opposite, views on each of these matters, which are outlined in this paper. PMID- 6502634 TI - The restoration of medical ethics. AB - The ethical behaviour of doctors has been influenced by recent social and political changes. This paper discusses some of the changes which may have resulted from two far-reaching changes, a major political change, the nationalisation of medicine in the National Health Service (NHS), and a social change, the establishment of the permissive society. Some of the ethical consequences of these changes which are not considered of benefit to the profession or its patients are discussed. The recognition of these changes and their open debate is now essential so that the restitution of professional standards may take place. PMID- 6502636 TI - The positive aspects of medical ethics today. AB - The author of this comment suggests that some of the important points made by Dr Adrian Rogers are vitiated by a tendency to contrast the worst of modern medical practice with an over-idealised view of the past. The state of medical ethics today, the author suggests, is more hopeful than Dr Rogers allows. PMID- 6502638 TI - Children in care: are social workers abusing their authority? PMID- 6502637 TI - Intended goals and appropriate treatment: an alternative to the ordinary/extraordinary distinction. AB - This article argues that the ordinary/extraordinary distinction has little or no moral value when preservation of life is not given a near absolute status. What is appealed to instead is a determination of both medical and moral duties, upon which appropriate treatment decisions should be based. Included is a partial delineation of those duties. PMID- 6502639 TI - Children in care: are social workers abusing their authority? AB - In reply to Dr Benians's article which suggests that social workers at times abuse their authority, three areas can be considered: the broader context of the social work task, the legal process itself, and the contribution made by child psychiatrists. PMID- 6502640 TI - Patients' ethical obligation for their health. AB - In contemporary medical ethics health is rarely acknowledged to be an ethical obligation. This oversight is due to the preoccupation of most bioethicists with a rationalist, contract model for ethics in which moral obligation is limited to truth-telling and promise-keeping. Such an ethics is poorly suited to medicine because it fails to appreciate that medicine's basis as a moral enterprise is oriented towards health values. A naturalistic model for medical ethics is proposed which builds upon biological and medical values. This perspective clarifies ethical obligations to ourselves and to others for life and health. It provides a normative framework for the doctor-patient relationship within which to formulate medical advice and by which to evaluate patient choice. PMID- 6502641 TI - Why you don't owe it to yourself to seek health. AB - Sider and Clements provide a critical response to my view that there is no independent obligation to seek one's own health. They then argue that such an obligation exists. They are incorrect in their characterisation of my view; their critical discussion of the view they erroneously attribute to me is unconvincing; the positive argument they offer for their own view is unsatisfactory; they misjudge the significance of what is at issue; and they conclude by affirming a position that lacks a due regard for the rights of patients. PMID- 6502642 TI - A rejection of doctors as moral guides. PMID- 6502643 TI - Dignity and cost-effectiveness: a rejection of the utilitarian approach to death. AB - Utilitarianism is commonly assumed to be the most appropriate sub-structure for medical ethics. This view is challenged. It is suggested that the utilitarian approach to euthanasia works against the patient's individual advantage and is a corrupting influence in the relationship between the physician and society. Dignity for the individual patient is not easily achieved by assessing that person's worth against the yardstick of others' needs and wishes. PMID- 6502644 TI - Dignity and cost-effectiveness: analysing the responsibility for decisions in medical ethics. AB - In the operation of a health care system, defining the limits of medical care is the joint responsibility of many parties including clinicians, patients, philosophers and politicians. It is suggested that changes in the potential for prolonging life make it necessary to give doctors guidance which may have to incorporate certain features of utilitarianism, individualism and patient autonomy. PMID- 6502646 TI - Sociobiology. PMID- 6502645 TI - Arresting but misleading phrases. AB - This paper discusses some common misconceptions of what a utilitarian approach to medical ethics is and of the conclusions it forces upon those disposed to accept such an approach. It suggests that broad and unargued characterisations of approaches to moral questions as 'utilitarian', 'Hippocratic' or whatever are likely to be misleading and counterproductive. What matters is not what to call the position that people feel inclined to accept but rather what arguments there are in its favour and what arguments there are against it. PMID- 6502647 TI - Periconceptional vitamin supplementation and the prevention of neural tube defects in south-east England and Northern Ireland. AB - A comparison has been made of the effectiveness of periconceptional vitamin supplementation for the prevention of recurrence of neural tube defects (NTD) in south-east England and Northern Ireland. These areas represent the extremes of birth prevalence of NTD (low and high respectively) within the United Kingdom. Vitamin therapy resulted in a slightly less than two-fold reduction in the recurrence risk in south-east England and a greater than three-fold reduction in Northern Ireland, when compared with unsupplemented women at the same risk from the two areas. It is probable that one of the recurrences in each area did not involve the multifactorial form of NTD and, if these are excluded, then the reduction in recurrence risk with vitamin supplementation is 2.4 times in south east England and 5.4 times in Northern Ireland. Either way, beneficial effects of supplementation are apparent in both areas but are more marked in the high prevalence area. The implications of this for the future are discussed. Two other important findings were that all but one of the recurrences of NTD with full supplementation occurred in male fetuses, and there was a higher than expected occurrence of isolated hydrocephalus in infants or fetuses following full supplementation. PMID- 6502648 TI - The femoral hypoplasia-unusual facies syndrome. AB - A series of thirteen persons with bilateral femoral hypoplasia are presented. Six of these had facial features compatible with a diagnosis of femoral hypoplasia unusual facies syndrome. One was attributable to severe fetal constraint secondary to oligohydramnios, three were associated with maternal diabetes, and two were idiopathic. All thirteen cases were sporadic. PMID- 6502649 TI - Hereditary coproporphyria: incidence in a large English family. AB - In a family inheriting the hereditary coproporphyria (HCP) gene, where 414 descendants have been traced through six generations and 135 members screened for faecal porphyrins, 27 subjects were found to have inherited the gene as well as the proband. Seven (six female and one male) in retrospect had probably previously suffered from a clinical attack of porphyria. Enzymological studies were carried out on 15 members and two unaffected parents and these results in general agreed with the faecal coproporphyrin readings. Symptomatic illness is low in HCP and is almost always precipitated by drugs known to have an adverse effect on the condition. If the gene is inherited, an attack can occur at any time between puberty and old age, such as in the proband at 84 years. We have detected abnormal faecal coproporphyrin levels in members of this pedigree as young as 12 years and as old as 87 years. Recommendations are given concerning the necessity of tracing relatives who may have inherited the gene and arranging for their biochemical screening and genetic counseling if indicated. PMID- 6502650 TI - Genetic heterogeneity in the Freeman-Sheldon syndrome: two adults with probable autosomal recessive inheritance. PMID- 6502651 TI - Parietal foramina in Saethre-Chotzen syndrome. PMID- 6502653 TI - Partial trisomy 16 as a result of familial 16;20 translocation. AB - Although trisomy 16 is well recognised in spontaneous abortuses, it is infrequent in livebirths and there is little information about the clinical effects. We report two sibs with partial trisomy 16q resulting in infant death. Both children were severely growth retarded with small elfin faces, prominent foreheads, low set ears, abnormal external genitalia, and intractable diarrhoea. PMID- 6502654 TI - A malformed girl with duplication of chromosome 9q. AB - A case of a 1 year old girl with a duplication of the long arm of chromosome 9 is described: 46,XX,dir dup(9)(q12----q32). The clinical features of the child are strikingly similar to those of the two cases reported by Turleau et al and Faed et al. The similarity of the abnormalities may help in recognising this syndrome by its characteristic dysmorphic features. PMID- 6502652 TI - A familial insertion involving an active nucleolar organiser within chromosome 12. AB - As far as the authors are aware this is the first report of the insertion of an active NOR into a non-acrocentric chromosome, although a simple translocation involving an active NOR has been previously recorded. More specifically, this case involves the non-reciprocal translocation of the centromere and stalk of an acrocentric into 12p, generating an apparently stable dicentric chromosome. The insertion is seen in three generations and may be relatively genetically benign. The abnormality is fully described by G and sequential C banding, DA/DAPI fluorescence, kinetochore staining, and Ag-NOR staining, and the findings are discussed in the light of the limited published reports of insertion in man. PMID- 6502655 TI - Familial centric fission of chromosome 4. AB - A centric fission of chromosome 4 is described in the proband and his mother, both phenotypically normal. In addition, partial monosomy for the long arm or the short arm or both of chromosome 4 may have been present in two of the proband's sibs who died in infancy and childhood, respectively. PMID- 6502656 TI - Pericentric inversion inv(3)(p11q21). PMID- 6502657 TI - Freeman-Sheldon (whistling face) syndrome in a Turner mosaic. PMID- 6502658 TI - Interstitial deletion of chromosome band 13q14 associated with squamous cell carcinoma. PMID- 6502660 TI - Impact of women and foreign medical graduates on specialty distribution of U.S. house officers. AB - The increase in the number of women and the decline in the number of foreign medical graduates (both foreign- and U.S.-born graduates of medical schools outside the United States) in U.S. medicine are studied by comparing the specialty distributions of U.S. house officers in the 1973-74 and 1979-80 training years. The joint effect of the distribution of sex and foreign versus U.S. medical graduate status on specialty selection is also examined. The results showed that although male and female house officers who were graduates of U.S. medical schools increased in number over the seven-year period, the rate of increase for females was over 12 times as great as the rate for men. By contrast, although male and female house officers who were graduates of foreign medical schools decreased over the same period, the rate of decrease for males was over nine times as great as the rate for women. U.S.-educated men and foreign-educated men had similar distributions across the specialties, whereas U.S.-educated women and foreign-educated women differed not only from each other but also from both groups of men. The specialty selection of foreign-educated females in the 1979-80 training year was especially different from the other three groups. Implications of these data are discussed in the context of the argument that there is a physician surplus. PMID- 6502659 TI - Ring chromosome 1 associated with radial ray defect. PMID- 6502661 TI - Survey of U.S. and Canadian medical schools on admissions and psychiatrically at risk students. AB - A survey of directors of admissions and chairmen of departments of psychiatry in U.S. and Canadian medical schools was undertaken concerning problems of the identification of students with emotional problems prior to admission and the role of psychiatry faculty members on the admissions committee. In general, the respondents felt that the preadmission interview was the best opportunity to identify the at-risk student but that current interview procedures would have to be improved. The respondents also indicated that U.S. law, which prohibits asking questions about psychiatric problems or treatment, is restrictive and greatly reduces the potential effectiveness of the interview. The survey results are compared with the results of earlier surveys. PMID- 6502662 TI - A community medicine clerkship on the Navajo Indian reservation. AB - An elective clerkship in community medicine for medical students has been conducted for 16 years on the Navajo Indian reservation. An important part of the clerkship is a project in which most students select a health problem which they investigate using epidemiological methods of assessment and for which they seek a solution. The requisites for the projects are that real health problems are involved, scientifically sound methods are used, usable information is provided, and data collection can be completed within the clerkship tenure. Topics for the projects are selected jointly by the students and the faculty members from several general subject areas; this allows the work of individual students to be carried out as independent subprojects of larger projects, and this, in turn, produces more information about and has more impact on the problems addressed. Other clerkship objectives also are achieved through investigative projects that may involve students in planning, organization, and evaluation of health care and in public health practice. PMID- 6502663 TI - Assessment by attending physicians of a seminar method to improve clinical teaching. AB - The authors in this article present assessments by attending physicians of a seminar method to improve clinical teaching. An experimental study was conducted to determine whether or not the seminar method (a) is perceived by attending physicians as beneficial, (b) modifies the physicians' attitudes toward teaching, (c) enables attending physicians to define needed teaching changes, (d) motivates them to improve their teaching performance, and (e) is perceived as having long term benefits. Forty-six inpatient attending physicians from four California institutions participated in the study. The physicians were randomly assigned to an experimental group which attended a seminar on clinical teaching or to a control group which received no such intervention. Questionnaires completed by the physicians indicated that the teachers who experienced the seminar method perceived it as beneficial, improved their attitudes toward clinical teaching, determined needed teaching changes, attempted to implement new teaching approaches, and perceived long-term benefits. PMID- 6502664 TI - A comparison of initial diagnostic hypotheses of medical students and internists. AB - Medical students and board-certified general internists were presented with two written clinical simulations and asked to list their initial diagnostic hypotheses. Bronchial asthma and respiratory infection were among the three most frequently listed causes of a sudden shortness of breath in a young male, while malignancy, depression, and thyrotoxicosis were among the six most frequently listed causes of fatigue and loss of weight in a young woman. Junior medical students in the preclinical phase of the curriculum responded with fewer and less specific initial diagnostic hypotheses than did the internists. The number and specificity of the hypotheses advanced by senior medical students, who had completed the medical clerkship, were similar to those of the internists. However, the senior students advanced a wider range of diagnostic possibilities, some of which are rare or virtually nonexistent in the age groups of the patients in the simulations. These findings identify two deficiencies in students' diagnostic problem-solving: (a) lack of familiarity with alternative diagnostic possibilities and (b) poor ability to consider diagnostic hypotheses in terms of probabilities. PMID- 6502665 TI - Assessment of clinical skills in U.S. medical schools. PMID- 6502666 TI - Formal resuscitation training in medical school. PMID- 6502667 TI - The effect of gender and training of residents on satisfaction ratings by patients. PMID- 6502668 TI - A prospective evaluation of performance during the first year of the medical residency. PMID- 6502669 TI - The effects of standardized feedback on orthopedic patient evaluation skills. PMID- 6502670 TI - Protecting the public, the profession, and the applicant. PMID- 6502671 TI - Financial assistance for medical students, 1983-84. PMID- 6502673 TI - Constraints on the development of a new medical device for use in man. PMID- 6502672 TI - Quality assurance for implants in bone surgery. AB - Quality assurance and, wherever possible, the improvement of implants are of very great importance on both health and economic grounds. The technical risk to the patient--who is the final recipient of the implant--must be minimal. This paper describes the various stages in quality assurance during the manufacture of osteosynthesis implants and hip prostheses. PMID- 6502674 TI - The assessment of arteriovenous fistulae created for haemodialysis from pressure and thermal dilution measurements. AB - A technique is described for the assessment of arteriovenous fistulae created for haemodialysis. This involves the measurement of intrafistula pressures and 'useful fistula flow' (UFF). The latter we define as the maximum blood flow available for twin needle haemodialysis without recirculation and without unacceptable pressures in the arterial ('A') and venous ('V') lines. The test circuit resembles that used for conventional haemodialysis except there is 'A' and 'V' line pressure and temperature monitoring and no dialyser. Intrafistula pressures are first measured at the time of insertion of the fistula needles. 'A' and 'V' line pressures are then recorded as the extracorporeal blood flow rate is increased in increments from zero to 500 ml/min. A check for recirculation is made at each flow rate. A bolus of cold saline injected into the 'V' line causes a momentary decrease in 'A' line temperature when recirculation is present; when there is no recirculation, 'A' line temperature remains constant. The blood flow rate at which recirculation is first detected will be above the useful fistula flow by definition. This technique allows identification of those patients who obtain high blood flows at the expense of recirculation and thus dialyse inefficiently. Combined pressure and thermal dilution measurements yield valuable information in the investigation of failing or problem fistulae. PMID- 6502676 TI - Evaluation of infusion pumps: third report--volumetric pumps. PMID- 6502675 TI - A simple insulated cot for neonates. AB - Commercially available transport incubators are sophisticated and expensive since they are designed to provide life support for premature or critically ill neonates. In maternity hospitals with inadequate heating systems, some healthy infants have difficulty maintaining their body temperature in wards and during transfer within the hospital. These babies do not require the sophistication of commercial incubators. We describe a simple insulated cot which meets these requirements at minimal cost. PMID- 6502677 TI - The bactericidal action of human serum on Bacteroides species. AB - Sera obtained from 60 healthy normal subjects were tested for their inhibitory action against four clinical isolates of the Bacteroides fragilis group. All the sera inhibited clinical strains of B. vulgatus and B. ovatus, 92% of 60 sera inhibited B. thetaiotaomicron and 62% inhibited B. fragilis. Bacterial inhibition required components of uninactivated serum and was related to the serum concentrations and species of the bacteria. The viable counts of all the strains, except B. fragilis, were significantly reduced in pooled sera from patients with anaerobic systemic infections and from non-infected patients. The bactericidal activity of the sera from infected patients was more pronounced than that of the 'normal' sera, on all strains except B. fragilis. These observations may explain in part the predominance of B. fragilis in serious clinical infections involving anaerobes. PMID- 6502678 TI - Media for isolation of Aeromonas spp. from faeces. AB - Five solid media were evaluated for isolation of Aeromonas spp. from faeces: desoxycholate citrate agar (DCA), MacConkey's agar (MAC), xylose-desoxycholate citrate agar (XDCA), Rogol's medium (ROG), which contained ampicillin 20 mg/L and p-nitrophenyl-glycerine 25 mg/L as inhibitors, and blood agar (BA) with ampicillin 10 mg/L. False negative oxidase tests limited the usefulness of DCA and MAC and, although the use of XDCA avoided the problem of fermentation of lactose, some Aeromonas spp. failed to grow on XDCA or produced minute colonies unsuitable for oxidase tests. BA yielded the highest rate of isolation for Aeromonas spp. from 323 faecal samples--15.2% for all Aeromonas spp. and 9.3% for enterotoxigenic (ENT+) strains. This compares with 10.8% for all strains and 6.5% for ENT+ strains isolated on DCA, 7.1% for all strains and 4% for ENT+ strains on MAC and 4% for all strains and 1.5% for ENT+ strains on ROG. Blood agar with ampicillin is recommended for isolation of Aeromonas spp. from faeces. PMID- 6502679 TI - Toxic effect of products of oxidative metabolism on the yeast form of Paracoccidioides brasiliensis. AB - The effectiveness of toxic oxygen metabolites in killing the yeast form of Paracoccidioides brasiliensis (the form that occurs in host tissues) was studied with a fluorescence method in vitro. The two isolates studied were similar in susceptibility and H2O2 alone was lethal with an LD50 of 15-25 mM. The addition of halide (5 X 10(-4) M) augmented the lethality of H2O2 and in that setting H2O2 was c.90% lethal at 5 X 10(-5) M. Killing was most effective in the presence of peroxidase, when only 5 X 10(-6) M H2O2 (a concentration attainable in vivo by phagocytes) was required for a 95% kill. Kinetic studies revealed that toxic concentrations of H2O2 alone or of the H2O2-halide-peroxidase (PPH) system produced significant killing in 1 min; killing was maximal in 15 min. The PPH system was the more rapid in action. The dependence of the PPH killing system on H2O2 was demonstrated by an absence of killing in the presence of catalase. The susceptibility of P. brasiliensis to H2O2 and the PPH system appeared different in some respects from that noted for other dimorphic fungal pathogens. These studies suggest that toxic oxygen metabolites are important in host defence against P. brasiliensis. PMID- 6502680 TI - Liposomal encapsulation augments delayed hypersensitivity reactions to tuberculin proteins. AB - Encapsulation of purified tuberculoproteins in liposomes augmented their ability to elicit delayed hypersensitivity reactions in BCG-immune rats. The effect was most marked with a low-molecular-weight tuberculopeptide that was relatively poor at eliciting reactions when in free form. These findings indicate that, in addition to the antigenic nature of the material, the physical form of presentation of mycobacterial test antigens can influence their ability to elicit hypersensitivity reactions. PMID- 6502681 TI - Acute synovitis caused by an organism of the Rhodochrous taxon. AB - A 36-year-old man with systemic lupus erythematosus developed synovitis of the right wrist caused by an organism of the Rhodochrous taxon. The capacity of this pathogen to produce a granulomatous inflammatory reaction in human tissues is discussed. The isolate was sensitive to chloramphenicol, gentamicin, carbenicillin and colistin in in-vitro tests and the infection responded promptly to treatment with chloramphenicol. PMID- 6502682 TI - Utilization of chlorhexidine gluconate to evaluate a nonhuman primate skin degerming model. AB - We have developed a nonhuman skin-degerming model to predict the in vivo effectiveness of topical antimicrobial formulations. The model incorporates a balanced, randomized, complete block design and uses the hands of anesthetized cynomolgus monkeys as treatment sites to measure product effectiveness. Two different 4% chlorhexidine gluconate formulations were evaluated in the primate model and then retested in a human skin-degerming model of identical design. Statistical analysis of the data revealed no significant differences between the two models with regard to the response exhibited by each to the test formulations. PMID- 6502684 TI - Alopecia totalis in a chimpanzee. AB - A case of alopecia totalis in a chimpanzee is reported. The disease was probably due to an autoimmune phenomenon and was successfully treated with immunosuppressive therapy. However, possible side-effects outweighed benefits. PMID- 6502683 TI - Intestinal parasites of the free-ranging Cayo Santiago rhesus monkeys (Macaca mulatta). AB - Free-ranging rhesus macaques on the island of Cayo Santiago, Puerto Rico, were surveyed for intestinal parasites for the first time in over 40 years. Results were compared with the only previous study, and the relationships between the prevalence of Strongyloides and dominance rank, body weight, age, and matriline examined in the sampled population. PMID- 6502685 TI - Effects of primaquine on serum biochemical and hematological parameters in anesthetized Macaca fascicularis. AB - Primaquine phosphate treatment (0.5 mg/kg/day, per os [p.o.], 14 days) significantly increased values for serum sodium, potassium, and uric acid, while calcium levels were decreased in male Macaca fascicularis. Serum values returned to baseline (pretreatment) levels by 30 days following primaquine treatment. PMID- 6502686 TI - Evidence of hypertrophic pulmonary osteoarthropathy in a chimpanzee, Pan troglodytes. AB - Dissection of a chimpanzee has revealed the association of an intrathoracic disease (probably coccidioidomycosis) with periosteal lesions that are restricted almost entirely to the appendicular skeleton and are distributed with bilateral symmetry. These pathological conditions are compatible with a diagnosis of hypertrophic pulmonary osteoarthropathy. PMID- 6502687 TI - Adult polycystic kidney disease in a rhesus monkey (Macaca mulatta). AB - Adult polycystic kidney disease was diagnosed at necropsy in a 16-year-old rhesus monkey dead from renal failure. Both kidneys were enlarged and contained multiple cysts ranging from 0.1 to 4.0 cm in diameter. The age of onset of the clinical signs, terminal uremia, and the gross and histologic findings in this macaque were consistent with adult (type III) polycystic kidney disease of man. PMID- 6502688 TI - A spontaneous bronchogenic carcinoma in a Sykes monkey (Cercopithecus mitis stuhlmani). AB - A male blue monkey (Cercopithecus mitis stuhlmani), a subspecies of the Sykes group, was purchased from a commercial trapper as an adult in July 1978 and kept at the Institute of Primate Research, Kenya, for 2 years. The animal developed acute respiratory distress and died. Small nodular foci were found in the lung at necropsy and diagnosed as bronchogenic carcinoma on histopathology. PMID- 6502689 TI - Trichoepithelioma in a Barbary ape (Macaca sylvanus): review of cutaneous tumors in nonhuman primates and case report. AB - A cutaneous tumor was surgically removed from a 10-year-old, male Barbary ape (Macaca sylvanus). Histologically, the tumor was primarily adnexoid in nature and contained structures that resembled abortive hair follicles. The tumor was diagnosed as a trichoepithelioma. PMID- 6502690 TI - Blood pressure values in Macaca fascicularis. AB - Normal data are presented for blood pressure values of adult Macaca fascicularis. The mean arterial pressure (direct) was 99 +/- 9.8 mmHg (mean +/- standard deviation) and was not correlated with sex, age, or weight. Normative data are presented that suggest that this species has a range of values similar to that observed in other primate species including man. PMID- 6502691 TI - Limitations of the nonhuman pregnancy kit for pregnancy diagnosis in baboons. AB - The Nonhuman Primate Pregnancy Test (NHPPT) kit was evaluated for diagnosis of pregnancy in baboons. Unreadable controls rendered 33% of all tests inconclusive. Refrigeration and dilution did little to improve the number of inconclusive tests. Positive-and false-negative results from readable tests on days 20 to 27 of confirmed pregnancy were 75% and 25%, respectively. The NHPPT did not always provide an accurate diagnosis of pregnancy and often proved unreadable. PMID- 6502692 TI - Research costs: man versus chimpanzee. PMID- 6502694 TI - Volume regulation by Necturus gallbladder: basolateral KCl exit. AB - Swelling of the epithelial cells of Necturus gallbladder caused by an 18% reduction in the osmolality of the mucosal bath is followed by rapid volume readjustment. This volume regulatory decrease requires Cl and is sensitive to the K and Cl gradients across the basolateral cell membrane. Volume regulatory decrease is not inhibited by amiloride, SITS, ouabain or bicarbonate removal. The process is blocked by bumetanide in the serosal bath. Measurement of the intracellular activities of K and Cl and the rate of volume regulation under five different experimental conditions showed that KCl exited from the cell across the basolateral membrane with a stoichiometry of 3 K to 2 Cl. This KCl exit process appears to be transiently activated following the reduction in osmolality of the mucosal perfusate. PMID- 6502695 TI - L- and D-alanine transport in brush border membrane vesicles from lepidopteran midgut: evidence for two transport systems. AB - In brush border membrane vesicles from the midgut of Philosamia cynthia larvae (Lepidoptera) the L- and D-alanine uptake is dependent on a potassium gradient and on transmembrane electrical potential difference. Each isomer inhibits the uptake of the other form: inhibition of L-alanine uptake by D-alanine is competitive, whereas inhibition of D-alanine uptake by L-alanine is noncompetitive. Transstimulation experiments as well as the different pattern of specificity to cations suggest the existence of two transport systems. Kinetic parameters for the two transporters have been calculated both when Kout greater than Kin and Kout = Kin. D-alanine is actively transported also by the whole midgut, but it is not metabolized by the intestinal tissue. PMID- 6502693 TI - Evidence for coupled transport of bicarbonate and sodium in cultured bovine corneal endothelial cells. AB - Using intracellular microelectrode technique, the response of the voltage V across the plasma membrane of cultured bovine corneal endothelial cells to changes in sodium and bicarbonate concentrations was investigated. (1) The electrical response to changes in [HCO3-]o (depolarization upon lowering and hyperpolarization upon raising [HCO3-]o) was dependent on sodium. Lithium could fairly well be substituted for sodium, whereas potassium or choline were much less effective. (2) Removal of external sodium caused a depolarization, while a readdition led to a hyperpolarization, which increased with time of preincubation in the sodium-depleted medium. (3) The response to changes in [Na+]o was dependent on bicarbonate. In a nominally bicarbonate-free medium, its amplitude was decreased or even reversed in sign. (4) Application of SITS or DIDS (10(-3) M) had a similar effect on the response to sodium as bicarbonate-depleted medium. (5) At [Na+]o = 151 mM and [HCO3-]o = 46 mM, the transients of V depended, with 39.0 +/- 9.0 (SD) mV/decade, on bicarbonate and, with 15.3 +/- 5.8 (SD) mV/decade, on sodium. (6) After the preincubation of cells with lithium, replacement of Li by choline led to similar effects as the replacement of sodium by choline, though the response of V was smaller with Li. This response could be reduced or reversed by the removal of bicarbonate or by the application of SITS. (7) Amiloride (10(-3) M) caused a reversible hyperpolarization of the steady state potential by 8.5 +/- 2.6 mV (SD). It did not affect the immediate response to changes in [Na+]o or [HCO3-]o, but reduced the speed of regaining the steady state potential after a change in [HCO3-]o. (8) Ouabain (10(-4) M) caused a fast depolarization of -6.8 +/- 1.1 (SD) mV, which was followed by a continuing slower depolarization. The effect was almost identical at 10(-5) M. (9) It is suggested, that corneal endothelial cells possess a cotransport for sodium and bicarbonate, which transports net negative charge with these ions. It is inhibitable by stilbenes, but not directly affected by amiloride or ouabain. Lithium is a good substitute for sodium with respect to bicarbonate transport and is transported itself. In addition, the effect of amiloride provides indirect evidence for the existence of a Na+/H+-antiport. A model for the transepithelial transport of bicarbonate across the corneal endothelium is proposed. PMID- 6502696 TI - Hypoxanthine transport in mammalian cells: cell type-specific differences in sensitivity to inhibition by dipyridamole and uridine. AB - We have measured by rapid kinetic techniques the zero-trans influx of hypoxanthine in various cell lines and its sensitivity to inhibition by uridine, dipyridamole, nitrobenzylthioinosine and nitrobenzylthiopurine. The results and those reported earlier divided the cells into two distinct groups. In mouse P388, L1210 and L929 cells uridine and hypoxanthine had little effect on the transport of each other, supporting the view that nucleosides and hypoxanthine are transported by different carriers. In these cells, hypoxanthine transport was also uniquely resistant to inhibition by dipyridamole (IC50 (50% inhibition dose) greater than 30 microM). In Novikoff and HTC rat hepatoma, Chinese hamster ovary and Ehrlich ascites tumor cells, on the other hand, hypoxanthine and uridine inhibited the transport of each other about 50% at a concentration corresponding to the Michaelis-Menten constant of their transport, and hypoxanthine transport was strongly inhibited by dipyridamole (IC50 = 100 to 400 nM). Although these results are compatible with the view that nucleosides and hypoxanthine are transported by a common carrier in these cells, this conclusion is not supported by the finding that uridine transport is strongly inhibited in some of these cell lines, as in the first group of cells, by nitrobenzylthioinosine, whereas hypoxanthine transport is highly resistant in all cell lines tested. In contrast, the transport of both substrates is highly resistant to inhibition by nitrobenzylthiopurine. The Michaelis-Menten constants for uridine transport are about the same in all cell lines. The Michaelis-Menten constants for hypoxanthine transport are similar to those for uridine transport in some cell lines, but are much higher in others.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502697 TI - Relationship between the shape and the membrane potential of human red blood cells. AB - Microscopic observations of isotonic suspensions of human red blood cells demonstrate that cell shape is unaltered when the transmembrane electrical potential, or Em, is set in the range -85 to + 10 mV with valinomycin at varied external K+, or Ko X Em was measured with the fluorescent potentiometric indicator, diS-C3(5), as calibrated by a delta pH method. Repeating Glaser's experiments in which echinocytosis was attributed to hyperpolarization, we found that at low ionic strength the pH-dependent effects of amphotericin B appear to be unrelated to Em. The effects of increased intracellular Ca2+, or Cac, on echinocytosis and on Em are separable. With Ca ionophore A23187 half-maximal echinocytosis occurs at greater Cao than that which induces the half-maximal hyperpolarization associated with Ca-induced K+ conductance (Gardos effect). Thus, cells hyperpolarized by increased Cac remain discoidal when Ca is below the threshold for echinocytosis. With A23187 and higher Cao, extensive echinocytosis occurs in cells which are either hyperpolarized or at their resting potential. The Ca-activation curve for echinocytosis is left-shifted by low Ko, a new observation consistent with increased DIDS-sensitive uptake of 45Ca by hyperpolarized cells. These results support the following conclusions: (1) the shape and membrane potential of human red blood cells are independent under the conditions studied; (2) in cells treated with A23187, the Gardos effect facilitates echinocytosis by increasing Cac. PMID- 6502698 TI - Effect of gangliosides on phospholipid bilayers: a study with the lipophilic ions relaxation method. AB - The presence of monosialoganglioside GM1 in dioleoylphosphatidylcholine black lipid membranes modifies the transport properties of the hydrophobic ion tetraphenylborate and the kinetics of relaxation of this ion after the application of a voltage step. At zero applied voltage, the difference in the relaxation time constants between pure phospholipid and ganglioside-phospholipid mixed membranes is large. This difference may possibly rise from changes in the membranes fluidity since it has been found that the two types of membranes do not show appreciable difference in thickness. A uniform distribution of GM1 in the membrane seems to be more probable than the presence of lateral phase separation phenomena. The partition coefficient of tetraphenylborate between the bathing NaCl solution and the membrane appears to depend on the ionic strength, which controls the screening effect of the Na+ ions on the COO- charged groups of the sialic acid of the ganglioside polar heads. Effects of dipolar potentials on the partition coefficient can be excluded, being the absorption plane of tetraphenylborate probably located outside the dipolar layer of the membrane. PMID- 6502699 TI - General method for the derivation and numerical solution of epithelial transport models. AB - A general method is presented for the formulation and numerical evaluation of mathematical models describing epithelial transport. The method is based on the principles of conservation of mass, and maintenance of electroneutrality within the cells and bathing solutions. It is therefore independent of the specific membrane transport mechanisms, and can be used to evaluate different models describing arbitrary transport processes (including passive, active and cotransport processes). Detailed numerical methods are presented that allow computation of steady-state and transient responses under open-circuit, current clamp and voltage-clamp conditions, using a general-purpose laboratory minicomputer. To evaluate the utility of this approach, a specific model is presented that is consistent with the Koefoed-Johnson and Ussing hypothesis of sodium transport in tight epithelia (Acta Physiol. Scand. 42:298-308, 1958). This model considers passive transport of an arbitrary number of permeant solutes, active transport of sodium and potassium, and osmotically induced water transport across the apical and basolateral membranes. Results of the model are compared to published experimental measurements in rabbit urinary bladder epithelium. PMID- 6502700 TI - Bacterial rhodopsins monitored with fluorescent dyes in vesicles and in vivo. AB - Three retinal-containing pigments have been detected in Halobacterium halobium membranes: bacteriorhodopsin (bR), halorhodopsin (hR), and slow-cycling rhodopsin (sR). The first two hyperpolarize the cell membrane by electrogenic transport of H+ and Cl-, respectively. The third pigment, sR, may be a photosensory receptor since mutants lacking bR and hR retain their retinal-dependent phototaxis responses. We monitored light-induced changes in fluorescence of several voltage sensitive dyes in cells and membrane vesicles. Red light-induced potential changes generated by bR and hR were similar to signals described previously. Signals generated by hR could be identified using four criteria: wavelength dependence, Cl- dependence, shunting by valinomycin and K+, and the absence of these signals in hR-deficient mutants. The absence (detection limit approximately 0.5 mV) of hyperpolarization signals in bR-hR-sR+ vesicles and cells shows that sR photochemical reactions are nonelectrogenic. Two signals independent of bR and hR were measured: blue light caused a decrease and red light an increase in dye fluorescence. Both signals appear to derive from sR on the basis of their retinal dependence and action spectra. In a retinal-deficient mutant strain (Flx3R), both sR signals appeared after addition of all-trans retinal. In this strain retinal also restores phototaxis sensitivity within the same time scale. The retinal concentration dependence for all four parameters monitored--the attractant (red) and repellent (blue) phototaxis, and the red light and blue light-induced fluorescence signals--is the same. This correlation is consistent with the hypothesis that both attractant and repellent responses are mediated by sR, as suggested by Bogomolni and Spudich (Proc. Natl. Acad. Sci. USA. 79:6250-6254 (1982)). PMID- 6502701 TI - Feedback inhibition of NaCl entry in Necturus gallbladder epithelial cells. AB - When Necturus gallbladder epithelium is treated with ouabain the cells swell rapidly for 20-30 minutes then stabilize at a cell volume 30% greater than control. The cells then begin to shrink slowly to below control size. During the initial rapid swelling phase cell Na activity, measured with microelectrodes, rises rapidly. Calculations of the quantity of intracellular Na suggest that the volume increase is due to NaCl entry. Once the peak cell volume is achieved, the quantity of Na in the cell does not increase, suggesting that NaCl entry has been inhibited. We tested for inhibition of apical NaCl entry during ouabain treatment either by suddenly reducing the NaCl concentration in the mucosal bath or by adding bumetanide to the perfusate. Both maneuvers caused rapid cell shrinkage during the initial phase of the ouabain experiment, but had no effect on cell volume if performed during the slow shrinkage period. The lack of sensitivity to the composition of the mucosal bath during the shrinkage period occurred because of apparent feedback inhibition of NaCl entry. Another maneuver, reduction of the Na in the serosal bath to 10 mM, also resulted in inhibition of apical NaCl uptake. The slow shrinkage which occurred after one or more hours of ouabain treatment was sensitive to the transmembrane gradients for K and Cl across the basolateral membrane and could be inhibited by bumetanide. Thus during pump inhibition in Necturus gallbladder epithelium cell Na and volume first increase due to continuing NaCl entry and then cell volume slowly decreases due to inhibition of the apical NaCl entry and activation of basolateral KCl exit. PMID- 6502702 TI - Percutaneous renal calculi removal. PMID- 6502703 TI - Metastases to bone as primary sign of laryngeal cancer. PMID- 6502704 TI - Severe neutropenia and infectious mononucleosis: brief report. PMID- 6502705 TI - Case report XX maternal mortality study. PMID- 6502706 TI - Role of catalytic residues in the formation of a tetrahedral adduct in the acylation reaction of bovine beta-trypsin. A molecular orbital study. AB - In the acylation reaction of serine proteases the effect of amino acid residues on the geometrical change of the catalytic site from Michaelis to tetrahedral state was studied by using ab initio molecular orbital calculations. Amino acid residues in the catalytic site and the peptide substrate were calculated as a quantum mechanical region, and all the other amino acid residues and the calcium ion were included in the calculation as the electrostatic effects. The effects of Asp102, Asp194, N-terminus and the oxyanion binding site are large. The oxyanion binding site directly stabilizes the tetrahedral substrate. Asp102 stabilizes the enzyme intermediate, interacting with the protonated His57 residue. In order to elucidate the roles of Asp102 and the oxyanion binding site, energy decomposition analyses were done for the intermolecular interactions. The contribution of Asp102 and the oxyanion binding site to the decrease of energy in the geometrical change is due to the electrostatic effect. The energies of the proton shuttle from Ser195 O gamma to the leaving group of the substrate were calculated for amide and ester substrate models. PMID- 6502707 TI - Analysis of membrane and surface protein sequences with the hydrophobic moment plot. AB - An algorithm has been developed which identifies alpha-helices involved in the interactions of membrane proteins with lipid bilayers and which distinguishes them from helices in soluble proteins. The membrane-associated helices are then classified with the aid of the hydrophobic moment plot, on which the hydrophobic moment of each helix is plotted as a function of its hydrophobicity. The magnitude of hydrophobic moment measures the amphiphilicity of the helix (and hence its tendency to seek a surface between hydrophobic and hydrophilic phases), and the hydrophobicity measures its affinity for the membrane interior. Segments of membrane proteins in alpha-helices tend to fall in one of three regions of a hydrophobic moment plot: (1) monomeric transmembrane anchors (class I HLA transmembrane sequences) lie in the region of highest hydrophobicity and smallest hydrophobic moment; (2) helices presumed to be paired (such as the transmembrane M segments of surface immunoglobulins) and helices which are bundled together in membranes (such as bacteriorhodopsin) fall in the adjacent region with higher hydrophobic moment and smaller hydrophobicity; and (3) helices from surface seeking proteins (such as melittin) fall in the region with still higher hydrophobic moment. alpha-Helices from globular proteins mainly fall in a region of lower mean hydrophobicity and hydrophobic moment. Application of these methods to the sequence of diphtheria toxin suggests four transmembrane helices and a surface-seeking helix in fragment B, the moiety known to have transmembrane function. PMID- 6502708 TI - Geminate recombination in carboxy hemoglobin A and its relation to overall carbon monoxide reactivity. AB - The geminate recombination of CO with carboxy hemoglobin (Hb4(CO)3) following a ten nanosecond laser pulse and the overall combination of the fourth CO with Hb4(CO)3 has been studied as a function of pH in the presence and absence of inositol hexaphosphate. The results indicate that the kinetics of both reactions are independent of pH and phosphate concentration. The results are discussed in terms of a two-step mechanism: a pre-equilibrium step followed by heme--ligand bond formation. The latter is also known as the geminate recombination reaction (Hb + CO in equilibrium Hb X CO in equilibrium HbCO). PMID- 6502709 TI - Crystallization and preliminary x-ray diffraction study of the 3-Fe ferredoxin II from the bacterium Desulfovibrio gigas. AB - The 3-Fe ferredoxin (FdII) from the bacterium Desulfovibrio gigas has been crystallized at pH 5.0 and 23 degrees C in two different crystal forms. One form is monoclinic, space group C2, with unit cell parameters a = 40.78 A, b = 44.98 A, c = 26.47 A, beta = 104.6 degrees, and one monomer of the FdII tetramer per asymmetric unit. The molecule can be either the monomer of molecular weight 6400 or a dimer of twice this molecular weight with 2-fold symmetry coincident with the 2-fold axis of the crystal. The other crystal form is orthorhombic, space group P2(1)2(1)2 and unit cell parameters a = 109.5 A, b = 37.0 A, c = 30.5 A. The asymmetric unit of this crystal contains two monomers of FdII. The orthorhombic crystal has not been reproduced since the initial crystallization. PMID- 6502710 TI - Transcriptional and post-transcriptional control of specific messenger RNAs in adult and embryonic liver. AB - The rate of synthesis and the concentrations of a variety of messenger RNA sequences have been compared between adult mouse liver cells and cells in other adult tissues, and between cells in fetal and neonatal liver. The sequences were distinguished as "liver-specific" or "common" in a previous report, where liver was compared with brain cells and cultured cells. Most of the liver-specific mRNAs are greatly decreased or absent in a large group of other adult mouse tissues. In two cases, kidney shares mRNA sequences with liver. The levels of the common mRNAs varied from two to fivefold in various tissues. For the liver specific mRNAs, the transcription rates in nuclei from adult tissues and from fetal liver showed a good correspondence to the presence and the level of mRNA. However, most of the common RNA sequences were transcribed at similar rates in all nuclei despite their different cytoplasmic concentrations. In addition, two liver-specific RNAs were transcribed in fetal liver nuclei but were not present as mRNA. Thus, the presence of tissue-specific mRNAs in adult cells is based first (and probably most importantly) on transcriptional control, but several instances were observed where post-transcriptional control also contributes to the level of mRNA. PMID- 6502711 TI - Gene expression during liver regeneration. AB - The concentration of a group of messenger RNAs, some of which are expressed only (or mainly) in the liver and others of which are expressed in all tissues, was examined during liver regeneration. Most of the tissue-specific mRNAs did not change greatly in concentration or in transcription rate, but mRNAs such as actin and tubulin increased by as much as tenfold without an equivalent transcriptional increase. However, the mRNAs for "acute phase" proteins such as serum amyloid A and metallothionine did increase dramatically and increased transcription was easily detected. In addition to these findings, there was no increase in the rate of synthesis of the RNA constituents necessary to make ribosomes, pre-rRNA and mRNA for ribosomal proteins. Thus, the differentiated hepatocyte continues to function as a differentiated cell during the two or so replications necessary for regeneration, and many of the constituents necessary to increase cell mass may be supplied by increased preservation and utilization of transcribed RNAs. PMID- 6502712 TI - Domains in human plasminogen. AB - Calorimetric studies of intramolecular melting of human plasminogen and of its fragments under various solvent conditions show that the intact plasminogen molecule consists of seven compact co-operative subunits, which can be regarded as structural domains. Five of these domains are formed by the homologous regions, the kringles, two domains are formed by the C-terminal part of the polypeptide chain that is split at activation, forming the light chain in plasmin, while the initial 76 amino acid residue peptide does not form any compact co-operative structure. The specific influence of epsilon-aminocaproic acid on the stability of the first, the fourth and, to a lesser extent, on the second kringle domain, provides evidence that these three domains in plasminogen possess lysine-binding ability. The first four kringle domains are almost independent in the molecule, while the fifth interacts with that part of the light chain not included in either of the two domains of this chain. These two domains are of different size and co-operate strongly in plasminogen, but at its activation into plasmin they decooperate and the stability of the smaller domain, which is formed by the N-terminal part of the light chain, decreases significantly. Since the light chain is responsible for the proteolytic activity of plasmin, it becomes clear that the active site of this protein is composed of two domains, as is the case for other serine proteases. PMID- 6502713 TI - Structure of papain refined at 1.65 A resolution. AB - Papain is a sulfhydryl protease from the latex of the papaya fruit. Its molecules consist of one polypeptide chain with 212 amino acid residues. The chain is folded into two domains with the active site in a groove between the domains. We have refined the crystal structure of papain, in which the sulfhydryl group was oxidized, by a restrained least-squares procedure at 1.65 A to an R-factor of 16.1%. The estimated accuracy in the atomic co-ordinates is 0.1 A, except for disordered atoms. All phi/psi angles for non-glycine residues are found within the outer limit boundary of a Ramachandran plot and this provides another check on the quality of the model. In the alpha-helical parts of the structure, the C = O bonds are directed more away from the helix axis than in a classical alpha helix, leading to somewhat longer hydrogen bonds, 2.98 A, compared to 2.89 A. The hydrogen-bonding parameters and conformational angles in the anti-parallel beta sheet structure show a large diversity. Hydrogen bonds in the core of the sheet are generally shorter than those at the more twisted ends. The average value is 2.91 A. The hydrogen bond distance Ni+3-Oi in turns is relatively long and the geometry is far from linear. Hydrogen bond formation, therefore, is perhaps not an essential prerequisite for turn formation. Although the crystallization medium is 62% (w/w) methanol in water, only 29 out of 224 solvent molecules can be regarded with any certainty as methanol molecules. The water molecules play an important role in maintaining structural stability. This is specially true for internal water. Twenty-one water molecules are located in contact areas between adjacent papain molecules. It seems as if the enzyme is trapped in a grid of water molecules with only a limited number of direct interactions between the protein molecules. The residues in the active site cleft belong to the most static parts of the structure. In general, disorder in atomic positions increases when going from the interior of the protein molecule to its surface. This behavior was quantified and it was found that the point of minimum disorder is near the molecular centroid. PMID- 6502714 TI - Oxygen binding to Octolasium complanatum erythrocruorin. Modulation of homo- and heterotropic interactions by cations. AB - The functional properties of erythrocruorin from Octolasium complanatum (a common earthworm of Central Italy) have been characterized in great detail. Special attention has been given to the reciprocal effects of the various ligands, namely oxygen, cations and protons. The data obtained under a variety of experimental conditions bring out the dominant role played by cations in the modulation of both homotropic and heterotropic interactions. In this respect, the most interesting observation concerns the unusual interplay between protons and cations that occurs in this erythrocruorin, the first respiratory pigment in which the Bohr effect is due totally to the O2-linked binding of an allosteric effector. The oxygen binding data collected under the various experimental conditions have been analyzed in terms of a modified two-state model, which takes into account the fact that allosteric effectors may also influence the ligand binding properties of the state that they stabilize. The analysis shows that the number of interacting sites necessary for the observed co-operativity in O2 binding is much smaller than the number of heme groups carried by the whole molecule, in accordance with previous findings on hemocyanins, the other class of giant respiratory pigments. Moreover, the analysis indicates that the dimensions of these "functional constellations" are under the control of allosteric effectors. PMID- 6502715 TI - Preparation of single crystals of a yolk lipoprotein. AB - Single crystals of a yolk lipoprotein from two species of lamprey oocytes have been prepared and shown to belong to the monoclinic space group C2. The unit cell dimensions combined with molecular weight determinations support the idea that the lipoprotein is a symmetrical dimer centered on a crystallographic 2-fold symmetry axis. The lipid content is estimated to be about 15% (w/w) and the crystals are suitable for structural studies by single crystal X-ray analysis. The X-ray results are correlated with those obtained by electron diffraction. PMID- 6502716 TI - Ethnicity and cancer prevention in a tri-ethnic urban community. AB - A pilot study of knowledge and behavior regarding primary cancer prevention was conducted in a tri-ethnic urban community. Knowledge of smoking and dietary risk factors was substantial, but awareness of cancer safeguards involving reduced sun exposure and mouth and proctological examinations was low. One of five respondents had taken measures to prevent cancer, and these persons tended to rate their own risk higher than respondents who made no life-style changes. Self motivated behavior change focused on avoidance of cancer-promoting food. Blacks differed from whites and Mexican-Americans in awareness of cancer cause and prevention, particularly regarding dietary factors and behavior modification. The findings have implications for the design of cancer control measures in multiethnic communities. PMID- 6502717 TI - Partial splenectomy for a splenic pseudocyst. AB - Based on the principles and techniques of partial splenectomy and splenorrhaphy, the feasibility of removing a splenic cyst while preserving normal functioning splenic tissue is demonstrated. This approach avoided the potential catastrophe of overwhelming postsplenectomy sepsis in a 16-year-old girl. PMID- 6502718 TI - Epidermoid carcinoma subsequent to a gunshot wound of the face. AB - Reported is a case of epidermoid carcinoma of the face following a gunshot wound. A review of the pertinent literature is included. PMID- 6502720 TI - Health care problems in the 1980s: Part 1. Presidential politics and minority health. PMID- 6502719 TI - Hemoglobin sickle cell disease and systemic lupus erythematosus. AB - An unusual association of hemoglobin sickle cell disease with systemic lupus erythematosus in an 11-year-old girl highlights the diagnostic dilemma that may arise because of the similarity of symptomatology. PMID- 6502721 TI - Health care problems in the 1980s: Part II. The black physician and the challenges of the 1980s. PMID- 6502723 TI - Occupational medicine: a challenge to comprehensive medical care. PMID- 6502722 TI - Refractory hypertension. PMID- 6502724 TI - Community health centers: providing care for urban blacks. PMID- 6502725 TI - Costs, choice, and competition: some considerations of alternative delivery systems. PMID- 6502726 TI - Small bowel obstruction: review of nine years of experience. AB - Strong evidence in the literature suggests that improvements in the management and outcome of small bowel obstruction result from early diagnosis, better fluid and electrolyte replacement, use of antibiotics, and early surgical intervention. This paper reviews the outcomes of 49 male and 31 female patients who were operated on for small bowel obstruction. The average age was 38 years (range, 3 to 87 years); the average hospital stay was 13 days. There was one death. The causes of obstruction included postoperative adhesions (78 percent), strangulated external hernia (11 percent), gangrenous bowel (4 percent), intussusception (2.5 percent), appendiceal mass (3.5 percent), and Meckel's diverticulum (1 percent). The outcome was worse with late presentation, perforation or gangrene of the bowel, and delayed surgery. PMID- 6502727 TI - Racial differences in personality, behavior, and family environment in Minneapolis school children. AB - Racial differences in personality, behavior, and family environment of lower elementary school children were examined in a sample of 433 black and 897 white children. Numerous significant differences in scores on scales of the Missouri Children's Picture Series, the Missouri Children's Behavior Checklist, and the Family Environment Scale persisted after adjustment for socioeconomic status. PMID- 6502728 TI - Glucose-6-phosphate dehydrogenase revisited. AB - Hemolytic diseases associated with drugs have been recognized since antiquity. Many of these anemias have been associated with oxidizing agents and deficiencies in the intraerythrocytic enzyme glucose-6-phosphate dehydrogenase. This paper outlines the discovery, prevalence, and variants of this enzyme. Methods of diagnosis of associated anemias are offered. PMID- 6502729 TI - Quercetin: a mutagen, not a carcinogen, in Fischer rats. AB - Purified quercetin, as well as diets containing quercetin at 0.1% and 0.2%, are mutagens to Salmonella typhimurium TA100. This mutagenicity is enhanced with the S9 metabolic activation system. The urine of Fischer rats fed the 0.2% quercetin diet also is mutagenic with the S9 activation system, but the feces of these animals exhibited enhanced mutagenicity only without activation. This may indicate different quercetin metabolites in urine and feces. Rats fed these diets for 64 wk showed no consistent tissue lesions, carcinogenicity, or reproductive changes. Male rats fed 0.2% quercetin showed lowered blood serum glutamic oxaloacetic transaminase and urea nitrogen levels, but these values do not reflect pathological changes. PMID- 6502730 TI - Cardiotoxicity of tricyclic antidepressants in primary cultures of rat myocardial cells. AB - Primary cultures of myocardial cells were used to evaluate the cardiotoxic potential of various tricyclic antidepressants (TCAs). Lactate dehydrogenase (LDH) leakage, cellular viability, and beating rates were measured to compare the cardiotoxicity of amitriptyline, desipramine, imipramine, and nortriptyline. Tricyclic antidepressants were added to the cultures to give final concentrations of 1 X 10(-5), 1 X 10(-4), and 1 X 10(-3) M. Treatments lasted 1 and 4 h. All TCAs tested caused significant release of LDH and decreased cellular viability when added at 1 X 10(-3) M for 1 and 4 h. Amitriptyline was the only compound that caused significant LDH release 4 h after exposure to lower doses. Decreased viability was observed 4 h after exposure to all TCAs at a concentration of 1 X 10(-4) and 1 X 10(-3) M. Arrhythmias were observed 1 h after exposure to 1 X 10( 5) and 1 X 10(-4) M amitriptyline. All doses of amitriptyline inhibited beating 4 h after exposure. Imipramine, desipramine, and nortriptyline at a concentration of 1 X 10(-5) M decreased the beating rates of cultured myocytes 1 and 4 h after exposure. Arrhythmias and/or total inhibition of beating were observed when the cultures were exposed to higher concentrations of these compounds. Based on these data, the rank order of cardiotoxicity was amitriptyline greater than imipramine = desipramine greater than nortriptyline. PMID- 6502731 TI - The effect of hepatic mixed-function oxidase enzyme inducers on the development of tri-o-tolyl phosphate-induced delayed neurotoxicity. AB - Adult White Leghorn hens were divided into 15 groups of 10 birds each. Five groups received the prototype mixed-function oxidase (MFO) enzyme inducer phenobarbital (PB) at a dosage of 50 mg/kg body weight for 3 consecutive days by intraperitoneal (i.p.) injection, 5 groups received the MFO enzyme inducer beta naphthoflavone (beta NF) at 20 mg/kg body weight for 2 consecutive days by i.p. injection, while the remaining 5 groups did not receive an inducer. At 24 h after the last injection, the birds received a single oral dose of tri-o-tolyl phosphate (TOTP) (an organophosphate that produces delayed neurotoxicity after metabolic activation by the MFO system) in doses of 62.5, 125, 250, or 500 mg/kg body weight. Corn oil served as the vehicle control. At 48 h after the administration of TOTP, half the birds in each of the 15 groups were killed for determination of whole-brain neurotoxic esterase (NTE) activity. The remaining birds were observed for the subsequent 19 d for onset of clinical signs characteristic of delayed neurotoxicity. Birds receiving beta NF prior to TOTP were protected by the inducer when compared to birds receiving PB + TOTP or TOTP alone. This was indicated by less severe clinical signs as well as less inhibition of whole-brain NTE activity. The protective effect offered by beta NF may be due to induction of enzymes responsible for the inactivation of the neurotoxic metabolite. PMID- 6502732 TI - Evaluation of the biological activity of cigarette-smoke condensate fractions using six in vitro short-term tests. AB - The biological activity of the volatile part of the particulate phase of cigarette-smoke condensate, the semivolatile fraction, has been examined, since the constituents of this material are accessible to selective filtration. Such a process offers a possibility to reduce the biological activity of total cigarette smoke without appreciably affecting the taste. Cigarette-smoke condensate, obtained from domestic American blend type cigarettes, was therefore separated into a nonvolatile and a semivolatile fraction, and the latter was fractionated by liquid-liquid extractions into four subfractions; acids, phenols, bases, and neutrals. The biological activity of these fractions was investigated using six in vitro short-term tests, of which two, the Ames test and the induction of sister chromatid exchanges, provided information on their genotoxicity, and the other four provided information on their cytotoxicity by measuring inhibition of cell growth, inhibition of oxidative metabolism, membrane damage, and ciliotoxicity. Sister chromatid exchanges were found to be induced by the total condensate, the nonvolatile and the semivolatile fractions, and the subfractions derived from the semivolatile fraction, except the bases. The Ames test showed the total condensate and the nonvolatile fraction to contain direct-acting base pair mutagens as well as indirect-acting frameshift mutagens. While the semivolatile fraction was found nonmutagenic, two of its subfractions, acids and phenols, were shown to contain base-pair mutagens, which did not require metabolic activation. The total condensate and the nonvolatile and semivolatile fractions showed similar activity in the four cytotoxicity tests. Of the semivolatile subfractions, the acids and the phenols exhibited the highest activity and the bases the lowest; the toxicity observed for the neutrals varied with the test system used. PMID- 6502733 TI - Stereoselective metabolism of 8- and 9-fluorobenzo[a]pyrene by rat liver microsomes: absolute configurations of trans-dihydrodiol metabolites. AB - Rat liver microsomal metabolism of 8-fluorobenzo[a]pyrene (8-fluoro-BaP) generated 3-hydroxy-8-fluoro-BaP, 8-fluoro-BaP trans-4,5-dihydrodiol, and 8 fluoro-BaP, 3,6-quinone as major products. A minor metabolite of 8-fluoro-BaP was tentatively assigned as 8-fluoro-BaP 9,10-dihydrodiol. Metabolism of 9 fluorobenzo[a]pyrene (9-fluoro-BaP) gave 3-hydroxy-9-fluoro-BaP, 9-fluoro-BaP trans-4,5-dihydrodiol, 9-fluoro-BaP trans-7,8-dihydrodiol, and 9-fluoro-BaP 3,6 quinone. All three dihydrodiol metabolites were optically active. Comparison of the circular dichroism spectra of BaP 4R,5R-dihydrodiol, 6-bromo-BaP 7R,8R dihydrodiol, and 6-fluoro-BaP 7R,8R-dihydrodiol with those of the respective dihydrodiol metabolites allowed assignments of an R,R absolute configuration to the major enantiomers of the three dihydrodiol metabolites. PMID- 6502734 TI - Effects of inhaled ammonium sulfate on benzo[a]pyrene carcinogenesis. AB - The effect of inhaled ammonium sulfate on benzo[a]pyrene carcinogenesis in the lungs of Syrian golden hamsters was studied. Exposure to ammonium sulfate at an airborne concentration 20 times average United States ambient levels resulted in a significant depression (p less than 0.05) of benzo[a]pyrene carcinogenesis in the first 6 mo of the study. However, at 2 yr, the termination of the study, there were no differences in cancer incidence between groups receiving benzo[a]pyrene and benzo[a]pyrene plus ammonium sulfate. In addition, at the concentration studied, inhaled ammonium sulfate did not significantly increase the incidence or severity of pneumonitis or pulmonary fibrosis in the hamster. However, this inhalation did increase the incidence of emphysema but not the severity. The decreased incidence of cancer during the first 6 mo of this study in animals receiving both benzo[a]pyrene and ammonium sulfate suggests that interaction between sulfate and benzo[a]pyrene does occur, but is insufficient to afford long-term protection against the development of cancer. No enhancement of carcinogenesis by benzo[a]pyrene occurs in the presence of inhaled sulfate. PMID- 6502735 TI - A farmworker death due to pesticide toxicity: a case report. AB - In the state of California, the use of pesticides is closely regulated. Physicians are required to report all occupational illness attributable to pesticide use. The case of a death involving the handling of aldicarb, a potent methylcarbamate insecticide, is presented. Although the autopsy indicated trauma as the cause of death, subsequent analysis of tissue residues of aldicarb and its metabolites suggested that pesticide toxicity may have been a contributing cause. PMID- 6502736 TI - Neurobehavioral assessment of chronic low-level methyl bromide exposure in the rabbit. AB - The research reported here was intended to identify the concentration at which methyl bromide begins to produce neurotoxic effects in the rabbit, a species known to be sensitive to this compound. Rabbits were exposed via inhalation to 27 ppm methyl bromide over a period of 8 mo for a total exposure duration of 900 h. Biweekly neurobehavioral tests, consisting of the latency rates of the ulnar and sciatic nerves and the amplitude of the eyeblink reflex of the orbicularis oculi muscle, failed to uncover any untoward consequences of the exposures. The rabbits gained weight and otherwise appeared to be healthy. In contrast to reports available in the literature, these findings suggest that long-term exposures to methyl bromide, in the present concentration range, are tolerated by this species. Also detailed in this report is the course of recovery of a separate group of rabbits previously given subchronic exposures to 65 ppm methyl bromide. These animals developed severe neuromuscular losses and had impaired blink reflexes and body weights. The symptoms partially subsided within 6-8 wk after removal from the exposures, suggesting that recovery from a nonfatal but seriously debilitating exposure is possible. PMID- 6502737 TI - Acute malathion toxicosis and related enzymatic alterations in Bubalus bubalis: antidotal treatment with atropine, 2-PAM, and diazepam. AB - Oral administration of malathion (MTH) in sublethal (100 mg/kg) or minimal lethal (125 mg/kg) doses in buffalo calves produced toxicity with an onset within 15-20 min and peak effects including severe tremors and convulsions within 40-60 min. Various antidotal drugs were administered alone or in combination at the time of peak malathion toxicity (within 1 h) and were assessed for their ability to alleviate signs of cholinergic toxicity. Blood cholinesterase and aminotransferases activities were monitored at various times. A combination of atropine sulfate (0.5 mg/kg, 1/4 iv and 3/4 im) and pyridine 2-aldoxime methiodide (2-PAM, 20 mg/kg, iv) reversed the clinical evidence of malathion toxicity within 15 min. The combination of atropine sulfate and diazepam (0.75 mg/kg, iv) prevented death and cholinergic signs of toxicity except for weak muscular fasciculations, which persisted for 30-60 min. Atropine sulfate alone was less effective and also did not reverse malathion-induced biochemical changes. In contrast, administration of either 2-PAM (10-30 mg/kg, iv) or diazepam (0.5-1.0 mg/kg, iv) alone accentuated malathion toxicity. Thus, the combination of atropine sulfate and 2-PAM was the most effective antidotal treatment in acute malathion toxicity. PMID- 6502738 TI - Teratogenicity of 2,3,7,8-tetrachlorodibenzofuran in the mouse. AB - 2,3,7,8-Tetrachlorodibenzofuran (TCDBF) was administered in single doses (0.1-0.8 mg/kg body weight) intraperitoneally to pregnant C57BL mice on d 10, 11, 12, or 13 of gestation. A dose-dependent increase was observed in the frequency of fetal resorptions and fetal death, especially in the earlier stages (d 10-11). Cleft palate and hydronephrosis as well appeared in a dose-dependent manner, with a peak in sensitivity after administration on d 11-12. TCDBF given at a dose level of 0.1 mg/kg body weight on d 12 of gestation (only dose- and stage-tested) produced a marked thymic hypoplasia as well. A few cases of general hydrops occurred. The pattern of malformations and time of sensitivity corresponded well to that observed earlier after administration of 2,3,7,8-tetrachlorodibenzo-p dioxin (TCDD; ED50 approximately equal to 25 micrograms/kg) and 3,3',4,4' tetrachloroazoxybenzene (TCAOB; ED50 approximately equal to 6 mg/kg), two congeners of TCDBF, indicating common mechanisms of action of this family of compounds. Ornithine decarboxylase (ODC) is an important enzyme in cell proliferation and growth with a high activity in embryonic tissues. Liver ODC activity has previously been found to be stimulated by TCDD in weaning mice. However, this enzyme was not found to be stimulated in fetal and placental tissues, but slightly in maternal kidney after treatment with TCDBF in teratogenic doses. It is possible that the ODC activity increases under certain conditions only, on administration of TCDD and its congeners. PMID- 6502739 TI - Comparative decontamination of hexachlorobenzene-exposed rats and rabbits by hexadecane. AB - The effect of 8 wk of hexadecane (Hex; 5% w/w) in the diet on the disposition of [14C]hexachlorobenzene (HCB) was examined under identical conditions in rats and rabbits. Urine and feces were collected daily. Blood was obtained periodically, HCB was determined in serum, erythrocytes, heart, muscle, lungs, liver, kidney, spleen, fat, skin, and brain, as well as in excreta. The half-life of HCB was similar in the two species examined (rat 24 d; rabbit 32 d). Hex treatment increased by 4-5-fold the daily fecal excretion of HCB, resulting in correspondingly reduced half-lives of HCB in both species (rat 8 d, rabbits 12 d). As a result of Hex treatment, HCB concentrations in fat (major tissue of storage) of rabbits were about 5 times and in rats about 13 times lower than in corresponding controls. In general, the decrease of HCB in other tissues paralleled that in fat. Data indicate that the effect of Hex on the disposition of HCB is very similar in rats and rabbits. PMID- 6502740 TI - Dose-dependent metabolic excretion of bromobenzene and its possible relationship to hepatotoxicity in rats. AB - Male Sprague-Dawley rats received an intraperitoneal injection of 0.25-, 0.5-, 1.0-, 2.5-, and 5.0-mmol/kg dose of bromobenzene in corn oil. The metabolic fate of bromobenzene was studied by measuring its various urinary metabolites 24 h following bromobenzene administration. The hepatotoxicity of bromobenzene was estimated by determination of the serum glutamic-oxaloacetic and glutamic-pyruvic transaminase activities (SGOT and SGPT) 24 h after dosing. Treatment of rats with bromobenzene at up to 0.5 mmol/kg did not influence the transaminase activities, but significant increases in such activities began to manifest at a dose of 1 mmol/kg. However, no further increase in hepatotoxic response was induced on exposure to higher doses (2.5 and 5.0 mmol/kg) of bromobenzene. The urinary excretion of toxic doses of bromobenzene was nonlinear, based on the quantitative composition of various urinary metabolites. Furthermore, the fraction of the dose converted to thioethers, p-bromophenol, m-bromophenol, and total phenolic metabolites decreased with increasing toxic dose, suggesting their formation to be capacity-limited. The ratios of thioethers to total phenolic metabolites, of thioethers to p-bromophenol, and of thioethers to o-bromophenol decreased with increasing dose of bromobenzene. The correlation of the dose-dependent fate of metabolic excretion of bromobenzene with the results of the dose-hepatotoxic response curves supports the conclusion that there exists an apparent threshold dose (approximately 1-2.5 mmol/kg) for the toxic effects of bromobenzene that coincides with saturation of the metabolic pathways involving both glutathione/glutathione S-transferase(s) and formation of certain phenolic derivatives for its detoxification. All these results further suggest a role of a saturable, metabolic activation process involving 3,4-epoxide rather than 2,3 epoxide of bromobenzene in the development of its hepatotoxicity. PMID- 6502741 TI - Relationship of serum thiocyanate concentrations to smoking characteristics. AB - Thiocyanate (SCN) concentrations were determined in serum samples from 130 young healthy persons (60 smokers) and related to their smoking and physiologic characteristics. Serum thiocyanate correlated strongly and approximately equally with the number of cigarettes/d X kg of ideal body weight (IBW) (r = 0.748), total nicotine intake in mg/d X kg IBW (r = 0.735), and total tar intake in mg/d X kg IBW (r = 0.731). Multiple linear regression analysis that included these factors as well as sex, marijuana use, menthol, and degree of inhalation only increased the multiple r to 0.803. A more sensitive statistical method (NYBAID) was also used to determine the most significant influences of these variables on serum SCN. The association with depth of inhalation (i.e., smoking versus nonsmoking) was dominant among the relationships considered. The highest SCN levels were exhibited in heavy nicotine users (8.58 +/- 3.00 mg/l), while average users had slightly lower concentrations (6.49 +/- 2.37 mg/l) (p less than 0.03). In nontobacco smokers, those who smoked marijuana several times weekly had higher SCN levels (4.66 +/- 2.16 mg/l) than noncannabis users (2.38 +/- 1.38 mg/l) (p less than 0.03). These studies confirm the utility of serum SCN as an index of smoking rate and demonstrate the role of secondary variables in accounting for the chemical in serum. PMID- 6502742 TI - Effect of chronic ethanol ingestion on the metabolism of copper, iron, manganese, selenium, and zinc in an animal model of alcoholic cardiomyopathy. AB - Alcoholic cardiomyopathy (AC) is one of the diseases caused by alcohol abuse, and there has been considerable debate about the possibility that nutritional factors may be important in the etiology of AC. In addition, there is evidence that ethanol may affect the metabolism of trace elements. The purpose of this investigation was to determine if chronic ethanol administration produces changes in the metabolism of the essential metals copper, iron, manganese, zinc, and selenium using an animal model of AC. Eighteen male Sprague-Dawley rats were divided into three groups: an ad libitum control group (AL), a pair-fed control group (PF), and an ethanol-dosed group (ETOH). The latter group received gradually increasing concentrations (5-25%) of ethanol in the drinking water for 15 wk. Food intake was monitored and urine and feces collected for a 4-d period during the study to determine ethanol effects on trace-element balance. Growth of both the PF and ETOH animals was inhibited. Ethanol produced substantial increases in liver manganese and decreases in liver copper and zinc. Metal concentrations in heart and concentrations in other tissues studied (spleen, testes, brain, bone, kidney, and muscle) did not differ significantly among the groups, except for testes selenium and kidney zinc. Reduced food intake and ethanol ingestion were associated with a reduced percentage of ingested selenium excreted in the urine. Deficiencies of copper, iron, manganese, selenium, and zinc in myocardial tissue are not likely to be involved in the pathogenesis of AC in the rat. PMID- 6502743 TI - Induction of metallothionein synthesis in cultured human trophoblasts by cadmium and zinc. AB - A system of primary cultures of human chorionic trophoblasts has been used for studying the effects of heavy metals on human reproductive tissue. Using this system, changes in cellular concentration of metallothionein (MT) in response to exposure to Cd or Zn were determined. Trophoblasts were isolated from term chorion leave, grown in RPMI-1640 medium, and exposed to Cd or Zn. Cellular content of MT was measured using the Cd/heme radioassay. MT increased in a concentration- and time-dependent manner after exposure to either metal. Cd increased the content of MT in trophoblasts at concentrations as low as 0.5 microM during a 24-h exposure. Moreover, extending exposure to Cd (2 microM) to 72 h resulted in a 3-4-fold increase in the concentration of MT. On a molar basis, Zn was not as potent a stimulus for MT synthesis as Cd, and required a concentration of 2.5 microM to increase the concentration of MT over a 24-h period. However, a 48- or 72-h exposure to Zn (10 microM) increased concentrations of MT nearly 8-fold over control values. Simultaneous exposure to Cd (2 microM) and inhibitors of protein synthesis, cycloheximide and actinomycin D, prevented the typical increase in MT concentration, suggesting that the metals act to increase the synthesis of MT. In another series of experiments, trophoblasts were exposed to Cd (2 microM) for 24 h, after which the cells were challenged with cytotoxic concentrations of Cd. Cells pretreated with Cd and then challenged with toxic concentrations of Cd had higher levels of MT and showed less toxicity, as indicated by leakage of lactic dehydrogenase. These results suggest that MT serves to sequester the metals in trophoblasts and reduce the toxicity of heavy metals. Thus, this system should be useful for studying the effects of heavy metals and characterizing the induction of MT in human reproductive tissue in vitro. PMID- 6502744 TI - Subacute toxicity of methylene-bis-(2,6-diisopropylaniline) in the rat and hamster. AB - Methylene-bis-2,6-diisopropylaniline (MDPA), a chemical having potential application as a polyurethane chain extender or an epoxy curing agent, was administered daily by gavage to male Fischer 344 rats and male Syrian golden FVG hamsters. Rats were administered MDPA at 10.5, 21.0, 42.0, 63.0, or 87.5 mg/kg in corn oil for 5, 10, or 28 d. Hamsters received 87.5 or 875 mg MDPA/kg daily for the same periods. Histopathologic evaluation of rat tissue showed diffuse vacuolar change and periacinar vacuolar degeneration of the livers, with congestion, hemosiderosis, and hematopoiesis in the spleen. Hepatic periacinar vacuolar degeneration decreased in incidence and severity from d 5 to d 28, and livers of rats sacrificed 28 d after cessation of MDPA treatment (d 56) were normal. Hepatic vacuolar change was characterized by lipid inclusions. Electron microscopic evaluation found no structural abnormalities in hepatocytes with a moderate level of lipid vacuolization, while degeneration was seen in cells with extensive vacuolization. Stage III, stage IV, and maximal respiratory rates of mitochondria isolated from livers of test animals were higher than age-matched controls after 28 d treatment. At the high dose (875 mg/kg), MDPA produced liver lesions consisting of periacinar vacuolar change, vacuolar degeneration, hepatocytic swelling, and necrosis in hamsters. The high dose also produced acute toxic tubular nephrosis and a high mortality rate. At a dose (87.5 mg/kg) equuimolar to the high dose in the rat, however, the only lesion observed in the hamster was periacinar vacuolar change. In summary, the degenerative hepatic lesion produced in liver decreased in incidence with continued administration, and higher doses were required to produce this lesion in the hamster than in the rat. PMID- 6502745 TI - Comments on "Formaldehyde and Hepatotoxicity" by Beall and Ulsamer. PMID- 6502746 TI - Methyltin mercaptide stabilizers employed in polyvinyl chloride water pipe. PMID- 6502747 TI - Ganglioside biosynthesis in Golgi apparatus: new perspectives on its mechanism. AB - The synthesis of gangliosides GM1 and GM2 in intact rat liver Golgi vesicles is stimulated by phosphatidylglycerol as much as or even more than by detergents (Triton X-100 and octyglucoside, respectively). The antibiotic tunicamycin, known as an inhibitor of the N-glycosylation of proteins, strongly inhibits the synthesis of the above gangliosides, in the presence as well as in the absence of the phospholipid. Both phosphatidylglycerol dependence and tunicamycin inhibition disappear when the Golgi vesicles are solubilized by addition of detergents or disrupted by ultrasonication or pretreated with pronase. Transport studies with UDP-[3H]Gal show that tunicamycin blocks the penetration of the sugar nucleotide into the Golgi vesicles in a concentration-dependent manner up to 80%. The results show that tunicamycin inhibits ganglioside biosynthesis by blocking the transport of the nucleotide sugar and not by inhibiting the transferase directly. Studies on glycoprotein-galactosyltransferase with ovalbumin as exogenous acceptor showed that phosphatidylglycerol does not destroy the integrity of the Golgi vesicles. So this phospholipid is an excellent tool for studying ganglioside biosynthesis at optimal transferase activities without solubilizing the Golgi membranes. PMID- 6502748 TI - Analytical and preparative high-performance liquid chromatography of gangliosides. AB - Analytical and preparative procedures are described for high-performance liquid chromatography (HPLC) fractionation of gangliosides without previous derivatization. These procedures make use of a reversed-phase Lichrosorb RB-8 or mu Bondapak RP-18 column, and of a mixture of acetonitrile and 5 mM phosphate buffer, at fixed or varying volume ratios, as solvent system. Peak elution from the column is monitored by flow through reading of absorbance at 195 nm. Under all the described conditions HPLC is capable of resolving all common gangliosides and of separating each of them into four molecular species containing C18 sphingosine, C18-sphinganine, C20-sphingosine, or C20-sphinganine. The analytical method has been successfully applied to fractionation of ganglioside mixtures from calf brain and to verification of homogeneity of single-ganglioside preparations. It is suitable for quantitative purposes, with high sensitivity (detection limit, 0.1 nmole) and precision (SD less than 10% of mean values in the concentration range 0.1-50 nmoles). The semipreparative method, which provides successive cycles of analysis in a fully automated way, enables the preparation in 2-4 days of 100-mg amounts of each molecular species starting from single gangliosides, like GM1 and GD1a. The preparative method makes use of acetonitrile-phosphate buffer-tetrahydrofuran as eluting solvent, and requires the addition to the starting ganglioside of the corresponding radioactive compound as tracer. This procedure, applied to GM1 ganglioside, is devised for processing up to 50 mg of ganglioside per analysis. PMID- 6502749 TI - Cytosolic gangliosides of rat brain: their fractionation into protein-bound complexes of different ganglioside compositions. AB - The sialic acid moiety of rat brain cytosolic gangliosides was radiolabeled by intracranial injection of N-(3H)acetylmannosamine. Upon ammonium sulphate fractionation, Sepharose 6B gel filtration, and hydroxylapatite-cellulose chromatography, ganglioside-bound radioactivity of brain cytosolic extract followed the behavior of protein and not that of purified gangliosides. This indicates that cytosolic gangliosides occur as ganglioside-protein complexes. By application of hydroxylapatite-cellulose column chromatography, fractions were obtained having different ganglioside composition. In particular, one fraction contained GM1, one GD1a, and one GT1b with a ganglioside homogeneity better than 95% in each fraction. This indicates the occurrence in brain cytosol of a GM1 protein complex, a GD1a-protein complex, and a GT1b-protein complex. PMID- 6502750 TI - Fatty acid and long-chain base composition of gangliosides isolated from adult human brain. AB - A series of major and minor ganglioside species were isolated from a single human adult brain and analyzed for their lipophilic composition. Hematosides, GM3 and GD3, each showing double bands on thin-layer chromatograms, were separated into the upper band and lower band fractions to be analyzed for the heterogeneity of their ceramide moieties. The upper band fractions of GM3 and GD3 were found to contain relatively high amounts of longer-chain fatty acids (C20-C26), whereas the lower band fractions contained high amounts of shorter-chain fatty acids (C16 C18). Compared to other gangliosides which contain hexosamine, the two hematosides contained a smaller proportion of stearic acid. The proportion of 4 eicosasphingenine was found to increase with increasing sialic acid content in gangliosides. These findings suggest that, in the biosynthesis of various gangliosides, N-acetylhexosamine is preferentially transferred to hematosides rich in stearic acid, and sialic acid residues are preferentially transferred to 4-eicosasphingenine-containing species. PMID- 6502752 TI - Differential expression of gangliosides on the surfaces of myelinated nerve fibers. AB - The binding of cholera and tetanus toxins to receptors on the surfaces of teased nerve fibers was used to localize GM1 and G1b-series gangliosides, respectively, by immunocytochemical methods. Native fibers and fibers treated with various hydrolytic enzymes to degrade specific surface components were studied. With native fibers, both toxins bound abundantly to nodes of Ranvier and poorly to the most external, internodal Schwann cell surfaces. Treatment of the fibers with proteases, hyaluronidase, and chondroitin ABC lyase neither eliminated receptors at the nodes nor unmasked receptors over the internodes. The axolemma underlying the paranodal or internodal myelin, exposed by extensive treatment with protease, bound both toxins in large amounts. Neuraminidase action induced cholera toxin receptors on the Schwann cell surface; these receptors were insensitive to protease. The results indicate that GM1 and G1b-series gangliosides are predominantly localized to axonal and glial structures of the node of Ranvier and to paranodal/internodal Axolemma, and that polysialogangliosides not of the G1b series are present on the internodal Schwann cell surface. PMID- 6502751 TI - Gangliosides of human spinal cord: aberrant composition of cords from patients with amyotrophic lateral sclerosis. AB - The ganglioside content of formalin-fixed human spinal cords and fresh human spinal cords was found to be both quantitatively and qualitatively similar. However, the spinal cord was found to be heterogeneous with respect to ganglioside content. In particular, a gradient of GD1a was observed, increasing from a low content in the cervical region to a relatively high content in the sacral region. Comparison of the ganglioside content of nine normal spinal cords and nine spinal cords from clinically diagnosed amyotrophic lateral sclerosis (ALS) patients revealed no major quantitative differences, but the unique presence of three additional gangliosides in ALS spinal cords. One of these was tentatively identified as sialosylglobotetraosylceramide and was absent from eight of nine control spinal cord samples, the sole exception being the cord from a 97-year-old female. PMID- 6502753 TI - Dorsal root ganglia and nerve growth factor: a model for understanding the mechanism of GM1 effects on neuronal repair. AB - The experimental strategy of adding monosialoganglioside GM1 to a culture medium of fetal chick dorsal root ganglia (DRG) was utilized as a model system in which to examine the potential role of GM1 in modulation of neuronal cell responsiveness to nerve growth factor (NGF). Data indicate that the addition of GM1 to DRG explants or to DRG dissociated neuronal cells in culture enhances NGF induced neurite outgrowth, neurite complexity, and neuronal cell survival following NGF withdrawal. The GM1 molecule apparently facilitates the acquisition or maintenance of the NGF-induced specific neuronal properties. Results are consistent with the hypothesis that the presence of GM1 molecules on the neuronal cell surface, either endogenous or following stable insertion of exogenous molecules, plays a prominent role in the modulation of functional neuronal cell behavior in response to varying neuronotrophic signals. This may prove to be relevant for the comprehension of GM1 effects on the facilitation of central nervous system repair processes. PMID- 6502754 TI - Studies on bioactive gangliosides: II. Requirement of ganglioside GD1a for prolonged GQ1b-driven nerve growth promotion in neuroblastoma cell lines. AB - The novel effects of gangliosides from human brain on the number of nuclei of nerve cells and neurite outgrowth were studied in cultures of human neuroblastoma cell lines GOTO and NB-1. Ganglioside GQ1b at a nanomolar level stimulated cell proliferation and neurite outgrowth during culture for 24 hours, as reported previously [J Biochem 94: 303-306, 1983]. Although the neurite promoting activity of GQ1b was similar to those of total human brain gangliosides (GS) and nerve growth factor (NGF), its activity on cell proliferation did not persist on longer culture; that is, the number of GQ1b-treated cells rapidly decreased to the control level during culture for 48 or 72 hours. In contrast, on treatment with GS or NGF, the number of cell nuclei increased continuously during prolonged culture. These results showed that either some other molecular species of ganglioside(s) than GQ1b or other substances such as proteins present in the GS fraction were responsible for the long-term activity. Studies on the GS fraction after its treatment with proteases and neuraminidases revealed that ganglioside GD1a (20 ng/ml) had the ability to prolong the activity of GQ1b. Namely, GQ1b and GD1a gangliosides cooperated in maintaining the number of nuclei in long-term cultures of neuroblastoma cell lines. PMID- 6502755 TI - Interaction of GM1 ganglioside with PC12 pheochromocytoma cells: serum- and NGF dependent effects on neuritic growth (and proliferation). AB - The effects of ganglioside GM1 on proliferation and neuritic growth of PC12 pheochromocytoma cells were studied in the presence and absence of nerve growth factor (NGF). In the absence of NGF, but not in its presence, a decrease in the total number of PC12 cells was first observed after 4-6 days of culture with 10( 6) M GM1 in 0.1% fetal calf serum, and with 10(-3) M GM1 on 10% serum. NGF, with or without GM1, limits cell growth to the first 4-6 days. GM1 enhanced neuritic recruitment with serum concentrations of 0.3% or more. Optimal neurite response varied from 10(-6) M GM1 with 0.3% serum to 10(-4) M GM1 with 10% serum. The influence of GM1 on neurites became more pronounced with increasing serum concentrations, becoming maximal with 1% or greater serum. Serum exhibited a concentration-dependent inhibitory influence (lag) on NGF-induced neuritic recruitment, which was abolished by GM1. Rates of neuritic recruitment following the lag were unaffected by GM1, while showing an inverse correlation with serum concentrations of 0.1-0.5%. Serum may delay the NGF-induced neuritic recruitment of PC12 cells by two independent mechanisms. These results suggest that GM1, in some manner, prevents the serum-induced delay in the onset of neuritic recruitment, rather than stimulating the rate at which it precedes. PMID- 6502757 TI - Tryptophan fluorescence properties of cholera toxin upon interacting with ganglioside GD1b. AB - A blue shift of the tryptophan fluorescence emission spectra of cholera toxin or the B protomer is induced by disialoganglioside GD1b with a capacity similar to that of monosialoganglioside GM1. Both gangliosides were also capable of decreasing or reversing the fluorescence quenching by iodide ion of the toxin. The quenching constants (Ksv) for the toxin fluorescence in absence of gangliosides was 2.8 M-1; in presence of GM1 or GD1b, Ksv was 0.8 M-1 and 0.7 M 1, respectively. Gangliosides GD1a and GT1b were unable to decrease the quenching effect. The results suggest that GD1b induces a perturbation in the tryptophan environment of the toxin molecule similar to that induced by GM1. PMID- 6502756 TI - Metabolism and function of gangliosides in developing neurons. AB - Previous experiments have shown that the addition of a mixture of gangliosides to the growth medium induced morphological changes in primary neuronal cultures, producing especially a trophic effect and a sprouting of neurites (neuritogenesis). The study reported here examined the changes of some biochemical parameters that paralleled the morphological modifications of cultured neurons from chick brain hemispheres treated with gangliosides. Neurons cultured from 3 to 7 days in the presence of various concentrations of a purified mixture or of single-species of gangliosides (GM1, GD1a, GT1b) revealed that these glycolipids were easily incorporated into the cells as a function of their exogenous concentrations. Incubation of neurons with N-acetyl-D-[U 14C]mannosamine showed a final labeling of all endogenous cellular and exogenous incorporated gangliosides; however, the radioactivity recovered decreased as a function of the number of sialic acid units of the exogenously added gangliosides. The treatment of neuronal cells from 3 to 7 days in culture with a mixture of 10(-8) M and 10(-5) M gangliosides led to the following observations on some neurochemical parameters: no effect on the influx of choline and dopamine; no effect on the spontaneous choline efflux, whereas the K+-provoked one is abolished; decrease of the spontaneous and K+-stimulated release of dopamine; no effect on the spontaneous release of GABA for 10(-8) M gangliosides but an increase of both spontaneous and K+-provoked release for 10(-5) M gangliosides. The data suggest that the possible insertion of gangliosides into the neuronal membranes may imply structural modifications that may influence enzymatic activities, neurotransmitter transport, and finally, some nerve cell mechanisms. PMID- 6502758 TI - Effect of GM1 ganglioside treatment on postlesion responses of cholinergic enzymes in rat hippocampus after various partial deafferentations. AB - The effect of intramuscular administration of monosialoganglioside (GM1) on postlesion responses of choline acetyltransferase and acetylcholinesterase activity in partially deafferented rat hippocampus was studied at various survival times. Lesions partially destroying the medioventral, septal area, or lesions performed in supracallosal stria including corpus callosum and cingulum evoked cholinergic denervation of the hippocampus, while those made in entorhinal cortex resulted in partial glutamatergic deafferentation. GM1 treatment potentiates the responses of both cholinergic enzymes, independently of whether the partial deafferentation was homo- or heterotypical. These data indicate that GM1 may facilitate the regrowth of new cholinergic nerve terminals. However, an effect on other compensatory processes, especially in the first postoperative period, is also possible. PMID- 6502759 TI - GM1 ganglioside facilitates the recovery of high-affinity choline uptake in the cerebral cortex of rats with a lesion of the nucleus basalis magnocellularis. AB - The effect of repeated administrations of GM1 monosialoganglioside on high affinity choline uptake (HACU) was investigated in the cerebral cortex of rats with a unilateral electrolytic lesion of the nucleus basalis magnocellularis. In saline-treated rats, 4 days after lesion, a 38% and 14% decrease in HACU-activity was found in the ipsilateral frontal and parietal cortex, respectively. A spontaneous recovery of HACU activity occurred within the next 20 days. In rats receiving daily injections of GM1 from the day of operation, no significant decrease in HACU activity was found in the lesioned hemisphere 4 days after the lesion. In contrast a 25% increase in HACU activity in the frontal area of the opposite hemisphere was detected. No effect of GM1 treatment could be seen on days 10 or 20 after lesion. The possibility that GM1 may exert its stimulatory effect on HACU independently of the well-known effect of gangliosides on neuronal sprouting is discussed. PMID- 6502760 TI - Effects of ganglioside treatments on lesion-induced behavioral impairments and sprouting in the CNS. AB - Recent findings suggest that exogenous gangliosides improve recovery of a learned behavior (alternation in a T-maze) which is thought to be related to sprouting after lesions of the entorhinal cortex. In the present investigation, we studied an unlearned behavior (the open-field hyperactivity resulting from bilateral entorhinal lesions) to evaluate whether ganglioside treatments reduce the severity of initial postlesion impairments or improve recovery. We also examined whether the treatments enhance the sprouting of septodenate fibers which parallels the recovery of open-field activity. The typical behavioral changes induced by bilateral entorhinal lesions include hyperactivity, reduced habituation of activity, and a gradual time-dependent return toward control levels. We found that rats treated with total brain gangliosides (30 mg/kg) showed a smaller lesion-induced increase, consistently lower levels, and greater within-session habituation of activity than did saline-treated counterparts. Control rats treated with gangliosides did not exhibit a reduction in activity, suggesting that the effect was on lesion-induced hyperactivity rather than on activity, per se. Ganglioside-treated rats showed a slight, but consistently smaller lesion-induced sprouting response by the septodentate pathway than did untreated counterparts at all postlesion intervals examined (3, 5, 7, and 10 days). The present findings indicate that ganglioside treatments reduce the severity of the initial behavioral effects after entorhinal lesions without enhancing the sprouting by septodentate fibers. PMID- 6502761 TI - Can functional reorganization of area 17 following monocular deprivation be modified by GM1 internal ester treatment? AB - It has been extensively reported that monocular exposure early in life leads to profound alterations in visual cortical areas, where the majority of cells become responsive only to the stimulation of the normal eye. We have investigated a possible effect of the monosialoganglioside internal ester, termed AGF2, on the neuronal cortical plasticity of the kitten's visual cortex following monocular deprivation. Results indicate that in monocularly deprived kittens treated with ganglioside the ocular dominance shift in favor of the normal eye is partially prevented. PMID- 6502762 TI - Changes in cerebrospinal fluid volume and cardiovascular functions induced by intraperitoneal injection of hypertonic glucose solution in rats. AB - The present experiment was undertaken to study the relationship between hemodynamic changes and intracranial hemorrhage induced by intraperitoneal injection of large doses of hypertonic glucose solution in rats. A fifty per cent glucose solution was intraperitoneally injected at a volume of 3.5 ml/100 g b.w. into Wistar rats anesthetized with urethanechloralose. The time span from the start of injection to death was expressed in terms of 100% corrected death time (100% DT) for each rat. Saline that was added to the cerebrospinal fluid in the brain ventricle disappeared gradually from 30% DT up to death. Blood colloid osmotic pressure was slightly elevated temporally 5 minutes (7% DT) after intraperitoneal injection of the glucose solution and returned to the former level 5 minutes later. With regard to hemodynamic changes, a decrease in blood pressure and heart rate began to occur between 5-10% DT. Thereafter, blood pressure and heart rate decreased significantly as compared with the pretreatment period, and the plasma levels of both epinephrine and norepinephrine showed sharply increasing curves as time elapsed after the intraperitoneal injection of the hypertonic glucose solution. It was suggested that the decrease in cerebrospinal fluid and the fall in blood pressure were related to the movement of water from the brain and the flow of body fluid into the hypertonic blood plasma which caused an enlargement of the ventricles due to brain reduction and a change in circulating blood volume. However, questions still remain concerning the mechanisms of the marked increase in plasma catecholamines and bleedings which occurred only in the subarachnoideal space and ventricles. PMID- 6502763 TI - The protective effect of cysteine on chemical-induced liver injury in rats. AB - The possible protective effect of cysteine on chemical-induced liver injury was studied in rats in vivo and in vitro. There was no increase in the activity of serum glutamic oxaloacetic transaminase (GOT) of rats pretreated with cysteine (1.2 g/kg, p,o.) followed by 0.25 ml/kg carbon tetrachloride (CCl4), d galactosamine (GalN) or alpha-naphthylisothiocyanate (ANIT). However, rats pretreated with cysteine followed by 0.5 ml/kg CCl4 were not protected. The content of cytochrome P-450, activity of aminopyrine N-demethylase or serum ratio of 5,5-dimethyl-2,4-oxazolidinedione (DMO) to trimethadione (TMO) (DMO/TMO ratio) after CCl4, GalN or ANIT were not altered by pretreatment with cysteine. However, pretreatment with cysteine prevented changes in the content of cytochrome P-450, activity of aminopyrine N-demethylase and DMO/TMO ratio in serum as well as the activities of serum GOT and GPT when the rats were treated with bromobenzene (BZ). The degree of lipid peroxidation from CCl4 was markedly reduced by the presence of 10(-4)M cysteine. These results suggest that cysteine has a protective effect on chemical-induced liver injury produced via epoxide metabolites. PMID- 6502764 TI - Immediate closed antegrade Ender nailing of femoral fractures in polytrauma patients. AB - Fifty-four trauma patients with 61 femoral fractures stabilized within the first 24 hours of admission by closed antegrade Ender nailing were included in this study. This technique involves the insertion of Ender nails from a portal at the proximal end of the femur through the piriformis fossa. The curved distal ends of the nails were distributed throughout the distal femur to achieve greater purchase in the enlarged medullary canal of the distal fragment. This technique was used in one proximal, 20 midshaft, 37 distal, and three segmental fractures. There were 51 closed fractures, eight Grade I open, and two Grade II open fractures. The average age of the patient was 26 years, and the majority had polytrauma. The operative procedure was well tolerated by this group of patients. Pulmonary care was improved by avoidance of traction and enhanced capability for mobilization. Forty-two patients with 49 femoral fractures were available for complete follow-up. Forty-five fractures healed with the average time to appearance of bridging callus being 33 days, and average time to full union remodeled callus being 5.9 months. There were four nonunions, one delayed union, and eight malunions. There were nail protrusions in 22 cases (19 proximal and three distal). Fourteen patients required a second operation for reimpaction of the protruding nails or premature nail removal. These results were inferior to those obtained with the use of the retrograde Ender nailing technique or the Kuntscher nail. This technique should be used only if other techniques are unavailable or inappropriate, and only for stable, noncomminuted fractures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502765 TI - Venous return and the pneumatic antishock garment in hypovolemic baboons. AB - The pneumatic antishock garment is widely used in trauma patients because it compresses small veins and should augment venous return. If the garment does augment venous return, it should probably be used in all injured patients in shock, regardless of injuries and regardless of anticipated transport time. On the other hand, the garment could distort and narrow large retroperitoneal and abdominal veins and impede venous return. We quantitated venous return in normovolemic and hypovolemic baboons. The garment both augmented and impeded venous return, the two effects counteracting each other. We believe that the pneumatic antishock garment should be used selectively. PMID- 6502766 TI - Urban helicopter response to the scene of injury. AB - Metropolitan Houston with a population of four million has the nation's poorest freeway system. Its two Level I trauma centers are adjacent within a centrally located freeway loop, therefore the city is ideally suited for a trauma scene helicopter transport service. During 1981 there were 577 flights to the scene of injury (blunt, 466; penetrating, 111). Flights were requested by 60 agencies (EMS, law enforcement, etc.). All flights were manned by a surgical resident and flight nurse. The flight distances ranged from 2 to 57 miles (average, 14.4). Three hundred six flights (53%) were within the city, including 59 (10.2%) within the freeway loop. In approximately one half of the flights, the initial responding EMS unit was a paramedic unit. The average time at the scene was 28 minutes. The overall mortality for trauma scene flights was 35.7% (206/577). Eighty-nine patients (15.1%) died at the scene and were not transported (initial median scene Trauma Score, 2). The mortality among transported patients was 24.0% (117/488). Twenty-nine patients died during attempted emergency-center resuscitation (initial median scene Trauma Score, 5). Eight-eight patients died after hospital admission (initial median scene Trauma Score, 10). Only 27 patients (5.5%) did not require hospitalization. Scene treatment (intubation, hyperventilation and, when appropriate, mannitol administration) was routinely initiated for patients with severe head injuries. Two hundred seventy-nine patients required cardiopulmonary resuscitation, tracheal intubation, chest-tube placement, or other invasive procedures. Based upon these resuscitative efforts and invasive procedures, a physician in attendance was deemed medically desirable for one half of the flights.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502767 TI - Gunshot injuries in children. AB - Ninety consecutive patients between 2 and 15 years of age sustaining gunshot wounds were analyzed and a management algorithm evolved. Key management steps included fluid resuscitation in the field by trained paramedical personnel and recognition of the severity of the wound when large-caliber or shotgun injuries were encountered. Arteriograms were most helpful in locating vascular injuries; venograms were inaccurate. Morbidity was directly related to missile size and impact area, and to the number of organs injured. Any hospitalization beyond 2 weeks' duration should have social service, home-bound school service, psychiatry, and physical therapy in consultation. During a 5-year period only two of the 90 patients died secondary to hemorrhagic shock. PMID- 6502768 TI - Changes in epicardial and core temperatures during resuscitation of hemorrhagic shock. AB - The hypothermic effect of resuscitation solution temperature on epicardial and core temperatures in 15 dogs during hemorrhagic shock was studied. Hemorrhagic shock was induced and dogs were then resuscitated with either body-temperature lactated Ringer's, room-temperature lactated Ringer's, 4 degrees C blood, warmed blood, or cold blood mixed with 50 degrees C lactated Ringer's. There was a significant decrease (p = 0.001) from baseline temperature recordings with the use of room-temperature lactated Ringer's, cold blood, and cold blood mixed with 50 degrees C lactated Ringer's. Baseline temperatures were not significantly changed with the use of warmed blood or body-temperature lactated Ringer's. The results of this study support the use of warmed blood or body-temperature lactated Ringer's during resuscitation from hemorrhagic shock. PMID- 6502769 TI - Infra-isthmal longitudinal fractures of the tibial diaphysis: results of treatment using closed intramedullary compression nailing. AB - A followup study of 103 patients with long spiral or oblique fractures of the shaft of the tibia distal to the isthmus of the intramedullary canal was done. The injuries were caused by indirect violence, and consequently the soft-tissue damage was minimal while the degree of initial displacement and instability varied considerably. The initial management was conservative by closed reduction and long plaster cast. Failure to retain the fragments in an acceptable position occurred in 32 cases, and in these closed intramedullary compression nailing with the Kaessmann rod was undertaken 9 days postinjury on an average. The ultimately nailed 32 fractures had a significantly shorter clinical union time than the 71 conservatively treated fractures in spite of the initially more severe average lateral displacement. Deep infections were not seen. The malunion rate was 9% after compression nailing and 27% after conservative treatment. The functional recovery showed a marked correlation with the anatomic restoration. PMID- 6502770 TI - Biomechanics of femur fractures secondary to gunshot wounds. AB - Nonlethal gunshot wounds to the femur produce four classical types of fractures. The 'drill-hole,' incomplete, and 'butterfly' fractures have been described in both clinical and experimental settings. The remote spiral fracture, sometimes attributed to the fall on the femur after wounding, is unique to the weight loaded femur. A mathematical model relying on the beam in bending and the mechanics of a cylindrical shell is offered. An experimental method utilizing an apparatus (the 'osteoclast') designed to apply torsion, bending, or combined forces to cadaveric long bones is discussed. Femur failure proximal or distal to the impact site of a projectile is a function of stress risers operating at relatively great distances. Predictable primary and secondary peak moment locations for fracture are illustrated. PMID- 6502771 TI - Hazards of nonoperative therapy of hepatic injury in children. AB - Several reports suggest that pediatric patients with stable liver injuries can be managed nonoperatively with few complications. From March 1978 to July 1983 seven children with hepatic injury were managed without surgery at CHNMC. Four children required greater than 50% total blood volume replacement, while the mean PRBC transfusion rate was 28 cc/kg. Eight major complications developed in five patients. Hospitalization averaged 23 days, without a mortality. This morbidity is greater than that described in earlier reports. In view of the limited cumulative clinical experience, we caution against routine nonoperative management of liver trauma in children until data with this new technique become available for analysis. PMID- 6502772 TI - Subtle neurological injuries in pelvic fractures. AB - Eleven of 28 patients with a fracture of the acetabulum, pelvis, or sacrum were found to have electromyographic changes, apparently due to injury to the lumbosacral plexus. There appears to be a higher incidence associated with sacral fracture or sacroiliac separation (64%) than with acetabular fracture (24%). The EMG changes are diffuse and the clinical manifestations are subtle but the changes do interfere with the rehabilitation process. PMID- 6502773 TI - Fractures of the talus. AB - A total of 35 patients treated in the years 1970 to 1977 for fractures of the talus were investigated for an analysis of the long-term clinical end results. Falling from height was the most common cause of injury (15 patients), the next most common being road traffic accidents (13 patients). The mean followup time was 8 years. At followup, 19 patients were free of any discomfort and none had pain at rest. The incidence of pain was correlated significantly (p less than 0.01) with the grade of dislocation both before and after reduction. In severely dislocated fractures open reduction and osteosynthesis with a compression screw are recommended. PMID- 6502774 TI - Injuries due to falling coconuts. AB - Falling coconuts can cause injury to the head, back, and shoulders. A 4-year review of trauma admissions to the Provincial Hospital, Alotau, Milne Bay Province, Papua New Guinea, revealed that 2.5% of such admissions were due to being struck by falling coconuts. Since mature coconut palms may have a height of 24 up to 35 meters and an unhusked coconut may weigh 1 to 4 kg, blows to the head of a force exceeding 1 metric ton are possible. Four patients with head injuries due to falling coconuts are described. Two required craniotomy. Two others died instantly in the village after being struck by dropping nuts. PMID- 6502775 TI - Trauma to the high cervical carotid artery. AB - An alternative approach to the treatment of distal extracranial nonoccluding internal carotid artery penetrating injuries is described in which internal carotid artery ligation is followed expectantly. A warning transient neurologic deficit prompted an unsuccessful attempt at revascularization via a superficial temporal artery to middle cerebral artery anastomosis. The failure of the anastomosis was thought to be secondary to a postinjury hypercoagulable state and a diminished demand for intracranial blood flow secondary to an unexpected, impressive development of collateral blood supply. PMID- 6502776 TI - Eyeball injury due to fish hook. AB - A case of fish hook injury to the eye is described. The removal can be accomplished by rotating the hook and pushing the barb through another part of the eye as near the limbus as possible, which has the least damaging effect, the barb is snipped, and the hook can be removed with good recovery of vision. PMID- 6502778 TI - Isolation of the flagellum and characterization of the paraxial structure of Herpetomonas megaseliae. AB - It was observed in thin sections that the flagellum from Herpetomonas megaseliae, a protozoan of the Trypanosomatidae family, has, besides the axoneme, a filamentous lattice-like structure, the paraxial rod. Crithidia deanei, a protozoan of the same family, does not possess a paraxial rod in its flagellum. The flagella of these two trypanosomatids were isolated. Cultures were sonified and fractionated thus resulting the following fractions: total homogenates, deflagellated cell bodies, crude flagellar fraction and purified flagellar fraction from both H. megaseliae and C. deanei. The flagellar fractions are very pure and the flagella have their structures well preserved: axonemes and paraxial structures, where they exist, are intact, associated with one another and surrounded by the flagellar membrane. A comparative analysis of the purified flagellar fractions from both trypanosomatids was made using polyacrylamide gel electrophoresis. Two protein bands, with molecular weights of 78,000 and 73,000 daltons, which were enriched along the process of purification of the flagella from H. megaseliae, were found to correspond to the main components of the paraxial structure. These two bands were not observed in the purified flagellar fraction from C. deanei. PMID- 6502779 TI - Sex differences in adrenocortical structure and function. XV. Cellular composition and quantitative ultrastructural study of adrenal cortex of adult male and female hamster. AB - Cellular composition of adrenal cortex of adult male and female hamster was evaluated and parallel quantitative ultrastructural studies were performed. The adrenal cortex of adult male hamster contained more parenchymal cells than that of female and the difference depended mainly upon the number of the zona glomerulosa and zona fasciculata cells. Moreover, cells and nuclei of the zona reticularis were markedly larger in male animals. Ultrastructural observations of both male and female adrenal glands did not reveal any significant difference; however, stereology showed that the volumes of mitochondrial compartment and membrane space, as well as the surface areas of mitochondrial cristae and smooth endoplasmic reticulum tubules were significantly higher in the male hamster zona reticularis cells. Cortisol output by adrenal slices and homogenates per unit weight of the gland was higher in male than in female hamster. On the ground of these data, it seems conceivable that the observed sex-differences in the rate of cortisol output by hamster adrenal gland depend upon the higher number of the zona fasciculata cells and larger size of the zona reticularis cells in male than female gland. PMID- 6502777 TI - Severe facial injury by impalement. AB - Severe facial trauma is a well recognized hazard of road traffic accidents. We describe severe injuries sustained in an unusual way. A car overturned onto a roadside fencing post, impaling the driver's neck and face. The stake was successfully removed in the operating room, and the fractures were fixed and lacerations sutured. PMID- 6502780 TI - Hypertrophy of the rat Golgi complex during enhancement of cholesterol and bile acids synthesis. AB - There are some evidences that the Golgi apparatus could be involved in bile salts transport. In this study we investigate the morphology of the Golgi apparatus in rats with a chronic bile fistula or treated with 4% cholestyramine, a bile salts chelating agent. In both models liver histology was normal by light microscopy. With electron microscopy--compared to sham groups--the only obvious change was the enlargement of the Golgi complex. Morphometric data confirmed that the Golgi rich area volume density was almost doubled after chronic bile fistula or cholestyramine treatment. These data give another support for the participation of the Golgi complex in bile salts transport. PMID- 6502781 TI - Atypical cristae (paracrystalline inclusions) in mitochondria of epithelial cell of the rat ureter. II. Image analysis. AB - Long mitochondria containing paracrystalline inclusions have been detected in the epithelial cells of the basal layer of the rat ureter close to the bladder (Barastegui and Ruano-Gil, 1978). In the first part of this investigation the origin of these inclusions from alterations of the cristae has been suggested. The current report deals with an analysis by microdensitometry, optical diffraction and goniometry of the inclusions as well as with their possible architecture. A tridimensional model of the paracrystalline inclusions is proposed. PMID- 6502782 TI - Effect of dimethylsulfoxide on the cell surface of Herpetomonas samuelpessoai. AB - The influence of dimethylsulfoxide (DMSO) on surface components (Con A receptors, antigenic sites recognized by monospecific antibodies and membrane associated polysaccharide components) of Herpetomonas samuelpessoai was investigated. Techniques such as light and scanning electron microscopy and gas-liquid chromatography were used. The characteristic flagellar-flagellar (F-F) pattern of cell agglutination with Con A was markedly modified by DMSO and besides the F-F interactions other types of agglutination, including flagellar-somatic (F-S) and somatic-somatic (S-S), were detected. DMSO induced significant antigenic alteration in H. samuelpessoai. The interaction with serum anti-flagellate was greatly decreased in DMSO-treated cells. The pattern of the composition of membrane-associated polysaccharides was also substantially changed: DMSO induced a preferential synthesis of galactose and a decrease of xylose, whereas mannose and glucose content remained practically unchanged. PMID- 6502783 TI - Autoradiographic demonstration of human 125I-interferon alpha in lysosomes of rabbit proximal tubule cells. AB - This investigation proves for the first time that by electron microscope autoradiography, 125I-interferon alpha can be located in the lysosomal system of the renal proximal tubule cells of the rabbit. The observation provides further evidence that the kidney has a major role in interferon catabolism. PMID- 6502784 TI - Diagnosis of pulmonary talcosis by electron-probe x-ray analysis. AB - A miner with a long history of drug abuse developed pulmonary fibrosis. It was not clear whether his disease was due to drug abuse or exposure to mine dust. Electron-probe x-ray analysis of mineral deposits in the lung showed that his disease was due to drug abuse and not occupational exposure to mine dust. PMID- 6502785 TI - Different toxicological profiles for various beta-blocking agents on cardiac function in isolated rat hearts. AB - Propranolol, timolol and sotalol were compared regarding their cardiotoxic properties in isolated, perfused and catecholamine depleted rat hearts. Catecholamine depletion was performed in order to exclude interference of the drugs with beta-adrenergic receptors. The results demonstrate that both in spontaneously beating and atrial- stimulated hearts propranolol (3 - 30 micrograms/ml) and timolol (30 - 300 micrograms/ml) induced a dose dependent decrease in myocardial contractility, stimulus formation and stimulus conduction. Lacking local anesthetic properties as evidenced by effects on coronary flow and threshold voltage in the heart it can be deduced that the negative inotropic effect and an impaired stimulus conduction due to timolol can neither attributed to beta-adrenoceptor antagonism nor membrane stabilising activity. In addition, both propranolol (5 micrograms/ml) and timolol (200 micrograms/ml) reduced myocardial contractility to the same extent in ventricular-paced hearts. Therefore, a direct myocardial depressive effect rather than an indirect effect due to a reduced heart rate must be responsible for the negative inotropy. The hydrophilic beta-blocker sotalol demonstrated a slight cardiodepressant activity either in the spontaneously beating and atrial-stimulated hearts (30 - 300 micrograms/ml) or ventricular-paced hearts (300 micrograms/ml). It is concluded that the toxicological profile of various beta-blocking drugs might be determined by an yet unknown pharmacological property apart from beta-adrenoceptor blockade or membrane stabilising activity. Furthermore, the degree of lipophilicity of the drug might be an important determinant for the cardiotoxic profile of this class of drugs. PMID- 6502786 TI - High pressure liquid chromatographic assay of 4-methylpyrazole. Measurements of plasma and urine levels. AB - 4-Methylpyrazole (4-MP), a potent competitive inhibitor of alcohol dehydrogenase activity, has potential usefulness as a treatment means for methanol and ethylene glycol poisoning as well as severe disulfiram-ethanol interactions. Further study of the safety and metabolism of 4-MP in human subjects is needed before it can be used in such therapies. An HPLC assay has been developed to measure 4-MP levels in plasma and urine samples. The method was sensitive enough to quantitate 4-MP in an amount as low as 0.1 nmol. Recovery of 4-MP from spiked urine and plasma samples was greater than 90%. 4-MP levels in the plasma and urine of rats injected with an oral dose of 50 mg/kg of body weight were determined; the detectability limit in these samples was about 3 microM. The method is easy to perform and thus has practical application for research laboratories dealing with ethanol metabolism and clinical laboratories desiring to monitor 4-MP levels. PMID- 6502787 TI - Sex related differences in acetaminophen toxicity in the mouse. AB - Acetaminophen LD50 was two fold lower in female than male mice, the greater sensitivity of female mice for acetaminophen was also reflected in the serum enzyme levels of glutamic oxaloacetic and pyruvic transaminases (SGOT/SGPT), where the enhancement of both enzymes was higher in female than male mice. We could also observe the L-cysteine protection against the toxic effect of acetaminophen. Our results demonstrate that the lethal action of acetaminophen administrated either P.O. or S.C., is sex related. PMID- 6502788 TI - New aspects in the treatment of water hemlock poisoning. AB - A man inadvertently ate a whole root of the highly poisonous water hemlock (Cicuta virosa L.) plant. The chief symptoms were convulsions, unconsciousness, reddish tinted cyanosis, dilated pupils and marked metabolic acidosis. The patient survived due to treatment with haemodialysis, haemoperfusion, forced diuresis and artificial ventilation. The cicutoxin molecule size was calculated and it was found to be dialysable. PMID- 6502789 TI - An analysis of poison control center reports of ciguatera toxicity in Puerto Rico for one year. AB - Forty-five cases of ciguatera poisoning in Puerto Rico (P.R.) are described. These cases represent all those reported to the P.R. Poison Control Center in 1982. Most of the cases were reported in the spring and summer months. The most common fish ingested was the grouper. The clinical presentation of acute and long term symptoms was similar to that reported in other geographical areas, except the incidence of paresthesias. Paresthesias were reported in 11% of the patients reported to the poison center. A companion telephone survey indicated that persons in P.R. that do not eat fish do so because of fear of ingesting the toxin. Our findings indicate an overall familial contact with the ciguatera toxin in Puerto Rico at 7%. This study is the first to document that ciguatera is a common poisoning reported to the Poison Control Center in Puerto Rico. Our findings also support other authors contentions of geographical variations in clinical symptomatology. PMID- 6502790 TI - Approaches to surveillance of occupational cancer. AB - The overall number of deaths from cancer is increasing. The absolute magnitude of this increase is in debate. Unfortunately, we are unable to estimate the interactions between two or more agents such as cigarettes and asbestos. None of the appropriate studies is precisely able to know the exact exposure to carcinogens. Regardless of the percentage of cancers related to the workplace, the numbers are clearly clinically significant. It is important to present to physicians medical conditions which have an increased probability of resulting from occupational exposure. This will allow clinics, hospitals and health departments to seek evidence of changing patterns or clusters of listed diseases. Individual physicians with a high index of suspicion play an important role in detecting occupational cancers. The current state of the art is, that with rare exceptions, a good occupational history which contributes to a reasonable diagnosis with appropriate background information is the best way for the practicing doctor to detect occupational cancers. All health care providers should look beyond cigarettes as the only cause of cancer worth noting in order to implement primary preventive medicine strategies. PMID- 6502791 TI - Epigenetic carcinogens: problems with identification and risk estimation. AB - The mechanisms of carcinogenesis are just beginning to be understood. There is recent interest in the broad classification of carcinogens into two categories based upon their mechanism of action: those that interact with DNA via a genetic mechanism are termed genetic carcinogens; and those that do not directly interact with DNA, but may cause changes in DNA tertiary structure or methylation patterns, and are termed epigenetic carcinogens. Present knowledge is inadequate to justify separate risk assessment methods for genetic vs. epigenetic carcinogens. Quantitative estimates of carcinogenic risk are currently best made using non-threshold models. PMID- 6502792 TI - Dietary carcinogens and anti-carcinogens. AB - The scientific understanding of cancer and degenerative disease is being aided by new methodologies which are now used to approach the problem of environmental and occupational carcinogens and anticarcinogens. This paper reviews these powerful new tools and relates them to "natural" mutagens and carcinogens in food. It also discusses the use of oxygen radicals as a cause of degenerative disease associated with aging. Since no human diet can be totally free of carcinogens or mutagens, it is necessary to consider the risks of alternative courses of actions and to quantitate the magnitude of the risks through the "quantification" of these risks. Since carcinogens and anticarcinogens differ in their potency in animals over one million fold, the extrapolation of risks from rodents to humans is difficult but it is a first step. Despite better understanding of all of these risks, it is important to realize that the overall trend in life expectancy in the United States is continuing steadily to improve. PMID- 6502793 TI - Detailed caliceal anatomy for endourology. AB - A thorough understanding of caliceal anatomy is required to interpret excretory urograms and to perform safely endourological manipulations. Caliceal angles, posterior rotation of the lateral renal margin and caliceal placement in relation to the lateral aspect of the body were studied in 26 right and 24 left kidneys. Differences between kidneys found to be Brodel's types from those of the Hodson type, and the significance of these findings for performing nephrostolithotomy are described. PMID- 6502794 TI - The eleventh rib transcostal incision: technique for an extrapleural approach. AB - The transcostal extrapleural flank approach to the kidney requires an understanding of thoracic and abdominal wall anatomy to prevent injury to the pleura and subsequent pneumothorax. Isolation of the intercostal neurovascular bundle, division of the lumbodorsal fascia inferior to the rib bed and simultaneous dissection of the diaphragmatic insertion along the superior and posterior aspects of the 12th rib toward the lumbocostal arch are necessary surgical maneuvers before release of the diaphragm, exposure of Gerota's fascia and positioning of a flank retractor. Pneumothorax usually results from attempts to separate the pleura from the diaphragm, dissection within the intercostal space rather than along the diaphragmatic insertions and failure to release the diaphragm fully as far as the lumbocostal arch before placement of the retractor. Precise appreciation of the pericostal anatomy allows the urological surgeon to remain extrapleural during this commonly used flank incision. PMID- 6502795 TI - Renal cell carcinoma extending into the inferior vena cava: the prognostic significance of the level of vena caval involvement. AB - The records of 24 patients with renal cell carcinoma involving the inferior vena cava who were free of metastatic disease at presentation were reviewed retrospectively. The over-all 2-year survival for the group was 45.8 per cent, with a mean survival of 38.9 months. When the group was analyzed according to the level of extension of the vena caval thrombus marked differences in the rate of survival and of incidence of local progression of disease were found. The 10 patients with an infrahepatic vena caval thrombus had a 2-year survival rate of 80 per cent and a mean survival of 61.4 months. Two patients (20 per cent) had extension of tumor into the perinephric fat and none had involvement of the regional lymph nodes. The 14 patients with a vena caval thrombus extending to the level of the hepatic veins or beyond had a 2-year survival rate of 21 per cent and a mean survival of 22.9 months. Tumor was present in the regional lymph nodes and/or perinephric fat in 9 of these patients (64 per cent). These results suggest that the level of vena caval involvement by tumor thrombus in patients with renal cell carcinoma has prognostic significance. PMID- 6502796 TI - Clinical experience with the Kock continent ileal reservoir for urinary diversion. AB - From August 1982 through January 1984, 51 patients underwent urinary diversion that included creation of a continent reservoir from an ileal segment, according to the method described originally by Kock. An important modification included removal of a narrow strip of mesentery for 8 cm. along the afferent and efferent limbs of the pouch to allow adequate ileal intussusception, and fixation to prevent reflux and to ensure continence. Previous urinary diversion was by ureterosigmoidostomy in 3 patients, standard ileal conduit in 7 and suprapubic cystotomy in 1. A total of 39 patients underwent simultaneous anterior exenteration for pelvic malignancy. There was 1 postoperative death and early complications occurred in 10 patients. Of these 10 patients 4 required reoperation: 2 for drainage of a pelvic abscess, 1 for conversion to a standard ileal conduit and 1 for bleeding. Late complications occurred in only 8 patients: 5 required reoperation and revision of the continence valve mechanism, and 3 required hospitalization for brief episodes of pyelonephritis. The end result in 49 of 50 patients has been an overwhelming success. Patients perform self catheterization every 4 to 6 hours during the day and once at night for volumes ranging up to 1,400 cc. Serum electrolytes have remained normal and hyperchloremic acidosis has been encountered in only 1 patient who had had compromised renal function preoperatively with hyperchloremic acidosis as a result of previous ureterosigmoidostomy. X-rays of the Kock pouch have shown evidence of reflux in only 1 patient, and all excretory urograms have demonstrated either normal upper tracts without obstruction or improvement in patients with preoperative hydronephrosis. Although preliminary, this clinical trial suggests that the quality of life for patients considered previously to be candidates for cutaneous diversion can be improved markedly by a modified Kock continent ileal reservoir. PMID- 6502797 TI - Histological changes in ileal conduits. AB - The histological appearances of 20 excised ileal conduits are described, 9 of which had been present for more than 10 years. Partial and subtotal villous atrophy associated with a chronic inflammatory infiltrate was seen in all cases. The more severe changes were seen adjacent to the stoma and ureteral orifices, and in the older conduits. The muscularis mucosa was thickened and splintered, and the submucosa showed edema and lymphatic dilatation. These appearances could not be related to the presence of infection or obstruction. The cause of the morphological abnormalities is likely to be multifactorial but the changes are not premalignant. The 2 carcinomas seen were recurrences from primaries elsewhere in the urinary tract. PMID- 6502798 TI - Prostatic biopsy in selected patients with carcinoma in situ of the bladder: preliminary report. AB - Transitional cell carcinoma was found in biopsies of grossly normal-appearing prostates in 4 of 40 patients with recurrent carcinoma in situ of the bladder. In selected patients prostatic biopsy may be warranted if conservative therapy does not control the bladder tumors and if cystectomy is contemplated. PMID- 6502799 TI - Endoscopic bladder neck suspension for stress urinary incontinence. AB - Endoscopic vesicourethral suspension is an acceptable procedure for the treatment of true stress urinary incontinence, and is associated with a high success rate and little morbidity. Endoscopic vesical neck suspension was performed in 60 patients, with cure of the incontinence in 49 (82 per cent). A higher success rate was achieved in patients without a prior hysterectomy and/or surgical procedure to correct incontinence. Abnormalities on urodynamic testing may be somewhat suggestive of outcome. However, these studies cannot be used to predict success or failure. PMID- 6502801 TI - Staging errors in prostatic cancer. AB - There is some question on the accuracy of staging in large epidemiological studies of prostatic cancer that rely on hospital tumor registry data. In an effort to assess the accuracy of tumor registry information in our institution registry staging was compared to surgical staging in 100 consecutive prostatic cancer patients. The tumor registry data had a 30 per cent understaging error. Other institutions may have the same problems. PMID- 6502800 TI - Anatomy of the penis and its deformities in exstrophy and epispadias. AB - The anatomy and erectile deformities of the penis in patients with exstrophy and epispadias are described. The information was derived from cavernosograms in 17 patients, an operation in 12, a pelvic computerized tomography scan in 1 and a cystectomy for carcinoma in 1. The inferior pubic ramus and, therefore, the corpora cavernosa are parallel to the floor when the patient is standing. Although the penis loses some of its length through the separation of pubic bones the corpora are shorter than in normal men. Ten corpora were rudimentary in 6 patients, perhaps because of vascular damage during a neonatal operation. The most common erectile deformity was tight dorsal chordee owing to intrinsic curvature of the corpora. The deformity is not caused by scar tissue or shortness of the reconstructed urethra. Patients with 1 rudimentary corpus have lateral deviation on erection. PMID- 6502802 TI - Radical transpubic prostatectomy. AB - Removal of an adequate wedge of symphysis pubis provides considerably improved exposure for radical prostatectomy. It is safer to remove the symphysis subperiosteally and to transect the bone with an oscillating bone saw or osteotome. The transpubic approach to radical prostatectomy affords the urologist the advantages of 1) early direct ligation of the dorsal vein, 2) reduced incidence of injury to the external urethral sphincter and subsequent urinary incontinence owing to visualization of the urogenital diaphragm, 3) simplified urethrovesical anastomosis and 4) increased opportunity for maintenance of potency by protecting the pelvic nerve plexus as they course in the lateral vascular pedicles. PMID- 6502803 TI - Detection of enteric-urinary fistulas with a noninvasive quantitative method. AB - The 51chromium test is an inexpensive, noninvasive test to evaluate patients for enteric-urinary fistulas. Of 11 patients studied the 51chromium test demonstrated correctly a fistula in 5 of 6 patients with fistulas and showed no lesion in all 5 without fistulas. Excretory urography, barium enemas, visible contrast medium, cystograms and upper gastrointestinal series failed to demonstrate the fistulas with similar accuracy. Cystoscopy suggested a possible lesion in 4 patients but was definite for a fistula in only 2 of those patients. PMID- 6502804 TI - When should patients with symptomatic urinary stone disease be evaluated metabolically? AB - To determine the optimal time at which to assess the urinary risk factors for calcium stone formation, we followed 11 patients after an episode of acute renal colic with sequential 24-hour urine collections, first in the hospital and then at regular intervals after they were discharged from the hospital. The changes that occurred in the urinary risk factors were compared to those of a control group in which samples were collected during the same interval. The in-hospital 24-hour urine volumes were high but decreased gradually to approach the relatively constant volume of the control group by 3 months. The opposite trend occurred with respect to the 24-hour urinary excretion of calcium. There were no significant changes in the 24-hour urinary pH or excretions of oxalate, uric acid and alcian blue precipitable polyanions. The over-all effect was to cause a progressive increase in the probability of stones forming in the patients. The accurate assessment of the urinary risk factors of calcium stone disease requires at least a 3-month delay following acute renal colic. This delay usually will provide sufficient time for the stone to pass and for the patient to return to the normal dietary and fluid intake. PMID- 6502805 TI - Urological endoscopic surgery under local anesthesia: a cost-reducing idea. AB - With the new resectoscope injection needle adequate local anesthesia was obtained in 81 selected patients who underwent transurethral incision and resection of the prostate, visual urethrotomy, ureteral meatotomy, and resection of primary and recurrent bladder tumors, as well as for the immediate relief of postoperative pain when transurethral resection of the prostate was performed with the patient under general anesthesia. PMID- 6502806 TI - Radiation exposure to patient and urologist during percutaneous nephrostolithotomy. AB - Radiation exposure to the patient and urologist was determined during 60 procedures for percutaneous removal of calculi from the upper collecting system. For male patients the average radiation dose at the surface of the testis was 160 mrem (1.6 mSv.). Surface dose to the female patient at the ovary level averaged 580 mrem (5.8 mSv.). Radiation doses to the small field or region of fluoroscopy on the skin surface anterior to the kidney averaged 25 rem (0.25 Sv.). Radiation exposure to the urologist at collar level averaged 10 mrem (0.1 mSv.) per case. Patient gonad doses from percutaneous nephrostolithotomy are similar to those from a 7-view excretory urogram. Patient surface exposures at the nephrostomy are comparable to skin doses from standard angiographic procedures. The exposure to the urologist is similar to that from other interventional fluoroscopic procedures and is within acceptable limits. Appropriate use of radiological technology and shielding can keep radiation exposures during percutaneous nephrostolithotomy within acceptable limits for patients and physicians. PMID- 6502807 TI - Suggested terminology for duplex systems, ectopic ureters and ureteroceles. AB - Recommendations are made for the standardization of nomenclature describing duplex systems, ectopic ureters and ureteroceles. The elimination of some terms and redefinition of others are proposed in the hope to eliminate the ambiguity and confusion that exist currently. PMID- 6502809 TI - Continent urinary diversion. PMID- 6502808 TI - Traumatic torsion of the testis. AB - Torsion of the testis is a common urological emergency. Blunt scrotal trauma also may precipitate an emergency. We recently treated 2 adolescent boys in whom blunt scrotal trauma induced testicular torsion. A retrospective review of the charts of 138 patients explored for acute scrotal pain at our hospital revealed a history of scrotal trauma in 3 of 57 patients (5 per cent) with testicular torsion and 7 of 73 (10 per cent) with torsion of the testicular appendages. The possibility of torsion must be considered in cases of scrotal trauma. PMID- 6502810 TI - Exstrophy and epispadias. PMID- 6502811 TI - The computerized tomography appearance of renal pedicle injury. AB - The computerized tomography findings in 2 cases of traumatic renal artery occlusion are reviewed. Both patients had a nonfunctioning, normal-sized kidney with minimal or no contrast enhancement. Based on a review of 60 cases of renal trauma at our institution these findings appear to be specific for occlusion of the renal pedicle. PMID- 6502812 TI - Immotile cilia syndrome associated with polycystic kidney. AB - The immotile cilia syndrome is an inherited disorder characterized by the inability of ciliated structures to beat effectively. The urological manifestation of this syndrome is sterility. We report a case of the immotile cilia syndrome associated with polycystic kidney, which also is a hereditary disease. PMID- 6502813 TI - Renal plasmacytoma: a case report and summary of reported cases. AB - Although multiple myelomas occur fairly frequently, extramedullary plasmacytomas are uncommon. To date, only 7 cases of renal plasmacytoma have been documented. We report case 8 and discuss its management. PMID- 6502814 TI - Renal tumors associated with tuberous sclerosis: the case for aggressive surgical management. AB - Tuberous sclerosis is associated commonly with renal angiomyolipoma. However, the radiographic differentiation of angiomyolipoma and renal carcinoma can be difficult, and the natural history of angiomyolipoma may be associated with serious complications. We present a case of bilateral renal cell carcinoma associated with tuberous sclerosis. Aggressive but conserving renal surgery should be considered in patients with tuberous sclerosis and enlarging renal masses. PMID- 6502815 TI - Single unilateral vaginal ectopic ureter: is it really a rarity? AB - Although previously regarded as a rarity, 13 of the 20 published cases of single unilateral vaginal ectopic ureter have been reported within the last year. We have seen 4 cases of a single unilateral vaginal ectopic ureter within a 4-month interval. The relationship of vaginal ureteral ectopia to mullerian and mesonephric duct anomalies is discussed. If the ureteral bud originates laterally from the mesonephric duct then the ureter may retain its connection with the mesonephric duct while failing to connect to the bladder. This condition combined with persistence of the distal mesonephric (Gartner's) duct, which ruptures vaginally, accounts for vaginal ureteral ectopia and incontinence. The diagnostic studies for vaginal ureteral ectopia include excretory urography, radionuclide scanning, ultrasonography and administration of oral phenazopyridine in conjunction with careful vaginoscopic examination. The combination of lifelong wetting and solitary kidney on excretory urography should alert the urologist to this syndrome. The single unilateral vaginal ectopic ureter may be more common than has been suggested previously. PMID- 6502816 TI - Bilateral amyloidosis of the ureter associated with carcinoma. AB - We report a case of coexisting amyloid and neoplasm in a localized ureteral lesion. This case also represents the third reported instance of sequential bilateral ureteral amyloidosis. Right nephroureterectomy revealed amyloid and an in situ focus of low grade transitional cell carcinoma. Three years later amyloid in the distal left ureter was resected and the gap was bridged by a bladder hitch and Boari flap. Subsequent followup has been uneventful. PMID- 6502817 TI - Primary carcinoma in situ of the ureter: a case report. AB - A case of primary carcinoma in situ of the right ureter without a history of bladder tumors is presented. Cytological investigation of the right ureteral urine specimens revealed malignant cells and computerized tomography showed focal thickening of the upper portion of the right ureter. The patient underwent right nephroureterectomy, including excision of a bladder cuff. The diagnostic role of exfoliative urinary cytology is emphasized. PMID- 6502818 TI - Penile gangrene: a complication of secondary hyperparathyroidism from chronic renal failure. AB - We present the third case and first reported survivor of penile gangrene due to secondary hyperparathyroidism from chronic renal failure. The patient was treated with distal penectomy and subtotal parathyroidectomy. This case stimulated us to review the metabolic and vascular changes associated with secondary hyperparathyroidism in chronic renal failure. Secondary hyperparathyroidism may cause diffuse vasculitis and vascular calcification, which can lead to widespread ischemic necrosis and gangrene. Early medical therapy, including oral phosphate binders, is crucial to maintain the serum calcium-phosphate product below precipitation level. Subtotal parathyroidectomy is indicated for patients in whom progressive arterial and soft tissue calcification develops despite medical therapy. PMID- 6502819 TI - Penile horns: report of 2 cases. AB - We report 2 cases of penile horns, including 1 in which verruca carcinoma developed in the base. Treatment of this disease and its potential malignant degeneration are discussed. PMID- 6502820 TI - Transverse testicular ectopia corrected by a modified Ombredanne operation. AB - We report a case of transverse testicular ectopia. The patient previously had undergone an operation for a left inguinal hernia and the right testis was absent. Each testis was placed in its respective side but the right vas deferens traversed the left inguinal canal (a modified Ombredanne operation). PMID- 6502821 TI - Endoscopic evaluation and treatment of patients with idiopathic gross hematuria. AB - We evaluated 4 patients with long-standing unilateral essential gross hematuria by newer endourological techniques. All 4 patients underwent ureterorenoscopy and 3 underwent percutaneous nephroscopy. Nephroscopy identified a bleeding site in 3 patients and ureteroscopy in 1. The bleeding sites were fulgurated and the hematuria has not recurred during followup. Percutaneous nephroscopy and/or ureterorenoscopy should be considered in selected patients with unilateral essential gross hematuria. PMID- 6502822 TI - Recurrent hematuria in 4 white patients with sickle cell trait. AB - Extensive investigations failed to disclose the etiology of recurrent gross hematuria in 4 white patients of Algerian descent. Hemoglobin electrophoresis revealed sickle cell trait in all cases. The hematuria ceased after bed rest and hydration in 3 patients, and following partial nephrectomy after visualization of the bleeding site at operative nephroscopy in 1. We recommend that hemoglobin electrophoresis be considered when evaluating every patient, black or white, presenting with unexplained hematuria. PMID- 6502823 TI - Prazosin-induced priapism in a diabetic. PMID- 6502824 TI - Re: Fournier's gangrene: report of 20 patients. PMID- 6502825 TI - Re: A comparison of pressure flow studies and renography in equivocal upper urinary tract obstruction. PMID- 6502826 TI - Nuclear magnetic resonance tissue analysis of acute renal artery and renal vein occlusion: the effect of a paramagnetic contrast agent. AB - In order to assess the potential sensitivity of nuclear magnetic resonance for the assessment and detection of renal vascular insufficiency, nuclear magnetic resonance spectroscopy was performed on rabbit renal cortices following 45 minutes of unilateral renal artery or vein occlusion with and without the injection of a paramagnetic contrast material (manganese chloride). Renal vein occlusions produced a marked increase in T1 and T2 relaxation times when compared to the contralateral control kidney (mean increase of 18 per cent in T1 and 27 per cent in T2). Renal artery occlusions produced no change in T1 and only a slight increase in T2 (mean increase of 5 per cent). After the intravenous injection of 0.03 mM/kg. of manganese chloride, T1 of the control kidneys was reduced by almost 50 per cent. Relaxation parameters from the kidneys undergoing arterial occlusion did not change after manganese injection when compared to the occluded kidneys without contrast. In the kidneys undergoing venous occlusion, a moderate decrease in T1 resulted from manganese chloride. We conclude that in the absence of a paramagnetic contrast material, nuclear magnetic resonance discriminates well between normal and (venous occlusion) congested kidneys, but not between normal and acutely ischemic (arterial occlusion) kidneys. In the presence of a renal paramagnetic contrast material, NMR aids in the differentiation of acute unilateral arterial insufficiency, as relaxation times from the normal kidney decline while the ischemic kidney does not change. PMID- 6502827 TI - Effect of orchiectomy and ovariectomy on oxalate production, transport and excretion in rats. AB - The role of sex hormones on oxalate synthesis by liver, transport by renal cortical mitochondria and urinary excretion was studied in adult male and female Sprague-Dawley rats. Orchiectomy decreased the hepatic synthesis of oxalate whereas ovariectomy increased it by 10 per cent. Castration inhibited oxalate transport by the renal mitochondria uncompetitively in both sexes. Urinary levels of oxalate were unaffected after orchiectomy whereas ovariectomy resulted in an initial elevation in the urinary oxalate levels which returned to control values by 21 days. The results are discussed in light of recent data. PMID- 6502828 TI - Enhancement of mouse natural killer cell activity after dearterialization of experimental renal tumors. AB - Dearterialization of intrarenally transplanted syngeneic or allogeneic tumors in C57Bl/6 mice resulted in a pronounced enhancement of spontaneous cell mediated cytotoxicity of spleen lymphocytes. The augmentation was evident 48 hours after occlusion of the renal artery and persisted for at least 1 week. Dearterialization of non-tumor bearing kidneys had no effect on spontaneous cell mediated cytotoxicity. The effector cells responsible for the increased cytotoxicity were identified as natural killer cells based on their lack of adherence to nylon-wool, resistance to treatment with Thy 1.2 antibodies and complement and complete elimination by antibodies to asialo-GM1 and complement. The increase in natural killer cell activity reported here is in close parallel to that observed after embolization of human renal tumors. The present murine system may provide a valuable tool for evaluation of immunobiological effects of tumor dearterialization. PMID- 6502829 TI - Radiation exposure during fluoroscopically controlled percutaneous lithotripsy. AB - Radiation measurements in the vicinity of a standard urologic table modified for fluoroscopic-guided lithotripsy demonstrate radiation levels as high as 3000 mrem per hour at the edge of the table. Excessive radiation exposure to the physician, exceeding the annual maximum permissible dose to the eyes and thyroid, can be expected after only 10 cases. Suggested radiation protection measures include the use of finger, wrist and neck radiation monitors, eye and thyroid shields and improved shielding of both collimator and patient scatter radiation. PMID- 6502830 TI - Early precursors of urogenital cancers in former college men. AB - Physical and social characteristics recorded at college physical examination or reported at subsequent alumni questionnaire in 1962 or 1966 by 47,271 male former students from Harvard University and the University of Pennsylvania were reviewed for their relationship to risk for cancers of the kidney, bladder, prostate and testis. The records of 213 subjects who died with 1 of these cancers in a 16-50 year followup period and of 280 subjects who reported such a cancer by mail questionnaire in 1976 or 1977 were compared with those of 1,972 matched classmates who were known to be alive and cancer-free at the time subjects with cancer had died or were diagnosed. Students with a record of proteinuria at college physical examination experienced increased risk of kidney cancer. Higher levels of body weight during college were associated with elevated risks of kidney and bladder cancers; however, increased weight in 1962/1966 related only to kidney cancer. A history of cigarette smoking as reported by questionnaire in 1962/1966 predicted increased occurrence of bladder cancer. Students with a history of tonsillectomy at college entrance experienced increased risk of prostate cancer, and those who reported cancer history in 1 or both parents were at increased risk for testicular cancer. These and other findings are presented as clues deserving further exploration for any etiological significance they may hold for the cancer sites studied. PMID- 6502831 TI - The limitations of predictability of success of femoral-popliteal bypass grafts. AB - This study was carried out to determine whether we could develop a model to identify predictive factors for success of femoral-popliteal (FP) bypass grafts. In a retrospective review of 199 operations, 24 factors influencing outcome were selected by stepwise logistic regression analysis, a sophisticated, multifactorial computer program. The top five indicators (excluding intraoperative technical problems) were runoff status, previous ipsilateral FP bypass, preoperative prediction of potential amputation level, concurrent proximal vascular reconstruction, and site of the distal anastomosis. We chose to validate the predictive model developed before applying it clinically. Data from 67 subsequent cases were presented to the computer without the known outcome, and the probability of 30-day patency was calculated. The model predicted 11 failures; there were actually eight thromboses in the 67 grafts. However, only three of the failures were predicted correctly, and eight cases of computer anticipated thromboses were patent at 30 days. The high false positive rate makes the clinical application of the predictive model inappropriate. The success of FP bypass grafts appears to be related to factors that cannot be assessed preoperatively, such as technical problems during surgery. Even those which seem to have a poor runoff and other high-risk factors may succeed; thus an aggressive approach is justified in lower extremity reconstructions. PMID- 6502832 TI - Assessment of peripheral vascular disease by postocclusive transcutaneous oxygen recovery time. AB - A method for assessing peripheral vascular disease (PVD) was developed from the pattern of transcutaneous oxygen (PtcO2) changes after temporary limb ischemia induced by pneumatic blood pressure cuff occlusion. The transcutaneous oxygen recovery half-time (TORT) was defined as the time required to recover half of the decrease in the limb/chest PtcO2 ratio produced by temporary limb ischemia. TORT was examined in subjects with and without significant PVD. Patients who underwent operative therapy for symptomatic PVD were studied before and after operation. Comparison was also made of the values of patients in whom therapy was successful in resolving symptoms vs. those in whom it was not. TORT was found to improve the diagnostic accuracy of PtcO2 measurements to differentiate normal vs. PVD limbs and successful vs. unsuccessful results of therapy. Normal subjects uniformly had TORT values less than or equal to 1.5 minutes at both calf and foot positions; limbs with symptomatic PVD consistently had TORT values that were significantly longer in duration (p less than 0.001). Limbs with PVD that received successful therapy had a significant improvement in calf and foot TORT values after surgery (p less than 0.01); postoperative values were usually slightly longer than those of normal subjects, probably reflecting some residual disease. Postoperatively, limbs with PVD that had received unsuccessful therapy either had only slight improvement or worsening of their TORT values, which were significantly greater than the TORT values of limbs that received successful therapy (p less than 0.001). We conclude that measurement of postocclusive TORT is a reliable method for diagnosing PVD and for quantitatively evaluating residual disease after operative therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502833 TI - Digital cutaneous fluorometry: correlation between blood flow and fluorescence. AB - Central to the use of fluorescein in vascular diagnosis is the requirement that the intensity of evoked fluorescence be proportional to blood flow. With the introduction of the digital dermofluorometer, a device that quantitates cutaneous fluorescence, establishment of this relationship has become possible. After experimentally producing measured reductions in the distal aortic flow of eight rabbits, the ratio of fluorescence in the flow-restricted and unrestricted areas was obtained by measuring hind- and forelimb fluorescence. At any time between 20 and 60 minutes following a bolus injection of sodium fluorescein (1 mg/kg body weight), there was a significant linear relationship (p less than 0.05, r greater than 0.75) between residual aortic flow and the ratio of hind-/forelimb fluorescence. Simultaneously obtained plasma fluorescein concentrations decayed rapidly by first-order kinetics with a half-life of 12.5 minutes, regardless of the degree of distal aortic occlusion. The time course of the rise and fall of cutaneous fluorescence was slower than that of the plasma fluorescein concentration, proving that interstitial rather than intravascular fluorescein was responsible for the measured fluorescence. We conclude that the intensity of tissue fluorescence is linearly related to blood flow and that conclusions regarding perfusion may be drawn from relative fluorescence at any time between 20 and 60 minutes following a bolus injection of fluorescein. Furthermore, the passage of fluorescein into the interstitium is dependent on a time-limited diffusion process, which along with flow, establishes the time to peak and the absolute amplitude of the tissue fluorescence curve. PMID- 6502834 TI - Aortofemoral bypass grafts: safety of percutaneous puncture. AB - To assess the safety of percutaneous puncture for the angiographic study of aortofemoral bypass grafts, we reviewed the medical records of 58 patients who underwent a total of 86 graft punctures. Short- and long-term follow-up revealed that in 83 punctures there were no complications. In three instances (3.5%) there was acute thrombosis of the punctured limb of the graft. This complication may have expedited but did not substantially alter the surgical plans of managing the underlying clinical problem. Although the incidence of complications of direct graft puncture is higher than that associated with puncture of native vessels, alternative approaches are also associated with complications, many of which may be more serious. Therefore, for angiographic studies of patients with aortofemoral bypass grafts, we favor the direct percutaneous puncture provided that enough time has elapsed from surgery. PMID- 6502835 TI - Acute acalculous cholecystitis complicating abdominal aortic aneurysm resection. AB - Acute acalculous cholecystitis developed in six patients recovering from repair of an abdominal aortic aneurysm. All patients were men with significant concurrent medical illnesses, and three patients had undergone operation for a ruptured aneurysm. Symptoms appeared at a mean of 3 weeks postoperatively and consisted of right upper quadrant pain, fever, leukocytosis, and slight elevation of liver function test results. Treatment consisted of cholecystostomy (three patients) or cholecystectomy (three patients), with an overall mortality rate of 50%. When cholecystitis is suspected after aortic aneurysm repair, early confirmation of the diagnosis should be obtained with ultrasound or a technetium hepatobiliary scan and cholecystostomy or cholecystectomy undertaken if the patient does not rapidly improve with medical management. PMID- 6502836 TI - Carotid steal syndrome following carotid subclavian bypass. AB - Subclavian steal syndrome may result from stenosis or occlusion of the subclavian artery proximal to the origin of the vertebral artery. The diagnosis can be confirmed by noninvasive vascular studies with the use of a directional Doppler probe or by time-sequence aortic arch angiography, both of which can detect retrograde flow in the vertebral artery. A variety of surgical approaches to this condition have been used in the past, but the simpler and much safer carotid-to subclavian bypass has become a more acceptable surgical procedure. There remains, however, a theoretical possibility that blood may be siphoned from the intracranial arteries perfused by the carotid. This phenomenon, which may be called the carotid steal syndrome, has been discussed, but no clinical cases have been reported. We present a patient who developed such a carotid steal syndrome 2 years after left carotid-subclavian bypass. This occurrence reemphasizes the importance of determining a normal carotid bifurcation prior to performing carotid-subclavian bypass. PMID- 6502837 TI - A critical review of amputation in vascular patients. AB - A study was made of 53 patients who underwent amputation for peripheral vascular disease over a 5-year period at West Virginia University Medical Center. The follow-up period ranged from 1 to 6 years. Data concerning operative deaths, risk factors, use of prosthetic devices, and ultimate self-sufficient living were obtained. The functional outcome for this group of patients was encouraging with modern prosthetic fitting and social rehabilitation. Approximately 75% of the patients were returned to a useful life with a prosthetic limb or in a wheelchair. Amputation is a less desirable alternative than successful revascularization, but with the prostheses available today, amputation does not foreshadow a dismal existence. PMID- 6502838 TI - Upper arm graft fistula for hemodialysis. AB - The repeated failure of forearm hemodialysis access grafts in patients with end stage renal failure often requires the use of an upper arm graft fistula. During a 7-year period, 20 upper arm graft fistulas were placed in 15 patients. The 5 year patency rate by life-table analysis, including graft fistula salvage by thrombectomy, is 53%. The mean survival from graft insertion until revision or thrombectomy is 36 months. Twenty of the twenty-two thrombectomies performed (91%) were successful in reestablishing graft fistula patency. Six grafts required more than one thrombectomy, and seven grafts required revision of the venous anastomosis. Only one arterial anastomosis required revision. We conclude that the upper arm graft fistula is an acceptable method of hemodialysis access in those patients without suitable forearm access sites. However, an aggressive approach to both graft fistula thrombectomy and the revision of stenotic anastomoses is necessary to maintain a satisfactory patency rate. PMID- 6502839 TI - Cholelithiasis and aortic reconstruction. AB - Identification of cholelithiasis during abdominal aortic reconstruction with placement of a vascular prosthesis provides cause for hesitation in performing a simultaneous cholecystectomy because of the potential contamination of the graft. However, the association of cholelithiasis with cholecystitis is well established and was observed in a group of patients who had known cholelithiasis following aortic reconstruction. Cholelithiasis was noted in 50 of 250 patients who underwent reconstruction of the abdominal aorta or its major branches. Seventeen of the 50 patients with cholelithiasis underwent a cholecystectomy prior to aortic reconstruction. Sixteen patients underwent a cholecystectomy at the time of aortic reconstruction and experienced no morbidity related to the cholecystectomy. Seventeen patients with cholelithiasis did not undergo cholecystectomy. All were asymptomatic. Nine of these individuals developed cholecystitis or symptoms related to their gallstones following aortic reconstruction. A subsequent cholecystectomy was performed in all nine patients. The interval between aortic reconstruction and cholecystectomy was from 2 weeks to 108 months. The remaining eight patients with cholelithiasis have been followed up for 17 to 50 months. Six of these patients remain asymptomatic. The two patients followed up for the longest period (42 and 50 months, respectively) have become symptomatic. If there are no mitigating circumstances, cholecystectomy is advised for patients undergoing aortic reconstruction with associated cholelithiasis. PMID- 6502840 TI - Inferior vena cava bypass: experimental evaluation of externally supported grafts and initial clinical application. AB - Inferior vena caval obstruction is an unusual but important clinical problem for which adequate treatment previously has not been available. Recently, a polytetrafluoroethylene (PTFE) graft with external rigid spiral supports was developed that appeared particularly applicable to the venous system. In 18 dogs a 15 cm length of Impraflex was placed from the proximal right common iliac vein to the inferior vena cava (IVC) at the level of the renal veins after IVC and right iliac vein interruption. End-to-end and end-to-side iliac vein anastomoses were alternated, with and without distal femoral arteriovenous (AV) fistulas (AVFs). At 2 months, with a distal AV fistula, 11 of 12 (92%) grafts were patent, angiograms demonstrated no evidence of intraluminal clot, and there was no hind limb edema. Following AVF ligation 2 months after graft insertion, 10 grafts remained patent, but five developed some intraluminal thrombus and one of them progressed to complete occlusion. Four months after fistula ligation (6 months after graft insertion) 9 of 12 grafts (75%) remained patent. All six grafts without distal AVF were occluded within 1 week. This procedure was performed on one severely symptomatic patient who had IVC occlusion, and currently the patient shows marked improvement. Thus IVC bypass is possible when an externally supported PTFE prosthesis is complemented by a temporary AVF. PMID- 6502841 TI - Blunt trauma to the axillary artery. AB - Blunt trauma to the axillary artery is an unusual injury. Patients with these injuries may not present with "classic" signs of arterial insufficiency; therefore a high index of suspicion is necessary to avoid delay in treatment. This article presents three patients with unusual injuries to the axillary artery and discusses their management. PMID- 6502842 TI - Ruptured abdominal aortic aneurysm with horseshoe kidney. AB - A case of ruptured abdominal aortic aneurysm associated with horseshoe kidney is presented. Two aspects of the operation are discussed: the vascular supply to the kidney and isthmus and the division of the isthmus. It is important in handling these cases either on an emergency basis or electively to be aware of the various vascular anomalies. PMID- 6502843 TI - Thigh claudication due to profunda femoris artery occlusion. AB - Thigh claudication is usually caused by aortoiliac occlusive disease. A patient with unilateral thigh claudication and normal femoral pulses was found to have isolated profunda femoris occlusion and was successfully treated by profundaplasty. Although this syndrome is rare, a review of vascular anatomy of the thigh and mechanisms of claudication explains its existence. PMID- 6502844 TI - Iliac appendiceal fistula: case presentation and review of management. AB - The management of aortoenteric fistulas is complex and demanding. The purpose of this review is to present a case of ilioappendiceal fistula and to review its proper management. PMID- 6502845 TI - Spinal cord ischemia following surgery for aortoiliac occlusive disease. AB - A 70-year-old man had aortobifemoral bypass for severe aortoiliac occlusive disease. He developed spinal cord ischemia with anterior spinal artery syndrome. He had minimal recovery of muscle function, multiple postoperative complications, and 11 months postoperatively he died. Spinal cord ischemia is a rare and unpredictable complication of abdominal aortic surgery. It most often has occurred following surgery for aneurysm but can also occur after apparently routine surgery for occlusive disease. PMID- 6502846 TI - Low-dose direct fibrinolysis in peripheral vascular disease. AB - One hundred thirty patients underwent low-dose, catheter-directed fibrinolytic therapy for arterial and graft occlusions present for various periods of time. In 65 consecutive patients the therapeutic parameters were identical, and a careful hematologic evaluation was performed. In the subsequent 65 patients, varying doses of fibrinolytic agents were employed. Fibrinolytic therapy was found to be beneficial in a diverse group of clinical situations and in patients whose occlusions had occurred at varying lengths of time. Early study demonstrated that effective fibrinolysis can be achieved at approximately one-twentieth of the systemic level and that systemic effects could be avoided in all patients during 24-hour infusions and in many patients infused up to 96 hours. Bleeding complications occurred only in patients in whom concomitant heparinization was employed, and this was thought to be the causative factor. Therapeutic success and avoiding complications are strongly dependent on close monitoring of patients and joint decision making by the vascular surgeon and radiologist. PMID- 6502847 TI - AMA offers recommendations for vaccine injury compensation. PMID- 6502849 TI - Leads from the MMWR. Pertussis--United States, 1982 and 1983. PMID- 6502848 TI - How to remedy possible harm to a few persons from vaccines that could benefit entire society? PMID- 6502850 TI - Excessive mycobacterial cultures. PMID- 6502852 TI - Medical student abuse. PMID- 6502851 TI - Undiagnosed myocardial infarction. PMID- 6502853 TI - Calcified hemangioma of the spleen. PMID- 6502854 TI - Sodium content of koshered meat. PMID- 6502855 TI - Effect of dietary ascorbic acid restriction and supplementation on urine pH in elderly males. PMID- 6502856 TI - Gastrojejunal and gastroesophageal fistulae following placement of an Angelchik prosthesis. PMID- 6502857 TI - False elevation in serum creatinine levels. PMID- 6502858 TI - Increased incidence of cervical and vaginal dysplasia in 3,980 diethylstilbestrol exposed young women. Experience of the National Collaborative Diethylstilbestrol Adenosis Project. AB - The incidence rates of dysplasia and carcinoma in situ (CIS) of the cervix and vagina were determined in 3,980 young women exposed prenatally to diethylstilbestrol. Strict criteria were developed to minimize selection bias among the subset of 744 pairs of matched exposed and unexposed (control) cohort participants, all of whom were identified through review of prenatal obstetrical records. A high degree of compliance was achieved throughout the seven-year study period since in each group about 90% of the women remained as active participants, kept 77% of the annual anniversary examinations, and had separate Papanicolaou smears of the cervix and vagina performed in 99% of the anniversary examinations. The incidence rate for dysplasia and CIS was significantly higher in the women exposed to diethylstilbestrol than in those not exposed in the matched cohort (15.7 v 7.9 cases per 1,000 person-years of follow-up). The rates were higher in the exposed women if squamous metaplasia extended to the outer half of the cervix or onto the vagina. In other respects, the matched cohorts were strikingly similar. PMID- 6502859 TI - Males exposed in utero to diethylstilbestrol. AB - An increased frequency of various genitourinary anomalies, infertility, and testicular cancer among males has been reported to follow intrauterine exposure to diethylstilbestrol, but not all studies have confirmed an association. This study was designed to determine whether a cohort of males exposed in utero to diethylstilbestrol had a higher frequency of urogenital abnormalities than an unexposed cohort. Biases in selection of exposed and control participants were minimized. Of 828 exposed and 676 control men studied by medical-record review, 265 exposed men and 274 controls also underwent a special clinical examination. Overall, the data suggest that diethylstilbestrol exposure of males in utero did not increase their risk of genitourinary abnormalities, infertility, or testicular cancer. Previously reported increased frequencies of these abnormalities in diethylstilbestrol-exposed men may have resulted from selection biases or differences in diethylstilbestrol use, or both. PMID- 6502860 TI - Do patients want to participate in medical decision making? AB - Although shared decision making by patients and clinicians has been advocated, little is known about the degree of participation in decision making that patients actually prefer or about clinicians' appreciation of these preferences. We administered questionnaires about three aspects of decision making to 210 hypertensive outpatients and to their 50 clinicians, who represented three types of medical practices. We found that 41% of patients preferred more information about hypertension; clinicians underestimated patient preferences for discussion about therapy in 29% of cases and overestimated 11% (k = .22); and 53% of patients preferred to participate in making decisions, while clinicians believed that their patients desired to participate in 78% of cases. Many patients who preferred not to make initial therapeutic decisions did want to participate in ongoing evaluation of therapy. Thus, clinicians underestimate patients' desire for information and discussion but overestimate patients' desire to make decisions. Awareness of this discrepancy may facilitate communication and decision making. PMID- 6502862 TI - Usefulness of mammography in the diagnosis and management of breast disease in postmenopausal women. AB - We evaluated the clinical usefulness of mammography in postmenopausal women by conducting a "vertical" analysis using indexes of sensitivity and specificity, and a separate "horizontal" analysis assessing the relationship between the mammographic test result and the occurrence of specific clinical management decisions. The patients included 105 women with breast cancer, 104 women with fibrocystic breast disease, and 103 women with clinically benign breasts. Our study confirmed the generally accepted high values reported for the sensitivity and for the specificity of mammography as a test for breast cancer, while also helping to reconcile the widely varying indexes of test efficacy reported in some studies. We also observed that physicians' management decisions vary according to the mammographic interpretation, and include such distinctive clinical strategies as watchful expectancy (observe and follow), repeated mammograms, or breast biopsy. Future studies will need to determine reasons for specific management decisions, especially when they appear to contradict authoritative recommendations. PMID- 6502861 TI - Laughter. AB - Knowledge of laughter, other than of its clinical manifestations, is tenuous. A unique, ubiquitous human phenomenon, laughter has largely been neglected by medical investigators and relegated to philosophers and naturalists, particularly Darwin. Clinical manifestations are well described, but the many physiological changes accompanying laughter are not. Neurological pathways remain speculative, and those described are based on pathological evidence. Laughter, as a behavior, has many causes, including humor, incongruity, relief, and a sense of well-being. Laughter may have developed for its cathartic effects and adaptive value. As an evolutionary device, laughter may have served to thwart aggression, spread information, and preserve social unity. Laughter's potential for a variety of clinical uses awaits future investigation. PMID- 6502863 TI - Suppurative flexor tenosynovitis after accidental self-inoculation with Streptococcus pneumoniae type I. PMID- 6502864 TI - Human ingestion of a 'superwarfarin' rodenticide resulting in a prolonged anticoagulant effect. PMID- 6502865 TI - Prolonged anticoagulation in rat poisoning. PMID- 6502866 TI - Early detection of breast cancer. Council on Scientific Affairs. PMID- 6502867 TI - CIN or not to sin. PMID- 6502868 TI - Benevolent 'world war' declared on humanity's longtime disease foes. PMID- 6502869 TI - Technology, funds promise new era in parasitology. PMID- 6502870 TI - 'Mild' vitamin A deficiency now major world problem? PMID- 6502871 TI - Worldwide polio suppression gains support. PMID- 6502872 TI - Leads from the MMWR. Evaluation of drought-related acute undernutrition- Mauritania, 1983. PMID- 6502873 TI - Leads from the MMWR. Lead poisoning-associated death from Asian Indian folk remedies--Florida. PMID- 6502874 TI - Impressions of clinical allergy in China. PMID- 6502875 TI - Toxic metal contamination of folk remedy. PMID- 6502876 TI - Sources of lead poisoning. PMID- 6502877 TI - Physicians for the developing world. PMID- 6502878 TI - Stress fracture of the calcaneus--still an enigma in the Israeli Army. PMID- 6502879 TI - Prevention of schistosomiasis. PMID- 6502880 TI - Environmental hazards to elderly artists. PMID- 6502881 TI - Treatment of mushroom poisoning. PMID- 6502882 TI - Delayed childbearing in Sweden. AB - Using data from the Swedish Medical Birth Registry, we examined whether reproductive history influenced pregnancy outcomes among women aged 30 to 39 years who gave birth to a first or second child in 1976 through 1980. They were classified group 1, primigravida; group 2, gravida 2, para O; and group 3, gravida 2, para 1. Compared with women aged 20 through 24 years with the same parity and gravidity, the relative risk (RR) of late fetal deaths was significantly greater among those aged 35 through 39 years (RR: group 1 = 1.76, group 2 = 2.22, and group 3 = 2.39). The risk of giving birth to newborns who were low birth weight and preterm, or low birth weight at term, or 2,500 g or greater but preterm was greater among women aged 30 through 39 years in groups 1 and 2--significantly so for group 1 aged 30 through 39 years v group 1 aged 20 through 24 years. Risk increased with maternal age, from 30 through 34 to 35 through 39 years. The increased risk with age and parity-gravidity has ramifications for the increasing rate of delayed childbearing in the United States and elsewhere. PMID- 6502883 TI - A cooperative model for provision of regional health services in a developing nation. AB - The development of health care in the Leogane region of Haiti has been a ten-year story of international cooperation among health professionals, of closely targeted assistance, and of policy coordination between assisting private agencies and the Haitian government. The broadly based health care program of l'Hopital Sainte Croix of Leogane is presented as a model of a cooperative effort that has resulted in rapid regional health care development and as an encouragement to the many differing types of groups responding to a world in medical need. PMID- 6502885 TI - The breaking of a profession. PMID- 6502884 TI - Interplast. A successful model for anesthesia and plastic surgery in developing countries. PMID- 6502886 TI - Incidence and prognosis of seizures in infants after cardiac surgery with profound hypothermia and circulatory arrest. AB - Fifteen of 165 infants and young children who underwent surgical correction of congenital cardiac defects using profound hypothermic and circulatory arrest experienced generalized or focal seizures postoperatively. The cause of the seizures was unexplained in ten. Among these ten, the onset of seizures was 25 to 48 hours after surgery. With appropriate treatment, all had complete seizure control by the third postoperative day. During 11 to 54 months (mean, 35.6 months) of follow-up, no further seizures occurred and none had neurological abnormalities. Long-term anticonvulsant therapy was not required for any of the children. There was no correlation between the type of cardiac abnormality (cyanotic v acyanotic) or the duration of hypothermic circulatory arrest and the development of seizures. Unexplained seizures following cardiac surgery with hypothermia and circulatory arrest are not a sign of permanent brain damage and do not detract from the use of this technique for early definitive repair of congenital heart defects. PMID- 6502887 TI - Recurrent pericarditis and celiac disease. PMID- 6502888 TI - Traditional Chinese concepts of mental health. PMID- 6502889 TI - Doctors Across the Sea. A doctor-to-doctor international medical education exchange. PMID- 6502890 TI - Peace on earth, good health for men. PMID- 6502891 TI - Cautiously optimistic researchers study hyperthermia's potential uses. PMID- 6502893 TI - Leads from the MMWR. Update: acquired immunodeficiency syndrome--United States. PMID- 6502892 TI - Fire, gases, smoke lower crash survival chances. PMID- 6502894 TI - A 'supersalivation syndrome'. PMID- 6502895 TI - Sexual orientation and physicians' fitness for military duty. PMID- 6502896 TI - Liver lover's headache: pseudotumor cerebri and vitamin A intoxication. PMID- 6502897 TI - Effects of food on behavior. PMID- 6502898 TI - Differential diagnosis of scrotal pain after break dancing. PMID- 6502899 TI - Breaker's neck. PMID- 6502900 TI - Injury caused by 'break dancing'. PMID- 6502901 TI - Standing: a good remedy. PMID- 6502903 TI - Deafness to digital watches. PMID- 6502902 TI - Two new causes of alopecia. PMID- 6502904 TI - Meralgia paresthetica from a wallet. PMID- 6502905 TI - Removal of small cactus spines from the skin. PMID- 6502906 TI - Removal of ticks. PMID- 6502907 TI - Medical education in facilities for the elderly. Impact on medical students, facility staff, and residents. AB - The development of positive attitudes toward elderly patients has been identified as being an important factor in providing quality geriatric care. Medical students (N = 234) interviewed elderly individuals in three types of facilities, ranging from independent apartment living to nursing homes, as part of a required medical interviewing course. The students' attitudes were measured by an Attitudes Toward the Elderly scale before and after this course. Analyses disclosed significant posttest improvement in students' attitudes concerning the functioning, integrity, and personal acceptability of the elderly at all sites, except for attitudes toward functioning at nursing home sites. Staff and residents of participating facilities rated the experience favorably. This study shows that students' attitudes toward the elderly can be positively changed through incorporation of training at appropriate community facilities for the elderly into existing curricula. PMID- 6502908 TI - Residency positions. Are there enough? AB - This article presents data on postgraduate year 1 positions in US residency programs. It points out the distinctions between data published annually in the Directory of Residency Training Programs and the data reported by the National Resident Matching Program on the subject of positions. On the basis of data reported from all accredited programs there were 1.3 positions for each US medical school graduate in 1983. The number of US graduates is expected to decrease in future years. The number of foreign medical graduates in residency programs is not increasing; however, the proportion of foreign graduates who are US citizens is increasing. PMID- 6502909 TI - Athletic facial injuries. AB - Most facial injuries that occur during athletic activities are of a minor nature, consisting of lacerations, contusions, and abrasions. These are usually treated by a team physician or an emergency department physician. However, minor injuries must be differentiated from the more significant injuries, especially those involving facial bone fractures. Significant facial trauma must be diagnosed accurately and treated with precision to avoid permanent facial deformity. Soft tissue trauma as well as fractures are included in this review, and evaluation of the injured athlete is emphasized. A systematic approach is developed for diagnosing and treating common facial injuries in athletes. PMID- 6502910 TI - Subclavian venous stenosis. A complication of subclavian dialysis. AB - Subclavian hemodialysis catheters are widely employed for temporary hemodialysis access, but there are few reports of serious complications. We report three cases in which the prolonged (greater than 15 days) use of subclavian dialysis catheters ipsilateral to the permanent vascular access was associated with the development of subclavian vein (SCV) stenosis three to six months after the temporary catheter was removed. In one case, the use of the permanent access was severely limited by massive arm edema. We conclude that, in addition to the usual complications of SCV cannulation, long-term use of SCV hemodialysis catheters can be associated with major late obstructive complications that may compromise permanent vascular access. We recommend that, wherever possible, temporary dialysis catheters and other subclavian lines be placed contralateral to the permanent vascular access site in patients undergoing hemodialysis. PMID- 6502911 TI - The fellowship application process. PMID- 6502912 TI - Prevention and treatment of toxic shock syndrome: a retrospective look. PMID- 6502913 TI - Differences of global and regional left ventricular function in anterior and inferior myocardial infarction: assessment by the use of a regional ejection fraction. AB - Radionuclide angiography was performed on 41 patients with transmural myocardial infarction (MI) [17: anterior MI, 24: inferior MI] and 10 normal subjects in order to evaluate the influence of the infarct site on the global and the regional left ventricular function. The severity of the wall motion abnormality agreed closely with the reduction in the relative regional ejection fraction (%REF). The depression of the left ventricular ejection fraction (LVEF) in anterior MI was greater than that in inferior MI (p less than 0.01). We also found that the depression of the performance in the infarcted zone in anterior MI was more marked than that in inferior MI (p less than 0.01). However, function in the non-infarcted zone was almost the same in the anterior MI as in the inferior MI. As to the extent of the hypokinetic area, there was no significant difference between the patients with anterior MI and those with inferior MI. The above results indicated that the infarct site is an important determinant of the regional and the global left ventricular function after MI. PMID- 6502915 TI - An altered distribution and elimination of digoxin in anemic patients and experimentally induced anemic rats. AB - Digoxin was administered orally to eight anemic patients in their anemic and convalescent stages, and serum digoxin concentration was determined by radioimmunoassay. In the anemic patients a significantly lower level of serum digoxin concentration was observed in anemic state compared with convalescent stage at 72 hours after the drug administration (p less than 0.01). In usual clinical use, a full digoxin effect is expected to be attained as 72 hours. Tritiated digoxin was administered intravenously to anemic and control rats and the tritium in samples of the blood, myocardium and urine were counted in a liquid scintillation counter. The anemic rats showed significantly lower level of serum 3H-digoxin at 6 hours (p less than 0.01) and lower myocardial concentration at 24 hours (p less than 0.01). Larger amount of urinary excretion of 3H-digoxin was observed in the anemic rats 6 hours after the drug administration. No significant difference in fecal excretion of 3H-digoxin was found between the anemic and control rats. PMID- 6502914 TI - Effect of spironolactone on fluid volumes and adrenal steroids in primary aldosteronism. AB - Plasma volume (PV) and extracellular fluid volume (ECF) were determined in 7 patients with essential hypertension (controls) and in 10 patients with primary aldosteronism, while on a high Na diet (342 mEq/day) and on a low Na diet (12 mEq/day). The volume studies were repeated in 6 of the primary aldosteronism patients during treatment with spironolactone for over 3 months. Plasma renin activity (PRA), plasma aldosterone concentration (PAC), cortisol concentration, and serum Na and K concentrations were measured in all patients while on a Na restricted diet (85 mEq/day) as well as on high-Na and low-Na diets. There were no significant changes in arterial pressure during different Na diets in any groups of patients with essential hypertension, or primary aldosteronism with and without spironolactone therapy. Spironolactone treatment normalized the arterial pressure in patients with primary aldosteronism at all Na intakes. These patients had greater values for PV and ECF than did those with essential hypertension. Spironolactone treatment reduced PV during the low-Na diet, but did not alter it during the high-Na diet. Spironolactone did not produce significant changes in ECF during either the high-Na or low-Na diets. Although there were no changes in PV and ECF in patients with primary aldosteronism due to changes in Na intake, both PV and ECF were significantly less in these patients during spironolactone treatment and in patients with essential hypertension during low-Na intake than during high-Na intake. With primary aldosteronism, PRA was depressed and PAC was elevated when compared to essential hypertension, these were not altered by different Na diets in the patients with primary aldosteronism as they were in those with essential hypertension. During treatment with spironolactone the PRA was restored to normal and showed normal changes with variations in dietary Na, but PAC remained elevated during spironolactone. Plasma cortisol was the same among those with essential hypertension and patients with untreated and spironolactone-treated primary aldosteronism. Serum K was less in untreated primary aldosteronism during all Na diets than in essential hypertension, but during spironolactone it was restored to normal. These results suggest that in primary aldosteronism the reduction in arterial pressure by spironolactone treatment does not occur simply by reductions in body fluid volumes. The long term treatment of patients with primary aldosteronism with spironolactone does not inhibit the production of aldosterone, possibly because of enhanced activity of the renin-angiotensin system and an increase in serum K. PMID- 6502916 TI - KCl inhibits hypothalamic activity to attenuate hypertension in DOCA-salt rats. AB - Potassium supplementation attenuated the development of hypertension in DOCA-salt rats but did not affect blood pressure in control rats. However, it caused a decrease in body weight in both groups of rats. Sympathetic nerve and pressor responses either to electrical stimulation of the hypothalamus or to intracisternal injections of hypertonic NaCl were enhanced in DOCA-salt rats but were normalized by KCl supplementation. Since the pressor responses to injected norepinephrine or tyramine remained unaltered by KCl treatment, a peripheral inhibition of cardiovascular reactivity was considered unlikely. Pretreatment with methyclothiazide also attenuated the elevation in blood pressure but did not affect the responsiveness to hypothalamic stimulation; hence increased natriuresis or diuresis alone could not account for the effects induced by KCl. These findings are consistent with the conclusion that KCl supplementation attenuates the development of DOCA-salt hypertension in rats by acting on the central nervous system to reduce sympathetic output. PMID- 6502917 TI - An inference on the biphasic pressure rise in response to norepinephrine infusion in vivo. PMID- 6502919 TI - [Experimental study on changes in PaO2 induced by FIO2 change]. PMID- 6502918 TI - [The effects of enflurane on somatosensory evoked responses simultaneously recorded from brain, spinal cord and peripheral nerve in man]. PMID- 6502920 TI - [Effects of halothane and enflurane on the airway dynamics]. PMID- 6502921 TI - [The effect of dopamine on pulmonary circulation]. PMID- 6502922 TI - [The effects of intravenous lidocaine on hemodynamics--comparisons among patients anesthetized with halothane, those with nitrous oxide-fentanyl, and the patients with acute pulmonary insufficiency]. PMID- 6502924 TI - [K+-selective microelectrodes--construction, calibration and intracellular K+ activity measurement]. PMID- 6502923 TI - [Contracture responses of the muscle from a patient with malignant hyperthermia to drugs]. PMID- 6502925 TI - [Psychological preparation of preoperative surgical cancer patients]. PMID- 6502926 TI - [Complications in pulmonary surgery using a Robertshaw double-lumen endobronchial tube]. PMID- 6502927 TI - [Cardiac arrest during anesthesia]. PMID- 6502928 TI - [Tracheostomy is not essential for surgical correction of maxillofacial deformity]. PMID- 6502929 TI - [Study of lincomycin concentrations in hepatocystic duct]. AB - Penetration of lincomycin (LCM) in choledochal and cholecystic bile as well as in the gallbladder tissue and liver tissue was investigated together with bacteria detectable in the bile in order to evaluate basically usefulness of this antibiotic in the treatment of infections of the hepatocystic duct. Intravenous drip infusion of LCM 1.5 g (in 500 ml of 5% glucose solution) over 1.5--2 hours resulted in mean drug concentrations of 33.9 and 10.1 micrograms/ml in serum at 2 and 4 hours post start of infusion respectively; 215.5 micrograms/ml in choledochal bile at 3 hours 15 minutes; 252.7 micrograms/ml in cholecystic bile at 3 hours 36 minutes; 28.1 micrograms/g in gallbladder tissue at 2 hours 55 minutes; and 15.4 micrograms/g in liver tissue at 4 hours. A cross-over study of LCM and cefazolin (CEZ) in 2 cases where T-tubes were employed demonstrated evidently higher biliary levels of LCM than CEZ. Bacteriological examination showed that Hafnia alvei plus Streptococcus faecalis were presented in choledochal bile from just 1 of 4 cases while in cholecystic bile from 9 of 15 cases were detected 22 strains of organisms including Klebsiella pneumoniae (7 strains), Bacteroides fragilis (5), Escherichia coli (2), Citrobacter freundii (2) and Serratia marcescens (2). A total of 7 strains of anaerobes including B. fragilis was isolated. The above concentrations of LCM in the bile, gallbladder tissue and liver tissue sufficiently covered the MIC90 of this antibiotic determined by us in 1980 for major species of anaerobes including clinical isolates of B. fragilis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6502930 TI - [Prevention of postoperative infection following cardiac catheterization in pediatric field. Study of air-borne bacteria in X-ray room and evaluation of an antibiotic used for prevention of postoperative infection]. AB - As part of preventive measures against postoperative infection following cardiac catheterization in infants with cardiac diseases, especially falling bacteria in X-ray room was studied. Moreover, a synthetic penicillin, ticarcillin (TIPC), was used as preventive antibiotic against postoperative infections due to falling bacteria which probably contaminate the air in the X-ray examination room, and the efficacy and side effects of the drug were observed. As result, coagulase negative Staphylococcus was detected the most, followed by Micrococcus and then by fungus. The number of these 3 organisms corresponded to 90.3% of the total number of falling bacteria detected during operation. The number of falling bacteria during operation was 5.1 times larger than that before operation. Taking into account normal flora of skin, falling bacteria present in the X-ray room and causative organisms of bacterial endocarditis, TIPC was administered to 30 cases intravenously 5 times at a dose of 30 mg/kg every 8 hours for the purpose of preventing possible postoperative infections following cardiac catheterization. The drug was effective to prevent such infections in all cases. No side effects were noted in any case, in peripheral blood and hepatic function tests and other observations. PMID- 6502931 TI - [Clinical studies on intravenous drip-infusion of micronomicin for complicated urinary tract infections]. AB - The clinical efficacy and safety of intravenous micronomicin (MCR) therapy were evaluated in cases with complicated urinary tract infections. MCR was administered to 13 patients by intravenous drip infusion over a period of 1 hour, in a dose of 120 mg twice daily for 5 consecutive days. Therapeutic results were evaluated by the criteria proposed by UTI committee and the judgement of the doctor in charge and the overall clinical efficacy rate was 69% (9/13) and 85% (11/13), respectively. Among 18 strains isolated before treatment, 15 strains were eradicated and bacteriological efficacy rate was 83%. No side effects including nephrotoxicity and ototoxicity associated with the treatment were noted, except for 1 case with transient elevation of A1-P. PMID- 6502932 TI - [Effect of cefaclor in urinary tract infections (2)]. AB - A second part of our continuous investigation on the clinical effect of cefaclor (CCL) against urinary tract infections was reported herein. CCL, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 76 cases with the uncomplicated acute cystitis in the women, and (II) 55 cases with the complicated. Rates of effectiveness were obtained 98.7% in (I) and 60% in (II). Side effects were noted in 13 cases out of total 150 cases. PMID- 6502933 TI - [Experimental tuberculosis in mice]. PMID- 6502934 TI - Simultaneous changes of left ventricular and left atrial size and function in normal subjects during exercise. AB - We performed dual M-mode exercise echocardiography, which records left ventricular (LV) and left atrial (LA) echocardiograms simultaneously, in 10 normal subjects to investigate mechanisms of cardiac adaptation to dynamic exercise. The LV end-diastolic dimension (EDD) increased significantly as exercise increased from mild to moderate (3-5%, p less than 0.05 and 0.001). At peak exercise the EDD was slightly increased, but it returned to the baseline during recovery. The LV end-systolic dimension (ESD) showed a progressive decrease with the severity of exercise (5-13%, p less than 0.05 and 0.001). It decreased further immediately after exercise (17-20%) and then returned to the resting value. The LV stroke dimension and fractional shortening increased as exercise changed from mild to moderate and reached a plateau at peak exercise. During recovery, they showed a transient increase and then decreased. By contrast, the LA dimensions, both maximum and minimum, increased significantly as exercise changed from mild to moderate (15-16% and 16-19%, p less than 0.01 and 0.001, respectively), but they were lower at peak exercise (12 and 14%). They returned rapidly to the resting values immediately after exercise. Thus, during exercise, LV function is augmented by the Frank-Starling mechanism in combination with increased contractility, while the LA is enlarged to receive the increased venous return accompanying dynamic exercise. These exercise-induced changes in LV performance return gradually to the resting state, but LA size recovers rapidly after the cessation of exercise. PMID- 6502935 TI - Echocardiography in sarcoidosis. AB - We examined 39 patients with biopsy proven sarcoidosis of the lungs by one dimensional, two-dimensional and pulsed Doppler echocardiography. In 18 (46.2%) we revealed a prolapse of one or both cusps of the mitral valve which can partly explain some of the complaints and objective findings in these patients (palpitations, chest pain, changes on ECG resembling myocardial infarctions, murmurs, etc.). A minor pericardial effusion was present in 8 (20.5%) of the patients. The finding of reduced systolic thickening and excursions of the interventricular septum in 4 (10.2%) may be related to the frequent prevalence of sarcoid granulomas in the septum. Asymmetric septal hypertrophy, recorded in 4 (10.2%) patients, may have had a similar origin. Administration of corticosteroids did not influence in a significant way any of the echocardiographic indicators nor the amount of pericardial effusion. In patients with palpitations and extrasystolic arrhythmias, however, the extrasystoles disappeared and the patients reported subjective relief in all instances. PMID- 6502936 TI - Cardiac dimensions and motion shortly after mitral valve surgery. AB - We studied 71 adult patients echocardiographically both before and 2-16 days (mean 8 days) after mitral valve surgery to systematically evaluate the early postoperative changes in cardiac dimensions and motion. The patients were divided into 4 groups: group I with predominant mitral stenosis (MS) (26 patients), group II with predominant mitral insufficiency (MI) (12 patients), group III with MS + MI (16 patients) and group IV with combined mitral and aortic valvular disease (17 patients). After operation the left atrial dimension at endsystole decreased (mean +/- standard deviation, 56 +/- 12 mm vs 46 +/- 11 mm, p less than 0.001), but did not completely normalize in the majority of patients. The left ventricular dimension at enddiastole decreased in group II from 67 +/- 12 mm to 54 +/- 5 mm (p less than 0.01) and in group IV from 59 +/- 13 mm to 54 +/- 13 mm (p less than 0.01), but increased in group I from 43 +/- 8 mm to 46 +/- 9 mm (p less than 0.05). Mitral EF slope increased from 15 +/- 11 mm/sec to 52 +/- 20 mm/sec (p less than 0.001) after commissurotomy, and decreased from 136 +/- 61 mm/sec to 66 +/- 30 mm/sec (p less than 0.05) after annuloplasty. However, the postoperative means were subnormal in these subgroups. Paradoxical or hypokinetic septal motion occurred in 5/71 (7%) before and 50/71 (70%) after operation. We conclude that: 1) partial normalization of cardiac dimensions and subnormal mitral EF slopes shortly after mitral valve surgery suggest a residual pressure gradient across the mitral valve as well as partial irreversibility of the heart after longstanding mechanical overloading, and 2) postoperative abnormal septal motion, which may be caused by pericardiotomy, can occur after any type of open heart surgery. PMID- 6502937 TI - Evaluation of right ventricular pressure by two-dimensional echocardiography. AB - To estimate the severity of right ventricular hypertension noninvasively, the two dimensional echocardiograms of 86 patients were examined--26 patients with atrial septal defect (ASD group), 22 with rheumatic valvular heart disease (VHD group), 12 with primary pulmonary hypertension (PPH group) and 26 with tetralogy of Fallot (Fallot group)--and data were compared with those of 20 normal persons. The interventricular septal (IVS) curvature index (delta r) from short axis view correlated well with the ratio of right to left ventricular systolic pressure (RVP/LVP). When IVS became convex towards the right ventricular cavity, the correlative coefficient between delta r and RVP/LVP was r = 0.75 in the ASD group, r = 0.83 in the VHD group, r = 0.71 in the PPH group and r = 0.77 in the Fallot group. The RVP/LVP approached a plateau when IVS became straight or convex towards the left ventricular cavity. Two-dimensional echocardiography provides a useful means to assess the right ventricular systolic pressure non-invasively. PMID- 6502938 TI - Right ventricular ejection fraction. Validation of first-pass radionuclide studies by contrast angiography. AB - The accuracy of first-pass radionuclide angiocardiography (FPRNA) in the assessment of right ventricular ejection fraction (RVEF) using a multicrystal scintillation camera in the right anterior oblique view has not been reported. To test the validity of this technique, RVEFs derived from first-pass time-activity curves with and without background correction were compared with those obtained from contrast ventriculography in 36 patients. Background regions-of-interest tested included tricuspid valve, free wall, and horseshoe-shaped approaches. The tricuspid valve approach yielded a mean RVEF of 0.485 +/- 0.100 (SD) which slightly underestimated the contrast mean value (0.553 +/- 0.099, p less than 0.05) but correlated well (r = 0.88). The horseshoe approach yielded a mean value of 0.548 +/- 0.100 which approximated the contrast mean value and also correlated well (r = 0.81). The free wall approach yielded a mean of 0.502 +/- 0.095 which did not differ from contrast data (p greater than 0.05) but correlated less well (r = 0.77). With the method without background correction, a much lower mean value (0.387 +/- 0.081, p less than 0.01) and less correlation (r = 0.77) were obtained. Thus, FPRNA using a multicrystal camera in the right anterior oblique view is a reliable technique for measuring RVEF when a tricuspid valve or horseshoe-shaped background approach is employed, but is less accurate if the time-activity curve without background correction is applied. PMID- 6502939 TI - The anatomo-pathological findings in Jatene's procedure. AB - At present, the most promising technique for correcting transposition of the great arteries is the arterial switch with coronary reimplantation, which is also being used to correct the Taussig-Bing double outlet right ventricle. A study was undertaken in 5 postmortem hearts from 11 patients aged from 2 to 17 months (average 10.6) who underwent surgery in Salvador, Brazil, between November 1976 and October 1980. Four of these patients died during surgery and 1 soon after. The anatomical diagnoses were transposition of the great arteries in 4 and double outlet right ventricle in 1. The anatomy of each heart was carefully studied, revealing some outstanding aspects: the interatrial septum was intact in 1 case, there was a patent foramem ovale in 2, an atrial septal defect created by atrioseptostomy in 1, and a single atrium in 1; the interventricular septum was intact in 2 cases, a ventricular septal defect of the membranous and muscular type was found in 1 and an atrioventricular canal type in 2; a ventriculotomy (40 mm) for closing a ventricular septal defect was seen in 2 cases; a shortened aortic stump was found in 3 cases and in 1 of these it had been necessary to interpose a dacron conduit between this stump and the pulmonary artery segment; a shortened pulmonary artery stump was seen in 3 cases; the caliber of the pulmonary artery stump had been reduced by 10 mm in 1 of the cases to facilitate anastomosis with the pulmonary artery stump; in 2 cases there was a retraction at the level of the anastomosis between the pulmonary artery stump and the aortic segment due to disproportionate calibers; in 3 cases there was a partial occlusion of the left coronary ostium, and in still another case the right coronary ostium was also partially occluded; displacement of coronary artery ostia from their original sites to new ones ranged from 5 to 13 mm (average 8.5 mm) for the right coronary artery and from 5 to 7 mm (average 6.5 mm) for the left coronary artery; in 1 case the left coronary artery was completely occluded very close to its point of origin, due to torsion and folding. PMID- 6502940 TI - Acute and chronic hemodynamic effects of the basic therapeutic regimen for congestive heart failure. Diuretics, low salt diet and bed rest. AB - The acute and chronic hemodynamic effects of the "basic regimen" for congestive heart failure (CHF), consisting of diuretics (furosemide) low salt diet and bed rest, was studied in 10 patients with CHF (all in NYHA class IV initially). In the acute stage, furosemide 80 mg i.v. effected rapid clinical improvement with reduction in ventricular filling pressures (VFP); however, no increase in cardiac (CI) or stroke volume index (SVI) was observed. Subsequently, furosemide 80 mg/day, p.o. was administered for a mean of 30 days with the patients hospitalized on a low salt diet. During this period, their clinical condition was stable. The second hemodynamic study revealed that SVI increased (p less than 0.05) with reduction in VFP maintained. Next, low molecular weight dextran was infused to construct the Frank-Starling ventricular function curve (VFC) and this was compared with the VFC at the acute stage (during diuresis). As a whole, CI and SVI at the chronic stage were significantly increased (p less than 0.05) at equal pulmonary wedge pressures (PWP: mean 20 mmHg). Mean arterial pressure and systemic vascular resistance were decreased during the chronic stage. These findings suggest that the "basic CHF regimen" is effective on a chronic basis in improving left ventricular pump function through afterload and preload reduction, in addition to acute symptomatic relief due to a decrease in PWP. PMID- 6502941 TI - Effects of L-carnitine on exercise tolerance in patients with stable angina pectoris. AB - The effects of L-carnitine (900 mg, p.o. daily) on exercise performance were studied in 12 patients with stable effort angina using a multistage treadmill exercise test. Exercise tests were performed at the end of the placebo period and after 4 and 12 weeks of carnitine therapy. While 12 patients experienced angina during treadmill tests in the placebo period, 2 patients were free of angina after treatment with carnitine. The mean exercise time was 11.4 +/- 0.7 min (mean +/- SE) in the placebo period. This increased significantly to 12.2 +/- 0.5 min (p less than 0.05) after 4 weeks and 12.8 +/- 0.5 min (p less than 0.01) after 12 weeks of treatment with carnitine. The time required for 1 mm ST depression to occur was 6.4 +/- 0.9 min in the placebo period. This increased significantly to 7.6 +/- 0.9 min (p less than 0.01) after 4 weeks and 8.8 +/- 1.0 min after 12 weeks of treatment with carnitine. There was significantly less ST segment depression during the same exercise load after 12 weeks of treatment as compared with that in the placebo period (p less than 0.05). The heart rate and the pressure rate product at the same work load showed no significant difference among the 3 testing periods. The results of this study suggest that L-carnitine may improve exercise tolerance in patients with effort angina. PMID- 6502942 TI - Relationship between regional myocardial blood flow and tissue ATP content in acute ischemia. AB - This study was undertaken to determine the relationships between myocardial mitochondrial function, regional myocardial blood flow (MBF), and tissue ATP content in acute ischemia. Fifty-one anesthetized dogs were used in the tests. MBF was measured by the H2 gas clearance method in order to define the ischemic area, during periods of coronary occlusion of 10, 20, 60, and 90 min. The correlation between MBF and myocardial ATP content in the ischemic area was positive and significant in each group (r = 0.54-0.82). The ATP content in the true ischemic area (where MBF was less than 20 ml/min/100 Gm) decreased significantly even after 10 min of occlusion, but mitochondrial function decreased only after 20 min of coronary occlusion when compared to the nonischemic area. Although ischemia induces mitochondrial dysfunction, a very short period of ischemia did not cause significant disturbance of mitochondrial function. Moreover, in the areas with MBF of 20-40 ml/min/100 Gm, the ATP content began to decrease 60 min after occlusion, whereas 10 or 20 min of occlusion did not reduce the ATP content. These results suggest that normal maintenance of ATP levels depends not only on MBF itself but also on the duration of ischemia plus the degree of damage to mitochondrial function, and that critical blood flow, defined as the minimum flow necessary to maintain the level of myocardial ATP, varies with the duration of ischemia. PMID- 6502943 TI - Rabbit hearts for the critical evaluation of drugs to reduce the size of experimentally produced acute myocardial infarction. AB - Using more than 500 rabbits, we found that the rabbit heart is a good model for the evaluation of drugs which affect acute myocardial infarction (AMI) size. When the ratio of the epicardial coloration area to the long axis length of the left ventricle was controlled immediately after the ligation of the left anterior descending coronary artery and small branches of the left circumflex artery, it was possible to estimate the size of the ischemic region because AMI region in rabbit heart was always transmural. The necrotic region in the left ventricle was determined by phosphorylase histochemistry 24 hours after the operation. The incidence of arrhythmia and death following the operation was negligible. Then, we evaluated several drugs to examine their effects on AMI size. Propranolol (1, 2, and 4 mg/Kg) and verapamil (0.25, 0.5, and 1.0 mg/Kg) reduced AMI size, although the mortality and AMI size increased at higher doses of verapamil. Another Ca2+ antagonist, diltiazem (2 mg/Kg) and an adenosine potentiator, dilazep (2 mg/Kg) also decreased AMI size, while nicardipine, a water soluble, photoresistant nifedipine analogue (0.01, 0.05, and 0.1 mg/Kg) did not show a significant effect. These data suggest that this rabbit model is useful for assessing drug effects on AMI size and that the mechanism(s) of action of nicardipine may differ from other Ca2+ antagonists. PMID- 6502944 TI - Sudden cardiac death during ambulatory Holter monitoring. Report on 3 documented cases. AB - Three cases are presented who died suddenly while being continuously monitored on ambulatory Holter ECG. Two patients with coronary artery disease and severe left ventricular dysfunction after multiple myocardial infarctions died instantly from ventricular fibrillation; this was preceded by a rapid uniform ventricular tachycardia in one patient with normal Q-T interval and by polymorphous ventricular tachycardia in the other whose Q-T was prolonged on combined antiarrhythmic therapy with propafenone and mexiletine. The third patient died from rapidly progressive circulatory failure and acute pulmonary edema due to secondary cardiomyopathy. Despite its occurrence within 30 min after the onset of symptoms, death was not primarily arrhythmic in origin. PMID- 6502945 TI - Intravenous leiomyomatosis of the uterus with continuous extension into the pulmonary artery. AB - A 56-year-old woman presented with an intracardiac tumor, as shown by two dimensional echocardiography. Surgical treatment, undertaken in two stages, revealed a tumor which arose in the uterus, passed through both ovarian veins, the inferior vena cava, the right atrium and ventricle, and the pulmonary trunk, and extended to both pulmonary arteries. The upper portion of the tumor was removed in the first surgical operation, and the remaining tumor was removed during a second operation 1 year later. Both specimens were identical in appearance, and a pathohistological diagnosis of benign leiomyoma was made. PMID- 6502946 TI - [Effect of pre-operative biopsy for breast cancer on survival rate]. AB - To study the effect of pre-operative biopsy for breast cancer on the 10-year survival rate, 1123 cases with single cancer radically operated at the Cancer Institute Hospital between Jan. 1960 and Dec. 1969 were analyzed. The survival rate in 292 biopsied and non-biopsied patients with cancers less than 2 cm in diameter and no lymph node metastasis was not significantly different. There was no difference between incisional- and excisional-biopsied patients. However, the survival rates tended to decrease as the interval between biopsy and radical surgery increased. We conclude that pre-operative biopsy does not worsen the prognosis in patients with breast cancer. Early detection and treatment are of great importance. PMID- 6502947 TI - [Treatment of operable breast cancer by tumorectomy and irradiation]. AB - Six patients with operable breast cancer were treated by tumorectomy followed by radiotherapy at Miyagi Seijinbyo Center between 1972 and 1982. All patients are alive but local recurrence at the irradiated breast and lung metastasis occurred in one patient each. Acute skin reaction was evident in two patients and slight fibrosis of the irradiated breast was observed in another patient. However, we encountered no severe complications in any of our patients. Cosmetic results were satisfactory with the exception of one patient who underwent mastectomy after local recurrence of the carcinoma. PMID- 6502949 TI - [Does fast-neutron radiotherapy merely reduce the radiation dosage?]. AB - We examined whether fast-neutron radiotherapy is superior to low-LET radiotherapy by comparing the relationship between cell survival and tumor control probabilities after exposure of tumor-bearing (species) to the two modalities. Analysis based on TCD50 assay and lung colony assay indicated that single dose of fast neutron achieved animal cures at higher survival rates than other radiation modalities including single and fractionated gamma-ray doses, fractionated doses of fast neutron, and the mixed-beam scheme with a sequence of N-gamma-gamma-gamma N. We conclude that fast-neutron radiotherapy cured animal tumors with lower cell killing rates other radiation modalities. PMID- 6502948 TI - [Detection of resection line in early gastric cancer]. AB - In patients with multiple gastric cancer and superficial spreading type gastric carcinoma (abbreviated as S.S.C.) accompanied by IIb, the remnant stomach is sometimes cancer positive. Our study population consisted of 44 patients with multiple early gastric cancer and 63 patients with depressed type S.S.C. The gastric mucosa was classified into 3 types according to the surrounding mucosal atrophy, 1) pyloric gland zone, 2) intermediate zone, 3) fundic gland zone. All lesions of multiple early gastric cancer and S.S.C. were located in the pyloric gland zone or the intermediate zone. The depressed type S.S.C. did not invade the fundic gland zone. Therefore, knowledge about the extend++ of surrounding mucosal atrophy is required for the proper diagnosis of early gastric cancer and the surgeon must recognize the relationship between the glandular border line and resection line. PMID- 6502950 TI - [Borderline cases between the laryngeal and hypopharyngeal cancers]. AB - Between July, 1978 and December, 1981, we treated 215 patients with laryngeal cancer and 57 patients with hypopharyngeal cancer. The former exhibited good, latter poor, prognoses. Ten patients required a differential diagnosis between supraglottic lesion and pyriform sinus lesion. The initial symptoms, habits of smoking and drinking, sputum cytology, laryngo-tomography and contrast laryngograms which may contribute important information such as failure of the pyriform sinuses to fill, aid in establishing the site of origin of the primary tumor preoperatively. Tumors originating in the pyriform sinus should be operated, paying attention to the mesopharyngeal margin and multicentric carcinogenesis. We also discuss preoperative irradiation, neck dissection and chemotherapy. PMID- 6502951 TI - [Acinic cell carcinoma of the trachea--a case report]. AB - A 27-year-old woman was admitted to our hospital complaining of dyspnea. Bronchoscopic examination revealed an endotracheal mass in the lower trachea. Endoscopic removal of the lesion was done by the electrocoagulation method followed by wide circumferential excision and reconstruction of the trachea three days later. The patient made an uneventful recovery and has had no recurrence in two years of follow-up. The diagnosis of acinic cell carcinoma was made by light microscopy. This is the first description, to our knowledge, of a primary neoplasma of the intrathoracic trachea having the histological appearance of a salivary gland acinic cell tumor. PMID- 6502952 TI - [A case of clear cell sarcoma of tendons and aponeuroses with a large amount of melanin--malignant melanoma of the soft part]. AB - We report a 62-year-old male with a clear cell sarcoma of tendons and aponeuroses arising in the area of the M. flexor carpi ulnaris. Grossly, the tumor had a black appearance. Light microscopic inspection showed a large amount of melanin. Electron microscopically, the tumor pigment was located within melanosomes. The possibility that the tumor represents a neural crest-derived melanotic tumor (malignant melanoma) of the soft part is discussed. PMID- 6502953 TI - [Alteration of platelet population in thrombotic diseases]. PMID- 6502954 TI - [Cerebral vessels and thrombosis]. PMID- 6502955 TI - [Arterial and venous thrombosis of the extremities]. PMID- 6502956 TI - [Failures of remission induction in adult acute leukemia]. PMID- 6502958 TI - [3 cases of Gaucher's disease (adult type), with reference to cases reported in Japan (1970-1981)]. PMID- 6502957 TI - [The causes of death in severe hematologic disorders. Increasing fatal fungal infection in hematologic malignancies]. PMID- 6502959 TI - [Thrombus formation with special reference to the substrates, fibrinogen and its related substances]. PMID- 6502960 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. G. Urinary polyamine values in multiphasic screening]. PMID- 6502961 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by enzymatic assay method and its clinical application. I. Urinary polyamines in patients with hematologic malignancies]. PMID- 6502962 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. J. Urinary polyamines in the aged]. PMID- 6502963 TI - [Urinary polyamine analysis and its clinical significance. III. Chemiluminescence method for the assay of urinary polyamines and its clinical application]. PMID- 6502964 TI - [Polyamine analysis of blood, tissue and gastric juice and its clinical significance. I. Blood polyamine analysis and its significance. A. Erythrocyte polyamine values in surgical patients with cancer]. PMID- 6502965 TI - [Polyamine analysis of blood, tissue and gastric juice and its clinical significance. I. Blood polyamine analysis and its significance. B. Erythrocyte polyamine analysis method and its clinical application]. PMID- 6502967 TI - [Urinary polyamine analysis and its clinical significance. I. Analysis by HPLC and its clinical application. A. Urinary acetylpolyamine in patients with malignant tumors]. PMID- 6502966 TI - [Polyamine analysis of blood, tissue and gastric juice and its clinical significance. III. Analysis of gastric juice polyamines and its clinical significance]. PMID- 6502968 TI - [Short history of polyamine research]. PMID- 6502969 TI - [Urinary polyamine analysis and its clinical significance. I. Analysis by HPLC and its clinical application. B. Clinical application to the fields of obstetrics and gynecology]. PMID- 6502970 TI - [Urinary polyamine analysis and its clinical significance. I. Analysis by HPLC and its clinical application. C. Urinary polyamine in pediatric patients with malignant tumors and its clinical significance]. PMID- 6502971 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application A. Urinary polyamines in patients with various tumors]. PMID- 6502972 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. B. Polyamines and the fields of obstetrics and gynecology]. PMID- 6502973 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. D. Polyamines in urogenital neoplasms]. PMID- 6502974 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. E. Polyamine in the field of pediatrics]. PMID- 6502975 TI - [Urinary polyamine analysis and its clinical significance. II. Analysis by the enzymatic assay method and its clinical application. F. CRP and polyamines]. PMID- 6502976 TI - [Plasma lipoprotein metabolism in patients with high density lipoprotein deficiency]. PMID- 6502977 TI - [Studies on determination of plasma lipoperoxide. 3. Effect of the bilirubin level]. PMID- 6502978 TI - [Studies on the histochemical quantitation of cell nuclei, smooth muscle cell, various connective tissues and calcium phosphate. I]. PMID- 6502979 TI - [Determination of lymphocyte subsets by monoclonal antibodies using a flow cytometric whole blood method]. PMID- 6502980 TI - [An approach of immunology. Malignancy and M-protein]. PMID- 6502981 TI - [An approach of immunology. Immunological abnormalities in multiple myeloma]. PMID- 6502982 TI - [An approach of infectious disease. Neonatal infection]. PMID- 6502983 TI - [Approach of hematology. Management of hematological disorders]. PMID- 6502984 TI - [Approach of hematology. Red cell deformability and membrane protein]. PMID- 6502985 TI - [Approach of hematology. Abnormal findings of coagulation and fibrinolytic factors in DIC]. PMID- 6502986 TI - [Elucidation of the clinical importance of measuring aminopeptidase activity in the serum. IV. The relation between other enzymes by multivariative statistical analysis]. PMID- 6502987 TI - [Serum adenosine deaminase: activity and multiple molecular forms]. PMID- 6502988 TI - [Simultaneous measurement of phagocytic and lysozyme activities in leukemic cells]. PMID- 6502989 TI - [Changes in size distribution during blastogenesis of lymphocytes induced by some mitogens]. PMID- 6502990 TI - [Peripheral blood cell counts and differential analysis in healthy women at 3 months postpartum. Increase in lymphocyte count and influence of lactation]. PMID- 6502991 TI - [Investigation on new instrument whole blood platelet analyzer Baker 810]. PMID- 6502992 TI - [Cardiac arrhythmias in master's two-step test]. PMID- 6502993 TI - [Lectin-binding sites and patterns of melanin-producing cells]. PMID- 6502994 TI - [A case of solar urticaria]. PMID- 6502996 TI - [Some problems associated with aging]. PMID- 6502995 TI - [NK activity in various skin diseases]. PMID- 6502997 TI - [Free radical as an aging index]. PMID- 6502999 TI - [Glomerular filtration rate in chronic obstructive pulmonary disease; clinical implication of biological index of age]. PMID- 6502998 TI - [Cardiovascular system: indices of aging]. PMID- 6503002 TI - [A survey of mental changes with aging]. PMID- 6503000 TI - [Age-related changes in nervous system]. PMID- 6503001 TI - [Physiological parameters of aging process]. PMID- 6503003 TI - [The intellectual ability at the upper limit of human aging]. PMID- 6503004 TI - [The clinical issues of primary dementia]. PMID- 6503005 TI - [Age-related change in the brain and calendar age]. PMID- 6503006 TI - [Determination of aortic medial wall smooth muscle cell and nucleic DNA in stroke prone hypertensive rats]. PMID- 6503007 TI - [A cytophotometrical study on the hepatocyte of centenarians]. PMID- 6503008 TI - [Peripheral vasodilator effect of 1,1,1-trichloroethane inhalation]. AB - It is presumed that systemic hypotension resulting from high concentration of 1,1,1-trichloroethane (1,1,1-TCE) inhalation may be induced by functional depression of the central nervous system. However, it is still uncertain the possibilities that one of the site of action where 1,1,1-TCE acts in systemic hypotension existed in the portion without the central nervous system. The present experiment was performed to investigate the role of the peripheral vessels as a site of action in the systemic hypotension following 1,1,1-TCE inhalation. The right hindlimb of a dog anesthetized with sodium pentobarbital (25-30 mg/kg, intravenously) was amputated at the central level of the thigh bone leaving muscles and nerves. The isolated hindlimb was perfused with blood at a constant flow rate using a pump. Venous blood circulated in the isolated hindlimb was returned to the femoral vein. To measure the perfusion pressure of the isolated hindlimb, a small catheter was inserted into the artery and was connected to a pressure transducer (Nihon Kohden, MPU-0.5). In this perfusion experiment, the changes in perfusion pressure following 1,1,1-TCE inhalation are shown to be the reaction of peripheral vessels only as the site of action of 1,1,1-TCE. In other words, the effects of 1,1,1-TCE on central nervous system could be completely removed. Various concentrations of 1,1,1-TCE vapor, made by an inside circuit vaporizer, were inhaled during a period of approximately 2 min. Perfusion pressure was continuously recorded before, during and after the termination of inhalation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503009 TI - [Acoustic reflex in workers using hand-held vibration tools. Combined effects of noise and local vibration]. AB - Combined effects of noise and local vibration on the threshold of acoustic reflex (ART) were investigated. ARTs for three different stimuli (ARTWN, ART1k, ART4k) were determined in workers using hand-held vibration tools. The results obtained from these 72 workers (Group A) were compared with the ARTs in 100 control subjects (Group C) who had normal hearing acuity without any history of occupational noise exposure, as previously reported by the authors. The mean age in group A was 46.6 ranging from 26 to 62. The mean period of noise and vibration exposure was 11.4 years in subjects mainly using chain saws and 9.2 years in subjects mainly using bush cleaners (Table 2). ARTWN and ART1k in the exposed group showed significant differences compared to those in the non-exposed group (p less than 0.001), i.e., mean ARTWN was 89.6 dB SPL in Group A and 83.8 in Group C, mean ART1k was 96.1 dB SPL in the former and 92.2 in the latter group (Table 7). No significant difference was observed in mean ART4k between the two group (p greater than 0.1). The difference between ART1k and ARTWN, [ART1k ARTWN], was significantly reduced in the exposed group (p less than 0.001), i.e., 2.7 dB in Group A and 12.4 in Group C (Table 8). To clarify the effects of aging on [ART1k-ARTWN], the exposed group was classified into three groups according to their HL(4k + 8k)/2. However, no significant correlation was observed between [ART1k-ARTWN] and age in any of these 3 groups (p greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503010 TI - Alteration of inorganic mercury accumulation due to selenite in organs of mice fed methylmercury. AB - Mice were fed methylmercury (10 nmol/g feed) and selenite (0, 8, 20 or 50 nmol/ml drinking water) for one or two weeks. Doses of selenite and duration of feeding were determining factors of total mercury and inorganic mercury concentrations in organs. Increasing the dose of selenite produced the following results: concentration of total mercury increased in the brain and liver and decreased in the blood, kidneys and spleen; concentration of inorganic mercury increased in the liver and spleen, decreased in the kidneys, and remained unchanged in the brain; the rate of inorganic mercury to total mercury increased in the liver and spleen, decreased in the brain, and remained unchanged in the kidneys. In every case, inorganic mercury in the blood was below the detection limit. PMID- 6503011 TI - Experimental studies on the effects of Mt. Sakurajima volcanic ashes on the respiratory organs. AB - Since 1978, the authors have collected ashes from Sakurajima volcanic eruption in Kagoshima City, and the ashes were administered to rats and rabbits through different routes and forms injecting into the trachea in order to see the effect of ashes on the respiratory organs. The authors experimentally and histopathologically demonstrated bronchitis, pulmonary emphysema, atelectasis lung, degeneration of blood vessel, dust nodes and induction of pneumoconiosis due to dust fibrosis in the study of the effect of volcanic ashes on the respiratory organs. PMID- 6503012 TI - Hemoglobin values in adult women of various occupational groups in the community. AB - In 1966 and 1971, the authors studied hemoglobin values of about 2,000 women of 10 different occupational groups and different social classes in the same district. The mean values of hemoglobin and serum iron were highest in nursing students followed by urban housewives and nutritionists and lowest in 3 groups of farm wives and shoe factory laborers. The difference in the mean values of hemoglobin observed among occupational groups was in principle assumed to be due to the difference of frequency in levels of 11-12 g/dl. Hemoglobin levels between 1966 and 1971 tended to improve as a whole and the differences among occupational groups have been reduced. In this study, some kinds of social conditions as well as some physiological factors related to hemoglobin values were investigated. In the same occupational group, unmarried women had a higher level of hemoglobin than married women. Further, married women with infants showed a relatively lower level than those with no infants. This suggests that hemoglobin values of female workers may be significantly influenced not only by work conditions but also by social conditions including family circumstances. PMID- 6503013 TI - [Vibration hazards in quarry workers]. AB - Vibration hazards were surveyed in a population of quarry workers using chipping hammers and to a lesser extent, rock drills. Sixty-nine male quarry workers, aged 49.1 +/- 8.7 and exposed to vibration for 16.4 +/- 5.1 years, were surveyed in 1981-82. They were exposed to vibration for about 2-4 hours per days, mainly under a piece-work pay system. They had a high prevalence of Raynaud's phenomenon (36.2%) and numbness in upper extremities (53.6%). It is considered that the high prevalence was mainly due to large vibration levels in chipping hammers and rock drills and long daily exposure time. The attacks of Raynaud's phenomenon were found predominantly in the left hand, which held chisels, whereas the restriction of motion in the elbow was predominantly in the right arm which pushed chipping hammers. The same 49 male quarry workers in this population were also surveyed in 1976-77 and the prevalence of their complaints between 1976-77 and 1981-82 was compared. The prevalence of Raynaud's phenomenon was the same, but the frequency of the attacks increased between the two periods. The prevalence of other complaints such as numbness, pain and chills in the upper extremities also increased. Between 1976-77 and 1981-82, the prevalence of Raynaud's phenomenon, numbness, and pain in the upper extremities increased in the population of quarriers exposed to vibration for above 2.6 hours per day and 200 days per year, or 600 hours per year. On the other hand, the prevalence of these complaints mostly decreased in the population of quarriers with less exposure. PMID- 6503014 TI - [Attenuation efficiency of hearing protectors for workers exposed to noise]. PMID- 6503015 TI - [Assessment of high-temperature working conditions]. PMID- 6503016 TI - [A case of trichloroethylene polyneuropathy]. PMID- 6503017 TI - [Measurement and analysis of respiratory arrhythmia]. PMID- 6503018 TI - [A hardware model of the neuro-muscular system in peristaltic movement]. PMID- 6503019 TI - [Development of a pulse generator for the prevention of syncope and sudden death during the monitoring of heart block]. PMID- 6503020 TI - [Computer simulation of sensory pain reception by an elastic skin model]. PMID- 6503022 TI - [Simulation of surface potential distribution on the human torso]. PMID- 6503021 TI - [Time series analysis of the R-R interval variability during a running load in man]. PMID- 6503023 TI - [Technic for the cancellation of power-line noise in biomagnetic measurements]. PMID- 6503024 TI - Yokenella regensburgei gen. nov., sp. nov.: a new genus and species in the family Enterobacteriaceae. AB - The name Yokenella gen. nov. is proposed for a group of organisms in the family Enterobacteriaceae isolated from clinical sources and insects. Yokenella is a gram-negative, oxidase-negative, fermentative, motile rod possessing the characteristics of the family Enterobacteriaceae and the guanine plus cytosine contents of the DNA range from 58.0 to 59.3 mol%. Biochemical characteristics of this group and DNA hybridization studies indicate that the 11 strains studied here comprise a separate species which should be best placed in a new genus. This single DNA hybridization group is named Yokenella regensburgei sp. nov. The type strain of Y. regensburgei is NIH 725-83 (JCM 2403). PMID- 6503025 TI - Titration of botulinum toxins for lethal toxicity by intravenous injection into mice. AB - Clostridium botulinum type A - F toxins can be titrated by the time-to-death method by iv injection into mice. The time to death is not dependent upon the molecular size, but upon the immunological type of the toxin. It is necessary to assure complete activation of the activable toxin produced by nonproteolytic as well as a certain proteolytic strains before subjecting to titration by the iv injection method. PMID- 6503026 TI - Production of cholera-like enterotoxin by Aeromonas hydrophila. AB - A total of 249 strains of mesophilic Aeromonas including 179 A. hydrophila and 70 A. caviae were tested for production of cholera-like enterotoxin by reversed passive latex agglutination (RPLA) assay. A cholera-like enterotoxin neutralized with cholera antitoxin was demonstrated in the culture filtrates from eight (4.5%) of the 179 A. hydrophila strains, while none of A. caviae strains revealed the enterotoxin production in the test. Production of the cholera-like enterotoxin in the eight strains of A. hydrophila was also confirmed by enzyme linked immunosorbent assay (ELISA). PMID- 6503027 TI - Responses of the vascular-interstitial-lymph system to saline loading in the rat. AB - The responses of the vascular-interstitial-lymph system to saline loading were examined in rats by continuous monitoring of circulating blood volume and simultaneous collection of thoracic duct lymph. About 90% of the infused volume shifted out of the intravascular space, of which 72% was imbibed in the interstitial space, 21% was drained through the thoracic duct, and 7% was excreted in the urine by the 50th min after the infusion amounting to 4% of body weight. The drainage of lymph protein following the infusion was about 50% of that expected from the interstitial protein concentration and even distribution of the infused saline. This result can be explained partly by the increase of lymph from skin and muscle after the infusion. PMID- 6503028 TI - Effects of Na+ depletion on fluid secretion and levels of phosphorus compounds as measured by 31P-NMR in perfused canine mandibular gland. AB - The dependency of fluid secretion on extracellular Na+ and the levels of phosphorus compounds were studied in the perfused canine mandibular gland (using 31P-NMR). During control perfusion, the resting levels of creatine phosphate (CP) and ATP were 0.62 +/- 0.05 mmol . kg-1 gland and 0.42 +/- 0.04 mmol . kg-1 (mean +/- S.E., n = 9), respectively. Acetylcholine (Ach; 1 mumol . l-1 for 3 min) induced a salivary secretion and decreased the CP level. When Na+ in the perfusate was completely replaced with Li+, Ach induced only a minimal salivary secretion and no change in the ATP and CP levels. Restitution of Na+ to the perfusion, even without added Ach, caused a decrease in ATP and CP, and a small increase in salivary secretion. These results suggest that the activity of Na+/K+ ATPase is increased inversely via a rise of the intracellular Na+ concentration and that the salivary secretion is induced not only by added secretagogues but by an increase in the Na+ entry without added secretagogues. PMID- 6503029 TI - Effects of low Na on the tetanic contractility of frog skeletal muscle. AB - The effects of low Na on the tetanic contractility after trains of twitch were investigated in frog skeletal muscle. Tetanic tension was induced by a stimulation of 100 Hz for 400 msec every 5 min and a train of twitches (150 or 250) with 1 Hz was interposed between two successive tetani. When the Na concentration was reduced to 50% by replacement with choline, each twitch constituting the positive staircase during stimulus train was augmented as compared with those in normal Ringer. The amplitude of action potential during the staircase was smaller than that in normal Ringer and was gradually decreased, suggesting that low Na solution made the release of twitch-Ca from the sarcoplasmic reticulum in twitch more effective. Although the tetanic contractility in low Na was almost the same as that in normal Ringer before applying twitch train, it was more markedly inhibited after the train. The relative size of the inhibited tetanus had a correlation with the relative size of the potentiated twitch in both normal Ringer and low Na. This tetanus inhibition after the twitch train might be due to the suppression of action potential and/or due to some inhibitory factor in the excitation-contraction (E C) coupling process. PMID- 6503030 TI - Constant mechanical efficiency of contractile machinery of canine left ventricle under different loading and inotropic conditions. AB - We have recently proposed that the total mechanical energy generated in each cardiac contraction can be quantified by the systolic pressure-volume area (PVA). PVA is the area in the pressure-volume (P-V) diagram that is circumscribed by the end-systolic and end-diastolic P-V relation curves and the systolic segment of the P-V trajectory. This area has dimensions of energy and comprises the external mechanical work and the elastic potential energy. In the left ventricle of cross circulated canine hearts, we studied the relation between PVA and oxygen consumption per beat (VO2) above VO2 for mechanically unloaded contraction. We assumed that this excess VO2 is utilized for mechanical contraction by the contractile machinery. The percentage of PVA in the excess VO2, both in the same unit of energy, J, would then represent the efficiency of energy conversion from the excess VO2 to the total mechanical energy in the contractile machinery. We obtained this efficiency in variously loaded contractions in both control and enhanced contractile states with epinephrine and calcium. We found that the efficiency was constant at 30-50 (mean 40) % regardless of the changes in both loading conditions and contractile states. By this constant efficiency and a variable fraction of external work in PVA, we accounted for the load- and contractility-dependent variability of the conventional mechanical efficiency (0 30%) of the heart. PMID- 6503031 TI - Effects of a brief treatment with saponin on the contractile and electrical activities of isolated uterine muscle of pregnant rat. AB - The isolated longitudinal or circular muscle strip of rat uterus on day 20 of pregnancy becomes quiescent when incubated with Krebs solution for about 2 hr. Electric stimulation gave rise to a twitch-like contraction with a small amplitude instead of the spontaneous phasic contraction observed during the early period of incubation. When saponin (30-500 micrograms/ml) was applied, the basal tension was elevated and spontaneous contractions having large amplitude were elicited. The amplitude was larger than the phasic contraction of the K contracture observed prior to the saponin treatment. The membrane was depolarized by about 25 mV, and periodic burst discharge was generated at the onset of saponin treatment. Raising the external Mg concentration from 0 to 2.4 mM in steps caused a depression of contractions in a dose-dependent manner before treatment with saponin, whereas the depression by Mg was much reduced after saponin treatment. The saponin-treated muscle recovered to exhibit control activity when tissues were superfused with Krebs solution for hours, i.e. the membrane was repolarized, the duration of action potential was detracted, and the depressant effect of Mg was again potentiated. For comparison, the effects of saponin and Mg on the contractions of ileal longitudinal muscle of pregnant rat were studied. In view of the above observations, the following were discussed. 1. Saponin impaired the depressant effect of Mg on the generation of contractions. 2. The membrane once impaired by saponin recovered in vitro probably under the influence of the genomic effect of ovarian hormones, a phenomenon which appeared characteristic for pregnant uterus. PMID- 6503032 TI - Transvascular fluid shift and thoracic duct lymph: analysis of lymph formation in the rat. AB - To analyze the effect of changes in interstitial fluid on lymph production, intravascular infusions of saline were given to splenectomized rats under pentobarbital anesthesia at 3 different rates (2, 3, and 4 ml/100 g of body weight) over 10 min. Change of blood volume was continuously monitored and, simultaneously, thoracic duct lymph was collected during and after the infusion. Equilibrium was attained approximately 40 min after the infusion; regardless of the infusion rate, 10% of the infused volume was incorporated into the vascular space and 90% was filtered into the extravascular space. Thus, the amount of transvascular fluid shift showed a linear relationship with the infused volume. However, the drainage from thoracic duct lymph amounted to 5.9%, 11.4%, and 17.8% of the infused saline volume when given at the rate of 2, 3, and 4 ml/100 g, respectively. The relation of lymph flow and infused volume could be regarded as a nonlinear system. By means of a simulation study, this relation was found to be attributed to the nonlinearity of conductance for fluid movement from tissue to lymph duct, which was only one sixth of that determined for the capillary membrane. The drainage of lymph protein following the infusion was only about 50% of that expected from the interstitial protein concentration in even distribution of the infused saline. These characteristics of interstitial fluid space play an important role in absorbing water and, hence, buffering changes in circulating blood volume after volume loading. PMID- 6503033 TI - Mechanism of calcium efflux from isolated bovine adrenal chromaffin cells. AB - Chromaffin cells isolated from bovine adrenals and maintained in culture were loaded with 45Ca, and the mechanism of 45Ca efflux from these cells was investigated. During exposure to a Ca-deficient, Mg (1 mM)-containing medium, replacement of NaCl with sucrose, choline Cl, or Tris Cl reduced the rate of 45Ca efflux by approx. 30-40%, showing the presence of a Na-dependent 45Ca efflux mechanism. In contrast to the previous findings, however, Li can partially replace Na in maintaining 45Ca efflux. Reintroduction of Ca to a Ca-deficient medium increased the rate of 45Ca efflux depending on the concentrations of Ca, showing the presence of a Ca-dependent Ca efflux mechanism. The marked but transient rise in the rate of 45Ca efflux in response to Ca reintroduction was observed under conditions in which the concentration of internal Na was raised either by inhibiting Na pumping activity (ouabain or K removal) or by removal of Mg from the medium. The increased 45Ca efflux was further potentiated by simultaneous Na removal and was markedly inhibited by Ca channel blockers, suggesting that the transiently increased Ca influx in exchange for internal Na facilitated the rate of 45Ca efflux. However, other conditions which evoke catecholamine secretion by stimulating Ca influx also increased the rate of 45Ca efflux, suggesting that the increased Ca influx via any route increases 45Ca efflux. These results thus confirmed the presence of both Na-dependent and Ca dependent Ca efflux mechanisms in chromaffin cells. PMID- 6503034 TI - Influences of glycine and neuron R14 on contraction of the anterior aorta of Aplysia. AB - Firing neuron R14 in the Aplysia parietovisceral ganglion enhances the force of stimulated contractions and causes rhythmic contractions rather than individual contractions in response to a single stimulation of the anterior aorta of Aplysia. Bath application of 1.0 mM glycine to the artery causes a small depolarization, rhythmic contractions and enhances the force of individual, neurally induced contractions of the anterior aorta. These observations suggest that the physiological role of the innervation of the anterior aorta by R14 is to convert the mode of contraction of the anterior aorta from direct neural control to a myogenic mode. R14 activity does not produce classical junction potentials and inotophoretically applied glycine does not produce detectable potential changes in the anterior aorta muscle fibers. Glycine increases the force and frequency of Aplysia heart beat, and blood pressure. Glycine causes release of preloaded Ca2+ from the ventricle of the Aplysia heart, implying that glycine causes intracellular release of Ca2+. The similarity of the actions of glycine and electrical activity in R14 extend previous evidence that R14 may utilize glycine to modulate the contractility of Aplysia circulatory muscle. PMID- 6503035 TI - Influence of body posture on maximum calf blood flow in reactive hyperemia. AB - Reactive hyperemia in the calf after arresting femoral blood flow for 3 min was measured by means of strain gauge plethysmography in different postures, i.e. supine, sitting with legs resting horizontally (sitting I), and sitting with the feet on the ground (sitting II). Blood flow in the calf at rest and hyperemia decreased more in the sitting I and II positions than in the supine position. However, the peak flow of the reactive hyperemia was higher in the sitting I and II positions than in the supine position. PMID- 6503036 TI - Influence of dopamine, levodopa and apomorphine on maximal electroconvulsive seizure in the domestic fowl (Gallus domesticus). AB - The influence of dopamine, levodopa and apomorphine on maximal electroconvulsive seizure was studied in young chicks, adult cocks and rats. The susceptibility of chicks to maximal electroshock seizure increased with age between 1 to 7 days. Low to moderate doses of dopamine (12.5-150 mg/kg, i.p.), levodopa (6.25-25 mg/kg, s.c.) and apomorphine (0.25-2.0 mg/kg, s.c.) significantly (P less than 0.005) protected chicks against electroshock seizure, while high doses (200-400 mg/kg, i.p. of dopamine, 50-200 mg/kg, s.c. of levodopa and 2.5-5 mg/kg, s.c. of apomorphine) enhanced electroshock seizure in 1 to 7 day old chicks. However, when 14 day old chicks were used, these dopaminoceptor agonists protected the chicks against maximal electroshock seizure. Noradrenaline (1-40 mg/kg, i.p.) had no significant effect on electroshock seizure in chicks. Both pimozide (4 mg/kg, i.p.) and haloperidol (0.4 mg/kg, i.p.) antagonized the effects of levodopa (12.5 and 50.0 mg/kg, i.p.) and apomorphine (0.5-5 mg/kg, s.c.) on maximal electroshock seizure. The seizure susceptibility of both adult rats and fowls to electroshock was not altered by dopamine (12.5-400 mg/kg, i.p.). Central dopamine neurotransmission might be involved in the biphasic dose-dependent effects of dopamine, levodopa and apomorphine on maximal electroshock seizure in young chicks. PMID- 6503037 TI - Roles of endogenous and exogenous taurine and glycine in the formation of conjugated bile acids: analyses using freshly isolated and primary cultured rat hepatocytes. AB - The regulatory roles of intracellular taurine and glycine, transported and biosynthesized in hepatocytes, on the formation of conjugated bile acids were studied using freshly isolated hepatocytes (fresh hepatocytes) and hepatocytes in primary culture (cultured hepatocytes). Transported taurine significantly increased the rate of taurocholic acid formation both in fresh hepatocytes and cultured hepatocytes. Similarly, the addition of cysteine and hypotaurine, which were metabolically converted to taurine in hepatocytes, facilitated the formation of taurocholic acid in these cells. On the other hand, exogenous glycine into the incubation medium had no effect on the formation of glycocholic acid both in fresh and cultured hepatocytes. In contrast, the addition of serine and threonine, which are metabolically converted to glycine in hepatocytes, significantly increased the formation of glycocholic acid in fresh hepatocytes, although little effect of the additions of serine and threonine on the formation of glycocholic acid was noted in the case of cultured hepatocytes. The present results indicate that the formation of taurine-conjugated bile acids in hepatocytes is maintained by both transported and intracellularly formed taurine in hepatocytes, while that of glycine-conjugated bile acids is regulated by glycine formed within hepatocytes, but not by transported glycine. PMID- 6503038 TI - Study of the use of the microwave magnetic field for the rapid inactivation of brain enzymes. AB - A new model of a microwave device was developed with a power of 10 kW at 2450 MHz. In order to accomplish even distribution of heating with minimum trauma and with a maximum certainty about enzyme inactivation, a modified magnetic field distribution was utilized rather than the conventional electric field. An integrated tuning system was used to increase efficiency and distribution of microwave energy absorption. This increased the ability of the instrument to properly inactivate the enzymes in the brain of both mice and large rats. In general, the time of irradiation for the rat was 600 to 900 msec and for the mice, 100 to 330 msec. The animal chambers used were designed so as not to impair breathing or too severely restrict movement. The effects of these improvements on microwave irradiation were confirmed by 1) observation of brain appearance, 2) effects on succinic dehydrogenase and cholinesterase activity, 3) measurement of regional temperatures in the animal's brain, 4) thermograms of the brain, 5) electron microscopic examination of brain tissue and 6) measurement of endogenous acetylcholine and catecholamines. PMID- 6503039 TI - Effects of trimebutine maleate (TM-906) on the smooth muscles of isolated guinea pig gallbladder. AB - Effects of trimebutine maleate (TM-906) on the smooth muscles of isolated guinea pig gallbladder were investigated. TM-906 inhibited the contractile responses to cholinergic nerve stimulation (5 Hz) and to acetylcholine (3 X 10(-8) g/ml) to the same extent, both of which produced much the same amplitude of contraction. TM-906 noncompetitively antagonized the contractile response to methacholine, and it caused a parallel shift of dose-response curves for the contractile response to CaCl2 to higher concentrations. Moreover, TM-906 inhibited the contractile response to 50 mM KCl in a dose-dependent manner. On the other hand, TM-906 itself evoked a slight contractile response in a dose-dependent manner. The contractile response induced by TM-906 was prevented by exposure to Ca++-free solution, but not by tetrodotoxin or atropine. From these results, it was suggested that TM-906 inhibited the contractile responses to cholinergic nerve stimulation, acetylcholine, methacholine and 50 mM KCl by reducing the influx of calcium ion across the cell membrane, while it was assumed that TM-906 itself evoked a slight contractile response by increasing in some way the concentration of the intracellular free calcium ion available for the contractile systems. PMID- 6503041 TI - Release of [3H]gamma-aminobutyric acid by taurocyamine in rat brain slices. PMID- 6503040 TI - The role of vagal reflex in mechanism of secretagogic action of bromhexine. AB - The in vivo effect of bromhexine on secretory activities of tracheal submucosal glands was investigated with a histological/histochemical technique with reference to a role of the vagal reflex. When bromhexine was given at 5, 10 or 20 mg/kg into the stomach of anesthetized dogs, the ratio of acinar inner diameter of the submucosal gland to wall thickness (AIWR) markedly increased in a biphasic manner; the early transient increase was seen 0.5 hr after administration, and the second prolonged increased occurred during 2 to 6 hr after administration. The early stimulant phase was almost abolished by atropine, 1 mg/kg i.v., or bilateral cervical vagotomy, whereas the second stimulant phase was not affected by these treatments. Emetine also induced a similar early increase in AIWR at 0.5 hr after administration, the change also being abolished by atropine or surgical vagotomy in this case. The number of submucosal glandular cells which stained blue and purple with a combination of alcian blue at pH 2.5 and periodic acid Schiff was decreased by bromhexine, but the cell number which stained red was markedly increased. These histochemical changes in glandular cells were not influenced by treatment with atropine or surgical vagotomy. In the present study, it was found that bromhexine exerts both a secretagogic action on submucosal glands and a mucolytic action toward acid glycoproteins inside the cells in vivo. Also, the secretagogic action of bromhexine occurs biphasically; the first phase results from the vagal reflex probably through a gastrointestinal irritation, and the second phase results from a direct action on the glands. PMID- 6503042 TI - Effects of psychotropic drugs on the development of activity-stress ulcer in rats. PMID- 6503043 TI - Inhibition of the release of bradykinin-like substances into the perfusate of rat hind paw by neurotropin. PMID- 6503044 TI - Sex difference in the cadmium effect on pulpal polyamines in rat incisor. PMID- 6503045 TI - Inhibition by reserpine of myocardial damage due to calcium paradox in isolated guinea pig hearts. PMID- 6503046 TI - Vasopressin-induced pressor responses following microinjection of kainic acid into the nucleus tractus solitarii of the rat. PMID- 6503047 TI - Gastric hyperacidity and duodenal ulcer formation induced by dulcerozine in rats. PMID- 6503048 TI - Antitumor activity of Klebsiella 03 lipopolysaccharide in mice. AB - The antitumor activity of Klebsiella 03 lipopolysaccharide (KO3 LPS) isolated from the culture supernatant against S180 sarcoma, Ehrlich carcinoma, MM2 mammary carcinoma and Meth A fibrosarcoma in mice was investigated. KO3 LPS significantly prolonged the lifespan of S180-bearing ddY mice and MM2-bearing C3H/He mice by intraperitoneal pre- or postmedication at doses ranging from 0.1 to 1.0 mg/kg. The LPS also inhibited the growth of subcutaneously inoculated Ehrlich carcinoma in ddY mice and Meth A sarcoma in BALB/c mice by intraperitoneal, intravenous or intratumoral administration. The intratumoral injection of KO3 LPS was most effective and results by the intravenous and the intraperitoneal administrations followed in effectiveness, but the administration through the subcutaneous route was hardly effective. Thus, KO3 LPS was shown to have antitumor activity on both allogeneic tumors and syngeneic tumors. It was also indicated in this study that the lifeprolonging effect of KO3 LPS on S180 ascites type tumor-bearing mice was significantly minimized by pretreatment of cyclophosphamide and that the LPS did not influence the cell viability of HeLa cells, Ehrlich cells and MM2 cells in vitro. These results suggest that the antitumor activity of KO3 LPS is provided by host-mediated actions. PMID- 6503049 TI - Effect of a muscle relaxant, chlorphenesin carbamate, on the spinal neurons of rats. AB - The effects of chlorphenesin carbamate (CPC) and mephenesin on spinal neurons were investigated in spinal rats. CPC (50 mg/kg i.v.) inhibited the mono-(MSR) and poly-synaptic reflex (PSR), the latter being more susceptible than the former to CPC depression. Mephenesin also inhibited MSR and PSR, though the effects were short in duration. CPC had no effect on the dorsal root potential evoked by the stimulation of the dorsal root, while mephenesin reduced the dorsal root-dorsal root reflex. The excitability of motoneuron was reduced by the administration of CPC or mephenesin. The excitability of primary afferent terminal was unchanged by CPC, while it was inhibited by mephenesin. Neither CPC nor mephenesin influenced the field potential evoked by the dorsal root stimulation. Both CPC and mephenesin had no effect on the synaptic recovery. These results suggest that both CPC and mephenesin inhibit the firing of motoneurons by stabilizing the neuronal membrane, while mephenesin additionally suppresses the dorsal root reflex and the excitability of the primary afferent terminal. These inhibitory actions of CPC on spinal activities may contribute, at least partly, to its muscle relaxing action. PMID- 6503051 TI - [Fusion of opposite visual images by high, medium and low creative groups under response free and response restricted situations]. AB - Two sets each of High, Medium, and Low Creative Groups (HCG, MCG and LCG), N=12 each, were selected on the basis of JARAT (RAT Revised In Japanese) scores from 364 male college students. One set was asked to entitle each of six pairs of superimposed slide photographs in order to assess mental fusion of visual images under Response Free Situation (RFS), and the other set under Response Restricted Situation (RRS). Under RFS, HCG showed significantly stronger propensity for fusing images that had opposite impression than the other groups. MCG and LCG responded to a few images more promptly, while HCG elaborated their responses more than the rest under both response conditions, and especially under RRS in which each group was encouraged to produce excellent ones. Thus, it was suggested that HCG might process opposites more flexibly and reversibly in both remote associative thinking and in homospatial imagery synthesizing. PMID- 6503050 TI - Heterogeneity of binding sites for glucocorticoid and the glucocorticoid-receptor complex in rat livers. AB - Glucocorticoid binding to cytoplasmic and nuclear fractions and glucocorticoid receptor complex binding to the nuclear fraction were investigated using rat liver. The glucocorticoid-receptor complex binding to the nuclear fraction was temperature-dependent, saturable, small in amount and of high affinity. The affinity and number of the glucocorticoid-receptor complex binding to the nuclear fraction were altered according to the glucocorticoid. Both the Bmax of nuclear glucocorticoid-receptor complex binding and the affinity of glucocorticoid to the cytoplasmic fraction were correlated with the relative anti-inflammatory potencies of glucocorticoids reported by Hynes and Murad (1980) and Fried et al. (1958). These results suggest that the number of nuclear binding sites of the glucocorticoid-receptor complex depends on the ligand steroid which is bound to the receptor of the cytoplasmic fraction and may be involved in physiological and pharmacological potencies of the glucocorticoid in addition to the affinity of the glucocorticoid to the receptor. PMID- 6503052 TI - [The effect of script frequency on semantic processing of Kanji and Kana words]. AB - To examine the effect of script type and/or script frequency on the semantic access to words, 34 undergraduates were required to category decision for each word presented tachistoscopically. Three classes of words were used as stimuli; Kana words with low Kana script frequency (Kana-Low), Kana words with high Kana script frequency (Kana-High), and Kanji words with high Kanji script frequency (Kanji). Mean decision latency for Kana-High was shorter than that for Kana-Low, while there was no difference of latency between Kana-High and Kanji. These results show that the speed of semantic access depends on script frequency rather than script type. PMID- 6503053 TI - [Discrimination reversal learning in rats under the treatment of chlordiazepoxide: effect of overtraining]. AB - A total of 48 rats were run in a black-white discrimination (original) learning task to the learning criterion of 18/20 correct responses. Correct responses were rewarded by food and a non-correction method was used. One group was intraperitoneally injected with 15 mg/kg of chlordiazepoxide (CDP) and the other with physiological saline (SAL), 30 min prior to the beginning of the daily trials. For half of the rats (NOT) of each group, reversal learning began on the next day after reaching the criterion, and for the other half (OT), 100 additional trials(overtraining) were given before the reversal. The results showed that CDP as well as overtraining significantly retarded the reversal learning. CDP had no effect on the original learning. Further analysis of the data revealed that perseverative errors early in the reversal increased significantly under the conditions of CDP and overtraining, but trials to criterion after the first occurrence of the correct response were not affected by both CDP and overtraining. These results were discussed in terms of CDP's disinhibitory action and overtraining reversal effect in such relatively easy discrimination task as in the present experiment. PMID- 6503054 TI - [Amplitude of cardiogenic oscillations (CO) of helium and nitrogen concentrations on simultaneous single-breath washout curves]. PMID- 6503056 TI - [Preoperative prediction of the loss of lung function due to the surgical treatment for lung cancer]. PMID- 6503055 TI - [Ventilation-perfusion (VA/Q) abnormalities in dogs with dirofilaria infection]. PMID- 6503057 TI - [Mucociliary clearance in diffuse panbronchiolitis, pulmonary emphysema and chronic bronchitis estimated by aerosol inhalation cine-scintigraphy]. PMID- 6503058 TI - [Computerized tomographic differentiation of mediastinal tumor from tumor of the chest wall]. PMID- 6503059 TI - [Hypersensitivity pneumonitis induced by Trichosporon cutaneum--a proposal of the etiologic agent of summer-type hypersensitivity pneumonitis]. PMID- 6503060 TI - [Autopsy findings of tuberous sclerosis accompanied by diffuse pulmonary hamartoangiomyomatosis]. PMID- 6503061 TI - [A case of sarcoidosis presenting with hoarseness due to false vocal cord tumor]. PMID- 6503062 TI - [The first case of Legionella longbeachae pneumonia in Japan]. PMID- 6503063 TI - [A case of mediastinal teratoma (dermoid cyst) showing a giant mass shadow]. PMID- 6503064 TI - [Blood coagulability in chronic respiratory failure]. PMID- 6503065 TI - [Provocation test by occupational challenge for hypersensitivity pneumonitis (farmer's lung)]. PMID- 6503066 TI - [An evaluation of intermittent mandatory ventilation therapy using diaphragm pacing for chronic obstructive pulmonary disease]. PMID- 6503067 TI - [Clinical study of miliary tuberculosis with adult respiratory distress syndrome]. PMID- 6503068 TI - [A case of systemic-pulmonary venous shunt with superior vena cava syndrome]. PMID- 6503069 TI - [Paragonimiasis westermani with exudative pleurisy]. PMID- 6503070 TI - [A case of posthyperventilation apnea provoked by asthmatic attack]. PMID- 6503071 TI - [A case of neurilemmoma with prominent cystic change]. PMID- 6503072 TI - [Surgical treatment of infective endocarditis]. PMID- 6503073 TI - [Selection of the prosthetic valve for mitral valve replacement]. PMID- 6503074 TI - [A successful correction of anomalous origin of the right pulmonary artery from the ascending aorta in a 16-day-old neonate]. PMID- 6503076 TI - [Sleeve lobectomy for lung cancer]. PMID- 6503075 TI - [A case of thoracic empyema with broncho-pleural fistula existing for 57 years. Histological findings of squamous cell carcinoma in the resected lung]. PMID- 6503077 TI - [Clinical evaluation of the newly developed membrane oxygenator; LPM-50]. PMID- 6503078 TI - [The use of the subclavian vein for temporary transvenous pacemaker therapy]. PMID- 6503079 TI - [Surgical treatment of severe valvular insufficiency due to or accompanied with infected endocarditis]. PMID- 6503080 TI - [A successful case of one-stage surgery for mitral stenosis combined with total obstruction of the terminal aorta]. PMID- 6503081 TI - [A case of chondrosarcoma of rib origin with intrathoracic extension]. PMID- 6503082 TI - [A case report of right atrial myxoma]. PMID- 6503083 TI - [A case of malignant localized pleural mesothelioma]. PMID- 6503084 TI - [Clinical conference at the Department of Cardiovascular Surgery, Tokyo Women's Medical College Hospital. 2. Case of myocardial infarction associated with ventricular tachycardia and atrial aneurysm]. PMID- 6503085 TI - [Experiences of continuous irrigation peritoneal dialysis for the treatment of acute renal failure following open-heart surgery in the pediatric patients]. PMID- 6503086 TI - [Bronchogenic carcinoma with adjacent tissue invasion. Factors affecting survival following surgical intervention]. PMID- 6503087 TI - [A case of saccular aneurysm of the azygos vein]. PMID- 6503088 TI - [Intra-graft balloon pumping. A clinical case report]. PMID- 6503089 TI - [Long-term observation of a child treated with mitral valve replacement using a Starr-Edwards (0M) ball valve]. PMID- 6503091 TI - [Surgical treatment of superior vena cava thrombosis (unknown etiology)]. PMID- 6503090 TI - [Two-staged operation of pulmonary atresia with intact ventricular septum. Report of a case with successful repair]. PMID- 6503092 TI - [A case report of multiple pulmonary hamartoma with spontaneous pneumothorax]. PMID- 6503093 TI - [Stenosis of the right ventricular outflow tract following cardiac surgery]. PMID- 6503094 TI - [Modified Fontan operation for tricuspid valve insufficiency]. PMID- 6503095 TI - [A case of intrapulmonary foreign body manifested 20 years after closed mitral commissurotomy]. PMID- 6503096 TI - [A case of primary cryptococcosis]. PMID- 6503097 TI - [A case of surgical repair of bilateral multiple pulmonary arteriovenous fistula]. PMID- 6503098 TI - [A case of broncholithiasis associated with bronchiectasis]. PMID- 6503099 TI - [A case report of mucoepidermoid carcinoma of the bronchus]. PMID- 6503100 TI - [A case report of congenital atresia of the left main coronary artery]. PMID- 6503101 TI - [Pulmonary atresia with ventricular septal defect and right coronary-pulmonary artery fistula]. PMID- 6503102 TI - [A case of congenital coronary artery fistula (left coronary arterio-right atrial fistula)]. PMID- 6503103 TI - [A case of coronary to pulmonary arterial fistulae--review and the consideration of surgical treatment]. PMID- 6503104 TI - [A case of post-operative valvular heart disease with angina pectoris and acute myocardial infarction probably due to coronary spasm]. PMID- 6503105 TI - [A case report of left ventricular wall rupture after aortic valve replacement]. PMID- 6503106 TI - [Corrected transposition of the great arteries associated with systemic atrioventricular valve regurgitation in viscero-atrial heterotaxic syndrome]. PMID- 6503107 TI - [A case of left ventricular aneurysm with normal coronary artery in mitral stenosis]. PMID- 6503108 TI - [Mitral valve replacement following closure of atrial septal defect]. PMID- 6503109 TI - [Experience of right atrial appendage to the pulmonary artery trunk direct anastomosis for type Ib tricuspid atresia]. PMID- 6503110 TI - [A study on the glucolytic enzyme activities in the experimental vesical cancer induced by N-butyl-N-butanol (4) nitrosamine in rats]. PMID- 6503111 TI - [Chemotherapy of renal cell carcinoma. 4. Interferon]. PMID- 6503112 TI - [Fine needle aspiration biopsy of metastatic lesions and regional lymph-nodes in genitourinary cancer]. PMID- 6503113 TI - [Hypertensive vascular lesions of testicular arteries associated with alteration of fibrous protein of testes in stroke-prone and -resistant spontaneously hypertensive rats]. PMID- 6503114 TI - [Microsurgical vasovasostomy]. PMID- 6503116 TI - [Serum sialic acid levels in acute urinary tract infection]. PMID- 6503115 TI - [Experiences of total cystectomy for superficial bladder cancer]. PMID- 6503117 TI - [Urinary tissue polypeptide antigen (TPA) in bladder cancer]. PMID- 6503118 TI - [Clinical evaluation of pelvic exenteration for carcinoma of the lower colon]. PMID- 6503119 TI - [Leiomyosarcoma of the kidney with renal vein thrombosis]. PMID- 6503121 TI - [A clinical study of hypercalciuria: hyperfunction of the parathyroid in patients with calcium nephrolithiasis]. PMID- 6503120 TI - [Primary squamous cell carcinoma of the prostate: a case report]. PMID- 6503122 TI - [Studies of trace elements in urinary tract stones. I. Trace element analysis in urinary tract stones]. PMID- 6503123 TI - [Ureteral crossover method: I. Experimental studies of new anti-reflux operation]. PMID- 6503124 TI - [Ureteral crossover method: II. Clinical studies of new anti-reflux operation]. PMID- 6503126 TI - [Experimental pyelonephritis induced in rabbits by immunological means. A morphopathological study]. PMID- 6503125 TI - [Renal function studies in adult type polycystic kidney disease]. PMID- 6503127 TI - [Accessory scrotum: a case report]. PMID- 6503128 TI - [A case of Sertoli cell tumor of the testis with prostatic cancer]. PMID- 6503129 TI - [A clinical study on tracheobronchial tuberculosis]. PMID- 6503130 TI - [Proposal of a flow chart for selection of the surgical methods in chronic thoracic empyema]. PMID- 6503131 TI - Effect of furosemide administration on glomerular and tubular dynamics in the rat. AB - Furosemide, a potent diuretic, has also been shown (1) to inhibit or reduce tubuloglomerular feedback activity, (2) act as a vasodilatory agent, and (3) exhibit a modest carbonic anhydrase inhibitory effect, which could potentially reduce proximal tubule reabsorption. If furosemide can inhibit tubuloglomerular feedback as well as cause vasodilation, then glomerular filtration rate (GFR) should increase through alterations in the dynamics of glomerular ultrafiltration. The effect of acute furosemide infusion (4 mg/kg of body wt per hour) on glomerular and tubular dynamics was examined in Munich-Wistar rats by two protocols: The first allowed a 3% volume depletion (based on body wt) to occur as a result of furosemide administration (group 1); the second allowed a complete replacement of volume after furosemide administration (group 2). The results demonstrated that when volume status was maintained after furosemide administration, the nephron filtration rate remained constant (35 +/- 3 vs. 33 +/ 2 nl/min, NS) despite a twofold increase in distal flow rate (5 +/- 1 vs. 10 +/- 1 nl/min, P less than 0.01), indicating an inhibition or suppression of the tubuloglomerular feedback system. With either protocol, furosemide administration did not alter total nephron vascular resistance and nephron blood flow (190 +/- 17 vs. 200 +/- 15 ml/min); however, the afferent arteriolar resistance did decrease in rats in which volume status was maintained. Finally, with volume status maintained, we were not able to demonstrate a reduction in absolute proximal fluid reabsorption despite a 7 mm Hg increase in interstitial hydrostatic pressure (4 +/- 1 to 11 +/- 1 mm Hg, P less than 0.01) and no compensatory increase in interstitial oncotic pressure. These data indicate that tubuloglomerular feedback was inhibited but that GFR was not increased. Major changes occurred in interstitial pressures and interstitial volume after furosemide administration, but absolute proximal reabsorption remained constant. PMID- 6503132 TI - Pathophysiological changes in rat kidneys with partial ureteral obstruction since infancy. AB - A partial ureteral obstruction (PUO) was created in 5-day-old rats by implanting the left ureter in the psoas muscle. The surgical technique was modified to produce mild or severe hydronephrosis [Hn (m) and Hn (s)]. The rats were studied at ages between 45 and 65 days with regard to kidney weight, number of functioning glomeruli, mean arterial blood pressure (MAP), total glomerular filtration rate (GFR), nephron filtration rate (SNGFR), tubular free-flow pressure (PT, and stop-flow pressure (SFP). Total GFR was determined after the release of obstruction. The other studies were performed in the obstructed state. Reference values were obtained from sham-operated and untouched control rats. The number of functioning nephrons was depressed 38% in Hn (m) and 73% in Hn (s). Total GFR was preserved in Hn (m) and depressed 54% in Hn (s). SNGFR in the remaining nephrons was significantly elevated in Hn (m) and normal in Hn (s). SFP was significantly elevated in Hn (s). The Hn (s) rats were hypertensive. The glomerular density was lower in the hydronephrotic than in the contralateral kidneys. This suggests a compensatory growth of the remaining nephrons in the Hn kidneys. We conclude that PUO present since infancy will either destroy the nephrons or elicit an adaptive response that will tend to preserve GFR. PMID- 6503133 TI - Glomerular filtration rate and plasma pH as determinants of phosphate reabsorption. AB - Glomerular filtration rate (GFR) was altered by varying renal perfusion pressure in volume-expanded, anesthetized dogs infused with ethacrynic acid. Phosphate reabsorption varied linearly with GFR (r greater than 0.9), 0.83 of the increase in filtered load being reabsorbed. Phosphate reabsorption at comparable filtered loads was not significantly changed by raising plasma bicarbonate concentration from 30 to 55 mM and adjusting PCO2 to keep plasma pH constant. Plasma pH was altered by inducing hyper- and hypocapnia or infusing bicarbonate. Plasma phosphate concentration varied with plasma pH before phosphate infusion and was kept constant at 3.4 +/- 0.1 mM in intact and thyroparathyroidectomized dogs; some of which were also examined during hyperchloremic acidosis. At comparable GFR, phosphate and bicarbonate reabsorption correlated (r greater than 0.9), except during acidosis when the filtered load of bicarbonate became inadequate. In all experiments phosphate reabsorption and plasma pH correlated (r greater than 0.85). Compared with control values at plasma pH 7.4, phosphate reabsorption increased by about 40% during acidosis (pH 7.1) and decreased by about 50% during alkalosis (pH 7.8) both in intact and thyroparathyroidectomized dogs. We propose that net hydrogen ion secretion is the common determinant of phosphate and bicarbonate reabsorption. PMID- 6503134 TI - Lipid alterations induced by renal ischemia: pathogenic factor in membrane damage. AB - Lipids of the renal cortex and outer stripe of outer medulla were analyzed in rats during ischemia and 2 hr after blood reflow. After 15 min of ischemia, there were marked elevations of free fatty acids (FFA) and diacylglycerol (DG), increasing further at 60 min. Percentile increases were greater for polyunsaturated FFA. These elevations were accompanied by alterations in phospholipids (PL): Elevations of lysophosphatidylcholine (LPC) at 15 min, phosphatidic acid at 15 and 60 min, and declines of phosphatidylcholine and phosphatidylinositol at 60 min. Triacylglycerol (TG) showed only modest decline, at 60 min, and in insufficient degree to account for increments in FFA and DG. Two hours after 15 min of ischemia, LPC returned to control levels and other PL were normal except phosphatidylinositol which was decreased, and phosphatidic acid, which remained elevated. FFA and DG approached or reached control values. Two hours after 60 min of ischemia, LPC, FFA, DGs and phosphatidic acid remained elevated; phosphatidylcholine and phosphatidylinositol remained decreased. Histological injury was seen 2 and 24 hr after blood reflow only in kidneys injured by 60 min of ischemia. Thus, irreversible ischemic damage correlates with persistent abnormalities of phosphatidylcholine metabolism and persistent elevations of FFA, LPC, and DG. It is not known whether lipids break down at normal or accelerated rates during ischemia. In this context, accumulation of lipid breakdown products in ischemic cells may be due to failure of their reutilization, or disposal. Similarly, depletion of phospholipids during ischemia may be due to the inability of cells to reconstitute the lipid following degradation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503135 TI - Differential effects of steroids on leukocyte-mediated glomerulonephritis in the rabbit. AB - The effects of steroids on the development of injury in two models of experimental glomerulonephritis (GN), (one mediated by neutrophils, the other by macrophages) were compared. The neutrophil-associated lesion [initiated by heterologous antiglomerular basement membrane (GBM) antibody] was characterized by the development of an exudative endocapillary GN with heavy neutrophil accumulation [mean, 6.9 neutrophils/glomerular cross section (N/GCS) +/- 2.9 SD], minor macrophage infiltration [7.9 macrophages/glomerulus (M/G) +/- 2.2 SD] and heavy proteinuria (1905 mg/24 hr +/- 520 SD). Steroid-treated (methylprednisolone, 2 mg/kg/12 hr i.v.) rabbits developed a marked monocytopenia, mild neutrophilia, and significant reduction in glomerular macrophage accumulation (0.3 M/G 0.02 SD). However, neutrophil accumulation (6.1 N/CGS +/- 2.5 SD), histological appearances, and proteinuria (1820 mg/hr +/- 490 SD) were unaffected. The macrophage-associated model of GN was induced by passive autologous rabbit anti-sheep IgG 15 hr after the injection of a subnephritogenic dose of the same anti-GBM antibody. The glomerular lesion was characterized by a diffuse endocapillary proliferative GN with heavy macrophage infiltration (54 M/G +/- 8 SD), insignificant neutrophil accumulation (0.8 N/GCS 0.02 SD), and the regular development of proteinuria (420 mg/24 hr +/- 80 SD). Steroid-treated rabbits developed a mild neutrophilia and a significant monocytopenia associated with abrogation of glomerular macrophage accumulation (2.3 M/G +/- 0.8 SD). This was associated with the prevention of the development of GN and proteinuria (22 +/- 9.5 SD). Thus, steroids produce monocytopenia and prevent glomerular macrophage accumulation and associated injury whereas neutrophil accumulation and injury is unaffected. These data suggest steroids may have widely varying effects on the outcome of leukocyte-associated experimental GN depending on the nature of the infiltrating cells. PMID- 6503136 TI - Bumetanide and furosemide in heart failure. AB - We assessed the handling of and response to oral bumetanide (1.0 and 2.0 mg) and to furosemide (40 and 80 mg) in 20 patients with stable, compensated congestive heart failure (CHF), comparing the two drugs and, in addition, examining differences from normal subjects. Bumetanide and furosemide were similar in time course of absorption, but patients with CHF had considerably prolonged absorption compared to normal subjects causing attainment of lower peak concentrations of drug. In both CHF and normal subjects, more bumetanide than furosemide was absorbed. The elimination half-life of furosemide was approximately twice that of bumetanide, and both were about two times longer than respective values in normal subjects. "Dose"-response curves were shifted downward from normal with both drugs. In patients with CHF, overall response did not differ between bumetanide and furosemide. The two drugs exhibit subtle differences, the clinical importance of which appears to be negligible from this study. Importantly, however, both drugs showed delayed absorption causing attainment of peak urinary excretion rates of diuretic two- to threefold lower than in normal subjects. This effect along with the abnormal responsivity of the tubule may contribute to the "resistance" to oral doses of diuretics observed clinically even though no quantitative malabsorption of drug occurs. PMID- 6503137 TI - Aluminum loading in children with chronic renal failure. AB - Plasma aluminum levels were measured in 17 children with chronic renal failure who were receiving aluminum containing antacids for the control of hyperphosphatemia. Seven children were on hemodialysis, five on peritoneal dialysis, and five were awaiting dialysis with creatinine clearances between 10 to 20 cc/min/1.73 m2. Plasma aluminum levels correlated directly with oral aluminum dosage; extremely high levels were documented in small, nondialyzed children. Bone aluminum levels were measured in four children with high plasma levels and confirmed significant aluminum loading. Other factors such as the level of aluminum in dialysate and tap water were measured and were not contributory. All patients with plasma aluminum levels greater than 100 micrograms/liter had signs of aluminum toxicity and were receiving greater than 75 mg/kg/day of elemental aluminum orally. We concluded that children who require greater than 30 mg/kg/day of elemental aluminum to control hyperphosphatemia should have plasma aluminum levels monitored and/or be considered for other forms of therapy including more restricted diets and earlier or more aggressive dialysis. PMID- 6503138 TI - Reduced glomerular filtration and enhanced bicarbonate reabsorption maintain metabolic alkalosis in humans. AB - The mechanism that sustains chloride-depletion metabolic alkalosis is presumed to be a stimulation of renal acidification, so that the elevated filtered bicarbonate load that attends hyperbicarbonatemia is completely reabsorbed. However, such enhancement of renal bicarbonate reabsorption is not necessary to maintain hyperbicarbonatemia if the filtered bicarbonate load is not increased owing to a concomitant reduction in glomerular filtration rate (GFR). To assess the relative contributions of enhanced renal bicarbonate reabsorption and reduced GFR in the maintenance of chloride-depletion alkalosis in humans, selective hydrochloric acid depletion was induced in five normal subjects. Plasma bicarbonate concentration increased by 27% (25.3 +/- 0.1 to 32.1 +/- 0.3 mEq/liter, P less than 0.005), whereas the rate of renal bicarbonate reabsorption increased by only 17% (2.7 +/- 0.1 to 3.2 +/- 0.2 mEq/min, P less than 0.05) owing to a 10% reduction in GFR (93.2 +/- 4.4 to 84.3 +/- 4.1 ml/min, P less than 0.01). Thus, in chloride-depletion metabolic alkalosis in humans, the increase in plasma bicarbonate concentration is not attended by a commensurate increase in filtered bicarbonate and rate of renal bicarbonate reabsorption. Both a reduction in GFR and an enhancement of renal bicarbonate reabsorption contribute to maintenance of the alkalotic state. PMID- 6503139 TI - [Measuring the effect of nutrition on the postnatal development of body weight]. PMID- 6503140 TI - [Comparative studies of the body mass development of newborn infants with respect to nutrition]. PMID- 6503141 TI - [Penetrating wounds of the major vessels]. PMID- 6503142 TI - [Intraoperative biopsy of the lymphatic vessels]. PMID- 6503143 TI - [Device and attachments for catheterization of peripheral lymphatic vessels]. PMID- 6503144 TI - [Renal turgor as a criterion of viability]. PMID- 6503145 TI - [Successful surgical treatment of a congenital defect of the arch of the aorta]. PMID- 6503147 TI - [Penetrating wound of the heart]. PMID- 6503146 TI - [Successful treatment of aortic injuries]. PMID- 6503148 TI - [Combined wound of the major vessels of the neck]. PMID- 6503150 TI - [Replantation of the upper extremity after traumatic amputation]. PMID- 6503149 TI - [Flap grafting using microsurgical technics in reconstructing the hand]. PMID- 6503151 TI - [Disruption of mesenteric circulation]. PMID- 6503152 TI - [Pseudoaneurysm of the popliteal artery caused by exostosis of the tibia]. PMID- 6503153 TI - [Closed abdominal injuries with isolated transverse rupture of the inferior vena cava]. PMID- 6503154 TI - [Open pneumothorax, rupture of the diaphragm and liver by a foreign body]. PMID- 6503155 TI - [Removal of a foreign body from a single lung]. PMID- 6503156 TI - [Surgery of wounds of the heart and major vessels]. PMID- 6503157 TI - [Role of scientific work in the education of a surgeon]. PMID- 6503159 TI - [Ways of reducing mortality among patients with acute vascular lesions]. PMID- 6503158 TI - [Quantitative evaluation of the severity of regional ischemia in injuries of the major vessels of the extremities]. PMID- 6503160 TI - [Extra-anatomic shunting in vascular occlusion in the aorto-iliac area]. PMID- 6503161 TI - [Reoperation on the aortofemoral segment in occlusive vascular lesions]. PMID- 6503162 TI - [Reconstructive surgery in acute ischemia of the extremities]. PMID- 6503163 TI - [Pathogenesis of varicose veins of the lower extremities]. PMID- 6503164 TI - [Thromboembolism of the portal vein in strangulation obstruction of the intestine]. PMID- 6503165 TI - [Embolic occlusion of the inferior vena cava after implantation of a cava filter]. PMID- 6503166 TI - [Temporary blood vessel prosthesis in emergency surgery]. PMID- 6503167 TI - [Chemical composition of the wall of the veins of the lower extremities in healthy subjects and patients with thrombophlebitis]. PMID- 6503169 TI - [Spontaneous pneumothorax in nonspecific lung diseases]. PMID- 6503168 TI - [Surgical treatment of vasorenal hypertension in children and adolescents]. PMID- 6503170 TI - [Pyocyaneus infection in surgical pneumonology]. PMID- 6503171 TI - [Bacteriologic examination in acute suppurative destructive pneumonia in children]. PMID- 6503172 TI - [Diagnosis and treatment of surgical diseases of the diaphragm]. PMID- 6503173 TI - [Continuous bougienage of cicatricial esophageal strictures as a result of burns]. PMID- 6503174 TI - [Causes of incompetence of esophago-intestinal anastomoses in the neck]. PMID- 6503175 TI - [Etiology and surgical treatment of acquired esophago-bronchial fistulas]. PMID- 6503176 TI - [Early retrosternal colonoplasty in esophageal atresia in newborn infants]. PMID- 6503177 TI - [Complications and hazards of long-term vascular catheterization for the conduct of intensive therapy]. PMID- 6503178 TI - [Aneurysms of synthetic vascular prostheses]. PMID- 6503179 TI - [Treatment of renal function disorders in late middle-aged and elderly patients in emergency surgery]. PMID- 6503180 TI - [Introduction of an enteral feeding tube during the postoperative period under endoscopic control]. PMID- 6503181 TI - [Myocardial revascularization using a laser beam (experimental study)]. PMID- 6503182 TI - [Effect of blood rheology on the modeling of a right-to-left pulmonary shunt in acute blood loss (experimental studies)]. PMID- 6503184 TI - [Genetics, diagnosis and surgical procedure in familial polyposis]. PMID- 6503183 TI - [Clinical laboratory studies before and after liver resection using antimicrobial polycaproamide mesh and sutures made in Bulgaria in an experiment]. PMID- 6503185 TI - [Importance of the preoperative bathing of patients with the Hibiscrub preparation--a bacteriological and clinical study]. PMID- 6503186 TI - [Mechanical jaundice caused by perforation of a hepatic echinococcal cyst into the biliary tract--the procedure in surgical treatment]. PMID- 6503187 TI - [Total plastic repair of the posterior wall of the inguinal canal in treating complicated forms of inguinal hernia]. PMID- 6503188 TI - [Emergency urological syndromes as a clinical manifestation of kidney tumors]. PMID- 6503189 TI - [Possibilities of diagnosing urothelial carcinomas involving the prostate via transrectal aspiration biopsy]. PMID- 6503190 TI - [Hypothermia in urological practice]. PMID- 6503191 TI - [A child with tetralogy of Fallot successfully operated on 3 times following recanalization of a Waterston-Cooley-type anastomosis]. PMID- 6503192 TI - [Extensive duodenopancreatic resection combined with cholecystectomy and right hemicolectomy]. PMID- 6503193 TI - [Case of traumatic rupture of the liver and of a hepatic echinococcal cyst]. PMID- 6503194 TI - [Case of extensive resection of the small intestine]. PMID- 6503195 TI - [Interesting case of foreign bodies in the digestive tract]. PMID- 6503196 TI - [Case of a urinoma following ureterolithotomy]. PMID- 6503197 TI - [Leiomyoma of the rectum]. PMID- 6503198 TI - [Experimental diabetes mellitus. B. Microscopic studies of the rat retina]. PMID- 6503199 TI - [Early examination of the macular structure after uncomplicated surgical treatment of senile cataract]. PMID- 6503200 TI - [Results of the surgical treatment of retinal detachment in aphakic eyes]. PMID- 6503201 TI - [Causes of failure of the surgical treatment of retinal detachment. Analysis of 100 cases]. PMID- 6503202 TI - [Acute allergic conjunctivitis in patients with food hypersensitivity]. PMID- 6503203 TI - [New uses of urea in ophthalmology]. PMID- 6503204 TI - [Incidence of positive tests for toxoplasmosis in schoolchildren]. PMID- 6503205 TI - [Inflammatory retinal and choroid changes in children with positive and negative tests for toxoplasmosis]. PMID- 6503206 TI - [State of the vitreous body after phacoaspiration of congenital cataract in children]. PMID- 6503207 TI - [Retinal detachment after cataract extraction in the Department of Ophthalmological Surgery, Cracow Ophthalmological Hospital]. PMID- 6503208 TI - [Late results of goniotrepanation in open-angle glaucoma]. PMID- 6503209 TI - [Trabeculectomy with an additional scleral band]. PMID- 6503210 TI - [Adaptation of the Retinophot camera for taking photographs of the fundus oculi at patient's bedside]. PMID- 6503211 TI - Pregnancy and rheumatic disease. A review of recent studies in rheumatoid arthritis and ankylosing spondylitis. AB - The present paper reviews the results of recent investigations into the influence of pregnancy and sex hormones on rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Prospective patient studies have shown that pregnancy exerts a beneficial effect on the majority of RA patients, while AS patients generally have unchanged disease activity during gestation. In AS, gestational remission was confined to patients with accompanying diseases. A postpartum disease flare up occurred commonly in both RA and AS. Blood parameters reflected mainly the biochemical changes of normal pregnancy. A decrease of circulating immune complexes has been found in RA patients remitting during pregnancy. No single serum factor or combination of serum factors responsible for gestational remission could be detected. The possible influence of alpha 2-pregnancy associated globulin on disease activity in pregnant patients remains contradictory. Hormonal contraceptives have been found to be protective against the manifestation of RA in four of five studies. However, no beneficial effect of sex hormones on the symptoms of established RA and AS could be demonstrated. PMID- 6503212 TI - [Analysis of prognostic factors in plasmacytoma]. AB - For analysis of prognostic factors the clinical course of 109 patients with multiple myeloma was evaluated. Survival curves of immunoglobulin (Ig)G- and IgA myelomas were identical (Fig. 1) with median survival times of 52 and 42 months, respectively, whereas patients with IgD- and Bence-Jones-myeloma had short survival times (median 3 months). Most important risk factors were anemia, renal insufficiency, and hypercalcemia (Figs. 7 and 8). Median survival time dropped from 52 months (Hb above 100 g/l) to 22 (Hb 85-100 g/l) and 1 month (Hb below 85 g/l). Patients with serum creatinine values below 2 mg/dl lived significantly longer than those with values above. Median survival times were 52 and 1 month, respectively. All seven hypercalcemic patients had a renal insufficiency and were in a very poor condition; their median survival time was 1 month. Analysis of the widely used staging system of Durie and Salmon gave disappointing results. Survival curves of the three A-stages ran close together with median survival times of 58, 51, and 36 months. Only the A-B classification according to renal function (A: creatinine under 2 mg/dl; B: creatinine above 2 mg/dl) proved prognostically relevant. PMID- 6503213 TI - [Hemodynamics during hemodialysis, hemofiltration and hemodiafiltration using bicarbonate vs acetate buffers]. AB - Hemodynamic parameters of five chronic renal failure patients have been compared intraindividually during hemodialysis, hemofiltration, and hemodiafiltration using either acetate or bicarbonate buffer. During acetate dialysis symptomatic hypotensive episodes were common. During hemofiltration with acetate buffering a satisfactory hemodynamic stability was maintained. Cardiac and circulatory compensation was found superior with bicarbonate buffering irrespective of the treatment mode. PMID- 6503214 TI - Transdermal clonidine application: long-term results in essential hypertension. AB - Skin patches of a clonidine transdermal therapeutic system (clonidine-TTS) with a constant release rate of either 0.1 or 0.2 mg clonidine/24 h continuously over 7 days were used in 32 essential hypertensives. These self-adhesive drug delivery systems (3.5 cm2), which were affixed to the upper outer arm, were changed by the patients at weekly intervals. During a mean observation period of 7 months (range 1-19 months) transdermal clonidine reduced the blood pressure from 162 +/- 15/107 +/- 5 mmHg to normal values (diastolic less than or equal to 95 mmHg) in 63% of our patients. However, chronic use of clonidine-TTS was accompanied by a high frequency of contact dermatitis (type IV allergy) in nearly half of our patients (n = 15, 47%). In 11 of these 15 patients transdermal clonidine administration had to be stopped because of intolerable local skin reactions (pruritus, erythema, vesiculation, and/or infiltration). Subsequent patch testing with all components of clonidine-TTS was performed in eight cases. Whereas in seven cases an allergic contact dermatitis to clonidine was found, only one patient showed an allergy to another component of clonidine-TTS (polyisobutylene). We conclude that this strikingly high incidence of local allergic skin reactions limits the use of clonidine-TTS in essential hypertension. PMID- 6503215 TI - [Successful treatment of kappa light chain nephropathy using membrane plasma separation]. AB - Often the diagnosis "light chain nephropathy" is not made before renal failure has developed. In the past these patients had a poor prognosis. Special features of this disease and improvement of renal function by plasma exchange therapy are shown in a case report. A 51-year-old man admitted to hospital with renal failure, proteinuria and hypercalcaemia was treated by Ca-free dialysis and membrane plasma separation (MPS). Renal biopsy studied by light and electron microscopy showed mainly tubular protein casts. It is assumed that this nephropathy is caused by a direct toxic effect of the kappa light chains on function and structure of tubuli. Proteinuria was markedly lowered and renal failure was made partly reversible by prompt and effective MPS. Thus, MPS may improve the prognosis of this stage of disease. PMID- 6503217 TI - [Hemorrheologic measuring methods in clinical practice. 3d Congress of the German Society for Clinical Hemorrheology, Homburg/Saar, 18-19 October 1984]. PMID- 6503216 TI - [Transcortin concentrations in the plasma of normal persons and patients with kidney and liver diseases]. AB - The purpose of the study was to assess the influence of chronic kidney and liver diseases on the transcortin concentrations in plasma. The mean (+/- SD) plasma concentration of transcortin was 45.0 +/- 6.7 mg/l in women not taking oral contraceptive steroids and 41.2 +/- 6.7 mg/l in healthy male volunteers. Patients with the nephrotic syndrome had low transcortin concentrations (females: 20.9 +/- 8.5 mg/l; males: 26.0 +/- 6.0 mg/l). Abnormally low concentrations were measured in females treated for endstage renal disease with chronic ambulant peritoneal dialysis (CAPD) (30.8 +/- 7.5 mg/l). Patients on hemodialysis or with a functioning renal allograft had normal transcortin concentrations in plasma. Females suffering from a primary biliary cirrhosis had normal transcortin concentrations and male patients with an alcoholic cirrhosis had abnormally low mean transcortin concentrations in plasma (32.6 +/- 7.4 mg/l). The transcortin concentrations in patients with a Gilbert syndrome were normal. Among patients with a kidney or liver disease, the large variability of the transcortin concentration in plasma indicates that the knowledge of the transcortin concentration or the unbound steroid concentration in plasma is mandatory for the interpretation of total glucocorticoid concentrations in plasma. PMID- 6503219 TI - Prajmaliumbitartrate-associated liver damage. Report on seven further cases with follow-up for two to five years. AB - Seven further cases with n-propyl-ajmaliumbitartrate (NPAB)-associated liver damage observed between 1976 and 1980 in two collaborating institutions are reported. The cause/effect relationship could be classified as probable in three cases and as potential in the remaining four patients. No drug rechallenge was carried out. In the clinical management, definite exclusion of biliary tract obstruction had a clear priority over histologic documentation of the degree of the transient liver damage. Follow-up data after 2 years 8 months to 5 years 9 months by personal reinvestigation of three patients and by questionnaire to family physicians and patients in the remaining four cases gave no clinical or serologic indication of persisting or relapsing liver damage. Liver biopsies were not considered to be warranted in the follow-up of these asymptomatic patients with normal liver function tests. PMID- 6503220 TI - Verapamil in two reperfusion models of myocardial infarction. Temporary protection of severely ischemic myocardium without limitation of ultimate infarct size. AB - The ability of verapamil to protect severely ischemic myocardium was assessed in dogs using 40 minutes of temporary coronary occlusion. Reperfusion was established for 4 days after which infarcts were sized histologically. Untreated dogs developed subendocardial infarcts (the more moderately ischemic subepicardial region being salvaged by reperfusion). Pretreatment with verapamil reduced the size of these subendocardial infarcts from 34 +/- 8 to 8 +/- 3% of the ischemic circumflex vascular bed at risk (identified by postmortem perfusion of the previously occluded and unoccluded arteries with different dyes). Thus, verapamil prevented cell death in the severely ischemic subendocardial region for the 40-minute test period. In a second study to establish whether verapamil could delay cell death for a longer period of time in the less severely ischemic subepicardial region, a 3-hour period of coronary occlusion was used. This period of occlusion caused infarcts averaging 60 +/- 6% of the ischemic area at risk in untreated dogs. Dogs treated with verapamil 15 minutes postocclusion and throughout the remaining 165 minutes of the 3-hour test period had no limitation of infarct size (53 +/- 3% of the area at risk). In this 3-hour study, the effect of variation in collateral blood flow on infarct size was evaluated by plotting infarct size versus subepicardial collateral flow. Verapamil neither improved collateral flow nor altered the relationship between infarct size and baseline collateral flow. Thus, pretreatment with verapamil prevented necrosis of severely ischemic myocytes, when reperfusion was established at 40 minutes, but failed to prevent necrosis of moderately ischemic myocardium and thus failed to limit infarct size when the period of coronary occlusion was prolonged to 3 hours and treatment was started 15 minutes after the onset of ischemia. PMID- 6503221 TI - In situ ultrastructural detection and quantitation of liver mononuclear phagocytes in contact with hepatocytes in chronic type B hepatitis. AB - An ultrastructural cytochemical method for detection of endogenous peroxidase was used to quantify the mononuclear phagocytes present in areas of tissue injury, i.e., in membrane contacts with hepatocytes, in liver biopsies from 12 patients with chronic type B hepatitis; 10 of them exhibited stable disease activity of various degrees of severity, and the other two displayed acutely exacerbated disease activity. Results were compared with those for three patients with acute type B hepatitis. The total percentage of mononuclear phagocytes was higher in patients with chronic hepatitis with stable high disease activity than in patients with stable low disease activity (31.3 +/- 7.4 versus 15.6 +/- 4.7%, p less than 0.01). Furthermore, in the former group of patients, recently recruited macrophages were significantly more frequent than in patients with low disease activity (11.6 +/- 4.0 versus 3.5 +/- 3.6%, p less than 0.01), and macrophages often displayed a markedly hypertrophied cytoplasm with numerous phagolysosomes, suggestive of an activated state. On the other hand, no significant differences in the percentage of the other leukocytes in contact with hepatocytes (lymphocytes, plasmocytes, and polymorphonuclear leukocytes) were noted between patients with high and low disease activity. In the three biopsies obtained from two patients with chronic hepatitis with acute exacerbation of disease activity, the profile of the leukocytes in contact with hepatocytes strikingly resembled the one observed in the three patients with acute type B hepatitis. In both instances, mononuclear phagocytes were rare, and a higher proportion of lymphocytes was observed than in patients with stable chronic liver disease activity. These results suggest that the mechanisms of hepatocyte necrosis in chronic type B hepatitis may differ from that in acute hepatitis due to this virus. Although lymphocyte-mediated mechanisms are likely to be predominant during acute episodes of hepatocyte necrosis, mechanisms mediated by mononuclear phagocytes might play a significant role in the low grade of hepatocyte necrosis characteristic of stable chronic type B hepatitis. PMID- 6503222 TI - Detection of phencyclidine usage by radioimmunoassay of saliva. AB - Paired serum and saliva samples, obtained from 100 emergency department patients suspected of phencyclidine (PCP) intoxication, were analyzed using a specific PCP radioimmunoassay (RIA). Seventy-four of the 100 saliva samples and 75 of the paired serum samples were positive for PCP. The final clinical diagnosis was PCP intoxication in 79 cases. Of these, both serum and saliva tests were positive in 70 cases, only serum was positive in two cases, and both serum and saliva samples were negative in seven cases. The concentration of PCP in the samples did not correlate with the severity of PCP intoxication. In the remaining 21 cases, with no clinical evidence of PCP intoxication, PCP assays were negative in both serum and saliva in 17 cases, three patients had positive saliva and serum tests, and one other patient had a positive PCP saliva assay. Thus, saliva would appear to be as reliable as serum as a specimen for PCP analysis. PMID- 6503223 TI - Response of breath-alcohol analyzers to acetone: further studies. AB - Seven quantitative evidential breath-alcohol analyzers in three categories of analytical principle were tested for response to dynamically generated vapor acetone concentrations of 3, 100, 150, 350, and 600 micrograms/L and to alcohol acetone vapor mixtures of 0.10 g alcohol/210 L and 350 or 600 micrograms acetone/L. No significant interference by acetone at any of these concentrations was found in four of the tested instruments. Two devices employing single wavelength infrared spectrometry displayed no unacceptable responses to acetone in concentrations to 350 micrograms/L, and one device employing solid-state (Taguchi) sensing was found to be significantly sensitive to acetone at the two highest tested concentrations. Except for the latter device, response to acetone of those instruments tested is not considered to be a significant problem in breath-alcohol analysis for traffic law enforcement or other purposes. PMID- 6503218 TI - [Fibronectin]. AB - Fibronectin is a dimeric glycoprotein with a molecular weight of 440,000. It is a soluble constituent of plasma and other body fluids and a fibrillar matrix protein of connective tissue. The two components are structurally similar and convertible. The possibility of multiple molecular interactions gives rise to a variety of biological functions. The regulation of cell growth and the reduced shedding of fibronectin from malignant cells raises the question as to whether fibronectin is valid as a tumour marker. In wound healing and chronic inflammation fibronectin serves as a scaffold for the formation of collagen. As opsonic protein it maintains reticuloendothelial function. Especially in shock, fibronectin may become the limiting factor of unspecific host defence mechanisms. The value of a substitution therapy will be discussed. PMID- 6503224 TI - The capillary gas chromatographic determination of trazodone in biological specimens. AB - A simple and specific method is presented for the capillary gas chromatographic determination of trazodone in postmortem blood and tissues. The drug and trimethobenzamide, which was used as an internal standard, were extracted with 1% isopropanol in n-butyl chloride. Chromatography was accomplished with a short (4 m) methyl silicone capillary column and hydrogen carrier gas. This combination of extraction solvent and chromatographic conditions was demonstrated to be both accurate and precise. Since trazodone is a relatively new drug, additional thin layer and packed column gas chromatographic data is presented to augment the incorporation of trazodone into routine analytical protocols. PMID- 6503225 TI - Evaluation of a radioimmunoassay (125I) kit for cannabinoid metabolites in urine and whole blood. AB - The Abuscreen kit (Roche Diagnostics) for the analysis of 11-nor-delta 9 tetrahydrocannabinol-9-carboxylic acid and other cannabinoids in urine was evaluated in terms of its accuracy, reproducibility, and sensitivity. A procedure is also presented for the analysis of total cannabinoids in whole blood using the RIA kit. PMID- 6503226 TI - Fatal metoprolol overdose. AB - Metoprolol, a beta 1-adrenergic blocking agent, has been found effective in the treatment of hypertension. A death due to deliberate ingestion of metoprolol is described, including the case history, postmortem toxicologic findings, and identification and quantitation of the drug by high pressure liquid chromatography and gas chromatography/mass spectrometry. Metoprolol levels were found to be 4.7 mg/L in blood, 194 mg/L in urine, 3.3 mg/L in vitreous humor, 3.9 mg/L in pleural fluid, 254 mg/L in bile, 7.1 mg/kg in kidney, and 6.3 mg/kg in liver. PMID- 6503227 TI - The Schotten-Baumann reaction as an aid to the analysis of polar compounds: application to the determination of tris(hydroxymethyl)aminomethane (THAM). AB - The separation of polar, low molecular weight, water-soluble compounds from specimens prior to quantitation has long been a problem in analytical toxicology. Others have successfully used in situ derivatization, prior to extraction, to resolve this problem (1,3). An application of the Schotten-Baumann reaction leading to a simple extraction of tris(hydroxymethyl)aminomethane (THAM) followed by HPLC is presented. This may be a generic approach to the analysis of other polyhydroxy, water-soluble compounds. PMID- 6503228 TI - Liquid chromatographic determination of salicylate and methyl salicylate in blood and application to a postmortem case. AB - A liquid chromatographic method is presented for the quantitation of salicylate and methyl salicylate in blood. It employs an initial alkaline extraction to separate methyl salicylate from salicylate. Methyl salicylate is then hydrolyzed to salicylate, extracted under acidic conditions and chromatographed. This method was used in an attempt to identify methyl salicylate and salicylate in a postmortem case. PMID- 6503229 TI - Another fatal case involving hydroxyzine. AB - Blood and tissue concentrations of hydroxyzine, an antihistamine with sedative properties, were determined in a fatal case of accidental hydroxyzine ingestion. Hydroxyzine was extracted at alkaline pH and analyzed by gas chromatography. PMID- 6503230 TI - Procainamide depleted tablets not a cause of death. AB - Sixteen apparently intact procainamide tablets, in varied stages of drug depletion, were found distributed throughout the gastrointestinal tract of a man who died of arteriosclerotic heart disease with pulmonary complications. The tablets were found to contain procainamide by a thin layer chromatography system with cataloged compound identification characteristics. The drug was confirmed by ultraviolet spectrophotometry and gas chromatography/mass spectrometry. The concentration of the drug in the liver was in a therapeutic range and the drug was not attributed as contributing to the cause of death. PMID- 6503231 TI - A high propoxyphene concentration. AB - Approximately 10% of reported fatal poisonings with propoxyphene have blood concentrations exceeding 10 mg/L. A few have concentrations exceeding 100 mg/L. It is evident, therefore, that the blood does not reach propoxyphene "saturation" at either concentration. The ratios of propoxyphene to norpropoxyphene do not appear to differ markedly between drug abuse deaths and nonabuse deaths. PMID- 6503232 TI - Genetic diagnosis in obstetrics/gynaecology. PMID- 6503233 TI - The hypotonic child not due to neuromuscular causes. PMID- 6503234 TI - The child with pallor. PMID- 6503235 TI - Serum copper, iron, iron-binding capacity and zinc levels in neonates. PMID- 6503236 TI - The peripheral blood buffy coat preparation & its usefulness. PMID- 6503237 TI - Repeated transfusions and serological markers of hepatitis A and hepatitis B. PMID- 6503238 TI - Measuring trait anxiety in general population samples. PMID- 6503239 TI - Type A behavior pattern and academic performance of college students in India. PMID- 6503240 TI - Psychological factors related to drinking-driving behavior. PMID- 6503241 TI - Sensory loss, family support, and adjustment among the elderly. PMID- 6503242 TI - Effects of two antecedent conditions on vocalization frequency of severely retarded children. AB - Rather than concentrating exclusively on consequences in early vocal instruction, the manipulation of antecedent conditions has been recommended. Few empirical data have been collected on the effect of different antecedent events. Therefore, a series of three experiments was conducted with three severely retarded children to investigate the vocalization-producing potential of two antecedent conditions: adult talk, a commonly cited antecedent, and adult silence. The conditions were evaluated using a modified alternating treatments design. In Experiment 1, 5 min of continuous adult talk was alternated with 5 min of adult silence; the results indicated that adult silence occasioned more vocalizations than did adult talk. In Experiment 2, a mixed (alternating 30-s periods of silence and talk) condition was compared to a silence condition; again the results indicated a higher frequency of vocalization during the silence condition. In Experiment 3, a modified talk (a question or comment presented every 10 s) condition was compared to a silence condition; the results indicated that the two conditions occasioned similar vocalization frequencies for two children, and the questions/comments condition occasioned more vocalizations for one child. In addition to studying optimal conditions for adult talk, the present investigation provides a methodology for deriving empirical data on the effects of differing antecedent conditions on vocalization frequencies. PMID- 6503243 TI - Pragmatic assessment: analysis of a highly frequent repeated utterance. AB - The present study examined the pragmatic role of a frequently repeated utterance, "it's gone," within the multiple context conversational interactions of a 4-year old specifically language-impaired boy. The data indicate that the phrase was an interactive access strategy to engage his partners in a nonexistence/disappearance game, a frequent type of early mother-child interaction. The assessment and intervention implications of these data are discussed. PMID- 6503244 TI - Acquisition of spoken and signed English by profoundly deaf children. AB - A sample of 327 profoundly deaf children from oral/aural (OA) and total communication (TC) programs across the country was tested on the Grammatical Analysis of Elicited Language--Simple Sentence Level (GAEL-S), which measures production of selected English language structures. Results were analyzed separately for four different response modes: the oral productions of OA children, the oral productions of TC children, the manual productions of TC children, and the combined productions of TC children. Percentage correct scores for the oral productions of TC children were substantially below scores for their manual productions and below the scores of OA children in all grammatical categories sampled on the GAEL-S. The percentage correct scores of OA children were significantly higher than the manual and combined production scores of TC children in more than 50% of the grammatical categories. The manual scores of TC children significantly exceeded the scores of OA children in less than 20% of the categories. The gap between oral and manual production of the children in total communication programs indicates that spoken English did not develop simultaneously with manually coded English and that these children educated in programs using manually coded English did not develop competence with early developing English syntax at a rate faster than those not using signs. PMID- 6503245 TI - Effects of modeling and corrected practice on generative language learning of preschool children. AB - A simultaneous treatments design was used to compare the effects of modeling and corrected practice on generative language acquisition of six preschool children. New syntactic forms used to describe agent-action and agent-action-object stimuli were taught concurrently. All six children learned both new syntactic forms. However, generative language learning was accomplished more efficiently with corrected practice, irrespective of the number of words or the linguistic complexity of utterance forms. When modeling was not effective initially, instructing two children to start talking like the model resulted in rapid observational learning. It is suggested that descriptive researchers may have prematurely discounted the possible role of corrected practice in the enhancement of language learning. This analog study indicates that corrected practice should provide a more efficient approach for establishing generalized syntactic responding, at least initially, in language intervention programs. PMID- 6503247 TI - Comparisons of speech recognition in noise by mildly-to-moderately hearing impaired children using hearing aids and FM systems. AB - Four hearing aid arrangements (monaural-omnidirectional, monaural-directional, binaural-omnidirectional, binaural-directional) and a number of FM system personal hearing aid combinations (including direct input, neck loop, and silhouette inductor--monaural and binaural--and environmental microphone on and off) were evaluated in a school classroom on nine children with mild-to-moderate sensorineural hearing losses. Two measures of speech recognition in noise were employed. First, the signal-to-noise ratio (S/N) yielding 50% identification of spondees was determined using a simple up-down adaptive procedure. Second, word recognition scores were obtained for three amplification arrangements at two different S/Ns (+6 and +15 dB). The average FM advantage over a personal hearing aid was equivalent to a 15-dB improvement in S/N. Activation of the hearing aid microphone caused most of the FM advantage to disappear. The benefit offered by the FM system decreased as the environmental S/N increased but remained significant even at +15 dB. Significant improvement also was found with the use of directional as compared to omnidirectional microphones, both in the hearing aids and FM teacher microphone. PMID- 6503248 TI - Nature and boundaries of phonologic categories: a case study of an unusual phonologic pattern in a language-impaired child. AB - This paper presents a detailed examination of an unusual phonologic pattern reflected in the speech of a language-impaired child. The most salient characteristic of this child's speech was the use of [s] in final position of all words except those containing final oral or nasal bilabials. Her pattern seemed best described as reflecting only two canonical forms for word production, CVC and CVCVC, and a dominant word-final category possessing a family resemblance structure with [s] as the prototype. Training was instituted to increase the number of appropriate categories in the child's phonologic system. Training on word-final [f] and [d] was successful. However, training on [d] seemed to result in the creation of a second category with family resemblance structure. The clinical and theoretical implications of this child's phonologic pattern are discussed. PMID- 6503246 TI - Relationship between two measures of aided binaural advantage. AB - The relationship between aided binaural squelch measured using a conventional paradigm and binaural squelch inferred from the ability to detect an intelligibility difference between binaural and pseudobinaural stimuli (presumably utilizing interaural time and intensity cues) was investigated. The conventional measures of aided binaural squelch included the NU-6 monosyllables and the high-predictability sentences from the revised SPIN test. For each measure, binaural squelch was derived by comparing the binaural intelligibility of speech-in-babble with corresponding monaural scores. Subjects were also asked to select the more intelligible hearing-aid-processed speech sample when presented with a paired-comparison task in which each pair consisted of a binaural and a pseudobinaural stimulus. Ability to choose the binaural stimulus as most intelligible was considered to be evidence of binaural squelch ability. Although the hearing-impaired subjects demonstrated typical binaural squelch for the conventional speech tests, they were usually unable to distinguish between the binaural/pseudobinaural pairs. These results suggest that (a) binaural squelch measured using conventional procedures does not necessarily quantify the listener's ability to profit from interaural differences, and (b) many hearing impaired individuals may be unable to utilize interaural differences to enhance speech intelligibility in noise. PMID- 6503249 TI - Stuttering: a review to research finding and theories circa 1982. Reply to Andrews et al (1983 and 1980) PMID- 6503250 TI - Definition is the problem. PMID- 6503251 TI - Differential subsystem impairment, differential motor system impairment, and decomposition of respiratory movement in ataxic dysarthria: a spurious trilogy. PMID- 6503252 TI - Bone blood flow measurement. AB - Methods of determining blood flow in bone are described and compared. Those based on clearances of bone-seeking tracers are inaccurate because of the variation of extraction with flow. The use of radioactive microspheres is the best available technique for measurements in animals; applications of this method are given. The washout of diffusible tracers is of limited use. PMID- 6503253 TI - Recanalization of human arteries using Nd-YAG laser carried by optical fibre. AB - Nd-NAG laser carried by optical fibres 0.2 mm diameter was used in experimental studies to recanalize obstructed human cadaver arteries. Successful perforation of atheromatous plaques was obtained in all cases with a power of 12 W and a duration of exposure of 30-50 s provided that blood and not saline was used. The arterial wall was protected from injury by coaxial position of the optical fibre that was inserted into an inflated balloon catheter, and by circulating blood that cooled the system. The feasibility of guiding these devices in man was demonstrated in femoral and coronary arteries. PMID- 6503254 TI - Transventricular simple-capacitor discharge defibrillation thresholds after coronary ligation and body hypothermia. AB - Peak current defibrillation thresholds (PCDT), i.e., values with 50% probability of success, were determined after ligation of the left anterior descending coronary artery (LADCA) while, simultaneously, body temperature was slowly decreased until central venous temperature reached an average minimum of 22.8 degrees C (s.d. 3.1). In 14 dogs with over 166 successful defibrillations, the average time elapsed between the moment of ligation and the last defibrillation was 179.1 min. (s.d. 31.9), with an average PCDT of 53.6 mA g-1 of heart (s.d. 20.5). This value was compared by means of the unpaired Student's t test with three previous values obtained, respectively, under hypothermia with no occlusion (HNO), normo-thermia with coronary occlusion (NCO), and normothermia with no occlusion (NNO), that is, HNO 69.5 (s.d. 30.4), NCO 81.1 (s.d. 29.3), and NNO 89.5 (s.d. 32.8), all expressed in mA g-1 of heart. All three differences even after Bonferroni's correction, were statistically significant (P less than 0.3%). We concluded that, (1) defibrillation thresholds were decreased by coronary occlusion and by hypothermia, (2) the decrease due to hypothermia was greater than that due to coronary occlusion, (3) both decrements appeared as additive. PMID- 6503255 TI - A force sensor and peak-reading recorder for measurement of cervical dilatation force. AB - Earlier dilatation force-sensing transducers, when subjected to side loads, suffered frictional losses which affected their accuracy. This new instrument incorporates a thermal-writing chart recorder and a digital readout of the peak force during dilatation of the cervix. PMID- 6503256 TI - A device for generation of electromagnetic fields of extremely low frequency. AB - A new device for generation of electromagnetic fields at extra low frequencies, to be used in fracture treatment, is described. The device involves a coil and a battery powered noise-generator. An alternating magnetic field of 4 X 10(-4) T (4 Gauss) (RMS value) with a frequency range 1-1000 Hz is generated. Results from a controlled randomized study of fresh fractures have shown significant differences (p less than 0.01) between the treated group and the control group. The results are encouraging and motivate further investigations with this method. PMID- 6503257 TI - Equivalence between one step kinetics and Hill's equation. AB - One step kinetics between oxygen and haemoglobin are shown to be equivalent to the well-known Hill's equation. We have modified the one step kinetics while dealing with the mathematical modelling of simultaneous transport of oxygen and carbon-dioxide in the blood flowing through the pulmonary and the systemic capillaries. In the process, the Hill's equation has been modified showing an explicit dependence on PCO2. We have proposed comparatively simpler equations to represent Hb saturation with O2 and CO2 allowing for the interaction between the gases. It is shown that the oxygen dissociation curve, obtained from modified equations, fits in fairly well with the experimental data and shows realistic shift with PCO2. The results computed from our comparatively simpler equations based on physical laws, are in good agreement with those obtained from Kelman's empirical relations that are accepted in anaesthesia and respiratory physiology as providing very good matches to reality. PMID- 6503258 TI - Computer-controlled temperature multiplexer for thermal dosimetry studies. AB - Thermistor probes are widely used for mapping thermal distributions in hyperthermia research. To facilitate multi-probe mapping, a computer-controlled multiplexer for automated thermistor impedance measurement and temperature conversion is described. A complete hardware interface schematic is shown. An algorithm which calculates individual temperature values as a function of thermistor impedance is tested. Total error is quantified by calculating the absolute error between the theoretical temperatures obtained from the algorithm and the experimental calibration temperatures obtained from a National Bureau of Standards referenced mercury thermometer. If calibration intervals of 1.00 degree C or less are used, the total error of the system is less than 0.10 degree C. PMID- 6503259 TI - A controllable artificial afterload for isolated heart studies. AB - This paper presents an artificial afterload, based on the Westerhof model, for use in isolated heart preparations. The system has adjustable elements representing peripheral resistance and total arterial compliance, together with a fixed element representing aortic impedance. It is controlled by a computer in a manner which incorporates feed forward and feedback techniques. The system maintains constant 'arterial' pressure in the face of large excursions of the flow through it. It can be programmed to change this pressure in a dynamic fashion. The time taken to recover from large changes in flow and to reset the pressure is at most 3 S. Absolute values of peripheral resistance are easily obtained without any knowledge of the actual flow being required. Tests of the system demonstrate its stability and rapid transient characteristics. PMID- 6503260 TI - Thermal entrainment and human ovulation. AB - The changes in the peripheral vascular response to temperature have been studied for ten menstrual cycles by calculating thermal entertainment levels. The entrainment levels exhibited peaks at around the time of ovulation, a result which we believe is due to the fluctuating levels of the hormones oestrogen and progesterone in the blood. An attempt has been made to explain the influence of these hormones on the vasomotor control system and where interactions may occur. PMID- 6503261 TI - Osteoarthritic gait dynamics from force-plate measurements. AB - A method is presented for calculating the displacement of the centre of body mass in lateral, horizontal and vertical directions during pathological gait; evaluations are made from measurements obtained by a single pair of small force plates. Results are presented for pre- and postoperative gait for 42 patients who, initially suffering from osteoarthritis of the hip, have had total hip placements. The method is shown to be more convenient, more direct and less expensive than techniques in present use. PMID- 6503262 TI - A mechanical device for leg disturbance during gait. AB - A method of applying a momentary mechanical stimulus to a human leg at any selected time during treadmill locomotion is described. The stimulus is produced by the breaking of a loop of fine copper wire by means of a motor and clutch device. An electrical signal at the time of stimulus is provided and the apparatus has no detrimental effect on normal walking. PMID- 6503263 TI - Measurement of anaerobic power and capacity in elite young track athletes using the Wingate test. PMID- 6503264 TI - Effect of speed and endurance activities on blood pressure, heart rate and blood lactate, and their correlation. PMID- 6503265 TI - Pain free physical training in intermittent claudication. PMID- 6503266 TI - Effects of seasonal training on physical and physiological function on elite varsity wrestlers. PMID- 6503267 TI - A trend analysis of steady state oxygen consumption during arm crank ergometry. PMID- 6503268 TI - Dark adaptation in long-distance runners. PMID- 6503269 TI - Death concerns of runners and nonrunners. PMID- 6503270 TI - Physiological response from 18-25 years women to aerobic and anaerobic physical fitness tests at different periods during the menstrual cycle. PMID- 6503271 TI - Physiological response of girls to aerobic and anaerobic endurance tests. PMID- 6503272 TI - Decreased training frequency and pulmonary function retention in the female athlete. PMID- 6503273 TI - Effects of aerobic dancing and walking on cardiovascular function and muscular strength in postmenopausal women. PMID- 6503275 TI - Towards preventing reinjury in contact sport. PMID- 6503274 TI - The challenge of multi-disciplinary studies. PMID- 6503276 TI - A comparison of the anaerobic threshold of sprint and endurance trained swimmers. PMID- 6503277 TI - Trends in lung cancer in Tennessee women. PMID- 6503278 TI - Nitrofurantoin-induced liver disease. A case report. PMID- 6503280 TI - China experience. PMID- 6503279 TI - Report of the Maternal Mortality Subcommittee of the TMA Maternal and Child Care Committee. PMID- 6503281 TI - CAT scan of the month. Pelvic lipomatosis. PMID- 6503282 TI - Successfully resolved geriatric abuse cases by the Geriatric Abuse Intervention Team. PMID- 6503283 TI - Documentation and postoperative management. PMID- 6503284 TI - Health risk behaviors of adult Tennesseans. PMID- 6503285 TI - Relationship of neuropsychological performance to primary alcoholism and self reported symptoms of childhood minimal brain dysfunction. AB - The relationship between neuropsychological performance and a childhood history of the hyperkinetic and minimal brain dysfunction syndrome (Hk-MBD) was studied in 60 men alcoholic patients at an alcoholism treatment center. Primary (N = 28) an secondary (N = 32) alcoholics and a matched group of 60 nonalcoholic controls were administered a checklist on the presence of childhood symptoms associated with Hk-MBD. The primary alcoholics reported a significantly higher number of Hk MBD symptoms than the secondary alcoholics and controls; they also performed significantly more poorly than the other groups on several neuropsychological tests. The secondary alcoholics did not differ significantly from the controls in the number of Hk-MBD symptoms reported or in neuropsychological functioning. Neuropsychological performance did not differ significantly between those with high and low numbers of Hk-MBD symptoms, but in almost all comparisons the direction of differences favored those with low numbers of Hk-MBD symptoms. In general, the results suggest that primary alcoholics might account for most neuropsychological deficits reported in alcoholics and that at least some of these deficits may be present premorbidly. PMID- 6503286 TI - Work-related outcomes of the constructive-confrontation strategy in a job-based alcoholism program. AB - Most job-based alcoholism policies and programs incorporate a strategy of constructive confrontation. Data from two national samples of over 600 managers in a large corporation were collected to assess the effectiveness of this strategy with both problem drinkers and other problem employees. Results showed that supervisors of problem drinkers took more actions than did supervisors of employees with other problems. Work performance of problem-drinking employees improved more than that of other problem employees. Oral discussions containing both constructive and confrontational topics were positively associated with employees accepting help and with better work performance following intervention for both samples of employees. However, more severe forms of discipline--written warnings, suspensions or discharges--were negatively associated with work performance following intervention in both samples. The results suggest that (1) the strategy is most effective when repeated discussions balance both constructive and confrontational elements, and (2) the presence of the alcoholism policy encouraged supervisors to take more actions with problem drinkers, legitimated those actions and made the threat of discipline more credible. PMID- 6503287 TI - Effects of program characteristics on treatment outcome: an interrupted time series analysis. AB - The methodological difficulties in comparing the effectiveness of alternative alcoholism treatment programs were addressed. An interrupted time-series design and MMPI scores were employed with 408 men veterans to test the effectiveness of four changes in an 8-week inpatient alcoholism treatment program: The program was given its own ward; the amount of time patients spent in common activities was increased; the staff: patient ratio was improved; and contract with the outside community was broadened. The scores of MMPI tests administered at treatment termination were available for the periods of 3 yr prior to and 3 yr after the change. The results of the time-series analysis indicated that the new program was indeed more effective than the old one because nine of the 13 subscales used and the Disturbance Index (a weighted combination of all the subscales) showed a reliable decline coincident with the introduction of the new program. However, the results also showed most of these effects to be short-lived. Implications of these results and issues involved in implementing this design are discussed. PMID- 6503288 TI - Personality characteristics and drinking patterns of high-risk drivers never apprehended for driving while intoxicated. AB - In a study of 124 high-risk drivers, almost 50% of the drives had a severe problem with alcohol and were driving without a valid license. The findings indicate that high-risk drivers, not identified as drinking drivers, are as potentially a threat to public health as those individuals arrested for driving while intoxicated. It is recommended that intervention programs for high-risk drivers cannot ignore alcohol education and, where appropriate, alcohol treatment as an identifiable programmatic strategy. PMID- 6503289 TI - Reasons for drinking among the elderly in rural Arizona. AB - Reasons for drinking, and past and present drinking patterns among the elderly in rural Arizona were examined. Interviews were conducted with 444 individuals (219 women) aged 65 +. Responses to a list of 20 reasons for drinking wee divided into six groups: social, mood change, food, health, personal coping and interpersonal coping. Respondents were grouped into categories on the basis of their quantity and frequency of alcohol consumption--abstainers, light drinkers, moderate drinkers or heavy drinkers. Approximately 80% of the positive responses were for the more acceptable reasons; only 12% indicated a positive response to one or more of the coping reasons. Light, moderate and heavy drinkers wee differentiated according to reasons for drinking, as were the various age groupings. Findings indicated that the rural elderly's alcohol use is generally at an acceptable level and style, that alcohol use diminishes with age, and that drinking patterns and reasons generally remain consistent into old age. PMID- 6503291 TI - Impediments to Alcohol Education. AB - Two major forces mitigate against alcoholism education within the medical school curriculum. One relates to the structure and organization of academic medicine with its emphasis on disease states and pathophysiology; sophisticated and technologically complex diagnostic and treatment modalities; and an acute illness, cure-oriented focus rather than a chronic illness, adaptational approach to illness. The second constellation of factors relates to the alcoholism field's failure to identify with other issues in medical education that similarly challenge the Flexnerian curriculum; the lack of a conceptual basis for defining the physician-alcoholism specialist in relation to other medical disciplines; the clinical treatment field's competing craft and professional orientations; and the absence of a scientific vocabulary suited to the existing biopsychosocial paradigms. It is suggested that these impediments could be overcome if the alcoholism field defined the model for managing chronic illness that is implicit in alcoholism treatment. PMID- 6503290 TI - Mortality of treated alcoholics and drug addicts: the benefits of abstinence. AB - A study of 2-yr treatment outcome and of mortality in the following 8 yr was conducted on all first admissions to Eagleville Hospital in 1970 (503 alcoholics and 221 drug addicts; 9% women). The average age of the alcoholics was 41.6 vs 23.0 for the drug addicts. Status (misusing vs not misusing) 2 yr after admission for treatment or at death was ascertained for 92% of the subjects. The 108 known deaths occurred in 18.5% of the alcoholics and 6.8% of the addicts. Death rates per 1000 person yr at risk were compared with expected general population rates, controlling for age, race and sex. Overall, mortality per 1000 person yr was 25.9 for alcoholics and 8.8 for addicts, each higher than expectancy (p less than .001). Ratios of observed to expected rates were similar (2.5 and 3.1, respectively). Excess mortality occurred only among those misusing alcohol or drugs at 2 yr; nonmisusers had expected death rates. Disease and violent deaths were excessive among alcoholics, but only violent deaths exceeded expectancy among drug addicts. Of the 108 deaths, 66 were excess deaths, attributable to substance misuse and the associated way of life. However, among the 254 who were not misusing on follow-up, 19 died rather than the 51 who would have died if their mortality had been that of the persistent misusers. PMID- 6503292 TI - Alcohol intake in the rat as a function of the method of selection of a single test solution. AB - Two methods of selection of a single test solution of alcohol were compared with 78 male Sprague-Dawley rats evenly divided into two groups that differed according to the method used. It was found that the method of selection affected many parameters of alcohol consumption, including its stability. It was concluded that the difference in the effects of the two methods was related to the fact that one method permits a higher degree of individuality for the establishment of a single test solution. PMID- 6503293 TI - Panic disorder and alcohol misuse. AB - The literature on the relationship of panic disorder to alcoholism is reviewed. Four cases of panic disorder are presented, illustrating instances in which the diagnosis of panic disorder was delayed or obscured by alcoholism. Professionals in alcoholism treatment should therefore be better able to recognize panic disorder. Also, since tricyclic antidepressants are very effective in the treatment of panic disorder, the opposition in the alcoholism field to the use of any medication is criticized. PMID- 6503294 TI - Increasing attendance in an outpatient alcoholism clinic: a comparison of two intake procedures. PMID- 6503295 TI - Effect of variation of drug dosage on disease control and regional toxicity in prophylactic perfusion for Stage I extremity melanoma. AB - One hundred and fifty-six patients with extremity melanomas of known level or thickness who were perfused prophylactically with l-phenylalanine mustard (1-PAM) between January 1974 and December 1978 were studied retrospectively to determine the effect of variation of drug dosage and temperature on regional toxicity and disease control. The median drug dosage of 1-PAM for 57 patients undergoing axillary perfusion was 0.85 mg/kg (range 0.48-1.0 mg/kg) and the median dosage was 1.2 mg/kg (range 0.59-1.69 mg/kg) for 99 patients undergoing iliac perfusions. Sixty-five percent of patients achieved a maximum skin temperature of between 101 degrees and 102 degrees F during perfusion. Determinate survival in the entire group was 93% at 5 years; 10% of patients developed positive regional nodes; and 2.5% developed local or intransit metastases. Based on analysis of other series of patients with extremity melanoma with equivalent Clark's level 5 year determinate survival might be expected to be between 65 and 80%. The expected incidence of nodal metastases should be 19.1%-24.0% and the incidence of local and intransit metastases should be 3-6%. While this series suggests a survival advantage for a series of extremity melanomas treated by regional chemotherapy when compared to other series treated by wide excision +/- regional node dissection, the results obtained were independent of dosage of drug administered or maximal temperature attained over the range studied. This suggests consideration be given to exploring other dose ranges of drugs and heat in an effort to achieve equivalent control with lower regional toxicity. PMID- 6503296 TI - Recurrences after irradiation in early vocal cord cancer with literature review. AB - Radiation therapy in early glottic cancer offers an excellent cure rate with preservation of voice. This study is an analysis of 25 (18%) patients who had failures after irradiation. Ten patients were in stage I (T1N0M0) and 15 patients in stage II (T2N0M0). All patients received megavoltage irradiation with an average dose of 6600 rad, 180 to 200 rad per day, 5 days in a week. Of the failures, 15 patients had the tumor controlled by salvage surgery, laryngectomy being the most common surgical procedure. The median time to recurrence was 23 months. A detailed analysis of the failures, along with a literature review, is done in this paper. PMID- 6503297 TI - Plasma cell granuloma of the tonsil. AB - Plasma cell granuloma (inflammatory pseudotumor) has been described most commonly in the lung. Review of the English literature fails to reveal occurrence of such a lesion in the tonsil. We are reporting such a case presenting as a unilateral tonsillar mass in a 63-year-old man. A more typical case of plasma cell granuloma of lung is also presented to illustrate the similarity between the tonsillar and pulmonary lesions. PMID- 6503298 TI - Cholesterol, weight, height, Quetelet's index, and colon cancer recurrence. AB - The association of low serum cholesterol with colon cancer mortality suggests that low serum cholesterol promotes colon cancer recurrence. We compared cumulative 5-year recurrence-free rates of 279 colon cancer patients in relation to serum cholesterol, weight, height, and Quetelet's index. The median value for each variable was used to divide patients into those above the median, or at the median and below. Patients with median and lower serum cholesterol exhibited an 11% lower disease-free rate at 5 years. Patients above median weight were at significantly increased risk of recurrence in both sexes (76 vs 54%, z = 3.0026, p = 0.003). Progressively decreasing weight was noted with advancing stage in males but not in females. Women above median Quetelet's index were also at significantly greater risk of recurrence (74 vs 52%, z = 2.6109, p = 0.009). Patients above median height were at insignificantly increased risk of recurrence. This study indicates that body weight is a significant prognostic factor for patients with colon cancer. PMID- 6503299 TI - Squamous carcinoma arising in a pilonidal sinus. AB - A patient with squamous cell carcinoma arising from an extensive pilonidal sinus was treated with wide local excision, resulting in an apparent cure over a 1-year follow-up period. Review of the literature revealed 32 previously reported cases of this entity. Forty-four percent of these patients developed recurrences or metastases, and 22% died of their disease. The largest historical treatment group with at least 1-year follow-up (19 patients with localized disease) underwent wide excision. Forty-two percent of these patients recurred or developed metastases. Ultimately, 89.5% of these patients were reported cured, but only five survivors were followed for as long as 5 years. Historical experience appears to identify pilonidal tract squamous carcinoma as an aggressive tumor. The reported success of wide local excision is based on a small number of patients followed for short periods of time. Continued experience with this disease should be reported to verify the adequacy of local excision or identify the need for adjunctive therapy. PMID- 6503300 TI - A complication of the implantable constant infusion chemotherapy pump. AB - The treatment of metastatic colorectal cancer to the liver has been a significant problem for clinicians in the past. Recent technical advances in infusion systems in the form of the infusaid pump has allowed delivery of chemotherapeutic agents to the liver with great reliability. As more chemotherapy pumps are implanted, undoubtedly, new and unusual complications will occur. This report centers on a patient who developed a disrupted catheter secondary to a high pressure side port injection. It includes a description of the complication, how it occurred, was recognized, and corrected. This report will, hopefully, save other clinicians from encountering similar complications in any of their patients. PMID- 6503301 TI - Veno-occlusive liver disease after dacarbazine therapy (DTIC) for melanoma. AB - A case of veno-occlusive disease of the liver with fatal outcome after dacarbazine (DTIC) therapy for melanoma is reported. There was a fulminant clinical course from start of symptoms until death. At autopsy the liver was enlarged and firm with signs of venous congestion. Small- and medium-sized hepatic veins were blocked by thrombosis. Eosinophilic infiltrations were found around the vessels. Published cases from the literature are reviewed and pertinent features discussed. PMID- 6503302 TI - Bilateral intrathyroidal hyperplastic parathyroid glands. AB - A patient with secondary hyperparathyroidism was found to have two intrathyroidal parathyroid glands. Parathyroid glands are found completely within the substance of the thyroid in approximately 2 to 8% of all cases. The surgical approach to hyperparathyroidism is discussed. PMID- 6503303 TI - Cavernous hemangioma of the anus. AB - Vascular tumors of the large bowel can be divided into malignant and benign lesions. The benign lesions can be divided into capillary and cavernous hemangiomas. Large-bowel hemangiomas are rare lesions, with the majority of cases reported in the rectum and rectosigmoid regions. Few cases of isolated anal hemangiomas are found in the literature. A case of an asymptomatic anal cavernous hemangioma, palpable on routine rectal examination and subsequently removed at proctosigmoidoscopy, is described. PMID- 6503304 TI - Clear cell ovarian adenocarcinoma. AB - A retrospective analysis of the clinico-pathologic aspects of 22 cases of clear cell ovarian carcinoma with a literature survey is the subject of this report. The rarity of these neoplasms below the age of 40 is reaffirmed. Tumor-related hypercalcemia was observed in two patients and postoperative thromboembolic complications were encountered in three others. Electron microscopic examination revealed abundant cytoplasmic glycogen content in two cases. Ten patients in this group and 26% in reported series had coexistent endometriosis. Association with endometrial carcinoma was observed in two patients and was reported in 14% of the cases. No patient of ours with Stage III or IV disease survived 5 years or longer and only 8% have reportedly survived in collective series. There was suggestive evidence of radiation tumor response in two patients with Stage IIC disease who had received 5,000 rads pelvic radiotherapy. Objective partial responses were also observed with adriamycin-, cytoxan-, and cis-platinum-containing combinations. A management plan is outlined. PMID- 6503305 TI - RNA splicing as an error-screening mechanism. AB - Eukaryote nuclear genes are generally split into coding (exon) and noncoding (intron) regions. During the formation of messenger RNA the introns are precisely excised and the exons religated. A widely accepted explanation for the split structure of eukaryotic genes is that proposed by Gilbert who hypothesized that the division of coding information into small units speeded up the rate of protein evolution by allowing for the recombination of the independent peptide domains encoded by these units ("exon shuffling"). However it has recently become clear that the exon:intron structure of genes most likely preceded the uninterrupted form. This makes it difficult to accept Gilbert's argument as it applies to the origin(s) of split genes since early genes were very inaccurately copied and a highly error-prone system needs less variation not more. Here I propose that split genes and the concomitant process of RNA splicing arose as a mechanism for maintaining the stability of the genetic information in the face of a high level of noise in the gene copier mechanism. PMID- 6503306 TI - Coordination: a vector-matrix description of transformations of overcomplete CNS coordinates and a tensorial solution using the Moore-Penrose generalized inverse. AB - Neuronal organisms express their function, such as a movement, by multicomponental actions. Thus, the problem of how the central nervous system (CNS) coordinates the elements of a single action is fundamental to our understanding of brain function. Coordinated activation of multijointed "limbs" has also become an acute problem in modern multivariable control theory and engineering, such as robotics. Thus, a coherent interdisciplinary approach is expected, one that arrives at concepts and formalisms applicable to this problem both in living and man-made organisms. By treating coordination with coordinates, tensor network theory of the CNS, which explains transformations through the neuronal networks of natural non-orthogonal coordinates that are intrinsic to living organisms, may successfully integrate the diverse approaches to this general problem. A link between tensor network theory of the CNS and multivariable control engineering can be established if the latter is formulated in generalized non-orthogonal coordinates, rather than in conventional Cartesian expressions. In general terms, the problem of coordinating an overcomplete (more than necessary) number of components of an action can be resolved by a three-step tensorial scheme. A key operation is a covariant-to-contravariant transformation executed by the Moore-Penrose generalized inverse when, in an overcomplete manifold, the covariant metric tensor is singular. In the neuronal organization of the CNS, it is assumed that the cerebellum plays this role of acting as a contravariant metric. A quantitative example is also provided, in order to demonstrate the viability of the numerical and network-implementations. PMID- 6503307 TI - On the possibility of the production of many rare proteins by higher eukaryotes. AB - Arguments are presented which support the idea that the large amount of single copy DNA in the haploid genome of higher eukaryotes is coding for many (approximately 10(6) rare proteins, that is, proteins present at the level of no more than a few molecules per cell. It is asserted that a large number of such rare protein species is consistent with (1) apparent slow rates of DNA sequence evolution as shown by DNA annealing experiments, (2) physiological complexity and the DNA content of organisms, and (3) evidence that there are many proteins already known whose primary purpose is the regulation of the function of other proteins. It is shown that the best available detection techniques would not uncover these proteins unless a concerted effort were made to do so. An outline of such an effort, based on immune precipitation and two-dimensional gel electrophoresis, is presented and discussed. PMID- 6503308 TI - A mathematical model for the co-existence of incompatible, conjugative plasmids in individual bacteria of a bacterial population. AB - A model is formulated to examine the possibility of coexistence of two or more plasmids of the same surface exclusion group in a bacterial chemostat culture. It appears that two plasmids are able to coexist. If two plasmids can coexist they will follow different survival strategies, one with a high conjugational transfer rate and a low fitness of its host, and other with a low transfer rate and a high host fitness. Coexistence of three plasmids of the same surface exclusion group is impossible. PMID- 6503309 TI - Adaptation of receptive field spatial organization via multiplicative lateral inhibition. AB - The interactions among electrically independent neurons via synapses mediating voltage controlled conductance become primarily multiplicative lateral inhibition. This nonlinear lateral inhibition among members of an array of neurons causes adaptation of the organization of the spatial receptive field. A proof of the adaptation is given and applications of the results to studies on insect visual interneurons are discussed. Given a simple hypothesis of spatial gradient of order of conductance dependence on neighboring cell voltage, a sharpening of spatial tuning of the receptive field is predicted with increased background level along with an increased linearization of the neuronal response function. PMID- 6503310 TI - Constraints on the models of carbohydrate metabolism in the two cell types of Dictyostelium discoideum. AB - The constraints in the parameters in models of the spore and stalk cells in Dictyostelium discoideum have been examined. It was found that the relative sizes of the two cellular glucose pools are not very critical, i.e. they can be varied in the models over a fairly wide range and still allow simulations which are compatible with the data. In contrast, the following model parameters are highly constrained, and must fall within narrow limits: flux through the glycogen cycle; the fraction of glycogen present which actually participates in glycogen turnover; the net rate of glycogen degradation; the concentration of exogenous labelled glucose which actually participates in cellular metabolism; the rates of exchange of this exogenous glucose with the two cellular glucose pools; the concentration of the spore glucose-6-phosphate pool, and the rate of exchange of stalk glucose-1-phosphate and stalk glucose-6-phosphate. PMID- 6503311 TI - Differential inhibition of protein synthesis: a possible biochemical mechanism of thalidomide teratogenesis. AB - A theory concerning the chemical and biochemical mechanisms of thalidomide teratogenesis is presented. A considerable body of evidence suggests that the glutarimide ring of thalidomide may exert its biological activity because of its resemblance to the imide pyrimidines thymine and uracil. In addition to the glutarimide ring, thalidomide contains a moderately reactive phthalimide moiety, which allows the spontaneous formation of various glutarimide derivatives in fetal tissues. A model is proposed in which the phthalimide group reacts with small nucleophiles, most likely the polyamines, to produce a derivative(s) having a similar biochemical potential to that of cycloheximide, a glutarimide which is a powerful inhibitor of the elongation phase of protein synthesis. Interference in the elongation phase results in the selective inhibition of the translation of messages which have a high translational efficiency. Evidence is reviewed concerning the differential inhibition or protein synthesis by cycloheximide and the effects of this inhibition on various biochemical and biological processes which are critical during development and differentiation. A similar biochemical activity by the putative thalidomide derivative(s) could explain its extreme teratogenic potential. A number of parallels between the biological effects of thalidomide and cycloheximide are discussed which support the idea that a similar biochemical activity is involved. The theory readily explains many of the observed biological effects of thalidomide including the large difference between fetal and adult toxicity. In addition, evidence is reviewed which suggests that the teratogenic properties of a number of drugs which are structurally related to thalidomide may have a common chemical basis due to the similarity of their imide core structures to thymine and uracil. PMID- 6503312 TI - Transposition of the great arteries with ventricular septal defects. Surgical considerations concerning the Rastelli operation. AB - We studied the anatomy of the ventricular septal defect in 20 heart specimens and eight operated patients with transposition of the great arteries regarding the feasibility of the Rastelli operation. They were divided into three groups. In Group I, comprising eight cases, creation of a left ventricle-aorta connection was not prevented by interposition of the atrioventricular valve tissue, and the ventricular septal defect was large or could be enlarged sufficiently. Thus, the Rastelli operation was feasible in all cases. In Group II, comprising 12 cases, interposition of the atrioventricular valves was not present, but the ventricular septal defect was inadequate in size for a good left ventricle-aorta connection. Small or even medium-sized ventricular septal defects were not enlargeable because of surrounding structures or inadequate septum for resection. In all cases, the ventricular septal defect was a tunnellike structure with two orifices; attempted enlargement would be more difficult at the left ventricular end (not obvious to the surgeon's view) than at the right one. The Rastelli operation was judged inadvisable in these cases. In Group III, comprising eight cases, the Rastelli operation was considered inadvisable because of interposition of atrioventricular valve tissue. The size of the ventricular septal defect and the presence of interposed atrioventricular valves can be diagnosed preoperatively. The presence of enough available space for resection, especially at the left ventricular end, should be determined preoperatively and/or intraoperatively in patients with medium-sized ventricular septal defects requiring enlargement. The anatomy of the ventricular septal defect may significantly alter the surgical approach for patients with transposition of the great arteries and ventricular septal defect. PMID- 6503313 TI - Coarctation of the aorta in infants. AB - Repair of coarctation of the aorta in the first year of life by resection and end to-end anastomosis has been reported to have a high rate of recurrence, and recent studies favor angioplasty techniques. Forty-seven consecutive infants less than 1 year of age who were operated upon over a 20 year period were analyzed. The hospital mortality was analyzed in three groups: Group I--two of 11 patients (18%) with coarctation; Group II--one of nine patients (11%) with coarctation and ventricular septal defect; Group III--12 of 27 patients (44%) with coarctation and major intracardiac anomalies. There was no difference in age or body surface area between survivors and nonsurvivors. Repair was performed by a resection and end-to-end anastomosis to the distal aortic arch in 43 and by patch angioplasty in four. Anastomosis was performed with 5-0 silk suture prior to 1972. Since then, 7-0 polypropylene suture has generally been used. Arm/leg pressure gradient was assessed at rest by the Doppler technique in 31 long-term survivors of the end-to-end anastomosis technique; 24 of them had polypropylene suture used and seven had silk suture. Recurrence of coarctation was defined as arm/leg gradient greater than or equal to 20 mm Hg. Actuarial freedom from recurrence at 5 and 10 years was 91% in the polypropylene group versus 57% and 44% in the silk group. Good long-term results with low incidence of recurrent coarctation achieved by end-to-end anastomosis with fine polypropylene suture justify continued use of this technique in preference to angioplasty techniques, which sacrifice the left subclavian artery or introduce prosthetic materials. Techniques chosen for coarctation repair should be compared with current operative techniques and not older studies. PMID- 6503315 TI - Unusual complication of direct left atrial pressure monitoring line. AB - We are here reporting the case of a left atrial pressure monitoring line that caused mechanical interference with the functioning of a Bjork-Shiley mitral valve. The catheter wedged the disc into a closed position and caused the patient's death. PMID- 6503314 TI - Degenerative and atherosclerotic aneurysms of the thoracic aorta. Determinants of early and late surgical outcome. AB - To identify significant predictors of early and late mortality, multivariate discriminant analyses were applied to the clinical outcome of 175 consecutive patients with thoracic aortic aneurysms operated upon over a 20 year span. Only atherosclerotic and degenerative aneurysms were included; the patients were segregated into two groups according to location of the aneurysm. The ascending aortic aneurysm group consisted of 124 patients, 85% of whom required concomitant aortic valve replacement. There were 51 patients in the descending aortic aneurysm group. Mean follow-up was 4.9 years (maximum of 19 years), with a total of 860 patient-years of follow-up. Multivariate analyses revealed that surgical priority and advanced age were independent determinants of hospital mortality in the ascending group; for the descending group, surgical priority and the presence of congestive heart failure were the strongest predictors of hospital mortality. Late mortality in the ascending group correlated with advanced age. Hypertension and the presence of preoperative congestive heart failure were independent determinants of late mortality in the descending group. Several variables did not have any independent bearing on hospital or late mortality, including etiology and location of the aneurysm, previous myocardial infarction, chronic lung disease, and concomitant aortic valve replacement. High-risk subgroups of patients with thoracic aortic aneurysms can be identified by these variables. Aggressive medical plus surgical management and operation prior to aneurysm rupture is necessary to improve both early and long-term survival rates. PMID- 6503316 TI - Thermodilution cardiac output studies as a cause of prosthetic valve bacterial endocarditis. AB - The injectate used for thermodilution cardiac output determinations is a potential source for direct bloodstream contamination, resulting in bacterial endocarditis after cardiac operations. An experiment simulating three techniques for obtaining injectate samples showed one of them to be clearly unacceptable. PMID- 6503318 TI - Internal mammary artery-saphenous vein composite conduit. PMID- 6503317 TI - Hypothermic circulatory arrest. PMID- 6503319 TI - Staged partitioning of single ventricle. AB - Five patients between the ages of 3 and 10 months underwent a two-stage septation for common ventricle. The first stage involved the placement of a small patch in the apex and a second patch between the atrioventricular and semilunar valves. A center section was left open, as if there were ventricular septal defect. A pulmonary band was placed at this time if one had not been previously placed. The second stage of the repair, consisting of closure of the ventricular septal defect, was performed 6 to 18 months after the first procedure. All five patients have survived and have been without rhythm disturbance. One patient subsequently developed pulmonary stenosis, and a right ventricle-pulmonary artery conduit has been placed. The first stage procedure seems to allow the apical and base patches to stiffen and heal to the endocardium, with fewer sutures required because the central area is open and no pressure differential exists across the patch. PMID- 6503321 TI - Should elective repair of coarctation of the aorta be done in infancy? AB - Our experience with the subclavian flap repair for coarctation of the aorta over the past 10 years includes 53 patients under 1 year of age. Of this group, 35 were newborn infants. All but two had an associated patent ductus arteriosus and 23 (66%) had associated intracardiac anomalies. All neonates had severe congestive heart failure and operation was carried out promptly after they were stabilized with diuretics and inotropic agents. Prostaglandin infusions have been essential to the care of many of these patients. Operative mortality was two of 53 patients (4%). No patient more than 4 days old operation has died, and concomitant pulmonary artery banding was performed in five infants with no deaths. Running nonabsorbable suture was used in 21 patients, interrupted nonabsorbable suture in 23, and continuous monofilament absorbable suture in the last nine. Mean follow-up time has been 46 months. Invasive follow-up studies, performed in 11 patients, have revealed residual systolic gradients of 5, 15, and 20 mm Hg in three and 0 mm Hg in one in whom continuous suture technique was used. The other seven had interrupted suture technique, and no gradient was present. Initial follow-up information for the group with absorbable suture repair suggests no residual gradients. No patient had significant upper extremity or hand morbidity. Eight patients had normal blood pressure and normal arm-to-leg gradients after exercise. When absorbable vascular suture is unavailable, an interrupted suture technique is superior to a continuous running repair. In view of the low operative mortality, the excellent growth of the repaired area, yet the likelihood of late development of cardiovascular disease (especially hypertension) if the repair is effected in childhood or adolescence, we favor prompt subclavian flap repair of coarctation of the aorta in all infants with or without symptoms. Concomitant pulmonary artery banding is seldom indicated. PMID- 6503320 TI - Dysphagia complicating hiatal hernia repair. AB - Dysphagia may be a continuing or added problem after operations for the control of reflux. In a series of 208 patients treated surgically for recurrent hiatal hernia, 34 (16.3%) presented with dominant dysphagia either caused by or aggravated by the operation. They were evaluated by history, radiology, manometry, and endoscopy. The causes of dysphagia were diagnosed in all patients: reflux stricture in nine patients, tight or long Nissen wrap in 15, muscle injury in three, inappropriate myotomy with reflux in three, myotomy with overcompetent repair in two, and early Nissen intussusception in two patients. Surgical correction was by total fundoplication gastroplasty in 32 patients, Nissen repair in one, and colon interposition in one. In four patients the myotomy was closed. Complete follow-up averages 5.4 years. There has been one anatomic recurrence, 28 patients are asymptomatic, and five are much improved but have minor persistent dysphagia. Only by complete investigation can the cause of dysphagia be recognized and treated. PMID- 6503322 TI - Experience with the Fontan procedure. AB - From 1975 to the present, 45 patients have undergone modifications of the Fontan procedure for complex congenital heart disease. There were 30 males and 15 females ranging in age from 2 to 38 years (mean 13 years). Primary diagnoses were tricuspid atresia in 19, univentricular heart in 24, and pulmonary atresia with intact ventricular septum in two. Right atrial-pulmonary arterial connections were performed in 32 patients, 11 with conduits (seven with valves and four without) and 21 by direct anastomosis with patch augmentation. Right atrial-right ventricular connections were made in 13 patients, six with valved conduits and seven without conduits. Follow-up ranged from 0.1 to 9 years, with a mean of 2.3 years. There were three early deaths (less than 30 days) (7%) and two late deaths (5%) in this series, all in patients with a univentricular heart. The late deaths were both related to venous hypertension. A venous assist device was used in eight patients in the immediate postoperative period and was effective in improving cardiac output and reducing fluid accumulation. Postoperative Doppler flow studies in 15 patients revealed biphasic pulmonary artery flow in all without distinction between the type of connection or the presence of a valve. Cardiac catheterization was performed in 16 patients a mean of 14 months postoperatively (range 1 to 42 months) and revealed a reduced cardiac index at rest. Exercise testing in eight patients demonstrated a marked rise in right atrial pressure with a reduced rise in the cardiac index, even in those without functional limitations. With a mean follow-up of 2.3 years, 78% of patients were in New York Heart Association Class I, 17% in Class II, and 5% in Class III. We conclude that the Fontan procedure is an excellent operation in carefully selected patients with tricuspid atresia and other forms of complex congenital heart disease. PMID- 6503323 TI - Pulmonary circulatory support. A quantitative comparison of four methods. AB - Profound right ventricular failure was produced in 16 goats by inducing ventricular fibrillation after the systemic circulation had been supported with a left atrial-aortic bypass pump. In each animal, four methods of providing pulmonary blood flow were compared quantitatively: passive flow through the pulmonary artery due to a right atrial to left atrial pressure gradient; pulmonary artery pulsation via a 40 ml intra-aortic type balloon within a 20 mm Dacron graft anastomosed to the main pulmonary artery; pulmonary artery pulsation via a 65 ml single-port, valveless, sac type pulsatile assist device; and right atrial-pulmonary arterial bypass via a valved pneumatic pulsatile pump. Average cardiac index of the 16 animals for each method was 31.1 +/- 12.9, 44.4 +/- 13.6, 64.3 +/- 16.9, and 102.0 +/- 20.7 ml/min/kg, respectively. Passive pulmonary artery flow alone provided inadequate pulmonary circulatory support. Addition of pulmonary artery pulsation via the intra-aortic balloon within a conduit increased cardiac index 13.3 ml/min/kg (43%) above passive pulmonary artery flow (p less than 0.0005); however, the cardiac index remained inadequate. Increasing pulmonary artery pulsation volume with a 65 ml sac device provided a 32.2 ml/min/kg (106%) increase in cardiac index above passive flow (p less than 0.0005) to a level that was marginally adequate. The valved right atrial pulmonary arterial bypass pump increased cardiac index 70.9 ml/min/kg (228%) above passive pulmonary artery flow (p less than 0.0005) to a satisfactory level and is the recommended method of pulmonary circulatory support in profound right ventricular failure. PMID- 6503324 TI - The effects of cardiopulmonary bypass on coronary blood flow in the dog. AB - The effects of cardiopulmonary bypass on autoregulation, maximum coronary flow, and regional blood flow in the heart were investigated in 25 dogs. A Gregg cannula was inserted into the left main coronary artery, and pressure-flow relations were then measured in the autoregulating state or with vasodilation produced by intracoronary adenosine infusion before, during, and after cardiopulmonary bypass. Seventeen of the dogs had radioactive microspheres injected to investigate regional blood flow changes at the same times. (1) Autoregulation was not present after bypass for at least 3 hours. (2) Blood flow was shifted toward the subendocardium on bypass (increased subendocardial/subepicardial ratio) and tended to return to prebypass distribution following bypass. (3) Blood flow after bypass was not significantly different to the subendocardium and subepicardium. (4) Response to a coronary vasodilator (maximum coronary flow) was significantly affected by cardiopulmonary bypass: blood flow to all layers of the heart could be increased with adenosine after bypass. (5) Global lactate and oxygen metabolism were not adversely affected by bypass. We conclude that cardiopulmonary bypass abolished the normal autoregulation of coronary flow; this may predispose the incompletely revascularized patient to a "coronary steal" syndrome. However, the heart with normal coronary arteries is not underperfused in any layer after bypass. Thus, the bypass technique is not the cause of the subendocardial ischemia that sometimes complicates cardiac operations. PMID- 6503325 TI - [Hyperprolactinemia and hypophyseal tumors--results of treatment with bromocriptine]. AB - Forty-one patients with hyperprolactinemia are presented. They were divided into two groups. In the first group, 11 or 27% women had radiological evidence of a pituitary tumour. Seven of 11 patients conceived by means of the bromocryptine treatment. The visual impairment in one patient in the tenth week of pregnancy disappeared after the re-institution of bromocryptine. The values of prolactin in this group varied between 4000 and 7000 mIE/ml. In the second group, 30 or 73% women were without radiological evidence of a pituitary tumour. The values of prolactin in this group ranged from 1200 to 5000 mIE/ml. Fourteen of 30 patients conceived by means of the bromocryptine treatment. PMID- 6503326 TI - [Immunoglobulins in women with cancer of the uterine body (before treatment)]. AB - Thirty-five women aged 40 to 79 years with the carcinoma of the body of the uterus were before treatment examined for humoral immunity to find out if the diminished function of the immunological system and immunodeficiency lead to an increased proneness to malignant diseases. Concentrations of total serum proteins, electrophoresis of proteins, and the quantitative determination of G-, A-, and M- immunoglobulins were performed. Lower mean values of IgG (11.94 g/L) and IgA (1.91 g/L) were observed, whereas IgM concentrations did not reveal a statistically significant difference compared with healthy women. The classes, light and heavy chains, as well as immunoglobulin fragments were investigated by immunoelectrophoresis with monospecific antisera. The results revealed a significant accumulation of certain parts of the immunoglobulin molecule, such as gamma heavy chains (in 63% of patients), kappa (77%) and lambda light chains (37%), and fragments--Fab (37%), Fc (57%) i Fd (40%), showing no antibody properties in comparison with the control group of healthy women. PMID- 6503327 TI - [Recognition of the problem and significance of genitourinary leptotrichosis]. AB - Out of a total of 54,236 outpatient women treated from 1975 up to December 1983, there were 515 cases (relative value 0,010) of leptotrichosis diagnosed on the basis of the analysis of the vaginal smear stained by the Gram and Pappenheim method. Out of this number, there were 664 pregnant women in whom leptotrichosis was diagnosed in 8 cases (relative value o.12). In the urine samples of 5 married couples, the wives being ill with leptotrichosis, the disease was diagnosed in 3 cases, while in men in none. The question is whether leptotrichosis is only a genital or genito-urinary infection in women possibly also in men. PMID- 6503328 TI - [Results of terminal salpingostomy and fimbrioplasty in distal occlusion and tubal phimosis]. AB - Terminal salpingostomy and fimbrioplastics were performed in 108 patients by conventional surgical technique: 78 had bilateral occlusion of the abdominal orifice of the uterine tube with hydrosalpinx, 21 unilateral distal occlusion coupled with stenosis and perisalpingitis on the other side, and 9 bilateral stenosis and perisalpingitis. In all patients other causes of sterility were excluded. The duration of their sterility lasted 2-15 years, while their age ranged from 21 to 40 years. In 96 out 108 patients laparoscopy was applied immediately before operation. Out of 108 surgically treated patients, 22 conceived and gave birth to a child (20%), 2 had abortion (0.92%), and 7 conceived outside the uterus (3.7%). In 72 patients who did not conceive six months after operation, control hysterosalpingography was applied; it showed that 58 patients had one or both tubes unobstructed (80.5%), while bilateral reocclusion was found in 14 patients (19.4%). Hydrotubation was performed by a mixture of antibiotics and hydrocortisone 3-5 days following operation. PMID- 6503329 TI - [Pregnancy and labor in women with heart diseases]. AB - In a ten-year period the frequency of pregnant women with heart disorders amounted to 0.50%. In 83.87% of cases the disorders were acquired and in 16.13% congenital. According to the functional condition of the heart, 95% of the women observed belonged to the first and the second stage. In 82.26% the deliveries were spontaneously vaginal. The frequency of cesarean section proved four times as frequent as that in the control group (P less than 0.05). In not a single case was heart trouble alone the indication for cesarean section. Newborn children of women with heart disorders were slightly asphyxial (Apgar index 7-4) in 9.68% of cases as compared with 5.0% in the control group (P less than 0.05). The average birth mass of these newborns was 3491.9 +/- 2 SD 780.5 g and that in the control group 3,767.5 +/- 2 SD 824.2 g (P less than 0.05). Sixteen (25.8%) newborns in the early neonatal days had one or more neonatal complications, while those in the control group developed such complications in 14.2% of cases (P less than 0.05). Not a single child died perinatally. In the course of pregnancy, delivery, and puerperium only 3 (4.84%) women received cardiotonics and 22 (34.84%) antibiotics. The second day after delivery one puerpera developed paroxysmal tachycardia, while in all the remaining women the course of pregnancy, delivery, and puerperium was normal. PMID- 6503330 TI - [Amniotic fluid embolism in multiple pregnancy in the second trimester of gestation]. AB - A rare case of amniotic fluid embolism in the 26-th week of pregnancy is presented. After the McDonald operation for the repair of the incompetent cervix, a premature rupture of the membranes occurred. After a five-day period of amniorrhea an elevation of the body temperature over 39 degrees C was observed, as well as respiratory distress, cyanosis, and coma. It ended with the patient's death. The pathomorphological finding demonstrated the amniotic fluid embolism of the lung and brain arterioles. PMID- 6503331 TI - [Ganglioneuroma of the suprarenal glands in gynecologic practice]. AB - A 41-year-old patient with enormous tumour in the abdomen, which by its form, size, and position corresponded to a large ovarian tumour, suddenly developed the picture of acute abdomen. Emergency laparotomy revealed a ganglioneurinoma of the right suprarenal gland, 13 X 18 X 20 cm in size, weighing 5.5 kg. The tumour was removed in toto. The postoperative course was normal. So was the finding of the follow-up examination after six months. PMID- 6503332 TI - [The role of clinical examination in the diagnosis of breast cancer]. AB - In Slovenia and Croatia breast cancer is registered as the most frequent kind of cancer in women. In 2951 women clinical findings were compared to those obtained by mammography, thermography, palpation and cytology. The analysis showed a statistically significant difference between them. In the analysed group, 41 patients with cancer were detected, of whom only in 28 (76%) was the disease confirmed by the clinical examination. The results of clinical examinations not satisfactory, especially in the early stage of carcinoma. PMID- 6503333 TI - [Analysis of the levels of gonadotropins and testosterone in the serum and sperm of patients with varicocele]. AB - In 26 patients with clinical varicocele, in 20 patients with "subclinical" varicocele, and in 90 clinically normal patients, measurements of the plasma follicle stimulating hormone (FSH), luteinising hormone (LH), prolactin (PRL) and testosterone were made. In 13 patients pre-operative and post-operative measurements were also performed. The difference in the serum testosterone values in patients with varicocele and in those without varicocele was not statistically significant. The level of FSH and LH markedly higher in the group of patients with subclinical varicocele than in the group with clinically expressed varicocele (p less than 0.05). The difference in the values of FSH, LH, PRL and testosterone in the serum and seminal plasma of clinically normal patients with thermographically verified scrotal hyperthermia due to the reflux into the pampiniform plexus and in those with euthermia was not statistically significant if the quality of the semen was similar. PMID- 6503334 TI - [Development of neural tube defects and genetic counseling]. AB - The analysis of thirty-seven cases of neural tube defects (NTD) resulted in the following conclusions: a) At least eleven cases had the Arnold-Chiari malformation, an autosomal recessive disorder which often remains unrecognized; b) Trisomy 18 and amniotic disease associated with NTD were diagnosed in two newborns; c) In eight cases there was one or more older children with NTD; d) In two families the parents were related. A review of the literature and the exposed data indicate a heterogeneous etiology and an important role of genetic factors in the genesis of NTD. PMID- 6503335 TI - [The effect of pregnancy on gastric emptying in rats]. AB - 2 ml 25% of glucose have been injected by sond into stomach of 15 nonpregnant and 6 pregnant rats (tenth day of gestation). Twenty minutes later in remaining content of animals' stomach 231,5 mg glucose on an average have been found, and in nonpregnant about one quarter more. The difference is significant, P 0,05. PMID- 6503336 TI - [The importance of histaminergic H1 and H2 receptors for the contractile effect of histamine on human umbilical veins]. AB - Influence of histamine and histaminergic H1 blockers (antazoline, promethazine) and H2 blockers (cimetidine, ranitidine) on isometric contraction of helically cut strips of human umbilical vein was examined. Histamine produced dose-related contraction of the vein strip, while histaminergic H1 and H2 blockers did not changed the tonus of the vein. The contractile activity of histamine was not influenced by cimetidine or ranitidine, while antazoline and promethazine antagonized mentioned activity of histamine completely. We suppose that histamine exerts contractile effect of human umbilical vein by acting on H1 receptors while H2 receptors are not involved in the mentioned activity of histamine. PMID- 6503337 TI - [Personal experience with the extraction of "lost" intrauterine devices by the Soonawalla method]. AB - From 1981 to 1983, 3660 intrauterine contraceptive devices were taken away, in 278 cases by the modified extractor after Soonawalla, because the short tread of the device was broken or drawn into the uterus. The most frequent indication for the removal of the device was irregular bleeding. Prior to extraction, X-ray and ultrasound were used to determine the position of the device in the uterus. PMID- 6503338 TI - [A full-term second abdominal pregnancy]. AB - A case is described of abdominal pregnancy in a 27-year-old patient with a previous salpingectomy of the right tube performed because of tubal pregnancy. The patient was hospitalized in the 22nd to the 28th week of pregnancy on suspicion of imminent abortion. Clinical and ultrasound examinations indicated intrauterine pregnancy, by just before the expected date of delivery, clinical symptoms suggested abdominal pregnancy. The oxytocin test was negative. Following laparotomy a live normal girl was born, weighting 3200 g. The placenta was inserted at the front wall and the right horn of the uterus from the outer side. In the right horn there was an opening at the site of the oviduct excision. Because of profuse bleeding, the uterus was amputated supravaginally. PMID- 6503339 TI - [Abdominal pregnancy terminating with a liveborn child]. AB - A case is presented of abdominal pregnancy in a pregnant woman with two previous deliveries and four spontaneous abortions. She was cachectic, had spider nevi, and palmar erythema. Hepatic insufficiency was suspected. In the 35th week of pregnancy, severe pain appeared in the epigastrium and a detailed examination indicated abdominal pregnancy. Following laparatomy, a liveborn was extracted, weight 1800 g, height 45 cm, without any malformations. Owing to an unfavourable insertion of the placenta and the patient's very bad condition, the placenta was left in situ, with the drainage of Douglas' space. Fourteen days after operation, the placenta was easily removed by relaparotomy. It was partly hyalinized and partly necrotic. PMID- 6503340 TI - [Extrauterine pregnancy for the 4th time in the same patient]. AB - A patient, aged 23, first underwent conservative operation for oviductal pregnancy three times (once in the right and twice in the left oviduct), and then cesarean section (a full-term liveborn). Three years following cesarean section, because of tubal pregnancy, salpingectomy of the left tube and the ligation of the right tube stump were performed on the patient's wish for sterilization. Each time tubal pregnancy was verified histologically. PMID- 6503341 TI - [Cervical pregnancy (case report)]. AB - In a 28-year-old patient, without menstruation for 2 months, curettage was performed on suspicion of an incomplete abortion. Owing to a profuse bleeding, cervical pregnancy was suspected and the patient was at once operated on, abdominal hysterectomy was applied, and cervical pregnancy was confirmed histologically. In the uterine corpus adenomyosis was revealed. This might have aggravated a normal nidation of the ova and contributed to the development of cervical pregnancy. PMID- 6503342 TI - [Femoral fracture in a child during spontaneous delivery in the occipital position]. AB - A case of the femoral fracture in a child during spontaneous delivery by vertex presentation is described. The newborn was a male, weight 3600 g, height 52 cm, Apgar score 10. When and how such a fracture occurs under the action of labour forces and its medico-forensic significance are discussed. PMID- 6503343 TI - [Intramuscular administration of Prostin for abortion in the second trimester]. AB - The effect of Prostin (15/S/15 methyl prostaglandin F2 alpha) ampules applied intramuscularly to induce abortion in the second trimester of pregnancy was investigated. Out of 30 women who underwent the treatment, 28 (93.3%) cases were successful and 2 (6.7%) unsuccessful. The average time from the application of the medicament to the output of the ovulum was 30.04 hours. The medicament proved to have a strong uterotonic effect associated with highly manifested side effects, such as vomiting, diarrhea, nausea, perspiration, etc. Among serious complications due to the Prostin application, a single case of an incomplete low uterine rupture and one case of the cervical rupture (6.6%) were evidenced. PMID- 6503344 TI - [Cervical pregnancy--conservative or radical operation?]. AB - Artificial abortus was induced in a 26-year-old patient in the 8th week of pregnancy. Within a month, curettage was applied three times on suspicion of a remaining small portion of the fetus. Only during the third curettage was a defect of the posterior cervical wall observed. The posterior cervical up was then incised, and the defect edges excised up to the unaffected tissue and sutured. Cervical pregnancy was diagnosed histologically. PMID- 6503345 TI - A pressure-regulated partial vena cava obstruction for the control of hypertension. PMID- 6503346 TI - Pacemaker electrodes and problems related to cardiac pacing and sensing: current solutions and future trends. AB - The current status of cardiac electrical stimulation requires electrodes improvements both in pacing and sensing features. A short overview of today's electrode problems and solutions is followed by the presentation of a new pyrocarbon tip lead. The new tip material and the conception of the lead allow an increase in energy transfer efficiency and a retention of good sensing properties. Clinical experience confirms theoretical expectations. New methods for tissue reaction limitation are under evaluation. PMID- 6503347 TI - Electrical stimulation of motor nerves: results of an animal experiment. AB - In an animal experiment, the effect of long-term electrical stimulation by a totally implanted stimulation system were studied. The threshold value of the femoral nerve of the cat was registered before, during and after the stimulation period. Contraction strength was measured, and after the experiment the histology of the nerve and muscle was examined and compared with the non-stimulated samples. As a result, there was a slight increase in the threshold value after six months, with initially an increase of contraction strength, but after six months there was a decrease to the values measured at the start of the stimulation period. No signs of nerve degeneration were seen except in one nerve. Moreover, no change could be found in the number and distribution pattern of muscle fibres. Although one should be careful in drawing conclusions from an animal experiment when attempting to apply the results to human beings, this method of electrical stimulation might be a reliable therapy in regaining the function of paretic muscles in patients who have a central paresis. PMID- 6503348 TI - Developmental and application of insulin infusion profiles for therapy of type-I diabetics with portable insulin infusion systems. AB - We studied the insulin requirements of seven insulin-dependent diabetics applying a glucose controlled insulin infusion system. The data were transformed into individually programmed and rectangular profiles. The MAGE, a measure of blood sugar fluctuations, was significantly lower when individually programmed step profiles were used (P less than 0.005) than it was when rectangular profiles were applied: 57.7 +/- 24.8 mg/dl vs 89.0 +/- 42.9 mg/dl. The average of measured blood glucose levels was significantly lower in individually programmed infusion profiles (P less than 0.025). The combination of individually programmed profiles and preprandial insulin bolus significantly reduced the postprandial blood glucose level and increase (P less than 0.001). Our investigations suggest that individually programmed insulin infusion profiles are able to smooth blood glucose fluctuations. When combined with an initial insulin bolus they may lead to a reduced insulin consumption after meals. PMID- 6503349 TI - Vascular substitute from human placental arteries: glycosaminoglycan and elastin synthesis in the neo-intimal hyperplasia. AB - Heparinized human placental arteries (internal diameter less than or equal to 1 mm) were cross-linked with glutaraldehyde and implanted in infrarenal aortas in rats (n = 78). At three months and one year following aortic replacement, the neo intimal hyperplasia covering the patent conduits and the host intima media were excised. Glycosaminoglycans (GAGs) and elastin were metabolically labelled in vitro with radioactive glucosamine and valine, respectively. The incorporation of 3H glucosamine into GAGs decreased sixfold in both neo-intima and host intima media from three months to one year. At three months, the 3H label of hyaluronic acid accounted for 66 per cent and 43 per cent of the 3H GAGs in the neo-intima and host aorta, respectively. At one year, 55 per cent of the 3H GAG label were identified as 3H heparan sulphate in the neo-intima and host intima media. From three months to one year, the ratio of chondroitin 4 sulphate (CS 4) to chondroitin 6 sulphate (CS 6) decreased from 6 to 1.5 in the neo-intima, whilst the ratio of CS 4 to CS 6 (0.6) was constant in the host aorta during the experimental period. At one year, the neo-intima contained elastin. The radioactive incorporation pattern of GAGs and the biosynthetic label of valylproline dipeptides indicated a decrease in biosynthetic activity in neo intimal and the host aortic cells with progressing time in vivo. PMID- 6503351 TI - International societies and the King's English. PMID- 6503352 TI - The histogenesis of Kaposi's sarcoma. PMID- 6503353 TI - Fibrogenesis in chronic lymphedema. PMID- 6503350 TI - Effects of lymph stasis on healing of rat intestinal anastomosis. AB - The effects of lymphatic drainage on ileal anastomotic healing using interrupted polyglycolic acid sutures were studied in rats after division and obstruction of celiac-mesenteric lymphatics, and the data compared with sham-operated controls. In 4 of 20 rats with lymph stasis, but not sham-controls, anastomotic leakage was associated with generalized peritonitis and death. Histologic examination of the anastomotic site at 7 and 14 days revealed prolonged exudation with acute inflammatory reaction and less prominent granuloma formation where lymphatics were interrupted. Whereas foreign body giant cell reaction predominated at 14 days with lymph stasis, histiocytic and fibroblastic proliferation dominated in sham-controls. The data suggest that an intact lymphatic system favors optimal intestinal healing and repair. PMID- 6503354 TI - Chylopericardium: a rare cause of pericardial effusion. AB - A 21 year old man presented with asymptomatic, isolated chylopericardium. Despite echocardiography, radionuclide-angiography, computer tomography, and chemical analysis of the chylous effusion, the etiology remained obscure. After patent blue dye infusion into peripheral soft tissues, the appearance of coloring material in the effusion at 4 hours suggested direct communication of the pericardium with an apparently large thoracic duct. Fifteen months later, cardiomegaly persists in site of medium-chain triglyceride dietary restriction. PMID- 6503355 TI - Acetylcholine "tightens" peripheral capillaries independently of pressure effects. AB - We previously showed that acetylcholine (ACh) infused into the abdominal aorta of dogs at a rate of 127 micrograms ACh min-1 caused an increase in lumbar trunk lymph flow (L) of 35% while protein clearance into the lymph (LR) remained unchanged. These effects were accounted for by a 34% increase in reflection coefficient (sigma) and a 54% increase in permeability-surface area product (PS). Since arterial pressure decreased, it was possible that the decrease in arterial pressure was responsible for observed changes. The current study was undertaken to test this possibility. Seven female dogs were anesthetized and prepared in the same manner as the previous study except that control abdominal aortic pressure was reduced with an aortic balloon to a mean of 81 mmHg. As ACh was infused, the balloon pressure was released so that the mean pressure for all dogs rose to 96 mmHg. The findings indicated that ACh produced a 24% increase in L (P less than .004) while LR was unaffected. In a similar fashion to the results of the previous study, sigma increased 43% (P less than .0000) and PS rose 51% (P less than 008). These results clearly dissociate the effects of acetylcholine on permeability from any effects on arterial pressure and indicate a more direct effect of acetylcholine on the permeable segment. The results also suggest a general response of the capillary or postcapillary venule to vasodilation which restricts accession of protein into the interstitium during unloading of the vasculature by the process of edema formation. PMID- 6503356 TI - Skeletal myopathy and magnesium depletion: cellular mechanisms. AB - Muscle weakness and abnormal electrical activity of muscle cells have been described in magnesium-depleted patients and animals. The cellular mechanisms by which magnesium depletion causes the skeletal myopathy are not known. We review here the available clinical and experimental data on the effects of magnesium on: skeletal muscle cellular bioenergetics; excitation-contraction coupling, and biochemical and functional integrity of the cellular membrane. The data suggest that abnormalities in one or more of the above pathways may mediate the myopathy of magnesium depletion. PMID- 6503357 TI - Inhibition of calcium by magnesium in the contraction of rat aortic smooth muscle. I. Mathematical model of calcium and magnesium binding. AB - A mathematical model of the effect of calcium and magnesium binding on muscle tension was developed. The model was tested on aortic smooth muscle tissue obtained from rats fed magnesium-sufficient (Mg: 650 ppm) and magnesium-deficient (Mg: 4.5 ppm) diets. Ca2+ binding constants of 2.51 X 10(3) and 2.3 X 10(3) M-1 were obtained for aortae from magnesium-sufficient and magnesium-deficient rats, respectively. The corresponding Mg2+ binding constants were 0.6 X 10(3) and 0.4 X 10(3) M-1. The data indicate that Mg2+ is a competitive inhibitor of Ca2+ in tension development in rat aortic smooth muscle tissue. PMID- 6503358 TI - Sodium kinetics and membrane potential in aorta of magnesium-deficient rats. AB - In light of the important role of magnesium (Mg) in vascular smooth muscle function, this study was undertaken to examine effects of dietary Mg deficiency on membrane potential (Em), sodium (Na) efflux and distribution, and total ion content in rat aorta. Rats were fed either Mg-sufficient or Mg-deficient diets for 30 days. The aortic arch was removed and a segment incubated in 22Na to monitor kinetics of Na efflux. Another segment was used for measurement of Em under control conditions and during ouabain suffusion. Total tissue water and ion content were also determined. Results of this work indicate that, in aorta from Mg-deficient rats, Em was less polarized and Na accumulated intracellularly. Although the Em in Mg-deficient aorta was not affected by ouabain, which suggested Na-K pump inhibition, Na efflux was greater in Mg-deficient aorta, suggesting increased passive permeability changes to Na as the mechanism responsible for these changes. PMID- 6503359 TI - Reduction of the lethality and the nephrocalcinotic effect of single fluoride doses by magnesium in rats. AB - Magnesium chloride, administered by gavage to fasting young rats, 30 min prior to sodium fluoride, elevated the LD50 for fluoride from 76 to 104 mg/kg body wt. The LD50 was elevated to greater than 180 mg/kg when magnesium was given in a dose equivalent to 2 or 3 times that of fluoride. In two experiments, a dose of 50 mg F/kg caused a mean 14- and 19-fold increase above the level of the control animals in the renal calcium content. The nephrocalcinotic effect of fluoride was nearly completely prevented by administering magnesium in a dose which is 3-fold the equivalent of the fluoride dose 30 min prior to fluoride. PMID- 6503360 TI - Effects of desoxycorticosterone acetate on magnesium metabolism in potassium depleted rats. AB - Metabolic balance studies were performed in two groups of 6 rats each, pair-fed a diet deficient in potassium. While one group was injected with desoxycorticosterone acetate (DOCA) for 11 days, the other group, used as a control, was injected with oil. The administration of DOCA suppressed or reversed the thirst, natriuresis, diuresis, calciuria and magnesiuria that developed in the potassium-deficient control group. Potassium-depleted DOCA-treated rats had a more positive water and sodium balance, experienced a significant expansion in plasma volume, had a more negative potassium balance and had a lower plasma potassium concentration. Magnesium balance decreased in the group fed the diet deficient in potassium and injected with oil but it rose towards control levels in the group fed the same diet and treated with DOCA. As the content of potassium in muscle decreased in rats fed the diet deficient in potassium and injected with oil, the concentration of magnesium in muscle also fell and the plasma concentration of magnesium increased. Thus, the hypermagnesemia of potassium depletion could be explained by the shifting of magnesium from tissue into the extracellular space. The partial compensation of the hypermagnesemia observed in the potassium-deficient group injected with DOCA may be the result of the hemodilution secondary to plasma expansion. PMID- 6503361 TI - Bone mineral density and skeletal fractures in familial benign hypercalcemia (hypocalciuric hypercalcemia). AB - To determine whether familial benign hypercalcemia, or familial hypocalciuric hypercalcemia (FHH), has adverse effects on the skeleton, we measured bone mineral density (BMD) in 31 affected persons from 14 families (16 women and 15 men), ranging in age from 19 to 68 years. Forearm BMD was measured by single photon absorptiometry, and spinal BMD was measured by dual-photon absorptiometry. In addition, we systematically queried 82 hypercalcemic and 52 normocalcemic family members about skeletal fractures. Both men and women with FHH had normal BMD (expressed as grams per square centimeter) in the lumbar spine, distal radius, and midradius. Osteoporotic-type fractures (vertebrae, hip, and distal radius) were virtually absent in both affected and unaffected family members. Detailed evaluation of larger numbers of of older affected persons may be necessary to resolve this issue definitively, but we conclude provisionally that FHH has no important adverse effects on skeletal health. PMID- 6503362 TI - Lack of association of swine flu vaccine and rheumatoid arthritis. AB - On the basis of available incidence rates, about 22,000 new cases of definite rheumatoid arthritis would have developed fortuitously among the 45 million recipients of the swine flu vaccine during the year after the immunization program. No excess has been detected. Proportional morbidity studies among all Mayo Clinic patients and among the active-duty personnel of the US Army showed no increase in the number of cases of rheumatoid arthritis after administration of the swine flu vaccine. These results do not support the claims based on anecdotal reports of an association of the vaccine with rheumatoid arthritis. PMID- 6503363 TI - High-energy versus low-energy defibrillation: experience in patients (excluding those in the intensive care unit) at Mayo Clinic-affiliated hospitals. AB - /he purpose of this study was to determine whether electric shocks of low (200 to 240 J), intermediate (300 to 320 J), or high (400 to 440 J) delivered energy were most successful in defibrillating hospitalized patients (excluding those in intensive care units) in whom resuscitation was attempted by a code emergency team. From January 1980 through December 1982, 101 cases of ventricular fibrillation in 100 patients were treated by Mayo Clinic code emergency teams. Many of the patients in this trial had secondary or agonal ventricular Defibrillation. Most patients (64%) were defibrillated by one to eight shocks. For the first shock, intermediate and high energy seemed to be more effective than low energy. Patient weight, time of delivery of shock 1 after onset of the code emergency, blood pH, acute and chronic medical diagnoses, and pharmacotherapy before the onset of ventricular fibrillation were not clearly related to the response to shock 1. Nine of 16 patients who did not initially respond to shocks of low or intermediate energy were defibrillated when higher energy was subsequently used. Only 14 patients ultimately survived and were dismissed from the hospital. These results suggest that in this patient population, high levels of delivered energy are preferable to low energy for the first shocks administered; we recommend that 400 J of delivered energy be used initially. The 360-J maximal energy dose available in most currently manufactured defibrillators should be sufficiently close to this recommendation to justify use of that dose with the initial shock.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503364 TI - Surgical pathology of pure aortic insufficiency: a study of 225 cases. AB - The gross surgical pathologic features of the aortic valve were reviewed in 225 patients who had had clinically pure aortic insufficiency and aortic valve replacement at our institution during the years 1965, 1970, 1975, and 1980. The four most common causes of aortic regurgitation were postinflammatory disease (46%), aortic root dilatation (21%), incomplete closure of a congenitally bicuspid aortic valve (20%), and infective endocarditis (9%). Other causes of aortic incompetence in our study included ventricular septal defects (2%) and quadricuspid aortic valves (1%); the cause was indeterminate in 1%. The mean age of patients at valve replacement was approximately 50 years for all etiologic factors except a ventricular septal defect. All forms of aortic insufficiency were much more common in male than in female patients, except the postinflammatory and indeterminate types, which occurred approximately equally in both sexes. Moreover, the incidences of postinflammatory disease and aortic root dilatation changed appreciably with time. Before 1980, their incidences were 51% and 17%, respectively, but during 1980, they were 29% and 37%, respectively. Accordingly, aortic root dilatation is now the most common cause of pure aortic regurgitation in our surgical population. The decrease in the incidence of postinflammatory disease may be a result of the decreasing incidence of acute rheumatic fever reported in western countries. PMID- 6503365 TI - Clindamycin versus chloramphenicol in treatment of anaerobic infections: a prospective, randomized, double-blind study. AB - Seventy patients with substantiated anaerobic infections were treated parenterally with clindamycin or chloramphenicol in a prospective, double-blind, randomized study. No significant differences in clinical response or toxicity were noted between the two groups of patients. PMID- 6503366 TI - Electroencephalographic abnormalities in interferon encephalopathy: a preliminary report. AB - Although several studies have shown that interferon does not readily cross the blood-brain barrier, recent reports have described central nervous system effects in patients receiving interferon. At our institution, we encountered three patients who had symptoms of toxicity of the central nervous system (somnolence, confusion, and gait difficulties) in association with electroencephalographic abnormalities while receiving alpha 2-interferon therapy for multiple myeloma. The electroencephalogram showed diffuse slow-wave abnormalities in two of the patients and generalized sharp-wave discharges in the third patient. Because the use of interferon is increasing, physicians should be aware of the central nervous system complications and the electroencephalographic changes that can be associated with such therapy. PMID- 6503367 TI - Invasive Hurthle cell carcinoma of the thyroid: natural history and management. AB - Debate surrounds the natural history and appropriate management of Hurthle cell neoplasms of the thyroid. Some of the uncertainty stems from difficulty in the differentiation of benign from malignant lesions. We report the presentation, management, and outcome of patients with invasive Hurthle cell carcinoma who were examined at this institution between 1946 and 1971. We believe that our review allows us to make reasonable recommendations concerning the management of patients with this type of carcinoma. PMID- 6503368 TI - Cancer metastatic to the thyroid: a diagnostic problem. AB - From 1946 through 1982, 30 cases of distant malignant disease that metastasized to the thyroid were diagnosed at the Mayo Clinic. Although metastatic thyroid lesions are not uncommon, they generally do not pose a problem because they are small or are associated with evidence of obvious widespread metastatic disease. The most common sources of such lesions are the kidney, breast, lung, and lymphoid tissue. The thyroid metastatic lesion may appear many years after the identification and treatment of the primary cancer. Because the thyroid lesion may be the only important malignant disease remaining, adequate surgical treatment may prove to be life-prolonging or life-saving. PMID- 6503369 TI - Familial benign hypercalcemia: nature's solution to neonatal hyperparathyroidism? PMID- 6503370 TI - Thyroid cancer at the Mayo Clinic. PMID- 6503371 TI - Child abuse and neglect: legal implications. PMID- 6503372 TI - Infants' resistance to bacterial infection. PMID- 6503373 TI - Osteoarthritis II: pathology and pathogenesis. PMID- 6503374 TI - Ophthalmological manifestations: a case of familial giant cell arteritis. PMID- 6503375 TI - Waveform analysis for the detection of airways obstruction in man. PMID- 6503376 TI - Moment analysis of multibreath nitrogen washout with a variable input gas composition. PMID- 6503377 TI - Response characteristics of a mass spectrometer. PMID- 6503378 TI - Computer studies of systemic and regional blood flow mechanisms during cardiopulmonary resuscitation. PMID- 6503379 TI - Cardiac assist by intrathoracic and abdominal pressure variations: a mathematical study. PMID- 6503380 TI - Application of a low-pressure differential filtration technique to suspensions of red blood cells. PMID- 6503381 TI - Analysis of the bidirectional optical three-stage prism grating system for red blood cell velocity measurements in microvessels. PMID- 6503383 TI - Validity of the transfer function model of the human arterial system of the lower limb in man. PMID- 6503382 TI - Mathematical model for turbulent blood flow through a disk-type prosthetic heart valve. PMID- 6503384 TI - Application of a bioelectric field model of the ERG to the effect of vitreous haemorrhage. PMID- 6503385 TI - Stationarity of the somatosensory evoked potential. PMID- 6503386 TI - Radial decline of the extracellular action potential. PMID- 6503387 TI - Electrical conductivity of skeletal muscle tissue: experimental results from different muscles in vivo. PMID- 6503388 TI - External recording and processing of fast electrical activity of the uterus in human parturition. PMID- 6503389 TI - EMG system for online gait analysis. PMID- 6503391 TI - Rigid polyurethane foam casts for the fixation of human limbs. PMID- 6503390 TI - Methods of data smoothing for instantaneous centre of rotation measurements. PMID- 6503392 TI - Four-digit LSI counter and controller for neurobiology. PMID- 6503393 TI - Twenty-four hour ambulatory pH recording with computerised analysis. PMID- 6503394 TI - Measurement of the volume displacement of blood-pressure transducers. PMID- 6503395 TI - Decision-modeling methods used to design decision support systems for staffing. AB - This paper explores the merits of two methods that extract the decision models of experts to serve as a decision support mechanism for staffing. One method has experts make judgments about hypothetical cases and the other has experts decompose the decision into criteria weighting and scaling. Staffing models were developed for each method using nurses who work in neonatology wards in two large hospitals. The four decision models were used to predict the demands for nursing time in both hospitals, which were compared with an ex post facto assessment of needs to validate the models. To measure transportability, the author used the model developed in one site to predict nursing hours for the other site. Both methods were found to be acceptable when applied at the site where they were developed. However, the ability to transport either model was negligible, suggesting that universal protocols for staffing do not exist. PMID- 6503396 TI - Foreign and United States medical graduates in practice. A follow-up. AB - A 9-year follow-up study of a national probability sample (n = 865) of foreign medical graduates (FMGs) and United States medical graduates (USMGs) who were house officers in United States hospitals in 1973-1974 reveals that more than three fourths of the alien FMGs were located in the United States in 1983. FMGs were distributed disproportionately across United States census regions (P less than 0.001), specialty areas (P = 0.071), and type of position (P = 0.059). Neither the switching of specialty areas nor the changing among United States census regions was significantly different for FMGs and USMGs. Census regions with net gains of FMGs over the 9-year period included the Pacific, South Atlantic, and West South Central regions, areas with either proportionately higher 1973-1974 USMG concentrations or net USMG gains. The results suggest a gradual assimilation of FMGs into the American medical system from an initial position different than that of USMGs. PMID- 6503397 TI - Sources of referral to alcoholism treatment from two low-income areas in a core city. AB - In this study the authors compare the patterns of referral to alcoholism treatment from two neighborhoods adjacent to a public mental health facility. The areas are alike in terms of socioeconomic status, but they differ in their racial composition and social organization. They hypothesized that referrals to alcoholism treatment originate from self, family, and friends in the organized neighborhood and from police and social service agencies in the unorganized area. Results support the following conclusions: 1) self, family, and friends account for the majority of referrals to alcoholism treatment from both an organized neighborhood and an unorganized area; 2) race and sex explain more variation in referral to alcoholism treatment than does neighborhood social organization; and 3) white female patients are more likely to be institutionally referred than any other group. PMID- 6503398 TI - Developing multiattribute health indexes. AB - This article reviews the procedures for developing a multiattribute health index for use in population health studies and program evaluations. The development of such indexes involves two steps: 1) the creation of a multiattribute health state classification system; and 2) the mapping of the system into a single metric scale. The system must be relevant for its intended use and as concise as possible. Because a limit exists in the number of attributes that can be included in the system while maintaining reliable measurement, there may be a trade-off between specificity of detail and breadth of coverage. When mapping the system into a scale of cardinal values, five issues arise: 1) the selection of a scaling technique; 2) the use of mathematic models to quantify health; 3) the selection of anchor points; 4) the selection of raters; and 5) the identification of factors that influence raters' judgments. The article reviews the procedures that are used, discusses the issues that arise, and proposes some solutions for the development of multiattribute health indexes. PMID- 6503399 TI - Regional differences in hospital utilization. How much can be traced to population differences? AB - Regional differences in hospital utilization are quite substantial, especially between the East Coast and West Coast. To determine whether or not differences in the socioeconomic composition of regional populations explain observed regional differences in hospital utilization, the authors assessed patterns of utilization for a sample of 18,660 New York City residents, 18,881 Los Angeles residents, 10,921 persons living in Northeastern Standard Metropolitan Statistical Areas (SMSAs) and 13,475 persons living in Western SMSAs. The results showed that the New York-Los Angeles difference in hospital days of care decreased from 43% to 22% after adjusting for differences in seven distinct socioeconomic characteristics of the two populations. The Northeastern-Western difference decreased from 18% to -6% (i.e., the Western rate exceeded the Eastern rate after adjustment). Adjusting for differences in socioeconomic characteristics of the local populations affected regional differences in admission rates more than differences in lengths of stay. In the case of New York City, the study also showed that the presence of an unusual number of very long hospital episodes (51 or more days) also is an important explanation of New York's high average stay. The difficulty of identifying posthospital placements for patients needing extended care is thought to cause these long stays in New York City. PMID- 6503400 TI - The relative complexity of primary care provided by medical specialists. AB - Utilizing national data on patient care provided by family practitioners, general internists, and subspecialists in internal medicine, this study examines the complexity of care provided by generalist physicians versus subspecialty physicians on a disease-specific basis. Limiting the analysis to "principal care" provided by office-based physicians, the study finds the complexity of care provided by cardiologists for heart disease and by endocrinologists for diabetes mellitus to be somewhat greater than that provided by family practitioners and general internists, though the magnitude of the differences is not large. For chronic obstructive pulmonary disease, however, pulmonary disease specialists are shown to provide care that is substantially more complex than that provided by their generalist colleagues. For all disease and specialties, hospital care is substantially more complex than ambulatory care. PMID- 6503401 TI - [Presence of fibronectin in cryoprecipitates of essential mixed cryoglobulinemia]. PMID- 6503402 TI - [Incidence and types of anemia in primary hypothyroidism. Sequence of the response to substitutive treatment]. PMID- 6503403 TI - [Influence of exercise on lipid metabolism in type 1 diabetes mellitus]. PMID- 6503404 TI - [Cryoprecipitates and fibronectins]. PMID- 6503405 TI - [Uremia-hemolytic syndrome associated with intake of anovulatories. Apropos of 2 cases]. PMID- 6503406 TI - [Obstetrico-gynecologic complications of oncologic treatments]. PMID- 6503407 TI - [Acute abdomen in a patient with pulmonary tuberculosis and gastric bezoar]. PMID- 6503408 TI - [Pharmacologic therapy of arteriosclerosis: current possibilities]. PMID- 6503410 TI - [Non-surgical treatment of a cerebral abscess]. PMID- 6503409 TI - [Malignant syndrome caused by neuroleptics. A case produced by loxapine]. PMID- 6503411 TI - [How and whom to vaccinate against hepatitis B in Spain]. PMID- 6503412 TI - [Non-bacterial thrombotic endocarditis associated with metastatic adenocarcinoma]. PMID- 6503414 TI - [The inexactitude of sphygmomanometry in the measurement of arterial pressure]. PMID- 6503413 TI - [IgM antibodies against hepatitis B core antigens, anti-HBc-IgM. Their diagnostic significance]. PMID- 6503415 TI - [Consumption of drugs in a sample of rural physicians in the province of Valladolid]. PMID- 6503416 TI - [Advances in hepatitis in 1984]. PMID- 6503417 TI - [Aspirin and dipyridamol or preventive diet]. PMID- 6503418 TI - [Course of hepatitis B virus infection in HLA-identical sisters]. PMID- 6503419 TI - [Calcification of soft tissue in systemic lupus erythematosus]. PMID- 6503420 TI - [Extrathoracic anthracosis]. PMID- 6503421 TI - [Neurolytic block of the celiac ganglia in the treatment of pain caused by chronic pancreatitis]. PMID- 6503422 TI - [Forced maximal expiratory flow at an altitude of 5,600 meters]. PMID- 6503423 TI - [Munchausen's syndrome in children]. PMID- 6503424 TI - [Drug consumption in Valladolid and its province]. PMID- 6503425 TI - [Leiomyosarcoma of the splenic hilus: cause of a febrile syndrome]. PMID- 6503426 TI - [Notification of possible adverse reactions to drugs in medical publications]. PMID- 6503427 TI - [Are dyslipemias a risk factor in cerebral vascular disease?]. PMID- 6503428 TI - [Subacute cerebellar degeneration and Hodgkin's disease]. PMID- 6503429 TI - [Disorders of auriculo-ventricular conduction in sick sinus syndrome]. PMID- 6503430 TI - [IgA nephropathy]. PMID- 6503431 TI - [Response of prolactin to cimetidine in males with hypogonadotropic hypogonadism or delayed puberty]. PMID- 6503432 TI - [Sick sinus syndrome and its results]. PMID- 6503433 TI - [Technics of image analysis and their application in pathologic anatomy]. PMID- 6503434 TI - [Extracapillary proliferation and pulmonary hemorrhage in the development of idiopathic membranous nephropathy]. PMID- 6503435 TI - [Cold tuberculous abscess as a cause of a unilateral adrenal mass]. PMID- 6503436 TI - [Cystic fibrosis in the adult]. PMID- 6503437 TI - [Double myeloma with mediastinal involvement]. PMID- 6503438 TI - [High calcitonin as a probable cause of sustained diarrhea in medullary carcinoma of the thyroid associated with Cushing's syndrome]. PMID- 6503439 TI - [Carcinoma of cutaneous adnexa: an unusual cause of meningeal carcinomatosis]. PMID- 6503440 TI - [Pleural needle biopsy]. PMID- 6503441 TI - Medical information science as 'science'. PMID- 6503442 TI - 'Medical information science': insisting on a name can blunt its impact. PMID- 6503443 TI - Career paths in medical information science. PMID- 6503444 TI - Medical information science: is it science? PMID- 6503445 TI - What are the medical information sciences? PMID- 6503446 TI - Informatics: a filing cabinet definition. PMID- 6503447 TI - Medical information science: its scientific and engineering aspects. PMID- 6503448 TI - Medical information science and application: the convergence of modern technologies. PMID- 6503450 TI - Some preliminary thoughts on medical informatics as a discipline. PMID- 6503449 TI - Issues in medical information science. PMID- 6503451 TI - Medical decision support systems: from theory to practice. PMID- 6503452 TI - The medicine-compatible computer: a challenge for medical informatics. PMID- 6503453 TI - The diffusion of computer applications in medical settings. PMID- 6503454 TI - Hospital information systems. What lies behind friendliness and flexibility? PMID- 6503455 TI - Education and research in medical information science. PMID- 6503456 TI - Validation of computer systems in clinical settings. PMID- 6503457 TI - Medical information and uncertainty. PMID- 6503459 TI - The principal research issues. PMID- 6503458 TI - What are the limiting factors in practitioner's uses of computers: the key research question. PMID- 6503460 TI - Training in medical information science: a critical perspective. PMID- 6503461 TI - Vertical and horizontal curricula: how they can work together in the integration of medical computer science and the classic medical sciences. PMID- 6503462 TI - A model of training needs in health information science. PMID- 6503463 TI - Education of specialists in medical informatics: the Heidelberg/Heilbronn experience in the Federal Republic of Germany. PMID- 6503464 TI - Training for a research career in medical information science: how much is enough? PMID- 6503465 TI - The baby roared--What do you tell the parents? PMID- 6503466 TI - Medical informatics: some practical suggestions for implementation. PMID- 6503467 TI - Why a teaching hospital needs a department of medical informatics. PMID- 6503469 TI - Education and medical information science. PMID- 6503468 TI - The teaching of medical computation. PMID- 6503470 TI - Health education for the twenty-first century. PMID- 6503471 TI - Statistical analysis of performance of a liquid chromatographic assay of anticonvulsants involving solvent-demixing extraction and reciprocal internal standardization. AB - Analysis of variance both factorial and nested was used to validate a HPLC method intended for routine clinical assay of ethosuximide, phenobarbital, phenytoin and carbamazepine. Drugs were salted out, together with the solvent, from 0.5 ml acetonitrile-deproteinized plasma samples with 80-90% recovery. The acetonitrile extraction solution contained a known amount of all four drugs. This added amount of any drug was used when absent from plasma as an internal standard for those present and when present as a calibrator. Results showed that assay precision was acceptable (CV 6%) over and above the therapeutic range when additions did not exceed the lower therapeutic plasma level and if as many replications were made as there were drugs to assay. In return for some loss of sensitivity, reciprocal internal standardization provides increased assay reliability owing to the usual availability of more than one internal standard and to easier identification of interfering chromatographic peaks. PMID- 6503472 TI - Energetic, metabolic and contractile effects of vasopressin in mammalian heart. AB - The effects of arginine vasopressin (VP), 8 mU/ml, on contractility, heat production and glucose metabolism were investigated in isolated, arterially perfused, interventricular rabbit septa. Rest tension linearly increased in the presence of VP with a slope of 0.095 +/- 0.008 g/min. Developed tension (DT), maximal rate of tension development (+dT/dt)max and maximal rate of relaxation ( dT/dt)max showed a biphasic response in the presence of VP. The first phase showed a rapid decline in all three contractile parameters [DT, (+dT/dt)max and ( dT/dt)max] with a half time of 4.4, 3.3 and 4.6 min, respectively. This rapid decline was followed by a recovery period that occurs with an increase in glycolytic flux and on lactic acid production. Along with the effects on contractile parameters, VP increases the ratio heat production over developed tension (40% over control values), indicating that in the presence of VP "muscle efficiency" decreases since it is energetically more costly to generate a given level of isometric tension. This was further confirmed by experiments performed under low Ca conditions (150 microM Ca Cl2) in which, while VP showed no significant changes on contractile parameters, myocardial heat production and heat production over developed tension increased. PMID- 6503473 TI - Effects of cholinomimetic drugs on reptilian atrial muscles. AB - The effects of some cholinomimetic drugs have been examined on isolated atria of rainbow lizards (Agama agama Linn.) and land tortoises (Kinixys spp. Linn.). Acetylcholine (ACh, 10(-8) - 5 X 10(-5) M) caused concentration-dependent, atropine-sensitive, negative chronotropic or inotropic responses in isolated spontaneously-beating right or electrically-driven left atria of rainbow lizards and land tortoises. This prototype cholinergic drug (ACh, 10(-8) 5 X 10(-5) M) also induced atropine-sensitive, concentration-related negative chronotropic or inotropic responses in isolated atrial muscles taken from guinea-pigs. Histamine (10(-8) - 5 X 10(-5) M) produced concentration-related positive chronotropic or inotropic responses in isolated spontaneously-beating right or electrically driven left atria of rainbow lizards and guinea-pigs without significantly affecting (P greater than 0.05) the tortoise atria. 5-Hydroxytryptamine (5-HT, 10(-7) - 5 X 10(-5) M) induced concentration-dependent positive chronotropic or inotropic responses in isolated, spontaneously-beating right or electrically driven left atria of rainbow lizards, tortoises and guinea-pigs. Nicotine (10(-8) - 5 X 10(-5) M) had no effect on the rate of beating of the lizard or tortoise isolated right atria, but caused concentration-dependent positive chronotropic responses in spontaneously-beating isolated right atria of the guinea-pig. Furthermore, nicotine (10(-8) - 5 X 10(-5) M) had no effect on contractile tension of isolated, electrically-driven left atria of the tortoise; it induced a biphasic inotropic response in driven left atria of the rainbow lizard and produced a concentration-related positive inotropic response in electrically driven isolated left atria of the guinea-pig.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503474 TI - Sorbent therapy of the porphyrias. III. Comparative efficacy of experimental plasma perfusion with several commercial hemoperfusion cartridges. AB - The manifestations of the acute attack of an hepatic porphyria may result from the actions of the excessive amounts of delta-aminolevulinic acid (ALA) or porphobilinogen (PBG) that accumulate during the event. Adsorption and removal of these materials by a solid phase sorbent may be an effective rapid treatment of the attack. We have compared the rate at which 5 commercial charcoal hemoperfusion cartridges remove ALA and PBG from an in vitro system, to ascertain if any of these may be useful in the treatment of the porphyric attack. Solutions of ALA (3.0 mg/L in plasma) or PBG (1.5 mg/L in saline) were circulated from a reservoir through the cartridge and back to the reservoir. Clearances (ml/min +/- SD) of ALA or PBG were determined from their concentration in both the reservoir (kept nearly constant by periodic addition of solute) and the cartridge effluent. For ALA, clearances decreased in the order Hemosorba (118 +/- 15), two Detoxyl 2 devices in series (93 +/- 17), one Detoxyl 2 (72 +/- 16), Adsorba 300 C (52 +/- 12), Haemocol 100 (48 +/- 14) and Hemodetoxifier (46 +/- 17). Differences in ALA clearance between the Hemosorba, one or two Detoxyl 2 cartridges and all other cartridges were of high statistical significance. For PBG, clearances decreased in the order Hemosorba (1462 +/- 23), one Detoxyl 2 (719 +/- 89), Adsorba 300 C (477 +/- 131), Hemodetoxifier (376 +/- 75) and Haemocol 100 (48 +/- 13). Differences in PBG clearance among all cartridges were statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503475 TI - The intracutaneous stimulus: a new pain model for algesimetric studies. AB - An intracutaneous pain stimulus is described for psychophysiological studies in man, which can easily be applied and which elicits highly reliable pain reactions in sessions repeated on different days, as well as in long-lasting sessions within a single day. The common electrical skin stimulation technique was modified by producing a circumscribed reduction in skin resistance under the stimulating electrode. A standardized procedure is described to reproducibly reduce this resistance by a factor of about 0.1 in a defined skin area of 1 sqmm. After this procedure, a definite and clear pain sensation could be elicited by current pulses which did not cause any sensation when conventionally applied. The reproducibility of pain reactions (pain ratings and late cerebral potentials) was tested in single sessions lasting up to 8 hours, as well as in weekly repeated experiments. First examples for applying these stimuli in algesimetric studies are given by double blind experiments with meperidine. PMID- 6503476 TI - [Stay in the shadow waiting for varicella!]. PMID- 6503477 TI - [Antabus is unsuitable in treatment of borderline personalities]. PMID- 6503478 TI - [A method for measuring the mobility of the ankle joint during weight bearing]. PMID- 6503479 TI - [Anxiolytic-hypnotic drugs in legal medical care--extent of use and abuse]. PMID- 6503480 TI - [Abdominal pregnancies in Sweden resulting in live infants 1970-81]. PMID- 6503481 TI - [Risk factors for premature death in middle-aged men in Malmo]. PMID- 6503482 TI - [Hemiplegic cerebral paresis--brain injury with predominantly a prenatal background?]. PMID- 6503483 TI - [Familial hypocalciuric hypercalcemia]. PMID- 6503485 TI - [Diagnosis related groups--a prescription for higher health care cost?]. PMID- 6503484 TI - [The resuscitation of a hanged man--an unusual case report]. PMID- 6503486 TI - [Endoscopic/histological diagnosis should be aimed at suspected colonic cancer]. PMID- 6503487 TI - [A cognitive-therapeutic relationship used at an emergency admission department]. PMID- 6503488 TI - [Claims for malpractice and complications following legal abortions 1975-1979]. PMID- 6503489 TI - [Claims for malpractice and complications following female sterilization 1975 1979]. PMID- 6503490 TI - [Psychotherapy in irritable colon and duodenal ulcer--an effective complement to drug therapy]. PMID- 6503491 TI - [[The effect of gastrointestinal diseases on fertility, pregnancy and breast feeding. Symposium]. PMID- 6503492 TI - [Roentgen study of suspected brain abscess]. PMID- 6503493 TI - [Local intra-arterial injection of reserpine in severe ischemia of the extremities--a good effect on ergotism]. PMID- 6503494 TI - [Noisy toys--a risk of hearing injuries?]. PMID- 6503495 TI - [Nutrition and food traditions among immigrant children]. PMID- 6503496 TI - [Combined Colles' and scaphoid fractures]. PMID- 6503497 TI - [Prolonged diarrhea in a patient taking diflunisal]. PMID- 6503498 TI - [Pancreas head resection in chronic pancreatitis]. PMID- 6503499 TI - [Duodenum-sparing pancreas head resection in chronic pancreatitis--results after 10 years' use]. AB - During a ten years period duodenum preserving pancreatic head resection was performed in 56 patients with chronic pancreatitis and related pancreatic head tumor. Immediate lethality was 1.8%, rate of reoperation 3.6%, late lethality after an average follow-up of 24 months (minimum 1, maximum 124 months) 3.6%. At the time of follow-up 87.3% of the patients were back at work, 58% were free of abdominal symptoms, 7.4% complained about occasional to frequent abdominal pains. 72.9% gained weight postoperatively. Duodenum preserving pancreatic head resection constitutes the subtotal resection of the pancreatic head and jejunal interpostition for the parenchymal defect. The procedure is advantageous as compared to Whipple's operation in so far as stomach, duodenum and bile duct remain intact. PMID- 6503500 TI - [Dynamic computer tomography following vascular operations in aortic aneurysms or aortoiliac occlusive disease]. AB - Thirty-five aorto-iliac reconstructions (27 aorto-bifemoral Y-grafts, two aortic tube grafts, one aortic endarterectomy, 5 ileo-femoral bypass operations) were studied by CT-scans one week to seven years postoperatively. A General Electric CT/T 8800 with Dynapak software was used. Coronary, sagittal and oblique reconstructions as well as time-density diagrams were performed. There were normal CT-findings in 22 patients (63%), excessive Neointima formation in seven, graft occlusion (one limb of Y-graft) in three, prosthetic dilatation in two and suspicious graft infection in one patient. Patent bypasses showed enhancement of contrast medium. CT-scans corresponded with clinical findings in all instances. Because of its non-invasiveness, assessment of perivascular alterations and semiquantitative measurements dynamic CT is applicable in the follow-up of aorto iliac arterial reconstructions. PMID- 6503501 TI - [Effect of local moderate hyperthermia in combination with chemotherapy by N nitroso-1,3-bis-(2-chloroethyl)urea (BCNU) on the descending colon of the rat with transplanted Yoshida sarcoma. 2. Monochemotherapy in combination with subsequent hyperthermia at various time intervals]. AB - There are numerous reports on in vitro and in vivo investigations of hyperthermia for cytostasis of malignant tumors. Combination of chemotherapy and hyperthermia is to potentiate the therapeutic effect. The time interval between the two types of therapy was the main subject of the present investigation. Local hyperthermia (43 degrees C, 60 min) following BCNU chemotherapy at intervals of 0, 3, 6, 9, 12, and 24 h, respectively, was studied in a colonic Yoshida sarcoma model in Sprague-Dawley rats. No significant increase in the curing rate resulted from hyperthermic treatment. The results suggest that the highly anticipated hyperthermic peritoneal lavages should be investigated in controlled animal experiments prior to clinical use. PMID- 6503502 TI - [Relaparotomy following stomach operations]. AB - From 1977-1982, 1.442 operations of the stomach were performed. In 82 cases a relaparotomy was necessary. In 27 cases the cause was peritonitis with anastomotic insufficiency. 7 patients had generalized peritonitis without anastomotic leakage. 14 had to be reopened because of localized abscesses. 11 patients had a bowel obstruction, 7 patients massive postoperative bleeding. 6 cases developed severe pancreatitis with peritonitis and 5 others developed bile leakage. The rest had several other complications. 47.6% of the reoperated patients died, most of them because of surgical complications. Therefore immediate reoperation should be performed before severe complications occur. PMID- 6503504 TI - [Sigmoid cancer: left hemicolectomy or segmental resection?]. PMID- 6503505 TI - [Proceedings of the German Surgical Society. 101st session, 25-28 April 1984]. PMID- 6503503 TI - [Gunshot injuries in peacetime and their therapy]. AB - Between 1976 and 1982 46 patients with gunshot injuries (43 m., 3 f.) were seen at the University of Heidelberg Department of Surgery. Frequent causes of injury in 42 adults (40 m., 2 f.) and 4 children (3 m., 1 f.) were suicide attempts (19) and carelessness in the handling of shotguns (11). Criminal offence was related to nine injuries; no retrospective classification of the event causing the injury was possible in further seven cases. Affected in descending order of frequency were brain and lung (10 each), soft tissue of thigh (9), intraabdominal organs (5), heart (4), liver and bone (3 each), blood vessels (2) and facial skull, penis, buttock, neck and mediastinum (1 each). Six patients suffered from combined injuries, in three cases a combined abdomino-thoracic injury was seen. Whilst suicidal injuries of the skull are related to poor prognosis, other peacetime gunshot wounds are less problematic when compared to military gunshot wounds due to the lower speed of the projectiles. Therapeutic procedures follow the general rules of open treatment of injuries including prophylaxis against tetanus and botulism as well as systemic antibiotic therapy. In general abdominal and abdomino-thoracic gunshot wounds as well as vascular injuries require immediate surgical procedure. In isolated thoracic injuries a conservative approach may be justified depending on the situation. The same rule applies to fractures caused by gunshots. PMID- 6503507 TI - [The spine]. AB - Spinal injuries must be divided into stable and unstable lesions. Stable fractures are treated functionally, in unstable cases a decision must be made whether conventional treatment will be satisfactory. Severe kyphosis or chronic instability must be avoided. Open reduction and spinal fusion are recommended very early, if conventional therapy is not successful. Surgical risks are minimized by technical standards. PMID- 6503506 TI - [Stress tolerance of patients following fractures of the lower extremities]. AB - In bone fractures in the lower extremities a high blood loss must be taken into consideration. An adequate blood transfusion should be given before and during diagnostic procedures. Diagnostic measures should proceed quickly and be limited to the necessary treatment. Operative setting of closed fractures can be programmed when conditions are optimal. Immediate setting of open fractures has proven to be valuable not only because the blood loss may be controlled, but also because extensive soft tissue distraction and possible infection can be prevented. The crush-syndrome can be caused by crushing injuries, pluck-out injuries and traumatic amputation and endanger the patient's life. PMID- 6503508 TI - [Esophageal cancer]. AB - Surgery of oesophageal cancer has a high risk demonstrated by the hospital lethality. 72 resections of the oesophagus done by one surgeon are analysed. The following parameters were used: 1) a nutritional index developed in carcinoma patients in a prospective analysis, 2) the EKG result, 3) the lung-function. Adding these 3 indices we get a certain correlation between the judgement of the preoperative risk and hospital lethality. The preoperative criteria of risk are essential for patients with cancer of the oesophagus since we have to choose among 3 groups of surgical treatment, the risks of which are significantly different. PMID- 6503509 TI - [Stress tolerance of patients with hemorrhage from ulcus ventriculi sive duodeni]. AB - 448 patients with severe haemorrhage from gastroduodenal ulcera during the last 15 years are presented. Within this period indication, organisation and the choice of method have changed in 3 phases. Included are the endoscopic diagnosis and treatment with very good results. As a result of endoscopy there is a negative selection of patients for surgery causing a depression of the results after surgical treatment. The propagation for early indication even in high risk patients still has validity. PMID- 6503510 TI - [Stress tolerance of pancreatic cancer patients]. AB - The patient with pancreatic carcinoma is tested in 4 phases: during diagnosis the non-invasive procedures take precedence; as regards pre-operative treatment, primary biliary decompression seems to bring no advantages in the icteric patient; the indications for various treatment forms show a resectability rate of only 13%; the final test is the mortality rate of the treatment selected: in 200 duodenopancreatectomies it amounted to 2.5%. PMID- 6503511 TI - [Liver tumors and parasites]. AB - The risk of a liver resection is determined by 3 factors: 1. Extent of the tumor 2. functional reserve of the remaining tissue 3. technique of resection. ad 1: Ultrasound and computed tomography are the most important methods to find out a liver tumor. ad 2: A modified model to judge the functional reserve is presented by means of the galactose-elimination-test, amino-pyrin-exhalation-test and indocyanin-green-test. ad 3: It is most important to avoid intraoperative blood loss. PMID- 6503512 TI - [Chronic inflammatory bowel diseases]. AB - Surgical decision making in inflammatory bowel disease also includes aspect of the patient's general condition. If conservative therapy fails surgical therapy in ulcerative colitis and diverticulitis is a curative procedure. In Crohn's disease the situation is principally different. Conservative and surgical treatment being only symptomatical, they cannot lead to a definite cure. Quality of life and disease-free interval must be compared to the general risk, i.e. lethality and morbidity of conservative therapy as well as of surgery. The analysis of our own patients shows a minimal risk after surgery. PMID- 6503514 TI - [Colon and rectal cancer]. AB - The therapeutic risk for patients with colorectal carcinoma has been reduced considerably by operation-accompanying measures (alimentary preparation, antegrade irrigation, perioperative antibiotic prophylaxis). Thus, the number both of resections as well as of curative operations increased and the prospects of continence-preserving operations of rectum cancer improved. The temporary transverse colostomy in leftside resection is extremely controversial, the author recommends its generos employment. The indications for the resection according to Hartmann and for palliative local tumor excisions in case of imponderably high therapeutic risk are suggested. PMID- 6503513 TI - [Diagnosis and therapy of ileus]. AB - This disease caused by intestinal obstruction progresses rapidly. Therefore diagnosis and therapeutic procedures have to be performed quickly. Whereas the diagnosis of the ileus itself can be made by simple methods which do not discomfort the patient, diagnosis of localization and etiology of bowel obstruction causes considerable strain for the patient. Nevertheless X-ray investigations and endoscopy have proved to be effective. Therefore these methods can be recommended in special cases. Operative procedures of ileus treatment have to be adapted to the patient's condition and cannot be generally recommended. PMID- 6503515 TI - [Use of lasers in esophageal and stomach surgery]. PMID- 6503516 TI - [Stress tolerance of the patient in pediatric surgery]. AB - In pediatric surgery pain and suffering are not those dominant problems as in adult surgery. So even an extended operative procedure can be performed in a child without hesitation, if it seems to be useful. Much more than in adult medicine, the pediatric surgeon has to consider the consequences of his treatment on the whole family, esp. on the patient's mother. There is a lack of experience concerning toleration of a pregnancy by a mother who knows already about a treatable malformation of the fetus. Two cases are presented: omphalocele and gastroschisis. PMID- 6503517 TI - [Stress tolerance of the patient in vascular surgery]. PMID- 6503518 TI - [Stress tolerance in general thoracic surgery]. AB - The degree of lung tissue-reducing operative procedures is determined by the functional reserves of the patients. The borderline functional reserves are well defined. The 30 days postoperative lethality may be regarded as the criterion for the immediate stress due to the surgery of the bronchial carcinoma. It amounts for pneumonectomies to 6-7% and for lobectomies to 3-4%. An unsolved problem is bifurcation surgery, which still leads to a lethality of 30%. Simultaneous bilateral resection of lung metastases has to prove its efficacy by long term observation employing an interdisciplinary concept. The operation lethality of the mesothelioma has decreased to 12%, long term observations are still missing. PMID- 6503519 TI - [Plastic surgery]. AB - Not only by coincidence surgeons tend to qualify a patients stress by physical factors only. In plastic surgery the psychological situation of the patient very often is paramount, especially in surgery dealing with function of appearance. Sometimes the declared motives of the patient hide emotional disorders. Irrealistic expectations are confronted with results. The text aims at a short typology of physiological stress in plastic surgical patients and its somatic consequences. PMID- 6503520 TI - [Burns--introduction and organizational tasks]. AB - A generally accepted treatment of severe burns has not yet been established. Important demands, such as early excision and avoidance of a granulating surface have not been asserted. Treatment frequently lasts too long, is too expensive, and results are disappointing. Organising preconditions are presented, increase of burn-centres and exact documentation of burns are postulated. PMID- 6503521 TI - [Secondary immunodeficiencies following severe skin burns]. AB - Despite of modern fluid resuscitation, electrolyte management and respiratory care techniques 70% of severely burned patients often survive the early posttraumatic phase only to later succumb to septic complications. Acquired deficiencies in host defense mechanisms are largely held responsible for this increase in susceptibility to sepsis. The thermal insult affects the complex interactions of cells of the immune system by generation and release of suppressive mediators which, in turn, either cause defective cellular functions or overstimulation of regulatory pathways of host defense. PMID- 6503522 TI - [First aid at the accident site--immediate measures at the hospital in burn cases]. AB - First aid on the scene of the accident consists in case of burns in removal of clothing, cooling with water (20 degrees C) and wrapping in metallic sheet dressing or sterile linen. Hands are dressed with non-adherent gauze and immobilized on splints in a functional position. No application of burn ointment, powder or cream. I.v. pain therapy with morphine derivates. Intravenous infusion (30 ml Ringer's lactate/kg bodyweight/h) tetanus prophylaxis. Hospitalization of all burn wounds of 15% of the body surface or more. Continuation of infusion therapy according to the exact balancing of water and electrolyte metabolism. PMID- 6503523 TI - [Early treatment of burn wounds]. AB - Primary excision and immediate grafting are limited by blood loss and donor areas. This may never prevent primary excision of burnt hands and face. Excision should be limited to about 20% of the body surface. Delayed primary excision is recommended after pretreatment with Iodine solution, 5% tannic acid solution, and 10% silver nitrate solution. This prevents infection for several weeks when second degree burns healed spontaneously under the artificial scab. Autografts are preferred; if donor areas are lacking staged excision and Chinese intermingled transplantation are performed using homografts containing small autograft islands for covering up to 300 cm2 with 1 cm2 autograft. PMID- 6503524 TI - [Peculiarities of anesthesia in severely burned patients]. AB - The main problem of anaesthesia for necrectomy and grafting is the correct evaluation of blood loss. Intensive monitoring enables one to avoid major complications. One has to have at least two venous lines of large calibre. Loss of volume is substituted by packed erythrocytes, fresh frozen plasma, warm whole blood and crystalloids. No particular type of anaesthesia is to be preferred. One should avoid depolarizing muscle relaxants between 5 to 90 days after the burn. Because of the possibility of microstomia and contractures the anaesthetist should be familiar with the technique of bronchofiberscope intubation. PMID- 6503525 TI - [Positioning, care and physical therapy in severely burned patients]. AB - Positioning, medical care, and physiotherapy for severely burned patients represent essential parts of the treatment in the complete plan of full rehabilitation and resocialization. From the beginning an individual programme for each patient must be organized in joint planning with the physio- and ergo therapists and be carefully controlled. PMID- 6503526 TI - [Facial burns]. AB - Deep partial and full thickness facial burns require early skin grafting. Pressure face masks and local steroids reduce hypertrophic scarring. Split skin and Z-plasties are used for early reconstructive surgery. Only after softening of the scar tissue definite reconstructive work should be undertaken. For this period full thickness skin grafts and local flaps are preferred. Special regional problems require skilled plastic surgery. Reconstructive surgery is the most essential part of the rehabilitation of severe facial burns. PMID- 6503527 TI - [Reconstruction in burn injuries]. AB - In third-degree burn injuries vital, functional or esthetic indications require surgical therapy. In order to keep the risk of infection as low as possible it is necessary to begin with the necrectomy as soon as possible. Extent and depth of the damaged tissue, the degree of the wound infection as well as the patient's physical condition decide whether the defect should be covered temporarily or whether an autologous splitskin transplantation should be performed. In addition to stripe transplants meshgraft-transplants of different sizes have proved to be very successful in surgery of burn injuries. PMID- 6503528 TI - [Peculiarities of burns in childhood]. AB - In contrast to adults the protein and energy loss leads to hypermetabolism in the burned child. This is because their glycogen and fat reserves are limited. The catabolism finds expression in the rapid loss of weight resulting from reduction of the structure proteins. Therapeutic consequences will be discussed in this paper. Furthermore cases will be demonstrated where extensive third degree burns were able to be treated by mixed allografts and autografts. PMID- 6503529 TI - [Late results following compression treatment of deep 2d and 3d degree burns]. AB - Pressure therapy following burns is necessary for at least 9 months, normally 12 to 15 months. Results are dependent on the age of the patient, anatomical localization and type of reepithelization. Side effects such as pruritus and swelling of maturing scars are minimized. The initially vulnerable epithelium is protected. PMID- 6503530 TI - [New developments in operative medicine--anesthesiology]. AB - New developments in anaesthesiology include: Preoperative analysis of the patients' risk, evaluation and treatment of preexisting illnesses in an increasing number of risk patients. The intraoperative use of a combination of different anaesthetic procedures, and an individually adapted monitoring. The postoperative surveillance, correction therapy in the recovery unit, continuation of treatment with improved intensive care methods. PMID- 6503531 TI - [Special developments in neurosurgery]. AB - Increase of intracranial pressure is an acute danger for the patient's life. Since direct measurement of ICP is used, early identification of dangerous dysfunctions of ICP is possible. Surgical treatment of vascular malformations involves less risks since microsurgical methods and "tailor made" clips have been applied together with controlled hypotension. Transrhinoseptal approach in surgery of hormonally inactive and active adenomas has lowered the lethality rate essentially and improved the functional results. New indication in spinal surgery: Treatment of spinal claudication resulting from a central spinal stenosis, by operative decompression of the spinal canal. PMID- 6503533 TI - [Care responsibilities of the surgeon in the jurisdiction of the federal court]. AB - Concerning his civil liability the surgeon's duty of care is determined by standards established in the first place by medicine. Jurisdiction has only control function. This task has to bring in line the protection of the patient's health from poor quality of medical treatment and "overtreatment" with the necessity and risks of specialisation and work sharing. The legal demands must not provoke overdiagnostics and defensive medicine themselves; in a limited manner they have to leave the choice of methods to the surgeon's authority. PMID- 6503534 TI - [Legal measures of medical standards]. AB - German law requires "due diligence" of the physician. The courts refer to the state of medical science that is available to a physician who makes every reasonable effort to obtain it. The relevant qualification is to be the skill of an "average" physician. The standard contains normative and factual elements: "good medical practice". The question, however, arises, who establishes the standards for the fields of surgery. The law refers to medical science but lays down minimum requirements. The prevailing standard does not prevent new techniques from being tested, but when they become the standard, cannot be determined in general. PMID- 6503532 TI - [New developments in pediatric surgery]. AB - New concepts in pediatric surgery have been developed concerning inter disciplinary problems such as ureter implantation or urinary undiversion as well as deformities of abdominal organs such as biliary atresia, anorectal malformations, adrenogenital syndrome and sinus urogenitalis. Considerable improvements in fetal surgery as a part of pediatric surgery were achieved. For diagnostic, surgical and ethical reasons, however, these efforts are, for the time being, only of theoretical interest. PMID- 6503536 TI - [Extremity preserving interventions in malignant bone tumors]. AB - Amputation or exarticulation are the easiest and safest ways to effect a radical cure of a malignant musculo-skeletal tumor. With progress in adjuvant chemotherapy and development of endoprosthetic devices tumor resections became more important for limb salvage procedures. Competitive surgical techniques for curative treatment always require radical tumor elimination. PMID- 6503535 TI - [Silicone rubber dressing in wound healing disorders]. AB - This report deals with new dressing method using silastic foam which was used on 55 patients with good success. Silastic foam dressings are indicated in cases of badly healing and infected wounds, especially caused by diabetes and arteriosclerosis. On account of the physical quality of the silastic foam the wounds were cleaned and healed quickly. The treatment with silastic foam dressing is a good alternative to conservative dressing methods. Two cases will demonstrate the success of the silastic foam dressing in surgery. PMID- 6503537 TI - [Iatrogenic lesions of peripheral nerves in surgery]. AB - The frequency of various iatrogenic nerve injuries is reported based on an evaluation of representative material from medical liability proceedings. During operations, nerve injuries occurred most frequently in the neck (lymph node biopsy, thyroidectomy) and the extremities (operations on the hand, total hip arthroplasty). Paralysis of the sciatic nerve following intragluteal injection is still the main injury caused by injection. PMID- 6503538 TI - [External fixation of wood as an example of an adapted technic]. AB - Logistic reasons gave rise to construction, production and application of an external fixation made of the wood of the rubber-tree (ficus elastica) during the treatment of Cambodian war-injured patients at the field hospital of Khao I Dang. Round pieces of wood 1.5 cm respectively 2 cm in diameter, with drill-holes (diameter 3.2 mm) for the "Steinmann"-nails were planed from well-seasoned planks of the Jang-tree. For the treatment of 25 open fractures - the wooden fixation proved to be the best solution. PMID- 6503539 TI - [Indications for operative stabilization of spinal fractures]. AB - Absolute indications are seen in lesions of the spinal cord; increase of an incomplete paralysis, paralysis after free interval or after a primarily good restitution and in case of an ascending complete paralysis. The decompression depends on the actual site of compression. If there is an anterior compression not laminectomy but only the anterior approach will be successful. Relative indications are instability, especially disco-ligamentious ones. Late results with permanent instability, pseudarthrosis of the dens axis and marked angulation (40 degrees) of the vertebral body. PMID- 6503540 TI - [Osteosynthesis of severe injuries of the thoracic and lumbar spine with internal fixation]. AB - From a posterior approach long Schanz screws are inserted through the pedicles into the bodies of the two vertebrae just adjacent to the lesion and connected by the threaded Fixateur-interne-rods. By tightening the nuts the Schanz screws are fixed in all directions. The advantages of the F.I.-system are: excellent reposition by the long lever-arm of the Schanz screws, immobilization of only two segments avoiding the iatrogenic loss of mobility and lumbar lordosis, stability against flexion forces better than with Harrington distraction rods, additional rotational stability. PMID- 6503541 TI - [Various technics of occipito-cervical fusion]. AB - Indications for occipital-cervical fusion are destruction by tumor, pathological instability and certain fracture dislocations of this region. For palliative surgery we prefer a combined fusion with tension band wire and bone cement; in curative procedures a well fitting cortical bone graft fixed by a circumferential tension band wiring is used. For occipital anchoring we suggest an epidural course of wires through 2 bore holes, in order to cervically fix a circumferential wire around the posterior arch of the vertebra. PMID- 6503542 TI - [Errors and dangers in the treatment of fractures and pseudarthroses of the clavicle]. AB - The rate of pseudarthrosis in 726 conservatively treated fractures of the clavicula was 0.69%. The danger of hyperporoses lies in neurovascular compression. Errors in treatment pertain to wrong operative indications and inadequate osteosyntheses. Surgery should be performed only in 2nd and 3rd degree open fractures and/or concomitant neurovascular lesions (2.06%), in distal fracture dislocations with instability of the AC-joint (1.6%) and in cases of painful pseudarthrosis (n = 46). The implant of choice is the 3.5 DCP. Six cortical contacts must be achieved in each fragment. PMID- 6503543 TI - [Operative treatment of distal intra-articular humerus fractures; results of 412 follow-up cases (AO-collected statistics)]. AB - Intraarticular fractures require a surgical therapy. The functional results are depending on the anatomical reconstruction of the joint surfaces and on early kinesitherapy. Remaining disabilities may be controlled in 2/3 of the cases to such an extent that no alterations are necessary in private or professional life. The overall result was very good in 23.8%, good in 36.0%, moderate in 22.3% and bad in 17.9%. These bad results are due to the rate of polytraumatized patients (18%) and the high rate of open comminuted fractures (27%). PMID- 6503544 TI - [Indications and results of plate osteosynthesis of the distal radius]. AB - Plating of the distal radius is indicated in: a) flexion fractures, b) irreducible intraarticular fractures, c) unstable extraarticular extension fractures, d) chisel fractures of the radial styloid process and the navicular bone, e) correction osteotomies after defective bone healing. The paper presents the final results of 124 radial plate fixations. 73.4% had excellent and good, 20.1% fair, and 6.5% bad results. There was a close correlation between radiologic appearance and clinical function. Early secondary surgery (4th-14th day) showed the best results. Old age had a highly negative influence. PMID- 6503545 TI - [What is a safe principle for therapeutic decision?]. AB - In surgery (as in other disciplines of medicine) a causal therapy is connected with a causal diagnosis. Many physicians confine themselves to symptomatic measures which are useless beyond self-healing or introduce some kind of poly pragmasia. Sometimes between those extreme positions there is a need of deliberations "as if" or primarily diagnostic operations. Diagnostics as a whole consist of logical as well as of psychological elements. Approximation is made either by some kind of hypothetico-deductive calculations or using some kind of pattern recognition. Anamnesis and immediate personal examination yield a preliminary diagnosis in about 80%. Yet a diagnosis of this sort has to be verified or falsified by scientific methods. The final decision is a function of both the theory of probability and the theory of utility. The combination is demonstrated by the so-called decision matrix and the so-called decision tree, going from simple models to complicated ones. PMID- 6503546 TI - [Ulcer hemorrhage--when operative hemostasis?]. AB - Considering natural history, epidemiology and prognostic criteria bleeding peptic ulcers should be operated: 1) in case of active "uncontrolled" bleeding: emergency operation. If bleeding is controlled by laser coagulation or sclerotherapy: early-elective operation. 2) in case of capillary persistent bleeding, blood loss of more than 2500 ml/24 h or continuous bleeding after 48 h: early-elective operation. PMID- 6503547 TI - [Acute cholecystitis--early cholecystectomy?]. AB - In acute cholecystitis different therapeutic approaches according to the individual situation are required: urgent (emergency) cholecystectomy is necessary in patients with acute life-threatening complications such as empyema and suspected or confirmed perforation. In uncomplicated cases early operation is recommended within 24 to 72 h. The reliability of diagnosis, technical complications and lethality are not different in patients undergoing early (less than 72 h) as opposed to delayed (less than 2 months) cholecystectomy. Early cholecystectomy prevents the complications of delayed operation and decreases costs for hospital care and is therefore the treatment of choice for most patients with acute cholecystitis. PMID- 6503548 TI - [Acute cholecystitis--early cholecystectomy?]. AB - Some controlled clinical trials have demonstrated that early or immediate operation for acute cholecystitis produces better results than delayed operation or conservative treatment. From 1969 to 1983, 397 patients have been operated for acute cholecystitis at the Surgical University Hospital Wurzburg, the results are discussed here. PMID- 6503549 TI - [Acute pancreatitis--discontinuation of conservative therapy, indications for operation and operation technic]. AB - The surgical treatment of acute pancreatitis aims at the removal of stones in the distal biliary duct, toxic implications and necroses and to treat complications. The correct diagnosis, according to the 3 stages of Kummerle is the basis for surgery. This staging is possible to a high degree of security by angio-CT and sonography. The effect of the following modalities has been proven: Early peritoneal dialysis which, however, decreases lethality only in combination with a delayed operation; removal of the biliary duct obstruction, and necrosectomy in stage II from the second week onwards. Early duodeno-pancreatectomy did not prove to be a successful procedure. PMID- 6503550 TI - [Surgical decision process]. AB - Surgical decision-making procedures can be illustrated as flow charts or decision trees in standard situations. As an example acute appendicitis is shown including techniques of how the methods of medical decision-making are applied in routine conditions. In single patients the possibility must exist to apply the very complex procedure of intuition and art of medical decision-making. However, a quantitative assessment of standard situations should help to improve surgical care especially in the hands of the younger, less experienced surgeon. PMID- 6503551 TI - [Crohn disease: II. Indications for operation]. AB - As the etiology of Crohn's disease is still unknown conservative as well as surgical treatment has to be symptomatic. Medical therapy is performed by use of prednisolone, salazosulfapyridine, metronidazole and elementary diet depending on the localisation and extension of the disease. Surgical treatment means therapy of complications like stenoses, fistulae and abscess formation. Neither after conservative nor after surgical treatment is the course of the disease predictable. PMID- 6503552 TI - [Psychiatric stress tolerance of acute and chronic surgical patients]. AB - The surgical patient is subjected to psychological stress through fear of pain, operation, anesthesia and finally death. The exact definition of psychic stress and the patient's resistance to it is even more problematic than the definition of somatic stress. It is the doctor's task to alleviate the psychic stress of the patient, to instill confidence and to recognise the limits of his resistance and finally to take all this into consideration in planning his treatment. PMID- 6503553 TI - [Law and freedom in medical decisions from the viewpoint of the law]. AB - Modern medicine has given doctors more and more possibilities for "manipulative" intervention in natural processes. However, even in the context of daily medical routine of beginning, continuing or terminating treatment, the doctor is repeatedly faced with the dilemma of whether to make use of the opportunities open to him. Contrary to the widely-held view that such decisions are of a purely empirico-medical nature, it becomes apparent with reference, for example, to the definition of death and the discontinuation of treatment that these decisions also have a normative-evaluative character. In relation to the postulate of the widest possible "medical discretion" emphasis is attached to the necessity for a legal framework for four functions of the law as regards the relationship between doctor and patient: protection--avoidance of abuse--presentation of guidelines- stabilisation of confidence. In conclusion the question of medical freedom in relation to active euthanasia is considered. PMID- 6503554 TI - [Stress tolerance of surgical patients from the viewpoint of internal medicine]. AB - The somatic functional capacity can be defined as an organ-specific functional reserve. Statistical studies have shown perioperative risks in reciprocal relationship to this limit. A stepwise (graduated) approach for the assessment of cardiac and pulmonary function is suggested, which depends on the estimated risk. Indications for surgical therapy and operability, especially in the treatment of tumors and for geriatric patients, are not only determined by the somatic functional capacity but also by multiple other conditions. PMID- 6503555 TI - [Limits of stress tolerance from the viewpoint of anesthesiology]. AB - The overall operative risk is determined by operation, anaesthesia and numerous additional factors which include the pre-existing physical status of the patient himself as well as external impacts. Check-lists have improved the validity of predicting these risks. However, evaluation of the operative risk is not the only prerequisite for extending the limits of the patient's stress endurance and expanding consecutively the margins of safety for the anaesthesist, surgeon and patient. Additionally, an optimal homoeostasis has to be achieved preoperatively with emphasis on respiration, circulation and nutritional status. PMID- 6503556 TI - [Stress tolerance of patients with multiple injuries and its significance for operative care]. AB - Treatment of severely injured patients requires exact planning and mature management. For practical reasons the classification into 4 phases has been introduced: acute, primary, secondary and tertiary phases. During the acute phase all life-saving operations are performed. In the primary, secondary and tertiary phases the procedures vary according to priority. Reviewed on the basis of 781 severely injured patients, the most reliable criteria are: pulmonary artery pressure, creatinine, bilirubin, extravascular lung water, the PaO2/FiO2 quotient and fluid balance. PMID- 6503557 TI - [Tolerance of patients with craniocerebral injuries to time and transportation factors]. AB - Primary care of head injuries at the scene of accident is of major importance for the stabilization of vegetative functions. In many cases death is caused by an acute increase of intracranial pressure. Thus prognosis is influenced by complications like arterial intracranial bleedings or brain edema. The decision on the means of transportation depends on the possibilities of early treatment of these complications. In clinical examples time as a factor in the care of head injuries and their complications are demonstrated. PMID- 6503558 TI - [Stress tolerance following traumas of the thorax and great vessels]. AB - After clinical investigation the most important diagnostic procedure is the simple chest X-ray in upright position. In case of hemothorax or pneumothorax the insertion of a large chest tube in the third of fourth intercostal space is necessary. Patients with traumatic flail chest and paradoxical respiration need first of all immediate intubation and artificial respiration, afterwards operative stabilization is beneficial in selected patients. In case of severe intrathoracic hemorrhage and in case of injuries of the lungs, heart and great vessels an active surgical approach is a life-saving treatment. Apart from patients with very bad general condition the usual diagnostic measures and an adequate conservative or surgical treatment can always be tolerated by the patient considering his life threatening condition. PMID- 6503559 TI - [Stress tolerance following blunt abdominal trauma and its significance for operational indications and tactics]. AB - Abdominal trauma in combination with other injuries continues to be a life threatening risk. In spite of intensive care multiple organ failure can result in death several days postoperatively. The initial respiratory therapy of the injured patients is of outstanding importance to ameliorate the unsatisfying results. PMID- 6503560 TI - [The pelvis and urinary organs from the surgical and urologic viewpoint]. AB - Our joint urological and surgical statements demonstrate that in cases of injuries of the pelvic ring and urinary organs there are numerous measures which guarantee adequate primary treatment. They also make it possible to postpone final and definitive treatment. On the other hand predictable as well as unpredictable complication may prevent timely reconstructive operations and may thus impair the final outcome. The purpose of this paper is to emphasize the importance of the fact that the treatment of a polytraumatized patient should be planned by the surgeon who is most experienced in traumatology. PMID- 6503561 TI - [Ovarian function after hysterectomy]. PMID- 6503562 TI - [Hypercalcemia seen by the internist]. PMID- 6503563 TI - [Primary hyperparathyroidism. Clinical presentation and anatomical findings. Experience with 152 surgically treated patients]. PMID- 6503564 TI - [Recent attainments in the field of impotence. II - Venous, neuropathic and endocrine impotence and the strategy for its exploration]. PMID- 6503565 TI - [Sotalol and torsade de pointes]. PMID- 6503566 TI - [Boxing]. PMID- 6503567 TI - [Treatment of renal colic with ketoprofen. Apropos of 39 episodes in 37 patients]. PMID- 6503568 TI - [Nuclear magnetic tomography in otorhinolaryngology. Case reports]. AB - Magnetic resonance imaging (MRI) promises the achievement of considerable improvements in diagnostic procedures in otorhinolaryngology. In this article, the advantages of the technique are presented and their significance in diagnosis of head and neck disorders is discussed. An important advantage is the fine and detailed representation of tumours particularly in the soft tissue of the neck and the base of the tongue, which is made possible by an enhancement of contrast and by the improved spatial imaging based on the frontal and sagittal projection plane. MRI also seems to provide a new approach to the diagnosis of tumours of the glomus jugulare and the carotid body and of acoustic neurinomas. Besides, it will be possible to obtain more detailed information on the depth of infiltration of laryngeal carcinomas with the aid of surface coils. PMID- 6503570 TI - [A simple measuring device for nystagmus amplitude. A contribution to rapid, exact and inexpensive evaluation of electronystagmograms]. AB - Different parameters in use for quantitative analysis of ENG recordings are being discussed. Special importance can be attributed to the slow-phase velocity of the nystagmus and above all to the total amplitude. However, measurement of the total amplitude via digital computers is very expensive. Hence we present a device to measure amplitudes by means of a potentiometer. This is easy to handle, works accurately and is inexpensive. PMID- 6503569 TI - [High resolution computer tomography of the middle and inner ear]. AB - High-resolution CT enables exact visualisation of the bony structures of the petrous bone; at the same time, all relevant nerval, vascular and muscular elements of the middle and inner ear are visualised. A wider range of findings can be attained in this region of wide differences in density than via conventional pluridirectional tomography. The normal anatomy of the petrous bone is demonstrated via CT series of slices in axial and coronal projection. PMID- 6503571 TI - [Hearing aid treatment with in-the-ear hearing aids]. AB - The market share of the In-the-ear hearing aids in the United States of America, which increased more than 50% last year, points to a possible comparable development in the Federal Republic of Germany, where the 1983 quotas were below 4%. Those who are responsible for the supply of hearing aids should pay more attention to imparting more information on the technique, adaption and further aspects of In-the-ear hearing aids. After outlining the various forms of In-the ear hearing aids (modular, custom-made, ear-channel apparatuses) initial experiences with In-the-ear hearing aids are reported together with technical points and questions of adaption. Our research results based on localisation tests, discrimination scores in quiet and noisy surroundings, and a questionnaire to compare In-the-ear with Behind-the-ear hearing aids, confirm the results communicated in other publications. Apart from the various positive aspects, which favour a more frequent use of In-the-ear hearing aids, their limitations are also pointed out and discussed. PMID- 6503572 TI - [Involvement of the tympanic membrane and ear ossicle system in ochronotic alkaptonuria]. AB - Ochronotic alcaptonuria is a rare hereditary disease in which the metabolism of phenylalanine and tyrosine is disturbed, leading to accumulation and urinary excretion of homogentisic acid. Its affinity towards bradytroph tissues makes e.g. cartilage, tendons, sclera etc. become stained dark, hard and inflexible, leading to early arthrosis or ruptures of tendons. In the ENT literature mostly signs like darkening of the conchas, the septum or the larynx are mentioned, whereas involvements of the middle ear are rarely described. Such changes were seen in a 60-year old patient, who showed dark discolourations of his thickened tympanic membranes. He had a combined high-frequency hearing loss, the conductive component of which we explain as an increase of mass and changed elasticity. It may also be due to alterations of the ossicular chain. The case was demonstrated to direct the ENT specialist's attention to findings suspicious of ochronotic alcaptonuria and - on the other hand - to present photos of involved tympanic membranes, which in this kind we did not see in the literature. PMID- 6503573 TI - Chondrosarcoma of the head and neck. AB - A review of 23 cases of chondrosarcoma of the head and neck is presented. The sites of involvement include the gnathic bones, paranasal sinuses and orbit, nasopharynx, base of skull, larynx and the cervical spine. Histologic grading of the neoplasms into I, II, and III, primarily dependent on deviation from phenotypic cartilage and mitoses, afforded excellent correlation with prognosis and survival. While increasing size of the chondrosarcoma is not always associated with higher grade tumors, rapidly growing and extensive neoplasms are usually grade II or III chondrosarcoma. PMID- 6503574 TI - Past, present, and future applications of the auditory middle latency response. AB - For many years (auditory) middle latency response (MLR) reportedly has been an excellent electrophysiological procedure for estimating frequency specific auditory thresholds. Currently the 40 Hz potential, a derivative of the MLR, holds even greater promise for threshold testing. MLR also appears to have potentially valuable applications in the evaluation of functional hearing loss and assessment of higher auditory function. However, MLR is not without controversy. Questions of origin, filtering effects, and its use in pediatric assessment are current issues surrounding applications of MLR. The following article analyzes the values and limitations of MLR within the framework of past, present, and future research and clinical uses. PMID- 6503575 TI - Repair of mandibular fractures via compression plating and more traditional techniques: a comparison of results. AB - To evaluate the results of compression plating in the repair of mandibular fractures, a retrospective analysis of mandibular fractures repaired at Upstate Medical Center in the past 3 years was performed. Only patients treated as inpatients were included. A total of 68 cases were reviewed, and follow-up data were available in 59. Of these, 18 had been repaired using A-O compression plating techniques, and the remaining 41 were treated using interosseous wiring, intermaxillary fixation, external fixation, soft diet, or any combination of these. Nonunion and malocclusion were considered major complications, while all other complications were considered minor. Using these criteria, there were no major complications in fractures treated with compression plates, and there were 6 minor complications in 4 patients (22% of patients). Using the more traditional techniques, there were 13 major complications, 6 malocclusions and 7 non-unions, or an incidence of 32%, and 5 minor complications in 4 patients (10% of patients). These findings suggest that compression plating is a useful and highly effective technique for repair of mandibular fractures. The technique generally obviates intermaxillary fixation and dental splints, particularly in the edentulous patient. The main disadvantage is the need for 2 open procedures. PMID- 6503576 TI - Dissemination of squamous papilloma by surgical manipulation: a case report. AB - The occurrence of multiple squamous cell papilloma in the upper and lower aerodigestive tract is well documented. While apparent inoculation to other areas in the lower respiratory tract at the time of bronchoscopy or tracheotomy is a frequently described occurrence, there have, however, been no reports of transmission of papilloma outside the respiratory tract as a result of surgical manipulation. The purpose of this paper is to report a case of squamous papilloma of the external auditory canal and tympanic membrane which resulted from apparent inoculation at the time of surgery for nasal cavity and nasopharyngeal papillomas together with myringotomies. This supports the hypothesis that an infectious agent, e.g., a virus could be the causative agent and that inoculation to other sites as a result of manipulation is possible. In light of our experience with this case we recommend specific guidelines for the handling of these patients and the protection of surgeons, anesthesia and operating room personnel. Hopefully this report will heighten awareness of papillomas as a potentially transmittable entity to sites outside the respiratory tract, and encourage others to approach these clinical situations with caution. PMID- 6503577 TI - Congenital laryngeal saccular cyst of the newborn. AB - Congenital laryngeal saccular cysts of the newborn frequently cause severe dyspnea and upper respiratory tract obstruction. When confronted with this emergency situation necessary therapeutic action may consist of intubation, puncture or incision to reduce the volume of the cyst or tracheotomy. The CO2 laser was effectively used not only to incise the supraglottic saccular cyst but also to vaporize the lining. PMID- 6503578 TI - Laryngospasm induced pulmonary edema. AB - Two case reports of laryngospasm-induced pulmonary edema following general anesthesia are presented. Therapy consisted of immediate reintubation, application of positive pressure ventilation, and diuresis. This phenomenon should be recognized rapidly with appropriate therapy instituted immediately to avoid other complications. Preventive measures are discussed and a modified protocol of the management is outlined. PMID- 6503579 TI - Surgical treatment of pyriform sinus cancer: a retrospective study. AB - Patients with squamous cell carcinoma of the pyriform sinus treated surgically from 1959 through 1979 at the University of California, San Francisco were reviewed. As several reports had previously suggested that the addition of radiation therapy, preoperatively or postoperatively, did not increase survival, our data collection and analysis was performed in such a way as to determine whether similar trends were present in our patients. Data were tabulated for patients having: 1. surgery alone (SA); 2. preoperative radiation and surgery (RS); and 3. surgery and postoperative radiation (SR). The surgery alone group demonstrated the best results, with 65% 3-year determinant survival, and 56% 5 year survival, compared to 50% 3-year and 33% 5-year survivals in the combined groups. In this patient population, the increased death rate in the combined therapy group appeared to be due primarily to a higher distant metastasis rate (50% vs. 26% for the surgery alone group). Although our numbers are too small for any of the comparisons to be significant, the findings of similar cure rates of pyriform sinus cancers by surgery alone support similar data from other authors. As staging was similar in the two groups, and none of the other variables examined appeared to explain these results, we could only conclude that further data is needed, and that the exact role of radiation therapy, in combination with surgery for pyriform sinus cancer remains to be defined. PMID- 6503580 TI - Mandibulectomy without reconstruction can cause sleep apnea. AB - Anterior mandibulectomy can precipitate the development of sleep apnea. All head and neck tumor patients having had extensive composite anterior oral cavity resections should be evaluated for sleep apnea before decannulation of their tracheostomy tube. Subsequent flap and/or rigid reconstruction of the lower jaw appears to prevent the development of sleep apnea. Fascial sling suspension of the lower lip does not appear to prevent sleep apnea. PMID- 6503581 TI - Ventilation during laryngoscopy in chronic obstructive lung disease. AB - Many patients requiring direct examination of the upper airway and gastrointestinal tract under general anesthesia have chronic obstructive lung disease, yet virtually no work has been done to assess the adequacy of their ventilation during laryngoscopy and in the early postoperative period. This study demonstrates that, using the Carden tube, their blood gases are well maintained even when areas outside the endolarynx, such as the upper esophagus, are examined. The Carden tube is shown to be easy to insert and remove as well as permitting a superior view of the larynx. Also, this study pinpoints the period of maximum danger of respiratory failure as occurring postoperatively in the recovery room. This should be independent of the method of ventilation employed at surgery and indicates the need for cocainization of the vocal cords before extubation, as well as careful, early postoperative monitoring. The problems of ventilation during direct examination of the upper airway and gastrointestinal tract are discussed and alternative methods evaluated. PMID- 6503582 TI - Split-thickness skin graft to control granulation tissue following permanent tracheostomy. PMID- 6503583 TI - Personal technique for columella reconstruction. PMID- 6503584 TI - Simple method for measurement of distance and length under the operating microscope. PMID- 6503585 TI - Surgeon's view of the skull base from the lateral approach. AB - This paper presents the surgical anatomy of the skull base and infratemporal fossa. The information has been derived from the author's own experience in surgical and cadaver dissection, standard anatomical references, and selected experience of other skull base surgeons. Because the lateral approach has become the utilitarian method of exposure, the intricate detailed anatomy is demonstrated from this view at five levels of dissection, so the surgeon may gain a practical understanding of the surgical relationship of critical structures. Consistent anatomical landmarks can be used by the surgeon in the location of these critical structures. The styloid process, sphenoidal spine, and middle meningeal artery identify the internal carotid artery as it enters the carotid canal. The bony or fibrous septum that divides the jugular foramen into neural and vascular compartments may be used to better identify nerves IX, X, and XI. The zygomatic root is useful for location of the middle fossa dura. The lateral pterygoid plate leads directly to the foramen ovale. The increased precision of dissection permitted by use of the microscope requires an increased level of knowledge of anatomical structures in this area. It is hoped that the information presented in this paper will assist surgeons in the meticulous and thorough removal of skull base tumors and in the preservation of neural and vascular structures that are presently being sacrificed. PMID- 6503587 TI - Lipid research methodology. PMID- 6503586 TI - Laser workshops in neurological surgery. AB - With the recent increased popularity of laser use in neurosurgery, there arises the question of the value and necessity of a "hands-on" laser workshop in preparing the surgeon for clinical use of the instrument. To find an answer, a questionnaire was recently circulated to those who had participated in such a workshop. Participants were asked whether they were actually using the laser clinically since attending the workshop and, if so, the type of laser they were using. Whether the course was influential in their decision to use a laser and whether they felt they could have used the instrument without such a course was also asked. In addition, the surgeons were asked how long it took them to become comfortable using the laser. The types of procedures, the percentage of operative cases and the mode (freehand or microlinked) in which the laser was used was also investigated. Finally, absolute indications for laser use in neurosurgery and methods to improve laser education were sought. The answers were varied and interesting, but it is our conclusion that a "hands-on" workshop is both a valuable and necessary means of preparing a neurosurgeon for clinical use of a laser, and participation in such a course should be encouraged. PMID- 6503588 TI - [Protein turnover in liver failure--determination using the stable isotope 15N]. AB - The 15N-tracer technique gives new opportunities to medical research for investigation of normal and pathological nitrogen metabolism. Analysis of 15N kinetic data derived from total nitrogen excretion in the urine allows to calculate quantitatively certain parameters of protein synthesis and protein metabolism. At the same time analysis of serum samples will allow measurement of 15N-nitrogen incorporation into particular protein or non-protein fractions of the plasma. In the study reported here patients with different liver parenchyme lesions (acute hepatitis, chronic active hepatitis, biliary obstruction, cirrhosis of the liver, hepatic coma) were investigated with a standardized 15N tracer method developed by us. It could be shown, that protein turnover in patients with liver insufficiency is significantly decreased as compared to healthy persons. Decrease of protein synthesis is associated with a still more pronounced decrease of protein catabolism. There are significant differences in dynamics of 15N in patients with hepatic coma as compared to other patients with liver parenchyme disease without portal encephalopathy. Nevertheless, even in hepatic coma 15N incorporation into plasma proteins can be shown. Differences in the 15N elimination kinetics of the non-protein pool between patients with chronic active hepatitis, biliary obstruction and hepatic coma could be found. PMID- 6503589 TI - [Possibilities of the early detection of scoliosis using moire topography]. PMID- 6503590 TI - [The value of the urologic examination in evaluating the invasiveness of carcinoma of the urinary bladder]. PMID- 6503591 TI - [Clinical characteristics of migraine in childhood]. PMID- 6503592 TI - [Changes in the structure of skiing injuries in Yugoslavia]. PMID- 6503593 TI - [Clinical and epidemiologic characteristics of herpes zoster in patients treated at the Clinic during a 5-year period]. PMID- 6503594 TI - [Hypovolemic shock in acute myocardial infarct]. PMID- 6503595 TI - [Study of the reactivity and immunogenicity of FSME-IMMUN vaccine against tick borne meningoencephalitis]. PMID- 6503596 TI - [The value of frontal and sagittal reconstruction in the diagnosis of hypophyseal tumors]. PMID- 6503597 TI - [Development and needs in component transfusion]. PMID- 6503598 TI - [The incidence of coronary disease in regions of Croatia]. PMID- 6503599 TI - [An epidemic of Q fever in northern Croatia in 1983 (epidemiologic-serological aspects)]. PMID- 6503600 TI - [Creatinine clearance in aged persons with normal values of serum creatinine]. PMID- 6503601 TI - [The perinatal fate of the second twin]. PMID- 6503602 TI - [Behcet's syndrome--clinico-diagnostic problems in a female patient]. PMID- 6503603 TI - [Primary sclerosing cholangitis]. PMID- 6503604 TI - [Computerized tomography diagnosis of primary aldosteronism (Conn's syndrome)]. PMID- 6503605 TI - [Intradermal administration of HDC vaccine in the immunization of people against rabies]. PMID- 6503606 TI - [Ulcerous colitis and Crohn's disease. II. Radiologic diagnosis]. PMID- 6503607 TI - [Immobilization of the ruptured achilles tendon after reconstructive surgery]. PMID- 6503608 TI - [The importance of training physicians to work according to common good management practices]. PMID- 6503609 TI - Circadian variations of lorazepam-induced neurologic deficits. AB - Circadian variations of lorazepam-induced neurologic deficits were tested in mice. The duration of the impairment after administration of 3 mg/kg lorazepam was considerably shorter at 2100 h compared to other times of the day. No significant variations could be found for brain concentrations of drug at recovery and 15 or 30 min after drug administration. Food intake did not seem to account for the circadian pattern observed. It was therefore concluded that chronergy of lorazepam is a result of altered sensitivity of the animal over time rather than to altered pharmacokinetics. PMID- 6503610 TI - Effect of estradiol and relaxin on collagen and non-collagen protein synthesis by mammary fibroblasts. AB - In order to determine the effect of relaxin and estradiol on collagen and noncollagen synthesis by mammary gland fibroblasts, fibroblasts isolated from guinea pig mammary glands were grown on plastic or Cytodex-3 collagen coated microcarriers. On plastic, estradiol (600 pg/ml) increased the incorporation of tritiated glycine into collagen. Non-collagenous protein synthesis was increased at all concentrations of estradiol, but it was greatest with 200 pg/ml estradiol. On Cytodex-3, 400 pg/ml estradiol increased the synthesis of collagen and non collagenous protein. Relaxin (1 microgram/ml) did not affect collagen synthesis but decreased the synthesis of non-collagenous protein. PMID- 6503611 TI - 2-Pyrrolidinone and succinimide endogenously present in several mammalian species. AB - 2-Pyrrolidinone and succinimide were identified in blood plasma of man, rat, and mouse. Dog plasma contained only traces of 2-pyrrolidinone not exceeding significantly the detection limit of our GCMS-method. Succinimide but not 2 pyrrolidinone could also be found in the brains of rat and mouse. Evidence is presented for a metabolic pathway leading from 2-pyrrolidinone to succinimide, with 5-hydroxy-2-pyrrolidinone as an intermediate. PMID- 6503613 TI - Effects of estradiol on the basal and evoked efflux of norepinephrine and 5 hydroxytryptamine from slices of rat hypothalamus. AB - 17-beta-Estradiol, at a concentration (100 ng/ml) approaching plasma levels found in pregnant women, inhibited the K+-evoked efflux of endogenous norepinephrine from superfused slices of rat hypothalamus. The same concentration of estradiol increased slightly the basal efflux of serotonin. Since estradiol crosses the blood-brain barrier with ease it is suggested that the inhibition of norepinephrine release from central neurons may contribute to the depression and emotional lability sometimes associated with estradiol therapy. PMID- 6503612 TI - Tolerance to an anticholinergic agent is paralleled by increased binding to muscarinic receptors in rat brain and increased behavioral response to a centrally active cholinomimetic. AB - Pretreatment of rats with agents with strong antimuscarinic activity in the CNS (scopolamine, benztropine, trihexyphenidyl, amitriptyline, and thioridazine) but not their inactive congeners (desipramine, fluphenazine, or haloperidol) led to significant increases in the maximum apparent density of binding sites for 3H-QNB in cerebral cortical or striatal membranes. The dopamine agonist bromocriptine induced a similar effect that was blocked by haloperidol in striatum. None of these treatments altered the apparent affinity of the test ligand. Tolerance to the behavioral activating action of scopolamine developed over two weeks of daily treatment. This change was paralleled by an increase in 3H-QNB binding in cerebral cortex which was dependent on the dose and duration of treatment with scopolamine and persisted for a week following two weeks of treatment. Scopolamine pretreatment led to a significant increase in basal, spontaneous motor activity in the rat, but also to a marked increase in the motor-inhibitory actions of the centrally active muscarinic agonist pilocarpine. These results add to the impression that decreased availability of ACh agonists can significantly increase the availability and functional activity of central muscarinic ACh receptors to reflect "disuse supersensitivity." PMID- 6503614 TI - Effects of systemic or intracerebroventricular naloxone injection on basal and 2 deoxy-D-glucose-induced ingestive behavior. AB - In order to examine the role and site of action of opiates on both hunger and thirst and food and water intake in rats after short term (3 hr.) food deprivation alone or in combination with 2DG-induced glucoprivic stress, naloxone was given to rats in either the jugular vein or the lateral ventricle. Both basal and 2DG-induced food and water intake were reduced by naloxone injected either peripherally or centrally. Latencies to eat and drink were used as measures of hunger and thirst respectively. Only central injection of naloxone significantly reduced 2DG-induced but not basal hunger. These results suggest a central site of action of naloxone on both food and water intake even if some peripheral effects cannot be totally ruled out. Our findings indicate central nervous system opiate receptor involvement in the hunger response to 2DG-induced glucoprivation. In all other treatment conditions, decreases in food intake cannot be related to reduction of hunger but may be due to potentiation of satiation during opiate receptor blockade. PMID- 6503615 TI - Cardiac norepinephrine releasing action of kynuramine, an endogenous diamine derived from L-tryptophan. AB - Kynuramine, an endogenous metabolite of L-tryptophan, was found to function as an indirectly acting sympathomimetic amine in rat atria in vitro. Kynuramine released tritium from atria preloaded with [3H]norepinephrine (NE), an effect which was blocked completely by pretreatment with reserpine or 6-hydroxydopamine. Release by kynuramine was calcium-independent and was potentiated by inhibition of monoamine oxidase but was only partially sensitive (50%) to inhibition by cocaine (10(-4)M). The ability of kynuramine to enter cardiac cells was demonstrated in whole atria by measuring its intracellular deamination rate by monoamine oxidase. Blockade of neuronal uptake (cocaine) and extraneuronal uptake (SKF 550) had no effect upon this measure. It is concluded that knyuramine releases cardiac NE, in part, by a cocaine-sensitive mechanism but that the process operating for the membrane transport of kynuramine in both neuronal and non-neuronal cells remains uncertain. The data are discussed in relation to the possible cardiac consequences of L-tryptophan ingestion in man. PMID- 6503616 TI - Sodium-dependent high-affinity binding of [3H]hemicholinium-3 in the rat brain: a potentially selective marker for presynaptic cholinergic sites. AB - This report describes the membrane binding properties of [3H]hemicholinium-3 ([3H]HC-3), a selective inhibitor of sodium-dependent high-affinity choline uptake (SDHACU) in cholinergic nerve terminals. Under the described assay conditions, [3H]HC-3 bind with a saturable population of high-affinity (apparent Kd = 1.9 nM) CNS membrane sites having the regional distribution: striatum much greater than hippocampus greater than cerebral cortex greater than cerebellum. High-affinity [3H]HC-3 binding is entirely dependent upon the presence of sodium chloride (EC50 = 35-50 mM) and is markedly reduced when other salts of sodium or monovalent ions are substituted. [3H]HC-3 binding is inhibited by choline (Ki = 6 microM) and acetylcholine (Ki = 35 microM) but markedly less sensitive to other cholinergic agents and metabolic inhibitors. In light of the similar ionic dependencies, regional distributions and pharmacological specificities of [3H]HC 3 binding and SDHACU, closely associated sites may be involved in both processes. PMID- 6503617 TI - The effect of 3-methylindole on the uptake and incorporation of 14C-choline into phospholipids in lung tissue slices. AB - 3-Methylindole (3MI) is the causative agent in the development of acute bovine pulmonary edema. Microscopic studies revealed a structural disruption in the lamellar bodies of type II cells, indicating an abnormal metabolism of phospholipid in the lung of 3MI treated animals. In the present study, lung slices from 4 goats were used to investigate the changes in phosphatidylcholine metabolism induced by 3MI. Eighteen slices were cut from each healthy lung and divided into control and 3MI groups. After a 4-hr pretreatment with 3MI (.19 or .57 mM) or carrier, the level of incorporation of 14C-choline into phosphatidylcholine, sphingomyelin and their water soluble intermediates was studied. The uptake of 14C-choline and its incorporation into phosphatidylcholine and sphingomyelin was depressed by 3MI treatment. In the water soluble fractions, the radioactivity increased in free choline and CDP-choline, while it decreased in P-choline. This suggests that choline kinase and the P-choline transferases have become relatively more rate limiting and may play a role in the depressed de novo synthesis of phosphatidylcholine induced by 3MI. PMID- 6503618 TI - Characterization of a cytosolic protein inhibiting lysosomal acid cholesteryl ester hydrolase. AB - An inhibitor of lysosomal acid cholesteryl ester hydrolase (Acid CEH), (EC 3.1.1.13) was found in the cytosolic fraction of rat liver and various other tissues. The extent of the inhibitory effect was dependent on the concentration of the cytosolic protein. The Acid CEH inhibitor was heat-labile, non-dialyzable, and its inhibitory activity significantly decreased by trypsin or chymotrypsin digestion, but not by lipase digestion. The inhibitor had no effect on the activity of cathepsin D, beta-glucuronidase and acid phosphatase, which are other enzymes found in lysosomes. The present findings suggest that the inhibitor may be involved in the regulation of the hydrolysis of cholesteryl esters in lipoproteins that have been transferred into the liver. PMID- 6503619 TI - Homeostasis of mucosal cholesterol in the small intestine of the rat. AB - This study was undertaken to investigate the capacity of the intestinal mucosa to maintain a constant cholesterol content under conditions where mucosal uptake or cholesterol transport into the lymph were manipulated. Two series of bile diverted unanaesthetised rats were infused intraduodenally with saline, triolein emulsified with Pluronic F68, or taurocholate with or without added tomatine. Pluronic F68 is a nontoxic detergent which promotes mucosal uptake of polar lipids but not cholesterol. Tomatine is a cholesterol-binding saponin. One series of rats was used for measuring mucosal cholesterol content, DNA and protein after the test infusions. A second series of rats had the thoracic lymph duct cannulated but otherwise remained the same as the first series. The second series was used for measuring the effect of the different infusions on mass cholesterol output into lymph. Mucosal cholesterol content of rats that were not fed decreased with bile-diversion and was restored with taurocholate infusion. This suggested a contribution of luminal cholesterol to the mucosal cholesterol pool. However, evidence for a contribution from the lumen was provided by only one of two groups of rats given infusions which did not promote mucosal uptake of cholesterol. First, addition of tomatine to the taurocholate infusate prevented both the increase in lymph output of cholesterol and the increased mucosal cholesterol content shown in rats given taurocholate alone. Second, in another group of rats in which mucosal uptake of cholesterol was prevented, i.e. in rats given Pluronic F68-triolein emulsions, the increased fat absorption was accompanied by a marked increase in cholesterol output into lymph without a concomitant decrease in mucosal cholesterol content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503620 TI - The effect of neurotensin on the concentration of cholesterol and bile acids in the guinea pig. AB - In guinea pigs, total plasma cholesterol concentrations increased above the control values after single intravenous injections and after 3 days of continuous subcutaneous administration of neurotensin (NT). A high dose of NT (125 pmol/100 g body weight) induced tachycardia and severe respiratory distress; the lowest dose (1.25 pmol/100 g body weight) had the greatest hypercholesterolemic effect 15 min after the injections. The bulk of the total plasma cholesterol was in low density lipoprotein fractions. Cholesterol increased in the same fractions after intravenous administrations of NT. NT induced a decrease in the cholesterol content in the ileum but did not affect significantly the cholesterol content in the liver, kidneys or adrenals. In 48-hr fasted controls, plasma cholesterol concentration and cholesterol content in the liver, kidneys, adrenals and terminal ileum increased; after intravenous injections of NT, plasma cholesterol concentration further increased but cholesterol content of the liver, kidneys and ileum decreased. In fed animals, the concentration of the biliary taurochenodeoxycholic acid increased above the control values 5 and 35 min after the intravenous injections of NT. In fasted controls, the total concentration of bile acids was higher than in fed controls, but only the concentration of taurochenodeoxycholic acid further increased after the injections of NT. Proportionately more taurochenodeoxycholic acid than cholesterol was present in bile after the intravenous injections of NT. These data are consistent with the hypothesis that NT has a regulatory role in intestinal cholesterol transport. PMID- 6503622 TI - Phospholipid studies of marine organisms: new branched fatty acids from Strongylophora durissima. AB - The phospholipids of the sponge Strongylophora durissima were analyzed. The major phospholipids present were phosphatidylethanolamine (PE), phosphatidylcholine (PC), phosphatidylserine (PS), phosphatidylglycerol (PG) and phosphatidylinositol (PI). The major fatty acid components of the phospholipids consisted of short chain (C14-C19) and very long chain (C25 -C30) "Demospongic" acids. Three novel branched delta 5 monounsaturated acids, Z-19-methyl-5-pentacosenoic, Z-19-methyl 5-hexacosenoic and Z-19-methyl-5-heptacosenoic acids were encountered in the sponge. The 3-saturated counterparts of these compounds, 19-methylpentacosanoic, 19-methylhexacosanoic and 19-methylheptacosanoic acids, as well as 19 methyltetracosanoic and 20-methyloctacosanoic acids also are hitherto undescribed acids present in the sponge. Trace amounts of 2 very long chain acids also were detected and their structures tentatively assigned as 19,21-dimethylheptacosanoic and 20,22-dimethyloctacosanoic acids. The distribution of these fatty acids according to phospholipid head groups also was described. PMID- 6503621 TI - Autoxidation of Acholeplasma laidlawii membranes. AB - Autoxidation of Acholeplasma laidlawii membranes (with equimolar ratio of palmitic and linoleic acid) lacks an obvious induction period, and the overall rate of disappearance of substrate does not follow closely that of typical autocatalytic kinetics. Throughout the course of autoxidation, the major oxygenated products isolated were hydroperoxides (as hydroxy esters) and compounds that gave rise to trihydroxy esters. The yield of trihydroxy esters was appreciable even at the early stage of the oxidation and eventually grew to surpass that of hydroperoxides. The positions of the three hydroxyl groups in the trihydroxy esters were determined to be mostly of the 1,2,5-type rather than 1,2,3-type arrangement. To a lesser extent, some degraded products, including dimethyl nonanedioate, methyl myristate, methyl pentadecanoate, methyl hexadecadienoate and methyl heptadecadienoate also were obtained. Dimethyl nonanedioate was a previously known degradation product from 9-hydroperoxide. The shorter chain esters presumably arise from the cleavage of alpha-hydroperoxides of palmitate and linoleate moieties. PMID- 6503624 TI - Essential fatty acids in plasma, red blood cells and liver phospholipids in common laboratory animals as compared to humans. AB - Essential fatty acids were estimated in plasma, red blood cells and liver total phospholipids in rats, mice, hamsters, guinea pigs, rabbits and humans. There were large species differences, suggesting that different species levels should be borne in mind when choosing an animal for a particular study. The 2 species most susceptible to atheroma, the guinea pig and the rabbit, had very high levels of linoleic acid and low levels of linoleic acid metabolites. n-3 fatty acid levels were low in guinea pigs and rabbits and the ratio of n-3 to n-6 fatty acids also was low in the rat. Mice and hamsters had the highest n-3 levels, suggesting they may be the best species to use for studies on the roles of n-3 essential fatty acids. Mice and hamsters and, in some respect rats, were closest to humans in their fatty acid patterns. PMID- 6503623 TI - Reduction of polyunsaturated fatty acid hydroperoxides by human brain glutathione peroxidase. AB - Glutathione peroxidase (GSHPx) activity in the normal human brain was investigated using lipid hydroperoxides as substrates. Samples were obtained from autopsied frontal gray matter of 5 normal human males with no known central nervous system (CNS) disease. Aliquots were homogenized in 0.9% NaCl-0.5% Triton X-100, and the supernatant solution, obtained after centrifugation at 105,000 X g, was used for GSHPx assay. Glutathione peroxidase was measured by following the oxidation of NADPH at 340 nm. Hydroperoxides of linoleic, linolenic, gamma linolenic, 11,14 eicosodienoic, homo gamma linolenic, arachidonic, docosotetraenoic and docosohexaenoic acids were prepared and used as substrates. All these hydroperoxides were reduced by the brain GSHPx system, but at different rates. Gamma linolenic and docosotetraenoic hydroperoxides were reduced rapidly, whereas the peroxides of docosohexaenoic and 11,14 eicosodienoic were reduced at the lowest rate. Arachidonic hydroperoxide had the highest affinity for the enzyme and linolenic the lowest. Our results suggest that the brain GSHPx system is capable of reducing hydroperoxides of polyunsaturated fatty acids. PMID- 6503625 TI - Influence of cholesterol feeding and dietary restriction on cholesterol absorption in rabbits. AB - Plasma cholesterol and cholesterol absorption were measured in rabbits given either a standard or cholesterol-rich diet which were fed either ad libitum or reduced to 50% of the control ration. The results confirmed the aggravating effect of dietary restriction on the plasma cholesterol response to cholesterol feeding. Hypercholesterolemia was doubled when cholesterol feeding was associated with reduced dietary intake. The percentage of cholesterol absorbed increased significantly in cholesterol-fed rabbits on normal caloric ration, while dietary restriction had no effect on this parameter either with the standard or the cholesterol-rich diet. These data indicate that the mechanisms by which plasma cholesterol increases in response to cholesterol feeding involve increased cholesterol absorption. Nevertheless the aggravating effect of dietary restriction cannot be attributed to increased cholesterol absorption. PMID- 6503627 TI - Fatty acid and squalene compositions of Mediterranean Centrophorus SPP egg and liver oils in relation to age. AB - The liver oil content of seven Mediterranean Centrophorus spp. were studied together with the oil of one unfertilized egg and one yolk bag. The relative weight of the liver ranges from 15 to 29% of total body weight; 63 to 89% of the liver weight is oil. Squalene, the major component (49-89% in oil) of the unsaponifiable fraction, is directly quantified by GLC following TLC separation. The squalene level increases with the age of the animals. More than 50 fatty acid species were identified. Among them, the most abundant are: 16:0 (22-27%), 18:1 omega 9 (21-36%) and 22:6 omega 3 (2-18%). The level of omega 3-fatty acids, essential in the fishes, shows a maximum in the egg (26%), decreases to a minimum in the young (5%) and stabilizes to an intermediate level in the adult (12%). PMID- 6503626 TI - Mammary transfer and metabolism in the rat of halogenated fatty acids of halogenated olive oil. AB - To assess possible incorporation of halogenated fatty acids into the neonate via the milk, a 4-day study was carried out in which lactating Wistar rats were orally dosed with either brominated olive oil (BOO) (0.6 g/kg body wt/day) or chlorinated olive oil (COO) (0.4 g/kg body wt/day) for the first 4 days. On days 1-5 inclusive 2 pups per litter were sacrificed and the stomach curd and livers analyzed for halogenated fatty acids by gas liquid chromatography (GLC). On day 5 all dams also were sacrificed and their livers and adipose tissue similarly analyzed. With BOO, brominated fatty acids (bfa) accumulated in both the milk lipids and neonate liver lipids, and appeared to plateau on day 4 at levels of 2% and 5% respectively. In contrast to the BOO in which approximately 100% of the bfa was dibromostearic (DBS), the milk bfa comprised 79% (DBS), 9% dibromopalmitic (DBP) and 12% dibromomyristic (DBM) acids, suggesting maternal metabolism to the shorter chain brominated acids. In the neonate liver lipids the bfa composition was 47% (DBS), 12% (DBP) and 41% (DBM), suggesting either further metabolism in the neonate and/or preferential accumulation of the shorter chain brominated acids. The analysis of maternal tissue indicated very low bfa residues, contrary to previous studies in non-lactating rats. Similar results were obtained with COO. PMID- 6503629 TI - Milk fat structure of a patient with type 1 hyperlipidemia. AB - Structural analyses were performed on milk fat samples obtained 3-10 days postpartum from a lactating patient with primary Type 1 hyperlipidemia. The milk triacylglycerols contained 3-7% C10, 14-21% C12, 20-30% C14, 22-26% C16 and 20 30% C18 (largely oleic) acids. Gas liquid chromatographic (GLC) analyses of the X 1,3- and X-1,2-diacylglycerols on polar siloxane columns showed a markedly non random association of acyl chains. Stereospecific analyses indicated that the short chain length fatty acids were confined essentially to the sn-3-position of the triacylglycerol molecule. Furthermore, these acids were largely absent from the phosphatidylcholines and the endogenous sn-1,2-diacylglycerols of the milk fat. It is concluded that the short chain fatty acids are incorporated into the milk triacylglycerols during the final stage of biosynthesis via the phosphatidic acid pathway, and that the overall fatty acid distribution is consistent with the 1-random 2-random 3-random hypothesis. PMID- 6503628 TI - The effects of dietary cholesterol on blood and liver polyunsaturated fatty acids and on plasma cholesterol in rats fed various types of fatty acid diet. AB - Male rats were fed on a fat-free diet for 8 weeks and then switched to diets containing 10% hydrogenated coconut oil (HCO), safflower oil (SFO) or evening primrose oil (EPO). Half of each group was also given 1% of cholesterol in the diet. After 5 further weeks, plasma, red cell and liver fatty acids were measured in the various lipid fractions. Plasma and liver cholesterol also were estimated. In almost all fractions and on all three diets, feeding cholesterol led to accumulation of the substrates of desaturation reactions and to deficits of the products of these reactions. The results were consistent with inhibition of delta 6, delta-5 and delta-4 desaturation of n-6 essential fatty acids. Since the diets were deficient in n-3 fatty acids, levels were very low but were also consistent with inhibition of desaturation. In contrast, cholesterol had relatively less consistent effects on 20:3n-9, suggesting that desaturation of n-9 fatty acids was less inhibited. Plasma cholesterol levels rose sharply in the HCO and SFO groups but not at all in the EPO group. EPO contains the product of delta-6 desaturation, 18:3n-6, suggesting that conversion of linoleic acid to 18:3n-6 and possibly to further metabolites may be important for the cholesterol-lowering effect of polyunsaturates. PMID- 6503630 TI - Studies of triacyglycerol structure of very low density lipoproteins of normolipemic subjects and patients with type III and type IV hyperlipoproteinemia. AB - The triacylglycerols of very low density lipoproteins (VLDL-TG) were analyzed in samples from normal subjects and patients with Frederickson's Type III and Type IV hyperlipoproteinemia. VLDL were obtained by conventional ultracentrifugation, and the triacylglycerols were isolated by thin-layer chromatography (TLC). Representative sn-1,2(2,3)- and sn-1,3-diacylglycerols were generated by Grignard degradation of the triacylglycerols, and were resolved by TLC on borate-treated silica gel. 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 ethers. The positional distribution of the fatty acids was established by the Brockerhoff stereospecific analysis. The results showed a marked asymmetry in the distribution of the fatty acids in all samples, with the saturated acids predominantly in the sn-1-position and the unsaturated fatty acids distributed about equally between the sn-2- and sn-3 positions. In all instances, the molecular species composition of the sn-1,2-, sn 2,3- and sn-1,3-diacylglycerols was found to be similar to that calculated for 1 random 2-random 3-random distribution of triacylglycerols. There were marked differences in the quantitative composition of the molecular species of the VLDL TG between normal subjects and patients, but these discrepancies were attributed to differences in the fatty acid composition of the samples. PMID- 6503631 TI - Purification of lysosomal cholesteryl ester hydrolase from rat liver by preparative isoelectric focusing. AB - Ion-exchange chromatography and preparative isoelectric focusing (PIEF) were compared to produce a stable rat liver lysosomal cholesteryl ester hydrolase of high specific activity. The PIEF purification method proved to be more rapid and easier to perform. PIEF purification involved the following steps: i) osmotic shock of the lysosome fraction, ii) (NH4)2 SO4 precipitation (10-70%, w/v), iii) Sepharose CL-6B gel filtration, and iv) PIEF. The enzyme was purified 60-120-fold with a yield of 2-4%. The activity of the purified enzyme was best restored by stabilizing with a 0.5% (w/v) albumin solution. The purified enzyme produced one major band on SDS-polyacrylamide gel electrophoresis having a MW of 58,500 daltons. Gel filtration showed a MW of 58,000 daltons. The optimum pH of the enzyme was 4.5, and the isoelectric point was 6.0-6.2. The specific activity of hydrolysis of cholesteryl oleate and triolein increased by similar rates during purification. PMID- 6503632 TI - Brominated fatty acid distribution in tissues and fluids of rats fed brominated vegetable oils. AB - Rats dosed orally for four days with 0.24 g/kg body weight per day of brominated olive oil (BOO) or brominated sesame oil (BSO) were found to accumulate dibromostearic (DBS) acid (from BOO) and DBS and tetrabromostearic (TBS) acids (from BSO) in the liver, heart and adipose tissue. The metabolites, dibromopalmitic, and dibromomyristic acids (from BOO and BSO), as well as their tetrabromo-analogues (from BSO) were found as determined by gas chromatography with halogen specific detection and confirmed by gas chromatography-mass spectrometry. Blood contained no DBS, TBS or metabolites. However, inorganic bromide was observed in both blood and urine while none was observed in the feces. The latter contained significant quantities of both DBS and TBS but showed the absence of the four brominated metabolites. PMID- 6503633 TI - Influence of long-term anticonvulsant treatment on liver ultrastructure in man. AB - In 35 patients on long-term anticonvulsant treatment (7-35 years, means = 19.6 years), various liver enzymes were measured. In 32 cases (91.4%), elevated levels of serum-gamma-glutamyl-transpeptidase (GGT) were found. Liver biopsy was performed in five of 13 patients with GGT levels of greater than 60 U/l (75-257, means = 123 U/l). Light microscopy showed a minimal steatosis and fine granular appearance of hepatocytes in two cases, and a slight portal fibrosis in one case. Two cases showed an unremarkable histology. Electron microscopy revealed signs of enzyme induction as overall swelling of the smooth endoplasmic reticulum and additionally a dilatation of the rough endoplasmic reticulum in all five specimens. No signs of liver damage or disturbance of liver function could be observed. PMID- 6503634 TI - Determinants for hepatitis B e antigen clearance in chronic type B hepatitis. AB - A 6-year (mean 24.5 months) longitudinal study has been undertaken in 237 HBeAg positive patients with clinicopathologically verified chronic hepatitis. HBeAg clearance occurred in 74 patients at a rate of 16% per year, and a cumulative probability of 67% at the end of a 5-year follow-up. HBeAg clearance was preceded by a temporary "exacerbation" with SGPT greater than 300 IU/L in 62% of the patients. On the other hand, irrespective of the level of SGPT elevation, only 23% of such exacerbations were followed by HBeAg clearance. Further analysis indicates that alphafetoprotein greater than 100 ng/ml, frequently associated with bridging hepatic necrosis, during "exacerbation" predicts HBeAg clearance. In addition, patients with chronic lobular hepatitis and chronic active hepatitis have a higher annual HBeAg clearance rate than patients with chronic persistent hepatitis and nonspecific histologic changes (greater than 15% vs less than 8%, P less than 0.03). Short-term immunosuppressive treatment did not delay HBeAg seroconversion. Male patients had a higher annual HBeAg clearance rate than female patients (18.2% vs 8.7%, P less than 0.05). It was concluded that, in addition to the time factor, the nature of chronic hepatitis, the extent of hepatic damage during "exacerbation", and the sex of the patients are important determinants for HBeAg clearance. PMID- 6503636 TI - [Roentgenotopometric studies using a simulator during the preparation of patients with uterine cancer for irradiation]. AB - During the examination of 170 patients with corpus and cervix uteri cancer it has been established that simulators give an opportunity to define orienting points in the same position as that used during irradiation, to obtain all necessary topometric data for preparing anatomotopographic maps and calculating with their help irradiation programs, and simulate geometric conditions of an irradiation program. PMID- 6503635 TI - Changes induced in human liver by long-term anticonvulsant therapy. Functional and ultrastructural data. AB - The study reports functional and morphological findings in eight male subjects undergoing anticonvulsant therapy for periods from 20 days up to 15 years. All subjects showed an increased activity of the hepatic microsomal NADPH cytochrome c reductase and an increased amount of smooth membranes in hepatocytes. The enzymatic activity was higher in the first years of treatment. Quantitative ultrastructural analysis showed that a twofold increase of the smooth membranes of hepatocytes had already been reached after 20 days of therapy, with a modest additional increase occurring thereafter. Both enzymatic and structural changes appear to be related to therapy. In addition, abnormal lipofuscin-related cytoplasmic formations were present in the hepatocytes of five subjects. Such formations are thought to represent an accumulation of abnormal degradation products, possibly related to an interaction of the drug(s) metabolites with cellular components. PMID- 6503637 TI - [Combined treatment of breast cancer using bremsstrahlung and electron radiation]. AB - Combined therapy with accelerator high-energy radiations was applied to 116 patients with breast cancer, Stages II-III. At the beginning the patients received preoperative irradiation of the affected breast and ipsilateral axillary zone with braking irradiation at 25 MeV. The summary focal dose of 20 Gy was delivered with 5 daily fractions, 4 Gy each. This was followed by radical mastectomy. In the postoperative period irradiation of the supraclavicular and parasternal zones on the ipsilateral side with electron radiation at 10-22 McV was used when indicated. The summary focal dose of 44-50 Gy was provided in 22-25 fractions. Local recurrences developed in 2.6% of the cases. No regional recurrences and metastases to the supraclavicular lymph nodes were noted. No marked reactions and complications were revealed. PMID- 6503638 TI - [Radiotherapy in the combined treatment of malignant tumors of the orbit in children]. AB - A study of the long-term results of treatment of 66 children with eye socket tumors has shown that use of a dose over 50 Gy in the postoperative period causes the development of radiation injuries of the facial skeleton and healthy eye. To lessen radiation exposure of the healthy organs and tissues it is advised that intracavitary radiotherapy should be used after eye socket exenteration. The use of this method makes it possible to deliver a necessary dose of irradiation to a focus of lesion with a 2-fold decrease in radiation exposure of the surrounding tissue. PMID- 6503639 TI - [Radiotherapy tactics in vertebral hemangiomas]. AB - Basing on the follow-up of 124 patients with vertebral hemangiomas over the period of 1964-1982, a differentiated approach to the choice of a therapeutic program was developed which was determined by clinical manifestations of the disease. Clinicoroentgenological findings taken as a whole were regarded as a decisive factor in determining indications to radiotherapy. The differentiated approach made if possible to use essentially different doses to achieve a therapeutic effect, and part of the patients were kept under observation. This kind of tactics seems justified with regard to benign tumors. PMID- 6503641 TI - [Economic analysis of the utilization of radiodiagnostic equipment]. PMID- 6503640 TI - [Combined gamma-therapy of rectal cancer using movable radiation sources in intracavitary irradiation]. AB - The authors present a technique of concomitant radiotherapy of rectal cancer using 60Co movable sources of the Agat-B unit for contact irradiation. The paper is illustrated with the schemes of radiation sources in relation to tumors and pictures of dose fields formed by various radiation sources and positions as well as their time intervals in each position during a therapeutic session. The results of treatment of patients in the main group (47 persons) and in the control group when the patients received gamma-beam therapy only (45 persons) are also given in the paper. Two-year survival rates have shown significantly improved long-term results in the main group. The new method is recommended for practical use as a variant for extended indications to concomitant radiotherapy of rectal cancer and for improving its results. PMID- 6503642 TI - [Formation of an optimum dose field in interstitial radiation therapy]. PMID- 6503643 TI - [Radioimmunoassay in the evaluation of the hormonal state of patients with malignant tumors of the female genitalia]. AB - Using a radioimmunoassay of hormones, disorders in the system of hormonal relations were revealed in 210 patients with malignant ovarian and corpus uteri tumors and correlated with a clinical course of disease. The recovery of the hormonal balance can serve an objective criterion for the evaluation of therapeutic efficacy and for a search for new antitumor drugs and means of correction of the disturbed feedback between hypophyseal and ovarian functions as one of the main factors of the pathogenesis of malignant ovarian and corpus uteri tumors. The author describes the importance of radionuclide methods in vitro for an all-round control over changes in the respective components of the neuroendocrine system in treatment of dyshormonal tumors and possibilities of their use in screenings of the hormonal status. PMID- 6503644 TI - [Prospects for the use of myoglobin radioimmunoassay]. PMID- 6503645 TI - [Radioimmunoassay in the testing of new pharmacological agents]. AB - The activity of Parathorm, a pharmaceutical obtained from parathyroid hormone (PTH), was studied. Human blood plasma proteins as well as bivalent anions have been shown to produce a negative effect on the antigen-antibody interaction. The proportion of the PTH-protein complexes with the elevation of the pharmaceutical dose is constant in many concentrations whereas with the elevation of the PTH dose the PTH-low molecular complexes account for ever increasing proportion of the radioactive complexes. PMID- 6503647 TI - [The use of radioimmunoassay in the diagnosis of various forms of endocrine infertility]. PMID- 6503646 TI - [Radioimmunoassay in the diagnosis of atypical forms of thyrotoxicosis]. AB - Fifty-six patients with "unmotivated" disorder of the cardiac rhythm were examined. A combined radionuclide study including a study of iodoabsorptive function with a standard technique, thyroid visualization and determination of the thyroxin triiodothyronine level in the blood serum with the radioimmunoassay using standart diagnostic kits, was conducted. Latent thyroid hyperfunction was revealed in 24 patients (42.8%). Study of iodoabsorptive function revealed pathological changes in 8 patients only, whereas radioimmunoassay revealed a significant elevation of the peripheral thyroid hormone level as compared to that of the control group in 24 patients. Change of the TSH level was not noted. The conclusion is that patients with "unmotivated" disorder of the cardiac rhythm often suffer from latent thyrotoxicosis which is the main etiological factor and trigger mechanism of arrhythmias. In such a situation they are the only clinical symptom of thyrotoxicosis that makes it possible to regard this form of disease as monosymptomatic. The early detection of the cause of cardiac rhythm disorder and the prescription of pathogenetic thyrostatic therapy resulted in the return of the cardiac cycle rate to normal in all the patients with sinus tachycardia and prevented relapses of the paroxysmal forms of rhythm disorder. PMID- 6503648 TI - [Clinical studies of the radiosensitizing effect of small doses of ionizing radiation (preliminary data)]. AB - The authors present the preliminary clinical results of radiation therapy of patients with uterine tumors (adenogenic endometrial cancer) under the conditions of short-term stimulation of proliferation with small doses of ionizing radiation to enhance the damaging effect of the main radiation. The results of a cytological study of 72 patients and 2-year follow-up results of 20 patients show that the use of small radiation doses as a radiosensitizing factor in radiation therapy of resistant cancer types holds promise. It is advisable that these studies should be continued. PMID- 6503649 TI - [The levels of occupational irradiation of medical radiologists in the USSR from 1981 data on centralized individual dosimetric control]. AB - By the 1981 centralized individual dosimetric control data using film dosimeters IFKU-1 the summary dose of medical radiologists in the Ukraine was 223 man-cSv X year-1. The mean annual doses in different occupational groups of medical radiologists varied from 0.07 to 0.60 cSv X year-1 and were in accord with the data available to the UN Scientific Committee on Atomic Radiation Effects concerning the levels of irradiation in similar professions in France, Canada and Austria in the period of 1974 to 1975. Persons in charge of the storage of radioactive substances are referred to high risk groups by the level of a mean annual dose (0.60 cSv X year-1). The distribution of irradiation annual doses of medical radiologists in the Ukraine was well approximated by Weibull function within the dose range of 0-1.1 cSv X year-1. This dose range accounts for 98.4% of all the cases. 1.6% of the persons received annual doses within the range of 1.1-3.5 per year-1, and their summary dose was 53.5 man-cSv X year-1. Basing on the data obtained a conclusion has been made that an increase in the frequency of stochastic effects in Ukrainian medical radiologists at the expense of occupational irradiation in 1981 is not to be expected. PMID- 6503650 TI - [Irradiation of cancer patients through the grid diaphragm]. AB - Irradiation through a grid diaphragm has some advantages. However, further development of this method is complicated by the absence of sufficiently substantiated theoretical principles using physical-dosimetric as well as radiobiological approaches. The correct presentation of the clinical data and precise statistical data processing are necessary, especially while comparing this method with other radiotherapeutic methods. PMID- 6503651 TI - [Dosimetric characteristics and radiobiological model of the irradiation of malignant tumors through a grid]. AB - The concepts of a "dose gradient" and a "focal dose" were considered. It was found inappropriate to regard in grid irradiation of the whole tumor a dose absorbed in tumor open parts as a focal dose. Open field and grid irradiation methods were correlated by the criterion of cancer cell survival. At the present stage of research it is difficult to prefer one of these methods because the problems of irradiation optimization have not yet been solved for either of them. PMID- 6503652 TI - [Standard grid diaphragms in the telegammatherapy of malignant tumors]. AB - The paper is concerned with the problem of uneven irradiation of tumors using standard grid diaphragms on Soviet gamma-apparatuses. It has been shown that the utmost spatial heterogeneity is formed by using the C-4 grid with the source surface distance (SSD) of 47 cm. The degree of spatial heterogeneity formed by the C-3, C-2, C-1 and C-5 grids is less pronounced. An increase in SSD results in the formation of more even irradiation. In uneven irradiation of tumors the nature of dose fractionation changes and it should be taken into account in the planning of radiotherapy. PMID- 6503654 TI - Expert witnesses--one view. PMID- 6503653 TI - [Radioimmunoassay of carcinoembryonic antigen, gastrin and immunoglobulin E in evaluating different methods of treatment of patients with esophageal and stomach cancer]. AB - A radioimmunoassay of the carcinoembryonic antigen, gastrin and immunoglobulin E was performed in the blood serum of more than 300 esophageal and gastric cancer patients. It has been noted that the CEA study makes it possible to determine the severity of disease and may serve as a yard-stick of radical therapy. Hypogastrinemia develops in 82-84% of patients with tumors of these sites. The gastrin level after therapy depends on the nature and type of antitumor therapy. An increase in the IgE level is a risk factor which makes it possible to identify patients with an "unfavorable" or complicated course of disease and to determine, to some extent, prognosis, to control therapeutic measures in combined treatment. The use of the radioimmunoassay for CEA, gastrin and IgE in the combined study of esophageal and gastric cancer patients allows one to evaluate the patients's status before treatment and to determine their response to tumor therapy. PMID- 6503655 TI - Knee injuries: their nature, cause and consequence. PMID- 6503656 TI - Physical risks in modern sport. PMID- 6503657 TI - Travel and performance. PMID- 6503658 TI - Sport injury and the law. PMID- 6503660 TI - Vehicular-related fatalities among teenagers--the Metro Dade County experience, 1978-82. PMID- 6503661 TI - A fatal case of toxic-shock syndrome following cholecystectomy. PMID- 6503659 TI - The second post-mortem and deaths overseas: a case report. PMID- 6503663 TI - Vampirism--legendary or clinical phenomenon? PMID- 6503662 TI - Driving and alcohol: a case report of a biological impossibility. PMID- 6503664 TI - The finance of sport--a talk to the British Academy of Forensic Sciences. PMID- 6503665 TI - Aqua-eroticum--a case of auto-erotic drowning. PMID- 6503666 TI - [Time sharing of channels in polyrheographic studies]. AB - Currently used methods of reducing interchannel effects in multichannel rheographs suffer from disadvantages that limit their metrologic parameters and the field of their application. Time sharing of rheograph channels enables the interchannel effects to be totally eliminated regardless of both the technique of signal recording and the location of electrodes. If optimal conditions are met, the high accuracy of measurements is provided. PMID- 6503667 TI - [Methods of reducing the level of parasitic oscillations in the construction elements of ultrasonic therapy applicators]. AB - The methods of reducing parasitic oscillations in hand-pieces for ultrasonic therapeutic probes are proposed. The set and the method for measuring these oscillations are described as well as some experimental results. PMID- 6503668 TI - [Laser flow-type counter-analyzer for microparticles]. AB - A flow-type instrument for studying microparticles distributed in liquid suspensions is presented. With the instrument, one can determine concentrations of microparticles, their size distribution, perform computer-based data analysis. Considerations are also given to the main units of the instrument, their characteristics, and data acquisition and processing. PMID- 6503669 TI - [General-purpose microcomputer for medical laboratory instruments]. AB - Presented in the paper is the microcomputer based on the KP580 microprocessor set. Debugging of the hardware and the software by using the unique debugging stand developed on the basis of microcomputer "Electronica-60" is discussed. PMID- 6503671 TI - [Steam generators for steam sterilizers]. PMID- 6503670 TI - [Errors of impulse photometers]. AB - Errors of pulse photometers intended for clinical biochemical studies have been analyzed. The recommendations are given how to minimize the errors and to improve metrologic parameters of pulse photometers. PMID- 6503672 TI - [Effect of nonequilibrium plasma parameters on the surface characteristics of titanium medical instruments]. AB - Hardening in the stream of nonequilibrium plasma seems to be promising for medical microinstruments made of titanium alloys. The impact of parameters of nonequilibrium plasma and operational conditions of the set on surface properties for several titanium alloys has been studied. PMID- 6503673 TI - [Method of electrochemical studies on the effect of corrosive media on the corrosion resistance of medical instruments]. AB - Considerations are given to some methodical problems, and corrosion performance of stainless steels 30 X 13 and 03X11H10 M2T2 used for production of medical instruments is studied by using the method of anode polarization curves. The treatment in hydrogen peroxide is shown to exert a distinct passivating effect on surfaces of the steels under study. Among the bioactive media the plasma substituting agent gelatinol is the most aggressive. When studying the corrosion resistance of metals by potentiostatic methods the physiological solution imitating the blood is proposed to be used as an operating medium. PMID- 6503674 TI - [Complex mechanization and automation in industry (based on the experience of the establishments of the "Soiuzmedinstrument" association)]. AB - Some results of data analysis in realizing the dedicated technological programs are presented, and the impact of the programs on the efficiency in the use of labor resources is discussed. PMID- 6503675 TI - [Experience in automating the matched selection of manufactured goods in serial production (using the selection of telephones for audiometry as an example)]. PMID- 6503676 TI - [Instruments for surgery on the liver and bile ducts]. AB - Newly designed instruments are intended for operations on the liver and bile ducts for cholelithiasis and other abnormalities of the bile tracts. In comparison with the earlier methods they are less invasive and easier in use. Some advantages of the instruments are considered with special reference to the decrease in post-operative complications. As clinical tests have shown, the application of the instruments offers new diagnostic and surgical possibilities in the treatment of various diseases of the liver and bile ducts. PMID- 6503677 TI - [Set of plastic connectors for catheters and probes (kit consisting of 3 types of connectors--regular, T-shaped and Y-shaped)]. PMID- 6503678 TI - [Rheocardiographic studies on the accuracy of cardiac stroke volume models]. AB - Some results of the studies on the accuracy of detecting pulsating stroke volume from rheocardiograms are discussed. Using a physical model it is shown that resulting values are strongly conditioned by relative positions of electrodes and pulsating volume, its shape, and the geometry of conducting medium. An approximate value of the stroke volume may be derived from the semiempirical formulae coupling relative variations of the resistance and the volume. It may differ from the true magnitude by the factor of 1.5-2. PMID- 6503679 TI - [Esophagogastroduodenal endoscopy in diagnosis in tropical areas. Apropos of 3000 studies performed in adults]. AB - The authors report on the results gained from 3000 peroral endoscopies (10% as urgent cases) carried out in adults at the Dakar General Hospital within a period of 30 months. They emphasize the low cost of such an exam, and they underline: a) the young age of examined patients b) the number of examinations on out-patients, demonstrating that oesogastroduodenoscopy is now well accepted by Africans. Digestive hemorrhages are mainly caused by duodenal ulcers, oesophageal varices, hemorrhagic gastritis. A new pathology is raising up: volontary ingestion of caustic pro ducts. The most frequent lesions observed are duodenal ulcers, oesophagic and gastric cancers, gastritis. The interest of endoscopic control of healing of cancers is confirmed. Revealing of oesophageal varices often take place before an hepatopathy is discovered. Therapeutic endoscopy and monitoring endoscopy should be developed. Through improved technics, diagnostic endoscopy has been efficient. PMID- 6503680 TI - [Pancreatic pathology in black Africans (excluding diabetes)]. AB - Number of cases of pancreatitis obviously increases in african Black not so much acute forms but mainly chronic calcifying forms of which ethylism represents the main etiology. As in cancers and pancreatic cysts, symptomatology shows no particular characteristic in Negroes. Moreover, because some deficiencies in the sanitary network, lethality remains at a high level. A special form, principally identified in Kerala and Java, is met in some african areas: the juvenile tropical pancreatitis syndrom, with diabetes as main symptom, of which no explanation can be given up to now. PMID- 6503681 TI - [Gastric tuberculosis. Apropos of a recent case report recorded in Abidjan]. AB - The authors describe a case of gastric tuberculosis in a 23 years old African patient from Abidjan. Symptomatology included epigastralgia, post prandial vomiting, severe impoverishment of health state and dehydration. Endoscopy showed a pseudopolypoid diffuse gastritis with an infiltrated like mucosa. Endoscopic biopsy was carried out, but, because of clinical aggravation (epigastric muscular defense), the patient underwent a laparotomy before knowing the results of the biopsy. Gastrotomy showed an hypertrophied granulomatous hemorrhagic mucosa. By histological examination it was concluded in favour of a granulomatous gastritis with pan-parietal tuberculoid lesions without acid-alcohol-fast bacilli. The different causes of granulomatous gastritis were reviewed and a tuberculous etiology suspected. An antituberculous therapy was prescribed with excellent results on clinical and endoscopic standpoint one year after the treatment started. PMID- 6503682 TI - [Duodenal tuberculosis associated with lymph node tuberculosis (apropos of a surgical case)]. AB - The authors report a case of duodenum tuberculosis associated to a lymph gland tuberculosis. Diagnosis has been made possible only with an exploratory laparotomy justified by an almost total duodenum stenosis. They review the different aspects (pathogenic, anatomopathologic, clinical, radiological, therapeutic) of a disease non frequent but not exceptional, especially in the african countries. PMID- 6503683 TI - Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. AB - The natural history and prognostic factors of medullary carcinoma of the thyroid (MCT) were studied in 161 patients seen at the University of Texas M. D. Anderson Hospital and Tumor Institute at Houston between 1944 and 1983. One hundred twenty five patients (77.6%) had the sporadic variety of MCT, 31 patients (19.3%) had multiple endocrine neoplasm (MEN) type IIa and 5 patients (3.1%) had MEN-IIb. The disease occurred equally in both sexes (M:F ratio 1:1.05). Thyroid nodules were the most common presenting feature especially in patients with the sporadic disease and MEN-IIb. Fifteen patients with MEN-IIa had occult MCT; the diagnosis was made through screening of family members with calcitonin measurement before and after stimulation with calcium or pentagastrin. Sixteen patients with MEN-II had pheochromocytoma and 7 had hyperparathyroidism. Total thyroidectomy was the most commonly performed operation. The lowest incidence of recurrence occurred in patients who underwent total thyroidectomy and modified neck dissection. Radioactive 131I was used as adjunct to surgery in 19 patients but it did not improve the survival or lower the incidence of recurrence. Patients who received postoperative radiotherapy had significantly lower adjusted survival rates than those treated by surgery alone, but we tended to irradiate patients with more advanced disease. Chemotherapy was administered to 11 patients with disseminated metastases but the response was poor. The 5- and 10-year adjusted survival rates of all the patients with MCT were 78.2% and 61.4%, respectively. Patients with MEN-IIa had much better rates than patients with sporadic disease (p = 0.0005), who were 7.74 times more likely to die of MCT. The stage of the disease at presentation was a major prognostic factor. Patients with stages III or IV disease were 7.31 times more likely to die of MCT than those with stages I or II. There was no significant difference in survival between patients with stages I and II or III and IV. The presence of cervical lymph node metastases did not affect the survival adversely. Direct extension with involvement of tissue was a bad prognostic sign. Patients younger than 40 years old at the time of diagnosis of MCT had a significantly better adjusted survival rate than those who were older. Women had a better prognosis than men, who were 1.89 times more likely to die of MCT. Diarrhea was a bad prognostic sign. However, it occurred more frequently in patients with advanced stages of the disease and larger tumor mass.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6503684 TI - [Morphological and cytochemical differentiation of the rat testis under physiological conditions and after administration of toxic doses of cadmium chloride]. AB - The paper describes morphological and cytochemical changes in rat testis starting with the first day of postnatal life to 1,5 year under physiological conditions and after single intraperitoneal injection of 1,5 mg CdCl2/kg. We have proved that sensitive cells in testis are: spermatogonia B and primary spermatocyte. Maximum morphological and cytochemical changes occur in the testis of 30-60 days old rats and in 15 year old rats following destruction of the testis begins in capillar walls and blod-testis barrier. PMID- 6503685 TI - [Effect of low doses of lead and cadmium on glyoxalase I and glyoxalase II activities of the liver and brain of rats]. AB - The effects of low doses of lead and cadmium on the activities of glyoxalase I and glyoxalase II in liver and brain of male Wistar rats were examined. Generations P, F1 and F2 received lead acetate and cadmium acetate in drinking water. The doses were as follows: group I-Pb 5 ppm, group II-Pb 50 ppm, group III Cd 0,1 ppm, group IV-Cd 5 ppm. group V-Pb 5 ppm + Cd 0,1 ppm, group VI-Pb 50 ppm- Cd 5 ppm. The control group received sodium acetate with water. P population received Pb and Cd for 40 days before fertilization, and then the pregnant females were given the same doses until the end of pregnancy. Animals of F1 and F2 generation were killed after 30, 60 or 90 days. In liver and brain homogenates the activities of glyoxalase enzyme system were determined by the spectrophotometric method at 240 nm. A little inhibition of glyoxalase I was observed in rats that were given lead for 30 days, while in rats treated for 60 and 90 days the activities of glyoxalase I increased. Glyoxalase II was activated both by lead and cadmium in all groups. In vitro examinations demonstrated that lead and cadmium inhibited the activity of glyoxalase I and activated glyoxalase II. PMID- 6503686 TI - [Toxic effect of carbon tetrachloride on the myocardium. I. Clinical aspects]. AB - Case histories of twelve patients treated for carbon tetrachloride poisoning at the Toxicological Clinic, Institute of Internal Medicine, Medical Academy of Cracow, during 1971-1975, ware analysed retrospectively. All patients were found to have developed some liver damage, two of them exhibiting acute renal failure, another two--impaired central nervous system. Nine of the patients developed changes indicative of adverse effects of carbon tetrachloride upon the cardiac muscle. PMID- 6503687 TI - [Biological evaluation of the aggressiveness of copper slag dust]. AB - By hemolytic, intraperitoneal and intratracheal tests, biological effects of the copper slag dust, which has recently been used in casts cleaning processes, have been investigated. It was found that the copper slag dust is not biologically inert. It exhibits slight fibrogenic properties resulting in fibrous changes after lung administration. The fibrosis resembles that of collagenosis. The fibrous reaction, in form of granulomas with developed procollagenic fibres, was found on intraperitoneal dust administration. Three and six months after intratracheal insufflation of 50 mg of the dust a significant increase in the content of hydroxyproline and lipids in lungs, as compared to controls, was found. Histopathological test revealed the connective tissue multiplication, of focal type, around dust clusters, forming granulomas consisting of macrophages and other mononuclear cells. In the hemolytic test the slag dust induced hemolysis of 7% ram erythrocytes. The test dust should be classified as weakly fibrogenic. PMID- 6503688 TI - [Condition of the nasal and pharyngeal mucosa in workers exposed to titanium dioxide dust]. AB - Fifty-eight workers occupationally exposed to titanium dioxide dusts underwent repeated laryngological and cytological examinations of their nasal mucous membrane smears. The clinical examination showed chronic, whether simple or atrophic, rhinitis (77 per cent) and pharyngitis (50 per cent). The cytological test revealed, in all smears, metaplasia of the respiratory epithelium, towards squamous epithelium. Both the rate of catarrhal changes and the degree of epithelial metaplasia have been found to vary with the duration of daily exposure. The changes in epithelium and nasal mucous membrane occurred after six months' exposure. PMID- 6503689 TI - [Reduction of health risk factors in workers exposed to carbon disulfide]. AB - The results of all the efforts made so far towards the reduction of CS2 concentrations at the workplaces of viscose rayon industry indicate that achievement of safe standards is little probable in the nearest future. Likewise, the preventive activities aimed at the reduction of the daily working time from 8 to 6 hours and referring workers to work with no exposure for several months are hardly effective. Basing on the results of clinical and epidemiological studies of the CS2 exposed population and relevant control groups the authors indicate their own solutions of decreasing the health risk. Pursuant to this suggestion the total time of work in exposure should not exceed 15 years and would be interrupted by so called periods of "health regeneration", consisting in the transfer to the production with no CS2 exposure for one year. This rotational system would apply to all those employed for over five years under CS2 concentrations exceeding the hygienic standards. PMID- 6503690 TI - [Function studies of the organ of sight in welders of the M-5 Division at the brown coal mine in Belchatow]. AB - The results of functional examinations of the sight organ (vision acuity, colour differentiation, ability to differentiate shapes in darkness at lowest luminances, glare test, stereometry), both in welders and controls, were not significantly changed after eight-hours' work. On the other hand, a statistically significant difference was found between the groups as regards colour differentiation, visual capability within the lowest luminations, and glare test. PMID- 6503691 TI - [Evaluation of the organ of sight in workers at the Masovian Refinery Petrochemistry Plant. II. Correlation of the results of ophthalmological tests with the results of specialized and laboratory tests]. AB - Basing on the results of examinations of 752 workers of the Refinery-Petro chemistry Plant, correlations have been searched for between changes in the macula region of retina and disturbances found due to other specialist tests (internal, laryngological, dermatological), as well as laboratory--and toxicological investigations. A statistically significant correlation was found between changes in the macula and dysgeusia at the water-sewage division as well as the level of triglycerides at the phenol-and-total cholesterol division. A strict correlation was found between an increase in arterial hypertension and the rate of macula changes. PMID- 6503692 TI - [Main coronary disease risk factors in metallurgy workers]. AB - The authors investigated the extension of major coronary risk factors among metal flatten workers. In the whole population the percentage of these factors was as follows: hypertension 14,4%, hypercholesterolemia, 17.7%, hyperglycemia 6,5%, overweight 35% and cigarette smoking 61,3%. The extension of the risk factors is dependent on age and increases with age. No significant correlation was found between these factors and working conditions. In comparison to other investigations carried out in Poland the examined population exhibited considerable tobacco smoking, overweight, hyperglycemia and hypercholesterolemia. PMID- 6503693 TI - [Changes in the incidence and structure of absenteeism due to illness in Poland 1970-1982]. AB - The dynamics of absenteeism due to particular causes of diseases of national economy workers in Poland, during 1970-1982, was analysed. An increase of the sickness absenteeism rate by approx. 48%, the annual increase rate coming to about 3%, was noted. The highest dynamics of increase related to the osseo muscular system diseases, approx. 15% annually, then the circulatory system diseases--approx. 7%, the specific index due to arterial hypertension increasing annually by about 17%. The highest dynamics of increase in absenteeism rates due to certain diseases resulted in considerable changes in sickness absenteeism structure at the time being analysed. PMID- 6503694 TI - Pre- and postlexical loci of contextual effects on word recognition. PMID- 6503696 TI - Memory for faces: encoding and retrieval operations. PMID- 6503695 TI - Combining attributes in specified and categorized target search: further evidence for strategic differences. PMID- 6503697 TI - The verification of category and property statements. PMID- 6503698 TI - Coactivation and comprehension: contribution of text variables to the illusion of knowing. PMID- 6503699 TI - Optimal learning strategies and their spontaneous use: the importance of task appropriate processing. PMID- 6503700 TI - The parameter preferences of acquired motor programs for rapid, discrete movements: I. Transfer of training. PMID- 6503702 TI - Is temporal order encoded automatically? PMID- 6503701 TI - Bilinguals in a monolingual and a bilingual speech mode: the effect on lexical access. PMID- 6503703 TI - Beliefs underlying random sampling. PMID- 6503704 TI - Diagnosticity and the base-rate effect. PMID- 6503705 TI - Strategy use in question-answering: memory strength and task constraints on fan effects. PMID- 6503706 TI - State and county mental hospitals, United States, 1980-81 and 1981-82. PMID- 6503707 TI - Distribution of psychiatric beds, United States and each state, 1982. PMID- 6503708 TI - Reduction of increased levels of blood glycerol and ketone bodies by propranolol in human hyperthyroidism: role of the fall of the triiodothyronine level. AB - Hyperthyroid patients in the postabsorptive state have elevated levels of blood glycerol and ketone bodies (KB): this is believed to be due to increased lipolysis and ketogenesis. These increased glycerol and KB levels return toward normal after oral propranolol administration. In order to investigate the mechanism of action of propranolol in hyperthyroid patients, we compared the effects of the oral administration of propranolol with those of timolol, propylthiouracil (PTU), and a placebo. The placebo had no effect. The free thyroxine index, immunoreactive insulin level and glucagon level were not modified by propranolol, timolol, or PTU. Propranolol decreased the pulse rate (P less than 0.01) and the levels of serum triiodothyronine (T3; P less than 0.05), blood glycerol (P less than 0.01), and KB (P less than 0.01). Like propranolol, timolol decreased the pulse rate (P less than 0.01) but had no effect on the T3, glycerol, or KB levels. Propylthiouracil did not modify the pulse rate, but like propranolol, it decreased the T3 (P less than 0.05), glycerol (P less than 0.01) and KB (P less than 0.01) levels. These results suggest that the metabolic actions of propranolol are not caused by its hemodynamic effects nor its beta blocking properties but are mediated by the decrease of the T3 level. PMID- 6503709 TI - Metabolic, endocrine, and reproductive changes of a woman channel swimmer. AB - We report the coordinated metabolic, hormonal, and reproductive data of a female channel swimmer during the pre-swim training period, immediately post-swim, and in the post-swim untrained state. Urine and blood samples collected at these times were assayed for diurnal urinary catecholamines, urinary C-peptide and 3 methylhistidine, total blood ketone bodies, glycerol, the reproductive hormones, adrenal androgens, and thyroid hormones. Subcutaneous fat was measured by ultrasonography. All of the metabolic and hormonal data post-swim except cortisol reflected the severe physiological stress. Urinary catecholamines returned to near-normal levels by 12 hours post-swim. The metabolic changes were associated with reproductive changes, including a shortened luteal phase, absence of ovulation, and increased LH secretion relative to FSH. The swimmer maintained high levels of body fat; she did not become amenorrheic. Metabolic and reproductive hormone levels returned to normal by 2 months post-swim. PMID- 6503711 TI - Posttranslational modifications. Part B. PMID- 6503710 TI - Increased cholesterol in plasma in a young man during experimental copper depletion. AB - Signs of copper depletion were produced in a healthy man by an amount of dietary copper (0.83 mg/day) similar to that in some contemporary diets. Urinary and fecal loss of copper exceeded intake. Plasma copper, ceruloplasmin, and superoxide dismutase activity in erythrocytes decreased. Cholesterol in plasma increased, and hematologic indices were unchanged. Lipid metabolism may be a more sensitive index of copper nutriture than are changes in hematology. The findings support the hypothesis that inadequate copper nutriture or altered copper metabolism contributes to the occurrence of ischemic heart disease. PMID- 6503712 TI - Detection and identification of substrates for protein kinases: use of proteins and synthetic peptides. PMID- 6503713 TI - N epsilon-(beta-aspartyl)lysine. PMID- 6503715 TI - Nonenzymatic formation and isomerization of protein disulfides. PMID- 6503714 TI - Formation and isomerization of disulfide bonds in proteins: protein disulfide isomerase. PMID- 6503716 TI - Disulfide bond formation in proteins. PMID- 6503717 TI - Phosphorus-31 nuclear magnetic resonance studies of phosphorylated proteins. PMID- 6503718 TI - Mixed-function oxidation of histidine residues. PMID- 6503719 TI - Dityrosine: in vitro production and characterization. PMID- 6503720 TI - Halogenated tyrosine derivatives in invertebrate scleroproteins: isolation and identification. PMID- 6503721 TI - Protein bromination by bromoperoxidase from Penicillus capitatus. PMID- 6503722 TI - Iodination by thyroid peroxidase. PMID- 6503724 TI - Iodotyrosine deiodinase from bovine thyroid. PMID- 6503723 TI - Thyroid hormones: mechanism of phenoxy ether formation. PMID- 6503725 TI - Gamma-carboxyglutamic acid: assay methods. PMID- 6503726 TI - Decarboxylation of gamma-carboxyglutamic acid residues in proteins. PMID- 6503727 TI - Glutamate carboxylase: assays, occurrence, and specificity. PMID- 6503728 TI - Citrulline in proteins from the enzymatic deimination of arginine residues. PMID- 6503729 TI - Fourth International Congress on the Menopause. Orlando, U.S.A., October 28 November 2, 1984. Abstracts of special communications and poster sessions. PMID- 6503730 TI - Fibroblast interferon from a human amniotic cell line: a strategy for rapid molecular cloning. AB - A strategy for rapid cloning and identification of cDNA clones was employed to obtain fragments of the gene for human fibroblast (beta) interferon. A human amniotic cell line (UAC), widely used for interferon assay, yielded high titers of beta-interferon and was used as a source for cDNA synthesis. Recombinant clones were screened by a combination of hybridization conditions: (a) comparing clones that hybridized with radioactive cDNA from induced UAC cells vs cDNA from cells not induced for beta-IFN; (b) using a synthetic oligonucleotide proble complementary to a region of the beta-IFN gene. Among clones selected on the basis of their positive response to both screening procedure, one (4F7) was sequenced and shown to be highly homologous to the beta-IFN gene. This clone was used as a probe to screen a human chromosomal DNA library, yielding the entire chromosomal beta-IFN gene. A "Northern" hybridization analysis of UAC mRNA from uninduced and induced cells revealed the existence of a single molecular species of mRNA for beta-IFN with the expected molecular weight. PMID- 6503731 TI - Influence of urease present in non viable organisms on the decline phase of Ureaplasma growth. AB - Broth cultures infected with ureaplasmas for 48 hrs were unable to support further growth of reinoculated ureaplasmas even when reconstituted with fresh ureaplasma medium. The apparent toxicity of spent cultures was ascribed to the presence of non viable ureaplasmas still containing a fully active urease since all the procedures adopted to abolish or reduce the urease activity restored the ability of these spent cultures to support ureaplasma growth. However, if the cause of the steep decline phase of ureaplasma cells could be reasonably ascribed to the enzymatic activity of urease present in the dead cells, the reasons for the poor field and the low titers achieved by the organisms during the logarithmic phase of growth remain an enigma. PMID- 6503732 TI - A bald superfertile U.V.-resistant strain in Streptomyces coelicolor A3(2). AB - The 'bald'(bld) mutants of filamentous bacterium Streptomyces coelicolor A3(2) are characterized by a lack of aerial myceliumand spores. A 'bald' mutant was isolated exhibiting unusual features. It forms slightly sculptured colonies producing a red-orange mycelial pigment, large amounts of agarase and methylenomycin A; it is also highly resistant to U.V. killing. The bld mutation (bld F1) never reverted to bld+ phenotype and was localized very closed to met A. PMID- 6503733 TI - Direct visualization of the coronary microcirculation for pharmacologic and physiologic studies. AB - An isolated, arrested rat heart preparation which has coronary tone similar to that found in vivo and allows direct visualization of the coronary microcirculation is described. The rat hearts are perfused in situ prior to isolation. This procedure obviates any ischemic ischemic damage to the heart. The perfusate used is a modified Krebs solution with 40 mM potassium, 2 g% albumin, and washed red cells (20% HCT). To directly view the coronary microcirculation, a fluorescent albumin conjugate is added to the cell-rich perfusate. The epicardial microvessels are illuminated and observed with a fluorescence microscope. It was found that the control intercapillary distance in this model (33 microns) was almost twice that reported by other investigators for working hearts and suggested a 60-70% coronary capillary reserve in the arrested heart. The calcium blocker nisoldipine (Miles Laboratories) caused a dose-dependent coronary vasodilation using either a constant-flow or constant-pressure protocol. The coronary reactivity of this preparation to nisoldipine was 50 times greater than reported for isolated hearts perfused with cell-free Krebs solution. Further, the preparation vasodilated in a dose-dependent manner to histamine, but histamine did not cause a significant increase in coronary permeability to macromolecules. This model is appropriate for both physiologic and pharmacologic studies. It is particularly well suited for determining the direct effects of an intervention on coronary tone and the coronary microcirculation. PMID- 6503734 TI - High-voltage electron microscopy of capillary endothelial vesicles. AB - Conventional electron microscopy of thin sections through capillary walls is inadequate to discern the relationships between endothelial vesicles and their association with the cell surface. High-voltage electron microscopy of thick sections through diaphragm muscle capillaries has been employed to visualize the three-dimensional structure of the vesicular system. Stereopairs of thick sections provide for direct three-dimensional observations of samples several vesicle diameters deep. A variety of simple and compound vesicular forms are present but not all are conjoined or maintain connections with the endothelial cell surface. This contributes to the concept of a dynamic interaction between free and attached vesicular structures where fission and fusion events compartmentalize and reconnect repeatedly. Such interactions would provide for a discontinuous pathway across the capillary wall but with a higher degree of complexity than a simple shuttling mechanism. PMID- 6503736 TI - Plasma-lymph albumin kinetics, total lymph flow, and tissue hematocrit in normally hydrated dog lungs. AB - Lung lymph flow was normalized for lung weight and total lung lymph flows were calculated in five mongrel dogs using a kinetic analysis of albumin distribution between the pulmonary capillaries, interstitial fluid, and pulmonary lymph. Using prenodal tracheobronchial lymph an intravenous bolus of 125I-labeled albumin equilibrated between plasma and lymph with mean T1/2 of 2 hr 22 min. The mean volume of interstitial fluid drained by the cannulated lymphatics was 9.9 ml which corresponded to the extravascular albumin distribution volume of 31% of the total lung weight. Lung tissue hematocrit was determined using 51Cr-labeled red cells and 125I-albumin and averaged 92% of the simultaneous mixed venous hematocrit. The extravascular albumin and 99mTc-DTPA (diethylenetriamine pentacetic acid) spaces in lung were corrected for differences between tissue and mixed venous hematocrit and were 18.5 and 33.0 ml/100 g, respectively. This indicated that albumin distributed in 57% of the interstitial volume at 4 hr after injection. Lung lymph flow normalized to postmortem lung mass during baseline conditions was 0.060 ml/min/100 g after correction for tissue hematocrit differences. Normalized lymph flows are used for quantitative comparisons of lung lymph protein flux data between different types of experiments. PMID- 6503738 TI - Here are health care views of candidates Levin and Lousma. PMID- 6503737 TI - Getting out the MD vote. PMID- 6503739 TI - Michigan has two Olympics physicians. PMID- 6503735 TI - Diffusional arteriovenous shunting in the heart. AB - Previous indicator dilution experiments in isolated blood-perfused dog hearts suggested that there was intramyocardial diffusional shunting of water relative to a flow-limited solute, antipyrine. Two sets of studies have been done to assess the importance of this shunting, since it implies the possibility of a diffusional bypass for oxygen and other substances, which may be important in ischemia. Nonconsumed tracers were used to show the phenomenon. In the first set, bolus injections of 133Xe dissolved in saline were made into the coronary inflow and the tracer content of the organ recorded by an external gamma detector. The initial Xe washout was disproportionately rapid at low flows, and the late phase was also relatively retarded. In the second set, boluses of cool saline containing indocyanine green were injected into the coronary arterial inflow while coronary sinus outflow dilution curves were recorded via a thermistor and a dye densitometer over a wide range of flows. The thermal curves showed emergence of heat preceding the dye; the degree of precession was much greater at low flows, and, unlike the dye curves, the thermal dilution curves showed dramatic differences in shape at different flows. A model for diffusional countercurrent exchange shows similar changes in residue curves and outflow dilution curves. The conclusion is that there is diffusional shunting of small lipid-soluble molecules whose diffusion coefficients in tissue are high. While the shunting of heat is great, the shunting of soluble gases will not be large and that of normal substrates will be negligible. PMID- 6503740 TI - British Medical Association at center of medical politics. PMID- 6503741 TI - 'Phlegmatic' British rarely sue for medical malpractice. PMID- 6503742 TI - Community outbreak of Yersinia pseudotuberculosis. AB - An outbreak of Yersinia pseudotuberculosis in Kurashiki, Japan is described. This is the first conclusive report of a community outbreak of this microorganism. A total of 535 pupils, five teachers, and one food attendant contracted the organism. Causative organisms were detected in 19 out of 30 patients. All isolated strains belonged to serotype VA. Out of 653 sera of the pupils, 488 showed elevated agglutinin titers ranging from 1:80 to 1:1,280 or more within a period of 3 months. PMID- 6503743 TI - Increased sister chromatid exchange in human lymphocyte cultures infected with mycoplasma. AB - The effects of fermenting, poorly arginine-utilizing Mycoplasma fermentans and arginine-utilizing Mycoplasma salivarium on the frequency of sister chromatid exchange (SCE) in cultured human lymphocytes were examined. M. fermentans caused no apparent mitosis inhibition of lymphocytes and the increase in SCE frequency was dependent on the inoculum size of the mycoplasma. An evident increase in SCE frequency was observed in lymphocytes infected with smaller inoculum sizes of M. salivarium whereas there was mitosis inhibition of lymphocytes infected with larger inoculum sizes of the mycoplasma. In lymphocyte cultures infected with M. salivarium, the addition of arginine to the culture medium reduced mitosis inhibition but did not diminish the increase in SCE frequency, indicating that arginine depletion was not involved in causing the induction of SCEs in mycoplasma-infected lymphocytes. With regard to the genetic effectiveness of SCE, these results suggested that mycoplasmas are capable of inducing cytogenetic changes in infected host cells. PMID- 6503745 TI - Detoxification of tween for the cultivation of Leptospira. PMID- 6503744 TI - Ultrastructures of leuco-adsorption on monolayers infected with influenza virus. AB - Leuco-adsorption occurring in influenza virus infected-cell cultures was studied morphologically to clarify the mechanisms of adsorption of leukocytes. Among the various types of chicken leukocytes studied, such as lymphocytes, monocytes, granulocytes, and thrombocytes, all were found to adhere to the virus-infected cells. The adsorption seems to occur through at least two processes, one is mediated by microvilli (microvillus-attachment), and the other is direct adherence of both cells (cell-to-cell-attachment). In the former, the leukocytes are bound to the microvilli protruding from the infected MDCK cells and in the latter both cell membranes attach directly. In the cell-to-cell-attachment, there was an electron-lucent gap of about 12 nm in width in the intermembranous space of the junctional regions. This region was similar morphologically to the gap junction. As a result of leucoadsorption no cytolytic effects occurred in the MDCK cells under the experimental conditions. PMID- 6503746 TI - Evaluation and consequences of teaching competence: Scandinavian developments. AB - Provision of health care, research and teaching are three major activities common to all medical schools. In spite of the fact that most medical schools emphasize the importance of basic education in their programme, both teachers and students point out that in reality teaching ability and experience are of little significance when academic positions are filled. A common objection to attaching a higher value to teaching competence is that teaching skills cannot be systematically and reliably evaluated. However, experience throughout the world shows that there are various methods of evaluating and considering teaching ability. Activities initiated in Scandinavia highlight concrete methods of considering the qualitative aspects of teaching skills with the basic point of view that there are great similarities between the processes of evaluating scientific and teaching competence. In this article the results of a survey of medical schools in Scandinavia on the relative importance of scientific and teaching merit are reported. Subsequent developments are provided from a task force working under the auspices of the Nordic Federation for Medical Education as well as from the Karolinska Institute in Stockholm. Suggestions are included for evaluation of teaching skills, including qualitative and subjective considerations. Arguments for increasing the value accorded to such skills are advanced and discussed. PMID- 6503747 TI - Aspects of the content versus process debate in medical education. AB - Traditional western medical education is often concerned with the absorption of an enormous number of facts, leaving the process of problem-solving to happen naturally. The current trend is to increase the process in medical education, sometimes at the expense of content knowledge. This paper analyses some of the literature pertinent to this dilemma. It concludes that a pluralistic approach to the presentation of the scientific process would enhance the student's motivation to obtain the content knowledge necessary to utilize that scientific process. It also suggests that such an approach to education might benefit all professions which rely on problem-solving as part of their activity. PMID- 6503748 TI - The structure of medical knowledge in the memories of medical students and general practitioners: categories and prototypes. AB - According to recent research on categorization, knowledge of a given category is structured in memory around key cases or clear examples, referred to as the prototypes, which capture the core meaning of the category. The purpose of this study was to establish a converging sequence of evidence concerning the internal structure of fourteen broad categories of medical disorders as stored in the long term memories of pre-clinical medical students and experienced doctors. It was shown that the mental representation of the categories was better described by the overlapping features of the prototype view of categorization than the criterial features of the classical view. It is argued that the prototype view may help facilitate the understanding of the learning and problem-solving process in medicine. PMID- 6503749 TI - Common errors in the statement of the present illness. AB - A review of 110 case histories recorded by medical students revealed four common types of errors in the presentation of the statement of the present illness: overemphasis on previous findings and diagnoses to the exclusion of the patient's symptoms; inappropriate description of the patient's complaints; failure to discriminate between main symptoms and symptoms of secondary importance; and failure to describe clearly the progression of the disease and the degree of resulting disability. The main difficulty students appeared to have in recording a case history was in the identification and description of the patient's complaints. PMID- 6503750 TI - Moral reasoning as a criterion for admission to medical school. AB - To determine whether admission interviews could differentiate applicants on their personal qualities (such as integrity, empathy and commitment) 456 applicants from two medical schools were tested on the Defining Issues Test (DIT), which measures the amount of principled or post-conventional moral reasoning. No difference was found between the DIT scores of the accepted and the rejected applicants of the school in which the admission criteria are the traditional scholastic ones. On the other hand, a great difference was shown in the school which admits students for their personal characteristics as assessed by interviews. Yet only moderate correlation was shown between the DIT and the interview scores. Since moral reasoning is a key concept in medical professional behaviour and is correlated with clinical performance, the findings deserve special attention. A possible use of the DIT in the student selection process is discussed. PMID- 6503751 TI - Formal instruction in United Kingdom medical schools about death and dying. AB - The paper reports the findings of a short questionnaire survey of medical schools conducted in June 1983. All U.K. schools replied. Only four schools do not provide formal instruction about death and dying for all their students. PMID- 6503752 TI - Countries of origin and languages of Australian medical students. AB - Monash University medical students were surveyed to determine whether they represented the cultural diversity of their community. A total of 878 students completed self reports which showed they originated from forty countries and spoke forty-one languages. The medical school academic intake procedure had selected students from many ethnic groups reflecting the cultural diversity of the community. All had passed the Higher School Certificate English Examination or equivalent to enter the course. A total of 21% reported fluency in a language other than English, and 62% reported having a usable other language in which they were not fluent. The number of fluent languages spoken was constant over the medical course while the number of languages in which students were not fluent decreased significantly. Findings refuted the stereotype that Australian medical students were all monolingual Anglo-Saxons. Training in use of interpreters, and positive discrimination for medical school entry were considered. PMID- 6503753 TI - The effect of a checklist on medical students' exposures to practical skills. AB - The effect is evaluated of a checklist exploring acquisition of practical skills by medical students during the first clinical course in internal medicine. A group of forty-five students using the checklist was compared with two reference groups doing their clerkship before and after the study group. The amount of exposure to practical procedures increased by about 30%. At the same time exposure to some simpler procedures was reduced, while there was an increase in exposures to more complicated procedures. The conclusion is that a checklist has potential value for increasing exposure to practical procedures, if given with advice about the procedures to be preferred and by demand for mastery of particular skills. PMID- 6503754 TI - A tutor programme in obstetrics and gynaecology. AB - A Tutor Programme was created in a third-year clerkship in obstetrics and gynaecology to remedy a student complaint of insufficient contact with teaching staff. Data obtained through the use of observational methodologies were integrated with data from questionnaires and student/teacher interviews to assess programme content, its contribution to student education, and the characteristics of student-teacher interactions. Teachers and students both expressed satisfaction at this opportunity to 'get to know each other'. A unique contribution of the programme was the discussion of a set of topics categorized as 'Medicine as a Career and Lifestyle', e.g. how to make career decisions, residency selection, etc.). These topics were not addressed elsewhere in the curriculum yet were of great importance to the students. The value of observational methods in comprehensive programme evaluation was reaffirmed. PMID- 6503755 TI - Coping with information overload: the development and evaluation of a journal review service. AB - With the publication of an ever-increasing quantity of professional reading general practitioners world-wide are confronted with problems of information overload. To help overcome these difficulties for general practitioners in New Zealand, a 'Journal Review Service' has been developed. The service is used by a wide cross-section of general practitioners and is seen as a very positive form of continuing medical education. PMID- 6503756 TI - The budget and medical research. PMID- 6503757 TI - Funding medical research. PMID- 6503758 TI - Research funding in Australia: the broader view. PMID- 6503759 TI - A problem with bananas. PMID- 6503760 TI - Survival of patients with cancer. PMID- 6503761 TI - Internal fixation of peritrochanteric fractures of the femur with the Harris condylocephalic nail. AB - Thirty patients in whom a peritrochanteric fracture of the femur was stabilized with a Harris intramedullary nail were studied retrospectively. The study showed an initially high complication rate and highlighted points of technique and selection which have led to improved results. In appropriate cases, this procedure is a fast, minimally traumatic, and secure method of internal fixation of peritrochanteric fractures. PMID- 6503762 TI - Cytological abnormalities of the cervix. Fifteen years' follow-up of a gynaecological cancer survey. AB - In a gynaecological cancer survey of 1026 women aged 21 years and over in May 1967, 74 women were found to have cervical cytological changes (designated as mild atypia in 71), which were followed to April 1982. No case of cervical cancer was found (0.3 were expected on the basis of population rates). Six women had had hysterectomies (6.2 were expected on the basis of rates of hysterectomy in the region of the survey). Reports on cervical smears taken since January 1, 1980, were available for 46 (75%) of 61 women who were alive and had not had a hysterectomy. Of these, 11 showed mild atypia; the remainder were within normal limits. PMID- 6503763 TI - What and how? Rural teaching of sixth-year undergraduates in Northampton, WA. PMID- 6503765 TI - Rational choice of drugs for ulcer therapy. PMID- 6503764 TI - Arrhythmias and antiarrhythmic agents. PMID- 6503766 TI - Heart transplant surgeon's move highlights two controversial trends. PMID- 6503767 TI - Cancer progress. Are the statistics telling the truth? PMID- 6503768 TI - Arthritis, sulindac and Medicare. PMID- 6503769 TI - Syphilis in NT Aborigines. PMID- 6503770 TI - Chorea gravidarum and SLE. PMID- 6503771 TI - Alleged work-related injuries. PMID- 6503772 TI - Inhalation of chlorofluorocarbons. PMID- 6503773 TI - Prevention of hypertrophic scarring. PMID- 6503775 TI - More unusual cases of tinnitus. PMID- 6503774 TI - Soldier's heart. PMID- 6503776 TI - Medicine and the animal liberation movement. PMID- 6503777 TI - To drink but not to drive? PMID- 6503778 TI - Driver education. PMID- 6503780 TI - Not so fun run. PMID- 6503779 TI - The Gut Foundation. PMID- 6503781 TI - A semi-closed loop computer-assisted insulin infusion system. Hospital use for control of diabetes in patients. AB - Closed loop insulin delivery systems are impractical for widespread hospital use. Thus, a semi-closed loop computer-assisted insulin infusion system (CAIIS) was developed for the intravenous delivery of insulin. In its basal program, insulin delivery is determined by blood glucose measurements at intervals of three hours, while the open-loop meal program delivers 7.5 units over three hours. Control of meal-induced hyperglycaemia was satisfactory in six subjects with diabetes tested over two to four days, as was mean glycaemic control in the four non-obese subjects (7.1 +/- 0.8 mmol/L). To allow for variations in insulin sensitivity, an adjustment incrementing or decrementing the basal insulin delivery rate was applied according to the progressive blood glucose response. Empirical use of this adjustment resulted in good control (mean blood glucose level, 4.1-7.5 mmol/L) in 10 additional subjects with diabetes. This study demonstrates the potential usefulness of a semi-closed loop insulin infusion system. PMID- 6503782 TI - Alpine travel. Mountain sickness, the unwelcome companion. AB - A personal observation and two cases from the literature are described to draw attention to the dangers of mountain sickness and to the rapid progression from the milder form, termed acute mountain sickness, to the more serious conditions of high-altitude pulmonary or cerebral oedema and their possible fatal outcome. The pathogenesis and treatment of the disorders are briefly reviewed. It is stressed that there are no substitutes for acclimatization through gradual ascent and that the best treatment is to descend to a lower altitude. PMID- 6503784 TI - Exertion-induced heat exhaustion and other medical aspects of the City-to-Surf fun runs, 1978-1984. AB - During the years 1978 to 1984, only 197 (0.14%) of 144 950 starters in a 14-km road race had suffered from heat exhaustion; of these, only three (1.5%) required admission to hospital. The effectiveness of treatment in medical centres was indicated by the fact that the mean time taken for the body temperature to fall to 38 degrees C was 31 +/- 12 minutes in all heat-exhaustion casualties, and 49 +/- 14 minutes in 41 subjects who had rectal temperatures of 42 degrees C and higher. When disaster teams from metropolitan hospitals were introduced in 1983, it became apparent that skilled staff members, despite their lack of experience in the resuscitation of combative heat casualties, could carry out the established procedures and protocols effectively and efficiently. PMID- 6503783 TI - Funnel-web spider (Atrax robustus) antivenom in the treatment of human envenomation. AB - Envenomation by the Sydney funnel-web spider may lead to serious illness or death. After an antivenom which had been raised in rabbits was proven to reverse the signs of envenomation in animals, a trial was conducted in patients. Nine patients (aged 3-82 years) with severe envenomation by funnel-web spiders received treatment with an antivenom to the venom of Atrax robustus. Concomitant diseases in the victims included rheumatoid arthritis, diabetes mellitus, complete heart block, pyrexia of unknown origin, and carcinoma of the ovary, which were being treated with appropriate drugs. Because of the introduction of the antivenom, the syndrome which previously caused either death or a hazardous illness which required two to three weeks of hospital care now became an illness lasting one to three days. So far there have been no definite adverse reactions to the antivenom. There have been no deaths since the antivenom has been used, and it is hoped that human fatalities as a result of funnel-web spider envenomation will become a thing of the past. PMID- 6503785 TI - Method of predicting the number of casualties in the Sydney City-to-Surf fun runs. AB - A simple and effective method of predicting the number of casualties who may require urgent medical attention, which is based on previous experience in the City-to-Surf fun runs, including weather forecasts and number of entries, is described. In 1983 and 1984, the method was used to predict a number of casualties which was found to be consistent with the actual number. As a result of these predictions, the human and material resources were deployed effectively and all casualties were treated efficiently. PMID- 6503786 TI - 1980 Melbourne marathon study. AB - Most of the 5423 entrants in the Melbourne 1980 Big M Marathon were non-elite athletes. A study of a stratified random sample of 459 entrants (which represented a 42% response rate) found that, while entrants reflected the community standards of disease, they pursued healthier lifestyles. Preparation for the marathon led to a number of positive changes in the health standard of runners. The principal negative consequence of marathon training was the high rate of musculoskeletal problems (30%). Before the race, only 4% of participants had an adequate fluid intake; 33% had pre-existing problems, mainly involving muscles and joints (63%) and viral or gastrointestinal illnesses (41%). These entrants had a 60% less chance of finishing the race. Symptoms during the race were reported by 92% of entrants, but most of these were not serious; only 6% of entrants were unable to finish the race. The pattern of symptoms after the race was similar to that during the race; 50% of these resolved within three hours. Ninety-seven entrants (2%) required medical attention during the race. Serious problems were rare (only in three entrants), and no runner required admission to hospital for longer than 24 hours. Entrants were at greater risk of requiring medical attention or experiencing problems during and after the race if they had a shorter preparation (less than two months), ran fewer kilometres per week (less than 60 km/week) in the last two or three months before the race, and had performed fewer long training runs (more than 24 km). PMID- 6503787 TI - Road safety. Perceptions of final-year secondary-school students. AB - Final-year high-school students were surveyed to assess their knowledge and opinions concerning various aspects of road trauma, in particular, its extent, its causes, its relationship to alcohol consumption and the possible solutions to the problem of drink-driving. When compared to the students who took part in a similar study conducted six years previously, it was found that the 1983 students knew more about road trauma in general, and its relationship to alcohol, and were more accepting of intrusive remedial measures such as random breath-testing and speed-humps. Recommendations are made which take into account the students' views on the matter of possible solutions to the problem. PMID- 6503789 TI - Dreading the millennium. PMID- 6503790 TI - Medical mystification. But we keep taking the tabloids. PMID- 6503788 TI - Evaluation of the Australian Medical Association drink-driving campaign in Wollongong. AB - A pilot public education campaign against drink-driving directed towards 18-24 year-old men in Wollongong in 1982 is described. Analysis suggested significant behavioural change in the target group. This was shown by a reduction in traffic accidents and by some reduction in drink-driving convictions. While a comparative assessment of the knowledge and attitudes of the community before and after the campaign showed a marked awareness of the campaign, attitudinal changes to drink driving were equivocal. PMID- 6503791 TI - A guide to Funnel-web spider identification. PMID- 6503792 TI - Doctor bashing: tall poppies or tall stories? PMID- 6503794 TI - Animal rights or human health? PMID- 6503793 TI - Envenomation by the inland taipan, Oxyuranus microlepidotus. AB - A case of envenomation by a three-week-old inland taipan (Oxyuranus microlepidotus)-the second recorded case of a bite by possibly the most venomous snake in the world - is reported. Evidence which supports the use of the term "inland taipan", and confirms the effectiveness of taipan antivenom in the treatment of bites by this snake, is presented. PMID- 6503795 TI - Gut popularity. PMID- 6503796 TI - The Oxford connection. PMID- 6503797 TI - Hospital crisis. PMID- 6503799 TI - Can you come with me? The student in the student-teacher relationship. PMID- 6503798 TI - CT-guided percutaneous biopsy. AB - Percutaneous biopsy procedures using current imaging methods are becoming increasingly popular. The result of a percutaneous biopsy may lead to a total rejection of surgery, and dictate appropriate palliative therapy in a patient with incurable malignant disease; in others, it will allow more precise preoperative planning. The techniques of percutaneous computed tomographic biopsy procedures is discussed, along with its advantages and disadvantages in comparison with other imaging methods. PMID- 6503800 TI - Code of practice for the care and use of animals for experimental purposes in Australia. PMID- 6503801 TI - Prevention of thermal injuries during distance running. Position stand. American College of Sports Medicine. PMID- 6503802 TI - War against mosquito. PMID- 6503803 TI - Debendox and pregnancy. PMID- 6503804 TI - Running drugs in Australia. PMID- 6503805 TI - Allergy in Australia. PMID- 6503806 TI - Malaria in Vanuatu. PMID- 6503807 TI - Scintiscanning in the management of phaeochromocytoma. PMID- 6503808 TI - Gonococcal cutaneous abscess. PMID- 6503809 TI - Ocular toxicity of quinine. PMID- 6503810 TI - An unusual cause of poisoning. PMID- 6503811 TI - Herpes zoster and cimetidine. PMID- 6503812 TI - Pigmented moles in children. PMID- 6503813 TI - Should Australia run drugs? PMID- 6503815 TI - Epidemiological surveillance of occupational health in Australia. PMID- 6503814 TI - Measles and subacute sclerosing panencephalitis. An argument for intensified vaccination in Australia. PMID- 6503816 TI - Surgery runs amok. PMID- 6503817 TI - "Health Watch": the Australian petroleum industry health study surveillance programme. AB - A surveillance system, capable of linking experience in specific jobs with certain health outcomes, has been established within the Australian petroleum industry. A defined population of 11 596 employees has been assembled, after personal interviews. Events recorded are death and its cause, and diagnosis of cancer. Members of the study population are followed up after leaving the industry. By the end of 1983, 33 deaths had occurred, fewer than would be expected from the prevailing rates in the general Australian population. With progressive accumulation of follow-up data, questions of greater complexity will be addressed. PMID- 6503818 TI - Prognosis of cardiac disease in the ambulant patient. AB - Much investigation and treatment in cardiac practice is based on the assumption that unexpected death is common in cardiac patients. The validity of this assumption was examined in 636 of 669 (95.1%) consecutive ambulant patients. During the period from 1978 to 1981, inclusive, 16 (3.9%) of the 407 men (median age, 52 years) and six (2.6%) of the 229 women (median age, 54 years) died. Nineteen of these 22 patients died of cardiac causes; most of these were elderly (average age, 68.5 years), had advanced cardiac disease for many years before their death, and complained of breathlessness at the initial interview. None of these deaths was unexpected. It is concluded that unexpected death is relatively uncommon, even in cardiology practice. The intensive diagnostic and therapeutic regimens directed at younger patients with cardiomyopathy and coronary disease who do not complain of breathlessness are unlikely to have an appreciable impact on mortality. PMID- 6503819 TI - "Australian" methicillin-resistant Staphylococcus aureus in a London hospital? AB - The Royal Free Hospital in London has experienced the spread of a phage 85 methicillin-resistant Staphylococcus aureus (MRSA). An analysis of a sample has demonstrated that the plasmids carried by these strains, and the type and location of their drug-resistance determinants, are similar to those of MRSA strains which have been causing problems in some Australian hospitals. PMID- 6503820 TI - Fracture of the femoral prosthesis after total hip replacement. AB - Although fracture of the femoral component is a well-known complication of total hip replacement, especially with the earlier types of prosthesis, it is seldom recognized in its initial stages. A series of 22 fractures of the femoral component of the prosthesis in 19 patients is presented for the benefit of the general practitioner and the radiologist, who, it is stressed, should both be aware of this complication and able to recognize the signs of a possible fracture, so that early treatment may be given to avoid excessive bone loss in the upper femur. The clinical features are described and discussed. PMID- 6503821 TI - Systemic sepsis and intravenous devices. A prospective survey. AB - Seventy-five episodes of bacteraemia or fungaemia related to indwelling temporary intravenous devices were assessed by the Infectious Diseases Unit of The Westmead Centre, to determine the quality of care of these devices. The estimated incidence of systemic sepsis was 1% for all central venous catheters inserted and 0.1% for all peripheral venous catheters inserted. Sepsis was a major cause of death in 14 of 17 patients who died. Despite the existence of protocols for the insertion, management and early removal of intravenous devices, factors increasing the risk of sepsis included delay in the removal of the intravenous device and the presence of thrombophlebitis. Staphylococcus aureus was the most common isolate (41%); antibiotic resistant Gram-negative rods were also common (38%). It is concluded that continued education of resident and nursing staff is essential to minimize the risk of intravenous catheter-related sepsis. PMID- 6503822 TI - Some aspects of the appeals in Chamberlain v. The Queen. PMID- 6503823 TI - Delineation of clinical privileges. PMID- 6503824 TI - Medicare, the federal government, and private hospitals. PMID- 6503825 TI - Medicare, the funds, and private hospitals. PMID- 6503826 TI - The federal opposition, Medicare, and private hospitals. PMID- 6503827 TI - The doctors, Medicare, and private hospitals. PMID- 6503828 TI - Reuse of medical devices. PMID- 6503829 TI - Caries in Sydney schoolchildren. PMID- 6503831 TI - Orthomolecular medicine. PMID- 6503830 TI - The economics of general practice. PMID- 6503832 TI - Chronic subacute hypoglycaemia. PMID- 6503833 TI - Medifraud and overservicing. PMID- 6503834 TI - Toward a clinical test for smell. PMID- 6503836 TI - An unusual case of tinnitus. PMID- 6503835 TI - Rupture of the quadriceps tendon. PMID- 6503838 TI - Alleged work-related injuries. PMID- 6503837 TI - Misuse of fireworks. PMID- 6503840 TI - [Noise, technology and TLV in the jurisprudence of the Supreme Court]. PMID- 6503839 TI - Epidemiological terms. PMID- 6503842 TI - [Validity of biological tests for the surveillance of exposed workers]. PMID- 6503841 TI - [Toxicity of ethylene oxide and its importance for man]. PMID- 6503843 TI - Mutagenesis test on urine of workers exposed to polycyclic aromatic hydrocarbons in a anode plant. PMID- 6503844 TI - [Computerized thermometry and skin esthesiometry of the hands in the diagnosis of peripheral vascular disease due to vibrating tools]. PMID- 6503845 TI - [Early effects of lung lesions due to asbestos on the hemodynamics of pulmonary circulation. Observations in 15 cases]. PMID- 6503846 TI - [Contribution of occupational health to the definition of risk due to exposure to hand-arm vibrations]. PMID- 6503847 TI - [A case of nephropathy clearly due to cadmium]. PMID- 6503848 TI - [Skin reactions to plaster and bandages]. PMID- 6503849 TI - [Therapy with vasodilators]. PMID- 6503850 TI - [Structure-activity relationships of opiates]. PMID- 6503851 TI - [Use of antibiotics in common infections]. PMID- 6503852 TI - The inner city three years later. PMID- 6503853 TI - The Dingo murder in retrospect. PMID- 6503855 TI - Gastric operations for obesity. PMID- 6503856 TI - 18th annual meeting: American Association for Cancer Education. October 30-31, November 1-2, 1984, Valhalla, New York. Abstracts. PMID- 6503857 TI - Cavernous hemangioma of the face, larynx, and subglottic region. PMID- 6503858 TI - Computerized tomography in the diagnosis of systemic candidiasis in patients with acute leukemia. AB - Seven patients with acute leukemia and systemic candidiasis presented with a clinical syndrome of fever, abdominal pain, organomegaly, and a cholestatic pattern of hepatic dysfunction with an elevated alkaline phosphatase and normal transaminases. The abdominal CT scan demonstrated diffuse hepatic and splenic abscesses in all seven patients. Culture and histology of liver biopsy specimens was nondiagnostic in four of five cases. The CT-directed percutaneous needle aspirations of these lesions yielded diagnostic material in two of three cases. Culture-negative visceral abscesses in persistently febrile patients with acute leukemia should be recognized as being due to candidiasis. The abdominal CT scan may be useful in identifying this clinical-radiographic syndrome and in facilitating rapid diagnosis. Promptly administered antifungal therapy may lead to successful eradication of this infection. PMID- 6503859 TI - [Morphologic characteristics of the dentate nucleus during its ontogenesis in man]. PMID- 6503860 TI - [Anatomic characteristics of the knee joint in dogs]. PMID- 6503861 TI - [Erythema nodosum in clinical practice]. PMID- 6503862 TI - [Treatment of complex deformities of the nose]. PMID- 6503863 TI - [Congenital obstructions of the duodenum]. PMID- 6503864 TI - [Obesity and cerebrovascular diseases]. PMID- 6503865 TI - [Congenital and acquired defects in children of central Backa]. PMID- 6503866 TI - [Tuberculosis of the kidney in a 3-year-old girl]. PMID- 6503867 TI - [A febrile state due to a liver abscess]. PMID- 6503868 TI - [The status of visual acuity and visual fields before and after decompression of the chiasma]. PMID- 6503869 TI - [Lipomas in the otorhinolaryngology field]. PMID- 6503870 TI - [The performance and use of the cerebral angioscintigraphy method under our conditions]. PMID- 6503871 TI - [Enuresis diurna (in the child who urinates during sleep)]. PMID- 6503872 TI - A scanning-slit x-ray videoabsorptiometric technique for bone mineral measurement. AB - An x-ray videoabsorptiometric technique was developed for measurement of bone mineral content (BMC) in vivo. The principle utility of this technique is the precise measurement of commonly fractured bones, such as the femoral neck, that are difficult to measure by other techniques because of repositioning problems. Scanning slits reduce scattered radiation and improve linearity of measurements. Heavily filtered, high-kVp beams are used to minimize errors from beam hardening, and data renormalization is employed to compensate for spatial nonuniformities of the beam and detector. Linearity of measured BMC over the range 0.8 to 5 g/cm2 is very good (r = 0.998) and compares well to single- and dual-photon absorptiometry. A 1.6% change in measured BMC is observed for a 10% change (approximately 2 cm) in tissue thickness while a 10% change in marrow type causes a 0.6%-0.8% change in BMC. Manual repositioning of a femur phantom revealed a variation of 0.84% over ten measurements when femur values were referenced to standards. A computer repositioning algorithm provides much easier identification of the region for analysis and yields comparable variation (0.9%). PMID- 6503873 TI - Detective quantum efficiency of x-ray image intensifiers: comparison of scintillation spectrum and rms methods. AB - For monoenergetic x rays, the detective quantum efficiency (DQE) of an x-ray image intensifier (XRII) obtained by measuring the ratio of signal to root-mean square (rms) noise is compared with the DQE obtained by the scintillation spectrum method. To obtain agreement between the two methods, the rms noise must be measured at a very low frequency because of the temporal response RXRII (f) of the XRII. This takes a long time and the measurement of the DQE from the scintillation spectrum is much quicker. Measurement of RXRII (f) shows that it is dependent on x-ray flux rate. RXRII (f) measured at the same flux rate as DQE permits correction of DQE measurements to zero frequency. In order to estimate DQE for polyenergetic beams, we need to know as a function of energy not only the DQE but the amount of energy deposited per absorbed x ray. The latter is also obtained from the rms measurement. PMID- 6503874 TI - A xenon ionization detector for scanned projection radiography: 95-channel prototype evaluation. AB - We have designed, constructed, and tested a 95-channel prototype xenon ionization detector for use in scanned projection radiography (SPR). This detector has higher spatial resolution, is more dose efficient, and is easier to construct than computed tomography (CT) xenon ionization detectors. It consists of two parallel plates separated by a 2-mm gap filled with xenon gas at 2 MPa (20 atm). One plate is a high-voltage electrode while the other is a circuit board etched to form an array of metal collector strips focused on the x-ray source. The resulting detector channels are 0.5 mm wide and 6 cm long. In this paper we present results from measurements of system noise and detector channel calibration. We compared the detector system to a screen/film system and found that it allows the detection of structures with 0.17% radiographic contrast compared to 2% contrast required for detection with screen/film when tested by imaging a 10-cm-thick Lucite phantom with a 10 X 10(-6) C/kg exposure. From images of resolution test patterns, the limiting resolution of the detector is 2.0 1p/mm at 1.6 magnification. Images of reduction mammoplasty tissue samples, obtained with 1/17 the exposure of screen/film images, had the same low-contrast sensitivity but contained less high-contrast detail than the film images. PMID- 6503875 TI - A xenon ionization detector for scanned projection radiography: Xenon/Freon 13B1 comparison. AB - In a companion paper, we reported on the construction and testing of a xenon gas ionization detector for use in line scanned projection radiography. Experimental results indicate that the detector has sufficient resolution for chest radiography, but higher resolution is required for mammography. Theoretical analysis suggested that a detector pressurized with Freon 13B1 would have better resolution and higher x-ray energy efficiency than a xenon-filled detector for energies below 60 keV. In this paper we compared, theoretically and experimentally, Freon 13B1 to xenon as the detector gas. For a 120-kVp x-ray spectrum, the detector filled with 2.0 MPa of xenon had less channel-to-channel crosstalk, a higher quantum efficiency (QE), and twice the output signal than the detector filled with 1.4 MPa of Freon (highest possible pressure at room temperature), while for a 60-kVp spectrum, crosstalk is the same, but the detector has slightly higher QE and 1.4 times the energy efficiency when filled with Freon instead of xenon. We conclude that xenon is better for high-kVp imaging, while Freon at a lower pressure is slightly better for low-kVp imaging. PMID- 6503876 TI - On the selection of stopping-power and mass energy-absorption coefficient ratios for high-energy x-ray dosimetry. AB - A method for the selection of average stopping-power (L/rho)medair and energy absorption coefficient (mu en/rho)medair ratios has been developed. The quality of the x-ray beam is characterized by the ratio of ionization chamber readings at depths of 20 and 10 cm in water (TMR)2010. For convenience, a relationship is established between experimental (TMR)2010 and the nominal accelerating potential (MV) of the accelerator. Experimental (TMR)2010 are related to (L/rho)medair and (mu en/rho)medair in a three-step process. First, using experimental and theoretical spectra in the range 60Co to 45 MV, (TMR)2010 were calculated for primary and first-scatter photons, and a graph of experimental versus calculated (TMR)2010 for these same spectra was constructed. Second, (L/rho)medair and (mu en/rho)medair were calculated for a large number of primary spectra [for most of which experimental (TMR)2010 were not available] and a graph constructed that related these quantities and (TMR)2010 calculated as above for this group of spectra. Third, using the graphs from the preceding steps, graphs relating the calculated (L/rho)medair and (mu en/rho)medair with experimental (TMR)2010 were constructed. Data are presented for water, polystyrene, acrylic, graphite, A-150, C-552, Bakelite, and nylon for beams with nominal accelerating potentials in the range 2-45 MV. PMID- 6503877 TI - Compton scatter densitometry with polychromatic sources. AB - The use of x-ray tubes as radiation sources for Compton scatter densitometry (CSD) is evaluated theoretically. Bias correction factors (bcf's) which correct for differential attenuation due to Compton shift and polychromaticity, and differential scattering cross section due to polychromaticity, are defined to facilitate comparison of monochromatic and x-ray tube CSD devices. Computer modeling indicates that a 100-kVp x-ray tube spectrum hardened with 0.64 mm of Pb filtration yields bcf's 0.008 to 0.34% higher than a 70-keV monochromatic source for various samples of nylon, and human muscle and bone. This difference is insignificant because multiple scatter errors are typically 1000% higher than errors corrected by bcf's. The high equivalent activities of x-ray tubes (10 to 80 TBq) and their small focal spots (1.0 to 2.0 mm) allow the long-standing CSD problems of marginal statistical precision, long counting times, and low spatial resolution to be overcome. PMID- 6503878 TI - Compton scatter with polychromatic sources for lung densitometry. AB - A mobile lung densitometer using conventional x-ray tubes, NaI detectors, and principles of two-source, two-detector Compton scattered densitometry, is described. The device is capable of one to two per second density measurements from a 45-cm3 volume with a precision of 5%. The expected in vivo accuracy (2% 3%) is determined by using an anthropomorphic phantom with replaceable lung inserts. The unintentional detection of multiple-scattered x rays results in a small density-dependent error. This error is predictable and relatively insensitive to differences in surrounding absorbers such as the chest wall. With this device, dynamic in vivo densitometry of the lung in the clinical laboratory and intensive care unit will be possible. PMID- 6503879 TI - Radionuclide selection and model absorbed dose calculations for radiolabeled tumor associated antibodies. AB - An absorbed dose calculation comparison has been computed for radiolabeled tumor associated antibodies distributed over a standard geometry and tumor location. Half-life data, maximum specific activities, and relative organ doses of nine radionuclides, Cu-67, Br-77, Br-82, Y-90, Tc-99m, In-111, I-131, Re-186, and At 211, have been compiled in which the radionuclides were assumed to be coupled with antibody. These nuclides were chosen on the basis of physical characteristics that warranted their inclusion as either imaging or therapy radiolabels. Radionuclide biodistribution data based on current available estimates for antibody uptake and clearance in humans has been adopted. Re-186 and Y-90 have been determined to be among the best therapy radiolabels since they possess sufficiently long half lives necessary for tumor localization, little or no gamma radiation, intermediate beta energy, stable daughter products, and have a reasonable chance to form a stable chelate with an antibody system. PMID- 6503880 TI - Dual-film cassette technique for studying the effect of radiographic image quality on diagnostic accuracy. AB - In order to investigate the relationship between diagnostic accuracy and radiographic image quality, we have developed a dual-film cassette which produces two radiographs simultaneously with a single exposure. One of these radiographs is of standard quality; the second is of lower quality because of degraded spatial resolution and a significantly lower exposure. We have studied the basic physical properties of the standard and low-dose screen-film systems which we use in the dual-film cassette by comparing their beam hardening, scatter fractions, contrasts, modulation transfer functions (MTFs), and Wiener spectra. The x-ray spectrum incident on the low-dose system contained more high-energy photons than that incident on the standard system, and the scatter fractions for the low-dose system were slightly less than or comparable to those for the standard system. While the radiographic contrast produced by the two systems were generally comparable, the standard system had a slightly higher contrast than the low-dose system in some cases. The MTF of the low-dose system was considerably lower than that of the standard system, and the low-dose system had a noise level considerably greater than did the standard system. Phantom images and clinical radiographs indicated that, for the low-dose system, the image quality degraded significantly. PMID- 6503882 TI - Image noise reduction on the EMI 7070 CT scanner by the reduction of the noise resident in the CT wedge profiles. AB - On the EMI 7070 CT scanner the data contained in the wedge files has been averaged resulting in a 6% reduction in the noise content of images. This noise reduction can either be used to improve image quality or can be offset by reducing the x-ray tube current by 12%. The averaging method will be outlined and its rationale discussed. PMID- 6503881 TI - The effect of various dissolved gases on the heat defect of water. AB - Recent measurements of the absorbed dose to air-saturated water, made using water calorimetry and assuming a zero heat defect for irradiated water, gave results 2% 5% higher than those determined by more conventional means. According to the current radiation chemical model for air-saturated water, the dose measured by water calorimetry assuming a zero heat defect should actually be 2% too low because of the endothermicity of the radiolysis processes in water. In order to examine possible sources for this discrepancy, we have constructed a small calorimeter (holding 100 ml of water) with which to measure the temperature rise in irradiated water saturated with various gases. The gases used were air, oxygen, argon, nitrogen, and hydrogen/oxygen mixtures. Irradiations were carried out with 20-MV x rays at a dose rate of 0.41 Gy/s. Our results are consistent with model calculations, except for some differences for accumulated doses of less than 100 Gy. The discrepancies we find at low doses and the discrepancies observed by others using water calorimeters may arise from impurities in the water. PMID- 6503883 TI - Demonstration of relatively new electron dosimetry measurement techniques on the Mevatron 80. AB - A comprehensive set of electron dosimetry measurements at 7, 10, 12, 15, and 18 MeV was made on a Mevatron 80. Dosimetry measurements presented include percentage depth dose, dose in the buildup region, field size dependence of output, output at extended distances, lead transmission measurements, and isodose curves. These beam measurements are presented to document the electron beam characteristics of this linear accelerator. Three relatively new dosimetry techniques, which have not been standardly used in the past, are illustrated. One technique determines the depth dose of fields too small to measure. A second technique accurately converts depth dose measured in polystyrene to depth dose in water. A third technique calculates the output at extended distances. PMID- 6503884 TI - The density scaling theorem applied to lateral electronic equilibrium. AB - Some theoretical considerations concerning the application of the density scaling theorem to secondary electrons from high-energy x-ray beams are discussed. It is concluded that the theorem is expected to be applicable with acceptable accuracy for 10-MV x-ray beams in low-density materials. Measurements reported by different groups of workers are discussed and shown to be in general agreement with the theorem, with one exception. It is shown that the theorem can be applied in combination with phantom scattering correction factors to calculate the dose in homogeneous bodies which differ from water in their density. The method of calculation is similar to the equivalent tissue-air ratio method, but takes account of the effects of loss of lateral electronic equilibrium. PMID- 6503885 TI - The effects of CT drift on xenon/CT measurement of regional cerebral blood flow. AB - A systematic increase in computed tomography (CT) number of approximately 0.13 Hounsfield unit per scan (HU/scan) was observed when serial DeltaScan 2020 CT scans of a uniform water phantom were equally spaced at 0.5, 1.0, or 2.0 min and a shaped aluminum beam-hardening filter was employed. Much smaller drifts (less than 0.06 HU/scan) were observed with flat aluminum or shaped beryllium oxide filters. This machine drift, which was not associated with a rise in water phantom temperature and did not consistently correlate with estimated x-ray tube heat, could result in a significant overestimation of regional cerebral blood flow (rCBF) for a xenon/CT rCBF protocol involving 5-7 sequential scans obtained at 1-min interscan intervals. PMID- 6503886 TI - Grid controlled x-ray tube switching time: implications for rapid exposure control. AB - The transient response properties of a conventional grid controlled x-ray source and the implications for rapid exposure control are studied. The use of a cathode cable with a length of only 1 m to connect the x-ray tube and the grid control electronics results in a switching time of 19 microseconds. The phototiming artifacts from the delayed radiation delivered during this transition time can be severe for short pulses. An analog correction technique that anticipates the magnitude of the delayed radiation is used to overcome this limitation and allows accurate phototiming over a wide range of pulse widths ranging down to 20 microseconds. PMID- 6503887 TI - Interlaced versus progressive readout of television cameras for digital radiographic acquisitions. AB - A comparison was made of two methods for reading the TV camera target for digital radiographic acquisition, interlaced and progressive readout. Experiments were performed with a plumbicon TV camera to measure x-ray exposure requirements and resolution capabilities after readout for the two modes. Real time digital (30 frames per second, 256(2) matrix) and single-frame electrocardiogram gated images of the contrast-filled coronary arteries in a dog were acquired with both formats. Results demonstrate a reduction in patient exposure of up to four times for single-frame progressive readout images over interlaced acquisition for static images of comparable quality. Imaging of rapid motion objects (e.g., coronary arteries) with interlaced TV scanning results in "scalloping" of edges and resolution degradation. The short pulse width capability of progressive readout eliminates motion blurring and preserves object detail. Progressive readout is the preferred mode of TV camera readout for most digital radiographic applications due to more flexible x-ray techniques, superior images, and total utilization of the input x-ray flux for lower patient exposure. PMID- 6503888 TI - The magnetic field dependence of water proton T1 in aqueous solutions: implications for magnetic imaging contrast media. AB - The magnetic field dependence of the water proton nuclear magnetic relaxation induced by a nitroxide radical both free and covalently bound to serum albumin has been measured from 0.23 mT to 0.7 T. The field dependence of the water proton 1/T1 shows only a minor dependence on the degree of radical immobilization, though the electron spin resonance (ESR) spectrum is very sensitive to the correlation time of the radical. The results and theory are described in more detail elsewhere (Journal of Chemical Physics, in press). The observed relaxation behavior arises because the long electron relaxation time of the nitroxide forces the correlation time for the magnetic interaction driving the water proton relaxation to become the correlation time for the relative translational motion of the water and the nitroxide. The relative insensitivity of the water proton relaxation to nitroxide immobilization should not change if the nitroxide is used as a contrast reagent for magnetic imaging in vivo. PMID- 6503889 TI - Determination of Aion and Pion in the new AAPM radiotherapy dosimetry protocol. AB - Simple equations are given by which accurate values of Aion and Pion can be obtained for use in applying the AAPM Task Group 21 dosimetry protocol. PMID- 6503890 TI - Serum aluminium in haemodialysis patients: relation to osteodystrophy, encephalopathy and aluminium hydroxide consumption. AB - The serum aluminium concentration of 82 patients undergoing regular dialysis treatment in a large dialysis department was measured. Duration of known uraemia, total cumulative aluminium hydroxide consumption, present level of aluminium hydroxide consumption and chronic interstitial nephropathy as primary kidney pathology were all positively correlated to serum aluminium concentration. Serum aluminium concentration was positively correlated to the incidence of clinical osteodystrophy and negatively correlated to bone mineral content. There was, however, no correlation to parathyroid hormone concentration or parathyroidectomy. The highest serum aluminium concentration was accompanied by clinical dialysis encephalopathy. The centre uses reverse osmosis for water purification, and there has never been measurable aluminium contamination. On the basis of these findings it is concluded that: the source of aluminium in our patients is aluminium hydroxide consumption and not the dialysis water; aluminium plays no role in the development of osteitis fibrosa; the findings are consistent with the theory that hyperaluminaemia plays a role in the development of osteomalacia, and serum aluminium measurement may be useful in the diagnosis of dialysis encephalopathy. PMID- 6503892 TI - Abnormal hyperphosphatemic response to fasting in X-linked hypophosphatemic mice. AB - It has been proposed that renal inorganic phosphate (Pi) transport adaptation is a prerequisite for the hyperphosphatemic effect of fasting in animals previously fed low Pi diet (LPD). To test the validity of this proposal we have used X linked hypophosphatemic (HYP) mice, since these animals are unable to adapt their renal Pi transport to LPD. HYP and control mice were pair-fed either high Pi diet (HPD) or LPD for 9 days. Then the influence of 24-hour fasting on plasma and urine Pi was studied. In the HPD condition, fasting led to a decrease in plasma Pi concentration, [Pi]P1, in both control and HYP mice. In the LPD condition fasting markedly increased [Pi]P1 from 1.61 +/- 0.13 mmol/l (mean +/- SEM, n = 8) to 2.33 +/- 0.05 mmol/l (n = 8, p less than 0.001) in control mice. In sharp contrast, in HYP mice fed LPD [Pi]P1 tended to decrease from 1.17 +/- 0.10 (n = 7) to 0.91 +/- 0.12 mmol/l (n = 7). As estimated from 24-hour urinary Pi excretion the mobilization of Pi from body stores was not different in HYP as compared to control mice fed either LPD or HPD. In conclusion, the results of this study support the hypothesis that the renal Pi transport adaptation to dietary Pi restriction is indeed the prerequisite for a hyperphosphatemic response to fasting. They also suggest that the mobilization of Pi from body stores during fasting with LPD is normal in HYP mice, even after Pi restriction. PMID- 6503891 TI - Effects of 25-OHD3 on renal function in pediatric patients with chronic renal failure. AB - 19 nondialyzed pediatric patients with chronic renal failure and renal osteodystrophy participated in a 4- year prospective trial of the effects of 25 hydroxycholecalciferol (25-OHD3) in the treatment and prevention of clinical symptoms of renal osteodystrophy. Controversy over the possible deleterious effects of other vitamin D metabolites, namely 1,25-dihydroxycholecalciferol and 1, alpha-hydroxyvitamin D3, led to an examination of the rate of decline in renal function both before and during treatment with 25-OHD3. Serum creatinine and glomerular filtration rates were stable in the patients who completed 2, 3, and 4 years of treatment with 25-OHD3. There was no acceleration in the deterioration of renal function during treatment with 25-OHD3 beyond that which would be expected without vitamin D therapy of any kind. There was an increase in mean serum creatinine after 1 year of treatment because 5 children who entered the study were already in the terminal (accelerated) phase of renal function deterioration. These children completed 1 year of therapy with 25-OHD3. PMID- 6503894 TI - [Evaluation of several parameters of water-saline metabolism in childhood]. PMID- 6503893 TI - Role of substrates and nucleotides in phosphate uptake by rabbit renal cortical cells. AB - We investigated the viability of isolated rabbit renal cortical cells and the effect of metabolic intermediates on phosphate uptake. Glucose production and its stimulation by hormones was similar to that previously reported for renal tubules. The uptake of alpha-methylglucoside and phosphate was reduced by 90% when sodium was removed from the media. ATP content of the cells was 9.4 +/- 0.7 nmol/mg protein. Succinate and fumarate stimulated phosphate uptake in a dose dependent manner by 30-60%. Valeric acid (1 mM) and butyric acid (10 mM) stimulated phosphate uptake by 20-30%. Glucose and fructose stimulated phosphate uptake by 18% but only at low concentrations (0.1 mM). Exogenous nucleotides had no effect on phosphate uptake at 0.2 mM, but inhibited 2.4 mM phosphate uptake at 2 mM. We conclude: rabbit renal cortical cells in suspension are metabolically and functionally viable; tricarboxylic acid cycle and glycolytic intermediates as well as short chain fatty acids can stimulate phosphate uptake, and exogenous nucleotides are hydrolyzed to produce free phosphate causing inhibition of isotopic phosphate uptake. PMID- 6503895 TI - [Initial findings on mitochondrial cytopathy in hypokalemic familial periodic paralysis. Ultrastructure study]. PMID- 6503896 TI - [Serum levels of ferritin in 268 children]. PMID- 6503897 TI - [Favorable outcome in chronic active hepatitis caused by B virus in childhood]. PMID- 6503898 TI - [Chronic cobalt poisoning. Presentation of a clinical case of cardiomyopathy]. PMID- 6503899 TI - [Rational use of theophylline in asthma in children]. PMID- 6503901 TI - [The role of calcitonin and parathormone in post-thyroidectomy hypocalcemia]. PMID- 6503900 TI - [Fine needle aspiration in the preoperative diagnosis of thyroid nodules]. PMID- 6503902 TI - [Gastric ulcer associated with malignant pheochromocytoma: coincidence or correlation?]. PMID- 6503903 TI - Differential clinical features of late-onset adrenogenital syndrome. Importance of early diagnosis. PMID- 6503904 TI - [3d International Symposim on Diabetes. Montecatini Terme, 21-23 October 1983]. PMID- 6503905 TI - [Semisynthetic human insulin therapy of type 1 diabetics treated with a microinfusor. Preliminary notes on insulin requirements and antibody titer]. PMID- 6503906 TI - [Hemorheologic and retinal microcirculatory aspects of diabetics undergoing treatment with human insulin using microinfusors]. PMID- 6503907 TI - [Acquired insensitivity to treatment with oral hypoglycemica in type 2 diabetes. Etiopathogenetic aspects]. PMID- 6503908 TI - [Insulin sensitivity, insulin receptors and C-peptide secretion in type 2 diabetes mellitus. Effects of insulin therapy]. PMID- 6503909 TI - [Hormono-metabolic profiles of patients with diabetes mellitus type 2 and acquired sulfonylurea insensitivity]. PMID- 6503910 TI - [Insulin resistance in Werner's syndrome]. PMID- 6503911 TI - [Effect of metformin on changes in blood glycerol levels induced by glucagon in insulin-dependent diabetics]. PMID- 6503912 TI - [Latent arterial hypertension in type 1 diabetes. Ergometric evaluations in diabetics, non-diabetics and hypertensive non-diabetics]. PMID- 6503913 TI - [Glycosylated hemoglobin (HbA1) in uremia and chronic respiratory failure]. PMID- 6503914 TI - [Prostaglandins and glucose metabolism. Effect of acetylsalicylic acid]. PMID- 6503915 TI - [Diet of the insulin-dependent diabetic: different roles of carbohydrates and lipids]. PMID- 6503916 TI - Glycaemic control and prevention of complications. PMID- 6503917 TI - Portable and implanted infusors. Different administration routes. PMID- 6503918 TI - [Improvement in peripheral and autonomic neuropathy during 18 months of treatment with subcutaneous continuous insulin infusion in type 1 diabetics]. PMID- 6503919 TI - [Ambulatory treatment of unstable diabetes with intraperitoneal insulin infusion. Long-term experience]. PMID- 6503920 TI - Atrioventricular node "mesothelioma" with multicystic ovaries. Report of a case in a nine-year-old girl. PMID- 6503921 TI - Leukemia. PMID- 6503922 TI - When a deflatable Foley's catheter won't. PMID- 6503923 TI - Adverse effects of non-steroidal anti-inflammatory drugs on the kidney. PMID- 6503924 TI - Cutaneous cryosurgery. PMID- 6503925 TI - MMIE malpractice claim review. Family practice. PMID- 6503926 TI - Major complications of leukemia. PMID- 6503927 TI - Care of the critically ill child. PMID- 6503929 TI - Symposium on borderland between neurology and psychiatry. PMID- 6503928 TI - Physician contracting. PMID- 6503930 TI - Practical management of children with apparent learning disabilities. AB - There should be a collaborative evaluation of a child with apparent learning disabilities. This article describes what the neurologist can expect from the other disciplines and how the services can be coordinated, using either the multidisciplinary services of a clinic or comprehensive assessment by a private practitioner. PMID- 6503931 TI - Infantile autism. AB - The authors define infantile autism, giving its time of manifestation, clinical development, differential diagnosis, management, and treatment. They hypothesize that the cause of autism probably will not be found in some consistent gross alteration in brain size or gross structure but that autistic children have some generalized deficit of neurologic function that is common to most or all cerebral neurons. PMID- 6503932 TI - Differential diagnosis between dementia and depression in the elderly. AB - Guidelines are given for the differential diagnosis of dementia and depression, with an emphasis on Alzheimer's dementia. Treatment for both the family and the patient is discussed. PMID- 6503933 TI - Sudden behavioral change. Guide to initial evaluation. AB - Described is an approach to understanding sudden behavioral change that is based on a simplified conceptual model of the functional anatomy of the CNS. The model explores the behavioral correlates of three interrelated CNS functional axes: vertical, lateral, and horizontal. PMID- 6503935 TI - Symposium on neurovirology. PMID- 6503934 TI - Speech and language disturbances. AB - A basic acquaintance with a variety of deviations in speech and language behavior that are encountered in a clinical setting is provided. Clinical differences among the various disorders are established, along with a glossary of frequently used terms. PMID- 6503936 TI - The pathogenesis of viral infections of the nervous system. PMID- 6503937 TI - Herpes simplex and herpes zoster. Nervous system involvement. AB - Mainly discussed are neurologic complications of two neurotropic herpesviruses: herpes simplex viruses types 1 and 2 and varicella-zoster virus. Briefly discussed are cytomegalovirus and Epstein-Barr virus. Treatment of immunosuppressed and nonimmunosuppressed patients is reviewed. PMID- 6503938 TI - Arthropod-borne virus infections of the central nervous system. AB - Arthropod-borne viruses (arboviruses) are an important cause of meningoencephalitis in North America. This article considers the common features of the four major CNS arbovirus infections in this country and gives detailed descriptions of the individual virus infections. PMID- 6503939 TI - Progressive multifocal leukoencephalopathy. AB - PML is a progressive opportunistic infection of the CNS caused by a commonly occurring virus that may become manifest in the context of reduced host resistance in persons of any age. The authors review the disease and its causes, including a discussion of treatment attempts and differential diagnoses. PMID- 6503940 TI - Neurologic complications in acquired immunodeficiency syndrome (AIDS). AB - Neurologic syndromes in AIDS are of four types: infections, para-infections, neoplastic, and paraneoplastic. All levels of the neuraxis can be affected. Neurologic complications may be the initial symptom or the cause of death. Aggressive evaluation, including biopsy of cerebral lesions, is indicated because effective treatment can be given. PMID- 6503942 TI - Another UMKC milestone. PMID- 6503941 TI - Rubella virus and its effects on the central nervous system. AB - Rubella virus appears to have few rivals in the variety of its pathologic expressions in man. The authors explore some of these, address the virus's ability to establish persistent infections, discuss the introduction of an effective vaccine for rubella, and touch on future research into rubella virus. PMID- 6503943 TI - Balloons and acupuncture. PMID- 6503945 TI - Misuse, abuse and diversion of prescription drugs. A Missouri response. PMID- 6503944 TI - The XY woman. Two cases of complete androgen insensitivity. PMID- 6503946 TI - [Nuclear DNA content of thyroid adenocarcinoma]. AB - In order to estimate biological behavior of thyroid adenocarcinoma, the nuclear DNA contents of various thyroid tumors were determined by flow cytometry and microfluorometry. Flow cytometry was performed on 21 patients with benign tumor and 20 with adenocarcinoma. Majority of their modal values in the DNA histograms were diploid or near diploid. There was no obvious difference in ploidy level between benign tumors and adenocarcinomas. However, the mean ratio of cells at a proliferative phase was significantly higher in adenocarcinomas than in benign tumors. Microfluorometry was performed on the surgical specimens taken from 6 patients with anaplastic carcinoma and 25 patients with adenocarcinoma. As to the adenocarcinoma, besides primary lesions, foci of tracheal invasion, lymph nodes with metastatic and recurrent tumors were studied. Most of the DNA histograms of the foci of tracheal invasion showed a wide distribution which was suggestive of dedifferentiation toward anaplastic carcinoma, but other lesions of adenocarcinomas showed no obvious difference from the primary lesions. In patients with recurrent adenocarcinoma, the shorter the interval between the operation and recurrence, the higher the incidence of cells with high ploidy range. From these findings, it was concluded that the nuclear DNA content was estimated as an objective index for the degree of malignancy of thyroid adenocarcinoma. PMID- 6503947 TI - [Effect of vagotomy on gastric wall autonomic responses, mucosal cholinesterase activity and gastric acid secretion in cats]. AB - Adrenergic and cholinergic innervation of the stomach was investigated using histochemical techniques, and gastric mucosal cholinesterase (ChE) activity was measured by a calorimetric method. The effects of vagal nerve stimulation on gastric mucosal ChE activity was examined, and the following results were obtained. No differences in innervation and mucosal ChE activity were found between the lesser and greater curvatures of the stomach. High ChE activity and a wide and dense network of cholinergic nerve fibers were observed in the fundic mucosa, but in the antral mucosa the fibers were limited and ChE activity was low. The number of cholinergic fibers was markedly reduced in the intermediate zone. Mucosal ChE activity increased temporarily after truncal vagotomy, but after 6 months it returned to the original value. Antral mucosal ChE activity became elevated temporarily after vagal stimulation, but decreased rapidly thereafter. Denervation of hepatic, celiac and antral branches of the vagus caused a significant decrease in acid secretion. This suggests that these nerves are also involved in gastric secretion, and that the vagal nerve fibers are distributed to the greater curvature of stomach via these branches. PMID- 6503948 TI - [Changes in serotonin and histamine levels in blood and liver after acute hepatic ischemia]. AB - To clarify the changes of vasoactive amines associated with acute hepatic failure, ammonia, tryptophan, serotonin (5-HT) and histamine in the blood and liver were studied in dogs (n = 22) of each three group of acute hepatic ischemia; occlusion of hepatic artery (controls), occlusion of hepatic artery and portal vein (THI), and portocaval shunt with THI (PCS + THI). These biochemical changes were studied in each group at six time intervals: Preocclusion, 15 and 30 minutes postocclusion, and 30, 60 and 120 minutes after release of occlusion. A rapid rise of blood ammonia levels was observed in groups of THI and PCS + THI after occlusion. Blood 5-HT increased in postocclusion of both controls and THI. However, a decrease of 5-HT was observed in PCS + THI. Hepatic 5-HT also increased after occlusion in THI and PCS + THI as compared with a decrease in controls. Plasma histamine rose significantly in all groups after the occlusion. These data demonstrated that the changes of vasoactive amines in hepatic ischemia and/or splanchnic pooling appeared to affect microcirculation of the liver and play a role of pathogenesis of hepatic failure after hepatic ischemia. PMID- 6503949 TI - [Experimental and clinical studies on regeneration of the cirrhotic liver after major hepatectomy: comparison with the volume and function of the normal liver during recovery]. AB - Experimental and clinical studies on the role of liver cirrhosis in the impaired hepatic regeneration after major hepatectomy were done comparing the changes of liver function measured by indocyanine green tolerance and hepaplastin test. In experimental cirrhosis induced by dimethylnitrosamine administration, canine livers revealed that the recovery of volume after 70% hepatectomy was slow but efficient in survivors. Two patients who had hepatic lobectomy with normal remaining liver showed complete recovery in both volume and function, but 2 patients with remaining liver of non-cirrhotic fibrosis showed slow recovery of liver function. Two cirrhotic survivors after lobectomy and segmentectomy revealed very slow recovery in function but gained sufficient volume. The study indicated that increased efficiency of liver function in the early stage of regeneration supported by effective hepatic blood flow was essential for the successive recovery of hepatic volume and for the survival in liver cirrhosis. PMID- 6503950 TI - [The influence of obstructive jaundice on wound healing of pancreatico jejunostomy with reference to the function of the pancreas as assessed by glucose tolerance and pancreozymin-secretin test]. AB - Mongrel dogs jaundiced by ligation of the common bile duct for 3-week period were submitted to simultaneous biliary drainage and pancreatico-jejunostomy and sacrificed on day 1, 3, 5, 7, 14 and 30 after operation. The wound healing process of the anastomotic site was evaluated in terms of microvasculature, histopathological findings, pancreatic hydroxyproline content, incidence of anastomotic leakage and bursting strength of the anastomotic site. Pancreatic function were assessed by intravenous glucose tolerance and pancreozymin-secretin test. Acute inflammation at the anastomotic site was severer in the jaundiced pancreas on day 1, 3 and 5, respectively, than in sham operated controls. The group of dogs with serum bilirubin levels ranging 1 to 5mg/dl (mean 3.2) tolerated significantly higher bursting strength (p less than 0.01) with less incidence in anastomotic leakage (p less than 0.01) as compared to the group of dogs with serum bilirubin higher than 5mg/dl (mean 7.6). The data demonstrate that pancreatico-duodenectomy is primarily indicated to the icteric patients after serum bilirubin is decreased lower than 5mg/dl. Exocrine function of the pancreas showed no significant differences between the control and jaundiced dogs, but glucose tolerance in jaundiced dogs was decreased without appreciable changes in serum insulin levels. PMID- 6503951 TI - [Pathophysiological assessment of continent ileostomy in patients with ulcerative colitis--with special reference to the internal pressure and capacity of ileostomy]. AB - Eight patients subjected to surgery for ulcerative colitis were followed up 1-27 years. Of eight, 3 patients received Kock's continent ileostomy and 5 patients end ileostomy. The survey was performed mainly in terms of emptying frequency, the internal pressure and the capacity of the ileostomy. The patients with continent ileostomy empty their reservoirs one to four times a day, while the patients with end ileostomy change the ileostomy bags four to ten times a day. In patients with Kock's ileostomy, high pressure zone was observed at 3 to 6 cm proximal to the stoma corresponding to the site of the nipple valve. The pressure of the nipple valve showed higher than the internal pressure of the reservoir. When the internal pressure at the site of 10 cm proximal to the stoma was measured after end ileostomy, it increased proportionally to the amount of infused saline. Infusion of 50 ml of saline induced its evacuation from the stoma without causing any sensation of fullness to the patients. The patients with Kock's ileostomy announced sensation of fullness when 80% of the maximal capacity of the reservoir was filled with saline. This sensation of fullness made it easy for the patients to control emptying the reservoir. Therefore, we conclude that Kock's procedure should be more widely performed to ulcerative colitis when ileostomy is required. PMID- 6503952 TI - [Pathophysiological study of the ileum after total colectomy in combination with mucosal proctectomy and ileoanostomy--the alteration in water and electrolyte absorption by the ileum after ileoanostomy]. AB - We have developed a new procedure, total colectomy in combination with mucosal proctectomy and ileoanostomy, to preserve anorectal function for the patients with adenomatosis coli and ulcerative colitis. Using dialysis method, we evaluated the alteration of the ability to absorb water and electrolytes at the ileum after ileoanostomy in 12 patients with adenomatosis coli and 4 patients with ulcerative colitis, and compared the result with fecal volume and content to investigate compensatory function of the small intestine after total colectomy. Volume of water absorbed at the ileum was 0.389 g in an average soon after the first stage operation but gradually increased after the intestinal continuity was restored following the second stage operation with the volume of 0.666 g after 1 year and 0.702 g after 2 years (1.8 fold increase). Fecal volume excreted was 852 g/day in an average after loop ileostomy (first stage operation) but decreased to 316 g/day in a year after the second stage operation with simultaneous change of fecal character from watery to solid. The decrease of fecal volume was inversely correlated with the increase of the volume of water absorbed at the ileum (p less than 0.001). The ability to absorb electrolytes increased after the second stage operation compared to that of after the first stage operation but subsequently minimal change was noted. And the absorption pattern was different from that of the large intestine. PMID- 6503953 TI - [Isolated iliac aneurysms]. AB - An isolated iliac aneurysm is an uncommon entity with a relative incidence to abdominal aortic aneurysm of 0.9 to 1.9 percent. Analysis of 16 cases with 20 isolated iliac aneurysms experienced at our vascular service makes the basis of this report. Seventeen aneurysms involved the common iliac artery, two the internal iliac artery and one the external iliac artery. As we experienced 341 abdominal aortic aneurysms during the same period, relative incidence of isolated iliac aneurysm to abdominal aortic aneurysm was 4.7 percent. Fifteen of the 16 cases were male; isolated iliac aneurysms had significantly higher preponderance for the male. Six of the cases were presented with ruptured aneurysms, giving a rupture rate of 37.5 percent. This rupture rate was significantly higher than that of abdominal aortic aneurysms of 11.1 percent. Operation was performed on 15 patients; the remaining one died before surgery. Although there was no operative death among the elective cases, three patients in the ruptured group died postoperatively giving a mortality rate of 60 percent. The least diameter of the ruptured aneurysms was 3.5 centimeter. Among the 16 patients 5 presented with a ruptured aneurysm and 3 had no symptoms related to the aneurysm. Five patients complained of a pulsatile abdominal mass. Two of the ruptured aneurysms were associated with an iliac arteriovenous fistula. Both of them involved the common iliac artery. Although emergency operation was performed on one of them, he died of acute renal failure due to preoperative dehydration and hypovolemia. The another one was operated on electively after intensive medical treatment for heart failure and the patient survived.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503954 TI - [Surgery in endocrine disorders. 1. Pituitary tumors]. AB - Microsurgical refinement of classical transsphenoidal pituitary surgery facilitated selective adenomectomy with preservation of normal residual pituitary, thus becoming the first choice in the management of functioning pituitary adenomas. However, lack of tumor capsule and invasive nature of the adenoma make its total removal still difficult. Peritumoral wedge resection is most recommended from our experiences. Surgical results of acromegaly have become quite satisfactory and normal postoperative serum GH levels have been obtained in nearly 100% of the cases with micro or enclosed-adenoma. Pituitary irradiation and/or bromocriptine therapy are, however, yet necessary in half of the cases with marked suprasellar extension or invasion into the surrounding tissues. In the management of macroprolactinoma, surgical excision should precede bromocriptine therapy, because fibrous changes of the adenoma caused by the drug make surgical intervention much difficult. Microprolactinoma can be treated satisfactorily either by surgery or by bromocriptine. Just follow-up observation may be indicated to the cases having no hope for baby. All impaired pituitary functions in Cushing's disease can be converted normal by selective adenomectomy. However, highly qualified microsurgical technique and systematical survey for microadenoma are mandatory, otherwise it is often elusive. PMID- 6503955 TI - [Functional aspect of thyroid tumors]. AB - Total of 1663 consecutive operative cases with thyroid tumors were analysed as to the hormonal function. These tumors consisted of 195 adenomas, 140 solitary adenomatous nodules, 121 multiple adenomatous goiters, 31 cysts, and 176 carcinomas. Among the cases with solitary nodules, 16 were classified as functioning. Cases which showed elevated serum T--4 and T--3 levels were those with functioning nodules. Among the cases with adenomatous goiter, elevated T--4 level was observed in 10 cases and elevated T--3 level in 7. delta TSH after TRH injection revealed minimum in many cases with adenomatous goiter. Microscopically no difference was observed between functioning and non-functioning nodules. However, findings of electron microscopy and histochemical observations (acid and alkaline phosphatase) revealed elevated activities in functioning nodules. Thyrotoxicosis is not severe in thyrotoxic adenomatous goiter (so-called adenomatous goiter with hyperthyroidism) and no specific findings were seen in patient's age and size of goiter. High proliferative index, derived from DNA histogram, was observed in cases with adenomatous goiter. PMID- 6503956 TI - [Surgical management of primary hyperparathyroidism]. AB - We have experienced 186 patients with proven primary hyperparathyroidism operated on during past 16 years. In this series, 147 patients (79%) had adenoma, 24 patients (12.9%) had carcinoma and only 15 (8.1%) had hyperplasia. Because of a 92% of single gland involvement, the removal of an enlarged gland is adequate, if the remaining gland are grossly normal. Besides, interestingly enough, an incidence of parathyroid carcinoma is rather high in Japan, so that surgeons should be alert to recognize the parathyroid carcinoma on the basis of clinical and operative findings. In an effort to minimize recurrence, en bloc resection of the parathyroid carcinoma is important. When a patient with parathyroid carcinoma has a local recurrence or distant metastases, an aggressive surgical approach is recommended to alleviate hypercalcemic symptoms. The majority of patients with hyperplasia belong to multiple endocrine neoplasia, type 1. Recent development of the non-invasive diagnostic methods is remarkable. The last consecutive 31 patients underwent preoperative localization study by 201Thallium (201TI-CI) scanning and ultrasonography. 201TI-CI scanning gave the most accurate results and 100% correct localization was obtained when the parathyroid tumor was more than 1 g. However, it is noteworthy that the parathyroid tumor was less than 1 g in 64% of patients who had no evidence of generalized fibrous osteitis. PMID- 6503957 TI - [Unilateral parathyroidectomy--a new surgical strategy in hyperparathyroidism due to solitary adenoma]. AB - Unilateral parathyroidectomy (UPTX) was applied as surgical principle for parathyroid adenoma 102 consecutive patients. Intraoperative oil-red-O staining was used for distinction between autonomous and suppressed chief cells. UPTX without contralateral exploration was achieved in 43 patients. In 45 patients two microscopically normal parathyroids were found at the first side and UPTX was performed contralaterally where the adenoma was located. In 14 patients non-UPTX was performed. If more than one, macroscopically, normal parathyroid was found one was removed for histopathology. The intended gland identification was achieved in 93-97%. Supernumerary glands were found in seven patients. Postoperative hypocalcemia was more pronounced after "atypical" operations than UPTX following bilateral exploration. All patients were followed up at least one year. None has developed hypercalcemia. Vitamin D-requiring hypocalcemia is present in two "atypically" operated patients. Removal of one, macroscopically, normal gland, preferably from the adenoma side is advocated. If UPTX can be performed at the first side explored, the contralateral need no exploration. PMID- 6503958 TI - [Current problems in adrenal surgery]. AB - Retrospective study on diagnosis and management during the perioperative period of patients with adrenal tumors who underwent adrenalectomy in the Second Department of Surgery Kyoto University, from 1960 to 1983, was carried out. Most of the patients presented with functioning tumors; primary aldosteronism (43 cases), Cushing's syndrome (53 cases), pheochromocytoma (39 cases), and DOC producing tumor (1 case), whereas, only 3 cases were non-functioning adenoma and cyst. Although recent development of CT has permitted easy and non-invasive diagnosis of adrenal tumors, aldosterone-producing tumors may be overlooked due to their small sizes, because their CT value is identical to that of fatty tissue. Moreover, blood sampling from vena cava at various levels is also necessary in patients with extra-adrenal pheochromocytomas. The preoperative control of blood pressure by alpha- and beta-adrenergic blocking agents was a prerequisite, and the clinical course was uneventful following intraoperative additive use of sodium nitroprusside in patients with pheochromocytoma. Autotransplantation of the adrenal cortex into the rectus muscle was performed in three patients with bilateral pheochromocytoma and two of them could return to work. Non-functioning adrenal tumors have been found increasingly by routine CT study without previous suspicion and the surgical indication of these tumors must be discussed in more detail in the future. PMID- 6503959 TI - [Evaluation of radiotherapy combined with surgery for esophageal carcinoma]. AB - The role of adjuvant radiotherapy combined with surgery for esophageal carcinoma was discussed. To improve the surgical results, pre- and/or postoperative irradiation (total doses was 5000 rads) were performed. The patients with esophageal carcinoma were divided into two groups by random selection. Eight patients of group A underwent pre- and postoperative radiotherapy and 11 patients of group B underwent postoperative radiotherapy alone. Dose of preoperative irradiation was 3000 rads in each patients of group A. Adjuvant chemotherapy of FT-207 (600mg/day) was also administered in all of these patients for long postoperative duration over 3 months. The incidence rate of the most neighbouring regional lymph nodes metastasis in group A showed high values as compared to that in group B. But the metastatic rate of other regional lymph nodes showed no significant difference between group A and group B. In comparison of prognosis between group A and group B, the patients of group A were survived well compared with the patients of group B, and postoperative distant metastasis was recognized frequently in the patients of group B. From these results, the treatment results were better in the group of pre- and postoperative irradiation than in the group of postoperative irradiation. PMID- 6503960 TI - [Evaluation of pre-operative irradiation therapy for carcinoma of the esophagus]. AB - Prognosis of 43 patients with esophageal squamous cell carcinoma with pre operative irradiation and that of 50 patients by surgical excision alone were compared by five year survival rate. The pre-operative radiation treatment comprised a daily doses of 2 Gy. given for consecutive days, up to total dosage of 40 Gy. (T.D.F.66). The operative excision was done two weeks after the the completion of the radio-therapy. In early cases (st. I, II), five year survival rate of the pre-operative irradiation group was 59.8% and 74.2% for surgical treatment alone group. In advanced cases (st. III, IV), the radiation group and surgical treatment alone group showed 21.8% and 15.1% respectively. Among advanced cases, the result in relation to the location of tumor in the esophagus was studied. In the cases which the tumor was located at the upper and middle intra-thoracic esophagus, five year survival rate in pre-operative radiation group was 21.4% versus no survivor in surgical excision alone. In contrast, five year survival rate was better by surgical treatment alone among these advanced cases located at the lower esophagus. The pre-operative irradiation treatment is indicated for esophageal cancer which is advanced and located in the upper and middle intra-thoracic esophagus. PMID- 6503961 TI - [The effects of preoperative irradiation therapy in advanced stomach cancer]. AB - Over the past 20 years the survival rate for advanced stomach cancer among Japanese remains the same. In order to increase the survival rate, 17 years ago we initiated a type of preoperative irradiation therapy as an adjunct to surgery. We have tried to develop an adequate plan for indication of preoperative irradiation. The results obtained were as follows. 1. In this study we used a computer simulated method which aided in determining a suitable plan for adjunct irradiation therapy. 2. The adequate total dosage ranged 3,000 +/- 1,000 rads, with a 2 weeks waiting period between irradiation treatment and surgery, especially for advanced gastric cancer invading to ss and up to 6 cm in diameter. 3. Histopathological findings from resected specimen, using pH 4.1 TBM staining method, indicated decrease in the depth of the carcinoma and extent and size of the tumor as well as degeneration and/or disappearance of the cancer cells due to the preoperative therapy. 4. We identified the decrease of metastatic rates of the regional lymphnodes in the irradiation group. 5. Clinical results indicated an improved resectability rate of 6.1% and an approximate 12.1% increase in the 5 years survival rate. PMID- 6503962 TI - [Experimental and clinical study on the radiation therapy for gastric cancer]. AB - In the pre-operative radiation therapy for gastric cancer, radiosensitivity of the tumor, anatomical limit of irradiated field, selection of the patient for this therapy and influence of irradiation to surgical procedures have remained unsolved. For these reasons, this treatment has not been widely used for gastric cancer. We tried to evaluate this therapy by animal experiment and clinical experience. Animal experiment: Radiosensitivity of gastric cancer transplanted to nude mice was measured and compared each other. Higher inhibition of the tumor growth was obtained by 3000 rad irradiation in gastric cancer group. Inhibition of cancer activity was observed on the seventh day after irradiation had started and on the 10th day, all tumor showed remarkable inhibition. Histological destruction of cancer tissue was observed in all cases unrelated to histologic pattern. However, well differentiated adenocarcinoma showed higher sensitivity than poorly differentiated. Clinical aspect: We applied this therapy to the patient with cardiac carcinoma only because of inability of systemic bursectomy and prevention metastasis to the esophagus. Using Linac X-ray, 300rad per day and 4000 rad in total were irradiated. Therapeutical effects and some side effects of this therapy are discussed in this report. PMID- 6503963 TI - [The role of radiotherapy in the management of cancer of digestive organs: the liver, bile tract and pancreas]. AB - Until February 1984, 75 patients have undergone radiotherapy using the following two methods: 1. During surgery, electron 3000 rads were given. 2. For external irradiation, X-ray or fast neutron was given with a TDF (time dose and fractionation factor) of 80-110. Hepatocellular carcinoma: There were 14 patients including 6 preoperative irradiation and 8 unresectable cases. Improvements were obtained image diagnostically in 9 of 13 patients. Serum AFP level decreased in 6 of 8 patients. And the resected specimens revealed degeneration or necrosis of the cancer tissue. Radiotherapy can given beneficial effect to the patients with tumor emboli within the portal vein, or even disappearance of the tumor emboli sometimes could be seen. Bile duct carcinoma: There were 30 patients including 12 with intraoperative irradiation. 2 irradiated during surgery and external irradiation, and 16 with external irradiation. More than 1-year survivals observed in 6 of 18 unresectable cases. The longest survival of non-curative operation was 6.5 years with treatment. Pancreas carcinoma: There were 31 patients including 29 unresectable and 2 resectable cases. Prolongation of survival time in unresectable patients was not obtained with an interval of 5 months at 50% survival rate. But some clinical complaints were relieved. We concluded that radiotherapy is useful to improve surgical curability by decreasing the cancer cell viability, to give a wider surgical indication if portal tumor emboli can be eliminated, to prevent early tumor recurrence, and to give some beneficial effects to unresectable or recurrent patients. PMID- 6503964 TI - [Effect of radiotherapy against advanced carcinoma of the rectum]. AB - In treating advanced carcinoma of the rectum, we have actively used radiotherapy as an adjunct to surgery to enlarge the group of patients indicating surgery and improve the remote results. Of total 423 patients with rectal cancer treated by us in the past 16 years, 202 patients (47.8%) received radiotherapy. Preoperative radiotherapy was performed on 90 of these patients, postoperative radiotherapy on 73 patients, preoperative plus postoperative radiotherapy on 15 patients, and radiotherapy alone on 24 patients. The present study is mainly concerned with preoperative radiotherapy. The purpose of preoperative radiotherapy is to increase the number of patients suitable for surgery. We selected Dukes-C cases without distant metastasis as indications for preoperative radiotherapy, and treated them by 2-step irradiation with 3,000-6,000 rads using Linac after 2 weeks of preoperative observation. The gross and histologic evaluation of the results of irradiation permitted us to conclude that over 3,000 rads was necessary for preoperative radiotherapy. Comparison of the results between preoperative radiotherapy and control groups showed that local recurrence occurred in 6.7% of the radiotherapy group and 9.0% of the control, and 5-year survival rate was 62.7% and 53.2% respectively, with prognosis improved in the radiotherapy group. PMID- 6503965 TI - [The indication and effect of radiation therapy in rectal carcinoma]. AB - A total of sixty one patients with carcinoma of the rectum accepted radiotherapy of 40 Gy/4W to whole pelvis including the perineum. Randomized study of preoperative radiation to the pelvis showed that patients with advanced carcinoma of the lower rectum and the anus benefited in the prevention of the local recurrence and in the curability of unresectable tumor. Postoperative radiation therapy was indicated in the case of the residual tumor, metastatic lymphnodes, distinct lymphatic permeation and insufficient excision of the rectum. For the pelvic recurrence irradiation of doses more than 36 Gy was effective in the case of slow growing tumor. A radical treatment is expected for patients with inoperable tumor or for patients without indication of major surgery because of age or medical problems by the whole pelvic irradiation plus interstitial irradiation. PMID- 6503966 TI - [Radiotherapy for carcinoma of digestive organs]. AB - Clinical results of intraoperative radiotherapy (IOR) applied to carcinomas of the stomach, pancreas, and rectum were reported. In stomach cancer, the 5-year survival rates of patients treated by operation alone were 93.0% for stage I, 61.2% for stage II, 36.8% for stage III and 0% for stage IV. On the other hand, the 5-year survival rates of patients treated by IOR were 90.2% for stage I, 77.0% for stage II, 54.4% for stage III and 15.3% for stage IV. It has been demonstrated that IOR has definite effects on locally advanced gastric cancer. In pancreatic cancer, the median survival times for all patients treated by operation alone, IOR and IOR+ external beams were 3.5 months, 4.5 months and 8 months respectively. The median survival times of stage III patients treated by operation alone, IOR and IOR+ external beams were 5.5 months, 5.5 months and 12 months respectively. Our clinical results suggest that prolongation of life can be expected in patients who are treated by IOR followed by external beams and stage III is best indicated. In rectal cancer, it was found that stage IV as classified according to the rules for colorectal cancer studies in Japan is best indicated for IOR from the analysis of the survival figures. In stage IV patients, those who received operation alone could not survive more than 50 months while about 50% of those who were treated by IOR are alive 50 months after the treatment. PMID- 6503967 TI - [Present status of hepatolithiasis in Japan]. AB - Research Group for Hepatolithiasis, Ministry of Health and Welfare, Japanese Government surveyed cases of hepatolithiasis in the member hospitals. Total of 414 cases were collected between 1977 to 1981. They were divided according to the classification of hepatolithiasis proposed by Research Group for the Study of Damage to the Intrahepatic Bile Duct. Four hundred fifteen patients consisting of 186 males and 228 females. Female predominance was statistically significant (p less than 0.05). Age incidence rose rapidly at their thirties and reached the peak at their fifties. Most stones were calcium bilirubinate stones. In IE classification (intrahepatic and extrahepatic classification), they were equally distributed in each subtype. Left lobe predominated (L and LR Type) in hepatic lobe classification. Bile duct stenosis and dilatation were present in 57% and in 95% of the cases respectively. Bile duct stenosis occurred frequently in the left intrahepatic bile ducts. Possible etiological significance of IE classification difference from those confined to hepatic lobe (I type) to those predominantly in extrahepatic bile duct (IE type) were discussed. PMID- 6503968 TI - [Treatment of hepatolithiasis--current problems in view of analysis of stones]. AB - We analyzed 24 intrahepatic gallstones for their components by chemical assay and evaluation of atomic absorbance. Those with high cholesterol and fatty acid contents were noted in addition to conventional bilirubin-calcium gallstones, and a mean cholesterol content of over 50% was observed in one fourth of the hepatic gallstones. Measurement of biliary bilirubin and calcium levels conducted to investigate the causative factors of bilirubin gallstones showed that they occur more readily in bile containing less bilirubin, suggesting that their development is largely dependent on the amount of bile acids in hepatic bile determined by the biliary acidity, presence of unconjugated bilirubin, and ionization of calcium. Our results suggest the necessity of treating hepatolithiasis as a hepatic disease with constitutional implications and, in the absence of clear insight into its etiology, of selecting surgical modes always with proper consideration to the possibility of recurrence. Therefore, choledochojejunostomy combined with jejunostomy is our primary surgical procedure. PMID- 6503970 TI - [Operative methods for hepatolithiasis based on its etiology]. AB - This study was undertaken to clarify the intrahepatic bile flow mechanism in man. The fasting cholescintigraphy was obtained from 40 healthy controls and 5 patients with hepatolithiasis by injection of 2 m Ci of 99mTc-EHIDA. The serial analog images were recorded at each 5 min for 1 hr and the radioactivity was simultaneously counted by a computer connected with a gamma camera at 1 frame per 15 sec. Results obtained are summarized as follows: The analog images and dynamic curves obtained from 32 out of 40 controls demonstrated that the bile flow of the left hepatic duct was significantly delayed than that of the right hepatic duct, and this seemed to coincide with the high incidence of left intrahepatic gallstones. The bile flow was always hampered throughout the biliary tracts in 5 cases of hepatolithiasis regardless of location of stones. Proximal drainage (hepatic portojejunostomy) and distal drainage (transduodenal sphincteroplasty) showed excellent drainage effects on the recovery of the disturbed bile flow in those patients. PMID- 6503969 TI - [Infected bile and intrahepatic gallstones]. AB - Currently, the incidence of the upper stenotic type and intrahepatic stenotic type have been increasing in number. These changes may be attributed to the improvements of the diagnostic tools for hepatobiliary diseases, especially in the progress of imaging methods. In view of the type of gallstone, most intrahepatic gallstones are the calcium bilirubinate stones generated on the basis of bile stasis and bacterial infection. For the formation of calcium bilirubinate stones the mutual relationship of bacterial beta-glucuronidase and glucaro-1, 4-lactone in the bile is thought to important. Free bile acids and fatty acids are detected in fairly large amount in calcium bilirubinate stones. This suggests that precipitation of calcium bilirubinate in the bile may coincidently occur with the deconjugation of the conjugated bile acids and decomposition of lecithin. In the formation of calcium bilirubinate stones, it is believed that diet and bacterial infection accompanying biliary stasis are important inducements. Since these stones are formed mainly in bile ducts and recurrence rates are likely to high, it is important to remove these inducements from therapeutic viewpoint. PMID- 6503971 TI - [Morphological studies on the pathogenesis and treatment of hepatolithiasis]. AB - Review of 108 patients with hepatolithiasis showed a recent increase of primary intrahepatic gallstones. 55 per cent of cases with hepatolithiasis had their gallstones in the left intrahepatic bile ducts. Clinicopathological study on the resected hepatic specimens of 33 patients revealed numerous intrahepatic periductal glandular formations. Periductal glandular formations were classified into the intramural and extramural glands. The mucous substances which might had been released from the periductal glands seemed to play a role in the formation of stones in combination with bilirubin pigments, cholesterin, bacterial organisms, cellular debris and other bile component. Intrahepatic gallstones and extramural glands were seen in the intrahepatic segment and area ducts. The defunctionalized atrophic hepatic lobe or segment should be resected in order to remove the calculi completely and to prevent the recurrence. PMID- 6503972 TI - [Pathological study of hepatolithiasis with special reference to unusual cases]. AB - Morphological survey was performed in 140 liver specimens of hepatolithiasis which were collected from several pathological and surgical Departments in Japan. Among them there were 19 cases with unusual features suggestive of presumed lithogenic processes. They consisted of association of congenital dilatation of biliary tree (5 cases), association of stenosis or obstruction of biliary tree occurring prior to lithiasis (4 cases), association of anomalous communication between biliary tree (1 case), presence of serous glands simulating to pancreatic exocrine glands in biliary tree (1 case), association of non-biliary hepatic cirrhosis (4 cases), association of chronic ulcerative colitis (1 case), intrahepatic cholesterol stone (2 cases) and association of granulomatous cholangitis (1 case). Chronic proliferative cholangitis which is consistently seen in a common type of hepatolithiasis was found in about a half of these unusual cases and not in the remaining cases. Based on the observations of these unusual cases, the following suggestions were obtained: dilatation, bile stasis or cholangitis may be a lithogenic factor of hepatolithiasis, and chronic proliferative cholangitis associated with a numerous amount of mucinous glands is not always a prerequisite lesion and exerts a promoting and accelerating effect in hepatolithiasis. PMID- 6503973 TI - [Intrahepatic stone formation and hepatectomy]. AB - In our hospital, we had experienced 3,036 cases of gallstones from January 1968 through December 1983, among which intrahepatic stone cases was 154, (5.1%). Intrahepatic stone formation is classified based on X-ray pictures, i.e., congenital intrahepatic cystic bile duct dilatation, for example, Caroli's disease. anomaly of the bile duct. acquired extrahepatic ductal stones. operation. Hepatectomy was performed in 49 of 154 intrahepatic ductal stone cases. We never experienced operative death. We should select operative methods, taking mode of formation into consideration. Hepatectomy for intrahepatic ductal stones was radical surgery and it shortened therapeutic period. Prognosis is good in 41 cases and poor in 6. In 2 among latter 6 cases, recurrence of stones was observed and in other 4 cases, residual stones and cholangitis were noticed. Two cases died, one due to hepatic abscess and the other another disease. PMID- 6503975 TI - [The appraisal of biliary drainage for intrahepatic gall stones, with special reference to an end-to-side hepaticojejunostomy]. AB - Between 1961 and 1983, eighty-six patients with intrahepatic gall stones were identified from a group of 1,140 patients admitted for cholelithiasis. Surgical procedures performed in this series were 37 choledochotomies with external biliary drainages, 33 transduodenal papilloplasties, 37 bilioenteric anastomosis and 15 hepatectomies. In the long term follow up studies after surgical treatment by each procedures, the favorite results were obtained in 41.2% of cases with choledochotomies with external drainages, in 34.4% of cases with transduodenal papilloplasties, in 82.4% of cases with bilioenteric anastomosis and in 88.7% of cases with hepatectomies. Hepatectomy seemed to be a most effective treatment for the prevention of recurrence of stones. However, if the calculi were in the right or both of hepatic lobes, hepatectomy might be a high risk operation and technical proficiency were required in operation. In such cases, we performed an end to side anastomosis between the common hepatic duct and the jejunum (Roux en Y anastomosis) for the postoperative endoscopic lithotomy. In this operation the jejunal stump was made to be an enterocutaneous fistula for the later percutaneous endoscopic lithotomy. This operation has the following advantages; 1) the time of operation were shortened in the removal of stones because of this operation were performed for the postoperative endoscopic lithotomy, 2) retrograde cholangitis was less likely to develop than other operations, 3) retained stones dropped into bowel easily by making a big anastomotic stoma, 4) the cholangioscope could be inserted into either bile ducts of the right and left hepatic lobes, 5) the fistula would be able to be reused for the endoscopic treatment at later recurrence of intrahepatic gall stones. PMID- 6503974 TI - [The role of endoscopic lithotomy in the treatment of intrahepatic stones]. AB - Although hepatolithiasis is a benign disease, its treatment is still the most difficult one in medical field. Before 1977, we had tried bilioenterostomy at the porta hepatis to expect spontaneous dislodgement of stones. However their results were very poor because of frequent occurrence of cholangitis which leads to hepatic failure or death in 8 of 15 patients. From 1977 to 1981, 35 patients had undergone postoperative cholangioscopy (POC). Complete stone removal was obtained in 24 patients. There were 13 difficult local problems in the remaining 11 patients including 6 being too narrow to permit the passage of the fiberscope, 3 having stones incarcerated, 3 having abnormal distribution of biliary tract and one being a missed stone. From 1981, we have carried out percutaneous transhepatic cholangioscopic lithotomy (PTCL) for the treatment of intrahepatic stones in 16 patients. Because abnormal distribution of biliary tract can be easily detected by PTC and incarcerated stones can be made into small pieces before removal following LASER application. We had succeeded in complete stone removal in 12 patients. 2 patients needed biliary reconstruction or liver resection after PTCL. We concluded that for treatment of the disease of intrahepatic stone PTCL should be considered as the first choice before surgery in order to avoid unnecessary hepatic resection or biliary reconstruction. PMID- 6503976 TI - [Infections following gastrointestinal surgery and prophylactic antibiotics]. AB - Of the 1,396 patients who underwent gastroenterological surgery at our department in the past seven years, 132 (9.5%) developed surgical wound infections. The incidence of such infections varied greatly depending on the location and method of the operation. The causative organisms isolated from these infections were often the same as the normal bacterial flora in the organ that was the object of the surgery. Frequent factors of intra-abdominal infection, of which there were 62 cases, were leakage and intra-abdominal bleeding after extended operations in a compromised host. Antibiotics are not substitutes for careful surgical technique. For Escherichia coli and Klebsiella isolated from clinical specimens, we found that the antibiotics Cephalothin and Cefazolin did have satisfactory antibacterial activity. The first and second generation cephems seem suitable for use as prophylactic antibiotics against surgical wound infection. The best time to start giving prophylactic antibiotics was during the operation. Useful indicators of postoperative infection are the fever index, leucocytosis, CRP, and the erythrocyte sedimentation rate. PMID- 6503977 TI - [Intra-arterial infusion chemotherapy of cancer of the liver, biliary tract and pancreas with or without hyperthermia]. AB - In order to obtain less severe toxic reactions and maximal therapeutic effects, 729 patients with cancer of the liver or biliary tract or pancreas were treated with intra-arterial infusion of 5-FU and mitomycin C (MMC) alone or in combination with 2450 MHz microwave hyperthermia. Approximately 60% of the patients with primary hepatic cancer showed objective response to the intra arterial infusion of 5-FU and MMC. However, many patients developed hemorrhage of esophageal varices, gastroduodenal ulcers, jaundice and ascites because of high incidence of hepatic cirrhosis with hepatoma. Fifty percent survival period was only 5.2 months and 26% of the patients so treated survived a year or longer. Metastatic liver cancers, on the contrary, showed better results as compared to those of the primary liver cancer. Fifty percent survival period for metastatic liver cancer was 8.0 month and 42 percent of the patients survived a year or longer. For the cancer of head of the pancreas, the combination of intra-arterial infusion chemotherapy and microwave local hyperthermia was proved to be the most effective way to control cancer. Nine patients before 1975 were treated with intra-arterial infusion chemotherapy alone and 25 patients in and after 1975 were treated by intra-arterial infusion chemotherapy in combination with hyperthermia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503978 TI - [Local immunotherapy for cancer]. AB - As for the non-specific cancer immunotherapy concerned, the effect is limited and local use of immunopotentiators which could collect effector cells around tumor tissues might be the best way of cancer immunotherapy. Intratumoral or intraperitoneal administration of large-dose of OK-432 (100 KE) has been investigated since many years with favorable results. Side effects were minimum with a few days continuing slight fever elevation. From the immunohistological examinations using monoclonal antibodies, participation of killer T cells and NK cells was confirmed after intratumoral administration of large-dose OK-432. On the other hand, after intraperitoneal administration of OK-432, neutrophil leucocytes appeared at first on the 2nd to 4th day and they were followed by lymphocytes on the 4th to 5th day and finally appeared lot of macrophages on the 6th and later days. From the results of in vitro and in vivo experiments, these macrophages seemed to play the leading role in the cytostatic activities after intraperitoneal OK-432 administration. As for the fear of introducing suppressor cells after large-dose OK-432 administration, detailed studies on suppressor activities before and after operation for gastric cancer patients revealed no particular increase of suppressor cell activities after intratumoral and intraperitoneal administration of 100 KE OK-432 as compared with curative resection cases with no OK-432 administration. PMID- 6503979 TI - [Clinical effects of total-body hyperthermia combined with anticancer chemotherapy for far-advanced cancer]. AB - We treated 27 patients with far-advanced cancer with extracorporeally induced total-body hyperthermia combined with anticancer chemotherapy (TBHC). All of them under went unsuccessful anticancer chemotherapy. Excluding 7 patients who could not be evaluated, a partial response was obtained in 7 of 20 patients (35%). Considering that the patients in our series were in the terminal stage of cancer, our results are encouraging. However, despite the regression of the mass in some patients, the survival time after TBHC was not always prolonged. A characteristic complication of TBHC was the weakness of the muscles in the lower extremities. The occurrence of muscle weakness could be prevented by administration of phosphate. To improve the therapeutic effects of TBHC, there are some problems to be solved. In combined anticancer chemotherapy, the selection of anticancer drugs and the timing of their administration are of importance. Thus, the optimal heating method and the combined anticancer chemotherapy are the areas requiring further study to determine the clinical efficacy of TBHC in patients. PMID- 6503980 TI - [Thrombolytic agents]. AB - The clinical efficacy of thrombolytic agents, urokinase, lysyl-plasminogen and batroxobin, was evaluated on the patients with deep venous thrombosis. In the group treated with combination of batroxobin, lysyl-plasminogen and urokinase, significantly better efficacy was obtained over the urokinase group in terms of judgement on venography and clinical improvement. Plasma fibrinogen, plasminogen and alpha 2-plasmin inhibitor were markedly reduced by batroxobin infusion. Fibrinolytic activity measured by plasminogen-free fibrin plate method was detected in 89% of blood samples taken after 120,000 I.U. urokinase infusion following lysylplasminogen administration. These results suggested that even moderate dosage of urokinase could induce fibrinolytic activity under conditions of low alpha 2-plasmin inhibitor and fibrinogen levels caused by batroxobin and additional lysylplasminogen. PMID- 6503981 TI - [Gallstone solubilizers]. AB - In spite of the great progress seen in the diagnostic and treating method for gallstone patients in this 10 years, the criteria of the operative indication for these patients have not been discussed for a long time. I wish to emphasize it is high time for us to examine a matter, since chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA) have begun to be popular in Japanese medical field as an oral gallstone solubilizer. I have mentioned the different dissolving mechanism of cholesterol after the administration of CDCA or UDCA. Recently, residual gallstones are removed using the newly developed instruments, such as a duodenal fiberscope, a choledochal fiberscope, a specially designed basket catheter and a YAG laser knife. Direct gallstone solubilizer, however, is still useful for special cases where gallstones are difficult to be removed by mechanical means. In an attempt to give answer to this, we have developed and used clinically the mixed solution of d-limonene and middle chain monoglyceride for cholesterol gallstones and 90% dimethyl sulfoxide and chelating polyphosphate for bilirubin gallstones. PMID- 6503982 TI - [Progress and problems in pediatric surgery--the Association of Pediatric Anesthesiologists]. AB - From the first meeting of the Japanese Society of Pediatric Surgeons in 1964 a small group discussion on anesthetic problems and patient care was held by some anesthesiologists at night. The Association of Pediatric Anesthesiologists (started in 1971) has undertaken the night meeting ever since the twelfth Annual Meeting of the Society of Pediatric Surgeons in 1975. The problems about pediatric respiratory management, neonatal emergency surgery and pediatric anesthesia were discussed frequently by doctors in different specialties. The recent decrease of mortality in neonatal surgery is thought to have come from the improvement of pediatric respiratory management. This night meeting of anesthesiologists has had a major role in the resolution of problems in pediatric respiratory impairment. The problems to be resolved in an emergency--persistent fetal circulation, barotrauma, nutritional problems in long term ventilatory support and so on--, will be discussed in the future. The purpose of this association is to elevate the quality of pediatric anesthesiologists by discussion with the other specialists of medicine and to make clear their responsibility in Children's Hospitals or Centers. PMID- 6503983 TI - [Progress and focal points discussed at the Japanese Committee on Pediatric Endoscopy]. AB - Recent advances of pediatric endoscopy were discussed. Progresses of technique and improvements of instrument have made it possible to scope safely resulting in the increase of pediatric endoscopies. Gastric endoscopy has become useful to find the peptic ulcer of the stomach in the newborn babies who showed hematemesis. ERCP has been done successfully in the newborn babies making it possible to differentiate congenital biliary atresia from infantile hepatitis. Colonofiberscopy has become reliable and useful procedure to search the source of rectal bleeding but still had some problems to be resolved. General anesthesia has been widely used at the performance of pediatric endoscopy. In some institutes, local anesthesia has been recommended in the patients over 8 years old. In 1983, 1161 pediatric endoscopies were performed in 24 institutes, which were twofold of those performed in 1978. Number of these cases is not enough for the training of pediatric endoscopist. Urgent theme is to establish the system for the education of "true" pediatric endoscopist. PMID- 6503984 TI - [Japan Study Group of Manometry of Digestive Tract in Childhood]. AB - The Japan Study Group of Manometry of the Digestive Tract in Childhood was organized in 1975. The 14th meeting was held in February 1984. During the meeting, the technique of anorectal manometry was established and the criteria of positive recto-anal reflex was defined. The mechanism of recto-anal reflex has been studied, but the details of it remain obscure. The relationship between postoperative fecal continence and the findings of anorectal manometry of patients with anorectal disorders are currently being investigated. It is in dispute whether the recto-anal reflex is present or absent in patients with pseudo-Hirschsprung's disease. Study of esophageal manometry in children was added to the work of the group in 1978, and gastroesophageal reflux has been studied using manometry and/or pH measurement. PMID- 6503985 TI - [Progress and problems in pediatric surgery--a study group on congenital biliary atresia]. AB - Japanese Study Group on Biliary Atresia was founded to make a standard classification of biliary atresia in 1975. The proposal of a new classification was made in the second meeting. Since then, annual meetings have been held to promote studies on biliary atresia. Various results have been obtained as follows: The diagnosis has been made more easily and accurately by use of new methods. As the operation have been performed more securely, the incidence of the disappearance of postoperative jaundice has risen to 80 percent, and more than 30 percent of the patients have been surviving for a long time. The patients who have had good outcome by the revision of the anastomosed region have increased. The endoscopic embolisation therapy was applied for the patients with postoperative esophageal varices. Various procedures preventing postoperative ascending cholangitis have been developed but there are no methods to prevent this complication completely. So the treatment of the ascending cholangitis remains one of the most important problems to be dissolved. PMID- 6503986 TI - [Activities of the Japanese Group for the Study of Anorectal Anomalies]. AB - Although an excellent classification of anorectal anomalies was proposed by Stephens and Smith in 1970, some problems came out when this classification was adopted to the clinical materials. In 1974, a study group on anorectal anomalies was formed in Japan to collect cases enough to undertake further investigation on the classification of anorectal anomaly. A registration form was defined in that year with standardization of technics and indications for clinical and roentgenological investigations. Through studies of the group, some aspects on the classification was reported on the Journal of Pediatric Surgery in 1982 with comments to the "International" classification. Recently, the study group also arranged a standard for the clinical assessment of the function of the anus and published it in the Journal of the Japanese Society of Pediatric Surgeons in 1982. Approximately 800 cases have been collected and analysed by the study group to date. Group study will continue to propel studies on anorectal anomalies and to improve results of surgical treatments. PMID- 6503987 TI - [Classification and clinical assessment of postoperative functions in anorectal anomalies]. AB - There were some problems in International Classification of Anorectal Anomalies. Recto-Urethral Fistula: The level of recto-urethral Fistule and that rectal pouch are different from case to case. Hypertrophied genital folds: this has no value in the diagnosis of low type. Recently the Japan Study Group of Anorectal Anomalies has proposed clinical score, which is based on four parameters, rectal sensation, continence, constipation and soiling. But this score has also some problems. We have proposed a new clinical assessment. PMID- 6503988 TI - [Lipid metabolism in surgery]. PMID- 6503989 TI - [Review on the process of my studies in surgery of the stomach]. AB - Achievements worth referring were selected from among the literature on gastric studies that were conducted since 1947 in my surgical department of Jikei University. And talks upon process of the studies were reminiscently given in terms of the following subjects. Why I was attracted by ulcer surgery, Experimental studies on gastroenterostomy and ulcer, Topography and extent of gastrectomy, advocation of the dual control mechanism theory, and My association with vagotomy. PMID- 6503990 TI - [Surgery in medical education]. AB - What is expected from medical education is not always one to both sides -the side expecting, the side expected. People expect it to give training of medical care for their own lives, in short, the art and morals in medicine. Medical students expect to learn medical science and the medical art. Medical educators expect medical science and to bring up researchers to advance it, namely in the present medical education we see mingled expectations of medicine, which to be a science and the right way of medical care in social life. Medicine is indispensable to medical care, while the former can be apart by itself. What men should be to keep social life is not fundamentally different, irrespective of the presence of intervention of medicine, but the reason why morals in medicine is especially emphasized is that consideration of life is covered in the name of medicine, namely science. Surgery, as it is generally called, is a general term for a field where operations are jointly used as a means of treating diseases. Operation is not fundamentally different from medication or radio therapy in point of being artificial, but its artificial participation as a remedy is remarkable and complete. In surgical treatment destruction and mending are a means and object as well. In life-saving, urgent surgery the means after comes close to the object, sometimes the order is inverted. Training for meeting active actions has an important mission.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6503991 TI - [Occlusion (ligation) of a branch of the portal vein for carcinoma of the liver]. AB - Rous and Larimore reported that ligation of a branch of the portal vein in rabbits resulted in atrophy of the corresponding hepatic lobe together with hypertrophy of the other lobe. Hirono, one of my collaborators, observed that experimentally produced carcinoma of the liver regressed more or less after ligation of a branch of the portal vein supplying the tumor-bearing area. Kozaka also demonstrated experimentally that occlusion of the portal blood supply to the area destined to be resected caused no serious impairment on the animals even those with liver damage. The principle of this operative procedure is ligation of the right or left branch of the portal vein supplying the affected hepatic lobe. Ligation of one branch was used for tumors confined to one hepatic lobe, and right portal branch ligation combined with lateral segmentectomy was used for multiple tumors, sparing only the middle hepatic lobe. The operation was performed in twenty patients with carcinoma of the liver. An average survival after operation is 13.6 months in 12 patients with primary carcinoma and 10.6 months in 7 patients with metastatic one excluding one patient now living over 16 years after surgery. PMID- 6503992 TI - [Fibronectin--its functions and roles in tissue repair]. AB - Fibronectin is a recently characterized 4.4 X 10(5) dalton glycoprotein consisting of two probably identical 2.2 X 10(5) dalton subunits held together by disulfide linkages. It is present as a soluble fraction in plasma at about 30mg/dl and is widely distributed as an insoluble component to various tissues, in close association with fibrillar structures of connective tissue matrices, basement membranes and certain mesenchymal cells including fibroblasts and smooth muscle cells. Fibronectin binds to fibrin and collagen reversibly and crosslinks to these filamentous proteins catalyzed by the activated blood coagulation factor XII (plasma transglutaminase). Plasma fibronectin appears to be utilized at the healing wounds, thus its concentration decreases during early postoperative days. Immunofluorescence study shows that fibronectin is closely associated with newly generated fibroblasts and fibrillar structures in the early stage of wound healing, and that it diminishes in accordance with the maturation of collagen fibers. Plasma fibronectin is shown to function to remove the colloidal debris from blood via the reticuloendothelial system and to play important roles in organizing the cytoskeleton and in the migration and spreading of interstitial cells. Thus fibronectin seems to play a pivotal role in the tissue repair via a variety of biological functions. PMID- 6503993 TI - [Experimental and clinical studies on the intestinal anastomosis and reconstruction of the alimentary tract]. AB - Healing process of anastomosis and its procedure were studied in following points: Four-interrupted sutures anastomosis in the Wistar rats revealed recanalization without leakage in 64 out of 69. Lymphangial recanalization through the anastomosis was completed within 21 days after operation by Gambee' layer-to-layer anastomosis. While 8 weeks were required by everted or inverted anastomosis. Serosal surface of invaginated intestinal segment of which length corresponded to x1-x2 luminal diameter in the telescoping anastomosis was covered within 8 weeks by the proliferated mucosae of the both proximal and distal segments. Telescoping anastomosis was found to be useful to make an intestinal valve which worked just the same as ileocoecal junction. IVH and elementary diet were effective on the healing of anastomosis. According to the above mentioned findings, following operative procedures were recommended: Esophago-jejunal conduit duodenostomy following total gastrectomy. Choledocho-jejunal conduit duodenostomy with the intestinal valve as bile duct reconstruction. Construction of the intestinal valve and an artificial sphincter using rectus abdominis muscle fibers for ileostomy or short bowel syndrome. Endorectal pull-through operation for anterior-resection of the rectum as well as for radical treatment of Hirschsprung' disease. PMID- 6503995 TI - [Cancer of the cervical esophagus with extension to hypopharynx: its behavior and treatment]. AB - Five year survival rate of 168 cases of cancer in the cervical esophagus with extension to the hypopharynx, which had been treated in ENT department of Keio University during the past 13 years, was shown to be as low as 28%. Factors responsible for this poor result were delineated from standpoints such as local recurrence, node metastasis, distant metastasis, skip lesions, double lesions and so on. Preoperative combination of chemo-radiotherapy was evaluated histopathologically, and the results indicated that macroscopic reduction of tumor in the cavity does not always correspond with histologic improvement. The author stressed the demerit of preoperative radiotherapy and proposed a trial of induction chemotherapy, radical excision with primary reconstruction and postoperative combination of immuno-chemo-radio-therapy. PMID- 6503994 TI - [Study on the application of EPTFE (expanded polytetrafluoroethylene) in the field of surgery]. AB - The vascular prosthesis was firstly developed by Carrel who established angioanastomosis. Initial attempts were to develop non-porous molded tubes, the inside of which was coated or which were prepared from materials which would prevent obstruction. Afterwards, fabric tubes were developed by Voorhees, which are still in use. Voorhees prepared a vascular prosthesis from Vinyon-N fabric. Vascular prostheses of this kind are porous. Preclotting prior to implantation of these fabric tubes results in the formation of thrombus layer which seals the pores of fabric, thereby preventing further thrombus formation. In addition, blood cells which have the ability to differentiate adhere onto the thrombus layer promoting the development of its organic properties, and eventually leading to the formation of pseudointima or neointima. These porous tubes are still used to reconstruct arteries with a diameter exceeding 10 mm. Fabric tubes have led to the development of clinically useful vascular prostheses. It is impossible, however, to reconstruct smaller arteries or large veins, even by means of fabric tubes. In 1972, we developed a new vascular prosthesis for small caliber arteries and large veins. This EPTFE vascular prosthesis has been used in about 460,000 patients throughout the world. This new vascular prosthesis which is a porous molded tube, devised by combining the properties of non-porous molded tube developed by Carrel in 1912 with the porous fabric tube by Voorhees. PMID- 6503997 TI - [Long-term evaluation of valvuloplastic surgery in congenital heart diseases]. AB - Valvuloplastic surgery was performed on the 89 cases of congenital aortic and mitral regurgitation between 1966 and 1983. There were 4 operative deaths and 4 late deaths. Reoperation was performed on the 5 aortic and the 6 mitral cases due to residual regurgitation. In the same period, all 4 cases died after valve replacement for the congenital aortic and mitral regurgitation. Long-term evaluation over 3 years was done for the 35 cases of aortic regurgitation with ventricular septal defect (AR + VSD) and the 38 cases of congenital mitral regurgitation except endocardial cushion defect, who were treated by valvuloplastic surgery at the initial operation. Statistical studies on the cases with AR + VSD showed 100% actuarial survival rate, 83% reoperation free rate and 91% valve replacement free rate after 17 years. Of the cases with congenital mitral regurgitation, 95% survival rate and 78% reoperation free rate after 16 years were revealed. In conclusion, the author believes that the operative results and the long-term stability of valvuloplastic surgery for regurgitant valvular lesions associated with congenital heart diseases can be more improved by keeping the precise indication and using the appropriate valvuloplastic procedures for the individual cases. PMID- 6503996 TI - [Valvuloplasty for congenital mitral valvular diseases]. AB - Valvuloplasty is first applied as the surgical treatment for congenital mitral regurgitation (MR). Follow up study after the operation around the valvuloplasty was performed in the patients with congenital MR. In the patient under 12 years old, there were isolated MR in 3; MR associated with VSD in 14; MR and ASD in 3; MR with PDA in 10; and MR with ECD in 36. Operative methods were suturing of mitral cleft in 27; mitral annuloplasty in 17; mitral valve a, advancement in 7; cusp plasty in 4; no treatment for the MR in 14. Early death was noted in 6 cases (9.0% of mortality) and late death was noted in 3 cases (mortality rate of 9.0%). Conclusions were as follows: Surgical treatment was required in the patients with MR more severe than Sellers' Grade-II. Single suturing was recommended for the suturing of mitral cleft because shortening of the valve occurred in a few degree and the residual regurgitation reduced. Mitral valve advancement by elongation of the valvular apex was useful for the impediment of the regurgitation caused by incompetence of mitral coaptation. Mitral annuloplasty increased the effect for the impediment of the regurgitation. Ultrasonic cardiogram was useful for the follow up after the operation of the mitral valvuloplasty. PMID- 6503998 TI - [Valve replacement for congenital valvular disease]. AB - Among 365 cases of mitral and aortic valve replacement (MVR, AVR) done in our institute during the period between 1968 and 1983, there were 20 congenital cases (5.5%), who were pointed out to have valvular disease since birth or early childhood and had no evident history of infectious disease. Mean ages at operation of MVR and AVR groups were 5.6 +/- 3.6 and 22.4 +/- 6.0 years respectively. Predominant pathology of mitral valve was regurgitation in 9 and stenosis in 2 cases. Seven cases were associated with other cardiac anomalies. Cumulative follow-up period was 34.3 patient-years (p-y). There were 3 late deaths resulted from xenograft calcification. In AVR group, predominant pathology of the valve was regurgitation in 8 cases and stenoregurgitation in one case. All cases were associated with other cardiac anomalies. There were 2 late deaths within the cumulative follow-up period of 39.5 p-y. Cumulative survival rates at 15 years, both in MVR and AVR groups were lower in congenital group than in the group of acquired disease. The incidences of prosthesis malfunction, prosthesis related complication and late death in the both MVR and AVR groups were higher in congenital group, when compared to that in the group of acquired disease. PMID- 6503999 TI - [Surgical treatment of pulmonary atresia (PA) and critical pulmonary stenosis (PS) with intact ventricular septum (IVS)]. AB - Patients with PA: IVS and critical PS: IVS tend to have hypoplastic right ventricles and tricuspid valves. There is a large range of hypoplasia, but the relationship between the size of the right ventricle cavity and the size of tricuspid valve ring were found to be statistically significant. Pulmonary valvotomy alone is usually not adequate for the first stage operation and a systemic-pulmonary shunt procedure often become necessary. Use of PGE1 improved the overall clinical prognosis of these patients. The appropriate operative method for the second stage operation should be determined by measuring right ventricle volume and evaluating the degree of hypoplasia of the right ventricle, tricuspid valve and pulmonary artery. In three patients with right ventricle and tricuspid hypoplasia, we performed the Glenn procedure in addition to right ventricle outflow reconstruction and obtained good surgical results. PMID- 6504000 TI - [External conduit repair for congenital heart diseases]. AB - Between January 1970 and March 1984, external conduit repair was performed in eighty-five consecutive patients for various complex anomalies. The age at operation ranged from 2 months to 47 years, and 41 patients were in an age group of 5 to 9 years. Among 85 complex anomalies, 20 cases of d-transposition with VSD + PS, 33 cases of Tetralogy of Fallot with pulmonary atresia, 11 cases of truncus arteriosus and 11 cases of 1-transposition were included. From January 1970 to December 1975, conduits used were aortic homograft in 1, formalin treated porcine valved conduits in 27, and valved conduits treated with 0.65% glutaraldehyde in 3 and from January 1976 to November 1982, 42 Hancock composite grafts were used. Since December 1982, valved conduits made of preserved pericardium treated with glutaraldehyde were employed. In sixty-one patients survived from operation, actuarial survival rate was calculated as 87% at five years, 82% at ten to fourteen years. However, systolic pressure of right ventricle after repair mostly affected actuarial survival rate which maintained 93% at twelve years in patients with systolic pressure lower than 80 mmHg, and reduced to 65% at fourteen years in patients with that higher than 80 mmHg. Although external conduit repair was valuable for surgical treatment in complex anomalies, proper selection of conduit material, prevention of infectious endocarditis, and pseudoendothelial proliferation in late stage were the problems to be solved in the future. PMID- 6504001 TI - [Reconstructive valve surgery in congenital heart disease]. AB - As part of various defects in congenital heart disease, valvular lesions are frequently encountered and remain as one of the difficult subjects. Recent advances in the management of valvular lesions and late results of repair and replacement were reported. In congenital aortic stenosis, most of patients have obtained satisfactory results with valvotomy, but some required reoperation with valve replacement even during childhood. In supracristed VSD associated with aortic regurgitation, late recurrence of regurgitation was found in some, but 70% of the patients showed free of diastolic murmur after 10 years. In tetralogy of Fallot, definitive repair of pulmonary valve was performed in last 5 years with composite patch with patient's own pericardium to reduce postoperative pulmonary regurgitation. Recently, pericardium is treated with glutaraldehyde on the operating table to prevent late shrinkage. As external conduit, homograft aorta, which had been utilized previously, showed good late results comparable to xenograft in terms of free from reoperation. Xenograft has been frequently utilized without significant late obstruction so far. In atrioventricular canal, endocardial cushion prosthesis technique has been utilized satisfactory with recent modification of the wings made by glutaraldehyde treated patient's own pericardium as well as in tetralogy. PMID- 6504003 TI - [Operative procedure for simultaneous spontaneous pneumothorax]. AB - We have treated 542 cases of spontaneous pneumothorax during the past 20 years, among them 40 cases of bilateral simultaneous spontaneous pneumothorax and 55 cases of non-simultaneous bilateral pneumothorax were included. This paper discusses when the bilateral operation for bilateral simultaneous spontaneous pneumothorax can be carried out and operative approach to bilateral simultaneous thoracotomy. The following results were obtained: Contralateral pneumothorax after an operation for unilateral spontaneous pneumothorax occurred in 25% of teenagers. In cases of spontaneous pneumothorax with occurrence of contralateral pneumothorax, bilateral simultaneous thoracotomy must be performed. In cases of simultaneous spontaneous pneumothorax, we performed simultaneous bilateral thoracotomy, thereby decreasing the psychologic tension of patients and shortening the hospitalization period. The bilateral axillary incision for simultaneous bilateral thoracotomy in cases of simultaneous spontaneous pneumothorax caused least blood loss compared with median sternotomy and transverse bilateral thoracotomy. The transverse bilateral thoracotomy, on the other hand, opens up a larger operating field. PMID- 6504002 TI - [Simultaneous bilateral operations for bullous emphysema by median sternotomy]. AB - Eighteen patients with bilateral bullae underwent simultaneous operations via median sternotomy. Each patient had giant bullae occupying at least one third of the each hemithorax and also had various degree of exertional dyspnea. All patients showed subjective as well as objective improvement and there was no mortality or morbidity. Late follow-up study for objective evaluation of this operative procedure clarified that the forced expiratory volume for one second (FEV1.0) and arterial oxygen tension (PaO2) were significantly improved after the operation, whereas the vital capacity and arterial carbon dioxide tension (PaCO2) showed no apparent changes. Serial study of cardiopulmonary hemodynamics during the bilateral thoracotomy was performed with Swan-Ganz catheter and hemodilution method. By abrupt decompression of the cyst, decreases in pulmonary arterial pressure, cardiac output, or systemic arterial pressure were noted during the bilateral thoracotomy. These hemodynamic changes were much more evident in the cases ventilated by single lumen tube than the cases operated upon using double lumen tube with separate ventilation. This operative procedure was applied on the cases with bilateral spontaneous pneumothorax and metastatic lung tumor. The clinical advantages of this bilateral operation via median sternotomy were discussed. PMID- 6504004 TI - [Changes in pulmonary function after bilateral lung resection]. AB - Recently, bilateral lung resection are often performed as a treatment of both sides of emphysematous bullae or metastatic lung tumor. In our studies, general status and pulmonary function after the surgery were well maintained in most patients treated with partial lung resection or bullectomy. However, in cases received the resection of three or more segments on both side of the lung, vital capacity after the second surgery decreased in greater degree than was expected from the total volume of lung removed, and their Hugh-Jones grades for dyspnea proceeded postoperatively to II degrees or III degrees. Postoperative disturbance in pulmonary function is an important problem in cases of bilateral lung resection in numbers of segments. We studied experimentally on changes of pleural pressure and pressure-volume curve (P-V curve) of the remaining lung lobe and chest wall after bilateral lobectomy. Pleural pressure became more subatmospheric following the lobectomies, i.e., the functional residual capacity of the remaining lobe increased. The compliance of the remaining lobe decreased after lobectomies and the P-V curves were shifted to the right, resulted in decrease of the lung volume under the condition of a high grade of inspiration, i.e., reducing vital capacity. PMID- 6504005 TI - [Bilateral pneumonectomy in metastatic pulmonary tumors]. AB - Until December 1978, 91 patients with metastatic pulmonary tumors underwent thoracotomy. Twenty nine of the 91 had bilateral metastases. Of the 29 patients, 24 underwent bilateral thoracotomies and 5 underwent thoracotomy on only one side. Of the 29 patients, 7 (24.1%) survived more than 5 years. These were patients with gestational choriocarcinoma (3), fibrosarcoma (1), renal adenocarcinoma (1), granulosa cell tumor (1), and giant cell tumor of the bone (1), respectively. Size of metastatic pulmonary lesions did not correlate with postoperative survival period. Patients with smaller number of metastatic pulmonary lesions tended to have longer survival period. One patient with preoperative vital capacity of 2 liter and FEV1.0 of 1.56 liter complained of severe dyspnea postoperatively. PMID- 6504006 TI - [Metachronous bilateral pulmonary resection for primary bronchogenic carcinoma]. AB - A metachronous bilateral pulmonary resection was executed on 11 cases of primary bronchogenic carcinoma. Of the 11 cases of secondary tumors, 5 were double primaries and 6 were metastatic foci. Except for 1 wedge resection, radical lobectomy was done for the first resection of the 11 cases. Modes for the second resections were lobectomy in 2, segmentectomy in 3, and wedge resection in 6. At the second operation, 2 cases underwent a complete regional lymphnode dissection but in the other 9 cases lymph node dissection was incomplete. Tumor infiltration was proven on the margin of surgical specimen for 2 cases. There was a necessity of ventilatory support for 3 cases after the operation but there were no surgical deaths. Of the 6 cases of recurrent diseases that underwent second resection, 1 case died of respiratory insufficiency a year after operation. The 5 remaining cases are living from 1 to 4 years. Of the 5 double primaries, 1 case died of respiratory insufficiency 7 months after operation and 1 case died of metastatic disease 10 months after operation. One case died of an accident 3 years 6 months after the operation. For the remaining 2 cases, one is living for 1 year and 6 months, the other for 3 years and 4 months following resection. The demand for second resection in primary bronchogenic carcinoma is increasing from year to year. PMID- 6504007 TI - [Bilateral thoracotomy in primary lung cancer]. AB - The indication of thoracotomy for double or recurred lung cancer was studied from viewpoints of oncology and performance status. In addition, the mode of operation for unilateral bullous carcinoma in the cases with bilateral giant bullae was discussed. In considering the bilateral thoracotomy for lung cancer, lung volume to be resected must be carefully decided to keep good performance status. It is also necessary to consider the difference of the mode of tumor invasion which frequently depends on the histological type. Factors of indication for bilateral thoracotomy in double or recurred lung cancer are 1) radicality of primary or first lung cancer, 2) no detectable metastatic lesion other than the lung, and 3) good general and cardiopulmonary conditions. As to unilateral lung cancer in the cases with bilateral giant bullae, the first point to be considered is the radicality of lung cancer. And the contralateral giant bulla can be just followed with the observation when it is asymptomatic. PMID- 6504008 TI - [Follow-up results of cases treated with bilateral surgical treatment for pulmonary tuberculosis]. AB - Follow up results of 187 cases who were employed bilateral surgical treatment for pulmonary tuberculosis in author's hospital from 1948 to 1978 were studied. One hundred and eighty seven cases were divided into two groups: one was followed shorter than 5 years (control group, 90 cases) and the other was followed longer than 5 years (subject group, 97 cases). For those 187 cases 578 operation were performed, which occupied 9.3% of all operations done in the hospital during the same period. In the subject group, preoperative disease was more advanced, preoperative positive rate of tubercle bacilli was higher and preoperative %VC was lower than those in the control group. However, in the subject group success rate was 79.4%, negative sputum rate was 85.6%, positive sputum rate was 5.2%, mortality rate was 9.3% and postoperative complication rate was 10.3%. These results were better than those in the control group. Results of all bilateral surgical cases were almost the same as results of pneumonectomy cases that showed positive sputum, which were reported in a collective study by Japan Tuberculosis Research Committee. However, low pulmonary function case of less than 39%VC reached to a large rate of 42.1%. Bilateral surgical treatment for new tuberculosis case will not be necessary if patient receive a regular initial intensive chemotherapy with regimens including RFP. PMID- 6504009 TI - [Nutritional support in surgery: with special reference to fat emulsion and carnitine]. AB - Energy metabolism of fat emulsion has been studied in rats with various conditions including postoperative catabolism, chronic and acute hepatic dysfunction, diabetes and sepsis. The results indicate that fat emulsion is rapidly eliminated from the blood stream and metabolized readily even in such conditions. Based on these findings, we have actively employed fat emulsion clinically as energy source. In septic rats, it was demonstrated that levels of carnitine decreased and that this decrease was based upon a decrease of synthesis. When carnitine was administrated together with fat emulsion, the energy metabolism returned to approximately normal level. This report also describes the tissue concentrations of carnitine in diabetic rats and the blood and urine concentrations of carnitine in postoperative patients. PMID- 6504010 TI - Demodicosis in cats. AB - Feline demodicosis, caused by Demodex cati, may be associated with immunosuppression, as from FeLV infection or diabetes mellitus. Clinical signs include nonpruritic alopecia, scaling, erythema and hyperpigmentation in the facial region. Local topical application of 2.5% lime sulfur solution every 10 days is usually curative in a few weeks or months. PMID- 6504011 TI - Myeloproliferative disease in a cat. AB - Myeloproliferative disorders, a complex of cytologic abnormalities arising in the bone marrow, are among domestic animals most frequently recognized in cats but are relatively uncommon. A 4-year-old female Siamese, with splenomegaly and weight loss, was listless, anorectic, pale and dehydrated. A hemogram showed severe, macrocytic normochromic anemia, leukocytosis and reticulocytosis, with abnormally high numbers of nucleated RBC and undifferentiated blast cells. Bone marrow smears contained predominantly undifferentiated blast cells, RBC precursors and myeloblasts. The fluorescent antibody test for FeLV was positive. The cat died 66 days later despite a blood transfusion and chemotherapy. Necropsy confirmed a diagnosis of myeloproliferative disease, with hepatic and splenic invasion. PMID- 6504012 TI - Isolation of leptospires in diagnosis of leptospirosis. AB - Though the microscopic agglutination test is commonly used as an aid to diagnosis of leptospirosis, it lacks sensitivity, cannot differentiate vaccinal titers from those of infection, and cannot identify shedders. The ELISA is sensitive but also cannot differentiate titers of vaccination and infection. Leptospire isolation is essential for a final diagnosis. Tissue or fluid samples should be aseptically collected, if possible, and quickly shipped to the diagnostic laboratory in transport medium or on ice, but should not be frozen. Samples to be collected may include urine, milk, kidney, aqueous humor, and fallopian tube or uterine mucosa. PMID- 6504013 TI - The importance of endoparasite counts at necropsy. AB - In a 2-year study of 49 Oklahoma cattle with a typical history of clinical endoparasitism, 12 animals had Ostertagia only, and Ostertagia was the predominant endoparasite in 21. Only 1 animal had a pure Haemonchus population. Though primary endoparasitism was diagnosed antemortem in 32 animals, postmortem worm counts confirmed the diagnosis in only 19. Worm counts documented inapparent disease in 8 animals. In 21 cases of suspected of toxicosis, 12 animals had endoparasitism none was poisoned. PMID- 6504014 TI - Congenital cardiac disease in dogs. AB - Ventricular septal defect (VSD) generally occurs high in the membranous septum rather than lower in the muscular portion. The English Bulldog and Siberian Husky may be predisposed. Clinical signs include a holosystolic or crescendo decrescendo murmur best heard low on the right side at the 3rd-4th intercostal space and, with large defects, pulmonary congestion, exercise intolerance, cyanosis and ascites. The ECG is normal unless the right ventricle is hypertrophied, which causes right axis deviation and other electrocardiographic signs of right-sided heart enlargement. Plain film thoracic radiographs reveal signs of right-sided heart enlargement but often are not diagnostic. Nonselective angiocardiography is often not useful in diagnosing VSD with a left-to-right shunt of blood. Selective angiocardiography, in which contrast medium is injected directly into the left ventricle via a catheter, is the method of choice for diagnosis of VSD. Dogs with a small VSD remain asymptomatic, but those with large defects require surgical correction with a prosthetic septal pathic or pulmonary artery band. PMID- 6504015 TI - Laboratory aspects of cancer. AB - Hematologic alterations unrelated to neoplastic bone marrow involvement include polycythemia, anemia, leukocytosis, leukopenia, thrombocytosis, thrombocytopenia and coagulopathies. Serum globulin levels may be increased or decreased, depending on the type of neoplasm. Plasma fibrinogen and fibrin degradation product concentrations are usually elevated in cancer patients, whereas cancer patients with DIC have low plasma fibrinogen concentrations. Hypercalcemia can be a sequel of osseous metastases. Neoplasia may cause the nephrotic syndrome in some patients. Effusions should be examined microscopically for signs of malignancy. Elevated serum enzyme levels are not specific in neoplastic disease. PMID- 6504016 TI - Placement of drain tubes in obstructed teats. A photo essay. PMID- 6504017 TI - Suspected Se-vitamin E deficiency in heifers. AB - A group of grain-fed heifers became stiff, and some sternally recumbent, upon exercising after winter confinement. All but 2 affected heifers gradually recovered after IM injections of Se-vitamin E and IV infusion of Ca-Mg solution. Though serum assays failed to detect low Se levels, the presumptive diagnosis was based upon clinical signs and a good response to Se-vitamin E treatment. PMID- 6504018 TI - Rhodococcus equi pneumonia in foals. AB - Rhodococcus (Corynebacterium) equi pneumonia is diagnosed by thoracic auscultation, radiographic and hematologic examination, and transtracheal aspiration. Treatment may be unsuccessful because of the organism's tendency to cause pulmonary abscesses. A 2-month-old, depressed, anorectic, febrile Quarter Horse colt, previously unresponsive to penicillin therapy, had loud, moist breath sounds in the ventral lung fields. Chest radiographs revealed pneumonia. Based on culture and sensitivity tests on organisms isolated from transtracheal washes, chloramphenicol and erythromycin, and then oral trimethoprim-sulfadiazine, were given, in addition to supportive therapy. The animal was fully recovered within 2 months. PMID- 6504019 TI - Colic and dyspnea in a dog. AB - Volvulus and incarceration of bowel by a hernia may cause a closed-loop obstruction, possibly with associated intramural accumulation of gas and/or blood. Standing lateral projections optimize diagnosis of strangulating obstructions. Accumulation of only fluid in the obstructed loop may resemble a tumor. Radiographic signs of exudation and peritoneal fluid accumulation may develop with closed-loop obstructions. PMID- 6504020 TI - Will your retirement funds be ready when you are? PMID- 6504021 TI - Is human histone gene expression autogenously regulated? AB - It has been well documented that core and H1 histone mRNAs accumulate in a manner which closely parallels the initiation of DNA synthesis and histone protein synthesis, suggesting that the onset of histone gene expression early during S phase is at least in part transcriptionally mediated. In fact, it appears that throughout S phase the synthesis of histone proteins is modulated by the availability of histone mRNAs. On the other hand, the stability of histone mRNAs and the destabilization of histone mRNAs when DNA replication is completed or inhibited are highly selective, tightly coupled and largely post transcriptionally controlled. We present a model to account for histone mRNA turnover whereby the natural or inhibitor-induced termination of DNA replication results in an immediate loss of high affinity binding sites for newly synthesized histone proteins which in turn brings about a transient accumulation of unbound histones. These unbound histones could modify the histone translation complex, via interactions with polysomal histone mRNAs, in such a manner as to render histone mRNAs accessible to cellular ribonucleases. This type of mechanism would be operative solely at the post-transcriptional level and would be compatible with the rapid, RNA synthesis-independent destabilization of histone mRNAs which occurs following inhibition of DNA replication, as well as with the requirement for protein synthesis for histone mRNA destabilization to be initiated. PMID- 6504022 TI - Differences in the kinetic properties of thymidine kinase isoenzymes in unstimulated and phytohemagglutinin-stimulated human lymphocytes. AB - The two thymidine kinases, TK 1 and TK 2, found in phytohemagglutinin-stimulated human lymphocytes and the thymidine kinase, TK 2N, found in unstimulated human lymphocytes were purified and characterized. All three kinases had molecular weights between 70 000 and 75 000 which increased to 170 000-200 000 in the presence of 2 mM ATP. Studies on the kinetic properties of the enzymes with thymidine and ATP as the substrates and dTTP as the inhibitor showed clear differences between TK 1 and TK 2, but a close similarity between TK 2 and TK 2N. With thymidine as the variable substrate, TK 1 showed Michaelis-Menten kinetics, whereas TK 2 and TK 2N showed characteristic biphasic kinetics. With ATP as the variable substrate, all three enzymes showed positive cooperative kinetics, but TK 2 and TK 2N lost the cooperativity in the presence of dTTP. The results from inhibition studies showed, that dTTP was a cooperative inhibitor of TK 1 but a non-cooperative inhibitor of TK 2 and TK 2N. PMID- 6504024 TI - [Analysis of polypeptides of virus-specific informosomes induced by tobacco mosaic virus and potato virus X]. AB - Informosome-like virus-specific ribonucleoprotein (vRNP) of tobacco mosaic virus (TMV) comprise a set of four major polypeptides having molecular weights of 17 500, 31 000, 37 000 and 39 000. Of the minor polypeptides, those of apparent molecular weights 25 000, 55 000, 68 000 and 70 000 had electrophoretic mobilities of polypeptides found in a ribonucleoprotein preparation from uninoculated plants. Polypeptide with mol.wt. 175 000 is TMV coat protein so far as: a) vRNP was precipitated with immunoglobulins against TMV and TMV coat protein; b) it had electrophoretic mobility similar to mobility of TMV coat protein; c) the peptide map of polypeptides with mol.wts 31 000, 37 000 and 39 000 are probably virus-specific-products. This is supposed because they are not present in cell informosomes protein, and they are not revealed in vRNP induced in cells after infection with potato virus X (PVX). Electrophoresis of vRNP-PVX protein reveals polypeptides of 23 000 (PVX coat protein), 55 000, 70 000, 78 000, 95 000, 120 000 and 145 000. PMID- 6504023 TI - Molecular mechanisms of action of general anesthetics. AB - While a plethora of information exists describing particular changes caused by anesthetics on the molecular architecture of membranes, it is clear that models for anesthetic action remain unproven by rigid scientific criteria. This article describes historical and contemporary theories of how anesthetics act on a molecular level, and examines the discrepancies between these hypotheses and current data. PMID- 6504025 TI - [Cooperation effects in binding of large ligands to DNA. II. Contact interactions between adsorbed ligands]. AB - Cooperative effects arising upon binding of biologically active ligands to DNA are considered. Equations are derived which enable one to describe the binding of two different ligands to DNA. We also consider the case when ligand can form two type of DNA complexes. The cooperative binding of the ligand in the vicinity of saturation level of binding can be described with a good accuracy by equation derived for the non-cooperative adsorption of the same ligand with some effective binding constant Keff. It is shown that cooperative effects arising upon binding of proteins and other ligands to DNA can be divided into two groups depending on the symmetry of interactions between the bound ligand molecules. In particular, if such interactions favor the formation of dimeric ligand species on the DNA, Keff approximately a1/2, where a is the ligand-ligand interaction constant. If cooperative interactions favor the formation of aggregates of unrestricted size, then Keff approximately aL+Y, where L is the size of the binding site for the ligand on DNA. PMID- 6504026 TI - [Photochemistry of phycobilisomes: photosensitized reduction of methylviologen]. AB - The ability of phycobilisomes (PBS) to photosensitize the reduction of methylviologen by dithiothreitol has been shown. This reaction has been studied in dependence on the structural integrity of PBS, nature and pH of the medium, and concentration of reagents. The action spectrum of the reaction has been measured, and its quantum yield has been detected. The quenching of PBS fluorescence by methylviologen has been studied. The maximum rate of electron transfer photosensitized by PBS is observed in 0.6 M phosphate buffer containing 30% of glycerine, pH 9.5. The saturation occurs at methylviologen concentration of 2 X 10(-4) M. Under these conditions the PBS activity reaches 0,3 mumol/mg PBS.h and increases 100 times after preliminary heating of the reaction mixture for 5 min. at 35 degrees C. The light in the range of 520-680 nm is active for the photosensitized reduction of methylviologen. The quantum yield of the reaction is about 2%. In structures phycobiliproteins are more effective sensitizers than in solutions. The highest activity is observed for the substructure of PBS which contains allophycocyanin B and allophycocyanin C (34S particle). The possible mechanisms of the reaction are under consideration. PMID- 6504027 TI - [Mechanism of hydrogen exchange in DNA]. AB - The hydrogen exchange mechanism of DNA bases imino- and amino protons is explained according to a suggested exchangeable state model. This state can be formed as a result of significant structural fluctuations which are not complete base pair openings. The exchangeable state model represents the hydrogen-bonded complex of two nucleotide bases and one water molecule made up dynamically. Quantum-mechanical calculations for the values of energy as the function of H bond proton positions in the complex were carried out and the two-proton positions in the complex were carried out and the two-proton transfer is shown to be possible. The suggested model allows to give a noncontradictary interpretation of the hydrogen exchange data in double-helical polynucleotides. PMID- 6504028 TI - [Intraglobular electrostatic field of an enzyme. IV. Electrolytic dissociation of the active center of alpha-chymotrypsin]. AB - The dissociation of the ionogenic groups of the active centre of alpha chymotrypsin is considered taking into account effects of short- and long-range solvation and intraglobular electric field. The ionic pair Asp102-CO2-. His57 ImH+ is shown to be the most probable state of the neutral active centre of alpha chymotrypsin, this ionic pair being stabilized substantially through electrostatic interaction of the ions. The pair dissociates releasing the proton from the N epsilon 2 atom of His57 and forming a catalytically active group Asp102-CO2-. His57-Im. The pK value approximately 7 characteristic of this acid base equilibrium pertains to the active centre as a whole rather than to the isolated imidazolium ion. The approach developed by the authors is compared with other works in this area. PMID- 6504029 TI - [Mechanism of action of cAMP-dependent protein kinase. IV. Interaction of the enzyme catalytic subunit with structural analogs of histone H1]. AB - A study was made of the specificity of the catalytic subunit of cAMP-dependent pig brain protein kinase with respect to structural analogs of the protein substrate, histone H1, namely: a) high-molecular-weight histone fragments obtained as the result of specific cleavage of histone with trypsin and N bromsuccinimide; b) synthetic peptides-substrates; c) synthetic peptides inhibitors. Analysis of the kinetic parameters estimated for these compounds allowed to evaluate the individual contribution of various elements of the primary and three-dimensional structure of histone in the processes of binding and phosphorylation. Factors of "near" and "remote" specificity in the protein substrate binding are suggested. PMID- 6504030 TI - [Study of calcium binding to calmodulin using laser raman spectroscopy]. AB - Laser Raman spectroscopy has been used to study calcium binding to calmodulin, Ca2+-dependent regulator protein. Cation binding accompanied by spectral changes of tyrosine residues in the regions of Fermi-resonance doublet and 1600-1620 cm 1, of some carboxylate-containing residues, amide I, III and C-C(N) skeletal vibrations. Amide III contour analysis and calculations of Amide I contours show that complexation causes peptide backbone conformational changes characterized mainly by increased alpha-helical content. PMID- 6504031 TI - [Study of the double-stranded fragments in the poly(A)-containing cytoplasmic RNA of the rat liver]. AB - The double-stranded sequences in the poly(A)-containing cytoplasmic RNA (c-dsRNA) hybridize mainly with the repetitive DNA. 70-80% of double-stranded regions in the cytoplasmic poly (A)-RNA are identical to double-stranded regions of heterogeneous nuclear RNA in normal as well as in cortisone-treated rats. The thermal stability of cytoplasmic double-stranded regions is higher in the presence of polyadenylate sequences than in their absence. It is suggested that the double-stranded sequences in the poly (A) +RNA interact with poly (A) stretches and form higher order structures. The thermal stability of c-dsRNA isolated from cortisone-treated rats is higher than that from control rats. PMID- 6504032 TI - [DNA interaction with low molecular weight ligands of different structure. III. DNA complexes with distactins]. AB - The DNA complexes with distactins have been investigated by means of spectrophotometry, viscosimetry and flow birefringence methods. The distactins are actinocin's derivatives containing in the 1,9 positions of the phenoxazone moiety oligopyrrolcarboxamide groups (like those of distamycin A), which have from one to three fragments of 1-methyl-4-amino-2-pyrrolic acid. The mode of DNA distactins binding in water solution depends on the quantity of the methylpyrrole rings in the oligopeptide groups. The ligand with oligopeptide groups containing three methylpyrrole rings joins the DNA double helix only from outside by means of oligopeptide groups. The compounds with one and two methylpyrrole rings form two kinds of complexes with DNA: external binding and intercalation. In the latter case both chromophore and methylpyrrole fragments, interact with DNA. PMID- 6504033 TI - [Histone H1 from the herring Clupea harengus pallasi testis structurally resembling histone H5]. AB - Erythrocyte- and testis-specific fractions of the lysine-rich histone of herring Clupea harengus pallasi were studied. Electrophoretically purified fractions were cleaved at residues of tyrosine and phenylalanine. The fragments thus obtained and intact proteins were investigated by the method of incomplete succinylation which permitted one to determine the number of lysine residues, the total number of arginine and histidine residues and the molecular length of polypeptides. It has been found that the testis-specific fraction has in its C-terminal half of the molecule 15 arginine residues and a high proportion of basic amino acid residues (0,49) and thereby resembles the histone H5 of birds and fishes. The N terminal half of this fraction however is close to the somatic variants of lysine rich histones by the number of arginine residues and by the proportion of basic amino acid residues. To the author's knowledge, the testis-specific fraction of the lysine-rich histone in fishes are described for the first time. PMID- 6504034 TI - [Molecular organization of pheophytin a in aqueous solutions of detergents]. AB - Absorption, fluorescence and excitation fluorescence spectra of pheophytin a have been measured in aqueous solutions of nonionic (Triton X-100), anionic (sodium lauryl sulphate) and cationic (Cetyl pyridinium chloride) detergents at different concentrations and pH after system relaxation. By measuring the second derivative and differential spectra, it has been shown, that if detergent concentrations are lower than critical micelles concentration, or if the detergent is completely absent, the pigment forms conglomerates containing both dimeric and monomeric forms with an efficient energy transfer between them. If detergent concentrations are higher than critical micelles concentration, pheophytin a localizes in detergent micelle in monomeric form at neutral and acidic pH, and allomerizes at alkaline pH. The spectral characteristics of pheophytin a dimers in the conglomerate and its monomers in micelles poorly (if at all) depend on the sign of the detergent molecule charge. PMID- 6504035 TI - [The effect of medium on functional and structural properties of serum albumins. II. The effect of temperature on the N-form of human serum albumin]. AB - In order to investigate effects of temperature in the physiological range (from 10 to 50 degrees C) on structural, physical and functional properties of the N form of human serum albumin (HSA), the temperature dependences of fluorescence parameters of Trp-214 residue of HSA and of the specifically bound dye ANS, as well as of association constants of ANS binding in the primary and secondary binding sites on HSA molecule were measured. The temperature-induced changes of these properties of HSA are essentially dependent on pH (7.0 or 5,6) and ionic strength (0.001-0.008 or 0.2 M NaCl). At pH 7.0 and 0.2 M NaCl the environment of Trp-214 remained invariant at temperature changes between 10 and 50 degrees C. On the other hand, the affinity to ANS of a primary binding site doubled and that of secondary ones halved. These affinity changes seem to be due, are least partly, to the heating-induced dissociation of Cl-ions, which are inhibitors of the primary dye binding. By lowering pH (to 5.6) and ionic strength the temperature induced changes in the Trp-214 environment were observed. The changes are interpreted as indole group transition into the buried region, inaccesible to water (the "closing" of a structural slit). The affinity of secondary binding sites of ANS was halved. PMID- 6504036 TI - [Characteristics of the tertiary structure of histone H1 from the calf thymus]. AB - By optical methods it has been previously shown that the globular "head" of histone H1 forms a hydrophobic cavity containing Tyr72. The latter is screened from the polar water surrounding and its intramolecular mobility is drastically hindered. As a consequence of the alteration in the micromilieu are a long wave shift (lambda max = 279,5 nm) and a more pronounced longwave absorption spectra, higher anisotropy (A = 0,11), augmented quantum yield of fluorescence (approximately 0,2) and a decrease of the Stern-Volmer constant for Hl at fluorescence quenching by acrylamide. It was found that changes in fluorescence intensity of histones are connected with alterations in the quantum yield of fluorescence at lambda exc = = 265 nm, but not at lambda exc = 280 nm. The changes in fluorescence intensity at light excitation 280 nm (F280) and 265 nm (F265) are in good accordance with shift delta E286 in differential absorption spectra. Introduction of parameter Cf = F280/F265 allows to study shifts of excitation spectra instead of shifts in absorption spectra of histones. This method has certain advantages, since it permits investigations with lower protein concentrations and in turbid solutions. The data obtained allow to draw out Tyr72 of histone Hl into a special class of fluorescent-tyrosyls, that differ in properties from those of other tryptophandevoided proteins: RNAse, insulin and core-histones H2A, H2B, H3 and H4. PMID- 6504037 TI - [Electron microscope study of chromatin in hepatocyte nuclei during the first hours after partial hepatectomy. V. Changes in the relative area of condensed chromatin and the density of chromatin fibril packing in the ultrathin sections]. AB - The degree of chromatin condensation was studied on ultrathin cell sections of guinea pig hepatocytes during the prereplicative period after partial hepatectomy. Three time points were chosen for analysis namely 2,5, 5 and 9 hrs after operation since they show marked increasing (2.5 hrs), decreasing (5 hrs) and repeated increasing (9 hrs) of the amount of ethidium bromide binding to chromatin. The degree of chromatin condensation was determined by measuring the area occupied by condensed chromatin and also by measuring the number of chromatin fibrils per a certain length. The condensed chromatin with varying localization in the nucleus were studied separately. The changes of nucleoplasmic chromatin were most pronounced: at 2.5 and 9 hrs after operation the decrease of the relative area and of the density of chromatin fibrils package was observed; these parameters were near to control at 5 hrs after operation. In general the changes in nucleoplasmic chromatin were correlated with the changes of the activity of the chromatin in the whole nucleus. The decondensation of the perimembranous chromatin was manifested in the decrease of its area and was expressed only at 9 hrs after operation. The perinucleolar chromatin was found to show the gradual decondensation which was manifested mainly by the decrease of its relative area. Thus the condensed chromatin seems to be a labile structure which undergoes essential changes in the process of the exit of the hepatocytes from G0-stage of the cell cycle, during the prereplicative period. PMID- 6504038 TI - [Hydratation of the rubredoxin polypeptide chain from data on the spatial structure]. AB - The hydration water distribution around the main chain protein rubredoxin has been analysed using the crystal data at high resolution obtained earlier. The analysis was based on the consideration of all nearest neighbour atoms around the N and O atoms of peptide groups. The atoms which can form hydrogen binds were the subject of final analysis. The nitrogen atom of a peptide NH group has only one vacancy for neighbours. The oxygen atom of a peptide CO group has one, two or more neighbours, some of them are oxygen-water atoms. About 27% of NH and 53% of CO peptide groups are hydrated, that corresponds to 0.12 H2O per gram of protein. A detailed analysis shows that NH and CO groups of the main chain are hydrated according to the principle of maximum possible in situ saturation of hydrogen bonds. Thus the peptide groups incorporated in the peptide hydrogen bond network were not hydrated as a rule. Consequently, for rubredoxin a pleated sheet region, some regions for the large and small main chain loops, and Fe-containing pocket are not hydrated. A method for evaluation of the main chain hydration is proposed when the coordinates of protein atoms are available. PMID- 6504039 TI - [tRNA(adenine-1-)-methyltransferase from Thermus thermophilus HB8]. AB - tRNA(adenine-1-)-methyltransferase (EC 2.1.1.36) was isolated from the extreme thermophile Thermus thermophilus strain HB8. The specific activity of the enzyme is about 50 000 and the yield of activity more than 20%. The method of isolation consists of five steps and is valid for isolation of mg quantities of the enzyme. The purified protein preparation is practically homogeneous in SDS-gel electrophoresis, the position of the protein band corresponds to a molecular weight of 25 000. By gel filtration on Sephadex G-100 the molecular weight of the native protein was found to be 70 000. These data allow to suggest a subunit structure of the enzyme. The enzyme is highly thermostable and is most active at 80 degrees C. The only activity of the enzyme is to methylate A58 in the T psi X loop of tRNA. PMID- 6504040 TI - [The effect of exogenous tRNA from different sources on the biosynthesis of milk proteins]. AB - The tRNA dependent cell--free protein--synthesizing system from rabbit differentiated mammary gland has been obtained. The level of protein synthesis including caseins was found to be much higher in the presence of homologous tRNA in comparison with tRNAs from non-differentiated mammary gland, liver, brewer's yeast. The efficiency of translation was shown to depend on the tRNA pool quantitative balance. The addition of tRNA to mammary gland explants causes stimulation of casein synthesis. The level of this stimulation depends on both the origin of tRNA and physiological state of the gland. It is concluded that the functional adaptation of tRNA is a regulatory link in specific protein biosynthesis at the translation level. PMID- 6504041 TI - Assignment of the human dihydrofolate reductase gene to the q11----q22 region of chromosome 5. AB - Cells from a dihydrofolate reductase-deficient Chinese hamster ovary cell line were hybridized to human fetal skin fibroblast cells. Nineteen dihydrofolate reductase-positive hybrid clones were isolated and characterized. Cytogenetic and biochemical analyses of these clones have shown that the human dihydrofolate reductase (DHFR) gene is located on chromosome 5. Three of these hybrid cell lines contained different terminal deletions of chromosome 5. An analysis of the breakpoints of these deletions has demonstrated that the DHFR gene resides in the q11----q22 region. PMID- 6504042 TI - High-level expression and molecular cloning of genes encoding Candida tropicalis peroxisomal proteins. AB - The development of peroxisomes in the cells of Candida tropicalis grown on oleic acid was accompanied by a markedly high expression of peroxisomal proteins. On the basis of this finding, the nuclear DNA library of this yeast was screened by differential hybridization, and 102 clones of oleic acid-inducible sequences were isolated. Seven coding regions were found to form clusters in three stretches of the genomic DNA. Five of the regions were identified as genes for peroxisomal polypeptides (PXPs). The coding sequence for PXP-2 hybrid selected an additional mRNA for PXP-4, the subunit of long-chain acyl coenzyme A oxidase, which was the most abundant PXP. PXP-2 and PXP-4 were close in apparent molecular weight and generated similar peptides when digested with a protease. The gene for PXP-4 was adjacent to that for PXP-2 on the genome and also hybridized to the mRNA coding for PXP-5. These and other similar results suggest that the genes for the peroxisomal proteins of this organism arose by duplication of a few ancestral genes. PMID- 6504043 TI - Starved Tetrahymena thermophila cells that are unable to mount an effective heat shock response selectively degrade their rRNA. AB - Tetrahymena thermophila cells that had been shifted from log growth to a non nutrient medium (60 mM Tris) were unable, during the first few hours of starvation, to mount a successful heat shock response and were killed by what should normally have been a nonlethal heat shock. An examination of the protein synthetic response of these short-starved cells during heat shock revealed that whereas they were able to initiate the synthesis of heat shock proteins, it was at a much reduced rate relative to controls and they quickly lost all capacity to synthesize any proteins. Certain pretreatments of cells, including a prior heat shock, abolished the heat shock inviability of these starved cells. Also, if cells were transferred to 10 mM Tris rather than 60 mM Tris, they were not killed by the same heat treatment. We found no abnormalities in either heat shock or non heat shock mRNA metabolism in starved cells unable to survive a sublethal heat shock when compared with the response of those cells which can survive such a treatment. However, selective rRNA degradation occurred in the nonsurviving cells during the heat shock and this presumably accounted for their inviability. A prior heat shock administered to growing cells not only immunized them against the lethality of a heat shock while starved, but also prevented rRNA degradation from occurring. PMID- 6504044 TI - Inducibility of metallothionein throughout the cell cycle. AB - Synchronized Chinese hamster cells were induced with ZnCl2 at multiple stages of the cell cycle and labeled with [35S]cysteine, and the 35S-labeled proteins were isolated and separated into metallothionein and nonmetallothionein fractions. Metallothionein was found to be inducible in all stages of the cell cycle and in G1-arrested cells. PMID- 6504045 TI - Changes in chromatin and the phosphorylation of nuclear proteins during heat shock of Achlya ambisexualis. AB - Heat shock led to marked changes in the apparent levels of phosphorylation of nuclear proteins in the fungus Achlya ambisexualis. We characterized these heat shock-induced changes in nuclear proteins on two types of two-dimensional polyacrylamide gel systems. We report here that one of two Achlya H3 histones (H3.1) and also the oomycete histone alpha appear to be highly phosphorylated with heat shock. Additional changes observed in acid-soluble nuclear proteins included an apparent increase in the 32P labeling of a 43,000-molecular-weight protein and the dephosphorylation of a major group of Achlya phosphoproteins in the 30,000-to-32,000-molecular-weight range. The changes in protein phosphorylation were accompanied by striking changes in the morphology of Achlya nuclei. Nuclei in the heat-shocked cells, but not in control cells, exhibited marked chromatin condensation and contained bundles of filaments which were approximately 4 nm in diameter. Concomitantly, the bulk of chromatin from heat shocked nuclei showed a decreased sensitivity to digestion with the enzyme DNase I relative to chromatin from control cells. PMID- 6504046 TI - Expression of a proto-oncogene (proto-myb) in hemopoietic tissues of mice. AB - This study addressed the possibility that proto-myb (also called c-myb), the cellular homolog of a retroviral transforming gene, plays a role in hemopoiesis, particularly during maturation of T cells. By gel blot hybridization, we confirmed previous reports that proto-myb transcripts are found at much higher levels in thymic lymphocytes and cells of the erythroid lineage than in other tissue sources. Using dot blot hybridizations, we demonstrated further that similar levels of proto-myb expression are found in thymic lymphocytes taken from young mice with active thymuses and from old mice whose thymuses have undergone involution and that the extent of proto-myb expression decreases at least 10-fold as T cells progress from immature cortical thymocytes to the mature, resting T cells taken from lymph nodes. These results suggest that the protein product of proto-myb functions during T-cell differentiation. PMID- 6504047 TI - Carbohydrate-binding protein 35: identification of the galactose-specific lectin in various tissues of mice. AB - In previous studies, a lectin designated as carbohydrate-binding protein 35 (CBP35) has been isolated from cultured mouse 3T3 fibroblasts. In this study, antibodies directed against CBP35 were used to screen for cross-reactive proteins in various cultured cells and in various organs and tissues of mice. Cross reactive proteins of the same molecular weight (Mr, 35,000) were found in human, mouse, and chicken fibroblasts and in a macrophage-like cell line, P388D1. Similarly, cross-reactive proteins were also found in the embryonic liver, lung, spleen, thymus, skin, and muscle tissue and in the lung, artery, thymus, and spleen of the adult mouse. Fractionation of extracts of mouse lung on affinity columns of asialofetuin-Sepharose yielded a protein whose molecular weight, carbohydrate-binding specificity, and immunological properties suggest that it is CBP35 derived from the lung, hereafter designated CBP35 (lung). The binding of 125I-labeled CBP35 (lung) to rabbit erythrocytes was quantitated in the presence and absence of various carbohydrates. It was found that only carbohydrates containing galactose were inhibitors of the binding; the disaccharide lactose was 100-fold more potent as an inhibitor than was the monosaccharide galactose. When extracts of the adult mouse liver were fractionated by asialofetuin-Sepharose chromatography, only a protein corresponding to CBP16 was isolated; no CBP35 was found. These results corroborate the immunoblotting data, which indicated that CBP35 was not detectable in the adult mouse liver. PMID- 6504048 TI - Osmotically induced microinjection of ricin bypasses a ricin internalization defect in a Chinese hamster ovary mutant cell line. AB - By osmotic lysis of pinocytic vesicles we were able to inject ricin or ricin A chain directly into the cytosol of Chinese hamster ovary cells. The lag time of 1 to 2 h before the onset of the inhibition of protein synthesis by ricin in intact cells was reduced to 15 to 30 min by this method. Preincubation of cells with a low concentration of nigericin, which was shown earlier to enhance the cytotoxicity of ricin, had no effect under this condition. Direct transfer of either intact ricin or the ricin A subunit by osmotic lysis of pinocytic vesicles into the cytosol of the ricin-resistant CHO mutant cell line 4-10 rendered the mutant 4-10 cells as sensitive to ricin as the CHO pro wild-type cells. Both the lag time and the rate of inhibition of protein synthesis in the wild-type and mutant cell lines after the introduction of ricin by osmotic lysis of pinocytic vesicles were the same. These results indicate that injection of ricin into the cytosol by osmotic lysis of pinosomes bypasses the internalization defect in the mutant cell line. PMID- 6504049 TI - Conformation takes precedence over sequence in adeno-associated virus DNA replication. AB - Deletion of an 11-base symmetrical sequence in the inverted terminal repetition of the adeno-associated virus 2 genome inhibits DNA replication. Substitution of either an 8- or a 12-base symmetrical sequence unrelated to the original 11-base sequence restores DNA replication. PMID- 6504050 TI - Natural DNP-binding immunoglobulins and antibody multispecificity. AB - Anti-DNP activity was found in normal human immunoglobulins with average affinities (10(4)-10(6) l/mole) and frequencies (15-2%) that correlate well with those expected from multispecific binding sites. PMID- 6504051 TI - Selective hepatobiliary transport of human polymeric IgA in mice. AB - Both subclasses of human polymeric IgA (pIgA) were selectively transported from the serum into the bile of mice relative to human IgG or IgM. Removal of human pIgA from serum corresponded to the clearance kinetics shown for murine pIgA. The biliary pIgA was intact as determined by sucrose density gradient ultracentrifugation. This hepatic uptake was specific for the IgA isotype and occurred independently of receptors in the liver specific for glycoproteins that terminate with galactose or mannose moieties. Desialylation of human pIgA resulted in its rapid clearance from serum and subsequent deposition in the liver in a manner similar to most other desialylated serum glycoproteins. The desialylated pIgA present in bile was also an intact molecule; thus the asialoglycoprotein receptor may represent an additional mechanism for the transport of serum pIgA into bile. PMID- 6504052 TI - A monoclonal antibody to the double-stranded polyribonucleotide complex poly(A) X poly(U). AB - A monoclonal antibody to the double-stranded polyribonucleotide complex poly(A) . poly(U) was derived from the fusion of spleen cells from immunized DBA/2 mice and the P3 X X63-Ag8 plasma cytoma. Specificity studies using radioimmunoassays showed that the anti-poly(A) . poly(U) does not cross-react with single-stranded polyribonucleotides. RNA X DNA hybrids or DNAs. In addition to RNA duplexes associating adenine and uracil, it recognizes synthetic poly(I) . poly(C) and naturally occurring reovirus RNA. It is thus directed against a conformational epitope with an absolute requirement for two polyribose phosphate chains. However, the antibody does not cross-react with poly(G) . poly(C) and is therefore able to distinguish between RNA double helices. PMID- 6504053 TI - Calorimetric study of rheumatoid factor binding to human IgG. AB - The binding of human IgM monoclonal rheumatoid factor (RF) to native human IgG was studied in a flow calorimeter. Thermal titration gave a enthalpy of binding of 5.5 X 10(4) J/mole site for the reaction, with 1 mole of RF binding to 2.5 moles of IgG; this corresponds to one RF subunit per IgG heavy chain. Similar experiments performed with heat-aggregated human IgG gave almost identical results. If the IgG molecule undergoes a conformational change upon heating, this is not such as to affect the enthalpic contribution of binding. PMID- 6504054 TI - Mouse IgG1 heterogeneity: variable binding of monoclonal IgG1 antibodies to protein A-sepharose. AB - Binding strength to protein A discriminates three definitive types of mouse monoclonal IgG1. Each of these types of IgG1 elutes from protein A-Sepharose as a coherent peak representing the great majority of IgG1 protein. One type of IgG1 is not present to any significant extent in polyclonal mouse IgG preparations, and to our knowledge has not been reported previously. This type of IgG1 does not bind firmly to protein A at pH 8.0, but is retarded sufficiently that it can be purified by protein A-Sepharose chromatography in high yields. PMID- 6504055 TI - Bacteriophage T4 particles are refractory to bisulfite mutagenesis. AB - Bisulfite-induced deamination of cytosine produces uracil, a thymine analog reported to be mutagenic both in vitro and in vivo. Although deamination of cytosine in DNA should produce G:C----A:T transitions, treating bacteriophage T4 particles with 0.9 M bisulfite at pH 5 at 37 degrees C produced no more mutations than did the equivalent buffer without bisulfite. Lack of bisulfite mutagenicity is fully consistent with the reported resistance of 5-substituted cytosines to bisulfite-induced deamination, since T4 DNA contains glucosylated 5 hydroxymethylcytosine. However, bisulfite also failed to induce mutations in T4 particles whose DNA contained unmodified cytosine. The lack of mutagenesis persisted in E. coli hosts deficient in uracil glycosylase, an enzyme expected to participate in the repair of the putative bisulfite-generated uracil. Cytosine in T4 DNA may be largely protected from bisulfite attack within phage particles. PMID- 6504057 TI - Chromosomal consequences of irradiation of human lymphocytes during S-phase, with special reference to chromatid exchanges. PMID- 6504056 TI - Gene dosage and complementation analysis of ataxia telangiectasia lymphoblastoid cell lines assayed by induced chromosome aberrations. AB - An approach of general applicability to mammalian radiosensitive mutants has been used in the analysis of gene dosage and complementation in ataxia telangiectasia (A-T). Thymidine residues in DNA of one parental lymphoblastoid cell line were substituted with bromodeoxyuridine before fusion with a second parental cell line, to allow differential staining of the two sets of chromosomes. Following gamma-irradiation, induced chromosome aberrations were scored in diploid and homokaryon cells from each parental line as well as in heterokaryons. Four complementation groups were ascertained among 7 A-T cell lines. Analysis of heterokaryons formed between appropriate combinations of normal, A-T homozygote and A-T heterozygote cells, gave a quantitative measure of gene dosage and demonstrated increasing radiosensitivity with increasing numbers of A-T alleles. PMID- 6504058 TI - Isolation of Chinese hamster cells hyposensitive to ethyl methanesulfonate and their characterization in induction and antagonization of sister-chromatid exchanges. AB - To better understand the molecular events involved in the formation of SCEs and mutations, 3 clonal sublines were established from a Chinese hamster cell line, Don D-6, on the basis of hyposensitivity to killing by ethyl methanesulfonate. These sublines, referred to as T80-4, T80-6 and T80-7, exhibited greatly altered karyotypes and altered frequencies of SCEs and mutations. These sublines were also less sensitive to chemical mutagens and ultraviolet irradiation as indicated by reduced frequencies of SCEs. This lower sensitivity was not due to differences in the rate of cell proliferation or to a cellular adaptive response. The rate of chemically- or UV-induced SCEs in these sublines did not always relate to cellular ploidy levels. The recent observation that, under constant experimental conditions, the rate of SCEs is a function of cellular ploidy level was not observed for these sublines. Thus, there appeared to be a modification in the intrinsic process of SCE formation. We reported previously that protein synthesis is essential for the induction of mutation as well as for SCE in Don D-6. However, the ability of cycloheximide (CH) to antagonize EMS-induced SCEs and mutations in the T80-7 subline was much lower than in the parental cells or in other sublines. The cells of this subline might contain a defective protein or a modification of the process for which the protein is required. PMID- 6504060 TI - Genetic injury in hybrid male mice exposed to low doses of 60Co gamma-rays or fission neutrons. I. Response to single doses. AB - Young adult male B6CF1 mice were exposed to single whole body doses of fission neutrons or 60Co gamma rays. Postspermatogonial dominant lethal injury, incidence of reciprocal chromosome translocations induced in spermatogonia, incidence of abnormal epididymal sperm 4-6 weeks after exposure, and testis weight loss 3-6 weeks after exposure were all measured. Emphasis is on response to neutron doses between 1 and 40 rad, and gamma-ray doses between 22.5 and 145 rad, although more limited data from a 4-fold higher dose range were integrated into the analysis. Significant effects were seen at 1 and 2.5 rad of neutrons consistent with extrapolation from higher doses, with the exception of dominant lethal mutations, which occurred in significant excess of expectation. Dose-response functions were linear or linear-quadratic, depending upon end point, radiation quality, and dose range. For translocation frequencies, the D2 term was negative for neutron and positive for gamma-ray irradiations. RBE values varied with dose and end point. For testis weight loss and abnormal sperm over the full dose range, the RBEs were between 5 and 6. They were between 7 and 9 at lower doses (less than 10 rad) for translocations. RBEs for postimplantation and total dominant lethal rates were 5 6 above 10 rad and 10-14 below 10 rad. The RBEs for preimplant losses were between 15 and 25 above 10 rad and possibly higher below 10 rad, although the data are statistically "noisy". The tentative interpretations of unusual results at lowest doses involve variation in cell sensitivity, cell selection, probability of neutron traversal per cell, variance of magnitude of the energy deposition events, dose rate, and DNA repair. PMID- 6504059 TI - Cultured human lymphocytes proliferate faster in medium lacking fetal calf serum and antibiotics. AB - When human whole blood was cultured in medium containing neither fetal calf serum nor antibiotics, more peripheral lymphocytes initiated DNA synthesis at about 24 h of culture than did lymphocytes in blood cultured in complete medium. Furthermore, the cells proliferated faster, so that by 48 h in culture approximately 20% of the metaphase cells in medium lacking fetal calf serum and antibiotics were in their second division. Such rapid cell proliferation can affect quantitative studies of chromosome aberrations, which should be observed in their first mitosis in culture, before cell death can cause a diminution in aberration yields. The rapid appearance of second-division metaphases should also be advantageous for the measurement of sister-chromatid exchanges (SCEs), which require two cell divisions for their observation. In contrast to cultures with complete medium, cells grown without fetal calf serum and antibiotics had fewer SCEs in second-division cells that divided later in the culture period. PMID- 6504061 TI - X-ray-induced translocations in marmoset (Callithrix jacchus) stem-cell spermatogonia. AB - The induction of reciprocal translocations in spermatogonial stem cells of marmosets (Callithrix jacchus) was studied after irradiation with different doses of X-rays (50, 100 and 200 rad) via spermatocyte analysis many cell generations later. The obtained results show a dose-effect relationship with clear saturation effects at 200 rad. The recorded frequencies of translocations were much lower than those reported for closely related marmosets (Saguinus fuscicollis and Saguinus oepidus). Possible reasons for this difference are discussed. PMID- 6504063 TI - Negative evidence for an adaptive response to lethal and mutagenic effects of alkylating agents in V79 Chinese hamster cells. AB - V79 Chinese hamster cells were subjected to a number of different pretreatment regimens with low concentrations of N-methyl-N-nitrosourea (MNU), N-ethyl-N nitrosourea (ENU) or N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). They were then treated with either MNU or ENU at toxic and mutagenic concentrations. No differences in cell killing or mutation induction to 6-thioguanine resistance were found between pretreated and non-pretreated cells. These results argue against the existence of an adaptive response to alkylating agents in this cell line. PMID- 6504062 TI - Pseudo dominant-lethal response in female mice treated with plant oils. AB - Corn oil, sesame oil, peanut oil, or olive oil, injected intraperitoneally to female mice prior to insemination, increased the number of deciduomata. In many plant oil-treated females the number of implantation sites was markedly higher than corpora lutea count. These effects were not observed among females that were treated similarly with mineral oil or among females that were given corn oil via oral administration. Evidence indicates that these effects did not arise from induced dominant-lethal mutations but from decidual responses resulting from traces of oil reaching the uterine lumen. PMID- 6504064 TI - UV-induced mutagenesis at the hypoxanthine-guanine phosphoribosyl transferase locus in two L5178Y mouse lymphoma cell strains with different UV sensitivities. AB - Two strains of L5178Y mouse lymphoma cells, L5178Y-R (LY-R) and L5178Y-S (LY-S), differ markedly in their sensitivity to 254 nm UV radiation (D0 = 0.7 and 5.5 J/m2; n = 6.0 and 2.0 for LY-R and LY-S cells, respectively). In this study, the frequency of hypoxanthine-guanine-phosphoribosyl-transferase-deficient mutants was determined, using 6-thioguanine (TG) as a selective agent, in populations of LY-R and LY-S cells exposed to various fluences of UV radiation. The spontaneous mutation frequency for LY-R cells was (3.7 +/- 0.6) X 10(-5) TGr mutants per viable cell, and the UV induction rate was (2.2 +/- 0.8) X 10(-4) TGr mutants per viable cell, per J/m2. Both spontaneous and induced mutation frequencies were much lower for LY-S cells. The spontaneous mutation frequency for these cells were too low to make its measurement practicable (less than 0.0013 X 10(-5) TGr mutants per viable cell). Mutation induction rate was (4.2 +/- 2.2) X 10(-7) TGr mutants per viable cell, per J/m2. These differences in mutability do not appear to be due to gene duplication in LY-S cells, or to selective growth disadvantage of LY-S-derived TG-resistant mutants. Possible mechanisms underlying the differences in mutability of LY-R and LY-S cells are considered. PMID- 6504065 TI - The nature of mutants induced by ionising radiation in cultured hamster cells. I. Isolation and initial characterisation of spontaneous, ionising radiation induced, and ethyl methanesulphonate-induced mutants resistant to 6-thioguanine. AB - A large number of thioguanine (TG)-resistant mutants of V79-4 Chinese hamster cells was isolated from untreated cultures and from cultures exposed to gamma rays, alpha particles or ethyl methanesulphonate (EMS). Selection conditions were chosen to optimise the survival of all types of TG-resistant mutant, and the isolation procedure ensured that each mutant originated independently of any other. Hypoxanthine-guanine phosphoribosyl transferase (HGPRT) enzyme activity was measured in cell-free extracts of each mutant, and compared with repeat measurements made on the parental V79-4 cells and on a series of non-mutant clones. Ionising radiation-induced mutants were found to be mostly (or perhaps entirely) of the 'zero HGPRT activity' type, but about 20% of EMS-induced mutants and 50% of spontaneously occurring mutants had significant HGPRT activity. However, none of the TG-resistant mutants were found to lack activity of another X-chromosome-linked enzyme, glucose-6-phosphate dehydrogenase. Few mutants were found with visible X-chromosome changes, but the incidence of hyperploidy was higher among spontaneous mutants than in the parental line and the induced mutants. Isoelectric focussing of cell extracts from those mutants which retained some HGPRT activity revealed several with shifts in the isoelectric points for HGPRT enzyme activity. PMID- 6504067 TI - Biologic actions and interactions of tetrachloroethylene. PMID- 6504066 TI - A report of the U.S. Environmental Protection Agency Gene-Tox Program. Evaluation of mutagenicity assays for purposes of genetic risk assessment. AB - For the vast majority of chemicals, mammalian germ-line (MG) mutation data do not exist. The question was examined of how best to utilize results of non-MG genotoxicity assays that are included in the Gene-Tox data base to provide information of the likelihood that genetic damage might be induced in and transmitted by the reproductive cells of exposed human beings. Two approaches were used to assess the relative value of different assays for genetic hazard identification. (1) Test results were weighted according to parameters by which conditions of an assay resemble those encountered in the potential induction of transmitted genetic damage in mammals. For this purpose, 35 assays were grouped into 16 categories that were assigned weights ranging from 1 to 15; there were 2367 chemicals in the data base. This system was evaluated by comparing the sum of weighted test results for each chemical with the outcome of MG-standard (MGst) tests where such had been reported. (MGst tests used were the specific-locus and heritable-translocation assays [SLT and HTT] for gene mutations and chromosome aberrations, respectively.) The weighting system produced a few false positives with respect to the MGst results. It produced no false negatives, but the available evidence is limited by the circumstance that MGst test have evidently been preferentially performed with chemicals that had already been shown to be positive in several other assays. (2) Findings from each MGst test were compared with those from each of the other assays in turn, provided that at least 10 chemicals had been tested in both of the assays. There were 11 such comparisons involving the SLT, and 14 such comparisons involving the HTT. The observed concordance was above random expectation in several comparisons, particularly those involving certain mammalian in vivo tests, but in only one case (HTT vs. unscheduled DNA synthesis in the testis) did the degree of elevation approach statistical significance. PMID- 6504068 TI - An analysis of the spectra of genetic activity produced by known or suspected human carcinogens. AB - For 24 agents classified by the International Agency for Research on Cancer as known or suspected human carcinogens, we previously catalogued the qualitative genetic bioassay data available in the literature. In the present analysis, dose information, where available, was added to this data base: either the lowest effective dose (LED) or the highest ineffective dose (HID) was recorded for each agent and bioassay system. Bioassay systems were organized according to classes of genetic activity and subdivided by the phylogenetic level of the test organism. For each compound, the quantitative results in the test systems were represented by computer-generated bar graphs ('genetic activity spectra'). The x axis unit values corresponded to the 100 different test systems, and the y-axis values were the logarithmically transformed LED or HID values. Statistical methods and pattern-recognition techniques were used to evaluate the genetic activity spectra. Spectra were compared among agents grouped according to target organ specificity. In addition, the spectra of all possible pairs of compounds were compared to identify compounds displaying qualitatively or quantitatively similar genetic activity. Chemically similar compounds frequently produced similar spectra of genetic activity, and it was possible to identify the most appropriate test systems for some classes of compounds. As the data base for human carcinogens is enlarged, analysis of genetic activity spectra may contribute to our understanding of the structure-activity relationships and mechanisms of action of these agents. PMID- 6504069 TI - Evaluation of modified dermatophyte test medium for isolation of dermatophytes. A preliminary report. PMID- 6504071 TI - In vitro antifungal effect of metronidazole on pityrosporum ovale. PMID- 6504072 TI - Prevention of myocardial infarction by very early treatment with intracoronary streptokinase. Some clinical observations. PMID- 6504070 TI - Familial infection by Trichophyton simii. PMID- 6504074 TI - Non-Hodgkin's lymphoma: management strategies. PMID- 6504073 TI - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 49-1984. A 64-year-old man with rheumatoid arthritis and cavitary pulmonary disease. PMID- 6504076 TI - Respiratory-muscle involvement in Parkinson's disease. PMID- 6504075 TI - Trade unionism for doctors. An idea whose time has come. PMID- 6504077 TI - Supplemental low-protein diet in chronic renal failure. PMID- 6504078 TI - Theophylline and chronic obstructive pulmonary disease. PMID- 6504079 TI - Stress and the aching heart. PMID- 6504080 TI - Contact-lens hand. PMID- 6504081 TI - Periodic microcirculatory flow in patients with sickle-cell disease. AB - We have applied the technique of laser-Doppler velocimetry to compare patterns of cutaneous blood flow in the forearms of patients with stable sickle-cell disease, with the patterns in normal subjects matched for age, race, and sex, and in patients with anemia due to beta+-thalassemia. The mean resting blood flow in the patients with sickle-cell disease was comparable to that of the control groups but was associated with large, local oscillations in flow with periods of 7 to 10 seconds and peak-to-trough magnitudes about half the mean flow. Oscillations occurred simultaneously at sites separated by 1 cm but were independent in phase and frequency. Since these laser-Doppler measurements represent the average flow pattern in about 1 mm3 of skin (i.e., in approximately 50 to 70 capillary loops), these results suggest that microcirculatory flow in patients with sickle-cell disease proceeds by synchronization of rhythmic flow in large domains of microvessels. These findings indicate that periodic flow may be a compensatory mechanism to offset the deleterious altered rheology of erythrocytes containing polymerized hemoglobin S, and suggest that laser-Doppler velocimetry may be a useful method to investigate microvascular physiology in patients with sickle cell disease. PMID- 6504082 TI - Grade I Reye's syndrome--outcome and predictors of progression to deeper coma grades. AB - We studied 83 biopsy-proved cases of Grade I Reye's syndrome to determine the outcome, possible clinical or laboratory predictors of progression to deeper coma grades, and hepatic ultrastructural findings. Seventy-eight patients had no change in coma grade during hospitalization, whereas five (6 per cent) had progression to deeper coma grades. All the patients survived without sequelae except one who sustained severe brain damage. The mean (+/- S.E.) level of serum ammonia on admission was significantly higher (P = 0.005) in patients whose disease progressed to deeper neurologic grades (291 +/- 42 micrograms per deciliter) than in those whose disease did not so progress (53 +/- 5 micrograms per deciliter), and the corrected prothrombin time was significantly more prolonged (P = 0.005) in patients with progressing coma (3.9 +/- 0.5 seconds) than in those whose coma grade did not change (1.6 +/- 0.2 seconds). The combination of a prothrombin time 3 seconds or longer than that of the control and a serum level of ammonia on admission of 100 micrograms per deciliter or more correctly predicted progression in 71.5 per cent of the cases (sensitivity, 100 per cent; specificity, 97.6 per cent). Our findings suggest that the prognosis is excellent for survival without sequelae in Grade I Reye's syndrome (98.8 per cent) when management includes hospital surveillance and intravenous glucose and electrolyte infusion. PMID- 6504084 TI - Rheology of sickle cells and the microcirculation. PMID- 6504083 TI - Mediastinal and supraclavicular lymphadenitis and pneumonitis due to Chlamydia trachomatis serovars L1 and L2. PMID- 6504085 TI - Radioactive iodine and testicular damage. PMID- 6504087 TI - More on flipped pacemakers. PMID- 6504086 TI - Antiemetic effect of dexamethasone. PMID- 6504088 TI - Warfarin. PMID- 6504089 TI - Case 24-1984: histoplasmosis. PMID- 6504090 TI - Psychosocial status in chronic illness. PMID- 6504092 TI - Oral contraceptives and reproductive mortality. PMID- 6504091 TI - Uncertainty in prognosis of violent conduct. PMID- 6504094 TI - Informed consent. PMID- 6504093 TI - Reduction in medical-school class size. PMID- 6504095 TI - Osteoporosis in women with anorexia nervosa. AB - Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 +/- 0.06 vs. 0.72 +/- 0.04 g per square centimeter, P less than 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes. The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P less than 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls. We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons. PMID- 6504097 TI - Another medium for the Journal. PMID- 6504096 TI - Respiratory allergies related to automobile air conditioners. PMID- 6504098 TI - Instructions for starting the use of oral contraceptives. PMID- 6504099 TI - Decrease in serum estradiol values with storage. PMID- 6504100 TI - Removing objects from the external auditory canal. PMID- 6504101 TI - Denial of antipregnancy prophylaxis to rape victims. PMID- 6504102 TI - Healing by the fundamentals. PMID- 6504103 TI - Ripping and filing Journal articles. PMID- 6504104 TI - Lessons from living with cancer. PMID- 6504106 TI - Association of respiratory viral infections with pulmonary deterioration in patients with cystic fibrosis. AB - In a two-year prospective study, we examined the effect of respiratory viral infections on pulmonary function in 49 patients with cystic fibrosis (mean age, 13.7 years). Nineteen normal siblings (mean age, 14) served as controls. Subjects were assessed quarterly and at the time of any respiratory illness. Each assessment included nasal washes for viral isolation and blood drawing for respiratory viral serologic studies. Pulmonary-function tests were performed at least twice yearly. Respiratory illnesses were reported significantly more often in the patients (3.7 per year) than in the normal siblings (1.7 per year), although the frequency of proved viral infections (1.67 per year) was identical. In the patients with cystic fibrosis significant correlations (P less than 0.0001) were found between the annual incidence of viral infections and every measure of disease progression in the two-year period, including the rate of decline of the Shwachman score (r = 0.71), the percentage of ideal weight for height (r = 0.80), the forced vital capacity (r = 0.85), the forced expiratory volume in the first second (r = 0.84), the forced midexpiratory flow rate (r = 0.68), and the frequency (r = 0.53) and duration (r = 0.84) of hospitalizations for respiratory exacerbations. We conclude that frequency of viral respiratory infections is closely associated with pulmonary deterioration in patients with cystic fibrosis. PMID- 6504107 TI - Cerebrotendinous xanthomatosis. PMID- 6504105 TI - Long-term treatment of cerebrotendinous xanthomatosis with chenodeoxycholic acid. AB - We studied the effect of chenodeoxycholic acid in 17 patients with cerebrotendinous xanthomatosis. Before treatment, all subjects were symptomatic, with Achilles tendon xanthomas (in 15 of 17), cataracts (in 12 of 17), dementia (in 13 of 17), pyramidal-tract signs (in all 17), cerebellar dysfunction (in 13 of 17), mild peripheral neuropathy (in 7 of 17), electroencephalographic abnormalities (in 10 of 13), and abnormal cerebral computerized axial tomographic scans (in 10 of 12). After at least one year of chenodeoxycholic acid treatment (750 mg per day), dementia cleared in 10 subjects, and pyramidal and cerebellar signs disappeared in 5 and improved in another 8. Peripheral neuropathy was no longer detected in six. The electroencephalogram became normal in five and showed fewer abnormalities in another three subjects. Cerebral computerized axial tomographic scans improved in seven patients; the changes included the disappearance of a cerebellar xanthoma in one case. Concomitantly, mean plasma cholestanol levels declined threefold, and abnormal bile acid synthesis was suppressed. We conclude that long-term therapy with chenodeoxycholic acid may correct the biochemical abnormalities and arrest and possibly reverse the progression of cerebrotendinous xanthomatosis. PMID- 6504108 TI - Respiratory viruses in cystic fibrosis. PMID- 6504109 TI - Frozen red cells revisited. PMID- 6504110 TI - Drug-resistant Salmonella from animals fed antimicrobials. PMID- 6504111 TI - Interaction of diazepam and cimetidine. PMID- 6504112 TI - AIDS in a bodybuilder using anabolic steroids. PMID- 6504113 TI - Intravenous versus intramuscular administration of pentamidine. PMID- 6504114 TI - Seizure recurrence. PMID- 6504115 TI - Reciprocal translocation in small-cell sarcomas. PMID- 6504116 TI - Crab lung. PMID- 6504117 TI - From the heavens, revenge on joggers. PMID- 6504119 TI - An ICU death: a Gordian knot in search of Alexander. PMID- 6504118 TI - The therapeutic value of singing. PMID- 6504120 TI - Should health-care professionals wear political campaign buttons? PMID- 6504121 TI - [Transformation reactions of special metals in organisms and in the environment. 3. In vivo reactions between mercury II chloride and monomethyltin trichloride in rats]. AB - Following the comments on the metabolism and the toxicity of methylmercury compounds as well as on the interaction with food components and a few environmental chemicals from literature study, the results of the in vivo experiments for examining the reaction between HgCl2 and CH3SnCl3 in the gastrointestinal tract and the subsequent distribution of the formed methylmercury are reported. The reaction between both of the substances proceeding in aqueous solution with immediate formation of methylmercury also leads in the intestinal tract very rapidly to the formation of methylmercury and its distribution into various organs. An increase in the relative weight of liver and kidneys was evident. PMID- 6504122 TI - Memory and molecular turnover. PMID- 6504123 TI - Complexities of cause and effect in anorexia nervosa. PMID- 6504124 TI - Basement membranes and epithelia. PMID- 6504125 TI - Metabolic oxidation phenotypes as markers for susceptibility to lung cancer. AB - That bronchial carcinoma is not an inevitable consequence of cigarette smoking has stimulated the search for host factors that might influence the susceptibility of the individual smoker. One plausible host factor would be a polymorphic gene controlling the metabolic oxidative activation of chemical carcinogens, giving rise to wide inter-subject variation in the generation of cancer-inducing and/or promoting species. Recently, three genetic polymorphisms of human metabolic oxidation have been demonstrated (as characterized by debrisoquine, mephenytoin and carbocysteine), with the metabolism of several substrates exhibiting the phenomenon. Debrisoquine 4-hydroxylation segregates into two human phenotypes, each comprising characteristic metabolic capability. We report here the frequency of debrisoquine 4-hydroxylation phenotypes in age-, sex- and smoking history-matched bronchial carcinoma and control patients. Cancer patients showed a preponderance of probable homozygous dominant extensive metabolizers (78.8%) with few recessive poor metabolizers (1.6%) compared with smoking controls (27.8% and 9.0% respectively). We conclude that the gene controlling debrisoquine 4-hydroxylation may be a host genetic determinant of susceptibility to lung cancer in smokers and that it represents a marker to assist in assessing individual risk. PMID- 6504126 TI - Molecular science: Japan's next target--biology. PMID- 6504127 TI - NIH budget. Reagan vetoes busybody bill. PMID- 6504129 TI - Animal antibiotics. PMID- 6504128 TI - Gloomy outlook for young neuroscientists. PMID- 6504130 TI - Jobs for biochemists. PMID- 6504131 TI - Scientists' oath? PMID- 6504133 TI - Protecting experimental animals. PMID- 6504132 TI - Hepatitis B. Taiwan plans mass vaccination. PMID- 6504134 TI - Seascale and cancer. PMID- 6504135 TI - Cell biology. Microtubule catastrophe. PMID- 6504136 TI - Conservation. Pandering to Western pandas. PMID- 6504137 TI - Microtubule assembly nucleated by isolated centrosomes. AB - Microtubules are involved in the morphogenesis of most cells and are the structural basis of the mitotic spindle. We report here that purified centrosomes nucleate the assembly of microtubules with unusual dynamic properties. This may have important implications for the mechanism by which microtubule arrays are organized and stabilized in cells. PMID- 6504138 TI - Dynamic instability of microtubule growth. AB - We report here that microtubules in vitro coexist in growing and shrinking populations which interconvert rather infrequently. This dynamic instability is a general property of microtubules and may be fundamental in explaining cellular microtubule organization. PMID- 6504139 TI - Horizontal cell synapses onto glycine-accumulating interplexiform cells. AB - Horizontal cells mediate lateral transmission of signals in the outer plexiform layer of the vertebrate retina, and are presumed to contribute to surround properties of photoreceptors and bipolar cells by chemical transmission. The cell bodies and dendrites of fish horizontal cells possess presynaptic specializations characteristic of conventional chemical synapses. Horizontal cell axon terminals have not so far been shown to contain presynaptic specializations nor have the targets of the somatic and dendritic synapses been fully characterized. Using electron microscope autoradiography of retinas labelled by high-affinity 3H glycine uptake, we show here that goldfish horizontal cells make somatodendritic and axodendritic synapses on glycinergic interplexiform cells (Gly-IPCs) as apposed to dopaminergic interplexiform cells. Thus, horizontal cells have at least three postsynaptic targets: photoreceptors, bipolar cells and Gly-IPCs. Gly IPCs may constitute a major alternative pathway for horizontal cell signals to reach the inner plexiform layer. PMID- 6504140 TI - Homology of Ti alpha-subunit of a T-cell antigen-MHC receptor with immunoglobulin. AB - Human T-cell receptors for antigen and major histocompatibility complex (MHC) determinants have now been defined on inducer, suppressor, and class 1 and class 2 MHC-specific cytotoxic T lymphocytes as T3-associated clonotypic molecules (Ti) of relative molecular mass 90,000 (90K) composed of one 49-54K alpha- and one 43K beta-subunit which are disulphide-linked. In the case of the Ti beta-subunit, N terminal amino acid sequencing and molecular cloning techniques led recently to identification of the Ti beta-gene and showed that T-specific V, D, J and C segments fuse to form an active beta-gene. So far, however, there have been little structural data available on the Ti alpha-subunit. Here we have derived the amino acid sequence of a portion of the Ti alpha-subunit by CNBr fragmentation. Sequence analysis reveals approximately 40% homology between the Ti alpha-subunit fragment and the third framework of the variable region of immunoglobulin light and heavy chains, supporting the notion that the Ti alpha subunit is a member of the immunoglobulin-Ti beta-gene family. PMID- 6504141 TI - Somatic mutation and the maturation of immune response to 2-phenyl oxazolone. AB - Studies on the development of the immune response suggest that the repertoire of expressed antibody specificities is strongly influenced by antigen (reviewed in ref. 1). One way in which this influence is manifested is by a progressive increase in the affinity of antibody for antigen with time after immunization. This phenomenon, termed the 'maturation' of the immune response, must be due to a change in the structure of the antibody being synthesized. However, the precise nature of the changes involved and the genetic mechanisms used to produce them have not been clearly defined. We have now investigated the maturation of the immune response to the hapten 2-phenyloxazolone by mRNA sequencing of specific hybridomas. We conclude that somatic mutation of germ-line encoded genes plays a major role in the generation of antibodies with increased affinity for oxazolone with time after immunization. PMID- 6504142 TI - DNA sequences from the quagga, an extinct member of the horse family. AB - To determine whether DNA survives and can be recovered from the remains of extinct creatures, we have examined dried muscle from a museum specimen of the quagga, a zebra-like species (Equus quagga) that became extinct in 1883 (ref. 1). We report that DNA was extracted from this tissue in amounts approaching 1% of that expected from fresh muscle, and that the DNA was of relatively low molecular weight. Among the many clones obtained from the quagga DNA, two containing pieces of mitochondrial DNA (mtDNA) were sequenced. These sequences, comprising 229 nucleotide pairs, differ by 12 base substitutions from the corresponding sequences of mtDNA from a mountain zebra, an extant member of the genus Equus. The number, nature and locations of the substitutions imply that there has been little or no postmortem modification of the quagga DNA sequences, and that the two species had a common ancestor 3-4 Myr ago, consistent with fossil evidence concerning the age of the genus Equus. PMID- 6504143 TI - Dinitrogen fixation by a thermophilic methanogenic bacterium. AB - Methanogenic bacteria are known to use NH+4 as a nitrogen source for growth. Previous work with an impure methanogenic culture suggested that a methanogen might fix atmospheric dinitrogen as a nitrogen source, but no further work on this phenomenon has been documented. We have now examined the use of N2 by Methanococcus thermolithotrophicus and find that the organism can grow well, with multiple transfers, in medium having N2 as the source of nitrogen. Control cultures without N2 and containing less than 0.1 mM NH+4 do not grow. Growth yields with N2 are on the average one-third those with NH+4, suggesting that, as in other nitrogen-fixing organisms, this bacterium requires a large amount of ATP for the reduction to occur. After growing in NH+4-containing medium, a long lag is observed before growth begins with N2 as the nitrogen source; the NH+4 levels must be very low for growth to begin. Cells grown in N2-fixing conditions reduce acetylene to ethylene. The discovery of a nitrogen-fixing archaebacterium has important implications for studies on the evolution of nitrogenase, and the fact that M. thermolithotrophicus nitrogenase is active at 64 degrees C suggests that a novel enzyme is involved. PMID- 6504144 TI - Optical quality during crystalline lens growth. PMID- 6504145 TI - Multiple levels of gene control in eukaryotic cells. PMID- 6504146 TI - Cell biology. A spectrum of spectrins. PMID- 6504147 TI - DNA sequence selection by eye. PMID- 6504148 TI - Confused comment on Warnock. PMID- 6504149 TI - NIH research: reducing grant-writing burden. PMID- 6504150 TI - European air pollution: Commissions's directive in balance. PMID- 6504151 TI - Creationism in confusion? PMID- 6504152 TI - Mind, body and intelligence. PMID- 6504153 TI - Actin-binding protein evolution. PMID- 6504154 TI - DNA methylation and G+C rich DNA. PMID- 6504155 TI - Aequorin measurements of free calcium in single heart cells. AB - The performance of the heart depends on the concentrations of free calcium ions in the cytoplasm of the myocytes. However, direct evidence for changes in free Ca concentration in physiological events during response to drugs and in pathogenesis has been difficult to obtain because of technical problems in measuring free Ca at 10(-7) M in cells with a volume of only a few picolitres. Here we describe measurements made with the Ca-sensitive photoprotein aequorin in single ventricular myocytes isolated from rat heart. We have detected signals from resting and contracting cells, and from cells exposed to media of altered ionic composition (raised K, lowered Na), ouabain and metabolic inhibitors. We report that free Ca in metabolically-poisoned myocytes is remarkably stable and that severe injury to the cell occurs before the free Ca concentration rises above 1-3 X 10(-7) M, hence cell damage seems to be a cause, not a consequence, of a rise in free Ca. The technique used here should help to resolve many uncertainties regarding free Ca in heart function, and should be particularly valuable for investigating the role of free Ca in ischaemic pathogenesis. PMID- 6504156 TI - Mucosal mast cells are functionally active during spontaneous expulsion of intestinal nematode infections in rat. AB - Infestation of the gastrointestinal tract by parasitic nematodes is invariably associated with mucosal mastocytosis, which is a thymus-dependent phenomenon in parasitized rats, and is adoptively transferable with a T cell-enriched population of thoracic duct lymphocytes. When derived by in vitro culture, mucosal mast cells (MMC) arise from a bone marrow precursor after stimulation by T cell-derived factors. In rats infected with the nematode Trichinella spiralis, mucosal mastocytosis is temporally associated with the immune expulsion of the adult worms whereas in the case of Nippostrongylus brasiliensis, mastocytosis is frequently observed to occur after worm expulsion has been completed. Consequently, there has been doubt as to whether MMC are active and serve a functional role in the expulsion of rat intestinal nematodes. MMC contain and secrete a neutral proteinase, rat mast cell protease II (RMCP II); detection and assay of secreted RMCP II therefore provides a direct measurement of MMC activity. Here we describe the release of this enzyme into the blood of rats infected with N. brasiliensis or T. spiralis. Our results show that the systemic secretion of RMCP II coincides with the immune expulsion of these nematodes, demonstrating clearly for the first time that rat MMC are functionally active during the immune elimination of primary nematode infections. PMID- 6504157 TI - Capacitance measurements reveal stepwise fusion events in degranulating mast cells. AB - Mast cells undergo an extensive and violent morphological transformation on stimulation. Here we describe the dynamics of fusion of the secretory granules in individual mast cells during exocytosis. The cell membrane capacitance (proportional to the cell surface area) was measured using the whole-cell patch pipette technique, in which the intracellular space is dialysed with the solutions used to fill the patch pipette. Our results show that degranulation occurs spontaneously and reproducibly if the GTP analogue, GTP-gamma-S, and Mg ATP are present in the pipette filling solution. Contrary to previous reports, in these conditions Ca2+ (and/or Ca2+ buffers) is not required for degranulation. Although electrogenic Ca2+ entry was not detected before or during degranulation and membrane conductance remained low, the capacitance, and by implication the area of the membrane of degranulating cells, increased sigmoidally and stepwise. We conclude that stepwise increases of capacitance are due to the fusion of individual secretory granules with the plasma membrane, and that guanine nucleotide regulatory proteins are involved in the control of this process. PMID- 6504158 TI - Similarities among retrovirus proteins. PMID- 6504159 TI - Sensory and energy transduction. Light-activated retinal proteins. PMID- 6504160 TI - Exclusive immunoglobulin genes. PMID- 6504161 TI - Mechanism of colour discrimination by a bacterial sensory rhodopsin. AB - A photosensitive protein resembling the visual pigments of invertebrates enables phototactic archaebacteria to distinguish colour. This protein exists in two spectrally-distinct forms, one of which is a transient photoproduct of the other and each of which undergoes photochemical reactions controlling the cell's swimming behaviour. Activation of a single pigment molecule in the cell is sufficient to signal the flagellar motor. This signal-transduction mechanism makes evident a colour-sensing capability inherent in the retinal/protein chromophore. PMID- 6504163 TI - Analysis of persistent virus infections by in situ hybridization to whole-mouse sections. AB - Nucleic acid hybridization techniques have contributed significantly to the understanding of gene organization, regulation and expression. In the context of persistent or latent viral infections, hybridization with specific labelled probes represents the most sensitive assay presently available for detection of viral genomes. During the course of persistence, viral genomes may exist in multiple and yet quite segregated areas in an infected host, but examination of all tissues remains difficult and time-consuming. At present, the application of hybridization assays to in vivo infections requires either chemical extraction of nucleic acid coupled with dot-blot and gel transfer techniques or in situ hybridization to cryostat tissue sections. In both cases, selected tissues must be removed by dissection before analysis. We describe here a procedure which allows efficient and reproducible screening of all tissue in an infected host. Our technique allows detection of viral genetic material in whole-body sections of infected mice, and provides the first evidence in vivo for accumulation of viral genetic material with a parallel decrease in infectious virus during persistent virus infection. This technique should be widely applicable to studies of developmental regulation of gene expression, for monitoring locations of gene expression in transgenic mice and for analysis of molecular mechanisms in pathogenesis. PMID- 6504162 TI - Monoclonal antibodies identify a cell-surface antigen associated with an activated cellular oncogene. AB - A variety of antigens have been identified on the surface of the malignant cell. However, identical antigens are often found on non-malignant cells of the same or different histological origin, or of a different stage of embryonic development. Many of these tumour-associated antigens appear to be only incidentally expressed on neoplastic cells. Clearly, it would be of great interest to identify cell surface antigens whose expression is associated specifically with the transformed state and linked directly with the mechanisms responsible for transformation. The detection of activated cellular oncogenes in human and animal cancer cells by the technique of DNA transfection has allowed the isolation of genetic elements which are thought to have a critical role in malignancy. Here, in an effort to identify cell-surface antigens associated with the neoplastic process, we have generated hybridomas which secrete monoclonal antibodies that react specifically with cell surface determinants found on NIH 3T3 cells transformed by transfection with a group of rat neuroblastoma oncogenes. These antibodies bind to and immunoprecipitate a phosphoprotein of relative molecular mass 185,000 (185 K) from a DNA donor rat neuroblastoma and 13 independent rat neuroblastoma DNA transfectants. There was no antibody reactivity with normal NIH 3T3 cells or with NIH 3T3 cells transformed by various other agents. PMID- 6504164 TI - Plant-inducible virulence promoter of the Agrobacterium tumefaciens Ti plasmid. AB - Agrobacterium tumefaciens is the causative agent of crown gall, a plant tumour that can arise on most species of dicotyledonous plants. The tumour-inducing capacity of the bacterium requires the presence of a large plasmid, designated the Ti plasmid, which itself contains two regions essential for tumour formation the T(umour)-region and the Vir(ulence)-region. The T-region is transferred to plant cells by an unknown mechanism, and becomes stably integrated into the plant genome. The Vir-region has been identified by transposon mutagenesis, but the DNA of this region has never been detected in tumour lines. However, trans complementation of Vir mutants indicates that genes of the Vir-region are functional in the bacterium. Moreover, the Vir- and T-regions can be physically separated in A. tumefaciens without loss of tumour-inducing capacity. Seven loci, designated virA-F and virO (refs 17, 20-22), have been identified in the Vir region of the octopine Ti plasmid, but their functions are unknown. As virC mutants in the octopine-type plasmid pTiB6 are invariably avirulent in tests on various plant species, this gene seems to be essential for virulence and we are studying it in detail. We report here that the promoter of virC shows no detectable activity in A. tumefaciens and Escherichia coli K-12 grown in standard medium, but that its activity is induced by a plant product. PMID- 6504165 TI - Helping out in Bhopal. PMID- 6504166 TI - Toxic gas: pesticide plant leak wreaks disaster in India. PMID- 6504167 TI - Ways of death. PMID- 6504168 TI - AIDS screening. PMID- 6504169 TI - British AIDS. PMID- 6504170 TI - Gene regulation: repression of activators. PMID- 6504171 TI - Microvesicles in meteorites, a model of pre-biotic evolution. PMID- 6504172 TI - Experimentally proved biosynthesis of vitamin C in a guinea pig. PMID- 6504173 TI - Circadian control of meal timing during temporal isolation. PMID- 6504174 TI - [Nicotine-containing chewing gum for stopping smoking; experiences in a general practice]. PMID- 6504175 TI - [The effect of smoking on mortality among married couples]. PMID- 6504176 TI - [The odds on hysterectomy and estimation of the number of cancer deaths prevented by hysterectomies in their current incidence]. PMID- 6504177 TI - [Medical decision making; pro or con?]. PMID- 6504178 TI - [Acetosal and the heart]. PMID- 6504179 TI - [The dyspneic child]. PMID- 6504180 TI - [Gingival hyperplasia: a possible side effect of nifedipine]. PMID- 6504181 TI - [Patients' opinions about their hospital stay]. PMID- 6504182 TI - [Decubitus in the hospital]. PMID- 6504183 TI - [The future of medical publications]. PMID- 6504184 TI - [Cheap alternative?]. PMID- 6504185 TI - [Registration of carcinoma in situ and squamous cell carcinoma of the uterine cervix in the screening area of Nijmegen from 1 January 1970 through 31 July 1982]. PMID- 6504186 TI - [Differences in oral, axillary and rectal temperature readings in the range of 36.5-40.5 degrees C]. PMID- 6504187 TI - [Coagulation disorders in pregnancy toxemias and pre-eclampsia]. PMID- 6504189 TI - [The significance of adipose tissue distribution for the relationship between obesity and disease]. PMID- 6504188 TI - [Dioxins]. PMID- 6504190 TI - [Anticoagulation therapy in patients with infectious endocarditis: a therapeutic dilemma]. PMID- 6504191 TI - [Interim advice from the Public Health Council concerning patients with acquired immunodeficiency syndrome]. PMID- 6504192 TI - [The elastic finger, often the thumb, in young children]. PMID- 6504193 TI - [The polemologic congress in Helsinki; nuclear warfare can be prevented]. PMID- 6504194 TI - [Treatment of trigeminal neuralgia and hemifacial spasm: another viewpoint]. PMID- 6504195 TI - [Yersinia enterocolitica sepsis and cholecystitis in a patient with primary hemochromatosis]. PMID- 6504196 TI - [In vitro fertilization and embryo transplantation: from experiment to treatment method for infertility]. PMID- 6504198 TI - [Simultaneous occurrence of influenza B and influenza A(H1N1) virus in the winter of 1983/84]. PMID- 6504197 TI - [What are the limits of birth control?]. PMID- 6504199 TI - [Donor insemination and the human viewpoint]. PMID- 6504200 TI - [Cardiotoxicity of doxorubicin in children]. PMID- 6504201 TI - [Respiration monitoring; an unusual application of used thermodilution catheters]. PMID- 6504202 TI - [Artificial middle ear prostheses]. PMID- 6504203 TI - [Lithium and pregnancy; psychiatric aspects]. PMID- 6504204 TI - [Ectopic HCG production in a patient with metastatic bladder carcinoma]. PMID- 6504205 TI - [Lithium and pregnancy; recommended guidelines]. PMID- 6504207 TI - Postpartum thyroiditis: a common cause of thyrotoxicosis and/or hypothyroidism after pregnancy. PMID- 6504206 TI - Suction lipectomy for removal of localized fat deposits. PMID- 6504208 TI - Pulmonary carcinoid tumors: experience at one hospital for a 12-year period. PMID- 6504209 TI - Submandibular gland tumors. PMID- 6504210 TI - Avulsion fracture of the fibula: the 'arcuate sign' of posterolateral knee instability. PMID- 6504211 TI - Assessment of lethal and cytostatic effects of alkylnitrosoureas on the cells of experimental tumors. AB - The action of a number of active anticancer agents belonging to the alkylnitrosoureas (MNU, DMNU, ADEKO, BCNU, CCMU, MeCCNU), as well as the effectiveness of a combined use of DMMU and ADEKO with cyclophosphamide was assessed on experimental tumors transplanted by inocula of different size. A mathematical model of the connection between survival of tumor-bearing animals with the kinetics of tumor growth was proposed to analyze the treatment effect. The contribution of lethal and cytostatic factors to the resultant effect of the drugs was evaluated. A combination of DMNU and cyclophosphamide was found to possess an additive effect. The synergism of the therapeutic action shown in a combined application of ADEKO and cyclophosphamide was stipulated by the potentiation of the lethal effect of these drugs on tumor cells. PMID- 6504212 TI - Changes in distribution of the phases of mitosis in human tumor xenografts following drug treatment. AB - Distribution of individual mitotic phases in different human xenografts on nude mice showed significant changes after treatment with a range of drugs when compared with untreated controls. The total amount of mitoses in prophase significantly decreased in all responsive tumors while those in all other phases increased but in a very variable degree. There was some correlation in between the range of the mitotic phase distribution changes and the degree of tumor response to treatment. PMID- 6504213 TI - Relationship between melanogenesis, proliferative activity and response to chemotherapy of human melanoma xenografts. AB - Wide range of different drugs used in the cytotoxicity studies in an amelanotic human melanoma xenograft on nude mice showed a clear inverse relationship between melanogenesis and proliferation. Decreasing rates in proliferative activity estimated by mitotic answer expressed by phase distribution changes as well as by the tumor volume response to drug treatment were in direct relationship with increasing rates in the degree of melanogenesis expressed in percentage of melanin containing cells in histological specimens. PMID- 6504214 TI - Chemical transformation of Swiss mouse embryo fibroblasts in primary culture. AB - Trypsinized secondary cultures of various cell systems have been frequently used by different investigators as models to study, in vitro chemical transformation. In the present study, non-trypsinized primary cultures of fibroblasts derived from fetuses of 14 days gestational age have been used to find out the timings of in vitro chemical transformation by 20-methylcholanthrene and has been designated as PMM-14 cells. These PMM-14 cells have been compared with trypsinized cultures of the same cell systems. The criteria for neoplastic transformation considered in the study involved the appearance of morphological changes, indefinite growth in tissue culture, acquisition of tumorigenic potential in vitro as evidenced by in vivo tests and in vivo latency period for palpable tumor formation. The time span of neoplastic transformation of non-trypsinized embryo fibroblasts in culture was remarkably reduced in comparison with trypsinized cultures of same cell systems. Such discrepancy seems to be due to repeated use of trypsin which may replace many of vital cell surface molecules causing a delay in the expression of carcinogen-induced malignancy. Similarly, repeated subculture before transformation may also have a role in the delayed expression of malignancy. PMID- 6504215 TI - Characterization of cathepsin B-like proteinase from ascitic fluid of patients with primary liver cancer. AB - Ascitic fluid of patients with primary liver cancer was shown to contain a latent thiol proteinase which can be activated by pepsin treatment or by autolysis at acidic environment. This enzyme resembles cathepsin B (EC 3.4.22.1) in many physical-chemical properties including substrate specificity, requirement for thiol activators and inhibition both by thiol blocking reagents and by peptidyl diazomethyl ketones, but has a higher molecular size even after activation. Pepsin treatment and autolysis reduce its Mr from 41 800 to 33 400 and 27 700, respectively, but all these forms are larger than human liver cathepsin B. The latent enzyme may be, therefore, an enzyme--inhibitor complex or an inactive precursor of cathepsin B due to an altered processing in Golgi endoplasmatic reticulum-lysosome compartment. PMID- 6504216 TI - The use of isoprenaline in experimental hyperthermia. AB - The paper presents the results of experiments in which the perfusion of Walker carcinoma 256 in rats was influenced by s.c. application of isoprenaline under conditions of 45 degrees C hyperthermia. Cumulation of heat energy in the tumor was selectively increased and higher speed of temperature rising was achieved. The changes in blood supply in tumor tissue and skin were quantitatively documented by a method of 86Rb uptake. PMID- 6504217 TI - Malignant neoplasms of the pancreas. A study based on autopsy data from 1953 to 1982 in Bialystok, Poland. I. Frequency, age and sex distribution. AB - Among 18 751 autopsies in persons over 20 years of age 195 primary malignant neoplasms of pancreas (MNP) were stated (117 in males, 78 in females; the ratio being 1.5 : 1). In the period of the investigation (1953--1982) MNP comprised 1.0% of all autopsies, 4.1% of all malignant neoplasms (MN), and 11.0% of MN of alimentary system (MNAS). The frequency of MNP in all autopsies was from 0.5% during the years 1953--1957 to 1.2% in 1978--1982, in all MN from 2.7% to 4.5%, and in all MNAS from 5.7% to 12.7%, respectively. MNP were observed most frequently at the age of 61--70. The mean age was 63.6 and was higher in females than in males (66.3 and 61.8, respectively), and increased in the period under study from 54.6 to 65.6 (in males from 50.8 to 64.8, in females from 59.3 to 66.8). The significant increase in the incidence of MNP in the population of patients who died in all hospitals in Bialystok (the north-eastern Poland) between 1953--1982 and were autopsied in our Department correlates with data indicating the rise in the incidence of MNP in many countries of the world. PMID- 6504218 TI - Malignant neoplasms of the pancreas. A study based on autopsy data from 1953 to 1982 in Bialystok, Poland. II. A survey of 195 cases. AB - Among 195 malignant neoplasms of the pancreas (MNP) diagnosed at autopsy in 1953- 1982 the exocrine carcinomas comprised 85.6% and inmular carcinomas 13.8% of cases. MNP were localized most frequently in the head of the pancreas (54.4%), then in the whole pancreas in 14.9%, in the head and the body or in the body and the tail in 20.5%, in the body or in the tail in 10.3% of MNP. There were no infiltrations and no metastases in other organs only in 16 patients (8.2% of MNP). The biliary tracts and duodenum were the most frequent sites of secondary infiltrations. Metastases were most frequent in the liver, then in the liver hilus and mesentery lymph nodes. The concordance of clinical and post mortem diagnosis of MNP was stated in 40.5% cases. PMID- 6504219 TI - [Non-epileptic seizures]. AB - Following definition of the non-epileptic seizures terminological problems are discussed and the symptomatology and classification of these seizures are described. Four main groups are differentiated: anoxic cerebral seizures, hypnic cerebral seizures, metabolic cerebral seizures and psychic seizures. Within the first group we have to distinguish between seizures caused by ischaemia, asphyxia and anoxia. The generalized ischaemic anoxic seizures--the syncopes--are differentiated into vegetative seizures (vagotonic, asympathicotonic, sympathicotonic) and into syncopes caused by cardiac disturbances. Disturbances of sleep rhythm are to be seen in narcolepsy, periodic hypersomnia, Kleine-Levin syndrome and Pickwickian syndrome. The group of metabolic seizures includes hypoglycaemic seizures, seizures in phaochromocytoma, in Addison's disease and Conn's syndrome and the tetanic seizures. PMID- 6504220 TI - [The electroencephalogram in advanced age]. AB - Aging, by definition, constitutes a biological process rather than a disease. The resulting functional deficiency in transmitter-metabolism is the basis of deviations in the electroencephalographic patterns. In general, the EEG exhibits greater variability in the old age than in the middle decades. The most important characteristic of the EEG in the aged is a slowing of the alpha-frequency often in association with discontinuity, voltage reduction, and successive disruption of alpha rhythm with passages of curve-flattening and slowing of the dominating rhythms. Such patterns of subvigilant activity can dominate the EEG in the aged under resting conditions. Another common feature of the EEG in older age is an increasing occurrence of theta-waves, especially in the temporal regions. Temporarily, beta-waves increase in frequency in old age--predominantly in the female--usually subsiding by the age of 75. The interpretation of an EEG focus can be difficult in the absence of clinical correlates. In the very old age, the resulting changes in sleep-pattern can be demonstrated in the EEG. EEG and psychic efficiency are related only occasionally; under pathologic conditions, however, the relationship between EEG-anomalies and the intensity of a psychoorganic syndrome demonstrates a closer correlation. Finally, the possibility of gaining new information about psychical activities during aging through the use of evoked potentials is discussed. PMID- 6504221 TI - [Clinical and neuroradiologic findings in venous angiomas]. PMID- 6504222 TI - [Differential diagnosis of non-epileptic seizures in childhood]. PMID- 6504223 TI - [Computer tomographic studies in Wilson disease]. AB - 5 patients with proven Wilson's disease had clinical examinations and follow-up scans up to 6 years while being under penicillamine treatment. Severe neurological deficits were associated with marked CT abnormalities. In all other cases clinical condition and CT finding was only loosely correlated. Under therapy, some hypodense areas normalized their attenuation partially or completely. In primarily normal CT's, cupruresis did not induce alterations. As there is no firm correlation between CT findings and clinical involvement the CT examination is of limited value in prognosis. PMID- 6504224 TI - [When do I give which antidepressant in the individual case?]. AB - The reaction to sleep deprivation (SD) and the changes in MAO activity resulting from sleep deprivation were tested on 60 depressive patients as predictors for antidepressant drug treatment. An increase in MAO activity after SD indicates a future response to Maprotiline. A decrease in MAO activity indicates a future response to Clomipramine. An improvement in mood after sleep deprivation is a predictor for a future response to Clomipramine. If this effect of sleep deprivation fails to appear, the future effectiveness of Maprotiline is indicated. An attempt is made to subdivide the predictor variables into two groups: 1. so-called static predictor variables such as sex, diagnosis, age at onset of first illness and other socio-demographic data and 2. dynamic predictor variables such as, for example, reaction to SD, acute reaction to the drug, course of treatment during the initial days, diurnal variations of mood and increase in the serum level during the initial days. It is explained why static variables can have scarcely any predictive value, whereas dynamic variables are more to the point and are, therefore, better suited for making a prognosis of the treatment success with a particular antidepressant. PMID- 6504225 TI - [Patholinguistics of schizophrenic texts. A comparative study of schizophrenic, depressive, brain organic and healthy patients]. PMID- 6504226 TI - Effects of metoprolol on digitalis-resistant atrial tachyarrhythmias in chronic obstructive pulmonary disease. PMID- 6504227 TI - Slow-release metoprolol, hydrochlorothiazide and hydralazine in stepwise treatment of essential hypertension. PMID- 6504228 TI - Myelination process in the rat sciatic nerve during regeneration and development: molecular species composition and acyl group biosynthesis of choline-, ethanolamine-, and serine-glycerophospholipids of myelin fractions. AB - The content of alkenyl-acyl, alkyl-acyl and diacyl types of the three major myelin glycerophospholipids such as PtdCho, PtdEtn and PtdSer was determined in myelin fractions prepared from sciatic nerve segments of rats at 12, 25 and 45 days after birth, and of adult rats (6-month-old) 90 days after crush injury. The biosynthesis and metabolic heterogeneity of lipid classes and types were also studied by incubation with [1-14C] acetate of nerve segments of young rats at different ages as well as crushed and sham-operated control nerve segments of adult rats. The analysis of composition and positional distribution in major individual molecular species extracted from light myelin and myelin-related fraction suggest that the metabolism of alkenyl-acyl glycerophosphorylethanolamines and unsaturated species of PtdCho and PtdSer may not be regulated in the same manner during peripheral nerve myelination of developing rat and remyelination of regenerating nerve in the adult animal. The 14C-radioactivity incorporation into lipid classes and alkyl and acyl moieties of the three major phospholipids of sciatic nerve segments during the developmental period investigated revealed that Schwann cells were capable of synthesizing acyl linked fatty acids in both myelin fractions at a decreasing rate and with different patterns during development. In regenerating sciatic nerve of adult animals the labeling of myelin lipid classes and types of remyelinating nerve segment distal to the crush site was markedly higher than that of sham-operated normal one; however, the magnitude and the pattern of the specific radioactivity never approached those observed during active myelination of the nerve in young animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504229 TI - Developmental changes of myelin-related lipids in brain of miniature swine. AB - The biochemical development of whole brains from male and female miniature swine aged 2 weeks to 1 year was studied. The data were similar for both sexes. The brain-body weight ratio declined rapidly for the first 10-12 weeks after birth, then decreased at a slower rate up to 1 year. Total brain lipid weight and lipid phosphorus changed rapidly during the first 8-10 weeks of life, but thereafter changed very little. The glycolipid content rapidly increased during the first 12 14 weeks of life and then increased at a slower rate. Total brain cholesterol increased continuously over the time period studied, although the rate of increase appeared to decline with age. Monogalactosyl diacylglycerol concentration remained constant up to about 8 weeks of age, but then decreased continuously up to 1 year. The alkali-labile fatty acid composition of pig brain remained relatively constant except for increases in 18:1 and 22:6(n - 3) and a decrease in 16:0. The increase in percentage of 18:1 was most rapid during the first 10 weeks of age. These data suggest that the "growth spurt" or active myelination phase of miniature pig brain development ends at 8-10 weeks post partum. PMID- 6504230 TI - Inhibitors of crayfish glutamic acid decarboxylase. AB - Crayfish glutamic acid decarboxylase (GAD), like the homologous enzymes from other species, is inhibited by carbonyl-trapping agents (e.g. aminooxyacetic acid; AOAA) and sulfhydryl reagents (e.g. 5,5'-dithiobis-(2-nitrobenzoic acid); DTNB). It also is inhibited by the product GABA, many anions (e.g. SCN- and Cl-), and some cations (e.g. Zn+2). The inhibition by AOAA, but not that by DTNB, was prevented by increasing the concentration of the pyridoxal phosphate (PLP) coenzyme. GABA blocked the effects of PLP on enzyme activity. The inhibition by AOAA, DTNB, GABA, and chloride all were competitive with substrate. The effect of GABA occurs at physiological concentrations and may contribute to the regulation of GAD activity in vivo. The quantitative effect of anions is dependent on the cation with which they are administered. ATP stimulated GAD activity in homogenates prepared with potassium phosphate or Tris-acetate buffer, even when no exogenous PLP was provided. PMID- 6504231 TI - Binding of imipramine and cocaine to a model lipid membrane: comparison with binding to brain membranes. AB - [3H]Imipramine and [3H]cocaine were concentrated at membranes of liposomes prepared from phosphatidylcholine, cholesterol, and dicetylphosphate. This "binding" has an apparent dissociation constant in the micromolar range and a density close to 2 pmol/micrograms of phosphatidylcholine. The potencies of various drugs in inhibiting the binding to liposomes correlated only weakly with those in inhibiting the high-affinity binding of [3H]imipramine and [3H]cocaine to brain membranes. However, there was a highly significant correlation between the potencies of drugs in inhibiting binding to liposomes and their lipophilic character, indicating the involvement of hydrophobic bonding. Although the amounts of phosphatidylcholine and cholesterol in brain preparations in assays for high-affinity binding to brain membranes were in the same range as those used in our assays with liposomes, the inhibition of the high-affinity binding to brain membranes was only weakly dependent upon the lipophilicity of the inhibiting drug. These results indicate that lipophilicity is but one of the factors in the complex binding interactions between lipophilic substances and integral brain membranes. In addition, the results are in agreement with the suggestion that phosphatidylcholine and cholesterol are not the primary sites of high-affinity binding [3H]imipramine and [3H]cocaine to brain membranes, although it cannot be ruled out that these lipids have different properties in natural biological membranes and in artificial liposome membranes. PMID- 6504232 TI - Role of drugs in recovery of metabolic function of rat brain following severe hypoglycemia. AB - Severe hypoglycemia with isoelectric EEG induced extensive deterioration of the energy state and gross alteration of amino acid contents on the rat cerebral and cerebellar cortex. During recovery, tissue glucose concentration returned to normal, while both lactate and pyruvate concentrations increased to above normal. In the recovery period, the ATP concentration increased but the adenine nucleotide pool remained reduced, even if the ADP and AMP contents were close to normal. Phosphocreatine was restored to normal concentration with reciprocal changes in creatine content. During recovery there was a rise in glutamate and glutamine concentrations, gamma-aminobutyrate content returning to normal value. Ammonia and aspartate decreased below normal, while alanine increased above normal. The effect of some pharmacological agents on the posthypoglycemic recovery was tested: (a) Ergot alkaloids (dihydroergocristine, dihydroergocriptine, dihydroergocornine); (b) Vinca minor alkaloids (vincamine TPS, (-) eburnamonine); (c) Rauwolfia serpentina alkaloids (reserpine, raubasine); (d) synthetic agent (piracetam). During the posthypoglycemic recovery, these different agents exhibited different, or even contrasting, interferences on glycolytic metabolites, amino acids and energy-rich phosphates. The metabolic alterations in the cerebellar cortex were qualitatively of the same character of those in neocortex. However, the metabolic alterations were less extensive and more sensitive to drug action. PMID- 6504233 TI - Histidine decarboxylase: isolation and molecular characteristics. AB - High levels of histidine decarboxylase activity were measured in rat basophilic leukemia cells grown in ascitic form in 4 week old WKY/N rats. The potent inhibition of this enzyme by brocresine and alpha-methylhistidine but not by alpha-methyl DOPA identified it as a specific histidine decarboxylase. Gel filtration and polyacrylamide gel electrophoresis revealed a molecular weight of 125,000 for the native enzyme, similar to that of fetal rat liver histidine decarboxylase. Using rat basophilic leukemia cells as starting material, histidine decarboxylase was purified extensively in a seven step procedure. Electrophoresis under denaturing conditions revealed that histidine decarboxylase is a dimeric protein consisting of two identical subunits with a molecular weight of 62,000. The results indicate that rat basophilic leukemia cells provide a new and rich source for the purification of histidine decarboxylase. PMID- 6504234 TI - Extra- and intracellular amino acids in the hippocampus during development of hepatic encephalopathy. AB - Fulminant hepatic failure was induced in rabbits by intravenous administration of galactosamine hydrochloride. The animals were sacrificed after 45 h and the hippocampus analyzed for free amino acids. In addition, free amino acids were measured in plasma and in the extracellular fluid of the hippocampus 20, 30 and 45 h after galactosamine injection. The extracellular fluid compartment was analyzed by slow perfusion of a thin dialysis tube which was implanted in the hippocampus one day prior to galactosamine administration. The amino acid concentration in the extracellular fluid agreed fairly well with that of the cerebrospinal fluid in the control situation. During development of hepatic failure, the plasma concentration of all amino acids increased. The changes in extracellular amino acids were smaller, except for phosphoethanolamine and glutamate. The concentration ratio intra/extracellular amino acids decreased in the hippocampus for amino acids with a normally high concentration gradient. PMID- 6504235 TI - Acyl-CoA cholesterol acyltransferase in cultured glioblastoma cells. AB - We investigated the incorporation of radioactive precursors into cholesteryl ester in cultured glioblastoma cells. It was found that polar cholesterol derivatives and exogenous cholesterol contained in lipoprotein complexes greatly enhanced intracellular cholesteryl ester formation. The direct transfer of the acyl moiety from acyl-CoA to free cholesterol was demonstrated in broken cell preparations. Further evidence of the existence of the acyl-CoA:cholesterol acyltransferase (ACAT) in glioblastoma cells came from the conversion of radioactive cholesterol to cholesteryl ester by glial cell homogenates. The characteristics of the enzymic assay were studied in detail. This enzymic activity was greatly enhanced in homogenates prepared from 7-ketocholesterol treated cells. Thus, cells more active in cholesterol esterification in cell-free preparations. The marked inhibition of intracellular cholesteryl ester formation in intact cells by progesterone is a strong argument for the exclusive role of ACAT in glioblastoma cells. Similar properties of cholesteryl ester biosynthesis have been observed in neuroblastoma cells and primary brain cell cultures. In conclusion, the same enzyme is involved in cholesteryl ester biosynthesis in all neural cells. Neural and nonneural cells share many fundamental characteristics of cholesteryl ester formation. PMID- 6504236 TI - Subcellular localization of acetylcholinesterase molecular forms in endplate regions of adult mammalian skeletal muscle. AB - The characterization of individual acetylcholinesterase (AChE) molecular form subcellular pools in adult mammalian skeletal muscle is a critical point when considering such questions as the origin, assembly, and neurotrophic regulation of these molecules. By correlating the results of differential extraction, in vitro collagenase digestion, and in situ pharmacologic probes of AChE molecular forms in endplate regions of adult rat anterior gracilis muscle, we have shown that: 1) 4.0S (G1) and 6.0S (G2) AChE are predominantly membrane-bound and intracellular; if an extracellular and/or soluble fraction of these forms exists, it cannot be adequately resolved by our methods; 2) 9-11S (globular) AChE activity is distributed between internal and external pools, as well as membrane associated and soluble fractions; 3) 16.0S (A12) AChE is not an integral membrane protein and exists both intracellularly (25-30%) and extracellularly (70-75%). PMID- 6504237 TI - Comparison of different myelin isolation methods by use of nonequilibrium pH gradient gel electrophoresis. AB - Myelin was isolated from bovine white matter by five published procedures and several modifications of two of them. Comparison of the protein profiles of the preparations by nonequilibrium pH gradient gel electrophoresis, revealed clear differences in myelin protein content and composition between preparations obtained by different methods. In isolation methods where the medium contained salts, some of the myelin proteins were solubilized, the phenomenon being most pronounced in long-period isolations in buffered CsCl solution. PMID- 6504238 TI - The distribution and turnover of tryptamine in the brain and spinal cord. AB - Tryptamine levels have been determined in mouse brain regions and spinal cord and in rat spinal cord. They were; caudate nucleus 2.5 ng X g-1, hypothalamus less than 0.5 ng X g-1, hippocampus less than 0.7 ng X g-1, olfactory bulb less than 0.7 ng X g-1, olfactory tubercles less than 0.6 ng X g-1, brain stem less than 0.4 ng X g-1, cerebellum less than 1.0 ng X g-1, and the "rest" 0.9 ng X g-1. The mouse whole brain was found to have 0.5 ng X g-1, the mouse spinal cord 0.3 ng X g-1, and the rat spinal cord 0.3 ng X g-1. These concentrations increased rapidly to 22.8 ng X g-1, 14.2 ng X g-1, and 6.6 ng X g-1 respectively at 1 hr after 200 mg X kg-1 pargyline. The turnover rates and half lives of tryptamine in the mouse brain and spinal cord and rat spinal cord were estimated to be 0.14 nmol X g-1 X h-1 and 0.9 min; 0.054 nmol X g-1 X h-1 and 1.5 min and 0.04 nmol X g-1 X h-1 and 1.6 min respectively. The aromatic L-aminoacid decarboxylase inhibitors NSD 1034 and NSD 1055 reduced synthesis of tryptamine in controls and pargyline pretreated animals. Tryptophan increased the concentrations of mouse striatal tryptamine and 5-hydroxytryptamine and brain stem 5-hydroxyindole acetic acid. p Chlorophenylalanine reduced formation of 5-hydroxytryptamine and 5 hydroxyindoleacetic acid but did not change that of tryptamine. PMID- 6504241 TI - [Clinical picture of left posterior cerebral artery occlusion. Alexia syndrome without agraphia]. AB - The authors present a clinical description of three cases of occlusion of the left posterior cerebral artery. The pathogenesis of the syndrome of alexia without agraphia is discussed, together with other coexistent symptoms and signs such as hemianopsia, colour anomia, disturbances of recent memory. The discussion is based on own observations and a review of the pertinent literature. PMID- 6504239 TI - Developmental changes in the synthesis of nonhistone nuclear proteins relative to the appearance of a short nucleosomal DNA repeat length in cerebral hemisphere neurons. AB - Fluctuations in the pattern of synthesis of nonhistone nuclear proteins were noted in cerebral hemisphere neurons during early postnatal development of the rat. Noteworthy changes included the synthesis of an acidic nuclear protein of relative molecular weight 41,000 (41K), two chromatin-associated basic proteins (37K and 38K) and several high molecular weight chromatin acidic proteins. These changes in the synthesis of nonhistone nuclear proteins occur at a developmental stage when a short nucleosomal DNA repeat length has appeared in cerebral hemisphere neurons. PMID- 6504240 TI - In vitro synthesis of myelin proteolipid protein from rat brain using a total homogenate system. AB - In vitro synthesis of myelin proteolipid protein (PLP) was explored at different ages using rat brain total homogenates, incubated for 30 min with [3H]glycine. Total proteolipids, extracted from the incubated samples, were separated by SDS PAGE and the radioactivity was measured in the band corresponding to myelin PLP. The incorporation into PLP in relation to the incorporation into brain total proteins increased from 0.04% at 10 days of age to 0.63% at 20 days, and declined slowly thereafter. Time course experiments were carried out using brain homogenates obtained from rats of 20 days of age (i.e. at the period of maximal synthesis of PLP). Labeled PLP molecules were already found at 2.5 min of incubation and the incorporation of the label into this protein, relative to the incorporation into total proteins, did not vary throughout the entire incubation time (30 min). Pulse-chase experiments using a similar system and adding cycloheximide at different incubation times showed that the appearance of label into mature PLP was immediately blocked by the inhibitor of protein synthesis. These data suggest that PLP is synthesized as such and not as a pre-protein which is subsequently processed to render mature PLP. PMID- 6504242 TI - [Use of gelatin-resorcinol-formaldehyde glue in the surgical treatment of cerebrospinal rhinorrhea]. AB - The introduction of tissue adhesives in neurosurgery for treating cerebrospinal fluid fistulas has been a major advance in the operative technique. The authors describe the use of gelatin-resorcin-formaldehyde adhesive (GRF) in the surgical treatment of cerebrospinal fluid fistulas. The method of preparation of GRF, the technique of adhesive application, its clinical use and advantages are described. PMID- 6504243 TI - [Surgical transposition of the ulnar nerve in progressive paralysis]. AB - The authors present a method of surgical treatment of progressive paresis of the ulnar nerve by means of transposition of this nerve to the anterior aspect of the cubital fossa. This method was used in 35 cases. The most frequent cause of the paresis was old fracture or contusion of the region of the cubital joint. In all cases the therapeutic result was good. PMID- 6504244 TI - [Diagnosis and treatment of injuries of the brachial plexus in our experience]. AB - The subject of the paper is an analysis of the pathomechanism of injuries and results of multispecialist diagnostic investigations and surgical treatment in 74 cases of traumatic brachial plexus injuries observed in a period of 5 years. The observations of the authors suggest the following conclusions: Direct injury to the brachial plexus requires emergency or delayed emergency surgical intervention. In indirect and secondary traumatic injuries of the plexus the best results are obtained by possibly early reconstructive operation carried out after establishing indications to surgical treatment. The optimal time for full diagnosis of brachial plexus injury and its surgical treatment is between 3 and 6 months after trauma. The full diagnosis of brachial plexus injury should include: radiological examination of the cervical spine with radiograms in flexion and extension (if necessary) and contrast investigations (myelography) of the vertebral canal for determining canal patency and cerebrospinal fluid changes and dynamics. Electromyography is one of the principal elements of the diagnostic procedures used for the localization of plexus damage and for evaluation of the return of function after surgery. It would be indicated to organize in Poland special hospital departments or centres for systematic diagnostic investigations and surgical treatment of patients with brachial plexus injury. PMID- 6504245 TI - [A case of the abdominal form of Wilson's disease with atypical clinical symptoms in a 19-year-old man]. AB - A case of the abdominal form of Wilson's disease is described in a male patient aged 19 years. The case progressed rapidly and presented rarely observed signs of central nervous system damage. Morphological examination of the brain demonstrated well developed picture of tissue damage characteristic of this disease entity. PMID- 6504246 TI - [A case of multiple neoplasm metastases to the brain with few clinical symptoms]. AB - In the reported case 74 malignant metastases were found in the brain. The primary tumour was a bronchogenic carcinoma. The clinical symptoms were scant and were restricted mainly to those produced by involvement of the pons without evidence of intracranial hypertension. In the discussion the only relative value of laboratory investigations is stressed, including computerized tomography. The case deserves publication in view of rare occurrence of such oligosymptomatic course despite a high number of metastases. PMID- 6504247 TI - [So-called parietal muscular atrophy]. AB - A case is reported of a tumour in the parietal area with atrophy of upper extremity muscles but without changes in laboratory investigations. PMID- 6504248 TI - [Late recurrent subarachnoid hemorrhage after strengthening the aneurysm wall with aneuroplastic]. AB - Two patients are presented in whom repeated subarachnoideal haemorrhages developed 4 and 13 years after operations for intracranial aneurysms including strengthening of aneurysm wall with aneuroplastic. The patients were reoperated on by microsurgery. In both cases it was possible to clip the aneurysm after removing aneuroplastic. PMID- 6504249 TI - [Surgery of pineal tumors--anatomical consideration of various approaches]. PMID- 6504250 TI - [Conservative treatment of traumatic intracerebral hematoma]. AB - In the previous report, it was insisted that traumatic intracerebral hematoma should be regarded as a variety of cerebral confusion and that conservative treatment would be therapy of choice in these situations. Adversely, unjudicious operation would sometimes result in more expansion of hematoma by untamponade effect of decompressive craniectomy. In the present investigation, it was attempted to provide therapeutic policy in the management of traumatic intracerebral hematoma. Consecutive thirty two cases of traumatic intracerebral hematomas were selected for this study. Those cases with other hematoma such as epidural or subdural hematoma were excluded. These 32 cases were divided into two groups, operative (15 cases) and non-operative (17 cases). Whether to be operated or not was arbitrarily decided by the surgeons who were faced to the patients. Disturbance of consciousness of the patients were divided into three categories, namely severe (III-100 to 200 level), moderate (II-10 to 30 level), and mild (I-1 to 3 level). They were 8 cases, 5 cases, 1 case in operative cases and 6 cases, 10 cases, 1 case in non-operative cases respectively. Mortality rates were 13.3% (2 cases) in operative cases and none in non-operative ones. Concerning the patients of severely disturbed consciousness, there were no difference in their final outcomes between the two groups. On the other hand, 7 out of 10 cases of moderately disturbed consciousness recovered completely without operation, whereas all operative cases of the same category were, more or less, handicapped. PMID- 6504251 TI - [Meningeal gliomatosis: development of experimental models]. AB - Experimental models of meningeal gliomatosis (MG) have been produced by intracisternal inoculation of C6 glioma and 9L glioma cells into Wistar and Fisher 344 rats, respectively. The tumor growth was steady and fast in both MG models if 10(6) cells were implanted. Median survival time(MST) of rats inoculated with tumor cells was inversely related to the number of cells inoculated. The clinicopathological features observed in both MG models were similar to those seen in diffuse leptomeningeal involvement of gliomas in human beings. The models will be useful for investigating the pathophysiology of meningeal gliomatosis and the efficacy of chemotherapeutic agents. PMID- 6504252 TI - [Aneurysm growth and enlargement of pre-aneurysmal lesions]. AB - Three patients with cerebral aneurysms newly growing and enlarging for 2 to 10 years are reported. Case 1, a 54-year-old woman, had subarachnoid hemorrhage due to rupture of an intracranial aneurysm, growing from a small residual aneurysmal neck on the left internal carotid artery 10 years after the repair of the aneurysm. Case 2, a 63-year-old man, had a junctional dilatation on the left internal carotid-posterior communicating artery, developing into ruptured aneurysm about 10 years after the first hemorrhage. Case 3, a 52-year-old man, had multiple aneurysms on the bilateral bifurcations of middle cerebral arteries and left anterior cerebral artery-frontopolar artery junction. Angiography 2 years after the repair of the aneurysms revealed the new growth of a small aneurysm on the anterior cerebral artery at the junction of the fronto-orbital artery, developing from a localized vascular dilatation which had been recognized by the preoperative angiography. The existence of pre-aneurysmal lesions in arterial wall and the addition of hemodynamic impingement were thought to be one of the precipitating factors of aneurysmal formation. The pre-aneurysmal lesions in our study are as follows; a small part of thin wall of residual aneurysmal neck, a junctional dilatation, and a small evagination of arterial wall. It is necessary to discriminate a junctional dilatation and a small evagination of arterial wall from a small aneurysm with observation from multiple directions by the preoperative angiographic study. Our observations suggest that preaneurysmal lesions of the cerebral artery may develop into aneurysm and rupture, and hence the follow-up angiography is recommended for the cases with a preaneurysmal lesion or a small aneurysm for many years. PMID- 6504253 TI - [One-way valve extension tube for continuous cerebrospinal fluid drainage system]. AB - We designed an extension tube with built-in one-way valve to be used in the external CSF drainage. Placement, replacement or removal of the value can be performed easily and rapidly in patients who require continuous external CSF drainage. Advantages of the system using this one-way value extension tube were discussed. History of ventricular drainage was also mentioned. PMID- 6504254 TI - [3 operated cases of congenital deficiency of Factor XIII associated with intracranial hematomas]. AB - Three operated cases of congenital deficiency of factor XIII (fibrin-stabilizing factor) associated with intracranial hematomas were described and the diagnosis, replacement therapy of the factor were discussed. Congenital deficiency of factor XIII is quite rare coagulation disorder and only 100 patients were reported in the literatures in which we could find only one case who had craniotomy for associated intracranial hemorrhage. Case 1: A 41-year-old female with the history of unknown hemorrhagic diathesis complained of headache and right hemiparesis on August 2, 1980. CT scan showed left parietal intracerebral hematoma caused by unknown hemorrhagic diathesis and operated on under fresh blood transfusion. Postoperative state was uneventful but bleeding from the operated wound and rebleeding in the operated hematoma cavity were found on 5th postoperative day. The screening test for factor XIII was abnormal but replacement therapy with fresh plasma and factor XIII failed to control hemorrhagic diathesis. The patients died of GI bleeding and recurrent intracerebral hematoma on 21st postoperative day. Case 2: A 1.4-year-old boy with the history of umbilical bleeding on delivery and diagnosed as congenital deficiency of factor XIII in the other hospital fall down and struck his occiput on September 20, 1980. He vomited and became stuporous two days after injury, and was transferred to Ryukyu University Hospital. CT can revealed epidural hematoma at the left posterior fossa which extended to the supratentorium. The hematoma was successfully evacuated under infusion of fresh plasma and he showed uneventful recovery without rebleeding by postoperative appropriate replacement therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504255 TI - [Cerebellar cyst--a variant of the isolated fourth ventricle]. AB - Two cases of cerebellar cyst showing mass effect were presented as a treatable clinical entity not fully mentioned before. Analysis of the clinical data including follow-up computerized tomographic findings suggested its pathogenetical relationship to cerebellar porencephalic cyst following perinatal distress, and also, similarity to isolated fourth ventricle which would be encountered more frequently with the advent of computerized tomography in perinatal care. The authors stressed the importance of early surgery during infancy as an effective therapeutic measure. PMID- 6504256 TI - [Electron microscopic study of metastatic hemangiopericytic meningioma]. AB - Electron microscopic observations in a case of metastatic hemangiopericytic meningioma was presented. Cell origin of this tumor was discussed in detail from the point of the leiomyoblastic differentiation. The patient was a 49-year-old woman who was operated four times in the past for the cerebellar tentorial and the left parasagittal tumors. Six years after the first operation, metastatic lesions were found in the rib, the liver, the cervical vertebra and the sternum. Specimens were prepared from the intracranial and the rib tumors. On light microscopy the tumor cells with large nuclei and scant cytoplasm were proliferated around an endothelial-lined capillaries constituting obstructive or distended lumens. Mitoses and focal necrosis also existed. On electron microscopy the tumor cells were ovoid or ellipsoidal and had large irregular-shaped nuclei with conspicuous nucleoli. Knob-ended cytoplasmic processes occupying among tumor cells formed interdigitation. Microorganellae such as rough endoplasmic reticulum, Golgi apparatus, and mitochondriae were well developed. Glycogen granules were abundant. Some cells had a large number of 5-7nm microfilaments. Occasionally these filaments condensed into the dense body-like structure parallel to the cell surface. Pinocytic vesicles were not observed. Vascular channels varied in shape. The capillaries were lined by an endothelial cell. The endothelium had pinocytic vesicles under the plasmalemma and intracytoplasmic processes projecting into the vascular lumen. The neoplasmic cells and capillaries were surrounded by the basement membrane-like substance which consisted of amorphous and fibrous components.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504258 TI - [Primary intracranial hypotension associated with chronic subdural hematoma- report of 2 cases]. AB - Low spinal fluid pressure syndrome is characterized by orthostatic headache aggravated in upright position. It is classified into two from etiological standpoint i.e. primary and secondary (most often seen after lumbar puncture). On the other hand, low spinal fluid pressure is one of the promoting factors of chronic subdural hematoma. We report 2 cases of primary low spinal fluid pressure syndrome (primary intracranial hypotension) associated with chronic subdural hematoma. Case 1 is a 47-year-old man who was admitted with disorientation following 2 week history of orthostatic headache. Spinal fluid pressure was 7mmH2O in the lateral recumbent position. CT scan revealed bilateral isodense chronic subdural hematoma. The subdural hematoma reaccumulated 17 days after the first operation. Case 2 is a 31-year-old woman who was admitted with 4 week history of progressive orthostatic headache accompanied by nausea and vomiting. Spinal fluid pressure was 0 mmH2O. CT scan and cerebral angiography showed bilateral chronic subdural hematoma. The hematoma reaccumulated 20 days after the first operation. Six cases including our two cases of primary intracranial hypotention associated with chronic subdural hematoma have been reported. When changes of characters of headache, especially mental symptoms and disturbances of consciousness occurred in patients with chronic orthostatic headache, association of chronic subdural hematoma should be suspected. In cases with chronic subdural hematoma associated with low spinal fluid pressure syndrome, the reaccumulation of hematoma tends to occur after burr hole opening and irrigation of hematoma. PMID- 6504257 TI - [A case of spontaneous spinal epidural hematoma presenting Brown-Sequard syndrome]. AB - Although there have been a few reports of spontaneous spinal epidural hematoma, it may be difficult to make a correct diagnosis of the lesion because of atypical clinical symptoms. The authors reported a case of spontaneous spinal epidural hematoma presenting Brown-Sequard syndrome, with a review of literature. This 75 year-old male experienced a sudden onset of severe dorsal neck pain during sleep associated with right hemiparesis which deteriorated quickly to hemiplegia, without loss of consciousness, nausea, vomiting and vertigo. The patient has a history of hypertension and has been treated for chronic hepatitis for one year. On admission, neurological examination revealed right hemiplegia with normotensive deep tendon reflexes, and loss of pain and temperature sensations below the level of C5 on his left side. Position sense of fingers and toes was diminished on his right side, and hyperesthesia was recognized at the area of C4 level. Consciousness disturbance, cranial nerve signs, and urinary incontinence were not seen. Right retrograde vertebral angiograms showed no abnormal vascular shadow, even though anterior spinal artery was visible at the level of C8 through C5. Cervical CT scan revealed a left-side dominant extradural high density mass which situated dorsally at around the upper part of C2 body changing it's position to dorsolaterally as it descended to the lower part of C5. On contrast enhancement study, only the margin of the lesion was partially enhanced, which might be the hematoma membrane. On the third day after the onset, laminectomy from C2 to C5 was performed and the epidural hematoma was evacuated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504259 TI - [Dissecting aneurysm of the anterior cerebral artery: report of a case]. AB - A 43-year-old man suddenly experienced severe headaches and involuntary flexion extension movements of four limbs, which were followed by hypertonic extension of the limbs lasting for a few hours. Two days later, he experienced generalized tonic seizure without loss of consciousness. After the seizures, he remained hemiparetic on the right side. His past medical history was non-remarkable, and the histories of hypertension, diabetes mellitus, head trauma and significant infectious diseases were all denied. Cerebral angiography performed 22 days after the onset showed a segmental, irregular narrowing of the left A2 segment and an aneurysmal outpouching immediately proximal to the stenosis. CT scan revealed a low density area in the left frontal lobe, corresponding to the territory of the involved left anterior cerebral artery. Cerebral angiography was repeated twice in the succeeding 6 months. Each time, the involved A2 segment showed persistence of narrowing, but its shape showed definite changes with the passage of time. A diagnosis of dissecting aneurysm of the anterior cerebral artery was reached by the characteristic angiographic features, and the patient was treated conservatively. Dissecting aneurysm of the cerebral arteries have been reported much less frequently than those of the aorta or other extracranial arteries. Recently, however, such reports are increasing in number, seemingly due to enhancement of knowledge of typical angiographic features, such as string sign, rosette sign, pearl reaction, double lumen and several others. Most of intracranial dissecting aneurysms involve the middle cerebral artery or vertebral basilar artery, and the ones involving solely the anterior cerebral artery as in this present case are very rare.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504260 TI - [Direct spinal cord and root injury caused by acupuncture--report of 2 cases]. AB - Two cases of the direct spinal cord and root injury caused by acupuncture were presented with a review of eight cases reported previously. Case 1 was 56 years old female who had been developed progressive lumbar pain, which occasionally radiating to the right lateral femoral region, since she had been treated with acupuncture for lumbago 13 months before. Examination revealed the mild sensory impairment on the right lateral femoral area and straight-leg-raising was limited on the both sides. Plain films and myelogram showed the needle between L4/L5 vertebrae and the tip of it stuck in the lumbar root. She recovered after the needle had been removed. Case 2 was 17 years old male who had initially noticed numbness over his left foot after acupuncture for easy fatiguability, which had been progressed stepwise over 2 years, and then examination revealed Brown Sequard syndrome. Radiological examination showed the needle stuck in the spinal cord between C1/C2 vertebrae and metrizamide CT myelogram disclosed the posterior end of it was in the subarachnoid space. Operative finding revealed a small cavity around the needle in the spinal cord. The needle was removed uneventfully. There was a good recovery of weakness but not of sensation. Although the direct spinal cord and root injury as a complication of acupuncture seems uncommon, our cases show one of a serious complication of acupuncture. PMID- 6504261 TI - [Disturbances of hydrogen electron transport system and free radical reactions after severe spinal cord injury]. AB - Local tissue oxygen consumption, nicotinamide-adenine dinucleotide hydrogenase, coenzyme-Q and alpha-tocopherol were measured and the relationships between damage to the hydrogen electron transport system and free radical reactions were examined in a irreversible rat spinal cord injury model. Damage to the hydrogen electron transport system became apparent in the injured spinal cord segment earlier than expected. Oxygen consumption declined to 26% of the baseline level within five to 30 minutes after injury, by one hour, further declined by 21% and by two hours another 17% and by three to four hours by an additional 13%. This severe disturbance of oxygen metabolism was associated with a marked reduction of adenosine triphosphate. A reduction in coenzyme-Q by 50% was noted within 10 minutes after injury and might be at least partially responsible for these changes since a reduction of coenzyme-Q promotes the semiquinone (.coenzyme-Q) forming reaction and also produces the superoxide radical X O2-. While coenzyme-Q reacts with H+ ion, this superoxide radical X O2-, produce a state of scavenger wastage and hyperoxygenation of nicotinamide-adenine dinucleotide hydrogenase at two hours after injury. Lipid peroxigenation resulted from damage to the hydrogen electron transport system which created a state of energy metabolite disruption and cellular membrane damage and ultimately led to cellular autolysis. PMID- 6504263 TI - [Agenesis of the corpus callosum associated with interhemispheric cyst. A case report]. AB - A 7-year-old boy was admitted because of convulsive seizures. He was diagnosed as agenesis of corpus callosum associated with interhemispheric cyst by CT scan and angiography. Metrizamide CT cisternography and cystography disclosed no communication between interhemispheric cyst and the third ventricle. By means of metrizamide CT cisternography and cystography, the authors considered this interhemispheric cyst gradually increased by some kinds of ball-valve mechanism. Cysto-peritoneal shunt was carried out. Postoperative course was uneventful and follow-up CT revealed disappearance of interhemispheric cyst and typical findings of the acallosal brain. Improvement of clinical symptoms and EEG findings occurred after operation. Agenesis of the corpus callosum associated with interhemispheric cyst is rare. The authors can find only one case of this brain anomaly in the literature in which there is no communication between interhemispheric cyst and the third ventricle. Metrizamide CT cisternography and cystography was very useful in diagnosis and selection of treatment. PMID- 6504262 TI - [Experimental model of venous hemorrhagic infarction by cerebral sinus occlusion]. AB - A new experimental model of the hemorrhagic infarction was devised to study the pathophysiology of the hemorrhagic infarction of the venous origin. To make a model of the hemorrhagic infarction by sinus occlusion, mixture of alpha cyanoacrylate monomer and pantopaque was injected through a catheter introduced into the superior sagittal sinus in 15 dogs, using embolization technique. These dogs were divided into three groups according to the volume of the mixture injected into the sinus. In control groups (3 dogs), no mixture was injected. For partial sinus occlusion (5 dogs), 0.5-1.0 ml of mixture was injected into the sinus and 1.0-1.5 ml of mixture, for complete sinus occlusion (7 dogs). Changes of intracranial pressure (ICP), superior sagittal sinus pressure (SSSP), tissue pressure (TP) rCBF and histological changes were evaluated before and after sinus occlusion. The following results were obtained. (1) In control groups, ICP, SSSP and TP were 9 +/- 2.2 mmHg, 4 +/- 2.5 mmHg and 4-5 mmHg respectively, but in partial and complete sinus occlusion, SSSP and TP were higher than ICP. ICP, SSSP & TP were 32 +/- 5.4 mmHg, 35 +/- 6.5 mmHg and 37-42 mg, in partial sinus occlusion and 62 +/- 5.9 mmHg, 65 +/- 6.0 mmHg, 65-72 mmHg in complete sinus occlusion. (2) R-CBF in partial sinus occlusion showed no change even after sinus occlusion, but in complete sinus occlusion, decreased to 20% of that of the control group due to marked venous congestion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504264 TI - [Case of occlusion of vertebrobasilar artery after subarachnoid hemorrhage due to rupture of posterior inferior cerebellar artery aneurysm]. AB - An autopsied case of ruptured saccular aneurysm at the junction of posterior inferior cerebellar artery and vertebral artery with which the aneurysm and basilar artery were occluded was reported. A 20-year-old female was admitted to our hospital because of consciousness disturbance and convulsion. CT scan revealed subarachnoid hemorrhage. Four vessel angiography did not show any aneurysms nor arteriovenous malformations but revealed occlusion of vertebrobasilar artery. Continuous ventricle drainage was performed but she died 5 days after the onset. On autopsy, a ruptured saccular aneurysm at the junction of right vertebral and posterior inferior cerebellar arteries, and occlusion with thrombosis of vertebrobasilar artery were found. We discussed how the aneurysm and main arteries were embolized just after the attack of subarachnoid hemorrhage. It is considered that the severe increased intracranial pressure in posterior fossa after subarachnoid hemorrhage and decreased blood pressure caused hemostasis of ruptured aneurysm while spreading the thrombosis in main trunks of vertebrobasilar artery. PMID- 6504265 TI - [Calcified chronic subdural hematoma. A case report in an old patient]. AB - Calcified chronic subdural hematoma is a well-known disease to many neurosurgeons as it is diagnosed with only a plain skull X-ray film. Although several reports on this condition are seen, many of them are dealing with those in children or young people, and those in the aged are only few. One case of calcified chronic subdural hematoma in an old man is described. An 86-year-old man with a sudden attack of left hemiparesis was admitted to the Kanto Rosai Hospital. Two years before, he had had a history of head injury on his right temporal area, which caused no neurological deficit before this attack. Neurological examination on admission revealed mild confusional state and severe left hemiparesis. A plain skull film of A-P projection showed a linear calcification in the right temporal area. CT scan revealed a right temporal chronic subdural hematoma with some calcification in the internal membrane, which caused moderate midline shift. Right temporal small craniotomy was performed. The hematoma contained no fluid as usual but paste-like substance, and was partially removed. Postoperatively, he showed an improvement in unstability, but the left hemiparesis remained. On the 23rd postoperative day, he expired of severe pneumonia. Autopsy showed 14.0 X 8.0 X 1.2cm sized subdural hematoma in the right temporal area. Microscopically, the internal layer of the dura markedly thickened, and the appearance of "pachymeningitis hemorrhagica interna" was clearly seen. The thicked internal layer was devided into two layers, and the hematoma was existed just between the two layers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504266 TI - Long-term treatment with estradiol induces reversible alterations in tuberoinfundibular dopaminergic neurons: a decreased responsiveness to prolactin. AB - Previous studies have demonstrated that short-term (3-5 days) treatment with estradiol increases the rate of turnover and synthesis of dopamine (DA) in terminals of tuberoinfundibular (TI) neurons in the median eminence by virtue of the ability of this hormone to increase circulating concentrations of prolactin. The present studies were undertaken to examine the long-term effects of estradiol on serum prolactin concentrations and TIDA neuronal activity (estimated by the rate of DOPA accumulation in the median eminence after the administration of a decarboxylase inhibitor). Female rats, ovariectomized for 2 weeks, were implanted subcutaneously with silastic capsules containing estradiol benzoate and sacrificed 6, 12 and 18 days after capsule implantation. Serum prolactin concentrations were markedly increased at 6, 12 and 18 days whereas the rate of DOPA accumulation was increased at 6 days but not at 12 days, and was decreased at 18 days. The concentration of DA in the median eminence was reduced at 6 days and further reduced at 12 and 18 days. The low rate of DOPA accumulation in the median eminence despite the high circulating concentrations of prolactin suggests that long-term estradiol treatment reduces the ability of TIDA neurons to respond to prolactin. This was confirmed by the finding that direct intracerebroventricular (icv) injections of prolactin increased the rate of DOPA accumulation in the median eminence of sham-implanted rats but not in 18 day estradiol-treated rats. To determine if the effects of estradiol were reversible, ovariectomized rats were implanted with estradiol-containing capsules for 18 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504267 TI - Endogenous prostaglandins affect growth hormone and thyrotropin release at a hypothalamic, not a pituitary level. AB - The role of prostaglandins (PGs) in the physiological secretion of the adenohypophyseal hormones, growth hormone (GH) and thyrotropin (TSH), in the unanesthetized, freely behaving male rat was investigated using pharmacological agents. Confirming previous observations, PG synthesis-inhibiting drugs, salicylate and indomethacin (INDO), reduced GH and TSH secretion. Another PG synthesis-inhibiting drug, acetaminophen, also reduced GH and TSH secretion. Antisomatostatin serum administered to INDO-treated rats indicated that somatostatin has a relatively small role in the GH and TSH suppression caused by PG synthesis inhibitors. Stimulation of GH secretion by the alpha 2-adrenergic receptor agonist, clonidine, and by morphine was similar in control and INDO treated rats whereas PGE2 evoked a significantly greater release of GH in INDO- than in DDC- (dopamine beta-hydroxylase inhibitor-)treated rats. Stimulation of TSH secretion was similar in response to thyrotropin-releasing hormone (TRH) in INDO-treated and control rats and was also similar in response to PGE2 in INDO- and DDC-treated rats. However, clonidine evoked a significantly greater rise in TSH secretion in control than in INDO-treated rats. These results confirm the observation that PGs are important in physiological GH and TSH secretion in the rat and suggest that PGs are involved in GH secretion by interaction proximally to the adrenergic synapse on growth hormone-releasing factor (GRF) neurons and are involved in TSH secretion by interaction postsynaptically to the adrenergic synapse on TRH neurons. PMID- 6504268 TI - Dermorphin stimulates prolactin secretion in the rat. AB - The effect of dermorphin, a new opioid peptide originally isolated from amphibian skin, on the release of prolactin (Prl) was studied in vivo and in vitro. In vivo experiments: subcutaneous administrations of different doses of dermorphin ranging from 0.1 to 5 mg/kg body weight to normal male rats induce a statistically significant, dose-related increase in serum Prl levels. Pretreatment with the specific opioid antagonist, naloxone (2 mg/kg i.p.) completely prevents the rise in serum Prl, induced by 2 mg/kg of dermorphin. In normal male rats, the intraventricular injection of 0.25 micrograms/kg of dermorphin is not able to induce any significant changes in serum Prl levels 10 min after injection. Serum Prl levels show a significant enhancement 30 min after the administration of this dose of dermorphin, and return to control values at 60 min. On the contrary, 1 microgram/kg of dermorphin significantly elevates Prl concentrations 10 min after injection, leaving serum Prl levels unchanged 30 and 60 min after the administration. Naloxone (25 and 100 micrograms/kg) alone does not substantially modify serum Prl concentrations at any time interval considered. Treatment with either dose of naloxone performed together with either 0.25 or 1 microgram/kg of dermorphin completely counteracts the stimulatory effect of the peptide at all time intervals in which dermorphin was active when given alone. In orchidectomized (3 weeks) rats, the intraventricular administration of dermorphin at the dose of 0.25 micrograms/kg appears effective in enhancing Prl levels only 30 min after treatment. No statistically significant modifications are observed at 10 and 60 min with this dose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504269 TI - Adaptation of the adrenocortical response during repeated stress in thalamic pigeons. AB - Chronic vascular catheterization allowed to obtain serial blood samples before and after stress application to thalamic pigeons. Daily repetition of the same stress, at the same hour, for 5 weeks led to drastic changes in the stress induced adrenocortical reaction. The rebounding, long-lasting rise in plasma corticosterone occurring after initial presentation of electrical footshocks was replaced by a single peak of corticosterone, lower and shorter than the initial response. Moreover, an anticipatory conditioned rise in corticosterone appeared before stress. Random distribution of stressful stimuli, thrice a day, for 5 weeks resulted in the single peak pattern of post-stress adrenocortical reaction, without any anticipatory component. When electrical footshocks were omitted after 5 weeks of daily regular presentation of stress, only the anticipatory peak in plasma corticosterone occurred. Shifting the daily lighting from the usual 06.00 a.m. to 04.00 a.m. led to a shift in the anticipatory conditioned endocrine response which appeared 2 h sooner than usual. Thalamic involvement in the process of adaptation to chronic stress is discussed. PMID- 6504270 TI - Central electrophysiologic correlates of pulsatile luteinizing hormone secretion in the rhesus monkey. AB - Characteristic increases in neuronal activity coincident with the pulsatile release of luteinizing hormone from the pituitary gland have been recorded from electrodes chronically implanted in the medial basal hypothalamus of the rhesus monkey. This electrophysiologic manifestation of the hypothalamic 'pulse generator' which governs the secretion of hypothalamic luteinizing hormone releasing hormone provides, for the first time, direct access to the central component of the neuroendocrine control system which regulates reproductive processes in this higher primate. PMID- 6504271 TI - Triiodothyronine receptors in adult rat brain: topographical distribution and effect of hypothyroidism. AB - The binding properties (affinity constant Ka and number of binding sites) of the nuclear receptors for triiodothyronine (T3) were studied in selected brain areas of the adult rat: cerebral cortex, cerebellum, olfactory bulb, caudate nucleus, hippocampus, hypothalamus and pituitary. Normal rats were compared to hypothyroid animals. The Ka of the nuclear receptors in the different parts of the brain had a similar order of magnitude (10(9) M-1) except for the hypothalamus where the value was lower (6 X 10(7) M-1). In hypothyroid animals, two main changes were observed in the properties of nuclear receptors: the Ka in the cerebral cortex was reduced by half, whereas in the pituitary the value was three times higher than in controls. In contrast to the decreased affinity, hypothyroidism enhanced the maximal binding capacity, especially in the cerebral cortex, the olfactory bulb, the caudate nucleus and the hippocampus. Of particular interest were the effects of hypothyroidism on the pituitary receptors which showed a markedly increased affinity for T3 and a reduced number of binding sites; this observation could be related to the control feedback mechanism of thyroid-stimulating hormone secretion by thyroid hormones. PMID- 6504272 TI - Short-day exposure eliminates the LH response to naloxone in golden hamsters. AB - Short-day-induced testicular regression in golden hamsters is accompanied by changes in opiatergic control of LH release. Serum LH in long-day-exposed hamsters is elevated by subcutaneous injections of naloxone. By day 42 of short day exposure, naloxone is unable to stimulate LH secretion; responsiveness to naloxone is restored after reexposure to long days. The change in response to naloxone may reflect a loss of opiate regulation of LH release; an alternative, but not mutually exclusive, hypothesis is that additional opiate-independent mechanisms inhibit LH despite the blockade of opiate LH inhibition by naloxone. PMID- 6504273 TI - [Psychopharmacologic therapy in children]. PMID- 6504274 TI - [Prescription of psychotropic drugs in child psychiatry]. PMID- 6504275 TI - [Problems of therapeutic interventions in infant psychiatry]. PMID- 6504276 TI - [Analytical therapy of children]. PMID- 6504277 TI - [Integration of the psychoanalytical and systemic approaches in the diagnostic process]. PMID- 6504278 TI - Traumatic acute epidural hematoma: unrecognized high lethality in comatose patients. AB - A series of 51 comatose patients suffering traumatic epidural hematoma after closed head injury is reviewed. This prospective series was accumulated from the National Pilot Traumatic Coma Data Bank during a 2-year period and represents 9% of all patients entered into the Data Bank. The overall mortality was 41%, with 4% remaining in the vegetative state. Fifty per cent of these patients, all of whom were in coma, also had an associated intracerebral contusion. There was no difference in outcome with regard to sex, mode of injury, or the presence or absence of contusion or shift on the computed tomographic (CT) scan. The motor score immediately before operation was the most powerful preoperative predictor of outcome. Sixty-seven per cent or two-thirds of the patients with a motor score of 4, 5, or 6 on the Glasgow coma scale had a satisfactory outcome at last follow up examination. In contrast, in patients with a motor score of 3 or less, two thirds either died or remained in a vegetative state. The acute traumatic epidural hematoma is often lethal in the comatose patient. We recommend early evacuation of epidural hematomas, i.e., when they are first noted on the CT scan, rather than waiting for clinical motor deterioration. PMID- 6504279 TI - Microsurgical anatomy of the deep venous system of the brain. AB - The microsurgical anatomy of the deep venous system of the brain was examined in 20 cerebral hemispheres. The deep venous system is composed of the internal cerebral, basal, and great veins and their tributaries. This system drains the deep white and gray matter surrounding the lateral and 3rd ventricles and the basal cisterns. The deep veins are divided into a ventricular group composed of the veins converging on the walls of the lateral ventricles and a cisternal group that includes the veins draining the walls of the basal cisterns. The internal cerebral vein is included in the ventricular group because it is predominantly related to the ventricles, and the basal and great veins are reviewed with the cisternal group because they course through the basal cisterns. The choroidal veins are included with the ventricle veins because they arise on the choroid plexus in the ventricles. The thalamic veins appear in both the ventricular and the cisternal groups because some course on the ventricular surfaces and others course in the basal cisterns. The operative approaches to the major trunks in this system are reviewed. PMID- 6504280 TI - Natural history of arteriovenous malformations of the brain: a clinical study. AB - The natural history of intracranial arteriovenous malformations (AVMs) was studied in 131 patients. The 83 patients managed nonsurgically and the 48 patients treated surgically were followed for an average of 8 years. Hemorrhage occurred in 61.8% of all patients. A second hemorrhage occurred in 67.4% of the survivors of the first hemorrhage. The mortality associated with recurrent hemorrhage did not increase significantly with successive episodes of hemorrhage. The rate of rebleeding was 17.9%/year initially, but declined to 3%/year after 5 years and then to 2%/year after 10 years. Among patients treated nonsurgically, the prognosis was more favorable for patients presenting with seizures than for patients presenting with hemorrhage. Patients in the seizure group had a 26.9% incidence of hemorrhage causing an 11.6% mortality; 40.5% of the patients in the hemorrhage group died. The prognosis was poor for patients with posterior fossa AVMs; the mortality was 66.7% with the first hemorrhage. Recurrent posterior fossa hemorrhage was the rule in survivors, and most of those hemorrhages were fatal. The prognosis for children with AVMs was no different from that for adults. PMID- 6504281 TI - Spontaneous intracerebral hematomas: a new proposal about the usefulness and limits of surgical treatment. AB - We analyzed the volume of 132 spontaneous supratentorial intracerebral hematomas calculated with computed tomographic (CT) scans and related it to the clinical condition of the patients on admission and to the outcome at their discharge from the hospital (1 to 3 months after the ictus). Fifty patients were operated on, and 82 received only medical treatment. In evaluating outcome, we were more interested in survival than its quality. The main problem is the evaluation and treatment of the many patients who are comatose upon admission (about half of the patients). We concluded that surgical treatment by evacuation of the hematoma increases the percentage of survival of comatose patients with a hematoma volume between 26 and 85 ml. PMID- 6504282 TI - Access to the posterior medial temporal lobe structures in the surgical treatment of temporal lobe epilepsy. AB - The authors describe a surgical technique that allows access to the posterior temporal horn of the lateral ventricle with preservation of the most functional lateral temporal cortex. Development of the technique was stimulated by the need to resect posteromedial temporal lobe structures in patients with intractable complex partial epilepsy and well-identified unilateral posterior hippocampal foci. This technique has also been of value in the resection of some lateral ventricular and posteromedial temporal lobe masses. The operation consists of three steps. No more than 4.5 cm of the anterolateral temporal lobe is removed en bloc such that the most anterior aspect of the temporal horn is entered. An incision is carried from the floor of the temporal horn through the inferior longitudinal fasciculus to the middle fossa dura mater and posteriorally into the lateral ventricular atrium. The lateral temporal cortex and white matter are then elevated with a self-retaining retractor. This exposes the posteromedial temporal horn or intraaxial mass for excision or allows en bloc resection of the entire hippocampus and medial temporal lobe structures while preserving the functional association areas of the lateral temporal cortex, including speech and visual spatial function. PMID- 6504283 TI - Microsurgical carotid endarterectomy in rats. AB - The purpose of this study was to develop an inexpensive experimental model of carotid endarterectomy. Unilateral common carotid endarterectomies 3 mm in length were performed on 25 rats using microsurgical techniques. The pattern of endothelial regrowth after endarterectomy, the pinocytosis of regenerated endothelial cells, and the effects of heparin and thromboxane A2 synthetase inhibitor on thrombus formation were examined 7 days after the resumption of flow. Pinocytotic vesicular transport in endothelial cells was evaluated using horseradish peroxidase. All endarterectomized vessels in both control and drug treated groups were patent 7 days after operation without apparent mural thrombus formation. Regenerated endothelial cells had spindle-shaped nuclei and cell bodies with long axes oriented parallel to the direction of blood flow. There were several instances where the leading edge of the endothelium at the distal end was reflected back in the distal direction. The extent of the endothelial ingrowth was often greater from the proximal end of the endarterectomy than from the distal end. These observations suggest that hemodynamic force affects endothelial regeneration. Pinocytotic activity was less in the regenerated endothelium than in either the endothelium remaining at the periphery of the endarterectomy or the endothelium of the control animals. PMID- 6504284 TI - A comparison of pressure-volume models in hydrocephalus. AB - Traditional descriptions of the pressure-volume properties of the craniospinal axis have expressed pressure as a function of volume. This study develops a theoretical and practical rationale for expressing volume as a function of pressure. We tested the rationale by comparing the two functions using pressure and volume data collected from 37 hydrocephalic patients during ventricular fluid removal. Two equivalent expressions were evaluated, one expressing pressure as an exponential function of volume and one relating volume as an exponential function of pressure. Each expression had three parameters, adjustable to the specific case. We used a nonlinear curve-fitting algorithm to determine the best estimate of the parameters. We could fit three-parameter exponential functions of either type to the data in all cases. We found a superior goodness-of-fit to aggregated data when expressing volume as a three-parameter exponential function of pressure changes. This finding is discussed in the context of the preferable number of parameters in a model and the interpretation of the terms in the models. This "reversed" volume-pressure relationship has importance in the development of more complicated models involving these same relationships. PMID- 6504285 TI - Traumatic aneurysm of the supraclinoid internal carotid artery: report of a case. AB - A case of traumatic aneurysm of the supraclinoid internal carotid artery is presented. Formation of the aneurysm was thought to be due to a direct injury to the wall of the internal carotid artery from a basal skull fracture of the anterior cranial fossa. PMID- 6504286 TI - Craniostenosis secondary to calcified subperiosteal hematoma: case report. AB - The case of a 5-month-old boy with sagittal synostosis secondary to a calcified cephalohematoma of the cranial vault is reported. Although birth trauma has been suggested as a cause of craniosynostosis, a review of the current literature failed to show a similar case. Surgical treatment to remove the calcified hematoma produced good cosmetic and functional results. PMID- 6504287 TI - Cerebrospinal fluid rhinorrhea 34 years after trauma: a case report and review of the literature. AB - Posttraumatic cerebrospinal fluid (CSF) rhinorrhea has been recognized since the 17th century, and its association with intracranial infection has been well documented. However, CSF rhinorrhea usually presents during the 1st month after trauma. Cases presenting more than 3 months after trauma are unusual. The authors report a case of CSF rhinorrhea that presented 34 years after head injury. PMID- 6504288 TI - Pseudobulbar palsy after posterior fossa operation in children. AB - The authors describe their experience with an unusual postoperative syndrome of pseudobulbar palsy occurring a few days after the extirpation of large midline vermian/4th ventricular tumors in children. The patients had a delayed onset of supranuclear cranial nerve palsies associated with emotional incontinence and lability that resolved over several weeks to months. It is postulated that retraction pressure on the medial cerebellum and split vermis is the operative insult responsible for edema that subsequently tracked along fiber pathways in the middle and superior cerebellar peduncles into the upper pons and midbrain. Modifications of operative technique to eliminate the need for retraction are presented. PMID- 6504290 TI - Usefulness of the orbitofrontomalar approach associated with bone reconstruction for frontotemporosphenoid meningiomas. AB - Seven cases of frontotemporosphenoid meningioma are reported. The principles of the orbitofrontomalar approach and of reconstruction of the orbital cone and of the frontomalar region with an orbitotemporal prop are discussed. PMID- 6504289 TI - Total removal of a falcotentorial junction meningioma by biparietooccipital craniotomy in the sea lion position: a case report. AB - The successful total removal of a huge falcotentorial junction meningioma in a 59 year-old woman by biparietooccipital craniotomy with the patient in the sea lion position (prone with a hyperextended neck and with 20 degrees elevation of the upper and lower halves of the body) is reported, with some comments on the advantages of this approach and position. Taking advantage of the exposure of the dural sinus, the confluens sinuum pressure was measured by direct catheterization with the patient in various positions. The pressure was 3.6 cm H2O in the sea lion position, 2.4 cm H2O in the reverse jackknife position (supine with 20 degrees elevation of the upper and lower halves of the body), and -12 cm H2O in the sitting position. PMID- 6504292 TI - Ipsilateral hemiparesis caused by subarachnoid hemorrhage in a patient with a ruptured middle cerebral artery aneurysm: a case report. AB - The authors report a patient with a ruptured middle cerebral artery (MCA) aneurysm who presented with ipsilateral hemiparesis. A computed tomographic (CT) scan and cerebral angiograms suggested that the ipsilateral hemiparesis was most likely due to compression by hematoma of the secondary motor area in the island of Reil. Two other cases that demonstrated ipsilateral motor weakness after rupture of MCA aneurysms have been reported. We emphasize not only the importance of considering dysfunction of the secondary motor area in patients with hemiparesis, but also the difficulty in differentiating ipsilateral secondary motor area dysfunction from contralateral primary motor area dysfunction in certain cases without CT scanning and angiography. PMID- 6504291 TI - Head injury from firework explosion. PMID- 6504293 TI - Acrylic prosthesis in rheumatoid arthritis of the cervical spine. PMID- 6504294 TI - Fetal neurosurgery. PMID- 6504295 TI - Aneurysm clips. PMID- 6504296 TI - Brain potentials during sentence verification: late negativity and long-term memory strength. AB - Subjects decided whether self-referential statements were true or false. Event related potentials (ERPs) associated with final words creating false statements displayed a late negativity (N340) relative to ERPs for true completions. The size of this difference between true and false statements was greater for highly familiar statements (e.g. "My name is Ira") than for less familiar ones (e.g. "I go to bed late") even after all the statements had been practised a number of times. The late negativity appears to be associated with a discrepancy between presented and remembered information, and its magnitude reflects the long-term familiarity or strength of the remembered information. PMID- 6504297 TI - Surface dyslexia in a child with epilepsy. AB - N.G. is a 13-year-old boy with surface dyslexia. He is significantly better at reading aloud words with regular spelling-to-sound patterns than those with irregular. He displays homophone confusion. N.G.'s case is particularly pure since he makes no invalid/visual errors. All errors are strictly rule-governed. Even long unfamiliar words are read with good accuracy. Both aural and reading comprehension are severely impaired. It is concluded that by age 13, an isolated and efficient system of phonic reading may develop which is based on grapheme phoneme conversion or on graphemic chunks converted to phonological segments. PMID- 6504298 TI - A longitudinal study of a hyperlexic child: hyperlexia as a language disorder. AB - The longitudinal study of a hyperlexic girl, A.E., is described. Although her WISC-R IQ was 58, her reading was significantly advanced for age and level of intellectual functioning. She was socially withdrawn and displayed repetitive and self-stimulation behaviors. At birth she weighed 1000 g and was 32 weeks gestational age. She had severe respiratory distress, seizures and apnea in the perinatal period. She had a history of significantly delayed development, although the delays were more pronounced in language than in perceptual motor skills. She demonstrated difficulties with semantic and syntactic processing of language and could read words and sentences of which she had little or no comprehension. The existence of reading in spite of severely disordered language suggests that reading may occur by visual and/or phonological routes but that semantic and syntactical processing of words is not essential. PMID- 6504299 TI - Impaired motor timing control in specific reading retardation. AB - The temporal organizations of unimanual and coordinated bimanual finger tapping was compared between adolescent normal and retarded readers of above average intelligence. The same subjects were examined for speech articulation during the timed repetition of single syllables and syllable sequences. Retarded readers had substantially greater difficulty on tasks of interlimb coordination than on unimanual tapping and substantially greater difficulty rapidly sequencing syllable strings than repeating single syllables. An experimental manipulation of movement speed for both tasks indicated that the threshold at which movement speed degrades timing precision for coordinated action best characterizes the motor impairment of retarded readers. PMID- 6504300 TI - Intermanual information transfer in patients with lesions in the trunk of the corpus callosum. AB - Interhemispheric transfer of haptic information was examined in six partially callosotomized patients and three control subjects. Three different portions of the trunk were severed in different subjects. The most anterior 10 mm of the trunk, anterior to the foramen of Monro, was sectioned in one patient. Three other patients had lesions restricted to the anterior part of the trunk posterior to the foramen of Monro. The posterior third of the trunk was damaged in two patients. The splenium, genu and rostrum of the corpus callosum were intact in all six patients, as were the anterior and hippocampal commissures. Poor transfer of haptic information was found only in the three patients with the lesion located in the anterior part of the trunk posterior to the foramen of Monro. The functional anatomy of this region is discussed. It is assumed to house fibers responsible for interhemispheric transfer of complex tactile information. PMID- 6504301 TI - Handedness data on the European neolithic. AB - An analysis of grinding striations on neolithic bone and antler implements yielded a regional variation of the percentage of left-handed individuals in Southern Germany and Switzerland during the fourth millenium B.C. While the Swiss data show as little as 6.3% to have been left-handed, the Southern German data reveal three times as much. PMID- 6504302 TI - Left-handedness and field-independence. AB - Left-handed persons have been reported to show less field-independence than right handed persons. Using a large sample of left-handers (96), a replication attempt was made and the opposite result was obtained. Left-handers were found to be more field-independent than right-handers. Results from previous studies were probably due to the use of extremely small samples of left-handers (four and 10). Different instrumentation was ruled out since the Embedded Figures Test and the Group Embedded Figures Test are essentially the same. PMID- 6504304 TI - Laterality effects in response to the offset of visual stimuli. AB - In a study of simple reaction time to visual stimuli it was found that the offset (or termination) of stimuli presented in the right visual field elicits significantly later responses than does the offset of stimuli presented in the left visual field. No such difference was observed for the responses to stimulus onset. A similar effect has been reported for responses to tonal stimuli. The results do not support the view that hemispheric asymmetries arise at higher stages of information processing than those which mediate simple reaction time. PMID- 6504303 TI - Unilateral right cerebral representation of reading in a familial left-hander. AB - Several recent hypotheses of cerebral functional organization in natural left handers hold that language, including reading, is localized either unilaterally in the left hemisphere or bilaterally, but not unilaterally in the right hemisphere. A case of alexia without agraphia in a left-hander with an infarct in the right occipital lobe and splenium of the corpus callosum is reported. That a permanent and complete alexia resulted from a single, right hemisphere lesion indicated that reading was completely lateralized to that hemisphere. The case demonstrates that in some natural left-handers language functions can be unilaterally represented in the right hemisphere. PMID- 6504305 TI - Encoding of spatial relations with amnesia. AB - Incidental and intentional learning of spatial location was studied in amnesics and normals. It was found that spatial encoding of amnesics improved with instruction whereas the spatial encoding of normal adults did not. The finding suggests that spatial encoding in amnesics may be qualitatively different from that of normal adults. PMID- 6504306 TI - The effects of stimulus and subject factors on a face matching task. AB - An initial experiment revealed that, under very rapid viewing conditions, the usual asymmetry for face recognition occurred only for low-detail facial sketches. Photographs and medium-detail sketches failed to show VF asymmetry. A further experiment revealed that the effect was unlikely to be attributable to discrimination difficulties; this experiment, however, replicated the LVF superiority on low-detail faces only for male subjects. These results are briefly examined in the light of Sergent's theoretical interpretation of hemisphere asymmetry (Sergent, J. Percept. Psychophys. 31, 451-461, 1982). They are also discussed in relation to sex differences in cerebral asymmetry. PMID- 6504307 TI - Organization and lateralization of reaching in infants: an extension of Bresson et al. AB - This study tested whether the development of one-handed and collaborative two handed reaching for an object on a support found by Bresson et al. (Neuropsychologia 15, 311-320, 1977) was related to the fluctuation in hand preference for manipulation and/or banging following duplicated syllable babbling onset found by Ramsay (Devl Psychol. 20, 64-71, 1984). Ramsay found that a preference for object manipulation and/or banging with the right hand emerged on the week of babbling onset, temporarily disappeared 3-4 weeks later and then re emerged on the subsequent (fifth) week. In the present study, a preference for one-handed reaching with the right hand for objects on a support was present only on the fifth week after babbling onset. No evidence was found for a hand preference in collaborative two-handed reaching. PMID- 6504308 TI - Ocular volume measured by CT scans. AB - Newer CT scans have greatly enhanced oculometric research and made it possible to measure ocular dimensions. With these measurements, ocular volume can be more accurately estimated to understand its relationship with age and sex. One hundred CT orbit scans with presumed normal eyes were used for the data base. The mean values and normal variations of ocular volumes at various ages in both sexes are presented. Rapid growth of the eyeball was noted during the first 24 months of age. It reached its peak between the ages of 18 and 30 years of age, after which there was a reduction. Results may be of help in recognizing eye abnormalities such as microophthalmus and macrophthalmia. PMID- 6504309 TI - Short review of CT in the study of some intraspinal diseases. AB - We present our experience of the usefulness of high definition computed tomography (HDCT) in 30 cases of isolated intraspinal pathology (12 extramedullary and 18 intramedullary cases). The results are assessed in comparison to myelography. PMID- 6504310 TI - Evaluation of Pott's disease with computed tomography. AB - The CT appearance of eight cases of culture-positive spinal tuberculosis is reviewed. Three patients had single level vertebral involvement, while five others showed multilevel involvement. In seven of eight cases, paraspinal soft tissue involvement was seen. In two, the process caused neurologic symptoms by extending into the epidural space. In three patients the paraspinal extension was not only local, but spread along multiple levels. The CT appearance can be highly suggestive of TB in cases where the diagnosis has not been suspected. In cases where the diagnosis is suspected by plain films, CT can display unsuspected extension of the disease and be helpful in needle localization for aspiration. PMID- 6504311 TI - Epidural venous stasis in spinal stenosis. CT appearance. AB - Computed tomography permits reliable demonstration of the spinal canal and its contents. Measurements of the sagittal diameter of the bony canal do not take into consideration size, shape and state of intraspinal soft tissue structures, i.e. the thecal sac and its own contents, epidural fat and blood circulation pattern. Three particularly illustrative cases were selected in which obvious epidural venous engorgement was visualized in association with spinal stenosis. The authors think that epidural venous stasis occurring in segmental spinal stenosis is a CT sign of clinically significant narrowing of the neural canal. Accurate recognition of the type of lumbar stenosis together with epidural blood flow alterations permits a better understanding of the existing lesions. Thus, a more precise and specific surgical approach is possible. PMID- 6504312 TI - Computed tomography of the intervertebral foramen. AB - 52 cases with pathologic lesions in the intervertebral foramen, studied with CT, are analyzed. The most frequent lesions are intraforaminal disc herniations. These are characterized by their hyperdensity in comparison to the dural sac (34 of 34 cases) and their broad contact with the intervertebral disc space (31 of 34 cases). Foraminal size and contour are usually normal. In contradistinction to disc herniations, benign tumors often show bone erosion of the pressure-type with enlargement of the foramen. Bone infiltration was seen only in malignant lesions and in the single case of Echinococcosis. Preoperative diagnosis of vascular lesions which present with foraminal enlargement is most important for the choice of the appropriate operative approach. Correct CT diagnosis of such vascular lesions is only possible with dynamic CT. PMID- 6504313 TI - Occlusion of internal carotid artery. Further clinical angiographic, and therapeutic considerations. AB - Patients with occlusion of ICA have been reviewed. Further ischemic attacks have been observed in 25-30%. The cause of the ischemia was generally embolization by way of collateral circulation through the ECA. Treatment of these patients is considered. PMID- 6504314 TI - Angiographic technique in extra-intracranial arterial bypass for cerebral ischemia. AB - Angiography is indispensable for the selection of appropriate candidates for extra-intracranial arterial bypass (E.I.A.B.). It allows the visualization of ICA and/or MCA occlusion or inaccessible stenosis which are considered indications for E.I.A.B. Complete angiographic study also gives information about other vascular lesions and the morphology of ECA and its branches as well as collateral circulation. Moreover angiography evaluates the result of bypass. The methods of the preoperative and postoperative angiography are described. PMID- 6504315 TI - Radiological features of the neuroectodermal tumours of childhood. AB - The radiological features of 10 cases of primitive neuroectodermal tumour (primary cerebral neuroblastoma) are presented. The angiographic and CT appearances were similar to those previously described in the literature. However, not previously documented was evidence on plain skull radiographs and CT scans of thinning and expansion of the overlying vault in 6 of the 10 cases. PMID- 6504316 TI - Computed tomography appearances in the linear sebaceous naevus syndrome. AB - The appearance of C.T. of the head in 11 cases of the linear sebaceous naevus syndrome are presented. From these it is argued that the pathology represents a disorder of neuronal migration and organisation rather than differentiation. Since three of the cases had evidence of CNS tumour in addition to two in the literature, it would appear that a further aspect of this disorder is a failure of growth constraint. This is paralleled by a similar tendency in the skin lesion which should be considered premalignant. Normal intelligence is rare in this condition and co-exists only with a normal C.T. scan. The early onset of fits is not necessarily associated with subsequent mental handicap. PMID- 6504318 TI - Computed tomography in primary lymphoma of the brain. AB - C.T. scans of 19 patients with histologically proved primary lymphoma of the brain were reviewed and divided into three groups: solitary tumors (58%), multifocal tumors (31,5%), diffuse involvement of the brain (10,5%). The C.T. differential diagnosis are manifold, including meningioma, glioma, metastases, progressive multifocal leukoencephalopathy. Arteriography is not specific, but, correlation with C.T. results may suggest the correct diagnosis and encourage biopsy. The radiosensitivity of primary lymphoma of the brain emphasizes, the importance of an early diagnosis. PMID- 6504317 TI - Exploration of the pituitary stalk and gland by high-resolution computed tomography. Comparative study of normal subjects and cases with microadenoma. AB - By means of high-resolution CT, pituitary stalks and glands were demonstrated in 189 normal subjects and in six patients with microadenomas. In the horizontal view and in reconstructed coronal and sagittal projections, the normal stalks and glands showed homogeneous enhancement with the contrast medium. On metrizamide CT, the stalks and glands were demonstrated in high-density areas as a "defect". The detection-rate of the stalks and glands was more than 93.6% in all dimensions on enhanced CT and 100% on metrizamide CT. On reconstructed sagittal projections, there was a tendency for the glands to decrease in size with advancing age. Under the age of 29, especially in females, most of the glands were demonstrated as an oval area that filled the sella turcica. After the age of 50, the gland frequently was flattened with enlargement of the CSF space within the sella turcica, giving an appearance reminiscent of the "empty sella". Of six patients with microadenomas, five presented the appearance of oval gland, and one showed visualization of CSF space in the anterosuperior portion of the sella turcica. On reconstructed coronal projections, the angle of inclination of stalks was 1.5 +/- 1.2 degrees in normal subjects and 9.3 +/- 2.4 degrees in patients with microadenomas. PMID- 6504319 TI - Hematoma of the brainstem in childhood. AB - Hematomas of the brainstem are revealed by signs of brainstem dysfunction. Sudden onset is characteristic but only demonstration of subarachnoid hemorrhage and typical CT-Scan appearance are diagnostic. Surgical evacuation of the hematoma may help in the acute stage but does not avoid recurrence; pronosis is guarded. PMID- 6504320 TI - Is viscosity important in the production of blood-brain barrier disruption by intracarotid contrast media? AB - A canine model was used to investigate the effects of intracarotid methylglucamine iothalamate (280 mgI/ml) at different viscosities on the normal blood-brain barrier. To alter viscosity, without changing physiochemical parameters, injections were made at either 23 degrees C or 37 degrees C. The degree of blood-brain barrier damage was assessed using Evans' Blue dye as a visual marker and by contrast enhancement measured by a computed tomographic (CT) scanner. It was found that methylglucamine iothalamate caused more blood-brain barrier damage at 23 degrees C than at 37 degrees C (p less than 0.1). Control studies at each temperature using intracarotid injections of physiological saline showed no temperature effect (p greater than 0.1). The implications of these findings are discussed. PMID- 6504321 TI - Traumatic and alternating delayed intracranial hematomas. AB - Repeat computed tomography has enabled us to confirm the concept of delayed hematomas. With this in mind we report two cases of alternating, post-traumatic intracranial hematomas; confirming also the role of tamponade after surgical removal of an intracranial hematoma. PMID- 6504322 TI - CCT and sonographic findings in congenital craniopharyngioma. AB - In a case of congenital craniopharyngioma results of the sonographic and CCT examinations are reported and compared with postmortem macroscopic cuts. Comparison is made of clinical data from six cases with congenital craniopharyngioma as reported in the literature. PMID- 6504323 TI - Cerebro-ocular dysgenesis (Walker-Warburg syndrome): neuropathologic and etiologic analysis. AB - We studied three cases (two of them siblings) with ocular and cerebral dysgenesis (Walker-Warburg syndrome). The histologic changes suggest that the disorder results from a sclerosing meningoencephalitis active through the second and third trimesters, but different from that typically encountered with known congenital pathogens. This illness was encountered first in the 1930s and has been reported with increasing frequency since 1970. The risk of recurrence among siblings exceeds 50%, with a predilection for involving consecutive siblings, a high incidence of reproductive failure, and no transmission across generations. The evidence suggests that an acquired agent may be transmitted transplacentally through consecutive pregnancies. PMID- 6504324 TI - Spinocerebellar ataxia in a large kindred: age at onset, reproduction, and genetic linkage studies. AB - We studied a large kindred with autosomal dominant spinocerebellar ataxia (SCA) to assess reproductive performance, the impact of genetic counseling, and linkage relationships of the SCA locus. Reproduction was not lower in those with SCA than in unaffected sibs or first cousins. Genetic counseling reduced reproduction during the risk period for development of SCA. Given autosomal dominant transmission of a single gene, we found strong evidence that the locus for SCA in this kindred is linked to the HLA loci. PMID- 6504325 TI - Caudate hemorrhage. AB - We studied 12 patients with intracerebral hemorrhage in the head of the caudate nucleus. These cases accounted for 7% of a consecutive series of intracerebral hemorrhage. The clinical findings differed from more common varieties of supratentorial hemorrhage. All patients had acute onset of vomiting, headache, stiff neck, decreased level of consciousness, and behavioral changes in a pattern that simulated subarachnoid hemorrhage. Seven patients had gaze paresis and hemiparesis, with or without sensory loss. Two of these seven patients had, in addition, elements of Horner's syndrome. The prognosis for recovery was good. No patient had recurrent hemorrhage or persistent hydrocephalus. PMID- 6504326 TI - Rates of decrease of cerebral blood flow in progressive dementias. AB - To determine whether cerebral blood flow (CBF) progressively decreases as dementia progresses, we studied 133Xe washout at two or three different times in 23 demented patients. All 15 patients with Alzheimer's and 5 of 8 patients with vascular dementias had more rapid declines of CBF than did nondemented age matched controls. Mean rate of change in Alzheimer's disease was -0.60 per month, compared with +0.29 per month in four controls tested twice. Regression analysis of CBF with age in 30 controls tested once showed a decline of CBF with aging at a rate of -0.013 per month. The rates of CBF decline in dementia were significantly correlated with rates of change of behavioral score measuring functional impairment. PMID- 6504327 TI - Neurologic disorder of vitamin E deficiency in acquired intestinal malabsorption. AB - Fifteen years after onset of a malabsorption syndrome, a 49-year-old man had sensory and oculomotor disorder with marked vitamin E deficiency. After 6 months of treatment with high parenteral doses of vitamin E, the neurologic signs slowly receded, but the patient died of gastrointestinal hemorrhage. Autopsy and sural nerve biopsy showed the changes in both central and peripheral nerves; these changes are considered characteristic of vitamin E deficiency. PMID- 6504329 TI - The effect of graded hypertonic intracarotid infusions on drug delivery to experimental RG-2 gliomas. AB - The RG-2 brain tumor model was used to determine whether unidirectional transport of alpha-aminoisobutyric acid (AIB) into brain and tumor tissue was increased after an intracarotid infusion of one of six different hypertonic solutions of L arabinose. Intracarotid infusion of hypertonic solutions that have been reported as subthreshold for normal brain were used to determine whether they would selectively increase blood-to-tissue transport in brain tumors. No increase in the transport rate constant (K) across RG-2 tumor capillaries resulted from the infusion of 0.8- to 1.4-osm solutions. Infusions of 1.6- and 1.8-osm solutions were also performed, and blood-to-tissue transport was measured under conditions that produce maximum blood-brain-barrier disruption; however, no increase in the transport rate across tumor capillaries was measured. In brain regions surrounding the tumor, there was a trend toward increasing K values associated with increasing osmolality of the infusate, but the magnitude of this increase was small. There was a progressive increase in the K of tumor-free brain regions. This increase correlated with increasing osmolality of the infusate (0.8 to 1.8 osm). We conclude that intracarotid infusion of hypertonic solutions of L arabinose does not increase the rate of delivery of water-soluble drugs to experimental RG-2 brain tumors. In this situation, the use of hypertonic infusions may be counterproductive and result in a greater delivery to and exposure of surrounding and normal brain tissue to levels of chemotherapeutic drugs which are potentially neurotoxic. PMID- 6504328 TI - Suppression of L-dopa-induced circling in rats with nigral lesions by blockade of central dopa-decarboxylase: implications for mechanism of action of L-dopa in parkinsonism. AB - Dopamine (DA) elevations in rat striatum produced by combined administration of L dopa and carbidopa were abolished when L-dopa was injected with NSD-1015, an inhibitor of central dopa-decarboxylase. In all rats with unilateral 6-OH-DA nigral lesions, L-dopa-induced contraversive circling occurred after carbidopa, but was totally abolished (in 60%) or markedly suppressed after pretreatment with NSD-1015. Administration of the DA metabolites DOPAC and HVA systemically and of 3-methoxytyramine intrastriatally evoked no circling in animals with 6-OH-DA lesions. In rats with unilateral nigrotomies, the direction of L-dopa-induced circling was reversed and became ipsiversive after DA receptors were reduced by the addition of kainic acid lesions in ipsilateral striata. Findings provide evidence that circling in rats--and by analogy, efficacy in parkinsonians- requires the decarboxylation of exogenous L-dopa and interaction of the formed DA with DA receptors in striatum. PMID- 6504330 TI - Drug-induced seizures: a 10-year experience. AB - Of 53 patients with drug-induced seizures seen in the last decade, 45% had single seizures, 40% had multiple convulsions, and 15% had status epilepticus. Generalized seizures with focal features were common, but simple partial (motor) seizures occurred in only two patients. Isoniazid, insulin, lidocaine, and psychotropic medications were the most common drugs that caused seizures. Forty nine patients recovered without ill effects, but 4 patients died of cardiovascular complications. The combined cardiovascular toxicity of the convulsants, antidotes, and anticonvulsants was more important than the number or duration of seizures in determining outcome. PMID- 6504331 TI - Slow saccades and hypometria in anticonvulsant toxicity. AB - We report a patient with abnormal saccades in association with anticonvulsant toxicity (phenytoin 27.5 micrograms/ml, phenobarbital 18.8 micrograms/ml). The patient looked toward visual targets either with multiple, small, hypometric saccades or with single slow saccades. These abnormalities resolved when anticonvulsant levels returned to therapeutic range. Thus, slow saccades may be clinical evidence of anticonvulsant toxicity. PMID- 6504332 TI - Phenobarbital-induced dyskinesia in a neurologically-impaired child. AB - A 2-year-old child with known neurologic impairment developed a dyskinesia soon after starting phenobarbital therapy for seizures. Known causes of movement disorders were eliminated after evaluation. On repeat challenge with phenobarbital, the dyskinesia recurred. Phenobarbital should be added to the list of anticonvulsant drugs that can cause movement disorders. PMID- 6504333 TI - Serum prolactin levels after epileptic seizures. AB - We prospectively studied serum prolactin (PRL) elevation after different types of documented seizures in 17 patients. Marked PRL elevations above normal and above three times baseline were seen at 15 or 30 minutes after 20 of 25 (80%) generalized tonic-clonic, 13 of 30 (43%) complex partial, and 1 of 10 (10%) simple partial seizures. Although marked postictal PRL elevation is a sensitive indicator of recent epileptic seizures, a normal 15- or 30-minute postictal PRL level does not exclude an epileptic seizure. PMID- 6504334 TI - Gm allotypes in Finnish myasthenia gravis patients. AB - Gm phenotype G1m 1,2, and 3 frequencies were examined in 103 Finnish myasthenia gravis patients. There were no significant differences as compared with the expected frequency, either in the total material or when patients were subdivided according to sex, age of onset of disease, thymus pathology, or presence of HLA B8. However, individuals with Gm(+1) had a significantly higher concentration of antibodies against acetylcholine receptor, possibly indicating a correlation with severity of disease. PMID- 6504335 TI - Pharmacologic effects of L-dopa are not closely linked temporally to striatal dopamine concentration. AB - In an attempt to gain insight into the mechanism of the "long-term response" to L dopa in parkinsonians, we studied the temporal relationship between turning behavior and striatal dopamine (DA) levels after L-dopa administration to rats with unilateral nigral lesions. Turning behavior peaked at 30 minutes (9.0 +/- 1.5 turns per rat per minute), diminished in intensity, reached a new peak (10.8 +/- 1) at 3 hours, and persisted for 280 minutes after L-dopa administration. In contrast, dopamine levels in the striatum ipsilateral to the lesion peaked at 20 minutes and returned to control levels by 90 minutes after L-dopa administration. These data suggest that behaviors elicited by an increase in brain (striatal) dopamine levels may persist long after the dopamine concentration has returned to control levels. PMID- 6504336 TI - Confusional syndrome in thalamic stroke. PMID- 6504337 TI - Action tremor with alternating activity in antagonist muscles. PMID- 6504338 TI - Heparin therapy for stroke. PMID- 6504339 TI - Nomifensine exacerbates depression and seizures in an epileptic patient. PMID- 6504340 TI - Cysticercosis and praziquantel therapy. PMID- 6504341 TI - Left-handedness in dementia. PMID- 6504342 TI - Pilomotor seizures. PMID- 6504343 TI - [Familial polyposis]. PMID- 6504344 TI - [Low anterior resection with latero-terminal mechanical anastomosis in the treatment of cancer of the rectus]. PMID- 6504345 TI - [Transparietohepatic drainage in the preoperative treatment of severe obstructive jaundice]. PMID- 6504346 TI - [Considerations on a peculiar case of Saint's triad]. PMID- 6504348 TI - [Surgical therapy of recurrent varices of the lower extremities]. PMID- 6504347 TI - [Technic for using the saphenous vein in the creation of a femoro-popliteal bypass in cases of anatomic changes of the saphenous vein]. PMID- 6504349 TI - [Radical surgical treatment of leiomyosarcoma of the inferior vena cava]. PMID- 6504350 TI - [Biliary peritonitis without perforation]. PMID- 6504351 TI - [Biliary peritonitis in the course of acute cholecystopathy. Analysis of 10 cases]. PMID- 6504353 TI - [Treatment, with a microsurgical technic, of injuries of the peripheral nerves. Observations on a series of 220 surgically treated cases]. PMID- 6504352 TI - [Torsion of the greater omentum. Presentation of 2 cases]. PMID- 6504354 TI - [Intraneural synovial cysts of the external popliteal sciatic nerve. Observations on 2 cases treated with microsurgical technics]. PMID- 6504355 TI - [Entrapment syndrome of the nerve of the median gemellus muscle, a branch of the posterior tibial nerve. Description of a case treated by a microsurgical technic]. PMID- 6504356 TI - [Spontaneous mono- and bilateral pneumothorax. Our current therapeutic orientation]. PMID- 6504357 TI - [Truncal vagotomy today]. PMID- 6504358 TI - [Evaluation of the results of different types of surgical intervention for pilonidal fistula]. PMID- 6504359 TI - [Technical aspects and first clinical evaluation of a new circular mechanical stapler: the I.L.S]. PMID- 6504360 TI - [Cysts of the jaw bone]. PMID- 6504361 TI - [Clinical and histopathological findings in malignant transformation of idiopathic hemorrhagic rectocolitis]. PMID- 6504362 TI - [Anterior thoraco-abdominal mediastinal lipoma]. PMID- 6504363 TI - [Experimental replacement of the hepatocholedocus with an autogenous Sparks prosthesis]. PMID- 6504364 TI - [Neurinoma of the pancreas]. PMID- 6504365 TI - [Splenectomy in Cooley's disease. Our experience and long-term results]. PMID- 6504366 TI - [Anatomo-clinical considerations concerning ligation of the common hepatic artery in aneurysm]. PMID- 6504367 TI - [Critical considerations on the treatment of chronic pleuropulmonary staphylococcal infections in childhood]. PMID- 6504368 TI - [Topical administration of antiseptics and antibiotics in the prevention of surgical wound infections in aseptic surgery]. PMID- 6504369 TI - [Pulmonary hamartoma. Apropos of 46 cases]. PMID- 6504371 TI - [A case of voluminous retroperitoneal hemangiopericytoma]. PMID- 6504370 TI - [A case of leiomyosarcoma of the spermatic cord]. PMID- 6504372 TI - [Diet therapy in chronic renal insufficiency. Scheme of a standard diet]. PMID- 6504373 TI - [Controlled protein administration diet and the prevention of hepatic encephalopathy]. PMID- 6504374 TI - [Effect of spironolactone and K-canrenoate in ascitic cirrhosis. Double-blind study]. PMID- 6504375 TI - [Efficacy and tolerance of ursodeoxycholic acid in the therapy of radiotransparent cholelithiasis]. PMID- 6504376 TI - [Evaluation of the choleretic property of 2 preparations containing extracts of boldo and cascara]. PMID- 6504377 TI - [Use of canrenoate potassium given orally in ascitogenic cirrhosis]. PMID- 6504378 TI - [Linoleic acid in the prevention of arteriosclerotic injuries]. PMID- 6504379 TI - [Ampullar duodenal carcinoma in diffuse familial polyposis]. PMID- 6504381 TI - [Diet, diabetes and atherosclerosis. Research on food consumption and on the influence of complex sugars and dietary fibers on the state of metabolic compensation in insulin-dependent and non-insulin dependent diabetic population]. PMID- 6504380 TI - [Considerations on 2 cases of Peutz-Jeghers syndrome]. PMID- 6504382 TI - Long-term effects of cholecystostomy on gallbladder function. AB - In eight patients without a history of gallbladder disease, cholecystostomy was performed for acute pancreatitis (four patients) and blunt abdominal trauma (four patients). In one case only, acute cholecystitis developed after discontinuation of the cholecystostomy. Six patients were followed for a mean period of 3.9 years, after which the gallbladder function was evaluated. Cholecystography and ultrasonography demonstrated good visualisation of the gallbladder without signs of gallstones. The contraction of the gallbladder produced by cholecystokinin varied. This could be due to adhesions impairing the motility of the gallbladder. After cholecystostomy in a previously normal gallbladder, its function will become normal in most patients. If no signs of gallbladder disease develop within the first year after cholecystostomy, the risk of late complications is minimal. PMID- 6504383 TI - Prospective study on the incidence of complications of right heart catheterization. AB - Indications for hemodynamic assessment by right heart catheterization include shock, pulmonary edema, severe trauma and sepsis. The introduction of the catheter and the location of the tip in the pulmonary artery, however, can cause severe complications. In the present study the incidence of complications was observed in 93 consecutive right heart catheterizations in critically ill patients with no evidence of recent myocardial infarction. The low incidence of complications during introduction and with the catheter tip located in the pulmonary artery justifies right heart catheterization in patients with hemodynamic and/or respiratory instability treated in an intensive care unit. PMID- 6504384 TI - Rupture of the quadriceps tendon. AB - Complete bilateral, simultaneous and spontaneous rupture of the quadriceps tendon is exceedingly rare; 17 cases have been reported, four with no predisposing cause. This report documents a fifth case, being the first in Dutch literature. Although diabetes, primary or secondary hyperparathyroidism, lupus erythematosus and gout are well-known predisposing factors, this case illustrates that the condition can occur in a previously healthy older patient. PMID- 6504385 TI - Cystadenocarcinoma of the pancreas. PMID- 6504386 TI - Three patients with a malignant felon. PMID- 6504387 TI - [Alcoholic beri-beri: a not yet clearly understood pathogenesis. Problems presented by a particularly clinical complex case]. AB - A detailed clinical and autoptic study of a case of alcoholic beri-beri is presented. In the light of recent experimental literature, the symptoms support the as yet tentative new hypothesis that pathogenesis may relate to the parasympathetic system, in which case there may be a concrete possibility of immediate medical cure. PMID- 6504388 TI - [Variations in the ratio of total calcium to plasma calcium ions in chronic liver diseases]. AB - Total Ca and Ca++ were evaluated with a Perkin Elmer 305 atomic absorption spectrophotometer and a specific Orion 93-20 electrode respectively in 29 cirrhotics and 76 non-cirrhotics. Stress is laid on the reliability of the Orion electrode. Mean C++ was 52.02 +/- 4.46 mg% in the non-cirrhotics, in cirrhotics was 49.90 mg% +/- 6.14 mg%. An inverted ratio vis-a-vis total Ca was also noted: 54.73 +/- 3.65% in the cirrhotics and 56.51 +/- 3.73% in the non-cirrhotics. Although lacking in significance, these data underscore the importance of both partial and total evaluation of plasma Ca in the prevention of mistaken therapeutic approaches when liver patients. PMID- 6504389 TI - [Association between ABO blood groups and gallbladder calculi: a dissenting opinion]. AB - A group of 174 hospital patients was studied to discover the incidence of ABO blood groups in comparison, with a similar analysis of a representative sample (1872 people) of the Amiata Community as a whole. Though this type of sampling is open to criticism, it is still felt that there is no statistical proof that one or more of these blood groups is more prone to gall stones, at least in Amiata. PMID- 6504390 TI - [Myxoma of the left atrium. General considerations and description of a case]. AB - A case of left atrial myxoma is described. The neoplasia was observed in a female with no previous rheumatic history in whom cardiopathy was diagnosed only a few months before hospitalisation. The rapid and erratic course of the cardiopathy, the fact that changes of posture modified objective symptoms, the presence of dyspnoea and peripheral microembolisms were all clinical indicators of a possible myxoma, later confirmed by echography and cardiac catheterism. The anatomical and functional characteristics of myxomas are also discussed. PMID- 6504391 TI - [Generalized melanosis of the colon associated with multiple recto-colonic adenomas]. AB - A case of diffuse rectocolonic melanosis in association with severely dysplasic recurring multiple adenomas is reported. The rarity of the condition gives rise to remarks based on a review of recent literature on the subject. PMID- 6504392 TI - [Lymphangioma of the spleen. Apropos of 2 cases]. AB - On the basis of two observed cases and a review of the literature, the extreme rarity of cystic lymphangioma of the spleen is pointed out. The presumed pathogenesis of the condition is described as are its greater frequency among the young, the possibility of dangerous complications and its non-malignity. The superiority of non-invasive instrumental diagnosis (echotomography and CAT) over traditional techniques is reported. Finally splenectomy is identified as the therapy of choice. PMID- 6504393 TI - [Presentation of a new instrument for the prolonged monitoring (24 hrs.) of endoesophageal pH, based on microprocessor technologies]. AB - Prolonged monitoring of oesophageal pH is the most sensitive test for GOR. An ideal instrument for this test should be simple, reliable and inexpensive. It should enable the patient to live a normal life, even at home, allows rapid analysis of the data, and monitors other parameters at the same time (intragastric pH). An instrument with these features has been devised at Padua University Surgical Clinic. It uses NSC 800 microprocessor technology and has a 32 K C-MOS memory. The examination can be programmed (patient code, date, start and end times, sampling duration and time). Postural changes are automatically recorded. Subjective symptoms are signalled by the patient through an alphanumeric keyboard. ROM software at the end of the test is employed for automatic processing according to Johnson and De Meester's parameters. Proxima is also made for a serial output to a larger-capacity computer and an analogue output compatible with a Beckman paper printer. PMID- 6504394 TI - [Effects of clindamycin and josamycin in experimental Toxoplasma gondii infections]. AB - The effects of clindamycin and josamycin on experimental toxoplasmosis of mice (RH strain) are studied. Oral administration of clindamycin 800 mg/kg daily for 14 days cured 80% of Toxoplasma-infected mice at 60 days after infection. Josamycin, administered subcutaneously at 100, 200, 500, 1000 mg/kg daily for 14 days did not prevent death due to acute infection, and no difference was demonstrated with untreated infected mice. PMID- 6504396 TI - [Medical complications in lung resections]. AB - The complications of pulmonary resections are discussed with reference to a group of 82 patients. Arrhythmias, infections of pleural space and post-operative atelectasis occur with major frequency. Pleuropulmonary infections are most serious events because they are associated with significant mortality. PMID- 6504395 TI - [Pyrosis in major diseases of the upper digestive tract. Computerized analysis of symptoms in 700 cases subjected to gastroduodenoscopy]. AB - The prevalence of the symptom pyrosis was investigated in 700 cases subjected to gastroduodenoscopy. The incidence of pyrosis was considered in relation to sex, age, "vices" (consumption of coffee, alcohol, cigarettes), character traits, family and pathological medical histories and the diagnosis formed during endoscopy. The incidence of pyrosis proved to be identical for both sexes and slightly higher in the first decades of life. There was no correlation between familial gastroduodenal or intestinal diseases and pyrosis. There seems to be no connection between cigarette smoking and alcohol consumption (assessed quantitatively) and a higher incidence of pyrosis; the consumption of coffee, however, does appear to increase the incidence of pyrosis. When interpreting these data, it should be remembered that many subjects may have modified their habits as a result of pyrosis. The incidence of pyrosis was always found in cases of oesophagitis, current bulbar ulcers, the initial stage of gastric tumours (not advanced cases) and, although with less certainty, in pyloric stenosis and duodenitis. A low incidence was recorded for cases of hypotrophic gastropathies, and cicatricial gastric or duodenal ulcers, for males with oesophageal varices or with a history of chronic hepatopathies. To conclude, pyrosis does not seem to show any characteristics of specificity or sensitivity. PMID- 6504397 TI - [Evaluation of the effect of flunitrazepam on the lower esophageal sphincter in man with intraluminal manometry]. AB - The effect of Flunitrazepam on the human lower oesophageal sphincter is evaluated. Pressure in the LOS and GOR using the Acid Reflux Test was evaluated in 22 surgical cases at rest (after ingestions of a placebo and Flunitrazepam). The results obtained indicate that the LOS pressure variations induced by flunitrazepam significantly increase the probability of GOR. PMID- 6504398 TI - [Prognostic value of CEA in postoperative monitoring of colorectal cancers]. AB - The prognostic value of CEA for the purposes of postoperative monitoring assessed in 45 patients with cancer of the colon and rectum. Values were obtained 1-36 months after surgery in all operable cases. Means were also evaluated statistically at various follow-up times. In patients who relapsed, values stayed significantly higher for up to 6 months after surgery than in those who did not. Cockran's method showed that the prognostic significance of this difference 6 months after surgery was p less than 0.05. PMID- 6504399 TI - [Initial experiences in the treatment of psoriasis with pulsating magnetic fields]. AB - The ability of a pulsed magnetic field to achieve regression in psoriasis was investigated in 110 patients. The best results were obtained in the scalp hair region (100% good results), patches in the classic sites (73,7% good results) in males, and in guttate forms (75% good results) in females. Persons in the 2nd, 5th and 6th decades of life showed the best response to this treatment, while longstanding forms responded better than those of more recent origin. The treatment seemed to be particularly successful when commenced in march-april (80% good results). No side-effects worthy of note were observed. It is felt that the field employed has a systemic effect. PMID- 6504400 TI - [Ischemic syndrome of the lower extremities from immersion in hot water]. AB - The present paper deals with an ischaemic syndrome which may affect an area of lower limb vessels with latent arteriopathy if limbs or whole body are immersed in very warm water. Two cases are described in which ischaemia appeared when the limbs involved were immersed in warm water (38 degrees C). Ischaemia may be explained by the occurrence of both haemometakinesia and insufficient reserve blood flow in the limbs involved. Aged patients are particularly prone to such syndrome due to the particular anatomic features of the vascular system in old age. PMID- 6504401 TI - [Treatment protocol for duodenal ulcers. Outlines of indications for surgery]. AB - 105 duodenal ulcer patients were examined over a two-year period. Apart from anamnesis, endoscopy and radiology, a personal treatment protocol was used to assess the indications for medical or surgical treatment. Endoscopy undeniably plays a central role in identifying the characteristics of the ulcer and its complications and will indicate medical treatment for the majority of duodenal ulcers though it also serves to confirm or modify the indication for surgery. PMID- 6504402 TI - Lingual lipase activity in cystic fibrosis. PMID- 6504403 TI - Infants of obese mothers are prone to hypoglycemia. PMID- 6504404 TI - Diet change and obesity among modernizing Polynesians. PMID- 6504405 TI - Anorexia nervosa due to a tumor of the hypothalamus. PMID- 6504406 TI - Caloric restriction and age-related changes in lens proteins. PMID- 6504407 TI - Menkes' disease: are we closer to learning its cause? PMID- 6504408 TI - Partially hydrogenated fats in the diets of nursing mothers: effect on contents of trans fatty acids and prostaglandins in milk. PMID- 6504409 TI - Weight gain after cessation of cigarette smoking. PMID- 6504411 TI - Conditioned copper deficiency due to antacids. PMID- 6504410 TI - The hypocalcemia associated with magnesium infusion is mediated through parathyroid hormone. PMID- 6504412 TI - Uncertainties in the mechanism of thiamin pyrophosphate-dependent alpha-keto acid dehydrogenase complexes. PMID- 6504413 TI - Ultrasonic measurement of depth of adipose tissue and muscle area in swine. PMID- 6504414 TI - Animal sleep: a review of sleep duration across phylogeny. AB - Sleep duration and placement within the twenty-four hour day have been primary indices utilized in the examination of sleep function. It is of value, therefore, to evaluate these variables in a wide range of animal species. The present paper examines the literature concerning sleep duration in over 150 animal species, including invertebrates, fish, amphibians, reptiles, birds, and 14 orders of mammals. We first present annotations of almost 200 studies, including number of animals used, photoperiod employed, sleep duration per twenty-four hours and placement of sleep period within the nychthemeron. Both behavioral and electrographic studies are reviewed, as are laboratory and field studies. These data are subsequently presented in a table with representative literature citations for each species. Following the table, a brief discussion is presented concerning some methodological issues which may affect the measurement of sleep duration and some suggestions are made for future examination of sleep duration. PMID- 6504416 TI - Thermal pleasantness and temperature regulation in man. AB - The temperature regulation system of man is complex and has not yet been fully understood. The "black box" is the nature of the set point which the system is known to defend. The set point is in fact a rhythmic function of time of day. Temperature-regulatory behaviour, more than autonomous response, has recently been confirmed as the dominant, effective and more sensitive control response tending to maintain body temperature close to the set point. It is possible to estimate the set point by a procedure involving a behavioural indicator, namely thermal pleasantness sensation. A number of examples are discussed in which the set point was determined by the aid of thermal alliesthesial response (i.e., change of thermal pleasantness sensation for the same stimulus according to the internal thermal state of the subject). The quantification of the set point is shown to be relevant for medical research and practice. PMID- 6504415 TI - Towards an improved serum-free, chemically defined medium for long-term culturing of cerebral cortex tissue. AB - The present study describes a series of experiments which have led to a substantially improved serum-free, chemically defined medium (CDM) for long-term culturing of reaggregated fetal rat cerebral cortex tissue. A reduction of the original medium concentrations of the hormones insuline, T3 and corticosterone, on the one hand, and an enrichment of the medium with the vitamins A, C and E, the unsaturated fatty acids linoleic and linolenic acid, and biotin, L-carnitine, D(+)-galactose, glutathione (reduced) and ethanolamine, on the other hand, formed the most important chemical adjustments of the medium. With the aid of this CDM (encoded R12), the light- and electron microscopic architecture of the tissue could be kept in a good condition (superior to that seen earlier in serum supplemented medium) up to 23 days in vitro. From that time on, the neuronal network lying between the reaggregates degenerated for the largest part, while a portion of the large neurons (probably pyramidal cells) plus some of the neuronal network within the reaggregates degenerated too. This degeneration process continued during the following weeks, but the reaggregates nevertheless retained most of their mass, so that both small and large neuronal cell bodies (visible in transparent regions at the edge of the reaggregates) remained in good condition up to at least 103 DIV. Stout, thick nerve bundles interconnecting the reaggregates, also survived up to this point. Electron microscopic evaluation of such 'aged' reaggregates revealed degenerating as well as healthy regions. The latter had indeed retained healthy-looking pyramidal and non-pyramidal neurons, embedded within a dense neuropil which was often traversed by myelinated axons. The numerical synapse density in such selected, healthy tissue regions reached its maximum during the sixth week in vitro, followed by a rapid decrease and a stabilization at about half the peak values. The present culture system has opened the possibility for performing controlled quantitative studies on the relationship between structure and function of cerebral cortex tissues during development and aging, on its dependence on nutrients, hormones and drugs, and on special factors synthesized by the tissue and released into the nutrient medium. PMID- 6504417 TI - Trigeminal sensorimotor mechanisms and ingestive behavior. AB - Selective section of trigeminal orosensory nerves was carried out to assess the contributions of trigeminal orosensation to the control of food and water intake in the rat. Trigeminal orosensory deafferentation reduces a responsiveness to food and water, disrupts jaw-opening and tongue protrusion reflexes mediating eating and drinking, impairs dietary self-selection and reduces the level of long term body weight regulation. The magnitude of the feeding behavior deficits is a joint function of the extent of the denervation and the sensory properties of the diet, and recovery takes place along a palatability gradient. Analysis of feeding and drinking patterns and of learned instrumental behaviors indicates that deafferentation reduces the probability of initiating a feeding or drinking bout and profoundly disrupts performance of operant responses reinforced with food or water. We conclude that the trigeminal system contributes to both the sensorimotor and motivational control of ingestive behavior. Its motivational contributions differ in both kind and magnitude from those of the gustatory system. PMID- 6504418 TI - Detection of breast carcinoma in a gynecologic practice. AB - The approach to detecting breast carcinoma in gynecologic practices remains controversial. Fourty-five breast carcinomas were detected in 8757 patients, using a combination of physical examination, mammography, thermography, and fine needle aspiration. The sensitivity of each modality is as follows: physical examination, 62.2%; mammography, 63.2%; thermography, 75.6%; and fine-needle aspiration biopsy, 93.7%. Review of the current literature reveals a lack of agreement concerning the indications and the recommended frequency of use of each type of examination. Because of inaccuracies in each technique, a multimodal approach is indicated for the earliest detection of breast carcinoma. PMID- 6504419 TI - Chromosomal complements in primary gonadal failure. AB - Twenty-nine patients underwent clinical, hormonal, endoscopic, and cytogenetic studies to determine the cause of primary amenorrhea or delayed sexual development. In 19 of them (mean age 17.6 years), the X chromosome was either missing or anomalous. In ten patients (mean age 25.5 years), the chromosomal complement was normal, 46 XX in six patients and 46 XY in four patients. Those with abnormal chromosomal complements were shorter (mean height, 141.9 cm) than patients with normal complements (158.7 cm). Somatic stigmas were observed more frequently in patients with chromosomally abnormal primary gonadal failure. In 23 patients (79.3%), the gonads were streaks, with fibrous stroma devoid of either follicles or tubules containing germ cells. In three patients the ovaries were hypoplastic, with few primordial follicles. Gonadoblastoma was present in two patients with XY and mixed XX/X/XY gonadal dysgenesis. In every patient with streak gonads and lack of germ cells, serum gonadotropin levels were elevated. Karyotype, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) assays, and eventually laparoscopy and gonadal biopsy are important in the management of patients with primary gonadal failure. PMID- 6504420 TI - Piperacillin versus clindamycin plus gentamicin for pelvic infections. AB - Piperacillin, a new semisynthetic penicillin, has broad spectrum activity against most clinically important aerobic and anaerobic bacteria. In the present study, piperacillin was compared with a combination of clindamycin and gentamicin for the treatment of 83 women with pelvic infection (42 with endometritis, 29 with posthysterectomy cuff infections, 11 with acute salpingitis, and one with a wound infection). There were 179 bacterial isolates, 98 (53%) aerobic and 81 (45%) anaerobic. Of the 42 patients treated with piperacillin, there were three (7.1%) clinical failures compared with one (2.4%) in the 41 patients treated with clindamycin-gentamicin. A single drug, piperacillin, was shown to be as safe and effective as the combined clindamycin plus gentamicin therapy for pelvic infections. PMID- 6504421 TI - Comparison of 5-fluorouracil and CO2 laser for treatment of vaginal condylomata. AB - Seventy nonpregnant women with extensive condylomata of the vagina were treated either with intravaginal 5-fluorouracil (5-FU) cream or the CO2 laser. Treatment results were correlated with the morphologic type of condylomata, ie, papillary acuminata (58 patients), and flat condylomata (12 patients). Ten and 31% of women with Condylomata acuminata had persistent disease within nine months after a single course of 5-FU and laser therapy, respectively. Total failure rates after a second either 5-FU or laser treatment were 3.4%. The failure rates for flat condylomata were 50 and 16.6% after 5-FU and laser treatment, respectively. Recurrences, defined as the development of new disease after a nine-month disease free period were 7.4 and 10% for C acuminata after 5-FU and laser therapy, respectively. Twenty-five and 20% of women with flat condylomata treated respectively with 5-FU and the laser had recurrent disease. Acute urethrovulvar vaginitis occurred in 12.2% of the 5-FU-treated group, whereas complications were absent in those treated with the laser. Although the number of patients in each treatment arm was small and the patients were not randomized, intravaginal 5-FU therapy with protection of the vulva seems more cost effective for C acuminata in nonpregnant women than the laser, which requires general anesthesia. Flat condylomata are best managed by laser therapy. Refractory lesions successfully respond to laser-5-FU combination therapy. PMID- 6504422 TI - Role of attempted vaginal delivery in the management of placenta previa. AB - Sixty-nine documented cases of placenta previa were managed at The Mount Sinai Medical Center during a five-year period. Vaginal delivery was attempted in six instances of partial placenta previa and was successful in five (83%). For these six cases, intrapartum bleeding was not excessive, blood transfusions were not necessary during or after labor, and all Apgar scores were greater than or equal to 7 at one and five minutes. Anemia in a neonate delivered at 32 weeks of gestation was the only neonatal complication that may have been due to intrapartum fetal hemorrhage. This series suggests that routine cesarean section is not necessary for all cases of partial placenta previa. A protocol is proposed for the intrapartum management of suspected placenta previa at term. Further clinical studies are necessary to evaluate the safety and clinical use of this mode of management. PMID- 6504424 TI - Vaginal semiradical hysterectomy: a new operative procedure for microinvasive carcinoma of the cervix. AB - Thirty-five patients with stage Ia epidermoid microinvasive carcinoma of the cervix were treated surgically by vaginal semiradical hysterectomy. The primary features of this new surgical procedure are the removal of an approximately 1-cm portion of vaginal cuff, partial resection of the vesico-uterine ligament for isolation of the ureter, and resection of approximately 2 cm of parametrial tissue. The extent of resection is almost the same as that of the abdominal modified radical hysterectomy. Operation time and blood loss were almost the same as those for simple hysterectomy. No postoperative complications were observed. From these results it is concluded that the method is an adequate, safe, and low risk operative therapy for patients with microinvasive carcinoma of the cervix. PMID- 6504423 TI - Karyotyping from uncultured human trophoblast in the first trimester of pregnancy. AB - Chorionic villi were sampled by transcervical aspiration after ultrasonic localization of the chorion frondosum. Sampling was successful in 82 of 98 women. Subsequent karyotyping of the chorionic material was done by the modified Evans method. Mitoses of reasonable quality were obtained providing an easy cytogenetic diagnosis from human cytotrophoblast. A second trimester chorionic plate biopsy and direct karyotyping in case of severe oligohydramnios and malformed fetus revealing numerical (45, XO) chromosomal abnormality is also reported. PMID- 6504425 TI - Pregnancy and acute optic disc edema of juvenile-onset diabetes. AB - Acute optic disc edema is a recently recognized, relatively benign manifestation of juvenile-onset diabetes mellitus. Twenty-three cases have been reported in the ophthalmology literature, two occurring during pregnancy. The authors present an additional case recognized in a pregnant patient and review the literature. The disorder manifests physical findings similar to those of papilledema, proliferative retinopathy with optic disc edema, inflammatory papillitis, and ischemic optic neuropathy, but has a benign course that requires no treatment and is not adversely affected by pregnancy. It is important to recognize this syndrome because failure to make the correct diagnosis in pregnancy may lead to inappropriate treatment, including therapeutic abortion. PMID- 6504427 TI - Tubal pregnancy after vaginal hysterectomy. PMID- 6504426 TI - Respiratory arrest during therapy for premature labor in a patient with myasthenia gravis. AB - A case of premature labor in a woman whose pregnancy was complicated by myasthenia gravis is presented. Ritodrine was given for tocolysis, and betamethasone was administered to accelerate fetal lung maturation. An acute, life-threatening exacerbation of muscular weakness requiring intubation and mechanical ventilation occurred. It appears that betamethasone initiated the respiratory crisis. It is apparent, however, that tocolytic agents currently being used in patients with premature labor (namely, beta-2-sympathomimetics and magnesium sulfate) also have the potential to produce severe exacerbations of weakness, and even respiratory arrest in patients with myasthenia gravis. Each must be used with extreme caution if prescribed for women with this disorder. PMID- 6504428 TI - Reactivation blastomycosis presenting as a tuboovarian abscess. AB - A 32-year-old Korean woman presented with a rapidly enlarging abdominal mass six months after an undiagnosed illness of fever and a large pleural effusion. Exfoliative cytology of a cervical discharge revealed Blastomyces dermatiditis. At laparotomy, a large peritoneal inclusion cyst was found surrounding a tuboovarian abscess with involvement from the cervix to the peritoneum. B dermatiditis was cultured from the excised uterus and fallopian tube. Female genital blastomycosis has rarely been described. The importance of cytology in making the diagnosis in the present case is emphasized. PMID- 6504429 TI - Breast cancer in postmenopausal estrogen-progestogen users. PMID- 6504430 TI - Chronic illness associated with aging can be postponed. PMID- 6504431 TI - Fire safety in-service provides hands-on experience. PMID- 6504432 TI - Instructions and techniques for reliable audiometric tests. PMID- 6504433 TI - Proper design enhances effectiveness of lab fume hoods. PMID- 6504434 TI - Smoking: legalized addiction unacceptable to health economics. PMID- 6504435 TI - Three companies encouraged by results of health promotion. PMID- 6504436 TI - Excessive stress affects worker health, productivity. PMID- 6504437 TI - Growing older: a study of stress and transition periods. PMID- 6504438 TI - Have we really stopped exposing workers to asbestos? PMID- 6504439 TI - Audiometric testing: review of audiograms and worker referral. PMID- 6504440 TI - Dayton's "movers and shakers" get an inside look at medicine. PMID- 6504441 TI - Putting a pricetag on a practice: a look at both sides. PMID- 6504442 TI - Adverse systemic reactions of ocular drops. PMID- 6504444 TI - Nicotine chewing gum--an adjunct to smoking cessation. PMID- 6504445 TI - Children with special needs--a priority. PMID- 6504446 TI - Images of the medical profession in the movies. PMID- 6504443 TI - The association between electronic fetal monitoring and cesarean section rate in a private community hospital. PMID- 6504447 TI - The small screen's larger-than-life image. PMID- 6504449 TI - OSMA media training seminars: facing the camera. PMID- 6504448 TI - What the Ohio print media are saying about today's doctors. PMID- 6504450 TI - The pros and cons of marketing. PMID- 6504451 TI - Reconsidering your insurance. PMID- 6504452 TI - Attempted suicide in response to refusal of elective abortion. PMID- 6504453 TI - [Early clinical signs of wound infection of the eye]. PMID- 6504454 TI - [Prevention of intraocular bacterial wound infection]. PMID- 6504455 TI - [Results of prophylactic antibacterial treatment in perforating eye wounds]. PMID- 6504456 TI - [Results of laser retinometry in refractive amblyopia due to astigmatism]. PMID- 6504457 TI - [Results of using a laser retinometer attachment for the slit lamp]. PMID- 6504458 TI - [Method of determining the ACA (accommodative convergence as related to accommodation)]. PMID- 6504459 TI - [Results of the diploptic treatment of patients with accommodative convergent strabismus using Bagolini's striate glasses]. PMID- 6504460 TI - [Corneal endothelial function in patients with primary open-angle glaucoma]. PMID- 6504461 TI - [Comparative effectiveness of the local use of sodium nitrite, platyphylline and complamine in treating optic atrophy]. PMID- 6504462 TI - [Differentiation of the transudative (moist) form of complicated myopia from the dry form by the blood protein composition and permeability of the vascular wall]. PMID- 6504463 TI - [Dissemination of senile cataract among the population of Poltava Province consuming water with various fluorine levels]. PMID- 6504464 TI - [Use of Soviet-manufactured plastic eye prostheses]. PMID- 6504465 TI - [Light absorption by the retinal photoreceptors of the human eye]. PMID- 6504466 TI - [Experimental hypotension of the eye. Rabbit hyalocytes in tissue culture]. PMID- 6504467 TI - [Dynamics of the anatomico-optical parameters of the eye in schoolchildren with initial myopia]. PMID- 6504468 TI - [Surgical treatment of glaucoma in children]. PMID- 6504469 TI - [1400 microoperations in glaucoma in children (many years' experience in the treatment of congenital glaucoma)]. PMID- 6504470 TI - [Efficacy of microsurgical procedures in post-traumatic glaucoma in children]. PMID- 6504471 TI - [Late results of trabeculostomy in congenital glaucoma in children]. PMID- 6504472 TI - [Combined single-stage microsurgical procedures in retinal detachment complicated by glaucoma in children]. PMID- 6504473 TI - [Biomicroscopy and tonography in congenital infantile glaucoma (methodology and diagnostic significance)]. PMID- 6504475 TI - [Diagnosis of optic nerve atrophy]. PMID- 6504474 TI - [Clinical picture of transudative macular dystrophy in myopia]. PMID- 6504476 TI - [Evaluation of the condition of the oculomotor apparatus in endocrine ophthalmopathies]. PMID- 6504477 TI - [Determination of values for positive spherical lenses to correct presbyopia using nomograms]. PMID- 6504479 TI - [Therapeutic action of contrical instillations in purulent ulcerative keratitis]. PMID- 6504478 TI - [Efficacy of tissue therapy in vascular pathology of the organ of vision]. PMID- 6504480 TI - [Surgical tactics in the treatment of retinal detachment with tears in the central zone]. PMID- 6504481 TI - [Use of various aqueous substitutes to restore the anterior chamber after cataract extraction]. PMID- 6504482 TI - [Features and efficacy of surgical treatment of children with convergent strabismus after elimination of incorrect visual fixation]. PMID- 6504483 TI - [Variation of a simplified table for recording and analyzing eye injuries]. PMID- 6504484 TI - [Analysis of identification of illumination engineering parameters in devices for testing visual acuity and ways of standardizing them]. PMID- 6504485 TI - [Effect of lithium hydroxybutyrate on intraocular pressure and the blood supply of ocular vessels]. PMID- 6504486 TI - [Role of the basal complex (Bruch's membrane) in the pathogenesis of experimental toxic tapetoretinal dystrophy of the retina]. PMID- 6504487 TI - [Role of the primary and secondary aqueous humor in the development of traumatic cataract]. PMID- 6504488 TI - [Incidence of eye diseases in different regions of the world]. PMID- 6504489 TI - [Closed-angle glaucoma with iridolenticular block]. PMID- 6504490 TI - [Features of the correction of bilateral cicatricial deformity of the eyelids after deep facial burns]. PMID- 6504491 TI - [Reconstructive filling-in of wide defects in the iris as a result of eye injuries]. PMID- 6504493 TI - Combined evaluation of serum ribonuclease and ferritin: any advantages in pancreatic cancer diagnosis? AB - In 116 subjects, serum ribonuclease (RNase) and ferritin were determined in order to evaluate whether their combined evaluation might improve the diagnostic accuracy of each test. Significantly higher levels were found in pancreatic cancer patients both for RNase and ferritin than in control subjects and chronic pancreatitis. Sensitivity and specificity in diagnosing pancreatic cancer were 86% and 46%, respectively for RNase; 76% and 65% for ferritin. One of the two tests was pathological in 100% of pancreatic cancer, with a specificity of 29.9%; both were pathological in 62.1%, with a specificity of 82.1%. The results emphasize the limits of the combined assessment of pancreatic cancer markers. PMID- 6504492 TI - Distribution of antiestrogen-specific binding sites in normal and neoplastic mammary gland. AB - Recently, several investigators have demonstrated the presence of triphenylethylene antiestrogen binding sites in the cytoplasm of many tissues, which specifically bind to radioactive tamoxifen with high affinity. Although mammary gland is one of the principal target organs for antiestrogen action, the characterization of antiestrogen binding in mammary tissues has not been reported. We have studied the antiestrogen binding properties of [3H]tamoxifen in the mammary glands of virgin, pregnant and lactating rats as well as in the N methyl-N-nitrosourea-induced mammary tumors. Tritium labeled tamoxifen bound specifically and with high affinity (Kd = 10(-9) M) to components present in 25,000 g supernatant. Unlabeled estradiol or DES did not compete for these sites, whereas unlabeled tamoxifen showed competitive inhibition. The mammary glands contained threefold higher levels of cytoplasmic binding sites as compared to the mammary tumors. Mammary glands from the pregnant rats bound tamoxifen to a greater extent than that of either virgin or lactating rats. The functional relevance of these binding sites is still unknown. PMID- 6504494 TI - Clustering of the upper urothelial tumours in a family. AB - In a Balkan nephropathy endemic area, 5 siblings developed haematuria over a period of 10 years. 4 of them were operated on and pathohystological examination revealed papillary transitional cell tumours of the renal pelvis and/or ureters. Both these tumours and the Balkan nephropathy affected only 1 generation of the family members. This fact, as well as the other relevant evidence, indicated that environmental factors played an important role in the process of carcinogenesis. PMID- 6504495 TI - Aminoglutethimide-induced leukopenia: a case report and review of the literature. AB - A 67-year-old patient with breast carcinoma on treatment with aminoglutethimide (AG) developed profound leukopenia and sepsis. WBC count recovered within 1 week and the drug was renewed without further complications. The hematological toxicity of AG is reviewed. Detailed descriptions of this side effect of AG are usually lacking in most published series. It appears though that blood dyscrasia due to AG occurs rarely and is promptly reversible upon discontinuation of the drug, but renewal of its administration is not always possible. PMID- 6504496 TI - Plasma activity inducing polymorphonuclear neutrophils (PMN) aggregation, chemotactic plasma activity, and plasma activity augmenting PMN adherence in untreated patients with Hodgkin's disease. Possible relationship to disseminated intravascular complement activation. AB - The activity inducing PMN aggregation, the chemotactic activity, and the activity augmenting PMN adherence were estimated in plasma of 40 untreated patients with Hodgkin's disease. The first two activities were evident in all patients with advanced clinical stages (III and IV). It seems to be the result of disseminated intravascular complement activation due to the circulating immune complexes. The plasma activity augmenting PMN adherence was similarly noticed, except for 1, in patients with advanced stages of the disease, but only when the general symptoms were present. Our results, if confirmed, might be helpful in improving clinical staging of patients with Hodgkin's disease. PMID- 6504497 TI - Effect of unilateral nephrectomy on tumor growth of the murine renal cell adenocarcinoma and neuroblastoma. AB - Compensatory renal growth has been observed following contralateral nephrectomy in man and in certain animals. In a recent study of murine Wilms' tumor, tumor growth was observed to be affected by contralateral nephrectomy; therefore, a murine renal cell adenocarcinoma and neuroblastoma were evaluated. Comparison of tumors in sham-nephrectomized animals to tumors in mice who had undergone unilateral nephrectomy showed no significant increase in tumor weights. However, the contralateral kidney in the uninephrectomized animals had increased in weight as compared to that in tumor-bearing intact mice and the kidneys removed at uninephrectomy. This study demonstrates that factors influencing compensatory renal growth do not affect all renal tumors or other solid tumors. PMID- 6504499 TI - [Mutant gene expression in mouse aggregation chimeras. 3. The brachypodism-H gene]. AB - The expression of gene brachypodism-H (bpH) was studied on the 12-, 14-, 16-, 17 , 19-day old embryos and 20-day old bpH/bpH C/C----+/+ c + c mice. In 18 chimaeras, the percentage of pigmented cells in the retinal pigment epithelium varied from 2.5 to 84.0%, suggesting a different proportion of the mutant and normal cells in their tissues. The limb development was quite normal in all chimaeras: even in the presence of 84% of mutant cells the lengths of femur, fibula and foot did not differ from those in the control animals. The differentiation and histogenesis of these bones proceeded also quite normally. No increase in cell degeneration was noted and the bpH/bpH cartilage cells were missing, indicating the normalization of the mutant chondrocytes. The absence of the bpH gene expression in the chimaeras appears to be due to a metabolic cooperation between the mutant and normal cells taking place at the early stages of limb development. PMID- 6504498 TI - [Formation of the external zone of the median eminence of rats in the perinatal period]. AB - The formation of interrelations of the axons of neurosecretory cells and of ependyme cells with the capillaries of primary portal plexus in rats from the 14th day of embryogenesis till the 9th day of postnatal life was studied using the light and electron microscope methods. During the whole period under study, the basal processes of the ependyme cells reach the primary portal plexus of the capillaries. The terminals of the basal processes are usually separated from the endothelium of the capillaries by two basal membranes and enclosed pericapillary space. After the birth, some basal process penetrate in the pericapillary space and terminate on the endothelium. The surface of contact of the ependyme cell processes with the external basal membrane increases with the age, this being accompanied by the increase of pinocytotic activity. The neurosecretory axons are found in the median eminence already on the 14th day of embryogenesis, but by the 20th day only they reach the external basal membrane and penetrate sometimes in the pericapillary space. After the birth, the number of axons reaching the external basal membrane and the surface of contact between them increase gradually with, apparently, a concomitant intensification of the transport of neurohormones in the portal circulatory system of the hypophysial-hypothalamic complex. PMID- 6504501 TI - [Nuclear behavior of embryonic cells and growing oocytes from the clawed toad in the cytoplasm of maturing axolotl oocytes]. AB - The behaviour of the nuclei of the X. laevis vitellogenic oocytes was studied by their transplantation into the cytoplasm of the axolotl maturing oocytes. After the germinal vesicle breakdown, in the case the transplanted nuclei were located close to each other a common giant spindle united the chromosomes of all transplanted nuclei. A mosaic spindle united sometimes the chromosomes of the two amphibian species. The embryonic nuclei transplanted in the cytoplasm of the maturing oocytes formed, after the nuclear envelope breakdown, individual spindles, sometimes united in multipolar figures. Thus, the nuclei of different cell types, embryonic cells and germ cells, behave in a different way in the same environment, the cytoplasm of the maturing oocytes. PMID- 6504500 TI - [Characteristics of the proliferative activity of the aggregates forming during recombination of the epithelium and mesenchyma of embryonic lungs from intact and carcinogen-treated mice]. AB - Methods of separation of the mouse embryonic lung mesenchyme (M) and epithelium (E) and obtaining homolinear and heterolinear organotypic aggregates of E and M from the intact and urethane-treated (transplacentally) A and C57BL mouse embryos. In the aggregates formed by E and M from the experimental A embryos, the index of labelled nuclei (3H-thymidine incorporation) in both the tissue components was several times that in the aggregates of E and M from the intact embryos. M from the experimental embryos aggregated with E from the intact embryos increased the proliferative activity of the latter 4 to 11 times, whereas M of the intact embryos aggregated with E of the experimental embryos decreased its proliferative activity to the normal level. A suggestion is put forward that the embryonic lung mesenchyme plays an important role in the realization of transplacental carcinogenic influences and in the development of lung epithelial tumours. PMID- 6504502 TI - [Use of highly sensitive radioautography for determining the optimal conditions for obtaining hybridomas]. AB - To detect the hybrid cells forming as a result of fusion of the mouse myeloma cells with the immunic mouse splenocytes, a radioautographic method was used which involved the application of 3H-hypoxanthine as a labelled precursor of nucleic acids and of high-sensitive UK emulsion for accelerated preparations of autographs. The optimal conditions of hybridization providing for the maximum yield of hybrid cells and hybrid clones in our experiments were: use of polyethylene glycol ("Loba", mol. weight 4000) in 50% (w/v) concentration, of NS O or X-653 myeloma cells in the ratio of parental cells 1:5 (myeloma cell: splenocyte). PMID- 6504503 TI - Delayed hyphema after argon laser iridectomy. AB - A 77-year-old black woman without neovascularization developed spontaneous hyphema two days after laser iridectomy. Bleeding originated at the site of iridectomy. This complication has not been previously reported. PMID- 6504504 TI - Histopathologic verification of position of laser burns in argon laser trabeculoplasty. AB - Surgical trabeculectomy was performed on 10 eyes of 10 patients following failure of argon laser trabeculoplasty. All specimens were examined by scanning electron microscopy to determine anatomic location of laser damage. Correlation with clinical data revealed accurate placement of laser burns in 11 out of 13 treatment sessions. The degree of laser injury varied with energy delivered and pigmentation of the posterior trabecular meshwork. Complications such as corneal endothelial, oblique, and confluent burns were present in 50% of cases studied. PMID- 6504505 TI - Lamellar tarsoplasty--a new technique for correction of horizontal tarsal kink. AB - A case of a congenital upper lid entropion with corneal ulceration is reported. The surgical repair by means of a lamellar tarsoplasty is presented as a simple technique to correct the congenital anomaly of a tarsal kink. PMID- 6504508 TI - New tips on use of the Cavitron unit. PMID- 6504506 TI - I'd rather have my surgeon do a good technical job than speak well. PMID- 6504507 TI - Fluorescein staining of formed vitreous to aid in vitrectomy. PMID- 6504509 TI - "Thanks again, Harvey". PMID- 6504510 TI - Radial keratotomy. PMID- 6504511 TI - Free-floating cells in the endolymphatic sac after surgical utricular nerve section. AB - Free-floating cells (FFC) in endolymphatic sac (ES) were microscopically examined, counted, and statistically studied in 8 squirrel monkeys after the unilateral section of the utricular nerve (UNS). After the operation these monkeys were kept for 17-38 days until the acquisition of functional (locomotor balance) compensation was completed. The result showed twice more FFC in the ES on the operated side, than those on the nonoperated side. The result showed a significant increase (p less than 0.05) of FFC in the ES under the pathological condition with autogenous debris in the endolymphatic space, and proved the existence of some reactive role of the ES to the labyrinthine insult. PMID- 6504513 TI - Saccades--random or constant stimuli and predictive adaptability. AB - The influence of the predictive adaptability on saccades was studied in 20 normal subjects ranging in age from 18 to 43 years. The average velocity of random and constant saccades showed almost the same results. The maximum velocity of constant saccades was slightly faster than that of the random saccades. The latency of the random saccades was shorter than that of the constant ones. Thus, the predictive adaptability of the stimuli has little influence on the maximum velocity and on the latency of saccades in normal subjects. PMID- 6504512 TI - Defense mechanism of the cochlear aqueduct against infection. A morphological study in the guinea pig. AB - Guinea pigs were used in this study. Physiological saline, india ink, and Staphylococcus aureus were injected into the cisterna magna, and S. aureus was also injected into the scala tympani. Changes in the microstructure of the cochlear aqueduct were observed by light microscopy and also by scanning electron microscopy, mainly by means of fracture preparations. From these experimental results, it could be confirmed that the periotic duct tissue of the cochlear aqueduct reacted especially to bacterial infection. PMID- 6504514 TI - Desquamation and squamotransformation of rhinomucosa as a prodromal sign of atrophic rhinitis. AB - The desquamation and squamotransformation of rhinomucosa is described in 10 patients who developed typical atrophic rhinitis later. It may be considered a prodromal sign of atrophic rhinitis, and may be helpful in early diagnosis. PMID- 6504515 TI - [Measuring the fructose level of the cervical mucus in infertile marriages]. PMID- 6504516 TI - [Management of infantile Hodgkin's disease with combined chemotherapy]. PMID- 6504517 TI - [Repeated plasma exchange for xanthomatosis in a case of primary biliary cirrhosis]. PMID- 6504518 TI - [Clinical and echocardiographic diagnosis of infectious endocarditis of the pulmonary valve]. PMID- 6504519 TI - [Peroxide hemolysis of the red blood cells of diabetic children]. PMID- 6504520 TI - [The role of percutaneous puncture of the kidney pelvis in urologic practice]. PMID- 6504521 TI - [Incidence of fetal damage after the 1978-79 measles epidemic in northeastern Hungary]. PMID- 6504522 TI - [Eosinophilic meningoencephalitis in childhood (Toxocara infestation?)]. PMID- 6504523 TI - [Successful treatment of injuries involving the common carotid]. PMID- 6504524 TI - [Roentgenologic examination of the stomach and colon]. PMID- 6504525 TI - A flash of light: a personal review of 21 years of study of the electrical activity of the visual pathway beyond the retina. PMID- 6504527 TI - Comparison of laser and infrared techniques for measurement of the resting focus of accommodation: mean differences and long-term variability. AB - The resting focus of accommodation was measured in the same subjects with both a laser optometer and a high-speed infrared optometer. Although i.r. optometer and laser optometer measures produce similar estimates of the mean resting-focus level in some subjects, others were found to have different levels of resting focus with the two techniques. Control studies demonstrated that these differences were not due to the temporal sampling characteristics of the laser optometer, but resulted instead from making judgments about the direction of speckle motion during the laser optometer procedure. The temporal stability of the resting focus of accommodation was also investigated with i.r. measures obtained several minutes, 1 day, and 1 and 2 weeks apart. Results indicated long term variability similar to that previously reported with the laser optometer. PMID- 6504526 TI - Short-term variability of the resting focus of accommodation. AB - Previous investigations have shown that, in dim illumination and empty visual fields, accommodation in most observers is for an intermediate distance referred to as the dark focus or resting focus of accommodation. Dynamic properties of the resting focus were examined in the present study with a high-speed infrared optometer. All subjects displayed fluctuations of accommodation in darkness that were primarily characterized by frequency components below 0.5 Hz. These fluctuations were substantially attenuated during cycloplegia or viewing a bright, high-contrast target. Both the mean resting-focus position and the magnitude of fluctuations varied from one subject to another and from day-to-day. A weak association was found between the mean a standard deviation of accommodation responses in the dark. The present findings suggest that the accommodation mechanism in most observers is somewhat unstable under degraded viewing conditions. In addition, the mean resting-focus value for a large sample of subjects was found to be lower for i.r. optometer measurements than for previous investigations employing a laser optometer. PMID- 6504528 TI - Fixational eye movements and autokinesis in amblyopes. AB - Eye movements were recorded from amblyopic and non-amblyopic eyes during monocular viewing of a small target on either a patterned or a patternless background. A continuous measure of autokinesis was also obtained. The variance in eye position was greater in amblyopic eyes than in non-amblyopic eyes. The presence of a patterned background did not reduce the variance in eye position of amblyopic eyes. Autokinesis was greater in amblyopic eyes, but was not correlated with the eye movements. A patterned background significantly reduced the magnitude of autokinesis in amblyopic eyes. These results provide support for the hypothesis that a patterned background improves the accuracy of visual direction by reducing spurious extraretinal signals. PMID- 6504529 TI - Astigmatic decomposition: an alternative subjective refraction test employing conventional instrumentation. AB - The Humphrey Vision Analyser introduced the refractive technique of astigmatic decomposition with the aid of Alvarez continuously variable sphere-cylinder lenses. The adaptation of astigmatic decomposition to conventional trial lens systems and a Stokes' lens is described. Refractive errors measured by this technique and by crossed cylinder are compared in 33 optometric patients (one eye each) to assess the relative validity of the method, which compares well with data published on the Humphrey Vision Analyser. Astigmatic decomposition can be considered as an alternative subjective refraction test to more conventional methods. PMID- 6504531 TI - Two spectacle lenses for aphakia. AB - Many different designs have been produced for aphakic power spectacle lenses. Two lenses are described which have a common design aim--to produce a lens of uncut diameter but reasonable cosmetic appearance and weight. These lenses both utilize a continuous aspheric surface on the front surface, which enables them to have a stabilized central power zone and a near plano peripheral flange, but without the disadvantages of the traditional lenticular construction. PMID- 6504530 TI - The choice of laser speckle exposure duration in the measurement of tonic accommodation. PMID- 6504532 TI - Mean and variance of meridional powers of sphero-cylindrical prescriptions. PMID- 6504533 TI - Prenatal genetics. PMID- 6504534 TI - [Handling the diagnosis: normal development]. PMID- 6504536 TI - [Prechtl's optimal concept--a review; with conclusions for medical practice]. PMID- 6504535 TI - [Definition, classification and evaluation of risk factors in obstetrics and pediatrics]. PMID- 6504537 TI - [The hematocrit--blood viscosity relations in childhood]. PMID- 6504538 TI - [Career choice of diabetic children]. PMID- 6504539 TI - [Spondylometaphyseal dysplasia--apparently Feldman type]. PMID- 6504540 TI - [Metabolic myopathies]. PMID- 6504541 TI - [Cares and hopes of the pediatrician]. PMID- 6504542 TI - [Nutrition in the child with diarrhea]. PMID- 6504543 TI - [Nutrition in congenital metabolic diseases]. AB - Today we know a great number of inborn errors of metabolism which can be treated by a special diet. The principle of therapy consists in a reduction or elimination of certain substances from feeding or in supply of substances which cannot be synthesized by the organism. The method of withdrawing these substances which cannot be degradated, as Phenylalanine in Phenylketonuria, was translated later to other disturbances as in the degradation of carbohydrates and lipids. In certain diseases, especially in those with hyperammonemia, it is possible only with a decrease in protein intake to overcome the illness, in others cofactor therapy in great doses may help. In phenylketonuric mothers diminishing of Phenylalanine in diet may avoid the non-phenylketonuric child of intrauterine Phenylalanine intoxication. The period in which therapy must be given is different. In some diseases diet can be finished after some years, in others it must be continued for the whole life. PMID- 6504544 TI - [Osteogenesis imperfecta: contribution to pathobiochemistry]. AB - Osteogenesis imperfecta (OI) is a hereditary disease characterized by increased bone fragility and marked skeletal deformities. As a generalized connective tissue disorder, many patients present with other typical symptoms, such as blue sclerae, dentinogenesis imperfecta, impaired hearing, joint laxity, and easy bruising of the skin. According to clinical and genetic characteristics, Sillence classified four different groups. Metabolic alterations of connective tissue components are thought to be responsible for the pathogenesis of OI. Collagen, the main constituent of connective tissue, was analyzed in autoptic tissue and/or skin fibroblasts from patients with OI. In fibroblast culture of patients with OI group I, the range of synthesized collagen type III is elevated to 15-48% (normal up to 15%). Patients in groups II and III show an increased presence of hydroxylysine in alpha-chains of collagen types I and III. The hydroxylation of lysyl residues of the cartilage specific collagen type II is slightly elevated. In both groups, the hydroxypyroline content in all tested collagen types was normal. In our investigation, the collagen of patients with OI group IV appeared normal. Although the clinical features of patients with OI of all groups were not homogeneous, OI group III and some subtypes of group II had similar clinical courses and biochemical findings. In addition, there are patients with OI who present with clinical symptoms, but who cannot be classified into any of the known groups. For a better differentiation, biochemical examination of collagen should be performed complementary to clinical and genetic criteria. PMID- 6504545 TI - [Physiopathology and therapy of severe cerebral hypoxia]. AB - The pathophysiological mechanisms of severe cerebral hypoxia (in men) are discussed: disturbance of autoregulation, vasoparalysis, luxury perfusion, cytotoxic and vasogenic brain swelling, rise of intracranial pressure (ICP), stop of cerebral circulation. Possible trials of therapy are presented: restitution of cardiovascular circulation, controlled hyperventilation, control of ICP, dexamethason bolus, early high-dose barbiturates. PMID- 6504546 TI - [Mortality and morbidity of newborn infants in intensive care (birth weight less than 1,501 grams)]. AB - A comparative analysis of the mortality and morbidity of premature infants with a birthweight below 1.501 g, born in the years 1974, 1978 and 1981, is given. The mortality rate has remained unchanged in the years 1974 (when a neonatal intensive care unit was installed at the University Children's Hospital Graz) and 1981 with 33% and 32% respectively. The total number of admissions rose from 36 (1974) to 67 (1978) and 91 (1981). Simultaneously the number of patients, who needed neonatal intensive care increased. Whilst in 1974 only 2 of 24 surviving infants needed artificial ventilation, in 1978 19 of 38 patients had respirator therapy. Despite the increasing severity of neonatal affections the number of severe handicaps caused by perinatal complications remained constantly low with altogether 5 cases in the years 1978 and 1981. Two children had a spastic tetraplegia, two others had a posthaemorrhagic hydrocephalus and one child was blind due to bilateral septic abscesses of the vitreous body. Only two of these children had long time artificial ventilation. Approximately 80% of the surviving children exhibited normal psychomotor development and showed no neurological sequelae. This rate was unchanged in the investigated periods. PMID- 6504547 TI - [Early diagnosis of hip dysplasias]. AB - Neonatal hip examination is only effective with the help of a large number of experts. Teamwork between pediatrician, pediatric orthopedic surgeon and general practitioner seems to be essential. Best results can be achieved with a hip examination during the first 4 days of life and controls with 3 months and with 12 months. The technic of clinical examination and diagnosis is described. Because of hip dysplasias without any clinical signs the importance of an x-ray of the hip with an age of 3 months is emphasized. PMID- 6504548 TI - [Rooming-in as a therapeutic possibility for a 6-year-old autistic girl]. AB - The possibilities of rooming-in as a form of therapy for the psychic abnormal child are demonstrated on the basis of the example of a mother-child-therapy, which lasted six weeks and happened during the stay of mother and child on our station. The patient was a six year old, intellectually retarded girl with autistic behavior disturbances. The points of main effort in our therapeutical interventions were set on reaching a higher selfreliance of the patient as far as every day life-routine was concerned, further more on increasing the child's social and intellectual capabilities and on eliminating the girl's sleeping troubles. In order to reach these aims we started a training in behavior modification (operant conditioning, modeling) for mother and child. The remarkable developmental progresses of our patient are attributed most of all to the thorough efforts that were made in order to improve the abilities of the girl by modifying the contact between mother and child. Besides, the possibility of being able to use the whole day for therapy, to discuss and,--if necessary--to correct immediately the learning experiences that have been made, seems to be a great chance for reaching the appropriate forms of action and interaction in a quicker way. PMID- 6504549 TI - [You make the diagnosis: congenital hereditary lymphedema]. PMID- 6504550 TI - A positive feedback loop between spinal cord nociceptive pathways and antinociceptive areas of the cat's brain stem. AB - Electrophysiological evidence has been obtained suggesting the presence of reciprocal excitation between descending pathways from the nucleus raphe magnus (NRM) and adjacent reticular formation (Ret.F) and spinal cord neurones projecting to these brain stem areas. In decerebrate and decerebellate cats, 40 spinal cord neurones were recorded whose recording sites were in or close to lamina VIII of the lumbar spinal cord. All 40 neurones recorded in the lumbar cord were postsynaptically excited by electrical stimulation of the NRM, the Ret.F. or most commonly, of both. The excitation was mediated by fast-conducting fibres and lasted for over 100 msec after a single shock. The shortest latency responses were obtained following stimulation of the contralateral Ret.F. These neurones had complex peripheral inputs subjected to descending controls. All the neurones could be excited by deep pressure of the ipsilateral and/or contralateral hind limbs. Peripheral inhibitory inputs were also observed. Eighteen out of the 40 neurones had axons that projected to NRM and the adjacent Ret.F. Conduction velocities ranged between 31.6 and 91 m/sec. In addition, 11 other axons were recorded in the white matter of the cervical cord from neurones projecting to NRM and Ret.F. Conduction velocities of this group of axons ranged between 13 and 70 m/sec. The majority of the axons projecting to NRM and Ret.F. were found to join pathways in the ventro-lateral quadrant of the spinal cord either ipsi- or contralaterally to their Ret.F. destination. Recordings were also made from 12 neurones whose recording sites were located in the NRM and Ret.F. Their responses to electrical stimulation of sites within lamina VIII of the lumbar spinal cord were studied. Only excitatory responses could be evoked by such stimulation. These results are discussed in relation to the mechanisms of activation of central antinociceptive systems. PMID- 6504551 TI - Internists and the chronic pain patient. AB - This study investigated the prevalence of chronic pain and the characteristics of the chronic pain population. Four hundred and seven Board Certified internists (with a 26% return rate) were surveyed to determine the characteristics of the population, treatment approaches used, treatment problems and outcomes, and the internists' educational needs. The results of this study suggest that there is a high prevalence of chronic pain with the majority of the patients being female and over 55 years of age. It was also found that internists attend to the disorder with a restricted range of treatments, patient reactions often interfere with the treatment of the disorder, and the internists have little or no formal education in the treatment of this disorder. PMID- 6504552 TI - Childhood pain: the school-aged child's viewpoint. AB - This interview study was designed to obtain a substantial body of information about childhood pain from a large cohort (n = 994) of Northern Californian school children between the ages of 5 and 12 years. The primary criteria for assignment to groups were extent of hospitalization experience, recency of hospitalization, presence of a painful chronic condition, and chronic iatrogenic pain. Open-ended questions were used to determine the extent of the children's knowledge and understanding of pain, their ability to describe pain, specific pain experiences, use of coping strategies, preferences concerning the timing of information about impending pain, and maladaptive pain usage. There was unequivocal evidence of the children's ability to communicate effectively concerning their pain, however, knowledge and understanding of pain for most of the sample was at a low developmental level, with no clearly defined age trends and no sex differences. There was relatively low use of coping strategies and the frequency of maladaptive pain usage was disquieting. PMID- 6504553 TI - Anticholinesterase drugs in the treatment of chronic pain. AB - Two patients with severe thalamic pain and one patient with causalgia from the shoulder-hand syndrome are described whose pain was markedly improved or abolished by anticholinesterase drugs. Both short-acting parenteral and oral anticholinesterase preparations were employed. Anticholinesterase drugs are a new and potentially valuable approach to the treatment of chronic pain. PMID- 6504554 TI - Is the temporo-mandibular pain and dysfunction syndrome a disorder of the mind? PMID- 6504555 TI - Tissue eosinophilia and Leishmania mexicana mexicana eosinophil interactions in murine cutaneous leishmaniasis. AB - Outbred albino mice were infected subcutaneously with 10(6) amastigotes of Leishmania mexicana mexicana and the subsequent lesions were evaluated by light and electron microscopy at various intervals after infection. The animals developed persistent nodules and a spectrum of lesions of variable size which was correlated with the host's ability to control the parasite in the tissue. During the acute phase of the disease the histopathological results showed an accumulation of granulocytes, some mononuclear phagocytes and a predominance of eosinophils as compared to other cell types. In this early acute phase, eosinophils were found in the tissue together with normal and degranulating mast cells. In the granulomatous inflammatory reaction of the chronic phases, there was infiltration of granulocytes parallel to parasite multiplication and the formation of parasitized vacuolated macrophages. The number of eosinophils was consistently greater than neutrophils, regardless of lesion type or number of parasites present in the tissue. During the acute reaction, the granulocytes apparently destroyed many parasites; however, there was an unvaryingly low level of phagocytosis of amastigotes during the chronic stages by both eosinophils and neutrophils. Neutrophils seemed to be more effective than eosinophils in the killing of ingested parasites. A close association between eosinophils and parasitized macrophages was seen in the chronic lesions; thus, eosinophils might contribute to parasite destruction through co-operation with macrophages. PMID- 6504556 TI - Immunoglobulin interactions with surfaces of sheathed and unsheathed microfilariae. AB - The sheath surface of Brugia pahangi microfilariae (mf) and the cuticle surface of Dirofilaria immitis mf were compared with regard to the ultrastructural arrangement of neutral and charged polysaccharides and binding of immunoglobulins from dog sera. Brugia pahangi: mf demonstrated large amounts of neutral sugar and negatively charged sugars just above the sheath surface, projecting some distance from the surface, in addition to a dense layer of sulphated material on the sheath surface. Microfilariae from high microfilaremic dogs showed no innately bound IgG or IgM when examined fresh from serum nor did they bind IgG or IgM from normal (NDS) or infected (IDS) dog sera after 48 h maintenance in RPMI 1640. Many of these mf did bind IgG and IgM from hyperimmune dog serum (ImDS) and these immunoglobulins were found binding at a distance from the sheath similar to that of the sugars. Dirofilaria immitis mf demonstrated much less neutral sugar at the cuticle surface, no negatively charged sugars and a diffuse, rather than dense, distribution of sulfated material extending from the cuticle. The majority of these mf showed innately bound IgG and IgM. After 48 h maintenance in RPMI 1640 D. immitis mf bound and shed IgG and IgM from NDS, high microfilaremia D. immitis IDS and D. immitis mf ImDS at distinctly different rates. PMID- 6504558 TI - Proceedings of the British Society for Parasitology. Bristol, 4-6 April 1984. Abstracts. PMID- 6504557 TI - Immunological and ultrastructural aspects of the cell-mediated killing of Dirofilaria immitis microfilariae. AB - Neutrophils in the presence of serum from dogs with occult Dirofilaria immitis infections were shown to be cytotoxic to D. immitis microfilariae recovered from the blood of microfilaraemic dogs. This cytotoxicity was correlated with the presence of IgM and IgG antibodies on the cuticular surface of microfilariae incubated in the sera from occult dogs. Such antibodies were not observed on the surface of microfilariae incubated in sera from microfilaraemic or normal dogs. The neutrophil attack was directed at the cuticular crypts, at which sites the worms appeared to be structurally most vulnerable because of the absence of the outer layer of the cuticle. The IgM antibodies were shown to be bound preferentially to these sites. Our data suggested that the neutrophil-mediated toxicity involved both hydrogen peroxide release and degranulation. PMID- 6504559 TI - Parasite density and the fecundity of Angiostrongylus cantonensis in rats. AB - The larval output of Angiostrongylus cantonensis at different initial densities in rats was examined throughout the reproductive life-span of the worms using a modified dilution technique. With an initial density of 2 worms the mean duration of larval output was 414.2 days. The output was at a level above 50000 larvae/female/day from 15 to 45 weeks after infection. The mean total output was 18.9 X 10(6) larvae/female. The larval output/female decreased with an increase in the worm burden and also with the passage of time after infection. The longevity of host rats also decreased with increasing worm density and many of the heavily infected rats died early during infection. These results suggest that worm density has an effect on the fecundity of this parasite, and that the effects may be due to fibrous changes in host lung tissue but not changes in the physiology of the worms. It is also suggested that density-dependent effects on fecundity play a role in the population dynamics of both the parasite and host as regulatory mechanisms in the field. PMID- 6504560 TI - Identification of an antigen of Onchocerca volvulus of possible diagnostic use. AB - Adult Onchocerca volvulus worms obtained by enzyme digestion from nodules of infected Mexicans were radio-isotope labelled by the chloramine-T or Bolton Hunter methods. No antigenic determinants were detected in extracts of worms labelled by the chloramine-T method but 3 antigens were detected in extracts of the Bolton-Hunter labelled worms. Two were present in such small amounts that it was impractical to investigate them further, but a major component of mol. wt 20 kDa was purified by gel filtration and used in a serological survey of inhabitants of villages in Southern Mexico. Using the 20 kDa antigen, which is superficially located on both sexes of O. volvulus, sera from both non-endemic and endemic regions were analysed by radio-immunoprecipitation of this antigen. In Southern Mexico, the average sensitivity of the test was 92%, and the specificity 98%. Whilst the 20 kDa antigen did not detect antibodies in the sera of Trinidadians infected with Wuncheria bancrofti or Mansonella ozzardi, this antigen detected high levels of antibodies in Indians exposed to W. bancrofti. PMID- 6504561 TI - Enzyme variation in Trypanosoma brucei spp. I. Evidence for the sub-speciation of Trypanosoma brucei gambiense. AB - Three groups of stocks of Trypanosoma brucei ssp, defined by the criteria of host, human serum resistance and place of isolation as T. b. gambiense, T. b. brucei (Nigeria) and T. b. brucei/rhodesiense (non-gambiense, Uganda) were screened for electrophoretic variation at 20 enzyme loci. One enzyme (Peptidase C) was found to differentiate all T. b. gambiense stocks from the other T. brucei stocks and, taken together with specific variants of 5 other enzymes, could be used to unambiguously define T. b. gambiense stocks. Using a population genetics approach, the frequencies of the different variants in the three groups of stocks were estimated and from them the average similarity and difference between groups were measured using the statistics of genetic identity (I) and genetic distance (D). These results show firstly, that T. b. gambiense is more different from the other two groups than they are from each other and, secondly, that the values of I and D obtained are consistent with T. b. gambiense constituting a sub- or sibling species of T. brucei. Three domestic animal isolates from Zaire and Cameroun were also screened for enzyme variation and two of these identified as T. b. gambiense, thereby establishing the existence of an animal reservoir host. In parallel, these stocks were tested for human serum resistance resulting in the same identification. Studies of the antigen repertoires and antigen gene structure were carried out by other workers on all the T. b. gambiense stocks reported here and the same conclusions reached as to the identification and ability to discriminate this subspecies from other groups of T. brucei stocks. The results presented here are discussed in relation to other published data on enzyme variation in T. brucei. PMID- 6504562 TI - Immunization of rats against Schistosoma mansoni using irradiated cercariae, lung schistosomula and liver-stage worms. AB - In PVG rats a single immunizing infection with Schistosoma mansoni cercariae exposed to 0, 5, 10 or 20 krad. gamma radiation failed to induce more than minimal resistance (17-29%) to challenge 4 weeks later, whereas 4 immunizations with 20 krad.-irradiated cercariae, over several months, induced substantial resistance (75%). In contrast, significant protection was induced in Fischer rats by a single immunization with unirradiated cercariae or cercariae irradiated with up to 80 krad. Comparable resistance was induced by unirradiated and by 2, 5 and 20 krad.-irradiated cercariae (67-74%) and lower levels by 10, 40 and 80 krad. irradiated infections (57, 48 and 33%, respectively). Although the resistance induced by a single dose of 1000 20 krad.-irradiated cercariae could be boosted by a second (88%), further immunizations failed to enhance this resistance. Also, increasing the number of immunizing cercariae in single or multiple vaccinations from 1000 to 3000 failed to increase the resistance. While the resistance induced by 20 krad.-irradiated cercariae persisted undiminished for at least 25 weeks (67%), the resistance induced by normal cercariae declined to insignificant levels by 25 weeks (21%). Comparison of the migration and survival of unirradiated and of 20 and 40 krad.-irradiated cercariae revealed dramatic differences in their fate: parasites exposed to 40 krad. remained in the skin, while the majority of 20 krad.-irradiated parasites died in the lungs after a sojourn of at least 14 days. Thus, although skin schistosomula alone could induce significant protection, optimal resistance was induced only by parasites which migrated to the lungs or beyond. The immunizing potential of these older parasites was investigated by exposing rats to lung- and liver-stage larvae injected into the tail and mesenteric veins, respectively. Irradiated 4-day lung schistosomula induced comparable resistance (79%) to that induced by a complete unattenuated cercarial infection (78%), whereas less resistance was induced by irradiated and unirradiated 11-day-old liver worms (30 and 27%) and by 25-day-old pre-adult worms (48%). PMID- 6504563 TI - Factors affecting the acquisition of resistance to Schistosoma japonicum in the mouse. I. The correlation between egg deposition and worm elimination. AB - Acquired resistance to Schistosoma japonicum was evident after the lung phase of migration of challenge schistosomula. 'Trickle' infections which gave similar primary worm burdens to single infections stimulated similar levels of resistance. There was a strong correlation between the size of the primary worm burden of individual mice and their ability to resist infection 8 weeks after exposure to S. japonicum. However, acquired resistance did not develop until 6 weeks, that is after the primary infection had become patent, and was maximal some 12 weeks after infection; thereafter resistance declined. The numbers of parasite eggs deposited in the tissues increased during acute infection (duration of 12 weeks or less) and tended to stabilize or decrease during chronic infection (longer than 12 weeks). There were good correlations between the resistance of mice to challenge and the numbers of eggs deposited in their livers, guts or lungs during acute infection, but these correlations were not evident during chronic infection. The inflammatory responses to tissue-bound eggs regress during chronic infection and this may influence the relationship between acquired resistance and egg burden. Comparable primary infections of S. japonicum or S. mansoni protected equally well against both heterologous and homologous challenges. However, unisexual infections of S. mansoni, which produced no overt pathology, failed to confer protection against a challenge of S. japonicum. PMID- 6504564 TI - Intergeneric reproductive stimulation and parthenogenesis in Schistosoma mansoni. AB - When mice were infected with female cercariae of Schistosoma mansoni and male cercariae of Schistosomatium douthitti, many mixed pairs formed. The paired females were approximately the same size as those in unisexual infections, far smaller than females paired with S. mansoni males. Although the Sch. douthitti males possessed well-developed testes, sperm were not found in their female partners, which developed scanty vitelline glands and produced laterally spined eggs typical of S. mansoni. Such eggs yielded swimming miracidia infective to the snail host of S. mansoni, Biomphalaria glabrata, but not to the lymnaeid snail host of Sch. douthitti. Sporocysts arising from these miracidia were haploid and produced cercariae infective to mice. Parthenogenetically derived female cercariae in mice co-infected with either parthenogenetically derived male or normal diploid male S. mansoni developed to large adults of normal appearance, whose eggs yielded diploid miracidia and subsequent generations of normal diploid schistosomes. Parthenogenetically derived females co-infected with Sch. douthitti males also paired and produced some eggs containing viable miracidia, which gave rise once again to haploid sporocysts. These observations confirm previous suggestions that the stimulus for maturation in female S. mansoni is distinct from that for growth, and is independent of insemination and fertilization. It is concluded that both diploid and haploid S. mansoni females are capable either of parthenogenesis or of bisexual reproduction when appropriately stimulated. PMID- 6504565 TI - [Summaries of communications presented at the annual meeting of the Fondation de Recherche en Hormonologie. (Paris) 26 January 1984]. PMID- 6504566 TI - [In vitro biosynthesis of estradiol in the testis of immature rats]. PMID- 6504567 TI - [Mechanisms of action of the testicular crisis in the newborn rat]. PMID- 6504568 TI - [Effects of sexual steroids on thymidine incorporation in human lymphocytes and on serum so-called thymidine activity]. PMID- 6504570 TI - [The microcomputer in bacteriology. Value in the automated performance of antibiograms in hospitals]. AB - In microbiology, most computerization is carried out by means of important centralized computers. On the contrary, our work is based upon the use of inexpensive microcomputers. We have developed general programs for the acquisition of data, their correction, and retrieval of lists arranged according to desired parameters (hospital department, germ, or sample) and various statistics, especially with respect to germ sensitivity. This system has been used on a routine basis since April 1982 in the Bacteriology Laboratory of Nancy University Hospital. It could easily be adapted to other laboratories and could provide a wide range of essential epidemiological data on the resistance of bacterial strains to antibiotics and their evolution with time. PMID- 6504569 TI - [Male contraception. Gonadal and adrenal functions in men treated with medroxyprogesterone]. PMID- 6504571 TI - [A specific radioimmunologic assay for human placental alkaline phosphatase and its clinical applications]. AB - A radioimmunoassay specific for placental alkaline phosphatase (PALP) has been performed. Sera from blood donors contain less than 15 micrograms of PALP per liter. The amounts of PALP found in sera of pregnant women are higher, as soon as the first trimester of the pregnancy, increasing until delivery (50-600 micrograms of PALP L I). Only 3,5% of the patients with various cancer diseases have amounts higher than 25 micrograms PALP/I. PMID- 6504572 TI - [Sensitization by repeated skin tests with candidin and PHA]. AB - Intra-dermal skin tests (IST) were applied with candidin (1:100) in 37 subjects and repeated 10 days later. The induration diameter of the second injection (read at 48 h) was greater (p less than 10(-8]. A correlation (r = 0.76, p less than 0.001) appears between the first and second induration diameters. In 17 of these patients (randomly distributed) we measured the absolute number of mononuclear cells bearing receptors of Fc IgG (RFc) before the first and before the second injection. The number of RFc was greater (p less than 0.02) after the second injection. It may be possible that candidin testing increase T suppressor cells. In 20 other subjects, we observed an increase of induration diameter (p less than 0.05) after a second IST of PHA (2 micrograms) applied 15 days after the first injection. Repeated IST with candidin and PHA induce a very high level of booster phenomenon. This fact may be kept in mind when interpreting serial IST in immunodeficiencies. PMID- 6504573 TI - [Biological study of spontaneous amyloidosis in PS mice]. AB - A remarkably severe spontaneous amyloidosis involving multiple organs has characterized the inbred PS mouse strain since the 25th generation. The amyloid substance was extracted with H2O and purified by successive gel filtrations on Sephadex G100, Sephadex G10 and Biogel P4. It was submitted to biochemical, immunochemical and histochemical analysis in order to determine its origin. Potassium permanganate resistance of the affinity for Congo Red dye, aminoacid composition, cross-reactivity with anti-mouse light chains antisera suggested an amyloidogenic process comparable to that described for the AL substance in man. However, even if abnormal lymphoid infiltrates were present in several organs, the presence of M component could not be demonstrated in serum or urine of these mice. This indicated either a limited tumoral mass or a tumor poorly secreting a precursor that would be strongly amyloidogenic. Alternatively, the existence of a so far unidentified precursor could not be excluded. PMID- 6504574 TI - [Osteoarthritis and tenosynovitis of the finger due to Mycobacterium intracellulare. A case report and review of the literature]. AB - The authors present one case of osteo-arthritis and tenosynovitis of the right forefinger due to Mycobacterium intracellulare, in a 61-year old woman. The treatment consists of a synovectomy of the finger's proximal interphalangeal joint and of the sheath of the flexor tendons and a drug regimen associating erythromycin and cotrimoxazole for 2 1/2 months. This therapy proves successful, as the patient is clinically cured. A literature review records 19 similar osteo articular and peri-articular infections due to the Mycobacterium avium intracellulare group, reported during these last 25 years. PMID- 6504575 TI - [Etiological evaluation of acute diarrhea in children hospitalized in Casablanca]. AB - A prospective study of pediatric diarrhea was conducted in Casablanca. An etiologic agent was found in 67,8% of 87 ill participants. Rotavirus was the most common cause while Campylobacter jejuni, reported as Rotavirus for the first time in Morocco, was isolated in 11% of the patients. PMID- 6504576 TI - [Comparison of 2 chemosensitivity tests by grafting a polyoma tumor in the cheek pouch of syngeneic hamsters and under the renal capsule of syngeneic mice]. AB - The immunocompetent subrenal capsule assay tumour graft is a good chemosensitivity test. We have compared it to immunocompetent white hamster cheek pouch tumour graft. These two assays are both easy to perform. Each has specific advantages and disadvantages. However the six days immunocompetent mouse subrenal capsule assay tumour graft is the most practicable and reproducible. The hamster cheek pouch assay would be used when mouse subrenal capsule assay would not be efficient for the molecules under study. PMID- 6504577 TI - Basic principles in the investigation of homicides. PMID- 6504578 TI - Pathology of so-called "spontaneous occlusion of the circle of Willis". AB - Abnormal cerebral vascular networks (Moyamoya blood vessels) are now recognized on cerebral angiograms as collaterals caused by chronic obstruction of the internal carotid arteries due to various conditions. After exclusion of cases in which the etiology is clear, there still remain a considerable number of cases characterized by bilateral involvement of the terminal portions of the internal carotid arteries, and by onset at early childhood due to unknown etiology. These cases should be called "spontaneous occlusion of the circle of Willis." This entity is a part of the "Moyamoya" syndrome. Further investigation is necessary to elucidate the exact cause of this entity. PMID- 6504579 TI - Bribery. PMID- 6504580 TI - Backward conditioning in Pavlovian type studies. Reevaluation and present status. AB - Authors of almost all learning texts have indicated that unconditional/stimulus conditional stimulus (UCS-CS) trials (backward conditioning) utilized in classical conditioning experiments will not result in establishing a conditional response (CR) (excitation). Recently, it has been proposed that backward conditioning can take place although whether UCS-CS trials results in excitation or inhibition has been left unspecified. It is proposed that the diversity of findings can be attributed to inadequate methodology and the use of a classical instrumental transfer paradigm. When only traditional Pavlovian conditioning studies are examined, the experimental findings suggest that UCS-CS trials will result in inhibition. PMID- 6504581 TI - Postnatal development of respiratory and vocal responses during aversive classical conditioning in cats. AB - Respiratory rate, respiration amplitude, and vocal responses were recorded in cats of different ages during classic conditioning. Vocal responses to the conditional stimulus (CS) appeared first in 8-week-old kittens, and became prominent at older ages. An increase in respiration rate occurred after the onset of the CS in cats of all ages. Similarly, the decrease of respiration amplitude was observed at all ages, but only in 8-week-old and older subjects did this response resemble an adult pattern. In 4-week-old kittens the response was characterized by an early and brief peak, suggesting an alpha conditional response (CR). Clear and significant discrimination between a warning and a safety signal was present in both respiratory and vocal responses after the age of 8 weeks. PMID- 6504582 TI - Psychophysiological and physiological aspects of T-wave amplitude in the objective study of behavior. AB - The objective study of behavior, which is the stated aim of our society, does not impose restrictions on the levels of explanatory constructs that are used. The only restriction is that the evidence concerning those constructs be stated in an objective or scientifically communicable way. Thus the concepts that we employ to explain behavior range from the sociologic to the biochemical. This article's underlying thesis is that behavior needs to be investigated at various levels, and that these levels should be clearly differentiated in order to bring these investigations into a scientifically meaningful relationship. The thesis is here illustrated by examining evidence and arguments concerning the utility and status of a noninvasive index of myocardial performance: T-wave amplitude (TWA). The examination begins at a psychophysiological-index level, wherein TWA is considered in terms of how well this noninvasive physiological index differentiates psychological processes. Secondly, at a lower physiological-index level, we consider the assumption that TWA reflects a relatively unitary physiological process, myocardial beta-adrenergic sympathetic influence. Both the grounds for and implications of this assumption are discussed. Finally, at the physiological-index level of discourse, brief reference is made to the mechanism by which changes in beta-adrenergic sympathetic innervation may produce correlated changes in TWA. The overall aim of the article is to differentiate these three levels of investigation, and yet also to consider the interrelationship among these three levels in order to provide a fuller scientific understanding of the phenomena involved. PMID- 6504583 TI - Child abuse: an endemic problem. PMID- 6504584 TI - The maltreatment syndrome of children. AB - The child abuse problem in this country with all its complexities and variations cannot be solved by any one single approach since we are dealing not only with a complex problem but with a multiplicity of human personalities and motivations; just as there is not one cause of child abuse, there certainly cannot be one treatment. We will need every social, medical and governmental resource working collectively in the future if we are to control the child abuse problem effectively in any community and, for that matter, in this country. To achieve any amount of success, massive programs on parenting and family care, standardized in quality with emphasis on prevention and early detection, must be effectively developed by the medical-social disciplines responsible for child welfare in this country. The fact that we do not have definitive answers to child abuse control is one of the depressing aspects of the problem today. However, clues to the prevention and control of this social-medical disease which appear to be increasing in epidemic proportions are beginning to surface and will become available to us in the very near future. Instead of believing that we always will be limited by the knowledge we now possess we should involve ourselves; we should engage in an all-out effort to recognize, report and protect the maltreated child while at the same time offering help to the parents. The task is before us, as physicians. We need all the help we can get from social workers, health professionals, teachers, psychologists, sociologists, academicians, and government. PMID- 6504585 TI - The epidemiology of child abuse and neglect. PMID- 6504586 TI - Sexual abuse of children--causes, diagnosis and management. PMID- 6504587 TI - The multidisciplinary treatment of abusive and neglectful families. PMID- 6504588 TI - Child abuse prevention and intervention. PMID- 6504589 TI - Team management of the maltreated child in the emergency room. PMID- 6504590 TI - Helping children overcome the effects of abuse and neglect. PMID- 6504591 TI - Symposium on pediatric cardiology. PMID- 6504592 TI - Management of the premature infant with a patent ductus arteriosus. AB - The maturation of the lung is one of the greatest challenges the premature infant must face after birth. Premature infants have been observed to have a higher prevalence of patency of the ductus arterious, presenting the physician with a dilemma and a challenge. This article discusses the clinical and pathophysiologic manifestations and the management of patent ductus arteriosus in the premature infant. PMID- 6504593 TI - Advances in the management of cardiac arrhythmias in children. AB - The authors discuss several recent developments in the diagnosis and management of cardiac arrhythmias in the young, focusing on areas in which the greatest progress has been made so that the pediatrician can incorporate these developments into his practice and participate more fully in the management of the patient requiring tertiary care. PMID- 6504594 TI - How to distinguish between innocent and pathologic murmurs in childhood. AB - While the distinction between innocent and pathologic murmurs may be readily made in most cases, the ability to clearly define and categorize the innocent murmur by precise criteria is most helpful in identifying those patients who may have more subtle or early manifestations of a pathologic condition. To this end, the author discusses the definition and classification of murmurs, how to evaluate a murmur, classification and features of innocent murmurs, differential diagnosis of the innocent murmur, features of pathologic murmurs, use of noninvasive laboratory studies in diagnosis, and management of the child. PMID- 6504595 TI - When to operate on the child with congenital heart disease. AB - This article outlines, under various hemodynamic categories, the multiple considerations required in considering a patient for surgery for congenital heart disease. PMID- 6504596 TI - Recreational and sports recommendations for the child with heart disease. AB - Although there is widespread acceptance that some children with congenital or acquired heart disease need exercise proscription, there is little data on which to base recommendations. In this article, the author, after reviewing the hemodynamic burdens of the common cardiac anomalies in children, gives his personal recommendations for recreational and sports activities. PMID- 6504597 TI - Cardiovascular complications of mucocutaneous lymph node syndrome. AB - The clinical and pathologic changes seen in patients with Kawasaki disease are discussed. Emphasis is placed on the cardiovascular manifestations and the present treatment and suggested long-term follow-up of this disorder. PMID- 6504598 TI - Comparison of chest radiography and static respiratory compliance in the assessment of the severity of pulmonary diseases in newborns with respiratory distress. AB - In 55 newborn infants with respiratory distress syndrome (RDS) we compared chest radiographs and static respiratory compliance to see which of the two methods would best characterize the severity of pulmonary disease. There was a significant correlation between radiological score and compliance (rs = -0.5776, n = 55, p less than 0.001). Healthy newborns, newborns with RDS who did not need artificial ventilation and those newborns who needed respirator treatment had significantly different values of radiological score and compliance. RDS may be differentiated into groups of diagnoses. Newborns with HMD could be separated from those with wet lung syndrome or aspiration pneumonia by analyzing the radiogram or measuring the compliance. When survivors are compared with those newborns who died, the static respiratory compliance alone could predict the final outcome. PMID- 6504599 TI - Computed tomography of the thymus of children under 10 years. AB - The CT appearance of the mediastinum of 27 patients under 10 years of age was analysed retrospectively, paying special attention to the anterior mediastinum and thymus. None of the patients had thymic disease. The purpose of the study was to record features which might be regarded as characteristic of the normal thymus. The lateral contour of the thymus was clearly seen. There were no infiltrations, but in one case there were displacements due to a prominent thymus. All the thymus glands appeared to be homogeneous. The use of contrast medium helped in distinguishing the thymus from other mediastinal structures; its use is well justified in studying the anterior mediastinum. PMID- 6504600 TI - Sonography of caudal hepatic veins in children. Incidence, importance and relation to cranial hepatic veins. AB - In 200 unselected upper abdominal sonographies in children the hepatic venous anatomy was examined with special reference to caudal hepatic veins. In 42% of patients caudal hepatic veins could be demonstrated sonographically, while large caudal hepatic veins could be shown in 12.5% of patients. The large caudal hepatic veins always drained from the posterior-inferior or posterior-lateral parts of the liver complementing the right (cranial) hepatic vein. When the size of the right cranial hepatic vein was small the caudal hepatic vein(s) were large. Sonographic demonstration of a small right hepatic vein is a useful indicator of large caudal hepatic veins, and the relative sizes of the cranial and caudal veins are inversely proportional. PMID- 6504601 TI - "Apple peel" syndrome. A radiological study. AB - Three cases of "apple peel" syndrome are reported. The radiological features of this abnormality are discussed, and the possibility of pre-operative diagnosis stressed. PMID- 6504603 TI - Tumorous osteomyelitis. Report of two cases. AB - Two cases of chronic osteomyelitis with unusual Ewing's like X-ray changes are reported. Inspite of extensive investigations no causative organisms were found. The infection was resistant to different kinds of therapy. The authors suppose that the strange X-ray appearances may be due to an unusual localised immune response of the bone to an unknown, possibly viral agent. PMID- 6504602 TI - Radiologic diagnosis of Hirschsprung's disease utilizing rectosphincteric reflex. AB - Artificial balloon distension of the rectum caused a reflex opening of the anal canal as seen during barium enema in 10 out of 10 normal children and in 7 of 7 children with idiopathic constipation. Reflex opening of the anal canal was not observed in any of 15 children with proven Hirschsprung's disease. This lack of response was independent of the length of aganglionosis or previous diverting colostomy and corresponded to the fact that on manometric study the intraluminal pressure of the anal canal fell in normal children but not in the children with Hirschsprung's disease. This finding greatly improves the reliability of barium enema in the diagnosis of Hirschsprung's disease. PMID- 6504604 TI - Slip of the capital femoral epiphysis: revival of a method of assessment. AB - A simple and exact method for evaluation of suspected or overt slip of the femoral capital epiphysis is revived. This procedure gives an estimate of all degrees of abnormality from the early stages to those with gross deformity. In our experience slip of the femoral capital epiphysis is always posterior and in approximately 80% of cases bilateral. Therefore, both hips should be examined whenever this condition is suspected. The method provides for examination of each hip separately. Strict adherence to the procedure also provides a precise way of assessing the femoral anteversion angle, significant in many orthopedic disorders. For the latter purpose access to a particular nomogram is mandatory. PMID- 6504605 TI - Radiologic classification of knee joint destruction in juvenile chronic arthritis. AB - A new radiologic classification of juvenile chronic arthritis (JCA) of the knee joint is presented. Osteoporosis, epiphyseal enlargement, erosions, subchondral cyst formation and deformity of the joint surfaces are expressed in terms of a score. No attention is paid to the joint space or soft tissues. Thirty knee joints in 15 patients with JCA were evaluated according to the radiologic classification. There was a good correlation between the radiologic score and the clinical findings. The inter- and intraobserver variation was low. The classification system is proposed as a valuable tool for measuring the degree of knee joint destruction in evaluation of the natural course or results of treatment in JCA. PMID- 6504606 TI - Inflammatory pseudotumor of the liver: a rare cause of obstructive jaundice and portal hypertension in a child. AB - Inflammatory pseudotumor (IPT) of the liver and intrahepatic bile ducts is a rare cause of obstructive jaundice and portal hypertension in the pediatric age group. Because it seems to have a better long-term outcome than many of the conditions with which it may be confused, it is important to recognize the radiologic and pathologic features of this rare lesion so that appropriate therapy may be instituted. PMID- 6504607 TI - Esophageal stricture secondary to drug-induced toxic epidermal necrolysis. AB - Toxic epidermal necrolysis is a cutaneous disorder with high morbidity and mortality. Esophageal stricture has rarely been reported following recovery from this abnormality. A case is presented demonstrating the occurrence of an esophageal stricture following successful therapy. New methods of treatment are changing the mortality and morbidity such that esophageal stricture will be observed more frequently. PMID- 6504609 TI - Scintigraphic imaging of renal angioma. AB - Renal angiomyolipomas are frequent findings in patients with tuberous sclerosis. They must be localized before a biopsy is done. Radionuclide blood pool scintigraphy is a simple noninvasive procedure for the localization of hemangiomatous tumours. A patient is presented with four renal angiomas shown by this technique. PMID- 6504608 TI - Association of Hirschsprung's disease and imperforate anus in a patient with "cat eye" syndrome. A report of one case and review of the literature. AB - Association of imperforate anus and Hirschsprung's disease is rare, the incidence of both events occurring together would be one child out of every 25 million live births. A case of "cat-eye" syndrome with association of high imperforate anus and long segment Hirschsprung's disease is presented. PMID- 6504610 TI - Delayed appearance of an intra-thoracic kidney. AB - This report describes a case of ectopic intra-thoracic kidney, in which there was delayed appearance of this condition after a documented prior normal chest film. PMID- 6504611 TI - Neonatal death dwarfism--a new form. AB - A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity. PMID- 6504612 TI - [Serum bilirubin levels in hypotrophic premature infants during the first few days of life]. PMID- 6504613 TI - [Preventive value of specific immunoglobulin in children born to mothers infected with hepatitis B virus]. PMID- 6504614 TI - [Fluorine level in the milk of parturients and its effect on connective tissue metabolism in newborn infants]. PMID- 6504615 TI - [Crigler-Najjar syndrome]. PMID- 6504616 TI - [Methemoglobinemia in a 2-day-old infant]. PMID- 6504617 TI - [Kofferath's syndrome in a 4-week-old infant]. PMID- 6504618 TI - [Unusual complication of septicemia in a newborn infant]. PMID- 6504619 TI - [Vitreous body abscesses as an exceptionally rare complication of generalized Pseudomonas aeruginosa infection in low-birth-weight newborn infants]. PMID- 6504620 TI - Pacifying effects of nonnutritive sucking on term and preterm neonates during heelstick procedures. AB - Behavioral state, heart rate, and respiration were monitored during heelstick procedures in samples of healthy, term neonates (N = 48) and preterm neonates treated in minimal care (N = 48) and intensive care (N = 48) nurseries. The treated infants who were given pacifiers spent significantly less time fussing and crying during and following the heelstick procedures. Physiologic arousal was monitored in both preterm groups but was attenuated only in the preterm infants who received pacifiers (minimal care group). As similar amounts of sucking were observed in both preterm groups, the inconsistency in treatment effects on behavioral and physiologic arousal was interpreted as a lack of cardiac-somatic coupling in the neonate in intensive care. Results suggest that nonnutritive sucking during heelstick procedures may attenuate behavioral distress in all neonates and physiologic arousal in neonates with less severe postnatal complications. PMID- 6504621 TI - Resting blood pressure and pulse rate distributions in black adolescents: The Philadelphia Blood Pressure Project. AB - Reference percentile distributions for blood pressure in black adolescents are not generally available. The most recently published BP percentile grids for children and adolescents were derived almost exclusively from information on white populations, and few data are available on the distribution of pulse rate for black adolescents. Reference percentiles for black adolescents for resting BP and 60-second pulse rate are presented. Given the tendency for high BP levels to track, these reference percentiles may be of value in determining the extent to which black adolescents are at risk for hypertensive disorders in adulthood. The percentiles were derived from a 3-year longitudinal study of black, urban Philadelphia adolescents, aged 12 to 17 years. Confirming results from studies of other populations in adolescence, a trend was found toward increased mean systolic BP for boys (P less than .001), and that boys have significantly higher (P less than .001) systolic BP than girls after chronologic age 15 years. Diastolic BP phase IV (muffling) exhibits no age or sex trends from ages 12 to 17 years, but adolescent girls overall have significantly higher (P less than .001) phase V diastolic (disappearance) than boys. Sixty-second pulse rate declines for both boys and girls in adolescence, although at every age 60-second pulse rate means are significantly faster in girls than boys (P less than .02). For girls older than 12 to 17 years, there is a significant, positive correlation between pulse rate and systolic BP (r = .16, P less than .01) and between pulse rate and phase IV diastolic (r = .23, P less than .01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504622 TI - Reduction of oxygen consumption, insensible water loss, and radiant heat demand with use of a plastic blanket for low-birth-weight infants under radiant warmers. AB - Eight very low-birth-weight premature infants (mean birth weight 1.11 +/- 0.05 [SEM]kg, mean gestation 30 +/- 1 weeks, and mean age 9 +/- 2 days) were studied under servocontrolled radiant warmers with and without a loosely fitted, transparent, and flexible Saran plastic blanket. Metabolic rate was significantly less in all infants when covered by the blanket (oxygen consumption was 7.99 +/- 1.13 mL/kg/min v 9.00 +/- 1.10 mL/kg/min uncovered, P less than .001). There were also significant reductions in insensible water loss (1.86 +/- 0.18 v 1.25 +/- 0.20 mL/kg/h, P less than .01) and in heat demand from the radiant warmer (14.3 +/- 1.3 v 9.9 +/- 1.4 mW/cm2, P less than .001) when infants were nursed under the blanket compared with the control condition, respectively. Covering the critically ill, very low-birth-weight infant nursed under a radiant heater with a thin, transparent layer of Saran is beneficial in reducing oxygen consumption, insensible water loss, and the need for exposure to high levels of radiant heat. Further investigation to confirm the benefits and possible complications of plastic blankets should be conducted before routine use can be recommended. PMID- 6504623 TI - Epidemiology of sudden infant death syndrome in American Indians. AB - A 7-year retrospective study of sudden infant death syndrome in Oklahoma Indians failed to support previous observations of a markedly elevated rate among the American Indians compared with the white population. The rate of sudden infant death syndrome in Oklahoma Indians was 2.32/1,000 live births. The rates of sudden infant death syndrome among white infants (1.8/1,000) and black infants (3.11/1,000) were similar to those reported in previous studies. Males had consistently higher rates of sudden infant death syndrome regardless of race. PMID- 6504624 TI - Pediatric clinicians' support for parents makes a difference: an outcome-based analysis of clinician-parent interaction. AB - Pediatric clinicians frequently must offer support (eg, reassurance) to anxious, stressed parents. Supportive clinician behaviors were studied to determine their impact on parents. Forty initial health supervision visits to a pediatric clinic were videotaped through a one-way mirror. Mothers were interviewed immediately before and 1 week after the visits to ascertain changes in concerns, opinions of clinicians, perceptions of infants, and self-confidence. Mothers also completed a postvisit satisfaction questionnaire. Coders blinded to these outcomes identified and enumerated three supportive clinician behaviors: encouragement, reassurance, and empathy. Analyses compared visit outcomes according to high and low levels of maternal exposure to clinician support. Mothers exposed to high levels of encouragement had significant improvement in their opinions of clinicians and higher satisfaction (P = .02). Mothers exposed to high levels of empathy had higher satisfaction and greater reduction in concerns (P less than .05). No significant differences in outcome were found for exposure to reassurance. Differences in visit outcomes were not related to either maternal demographic factors or clinician type (pediatricians v pediatric nurse practitioners). These results suggest that pediatric clinicians' support for parents makes a difference. Additional outcome-based analyses are needed to identify the full range of effective pediatric communication. PMID- 6504625 TI - Learning disability: 10-year follow-up. AB - A 10-year follow-up of 114 learning-disabled students has been conducted, gathering information on their academic achievement, social success, and job satisfaction. These students have been compared with 144 siblings without learning disabilities. Significantly lower levels of school attainment, academic success, and social success are found for the learning-disabled group. No difference is found in level of job satisfaction. Significant positive factors contributing to school success in the learning-disabled group were high IQ, less severe learning disability, positive personality characteristics in the child, effective family function, strong family support, high occupational level of family breadwinner, and high education level attained by the mother. Negative factors are a more severe degree of learning disability, the presence of hyperactivity, and a concomitant disability in mathematics. PMID- 6504626 TI - Value of systolic time intervals in the diagnosis of large patent ductus arteriosus in fluid-restricted and mechanically ventilated preterm infants. AB - M-mode echocardiographic features suggesting a patent ductus arteriosus are based on two groups of indirect criteria: dilation of the left cardiac cavities and changes of systolic time intervals. The reliability of the first group of criteria has been questioned in fluid-limited, mechanically ventilated preterm infants. The sensitivity of the systolic time intervals in the same circumstances is investigated. Twenty-three patients with a large patent ductus arteriosus were selected. Review of their echocardiograms shows that the sensitivity of the various criteria (expressed as percentage of positivity) was as follows: inversion of the ratio of left ventricular preejection period to right ventricular preejection period, 91.3%; left ventricular preejection period to left ventricular ejection time over right ventricular preejection period to right ventricular ejection time less than 1,83%; left atrium dilation, 74%; shortening of left ventricular preejection period, 70%; dilation of left ventricular internal dimensions in diastole, 65%; increase in left atrium/aorta, 52%; and decrease of left ventricular preejection period to left ventricular ejection time, 48%. Three criteria involving time intervals (left ventricular preejection period to right ventricular preejection period, left ventricular preejection period, and left ventricular preejection period to left ventricular ejection time) had 100% specificity. The lowest specificity was found with criteria involving the left atrium (left atrial to aortic root ratio 75% and left atrium 63%). It is concluded that study of systolic time intervals is a reliable means of detecting preterm infants with hemodynamically significant left-to-right shunt through a patent ductus arteriosus even if the infants are mechanically ventilated and fluid restricted. PMID- 6504627 TI - Research and practice in the treatment of insulin-dependent diabetes: a survey of 53 pediatric diabetologists. AB - New techniques are available for the treatment of children with insulin-dependent diabetes mellitus. These include more intensive methods of insulin delivery by multiple daily injections or continuous subcutaneous infusion by portable pumps combined with patient self-monitoring of blood glucose. Long-term diabetic control can be evaluated by measurement of glycosylated hemoglobin, HbA1 or HbA1c. Pediatric practitioners may be in doubt as to the extent to which these techniques should be incorporated into their own practices. In order to provide some guidance in this quandary, the treatment practices as of June 1982, of 53 physicians with a special interest in the treatment of diabetic children were surveyed by questionnaire. The respondents estimated that they cared for 12,350 diabetic patients less than 19 years of age. Among their patients, 72% received twice-daily injections of insulin, 3% received three or more injections daily, and only 195 patients (2.7% of the total) were treated with insulin pumps. Among patients older than 10 years of age, 50% performed self-monitoring of blood glucose four times daily on one or more days per week and 32% of these patients did so daily. Two thirds of the patients utilized glucose oxidase-impregnated strips for blood glucose estimation and the remainder used reflectance meters. Essentially all respondents utilized glycosylated hemoglobin to evaluate quality of control. The mean number of determinations was 3.8 per year. Reasons for introducing pump therapy or discontinuing its use, glycemic targets for pump patients, and experience with utilization of the pump are described.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504628 TI - Knowledge of testicular cancer risk and need for self-examination in college students: a call for equal time for men in teaching of early cancer detection techniques. AB - College athletes were surveyed about their knowledge and practice of early cancer detection techniques. Males were almost completely unaware of their risk for testicular cancer (87%). Only 9.6% had been taught testicular self-examination and only half of these by their physician. Six percent actually examined themselves regularly. In comparison, more than 60% of women had been taught breast self-examination (75% by a physician) and about one third were doing regular examinations. More than 90% of the young men and women had been seen by physicians for a physical examination within the past 3 years. Physicians need to begin educating males about testicular cancer and its early detection. PMID- 6504629 TI - Basilar impression in children. AB - Ataxia is a common neurologic sign in childhood. Basilar impression due to bony abnormalities of the craniovertebral junction is an uncommon but readily treatable cause of ataxia in children. Two children who had neck stiffness, ataxia, nystagmus, and corticospinal tract signs are described. Basilar impression was recognized only after specific radiologic studies were performed. Both children were treated surgically with good results. PMID- 6504630 TI - Munchausen's syndrome by proxy (child abuse) presenting as apparent autoerythrocyte sensitization syndrome: an unusual presentation of Polle syndrome. AB - Munchausen's syndrome was initially described in 1951. It has become increasingly recognized since that time. Recently, Munchausen's syndrome by proxy or Polle syndrome has been described. In this disease entity, a parent causes a factitious disease in a child. The disease may require extensive medical testing and the result may even be death. A wide variety of presentations of Polle syndrome have been reported including cardiac arrest, recurrent sepsis, and factitious bleeding. Autoerythrocyte sensitization, a syndrome of spontaneous purpura, was initially described in 1955. The diagnostic test described is intradermal injection of autologous blood which produces an area of painful purpura. The syndrome is therefore postulated to be due to hypersensitivity in the patient's own RBCs. The majority of patients with autoerythrocyte sensitization have had psychiatric disorders and the symptoms have improved only with psychotherapy. An infant who had a clinical picture of autoerythrocyte sensitization and who was later found to be a victim of Polle syndrome is reported. PMID- 6504631 TI - Drinking-water-induced copper intoxication in a Vermont family. AB - Three of four family members reported recurrent episodes of gastrointestinal illness while residing in a house in a small northwestern Vermont village. The father and two daughters repeatedly experienced episodes of emesis and abdominal pain after drinking water drawn from their kitchen faucet. One early-morning water sample taken from the family household contained a copper level of 7.8 mg/L, which is above the standard for drinking water (1.0 mg/L). Values for the second daughter's copper in hair analysis (1,200 micrograms/g) and copper in nail analysis (100 micrograms/g) were elevated (normal range 11 to 53 micrograms/g). The household was at the end of a 3/4-in (19.05-mm) copper main, and it is suspected that copper levels increased in water when the water remained stagnant in the main. All symptoms of the family resolved when they stopped drinking water in their home. This is the first report of copper-induced gastrointestinal illness attributable to a public supply of drinking water. PMID- 6504632 TI - Intraventricular hemorrhage and vitamin E in the very low-birth-weight infant: evidence for efficacy of early intramuscular vitamin E administration. AB - To determine whether early intramuscular vitamin E supplementation influences the incidence of intraventricular hemorrhage (IVH) in infants with birth weight less than or equal to 1,500 g, data were analyzed from 134 infants enrolled on a protocol to evaluate the efficacy of intramuscular plus oral vitamin E v oral supplementation alone in the treatment of retrolental fibroplasia. All 134 infants received, via nasogastric tube, 100 mg/kg/d of vitamin E daily (dl-alpha tocopheryl acetate in MCT [medium-chain triglyceride] oil; 150 mosM) for at least 8 weeks with the first dose administered within the first eight hours of life. Sixty-four patients received, in addition, intramuscular vitamin E on days 1, 2, 4, and 6 of life and 70 patients received placebo injections in a randomized double-blind fashion. In the first week, vitamin E plasma levels were significantly higher in the 64 patients given intramuscular vitamin E. In spite of this difference no change in the incidence of sepsis or necrotizing enterocolitis was observed. Both the incidence and severity of intraventricular hemorrhage were reduced significantly in the patients given intramuscular vitamin E as compared to the patients given placebo (P = .013 and P = .04, respectively). The data suggest that vitamin E, a natural antioxidant, may play an important role in protecting the CNS microcirculation from the effects of hypoxic/ischemic injury. PMID- 6504633 TI - Vitamin E and CNS hemorrhage. PMID- 6504634 TI - E-ferol: what happened and what now? PMID- 6504635 TI - Differentiation of chronic salicylism from Reye syndrome. PMID- 6504636 TI - High-dose intravenous immunoglobulin for severe platelet alloimmunization. PMID- 6504638 TI - Treatment of occult bacteremia. PMID- 6504637 TI - Computed tomography in an infant with salt poisoning: relationship of hypodense areas in basal ganglia to serum sodium concentration. PMID- 6504639 TI - Phenobarbital side effects: hyperactivity with speech delay. PMID- 6504640 TI - Rheumatic fever article questioned. PMID- 6504641 TI - Self-induced urinary tract infection in boys. PMID- 6504643 TI - Who provides health care to children and adolescents in the United States? AB - Face-to-face visits by children and adolescents in office-based practice in the mid-1970s were studied. Pediatricians, family physicians, and general practitioners accounted for 35%, 6%, and 30%, respectively, of all child visits. Although 40% to 45% of preventive and medical encounters were with pediatricians, only 12% of visits for minor surgery, 20% of visits for psychosocial problems, and 9% of visits for combined medical-surgical reasons were to pediatricians. Only in very young children did pediatricians provide a substantial proportion of care for each of the types of visits. For some common diagnoses (acne, refractive error) most care was provided by specialists other than primary care specialists, but less than 16% of all preventive care visits (including routine eye examinations) was provided by specialists other than primary care physicians. A substantial proportion of the prenatal care and management of minor trauma was provided by family physicians and general practitioners. Although the limitations of the study (including an average response rate of 55%, exclusion of certain specialties and institutional physicians, sampling at different times of the year, lack of control for area of location of practice, and lack of information about response rates of different types of physicians within each specialty) preclude definitive conclusions, the findings raise important questions for future study. PMID- 6504642 TI - Annual summary of vital statistics--1983. AB - Data for this article, as in previous reports, are drawn principally from the Monthly Vital Statistics Report, published by the National Center for Health Statistics. The international data come from the Demographic Yearbook and the quarterly Population and Vital Statistics Report, both published by the Statistical Office of the United Nations, which has also been kind enough to provide directly more recent data. Except for mortality data by cause and age, which are based on a 10% sample, all the US data for 1983 are estimates by place of occurrence based upon a count of certificates received in state offices between two dates, one month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimates are very close to the subsequent final figures. There are, however, considerable variations in a few of the states, particularly in comparing data by place of occurrence with data by place of residence. State information should be interpreted cautiously. PMID- 6504644 TI - [Ambulatory step-by-step rehabilitation of children with bronchopulmonary diseases]. PMID- 6504645 TI - [Lipid peroxidation and superoxide dismutase activity in the erythrocytes of young children with pneumonia]. PMID- 6504646 TI - [Course and outcome of acute pneumonia in young children treated at home]. PMID- 6504647 TI - [Acetylsalicylic acid and thrombocyte function]. PMID- 6504648 TI - [Objectives of public health authorities and institutions with regard to schoolchildren's health]. PMID- 6504649 TI - [Various nonspecific factors of immunity in iron deficiency in children]. PMID- 6504650 TI - [Characteristics of recurrence of iron deficiency anemia in children 10-15 years of age]. PMID- 6504651 TI - [Indications for immunotherapy of acute hematogenic osteomyelitis in children]. PMID- 6504652 TI - [Determination of proteolytic activity and chromogastroscopy in the diagnosis of pre-ulcer states in children]. PMID- 6504653 TI - [Colonofibroscopy in children and adolescents with bacterial chronic colitis]. PMID- 6504654 TI - [Value of roentgenodiagnosis of respiratory distress syndrome in infants during the first few days of life]. PMID- 6504655 TI - [Results of the conservative treatment of persistent regurgitation of a dysfunctional nature in infants]. PMID- 6504656 TI - [Incidence and clinical characteristics of rotavirus infection in children]. PMID- 6504657 TI - [Toxoplasma stomatitis in children]. PMID- 6504659 TI - [Mycotic pharyngitis in childhood]. PMID- 6504658 TI - [Clinical course of the respiratory form of Mycoplasma infection in children]. PMID- 6504660 TI - [Review of scientific research activity in pediatrics 1983]. PMID- 6504661 TI - [Williams-Campbell syndrome in children (a form of congenital developmental defect of the bronchi)]. PMID- 6504662 TI - [Unidentified partial immunodeficiency state in a 61/2-year-old child]. PMID- 6504663 TI - [Wegener's granulomatosis in a 5-year-old child]. PMID- 6504664 TI - [Tomsen's myotonia associated with paroxysmal myoplegia]. PMID- 6504665 TI - [Esophageal foreign body simulating clinical symptoms of foreign body of the respiratory tract]. PMID- 6504666 TI - [Virilism syndrome in a girl with ovarian teratoma]. PMID- 6504667 TI - [Value of prostaglandin E1 in cardiac malformations in the newborn infant]. AB - Prostaglandin E1 (PGE1) was administered to increase ductus patency in 26 neonates who present a cyanotic heart disease with right ventricular obstruction (1st group, 13 cases) or congestive heart failure with left ventricular outflow obstruction (2nd group, 13 cases). Clinical improvement occurred in all but the oldest infant in the first group. The efficacy of PGE1 is inconstant in the second group, but medical status was very poor before treatment. We could usually reduce the dose of PGE1 but in no case we could stop the drug before surgery. Surgery could be delayed several hours or days to get an hemodynamic and biologic satisfactory condition and even a few weeks until the infants and their pulmonary arteries had grown (1st group). Side effects are common but relatively minor. PMID- 6504668 TI - [Extrinsic allergic alveolitis in children. Apropos of 4 cases]. AB - Four cases of extrinsic allergic alveolitis are reported. About them, we discuss: The difficulties of diagnosis that we can only affirm on the association of several clinical, biological, and radiological arguments. The physiopathology: association of immune complex hypersensitivity type III and immediate hypersensitivity type I. It's important to always search for a probable starting infectious factor (mycoplasma). The therapy: antigenic exclusion is the only way to avoid a lung fibrosis. PMID- 6504669 TI - [Pulmonary valve agenesis and giant lobar emphysema. A not uncommon association]. AB - A case of neonatal giant lobar emphysema secondary to a complex cardiac anomaly with pulmonary valvular agenesis is presented. Clinic and radiologic findings are sufficient to suggest diagnosis. Right heart catheterization is required to demonstrate the pulmonary valvular agenesis. Such an investigation should be recorded when observed a giant neonatal emphysema. Is failure occurs in the neonatal period the prognosis of this association is poor. PMID- 6504670 TI - [Dyssegmental dwarfism. A new case]. AB - In a 3 1/2 month old child with micromelic dwarfism, a case of dyssegmental dwarfism is reported. This affection is characterized, on one hand, by a shortening and a squat aspect of long bones with diaphyseal curve, and on the other hand, by a trouble of vertebral segmentation associated to a variability in the size of vertebral bodies. The differential diagnosis appears adequate to differentiate the dyssegmental dwarfism from other types of neonatal chondrodysplasia, in particular from Kniest syndrome and micrognathia dwarfism. PMID- 6504671 TI - [Intolerance to rice: a food intolerance uncommon in children]. AB - We report the first case, in our knowledge, of dietary intolerance only to the rice in childhood. Gastrointestinal symptoms and shock-like state in relation to the ingestion of ground rice were observed in a 5-month-old girl. At 34 months she was still clinically intolerant to this food. PMID- 6504672 TI - Errors towards the perpendicular in children's copies of angular figures: a test of the bisection interpretation. AB - Children distort angular figures so that the constituent angles are nearer 90 degrees than they should be. This could be due to a perpendicular bias or a bisection bias, or to both. A study is reported which was designed to establish whether a perpendicular bias would appear independently of bisection. Twenty four year-old children were tested on two types of angular figure: (i) a baseline with another line joining at the end at 45 degrees, 90 degrees, or 135 degrees and (ii) a baseline with another line joining at the middle at 45 degrees or 90 degrees. Perpendicular errors were obtained both for 'end' and for 'middle' figures, but overall more strongly for 'middle' figures. However, while 90 degrees 'middle' figures were copied more accurately than 45 degrees/135 degrees figures, this effect was only obtained for vertical and horizontal presentations of 'end' figures, and was reversed for oblique presentations. Also, for 'end' figures, directional errors varied with subtended-line orientation, whereas for 'middle' figures they varied with baseline orientation. It is concluded that although errors towards the perpendicular do occur with single-angle figures, angle equalisation may take place when there are two adjacent angles in the figure. One interpretation of the differing orientation effects is that in 'middle' figures strong internal relational forces produce a distortion that varies with the angle at which the figure is viewed, whereas in 'end' figures the absence of relational forces within the figure leads to a stronger influence from external cues. PMID- 6504673 TI - Information about three-dimensional shape and direction of illumination in a square-wave grating. AB - A homogeneous grey picture and a 'Mondrian' type of picture were illuminated by a projector with square-wave gratings of thirty different contrast values used as slides. Ten observers reported whether the picture appeared three-dimensional (3 D) (pleated) or flat. 3-D responses in this situation indicate colour constancy 'at the cost of' nonveridical depth perception. The frequencies of 3-D responses were significantly higher for the structured picture than for the homogeneous grey one. In reports of the direction from which the apparent 3-D object appeared to be illuminated there was a significant preference for responses "from above" when the grating was horizontally oriented. With vertical orientation there was no preference for "from the left" or "from the right". The results from the first experiment contradict traditional cue theories of depth perception since the projection of the borders between the fields of the structured picture was invariant and expected to inform about the flatness of the picture. They are, however, in line with a model for perceptual analysis of reflected light into common and relative components proposed earlier by Bergstrom. The difference in perceived direction of illumination between horizontally and vertically orientated gratings is discussed in connection with human ecology. PMID- 6504674 TI - The dependence of monocular rivalry on spatial frequency: some interaction variables. AB - The effect of spatial frequency upon the rate of monocular rivalry has been investigated on several occasions, with conflicting results. With increases in spatial frequency the rivalry rate has been variously reported as declining monotonically, increasing slightly and briefly before declining sharply, or showing a sharp increase before a sharp decrease. Experiments are reported which show that all three functions may be obtained depending on whether the number of cycles of the gratings is held constant across spatial frequency, or the field size is held constant (and, if the latter, what field size is used). The point at which any high-frequency decline occurs is also shown to increase with increasing luminance. All functions obtained correspond to visual sensitivity functions obtained under comparable conditions. PMID- 6504675 TI - A new angle on the freemish crate. PMID- 6504676 TI - The effects of illumination level and retinal size on the depth stratification of subjective contour figures. AB - The apparent stratification in depth of subjective contour figures over their backgrounds was investigated as a function of illumination level, figure size, and viewing distance. Magnitude estimation, with a real contour figure serving as the modulus, was used to measure the stratification in depth of a subjective contour figure over its background. Illumination level and retinal size both had significant effects on the depth stratification of the subjective contour figures. The greatest apparent depth differences were obtained for figures of small retinal size under low levels of illumination. These results paralleled previous findings for judgments of subjective contour strength. Consequently, both contour clarity and depth stratification of subjective contour figures are affected in similar ways by illumination level, figure size, and viewing distance. The implications of this response coupling are discussed in terms of current theories of subjective contours. PMID- 6504677 TI - Parallel-alleys and distance-alleys on horopter plane in the dark. AB - On each of three frontoparallel planes at distances of about 98, 186, and 276 cm from the subject, two series of light points running horizontally in the dark, one above the other, were constructed by six subjects: a P-alley in which the two series appear as two straight lines that are parallel, and a D-alley in which each pair of points appear equally separated in the vertical direction. Luneburg's mapping functions between visual space and physical space have been used to obtain estimates of K (curvature) and sigma (a constant related to depth perception). In addition, ratios of perceptual distances were assessed by four out of the six subjects with eleven triplets of points on the alleys and values of K were estimated (and the fits of theoretical equations were tested) without the use of the mapping functions. In contrast to experiments with P-alleys and D alleys on the horizontal plane, K was not unequivocally negative in either of the two experiments. PMID- 6504678 TI - Summation of target and mask metacontrast stimuli. AB - Three experiments are reported; they show the following: (i) Metacontrast occurs at high photopic conditions (250 cd m-2); at this luminance the function peaks at stimulus asynchronies of approximately 40 ms (compared with 100 ms at lower luminances). (ii) The strength of metacontrast is contrast-independent, down to contrast very near detection threshold. (iii) Detection thresholds for the combined target and mask presentation are lower than those for the mask alone, implying summation between target and mask. Summation is greatest at the same asynchronies which yield maximum metacontrast masking. The experiments are taken as evidence in favour of a fusion explanation for metacontrast. An argument is made which implicates temporally units of the motion detection system as being instrumental in the fusion process. PMID- 6504679 TI - Binocular summation on fused annular backgrounds. AB - A paradigm has been proposed to test the hypothesis that binocular fusion results in simple summation, S, of monocular photopic luminances: S = delta LBM(L)/delta LB(2L) = 1, where delta LBM and delta LB are threshold luminances for a monocular and a binocular increment, appearing on a fused background of luminance L or 2L, respectively. This prediction was tested psychophysically, with background size as parameter. Thresholds were measured for a brief (20 ms) foveal flash centered on a luminous disk encircled by a massive black annulus serving as a fusion lock. The flash was presented binocularly, or monocularly, at 30 and 60 cd m-2 background luminances. The diameter of the disk was varied from 3 min to 40 min visual angle. The size of the flash was constant (6 min diameter), except for the smallest disk (3 min diameter). All thresholds varied as a function of background size (the known 'sensitization effect'). The summation index S did not vary with background size. A mean value S = 0.9 was found; this is consistent with the notion that summation of the order of 90% occurs during binocular fusion. We surmise that even a weak monocular test flash makes fusion less than perfect. PMID- 6504680 TI - The 'shrinking circle illusion' is a shrinking ellipse. AB - Twenty-four subjects judged the size of the horizontal and vertical extents of the path traversed by a circularly rotating target. The target was rotated at velocities ranging from 0.18 to 1.13 cycles s-1, and observed with smooth pursuit eye movements or by fixating a point in the center of the path. It was found that underestimation of the target path increased with velocity, and was more pronounced for the horizontal than vertical component of the target path. These effects were quite strong during smooth pursuit, but weak during fixation. In previous research on the 'shrinking circle illusion' the vertical component of the path was not measured. The present findings indicate that the apparent shape of the path is elliptical, and that the eccentricity of this ellipse increases with velocity during smooth pursuit. PMID- 6504681 TI - A counterexample to the rigidity assumption in the visual perception of structure from motion. AB - It has been proposed that the human visual system prefers perceptions of objects that are rigid or undergo minimum form change. A counterexample is presented in which a rigid two-dimensional figure rotating in the frontal plane is perceived as a distorting three-dimensional shape. It is argued that this perception results from the stimulation of automatic processes for perceiving size change, and that these processes are not subject to a general rigidity assumption. PMID- 6504682 TI - Rigidity and misperceived motion. PMID- 6504683 TI - A new reversible and impossible object. PMID- 6504684 TI - Complex and simple proportions and the aesthetic attractivity of visual patterns. AB - It is hypothesized that a figure with sides and angles in complex ratios (that is, other than 1:1) makes an aesthetic impression only when the complex ratios entail simple ones. An experiment is reported in which twelve pairs of line drawings were presented in which one drawing (A) always contained one or more 1:1 ratios, whereas in the other drawing (B) such simple ratios could not be indicated. In seven pairs the A pattern was preferred significantly. In this context, the alleged aesthetic appeal of the golden section is discussed. PMID- 6504685 TI - Modelling the stages of the identity theory of object-concept development in infancy. AB - A computational model is presented for the three stages of development of the object concept in infancy identified by Bower and Wishart in their research. The stages are described by sets of PROLOG clauses that interpret object structures representing the perceptual phenomena interpreted by the infants themselves. The infant's changes between developmental stages can be described by differences between the rules modelling each stage. Three experiments are presented and the behaviour of the PROLOG model is described for each stage of development. Motion, rest, and boundedness of objects constitute the theoretical underpinning of the running PROLOG model and are hypothesized as the invariant aspects of perception that explain the behaviour of the infant at each stage of development. A possible explanation for transitions between stages is offered and justified in part by the output of the model, which in turn is used to predict the behavioural outcome of an experiment. PMID- 6504686 TI - Development and optimization of pharmaceutical formulations using a simplex lattice design. AB - The composition of pharmaceutical formulations is often subject to trial and error. This approach is time consuming and unreliable in finding the best formulation. Optimization by means of an experimental design might be helpful in shortening experimenting time. Such a design with the concomitant mathematical models, reveals effects and interactions of the variables. The independent variables are the different compositions of the mixtures of the chosen ingredients [drug(s) and excipients]. The dependent variables are the properties (responses) of the formulation. When all responses of interest have been expressed in models that describe the response as a function of the composition of the mixture, the models can be combined graphically or mathematically to find a composition satisfying all demands. In this paper an introduction to the use of mixture designs will be given by means of a theoretical part and an example: optimizing a tablet formulation consisting of excipients only. PMID- 6504687 TI - Specific cation effect in the reaction of nitroprusside with cysteine, acetophenone and sulfite (Legal and Boedeker reaction). AB - The colour formation of cysteine (I), acetophenone (II) and sulfite (III) with the sodium and tetrabutylammonium (TBA) salt of nitroprusside (NP2-) in aqueous solution was studied. The intensity of colour formation depends strongly on the nature and concentration of the cations and increases in the order TBA less than Li less than Na less than K less than Rb less than Cs (in case of cysteine TBA and Li are interchanged). This specific cation effect was known for the Boedeker reaction (III) and is now also demonstrated for the Legal reaction (I and II). The adduct formation between NP2- and I to III is based on an anion-anion interaction. The role of the cation is to reduce the Coulombic repulsion between the reactants by ion-pair formation. The efficiency of ion-pair formation corresponds with the order given before except for TBA, which behaves divergently. PMID- 6504688 TI - Pulsed proton NMR and solid-liquid fat ratio determinations in suppository vehicles and aminophylline suppositories. AB - The physical state, melting behaviour and release rate of aminophylline suppositories were studied during storage. The fraction of non-crystallized fat, assessed by pulse NMR, varies between different vehicles. At room temperature several vehicles do not seem to be completely crystalline. Aging, as observed in prolonged melting time and a reduced release rate, is not expressed in a drastic reduction of the fraction of non-crystallized fat, as observed by NMR. On the contrary the mobility of the protons in the non-crystallized state is likely to offer a more promising tool to monitor aging. PMID- 6504689 TI - Microbiological aspects of heat sterilization of medicines. II. A method for the determination of the effectiveness of a sterilization process using the bioburden and the bioburdens heat resistance. AB - In order to verify whether the sterilization process of 60 min at 100 degrees C for invert sugar 20% is sufficiently effective to attain the generally accepted probability of survival of maximum 1 X 10(-6), we determined the bioburden and the bioburdens heat resistance for this product. We examined 98 bottles by the membrane filtration method and found 84 bottles with 0 colony forming units (CFU's) and 14 bottles with 1-9 CFU's. Because none of the isolated CFU's was heat resistant (Bacillus species), we isolated heat resistant CFU's from the environment and determined the heat resistance in invert sugar, water and NaCl solution 0.9% of four different Bacillus species. The results in invert sugar for the most heat resistant Bacillus species were a D-value of 0.92 min at 100 degrees C. For the determination of the D-value the end-point method is the most practical one, and the D-value calculation with the most probable number method is sufficiently accurate. Because of unavoidable inaccuracies in the experimentally determined D-value, safety margins of 100% have to be taken into account in the sterilization process calculations in which these D-values are used. Hence, in our case, we have to use a D-value of 2 X 0.92 min in the sterilization process calculation for invert sugar 20%. The maximum bioburden in the examined 98 test bottles was 9 CFU's. The maximum heat resistant bioburden which must be used in sterilization process calculations may be safely fixed at 10% of the total bioburden, therefore we have to use 0.9 micro-organisms in our calculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504690 TI - Respiratory effects of high cervical cord cold blockade on efferent vagal and phrenic discharges in the rabbit. AB - A technique of reversible cold blockade was applied in decerebrate and vagotomized rabbits that were immobilized and artificially ventilated to study the modulation of spontaneous respiratory rhythms. Respiratory discharges were recorded from vagal and phrenic efferents before and during cold blockade at the second cervical segment (C2) with a coolant-circulated thermode (-15 degrees C). Measurement of the cooling profile demonstrated that there was significant hypothermia in the regions of the phrenic nucleus (+25 degrees C) and obex of the medulla (+26 degrees C). Arterial pressure was maintained by continual norepinephrine infusion, end-tidal carbon dioxide tension was held at hypercapnic levels, and rectal temperature was regulated near 38 degrees C. The cold blockade of descending respiratory drives to the cervical phrenic nucleus inhibited the spontaneous activity in the phrenic nerve for more than 90 min. Phrenic activity could be induced by the intravenous injection of strychnine, but not doxapram, although this was not of respiratory quality. These results show that in the absence of descending and pharmacologic drives, but in the presence of phrenic hypothermia, spinalized rabbits are incapable of generating rhythmic patterns of discharge. C2 cold blockade also significantly slowed the spontaneous central respiratory rhythm with no change in integrated vagal amplitude, presumably due to a direct cooling effect on brainstem oscillators for breathing. PMID- 6504691 TI - Dependence of renal protein reabsorption on glomerular filtration rate and infusion time. AB - Egg-white-lysozyme was infused into rats intravenously to achieve plasma concentrations of lysozyme (PLy) in the range of 10-3,500 mg X l-1. Concentrations of inulin and lysozyme in plasma and urine samples were determined spectrophotometrically. The glomerular filtration rate (GFR) was measured as clearance of inulin. The lysozyme reabsorption rate (TLy) was calculated as the difference between the filtered load and excreted amount of lysozyme. TLy increased with increasing filtered loads of lysozyme up to 1,000 micrograms X min 1 whether the increase in load was caused by an increase in PLy or GFR. These TLy were not dependent upon lysozyme infusion time. At lysozyme loads above saturation of reabsorption (1,000 micrograms X min-1) TLy was dependent on GFR and on the passed time after onset of lysozyme infusion. The results of this study indicated that the transport rate of lysozyme is a function of PLy, GFR and duration of lysozyme delivery to tubular cells. PMID- 6504692 TI - Inhibition of Na-alanine cotransport in oocytes of Xenopus laevis during meiotic maturation is voltage-regulated. AB - During progesterone-induced maturation of oocytes of Xenopus laevis the fast decrease of the rate of Na+-alanine cotransport is accompanied by a depolarization of the membrane potential and an increase in the intracellular Na+ activity. It is demonstrated that the decrease of the Na+-dependent alanine uptake is the result of the depolarization while the simultaneous increase in intracellular Na+ activity has no significant effect. PMID- 6504694 TI - The time course of changes in contraction kinetics during the tonic activation of the rat tracheal smooth muscle. AB - The tension increase after onset of electrical stimulation (30 Hz square wave; 1.65 ms pulse duration) and after the cessation of inhibiting length vibration (frequency 100 Hz sinus; amplitude 6% of the muscle length) was analysed in the isolated rat tracheal smooth muscle. In the first experimental series, tonic contraction was interrupted by a 2 s vibration applied 4-256 s after a preceding stimulation. In the second series, the onset of force development was delayed by a long-term vibration stopping 6-258 s after the commencement of a simultaneously performed electrical stimulation. In both the experimental series tested, the time course of post-vibration tension recovery showed an initial fast and a subsequent slow component. The former reflects the kinetics of cross-bridge reattachment and the latter those of the normal actin-myosin interaction cycle. The time constants of both these components reached a minimum of 0.58 +/- 0.04 s (fast) and 3.49 +/- 0.28 s (slow component) when the vibration stopped 18 s after the start of stimulation. Both values increased to 1.29 +/- 0.15 s and 9.98 +/- 1.17 s after a preceding stimulation of 256 s. These changes in the time constants may reflect the slowing of cross-bridge action under prolonged contraction. Such variations in the time constants of post-vibration tension recovery occurred without any corresponding changes in the steady state tension developed after cessation of vibration. These results lend further support to the supposition that different mechanisms might control the rate and extent of smooth muscle contraction. PMID- 6504695 TI - [Thrombocytopenia due to antibodies induced by ticlopidine]. AB - Ticlopidine is a new drug for the inhibition of the aggregation of platelets, which is used in arteriosclerosis. Here we describe a patient, who developed a thrombocytopenic purpura whilst using this drug. After stopping the drug, platelet counts normalized in two weeks. In the serum of this patient antibodies were found which reacted with the Ticlopidine exposed platelets of the patient after recovery and with those of healthy donors. These antibodies did not react when these platelets were exposed to tetrahydro-4,5,6,7,thieno(3,2-c)pyridine, a metabolite of Ticlopidine. We conclude that after adherence of the drug to the platelet membrane, antibodies induced by Ticlopidine destroy the platelets as carriers of the drug. PMID- 6504696 TI - Correlation between mean volume of lymphocytes and their nuclei and the number of lymphocytes in chronic lymphocytic leukaemia. AB - Tests evaluating the mean volume of lymphocytic cells and the mean volume of their nuclei were performed using 17 patients with chronic lymphocytic leukaemia. A negative correlation was observed between the values obtained from the measurements of mean volumes of cells and nuclei and the logarithm taken from the number of lymphocytes in 1 mm3 of blood. PMID- 6504693 TI - Substrate utilization in the isolated perfused cortical thick ascending limb of rabbit nephron. AB - Isolated segments of cortical thick ascending limbs (cTAL) of rabbit kidney were perfused in vitro and the equivalent short circuit current (Isc) was measured. In a first series all substrates were removed on either side. Isc fell rapidly to 50 +/- 12% after 3 min and to 27 +/- 6% (n = 5) after 10 min. This indicates that in cTAL segments Isc is strictly dependent on the presence of substrates. In series two it was tested what substrates can be utilized by the cTAL segment, and from which epithelial side [bath (b) or lumen (1)] the substrates are taken up. From the 1-side only butyrate (10 mmol X 1(-1) sustained the Isc at 95 +/- 2% (n = 7). All other tested substrates (10 mmol X 1(-1): pyruvate, acetate, beta-OH butyrate, D-glucose, and L-lactate lead to a marked decline in Isc. From the b side several substrates (5--10 mmol X 1(-1) sustained the Isc: D-glucose, D mannose, butyrate, beta-OH-butyrate, acetoacetate, L-lactate, acetate and pyruvate. Other compounds (1--10 mmol X 1(-1): citrate, alpha-ketoglutarate, succinate, glutamate, glutamine, propionate, caprylate and oleate did not sustain Isc. In the third series the mechanism of substrate utilization from the basolateral cell side was studied. It was shown that the Isc is a saturable function of the D-glucose, L-lactate, acetate, pyruvate or beta-OH-butyrate concentration with apparent Km's between 0.05--1.0 mmol X 1(-1). Several known inhibitors of sugar and of anion transport were tested at the bath side: phlorrhizin was without effect. Phloretin (500 mumol X 1(-1) inhibited Isc by 96%, yet its effect was not dependent on the presence of substrates on the b-side since inhibition occurred also if the b-perfusate contained no substrate and Isc was driven by luminal butyrate. Also SITS (5 mmol X 1(-1) exerted only a small inhibitory effect which was not specific since it was also observed with luminal butyrate. alpha-Cyano-m-OH-cinnamate (10 mmol X 1(-1) inhibited the Isc specifically when L-lactate was the bath substrate. Probenecid (1 mmol X 1(-1) had a similar yet less marked inhibitory effect. The D-glucose uptake from the b side was specifically inhibited by cytochalasin B at 5 X 10(-6) mol X 1(-1). We conclude that the cTAL segment of the rabbit utilizes D-glucose and/or small anions such as pyruvate or L-lactate or acetate to energize salt reabsorption.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6504697 TI - [Evaluation of the performance of the Coagulyzer II (Lancer)]. AB - The automation of equipment is essential in laboratories performing a large number of procedures with high precision. An evaluation of performance characteristics of a photoelectric automated coagulation instrument, the Coagulyzer II (Lancer) is reported and compared with performances of the Coag-a pet 200. PMID- 6504699 TI - Polymer-stimulated ligation: enhanced ligation of oligo- and polynucleotides by T4 RNA ligase in polymer solutions. AB - The effects of macromolecular crowding were tested on several reactions catalyzed by T4 RNA ligase. The rate of cyclization of oligoriboadenylates was stimulated up to 10-fold by relatively high concentrations of several polymers (polyethylene glycol (PEG) 8000 or 20,000; bovine plasma albumin; Ficoll 70). In addition, higher concentrations of PEG 8000 or PEG 20,000 allowed the novel formation of large linear products from the oligoriboadenylates. Also stimulated by high concentrations of PEG 8000 were the rate at which T4 RNA ligase joined p(dT)10 to oligoriboadenylates and the rate at which the enzyme activated p(dT)n by transfer of an adenylyl moiety from ATP to the oligonucleotides. These results with T4 RNA ligase are compared to earlier studies on the effects of crowding on DNA ligases. PMID- 6504698 TI - Studies on the conformation and dynamics of the C8-substituted guanine adduct of the carcinogen acetylaminofluorene; model for a possible Z-DNA modified structure. AB - The structure of an adduct between guanine and the carcinogen acetylaminofluorene has been examined in the solid state by X-ray crystallography, and in solution by NMR techniques. The observed conformations have been compared with predictions from energy calculations and their relevance to models of adducts with DNA has been examined. PMID- 6504701 TI - Is there sometimes T-T wobble pairing in thymidylyl-3',5'-thymidine? AB - A fibre-type x-ray diffraction photograph from thymidylyl-3',5'-thymidine is interpreted in terms of a seven-residues per turn, left-handed helical structure in which the first thymine of one molecule is linked to the second thymine of the next molecule by 'wobble' type hydrogen bonds. The first thymidine is in the anti conformation, with a C2'endo - C3'exo sugar and the second is in the syn conformation with a C3'endo - C4'exo sugar. The C5' - 05' bond in the inter nucleotide linkage is in the g- conformation and that of the P-05' is g+. PMID- 6504700 TI - Helix opening in deoxyribonucleic acid from a proton nuclear magnetic resonance study of imino and amino protons in d(CG)3. AB - All exchangeable protons in a short DNA helix, d(CG)3 sodium salt, have been studied by proton nuclear magnetic resonance. The cytidine and guanosine amino protons have been assigned for the first time. As a function of temperature the cytidine amino protons and the imino protons behave very similarly, their relaxation is dominated by exchange with solvent above 30 degrees C. The guanosine amino protons, however, show that helix opening can only be described by a multistate model. The most rapid process observed is probably a twist about the helix axis which lengthens or breaks the guanosine amino hydrogen bond and allows rotation of the amino group. The second fastest process is a scissor opening into the major groove which gives rise to solvent exchange with the imino and cytidine amino protons. The slowest process observed is the complete base pair opening in which the guanosine amino protons also exchange with solvent. For the ammonium salt of the oligonucleotide, a specific ammonium ion complex is observed which at low temperature may catalyze exchange of the guanosine amino protons with the protons of the ammonium ion, but retards exchange with solvent. The complex appears to be specific for the sequence d(CpG). PMID- 6504702 TI - Changes in chromatin structure accompany modulation of the rate of transcription of 5S ribosomal genes in Tetrahymena. AB - The chromatin structure of a single cluster of six tandemly repeated 5S ribosomal RNA genes (5S genes) in Tetrahymena thermophila has been characterized. Indirect end labeling experiments indicate that the actively transcribed 5S genes in macronuclei are rapidly cut by DNAse I near the putative internal promotor and just 5' to the transcribed region. When cells are starved to reduce 5S gene transcription rates, the DNAse I sensitivity of the intragenic site is reduced relative to the 5' site. In the nontranscribed 5S genes in micronuclei, neither of these sites is hypersensitive to DNAse I. Thus structural alterations accompany both the activation of transcription during macronuclear development and physiological changes in the rate of transcription of the 5S genes. These DNAse I data together with studies using Staphylococcal nuclease suggest that rapidly transcribed 5S genes may not be associated with histones as nucleosomes. In contrast, the genes in starved cell macronuclei appear to be associated with one nucleosome per 280 base pair tandem repeat. PMID- 6504703 TI - DNA-binding of water-soluble furocoumarins: a thermodynamic and conformational approach to understanding different biological effects. AB - The interaction of two water-soluble furocoumarins, 8-(omega-diethyl aminopropyloxy)psoralen hydrochloride (I) and its 5-isomer (II), with DNA has been investigated by spectroscopic, equilibrium dialysis, hydrodynamic and chiroptical techniques. Both compounds intercalate into the polynucleotide double helix. From the dependence of the binding on ionic strength, ion release and binding free energy corrected for counterion release have been quantitatively estimated. It is shown that the differences in DNA-affinity observed for compounds I and II arise primarily from non electrostatic contributions. The binding process is exothermic, with slightly different van't Hoff enthalpies for the examined furocoumarins. Helix lengthening and dichroic effects indicate different intercalation geometries for the isomeric compounds. These studies allow a possible explanation for the finding that isomer I exhibits largely better DNA-photobinding properties, while isomer II is by far more effective as an antiviral agent. PMID- 6504704 TI - Evolution of vitellogenin genes: comparative analysis of the nucleotide sequences downstream of the transcription initiation site of four Xenopus laevis and one chicken gene. AB - Electron microscopic analysis of heteroduplexes between the most distantly related Xenopus vitellogenin genes (A genes X B genes) has revealed the distribution of homologous regions that have been preferentially conserved after the duplication events that gave rise to the multigene family in Xenopus laevis. DNA sequence analysis was limited to the region downstream of the transcription initiation site of the Xenopus genes A1, B1 and B2 and a comparison with the Xenopus A2 and the major chicken vitellogenin gene is presented. Within the coding regions of the first three exons, nucleotide substitutions resulting in amino acid changes accumulate at a rate similar to that observed in globin genes. This suggests that the duplication event which led to the formation of the A and B ancestral genes in Xenopus laevis occurred about 150 million years ago. Homologous exons of the A1-A2 and B1-B2 gene pairs, which formed about 30 million years ago, show a quite similar sequence divergence. In contrast, A1-A2 homologous introns seem to have evolved much faster than their B1-B2 counterparts. PMID- 6504706 TI - BD-40, an ellipticine-related DNA intercalative agent induces DNA-protein bridges in vivo. AB - The ability of BD-40, a DNA intercalative Ellipticine analogue, to induce DNA protein-cross links (DPLs) in mammalian cell DNA was studied by measuring DNA extractability with 0.5M KCl. Like Ellipticine, BD-40 was found to decrease the extractability of DNA, indicating the presence of DPLs, at inhibitory doses as well as at cytotoxic doses. Further analysis by alkaline sucrose gradient sedimentation of BD-40-induced DLPs indicated that the apparent size of DNA was not modified in comparison to that of control cell DNA. Abolition of DPLs by a prior proteinase K treatment of nuclear lysates resulted in DNA size reduction revealing the existence of hidden DNA strand breaks. In contrast, no proteolytic treatment was required to obtain a similar size reduction of DNA from Ellipticine treated cells. These data suggest that BD-40 induced DPLs involve NaDodSO4+alkali resistant DNA strand-protein bridges which maintain cohesiveness of adjacent DNA termini. Thus, BD-40 appears to be different from other DPL-inducing intercalative agents which have not been reported to induce DNA-protein bridges. PMID- 6504705 TI - Sequence homologies in the region preceding the transcription initiation site of the liver estrogen-responsive vitellogenin and apo-VLDLII genes. AB - In the liver of oviparous vertebrates vitellogenin gene expression is controlled by estrogen. The nucleotide sequence of the 5' flanking region of the Xenopus laevis vitellogenin genes A1, A2, B1 and B2 has been determined. These sequences have been compared to each other and to the equivalent region of the chicken vitellogenin II and apo-VLDLII genes which are also expressed in the liver in response to estrogen. The homology between the 5' flanking region of the Xenopus genes B1 and B2 is higher than between the corresponding regions of the other closely related genes A1 and A2. Four short blocks of sequence homology which are present at equivalent positions in the vitellogenin genes of both Xenopus laevis and chicken are characterized. A short sequence with two-fold rotational symmetry (GGTCANNNTGACC) was found at similar positions upstream of the five vitellogenin genes and is also present in two copies close to the 5' end of the chicken apo VLDLII gene. The possible functional significance of this sequence, common to liver estrogen-responsive genes, is discussed. PMID- 6504707 TI - Inhalation-induced immunosuppression: sniffing out the volatile nitrite-AIDS connection. PMID- 6504708 TI - Indacrinone: natriuretic and uricosuric effects of various ratios of its enantiomers in healthy men. AB - Indacrinone is an investigational loop-acting diuretic. To evaluate the natriuretic and uricosuric effects of varying ratios of its enantiomers, 10 healthy men, on a controlled Na+ (100 mEq) and K+ (80 mEq) diet, participated in a double-blind, randomized, balanced incomplete block, multiple-dose (one week) study of a fixed daily dose (10 mg) of (-) enantiomer combined with increasing doses (40, 90 and 140 mg) of (+) enantiomer versus 50 mg hydrochlorothiazide and placebo. On day 1, mean 24-h urinary Na+ increased (p less than 0.01) comparably (approximately 285 mEq) after each enantiomer combination and hydrochlorothiazide; however, the enantiomer combinations had marked uricosuric and hypouricemic effects that were enhanced with increased (+) enantiomer doses. By day 7, while enantiomer combinations and hydrochlorothiazide demonstrated comparable natriuretic activity, mean serum uric acid levels (mg/dl), in comparison to placebo, were increased (p less than 0.05) with hydrochlorothiazide but progressively decreased with increases in (+) enantiomer. Thus varying the ratio [(+, uricosuric): (-, natriuretic)] of the enantiomers of indacrinone caused natriuresis similar to hydrochlorothiazide, but had an opposite effect on serum uric acid. PMID- 6504709 TI - Antihypertensive and biochemical effects of indacrinone enantiomers. AB - The enantiomers of indacrinone (I), an investigational loop diuretic, have different pharmacologic activity. The (-) enantiomer is natriuretic, and the (+) enantiomer is uricosuric. To determine the antihypertensive effects and an isouricemic ratio of indacrinone enantiomers, 37 patients with sitting diastolic blood pressure (BP) between 90 and 104 mm Hg, after a 4-week placebo washout, randomly received one of the ratios of I enantiomers, namely -2.5/+80 mg (A), 5/+80 mg (B), -10/+80 mg (C) or placebo (P), once daily for 12 weeks in a double blind, parallel study. The mean reductions (baseline-end of treatment) in BP of 23/8, 20/10 and 25/10 mm Hg with treatments A, B and C respectively were greater (p less than 0.01) than that on P (0/3). Initially, serum uric acid decreased with treatments A and B but not with C. Mean changes in serum uric acid were 0.3, -0.4, 0.2 and 0.3 mg/dl respectively with treatments A, B, C and P. The ratio of -10/+80 mg produced least variation in serum uric acid. Reduction in serum K+ and Cl- appeared to be dose related to (-) enantiomer. No serious adverse effects were reported. A 1:9 ratio of I enantiomers intended for wide scale use as a diuretic also showed good antihypertensive activity, a favorable uric acid profile and absence of hepatic toxicity in 14 patients. PMID- 6504710 TI - [Various problems related to the current cytogenetics of leukemia]. PMID- 6504711 TI - [Effect of a single dose of strophanthin on left and right ventricular function and pulmonary circulation in patients with mitral stenosis and preserved sinus rhythm]. PMID- 6504712 TI - [Evolution of angioimmunoblastic lymphadenopathy to Hodgkin's disease. Description of 2 cases]. PMID- 6504713 TI - [Role of radiography in the diagnosis of gastroduodenal ulcer]. PMID- 6504715 TI - [Current views on the conservative treatment of peptic ulcer]. PMID- 6504714 TI - [Place of fibroendoscopy in the diagnosis of peptic ulcer in the second decade of its routine use]. PMID- 6504716 TI - [Current methods of the surgical treatment of peptic ulcer]. PMID- 6504717 TI - [Proximal gastric vagotomy in the treatment of duodenal ulcer; its evaluation in the light of a 10-year prospective study]. PMID- 6504718 TI - [New theories on the etiopathogenesis of gastroduodenal ulcer]. PMID- 6504719 TI - Effects of beta-neo-endorphin on behaviors in mice using multi-dimensional behavioral analyses. AB - The effect of beta-neo-endorphin on mouse behaviors were examined using multi dimensional behavioral analyser. The intracerebral injection of beta-neo endorphin (30 micrograms) decreased the ambulation. However, the decrease in the ambulation was not antagonized by pretreatment with 2 and 4 mg/kg doses of naloxone. These results suggest that the decrease in the ambulation induced by beta-neo-endorphin is not mediated by opioid receptors in the brain. PMID- 6504720 TI - Purification and sequence of a non-opioid peptide derived from ovine proenkephalin: implications for possible species specific processing. AB - A non-enkephalin containing pentadeca peptide derived from ovine adrenal proenkephalin has been purified and sequenced. The sequence of the peptide is: Phe-Ala-Glu-Pro-Leu-Pro-Ser-Glu-Glu-Glu-Gly-Glu-Ser-Tyr-Ser (preproenkephalin 237 251) representing the amino portion of peptide B (preproenkephalin 237-268). The sequence is identical to bovine preproenkephalin 237-251, differing from the corresponding human sequence at positions 240 and 244. This peptide can be generated by a processing event common to other opioid peptides and is present in chromaffin granules in significant amounts. The presence of this peptide in substantial quantities suggests a possible difference in proenkephalin processing between the bovine and ovine adrenal medulla. PMID- 6504721 TI - Effects of HIS1 modifications on the ability of vasoactive intestinal peptide to stimulate adenylate cyclase from rat and human tissues. AB - The importance of the N-terminal His residue of VIP for stimulating adenylate cyclase was appreciated by estimating the intrinsic activity and EC50 of four VIP analogues on membranes from rat lung, liver, brain, anterior pituitary, and pancreas, and on human heart membranes. In all tissue preparations tested except one, the order of efficacy (and often potency) was: VIP greater than (Ac-His1)VIP greater than (Phe1)VIP = (3-Me-His1)VIP greater than (D-His1)VIP. In rat heart membranes, the order of efficacy was somewhat different: VIP greater than (Ac His1)VIP = (Phe1)VIP greater than (D-His1)VIP greater than (3-Me-His1)VIP. These data demonstrated the key role of His1 in VIP in activating adenylate cyclase. They suggest that a given VIP analogue might act as full agonist in tightly coupled adenylate cyclase systems (such as those of rat lung and liver membranes) whereas the same analogue could not promote full activity in poorly coupled systems (such as that present in rat brain synaptic membranes). PMID- 6504722 TI - Biosynthesis, processing and release of pro-opiomelanocortin related peptides in the intermediate lobe of the pituitary gland of the frog (Rana ridibunda). AB - The biosynthesis of pro-opiomelanocortin (POMC) and related peptides by the intermediate lobe of the pituitary gland was studied in the frog Rana ridibunda using the pulse-chase technique. Analysis of radioactive proteins by dodecyl sulfate polyacrylamide gel electrophoresis showed that during pulse incubations a 36,000 dalton (36K) glycosylated prohormone was synthesized. It disappeared slowly during chase incubations, giving rise to another glycosylated protein (Mr 18K), identified as the N-terminal fragment of POMC. This latter protein was secreted to the incubation medium. High performance liquid chromatography analysis of peptides synthesized during chase incubations revealed the biosynthesis of two peptides related to gamma-MSH, three peptides related to alpha-MSH, one endorphin-related and one CLIP-related peptides. These newly synthesized peptides were slowly secreted to the incubation medium. Among the alpha-MSH related peptides, only the des-N alpha-acetyl alpha-MSH form of the peptide was found to be present within the cells, in contrast to the incubation medium where the presence of des-N alpha-acetyl alpha-MSH and a modified alpha MSH was demonstrated. PMID- 6504724 TI - [Effect of metoclopramide on prolactin secretion in patients with primary hypothyroidism]. PMID- 6504723 TI - A group of neurons highly reactive for enkephalins in the rat hypothalamus. AB - Enkephalin-like immunoreactivity was demonstrated in a group of highly reactive neurons (HRN) of the rat hypothalamus by the biotin-avidin immunohistochemical technique. The location of the HRN spans several nuclei but the consistent immunoreactivity, the constant topography, and the uniform dimensions of the neurons suggest that they belong to one group. At its caudal end the group appears within the rostral dorso-medial nucleus. At the level of the caudal paraventricular nucleus (PVH) the HRN are assembled in a spherical pattern around a subgroup of neurons in the anterior hypothalamus (AH). The HRN then are found in a position directly between the PVH and the fornix. Before the HRN disappear at the level of the caudal preoptic area, many of the HRN become associated with the fornix. The close association of the HRN with the AH subgroup and the fornix suggests that the HRN may influence the activity of these structures. The HRN are small to medium in size and their short processes suggest that the HRN communicate with other neurons in their vicinity. The areas of the hypothalamus in which the HRN are found are involved in neuroendocrine and thermoregulatory functions suggesting that the HRN may play a role in modifying the activity of neurons and fibres involved in these functions. PMID- 6504725 TI - [Hydrochlorothiazide and chlorthalidone in the treatment of patients with calcium phosphate disorders]. PMID- 6504726 TI - [Specific immunotherapy of atopic diseases]. PMID- 6504727 TI - [Immune complexes during specific immunotherapy in patients with hay fever]. PMID- 6504729 TI - [Analysis of cases of decompression sickness treated by hyperbaric oxygenation at the Polish Army Center for the Training of Divers and Frogmen in the summer of 1983]. PMID- 6504728 TI - [Effect of fenflumizole on platelet aggregation and the results of spirometric studies in patients with bronchial asthma]. PMID- 6504731 TI - [Spinal injuries with injuries of the spinal cord and spinal nerve roots]. PMID- 6504730 TI - [Case of Sprengel's deformity associated with Klippel-Feil syndrome]. PMID- 6504732 TI - [Spinal injuries caused by motorcycle accidents]. PMID- 6504733 TI - [Spinal injuries caused by falling from horse carriages]. PMID- 6504735 TI - [Familial occurrence of Albers-Schoenberg disease]. PMID- 6504734 TI - [Types of orthopedic equipment and its utilization in patients with severe lesions of the musculoskeletal system]. PMID- 6504736 TI - [Etiology and pathogenesis of familial spastic paraplegia (Strumpell-Lorrain disease)]. PMID- 6504737 TI - [Preliminary evaluation of the results of treatment of chronic active hepatitis (HBsAg+) with calf thymus extract (TFX-Polfa)]. PMID- 6504738 TI - [Infection with hepatitis B virus of children born to mothers-carriers of HBsAg; possibilities of passive immunization]. PMID- 6504739 TI - [Mechanisms of liver damage during general anesthesia]. PMID- 6504741 TI - [Evaluation of peripheral nervous system function in diabetes mellitus by studying the Hoffmann reflex]. PMID- 6504740 TI - [Treatment of hypertension in patients with diabetes mellitus]. PMID- 6504742 TI - [Study of medicine based on the conceptual structure of science-- using the example of diabetology]. PMID- 6504743 TI - [Pregnancy in women with heart disease--hemodynamics and pharmacotherapy]. PMID- 6504744 TI - [Pregnancy in women with heart disease--our experience]. PMID- 6504745 TI - [Pregnancy in women with heart diseases--selected psychological aspects]. PMID- 6504746 TI - [Closed commissurotomy for health reasons in pregnant women with mitral stenosis]. PMID- 6504748 TI - [Clinical and radiographic symptoms of pancreatic neoplasms and pancreatitis]. PMID- 6504747 TI - [Case of plasmacytic leukemia with complete remission and 1-year survival after a combined 5-drug sequence therapy]. PMID- 6504749 TI - [Results of the treatment of acute pancreatitis associated with cholelithiasis]. PMID- 6504750 TI - [Acute appendicitis in elderly patients in the light of our observations]. PMID- 6504751 TI - [Intraperitoneal abscesses]. PMID- 6504752 TI - [Gluten enteropathy in dermatitis herpetiformis]. PMID- 6504753 TI - [Work capacity evaluation in patients with chronic bronchitis]. PMID- 6504754 TI - [Mental disorders in arterial hypertension]. PMID- 6504755 TI - [Leukocyte system of the peripheral blood in infectious mononucleosis]. PMID- 6504756 TI - [Correction of the ionic composition of Ringer's solution]. PMID- 6504757 TI - [Case of candidiasis of the central nervous system in an adult patient]. PMID- 6504758 TI - [Various plasma components and whole blood viscosity in workers exposed to combined effects of the work environment (mainly mechanical vibration and noise)]. PMID- 6504759 TI - [Erythrocyte aggregation indicator and blood viscosity in workers exposed to combined effects of the work environment (mainly mechanical vibration and noise)]. PMID- 6504761 TI - [Nervous system disorders in workers constantly exposed to manganese]. PMID- 6504760 TI - [Health resort treatment of peripheral blood flow disorders in the hands caused by local vibration]. PMID- 6504762 TI - [Comparison of the incidence of various types of anemia in patients hospitalized in 1977, 1982 and 1983]. PMID- 6504763 TI - [A case of atypical vibration syndrome]. PMID- 6504764 TI - Hydrops fetalis associated with Gaucher disease. AB - The rare association of hydrops fetalis with acute neuropathic Gaucher disease, diagnosed at autopsy, is described. Mechanisms for the fetal edema in this case are discussed. Unusual medial calcification of the aorta was present; and although its etiology is unknown, a possible relationship to Gaucher disease is suggested. PMID- 6504765 TI - The intramucosal cysts of the stomach. VI. Their quantitative and qualitative characteristics in focal (elevated) neoplastic lesions. AB - The topographical position of the atypical epithelium replacing the lining of intramucosal gastric cysts was systematized in 88 Japanese resected stomachs having focal (elevated) neoplastic lesions. In the majority of lesions (87.5%) the atypical epithelium had replaced part of the luminal aspect of the cysts, suggesting that the replacement of the cysts by the atypical epithelium followed a downwards direction (i.e. towards the muscularis mucosa). Micrometric determinations indicated that the intramucosal cysts were larger beneath focal (elevated) neoplastic lesions than in the adjacent non-neoplastic gastric mucosa, suggesting that the cause (s) responsible for the retention of secretion had been present for a longer time in the former lesions. In some cysts, clusters of atypical cells or papillary formations with atypical cells were present at the narrowest part of the outlet from the glands, substantiating an obstructive causal mechanism in those cysts. PMID- 6504766 TI - An unusual tumor of the ovary. PMID- 6504767 TI - The use and disuse of morphometry in the diagnosis of endometrial hyperplasia and carcinoma. AB - Endometrial adenomatous hyperplasia, and the different grades of endometrial carcinoma form a continuous spectrum of morphologic deviations. The reproducibility and consistency of the assessment of these microscopical patterns is a historical problem ("nicht Karzinom - aber besser hinaus"). Lack of objective criteria is the major cause of this. Computer-aided morphometric analysis has revealed the diagnostic significance of several quantitative microscopical features. Using these in a multivariate combination, a highly reproducible and objective classifier has been developed. Selection of the significant areas by skilled gynaecopathologists is essential for the useful application of this algorythm. Especially in cases of doubt, this classification rule can be of decisive importance. Routine application in diagnostic gynaecopathology of this selective type of morphometry over a period of four years has regularly corrected the original subjective histopathological grade. In a case of a young patient with an unsuspected sexcord tumor of the ovary with annular tubules, the erroneous diagnosis of endometrial carcinoma was corrected by the application of morphometry into adenomatous hyperplasia. An excision of the ovarian tumor was performed, and slowly the morphologic pattern of the subsequent microcurettings revealed a more and more normal microscopical pattern, with eventually signs of secretion. Other studies have shown, that morphometrical analysis of adenomatous hyperplasias can predict the majority of those patients, who will develop frank carcinoma in their later course. Finally, objective histopathological grading of carcinomas reveals the superior quality of morphometry above subjective qualitative methods. Prevention of under- or overtreatment with radiotherapy can therefore be the result of routine diagnostic morphometry.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504768 TI - On the origin and histological structure of adenocarcinoma of the endocervix in women under 50 years of age. AB - In the last 10 years 28 adenocarcinomas of the endocervix developing in women up to the age of 50, have been encountered at our clinic. Of these women, 23 (82%) had taken oral contraceptives, in most instances continuously for up to 19 years, and for a median of 10 years. During the same period of time, 12 adenocarcinomas in situ of the endocervical mucosa were seen, 11 of which developed after 1 to 20 years of use of oral contraceptives. In contrast, only 40% of women with invasive squamous carcinoma under age 50 had used oral contraceptives. Fourteen of the 23 patients with invasive adenocarcinomas and 9 patients with adenocarcinoma in situ had taken contraceptives containing a potent gestagen, Norgestrel; the others had taken either Norethisterone acetate or Lynestrenol, usually in relatively high doses. Microscopically, the adenocarcinoma in the 28 women occurred in 3 forms, two of which did not appear in the 5 noncontraceptive users. In the women taking oral contraceptives, microglandular hyperplasia of the endocervix was diagnosed either prior to or coincident with the adenocarcinoma. The clinical observations are supported by experimental findings: 2 of 12 rhesus monkeys treated for 10 years with medroxyprogesterone acetate at doses 50 times those prescribed for women developed a similar type of adenocarcinoma. The longterm use of synthetic gestagens may be causally related to the development of endocervical adenocarcinoma. PMID- 6504769 TI - Accuracy of frozen section diagnosis in breast cancer detection. A review of 4436 biopsies and comparison with cytodiagnosis. AB - Frozen section diagnosis (FSD) given in 4436 consecutive breast biopsies performed in 5 years in a single pathology laboratory were checked against the final pathological report. In 4284 cases (96.57%) there was no difference between the FSD and the definitive diagnosis. There were 74 (1.66%) false negative reports and no false positive diagnoses. The diagnosis was deferred to paraffin sections in 78 cases (1.75% of biopsies). The predictive value for positive results was 100% and for negative results 97.5%; the specificity was 100%, the sensitivity 94.6% and the accuracy 98.3%. Minimal breast cancer, in situ (CIS) especially, was the main source of false negative reports. In non minimal invasive cancers (NMIC) FSD was correct in 99.42%. In minimal invasive cancers (MIC) FSD was correct in 80.21%, false negatives and deferred diagnosis increased to 8.79% and 10.98%. In CIS false negatives increased to 76.82% and deferred diagnoses to 12.19%. The sensitivity of fine needle aspiration, performed before biopsy in a portion of the patients, was lower than FSD in NMIC (71.39% versus 99.21%) and in MIC (41.66% versus 80.55%), identical to FSD in CIS (7.40% versus 7.40%). The value of cytodiagnosis in addressing surgery is discussed. PMID- 6504770 TI - Formation of transendothelial channels in traumatic human brain edema. AB - The formation of incomplete transendothelial channels is reported in four cases of traumatic human brain injury complicated with subdural or epidural hematoma or hygroma. Such structures were observed coexisting with increased transendothelial vacuolar and vesicular transport. They appeared in the following manners: as electron lucent corridors formed by deep invaginations of luminal endothelial plasma membranes, as chained spheroidal or elongated vacuoles connected with the luminal and abluminal endothelial membranes, as a result of a combined process of membrane fusion and fission, as a large protein containing vacuole or a micropinocytotic vesicle occupying the entire width of peripheral endothelial cytoplasm, as abluminal profiles of dilated basement membrane expansions, extending their course to the vicinity of endothelial luminal plasma membrane. The endothelial junctions appeared intact in most cases. The transendothelial channels apparently represent a transcytosis response to the traumatic brain injury. They may provide specific cytoplasmic corridors of facilitated transport for edema formation, which incorporate the intraluminal capillary content, ferry it across the peripheral zone of endothelial cytoplasm and empty it at the abluminal surface, into the surrounding basement membrane, from where it floods the intercellular spaces of neighbouring neuropile. The albuminal transendothelial channels, formed by the dilated basement membrane bifurcations, might be a reverse shuttle for endogeneous substances moving from parenchymal clefts to blood as a capillary mechanism of edema resolution. PMID- 6504771 TI - Histopathologic types and clinical behaviour of occult papillary carcinoma of the thyroid. AB - On studying 182 papillary neoplasms of the thyroid, 32 nonencapsulated lesions were found to be occult papillary carcinomas (maximum diameter 1.5 cm); out of these 32 patients 18 cases of cervical lymph node metastases were observed. Histologically, 4 circumscribed microcarcinomas, 3 partially encapsulated carcinomas, and 25 occult sclerosing carcinomas were distinguished. The mean diameter of the 4 circumscribed tumours as compared to that of the remaining 28 lesions proved to be statistically significantly smaller, but no significant differences could be observed regarding the rate of lymph node metastasis. One occult sclerosing carcinoma showed a morphologic pattern different from the remaining cases--namely that it had an exclusively solid appearance in the primary lesion and also in its lymph nodes metastases. The follicle cell origin of this lesion was established immunohistochemically by patchy thyroglobulin synthesis. The excellent prognosis of the occult category of papillary thyroid carcinoma was confirmed by a follow-up (mean 7.7 years, range 1.1 to 16.3 years), in which only 2 instances of eradicable recurrent lymph node metastases within the group of occult sclerosing carcinomas were recorded. PMID- 6504772 TI - Occult carcinoma of the thyroid gland. AB - Ten occult carcinomas of the thyroid gland were found in 274 unselected autopsies at the Pathology Service, Hospital Jose Joaquin Aguirre, between December 1980 and March 1983. This is the lowest incidence among the most recent published series. The present results suggest that environmental factors play an important role in the etiology of this type of carcinoma. PMID- 6504774 TI - Clinical and anatomo-histopathological features of experimental infection by DF-2 in rabbits. AB - Clinical and anatomo-histopathological features of experimental infection by DF-2 in rabbits are described. Hyperthermy, sensory reduction, diarrhoea, weight loss and catarrhal nasal discharge are reported. PTT and PT are shown to increase and number of platelets diminish markedly. Considerable haemorrhagic diathesis is reported for several organs. Several clots (especially in pulmonary vessels), serious alterations in kidney glomeruli, degeneration of hepatocytes and disseminated necrosis foci are also reported. Lesions are stated as being very similar to those observed in man. PMID- 6504773 TI - DNA-Feulgen-cytophotometric analysis of single cells isolated from paraffin embedded tissue. AB - This study describes a method for the isolation of cells from paraffin embedded tissues for DNA-Feulgen-cytophotometric measurements. The relevance of the method used is demonstrated by the analysis of the DNA-distribution pattern of cells isolated from an alveolar sarcoma of the soft tissues of a 10-year old girl. The comparison between freshly prepared imprint preparations and specimens after pepsin--extraction clearly shows, that the preparation mode used did not influence the relative DNA-content. The mean values of DNA/nuclei did not show a decrease even after prolonged pepsin treatment (90 minutes). Therefore this method permits access to stored histopathological material for retrospective DNA Feulgen-Cytophotometric investigations. PMID- 6504775 TI - Multiple pilomatricomas (calcifying epitheliomas of Malherbe). AB - Three patients with multiple pilomatricoma were seen. One had 10 nodules occurring sporadically over a four-year period. This is the greatest number of lesions reported in a single individual. Discussion of all three cases and a review of the literature are included. PMID- 6504776 TI - Woolly-hair nevus: a case report and study by scanning electron microscopy. AB - Woolly-hair is a congenital defect that produces a localized patch of lightly colored, curly scalp hair. Scanning electron microscopy of the abnormal hairs demonstrates twisting of the hair shaft and abnormal cuticle formation. PMID- 6504777 TI - Congenital smooth muscle hamartoma of the skin. AB - Three cases of circumscribed congenital smooth muscle hamartoma (CSMH) in the neonate are described, including typical characteristics and differential diagnosis. This condition is a clearly defined, distinct entity, separate from similar lesions that are considered in the differential diagnosis. It is possibly more common than is evident from the literature. PMID- 6504778 TI - Disseminated cutaneous Nocardia brasiliensis infection. AB - Nocardia brasiliensis is an uncommon pathogen in the United States despite its presence in soil samples. It is most frequently seen in patients who are immunosuppressed, but can occur in the immunocompetent host also. Usually in a healthy host the infection is localized to one area of the body. Disseminated infection was diagnosed in a healthy child who recovered fully after initiation of oral sulfonamide therapy. We suspect that the source was soil to which the patient was exposed during a family camping trip. Nocardia asteroides is the most frequent cause of nocardial infections in North America. These infections are unusual in healthy individuals, occurring more often in immunologically compromised hosts. They are usually acquired by a pulmonary route and may disseminate widely, most commonly to the central nervous system and skin. Nocardia brasiliensis, when it does occur in the United States, usually causes a chronic cutaneous and subcutaneous infection manifesting itself as mycetoma, abscess, or ulcer. We saw acute suppurative lymphocutaneous Nocardia brasiliensis infection in an otherwise healthy 2-year-old boy. PMID- 6504779 TI - Halo scalp ring: a form of localized scalp injury associated with caput succedaneum. AB - Caput succedaneum is a common birth injury attributed to cervical, uterine, or vaginal pressure on the fetal presenting part. It usually consists of diffuse soft tissue swelling and bruising, which resolve in a few days without sequelae. We have seen two patients who had an unusual alopecic "halo" ring on the scalp associated with a caput succedaneum. PMID- 6504780 TI - Treatment of plantar warts in children with a salicylic acid-podophyllin cantharidin product. AB - One hundred and twenty-one children with plantar warts were treated with a topical preparation containing salicylic acid, 30%; podophyllin, 5%; and cantharidin, 1%. One hundred patients or their families were reached 6 months to 1 year later. This treatment was effective in 81 cases. PMID- 6504781 TI - Resistant childhood psoriasis: an analysis of patients seen in a day-care center. AB - During a three-and-one-half-year period, 54 children aged 1 to 16 years, all of whom had resistant psoriasis, were seen at a day-care center. The female: male ratio was 3:2. In 74% of the patients, the onset of psoriasis occurred when they were below 10 years of age. Papules and plaques occurred in 78% of cases, guttate lesions in 16%, and nail involvement in 21%. A family history of psoriasis was present in 69% of cases, preceding upper respiratory tract infections occurred in 35%, and prior cradle cap and/or diaper rash in 50%. In the day-care center, Goeckerman therapy was given to 31 children. The average duration of treatment was 12 days, producing maximum clearing of over 90% in 64% of patients, with substantial improvement in the remainder. After three months, the psoriasis in 83% of these patients was over 90% clear; 43% showed maximum clearing at one year. Two patients were treated with anthralin and ultraviolet light alone, one with good results. One patient with nail psoriasis alone was not treated. The remaining 20 patients were either unable to attend for treatment at the center or had less extensive psoriasis. Home treatment was prescribed for them, with less satisfactory results. PMID- 6504782 TI - Ink-blot macules: an alternative to "Mongolian spots". PMID- 6504783 TI - The demise of fluorescent tinea capitis. PMID- 6504784 TI - The Mason Clinic. Its special role in the Pacific Northwest. PMID- 6504785 TI - Adjusting the hypertension regimen. Simple method based on circulatory assessment. AB - Simple clinical observations allow the physician to obtain clues as to whether hypertension is volume-mediated, due to cardiodynamic factors (increased heart rate and contractility), or due to increased peripheral vascular resistance. When drugs are chosen to correct defined circulatory abnormalities, the effectiveness of antihypertensive therapy is maximized, circulatory balance is maintained, and side effects are minimized. In the five cases presented here, drug therapy was adjusted after clinical assessment showed a circulatory imbalance. PMID- 6504786 TI - Short-term group psychotherapy. A successful approach to functional complaints. AB - The term "functional illness" describes a large group of patients who have psychologically determined physical symptoms for which they repeatedly seek medical treatment to little or no avail. At the Mason Clinic, Seattle, we in the section of behavioral medicine have devised a psychotherapeutic format for treating these chronically disabled patients. With short-term intensive group psychotherapy, patients with functional complaints are removed from the discouraging isolation of their home environment for three or four weeks, yet are spared the expense and stigma of psychiatric hospitalization. Group support is coupled with intensive self-inquiry in daily psychodynamic treatment. This immersion in a variety of therapeutic modalities helps foster new adaptations to past and present psychological conflicts. In addition to symptomatic relief, some degree of constructive and enduring personality change takes place. PMID- 6504788 TI - The 'Oh, by the way, Doctor' syndrome. PMID- 6504787 TI - Management of primary breast cancer. What the past decade has taught us. AB - Early detection of breast cancer provides the best chance of cure. For women with stage O or clinical stage I disease, two surgical options are available, with equivalent long-term survival. An increasing number of these women are choosing lumpectomy with radiation therapy to the remaining breast tissue rather than modified radical mastectomy. Clinical stage II patients are treated with modified radical mastectomy. For premenopausal women with positive axillary lymph nodes, six months of adjuvant chemotherapy increases survival. Whether postmenopausal women with positive nodes benefit from chemotherapy is unclear. At present they are best treated in the context of a therapeutic trial. A subset of premenopausal women with stage I breast cancer have tumors that are estrogen receptor-negative and are at high risk of recurrence. These women may benefit from adjuvant chemotherapy and should be entered into a therapeutic trial. PMID- 6504789 TI - Tetracycline's effects on teeth preclude uses in children and pregnant or lactating women. PMID- 6504790 TI - The aging face. Why changes occur, how to correct them. AB - Most changes that occur in the aging face are related to gravity working on skin that is becoming progressively thinner, drier, and less elastic. Exposure to sunlight hastens these changes, and protection from the sun is the only proved way to delay them. Dermabrasion, chemabrasion, and collagen implant (Zyderm) injection are safe and effective nonsurgical procedures that can improve the appearance of the aging face. Plastic surgical procedures to remove excess skin at the upper eyelids, raise the eyebrows, tighten the lower lids, and elevate the nasal tip can provide functional as well as cosmetic improvement. PMID- 6504791 TI - Reactive hepatopathy. Liver signs without primary liver disease. AB - "Reactive hepatopathy" is the term that defines a common clinical syndrome seen in seriously ill patients with disorders other than primary hepatobiliary disease. A variety of factors, including circulatory changes, metabolic stress, increased bilirubin formation, and especially uncontrolled sepsis, may lead to marked changes in parameters of liver function and frequently to frank jaundice. It is important for the practitioner to be aware of this syndrome and to avoid being distracted into spending undue time and resources in investigating the liver and biliary tree. Otherwise, there may be crucial delay in treating underlying abnormalities. PMID- 6504792 TI - Gastroesophageal reflux disease. What to do when conservative measures fail. PMID- 6504793 TI - Chronic neurologic disease. Easing the special problems of long-term care. PMID- 6504794 TI - Hereditary and acquired coagulation factor abnormalities. A primary care primer. AB - The primary care physician is usually the first to see patients with acquired or previously undiagnosed hereditary coagulation factor disorders. In addition, although such patients are best referred to a comprehensive center with specialized personnel and equipment, the referring physician is often involved in the overall care of such patients. Thus, some basic knowledge of these rare and complex syndromes is necessary to enable recognition of a suspicious history or clinical findings and to permit an understanding of the principles of therapy. PMID- 6504795 TI - Use of anticoagulants. Therapy and prophylaxis for thromboembolic phenomena. PMID- 6504796 TI - Thrombocytopenia and granulocytopenia. Characteristics, causes, evaluation, and management. AB - Thrombocytopenia and granulocytopenia have a wide variety of causes, and the history is the most useful tool in definitive diagnosis. Management depends on an accurate etiologic diagnosis. Fortunately, in most cases modern technology provides the means to deal with these problems and their complications. PMID- 6504797 TI - Diagnosis of dysuria in adolescent girls. A protocol encompassing common, often nonurinary, causes. AB - Vulvovaginitis, not urinary tract infection, is the most common cause of dysuria in adolescent girls, and the work-up for this condition involves more than just ordering urinalysis and urine culture. Factors essential to proper evaluation of dysuria include determination of the patient's age, stage of pubertal development, and sexual activity, as well as assessment of associated symptoms, concomitant conditions, and use of contraceptive or feminine hygiene products that may cause irritation. Thus, a thorough history and physical examination, including examination of the genital area, are mandatory. PMID- 6504798 TI - Motor neuron disease presenting with respiratory failure. Report of two cases. AB - In the two cases reported here, acute respiratory failure developed as a manifestation of motor neuron disease (amyotrophic lateral sclerosis). Both patients complained of systemic weakness before respiratory failure occurred. In one patient, respiratory support could not be discontinued because of poor inspiratory and expiratory pressure. Although acute respiratory failure is an uncommon manifestation of motor neuron disease, we believe this disorder should be considered in patients with unexplained respiratory failure and in those who cannot be weaned from a respirator for mechanical reasons. PMID- 6504799 TI - Acute knee injury. How to determine if the knee is stable. AB - Knee injuries are common in patients of all ages. A detailed history concerning the mechanism of injury and symptoms is helpful in establishing a tentative diagnosis, and the physical examination can easily provide confirmation. X-ray films occasionally are helpful, but stress views and arthrograms should not be relied on for definitive diagnosis. Arthroscopy may be required for definitive evaluation of internal derangement of the knee and can be used therapeutically in meniscal injuries and other problems. Proper rehabilitation is mandatory for a good outcome; therefore, physical therapy is essential regardless of whether conservative or surgical treatment is required. Proper muscle conditioning and use of braces such as the one described here may aid long-term prevention of knee injury. PMID- 6504800 TI - Life-threatening neck infections. Early diagnosis to forestall crisis. AB - Infections of the neck become life-threatening with airway or systemic involvement. The first step in successful management is early recognition by the initial examiner. Patient evaluation includes a thorough history and physical examination, laboratory studies, and if the patient's condition is stable, roentgenographic studies. With early diagnosis of neck infections, serious complications such as spread to vital structures, toxicity, airway compromise, and sepsis can be prevented. PMID- 6504801 TI - Vaginal douching. Pros, cons, and proper technique. AB - Vaginal douching is not necessary in routine feminine hygiene. When performed infrequently it is not harmful, but frequent douching may lead to recurrent vaginitis and mucosal irritation or ulceration. Douching should not be performed during pregnancy. PMID- 6504802 TI - Recent changes in the patterns of chronic digestive disease in the United Kingdom. PMID- 6504803 TI - The polyp story. PMID- 6504804 TI - The King's Fund and quality of medical care. PMID- 6504806 TI - The place of PUVA in the management of psoriasis. PMID- 6504805 TI - The management of hand eczema. PMID- 6504807 TI - Entomological components to urticaria. PMID- 6504808 TI - The National Eczema Society. PMID- 6504809 TI - Some spots of no significance. PMID- 6504810 TI - Local skin complications of BCG vaccination. PMID- 6504811 TI - A social worker attachment to a primary care team. PMID- 6504812 TI - An anti-smoking clinic in general practice. PMID- 6504813 TI - The patient map as an aid to surgery planning. PMID- 6504814 TI - Setting up neighbourhood antenatal clinics. Problems encountered in the inner city. PMID- 6504815 TI - An alternative to anticoagulant clinics. PMID- 6504816 TI - Promoting exercise from general practice. PMID- 6504817 TI - Asymmetrical tanning in hemiplegia. PMID- 6504818 TI - The face of general practice in the year 2005. PMID- 6504819 TI - Patients--past and future. PMID- 6504820 TI - The doctor, the patient and the computer. PMID- 6504821 TI - Planning for the future in general practice. PMID- 6504822 TI - How can we improve team working in primary care? PMID- 6504823 TI - The challenge of prevention. PMID- 6504825 TI - Mental illness and the general practitioner. PMID- 6504824 TI - The family doctor's role in the care of the elderly. PMID- 6504826 TI - Cardiovascular diseases. PMID- 6504827 TI - Cyclic antidepressants and cardiotoxicity. PMID- 6504828 TI - [Value of thoracic fluoroscopy]. PMID- 6504829 TI - [Histoplasmosis of the lung]. PMID- 6504830 TI - [Interstitial pneumonia caused by molds from a cold storage house for fruit]. PMID- 6504831 TI - [What does computer tomography accomplish in the evaluation of bronchopulmonary and mediastinal lymph nodes in bronchial cancer?]. PMID- 6504832 TI - [Endobronchial laser treatment of benign and semimalignant stenoses of the bronchial system]. PMID- 6504833 TI - [Diagnostic and forensic problems in the simultaneous occurrence of asbestosis and pulmonary sideroelastosis (Ceelen disease). A case report]. PMID- 6504834 TI - [The function of macrophages in sarcoidosis. II. Parameters of the clinical activity of the disease correlated with the cytology of bronchoalveolar lavage]. PMID- 6504836 TI - [An unusual cause of postoperative hemothorax: spontaneous rupture of the internal mammary artery]. PMID- 6504835 TI - [Effect of atropine on mucociliary clearance 24 hours after administration]. PMID- 6504837 TI - [Preventive vaccination against tuberculosis]. PMID- 6504838 TI - [Death caused by tuberculosis: a problem in a pneumology intensive care unit]. PMID- 6504839 TI - [Tracheal stenoses--observations on the functional course following surgical correction]. PMID- 6504840 TI - [Heart failure therapy with digitalis and spironolactone--studies within the scope of preoperative treatment before lung resection]. PMID- 6504841 TI - [25 years of the district screening center in Mainz]. PMID- 6504842 TI - [Generalized chronic sarcoidosis with clinically silent myocardial involvement]. PMID- 6504843 TI - [Power and powerlessness in dealing with children]. PMID- 6504844 TI - [The presuicidal syndrome in children and adolescents]. PMID- 6504846 TI - [Stress management in children and adolescents with behavior disorders]. PMID- 6504845 TI - [Family conditions in concentration and performance disorders]. PMID- 6504847 TI - [Use of child guidance facilities and child psychiatric polyclinics compared]. PMID- 6504848 TI - [A 2-system theory of information processing and its significance for the autistic syndrome and other psychoses]. PMID- 6504849 TI - [Practical use and theoretical considerations on handling therapy in children with early childhood autistic syndrome]. PMID- 6504850 TI - Prenatal diagnosis of atypical Tay-Sachs disease by chorionic villi sampling. AB - We studied a family at risk for atypical TSD in which the index case showed, clinically, a late onset and a gradual psychomotor deterioration and biochemically, a residual hex. A activity in leucocytes. Two prenatal diagnoses of affected fetuses were made in this family. The first one on amniotic cells, the second one on trophoblast biopsy samples. Both of them were confirmed after abortion on cultured cells. Prenatal diagnosis of TSD, even of some atypical forms is possible using trophoblast biopsy, but formal confirmation should be obtained on cultured trophoblasts. PMID- 6504852 TI - [Liver metastases. Cytohistologic studies]. PMID- 6504851 TI - Prenatal diagnosis of trisomy 9 mosaicism possibly limited to fetal membranes. AB - In repeat amniotic fluid cultures mosaicism due to trisomy 9 was noted. Autopsy of the aborted female fetus showed a sinus urogenitalis and gonadal dysgenesis with absence of germ cells only. Fetal lymphocytes and skin fibroblasts had a normal karyotype but trisomy 9 was found in cells grown from placenta. It is likely that trisomic cells were limited to fetal membranes. PMID- 6504853 TI - [Risk of metastasis in fine needle puncture]. PMID- 6504854 TI - [Complications of the aorta following sclerosing of esophageal varices]. PMID- 6504855 TI - [Mucoepidermoid cancer of the breast]. PMID- 6504856 TI - [2 rare nonepithelial benign tumors of the penis]. PMID- 6504857 TI - [A piece of tooth with a history]. PMID- 6504858 TI - Mechanical and metabolic viability of a placental perfusion system in vitro under oxygenated and anoxic conditions. AB - In vitro dual circuit perfusion of the placenta with well-oxygenated medium results in the continuous and stable consumption of oxygen and glucose over a 2-h perfusion period. This is reflected in a stable production of lactate and an energy charge which is higher at the end of the perfusion period than that seen in fresh placental tissue immediately after vaginal delivery. Anoxic perfusion causes an increase in glucose consumption which is more than twofold higher than that seen in the oxygenated perfusion, resulting finally in placental uptake of glucose not only from the maternal but also from the fetal circulation. Lactate production is increased during the anoxic perfusion, while the final tissue energy charge value lies between the values observed for fresh tissue and for the oxygenated perfusion. The shift to anaerobic metabolism shown by placental tissue in anoxic conditions enables continued functioning of the tissue over the 2-h perfusion period but it appears that under anoxic conditions the tissue may incur an energy debt not observed in oxygenated perfusions. PMID- 6504859 TI - Decidual changes in the endometrium and morphological adaptation of the associated supplying arteries in the normal and diabetic pseudopregnant rat. AB - After an electrically induced pseudopregnancy in rats in which deciduomas were produced by an intraluminal oil injection, the decidual tissue was studied morphologically on days 7, 10 and 13. A constant and dynamic wave of mitotic figures was found, which started on day 7 in the antimesometrial decidua, moving to the mesometrial decidua on day 10 and finally to the mesometrial triangle area on day 13 of pseudopregnancy. This and other morphological changes were compared with those found in pseudopregnant rats with streptozotocin-induced diabetes. On days 7 and 10 the incidence and distribution of mitotic figures were practically identical in both groups and statistically no significant difference was found in the uterine weight between the two groups on these two days. On day 13, two statistically significant differences were observed in the diabetic group: a fall in the uterine weight and a fall in the incidence of mitotic figures in the mesometrial triangle decidual cells. Associated with decidualization, a series of histological changes were studied in the arteries of the mesometrial triangle. Although the difference was not statistically significant, changes seemed to occur to a lesser degree in the diabetic group. It is concluded that the diabetic state has no influence in the early decidualization period, but it does have influence late in pseudopregnancy: a fall in the mitotic activity in the decidual tissue, a fall in the uterine weight and a less marked change in the spiral arteries which during pregnancy would supply the developing placenta with maternal blood. PMID- 6504860 TI - Investigation of the rate-limiting step in the synthesis of acetylcholine by the human placenta. AB - The uptake of [3H]choline and its conversion to [3H]acetylcholine were investigated in term human placental tissue in vitro. Although the net uptake of [3H]choline increased throughout a 45 min incubation period, intracellular [3H]choline levels reach a plateau after 2 min. There was a constant increase in [3H]acetylcholine levels throughout the incubation period. After 45 min, 36.5 per cent of the total intracellular tritium was recovered as acetylcholine by high voltage electrophoresis. The effects of the choline acetyltransferase inhibitors, 2-benzoylethyltrimethyl-ammonium chloride (BETA) and 4-naphthylvinyl pyridine (NVP), and an inhibitor of choline uptake, hemicholinium-3 (HC-3), were also investigated for their influence on the uptake and metabolism of [3H]choline. A significant depression in both [3H]choline uptake and [3H]acetylcholine synthesis could be demonstrated with all three compounds, although with somewhat different time courses and activities. An analysis of the accumulation of [3H]acetylcholine in relation to the uptake and intracellular levels of [3H]choline as well as the patterns of inhibition produced by the inhibitors indicates that, unlike nervous tissue, the rate-limiting step in the synthesis of acetylcholine in human placental tissue is the transacetylation reaction catalysed by choline acetyltransferase. PMID- 6504861 TI - Purine re-utilization in normal and malignant cells of human placental origin. AB - The metabolism of the purine compounds adenine, hypoxanthine and adenosine, was studied in cultured human choriocarcinoma cells (BeWo) and in term human placental cells in primary culture. Both preparations retained at least some specific placental functions, as shown by secretion of human chorionic gonadotrophin, which was less in the malignant cell line than in the primary culture. In contrast, choriocarcinoma cells incorporated substantially more purine bases (adenine and hypoxanthine) and nucleoside (adenosine) into nucleotides, mainly ATP. Adenosine metabolism was concentration-dependent, with a higher proportion metabolized to hypoxanthine at higher substrate concentration. The term placental cells, which do not divide in culture, have a less active purine metabolism, but they retain a degree of specialized function higher than that of malignant cells of placental origin. PMID- 6504862 TI - The effects of unilateral ovariectomy during pregnancy on placental and fetal growth in mice. AB - A comparison between placental weight and number of fetuses in normal mice and those in mice unilaterally ovariectomized on the sixth day of pregnancy, revealed a relative hypertrophy of the placentae of the latter group, with a predominance of the effect in litter sizes of five or less. The weights of the fetuses in the unilaterally ovariectomized group were not significantly different from those of the controls, thus affording no evidence of a causal connection between fetal weight and gross placental weight. PMID- 6504863 TI - Agreement of self-reported and physiologically estimated fitness status in a symptom-free population. AB - A population of 204 symptom-free clerical and white-collar employees who volunteered for a corporate-based health promotion program was studied to determine agreement between self-reported and physiologically determined fitness status. Physiologic fitness was estimated using exercise treadmill performance. There were statistically significant differences between self-reported and treadmill-estimated fitness status. The study population rated their fitness substantially higher than that estimated by treadmill performance. Self-reported fitness was found to be poorly correlated with physiologic fitness, indicating independent distributions. These relationships persisted across gender. The results question the use of self-reported estimates of physical health in health services research. PMID- 6504864 TI - Prognostic importance of cholesterol levels after myocardial infarction. AB - The aim of this study was to analyze the relationship between serum cholesterol level and all causes mortality in men who sustained a first myocardial infarction. The cholesterol distribution 3 months after the infarction was established. Ten annual cohorts (n = 1,204) were followed for a maximum period of 11 years. Secondary risk factors were comparable among the groups of the serum cholesterol distribution quintiles according to a multiple logistic prognostic function based on left heart failure, atrial fibrillation, breathlessness on infarction, maximum S-ASAT, relative heart size, and a history of hypertension. When all ages were analyzed together, the total mortality was higher in the upper cholesterol quintiles (P = 0.02). This association was confirmed when analyzed with Coxian adjustments for age, change in smoking habits after infarction, and the previously mentioned prognostic function. When broken down by age (less than or equal to 49, 50-59, greater than or equal to 60) and period of follow-up (3-24 and 25-84 months), the association between mortality and cholesterol quintiles was confined to patients under 50 years during the late follow-up period (P = 0.01), whereas there was no association for the other age groups. PMID- 6504865 TI - Perceived vulnerability in adolescents to the health consequences of cigarette smoking. AB - Adolescent feelings of vulnerability, an aspect of the Health Belief Model and Elkind's concept of adolescent egocentrism, were examined in two groups of white, middle-class 6th to 12th graders. Feelings of vulnerability were examined with respect to developmental course, antecedents, and relationship to the specific risk-taking behavior of cigarette smoking. Feelings of vulnerability to the negative consequences of smoking were found to decrease rapidly from sixth to eighth grade and to increase slowly thereafter. Experience with illness and accidents was correlated with the general vulnerability measure. However, experience with illness due to smoking was not related to smoking vulnerability. This may have been because few adolescents were found to have had personal experiences with the health consequences of smoking. Feelings of vulnerability with respect to the negative consequences of cigarette smoking were correlated with adolescent smoking behavior. General feelings of vulnerability were unrelated to cigarette smoking. PMID- 6504866 TI - The economic costs of smoking and benefits of quitting for individual smokers. AB - The results of a study that estimated the expected lifetime economic consequences of cigarette smoking for individual smokers are reported herein. The estimates were obtained by combining age- and sex-specific estimates of the incidence-based costs of three smoking-related diseases (lung cancer, coronary heart disease, and emphysema) with estimates of smokers' increased likelihood of developing these illnesses in each remaining year of life relative to nonsmokers. Estimates of the economic consequences of quitting based on these disease cost estimates and on estimates of exsmokers' probability of future disease relative to continuing smokers are also reported. Both the estimates of the economic costs of smoking and the benefits of quitting were calculated separately for men and women between the ages of 35 and 79 who were light, moderate, or heavy cigarette smokers. While the economic costs of smoking varied considerably by sex, age, and amount smoked, they were significant for all groups of smokers. Costs for a 40-year-old man, for example, ranged from $20,000 for a smoker of less than one pack of cigarettes per day to over $56,000 for a smoker of more than two packs of cigarettes per day. The economic benefits of quitting also were found to be sizable for all groups of smokers. PMID- 6504867 TI - Knowledge of and attitudes toward coronary heart disease and nutrition in Oregon families. AB - In an effort to examine knowledge about heart disease and nutrition and attitudes toward dietary change, 754 women and 125 men were interviewed. The majority of respondents recognized the association between coronary heart disease and various risk factors, including dietary cholesterol. Although they acknowledged the value of dietary change in reducing risk, the majority denied that the food they now eat increases their risk for heart disease, which suggests a lack of perception about possible benefits to be derived from dietary change. The importance of addressing perceived barriers to change is discussed. PMID- 6504868 TI - Economics and extended longevity: a case study. AB - Preventive and therapeutic advances have brought life expectancy in the United States to well over 70 years and have shifted mortality causes from acute to chronic diseases, the determinants of which are genetics, lifestyle, the environment, and aging itself. Plausible approaches to chronic disease prevention are likely to increase longevity further, with some foreseeable effects on demographic and economic projections. Primarily, longevity advances would swell forecasts of population size, and would thus have to be met by production advances in order to maintain or improve living standards. This study, a restricted example, considers the probable demographic and economic consequences of a limited prevention program in the context of the Ford Motor Company, based on actual experience and certain expectations up to the year 2000. According to the results, prevention would reduce outlays for life insurance, disability, and health care, but would also generate the higher costs of extending pension plans. Undoubtedly, prevention will continue to be highly ranked in society's pursuit of happiness, and society must prepare to meet its effects with appropriate social and economic policies. PMID- 6504869 TI - Comparison of dietary and smoking habit changes in physical fitness improvers and nonimprovers. AB - Changes in dietary, smoking, and alcohol intake habits of men who voluntarily increased their physical fitness level (n = 532) were compared with men who did not increase physical fitness (n = 390). These men were middle-aged (average age = 43 years), initially sedentary and free of disease, and had been examined twice at a preventive medicine clinic within a 1- to 6-year period. Subjects were retrospectively assigned to two fitness groups--improvers and nonimprovers--based on changes in treadmill performance between baseline and follow-up examinations. Fifteen lifestyle variables were assessed by questionnaire and evaluated for change. At baseline the two groups were similar in demographic variables and diet, differing significantly only in follow-up interval (P less than 0.001), treadmill time (P less than 0.001), whole milk consumption (P less than 0.003), and smoking (P less than 0.001). At follow-up, positive changes in health habits were seen for both groups. Statistically significant differences in health habit change between the groups were seen only for beef (P less than 0.003) and coffee (P less than 0.003) consumption (consumption of both decreasing in more improvers than nonimprovers). Smokers at baseline were less likely to improve their physical fitness. We concluded that individuals who voluntarily increased their physical fitness level were not more likely to change their dietary and alcohol habits than persons who maintained a more sedentary lifestyle. PMID- 6504870 TI - Cigarette smoking among high school seniors: did the rate decline? AB - Some questions about adolescent smoking levels as reported in national surveys were recently raised by M. B. Mittelmark, D. M. Murray, R. N. Luepker, and T. F. Pechacek, [Prev. Med. 11, 708-712 (1982)]: such levels may be underreported, calling into question the decline in adolescent smoking. The present article suggests that the most plausible interpretation of available data is that smoking is, in general, validly reported and that there was a real decline in smoking rates among high school seniors during the period 1977-1981. PMID- 6504871 TI - Response to O'Malley: cigarette smoking among high school seniors. AB - P. M. O'Malley (Prev. Med. 13, 421-426, 1984) has stimulated discussion on the issues of self-reported smoking, the use of validation procedures to enhance self report of smoking behavior, and the question of trends toward increases in underreporting of adolescent smoking. O'Malley's analysis was prompted by an earlier report of data from the Childhood Antecedents of Smoking Study. In response to O'Malley, further analysis comparing data from the Childhood Antecedents of Smoking Study with data from the Monitoring the Future study is presented, and recent evidence on the "bogus pipeline" methodology is reviewed. PMID- 6504872 TI - [Interaction of erythrocytes with aminoalkylagarose]. AB - Some properties of aminoalkyl-agarose as a carrier for adsorption immobilization of erythrocytes were being studied. The effect of the hydrophobic spacer on the erythrocyte affinity for the matrix is shown. The erythrocyte adsorption is characterized by a positive cooperativity; the shorter the spacer, the higher is cooperativity. PMID- 6504873 TI - [Effect of gamma irradiation on immobilized trypsin]. AB - The effect of ionizing radiation of 0.05-10 Mrad on trypsin immobilized on dialdehyde cellulose was being studied. After irradiation the activity of native trypsin decreases by 25%, as compared with the initial, while the activity of immobilized trypsin remains constant. Before immobilization cellulose undergoes special pretreatment that leads to a decrease in the initial contamination. Some samples of modified cellulose were contaminated by staphylococcus culture (200,000 microbes per 0.2 g) and then exposed to irradiation of 0.05-0.4 Mrad. A distinct correlation between the irradiation dose (0.05-0.4 Mrad) and contamination of the object was registered. PMID- 6504874 TI - [Characteristics of thyrotoxicosis in men]. AB - The clinical and laboratory data were examined in 227 men presenting with thyrotoxicosis and compared with the data obtained during examination of 100 thyrotoxic women. In men, thyrotoxicosis ran a far graver course than in women, showing a rapid progress. Early manifestations of the disease consisted in the impairment of cardiovascular and nervous system functions. Diagnosis of thyrotoxicosis in men is associated with considerable difficulties, particularly at the early disease stages. It should be based on a comprehensive analysis of the disease history, the clinical and laboratory data and study of the impairment of the functions of the cardiovascular, nervous and other systems. PMID- 6504875 TI - [Autoimplantation of cryopreserved (- 196 degrees C) thyroid gland parenchyma as a treatment method in postoperative hypothyroidism]. AB - To treat postoperative hypothyrosis, use was made of implantation of autologous thyroid tissue preserved and stored for 4 to 12 months before patients developed hypothyrosis. It was established that the treatment was followed by an increase in 131I accumulation in the body at the expense of its accumulation by the implant and stimulation of the process in the stump. This was paralleled by a considerable rise in T3 and T4 and reduction in TTH in the patients' blood. The patients substantially improved while the manifestations of hypothyrosis disappeared. The effects detected could be seen throughout the whole observation period (up to 18 months). The patients did not require any additional drug treatment. The data provided attest to the efficacy of autoimplantation of cryopreserved thyroid parenchyma for the treatment of postoperative hypothyrosis. PMID- 6504876 TI - [Chronic thyroiditis with hypothyroidism in patients with Addison's disease]. AB - The authors describe two cases of Schmidt's syndrome (combined idiopathic Addison's disease and chronic autoimmune thyroiditis). In both cases, the damage to the thyroid gland occurred before adrenal pathology. In one case it was associated with overt hypothyrosis and in the other one with subclinical hypothyrosis. It is suggested that these diseases are caused by an autoimmune process, which is supported by demonstration in the blood of both patients of antibodies against thyroid and adrenal tissues. PMID- 6504877 TI - [Craniopharyngioma associated with osteoporosis]. PMID- 6504878 TI - [Effect of chorionic gonadotropin on water diuresis and electrolyte excretion in rats]. AB - Experiments on male rats were made to study the effect of chorionic gonadotropin (CG) on water diuresis and electrolyte excretion. CG was injected parenterally in a dose of 200 U/100 g bw for 1, 10 and 20 days. The volume of diuresis during the first hour decreased because of a rise in water reabsorption. It was demonstrated that CG was capable of raising membrane permeability of the frog urinary bladder. Sodium excretion fell proportionally to the duration of CG injections. The blood aldosterone dropped after a single CG injection and ascended 20 days after injection. Potassium, calcium and magnesium excretion decreased after CG injections. It is suggested that CG may play an important part in the retention of mineral substances during pregnancy while its excess may be involved in the genesis of late toxemia of pregnancy. PMID- 6504880 TI - [Diagnosis and differential diagnosis of arteriovenous aneurysms of the pulmonary blood vessels in an antituberculosis dispensary]. PMID- 6504879 TI - [Effect of human chorionic gonadotropin on the endocrine function of Papio testes]. AB - Radioimmunoassay was used to study secretion of Papio hamadryas testis under stimulation with human chorionic gonadotropin (hCG). It was discovered that hCG had an acute stimulating effect on testicular secretion of testosterone, androstendione and 17-hydroxyprogesterone. It was demonstrated that repeated stimulation with hCG in the presence of the maximal secretory response of the testis (24 h after the first injection and in the presence of its partial reduction (after 72 h) did not provoke any additional rise of testosterone secretion. Unlike the initial response, repeated stimulation with hCG gave rise to dissociation in the time-course of testosterone and 17-hydroxyprogesterone responses. The data obtained attest to temporary "desensitization" of the testis to repeated stimulation with hCG. PMID- 6504881 TI - [Levamisole and diucifon immunochemotherapy of chronic destructive pulmonary tuberculosis]. PMID- 6504883 TI - [Morphological and radionuclide studies of regional blood flow in nonspecific lung diseases]. PMID- 6504882 TI - [Evaluation of cellular immunity in patients with pulmonary tuberculosis by skin tests with 2,4-dinitrochlorobenzene, streptokinase and phytohemagglutinin]. PMID- 6504884 TI - [Use of immunologic tuberculin provocation tests in the diagnosis of tuberculosis of the female internal genital organs]. PMID- 6504885 TI - [Circulating immune complexes in limited forms of pulmonary tuberculosis]. PMID- 6504886 TI - [Clinical pharmacology of isoniazid]. PMID- 6504887 TI - [Phagocytic activity of monocytes and alveolar macrophages in exogenous allergic alveolitis and other disseminated processes in the lungs]. PMID- 6504888 TI - [Effect of influenza on the course of pulmonary tuberculosis]. PMID- 6504890 TI - Bladder cancer. Part B: Radiation, local and systemic chemotherapy, and new treatment modalities. Proceedings of the First International Symposium on Tumors of the Urinary Bladder. Paris, July 4-6, 1983. PMID- 6504889 TI - [A case of inhalation bronchopulmonary aspergillosis]. PMID- 6504891 TI - Preoperative irradiation with cystectomy for bladder cancer. PMID- 6504892 TI - The place of chemotherapy associated with active immunotherapy with levamisol in advanced bladder cancer. PMID- 6504893 TI - Comparative study of actuarial survival rates in P3 P4 (N+ Mo) transitional cell carcinoma of bladder managed by total cystectomy alone or associated with preoperative radiotherapy and pelvic lymphadenectomy. AB - In P3 P4 (N+ Mo) bladder cancer patients we conclude the following: 1) The addition of preoperative radiotherapy and meticulous pelvic cellulo lymphadenectomy to total cystectomy has improved the actuarial survival at five years from 10.5% to 41%. 2) With this protocol, the pelvic recurrence has been reduced from 47.4% to 4.5% and presently the failures are due to undectectable distant metastases. PMID- 6504894 TI - Intravesical instillation of formol in the treatment of bladder tumours. PMID- 6504895 TI - Intravesical chemotherapy--other agents. PMID- 6504896 TI - What therapeutic approach should be adopted for superficial bladder tumours? PMID- 6504897 TI - Management of flat carcinoma in situ of the bladder. PMID- 6504898 TI - How I treat invasive bladder carcinoma. PMID- 6504899 TI - Post-operative radiotherapy for bladder cancers. PMID- 6504900 TI - Management of intractable bleeding in advanced bladder tumors. PMID- 6504901 TI - Hydrostatic bladder distension for bladder cancer. PMID- 6504902 TI - Loco-regional immunotherapy for bladder cancer. PMID- 6504903 TI - Cobalt therapy prophylaxis of recurrence of T1 bladder cancer. AB - Eighteen patients with T1 transitional cell carcinoma of the urinary bladder were submitted to transurethral resection of the tumor, followed by Cobalt therapy (5,500 rads to the pelvis and 6,500 rads to the bladder in six weeks). The recurrence rate at three years follow-up was 33% (6/18). Recurrence of transitional cell carcinoma of the urinary bladder is a well known condition in stage O and A, even when low grade is present. Recurrence rates at one year as high as 84% (Loening et al., 1983) are reported in the current literature. In recent years many studies have been performed which were oriented to the use of intravesical chemotherapy in order to reduce the recurrence rate (Adolphs and Bastian, 1983; Huland, 1983; Loening et al., 1983; National Bladder Cancer Collaborative Group A, 1977; Rodriguez and Caserta, 1983; Zincke et al., 1983) of this tumor. We started a protocol on treatment of the transitional cell carcinoma of the urinary bladder in 1963. The protocol calls for transurethral resection of the tumor followed by Cobalt therapy. This is an interim report on stage T1 (stage A) with such a treatment. PMID- 6504904 TI - Cryotherapy in bladder tumours. AB - Four bladder cancers were treated by cryo-tumorectomy under impedance-metry. In 3 very advanced cases, the result was favourable for several months, without any local recurrence, but there was generalization of the cancer. In the 4 th case, the excellent result has been maintained for 3 1/2 years, with a normal life style, but the treatment was completed with gamma therapy. This technique is proposed as an exceptional measure in very fragile patients as an alternative to cystectomy. In the absence of any proven cryo-immunological effect, complementary gamma therapy is recommended. PMID- 6504905 TI - Definitive radiation therapy and bladder cancer: do results reflect intrinsic tumor character? PMID- 6504906 TI - Does pre-operative radiotherapy sterilize metastatic lymph nodes in patients with transitional cell carcinoma of the bladder? PMID- 6504907 TI - Interstitial radiotherapy of carcinoma of the bladder at the Rotterdam Radiotherapy Institute (RRTI). PMID- 6504909 TI - The red cell. Sixth Ann Arbor Conference. Proceedings of the Sixth International Conference on Red Cell Metabolism and Function held in Ann Arbor, Michigan, October 3-5, 1983. PMID- 6504908 TI - Iridium-192 wiring after partial cystectomy as a treatment of small malignant bladder tumors. AB - Small tumors of the mobile portion of the bladder may be treated by means of interstitial irradiation by iridium-192 wiring. Forty-four tumors (mostly T1, but also T2 and T3) were treated by this procedure and followed over five years. Good results are attained in 66 per cent of the cases. This method has the benefit of avoiding irradiation to the surgeon's hands, and of delivering to a specific site a dose of 6,000 rads. No bladder contraction was observed. Supplementary treatment by irradiation has to be considered in view of frequent recurrences of malignant bladder tumors after transurethral resection of partial cystectomy. In small cancers slightly infiltrating the bladder wall, many attempts have been made to replace tele-irradiation by interstitial irradiation. The latter delivers specifically high rad dosage to the involved area. Radium needles has been used in France by Darget before 1951 but evaluation of accurate dosage proved difficult. This material was dangerous to the surgeon's hands, and the procedure lead frequently to bladder sclerosis. This technique is currently used by Van der Werf-Messing in Rotterdam. She strongly advises preoperative tele-irradiation (3 X: 350 rads) to prevent tumor implants in the scar. An intravesical balloon filled with fluid radioisotope of gold-198 or cobalt-60 has been used for diffuse malignant papillary epithelioma. It was discontinued because of radiation cystitis and subsequent contraction of the bladder. Recently in well-limited tumors, Bloom and Wallace have used Tantalum-182 needles which have interesting physical properties (high energy and short half-life period) (2). PMID- 6504910 TI - Encapsulation of hemoglobin in phospholipid vesicles: preparation and properties of a red cell surrogate. PMID- 6504911 TI - Aging of rat erythrocytes: differences in genetically high and low 2,3-DPG rat lines. PMID- 6504912 TI - The role of metabolic energy in the maturation-associated loss of reticulocyte membrane transport. AB - The role of metabolic energy in cell maturation-associated loss of membrane functions has been studied using sheep reticulocytes incubated in vitro at 37 degrees C for periods up to 41 hours. ATP either was maintained with glucose, adenosine plus inosine or depleted with 2-deoxyglucose plus arsenate. Two membrane transport systems were studied: Na+-dependent glycine transport and the sodium pump, estimated from the number of specific [3H] ouabain binding sites per cell. Although both transport systems decreased during maturation, the decrease was much less in ATP-depleted cells compared to ATP-replete cells. The phenomenon is relatively specific: not all maturation-associated changes are similarly affected. Thus, the decreases in activity of the cytoplasmic enzymes glucose-6 phosphate dehydrogenase, hexokinase and phosphoglucose isomerase were not prevented by energy depletion. It is concluded that the loss of certain functions during reticulocyte maturation is retarded by metabolic depletion. PMID- 6504913 TI - The erythrotropins, new factors which stimulate thymidine incorporation and globin chain synthesis in liver erythroid cells. AB - A serum-free culture system of erythroid cells of fetal rabbit liver was used for the determination of the erythropoietin-like activity present in fetal calf plasma. The activity found was too high to be explained solely by the presence of erythropoietin. For this reason we decided to investigate the nature of factors present in fetal calf tissues which could have an erythropoietin-like effect in a serum-free medium. The use of fetal calf liver cells and the replacement of the 59Fe incorporation with thymidine incorporation into acid-insoluble materials improved the sensitivity of the assay. This method was used for the rapid screening for the presence of erythropoietin-like factors in reversed-phase extracts of livers, kidneys, lungs, intestines and brains from fetal calves. Intestine extracts stimulated thymidine incorporation and were therefore used as the source for the isolation by reversed-phase and gel permeation high performance liquid chromatography (HPLC) of two active factors (1 and 2). They had different retention times on reversed-phase HPLC but had very similar amino acid compositions and a molecular weight of about 3500 daltons. Both factors added to cultures of calf liver cells caused an increase of alpha and gamma globin chain synthesis equivalent to that observed in the presence of erythropoietin. However, there were important functional differences between both factors and erythropoietin in a rat liver bioassay of thymidine incorporation similar to the one described above. Factors 1 or 2 could not increase the number of cells after a 20h incubation whereas erythropoietin caused a modest increase in cell numbers. Both factors were less potent than erythropoietin in stimulating thymidine incorporation in rat liver cells. Finally, factors 1 and 2 were synergistic with erythropoietin. It is concluded that fetal calf intestine contains factors acting on erythroid cells which have different physical and biological properties from those of erythropoietin. The names erythrotropins I and II are proposed for these factors. PMID- 6504914 TI - Calmodulin-dependent protein kinase from avian erythrocytes. PMID- 6504915 TI - Subunit assembly of normal and variant human hemoglobins. PMID- 6504916 TI - Quantitation of glucose-6-phosphate dehydrogenase in single cells by microspectrophotometry. PMID- 6504917 TI - Structural and functional features of the alpha-1 domain from human erythrocyte spectrin. AB - The complete sequence of the alpha-I domain of human erythrocyte spectrin has been determined. It contains a single type of internal homology comprised of multiple 106 amino acid repeats consistent with the occurrence of multiple gene duplications during the course of spectrin evolution. The only portion of the alpha-I sequence that does not appear to contain the sequence repeat is a segment containing the amino terminal 17 residues which may contain all or part of the alpha subunit portion of the self-association site. Secondary structural predictions and modeling suggest that each repeat unit contains a triple helical segment approximately 50 A in length. The alpha-I sequence is apparently unrelated to any other known protein sequence and apparently represents the first structural elucidation of a new class of proteins. PMID- 6504918 TI - Oxidation of membrane thiols in sickle erythrocytes. PMID- 6504919 TI - The role of the genetics of sodium lithium countertransport in the determination of blood pressure variability in the population at large. PMID- 6504921 TI - Erythrophagocytosis as a determinant of hemolytic rate in sickle disease. PMID- 6504920 TI - Zinc deficiency in sickle cell disease. AB - Occurrence of zinc deficiency in adult sickle cell anemia subjects has been reported previously. Improvement in secondary sexual characteristics, normalization of plasma ammonia and serum testosterone levels, and reversal of dark adaptation abnormality and anergy following zinc supplementation to sickle cell anemia subjects have been observed. In this paper we report the results of a controlled trial with zinc supplementation in 14 to 19 year old sickle cell anemia subjects who were retarded in growth. Our data show that zinc supplementation significantly improved longitudinal growth and body weight in these subjects. PMID- 6504922 TI - Human alkaline phosphatases. Introduction and nomenclature. PMID- 6504923 TI - Human alkaline phosphatases. Proceedings of a satellite symposium to the International Society for Oncodevelopmental Biology and Medicine annual meeting, Umea, Sweden, September 16-18, 1983. PMID- 6504924 TI - Monoclonal antibodies as structural probes in the study of placental and placental-like alkaline phosphatases. PMID- 6504925 TI - Human alkaline phosphatase isozymes. Genetic variations and their relationship to natural selection. PMID- 6504926 TI - Visualization of alkaline phosphatase genesis and transport following induction. PMID- 6504927 TI - The expression of alkaline phosphatases in human gastrointestinal and pancreatic tissues and cell lines. PMID- 6504928 TI - Heat-stable alkaline phosphatase in normal uterus and deviation of isozyme profile during uterine carcinogenesis. PMID- 6504929 TI - Studies of intestinal-like alkaline phosphatase (the Kasahara variant). PMID- 6504930 TI - Tumor immunolocalization using monoclonal antibodies which bind placental alkaline phosphatase. AB - Increased levels of PLAP in the serum of patients with certain types of cancer, particularly ovarian cancer and seminoma, indicate that PLAP may be a useful marker for detection of those tumors. Our goal was to further examine the usefulness of PLAP as a tumor marker by investigating the possibility that monoclonal antibodies binding PLAP may be useful for detection of the growth and metastasis of tumors which express the enzyme. Thus, we developed an experimental system where both a PLAP- positive and PLAP- negative tumor were grown in nude mice. The mice were then injected with radioactively-labeled F(ab)'2 fragments of a monoclonal antibody. The results are in accord with those of others and indicate that the monoclonal antibody localized in the PLAP-positive tumor 10 times or more often than it localized in the PLAP-negative tumor or in normal mouse tissues. Therefore, PLAP would appear to be a useful marker for the immunodetection of certain tumors in humans by external scintigraphy. PLAP may similarly be effective as a target for the delivery of toxic reagents to tumor cells in vivo using drugs conjugated to PLAP-specific monoclonal antibodies. PMID- 6504931 TI - Localization of human tumor xenografts by 125I-labelled monoclonal and polyclonal antibodies to placental alkaline phosphatase. PMID- 6504932 TI - Clinical use of the characterization of alkaline phosphatases. PMID- 6504933 TI - Evidence for the hormonal regulation of the multimolecular forms of serum alkaline phosphatase. PMID- 6504934 TI - Monoclonal antibodies as a tool in the detection of human placental alkaline phosphatase. PMID- 6504935 TI - Present status and future trends of human alkaline phosphatases. PMID- 6504936 TI - Placental and placental-like alkaline phosphatases in sera from healthy adults and cancer patients. PMID- 6504937 TI - Serum heat stable alkaline phosphatase activity in smokers and non-smokers. PMID- 6504938 TI - Radioactive derivatives of 2-methyl-1, 4-naphthoquinol bis (diphosphate salt) as anti-cancer drugs with high LET radiations. AB - From the results of the alpha-particle track autoradiography, the alkaline phosphatase studies, the biodistribution investigations and the therapeutic experiments with the transplanted Franks and Hemmings (1978) adenocarcinoma of the rectum in mice, an important finding is the striking selectivity of the uptake of the compound 6-211 At-astato-2-methyl-1, 4-naphthoquinol bis (diphosphate salt), after intraperitoneal injection into the tumour cell nuclei and in many cases into the nuclei of tumour stem cells, together with negligible uptake into normal colon and narrow. The compound, 6-211 At-astato-2-methyl-1, 4 naphthoquinol bis (diphosphate salt) has been found to cure about two-thirds of the transplanted adenocarcinoma of the rectum in mice after a single intra peritoneal injection of 3-4 microCi. This approach can be regarded as a form of metabolically-directed drug targetting on to a tumour product which is an enzyme, an alkaline phosphatase isozyme, present in the cells of some tumours. The compound is being studied further from the point of view of possible human therapeutic applications. PMID- 6504939 TI - Evaluation of a new, sensitive radioimmunoassay for placental alkaline phosphatase in pre- and post-operative sera from the Danish testicular cancer material. PMID- 6504940 TI - A sensitive, specific radioimmunoassay for placental alkaline phosphatase. PMID- 6504941 TI - The application of a monoclonal antibody for the detection of human placental alkaline phosphatase in sera and tumor extracts of cancer patients. PMID- 6504943 TI - Structural analysis of human alkaline phosphatase. PMID- 6504942 TI - Aspects of the relationship between liver, kidney and bone alkaline phosphatases. PMID- 6504944 TI - Cerebral blood flow under hypobaric conditions: effects of pentoxifylline ('Trental' 400). AB - A single-blind, crossover study was carried out in 9 healthy subjects to investigate the effect of a single dose of 2 tablets of 400 mg pentoxifylline ('Trental' 400) or placebo on cerebral blood flow, cerebral perfusion quotient and mental functions under experimental hypobaric conditions. Subjects were exposed in a low pressure chamber to simulated atmospheric pressures at sea level, 4000 and 7000 metres, and tests were performed 2 hours after intake of the dose, using 99m technetium brain scintigraphy and psychometric tests, to assess acutely induced impairment of cerebral function. After placebo, cerebral blood flow was decreased, especially at the 7000 metre level, whereas there was significantly less decrease after pentoxifylline. The perfusion quotient was normal throughout the pentoxifylline period but was outside the normal range in 8 of the 9 subjects after placebo. Psychometric testing showed better performance by the subjects after drug than after placebo intake. The results suggest that pentoxifylline may protect cerebral blood flow, nutrition and function under impaired supply conditions. PMID- 6504945 TI - A general practice evaluation of pivmecillinam given twice daily as a treatment for acute urinary tract infection. AB - In a multi-centre study in general practice, 292 female patients with acute urinary tract infection received a 5-day course of pivmecillinam at a dosage of either 200 mg or 400 mg twice-daily. Positive bacteriological cultures were obtained from 64 (31%) of 206 patients for whom bacteriological data was complete, and bacteriological cures were obtained in all 38 patients in the lower dose group and 22 (85%) of the 26 patients in the higher dose group. An equally good clinical response was seen with both treatments and the mean symptom score (maximum possible 15) was reduced from 7.46 to 0.73. Side-effects were reported for 7 (4%) patients in the lower dose group and 11 (10%) patients in the higher dose group. Two patients in each group ceased treatment due to nausea, which was the most frequently reported complaint. PMID- 6504946 TI - Modification of transoperative changes in blood fluidity by hydroxychloroquine: a possible explanation for the drug's antithrombotic effect. AB - A study was carried out in 40 patients undergoing minor surgery to investigate the effect of hydroxychloroquine on haemorrheological parameters which might explain its reported anti-thrombotic action. Twenty patients received 600 mg to 1400 mg hydroxychloroquine sulphate in the 48-hour period before operation and the control group of 20 patients received placebo. Blood samples were taken during the 24 hours before and on the day after operation. The results showed that in the hydroxychloroquine-treated group the transoperative increase in fibrinogen was associated with a reduction in plasma viscosity compared with an increase in the control group. Furthermore, the mean value for whole blood viscosity at middle shear rate decreased post-operatively in the drug-treated group whereas it increased in patients who had received placebo. PMID- 6504947 TI - Comparison of a fixed ratio combination of hydrochlorothiazide, amiloride and timolol ('Moducren') given once versus twice daily in mild to moderate hypertension. AB - An open, multi-centre study was carried out in general practice to compare the efficacy and tolerance of antihypertensive therapy with once-daily and twice daily dosage of a fixed ratio combination of hydrochlorothiazide (25 mg), amiloride (2.5 mg) and timolol (10 mg). A total of 604 patients with mild to moderate hypertension were treated over a period of 12 weeks with either 1 to 2 tablets once-daily (294 patients) or 1/2 to 1 tablet twice-daily (310 patients). The results showed that there was a significant reduction in systolic and diastolic blood pressures in both groups after only 2-weeks' therapy and the overall reduction after 12 weeks was 31/19 mmHg, with 57% of patients being adequately controlled on the equivalent of 1 tablet per day, whether taken once daily or in divided doses. Forty-six (8%) patients withdrew from the study because of drug-related symptoms, mainly central nervous system in origin. Overall, treatment with either regimen was considered suitable and acceptable by over 80% of patients and doctors. PMID- 6504948 TI - Drug-induced modulation of locomotor hyperactivity induced by picrotoxin in nucleus accumbens. AB - Locomotor hyperactivity was induced in rats by bilateral injection of picrotoxin (PIC) into the nucleus accumbens (NAC) followed by intraperitoneal (IP) or intra accumbens (IA) injection of agents affecting dopamine (DA), acetylcholine, serotonin, or GABA receptors. IP injection of haloperidol and diazepam attenuated PIC-induced hypermotility in a dose-dependent manner. Low (sedative) doses of the DA agonists apomorphine (APO) and lisuride, or pretreatment with reserpine abolished PIC-induced hypermotility. Independent of a preceding IA injection of PIC, higher IP doses of APO produced the well-known locomotor effect. LSD, and the atypical neuroleptic, sulpiride, potentiated PIC-induced hypermotility strongly whereas clozapine was ineffective. IA injection of carbachol or haloperidol, in doses which antagonized hypermotility induced by APO IP, did not influence PIC-induced hypermotility. The atypical neuroleptics, clozapine and sulpiride, and the benzodiazepine, diazepam, inhibited PIC-induced hypermotility. The results suggest that there is a complex involvement of GABA, DA and serotonin functions in the effectuation of PIC-induced hypermotility and that PIC-induced hypermotility may be affected by DA-sensitive structures situated outside the NAC. PMID- 6504949 TI - Opiate antagonists stereoselectively attenuate the consumption of food but not of water by pigeons. AB - Three experiments were performed to evaluate the influence of the two opiate antagonists, naloxone HCl (NAL) and Mr 2266, on the ingestive behavior of domestic pigeons. In the first and second experiments, these drugs were administered at 3 doses (0.25, 1 and 4 mg) to non-deprived and to 24 hr-fasted pigeons, respectively. Measure of the food and water consumption of the birds for up to 6 hrs post-injection revealed that as compared to control values, administration of both antagonists attenuated feeding without reducing drinking. Administration of both drugs produced a rather similar anorexic effect, with the difference that Mr 2266 tended to decrease the food intake for a longer period of time than did NAL. In the third experiment, the food consumption of fasted pigeons was reduced by the injection of Mr 2266, but not of its (+) stereoisomer Mr 2267, showing that the behavioral influence of Mr 2266 is stereoselective. Confronted with other studies, these results suggest that in pigeons, opiate receptors participate in the regulation of the food consumption without playing a major role in the control of the water intake. PMID- 6504950 TI - Nicotine-induced taste aversion: characterization and preexposure effects in rats. AB - Rats were trained to drink their 24 hr water intake during a single daily 30 min period. After stabilization, rats were presented with 0.1% (w/v) of sodium saccharin for 30 min. Immediately after removal of the saccharin solution, the animals were injected with saline, mecamylamine hydrochloride or hexamethonium hydrobromide; thirty minutes later, saline or nicotine, 0.05, 0.16, or 0.50 mg/kg were administered. Twenty-four hr later, rats were allowed access to both water and saccharin. Nicotine caused a dose-related decrease in the proportion of fluid consumed as saccharin solution during the 30 min testing situation. Neither mecamylamine nor hexamethonium alone decreased saccharin preference; however, 3 mg/kg of mecamylamine blocked the decrease of saccharin preference induced by nicotine. Preexposure of drug-naive rats to 0.5 mg/kg of nicotine for 2 or 4 days abolished the nicotine-induced taste aversions to saccharin when tested one day, or one week, after conditioning. PMID- 6504951 TI - Neurohypophyseal peptides maintain tolerance to the incoordinating effects of ethanol. AB - Arginine vasopressin (AVP), lysine vasopressin (LVP) and [des-9-glycinamide]LVP (DGLVP), administered systemically, delayed the disappearance of functional tolerance to the motor-incoordinating effect of ethanol in mice. This result is consistent with previous findings that AVP and related neuropeptides maintain tolerance to the sedative-hypnotic and hypothermic effects of ethanol, and suggests that the peptides modulate the rate of disappearance of tolerance per se, rather than simply influencing the tests used to evaluate tolerance. However, both the duration of tolerance to the incoordinating effect of ethanol, and the duration of peptide maintenance of this tolerance, were less than those observed for tolerance to the hypnotic and hypothermic effects of ethanol. Tolerance to various effects of ethanol clearly can develop and dissipate at different rates, and our results suggest that the characteristics of the maintenance of ethanol tolerance by neurohypophyseal peptides are influenced, to some extent, by the neural systems which mediate the expression of the functional tolerance which is being investigated. PMID- 6504952 TI - Conditioned place preference with morphine: the effect of extinction training on the reinforcing CR. AB - Rats were injected with either morphine (5 mg/kg) or saline in association with one set of distinct environmental stimuli, and injected with saline in association with a different set of stimuli. After four conditioning trials, animals were given a 15-minute free-choice test to determine which stimulus environment was preferred. Animals displayed CPP as a significant increase in duration spent within the morphine-associated environment, but did not display any change in number of entries into that environment. In contrast, when extinction training was given following CPP, animals displayed a significant decrease in duration spent per entry into the morphine-associated environment, but did not display any change in total duration spent in that environment. These results suggest that assessment of the reinforcing conditioned response (CR) in the CPP model may require measurement of both duration spent in and number of entries into the drug-associated environment. PMID- 6504953 TI - Quantitative analysis of physostigmine-induced changes in behavior. AB - This paper reports the use of an RF capacitance field transducer and spectral analysis to examine the effects of the cholinesterase inhibitor physostigmine on the behavior of unrestrained rats. The technique is shown to permit simultaneous quantification of changes in a variety of motor behaviors. Physostigmine induced a dose-related increase in high-frequency movements and reduced low-frequency movements, but had no effect upon habituation of five to ten Hz movements which occurred with continuous exposure to the testing apparatus. PMID- 6504954 TI - Alterations in the dopaminergic system and behaviour in rats reared on iodine deficient diets. AB - Male rats raised on an iodine-deficient diet were found to be retarded in growth rate, to have lowered body temperature, and to have poorer memory retention of a passive avoidance task than rats raised on a similar diet but with adequate iodine concentration. In addition, the iodine deficient rats showed increased locomotor activity and sniffing frequency after the dopamine agonist, apomorphine; while their operant performance was inhibited to a greater degree after apomorphine. However, the hypothermic effects of apomorphine were comparable in both iodine-deficient and normal rats. At sacrifice the iodine deficient rats were found to have significantly depressed thyroxine levels (less than 10% of normal), significantly elevated TSH levels (greater than 700% of normal), and a significantly greater concentration of dopamine receptors in the striatum (28% increase). Thus, rats raised on iodine-deficient diets have considerable behavioural and physiological alterations, including an increased concentration of dopamine receptors. PMID- 6504955 TI - Contribution of hypothermia to effects of chloral hydrate on flash evoked potentials of hooded rats. AB - This study examined the contribution of hypothermia to the effects of chloral hydrate on the flash evoked potential (FEP) of hooded rats. Three experiments were performed, all employing intraperitoneal injections of saline, and of 75, 150 and 300 mg chloral hydrate/kg body weight. In the first experiment, body temperature was measured in a standard (23 degrees C) environment for 6 hr following injection. Rats were hypothermic following administration of the 150 and 300 mg/kg dosages for up to 1 and 2 hr, respectively. In the second experiment, FEPs were recorded from the visual cortex of chronically implanted rats 30 min after injection (22 degrees C environment). P1N1, N1P2 and P2N2 amplitudes and P1, N1, P2, N2 and P3 peak latencies were significantly increased by the 300 mg/kg dosage. Increased latencies were also noted for the primary components with the 150 mg/kg dosage. The final experiment replicated the second experiment, but at an ambient temperature of 30 degrees C, which prevented hypothermia. Amplitudes were unaffected by chloral hydrate. Significantly increased peak latencies were observed, even with the 75 mg/kg dose for some components. However, the magnitude of the latency increases of the primary components was less than half of that found with a standard environment. These results indicate that depending upon ambient temperature, hypothermia may contribute to chloral hydrate-induced alterations in FEPs. PMID- 6504956 TI - Absence of reinforcement with low dose intravenous ethanol self-administration in rats. AB - Male hooded rats were implanted with intravenous cannulas and housed in operant chambers supplied with 2 levers and enclosed in sound-attenuating cubicles. In Experiment 1, seven rats received a 1.0 mg/kg infusion of ethanol for each press on the previously determined non-preferred lever. The other lever served to count "activity lever presses." An additional 7 rats served as controls and were treated identically except that each press on the non-preferred lever led to an infusion of saline, isovolumetric to the ethanol infused in the experimental subjects. The rats were tested under these conditions of continuous reinforcement for 9 days. Throughout this period, self-infusions and "activity lever presses" did not differ between the groups, suggesting that ethanol was not reinforcing at a dose of 1.0 mg/kg. These results were replicated, and extended to other low doses of ethanol in Experiment 2. Here, we employed a design where depression of either lever, under conditions of continuous reinforcement, led to the infusion of a solution. Fifteen rats were randomly assigned to one of three groups (5 rats/group). In one group, depression of the previously determined non-preferred lever led to an infusion of 16.0 mg/kg of ethanol, while depression of the other lever led to an infusion of isocaloric glucose. For the other two groups, depression of the non-preferred level led to an infusion of 4.0 and 1.0 mg/kg ethanol respectively, and depression of the other lever led to a glucose infusion. The animals were tested for 9 days, and in each case, ethanol self infusions did not differ significantly from glucose self-infusions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504957 TI - Characterization of vomeronasally-mediated response-eliciting components of earthworm wash-II. AB - Garter snakes reliably spend more time and tongue flick more frequently at a dish containing surface washings of earthworm (EW) than at a control dish containing water or sodium chloride. In a series of experiments EW was examined to further characterize and purify the snake-attracting component(s). Earthworm wash boiled for up to two hours did not lose its snake-attracting activity, but EW boiled for four hours was not discriminated from a control substance. The active components of EW were completely precipitated by 90 and 100% saturated ammonium sulfate solutions. The molecular weight of the active components, as determined by dialysis, is larger than 67,000 daltons. Earthworm wash was separated into two peaks on either G-75 or AcA 44. The larger peak (F2) contains snake-attracting material of molecular weight greater than 67K. The smaller peak material (F4) is inactive as a snake-attractant and contains material of approximate molecular weight of 3K. Biological activity of EW covaried with Lowry (protein) assay and Dubois (carbohydrate) assay values and 280 nm absorbance. The response eliciting components of EW are not extractable from earthworms at temperatures below 60 degrees C, but can be extracted at 60 degrees C (for one minute) from the worms or the soil that forms the bedding for the earthworms. PMID- 6504958 TI - The effect of d-amphetamine on short-term memory for time in pigeons. AB - The effect of d-amphetamine on pigeons' perception and short-term memory of time was investigated within a delayed symbolic matching to sample paradigm in which pigeons were rewarded for choosing one color after a 1-sec sample and another color after a 5-sec sample. On trials with no delay between sample offset and onset of the choice phase, d-amphetamine produced a bias toward choosing the color that was correct after long samples, suggesting that the birds overestimated the sample durations under amphetamine. With a 20-sec retention delay, d-amphetamine lowered choice accuracy to chance level, suggesting that it impaired the bird's short-term memory for sample durations. It was postulated that an amphetamine-induced increase in the rate of perceptual processing could mediate the effects of amphetamine on both time perception and memory. PMID- 6504959 TI - Effect of sex and castration on nicotine-induced activity responses. AB - The nature of the short-term interactions between nicotine and sex hormones in affecting activity remain unclear. The present study was an investigation of these effects. Three levels of nicotine injection--0.0 (saline control), 0.2 mg/kg body weight, and 0.4 mg/kg body weight-were given to male, female, and castrated Sprague-Dawley albino rats. Activity was measured when the animals were 6 weeks and 12 weeks old. Nicotine produced an initial depression of activity relative to the saline control levels, and a later activation which peaked at 40 to 60 minutes. The biphasic effect was most striking in female animals, but the forms of the curves relating activity to time in all groups were quite similar. PMID- 6504960 TI - Potentiation of thermoregulatory and analgesic effects of morphine by calcium antagonists. AB - Diltiazem, a calcium slow channel blocker, greatly potentiated and prolonged the antinociceptive effect of morphine in rats. Hypothermia, the primary thermoregulatory effect of morphine, was also potentiated. Verapamil, another calcium blocker elicited corresponding changes in the analgetic and thermoregulatory effects of morphine. These findings seem to be in concert with the suggestions that opiate effects on thermoregulation and nociception are exerted via modulation of calcium fluxes across neural membranes. PMID- 6504961 TI - The effect of clonidine and yohimbine on audiogenic seizures (AGS) in rats. AB - Clonidine in high doses (0.5,1.0 mg/kg) significantly increased the latency for audiogenic seizures (AGS) in rats and reduced seizure severity. At a dose (0.05 mg/kg) which acts more specifically on presynaptic alpha 2-receptors, clonidine did not affect seizure latency, but showed a slight proconvulsant action. Yohimbine tended to decrease seizure-latency at all doses, but statistical significance (p less than 0.05) was only reached at 10 mg/kg. Smaller doses of yohimbine (0.5 and 1.0 mg/kg) showed a proconvulsant effect, while a high dose (10 mg/kg) markedly reduced the severity of AGS. The effect of clonidine on seizure-latency was only antagonized by high-dose yohimbine (10 mg/kg), the combination of these drugs being of marked anticonvulsant efficacy. From these results it can be concluded that the anticonvulsant effect of clonidine does not seem to be mediated through presynaptic alpha 2-receptors. Action on other central noradrenergic receptors, and influences on other transmitters must be taken into account when interpreting the effect of clonidine and yohimbine on AGS in rats. PMID- 6504962 TI - Senility and molecular suicide. PMID- 6504963 TI - Influence of pH on the responses of guinea-pig isolated trachea to sympathomimetic amines. AB - Sympathetic amines were tested on isolated trachea of guinea pig at physiological (7.4) and acid (6.6) pH. At physiological pH noradrenaline and phenylephrine relaxed the spontaneous tone of the tracheal muscle preparation; when propranolol was previously added to the organ bath solution, noradrenaline and phenylephrine didn't affect the tracheal muscle tone. Tested at acid pH (6.6), noradrenaline and phenylephrine still relaxed tracheal muscle preparations, but in the presence of propranolol these drugs increased the muscle tone. The spasmogenic effect produced by noradrenaline and phenylephrine after beta-receptor blockade by propranolol, was completely abolished by phentolamine. The present results suggest that acidosis could alter the responsiveness of both alpha- and beta adrenoceptors in the tracheal muscle of guinea pig. PMID- 6504964 TI - Influence of DL-2-phenyl[6-ethoxybenzothiazolyl-(2)-thio]propionic acid (EMD 34853) on gallstone formation in hamsters. AB - The effects of two levels (50 and 167 mg/kg) of a new hypocholesterolemic drug (EMD 34853) on gallstone formation in hamsters were investigated. Lithogenicity was inhibited by 28-45%. Levels of biliary lipids (cholesterol, phospholipid, bile acids) were reduced in the drug-treated animals. PMID- 6504966 TI - Effects of multiple doxorubicin doses on mouse cardiac and hepatic catalase. AB - Catalase activity was followed up in the hearts and livers of CD 1 mice treated with Doxorubicin 4 mg/Kg, i.v., weekly for 9 weeks. In this murine model the antiblastic induces cardiac morphological lesions which are progressively severer with the increase of the administered cumulative dose. Heart catalase showed a consistent elevation which reached a maximum (+116.2%, P less than 0.05) after the 5th dose. In the case of hepatic catalase no significant variation was observed except a transitory elevation following the first administration. The specific increase of heart catalase activity following multiple Doxorubicin doses could be an indicator that an enhanced free radical generation acts "in vivo" along with the onset of the cardiac lesions due to antiblastic. PMID- 6504965 TI - Apparent lack of influence of the genetic drug oxidation status on plasma cholesterol concentration in man. PMID- 6504967 TI - The role of iron in the NADPH-dependent lipid peroxidation due to glutathione depletion by phorone. AB - Enhanced NADPH-dependent LPO in rat liver postmitochondrial supernatants in vitro due to depletion of GSH by treatment with phorone (diisopropylidene acetone) in vivo was inhibited by Fe2+-chelating agents (desferrioxamine, DETAPAC), but not by scavengers of .O2-, H2O2, singlet oxygen or .OH-radicals, indicating that a perferryl ion (Fe2+ . O2) is needed as an initiating factor. In vivo, rats treated with phorone (250 mg/kg i.p.) exhaled 1.4 times as much ethane within 4 h as compared to controls. Pretreatment with FeSO4 resulted in a 6.9-fold enhancement of LPO as compared to Fe2+-pretreated controls. Our results indicate that GSH-depletion results in a strong enhancement of NADPH-dependent LPO also in vivo, provided that an initiating factor is present. PMID- 6504968 TI - Pyroglutamic acid administration modifies the electrocorticogram and increases the release of acetylcholine and GABA from the guinea-pig cerebral cortex. AB - Pyroglutamic acid (1-PCA), a cyclic derivative of glutamic acid, was administered i.p. (7.7 mmol/kg) or intracerebroventricularly (25 - 50 mumol) to freely moving guinea-pigs, provided with semi-permanently implanted epidural cups. The effect of this compound on cortical Acetylcholine (ACh) and GABA outflow, as well as on gross behaviour and electrocorticogram (E.Co.G.) was investigated. 1-PCA increased the release of ACh and GABA from the cortical surface, did not change their cortical content, decreased the spontaneous motor activity and synchronized the E.Co.G.. These results suggest that 1-PCA increases GABA release, possibly by changing amino acid transport through the biological barrier or by acting as antagonist on the receptors for glutamic acid. In turn, the activation of the GABA system increases, as previously demonstrated, the cortical ACh release and causes mild sedation and E.Co.G. synchronization. PMID- 6504969 TI - Cortical and thalamic effects of local application of pentazocine to the rat somatosensory cortex. AB - Cortical and thalamic somatosensory evoked activity was studied following local application of 3% pentazocine to the primary somatosensory SI area (PSA) or to the parietal association area (PAA) of the rat cerebral cortex. At cortical level pentazocine affected the responsiveness of the two cortical areas in a way at least in part opposite. In PSA it essentially depresses the negative wave of the responses, whereas in PAA it increases both the positive and the negative components of the evoked potentials. The changes observed were restricted to the cortical region on which the drug was applied. At thalamic level, administration of pentazocine to the PSA or the PAA did not modify the bioelectrical activity recorded from the center median-parafascicular complex. It is concluded that pentazocine has a direct influence on cortical neurons involved in somatosensory processes. The failure of pentazocine-induced cortical changes to modulate neuronal activity at thalamic level is discussed. PMID- 6504970 TI - Tissue distribution of chlorimipramine and its demethylated metabolite after a single dose in the rat. AB - The pattern of distribution of chlorimipramine (CI) and of its demethyl derivative (DMCI) in different organs (lung, liver, kidney, heart and spleen) 24 h after a single dose of CI was examined and related to the amounts of the most representative classes of lipids present in tissues. The findings here reported show that lung and liver have the highest capacity to accumulate CI while DMCI was preferentially accumulated by lung, spleen and kidney. The capacity of the examined tissues to accumulate CI and DMCI did not relate to their lipid content. PMID- 6504971 TI - Biological activity of new phosphorylated analogues of oxotremorine. AB - A number of N-4 (4-dialkylamino-2-butynyl) phosphoramide derivatives related to the oxotremorine structure were prepared and evaluated for their muscarinic activity on isolated perfused rat hearts. A structure-activity relationship study revealed that among other factors, muscarinic activity is directly related to the environment of the phosphorus atom. PMID- 6504972 TI - Behavioral effects of arginine in male rats. AB - The effects of aminoacid arginine on conditioned and unconditioned behavior were studied in male rats. Arginine was administered orally at different dose levels. Both acute and subchronic (7 days) treatment schedule was performed. Exploratory behavior of the rats was studied in an open field. Acquisition of active avoidance behavior was studied in the shuttle-box test situation, and retention of passive avoidance reaction was studied in a step-through type of passive avoidance behavior. Acute administration of arginine failed to affect the acquisition and the retention of avoidance responses, and exploratory behavior of the rats. A 7-day treatment with the aminoacid caused an increase in ambulation of rats of Wistar strain, and a facilitation of acquisition and retention of avoidance responses in rats of CDR strain with poor learning capacity. It is possible that behavioral effects or arginine depend on its involvement in nucleic acid synthesis. PMID- 6504973 TI - Increase in stage 4 sleep after ingestion of a tryptophan-free diet in humans. AB - The polygraphic sleep pattern following the ingestion of an aminoacid mixture containing all essential aminoacids was compared with that following the same mixture lacking tryptophan in 12 healthy volunteers. The tryptophan-free mixture caused a decrease in stage 4 sleep latency and an increase (from 14.9% to 28.3%) in stage 4 sleep during the first 3 hours of sleep. A not significant decrease in light sleep and REM sleep was observed during the same period. During the second part of the night no significant differences were found between the two treatments. PMID- 6504974 TI - Hyperpolarization produced by methohexitone in the chick biventer cervicis skeletal muscle. AB - The effect of methohexitone on endplate potential and on depolarizations produced by acetylcholine (ACh) and tetraethylammonium (TEA) was studied in the isolated chick biventer cervicis skeletal muscle using a sucrose-gap recording technique. Methohexitone (5.5-180 uM) produced concentration-dependent hyperpolarization in the chick skeletal muscle without producing an initial contracture. Methohexitone had a differential effect on the depolarizations produced by ACh (5.5 uM- 11 mM) and TEA (0.95- 48 mM); it greatly reduced the ACh whereas it increased the TEA induced responses. It was suggested that methohexitone had a dual postjunctional action, but a presynaptic effect was not ruled out. PMID- 6504975 TI - [The East German Pharmacopoeia in its official 1 December 1983 version]. PMID- 6504976 TI - [Potentially bioactive pyrimidine derivatives. 1. 2-Amino-4-aryl-8-arylidene 3,4,5,6,7,8-hexahydroquinazoline]. AB - Six condensed 2-amino-4-arylpyrimidines (1a-f) were synthesized by the base catalyzed reaction of some monoarylidenecycloalkanones and guanidine. The reaction of 2,6-diarylidenecyclohexanones with guanidine yielded 2-amino-4-aryl 3,4,5,6,7,8-hexahydroquinazolines which were stable only as salts 3a-j. The oxidation of 3a-j led to 2-amino-4-aryl-8-arylidene-5,6,7,8 tetrahydroquinazolines 4a-j. PMID- 6504977 TI - [The evaluation of non-isothermal short-term tests of drug solutions]. AB - Non-isothermal short-term tests to examine the stability of drug solutions, are critically discussed with regard to their application to simple and complex reaction mechanisms. The influence of additional temperature dependences (ionic product of water, activity coefficient) is assayed. By example of the decomposition of tetracaine hydrochloride and acetylsalicylic acid, the evaluation of experimental results is discussed considering these factors. PMID- 6504978 TI - [The use of short-term tests for oxidation studies of drugs. 2. Kinetics of 2 mercaptobenzthiazole oxidation]. AB - By the example of 2-mercapto-benzthiazole it has been ascertained how far the k25 value obtained by extrapolation from the Arrhenius equation corresponds with the k25 value of the long-term test. To record besides oxidation products the 2 mercapto-benzthiazole, a UV-spectrophotometric method has been produced. The isothermal short-term test has been performed at 50, 60, 70, 80 and 90 degrees C after identification of the temperature independence of the reaction mechanism and of the reaction rate pH dependence. PMID- 6504979 TI - [Extraction behavior of polypropylenes. 87. Problems in the use of plastic containers for fluid drugs]. AB - Studies on the extraction of antioxidants in different polypropylene samples subjected to variable extraction terms proved that storing neutral or faintly acid infusion solutions or those with an ethanol content up to 10% for several months, the extracted antioxidants are in allowable ranges. Insignificantly increased amounts of antioxidants are delivered to alkaline solutions and to ethanol/water mixtures having increased ethanol contents. The methods and specified limiting values of the GDR pharmacopoeia have been consulted for the semiquantitative estimate of extractives. PMID- 6504980 TI - Cyclodextrin-stabilized volatile substances for inhalation therapy. AB - Diapulmon (Chinoin) which comprise camphor, 1-menthol, eucalyptus oil and quinine dissolved in sunflower oil (Oleum helianthi) is marketed in ampoules of 2 ml but utilized almost exclusively for inhalation therapy. Complexing the active ingredients of Diapulmon with beta-cyclodextrin (beta-CD) a stable non hygroscopic microcrystalline substance is obtained. When this powder sprinkled on hot water, the included volatile compounds are gradually released and the desired pharmacological effect can be brought about. PMID- 6504981 TI - Effect of relative humidity on drug release from phenytoin sodium tablets and capsules. Part 1: Commercial preparations. AB - In this study the release rate of the active substance from different lots of commercial tablets and capsules of phenytoin sodium kept in different relative humidities (56, 75, 95%) was studied. It was observed that in both tablets and capsules, the effect of relative humidity and ageing was evident on the in vitro dissolution rate when compared with the in vitro dissolution profiles obtained before storage. The release rate differed from one lot to another after storage, the lots with higher release rates before storage in general showing a decrease and the ones with lower dissolution rates showing a higher release rate after storage. PMID- 6504982 TI - [Penetration kinetics of potential virustatics into the human skin]. AB - Caffeic acid oxidation product (KOP), a substance effective against various human viruses, penetrates quickly from a 1% W/O-emulsion into the skin and forms a reservoir in the horny layer. In the epidermis and dermis approximately 30 min after external application KOP concentrations of 1 to 3% of the applied total quantity are achieved, which remain nearly unchanged even after longer penetration time. In addition to references for therapy derivable from this the results permit to draw conclusions about drug resorption that can be proved in animal experiments under in-vivo conditions. PMID- 6504983 TI - [The effect of di-n-octyl tin dichloride (DOTC) on immunocompetent organs and immunoreactivity of rats]. AB - This article investigates the effects of di-n-octyl tin dichloride (DOTC) on some morphologic changes in spleen and thymus as well as on the immune reaction of rats. One i.v. injection of DOTC in a dose of 4 mg/kg led in female rats to an atrophy which was reversible within six weeks, and to cell depletion of the thymus. The time needed for the regeneration (the thymus indicated a dose dependency of the action of DOTC (4-12 mg/kg) on these morphologic changes, which was established by examining immunostimulated rats. Changes in the spleen were observed only with extremely high doses of DOTC. The action of DOTC after one or repeated immunization of rats erythrocytes taken from sheep, on the daughter-cell dependent production of antibodies was examined by means of an immuno-rosette test and by determining the hemagglutination titre. The number of lymphocytes in the spleen which form rosettes was reduced after one intravenous administration (4 mg/kg) of DOTC 1, 2, 3, or 8 d prior to antigenic stimulation. The time needed to form rosettes was dependent on the dose. The immunoglobulin-G-immunoglobulin-M antibody titre remained unaffected if DOTC was given once by i.v. injection 7 or 8 d prior to immunostimulation, the doses ranging from 4 to 12 mg/kg. DOTC treatment carried out twice with 4 mg/kg led to a complete suppression of the immunoglobulin-G/immunoglobulin-M antibody production against erythrocytes taken from sheep, if DOTC had been applied on eight consecutive d and on d 0 (the d of the primary immunization).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6504984 TI - [Tests of drug stability then and now]. PMID- 6504985 TI - [Synthesis of potential biologically active benzotheno-oxazinones]. PMID- 6504987 TI - [The stability of prednisolone in urea-containing emulsion ointments of the W/L type]. PMID- 6504986 TI - Constituents of Conyza aegyptiaca L. PMID- 6504988 TI - [The effect of nootropic drugs on post-convulsive behavior]. PMID- 6504989 TI - On the effect of the new progestagen dienogest (STS 557) on the proliferative responses of rabbit blood lymphocytes to mitogens. PMID- 6504990 TI - Potent molluscicides from Asparagus. PMID- 6504991 TI - [The effect of peptic blood peptone (2. AB-GDR) on the intake of 3H-thymidine into endothelial cells]. PMID- 6504992 TI - [Transport mechanism and influencing factors on the ointment-skin and drug ointment systems]. PMID- 6504993 TI - [The influence on some physicochemical parameters on drug release from PMMA salt hydrogels]. AB - In vitro drug liberation results from PMMA (Eudispert)-salt hydrogels are explained from the aspect of polymer concentration, polymer molecular mass, viscosity as well of neutralisation grade and cation (Na+, K+, NH+4, ethanolamine, triethanolamine) of the polymer molecule and solubility properties of the drugs. Drug diffusion through hydrogel is regulated with the polymer network, in dependence of polymer nature and further with die mobility of water. The considered influences predominantly cover each other. PMID- 6504994 TI - [The influence of drug liberation from drug forms on local therapy of infected bone cavities]. AB - With regard to an optimum local pharmaco-therapy in infected bone cavities, in vitro examinations by means of a flow model based on the half-change method had been performed to liberate Gentamycin from globular embeddings in polymethylmethacrylate. The Gentamycin had been determined in a micro-biological manner. The release behaviour of the polymere carrier could be controlled by adding Polyethylenglycol 400 as softener or butane dioldimethacrylate as wettener. Adding 20 vol.-% of Polyethylenglycol 400, the Gentamycin release could be increased to the 8-fold, whereas the addition of 5 vol.-% of butane dioldimethacrylate resulted in a decrease amounting to 7/8 exit value. PMID- 6504995 TI - [The ratio of free and fixed interlamellar water as quality criteria for O/W creams]. AB - O/W creams with crystalline gel structures are supposed to be four phase systems. Their dominant structural elements are the hydrophilic and lipophilic gel phases. The hydrophilic gel phases have - depending on the hydrophilic character of their polar groups - a very strong swelling capacity. Further, a dynamic equilibrium is maintained between the water interlamellarly inserted into the hydrophilic gel phase and the bulk water phase. The latter is mainly fixed mechanically by the hydrophilic gel phase. The lipophilic gel phases, however, which immobilize the dispersed phase, have no or only an extremely weak swelling capacity. By means of thermogravimetry (TG) a quantitative differentiation between water interlamellarly fixed in the hydrophilic gel phase and bulk water is possible. Using dynamic TG, the curves of water release and the results obtained are discussed. In the water-containing hydrophilic ointment DAB 8 and in the non ionic hydrophilic ointment DAC the fractions of interlamellarly fixed water are substantially higher than those of the bulk water. In the investigated stearate creams, however, the fraction of the bulk water is much higher than the fraction of interlamellarly fixed water. Consequently the water release from these stearate creams is higher than that of the other O/W creams mentioned above. It is concluded that the ratio of interlamellarly fixed water and bulk water is an important criterion for the properties of such O/W creams and that TG can be suitably applied not only as in process control during product manufacturing but also as a useful tool in the development of O/W creams with a controlled water release. PMID- 6504996 TI - [The pharmacokinetics of external skin preparations]. PMID- 6504997 TI - [Parameters influencing the clinical action of phenylbutazone ointments]. PMID- 6504998 TI - [Factors influencing the in vitro and in vivo liberation of drugs from hydrogels]. AB - Interactions of drugs containing macro-molecular agents (cellulose derivatives, polyvinylpyrrolidone) as determined by equilibrium dialyses influence on the in vitro liberation (hydrophilic membrane) from hydrogels of the same viscosity acc. to the binding intensity. Utilizing a lipophilic membrane, this can be proved, too, the liberation intensity, however, is substantially determined by the lipoidwater distribution behaviour of the drugs. In-vivo liberations revealed in this, that differentiations in the liberation from methylcellulose and polyvinylpyrrolidone gels occur solely in drugs having a more intense affinity. The penetration intensity of the hydrogel into skin is, however, not caused by the binding tendency but by the lipoidwater distribution behaviour of the drugs. Analysing the in-vitro liberation with the use of a lipophilic membrane or knowing the distribution coefficient, informations on the level of the probable drug penetration gel/skin can be given. PMID- 6504999 TI - [The use of preservatives in skin preparations]. AB - Dermatological preparations may be contaminated during their manufacture and their use. On account of the danger of this contamination, different Pharmacopoeia prescribe the maximal allowable number of microorganisms in the different dermatological preparations. The preservatives used must kill or diminish their number in a period of time equal to the time elapsed between two applications. This time however could be different for each preparation. Therefore the preservatives must have antibacterial activities adapted to the use of the dermatological preparation. The activity can be given by the D-value or the decimal reductiontime. The D-values of the different kinds of dermatological preparations have been calculated with a startcontamination of 10(6) microorganism g. The activity of a preservative must be determined directly in the preparation. Firstly the preparation with a preservative is contaminated with microorganisms, secondly the killing rate is determined and finally the D-value is calculated. After the calculation of the D-value of different samples each containing a different preservative and several concentrations, it is possible to select a preservative and to determine his concentration giving a D-value corresponding to the D-value required by the use of the dermatological preparation. PMID- 6505000 TI - [The influences of drugs and vehicles on drug diffusion from acrylate films]. PMID- 6505001 TI - [Liposomes as drug vehicles in percutaneous therapy]. AB - Liposomes may be utilized as favourable drug-carriers also in ointments. The experiments on men have demonstrated that triamcinolone entrapped in liposomes consisted of egg lecithin and cholesterol, put on the forearm skin in form of the ointment, was absorbed in three times greater amount than from the ordinary ointment. PMID- 6505002 TI - [Factors influencing the therapeutic effect of ointment gels]. AB - It is published on new results of research from the institute of the author in which were examined some combined ointment gels putting recently in circulation and new emulsifiers from that may be prepared compositions with suitable rheological stability and large water-absorbing capacity. These systems have suitable thermostability and retentivity of water. The release of many active ingredients were investigated with in-vitro and in-vivo-methods. PMID- 6505003 TI - [Some aspects of drug-pharmaceutic aid interactions and their effects]. PMID- 6505004 TI - [The of "laminar air flow" systems]. PMID- 6505005 TI - Influence of uremia and hemodialysis on the plasma protein binding of tolmetin. AB - Binding of the nonsteroidal anti-inflammatory drug, tolmetin, to plasma from uremic patients before hemodialysis and from healthy subjects was compared using microequilibrium dialysis techniques. The percent age of free tolmetin was 2-15 times greater in plasma from uremic patients (1.33-3.08%) than in plasma from healthy volunteers (0.37-0.63%) at all three concentrations of the drug studied (0.5, 5 and 50 micrograms/ml). The reduced plasma binding of tolmetin in plasma from uremic patients was associated with significantly higher dissociation constants for the high-affinity tolmetin binding site on plasma albumin. When added at concentrations of 2.0 mM oleic, stearic and palmitic acids, 3 representative nonesterified fatty acids (NEFA) were found to significantly enhance tolmetin binding to plasma proteins. No differences in total plasma NEFA concentrations were observed between uremic patients before hemodialysis and healthy subjects. However, higher total NEFA concentrations in plasma from uremic patients after hemodialysis were accompanied by increased tolmetin binding. Possible NEFA effects on tolmetin binding could not be dissociated from other influences, such as the removal of endogenous binding inhibitors during hemodialysis. PMID- 6505007 TI - Morality and medicine on the modern stage. PMID- 6505008 TI - Two hemispheres and the medical connection. PMID- 6505006 TI - Studies on 5-hydroxytryptamine receptors on isolated human femoral veins and arteries and the influence of dihydroergotamine. AB - 5-Hydroxytryptamine (5-HT) caused concentration-dependent contractions in human postmortem femoral venous and arterial strips. In veins, it was a more potent agonist than noradrenaline, while the reverse was true for arteries. Pizotifen and methysergide were competitive antagonists against 5-HT in femoral arteries with pA2 values of 8.18 and 8.37, while in femoral veins they exerted noncompetitive antagonism. Dihydroergotamine (DHE) antagonized the 5-HT effect in a manner which was not competitive both in veins and arteries. At concentrations employed in antagonist experiments, it increased the resting tone, particularly in veins. The contractile response of veins to DHE was inhibited when the vascular preparations were preincubated with pizotifen at nanomolar concentrations. The results suggest that 5-HT receptors on veins differ from those on arteries. DHE possesses comparatively high affinity for 5-HT receptors on veins. It is concluded that 5-HT receptors may be involved in the contractile response of veins to DHE. PMID- 6505009 TI - Dissecting the clinical art. PMID- 6505010 TI - Further musings on medical education. PMID- 6505011 TI - Physicians' future work. PMID- 6505012 TI - Steroids for athletes. PMID- 6505013 TI - Regulation vs. autonomy: matching ethics and technology in medical practice. PMID- 6505014 TI - Sodium in man and the assessment of radiation dose after criticality accidents. AB - Recent observations on the sodium content of the human body, both total and exchangeable, using isotope dilution methods and activation of sodium by whole body irradiation with neutrons in the course of clinical research, suggest that ICRP Reference Man is a misleading guide to the sodium content of the body and of the skeleton and its parts. They also show that reasonable predictions of body sodium content can be made from body weight, height and age, or even from body weight alone. Mean sodium in the average man is about 1.04 g per kg and in the average women about 0.98 g per kg in British and N. American populations. Within each sex mean tissue concentration is inversely related to body weight. Review of the dosimetry for the criticality accident at Y-12 Oak Ridge shows that dose estimates should be increased by about 10% because whole blood values of 24Na were relied on instead of plasma values. Taking account of body build reduces the range of dose amongst the four most heavily irradiated subjects. The absorbed doses reported for the subjects exposed at the criticality accident at Vinca, Yugoslavia, need to be increased by about 30% because the normal sodium content of the body was grossly overestimated. The more severe clinical picture at Vinca than at Y-12 is now more easily understood in terms of differences in dose. These changes are solely the result of improved information about sodium in the body. Other uncertainties in the dosimetry at Y-12 and Vinca are unaltered. PMID- 6505015 TI - Energy imparted to the patient in diagnostic radiology: calculation of conversion factors for determining the energy imparted from measurements of the air collision kerma integrated over beam area. AB - The energy imparted to the patient in diagnostic radiology, related to radiation risk in examinations of the trunk and head, can be deduced from a measurement of the air collision kerma (or exposure) of the incident primary photons integrated over beam area by using a thin, flat ionisation chamber covering the entire roentgen beam. Factors for converting the integral of the air collision kerma to energy imparted to the patient have been calculated using a Monte Carlo method. The patient is simulated by laterally infinite water slabs with thicknesses from 100-300 mm. Calculations are performed for monoenergetic photons (5-300 keV) and energy spectra commonly used in diagnostic radiology (40-130 kV acceleration potential differences and values of the half-value thickness of air collision kerma in aluminium from 0.9 to 9.9 mm). Correction factors which take into account the additional escape of scattered photons from the sides of a laterally finite water slab as a function of field size and focal distance are also given. PMID- 6505016 TI - Analysis of x-ray computed tomography images using the noise power spectrum and autocorrelation function. AB - A discrete representation of the reconstruction process, consistent with the method of data collection, has been used to derive expressions for the noise power spectrum, autocorrelation function and noise equivalent quanta (NEQ) of a computed tomography (CT) image. These parameters have been expressed in terms of basic scanning factors such as tube current, exposure time, slice width and number of detectors. Each of these factors affects the overall magnitude of the noise power spectrum, but the spatial frequency dependence is also determined by the type of reconstruction filter used in the computer algorithm. The noise power spectrum has been calculated for scanners employing either a ramp or Hanning weighted ramp filter. Predictions made from this theoretical analysis have been compared with experimental measurements made on various CT scanners. Measurements were made of the modulation transfer function (MTF) by techniques which permitted us to deduce the contributions of the algorithmic and non-algorithmic components to the overall MTF. NEQ values have been calculated for a number of CT scanners. PMID- 6505017 TI - Compton scatter axial tomography with x-rays: SCAT-CAT. AB - A method of extracting information from the backscattered field produced in parallel beam x-ray computed tomography (CT) is presented. A calculational model to predict the backscattered field based on Compton scattering is described, and the model is verified by measurements of simple phantoms. The phantoms tested- cylinders of polymethylmethacrylate (PMM) with air gaps and aluminium rods placed internally--are irradiated on a scanning assembly, built to simulate a first generation CT scanner with a transmission and a scatter detector (the SCAT-CAT). Data from the transmission detector are reconstructed by traditional CT methods to provide a transmission image; it is the data from the backscatter detector which are analysed in this study. After verification of the model for the scattered field calculations, a method of extracting information from the scattered field is developed, based on ratios of scatter signals from non-uniform to uniform phantoms. This method is demonstrated for predicted data of a simulated phantom and for measured data of the same and two additional phantoms. The method is very sensitive to air gaps in the phantoms because of the relative electron density of air with respect to PMM; it is not as sensitive to aluminium rods for the same reason. Various methods of applying the scattered field information to produce an image representing a simulated phantom are considered, and a preferred method is chosen to reconstruct scattered field data into an image for the three phantoms studied. PMID- 6505018 TI - Photon scattering in biomedically important elements. AB - A survey of recently published work on the biomedical and other applications of the ratios of coherent to incoherent scattering of gamma radiation off low Z elements has revealed that the functional dependence of any individual process is, for the most part, misrepresented. It is shown, by analysis of the available tabulated coherent and incoherent scattering functions, that an explicit power dependence of Z may not be easily expressed. Furthermore, Rayleigh scattering is much better represented by the modified form factor rather than the usual form factor approach. The quantities of interest in using the coherent to incoherent scattering intensity ratio have been identified and various parametrical procedures have been developed within the range of atomic number and momentum transfers of biomedical interest. Applications to bone mineral measurements are discussed and future investigations based upon recent, more accurate theoretical predictions of scattering cross-sections are suggested. PMID- 6505019 TI - Microwave dielectric measurements (0.8-70 GHz) on Artemia cysts at variable water content. AB - Dielectric permittivity measurements are reported for cysts of Artemia, a crustacean known as the brine shrimp. Using coaxial and waveguide techniques we examined the frequency range from 0.8 to 70 GHz. Taking advantage of the ability of this system to reversibly lose essentially all intracellular water, we determined the permittivity over the entire range of cyst water contents. Although experimental errors prevent a rigorous treatment of the data, we advance the general conclusion that little of the water in this system behaves dielectrically like pure water, regardless of water content. This conclusion is supported by, and is consistent with, the results of previously published studies that probe the motional properties of water in this system using nuclear magnetic resonance spectroscopy and quasi-elastic neutron scattering. PMID- 6505020 TI - An instant dose obtainable in situ calorimeter. PMID- 6505021 TI - Temperature and calibration corrections to puff volume measurements in cigarette smoking. PMID- 6505023 TI - Kinesiology versus biomechanics. A perspective. PMID- 6505022 TI - Biomechanics and physical therapy. A perspective. PMID- 6505024 TI - Biomechanics. A neural control perspective. PMID- 6505025 TI - Biomechanics. A summary of perspectives. PMID- 6505026 TI - Electromyography in biomechanics. AB - The purpose of this paper is to discuss the use of EMG as related to biomechanical function and dysfunction. The uses and limitations of this technique are described and instrumentation features and methods of data collection and interpretation are presented. We also discuss factors that influence the relationship of EMG to biomechanical measurements and cite as examples studies that have used EMG. Emphasis is placed on improving the ability of the physical therapist to use and interpret EMG data in kinesiology and biomechanics. PMID- 6505027 TI - Techniques for clinical assessment of human movement. AB - Conventional, clinically available techniques used in the measurement and analysis of human movement are overviewed in the first part of the article. I examine the data produced by these techniques in terms of information content and potential usefulness in assessing human movement. Consideration is given to the observation process and to specific techniques for determining temporal and spatial, kinematic, and kinetic variables. The techniques examined document the end result of the movement process, which limits the information content to a descriptive level. Of these descriptive variables, the temporal and spatial variables have the advantage of being much easier to obtain and interpret. In the last part of the paper, I review more complex methods of analysis. These methods enable the determination of mechanical energy levels and joint moments, which exposes the underlying biomechanics of the movement. Such information can be related to the causes of the movement disorder and can help to diagnose the abnormal movement pattern. PMID- 6505028 TI - Gait analysis techniques. Rancho Los Amigos Hospital gait laboratory. AB - In the gait laboratory at Rancho Los Amigos Hospital, the emphasis is on patient testing to identify functional problems and determine the effectiveness of treatment programs. Footswitch stride analysis, dynamic EMG, energy-cost measurements, force plate, and instrumented motion analysis are the techniques most often used. Stride data define the temporal and distance factors of gait. We use this information to classify the patient's ability to walk and measure response to treatment programs. Inappropriate muscle action in the patient disabled by an upper motor neuron lesion is identified with dynamic EMG. Intramuscular wire electrodes are used to differentiate the action of adjacent muscles. We use the information to localize the source of abnormal function so that selection of treatment procedures is more precise. Force and motion data aid in determining the functional requirement and the muscular response necessary to meet the demand. Determining the optimum mode of locomotion and developing criteria for program planning have become more realistic with the aid of energy cost measurements. Microprocessors and personal computer systems have made compact and reliable single-concept instrumentation available for basic gait analysis in the standard clinical environment at a modest cost. The more elaborate composite systems, however, still require custom instrumentation and engineering support. PMID- 6505029 TI - Pathomechanics of stance. Clinical concepts for analysis. AB - This paper presents some basic biomechanical considerations that can form a basis for analysis of stance deviations. The floor reaction forces and their effects on the lower extremity are reviewed as a basis for understanding the pathomechanics of stance. Pathomechanics includes the unwanted motions that tend to be created by the floor reaction forces in the absence of critical muscle activity. Compensatory postures that a patient may assume to prevent these unwanted motions and compensatory postures that a patient may assume at one joint because of abnormal positioning at another joint are discussed. Finally, the influence of joint posture from one phase of gait to another is explained. PMID- 6505030 TI - Biomechanics in clinical practice. AB - Evidence from dynamic biomechanical analyses of physical activities has greatly expanded our knowledge about the mechanical bases for human movement function with potential implications for further understanding movement dysfunction. The purpose of this review is to relate these findings to present knowledge about the effect on human joints during movement, the role of muscle action on human skeletal levers during movement, and the application of this information to functional tasks by physical therapy clinicians. Also presented are some thoughts regarding what must be accomplished so that this material can be generalized to clinical practice. PMID- 6505031 TI - Biomechanics of noncontractile tissue. A review. AB - I present a review of the literature pertaining to the mechanical properties of bone, articular cartilage, and collagenous tissues such as ligament and tendon. The basic terminology involved in the mechanics of materials is briefly discussed. I also discuss the influence of physical activity, disuse, and age on the mechanical properties of these tissues. PMID- 6505033 TI - Glossary of biomechanical terms, concepts, and units. PMID- 6505034 TI - The effect of medium polarity on the hematoporphyrin-sensitized photooxidation of L-tryptophan. PMID- 6505032 TI - Developmental biomechanics. Effect of forces on the growth, development, and maintenance of the human body. AB - The purpose of this paper is to present an overview of growth principles that are influenced by mechanical factors. These general principles are followed by some biomechanical examples of the growth and development of weight-bearing body areas, and examples of growth principles and mechanics related to therapeutic applications. PMID- 6505035 TI - Alpha polymerase involvement in excision repair of damage induced by solar radiation at defined wavelengths in human fibroblasts. PMID- 6505036 TI - Action spectrum for photoreactivation of ultraviolet-induced morphological abnormality in sea urchin eggs. PMID- 6505037 TI - Transmission of human epidermis and stratum corneum as a function of thickness in the ultraviolet and visible wavelengths. PMID- 6505038 TI - Testing kinetic models for the bacteriorhodopsin photocycle--II. Inclusion of an O to M backreaction. PMID- 6505039 TI - A wavelength effect on urocanic acid E/Z photoisomerization. PMID- 6505040 TI - Some physicochemical properties of the gadolinium-DTPA complex, a contrast agent for MRI. AB - The physicochemical characteristics of a good contrast agent for NMR are met by the gadolinium-DTPA complex. Measurements of density, viscosity and osmotic pressure of solutions to be injected are reported. A short survey of the results of X-ray analysis of the di-sodium-Gd-DTPA is given. PMID- 6505041 TI - Safe common agents for improved NMR contrast. AB - As nuclear magnetic resonance imaging techniques have developed, a need for agents which can enhance and improve the natural tissue relaxation time differences has become apparent. Especially valuable would be agents that differentially alter NMR images in a manner related to tissue physiology and disease processes. Sophisticated para-magnetic and free radical contrast agents will be discussed in other papers in this issue. However, in this report, some common agents which are currently used in research and in human clinical studies for other purposes, but which can alter NMR contrast will be discussed. These agents include olive oil, estrogen hormones, diuretics, ethanol, glycerin, and dimethyl sulfoxide. Measurements of their relative effects on T1 and T2 of normal and cancerous breast tissues, a variety of body organs, and brain are presented. Some of these agents may have immediate practical applications in human NMR imaging studies. PMID- 6505042 TI - First use of GdDTPA/dimeglumine in man. AB - The dimeglumine salt of the Gd-DTPA complex has a strong paramagnetic effect and a very low toxicity in animals. This report of its use in human volunteers confirms its low toxicity and indicates its usefulness in the enhancement of signal intensity of the kidney and bladder. PMID- 6505043 TI - Pharmacokinetics of GdDTPA/dimeglumine after intravenous injection into healthy volunteers. AB - Pharmacokinetic studies of GdDTPA/dimeglumine in man show a rapid renal clearance and no evidence for dissociation or retention of the complex in the body. These features, in conjunction with its strong proton relaxation enhancement and its low toxicity suggest that this complex may be an excellent contrast medium for magnetic resonance imaging. PMID- 6505044 TI - Contrast enhancement in biomedical NMR. PMID- 6505045 TI - Effects of mastectomy and vagotomy on grooming behavior of the rat: possible involvement of prolactin. AB - Surgical interventions such as unilateral mastectomy or vagotomy affect plasma prolactin (PRL) levels. Right-side mastectomized rats exhibiting high levels of plasma PRL showed increased grooming behavior. Left-side mastectomized rats with low levels of plasma PRL performed poor grooming activity. Bilateral mastectomy that caused a slight increase in plasma PRL levels was followed by enhanced grooming behavior. Both left and right vagotomy resulted in a significant increase in plasma PRL levels. However, only left-side vagotomized rats exhibited increased levels of grooming behavior, while no difference between right-side vagotomized rats and controls occurred. It is possible that changes in plasma PRL levels induced by surgical interventions affect grooming activity of the rat. However, the hypothesis that the integrity of peripheral organs is important for the display of grooming behavior cannot be ruled out. PMID- 6505046 TI - Critical period for the entrainment of the circadian rhythm in blinded pups by dams. AB - The critical period for the entrainment of circadian rhythm in blinded pups by a foster mother with a rhythm inverted to that of the natural mother was determined by a convenient method for the analysis of the circadian rhythm of drinking behavior. The pups, optically enucleated on day 1, were transferred to the foster mother at various ages, measured in days from birth, and raised until weaning. When the pups were transferred before 4 days of age, the drinking rhythm of the adopted pups was in phase with that of the blinded natural pups born of and raised by the foster mother. On the other hand, when the mother was exchanged after 10 days of age, the rhythm of the adopted pups was out of phase with that of the natural pups of the foster mother. Pups exchanged on 5 or 7 days of age showed inconsistent phase of rhythm, either being entrained by the foster or the natural mothers, or affected by both mothers. These results indicate that blinded pups must be adopted by the foster mothers earlier than day 4 for the foster mothers to fully entrain the circadian rhythm of blinded pups. PMID- 6505048 TI - A detailed analysis of sucrose drinking in the rat. AB - The present report represents an initial attempt to examine and quantify the eating and drinking patterns of rats presented with water, laboratory chow, and sucrose solution for 23 hours. The concentration of the sucrose solution was systematically increased (0.10 M, 0.25 M, 0.5 M, 1.0 M) with a single concentration being presented to rats in four-day blocks. As has been previously shown, total intake (ml) of sucrose solution increased with concentration to a peak at 0.25 M and then decreased with further rises in concentration. Calories consumed from sucrose monotonically increased with concentration, reaching a maximum at 0.50 M. As calories consumed from sucrose increased with rising concentration, chow intake monotonically decreased. This compensatory decrease in chow intake was primarily attributable to decreases in nighttime chow consumption when the concentration of sucrose available was less than or equal to 0.25 M; when the concentration was greater than 0.25 M, further reductions in chow intake occurred during the day. Moreover, the decrease in chow intake was due solely to a reduction in the number of chow bouts. As the concentration of sucrose increased, the day-to-night ratio of sucrose intake approached unity. Bout volume increased with concentration to a broad peak spanning 0.25-0.5 M, and then decreased with 1.0 M. Bout duration changed with sucrose concentration such that the bout drinking rate (ml/min) was seen to monotonically increase, reaching a stable maximum at 0.5 M. Since the caloric intake per sucrose bout progressively increased with each rise in concentration, the asymptotic portion of the curve describing calories consumed from sucrose was attributable to alterations in sucrose bout number and not sucrose bout size. PMID- 6505047 TI - Self-selection and the obese Zucker rat: the effect of dietary fat dilution. AB - Adult female lean and obese Zucker rats were allowed to compose their own diets by giving them access to three macronutrient sources. After a baseline period, the fat source was serially diluted. In all, eight concentrations of fat were used. Dilution of the fat source promoted significant increases in the intake of fat by both lean and obese rats. The increased intake of fat was not simply compensatory in nature, but rather represented significant increases in fat consumption. These results suggest that the reported increased appetite for fat of the obese rat is not a unique trait of that genotype. Further, results from this experiment demonstrate that caloric and protein regulation mechanisms may not be controlling the intake of obese and lean rats as precisely as once believed. PMID- 6505049 TI - Novel long-term cardiovascular effects of industrial noise. AB - Baboon subjects were instrumented with indwelling arterial catheters for continuous measurement of blood pressure and heart rate before, during, and after exposure to industrial noise eight hours daily. Initial exposure to noise produced transient, acute elevations of systolic and diastolic blood pressures and heart rates at noise onset, which habituated over the course of noise exposure. Chronic exposure to noise lowered blood pressure and heart rate not only during noise, but particularly after daily noise offset. Blood pressures returned toward baseline after noise exposure was terminated. Plasma catecholamines were also decreased during noise exposure. A control animal which received only masking noise did not demonstrate decreases in cardiovascular parameters. The possibility of classically conditioned associations of noise onset with feeding was discussed. PMID- 6505050 TI - Baroreceptor involvement in classically conditioned heart rate responses of restrained rats. AB - A group (N = 8) of restrained, baroreceptor denervated rats and a sham-operated control group (n = 8) received discriminated classical conditioning consisting of 30 reinforced trials in which a CS+ was paired with an electric shock US and 30 non-reinforced trials in which a different CS (CS-) was presented alone. The control group displayed a decelerative heart rate CR and a biphasic pressor depressor blood pressure CR. The denervated group failed to show a heart rate CR but did show a pressor-only blood pressure CR. The URs of the denervated group consisted of a major depressor change in blood pressure and a slight tachycardia whereas the URs of the control group consisted of a slight pressor response and tachycardia. The results indicated that centrally initiated activity in the efferent vagal pathways mediating the decelerative HR CR in rats may be blocked by the absence of normal afferent baroreceptor neural discharge. An integrating role of baroreceptor input was also suggested for the URs. PMID- 6505051 TI - Dihydrotestosterone stimulates mounting behavior but not lordosis in female rats. AB - The ability of androgens to stimulate masculine sexual behavior is thought to depend on the aromatization of such androgens to estrogens. In this scheme, reduced androgens such as dihydrotestosterone (DHT) which cannot be aromatized, are thought to exert major peripheral but little or no central nervous system influences on the display of masculine sexual behavior. Further, an early report that DHT can induce lordosis, an estrogen (E) dependent behavior, led to a notion that DHT may effect behavior through metabolic intermediates such as 5 alpha androstane-3 beta, 17 beta-diol (ADIOL) which then binds to estrogen receptors eliciting the E-dependent lordotic response. The present study reexamined and compared the relative effectiveness of a range of DHT dosages in stimulating a characteristic masculine (mounting) and feminine (lordosis) sexual behavior. Adult ovariectomized rats were randomly assigned to either 250 micrograms or 1 mg daily injections of DHT or DHTP. Other animals received OIL injections or crystalline DHT delivered by two different lengths (20 mm or 40 mm) of Silastic capsules. Animals were tested once weekly (for 5 weeks) for mounting behavior (20 minute test). Then animals were tested thrice (once weekly) for lordosis 4 hrs after the addition of 500 micrograms Progesterone (P). Finally, all females were tested for lordotic potential to respond to 10 micrograms EB plus P. 1 mg DHT or DHTP dosages and the 40 mm-Silastic condition significantly increased mounting behavior over that of lower dosages and OIL controls. A significant correlation existed between mounting frequency and circulating level of serum DHT. Treatment with DHTP was not different than DHT in eliciting mounting behavior.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505052 TI - Alleviation in the rat of a GABA-induced reduction in food intake and growth. AB - Cold exposure and diet dilution which stimulate food intake of normal rats lessened depressions of food intake and growth induced by dietary GABA. During a 3-day adaptation to the cold, rats fed a diet containing 4.5% GABA lost weight; thereafter, food intake and growth rate differed little from those of cold control rats and were usually greater than those of normal rats fed GABA. Hepatic GABA-aminotransferase activity of cold-exposed rats fed the GABA diet increased to about twice that of normal control rats. Rats fed a control diet diluted by half with cellulose ate 50% more of this diet than of the undiluted diet but gained only 20% less weight. Rats ate twice as much of a diluted, 9% GABA diet as of an undiluted, 4.5% GABA diet (thus doubling their GABA intake) and gained three times as much weight. A novel food (condensed milk) barely lessened the adverse responses to GABA. These results show that conditions requiring rats to increase their food intake in order to maintain body weight can also increase their acceptance of a diet high in GABA. PMID- 6505053 TI - Four- versus five-day estrous cycles in rats: vaginal cycling and pregnancy. AB - Five- compared to four-day cycling rats had earlier onsets and prolonged periods of full vaginal cornification at estrus, and similar times of the first appearance of the "pavement" cells that signal the end of estrus. In mating tests, a larger proportion of five- compared to four-day cyclers became either pregnant or progestational after mating to one ejaculation by the male. As groups, four- and five-day cyclers did not differ in measures of male or female sexual behavior during the mating test. The observed differences between four- and five-day cyclers in the progestational response to one ejaculatory series and in cyclic vaginal cytology are consistent with previously reported hormonal differences between four- and five-day cycling female rats. PMID- 6505054 TI - [Effect of the presence of females on the concentration of androgens in the male guinea pig at puberty]. AB - At weaning (21 days), male guinea-pigs were assigned to three groups: A: two or three males with females in separate cages but in the same room; B: two males with one pubertal female in each cage; C: males without female in the environment. Animals were sacrificed on 50th day. Testosterone and androstenedione concentrations in the blood plasma and the testis were estimated by gas chromatography. The body and testicular weights of group C were lower than those of other groups. Testosterone and androstenedione levels in the plasma were lower in group C; testicular concentration of testosterone was similar in group A and C whereas level was weak in group B. Testicular concentration of androstenedione was increased with animals isolated of female. The results showed that, in guinea-pig at puberty, the presence or the lack of female, modify testicular weight and androgen concentration. PMID- 6505055 TI - Adrenocortical adaptation to chronic intermittent stress in hemispherectomized pigeon. AB - Hemispherectomized pigeons were exposed daily to electrical footshocks delivered for 15 sec, at the same hour, for 8 weeks. Serial blood samples were obtained through a chronic vascular catheter. The adrenocortical response to chronic intermittent stress was measured kinetically at one week intervals. The initial response including several successive peaks of plasma corticosterone progressively adapted: Late peaks disappeared and only the first one subsisted 12 14 min after stressor application; this first peak diminished in magnitude; furthermore, an anticipatory peak occurred, starting 14 min before stress. In pigeons lesioned in the anterior dorsomedial thalamus, the only response to the stressor was of the single peak (12-14 min) type without any development of anticipatory conditioned response. This phenomenon was consistant all over the experimental period. Thalamic-hypothalamic interrelationships may be suggested to provide neuronal loops that underlie the long lasting, pulsatile repetitive components of the adrenocortical response to acute stress and also the adaptative process of such a response to chronic intermittent stress, including a conditioned, anticipatory endocrine activation. PMID- 6505056 TI - Feeding in infancy, adipose tissue cellularity and obesity. AB - Female Sprague-Dawley rats were raised in litters of four (L4), nine (L9) and 24 (L24). The well nourished L4 rats grew insignificantly larger, heavier and fatter than the L9 controls; the underfed L24 rats remained small and stunted, and had absolutely and relatively less adipose tissue than the L4 and L9 rats. Approximately half of the rats of these three groups were fed a high-fat diet from age 18 to 43 weeks. Almost all of the rats in the fat-fed groups became obese. The amount of adipose tissue expressed as percent body weight was essentially the same in all three fat-fed groups, with the greatest relative enlargement of fat stores and increase in fat cell number in the 24-litter rats. The results show that the feeding pattern during adult life is of greater importance than early feeding experiences. The literature regarding overfeeding and underfeeding during early life is reviewed; it confirms that early overfeeding does not predispose to obesity in later life and that early underfeeding does not prevent or diminish the development of nutritional obesity and adipose tissue hypercellularity. Early underfeeding seems to affect more the regulation of the feeding behavior than the intrinsic functions and growth potential of adipose tissue; it may even stimulate the development of obesity. PMID- 6505057 TI - Chronic vascular catheterization in the rat: comparison of three techniques. AB - Rats were implanted with an indwelling vascular cannula in the jugular vein, femoral artery or carotid artery, and evaluated for postsurgical weight changes and cannula patency. Complete details for surgical methods and materials are presented for each procedure. Over a 14 day period, the carotid artery procedure produced the most profound weight loss, while the jugular vein implantation was followed by minimal changes in body weight. Weight loss was intermediate for the femoral artery group. Body weight had returned to, or was above presurgical weight at 2, 4 and 6 days postsurgery for the jugular, femoral and carotid catheterizations, respectively. By 14 days following implantation 83%, 67% and 50% of the femoral, carotid and jugular cannulas, respectively, were patent. We conclude that for long-term sampling of blood in the rat, the femoral artery catheterization procedure is preferable in terms of patency and postsurgical weight loss. PMID- 6505058 TI - Individual recognition of female hamsters by males: role of chemical cues and of the olfactory and vomeronasal systems. AB - Sexually satiated male hamsters preferred to investigate and to mount an anesthetized, estrous, novel female over a similarly presented female with which the male had become satiated (the Coolidge effect); likewise, such males preferred a novel female recently mated with another male over the familiar female but showed no preference between fresh and mated novel females. Thus the Coolidge effect is at least partly dependent on discrimination of a new female by chemical cues. Another experiment indicated that transfer of a male's own scent during mating is not involved in discrimination between familiar and novel females. Flank gland secretion of females were sufficient for individual discrimination by males, whereas head region scents and vaginal secretions were not sufficient. The presence of female's flank glands was not, however, necessary for such discrimination. Lesions of or removal of the vomeronasal organ did not disrupt the preferences of sexually satiated males for a novel female, but elimination of main olfactory system function by ZnSO4 treatment of the olfactory mucosa did abolish such preferences. Thus olfactory cues are sufficient for individual discrimination of novel females by sexually satiated male hamsters, and such recognition leads to increased sexual arousal. These processes are mediated by the main olfactory system but not the vomeronasal accessory-olfactory system. PMID- 6505059 TI - Sex differences in the response to neonatal steroid treatment in the mongolian gerbil. AB - The present study examines whether genetic male and female gerbils differ in response to neonatal steroid treatment as evidenced by the display of sexually dimorphic territorial marking behavior in adulthood. The advantage of this behavioral endpoint is that male and female marking differs only in frequency, permitting direct between-sex comparison of neonatal treatment effects. Females and day-2 castrated males received a single SC injection of 10 to 100 micrograms testosterone propionate (TP) or estradiol benzoate (EB) between birth and day-14 postpartum. Between 7 and 9 months of age, the territorial marking behavior response to exogenous TP was determined in all animals. Based on marking frequency, the time of greatest sensitivity to TP administered during the critical neonatal period occurred earlier in the male (days 3-5) than in the female (days 5-7). In addition females consistently showed greater sensitivity to a given dose of either TP or EB than did males. EB was more effective than TP at the 10 micrograms dose in both sexes. These results indicate that sex differences exist in timing and steroid sensitivity in the sexual differentiation of the neural substrate regulating territorial marking behavior. PMID- 6505060 TI - Plasma corticosterone and meal expectancy in rats: effects of low probability cues. AB - The plasma corticosterone levels of rats were examined prior to their morning meal on Days 1, 7 and 20 of a regimen of 1 hr access daily to food mash and water. The relationship between external cues and meal provision was varied by feeding some groups immediately upon room entry each morning, and others with a variable interval 90-min delay. On Day 1, corticosterone levels of the hungry rats were elevated around the time of light onset, and until 90 min following room entry. On Day 7, corticosterone levels increased in response to room entry in the delay-fed rats, but did not increase further in immediately fed rats. These results were interpreted as indicating that low, but nonzero, expectancy of meal availability elevates corticosterone levels. On Day 20, the immediately fed rats showed a dip in corticosterone levels after room entry, responding to cues highly predictive of imminent meal availability. Delay-fed rats no longer showed an elevation to room entry. The relationship between corticosterone level and meal expectancy is essentially curvilinear in the hungry rat. The corticosterone levels are high when there is uncertainty about whether food is coming or not, and low when there is a very high or very low probability that food is coming. PMID- 6505061 TI - Head movements elicited by electrical stimulation of the anteromedial cortex of the rat. AB - Electrical stimulation, 5-sec trains, 0.5 msec rectangular pulses, 20 Hz pulse frequency, was applied to the anteromedial cortex of awake rats (N = 28) to determine if head orienting behavior could be elicited. Following recovery from surgery in which up to six monopolar electrodes were implanted, the rats were adapted to and tested on a small platform surrounded by water. Elicited behavior patterns reliable at 150 microA or less in Experiment 1 (66 sites) and at 100 microA or less in Experiment 2 (32 sites) were analyzed. The most common response was a single head turn in a direction contralateral to the side of stimulation. Positive sites occurred throughout the anterior cingulate and the medial precentral regions. Coordinated forelimb movements were associated with contralateral head movements at dorsal anterior cingulate sites. Ipsilateral head turns were elicited at sites in the most rostral and ventral parts of the anteromedial cortex, including the prelimbic area. Lateral scanning sites were widespread but tended to concentrate at the mergence of the contralateral and ipsilateral movement fields. Vertical movements were often elicited with ipsilateral movements; dorsal sites supported downward head movements and ventral sites supported upward head movements. Sites supporting forward head movements were concentrated in the anterior cingulate region caudal to the genu of the corpus callosum. Neck extension usually appeared in conjunction with lateral head movements and frequently with forelimb movements. PMID- 6505062 TI - Forelimb and hindlimb stepping by the anesthetized rat elicited by electrical stimulation of the pons and medulla. AB - This study determined the lower brainstem sites at which electrical stimulation elicits stepping movements of the forelimbs and hindlimbs. Rats (N = 45), anesthetized with nembutal, were fixed in a stereotaxic apparatus so that their limbs contacted a moving treadmill belt. Electrical stimulation (100 microA, 10 sec trains, 0.5-msec cathodal pulses, 50-Hz pulse frequency) was applied every 200 micron through 173 movable electrodes. Well coordinated quadrupedal stepping was elicited by stimulation at dorsal posterior mesencephalic sites including the inferior collicular commissure, the central gray, the nucleus cuneiformis and lateral aspects of the pedunculopontine tegmental nucleus. Caudal and ventral to this general region, sites supporting quadrupedal stepping appeared mainly in or near the spinal trigeminal nucleus. Stepping with only the forelimb and hindlimb contralateral to the stimulation site was associated with the corticospinal tract, the lateral pontis oralis, the lateral pontis caudalis and the ventral reticular nucleus of the medulla. Bilateral forelimb stepping was associated with the trigeminal system and the gigantocellular reticular nucleus. At the level of the rostral medulla, systems involved in bilateral forelimb stepping and contralateral hindlimb stepping appear to be located medially. Systems concerned with bilateral hindlimb stepping appear to be located laterally. PMID- 6505063 TI - Changes in rectal and mean skin temperature in response to suggested heat during hypnosis in man. AB - Rectal temperature, mean skin temperature and heart rate were recorded in 7 subjects during hypnosis, induced either alone or while sensations of heat were suggested. During hypnosis alone, a fall in the heart rate of about 10 beat X min 1 was the only autonomic response observed; body temperatures were unaltered. In contrast, during hypnosis with suggestion of heat, the following changes occurred: (1) Mean rectal temperature decreased 0.20 degrees C (p less than 0.05) within 50 min. Its mean time course differed significantly from that for hypnosis alone (p less than 0.001). (2) Comparison of individual rectal temperature time sequences showed that in fact this temperature only declined in 4 subjects out of 7, and tended to form a plateau located 0.35 degrees C below the value of the preceding waking state. Despite reinforcement of heat suggestion, the plateau continued until the end of the hypnotic trance. (3) Mean skin temperature tended to rise. (4) When hypnosis with suggestion ceased, both rectal and skin temperatures very slowly returned to their levels during the preceding waking state. PMID- 6505064 TI - Recovery of anticipatory activity to restricted feeding in rats with ventromedial hypothalamic lesions. AB - Entrainment of circadian activity rhythms to a fixed daily mealtime was measured in intact and ventromedial hypothalamic (VMH) lesioned rats housed in tilt-cages. Intact rats showed a clear increase in activity for 2-3 hr prior to the 2 hr daytime feeding period. Anticipatory activity in lesioned rats was attenuated or absent during restricted feeding 5-9 weeks after surgery, but was evident in all rats, even those bearing apparently total VMH damage, during a second restricted feeding schedule 14-21 weeks after surgery. These results show recovery of function and argue against a necessary role for the VMH in food entrained rhythms. PMID- 6505065 TI - Metabolic fuel homeostasis in Syrian hamsters: nycthemeral and exercise variables. AB - The food intake and growth of male and female golden hamsters, with and without access to running wheels, were measured under several conditions. These included different seasons, photoperiods and diets. Chow-fed males in wheels invariably had slowed weight gain and showed little hyperphagia relative to sedentary controls. One group of exercising female hamsters, fed high fat diet, grew faster than sedentary controls. The food intake of both exercising and sedentary groups was distributed evenly through the day/night cycle, but the exercising animals took smaller, more frequent meals at night. The nycthemeral variations in plasma glucose, triglycerides, free fatty acids and liver glycogen were quite small in sedentary hamsters. In exercising hamsters, however, liver glycogen was elevated in the late daytime and depleted in the mid-to-late night. In vivo lipogenesis rates in white and brown adipose and liver were elevated by day in the exercising compared to sedentary hamsters, and were lower at night in both groups. It appears that in exercising hamsters, and to a lesser extent sedentary hamsters, the day phase is one of inactivity and fuel storage, and the night phase is one of exercise and fuel mobilization. PMID- 6505066 TI - Effects of chronic cold exposure on wheel running, food intake and fatty acid synthesis in Syrian hamsters. AB - Mesocricetus auratus with established wheel running in a thermoneutral environment (23 degrees C) showed an immediate suppression of running when placed in a cold room at 4 degrees C. This suppression was seen in three separate studies and lasted at least 1 month. Food intake of these hamsters rose within 48 hr in the cold, and body weight was maintained. In contrast, hamsters which had been sedentary in the 23 degrees C room showed a slower rise in food intake in the cold and sustained a chronic drop in body weight. In vivo fatty acid synthesis rates were greatly elevated in white and brown adipose tissue, but not liver, of exercise versus sedentary hamsters after 1 month in the cold, despite the relative inactivity of both groups throughout the cold exposure. Previous exercise training predisposes hamsters to efficient energy storage in the cold. The energy demand of the cold environment may be responsible for the decreased voluntary running. PMID- 6505067 TI - Short-chain polyhydroxymonocarboxylic acids as physiological signals for food intake. AB - In order to clarify the effects of endogenous organic acids on short and long term feeding behavior, ingestive behavior was monitored for 2 hr before and after intra-third ventricular infusions of 3,4-dihydroxybutyric acid (2-deoxytetronic acid, 2-DTA), 2,4,5-trihydroxypentanoic acid (3-deoxypentonic acid, 3-DPA), and 3 hydroxybutyric acid (3-HBA). In addition, meal patterns were recorded for 2 days before and after the ventricular infusions. 2-DTA suppressed both short and long term feeding by decreasing meal size (MS). 3-DPA elicited transient feeding behavior, but caused no change in long-term feeding. 3-HBA initially stimulated feeding, but subsequently suppressed long-term feeding by decreasing MS and prolonging postprandial intermeal interval (IMI). The suppressive effects of 3 HBA on feeding behavior lasted about 24 hr longer than those of 2-DTA. Based upon these observations as well as our previous reports, it appears that some of the processes affecting hunger and satiation are mediated by changes in central and peripheral concentrations of these organic acids. PMID- 6505068 TI - The number of pre-shock trials affects sex differences in passive avoidance behavior. AB - Different groups of male and female Wistar rats were exposed to a standard passive avoidance procedure in which the number of pre-shock trials was experimentally manipulated (1, 3 or 9 trials). Sexually dimorphic passive avoidance behavior was observed after 1 and 3 pre-shock trials. Entrance latencies on the pre-shock trials did not differ for males and females after 1 trial. In the 3 trial condition, latencies differed between the sexes and were also a function of repeated trials for male subjects, as their latencies increased over trials, while those of females did not. When 9 pre-shock trials were presented, the sex difference in entrance latencies was still observed, but latencies increased for both males and females. Although the results of the experiment suggest that sex differences in passive avoidance behavior might be attributable to sex differences in habituation processes to the stimuli associated with exposure to the platform, correlations between the latencies on the final pre-shock trial and behavior on the post-shock trial were not significant. The variables responsible for the occurrence of sexual dimorphism in passive avoidance behavior remain, therefore, largely unknown. The interpretation of this behavioral difference in terms of more general differences between males and females should proceed very cautiously. PMID- 6505069 TI - Cimetidine and stress ulcer in aged rats. AB - Male Sprague-Dawley rats, 2, 6, 11, 18, and 26 months old, were subdivided into four drug treatment groups and received either 25, 50, 100 mg/kg of cimetidine or a placebo control before being exposed to restraint plus cold stress for 3 hr. Cimetidine, at all dose levels, significantly reduced ulcer severity in all age groups except the 18- and 26-month-old rats. Senescent rats were not more susceptible to restraint ulcer and cimetidine had the least anti-ulcer effect with the senescent 26-month-old rats. PMID- 6505070 TI - Quality and intensity of binary odor mixtures. AB - The perceived intensity and quality of binary mixtures consisting of the common but dissimilar odorants, benzaldehyde (almond), eugenol (cloves), propionic acid (vinegar) and (-)-carvone (spearmint), were determined over a wide range of environmentally relevant concentrations. Consistent data were obtained from each of the odor pairs. This showed that the intensity of odorants not their quality determined the contribution of each to the quality of a mixture. Except for the pair carvone-propionic acid, both odorants were perceived only when the difference between their intensities was small. The results confirmed an earlier finding that the total intensity of a mixture is less than the sum of the intensities of the two components, and also showed that it is never less than the intensity of the weaker component. Seven major characteristics of binary odor mixtures are defined. PMID- 6505071 TI - Dietary obesity and exercise in young rats. AB - Food intake, body weight, body composition, resting metabolic rate (RMR) and the thermic effect of food (TEF) were measured in young rats, some of which were fed a high energy (HE) diet and some of which were forced to swim daily. In general, high energy feeding as compared to chow feeding, resulted in higher food intake, higher body weight, higher body fat, and a slightly lower TEF. In many cases, however, the specific effects varied with the age and sex of the animals. Animals forced to swim weighed less; were leaner; and had higher RMR and TEF than sedentary animals. The effects of exercise on energy balance were greatest in males, while the effects of the high energy diet on energy balance were greatest in females. All HE-fed rats were switched to lab chow at 104 days of age. Body weights of sedentary HE-fed rats returned to control levels but those of exercised HE-fed rats did not. Both HE-fed groups remained fatter than chow-fed controls, even two months after the diet switch. PMID- 6505072 TI - Metoclopramide potentiates the hypophyseal reactions to oestradiol. AB - Male rats to which oestradiol benzoate was administered intramuscularly twice a week for three weeks in 1 mg doses as an aqueous microcrystal suspension showed an increase in adenohypophyseal weight, in the number of lactotropic cells in the adenohypophysis (demonstrated by immunohistochemical detection of prolactin) and in polyphenol oxidase (ceruloplasmin) activity in the blood and hypothalamus. The simultaneous administration of metoclopramide (methoxychloroprocainamide) in doses of 10 mg/rat per day in food potentiated the adenohypophyseal reaction to oestradiol (weight and the number of lactotropic cells), but potentiated the polyphenol oxidase reaction only little or not at all. Metoclopramide thus has an anti-dopaminergic effect similar to that of perphenazine and other inhibitors of dopaminergic neurones. PMID- 6505073 TI - Urease activity of adherent bacteria in the sheep rumen. AB - In experiments on six sheep fed on a low protein diet (6.2 g N/day), it was found that the urease activity of the rumen fluid did not change significantly in the first 6 hours after feeding and that it ranged from 45 to 75 nkat.ml-1. The major portion was bound to the bacterial fraction and formed about 70% of total rumen fluid activity. Urease activity determined in food particles with adherent bacteria removed from the rumen before and 3 and 6 hours after feeding ranged from 20 to 26 nkat.g-1 food (wet weight), and on rumen wall samples with adherent bacteria from 30 to 800 nkat per 2.5 cm2 tissue. Again, no significant changes correlated to the time after feeding were found. The results show that urease activity in the sheep rumen is localized on food particles and on rumen wall epithelium with adherent bacteria, as well as in the rumen fluid. PMID- 6505074 TI - Developmental fatty acid changes in different parts of the rat brain. AB - The proportion of 26 fatty acids (FA) in the lipids of the cerebral cortex, subcortical formations (the thalamus, hypothalamus and basal ganglia) and the medulla oblongata was studied in rats aged 5, 10, 14 and 90 days. Very marked developmental changes in the proportion of the various FA were demonstrated in the different parts of the brain. In the cerebral cortex the proportion of 17:1 rose by 285%, 18:3 n-3 by 1820% and 22:6 n-3 by 80%, while the proportion of 14:0, 16:0 and 16:1 fell significantly. In the tissue of subcortical formations we found an increase in the proportion of FA with 18 carbons (18:0 by 40%, 18:1 by 100%, 18:3 n-3 by over 5000%) and a decrease in the proportion of 14:0, 16:0, 16:1 and 20:4 n-6. The situation in medulla oblongata tissue was similar to the one in subcortical formations. On comparing the proportion of FA in individual parts of the CNS in the same age category, we found the smallest number of statistically significant differences in 5-day-old rats. In adult rats we found significant differences chiefly in the proportion of palmitic acid (16:0), oleic acid (18:1), linolenic acid (18:3 n-3) and acids with 20-22 carbons. PMID- 6505075 TI - Seasonal changes in the relationship of blood calcium levels to immunoglobulins and some of the blood proteins in schoolchildren. AB - Blood and saliva were collected in the autumn and spring from a group of schoolchildren (39 girls, 35 boys) with a mean age of 11.4 years. Serum immunoglobulin IgG, IgA, IgM and IgE, alpha 1-antitrypsin (A 1-AT), alpha 2 macroglobulin (A 2M), transferrin (TRF), ceruloplasmin (CPL), lysozyme (LYS) and pertussis (PE) antibody levels were determined. Calcium (Ca2+) and total serum protein levels were also determined. Secretory IgA (sIgA) and secretory lysozyme (sLYS) levels were assessed in the saliva. A highly significant drop in Ca2+ levels was found in the spring in boys, while in girls there was only a greater scatter of the values. Mean IgG, IgA and IgM values fell significantly in the spring in both sexes, but IgE levels fell significantly only in boys. PE levels rose significantly in the spring in girls. Among the other proteins, all the values rose in boys, except for TRF, whose levels fell. In girls, LYS and TRF levels rose, but all the other values fell. The coefficients of correlation between Ca2+ and the tested proteins showed a significant relationship only for A 2M and PE in girls and only for the total protein level in boys; in boys, the determination coefficient for sIgA and IgM was over 10%. The results do not testify to the existence of a close relationship between blood Ca2+ levels and Ig and other blood protein levels. PMID- 6505076 TI - Dependence of the cytotoxic effect of guanethidine on the degree of sympathetic activity. AB - Young rats aged 15-29 days received a subcutaneous injection of guanethidine sulphate (5 mg/kg body weight) every day. Owing to damage to the postganglionic sympathetic neurones, on about the 60th day of life we observed a significant decrease in the noradrenaline concentration in these animals' hearts compared with the controls. If every guanethidine injection was followed immediately by intensive physical exercise, there was no drop in the heart noradrenaline concentration. Physical exercise of the same intensity performed a few hours before injecting guanethidine did not prevent the drop in the noradrenaline concentration in the heart. The results show that an exercise-induced increase in sympathetic activity, at a time when guanethidine is circulating in the blood and accumulating in the adrenergic neurones, inhibits the cytotoxic effect of guanethidine. Isolated physical exercise performed between the 15th and 29th day of life leads to an increase in the noradrenaline content of the heart of rats aged 60 days. PMID- 6505077 TI - Effect of acetylcholine and adrenaline on ventricular action potentials of the human embryonic myocardium. AB - Using the glass microelectrode technique we measured the effect of adrenaline (ADR, 10(-5) mol . l-1) and acetylcholine (ACh, 10(-5) mol . l-1) on action potentials (AP) of the ventricular myocardium of 8- to 11-week-old human embryos. ACh prolonged the AP (by 20%), without affecting voltage of the plateau phase. ADR markedly elevated the plateau phase (by 8 mV) and prolonged the AP (by up to 40% of the initial duration). The ACh effect attained the maximum in 5-7 min and was frequency dependent. The ADR effect reached the maximum in 1-2 min. Neither ACh nor ADR affected the resting membrane potential value. The effect of ACh was blocked by atropine (10(-6) mol . l-1), showing that it is mediated by way of M receptors. Propranolol (6.10(-6) mol . l-1) only partly blocked the effects of ADR. The results show that the human ventricular myocardium is already sensitive to the action of ACh and ADR before autonomic innervation of the heart develops. PMID- 6505078 TI - Biological activity of diospyrin towards Ehrlich ascites carcinoma in Swiss A mice. PMID- 6505079 TI - Mechanism of antihepatotoxic activity of glycyrrhizin. I: Effect on free radical generation and lipid peroxidation. PMID- 6505080 TI - Pharmacological trials of crude extract of Passiflora alata. PMID- 6505082 TI - Studies on antitumour cyclic hexapeptides RA obtained from Rubiae radix, Rubiaceae (IV): Quantitative determination of RA-VII and RA-V in commercial Rubiae radix and collected plants. PMID- 6505081 TI - Cardiac and extracardiac activity of an ethanolic extract of leaves of Isoplexis canariensis. PMID- 6505083 TI - [Coumarin derivatives as protective agents against the cytotoxic and mutagenic effect of 5-methoxypsoralen and UV-A in Chlamydomonas reinhardii]. PMID- 6505084 TI - Saponins from Chinese medicinal plants. (I). Isolation and structures of hemslosides. PMID- 6505085 TI - Saponins from Anemone rivularis. PMID- 6505086 TI - 2-Acylindole alkaloids from leaves of Pterotaberna inconspicua. PMID- 6505087 TI - A second pathway for the terminal steps in the biosynthesis of morphine. PMID- 6505088 TI - Rosmarinic acid production and growth characteristics of Anchusa officinalis cell suspension cultures. PMID- 6505089 TI - Analgesic and antihepatotoxic actions of dianosides, triterpenoid saponins of Dianthus superbus var. longicalycinus herbs. PMID- 6505090 TI - 6,7-Dehydroroyleanone, a diterpenoid quinone from Salvia moorcraftiana. PMID- 6505091 TI - Quinoline alkaloids from Anthocephalus chinensis. PMID- 6505092 TI - Evaluation of antiinflammatory activity of a chamomile extract topical application. PMID- 6505093 TI - New guaianolides from Centaurea kandavanensis. PMID- 6505094 TI - Constituents of Michelia champaca and Lewis acid catalysed transformations of parthenolide into guaianolides. PMID- 6505095 TI - An in-depth look at pressure sores using monolithic silicon pressure sensors. AB - Three-dimensional scalar pressure distributions were measured in solid tissue near bony prominences in vitro in meat and in vivo in pigs using silicon pressure sensors. Data are in accord with previous theoretical models and indicate that pressure is three to five times higher internally near a bony prominence than it is at the skin over the prominence. Pressure sores are thus thought to begin internally; by the time they are evident at the skin, the sore has worked its way completely from bone to skin. This conclusion is in accord with previous clinical data. Future measurement of local vector forces is needed to fully characterize the force distribution in vivo. PMID- 6505096 TI - The expansive gluteus maximus flap. AB - The rich vascular network of the gluteal and posterior thigh region provides for a larger range of flaps for reconstructive surgery than previously described. Facility with these flaps requires an appreciation of relevant anatomy, embryology, and anthropology. Structural changes in the gluteus maximus muscle are critical to the evolutionary advance toward an upright stance during walking. The superficial and deep segmentation of the gluteus maximus are best appreciated by phylogenic and ontogenetic study. Femoral arterial and gluteal arterial anastomotic hemodynamics are affected by the relative involution of the gluteal system in late embryogenesis. The gluteal thigh flap should include contributions from the femoral system when the cutaneous branch of the inferior gluteal artery cannot be identified. Huge sacral wounds can be closed with gluteus maximus myocutaneous flaps with maintenance of muscular function by detaching the entire origin, sliding the muscle medially, and reconstructing these attachments. By dissection between the divergent inserting fibers of the gluteus maximus, a long, superficial portion of the muscle can be raised that forms the basis of the extended gluteus maximus flap. The pedicle of the flap is at the level of the piriformis muscle and the skin paddle can be placed over the midportion of the posterior thigh. Finally, the first deep femoral perforating artery forms the basis of a posterolateral fasciae latae flap that is well suited for coverage of defects over the trochanter. PMID- 6505097 TI - The nasal tip: cartilage repositioning. AB - Two hundred and forty patients who underwent a corrective rhinoplasty have been presented. Of these, 224 patients (93.3 percent) had a cartilage repositioning procedure in which the alar cartilages were only undermined and repositioned, and 16 patients (6.7 percent) had a cartilage resection procedure. The techniques and indications for both procedures are described and discussed. The results obtained in this series of patients indicate that cartilage repositioning is an effective and reliable procedure to refine and reshape the nasal tip. Cartilage resection is less reliable and should be reserved for a few selected patients with specific indications. Indiscriminate resection of the lower alar cartilage is neither warranted nor wise. PMID- 6505098 TI - Advanced applications of revascularized free jejunal flaps for difficult wounds of the head and neck. AB - The rationale, technique, and an example of full utilization of the jejunomesenteric free flap have been described as a means of reconstructing complex wounds of the head and neck. Not only jejunum, but also well-vascularized mesentery will protect vascular structures and intestinal anastomoses and, in addition, accept a skin graft. No additional muscular or other flaps are necessary to achieve these ends. Finally, no additional donor-site morbidity is incurred by harvesting the supplementary mesentery. PMID- 6505099 TI - The effect of exogenous fibronectin on wound breaking strength. AB - Experimental wounds in rats were tested for breaking strength at 4, 7, 11, 14, and 21 days to determine whether incisions treated with homogenous fibronectin differed from control incisions. At 7, 11, 14, and 21 days after wounding, the fibronectin-treated incisions were significantly stronger than the control incisions. PMID- 6505100 TI - Closure of the circular defect with double rotation flaps and Z-plasties. AB - A method is presented for the closure of a circular defect without altering its shape. It employs semicircular rotational flaps and Z-plasties. Its use in 178 patients with malignant skin neoplasms is presented. PMID- 6505101 TI - The double-Z rhomboid plasty: an improvement in design. AB - From clinical experiences with the double-Z rhomboid, which was originally described by Cuono, the differences between the original description and our operative results were pointed out. Our improved concept and procedure of the double-Z rhomboid are presented and clinical cases are demonstrated. PMID- 6505102 TI - Ten-digit replantation. AB - A case is presented of replantation of 10 digits at the proximal phalangeal level. Seven digits survived. Osteotomies and flexor tenolysis were done on the right thumb, long, and ring fingers and left index and long fingers 11 months later. A toe-to-hand transfer was done to reconstruct the failed left thumb replantation. Functional and sensory recovery is satisfactory. PMID- 6505103 TI - Subungual osteochondroma. AB - Subungual osteochondromas are rare tumors that occur in the toes and fingers. This case report of a large subungual tumor of the right ring finger demonstrates the classic radiologic features and successful management of a large tumor by complete excision of the nail bed and the tumor and reconstruction of the distal nail bed with a split-thickness nail bed graft from the great toe. PMID- 6505104 TI - Angiokeratoma of Fordyce: successful treatment with the argon laser. AB - Argon laser photocoagulation of angiokeratomas of Fordyce, or scrotal angiomas, has been described. The benefits of the argon laser in treatment of these lesions include permanent eradication of the lesions and alleviation of the symptoms of pruritus and episodic bleeding. This method of treatment is safe, does not produce iatrogenic malignant neoplasms, is noninvasive, and is accomplished as an outpatient procedure under local anesthesia with minimal discomfort or disability. PMID- 6505105 TI - Rhinoplasty in blacks: the Michael Jackson factor. PMID- 6505106 TI - Teaching model for rhinoplasty. PMID- 6505108 TI - Zyderm. PMID- 6505107 TI - Quantitative assessment of skin-flap survival. PMID- 6505109 TI - The rat cradle. PMID- 6505110 TI - [A computed tomography study of Pick's disease]. PMID- 6505111 TI - [Application of new diagnostic standards: ICD-9 and DSM-III]. PMID- 6505112 TI - [Selective attentional functioning as reflected in ERPs during syllable discrimination tasks. (II). Correlations between cognitive deficits and abnormal ERP findings in schizophrenics]. PMID- 6505113 TI - [Recent advances in geriatric psychiatry]. PMID- 6505114 TI - Ecological constraints on internal representation: resonant kinematics of perceiving, imagining, thinking, and dreaming. PMID- 6505115 TI - Evolutionary trends and evolutionary origins: relevance to theory in comparative psychology. PMID- 6505116 TI - Quest for accuracy in person perception: a matter of pragmatics. PMID- 6505117 TI - Relation of temporal stability and cross-situational consistency in personality: comment on the Mischel-Epstein debate. PMID- 6505118 TI - Getting lost in the search for large coefficients: reply to Conley. PMID- 6505119 TI - Acetylcholine and alpha 1-adrenergic sensitivity in the separation of depression and anxiety. AB - Three relatively clear-cut diagnostic groups, namely primary major depressive disorder-endogenous subtype (PRI MDD-E), primary anxiety disorder with no depression (PRI ANX), and normal controls as well as two additional patient groups with mixed or coexisting anxious/depressive diagnoses were studied. Clinical assessment was made by routine psychiatric interview, Schedule of Affective Disorder and Schizophrenia (SADS) research interview, and obtaining family history of MDD. Subjects underwent both routine 'baseline' sleep EEG polygraphic arecoline, a muscarinic, cholinergic agonist infused during sleep. Cholinergic sensitivity was assessed by measuring the time to induction of REM sleep after arecoline infusion. In addition, a subgroup of MDD patients underwent pupillographic testing. Peripheral alpha-adrenergic responsivity was measured by the magnitude of pupillary mydriatic response after local ocular instillation of phenylephrine. Successful separation (83% correct classification) of the 'pure' groups (PRI MDD-E, PRI ANX, and normal) was achieved by discriminant function analysis of sleep EEG variables. Compared to PRI ANX and normal groups, patients with PRI MDD-E had supersensitive cholinergic REM-induction response, shorter REM latency, increased first REM density and REM percent. Separation of the PRI ANX and normal groups was by intermittent awake time, delta sleep percent, and total REM density. Classification of the mixed anxious/depressive groups was next attempted using the discriminant coefficients derived from the above analysis of 'pure' groups. We found that the presence of absence of family history of MDD in patients with mixed diagnosis offered the best prediction of classification into PRI MDD-E and PRI ANX groups, respectively. MDD patients with coexisting panic disorder were significantly subsensitive to phenylephrine-induced mydriasis compared to MDD patients without anxiety. PMID- 6505120 TI - beta-Carboline-induced anxiety states. AB - Several C-3-substituted beta-carbolines (e.g., the ethyl ester of beta-carboline 3-carboxylic acid) have high affinities for benzodiazepine receptors and can antagonize the principal pharmacologic actions of the benzodiazepines. The observation that some of these compounds also possess 'intrinsic' actions, best described as pharmacologically opposite to the benzodiazepines, has provided a chemically induced model of extreme stress or anxiety. The actions of such compounds in currently used animal models of anxiety are reviewed, as well as the effects of these compounds in primates, including man. PMID- 6505122 TI - Panic disorders: clinical update 1984. Diagnostic dilemmas. PMID- 6505121 TI - Fear and anxiety: relationship to noradrenergic function. AB - The experiences of human fear and anxiety are discussed within the context of locus ceruleus function in animals. The rationale for studying correlates of noradrenergic function, such as 3-methoxy-4-hydroxyphenethylene glycol (MHPG), is reviewed, and data demonstrating a positive correlation between plasma free MHPG and state anxiety in normal volunteers is presented. The behavioral effects of oral caffeine (240-720 mg), intravenous clonidine (2 micrograms/kg), and oral yohimbine (20 mg) were studied in various psychiatric patients and normal volunteers. Caffeine and yohimbine had anxiogenic properties; conversely, clonidine reduced self-rated measures of anxiety across a wide spectrum of psychiatric conditions. These findings expand previous research indicating that noradrenergic hyperactivity may be associated with many types of human fear and anxiety. PMID- 6505123 TI - Anxiety in patients with heart disease. PMID- 6505124 TI - Psychopharmacologic treatment of panic disorder. PMID- 6505125 TI - Panic disorders: clinical update 1984. Overview. PMID- 6505126 TI - Clinical presentations of panic and anxiety. PMID- 6505127 TI - Treating depression in asthmatic patients. PMID- 6505128 TI - A comprehensive support system for reducing house staff distress. PMID- 6505129 TI - Psychotherapy as an adjunct to supervised fasting for obesity. PMID- 6505130 TI - Hemophilia and the family system. PMID- 6505131 TI - Panic attacks with panic masked by alexithymia. PMID- 6505132 TI - Identifying depression secondary to lithium-induced hypothyroidism. PMID- 6505133 TI - The old and the young. PMID- 6505134 TI - Outcome of admissions of elderly people to hospitals and homes: a survey and follow-up. PMID- 6505135 TI - Smoking and weight control in teenagers. PMID- 6505136 TI - Perceptions and beliefs about nine diseases. PMID- 6505137 TI - Do we need objective measures to validate self-reported smoking? PMID- 6505138 TI - Comparative evaluation of hyperthermia heating modalities. I. Numerical analysis of thermal dosimetry bracketing cases. AB - A method for comparing the relative abilities of different hyperthermia heating modalities to properly heat tumors has been developed using solutions of the bio heat transfer equation. A single measure, the range of absorbed powers that gives acceptable tissue temperature distributions, is used to characterize the ability of a given heating technique to heat a given tumor. An acceptable tissue temperature distribution is one for which (a) the temperatures in the coolest regions of the tumor are above a minimum therapeutic value, (b) the temperatures in the hottest regions of the tumor do not exceed a maximum clinically acceptable value, and (c) the normal tissue temperatures do not exceed maximum clinically acceptable levels. This measure can be interpreted directly in clinical terms as the range of power settings on the power indicator of a heating device for which acceptable tumor heatings will occur. This paper describes the basis of the method and investigates the role of tumor blood perfusion patterns in determining the size of the acceptable power range. Three tumor perfusion patterns are investigated: uniform tumor perfusion, a concentric annulli perfusion model in which the tumor consists of a necrotic core surrounded by two concentric layers of increased perfusion, and a random perfusion distribution model. The results show that, in general, the uniform and annular perfusion models serve as bracketing case patterns. That is, they give acceptable power range values that are upper and lower limits of the acceptable power ranges obtained for the random perfusion patterns. The method is applied to heating patterns that simulate those obtained from a variety of different available heating techniques, and it is found to be valid for all cases studied. The role of normal tissue limiting conditions is also investigated. PMID- 6505139 TI - Comparative evaluation of hyperthermia heating modalities. II. Application of the acceptable power range technique. AB - The acceptable power range technique previously described in a companion paper [R. B. Roemer, T. C. Cetas, J. R. Oleson, S. Halac, and A. Y. Matloubieh, Radiat. Res. 100, 450-472 (1984)] is applied to two heating modalities to demonstrate its application to simulated clinical situations. Comparisons of the abilities of the different modalities to heat given tumors are made using the relative sizes of the acceptable power ranges obtained for each modality. Similar comparisons are also possible for determining the efficacy of physiological manipulations and adjustments in power deposition patterns for a given heating modality. Predictions of the ability of modalities and configurations to properly heat tumors are made using the bracketing nature of the uniform and annular tumor perfusion models. These comparisons and predictions are possible because a single measure of the ability of any heating technique to heat an arbitrary tumor in any location is utilized (the size of the acceptable power range). While relatively simple models are presently utilized, this approach can be extended to take into account a host of physical and biological conditions that model the patient device interaction to an arbitrarily high degree of detail. These refinements will be based on extended clinical and experimental data, particularly as tumor and normal tissue blood perfusion characteristics either become better known in general cases or can be specified for each real tumor. The applications of this approach should be far-reaching and complementary to clinical hyperthermia, especially as further model refinements are incorporated. Additional data are presented which reinforce the bracketing nature of the uniform and annular tumor perfusion models presented in the companion paper. PMID- 6505140 TI - Validation of a metabolic model for tritium. AB - The purpose of this paper is to validate a metabolic model describing the kinetics of tritium in man. The validation is based on measurements of background levels of loose and bound tritium in Italian subjects and their diets. Model predictions are compared with empirical measurements of tritium in human urine and tissue samples, and appear to be in close agreement. PMID- 6505141 TI - Effects of fasting and/or oxidizing and reducing agents on absorption of neptunium from the gastrointestinal tract of mice and adult or neonatal rats. AB - Neptunium-237(V) nitrate was administered by gavage to groups of fed or fasted adult and 5-day-old rats. Some groups also received the oxidants quinhydrone or ferric iron, and others received the reducing agent ferrous iron. Adult mice received ferric or ferrous iron and 235Np. When the adult rats were killed at 7 days after gavage, measurements showed that, compared with rats that were fed, a 24-hr fast caused a fivefold increase in 237Np absorption and retention. Both quinhydrone and ferric iron caused an even greater increase in absorption in both fed and fasted rats. Ferrous iron, on the other hand, decreased absorption in fasted rats to values lower than those obtained in fed rats. Similar results were obtained in mice treated with 235Np and either ferric or ferrous iron. The highest absorption obtained after gavage of ferric iron to fasted rats and mice was about two orders of magnitude higher than the value obtained in animals that were fed before gavage. The effects of ferric and ferrous iron on neptunium absorption by neonatal rats were similar to their effects on adult animals but of lesser magnitude. These results are consistent with the hypothesis that Np(V), when given in small mass quantities to fed animals, is reduced in the gastrointestinal tract to Np(IV), which is less well absorbed than Np(V). PMID- 6505142 TI - Failure of 5-thio-D-glucose to alter cell survival in irradiated or unirradiated EMT6 tumors. AB - The antineoplastic effects of the glucose analog 5-thio-D-glucose (5TG) were tested using EMT6 mouse mammary tumors in vivo and EMT6 cells in cell culture. In vitro, 5TG selectively killed hypoxic EMT6 cells. However, administration of 5TG to mice bearing EMT6 tumors produced no significant toxicity to the cells of unirradiated tumors and did not alter the survival of cells in irradiated tumors. Fasting the mice to lower blood glucose concentrations before administration of 5TG increased the toxicity of the drug to the mice, but did not allow more efficacious treatment of the tumors. The data provided no evidence that 5-thio-D glucose can be used effectively for the treatment of solid tumors, either as a cytotoxic agent or as a radiosensitizer. PMID- 6505143 TI - Theoretical temperature distributions produced by an annular phased array-type system in CT-based patient models. AB - Theoretical calculations for the specific absorption rate (SAR) and the resulting temperature distributions produced by an annular phased array (APA)-type system are made. The finite element numerical method is used in the formulation of both the electromagnetic (EM) and thermal boundary value problems. A number of detailed two-dimensional patient models based on CT-scan data from the pelvic, visceral, and thoracic regions are generated to simulate a variety of tumor locations and surrounding normal tissues. The SAR values from the EM solution are put into the bioheat transfer equation, and steady-state temperature distributions are calculated for a wide range of blood flow rates. Based on our theoretical modeling, the APA shows no preferential heating of superficial over deep-seated tumors. However, in most cases for all three regions of the human trunk only fair thermal profiles (therapeutic area near 60%) are obtained in tumors with little or no blood flow and poor temperature patterns (therapeutic area less than 50%) are found in tumors with moderate to high perfusion rates. These theoretical calculations should aid the clinician in the evaluation of the effectiveness of APA-type devices in heating tumors located in the trunk region. PMID- 6505145 TI - Cell cycle dependent G2 delay and killing of L929 cells after exposure to 241Am alpha particles. AB - Survival and G2 delay of L929 mouse fibroblasts exposed to 3.4-MeV alpha particles depend on the cell age at the time of irradiation. Greatest sensitivity for both endpoints has been found at the G1/S transition: The surviving fraction of G1/S cells is reduced to 0.11 following 1 Gy of alpha particles compared to 0.31 for early G1 cells. The G2 + M transit time rises from 3 hr for control cells to 22 and 30 hr for cells irradiated with 0.3 Gy in G2 or at the G1/S boundary, respectively. Cells irradiated in early G1 do not show increased G2 + M transit times. Growth delay as calculated for the entire population increases linearly with dose by 23 hr/Gy of alpha particles. PMID- 6505144 TI - Retention and dosimetry of injected 241Am in beagles. AB - Equations have been derived, from the results of total-body and partial-body counting and gamma-ray counting of individual bones and soft tissues, which describe the retention of injected 241Am in the liver, in the nonliver tissue (including skeleton), and in the skeleton of young adult beagles. Retention was found to be dependent upon injection level, and different sets of equations were developed for dogs given about (a) 2.8 microCi/kg (b) 0.9 microCi/kg (c) 0.3 microCi/kg, and (d) 0.1 microCi/kg and less. Liver rention, RL, was characterized by a single exponential equation of the form RL = ce-beta t, with c = 0.49 +/- 0.04 and beta = a function of injection level. Nonliver tissue was assigned a retention equation of the form RNL = d + alpha + J(l - e-mt), with d = 0.102 +/- 0.024 e-1.22t, alpha = 0.41 +/- 0.04, and both J and m as a function of injection level. Skeletal retention was found to be about 0.885 +/- 0.037 of nonliver retention with no significant dependence upon either injection level or time after 241Am injection. Dosimetry equations based on these retention expressions were derived. Individual bones of 55 beagles were assayed at death for their 241Am content for a determination of 241Am distribution within the skeleton. PMID- 6505146 TI - The action of caffeine on X-irradiated HeLa cells. VII. Evidence that caffeine enhances expression of potentially lethal radiation damage. AB - HeLa cells irradiated with 2 Gy of 220-kV X rays suffer a 60-70% loss of colony forming ability which is increased to 90% by postirradiation treatment with 10 mM caffeine for 6 hr. The detailed postirradiation patterns of cell death and sister cell fusion in such cultures and in cultures in which the colony-forming ability was brought to about the same level by treatment with a larger (4 Gy) X-ray dose alone or by longer (48 hr) treatment with 10 mM caffeine alone were recorded by time-lapse cinemicrography. Because the patterns of cell death and fusion differ radically in irradiated and in caffeine-treated cultures, the response of the additional cells killed by the combined treatment can be identified as X-ray induced rather than caffeine induced. The appearance of cultures after several days of incubation confirms the similarity of the post-treatment patterns of proliferation in cultures suffering enhanced killing to those occurring in cultures treated with larger doses of X rays alone. It is concluded that X rays do not sensitize cells to caffeine, but rather that caffeine enhances the expression of potentially lethal radiation-induced damage. PMID- 6505148 TI - [Genetic control of the processes of postradiation repair of a compact chromosome in Micrococcus radiodurans cells]. AB - X-irradiation of Micrococcus radiodurans cells with sublethal doses caused disturbances in the structure of a membrane-bound compact chromosome. Recovery of the compact chromosome occurred during the postirradiation incubation of the wild type cells and cells of the UVS-17 mutant deficient in DNA-polymerase. This process was blocked in cells of rec-30 mutant with the impaired system of genetic recombination: this is indicative of an important role played by rec-30 gene product in the postirradiation recovery of the compact chromosome in M. radiodurans cells. PMID- 6505147 TI - [Products of laser photolysis of thymine and their transformation in chemical hydrolysis of polynucleotides to the bases]. AB - Some main products of laser photolysis and gamma-radiolysis of thymine were shown to undergo subsequent transformations during DNA hydrolysis by formic acid to the bases. The method has been developed for the quantitative determination of the character and the degree of thymine transformations under the effect of laser- and gamma-radiations with a reference to the end-products of the irradiated thymine hydrolysis. PMID- 6505149 TI - [The effect of x-rays on the level, composition and para-nitroanisole-o demethylase activity of cytochrome P-450 in the liver microsomes of rats]. AB - A study was made of the effect of X-radiation of different doses on the content of P-450 cytochrome in a microsomal fraction of rat liver. When the haemoprotein level markedly decreased an increase in Km and a decrease in Vmax were noted in the reaction of O-demethylation of para-nitroanisole by microsomes of the irradiated rat liver. It is suggested that one of the cause of the effect observed is the postirradiation change in the composition of cytochrome P-450 pool resulting from a selective decrease in the level of the radiosensitive forms of haemoprotein. PMID- 6505150 TI - [Mechanisms of action of high and superhigh doses of gamma-quanta and neutrons on the central nervous system]. AB - Wistar rats were exposed to gamma-quanta (60Co, 100-400 Gy) and neutrons (100-200 Gy). The C. N. S. syndrome was shown to develop the neuron lesions being relatively minor. With a reference to this index, the RBE of neutrons was 1.75. The permeability of blood vessels of the brain was decreased during the development of the C. N. S.-syndrome. Disturbances in the functional state of neurons and interneuron reactions, including the changes in the mediator metabolism (these changes were manifested by the increased GABA content of the cerebellum), play, in all appearance, an important role in the impairment of the brain function under the effect of high doses of neutrons and gamma-quanta. PMID- 6505152 TI - [Radiation injury of hemopoiesis in alpine conditions depending upon the duration of adaptation]. AB - A study was made of the disturbance of haemopoiesis in the small laboratory animals and dogs kept in Alpine conditions (3200 m) and exposed to ionizing radiation on days 3, 15, 22, 25 and 33 of adaptation. The radiation damage to haemopoiesis in Alpine conditions was shown to decrease at the beginning of the adaptation due to the intensification of the regenerating processes, which was manifested by the increase in the rate of DNA synthesis in the haemopoietic organs, and activation of erythropoiesis, myelopoiesis and lymphopoiesis. Later (after 30-35 days), a 2-4-fold increase was noted in the number of haemopoietic stem cells which improved the compensatory potency of the tissue under study and increased the total resistance of the organism. PMID- 6505151 TI - [Repaired and unrepaired DNA damage induced by x-irradiation of nonproliferating rat hepatocytes]. AB - An effective system of repair of double-strand DNA breaks was found in the stock culture of rat hepatocytes by the method of elastoviscosimetry. The inhibitors of DNA resynthesis, hydroxyurea and arabinosyl cytosine, which transformed single strand breaks into double-strand ones were used to estimate the level of spontaneous affection of the hepatocyte genome. With a reference to this level the authors have demonstrated that after a dose of 2 Gy and 6-24-hour repair, the additional number of lesions was registered. These lesions were shown to be incised by nucleases similar to those involved into the conventional repair process. PMID- 6505153 TI - [Oxygen status and angioarchitectonics of different types of tumors and their changes after radiotherapy]. AB - The study of the oxygen tension and blood supply to the implanted tumors of different histological structures demonstrated a correlation between pO2 and blood supply of sarcoma 37 after a single and fractionated irradiation. As to Lewis carcinoma and B-16 melanoma, the correlation was only found in tumors of a small size: as the tumor grew up to 14-15 mm such a correlation was absent. It was also established that the radiation-induced changes in the vessels and the oxygenation depended upon the histological structure of the tumor. PMID- 6505154 TI - [Morphological changes in the intrapulmonary bronchi of rats a long time after 239PuO2 inhalation]. AB - Destructive, inflammatory, sclerotic, compensatory and adaptive, pretumoral and tumoral changes in the respiratory tracts of rats were revealed 180-540 days following a single inhalation of 239PuO2. The thickness of the bronchus wall and the diameter of their lumen remained significantly increased, as compared with the controls of the same age, throughout the entire period of observation. PMID- 6505155 TI - [Repair of the nucleoid of sarcoma 37 cells in vitro or in vivo. The effect of HEPES buffer]. AB - The method of sedimentation was used to study the repair of Sarcoma 37 cell nucleoid after irradiation of cells in vitro or after irradiation of mice with a dose of 9 Gy. It was shown that the process of repair in vitro was completed after 10 min of incubation of cells in the nutrient medium while the repair in vivo ceased 120 min after irradiation. In the presence of HEPES buffer (20 mM) in the medium the kinetics of the nucleoid repair in cells incubated in vitro was the same as that in vivo. PMID- 6505156 TI - [The effect of oxygen on denaturation and aggregation of enzyme macromolecules during gamma-irradiation]. AB - The ribonuclease molecules irradiated in a solution in the presence of 18O2 were separated, by the method of gel-chromatography, into fractions of aggregated macromolecules, denatured monomers and the molecules which retained the original sizes. Oxygen was bound by the molecules of all fractions. The oxygen binding prevented the aggregation of macromolecules. The fractions of molecules of monomer forms, obtained after irradiation in the presence of oxygen, were more inactive than those obtained after irradiation in vacuum. PMID- 6505157 TI - [The effect of irradiation on the lipid composition of plasma membranes of liver cells]. AB - The level of total phospholipids decreases, a cholesterol/phospholipid molar coefficient increases, and lipid/protein ratio in plasma membranes of liver cells decreases at early times following total-body X-irradiation of rats (LD50/30). Changes in individual phospholipids were differently directed. A possible correlation between the data obtained and the structural-functional status of the surface membrane is discussed. PMID- 6505159 TI - [Dynamics of mitotic activity and frequency of pathologic mitoses in solid Ehrlich tumor after exposure to ultrasound and x-rays]. AB - The dynamics of mitotic activity and the frequency of pathologic mitoses and their spectrum in 180 mice bearing Ehrlich solid tumors were studied after exposure to X-rays (XR) (5.6 Gy), ultrasound (US) (2W/cm2, for 5 min) or the combined exposure to both agents delivered in a different sequence. The harmful effect of the above-mentioned agents diminished when they were delivered in the following order: US+XR, XR+US, XR, and US. After the combined treatment the spectrum of the pathologic mitoses widened. PMID- 6505158 TI - [The effect of cystamine on the survival of mice and endogenous colony-formation in combined radiation-thermal injuries]. AB - In experiments on mice it was shown that cystamine exerts its protective action not only against the concurrent effect of ionizing radiation and weak thermal injury but also against the effect of heat (burn) 48 h after irradiation with a midlethal dose (30-day-death decreased from 95 to 20%). PMID- 6505160 TI - [Pu(IV) behavior in the serum]. AB - This paper presents the results of studies of the hydrolysis and polymerization of Pu(IV) in blood serum. With nitrite Pu(IV) solutions incubated with blood serum 20-34% of the nuclide were precipitated as hydroxide and 11-36% converted into polymeric forms bound by high molecular weight proteins. For citrate solutions, these values were 3.8 and 3.0%, respectively. PMID- 6505161 TI - [Mechanism of distribution of neptunium and plutonium in rats]. AB - Neptunium administered intravenously together with the high molecular weight protein fraction of blood serum was almost completely accumulated by the liver after 60 min. Then neptunium left the liver and was partially deposited in the skeleton. Plutonium, being a component of a nonprotein and a low molecular weight protein fractions, was mainly found in the skeleton where it had been accumulated throughout the entire period of observation (14 days, 52-58%); as to the nonprotein fraction, the value of accumulation was somewhat higher. PMID- 6505162 TI - [Comparative radioprotective efficacy of native and irradiated in vitro immunoglobulins from horse serum]. AB - The therapeutic application of native and in vitro exposed (20000 Gy immunoglobulins of horse blood serum increased the survival of irradiated (LD75 95) animals, normalized the quantitative and qualitative status of the small intestine microflora and prevented enterobacteria from penetrating the internal organs. The irradiated preparations were more active than native ones. PMID- 6505163 TI - [Simulation of an interaction between various hematopoietic stems in the limited proliferating potential of bone marrow]. AB - A model is proposed to describe the interaction between the erythroid and myeloid haemopoietic compartments their total proliferating potential being limited and the myelopoiesis inhibited in favour of erythropoiesis. With the consecutive diminution of the bone marrow proliferating potential the model describes: (1) the delay in the recovery processes, (2) the fluctuation regime for all the cell strains under study, (3) and the complete inhibition of myelopoiesis. PMID- 6505164 TI - [Radiosensitivity of animals irradiated in a modified gaseous medium. Modification of cerebral syndrome in mice by hypoxic hypoxia and hyperoxia during irradiation]. AB - The cerebral syndrome of mice was shown to be modified by the use of a changed gas medium during irradiation of the head. This was manifested by the decrease in the severity of the syndrome in the hypoxic medium (HGM-8) and aggravation in the hyperoxic medium. When the body was exposed the modifications of the radiation damage were opposite. PMID- 6505165 TI - [Comparative evaluation of the carcinogenic effects of chronic exposure to tritium oxide and external gamma-radiation]. AB - In experiments of on rats a study was made of late effects of chronic action of tritium oxide (3HOH) during 6 months (37 X 10(4) Bq/g/day) and external gamma radiation (137Cs) which were delivered in comparable daily and cumulative doses. It was shown that 3HOH produced a more pronounced blastomogenic effect. The RBE coefficient of tritium oxide approximated 1, with a reference to the average life shortening, and 4.2 and 2.5, with a reference to the incidence of malignant tumors and leukoses, respectively. PMID- 6505166 TI - [Mathematical model of yeast cell recovery after combined exposure to ionizing radiation and hyperthermia]. AB - A mathematical description of yeast cell recovery after the combined effect of ionizing radiation and hyperthermia is presented. The degree of cell injury was predicted using a calculated irreversible component. A good agreement between the experimental and theoretical results was demonstrated. The possibility of using the proposed model for quantitation of the postirradiation recovery after other combined treatments is discussed. PMID- 6505167 TI - [Characteristic cytogenetic effects of small doses of ionizing radiation]. AB - A study was made of the frequency of chromosome aberrations in human lymphocyte culture after gamma-irradiation (60Co) with doses ranging from 0.05 to 1.0 Gy at dose--rates of 0,005, 0.05 and 0.5 Gy/min. The frequency of structural changes in chromosomes at low doses was higher than it was expected in the case of extrapolating the effect produced by high to low doses of radiation; within the dose range from 0.1 to 0.5 Gy a plateau was registered for aberrations of the exchange type (dicentrics and rings). The abnormal character of the dose dependence of the yield of chromosome aberrations persisted with all three dose - rates under study. PMID- 6505169 TI - Performance characteristics of X-ray tubes and generators. PMID- 6505168 TI - Radiographic investigation of palatal incompetence. AB - The purpose of this article is to describe the radiographic technique by which the author's department investigates the children and adults referred with palatal incompetence. It is not intended to compare it with any other type of investigation. The technique described has been used at Frenchay Hospital for the past 10 years and has yielded very reliable results. The information obtained has led to better planning of treatment for each individual patient. PMID- 6505170 TI - A radiographer's guide to computerized patient administration. PMID- 6505171 TI - Patient administration: how to avoid bottle-necks. AB - The object of this paper has been to outline and to assist others in eliminating the obstacles of which we are all aware in any busy radiography department. From experience the value of team work from the porters to the radiologists cannot be over-emphasized. Any weak link in the chain can produce a bottle-neck and by tackling the elementary problems which we have discussed, a smooth day to day operation of the department, can generally be achieved, making the launching of the computer a relatively simple task. PMID- 6505172 TI - Using a computer for school administration. PMID- 6505173 TI - Computer education for radiographers: courses available. PMID- 6505175 TI - Tomographic exposure angle. PMID- 6505174 TI - Malignancies induced by low dose ionizing radiation: consequences for diagnostic radiology. PMID- 6505176 TI - Proliferation activity and radiosensitivity of CFU-S in their decreased compartment in continuously irradiated rats. PMID- 6505177 TI - Radioprotective effect of 2-mercaptopropionylglycine (MPG) on the alkaline phosphatase activity in the liver of Swiss albino mice against gamma irradiation. PMID- 6505178 TI - Effect of 2-mercaptopropionylglycine (MPG) on the radiation induced chromosome aberrations in the bone marrow of mice. PMID- 6505179 TI - Radiation induced peripheral blood changes in mice and its modification by MPG. PMID- 6505180 TI - [Radiobiological limits in conventional after-irradiation of breast cancer. II. Observations on soft tissue changes]. PMID- 6505181 TI - [Radiobiological limits in conventional after-irradiation of breast cancer. III. Observations on functional disorders]. PMID- 6505182 TI - [Salivation and taste disorders following irradiation in the oropharyngeal region]. PMID- 6505184 TI - [Views on the outlook for radiotherapy to the year 2000 (with special reference to the GDR)]. PMID- 6505183 TI - Education and training in radiobiology in the United States and Canada. A report of the Education and Training Committee (1978) Radiation Research Society. PMID- 6505185 TI - [Effect of adjustment inaccuracies on dose distributions]. PMID- 6505186 TI - [Postoperative percutaneous irradiation of thyroid carcinoma. Results of treatment of 170 patients with special reference to rehabilitation]. PMID- 6505187 TI - [Kinetic model of combined radiation damage to a cell population with heterogeneous sensitivity]. PMID- 6505188 TI - Experimental therapy of protein deficit by inhibition of fibrinolysis in continuously irradiated rats. PMID- 6505189 TI - Characterization of antithyroglobulin antibodies. PMID- 6505190 TI - Determination of thyroid antimicrosomal antibodies by solidphase radioimmunoassay. PMID- 6505191 TI - The problem of thyroglobulin-determination in presence of thyroglobulin antibodies. PMID- 6505193 TI - Fine-needle aspiration biopsie of the thyroid in the diagnosis of thyroid autoimmunity. PMID- 6505192 TI - [Immunologic and cytologic findings in the course of a complex thyroid diagnosis. Comparison of 2 patient groups]. PMID- 6505194 TI - [Cytology and histomorphology of thyroiditis]. PMID- 6505195 TI - [Oncocytes in thyroid gland aspirates--differential diagnostic problem: tumor/thyroiditis]. PMID- 6505197 TI - [CT following abdominosacral amputation of the rectum--a critical study of methods]. PMID- 6505196 TI - [Ausria/Core. Simultaneous detection of hepatitis B virus core surface antigen and antibody using 3rd generation tests]. PMID- 6505199 TI - [New detachable balloon for therapeutic embolization. Experimental studies]. PMID- 6505198 TI - [Computed tomographic diagnosis of abscesses in the trunk]. PMID- 6505200 TI - [New detachable balloon for therapeutic embolization. Animal experiments, histological and clinical studies]. PMID- 6505201 TI - [Diagnostic value of arteriography in morphological changes in the adrenal glands]. PMID- 6505202 TI - [Effect of calibration factors on roentgenologic volumetry of the left ventricle (comparative studies on human heart casts)]. PMID- 6505203 TI - [Endoscopic roentgen diagnosis of malignant tumors of the proximal colon]. PMID- 6505204 TI - [Adaptational changes in the gastrointestinal tract following jejuno-ileal bypass for obesity]. PMID- 6505205 TI - [Osteopenia caused by metabolic changes following jejuno-ileal bypass for obesity]. PMID- 6505206 TI - [Humeroscapular periarthritis as a main symptom of gout]. PMID- 6505207 TI - Hysterosalpingoscintigraphy. PMID- 6505209 TI - [Assessment of the information value of isotope nephrography: ING segmental analysis]. PMID- 6505208 TI - [Comparison of the relative sensitivity of analog and digital bone scintigraphy]. PMID- 6505210 TI - [Animal experiments on the radiopharmacokinetics of 125I-liposomes following direct intralymphatic administration. 1]. PMID- 6505211 TI - [Animal experiments on the radiopharmacokinetics of endolymphatically administered 125I-liposomes for the diagnosis of regional lymph node tumors. 2]. PMID- 6505212 TI - [Animal experiments on the radiopharmacokinetics of endolymphatically administered, labeled albumin-microspheres for the diagnosis of regional lymph node tumors. 3]. PMID- 6505213 TI - [Standards for roentgen tubes for roentgen diagnosis]. PMID- 6505214 TI - [A new protective circuit for roentgen tubes]. PMID- 6505216 TI - Incorporating general education competencies in the radiography curriculum. AB - Due to the absence of general education (ie, arts and sciences) competencies in radiography accreditation standards, individual programs vary with regard to the amount and type of general education offered. Throughout the last 15 years, renowned educators have repeatedly suggested that, amongst other things, career mobility for the radiographer could be improved as a result of introducing general education into the curriculum. A method for incorporating general education competencies in the radiography curriculum through revision of the accreditation standards is presented. PMID- 6505215 TI - Microradiography using a noncommercially constructed Grenz ray unit. AB - A simplified microradiographic technique is described that does not require expensive, specialized equipment. Single emulsion radiographic film was used in conjunction with a noncommercially constructed Grenz ray unit to produce good to excellent general survey microradiographs of tissue specimens. This technique proved satisfactory for visualization of vessels larger than 100 mu in diameter. PMID- 6505217 TI - Electrifying artifacts. PMID- 6505218 TI - The POEMS syndrome: report of three cases with radiographic abnormalities. AB - Three cases of a unique multisystemic syndrome with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (the POEMS syndrome) are presented, along with a review of the literature. Clinical and radiographic features of this syndrome and etiological considerations are discussed. A variety of osteosclerotic lesions, nonspecific pleural effusion and ascites are characteristic radiographic manifestations. PMID- 6505219 TI - [Abscess-forming pneumonia in esophageal cancer. A case contribution]. AB - A 46-year-old male patient with rapidly progressive Klebsiella pneumonia and abscess formation is presented. The infection resulted from a mediastinal pulmonary fistula that developed during irradiation of a widespread carcinoma of the oesophagus. PMID- 6505220 TI - [Hemorheologic effects of ioxaglate: a contribution to an interpretation of the effect of hyperosmolar roentgen contrast media on the fluidity of erythrocytes]. AB - Almen and Aspelin have shown that the use of non-ionic radio contrast media allows the iodine concentration to be increased (which is desirable because of its effect on radio opacity) without a very large increase in osmolarity (which is undesirable because it impairs the fluidity of erythrocytes). This latter effect can also be diminished by reducing the osmolarity of a dimeric contrast medium as has been achieved by incorporating more iodine atoms into the molecule in the case of Ioxaglate (Hexabrix). In various microrheological tests systems, the fluidity of packed red cell suspension, the corrected filtration rate though 5 micron pores and the relative apparent viscosity of blood-contrast media mixtures (1 to 50% concentration) were determined in experiments comparing this compound with Urografin 76 of the same iodine content. In all systems, the former showed fewer rheological effects. In whole blood viscometry, this can be detected only after appropriate corrections for the effects of the two contrast media on hematocrit and plasma viscosity. As there is a more pronounced water shift from the cells to the plasma, Urografin tends to reduce the viscosity of the plasma contrast media mixture. The concomitant reduction in MCV and hematocrit level tends to conceal the macrorheological influence of strong cell stiffening. This microrheological effect of the dehydrated cells becomes immediately obvious when the viscometric data are corrected for hematocrit value and plasma viscosity effects. PMID- 6505221 TI - [Comparison of the side effects of urographic contrast media (iothalamate, diatrizoate, iodamide, iopamidol) within the scope of a CT study]. AB - In 1465 patients the side effects of urographic contrast media for enhancement in CT were compared. The results show that the reaction frequency with iotalamate is 5.1%, with diatrizoate 7.0% and with iodamide 8.9%, but only 0.5% with iopamidol. The number of incidents to be expected with iopamidol is one decimal place lower. Obviously this has to do with its low osmolality. On the other hand we interpret the comparatively slightly higher incidence rate when using iodamide as a result of its higher lipophilic nature. PMID- 6505222 TI - [Unclear leg swelling following osteomyelitis]. PMID- 6505223 TI - [Electron transport system of microsomes: an interview with Dr. Ryo Sato]. PMID- 6505225 TI - A pharmacologic analysis of the action of platelet-activating factor in the induction of hindpaw edema in the rat. AB - Platelet-activating factor (PAF), a phospholipid product of neutrophils, alveolar macrophages, monocytes, and platelets and an important mediator of inflammatory reactions, was studied for its ability to evoke hindpaw edema in the rat. PAF caused edema, peaking at 1 hr and gradually declining over the next 2 hr. The H1 and H2 antihistamines, mepyramine and cimetidine, the serotonin/histamine antagonist, cyproheptadine, and the serotonin antagonist, methysergide, were ineffective in reducing PAF-induced paw edema. Indomethacin, acetylsalicylic acid, and dexamethasone did not inhibit the peak edematous response but significant reduction was noted with only dexamethasone at 3 hr. Prazosin and propranolol did not prevent PAF-induced edema, whereas, yohimbine, phentolamine, rauwolscine, verapamil and theophylline partially inhibited edema. Clonidine and guanfacine did not induce edema when injected into the rat hindpaw. These results suggest that PAF elicits edema at vascular sites of the rat hindpaw which are partially dependent on extracellular Ca2+ movement, are not due to alpha-1 or alpha-2-adrenoreceptor stimulation, histamine, serotonin, or prostaglandin activity, and demonstrates variable sensitivities to agents blocking Ca2+ entry. Inhibition of specific PAF-sensitive receptors await the discovery of specific PAF antagonists. PMID- 6505224 TI - Effects of a contractile prostaglandin antagonist (L-640,035) upon allergen induced bronchoconstriction in hyperreactive rats and conscious squirrel monkeys. AB - The effects of an antagonist of contractile prostanoids, L-640,035 (3 hydroxymethyl-dibenzo[b,f]thiepin-5-dioxide) upon antigen-induced bronchoconstriction have been studied in inbred rats with non-specific bronchial hyperreactivity and in conscious squirrel monkeys. L-640,035 was a potent inhibitor of antigen-induced dyspnea (ED50 3.1 mg/kg p.o.) in inbred rats pretreated with methysergide (3 micrograms/kg i.v.) but produced no significant inhibition in untreated rats. Administration of L-640,035 (10 mg/kg p.o.) to conscious squirrel monkeys exposed to aerosols of ascaris antigen markedly inhibited changes in pulmonary resistance (RL) and dynamic compliance (CDYN). At a lower dose (1 mg/kg p.o.) the inhibition of changes in CDYN were similar but the effects on RL were reduced. It was concluded first that contractile prostanoids may be important mediators of antigen-induced bronchoconstriction and secondly that L-640,035 may be effective in human allergic asthma. PMID- 6505226 TI - [Whooping cough 1982]. PMID- 6505227 TI - [Scarlet fever 1982]. PMID- 6505228 TI - [Epidemic parotitis 1982]. PMID- 6505229 TI - [Influenza 1982]. PMID- 6505230 TI - [Rubella 1982]. PMID- 6505231 TI - [Cerebrospinal meningitis and encephalitis 1982]. PMID- 6505233 TI - [Food poisoning 1982]. PMID- 6505232 TI - [Salmonella infections 1982]. PMID- 6505234 TI - [Botulism 1982]. PMID- 6505235 TI - [Diarrhea in infants under 2 years of age 1982]. PMID- 6505236 TI - [Viral hepatitis 1982]. PMID- 6505237 TI - [Infectious mononucleosis 1982]. PMID- 6505238 TI - [Tetanus 1982]. PMID- 6505239 TI - [Brucellosis and other zoonoses 1982. Human brucellosis]. PMID- 6505240 TI - [Rabies 1982]. PMID- 6505241 TI - [Trichinosis 1982]. PMID- 6505242 TI - [Intestinal parasites 1982]. PMID- 6505243 TI - [Scabies 1982]. PMID- 6505244 TI - [Epidemiology and prevention of toxoplasmosis]. PMID- 6505246 TI - [Measles 1982]. PMID- 6505245 TI - [Communicable diseases in Poland 1982]. PMID- 6505247 TI - Smoking and pregnancy: I. Maternal and placental risks. PMID- 6505248 TI - Descriptive epidemiology of cerebral palsy. PMID- 6505249 TI - [Where language cannot reach]. PMID- 6505250 TI - [High-density lipoproteins and arteriosclerosis]. PMID- 6505251 TI - [Relation between daily patient visits to district physicians and atmospheric air pollution]. PMID- 6505252 TI - [Indications for use of antibiotics in gynecology]. PMID- 6505253 TI - [Surgical treatment of ectopic ureterocele]. PMID- 6505254 TI - [Serum haptoglobin concentrations in workers chronically exposed to vinyl chloride]. PMID- 6505255 TI - [Niemann-Pick disease in a 2-month-old infant]. PMID- 6505256 TI - Lymphocyte predominant Hodgkin's disease: clinical presentation and results of treatment. AB - The records of 59 patients with lymphocyte predominant Hodgkin's disease (LPHD) evaluated and treated at Stanford University Medical Center between 1963 and 1983 were reviewed. Of these 59 patients, 92% are alive at 10 years following treatment, 78% are relapse-free, and none have died of Hodgkin's disease. Compared with the other histologic subtypes of Hodgkin's disease, LPHD presents more frequently as stage I or II disease (78% vs. 55%) and less frequently with constitutional symptoms (7% vs. 32%). Despite these factors, there is no statistically significant difference in either survival or freedom-from-relapse (FFR) between the histologic subtypes when comparisons are made on a stage-for stage basis. Analysis of sites of presentation and relapse reveals that LPHD rarely involves intrathoracic structures. Patients with C.S. I disease presenting in inguinofemoral or high cervical lymph nodes do not require staging laparotomy as none of these patients were upstaged by surgery. Patients with stage I disease involving high cervical lymph nodes may be treated with limited field irradiation employing fields no more extensive than a mantle and Waldeyer's ring field, as no relapses have been seen in such patients treated in this fashion. Although limited field irradiation was used successfully for LPHD presenting in other localized sites, inadequate patient numbers preclude assessment of this treatment for those clinical presentations. PMID- 6505257 TI - Chemotherapy and radiotherapy in advanced testicular non-seminoma. 2. Results of treatment. AB - Between 1976 and 1981, 63 patients with Stage II-IV testicular non-seminoma were treated by chemotherapy followed 4-6 weeks later by involved field radiotherapy. Of this group, 58 (92.1%) are alive and tumour-free, one patient died post operatively and four of uncontrolled disease. There were no deaths from drug induced neutropenic sepsis. During the same period a second group of 53 patients who had received radiotherapy were given chemotherapy for recurrent disease. Of this group, 38 (71.7%) are alive and tumour-free, eight died of uncontrolled malignancy, six from drug-related complications and one from a myocardial infarct. In patients receiving elective post-chemotherapy irradiation, tumour volume exerted little influence on treatment outcome, the disease-free survival rates for small volume and bulky disease being 100% and 87.2%, respectively. Conversely, in patients receiving chemotherapy after prior irradiation there was a significant difference; 96.7% and 43.4%, respectively (p less than 0.001). Of the 63 patients in the drug-irradiation protocol group 23 (36.5%) had residual masses excised. In 18 patients (78.2%) the excised tissue showed either fibrosis or mature teratoma. Despite the excellent survival figures for patients receiving post-chemotherapy irradiation the value of this approach cannot be assumed, although the slight difference between small and bulky presentations suggests that radiotherapy may have contributed to the therapeutic result. PMID- 6505259 TI - A block localizer for easy and reproducible transfer of shielding block positions from simulator to treatment unit. AB - For the localization of shielding blocks at the simulator a special tray called "block localizer" was constructed. It can be attached to the simulator head by means of magnets in the top frame. The "block localizer" provides a platform at a distance from the X-ray source corresponding to the source-to-block distance at the treatment unit. On the platform templates made from 0.5 mm brass to the size of the block bases can be positioned under fluoroscopy. Before taking the beam localization exposure a low sensitivity film is placed in a slit in the platform. On this film the template (block) position is recorded. For treatment the developed film is attached to the block tray and the shielding block inserted according to the light shadow of the template projected from the film onto the patient. An easy and reliable positioning of blocks during repeated irradiations is thus provided. The block (template) position is also recorded on the beam localization film of the patient as a transparent shadow. PMID- 6505258 TI - Dose-response relationship for radiation therapy of recurrent, residual, and primarily inoperable colorectal cancer. AB - One hundred and thirteen patients with advanced locoregional recurrent (77), residual (18) or primarily inoperable (18) colorectal carcinoma were treated with radiotherapy. Eighty-five patients had locoregional disease only and 28 had both local disease and distant metastases. The treatment was given with varying dose levels (23-73 Gy) in daily fractions of approximately 2 Gy in 3-8 weeks. This dose variation allowed an evaluation of the dose-response relationship for radiation treatment of this tumour. A good subjective response was obtained in 63%. This effect showed no dose-response relationship except for doses greater than or equal to 56 Gy, where all patients received relief of symptoms. Eighty two per cent of evaluable patients achieved an objective response (PR 53%, CR 29%). The frequency and duration of the complete responses showed a marked dose response relationship. Thus, at doses greater than or equal to 56 Gy, a 2-year actuarial complete response rate of 40% was found compared with 7, 4 and 0% at doses of 46-55 Gy, 36-45 Gy and less than or equal to 35 Gy, respectively. The dose-response relationship for local control also influenced the survival rate, although a number of patients died from distant metastases even when local control was obtained. However, with regard to locoregional disease, the 2-year survival was 53% for patients with complete tumour regression but only 8% for patients without complete tumour regression. PMID- 6505260 TI - A critical appraisal of clonogenic survival assays in the evaluation of radiation damage to normal tissues. AB - Assessment of radiation damage to normal tissues in terms of dose-response curves for infinite proliferative potential ("survival curves") does not take into account the decrease with increasing dose of the multiplication rate of the clonogenic and non-clonogenic (radiation-sterilized) cells which may be implicated in the expression of the damage to tissue function or gross appearance. While radiation selectively lowers the chance of successful mitotic divisions, other anticancer agents may in addition interfere with different cellular processes. Comparisons of effectiveness of radiation with that of other modalities should not therefore be limited to analysis of survival curves. Assays of cell "survival" in self-renewing normal tissues in situ often define properties of a non-random sample of the clonogens. The nature of repair associated with the post-irradiation delay in performance of transplantation assays for normal clonogenic cells remains unclear. Dose-response relationships for functional impairment or gross damage to tissue, especially those obtained by irradiation with many fractions, do not necessarily yield to interpretation in terms of clonogenic cell "survival". PMID- 6505261 TI - The kinetics of repair of sublethal damage in the rat cervical spinal cord during fractionated irradiations. AB - The kinetics of repair of sublethal damage were investigated in the cervical spinal cord of rats. Two and 4 fractions have been given with intervals ranging from 20 min to 24 h. The occurrence of paralysis within 7 months after irradiation (due to white matter necrosis) was used as the endpoint. From dose response curves, ED50 values (dose at which 50% of the animals develop paralysis) were determined, from which the proportion of the dose repaired (FR) during the different intervals can be calculated. It was found that the rate of cellular repair of sublethal damage was exponential, with a half-time of approximately 110 min after a fraction size of 11-15 Gy and 85 min after 7-11 Gy. The corresponding time to complete cellular repair was calculated to be 8 and 6 h, respectively. This suggests that the rate of cellular repair is faster after smaller fractions. PMID- 6505262 TI - Potentially lethal damage repair as a possible determinant of human tumour radiosensitivity. AB - In this paper we review the current data on the role of potentially lethal damage (PLD) recovery in human tumour cell lines, both in vitro and in vivo. In the case of cell lines studied in vitro, the mean recovery ratios found were higher for cells derived from tumours of low curability (glioblastoma, hypernephroma, osteosarcoma, melanoma) than for cells derived from tumours of high curability (breast carcinoma, neuroblastoma). Experiments were performed in vivo only with tumours of low and intermediate curability (melanoma, adenocarcinoma of the colon, pancreatic tumour). Although fragmentary and obtained only with established cell lines, these results argue in favour of the occurrence of PLD repair in human tumour, the amplitude of this repair being, in certain cases, sufficient to explain the incurability of a tumour by radiation therapy. PMID- 6505263 TI - Ploidy level and short-time prognosis of early cervix cancer. AB - The DNA distribution in carcinoma of the uterine cervix was investigated by flow cytometric analysis. The study includes 105 patients stages Ib and IIa. Approximately 80% of the tumours contained aneuploid cell populations. According to the distribution of ploidy levels the tumours were divided into two groups with a cellular DNA content below and above 1.5 X the normal diploid DNA content, respectively. The ploidy level was not correlated with the extension of the tumours, but an obvious correspondence was found between the ploidy level and the frequency of lymph node metastases in surgically treated patients. A statistically significant correlation was also demonstrated between the ploidy level and the recurrence frequency irrespective of treatment with radiotherapy or surgery. PMID- 6505264 TI - A method to reduce radiation injury to intestine--a preliminary report. PMID- 6505265 TI - Repair factors for multifraction irradiations. PMID- 6505266 TI - Multiple small fractions per day versus conventional fractionation. Comparison of normal tissue reactions and effect on breast carcinoma. AB - Hyperfractionation (3 fractions of about 1.0 Gy/day) and conventional fractionation were compared in two studies. In the first, the acute skin reactions, erythema and pigmentation, and the development of telangiectasia were analysed on postoperatively irradiated bilateral parasternal fields in patients with breast carcinoma. In the second study, the tumour effect in patients with inoperable breast carcinoma was investigated under conditions of equivalent normal tissue reactions for both fractionation schedules. With hyperfractionation the late-responding normal tissue was spared relative to the acutely responding normal tissue about 5% in absorbed dose. Concerning the therapeutic effect on adenocarcinoma of the breast 3 X 1.0 Gy/day was not better than 1 X 2.4 Gy/day. These daily doses resulted in equivalent late effects as was predicted from the normal tissue study. PMID- 6505267 TI - External beam radiotherapy in cancer of the prostate. The University of Arizona experience. AB - Between 1973 and 1979, 218 patients with adenocarcinoma of the prostate stage A2 through D1 were treated with primary external beam radiotherapy. The majority of the patients (211) received 6000-7000 rad to the prostate using a small (160) or large (58) volume technique. With a minimum follow-up of 36 months and a maximum of 120 months, the control rates of the local tumor were 96%, 95%, 88% and 81% for stage A2, B, C and D1. The corresponding 5-year survivals were 100%, 82%, 60% and 42%. Mild to severe complications were documented in 35 cases (16%). The frequency and severity of the complications correlated with the size of the irradiated volume and history of previous surgery. The use of large fields, to encompass the regional lymphatics, is not associated with improved survival. PMID- 6505268 TI - A medical chart review for information about sexual functioning in cervical carcinoma. AB - Fifty medical charts from two departments of radiotherapy, one in France and the other in the United States, were reviewed to determine their utility in contributing to information about sexual functioning after treatment for cervical cancer. For both settings, useful information about the disease, its treatment and the post-treatment complications was readily available. Significant differences were found between the settings in the documentation of data about sexual function, vaginal dilator use and dilator compliance. The utility of medical records for the purpose of gathering information about sexual functioning after radiotherapy for cervical cancer was found to be significantly higher in one of the settings for several variables. Possible reasons for these findings are given along with medical charts for the promotion and study of sexual rehabilitation for patients with cervical carcinoma. PMID- 6505269 TI - High dose rDNA human alpha 2 interferon therapy in patients with advanced colorectal adenocarcinoma: a phase II study. AB - Eighteen patients with advanced and inoperable colorectal adenocarcinomas were treated with high doses of alpha 2 Interferon (Schering-Plough Corporation). The patients were randomized to receive either subcutaneous injections of 20 X 10(6) I.U./m2 three times weekly for 3 months, or pulsed treatments of 50 X 10(6) I.U./m2 daily, given intravenously, for 5 consecutive days every 4 weeks. No objective tumour regression was seen in any patient. The side effects were considerable. PMID- 6505270 TI - Determination of the accuracy of different computer planning systems for treatment with external photon beams. AB - The performance of computer planning systems has been tested by comparing calculations using the local beam data and computer facilities with measurements at the local installations. Relative absorbed dose distributions have been determined in a water phantom, irradiated with megavoltage photon beams with qualities from 60Co up to 25 MV. Three clinically relevant situations were studied: oblique incidence, tangential beams and wedged fields. For 45 degrees oblique incidence the mean deviation between the calculated and measured relative absorbed dose was less than 1%. Individual deviations, however, ranged from -2% up to +7%. A systematic difference, due to a straightforward application of the modified effective SSD method, was observed. For tangential irradiation the planning systems which do not consider the lack of scattering material showed deviations up to 8% between calculated and measured relative absorbed dose. For wedged beams, especially when they impinge obliquely on the phantom surface, differences were found up to 10%. Differences up to 20% were found for a point in the build-up region of an obliquely impinging wedged beam. From this study it can be concluded that planning systems may produce clinically unacceptable errors. PMID- 6505271 TI - Acute reactions of the lip mucosa of mice to fractionated irradiations. AB - The acute reaction of the lip mucosa of mice after single and fractionated irradiations has been investigated. The mouths of 24 mice were irradiated simultaneously in a single field. It was found that the acute reaction of lip mucosa can easily and reliably be scored. The variation in scoring between different observers is small and the reaction is reproducible. The mucosal reaction starts at day 7, reaches a maximum at about day 11-12 and regresses rapidly during the following 6 to 7 days. The overall reaction period is thus shorter for lip mucosa than for skin in the mouse, indicating a shorter cell cycle time. Dose-response curves can be constructed by plotting the average reaction from day 8 to 17 versus the total dose. The curve of log isoeffect dose for an average reaction level 3 against log number of fractions has a slope of 0.35 for a dose rate of 200 cGy/min and 0.29 for 33 cGy/min. The dose required to induce focal mucosa desquamation is significantly lower than that necessary to produce spotted epidermolysis in skin (16.5 Gy vs. 33 Gy for single dose). PMID- 6505272 TI - Radiotherapy for inverted papilloma: a case report. AB - Inverted papilloma is an infrequent tumour of the nasal cavity and paranasal sinuses associated with controversy. The incidence of carcinoma in situ associated with inverted papilloma, has not been very well documented until now. Therefore, we present a case report characterized by an aggressive clinical behaviour, treated by extensive surgery and ultimately controlled by radiotherapy. PMID- 6505274 TI - Dosimetry in a magnetically swept electron beam. AB - In a magnetically swept electron beam the recombination correction applicable to conventional ionization chambers can become very large. The paper presents the general saturation curve which obtains under these conditions and describes the two-voltage technique for evaluating the true value of the dose. A chart is provided for solving the relevant equation. PMID- 6505273 TI - Are postoperative complications more frequent and more serious after irradiation for laryngeal and hypopharyngeal cancer? AB - In order to improve local cure rates and survival in patients with head and neck cancer, combinations of radiotherapy and surgery are used. Most reports on such treatment results indicate an improvement with combined therapy. However, it is not clear whether it is best to irradiate before or after surgery. There is disagreement in the literature, whether postoperative complications are more frequent when the irradiation is given prior to surgery. The incidence of postoperative complications was studied in 213 patients who had a laryngectomy for laryngeal or hypopharyngeal cancer. The incidence of major complications was 8.5% after a preoperative dose of 40 or 50 Gy. After rescue surgery for radiation failure this percentage was 32%. In our experience, the incidence of postoperative complications after doses up to 50 Gy/5 weeks is comparable to what can be expected after surgery alone. When higher doses are given, these complications are more frequent. In designing treatment plans, such considerations should be kept in mind. PMID- 6505275 TI - Repair of fractionated radiation in plateau phase cultures of human tumor cells and human multicellular tumor spheroids. AB - We have measured potentially lethal damage repair (PLDR) after fractionated radiation, delivered at 24-h intervals in density-inhibited plateau phase cultures of four human tumor cell lines derived from tumors of differing radiocurability (two melanoma and two breast). The repair of potentially lethal damage conferred significant radioresistance on the human melanoma cells but not on the breast carcinoma cells. We examined the effects of fractionated radiation on human tumor cells adapted to become multicellular tumor spheroids (MTS). MTS derived from a human neuroblastoma were "cured" by a total fractionated radiation dose about 50% of that required for MTS derived from a human melanoma. PMID- 6505276 TI - Chemotherapy in combination with pelvic irradiation: a time-dependence study in mice. AB - The importance of timing of drug administration in combination with pelvic irradiation on animal lethality was investigated in male CBA mice. The chemotherapeutic agents cyclophosphamide, cytosine arabinoside, 5-fluorouracil, methotrexate, cis-dichlorodiammine platinum (II), adriamycin, CCNU, VP-16 and bleomycin were administered at various times up to 2 weeks before and 2 weeks after pelvic irradiation (4 weeks before and after in the case of cyclophosphamide) of unanaesthetised mice and the LD50/30 days and dose enhancement factors determined. The results indicate a potentiation of radiation induced damage when drugs are given near to the time of irradiation, particularly at about 3 days post-irradiation. PMID- 6505277 TI - Tumor-to-tumor variability in the hypoxic fractions of experimental rodent tumors. AB - Paired determinations of the radiation responses of normally-aerated and artificially hypoxic rodent tumors, performed to measure the hypoxic fractions of the tumors, were obtained from our own laboratories and from the literature. The data were reanalyzed to assess whether the variabilities in the radiation responses of the normally-aerated and artificially hypoxic tumors were similar. If there were large differences in the hypoxic fractions of individual tumors within the experiments, the variability in the data from aerobic tumors would be expected to be greater than the variability in the data from artificially hypoxic tumors (which should all be brought to uniform hypoxia and therefore uniform radioresistance). The analyses revealed the variability to be as great or greater for hypoxic tumors as for normally-aerated tumors. This finding suggests that factors other than tumor-to-tumor differences in oxygenation produce most of the variability in the radiation responses of individual tumors from an experimental tumor line. PMID- 6505278 TI - Effects of radiomodifiers on high and low LET responses in vivo. AB - The radioprotector WR-2721 and the radiosensitizer misonidazole have been studied for their influence on the response of mouse skin and tumours when irradiated with either single or fractionated doses of 240 kV X-rays or 3 MeV neutrons. The modification of radiosensitivity to neutrons was significantly less than that for X-rays, both for tumours and skin. When the two drugs were given in combination before single neutron doses, competitive interaction was observed. PMID- 6505279 TI - Carcinoma of the oesophagus, treated radiologically. AB - Radiotherapy according to a "small volume/large absorbed dose"-concept was given to 31 patients with carcinoma of the oesophagus. Tumour control in the treated volume was obtained in 52%, but only 13% of the patients survived for 6 years. Metastases outside the treated volume were seen in 65% of the patients. The palliative results may be judged as not optimal. PMID- 6505280 TI - Non-seminoma testis treated by irradiation at the Rotterdamsch Radio Therapeutisch Instituut: the risk of metastasis. AB - One hundred and thirteen patients with non-seminoma testis and without clinical evidence of distant metastasis (category M0) have been analyzed with regard to the risk of subsequent metastasis after subdiaphragmatic irradiation. Important prognostic factors were: histology (malignant teratoma intermediate (MTI), malignant teratoma undifferentiated (MTU), T-category (T4, T less than 4), clinical regional and juxta-regional subdiaphragmatic lymph node involvement (N0, N1,2, N3,4) and vascular invasion in the orchidectomy specimen (V-, V+). If vascular invasion was considered, the histological type MTI or MTU lost its prognostic impact. Categories T4 and N greater than or equal to 1 worsen prognosis and if vascular invasion could be observed metastasis-risk would be additionally increased. Watch-and-wait policy is probably most justified in categories T less than 4, N0, V-. Elective chemotherapy might be most justified in categories T4N0V+ and T less than 4N greater than or equal to 1V+. PMID- 6505282 TI - Dose-response curve and split-dose recovery in human skin cancer. AB - The data of 946 skin cancer patients treated with single doses or with 4, 8, 17, 40 or 47 fractions of X-rays were analysed using Strandquist's formalism and the linear-quadratic model. The analysis of tumour control in relation to tumour size and fractionation schedule shows a strong correlation between tumour size and tumour control rate. For small tumours, single dose irradiation was as effective as fractionated treatment. For large tumours, a straight line was easily fitted to the TCD50 and TCD90 values plotted logarithmically against time or number of fractions; the exponent for overall treatment time was 0.27 and for number of fractions it was 0.31. With the linear-quadratic model, an alpha/beta ratio of 13.8 Gy was calculated. On the assumption that the number of clonogenic cells in the tumour increases in proportion to tumour volume, Do values between 0.76 and 1.33 Gy were calculated and cellular survival curves were constructed. The estimated clonogenic fraction of tumour cells is about 10(-3); no influence of hypoxic clonogenic cells on local tumour control with single doses could be demonstrated. PMID- 6505281 TI - Radiotherapy as an integrated part of the treatment of soft tissue sarcomas. AB - A considerable improvement in the prognosis of soft tissue sarcomas in the adult has been obtained with a treatment schedule combining surgery and routine radiation therapy (possibly preoperative and certainly postoperative); local recurrences, the predominant element in the natural history of the disease, have become very rare and limb function is generally maintained. Metastatic risk presents the major problem, and in our series spread of the disease remained uncontrolled in 25% of cases. Further research is required in this area, and a better definition of the risk factors, especially with regard to histology, is needed. We suggest that the possibility of reinforcing treatment of those histological forms at high metastatic risk by the introduction of multidrug therapy after local treatment be investigated. Such studies can only be effectively conducted within the framework of a multicenter collaborative controlled clinical trial. PMID- 6505283 TI - Multifraction irradiation of mouse bladders. AB - The response of mouse bladders to multifraction irradiation was assessed from increases in urination frequency or the reduction in bladder capacity after irradiation. A range of electron doses were given as 1, 2, 5, 10 or 20 equal fractions in overall treatment times of 1-2 weeks. Dose-related increases in urination frequency were measured from 10 to 14 months after irradiation and a dose-related reduction in bladder capacity (at inflation pressures of 20 mm Hg) was apparent at the time of sacrifice. The extent of repair of sublethal and potentially lethal damage was estimated from a comparison of the isoeffective doses in fractionated regimes and single dose treatments. After small doses per fraction (2.5-6 Gy), the extent of repair in bladder was very similar to that in mouse skin. After larger doses per fraction (greater than 8 Gy) slightly more repair was seen in bladder than skin. Linear-quadratic analysis of the data suggests quite a high value for the ratio alpha/beta, in the region of 5 to 10 Gy. This is higher than the alpha/beta ratios which have been reported for most other slowly dividing normal tissues. PMID- 6505284 TI - Acute reactions in rat feet exposed to multiple fractions of X-rays per day. AB - Acute reactions of rat foot skin to regimens of X-irradiation involving single and multiple fractions per day were determined. The influence of an interval halfway through the treatment course was investigated for a multiple fractions per day regimen. The regimen was one in which 4 fractions of 2 Gy were given each day. Two courses of up to the tolerance dose separated by an interval of several weeks can be given without causing excessive skin damage. Repopulation during the interval was found to be responsible for the increase in tolerance. Repopulation started at about 2 weeks after the beginning of treatment. Using Barendsen's isoeffect model [4], doses which when given daily would result in the same biological effect as 4 X 2 Gy given daily, were calculated. Rat feet were irradiated with these doses. It was concluded that the isoeffect model provides good predictions of the tolerance doses in new irradiation regimens for the acute reaction of the rat foot skin. PMID- 6505285 TI - Split-dose recovery in epithelial and vascular-connective tissue of pig skin. 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 24 h produced a D2-D1 value of 7.0 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 4.5 Gy. Over this same dose range of X-rays the D2-D1 value for the first wave epithelial reaction was 3.5 Gy. These values of D2-D1 for epithelial and dermal reactions in pig skin were compared with published data and were examined in relation to the theoretical predictions of a linear quadratic model for tissue target cell survival. The results were broadly in keeping with the predictions of such a model. PMID- 6505286 TI - A study of the effects of prior heat treatment on the skin reaction of mouse feet after heat alone or combined with X-rays: influence of misonidazole. AB - The skin of mouse feet was used to study the effects of hyperthermic treatment, either alone or combined with irradiation. The present experiments show that a priming heat treatment induces resistance both to a subsequent heat treatment and to a subsequent combined irradiation-heat treatment. The development of resistance to a combined irradiation-heat treatment after a priming heat treatment (30 min at 43 degrees C) was relatively slow (18-24 h) compared to development of resistance to a heat treatment without irradiation (6 h). Misonidazole, when administered prior to heat treatment only, did not influence the heat-induced skin reaction. However, when misonidazole was administered prior to combined irradiation-heat treatment, a slight but significant increase of the skin reaction was observed. Also, in combination with misonidazole resistance to combined treatment was observed by a priming heat treatment. PMID- 6505287 TI - Selective avoidance of lymphatic irradiation in the conservative management of breast cancer. AB - High-dose lymphatic irradiation is a contributory factor to the morbidity of treatment after local excision and high-dose radiotherapy for early stage breast cancer and may detract significantly from the cosmetic result. The apparent inability of lymphatic irradiation to influence the survival of patients with early stage breast cancer supports an argument for the selective avoidance of regional radiotherapy in a proportion of patients. Based on a review of the effects of lymphatic radiotherapy on lymphatic control, complications, cosmesis, survival and the effects of withholding lymphatic irradiation, recommendations are made for the selective treatment of patients at high risk of regional recurrence. In patients submitted to full axillary dissection, node negative patients require no lymphatic irradiation. After full axillary dissection radiotherapy is confined to the supraclavicular fossa in patients with heavy axillary involvement. A policy for patients having limited axillary dissection is discussed which identifies approximately 50% of patients as eligible for careful watch policy following local excision and high-dose radiotherapy to the primary disease. PMID- 6505288 TI - Radiation injuries of the gastrointestinal tract in Hodgkin's disease: the role of exploratory laparotomy and fractionation. A study of 19 cases observed in a series of 134 patients treated at the Institut Gustave Roussy from 1972 to 1982. AB - Out of 134 patients irradiated below the diaphragm to a dose of 40 Gy for Hodgkin's disease at the Institut Gustave-Roussy, 19 (14%) were subsequently found to present with radiation injuries of the gastrointestinal tract. Since five patients presented with two different injuries, 24 radiolesions were observed. Most of them (17 out of 24) were gastric or duodenal. Twelve (out of 24) were ulcers. Nine patients required surgery. A complete cure of the radiation injuries was obtained in 15 out of 19 patients. Sex, age, stage, histology or initial chemotherapy were not found to play a role in the occurrence of radiation damage. On the contrary, the role of a previous exploratory laparotomy appeared important; for the patients who underwent laparotomy and irradiation, the complication rate was 23%. For the patients treated by irradiation alone, the complication rate was 7% (p less than 0.01). Fractionation was found to be another important parameter: for 52 patients treated using 3 weekly fractions of 3.3 Gy, the complication rate was 25%, compared to 8% (p less than 0.01) for 76 patients treated using 4 weekly fractions of 2.5 Gy. Combining these two factors, we found a 42% complication rate for the group of patients who underwent laparotomy and who were treated by means of 3 fractions of 3.3 Gy per week, whereas patients irradiated using 4 weekly fractions of 2.5 Gy, without any previous laparotomy, had only a 5% complication risk (p less than 0.001). PMID- 6505289 TI - Bombesin-like immunoreactivity in human gastrointestinal tract. AB - In the present study the distribution and molecular characteristics of bombesin like immunoreactivity (BLI) were studied in acid extracts of human gastrointestinal tract. The highest levels were found in the fundus, antrum, pylorus and pancreas with lower levels in the duodenum, jejunum, terminal ileum and colon. BLI was also detected in both the muscle and mucosal layers of the antrum and colon. Sephadex G-50 gel chromatography under acid dissociating conditions revealed two peaks of immunoreactivity, one in the position of synthetic porcine gastrin releasing peptide (GRP) and the second eluting with synthetic amphibian bombesin. Variations in the proportions of the two molecular forms were seen in different regions of the gut. In the stomach and pancreas greater than 70% of the BLI eluted with the GRP marker while in pylorus, jejunum and terminal ileum only 20% was present in this form. Reverse-phase ODS silica HPLC of the major antral BLI peak, utilising a methanol/trifluoroacetic acid gradient indicated that this peptide was similar to porcine GRP. We have therefore (1) demonstrated the presence and heterogeneity of bombesin-like immunoreactivity throughout the human gastrointestinal tract and (2) shown for the first time that a proportion of this BLI closely resembles porcine GRP. PMID- 6505291 TI - Distribution of bombesin- and cholecystokinin-like immunoreactivity in rat and dog brain and gastrointestinal tract. AB - Using a specific bombesin radioimmunoassay and an immunoassay for cholecystokinin which sees all C-terminal fractions, the distribution of bombesin-like (BLI) and cholecystokinin-like (CCK-LI) immunoreactivity in the brain and gastrointestinal tract of the rat and dog has been studied. Both peptides are found in the brain and gut but the rat contains more CCK and BLI than the dog; this is particularly noted in the stomach, colon and cerebral cortex whereas the small intestine of both species contains equivalent amounts of peptides. This contrasts with other comparative studies, mainly on nervous system CCK, which find no major distribution differences in man, monkey, pig and rat. This finding suggests that CCK-LI and BLI peptides may have a more predominant role in the rat than in the dog. PMID- 6505290 TI - The heterogeneity of gastric inhibitory polypeptide in porcine and human gastrointestinal mucosa evaluated with five different antisera. AB - The Sephadex G-50 gel filtration profile of immunoreactive gastric inhibitory polypeptide (GIP) in porcine and human gastrointestinal mucosa was determined in assays with antisera obtained from five different groups working with GIP. Tissue was extracted in acid ethanol or using a boiling method. Three well-defined components were detected with three of the antisera: one component corresponding to natural porcine GIP (5 kDa GIP), one component corresponding to what has been called 8 kDa GIP, and one component somewhat larger than the latter. One antiserum did not measure 8 kDa GIP at all, while the fifth antiserum measured small amounts of 8 kDa GIP in porcine but not in human extracts. While the antisera measured the same amounts of GIP in porcine extracts, two of the antisera measured significantly more GIP than the remaining three in extracts of human mucosa. The elution position of human 5 kDa GIP differed significantly from that of porcine 5 kDa GIP. In addition to the identification of a new molecular form of GIP, and the demonstration of important specificity differences among GIP antisera currently in use, the present results indicate that human and porcine 5 kDa GIP differ in chemical composition. PMID- 6505292 TI - Physiological circulating levels of secretin-like immunoreactivity in the human do not stimulate free fatty acid production. AB - An in vivo study was carried out to establish whether infused secretin, which achieves physiological levels of secretin-like immunoreactivity (SLI), promotes lipolysis. Six healthy volunteers received two infusions after separate 8 h overnight fasts. The paired infusions of either 500 ml of normal saline or 150 C.U. of porcine secretin in 500 ml of normal saline were infused at a constant rate of 1.38 ml/min. Venous blood was sampled at 0, 1, 2, 3, 4, 5 and 6 h after the infusion started. Mean plasma concentrations of SLI were significantly higher after infusion of saline with secretin in comparison to infusion of saline alone but remained within the physiological range. Mean serum free fatty acid (FFA) and 3-hydroxybutyrate concentrations rose significantly with time during both infusions but the mean FFA and 3-hydroxybutyrate concentrations did not differ significantly between infusions at each time of assessment. We conclude that a lipolytic role for secretin has not been shown to be of importance in relation to the in vivo rise in FFA concentrations observed in the fasting normal subject. PMID- 6505293 TI - [A new computational method for estimating X-ray spectral distributions]. AB - A new computational method is described for estimating the exposure-rate spectral distributions of X-rays from attenuation data measured with various filtrations. The estimation problem of X-ray spectra is formulated as the numerical computation of solving a set of linear equation with an ill-conditional nature. In this paper, the singular-value decomposition technique, which differs from the iterative method, is applied to this singular numerical computation problem. The principle of the analysis method is based on that the response matrix of filtrations can be decomposed into some inherent component matrices. X-ray spectral distributions are then represented in a simple combination of some component curves, so that the estimation process can be systematically constructed. The singularity in its computation is removed by selecting the components of the combination, and a performance index is also presented for the optimal selection. The feasibility of the proposed method is studied in detail in a computer simulation using a hypothetical X-ray spectrum produced by assuming experimental conditions. The application results are also shown about the spectral distribution from a 140 kV constant voltage X-ray source. PMID- 6505295 TI - [Analysis of aerosols for light elements by forward alpha scattering technique]. AB - By forward alpha scattering technique (FAST) light elements, from hydrogen through fluorine, are shown to be determined nondestructively and simultaneously, though these elements cannot be measured satisfactorily by any other physical method. We have studied on the application of this method to atmospheric aerosol, photochemical and aerosol, etc. It was assured that the whole mole ratio of aerosol can be determined by the cooperative application of the FAST and the conventional fluorescent X-ray analysis. FAST has been realized to give the water content of aerosol, although the sample should be analyzed in vacuum. PMID- 6505294 TI - [Effect of chemical quenching on background counting rate in tritium channel of a large volume liquid scintillation counter]. AB - Background counting rate in tritium channel of a large volume liquid scintillation counter increased with water content ranged 0 to 50% of liquid scintillator. This phenomenon can be explained as follows: The height of scintillation pulses of Compton electrons induced by background gamma radiation is lowered by chemical quenching and shifts to tritium channel. The background counting rate in tritium channel showed a linear relationship with external standard channel ratio of background samples. This relationship is applicable to determine the correct background counting rate for quenching samples and to achieve higher precision of tritium measurement. PMID- 6505296 TI - Moderator effects on recoil tritium reactions with lithium beta-phenylpropionate. AB - The recoil tritium reactions were studied with lithium beta-phenylpropionate having both the aromatic and aliphatic C-H bonds in the molecule, mainly in terms of the moderator effect on the intramolecular tritium distribution. Recoil tritium atoms were produced by the 6Li(n,alpha)3H reaction. Water molecules were used as the moderator. The tritium activity of the ethylene group represented relative to that of the corresponding ring assumed as a standard (= 100) is 30 in the moderator-free system and is reduced to 13 in the moderated system in which the H2O/beta-PhC2H4CO2Li mole ratio is 328. In the ring, the tritium distribution shows a slight ortho- and para-orientation in the moderator-free system and the selectivity is pronounced when the H2O/beta-PhC2H4CO2Li mole ratio is large. The data show that the aromatic ring tritiation in the moderated system is given by increasing contribution of the reactions of tritium atoms having lower energy than the threshold energy of the ethylene group tritiation. PMID- 6505297 TI - [Radioactive nuclides in the marine environment--distribution and behaviour of 95Zr, 95Nb originated from fallout]. AB - To investigate behaviour of 95Zr, 95Nb in the marine environment, various samples have been collected and measured by means of Ge(Li) gamma-ray spectrometry and/or radiochemical analysis during a period from 1974 to 1982 at coastal area of Tokai mura, Ibaraki prefecture. Concentration of the nuclides in seaweeds increased remarkably after atmospheric nuclear detonation by P.R. of China, and the activity ratio between the nuclides changed by time was not fit well by the transient decay equation. Concentration variation in sea water was smaller than that in sea weeds, and the minimum change in sea sediment. Increase of concentration in these environmental samples was observed in chronological order of sea water, sea weeds then sediment after detonations, suggesting that the uptake of the nuclides by these sea weeds from sea water is faster than that via root. Observed concentration factors on the nuclides by sea weeds were calculated from the observed concentrations in sea water and sea weeds. Maximum values on 95Zr and 95Nb were 2110, 2150, respectively for Ecklonia cava and Eisenia bicyclis. PMID- 6505298 TI - Effects of tritiated water on the DNA of plasmid pBR 322. AB - In an attempt to shed light on the influence of tritiated water for DNA we have investigated the damage with a simple plasmid DNA, pBR 322. The survival of covalently closed circular (CCC DNA) form was directly followed by agarose of gel electrophoresis. It was found that the survival percentage of DNA in tritiated water was observed almost the same as the irradiation of X-rays at the same absorbed doses. For the irradiation of gamma-rays, on the other hand, the decay rate was larger than those of both tritiated water and X-rays. The yields percentage of the broken pieces of DNA in tritiated water, X-rays and gamma-rays were found to be 43, 38 and 33% at 10(4) rad of the absorbed dose. It may be considered that the degree of danger in tritiated water is quite larger than of gamma-rays. It was also found that the dose rate effect was not observed in the case of tritiated water, X-rays and gamma-rays irradiation. PMID- 6505299 TI - [Experimental studies of PTH-C radioimmunoassay kit]. PMID- 6505300 TI - [Radioimmunoassay kit using beads to separate free and antibody-bound triiodothyronine]. PMID- 6505301 TI - [Current topics in radiopharmaceuticals in Japan (VIII). Quality control for radioimmunoassay]. PMID- 6505302 TI - [Current topics in radiopharmaceutical in Japan (IX). Future trend of radiopharmaceuticals]. PMID- 6505303 TI - [Disposition and metabolism of 14C-dehydrocorydaline in mice and rats]. AB - Dehydrocorydaline, an alkaloid from Corydalis bulbosa possessing anti-ulceric activity, was labeled by methyl-14C at position 13, and its disposition and metabolism were studied in mice and rats after oral (50 mg/kg) or intravenous (6.8 mg/kg) administration. Blood levels were as low as 0.5 (mice) and 0.06 (rats) microgram eq./ml at maximum, conceivably due to its poor absorption from digestive tracts. Radiometric and autoradiographic studies after oral administration of 14C-dehydrocorydaline revealed that appreciable radioactivity was distributed in rather restricted organs, namely, digestive tracts, liver and kidney. Comparison of distribution with that after intravenous administration suggested that the compound is subject to the significant first pass effect by the liver. The distribution pattern of radioactivity in the liver was heterogeneous regardless to administration routes. Radiometry and autoradiography also revealed that the disposition did not differ significantly from each other in normal rats and those with experimentally induced gastric ulcer. Excretion of radioactivity occurred largely in feces. Excretion via urine and bile was quite minor. Metabolite analysis suggested that dehydrocorydaline was metabolized by O demethylation and subsequent conjugation with glucuronic acid. However, metabolites were minor relative to the unchanged compound. PMID- 6505304 TI - [Comparative distribution study of 14C labeled amino acids, glucose-analogue and precursor of nuclei acid, as tumor seeking agents]. AB - As tumor-seeking agents, glucose analogues, natural amino acids, synthetic nonmetabolized amino acids, and precursor of nucleic acids, etc., labeled with positron emitter, such as 11C and 18F have been recently investigated. However, there are very few reports concerning comparative study of tumor uptake and tissue distribution of these agents. This preliminary paper describes comparative distribution and whole-body autoradiography of these agents. 14C labeled deoxy-2 fluoro-D-glucose (FDG), L-, DL-leucine, 1-aminocyclopentane carboxylic acid (ACPC), alpha-amino isobutyric acid (alpha-AIB), and thymidine were intravenously injected through tail vein into separate groups of the experimental animals. As the experimental animals, the mice with Ehrlich tumor and the rats with Hepatoma AH109A were used. Within 30 min after injection, FDG had the highest tumor uptake and tumor to tissue ratios, although FDG was inferior to ACPC and thymidine in related to tumor to heart, lung and brain ratios. However, the time course study indicated that tumor uptake of ACPC, alpha-AIB and D-leucine increased with time, whereas those of other agents decreased with time or reached a plateau. Thus, at 120 min after injection, ACPC had the highest tumor uptake and tumor to tissue ratios, although ACPC was inferior to FDG in related to tumor to blood, liver and pancreas ratios. Autoradiogram of ACPC showed very clear tumor image as well as that of FDG. The above data suggest that synthetic nonmetabolized amino acids, such as ACPC may be promising as tumor-seeking agents, when used with a single photon emission computed tomography, while glucose analogue such as FDG, are the best tumor-seeking agent, when used with a positron emission computed tomography. PMID- 6505305 TI - [A study of quality control for radioimmunoassay kit using moving average method]. AB - New method of quality control based on mean-R control chart for radioimmunoassay (RIA) kit was investigated. Conventional mean-R control chart was hard to found variations in each RIA kits. But the new method, trend variation analysis of mean R control chart by moving average method, could detect variation among th different lot of RIA kits. This method should be very useful to do a quality control in RIA kits. PMID- 6505306 TI - [Optimization of liquid scintillation counting by using multichannel pulse-height analyzer]. AB - The method for determining optimum conditions of a liquid scintillation counter (LSC) for low-level counting of tritium was studied. To compare the lower limit of detection, the figure of merit EM/square root B was used. Th measurement system is a LSC connected with a multichannel pulse-height analyzer (MCA). Both of tritium spectra and background spectra were searched for the condition that maximizes the figure of merit. The optimum condition obtained by using the MCA was fitted for a single channel pulse-height analyzer of the LSC. The figure of merit obtained by this method was 20.6% greater than that obtained by the balance point method. PMID- 6505308 TI - Exposure time in scintillation autoradiography of 3H-incorporated samples. PMID- 6505307 TI - Detection of tumor-inducing plasmid DNA sequence in Agrobacterium tumefaciens by DNA-DNA hybridization. AB - Absence of plasmid DNA sequences in non-tumorigenic (crown gall tumor) strains of Agrobacterium tumefaciens was confirmed by DNA-DNA hybridization between purified tumor-inducing (Ti) plasmid DNAs isolated from the progenitor tumorigenic strains and 3H-labeled whole cell DNAs from tumorigenic strains and their non-tumorigenic derivatives. The genes controlling tumorigenicity in plant and utilizability of nopaline as their sole nitrogen source were confirmed to locate on Ti-plasmids. PMID- 6505309 TI - [Experimental studies of the Amerlex free T3 radioimmunoassay kit]. PMID- 6505310 TI - [Clinical studies of the Amerlex free T3 radioimmunoassay kit]. PMID- 6505311 TI - [Radioimmunoassay of serum thyroxine concentration by magnetic T4 radioimmunoassay kit]. PMID- 6505312 TI - [Radioimmunoassay for serum thyroxine concentration by magnetic T4 radioimmunoassay kit]. PMID- 6505313 TI - [Experimental and clinical studies of magnetic T3U kit]. PMID- 6505314 TI - [The 5th Quality Control Survey for Radioisotopes in vitro Tests in Japan, 1983 (II)]. PMID- 6505315 TI - [Computerized tomography of bladder neoplasms]. AB - A comparison was made between the pelvic CT picture and clinical and instrumental findings in 89 patients with bladder neoplasm. A close critical assessment was also made of CT as a reliable way of determining the TNM stage, and its effective aid in the choice of a therapeutic strategy. The advantages and limits of CT are discussed. The conclusion is drawn that it is of assistance in overall TNM rating, and may sometimes provide useful informations concerning the involvement of surrounding structures. Particularly as far as the choice of radical management is concerned, however, it is prone to by no means negligible staging errors, though these are open to correction in the light of non-radiological criteria. PMID- 6505316 TI - [Prone position in hysterosalpingography]. AB - The authors discuss the importance of prone hysterosalpingography to the aim of a careful tubal examination. Nearly all the complete or partial tubal obstructions, observed during supine hysterosalpingography, have been resolved by the simple prone position. The high percentage (91%) of successes, without pharmacological help, recommends the routine use of this simple method in all cases of doubtful tubal obstructions. PMID- 6505317 TI - [Pneumocephalus secondary to fronto-ethmoidal osteoma]. PMID- 6505318 TI - [Computerized tomography in the diagnosis of a right aortic arch with an aberrant left subclavian artery in adults]. PMID- 6505319 TI - [Radiology of the small intestine]. PMID- 6505320 TI - [Oral pneumocolon in the study of the last ileal loops and the ileocecal region]. PMID- 6505321 TI - [Localization of Crohn disease in the small intestine]. PMID- 6505322 TI - [Radiology of tumors of the small intestine]. PMID- 6505323 TI - [A new catheter set for continuous axillary plexus anesthesia]. PMID- 6505324 TI - [Electrical nerve localization and catheter technic. A safe method for brachial plexus anesthesia]. AB - A technique for sub-axillary blockade of the brachial plexus by means of a special catheter set is presented. A plastic self-retaining cannula is placed within the vasomotor nerve sheath, using the advantages of electric nerve stimulation. In our opinion the decisive advantages of this procedure lie in the fact that the user is not dependent on the cooperation of the patient and anatomical orientation takes place on the basis of clear and objective criteria through the muscle contractions induced in this way. If required, a catheter can be inserted into the vasomotor nerve sheath, without any additional expenditure of time, through the small-lumen puncture cannula by the Seldinger technique. If this procedure is carried out properly there is practically no danger of neural and vascular injuries. This method makes subsequent injections into the vasomotor nerve sheath through repeated puncture unnecessary. The catheter technique makes it possible to operate on the upper extremity using regional anaesthesia, whose effects can be prolonged beyond those of long-acting anaesthetics. The possibility of incomplete blockade resulting from individual variations in the amounts of local anaesthetics needed, is excluded and the anaesthetist can, if necessary, carry out pre- and post-operative pain therapy. PMID- 6505325 TI - [The RACZ-epidural catheter. First clinical experiences]. AB - We tested a new epidural catheter, which is made of a stainless steel spiral (similar to an anode endotracheal tube) covered with a fluorpolymer. This catheter was tested in 15 patients who were administered lumbar epidural anaesthesia for pain relief during labor. We also have information on the evaluation of this catheter in about 100 patients from the obstetric anesthesia service, Stanford-University Medical Center. The main advantage of this catheter is, that it does not kink. The disadvantages are: 1. catheter leakage either at the skin interface or just below the injection port particular after prolonged usage, 2. difficult or impossible injection if the catheter injection port is screwed on too tight which requires cutting the catheter (not recommended by the manufacturer), 3. a 17 gauge rather than a 18 gauge epidural needle is recommended and 4. the high price of the catheter. PMID- 6505326 TI - [Continuous, long-term peridural morphine analgesia in an ambulatory cancer patients]. AB - For the treatment of cancer patients opioids can be administered epidurally. Continuous epidural analgesia with morphine, carried out with an externally portable pump, which can be programmed as to dosage, offers certain advantages as compared to a bolus injection. In contrast to the method of implanting a pump system our procedure is considerably less invasive, more economical, due to reusage of the pump, and more convenient to the patient. PMID- 6505327 TI - [Is 0.5% bupivacaine solution isobaric?]. AB - Bupivacaine 0.5% 3 ml was administered by subarachnoid injection to 100 patients. They were divided to four equal groups, according to the body position immediately following the injection: horizontal supine and lateral, sitting and Trendelenburg position. 15 min after the injection was the median dermatome in the later group at T 8.64, and after 60 min at T 7.44 level. The corresponding values for sitting patients were T 5.48 respect. T 3.08. It was concluded that subarachnoidally applied bupivacaine 0.5% shows hypobaric characteristics. This is in agreement with already reported in vitro determinations. PMID- 6505328 TI - [Methemoglobinemia following blockade of the brachial plexus with prilocaine (Xylonest)]. AB - A case report of methemoglobinemia induced by an overdosage of prilocaine is given. The causes, possibilities and dangers of therapy of prilocaine-induced methemoglobinemia are discussed. PMID- 6505329 TI - [Roentgen contrast medium representation, a possibility for controlling catheter placement in continuous brachial plexus anesthesia]. AB - The correct positioning of catheters for continuous plexus brachialis anaesthesia/analgesia in uncooperative patients via x-rays is reported. PMID- 6505330 TI - [Delayed respiratory arrest following spinal anesthesia]. AB - A 71 year-old woman was admitted for transurethral resection of bladder carcinoma. The procedure was performed under spinal anaesthesia with mepivacaine 4% hyperbaric. The procedure was carried out without any technical problems. Despite appropriate positioning the patients spinal anaesthesia spread slowly cephalad. 60 minutes after injection of the local anaesthetic aphonia and respiratory insufficiency occurred. The patient was intubated and controlled ventilation was started. 4 hours later the tube could be removed again. 6.5 hours after performing the block no residual block could be detected. The authors discuss the aetiology of this rare complication. It is recommended to keep all patients under continuous anaesthesiologic supervision where the spread of spinal anaesthesia is not definitely declining. PMID- 6505331 TI - [Ectoparasites of wild rodents of Belo Horizonte, MG]. PMID- 6505332 TI - [Nutritional evaluation of pediatric patients with solid tumors]. PMID- 6505333 TI - [Chronic segmental and focal glomerulonephritis with hyalinosis and focal and global glomerulosclerosis]. PMID- 6505334 TI - [Transient neonatal diabetes]. PMID- 6505336 TI - [Trends in birth weight and Apgar score 1979-1983 in the western area of Santiago]. PMID- 6505337 TI - [Concepts on ethics in pediatrics]. PMID- 6505335 TI - [Breast feeding and socioeconomic level of Chilean infants under 1 year of age]. PMID- 6505338 TI - [Genetic aspects of Alport's syndrome: a heterogeneous syndrome]. PMID- 6505339 TI - [Resuscitation, anesthesiology and realism]. PMID- 6505340 TI - [Prognosis of severe cranio-encephalic injuries. Study of 22 cases with continuous monitoring of intracranial pressure and evoked potentials]. PMID- 6505341 TI - [Echocardiographic evaluation of patients with postoperative low cardiac output syndrome]. PMID- 6505342 TI - [Butorphanol. A new synthetic analgesic]. PMID- 6505343 TI - [Internal blistering of armored latex endotracheal tubes]. PMID- 6505344 TI - [Malignant hyperthermia in pigs]. PMID- 6505345 TI - [Less traumatic, facilitated nasotracheal and orotracheal intubation]. PMID- 6505346 TI - [Dosage and latency period of morphine administered by peridural route]. PMID- 6505347 TI - [Report of the National Cardiology Commission (1978-1983)]. PMID- 6505348 TI - [Functional aerobic capacity in valvular cardiopathy. Short-term (3 months) and medium-term (9 months) postoperative development]. PMID- 6505349 TI - [Diastolic properties of the left ventricle in hypertensive cardiopathy. Acute effect of nifedipine, verapamil and diltiazem]. PMID- 6505351 TI - [Anti-arrhythmic effects of propafenone in coronary patients with ventricular arrhythmias]. PMID- 6505350 TI - [Study of left ventricular relaxation using computerized M-mode echocardiographic analysis]. PMID- 6505352 TI - [Mitral insufficiency of ischemic origin. Surgical experience]. PMID- 6505353 TI - [Use of the internal mammary artery in myocardial revascularization surgery]. PMID- 6505354 TI - [Giant aneurysm of the descending aorta with coarctation of the aorta]. PMID- 6505355 TI - [Aneurysm of the interatrial septum. Echocardiographic diagnosis]. PMID- 6505356 TI - [Brucellar endocarditis in a patient with Marfan's syndrome]. PMID- 6505357 TI - [Recent advances and future objectives in pediatric cardiac surgery]. PMID- 6505358 TI - [The potential clinical significance of the isoniazid acetylator phenotype in the treatment of pulmonary tuberculosis]. AB - The most important factor determining the speed with which isoniazid is eliminated from the body is the rate of its acetylation in the liver. There are large differences between individuals in the rates at which isoniazid is acetylated. Over 98% of subjects can be clearly characterized as being either rapid of slow acetylators. Among the many satisfactory procedures for determining the acetylator phenotype of subjects, the simple sulphamethazine method is probably the most convenient. The proportions of rapid acetylators among different populations vary from about 40% among those of European and South Indian descent to over 85% among Japanese and Eskimos. The isoniazid acetylator phenotype of tuberculosis patients treated with isoniazid-containing regimens is without prognostic significance when treatment is given daily and only of doubtful importance when weak twice-weekly regimens are employed. However if treatment is given on a once-weekly basis, the response of rapid acetylators is generally much less satisfactory than that of slow acetylators. Since isoniazid is eliminated from the body predominantly by metabolism its clearance is not greatly diminished in the event of renal failure. As a consequence there are no grounds for reducing the dosage of isoniazid given to patients with impaired renal function. The incidence of the commonly encountered asymptomatic increases in serum transaminases associated with isoniazid treatment is similar in rapid and slow acetylators. Clinically important hepatic toxicity manifested by jaundice only occurs in 1-2% of patients treated with isoniazid-containing regimens. Despite earlier suggestions to the contrary, it is no more common in rapid than among slow acetylators. Since all patients can be treated effectively and safely with standard isoniazid dosages, determining patients' isoniazid serum/plasma levels or acetylator phenotype is hardly ever worthwhile. By contrast, since poor patient compliance is a major cause of therapeutic failure, monitoring the regularity with which patients self-administer their prescribed isoniazid treatment using simple urine-test methods can be of considerable value. PMID- 6505359 TI - [Radiotherapy of primary malignant tumors of the trachea. Apropos of 31 cases]. AB - We report 31 cases of primary malignant tumours of the trachea, treated with radiotherapy at the Tumour Centre, Pitie-Salpetriere, from June 1968 to January 1982. Three patients received complementary post-operative irradiation: one had an epidermoid carcinoma, operated by incomplete resection and anastomosis, and survived 12 months after irradiation with 60,00 grays in 6 weeks (local recurrence of tumour and mediastinal extension); the other two had cylindromas of the trachea with complete resection and anastomosis: the first remains alive 6 years after an irradiation of 65,00 grays over 6 weeks, the second is alive 5 years after post-operative irradiation of 60,00 grays in 6 weeks. These two latter tumours evolved slowly and local recurrence may occur after five years and sometimes longer, after local treatment. 28 other cases presenting with an epidermoid carcinoma of the trachea received radiotherapy exclusively, when a surgical cure was impossible. Irradiation was interrupted in two patients: one after a dose of 12,00 grays for sudden massive haemoptysis, the other after a dose of 22,00 grays for an oesophago-tracheal fistula. An apparent complete remission was obtained in 80% of cases, judged by a tracheo-bronchial endoscopic examination carried out in the six weeks following the treatment. Two deaths were seen from intercurrent disease: one at two months from a granulocytosis caused iatrogenically from medication and the other at five months from bilateral bronchopneumonia. One patient was alive at 9 months in apparent complete local remission, but lost to follow up.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505360 TI - [Evaluation of left cardiac function in chronic obstructive bronchopneumopathy. Correlation of the radiographic analysis of the thorax and hemodynamic data]. AB - Chest radiographs, taken in the standing position, were reviewed in 47 hospitalised patients with chronic obstructive respiratory failure; the review was done retrospectively and the radiographs were examined for signs of left ventricular failure. Only interstitial and alveolar oedema were considered, upper lobe blood diversion was commonly seen in patients, probably reflecting pulmonary hypertension independent of any re-distribution of left ventricular origin. Interstitial oedema was seen in 9 patients (19.2%) of whom only one reached a pulmonary capillary pressure of 25 mmHg, traditionally considered as a threshold of interstitial oedema. In 8 other patients, the pulmonary capillary pressure was either moderately elevated between 15 and 25 mmHg (3 cases) or strictly normal (5 cases). The discordance observed between the radiological data and haemodynamics very probably reflects (bearing in mind the descriptions in valvular and ischaemic heart disease) a greater sensitivity of the radiograph when compared to measurements of pulmonary capillary pressure at rest in cases of left ventricular failure "fruste". The greater sensitivity of radiological analysis in patients suffering from chronic airflow obstruction contrasts with the classical notion, according to which the radiological expression of definite left ventricular failure was frequently poor in this kind of patient by reason of a destruction of the vascular bed, which limited the development of pulmonary oedema. PMID- 6505361 TI - [Pulmonary mucormycosis. Apropos of a case with serologic confirmation]. AB - We report a new case of primary pulmonary mucormycosis. The radiographic evidence and anatomopathological facts demonstrate an intra-cavitary mycetoma of Fowler associated with a chronic pneumonia in the left basal segment. The patient was not immunosuppressed but had undergone a left upper lobectomy 25 years before. This appears to be the first case in which a serological study has confirmed the diagnosis. PMID- 6505362 TI - [Pulmonary hemodynamic monitoring in chronic respiratory insufficiency treated with almitrine bismesilate for 4 months in a double-blind study]. AB - Six subjects suffering from chronic airflow obstruction and respiratory failure were treated with oral almitrine bismesylate (3 mg/kg/day). Studies were made before and after 2 and 4 months treatment on: total ventilation, arterial blood gases, pulmonary artery pressure by a micro-catheter and cardiac out-put by rebreathing CO2. The results were compared with those of a placebo group of 3 subjects. While in the almitrine group a significant improvement in blood gases was observed, no change was seen in the two populations in either the haemodynamic or ventilatory variables. The medium term haemodynamic stability observed is contrasting with single dose effects of almitrine. This discrepancy could be due, at least in part, to a balance between the possible vasoconstrictor effect of almitrine bismesylate and vasodilator consequences of blood gases improvement. PMID- 6505363 TI - [Diagnostic and therapeutic approach in thromboembolism disease. Reflexions apropos of 105 cases]. AB - 105 patients suffering from thrombo-embolic disease (MTE) were explored by venography of the lower limbs, ilio-vena cavography and pulmonary angiography at the time of the initial diagnostic work up. These examinations served as a control for the different therapies, anticoagulants, thrombolytics, curative and preventive surgery, separately (77 controls) or in association (92 controls). From the base-line vascular investigations it appears that the gravity of the pulmonary emboli was not correlated with either a proximal or distal site of venous thrombosis. From the results of controlled therapy there were significant differences between the efficacy of medical treatment at the level of the pulmonary artery and at venous level where the progression of phlebo-thrombosis was often seen. Recurrence of emboli and overall prognosis of the disease usually depended on the persistence of thrombi at venous level. Such a phlebo-thrombosis is rarely aggravated by techniques of partial interruption of the inferior vena cava (IPVCI) which ensure effective protection of the pulmonary circulation. The IPVCI often appears to be the only effective method of preventing recurrent pulmonary emboli, which has led us to reconsider its indications. PMID- 6505364 TI - [Homan's sign revisited: is the clinical diagnosis of deep venous thrombosis reliable?]. PMID- 6505366 TI - [Risk factors present in 1542 patients stricken with stroke]. PMID- 6505365 TI - [Pulmonary thromboembolism in the Florentine medico-legal sector from 1957 to 1981. Implications for professional responsibility]. PMID- 6505367 TI - [Theophylline therapy]. PMID- 6505368 TI - [Sudden death]. PMID- 6505369 TI - REACH for a difference--in the way you live: guidelines for disabled adolescents. PMID- 6505370 TI - Computer accessibility: a study. PMID- 6505371 TI - Effects of verapamil and nifedipine on renal function and hemodynamics in the dog. AB - This study evaluates the direct effects of verapamil (5 micrograms/kg/min) or nifedipine (0.32 micrograms/kg/min) when infused into one renal artery for 2 h. The role of calcium in the systemic and renal vascular effects of angiotensin II (1 microgram/i.v. bolus) was examined in each period. Renal blood flow was increased 11% by verapamil and 29% by nifedipine. Unlike other vasodilators, these drugs markedly increased GFR (by 75% with verapamil and 50% with nifedipine), and both caused a profound natriuresis, which outlasted the renal hemodynamic changes. Further, they abolished the renal vascular responses to angiotensin II. These major direct effects on renal function and hemodynamics suggest that: (a) calcium blockers may affect the determinants of GFR differently from other vasodilators, and (b) they may interfere with proximal tubular Na+ transport. PMID- 6505372 TI - Angiotensin II effects upon glomerular intracapillary volume in the rat. AB - The direct action of angiotensin II on renal glomeruli was quantified by measuring extracellular space in isolated, decapsulated rat glomeruli using 14C inulin. The glomerular inulin space significantly decreased when treated with 0.1 nM to 1 microM of angiotensin II. The decrease was dose-dependent and blocked by 1-Sar, 8-Ile angiotensin II. Since the glomerular intracapillary space seems to occupy the majority of the extracellular (inulin) space in decapsulated glomeruli, these results suggest that angiotensin Ii decreases the glomerular intracapillary volume. This action of angiotensin II may lead to a reduction in glomerular filtering surface area, and thus, in the ultrafiltration coefficient. PMID- 6505373 TI - Taurine transport in brush border membrane vesicles isolated from hyper- and normotaurinuric mouse kidney. AB - The mouse strain C57BL is characterized by a high urinary fractional excretion of taurine. Hypertaurinuric [tau(-)] C57BL mice and three normal taurine 'excretors' [tau(+)]-Swiss, A/J, and C3H-were compared. Clearance experiments showed that fractional excretion of taurine was 4-8 times higher in C57BL relative to the other strains. Transport studies performed in brush border membrane vesicles, isolated from C57BL and C3H mouse renal cortex, showed that D-glucose uptake was similar in both strains while the taurine uptake appeared to be faster in tau(+) than in tau(-) mice. This difference was observed only in the presence of an inwardly directed NaCl gradient. The comparison of kinetic parameters showed a significant difference of apparent Km values: 90.8 +/- 11.4 microM in tau(+) mice vs. 129.5 +/- 17.1 microM in tau(-) mice. Jmax were not significantly different in both strains. These observations suggest a lower affinity of the taurine brush border membrane carrier in the hypertaurinuric strain as compared to the normotaurinuric mice. It is concluded that, in addition to a possible alteration of peritubular taurine efflux described by Rozen et al. (1983), a defect of taurine transport at the luminal membrane cannot be excluded and could account for the hypertaurinuria of the C57BL mice. PMID- 6505375 TI - 7th International Symposium on Biochemical Aspects of Kidney Function. Smolenice, Czechoslovakia, April 9-12, 1984. Abstracts. PMID- 6505374 TI - Glomerular albumin leakage and morphology after neutralization of polyanions. I. Albumin clearance and sieving coefficient in the isolated perfused rat kidney. AB - In order to decide whether foot process abnormalities in nephrotic states are the cause or the consequence of proteinuria, the polycation protamine has been applied to isolated perfused rat kidneys and functional parameters and morphology have been compared. With 110 micrograms/ml protamine the albumin clearance ratio increased from 2.0 +/- 0.7 x 10(-3) in controls to 14.8 +/- 6.9 x 10(-3) 10-20 min after application and even to 98.0 +/- 30.8 x 10(-3) after 50-80 min. Micropuncture samples collected from early proximal tubules with pressure control were used to calculate the sieving coefficient which correlated with albumin clearance ratios (controls: 1.8 +/- 1.0 x 10(-3); after 10-20 min: 11.8 +/- 6.4 x 10(-3); after 50-80 min: 52.0 +/- 8.5 x 10(-3). Glomerular filtration rate decreased in the early beginning from 1.1 +/- 0.2 ml x min-1 x g-1 kidney to 0.7 +/- 0.2 ml x min-1 x g-1 kidney, but remained constant throughout the whole experiment. Despite the markedly increased albuminuria there were no changes in glomerular foot process morphology with the protamine dose used. PMID- 6505376 TI - The clinical relevance of the drug displacement interaction between meperidine and bupivacaine. AB - The effect of meperidine at two clinically relevant concentrations (0.4 and 0.8 microgram/ml) on the serum protein binding of bupivacaine was studied. The serum protein binding profile for meperidine was characterized over a wide concentration range (0.5-100 micrograms/ml). All bupivacaine binding experiments were characterized by a two classes of binding sites model. Bupivacaine binding was independent of added meperidine. Meperidine binding was characterized by a one class of binding sites model and the unbound meperidine concentration was relatively constant over the entire range studied. The capacity and affinity of the meperidine binding site are suggestive of binding primarily to albumin. At clinically encountered meperidine concentrations, no increased toxicity due to an increase in unbound bupivacaine would be expected. PMID- 6505377 TI - High doses of clonidine elicit jumping behavior in the mouse. AB - Neuronal mechanisms involved in the jumping produced by high doses of clonidine were studied in adult mice. Intraperitoneal administrations of clonidine at doses ranging from 10 to 40 mg/kg elicited jumping behavior in dose-dependent manner, the highest frequency of jumping being observed at a dose of 30 mg/kg. The jumping behavior induced by clonidine (30 mg/kg) was decreased by pretreatment with physostigmine (0.2 mg/kg IP), apomorphine (2 mg/kg IP) and phentolamine (10 mg/kg IP), and conversely increased by atropine (5 mg/kg IP), apomorphine (0.25 mg/kg), haloperidol (2 mg/kg IP) and propranolol (10 mg/kg IP). The jumping behavior was unaffected by methylatropine (5 mg/kg IP) and mecamylamine (0.1 mg/kg IP). In addition, N6-cyclohexyl adenosine (0.2 mg/kg IP) or diazepam (2 mg/kg IP) did not affect, either. The result suggests that high doses of clonidine elicit jumping in which alpha-adrenoceptor activation, dopaminergic and cholinergic inhibition are concomitantly involved. PMID- 6505378 TI - Ultrastructural changes in mouse dermal capillaries induced by cytochalasin E. AB - Cytochalasin E increased the vascular permeability in the dermis of one-day-old mouse. It simultaneously induced edema and erythema as resulted from the leakage of plasma and red blood cells through the intercellular gaps of endothelial cells in both capillaries and venules. Meanwhile, there was a markedly decrease in plasma protein transport via pinocytotic vesicles. PMID- 6505379 TI - Effects of osmotic dehydration on the nucleotides of isolated chromaffin granules: evaluation by 31p nuclear magnetic resonance. AB - The 31P nuclear magnetic resonance spectrum of chromaffin granules isolated from bovine adrenal medulla, when examined at 30 degrees C in 0.3 M sucrose, shows sharply defined gamma, alpha, and beta nucleotide resonances with linewidths of 141, 58 and 90 Hz respectively. These are essentially unchanged when examined at 4 degrees C. When the granules are resuspended in 1.6 M sucrose, the linewidths of 161, 117 and 162 Hz seen at 30 degrees C reversibly broaden to greater than 1000 Hz at 4 degrees C. Addition of quinacrine produces no discernable change in the nucleotide linewidths of either preparation. The broadening at high osmolarity and low temperature appears to be due to ATP:catecholamine complex formation rather than to increased viscosity. Since purification of chromaffin granules is often performed utilizing sucrose gradients, the present results raise the question of whether dehydration may alter the structure of the granule core. PMID- 6505380 TI - Radiation induced brain edema in primates, studied with sequential brain cat scanning and histopathology. Protective effect of sodium meclofenamate. A preliminary report. AB - Four Cynomologous monkeys (Mecaca fascicularis) received 2000 Rad whole brain irradiation. One remained untreated and exhibited loss of hair, facial edema, brain edema and hydrocephalus. There was loss of alertness and motor activity. One was scheduled to be treated with phenobarbital, but died in 24 hours after irradiation. One animal received 2 mg/kg dexamethasone I.M. daily. It died two weeks after irradiation apparently due to treatment related infection. One animal received 20 mg/kg sodium meclofenamate (Meclomen) orally daily. This animal showed no brain edema and only minimal hydrocephalus, delayed and incomplete hair loss and no facial edema. Further studies of this treatment appear to be justified. PMID- 6505381 TI - In vitro binding of butyric acid and crotonic acid by the soluble glutathione S transferases from rat liver. AB - The in vitro interaction of butyric acid, crotonic acid and n-butylamine with rat liver glutathione S-transferase (GST) was studied, using glutathione (GSH) and 1 chloro-2,4-dinitrobenzene (CDNB) as substrates. Both acids inhibited the GST activity in crude extracts in a dose dependent manner; the amine did not. The GST isoenzymes were inhibited at different degrees. Kinetic studies never revealed competitive inhibition kinetics, with GSH nor with CDNB as the variable substrate. Titration of remaining GSH in appropriate incubation mixtures revealed no GST catalyzed conjugation with GSH. It is concluded that butyric and crotonic acid interact with GST by direct binding to these proteins via their carboxyl group. This binding could have a protective function against these compounds. PMID- 6505382 TI - Further characterization of the pulmonary ethanol metabolizing system (PET). AB - A postmitochondrial preparation of rat lung homogenate was able to metabolize ethanol (205.8 mumoles/g X hr) only in the presence of uridine diphosphate glucuroniate, with a Km for ethanol of about 14 mM. Lung slices from the same animals incubated in a Krebs ringer bicarbonate buffer showed a biphasic time curve for ethanol metabolism. The amount of metabolized ethanol first increased and then decreased. The metabolic product of this system (PET-I) was sensitive to the action of betaglucuronidase. Lung slices from some animals, however, showed a monophasic time-curve for ethanol metabolism. The metabolic product of this system (PET-II) was insensitive to the action of beta-glucuronidase but sensitive to that of sulfatase. These results confirm our previous suggestion that the lung of the rat is able to metabolize ethanol by a conjugation process catalyzed by a glucuronyl-transferase. In addition, the evidence obtained in this work also suggests that in some animals PET is represented by a sulfotransferase. PMID- 6505383 TI - Effects of chlorobenzenes on hepatic porphyrin and drug metabolism in chick embryo and day-old chick. AB - Administration of monochlorobenzene (MCB), p-dichlorobenzene (DCB), or 1,2,4 trichlorobenzene (TCB) at single doses of 800 mg/kg produced an increase in the total porphyrin content of liver of day-old chicks. Porphyrinogenic activity was higher in DCB- and TCB-treated chicks than in MCB-treated chicks. Administration of any of these compounds to chick embryos (40 mg/egg) failed to produce an induction of liver porphyrins. TCB enhanced the excretion of porphyrin in bile of chicks but not of chick embryos. In day-old chicks TCB increased hepatic cytochrome P-450 levels and the activity of 7-ethoxyresorufin deethylase. However, 7-ethoxycoumarin deethylase activity was decreased while cytosolic glutathione S-transferase activity was unchanged. These results point out the differential response of chick embryos and day-old chicks to chlorobenzene induced changes in porphyrin metabolism as well as the differential induction of microsomal monooxygenases in chicks by TCB. PMID- 6505384 TI - Effects of pyrethroids on lymphocyte mitogenic responsiveness. AB - The in vitro effects of pyrethroids on the mitogenic responsiveness of murine splenic lymphocytes to concanavalin A (Con A) and lipopolysaccharide (LPS) have been determined. Mitogenic stimulation was measured by uptake of [6-3H] thymidine. Permethrin and cypermethrin inhibited the mitogenic response to Con A over a concentration range of 1 X 10(-5) M to 5 X 10(-5) M. Relative to these pyrethroids, slightly lower concentrations of fenpropathrin were required to inhibit mitogenic responsiveness to Con A. Fluvalinate was least effective of the pyrethroids tested, and caused mitogenic inhibition at concentrations of 1.5 X 10(-5) M to 5 X 10(-5) M. Unlike the other pyrethroids, concentrations of fluvalinate as high as 1 X 10(-4) M did not result in complete inhibition of the mitogenic response to Con A. Allethrin, was the most potent inhibitor, with effective concentrations in the range of 1 X 10(-6) M to 1.5 X 10(-5) M. Permethrin (3 X 10(-5) M) inhibited the mitogenic response at each of several concentrations of Con A tested, and did not cause a shift in the lymphocyte mitogenic dose-response to Con A. The mitogenic responsiveness to LPS was found to be inhibited by allethrin and permethrin at the same concentrations which inhibited the mitogenesis induced by Con A. The results support the possibility of immune suppression by pyrethroid exposure. PMID- 6505385 TI - Central serotonin antagonist activity of ketanserin. AB - Ketanserin, given i.p. 1 hr before quipazine, antagonized the elevation of serum corticosterone by quipazine in rats. The relatively low ED50 value of ketanserin (0.9 mg/kg) supports other literature data showing that ketanserin is selective for the 5HT2 subtype of serotonin receptors, the data also suggest that 5HT2 receptors are involved in the elevation of serum corticosterone by the serotonin agonist, quipazine. PMID- 6505386 TI - Effect of metabolic acidosis on acinar cells of rat submandibular gland. AB - Metabolic acidosis of the exocrine glands could be an important factor in the pathogenesis of the disease cystic fibrosis, a generalized exocrinopathy. Acidosis was induced in rats by addition of ammonium chloride to the drinking water. X-ray microanalysis of the mucous acinar cells of the submandibular gland showed increased intracellular calcium concentrations, and an increased intracellular potassium to sodium ratio. Transmission electron microscopy showed a swelling of the cells, and an increase in the relative cellular mucus content. The changes in structure and composition of the submandibular gland cells in the acidotic rat resemble those found in cells from cystic fibrosis patients and in pharmacologically induced animal models of the disease. PMID- 6505388 TI - Antagonistic effects of guanabenz, carteolol, and muzolimine on hypertensive responses in the anesthetized dog. AB - In dogs, treatment with guanabenz, carteolol, and muzolimine for 7 days, reduced the blood pressure responses to bilateral occlusion of the carotid arteries, electric stimulation of central vagus nerve, acetylcholine after atropinization, nicotine, l-noradrenaline, angiotensin II, l-adrenaline, KC1 and asphyxia. PMID- 6505387 TI - Glucose induced paradoxical serum potassium elevation exclusively in the upright posture in metoprolol treated hypertensives. AB - Paradoxical glucose-induced serum potassium elevation was found exclusively in the upright position in 9 patients with essential hypertension treated with metoprolol. The finding of depressed plasma aldosterone by the drug shed light only at one of the possible mechanisms leading to the unexpected changes in internal potassium balance. PMID- 6505389 TI - Cardiovascular effects of putrescine in dogs after systemic, intra-arterial vertebral and intraventricular injection. AB - Putrescine produced in anesthetized dogs significant cardiovascular changes at higher doses than other transmitters. The hypotensive response observed after intravenous injection is due to histamine release. Tachycardic effects seem to be due both to release of histamine and to a reflex stimulation of carotid-sinus baroreceptors. The hypotensive and bradycardic effects observed after microinjection of putrescine into the III cerebral ventricle or into the vertebral artery are due to an increase in parasympathetic output. PMID- 6505390 TI - Monthly variations in the clearance of antipyrine in the rat. AB - The variation in the pharmacokinetics of antipyrine was determined in synchronized rats over a period of 12 consecutive months. The mean values +/- SE (range) for the serum half-life, apparent volume of distribution and total body clearance of antipyrine were: 2.5 +/- 0.6 (1.6-4.9) h, 868.7 +/- 203.9 (590-1275) ml/kg and 269.2 +/- 14.7 (165-516) ml/h/kg respectively. The magnitude of the variation was three fold for the serum half-life and body clearance and two fold for the apparent volume of distribution. A new gas-liquid chromatographic assay for antipyrine is also described. PMID- 6505391 TI - Teratogenicity of aspirin and its metabolite, salicylic acid, in cultured rat embryos. AB - Rat embryos were exposed to aspirin or its metabolite, salicylic acid in culture. In these embryos acute reduction of heart beat was observed during 4 hours of administration compared to that in non-treated one. Protein contents and crown rump length of cultured embryos were significantly decreased in aspirin-treated group, but were not so decreased in salicylic acid-treated one. The predominant defects of the embryos exposed to aspirin were edematous facial malformations and abnormality of tail. On the other hand, facial anomalies such as cleft lip and curly tail were observed in the embryos cultured with salicylic acid. Anomalies induced by aspirin were systemic, while salicylic acid induced localized malformations. These results might be due to the differences between aspirin and its metabolite, salicylic acid in their teratogenicity. PMID- 6505392 TI - Influence of chronic vagotomy on inotropic responses of isolated cat heart papillary muscle. AB - Isolated cat heart papillary muscle bathed at 37 degrees C, electrically driven at the rate of 30 per min, subjected to high voltage stimulation, or the addition of tyramine 1.7 microM, or high doses of acetylcholine (0.55mM) induced a positive inotropic effect revealed by an increase of peak tension developed (PTD). Papillary muscles obtained from cats after 7 to 8 days chronic bilateral cervical vagotomy showed a basic PTD (mg) similar to papillary muscles from non vagotomized control or sham operated cats. The inotropic effect of both tyramine and high voltage stimulation was absent in these animals as compared to controls or sham operated cats. Nevertheless, the inotropic effect of high acetylcholine concentration was still present and was of similar magnitude than in muscles of sham operated cats. The results suggest the existence of a neural cholinergic mechanism that is suppressed by chronic vagotomy which might be necessary for the synthesis, storage and/or release of adrenergic neurotransmitter in ventricular myocardium. It is suggested also, that suppression of general trophic function of vagus nerve might interfere with inotropic actions mediated by norepinephrine release. PMID- 6505393 TI - Variations in blood composition in dairy cows during pregnancy and after calving. AB - The effects of pregnancy and of the onset of lactation on blood composition was studied in 21 Friesian cows. Among the 23 components studied only seven showed significant variations. Serum iron decreased at the end of pregnancy while creatinine increased throughout the last six months. There were decreases in blood glucose, cholesterol and alanine aminotransferase at the end of pregnancy. Triglycerides increased rapidly after drying-off and serum urea increased in the first month after calving. PMID- 6505394 TI - Relationships between counts of nasopharyngeal bacteria, temperature, humidity and lung lesions in veal calves. AB - Nasopharyngeal swabs were taken from four groups of veal calves at intervals throughout their growth and the aerobic bacteria cultivated from the swabs counted. The calves were kept under three different husbandry systems; naturally ventilated straw-yards, fan-ventilated crates and crates with a controlled climate. The numbers of bacteria isolated varied in a complex manner; however, in one group of calves a significant proportion (P less than 0.01) of the variation in weekly bacterial counts was associated with the changes in vapour pressure and temperature which took place between two and four days previously. In calves kept at a constant temperature of 16 degrees C, the bacterial populations in the nasopharynx were at a minimum between 65 and 75 per cent relative humidity and tended to rise at humidities outside this range. There was a temporal relationship between nasopharyngeal bacteria and lung lesions. In three groups the numbers of bacteria in calves at nine weeks old were positively correlated (P less than 0.05) with lung damage observable at 16 to 18 weeks old. PMID- 6505396 TI - Time to loss of brain responsiveness following exsanguination in calves. AB - In the anaesthetised calf the time to loss of visually evoked cortical responsiveness after cutting the common carotid arteries and the jugular veins was 17 seconds. An earlier study showed that the corresponding interval for sheep was 14 seconds. In contrast to suggestions made by other workers, it is concluded that the time necessary for sticking at slaughter to induce brain dysfunction is similar in the two species. PMID- 6505395 TI - Genesis of oestrogenic inhibition of soleus muscle development in female mice. AB - The mechanism by which oestrogen inhibits development of muscle mass was investigated in the soleus muscle of 20 sexually immature female mice. Half of the population were injected weekly (from one to nine weeks old) with a physiological dose of 0.01 mg stilboestrol dipropionate (synthetic oestrogen). After each mouse was killed at 10 weeks old, the weight and muscle index was determined for each muscle. The number of muscle fibres was counted in each soleus muscle. The muscle fibre size for each muscle was determined by measuring the greatest diameter of at least 100 fibres. The number of muscle fibres was similar in both normal and oestrogen treated animals but the individual muscle fibre sizes were significantly smaller in oestrogen treated animals. These observations indicated, therefore, that oestrogen inhibits development of muscle mass in females by limiting the size of individual muscle fibres and not by inhibiting the multiplication of muscle fibres. PMID- 6505397 TI - Seasonal changes in pasture populations of infective larvae of gastrointestinal nematodes of cattle in eastern Nigeria. AB - The seasonal changes in the populations of trichostrongylid infective larvae (L3) on herbage and in soil samples collected from pastures grazed by beef cattle were studied at Nsukka, eastern Nigeria, from April 1980 to July 1981. Large numbers of L3 were recovered from all samples collected during the rainy season (April to October). The rainy season herbage infestation was characterised by three clearly defined peaks. The first, which followed an 'early rains' (April) rise, occurred in the second half of May while the larger second and third peaks occurred in late July and October respectively. It is suggested that each of these peaks represented a distinct wave of infestation by a separate generation consisting of the three trichostrongylids concerned, namely Cooperia, Haemonchus and Trichostrongylus species. Although there was a sharp fall in pasture infestation following the onset of the dry season, appreciable numbers of L3 were still present on herbage in early December. The implications of these findings have been discussed in relation to the choice of effective strategic anthelmintic programmes for the prophylaxis and control of bovine parasitic gastroenteritis in the Nsukka area. PMID- 6505398 TI - Development and survival of infective larvae of gastrointestinal nematode parasites of cattle on pasture in eastern Nigeria. AB - A study of the development and survival of the infective larvae of the common strongylate nematodes of cattle at Nsukka, eastern Nigeria, from September 1981 to March 1982 showed that the dry season (November to March) was generally unfavourable for preparasitic development and survival of Cooperia, Haemonchus and Trichostrongylus species. However significant development may occur during the last two months of the season as a result of the small amounts of rain that usually fall at that time of the year. It was shown, using tracer goat kids, that only paddocks contaminated late in the dry season were infective at the start of the rainy season and that March contamination, in particular, is an important source of the 'early rains' (April/May) rise in herbage infestation commonly observed. PMID- 6505399 TI - Immunoreactive gastrin concentrations in gastrointestinal tissues of sheep. AB - Radioimmunoassay of gastrin in gastrointestinal tissues of lambs and adult sheep showed highest concentrations (796 to 11,156 pmol g-1 mucosa) in the antral region of the abomasum. The next highest concentrations of gastrin were in the proximal duodenal mucosa (16 to 518 pmol g-1). Gastrin was undetectable or present in lower concentrations in caudal regions of the duodenum (less than 11 X 5 pmol g-1), the pancreas and in the body of the stomach. It is concluded that the distribution of gastrin secreting cells in sheep is similar to that in other animals. PMID- 6505400 TI - Bacteria associated with calf pneumonia and their effect on gnotobiotic calves. AB - Samples of pneumonic lung tissue from 140 calves with subclinical pneumonia and 65 calves with fatal pneumonia were examined bacteriologically. Sixty-eight (48 per cent) of the lungs from the subclinical cases and 27 (41 per cent) of the lungs from the fatal cases contained bacteria at more than 10(4) colony forming units (cfu) per gram of tissue. Pasteurella haemolytica was associated more with fatal cases than subclinical cases (P less than 0.001). Of the seven species of bacteria inoculated endobronchially into gnotobiotic calves only P haemolytica produced severe respiratory disease, although some strains of P multocida produced a fatal septicaemia. PMID- 6505401 TI - Effects of dietary copper depletion on acute and delayed inflammatory responses in mice. AB - Acute and delayed hypersensitivity reactions were compared in mice fed diets low in copper (less than 20 mumol copper kg-1) or adequate (more than 300 mumol copper kg-1) for seven to nine weeks after weaning. In the copper depleted animals there was a significant enhancement (P less than 0.01) of histamine induced paw oedema measured 15 minutes after challenge. The variance of responses within the two dietary groups was similar. Delayed contact hypersensitivity reactions to oxozalone were also significantly increased (P less than 0.01) in the deficient mice. In this study there were some signs of differences in variance heterogeneity but they were statistically insignificant. Delayed-type hypersensitivity to sheep erythrocytes was similarly but less markedly (P less than 0.05) affected. Group differences just failed to reach statistical significance after logarithmic transformation (P less than 0.07) or non parametric analysis (P less than 0.06). At challenge, the copper deficient mice had a significant (P less than 0.05) plasma hypercholesterolaemia. A few individuals also showed signs of spleen enlargement and mild haemoglobinaemia but otherwise the animals appeared clinically normal and were similar in weight to the controls. Plasma (P less than 0.001), erythrocyte (P less than 0.01) and liver (P less than 0.01) copper concentrations were significantly reduced in the copper-depressed mice, although the concentrations of copper and zinc in the spleen were increased (P less than 0.05) in the same group. Whole blood superoxide dismutase activity was also significantly decreased (P less than 0.01) but erythrocyte glutathione peroxidase activities were similar in both groups, as were blood and liver zinc concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505403 TI - Differences in behaviour between sheep and cattle during slaughter. AB - Three fully conscious lambs, two adult sheep, five calves and one young bull were slaughtered by bilateral severance of the carotid arteries and jugular veins while standing. The calves and bull exhibited apparently coordinated body movements for much longer than the lambs and adult sheep. Other signs assumed to be associated with cerebral hypoxia, such as clonic convulsions and pupillary dilation, occurred earlier in the sheep than in the cattle. Although there is no single definitive method for assessing the onset of insensibility in animals during slaughter, it is believed that these findings support previous more objective encephalographic studies which indicated that there are clear cut differences between sheep and cattle. PMID- 6505402 TI - Early migration of immature Fasciola hepatica and associated liver pathology in cattle. AB - Immature Fasciola hepatica were successfully recovered from the body cavity of cattle from two to 21 days after oral infection. Flukes had penetrated the liver in large numbers by day 7 but there did not appear to be a corresponding reduction in the numbers recovered from the body cavity. Liver pathology showed a typical progressive tissue disruption with a neutrophil and lymphocyte infiltration by day 7 and a marked eosinophil response from day 14. The mesothelium of the liver capsule underwent metaplasia, becoming ultimately highly active and columnar. PMID- 6505405 TI - [Diabetic osteoarthropathy (report on 2 patients)]. PMID- 6505404 TI - Chemotherapy of bovine tropical theileriosis: Theileria annulata infection. AB - Seven groups of calves were treated with parvaquone (993C: Clexon, Wellcome) (20 mg kg-1 intramuscularly) or halofuginone lactate (1.2 mg kg-1 orally) on the first, third or sixth day of significant pyrexia following artificial infection with the Hissar strain of Theileria annulata. Eight untreated control animals developed severe theileriosis and five died. All animals treated with parvaquone or halofuginone lactate on the first or third day of fever underwent relatively mild theileriosis and all of them recovered. One of five animals treated with parvaquone and three of six treated with halofuginone on the sixth day of fever died of theileriosis. PMID- 6505406 TI - [Treatment of rheumatoid diseases using naphthalan]. PMID- 6505407 TI - [Electrocortical study of acquired language disorders in children]. PMID- 6505408 TI - [Lesion, affect, function]. PMID- 6505409 TI - [Orthophonic evaluation of children with Landau-Kleffner syndrome]. PMID- 6505410 TI - [Borderline cases of Landau-Kleffner syndrome]. PMID- 6505411 TI - [Toward an environmental-cognitive theory of the acquisition of language]. PMID- 6505412 TI - [Language testing in children from 18 months to 6 and a half years of age. Methods, reflections]. PMID- 6505413 TI - [Longitudinal study of language in children from 3 to 6 years of age]. PMID- 6505414 TI - [Problems posed by early treatment in orthophony]. PMID- 6505415 TI - [Bilingual education of deaf children]. PMID- 6505416 TI - [Pommez's VVVA (voluntary variation of the speed of articulation) logometric test]. PMID- 6505417 TI - [The buccal cavity : a space for speaking, breathing, feeding]. PMID- 6505418 TI - [Vocal retraining following partial laryngectomy]. PMID- 6505419 TI - [Striae of vocal cords]. PMID- 6505420 TI - Speech disorders due to chronic hypertrophic tonsillitis and the sonographic and manophonic investigations of the effects of tonsillectomy. PMID- 6505421 TI - [Acoustic study of esophageal voice. Comparison with laryngeal voice]. PMID- 6505422 TI - [Dynamic testing of the vocal cords : comparison between laryngostroboscopy with a rigid endoscope and fiberoptic endoscopy]. PMID- 6505423 TI - [Thrombolytic treatment. A new stage]. PMID- 6505424 TI - [Hypocaloric and high-protein diet in obese patients: changes in the lean mass]. AB - We have followed for 40 days seven hospitalized, young (age, mean SD : 33 +/- 8 yrs), and moderately obese (W/H : 35 +/- 3.92) women. During the first 5 days (DO to D5) they received a diet similar to their customary home-diet; from D6 to D40, their daily caloric intake was adjusted to 3,41 +/- 0.13 MJ (816 +/- 30 kcal). This diet comprised 21 p. 100 of sugars, 35 p. 100 of lipids, 1.57 +/- 0.09 g proteins per kg ideal body weight. Five seven-day periods have been studied. On the first day of each period, we recorded body weight and measured plasma albumin, pre albumin, retinol binding protein, complement (CH50 and C3) C peptide (in the fasting state and after glucagon stimulation), and thyroid hormones (T3 and rT3). On each of the 35 days of this study, total nitrogen was measured (Kjeldahl's method) in food, urine and faeces. On D0 and D41 lean and fat body masses were evaluated through measurements of total water (dilution of tritiated water) and of skin fold thickness respectively. From D0 to D40, the average weight loss was 8.76 +/- 1.86 kg; the cumulated nitrogen balances were negative in 6 patients and positive in one, with variations from one period to another and from one patient to another. Plasma proteins and hormones did not vary significantly. Changes in lean mass were comprised between + 0,7 and -- 1,6 kg in spite of the fact that all patients received the same caloric and protein intake. PMID- 6505425 TI - [Facial vasomotor flushing due to alcohol-chlorpropamide. Prevalence in diabetic and non-diabetic patients]. AB - Using a standard test (sherry 40 ml 12 hours and 36 hours after 250 mg chlorpropamide), chlorpropamide-alcohol flush (CPAF) prevalence was 34 p. 100 (19/56) in non insulin-dependent diabetics (NIDD), 10 p. 100 (3/30) in insulin dependent diabetics and 7 p. 100 (2/27) in controls. Family history of diabetes was not associated with CPAF trait. Conflicting results in the literature might be explained by bias in patients selection or methodology. PMID- 6505426 TI - [Acquired immunodeficiency syndrome in a couple from Zaire]. PMID- 6505427 TI - [Thyroid tuberculosis: rare disease or rarely diagnosed?]. PMID- 6505428 TI - [Role of periarterial sympathectomy in the treatment of digital gangrene. Apropos of a case of paraneoplastic gangrene]. PMID- 6505429 TI - [Hypercalcemic sarcoidosis and primary hyperparathyroidism disclosed by renal insufficiency]. AB - Primary hyperparathyroidism and sarcoidosis were found in one patient with hypercalcemia and renal failure. Cervicotomy disclosed a parathyroid adenoma and renal biopsy demonstrated interstitial nephropathy. Association of sarcoidosis with hyperparathyroidism, if not fortuitous, has not yet been clearly established. PMID- 6505430 TI - [Lambert-Eaton syndrome. Diagnostic, nosologic and therapeutic problems]. AB - We report on five cases of this myasthenic disorder associated with a loss of deep tendon reflexes, dry mouth and impotence. The diagnosis relies upon the response to repeated electric stimulations: with stimulations at a frequency of 5 Hz, the size of the potentials decreases by more than 30 p. 100 and, at 30 Hz, increases by more than 60 p. 100. This profile differentiates Lambert-Eaton syndrome from myasthenia gravis. Lambert-Eaton syndrome occurs usually in the course of malignant diseases; when it seems isolated, a visceral neoplasm, mainly bronchogenic carcinoma, should be suspected. Nevertheless, in some cases, no malignant disease is found. The mechanism is a presynaptic block of neuromuscular transmission because of an unknown hypothetic substance produced by the tumor. Therapeutic resources (Guanidine) are scarce. PMID- 6505431 TI - [Present status of the regulation of physiological fibrinolysis. Therapeutic prospects of lys-plasminogen]. PMID- 6505432 TI - [Intra-arterial thrombolysis with the combination of urokinase and lysyl plasminogen. 27 cases of acute arterial obliteration of the lower limbs]. AB - Twenty-five in situ thrombolysis using Lysyl Plasminogen and low doses of urokinase were performed on 25 acute, recent and severe arterial occlusion of lower limbs. Early success were 56% and 44% with a follow up of 5 months. Complications were very limited. Thus the thrombolytic treatment used in this study appears as effective as locally administered streptokinase but higher tolerated. It seems to be able to win one of the best places in the treatment of the arterial disease of the lower limbs. PMID- 6505434 TI - [Topographic distribution of stenotic lesions of coronary arteriosclerosis. Angiographic study of 500 patients]. PMID- 6505433 TI - [Local low-dose thrombolytic treatment with sequential urokinase-plasminogen in deep central venous thrombosis]. AB - Four patients with recent central deep vein thrombosis (pelvis-superior mediastinum) were treated by local low dose infusions of urokinase (500 to 1000 IU/kg/h for 6 to 9 hours) followed by plasminogen (20 to 30 microkatals/h for 2 to 3 hours) associated with simultaneous anticoagulation with heparin. The treatment was continued for 83 to 160 hours until control phlebography showed dissolution of the thrombus. There were no haemorrhagic complications despite the presence of a number of risk factors which contraindicated treatment by a systemic route. Fibrinogen and FDP levels did not alter significantly. This therapeutic approach is worth considering and should be integrated among the therapeutic options available for cases of central deep vein thrombosis. PMID- 6505435 TI - [Computerized study of M mode echocardiogram. Normal values and in the presence of obstruction to ventricular filling]. PMID- 6505436 TI - [Glutamine in cerebrospinal fluid in the diagnosis of altered consciousness of hepatic origin]. PMID- 6505437 TI - [Preliminary evaluation of the treatment with folic acid in 2 patients with sex linked mental retardation and macroorchidism]. PMID- 6505438 TI - [Upper endoscopy in the etiological diagnosis of pyloric syndrome]. PMID- 6505440 TI - [Use and abuse of instrumentation in gastroenterology]. PMID- 6505439 TI - [Torsade de pointes or atypical ventricular tachycardia in a patient with Chagas' cardiomyopathy]. PMID- 6505441 TI - [Respiratory function studies. II. Pulmonary gas exchange]. PMID- 6505442 TI - [Pneumoconiosis in Chile]. PMID- 6505443 TI - [Ethical code of the Chilean Medical Association]. PMID- 6505444 TI - Biochemical events in cell activation. PMID- 6505446 TI - The surgical management of advanced abdominal disease. PMID- 6505445 TI - Testicular cancer: diagnosis and staging. PMID- 6505447 TI - The identification and management of poor-risk patients with testicular tumors. PMID- 6505448 TI - The management of advanced seminoma. PMID- 6505450 TI - [Computers in medical practice. Why and how?]. PMID- 6505451 TI - [Withdrawal syndrome upon discontinuing antihypertensive drugs]. PMID- 6505449 TI - Fertility issues following therapy for testicular cancer. PMID- 6505453 TI - [Prophylaxis of primary ventricular fibrillation in the acute phase of acute myocardial infarct]. PMID- 6505452 TI - [Chondrocalcinosis mimicking a severe infectious syndrome]. PMID- 6505454 TI - [Value of radiotherapy in the treatment of cancer of the prostate]. PMID- 6505455 TI - [Treatment of male infertility]. PMID- 6505456 TI - [Symptomatology of peptic esophagitis]. PMID- 6505457 TI - [Carcinoid tumors of the appendix]. PMID- 6505458 TI - [Practical problems in urodynamics. III. Symptomatology of urodynamic tests]. PMID- 6505459 TI - [Update]. PMID- 6505460 TI - Anatomical studies of the spinocervical tract of the rat. AB - The retrograde transport of horseradish peroxidase (HRP) was used to identify and examine the cells of origin of the spinocervical tract (SCt) in the rat. Initially, precise data on the boundaries of the rat lateral cervical nucleus (LCn) were gathered after injecting HRP into the ventrobasal thalamus. These data indicated that the LCn of the rat is restricted to a region on the extreme lateral edge of the dorsalmost portion of the lateral funiculus (DLf) within spinal segment C2. Following small iontophoretic injections of HRP that were restricted to this area, labeled SCt neurons were found in the ipsilateral nucleus proprius at all levels of the spinal cord but were most numerous in the cervical enlargement. Lesion studies indicated that the overwhelming majority of SCt axons ascend to the LCn within the DLf. In an attempt to determine whether our injection techniques labeled a significant number of cells through axons of passage, HRP injections were made in the DLf ventral to the LCn. Such injections labeled, presumably through axons of passage, cells in several areas of the spinal cord gray matter, including a large number in the contralateral marginal zone. Injections in areas immediately rostral to the LCn labeled 20% or less of the total number of cells within the enlargements that were labeled by injections into the LCn. Thus, the majority of cells labeled by injections of HRP into the LCn were labeled through preterminal fibers or terminals themselves. The cells of origin of the SCt in the rat are similar in location to those in the cat but far fewer in number. PMID- 6505461 TI - The boundary of proximal hindlimb representation in the dorsal horn following peripheral nerve lesions in cats: a reevaluation of plasticity in the somatotopic map. AB - Some investigators have reported that deafferentation markedly alters the somatotopic organization of the dorsal horn in adult mammals, whereas others, including the present investigator, have not. Failure to observe changes in somatotopy might be attributable to insufficient deafferentation, inadequate sampling, limitation of the observations to a population of neurons that does not exhibit the phenomenon, or a variety of technical factors. The most striking changes in somatotopy have been reported following total deafferentation of the medial dorsal horn by sciatic and saphenous nerve lesions (Devor and Wall, 1981a; Lisney, 1983). The present study was an attempt to replicate this result to determine which explanations might account for the failure of some earlier investigations to observe changes in somatotopic organization. Other variables to be considered include type of anesthesia, type of electrode, and mapping and reconstruction procedures. The somatotopic organization of the lumbar dorsal horn in the adult cat was examined ipsilateral to sciatic and saphenous nerve lesions at postoperative survival times of 1-98 days. Half of these experiments were performed using chloralose anesthesia and half using pentobarbital. Microelectrodes were used to record single and multiunit activity in transverse rows of penetrations across the dorsal horn of L6 and adjacent segments. The results of these experiments were compared with data taken from dorsal horns ipsilateral to intact nerves. Sciatic and saphenous nerve lesions completely abolished dorsal horn neuronal responses to foot and toe stimulation at all survival times, yet there was no significant shift of proximal hindlimb representation into the medial dorsal horn following these lesions at any survival time. It is suggested that the method of anatomical reconstruction of recording sites used by investigators reporting such changes might best explain their findings. PMID- 6505462 TI - A comparison of force and depth of skin indentation upon psychophysical functions of tactile intensity. AB - Tactile sensory intensities related to force applied to the skin, and depth of skin indentation were measured with a magnitude estimation procedure at various sites on the left hand of four human subjects. These same skin sites were measured for "compressibility"--that is, the indentation depths that resulted from controlled forces. Graphic examination of the magnitude estimation data indicated that, in most cases, growth of sensory intensity was relatively shallow at the lower stimulus intensities, and steeper at higher stimulus intensities. The "breakpoint" between the shallow and the steep legs of the psychophysical functions was routinely found between 0.30 and 0.40 mm of indentation, and between 12.0 and 20.0 mN of force. Two subjects consistently produced positively accelerating psychophysical functions, whereas the other two produced negatively accelerating or nearly linear functions above the breakpoint. Differences in skin compressibility did not systematically alter the exponent of the psychophysical functions, regardless of the stimulus dimension (i.e., force or depth of skin indentation). Psychophysical functions based on controlled depth of skin indentation, at a constant rate of indentation, consistently produced higher r2 values than psychophysical functions based on controlled force. When the exponents of psychophysical functions based on controlled skin indentation were compared across different regions of the hand, the values were ordered such that dorsum of hand greater than finger greater than thenar. It was concluded that tactile sensory intensity is more closely related to depth of skin indentation than to force, but only when the rate of skin indentation is controlled. PMID- 6505463 TI - Time-dependent changes in the functional organization of somatosensory cerebral cortex following digit amputation in adult raccoons. AB - Surgical removal of the third forepaw digit in raccoons causes both long-term and short-term changes in functional organization within the digit 3 primary somatosensory (SmI) cortex. Previous studies have shown that 36-52 weeks following amputation in infant raccoons, neurons within the digit 3 cortical territory had become responsive to cutaneous stimulation of "new" forepaw regions adjoining the digit stump (Carson et al., 1981; Kelahan et al., 1980, 1981); the "novel" receptive fields (RFs) were often larger than normal and revealed no orderly somatotopic organization. In the present study, the cortical effects of digit 3 removal were examined in adult raccoons. Within 36 weeks after amputation, the digit 3 zone was also found to be reactivated by "novel" inputs from the forepaw, with no strictly topographic representation of the "new" skin fields. The basic features of cortical reactivation were very similar in animals amputated as adults and as infants, except that the former typically had larger neuronal RFs than the latter. Short-term cortical changes were studied in adult raccoons within 1 day and between 1 and 4 weeks after amputation: Significant time-dependent differences were found in the reactivated digit 3 territory. Within 1 hr following amputation, some cells in the digit 3 zone began to respond to low-intensity cutaneous stimulation of "new" forepaw regions, limited almost exclusively to digits 2 and 4. Neuronal RFs tended to be larger than normal and showed no strictly topographic organization. One to 4 weeks following amputation, the condition of the digit 3 zone differed dramatically from that found immediately and long after amputation--the majority of responsive neurons could be excited only by high-intensity stimulation of small RFs on the digit 3 stump; relatively few cells were sensitive to low-intensity stimulation of adjacent, intact skin regions. Again, no true somatotopic organization was evident. The combined results of these experiments indicate that within 36 weeks following removal of a digit in raccoons, the deprived SmI cortical sector undergoes a dynamic sequence of changes in functional organization: Neurons that are normally excited by stimulation of digit 3 first become responsive primarily to stimulation of digits 2 and 4 (within 1 day after amputation), then to the digit 3 stump (from at least 1-4 weeks after amputation), and finally again to digits 2 and 4 (within at least 36 weeks after amputation).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6505464 TI - The organization of saphenous nerve fibers in the dorsal roots of the rabbit and cat. AB - Electrophysiological experiments have been carried out on rabbits and cats to find out whether there is a relationship between the dorsal rootlet by which a particular saphenous nerve fiber passes to the spinal cord and the part of the saphenous nerve territory it supplies. Preliminary experiments were carried out to determine the extent of the saphenous nerve field in both animals and to determine the dorsal rootlets by which saphenous nerve fibers reach the cord in rabbits. Then, in experiments on rabbits and cats in which recordings were made from fiber bundles dissected from dorsal rootlets, it was found that saphenous nerve fibers in any one dorsal rootlet supplied only a limited portion of the saphenous nerve field; that there was overlap in the areas of the saphenous nerve field supplied by adjacent rootlets; and that moving caudo-rostrally through the rootlets containing saphenous fibers, the areas of skin supplied gradually moved from distal parts of the field to proximal ones. The results show that the saphenous nerve input to the spinal cord is somatotopically organized. PMID- 6505465 TI - [Gray areas in endoscopic papillotomy]. PMID- 6505466 TI - [Radiologic supplementation and/or alternatives to endoscopy]. PMID- 6505467 TI - [Risk factors in diagnostic and therapeutic use of ERCP]. PMID- 6505468 TI - [Results of endoscopic implantation of large luminal biliary endoprostheses]. PMID- 6505469 TI - [Endoscopic papillary and bile duct manometry in evaluating the function of Vater's papilla. Studies on patients with cholecystolithiasis]. PMID- 6505471 TI - [The insulin pump in ambulatory diabetic therapy]. PMID- 6505470 TI - [ERCP using a new contrast catheter movable in all directions. An aid in typical ERCP problems]. PMID- 6505472 TI - [Bruton's disease, a rare disease?]. PMID- 6505475 TI - [Early exercise test following myocardial infarct: yes or no]. PMID- 6505473 TI - [Arrhythmia and epilepsy: which does what?]. PMID- 6505474 TI - [Acute placental insufficiency and listeriosis]. PMID- 6505477 TI - [An experience with multidisciplinary therapy in psychiatry]. PMID- 6505476 TI - [Massive accidental oral poisoning due to opiates. Details and treatment. Use of naloxone in an emergency situation]. PMID- 6505478 TI - [An experience with return to the community]. PMID- 6505479 TI - [Benzodiazepines and dependence on them]. PMID- 6505480 TI - Biological properties of toxic shock syndrome exotoxin. PMID- 6505481 TI - Corrective factor of Bloom syndrome: identity and relevance. PMID- 6505482 TI - [Infarction of the olivary area of the medulla oblongata]. AB - The two first cases of an infarct involving the arterial olivary territory of the medulla oblongata are reported. In the first one, an old infarct of the medial territory and a recent infarct involving the whole inferior olivary nucleus at its middle third level were associated. Rostrally this infarct was reduced to the medial reticular formation and internal half of the olive. Caudally it was reduced to its external half. In the second case the infarct involved only the external half of the right olive, but involved also the external half of the left olive with the lateral territory. From these two cases and from the anatomic, pathologic and clinical data reviewed in the literature, the authors propose as "total" olivary territory a triangular area including all the inferior olivary nucleus, the dorsal accessory olivary nucleus and partly the medial reticular formation, and as "minimum" olivary territory the external half of the olive. The many important medial, lateral and cranio-caudal arteries which supply the olivary territory account for these "total" and "minimum" territories, as well as for some cases in the literature. They account also for the pyramid-like cranio caudal extension of the olivary territory infarction. The olivary territory is likely to be supplied by two short circumferential arterial groups, i.e. inferior bulbar and superior medullo-pontine. Nevertheless, the cause of the olivary territory infarction is an occlusion of the vertebral artery. PMID- 6505483 TI - [Central pontine myelinolysis with regressive development and x-ray computed tomographic interpretation]. AB - A 68 year-old woman presented after rapid correction of a hyponatremia a clinical picture suggestive of central pontine myelinolysis. Clinical disorders regressed but serial CT scans showed the late development of a central pontine low density area which persisted for several months. Such a lack of correlation between clinical and CT scan data has been previously reported. On the present case the demyelination lesions appeared to have resulted principally from the rapid increase of natremia. PMID- 6505484 TI - [Nonrecognition of familiar animals by a farmer. Zooagnosia or prosopagnosia for animals]. AB - A farmer no longer recognized his own cows, and presented disorders of topographic memory. In contrast agnosia for human faces, present initially disappeared almost completely. On CT scan, there were lesions in the temporo occipital and occipital regions of the internal surface of both hemispheres. PMID- 6505485 TI - [Brown-Sequard syndrome caused by a spinal cord infarction]. AB - A 77-year old woman presented a Brown-Sequard syndrome of sudden onset at level C4, and a few days later a tetraplegia. Postmortem findings demonstrated, at C3 C4, a left spinal cord infarct accounting for the Brown-Sequard syndrome, and a second C5-C6 bilateral infarct responsible for the tetraplegia. Alternating distribution of sulcal arteries explains the limitation of the first lesion to one half of the spinal cord. PMID- 6505486 TI - [Hemiparesis with lingual involvement. Hematoma of the genu of the internal capsule]. AB - A 62 year-old hypertensive patient with a small left lenticulo-capsular hematoma presented with a right facio-brachial hemiparesis, dysarthria, and a right lingual paresis. The hematoma was limited to the genu and the anterior part of the posterior limb of the internal capsule. The occurrence of this incomplete pseudo-opercular syndrome in relation to a capsular lesion provides evidence for a cortico-hypoglossal projection with predominantly crossed fibers. The situation of the pyramidal tract in the internal capsule is considered. PMID- 6505487 TI - [Pure spinal cysticercosis. Note on the cerebrospinal fluid]. AB - A patient from Benin experienced bilateral sciatic pain, followed by a progressive sensori-motor defect of the lower limbs. Five years after, he displayed symptoms and signs of a thoracic spinal cord compression, but no definite level could be determined. Myelography showed numerous intrathecal cysts from the cauda equina to the cervical cord. The diagnosis of cysticercosis was made by examination of the cysts removed after lumbar laminectomy. The search for another localisation of the parasite was negative. Repeated examination of cerebrospinal fluid (CSF) showed the presence of eosinophils, a high protein concentration, and a local synthesis of immunoglobulin G with an oligoclonal profile on electrophoresis. An accidental cyst punction revealed a fluid with protein migration in the alpha, beta and gamma ranges and a local synthesis of immunoglobulin A. Treatment with Praziquantel was uneffective. PMID- 6505488 TI - [Dura mater arteriovenous fistula and lateral sinus occlusion]. AB - It is rare to find an arteriovenous fistula of the dura mater associated with a venous sinus occlusion, but this may provide evidence of an etiology. In the case reported, the malformation was probably of congenital origin, the sinus thrombosis having occurred secondarily to the venous stasis adjacent to the fistula. PMID- 6505489 TI - [Diagnostic value of electronystagmography in closed head injuries]. AB - Electronystagmographic recordings were performed in 82 patients, 2 to 3 days after a closed head injury with cerebral concussion. Sensibilization procedures (positional tests, sleep) enabled detection of vestibular disorders in more than 80% of cases with mild signs of brain stem disorders, and in more than half of the patients with no clinical abnormalities. PMID- 6505490 TI - [Connections of the laterodorsal nucleus of the thalamus in the monkey. Study of efferents]. AB - Efferent pathways of the LD nucleus of the thalamus were studied in 6 Papio-papio baboons with the retrograde transport technique utilizing HRP. Injections were made in cingular and parietal cortex and hippocampal formation. Large projection from the LD to the cingular and subicular cortex were visualized as reciprocal connections. No pathway to parietal area 7 was found. The course of the fibers is via the fornix, the cingular bundle and the retro-lenticular portion of the internal capsule. The result of this study make it necessary to reconsider neuropathological hypotheses on memory. PMID- 6505493 TI - [Chronic spinal amyotrophy with paralysis of the vocal cords: Young-Harper syndrome]. AB - A 59 year old man had a 20 year history of proximal muscle weakness and proximal and distal amyotrophy with areflexia and vocal cords paralysis. The EMG and muscular biopsy were compatible with a chronic spinal atrophy. The sister of this patient was said to be suffering from a similar syndrome. The only similar cases published are the cases inherited as an autosomal dominant trait reported by Young and Harper. They are differentiated by the distal predominance of the amyotrophy. These cases can be compared with the rare cases of hereditary laryngeal palsy which have also an autosomal dominant inheritance. PMID- 6505491 TI - [Bilateral meningiomas of the optic nerves associated with partial unilateral Duane's syndrome]. AB - A 34 years old man, with right eye blindness since childhood, presented with a decreased vision of the left eye 28 years later. Apart from bilateral papillary atrophy, right blindness and decreased left visual acuity, neuro-ophthalmological examination revealed a partial Duane's retraction syndrome on the right. Optic canal X-rays and cerebral CT-Scan revealed calcified meningiomas of both optic nerves. The diagnosis was confirmed at surgery. Cases of bilateral optic nerve meningioma are reviewed. The difficulties of diagnosis, the usefulness of the CT Scan, the poor prognosis of the disease, even with surgery and radiotherapy are considered. No explanation was found for the association of the tumors with Duane's retraction syndrome. PMID- 6505492 TI - [Ocular flutter: really a cerebellar sign?]. AB - Two post-operative cases of ocular flutter with electro-oculographic recordings are reported. In both cases, the lesion was unique and restricted, suggesting that a cerebellar damage was responsible for this abnormal eye movement. In both cases, ocular flutter was directed toward the healthy side. Therefore it is suggested that flutter may result from a focal cerebellar lesion and in that case be an oriented eye movement. PMID- 6505494 TI - [Basilar migraine with alexia but not agraphia: arterial spasm on arteriography and the effect of naloxone]. AB - A basilar migraine with alexia without agraphia and episodes of dysmnesia was treated with naloxone. The triggering of an attack by angiography, allowed to see an arterial spasm. The beneficial effect of naloxone is discussed, together with the respective roles of spasm and neuronal metabolic changes in the mechanisms of symptoms and signs. PMID- 6505495 TI - [Acute neurologic complications of rubella]. AB - Two cases of rubella with neurological complications are reported. In one case an extensive atypical polyradiculoneuritis was associated with a late albumino cytologic dissociation. The other presented as a transverse myelitis with meningitis and radiculitis. In neither case was an history of contagion or recent vaccination elicited, and no eruption appeared in either patient. Clinical onset was sudden, with an acute meningitis followed several days later by neurological deficits. The course was marked by successive phases of early rapid deterioration, stabilization and slow regression over several months. Sequelae were minimal. Diagnosis was based on a sharp fall in the ratio of serum/CSF levels of specific antibodies to the rubeola virus. This was sure evidence of the presence of intrathecal synthesis of specific antibodies. PMID- 6505496 TI - [Cerebral infarction in the area of the anterior choroidal artery with oculomotor disorder]. AB - A 84-year-old diabetic man had a complete right-sided hemiplegia with ipsilateral hypoesthesia and vertical diplopia, but no aphasia or hemianopia. The CT scan showed a low-density area in the posterior limb of the left internal capsule, in the territory of the anterior choroidal artery. The mechanism of diplopia is discussed and is attributed to the involvement of the mesencephalic territory of the anterior choroidal artery. PMID- 6505497 TI - [Myositis disclosing systemic scleroderma]. AB - A 61 year old patient presented with muscular atrophy and weakness, predominant at the shoulder girdle, as the first manifestation of a progressive systemic sclerosis with the signs of the CREST syndrome: subcutaneous calcinosis, Raynaud phenomenon, esophagus disorders, sclerodactyly, telangiectasia. The histological features were consistent with polymyositis. In spite of corticotherapy, total recovery was not obtained. The nosological relationships with Mixed Connective Tissue Disease is discussed. Myositis is infrequent in progressive systemic sclerosis and corticosteroid therapy is discussed. PMID- 6505498 TI - Epidemiologic designs for the study of acquired immunodeficiency disease: options and obstacles. AB - Epidemiologic methods are designed to identify risk factors involved in production of a particular disease, even when the specific etiologic agent is unknown. However, a major problem currently presenting obstacles to research on the acquired immunodeficiency syndrome (AIDS) relates to classification; approaches are described that will permit reclassification when better laboratory techniques are developed or when more information is available from studies on natural history. Further descriptive studies will be valuable in the determination of whether extension of disease has occurred to new population groups or geographic areas. Case control studies can provide information on changes of known risk factors or can confirm and help to specify those factors already recognized. Because of the dynamic nature of AIDS and the probable existence of multiple risk factors, prospective cohort studies will be of greatest value, although they will take longer to complete. As understanding of the etiologic factors improves, preventive measures will become more efficient. PMID- 6505499 TI - [Study of pathways and function of the proprioceptive system in the extrinsic muscles of the eye]. PMID- 6505500 TI - [Role of afferent signals from the extrinsic muscles of the eye during visual development]. PMID- 6505501 TI - [Neurophysiology of ocular proprioceptors. Clinical value]. PMID- 6505503 TI - [Role of oculomotility in the maintenance of equilibrium]. PMID- 6505502 TI - [Oculocephalic coupling]. PMID- 6505504 TI - [Diagnostic approach to multiple sclerosis by evoked potentials (visual, somesthetic and early auditory potentials). Study concerning 113 patients]. PMID- 6505506 TI - [Acquired immunodeficiency syndrome: epidemiological data in France and throughout the world]. AB - Nearly three years after the first A.I.D.S. cases were detected in the United States, a lot of countries throughout the world have reported varied numbers of such cases. While several U.S. towns have to face up to an epidemic situation, the same phenomenon has not been observed yet in the other areas, including European countries. In those latter countries homosexuals represent the most important group among patients. Two differences have to be noticed with the U.S. situation: numerous cases among patients from Equatorial Africa have been reported, and the disease has not spread over among I.V. drug abusers. Although no specific agent can be identified yet, A.I.D.S. features are characteristic of a transmissible disease. PMID- 6505505 TI - [Strategy of ocular movements during reading]. PMID- 6505508 TI - [Practical impact of instructions concerning AIDS]. AB - Following an inquiry to determine what measures has been taken since january 1984 in French Blood Centers to avoid transmission of AIDS by blood, answers from 49 % of the centers, representing 75 % of the blood collection in France were analyzed. Due to the absence of a biological marker, only information given to blood donors, unpaid in France, permitting spontaneous autoexclusion had been used to screen donors in blood center. Direct questioning of donor for risk factors before taking blood raised numerous problems in donors of whole blood, but could be satisfactorily implemented in cytapheresis and plasmapheresis donors mainly because of closer human contact between volunteers and the medical staff. PMID- 6505507 TI - [A case of AIDS in a hemophilia B patient in France]. AB - AIDS is reported in a 14 year old hemophiliac B. This patient was treated on demand and used 800 F IX IU per kg B.W. and per year. He presented with severe opportunistic infection (Toxoplasmosis) and profound impairment of cellular immunity. He suffered of chronic active hepatitis and he was chronic HBs Ag carrier. A retrovirus (LAV) was isolated from his cultured T lymphocytes. He had no other identified risk factor than severe hemophilia B. The occurrence of AIDS in hemophiliacs suggests a relationship between the transfusion of blood products and the disease. The cause of AIDS is unknown. A possible relationship between LAV and AIDS is discussed. PMID- 6505509 TI - [Cost of transfusion in AIDS. Experience at the Claude-Bernard Hospital apropos of 28 cases]. AB - The study of 28 confirmed cases of AIDS shows that transfused patients use a large amount of hospital's blood products, especially platelets. For these patients, the average cost of transfusion is higher than that, for intensive care unit patient's. The use of irradiated products increases the cost (+ 35%). As there is a shortage of donors, if the present precautions are respected, there is no reason why the hospital should not continue to ask the patient's family and circle of friends, to donate blood. PMID- 6505510 TI - [Acquired immunodeficiency syndrome. Measures to be taken in blood transfusion establishments in order to protect the personnel]. AB - There is presently no evidence of AIDS transmission to laboratory workers. Because transmissible agent is suspected, precautions should be taken in laboratories. As a general rule, procedures appropriate for hepatitis B prevention are advised. These procedures concern blood collection, carrying, and processing. Measures should be taken in order to avoid blood spilling and work surfaces should be decontaminated. Disposable material should be preferred, and all potentially contaminated material should be decontaminated before disposal or reprocessing. All personnel should be aware of usual laboratory procedures concerning pipetting, hand washing, protective clothing and of general precautions against viral contaminations. PMID- 6505511 TI - [Experience with pelvic osteotomy in the surgical reconstruction of bladder exstrophy]. PMID- 6505512 TI - [Necrosis of the lesser gastric curvature after proximal gastric vagotomy caused by a traumatic lesion of the gastric wall. Experimental study in dogs]. PMID- 6505513 TI - [Passive hemagglutination reaction as a screening test in assessing antitetanus immunity]. PMID- 6505514 TI - [Duodenal paracoccidioidomycosis with digestive bleeding]. PMID- 6505516 TI - Committee report on standardization of rhinomanometry. PMID- 6505515 TI - [Microsporum nanum. Report of the 2d case of human infection in Brazil]. PMID- 6505517 TI - Pathogenesis and surgical therapy of migraine attacks caused by weather (Foehn) and menstruation. AB - This work reports for the first time on the pathological background and the successful definitive surgical treatment of migraine attacks caused by weather (Foehn) changes, menstruation, nutrition (cheese, chocolates, red wines etc), and psychophysical stress. Forty-two patients between the ages of 13 and 48, who were subdivided into an earlier and later treatment group, were surgically treated for migraines caused by the factors mentioned above. In the first group of 15 female patients that was treated, the surgical technique consisted of subperichondral septum correction crushing and partial or total resection of the middle concha and ethmoidal opening. In four of the patients where no septum deviation was observed, a resection of the middle nasal concha and a transnasal opening of the ethmoidal cells in the area of the middle nasal passage was performed. In the later group consisting of 27 patients, the surgical technique was simplified so that only subperichondral septum correction and crushing of the middle concha was performed, without total resection of the concha and ethmoidal cell opening. Up to the present all the 42 patients operated on have been free from migraine attacks, the first operation having been performed seven years ago and the last eight months ago. PMID- 6505518 TI - The effect of beclomethasone dipropionate treatment on the nasal provocation test. AB - A total of 50 patients with hay fever of perennial rhinitis were treated for 14 days with beclomethasone dipropionate nasal spray. Dosage was one puff (50 micrograms) in each nostril four times a day to a total daily dose of 400 micrograms. Rhinomanometry was used to determine the efficacy of beclomethasone dipropionate in immediate type allergic responses provoked by a nasal challenge with either grass pollen or house dust/house mite allergen. Treatment with beclomethasone dipropionate nasal spray resulted in a significant increase in tolerance to both house dust/house mite allergen (P = 0.01) and grass pollen allergen (P = 0.005). Passive anterior rhinomanometry would seem to offer an easy suitable technique for measuring nasal resistance during nasal provocation tests. PMID- 6505519 TI - Ultrastructural study of immotile cilia syndrome. AB - Recently immotile cilia syndrome has gained the interest of a number of investigators from the aspects of the physiology and pathology of the ciliary movement. This is because microstructural abnormalities of the dynein arms in the cilia of the respiratory mucosal epithelium and in the flagella of sperm tails have been identified in this syndrome. The present study was designed to find a simple clinical method for detecting patients having this syndrome, and was conducted to elucidate the clinical significance and etiology of this syndrome. In order to detect patients with immotile cilia syndrome, 72 patients with one of more conditions such as sinusitis, bronchiectasis, situs inversus and sterility were examined using a ciliary function test and electron microscope observation of the nasal cilia. Seven of the examined patients were diagnosed as having immotile cilia syndrome on the basis of the presence of the characteristic ultrastructural patterns of the nasal cilia, i.e., disorders of the dynein arms. The possibility of positive test results increases greatly as the degree of the complications increases, especially in the case of a combination of chronic inflammation of the respiratory tract with situs inversus and sterility. As the electron microscope findings of this syndrome, Afzelius (1979) has reported defects of the dynein arms, spoke head and central sheath. Beyond these microstructural abnormalities, I have identified abnormal attachment of the dynein arms as a new parameter in the electron microscopic diagnosis of immotile cilia syndrome. PMID- 6505520 TI - M-cells in the epithelium of the nasopharyngeal tonsil. AB - Electron-microscope investigation on the epithelium was carried out in 23 nasopharyngeal tonsils. Adenoidectomy was performed on the ground of recurrent adenoiditis in the interattacks period in 13 boys and 10 girls between the ages of 2 to 4. The presence of five characteristic cellular types was found on the surface of the adenoid epithelium: tall cylindrical ciliated cells; cylindrical cells covered only with microvilli; secretory cells with the predominance of the so-called "dark granules"-producing cells; flat epithelial cells; cubic cells with microvilli on the surface and many vesicles in the cytoplasm. The last type of cells rank together with the M-cells, described by Owen and Jones in the epithelium of Peyer's patches in human beings and found in the palatal tonsil by various authors. A discussion is made on the pinocytary and secretory activity of the M-cells that is being linked with the immunogenesis of the nasopharyngeal tonsil. It is pointed out that in normal conditions the reticulation of the epithelium of the adenoid is found only in the zones that had their surface covered by M-cells. PMID- 6505521 TI - Olfactometry in Japan (II). Roentgenologic and endoscopic observations of the olfactory cleft. PMID- 6505522 TI - [Blalock-Taussig operation using vertebral flap method and modified Blalock Taussig operation]. PMID- 6505523 TI - [Optimal temperature during cardioplegic arrest as a factor for myocardial preservation (II)]. PMID- 6505524 TI - [Experimental study on the optimal sodium, potassium and magnesium concentrations in the cardioplegic solution]. PMID- 6505525 TI - [Clinical experience of oxygenated cold crystalloid cardioplegic solution]. PMID- 6505526 TI - [Roles of potassium and oxygen in hypothermic cardioplegic myocardial protection]. PMID- 6505527 TI - [Is alkalosis necessary for blood cardioplegic solution?]. PMID- 6505528 TI - [Evaluation of blood cardioplegia in view of coronary microcirculation- preliminary report on experimental studies]. PMID- 6505529 TI - [Protection from reperfusion injury--efficacy of extreme hemodilution at the initial reperfusion period]. PMID- 6505530 TI - [Myocardial protection with cold blood cardioplegia]. PMID- 6505531 TI - [Ventricular septal defects with mitral regurgitation]. PMID- 6505532 TI - [Manouguian's aortic annulus enlargement to allow single or double valve replacement--comparison with other surgical procedures]. PMID- 6505533 TI - [A case report of pulmonary embolism after operation of lung cancer]. PMID- 6505534 TI - [A case of mediastinal teratoma with an appearance of intra-pulmonary tumor]. PMID- 6505535 TI - [A case of myasthenia gravis associated with thymoma and thyroid cancer]. PMID- 6505536 TI - [Norwood's operation (phase 1) for a case of hypoplastic left heart syndrome (aortic atresia)]. PMID- 6505537 TI - [Isolated tricuspid insufficiency]. PMID- 6505538 TI - [Leiomyoma of the pulmonary valve]. PMID- 6505539 TI - [Studies on sustained maximal inspiration (TRIFLO II) to prevent postoperative pulmonary complications]. PMID- 6505540 TI - [The sizer for tricuspid annuloplasty]. PMID- 6505541 TI - [Surgery for mitral stenosis and mitral stenosis index]. PMID- 6505542 TI - [Changes in slow cerebral potentials (CNV) subsequent to midazolam administration. Double-blind study]. AB - The result of a study on the modifications of the Expectancy Wave (or Contingent Negative Variation) induced in 10 cases by a new benzodiazepine, midazolam, is reported. A double blind cross-over comparison with placebo has been carried out. The administration of placebo did not give rise to significative variations of the Expectancy Wave after 10, 30 and 240 minutes. The administration of midazolam was followed by a statistically significative reduction of the amplitude of the area and of the maximum peak of the Expectancy Wave. This effect was manifest after 30 minutes from the ingestion of a 15 mg tablet of the drug. After 4 hours both parameters showed again values similar to those observed in basal conditions. Midazolam thus appears to possess a central activity typical of the benzodiazepines group, which is of an early onset and short duration and could be properly utilized on a clinical ground. PMID- 6505543 TI - [Transient global amnesia]. AB - Transient global amnesia is a well known syndrome, characterised by sudden loss of short term memory with retrospective amnesia, that appears in otherwise good healthy subjects. Transient global amnesia is often unknown and misunderstood. Authors explain pathogenetic hypothesis and diagnostic criteria, showing some clinical cases. PMID- 6505544 TI - [Case of hepatic coma with lateral conjugate deviation of gaze]. AB - The forced horizontal deviation of gaze, persisting more then 48 hours, has been observed during a rapidly developing hepatic coma in a patient whose post mortem examination did not reveal any structural lesion involving the central nervous system. PMID- 6505545 TI - [Orbital apex syndrome as a result of fibrous dysplasia of the skull with malignant evolution]. AB - The authors present a case of syndrome of the orbital apex subsequent to a fibrous dysplasia in malignant evolution; they underline the usefulness of T.A.C. in the case, generally extremely rare, of such transformation. PMID- 6505546 TI - [Instrumental diagnosis of multiple sclerosis: correlation between electrophysiologic and cerebrospinal fluid findings]. AB - Since a few years the technique of evoked potentials (PE), both visual (VERs) and acoustic (BAERs), of the encephalic trunk has been introduced in the diagnosis of SM. The electrophysiologic data thus obtained are usefully completed by liquor's ones, often allowing a precocious diagnosis of this disease. In this work the authors compare the results of liquor analyses (dosage of the relation IgG/total proteins; electrophoretic research of Oligoclonic Bands) with those of the PE in 28 patients with suspect SM. The high positive percentages of BAERs (78.8%) and of VERs (90%) in certain multiple scleroses, as well as in suspect multiple scleroses (53.6% and 82.1% respectively), prove the high sensibility of these techniques. The positive percentages of liquor analysis appear to be slightly inferior as to those of evoked potentials, even if these differences are not statistically significant. Besides the authors noticed a high degree of accordance between PE and liquor anomalies (in the cases of defined SM the patients with altered liquor presented at least an altered PE). PMID- 6505547 TI - [Case of "Friedreich's paramyoclonus multiplex". Clinical and neurophysiologic study]. AB - The author reports the case of 13 years old girl, who since at least three years displays very frequent partial involuntary contractions of some arm's and leg's muscles, especially on the right but also on the left side. The girl was examined with EEG and contemporary registration of the myogramm of the muscles in question and with EMG. The DD of the myoclonic syndrome, and especially between Schultze myochimie, Kny's fibrillar myoclonus and Friedereich paramyoclonus multiplex has been discussed. The conclusion was that the case under discussion, is a case of paramyoclonus multiplex of Friedereich. PMID- 6505548 TI - Purification and characterization of human neuron-specific enolase: radioimmunoassay development. AB - Human neuron-specific enolase, NSE, (E.C.4.2.1.11), has been purified from the brain. The method includes a salt precipitation and column chromatography on DEAE Sephacel, Sephacryl S-300, DEAE-Sepharose and Blue-Sepharose. The specific activity of the purified NSE was 51 units/mg protein and the yield was 28%. The molecular weight of human NSE was compared to the bovine form purified by the same procedure. On Sephadex G 150 both human and bovine NSE chromatographed, in the dimeric form, as 77,000 Dalton proteins, while the molecular weight of the monomer was 45,000 Daltons as determined by SDS poly-acrylamide gel electrophoresis. An antiserum, specific for NSE, was raised in rabbits and a radioimmunoassay developed. The contribution of lyzed blood cells to the serum NSE levels in eight healthy donors was determined and correlated with the haemoglobin content. Minimal haemolysis can add 5-10 ng NSE/ ml to the true serum level. For accurate serum NSE determinations, serum samples must be free from haemolysis. PMID- 6505549 TI - Plasma oncomodulin is proportional to tumour burden in rats bearing Morris hepatomas 5123D, 5123tc, 7288 and 7777. AB - The small acidic calcium-binding protein, oncomodulin, was detected by radioimmunoassay in the plasma of rats bearing Morris hepatomas 5123D, 5123tc, 7288ctc, and 7777. The concentration of plasma oncomodulin was proportional to the tumour burden. When the tumour was surgically removed, the plasma oncomodulin level dropped to undetectable levels. No oncomodulin was detected in the circulation of normal rats. PMID- 6505550 TI - Urinary neopterin in the diagnosis and follow-up of neoplasia: a biochemical parameter to detect cell-mediated immune response. AB - Neopterin is excreted at high levels during disease states challenging the T lymphocyte-macrophage system. Stimulation of T-lymphocytes in mixed lymphocyte culture in the presence of macrophages is accompanied by raised neopterin levels in the supernatant. Neopterin may therefore be considered a specific indicator of cell-mediated immunity. Pretreatment analysis of patients with hemopoietic (191), urological (82) and gynecological (224) neoplasia revealed neopterin levels above the upper normal limits, with frequencies ranging from 57% (cervical carcinoma) to 96% (chronic lymphocytic leukemia). In patients with tumors of the genitourinary tract or with hemopoietic neoplasms, urinary neopterin levels were correlated with the tumor burden and became normal when remission was achieved. In gynecological cancer long term follow-up studies showed the value of neopterin excretion levels as a tumor marker. Tumor progression was indicated early by a rising neopterin level. Based on a comparison of different tumor types, the association of cell-mediated immunity and of neopterin excretion levels in less differentiated neoplasm is discussed. PMID- 6505551 TI - [Feeding of children in the schools 1982]. PMID- 6505552 TI - [Biochemical evaluation of zinc metabolism in infants, children and adults. Zinc metabolism balance]. PMID- 6505553 TI - [Chromium content of plant food products from the environs of a copper-processing plant]. PMID- 6505554 TI - [Methods of evaluating vegetable crops in areas of increased emission of pollutants in the Katowice district]. PMID- 6505555 TI - [Harmful substances in cigarette smoke]. PMID- 6505556 TI - [Determination of organophosphate insecticide residues in milk]. PMID- 6505557 TI - [Determination of monensin in eggs]. PMID- 6505558 TI - [Hygienic evaluation of toys for infants]. PMID- 6505559 TI - [Hygienic evaluation of articles made of plastics intended for contact with food]. PMID- 6505560 TI - [Hydrobiological analysis of tap water from communal water supply installations using underground water sources]. PMID- 6505561 TI - [Effect of the quality of drinking water on the health status of the adult population near irrigated fields in the city of Wroclaw. II. Analysis of the studied material]. PMID- 6505562 TI - [Effect of permethrin and borax in food poisons on selected insects of hygienic importance]. PMID- 6505563 TI - [Effect of noise on the results of the visual motor coordination test and coding test in elementary school pupils]. PMID- 6505564 TI - [Diagnosis of eczema in adults]. PMID- 6505566 TI - [Allergologic investigation in eczema]. PMID- 6505565 TI - [Atopic dermatitis in children]. PMID- 6505567 TI - [Treatment of eczema]. PMID- 6505568 TI - [Should borderline hypertension be treated?]. PMID- 6505569 TI - [Characteristics of the treatment of cardiac insufficiency in patients over 70 years of age]. PMID- 6505570 TI - [Echocardiography: key to the diagnosis of congenital cardiopathies in newborn infants and infants]. PMID- 6505571 TI - [Physiopathology, classification and symptoms of pulmonary arterial hypertension in adults]. PMID- 6505572 TI - [Primary pulmonary arterial hypertension. Diagnosis and treatment]. PMID- 6505573 TI - [Way of life of epileptics]. PMID- 6505574 TI - [Automobile driving of epileptics]. PMID- 6505575 TI - [Contraception and pregnancy in epileptics]. PMID- 6505576 TI - [Anticonvulsants in the everyday life of epileptics]. PMID- 6505577 TI - [IgA and transferrin]. PMID- 6505578 TI - [Diagnosis and treatment of chronic active viral hepatitis]. PMID- 6505579 TI - [Primary sclerosing cholangitis]. PMID- 6505580 TI - [Treatment of attacks of biliary colic]. PMID- 6505581 TI - [Diagnosis and natural history of chronic pancreatitis]. PMID- 6505582 TI - [Medico-surgical management of chronic pancreatitis]. PMID- 6505583 TI - [Anatomo-physiological review of the shoulder]. PMID- 6505584 TI - [Radiological examination of the shoulder]. PMID- 6505585 TI - [Peri-articular degenerative pathology of the shoulder]. PMID- 6505586 TI - [Intra-articular degenerative pathology of the shoulder]. PMID- 6505587 TI - [Fractures of the upper end of the humerus]. PMID- 6505588 TI - [Traumatic dislocations of the shoulder]. PMID- 6505589 TI - [Physiopathologic concept of obesity symptoms]. PMID- 6505590 TI - [Can we recognize clinically obese subjects at risk for complications?]. PMID- 6505591 TI - [Resistance to weight loss]. PMID- 6505592 TI - [Drugs and obesity: current status, prospects for the future]. PMID- 6505593 TI - [Obesity: who, when, and how to treat? From strategy to practice]. PMID- 6505594 TI - [Cellular aspects of the aging of the articular cartilage. II. Condylar cartilage with fissured surface taken from normal and arthritic knees]. AB - The authors studied the cellular density (number of cells per mm2) of cartilage taken from the femoral condyles of 46 cadavers (73 knees). In each case, the cartilage was taken from the summit of the condyle and, in 46 joints (27 subjects), a sample was also taken from the posterior surface (non weight-bearing zones). The fragments of non-calcified cartilage were sectioned with a cryostat and the sections (10 micrometers) were stained with hematein-eosin and solid red Alcian blue. This study demonstrates: 1) a decrease in the cellular density of fissured cartilage compared to normal cartilage; this decrease appears to be proportional to the degree of fibrillation; 2) a decrease in the cellular density of apparently normal cartilage from arthrotic joints compared with normal cartilage from healthy joints; 3) with the age of the subjects, an increase in the density of the clones (number of clones per mm2) and the density of clonal cells (number of clonal cells per mm2) together with a decrease in the mean number of chondrocytes per clone. In fissured cartilage, the density of the clones, the density of the clonal cells and the number of chondrocytes per clone are slightly higher on the posterior surface of the condyles than on the summit of the condyles. These results emphasise the importance of the role that might be played by cellular phenomena in the mechanisms of deterioration of cartilage with aging and with arthrosis. PMID- 6505595 TI - [Enthesopathy in inflammatory spondyloarthropathy. Incidence, clinical, radiological and anatomical descriptions. Current status of the question. Apropos of 37 cases]. AB - Based on a series of 37 personal patients and data from the literature, a number of characteristics of enthesopathies can be observed in the course of inflammatory spondyloarthropathies. Our series is based on 20 cases of ankylosing spondylitis (ASP), 8 cases of Fiessinger-Leroy-Reiter syndrome, 8 cases of psoriatic rheumatism (Pso Rh) and one combined form (psoriasis + Reiter + ASP). As well as the frequent involvement of the calcaneus (29 patients), we found more unusual extra-calcaneal localisations in 23 patients. The clinical symptomatology consisted of pain on activity and on weight-bearing at the sites of insertion of the tendons, which were sometimes swollen. The disease was occasionally very incapacitating. The radiological signs consist of lesions of erosion (initially) and reconstruction (subsequently). The histological signs consist of zones of osseous reorganisation and osteo-tendinous inflammatory infiltration. The mechanism of these enthesopathic lesions is still unclear. Our observations are similar to those reported in the literature, which are essentially paediatric studies. Enthesopathy appears to be a diagnostic and lesional element in common with inflammatory spondyloarthropathies (which include ASP, Reiter's Pso Rh, enteropathic rheumatisms and Behcet's disease) and, at least partially, with juvenile rheumatisms. In the latter case, the precocity of the tendinoperiosteal signs seems to be a very important element in the orientation of the diagnosis at the pre-spondylitic stage. PMID- 6505597 TI - [Our experience with unicompartmental knee prostheses. 61 cases]. PMID- 6505596 TI - [How to evaluate the activity of Paget's disease in clinical practice and which patients should be treated?]. AB - In patients with Paget's disease, the alkaline phosphatase level (AP) is a measure of the phosphatase activity throughout the skeleton, i.e. the activity of normal bone tissue as well as that of Pagetic bone, in proportion to their respective volumes. This test therefore greatly under-estimates the activity of Pagetic bone in localized forms of the disease. To accurately evaluate the activity of Pagetic bone, the value of AP needs to be expressed in terms of the percentage of bone tissue affected by the disease. Two tables enable us to assess this percentage approximately. It is therefore possible to evaluate the activity of Pagetic bone on the basis of the tables presented by the authors. We can see that localized forms of Paget's disease may have an alkaline phosphatase activity of 2 000 or 3 000 I.U., while the AP levels in the blood are less than 200. So, in the presence of localized forms of the disease, we are unable to say that the disease is barely active on the basis of very low values for AP. It is important to treat localizations which have a "functional" risk for the future, especially when there localizations are highly active. The histopathological and scintigraphic data are compatible with areas of ery high activity. A similar rationale should be applied to the figures obtained for urinary hydroxyproline and the results of 45Ca kinetic studies. PMID- 6505598 TI - [New data on stress fractures. Apropos of a case of a bilateral talus stress fracture. Value of bone scintigraphy in the diagnosis of stress fractures]. PMID- 6505599 TI - [A case of fibrous bone dysplasia associated with a soft tissue fibromyxoma detected simultaneously]. PMID- 6505600 TI - [Osteoid osteoma of the spine. Clinical, radiological, isotopic and x-ray computed tomographic study. Apropos of a case simulating spinal cord compression. Review of the literature]. PMID- 6505601 TI - [Long-term treatment of systemic scleroderma with coagulation factor XIII. Developmental monitoring, especially of respiratory function]. PMID- 6505602 TI - [Anthropometric criteria in the diagnosis of malnutrition in child care programs]. PMID- 6505603 TI - [Prevalence of hypovitaminosis A in preschool children of a municipality of the metropolitan area of Sao Paulo, Brazil]. PMID- 6505605 TI - [Preventive activities in vision problems of school children]. PMID- 6505604 TI - [Enterotoxigenic Staphylococcus aureus in the nasal vestibule of food handlers in hospital kitchens of the municipality of Joao Pessoa, Paraiba]. PMID- 6505606 TI - [Leukocyte migration inhibition test after BCG in patients with liver diseases]. PMID- 6505607 TI - [Active lymphocytes in chronic liver diseases]. PMID- 6505608 TI - [Dibromodulcitol in combination with actinotherapy of spinocellular carcinoma]. PMID- 6505609 TI - [Diagnosis of lymph node metastases in patients with carcinoma of the prostate]. PMID- 6505610 TI - [Possibilities of the quantitative assessment of sites with an increased concentration of 85Sr in the skeleton using whole body profilography]. PMID- 6505611 TI - [Stuttering in inborn defects of amino acid metabolism]. PMID- 6505612 TI - Scanning electron-stimulated desorption microscopy of red blood cells. AB - Scanning electron-stimulated desorption (SESD) has been used to image the surface of unfixed red blood cells with high surface specificity and with a lateral spatial resolution of less than or equal to 1 micron. The micrographs were obtained using a scanning Auger microprobe with an appended secondary ion mass spectrometer (SIMS). The instrument was operated at low electron beam energies (2 kV) to maximize electron-stimulated desorption probabilities and minimize the interaction of the electrons with the biological substrate. ESD spectra from the surface of red blood cells prepared from smears of whole blood show H+ as the predominant desorbed positive ion and O+, OH+, H3O+, Na+, and Cl+ as secondary species. SESD images and line-scans obtained with the above ion signals demonstrate that SESD can be used to map the surface chemistry of cells at submicron resolution. The parent molecules contributing to the desorbed ion signals are shown to originate from the first few atomic layers of the cell surface and are believed to be components of the blood plasma (H2O, NaCl, etc.) which coalesced onto the cells as they dehydrated in the vacuum chamber of the microprobe. An interesting extension of this work is the possibility of mapping the concentration of adsorption sites of specific cell-surface binding species using ESD labels. PMID- 6505613 TI - Trypan blue method for the identification of areas of damage to airway epithelium due to mechanical trauma. AB - A method has been developed for locating the regions of pulmonary epithelial damage due to mechanical trauma, based on the inability of the injured cells to exclude vital stains such as trypan blue. Scanning electron microscopy was used to confirm the sites, as well as the specific type of mechanical damage. The damaged area on rabbit tracheal epithelium due to gentle stroking was characterized by denudation of the ciliated epithelial cells, leaving only a layer of flat, non-ciliated cells. Repeated gentle stroking of the epithelial surface removed all the epithelial cells, exposing the underlying connective tissue layer. The trypan blue method provides a fast and sensitive means of locating damaged airway epithelium due to mechanical trauma. Because the dye is non-toxic, the repair process of the epithelium can also be studied, following the initial assessment of the extent of epithelial damage. PMID- 6505614 TI - Radiation damage in rat kidney microvasculature. AB - Scanning electron microscopy (SEM) combined with a specialized polymer injection casting technique permits the analysis of radiation induced damage in rat kidney glomeruli. A lead shielding device is constructed to enable the irradiation of the living rat left kidney, while the remainder of the animal is shielded from the dose, the right kidney serves as a control. The source of radiation is 137Cs which produces 0.66 MeV gamma-rays to achieve a kidney dose of 100 rad and 5000 rad in these experiments. Radiation damage to kidney glomeruli is assessed at intervals of 0, 1, 3 and 7 days post-irradiation at the two dose levels. It is found that radiation damage to kidney glomeruli is expressed morphologically at 7 days post-irradiation at the 100 rad dose level, while glomerular damage is apparent as early as 3 days post-irradiation at the 5000 rad dose level. Moreover, by 7 days post-irradiation with a 5000 rad dose, the kidney glomerulus thoroughly degenerates to a leaky fused mass of vessels. From a morphological viewpoint, kidney glomeruli are significantly more sensitive to radiation than surrounding vasculature. The methods developed here for assessment of radiation damage are highly repeatable and could serve as a standard technique in radiobiology. PMID- 6505615 TI - Mammalian cell growth on collagen-hydrogels. AB - Hydroxyethylmethacrylate (HEMA) hydrogels have a peculiar crater-like topography which renders them ideal for studying cell-to-substrate contact formation. Cultured rabbit aortic smooth muscle cells (SMC) were grown on collagen-HEMA hydrogels, and the ultrastructure of developing cell attachment sites was studied. By 3 hours after cell seeding, both the rounded and spreading SMC appeared anchored to the hydrogel via extra-cellular connective tissue-like material. The fully formed attachment site present at 5-8 day was characterized by large bundles of intracellular myofilaments inserting onto areas of increased electron density along the plasmalemmal membrane. Large amounts of extracellular connective tissue-like material also appeared attached to the areas of increased electron density. Fully formed cell substratum attachment sites were not observed when either elastin-HEMA or hydrogels polymerized in the absence of protein were employed. The growth and collagen synthesis by human embryonic lung fibroblasts (IMR-90) and endothelial cells on collagen-HEMA hydrogels and tissue culture plastic were also examined. Although the two cell types grew equally well on the two surfaces, differences in protein synthesis were observed. The procollagen Type I and III ratio synthesized by the fibroblasts remained the same while the ratio synthesized by the endothelial cells varied even though their morphology appeared similar. The fibroblasts synthesized less collagen when grown on collagen-HEMA hydrogels (this effect may be related to age), while the amount of collagen synthesized by the endothelial cells grown on the two surfaces was similar. PMID- 6505616 TI - Fibroblast-collagen sponge interactions and the spatial deposition of newly synthesized collagen fibers in vitro and in vivo. AB - Fibroblast-collagen sponge interactions were studied in cell culture and dermal wound systems. In both models fibroblasts appear to adhere, attach and orient in the presence of type I collagen fibrils. In the presence of fibronectin, purified from bovine blood, adhesion and alignment of fibroblasts appeared to be enhanced as well as the deposition of thick collagen fibers. When collagen sponges were grafted onto full thickness dermal wounds the granulation tissue that was laid down within the collagen sponge appeared to differ from granulation tissue laid down below the collagen sponge or on similar wounds in the absence of a sponge. In the absence of a collagen sponge the granulation tissue is characterized by wavy collagen fibers that exhibit an extinction pattern characteristic of crimped fibers found in tendon when examined under polarized light. In contrast, collagen fibers laid down within the sponge appear to be highly oriented and lack evidence of crimp. These results suggest that the presence of a collagen matrix acts as a template that allows for the organized spatial deposition of newly synthesized collagen fibers. The enhanced biosynthesis of thick collagen fibers in the presence of a collagen sponge containing fibronectin may decrease the remodeling phase that is associated with dermal scarring. PMID- 6505618 TI - Inhibition of platelet shape-change by sodium thiamylal. AB - Canine platelets were treated in vitro with sodium thiamylal and allowed to surface activate on glass coverslips. Platelet surface activation was markedly inhibited by sodium thiamylal at concentrations as low as 2 X 10(-4) M and this inhibitory effect was most pronounced after pretreating the platelets for 30 minutes with sodium thiamylal. Treatment with sodium thiamylal prevented spreading platelets from reaching the fully spread stage. Additional experiments demonstrated that sodium thiamylal need not be present in the medium during the activation process in order to exert its effect. Preliminary platelet aggregation studies show sodium thiamylal in the 10(-4) - 10(-3) M range to be capable of inhibiting aggregation induced by adenosine diphosphate. PMID- 6505617 TI - Morphology of rabbit endocervical mucosa after mating. AB - The distribution and morphology of rabbit endocervical mucous cells before and after mating were studied histochemically with Alcian blue, pH 2.5, and periodic acid-Schiff (AB-PAS) and by scanning and transmission electron microscopy. Before mating, the lower and upper segments of the endocervical canal contained approximately 75% and 93% of cells engorged with AB-PAS positive granules. Two hours after mating, the percentage of histochemically positive cells decreased to less than 46% and 85%, respectively. Before insemination, mucous cells were prominent among ciliated cells and contained numerous secretory granules some of which appeared to be undergoing release through exocytosis. Granule-engorged apices of mucous cells were rarely seen after insemination. Instead, cells displayed a markedly reduced complement of mucous granules and their apical surface contained numerous exocytotic pits. In many areas, a blanket of mucous material covered mucous and ciliated cells. As for the observed variation in mucous cell distribution, these changes were predominant in the endocervical mucosa of the lower cervix. We have previously shown that both native and isolated mucous cells respond to serum with rapid and massive granule release. Degranulation of endocervical mucous cells in response to semen may play an important role in regulating sperm access to the upper reproductive tract under physiologic and pathologic conditions. PMID- 6505619 TI - Morphological characteristics of initial lymphatics in the tongue as shown by scanning electron microscopy. AB - The subepithelial lymphatics of the rat tongue were examined by scanning electron microscopy in interstitially fixed tissue and corrosion casts. In tissue preparations fixed at low interstitial pressures, the endothelium exhibits broad and flat cells with serrate endothelial borders. In the course of the intercellular border system, simple junctions and overlapping zones occur. The latter have the appearance of pocketings. In tissue fixed at high interstitial pressures of up to 75 mm Hg, many endothelial cells become bulged and show long or short processes. The pocketings disappear and are replaced by openings which are covered by a fine fibrous network surrounding the vascular wall. The plexus like arrangement of the subepithelial lymphatics of the tongue can well be demonstrated in corrosion casts. The vascular system consists for the most part of capillary vessels anastomosing like a net or terminating blindly in rootlets. The imprints of endothelial nuclei and cellular borders as well as of valve patterns in the casts enable a good differentiation between vascular and interstitial structures. The findings on the special morphological characteristics of the initial lymphatics are also discussed under functional aspects. PMID- 6505620 TI - Scanning electron microscopy of the normal and experimentally infected ocular surface. AB - Scanning and transmission electron microscopy were used to characterize the normal pup and adult mouse ocular surface. Various fixatives were examined and categorized into those which stabilize and preserve ocular mucus associated with surface corneal epithelial cells and those which do not, but allow good visualization of surface detail for scanning electron microscopy. Desquamation patterns of corneal epithelial surface cells in the mouse pup and adult were examined, compared with each other and with desquamation patterns originally reported for several other animal species. Once the normal cytoarchitecture of the corneal surface and its associated ocular mucus was established for the mouse pup and the adult animal, the murine ocular response to P. aeruginosa infection was studied. Those studies revealed that in the pup, after inoculation of bacteria beneath the eyelid, with no corneal scarification, organisms adhered preferentially to young surface cells and quickly penetrated the corneal and conjunctival epithelium. In contrast, scarification of the corneal surface had to precede topical bacterial inoculation for infection to occur in the adult cornea. In this model, bacteria adhered initially to the wound site and to aged cells but did not preferentially adhere to young surface cells. An extracellular virulence factor, exotoxin A, produced by the bacteria, was also examined to determine its role in P. aeruginosa pathogenesis. Studies using toxin A, have shown that it was capable of inducing epithelial and endothelial cell death and corneal necrosis in the adult scarified cornea. In the pup, where no scarification preceded toxin A challenge, little corneal epithelial damage was produced when compared with the infection model. Nonetheless, as with bacterially challenged pups, experimental toxin A treated animals died within 24 hr following toxin administration. PMID- 6505621 TI - Low resolution scanning electron microscopy of cerebellar neurons and neuroglial cells of the granular layer. AB - Teleost fishes, Arius Spixii and Salmo trout and adult Swiss albino mice have been processed with the freeze-fracture technique for SEM to explore the inner cytoplasmic and nuclear surface details of neurons and neuroglial cells. The specimens were fixed by vascular perfusion with Karnovsky fixative and 2-3 mm thick cerebellar slices were subsequently fixed by immersion in the same fixative. They were postfixed in osmium tetroxide, dehydrated in ethanol, frozen in Freon 22, cooled by liquid nitrogen and fractured. After thawing in ethanol, they were critically point dried, coated with gold-palladium and viewed by SEM. The surface features of perikaryon were examined at low resolution and magnifications. The image of endoplasmic reticulum, GERL complex and chromatin were described in fractured cerebellar neurons (granule and Golgi cells). The fractured protoplasmic astrocytes displayed a characteristic glass surface appearance of cytoplasmic body and processes, which facilitated their recognition at the neuropile and perivascular region. The oligodendrocytes appeared as fusiform cells depicting a thin rim of perinuclear cytoplasm. The surface view of endoplasmic reticulum was well studied at the nuclear poles. Fine cytoplasmic beaded canaliculi appeared connecting the outer surface of nuclear envelope with the plasma membrane inner surface. The nucleus exhibited well developed peripheral heterochromatin masses forming anastomotic bands separated by vacuolar spaces. The SEM nerve and neuroglial cell fractographs were compared with similar images obtained by conventional transmission electron microscopy and freeze etching technique. PMID- 6505622 TI - Microscopic observation of cochlear hair cell motility. AB - Inner and outer hair cells were dissociated from mammalian organ of Corti and maintained using cell culture techniques. Micro-video recording was used to study motile responses in outer hair cells that were evoked by intra- and extracellularly injected electric currents and by iontophoretic application of acetylcholine. When intracellular current injections were made in the synaptic end of cells, the cells became shorter in length and wider in diameter in response to depolarizing currents and longer and narrower in response to hyperpolarizing currents. Transcellular stimulation with alternating currents could result in either length increase or decrease and in some cells the direction of the evoked response depended on the stimulus frequency. Iontophoretic application of acetylcholine to the synaptic end of outer hair cells also evoked shape changes. Inner hair cells and other cells from the organ of Corti were non-motile. The evoked motile response of outer hair cells may produce a portion of the mechanical energy required for the sharp tuning and low threshold of mammalian hearing and suggests that outer hair cells have an effector as well as a sensory function. PMID- 6505623 TI - Scanning electron microscope specimen preparation technique for dissociated strial marginal cells. AB - Single strial marginal cells from the cochleas of guinea pigs and chinchillas were successfully isolated in tissue culture medium using the enzyme dissociation technique. Such single cells were successfully preserved for scanning electron microscopic observation in special glass wells following the freeze drying technique. Judging by transmission electron microscopic examination of such cells, the ultrastructural preservation of the dissociated strial marginal cells was excellent. PMID- 6505624 TI - Chronic electrical stimulation of the chinchilla cochlea. AB - The scanning electron microscope (SEM) was used to investigate morphological changes to the chinchilla cochlea following chronic extracochlear electrical stimulation. Silver ball electrodes were placed on round window membranes and various types and levels of electrical pulsatile stimulation was given. Positive or negative square wave pulse (with DC offset) stimulation caused severe damage to the organ of Corti. In the most severely damaged area, most outer hair cells were missing and degenerative changes to pillar cells were observed. Some damage to the inner hair cells was also evident. These changes were limited to the basal turn. Some damage to stereocilia of first row outer hair cells was seen when symmetrical, biphasic, charge balanced pulses were used. PMID- 6505625 TI - Scanning electron microscopy of urinary calculi--some peculiarities. AB - Within the scope of the investigation of more than 1,500 urinary calculi by scanning electron microscopy (SEM), some peculiarities arose concerning secondary phase transitions and morphology of some of the crystalline phases present. There is evidence for a phase transition from Ca-oxalate dihydrate to the monohydrate form in oxalate rich stones. This is characterized by a transitional zone, in which often relatively large monocrystals of newly formed whewellite are found, sticking within weddellite crystals with typical dissolution signs. We conclude that the phase transformation is regulated by dissolution and recrystallization. In mixed uric acid / uric acid dihydrate stones, occasionally parallel growth of apparently two different kinds of crystals upon each other can be observed, which possibly are uric acid crystals grown epitaxially on uric acid dihydrate. A few nearly pure whewellite stones with little Ca-phosphate at the central core show tubules which obviously had been part of a calcified renal papilla and so had been acting as a nidus for stone formation. Bacterial footprints as well as calcified bacteria have only been found in apatite containing stones of patients with urinary tract infections by Escherichia coli. These bacteria are likely responsible for the origin of these footprints. PMID- 6505626 TI - Range and clinical significance of the number of myeloid-committed stem cells in the blood of patients with acute leukaemia in remission. AB - Circulating granulocyte/macrophage progenitor cells (CFU-GM) were assayed serially during remission in 17 patients with acute leukaemia (9 ALL, 8 AML). In patients with ALL receiving cyclophosphamide, 6-mercaptopurine and methotrexate, CFU-GM numbers were significantly lower than in normal individuals; cycles of 'reinduction' chemotherapy (vincristine, prednisolone) caused a 10-fold increase in CFU-GM per ml of blood. In 2 ALL patients a substantial increase in CFU-GM numbers preceded the morphologically detectable relapse. In patients with AML receiving repeated courses of cytosine-arabinoside and 6-mercaptopurine, circulating CFU-GM were likewise reduced. In 6 patients who relapsed, a further reduction of CFU-GM was seen. A complete absence of circulating CFU-GM was observed in 10 of the 23 investigations performed within 6 weeks prior to the morphologically detectable relapse, while such a 'zero'-growth occurred in only 1 of 54 experiments performed during stable remission. In summary, in patients with ALL in remission, circulating CFU-GM are increased following treatment with vincristine and prednisolone. In patients with AML, declining numbers of circulating CFU-GM may predict an imminent relapse. PMID- 6505627 TI - Iron overload and lysosomal stability in beta zero-thalassaemia intermedia and trait: correlation between serum ferritin and serum N-acetyl-beta-D glucosaminidase levels. AB - Increased iron storage represents a characteristic condition in patients with beta zero-thalassaemia intermedia. Iron overload is an important factor in cellular damage. Recent studies have shown an enhanced lysosomal fragility due to increased iron storage. 13 patients with beta-thalassaemia intermedia, aged 17-44 years, were studied. Both serum ferritin and serum N-acetyl-beta-D glucosaminidase levels were evaluated in all subjects studied. A significant linear correlation (P less than 0.05) between serum ferritin and serum N-acetyl beta-D-glucosaminidase levels were found. PMID- 6505628 TI - Serum ferritin in Danish children and adolescents. AB - Serum ferritin concentrations were measured in 909 urban Danish schoolchildren (451 boys, 458 girls) 6 to 17 years old. The children had been randomly selected and served as an urban reference population. Geometric mean ferritin values were identical in boys and girls 6 to 15 years old, while 16- and 17-year-old boys had higher values than girls (P less than 0.01). There was a slight rise in mean ferritin values from 6 to 11 years, followed by a temporary fall during the subsequent adolescent growth period. Geometric mean ferritin values and significant differences were as follows: Children 6 to 11 years old (n = 335), 29 micrograms/l and adolescents 12 to 15 years old (n = 417), 26 micrograms (P less than 0.01): Adolescent boys 16 to 17 years old (n = 76), 32 micrograms/l and adolescent girls same age (n = 81), 24 micrograms/l (P less than 0.01). The frequencies of low ferritin values less than 10 micrograms/l (i.e. exhausted iron stores) were: Children 6 to 11 years old, 2.1%: Adolescents 12 to 15 years old, 5.0%: Adolescent boys 16 to 17 years old, 0.0%: Adolescent girls 16 to 17 years old, 11.1%. High ferritin values greater than 60 micrograms/l (i.e. large iron reserves) were observed in 6.2% of boys and 6.9% of girls. PMID- 6505630 TI - Characterization of erythroid and granulocyte monocyte progenitors in human cord blood. AB - Some characteristics of both erythroid and granulocyte monocyte progenitors in human cord blood were compared to those in adult blood and bone marrow. The number of progenitors in cord blood was higher than that in adult blood and bone marrow. Most colonies in cord blood culture were monocyte-macrophage, whereas those from adult blood were largely eosinophilic. Cord blood progenitors had a slower sedimentation velocity than that reported for marrow, but sedimented faster than that for adult blood. A significant proportion of progenitors in cord blood as well as adult marrow was found to be in the DNA synthetic phase of the cell cycle whereas progenitors in adult blood were not. Cord blood BFU-E were more resistant than adult blood BFU-E but cord blood CFU-GM were not different from adult blood CFU-GM with regard to radiation sensitivity. Cord blood CFU-GM appeared to be more radio-resistant than adult marrow GFU-GM. From these results is seems clear that progenitors in cord blood differ in some aspects from those in adult blood and bone marrow. PMID- 6505629 TI - The effect of tetradecanoyl-12, 13-phorbol acetate on 'hairy' cells. AB - Hairy cell leukaemia (HCL) cells on exposure to the tumour promoter tetradecanoyl 12,13-phorbol acetate (TPA) undergo a striking morphological change in culture, with the formation of long, slender cytoplasmic processes, and adhere to the plastic surface. By time lapse photography this change is seen to start within 10 min of exposure to the TPA and is characterised by slow but continuous extension and retraction of the processes. Apparent phagocytosis of sheep red cells but not of sensitised human red cells occurs. This response to TPA is prevented by cytochalasin D but not by 13 cis-retinoic acid. Lymphocytes from normal individuals and patients with chronic lymphocytic leukaemia and lymphoblasts from a patient with acute lymphoblastic leukaemia reacted by adhering to each other in small aggregates but did not adhere to the plastic surface. Monocytes adhere to plastic surfaces and respond to TPA by extension and retraction of cytoplasmic folds differing from the long slender processes formed by the HCL cells. Thus HCL cells are different in their response to TPA from both normal lymphocytes and monocytes. PMID- 6505631 TI - Diabetes insipidus in the preleukaemic phase of acute non-lymphocytic leukaemia. A monosomy 7-associated condition? PMID- 6505632 TI - Transcobalamin II deficiency in infancy and the diagnostic value of serum B12 binders. PMID- 6505633 TI - Haemolysis in a G6PD-deficient child induced by eating unripe peaches. AB - A child suffering from G6PD deficiency developed a severe haemolytic crisis without an apparent trigger. The possible pathogenetic role of the ingestion of unripe peaches was studied biochemically in this anaemia. We show that an extract from the unripe peach exerts an oxidative challenge on normal as well as on asymptomatic G6PD-deficient erythrocytes. This effect is analogous to that of the favism-inducing agents. The effect of the extract on the patient's red blood cells was more pronounced than on other asymptomatic G6PD-deficient erythrocytes, particularly during his haemolytic crisis. The chemical nature of the deleterious component was not identified. It is suggested that unripe peaches be added to the list of hazards for G6PD-deficient subjects in combination with other factors. PMID- 6505634 TI - Testicular function in young men in long-term remission after treatment for the early stages of Hodgkin's disease. AB - 16 young men in long-term remission after standard treatment for the early stages of Hodgkin's disease were examined for testicular function 48 to 125 months after termination of therapy. The patients had received mantle field irradiation, plus either irradiation of infradiaphragmatic lymph nodes (7 patients) or 6 cycles of MOPP (9 patients). 5 patients had almost normal semen quality judged by seminal fluid analysis. 11 patients had reduced semen quality (8 severely reduced) and often elevated FSH values. Semen samples of poor quality were significantly more common in patients treated with MOPP (7/9) than in those treated with infradiaphragmatic irradiation (1/7). One patient showed signs of regeneration of spermatogenesis. None had experienced reduction in libido and sexual performance after therapy; correspondingly, none had below normal testosterone values or elevated LH values. Patients should be informed about the risk of infertility before treatment. If in a given case several treatment options with equal prospective antineoplastic effect are weighed against one another, the patient's possible desire to retain fertility should favour the use of radiotherapy as opposed to chemotherapy, especially including alkylating agents. PMID- 6505635 TI - Yeast cell phagocytosis by mononuclear leucocytes from peripheral blood: significance of the substrate. AB - Lymphoprep-isolated mononuclear leucocytes (L-MNs) from peripheral blood of healthy donors were mixed with yeast cells and filmed by time-lapse microcinematography in glass chambers at +37 degrees C. The concentration of L MNs and yeast cells was lowered so as to make directional L-MN movement (chemotaxis) a necessary condition of phagocytosis. 54 cases of phagocytosis were filmed. Only yeast cells lying immobile on the glass surface were engulfed. In addition, 11 collisions between free-floating yeast cells and glass-adherent L MNs were noted. None of these collisions led to immediate engulfment. It is suggested that the process of phagocytosis requires prolonged leucocyte-prey contact, in the order of magnitude of 3 to 5 seconds. PMID- 6505636 TI - Red cell basic ferritin content of patients with megaloblastic anaemia due to vitamin B12 or folate deficiency. AB - The basic ferritin content of red cells was measured in patients with untreated megaloblastic anaemia. The red cell ferritin of 10 patients with anaemia and vitamin B12 deficiency (mean 579, range 68-2616 attogram (ag)/cell); and of 8 patients with folate deficiency (mean 792, range 141-2373 ag/cell) were significantly elevated (P less than 0.001) compared with normal subjects (mean 10.7, range 4-47 ag/cell) and showed a significant correlation with pre-treatment levels of plasma ferritin and less so with percent transferrin saturation. Following vitamin replacement elevated red cell ferritin levels decreased during the period of reticulocytosis and was normal in 9 patients evaluated after 6 months. The magnitude of increase in red cell basic ferritin levels observed in untreated megaloblastic anaemia is comparable to that of subjects with idiopathic haemochromatosis and suggests that interpretation of this index for iron overload should take into consideration concomitant body folate or vitamin B12 status. PMID- 6505637 TI - International Committee for Standardization in Haematology/International Committee on Thrombosis and Haemostasis: ICSH/ICTH recommendations for reporting prothrombin time in oral anticoagulant control. PMID- 6505638 TI - Impact of renal function on the myeloma staging. PMID- 6505639 TI - Purification of cytostatic protein factors released from human monocytes. AB - Human monocytes release cytostatic protein factors (CF) upon activation with lymphokines and lipopolysaccharide. CF has been purified from monocyte supernatants by ion-exchange chromatography, chromatofocusing and gel filtration, and this resulted in a 10,000-fold reduction in the amount of protein in the purified CF preparation compared to the amount in the monocyte supernatant. About 5% of the cytostatic activity was recovered after purification. CF constitutes a population of proteins heterogeneous with respect to ionic charge and differing in their isoelectric points, since CF eluted as a broad peak both upon ion exchange chromatography and chromatofocusing. The isoelectric points of the CF proteins were determined by chromatofocusing to be between 6.0 and 5.0. The molecular weight of CF as determined by gel filtration was in the range of 45,000 to 35,000 daltons. Only one monocyte-secreted protein with a molecular weight of 40,000 was detected upon sodium dodecyl sulphate-polyacrylamide gel electrophoresis of proteins in the purified CF preparations obtained after the final gel filtration step, and this protein may consequently be CF. If the 40,000 dalton protein is CF, one may estimate that about 10(6) monocytes produced roughly 0.1 microgram CF upon activation and that significant cytostasis may be detected with less than nanogram quantities of CF. PMID- 6505640 TI - Stimulatory effect of immobilized glycans on macrophages in vitro. AB - Mouse macrophages were cultured on chemically modified plastic dishes. On dishes covered with immobilized glycans, the macrophages were stimulated as judged by increased 14C-glucosamine incorporation, increased cytostatic and cytolytic capacities and by morphology as seen by scanning electron microscopy. The corresponding soluble glycans did not have the capacity to stimulate macrophages as measured by these criteria. Plastic surfaces covered with polyethylenimine showed stimulation of the macrophages with regard to some of the parameters measured. These results may indicate that the stimulation is a multistep process and that, contrary to earlier findings, it is not a prerequisite for stimulation that the glycan be intracellular. The results support the idea that a fixed steric arrangement of glycans is necessary for the stimulation of macrophages in vitro. PMID- 6505641 TI - The urethral pressure profile during flow. An experimental study. AB - As part of a project aimed at developing a method for accurate evaluation of the position and significance of infravesical outflow obstructions, a technique for recording urethral pressure profiles during flow in male patients was tested in a rigid bladder-urethral model. The catheter which proved to give the most accurate recording of the static pressure in the urethral model had a measuring eye about 250 mm from the tip. With this arrangement, the tip of the catheter did not leave the bladder until the measuring eye had passed the whole length of the urethra and the effective diameter of the urethra and the flow did not change during the recording. The pressure profiles for the different urethral models closely resembled the theoretically calculated curves. Furthermore, the constant recording conditions made it possible to compensate for the influence of the measuring catheter and to calculate the "true" diameter as well as the "true" resistance in different segments of the models. PMID- 6505642 TI - Penile implants in erectile impotence: outcome and prognostic indicators. AB - In a prospective, multi-disciplinary study thirteen men with protracted, organic erectile impotence were examined before and after penile implantation. Outcome after one year was judged as favourable in nine, doubtful in two, and unfavourable in two cases. Neurotic functioning was unexpectedly common in the group and the more neurotic subjects fared less well after surgery and reported less benefit from it. Findings in the preoperative psychiatric examination that correlated significantly with unsuccessful outcome were immature and neurotic, particularly hysterical traits, low sexual drive, low sexual activity, disavowal of ambivalence towards penile implantation and high "femininity" scores on a sex role inventory, the Gough Femininity Scale. PMID- 6505643 TI - Reproducibility and reliability of urinary incontinence assessment with a 60 min test. AB - Urinary incontinence was objectively assessed in 50 patients. The urine loss was measured as weight gain of perineal pads worn during a 60 min standardized activity period. The test was initiated by drinking 500 ml (not milk and soda water). The patients were instructed not to void before and during the test. After the test, the voided volume was collected. The test proved handy, reproducible and reliable compared to the subjective day-time incontinence. Prior to the actual test, 15 patients participated in a pilot study having an initial voiding and a test period of 3 1/2 hours. This longer test period was not found practical and the gain in positive diagnosis was minimal compared to the disadvantages with a higher number of unscheduled voidings. PMID- 6505644 TI - Acute effects of full urinary bladder and full caecal urinary reservoir on regional renal function. A study with scintillation camera renography. AB - Scintillation camera renograms were recorded in six patients without a history of bladder function disturbances and in eight patients with caecal urinary reservoir. Each patient was studied once with empty bladder/reservoir and once with full bladder/reservoir. Renograms were obtained from parenchyma, pelvis and whole kidney. Time was measured from injection of isotope to peak of the renogram curve (Tmax) and to the point corresponding to the centre of gravity of the area under the curve (Tg). A full reservoir gave longer Tmax and Tg for both parenchyma and pelvis than an empty reservoir. With full bladder the only significant change was Tg increase for renal pelvis. In the patients with full caecal reservoir, the elimination of radioisotope from the renal pelvis was significantly slower, reflected as longer Tmax and Tg, than in the subjects with full bladder. In comparisons between empty and full bladder/reservoir, Tg permitted clearer separation between the groups than did Tmax. The higher Tmax and Tg values for full than for empty reservoir indicated obstruction to urinary flow and could be ascribed to the high intrareservoir pressure. Regularly occurring pressure waves with amplitudes of 30-65 cm H2O were recorded in the reservoirs, sometimes reflected as transient increases in radioisotope activity in the renograms. In some patients the two kidneys differed considerably in their response to a full urinary bladder or reservoir. The cause may have been difference in the dynamics of the two ureterovesical junctions or of the ureterointestinal anastomoses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505645 TI - Renal function after urinary diversion. A study of continent caecal reservoir, ileal conduit and colonic conduit. AB - Total and separate renal function, renal parenchymal thickness and dilatation of the upper urinary tract were studied in 40 patients preoperatively and 24 to 67 months after urinary diversion, using 51Cr-EDTA clearance test, scintillation camera renography and urography. In ten patients a continent caecal reservoir was used for diversion. In the other patients, an ileal or a colonic conduit (15 patients with each method) was used, one ureter being implanted with an anti reflux method and the other with direct technique. Renal function following urinary diversion showed little or no deterioration in most patients. The functional outcome was not related to the method of diversion or, in the conduit groups, to the mode of ureteral implantation. Serum creatinine tests and urography were not adequate for determining loss of renal function. Radionuclide studies proved to be valuable for assessing renal function after urinary diversion. PMID- 6505646 TI - Surgical alleviation of ureteric obstruction in idiopathic retroperitoneal fibrosis. An analysis of 9 cases. AB - Nine patients with retroperitoneal fibrosis were reviewed. All patients had idiopathic disease, bilateral in eight patients. An IVP on admission was normal in only one of 17 kidneys with delayed excretion in seven. The upper urinary tract was dilated in eight kidneys and no excretion of contrast medium was seen in four; another four kidneys were not examined by IVP because of uremia. Surgical alleviation of ureteric obstruction was carried out by ureterolysis alone (2 ureters), ureterolysis and lateral displacement of the ureter (2 ureters), ureterolysis and neoimplantation into the bladder (2 ureters), ureterolysis and intraperitonealization (2 ureters), and ureterolysis and omental wrap (7 ureters). After surgery, an IVP showed normal excretion in six of the seven kidneys with delayed excretion preoperatively. Two of the four preoperatively nonfunctioning kidneys also showed normal excretion at IVP. Of the four kidneys not preoperatively examined by IVP because of uremia two showed a normal excretion on postoperative IVP. Two ureters developed recurrent obstruction and required additional surgery whereas 10 ureters remained unobstructed in the follow-up period of 26-89 months. Our experience suggests that complete and extensive ureterolysis combined with omental wrapping gives the best results on a long-term basis. PMID- 6505647 TI - Indomethacin as prophylaxis against recurrent ureteral colic. AB - In a prospective, randomized study, the prophylactic effect of indomethacin (150 mg daily) in regard to recurrence of ureteral colic was investigated in 78 patients. Severe recurrent attacks were experienced in 78 patients. Severe recurrent attacks were experienced by 4 of 37 patients in the test group and by 16 of the 41 controls without indomethacin. The mean duration of recurrent pain including the severe attacks was 5.6 +/- 1.1 hour/patient/week in the test group and 12.5 +/- 2.9 in the control group. Passage of stone within 7 days was not influenced by indomethacin (22/37 and 25/41 cases). Indomethacin administration for 7 days after an acute attack of ureteral colic thus reduced the frequency of severe attacks and the total duration of recurrent pain, without influencing the stone passage. PMID- 6505648 TI - Renal pelvis pressure flow relationship in pigs after transsections of the ureter. AB - The relationship between pressure and flow of the multicalyceal renal pelvis of the pig was investigated in 10 units. The relationship was studied in the intact system and after three consecutive transsections of the ureter 3 cm proximal to the ureterovesical junction, at the lower pole of the kidney and as proximal on the renal pelvis as possible. The mean resting renal pelvic pressure changed from 7.3 to 8.8 cm H2O when a distal transsection was performed. The resting pressure after proximal transsection and pelvic transsection was 8.0 and 6.5 cm H2O respectively. During perfusion the intact system as well as the distal transsection showed a three-phased relationship. In the latter the phases showed a shift to the right and the renal pelvic pressure was significantly decreased at flow rates from 4-10 ml/ureter/min. Perfusion after proximal transsection and pelvic transsection caused only minor increases in the renal pelvic pressure approximating a linear relationship. The study confirms a three-phased relationship between pressure and flow in renal pelvis and a resistance to high flow rates depending on the length of the ureter. PMID- 6505649 TI - Angiographic staging in renal cell carcinoma. A retrospective study of 96 patients. AB - The International Union Against Cancer (UICC) recommends renal angiography to T stage renal cell carcinoma. 96 angiograms were reviewed, staged and compared with the histopathologic staging. 55% of renal cell carcinomas were overstaged and 4% were under-staged. We conclude that renal angiography cannot be used for precise preoperative staging of renal cell carcinoma. PMID- 6505650 TI - Leydig cell tumour--a malignant tumour? AB - A case of feminizing Leydig cell tumour is presented. The report includes the results of paraclinical tests performed inter alia to determine whether this rare tumour was benign or malignant. PMID- 6505651 TI - Acute renal failure caused by a rapidly progressive arterio-occlusive syndrome- Kohlmeier-Degos' disease? AB - A 45-year-old man who presented with acute renal insufficiency is described. He deteriorated during haemodialysis, developed severe gastrointestinal bleedings, and died two months after his initial admission. Histopathological changes responsible for his renal disease were focal narrowing and occlusion of the arteries of the kidneys due to concentric intimal proliferation. These findings are consistent with those described in Kohlmeier-Degos' disease, a fatal cutaneo intestinal arterio-occlusive syndrome. Therefore we consider our patient to represent a case of this disease, which may be added to the list of rare causes of acute renal failure. PMID- 6505653 TI - Human psychobiology in Scandinavia: II. Psychoneuroendocrinology--human stress and coping processes. PMID- 6505652 TI - Lysis of obstructive renal pelvic clots with retrograde instillation of streptokinase. A case report. AB - In haematuria blood clots may form in the renal pelvis, with risk of outflow obstruction, impairment of renal function, pain and infection. The clots can also provide a matrix for stone formation. Ureteral catheterization and/or pyelostomy may be required if clots are not spontaneously excreted. Based on experience from a case of intrapelvic clotting due to haematuria after renal biopsy, a technique of coagulolysis is described. Via a ureteral catheter a solution of serum and streptokinase was intermittently infused into the renal pelvis. The case is presented. The clots disintegrated within 48 hours and urinary excretion recommenced, with reversal of rise in the blood creatinine level. There were no complications from the procedure, which seems to be a satisfactory alternative to surgical evacuation of clot. PMID- 6505654 TI - Character and defense: relationships between oral, obsessive and hysterical character traits and defense mechanisms. PMID- 6505656 TI - Unemployment--a challenge to public health. PMID- 6505655 TI - Does unemployment challenge public health? PMID- 6505657 TI - Estimating sensitivity and specificity in order to correct for misclassification. PMID- 6505658 TI - An alternative sampling approach to the study of diabetes prevalence. AB - Sampling methods hitherto used in epidemiological surveys have generally faced two major sorts of potential bias: a latent period between listing and testing of listed individuals which can cause a misrepresentation of the population under study, compared with the population basis; population migration and death during the study period, which may result in a discrepancy between the population selected for study and the part of the population examined. A Central Population Register, found in all Scandinavian countries, permits an evaluation of the size of these problems of bias and makes it possible to use an alternative sampling method based on test samples successively drawn from the actual dynamic population. The feasibility of this new approach was tested in an epidemiological survey of diabetes mellitus among individuals in the age group 60-74 years living in a Danish municipality (Fredericia). It is concluded that this alternative dynamic method produces a more representative study population with less bias, thanks to the smaller number of deaths and migration among non-responders during the study, than do the methods previously used. Furthermore, the length of the study period, the size of the test samples, as well as the intervals between selecting samples may be adjusted to the capacity available, thus reducing the resources required. By using a correction in the computer program for selecting test sample size, the sex and age profile of the whole study population may be chosen in accordance with the incidence of the disease studied. In the Scandinavian countries a unique possibility exists to carry out prevalence studies on all kinds of diseases by the method described and evaluated here. PMID- 6505659 TI - The ubiquitous 2X2 table, its parameters and their confidence limits. AB - The confidence limits for all parameters derived from a 2X2 contingency table are uniquely determined by the limiting matrices that arise from adding or subtracting certain values to or from the four cell entries. Various methods to determine these addends are discussed and a computer program is presented that produces reliable results. The limiting matrices thus produced bypass the more complicated expressions for the standard errors of the many epidemiological parameters that are used to interpret the 2X2 table. PMID- 6505660 TI - Dental health and perceived treatment needs of Finnish immigrants in Sweden. AB - The purpose of this study was to analyse the dental health and perceived treatment needs of Finnish immigrants in Sweden, using a representative sample and questionnaire technique. The material consisted of a random sample of 1 332 persons aged 20-59 years, resident in a Stockholm suburb. The response rate was 80%. Validity of the questionnaire was tested in a subgroup by comparing the number of teeth reported present in the questionnaire with the number observed clinically. Correlation coefficient (r) was 0.98. Compared with a study of Swedes, the mean number of remaining teeth was found to be lower and the proportion of edentulous persons higher in this study. The mean number of teeth was, however, higher than that found in a clinical study of Finnish immigrants 5 years previously, indicating a possible slight improvement in the dental health of Finnish immigrants. Almost 70% of the younger and about 45% of the older respondents had a perceived treatment need, primarily for fillings and scaling, older respondents also requiring prostheses. The real treatment need was probably greater than the study indicated. The study shows that Finnish immigrants to Sweden, as a social group, are in great need of dental treatment. PMID- 6505661 TI - [Sperm flagella and cilia with pathologic motility and ultrastructure]. AB - Motility of sperm flagella as well as of cilia is mechanically based on the principle of 9 + 2-tubules. It functions essentially by coordinated action between microtubules and the adenosine-triphosphatase dynein and was already present at the beginning of the evolution of the eucaryotes. Experimentally induced mutations in algae have resulted in numerous variations of the flagellar 9 + 2-structure. A mutation of this kind is also found in man, as immotile cilia syndrome (ICS) where anomalies in spermatozoa and in cilia (e.g. of the respiratory tract) are observed. Clinical manifestations of the syndrome have long been known (chronic bronchitis, bronchiectasis, sinusitis and male sterility). In addition, half of the patients exhibit situs inversus viscerum, known as Kartagener's syndrome, a subgroup of ICS. Electron microscopy was used to investigate sperm flagella with reduced motility from 9 patients (one with ICS) with primary infertility. Cilia of the respiratory tract from 7 patients (several with ICS) with chronic bronchial problems were analyzed for motility (using video techniques) and ultrastructure. Reduced motility or immotility of spermatozoa and immotile or dyskinetic cilia were always accompanied by ultrastructural anomalies. In spermatozoa, lack of dynein arms, 9 + 0 configuration and extratubuli were most frequently observed. The fibrous sheath was always asymmetrical. Structural ciliary defects resulted in non-parallel arrangements, electron dense matrix substance, extratubuli and lack of radial spokes. In one case, ciliary microtubuli were found in microvilli. In two patients, cilia as well as spermatozoa were analyzed. In the first, immotile spermatozoa without dynein arms and structurally normal cilia were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505662 TI - [Diagnosis of alcoholism in repeatedly intoxicated motorists. A study of 100 evaluations]. AB - A total of 100 persons who had been repeatedly convicted of drunken driving were submitted to assessment by a medical expert. A series of uniform criteria were used to determine whether they suffered from alcoholism. The following methods of investigation were used: 1. a conversation relating to drinking habits, psychosocial background and sociological circumstances; 2. the MALT (Munich alcoholism test); 3. physical examination; 4. laboratory tests. Using these methods it was possible to distribute those examined into one of the following groups (according to WHO and Jellinek): non-alcoholics (10%), problem drinkers (49%) and addicted drinkers (41%). These three large groups presented a typical picture in respect of age, occupational group, blood alcohol concentration/journey, MALT index, pathological findings at physical examination and abnormally raised laboratory values. In particular, the triad of MCV, gamma GT and macrocytosis played an important role in aiding the recognition of alcoholism or alcohol dependence. The additional presence of a raised value for SGPT further supported the diagnosis. In 37% of cases, regular alcoholic intake began during basic military service and in 28% at the place of work (mostly on building sites). In both of these groups it would appear important to institute appropriate preventive measures. PMID- 6505664 TI - [Acute complications caused by a mucilaginous laxative]. AB - Prescription of so inoffensive-seeming and common a treatment as mucilaginous laxative may have major (if rare) side effects, such as sudden esophageal obstruction. This usually occurs in old people who do not take enough water with the laxative and who may have minor esophageal pathology such as motility disorders or epibronchic diverticulum. The usually typical symptoms are sudden onset, with retrosternal pain, dysphagia or total aphagia, alimentary vomiting and pseudohypersialorrhea. Diagnosis is always by radiography and endoscopy. Radiography must be performed with gastrografin, due to the risk of bronchoaspiration or esophageal fissure. Endoscopy may demonstrate the mucilagenous mass responsible for the obstruction and in most cases restore patency of the esophagus. This technique should always be attempted, if necessary several times, before resorting to surgery. The authors stress that in patients with a risk of esophageal obstruction, such as old people with esophageal disorders, it is essential to explain clearly to the patient that the laxative must be taken with a sufficient quantity of liquid. PMID- 6505663 TI - [Vasospastic syndrome in a young women with migraine, Raynaud's disease, cerebral ischemia and myocardial infarction]. AB - The case is described of a 32-year-old female patient who has suffered since puberty from acute migraine attacks and Raynaud syndrome of both hands. In June 1981 acute posterior cerebral ischemia occurred. 11/2 years later the patient was hospitalized for acute myocardial infarction with normal and patent coronary arteries. Thereafter, the patient was treated with nifedipin and anticoagulation, and no other vascular complications have since occurred. The authors suggest that the patient is suffering from a diffuse vasospastic disorder leading to migraine attacks, Raynaud syndrome, cerebrovascular ischemia and myocardial infarction, in view of the fact that the patient has no other known risk factors for early vascular complications. PMID- 6505665 TI - [Cardiovascular syncope]. AB - The sudden and transient loss of consciousness and muscular tone from which the patient usually recovers spontaneously, i.e. syncope, is a frequent symptom. Diseases of the heart with and without rhythm disturbances together with disorders of the reflex, in particular the orthostatic regulation of the circulation, are among the main causes of syncopal events. The pathophysiological mechanisms of cardiovascular syncopes are manifold, and more than one factor can contribute to a single mechanism. Their aetiological assignment may be straightforward, but sometimes requires laborious and expensive investigational procedures. The treatment of a syncopal attack ranges from simple manipulations to true reanimation, its long-term prevention from antiarrhythmic drugs to major heart surgery, and its prognosis from the bagatelle to sudden death. PMID- 6505666 TI - [Mechanisms of cerebral ischemia following occlusion of the carotid artery]. AB - During a follow-up study (40 months) of 80 patients with proven uni- or bilateral occlusion of internal carotid artery (ICA), delayed cerebroretinal ischemic events occurred in 46% of the cases (distal to the occluded ICA in 40%). Ischemia in the area ipsilateral to the ICA occlusion most often corresponded to microemboli following the external carotid collateral pathways, less often to hemodynamic hypoperfusion, and exceptionally to microemboli from stenosis of the contralateral ICA or of the vertebrobasilar system. Ischemia in the contralateral ICA area was due to microemboli from stenosis of the corresponding ICA. Vertebrobasilar ischemia was usually hemodynamic, and foreshadowed a poor outcome. A variety of medical or surgical treatments may be indicated according to the mechanisms of these delayed episodes. PMID- 6505667 TI - [The Mirizzi syndrome]. AB - Three cases of Mirizzi's syndrome are reported, with special emphasis on differential diagnosis and preoperative evaluation. The syndrome consists of the triad cystic duct stone, inflammatory reaction and benign hepatic duct stenosis. Endoscopic retrograde cholangiography or percutaneous transhepatic cholangiography is mandatory for preoperative evaluation. Cholecystectomy with clearance of the bile duct is the treatment of choice. PMID- 6505668 TI - [Chloroform sniffing: a new variant of substance abuse]. AB - The nearly fatal outcome of a case of chloroform sniffing is described. After a brief review of the organ toxicity of chloroform, a potential therapeutic approach is discussed. Inhalation anesthetics should be considered in the differential diagnosis of coma of unknown etiology in the adolescent. PMID- 6505669 TI - [Puerperal disease control in sows]. PMID- 6505670 TI - [Tiamulin and salinomycin intolerance in swine]. PMID- 6505671 TI - Contrast sensitivity measured during smooth pursuit movement. AB - When pursuit eye movement is guided by a light spot which moves at the same velocity as that of a drifting grating, the reciprocal of the threshold contrast (TC) needed for the eye to perceive the grating moving at the same velocity as the auxiliary spot is defined as the guided pursuit contrast sensitivity (GP-CS). GP-CS and flicker (F-) or motion-CS are determined for 20-21 out of 25 possible combinations of 0.75, 1.5, 3, 6 and 12 c/deg grating drifting at 1, 2, 4, 8 or 16 Hz. Up to a drifting velocity of about 5 degrees/s, the GP-CS is near to the pattern recognition (PR)-CS for a stationary grating (+20 to -40%), while the F CS shows systematic higher (100-200%) to lower (30-60%) values than the PR-CS from low to high spatial frequency (SF) gratings as found by previous investigators. These differences can be most easily seen when the GP-CSF's for gratings drifting at 2, 4 and 8 Hz are plotted and compared with the respective F CSF's against SF. The general shape of the GP-CSF's shows remarkable similarity to that of PR-CSF at 0 Hz which is generally regarded to be mediated by the so called sustained system. Apparent motion sensation is inevitably associated with GP. Participation of sustained system in the mediation of motion sensation and the implication of pattern vision during smooth pursuit eye movement are discussed. PMID- 6505672 TI - The cooperative behavior of yeast D-glyceraldehyde-3-phosphate. Dehydrogenase as studied by the formation of the fluorescent NAD derivative. AB - The ultraviolet irradiation of the yeast D-glyceraldehyde-3-phosphate dehydrogenase carboxymethylated at the active site Cys residues, as with the rabbit muscle enzyme, led to the formation of a fluorescent NAD derivative with an emission maximum at 410 nm. Similar results were obtained with the enzyme selectively carboxymethylated at only 2 of its 4 active site Cys residues. The binding of NAD+ to both the carboxymethylated enzymes is non-cooperative or only weakly negatively cooperative when determined by NAD+ quenching of the intrinsic protein fluorescence. However, determinations of the amount of fluorescent NAD derivative formed under different NAD+ concentrations show that both the carboxymethylated enzymes appeared to bind NAD+ with positive cooperativity as in the case of the binding of NAD+ to the native apoenzyme. This seems to suggest that the spatial positioning of the nicotinamide moiety at the active site of the irradiated enzyme resembles more closely that of the nicotinamide ring in the native holoenzyme as compared to the carboxymethylated enzymes. PMID- 6505673 TI - Salmonella food poisoning. PMID- 6505675 TI - Frog genes jump species. PMID- 6505674 TI - Nucleosome reconstruction via phosphorus mapping. AB - Electron spectroscopic imaging was combined with reconstruction algorithms to derive the three-dimensional structure of the nucleosome core particle to a resolution of 1.5 nanometers. Images of phosphorus distributions within individual nucleosomes were interpreted as projections of a supercoil of DNA. These were used to orient the corresponding individual nucleosome images, making it possible to reconstruct the entire nucleosome in three dimensions. The structure is consistent with known biochemical and biophysical data and explains site-specific nuclease sensitivity, although differing in part with other nucleosome models. PMID- 6505676 TI - Scrutinizing sleeping sickness. PMID- 6505677 TI - Antidepressants cause lethal disruption of membrane function in the human protozoan parasite Leishmania. AB - The antidepressant compounds clomipramine and nitroimipramine were cidal to extracellular promastigotes of both human protozoan parasites Leishmania donovani and Leishmania major. Clomipramine also killed amastigotes of both species within murine macrophages with no apparent toxicity to the host cells. Further, amastigotes were more sensitive than promastigotes to clomipramine. Clomipramine (100 micromoles per liter or 0.2 nanomole per 1 X 10(6) cells) inhibited L proline transport in promastigotes. Synergistic inhibition of L-proline transport was observed with clomipramine after addition of either of the ionophores valinomycin or nigericin. These observations suggest that the cytotoxic effects of clomipramine result from its disruption of the proton electrochemical gradient of the parasite surface membrane. PMID- 6505678 TI - Modulation of the metastatic activity of melanoma cells by laminin and fibronectin. AB - Metastatic mouse melanoma cells have a high affinity for the basement membrane and the ability to degrade it; these properties may allow tumor cells to invade the membrane and disseminate. In this study it was found that the metastatic potential of mouse melanoma cells varied when the cells were exposed in culture to fibronectin or laminin. After removal of fibronectin or exposure to laminin, the cells had an increased affinity for basement membrane collagen, were more invasive of basement membranes in vitro, and produced more lung colonies in vivo. These changes are correlated with and may be due to an increase in the laminin binding capacity of the tumor cell surface. PMID- 6505679 TI - Inhibitors of lysosomal enzymes: accumulation of lipofuscin-like dense bodies in the brain. AB - Injections of leupeptin (a thiol proteinase inhibitor) or chloroquine (a general lysosomal enzyme inhibitor) into the brains of young rats induced the formation of lysosome-associated granular aggregates (dense bodies) which closely resembled the ceroid-lipofuscin that accumulates in certain disease states and during aging. The dense material increased in a dose- and time-dependent fashion and was differentially distributed across brain regions and cell types. These observations provide clues to the origins of ceroid-lipofuscin and suggest means for studying the consequences of its accumulation. PMID- 6505681 TI - Initiation of behavior by single neurons: the role of behavioral context. AB - Flying crickets avoid sources of ultrasound, possibly echolocating bats, by making rapid steering movements that turn them away from the stimulus. Electrical stimulation of a single, identified sensory interneuron (Int-1) elicits avoidance steering; depressing its response to ultrasound abolishes avoidance steering. Int 1 is necessary and sufficient for this behavior but only while the cricket is in flight. Thus, the sufficiency of Int-1 for eliciting this behavior is contingent on behavioral context. PMID- 6505680 TI - The spiracular organ of sharks and skates: anatomical evidence indicating a mechanoreceptive role. AB - The elasmobranch spiracular organ is a specialized receptor associated with the first visceral pouch. The structure of the sensory epithelium of the spiracular organ and the pattern of central termination of the afferent neurons that innervate it show that the spiracular organ is a mechanoreceptor closely related to the lateral line system of sense organs. Its position and orientation within the spiracular cleft suggest that it plays a role in proprioception or equilibrium-audition. PMID- 6505682 TI - Smooth curve of evolutionary rate: a psychological and mathematical artifact. PMID- 6505683 TI - Values, research questions, and the news media. PMID- 6505684 TI - New army biowarfare lab raises concerns. PMID- 6505685 TI - DNA reveals surprises in human family tree. PMID- 6505686 TI - Tracking exposure to toxic substances. PMID- 6505687 TI - The long terminal repeat sequences of a novel human endogenous retrovirus. AB - The complete nucleotide sequence of both the 5' and 3' long terminal repeats (LTR's) has been determined for a human endogenous retroviral genome. These sequences are 593 and 590 nucleotides long and have diverged from one another by 8.8 percent. The LTR's resemble those of functional mammalian type C retroviruses in length and in the presence and location of eukaryotic promoter sequences. The 5' LTR is followed by a presumptive primer binding site unlike that of any known mammalian type C retrovirus, exhibiting 17 out of 18 nucleotides complementary to arginine transfer RNA rather than proline transfer RNA. PMID- 6505688 TI - Cloned mycoplasma ribosomal RNA genes for the detection of mycoplasma contamination in tissue cultures. AB - A cloned fragment of the mycoplasma ribosomal RNA operon was used as a molecular probe for the detection of mycoplasmas in cell cultures. According to the conditions of hybridization, the probe can detect prokaryotes in general or mycoplasmas specifically. PMID- 6505689 TI - Morphine analgesia potentiated but tolerance not affected by active immunization against cholecystokinin. AB - Administration of cholecystokinin was recently found to attenuate opiate analgesia. In the present study, the role of endogenous cholecystokinin in opiate analgesia was examined. Endogenously released cholecystokinin was sequestered by antibodies to cholecystokinin developed in response to an active immunization procedure. Morphine analgesia was potentiated and prolonged in rats immunized against cholecystokinin. The rate of development of morphine tolerance, however, was not affected by the antibodies. Endogenous cholecystokinin appears to function as a short-term modulator of opiate action. PMID- 6505690 TI - Incidence of low birth weight among Love Canal residents. AB - The incidence of low birth weight among white live-born infants from 1940 through 1978 was studied in various sections of the Love Canal. A statistically significant excess was found in the historic swale area from 1940 through 1953, the period when various chemicals were dumped in this disposal site. Potential confounding factors such as medical-therapeutic histories, smoking, education, maternal age, birth order, length of gestation, and urban-rural difference did not appear to account for this observation. Low birth weight rates were comparable to those of upstate New York from 1954 through 1978, the period when there was no deposition of chemical wastes. PMID- 6505691 TI - Intrinsic mechanisms of pain inhibition: activation by stress. AB - Portions of the brain stem seem normally to inhibit pain. In man and laboratory animals these brain areas and pathways from them to spinal sensory circuits can be activated by focal stimulation. Endogenous opioids appear to be implicated although separate nonopioid mechanisms are also evident. Stress seems to be a natural stimulus triggering pain suppression. Properties of electric footshock have been shown to determine the opioid or nonopioid basis of stress-induced analgesia. Two different opioid systems can be activated by different footshock paradigms. This dissection of stress analgesia has begun to integrate divergent findings concerning pain inhibition and also to account for some of the variance that has obscured the reliable measurement of the effects of stress on tumor growth and immune function. PMID- 6505692 TI - Monoclonal idiotope vaccine against Streptococcus pneumoniae infection. AB - A monoclonal anti-idiotope antibody coupled to a carrier protein was used to immunize BALB/c mice against a lethal Streptococcus pneumoniae infection. Vaccinated mice developed a high titer of antibody to phosphorylcholine, which is known to protect against infection with Streptococcus pneumoniae. Measurement of the median lethal dose of the bacteria indicated that anti-idiotope immunization significantly increased the resistance of BALB/c mice to the bacterial challenge. Antibody to an idiotope can thus be used as an antigen substitute for the induction of protective immunity. PMID- 6505693 TI - Carbohydrate dramatically influences immune reactivity of antisera to viral glycoprotein antigens. AB - Analysis of the ability of heteroantisera, monoclonal antibodies, and antibodies to synthetic peptides to react with viral glycoproteins deglycosylated with endoglycosidase F revealed that the reactivities of most of the antibodies to these glycoprotein antigens were influenced by the attached carbohydrate moieties. All heteroantisera prepared in rabbits or goats to either fully glycosylated retroviruses or influenza virus were virtually unreactive toward the viral glycoproteins after carbohydrate removal. Analyses with a panel of monoclonal antibodies to purified Rauscher murine leukemia virus gp70 indicated that the reactivity of most of these antibodies improved while the reactivity of others decreased or remain unchanged after carbohydrate removal. Most of the antibodies to synthetic peptide sequences in the influenza virus hemagglutinin also improved in reactivity after carbohydrate removal. These data indicate that carbohydrate side chains on viral glycoproteins influence the immune response to these antigens, and the more native the glycoprotein immunogen, the more dramatic the carbohydrate influence. Thus the immune response to these glycoproteins is not simply a function of the immunogenicity of certain domains over others but rather is a direct measure of carbohydrate influences on the host's perception of the foreign antigen. PMID- 6505694 TI - Activated expression of the N-myc gene in human neuroblastomas and related tumors. AB - In neuroblastoma lines in which the N-myc gene is present as a single copy, the expression of N-myc as messenger RNA is increased relative to that in nonneuroblastoma cell lines and tumors. The increase of expression in neuroblastomas with amplified N-myc genes is the result of (i) an increase in the absolute amount of expression of each N-myc gene and (ii) an increase in the copy number of the N-myc gene. A second gene--which is amplified in many of the same lines as N-myc--is expressed to about the same degree in most human cell lines and primary tumors regardless of origin (when normalized to gene copy number). Thus, a change in the regulation of N-myc expression in neuroblastomas and certain other tumors results in greatly increased expression of each N-myc gene copy. PMID- 6505695 TI - Reported laboratory frauds in biomedical sciences. PMID- 6505696 TI - NIH proposes extending life of grants. PMID- 6505697 TI - The riddle of development. PMID- 6505698 TI - Acid rain's effects on people assessed. PMID- 6505699 TI - High-resolution proton nuclear magnetic resonance analysis of metastatic cancer cells. AB - High-resolution proton nuclear magnetic resonance (NMR) studies of intact cancer cells revealed differences between cells with the capacity to metastasize and those that produce locally invasive tumors. The NMR resonances that characterize the metastatic cells were associated with an increased ratio of cholesterol to phospholipid and an increased amount of plasma membrane-bound cholesterol ester. High-resolution NMR spectroscopy could therefore be used to assess the metastatic potential of primary tumors. PMID- 6505700 TI - Smell identification ability: changes with age. AB - Smell identification ability was measured in 1955 persons ranging in age from 5 to 99 years. On the average, women outperformed men at all ages, and nonsmokers outperformed smokers. Peak performance occurred in the third through fifth decades and declined markedly after the seventh. More than half of those 65 to 80 years old evidenced major olfactory impairment. After 80 years, more than three quarters evidenced major impairment. Given these findings, it is not surprising that many elderly persons complain that food lacks flavor and that the elderly account for a disproportionate number of accidental gas poisoning cases each year. PMID- 6505702 TI - Hemoglobin I mutation encoded at both alpha-globin loci on the same chromosome: concerted evolution in the human genome. AB - Genetic analysis of an individual expressing an unexpectedly high level of hemoglobin I, an alpha-globin structural mutant, reveals that the mutation is present at both the alpha 1- and the alpha 2-globin gene loci. Kindred analysis confirms that the two affected genes are located in cis. The most likely explanation for this finding is that a recent conversion event occurred within the human alpha-globin gene cluster. PMID- 6505701 TI - Evidence for cholinergic neurites in senile plaques. AB - In the neocortices and amygdalae of young and aged macaques, cholinergic axons were identified by means of a monoclonal antibody to bovine choline acetyltransferase. Many fine, linear, immunoreactive profiles were seen in these animals. In the older animals, some cholinergic axons showed multifocal enlargements along their course. In some instances, neurites with choline acetyltransferase immunoreactivity were associated with deposits of amyloid (visualized with thioflavin T fluorescence). The appearance of these amyloid associated abnormal cholinergic processes was similar to that of neurites in senile plaques, as shown by conventional silver impregnation techniques. Cholinergic systems thus give rise to some of the neurites within senile plaques. PMID- 6505703 TI - The diagnosis and differential diagnosis of hairy cell leukemia in bone marrow and spleen. AB - In this study we reviewed the morphologic features of marrow biopsies and aspirates as well as splenic sections derived from 28 patients with hairy cell leukemia. Marrow biopsies proved reliable in establishing and/or confirming the diagnosis in every patient, when available for review. Regardless of the degree of marrow involvement, the hairy cell infiltrates consistently exhibited wide spacing of their nuclei due to relatively abundant pale to clear cytoplasm. Hairy cells appeared homogeneous and bland, without mitotic activity or prominent nucleoli; nuclear contours characteristically were ovoid and to a lesser extent slightly indented or reniform. The splenic histology of hairy cell leukemia was equally distinctive. The splenic red pulp was diffusely infiltrated by a uniform population of cytologically monotonous mononuclear cells that expanded the red pulp cords, filled the sinuses, and generally led to atrophy or obliteration of the white pulp. Moreover, the clear cytoplasm of hairy cells usually was highlighted in sinusoidal blood-filled lakes. Despite the employment of these characteristic morphologic criteria for the diagnosis of hairy cell leukemia in marrow and spleen, these pathologic changes may vary and may be simulated in part by a variety of other hematologic disorders. Accuracy of diagnosis requires not only knowledge of the usual pathologic features of hairy cell leukemia but also knowledge of the unusual. Awareness of these pathologic variations will aid in the improvement of diagnosis and will provide a foundation for understanding the clinical and biologic aspects of hairy cell leukemia. PMID- 6505704 TI - Autopsy findings in hairy cell leukemia. AB - Autopsy material from 22 patients with hairy cell leukemia was examined. All patients had the expected widespread involvement of the hematopoietic system. Peripheral lymphadenopathy was detected in only three cases, but significantly enlarged mediastinal, retroperitoneal, and abdominal lymph nodes were present in 15. Lymph nodes of two patients showed malignant lymphoma, large-cell type. Evidence of pulmonary infiltration by hairy cells was present in 15 cases; but in 14 of the 15, there was evidence of coexisting pneumonia, and in 13 of the 15 cases the presence of microorganisms was documented. Only one patient demonstrated clinical findings attributable solely to lung involvement by hairy cell leukemia. Liver involvement was present in every case, but the extent of the leukemic infiltration did not always correlate with serum biochemical abnormalities, and there was no correlation with the hairy cell count in the peripheral blood. M kansasii was found in the lymph nodes of three patients and in the lung and liver specimens of one of these. The tissue response in two of the patients with M kansasii consisted of the presence of poorly formed granuloma; the third patient had only focal areas of necrosis, with no polymorphonuclear or macrophage response. PMID- 6505705 TI - Biochemical studies on hairy cell leukemic cells. PMID- 6505706 TI - Cell membrane complex carbohydrates in leukemia: glycoproteins in hairy cell and other leukemias. PMID- 6505708 TI - Hairy cell leukemia: clinical presentation and follow-up of 211 patients. PMID- 6505707 TI - Effect of phorbol ester tumor promoters on hairy cell leukemic cells. PMID- 6505709 TI - The history of hairy cell leukemia: characteristics of long-term survivors. PMID- 6505710 TI - Hairy cell leukemia: a comparative study of Japanese and non-Japanese patients. PMID- 6505711 TI - Therapeutic leukapheresis in hairy cell leukemia: review of literature and personal experience. PMID- 6505712 TI - Chlorambucil therapy of twenty-four postsplenectomy patients with progressive hairy cell leukemia. PMID- 6505713 TI - Biologic therapy of hairy cell leukemia. PMID- 6505714 TI - Use of daunorubicin in patients with solid tumors. PMID- 6505715 TI - Pharmacology and phase I clinical studies of daunorubicin in patients with advanced malignancies. PMID- 6505716 TI - A phase I study of daunorubicin in advanced untreatable malignancies. PMID- 6505717 TI - Clinical pharmacology of daunorubicin in phase I patients with solid tumors: development of an analytical methodology for daunorubicin and its metabolites. PMID- 6505718 TI - Chemotherapy with daunorubicin-anti-CEA conjugates in human colon adenocarcinoma grafted in nude mice. PMID- 6505719 TI - Daunorubicin-albumin copolymer targeting to leukemic cells in vitro and in vivo. PMID- 6505720 TI - Peritoneal dialysis--a review with consideration of the role of CAPD in renal replacement therapy in developing countries. PMID- 6505721 TI - Teenage marriages in Singapore. PMID- 6505723 TI - Clinical presentation of buccal carcinoma. A review of twenty nine patients. PMID- 6505722 TI - National University of Singapore students who come for psychological help. PMID- 6505724 TI - Self-poisoning: a study of female patients hospitalised in a general medical department in one year. PMID- 6505725 TI - Infectiousness with respect to HBV of medical staff and patients in the General Hospital, Kuala Lumpur. PMID- 6505726 TI - Child stealing in Sri Lanka. A case report. PMID- 6505727 TI - Renal papillary necrosis. Retrospective radiological study. PMID- 6505728 TI - Some aspects of sexual knowledge and sexual behaviour of local women. Results of a survey. II. Female masturbation. PMID- 6505729 TI - Well-differentiated fibrosarcoma of the maxilla--a case report. PMID- 6505730 TI - The objective assessment of hearing in children using the auditory brainstem responses. PMID- 6505731 TI - Normal thermographic standards for the cervical spine and upper extremities. AB - Although thermography has been used for a variety of abnormal conditions, extensive data on large, relatively asymptomatic populations has heretofore not been available. More specifically, no data deal with the upper extremities and, more particularly, no analyses are based on simultaneous thermograms of the posterior neck and shoulders. The current study undertook this task. The results confirm the existence of thermal symmetry in the overwhelming majority of 100 normal relatively asymptomatic, actively employed factory workers. Conversely, if persistent, statistically significant thermal asymmetry exists, as outlined and correlates with patient symptomatology, an organic basis for it should be sought. PMID- 6505732 TI - Fibrocartilaginous mesenchymoma with low-grade malignancy. AB - In a review of cases of fibrous cartilaginous dysplasia of bone, five of fibrocartilaginous lesions were found to be different in clinical behavior and radiographic and morphologic features from the others. We have named these previously undescribed tumors "fibrocartilaginous mesenchymomas with low-grade malignancy in the fibrous elements." PMID- 6505733 TI - Case report 285. Diagnosis: osteomalacia (rickets) and cerebellar atrophy secondary to the effects of diphenylhydantoin (dilantin). PMID- 6505734 TI - Case report 293. Diagnosis: nonossifying fibroma (NOF) of the upper tibial diametaphysis, with considerable increase in size over a three-year period. PMID- 6505735 TI - Case report 294. Diagnosis: dialysis osteomalacia with response to desferrioxamine therapy. PMID- 6505736 TI - Sex of provider as a variable in effective genetic counseling. AB - Selected aspects of the interaction in genetic counseling sessions, as reported by women patients seen by a female provider, were compared to the interaction reported by women patients seen by a male provider. Although counseling sessions were comparable in terms of length of time, significantly more in-depth discussion of selected medical and genetic topics was reported when the provider was female; more discussion was reported of medical and genetic topics which patients came to counseling to discuss when the provider was female; and women patients reported a greater willingness to raise issues of concern in counseling when the provider was female. Women patients also were more likely to report the explanations offered by female providers as clearer than those offered by male providers. In general the data suggest that women patients in genetic counseling receive a somewhat different and less comprehensive type of counseling when seen by a male as opposed to a female provider. Analysis suggests that the differences observed may be due less to variation between male and female providers in terms of professional preparation than to variation in how male as opposed to female providers orient themselves to women patients, as well as to how women patients orient themselves to female as opposed to male providers. PMID- 6505737 TI - Attendance pattern and continuity of dental care of Finnish adults over a 5 year period. AB - The study deals with the frequency of using dental services and continuity of visting the same dentist by adults in Finland during the 5 years up to 1981. A representative sample of 17-65 year old Finnish adults was interviewed by telephone or when this was not possible, personally. The data were collected by the Central Statistical Office of Finland in autumn 1981. Twenty-two per cent of the subjects had not visited a dentist during the past 5 years. One-third had had more than three treatment courses during the same period. The number of treatment periods increased with higher educational and professional status. Half of the subjects who had had more than one treatment period had continued to attend the same dentist during different treatment periods. Young persons had changed dentist more often than older ones. The most common reason for changing dentist was change of residence. Nine percent did not wish to continue treatment with the same dentist. Income, age, profession and region of living accounted for 10% of the number of changes of dentist. PMID- 6505738 TI - Byrne and Long: a classification for rating the interview style of doctors. AB - In order to assess the doctor's verbal behaviour in the consultation, a classification instrument is needed that will enable us to summarize the doctor's interview style. Such an instrument, developed by Byrne and Long, is evaluated in this study. After presenting the procedure as it has been worked out by Byrne and Long, some points of criticism are formulated. On account of our criticism, some changes have been introduced into the instrument. To test the relevance and reliability of the instrument, 36 consultations have been classified according to the adjusted system. This procedure showed that it was possible to represent a consultation with the 45 categories the system consisted of (although only 15 categories occurred in more than half of the consultations). Those categories that occurred often enough, could be measured with sufficient reliability, with inter-observer reliability coefficients mostly above 0.70. An example shows that the procedure is extremely useful to indicate certain differences between doctors and types of consultations. PMID- 6505739 TI - Self-medication: an important aspect of primary health care. AB - The main objective of this study was to determine the degree to which individuals practised self-medication in relation to their educational status. Kalutara, a small town in Sri-Lanka is semi-urban and has a good mixture of literates and illiterates. Important findings include the fact that knowledge of drugs was grossly inadequate, literates self-medicated far more than illiterates and a high percentage of the total sample population by-passed other health personnel in preference for Western trained doctors. Self-medication, though desirable, can be dangerous and should be emphasized as a component of primary health care because (i) it is commonly practised even where health professionals are easily accessible, (ii) it encourages self-reliance for curative, preventive, promotive and rehabilitative care and (iii) literacy, which seems to enhance its practice, is increasing worldwide. PMID- 6505740 TI - The imitation of madness: the influence of psychopathology upon culture. AB - Psychiatry and ethnography have been reluctant to consider the possibility that psychosis may provide a model for social organisation and belief. The situations in which this may occur are considered and two examples discussed: the historical leader of a Jewish messianic movement and the contemporary founder of a Trinidadian sect. Individual delusions may be converted into a shared public culture by the manipulation of previously accepted symbolism and a simple inversion of the traditional values in some area may enable the whole community to attain a more sophisticated conceptualisation. In particular, antinomian acts rooted in psychopathology may generate more universal dispensations out of systems of dual classification. PMID- 6505741 TI - Perceptions of childhood diarrhoea and its treatment in rural Zimbabwe. AB - In the course of a study on the acceptability and feasibility of home-based oral rehydration therapy in rural Zimbabwe, information was collected on attitudes and beliefs about diarrhoea and on action taken in response to an episode of diarrhoea in a child. Diarrhoea was found to be a perceived threat at community and family level and numerous possible causes of diarrhoea were described which were assigned to two broad classes: (1) 'physical' causes, such as a polluted environment, diet and teething and (2) 'social and spiritual' causes such as those associated with a depressed fontanelle. These domains were not, however, mutually exclusive; 76% of the described episodes of diarrhoea were attributed to 'physical' causes, 15% to 'social and spiritual' causes and 8% to a combination of both. Reported utilization rates of the formal health services were unexpectedly high. In contrast, we recorded a low demand for indigenous herbalists (n'angas). Home management was common and comprised the administration of indigenous herbal remedies, of sugar and salt solutions, of over-the-counter drugs or of enemas. These remedies were given on their own or alongside the treatment prescribed by a health worker. A number of variables were examined to assess their influence on health-seeking behaviour: perceived cause and severity of the illness, socio-demographic characteristics of the respondent or child and accessibility of the health services.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6505742 TI - Estimates of the demand for health: males in the pre-retirement years. AB - The demand for health is estimated for black and white males in the pre retirement years using data from the first wave of 1966 National Longitudinal Survey of men aged 45-59. This survey includes direct measures of the wage rate and family assets. Findings for whites generally corroborate Grossman's initial estimates of the demand for health. In contrast to whites, blacks show a much stronger wage effect and a significant positive effect of wife's education, with no other factors being significant. The issue of reverse causality between the wage and health is addressed via a simultaneous equations health-wage model. Contrary to expected, but consistent with previous findings, the structural model yielded an even larger wage effect. PMID- 6505743 TI - Temporal trends of cancer mortality in eastern New England compared to the nation, 1950-1975. AB - Cancer mortality trends among the white population in eastern New England are compared to National trends for the years 1950-1975 for 62 age and sex standardized sites. The 26 years considered in the study are divided into five time periods (1950-1954, 1955-1959, 1960-1964, 1965-1969, 1970-1975) representing rates age-adjusted to the 1960 white population. The findings show that male cancer mortality in eastern New England is increasing at a rate consistently higher than and almost parallel to National male cancer mortality. Female cancer rates in eastern New England are declining, but less rapidly than National female cancer mortality. Female lung cancer in the study region has experienced a dramatic increase from 1950 to 1975; and the greatest increases occurred in areas of the lowest relative urbanization. PMID- 6505744 TI - Housing change of chronic schizophrenic patients: a consequence of the revolving door. AB - A study of 119 chronic schizophrenics discharged to the community revealed that by 1 year post release, 50% have changed their living arrangement at least once. Housing changes, which typically involved movement from one non-institutional living situation to another, followed rehospitalization episodes and appear to be a consequence of the revolving door phenomenon. By virtue of its impact on rehospitalization, interpersonal stress in the patient's living environment has an indirect effect on housing change. The remarkable frequency with which housing changes occur among the mentally ill in both sheltered care and non-institutional living settings deserves consideration in the planning of mental health and social welfare service for this constituency. PMID- 6505745 TI - The effects of an exercise program on selected risk factors to coronary heart disease in children. PMID- 6505746 TI - Primary health care in practice: a study in Mozambique. AB - This study investigates the delivery of all aspects of Primary Health Care (PHC) in a case study of one urban health centre in Maputo, Mozambique. Within the context of overall social and economic change, Mozambique has given priority to primary health care as the driving force in its newly developed National Health Service. The urban and rural health centres are intended to be the principal vehicles for PHC delivery, and in this study one of Maputo's recently opened health centres was investigated by observing all clinic sessions, interviewing all health centre workers and collecting data from health centre records. It was found that a dichotomy exists between the tasks ascribed to the health centre in the PHC framework, and the feasibility of their execution given existing personnel and material resources. This derives in part from lack of involvement of PHC practitioners in the organisation and planning of PHC, plus resource allocation which remains in favour of secondary and tertiary rather than primary care. Prevention is accorded priority in PHC theory, yet investigation showed that the major demand on the health centre is for curative care. The quality of both curative and preventive care was evaluated and the need for training in specialist diagnostic skills, and a more socially-based understanding of the determinants of health status and risk emerged, respectively for the groups of workers in the two sectors. The level of contact between the curative and preventive sectors was investigated as was the integration of the health centre into the health service as a whole. The problems arising in these areas must be viewed in the context of the very recent development of a National Health Service in a country where, previously, curative care was available only in urban areas and virtually no preventive programmes existed. This study shows that significant steps are being taken to develop a comprehensive PHC programme in Maputo. More important still will be the extension of this level of care provision to the country as a whole. PMID- 6505747 TI - Company doctors: standards of care and legitimacy: a case study from Canada. AB - Company doctors have been criticized for poor standards of care and bias towards their employers interests. This paper reports on interviews with 24 company doctors in the province of Ontario, Canada. It uses company doctors' accounts of their work and careers to highlight aspects of corporate medicine which may help to produce questionable standards of care and present obstacles to doctors' attempts to increase their legitimacy. Apparent variations in the quality of care in contract practice and full-time employment in a company are discussed and it is suggested that greater attention may need to be devoted to improving the standards of care in smaller companies. Patterns of recruitment, doctors' beliefs about the changing nature of occupational medicine, as well as contradictory definitions of the proper sphere of occupational medicine may also have an effect on standards of care and the degree of legitimacy accorded to company doctors. The responses of doctors to charges of bias are discussed and it is suggested that they may neglect the major reason for such charges--that they are employed by companies and are thereby constrained to favour their employers' interests. The paper proposes the need for further research on standards of occupational medical care, whether these vary with respect to context of practice and whether there are appreciable differences in standards of practice among doctors employed by companies, unions, universities and government. Modest proposals for future health policy are also indicated. PMID- 6505748 TI - The health belief model and participation in programmes for the early detection of breast cancer: a comparative analysis. AB - Extravagant claims have been made about the power of the Health Belief Model (HBM) to explain both decisions to adopt patterns of health behaviour and to use preventive health services. However, studies where information on beliefs are collected before information on behaviour are not common. The analyses presented here are based on prospective studies examining how far the variables which make up the HBM predict attendance at (i) a class teaching breast self-examination and (ii) a clinic providing mammography. The results show that different dimensions of the HBM are amongst the best predictors of attendance at each of the different services although the overall variance explained by the HBM in both sets of analysis was small. PMID- 6505749 TI - The relationship of two dimensions of social support to the psychological well being and social functioning of women with advanced breast cancer. AB - Of interest to the field is the mechanism through which social support acts as a resistance resource for individuals undergoing stressful life circumstances. Women with advanced breast cancer (N = 86) were interviewed to determine how their outlook on life and social functioning were affected by the social support they received. Emotional support provided by the family was predicted to affect the woman's sense of well-being whereas the opportunities for social exchange provided by one's social activities were expected to effect the woman's social functioning. Consistent with the predictions, the data indicate that social support is multidimensional. Emotional support was strongly related to one's outlook. However, one's opportunities for social exchange affect not only one's social functioning, but also one's outlook on life, suggesting an interactive process whereby family support improves outlook, both outlook and opportunities for social exchange are related to one's sense of social functioning. These data explain the erosion of social support during life-threatening illness such as cancer as a result of the limitations imposed by the illness on one's opportunities for social exchange. PMID- 6505750 TI - Patients' perception of dentists' positive and negative attributes. AB - Earlier studies have shown that dental patients concern themselves with the personality characteristics of their dentists as well as with their professional competence. The present study is part of a wider survey which compared the characteristics of regular and irregular or non-attenders for dental check-ups. In this article patients' characteristics such as sex, age, level of dental anxiety and certain previous dental experiences were related to their perceptions of dentists' positive and negative attributes. The results confirmed previous findings that dentists were seen generally by their patients in a favourable light. Respondents who admitted to higher levels of dental anxiety were more likely to choose more negative attributes and less positive ones than respondents who admitted to lower levels; women, younger subjects and the dentally anxious consistently chose unsympathetic and indifferent as the two top negative characteristics of their dentists. PMID- 6505751 TI - The health care system in Poland: the case of Lodz as compared with foreign regions; a secondary analysis. AB - This paper is based on the results of empirical research on the utilization of the Health Care System (HCS) by twelve study areas from seven countries (WHO/International Collaborative Study of Medical Care Utilization). The aim of the secondary analysis was to compare the health care needs, resources and determinants of use of the HCS between the Polish city, Lodz, and the remaining study areas. The chief findings were as follows: The level of needs for health care is higher in Lodz than in other study areas. The volume of HCS resources in Lodz is at the medium level, but its organization makes the utilization of the HCS difficult. The utilization of medical assistance by physicians in Lodz is near the median comparing with the remaining study areas but the length of hospital stay in Lodz is the longest among all study areas. Problems of the accessibility of medical assistance cause an overloading of the inadequate hospital system. The extra-medical causes of the use of the HCS are stronger in Lodz than in other study areas, whereas the medical determinants (perceived morbidity) are weaker. PMID- 6505752 TI - Childhood leprosy and social response in south India. AB - This paper reports a field study of childhood leprosy in the state of Karnataka, India, as encountered through a private, secular leprosy hospital and its rural outpatient program serving some 60 villages. Symptoms of leprosy among children are subtle, ambiguous and not readily distinguishable from those of relatively innocuous skin ailments with which villagers of the region commonly lump them. In addition, severe stigma attaches to the disease. As a result, diagnosis tends to be resisted, rendering effective treatment difficult. The research focused on the hospital's comprehensive program of diagnosis, treatment, education and rehabilitation, and the responses of people of it. Three categories of response to diagnosis and treatment, as defined by the hospital program, were investigated: regular acceptors, irregular acceptors and refusers. Contrary to expectation, those who accept treatment irregularly and hence ineffectively, express greater awareness of the cause, symptoms and treatment of the disease than either those who accept regular treatment or those who refuse treatment. Despite frequent verbal denials of belief in, or fear of, contagion, people's behavior regarding leprosy and its victims indicates that such beliefs are indeed harbored. The effectiveness of the program is assessed with reference to its policies and procedures as they affect the rural population. Especially effective is the policy of not confronting people with diagnoses of leprosy in problematic childhood cases, but of asserting instead that leprosy can be averted if treatment is accepted. Resistance generated by the fear and stigma of leprosy is thus mitigated by presenting its childhood symptoms as pre-leprous rather than as early leprosy. The research concludes that the program has achieved notable success in each of its aspects and is therefore worthy of emulation elsewhere. PMID- 6505753 TI - 'Barefoot doctors' in rural Georgia: the effect of peer selection on the performance of trained volunteers. AB - Does volunteer selection by peers have a measurable effect on volunteer performance? This paper examines this question in the context of a field experiment which used community organizations as a means to select people to serve as Emergency Medical Coordinators (EMCs). Field sites were 36 rural Georgia communities with populations ranging from 150 to 1850. EMCs were trained in a 40 hour program as first responders to emergency incidents and as organizers of an emergency response system within their communities. Their performance in each of these roles was assessed by composite measures (a first aid performance index and an activity index) developed as part of the study. Each sponsor organization conducted the selection of EMCs for their respective communities. The process was monitored and assessed as either comprehensive, including the evaluation and elimination of candidates, or as unstructured where interested individual self volunteered. Performance scores were regressed on the selection process variable as well as a set of structural, predisposing and enabling variables. Peer selection was a statistically significant predictor of EMC performance as a first responder but not as a response system organizer. Implications of this result as well as the influence of other independent variables are discussed. PMID- 6505755 TI - Characteristics of the distribution of emigrant Indian radiologists, pathologists and anesthesiologists in the United States. AB - We present the results of a questionnaire sent in the autumn of 1981 to all board certified specialists practicing radiology, pathology and anesthesiology who are graduates of Indian medical schools and now reside in the United States. Respondents were asked to indicate their Indian state of birth, the size of the community in which they were born. The location of their medical school, the size of the city in which they now reside and their reasons for emigrating to the United States. The respondents tended to settle in the larger cities of the Northeast and Midwest, filling, to some degree, positions provided by the movement of American trained physicians to the West and South. Most came from urban areas and from the more urbanized Indian states. Rajasthan, Madhya Pradesh and the East Indian states were underrepresented. The limited opportunities for specialty practice at home and the perception of an unmet physician demand in the United States were the twomost important reasons for emigration. Job availability largely determined locational choice in the United States. The distribution of emigrants arriving from 1965 to 1975 were similar to that of a much smaller group of early emigrants. Restrictions on entry of foreign born, foreign trained physicians as prescribed by the Health Professionals Assistance Act of 1976 (Public Law 94-284) mandates that the cohort of young specialists will not be supplemented to a significant extent by future arrivals from the Indian sub continent. This will create an encapsulated minority of highly trained Asian Americans. As they grow older their locational choices and integration into American society bears watching. PMID- 6505754 TI - The relationship between distance from inpatient facilities and the rate of psychiatric admissions in Western Australia. AB - Western Australia is the largest and most sparsely populated state in Australia with all its specialised psychiatric inpatient facilities in Perth, the capital city. This study tested a number of hypotheses concerning the effect of distance from Perth, firstly, on total hospitalisation rates for psychiatric illness of the rural population and secondly, on the proportion who were hospitalized in Perth. High rates of alcoholism in males and of neuroses in females, together with local conditions in various rural centres, rather than distance from Perth, were major determining factors affecting both total hospitalisation and th proportion sent to Perth. The major exception was that the proportion of male alcoholics admitted to Perth hospitals decreased the further the patient lived from Perth. These findings were contrary to those reported in the literature. However the distances from Perth were much greater than those usually reported elsewhere. It was concluded that beyond a certain distance from psychiatric facilities, distance per se was not a major factor governing admissions to these facilities. PMID- 6505756 TI - [Analysis of cases of deliberate injuries with a fatal outcome during 1972-1981 from autopsy material of the Institute of Forensic Medicine at the Medical School Hospital in Martin]. AB - Authors had performed statistical analysis of decenal autopsy material from Department of Forensic Medicine, Faculty Hospital, Martin, with particular focusing on deliberated fatal injuries (81 cases). The analysis of circumstances and mode of the crime with focusing on the personality and relations between the agressor and the victim was also done. The future step in the analysis will be forwarded to explain possible bioclimatological influences on committment of such kind of violences. PMID- 6505757 TI - Pelvic arteriography in obstetrics and gynecology: arteriovenous fistulas and embolization. AB - Pelvic arteriography has become an increasingly useful diagnostic and therapeutic tool in the past decade along with angiography of other areas of the body. A brief historical review of its development in obstetrics and gynecology since 1950 is presented, including placental localization and study of pelvic arterial adequacy. Modern practical uses include (1) diagnosis and therapy of pelvic arteriovenous fistulas, and (2) arterial embolization for intractable recurrent pelvic hemorrhage associated either with malignancy or with trauma or uncontrollable surgical bleeding. PMID- 6505758 TI - Alternative sites for continuous arterial monitoring. AB - During a 13-month period, we studied 148 patients who had percutaneous arterial cannulation for continuous intraoperative, postoperative, and intensive care monitoring. In all patients, alternative arteries were cannulated, which included the brachial (43%), axillary (19%), femoral (28%), dorsalis pedis (8%), and superficial temporal artery (1%). No patient sustained any functionally significant or serious complication requiring surgical intervention. Eighteen patients (12%) had minor, clinically insignificant complications. We conclude that in the absence of an available radial artery, there are at least five other reliable arterial sites that may be cannulated and safely used when direct arterial monitoring is required. PMID- 6505759 TI - Experience with a needleless vascular access device (Hemasite) for hemodialysis. AB - Experience with 35 needleless implants (Hemasite) in 27 patients over the past 27 months has shown that this device can provide immediately available painless access in patients lacking adequate veins for a direct internal fistula for hemodialysis. The cumulative patency rate of 46% at two years is comparable to that of polytetrafluoroethylene grafts. The major complication was infection which contributed to graft loss in one third of patients. Obese female patients were particularly susceptible to infection and had a worse graft prognosis. Long term results with a graftless model were poor. PMID- 6505760 TI - Hormones in the etiology and prevention of breast and endometrial cancer. AB - Since the incidence of endometrial cancer among estrogen-treated women at Wilford Hall Air Force Medical Center was not increased as reported by others, a prospective study was begun in 1975. With this data base, the cases of breast and endometrial cancer in estrogen and oral contraceptive users were reviewed. The incidence of mammary malignancy in postmenopausal estrogen users (141.0:100,000) was lower than that of the untreated women, ie, nonhormone users (342.3:100,000) (P less than or equal to .01). The incidence of breast cancer in the estrogen progestogen users (67.3:100,000) was significantly lower than that of the untreated women and than that expected from the Third National Cancer Survey (188.3:100,000) and the National Cancer Institute (NCI) data (229.2:100,000) (P less than or equal to .01). Oral contraceptives also decreased the risk of breast carcinoma, since the incidence in users (10.3:100,000) was significantly lower than expected in this age group according to both the Third National Cancer Survey (53.3:100,000) and the NCI data (57.3:100,000) (P less than or equal to .01). Unopposed estrogen replacement therapy increased the incidence of endometrial cancer to 410.8:100,000, but progestogen added to estrogen therapy significantly decreased this incidence to 68.1:100,000 (P less than or equal to .0001). The estrogen-progestogen users also had a significantly lower incidence of endometrial carcinoma than the untreated women (258.3:100,000) (P less than or equal to .005). Oral contraceptives, particularly the combination pill with estrogen and progestogen in each tablet, are protective against adenocarcinoma of the endometrium. The incidence of endometrial cancer apparently increased in premenopausal women during our study from 10.9:100,000 women in the first five years to 41.9:100,000 during the last two years as birth control pill use declined from 8,693 users in 1975 to 5,563 users during 1981, primarily in women over the age of 35. PMID- 6505761 TI - Craniopharyngioma arising in the pharyngeal hypophysis. AB - Four cases of nasopharyngeal craniopharyngiomas have been previously reported in the medical literature. They were, in fact, only nasopharyngeal extensions of tumors originating in the anterior pituitary of the sella turcica. Pituitary adenomas can arise from any part of the craniopharyngeal canal. Supporting this theory are four reported cases of pituitary adenomas in the body of the sphenoid bone separate from both the sella turcica and the nasopharynx. The discovery by Erdheim in 1904 of the pharyngeal hypophysis located on the posterior edge of the vomerine bone raises the possibility of a tumor arising in this tissue. We report the case of a craniopharyngioma limited entirely to the nasopharynx and specifically to the posterior end of the vomer. We believe it to be the only reported example of a true neoplasm of the pharyngeal hypophysis first described by Erdheim. PMID- 6505762 TI - Ileoanal reservoir: functional results and management. AB - Restorative proctocolectomy with ileoanal reservoir is an alternative to Brooke ileostomy. This study of 56 patients emphasizes functional results and management of the loop ileostomy, transient incontinence, frequency of bowel function, constipation, perianal skin, and psychosocial issues. PMID- 6505763 TI - Acute yersiniosis and its surgical significance. AB - During early 1982, an outbreak of yersiniosis occurred in northern Mississippi. Abdominal pain suggestive of appendicitis was a common manifestation, but laparotomy revealed mesenteric adenitis. Yersinia enteritis should enter the differential diagnosis of acute appendicitis. PMID- 6505765 TI - Life after general surgery residency: subsequent practice patterns of chief residents. AB - No recent reports characterize the practice patterns of graduates of current general surgical residency programs. The University of Louisville Department of Surgery surveyed recent graduates of our program who were established in practice, to determine whether the training they had received had adequately prepared them for their subsequent positions. Ninety percent of our graduates responded to a questionnaire. More than 80% of residents still regularly performed general surgical procedures even though more than 38% had completed some additional fellowship training. More than 75% of our graduates were satisfied with their income. The vast majority were satisfied with their work load and their training. Although more data are needed to determine how practice patterns develop, no current evidence suggests that current training practices are inadequate or wasteful. PMID- 6505764 TI - Malignant external otitis. AB - Malignant external otitis (MEO) is a potentially life-threatening Pseudomonas infection of the external auditory canal in which rapid diagnosis is the key to proper treatment. We present an anatomic description of the ear and skull base, with a review of the literature on MEO, in the hope that it will enable primary care physicians to work more closely with otolaryngologists in dealing with this illness. PMID- 6505766 TI - Electron microscopy in determining origin of metastatic adenocarcinomas. AB - Light microscopy has limited value in predicting where the primary site of a metastatic adenocarcinoma might be located. In our series, electron microscopy was useful in determining the primary site in approximately 85% of patients with a metastatic adenocarcinoma of unknown origin. This study is based on the ultrastructural examination of more than 100 such cases. In the remaining 15% of the cases, electron microscopy usually provided assistance in reducing the differential diagnosis to a minimum, usually to two possible primary sites. The majority of the metastatic adenocarcinomas showed rather specific ultrastructural features to suggest the site of origin. This application of electron microscopy has never been fully explored and has considerable clinical importance and economic impact in health care systems. An extensive work-up to determine the primary site, with its inconvenience to patient and family, as well as delay in adequate treatment, can be avoided with early diagnosis of the primary site. PMID- 6505767 TI - Veterinary diagnosis in clinical medicine. PMID- 6505768 TI - Procainamide-induced agranulocytosis. AB - We have described six new patients accounting for seven episodes of agranulocytosis due to procainamide. Six episodes involved the slow-release oral preparation. With continued use of this convenient antiarrhythmic agent, it is important that physicians be alert to the possibility of agranulocytosis in febrile patients receiving procainamide. If agranulocytosis occurs, procainamide should be discontinued promptly and the fever should be treated aggressively with combination broad spectrum antibiotics. PMID- 6505769 TI - Rhinosporidiosis: ultrastructural study of an infection in South Carolina. AB - We have morphologically described and ultrastructurally analyzed Rhinosporidium seeberi, the causative agent of rhinosporidiosis, obtained from a nasal polyp of a man who had never traveled to India or Ceylon. The morphology, endosporulation phases, and cell wall were similar to those in previously described infections. A common etiology is suggested and potential therapy is discussed. PMID- 6505770 TI - Adrenal insufficiency due to metastatic lung carcinoma and shown by abdominal CT scan. AB - Our patient's symptoms of adrenal insufficiency were the first evidence of recurrence of the primary tumor. The diagnosis of hypoadrenalism was established by the standard ACTH stimulation test. The elevated ACTH level provided corroborating evidence that this was primary adrenal insufficiency rather than secondary to hypothalamic-pituitary dysfunction. The CT scan of the abdomen then revealed bilateral adrenal gland enlargement as well as a less dense area in the spleen, both suggestive of metastatic disease. The CT scan has proven to be of value in diagnosing tumor involvement of the adrenal glands. The patient's response to hormonal replacement was both rapid and gratifying, and he was able to leave the hospital to resume his usual activities. The possibility of adrenal insufficiency should be considered in any patient with a history of carcinoma who has malaise, weakness, and weight loss. Adrenal insufficiency is a treatable condition, and treatment of it provides symptomatic relief that may increase the quality of life. As patients with cancer survive longer, this complication may be observed more frequently. PMID- 6505772 TI - Intrahepatic arterial aneurysm: treatment by ligation complicated by hepatic necrosis and biliary-cutaneous fistula. AB - An intrahepatic hepatic artery aneurysm with massive hemobilia was successfully obliterated by intraoperative ligation of a branch of the right hepatic artery. Subsequent CT studies showed a large area of intrahepatic necrosis that was well tolerated, but was eventually manifested as a biliary-cutaneous fistula. Our patient's benign course argues that management of segmental hepatic necrosis can be tailored to the clinical response. PMID- 6505771 TI - Bronchoalveolar lavage in acute drug-hypersensitivity pneumonitis probably caused by phenytoin. AB - We have reported a case of acute hypersensitivity pneumonitis, probably caused by phenytoin, in which the results of bronchoalveolar lavage suggested a predominantly lymphocytic type of alveolitis, comparable to the alveolitis of sarcoidosis or chronic hypersensitivity pneumonitis. PMID- 6505773 TI - Primary subcutaneous abscess due to Streptococcus pneumoniae. AB - A primary subcutaneous abscess and associated bacteremia due to Streptococcus pneumoniae, type 9V, occurred in a healthy 23-year-old man. Penicillin therapy and surgical drainage were curative. PMID- 6505774 TI - Propranolol-induced mania. PMID- 6505775 TI - Acute memory loss and nominal aphasia caused by phenylpropanolamine. AB - I have reported a case of acute memory loss and nominal aphasia in a 36-year-old woman after the use of Dexatrim Extra Strength. The toxic reaction improved within 36 hours after discontinuation of the drug. PMID- 6505776 TI - Perforation of the intrapericardial aorta during subclavian catheterization. AB - We have reported a case of fatal perforation of the intrapericardial aorta during attempted subclavian venipuncture through the infraclavicular route in a patient with a ruptured ectopic pregnancy. The case illustrates the importance of having the procedure done only by personnel experienced in the technique, even in emergency situations. PMID- 6505777 TI - Escherichia vulneris: isolation and treatment. AB - We have described two cases of Escherichia vulneris wound infections resistant to ampicillin given orally, but susceptible to higher blood levels obtainable by parenchymal administration. PMID- 6505778 TI - Extrapleural exclusion of esophageal perforations. AB - Perforations of the esophagus require prompt treatment. We have described a patient in whom extrapleural exclusion of a primary repair was used. This procedure, which has not been previously reported, is not technically difficult and is similar to the approach used in the treatment of tracheoesophageal fistula. It allows good mediastinal drainage and prevents pleural soilage by providing an effective buttress to the esophageal repair. PMID- 6505779 TI - Primary meningococcal arthritis. AB - We have reported a case of primary meningococcal arthritis of the left ankle in a previously healthy man. Although primary meningococcal arthritis clinically resembles gonococcal arthritis, prolonged antibiotic therapy and open joint drainage are often required. Even with prompt appropriate antibiotic and surgical therapy, primary meningococcal arthritis may lead to permanent joint damage. PMID- 6505780 TI - Campylobacter osteomyelitis. AB - We have reported a case of Campylobacter osteomyelitis, which we believe has not been previously reported. Symptoms and signs were nonspecific, but darkfield microscopy of a suspension of isolated bacteria was useful in making a presumptive diagnosis. Initial parenteral therapy based on sensitivity testing and prolonged oral doxycycline therapy was successful. PMID- 6505781 TI - Mycobacterium avium-intracellulare infection. PMID- 6505782 TI - Blue diapers in a nonagenarian. PMID- 6505783 TI - Pulmonary infiltration eosinophilia with chlorpropamide therapy. PMID- 6505784 TI - Experimental infection of Oncomelania quadrasi with Paragonimus ohirai. AB - Two hundred Oncomelania quadrasi collected from Leyte, Philippines were exposed to infection with Paragonimus ohirai, a rodent type lung fluke. In a group, each snail was exposed individually to 10 miracidia hatched from eggs which were brought from Japan to the Philippines. In another group, 100 snails were placed in a Petri dish and P. ohirai miracidia were added to provide 10 per snail. The observations were made each successive week after exposure. All the snails examined were positive for the larvae of P. ohirai. Nine-ten weeks after exposure, many cercariae were recognized. It was proved that O. quadrasi is highly susceptible to P. ohirai. PMID- 6505785 TI - Susceptibility of Oncomelania hupensis subspecies to infection with geographic strains of Schistosoma japonicum. AB - Subspecies of Oncomelania hupensis were exposed to infection with zoophilic and anthropophilic strains of Schistosoma japonicum. The snails were Philippine O. h. quadrasi from the islands of Bohol, Leyte and Mindanao, O. h. formosana from Changhua and Ilan, and O. h. chiui from Taiwan, O. h. hupensis from China, O. h. nosophora from Japan and O. h. lindoensis from Indonesia. Anthropophilic strains of S. japonicum were from Bohol and Leyte in the Philippines, China, Japan and Indonesia. The zoophilic strains were from Changhua and Ilan, Taiwan. All geographic strains of the parasite developed exceptionally well and produced cercariae in 32-50% of O. h. chiui and 5-43% of the natural snail hosts. Development in other subspecies of snails with geographic strains of the parasite were variable. Only a few O. h. formosana (Changhua) could be infected with the parasites from other geographic areas and only one O. h. quadrasi each from Mindanao became infected with the Bohol and Changhua strains of S. japonicum. PMID- 6505786 TI - Hybridization between Brugia malayi and Brugia pahangi from south Kalimantan, Indonesia. AB - Hybridization experiments were carried out between sub-periodic Brugia malayi and B. pahangi recovered from cats originating from the same area in South Kalimantan (Borneo), Indonesia. Five to six week-old immature males and females of both species from Mongolian gerbil (Meriones unguiculatus) intraperitoneal infections were inoculated into the peritoneal cavity of other gerbils. Mating occurred between the species and microfilariae developed into infective third-stage larvae in mosquitoes. Larvae from the mosquitoes developed into adults in the peritoneal cavity of gerbils but microfilariae were not produced since the males were sterile. Back-crossing between hybrids and males and females of the parental species were also done and female hybrids produced microfilariae when crossed with parental males but females from the parental species did not produce microfilariae when mated with the hybrid males. This confirmed that the males were sterile but the females were not. If these species are hybridized in nature and humans are exposed to hybrid third-stage larvae, could this lead to occult filarial infection? These results confirmed previous hybridization experiments of these species orginating from other geographic areas. PMID- 6505788 TI - Zinc in the pathogenesis of hookworm anaemia. AB - Serum zinc levels in 90 patients with hookworm infection were compared with those of 26 uninfected controls. The severity of infection was graded in terms of haemoglobin levels as well as egg loads. The results showed that the serum zinc levels in anaemic patients with hookworm infection were significantly lower than those of the controls (p less than 0.01). PMID- 6505787 TI - Subcutaneous and cerebral cysticercosis treated with praziquantel. AB - Subcutaneous and cerebral cysticercosis, the latter visualized in computer tomography, occurred in a 38 year-old Filipina who had multiple asymptomatic subcutaneous nodules and headache. Treatment with praziquantel was given at 35 mg/day for 10 days, dexamethasone and carbamazepine were also given to reduce side effects. Three months after praziquantel therapy most of the subcutaneous nodules, the headache and the intracranial lesion disappeared and at 9 months 23 of the original 26 subcutaneous nodules had disappeared. Computer tomography is a valuable adjunct to the diagnosis and follow up of cerebral cysticercosis and praziquantel was found to be very effective in the treatment of the parasitoses. PMID- 6505789 TI - Health status of Indochinese refugees in Japan: statistical analyses on anemia, eosinophilia and serum alkaline phosphatase. AB - Detailed statistical analyses were attempted on anemia, eosinophilia and elevation in serum alkaline phosphatase in the Indochinese refugees in Japan. A high statistical correlation was found between hemoglobin concentration and hematocrit for most of the refugees except the Cambodian females. Refugees with parasitic infections, particularly hookworm infection had significantly lower values for hemoglobin concentration and hematocrit. Significant eosinophilia was observed in the refugees infected with hookworms, Strongyloides stercoralis, Rhabditis sp., Endolimax nana and/or Hymenolepis nana. However, these parasites were found in the same subpopulations more frequently than expected by chance. Elevation in serum alkaline phosphatase was observed in young Cambodian immigrants. Analyses showed that the variations of this enzyme could be well predictable by those of enzymes such as serum glutamic oxaloacetic transaminase, which are good markers for liver functions, in Cambodian immigrants, 13-24 of age, whereas no such correlation was observed in non-Cambodians of the same age group. PMID- 6505791 TI - Effects of cercarial concentration and length of exposure on the infection of mice by Schistosoma japonicum and S. mekongi cercariae. AB - The effects of cercarial concentration and length of exposure on the infection of mice by Schistosoma japonicum and S. mekongi were studied under laboratory conditions. For all cercarial concentrations of 10, 20 and 30, mice exposed for 1 min acquired little or no infection. Total worm recovery tended to rise with an increase either in cercarial concentration or exposure time. The highest infection rate and worm burden were obtained in mice exposed for 64 min to 30 cercariae per mouse. The present investigation suggested that exposures of 1 min or less carried little risk of infection at low cercarial concentration. There was a greater risk of infection in prolonged exposure to low cercarial concentration. Prolonged exposures to high cercarial concentration carried the greatest risk of high infection rate and worm burden. PMID- 6505790 TI - Inhibitor to the cell-bound haemagglutinin of Vibrio cholerae. AB - An inhibitor to cell-bound HA was found to be produced at the non haemagglutinating phase of the culture cycle by a classical vibrio strain which produced a cell-bound HA early and transiently during its growth. The HA-negative filtrate obtained from the late log-culture was found to inhibit the cell-bound HA activity produced by the same vibrio strain. It was also found to be produced early in shaking cultures at 37 degrees C and to mask the activity of early cell bound HA in whole culture tests. This inhibitor is suggested to be responsible for the failure to obtain HA activity or adhesive vibrio cells grown at 37 degrees C and for the transient expression of cell-bound HA by some V. cholerae strains. PMID- 6505792 TI - Effects of physico-chemical factors on the infection of mice with Schistosoma japonicum and S. mekongi cercariae. AB - The three physico-chemical characteristics of water tested-pH, temperature and salinity were found to affect the infection of mice by cercariae of S. japonicum and S. mekongi. For both species of schistosomes, the range of optimal pH that showed highest infection and worm recovery rates was between 5.4-7.4 and decreased as the pH increased. Cercariae exposed to temperatures between 15 degrees-30 degrees C showed the highest infection and worm recovery rates. As temperature decreased or increased, the infection and worm recovery rates decreased. Sodium chloride concentration at low level (0.5-200 ppm) did not have great effect on the infection and worm recovery rates. The infection and worm recovery rates decreased as salinity increased. High sodium chloride concentration at 3200 ppm for S. mekongi cercariae and at 6400 ppm for S. japonicum cereariae inhibited cercarial penetration and no infection occurred. PMID- 6505793 TI - Hemorrhagic diphtheria. AB - Two cases of hemorrhagic diphtheria, a rare entity and severest form are reported. Both of them have been mildly ill for more than 3 days and did not seek medical attention, suddenly developed bleeding episodes with clinical evidence of diphtheria in association with severe thrombocytopenia. Inspite of antitoxin, antibiotics therapy and supportive care one died on the third day. The second case was given additional steroid therapy to the regimen and survived with diphtheria myocarditis. PMID- 6505794 TI - Cholecystitis associated with Enterobacter agglomerans. AB - A case report of chronic cholecystitis due to Enterobacter agglomerans, occurred in a 54-year old female with homozygous beta-thalassemia. The patient responded successfully to cholecystectomy and sulfamethoxazole + trimetroprim therapy. The source of the infection was not known, however, cystic duct obstruction and immune deficit were thought to be the predisposing causes. PMID- 6505795 TI - [Development and implementation of systems evaluation of medical work]. PMID- 6505796 TI - [Effect of social-hygienic factors on indices of physical development among children and adolescents]. PMID- 6505797 TI - [Role of the "health shop" in further reducing sick leave and increasing productivity]. PMID- 6505798 TI - [Evaluation of the treatment efficacy on the basis of life span tables]. PMID- 6505799 TI - [Prevention of cardiovascular diseases through annual screening of the entire population]. PMID- 6505800 TI - [Comparative evaluation of the loss related to the early death of patients with arterial hypertension]. PMID- 6505801 TI - [Experience in educating public health organizers in the advanced training department of a medical school]. PMID- 6505802 TI - [Organization and efficacy of the team method of preventive ultraviolet irradiation of coal miners]. PMID- 6505803 TI - [Evaluation of the quality of the university training of physicians]. PMID- 6505804 TI - [Problems in improving public health management personnel in foreign countries]. PMID- 6505805 TI - [Organizational and medical problems in the prevention of viral diseases]. PMID- 6505806 TI - [Several patterns in the physical development of children]. PMID- 6505807 TI - [Organizational aspects of the use of x-ray studies]. PMID- 6505808 TI - [Clinical pharmacology and clinical pharmacy in a general clinical hospital]. PMID- 6505809 TI - [Activities of epidemiologists and their assistants at rural regional sanitary epidemiologic stations]. PMID- 6505810 TI - [Forms and methods of increasing physicians' qualifications in disability evaluation]. PMID- 6505811 TI - [Method of testing the training of paramedical personnel]. PMID- 6505812 TI - [100th anniversary of the organization of sanitation in the city of Moscow]. PMID- 6505813 TI - [Images of physicians in literature and art]. PMID- 6505814 TI - [Current goals of medical education and the teaching of social hygiene and public health organization]. PMID- 6505815 TI - [The breast in patients with uterine myoma and dysfunctional uterine hemorrhage examined by the thermovision method]. PMID- 6505816 TI - [Sulfur-containing drugs used in the treatment of postmastectomy edema of the upper limbs]. PMID- 6505817 TI - [A rare form of leiomyoma of the cervical segment of the esophagus]. PMID- 6505818 TI - [Reflexotherapy in duodenal ulcer]. PMID- 6505819 TI - [Hypersecretory syndrome in transpyloric prolapse of the gastric mucosa]. PMID- 6505820 TI - [Clinico-genetic characteristics of hereditary nephritis]. PMID- 6505821 TI - [Closed cranio-cerebral trauma associated with extracranial injuries]. PMID- 6505822 TI - [Characteristic features of immunity in parturients after cesarean section]. PMID- 6505823 TI - [Development of an integrated curriculum for training students in obstetrics and gynecology]. PMID- 6505824 TI - [Various clinico-immunological indicators in bronchial asthma]. PMID- 6505825 TI - [Prevention of supraventricular paroxysmal tachycardia with cordarone]. PMID- 6505826 TI - [Acute disorders of mesenteric circulation]. PMID- 6505827 TI - [Intraoperative cytological diagnosis of diseases of the pancreatoduodenal region]. PMID- 6505828 TI - [Reducing the mortality rate of middle-aged and old patients with incarcerated hernias]. PMID- 6505829 TI - [Angiographic diagnosis of brain injuries]. PMID- 6505830 TI - [Lesions of the central nervous system in measles]. PMID- 6505831 TI - [Diagnostic and therapeutic errors in injuries of the liver and spleen]. PMID- 6505833 TI - Anterior cervical fusion for degenerated or protruded discs. A review of one hundred forty-six patients. AB - The results of 146 patients with anterior cervical intervertebral disc removal and fusions are reviewed. The diagnosis was cervical spondylosis in 75%, disc protrusion in 16%, and spondylosis at one level with disc protrusions at another in 9%. There were 81 women and 65 men with an average age of 48 +/- 9 years. The average follow-up was 5 +/- 3.3 years. The rate of fusion was 97%. Complete pain relief occurred in 78%, partial in 18% and little or no pain relief in 4%. There were no serious complications, and none of the patients thought they were made worse by surgery. PMID- 6505832 TI - Cervical sagittal spinal canal size in spine injury. AB - This study investigated the relationship between cervical spine sagittal canal diameter and neurologic injury in cases of spinal fracture-dislocation. A group of 98 patients with such injuries was reviewed; 45 had no neurologic deficits, 39 had incomplete quadriplegia, and 14 had complete quadriplegia. Spinal canal sagittal diameter was measured in all, and large diameter and small canals were defined. Small diameter canals were correlated significantly with neurologic injury, while large diameter canals allowed protection from neurologic injury in cervical fracture dislocation. PMID- 6505834 TI - Acute spinal subdural hematoma. A case report and review of literature. AB - A case of acute spinal subdural hematoma is reported in a 24-year-old woman. Presentation occurred in the postpartum period, 4 days following epidural anesthesia. Emergency decompressive laminectomy attained partial recovery. Subsequent pathology demonstrated evidence of a low-grade ependymoma. Reported cases of spinal subdural hematomas are reviewed and compared with the characteristics of this unique case. PMID- 6505835 TI - Effects of a contusion injury on spinal cord blood flow in the sheep. AB - The effect of experimental trauma on the blood flow in the central (essentially gray matter) and peripheral (essentially white matter) regions of the sheep's spinal cord was studied using a radioactive microsphere technique. In seven out of eight animals, a progressive fall in blood flow occurred in both the peripheral and central regions of the cord within 2 hours following injury and remained reduced over the period of recording (up to 12 hours). Changes in local vascular resistance indicated that in approximately 60% of our animals, changes in arterial pressure alone contributed highly significantly to the decreased spinal blood flow. There remains the possibility that early therapeutic intervention could sustain neuronal function where local blood flow would otherwise be inadequate in the damaged spinal cord. PMID- 6505836 TI - Proprioception in idiopathic scoliosis. AB - Proprioception testing and gait analysis was performed on a group of 17 patients with idiopathic scoliosis. All curves had documented progression. The average curve was 26.8 degrees, all primary curves being right thoracic. The average age was 14.8 years. Twelve, healthy, age-matched controls underwent identical testing. Results showed that scoliotic subjects had asymmetry in their ability to reproduce angles between their two knees, as well as an absolute deficit in their ability to reproduce angles as compared with controls (P less than 0.01). The threshold of detection of change in angle at the knee was also quantitatively higher than controls (P less than 0.05), although asymmetry was not statistically significant. No significant differences were measured in gait parameters between scoliotics and controls. These joint position tests have been applied previously to young and elderly adults, athletes, and total joint patients. In no group has any asymmetry of response been demonstrated, both extremities showing virtually identical performance in each case. The tests administered measure sensory modalities, which are conducted through the posterior columns. Although the site of damage in the neural pathway cannot be specifically localized by these tests, results of this study support the presence of a neurologic deficit in idiopathic scoliosis. PMID- 6505837 TI - The role of tomography in the evaluation of the postoperative spinal fusion. AB - Despite the fact that pseudarthrosis is the most common complication after posterior spinal fusion, no reproducible diagnostic method has been established. This study analyzes the accuracy of the anteroposterior trispiral tomography in evaluating the posterior spinal fusion mass. Tomography was shown to be both sensitive and specific in its ability to detect the presence or absence of a pseudarthrosis. Radiation exposure is not increased when tomography is performed in lieu of less accurate diagnostic studies. Anteroposterior trispiral tomography is a useful adjunct in the routine postoperative evaluation of the patient who has undergone a posterior spinal arthrodesis. PMID- 6505838 TI - Severe postlaminectomy kyphosis treatment by total vertebrectomy (plus late recurrence of childhood spinal cord astrocytoma). AB - A case of recurrent spinal astrocytoma is presented 25 years following initial biopsy and radiation therapy. Extensive laminectomy was performed when the patient was 20 months old. Three years later the patient became paraplegic as the result of progressive severe kyphosis. Late recurrence of tumor was marked by pain onset. In addition to treating the tumor, extensive spinal reconstruction was required to control the kyphosis. PMID- 6505839 TI - Primary vertebral tumor in an adolescent girl. AB - A 13-year-old girl presented with a 6-month history of back pain, a palpable paravertebral mass, and a left third lumbar radiculopathy. Radiologic studies were consistent with a primary vertebral neoplasm. Posterior biopsy yielded material consistent with osteoblastoma. Anterior tumor excision and vertebral reconstruction followed. Elements consistent with aneurysural bone cyst were present in the resected tumor. PMID- 6505840 TI - Anatomic studies of the circulation in the region of the vertebral end-plate in adult Greyhound dogs. AB - In order to study the detailed arrangements of vascular terminations in the region of the vertebral end-plate in adult dogs, infusions of Japanese ink mixed with a suspension of barium sulfate were used to produce filling of the vascular terminations at the vertebral end-plates. Radiographs were made of the decalcified specimens. Photomicrographs were prepared from transparent sections embedded in celloidin. The distribution of the large veins within the vertebral bodies was found to be more complex than described earlier. Over the entire bone disc interface there is a continuous capillary bed that is most dense in the area related to the nucleus pulposus. These vessels drain either into the subchondral postcapillary venous network or directly into the veins of the marrow spaces in the vertebral bodies. PMID- 6505841 TI - Effects of disc injury on mechanical behavior of the human spine. AB - The effects of injury to the intervertebral disc were investigated using three dimensional flexibility and creep measurements of functional spinal units from fresh cadaver lumbar spines. The techniques utilized were accurate and the data had a high degree of reproducibility. An injury to the annulus and a removal of the nucleus significantly altered the mechanical properties of the spinal unit. Not only were the main motions affected but also the coupled motions. Sagittal plane symmetry was disturbed, resulting in asymmetric facet joint movements. These effects of injury could be measured because of the three-dimensionality of the experiments. Previous studies, utilizing only axial compression loading, claimed to observe no changes due to the disc injuries and are, therefore, in conflict with the present findings. PMID- 6505842 TI - The nature of instability. AB - (Clinical) instability is that (symptomatic) condition where, in the absence of new injury, a physiologic load induces abnormally large deformations at the intervertebral joint. PMID- 6505843 TI - Biomechanical properties of human intervertebral discs subjected to axial dynamic compression. A comparison of lumbar and thoracic discs. AB - This investigation revealed biomechanical properties and some morphological parameters of isolated intervertebral discs at various disc levels. One hundred twenty-three specimens were subjected to axial dynamic compressive loads. The duration of testing was 5 minutes, the loads Fd1 = 650 N +/- 400 N (discs from T5 6 to L1-2) and Fd2 = 950 N +/- 540 N (discs from T9-10 to L5-S1). Down the spine, the mean disc heights and cross-sectional areas increased; the water content seemed to be nearly constant. Axial deformation and ventral bulging increased down the spine as well, which is mainly due to the increasing disc height. Creep showed different characteristics. It was smallest within the region T10-11 to L1 2 and increased above and below this level. The increase below L1-2 is mainly due to the increasing disc height; the increase above T10-11 occurs because the thoracic discs behave in a more viscous manner than the lumbar discs. PMID- 6505844 TI - Posture related to myoelectric silence of erectores spinae during trunk flexion. AB - Electromyographic activity of erectores spinae exhibits points of abrupt change during trunk flexion from the erect position and return extension. This study examined the positions at which the myoelectric activity suddenly disappeared and later reappeared. Forty adults were investigated to define accurately the inclinations of the trunk, pelvis, and vertebral column at these positions. The positions at the commencement and cessation of the period of electrical silence both occurred at two-thirds of maximum trunk flexion (mean = 80 degrees +/- 13 degrees SD). At these positions, all flexion measurements were significantly less than their maxima (P less than 0.001). Hip flexion at the commencement of electrical silence was slightly above one-half its maximum range, and similar to the position at the recommencement of electrical activity (mean = 40 degrees +/- 12 degrees SD). The most reproducible measurement (r = 0.88) in both positions was vertebral flexion (89% Max.; mean = 48 degrees +/- 6 degrees SD). Eleven of the male subjects repeated the experimental task holding 10.1 kg in their hands. The effect of this was to produce inhibition and reactivation of erectores spinae at a greater degree of vertebral flexion. PMID- 6505845 TI - Ethnic and sex differences in response to clinical and induced pain in chronic spinal pain patients. AB - There is widely held clinical opinion and some tentative research justification for stereotypic or ethnic and sex differences in response to pain. To more adequately test this notion, 60 chronic spinal pain patients (black, Mexican American, and Caucasian, with ten men and ten women per group), all having persistent spinal pain for over 1 year, were studied. They were administered the ischemic pain test, a numerical estimate of spinal pain, and two independent raters scaled the amount of pain emphasis, based upon the patient's physical condition and pain behaviors. Results showed ethnic differences on the ischemic test (a psychophysiologic scaling technique used to approximate clinical pain and pain tolerance) with Mexican Americans describing the highest levels. Women of all ethnic groups tended to be judged as emphasizing their pain more than men, based upon judgment of their pain behaviors, and upon their own numerical estimates of pain. They also indicated that they more nearly approached their pain tolerance. It was concluded that while ethnic and sex differences were found, stereotypic responses were not uniform, and tended to be related to the manner in which that pain was assessed. These results are discussed in light of cultural differences. PMID- 6505846 TI - Differential diagnosis of recurrent lumbar disc herniation and postoperative deformation by myelography. An impossible task. AB - A series of 44 patients with persistent or recurring sciatic pain after myelography and operation for disc herniation were remyelographed and reoperated. Patients with lesions at a new level or at the same level but on the opposite side presented no diagnostic problems. However, in patients with myelographic changes at the same level and on the same side as at the first operation, it was impossible to distinguish disc herniation from postoperative extradural scarring. This was true whatever myelographic sign or combination of signs was chosen. PMID- 6505847 TI - [Diaphragmatic hiatal hernia in a 2-year-old girl with penetration of the entire stomach into the thoracic cavity]. PMID- 6505848 TI - [Early detection of stapediovestibular otosclerosis]. PMID- 6505849 TI - [The effect of drugs on peritoneal dialysis clearance]. PMID- 6505850 TI - [Particular problems in the radioimmunoassay determination of human parathyroid hormone levels in serum]. PMID- 6505851 TI - [Late onset of gout]. PMID- 6505852 TI - [Remission of insulin-dependent diabetes]. PMID- 6505853 TI - [The effect of endemic nephritis on a large number of complications in pregnant women]. PMID- 6505854 TI - [Lipids in children with diabetes mellitus]. PMID- 6505855 TI - [Malignant tumors in patients with regular hemodialysis]. PMID- 6505856 TI - [Complications in women due to continual use of oral contraceptives]. PMID- 6505857 TI - [Intensive monitoring of the fetus during pregnancy and labor]. PMID- 6505858 TI - [Clinical use of low osmolar roentgen contrast media]. PMID- 6505859 TI - [Ascending leg phlebography with Solutrast 200. Experiences with nonionic roentgen contrast media in 150 patients]. PMID- 6505860 TI - [NMR tomography of the brain using various pulse frequencies]. PMID- 6505861 TI - [Choice of image sequence in contrast medium nuclear magnetic tomography: contrast behavior of brain tumors following gadolinium-DTPA use in various spin echo procedures]. PMID- 6505862 TI - [NMR-site determination. Report of the Workshop NMR-Tomography, Hannover-Technic and clinical aspects]. PMID- 6505863 TI - [Angio-CT in the diagnosis of liver metastases of colorectal tumors]. PMID- 6505864 TI - [Effect of computer tomography on the roentgen diagnosis of the spinal canal]. PMID- 6505865 TI - [General and local reactions following leg venographies]. PMID- 6505867 TI - [Stress ulcers]. PMID- 6505866 TI - [Aerophagia and postlaparotomy gastric atony]. PMID- 6505869 TI - [Mirror image perforation of peptic ulcers of the jejunum after GEA in old age]. PMID- 6505868 TI - [Hemorrhaging relapsing peptic ulcer after a type B II operation treated with truncal vagotomy and excision]. PMID- 6505871 TI - [Splenic abscess]. PMID- 6505870 TI - [Intramural hematoma of the duodenum and jejunum]. PMID- 6505872 TI - [Extreme loss of bile through the Kehr T-drain]. PMID- 6505873 TI - [An interesting case of urinary peritonitis]. PMID- 6505874 TI - [Metronidazole in the treatment of peritonitis of appendiceal origin]. PMID- 6505875 TI - [Prevention of postoperative thromboembolic accidents using small doses of heparin]. PMID- 6505876 TI - [Prevention of serious anaerobic infections]. PMID- 6505877 TI - [Neurogenic tumors and pseudotumors of the hand]. PMID- 6505878 TI - [Inhibition of polymorphonuclear leukocyte chemotaxis by sera and synovial fluids in rheumatoid arthritis]. PMID- 6505880 TI - [Stress fracture of the pubic ramus in rheumatoid arthritis--a report of three cases]. PMID- 6505879 TI - [Comparison of clinical symptoms and immunological findings between two groups of patients with complete remission and persisting course of juvenile rheumatoid arthritis]. PMID- 6505881 TI - [Revised diagnostic criteria for progressive systemic sclerosis]. PMID- 6505882 TI - The causes of non-natural deaths in children over a 15-year period in greater Cape Town. AB - This study was undertaken to describe the causes of non-natural death in children aged under 15 years in the Cape Peninsula. Information was abstracted from the official death register kept at the South African Police Mortuary in Cape Town for the period of 1 July 1966-30 June 1981. During the 15-year period 3 248 medicolegal autopsies were performed on children under 15 years of age who had died of non-natural causes. There were significantly higher percentages of Coloureds and Blacks, males, and children aged under 6 years in the sample than in the general population aged under 15 years in the Cape Peninsula. The majority of deaths (54,4%) were caused by road traffic injuries. Other important causes of deaths were burns (12,8%), drowning (11,0%), assault/abuse (5,4%) and poisoning (3,3%). Special attention was paid to the causes of fatal head injuries--head injury alone was given as the cause of death in 819 autopsies (25,2%). The majority of fatal head injuries (72,4%) were also caused by road traffic accidents. This study demonstrates the alarming number of deaths from non-natural causes among children aged under 15 years in the Cape Peninsula. The finding that more than half of these deaths were due to road traffic accidents indicates the impact that successful intervention could have. PMID- 6505883 TI - A retrospective study of head-injured children admitted to two hospitals in Cape Town. AB - A retrospective study was undertaken to describe the patterns of head injury in children in the Cape Peninsula. Information was abstracted from Groote Schuur Hospital and Red Cross War Memorial Children's Hospital records for all children aged under 15 years admitted with head injury between July 1966 and June 1981. Data were collected on 1 820 admissions. There were significantly higher percentages of Coloureds and Blacks, males and children aged under 6 years in the sample than in the corresponding population of the Cape Peninsula. In children under 1 year old, fails accounted for approximately 70% of head injuries in all three race groups. In the 1-5-year age group, transport-related injuries were the most common cause of admission in Blacks (63,1%) and Coloureds (46,5%), but in Whites falls were still most common (58,2%). In the 6-14-year age group, transport-related accidents accounted for approximately 64% of head injuries in all three race groups. Pedestrian accidents were the commonest cause of admissions due to transport-related head injury. Severe or very severe concussive injuries, multiple injuries or death occurred more commonly in transport-related injuries than among those caused by falls or assault/abuse. Transport, falls and assault/abuse together accounted for 88,4% of all causes of head injury. PMID- 6505884 TI - Mononuclear and polymorphonuclear leucocyte dysfunction in male homosexuals with the acquired immunodeficiency syndrome (AIDS). AB - In addition to the well-documented abnormalities of cell-mediated immunity we have observed that both polymorphonuclear leucocytes (PMNLs) and mononuclear leucocytes (MNLs) from 3 patients with the acquired immunodeficiency syndrome (AIDS) showed markedly defective migratory responsiveness to leuko-attractants in vitro. Reduced PMNL and MNL chemotaxis is attributable, at least in part, to a serum inhibitor of leucocyte migration, since co-incubation of PMNLs from healthy control subjects with 10% AIDS serum inhibited the migration to leuko-attractants of these cells. This serum-inhibitory effect on leucocyte migration was not due to the presence in AIDS serum of increased levels of prostaglandin E2, cytomegalo virus or anti-leukocyte antibodies. However, elevated serum immunoglobulin A (IgA) levels were observed in all 3 patients. IgA is a potent inhibitor of PMNL and MNL migration. It is possible that serum inhibitors of leucocyte migration perpetuate the profound immunosuppression characteristic of AIDS. PMID- 6505885 TI - Pseudoxanthoma elasticum in South Africa--genetic and clinical implications. AB - After investigation by a multidisciplinary team, 19 cases of biopsy-proven pseudoxanthoma elasticum are described. Evidence for an increased gene frequency in the Afrikaner population was found, as was support for the claim of genetic heterogeneity in the disorder. The well-described clinical manifestations involving the eyes, skin and cardiovascular system were seen, as were more rarely reported features such as acne, telangiectasia of the lips and bilateral cataracts. Mitral valve prolapse and gastro-intestinal haemorrhage were not found in our patients, although there are several reports in the literature. PMID- 6505886 TI - Endoscopic retrograde sphincterotomy in the management of common bile duct stones. AB - Endoscopic retrograde sphincterotomy (ERS) was performed in 53 patients with choledocholithiasis, 26 of whom had an intact gallbladder. An adequate sphincterotomy was achieved in every patient, and all stones were removed in 90%. There was 9% morbidity but no mortality. ERS is a major advance in the management of common bile duct stones with significantly lower morbidity and mortality than those associated with conventional surgery. In particular, the role of ERS in pre cholecystectomy patients is discussed. PMID- 6505887 TI - Dettol (chloroxylenol and terpineol) poisoning in a pregnant patient. A case report. AB - A 30-year-old woman who was 28 weeks pregnant was admitted to hospital after deliberate ingestion of 300 ml Dettol. The patient's management and that of Dettol overdose are discussed. PMID- 6505888 TI - Effect of physical exercise on plasma melatonin levels in normal volunteers. AB - Plasma melatonin, cortisol and prolactin levels were determined in clinically normal adult Black male volunteers before, immediately after, and 1 hour after a period of controlled physical exercise. In all subjects the levels of these three hormones showed highly significant increases immediately after exercise and returned to pre-exercise levels 1 hour after physical exertion. In subjects who exercised in a room with reduced environmental lighting (54 lux), the plasma melatonin level immediately after exercise was significantly higher than in the group who exercised in a room with a lighting level of 320 lux. Reduction of environmental lighting had no effect on the plasma cortisol and prolactin values immediately after exercise. Significant positive relationships between post exercise melatonin levels and body mass, age and pulse rate were noted in all volunteers. Since plasma melatonin reached a plateau level after 30 minutes, it is suggested that controlled exercise (step-climbing), which induces an energy output of 185 W/m2 body surface, conducted in a room with reduced environmental lighting for a period of 30 minutes, may form the basis for a pineal function test. PMID- 6505889 TI - Schistosomiasis and bladder carcinoma in Natal. AB - In a retrospective study 184 biopsy reports of primary malignant bladder tumours in males which had been received from the Department of Pathology, University of Natal, during 1971-1982 were analysed. The age and race of the patients, the histological type of the tumours and the presence or absence of concomitant schistosomal infection were noted. There were 103 squamous and 62 transitional cell carcinomas, and 19 adenocarcinomas or undifferentiated types of malignant tumour. Of the patients 153 were Blacks and 31 Indians, 61,4% of the Blacks had squamous cell carcinoma, as against 29% of the Indians (P less than 0,01). Bladder carcinoma among Blacks occurred at a younger age (5th decade) than that among Indians (6th decade). The prevalence of schistosomiasis in the whole group was 40,8%. The prevalence was highest in the Blacks (44,4%); in the Indians it was 22,6%. Schistosomal infection was most commonly associated with squamous cell carcinoma (61%) (P less than 0,0001). PMID- 6505890 TI - Neck manipulation causing stroke. Case reports. AB - Neck manipulation may cause injury to the vertebrobasilar arterial system with resultant brainstem ischaemia or infarction. This complication has been recognized for many years, and although rarely reported in the literature is a well-recognized problem encountered by neurologists. This article describes 3 patients with this condition seen at the Johannesburg Hospital. The probable pathogenesis is that a thrombus occurs at a site of vertebral artery injury created by sudden sharp neck movement chiefly between the axis and atlas. This thrombus may propagate or embolize. The therapeutic role of anticoagulants is discussed. PMID- 6505891 TI - Propranolol for the treatment of diazepam withdrawal symptoms. PMID- 6505893 TI - Peri-operative management and administration of anaesthesia in children with congenital complete heart block. A case report and review. AB - The clinical presentation and natural history of congenital complete heart block (CHB) differ from those of acquired third-degree heart block. Although perioperative prophylactic cardiac pacing is considered mandatory in patients with acquired CHB, it is not usually necessary in children with asymptomatic congenital heart block. The anaesthetist should be able to identify which patients require temporary perioperative pacing, and should modify his anaesthetic technique appropriately for patients who do not. An 8-year-old patient with congenital CHB who required emergency surgery for acute appendicitis is presented and the anaesthetic management, including the indications for pacing, is discussed. PMID- 6505892 TI - Absence of evidence of myocarditis in endomyocardial biopsy specimens from patients with dilated (congestive) cardiomyopathy. AB - This study aimed: to assess the clinical value of endomyocardial biopsy (EMB) in 76 patients with dilated cardiomyopathy (DCM); to look for residual evidence of myocarditis, especially in patients in whom EMB was undertaken shortly after the onset of cardiac symptoms; to identify ultrastructural changes which may indicate the cause of DCM; and to see if the observed ultrastructural alterations correlated with duration of symptoms, left ventricular ejection fraction and the ratio of left ventricular wall thickness to chamber diameter. Biopsy diagnosis of DCM was possible with adequate exclusive clinical data combined with evidence of myofibre hypertrophy and exclusion of other morphologically detectable causes of cardiac hypertrophy and dilatation, e.g. myocarditis. The ultrastructural features did not correlate with duration of symptoms, ejection fractions or ratio of left ventricular wall thickness to chamber diameter. The lack of evidence of myocarditis in EMB specimens from our DCM patients, including those with a short history, suggests that myocarditis is an uncommon cause of DCM. Only a quarter of the biopsy specimens showed fibrosis and the ultrastructural features were those of hypertrophy. Degenerative changes were present in varying percentages of the specimens examined (e.g. myofilament loss in 64%). This study suggests that conditions other than myocarditis should be considered as causes of DCM--such causes (e.g. metabolic dysfunction) may be potentially reversible if recognized and treated. PMID- 6505894 TI - Short duration of survival among South African blacks with oesophageal cancer. AB - South African urban Blacks are very prone to oesophageal cancer, and mean age at diagnosis is almost a decade lower than that of White patients (male preponderance is equally marked in both ethnic groups). In recent years the socio economic position of urban Blacks has improved greatly, with considerable strides being made in literacy and awareness of hospital services. This socio-economic improvement could conceivably improve the extremely short durations of survival among oesophageal cancer patients noted in earlier studies; this, however, has not occurred. Of a series comprising 146 male and 37 female patients, 50% had died after 3,6 and 4,2 months respectively. The corresponding periods noted for White patients are about twice as long. PMID- 6505895 TI - Drugs in sport. A report of laboratory investigations into the prevalence of their use in South Africa. AB - Screening procedures utilizing two-dimensional thin-layer chromatography, gas liquid chromatography and gas chromatography-mass spectrometry were carried out in an attempt to detect stimulant drugs in urine specimens collected from competitors in three major sporting events held during 1983. Drugs classified as forbidden stimulants by the International Olympics Committee were detected in 4% of the specimens collected from competitors in the South African Athletics Championships and in 28% of the specimens collected from competitors in the 1983 Rapport Cycling Tour, while none were detected in specimens collected from competitors in the South African Senior Swimming Championships. PMID- 6505896 TI - Publish or perish--the growing trend towards multiple authorship. AB - This study was undertaken to investigate the subjective impression that medical articles written by a single author predominated a decade ago, whereas multiple authorship is the rule today. Samples from 1971 and 1982 issues of the South African Medical Journal were studied, and the impression is shown to be valid. The mean number of authors per article increased from 1,77 in 1971 to 2,35 in 1982, while the proportion of articles with only 1 author decreased from 60,8% to 40,8%. Possible reasons for this are mentioned, of which the pressure to publish may not be the least. PMID- 6505897 TI - Pregnancy following treatment of retrograde ejaculation with clomipramine hydrochloride. A report of 3 cases. AB - In 2 out of 3 cases of retrograde ejaculation treatment with clomipramine hydrochloride resulted in normal ejaculation and conception. The 3rd patient was only partially helped by the drug. The mechanisms of ejaculation, the causes of retrograde ejaculation, the management of the condition and the relevant pharmacological features of the tricyclic anti-depressants are discussed. PMID- 6505898 TI - Staphylococcus aureus tricuspid valve endocarditis in young women after gynaecological events. A report of 3 cases. AB - Three cases of Staphylococcus aureus tricuspid valve endocarditis are reported; each was preceded by a gynaecological event. In 2 cases there was no overt pelvic sepsis and there had been no operative or instrumental intervention, but in the 3rd pelvic inflammatory disease was present, probably not as a result of interference. There are few reports in the recent literature of gynaecological events precipitating this condition; in contrast, intravenous narcotic abuse is well documented. In the literature there is insufficient stress laid on the fact that non-septic gynaecological events may cause the endocarditis. The difficulties in diagnosing tricuspid endocarditis, especially in a milieu where intravenous narcotic abuse is virtually unknown, are noted. When endocarditis is present in women known not to abuse narcotics, the absence of signs of pelvic inflammation may also cause difficulties in diagnosis. PMID- 6505900 TI - Systemic lupus erythematosus in a black man. PMID- 6505899 TI - Physostigmine and the adrenergic/antimuscarinic syndrome. A case report. AB - A 14-year-old White boy was recently admitted to the Universitas Hospital, Bloemfontein, with an adrenergic/antimuscarinic syndrome following drug overdose. The causation of the syndrome and successful management with physostigmine salicylate are discussed. PMID- 6505901 TI - A clinical and ultrastructural study of osteogenesis imperfecta after flavonoid (Catergen) therapy. AB - A trial of the flavonoid Catergen (Zyma) has been undertaken in 11 adults with osteogenesis imperfecta (Ol). The only significant clinical or metabolic side effects were severe headaches, which necessitated the withdrawal of 3 patients from the trial. Patient compliance in terms of palatability of Catergen was good, and 3 of the 8 patients who completed the trial experienced subjective improvement. After 6 months' treatment with Catergen, the abnormally narrow collagen fibrils found in the osteoid region in a pretreatment bone biopsy specimen from a middle-aged man with the common type 1 (autosomal dominant) form of Ol showed a significant reversion to normal diameters. Post-treatment specimens from his 2 affected sons, who exhibited the same defect, showed a similar but less marked response. PMID- 6505902 TI - Management of patients with a diastolic blood pressure of 90 mmHg in the third trimester of pregnancy. AB - A retrospective study of 50 patients admitted to the Peninsula Maternity Hospital, Cape Town, with a diastolic blood pressure of 90 mmHg was carried out. Proteinuria and a serum urate level of 0,36 mmol/l or more were found to be risk factors in this group. It is suggested that these patients can be managed as outpatients if no proteinuria is present and the serum urate level is less than 0,36 mmol/l; they should be trained to test urine at home and should be followed up on a weekly basis. A small prospective study showed that home urine testing was both workable and satisfactory. PMID- 6505904 TI - Dermatofibrosarcoma protuberans in black patients. AB - Twelve cases of dermatofibrosarcoma protuberans in Black patients admitted to Baragwanath Hospital, Johannesburg, between 1979 and 1983 are reviewed. The cause of this slow-growing, low-grade malignant fibrous histiocytoma is unknown, but there is some evidence that trauma may be a predisposing factor. The clinical and histological features of dermatofibrosarcoma protuberans are described, and treatment by wide tridimensional excision with local reconstruction is recommended. PMID- 6505903 TI - Extradural haematoma. An analysis of two 8-year series at Groote Schuur Hospital. AB - Between 1954 and 1961 85 patients were operated on at Groote Schuur Hospital (GSH) for extradural haematomas and between 1968 and 1975 84 operations for this condition were performed. The 169 patients included 22 children; they had a mortality rate of 4,5% (1 death) compared with the 18,9% mortality for the combined total. There were 19 males to each female. The ratio of White to Coloured to Black patients was 3:8:5. Forty-eight per cent of extradural haematomas resulted from assaults, 24% from road traffic accidents and 28% from other injuries; these figures did not differ significantly in the two series. Among the 72 patients operated on within 24 hours of injury the mortality rate was 26,4%, whereas among the 97 operated on later the rate was significantly better--13,4%. The most significant feature was the difference in outcome for the 97 patients admitted direct to the neurosurgical unit at GSH, of whom 12,4% died, compared with 21 transferred from suburban hospitals, where the mortality rate was 33,3%, and the 51 patients sent from rural hospitals, of whom 25,5% died. Although neuroradiological methods are the most reliable means of localizing intracranial haematomas, the advantages gained may be outweighed by the urgency with which decompression is required. This means that the staff of rural and suburban hospitals must be trained to carry out diagnostic burr-holes followed by craniotomy if it should be necessary. PMID- 6505905 TI - Circulating immune complexes in typhoid fever. AB - Levels of circulating IgG- and IgM-containing immune complexes were studied in patients with typhoid fever. Raised levels of both were always found at the time of presentation; they fell towards normal over 3-4 weeks. In 1 patient with a less favourable clinical course the immune complexaemia lasted longer than in the others. PMID- 6505906 TI - Massive oedema of the ovary. Case reports. AB - Six cases of massive oedema of the ovary are presented. This is an uncommon condition occurring in young women, and is thought to result from periodic torsion. The patients most commonly present with lower abdominal pain, but there may be endocrine effects which are probably related to luteinization of stromal cells within the oedematous ovary. Although the reported treatment has been oophorectomy, since the lesion is benign conservative therapy should be considered. PMID- 6505907 TI - Extracranial internal carotid artery aneurysm. A case report. AB - A patient with an asymptomatic, right-sided internal carotid artery aneurysm is reported. The entity was accurately located and diagnosed pre-operatively by utilizing a duplex ultrasonographic scanner. Treatment comprised aneurysmectomy and restoration of arterial continuity by autogenous venous grafting. The patient recovered without the occurrence of any sequelae. PMID- 6505908 TI - Muscle invasion by Basidiobolus haptosporus. AB - Invasion of muscle tissue in addition to dermis and subcutaneous tissue by Basidiobolus haptosporus is reported in a 40-year-old female housewife. This infection followed intramuscular injection injury of the right gluteal region. Oral KI cured the condition completely in 6 months. Intramuscular implantation of B. haptosporus by the injection needle is the probable mode of infection in this case. Possible blood vessel invasion seen in histology suggests the possibility of dissemination of the fungus. PMID- 6505909 TI - [Dermatophytosis caused by Aphanoascus fulvescens]. AB - Aphanoascus fulvescens was isolated from lesions resembling a dermatophyte infection in a 45-year-old woman who had used steroid cream for several months to treat a dermatosis of the neck. Treatment with griseofulvin and tolnaftate cured the lesions in 6 weeks. The microscopic characteristics of the isolate and its size differed slightly from those described by several other authors, and bore a closer resemblance to isolates previously described from Australia and New Guinea. PMID- 6505910 TI - Comparison of cell wall and membrane proteins from eight Candida species. AB - Cell surface proteins from eight Candida species were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The cell wall proteins of these species were similar in their electrophoretic patterns. On the other hand, differences were detected among the patterns of membrane proteins, although C. albicans serotypes A and B gave similar electrophoretic patterns, and so did two species (C. pseudotropicalis and C. parapsilosis). PMID- 6505911 TI - A serum mannan-binding protein and candidiasis. AB - A mannan-binding protein purified from rabbit serum agglutinated Saccharomyces cerevisiae in a Ca2+-dependent manner. Its binding to related carbohydrate ligands is reduced either by yeast mannan at 10 ng ml-1 or serum from patients with suspected deep-seated candidiasis. A role for mannan-binding protein in diagnosis and pathogenesis is considered. PMID- 6505912 TI - A colorimetric assay for the assessment of cytotoxicity of yeasts. AB - A colorimetric assay for the quantitation of microbial cytotoxicity has been developed using cells from a monocyte-like human cell line (U937), epithelial cells (Hela), and fibroblast-like cells (Vero) as targets. The fraction of surviving cells was determined by their content of the dye neutral red which is retained only by live cells and can be quantitated photometrically after controlled lysis. The neutral red retention assay was at least as sensitive as the 51Cr-release assay; it was considerably less laborious, faster, and avoided handling of radioactivity. Among the different Candida species tested, the highest cytotoxicity was associated with C. albicans and C. tropicalis; a lower degree of cytotoxicity was exhibited by C. glabrata, C. guilliermondii, C. krusei, C. parapsilosis, and C. pseudotropicalis. Among the strains of a given fungal species cytotoxicity varied by up to 40%. PMID- 6505913 TI - Analytical isoelectric focusing of secreted dermatophyte proteins applied to taxonomic differentiation of Microsporum and Trichophyton species (preliminary studies). AB - Culture filtrates were prepared from dermatophytes under standard conditions and adapted for analytical isoelectric focusing in thin layer polyacrylamide gels over the pH range 3.5-9.5. Dermatophytes grown in trypticase soy broth secreted a large number of proteins displaying a wide range of isoelectric points (pIs). Trichophyton megninii extracts contained a triplet of proteins focusing in the pH 8.0-8.5 range that were absent in taxonomically related T. kuryangei isolates. Single ascospore isolates and standard tester strains of Nannizzia otae (+) mating type were differentiated from the (-) mating type by proteins focusing at pH 6.5 and 8.4. These were markedly reduced in the (+) type. The isofocused pattern of Microsporum canis conformed closely to the (-) mating type of N. otae. The protein patterns of T. megninii and T. kuryangei were distinct from those obtained with M. canis and M. equinum because of an intense-staining broad protein band, pI 7.2, and three periodic acid-Schiff-positive glycoproteins focusing in the acidic range which were absent in the Microsporum species. A characteristic protein or doublet (pI 8.7) was present in the Microsporum species and absent in the Trichophyton species. Analytical isoelectric focusing is a potentially useful method to distinguish inter- and intra-species differences in the pattern of secreted dermatophyte proteins present in culture filtrates and in trichophytins. The information derived may be useful in the classification of species. PMID- 6505915 TI - Subcutaneous phaeohyphomycosis caused by Cladosporium devriesii, sp. nov. AB - A 26-year-old woman from Grand Cayman Island with a 3-month history of a lump in the left breast was presumptively diagnosed as having a carcinoma. A segmental resection was attempted. Histologic examination of the biopsied tissue showed extensive granulomatous inflammation, necrosis, and septate, branched, dematiaceous hyphae in the intralobular ducts as well as in the surrounding tissues. When cultured on Sabouraud dextrose and brain heart infusion agars, the tissue yielded a slow-growing, downy, dematiaceous mould. Microscopically, it produced short, branched and unbranched chains of holoblastic conidia in acropetal manner from erect conidiophores that were characteristic of the genus Cladosporium. The isolate grew well at 36-37 degrees C, but failed to grow above 37 degrees C. It did not liquefy gelatin nor decompose casein, xanthine, hypoxanthine, or tyrosine, but did hydrolyze urea. Comparative studies with other pathogenic and saprophytic species of Cladosporium revealed that it represented an undescribed species. It is named Cladosporium devriesii, sp. nov. PMID- 6505914 TI - A comparison of experimental pathogenicity of Candida species in cyclophosphamide immunodepressed mice. AB - The experimental pathogenicity of Candida albicans, C. krusei, C. guilliermondii, C. parapsilosis, C. tropicalis and C. viswanathii was tested in normal and in cyclophosphamide-(Cy) immunodepressed mice. In unpretreated CD1 mice only C. albicans, C. tropicalis and C. viswanathii were pathogenic on intravenous challenge, with LD50 of 1.0 X 10(6), 4.8 X 10(6), 7.2 X 10(8) cells, respectively, per kg. Three days after a single intraperitoneal injection of Cy (150 mg kg-1) mice had a marked decrease in spleen weight and cellularity as well as reduced numbers of circulating leukocytes. Under these conditions, there was a significant, proportional increase in pathogenicity of C. albicans, C. tropicalis and C. viswanathii but the animals were still resistant to challenge with C. krusei, C. guilliermondii and C. parapsilosis. This pattern of susceptibility was not influenced by higher doses of Cy. Only C. albicans and C. tropicalis were capable of rapid and extensive multiplication in target organs such as kidney and brain in normal and Cy-treated mice and for both these species of Candida, there was a 'rebound' effect of increased resistance to experimental infection after 12 days from Cy administration. This study shows that the strong immunodepression provoked by Cy does not modify significantly the susceptibility of the animal to those species of Candida which were endowed with low or no pathogenicity for normal mice, but it greatly increases the susceptibility to those species of Candida that are already pathogenic for unmodified host. PMID- 6505916 TI - Imported penicilliosis marneffei in the United States: report of a second human infection. AB - The first natural infection due to Penicillium marneffei in a human was reported in the United States in 1973. We describe a second case of penicilliosis marneffei that was diagnosed in Florida. In both instances, the patients had a history of travel in Southeast Asia where P. marneffei is endemic. The Florida patient had recurrent episodes of hemoptysis attributed to bronchitis and bronchiectasis. In spite of therapy with various antibacterial antibiotics for tuberculosis, the granulomatous lesions in the left upper lobe of the lungs persisted. The diagnosis of penicilliosis marneffei was established by isolating and identifying the dimorphic species of Penicillium, P. marneffei. The histopathologic features of the lung tissue included granulomata with central areas of necrosis and neutrophilic infiltration with many yeast-like, tissue-form cells of P. marneffei, which multiplied by a fission rather than a budding process. PMID- 6505917 TI - Decision analytic approach to the management of gonorrhea contacts. AB - We used a combination of decision analytic and modeling techniques in constructing a model for study of the management of an asymptomatic woman presenting to a sexually transmitted disease clinic as a contact of a man with gonorrhea. Total cost (physical, emotional, and economic) is expressed in units of dysutility. Initially the probabilities and "costs" of anogenital gonorrhea, incubating syphilis, carriage of the agents of nongonococcal urethritis, and coincident pharyngeal gonorrhea are considered; complications and sequelae are then accounted for. The best strategy is to culture for Neisseria gonorrhoeae, treat immediately with tetracycline, and follow up sexual partners if the culture is positive. Dysutility values calculated for the strategies of just treating with standard regimens of tetracycline, procaine penicillin, or amoxicillin are 288, 310, and 560, respectively. Sensitivity analyses show that the most important factors in determining optimal strategy are the probabilities and costs associated with the patient's carriage of the agents of nongonococcal urethritis. In order for this decision to change, the dysutility value for nongonococcal urethritis would have to decrease to 17% of our best estimate, or the overall prevalence of nongonococcal urethritis would have to be reduced to 16% of our best estimate. PMID- 6505918 TI - Infections in sexual contacts and associates of children with gonorrhea. AB - The productivity of gonorrhea case-finding among persons epidemiologically associated with children infected with Neisseria gonorrhoeae was examined. During a 33-month period, 36 cases of gonococcal infection in children prompted the examination of 244 individuals who were identified as either sexual contacts, household associates, or nonhousehold associates. Overall, we found an infection rate of 18.4% among 244 persons associated with cases of gonococcal infection in children. Of 21 sexual contacts examined, ten (47.6%) had gonorrhea. Of 223 persons associated with the childhood cases of gonorrhea, 21 (16%) of household associates and 14 (15.2%) of nonhousehold associates were found to have gonorrhea. Associates aged greater than or equal to 30 years who were not named as sexual contacts had a risk of infection significantly lower than that of younger persons examined. These results emphasize that gonorrhea screening prompted by reports of cases in children should not be limited to those persons identified as sexual contacts or household members. PMID- 6505919 TI - Mycoplasma hominis--a human pathogen. PMID- 6505920 TI - Condylomata lata of the toewebs: a case report of an unusual manifestation of syphilis. AB - The case of a young man with condylomata lata in the toewebs of both feet is presented. Treponema pallidum was identified in these lesions. Examination two weeks after intramuscular injection of 2.4 X 10(6) units of benzathine penicillin showed resolution of the lesions on the toewebs. PMID- 6505922 TI - The state and the prospective development of automated management systems (AMS) for public health. PMID- 6505921 TI - [Implications of the use of nuclear medicine for the irradiation of the population and persons occupationally exposed]. PMID- 6505923 TI - Experiment of periodical medical examinations by computers. PMID- 6505924 TI - [Methodology of tables on the causes of death and their use for assessing mortality relationships of the East German population in a longitudinal comparison]. PMID- 6505925 TI - Usage of dispersion analysis in studying risk factors of morbidity for metallurgy industry workers, by cardiovascular system diseases. PMID- 6505926 TI - Considerations on the use of some health indicators in the assessment of the population's living standard. PMID- 6505927 TI - [Immunologic aspects of asymptomatic chronic carriers of HBsAg]. PMID- 6505928 TI - [Relation between the hemolytic system and cell variants in paroxysmal nocturnal hemoglobinuria]. PMID- 6505929 TI - [The effect of thrombin on platelet membrane glycoproteins measured by lectins]. PMID- 6505930 TI - [Multifocal eosinophilic granuloma. Analysis of 19 cases]. PMID- 6505931 TI - [Analysis of constitutional heterochromatin in multiple myeloma]. PMID- 6505932 TI - [Group for the Study of Immunohematology and Hemotherapy. Norms for the selection and care of platelet and granulocyte donors for pheresis technics]. PMID- 6505933 TI - [Evaluation of sodium and potassium fluxes across the red blood cell membrane]. PMID- 6505934 TI - [Megaloblastic anemia in Lesch-Nyhan disease]. PMID- 6505935 TI - [Idiopathic myelofibrosis with cutaneous myeloid metaplasia]. PMID- 6505936 TI - Effects of betacarbolines on the automaticity of the guinea pig sinus node. AB - The effects of betacarbolines on guinea-pig isolated sinus nodes superfused with Tyrode's solution at 35 degrees C were analyzed. All analogs depressed the automaticity. The phase 4 of transitional fibers was depressed, in the absence of any change in maximum diastolic potential. The threshold for harmaline action was 10(-7)M. Dehydrogeneration of harmaline into harmine increased the potency. Removal of the methoxy group (harmane) did not modify the potency but accelerated the recovery. Substitution of the methoxy group by a hydroxy group (harmalol and harmol) reduced markedly the potency of harmaline and harmine, respectively. PMID- 6505937 TI - Management of penetrating wounds of the back and flank. AB - The results of a retrospective and prospective study of patients with penetrating wounds of the back and flank showed that physical examination alone was accurate in 72 and 83 per cent, respectively. The inaccuracy was primarily due to false negative examinations. The most commonly injured organs were the liver and kidney. The presence of gross hematuria and intravenous pyelography proved to have an accuracy rate of 95 per cent in patients studied prospectively. Peritoneal lavage, although similarly accurate (95 per cent), was associated with a 10 per cent false-negative result when the wound was located in the back. Guidelines for the management of these patients include hospital admission, careful physical examination, urinalysis by dipstick and cell count, intravenous pyelography and peritoneal lavage. Initial hypotension usually is associated with visceral injury and is an indication for exploratory laparotomy. Strict adherence to these guidelines was associated with a negative exploration rate of less than 10 per cent and a decrease in the number of patients observed with visceral injury from 50 to 6 per cent. PMID- 6505938 TI - The spectrum of polyposis. AB - Familial polyposis is a systemic defect of growth regulation. Extracolonic expressions are common and serious, about equal in risk to carcinoma of the large intestine. Periodic surveillance of the upper gastrointestinal tract is particularly important. More intensive surveillance of the large intestine may lead to better results in patients with polyposis who have carcinoma of the large intestine develop. PMID- 6505939 TI - Embolism of the popliteal artery. AB - The experience with popliteal arterial embolism at the Massachusetts General Hospital was surveyed, and the results of therapy prior and after the introduction of the balloon-tipped embolectomy catheter were compared. During the 17 year period from January of 1964 to January 1981, 67 popliteal emboli were diagnosed. Nonsurgical management was successful in salvaging 11 of 13 extremities in ten patients with one death. Surgical embolectomy was performed upon 54 extremities in 48 patients with 40 limbs salvaged and 11 deaths. Although the percentage of patients undergoing surgical therapy for popliteal emboli has dramatically increased since the introduction of embolectomy catheters, no improvement in limb salvage or in patient survival has resulted. In fact, the limb salvage rate has declined. Nonsurgical management in appropriately chosen patients is clearly successful. The results of this survey emphasize the necessity of early diagnosis and treatment as well as selective patient management. Recommendations for a therapeutic approach to popliteal emboli are presented which hopefully will improve the results. PMID- 6505940 TI - Minimal deviation melanoma. AB - Minimal deviation melanoma is a recent concept of uncertain biologic significance. Minimally deviant melanocytes are not seen in metastases, suggesting they do not have the same biologic behavior as clearly malignant cells. Therefore, the Breslow and Clark prognostic criteria may not be applicable. Eight patients with MDM are presented. All were treated by scar re excision and primary closure. Lesions ranged from 0.31 to 1.65 millimeters thick and four were Clark's level IV. Median follow-up study has been 19 months without evidence of local recurrence or distant metastasis. We concluded that MDM has a low likelihood for aggressive behavior in spite of tumor penetration which might suggest otherwise and that radical surgical therapy appears unnecessary. PMID- 6505941 TI - Diabetes mellitus and atherosclerotic involvement of the profunda femoris artery. AB - Arteriosclerotic involvement of the PFA is correlated with diabetes mellitus. While patients without diabetes have disease limited to the PFA orifice and the circumflex vessels of the PFA, patients with diabetes are prone to extensive PFA involvement. Severity of atherosclerosis involving the CFA and SFA was not found to be specifically related to diabetes. PMID- 6505942 TI - The development of infections of the genitourinary tract in the wives of infertile males and the possible role of spermatozoa in the development of salpingitis. AB - Genitourinary tract infections developing in wives during marital life in 1,350 infertile couples were examined. Women married to men with a history of genital tract infection had a significantly higher incidence of vaginitis, urinary tract infection, salpingitis and genital herpes when compared with women whose husbands did not have genital tract infections before the marriage. Of the variables examined, the two factors that showed the most significant association with the tendency to develop salpingitis were the sperm count and the length of time the couple had been trying to achieve a pregnancy. The wives of azoospermic males did not have pelvic inflammatory disease develop but had the same incidence of infection of the lower part of the genital tract as the other studied groups. It is suggested that the bacterial flora of the seminal fluid can play a role in developing salpingitis in the female and that spermatozoa may be involved in delivering bacteria to the higher genital tract structures. PMID- 6505943 TI - Inguinal hernias after ventriculoperitoneal shunt procedures in pediatric patients. AB - The results of this study of 134 patients confirm the increased incidence of previously unrecognized inguinal hernias after ventriculoperitoneal shunting procedures. Infants with intraventricular hemorrhage appeared to be the most susceptible, although associated prematurity may play an additional role. Close observation of infants and children who undergo ventriculoperitoneal shunting is required, to allow early detection and repair of inguinal hernias. Inguinal herniorrhaphy can be performed safely with few or no postoperative complications and no deleterious effects to the VP shunt. PMID- 6505944 TI - A technique of ilioinguinal lymph node dissection for carcinoma of the penis. AB - A technique has been described for ilioinguinal lymph node dissection that provides good exposure for both the pelvic and inguinal dissections and circumvents the anatomic barrier presented by the inguinal ligament. It also enables one to evaluate the pelvic lymph nodes unilaterally or bilaterally prior to the inguinofemoral dissection if one elects to do so. A limited experience demonstrates the practical feasibility of this procedure. Although the results with this technique compare favorably with those of other techniques, experience is too small to permit categoric assessment of its relative advantages and disadvantages. PMID- 6505946 TI - A new instrument for thoracentesis. AB - Thoracentesis is a commonly performed procedure. Standard techniques have been generally acceptable, but there are occasional serious complications requiring additional treatment and operative procedures. Attempts at near complete aspiration of fluid are often unsuccessful and time consuming with the currently used methods. The change from a sharp needle technique to an intravenous catheter technique has been an improvement, but creates the additional difficulty of briefly exposing the pleural space to atmospheric pressure. Also, blunt end catheters without sideholes may produce incomplete evacuation of fluid, and some intravenous catheters have been cut off and retained in the pleural space. The new instrument described has produced excellent results in a small clinical series. It has effectively overcome the disadvantages of both the standard needle technique and the more current intravenous catheter techniques. The time spent on thoracentesis has been considerably shortened, an advantage for both the patient and the physician alike. PMID- 6505945 TI - A denervated pancreatic flap for control of chronic pain in pancreatitis. AB - These preliminary results of a new approach for the control of pain in chronic pancreatitis are presented with the hope that others experienced in this field will test this concept. PMID- 6505947 TI - Facilitated endotracheal and tracheostomy tube replacement. AB - Techniques are presented for facilitating rapid replacement of endotracheal tubes and tracheostomy cannula. These techniques are of the greatest benefit to severely ill patients as the duration of separation from respiratory support is minimized by their use. PMID- 6505948 TI - What is a Nissen fundoplication? PMID- 6505949 TI - Vertical prisms. Why avoid them? AB - Vertical prisms are useful in the permanent or temporary alleviation of asthenopic symptoms arising from a vertical misalignment of the visual axes. A wide variety of both comitant and noncomitant hyperdeviations may be candidates for vertical prism use. Vertical prism strength is seldom difficult to compute and when properly employed, vertical prisms do not lead to unsightly spectacles. PMID- 6505950 TI - Nuclear magnetic resonance imaging in neuro-ophthalmology. Demonstration of a pontine glioma. AB - The development of nuclear magnetic resonance imaging techniques provides the physician with a non-invasive means of obtaining anatomic, physiologic and biochemical information about neuro-ophthalmic disorders. The authors summarize the principles of nuclear magnetic resonance imaging and present a case report illustrating its particular application to the demonstration of a pontine glioma. PMID- 6505951 TI - Ophthalmic drug delivery systems. AB - In recent years, increased attention has been given to the development of new systems for the delivery of ophthalmic medication. These systems are of interest for several reasons: they generally require less frequent administration than eyedrops; some of them provide therapy with fewer drug side effects than eyedrops; and they can offer practical advantages in situations where repeated, self-medication by patients is not feasible. Further, by providing continuous delivery, they allow the use of some newly emerging drugs that have very short biological half-lives. Some ocular delivery systems extend the duration of drug action by enhancement of corneal absorption; these include soluble gels and emulsions, hydrophilic ocular inserts, ion-pair associations, pro-drugs, and liposomes. Other delivery systems provide for a controlled release of drugs, thus avoiding the pulse-entry with which side-effects are associated. These systems can be based on any of several different mechanisms, and include both erodible and nonerodible matrices. The various new systems that have been developed, or are known to be under development, are described in this review, along with their mechanisms and limitations, and with the therapeutic rationale for their use. PMID- 6505952 TI - Night myopia. AB - Although the phenomenon of night myopia has been recognized for two centuries, its causes are still not fully understood. Early studies implicated spherical aberration and accommodation, but the degree to which either contributed was not clearly established. More recently, "laser speckle" techniques to measure myopia have allowed the collection of data on large subject populations and it appears that night myopia represents a tendency for accommodation to approximate the dark focus as low luminance levels degrade the clarity of the retinal image. In this article, the authors review the past and present literature on night myopia and related anomalous myopias, and describe techniques for their evaluation and correction. PMID- 6505953 TI - Problems of conscience and fact: consulting on medicolegal claims. AB - The physician is not obliged to act as a consultant in medicolegal cases, but if one does, one should consult for either the defense or the plaintiff. I believe that acting as a consultant is of service to one's medical colleagues and to society as a whole. Moreover, a series of cases substantiates the view that it should be an advantage to physicians if more ophthalmologists of stature would accept this task. PMID- 6505954 TI - Melting corneas with collapsing nose. AB - A 31-year-old white woman with relapsing polychondritis presented with profound, diffuse episcleritis, marked conjunctival chemosis, and corneal-limbal inflammation and melting, which was refractory to corticosteroid treatment. With the initiation of chlorambucil the inflammation subsided, leaving an almost normal slit-lamp picture. The associated findings of nasal cartilage and pinna cartilage inflammation helped to establish the diagnosis of relapsing polychondritis in this patient. PMID- 6505955 TI - The nonspecific orbital inflammatory syndromes. AB - The nonspecific orbital inflammatory syndromes are a peculiar group of inflammations that may occur in acute or subacute forms and can become chronic. They may be diffuse or primarily localized to a specific tissue of the orbit. The nonspecific inflammations that are targeted toward specific tissues are myositis, dacryoadenitis, perineuritis, and periscleritis. Each of these syndromes has definite signs, symptoms, ultrasonic and radiologic findings. Therefore, this group of nonspecific inflammations should be more clearly classified for purposes of better understanding and better management. All of these inflammatory syndromes in the acute form respond well to high doses of oral corticosteroids tapered gradually over a period of months, but may be reoccurrent or become chronic. The subacute form responds less well. Occasionally, patients require radiation to stop the inflammation in the subacute or chronic state, but these patients are often left with a functional deficit. The cause, although presumed to be an immune disorder involving the orbital tissues, remains unknown. PMID- 6505956 TI - Management problems in coexisting parathyroid crisis and florid thyrotoxicosis. AB - The etiologic relationship between parathyroid and thyroid disease is controversial and still not well defined. An increased incidence of parathyroid adenomas with thyroid disease has been suggested by some researchers. Other authors are unable to confirm this and maintain that the major factor contributing to the coexistence of parathyroid adenomas and thyroid disease is the prevalence of these conditions, independently, in middle-aged women. Serum parathyroid hormone levels are generally lower in patients with thyrotoxicosis and higher in patients with hypothyroidism. The simultaneous occurrence of thyrotoxicosis and symptomatic hyperparathyroid crisis has been reported previously only once in the American literature. We report a case of a 32-year old woman with documented uncontrolled Graves' disease (T4 = 20 micrograms/dl [normal = 4.5 to 11.5 micrograms/dl], total T3 = 361 ng/dl [normal = 115 to 190 ng/dl], T3RU = 53% [normal = 35% to 45%]), who developed parathyroid crisis (serum calcium = 15 mg/dl [normal = 9 to 11 mg/dl], N-terminal parathyroid hormone = 121 pg/ml [normal = 11 to 24 pg/ml], C-terminal parathyroid hormone = 9416 pg/ml [normal = 60 to 450 pg/ml]). After a turbulent 10-day period to achieve a euthyroid state with propranolol, propylthiouracil, and a saturated solution of potassium iodide, operation revealed a large parathyroid adenoma (2 by 2 by 3 cm) and a diffusely hyperplastic thyroid gland. Adenoma excision and bilateral subtotal thyroidectomy were performed. This case illustrates management guidelines of a true endocrine emergency in which prompt operation for acute hyperparathyroidism could not be undertaken until a euthyroid state and reduction in serum calcium levels were achieved with aggressive medical management. PMID- 6505957 TI - Implantable infusion pump in the therapy of canine adrenal insufficiency. AB - To test the feasibility of a commercially available infusion pump in the treatment of human adrenal insufficiency, we employed the pumps initially in dogs. Two dogs underwent total adrenalectomy and placement of an Infusaid Model 400 infusion pump. These pumps have a drug reservoir of 45 ml and are refilled by percutaneous injection approximately every 2 weeks. Hydrocortisone phosphate was used as replacement glucocorticoid. Serum cortisol values correlated with the amount of drug delivered, and daily administration of 10 to 50 mg/day maintained the plasma cortisol level within the normal range (1 to 6 micrograms/dl). Mineralocorticoid replacement initially consisted of fludrocortisone by mouth and subsequently aldosterone via infusion pump. Serum electrolytes fluctuated with the amount of drug delivered, and doses of approximately 100 to 400 micrograms administered orally per day and 70 to 100 micrograms/day per pump maintained serum electrolytes within the normal range. Dependence upon and effectiveness of pump administration of steroids for long-term survival was demonstrated by: (1) ACTH-stimulation tests after operation and approximately 1 year later, (2) autopsy studies demonstrating total adrenalectomy, (3) repeatedly undetectable plasma cortisol levels during periods of no glucocorticoid supplementation, and (4) repeated hyperkalemia and hyponatremia during periods of no mineralocorticoid supplementation. This study demonstrates that glucocorticoid and mineralocorticoid preparations can remain bioactive for 2 to 3 weeks at 37 degrees C and can be delivered in amounts adequate to sustain a totally adrenalectomized dog via a commercially available infusion pump. In the adrenalectomized dog hydrocortisone sufficient to maintain plasma cortisol values in the normal range does not provide adequate mineralocorticoid replacement. PMID- 6505958 TI - Successful adrenal autotransplantation in Cushing's disease. AB - Since Cushing's disease was delineated as a distinct entity, a wide array of therapeutic modalities has been employed to treat its symptoms, which are primarily the result of hypercortisolism. With the advent of pituitary polytomography and the concept of microadenomas, a wave of enthusiasm has developed in recent years in favor of transsphenoidal microdissection. In a recent national survey, however, one third of 30 endocrinologists reported cure rates below 60% and, according to several respondents, recurrence was a serious problem at 50% or greater incidence. We report on four patients treated by bilateral adrenalectomy and autotransplantation. They were weaned off all corticosteroid medication for up to 6 years. Two of the four patients have demonstrable iodocholesterol uptake at the site of autotransplantation. We also report on three additional patients who are taking reduced doses of cortisone. All seven patients have no demonstrable iodocholesterol uptake in the adrenal fossae or other possible ectopic sites. We believe that bilateral adrenalectomy with autotransplantation is a worthy alternative in the long-term treatment of Cushing's disease. PMID- 6505959 TI - Oncologic aspects of pheochromocytoma: the importance of follow-up. AB - During a 33-year period at Vanderbilt University Medical Center and its long standing affiliated hospitals, Veterans Administration Medical Center and Metropolitan Nashville General Hospital, 69 patients with pheochromocytoma were seen. Despite the fact that hypertension was present in all patients at initial admission, in 11 patients seen during the 1950s the clinical diagnosis of pheochromocytoma was not made and the existence of this tumor was discovered at autopsy examination. In 58 patients the clinical diagnosis of pheochromocytoma was made and surgical excision of pheochromocytoma (or biopsy only in two cases) was carried out. One patient died during the initial postoperative period (1.7%). All of the operative survivors were followed to date or the death, with the exception of three who were lost to follow-up at 18 months and 7 and 11 years, respectively. The incidence of malignant disease in this carefully followed group of patients with pheochromocytoma was impressive. Nine of 69 patients (13%) proved to have malignant pheochromoblastoma, all but one of whom have died. Additional malignant tumors have occurred in two of these nine patients (22%) with proved malignant pheochromoblastoma and in 14 of 60 patients (23%) with benign pheochromocytoma. The overall incidence of additional malignant tumors in the collective group of patients with the histopathologically confirmed diagnosis of pheochromocytoma was thus 23% (16/69 patients). It is also interesting that a variety of benign neoplasms occurred in the 60 patients with benign pheochromocytomas (9/60; 15%). If the nine patients with malignant pheochromoblastoma are added, the overall incidence of malignant disease in these 69 patients with pheochromocytoma is 25/69 or 36%. Follow-up of patients with pheochromocytoma is mandatory on a lifetime basis and preferably by the operating surgeon. PMID- 6505961 TI - Solitary parathyroid microadenoma. AB - In our experience with operations for primary hyperparathyroidism, a recurring problem centers on patients whose solitary adenomas are too small to be appreciated at the initial exploration. We have seen four patients with parathyroid microadenomas, which we define as lesions less than 6 mm in diameter in externally undeformed parathyroid glands. Two such patients were fortuitously cured at the initial exploration even though the operative findings were inconclusive. One, a 25-year-old man, underwent excision of an externally normal gland that contained a 3 by 2 by 2 mm microadenoma. He is eucalcemic since the operation. The other patient, a 70-year-old woman with hypercalcemia, responded to prednisone. She then underwent a neck exploration at which the diagnosis of sarcoidosis was confirmed by lymph node biopsy examination. A 4 by 2 by 2 mm parathyroid microadenoma was incidentally removed. The patient is normocalcemic receiving low-dose steroid treatment since the operation. In a third patient, a 34-year-old practical nurse, three explorations were needed to find a parathyroid gland, which was negative for adenoma on frozen-section microscopy. The solitary adenoma, 6 by 3 by 3 mm, was appreciated only on permanent sections. The majority of oxyphil microadenomas should be suspected to be nonfunctioning, as in a 59 year-old woman in whom the lesion coexisted with primary chief cell parathyroid hyperplasia. The hyperparathyroidism responded well to three and a half-gland resection. The 2 by 2 by 2 mm oxyphil adenoma was also removed. Solitary parathyroid adenomas can be subtle and small. Appraisal of parathyroid disease at the operating table is not always straightforward. As more patients with early hyperparathyroidism appear on routine calcium screening, we may expect to see increasing numbers of challenging solitary parathyroid microadenomas. PMID- 6505960 TI - Nelson's syndrome after Cushing's disease in childhood: a continuing problem. AB - Nelson's syndrome--progressive cutaneous hyperpigmentation with x-ray film evidence of an expanding pituitary tumor--is now a well-recognized sequela of bilateral adrenalectomy for Cushing's disease. It is estimated to occur in 8% to 38% of adults. Because Cushing's disease is rare in children, a higher incidence of Nelson's syndrome has not been suggested until recently. Although transsphenoidal operation is now the treatment of choice for Cushing's disease, children who have undergone bilateral adrenalectomy remain at risk for the development of Nelson's syndrome. A review of our experience and the literature indicates that the incidence of Nelson's syndrome after the treatment of Cushing's disease is higher in children than in adults. In our six children who underwent adrenalectomy between 8 and 17 years of age, four developed Nelson's syndrome at 2, 6, 10, and 12 years after adrenalectomy. Two of these patients remain well at 6 and 9 years after treatment with external irradiation. One patient treated with external irradiation developed recurrence at 5 years and required total hypophysectomy. The fourth patient required total hypophysectomy followed by external irradiation. Of the 37 patients reviewed and analyzed, the mean age at diagnosis of Cushing's disease was 12 years, with a mean interval of 8.4 years between adrenalectomy and Nelson's syndrome. Information regarding treatment for Nelson's syndrome was known in 24 patients and included pituitary irradiation (four patients), pituitary operation (11 patients), pituitary irradiation followed by operation (six patients), and pituitary operation followed by irradiation (three patients). PMID- 6505962 TI - The anatomy of parathyroid hyperplasia. AB - Parathyroid hyperplasia aids the surgeon in studying parathyroid anatomy for several reasons: (a) Nature magnifies the glands in hyperplasia; (b) there is a strong clinical imperative to find all glands; (c) histologic controls help guide the dissections; and (d) postoperative clinical and laboratory responses help determine the presence of supernumerary glands. In this study of parathyroid hyperplasia we found four glands in each of 34 patients (136 glands total--37 operations). Six patients (18%) had parathyroid glands totally covered by thyroid tissue, five patients (15%) had mediastinal glands, one patient (3%) had a retroesophageal gland, and one (3%) had a "kissing pair." In addition, after four gland parathyroidectomy, three patients gave evidence of functioning supernumerary glands (9%). Abnormalities in parathyroid anatomy occurred in almost half (47%) of these patients with parathyroid hyperplasia. PMID- 6505963 TI - Subtotal parathyroidectomy for secondary hyperparathyroidism. AB - Controversy exists regarding the relative merits of subtotal parathyroidectomy (SPTX) versus total parathyroidectomy with autotransplantation in the treatment of secondary hyperparathyroidism (HPT). Fourteen patients who underwent SPTX for secondary HPT were evaluated to determine the efficacy of this treatment in view of modern dialysis, diet, and drug treatment. Indications for operation included intractable symptoms (two patients), progressive renal osteodystrophy (eight patients), or both (four patients). Duration of renal failure ranged from 3 to 15 years (mean 7.8 years) before SPTX. The operative serum calcium level was normal in 10 patients, elevated in three patients, and low in one patient. Preoperative parathyroid hormone (PTH) levels ranged from 3.9 to 144 ng/ml (average 41 ng/ml) and decreased after operation to an average of 3.6 ng/ml (normal PTH less than 1 ng/ml). There were no deaths or major postoperative complications. Clinical or radiographic improvement occurred in 80% of patients but did not correlate with absolute reductions in PTH levels. Our results reveal that SPTX is a simple and effective treatment in the initial surgical management of uremic, secondary HPT and appears to be comparable to those obtained with more complicated surgical approaches such as total parathyroidectomy and autotransplantation. PMID- 6505964 TI - Primary hyperparathyroidism during pregnancy. AB - Primary hyperparathyroidism during pregnancy is associated with significant risk of fetal loss and neonatal and maternal morbidity. Neonatal hypocalcemia probably results from transient hypoparathyroidism consequent to abnormal suppression by fetal hypercalcemia. Loss of the protective effect provided by the placental calcium transport mechanism produces significant maternal risk for development of acute hypercalcemia and possible crisis immediately postpartum. Management of maternal primary hyperparathyroidism diagnosed during pregnancy should be based on the patient's symptoms, severity of the disease, and gestational age of the fetus. Patients without symptoms and those with mild hypercalcemia may be managed effectively and safely for a short time with oral phosphate therapy, postponing operation until after delivery. More severe disease characterized by progressive symptoms and inadequately controlled hypercalcemia should be treated surgically after control of hypercalcemia has been achieved with diuretic and/or other medical therapy. Maternal operative morbidity is low and risk to the fetus is slight once organogenesis has been completed. Maternal parathyroidectomy should be performed preferably after the first trimester and should not be deferred unless delivery is imminent. PMID- 6505965 TI - Neuropsychologic deficits associated with primary hyperparathyroidism. AB - Although neuropsychologic dysfunction has been recognized as a symptom of primary hyperparathyroidism since the earliest descriptions of the disease, the nature of the memory, learning, and cognition deficits has been poorly defined. To assess the nature and extent of the deficits, 10 patients with hyperparathyroidism without specific neuropsychologic complaints and 10 normocalcemic patients were tested with a battery of psychologic tests before and after operation. Postoperative test scores for the Wechsler Logical Memory and Associate Learning, Wechsler Memory Digit Span, and the Similarities subtest of the Wechsler Adult Intelligence Scales, which test short-term verbal memory and cognition, showed statistically significant improvement for the patients with hyperparathyroidism. The patients with hyperparathyroidism improved on the Wechsler Memory Quotient an average of 17%. Tests measuring conceptual tracking, short-term visual memory, graphic skills, and fine motor coordination were unchanged. The results suggest that dominant hemispheric functions are disrupted by hyperparathyroidism. Improved neuropsychologic function can be expected after parathyroidectomy and, since the deficit is difficult to assess before operation, may be an indication for operation in the patient without symptoms. PMID- 6505966 TI - Parathyroid carcinoma: biochemical and pathologic response to DTIC. AB - Parathyroid carcinoma is a rare cause of hyperparathyroidism. Cure results from successful en bloc resection. However, because of its rarity, the malignant nature may not be appreciated at the initial operative procedure and as a result, definitive resection may not be accomplished. However, even with extensive en bloc resections, local recurrences do occur and patients die of metabolic derangements associated with hypercalcemia. Thus in addition to operative intervention, palliative chemotherapy may be required to control the hypercalcemia. Radiotherapy has been unsuccessful. A single case of nonfunctioning parathyroid carcinoma responding to treatment with methotrexate, Adriamycin, cyclophosphamide, and CCNU has been reported. We report a case of recurrent functioning parathyroid carcinoma treated with dacarbazine (DTIC) in which biochemical and pathologic evidence of at least a partial response was seen. The patient, a 33-year-old woman, had undergone five previous neck explorations during a 26-month period for aggressive locally recurrent disease. Before DTIC therapy the intact parathyroid hormone (PTH) level was 1032 pg Eq/ml (normal 163 to 347 pg Eq/ml) and the serum calcium level was 16.8 mg/dl (normal 8.8 to 10.0 mg/dl). After a course of DTIC there was a marked improvement in her clinical status and biochemical parameters (intact PTH 545 pg Eq/ml; serum calcium 11.8 mg/dl). For 2 months her condition stabilized, with PTH levels between 700 and 760 pg Eq/ml and serum calcium levels between 10.2 and 16.0 mg/dl. With a slowly progressive rise in biochemical parameters a second course of DTIC was initiated and a marked drop in serum calcium levels (5.7 mg/dl) occurred, but PTH levels remained unchanged. A progressive course of septicemia, malnutrition, and disseminated intravascular clotting ultimately lead to her death 4 weeks later. At autopsy examination the tumor was confined to the neck. Grossly and microscopically there was extensive central as well as peripheral necrosis of the tumor, which was thought to be the result of the cytotoxic effect of DTIC. From this experience and because of the grim prognosis in patients with recurring parathyroid carcinoma, it may be that aggressive use of chemotherapy with DTIC early in the course of treatment should be considered. PMID- 6505967 TI - Hyperparathyroidism and hypergastrinemia revisited. AB - The prevalence of hypergastrinemia was determined in 38 consecutive patients with proved primary hyperparathyroidism. Uncorrected serum calcium levels ranged from 2.6 to 4.0 mmol/L and parathyroid hormone levels from 260 to 8750 ng/L (normal less than 600 ng/L). Preoperative serum gastrin levels were grossly elevated (1000 to 4000 ng/L) in three patients (normal median 63 ng/L; range 30 to 120 ng/L). Two patients were achlorhydric. After parathyroidectomy (adenomatous hyperplasia) in the third patient, the serum gastrin level decreased from 4000 to 3000 ng/L, with a negative response to both a secretin challenge and a meal test. The latter patient was subsequently shown to have an adrenal ganglioneuroma and islet cell hyperplasia, neither containing gastrin, and at 4-year follow-up she still has no symptoms from the hypergastrinemia. Eight patients had a modest hypergastrinemia. Serum gastrin levels returned to normal in three of the four patients after parathyroidectomy. The fourth patient had rheumatoid arthritis, which can be associated with hypergastrinemia. The mean plasma gastrin level before operation (100.3 +/- 26.1 ng/L) was similar to the postoperative value (67.0 +/- 18.5 ng/L). There was no correlation between parathyroid hormone and gastrin levels nor between serum calcium and gastrin levels. The three patients with duodenal ulcers did not have elevated gastrin levels. Therefore it would appear that routine screening of patients with primary hyperparathyroidism adds little to their clinical management. PMID- 6505968 TI - Parathyroidectomy for primary hyperparathyroidism: early discharge. AB - With increasing awareness of cost-containment measures, early discharge after parathyroidectomy for primary hyperparathyroidism is to be evaluated. This report concerns the Cleveland Clinic experience with the last 70 consecutive patients treated for primary hyperparathyroidism from June 1981 to June 1983. The mean postoperative hospital stay was 1.4 days. Most patients were discharged on the morning of the second postoperative day receiving oral calcium supplements for 3 weeks. Three patients were discharged on the morning of the first postoperative day. The overall mortality rate was 0%. Morbidity included two patients (2.9%) who developed symptoms of mild tetany after discharge that responded to an increased dose of oral calcium. The usual practice of most surgeons of delaying hospital discharge after neck exploration for primary hyperparathyroidism for 5 to 7 days in fear of symptomatic hypocalcemia is unnecessary. Considerable cost containment can be achieved by sparing patients from 3 to 5 extra days of hospitalization. PMID- 6505969 TI - Biologic considerations and operative strategy in papillary thyroid carcinoma: arguments against the routine performance of total thyroidectomy. AB - Reasons cited for the routine performance of total thyroidectomy in patients with papillary thyroid carcinoma include: fear of multicentric neoplastic foci causing local recurrence and death; risk of anaplastic transformation of unresected multifocal microscopic carcinoma; toxicity of high-dose radioactive iodine to ablate normal thyroid remnants; and lack of reliable criteria for grading malignancy and identifying patients at high risk. However, autopsy studies have detected microscopic foci of papillary thyroid cancer as incidental findings in up to 24% of patients dead of other diseases. The prevalence of anaplastic transformation of papillary thyroid carcinoma as determined from reports in the literature is less than 1%. A retrospective investigation of 90 patients with papillary thyroid carcinoma derived from the Swedish National Cancer Registry showed no complications from radioiodine ablation of postoperative thyroid remnants in 45 patients. Retrospective analysis of the DNA content of tumors at the time of the initial operation showed a significant difference between a group of 10 patients who died of recurrent and metastatic papillary thyroid carcinoma and a group of 16 patients alive at least 10 years after operation despite distant metastases or recurrent cancer in the thyroid bed and/or cervical lymph nodes. The risk of permanent hypoparathyroidism is higher in patients after total thyroidectomy without apparent improvement in survival rates when compared with less extensive resections. Therefore it is proposed that the criteria for total thyroidectomy in patients with papillary thyroid carcinoma be limited to: tumors that clinically involve both lobes of the thyroid gland, extracapsular spread of cancer requiring enbloc resection, and reoperations where scarring prevents accurate delineation of the extent of the tumor. By differentiating patients at high risk for death from papillary thyroid carcinoma from patients at low risk, the measurement of DNA content may decrease the need for routine total thyroidectomy. PMID- 6505970 TI - Follicular carcinoma of the thyroid gland: trends and treatment. AB - Pure follicular carcinoma of the thyroid gland has become a relatively uncommon type of primary thyroid neoplasm in the United States. During a 20-year period (1962 to 1982) 37 cases of pure follicular carcinoma were treated at the University of Michigan Medical Center. Cases of the follicular variant of papillary carcinoma and Hurthle cell carcinoma were excluded. There were 26 women and 11 men in the series. The mean ages were 46.9 +/- 17.5 and 45.3 +/- 11.5 years, respectively. The overall, mean age was 46.4 +/- 15.9 years. Surgical treatment included total thyroidectomy in 83.8% of the cases. Seventy-six percent of the patients were treated after operation with 131I irradiation. The mean total dose was 230.5 mCi. Three patients (8.1%) had regional lymph node involvement. Six patients (16.2%) had distant metastases to bone and/or lung at the time of diagnosis. Seven patients (18.9%) died after a mean survival of 7.7 years. Six patients (16.2%) died of their disease. Twenty-nine patients (78.4%) are alive and disease free after a mean follow-up interval of 11.8 years. Pure follicular carcinoma is decreasing in incidence and usually occurs at an older age than do other forms of differentiated thyroid cancers. It is frequently more aggressive than papillary carcinoma although lymph node metastases are less common. Total thyroidectomy and 131I therapy are the recommended treatments since metastases to bone and/or lung are the usual locations of distant spread. Bone metastases are rarely if ever cured. However, excellent long-term palliation may be achieved. PMID- 6505971 TI - High-dose radiation and the emergence of thyroid nodular disease. AB - High-dose radiation (in excess of 2500 rads or centiGray) to the head and neck area is reputedly infrequently associated with the emergence of thyroid nodular disease. Thirty-three patients who underwent high-dose radiation and who developed thyroid nodular disease have been described. Radiation was originally administered for hyperthyroidism in 11 patients, postmastectomy in five, oral cancer in three, Hodgkin's disease in three, facial hirsutism in three, hemangioma in three, cancer of the larynx in one, skin cancer in one, desmoid tumor of the neck in one, Ewing's tumor in one, and pituitary tumor in one. Treatment included radioiodine in 11, external radiation in 21, interstitial radiation in one, and combined radiation in one. Associated head and neck neoplasms included four parathyroid tumors, one osteogenic sarcoma of the maxilla, two basal cell cancers of the facial skin, and one parotid gland carcinoma. The study group consisted of five men and 26 women varying in age from 22 to 75 years, with a duration of latency of effect varying from 1.5 to 50 years. Thyroid disease consisted of 21 cancers, six adenomas, four colloid goiters, and two cases of thyroiditis resulting in four deaths caused by cancer, for a 20% mortality rate. Consideration of radiation beam behavior showed that isodose curve, penumbra effect, back scatter, and special field resulted in the thyroid gland receiving a low dose, namely under 2500 rads. Clinical factors such as an overlooked goiter, coincidental carcinoma, error in presumption of dose, and second primary malignancy were also considerations. True biologic radiation oncogenesis may have been seen in our radioiodine-treated group with hyperthyroidism as well as the group with Hodgkin's disease who underwent mantle irradiation. It is apparent that for whatever reason and by whatever means and by whatever mechanism, high-dose radiation to the head and neck area can result in significant thyroid disease, and patients undergoing such radiation should be followed with this in mind and considered for thyroid feeding on a prophylactic basis. PMID- 6505972 TI - Androgen receptors in human thyroid tissue. AB - To evaluate the potential effect of androgens on human thyroid tumors, the incidence and distribution of cytosolic receptors for androgens were analyzed in thyroidectomy specimens from 31 patients. Fourteen specimens were from male and 17 from female patients. The specimens included five papillary carcinomas, five follicular adenomas, 15 colloid goiters, and six relatively normal thyroid tissues. All assays were performed by a protamine sulfate precipitation technique and analyzed by the method of Scatchard. Selected specimens were analyzed by sucrose density gradient. A receptor content greater than 1 fmol/mg cytosol protein was taken as positive if the dissociation constant was less than 1 nm. Seventeen of 31 specimens were positive for androgen receptors, with a dissociation constant of 0.26 +/- 0.09 X 10(-10) M and a receptor content of 11.20 +/- 4.77 fmol/mg cytosol protein. Four of five carcinomas, four of five adenomas, and nine of 21 benign thyroid tissues were positive for androgens. These androgen receptors are a single class with high affinity that are saturable and precipitate at the 6S (Svedberg unit) region similar to receptors in other androgen-dependent tissue. The data suggest that physiologic androgenic milieu may influence the growth of thyroid tumors. PMID- 6505973 TI - Psychosocial factors in burn injury. PMID- 6505974 TI - Neuroblastoma and cerebellar ataxia. PMID- 6505976 TI - Medicine speaks: what we expect from business. PMID- 6505975 TI - Business speaks: what we expect from health care. PMID- 6505978 TI - Prevention of burn injuries. PMID- 6505977 TI - Community radiation therapy centers. PMID- 6505979 TI - Medicine and the law. More dollar signs at the end of the rainbow. PMID- 6505980 TI - Line-of-descent and genealogical processes, and their applications in population genetics models. AB - A variety of results for genealogical and line-of-descent processes that arise in connection with the theory of some classical selectively neutral population genetics models are reviewed. While some new results and derivations are included, the principle aim is to demonstrate the central importance and simplicity of genealogical Markov chains in this theory. Considerable attention is given to "diffusion time scale" approximations of such genealogical processes. A wide variety of results pertinent to (diffusion approximations of) the classical multiallele single-locus Wright-Fisher model and its relatives are simplified and unified by this approach. Other examples where such genealogical processes play an explicit role, such as the infinite sites and infinite alleles models, are discussed. PMID- 6505982 TI - [Physiologic principles of equilibrium]. PMID- 6505981 TI - Evolution and intraspecific exploitative competition. II. A two-locus model for additive gene effects. AB - A two-locus model corresponding to the model of Christiansen and Loeschcke (1980, theoret, Popul. Biol. 18, 297-313) is analysed. The two loci each have two alleles, and the loci influences a character which determines the utilization of resources in a one-dimensional continuum. The analysis of the model is supported by numerical iterations of the recurrence equations. The previous prediction of high linkage disequilibrium for small allele contributions to the character and close linkage between the loci is confirmed. For larger allele contributions results comparable to those for the symmetric viabilities model are obtained. The model degenerates when the allele contributions at the two loci are equal, i.e., in the most symmetric situation. The results are discussed as the outcome of a balance between optimizing selection and disruptive selection. For small allele contributions the results are virtually independent of which genotype is most favoured by the optimizing aspect of the selective forces. PMID- 6505983 TI - [Vertigo from the internal medicine viewpoint]. PMID- 6505984 TI - [Vertigo in neurologic diseases]. PMID- 6505985 TI - [Vertigo and epilepsy]. PMID- 6505986 TI - [Pseudo vertigo? Psychiatric aspects]. PMID- 6505987 TI - Penetration of cefaclor into bronchial mucosa. AB - Bronchial mucosal biopsy specimens were obtained during fibreoptic bronchoscopy in 30 patients receiving a new oral cephalosporin antibiotic, cefaclor (10 had 250 mg, 10 had 500 mg, and 10 had 1000 mg every eight hours). In 10 patients (from all dosage groups) cefaclor was undetectable in the bronchial mucosa but in every case the serum concentration was low, suggesting incomplete absorption. The mean (SD) bronchial mucosal concentration after 250 mg was 3.78 (1.77) micrograms/g (range 2.1-5.8 micrograms/g, n = 4), after 500 mg 4.43 (2.04) micrograms/g (range 2.0-7.1 micrograms/g, n = 8), and after 1000 mg 7.73 (2.76) micrograms/g (range 5.0-12.7 micrograms/g, n = 6). A significantly higher concentration in the bronchial mucosa was achieved with 1000 mg than with 250 mg (p less than 0.05) or 500 mg (p less than 0.025). These concentrations should be effective against Streptococcus pneumoniae, most strains being inhibited below 1.0 microgram/ml. The concentrations were within one dilution of the minimal inhibitory concentration for Haemophilus influenzae, most strains being inhibited below 4.0 micrograms/ml. Some strains of H influenzae will not be inhibited by the concentrations of cefaclor found in the bronchial mucosa, particularly those that are ampicillin resistant. PMID- 6505988 TI - Effect of encouragement on walking test performance. AB - Walking tests, frequently used to document effects of treatment on exercise capacity, have never been standardised. We studied the effects of encouragement on walking test performance in a randomised study that controlled for the nature of the underlying disease, time of day, and order effects. We randomised 43 patients with chronic airflow limitation or chronic heart failure or both to receive or not receive encouragement as they performed serial two and six minute walks every fortnight for 10 weeks. Simple encouragement improved performance (p less than 0.02 for the six minute walk), and the magnitude of the effect was similar to that reported for patients in studies purporting to show beneficial effects of therapeutic manoeuvres. Age and test repetition also affected performance. These results demonstrate the need for careful standardisation of the performance of walking tests, and suggest caution in interpreting studies in which standardisation is not a major feature of the study design. PMID- 6505989 TI - A standardised method of estimating KCO on exercise. AB - This study was designed to standardise a progressive exercise test for the assessment of change in carbon monoxide transfer coefficient (KCO) with exercise and to examine the variation between subjects and the reproducibility within subjects. Normal subjects exercised on a bicycle ergometer while ventilation, heart rate, and expired gas concentrations were recorded continuously. Preliminary studies showed that reduction of the breath hold time to six seconds made measurements of KCO during heavy exercise more comfortable without affecting the result. When KCO was measured immediately after exercise it was lower than when measured during exercise. KCO was measured in 50 normal subjects at rest and at three different work loads maintained for three minutes with a pause of five minutes between each. The relationships between KCO and both oxygen consumption and work load were linear in all subjects but the relationship between KCO and heart rate was distorted by high resting heart rates in some subjects. The mean slope of the relationship between KCO and oxygen consumption (VO2) was steeper in women than in men (mean slopes 0.627 and 0.348 mmol min-1 kPa-1 l-1 per 1 min-1 respectively), and the same was true for the relationship between KCO and work rate. The heart rate rose more steeply in relation to VO2 in women, so that the relationship of KCO to heart rate was similar in men and women (mean slope 0.01 mmol min-1 kPa-1 l-1 per beat min-1). Repeat studies on five occasions in five individuals gave coefficients of variation for the slopes of the relationships between KCO and VO2, work rate, and heart rate of 5-10%. PMID- 6505990 TI - Peak flow rate records in surveys: reproducibility of observers' reports. AB - Records of peak expiratory flow rate (PEFR), commonly used in hospital in the management of asthma, have not been evaluated as a method of identifying cases of asthma in population surveys. Four observers were asked to report on whether asthma was present or absent in 61 graphs of PEFR recorded two hourly for four weeks during surveys of working population. Agreement within individual observers was measured using a subset of 29 graphs which had been copied and distributed at random among the set of 61; agreement was good, from 90% in one observer to 100% in two. Agreement between observers was measured on the basis of all 61 graphs. Agreement occurred between all four observers in 69% of graphs, between at least three out of four in 97%, and, when pairs of observers were examined, between 72% and 93% of graphs. Graphs assessed as showing asthma demonstrated more within day PEFR variability (expressed as the number of days in which the difference between maximum and minimum readings was at least 15%) than graphs assessed as not showing asthma. Some graphs with little within day variability were assessed as showing asthma, apparently because they demonstrated between day PEFR variability. PMID- 6505991 TI - Goblet and Clara cells of human distal airways: evidence for smoking induced changes in their numbers. AB - The goblet cell and Clara cell populations of human distal airway epithelium were examined. The bronchioles, terminal bronchioles, and respiratory bronchioles of 16 smokers and four non-smokers were studied by both light and electron microscopy in surgically resected specimens. A very significantly (p less than 0.001) greater number of goblet cells were found in the bronchioles of smokers compared than in those of non-smokers but no such difference was evident in terminal/respiratory bronchioles. Clara cell numbers in contrast were lower in the bronchioles (p less than 0.01) and terminal and respiratory bronchioles of smokers (p less than 0.01). Both of these alterations in cell frequency may adversely affect small airway function in smokers. PMID- 6505992 TI - Cryptogenic fibrosing alveolitis: pattern of disease in the lung. AB - The distribution of disease has been studied in 10 patients with histologically confirmed cryptogenic fibrosing alveolitis by means of computed tomography of the lungs, gallium 67 uptake scintigraphy, and ventilation and perfusion scintigraphy. The findings of computed tomography and scintigraphy showed no correlation with the UICC/Cincinnati grades of the plain chest radiographs, even when these were supplemented with information from lateral and oblique chest films. Computed tomography showed subpleural shadowing in every patient except one who had responded well to corticosteroid treatment. Subpleural shadowing was commoner in the inferior and posterior parts of the lung lobes and was commonest in the posterior lower subpleural areas. The central lung showed three types of change--firstly, a dense shadowing, which was sometimes associated with much increased gallium uptake; secondly, dilated smaller airways with small bullae, suggesting airway disease; and, thirdly, gross bullous change. PMID- 6505993 TI - Conservative surgery of the mitral valve in bacterial endocarditis. AB - Surgical repair of the mitral valve was undertaken in two young female patients during the active phase of bacterial endocarditis to eradicate persistent infection. Operation resulted in rapid resolution of infection with good haemodynamic results in both patients. A mitral valve prosthesis has the disadvantage for children of needing replacement because of growth, and for young women of leading to problems in pregnancy because of the need for lifelong anticoagulant treatment. Thus repair rather than replacement of the mitral valve should be considered in patients, especially young women, presenting with mitral regurgitation in these circumstances. PMID- 6505994 TI - Pleural mesothelioma and the syndrome of inappropriate secretion of antidiuretic hormone. PMID- 6505995 TI - Recovery from severe pulmonary damage due to paraquat administered intravenously and orally. PMID- 6505996 TI - Mycobacterium kansasii pericarditis. PMID- 6505997 TI - Investigation of superior vena caval obstruction. PMID- 6505998 TI - Comparison of oral prednisolone and intramuscular depot triamcinolone in patients with severe chronic asthma. PMID- 6505999 TI - [Concepts of the incidence and severity of undesirable effects. The point of view of the generalist]. PMID- 6506000 TI - [Drug surveillance as seen by the general practitioner. Apropos of a survey of 4175 physicians]. PMID- 6506002 TI - [Drug hepatopathies. Analysis of a sample of French publications (1979-1983)]. PMID- 6506001 TI - [Is rechallenge necessary for complete imputability? Comparative value of 7 methods of determining imputability]. PMID- 6506003 TI - [Current criteria pointing to the drug origin of hepatitis]. PMID- 6506004 TI - [Specific serologic markers of viral hepatitis]. PMID- 6506005 TI - [Evaluation of drug-induced hepatic complications collected by the French drug surveillance organization]. PMID- 6506006 TI - [Drug hepatopathies in a hospital milieu. Retrospective analysis from 46 cases seen between 1979 and 1982 in a hepatology department]. PMID- 6506007 TI - [Hepatitis from antidepressants. Evaluation of cases from the French Association of Drug Surveillance Centers and the Technical Committee]. PMID- 6506008 TI - [Hepatitis during antibiotic therapy. Retrospective evaluation of the Association of Drug Surveillance Centers and the Bureau of Drug Surveillance, Health Office]. PMID- 6506009 TI - [Hepatic complications of clometacin]. PMID- 6506010 TI - [Acute hepatitis due to pyricarbate (Angioxine). Apropos of 5 cases]. PMID- 6506011 TI - [Increase in transaminases during treatment with danazol in lupus patients]. PMID- 6506012 TI - [Blood cytopenia associated with the ingestion of cimetidine. Critical review of the literature]. PMID- 6506013 TI - [Severe hematologic complications of gold salts prescribed in excessive doses. Apropos of 2 cases]. PMID- 6506014 TI - [Adverse effects of nonsteroidal anti-inflammatory agents. Experience at the Drug Surveillance Center in Nancy]. PMID- 6506015 TI - [Can the glycine bladder lavage solution used in urologic surgery be toxic? Apropos of a case of acute renal insufficiency]. PMID- 6506016 TI - [Hyponatremia and water intoxication during treatment with carbamazepine]. PMID- 6506017 TI - [Cochlear toxicity of erythromycin in elderly patients]. PMID- 6506019 TI - [Caffeine poisoning in infants resulting from confusion between dosage forms. Apropos of 5 cases]. PMID- 6506018 TI - [Ocular side effects of flumequine. 3 cases of macular involvement]. PMID- 6506020 TI - A comparison of the antithrombotic and haemorrhagic effects of low molecular weight heparin fractions: the influence of the method of preparation. AB - Bleeding is an important complication of heparin therapy. A number of low molecular weight heparin fractions produce less bleeding than standard heparin for an equivalent antithrombotic effect in experimental animals. Low molecular weight heparin fractions and fragments are produced by a number of different procedures but their relative effects on haemostasis and thrombosis have not been evaluated. We have compared the antithrombotic and haemorrhagic effects of two low molecular weight heparin fragments and of a heparinoid with porcine mucosa heparin and related these in vivo findings to the results of ex vivo tests of blood coagulation and in vitro tests of platelet vivo tests of blood coagulation and in vitro tests of platelet function. Haemorrhage was assessed using a rabbit ear bleeding model. The antithrombotic effects were assessed by measuring inhibition of a tissue thromboplastin-induced jugular vein thrombus and by inhibition of fibrin and platelet accumulation in an arterial-venous shunt. The ex vivo anticoagulant effects were assessed with the thrombin clotting time, activated partial thromboplastin time and anti-Xa assay, and the effect of these glycosaminoglycans on platelet function was assessed by measuring collagen induced platelet aggregation. For a similar antithrombotic effect, standard heparin produced significantly more bleeding than the other 3 glycosaminoglycans. The antithrombotic effects of all 4 glycosaminoglycans occurred at similar levels of anti-Xa activity but there was no relationship between blood loss and the effects of these glycosaminoglycans on any of the other tests of blood coagulation. Standard heparin had a greater inhibitory effect on collagen-induced platelet aggregation than the low molecular weight glycosaminoglycans, supporting the possibility that the increased bleeding observed with heparin is related in part to its inhibitory effect on platelet function. PMID- 6506021 TI - Assay of unfractionated and LMW heparin with chromogenic substrates: twin methods with factor Xa and thrombin. AB - Utilizing two newly synthesized chromogenic substrates (CS), two different assay methods for heparin in plasma have been developed. The assay with bovine factor Xa and the highly reactive "Substrate FXa-1" (CH3 OCO-D-CHA-Gly-Arg-pNA X AcOH) measures both unfractionated (UF) heparin and low molecular weight (LMW) heparin within a single standard curve in the 0.05-1.5 U/ml plasma range. The very similar (and less expensive) assay with bovine thrombin and "Substrate Th-1" (2AcOH X H-D-CHG-Ala-Arg-pNA), measures UF heparin, but not LMW heparin. The standard curves are highly reproducible (CV 3.5-4.7%). For clinical work, a linear standard curve is obtained with three standards and lin-log plot. The "within run" SD was 0.007-0.026 U/ml. Mean recovery of 0.5 U/ml heparin added to 10 pathological plasma samples ranged 0.46-0.53 U/ml (SD 0.034-0.040). Activities of three UF heparin and three LMW heparin preparations are reported. PMID- 6506022 TI - In vitro evaluation of a biologic graft surface. Effect of treatment with conventional and low molecular weight (LMW) heparin. AB - Human umbilical vein grafts were treated with either conventional or LMW heparin, followed by exposure to alcohol. The grafts were investigated for their ability to adsorb and inactivate thrombin, and comparison was made with non-heparinized and saline-alcohol treated grafts and grafts supplied with a covalently bonded layer of conventional heparin. In addition, the effect of protamine exposure to heparin-alcohol and LMW heparin-alcohol treated grafts as well as native human umbilical veins (HUV) was studied. Native HUV and heparin treated graft surfaces adsorbed and inactivated thrombin, whereas non-heparinized and saline-alcohol treated grafts inactivated surface-bound thrombin to only a small degree. Surface bound LMW heparin exhibited a significantly lower ability to inactivate thrombin as compared with conventional heparin, but LMW heparin-alcohol surfaces were better than non-heparinized ones. Protamine treatment of "heparinized" surfaces impaired the thrombin inhibiting ability of the heparin-alcohol surface, whereas this property was totally abolished for the LMW heparin-alcohol surface. The findings indicate that LMW heparin, despite its weaker thrombin inhibiting capacity, may be an alternative to conventional heparin, for "heparinizing" the human umbilical vein graft. Protamine exposure may be potentially harmful for a heparin treated surface, although protamine concentrations used in the present in vitro study may not be reached in vivo. The native HUV was not at all affected by protamine exposure regarding its ability to inactivate thrombin. PMID- 6506023 TI - One milligramme of acetylsalicylic acid daily inhibits platelet thromboxane A2 production. AB - To seek the lowest dose of acetylsalicylic acid (ASA) capable of inhibiting platelet thromboxane A2 (TxA)2 production, 18 healthy volunteers ingested 9 mg, 3 mg or 1 mg of ASA/day for twenty days and the release of TxB2 (a metabolite of TxA2) during the spontaneous clotting of blood was measured by radioimmunoassay. In addition, the production of prostacyclin (epoprostenol, PGI2) was investigated by measuring the urinary excretion of its break-down product, 6-keto prostaglandin F1 alpha (6-keto-PGF1 alpha) by radioimmunoassay. Significant inhibition of platelet TxA2 production was seen from the 15th day of treatment onwards with 1 mg of ASA (maximally 15%), from the 4th day of treatment onwards with 3 mg of ASA (maximally 40%), from the 1st day of treatment onwards with 9 mg of ASA (maximally 67%). No ASA dose changed platelet counts or urinary 6-keto PGF1 alpha excretion. One mg of ASA daily, is the lowest dose ever shown to inhibit platelet TxA2 production. PMID- 6506024 TI - Agonist-specific desensitization of shape change of platelets. AB - Using scanning electron microscopy and light scattering we have investigated the shape change of bovine platelets. The extents of shape change obtained by ADP and 5-hydroxytryptamine(5HT) increased in dose-dependent manner, and the maximum obtained by these agonists were additive. The agonist-specific desensitization in shape change was observed with ADP, 5HT and thrombin. The extent of desensitization by pre-exposure to ADP was dependent upon the concentration of ADP. It was strongly indicated that receptors or their subsequent stimuli transmission apparatus became unable to respond to further stimulation after the exposure to the initial stimulation. PMID- 6506025 TI - Peptide heterogeneity in a preparation of synthetic fibrinopeptide B. AB - A commercially available preparation of synthetic human fibrinopeptide B (FpB) was shown by hplc to contain two chromatographically distinct peaks, one of which was identical to FpB. Our results suggest that the contaminant peptide (FpB-2), which represented approximately 43% of the total peptide composition, is FpB containing an alpha-aminosuccinimide (Asc) residue. This Asc residue probably arose as a result of the cyclization of 5Asp-6Asn during either the coupling or deprotection reactions. FpB-2 was rapidly hydrolysed by carboxypeptidase B to des Arg-FpB-2. It was stable under acidic conditions but in dilute alkali was converted to equimolar amounts of FpB and FpB containing beta-Asp at residue 5. Since it has been suggested that 5Asp-6Asn is a major immunorecognition site in FpB, our observations emphasize the need to establish the purity of synthetic FpB preparations destined for use in the immunoassay of either FpB or des-Arg-FpB. PMID- 6506026 TI - Assay of factor IX antigen using an enzyme immuno assay. AB - An Enzyme Linked immuno Sorbent Assay (ELISA) was developed for the measurement of factor IX:Ag. The results obtained in 90 control subjects, 56 hemophilia B patients and 40 patients under oral anticoagulant treatment were compared with factor IX:C and factor IX:Ag levels according to Electro Immuno-Assay (EIA). In healthy volunteers the mean factor IX:C level was 106.7 U/dl, the mean factor IX:Ag level was 96.8 U/dl according to EIA procedure and 101.5 U/dl according to ELISA method. Using ELISA, 10 hemophiliacs had no detectable antigen, and 13 had minute amounts of IX:Ag. All these patients are classified as B-. Among the others 21 had reduced antigen and are considered as BR and 12 had normal level of IX:Ag and are B+. Patients taking oral anticoagulants had not only a decreased factor IX:C level but also a reduced factor IX:Ag level which is always lower when using EIA procedure in the presence of EDTA than according to ELISA method. PMID- 6506027 TI - Evidence for independent pathways for the induction of platelet prothrombin converting activity by thrombin and collagen. PMID- 6506028 TI - Mislabeling of commercial fibrinogen preparations: bovine or human? PMID- 6506029 TI - An assessment of whole blood impedance aggregometry using blood from normal subjects and haemodialysis patients. AB - Impedance aggregometry allows the measurement of platelet responses in whole blood as well as in PRP. The variability of haematocrit values encountered when applying this technique to haemodialysis patients prompted an investigation of the effects of red cells on platelet aggregation in whole blood. Collagen induced aggregation was measured in both PRP and whole blood from haemodialysis patients and healthy controls. Platelets from haemodialysis patients were less aggregable than those from the controls when tested in PRP, but more aggregable when tested in whole blood. Blood samples with a range of haematocrit values were prepared by mixing PRP and autologous red cells, and used to study the effect of haematocrit on platelet aggregation. In blood from control subjects aggregation rate was reduced by rising haematocrit but no reduction of maximum aggregation occurred until haematocrit exceeded 40%. In contrast uraemic platelets showed increased responses in the presence of red cells. In a limited cross over study no significant difference was found in the effect on platelet aggregation of washed erythrocytes from uraemic and non-uraemic donors. It is concluded that red cell presence influences platelet aggregation by complex mechanisms during impedance aggregometry and that this effect must be considered when interpreting results. PMID- 6506030 TI - Role of red cells in preventing the growth of platelet aggregation. AB - Using high-resolution real-time two-dimensional ultrasound, we have investigated the role of red cells in the growth of already established platelet aggregates under controlled flow conditions. Platelet rich plasma (PRP) was circulated in vitro in horizontally and vertically arranged tubing at mean shear rate ranging from 60 to 0 sec-1, and adenosine diphosphate (ADP) was used to induce platelet aggregation. ADP-induced platelet aggregates grew in size and tended to sediment as shear rate decreased, in particular, below 10 sec-1. At 0 sec-1 (stasis), large clusters of platelet aggregates formed. The addition of washed red cells to produce a hematocrit of only 2% significantly interfered with the growth and sedimentation of platelet aggregates as shear rate was reduced. Formaldehyde hardened erythrocytes had a similar effect in preventing the growth of platelet aggregates, suggesting that mechanical collision of red cells with platelet aggregates may be the cause of growth inhibition. Therefore, the thrombotic process may be enhanced in red cell poor zones in circulation resulting from flow disturbances associated with vascular stenosis or within artificial organs and extracorporeal systems. The present study also suggested that red cell free PRP should be carefully administered therapeutically. PMID- 6506031 TI - The effect of ultra-low-dose heparin in experimental venous thrombosis. PMID- 6506032 TI - A new rapid and simple assay for factor XIII activity using dansylcadaverine incorporation and gel filtration. AB - A new sensitive, reproducible and simple assay for factor XIII activity was developed, in which fluorescent dansylcadaverine (DC) is incorporated into casein and DC-casein is separated from free DC by gel filtration. A good correlation was found between our method and Lorand's. The main advantages of our method are: (1) our assay technique is simple with good reproducibility and takes only a couple of hours; (2) the detectable limit of factor XIII activity is about 1% of normal pool plasma, but, if necessary, can be lowered by increasing the sample amount and lengthening the reaction time. PMID- 6506033 TI - Quantitation of platelet membrane glycoproteins in Glanzmann's thrombasthenia and the Bernard-Soulier syndrome by electroimmunoassay. AB - A rapid and precise electroimmunoassay for quantitation of glycoprotein Ib and IIb-IIIa in platelet lysates is described. Using this method, platelets from two patients with Type II thrombasthenia contained 8% and 12% of normal levels of IIb IIIa, whereas IIb-IIIa was undetectable in platelets of one Type I thrombasthenic patient. The level of Ib in two patients with Bernard-Soulier syndrome was essentially nil. The increased precision of this assay, when compared to CIE, allows for estimations of glycoproteins levels varying by no more than a few percent. PMID- 6506034 TI - Physiological role of alpha 2-plasmin inhibitor in rats. AB - For understanding the physiological role of rat alpha 2-plasmin inhibitor (alpha 2-PI), the effect of alpha 2 PI deficiency on the fibrinolytic system was studied in rats in vitro and in vivo. Selective removal of alpha 2 PI from plasma was achieved in vitro and in vivo by immune complex formation with specific anti-rat alpha 2 PI rabbit gamma-globulin and the F(ab')2 fragments derived from specific anti-rat alpha 2 PI rabbit IgG, respectively. Depletion of alpha 2 PI from plasma resulted in almost complete loss of the fast-acting antiplasmin activity of the plasma and in a marked acceleration of urokinase-induced plasma clot lysis. A similar acceleration of thrombus dissolution was also observed, when a thrombus isolated from a thrombosed rat was incubated in alpha 2 PI-deficient serum in vitro. The effect was found to be inversely proportional to the alpha 2 PI levels in plasma or serum. When alpha 2 PI deficiency was induced in rats with experimental venous thrombosis, thrombus size was markedly decreased in association with elevation of serum fibrin degradation products and reduction of plasma plasminogen, indicating enhanced fibrinolysis in vivo. In addition, alpha 2 PI deficiency for a longer period induced a mild bleeding tendency at the sites of venipuncture. These results indicate that alpha 2 PI plays an important role as a stabilizer of fibrin in rats, as in humans. PMID- 6506035 TI - A model for thrombin protection against endotoxin. AB - Infusion of dogs with thrombin (0.5 U/kg/min) for 90 minutes significantly increased percent survival following infusion of endotoxin (0.06 mg/kg/min) for 30 minutes. Nine of fourteen dogs infused with thrombin survived seven days (permanent survivors), whereas thirteen of fourteen dogs infused with saline died within 36 hours. Those dogs which survived responded immediately to endotoxin with enhanced anticoagulant and fibrinolytic activity as measured by the Xa one stage and fibrin degradation product assays, respectively. Those dogs receiving saline instead of thrombin did not respond with anticoagulant or fibrinolytic activity until the end of the study. We concluded that thrombin in the correct amounts protected dogs from endotoxin and that this protection was associated with an early anticoagulant and fibrinolytic response to endotoxin infusion. PMID- 6506036 TI - [Functional conservative fracture treatment of tibial fractures. The functional stage]. PMID- 6506037 TI - [Functional conservative fracture treatment of humeral fractures]. PMID- 6506038 TI - [The pill and cerebrovascular disease]. PMID- 6506040 TI - [Abdominal aortic aneurysm. Surgical treatment without resection]. PMID- 6506039 TI - [Injuries of the midtarsal joint]. PMID- 6506041 TI - [Acute stomach volvulus]. PMID- 6506042 TI - [Functional conservative fracture treatment of tibial fractures. The practical set-up]. PMID- 6506044 TI - [Does digitalis help in heart failure when heart rhythm is normal?]. PMID- 6506043 TI - [Percutaneous nephrolithotomy]. PMID- 6506045 TI - [Polyneuropathy as the first sign of osteosclerotic plasmacytoma]. PMID- 6506046 TI - [Vincristine treatment of autoimmune thrombocytopenia]. PMID- 6506047 TI - [Postoperative liver damage due to halothane. Should we stop using halothane for adult patients?]. PMID- 6506048 TI - [Ascites in liver cirrhosis treated with peritoneovenous shunt]. PMID- 6506049 TI - [Chronic purulent maxillary sinusitis in horses]. AB - The surgical treatment of eighty-nine horses and ponies suffering from chronic empyema of the maxillary sinus is reported. Treatment consisted in trephination and drainage of the sinus involved in thirty-six animals; the affected teeth were removed at the same time in fifty-three animals in which sinusitis was caused by an alveolitis. The recovery rate was seventy-five per cent in group one and seventy per cent in group two. Postoperative treatment is also reported and attention is paid to complications which may occur during and after surgery. PMID- 6506050 TI - [Ruminal drinkers and clay defecators]. AB - In this clinical lecture, attention is drawn to the phenomenon of young milk-fed calves showing irregular appetites and recurrent bloat. These patients often produce faeces which are too dry and too light in colour. These symptoms are preceded by inadequate closing of the oesophageal groove during milk intake, which causes an inflow of milk into the rumen rather than into the abomasum. The present authors introduced the term 'Ruminal Drinkers' to describe this type of patient. The identification of ruminal drinkers as well as the clinical findings are reviewed. The effects of ruminal drinking, the therapy indicated and a number of preventive measures are discussed. PMID- 6506052 TI - [Biotechnology and vaccine manufacture]. AB - Modern biotechnology offers great possibilities for the large-scale manufacture of effective, safe and inexpensive vaccines. Improvements can also be expected in the manufacture of traditional vaccines, and there would appear to be prospect of producing vaccines against (tropical) parasitic disease for the first time. Close cooperation between university centres, research institutes and industry is essential to the development of biotechnology. PMID- 6506051 TI - [Long-term effects of a deworming program using flubendazole and levamisole on the percentage of condemned livers in slaughtering pigs]. AB - A deworming programme continued over a period of twenty-four months was carried out to study the proportion of livers condemned because of milk spots, which was unacceptably high on a pig-fattening farm in the Province of Limburg, the Netherlands. In order to remove Ascaris suum from the fattening pigs initially present and to prevent subsequent contamination of the houses with worm eggs, three courses of deworming treatment with flubendazole were initiated on the farm. All newly incoming piglets were systematically treated with 2 ml. of 5 per cent levamisole from the beginning of the trial, this treatment being continued from December 1976 to January 1979. A total number of 3,861 animals took part in the trial. Observations in the slaughter-house started within eight months after the first treatment. The proportion of livers condemned wholly or in part had dropped to 3.6 per cent by that time and showed a further decrease to a mean level of 2.4 per cent during the 17-month period of observation. A significant increase of the mean daily growth was observed at the same time. These results were verified by a similar trial on another farm. PMID- 6506053 TI - [Report of the survey on Zuid-Limburg rabies control carried out by the Animal Health Service in Limburg]. PMID- 6506054 TI - [1984 annual address of the Royal Netherlands Society of Veterinary Medicine]. PMID- 6506055 TI - [Plasma fibrinogen as a parameter of the presence and severity of inflammation in horses and cattle]. AB - Determination of the plasma fibrinogen concentration was found to be particularly useful in detecting inflammatory diseases. The highest levels were observed in inflammatory lesions of serous surfaces and in endocarditis. Plasma fibrinogen levels correlated with the severity of the disease: levels of 1,000 mg per 100 ml or more reflected a prognosis ranging from poor to bad. PMID- 6506056 TI - [Echographically controlled ventricle punctures]. AB - Ventricular taps are performed either for diagnostic or for therapeutic purposes. They are not free of risks. A new technique is presented, in which the placement of the needle is echographically monitored. Fifteen punctures were done in five children. All punctures were successful at first attempt, and were uneventful. PMID- 6506057 TI - [Dyggve-Melchior-Clausen syndrome]. AB - The Dyggve-Melchior-Clausen syndrome is a probably autosomal recessively inherited disorder characterized by mental retardation, dwarfism, and skeletal abnormalities especially of the spine, pelvis and hands. It is possibly caused by a disturbance in the protoglycan metabolism. Two Moroccan sibs with this syndrome are described, the first in Dutch literature. PMID- 6506058 TI - [Transposition of the great vessels, results of 2 surgical technics]. AB - Venous switch operations for simple transposition of the great arteries are being carried out in increasingly younger patients. To guarantee sufficient growth of the reconstructed atria into adulthood it is advantageous to use as little prosthetic material as possible. We therefore compared the results in 36 patients who underwent the Mustard operation in which a large amount of foreign material is used with the results in 36 patients who underwent the Senning operation in which a small amount, if any, foreign material is used. The Senning operation resulted in a lower hospital mortality and a lower incidence of dysrhythmias. PMID- 6506059 TI - Acidic glycopeptides isolated from young human aortas. AB - Intima-media of young human thoracic aortas were digested with pronase, after extraction of saline-soluble matters and fat. Glycopeptide fractions were separated from the resulting glycoconjugate fractions by fractionation with cetylpyridinium chloride. Acidic glycopeptides (0.15 M Fr and 0.3 M Fr) were then isolated from the glycopeptide fractions by DEAE-Sephadex A-25 (Cl- form) column chromatography. They contained glucosamine, galactose, mannose and sialic acid as the major sugars and glucose as the minor one, although the proportions of these constituents differed from each other. In addition, galactosamine and fucose were the minor sugars in 0.3 M Fr and 0.15 M Fr, respectively. 0.3 M Fr contained much more sulfate and amino acids than 0.15 M Fr. Aspartic acid, proline, glycine, threonine, glutamic acid, valine, serine and alanine were the major amino acids, amounting to 82-89% in total, in these acidic glycopeptides, although their contents differed from each other. It is noteworthy that the proportions of the constituents in the corresponding fractions from young boy and girl with the same age showed similar trend. Although the data indicated the heterogeneity of the carbohydrate and peptide chains of the acidic glycopeptides, the degree of the heterogeneity is smaller than that of sialoglycopeptides isolated previously from aged human aortas. PMID- 6506060 TI - High yield of platelet-rich plasma from CPD blood compared to ACD blood. AB - The yields of platelet-rich plasma (PRP) obtained by centrifugation of CPD (citrate-phosphate-dextrose) blood and ACD (acid-citrate-phosphate) blood were compared. The volumes of PRP from 5 ml blood in test tubes and 200 ml blood in bags were larger by 4% and 4.5%, respectively, when CPD was used as an anticoagulant. In addition, the number of platelets in PRP from CPD blood was higher than that from ACD blood. These data suggest that the optimal centrifugal condition for CPD blood should be different from that for ACD blood. PMID- 6506062 TI - The effect of heart rate and left ventricular end-diastolic pressure on the direction of ST segment displacement in acute ischemia. AB - The correlation between the ST segment displacement and coronary blood flow in various hemodynamic conditions was studied. Five isolated, isovolumic contracting canine hearts were used. The left main and the right and left circumflex (LCx) coronary arteries were cannulated and perfused with support dog's arterial blood. Four pairs of Ag-AgCl ECG electrodes were attached to the epicardium and subendocardium in the LCx perfused area. Heart rate and left ventricular end diastolic pressure (LVEDP) were controlled by means of right atrial electrical pacing and infusion or withdrawal of arterial blood into the left ventricle, respectively. LCx flow was reduced by 75, 50, 25% of the control level under the condition of 200 beats/min of heart rate and 20 mmHg or 5 mmHg of LVEDP, and ECGs were recorded. The ST segment elevation was observed in epi- and subendocardial lead ECGs when LCx flow was reduced from 110 +/- 27.5 ml/min/100 g to 72 +/- 3 ml/min/100 g under the condition of normal LVEDP (5 mmHg) and a high heart rate (200 beats/min), whereas the same degree of reduction in LCx flow under the condition of high LVEDP (20 mmHg) and high heart rate (200 beats/min) resulted in an epicardial ST segment depression associated with marked subendocardial ST segment elevation. The results suggest that the coronary flow reduction with a higher LVEDP will induce subendocardial ischemia, whereas the same degree flow reduction with a normal LVEDP induce transmural ischemia. PMID- 6506061 TI - Evidence for endogenous dopaminergic control of mineralocorticoids secretion in normal subjects and in patients with hyperaldosteronism. AB - The role of endogenous dopamine (DA) in the secretion of several mineralocorticoids was studied in six normal subjects, eight patients with primary aldosteronism (PA), two patients with non-familial idiopathic hyperaldosteronism (NF-IHA), and four patients with familial IHA (F-IHA). To these subjects 10 mg metoclopramide (MCP) was administered intravenously, and plasma aldosterone (Ald), 18-OH-corticosterone (18-OH-B), 18-OH-11 deoxycorticosterone (18-OH-DOC), and DOC were measured by RIA. Further, five normal subjects were studied with MCP test after pretreatment with DA infusion (5 micrograms/kg/min over 90 min). After the administration of MCP, normal subjects showed significant increases in their plasma Ald and 18-OH-B, and slight increases in plasma 18-OH-DOC and DOC. However, no significant changes were observed in plasma ACTH, cortisol, PRA, or serum K, Na or Cl. In patients with PA and NF-IHA, plasma Ald and the three precursors were increased after administration of MCP. Especially, marked increases in plasma 18-OH-DOC were seen in PA patients. In contrast, F-IHA patients showed increases in the above mineralocorticoids except 18-OH-B. Following DA infusion in normal subjects neither basal plasma Ald secretion nor the responsivenesses to MCP were modified. These results suggest that endogenous DA plays an inhibitory role in the terminal stages of mineralocorticoids production in man. However, the degrees of the dopaminergic inhibition may be different in normal subjects and the patients with mineralocorticoids excess, and among the three groups of aldosteronism mentioned above. PMID- 6506063 TI - Results of surgical treatment of gastric cancer--special reference to pathological findings. AB - During 16 year period from 1967 to 1982, a total of 1,471 patients with gastric cancer were surgically treated at the authors' clinic and 1,347 of them underwent gastric resection. The 5-year survival rate for 692 of curatively operated patients was 73.8%, in contrast to 11.8% for non-curatively operated cases. A correlation study disclosed the depth of cancer infiltration and the extent of lymphnode metastasis to be most reliable prognostic factors. The 5-year survival rate for stage I cases was 91.0%, 70.0% for stage II, 46.7% for stage III, and 8.6% for stage IV. An improvement in the end-results was attributed mainly to the increased incidence of early cancer in surgical cases, and partially to proper adjuvant chemotherapy for the advanced cancer cases during or long-term after surgery. In fact, the cases of early gastric carcinoma whose depth invasion was limited within the mucosa or submucosa constituted 41.9% of the authors' surgical series in 1967-1982, and 5-year survival rates of patients in stages II, III and IV receiving cancer chemotherapy strikingly improved to 80.6%, 57.3%, and 13.2%, in contrast to 59.7%, 35.2% and 2.4% for control groups not treated with anticancer agents. PMID- 6506064 TI - Lack of cross-reactivity between human placental and rat liver glucocerebrosidases. AB - The production of anti-human placental glucocerebrosidase antibodies in rabbits immunized with a mixture of human placental glucocerebrosidase and Freund's complete adjuvant was confirmed by the immunoprecipitation reaction, immunocompetition and Graber and Williams' immunoelectrophoresis. These immunochemical techniques also unviled a lack of cross-reactivity between human placental and rat liver glucocerebrosidases against the rabbit antiserum. PMID- 6506065 TI - Prognostic evaluation of early detection of relapse in adult acute leukemia. AB - A criterion was established in a previous study to detect the relapse of adult acute leukemia in its early stage, i.e., when lymphocytes in peripheral blood increased over 45% of the leukocytes during the maintenance therapy, bone marrow puncture was immediately performed to examine the leukemic cells. By this criterion the relapse was detected earlier than by other criteria. To study the effect of early detection of the relapse in adult acute leukemia on the results, the second remission rate and the survival time were compared between the following groups. Group I consisted of 11 patients, whose relapse was determined by our criterion. Group II consisted of 8 patients whose relapse was determined by the appearance of leukemic cells in peripheral blood. The second remission was accomplished in 7 of 11 patients in Group I (64%) and in 1 of 8 in Group II (13%) (p less than 0.05). The mean (+/- S.D.) duration of complete remission in Group I was 9.7 +/- 7.8 months and not significantly longer than the value in Group II (5.3 +/- 3.9 months). The interval from relapse to death was 10.3 +/- 5.9 and 6.1 +/- 3.8 months in Groups I and II, respectively. The interval from relapse to death of 7 patients who accomplished the second remission in Group I was 12.5 +/- 5.5 months. This interval was significantly longer than in Group II (p less than 0.02). The mean survival time was 22.2 +/- 9.6 months in Group I and 13 +/- 2.5 months in Group II. The mean survival time of 7 patients accomplished the second remission in Group I was 26. 7 +/- 9.4 months which was significantly longer than in Group II (p less than 0.01). The results showed that our criterion to detect relapse in the early stage was effective for prolongation of the survival time in adult acute leukemia. PMID- 6506066 TI - Role of rice in dietary cadmium intake of farming population with no known man made pollution in Japan. AB - The 24-hr duplicates of a whole day diet were collected in winter seasons from 1042 farmers in 49 non-polluted regions in Japan, and the amount of boiled rice in each duplicate was compared with the cadmium content in the duplicate to evaluate the role of rice in daily cadmium intake via food. The daily boiled rice intake (in terms of regional geometric means) varied in the range of 720-1,100 g/day for males and 300-800 g/day for females, yet positively correlated with whole day dietary cadmium intake in males (0.07 less than p less than 0.08), in females (p less than 0.01) and the combination of the two sexes (p less than 0.01). The findings, in accordance with other reports, suggest that rice is an important source of cadmium intake among Japanese population even in non-polluted areas. The roles of sake (rice wine) and beer appeared to be quite minor as the cadmium contents were very low. PMID- 6506067 TI - Consideration of the mechanism of pulmonary adenogenesis in urethane-treated Swiss mice. AB - A number of investigators have observed a quadratic relationship between acute urethane dose and cumulative pulmonary adenoma incidence in mice. The hypothesis was tested that this dose-effect relationship may be explained by consideration of the elimination kinetics of urethane. Single doses of 0.4 to 1.8 mg urethane per g body weight were given ip to 6-week-old Swiss-Cox mice. The measure of internal exposure to the intact urethane molecule for a given external urethane dose was taken to be the area under the curve (AUC alpha) of a blood urethane concentration versus time plot. AUC alpha was linearly related to tumor prevalence. When urethane elimination was induced by pretreatment of the mice with p,p'-DDT, the linear relationship of AUC alpha to tumor prevalence was shifted. Reduction of tumor prevalence by p,p'-DDT pretreatment was more marked than that predicted on the basis of exposure to urethane. Thus, the kinetic evidence is consistent with biochemical evidence from other investigators supporting the premise that activation of urethane to a reactive metabolite is required for adenoma formation in the mouse lung. While exposure to the adenogenic moiety is evidently closely proportional to internal exposure to urethane in both pretreated and non-pretreated mice, p,p'-DDT pretreatment causes a shift in this proportionality. PMID- 6506068 TI - Toxicity of 1-phenylcyclohexene and its interaction with phencyclidine. AB - The toxicity of 1-phenylcyclohexene (PC), a pyrolysis product of phencyclidine (PCP), and its interaction with PCP were evaluated. The ip LD50 of PC in Swiss male mice was 22 mmol/kg. Treatment of mice with PC at 2.2 mmol/kg/day, ip, for up to 7 days increased the liver/body weight ratio, which returned to normal within 7 days after PC withdrawal. Increases of 32% in serum glutamic-oxalacetic transaminase (SGOT) and 94% in serum glutamic-pyruvic transaminase (SGPT) were observed within 4 hr following the initial (Day 1) dose of PC. Smaller increases in the SGOT activity continued following Day 2 and 3 PC administrations. The SGPT activity remained elevated after these treatments. Activities of both enzymes, however, returned to normal within 24 hr following daily PC injections. No pathologic changes were observed in liver, brain, spleen, kidneys, and lungs with light microscopy. PC treatment for 4 days at 2.2 or 4.4 mmol/kg produced proliferation along with dilatation and fragmentation of the endoplasmic reticulum in liver. Scattering of ribosomes in the cytoplasm and dilatation of rough-surfaced cisternae were prominent at the higher dosage. Pretreatment of animals for 4 days with PC (1.1, 2.2, and 4.4 mmol/kg, ip) decreased pentobarbital- (60 mg/kg) induced sleeping time by 27, 64, and 80% and lowered PCP- (16.4 mumol/kg) stimulated locomotor activity by 18, 28, and 41%, respectively. Pretreatment of animals with PC for 1 hr inhibited (ED50: 2.3 mmol/kg) the PCP-induced locomotion. These results indicate that the PC treatment during a 7-day period produces some undesirable effects on liver function, which are reversible on its discontinuation. However, PC also weakens toxic effects of PCP. PMID- 6506069 TI - The effects of ethanol on the kinetics of toluene in man. AB - Eleven men were exposed in an exposure chamber to toluene vapor (3.2 mmol/m3, 4.5 hr) with and without a simultaneous po intake of ethanol (15 mmol/kg body wt). The ethanol was administered 70 to 85 min after the onset of the toluene exposure to achieve maximum concentrations of toluene and ethanol in blood at the same time. During the exposure period the solvent concentrations in inspired and expired air as well as the pulmonary ventilation were determined. The solvent concentrations in blood were measured during and for 3 hr after the exposure period. No effect of ethanol on the pulmonary ventilation could be seen during the exposure period. Ethanol decreased the total uptake as well as the relative uptake of toluene. The maximum toluene concentration in the blood increased from 7.4 to 12.5 mumol/liter in the presence of ethanol and apparent clearance of toluene decreased significantly. Toluene exerted no effect on the uptake and elimination of ethanol in blood. The results indicate an influence of a moderate dose of ethanol on the kinetics of toluene. The distribution and/or elimination of toluene from the blood was inhibited resulting in increased tissue exposure. PMID- 6506070 TI - Effect of cadmium on plasma aldosterone and serum corticosterone concentrations in male rats. AB - Cadmium chloride (CdCl2) at a dose of 1 mg/kg of body weight was injected into male Wistar rats twice a day (12-hr intervals) for 7 consecutive days. A group of treated rats was maintained without any treatment for an additional period of 10 days and killed on the following day (on Day 18). Plasma aldosterone concentrations were markedly increased in Cd-treated rats on Days 2, 3, and 8. The metabolic clearance rate (MCR) of plasma aldosterone on Day 3 was within the same range as the control value, and the production rate (PR) of aldosterone markedly increased on Day 3, suggesting that the increased plasma aldosterone on Day 3 may be associated with the increase of PR of aldosterone. The serum corticosterone concentration was significantly decreased on Day 8 while the MCR of corticosterone markedly increased on Days 3 and 8 and the PR of corticosterone also significantly increased on Days 3 and 8. The increased ratio (the value in treated rats/the value in control rats) in MCR of corticosterone on Day 8 was higher than that in PR of corticosterone on Day 8, suggesting that the increased MCR was a factor for the decreased serum corticosterone on Day 8. Serum potassium and sodium concentrations significantly increased on Days 1 and 3. No significant differences in Cd contents were observed between the zona glomerulosa and zona fasciculata plus zona reticularis in the Cd-treated rats on Days 3, 8, and 18. PMID- 6506071 TI - Dose-response relationships in ketone-induced potentiation of chloroform hepato- and nephrotoxicity. AB - Chloroform (CHCl3)-induced hepato- and nephrotoxicity was evaluated in male, Fischer 344 rats pretreated with various dosages (1.0 to 15.0 mmol/kg, po) of acetone (Ac), 2-butanone (Bu), 2-pentanone (Pn), 2-hexanone (Hx), or 2-heptanone (Hp). The CHCl3 challenge dosage (0.5 ml/kg, ip) produced slight centrilobular hydropic degeneration and patchy degeneration and necrosis in the proximal tubules of corn oil-pretreated rats. Each of the ketones studied produced a dose related potentiation of CHCl3 liver and kidney injury. CHCl3 produced extensive tubular and centrilobular necrosis when administered to ketone-pretreated rats. The relationship between ketone dosage and the magnitude of the potentiated response was nonlinear. Maximum potentiation of CHCl3 toxicity occurred in the dosage range of 5.0 to 10.0 mmol ketone/kg. Ketone dosages greater than 10.0 mmol/kg were associated with a reduction in the degree of CHCl3 injury. At the lowest ketone dosage (1.0 mmol/kg), potentiating capacity appeared to be related to ketone carbon skeleton length. No differences in potentiating capacity were discernable between the ketones at dosages of 5.0 to 10.0 mmol/kg. Thus, whether or not there is a relationship with carbon chain length and potentiation depends upon the dosage of the ketone. PMID- 6506072 TI - The hemostatic derangement produced by T-2 toxin in guinea pigs. AB - T-2 toxin produced significant coagulation abnormalities when administered parenterally to Hartley strain guinea pigs. The animals developed depressed activity of all coagulation factors except fibrinogen. Platelet aggregation in whole blood was depressed in response to ADP and collagen. The animals also exhibited an initial rise followed by a fall in hematocrit level, leukocytosis, and a decrease in platelet count. These changes were detectable within hours of toxin administration, reached a maximum at 24 hr, and returned to normal over the next 2 days. Pretreatment of animals with vitamin K1 had no effect on the activity of coagulation factors. The activated partial thromboplastin time of dilutions of plasma from animals given T-2 toxin with plasma from control animals revealed a pattern which pointed to a deficiency of coagulation factors as the principal cause of prolonged clotting times in treated animals. The presence of a weak circulating anticoagulant could not be ruled out. The addition of T-2 to plasma and blood of normal animals in a concentration of 1 microgram/ml had no effect on clotting times or platelet aggregation. PMID- 6506073 TI - Systemic effects of topical application of T-2 toxin in mice. AB - Topical application of T-2 toxin in dimethyl sulfoxide (DMSO) resulted in the death of 20/20 mice in the 20-, 30-, and 40-mg/kg body weight (BW) dose groups within 4 to 6 days after application, whereas 17/20 and 5/20 animals died in the 10- and 5 mg/kg BW groups, respectively, within 7 days. Histological examination of thymus, spleen, and duodenum at 6, 12, 18, and 24 hr after topical application of 5 or 40 mg/kg BW to mice revealed that the characteristic radiomimetic effects of this trichothecene mycotoxin are easily recognizable at 6 hr after topical application, with the severity of damage being dependent on the organ and time. The lesions are quantitatively and qualitatively identical with those seen after intragastrical application of T-2 toxin. Both the postmortem and, to some extent, the general histological findings were not specific enough to arrive at an etiological diagnosis without prior knowledge of the fact that a mycotoxin was applied to the skin, unless one had the opportunity to look for the characteristic intestinal lesions prior to 24 hr after application, or for necrosis in spleen an thymus after 24 hr. PMID- 6506074 TI - Comparative plasma lipid response of pullets and laying hens to estradiol and progesterone. AB - The effects of estradiol and progesterone treatment on plasma hormone and lipid concentrations were measured in laying hens and sexually immature pullets. Pullets and hens were divided into three groups and injected with estradiol (1 mg/kg bw), progesterone (4 mg/kg bw), or vehicle (propylene glycol) once each day for 14 days. Blood samples were collected before treatment and 24 hr after the 7th and 14th treatments. Plasma progesterone (P), estradiol (E2), triglycerides (TG), cholesterol (C), and phospholipids (PL) were measured. E2 treatments elevated hen plasma TG 7.2X, PL 5.1X, and C 7.2X; and pullet plasma TG 6.8X, PL 3.7X, and C 2.5X. However, because hen plasma was initially mildly hyperlipidemic, the E2-treated hens developed severe hyperlipidemia, but egg production was unaffected. Progesterone treatments of pullets had little or no effect on plasma lipids, but progesterone treatment of hens significantly reduced initial plasma TG and PL and also reduced egg production. No substantial differences were found in circulating E2 or P in hormone-treated hens and pullets, which indicated no extreme differences in plasma hormone clearance rates. These results indicate that long-term rather than short-term hepatic priming may account for observed differences in layer and pullet response to estradiol treatment. PMID- 6506075 TI - The influence of milk diet, grain diet, and method of dosing on lead toxicity in young calves. AB - Twenty 2- to 3-week-old calves were fed a milk diet or a mixture of grain and hay. After acclimatization, all calves were dosed po with lead acetate for 7 days, either in solution via a nursing bottle or in a gelatin capsule. At the end of the treatment period, 6 of 10 calves fed milk were either dead or showed multiple signs of Pb poisoning. All calves fed grain and hay appeared normal. Tissue Pb was significantly higher in calves on a milk diet (p less than 0.05) compared to tissue from calves on a grain and hay diet. No significant differences wee found when dosing methods wee compared. These data clearly show that diet but not dosing methods greatly influenced the absorption and tissue distribution of Pb in calves. delta-Aminolevulinic acid dehydratase (ALAD) activity in blood dropped to approximately 20% of pre-Pb exposure concentrations within 24 hr after the initial dose of Pb and remained at this concentration despite continued Pb administration. Blood Pb concentrations indicate that, in this model, the Pb enters the blood rapidly and retention is prolonged. The calf model warrants further studies on absorption and metabolism. PMID- 6506076 TI - A subchronic inhalation study on the toxicologic potential of ethylene oxide in B6C3F1 mice. AB - Four groups of B6C3F1 mice, each containing 30 per sex, were exposed to ethylene oxide (EtO) vapor at target concentrations of 250, 100, 50, 10, or 0 ppm which are equivalent to 450, 180, 90, 18, and 0 mg/m3, respectively. The actual mean chamber concentrations were 236, 104, 48, 10, and 0 ppm, respectively. After an exposure regimen of 6 hr per day, 5 days per week, for 10 weeks (males), or 11 weeks (females), urine and blood samples were taken for clinical pathologic evaluation and selected tissues were weighed and examined by light microscopy. Statistically significant findings that could be indicative of a toxic response were observed in the 250-ppm exposure group. These included minimal changes in certain erythroid parameters, increased liver weight, decreased testicular weight, and decreased spleen weight which was noted also in the 100-ppm group. However, there were no microscopic findings to support or explain any of these apparently treatment-related effects. Results of a neuromuscular screening test indicated that certain reflex responses and locomotor activities were altered in the EtO-exposed animals. A dose-related trend of response in the 250-, 100-, and 50-ppm exposure groups was noted in the evaluation of locomotor function; however, because of the small sample size, it was not possible to determine a threshold concentration for this effect. There were no accompanying histopathologic alterations in muscle and central or peripheral nervous tissue. PMID- 6506077 TI - Body weight regulation in rats treated with 2,3,7,8-tetrachlorodibenzo-p-dioxin. AB - Rats treated with a sublethal dose of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, 15 micrograms/kg) exhibited reduced feed intake and loss of body weight for the first 3 weeks after treatment. During the next 10 weeks, TCDD-treated rats maintained their body weight at a lower nearly constant percentage of that of control rats fed ad libitum. At no time did rats treated with TCDD exhibit hyperphagia which would have returned their weight to a normal level. Control rats pair-fed to TCDD-treated rats for more than 7 weeks displayed compensatory hyperphagia when permitted to feed ad libitum and their weight recovered to a near-normal level. The lower level of body weight in TCDD-treated animals was apparently due to a reduction in the regulation level or "set-point" for body weight. The following findings in TCDD-treated and control rats fed ad libitum supported this idea. First, when the reduced weight of the TCDD group was challenged by changes in the caloric density or palatability of the diet, TCDD treated rats exhibited adjustments in feed intake and body weight that were essentially identical to those of control rats. Second, when body weight was manipulated by feeding a high-calorie diet or by restricting feed intake, both TCDD-treated and control rats quickly returned to weight levels from which they had been displaced. Third, carcass analyses conducted 7 weeks after treatment revealed that TCDD-treated rats had lower absolute amounts of body fat, protein, and water. However, when these constituents were expressed as percentages of total body weight no remarkable differences from the control were observed. Fourth, when TCDD-treated rats were induced to overeat and restore body weight to the same level as control rats fed ad libitum. TCDD-treated animals did not reassume a normal body composition but became obese. Obesity was also observed when control rats were induced to overeat. Thus, TCDD-treated rats regulate their body weight in the same fashion as control rats but at a weight regulation level or set-point that is markedly reduced. PMID- 6506078 TI - The estrogenic activity of DDT: the in vitro induction of an estrogen-inducible protein by o,p'-DDT. AB - Induced protein is a commonly measured marker for estrogenic action. The induction of induced protein by o,p'-DDT was studied in an in vitro system. Nuclear levels of estrogen receptor translocated by o,p'-DDT correlated highly with induced protein induction, and the time course for induced protein induction was consistent with an estrogen receptor-mediated mechanism. While the maximum amount of induced protein produced by o,p'-DDT was less than after 17 beta estradiol exposure, the induced protein formed by each compound was indistinguishable on nondenaturing and denaturing polyacrylamide gels. Also, it was shown that o,p'-DDT does not cause additional induction of induced protein over that seen with maximum levels of 17 beta-estradiol, further supporting the premise that these compounds share a common pathway in stimulating the synthesis of induced protein. PMID- 6506079 TI - An aerosol generator for the resuspension of cotton dust. AB - An aerosol generator, the Pitt 3 model, was designed, fabricated, and characterized for the resuspension of inhalable particles from bulk cotton dust. The generator was constructed around a loudspeaker whose energy is transferred into an air column through latex rubber dams. This action tumbles the bulk dust, and small particles are loosened which can then be carried out of the column with the air passing through it. Thirty to forty grams of bulk cotton dust produced a stable aerosol concentration for at least 90 min. The maximum output of about 100 mg/m3 can be reduced to lower concentrations by adding dilution air. In one application, the generator produced a stable aerosol cloud in the range of 2 to 30 mg/m3 with a mass median aerodynamic diameter (MMAD) of about 3 microns and a geometric standard deviation (sigma g) of about 1.5. In another application the concentration in an animal exposure chamber was kept at 20.8 mg/m3 with an MMAD = 2.5 microns and a sigma g = 1.8 for over 6 months. The Pitt 3 generator proved to be trouble-free and produced large amounts of inhalable particles from bulk cotton dust. The generator was also used to generate dust clouds from silica powder, fly ash, and cellulose dust. The only requirement for successful resuspension of any dust with this generator is the presence of small particles in the bulk feed dust. PMID- 6506080 TI - A model system for measuring comparative toxicities of cardiotoxic drugs with cultured rat heart myocytes, endothelial cells and fibroblasts. I. Emetine, chloroquine and metronidazole. AB - Neonatal rat hearts were separated into separate cultures of beating myocytes (M cells), endothelial cells (E cells) and fibroblasts (F cells). Their susceptibilities to the toxic effects of emetine, chloroquine and metronidazole were then compared using a quantitative metabolic inhibition test (QMIT) and morphologic and beating changes as indices of injury. Measurements on the same cultures were made at 6 h and 12 h daily for 7 days with E and F cells; with M cells for 3 days. Metronidazole was non-toxic for all cell types at 810 micrograms/ml, whether as the parent compound or after attempted rat liver microsomal activation. QMIT data, integrated as time-concentration effects, showed all cell responses to either emetine or chloroquine to be parallel (P less than 0.05), and their order of susceptibility to be: E greater than M greater than F cells. Although morphologic signs of injury and changes in beating are not readily evaluated statistically, there was a general parallelism between these indices of injury and those of QMIT. As judged by QMIT emetine was more toxic than chloroquine. However, at equivalent QMIT grades chloroquine produced greater effects on morphology and beating. Toxic concentration-50 values for chloroquine with the QMIT were similar to reported human toxic and lethal blood concentrations. PMID- 6506081 TI - A model system for measuring comparative toxicities of cardiotoxic drugs for cultured rat heart myocytes, endothelial cells and fibroblasts. II. Doxorubicin, 5-fluorouracil and cyclophosphamide. AB - Separate cultures of beating myocytes (M cells), endothelial cells (E cells) and fibroblasts (F cells) from neonatal rat hearts were compared for their susceptibilities to the toxic effects of doxorubicin, 5-fluorouracil and cyclophosphamide. Toxic injury was measured as inhibition of metabolism and changes in morphology for all cell types, and changes in beating of myocytes. Cells were exposed to the anti-tumor agents for 3 days with myocytes and 7 days for endothelial cells and fibroblasts. All measures of injury were made several times the first day and daily thereafter, with the same cultures used throughout. Toxic effects of DOX and 5-FU were greater for E and F cells than for M cells, and all measures of toxicity were generally parallel. Cyclophosphamide, whether activated by liver microsomes or unactivated, was less toxic in general than the other agents, but it was more toxic for M cells than for E cells or F cells. PMID- 6506082 TI - Sustained induction of hepatic xenobiotic metabolising enzyme activities by phenobarbitone in C3H/He mice: relevance to nodule formation. AB - Phenobarbitone (PB) was administered to male C3H/He mice at a dose of 85 mg/kg/day in a semisynthetic diet for up to 90 weeks. Throughout the treatment period a sustained induction of a number of parameters of hepatic Phase I and Phase II xenobiotic metabolism was observed. Histological examination revealed hypertrophy of the centrilobular cells of the liver lobule in PB treated mice and after 25 weeks small basophilic nodules were found in control and PB treated animals. In addition eosinophilic nodules, which were often large, developed in PB treated mice. Xenobiotic metabolising enzyme activities in large excised nodules after 70 or 90 weeks of PB treatment were either similar to or greater than those present in surrounding host tissue. Both phenobarbitone- and polycyclic hydrocarbon-type mixed function oxidase enzyme activities were induced in large nodules. In conclusion, PB produced a sustained induction of xenobiotic metabolising enzymes both in host tissue and in large eosinophilic nodules. The formation of these nodules in C3H/He mice was thus not associated with any failure of induction of hepatic xenobiotic metabolism. PMID- 6506083 TI - Biochemical and histological anomalies in the rat hepatic tissue following administration of bichromate and nickel in ionized form. AB - Administration of bichromate ions at a dose of 60 mg/kg body wt to female rats, reduced dramatically both hepatic microsomal cytochrome P-450 content and the monooxygenase activities assayed, namely: N-demethylation of aminopyrine and O demethylation of p-nitroanisole. At the same dose the bichromate ion treatment caused a substantial decrease in cytochrome b5 content, but there was no significant reduction in NADPH-cytochrome c reductase activity. Administration of phenobarbital to bichromate ion pretreated rats did not induce a significant increase in cytochrome P-450 content nor in aminopyrine N-demethylase activity. Administration of nickel ions at a dose of 60 mg/kg body wt to female rats did not reduce to a significant level the content or the activity of any of the hepatic microsomal enzymes mentioned above, but did interfere in the de novo synthesis of cytochrome P-450 following phenobarbital treatment. The concentrations of nickel residues in the hepatic tissue of treated rats were only 5.8 times higher compared to the control rats, while those of chromium were 42 times higher than in control rats. Histological changes associated with the increase of bichromate concentration in treated rats were the formation of necrotic areas in the hepatic tissue and partial disintegration of the glomeruli and tubules in the kidney. PMID- 6506084 TI - Interaction of potassium dichromate with the nephrotoxins, mercuric chloride and citrinin. AB - Potassium dichromate enhanced the effects of mercuric chloride or citrinin on renal slice transport of the organic ions p-aminohippurate (PAH) and tetraethylammonium (TEA) under certain experimental conditions. At the doses employed and times studied no effects, or only minimal effects, were observed on renal slice transport when the toxins were tested individually. Potassium dichromate (10 mg/kg) administered subcutaneously (s.c.) in combination with mercuric chloride (4 mg/kg, s.c.) or citrinin 35 or 55 mg/kg administered intraperitoneally (i.p.), resulted in a marked depression of organic ion transport. Similarly, the addition of potassium dichromate to fresh renal cortex slices in combination with mercuric chloride, enhanced the mercuric chloride induced reduction of transport. No other interactions were observed under in vitro conditions. PMID- 6506085 TI - Teratogenicity and embryotoxicity of titanocene dichloride in mice. AB - The teratogenic and embryotoxic effects of the antitumor agent titanocene dichloride (TDC) were investigated after application of single doses of TDC (30 or 60 mg/kg) to pregnant mice on days 8, 10, 12, 14 or 16 of gestation. The fetuses were removed on day 18 by caesarian section and examined for external, internal and skeletal malformations as well as for toxic phenomena. The most striking result was the occurrence of cleft palate in numerous fetuses (10% of the fetuses, 30 mg/kg; 40-50%, 60 mg/kg) after TDC application on days 10 and 12. Besides the additional appearance of costal malformations in some fetuses, no other malformations were recognizable. On the other hand, the embryotoxic influence of TDC was significant and caused diminution of the number of live fetuses per litter, marked and dose-dependent reduction of mean fetal body weight after TDC application on day 8 through day 16 and distinct retardation of skeletal ossification. PMID- 6506086 TI - Cadmium accumulation and subcellular distribution in relation to cadmium chloride induced cytotoxicity in vitro. AB - A bovine kidney cell culture system was used to assess what relationship cadmium (Cd) uptake and subcellular distribution had to cadmium chloride induced cytotoxicity. Twenty-four hour incubation with 0.1-10 microM Cd elicited 0-90% cytotoxicity. Fifty percent cytotoxicity was estimated to result from 0.8 microM Cd. A concentration-related Cd accumulation paralleled the cytotoxicity profile. The time-course for Cd accumulation was linear for the first 6 h of exposure and plateaued by 18 h post-exposure. When the degree of cytotoxicity was compared with the cellular Cd burden at 24 h post-treatment a least-squares linear regression analysis (r = 0.93) indicated a direct relationship. Subcellular distribution studies indicated greater than 90% Cd recovery from the soluble supernatant (105 000 g) at all levels of cytotoxicity studied. Metallothionein sequestered less than 25% of the cellular Cd. As a result of the correlation of the degree of cytotoxicity with the cellular Cd burden and the independence of subcellular distribution from cytotoxicity, a cumulative mechanism of toxicity for Cd in MDBK cells was suggested. PMID- 6506087 TI - Acute and subacute toxicity studies of AC-1370 sodium in mice and rats. AB - The i.v. LD50 of the cephalosporin antibiotic 7-beta-D(-)-alpha-[4(5) carboxyimidazole-5(4) carboxamido]phenylacetamido-3-(4-beta-sulfoethylpyridinium) methyl-3-cephem-4 carboxylic acid sodium (AC-1370 sodium) for the rat was found to be 4.2 and 3.5 g/kg body weight for males and females, respectively; corresponding values for the mouse were 2.7 (male) and 2.9 (female). Daily i.v. administration to rats for 35 days caused decreased food intake and increased water consumption and body weight gain, relative increase of kidney weight, elevated blood urea nitrogen (BUN) and proteinuria, renal tubular degeneration and/or necrosis and ballooning of the caecum at 1500 mg/kg/day, and less marked changes at 500 mg/kg/day. There were so significant adverse effects at 40 or 150 mg/kg/day. The approximate LD50 values (g/kg) by other routes were: s.c. mouse, 7 8; s.c. rat, 11-12; i.m. mouse and rat, greater than 1.2; per os mouse and rat, greater than 15. PMID- 6506088 TI - An electrophysiological study of 2-hexanone and 2,5-hexanedione neurotoxicity in rats. AB - n-Hexane and its metabolites are neurotoxic to animals and man. Studies have revealed a progressive neuropathy which affects the distal regions of motor and sensory peripheral nerves. This paper describes efforts to determine whether 2 hexanone or 2,5-hexanedione is more neurotoxic than 2-hexanone and that it first affects the distal axon. Concentrations of 20 mM produced no effects after 3 weeks but 40 mM increased distal latency after 2 weeks. PMID- 6506089 TI - Acute toxicity of endosulfan 35EC to two freshwater bivalve molluscs from Godavari river at Maharashtra State, India. AB - Static bioassay tests were conducted using commercial grade endosulfan 35EC to study its toxicity during different seasons to two species of Lamellidens from the Godavari river at Paithan (Maharashtra State). Acute toxicity studies for 96 h showed that both species of Lamellidens were more sensitive to endosulfan 35EC in summer, at times of high temperature, pH and total carbonate content of the water used, than in monsoon and winter. LC0 and LC50 values were determined for L. corrianus and L. marginalis, during summer, monsoon and winter. Statistical analyses showed that both species were more sensitive during summer (P less than 0.001) than in monsoon and winter and that L. marginalis was more sensitive to endosulfan 35EC than L. corrianus in summer (P less than 0.001). Behavioural changes and mortality of the bivalves were dose-related. Regression equations and 95% confidence limits for each species were established in different studies. The results are discussed in the light of possible effects of endosulfan on these species of bivalve molluscs. PMID- 6506090 TI - Activation of styrene to styrene oxide in hepatocytes and subcellular fractions of rat liver. AB - The oxidation of styrene to styrene oxide and the hydration of this metabolite to styrene glycol was investigated in hepatocytes, 9000 x g supernatant (S9) and the microsomal fraction from rat liver. Similar amounts of free styrene oxide were found in microsomes, hepatocytes and S9. However, on the basis of the formation of styrene glycol and the depletion of glutathione (GSH), it appeared that hepatocytes were the most active system in the metabolism of styrene, followed by S9 and microsomes. PMID- 6506091 TI - Influence of dietary ingredients on the body retention of strontium, cadmium and mercury in suckling rats. AB - Six-day-old suckling rats were artificially fed over 8 h with cow's milk or a mixture of rat food ingredients (fish meal, sunflower meal, alfalfa, cane molasses and premix) labelled with 85Sr, 115mCd or 203Hg. Whole-body radioactivity was determined in a double crystal scintillation counter every 24 h over a 6-day period. Carcass, gut, liver and kidney retention were determined at the end of the experiment. Relative to pups that were fed on cow's milk, administration of the mixture of the solid dietary ingredients caused a significant reduction in whole body, carcass and organ retention of all metals and was highest for 203Hg. This indicates that high absorption of toxic metals in sucklings can be reduced by dietary means. Rat food ingredients deserve further consideration because they are non-toxic dietary constituents and might be useful for decreasing the body burden of some metals in conditions of increased environmental exposure. PMID- 6506092 TI - Serum and tissue thiocyanate concentrations in growing pigs fed cassava peel or corn based diets containing graded protein levels. AB - Thiocyanate concentrations of serum, liver, kidney, spleen and longissimus dorsi were determined in 64 growing Large White x Landrace pigs offered 8 experimental isocaloric diets containing different levels of cassava peel and crude protein. Cassava peel increased serum thiocyanate on day 60 (P less than 0.01) and day 90 (P less than 0.01) of the trial, while the crude protein level increased it (P less than 0.05) on days 30 and 90, respectively. Interaction of the two factors was significant on day 30 (P less than 0.05) and day 90 (P less than 0.05). There was a correlation between cyanide intake and serum thiocyanate level. Coefficient of determination revealed that cyanide alone accounted for 28.5; 60.6 and 48.8% variation in serum thiocyanate on days 30, 60 and 90, respectively. Liver, spleen and longissimus dorsi thiocyanate were affected by dietary protein intake (P less than 0.05). Thiocyanate concentration was higher (P less than 0.05) on cassava peel diet. Generally, crude protein at 5% reduced organ and muscle thiocyanate concentrations. A diet containing 112.2-117.3 mg/kg hydrocyanic acid (HCN) affected serum but not organ and muscle thiocyanate in protein-sufficient diets. PMID- 6506093 TI - Catalytic potential of field mouse Mus booduga brain acetylcholinesterase during repeated hexachlorophene treatment. AB - The catalytic efficiency of the field mouse (Mus booduga) brain acetyl cholinesterase (AChE, EC 3.1.1.7) was significantly (P less than 0.001) decreased probably through the reduction in the active site density of the enzyme content and elevation in the activation energy (delta E) requirements during repeated hexachlorophene (HCP) treatment. Fall in the activity potential of AChE may account for the interference of HCP or its reactive metabolites with the acetylcholine (ACh)-AChE system and deserve consideration in contributing to the neurotoxicity. PMID- 6506094 TI - Comparative effects of the sublethal poisoning of zinc, copper and lead on the gonads of the teleost Puntius conchonius ham. AB - The histopathological impact of the sublethal concentrations of zinc, copper and lead on the gonads of Puntius conchonius was evaluated. Copper (Cu) interfered with spermatogenesis temporarily while zinc (Zn) and lead (Pb) produced dilation in the testicular blood capillaries with necrosis and disintegration of the seminiferous tubules. All three metals induced significant atresia in the ovary. The damaged mainly the younger oocytes, whereas Cu and Pb were more effective on relatively older oocytes. The studies suggest a direct action of heavy metals on the gonads. PMID- 6506096 TI - Gentamicin-induced stimulation of DNA synthesis in rat kidney. Comparison between in vivo and in vitro models. AB - We have performed combined in vivo and in vitro measurements of thymidine uptake into kidney cortex DNA of animals treated with gentamicin for 7 days at 10 or 20 mg/kg daily (BID). Labelled thymidine is taken up by cortex fragments in vitro (90 min incubation) and incorporated into DNA; treatment of the animals with gentamicin results in a significant dose-dependent enhancement of this in vitro thymidine incorporation; labelled cells are found primarily in the proximal tubules and interstitium; there is an excellent correlation (r : 0.983, n = 15) between the changes of incorporation measured in vivo and in vitro as demonstrated by the sequential use of [3H]thymidine (in vivo) and [14C]thymidine (in vitro) within the same animals. PMID- 6506095 TI - Effect of ampicillin on hepatic microsomal mixed-function oxidase system in male mice. AB - The effect of ampicillin [(D)-alpha-aminobenzyl penicillin] administration on the hepatic mixed-function oxidase (MFO) system was studied in male mice. Ampicillin (100 mg/kg, i.p., 3 days) decreased the levels of cytochrome P-450, aminopyrine N demethylase, acetanilide hydroxylase and cytochrome c-reductase activity significantly. In carbon tetrachloride (CCl4)-pretreated mice, ampicillin increased acetanilide hydroxylation compared with CCl4 treatment alone; however, all other parameters of the MFO system remained unchanged. Ampicillin exhibited type II binding with microsomes (trough at 388 nm, peak at 430 nm). Thus ampicillin acts as an inhibitor of the MFO system. PMID- 6506097 TI - Reduction of brain specific gravity in mice prenatally exposed to trichloroethylene. AB - The specific gravity of the brain is low at birth and increases in parallel with myelination and maturation. The brain specific gravity of litters from mice exposed to trichloroethylene (TCE) before and after mating was significantly lower than in litters from unexposed parents at birth as well as at the age of 10 and 20-22 days. This might indicate a delayed maturation. No significant difference between exposed and unexposed litters was observed at the age of one month. PMID- 6506098 TI - Toxicity of flavoglaucin from Aspergillus chevalieri in rabbits. AB - Female rabbits were injected intraperitoneally (i.p.) with purified flavoglaucin from Aspergillus chevalieri. After 2 h the rabbits were bled and the livers removed for enzyme assays. No changes were found for plasma lactate dehydrogenase (LDH) and its isozymes or liver transketolase (TK) activities. A small but not statistically significant increase was found in plasma glutamate pyruvate transaminase activity. A highly significant increase in plasma glutamic oxaloacetate transaminase activity was observed along with an increase in liver LDH which was, however, not quite significant. The liver also showed some histological evidence of hepatic damage. PMID- 6506099 TI - Parathion-induced suppression of humoral immunity in inbred mice. AB - Numbers of IgM plaque-forming cells (PFC) were reduced by 65% in C57Bl/6 mice given parathion 2 days after immunization with sheep red blood cells (SRBC). The immunosuppressive dose (16 mg/kg, p.o.) caused signs of cholinergic poisoning and 20% mortality. Survivors appeared to have recovered fully from the cholinergic crisis at the time of immunologic assay. However, these animals had reduced tissue cholinesterase (ChE) activities and decreased numbers of nucleated spleen cells. Immunosuppression was apparent on day 4 but not on day 3 or days 5-8 of the primary IgM response. Reduction of serum hemagglutinin titers coincided with reduction of the number of splenic PFC. A lower dose of insecticide (4 mg/kg, p.o.) did not produce signs of poisoning and was not immunosuppressive. The number of 8-day IgG PFC was reduced by 45% when parathion (16 mg/kg, p.o.) was given 6 days after immunization, but not when parathion was given 2 days after immunization. The data suggest that cholinergic stimulation and/or the associated toxic chemical stress may be involved in parathion-induced immunosuppression. PMID- 6506101 TI - Involvement of WHO in the improvement of radiotherapy in developing countries. PMID- 6506100 TI - Increased o- and p-cresol/hippuric acid ratios in the urine of four strains of rat exposed to toluene at thousands-ppm levels. AB - Rats (Fisher, Wistar, Donryu and Sprague-Dawley strains) were exposed to 5 approximately 3500 ppm toluene for 8 h, and urine samples were analyzed for hippuric acid and cresols. While hippuric acid increased in proportion to the exposure concentration, a sharp increase in o-cresol excretion was observed at high toluene concentrations so that the o-cresol/hippuric acid ratio was elevated after 500 approximately 3500 ppm exposures. Changes in the p-cresol: hippuric acid ratio were less marked. There were strain differences in toluene metabolism. Fisher rats were highest and Sprague-Dawley rats lowest in o-cresol excretion and in the o-cresol: hippuric acid ratio, whereas Wistar rats excreted p-cresol most abundantly. PMID- 6506102 TI - Tumor vascularization, hypoxia, staging of tumors and radiocurability. AB - Retrospective, morphometric analysis of histological preparations from cervical cancers indicate that the stromal component of the neoplastic tissue is richer in vascular elements in the cases in which the patients have a prolonged survival after radiotherapy. The finding supports earlier observations which indicate a relationship between intercapillary distance and radiocurability of cervical cancers. The routine determination of a vascularity index V, denoting the grade of vascular density in the neoplastic tissue, is suggested as a complementary parameter for the classification of tumours. Access to such an index could promote a more individualized tumor therapy, especially in regard to the control of radioresistant, hypoxic cells. PMID- 6506103 TI - An approach to the individualization of cancer therapy--determination of DNA, SH groups and micronuclei. AB - Localization and histo-pathology are the basis for the decision, which modality of therapy is used to treat a tumour today. The great variety of biological factors in human tumours is generally largely neglected. The variety of such factors is shown by measuring the DNA content in tumour cell lines, their distribution in the cell generation cycle and the content of bound SH-groups in the cell nuclei. Further the micronuclei which are an expression of cytogenetic damage and which can be used as an indicator of cell loss have been determined. These parameters have been studied in primary and secondary tumours in the brain as well as in rectal adenocarcinoma. It was found that primary brain-tumours had only diploid and tetraploid cell lines while in almost 50 per cent of metastases in the brain and of the rectum adenocarcinoma aneuploid cell lines appeared. These latter cell populations had a higher number of cells in S-phase. The cells in the primary brain-tumours had less micronuclei and appeared as comparatively stable cell lines. Also a difference in the content of nuclear SH-groups could be demonstrated between primary brain-tumours and brain-metastases. In one recurrent tumour, which could be compared with the original tumour, the amount of bound nuclear SH-groups increased by a factor of about 15. In several cases biopsies from adenocarcinoma of the rectum could be studied before and after preoperative radiotherapy. In aneuploid tumours the reduction of the tumour cell line could be demonstrated, at the same time the number of micronuclei increased. However this was not consistent in all investigated cases. PMID- 6506104 TI - Differences among tissues with respect to iso-effect relations for fractionated irradiation. AB - An analysis has been made of responses of a variety of normal tissues in animals to fractionated irradiations. It is shown that the influence of fractionation can be described on the basis of a simple formula relating the effectiveness for induction of cellular effects to the dose per fraction Dn:F(Dn) = a1Dn+a2D2n. The ratio a1/a2 is shown to be an essential parameter for the description of fractionation effects. It is concluded that the values of a1/a2 for responses of various tissues range widely from 2 to 10 Gy. On the basis of a review of radiobiological data, a formalism is developed for the analysis and prediction of iso-effect relations for tissue tolerance. An essential characteristic of the formalism ist that three groups of tissue responses are distinguished for which fractionation effects can be described by average values of a1/a2 = 10, 5 and 2.5 Gy, respectively. The first group comprises a.o. skin, intestine, mucosa, the second group a.o. connective tissue, bone marrow, and the third group a.o. lung, vascular system, and kidney. Dose rate effects can be described by a similar formalism. For the calculation of equivalent total doses, which cause early or late normal tissue damage, a concept is introduced, termed Extrapolated Tolerance Dose (ETD) of Extrapolated Response Dose (ERD). This ETD is the tolerance dose for an infinite number of very small fractions. Specific treatments can be expressed as fractions of the corresponding ETD. An important feature of the described formalism is that it is directly based on radiobiological insights and it provides a more logical concept to account for the diversity of tissue responses than the assumption of different exponents of N and T in the NSD formula. PMID- 6506105 TI - Biological bases for modifying conventional fractionation regimens in radiotherapy. AB - Radiobiological data concerning dose fractionation that have mostly become available only during the past decade could be used to design modifications of conventional radiotherapy that may be necessary in developing countries. Such modifications made in the past without the benefit of recent advances in radiobiological understanding have been disastrous (e.g. [23]). Since it is unreasonable to expect developing countries to support radiobiology research when there are more pressing priorities for their national resources, their interests could be best served by making available to them, through some agency such as the World Health Organization, the consultative services of radiotherapists and radiobiologists to resolve specific problems and thereby to help them achieve maximum cost-effectiveness in the utilization of their available radiotherapy facilities. PMID- 6506106 TI - The problem of individualized monitoring for tumour and normal tissue responses during radiation therapy. PMID- 6506107 TI - Some considerations on the role of chemotherapy in individualization of cancer therapy. PMID- 6506108 TI - Radiosensitizing drugs in relation to individualized treatment. PMID- 6506109 TI - CT-CBF correlations of cognitive deficits in multi-infarct dementia. AB - Fifteen right-handed patients with Multi-Infarct Dementia underwent cognitive testing by the Jacobs Mini-Mental Scale (MMQ), and xenon contrast CT scanning. Local cerebral blood flow (LCBF) and local partition coefficient (L lambda) values were measured by stable xenon contrast CT scanning and potential methodological errors were discussed. Reduced values were graded: 0 = normal, 1 = mild, 2 = moderate, 3 = severe. Graded values were pooled and plotted on composite brain maps to display locations of abnormal L lambda and LCBF values. Topographic brain maps, showing most frequent locations of reduced L lambda values, confirmed the common anatomical locations of multiple cerebral infarcts to be distributed in both thalami, temporal lobes, basal ganglia, left internal capsule and right cingulate cortex. Gray matter flow values were reduced in similar cortical and subcortical regions. There were no correlations between MMQ scores and reduced LCBF values for caudate and lenticular nuclei. Direct and statistically significant correlations were found between reduced MMQ scores and mean LCBF values for left or right frontal cortex, left or right temporal cortex and left or right thalamus. Subgrouping MMQ tests according to functions assessed, indicated that left mid-temporal ischemia correlated with dyscalculia and memory disturbances while ischemia of both frontal lobes correlated with disorientation to time and place. PMID- 6506110 TI - Headache in cerebrovascular disease. AB - Two hundred fifteen consecutive patients with cerebrovascular events were evaluated prospectively for the incidence and characteristics of headache. Of 163 patients able to communicate, headache occurred in 29% with bland infarcts, 57% with parenchymal hemorrhage, 36% with transient ischemic attacks and 17% with lacunar infarcts. Patients with a history of recurrent throbbing headache were significantly more likely to have headache, usually throbbing in quality, during the present illness. Women developed headache significantly more often than men. Headache began prior to the vascular event in 60% of patients and at its onset in 25%. The quality, onset and duration of the headache varied widely among patients. Headache in cerebrovascular disease is common, though neither its occurrence nor characteristics predict lesion type or location. Though the pathogenesis of the headache is unknown, its association with prior throbbing headache suggests that similar factors may operate in both. PMID- 6506111 TI - Moderate homocysteinemia--a possible risk factor for arteriosclerotic cerebrovascular disease. AB - Highly elevated concentrations of homocysteine measured as homocysteine or cysteine-homocysteine mixed disulfide (MDS) are found in plasma and urine in subjects with inherited abnormalities of the methionine metabolism. These subjects have a high incidence of arteriosclerotic vascular complications during childhood. Homocysteine causes endothelial cell injury and cell detachment that initiates the development of arteriosclerosis. The present study demonstrates a significantly elevated mean plasma MDS concentration in 19 patients with arteriosclerotic cerebrovascular disease compared to 17 controls. Our findings suggest that moderate homocysteinemia might be a risk factor for arteriosclerotic cerebrovascular disease. PMID- 6506113 TI - Inhibition by ketanserin of serotonin induced cerebral arteriolar constriction. AB - We studied the effects of serotonin on pial arterioles in anesthetized cats equipped with acutely implanted cranial window for the observation of the pial microcirculation. Serotonin topically applied caused cerebral arteriolar constriction. Ketanserin, a specific 5-HT2 inhibitor, completely blocked the vascular response of serotonin. Aggregated platelet supernatant was topically applied and caused generalized cerebral arteriolar constriction that could be blocked with ketanserin. We conclude that serotonin causes generalized cerebral arteriolar constriction that is due to the stimulation of 5-HT2 receptor. Aggregating platelets release serotonin, which mediates the vasoconstrictive action of the supernatant solution. PMID- 6506112 TI - The effects of calcium antagonism on the epicerebral circulation in early vasospasm. AB - We have studied the effects of the calcium antagonist verapamil on the epicerebral arteriovenous transit time and regional epicerebral circulation of dogs by direct measurement of arterial diameters, fluorescein angiography, and krypton-85 regional epicerebral blood flow analysis. A large craniectomy was performed and vasoconstriction was induced by the subarachnoid injection of human platelet-rich plasma (PRP) pretreated with 25 mu M of ADP to cause maximum aggregation. Once vasoconstriction was established, verapamil (0.1 mg/kg) was topically applied to the perforated arachnoid. The PRP-ADP produced a mean decrease in the arterial diameters of 38.2 +/- 1.6% (p less than 0.01) at 10 minutes after its injection and verapamil produced a mean dilatation of 19.5 +/- 2.5% (p less than 0.01), compared to control values. Regional epicerebral blood flow was 54.9 +/- 3.4 ml/100 g/min in the control state, 34.8 +/- 3.2 ml/100 g/min (p less than 0.01) during vasospasm, and 78.2 +/- 4.5 ml/100 g/min (p less than 0.01) after verapamil. Fluorescein angiography, after verapamil, demonstrated a mean acceleration of the arteriovenous circulation time of 4.5 +/- 0.8 seconds (p less than 0.01) compared to the spasm value. We concluded that the topical application of verapamil can dilate previously constricted cortical arteries and that this dilatation is associated with acceleration of the epicerebral transit time and increased cerebral blood flow. PMID- 6506114 TI - Comparison of the effect of naloxone on cerebral versus mesenteric arterial smooth muscle in feline and primate species. AB - This study was conducted in order to investigate naloxone's in vitro action on both epinephrine-induced constriction of mesenteric artery and norephinephrine induced constriction of cerebral arteries in different species (cat and monkey). Naloxone (3 X 10(-5)M) augmented the epinephrine-induced constriction of both feline and monkey mesenteric artery at epinephrine concentrations of 10(-7) to 10(-5) M. Naloxone (3 X 10(-5)M) suppressed the constriction of feline basilar artery induced by high concentrations (10(-4), 10(-3) and 3 X 10(-3)M) of norepinephrine, while it failed to alter the constriction induced by lower concentrations (10(-7) to 10(-5)M) of norepinephrine. The constrictor response of monkey basilar artery to norepinephrine (10(-8) to 10(-5) M) was not altered by treatment with naloxone (3 X 10(-6) and 3 X 10(-5)M). Such varying effects of naloxone in different tissues and species may have to be taken into account when evaluating the cerebral blood flow changes following naloxone administration. PMID- 6506115 TI - The profile of recovery from stroke and factors influencing outcome. AB - The recovery from stroke of 154 survivors out of 255 stroke patients was analyzed. The outcomes documented were: discharge from hospital, activities of daily living (ADL) and return to work. A clear improvement in neurological and neuropsychological deficits was seen from the acute stage to three months, and this continued to twelve months, but to a lesser degree. 69% and 78% respectively, of the patients were at home three and twelve months after stroke. Independence in ADL increased from 32% acutely to 62% and 68% by three and twelve months, respectively. Of those gainfully employed prior to stroke, 55% had returned to work after twelve months. As a group, SAH patients seemed to recover better, but, for those that could be age-matched with infarction patients, there was no difference in outcome. Old age, acute stage hemiparesis, impairment of intelligence and memory, visuoperceptual deficits, nonadequate emotional reactions, and living alone all had a major negative influence on outcome. This study suggests that neurological and neuropsychological deficits, as well as emotional reactions, influence the outcomes after stroke, and all should be taken into consideration in prognosis. PMID- 6506116 TI - Prognosis for patients treated conservatively for spontaneous intracerebral hematomas. AB - The long-term clinical and CT-outcome of 53 conservatively treated patients with spontaneous intracerebral hematomas (ICH) was studied in relation to the acute findings. The acute mortality of ICH was 27%. Determinant for the immediate prognosis was the level of consciousness and the volume of the hematoma. The crucial size was 50 ml with a mortality of 90% for hematomas larger and 10% for hematomas smaller than that. Intraventricular hemorrhage was a bad prognostic sign only in the ganglionic-thalamic hematomas. At follow-up at a median of 4 1/2 years after ICH, 30% of the total series had a completely normal neurological examination and 28% had resumed work. Thirteen per cent had minor neurological deficits and 17% had debilitating sequelae. During the follow-up period 7 patients had died, which indicates an excess mortality for ICH survivors. The CT findings at follow-up consisted of low density areas smaller than the original hematomas, focal atrophy, calcifications and porencephalic cysts. In 10% the CT scan revealed no trace of the previous hematoma. PMID- 6506117 TI - Intravertebral artery adenosine fails to alter cerebral blood flow in the dog. AB - The effect of intra-arterial adenosine on cerebral blood flow was studied in 11 anesthetized dogs. In a first group of 6 dogs, adenosine was infused into a vertebral artery for 40 minutes at a dose of 0.3 to 0.5 mg/kg/min. Blood flow was determined before, during and after the adenosine infusion using the radioactive microsphere technique. In a second group of 5 dogs, adenosine (3 +/- 1 mcg/kg/min) was infused in a similar manner after potentiating its effect with intravenous dipyridamole, and measurements before and after the intravenous dipyridamole and during and after the adenosine infusion were performed. Systemic arterial pressure and blood gases were unchanged throughout the experiment in both groups of dogs. Blood flow to the cerebral hemispheres, cerebellum, brain stem, paraspinous and temporalis muscles remained unchanged during the adenosine infusion in both groups of dogs. Adenosine has been implicated as an active agent in the vasodilatory component of cerebral autoregulation. A controversy exists as to whether intervascular or only interstitial adenosine is of physiologic importance. These findings suggest that intra-arterial adenosine does not play a significant role in the regulation of cerebral blood flow. PMID- 6506119 TI - Orthostatic transient ischemic attacks: a symptom of large vessel occlusion. AB - Orthostatic transient ischemic attacks (TIA) are very much rarer than orthostatic generalized cerebral ischemia (syncope). A case is described and previous reports reviewed. Orthostatic TIA appears to occur only with large vessel occlusion. In these patients, collateral blood supply is marginal and unable to support normal postural autoregulation. PMID- 6506118 TI - Chemiluminescence in hypoxic brain--the first report. Correlation between energy metabolism and free radical reaction. AB - The possibility that cerebral ischemia or cerebral hypoxia may initiate a series of free radical reactions in brain tissue lipid constituents was explored by measuring sequential changes in chemiluminescence values and energy metabolism during brain hypoxia in the rat. Brain hypoxia was induced by means of arterial hypoxemia (PaO2 17-22 mmHg), normocapnia (PaCO2 28-38 mmHg) and normotension (MABP 100-140 mmHg). To obtain lowered PaO2, 4% O2--96% N2 mixed gas was used. Analysis of the chemiluminescence spectra for the purpose of luminous mechanism investigation was again attempted. No peroxidation occurred in the pre-hypoxic state since there were no photon counts. Chemiluminescence began to rise in the hypoxic state and remained at a high value in the post-hypoxic state. Specifically in the hypoxic state, the 3 min period showed 231 +/- 35 counts/10 sec X g (n = 5) and the 5 min period showed 154 +/- 62 (n = 19) counts/10 sec X g. In the post-hypoxic state, the 5 min period showed 217 +/- 79 counts/10 sec X g (n = 9) and the 30 min period showed a decrease similar to the pre-hypoxic state. The chemiluminescence spectroanalysis showed five peaks in wavelength at 480 nm, 520-530 nm, 570 nm, 620-640 nm and 680-700 nm. Sequential changes in energy metabolism revealed that hypoxia caused marked brain lactic acidosis, an increase in both ADP and pyruvate, and a fall in glucose. However, all metabolites recovered at 30 min in the post-hypoxic state, which suggests this was reversible brain hypoxia. Sequential changes in chemiluminescence values and energy metabolism imply the occurrence of free radical reaction in the hypoxic and post-hypoxic brain. The spectroanalysis reveals the luminous mechanism as follows: 1 delta g + 1 delta g----23O2 + h mu PMID- 6506120 TI - Federal funding for research in stroke. PMID- 6506121 TI - The performance of endarterectomy for disease of the extracranial arteries of the head. AB - Data from the National Hospital Discharge Survey, the Veterans Administration Hospitals and Armed Forces Hospitals were reviewed to estimate the number of endarterectomies of extracranial vessels of head and neck performed in the United States. The number increased from around 15,000 in 1971 to around 85,000 in 1982. An estimated 2.8% of those operated in non-federal hospitals were discharged dead. PMID- 6506123 TI - Review of a community hospital experience with carotid endarterectomy. AB - Carotid endarterectomy was performed 743 times during 56 months in a community hospital by 24 surgeons. The mortality rate was 2.7% and permanent stroke occurred in 1.8%. Temporary postoperative neurologic deficit occurred in 3.5%. The frequency with which the surgeon performed the procedure did not appear significant in the incidence of postoperative morbidity and mortality. PMID- 6506122 TI - The practice of carotid endarterectomy in a large metropolitan area. AB - All carotid endarterectomies performed in the greater Cincinnati metropolitan area during 1980 were reviewed. For the 431 procedures performed in 16 hospitals, the operative stroke rate was 8.6% (37 of 431), and the operative mortality rate was 2.8% (12 of 431). The combined morbidity and mortality was 9.5% (41 of 431). Fifty percent of the procedures were done for asymptomatic carotid disease (216 of 431) and 50% were done for symptomatic carotid disease (215 of 431). The stroke rate was 5.6% for the asymptomatic patients and 11.6% for the symptomatic patients (difference significant, p less than 0.05). Neurosurgeons and vascular surgeons had similar surgical morbidity. All of the operative strokes involved the hemisphere ipsilateral to the endarterectomy. Fifty-seven percent of the operative strokes (21 of 37) occurred after a neurologically intact interval lasting hours to days. Four occurred following combined endarterectomy-coronary bypass surgery, and one was an intracerebral hemorrhage. The other late strokes (17) occurred without evidence for cardiac embolus or hemorrhage, consistent with a thrombogenic-embologenic operative site, and raising the question of need for adjunctive perioperative medical therapy. PMID- 6506124 TI - Outcome of surgical treatment of 110 patients with transient ischemic attack. AB - Between 1980 and 1982, 227 consecutive patients with transient ischemic attack (TIA) or ischemic brain infarction (IBI) were evaluated as possible candidates for carotid surgery in the Department of Neurology, University of Helsinki. One hundred and ten patients (mean age 58, range 41-72 years) were selected for surgery; 82 of them had had TIA and 28 IBI as the presenting symptom. After a total of 128 operations (84 unilateral and 18 bilateral endarterectomies, and 8 arterial reconstructions), 16 patients (14.5%) developed neurological deficits. In 7 patients (6.4%), the deficit was severe and 4 of them (3.6%) died within the first four days after surgery. Ten patients had occlusion of the contralateral internal carotid artery and/or severe hypertension. Five of them suffered ischemic brain infarction after the operation and two died. Operation on an occluded internal carotid artery in 7 patients was complicated by hemiparesis in two patients, one of whom died. Patients with surgical complications more often had severe hypertension (p less than .001), total occlusion of the contralateral internal carotid artery, (n.s.) and severe angiographic changes (n.s.) compared with patients without complications. During the follow-up the annual rate for IBI was 3.3% and for acute myocardial infarction (AMI) 4.4%. Vascular death occurred with a frequency of 1.7% per year. The results emphasize that patients with TIA or IBI should be carefully evaluated before recommending surgical treatment for prevention of threatened stroke. Patients with severe risk factors may fare better on medical treatment than with surgical intervention. PMID- 6506125 TI - The case against surgery for asymptomatic carotid stenosis. AB - Asymptomatic cervical bruits with their implication of underlying carotid artery disease, carry an established but low risk of stroke. In spite of the rising numbers of patients subjected to carotid endarterectomy for this condition, there is little evidence that the benefits outweight the risks. Outcome data from community studies and the current prospective Toronto study of patients with asymptomatic neck bruits indicate that the annual stroke rate is 1-2%, and the annual cardiac death rate is 2-4%. Published data of the results of carotid surgery suggest that surgical risks outweigh any possible benefits, unless a subgroup with spontaneous stroke risk of at least 5% can be identified. PMID- 6506126 TI - Sample size for randomized trials in stroke prevention. How many patients do we need? PMID- 6506127 TI - Myocardial damage from acute cerebral lesions. AB - Autopsy findings in 58 patients with intracranial lesions were compared with those in 50 control patients for myocardial damage, characterised by a change from a myofibrillar to a granular staining pattern, using a histochemical method for succinic dehydrogenase. Transmurally scattered foci of damaged myocardial fibres were significantly more common (p less than 0.01) in patients with intracranial lesions (62%) compared to controls (26%). No victims of sudden violent deaths showed these cardiac lesions. Focal myocardial damage required at least six hours to develop after onset of the acute neurological event and was not observed after the second week. It was associated with lesions producing a rapid increase in intracranial pressure and was usually absent in patients with slowly enlarging or small cerebral lesions. Similar myocardial changes were seen in patients in the control group dying from prolonged shock or other forms of acute circulatory or metabolic failure. The postulated mechanism of cardiac damage in these patients is increased levels of plasma catecholamines secondary to rapidly increasing intracranial pressure, irrespective of the cerebral pathology. PMID- 6506128 TI - Pathogenesis of carotid bifurcation atherosclerosis in cynomolgus monkeys. AB - We report here the effect of diet and social environment on the carotid bifurcation atherosclerosis of 60 adult male cynomolgus monkeys (Macaca fascicularis) fed either an atherogenic diet (AD) or a more "prudent" diet (PD). Animals within each dietary condition lived either in unstable social groupings (which had their memberships reorganized on a regular basis) or in stable groupings. The experiment lasted 22 months, after which animals were necropsied and the extent of atherosclerosis was measured both at the carotid bifurcation and at other arterial sites. Carotid bifurcation atherosclerosis (CBA) was significantly more extensive and severe among animals fed the AD diet. Among these animals, all of which were normotensive, lesion extent was positively associated with both plasma cholesterol concentrations and heart rate response to behavioral stress, and negatively associated with the ability to clear glucose. No experimental variables correlated with the CBA of the PD animals; these lesions, some of which were extensive, were probably pre-existing. The social conditions and individual behavior patterns of the animals had no effect on CBA in either group, despite a pronounced effect on the coronary arteries (CA) of the same animals. While the overall correlation between CBA and CA atherosclerosis was not high, animals with extensive CBA almost always had extensive CA atherosclerosis. The factors influencing CBA in the cynomolgus monkey may be similar to those affecting humans. PMID- 6506129 TI - Proposal for a distinctive diagnosis: the deliberate self-harm syndrome (DSH). AB - Self-destructive behavior is a major clinical problem in psychiatry. A review of the literature reveals the existence of enough clinical data to identify a diagnostic entity, "The Deliberate Self-Harm Syndrome" (DSH). The authors present a diagnostic formulation of the DSH syndrome (in the DSM-III format) which consists of four essential clinical features, a group of associated features, clinical features, a group of associated features, a clinical course of typical onset in late adolescence, with multiple recurrent episodes, with multiple methods of low lethality physical self-injury, extending over many years. On the basis of relatively exclusive association of clinical signs and symptoms a heuristic clinical entity is proposed. PMID- 6506130 TI - The structure of fantasied movement in suicidal children and adolescents. AB - Guided by the hypothesis that imagining actions is a way of rehearsing actions in the service of effective adaptations to reality, various characteristics of imagined motion, assessed by the Rorschach Test, were compared in hospitalized suicidal and nonsuicidal preadolescents and adolescents, and in public school children. A number of differences were found for example, suicidal children imagined less vigorous motion than distinguished suicidal and nonsuicidal children and preadolescent and adolescent suicidal children. Further, the scale devised to assess imagined motion successfully predicted about 75 percent of the suicidal children. Implications for diagnosis and treatment of suicidal children are discussed. PMID- 6506131 TI - A reciprocal control approach to the treatment of repeated parasuicide. AB - Patterson and Reid's formulation of coercive versus reciprocal control offers a theoretical model for understanding both parasuicide and nontherapeutic exchanges between treatment staff and repeat suicide attempters. An interpersonal treatment program, derived from the Patterson and Reid formulation, which has been consistently associated with positive changes in the course of hospitalization for moderate-risk inpatients, is outlined, followed by a case illustration and discussion of the treatment strategy. The article stresses the importance of targeting the interpersonal environment as well as parasuicidal acts in the treatment program for repeat suicide attempters. PMID- 6506132 TI - Environmental and personality similarities in case histories of suicide and self poisoning by children under ten. AB - Research on suicide in latency age children is reviewed and case histories of two 9-year-old children who suicided by shooting themselves and one 7-year-old who died by self-poisoning are presented. Similarities in environmental and family histories, and in personality variables among these three cases have suggested underlying mechanisms in development and maintenance of symbiotically shared self concept between parent and child which may be useful in helping to identify similar cases and in assessing potential for suicidal and self-destructive behavior in latency age children. PMID- 6506133 TI - Carbamazepine-10,11-diol steady-state serum levels and renal excretion during carbamazepine therapy in adults and children. AB - Steady-state levels of carbamazepine (CBZ), CBZ-10,11-epoxide (CBZ-E), and 10,11 dihydro-10,11-trans-dihydroxy-CBZ (CBZ-diol) were monitored in 53 adults and 16 children, and 24-h urinary excretion of CBZ-E and CBZ-diol was measured in 25 adults and 8 children. The CBZ dose correlated significantly with the serum level of the metabolites but not with the CBZ level. The variability of the CBZ dose/level ratio was related to comedication. Similarly, comedication altered the serum CBZ-diol/CBZ ratio and, to a lesser extent, the CBZ-E/CBZ as well as the CBZ-diol/CBZ-E ratios. Fluctuations of the CBZ-diol levels during the day were less than half as high as CBZ fluctuations. Children had a higher CBZ dose/level ratio and a relatively lower serum CBZ-diol/CBZ ratio, possibly because they also had a higher renal clearance for CBZ-diol. The fraction of the CBZ dose excreted as urinary CBZ-diol was equal in adults and children (35.2 and 36.2%, respectively). The results of this study suggest that the steady-state serum CBZ diol/CBZ ratio is a sensitive indicator of enzymatic induction and that it can be useful in determining if unexpected CBZ levels can be attributed to the rate of enzymatic conversion of CBZ. PMID- 6506134 TI - Nonlinear pharmacokinetics of CI-912 in adult epileptic patients. AB - We studied the pharmacokinetics of CI-912 (1,2-benziosoxazole-3 methanesulfonamide) in 10 adults with refractory partial seizures during an open label pilot study. Plasma and whole blood concentrations were measured by a high performance liquid chromatograph method after a single dose and up to and at steady state with one or two dosage regimens. Steady-state clearances averaged only 42% (range 20-60%) of single-dose clearances. Vm and Km values of the Michaelis-Menten equation were calculated for 9 of the 10 patients by a new method: Vm averaged 1,272 (range 500-1,973) mg/day and Km averaged 25.1 (range 9.23-52.5) micrograms/ml. The best initial dosage for a new patient is 300 mg CI 912 every 12 h. PMID- 6506135 TI - Dose-dependent kinetics of theophylline in adults with pulmonary diseases. AB - The incidence of dose-dependent pharmacokinetics of theophylline was retrospectively investigated in adults with pulmonary disease receiving continuous aminophylline infusions. Twenty-one of 180 successive admissions to medical intensive care units with a diagnosis of chronic obstructive pulmonary disease, asthma, or respiratory failure met the criteria of two steady-state serum theophylline concentrations on two different doses. Of these, 14 patients continued to smoke, whereas 7 had never smoked or had stopped greater than 1 year prior to admission. No statistical difference existed between the mean systemic clearances of theophylline at the two different doses, using either total body weight or ideal body weight. Only 1 of the 21 patients met the criteria for dose dependency of a greater than or equal to 50% reduction in clearance with dosage increase. Six of eight subjects with decreased clearance on the higher dose were nonsmokers. In contrast, all nine with augmented clearance following dosage increase were smokers. Four were considered to have proportional changes. In general, nonsmoking patients tended to have greater changes in serum theophylline concentration than in dosage. Conversely, smoking patients demonstrated smaller changes in concentration. The relationship of smoking status and dose-dependent theophylline elimination is discussed. PMID- 6506136 TI - Nonlinear metabolic disposition of theophylline. AB - Eleven healthy volunteers were given maintenance treatment with oral theophylline in increasing doses (210-1,260 mg/day). Seven subjects took four different doses, three subjects took three doses and one subject discontinued treatment after only two doses. Plasma and urine were collected during a dose interval at steady state. Theophylline in plasma and urine and metabolites in urine (1-methyluric acid, 1-MU; 3-methylxanthine, 3-MX; 1,3-dimethyluric acid, DMU) were determined by high-performance liquid chromatography. Total clearance of theophylline as well as clearances to all three metabolic products (but not theophylline renal clearance) decreased with increasing dose. The individual Michaelis-Menten parameters Km and Vmax could be estimated for six subjects who took all four doses. Considerable interindividual variability in these parameters and particularly Km:s was found. The Km for overall elimination averaged 133 mumol/L (range 55-213 mumol/L) and the Vmax 611 mumol/h (2,640 mg/day; range 452-813 mumol/h). With regard to individual metabolic routes, the Km for theophylline metabolism to 1-MU was 88 +/- 41 (mean +/- SD) mumol/L and the Vmax was 110 +/- 15 mumol/h; the Km for metabolism to 3-MX was 90 +/- 37 mumol/L and the Vmax was 78 +/- 13 mumol/h; the Km for metabolism to DMU was 179 +/- 92 mumol/L and the Vmax was 357 +/- 122 mumol/h. The Km values for the N-demethylation pathways (1 MU and 3-MX) were significantly correlated (r = 0.95; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6506137 TI - Gentamicin penetration into diseased appendix tissue. AB - Gentamicin concentrations in appendix tissue, serum, and peritoneal fluid were obtained in suspected cases of gangrenous or perforated appendicitis. Despite widely ranging gentamicin concentrations, no infectious complications developed. Correlations were made between the pathologic state of the tissue and the tissue gentamicin concentrations. Correlations were also made with tissue gentamicin concentrations and the time after the antibiotic dose to the time of sampling. PMID- 6506138 TI - Effect of cimetidine on quinidine clearance. AB - Cimetidine has been reported to inhibit the hepatic metabolism of numerous drugs. Theoretically cimetidine could inhibit the metabolism of quinidine. This study was undertaken to determine the effect of cimetidine on quinidine plasma concentrations. Nine healthy volunteers were entered into the matched-pairs study. Baseline quinidine pharmacokinetic parameters were determined after a single oral 400-mg dose. Study parameters were determined after 3 days of cimetidine 300 mg p.o. q.i.d., when 400 mg quinidine was again administered. Cimetidine increased the area under the time-concentration curve (14.5%, p less than 0.01), decreased the total body clearance (24.9%, p less than 0.05), and prolonged the half-life (22.6%, p less than 0.05) of quinidine in this study. There was no change in peak quinidine concentrations or time to peak. These data document an interaction between cimetidine and quinidine. The clinical importance of this interaction should be greatest in patients with impaired liver function, patients with preexisting near-toxic plasma concentrations of quinidine, and the elderly. Patients placed on cimetidine and quinidine should be monitored closely for signs and symptoms of quinidine toxicity. PMID- 6506139 TI - High-performance liquid chromatographic measurement of cyclophosphamide in serum. AB - The analysis of cyclophosphamide [N,N-bis(2-chlorethyl)-tetrahydro-2H-1,3,2 oxazaphosphorin-2-amine -2-oxide] by high-performance liquid chromatography using ultraviolet detection is described. The method will enable measurement of serum concentrations of cyclophosphamide over a period of approximately 24 h after a dose of 150 mg, and requires 1 ml of serum. The between-day precision of the assay at concentrations of 0.3, 1.0, and 15.0 mg/L generated coefficients of variation of 11.8, 12.2, and 7.7%, respectively. Percentages of analytical recovery of cyclophosphamide and internal standard (5-ethyl-5-p-tolylbarbituric acid) were 63 and 73%, respectively. Preliminary data providing the half-life for two patients with normal renal function are presented. PMID- 6506140 TI - Effects of heparin sodium on gentamicin assay measured by fluorescence polarization immunoassay method. AB - The effect of heparin sodium on the assay of gentamicin using the fluorescence polarization immunoassay system was investigated with varying heparin and gentamicin concentrations. Heparin had no significant effect on gentamicin concentrations as measured by this system. PMID- 6506142 TI - Monitoring of cyclosporine: a status report. PMID- 6506141 TI - Systematic comparison of three basic methods of sample pretreatment for high performance liquid chromatographic analysis of antiepileptic drugs using gas chromatography as a reference method. AB - Sera of epileptic patients which were routinely examined by gas chromatography (GC) were also analysed using high-performance liquid chromatography (HPLC). Three basic methods for the pretreatment of samples for HPLC analysis were compared: protein precipitation by adding acetonitrile to the serum, direct serum extraction using ethylacetate, and partitioning of serum and buffer solution over a stationary phase and extraction with dichloromethane/2-propanol. The analytical performance and practicability of the three methods were tested under routine conditions. The following anti-epileptic drugs and metabolites were used in the comparison of HPLC with GC: ethosuximide, primidone, phenobarbital, phenytoin, carbamazepine, N-desmethylmethsuximide, and phenylethylmalonediamide. PMID- 6506144 TI - [Attitude toward retirement of employed workers in 5 Dutch communities; a research report]. AB - Most studies on retirement in the Netherlands concern workers of one specific industrial branch or company. This puts restrictions on the generalization of research outcomes. We selected 553 male workers, aged 64 (N = 376) and 60 (N = 177) via the population registers of five northern municipalities, who were on the pay-roll for at least eight hours a week. The mean total of working hours per week, however, was 41,5. From a pilot study with other, although similar respondents 35 items relating to retirement were generated. These could be reduced in the main study to four, a priori hypothesized dimensions: the attitude toward retirement, the perception of retirement and life after retirement, the attitude toward loss of social work contacts and the actualization of self after retirement. The data from the longitudinal research project, that are reported in this article, are gathered in the period 1973-74. We estimate that in the population of those aged 64, 15-25% had a negative attitude toward retirement, 16 26% a negative perception of retirement, 45-55% a negative attitude toward the loss of social work contacts and 61-70% a negative perception of self actualization after retirement. For those aged 60 we estimate these intervals at respectively 8-22%, 13-27%, 45-59% and 62-76%. PMID- 6506143 TI - [Current developments in the field of endoscopy in the treatment of digestive system disorders]. AB - A review is given of new developments of endoscopic treatment of diseases of the gastrointestinal tract. Endoscopic treatment is possible in patients with peptic stricture or inoperable tumors of the oesophagus, achalasia of the oesophagus, oesophageal varices, polyps and angiodysplasia of the large bowel, stomach and duodenum, choledocholithiasis and unresectable stenosing tumors of the bile ducts. In comparison with surgical therapy endoscopic treatment is relatively simple and has a much lower morbidity and mortality, especially in patients with an increased surgical risk. PMID- 6506145 TI - [Application of the BOP (an evaluation scale for older patients) in a psychiatric hospital. A clinical study]. AB - In this study we examined the relationship between BOP rating scores and psychiatric diagnoses at discharge of 74 psychogeriatric patients admitted to the AZUA psychiatric clinic. The BOP is the Dutch rating scale modelled after the Stockton Geriatric Rating Scale. The BOP was administered two weeks after admittance, and a second time four weeks later. These results were compared with results from an earlier study. The usefulness of the BOP as viewed by the treatment and nursing staff was evaluated. Treatment team evaluation of the BOP revealed some shortcomings. Members found the information too global und redundant. Reflecting their training and own point of view, the nursing staff too gave critical assessments of the BOP. Analysis of the first BOP rating scores showed a positive correlation between three BOP subscale scores and the discharge diagnosis of dementia. Closer inspection revealed that this relation was limited to male patients suggesting that both the patient sex and the nature of the dementia may be factors influencing BOP rating scores. PMID- 6506146 TI - [Cost and financing of health services for the aged in the 80s]. AB - Using the micro-simulation method an estimate is made of the costs of six facilities for the elderly in 1991. The estimate is based on three factors: the use of facilities, the price of facilities and the income of the elderly. The latter is important because some of the facilities are income-tested. Changes in the income position of the elderly affect the contribution of the public sector in total expenses and the contribution of the users of the facilities. The income of the elderly is also an important prerequisite for a policy for the aged which is aimed at shifting the care for the elderly from within institutions to facilities outside institutions and to self-help. Three different versions have been calculated: a basic version, assuming a constant level of provision of facilities; a trend version extrapolating past trends in the use of facilities, and a policy version, assuming that the shift of care from within institutions to facilities outside institutions and self-help will be realised in 1991. According to the basic version expenses for the six facilities in 1991 will amount to 4,7 milliard guilders more than in 1981. Compared with the outcome of the basic variant, the trend version shows a reduction of expenses in 1991 of 150 million guilders, and according to the policy version 1,1 milliard lower. PMID- 6506147 TI - The immunological aspects of praziquantel in unsensitized mice with experimentally induced schistosome pulmonary granuloma. AB - The effects of praziquantel on cellular and humoral immune responses were studied in Swiss Albino mice and compared with the effects of potassium antimony tartrate. The experimental animals were antigenically primed by intravenous injection of Schistosoma mansoni eggs; the test drugs were given one day before egg injection and their effects monitored 16 days later. The size of the experimentally-induced pulmonary granulomata, immediate and delayed antigen induced foot pad swelling, in vitro macrophage migration inhibition and the percentage of lymphocytes forming antibody and complement-dependent rosettes with erythrocytes (% EAC-R) were parameters used to assess the effect of the drugs. Praziquantel suppressed the size of pulmonary granulomata and the immediate and delayed foot pad reaction. Macrophage migration inhibition and the percentage of lymphocytes forming EAC-rosettes were not significantly affected. Tartar emetic was more effective as an immunosuppressant drug in these tests than praziquantel. PMID- 6506148 TI - A case of blastomycosis from Zaria, Nigeria. AB - A case of blastomycosis from Zaria, Nigeria is reported. The clinical features were indistinguishable from those of tuberculosis which is very common in this environment. Lack of response to anti-tuberculosis therapy within eight weeks prompted the search for other organisms which resulted in the isolation of Blastomyces dermatitidis. Compatible histological evidence was obtained. Subsequent favourable response to amphotericin B was evident. Infection with this organism should be included in the differential diagnosis of pulmonary and pleural lesions simulating tuberculosis in West Africa. PMID- 6506149 TI - Pediculosis capitis among rural and urban schoolchildren in Nigeria. AB - The prevalence of head lice (Pediculus humanus capitis) was investigated among urban and rural schoolchildren in Ibadan City and three surrounding villages all in Southern Nigeria. 106 (5.7%) of 1860 urban schoolchildren examined were infested compared with only seven (1.5%) of 473 children from rural schools (P less than 0.05). Pediculosis appears to be an urban problem which may be associated with overcrowding. However, the intensity of head louse infestation was low among the urban schoolchildren with 74.6% of all lousy children harbouring one to five lice per head and only 6.0% with more than 30 lice per head. PMID- 6506150 TI - The prevalence of severe leptospirosis among humans on Barbados. AB - Leptospirosis was confirmed by the Leptospira Laboratory in 138 hospital patients on Barbados between early November 1979 and the end of 1982 (annual average 43.6 cases). These were the great majority of severe cases occurring on the island during that time. The crude incidence rate ranged between 15 and 23 per 100,000 population per year (average 17.6). 26 of the patients died (15 males, 11 females), giving an over-all case fatality rate of 18.8%, and an average of 8.2 deaths per year. 68% of all cases were in males. The highest percentages of cases were in males aged 20 to 24 and females aged 55 to 59, but the incidence of the disease in both sexes increased with age up to 60 years. Previous figures recorded on the island by the Ministry of Health for 1975-79 were considerably lower, with a mean of 23.6 cases per year and a crude annual incidence of 9.5 per 100,000. 15 of the patients died (13 males, 2 females), giving an over-all case fatality rate of 12.7% and an average of 3 deaths per year. 74% of all cases were in males. The highest percentages of cases were in the 20 to 29 and 50 to 59 year age groups for males and females, respectively, i.e., similar to those in the present series. In both sexes the incidence of leptospirosis increased with age up to 60 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6506151 TI - Cryopreservation of viable Giardia intestinalis trophozoites. AB - A technique is described for the cryopreservation of Giardia intestinalis trophozoites. The most satisfactory results were obtained when organisms were preserved with either 7.5 or 10% dimethyl sulphoxide (Me2SO) and cooled using a liquid nitrogen controlled freezer. Under these conditions more than 70% of organisms were motile after thawing. Lower recovery rates were obtained using glycerol as the cryopreservant or when samples were placed directly into a -70 degrees C refrigerator to cool. Cultures were successfully re-established from material cooled under controlled conditions using either 7.5% Me2SO or glycerol as the cryopreservant. However, the former had an initial generation time of 12.0 hours compared to 24.5 hours for the latter. PMID- 6506152 TI - Histological evolution of caecal lesions in experimental amoebiasis. AB - Histopathological studies in guinea-pigs infected intracaecally with Entamoeba histolytica were carried out longitudinally on days 3, 7, 11, 15, 20 and 35 after infection. Three characteristic modes of development of caecal lesions were observed. These in order of their prevalence were the classical inflammatory cellular infiltration, lymphoid hypertrophy and necrotizing colitis. Occasional amoeboma formation was observed in progesterone-treated animals. This is the first time that histological lesions which mimic the human intestinal amoebiasis have been described in the experimental animal. PMID- 6506153 TI - Patterns of attendance at Jamaican sickle cell clinics 1952 to 1981. AB - The development of sickle cell clinics in Jamaica over a 30-year period is reviewed. The clinics are expanding almost exponentially, new cases of SS disease being recruited at approximately 150 per year and new cases of SC disease at approximately 60 per year. In the first 20 years, the median age of clinic attenders increased markedly but has remained stable since 1970. This stable age structure in the presence of an almost exponential rate of clinic expansion implies that the influx of young cases is balanced by the increasing age of existing clinic attenders. The pattern of new referrals has also changed to that of predominantly young patients, suggesting that the bulk of symptomatic older patients in the community have already been recruited into the clinic population. PMID- 6506154 TI - Antibody responses in tinea imbricata: the role of immunoglobulin E. AB - Patients with tinea imbricata were found to have raised specific immunoglobulin levels of all classes to Trichophyton concentricum antigen using an enzyme linked immunosorbent assay (ELISA). Both total and specific IgE class antibodies were raised and this correlated with immediate type hypersensitivity seen on skin testing as well as the duration of infection. The significance of these findings is discussed in the light of the association between chronic fungal infections and IgE. PMID- 6506155 TI - Sarcoid in a Nigerian: geographical variation of the frequency of sarcoid among blacks considered. AB - A 30-year-old Nigerian male with sarcoid manifested by hilar and peripheral lymphadenopathy is presented. Sarcoid and other immune disorders such as systemic lupus erythematosus and polymyositis are rare in Africa. In contrast, these disorders, and especially sarcoid, display a predisposition for blacks in the USA where blacks are affected by sarcoid 10 times as frequently as whites. The importance of reporting and, where possible, immunological study of African patients with sarcoid is emphasized. PMID- 6506156 TI - The coil works (against mosquitoes in Papua New Guinea). PMID- 6506157 TI - Cerebral toxoplasmosis in AIDS: a simple laboratory technique for diagnosis. PMID- 6506158 TI - Histopathological and ultrastructural aspects of interstitial pneumonitis of experimental visceral leishmaniasis. AB - Golden hamsters inoculated with Leishmania donovani developed interstitial pneumonitis. Three developmental phases were characterized: exudative, cellular and fibrotic. From the sequence of events, a relationship between the types of cellular proliferation and the appearance of fibrosis could be established. The participation of septal interstitial cells with lipid inclusions (ICLI) in the process and their possible role in the development of fibrosis was demonstrated. PMID- 6506159 TI - The characterization by isoenzyme electrophoresis of Leishmania isolated in the People's Republic of China. AB - Seven isolates of Leishmania from mainland China were characterized on the basis of their isoenzyme profiles for 10 enzymes. Five isolates were from human visceral leishmaniasis patients, and four of these showed isoenzyme patterns similar to the marker strain of Leishmania infantum, while one was similar to L. donovani sensu lato. One isolate was from a presumed reservoir host of human visceral leishmaniasis, the racoon dog Nyctereutes procyanoides, and was isoenzymically indistinguishable from L. infantum. An isolate of L. gerbilli from the great gerbil Rhombomys opimus was readily distinguishable from Old World marker strains and other Chinese leishmanias. This is the first report of the biochemical characterization of Chinese isolates of Leishmania. PMID- 6506161 TI - International Commission on Zoological Nomenclature. The importance of stability in the scientific names of animals. PMID- 6506162 TI - Characterization of parasites. Abstracts. PMID- 6506160 TI - The superiority of the miniature Anion-Exchange Centrifugation Technique for detecting low grade trypanosome parasitaemias. AB - The efficiency was tested of the Haematocrit Centrifugation Technique (HCT) and the miniature Anion-Exchange Centrifugation Technique (mAECT) for demonstrating trypanosomes in the blood of four antelopes experimentally infected with Trypanosoma brucei gambiense in Liberia. During simultaneous daily application of both methods over a period of six months, parasitaemias were detected on 12 occasions by HCT and on 73 occasions by mAECT during 473 examination days, thus indicating the superiority of the mAECT for the detection of low grade trypanosome infections. PMID- 6506163 TI - Allopurinol treatment in human Leishmania braziliensis braziliensis infections. PMID- 6506164 TI - On the identity of Leishmania mexicana pifanoi and L. mexicana garnhami. PMID- 6506165 TI - Further improvements in the miniature anion/exchange centrifugation technique (mAECT) for field work. PMID- 6506166 TI - Intestinal infection by terrestrial Isopoda (Oniscus spp.) and Oligochaeta (Lumbricus spp.) PMID- 6506167 TI - Characterization of Leishmania isolates from children with visceral infections contracted in Alexandria, Egypt. PMID- 6506168 TI - Lack of secular increase in height and weight of South African black and white pre-schoolchildren. PMID- 6506169 TI - Some preliminary observations on the molluscicidal property of Alternathera sessilis (Amaranthaceae) PMID- 6506170 TI - Isolation and purification of microfilariae from nodules of Onchocerca volvulus. PMID- 6506171 TI - Identification of human stocks of Leishmania spp. isolated from patients with mucocutaneous leishmaniasis in Tres Bracos, Bahia, Brazil. PMID- 6506172 TI - Asynchronism in the development of daughter sporocysts of Schistosoma mansoni. PMID- 6506173 TI - Abandonment: actual or constructive premature termination of the physician patient relationship. PMID- 6506174 TI - Iron stores in male blood donors evaluated by serum ferritin. AB - Iron stores were evaluated by serum ferritin measurements in 1348 male blood donors. Blood donation was associated with a decrease in serum ferritin concentrations. First-time donors (n = 21) had a geometric mean serum ferritin concentration of 52 micrograms per l, and multiple-time donors (n = 1327) of 36 micrograms per l (p less than 0.01). In the donating population, 6.0 percent had serum ferritin values less than 15 micrograms per l (i.e., depleted iron stores), 33.9 percent had values from 15 to 30 micrograms per l (i.e., reduced iron stores), 52.5 percent had values from 31 to 90 micrograms per l, and 7.6 percent had values greater than 90 micrograms per l (i.e., normal iron stores). The frequency of donations per year was more predictive of decreased iron stores than the number of lifetime donations. Serum ferritin showed a moderate fall up to the fourth donation (p less than 0.001); thereafter serum ferritin levels showed only minor insignificant changes. An increase in donation frequency was accompanied by a significant decrease in serum ferritin; values less than 15 micrograms per l were found in 1.3 percent of donors bled two times per year, in 6.0 percent bled three times per year, and in 7.9 percent bled four times per year. Regular monitoring of iron stores by serum ferritin in blood donors seems justified in order to identify those with depleted iron stores who will benefit from iron supplementation. PMID- 6506175 TI - Iron supplementation for menstruating female blood donors. AB - Depletion of body iron stores is a major factor limiting regular blood donations by menstruating females. To determine if regular iron supplementation would solve this problem, we conducted a double-blind study in which menstruating female donors were randomly placed into one of three groups: one taking 39 mg elemental iron, a second taking 39 mg of iron plus 75 mg vitamin C, and a third taking 100 mg vitamin C daily. The women were requested to donate every 8 weeks for at least 1 year. Blood samples were taken on each donation for measurements of hemoglobin, total iron binding capacity (TIBC), and ferritin. In the two groups taking iron supplements hemoglobin and ferritin increased from baseline values and the TIBC decreased. The vitamin C control group showed decreases from baseline for hemoglobin and ferritin and increases in TIBC. Differences between groups taking iron supplements and the group not taking supplements were highly significant. Drop-out from the study was due to various causes; however, iron intolerance was uncommon. Minimal daily iron supplementation was beneficial in maintaining body iron stores and hemoglobin levels in menstruating females on a schedule of blood donation as often as every 8 weeks. PMID- 6506177 TI - Membrane-bound immunoglobulins and complement components on young and old red cells. AB - In order to characterize changes in membrane-bound immunoglobulins and complement components, red cells (RBCs) were separated into young and old populations by simple centrifugation. Old RBCs had reduced mean corpuscular hemoglobin volume, increased mean corpuscular hemoglobin concentration, and reduced sialic acid. Using radioactive anti-antiglobulin techniques, old RBCs were shown to have more IgG, IgM, IgA, and C3d on their surfaces than did young RBCs; there was no increase on old RBCs of C3b, factor B, C4b, or C5. Similar results were observed with RBCs strongly coated with C3d in vivo from a patient with cold agglutinin disease. RBCs taken into ethylenediamine tetraacetate, washed thoroughly in saline, and then stored for prolonged periods in Alsever's solution or kept in autologous ethylenediamine tetraacetate plasma, at 4 degrees C, showed no increase in RBC-bound C3d with increased storage time. If, however, blood was taken into citrate-phosphate-dextrose and maintained at 4 degrees C in autologous plasma, a significant increase in RBC-bound C3d was observed in the mixed-cell population with prolonged storage time. Order donor blood units, taken into citrate-phosphate-dextrose and stored at 4 degrees C as packed red cells, showed higher levels of RBC-bound C3d in the mixed-cell population than did units stored for a shorter time. In no case did donor unit RBCs give a positive direct antiglobulin test on serologic testing with anti-C3d. The findings complement data already collected on membrane and cytoplasmic changes in aging RBCs and may contribute to an understanding of RBC senescence. PMID- 6506176 TI - Quantitation of red cell-associated IgG using an immunoradiometric assay. AB - In this report, we describe a sensitive immunoradiometric assay (IRMA) for quantitating IgG on the surface of red cells. Washed red cells were prepared to a purity of greater than 99.9 percent. Varying dilutions of these cells were incubated with a fixed concentration of 125I-anti-IgG. After equilibrium was achieved, the unbound 125I-anti-IgG was measured by the addition of IgG covalently linked to agarose beads. The red cells were lysed by detergent, and the 125I-anti-IgG bound to the IgG-beads was measured. The amount of IgG on the red cells was determined by relating the concentration of test red cells causing 50 percent inhibition of binding of the 125I-anti-IgG to the IgG-beads to 50 percent inhibition of binding caused by the IgG standard. Using this assay, the red cell-associated IgG (RCA-IgG) of 20 healthy male and female controls with normal hemoglobin concentrations was 7.23 +/- 6.11 fg IgG per 10(3) cells (mean +/- 2 SD). The mean RCA-IgG on washed cells from 34 different tests performed on 19 anemic patients with clinically diagnosed autoimmune hemolytic anemia was 176.1 +/- 375.6 fg IgG per 10(3) cells. There was no correlation between the levels of RCA-IgG and the hemoglobin levels or reticulocyte counts in these patients. PMID- 6506178 TI - Alloimmunization in patients with warm autoantibodies. A retrospective study employing three donor alloabsorptions to aid in antibody detection. AB - We examined the value of performing alloabsorptions to detect clinically significant alloantibodies in patients with warm autoantibodies who must receive crossmatch-incompatible blood. One hundred and twenty-five (125) patients were evaluated using alloabsorption with red cells (RBCs) from three donors: R1R1, R2R2, and rr, whose phenotypes other than Rh were selected to exclude 98 percent of clinically significant alloantibodies. This technic was selected rather than autoabsorption due to insufficient quantities of patient cells available and to the possible presence of transfused cells in some instances. Patients were divided into three risk categories: I--no prior pregnancy or transfusion; II- history of pregnancy and/or one to five transfusions; and III--greater than five transfusions. No significant alloantibodies were found in 32 category I patients. Of 74 category II patients, 13 (17.5%) had significant alloantibodies detectable after absorption. Six of 19 (31.5%) category III patients had alloantibodies. The majority showed Rh specificity: anti-E (13), -C (6), -c (2), -D (1). Anti-K was found in five samples. Forty-two (42%) percent of the alloantibodies were undetectable prior to the alloabsorptions. We conclude that category II and particularly category III patients are at significant risk of allosensitization and should be evaluated by an absorption procedure prior to the transfusion of crossmatch-incompatible red cells. PMID- 6506179 TI - Human erythrocytes shed exocytic vesicles in vivo. AB - Studies were designed to demonstrate whether red cells (RBCs) lose membrane segments in vivo. Plasma separated from fresh blood collected in citrate phosphate-dextrose-adenine-one was passed through 0.8 mu nitrocellulose filters to remove residual RBCs and formed elements. Exocytic vesicles were separated by centrifugation at 70,000 X g. Transmission electron microscopy showed vesicles 50 to 200 nm in diameter which contained hemoglobin. Sodium dodecyl sulfate polyacrylamide gel electrophoresis of vesicle membranes showed that spectrin bands 1 and 2 and ankyrin band 2.1 were absent. These observations are the initial demonstration that RBCs shed exocytic vesicles in the normal circulation. PMID- 6506180 TI - Incorporation of plasticizer into red cells during storage. AB - The development of flexible plastic blood bags has permitted effective blood component production and therapy. However, the plasticizer di(2 ethylhexyl)phthalate (DEHP), whose toxicity in humans is still undefined, is known to leach from the plastic into stored blood. Despite the availability of bags made of plastics not using DEHP, the collection and storage of red cells is still done in DEHP plasticized packs, and in fact the storage life for red cells has recently been increased up to 49 days using new anticoagulant-preservative solutions. We examined the relationship between DEHP and stored red cells. We found that 28 percent of available 14C-DEHP binds immediately to sites in both the membrane and cytosol fractions of the red cells, and that the total amount and distribution of 14C-DEHP does not change significantly over 7 days. When red cell concentrates were stored with or without DEHP, using either plastic (polyolefin) bags not containing DEHP or glass, definite reduction in the osmotic stability of the red cells was found in the absence of DEHP. Plasma-free hemoglobin levels were 90.3 mg per dl after 35 days of storage in plastic packs containing DEHP and 181.7 mg per dl in the polyolefin bags. The advantages of improved in vitro stability of red cells stored in plastics containing DEHP must be weighed against the potential hazards of patient exposure to DEHP. PMID- 6506181 TI - Preservation of red cell antigens during storage of blood with different anticoagulants. AB - A major concern when storing blood is that the antigens of the red cells will lose some of their reactivity in vitro. As part of a study of blood stored in newer anticoagulants, we tested the persistence of the ABO, Rh, Lewis, and P antigens. Blood was stored for 21 to 35 days in several anticoagulant preservative systems, such as citrate-phosphate-dextrose and several additive solutions, while using bags of polyvinyl chloride plasticized with di(2-ethyl hexyl) phthalate or tri (2-ethyl hexyl) trimellitate. No significant loss of antigenicity occurred in the ABO and Rh systems, but antigens in the Lewis and P systems lost some reactivity during storage. PMID- 6506182 TI - Histamine levels in stored human blood. AB - The histamine content in plasma samples obtained from a group of healthy blood donors, from blood stored in citrate-phosphate-dextrose supplemented with adenine (CPDA) packs for up 28 days, and from the side arm of a transfusion line was measured by radio-enzymatic assay. Healthy donors had a mean plasma histamine content of 0.79 ng per ml. Blood stored in CPDA initially showed a similar histamine level (0.69 ng/ml on day 3 of storage), but there was a progressive rise with time, and at 28 days, the level was 20.5 ng per ml. The increase in histamine is best described by a positive exponential and may be explained by a process whereby the plasma histamine level increases the degree of histamine release from blood cells. The histamine levels in the blood infused into patients tended to be higher than those found in the stored units of the same age, if these packs were less than 7 days old. This may have been caused by the unit becoming warmer during transfusion. We speculate that the histamine levels in the older units of stored blood were high enough to cause or augment transfusion reactions and that the storage age of blood may have a bearing on the incidence of transfusion reactions. PMID- 6506184 TI - Simple and rapid preparation of granulocytes for the treatment of neonatal septicemia. AB - Recent reports have documented benefit from the infusion of granulocytes into septic neonatal patients. However, while the requirement of 1 X 10(9) per kg of granulocytes is easily met by apheresis procedures, treatment of neonatal septicemia requires immediate response 24 hours a day. Unfortunately, this rapid response is beyond the capability of most apheresis units. Therefore, we developed a method for obtaining granulocytes from whole blood collected by routine blood donation. Hydroxyethyl starch (60 ml of a 6% solution) is introduced into a unit of whole blood within 24 hours of collection. Following sedimentation and subsequent centrifugation, a buffy coat is obtained which contains more than 75 percent of the granulocytes; an average of 1.62 X 10(9) WBC, of which 1.25 X 10(9) were granulocytes that were recovered in an average 17 ml final volume with a hematocrit of 4 percent. Granulocyte morphology and function as measured by chemiluminescence indicated good maintenance of function. Total processing time was short, requiring less than 2 hours, and the procedure was performed easily in a routine blood bank. The recovery of 1.25 X 10(9) granulocytes from a single, routine blood donation without steroid treatment of the donor makes this product ideal for use in the treatment of neonatal septicemia. PMID- 6506183 TI - On the safety of using stored bank blood for chronic hemodialysis patients. AB - Red cells stored either for 3 days or 2 weeks were equally susceptible to lysis during in vitro dialysis. Furthermore, the small increases in plasma hemoglobin during hemodialysis of 10 patients were independent of transfusion. We examined the patients during three separate hemodialyses: one without transfusion, one with transfusion of three units of red cells stored for less than 5 days, and one with transfusion of red cells stored for 2 weeks. The mean concentration of hemoglobin in plasma increased from 0.7 to 3.6 mumol per l (p less than 0.01), and it was normal again after 2 days. No significant changes occurred in the mean concentration of haptoglobin in plasma. The results indicate that red cells stored for 2 weeks are not more prone to lysis than those stored for less than 5 days. Consequently, we recommend a storage interval of less than 2 weeks, instead of 5 days, for blood transfused to chronic hemodialysis patients. PMID- 6506185 TI - Changes in neutrophil aggregation and chemotaxis response during 18-hour cold storage. AB - Providing neutrophil transfusions to septic neonatal patients with depleted neutrophil reserves can be troublesome and require unscheduled blood donations. Buffy coats from stored whole blood are a potential source of neutrophils provided they remain viable during the interval between the whole blood collection and the buffy coat production. This study determined neutrophil function during storage of whole blood at 4 degrees C for 18 hours. Whole blood pH, hematocrit, platelet, and white cell counts remained unchanged. Chemotactic response to formyl methionyl leucyl penylalanine (FMLP) declined from 172.5 +/- 29 units (mean +/- SD) to 125 +/- 48 at 9 hours and 63.6 +/- 48 (p less than 0.05) at 18 hours. Aggregation response to FMLP remained normal for 9 hours but dropped to 15.5 percent of normal after 18 hours. Neutrophil response to cytaxins was maintained for at least 9 hours during storage of whole blood at 4 degrees C but seriously declined within 18 hours. Limiting 4 degrees C storage of whole blood to 9 hours prior to preparing buffy coats may provide flexibility needed for urgent provision of neutrophil transfusions. PMID- 6506186 TI - Use of an electromechanical infusion pump for transfusion of platelet concentrates. AB - To determine whether platelet concentrates can be administered safely through electromechanical infusion devices, we studied stored platelet concentrates passed through one pump system (Abbott). We measured in vitro changes in platelet count and lactic dehydrogenase (LDH) and beta-thromboglobulin (beta-TG) release which occurred after passing the concentrates through the pump system. To compare in vivo survival, five normal volunteers were given an injection of autologous Indium-111-labeled platelet concentrates at two different times, once using platelets which had been passed through the pump system (test group) and once using platelet concentrates which had not (control group). In vitro studies showed no significant changes (p greater than 0.05) in platelet count, or in LDH or beta-TG release after passage through the pump system. In vivo platelet recovery at 2 hours was 39.8 +/- 4.7 percent (mean +/- 1 SD) for the control platelets and 40.7 +/- 9.3 percent for the platelets passed through the pump system (p greater than 0.05; n = 5). There was no significant difference in platelet survival measured in days between the control group and the test group using a linear (8.0 +/- 0.9 vs. 7.2 +/- 0.3), exponential (3.7 +/- 0.7 vs. 3.1 +/ 0.5), or multiple hit (5.4 +/- 2.3 vs. 4.8 +/- 1.0) (p greater than 0.05; n = 5) model. We conclude that this pump system is acceptable for use in clinical practice when control over volume and rate of platelet transfusion is important. PMID- 6506187 TI - Platelet production planning to ensure availability while minimizing outdating. AB - Steps were undertaken to reduce platelet concentrate outdating while maintaining the ability to provide them to hospitals as needed. A brief daily information exchange was established with the purpose of determining a platelet concentrate production goal for each weekday. This procedure has resulted in the ability to meet 100 percent of the hospital demand while reducing platelet concentrate outdating from greater than 20 percent to 2.95 percent over a 6-month period. When considering the 4 months when all platelet concentrates had 5-day expiration dates, the outdating rate was 2.57 percent. The significant reduction in outdating brought about by our procedure can result in substantial economic savings for a regional blood supplier. PMID- 6506189 TI - Neuraminidase-like impurity in bovine albumin. PMID- 6506188 TI - The rare red cell phenotype Lan negative in Japanese. AB - Two patients and a healthy blood donor were found to be Lan negative and to have anti-Lan in their sera. These are the first three examples of the Lan-negative phenotype to be described in Japanese. The families of two of the propositi were studied: the parents of both were first cousins and one of the propositi had a Lan-negative sibling. No Lan-negative examples were found in 15,000 Japanese donors screened with anti-Lan. PMID- 6506190 TI - 2-aminoethylisothiouronium-treated red cells and the Cartwright (Yta) antigen. PMID- 6506191 TI - Absorption of saline agglutinins with rabbit red cells. PMID- 6506192 TI - Elimination of 37 degrees C reading: reduction of workload in a transfusion service. PMID- 6506193 TI - Antithrombin III activity in stored whole blood. PMID- 6506194 TI - Experience with the manual Polybrene method in Taiwan. PMID- 6506195 TI - More about alloimmunization by transfusion of fresh-frozen plasma. PMID- 6506197 TI - Improved function of perfused rabbit kidneys by prevention of oxidative injury. AB - This study explored the effect of adding small amounts of the reducing agents ascorbic acid and glutathione to a Ringer's-albumin perfusate used for 24-hr hypothermic perfusion of rabbit kidneys. Maintenance of function during preservation was evaluated with a shunt perfusion model and by measuring the ability of cortical slices to restore normal K/Na ratios after incubation in a electrolyte medium. When placed in contact with the unmodified perfusate, an electrode of pyrolytic carbon registered a potential of +190 mV relative to the silver-silver chloride couple. This reading fell rapidly by 100-125 mv when kidneys were placed on the circuit. The mean creatinine clearance after 24-hr perfusion was significantly improved from 162 +/- 56 ml/hr in controls to 284 +/- 92 ml/hr when the potential indicated by this electrode was preadjusted to 43-54 mv with reducing agents, and to 237 +/- 62 ml/hr when this adjustment was made after 2 hr. These creatinine clearances were similar to those of kidneys stored on ice for only 1 hr. These findings indicate minimal injury occurred in the chemically reduced groups and emphasize the importance of preventing oxidative damage to kidneys during hypothermic organ perfusion. The time course of the changes in potential registered by this electrode was consistent with our previous finding that much of the damage to perfused kidneys occurs very early in the course of perfusion. The tissue slice studies showed no detectable damage to the renal parenchyma of the kidneys in the control group despite diminished creatinine clearance. This suggests that the site of oxidation injury is the vascular compartment. PMID- 6506196 TI - Experimental small bowel transplantation utilizing cyclosporine. AB - Cyclosporine prolonged the survival of ectopic small bowel allografts in a canine model. A 9-fold increase in mean survival as compared with controls was obtained. Addition of prednisone to cyclosporine did not result in further graft prolongation, but improved the gross and histological appearance of the allograft. Monitoring the motility and histology of the allograft appears to be useful in predicting approaching rejection. Xylose absorption was not helpful in this regard. A new technique for measuring fat absorption in the transplant is described. Following allografting, fat absorption is resumed by 14 days posttransplantation. PMID- 6506198 TI - Effect of renal transplantation on zinc metabolism and taste acuity in uremia. A prospective study. AB - The effect of successful renal transplantation on zinc metabolism and taste acuity was determined prospectively in 15 adult uremic patients. Before transplantation all patients had subnormal concentrations of zinc in plasma and hair, as well as abnormal taste detection and recognition thresholds for sodium (salty), sucrose (sweet), hydrochloric acid (sour), and urea (bitter). Following renal transplantation, abnormalities of taste acuity and zinc metabolism persisted and were accompanied by increased urinary zinc excretion in all patients. Normalization of zinc concentration in plasma and hair as well as taste acuity did not occur until one year after transplantation and was associated with a concomitant decrease in urinary zinc excretion. The plasma zinc levels and daily urinary zinc excretion were inversely related (r = 0.62, P less than .001) in all patients with normal allograft function. None of the zinc parameters was significantly related to azathioprine or corticosteroid dosage. The results of this study suggest that zinc deficiency and taste abnormalities of uremia persist up to one year posttransplant and may be related to increased urinary zinc losses. The mechanisms underlying post-transplant hyperzincuria as well as clinical significance of zinc deficiency following transplantation remain to be determined. PMID- 6506199 TI - Fourth International Symposium on Immunological Monitoring of the Transplant Patient. Houston, November 2-5, 1983. PMID- 6506200 TI - Experimental study of nerve allografts: especially on the influence of histocompatibility in fresh nerve grafting. PMID- 6506201 TI - Sarcoidosis in the West African. A report of eight Nigerian patients with cutaneous lesions. AB - The clinical features of 8 Nigerian cases of sarcoidosis are presented. All of them had skin lesions and at least one other organ involved. Great variability in morphology of skin lesions was found and patients with discoid lupus erythematosus-like changes, cicatricial alopecia, xanthelasma-like lesions and an annular lichen planus-like picture were observed. Review of the literature revealed only 11 previously reported cases of cutaneous sarcoidosis in West Africa. The question of the rarity of sarcoidosis in West Africa in the light of its high frequency in American Negroes who predominantly descended from West Africans is discussed. PMID- 6506202 TI - Diabetes mellitus at a rural hospital in northwestern Tanzania. AB - During the 5-year period 1978-82, 120 diabetic patients were admitted to a rural hospital in Tanzania. They were admitted a total of 172 times, which was 1.0% of all admissions corresponding to 1.7% of all admission days. Most diabetics were between 40-60 years of age (mean age 49 years). Sixty-one patients were newly discovered cases. During the period, 11 patients (9.2%) died and 20% were lost to follow up. At present 71% are attending a diabetic clinic but only 58% do so regularly and with a good compliance. At this clinic 45% are treated with insulin, 46% with oral agents and 8% with diet alone. The study indicates a need for improved detection and motivation for follow up, and also shows the pressure diabetes exerts on a rural hospital in Tanzania at present. PMID- 6506203 TI - Bicycle injury pattern among children in rural India. AB - 205 children treated with bicycle injuries during the four year period 1979-1982 at General Hospital, Sangli, in rural Western Maharashtra were reviewed. Amputation of the right toe was the most common injury comprising 74% of all the injuries. This occurred in children carried as passengers on the rear carrier of the bicycle, who hang their legs on either side of the spoke wheel. The right big toe of the passenger is then trapped by the chain above, the spokes at the extreme inner end, horizontal fork below and the free wheel posteriorly. Peddling of the bicycle in a reverse direction followed by forward propulsion results in amputation of the toe by the rotating teeth of the free wheel. In 122 cases amputation was through the proximal phalanx, in 28 cases through the distal phalanx and in 2 cases at the level of the metatarso phalangeal joint. A disarticulation through the proximal joint was performed in these cases. A four year follow up showed no residual disability. PMID- 6506204 TI - Breast carcinoma in young Nigerian women. AB - Breast cancer presenting in 32 Nigerian women 30 years of age or younger was studied; 32 other premenopausal women matched in TNM stage of disease served as controls. More than 80% of both groups presented with advanced breast carcinoma; 18.7% of the study group patients were pregnant or lactating. Management consisted of some form of surgery and chemotherapy (methotrexate, cyclophosphamide, 5-fluorouracil and prednisolone for both groups). Two year survival for the study group (25%) was lower than that of the control group (37.5%). Breast cancer in this age group is a problem which needs further documentation in Africa. Earlier diagnosis, and a more aggressive combined modality therapy are needed to improve the prognosis. PMID- 6506205 TI - Physiological performance and work capacity of tin mine labourers infested with schistosomiasis in Zaire. AB - The aim of the study was to test the applicability and reliability of study design and methodology for estimating the impact of schistosomiasis (mansoni) on work capacity. 160 tin-mine labourers in 4 villages in the district of Maniema (Zaire) were investigated (age 20-35 yrs). In two villages the prevalence of schistosomiasis amounts up to 100%, whereas in the other two no local transmission takes place and only some lightly infected cases are to be found. Living, working, socio-economical and ecological conditions are highly comparable. Work capacity was estimated by mean of sub-maximal work tests (Monark bicycle ergometer and double Master step-test). The population involved is unfamiliar with bicycling. Although the technique could be easily learned the work test on the bicycle ergometer as compared to the step-test gave less reliable results. Haemoglobin levels in Schistosoma positive individuals were not reduced. Work capacity as indirectly estimated by the step-test, showed no significant difference between the groups. It is concluded that the influence of schistosomiasis on work capacity, if present, is small and not detectable with the methods used in this pilot-study. PMID- 6506206 TI - Utilization of primary health services in Port Sudan, Sudan. AB - The utilization of primary health services provided by two health centres and a hospital out-patient department was studied. The epidemiologic pattern was similar in the three health care facilities; minor gastrointestinal tract, respiratory tract and skin conditions formed the majority of cases. Distance was a limiting factor for utilization of health services in the health centres and not in the hospital. The average consultation time per patient was two minutes. Lack of drugs was the universal problem. Suggestions and recommendations to solve some of the problems and improve services are presented. PMID- 6506207 TI - Is avoidance of sunlight a cause of fractures of the femoral neck in elderly Saudis? AB - A study of the frequency of admitted cases of femoral neck fractures to Riyadh Central Hospital, Riyadh, Saudi Arabia, showed admission of 95 patients over 40 years of age in a period of one year. The male to female ratio was 64% males to 36% females. Vitamin D nutritional status of patients with fractures of the neck of the femur expressed as 25-(OH)D3 was significantly lower (5.9 +/- 2.9 ng/ml) than of controls (9.7 +/- 4.7 ng/ml). Comparison of the housing types of both patients and controls showed that those living in traditional mud houses have significantly lower levels of 25-(OH)D3 than those occupying villas or flats. A third group of patients with low stores of vitamin D were exposed to natural ultraviolet light for a short period. This resulted in a significant increase in the levels of serum 25-(OH)D3 and a decrease in alkaline phosphatase activity. It is concluded that low levels of serum 25-(OH)D3 may play a role in the pathogenesis of femoral neck fractures in elderly Saudis and this may be due to minimal exposure to natural ultraviolet irradiation. PMID- 6506208 TI - Splenectomy in kala-azar. AB - At the beginning of the century, splenectomy was used in the treatment of kala azar, but now is rarely needed, the major indication being for drug resistant kala-azar. Inadvertent splenectomy prior to the diagnosis of kala-azar continues to occur, probably because of a reluctance to perform splenic aspiration in the investigation of splenomegaly. Five Kenyan children underwent splenectomy for drug resistant kala-azar. All were immediately improved, but one died of overwhelming post splenectomy infection (OPSI) two months later and another of a malignant lymphoma seven months after surgery. The other three patients appear to be cured. Splenectomy was considered in a sixth child with kala-azar because of a Salmonella abscess in the spleen, but the abscess ruptured catastrophically before surgery could be arranged. PMID- 6506209 TI - Acute gangrene of the scrotum in a one month old child. AB - Since Fournier first described the fulminating idiopathic gangrene of the scrotum in 1883 there have been sporadic reports of cases from various parts of the world. The condition is, however, rare in infants. We present here a case of scrotal gangrene following circumcision, in a one month old baby. PMID- 6506210 TI - Pseudomonas septicaemia following tribal tatoo marks. AB - It is tradition in Northern Nigeria to make tribal tatoo marks on the face of a newborn, commonly on both sides of the angle of the mouth. A case of fatal septicaemia due to Pseudomonas aeruginosa following such tribal tatoo marks is reported. PMID- 6506211 TI - Successful treatment of neurocysticercosis with low-dose praziquantel. AB - A patient with neurocysticercosis was successfully treated with praziquantel. The clinical improvement was paralleled by the resolution of cerebral lesions as revealed by computerized tomography. This case study demonstrates the success of praziquantel and the effectiveness of low-dose regime in treatment of neurocysticercosis. PMID- 6506212 TI - A case of hemorrhagic dengue without hypovolemia in an adult. AB - Dengue hemorrhagic fever, though prevalent in South East Asia was diagnosed for the first time in Hong Kong. The subject in this report made frequent visits to endemic areas including the Philippines. Hypovolemia was not evident at the time of presentation. The nature and the status of the disease in this area are discussed. PMID- 6506213 TI - A case of histoplasma posthitis. AB - The present report describes a case of disseminated histoplasmosis with involvement of the prepuce. Phimosis resulting from histoplasma posthitis is exceedingly rare and hence being documented. PMID- 6506214 TI - [Structural bases for the minimization of function of the proximal epitheliocytes of the nephrons in a single acute overheating of the body]. AB - Morphological bases of functional potentialities of nephrons were studied in the experiment with 115 two-month rats under conditions of general momentary hyperthermia. The size of renal corpuscles tends to diminish. It is found that damages occur mainly in epithelium of the proximal parts of nephrons with disturbances in the reabsorption apparatus. The lowered epithelium reabsorptivity is directed to provide survival of the cells and their further participation in reparative processes. PMID- 6506215 TI - [3-dimensional ultrastructural characteristics of the cardiomyocytes of SHR strain rats with spontaneous genetic hypertension]. AB - The quantitative morphological analysis of hypertrophied cardiomyocytes was carried out in SHR rats (spontaneously hypertensive rats). The features of spatial ultrastructural organization of heart muscle cells were shown as manifested in the increased synthesis of contractile proteins and focal disorders of myofilament arrangement. Stereological analysis revealed the decrease of the ratio of the summary volume of the main cardiomyocyte organelles (mitochondria, smooth sarcoplasmic reticulum and T-system) to the myofibril volume. PMID- 6506216 TI - [Cytogenetic effects of 1,4-dihydropyridine in various test systems]. AB - Cytogenetic effect of 1,4-dihydropyridine was studied in different test-systems. The preparation is shown to decrease the level of complete sex-chromosome losses in Drosophila and chromosome aberration frequency in Allium fistulosum seedlings. The preparation does not affect spontaneous mutability of bone marrow cells in mice, high doses of the preparation have no mutagenic potential. Thus, 1,4 dihydropyridine shows antimutagenic activity reducing the chromosome mutation level in sex and somatic cells of eucaryotic organisms. Absence of the effect on mice chromosomes may testify to the specificity of 1,4-dihydropyridine action. PMID- 6506217 TI - [Comparative effectiveness in the induction of sister chromatid exchanges and chromosome aberrations]. AB - The dose curves for 5 chemicals were studied to compare the efficiency of induction of SCEs and chromosomal aberrations by "polycentric" mutagens. The number of SCEs was found to increase linearly with the dose while that of chromosomal aberrations--nonlinearly. The efficiency of SCEs induction by these mutagens was found to be 25-50 times as high as in the induction of chromosomal aberrations. Division of alkylating mutagens into "monocentric" and "polycentric" is shown to be useful. It reflects their different efficiency in damaging one or simultaneously two DNA strands. The correlation between SCEs and formation of aberrations of the chromatid type is stated. PMID- 6506218 TI - [Pigment epithelium of the eye in the human embryo in vitro]. AB - A model is developed and described for studying cytological differentiation of pigment epithelium cells of the human eye in vitro. It is shown that the differentiation pattern depends on the stage of embryogenesis. PMID- 6506219 TI - [Cell center of macrophages, granulocytes and lymphocytes during in vitro cell spreading, polarization and movement]. AB - Different motile blood cells behave in a different way upon spreading on the glass surface. Macrophages pass through all the stages of spreading described for fibroblasts (Vasiliev, Gelfand, 1976); granulocytes are polarized after a short staying in badly spread conditions, lymphocytes are polarized immediately after setting of the glass surface. In relation to the leading edge and the cell nucleus, centrioles in the described cell types are located differently. In macrophages they are mainly in the front or on one side of the nucleus, in granulocytes they lie within the ring-like nucleus, in lymphocytes they are strictly located behind the nucleus in the uropode. In all the cases, however, centrioles are localized in the central region of the cytoplasm. Their location does not appear to be connected with the movement direction of blood cells. The distal ends of the active centrioles are faced to the upper cell surface in the examined cells. It is suggested that the centriole can distinguish the free cell surface and the surface associated with the substrate. PMID- 6506220 TI - [Age-related changes in the growth-stimulating effect of serum on BHK-21 cells]. AB - The growth-stimulating effect of two calf and adult animal serum ultrafiltrates (with molecular weight of the components up to 100 000 dalton) on BHK-21 cells has been compared. The growth-stimulating activity of the calf serum ultrafiltrate was much greater. Aggregation of cells--the result of their reduced adhesion to the substrate--was much less pronounced in the presence of the calf serum ultrafiltrate than in the medium with the serum ultrafiltrate of adult animals. The data obtained show that the components containing in the studied ultrafiltrates (mol/wt up to 100 000 dalton) and not gamma-globulins (mol/wt 150 000 dalton), as it was considered earlier, primarily determine the ageing change of growth-stimulating activity of the serum. It should be suggested that the different influence of ultrafiltrates on cell adhesion is due to the presence of factors of adhesion with molecular weight up to 100 000 dalton in the calf serum and to its absence in the serum of adult animals. PMID- 6506221 TI - [Changes in the self ultraviolet fluorescence of HeLa cells undergoing ionizing irradiation]. AB - A study was made of the influence of irradiation on the ultra-violet fluorescence respond of the resting HeLa cells being in the stationary growth phase. No change in the cell ultra-violet fluorescence (UVF) intensity was seen immediately after irradiation (1.5 hours). The time dynamics observation of fluorescence intensity changes after irradiation demonstrated the highest values of UVF on the 3rd day- at the start proliferating point. At doses of 10 and 500 rad the action of irradiation on HeLa cells has an opposite UVF respond, compared with the control. The effect of the 500 rad dose irradiation increases the cell UVF intensity on the 3rd recultivating day, but the 10 rad dose irradiation makes it lower compared to the control level. Radiometric analysis makes it clear that HeLa cell UVF changes are not related to the change of protein synthesis with the precursors of 3H-tryptophan. PMID- 6506222 TI - [Structural changes in the mitotic apparatus of metaphase cells exposed to 2 mercaptoethanol in a porcine embryonic kidney cell culture. A light microscopy study]. AB - The sequence of reconstruction of the metaphase mitotic apparatus of the KEPV cells under the action of 2-mercaptoethanol (0.001 M) and after moving off the agent has been studied. In the presence of 2-mercaptoethanol, a destruction of the metaphase plate and that of the mitotic spindle proceed independently. The destruction of the mitotic spindle does not involve an immediate disorganization of the metaphase plate, and vice versa. In the course of resumption of the normal division after moving off the agent, the restoration of the mitotic apparatus structure proceeds within a definite temporal sequence: at first, the mitotic spindle reestablishes, and after that the metaphase plate forms. Distinctions between the 2-mercaptoethanol action and the action of other antimitotic agents are discussed. PMID- 6506223 TI - Modulation of heat shock protein synthesis in two human melanoma cell lines. AB - Two human melanoma cell lines, largely different from one another in their intrinsic thermosensitivity, were exposed to supranormal temperatures and labeled with 35S-methionine. The protein patterns resolved by SDS-polyacrylamide gel electrophoresis showed in both cell lines an increased synthesis of a unique set of heat shock proteins (HSP) of 72 Kdalton (KD). Already evident after 15 min at 42 degrees C, the relative rate of synthesis of these HSP increased progressively for up to 3 h of continuous heat treatment. The cells exposed for 1 h at 42 degrees C and then returned to 37 degrees C maintained a high relative rate of HSP synthesis for more than 6 h. The rate of decay of the neosynthesized HSP did not differ from that of the overall cell proteins. Since in both cell lines all the parameters concerning HSP induction were identical, no correlation can be established between their intrinsic sensitivity towards the conditioning treatment and the capacity to respond to heat treatment with an increased synthesis of these proteins. PMID- 6506225 TI - The histologic typing of tonsillar carcinoma. AB - In a retrospective review of 170 cases of malignancies of the tonsil the authors report on 81 malignant epithelial tumors. In 56 cases (69.1%), the tumor (squamous cell carcinoma) was composed of solid epithelial nests with different degrees of keratinization. In 24 cases (29.6%) the tumor (undifferentiated carcinoma of nasopharyngeal type) had histologic characteristics similar to the undifferentiated carcinomas observed in the nasopharynx. Only one case was unclassifiable. Squamous cell carcinomas occurred more frequently in males (6:1), in older age, with more frequent extratonsillar and nodal extension and a poorer prognosis. Undifferentiated carcinoma had a similar incidence in both sexes, occurred also at an early age, and more often seemed to be limited to the tonsil. The 10-year disease-free survival rate was 30% for undifferentiated carcinoma; all the patients affected by squamous cell carcinoma had a recurrence within 6 years of the diagnosis. PMID- 6506224 TI - Prognosis of chronic lymphocytic leukemia: analysis of one hundred cases. AB - One hundred patients with chronic lymphocytic leukemia (CLL) followed in our department between November 1969 and December 1982 were reviewed and classified according to the staging system proposed by the International Workshop on CLL (IWCLL). Analysis of actuarial survival curves revealed a significant chi-square value for heterogeneity and trend. In addition, thrombocytopenia and anemia appeared to be the most important risk factors. A large variability in the course of disease, not well explained by the staging system of the IWCLL, was found among the nonanemic and nonthrombopenic patients. Analysis of A and B stage patients according to absolute peripheral blood lymphocytosis (less or more than 50 X 10(9)/liter) showed two separate patterns of survival. PMID- 6506226 TI - Metastatic medullary and undifferentiated thyroid cancers are not associated with elevated levels of serum thyroglobulin. AB - It is now well accepted that serum thyroglobulin (Tg) determination is a specific marker of disease activity in well-differentiated thyroid cancer after total thyroidectomy. In this study we examined 15 thyroidectomized patients with metastases from medullary thyroid cancer and 10 patients with metastases from undifferentiated thyroid cancer, to determine whether serum Tg measurement could be useful also in these types of thyroid tumors. In contrast with differentiated thyroid cancer, which had high levels of circulating serum Tg, patients with medullary and undifferentiated thyroid cancer had undetectable or low levels of serum Tg. Thus, serum Tg measurements are not useful in the diagnosis of metastatic disease in these patients. PMID- 6506227 TI - Diagnostic value of carcinoembryonic antigen (CEA) assay in pleural effusions. AB - Carcinoembryonic antigen (CEA) levels were evaluated by a direct radioimmunoassay in the effusion fluids and plasma samples from 107 patients with pleural effusions of unknown etiology. CEA levels higher than 20 ng/ml were detected in 55% of pleural effusions from patients with malignant disease: 40% of the patients in this group had values of plasmatic CEA lower than 20 ng/ml. With the only exception of 4 patients with empyema, CEA levels were uniformly lower than 20 ng/ml in the effusion fluid of patients with benign disease. Moreover, CEA levels higher than 20 ng/ml were observed in 81.2% of pleural effusions and 31.2% of plasma samples from patients with cytology positive for malignancy, whereas increased CEA levels were observed in 37.5% of effusion fluids and 33.3% of plasma samples from patients with malignant disease but negative cytology in the pleural effusion. CEA assay in the effusion fluid represents a useful tool of high specificity and good sensitivity to discriminate between benign and malignant etiology of pleural effusions. PMID- 6506228 TI - The growth rate in the interpretation of the natural history of lung cancer. AB - The relationship between growth rate, expressed as doubling time (DT), of 110 lung cancers from randomly collected patients and patient age, sex, histological type, symptoms, smoking habits, size and lymph node involvement was studied. Median DT values of epidermoid carcinomas and adenocarcinomas were superimposable (98 and 99 days, respectively), but 15% of adenocarcinomas had a DT of more than one year. Significant correlations were found with sex (slower growth rate in females) and symptoms (faster growth in symptomatic patients), but only for adenocarcinomas. The number of cigarettes smoked did not seem to affect the growth rate of lung cancers. There was no correlation between growth rate and tumor size or lymph node involvement. PMID- 6506229 TI - Hormone receptors and breast cancer: correlations with clinical and histologic features. AB - The possible relationships between hormone receptor status and several clinical (age, gynecologic history, clinical stage) and morphologic aspects (histologic grade, vascular invasion, lymphocytic infiltration, necrosis, fibrosis, elastosis and lymph node metastasis) were evaluated. A highly significant correlation between estrogen receptor levels, patient age, menses regularity and postmenopausal status was found. The histologic features most significantly related to tumor receptor status were histologic grade, lymphocytic infiltrate, necrosis and elastosis. Since these same histologic aspects appear to influence prognosis in breast cancer, the prognostic significance attributed to tumor receptor levels is substantiated. Therefore the importance of this assay is confirmed, not only for its diagnostic and therapeutic purposes, but also for its prognostic value. PMID- 6506230 TI - Immediate breast reconstruction following modified radical mastectomy. AB - Reducing postoperative psychological morbidity is an important goal in breast cancer patient care; a multidisciplinary approach is crucial in order to select candidates for immediate breast reconstruction. There is no oncologic reason for a delay after a modified radical mastectomy. Our procedure allows immediate breast reconstruction without significantly prolonging operative time and hospitalization. Complete muscular coverage of the implant and shifting of the redundant skin to the mastectomy site minimize the risk of postoperative complications and provide a natural looking reconstructed breast. Delayed reconstruction of the nipple-areolar complex performed at the time of contralateral mammaplasty ensures satisfactory breast symmetry. Satisfactory reconstruction of the nipple-areolar complex is achieved without additional scars by means of grafts taken from the opposite breast or utilizing the cryopreserved nipple and areola. PMID- 6506232 TI - Histomorphometry and pattern recognition analysis of urothelial papillary lesions. AB - The authors report the results of the grading of urothelial papillary carcinoma using histomorphometry and pattern recognition analysis. Features concerning nuclear area, the nuclear roundness factor and inclination angle were measured in 38 cases of urothelial papillary carcinomas. The relative frequency distribution showed overlapping among the grades with a reduction in the practical significance of histomorphometry. To overcome this problem, the pattern recognition analysis was applied. It was found that mean nuclear area, mean roundness factor and percentages of round and horizontal nuclei represent the optimal discriminating set of the subsequent steps in the malignant urothelial transformation. PMID- 6506231 TI - Telethermography and axillary node status as predictors of early relapse in breast cancer: preliminary report. AB - The authors report on 141 primary, non-metastatic, breast cancer patients with a minimum follow-up of 12 months after surgery to a maximum of 5 years. All cases were studied according to the patterns of the preoperative telethermography (TH) and nodal status (N). Prognosis was evaluated in terms of incidence of relapse. A statistically significant correlation was found between TH+ and early relapse, and for N+, but there was no correlation between TH and N, both for negative and positive values. The results suggest a complementary prognostic value of the two parameters. PMID- 6506233 TI - [Basal phosphorylation of synaptic membrane proteins in the presence of ATP and GTP]. AB - A comparative study of endogenous ATP- and GTP-used basal protein phosphorylation in synaptic membranes from the rat brain cortex was carried out using the method of determination of total protein phosphorylation and autoradiography of proteins separated in PAGE. Under identical conditions 33P incorporation into proteins was shown to be appropriate in the presence of ATP as contrast to that in the case of GTP; in both cases the same proteins were phosphorylated. Inhibition of endogenous basal phosphorylation by alkali cations (K+, Na+, Li+) was more effective in the presence of GTP as compared to that with ATP. The differences between synaptic membrane protein kinases used by ATP and GTP are discussed. PMID- 6506234 TI - [Physico-chemical properties of IgG characteristic for normal growth]. AB - It is shown that IgG typical of the normal growth appears in blood of rats with the regenerating liver and in pregnant ones and its capacity to form complexes with alpha-globulins insoluble in acid medium, isoelectric point and molecular mass are similar to these features in IgG typical of the malignant growth. At the same time hydrophobic properties and energy stability of this protein are close to those of IgG in control animals. The accessibility of ionogenic groups for titration in the studied protein varies like that observed in IgG typical of the malignant growth but is less pronounced. The data obtained evidence for the fact that subpopulations of IgG molecules with similar but not identical properties appear in blood of animals with the normal and malignant growth. PMID- 6506235 TI - [Impairment of protein biosynthesis in the spinal cord in ischemia and recirculation]. AB - Polysomic profiles and ultrastructure of granulated endoplasmic reticulum of the dog spinal cord as well as incorporation of labelled amino acids to cytosol proteins during ischemia and recirculation are studied. Ischemia does not evoke serious changes of the studied parameters while several minutes after ligature removal there appear pronounced changes in the ribosome distribution confirmed by electron-microscopic examination. Complete restoration of the observed parameters after the induced ischemia requires two days. PMID- 6506236 TI - [Isolation and purification of histone-specific acetyltransferases from the rat liver]. AB - There forms of histone-specific acetyltransferases--A, B and C are obtained from the rat liver nuclei. The isolation process included nuclei generation, ammonium sulphate salting-out of proteins, DEAE-cellulose, hydroxyl-apatite, phosphocellulose chromatography and Sephadex C-200 gel-filtration. Acetyltransferases A, B and C from the nuclei were purified 56.8, 144.1 and 42.3 times, respectively. Histones were preferential substrates of the obtained enzymes. Molecular mass of acetyltransferases was determined by Sephadex G-150 and G-200 gel-filtration. It was 120 for enzyme A, about 90 for B and above 200 kDa for C. PMID- 6506237 TI - [Spectral characteristics of muscle aspartyl- and valyl-tRNA- synthetases and their complexes with substrates in normal conditions and after prolonged starvation]. AB - Spectral characteristics of aminoacyl-tRNA-synthetases (ARSases) isolated from muscles of normal rabbits and of those fasted for a long time were studied by the methods of fluorescence and differential spectroscopy. Fluorescence spectra and differential absorption spectra of the compared proteins evidenced for more hydrophobic surrounding of tryptophanyls and their less accessibility for Cs+ ions in proteins of fasted animals. Interaction of aspartyl- and valyl-tRNA synthetases from muscles of normal and long-fasted rabbits with substrates is accompanied by the essential quenching of tryptophan fluorescence of ARSases. Equilibrium constants of substrate binding calculated from the fluorescence quenching curves are higher for specific amino acids than for non-specific ones. The effect of a long-wave shift of fluorescence spectra under marginal excitation of tryptophan residues was used to determine structural differences of enzymes in norm and under fasting and to find their structural peculiarities during formation of aminoacyl adenylate. Aminoacyl-tRNA-synthetases (ARSases) are key enzymes of the protein biosynthesis. High specificity of their interaction with substrates is the basis for the accuracy of genetic information implementation, namely translation of the genetic code. Molecular mechanisms of substrates "recognition" by ARSases are the objects of great attention of researchers. PMID- 6506238 TI - [Lipogenesis and gluconeogenesis in the liver of irradiated rats]. AB - The incorporation of 14C from [U-14C] glucose and 3H from 3H2O into the total lipids fatty acids and glycogen of the liver incorporation of 3H from 3H2O into blood glucose was studied in rats totally irradiated in a dose of 14.4 Gy. It is shown that in the liver of irradiated rats glucose is accumulated in considerable amounts as glycogen but it is slightly used as a source of carbon for lipid synthesis. The study of 3H incorporation shows that irradiation stimulates glucogenesis, glyconeogenesis and lipogenesis in the liver. PMID- 6506240 TI - [Enzymes as a subject of invention]. AB - A patent-legal situation is analyzed which has arisen in the world in connection with the problem on protection of native enzymes as objects of invention. The objects under study are shown to correspond to the demands of novelty, essential distinctions and positive practical effect which are made by the legislation of the USSR to inventions. Possibility of legal protection of enzymes as substances with unstated structure obtained microbiologically is determined in terms of acting standard statements. A set of characters necessary and sufficient for recognition of enzymes and substantiation of their novelty is suggested for characteristics of enzymes in original papers and patent documents. General approaches to optimization of native enzyme examination for the novelty and essential characteristics are developed. PMID- 6506239 TI - [The effect of testosterone propionate, 5 alpha-dihydrotestosterone and 5 alpha androstan-3 beta, 17 beta-diol on acid phosphatase activity in the prostate of castrated rats]. AB - The acid phosphatase is studied in the prostate gland of rats. It is shown that 10 days after gonadectomy the activity of acid phosphatase lowered considerably. Administration of testosterone propionate or 5 alpha-dihydrotestosterone to castrated animals restored the enzyme activity whereas 5 alpha-androstan-3 beta,17-diol was not effective. Administration of testosterone propionate with one of its metabolites increased the activity of acid phosphatase in the prostate gland, however to a less extent than with the use of the hormone itself. The lowest activity is detected with the simultaneous application of three androgens. PMID- 6506241 TI - [Use of pacemakers in Denmark 1982. Report from the Danish pacemaker registry]. PMID- 6506242 TI - [Pacemaker treatment with the self-anchoring electrode. Experience of 278 consecutive patients]. PMID- 6506243 TI - [Occurrence of hypophyseal tumors in secondary amenorrhea]. PMID- 6506244 TI - [Polyarthritis associated with hyperlipoproteinemia type II]. PMID- 6506245 TI - [Plasma fibronectin during premedication, anesthesia and surgery]. PMID- 6506246 TI - [Extensoraponeurosis and it's significance for extension of the distal joint of the thumb]. PMID- 6506247 TI - [Cyclic mastalgia and prolactin stimulating drugs. A case-control study]. PMID- 6506248 TI - [Massive spontaneous hemorrhage from renal cysts]. PMID- 6506249 TI - [Development of endometrial cancer in a case of estrogen producing granulosa cell tumor]. PMID- 6506250 TI - [Diabetic renal disease--is prevention possible? A review based on studies of renal function]. PMID- 6506251 TI - [Ulcerative colitis and pregnancy]. PMID- 6506253 TI - [Crohn disease and pregnancy]. PMID- 6506252 TI - [Chronic inflammatory intestinal disease and pregnancy]. PMID- 6506254 TI - [Complications, mortality and time of discharge in acute myocardial infarct]. PMID- 6506255 TI - [Theophylline poisoning with particular attention to cardiac complications]. PMID- 6506256 TI - [District psychiatric projects in Denmark based on the hospital services. Description and current status]. PMID- 6506257 TI - [Social network of the elderly in Copenhagen. Report of an epidemiologic, socio medical interview study of persons aged 75, 80 and 85 years in Copenhagen]. PMID- 6506258 TI - [Physician's notification of occupational injuries. II. Notification system]. PMID- 6506259 TI - [Neurosurgical treatment of Cushing's disease]. PMID- 6506260 TI - [Spontaneous course of hypophyseal adenoma]. PMID- 6506261 TI - [Pituitary apoplexy]. PMID- 6506262 TI - [Microsurgical revascularization of the brain by means of temporal-to-media anastomosis]. PMID- 6506263 TI - [Hydrocephalus. Subdivision, physiopathology and fluid dynamics]. PMID- 6506264 TI - [Saccular vertebro-basilar aneurysm. 27 operated patients]. PMID- 6506265 TI - [Percutaneous nephroscopic removal of renal calculi]. PMID- 6506266 TI - [Retrograde ureteropyeloscopy. Preliminary results]. PMID- 6506267 TI - [Pyeloureteroscopy with a fiberscope]. PMID- 6506268 TI - [Intervention studies in the field of occupational accidents]. PMID- 6506269 TI - [Impact noise and discant hearing loss. A retrospective study]. PMID- 6506270 TI - [Treatment of casualties in general practice]. PMID- 6506271 TI - [Prenatal diagnosis of chromosomal and hereditary metabolic disease during the 1st trimester]. PMID- 6506272 TI - [Prenatal genetic diagnosis. Results from a 12 year period]. PMID- 6506273 TI - [Spontaneous abortions and stillbirths in relation to prenatal examinations in Denmark. Report from the Cytogenetic Central Register]. PMID- 6506274 TI - [Possibilities of amniocentesis for pregnant women aged 35 years or older. A study of the distribution and utilization in 4 counties]. PMID- 6506275 TI - [Magnesium deficiency]. PMID- 6506276 TI - [A fatal case of lightning striking]. PMID- 6506277 TI - [Intrapericardial teratoma in a stillborn infant]. PMID- 6506278 TI - [Traumatic dislocation of the testis]. PMID- 6506279 TI - [Cortical edema in hemoplegic migraine]. PMID- 6506280 TI - [Deliberate self-poisoning with drugs]. PMID- 6506281 TI - [Regional long-term medical assessment of pensioners living at home]. PMID- 6506282 TI - [Automatic pushing doors in shops]. PMID- 6506283 TI - [The contractility, work and energy consumption of the heart]. PMID- 6506284 TI - [The value of routine bone scintigraphy in primary operable breast cancer]. PMID- 6506285 TI - [Cervical disk disease treated by the Cloward method. A study of 1106 patients]. PMID- 6506286 TI - [Penicillamine treatment of rheumatoid arthritis. A clinical and radiological report from a period of 2 years]. PMID- 6506287 TI - [WR--still an current blood test]. PMID- 6506288 TI - [Arthrodesis of the interphalangeal joint of the great toe]. PMID- 6506289 TI - [Myxoma of the left atrium. The clinical picture and diagnostic significance of two-dimensional echocardiography]. PMID- 6506290 TI - [Myxoma of the right atrium. The value of echocardiography in the diagnosis of cardiac causes of vertigo and syncope]. PMID- 6506291 TI - [Malignant transformation of a mixed adenoma of the parotid gland]. PMID- 6506292 TI - [Granulosa cell tumor. A case with primary peritoneal carcinosis and recurrence after 24 years]. PMID- 6506293 TI - [Breakage of a coil in utero]. PMID- 6506294 TI - [Experience from a local authority clinic for advice on contraception. A consecutive study of 1000 women attending a clinic for advice on contraception in the Municipality of Fredriksberg]. PMID- 6506295 TI - [Survey of experimental activity in the primary health service]. PMID- 6506296 TI - [Admission to nursing homes for limited periods. An alternative to hospital admission]. PMID- 6506297 TI - [Medullary carcinoma of the thyroid]. PMID- 6506298 TI - [Cerebrovascular insults caused by manipulation of the cervical spine]. PMID- 6506299 TI - [Continuous arterio-venous hemofiltration in critically ill patients]. PMID- 6506300 TI - [Intramedullary fixation of Colles' fracture by the Rush method]. PMID- 6506301 TI - [Leucoagglutinin-induced non-cardiac pulmonary edema]. PMID- 6506302 TI - [Poisoning by amoxapine (Demolox). A new tricyclic antidepressive agent]. PMID- 6506303 TI - [Urinary infection complicated by spinal osteomyelitis and aortic aneurysm]. PMID- 6506304 TI - [Marfan syndrome and pregnancy]. PMID- 6506305 TI - [Primary squamous cell carcinoma of the uterus]. PMID- 6506307 TI - [The casualty department study in the western part of the County of Frederiksborg. III. Contact pattern in a public casualty department]. PMID- 6506306 TI - [Registration of diagnoses in a national patient register. Preliminary assessment of the validity of the register]. PMID- 6506308 TI - [The casualty department study in the western part of the County of Frederiksborg. IV. Public and restricted casualty departments compared]. PMID- 6506309 TI - [Monitoring of antiepileptic therapy. A basis for the clinical use of plasma levels in the treatment of epilepsy]. PMID- 6506310 TI - [Lead poisoning from shot and bullets]. PMID- 6506311 TI - [Forearm fractures with distal radio-ulnar dislocation]. PMID- 6506312 TI - [The resistances in 3,0 and 3,5 mm tracheal tubes. Comparison of 4 commonly used types]. PMID- 6506313 TI - [Audio-vestibular examination of persons with chronic toxic encephalopathy]. PMID- 6506314 TI - [Injuries sustained in the world championship in the sport Taekwondo]. PMID- 6506316 TI - [Intrauterine fetal death caused by stricture and torsion of the umbilical cord]. PMID- 6506315 TI - [Salpingitis after laparoscopic sterilization]. PMID- 6506317 TI - [Vascular catastrophies in the surgical treatment of abscesses in the groin]. PMID- 6506318 TI - [Hematuria resulting from secondary amyloidosis of the bladder]. PMID- 6506319 TI - [Glycopyrron (Robinul). An anticholinergic agent with new indications]. PMID- 6506320 TI - [Occupational bladder cancer]. PMID- 6506321 TI - [Accidents due to violence in Greenland]. PMID- 6506322 TI - [The need for eye operations in Denmark 1979-1982]. PMID- 6506323 TI - Estimates of validity of projection approximation for three-dimensional reconstructions at high resolution. AB - As spatial frequency increases, the electron microscope "image" deviates increasingly from a true projection of the specimen's structure. This is due to the finite radius of the Ewald sphere. Quantitative estimates of these deviations of the reconstruction from the true projection are presented for a range of accelerating voltages, spatial frequencies, specimen thicknesses, and specimen tilts. PMID- 6506324 TI - Acoustic cavitation series: part six. Gas body activation. AB - A small body of gas which is stabilized against dissolution in a liquid by a supportive structure may oscillate in response to an ultrasonic field and this form of cavitation is termed gas body activation. Linear theory describes the response of gas-filled intercellular channels in plant tissue and of gas-filled micropores in thin sheets of plastic. Calculations from this theory yield good agreement with indirect observations of resonance frequencies and rough agreement with direct measures of aggregate response (transmission and reflection coefficients). Studies of gas body activation in biological systems should allow quantitative analysis of cavitation bioeffects for relatively low-intensity ultrasound applications. PMID- 6506325 TI - A simple device for checking the acoustic beam of ultrasonic therapy equipment. AB - Ultrasound of time average acoustic intensities between 0.5 and 3 W cm-2 is widely used in physiotherapy. A simple device for semiquantitative checking of output power and beam shape has been designed. The beam tester consists of an absorbing plate and a sheath liquid crystal thermometer for temperature distribution display. The ultrasonic beam is fed to the absorber through a simple water tank. PMID- 6506326 TI - 25 + 1 channel pulsed ultrasound Doppler velocity meter for quantitative flow measurements and turbulence analysis. AB - A multichannel pulsed ultrasound Doppler instrument designed to measure velocity and volume flow rate quantitatively has been applied for turbulence detection. A 7-MHz transmitting frequency and a phase locked loop technique for the frequency to velocity conversion have been used to obtain high temporal resolution in the single channel mode. To provide for reliable positioning of the single gate within the arterial lumen the device could first be operated in the multichannel mode measuring the velocity profiles with zero crossing detection methods. Measurements of the velocity in the center of the lumen of the common and internal carotid arteries have been recorded on a beat to beat basis. An ensemble average of 16 consecutive pulses was determined. Thereafter, the root mean square of the differences between ensemble average and individual velocity pulses was computed, and a disturbance index was defined by dividing the disturbance velocity by the mean velocity. First clinical results show that the method presented is a valuable complement to the analysis of flow pulse patterns in the transcutaneous examination of carotid arteries. PMID- 6506327 TI - A reflection technique for measurement of high acoustic intensities. AB - A number of commercially available hydrophones having a uniform frequency response suitable for measurement of pulse echo waveforms overload at high acoustic intensities. A reflection technique which reduces the magnitude of this incident energy is described and permits these hydrophones to measure high intensities without distortion. PMID- 6506328 TI - Quantitative assessment of valvular regurgitations using the pulsed Doppler technique. Approach to the regurgitant lesion. AB - It is now possible with pulsed Doppler to grade the severity of aortic, mitral and tricuspid regurgitations on a quantitative basis. "Indices" were devised, using the measurement of the spatial extent of abnormal Doppler signals. For aortic regurgitation: (1) at the aortic valvular orifice area, by measurement of the regurgitant aortic valvular area and calculation of the valvular regurgitant "index". (2) In the left ventricle outflow tract, by calculation of an "index" combining information from two echographic (short and long axis) planes. For mitral regurgitation: by calculation of the total regurgitant "index" combining information from examination of the annulus in short axis, and of the left atrium in long axis view. For tricuspid regurgitation: at the tricuspid annulus, by averaging the depth of the reversal wave on two samples recorded using various echographic approaches. A group of patients with aortic (42), mitral (55) and tricuspid (57) regurgitation proven by invasive procedures, was investigated with this procedure using a 3 MHz two dimensional pulsed Doppler echo device. Correlative coefficients between the Doppler grading and that provided by independently performed invasive procedures on a three point scale, ranged between 0.66 and 0.88, with significant differentiation of mean values of indices (P less than 0.01 to P less than 0.001) for each grade of severity. Success in the Doppler grading of severity of the regurgitations requires (1) a sampling as close as possible to the lesion, and optimally at ther very site of the lesion, (2) the largest explorable area at the site of the lesion, (3) the relevancy of the selected Doppler parameter in order to take into account, as much as possible, the three dimensional configuration of the regurgitant jet. Moreover, this mapping procedure provides a pathophysiological insight of the regurgitant lesion for left-sided regurgitations. PMID- 6506330 TI - Maximal blood flow velocities--haemodynamic data obtained noninvasively with CW Doppler. AB - With continuous wave (CW) Doppler the maximal velocity in intracardiac jets can be recorded and simultaneous imaging makes the localization of these jets easier and unambiguous. The image may indicate the angle to the velocity, but the Doppler signal should be used to obtain the smallest angle and the highest velocity. Corrections for an assumed angle should be avoided since this may cause overestimation. With the maximal velocity a pressure drop can be calculated across obstructions and between chambers in regurgitations and shunts. The combined anatomic and haemodynamic information obtained with simultaneous two dimensional echo and CW Doppler provides a good noninvasive assessment of most congenital and valvular lesions, including prosthetic valves. PMID- 6506329 TI - CW and pulsed Doppler echocardiography utilizing a stand-alone system. AB - An independent directional Doppler system operating in pulsed or continuous-wave mode and a real-time spectral analyzer with a 3 ms temporal resolution have been used to supplement conventional real-time and M-mode echocardiography. Examination techniques as well as findings in normal and abnormal hearts are presented. Continuous-wave Doppler is most useful for detection of peak frequency shifts for calculation of valvular gradients while pulsed Doppler is superior in the detection of small jets of abnormal flow and in display of spectral broadening. Real-time spectral analysis allows interactive selection of peak frequency shifts, can separate coincident flows by signal intensity and depicts high frequency valvular movements to rival the capabilities of M-mode. PMID- 6506331 TI - Pulsed Doppler echocardiography in the assessment of tricuspid regurgitation. AB - Pulsed Doppler echocardiography is a noninvasive method with high sensitivity and specificity for the assessment of tricuspid regurgitation. In patients with tricuspid regurgitation, pansystolic unusual Doppler signals are detected in the right atrial cavity, which are interpreted as tricuspid regurgitant flow signals. They distributed in a spindle-shaped area from the tricuspid orifice toward the right atrial posterior wall in parallel with the interatrial septum. The orientation of the range where the regurgitant Doppler signals are detected in the right atrial cavity shows the direction of the regurgitant jet. However, such a result is determined mainly in patients with functional tricuspid regurgitation. In regard to patients with organic tricuspid lesion, different considerations may be necessary. Semiquantitative grading of the severity of regurgitation is possible, based on the distance covered by the regurgitant signals from the tricuspid orifice. Tricuspid regurgitation is demonstrated also by contrast echocardiography. The severity is graded based on the distance reached by regurgitant curvilinear contrast echoes from the tricuspid valve in the M-mode echocardiography. If the ultrasound beam is adequately directed through the tricuspid orifice, the grade estimated by the contrast echoes are well correlated with that by the Doppler. However, if the M-mode is performed without the guide by the two-dimensional image, it may miss the most adequate beam direction for the observation, resulting in underestimating severity. The influences of tricuspid regurgitation are generally seen in the flow pattern of the major veins. However, they are more sharply reflected by the flow condition in the right atrial cavity than by the flows patterns in the major veins. PMID- 6506332 TI - Diagnosis and follow-up of congenital heart disease in children with the use of two-dimensional Doppler echocardiography. AB - Two-dimensional echocardiography (2D) represents a major advance in non-invasive diagnosis of congenital heart disease (CHD) in children. Nevertheless it has diagnostic limitations in nearly all kinds of heart lesions. These can be overcome for the most part by integration of a pulsed Doppler system. This may be called two-dimensional Doppler echocardiography (2DD). Hereby blood flow information is added to the 2D image. Some common types of CHD including ventricular and atrial septal defects, persistent ductus arteriosus, pulmonic stenosis and coarctation are described with their typical 2DD findings. Non invasive follow up of children with CHD and early recognition of typical complications can be achieved reliably using 2DD. Future prospects consist in a more quantitative diagnostic application of 2DD. PMID- 6506333 TI - On velocity changes caused by tissue fixation. PMID- 6506334 TI - Ultrasonically induced temperature elevation in mouse ovary. AB - Temperature increases, resulting from exposure to 1 MHz ultrasound, were measured in in situ and in exteriorized mouse ovaries. It is concluded that temperature increases from exposure to 10 W/cm2 and less are probably not significant for producing ovarian tissue damage, but that 25 W/cm2 exposures, and greater, are of such magnitude that damaging thermal levels ensue. The significance of blood flow in removing ultrasonically generated heat has been observed quantitatively. PMID- 6506335 TI - Cerebral arterial air embolism: I. Is there benefit in beginning HBO treatment at 6 bar? AB - A method for studying treatment of cerebral arterial gas embolism in dogs is described. The model produces severe cortical dysfunction and cerebral blood flow deficits. The efficacy of treatment was assessed using median nerve somatosensory cortical evoked potentials (CEP), [14C]iodoantipyrene autoradiographic cerebral blood flow studies, brain water content, and various physiological parameters. A direct comparison of modified U.S. Navy Treatment Tables 6 and 6A is reported. Complete recovery of CEP was not seen after 90 min of treatment. The maximum rate of CEP recovery occurred in the first 15 min of treatment. Recovery continued out to 60 min. Thereafter, some dogs on treatment 6A showed signs of deterioration. The cerebral blood flow studies were the same in both groups and showed no sign of pathologically low levels of flow. It appeared that there was no advantage in preceding 2.8-bar (60-ft) oxygen treatments with compression to 6 bar (165 ft) on air for the treatment of arterial air embolism in this model. PMID- 6506336 TI - Cerebral arterial air embolism: II. Effect of pressure and time on cortical evoked potential recovery. AB - In a dog model of cerebral arterial gas embolism we studied the relative merits of several different treatments: air breathing at 2.8, 6, 8, and 10 bar (60, 165, 230, and 300 ft), and oxygen breathing at 2.8 bar. The study was confined to the recovery of cortical evoked potentials (CEP) while at pressure. It was confirmed that this was a very severe model; few dogs achieved full recovery and three failed to show any recovery. Injecting 0.4 ml of air into the right internal carotid artery was seen to be as effective in suppressing function in the left hemisphere as in the right. The level of recovery with compression treatment as a percentage of control was directly related to the level to which CEP was suppressed. No other physiological correlates were found with either the degree of CEP suppression or the degree of recovery. Nor was any improvement observed in the rate or maximum amount of recovery at any time out to 20 min as a result of pressures greater than 2.8 bar. Overall, no treatment surpassed oxygen at 2.8 bar. PMID- 6506337 TI - Cerebral arterial air embolism: III. Cerebral blood flow after decompression from various pressure treatments. AB - The effect of various combinations of time between 2 and 20 min and between pressures of 2.8 and 10 bar (60 and 300 ft) breathing air or oxygen at 2.8 bar (60 ft), on the continued recovery of cortical evoked potentials (CEP), cerebral blood flow (CBF), and water content of the brain were studied in the dog cerebral arterial air embolism model. It was found that the compression-decompression cycle alone resulted in a rise in cerebrospinal fluid pressure sustained for at least 20 min. The CBF study at 30 min showed an increased flow in dived, nonembolized animals. Water content of the brain was also significantly increased in these animals. The data suggest that the clearance of air is probably independent of pressure once past a threshold of 2.8 bar and is certainly hastened by oxygen. A time of around 8 min is probably required to clear the embolism. The evidence of gas bubble redistribution with recurrence and development of new sites of vascular obstruction in dogs exposed to significant inert gas uptake, however, suggests that a second problem of the clearance of recirculating gas exists. An incidental observation suggests that recently dived dogs may have been more prone to secondary deterioration. The results of these studies again suggest that there may be advantages to confining the treatment of arterial gas embolism to 2.8 bar breathing oxygen. PMID- 6506338 TI - Cerebral arterial air embolism: IV. Failure to recover with treatment, and secondary deterioration. AB - Cerebral arterial gas embolism was induced in 23 dogs that were then treated using one of six routines: no treatment; air at 2.8 bar (60 ft) for 2 min; air at 10 bar (300 ft) for 5 min; oxygen at 2.8 bar for 10 or 20 min; and air at 6 bar (165 ft) for 10 min. After decompression they were monitored for a total of 90 min after the time of embolization. The dogs then underwent an autoradiographic study of cerebral blood flow (CBF). A number of the air-treated dogs experienced a reduction in cortical evoked potential after decompression. Dogs in all groups, except the untreated group and the dog at 10 bar for 5 min, showed an improved CBF compared with their short-study counterparts. After compression treatment, CBF improved with time. Function in 7 dogs deteriorated to a variable small degree in the air-treated groups, while only 3 dogs in the group on oxygen for 10 min deteriorated by around 10%. The CBF of the oxygen groups was close to the undived control values, and their cerebrospinal fluid (CSF) pressures had returned to control levels. There was a dissociation between improving CBF and deteriorating function. It is evident that secondary deterioration is a random affair and therefore not easily studied. The results of the four-part series are summarized and discussed. PMID- 6506340 TI - Relations of smoking and diving experience to pulmonary function among U.S. Navy divers. AB - The relations of 4 pulmonary function parameters (measured from the forced expiratory spirogram) with diving experience (in years) and indices of cigarette smoking were examined in a group of 93 healthy U.S. Navy divers. Years of diving was not significantly related to lung function. The value for pack-years of smoking was inversely associated with both percentage of predicted forced expiratory volume in 1 s (FEV1) and percentage of predicted maximal midexpiratory flow rate (MMFR). Divers who have relatively heavy smoking histories may be at greater risk for developing significant decline in pulmonary function, and diving exposure factors other than years of diving may contribute to this risk. PMID- 6506339 TI - Physiological effects of ventilation with liquid fluorocarbon at controlled temperatures. AB - Body cooling, respiratory heat loss, and the physiological effects of liquid ventilation at various temperatures were studied in 10 adult cats with applications to the deep sea diver. The animals were stabilized on mechanical gas ventilation with 100% oxygen during a control period and then mechanically ventilated for 1 h with liquid fluorocarbon. Fluorocarbon (Rimar 101) temperatures of 10 degrees C, 20 degrees C, and 30 degrees C were used to ventilate the animals while rectal and subcutaneous body temperatures were being measured. For the 3 temperature conditions, respective cooling rates of 9.0 degrees C/h, 7.8 degrees C/h, and 3.6 degrees C/h, as well as respiratory heat losses of 65,637 J X kg-1 X h-1, 33,488 J X kg-1, X h-1, 18,036 J X kg-1 X h-1 were observed while maintaining effective physiological gas exchange [mean PaO2 = 353 +/- 28 (SEM) mmHg, mean PaCO2 = 30 +/- 2 (SEM) mmHg]. Changes in cardiovascular variables were noted as mild (35 degrees C-30 degrees C) and moderate (30 degrees C-25 degrees C) levels of hypothermia were reached. Cardiac output, oxygen consumption, heart rate, and mean blood pressure were significantly correlated with rectal temperature. The data presented herein quantitate the effects of liquid ventilation on body cooling and respiratory heat loss. Furthermore, the physiological alterations associated with the observed hypothermic condition could severely limit the effectiveness of a human diver if not carefully controlled. PMID- 6506341 TI - [Treatment of chronic anterolateral instability of the upper ankle joint: direct ligament reconstruction--periosteal flap--tenodesis]. PMID- 6506342 TI - [Treatment of chronic bone infections with extensive skin/soft tissue defect using free transplanted flaps with microvascular anastomoses]. PMID- 6506343 TI - [Joint surface replacement with silicone rubber. Experimental studies]. PMID- 6506345 TI - [Medical life in the Laval City of Health]. PMID- 6506344 TI - [Radius joint surface replacement with silicone rubber. Clinical results]. PMID- 6506346 TI - [The role of the family physician toward his hospitalized patient: an essential role]. PMID- 6506347 TI - [The coronary rehabilitation program at the Laval City of Health]. PMID- 6506348 TI - [The health care system in Quebec: care objectives or health objectives?]. PMID- 6506349 TI - [The arterial hypertension control program at Laval]. PMID- 6506350 TI - [Suicide or pseudo-suicide? The dilemma in the emergency department]. PMID- 6506351 TI - [The pharmacy service at the Laval City of Health: a dual vocation]. PMID- 6506352 TI - [Shock and the administration of naloxone]. PMID- 6506353 TI - [Ampulloma: a study of 6 new cases]. PMID- 6506354 TI - [Membranous external otitis]. PMID- 6506355 TI - [The periodic health examination: update. 1. Introduction]. PMID- 6506357 TI - [The periodic health examination. 3. An evolving concept]. PMID- 6506356 TI - [The periodic health examination. 2. Update (1984). From the Canadian Task Force on the Periodic Health Examination (1982-84)]. PMID- 6506358 TI - The value of the DNCB test in bladder cancer. Pretreatment evaluation of immune function and 5-year follow-up of patients with urinary bladder cancer. AB - In 68 patients with histologically verified tumors of the urinary bladder, cell mediated and humoral immune parameters were investigated before therapy and the results were re-evaluated after a 5-year observation period in order to correlate them with relapse rate and survival time. Skin test reactivity, as measured with recall antigens (tuberculin, streptokinase-streptodornase, mumps, toxoplasmin and candidin), and serum levels of immunoglobulins do not differentiate between levels of invasion and grade of malignancy. However, it was found that patients with tumors of high grades of invasiveness and malignancy were anergic to the primary skin test antigen dinitrochlorobenzene (DNCB). Furthermore, a correlation between anergic reactivity to the DNCB test and absence of local inflammatory reactions at the tumor site was detected, showing that patients with a negative DNCB challenge test were those in whom no immunocytes could be detected in the intra- and peritumoral area. Survival time and incidence of relapse were also correlated with initial skin test reactivity to DNCB, i.e. all patients with tumor stage pT3 and skin test anergy developed recurrences and died within the 5 year observation period. The correlation between morphological inflammatory criteria and immunological parameters detected in patients with advanced tumor stages should therefore be taken into consideration when taking therapeutic decisions at the time of diagnosis. PMID- 6506359 TI - Relationship between postoperative blood pressure change and renal pathophysiology in primary aldosteronism. AB - 32 patients with primary aldosteronism due to adrenal adenoma were studied to elucidate the relationship between blood pressure (BP) and renal functions before and after the removal of aldosteronoma. The relationship between either BP or renal functions and the structural changes of the renal biopsy specimens obtained at the operation was also examined. Renal function studies included serum urea nitrogen (BUN), creatinine, creatinine clearance (Ccr), phenolsulfonphthalein (PSP) test, and urine concentration test (max SG). Renal plasma flow (RPF), renal blood flow, and filtration fraction (FF) were measured. Serum sodium was significantly decreased and potassium was increased after the removal of the aldosteronomas. The levels of BUN, Ccr, PSP, and max SG were not significantly correlated to either pre- or postoperative BP levels, and to the improvement of hypertension after the operation. On the other hand, BP was significantly correlated with RPF and FF before surgery. Furthermore, the postoperative improvement of hypertension was correlated with the decrease of FF and the increase of hematocrit after surgery. The influence of duration of preoperative hypertension on BP response after adrenalectomy was not significant in the present study. The higher the BP level, the more marked histological changes were found. But, there was no relationship between renal functions and histological changes of renal biopsy specimens. The results indicate that RPF may participate in the hypertension of primary aldosteronism and that the BP level after surgery may be predicted by examination of the pathological changes present in the kidney. PMID- 6506360 TI - Recurrency after optical internal urethrotomy. A comparative study of long-term and short-term catheter treatment. AB - The rate of recurrence after internal urethrotomy a.m. Sachse was studied in a prospective, consecutive, randomized series of 43 patients using short-term (1 day) and long-term (14 days) postoperative catheter treatment. No significant difference was found between the two groups according to voiding interview, flowmetry and retrograde urethrography. PMID- 6506361 TI - Rhythmic activity in pelvic efferents to the bladder: an experimental study in the cat with reference to the clinical condition 'unstable bladder'. AB - Efferent nerve activity was recorded from pelvic nerve filaments to the urinary bladder of the cat. At intravesical pressures below 5-7 cm H2O there was no activity, but at higher pressure levels the parasympathetic neurones discharged in 10- to 15-second-long rhythmic bursts separated by silent periods. The frequency of the burst varied from about 1/min at 5 cm H2O to 6-7/min at 15-20 cm H2O. Each burst of activity was followed by a small bladder contraction. The nervous activity preceded the contraction by several seconds, indicating that the bladder response was caused by the efferent discharge. Prolonged continuous efferent activity could occur immediately after pressure changes, at pressures above 20-25 cm H2O or after inhibition caused by intravaginal stimulation. In these situations, rhythmic activity resumed as inhibition of the tonic discharge. This behaviour indicates that the rhythmicity is primarily determined by a central inhibitory mechanism. The findings are discussed in relation to the normal function of the neuronal feedback systems of the bladder and their possible role in the development of the clinical condition 'unstable bladder'. PMID- 6506362 TI - Application of Teflon paste for urinary incontinence--report of 2 cases. AB - A Teflon paste injection in the subdermal area directly below the glans penis has proved a useful method for making a stopper to maintain a secure position of an exdwelling condom catheter on the penis of the spinal cord injured patient. A male patient who has undergone this procedure is described, as well as a female case with severe urinary incontinence of stress type following an orthopedic operation, who was also treated with a periurethral Teflon paste injection and has since revealed significant improvement. PMID- 6506363 TI - Vasectomy to prevent acute epididymo-orchitis after prostatic adenomectomy: still a controversy. AB - There has been a controversy for almost 80 years about the usefulness of vasectomy in the prevention of acute epididymo-orchitis (EO) after prostatic adenomectomy (PA). In the last few years, improved surgical equipment and new more effective antibiotics have drastically diminished the incidence of this complication. The purpose of this report is to show that because of the devastating effect of the disease, and in spite of its low incidence there is still a clear indication for vasectomy, and also that infected urine, a preoperative indwelling urethral catheter, duration of postoperative catheterization and postoperative complications do not affect the incidence of post-PA acute EO. PMID- 6506364 TI - Transurethral sphincteroresection in traumatic tetraplegia. AB - Transurethral sphincteroresection is a method to resect the external sphincteric area more aggressively than the ordinary transurethral sphincterotomy which is routinely adopted. 9 cases of traumatic cervical spinal injury (including 1 case with Th6 injury), 6 of which had still stayed under catheterized condition and 3 had not been achieved thoroughly to the catheter-free condition, were treated by this newly attempted method. As a result, they have obtained a more encouraging condition for their urination. PMID- 6506365 TI - Transcoccygeal approach for rectourethral fistula repair. AB - The fistulae between the lower urinary tract and the rectum are a surgical challenge which have given rise to various surgical techniques. The transcoccygeal route allows an easy reconstruction of the urethral and rectal walls under clear vision. PMID- 6506367 TI - Fibrous pseudotumor of the tunica vaginalis testis. AB - The incidence of fibrous pseudotumor of the tunica vaginalis testis is rare. It is a benign, fibroproliferative process with hyalinization and sometimes with focal calcification. In most cases malignancy is suspected although by careful physical examination it may be possible to establish the diagnosis pre operatively. The best form of therapy is frozen section biopsy of the pseudotumor followed by excision; including if necessary the tunica vaginalis. If the pseudotumor is locally extensive an epididymectomy is sometimes necessary. A study of the literature reveals that because of the rarity of this lesion orchidectomy appears to have been performed in most cases. A case report of a patient with fibrous pseudotumor of the tunica vaginalis testis is presented. PMID- 6506366 TI - Effect of estrogen on the formation of struvite calculi in female rats. AB - The administration of 1 mg estradiol every other week for 12 weeks to female rats resulted in a high incidence (about 50%) of bladder stones. Most calculi were struvite, suggesting the predisposition to urinary tract infection. Enterobacteria, staphylococcus and streptococcus were identified as infecting organisms. Metaplasia of the transitional bladder epithelium by estrogen to a stratified or pseudostratified columnar epithelium may be involved in the underlying cause of urinary tract infection. PMID- 6506369 TI - Symposium on advances in the management of urothelial cancer. PMID- 6506368 TI - Effect of emepronium bromide (Cetiprin) on symptoms and urinary bladder function after transurethral resection of the prostate. A double-blind randomized trial. AB - 75 patients were randomized to be treated with either emepronium bromide (Cetiprin) 200 mg 4 times a day or placebo after transurethral resection of the prostate. The patients were evaluated urodynamically pre- and postoperatively, and further evaluated by micturition symptom charts. No significant differences in symptoms or objective findings were found between the patients treated with emepronium bromide and those treated with placebo. PMID- 6506370 TI - Advances in the etiology of urothelial cancer. AB - Cigarette smoking has been shown to be the most important known preventable cause of bladder cancer. Occupations have continued to come under suspicion, although many of the newer findings are tentative. Neither coffee drinking nor use of artificial sweeteners appears to have been responsible for much, if any, human bladder cancer. PMID- 6506371 TI - An assessment of the impact of urine cytology screening using a computer-based model of bladder cancer. AB - Utilizing a computer-based model of bladder cancer, the applications of various urine cytology screening strategies are assessed. Outcomes for patients diagnosed by screening with respect to numbers of cases diagnosed, mean length of life, and numbers of cancer deaths are compared with a similar population of patients diagnosed after the development of symptoms. Diagnostic and treatment modality costs can be used to predict the cost per man-year of life extension afforded by a screening program. PMID- 6506372 TI - Retrograde brushing and nephroscopy in the diagnosis of upper-tract urothelial cancer. AB - Very selected cases of upper-tract urothelial cancer benefit from diagnostic evaluation with retrograde brush biopsy and with operative nephroscopy. The selection of cases, techniques, results, and complications are presented. PMID- 6506373 TI - Carcinoma of the urinary bladder treated by interstitial radiotherapy. AB - Bladder cancers are usually only poorly radiosensitive and require a very high dose of radiation in order to become completely eradicated. Radioactive material inserted interstitially, however, can deliver an extremely high dose to the bladder malignancy and still spare vulnerable adjacent tissues and organs. Indications for implantation, treatment results, and prognosis are presented. PMID- 6506374 TI - Intraoperative radiation therapy for bladder cancer. AB - The combination of intraoperative radiation therapy and external beam irradiation, a new treatment modality, has been added to the therapeutic armamentarium in the management of patients with bladder cancer. Encouraging results are seen when this combination is utilized for patients with superficial (Tis, T1, T2) bladder cancer. With more experience, the specific indications of this combined treatment modality will be identifiable. PMID- 6506375 TI - Role of lymphadenectomy in the treatment of bladder cancer. AB - The value of pelvic lymphadenectomy in patients undergoing cystectomy for bladder cancer continues to remain controversial. It has been the authors' policy to perform a complete bilateral pelvic lymphadenectomy on all patients for whom radical cystectomy is potentially curative. They discuss distribution and incidence of nodal disease, limits of pelvic node dissection, the technique of pelvic lymphadenectomy, and their results. PMID- 6506376 TI - Feasibility of conservative surgery for transitional cell cancer of the upper urinary tract. AB - The controversy between the proponents of radical surgery for treatment of transitional cell cancer of the upper urinary tract (total nephroureterectomy) and those of conservative surgery (segmental resection) continues. In an in-depth analysis of a large group of patients presented in this article, an attempt has been made to rationalize a conservative surgical treatment approach for certain upper-tract tumors. PMID- 6506377 TI - [Use of dibunol in diseases of the urinary bladder]. PMID- 6506378 TI - [Features of the sclerotic process in the kidneys in hydronephrosis and pyelonephritis in children]. PMID- 6506379 TI - [Multiple detrusor myotomy in the treatment of neurogenic urination disorders in children]. PMID- 6506380 TI - [Age and echographic parameters of the kidneys in children]. PMID- 6506381 TI - [Autohemotransfusion and hemodilution in children]. PMID- 6506382 TI - [Steroid hormone receptors in kidney cancer tissue]. PMID- 6506383 TI - [Multicystic kidney dysplasia]. PMID- 6506384 TI - [Optical internal urethrotomy]. PMID- 6506386 TI - [Risk factors and predicting the outcome of surgery on late middle-aged urology patients with chronic renal failure]. PMID- 6506385 TI - [Intracavernous implantation of prostheses for erectile impotence]. PMID- 6506387 TI - [Intravesical chemotherapy of bladder cancer using adriamycin]. PMID- 6506388 TI - [Pheochromocytoma of the urinary bladder]. PMID- 6506389 TI - [Amyloidosis in renal cancer]. PMID- 6506390 TI - [Cellular infiltration of the stoma as a factor in the prognosis of patients with bladder tumors]. PMID- 6506391 TI - Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for Stage C adenocarcinoma of prostate. AB - A series of 105 patients with surgical Stage C adenocarcinoma of the prostate underwent pelvic lymphadenectomy and radical retropubic prostatectomy and were followed up from one and one-half to fifteen years; 33 (31%) of the 105 had clinical Stage C disease. Of the 105 patients, 92 were at risk for greater than or equal to two years, 42 for greater than or equal to five years, and 12 for greater than or equal to ten years. Survival and disease progression were related to tumor grade (Mayo grades 1 through 4) and tumor bulk (less than 3, 3 to 10, greater than 10 cm3) but not to seminal vesicle involvement. Twenty-seven patients received adjuvant treatment (orchiectomy, DES, radiation, or combinations of these); it was administered to patients with higher tumor grades, larger tumor bulk, and/or residual cancer. Overall actuarial survival at five and ten years was 85 per cent and 72 per cent, respectively; five-year nonprogression rate was 64 per cent. Local recurrence was noted in only 8 patients (7.6%). Radical surgical treatment for nonbulky Stage C disease of the prostate is associated with favorable survival results and good local control. Adjuvant treatment may favorably affect disease outcome. Clinical seminal vesicle involvement with negative urethrocystoscopy should not necessarily deter the surgeon from planning radical prostatectomy. Prospective adjuvant treatment protocols need to be developed to identify the value of adjuvant hormone and/or radiation therapy. PMID- 6506392 TI - Pelvic lymph node dissection in prostate cancer. AB - The results of pelvic lymph node dissections in 105 prostate cancer patients were analyzed to compare the clinical with the pathologic stages. Twenty-four per cent of patients clinically believed to be node-negative had positive nodal involvement with cancer. PMID- 6506393 TI - Primary transitional cell carcinoma of prostate. AB - Primary transitional cell carcinoma of the prostate (TCC-P) is a rare tumor for which definitive therapy remains undefined. To establish a basis for therapy, we analyzed 3 new cases and reviewed the literature. The following points were observed: (1) the true diagnosis is often missed at initial pathologic examination; (2) the tumor has a propensity for extensive local invasion; and (3) it commonly presents with obstructive symptoms in relatively young patients. Treatment recommendations based on our review include: maintenance of a high index of suspicion, especially for fifty to sixty-year-old men with prostate tumors or for suspected prostatic adenocarcinoma that is rapidly progressive and/or unresponsive to hormonal therapy; preoperative pelvic irradiation followed by radical cystoprostatourethrectomy is the treatment of choice in low-stage disease, and combined radiation therapy and chemotherapy should be used for disease beyond the prostate. PMID- 6506394 TI - Women's satisfaction with partners' penile implant. Inflatable vs noninflatable prosthesis. AB - We evaluated 49 women whose sexual partners were organically impotent and subsequently received either an inflatable or noninflatable penile prosthesis. The women comprised three groups, based on the type of prostheses their partners had received: inflatable (n = 34), noninflatable (n = 11), and a double implant group (n = 4). The comparisons made were (1) dimensions of sexual satisfaction, (2) emotional stability, (3) satisfaction with the prosthesis, and (4) relationship changes. Two special questionnaires and the Derogatis Sexual Functioning Inventory were utilized in this evaluation. Women in the inflatable prosthesis group were found to be significantly more satisfied with the quality of their sexual relations and with their partner's prosthesis than were the women in the noninflatable prosthesis group. There apparently is a general advantage to women whose partners have received an inflatable prosthesis compared with the noninflatable alternatives. PMID- 6506395 TI - Inflatable penile prosthesis. New device design and patient-partner satisfaction. AB - The three most significant factors in achieving patient-partner satisfaction with a penile prosthetic device are selection of the patients, realistic expectations of both the patient and the partner, and reliability of the device. Exchange of information between the clinical observers and the design engineers can significantly enhance the reliability of the device. PMID- 6506396 TI - Subperiosteal rib-saving approach to kidney. AB - An operative approach to the kidney is described which takes advantage of the single attachment of the eleventh and twelfth ribs to their vertebral bodies, and an avascular plane that is present in the periosteal bed of the rib. By separation of the posterior attachments, the rib can pivot posteriorly and give a wide exposure of the kidney. By using an approach through the bed of the rib, the vascular supply to the intercostal space is avoided and less operative blood loss occurs. Saving the rib, rather than transecting it, avoids pleural and glove damage during the operation and adds a firmness to the wound not present when the rib is excised. PMID- 6506397 TI - Human lymphoblastoid interferon therapy for advanced renal cell carcinoma. AB - Antitumor activity of human lymphoblastoid interferon (HLBI) in advanced renal cell carcinoma was studied. Intramuscular injection at a dose of 3 X 10(6) IU was given daily to 18 patients, including 14 patients who had undergone nephrectomy and 4 patients who had not undergone the procedure. One patient (5.6%) showed complete remission; 2 patients (11.1%) minor remission, 8 patients (44.4%) stable disease, and 7 patients (38.9%) progression. Three responders were the patients who had had nephrectomy, and whose metastatic sites were lung. Tumor responses were observed in patients with renal cell carcinoma of clear cell type or mixed type of clear cells and granular cells. We concluded that interferon has a potential antitumor activity in selected patients with advanced renal cell carcinoma. PMID- 6506398 TI - Sclerotherapy with tetracycline solution for hydrocele. AB - A study of sclerotherapy for hydrocele using different concentrations (10%, 5%, 2.5%) for tetracycline solution was done on 24 patients, 23 patients were cured. The effectiveness of sclerotherapy was the same for the three groups of patients with use of each different concentration of the solution. Pain was the only adverse effect. Nonspecific cellular foreign body reaction and fibrin strand proliferation were observed in the hydrocele fluid after this procedure. We consider sclerotherapy for hydrocele with tetracycline solution safe and the procedure of choice for patients in whom surgery or anesthesia is contraindicated, for patients who refuse surgery, and for economic reasons. PMID- 6506399 TI - Effect of sympathetic denervation of rat internal genitalia on daily sperm output. AB - Using the technique of vasocystostomy, daily sperm output was determined in rats undergoing surgical removal of the sympathetic nerves to the internal genitalia. Between ten and fourteen days after denervation, the daily sperm output significantly (p less than 0.001) decreased below presurgical rates and those of sham-operated control animals (p less than 0.01). This change occurred without changes in plasma testosterone concentration or testicular histology. These data suggest neural control of sperm transport in the rat. PMID- 6506400 TI - Vesical gigantism or congenital megacystis. AB - We report on a child who was born with a large unobstructed bladder with normal trigone and normal ureteral insertions. The differences between vesical gigantism and the congenital megacystis-megaureter syndrome are discussed. In our patient, reduction cystoplasty was efficacious in alleviating the child's symptoms and recurrent urinary tract infections. More cases would be of benefit in confirming the usefulness of this procedure. PMID- 6506402 TI - Spring retractors: applicability to urologic surgery. PMID- 6506403 TI - Dilamezinsert: aid to semirigid penile prosthesis insertion. PMID- 6506401 TI - Appendicovesical fistula. AB - Appendicovesical fistula is a rare complication of unrecognized appendicitis. Only 99 previous cases have been reported in the literature. We reviewed these cases and contribute an additional one with hope that increased awareness of this entity may facilitate the correct diagnosis and avoid inappropriate management. PMID- 6506404 TI - Atraumatic color-coded mosquito clamps for inflatable penile prostheses. AB - Use of atraumatic color-coded mosquito clamps has facilitated surgery involving inflatable prostheses and so far eradicated the complication of fluid loss associated with tubing injury. Instrument tests and clinical experience is reported. PMID- 6506405 TI - Metastasis to pampiniform plexus from left renal adenocarcinoma presenting with acute varicocele. AB - A case of metastatic adenocarcinoma from the left kidney to the veins of the pampiniform plexus is described following initial presentation with an acute varicocele. It provides further evidence to support the retrograde venous route for intrascrotal secondary malignancy and also for low ligation of the left testicular vein at radical nephrectomy. PMID- 6506406 TI - Case profile: ureteral pellet. PMID- 6506407 TI - Direct venous extension of renal cell carcinoma to common iliac vein with patent main renal vein. PMID- 6506408 TI - Site of entry of single main renal artery. Angiographic study. AB - In an effort to determine the frequency of extrahilar entry of the single main renal artery, renal angiographies of 124 left and 124 right kidneys were examined and the findings reviewed. Extrahilar entry of the main renal artery was found in 33 per cent of the kidneys. In 81.7 per cent of the kidneys with extrahilar entry, the artery penetrated the kidney through the upper zones (above the normal hilus). Apical entry of the renal artery was found in 1.6 per cent of the 248 kidneys. There was no entry of the single main renal artery below the hilus of the right kidney. An embryologic explanation of these findings is suggested, and some practical aspects are mentioned. PMID- 6506409 TI - Managing prostatitis: practical aspects of antibiotic therapy. Proceedings of a symposium, annual meeting of the North Central Section of the American Urological Association. Maui, Hawaii, November 4, 1983. PMID- 6506410 TI - The effects of task interest and difficulty on procrastination. PMID- 6506412 TI - Reproduction of acute bracken poisoning in a calf with ptaquiloside, a bracken constituent. AB - Acute bracken fern toxicity in a calf was reproduced with ptaquiloside, a norsesquiterpene glucoside, isolated from the boiling water extract of bracken fern. Ptaquiloside was dissolved in 500 ml of saline and administered by drench at increasing dosages for six days out of every seven for the following periods: 400 mg/day for 24 days, 800 mg/day for 14 days and 1600 mg/day for four days. Neutrophilic granulocytes began to decrease markedly around 50 days after the start of the experiment, and granulocytopenia continued for a further 35 days until the autopsy, despite the discontinuance of ptaquiloside administration. Thrombocytes showed a relatively slow depression and reached 1 X 10(5)/mm3 at the lowest level. The calf was autopsied 86 days after the start of administration of ptaquiloside. Sternal bone marrow was found to be mostly replaced with fat marrow and only small foci of erythropoietic cells and a small number of megakaryocytes remained. PMID- 6506411 TI - A cell cycle model based on the estrogen-stimulated uterus. PMID- 6506413 TI - Apparent pregnancy failure following mating of bitches at PMSG induced oestrus. PMID- 6506414 TI - Persistent hyperplastic primary vitreous in the Staffordshire bull terrier. PMID- 6506415 TI - Rickettsial link with acute equine diarrhoea. PMID- 6506416 TI - Size, time, ketamine and birds. PMID- 6506417 TI - Could canine cancer be reduced by selective breeding? PMID- 6506418 TI - Salmonellosis in an African elephant. PMID- 6506419 TI - Diagnosis and treatment of coenuriasis (gid) in sheep. AB - A procedure for the clinical investigation and surgical treatment of cases of coenuriasis in sheep was assessed. The results were based on a series of 62 cases of coenuriasis, of which 58 per cent did not have any palpable skull softening. A useful correlation between the neurological signs and the location of cysts was demonstrated, enabling accurate localisation of cysts in 68 per cent of cases. The surgical technique for the removal of cysts gave a success rate of 74 per cent among the 42 cases selected for surgery, as judged by the complete removal of the cyst and recovery of neurological functions. PMID- 6506420 TI - Space occupying lesions of cranial nerves in calves with facial paralysis. AB - Clinical and pathological data of a recently discovered neurological disorder in young calves were studied. The symptoms were those of a paralysis of the nervus facialis and a dysfunction of the nervus vestibulocochlearis. Macroscopically, space occupying lesions were found at the roots of these two cranial nerves and in some cases further on their course into the os petrosum. On histological examination, these legions contained multiple nodules with mainly histiocytic cells, some plasma cells and multinucleated giant cells. Around these nodules, dense bands of connective tissue with fusocellular fibroblasts, some plasma cells and small blood capillaries were present. The nodular lesions were usually in close contact with the nerve. Ultrastructurally, a variety of cells, predominantly histiocytes and some plasma cells, were seen next to Schwann cells which contained degenerating axons. PMID- 6506421 TI - Dental calculus and periodontal disease in sheep. PMID- 6506422 TI - Apparent iatrogenic clostridial myositis in cattle. PMID- 6506424 TI - Mesenteric hernia in a cow. PMID- 6506423 TI - Pododermatitis aseptica diffusa (laminitis) in free range beef cattle in tropical Africa. PMID- 6506425 TI - 'Disbudding' of kids. PMID- 6506426 TI - Icterus-haemoglobinuria in calves. PMID- 6506428 TI - The spread of maedi-visna virus. PMID- 6506427 TI - Portable anaesthetic unit. PMID- 6506429 TI - The Leverhulme residency programme at the Royal Veterinary College, University of London and the faculty of veterinary science, University of Liverpool. PMID- 6506430 TI - Maedi-visna virus infection in commercial flocks of indigenous sheep in Britain. AB - The recent identification of maedi-visna virus infection in three commercial flocks of indigenous sheep in Britain is described. In one flock the evidence suggested that overt clinical disease was present. The implications of the findings are discussed. PMID- 6506431 TI - Increased conception rate in dairy cows after early post partum administration of prostaglandin F2 alpha THAM. AB - Commercial dairy cows were given a routine injection of dinoprost tromethamine (prostaglandin F2 alpha THAM) in the early post partum period. The first service conception rate of 64 cows given a single 25 mg injection of dinoprost during the period 14 to 28 days after calving was 68 per cent, that of 64 untreated controls was 43 per cent. The difference was highly significant at the level P = 0.007. In cows with no blood progesterone and with basal progesterone concentrations at the time of treatment, indicating absence of an active corpus luteum, the mean conception rates for 30 treated and 38 control cows were 70 and 44 per cent, respectively, demonstrating that this is not a luteolytic effect. Although that implies a positive myometrial effect, the interval from calving to first service was not shortened in treated cows. PMID- 6506433 TI - Equine whole saliva: a sample collection system and biochemical analysis. PMID- 6506432 TI - Quantitative evaluation of a transport-enrichment medium for Campylobacter fetus. AB - The enrichment feature of a selective serum-based transport medium for Campylobacter fetus was quantitatively examined. Preputial samples from artificial insemination bulls were spiked with known numbers of C fetus strains and inoculated into transport-enrichment medium (TEM). The survival and multiplication of these strains in TEM under different incubation periods and temperatures were assessed by plate counts. Mean enrichment values of 3.72 log and 4.42 log were observed after incubation at 37 degrees C for two and four days, respectively. There was no significant difference in the enrichment values between the C fetus subspecies venerealis strains and a C fetus subspecies fetus strain. Incubation of inoculated TEM vials at room temperature for up to two days neither improved the growth of C fetus nor affected its subsequent enrichment when the vials were reincubated at 37 degrees C. Comparison of the survival of C fetus with and without the use of TEM under simulated transport conditions demonstrated the superiority of TEM. PMID- 6506434 TI - Melioidosis in a banded leaf-monkey (Presbytis melalophos). PMID- 6506435 TI - Diaphragmatic hernia in a sheep. PMID- 6506436 TI - Mycoplasma hyosynoviae treatment in pigs. PMID- 6506437 TI - Juvenile renal disease in a dobermann. PMID- 6506438 TI - Treatment of canine heartworm disease in Britain. PMID- 6506439 TI - Instability of penicillin in feed. PMID- 6506440 TI - Drug prescription and equine events. PMID- 6506441 TI - Control of sheep scab and other sheep ectoparasites with propetamphos. AB - Propetamphos is a new organophosphorous compound with broad spectrum acaricidal and insecticidal activity. Dip wash concentrations of 100 to 200 ppm protect sheep against field challenge for approximately 10 weeks for blowflies, 16 weeks for lice and keds and six weeks for ticks. During laboratory and field trial studies a wash concentration of 125 ppm propetamphos eradicated sheep scab and protected from reinfestation for over four weeks. PMID- 6506443 TI - Wooldridge Memorial lecture. Pharmacology and new drug discoveries--should veterinarians be interested? PMID- 6506442 TI - Use of pyrethroid impregnated tags in the control of sheep headfly disease. AB - Plastic tags containing 8.5 per cent w/w cypermethrin or 10 per cent w/w permethrin reduced the severity of damage caused to sheep by the headfly Hydrotaea irritans. A similar pattern of protection extended from the tagged ewes to their untagged lambs. Tags containing 8.5 per cent w/w fenvalerate failed to reduce the level of headfly damage in gimmers. PMID- 6506444 TI - When to spay bitches. PMID- 6506445 TI - Anaesthetising reptiles. PMID- 6506446 TI - Effect of passively-acquired antibodies and vaccination on the immune response to contagious ecthyma virus. AB - Lambs which received colostrum from ewes vaccinated with contagious ecthyma (CE) virus and other lambs vaccinated with CE virus were compared for serum anti-CE immunoglobulin (Ig)G levels, delayed-type hypersensitivity (DTH) responses to CE viral antigen, and protective immunity to challenge with CE virus. Ewes vaccinated 3-4 weeks prior to parturition transferred CE antibody to lambs via colostrum. Although these lambs had higher levels of antibody at challenge than lambs vaccinated when 1-4 days old, only the vaccinated lambs were protected against challenge with CE virus at 1 month of age. Furthermore, the presence of colostrum-derived maternal antibody prevented an active antibody response in lambs to vaccination and/or challenge with CE virus, except where pre-inoculation titres were low. In contrast, the DTH response to CE viral antigen and induction of protective immunity by CE vaccination were not impaired by passively-acquired antibody. Actively immunised lambs could be distinguished from those only receiving passively-acquired antibody by the DTH response to heat-killed CE viral antigen. PMID- 6506447 TI - Antibodies to Berne virus in horses and other animals. AB - After inoculation into 2 foals, Berne virus induced neutralizing antibody, but did not cause clinical symptoms. In a horizontal study of seropositive mares and their offspring, a decline of maternal antibodies and a sudden synchronous seroconversion in all foals were observed, again without clinical symptoms. The virus is widespread in the Swiss horse population and has been so during the last decade; rises in antibody titers were noted in 9% of paired sera sampled at random. Positive reactions were also obtained in serum neutralization tests and ELISA using small numbers of horse sera from Germany, France and the U.S.A. The results of neutralization tests and ELISA were correlated in 83% of random samples tested; 13% were neutralization-positive and ELISA-negative and in 4% the inverse was observed. Neutralizing activity was found in the sera of other ungulates (cattle, goat, sheep and pig), laboratory rabbits and 2 species of wild mice (Clethrionomys glareolus and Apodemus sylvaticus). Inconclusive results were obtained with feline and human sera; those from dogs and foxes (Vulpes vulpes) were consistently negative. The probable occurrence of antigenic variants in Berne-type viruses is discussed. PMID- 6506448 TI - Experimental infection of sheep with Mycoplasma ovipneumoniae and Pasteurella haemolytica. AB - A group of Caesarian-derived, colostrum-deprived lambs was inoculated intranasally and intratracheally with a virulent Mycoplasma ovipneumoniae isolate selected from ovine mammary studies and propagated in an ovine mammary gland. Other groups of lambs were inoculated with M. ovipneumoniae in combination with Pasteurella haemolytica type Al or P. haemolytica alone. The M. ovipneumoniae isolate alone did not induce any specific pneumonic lesions in the lambs and when combined with P. haemolytica type Al did not increase the severity of the P. haemolytica-type lesions. Fifty percent of lambs inoculated with P. haemolytica developed a purulent and exudative bronchopneumonia with pleurisy and high titres of P. haemolytica were recovered from these lesions. PMID- 6506449 TI - Humoral immune response of dogs after vaccination against leptospirosis measured by an IgM- and IgG-specific ELISA. AB - An IgM- and IgG-specific ELISA was used to measure the antibody response stimulated in dogs by vaccination with a leptospiral bacterin containing chemically inactivated Leptospira interrogans serotype icterohaemorrhagiae and serotype canicola leptospires. All dogs produced anti-leptospiral IgM and IgG. The IgM production was of the primary response type after each vaccination (primary vaccination, booster vaccination and annual revaccination). A substantial anti-leptospiral IgG response could be demonstrated only after the first booster vaccination and the annual revaccination. Annual revaccination resulted in a higher and much longer persisting IgG response than did the first booster vaccination. A revision of the vaccination scheme is suggested. PMID- 6506450 TI - An investigation of the role of immunologic factors in anemia associated with canine heartworm disease. AB - Direct Coombs' antiglobulin tests were performed on 80 dogs with patent Dirofilaria immitis infection and 170 dogs negative for microfilaria of D. immitis. Presence or absence of anemia was determined by hematocrit in 55 of the heartworm negative dogs and 68 of the dogs with heartworm disease. Heartworm infected dogs showed a higher incidence (37%) of anemia than noninfected dogs (14.5%). Anemia was most prevalent in two groups of dogs with heartworm infection, one group showing vena caval syndrome (91%) and the other occult dirofilariasis (62.5%). These latter two groups of dogs also showed a significantly higher number of positive Coombs' reactions at 37 degrees C than other dogs with heartworm disease and the noninfected dogs. The number of positive Coombs' reactions at 4 degrees C among the total of 80 dogs with heartworm infection was significantly higher than that for dogs without heartworm disease. However, there was no positive correlation between anemia and the outcome of the Coombs' test at either temperature. These findings do not suggest that immunologic factors play a major role in the pathogenesis of anemia in dogs with heartworm disease. PMID- 6506451 TI - Protection of rams against epididymitis by a Brucella ovis-vitamin E adjuvant vaccine. AB - Rams vaccinated at 7 and 8 months of age with a B. ovis-vitamin E adjuvant vaccine had increased antibody titers compared with Freund's incomplete adjuvant or commercial bacterin vaccinated rams. The percent overall infectivity in an experimental infection of B. ovis-vitamin E adjuvant vaccinated rams was 22% compared to 44% for B. ovis-Freund's incomplete adjuvant or bacterin vaccinated rams and 67% for control. PMID- 6506452 TI - Effect of Rhodococcus equi on equine polymorphonuclear leukocyte function. AB - A procedure was developed for isolating large numbers of purified polymorphonuclear leukocytes (PMNs) from the peripheral blood of horses. Equine PMN function was evaluated by three procedures: 1) Staphylococcus aureus ingestion, 2) nitroblue tetrazolium reduction, and 3) iodination. Four preparations of R. equi were added to polymorphonuclear leukocytes (PMNs) in each test system. Live bacteria, heat-killed bacteria, the washed pellet from heat killed bacteria, and the supernatant fluid from heat-killed bacteria were evaluated for effects on equine PMN function. None of the R. equi preparations had an effect on S. aureus ingestion by equine PMNs. Nitroblue tetrazolium reduction by PMNs, a measure of oxidative metabolism, was suppressed by pellet and supernatant fractions. Values for the iodination reaction were depressed by all R. equi preparations, indicating decreased activity of the myeloperoxidase H2O2-halide system of the PMN. Further evaluation of the supernatant from heat killed R. equi showed that it retained its inhibitory effect on iodination following autoclaving and/or passage through a 10,000 MW filter. R. equi fractions did not alter the enzymatic conversion of 125I to a protein-bound form in a PMN-free assay developed to evaluate this reaction. The presence of a surface component capable of inhibiting bactericidal mechanisms of the PMN may play an important role in intracellular survival of R. equi. PMID- 6506453 TI - Increase in the haemolytic complement activity of dogs affected with cyclic haematopoiesis. AB - Cyclic haematopoiesis (CH) is an inherited disorder which occurs in both humans and Grey Collie dogs. The disease is characterized by fluctuations in the numbers of peripheral blood leucocytes, reticulocytes and platelets at regular intervals and is associated with a variety of clinical signs. The most prominent cycle observed is that of neutrophils. The 12-day neutropenic cycle includes a period of relatively normal neutrophil counts, a period of neutropenia and generally a period in which neutrophil counts greatly exceed the normal range. In this study the daily serum haemolytic complement activity (classical pathway CH50) of CH and normal Collie dogs was assayed. The serum CH50 of normal Collie dogs was relatively stable throughout the test period. In contrast, the serum CH50 of CH dogs fluctuated extensively and the mean serum CH50 of CH dogs during the neutropenic cycle greatly exceeded that of normal Collie dogs over the same test period. A close temporal relationship between the stage of the CH neutropenic cycle and the serum CH50 was observed. The mean serum CH50 during neutropenia was not significantly different from that observed when neutrophil counts were within normal range, both values being significantly higher than that of normal dogs. However, the mean serum CH50 during the period of neutrophil rebound was significantly (P less than 0.01) higher than that during the period of neutropenia or normal neutrophil counts. These data suggest that alterations in the production of complement components or regulatory proteins occur at regular intervals in CH dogs. PMID- 6506454 TI - [Microbiological studies of pheasant meat]. AB - Investigations were carried out to establish the total count of aerobic mesophiles and that of coliform bacteria, enterococci, staphylococci, micrococci, and sulfite-reducing clostridia in the meat and internal organs of pheasants that were eviscerated up to 30 and 60 minutes following their killing. It was demonstrated that the total counts of all bacteria mentioned rose 2.8, 2.4, and 2.2 times when studying the meat and viscera of pheasants 60 min after killing as against those found 30 min after killing. Determined was the species composition of the isolated microflora. No Salmonella bacteria, pathogenic staphylococci, and sulfite-reducing clostridia were isolated. PMID- 6506455 TI - [Pathomorphology of acute furazolidone poisoning in calves]. AB - Studied was the morphologic picture in a total of 13 calves spontaneously intoxicated with furazolidon following its overrating and use once and severalfold as a therapeutic means against infectious enteritis. There were hemorrhages in the subcutaneous tissue and the muscles, kidneys, abomasum, spleen, and heart as well as liver dystrophia and hyperemia and edema of the leptomeninges and the brain cortex. Histologically, there were hyperemia, strong and diffuse pericellular and perivascular edema of the cerebrum and the cerebellum with degenerative changes in the Purkinje layer, fatty degeneration and biliary thrombi in the liver, hemorrhages and activation of the endothelial cells and glomeruli of the kidneys, hyperemia and fatty infiltration of the myocardium, and hemorrhages in the spleen. PMID- 6506456 TI - [Clinical cases of infectious coryza and the properties of isolated Haemophilus strains]. AB - Studied were a total of sixteen cases with the clinical picture of coryza. Leading role in eleven of them had Haemophilus, in one the signs of chronical cholera and pox were seen, and in three there was a Pseudomonas aeruginosa infection. All cases were serologically positive for CRD. By their needs of nutrient growth factors the isolated Haemophilus strains belonged to H. paragallinarum, and they proved pathogenic for 8-week-old birds and poults that were about to lay their first eggs, killing 4-7-day-old chick embryos up to the 48 h hour. Tests for resistance to therapeutic means with the use of the disk diffusion method revealed sensitivity to streptomycin, tetracycline, chloramphenicol, gentamycin, erythromycin, spectinomycin, furazolidon, imekil, cosumix, trimetoprim, and sulfadoxin. Good and very good therapeutic and prophylactic effects were produced with the use of sulfotin, cosumix, linkospectin, and trimedin coupled with aerosol disinfection with rivanol, the birds being present on the premise. It is stated that with regard to differential diagnosis coryza caused by Haemophilus paragallinarum should not be confused with fowl cholera, pox, CRD, and Pseudomonas aeruginosa infection which may run their course in a mixed infection. PMID- 6506457 TI - [Achievements, problems and prospects in veterinary medical science]. PMID- 6506458 TI - [Dynamics of a latent epizootic process as evaluated by an incidence-of-infection index]. AB - The index of infection (the number of positive samples to the total number of investigated samples ratio) was used to study the intensity of the inapparent epizootic process in avian salmonellosis. Two flocks of broiler birds were followed up for the presence of Salmonella organisms over the period of hatching up to the end of fattening. The study of samples taken from the cloaca revealed a high index of infection (15 to 31.7 per cent) among the clinically normal birds. Two laboratory tests were carried out to confirm the results. Sixteen, resp., 26 day-old, Salmonella-free birds were kept together with 2 (in each group) birds orally infected with S. isangi. Up to the 13th day (the end of the experiment) the percent of the infected contacts reached 92.3 and 100. This made it reasonable to believe that there was a chain of infections following one after an other among healthy birds maintained by sources of Salmonella organisms--an inapparent epizootic process. PMID- 6506459 TI - [Metabolism of free amino acid in strains of Pasteurella multocida and their division into biological types]. AB - A total of 29 Pasteurella multocida strains were isolated in cases of atypical fowl cholera with swelling of the wattles as well as from pigs and calves with pneumonia. All strains were used to study the metabolism of 10 amino acids. Glutaminic acid was found to be metabolized by all investigated strains. Arginine was metabolized by Pasteurella organisms isolated from mammals (calves and pigs), and was metabolized by Pasteurellae isolated from birds. By their positive reaction with proline and their negative one with alanine the Pasteurella strains isolated in cases of acute cholera differed from all other Pasteurella organisms. Asparagine was metabolized only by Pasteurellae isolated in cases of atypical fowl cholera, and serine--only by Pasteurellae isolated from pigs. PMID- 6506460 TI - [Protective medium for the lyophilization of a live vaccine against swine erysipelas--VR2]. AB - Hydrolysate was obtained through enzyme hydrolysis from waste residual fibrin in the production of hyperimmune swine blood. Fibrin hydrolysate and gelatose in 2.5 : 1.5 ratio were tested as protective medium for the freeze-drying of VR2 vaccine against swine erysipelas. It was found that the freeze-drying of the vaccine with the addition of the hydrolysate-gelatose medium at the rate of 4-5 per cent of the vaccine volume met the requirements of the standard for sterility, innocuity, vaccinal titer, and residual moisture. PMID- 6506462 TI - [Quality of meat from lambs fattened on feed mixtures with added bacterial protein]. AB - Physico-chemical, microbiologic, and histologic investigations were carried out with meat and parenchymal organs of lambs offered feed mixtures with a supplement of bacterial protein on methanol basis in fattening the animals up to 35 kilograms. The addition of 5 per cent bacterial protein which replaced in terms of protein equivalent 60 per cent of the sunflower oil meal and totally the amount of urea in the mixtures had no negative effect on the physical and chemical composition of the meat and its biologic value. Histologically, no degenerative changes in the skeletal muscles and parenchymal organs were found. There was hypofunction of the thyroid gland in the test lambs. No pathogenic and occasionally pathogenic organisms were found in the sampled meat and organs. PMID- 6506461 TI - [Fatty acid content of the lipid fraction of the meat of chickens fed mixed feeds with added bacterial protein]. AB - Studies were carried out to establish the content of fatty acids in the lipid fraction of the meat of birds that were given combined feeds with the supplement of bacterial protein. A Perkin Elmer gas chromatograph with a flame-ionization detector were used to evaluate the fatty acid content. It was found that with the increase in the bacterial protein content of the feed mixtures there was a rising trend in the sum total of the unsaturated fatty acids (C16:1, C18:1, C18:2) and a lowering one of the saturated fatty acids (C14, C16, C18) as against their content in the meat of the control group. PMID- 6506463 TI - [Conditions for lipid extraction and their quantitative determination in meat products]. AB - Stated are the conditions under which the extraction of lipids and their quantitative evaluation by classes in meat products could be carried out through the combined use of thin-layer and gas chromatography. The amounts of neutral class lipids were determined by the high-molecular fatty acids contained in them in the form of methyl esters. Their re-esterification was performed directly on silica gel with methanol and BF3 catalyst in a strongly alkaline medium in airtight flasks. There was methylation not only of the free fatty acids, but also of the bound ones thanks to the processes of saponification and esterification which ran their course simultaneously. This procedure shortened the time for analysis and made analytical work more feasible. Differences were found in the content of triglycerides and free fatty acids between Rousse ham, Hemous alami, and Turnovska loukanka (a highly seasoned sausage) that were due to he various technologic regimes of production, at a standard error of the mean values of from 0.11 to 1.11. PMID- 6506464 TI - Characteristics of smooth eye movements with stabilized targets. AB - Eye movements of two subjects were recorded with a Double Purkinje Image Tracker while they pursued horizontal triangle or ramp stimuli (1, 2, 4 or 8 degrees/sec, p--p 8 degrees). Subjects then attempted to imitate their smooth pursuit eye movement patterns with an electronically-stabilized target or with an afterimage. Next, they attempted to reset the velocity of the stimulus to their memory of the velocity they had previously pursued. The smooth pursuit eye movements of both subjects were very similar. Their attempts to imitate this pattern of eye movements with a stabilized target were only partially successful and subject to large, qualitative individual differences. These differences did not arise from faulty memories of the nature of the pursuit stimuli. Similar results were obtained on the vertical meridian, with a lighted background, and with the stabilized target in eccentric retinal positions. We conclude that stabilization techniques are of dubious value in elucidating properties of the human smooth pursuit subsystem. PMID- 6506465 TI - Color perception under contralateral and binocularly fused chromatic adaption. AB - Observers viewed a thin (1.0-1.5 degree) annular mixture of 450 plus 660 nm light with the left eye, and a 4.8 degrees circular 660 nm adapting field with the right eye. The annular test was centered upon the adapting field in the fused percept. The contralateral field, which bleached negligible photopigment, caused the test to appear more reddish; however quantitative results reject the hypothesis that a given contralateral 660 nm light simply adds redness to the test. Additional experiments with a separate 660 nm adapting light presented to each eye reveal that fused chromatic adapting fields affect a complex central mechanism. For example, a dim background presented to the same eye as the annular test can reduce the effect of an opposite-eye field, even when the dim test-eye background has no measurable influence in a purely monocular experiment. PMID- 6506466 TI - Detection and identification of spatial frequency: models and data. AB - Detection and identification of up to four simple sinusoidal gratings were studied. The experimental results were quantitatively compared to predictions from several models. The models all assumed probabilistically independent channels sensitive to different ranges of spatial frequency. The models differed in the shapes of their underlying distributions and, for detection, their decision rule. Detection and identification of far-apart spatial frequencies were consistent with these models. Thus, uncertainty effects for both detection and identification (the decrease in performance with an increase in the number of possible spatial frequencies) can be explained without assuming that attention capacity is limited. PMID- 6506467 TI - Spatial contrast sensitivity of the tree shrew. AB - Spatial contrast sensitivity functions (CSFs) were measured for 3 tree shrews. Our two-alternative forced-choice discrimination paradigm required the animals to discriminate a vertical sine-wave luminance grating from a homogeneous field of the same size (16 degrees) and mean luminance (35 cd/m2). Spatial frequencies tested ranged from 0.1 to 2.0 c/deg and grating contrast was varied trial-by trial using a modified staircase technique. Small between-subject variations in the shape of the CSFs appeared to be correlated with our estimates of refractive error for each animal. In general, the CSFs were of the typical band-pass type with peak sensitivity occurring at approximately 0.7 c/deg. Estimates of grating acuity derived from the CSFs ranged from 1.2 to 2.4 c/deg and are within the limitations set by the eye size and retinal anatomy of the tree shrew. PMID- 6506468 TI - Interocular transfer and dark adaptation to long-wave test lights. AB - Extrafoveal thresholds for 660 nm test flashes were measured for the two eyes separately following 30 min of dark adaptation. Then, the right eye was exposed to red light while the left eye was covered. Thresholds in the adapted right eye recovered to a plateau raised about 0.3 log units above the level measured in the dark. In contrast, thresholds in the nonlight-adapted left eye dropped by about 0.3 log units. These effects persist for about 15 min. They may be accounted for in terms of a hypothetical interocular inhibitory mechanism. Results of changing the intensity, duration and wavelength of the light adaptation upon this effect are described. PMID- 6506469 TI - A study of stimulus range effects in free modulus magnitude estimation of contrast. AB - The exponents of perceived contrast functions determined for sine wave gratings varied from 1.1, when perceived contrasts were estimated over a 0.6 log unit range of stimulus contrast, to 0.56 when perceived contrasts were estimated over a 1.9 log unit range of stimulus contrast. Intermediate stimulus contrast ranges produced intermediate exponents. This contrast range effect appears to account for the different exponents reported in previous magnitude estimation studies and for the fact that some studies show an exponent increasing with increasing spatial frequency while others do not. PMID- 6506471 TI - The perception of depth in simple figures. AB - When subjects with good stereoscopic acuity are given the task of judging which of two vertical lines lies nearer, the presence of other features nearby alters the perceived depth within the test pair. In the presence of a single flanking line shown with disparity, the test line pair is seen as fronto-parallel when it has disparity in the direction which tends to align it in depth with the flanking line. The notion of "salience" is introduced. This is the summed disparity- weighted approximately inversely with distance--between test objects and their neighbours. We make the hypothesis that objects appear at equal depths when they have equal salience. The salience hypothesis accounts for a variety of depth interaction effects between test lines and adjoining features, such as one or more other lines and a lattice of dots with a disparity gradient. Whether features other than nearest neighbours influence depth judgments depends on the individual. For five good stereo subjects, in two a single line completely masked all effects beyond the nearest neighbour, two others had partial masking, and one had none. If the visual system is interested in corners between planes in depth and in objects protruding from such planes, then salience constitutes a useful indicator for this purpose. PMID- 6506470 TI - Spatial frequency tuning in the visual evoked potential elicited by sine-wave gratings. AB - This investigation examined the onset response of the transient visually evoked potential elicited by the appearance-disappearance of sine-wave gratings at various levels of spatial frequency, suprathreshold contrast, and stimulus duration. The response was most easily characterized by two negative-positive complexes that were differentially tuned to spatial frequency. The earlier complex peaked at high spatial frequencies while the later complex peaked at low spatial frequencies. For both complexes, amplitude showed only slight variations across three-octave ranges of contrast and duration. Latency was curvilinearly related to spatial frequency, decreased with increasing contrast, and showed no apparent change as a function of duration. PMID- 6506472 TI - The influence of background motion on the motion aftereffect. AB - The motion aftereffect caused by adaptation to moving bars is visible in a stationary test pattern consisting of static visual noise (texture). The aftereffect resulting from adaptation to moving bars presented on a background of texture is highly dependent on the direction and velocity of motion of the background during adaptation, and less dependent on the nature of the test pattern. Background motion in the same direction as bar motion during adaptation enhances the aftereffect, whilst a stationary background or background motion in the opposite direction suppresses, and in some cases reverses the direction of, the aftereffect. The influence of background motion is greatest using a textured test pattern, a low adapting texture velocity, and a low grating spatial frequency. The physiological implications of these results are discussed. PMID- 6506473 TI - Illusory motion in visual displays. AB - The apparent motion of a change in the structure of a random check pattern is studied by spatially masking it with another noise pattern and it is compared with phi motion. A fundamental difference with phi motion is the insensitivity of second order correlators (Reichardt mechanisms) to this apparent motion. The following experimental characteristics distinguish this motion from phi motion: it induces no motion after-effect, it is not transparent to another simultaneous motion, it is strongly influenced by spatial masking and it does not evoke optokinetic nystagmus. A fourth order detector is introduced which is sensitive to this illusory motion as well as to phi motion. Simulation experiments with this detector together with the subjective reports of the observers lead us to the conclusion that human subjects inadvertently treat the coarsest spatial structures as signal and the finest as the disturbing noise. PMID- 6506474 TI - Why the cortical magnification factor in rhesus is isotropic. AB - We examine the arguments advanced recently [by Sakitt (Vision Res. 22, 417-421, 1982), and Tootell et al. (Science 218, 902-904, 1982)] leading to the conclusion that the retino-cortical magnification factor cannot be isotropic. The relevance of the issue is discussed through the use of complex function theory as the appropriate tool to express the geometry of interconnections between neural lamina. A general expression is obtained to compute the length of a curve under a conformal transformation. When this result is applied to circles in the visual field, it is shown that Sakitt's findings imply radial asymmetry of the retino cortical map, and not local anisotropy, as claimed. In fact, by taking Schwartz's (Vision Res. 20, 645-670, 1980) proposal that the complex log map including a constant eccentricity term be used to represent the retino-cortical mapping, we show that both local isotropy and radial asymmetry are simultaneously valid. Furthermore, the values of cortical length predicted from this approach account exactly for the data shown by Sakitt. A quantitative prediction is offered also for the ratio between the magnification factor of vertical and horizontal meridians at different eccentricities, which is precisely the value reported by Tootell et al. We conclude that these results show that (1) conformal transformations are appropriate tools to describe the geometrical interconnections between neural lamina; (2) for the case of the retino-cortical mapping the appropriate conformal transform is an eccentric complex logarithm. PMID- 6506475 TI - Diffusion of the retinal layers of the living human eye. AB - We measured the modulation depth of an interference pattern after double passage through the eye with different entry positions of the linearly polarized incident beam in the pupil plane. This shifting of the incident beam greatly modifies the mean irradiance and the modulation depth of the aerial image, whatever the direction of the polarizer. These measurements give a better understanding of the respective contributions of the retinal layers to the formation of the aerial image. Consequently, the modulation transfer function of the optics of the eye deduced from measurements with the aerial image must be considered cautiously. PMID- 6506476 TI - Photopic spectral sensitivities of the red and the yellow field of the pigeon retina. AB - The spectral sensitivities of the red field and the yellow field in the retina of the homing pigeon (Columba Livia) were determined on the basis of ERG responses. Between 450 and 550 nm the relative spectral sensitivity of the yellow field turned out to be higher than that of the red field. The results are in agreement with spectral sensitivity data, obtained by behavioural threshold procedures. PMID- 6506477 TI - Contrast sensitivity for stationary gratings. PMID- 6506478 TI - Spatial visual channels in the Fourier plane. AB - Properties of human spatial visual channels were studied in two-dimensional form by a signal detection masking paradigm. Tuning surfaces of contrast threshold elevation induced by a sinusoidal mask were generated for four Subjects, interpolated from an 11 X 11 Cartesian grid over the Fourier plane, and numerically Fourier transformed in two dimensions to infer putative filter profiles in the 2D space domain. Among the main findings in the 2D frequency domain were: (1) Threshold elevation surfaces are highly polar nonseparable--they cannot be described as the product of a spatial frequency tuning curve times an orientation tuning curve. (2) Iso-half-amplitude contours of the spectral tuning surfaces have a length/width elongation ratio of about 2:1. (3) Necessarily, resolution for spatial frequency and for orientation are in fundamental competition with 2D spatial resolution. By calculating the occupied area of the inferred filters both in the 2D space domain and in the 2D frequency domain, it was estimated that these mechanisms approach within a factor of 2.5 of the theoretical limit of joint resolution in the two 2D domains that can be derived by 2D generalization of Gabor's famous Theory of Communication (1946). Other classes of 2D filters, such as an ideal 2D bandpass filter, have joint 2D entropies which are suboptimal by a factor of 13 or more. Subject to the inherent constraints on inference from these 2D masking experiments, the evidence suggests that 2D spatial frequency channels can be described as elongated 2D spatial wave packets which crudely resemble optimal forms for joint information resolution in the 2D spatial and 2D frequency domains. PMID- 6506479 TI - Nonlinear codes for the yellow/blue mechanism. AB - The opponent yellow/blue mechanism is studied by means of an iso-cancellation technique. A qualitative and quantitative analysis of different photopigment models for the yellow/blue code is presented. On the basis of this analysis we provide a new model which ascribes the nonlinear character of the code to a power transformation of the short wave cone activity. This new model leads to predictions concerning the wavelength shift of the short wave component of a unique red. Tests of these predictions support the new model. PMID- 6506480 TI - The connections of the retinal on and off pathways to the lateral geniculate nucleus of the monkey. AB - This study examined the manner in which the On and Off systems originating in the retina make their connections with the lateral geniculate nucleus (LGN) of the rhesus monkey. 2-amino-4-phosphonobutyric acid (APB) was either infused or injected into the vitreous chamber of the eye to block the On channel while the response properties of LGN cells were assessed. APB in concentrations of 50-600 microns effectively blocked On-center cell responses in the LGN. The responses of Off-center cells were not affected significantly, although some cells showed a brief period of response increment following APB infusion while other cells showed a small response decrement. The sustained component of the response of On center cells was blocked more effectively, more quickly and at lower concentrations than was the transient component of the response. Parvocellular cells were blocked at lower concentrations and for longer time periods than were magnocellular cells. Both the center and the surround responses of On-center cells were blocked by APB. The center and the surround responses of Off-center cells were not affected differentially by APB administration. Blue On-center responses were also blocked by APB. These results suggest that in the monkey the On and Off channels originating the retina remain functionally separated at the level of the LGN. PMID- 6506481 TI - A multiple-channel model for grating detection. AB - The multiple-channel model that was proposed in 1974 by MacLeod and Rosenfeld to describe the sensitivity of the visual system to complex gratings has been applied to a variety of complex gratings. The model predicts correctly the contrast sensitivity at both high and low spatial frequencies to square-wave gratings, square-wave with missing fundamental, sawtooth-wave, and trapezoid-wave gratings of different ramp widths. It provides a physiologically reasonable explanation of the detection of luminance gradients without requiring special gradient detectors. The model resembles the threshold behavior of the visual system in that it is sensitive to the relative phase of frequency components at low frequencies, but not at high frequencies. PMID- 6506482 TI - Fluorescent tube light evokes flicker responses in visual neurons. AB - Single neurons in the cat visual system respond distinctly to the temporal information present in light from fluorescent tubes driven by 50 or 60 Hz alternating current. Despite the resulting flicker frequencies of 100 or 120 Hz all retinal and most thalamic neurons show strong phase locking of the neuronal responses to the modulation of fluorescent tube light. Some retinal ganglion cells have not yet reached their critical flicker fusion frequency under such conditions. Though usually beyond perception, the frequency and depth of modulation of artificial light thus might well play a role in biological light effects. PMID- 6506483 TI - Measurement of the mechanical stiffness in cyclotorsion of the human eye. AB - We have measured the stiffness in cyclotorsion of the human eye using a scleral suction contact ring mounted on a shaft fitted with an eddy current motor to provide the torque to turn the eye and a shaft-position-encoder to register the torsion. The relation proved to be almost linear within the measuring range in four subjects with constant slope values of about 0.75, 0.60, 0.55 and 0.45 g . cm/deg. The average, 0.6 g . cm/deg, equals 0.5 g if applied at the radius of the globe. This value is rather low compared to the values obtained by other authors for horizontal eye movements. This may be due to different length-tension characteristics of oblique muscles compared to recti muscles. PMID- 6506484 TI - The efficiency of the central and peripheral retina in driving human optokinetic nystagmus. AB - Previous experiments to decide whether the gain of optokinetic nystagmus (OKN) is increased or decreased by occlusion of the central retina involved the use of stationary edges on the occluder and unmatched contrasts. With these factors controlled, it was confirmed that OKN gain is severely reduced by occlusion of the central retina but only at stimulus velocities above about 30 degrees/sec. The gain of horizontal OKN was found not to increase with increasing width of the display if the lateral edges are blurred. The high gain of centrally driven OKN may be related to the ability of higher mammals to stabilize the images of objects at a given distance in a complex parallactic visual field. PMID- 6506485 TI - An inherent nonlinearity in near-threshold contrast detection. AB - We measured an essentially normal pedestal effect using stationary gaussian targets and slowly moving pedestal gratings. Since these conditions greatly reduce the information provided by the pedestal, we question whether uncertainty about the stimulus can be the main cause of the pedestal effect. PMID- 6506486 TI - Facilitatory and inhibitory after-effect of spatially localized grating adaptation. AB - Aftereffects of spatially localized grating adaptation were measured for different locations of the adaptation grating relative to test grating. When the adaptation grating was located on or near the retinal area occupied by the test grating, contrast sensitivity was markedly reduced. When the adaptation grating was spatially separated from the test grating, contrast sensitivity was significantly increased. This aftereffect of spatially localized grating adaptation suggests that spatial-frequency-selective detectors are not spatially independent, but tonically inhibited by spatially contiguous mechanisms. Thus the adaptation of these mechanisms might cause an increase in contrast sensitivity of detectors subserving the test grating. PMID- 6506488 TI - The razor's edge: a dichotomy between monohedral and dihedral edge perception. AB - The "motion-induced contour" is seen in an image where a motion sequence specifies a dihedral edge. Five experiments examined the role of dihedral angle size in the perception of this illusory contour. Observers used free magnitude estimation of contour perceptibility; the data were analyzed by a repeated measures ANOVA and Newman-Keuls procedure. It was found that planar motion is the motion-induced contour in the "dihedral edges" where the dihedral angles are 45, 90, or 135 deg. However, the "monohedral edge," where the dihedral angle is zero, does not show a superiority of three-dimensional motion over planar motion. The difference between these two classes of edges is described in terms of ecological optics. PMID- 6506487 TI - Spatial properties of red-green and yellow-blue perceptual opponent-color response. AB - Opponent color responses for an equal illuminance spectrum were measured for field size from 10' to 2 degrees, by means of a hue cancellation procedure. Results showed that when the field diameter was increased, the red and yellow response relatively increased and the green and blue response relatively decreased. There existed a different spatial property between the red-green and yellow-blue opponent-color response function. The results were compared with the optical density hypothesis of the cone visual pigments and with the neurophysiologically obtained receptive field properties of opponent-color cells. PMID- 6506490 TI - Utilization of short-stay hospitals. Annual summary. PMID- 6506489 TI - Health indicators for Hispanic, black, and white Americans. PMID- 6506491 TI - Patterns of ambulatory care in office visits to general surgeons: The National Ambulatory Medical Care Survey. United States, January 1980-December 1981. PMID- 6506492 TI - Trends in teenage childbearing. United States 1970-81. PMID- 6506493 TI - Birth and fertility rates for States. United States, 1980. PMID- 6506494 TI - [Immunologic aspects of ischemic heart disease in women of reproductive age]. PMID- 6506495 TI - [Anti-aggregation effect of verapamil in healthy persons and in patients after myocardial infarct]. PMID- 6506496 TI - [Nitrogen balance in viral hepatitis B]. PMID- 6506497 TI - [Radioimmunoanalytic determination of surface antigens and nuclear antibodies of hepatitis virus B. Comparison of the AUSRIA/CORE, AUSRIA II-125 and CORAB kits]. PMID- 6506498 TI - [The effect of alkylating cytostatics on the development of secondary malignant tumors]. PMID- 6506499 TI - [A 2-year echocardiographic study of patients with irreversible renal failure]. PMID- 6506500 TI - [Hemodynamics of acute myocardial infarct. I. Methods of invasive measurement]. PMID- 6506501 TI - [Hemodynamics of acute myocardial infarct. II. Assessment of variables and the norms]. PMID- 6506502 TI - [Hand mirror cell leukemia]. PMID- 6506503 TI - [Wegener's granulomatosis--an uncommon form with a rapid course]. PMID- 6506504 TI - [Rheocardiographic study during the isometric loading test]. PMID- 6506505 TI - [Carotid sinus syndrome manifested as spontaneous syncope states]. PMID- 6506506 TI - [Invasive electrophysiologic methods in the diagnosis of sick sinus syndrome]. PMID- 6506507 TI - [Linoleic acid in patients with ischemic heart disease]. PMID- 6506508 TI - [Index of atherogenicity in forestry workers. Comparison of samples of the Czech and Vietnam populations]. PMID- 6506509 TI - [Reliability of HLA typing. Analysis based on the results of repeated testing in paternity disputes]. PMID- 6506510 TI - [Antihypertensive effectiveness of a domestically manufactured preparation of prazosin (Prazosin VUFB)]. PMID- 6506511 TI - [Empyema of the chest in a patient receiving regular hemodialysis treatment]. PMID- 6506512 TI - [Inhibitors of the slow Ca++ current and their cardioprotective effect]. PMID- 6506513 TI - [Hemodynamics of acute myocardial infarct. III. Hemodynamic groups]. PMID- 6506515 TI - [Means for further improvement in military ophthalmology]. PMID- 6506514 TI - [Hemodynamics of acute myocardial infarct. IV. Comparison of hemodynamic and clinical groups]. PMID- 6506516 TI - [Method for determining the optimal level of carryover stock of medical stores in a medical installation or unit pharmacy]. PMID- 6506517 TI - [Experience with the programmed control of student instruction in a military department]. PMID- 6506519 TI - [Estrogen content of the blood of men with chronic hepatitis and liver cirrhosis in various phases of the disease]. PMID- 6506518 TI - [Temporary endocardial electrical heart stimulation in disorders of heart rhythm and conduction]. PMID- 6506520 TI - [Potentials for the rapid restoration of work capacity in operations specialists]. PMID- 6506521 TI - [Basic research trends in the field of medical support for flight safety]. PMID- 6506522 TI - [Metabolic function of sailors during a cruise]. PMID- 6506523 TI - [Role of an active surgical procedure in treating acute cholecystitis]. PMID- 6506524 TI - [Pathogenetic therapy of neurodermatitis with concomitant chronic focal infection of the nasopharynx]. PMID- 6506525 TI - [Emergency care in the acute form of ischemic heart disease at the first-aid stage]. PMID- 6506526 TI - [Electrical technology for medicine]. PMID- 6506527 TI - [Effectiveness of treating enuresis with Eleutherococcus (People's Republic of Bulgaria)]. PMID- 6506528 TI - [The progressive collective]. PMID- 6506529 TI - [Nonparametric comparison methods in trials of hypotheses on risk factors]. PMID- 6506530 TI - [Philosophy and the psychosomatic problem of medicine]. PMID- 6506531 TI - [Organization of triage at a regimental medical center]. PMID- 6506532 TI - [Training of military otorhinolaryngologists to perform the duties of garrison specialists]. PMID- 6506534 TI - [Trends in the further improvement of dispensary work in the Army and Navy]. PMID- 6506533 TI - [Effectiveness of therapy in severe craniocerebral injury combined with acute massive hemorrhage]. PMID- 6506535 TI - [Effect of mountain conditions on the immunological resistance of young people]. PMID- 6506537 TI - [Basic principles of the development of a system for the occupational psychological selection of servicemen and its performance]. PMID- 6506536 TI - [Determination of the risk factors in the development of borderline mental disorders, by electropolygraphic analysis]. PMID- 6506538 TI - [Experience in the treatment and rehabilitation with viral hepatitis patients on a hospital ship on a long cruise]. PMID- 6506539 TI - [Ways of shortening the time of patient treatment in planned surgery]. PMID- 6506541 TI - [Medical rehabilitation of dental patients]. PMID- 6506540 TI - [Use of a photoelectric device for determining the degree of fracture consolidation]. PMID- 6506542 TI - [Increased reliability of laboratory information]. PMID- 6506543 TI - [Diagnosis of acute appendicitis using a working classification of its symptoms]. PMID- 6506544 TI - [Characteristics of medical support for personnel in the Arctic]. PMID- 6506545 TI - [Use of the UPO-16 suturing apparatus in gastric resection]. PMID- 6506546 TI - [A needle stabilizer for an extrafocal osteosynthesis apparatus]. PMID- 6506547 TI - [To new limits]. PMID- 6506548 TI - [Characteristics and significance of coronary collateral circulation in patients with total occlusion of the left main branch of the coronary artery]. PMID- 6506550 TI - [Serum lipids and ischemic cerebrovascular disorders]. PMID- 6506549 TI - [Chemical changes in CPD-blood]. PMID- 6506551 TI - [Yersinia enterocolitica--possibilities of its isolation on differential and selective media]. PMID- 6506553 TI - [Control of the maintenance of military medical equipment]. PMID- 6506552 TI - [Dissimulation of epilepsy by soldiers]. PMID- 6506554 TI - [Anesthesia in patients with ischemic heart disease]. PMID- 6506555 TI - [Radioisotope study in heart disease]. PMID- 6506556 TI - [Difficulties in the diagnosis of abdominal typhus. 3 case reports]. PMID- 6506557 TI - [Garcin's syndrome]. PMID- 6506558 TI - [Development of studies on the functional system in health resort science and physiotherapy]. PMID- 6506559 TI - [Theory of functional systems and its role in the solution of problems of medical climatology]. PMID- 6506560 TI - [Effect of Nishka Banya radon baths on arterial pressure and phase structure of cardiac rhythm in patients with arterial hypertension]. PMID- 6506561 TI - [Effect of heat-treated Naftusia mineral water on bile-producing liver function in rats (experimental study)]. PMID- 6506562 TI - [Conservative treatment of lumbofemoral extension rigidity in children and adolescents with lumbar osteochondrosis]. PMID- 6506563 TI - [Thermoregulation in adolescents with diffuse neurodermatitis and psoriasis and its changes during sulfide balneotherapy]. PMID- 6506564 TI - [Use of a modified method of electrosleep in the treatment of neurostomatological diseases]. PMID- 6506565 TI - [Methods of complex functional rehabilitation treatment of inveterate humeral fractures and fractures of bones of the elbow joint associated with peripheral nerve injuries (in the system of surgical treatment]. PMID- 6506566 TI - [Medico-climatic and heliophysical characteristics of Moscow]. PMID- 6506567 TI - [Effect of a low-frequency alternating magnetic field on the course of pyrogenal induced fever]. PMID- 6506568 TI - [Reaction of the human body to heat in a sauna]. PMID- 6506569 TI - [Effect of decimeter-range waves at various localizations on platelet aggregation in patients with cerebral infarct]. PMID- 6506571 TI - [Criteria for the classification of mineral waters without specific components and properties]. PMID- 6506570 TI - [Effect of changes in atmospheric pressure on enzyme activity in the lymphocytes and organs of mice]. PMID- 6506572 TI - [Safe method of decantation of a radium salt solution or other highly toxic liquid from a damaged diffuser into a new one]. PMID- 6506573 TI - [Analysis of various problems of physical therapy in relation to the theory of functional systems]. PMID- 6506574 TI - [Mechanical and automated methods of preparation of therapeutic mud mix and conduction of irrigation of the intestine]. PMID- 6506575 TI - [Thiamine triphosphate content of the liver of albino rats with different levels of thiamine]. AB - Content of thiamine triphosphate (TTP) was studied in rat liver tissue under conditions of normal state, thiamine deficiency and after loading with thiamine. The concentration of TTP in hepatocytes of control animals was found to be 3.2 3.6 micrograms/g, corresponding to 40% of the total thiamine pool in the cells. The TTP appears to serve as a reserve of vitamin B1 deposited in mitochondria of the cells in which the biosynthesis of thiamine pyrophosphate of their own did not take place. Administration of thiamine did not induce the TTP overproduction in hepatocytes; the content of TTP was maintained in the mitochondria of the hepatocytes at the constant level. PMID- 6506576 TI - [Comparative characteristics of several properties of the estradiol-binding system of the human uterus and fallopian tubes]. AB - Kinetic and thermodynamic parameters of estradiol-receptor interactions were studied in cytosol of human uterus endometrium and of uterus tubes. Specificity of these reactions was investigated. The receptor systems studied were distinctly dissimilar in the values of Ka equilibria, rate constants of association and dissociation with estradiol as well as in the affinity to a series of natural and synthetic estrogens. PMID- 6506577 TI - [Structural-functional analysis of single-stranded particles of rat liver DNA]. AB - A base composition of single-stranded DNA regions differed from those of total rat DNA mainly due to increase in content of 5-methylcytosine. Content of this base in the regions studied reduced with age and after cortisol administration. The single-stranded regions appear to shield the informative DNA sequences. PMID- 6506578 TI - [Effect of the conditions of isolation of free and bound ligands on the accuracy of the radioimmunoassay of steroids]. AB - Testosterone radioimmunoassay (RIA) was used to analyse the factors which influenced the precision and accuracy of steroid RIA. Selection of optimal parameters (concentrations of activated charcoal and of the radioactive steroid) was necessary in order to reduce the influence of non-specific binding and error of fractionation on the RIA results. The scheme for estimation of the optimal values of these parameters is described. PMID- 6506580 TI - [Distribution of free amino acid in blood plasma and erythrocytes in Becker-Kiner muscular dystrophy]. AB - Content of free amino acids was altered in blood plasma and erythrocytes of patients with Becker-Kiner progressive muscular dystrophy; these alterations were more distinct in blood plasma as compared with erythrocytes. Spectra of individual free amino acids were distinctly altered both in blood plasma and erythrocytes. Development of the myodystrophia process correlated with alterations in glycogen and branched-chain amino acids content. The data obtained suggest the important functions of erythrocytes in intertissue transport of free amino acids. Similarity between the alterations, observed in progressive muscular dystrophy and in other pathological states accompanied by accelerated metabolism of proteins, suggests that these impairments are among the components in the adaptation reactions to metabolic stresses. PMID- 6506579 TI - [Spectrophotometric evaluation of diene conjugates]. AB - Primary products of lipid peroxidation in liver tissue (diene conjugates) were extracted using various systems of solvents. In the system heptane-isopropanol 1:1 the diene conjugates were mainly extracted by the alcohol. The procedure for estimation of the tissue diene conjugates involved extraction with heptane isopropanol, purification and spectrophotometric measurement of the extinction in the alcohol fraction. PMID- 6506581 TI - [Changes in blood phospholipid and sugar levels and hemocoagulation in long-term cooling]. AB - Overcooling of organism was accompanied by an initial increase of total phospholipids and sugar in blood serum with the subsequent gradual normalization. PMID- 6506582 TI - [Isolation of orotic acid from the liver and its metabolism in the rat]. AB - A method is described for isolation of orotic acid from rat liver tissue for study of the kinetics of its radioisotopic labelling. Within 24 hrs after injection of 400 mg hydroxylamine per kg of body mass, the concentration of hepatic orotate decreased, while its transport into liver tissue and the kinetics of labelling of its endogenous pool remained unaffected. PMID- 6506584 TI - [Interaction of the pentosephosphate cycle and nucleic acid metabolism during the healing of experimental fractures]. AB - In healing of rat femur fracture activity of glucose-6-phosphate dehydrogenase and total content of nucleic acids were increased in callus, reaching the maximal value within 1 week after the fracture and decreased down to the level observed in intact controls within 10-15 weeks. The enzymatic activity correlated closely with the content of nucleic acids. The data obtained suggest that the tissue reparation depends considerably on the activity of pentose phosphate shunt at the initial periods of healing, which has to be taken into consideration in studies on stimulation of consolidation process. PMID- 6506583 TI - [Effect of alpha-tocopherol and hyperbaric oxygenation on lipid fatty-acid composition of the plasma in hypercholesteremic rabbits]. AB - When simultaneous effect of alpha-tocopherol and hyperbaric oxygenation on fatty acid composition of lipids was studied in blood plasma of rabbits with experimental atherosclerosis, 3-5-fold increase in activity of lecithin cholesterol acyl transferase was detected (P less than 0.05). At the same time, alterations in the linoleate/oleate ratio were found involving a decrease in phospholipids, free fatty acids and triglycerides as well as an increase cholesterol esters. Concentration of free cholesterol was decreased 1.5-fold. PMID- 6506585 TI - [Levels of biogenic amines in the salivary and lacrimal glands in experimental staphylococcal pancreatitis in rats]. AB - Staphylococcal intoxication caused distinct alterations in content of biogenic amines estimated in salivary, lacrimal and pancreatic glands. Development of pancreatitis was accompanied by a decrease in content of adrenaline and noradrenaline in all the glands studied, while histamine content was increased in pancreas and-unaltered in salivary and lacrimal glands. PMID- 6506586 TI - [Biochemical estimation of individual sensitivity to oxygen intoxication in rabbits]. AB - Correlation between a pro-oxidant activity of blood, estimated by means of chemoluminescence in the system H2O2-luminol-blood plasma, and individual sensitivity of rabbits to the effect of oxygen was studied. Alterations in the blood pro-oxidant activity, as shown by treatment of the blood sample with 0.7 MPa of oxygen in vitro, correlated distinctly with the period of convulsions as well as with viability of animals during acute hyperoxia. PMID- 6506588 TI - [Cholesterol content of erythrocytes in humans with different levels of plasma cholesterol]. AB - The mean cholesterol content in erythrocytes of patients, which are not impaired by hepatic diseases is 1.26 +/- 0.02 X 10-13 g/cell and it is not depended on the plasma cholesterol level. PMID- 6506587 TI - [Factors affecting the metabolism and distribution of phenazepam in subcellular fractions of animal hepatocytes]. AB - Metabolism and intracellular distribution of 14C-phenazepam and its derivatives were studied in rat and mice liver tissue. Phenazepam was found mainly in microsomal fraction of the animal hepatocytes, where rapid turnover of the substance occurred. The metabolites formed were uniformly distributed in the cell and penetrated into other tissues. The rates of phenazepam metabolites conjugation and binding with proteins were dissimilar in rat and mice tissues. Metabolism of phenazepam was shown to depend on doses of the drug administered. Incorporation of phenazepam into liposomes affected distinctly its turnover in mice tissues. PMID- 6506589 TI - [Effect of different forms of vitamin A and its combination with vitamin E on the peroxidation of lipids]. AB - Effect of vitamins A and E derivatives on Fe-ascorbate dependent peroxidation was studied by means of thiobarbituric acid test in liposomes prepared from egg lecithin. Retinol, incorporated into liposomes at concentration less than 0.1 mol%, increases the lecithin oxidation, retinyl palmitate was less active and alpha-tocopherol inhibited the reaction. Synergistic effect of alpha-tocopherol and retinol was observed. After simultaneous administration of retinol and alpha tocopherol into liposomes, vitamin A did not accelerate the lecithin oxidation but increased distinctly the inhibitory effect of alpha-tocopherol. This interaction did not occur between retinol and alpha-tocopherol acetate as well as between m-retinyl acetate and alpha-tocopherol. The data obtained suggest that vitamins A and E affect the lipid peroxidation not only via direct participation in free radical oxidation but also due to transformations of biological membranes structure. PMID- 6506590 TI - [Effect of a purine-free diet on the purine phosphoribosyltransferase activity of erythrocytes in patients with Lesch-Nyhan syndrome]. AB - Activity of purine phosphoribosyl transferases was studied in 11 patients with Lesch-Nyhan syndrome before and within 1 or 3 months after beginning of the purine-free diet treatment. The enzymatic activity tended to normalization within 1 month after the dietary treatment but the ratio of the enzymes activity was deteriorated within the subsequent 3 months of treatment. A positive clinical effect of the purine-free diet was noted. PMID- 6506591 TI - Platelet storage in glow discharge-treated polyvinylchloride bags: effects of a plasticizer on platelet hypotonic shock response. AB - The effect of a plasticizer (DEHP) of PVC blood bags on platelet response to hypotonic shock was examined. The response of the platelet concentrate (PC), stored in the bag in which DEHP elution was prevented by glow-discharge treatment, did not change until 72 h of storage. On the other hand, during PC storage in control bags or in plasma containing DEHP, the response decreased approximately linearly. The time course of DEHP incorporation into platelet agreed well with that of the decrease of the response to hypotonic shock. PMID- 6506593 TI - Should the blood donor examination be used to screen for clinically hidden diseases and risk factors as a part of preventive medicine? PMID- 6506592 TI - Monoclonal antibodies to an immunoglobulin allotype marker G1m(f). AB - The properties of a group of mouse monoclonal antibodies (McAbs) specific for the human G1m(f) allotype marker on immunoglobulin G are described. The specificity of all 5 McAbs was anti-Gm(f) in haemagglutination assays detecting the G1m(f) determinant on 6 ng of purified G1m(f) paraproteins. A high dilution (greater than or equal to 1/10(4)) could be used for the majority of McAbs in this assay. In Elisa the G1m(f) marker could be detected in homozygote G1m(f+z-) sera at a serum dilution of greater than or equal to 1/10(4). In Elisa assays the G1m(f) specificity was lost when IgG was bound directly to polystyrene but was restored when IgG was bound via anti-human IgG to the polystyrene plate. A possible conformational change in IgG to account for this loss of specificity is discussed. It is expected that these McAbs with their high titre and increased sensitivity over conventional Gm antisera will allow more detailed analysis of the Gm marker system. PMID- 6506594 TI - [Work organization and equipping of a central dispatcher-controlled station for first aid and emergency medical care in a large city]. PMID- 6506595 TI - [Effectiveness of different regimens of physical rehabilitation with patients with microfocal myocardial infarct]. PMID- 6506596 TI - [Clinical characteristics of repeated attacks of delirium tremens]. PMID- 6506597 TI - [Early diagnosis of cardiac disorders in coal miners]. PMID- 6506598 TI - [Cardiovascular diseases in workers in the mining industry]. PMID- 6506599 TI - [Nature of the effect of cyanuric chloride on the human body]. PMID- 6506600 TI - [Morbidity with temporary loss of work capacity in petroleum refining industry workers in the western provinces of the Ukrainian SSR]. PMID- 6506601 TI - [Dynamics of ionized blood plasma calcium in acute myocardial infarct patients during counterpulsation]. PMID- 6506602 TI - [Suppurative myocarditis with rupture of the myocardium]. PMID- 6506603 TI - [Clinico-immunological characteristics of the course of rheumatism in Afghanistan]. PMID- 6506604 TI - [Staged treatment of rheumatoid arthritis patients using hydrogen sulfide baths and peat-mud applications for the Konopkivka spring]. PMID- 6506606 TI - [Function of the adrenal medullary layer in endarteritis obliterans]. PMID- 6506605 TI - [Variation in Wegener's granulomatosis]. PMID- 6506607 TI - [Phonocardiographic changes in patients with primary pulmonary hypertension]. PMID- 6506608 TI - [Use of encephabol in the combined therapy of chronic cerebral circulatory failure]. PMID- 6506609 TI - [Morphofunctional characteristics of the walls of the major veins in intensified muscle activity]. PMID- 6506610 TI - [Effect of alpha-tocopherol on thrombocyte aggregation activity in chronic cor pulmonale patients]. PMID- 6506612 TI - [Current problems of the pathogenesis, clinical aspects and diagnosis of amyloidosis in pulmonary tuberculous pathology]. PMID- 6506611 TI - [Disorders of microcirculation, hemodynamic indices and external respiratory function in nonspecific inflammatory lung diseases]. PMID- 6506613 TI - [Chediak-Higashi syndrome]. PMID- 6506614 TI - [Characteristics of relapse in pulmonary tuberculosis]. PMID- 6506615 TI - [Device for practicing the venipuncture technic]. PMID- 6506616 TI - [Combined chronic lympholeukemia and myeloma disease]. PMID- 6506617 TI - [Hemodynamic indices of middle-aged and elderly patients suffering from diabetes mellitus and chronic pyelonephritis]. PMID- 6506618 TI - [Circulating immune complexes in pyelo- and glomerulonephritis patients]. PMID- 6506619 TI - [Enzymological mechanisms of arginine and glutamine metabolic disorders in the evolutionary stages of chronic glomerulonephritis]. PMID- 6506620 TI - [X-ray characteristics of the small intestine in Crohn's disease]. PMID- 6506621 TI - [Case of Summerskill's syndrome]. PMID- 6506623 TI - [Problems in the pathogenesis, clinical aspects and treatment of the Pickwickian syndrome]. PMID- 6506622 TI - [Development of elephantiasis in recurrent erysipelatous inflammation]. PMID- 6506624 TI - [Antenna properties of acupuncture needles]. PMID- 6506625 TI - [Treatment and rehabilitation of patients with neurological manifestations of cervical osteochondrosis]. PMID- 6506626 TI - [Diagnostic significance of a cytological study of the fluids from serous cavities]. PMID- 6506627 TI - [Cardiorespiratory system function in those working with tetramethylthiuram disulfide]. PMID- 6506629 TI - [Increased efficiency of the prophylactic examinations of workers and employees in industrial enterprises]. PMID- 6506628 TI - [Use of sodium oxyferriscorbone, lidocaine and therapeutic endoscopy in peptic ulcer]. PMID- 6506630 TI - [Nervous system disorders in those working with copper-containing and other pesticides]. PMID- 6506631 TI - [Current problems of planning under the intensive prioritized development of public health]. PMID- 6506632 TI - [Local treatment of stomach and duodenal ulcers]. PMID- 6506633 TI - [Leiomyoma of the stomach]. PMID- 6506634 TI - [Use of galvanomud in the combined treatment of chronic gastritis patients]. PMID- 6506635 TI - [Regional blood flow, acid-forming and motor functions of the stomach in chronic reflux gastritis patients]. PMID- 6506636 TI - [Efficacy of dispensary care of patients with chronic recurrent pancreatitis]. PMID- 6506637 TI - [Blood content of testosterone, progesterone and aldosterone in patients with chronic hepatitis and liver cirrhosis]. PMID- 6506638 TI - [A case of atypical necrotic pancreatitis]. PMID- 6506639 TI - [Hepatocyte ultrastructure in cholestasis]. PMID- 6506640 TI - [Differentiated treatment of benign hyperbilirubinemia at the Truskavets health resort]. PMID- 6506641 TI - [Changes in the secretion of hypophyseotropic hormones and testosterone in men with chronic glomerulonephritis]. PMID- 6506642 TI - [Interrelation of the structure and function of morphological systems]. PMID- 6506643 TI - [Characteristics of the course of pyelonephritis and its treatment in diabetes mellitus patients]. PMID- 6506644 TI - [Personality study in assessing the mental status of thyrotoxicosis patients]. PMID- 6506645 TI - [Circulating immune complexes in gout]. PMID- 6506646 TI - [Characteristics of the course of gouty arthritis deformans]. PMID- 6506647 TI - [Effect of undevit on the permeability of potassium and sodium cations across erythrocyte membranes in bronchial asthma patients]. PMID- 6506648 TI - [Hypertensive crises of the lesser circulation in patients with chronic or pulmonale]. PMID- 6506649 TI - [Effect of a low-frequency magnetic field on the blood lipoprotein spectrum in hypertension patients]. PMID- 6506650 TI - [Meteoropathic reactions in chronic cholecystitis and hypertension patients at the Mirgorod health resort]. PMID- 6506651 TI - [The transcapillary metabolic index in evaluating microcirculatory function]. PMID- 6506652 TI - [Thyrotropic-thyroid activity of the blood in patients with various manifestations of ischemic heart disease]. PMID- 6506653 TI - [Seasonal characteristics of the late recovery period in young and middle-aged patients after stroke]. PMID- 6506654 TI - [Characteristics of the clinical course of systemic scleroderma]. PMID- 6506655 TI - [Compensatory potentials of the brain in patients with a history of closed craniocerebral injury]. PMID- 6506656 TI - [Characteristics of the course of closed craniocerebral injury in children, the middle-aged and elderly]. PMID- 6506657 TI - [Reactive (functional) hypoglycemia--a report on 4 cases]. PMID- 6506658 TI - [Serum immunoglobulin levels and histomorphological changes in the liver in chronic liver diseases]. AB - The level of serum immunoglobulins were juxtaposed, in the paper, to the histomorphological liver changes of 121 patients with chronic liver diseases. Immunoglobulins were also studied in 33 patients with alcoholic cirrhosis as well as in 66 healthy control subjects. Myelogram was performed to 40 patients. The authors' own actualized histomorphological classification of the chronic liver diseases was used. The patients with chronic hepatitis and cirrhosis have an elevated serum level of immunoglobulins G, A and M, proportional to the degree of the histomorphological liver changes. Most manifested was the increase of IgA in alcoholic cirrhosis, and steatosis, alone or in combination with inflammatory process, induces no substantial changes in serum immunoglobins. Increased number plasmatic cells was established in the bone marrow of the patients with chronic liver diseases, with cirrhosis in particular, suggesting an extrahepatal participation in immunoglobulin biosynthesis. PMID- 6506659 TI - [Changes in the histamine content and morphology of the gastric mucosa in duodenal ulcer after pentagastrin stimulation]. AB - A parallel study on histamine concentration and morphology of biopsy from gastric mucosa, was carried out with 60 patients with duodenal ulcer, prior to and post stimulation with pentagastrin--6 micrograms/kg. Histamine was spectrofluorimetrically determined. The functional-morphological changes that developed were followed up on 15, 30 and 60 min after the stimulation. They were a functional character and were due to disturbed microcirculation of the gastric mucosa: edema, venous stasis and leukopedesis. The latter were progressively increased within the course of 1 hour after the stimulation. The histamine mobilizing effect of pentagastrin was manifested with a short-term decrease, followed by a considerable increase of histamine content in gastric mucosa of the patients with duodenal ulcer. PMID- 6506660 TI - [Minimal change glomerulonephritis, diffuse mesangioproliferative glomerulonephritis and focal and segmental glomerular sclerosis and hyalinosis]. AB - A hypothesis is proposed, according to which the glomerulonephritis with minimum changes, the diffuse mesangioproliferative glomerulonephritis of the focal and segmental glomerular sclerosis and hyalinosis are stages in the development of one and the same glomerulonephritis--idiopathic nephrosis syndrome. The grounds of that presumption are searched in the characteristics of immune pathogenesis, morphological picture and clinical manifestations in the patients with those three clinical-morphological variants of glomerulonephritis. PMID- 6506661 TI - [Curbing of arrhythmias under outpatient polyclinic conditions]. AB - The material has been collected in the course of two years and covers 48 cases with paroxysms of supraventricular paroxysmal tachycardia (28), auricular fibrillation (4) ventricular tachycardia (2), group and polytopic ventricular extrasystoles (14), organic cardiac diseases (30) and 18--inorganic heart diseases. Paroxysms were interrupted by isolamid, tachmalin lidocain via slow intravenous infusion with constant ECG, auscultation and hemodynamic control, monitor follow up. The paroxysms successfully coped were 43. It proved possible to interrupt the rhythm disorders under the conditions of non-integrated polyclinic provided the functional consulting room is well equipped. The problem of early and effective treatment of rhythm disorders even under polyclinical conditions is solved, thus avoiding the unnecessary hospitalization of some of those patients and delay in the effective treatment of the other part of the patients. The early diagnosis and proper therapeutic behaviour of the physician towards the patient from the very first moment of contact to the transportation and hospitalization of the patient is of vital importance. The interruption of rhythm disorders must very cautiously be performed--the ventricular tachycardia and polytopic extrasystoles in particular, that considered only an introductory treatment. PMID- 6506662 TI - [Electrical positions of the heart and its variants in orthogonal electrocardiographic systems]. AB - In a total of 151 healthy subjects the changes in the orthogonal electrocardiographic systems of Frank, McFee, SVEC III and Akulinicev were followed up, in the groups with vertical indifferent and horizontal positions, grouped into three age subgroups and according to age. They were compared with the general groups of the corresponding age and sex. It was established that at the age from 20 to 29, the changes with the systems of Frank, McFee and SVEC III were in RY, in both sexes that index, at vertical position, was increased versus the general group; at indifferent position the same index showed a reduction in males. Akulinicev system revealed changes of SX (increase) and SY (decrease) only at vertical position and only in females. At the age from 30 to 44 the vertical position in both sexes revealed changes only in RY (increase) with Frank, McFee and SVEC III, whereas the horizontal position revealed a decrease of the same index. At the age from 45 to 60 years, changes in some of the systems were established only at the horizontal position--increase of RX mainly in males and with some systems in females--reduction of RY. The statistically significant changes in the individual indices at the various positions subgroups are discussed as well as the possibilities of their differentiation from pathological states (left- and right-ventricular hypertrophy). PMID- 6506663 TI - [Excretion of free and bound catecholamines in the urine of diabetes mellitus patients]. AB - The 24-h excretion of free, conjugated and total fractions of dopa, dopamine, noradrenaline and adrenaline was studied in 32 patients with diabetes mellitus. Adrenaline and dopamine were established to be increased--dopa decreased and noradrenaline--not changed. An attempt is made to explain the hormonal changes on the base of the analysis of the so called synthetic and dissociative coefficients of catecholamines. A moderate reverse correlation of the changes with the age of the patients and duration of diabetes was established as well as lower values in the female-diabetics versus the male-diabetics. The hormonal deviations are associated with the disturbances in the carbohydrate metabolism, have a reactive character and are manifested in insulin-dependent type of diabetes. PMID- 6506664 TI - [Immunological changes in Schonlein-Henoch patients]. AB - The level of serum IgI, A, M, complement titre and circulation immune complexes were studied under clinical conditions of 17 patients with Schonlein-Henoch, active phase. The following changes were established as compared with the control, healthy subjects: four-times increased values of the circulating immune complexes, elevated IgA serum level, and IgG--to a lesser degree and reduced titre of the complement. Prognosis is more unfavourable in patients with extremely high values of the circulating immune complexes and complement consumption. PMID- 6506665 TI - [Analytical reliability of the results of a pH and blood gas study using automatic analyzers]. AB - The analytical reliability was studied of the results from the determination of pH, pCO2, and pO2 obtained by automatic analyzers "Corning 178" and "ABL 2". Control materials Confirm, Certain and Acidbasol were used for that purpose, within the normal, acid and alkaline region, as well as arterial blood. The reproducibility in series and in time for all three parameters correspond to the present day requirements for both preparations (VC: pH--under 0,2%; pCO2 and pO2- under 5%), pH--better for "Corning 178". The accuracy of the results for pH and higher values of pO2 is better (d%: pH--under 0,2%; pO2--under 5%). With the diminution of the values of the latter index--the accuracy deteriorated. The accuracy established for pCO2 is unsatisfactory with both the apparatuses and with all three control materials. The results from the comparative analysis reveal a high-degree positive correlation between the apparatuses (rover 0,9). The analytical reliability established for both automatic pH and blood gases analyzers is sufficient to provide the diagnostic reliability of the results necessary for the clinical practice. PMID- 6506666 TI - [Practicable method for preparing and controlling aqueous solutions of potassium bromide with very precise hydratic density]. AB - With a view to realization the conditions of ultrasedimentative isolation of plasma lipoproteins the correlation between density (d4), coefficient of light refraction (nD20) and concentration (0,72-2,77 mol/l) of aqueous KBr solutions were analyzed. The tendency of alteration in nD20 with the change of d4 of KBr solutions have a linear character and the regression line is presented by the equation: nD20 = 1,1783 + 0,1552. It could be concluded from the analysis that the hydratic density of KBr solutions could be rapidly and very precisely controlled via Abbe refractometer at 20 degrees C. PMID- 6506668 TI - Highlights of the Thirty-Seventh World Health Assembly. PMID- 6506667 TI - Voices in harmony for health for all. PMID- 6506669 TI - Exchange of experience on primary health care. PMID- 6506670 TI - Brain infarction and hemorrhage in young and middle-aged adults. AB - Of 131 young (17 to 44 years) and middle-aged (45 to 55 years) adults who had brain infarction or hemorrhage, the most common etiologic factors were rheumatic heart disease, migraine and oral contraceptive use among the younger group. In contrast, atherosclerotic, hypertensive and diabetes-associated cerebrovascular were the most common causes in the middle-aged group. Patients who have a stroke before age 45 should have prompt, complete laboratory and radiologic testing to define a possible treatable cause. PMID- 6506671 TI - Valued outcomes in the selection of a contraceptive method. PMID- 6506672 TI - Low prevalence of hepatitis B infections among residents of an institution for the mentally retarded in New Mexico. AB - Residential institutions for the mentally retarded are considered high-risk settings for hepatitis B (HB) infection. Accordingly, HB vaccine is recommended for susceptible clients and selected staff of such facilities. However, a serologic screening program among 364 residents of Los Lunas Hospital and Training School (LLHTS) in New Mexico found only 11 residents to be anti-HBc positive (3%) and only one of these residents was also HBsAg-positive (0.3%). The unexpectedly low prevalence of HB infections at LLHTS probably reflects infrequent HB introductions into the institution. Using these serologic data, a vaccination program was instituted to prevent HB infection among LLHTS residents, thereby eliminating the need for mass screening and HB vaccination of LLHTS employees. Serologic screening among residents of other smaller institutions for the mentally retarded is recommended before design of HB prevention programs for clients and staff. PMID- 6506673 TI - Chest pain in adolescents--functional consequences. AB - In prospectively evaluating 100 cases of adolescents with chest pain (along with two control groups), 91 were found to have recurrent chest pain; fewer than 5 had a serious organic cause. Significantly higher school absenteeism occurred in patients with either chest or abdominal pain than in patients without pain. Adolescents with chest and abdominal pain were more likely to be high users of medical services than those with no pain. Most adolescents believed that persons their age could have attacks; 44 of those with chest pain thought their symptom was due to a heart attack. The occurrence of chest pain was not influenced by an adolescent's age, sex, race, smoking status or family structure, nor was it consistently associated with depression. Chest pain is thus a common problem of adolescence that produces considerable functional impairment not attributable to serious underlying disease. PMID- 6506674 TI - What is extraordinary life support? AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Associate Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 6506676 TI - Cough radiculopathy--another cause of pain in the neck. PMID- 6506677 TI - Nephrotic syndrome associated with degenerating uterine leiomyoma. PMID- 6506675 TI - Shigellemia. PMID- 6506678 TI - Prescribing exercise. PMID- 6506679 TI - Withholding or withdrawing extraordinary life support. Optimizing rights and limiting liability. AB - For many years physicians, ethicists and members of the legal community have attempted to minimize ambiguity and unpredictability in making decisions to withhold or withdraw extraordinary life support. Recent developments in national and California law now afford medical care providers unparalleled protection from criminal and civil liability in surrogate decision-making situations. They also reinforce the concept of patient's rights by providing medical care consumers with new and effective mechanisms for enforcing their "right to decide," even after they have lost decision-making capacity. A case in point is California's new Durable Power of Attorney for Health Care, which serves as a model for other jurisdictions that do not have such legislation. Thus, the medical and legal professions, working together, can contribute immeasurably to respectful medical decision making by educating the public about these developments and by adopting policies that reinforce these rights. PMID- 6506680 TI - Preoperative evaluations by an internist--are they worthwhile? AB - The value of preoperative examinations done by internists on ophthalmology patients was assessed. A retrospective chart review of 258 consultations was conducted and information about surgical risk, as defined by strict criteria, was abstracted. A total of 59 surgical risk conditions and 62 incidental problems were detected. In 65% of the risk conditions internists intervened to lessen the patients' risk. Most of these benefits were in patients older than 60 years and very few important problems were detected in those younger than 50. The average cost of the consultation and additional laboratory tests was $146.60. It is concluded that significant benefit was derived at a reasonable cost by patients older than 50 years. PMID- 6506681 TI - The University of Colorado School of Medicine. PMID- 6506682 TI - Chronic obstructive lung disease. PMID- 6506683 TI - Hypertension--indications, goals and potential risks of drug therapy. AB - Double-blind, placebo-controlled studies show that drug treatment of hypertension does not significantly reduce morbidity and mortality at diastolic pressures less than 105 mm of mercury. Nevertheless, most physicians start drug therapy at 90 to 104 mm of mercury. Few reports have dealt with the level to which blood pressure should be reduced. Available data, including reports from two large-scale studies, suggest that excessively low diastolic pressure due to drug therapy may cause an increase in deaths from coronary heart disease. Other studies suggest that reducing diastolic pressure below 100 mm of mercury does not enhance the prevention of complications of hypertension nor the reversal of pretreatment secondary change. Therefore, it is suggested that drug treatment of hypertension should be begun only if diastolic pressure is consistently 105 mm of mercury despite hygienic measures of treatment. A goal diastolic pressure of at least 100 mm of mercury is suggested. PMID- 6506684 TI - Gastrointestinal symptoms of marathon runners. AB - A survey of 707 participants in the 13th Annual Trail's End Marathon in Seaside, Oregon, showed a high incidence of gastrointestinal disturbances, predominantly of the lower tract, associated with long-distance running. The urge to defecate, both during and immediately after running, occurred in over a third of runners. Bowel movements (35%) and diarrhea (19%) were relatively common after running, and runners occasionally interrupted hard runs or races for bowel movements (18%) or diarrhea (10%). Lower gastrointestinal disturbances were more frequent in women than in men and in younger than in older runners. Awareness of the frequency and nature of gastrointestinal symptoms documented by this survey will assist physicians in evaluating abdominal complaints in runners. PMID- 6506685 TI - Use of beta-blockade and hemoperfusion for acute theophylline poisoning. AB - Five adults were treated successfully for severe theophylline poisoning due to intentional overdosage. Clinical features included nausea, tremor, delirium, hypotension and cardiac arrhythmias, metabolic acidosis, hyperglycemia, hypokalemia and hypophosphatemia. No seizures or deaths occurred despite very high serum theophylline concentrations (between 96 and 194 mug per ml). Extreme elevations of plasma catecholamines were documented and are implicated in the toxicity. beta-Blockade with intravenous administration of propranolol hydrochloride was the most effective therapy for theophylline-induced hypotension. All patients were treated with resin hemoperfusion, which resulted in significant clinical improvement and rapid lowering of the serum theophylline level. PMID- 6506686 TI - Magnetic resonance imaging. Part I--physical principles. AB - Magnetic resonance (MR) imaging is the most complex imaging technology available to clinicians. Whereas most imaging technologies depict differences in one, or occasionally two, tissue characteristics, MR imaging has five tissue variables spin density, T(1) and T(2) relaxation times and flow and spectral shifts-from which to construct its images. These variables can be combined in various ways by selecting pulse sequences and pulse times to emphasize any desired combination of tissue characteristics in the image. This selection is determined by the user of the MR system before imaging data are collected. If the selection is not optimal, the imaging process must be repeated at a cost of time and resources. The optimal selection of MR imaging procedures and the proper interpretation of the resultant images require a thorough understanding of the basic principles of MR imaging. Included in this understanding should be at least the rudiments of how an MR imaging signal is produced and why it decays with time; the significance of relaxation constants; the principles of scanning methods such as saturation recovery, inversion recovery and spin echo; how data obtained by these methods are used to form an image, and how the imaging data are complied by multi-slice and volumetric processes. In selecting an MR imaging unit, information about different magnet designs (resistive, superconductive and permanent) is useful. Although no bioeffects are thought to be associated with an MR imaging examination, some knowledge of the attempts to identify bioeffects is helpful in alleviating concern in patients. PMID- 6506688 TI - Kawasaki syndrome in office pediatrics. PMID- 6506687 TI - Fat embolism syndrome. AB - These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from transcriptions, they are prepared by Drs Homer A. Boushey, Associate Professor of Medicine, and David G. Warnock, Associate Professor of Medicine, under the direction of Dr Lloyd H. Smith, Jr, Professor of Medicine and Chairman of the Department of Medicine. Requests for reprints should be sent to the Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, CA 94143. PMID- 6506689 TI - Community-acquired Pseudomonas aeruginosa pneumonia associated with the use of a home humidifier. PMID- 6506690 TI - Benign prostatic hyperplasia. PMID- 6506691 TI - A clinician looks at health planning. PMID- 6506692 TI - Educating internists in emergency medicine. AB - The education of internists in emergency medicine needs to be thoughtfully planned by those involved in their education. Objectives for their emergency medicine rotation include the recognition and initial treatment of true medical and surgical emergencies, clinical experience with and knowledge of common acute primary care problems, the ability to handle several patients with problems having different degrees of urgency, effective use of consultants in the follow up and management of difficult patients and a knowledge of and clinical experience with the prehospital care system. A curriculum should be designed to give the resident a core of didactic material in addition to supervised clinical experience. The rotation should be evaluated by both residents and faculty from internal medicine and emergency medicine to determine if it is accomplishing the objectives set forth. PMID- 6506693 TI - The retired husband syndrome. PMID- 6506694 TI - A stepwise guide for treating tuberculosis. PMID- 6506695 TI - [Usefulness of function tests for the evaluation of the effect of the autonomic nervous system on premature heart beats in children and adolescents]. PMID- 6506696 TI - [Resting ankle-arm pressure index in the contralateral leg in patients with vascular diseases referred for consultation or surgical treatment]. PMID- 6506697 TI - [Bioelectric activity of the stomach in duodenogastric reflux]. PMID- 6506698 TI - [Case of arteriovenous fistula in a boy with hemophilia A]. PMID- 6506699 TI - [Traumatic arteriovenous fistula with false aneurysm]. PMID- 6506701 TI - [Case of funicular degeneration with exclusive involvement of the pyramidal tracts]. PMID- 6506700 TI - [Case of funicular degeneration with atypical course]. PMID- 6506702 TI - [Results of ambulatory observation of patients after myocardial infarction treated at the Scientific Research Center in Naleczow and those not subjected to sanatorium rehabilitation]. PMID- 6506704 TI - [Composition of plasma lipoproteins and clinical indicators of the progression of arteriosclerosis in patients with primary hyperlipoproteinemia and different degrees of lipid change in the soft palate]. PMID- 6506703 TI - [Hospital mortality of patients with recurrent myocardial infarction treated in a cardiological intensive care unit]. PMID- 6506705 TI - [Subcutaneous heparin in the prevention of postoperative thrombosis]. PMID- 6506706 TI - [Case of ventricular tachycardia after blunt chest injury in a sportsman]. PMID- 6506707 TI - [Conservatively treated splenic rupture]. PMID- 6506709 TI - [Fraley's solitary kidney syndrome in an 11-year-old girl]. PMID- 6506708 TI - [Non-parasitic liver cysts]. PMID- 6506710 TI - [Basic principles in diagnosis of breast neoplasms in women]. PMID- 6506711 TI - [Value of suction drainage in wound healing after vascular operations]. PMID- 6506712 TI - [Myocardial infarction after the first dose of nifedipine]. PMID- 6506713 TI - [Diabetes mellitus with developing vascular changes in a 13-year-old girl]. PMID- 6506714 TI - [2 cases of Warren's distal splenorenal anastomosis in children with portal hypertension]. PMID- 6506715 TI - [Peculiar case of a foreign body in the digestive tract]. PMID- 6506716 TI - [Late results of the surgical treatment of esophageal stenosis of tuberculous origin]. PMID- 6506717 TI - [An extremely difficult case of surgical treatment of cicatricial esophageal stenosis by esophagoplasty]. PMID- 6506718 TI - [A rare case of histologically "pure" colonic adenoma with the macroscopic and clinical features of a malignant neoplasm]. PMID- 6506719 TI - [Endoscopic removal of a foreign body from the stomach]. PMID- 6506720 TI - [Nonspecific inflammatory tumor of the transverse colon]. PMID- 6506721 TI - [2 cases of acute irreversible renal failure]. PMID- 6506722 TI - [Case of post-traumatic renal artery thrombosis]. PMID- 6506723 TI - [Histochemical studies of the adrenal cortex of guinea pigs with larval ascariasis]. PMID- 6506724 TI - [Morphological and histochemical changes in the hepatopancreas of Galba truncatula Mull. and Limnea tomentosa Pfeiffer as affected by Fasciola hepatica sporocysts]. PMID- 6506726 TI - Evaluation of jejunal mucosa biopsy in patients with giardiasis. PMID- 6506725 TI - [Use of Giardia intestinalis cultures in chemotherapeutic studies]. PMID- 6506727 TI - [Diagnostic and therapeutic problems of chronic toxoplasmosis in pregnancy]. PMID- 6506728 TI - [Nematoda of birds (Charadriformes) of Lower Silesia]. PMID- 6506729 TI - [Entomelas dujardini (Maupas, 1916), (Nematoda) in the lizard Anguis fragilis L]. PMID- 6506730 TI - [Arthropod population of Sorex araneus L. and Sorex minutus L. in forests and forest-free areas of the Niemczanskie Hills]. PMID- 6506731 TI - [Differential diagnosis and surgical indications in lumbar intervertebral disk recurrence]. AB - This retrospective study concerns 48 patients who underwent reoperation some time after lumbar disc surgery because of persistent or recurring leg pain. During the same period (January 1980 to October 1982) 821 primary lumbar discectomies were done. Surgical findings at reoperation of 48 patients: 30 patients (3%) had a recurrent disc herniation at the previous site, 9 patients (1%) had disc herniations at a new site only, and 9 patients (1%) had only considerable epidural scar formation. The preoperative differentiation between symptoms related to recurrent disc herniation and those related to epidural scar formation is difficult, because in this situation myelography can not be relied upon. In our series of 48 patients, myelography showed in 27% of the cases false positive or false negative results. The clinical signs and symptoms are therefore of paramount importance. PMID- 6506732 TI - [Course of atypical nodular sclerosing lymphogranulomatosis with intestinal polyposis in a 62-year-old female]. AB - The etiology of a diarrhoea is in most of the cases a bacterial or viral infection or of allergic origin. In some cases histopathologic alterations of the gut like carcinomas or systemic involvement in other malignancies can lead to similar clinical symptoms. PMID- 6506733 TI - [Pathology of advanced maxillary cancer following combined radiotherapy and surgical therapy]. AB - Case report of a 44 year old patient with an invasive partially keratinizing squamous cell carcinoma which broke into the middle base of the skull and penetrated into the brain. By combined radiotherapy and chemotherapy a surgical treatment of the originally extensive primary tumor became possible. Histologically no cancer tissue was found in the resected parts. 2 1/2 years later the patient died from pneumonia. The autopsy revealed a "restitutio ad integrum" of the skull and brain which according to several computertomographies were invaded by the tumor. PMID- 6506734 TI - Esophageal transection with paraesophagogastric devascularizations (the Sugiura procedure) in the treatment of esophageal varices. PMID- 6506735 TI - An update of portal systemic shunting and its complications. PMID- 6506736 TI - Surgical management of patients with the Budd-Chiari syndrome. PMID- 6506737 TI - Surgical treatment of portal hypertension in schistosomiasis. PMID- 6506738 TI - Hepatic secondaries: minimal tumor and resectable tumor. PMID- 6506739 TI - Intraoperative irradiation combined with radical resection for cancer of the head of the pancreas. PMID- 6506741 TI - Intrabiliary rupture of the hydatid cyst of the liver. PMID- 6506740 TI - Long-term evaluation of patients treated by radical operation for carcinoma of the thoracic esophagus. PMID- 6506742 TI - Changing trends in the management of combined pancreatoduodenal injuries. PMID- 6506743 TI - Health projections. Introduction. PMID- 6506744 TI - Health manpower projections: the Indonesian experience. PMID- 6506745 TI - Strategies and techniques for the implementation of health manpower and other health projections: the case of Hungary. PMID- 6506746 TI - Intersectoral aspects of mortality projections in developing countries. PMID- 6506747 TI - Methods and issues in the projection of population health status. AB - The discussion of strategies for forecasting health status changes in human populations often becomes immersed in efforts to utilize simple projection strategies that will produce crude projections. The motivation behind this effort is that simple projection strategies have limited data requirements and the crude projection strategies will be, in some ill-defined sense, robust (i.e., insensitive to assumptions). Actually there is a wide range of projection tools available. It seems appropriate to appraise the nature and attributes of each when considering the uses to which the projections will be put. For example, simple models are not necessarily more robust than more sophisticated procedures, especially for longer term temporal projections. Clearly we have many examples in developed countries where the use of simple actuarial or demographic projections has underestimated the true cost of a health programme by factors of 200-300%. The reason why the failures of such simple projection efforts become so rapidly manifest is that the programmes, once implemented, are expanded to meet the population's needs. In projecting only health services or utilization one has nearly a self-fulfilling prophecy--that resource constraints or the actual organization of the programme will directly determine the course of the level and mixture of health services consumption. Therefore failure to base the projections on a detailed model of underlying population needs leads in such cases to grossly inaccurate results. Clearly, projecting a population's health needs requires even more data than projecting health service requirements. Such information constraints require the use of a model to organize data from multiple objective and subjective sources, and to reflect the best scientific understanding of the processes involved. This article briefly discussed the application of 2 such models. One was designed for the analysis of discrete state health changes using population and vital statistics data, the other described both discrete and continuous changes using data from longitudinally followed community populations. One is designed to work only with detailed aggregate data with heavy inputs from scientific experts; the other deals with relatively information-rich measurements. Both can be modified on the basis of expert judgement to deal with simulations of a multiplicity of possible interventions. Both appropriately calculate the relative costs and benefits of select health initiatives.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6506748 TI - The projection of chronic diseases using data on risk factors and risk factors intervention: the case of cancer. PMID- 6506749 TI - The metabolism and disposition of [2-14C]diazepam in the streptozotocin-diabetic rat. AB - The oral administration of [2-14 C]diazepam to streptozotocin (STZ)-diabetic rats resulted in decreased faecal and biliary levels of metabolites with a concomitant rise in urinary radioactivity when compared to control values. This situation was reversible upon insulin treatment. The increased urinary metabolite excretion could not be ascribed to the diuresis observed in STZ-diabetic rats. No alteration in the phase I or II routes of [14C]diazepam metabolism in diabetic animals was observed either in vivo or in vitro. Following i.v. administration of [2-14C]diazepam, blood 14C levels in diabetic rats were elevated above those observed in normal animals. PMID- 6506750 TI - Hepatic mixed-function oxidase activities of wild pigeons. AB - Hepatic mixed-function oxidase activities of wild pigeons were determined and compared with those of rat to assess the apparent differences in avian and mammalian drug metabolism. Aminopyrine N-demethylase, benzphetamine N demethylase, ethylmorphine N-demethylase, aniline hydroxylase, NADPH-cytochrome c reductase, glutathione S-transferase activities and cytochrome P-450 levels in pigeon liver were 30-80% lower than the corresponding activities in rat liver. p Nitroanisole O-demethylase activity in pigeon liver was similar to that of rat liver. Wild pigeon-liver benzo[a]pyrene hydroxylase activity was approx. five times higher than that in the rat. Pigeons did not reveal any noticeable sex differences in mixed-function oxidase activities. Administration of 3 methylcholanthrene and phenobarbital to pigeons resulted in the induction of demethylase and benzo[a]pyrene hydroxylase activities and in cytochrome P-450 levels. PMID- 6506752 TI - Metabolism of (+)-catechin and some of its C-6 and C-8 substituted derivatives in the isolated perfused pig liver. AB - The metabolism of (+)-catechin, 8-benzyl-(+)-catechin, 6-bromo-, 8-bromo- and 6,8 dibromo-(+)-catechin and 6- and 8-carboxymethyl-(+)-catechin by the isolated perfused pig liver resulted in the formation of the corresponding 3'-O-methyl derivatives. The position of O-methylation was determined by alkaline fusion. The bromo derivatives also underwent debromination. Unmetabolized material and metabolites were present as two glucuronides, a 3,4'-diglucuronide and a 3,5 (or 7)-diglucuronide, both in serum and bile. The position of conjugation was determined by methylation of free hydroxyl groups in the conjugates followed by unmasking of the conjugated hydroxyl groups by enzymic hydrolysis. Results indicate that substitution on the A-ring of (+)-catechin has little influence on the type of metabolites obtained. PMID- 6506751 TI - The metabolism of S-methyl-L-cysteine in man. AB - The excretion and metabolism of radiolabelled S-methyl-L-cysteine (150 mg orally) was studied in three male volunteers. The major route of excretion was the urine with 55.9% of the administered radioactivity being voided over three days (33.3% during the first 24 h). Faecal excretion was relatively unimportant (c. 1.4%). The remaining radioactivity was either slowly excreted in the urine over the next 21 d (35S-labelled compound) or exhaled (14C-labelled compounds). Metabolism occurred via the pathways of S-oxidation, N-acetylation and deamination. Extensive degradation of the molecule was observed with the production of large amounts of inorganic sulphate and CO2. The options for the sequence of metabolic degradation of the amino acid derivative are discussed. PMID- 6506753 TI - The interactions of hydrazine derivatives with rat-hepatic cytochrome P-450. AB - The ability of different classes of hydrazine derivatives to modify cytochrome P 450 function during turnover as judged by loss of absorbance at 416 nm, loss of CO-reactive cytochrome P-450, or destruction of haem has been studied. Addition of monosubstituted hydrazines to rat-liver microsomes caused considerable loss of CO-reactive cytochrome P-450 and haem destruction; monosubstituted hydrazides caused mainly loss of CO-reactive cytochrome P-450, most likely due to abortive complex formation. Metabolism of 1,1-disubstituted hydrazines by microsomal cytochrome P-450 resulted in loss of CO-reactive cytochrome P-450 only, with no haem destruction. The 1,2-disubstituted hydrazines and hydrazides, procarbazine and iproniazid, acted similarly to the monosubstituted hydrazines, while 1,2 dimethylhydrazine elicited no response, either in observable spectral changes or loss of CO-reactive cytochrome P-450. Synthetic diazene intermediates of phenylhydrazine and N-aminopiperidine reacted rapidly with microsomal cytochrome P-450 to form a spectral intermediate resembling the putative iron porphyrin diazenyl complex. The decomposition of certain iron porphyrin-diazenyl derivatives apparently leads to destruction of the porphyrin prosthetic group, most likely due to haem alkylation. PMID- 6506754 TI - The site of reduction of sulphinpyrazone in the rabbit. AB - Comparison of oral and i.v. administration of sulphinpyrazone (10 mg/kg) to rabbits showed that the oral route was associated with an incomplete bioavailability and a six-fold greater formation of the active sulphide metabolite. The bile was an important route of elimination of unchanged sulphinpyrazone in rabbits (18% of an i.v. dose in four hours). Only small amounts of the sulphide appeared in the bile after i.v. administration. Pretreatment with oral antibiotics decreased the area under the plasma concentration-time curve (AUC) for the sulphide but increased that of the parent drug. Excretion of the p-hydroxysulphide metabolite in urine was decreased 30 fold by antibiotic treatment. The contents of the caecum showed the greatest capacity for sulphinpyrazone reduction in vitro. The liver possessed a slight ability to reduce sulphinpyrazone in vitro under anaerobic, but not aerobic, conditions. The gut bacteria are the main site of reduction of sulphinpyrazone to the active sulphide metabolite in the rabbit. These findings contrast with those obtained for sulindac which was reduced extensively under both aerobic and anaerobic conditions by rabbit-liver soluble fraction in vitro. The sulphide metabolites of both sulphinpyrazone and sulindac were oxidized to the parent drug by rabbit-liver microsomes. PMID- 6506755 TI - Role of the intestinal microflora in clonazepam metabolism in the rat. AB - The metabolism of clonazepam was studied in vitro and in vivo using germ-free and ex-germ-free rats. Incubation of clonazepam with rat-intestinal lumen contents gave nearly complete reduction of clonazepam to 7-aminoclonazepam. Rat-hepatic microsomes also reduced clonazepam but only under anaerobic conditions. Aerobic microsomal incubations gave 3-hydroxyclonazepam as the predominant metabolite. Both aerobic and anaerobic microsomal metabolism were induced by phenobarbital. Carbamazepine pretreatment significantly induced only 3-hydroxylation slightly; whereas beta-naphthoflavone had no significant effect. Extensive biliary disposition of hydroxylated clonazepam metabolites into the gut occurred. Only very low levels of clonazepam were found in bile. Using a linked-rat procedure enterohepatic recirculation of biliary metabolites was demonstrated and suppression (antibiotic treatment) or absence (germ-free) of the gut microflora nearly eliminated recycling. Following oral administration of [14C]clonazepam to germ-free rats, reduced metabolites accounted for 15% of the radioactivity in the urine, with over 70% of the 14C attributed to a phenolic clonazepam metabolite. In contrast 77% of the recovered metabolites were derived from nitroreduction in the same animals following acquisition of an intestinal microflora; 7 acetamidoclonazepam was the major metabolite in these ex-germ-free animals. These studies show that clonazepam metabolism is primarily reductive in the presence of gut flora and oxidative in its absence. PMID- 6506756 TI - Disposition and metabolism of a new benzothiophene antiestrogen in rats, dogs and monkeys. AB - A new benzothiophene-derived antiestrogen (LY156758) when orally administered was well absorbed in rats and monkeys while approx. 20% was absorbed in dogs. In the rat the compound was subject to first-pass hepatic metabolism which led to low levels of parent drug in the systematic circulation together with a small amount as the glucuronide conjugate. In monkeys the compound occurred primarily as the glucuronide conjugate of parent drug with very little circulating free drug. The systemic bioavailability of free parent drug in plasma was 39% in rats, 17% in dogs and 5% in monkeys. Excretion of the drug in rats and dogs was primarily via the bile. Approx. 1% of the dose was excreted in the urine of rats and dogs after oral dosing. In rats, at least 50% of an oral dose was excreted in bile as the glucuronide conjugate of parent drug. PMID- 6506757 TI - Influence of cytochrome P-450 type on the pattern of conjugation of 7 hydroxycoumarin generated from 7-alkoxycoumarins. AB - Pretreatment of rats with phenobarbitone increased hepatic microsomal 7-methoxy and 7-ethoxy-coumarin O-dealkylase activities. Pretreatment with beta naphthoflavone increased only the 7-ethoxycoumarin O-dealkylase activity. The addition of metyrapone in vitro inhibited the O-dealkylations to different extents. Similar results were obtained with diphenyloxazole and ethanol. These results are taken to indicate that different forms of cytochrome P-450 are involved in the O-dealkylation of these two substrates. The pattern of metabolism (Phase I and Phase II) of each alkoxycoumarin in rat isolated hepatocytes was very similar. The sulphate conjugate was the major metabolite produced, the amount of which approached a plateau as the rate of O-dealkylation increased. It is concluded that the type of cytochrome P-450 involved in the initial Phase I metabolism does not influence the subsequent pattern of conjugation. PMID- 6506758 TI - Studies on N-demethylation of methamphetamine by liver microsomes of guinea-pigs and rats: the role of flavin-containing mono-oxygenase and cytochrome P-450 systems. AB - Relative participation of flavin-containing mono-oxygenase and cytochrome P-450 systems in N-hydroxylation of and formaldehyde release from methamphetamine were studied in vitro using liver microsomes of guinea-pigs and rats. In guinea pigs, only methimazole, an inhibitor of flavin-containing mono-oxygenase, significantly suppressed the above reactions. Formaldehyde release from methamphetamine was significantly inhibited not only by methimazole but also by inhibitors of the cytochrome P-450 system in liver microsomes from rats, but not guinea-pigs. Pretreatment of guinea-pigs with phenobarbital and 3-methylcholanthrene did not enhance the metabolism of methamphetamine. Pretreatment of rats with phenobarbital but not 3-methylcholanthrene increased slightly the N-demethylation of methamphetamine by liver microsomes. The results indicate that a marked species difference exists in the enzymes concerned with N-demethylation of methamphetamine. N-Oxidation predominates in guinea-pigs, whereas in rats, N oxidation and C-oxidation of the methyl group participate equally as the initial reaction of the N-demethylation pathway. PMID- 6506759 TI - Metabolism of methamphetamine, amphetamine and p-hydroxymethamphetamine by rat liver microsomal preparations in vitro. AB - Methamphetamine N-demethylation and p-hydroxylation activities of rat liver were located mainly in the microsomal fraction. The Km values for methamphetamine and p-hydroxymethamphetamine demethylations were 1.0 and 1.6 mM, respectively. The Km value for amphetamine p-hydroxylation was 10.2 microM; substrate inhibition occurred at high substrate concn. Two Km values were obtained for the aromatic hydroxylation of methamphetamine (10.6 microM and 2.2 mM). N-Demethylation of methamphetamine and p-hydroxymethamphetamine were depressed in rats pretreated with 3-methylcholanthrene, CoCl2 or SKF 525-A. In rats pretreated with phenobarbital, methamphetamine demethylase was induced and p hydroxymethamphetamine demethylase was depressed. The p-hydroxylation of methamphetamine and amphetamine in rats pretreated with phenobarbital, CoCl2, SKF 525-A or iprindole were depressed. PMID- 6506760 TI - The metabolism of some 1-hydroxylated indoles in the rat. AB - A number of N-hydroxylated indole derivatives have been fed to rats and the urinary metabolites compared with those obtained on feeding the corresponding N-H indoles. 1-Methoxy- and 1-acetoxy-indole were metabolized to compounds normally observed on feeding indole. 1-Hydroxy- and 1-methoxy-indole-3-carboxylic acids were both partially excreted unchanged and reduced to indole-3-carboxylic acid which was excreted along with its glucuronide. Indole-3-glyoxylic acid and its 1 methoxy derivative were excreted almost entirely unchanged. 1-Hydroxyindole-3 glyoxylic acid was mostly excreted unchanged, but some reduction to indole-3 glyoxylic acid took place. The stability of these acids is associated with their low pKa values. The significance of the removal in vivo of groups attached through oxygen to the 1 position of indoles in relation to the synthesis of new potential medicinal agents is noted. PMID- 6506761 TI - Disopyramide elimination in the isolated perfused rat liver. AB - The elimination kinetics of disopyramide, [14C]disopyramide and [2H]disopyramide have been studied in the isolated perfused rat liver. Disappearance of disopyramide from perfusate was dose- and time-dependent over the dose range 0.3 7.5 mg. Although the mechanism underlying these observations is unclear, the data are consistent with the presence of enzyme saturation and product inhibition. Biliary secretion of conjugated metabolites appeared to be the rate-limiting step in the perfusate clearance of total radioactivity. At doses of 0.3 and 7.5 mg the kinetics of [2H]disopyramide showed a small isotope effect probably of negligible importance. PMID- 6506762 TI - Saturation of an alpha, beta-unsaturated ketone: a novel xenobiotic biotransformation in mammals. AB - Reduction of an alpha, beta-unsaturated ketone to the corresponding saturated ketone in a 2-benzylidene-3-ketocoumaran derivative has been investigated. Reductase activity resides in the cytosolic fraction of liver, lung and kidney. Rat and human blood also contain significant reductase activity. Hepatic reductase activity was high in guinea-pigs followed by hamsters, rabbits, rats and mice. The substrate had an apparent Km and Vmax of 5.6 microM and 1.3 nmol/min per mg protein, respectively. The reduction was dependent upon NADPH having an apparent Km of 14.8 microM and a Vmax of 1.0 nmol/min per mg protein. Only the A side hydrogen of NADPH was incorporated into the reduced product. The reaction was inhibited by cyanide, and sulphydryl reagents. Phenobarbital did not induce the activity in rats. PMID- 6506763 TI - The measurement of FAD-containing mono-oxygenase activity in microsomes containing cytochrome P-450. AB - Antibodies to NADPH-cytochrome P-450 reductase have been used to essentially abolish the contribution of cytochrome P-450 to xenobiotic metabolism by mammalian microsomes. This permits the determination of the activity of the FAD containing mono-oxygenase and the stoichiometry between substrate, O2 and NADPH, in the microsomal membrane, and in the absence of cytochrome P-450-dependent activity. FAD-containing mono-oxygenase oxidation rates were determined for sulphur- and nitrogen-containing substrates, including: thiols; sulphides; thioamides; primary, secondary and tertiary amines; hydrazines. Although the enzyme in mouse, rabbit, rat and pig microsomes displays similar substrate specificity, some catalytic characteristics are different between species and tissues. PMID- 6506764 TI - Effect of O2 tension on the bioactivation and metabolism of aliphatic halides by primary rat-hepatocyte cultures. AB - The covalent binding of CCl4 and CF3CHBrCl to cultured rat hepatocytes was enhanced by anoxic conditions, indicative of enhanced reductive biotransformation. The covalent binding of CHCl3 and CHCl2CH2Cl decreased as the O2 concentration was decreased, indicating a preference for oxidative metabolism. Lower O2 tensions decreased the formation of polar water-soluble metabolites with CHCl3 and CHCl2CH2Cl, while CCl4 and CF3CHBrCl were unaffected. The results indicate that primary cultured hepatocytes can reductively biotransform and bioactivate aliphatic halides under anoxic conditions. PMID- 6506765 TI - Epidermal benzo[a]pyrene metabolism and DNA-binding in Balb/C mice: inhibition by ellagic acid. AB - Topical application of ellagic acid, a common plant phenol, to control or to 3 methylcholanthrene (3-MC) pretreated Balb/C mice, resulted in significant inhibition of hepatic and epidermal microsomal aryl hydrogen hydroxylase activity, and of benzo[a]pyrene (BP) binding to epidermal and hepatic DNA in vivo. In vitro addition of ellagic acid (0.25 mM) to epidermal microsomal incubation systems from either control or 3-MC-treated animals resulted in 62-75% inhibition of BP binding to calf thymus DNA. These studies suggest that ellagic acid could prove useful in understanding and/or modulating polyaromatic hydrocarbon carcinogenesis. PMID- 6506766 TI - Effects of BHA, d-alpha-tocopherol and retinol acetate on TCDD-mediated changes in lipid peroxidation, glutathione peroxidase activity and survival. AB - Daily treatment of female rats with butylated hydroxyanisole (BHA) protected against 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) toxicity. This protective effect was associated with reduced microsomal lipid peroxidation, increased glutathione peroxidase (GSH-PX) activity and decreased aryl hydrocarbon hydroxylase (AHH) activity. Retinol acetate (vitamin A) inhibited lipid peroxidation, elevated GSH-PX activity, and enhanced AHH activity. Thirty per cent of vitamin A-treated animals were alive 25 d after a lethal dose of TCDD. d alpha-Tocopherol (vitamin E) inhibited markedly microsomal lipid peroxidation, enhanced AHH activity, and had no effect on GSH-PX activity. Only 10% of the vitamin E-treated animals were alive 25 d after a lethal dose of TCDD. The mechanism of TCDD toxicity may involve in part inhibition of GSH-PX activity with resultant lipid peroxidation by hydrogen peroxide. PMID- 6506767 TI - Detection and half-life of bromobenzene-3,4-oxide in blood. AB - Bromobenzene-3,4-oxide can be detected in venous blood of rats by trapping it as the corresponding 35[S]glutathione conjugates. More bromobenzene-3,4-oxide is detected in venous blood of rats treated with phenobarbital and diethyl maleate than in venous blood of rats treated with phenobarbital alone. The half-life of bromobenzene-3,4-oxide in venous blood was about 13.5 s. Bromobenzene-3,4-oxide may contribute to the extrahepatic covalent binding and presumably the toxicity observed after bromobenzene administration. The present technique may be used to determine in blood, the presence or absence of other reactive metabolites that form glutathione conjugates. PMID- 6506768 TI - Glutathione transferase-mediated and non-enzymatic activation and detoxication of the N-hydroxy derivative of Trp-P-2, a potent pyrolysate promutagen. AB - Glutathione (GSH) transferase-mediated and non-enzymatic activation and detoxication of 3-hydroxyamino-1-methyl-5H-pyrido[4,3-b]indole (N-OH-Trp-P-2) were studied in vitro. N-OH-Trp-P-2 is an active metabolite of 3-amino-1-methyl 5H-pyrido[4,3-b]indole (Trp-P-2), a mutagenic and carcinogenic heterocyclic amine. The enzymatic GSH conjugation with N-OH-Trp-P-2 was catalysed by rat-liver GSH transferase and a rat-liver cytosol fraction to form three conjugates (CH-1, CH-2 and CH-3). The mutagenicities of the GSH conjugates were studied by using Salmonella typhimurium TA98 as the tester strain. The GSH conjugates except for CH-3 were completely detoxicated products, but CH-3 was found to be a more potent mutagen than N-OH-Trp-P-2. The mutagenicity of CH-3 seemed to be due to the direct action of the conjugate, but not to N-OH-Trp-P-2 formed from it. PMID- 6506769 TI - Electrophilic metabolites of 3-methylindole as toxic intermediates in pulmonary oedema. AB - [methyl-14C]-3-Methylindole (3MI) was incubated with goat-lung microsomes, an NADPH-generating system and glutathione. An adduct between an oxidative metabolite of 3MI and glutathione was formed only when the complete system was employed. The adduct, which was detected by u.v. absorbance and scintillation counting of h.p.l.c. fractions, was purified to homogeneity by reverse-phase h.p.l.c. The ability of 3MI to bind to microsomal protein was reduced to 52% and 46% of controls when 2 mM and 4 mM glutathione, respectively, were included in the incubations. These results suggest the involvement of an electrophilic metabolite as the toxic intermediate in 3MI-mediated pulmonary oedema. PMID- 6506770 TI - Structure-activity relationships in the induction of hepatic drug metabolism by azo compounds. AB - Lipophilic azo compounds possessing 1-phenylazo-2-naphthol or 1-phenylazo-2 naphthylamine moieties induced cytochrome P-448 and related mono-oxygenase activities, UDP-glucuronyltransferase activity towards p-nitrophenol, glutathione S-transferase activity towards 1-chloro-2,4-dinitrobenzene, aldehyde dehydrogenase, and menadione reductase activities. This pattern of induction by azo dyes is very similar to that by 3-methylcholanthrene. None of the hydrophilic azo compounds tested and none of the other lipophilic azo compounds tested including 4-phenylazo-1-naphthol induced these activities. It is suggested that the formation of a third six-membered ring fused to naphthalene in a phenanthrene like arrangement by hydrogen bonding between the phenolic hydroxyl and azo nitrogen is required for induction. PMID- 6506771 TI - Cholesterol ester formation by transesterification of chlorambucil: a novel pathway in drug metabolism. PMID- 6506772 TI - Peroxidase activity of oxyhaemoglobin in vitro. AB - In bovine erythrocyte suspensions incubated with 16 mM aniline, 4-phenetidine, 4 chloro- or 3,4-dichloroaniline for three hours at 37 degrees C, HbFe3+ concentrations of 10, 35, 77 and 93%, respectively, were found. N- and C oxygenation products of aniline, 4-chloro-, and 3,4-dichloroaniline were formed, which can explain the oxidation of HbFe3+, indicative of peroxygenase activity of oxyhaemoglobin. The same N- and C-oxygenated derivatives of 4-chloro- and 3,4 dichloroaniline were also formed by hepatic microsomes, although at a 25- to 5000 fold higher rate. HbFe3+ was formed more readily on incubation of either bovine erythrocytes or purified human Hb with various N-arylacetohydroxamic acids. The metabolites of N-(4-chlorophenyl)-N-hydroxyacetamide are the same as the products of chemical oxidation of NOH-4ClAA by PbO2 or KMnO4, indicating the peroxidase activity of oxyhaemoglobin. PMID- 6506773 TI - Purification and characterization of glutathione-S-transferase from liver cytosol of phenobarbital-treated rabbits. AB - Glutathione-S-transferase (GST) from the liver cytosol of phenobarbital (PB) treated rabbits was purified by DEAE-cellulose, CM-cellulose and hydroxylapatite column chromatography. Four species of GST were obtained by eluting the CM cellulose column with a linear KCl gradient, and the major protein investigated. The purified enzyme from PB-treated and untreated rabbit had specific activities of 125.16 units/mg and 72.8 units/mg of protein, respectively, and the apparent Km was 0.6 X 10(-3) M for GSH and 1.6 X 10(-3) M for 1-chloro-2,4-dinitrobenzene. The optimum pH value was 8.7 and the enzyme was able to conjugate with 1-chloro 2,4-dinitrobenzene, 1,2-dichloro-4-nitrobenzene, 1,2-epoxy-3-(p nitrophenoxy)propane and p-nitrobenzyl chloride. PMID- 6506774 TI - [Epitheloid cell granuloma of the liver]. PMID- 6506775 TI - [New developments in the field of cardiopulmonary resuscitation]. PMID- 6506776 TI - [Permeability of antibacterial drugs in the cerebrospinal fluid]. PMID- 6506777 TI - [Pilonidal sinus]. PMID- 6506778 TI - [Physical and psychological rehabilitation of breast cancer patients (partial results from an extensive study)]. PMID- 6506779 TI - [Use of medical treatment in the principle care of children in the Zittau district]. PMID- 6506780 TI - [Evaluation of the biologic exposure test]. PMID- 6506781 TI - [Detection and monitoring of asbestos exposed persons in a district area]. PMID- 6506782 TI - [Unity of etiology and pathogenesis as well as diagnosis and therapy as a basic prerequisite of successful medical care]. PMID- 6506783 TI - ["Childhood diseases" in adults]. PMID- 6506785 TI - [Drug therapy in childhood]. PMID- 6506784 TI - [Use of antithrombotic agents within the scope of anesthesiology and intensive therapy]. PMID- 6506786 TI - [Early diagnosis of laryngeal cancer by endoscopy and histology in the risk group dispensary]. PMID- 6506787 TI - [Significance of intra-abdominal collaterals in the obliteration of visceral vascular trunks]. PMID- 6506788 TI - [Injuries of the esophagus]. PMID- 6506789 TI - [Analysis of inpatient morbidity of infants and influential factors, 1971 to 1981]. PMID- 6506790 TI - [The role of psychodiagnosis in clinical psychology and psychiatric neurology]. PMID- 6506791 TI - [New cardiovascular-active drugs]. PMID- 6506792 TI - [Differential diagnostic problems in delirium tremens]. PMID- 6506793 TI - [Various viewpoints on the prescription of ambulatory physical therapy with special reference to the specialist in general medicine]. PMID- 6506794 TI - [Psychogenic seizures and their therapeutic problems]. PMID- 6506795 TI - [Duplication of the digestive tract]. PMID- 6506796 TI - [Incorporation of a rescue station into an emergency care system]. PMID- 6506797 TI - [Differential diagnostic problems in Amanita pantherina poisoning]. PMID- 6506799 TI - [Planning and course of promotion A--counseling for doctoral candidates]. PMID- 6506798 TI - [Ileus caused by food]. PMID- 6506801 TI - Respiratory tract immunity in the aged. AB - In the elderly, respiratory infections are frequent and constitute the leading cause of death. Presumably this is the consequence of reduced local immunity in the respiratory tract. The present knowledge based on investigations in man and laboratory animals, including results of own research, is reviewed. Further research is needed to give a definite answer and to improve immunoprophylaxis in the elderly. PMID- 6506800 TI - [Diagnostic bronchoalveolar lavage]. AB - The bronchoalveolar lavage (BAL) is an important new method in the diagnosis of several lung diseases. It is shown that there are clear differences in the cytological pictures allowing an assertion of the activity of disease. Therefore BAL is suitable for follow-up studies during the treatment. In contrast to other authors BAL is performed during an otherwise indicated bronchoscopy under general anesthesia using a catheter. PMID- 6506802 TI - [Peculiarities of respiratory mechanical studies in spontaneously breathing newborn infants. 2: Evaluation technics, parameter distribution and diagnostic validity]. AB - Manual evaluation techniques are commonly used until now for the evaluation of recordings. They will be replaced by a computer-aided evaluation of the measuring signals which has several advantages, e.g. reduction of manual expense, processing of high quantities of data, application of powerful algorithms for computation. Both methods are discussed shortly. Hitherto a lot of reference values for the breathing mechanics in newborns have been set up but the various parameters show a wide scatter. This reduces the diagnostical value of breathing mechanical investigations and the clinical interpretation of the measuring results is rendered more difficult. Possibilities for the reduction of the scatter of parameters consist in standardizations of the measurement technique, the investigative conditions and the evaluation techniques as well as in the evaluation of a higher number of breaths in order to get characteristical values for the actual clinical state. The judgment of the diagnostical value of breathing mechanical investigations is commonly based on the subjective assessment by the investigator. Until now systematic investigations for the quantification of the diagnostic value (sensitivity, specifity, predictive value, ...) are not known, because the computation needs a high quantity of data from healthy newborns and such with respiratory distress. The number of cases in the different publications is often too small for these computations. The missing standardization makes it for some purposes impossible to combine the results of the different working groups. PMID- 6506804 TI - [Experiences with oscilloresistometry in addition to spirometry in preoperative function diagnosis in the elderly]. AB - A sample of 57 geriatric surgical patients were investigated with the aim of establishing which additional information the forced oscillation method yields for the assessment of an increased operation risk as compared with spirometry. In addition to the proved diagnosis of a restrictive ventilatory disturbance as causing a limitation of the maximum available respiratory volume, the measuring of the oscillatory resistance makes it possible in particular to prove and quantify the obstruction. Over and above this, the measuring of resistance fluctuation while breathing at rest makes it possible to differentiate a geronto typical exobronchial component of the obstruction. Conclusions are drawn for the improved care of geriatric surgical patients. PMID- 6506803 TI - [Lymphocyte populations in bronchoalveolar lavage fluid in various interstitial lung diseases]. AB - Differential cell counts, T-, Tactive-, Tstable-, and B-lymphocytes were studied in bronchoalveolar lavage (BAL) fluid and in peripheral blood from patients with thoracic sarcoidosis (S), extrinsic allergic alveolitis (EAA) and idiopathic pulmonary fibrosis (IPF). In patients with S and EAA the total number of lymphocytes, the percentage of T-, Tactive-, and Tstable-lymphocytes were increased in BAL-fluid, especially in cases of active S and of acute EAA. Contrary to the BAL-fluid the peripheral blood values for T-lymphocytes were decreased in S and in the range of the control group (healthy volunteers) in EAA. The BAL-fluid of patients with IPF is characterized by a high number of polymorphonuclear cells, especially neutrophils. Current concepts of pathogenesis of interstitial lung diseases are discussed and the possible key role of alveolitis in this process is elucidated. PMID- 6506805 TI - [Reproducibility of nonspecific bronchial reactivity]. AB - The control of the non-specific bronchial reactivity (acetylcholine-test a 0.01% solution as ultrasonic aerosol) after a lapse of a year indicates that the findings of a bronchial hyperreactivity were reproducible in 32,6%, but the in the beginning observed inconspicuous reactivity in 92,9% of cases. In dependence upon a reproducible bronchial hyperreactivity manifest ventilation disturbances were significant more frequently ascertainable. PMID- 6506807 TI - [Hepatic diaphragmatic interposition--Chilaiditi syndrome]. AB - The subphrenic displacement of the colon (Chilaiditi's syndrome) is an interposition of the flexura hepatica coli between liver and diaphragm caused by an anomaly of the liver ligaments occurring in adults about 1: 50 000. The distinction from air in the peritoneal cavity is the most important differential diagnostic problem. PMID- 6506806 TI - [Cooperative study on the recurrence of lung tuberculosis in East Germany]. AB - 144 patients with bacteriologically positive results were analysed out of 258 relapses of pulmonary tuberculosis within one year (1979/80) to find the causes which are favouring relapses. It has been found that in 28% an inadequate chemotherapy, in 16% uncontrolled use of drugs, and in 13% of cases uncooperative attitude of patients were supposed causes of relapse. Causes of relapse could not be established in 23% of patients. Silicosis and chronic alcoholism were observed in 22% of patients with relapse. PMID- 6506808 TI - [Alveolitis--a rare side effect of gold therapy]. PMID- 6506809 TI - Endogenous 3-methylhistidine excretion in healthy women and men with reference to muscle protein metabolism. AB - Presently 3-methylhistidine excretion is widely used for monitoring the metabolic status of patients during different kinds of clinical conditions. Aim of the study was to reconsider its predicative value on the basis of a larger collective of healthy persons and to find a standardization independent from sex. Therefore endogenous 3-methylhistidine release of 40 healthy adults (24 women and 16 men) was measured and related to body weight, body surface area, arm muscle circumference, and nitrogen and creatinine excretion. A positive correlation could be observed only for 3-methylhistidine and creatinine excretion and that to the same extent both for females and males. Assuming that the excreted 3 methylhistidine is mainly originating from muscle protein the calculated daily protein breakdown amounted for women 39.9 g and 68.1 g for men. No difference between females and males could be observed in the percentual turnover of myofibrillar protein which has been estimated with 0.90 and 0.98 respectively. We interpret our results saying that endogenous 3-methylhistidine excretion is a valuable indicator for muscle protein breakdown in humans with intact kidney function. For the assessment of muscle proteolysis by 3-methylhistidine excretion in heterogenous groups of patients it is recommended to use the 3 methylhistidine/creatinine ratio or the percental turnover of myofibrillar protein. PMID- 6506810 TI - The selenium content of infant food. AB - The selenium content of food exhibits great regional differences. Food samples of infants and young children from the North Rhine-Westphalia State in the Fed. Rep. of Germany were analysed by instrumental neutron activation analysis and showed that the average selenium content of local vegetable and fruit is below 5 ng/g wet weight. Only samples of potatoes and bananas exhibit higher selenium contents. The bananas, probably imported from different areas of the world, show an extremely high variance with values between 4 and 164 ng Se/g. Commercially available ready-for-use meals for infants or young children have a low Se content (median 24 ng/g) which is comparable to cow's milk. Besides eggs, cereals enriched with milk and some other cereal products contain more than 100 ng Se/g. PMID- 6506811 TI - [Plasma exchange therapy (plasmapheresis/plasma filtration). I. Technic]. AB - With the help of an extensive study of literature as well as of own experiences the technical aspects of the plasma exchange therapy are described. Issuing from their hitherto existing course of the development and corresponding to their present significance the essential signs of the nowadays usual modifications (plasmapheresis by means of sedimentation in transfusion containers or by means of blood cell separator as well as plasma filtration) are explained. The discussion of problems of anticoagulation, the kind and quantity of substitution solutions as well as of developmental tendencies to more specific separation techniques leads over to the survey of essential indication areas (part II). PMID- 6506812 TI - [Diabetes mellitus and exocrine pancreas function]. AB - In 60 patients with diabetes mellitus type II needing insulin for the control of the exocrine pancreas function a secretin-pancreomycin test was performed, which had a pathological result in 26.6% of the patients, in which case the functional disturbance achieved only a small size. In one part of these patients concomitant diseases of diabetes mellitus, such as cholelithiasis and hyperlipidaemia could be found. A connection between the duration of the diabetes and disturbed function of the pancreas could not be established. Corresponding with other authors the relations between incretory and excretory organ should not be overestimated. PMID- 6506813 TI - [Hemodynamics of microcirculation during thoracoscopy under anesthesia]. AB - Under the conditions of the thoracoscopy under anaesthesia the behaviour of the haemodynamic measuring values is investigated in 10 patients of either sex. The time of intubation and the phase of the open thorax represent the most remarkable periods of examination which are parallel to the alterations of the arterial oxygen partial pressure and the pressure parameters of the circulations within the lesser an the systemic circulatory system. The investigation results obtained from the behaviour of the oxygen partial pressure will prove to be decisive, whether treatment with thorax opening under simultaneously carried out analytic blood-gas measurements should be recommendable. PMID- 6506814 TI - [Acute course of schistosomiasis with pulmonary and hepatogenic localization]. AB - On the basis of a case report the acute course of a bilharziasis with pulmonary and hepatogenic localisation is described. The importance of an exact geomedical compilation of the anamnesis and the consideration of geoepidemiological facts in diseases of foreigners and returners from tropic countries is emphasized. The treatment of bilharziasis should be performed with Niridazol or Praziquantel. PMID- 6506815 TI - [Long-term behavior of serum fatty acids--results of a Leipzig gerontologic longitudinal study]. AB - In the Leipzig longitudinal study performed from 1968 to 1980 in 383 test persons with healthy metabolism in 2-3--year time intervals gas-chromatographic analyses of the serum fatty acid pattern were carried out. The dependence upon age, sex, and body-weight the vasoprotective linoleic, linolenic and arachidonic acid increased and the vasoaggressive palmitinic and eicosatrienic acid decreased. Influences of age as well as the change of the feeding habits are causally discussed for this purpose. PMID- 6506816 TI - [Malignant immunoblastic lymphoma under a pneumolytic scar in pleural empyema]. AB - It is reported on a case in which a 51-year-old man 28 years after the pneumolytic treatment of a pulmonary tuberculosis developed a thoracic empyema under the existing pneumolysis scar. On account of the considerable scar formation in the region of the right hemithorax the thoracotomy was carried out for the purpose of decortication. Histologically a malignant immunoblastic lymphoma was verified in the area of the old scar. PMID- 6506817 TI - [Increase of venous tonus and the prevention of thrombosis]. PMID- 6506818 TI - [Use of heparin in combination with dihydroergotamine for the postoperative prevention of thrombosis in general surgery]. AB - The administration of a combination of heparin and dihydroergotamine for the prevention of postoperative thromboembolism is based on the findings concerning the venous thrombogenesis that heparin low doses (2 X 5,000 E/d, subcutaneously) inhibits the coagulation processes and the venous backflow of blood is improved by dihydroergotamine (2 X 0.5 mg/d, subcutaneously). In numerous studies this combination has proved to be the most effective method in general surgical interventions to prevent both postoperative deep vein thromboses and pulmonary embolism. Therefore, this prophylaxis is recommended for the use in clinical practice on condition that contraindications are taken into consideration. Further trends are reduction of the heparin dose to 2 X 2,500 E/d and buccal application of dihydroergotamine. PMID- 6506819 TI - [Behavior of blood pressure and peripheral hemodynamics in interval therapy in untreated and propranolol-treated patients with arterial circulatory disorders of the lower extremities]. AB - Searching for a possibility of an effective therapy of disturbances of peripheral arterial blood supply (stage I and II), the authors examined a medicamentously untreated group of patients as well as a comparable group of patients which was pretreated with propranolol. The two groups of patients performed twice a week an interval run exercise. Under the three-month training therapy in the two groups significant systolic and diastolic blood pressure reductions as well as statistically ascertained shortenings of the xenon-133-half-value time under working conditions and enlargements of the average functional vascular cross section A appeared. The distance of the intermittent claudication and the standardized moving up and down test prolonged. An influence on the microcirculation caused by propranolol could not be proved. The results are discussed on the basis of literature. PMID- 6506820 TI - [Clinical significance of gas-chromatographic dietary fat analysis]. AB - In 22 customary fats for food (vegetable oils, sorts of margarine, animal fats) the composition of fatty acids was gas-chromatographically established. The following fats in food have high proportions of essential fatty acids and prostacyclin precursors, respectively, and thus favourable PS/quotients: 1. sunflower oils (C18:2 60 to 70%); 2. linseed oil (C18:3 62%); 3. soya oil (C18:2 53%; C18:3 7%); 4. Cama (C18:2 46%); 5. Marella (C18:2 48%); 6. Soma (C18:2 46%). These oils and fats, respectively, are at best suitable for the prevention and dietetic therapy of HLP and degenerative diseases of heart and circulation. PMID- 6506821 TI - [Longitudinal studies on the prognostic significance of plasma fibrinogen in diabetes mellitus]. AB - In 243 diabetics of different duration of the disease the prognostic value of an initial estimation of plasma fibrinogen for life expectancy and development of macroangiopathy was controlled over a period of ten years. Diabetics with a cardiovascular cause of death showed at the beginning with 3.68 in contrast to 3.24 g/l weakly significantly higher fibrinogen values than the surviving patients. In analogy to this in the surviving patients the diabetics with a meanwhile appearing myocardial infarction, chronic ischaemic heart disease or manifest disturbances of the peripheral blood supply differed by higher fibrinogen concentrations from test persons without manifest macroangiopathy. There was a close correlation between plasma fibrinogen level and development of hypertension. The increase of plasma fibrinogen is apparently associated with the atherogenesis without rendering a secure prognosis in the individual case on account of a critical limiting value. PMID- 6506822 TI - [Longevity of a population exposed to fluorides for decades]. AB - Among a population with considerable fluor exposure lasting for decades and that of the corresponding district the proportion of older persons was compared per cent. In the five-year groups from 70 to 89 years without any exception a prevalence in favour of the place with fluor load was found. Cumulatively significant differences in favour of the population under influence of fluor was found. The possible causes for the suggested connections between fluor effect in the organism and obtaining of older ages are represented. PMID- 6506823 TI - [Theses on the evaluation of arterial circulatory disorders of the extremities]. AB - In an expert opinion of disturbance of the arterial blood supply concerning invalidity the vascular disease must be proved with sufficient ascertainment as well as the functional capacity remained must be estimated. Every expert opinion should contain as far as possible concrete data already in the angiologic diagnostic minimum programme. In problematic cases supplementations by a special angiological diagnostics are necessary. The criteria of evaluation of arterial obstructive diseases for an expert opinion concerning invalidity are also summarized in theses. Also the relations between disturbances of the peripheral blood supply and effects of injury are discussed. The paper concludes with references to the acknowledgement of a disability card in arterial obstructive diseases and to the motor-car driving ability of patients with vascular diseases. PMID- 6506824 TI - [Results of anorectal manometry for the determination of age- and sex-dependent pressure differences]. AB - Manometric findings in 88 anorectal healthy probands are reported. Basal (PAC) and maximal squeeze (PAC max) pressures in the anal canal as well as rectal pressure at rest (PAR) and the pressure increase in the anal canal after dilatation of the ampulla recti (delta PAC) were registered with a 2 balloon catheter and statistically analysed in the 52 male and 36 female probands, divided in three age groups (group I under 40 years, group II 40-60 years and group III over 60 years). PAC showed for all three groups a statistically significant difference for men and women as well as a statistically significant decrease with age in both sex groups. PAC max, PAR and PAC decreased statistically significantly with age in both sex groups whereas in the three age groups, men and women showed nearly equal values. These age- and sex correlated differences in the anorectal pressure profile must be considered in the evaluation of the continence function. PMID- 6506825 TI - [Antipyrine clearance as a measure of drug metabolism in patients with diabetes mellitus]. AB - Antipyrine-clearance calculated from a single 24 hrs blood sample following i. v. injection of 1 g was determined in insulin dependent diabetics (n = 20), patients with liver cirrhosis (n = 8), with fatty liver + hepatitis (n = 5) and alcoholics with normal liver morphology (n = 3). Antipyrine-clearance values in normal subjects amounted to 58,7 +/- 4,8 ml/min (means +/- s), in cirrhotics to 11,8 +/- 10,1 ml/min (p less than 0.01), in patients with fatty liver to 43,3 +/- 10,1 ml/min (p less than 0.01), and in alcoholics to 62,5 +/- 18,6 ml/min. In diabetics, diseased for many years, also a decrease in the clearance values was seen (41 +/- 17,5 ml/min; p less than 0.05). 15 out of them were below the 2 s range of normal subjects. Thus, the drug-metabolizing capacity in diabetics seems to be markedly reduced, and drug dosage might have to take account of this fact. PMID- 6506826 TI - [Need for randomizing microvascular surgical experiments for testing new prosthesis material, with special reference to personal surgical errors from a morphological viewpoint]. AB - In the examination of material involving two microvascular prostheses of different nature the need is discussed of randomising experimental series to achieve a self-critical control of operative dexterity in microsurgical techniques and to exclude eventual errors arising and influencing the results. A comparison was made of two polyurethane prostheses, one porous (n = 15), and the other covered internally with a smooth silicon layer (n = 15). They were implanted using microsurgical techniques into the infrarenal portion of the abdominal aorta in rats. The main criterion for successful implantation was a patency over a prolonged period of observation lasting a maximum of 407 days. The porous prosthesis showed the best results. Most frequent complications were early thrombosis and technical faults demonstrated by histology. Therefore, the distribution through prospective randomisation of good and bad results based on technical errors enhances the significance of material analysis. PMID- 6506827 TI - [Reservoir capacity of esophagojejunostomy following gastrectomy determined by the radioisotope method]. AB - The substitute reservoir emptying was determined quantitatively in 16 patients with total gastrectomy by means of the radio-isotope method. The continuity was restored in 15 patients by an entero-anastomosis in modification according to Graham and in one patient by esophagoduodenostomy. The investigation was carried out in 11 patients with total gastrectomy in upright position and in 4 patients in lying position. As control group there were used 14 normal subjects. The emptying traces, the radioactive half-life, and the emptying rate show a clear acceleration of the emptying. The behaviour of the emptying returns to normal in lying position. A constant relation of these findings could not be found out compared with the nutritional state or the postprandial complaints. PMID- 6506828 TI - [Clinical experiment studies in the treatment of echinococcosis with mebendazole (Vermox)]. AB - 3 patients with echinococcosis were treated with Mebendazol conservatively. One patient got a drug allergy. The other two were operated after a conservative therapy during 3 years in one case and in the course of 110 days in the other case. Dead as well as vital echinococcus cysts and protobrood-cysts were found intraoperatively. The intraabdominal transmission of protobrood-cysts to white infantile mice led to a secondary echinococcosis. The surgical therapy appeared more efficacious in contrast to the conservative treatment. A combination of surgical therapy and conservative treatment is to be recommended in severe disseminated forms of the echinococcosis. PMID- 6506830 TI - [A simple method of blood pressure measurement in nonanesthesized rabbits]. AB - A technically simple method for the continuous recording of the arterial blood pressure in the conscious rabbit is described. For the placement of the catheter it is not necessary to perform a temporally expensive preparation. The median auricular artery of the animal can be used repeatedly above all. In case the arterial mean pressure is needful as a control mechanism then this method is recommended especially. PMID- 6506829 TI - [Modification of bone fracture healing by ultrasound in an animal experiment model]. AB - Both tibiae were osteotomised after medullary nailing in 40 rabbits. In each case the right fracture was treated with ultrasound of 0.1 W/cm2 for 2 minutes 4 times every second day after on week. The left extremity is used as control. An accelerated and increased callus formation and callus maturation were found by ultrasonic therapy. This was possible to be shown on a higher level of the alkaline phosphatase, a higher temperature, and an accelerated calcium and phosphate incorporation in the callus in comparison with the untreated side. The mineralisation by means of ultrasound showed a characteristical three phase behaviour. The mechanism of action is probably the piezo-electric effect of the local tension induction by ultrasound with resultant activation of the metabolism. The advantage of the mineralisation amounted to 2 weeks in contrast to the untreated extremity in the 4th week after the fracture. These findings confirm numerous positive clinical results. PMID- 6506831 TI - [Toxoplasmosis screening of pregnant patients in Austria]. AB - The frequency of congenital Toxoplasma infection is strictly correlated with the frequency of Toxoplasma primary infection in child bearing age. The latter corresponds directly to the increase of contamination rate in the normal population between 20 and 40 years of age, if determined with a sensitive method detecting also low antibody concentrations with certainty (Sabin-Feldman-dye test). In four representative studies the relation was 0.52 conversions id est 0.26 congenital infection per 1 000 per 1% contamination increase. Most congenitally infected children seem normal in newborn age. Follow up studies for long enough periods--many years!--have shown that practically all these children develop sequelea, chorioretinitis and/or cerebral defects. Postnatal treatment does not influence this evolution but preventive treatment in pregnant women selected by serological screening uncovering primary infections does prevent fetal infections with their consequences. PMID- 6506832 TI - [Prognostic significance of risk factors in pregnancy. I. Observations of onset and duration of observed pregnancy risks]. AB - In a prospective study 383 from 712 women attending our antenatal clinic were found on examination to have pregnancy risks. These were followed with regard to the time of first occurrence, duration and time of last occurrence, as well as their relation to other risk factors occurring in both history, examination or during labour. The method of delivery, necessity for postpartal intensive pediatric care and the perinatal mortality were considered. Risks included antepartal haemorrhage in the first trimester (median time of onset 11 weeks); in the second trimester: hypotension (20 weeks), cervical incompetence (21 weeks), anaemia (25,5 weeks), premature labour (29 weeks) and uterus size inappropriate to gestational age (34,5 weeks) in the third trimester. Antepartal haemorrhage tends to be episodic (median duration of bleeding one week). The average duration for a cerclage was 16 weeks. The other risk factors were observed to last between 3 and 8 weeks. The onset and duration of risk factors found on examination considered alone do not present a sufficient criterion to enable their gravidity to be judged. PMID- 6506834 TI - [Relation between procoagulant activity and fetal lung maturity in amniotic fluid]. AB - A total of 146 samples of amniotic fluid from the 15th to 43rd weeks of pregnancy were taken by either transabdominal amniocentesis or amniotomy during birth. In addition to the palmitic/stearic ratio (P/S) the following coagulation tests were determined: clotting time, modified prothrombin time, partial thromboplastin time (PTT), recalcification time and, in selected samples, thrombelastograms. In the course of pregnancy there is a significant shortening of all coagulation tests measured in amniotic fluid. Comparing the values obtained in the 15th to 18th and the 37th to 43rd weeks of gestation and literature results the following values may indicate fetal maturity: clotting time less than 100 sec., modified prothrombin time less than 80 sec., PTT less than 30 sec. and recalcification time less than 80 sec. The lower limit for P/S ratio in normal pregnancy is 5,0. In 58 cases, amniotic fluid was obtained in the 37th to 43rd week at most 24 hours before delivery; there was no case of RDS in this group. Eliminating intermediate P/S values of 4,5 to 5,0 a false negative rate of 1,7% for the prediction of fetal lung maturity was seen. The corresponding rate for the modified prothrombin time was 3,4% and for the clotting time 6,4%. In 7 RDS cases all cases could be properly predicted from the recalcification time and the PTT. The fetal lung maturity may be estimated by means of simple and rapid coagulation tests and this may facilitate the indication for RDS-prophylaxis. The determination of the L/S or P/S ratios, however, cannot yet be dispensed with. PMID- 6506833 TI - [Prognostic significance of risk factors in pregnancy. II. Risk status at onset of labor]. AB - A group of 383 women with pregnancy risks were screened at the onset of labour. 70% of the EPH-Gestosis, 56% of the urinary tract infections and cervical incompetence, 48% of the anaemias, 38,6% of the premature labour, 11% of the hypotension and 4% of the antepartal haemorrhages were found still to be present at the onset of labour. In those women with EPH-Gestosis at the onset of labour, the risk of cesarean section was markedly higher. When the risks premature contractions and cervical incompetence were recorded, the resulting birth weights were lower and the necessity for intensive paediatric care higher than normal. EPH-Gestosis and urinary tract infections which were still present at the onset of labour were of a longer duration. If the risks premature contractions and cervical incompetence were present at the onset of labour one could imply a shorter period of gestation. PMID- 6506835 TI - [Changes in antithrombin III concentration in gestosis patients]. AB - Antithrombin-(AT)-III-levels from 22 patients were determined at the day of delivery but also at the first and fifth day post partum. 7 patients had an AT III-level in a pathologically low range. Furthermore we found a close correlation between the degree of seriousness of gestosis and AT-III-reduction as well as hypercoagulolability expressed in an elevated normotest. With two patients serious complications arised intra- and postoperatively. One patient got a coagulopathy during the sectio, the other patient developed in spite of heparin treatment a deep thrombosis in the leg vein. These women had the lowest AT-III levels from all 22 patients. These results underline the importance of an AT-III control, above all with surgical operations of gestose patients. PMID- 6506836 TI - [Myoglobin behavior with hexoprenaline and beta blockade]. AB - The addition of the calcium-antagonist Verapamil in order to antagonize myocardial side-effects under tokolysis with beta-mimetic agents was more and more critisized in the last time. We have therefore combined the tocolytic agent Hexoprenalin with the beta 1-blocking agent Metroprolol in 24 patients and have analysed the myoglobin level before as well as two and four hours after the beginning of tokolysis. There was no increase of serum-myoglobin seen under this tocolytic regime. PMID- 6506837 TI - [Psychosomatic aspects of emesis gravidarum: somatic and psychosocial status of females in early pregnancy]. AB - 81 women were tested in early pregnancy with a personality questionnaire (FPI), a bodily symptoms checklist and a structured questionnaire with respect to various psychosocial events. Women with and without Emesis in early pregnancy differ significantly according to the following characteristics: Quality and quantity of past and present bodily symptoms, psychosomatic affect-resonance, calmness, occupational attitudes, description of family-relationship and expectancy to vomit. Results are interpreted that vomiting in early pregnancy seems to be a psychosomatic reaction, based on a extenuated perception of reality, in combination with difficulties "leaving home" as well an expectancy to vomit in pregnancy. PMID- 6506838 TI - [Groenblad-Strandberg syndrome]. AB - On the basis of medical history and clinical findings of two affected soldiers, we discuss Strandberg syndrome with regard to clinical symptomatology, pathogenesis, hereditary behaviour, differential diagnosis and prognosis. Electron optical as well as histological studies and HLA-type are presented. PMID- 6506839 TI - [Significance of the sympathetic nervous system for the coronary circulation]. AB - The activation of sympathetic nerves plays a significant role in the initiation of acute myocardial ischemia. In this review the effects of sympathetic nerves on coronary blood flow are summarized. Under physiological conditions the increase in myocardial performance during sympathetic activation is accompanied by metabolic coronary vasodilation. The resulting increase in coronary blood flow is limited by about 30% by alpha-adrenergic coronary constriction. Extravascular compression and beta-adrenergic coronary dilation are of minor importance during sympathetic activation. With exhausted coronary reserve distal to severe coronary stenoses metabolic vasodilation during sympathetic activation is not possible any more; an alpha 2-adrenoceptor-mediated coronary vasoconstriction now predominates. This coronary constriction induces ischemia of the post-stenotic myocardium. The alpha-antagonists Phentolamine and Rauwolscine as well as the calcium-antagonist Nifedipine prevent poststenotic coronary constriction and myocardial ischemia. Also in the genesis of coronary arterial spasm the sympathetic nervous system may play an important role; the constriction of epicardial coronary arteries is mediated by alpha 1-adrenoceptors. The sympathetic nervous system is not only involved in the initiation of myocardial ischemia, but is also activated by ischemia. This feedback-activation of sympathetic nerves leads to an aggravation of myocardial ischemia. PMID- 6506840 TI - [Nisoldipine, a new calcium antagonist: its effect on systolic function and relaxation in the dog]. AB - The effect of calcium-blockers on left ventricular (LV) relaxation is still a matter of debate. In 7 open-chest dogs we studied the effect of 0.01 mg/kg Nisoldipine intravenously on LV systolic function and relaxation. LV long and short axes and LV wall thickness were measured by ultrasonic crystals. LV high fidelity pressure and aortic pressure were recorded at rest, and 2 and 30 min after i.v. Nisoldipine. Partial obstruction of the ascending aorta was performed to keep LV peak systolic pressure close to control values. LV systolic wall stress and LV ejection fraction were calculated in all dogs. The time constant of LV pressure decay (T; ms) was determined from a linear regression of LV pressure and neg. dP/dt. Heart rate and LV end-diastolic pressure remained unchanged following the administration of Nisoldipine. LV peak systolic pressure and wall stress decreased significantly 2 and 30 min after Nisoldipine but were in the normal range with partial obstruction of the ascending aorta. Max. dP/dt decreased slightly although not significantly after Nisoldipine. LV ejection fraction increased, however, significantly from 30% to 39% at 2 min and to 35% at 30 min after Nisoldipine. The time constant T increased from 27 ms to 40 ms (P less than 0.05) at 2 min and amounted to 28 ms at 30 min following Nisoldipine. It is concluded that Nisoldipine is associated with a persistent decrease of LV afterload and a transitory increase in T.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6506841 TI - Toxoplasma infection and response to novelty in mice. AB - Three groups of mice were infected with Toxoplasma and used for behavioral testing using a Y-maze. One group was infected when adult and two groups congenitally, one of these born to dams infected during gestation, the other to dams chronically infected prior to mating. In an initial habituation period each mouse was exposed to a black arm and stem of the maze, entrance to a white arm being blocked by a transparent door. In a subsequent free-choice trial both arms were black and the mouse was free to explore all parts of the maze. During both periods infected mice were more active than controls. Infected mice engaged in less grooming behavior indicative of less approach-avoidance conflict than controls prior to entry into a choice arm at the beginning of the free-choice trial. Infected mice spent more time in the familiar than in the novel (previously blocked) arm during the free-choice trial; conversely, uninfected mice spent more time in the novel than in the familiar arm. It is suggested that the reported behavioural changes would lead to dissemination of the infection in the environment by ultimately making infected mouse intermediate hosts more susceptible to predation by domestic cats, the definitive hosts of Toxoplasma. PMID- 6506842 TI - Immunoelectrophoretic analysis of erythrocytic stages of Plasmodium yoelii and P. chabaudi. AB - Triton X-100 extracts of erythrocytes infected with Plasmodium chabaudi and P. yoelii were analysed in crossed immunoelectrophoresis with rabbit antisera. The parasite origin of the antigens detected was assessed by metabolic radiolabelling of the parasites with 35S-methionine. About 12 immunoprecipitates were obtained with both extracts and their homologous antiserum. Cross-tests showed that the two parasite strains were very similar antigenically. Species-specific antigens could, however, also be demonstrated. Two antigens, present on both P. yoelii- and P. chabaudi-infected erythrocytes, were located on the surface of the host cell membrane as judged from 125I-labellings with lactoperoxidase. Experiments with phenyl-Sepharose showed that most of the antigens detected were hydrophilic and none of them reacted with concanavalin A. PMID- 6506843 TI - An in vitro screen for new fasciolicidal agents. AB - In vitro screens employing newly excysted, 6- and 12-week-old flukes, in a medium permitting the linear growth of the parasites, were assessed. When exposed to certain known fasciolicides, newly excysted flukes were susceptible only to diamphenethide, the free amine of diamphenethide, emetine hydrochloride and albendazole. Older flukes were affected by a much wider range of compounds including the chlorinated hydrocarbons, the substituted phenols and the salicylanilides. However their susceptibility to diamphenethide and its active metabolite was decreased significantly. The activity of fasciolicides in these in vitro assays therefore closely parallels their activity in vivo. When several broad spectrum anti-nematode agents were evaluated against newly excysted flukes in these screens the benzimidazole, isothiocyanate, pyrimidine and imidazothiazole anthelmintics showed activity but 12 potent antiprotozoal agents were all inactive. It is concluded that these in vitro assays were useful for detecting any intrinsic activity that a compound might possess against flukes. Such activity could often be missed in conventional in vivo screens because of problems associated with host pharmacokinetics. Negative results from such in vivo screens could preclude the development of more bioavailable derivatives or pro-drugs as novel and useful fasciolicidal agents. PMID- 6506844 TI - Delayed expulsion of Hymenolepis diminuta in Trypanosoma brucei infected mice. AB - An experiment was conducted to study the effect of Trypanosoma brucei on the expulsion of Hymenolepis diminuta in the mouse. The study showed that T. brucei given 8 days before infection with H. diminuta resulted in a significant delay in the expulsion of the H. diminuta worm burden. This finding is suggested to be due to the immunosuppressive effect of the trypanosome. PMID- 6506845 TI - The effect of anaerobiosis on adenosine triphosphate levels in larval Nippostrongylus brasiliensis and Haemonchus contortus. AB - The adenosine triphosphate (ATP) content of the pre-parasitic stages of Nippostrongylus brasiliensis, Haemonchus contortus (L1, L2 and L3) and the adults of the free-living nematode, Panagrellus redivivus, have been measured by bioluminescent photometry in aerated or near-anoxic conditions. The ATP content of the L1 and L2 stages of both parasitic species was unaltered by a lack of oxygen over a 90-min period. However, the L3 stage of both species and the adults of P. redivivus showed a significant fall in the level of ATP within 10 min of near-anoxia. This lower level of ATP was maintained during oxygen lack but the initial content was restored on return of the nematodes to aerobic conditions. The results suggest that measurement of ATP by bioluminescent photometry offers a readily measured and sensitive indicator of the capacity of a nematode to cope with transient changes in oxygen supply without undue metabolic stress. PMID- 6506846 TI - Occurrence of Glossina nashi Potts 1955 Diptera-Glossinidae in the Republic of Gabon. AB - Glossina nashi, a little known species of tsetse fly, inhabits the forests of central Africa. It has recently been detected in the Province of Haut Ogooue in the south-east of the Republic of Gabon. PMID- 6506847 TI - Finds clonidine effective in treating narcotic addicts. PMID- 6506848 TI - The risk-benefit ratio in medical hero-worship. PMID- 6506849 TI - Fatal typhlitis secondary to procainamide-induced agranulocytosis. PMID- 6506850 TI - Mitral-valve prolapse presenting with seizures: case report. PMID- 6506851 TI - [Bioethics, the science of medical morals]. PMID- 6506852 TI - [Hemorheologic disorders in septic shock in peritonitis]. PMID- 6506853 TI - [Chronic non-rheumatic carditis in children and cardiomyopathies]. PMID- 6506854 TI - [Hyperthyroid cardiomyopathy: disorders in the creatine transport system and increased sensitivity to ischemic damage]. PMID- 6506855 TI - [Various hygienic aspects of the problem of using and disposing of the wastes of enterprises synthesizing organic chemicals]. PMID- 6506856 TI - [Determination of cholera enterotoxin using the coagglutination reaction]. PMID- 6506857 TI - [Latent course of lung cancer and the sex factor]. PMID- 6506858 TI - [Carcino-embryonic antigen and ferritin during the treatment of patients with primary and metastatic cancer of the liver]. PMID- 6506859 TI - [Steroid hormone receptors in malignant neoplasms of the human prostate gland]. PMID- 6506860 TI - [Dynamics of calcitonin, prolactin and carcino-embryonic antigen during the treatment of breast cancer in menopausal patients]. PMID- 6506861 TI - [Effect of verbal reinforcement on evoked cortical activity]. AB - Adult healthy subjects did not manifest any difference in latency and amplitude of the wave P300 elicited by a positive ("good") and negative ("error") reinforcing stimuli. After the negative reinforcement, the P300 wave amplitude decreases in response to the standard stimulus (light bars) and increases to a lesser degree in response to test stimuli (the same bars but presented with different pauses). In the processes of learning to assess time microintervals in comparison with the standard, the latency of wave P300 to the test stimuli shortens. It is suggested that formation and consolidation of feedback connection elaborated with the participation of a reinforcing verbal stimulus constitute the physiological basis for learning of comparative assessment of time microintervals. PMID- 6506862 TI - [Electrophysiologic analysis of interhemispheric differences in mechanisms of visual recognition]. AB - During tachistoscopic lateralized presentation of a series of geometrical figures in different conditions of recognition, early and late EP components were analyzed in the occipital, occipito-temporo-parietal, parietal and frontal cortical areas of the left and right cerebral hemispheres in juveniles and adult subjects. In both age groups, the right side dominance of the early EP component, P50-70, was revealed in the caudal cortical parts that may be connected with the predominant role of this hemisphere in the integral description of images. Asymmerty of the frontal associative zones gets formed at the mature age and consists in prevailing of the late EP components of the left frontal zone in comparison with the right one. The data are considered to reflect age-dependent mechanisms of classification type of recognition in the left hemisphere. PMID- 6506863 TI - [Effect of the spatial frequency of sinusoidal gratings on amplitude and temporal parameters of visual evoked potentials in man]. AB - Visual evoked potentials (EPs) in response to sinusoidal gratings of different contrast, with spatial frequencies of 0,5-15 cycles/grad presented in "on-off" order, were studied in six grown-up subjects with normal sight. Peak latencies of all EP components and the amplitude of the relatively early N95-130-P-120-190 complex increased with increasing spatial frequency. Presentation of low frequency gratings led to an increase of the late EP complex (N150-230-P 210 290). The EP configuration in response to sinusoidal gratings of different spatial frequencies determined by the dominance of the early or late EP complex is supposed to reflect involvement of independent mechanisms of processing of information on low or high spatial frequency differently localized in the visual cortex. PMID- 6506864 TI - [Formation and development of temporary connections with participation of unconscious and conscious stimuli]. AB - Simultaneous elaboration of motor conditioned responses to perceived (PSS) and nonperceived (NSS) sound stimuli was carried out in humans. Development and extinction of electrographic components (skin galvanic response and depression of background rhythmical activity) of the orienting response to NSS was going on significantly slower than that to PSS. The same relations were observed during formation of temporary connections with participation of PSS and NSS being reflected in a more expressed EEG depression reaction in the hemisphere participating in conditioned motor performance. The data obtained are discussed from the point of view of the hypothesis of relative independence of processes of formation of reactions to PSS and NSS even of the same modality. PMID- 6506865 TI - [Dynamics of the formation, reproduction and recognition of trace conditioned reflexes to positive and negative stimuli]. AB - The dynamics of formation, reproduction, and recognition of trace conditioned reflexes to positive and differentiation stimuli was studied on subjects of 15-17 years old. Formation and reproduction of such reflexes was found to occur under a close interaction of both levels of the higher nervous activity--recognized and unrecognized levels. Recognized reactions prevailed on unrecognized ones in cases of involvement of active attention. On the basis of this fact, the formation and reproduction of trace conditioned reflexes to positive stimuli has been supposed to occur with an active participation of the left hemisphere. The right hemisphere apparently plays a leading role in formation and reproduction of trace conditioned reflexes to differention stimuli to which the attention of the subjects was not fixed. PMID- 6506866 TI - [Systems organization of cerebral processes in the cat during learning while undergoing electrical stimulation of the neocortex]. AB - A delayed spatial choice (DSC) was elaborated in five cats during electrical stimulation (ES) of the frontal cortical parts with a frequency of 80 imp/s. Then the task fulfillment was tested following cessation of the electrostimulation or under the action of other current frequencies (35,3 and 120 imp/s). The number of erroneous choices increased in the absence of ES or during 3 imp/s ES of the frontal parts. The effects of frequencies of 35,80 and 120 imp/s did not differ. Three cats were trained to DSC without ES. The conditioned reflexes were tested during ES of the frontal cortical parts with current frequency of 3 and 80 imp/s. Statistically significant increase of the number of erroneous responses took place in both situations. The obtained data are discussed from the point of view of the integrative activity of the cerebral structures in DSC. Its disturbance during ES of the cortical zones and dissociation (discordance) after cancellation of stimulation during which the conditioned reflex had been elaborated, point to systemic organization of brain functioning in goal-directed forms of behaviour. PMID- 6506867 TI - [Role of acetylcholinergic structures of the caudate nucleus in mechanisms of inhibition of a conditioned food-getting reflex in the cat]. AB - The effect of acetylcholinergic structures stimulation on the acquisition and inhibition of a conditioned food-procuring reflex was studied in cats. Physostigmine injections (0.1 mg/kg) did not facilitate the extinction of the non reinforced food-procuring reactions of caudatectomized cats in contrast to the intact or lobectomized ones. The conclusion is made that acetylcholinergic structures of the caudate nucleus play an important role in the central inhibitory mechanisms responsible for the extinction of nonreinforced reactions. PMID- 6506869 TI - [Effect of the midbrain reticular formation on the response of cortical neurons in the rabbit during learning]. AB - The influence of low-frequency rhythmic stimulation of the midbrain reticular formation (RF) on neuronal activity in the visual cortex was studied in waking, non-immobilized rabbits during elaboration of defensive conditioned reflex to light flashes. In most neurones, the RF stimulation acted in the same direction as the painful reinforcement (electrocutaneous stimulation of the limb), potentiating the effect of the latter and contributing to changes of reactions to light flashes which became a signal of defensive response, with an increase of their similarity to reactions to paired stimuli. In some of the neurones RF stimulation produced changes in structure of phase reactions to light flashes, i.e. intensified the first phase of activation, reduced initial inhibitory pause, and augmented the number of periods of activation--inhibition alternation. PMID- 6506868 TI - [Role of dominant motivation in organizing the functions of the higher divisions of the auditory analyzer in the cat]. AB - In chronic experiments on cats, reorganization of initial interrelations between alpha-activity of higher parts of the auditory analyzer during acoustic stimulation was of a selective character and depended on motivational properties of the elicited excitation. A conditioned acoustic signal of alimentary situation, greatly intensified the functional conjugation of the majority of studied auditory projections and a number of non-specific structures, while in a defence situation there was a considerable reduction of correlative dependence between compared characteristics of the auditory centers state and a change in the hierarchy of their functional interrelations. PMID- 6506870 TI - [Effect of destruction of the hippocampus and septum on learning in the rat in "negative transfer" situations]. AB - Intact rats and rats with lesions of the hippocampus and septum were trained to repeated switching-over of the habit of choosing the reinforced side of the maze as well as to alternation of reinforced side choice. Repeated switchings-over of the habit impedes the subsequent elaboration of the choice alternation ("negative transfer"). In operated animals, the interferating effect of the previous experience is more expressed. The observed deficit of training is due to disturbance in the apparatus limiting the process of search and retrieval of adequate information from the memory. PMID- 6506871 TI - [Effect of tryptophan and its metabolites on the conditioned reflex activity of the honeybee]. AB - The effect of tryptophane and its derivatives on the rate of elaboration and transformation of conditioned reflexes (CR) to odour, with alimentary reinforcement, was studied in wild bees under two conditions: free movement of the bee or its immobilization (stress situation), by means of genetic models (mutations, successive blocking stages of kynurenin path of tryptophane metabolism). It was shown that mutations eliciting accumulation of free tryptophane and serotonin in the hemolymph of the bees and creating a deficit of kynurenins accelerate the transformation of conditioned reflexes and aggravate the depression of conditioned activity usually elicited in wild bees by monotonous prolonged presentation of conditioned signal. The injections of tryptophane and serotonin (5 mg) produce the same action. Mutations, eliciting accumulation in the hemolymph of the kynurenins (kynurenin and 3 hydroxikynurenin) accelerate, in conditions of immobilization, the formation of conditioned reflexes and delay the process of their transformation, and also contribute to maintainance of a higher (in comparison with the norm) level of the conditioned activity under monotonous presentation of the signal. The same action is produced by the injection of 1 mcg kynurenin. PMID- 6506872 TI - [Effect of proprioceptive and visual stimulation on brain stem auditory evoked potentials in the cat and in man]. AB - Proprioceptive effect on the activity of different levels of the auditory system was studied in cats under Nembutal anaesthesia and in humans, by means of recording brain stem auditory evoked potentials - BAEPs (in response to cliks), whose consecutive waves correspond to successive levels of the auditory system. BAEPs were compared when the head was in a straight position and when it was turned 45 degrees to one side. The turns elicited changes in amplitudes and latencies of all BAEP waves similarly in cats and humans but in different combinations and in different directions, which points to plurality and heterogeneity of proprioceptive effects at different auditory levels. Analogous effect on BAEPs was produced by photic stimulation - illumination of one eye in cats and of the experimental chamber in humans. The character of the effects suggests participation of the activity of descending auditory paths and the cerebellum. PMID- 6506873 TI - [Bioelectric activity and metabolism of individual brain structures at different times after administration of synthetic tetrapeptidamide]. AB - Complex study of the opioid tetrapeptide amid (TPA) effect on metabolism and neurophysiological processes of different cortical areas, caudate nucleus n. accumbens allowed to detect prolonged (several days) specific action on these structures. The influence was manifested in certain changes of transmitter metabolism, background bioelectric activity, as well as in changes of EEG reactions to adequate afferent signals. The duration of the detected changes significantly exceeded the duration of anti-pain TPA effect. PMID- 6506874 TI - [Functional integration of the nervous tissue of the rat following xenotransplantation into the brain of a rabbit]. AB - Surviving grafts of the nervous tissue taken from the septum and hippocampus of rat embryos and xenotransplanted into the rabbit's brain were observed in 4 out of 6 animals 2-3 months after surgery. The grafts contacted the neocortex or hippocampus of the recipients. Extracellular recording of neuronal activity in the grafts revealed spontaneous discharges with normal patterns and without any signs of pathology. Electrical stimulation of the recipients' brain (contralateral hippocampus, mesencephalic reticular formation, posterior cingulate cortex) induced changes of spontaneous discharges in 41% of the units in the grafts. Diffuse tonic shifts of the level of discharge were usually observed, though driving effects (in two units) were also encountered. Reactions to sensory stimulation of the recipients were observed in 61% of grafted units. Excitatory and inhibitory reactions, tonic, phasic and specific on-effects were evoked mainly by auditory and somatosensory stimuli. The data show the possibility of integration of xenografted tissue with the brain of the recipient and of its participation in processing of sensory information. PMID- 6506876 TI - [Effect of ethanol on the interaction of hippocampal neurons in tissue culture]. AB - Background unit activity and that evoked by ethanol of neighbouring neurones in hippocampal tissue culture of 9-19 div was studied by means of cross correlational analysis. The results obtained point to a possibility of existence of complex neuronal networks consolidated by functional synaptic connections, even in such a simple model system as neuronal tissue culture. Excitatory interactions of neighbouring neurones were more sensitive to ethanol than the inhibitory ones. The effect of ethanol administration consisted mainly in a weakening of correlational connections. Such changes are supposed to be the basis for different coordination disorders in the work of brain structures observed during chronic alcoholic intoxication. PMID- 6506875 TI - [Effect of 5,6-dihydroxytryptamine and 6-hydroxydopamine on the maze behavior of the snail Helix lucroum]. AB - One-trial Y-maze test in snails did not reveal any predominance of the right or left alley choice. The choice of the right alley (but not of the left one) was accompanied by a slowing down of forward motion. After the administration of 10 mg/kg of 6-hydroxydopamine 24 hr before the test, right alley choice without slowing down became more frequent. Administration of 5,6-dihydroxytrypamine (10 mg/kg) caused a reduction of motion rate along all parts of the maze and an increase in frequency of the orienting head movements towards the alley to be chosen. PMID- 6506877 TI - [Modification of Eysenck's typology in the rat]. AB - Elaboration of conditioned avoidance of artificial (increase of illumination and presentation of a sound) and zoosocial (cry of pain) aversive stimuli reveals rats with stable individual behavioural properties comparable to parameters of H. Eysenck's typology: extra-introversion, neuroticism and psychoticism. PMID- 6506878 TI - [Determination of the functional lability of the human nervous system recorded on device PNN-3]. PMID- 6506879 TI - [Reorganization of the process of visual recognition in response to a change in perceptual conditions]. PMID- 6506880 TI - [Effect of unilateral cold exclusion of the sensomotor area of the cortex in the cat on the neuronal activity of the symmetrical area]. PMID- 6506883 TI - [Multi-channel self-stimulation of brain structures in a controlled experiment]. PMID- 6506882 TI - ["Conditioned response" of the electro-excitable membrane of isolated neurons of Helix pomatia]. PMID- 6506881 TI - [Comparative analysis of the concentration of monoamines in the brain of the rat during food and water deprivation]. PMID- 6506884 TI - [Skin tanning and light protection-theory, agents and analytic aspects. 1. Skin tanning and skin tanning agents]. AB - The different approaches to achieving skin tanning with emphasis on natural tanning, due to UV radiation of the sun or solaria, and artificial tanning through tannings agents are described. In contrast to the artificial tan the natural tan is a protection against UV radiation and is caused by pigmentation (melanin formation). The artificial tanning is based on a chemical reaction usually by means of dihydroxy acetone (melanoidin formation). Reaction mechanisms by both agents are reported. The determination of dihydroxy acetone in cosmetic tanning preparations by TLC, GC, HPLC, enzymatic tests and by a new method for capillary GC including sample preparation is described. When exceeding the natural protection mechanisms the skin should be protected by physico-chemical measures. The active principles in sunscreens are the UV filtering substances. UV filters permitted in the EG are listed. 2-Hydroxy benzophenone is used as an example to explain the mechanism of UV filtering substances. Analysis of UV filtering substances in cosmetic sunscreens by TLC, GC, HPLC is described as well as a fast and simple method for separation of lipophilic UV filters followed by capillary GC determination. PMID- 6506885 TI - Polycyclic aromatic compounds in curing smoke. AB - The curing smoke, generated by the smouldering of alder chips, from a commercial food smoking plant was investigated with respect to polynuclear aromatic compounds (PAC). Samples were taken from inside the ovens and in the working zone immediately outside them. Analysis showed that considerable amounts of methyl phenanthrenes were present in the smoke as a major part of the PAC content. PMID- 6506886 TI - [Diagnostic judgment in psychoanalysis. A name for a subject or the result of communication processes?]. AB - According to the differentiation "normative" and "interpretative" paradigm, as coined by symbolic interactionism for the social sciences, two types of investigatory measures corresponding to these paradigms are distinguished in psychoanalysis: Investigation of psychoanalysis and psychoanalytic investigation. Psychoanalytic investigation in the narrower sense of the term is associated with the psychoanalytic method of investigation where the recorded sentences are sentences concerned with statements in need of interpretation and not sentences about events which, in principle, can be observed and the validity of which requires a divided system of interpretation. Diagnostic opinions in psychoanalysis are the result of the linking of such recorded sentences to the diagnostician's pool of theoretic knowledge along the lines of specific rules of discrimination or background hypotheses. This may be considered as one of the central objects of psychoanalytic investigation. PMID- 6506887 TI - [Anamnesis as drama--the first sentences]. AB - The encounter between therapist and patient can be viewed as a drama involving two actors, each attempting to convert the other. This conversion proceeds through unconscious and preconscious elements of interaction whose manifest and latent meaning/definition/interpretation is determined by the manner in which the conflict dynamics evolve within the developmental structure of the anamnesis. In this context one can observe three areas of decisive importance, namely information of an objective, subjective and dramatical nature. An analysis of the opening sentences from two case studies serves to illustrate how the dramatic process is being staged. PMID- 6506888 TI - [The pathology of susceptibility to hurt feelings]. AB - Working from a survey of the psychoanalytical literature, this paper develops the thesis of a specific pathology of the susceptibility to feeling hurt. Susceptibility to feeling hurt and the state of feeling hurt are described first by listing definite symptoms and deficient forms of coping. The characteristics of heightened susceptibility to feeling hurt are compiled on the basis of various psychodynamic interpretations and in the terminology of the psychoanalytical theory of neuroses. Symptoms, deficient forms of coping and psychodynamic methods of interpretation are then related to the four levels of experiencing urge. From this, finally, the thesis of a specific pathology of the susceptibility to feeling hurt is derived as characterized by a group of specific inhibitions and attitudes. PMID- 6506889 TI - [Time and the psyche. On the genesis and dynamics of subjective time perception]. AB - Phylogenetic and ontogenetic aspects of human time perception are discussed with respect to topical considerations as well as to suggestions related to Ego Psychology. Some phenomena of undisturbed time perception are compared to conscious and non-conscious disturbances of time perception whereby emphasis is put on modalities of the neurotic's specific and unspecific attitudes to time. The question of timelessness of the Unconscious is brought up with regard to contributions of analytic literature. The specificity of time in the situation of psychoanalytic therapy is investigated; aspects of the patient's inner and outer attitude to time in this situation are pointed out and completed casuistically. PMID- 6506890 TI - [Affect processing in psychosomatic patients. II]. AB - This study is the continuation of an earlier investigation (Ahrens, 1984) concerned with the working-through of affects in patients suffering from psychosomatic disorders. In the present study a group of psychosomatic patients is compared to a group of patients with organic complaints. Using the same methods (showing of film episodes in accordance with an experimental design, evaluation of the working-through of affects both on the cognitive and on the subconcious level) it was attempted to obtain findings of greater universality. Therefore, in contrast to the first investigation, the film episodes were of normal every-day situations in order to avoid as far as possible any personal involvement of the test subjects. The results confirm an important finding from the previous investigation, namely that even in psychosomatic patients a high rate of reaction to affective stimuli on the subconcious level can be observed. In contrast to the earlier investigated situation of intensive personal involvement, however, the group of patients suffering from psychosomatic disorders and the control group did not differ on the cognitive level with regard to their perception of the affective content of the film episodes. PMID- 6506891 TI - [Aspects of the preliminary psychotherapeutic phase before analytic treatment of psychosomatically ill patients]. AB - Practical aspects of the treatment of badly affected psychosomatic patients with deficient ego functions are to be presented and discussed here: The presence of the therapist with the patient must be measured in terms of time, space and emotion (not more than 30 minutes; the distance of eye-contact of 1-1,5 m must be kept; kind, dependable devotion). The growth of self-representation and a separate object-representation should be encouraged. This happens a) by enticing the patient to turn his attention from his inner body to the surface of his body and finally to the therapist; b) through the willingness of the therapist to let himself be scrutinized in peace; c) through dialogue between the patient and the therapist. It is of value to attain libidinal cathexis of the body ego of the patient with the help of the therapist and by the patient himself; thereby the old significance can retreat into the background. Overcoming the primary disassociation should be encouraged, namely a) by accepting the limited possibilities of the therapist. b) by showing opposite feelings in the therapist. The present social as well as the previous social situations with the various accompanying inter-personal feelings should make up the content of the discussions between the therapist and the patient in the latter part of the preliminary phase of the treatment. Only after the depicted phase in psychotherapy with badly affected psychosomatic patients attention can be focused on analytical treatment. PMID- 6506892 TI - [Psychodynamics of the wish for a penis prosthesis]. AB - The paper presents the results of the psychoanalytic investigation of 23 patients, who wanted a penile prosthesis because of psychogenic impotence. Unconscious motivations and the basal neurotic phantasies are demonstrated on the ego-psychological and drive oriented level. Usually surgeons and patients neglect the psychodynamic basis and complications of the symptom. The indication for the operation of patients suffering from psychogenic impotence has to be qualified. PMID- 6506893 TI - [The role of computerized tomography in the diagnosis and treatment planning of prostatic cancer]. AB - The influence of computerized tomography on planning the therapy of 58 patients with histologically confirmed carcinoma of the prostate gland was examined. In classifying the early tumour stages there were differences from the clinical findings. With more advanced stages CT in some cases gave much more detail for diagnosing the extension. In 11.5% of the cases this led to the irradiation field being either enlarged or reduced. CT also proved to be useful for follow-up, especially as regards decisions on increasing the irradiation dose. PMID- 6506894 TI - [Histomorphologic studies of prostate biopsies, prostatectomy preparations and lymph node metastases in prostatic cancer]. AB - Histomorphological studies on 40 prostatectomy and 122 lymphadenectomy preparations from patients with carcinoma of the prostate revealed the limits of prostate biopsy in assessing the volume of the tumour preoperatively, of capsule infiltration and of tumour histology in general. Multiple foci, the exclusion of dedifferentiated portions of a tumour and the lack of correlation between the histology of primary tumours and the degree of lymphogenous metastasis are limiting factors in the individual use of the histology of primary tumours for grading purposes. Our studies furthermore revealed the necessity for differentiated consideration of the category T3 and for intraoperative microscopic examination of resection margins in total prostatavesiculectomy. PMID- 6506895 TI - [Conventional or microsurgical op-technic in diagnostic deferens vesiculography?]. AB - A catamnestic study revealed azoospermia in the spermiogram following one in three radiodiagnostic operations on vasa deferentes using conventional techniques, whereas this was not found in a single case following the use of microsurgical techniques. The authors agree with the literature that manipulation of the vas deferens with large surgical instruments is a significant cause of postoperative occlusion, which is to be seen as an avoidable complication when microsurgery is used. Criteria for the indication and contra-indication of deferento-vesiculography are recommended, which may help to lower the at present high rate of post-operative occlusion azoospermia. PMID- 6506896 TI - [Vas deferens-obstructive azoospermia following inguinal herniotomy]. AB - Azoospermia due to obstruction of the vas deferens following herniotomy in childhood is rare; its therapy is technically difficult and its prognosis appears unfavourable. The problems are discussed on the basis of 6 of our own patients. PMID- 6506897 TI - [Effect of computer tomography on the diagnostic findings and therapy planning in diseases of the epigastrium]. AB - Computed tomography is a reliable and non-invasive, however quite expensive diagnostic method. Its use as a screening procedure should be avoided until conventional X-ray and endoscopic examinations are exhausted, as tumours in the gastrointestinal tract might be overlooked and, on the other hand, radiation exposure should not be underestimated. The specific application of CT in finding a diagnosis and planning a therapy of upper abdominal diseases, especially concerning pancreas and malignant tumours, is of considerable importance in spite of occasional errors. In any case a critical point of view is indicated. PMID- 6506898 TI - [Enterogastric reflux following resected and nonresected stomach operations]. AB - In 20 controls and 60 patients who underwent partial gastrectomy or vagotomy respectively the bilirubin-contents of the gastric juice was traced and related to pH, intragastric pressure and bacterial contamination. A reflux of bilirubin could be ensured in 70% of the controls. Low bilirubin values could be found in the control group and after selective proximal vagotomy without pyloroplasty; higher values after SPV with pyloroplasty according to Finney, antecolic B-II resection with ileo-ileostomy and in B-I-resection. Maximal values could be found after retro- and antecolic B-II-resection without ileo-ileostomy. There was a close correlation of these values to bacterial contamination and pH-value, but no correlation existed to the intragastric pressure. PMID- 6506900 TI - [A set of instruments for abdominal lavage]. PMID- 6506899 TI - [Risk of ulcer in Billroth I interposition]. AB - The ulcer risk of jejunal interposition following gastric resection was analyzed experimentally and clinically. There was a strong correlation between the rate of ulcer and the length of the interposed segment. The longer the segment and the better the reflux preventive effect was the higher was the ulcer risk. By additional vagotomy a partial protective effect could be obtained. PMID- 6506901 TI - [Histological verification of the recurrence of early gynecologic tumor and primary tumors by puncture biopsy]. AB - Needle biopsy feasible in a technically simple manner was used on 85 patients for primary histological proof of malignant tumors and tumor relapses from 1979 to 1982. The obtained tissue cylinders of about 1,2 mm in diameter and about 10 mm in length were examined histologically. A clear diagnosis could be made in 79 cases (92,8%). We did not observe any complication. PMID- 6506902 TI - [Case of XY-type gonadal dysgenesis with the development of bilateral gonadoblastomas]. AB - We report a case of bilateral gonadoblastoma caused by xy-type true gonadal dysgenesis. Specific patterns in diagnostics and therapy are discussed. Due to rare entity interdisciplinary cooperation in management is emphasized. PMID- 6506903 TI - [Experiences with expert opinion in gynecological urology]. AB - Lesions of the ureters and the bladder are represented with a relatively high portion of 40% within all gynaecological and obstetrical cases under expert opinion in the Central Office for Medical Expert Opinion. The so far mostly practisized judgement as an operational risk could not generally be consented. It is therefore that the Central Office for Medical Expert Opinion elaborated the directive No. 9: "Medical expert opinion of urological complications connected to gynaecological operations". The directive first of all means to coordinate the work within the expert opinion commissions at district level; it furtheron motivates the operator to think over his mode of action. Experiences from expert opinion result in perceiving the following main points: Even in technically simple operations the operator must know the course of the ureter; 2. if its course is not clear it must be made visible dependent on the operational situation in each case; 3. the preoperative methods of urological diagnosis have to be appropriate to the intended operation; 4. even in smallest grounds for suspicion of a lesion or complication a consequent control is necessary; a detailed documentation of the operational course is needed for various reasons; 6. the correction of lesions of the ureters and the bladder requires experience and operational ability. Because of possible grave damages to the woman the operator must be conscious of the limits of his ability. Details are demonstrated by examples of the Central Office for Medical Expert Opinion. PMID- 6506904 TI - [Treatment of the symptoms of urinary urge and urge incontinence with propiverin hydrochloride (Mictonorm)]. AB - First report about therapeutic experiences with Mictonorm (Propiverinhydrochlorid) in the field of urogynaecology. Mictonorm is a new preparation and acts as a parasympathicolytic (anticholinergic) agent and also as a direct musculotropic relaxans. In 25 patients suffering from urge- or combined urge-stress incontinence a significant increase in the capacity of the urinary bladder, a significant decrease of the intravesical pressure and a distinct reduction of the complaints has been registered. Mictonorm is recommended for the treatment of urge-incontinence and other diseases with urge-symptoms (urgency, pollacisuria, enuresis etc.) and also as a adjuvant in the treatment of acute or chronic cystitis. PMID- 6506905 TI - [Prolactin-producing hypophyseal adenomas]. AB - It is a report about the diagnostic and the therapy of 10 women with a hyperprolactinemia caused by microadenomas of the hypophysis. The diagnose was made by reason of clinical symptomatology and hormonal and neuroradiological investigations. In six cases the tumor was removed by transsphenoidal route. One women does not give her consent to the microsurgical operation. In three patients the operation seemed not to be indicated absolutely. We gave them a longlasting therapy with bromocriptine. After operation galactorrhea decreased and we found ovulatory cycles in any case. It was concluded, that the results may be better, if the patients are dealt with bromocriptine for a long time, so abolishing the still existing complaints. PMID- 6506906 TI - [The roll-over test in clinical use and its significance in the early detection of hypertensive gestosis]. AB - The roll-over-test introduced 1974 by Gant and coworkers was said to open new possibilities for prediction of gestational hypertension. The convincing results of these authors could not be reached by other study groups. The test was done in 115 pregnant women, mainly primigravidae, in the 28th gestational week. Based on our results we cannot recommended clinical use of the roll-over-test. PMID- 6506907 TI - [Data and comments on the general validity of the weight limit of 2500 g for low birth-weight infants]. AB - The authors describe the role of maternal body weight, duration of pregnancy and sex of newborn in the intrauterine growth of the fetus, more exactly in the development of birth weight. In this context they dealt with the validity of the 2500 g upper limit of low-birth-weight-infants in ethnically different populations. From the findings of their studies they draw the conclusion that the weight limit of 2500 g cannot be regarded as valid for all the populations at the statement of the proportion of low-weight births. In the authors view the question of the upper limit of low-weight newborns should be revised. At the statement of the weight limit a differentiation is necessary taking into consideration the constitutional difference in the populations as well as the average birth weight of the newborn and the sex. Authors find it permissible to use the weight value of 2500 g in comparative studies only in case of some populations with identical constitutional characteristics. PMID- 6506908 TI - [The behavior of serum concentrations of carcinoembryonic antigens in patients with cervical cancer. 1]. AB - Immunologic detection of tumor associated antigens, especially of carcinoembryonic antigen (CEA) in the last years results in clinically utilizable experiences. An early diagnosis of malignancies with CEA is not possible. But there is a good correlation between tumor mass and serum level of CEA which is suitable for follow up and recurrence prognosis. The behaviour of serum levels of CEA is examined in 58 patients with cervical carcinomas of different stages from diagnosis for 4 months. PMID- 6506909 TI - [The behavior of serum concentrations of carcinoembryonic antigens in patients with cervical cancer. 2]. AB - Report about the prognostic importance of CEA in the long lasting follow up of patients with cervical carcinomas. In 63 women with different stages serum levels of CEA were determined for two years after finishing therapy in intervalls of three months. This is of diagnostic value, because persistent or increasing concentrations with high likelihood indicate a progression or a recurrence of the tumor. PMID- 6506910 TI - [Adenomatoid tumors of the uterus]. AB - The clinical behavior and the histogenesis of adenomatoid tumors of the uterus are discussed by means of an own case and of the relevant literature. For some time reports increase suggesting a mesothelial origin of this entity. These tumors are regarded as a variety of benign mesotheliomas. The own findings support this idea. PMID- 6506911 TI - [Differential diagnosis of adnexal tumors using computer tomography]. AB - A correct differential diagnosis of pelvic tumors is sophisticated in gynecology. The present effort concerns with introducing of computertomography in our diagnostic facilities. The ultrasound method being of value in detection of early developing ovarian tumors and showing their size as well as the extent of tissue transformation is however unprecise in comparison with CT-method which allows to evaluate the anatomical relations and tissue differences. The latter one allows differentiation of cystic tumor from dermoid cyst as well as from solid tumor. Density measurement scrutinizes with more precision endometriosis, lipomatosis and tubo-ovarial abscesses. The CT-diagnosis has been proving useful especially in differentiation between ovarian and intestinal tumors. PMID- 6506912 TI - [Chlamydia infections in the gynecology outpatient clinic]. AB - Chlamydia trachomatis is a common agens of non-specific genitourinary inflammatory conditions. We examined 269 female outpatients of the clinic. For 16 per cent of the patients Chlamydia trachomatis could be isolated. In these positive cases we found the following distribution: 32.5 per cent in the cervix and urethra, 60.5 per cent only in the cervix and 7 per cent only in the urethra. The clinical symptoms and importance of the disease are discussed. PMID- 6506913 TI - [Substitution of immunoglobulins in severe infections]. AB - In cases of severe infections substitution therapy of immunoglobulins shall improve the course of the disease. At example of a case report the possibility of the immunosubstitution is demonstrated. 31 days after the radical vulvectomy a bacteriantoxic phlegmone of the cutis and the subcutis in the abdominal, genital and thigh regions has been occurred. The acute medical care consists of shock therapy, large incisions of the cutis and the subcutis and high level antibiotic therapy. In the following course the immunoglobulins (Gamma-Venin) were substituted. The serum concentrations of IgG, M and A were estimated. The dosage of Gamma-Venin amounted to 1,5 grams per day. This dosage is lower compared with the amounts reported from other authors. PMID- 6506914 TI - [Actinomycotic tubo-ovarian abscess in the presence of an intrauterine device]. AB - Two cases of women with actinomycotic tubo-ovarian abscesses are reported. Both of the patients were users of intrauterine contraceptive devices. They were successfully treated by abdominal hysterectomy with salpingooophorectomy--in one cases appendectomy in addition--and pelvic drainage combined with antibiotic therapy. Aspects of nature, diagnosis, mode of infection and therapy of actinomycosis are discussed. PMID- 6506916 TI - [Usefulness of the S-S-G, a questionnaire for measuring attitude to pregnancy, sexuality and birth]. AB - As a part of a larger research-project a questionnaire to measure attitudes towards pregnancy, sexuality and birth was used. The questionnaire, S-S-G, was developed by Lukesch and Lukesch. It is designed to measure attitudes which are believed to be very important for the processes of pregnancy, birth and eventually to the fetal development, as well. Our findings do not support the relevance and significance of this questionnaire. The further use of the S-S-G cannot be recommended because: 1. The standardization is not valid according to our and other random samples. 2. The authors' proofs of validity are not sufficient and cannot be replicated with the exception of one statement. 3. Other correlations postulated cannot be confirmed with our sample. 4. The questionnaire is both in substance and method insufficient. 5. The questionnaire is recommended by the authors for uses which have not been tested by them. PMID- 6506915 TI - [Remarks and indications for the continuous monitoring of females and pregnant patients with cardiovascular diseases]. AB - A centralization of the pregnant cardiacs within the districts of the GDR is discussed based upon an analysis of the centre for cardio-angiopathies during pregnancy in Brno and own experiences. A formerly demand for a high-specialised medical care and hospitalisation for pregnant women with cardio-angiopathies seems not to be necessary. PMID- 6506917 TI - Personality and attitude variables of women and their spouses as predictors of women's experience of pregnancy. AB - Data were collected from 138 expectant couples at three points during pregnancy and at one month postpartum with aid of a standardized questionnaire including demographic information, attitudes toward childbearing and physical and emotional symptoms. These data have been analyzed in detail to predict women's experience of pregnancy. PMID- 6506918 TI - [Fertility of females with abnormalities of the uterus]. AB - In 209 females examined with hysterosalpingography indications for examination were fertility disturbances in 131 cases, inspection of operation scar after caesarean section in 42 cases, repeated failure of intrauterine device in 9 cases and other causes in 27 cases. Development malformations of the uterus were observed in 54 females (25.8%), which comprised 40 cases with fertility malfunctions and 14 cases who had been delivered of before. The high percentage of women, who, in spite of malformations of the uterus, were delivered either spontaneously or by means of the caesarean section of live children leads to the following conclusions: 1. The occurrence of uterine malformations is more frequent than the incidence in women examined because of fertility malfunctions would indicate. 2. Uterine malformations in women who had been delivered were not always diagnosed. 3. The occurrence of repeated failure of intrauterine device coincides conspicuously with the occurrence of uterine malformations. The diagnosis of developmental malformations of the uterus cannot be always the cause of infertility. PMID- 6506919 TI - [Clinical aspects and physiopathology of fetal left heart hypoplasia. 2 case reports]. AB - 2 cases of congenital hypoplastic left heart syndrome are presented with regard to clinical signs and pathophysiology. The hypoplastic left heart syndrome consists of a hypoplastic left ventricle and absence or atresia of the aortic valve, associated with severe hypoplasia of the ascending aorta and various degrees of mitral valve hypoplasia. Infants are well developed at birth but are unable to maintain sufficient circulation after physiologic closure of the ductus arteriosus. PMID- 6506920 TI - Use of formaldehyde-PBS for serum dilution in the microscopic agglutination test (MAT) for leptospirosis. AB - Altogether, 431 sera (381 positive and 50 negative sera) were tested against different Leptospira serovars in the microscopic agglutination test (CMAT) using PBS with and without formaldehyde for comparative purposes. For the preparation of serum dilutions with formaldehyde-PBS, formaldehyde was added to PBS at a final concentration of 0.4%. When retested after storage, 234 from the 381 formerly positive sera gave positive, 68 doubtful and 79 negative results in the MAT. Out of the 234 sera with positive reaction in MAT, 212 (90.6%) showed positive reactions in the MAT with formaldehyde as well, 19 (8.1%) doubtful reactions and 3 (1.3%) became negative. All sera with negative reaction in the routine MAT were found to be negative in the MAT with formaldehyde as well. PMID- 6506921 TI - Evaluation of the slide agglutination test for detection of leptospiral antibodies in serum samples of slaughter pigs. AB - Serum samples of 259 randomly selected slaughter pigs were studied comparatively in the microscopic agglutination test (MAT) and the slide agglutination test (SAT) for the presence of leptospiral antibodies. 12 of 13 serum samples with MAT titres of 1:400+ + and higher were positive in the SAT. 27 of 46 sera with MAT titres in the borderline range (1:100+ + to 1:400+) showed a positive reaction in the SAT. 31 of 200 serum samples with MAT titres of 1:100+ and less reacted also positively in the SAT. Statistical evaluation of the results showed that the SAT is accurate if results are positive but less so if the results are negative (sensitivity 92.3%, specificity 76.4%). PMID- 6506922 TI - New trends in the rapid serodiagnosis of leptospirosis. AB - TR/Patoc slide test, ELISA and TIA (Thin-Layer Immunoassay) were evaluated for their use in a rapid serodiagnosis of human leptospirosis. The results obtained indicated that the TR/Patoc slide test is very sensitive and able to detect within a few minutes early antibodies against whichever serovar of leptospires, like the antigens of the Galton test. The value of the ELISA test in detecting antibodies at a low level is confirmed. The TIA assay, employed here for the first time for the diagnosis of leptospirosis, though sensitive seemed too long to perform and consequently it is not a test of choice for a rapid screening of sera. PMID- 6506923 TI - An IgM- and IgG-specific enzyme-linked immunosorbent assay (ELISA) to detect anti leptospiral immunoglobulins in dogs. PMID- 6506924 TI - Application of an immuno-enzyme technique to titration of antibodies in leptospirosis: ELISA (enzyme-linked immunosorbent assay). PMID- 6506925 TI - May human leptospirosis develop as a chronic infection? AB - In connection with some rather uncommon cases, the authors asked themselves whether leptospirosis may also develop as a chronic infection. To answer this question, we took into consideration four of the most representative investigated cases encountered during the last 22 years. In conclusion, it appears that in some circumstances, human leptospirosis could present itself as a chronic disease. PMID- 6506926 TI - Leptospiroses in 1982 in France and French overseas departments. PMID- 6506927 TI - Leptospirosis in New Caledonia (Melanesia). PMID- 6506928 TI - Leptospiral abortions of sows: new data. AB - In an immunization experiment, 460 sows at 7-60 days of gestation were inoculated with a rodent-adapted live strain of Leptospira interrogans serovar tarassovi at a large swine farm previously affected by this serovar. The inoculum consisted of a haemoculture prepared from the 52nd guinea-pig passage and the dose was 2 X 10(7) leptospires per sow. Over the period from the 48th to the 73rd day after inoculation 54 out of 283 sows having been inoculated at 32-60 days of gestation, aborted or delivered weak piglets. At the same time, 177 sows inoculated at days 7-32 of gestation farrowed normal litters. Altogether 18 underdeveloped piglets 2 5 weeks old derived from naturally infected litters were killed, but leptospires were not demonstrated or cultivated from their swollen and pale kidneys. It seems that L. interrogans serovar tarassovi is able to cause foetal damage in susceptible sows at one-two months of pregnancy and that previous adaptation of this serovar to rodents does not reduce its pathogenicity for porcine foetuses. PMID- 6506929 TI - [Transdural rupture of lumbar intervertebral disk prolapse]. AB - Prolapses of intervertebral disks with intradural localisation are extremely rare. Up to 1981, a total of 41 cases have been published in the world literature. A report is given on two further patients in whom intradural sequesters of intervertebral disks were found during the operation. In one patiente there were at the same time two total intrathecal sequesters from the intervertebral spaces L 3/4 and L 4/5. Until now, no reports have been published on such cases in the world literature. PMID- 6506930 TI - Prognosis of oculomotor palsy following subarachnoid hemorrhage due to aneurysms of the posterior communicating artery. AB - The incidence of an unilateral oculomotor palsy due to aneurysms in the junction of the internal carotid-posterior communicating artery is about 30 to 40%. The prognosis of these palsies is dependent of several factors. These are: 1) Is the palsy complete or incomplete? 2) Could the aneurysms be surgically treated within 14 days after onset of palsy? 3) Was decompression of the oculomotor nerve achieved by surgery? Generally the levator palpebrae recovers the fastest and most frequently. The bulbus movements have the least tendency to recover. An incomplete palsy has an essentially better prognosis than a complete palsy. Recovery can be expected if palsy is present not longer than 14 days. Cases, in which the aneurysm was clipped and reduced in size, showed the best recovery of the oculomotor palsy. The results are discussed in reference to the literature and in terms of 24 patients. PMID- 6506931 TI - [Meningioma of the posterior cranial fossa]. AB - Within 30 years a total of 60 patients with infratentorial meningiomas have been treated at the Leipzig Neurosurgical clinic: Tentorium 9, cerebellopontine angle 27, Foramen magnum 10, cerebellar hemisphere 13, clivus 1. Case history, clinical data, instrumental diagnostics and change in the therapy are broken down. Present focal points are computer tomography and microsurgery. Both principles have led to a fundamental improvement of morbidity and lethality of these tumour diseases. This tendency has been corroborated by comparisons with the international literature. The individual problems that are dealt with are computer tomography, microtechniques, acusticus and facial nerve functions, vascularisation of the tumours, dural occlusion, the access pathways and the possible postoperative complications. PMID- 6506932 TI - [Chronic subdural hematoma--operative treatment in 77 patients with burr trepanation]. AB - It is reported of 77 patients with chronic subdural haematoma all treated by burr hole trepanation. The results are demonstrated and compared to those of other kinds of treatment. In our opinion burr-hole trepanation is the superior treatment of chronic subdural haematoma, because only by surgical treatment there is a rapid ans definitive relief of brain pressure. In comparison with osteoplastic craniotomy burr-hole trepanation is less invasive and more considerate for the patients. PMID- 6506933 TI - [Importance of meningioma. Clinico-epidemiologic and histologic studies]. AB - The clinical data and histological findings of 195 patients operated on because of meningiomas have been evaluated for the comparative epidemiological morphological study of the biological validity of meningiomas under special consideration of the incidence of recidivation and malignant transformation. These were 127 women (65%) and 68 men (35%). The incidence peak of the tumour diseases for both sexes was found to lie between the 40th and the 59th year of age showing a frequency of 61 per cent. The assessment of the biological validity of meningiomas was based on the localisation, growth rate and recidivity of the tumours including histological criteria in the sense of the grading system after Zulch. The incidence of malignant meningiomas may amount to up to 10 per cent of the meningioma cases; the share in our own patients was 5.1 per cent. The incidence of recidivation of meningiomas was found to be 11.5 per cent after total tumour removal and 32 per cent after subtotal operation. The rate of the recurrence of meningiomas of the base was 52 per cent, thus being considerably higher than that of meningiomas of other localisations (3-28%). Malignant meningiomas show a particularly high recidivity. Among our own patients, there were ten cases of malignant meningiomas with 15 relapses (150%) while 185 benign meningiomas only showed a total of 30 relapses (16%). Invasive growth was found in the meningioma form classified histologically as malignant with 2.5 higher frequency than that of the benign forms of meningiomas. In recurrent tumours a malignant transformation of primary benign meningiomas was found. Malignant meningiomas with a formation of extraneural metastases are rare. Until now, only 72 cases have been reported in the literature. PMID- 6506934 TI - Microanastomosis of temporal external artery (TEA) to middle cerebral artery (MCA) branch in 150 cases of cerebrovascular occlusive disease. AB - There are presented the results of control clinical examination and control angiography in a group of 150 patients with signs of cerebral ischaemic syndrome. These patients were treated by superficial temporal artery - cortical branch of middle cerebral artery microneurosurgical anastomosis. Clinical and angiographic examination was carried out shortly after operation and after an extended period since operation. On the basis of these results the question of qualification of patients for operation is discussed, as well as the risk factor. The problem of long-term patency of the anastomosis of the superficial temporal artery with medial cerebral artery is discussed. Attention is directed to the influence of haemodynamic factors in extra-intracranial circulation, to the shape and other qualities of the anastomosis. This problem is discussed on the base of laws governing the flow of fluid in tubes of varying cross-section. In the opinion of the author microneurosurgical anastomosis of the superficial temporal artery and medial cerebral artery plays a large part in prophylaxis and less in treatment of cerebral vascular incidents. PMID- 6506935 TI - [Value of computer tomography in the diagnosis of impression fractures of the cranial vault]. AB - There are only few statements about the validity of computed tomography for the identification of impression fractures of the skull cap. The diagnostic information of roentgenograms without contrast medium and computed tomograms of a total of 15 patients were evaluated and compared. It was found that computed tomography was slightly superior to conventional X-ray examinations with respect to the diagnostic accuracy. Exact localisation, size, shape, and position of the bony impressions can be better appraised by the assessment in several axial CT section planes. The simultaneous consideration of the sequelae of the intracranial traumata by computed tomography enables a complete assessment of the craniocerebral trauma. The appropriate combination of conventional X-ray diagnosis with computed tomography should lead to an optimum diagnostic information also for these clinical pictures. PMID- 6506936 TI - [Effect of cucumarioside (a triterpene glycoside from the holothurian Cucumaria japonica) on the development of an immune response in mice to corpuscular pertussis vaccine]. AB - The influence of cucumarioside, triterpene glycoside obtained from Cucumaria japonica (Echinodermata, Holoturioidea), or sea cucumbers, on the resistance of mice to Bordetella pertussis infection (with the use experimental pertussis meningoencephalitis as a model) and on the development of immune response to corpuscular pertussis vaccine was studied. The preparation under test was shown to have greatly pronounced immunomodulating properties depending on both the concentration of cucumarioside and the route of its administration, as well as on the dose of pertussis vaccine. When administered orally in a dose of 4 micrograms per mouse and intraperitoneally in doses of 0.04 and 0.0004 micrograms, cucumarioside enhanced the protective effect of corpuscular pertussis vaccine. The use of cucumarioside in a dose of 0.001 micrograms per mouse abolished the suppressive action of large doses of pertussis vaccine in the background rosette formation test at an early period after immunization and increased number of immune rosettes formed by lymphocytes in the spleen of mice immunized with different doses of the corpuscular vaccine. PMID- 6506937 TI - [Biological properties and ecological variants of Staphylococcus aureus strains isolated from Macaca rhesus monkeys]. AB - The biological properties of staphylococci isolated from 38 healthy M. rhesus and 28 dead ones were studied. Of 90 isolated staphylococcal strains, 62 proved to be S. aureus strains belonging to 6 different ecological variants. PMID- 6506939 TI - [Sensitivity of the phage titer increase test in detecting Listeria]. AB - The optimum conditions for performing the phage titer increase test aimed at the detection of Listeria in water and soil have been established. PMID- 6506938 TI - [Determination of bacterial endotoxin admixtures in inactivated influenza vaccines]. AB - The materials substantiating the possibility of using the method for the determination of the lethal effect of endotoxin on dactinomycin-treated mice are presented. This determination is made with a view to detecting the admixtures of endotoxins in whole-virion and subvirion inactivated influenza vaccines at different stages of their manufacture, as well as in the final product. The proposed test is highly sensitive, rather simple in its practical realization and can be used for evaluating the degree of the purification of influenza vaccines from endotoxins. PMID- 6506940 TI - [Evaluation of the toxicity of a chemical by adsorbed typhoid vaccine by a pharmacological test (hexenal sleep) and by a change in thymus weight in white mice]. AB - With the wide spread of immunoprophylaxis, investigations aimed at introducing new methods for the control of vaccines are gaining in importance. As indicated by the results of investigations, the reactogenicity of vaccinal preparations for humans may be evaluated, to a certain extent, by the degree of the stress action produced by these preparations and the duration of hexenal narcosis in laboratory animals. PMID- 6506941 TI - [Effect of homologous serum globulin preparations on the intestinal automicroflora of mice after irradiation]. AB - In experiments on 4000 noninbred and CBA mice the influence of the injections of alpha-, beta- and gamma-globusin, IgG and IgM, obtained from the sera of hemostimulated and intact mice, on the intestinal microflora after irradiation has been studied. The experiments have revealed that 3 subcutaneous or intraperitoneal injections of 1 mg per mouse, made 2, 24 and 48 hours after the irradiation of the animals with gamma-rays in a dose of 700 r, considerably reduce the intensity of the accumulation of opportunistic bacteria in the small and large intestines, commonly occurring in irradiated animals. A decrease in the number of lactobacteria is less pronounced. The preparations of globulin and IgG obtained from hemostimulated mice, i.e. enriched with normal tissue antibodies, have proved to be most effective. PMID- 6506943 TI - [Prognosis of the dynamics and intensity of the epidemic process in viral hepatitis A]. AB - The article deals with approaches to the calculation of the annual morbidity rate in virus hepatitis A at the period preceding the season of maximum morbidity, necessary for planning the relevant prophylactic and antiepidemic measures in due time. The method for calculating the monthly levels of sporadic morbidity in virus hepatitis A is proposed. This method permits the detection of complications on the epidemic situation, which is necessary for the timely organization of antiepidemic measures. The proposed method for predicting annual and monthly morbidity levels can be used in the practical work of specialists at sanitary and epidemic stations. PMID- 6506942 TI - [Possible use of a concentrated vaccine against tick-borne encephalitis for immunizing donors to obtain specific immunoglobulin]. AB - The immunization of donors with dried, purified, inactivated and concentrated cell-culture tick-borne encephalitis vaccine, produced at the Institute of Poliomyelitis and Viral Encephalitides in Moscow, has been carried out with the aim of obtaining immune raw material for the production of specific donor immunoglobulin. The high immunogenic potency and low reactogenicity of the vaccine, introduced in 2 injections at an interval of 6 months, have been confirmed. Immunization in 2 injections has proved to be as effective as that achieved by 3 injections. The expediency of the immunization of regularly bled donors has been established: hemagglutinin titers in these donors have been found to be significantly higher than in a group of persons never bled before. The optimum time for taking blood has been determined: 3 weeks for regularly bled donors and 2 weeks for donors bled for the first time. Blood may be taken again 2 months after the first bleeding without booster immunization and 2 weeks after the third injection of the vaccine. PMID- 6506944 TI - [Effect of the cell components of Staphylococcus aureus on the functional activity of hemopoietic cells in mice]. AB - The data on the stimulating action of S. aureus cells, strains B-243, 2287, Wood 46, Cowan I, as well as cell-wall peptidoglycan, on the formation of endogenous colonies in the spleen of sublethally irradiated mice are presented. Teichoic acid, S. aureus ribosomal and cytoplasmic antigens produced no such effect. Whole S. aureus cells and their components were incapable of activating transitory colonies in the spleen of sublethally irradiated mice. After immunization with cell walls, peptidoglycan and protein A the mice showed a rise in the absolute and relative content of blood-forming stem cells in the marrow and the spleen. Killed S. aureus cells increased the relative content of blood-forming stem cells in the marrow, while in the spleen a rise in both absolute and relative content of such cells occurred, which was detected in the exocolonization test. PMID- 6506945 TI - [Comparative evaluation of stress-induced depression of normal killer activity in old and young animals and its elimination by interferon]. AB - The data are presented on the comparative evaluation of a poststress decrease in the activity of normal killer cells, determined in the test of the release of 41Cr from target cells YAC-1 in young and old CBA mice after 6-hour immobilization. The use of mouse leukocyte interferon and poly I . poly C acid has been shown to be highly effective for the restoration of the activity of normal killer cells in young animals after its stress-induced suppression, while in old animals these immunomodulators have proved to be considerably less effective in restoring the activity of natural killer cells at the period following the stress. The probable role of disturbances, affecting the functional properties of the normal killer cell population in old animals, in the mechanism of the poststress decrease of natural cell-mediated immunity is discussed. PMID- 6506946 TI - [Problems in antenatal neurology]. AB - This is a review of the current state of research in the area of antenatal diagnosis and prevention of nervous system diseases. The author assesses the diagnostic value of the cytogenetic, biochemical and immunological methods of analysis of the amniotic fluid as well as the role of fetal ultrasonography in detecting intrauterine damage to the nervous system. The problem of the influence of adverse factors during antenatal ontogenesis is reviewed from the contemporary point of view. Much attention is given to the effect on the fetus of the drugs used by the pregnant woman. The cardinal tasks facing investigators working in the field of the early ontogenesis of the nervous system are also formulated. PMID- 6506947 TI - [Features of cerebral cortical pathology in children with perinatal encephalopathy in infantile cerebral palsy]. AB - The results of a clinico-morphological examination of 4 patients with perinatal encephalopathy and 2 patients with infantile cerebral paralysis who died of intercurrent diseases at the age of 1 to 8 months are presented. It has been established that considerable alterations in the cytoarchitectonics in the cortical portions of the brain correlate with the functional disorders of cortical-subcortical interactions in these patients, particularly in grave course of infantile cerebral paralysis. PMID- 6506948 TI - [Malignant forms of phenylketonuria]. AB - Forty-eight patients with pernicious phenylketonuria (PKU) were examined. It was revealed that the prognostically unfavourable symptoms in relation to the malignant course of the disease included early development of epileptic attacks and neurological disturbances, the small cranial size and early extensive eczematous lesions of the skin. It was established that children with pernicious PKU more often displayed high levels (over 30 mg/100 ml) of phenylalanine and low levels (under 1 mg/100 ml) of tyrosine in the blood as compared with other patients. The results of the study of families with two or more children with PKU suggest that the malignant course of the disease may be observed not only in primary genetic defect of the cofactor and the enzymes reducing it but also in the primary genetic defect of phenylalanine hydroxylase itself. The familial criteria of differentiating between various genetic forms of pernicious PKU are presented and the methods of its treatment are substantiated pathogenetically. PMID- 6506949 TI - [Foix-Alajouanine disease in childhood (clinico-morphologic case)]. AB - It is the first report in the Soviet literature on Foix-Alajouanine's disease in childhood. The disease is marked by congenital multiple angiomatosis of the spinal vessels attended by gliosis and cavity formation. A thorough morphological analysis of the case was performed. PMID- 6506950 TI - [Experience in studying flexor pyramidal signs in premature infants]. AB - Fifty-five premature newborns weighing from 800 to 2000 g were observed for several weeks. The subject of examination was flexory pyramidal signs--the Rossolimo and Mendel-Bekhterev symptoms. The presence of these reflexes after 12 weeks of life may signal impairment of the upper motoneuron in children with perinatal pathology. PMID- 6506951 TI - [Motor-coordination disorders in patients with infantile cerebral palsy]. AB - A clinico-electrophysiological study of motor-coordinatory impairments was carried out in 117 patients with infantile cerebral paralysis. The results obtained suggest a possibility of a slow rate of myelinization, inadequate development of the coordinatory systems due to early damage to the brain associated with the systemic localization of the defect, and the obligatory involvement of extrapyramidal impairments in the realization of pathological dyskinesias. The clinical and electrophysiological examination made it possible to sum up all clinical manifestations of the pathology under a heading "discoordinatory extrapyramidal dyskinesias". PMID- 6506952 TI - [Microcirculatory disorders in the acute period of craniocerebral injuries in children]. AB - The authors analyzed the results of the biomicroscopy examination of the microcirculation in patients aged 2.5 to 15 years in the acute period of craniocerebral trauma. It was established that the changes in the condition of the conjunctival microvessels reflect the general cerebral microcirculation impairments following craniocerebral injury, their severity depending on the degree of brain involvement. They are characterized by spastic arterioles, distended venules as well as the development of the sludging phenomenon and the disruption of the capillary blood flow depending on the severity of craniocerebral trauma. PMID- 6506953 TI - [Bioelectric activity of the brain in the acute and convalescent periods of tick borne encephalitis in children]. AB - The bioelectrical activity of the brain was studied in 86 children in the acute period of tick-borne encephalitis and during convalescence. A total of 183 electroencephalograms were analyzed, predominantly in the subclinical form of the disease (153). The acute stage was characterized by impairments in the bioelectrical activity of the brain in children of all age groups. The severity of the disorders and the form of the disease were closely correlated both according to the data of the baseline EEG and the findings of the functional tests. The changes were mostly manifest in a lowered threshold of cerebral excitability and, consequently, in increased convulsive readiness. In the course of the follow-up (2-3 years) these changes leveled off. PMID- 6506954 TI - [Acute necrotic encephalitis in children (clinico-electroencephalographic study)]. AB - Twenty-five children aged 3 months to 13 years were examined electro encephalographically. Most of the patients (20 of the 25) were young children (under 3 years of age) with the diagnosis of acute necrotic encephalitis. The characteristic changes of the EEG expressed in the form of cyclically arising asymmetric giant slow waves were established. The nature of the EEG was shown to correlate with the gravity of the clinical course. The data obtained may be used both diagnostically and prognostically. PMID- 6506955 TI - [Treatment of movement disorders in children with cerebral palsy]. AB - The author describes the results of the treatment of motor disorders in 909 children with cerebral paralyses (aged 3-7 years) carried out in the health resort "Saulute" in the Lithuanian Soviet Socialist Republic. A complex of methodological techniques elaborated in this health resort is most optimal for ensuring the possibility of unassisted standing and walking with the maintenance of balance without any auxiliary devices (crutches, walking sticks, etc.). The method proposed by the author is based on the simultaneous involvement of all functional systems of the brain into the activity ensuring the possibility of active normal movement. Of the 909 children with motor cerebral paralyses unable to walk, 30% began to walk after the course of treatment, 70% were able to stand up and stay on their feet keeping balance without any support. PMID- 6506956 TI - [Improving the systematics of mental disorders in children and adolescents]. AB - An original Soviet classification of mental diseases in children and adolescents based on three components (clinico-nosological, quantitative (reflecting a depth of lesion) and syndromologic) is described. Suggestions are proposed aimed at the improvement of the International Classification of Diseases, Injuries and Causes of Death, the 9th modification. PMID- 6506957 TI - [Variants of movement disorders within the psychopathologic structure of borderline neuropsychiatric diseases in young children]. AB - On the basis of the examination covering 30 young children (aged 2 months to 3.5 years), three variants of motor psychogenic disorders were specified. Group I included elementary, stereotypic motor phenomena expressed as special poses, rocking, jack-knifing, finger sucking and other stereotypes of motor acts. Group II was characterized by more complicated motor and psychomotor disorders in the form of various manifestations of motor infantilism. Group III comprised children with neurotic motor monosymptomatic and ritual-behavioural obsessive actions. The above disorders are assessed from the evolutional-dynamic point of view. PMID- 6506958 TI - [Clinico-physiologic analysis of psychogenic tics in children]. AB - The results obtained in a study of 100 patients formed the basis for major differential diagnostic criteria of psychogenic tics in children. Polygraphic examination of the sleep-wakefulness cycle revealed dysfunctions in the nonspecific cerebral systems in the form of hyperfunction of the activating and insufficiency of the inhibitory apparatuses which were expressed in all functional states in the EEG, motor and vegetative spheres. These changes are considered to be pathogenetically important in view of their connection with the most significant clinical characteristics of the disease. On the basis of electrophysiological indicators, the data were obtained which substantiate therapeutic efficacy of psychostimulators in patients with the syndrome of motor hyperactivity. PMID- 6506959 TI - [Initial neuropsychiatric disorders in children with hepatitis and the effect of microsocial-psychological factors on their development]. AB - The psychic hepatitis-associated disorders in children with different biological and microsocial influences were studied. The development of mental disturbances correlated with the severity of hepatitis. It is concluded that identification of aggravating factors of the microsocial environment is necessary for timely conduction of prophylactic measures. PMID- 6506960 TI - [Blood testosterone levels in nonpsychotic psychopath-like behavior disorders among adolescents with accelerated or delayed physical development]. AB - The authors examined 128 male adolescents admitted to a psychiatric hospital for the psychopathlike syndrome free of psychotic manifestations which was associated with the abnormal rate of sexual development. A correlation was established between the maturation rate, plasma testosterone levels and clinical features of behavioural abnormalities. Retarded puberty was related to decreased testosterone concentrations throughout the pubertal period. In cases of accelerated development the testosterone content was increased at the age of 14-15 years, i.e. in the period of the most intensive maturation; later on, in the process of reaching puberty, the hormone level approaches the age specific rate. The clinical picture of behavioural disorders in the presence of retarded or accelerated development depends on whether the symptoms caused by abnormal rates of maturation were combined with the symptoms of cerebral insufficiency. Adolescents with accelerated development unattended by cerebral insufficiency manifestations were characterized by marked aggression and an increase in desires. Depending on the degree of activity, asthenic nature, leadership capacities and the level of intellect, they are divided into two clinical variants: epileptoid and conformational-epileptoid types of accentuations. Cerebral insufficiency was reflected in the form of lowered intellect, explosiveness and impaired desires in the clinical picture of both accelerated and retarded pubertal development. PMID- 6506961 TI - [Effect of exogenous factors on clinical features of initial disorders in adolescent schizophrenia]. AB - Using clinical and experimental-psychological methods (a method of fixed orientation), the authors have studied 34 adolescents with continuous schizophrenia whose manifestation was attended by some exogenic factors (psychogenies, somatogenies, tox-infectious, and cranial traumas). The results obtained indicate some complications of psychopathological disturbances at the initial stage, manifesting in their marked acuteness, extension of the polymorphic spectrum and inclusion of heteronomous formations uncharacteristic of schizophrenia. A group of heteronomous manifestations should include sensorium disorders, pronounced emotional lability, general cerebral impairments, episodes of visual illusions and hallucinations, etc. The fixed orientation in the cases described is largely the same as in "nuclear" schizophrenia but some specificities, predominantly in the presence of psychogenic factors, are also observed. PMID- 6506962 TI - [Various features of the syndrome of pathologic fantasizing in slowly progressing schizophrenia in children]. AB - Thirty-eight children with the syndrome of pathological fantasies at the neurotic level were examined. Four groups were identified: (1) pathological fantasies connected with plays and interests of a superworship nature; (2) fantasies manifested as inclination pathology; (3) fantasies expressed as play transformation and (4) expressed in the form of slander allegations against others and oneself. PMID- 6506963 TI - [Protracted maniacal disorders in schizophrenic children]. AB - The results of the study of 29 patients (25 boys and 4 girls) aged 4-11 years suffering from schizophrenia with manic disturbances are reviewed. These conditions were characterized by the absence of affect vitality, its homogeneity in the presence of emotional deficiency, dissociation of the manic syndrome, combination with autism, mental infantilism, superworship formations and neurosis like disturbances. Four variants of chronic manias have been specified: benevolent, mischievous, hyperdynamic and hypomania with monotonous activity. PMID- 6506964 TI - [Comparative study of features of the perceptive and intellectual activity of schizophrenic children]. AB - A comparative study of the formation of the intellectual and perceptive activity in schizophrenic children aged 5 to 13 years (n = 102) as compared to healthy age matched controls (n = 150) was carried out. Two complexes of techniques were employed, aimed at investigation of two interrelated aspects (operational and selective) of intellectual and perceptive (visual perception) activity. Dissociation of these components of cognitive activity observed in schizophrenic children already during the formation of perception gets more pronounced in the formation of thought. Dissociation of the development of the intellectual and perceptive activity of schizophrenic children may be considered as a component of abnormal mental development. PMID- 6506965 TI - [Features of the clinical picture and dynamics of endogenous depression developing in adolescence (clinico-catamnestic study)]. AB - The clinical picture and time-course of endogenic depressions were studied in 31 subjects who fell ill in adolescence, at the age of 10-17 years. The follow-up continued for 22 years. At the initial stages the overwhelming majority of the adolescents (93.55%) showed "masked" atypical manifestations of depression. The follow-up findings made it possible to identify a certain pattern in the time course and transformation of affective disturbances. With time the affective disorders became clear-cut in half of the patients and no further complications of the syndrome structure were observed. In other cases the affective symptomatology was attended by hallucinational and hallucination-delirious disturbances. In the remaining cases a short stage of affective disturbances was followed by a negative symptomatology or the disease assumed a continuous course with the appearance of chronic productive disorders. The premorbid characteristics of adolescents and the structural specificities of the first depressive attack can serve as early prognostic criteria. PMID- 6506966 TI - [Suicidal behavior in adolescents]. AB - Suicidal actions of 156 children and adolescents aged 11-17 years are analyzed. An attempt is made to classify suicidal behaviours according to psychopatho dynamic signs into certain definite syndromes (balanced, persistent, ambivalent, impulsive and demonstrative suicidal actions) and to differentiate them depending on the degree of suicide intention into "suicidal" and "parasuicidal". PMID- 6506967 TI - [Disorders of higher mental functions in children with the Lesch-Nyhan syndrome]. AB - The authors analyzed higher psychic dysfunctions, the structure of intellectual impairments, the characteristics of the emotional-motivational sphere in four children with the classical and in 12 children with the psychopathological variant of hereditary purinosis. Disturbances of higher psychic functions are associated with damage to the profound portions and the limbic system of the brain. The described structure of higher mental functions along with the characteristic features of the emotional-motivational sphere may serve as sufficient clinical-psychopathological criteria for diagnosing Lesch-Nyhan's syndrome. PMID- 6506968 TI - [System of therapeutic-health-improving measures in the screening of adolescents with mental disorders]. AB - The authors present a system of the screening of adolescents with mental aberrations which involves the identification of five groups of follow-up depending on the status of the patient on the one hand and the types of necessary therapeutic and roborant help on the other. PMID- 6506969 TI - [Unconscious mental activity]. PMID- 6506970 TI - [Comparative evaluation of the diagnostic possibilities of radioisotope angiography and rheoencephalography in patients with vascular diseases of the brain]. AB - Forty-one patients with dyscirculatory encephalopathy complicated by a transient impairment of the cerebral circulation were examined in a neurological department. A comparative analysis of the findings obtained during comprehensive study of the cerebral circulation showed that in the overwhelming majority of cases (37 out of 41), the results of isotope angiography and rheography coincided and corresponded to the clinical findings. To a certain degree these methods complemented each other: rheoencephalography was more informative in the diagnosis of cerebral atherosclerosis and essential hypertension while radioisotope angiography allowed a more accurate determination of the area affected. PMID- 6506971 TI - [Diagnosis of hemorrhages in the brain with rupturing of blood into the ventricular system]. AB - Clinical observations of 424 patients with intracerebral hemorrhages (314 with parenchymatous-ventricular and 110 with parenchymatous) verified at autopsy are reviewed. An analysis of the observations allowed the differentiation of the very acute, acute and subacute forms of parenchymatous-ventricular hemorrhages. The incidence of some "classical" symptoms of parenchymatous-ventricular bleeding was shown to change. The erroneous diagnosis of the ischemic nature of the stroke in 7.7% of observations was analyzed. The accuracy of computing differential diagnosis (using Bies's procedure in postulating the independence of the signs) was 75-79% depending on the type and localization of cerebral hemorrhages. PMID- 6506972 TI - [Status of the central and cerebral circulation in healthy subjects and patients with the initial manifestations of insufficient blood supply to the brain]. AB - Using a complex of rheographic techniques, the central and cerebral circulation was studied in 62 healthy subjects and 172 patients with incipient manifestations of cerebral circulation insufficiency (IMCCI). In the group of normal subjects, the hemodynamic indices corresponded to the hyper-, eu-, and hypokinetic types of circulation; the pulse blood filling of the brain depended on the magnitude of the stroke volume. Patients with IMCCI and different hemodynamic types of various intensity demonstrated changes in the ratios of the pulse blood filling and the volumetric speed of the cerebral blood flow to the stroke volume and cardiac output which resulted in the formation of cerebrovascular insufficiency. PMID- 6506973 TI - [Variability of the EEG in the acute period of comas resulting from cerebral circulatory disorders]. AB - Up to now there has been a general consensus in the literature that the development of the comatose state is attended with the appearance on the EEG of high amplitude slow activity. The article shows that the acute period of coma is not always associated with this regularity. A large part of the EBG presents low amplitude irregular activity with occasional rapid fluctuations. In some cases there are phenomena characteristic of the physiological nocturnal sleep. The data obtained make it possible to consider the role of different synchronizing and desynchronizing cerebral systems in the genesis of electrical activity in the period of coma and are of certain interest in terms of studying the neurophysiological mechanisms of comatose states. PMID- 6506974 TI - [Effect of papaverine on systemic and cerebral hemodynamics in atherosclerosis complicated by chronic cerebral circulatory insufficiency]. AB - The parameters of the general and cerebral hemodynamics were studied in 36 patients with chronic insufficiency of the cerebral circulation following papaverine administration. In patients with the early stages of the disease, papaverine elicited a decrease in the arterial pressure and the peripheral resistance to the blood flow. The amplitude of the rheographic curve increased significantly two minutes after the intravenous injection of papaverine. Papaverine is recommended for patients with the compensatory and remitting stages of the disease. In latent cardiovascular insufficiency, papaverine should be combined with cardiogenic agents and drugs promoting metabolism in the cardiac muscle. PMID- 6506975 TI - [Comparative indices of proserine therapy in complex muscle relaxation in post stroke motor disorders]. AB - Fifty young patients with post-stroke motor disorders of a 1-5-year standing treated with proserine showed no beneficial response to the treatment. The use of a combination of myorelaxants in these patients improved considerably the patients' ability to take care of themselves. PMID- 6506976 TI - [Nocturnal sleep and cerebral hemodynamics in different sleep stages and cycles among patients with early manifestations of cerebral circulatory insufficiency]. AB - Clinical and polygraphical (EEG, EOG, EMG, ECG, REG) studies of nocturnal sleep and of the hemodynamics were carried out in 60 patients with dyscirculatory encephalopathy induced by hypertension and atherosclerosis. The findings obtained demonstrate that the clinical picture in these patients is always characterized by sleep disturbances which decrease the level of their diurnal wakefulness and their capacity for work. Hemodynamic disturbances responsible for sleep disorders are in turn maintained by the latter which leads to the formation of the vicious circle. This is also supported by the fact that compromized cerebral circulation causes changes in the activity of the structures involved both in sleep wakefulness function and the regulation of the cerebral and systemic hemodynamics. Hence, deviations in the nocturnal sleep pattern attended with pronounced alterations in the cerebral hemodynamics may contribute to the development of acute disorders of the cerebral circulation. The authors recommend correcting not only the disrupted structure of sleep but also the cerebral circulation with relation to he sleep-wakefulness cycle. PMID- 6506977 TI - [Therapeutic use of hyperbaric oxygenation in ischemic strokes]. AB - Hyperbaric oxygenation is a valuable adjunct to the complex of measures devised to treat patients with ischemic cerebral strokes, including those who have undergone surgical operations on the extracranial portion of the cerebral major vessels. Although the best therapeutic effect of hyperbaric oxygenation is observed in the acute period of a stroke, its employment may be useful in many patients in the residual period of the stroke as well. The therapeutic action of hyperbaric oxygenation may be due to not only a certain recovery of the function of the damaged neural centres but also to the mobilization of various mechanisms of the CNS compensatory recovery. PMID- 6506978 TI - [Dimexide (dimethylsulfoxide) in the treatment of multiple sclerosis]. AB - Thirty-four patients with multiple sclerosis were treated with dimexide. The use of the drug was found to be desirable, since it had a positive effect on immunity and antiallergic and reparative action on the injured tissues. The treatment proved most effective in patients with a remitting course of the disease. In patients with a rapidly progressive course, the improvement was unstable. No side effects were observed. The beneficial therapeutic effect of dimexide may be explained by remyelinization, a reduction in the edema and neurodynamic improvement. PMID- 6506979 TI - [Trans-cerebral electrophoresis of L-DOPA in the complex treatment of parkinsonism]. AB - Based on the established electrophoretic mobility of L-DOPA and on pathogenetic assumptions, the authors carried out multiple modality treatment employing transcerebral L-DOPA electrophoresis in 48 patients with postencephalic and atherosclerotic parkinsonism. The majority of patients (43 subjects) showed an improvement of various degrees, particularly when rigidity and oligo- and bradykinesia were predominant in the clinical picture of the disease. Of the 48 patients treated, 29 received L-DOPA per os and 19 patients were given low drug doses. The therapeutic effect persisted from 2 weeks to 2-3 months. PMID- 6506981 TI - [Effect of aging and senile dementia on the course of schizophrenia]. AB - The author compares the clinical data obtained from 4 groups of elderly patients: schizophrenia that began in young age (n=49), late schizophrenia (n=49), schizoform psychoses in senile dementia (n=72), a combination of senile dementia with a long-standing schizophrenia (n=31). Ageing was associated with changes in the clinical picture of schizophrenia similar to those seen in schizophrenia complicated with senile dementia. Age-related clinical manifestations characteristic for combined schizophrenia and senile dementia are far more pronounced than in cases of natural ageing in schizophrenic patients. Patients with an early onset of schizophrenia had a significantly greater incidence of senile dementia before they reached 60 years. PMID- 6506980 TI - [Several functional psychosomatic diseases of the gastrointestinal tract]. AB - Using a clinico-psychological method, 170 patients with functional psychosomatic pathology of the alimentary apparatus (functional dysphagia, neurogenic vomiting, gastralgias, the syndrome of the irritable large intestine) were examined. The study showed that these diseases manifested themselves after a considerable psychotraumatic situation. In women, the role of the stressor was played by disruptions in familial relations while in men, job-related stresses were usually involved. Particular vulnerability of the gastrointestinal tract expressed in episodic dysfunction from early childhood was a predisposing factor in all observations. The personality characteristics of the patients (as judged from the data obtained by techniques of Taylor, Aizenk, M.H.Q., "incompleted sentences" and the index of the stability-instability of marriage) are characterized by high anxiety, neurotism, depression, and liability to obsessive-phobic reactions. Comparison of the research findings with the relevant results obtained in an organic psychosomatic disease (duodenal ulcer) demonstrated that with further somatization of the affect, the above personality features tend to decrease. According to the data obtained functional psychosomatic disturbances progress to organicones only in 7.4% of cases. PMID- 6506982 TI - [Clinical characteristics of the psychopathological variant of hereditary purinosis]. AB - The authors describe the clinical picture of hereditary purinosis with predominantly psychopathological manifestations in 12 boys, aged 12-15 years, identified among slightly oligophrenic children on the basis of the psychopathological similarity with the classical Lesh-Nyhan syndrome and the determination of the activity of purine phosphoribosyl transferases in erythrocyte lysates. The authors believe that diagnostically significant in such cases is a specific complex of disorders at the instinctive-emotional, psychomotor and intellectual levels. They also claim that this variant of hereditary purinosis is more prevalent than the classical one. PMID- 6506983 TI - [Pressing questions concerning the organization of treatment divisions of modern psychiatric hospitals]. AB - The article is concerned with the contemporary principles of organizing inpatient psychiatric care. The authors analyze the negative aspects of the territorial principle in structuring the work of mental hospitals and in the specialization of the inpatient capacity. On the basis of the experience gained and the results of the study, they suggest the specialization of psychiatric hospitals according to the functional principle, i. e. depending on the functions carried out and age related and nosological characteristics of inpatients. Thus, in organizing or reorganizing psychiatric hospitals, it is recommended setting up specialized departments intended to implement specific tasks: diagnostic, expert, therapeutic, rehabilitation, etc. The advantages of such specialization of the inpatient capacity of hospital departments are substantiated. The advisability of the organization of hospital departments in psychiatric care without sex segregation is emphasized because it is an important factor in the rehabilitation of patients. PMID- 6506984 TI - [One of the forms of operation of a day-night hospital complex (with a stage of round-the-clock hospital stays) at a psychoneurologic dispensary]. AB - A variant of a diurnal-nocturnal inpatient complex on the basis of a psychoneurological dispensary involving a short period of round-the-clock hospitalization of patients is described. This proved advisable in the treatment of three groups of patients (n = 260): (1) those with acute manifestations of the disease (to carry out intensive therapy), (2) those with subacute paroxysms and prolonged psychotic states (to conduct arresting therapy), (3) with conflicts in the microsocial environment (with the aim of their temporary isolation). Such an organizational form makes it possible to expand intensive therapy and increase a number of patients with acute psychotic manifestations treated outside the settings of a closed hospital. PMID- 6506985 TI - [Relation between the effect of tranquilizers and various features of personality structure among patients with borderline states]. AB - The authors revealed differences in the clinico-psychopathological structure, therapeutic time-course and efficiency of the treatment by tranquilizers (e. g. phenazepam, a drug whose effect is typical for the entire group of tranquilizers) in 86 patients with borderline states, the nature of differences depending on the typological characteristics of their personality structure. Hypersthenia was associated with a tranquilo-sedative effect while in hyposthenia a tranquilo stimulating effect was observed. Electroencephalographic examinations also point to various routes of realization of the modulating influence of tranquilizers. PMID- 6506986 TI - [Neurotic disorders in epilepsy and their treatment by technics of psychotherapy and reflexotherapy]. AB - The paper reports on observations of the onset and development of neurotic states in patients (n = 51) suffering from various forms of epilepsy at different stages of the disease. The clinical features of the principal types of neuroses such as neurasthenia, hysteria or neurosis of obsessive states proceeding in the presence of epilepsy are considered and clinical examples are adduced. Recommendations are given on the treatment of such patients using psychotherapy (including hypnotherapy) and acupuncture combined with basic anticonvulsion treatment. Peculiar phenomena resulting from the application of these methods and their therapeutic value are described. PMID- 6506987 TI - [Various approaches to the problem of mass screening in psychiatry]. PMID- 6506988 TI - [Value of electroencephalography in surgical procedures for the creation of extra intracranial microvascular anastomoses]. AB - EEG was conducted in 55 patients before and after operation of EICMA. Besides clinical improvement, improvement of the EEG values was observed in most cases. The discrepancy between the EEG values and the neurological symptomatology depends on the localization of the pathological focus in the cerebral hemispheres. The EICMA operation is ineffective when focal delta activity is recorded on the EEG. This should be taken into account in determining the contraindications for EICMA operation in patients with ischemic disorders of cerebral circulation. PMID- 6506989 TI - [Branches of the perforating portions of the internal carotid arteries and their commissural anastomoses]. AB - By means of injection methods allowing microscopic preparation of vessels 0.015 mm and less in diameter the author examined 25 block-specimens of the base of the skull which contained the left and right cavernous parts of the internal carotid arteries and structures adjacent to them. The specimens were obtained in cases in which death was caused by the disease not associated with pathological conditions of the central nervous system. Arteries arising from the cavernous part of the internal carotid artery are described. The author determined the existence of a system of permanent commissural anastomoses between the cavernous parts of the left and right internal carotid arteries which is formed by the branches of the dorsal meningeal, inferior hypophyseal, and capsular arteries (McConnell arteries). The importance of the system in the diagnosis and treatment of pathological processes of parasinus and parasellar localization, particularly arteriosinus malformations of this region, is pointed out. PMID- 6506990 TI - [Multi-axial echoencephalography in the diagnostic system for brain tumors]. AB - The authors examined 204 patients with tumors of the brain of supra- and subtentorial location. It is shown that multiaxial echoencephalography is simple and informative. The echographic criteria studied, whose changes are determined by the location and character of the tumor, are very important. On the basis of the changes of these parameters, the possibilities of earlier and diagnosis of brain tumors were established. PMID- 6506991 TI - [Relation between criteria for the outcome of craniocerebral trauma and the severity of consciousness disorders in the acute phase]. AB - Prognostic criteria of outcomes after severe craniocerebral traumas observed in 66 patients have been presented with the account of the degree of consciousness disorders in the acute phase. Favourable outcomes were confirmed in subjects whose level of consciousness impairments was not below 20 points according to coma quantity classification accepted at the N. N. Burdenko Institute of Neurosurgery. PMID- 6506993 TI - [Visual evoked potentials in optochiasmal arachnoiditis]. AB - Visual evoked potentials (EP) were studied in 24 patients with optochiasmal arachnoiditis. Distinct changes were registered in the visual EP in the form of increased latent period of the response, diminution of its amplitude and separability, and poor structuralization. The critical level of visual acuity for the specific and nonspecific visual EP was determined. From analysis of the visual EP time-course during treatment the authors established the criteria of the prognosis for the recovery of visual functions in patients with optochiasmal arachnoiditis. PMID- 6506992 TI - [Immunologic changes in the acute period of slight craniocerebral trauma]. AB - The authors discuss the results of a dynamic study of the characteristics of nonspecific immune responsiveness (properdin, total protein and globulin fractions in blood plasma, C-reactive protein, and immunoglobulins G, A, and M) as well as of the index of water metabolism of the brain matter--the antidiuretic hormone (ADH) in plasma, in 259 patients with the nosological forms of a mild craniocerebral injury 145 of whom had concussion of the brain and 105 had mild contusion of the brain. Congruence of the clinical manifestations of the injury and the level of plasma ADH was recorded. The participation of the factors of nonspecific immune responsiveness in the body compensatory posttraumatic reactions and the genesis of the clinical manifestations of a mild craniocerebral injury is emphasized. PMID- 6506994 TI - [Motor function compensation in patients with infantile residual encephalopathy and epilepsy following hemispherectomy]. AB - The author studied the time-course of motor function in the paretic and healthy limbs of 12 patients who underwent hemispherectomy. The neurological symptomatology, H-reflex parameters, and the results of a series of motor tests were appraised. In the acute postoperative period, the short-lived signs of central shock in the paretic limbs were observed, which were then replaced by increased excitability of the central nervous system on the side of the hemiparesis. Besides cessation of attacks and epileptic activity on the ECG in the late period, the author recorded total rise of the threshold of H-reflex production and improvement in the performance of the motor tests in unispheric patients, which were regarded as signs of epilepsy compensation. PMID- 6506995 TI - [Significance of a displaced, calcified pineal body in the diagnosis of traumatic intracranial hematomas]. PMID- 6506996 TI - [Superselective catheterization of cerebral vessels]. AB - Superselective catheterization of 213 cerebral vessels in 84 patients with arteriovenous malformations (AVM) of the brain was conducted by means of different designs of balloon catheters and catheters without balloons. The authors performed superselective contrast study of 48 vessels of the 2nd order, 120 vessels of the 3rd order, and 45 vessels of the 4th order. Catheters were introduced into 35 branches of the anterior cerebral artery, 124 branches of the middle cerebral artery, anterior villous artery, catheters, twin-lumen balloon catheters and balloons with two catheters, balloon catheters with an opening in the head end of the balloon or those in which the balloon was made airtight temporarily, and catheters without balloons were tested. The authors prefer catheters with an open balloon and those without balloons for superselective catheterization of afferent vessels of AVM and for subsequent intravascular thrombosis. PMID- 6506997 TI - [Diseases of the large intestine, rectum and perianal region (excluding malignomas)]. PMID- 6506998 TI - [Fractures of the pelvis]. PMID- 6506999 TI - [Organization and care of multiple injuries under peacetime conditions]. PMID- 6507000 TI - [Acute ileus]. PMID- 6507001 TI - [Stenoses in surgery]. PMID- 6507002 TI - [Volvulus of the sigmoid]. PMID- 6507003 TI - Characterization of growth hormone release in response to external heating. Comparison to exercise induced release. AB - The effects of increases in body temperature on growth hormone (GH)-release were studied in 10 young normal males in the fasting state as well as postprandially. The temperature increase of one degree centigrade was attained by external heating using thermostatically controlled water blankets covered by heat reflecting aluminium foil. The increase in plasma GH after heating was partially suppressed in the non-fasting state reaching a mean of 7.9 +/- 3.5 (SEM), ng/ml, range 1.0-36 ng/ml. In contrast all subjects exhibited higher increases, mean 18.3 +/- 4.0 ng/ml, range 7-44 ng/ml, in response to heating when fasting. The results were compared in the same subjects to the plasma GH-responses obtained during exercise (450 kpm/min for 40 min) inducing a similar increase in body temperature of about one degree centrigrade. Nevertheless the response in plasma GH (8.4 +/- 3.3 ng/ml, range 0.4-34 ng/ml) was smaller than obtained by the heat test despite a rate of temperature increase on exercise which was about twice as high. Furthermore, the same exercise performed in a cold room under circumstances which precluded any major rises in core temperature resulted in complete inhibition of GH-release. The results indicate that exercise per se does not stimulate GH-secretion, indeed it may inhibit the response expected to be evoked by the exercise-induced rise in temperature. Evidence is also presented that it is core and not cutaneous temperature which modulated GH release. The procedure used for inducing the rise in temperature and plasma GH may be used as a simple, acceptable and safe clinical test for GH-insufficiency. PMID- 6507004 TI - Effects of aging on prolactin release after stress in female and male rats. AB - Young adult and elderly male and female intact rats, as well as chronically ovariectomized (OVX) young and elderly female rats, were subjected to an acute stress by cutting the tip of the tail and prolactin (Prl) concentrations were measured in their blood collected by decapitation at various times thereafter. Maximum concentrations of the hormone were markedly lower in all the three groups of elderly rats than those found in the corresponding young animals, and appeared to occur with a delay in the females, but not in the males. In addition, the Prl response to stress was attenuated in OVX animals regardless of their age. The result of these experiments, performed at two points on the age scale, suggests that in sexually mature rats of both sexes the stress-induced secretion of Prl is inversely related to the age of the animal and that the reverse relationship is retained in OVX females. PMID- 6507006 TI - Differential calcium response of normal and adenomatous parathyroid glands. AB - In vitro parathyroid hormone secretion of normal (n = 10) and adenomatous (n = 20) human parathyroid glands was compared in response to different calcium (Ca++) concentrations. The glands, prepared for tissue culture immediately after surgical removal, were incubated under identical conditions for 6 h. The medium was changed hourly and analyzed for PTH and cAMP using radioimmunoassay. During the first 2 h of the experiment, the Ca++ concentrations of all preparations was kept constant at 1.2 mM equivalent to the normal Ca++ level of the intercellular space. The PTH level of the 2nd h was defined as reference value corresponding to 100%. After the 2nd h of incubation the Ca++ concentration in the medium was shifted either to low (0.9 or 0.6 mM) or to high (1.9 or 2.6 mM) values. In low Ca++ concentrations (0.6 mM) the normal parathyroid glands responded by stimulation of the PTH release up to 310% in relation to the reference value, whereas the adenomas enhanced the PTH release to 160% only. The incubations in 0.9 mM Ca++ resulted in a slightly lower degree of stimulation. During the incubation in high Ca++ the PTH secretion was reduced to 28% by normal glands and to 52% by adenomatous parathyroid glands. Movements of cAMP measurements paralleled PTH values. The study provides evidence for an abnormally low responsiveness of parathyroid adenomas to Ca++ when compared with normal glands. The reduction in Ca++ responsiveness of adenomatous cells appears to have a fundamental role in primary hyperparathyroidism since the tumour cells may obviously recognize normal Ca++ levels as 'hypocalcaemic' and react by a stimulated PTH secretion. PMID- 6507005 TI - Serum free T4, T3, rT3, 3,3'-diiodothyronine and 3',5'-diiodothyronine measured by ultrafiltration. AB - A simple and accurate method for estimation of the free fractions (FFT) of T4, T3, rT3, 3,3'-diiodothyronine (3,3'-T2) and 3',5'-diiodothyronine (3',5'-T2) in serum is presented. The method is based on ultrafiltration of serum pre-incubated with tracers of high specific activity, followed by purification of the ultrafiltrate on small Sephadex columns. The addition of tracer only dilutes serum negligible (about 5%) and the ultrafiltration procedure only removes about 7% of the volume of serum, thus probably not disturbing the equilibrium between the free and protein bound fraction of iodothyronine. Progressive reduction of tracer to less than 10% of the amount usually used did not reduce the FFT of any of the iodothyronines. In contrast, addition of T4 to serum led to an increase of all FFTs except that of 3',5'-T2. These data suggest that FFT of T4, T3, rT3 and 3,3'-T2 primarily is determined by the amount of T4 present in serum and that significant amounts of these iodothyronines are bound to TBG, whereas 3',5'-T2 possibly primarily is bound to albumin. The median FFT of T4, T3, rT3, 3,3'-T2 and 3',5'-T2 in serum from euthyroid subjects (n = 38) was: 0.030, 0.29, 0.14, 1.10 and 1.07%, respectively. The corresponding median free concentrations in pmol/l were: 30, 4.79, 0.59, 0.44 and 0.77, respectively. Pregnant women in 3rd trimester had normal levels of free T4, free T3 and free rT3, whereas the median free 3,3'-T2 was reduced in contrast to elevated median free 3',5'-T2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507007 TI - Oxygenation of 18-hydroxycorticosterone as the final reaction for aldosterone biosynthesis. AB - Incubation of 18-hydroxycorticosterone with the sonicated mitochondrial preparation of bovine adrenal glomerulosa tissue leads to the production of aldosterone, as measured by radioimmunoassay. The in vitro production of aldosterone from 18-hydroxycorticosterone requires both molecular oxygen and NADPH, and is inhibited by carbon monoxide. Cytochrome P-450 inhibitors such as metyrapone, SU 8000, SU 10603, SKF 525A, amphenone B and spironolactone decrease the biosynthesis of aldosterone from 18-hydroxycorticosterone. These results support the conclusion that the final reaction in aldosterone synthesis from 18 hydroxycorticosterone is catalyzed by an oxygenase, but not by 18-hydroxysteroid dehydrogenase. By the same preparation, the production of [3H]aldosterone but not [3H]18-hydroxycorticosterone from [1,2-3H]corticosterone is decreased in a dose dependent manner by addition of non-radioactive 18-hydroxycorticosterone. PMID- 6507008 TI - Growth and bone haemodynamic responses to castration in male rats. Reversibility by testosterone. AB - Orchidectomy in postpubertal 55 day old rats, compared to sham-operated controls, led beyond 2 months to a decrease in body weight (87% of controls by 120 d), tibial length (97% of controls) and in tibial calcium content (85% of controls). Bone plasma flow increased three times to reach a peak at 31 days; it was decreased but no significantly at 86 and 120 days. The number of osteoclasts was maximal at 51 days (X 2.3) and was still elevated at 120 days. The calcium accretion rate increased briefly at 31 days (110% of controls) and was diminished at 86 and 120 days (78% of controls). The initial 'physiological' changes in the tibia occurred before any weight change and might be directly due to the lack of androgens. They can be interpreted as inducing the conditions for enhanced bone resorption. Testosterone replacement therapy, initiated after the initial haemodynamic response, inhibited the negative effect of castration on bone growth. PMID- 6507009 TI - Serum ferritin and non-Hodgkin's lymphoma. PMID- 6507010 TI - Effect of cryopreservation on recovery of megakaryocytic colony-forming units in murine bone marrow. PMID- 6507011 TI - Experimental autoimmune hemolytic anemia in mice induced by repeated immunization with ultrasonicated syngeneic erythrocytes together with Klebsiella O3 lipopolysaccharide. PMID- 6507012 TI - Changes in erythrocyte glycolytic intermediates during general anesthesia. PMID- 6507013 TI - The fatty acid composition in the red cell membrane of the patients with paroxysmal nocturnal hemoglobinuria. PMID- 6507014 TI - In vitro study on the membrane of spur cells. PMID- 6507015 TI - Evaluation of colorimetric method using thiobarbituric acid for the determination of glycosylated hemoglobin. PMID- 6507016 TI - Iron uptake in iron-deficient reticulocytes. PMID- 6507017 TI - Regulatory factors of erythrocyte expansibility observed in hypotonic stress. PMID- 6507018 TI - Hemolytic disease of the newborn due to anti-M. PMID- 6507020 TI - Murine marrow hemopoietic inductive microenvironment (HIM) I. A modified long term bone marrow culture system for analysis of HIM function. PMID- 6507019 TI - A Japanese boy with hemolytic anemia due to an unstable hemoglobin (Hb Bristol). PMID- 6507021 TI - Murine marrow hemopoietic inductive microenvironment (HIM) II. Radiation-induced damages of stromal precursors and the function of their progenies analysed by a modified long-term bone marrow culture. PMID- 6507022 TI - Viability of megakaryocytic and erythroid progenitors after cryopreservation in comparison with myeloid progenitors and multipotent stem cells. PMID- 6507023 TI - A case of myeloid metaplasia with fatty and partially fibrotic bone marrow. PMID- 6507024 TI - Favourable effect of physical exercise on informational pathology of higher nervous activity. AB - As a model of neurotic states induced by information overload experimental neurotic states were evoked in 13 dogs reared under conditions of partial social isolation by shortening the intertrial intervals in an alimentary conditioned reflex situation with delayed reinforcement. Both behavioural and autonomous disturbances were completely abolished in 4 of 5 dogs which were systematically exposed to muscular activity. Similar protective and therapeutic effect had the muscular exercise which formed a main component of the therapy in 59 neurotic subjects. PMID- 6507025 TI - Free amino acids in the spinal cord, ganglia and ischiadic nerve of the dog after ligature of the abdominal aorta. AB - The effect of occlusion of the abdominal aorta for 10, 20 and 40 minutes on the concentration of aspartic and glutamic acids, glutamine, glycine, alanine and gamma-amino butyric acid in the anterior and posterior horns of the lumbosacral spinal cord was studied in the dog, further, concentration of amino acids (except GABA) in lumbosacral spinal ganglia and in the ischiadic nerve following 40 minutes of occlusion. The changes were most marked after 40 minutes of occlusion with a rise in concentration of alanine, glutamine and glutamic acid in the dorsal part of grey matter. Striking was also the simultaneous elevated concentration of Glu and Gln in spinal ganglia. The significance of these changes is discussed from the aspect of metabolism and function of nerve cells. Under physiological conditions the free amino acid pool in the central nervous system remains essentially constant. Under pathological conditions, however, like ischemic-hypoxic states, various changes occur. PMID- 6507026 TI - European CIANS conference. Olomouc, Czechoslovakia, July 4-8, 1983. Abstracts. PMID- 6507027 TI - [Spinal nerves of the female shark (Mustelus manazo) innervating the cloaca and cloacal opening]. PMID- 6507028 TI - Laryngeal cartilages in the house musk shrew (Suncus murinus). PMID- 6507029 TI - Abstracts: 23rd meeting of the Hungarian Biochemical Society. 26-29 August, 1984, Pecs. PMID- 6507030 TI - Number of potential reversals (turns) and amplitude of the pattern of electrical activity of the abductor pollicis brevis muscle in patients with neurogenic diseases. AB - We have quantified the pattern of electrical muscle activity at a force of 0.3 kg, 30% of maximum force, and maximum force in the abductor pollicis brevis muscle of 21 patients with neurogenic disorders (10 with carpal tunnel syndrome, 9 with polyneuropathy and 2 with motor neurone disease) and of 15 normal subjects. In normal subjects, the number of turns, the mean amplitude and the ratio between them were independent of maximum force, age and sex of the subjects. In 21 patients with neurogenic disorders, the cumulative diagnostic yield of the analysis of the pattern of electrical activity was 86% compared to the diagnostic yield of the mean duration and mean amplitude of individual motor unit potentials of 90%. These diagnostic yields in a small distal muscle were of the same order as those of the brachial biceps muscle in previous studies. PMID- 6507031 TI - Heart disease in myasthenia gravis. AB - Patients with myasthenia gravis (MG) may develop heart disease. Our data on 108 MG patients were examined to assess the type and frequency of this. 17 of 108 patients (16%) showed signs of heart disease which could be regarded as MG related. 11 of these, of whom 5 died suddenly, had clinical symptoms, mainly arrhythmias. Signs of heart disease were most frequent in thymoma patients (5 of 10), and all 3 microscopically examined hearts from these patients showed a focal myocarditis. 44 spinal muscular atrophy patients serving as controls showed a 16% frequency of signs of heart disease of unknown etiology. However, only 1 of 44 spinal muscular atrophy patients (2%) had clinical symptoms as compared to 11 of 108 MG patients (10%). Together with the characteristic focal nature of the myocarditis and the microscopic similarities between lesions of heart and skeletal muscle, this indicates that the heart disease is specifically related to MG. PMID- 6507032 TI - Abnormalities of the erythrocyte membrane phospholipids in Friedreich's ataxia. AB - The phospholipid composition and the fatty acids of the phospholipids in the erythrocyte membranes were studied in 5 patients with Friedreich's ataxia. The sphingomyelin content was found to be insignificantly reduced, that of phophatidylethanolamine was, on the contrary, increased even if non significantly. The linoleic acid content was significantly decreased both in the total fraction of the phospholipids and in the isolated phosphatidylcholine. The relationship between the phospholipid composition and the structure and function of the membrane are discussed. PMID- 6507034 TI - Joint meeting of British, Danish and Dutch chapters of the International League against Epilepsy. October 10-12,1984, Elsinore, Denmark. Abstracts. PMID- 6507033 TI - Adult hydrocephalus and the empty sella. AB - A 51-year-old man presented with a pituitary apoplexy with symptoms and signs predominantly of meningitis. Later on, hydrocephalus and an empty sella were disclosed. It is likely that the empty sella and the hydrocephalus were both caused by the adenoma necrosis. Based on this case and cases reported in the literature, it is suggested that concomitant presence of an empty sella and hydrocephalus results from necrosis in a pre-existing pituitary adenoma. PMID- 6507035 TI - Epidemiological investigations into multiple sclerosis in southern Hesse. I. Methodological problems and basic epidemiologic characteristics. AB - An epidemiological field-survey on multiple sclerosis (MS) was carried out in the southern part of the state of Hesse (West Germany). Out of 472 patients primarily ascertained, 75% could finally be accepted as definite or probable MS cases. Cross-checking of the 3 sources for case-finding (practitioners and specialists, neurological hospital, MS society) revealed that case-finding in all and especially that of definite and probable MS cases was rather complete. The overall prevalence rate was 58.3, the annual incidence 2.15 and the mortality rate 2.0 per 100,000. Male patients showed a faster course than females. The prevalence in immigrants who mostly originated from Mediterranean countries, was significantly lower (14.3 per 100,000) than the prevalence in the German population (63.1 per 100,000). PMID- 6507036 TI - Epidemiological investigations into multiple sclerosis in southern Hesse. II. The distribution of cases in relation to exogenous features. AB - In order to discover possible exogenous variables associated with a higher multiple sclerosis risk, the distribution of cases with definite and probable multiple sclerosis ascertained in the course of a micro-epidemiologic study in Southern Hesse was evaluated and compared with some environmental factors. The prevalence in 1980, the prevalence of cases with disease-onset within the region according to locality of onset and the rate of native Southern Hesse patients according to childhood residence all showed a similar geographical distribution, with the highest values in the south-eastern, mountainous part of the region. This district has a lower annual mean temperature, more annual snow-days and a higher annual precipitation compared to the remaining area. A statistical comparison revealed no association with industrial or agricultural activities, with a particular type of land use, with cattle, pig- or horse-breeding, or with sanitary or housing standards. On the other hand, a slight association with the soil type could be demonstrated, with higher rates on loam and clay subsoils when compared to predominantly sandy regions. Whether this finding has any significance or not remains to be clarified. PMID- 6507037 TI - Epidemiology of myasthenia gravis in Norway. AB - The number of patients with myasthenia gravis diagnosed and registered in Norway from 1912-1981 has been collected, representing essentially all diagnosed cases during these 70 years. Until 1948, Oslo University Hospital, the National Hospital, had the only neurological department. in Norway. Since then, neurological departments have been established throughout our country. All these departments and all practising neurologists in Norway responded to the appeal for the necessary information on their diagnosed patients up to the end of 1981. The majority of the results are based on the period 1951-1981. The National Bureau of Statistics has registered the deaths of myasthenia gravis cases since 1951, and since 1956 where it has constituted an underlying or contributory cause. The incidence rate by diagnosis per million population 1951-1981 is 2.6 for males, 5.3 for females and 4 for both sexes. The prevalence per million population is 52 for males, 127 for females and 90 for both sexes. The mortality in males is 144% and in females 155% of the mortality in the population. The excess mortality is much greater in patients below 60 years of age, especially in females where a value of 483% if found. PMID- 6507038 TI - Long-term effects of severe closed head injury on memory: evidence from a consecutive series of young adults. AB - Long-term cognitive sequelae of severe closed head injury were studied in a consecutive series of 39 young head-injury adults without gross intellectual deficits. Testing was carried out 2-5 years post-injury. Patients with a post traumatic amnesia (PTA) greater than 3 weeks were impaired on a wide range of tests, particularly those requiring long-term retention of complex materials or where time constraints were a salient feature. Patients with a PTA of 1-3 weeks were unimpaired on all tasks. The results suggest that in young adults a threshold of brain damage related to long-term cognitive impairment operates at around a 2-3 week PTA duration. PMID- 6507039 TI - Sexual disturbances arising from multiple sclerosis. AB - Multiple sclerosis patients under the age of 50 with only a slight handicap were very often found to have disturbances of sexual functions (among male patients 71.4%; among female patients 73.9%; control group 18.7%). In 19.6% of the cases, the disturbances were of a serious nature. These disturbances, as well as disturbances of function of bladder and colon, were found to be mainly brought about by separate damage in the lumbosacral region of the spinal cord. The incidence of these disturbances bore no relationship to the degree of motor disturbances, age of the patient or duration of the disease. PMID- 6507040 TI - Regional spinal cord blood flow in the rabbit, cat and monkey. AB - Regional blood flow in the spinal cord was measured in rabbits, cats and monkeys with radioactively labelled microspheres. The reproducibility of the method was tested in rabbits by 3 consecutive determinations with differently labelled microspheres within the different cord regions, and was found to be good. In all 3 species, the blood flow was higher in the lumbar part of the cord than in the thoracic part, and in rabbits and monkeys it was also higher in the cervical than in the thoracic part. The flow values for the cervical, lower thoracic and lumbar parts of the cord in rabbits were 33.3, 24.7, and 27.3 ml X min-1 X 100 g-1, respectively, and in monkeys the respective figures were 14.9, 10.5 and 19.7 ml X min-1 X 100 g-1. Corresponding values for cats were only obtained during moderate hyperventilation, and were 12.2, 10.6, and 15.4 ml X min-1 X 100 g-1, respectively. The results are in good accordance with those of previous studies of the blood flow in the spinal cord in which other techniques have been employed. PMID- 6507041 TI - Vasoactive intestinal polypeptide (VIP) in cerebrospinal fluid from men after long-term exposure to organic solvents. AB - Vasoactive intestinal polypeptide (VIP) is widely distributed within the central nervous system (CNS) and is thought to function as a neurotransmitter. VIP was measured in CSF from 14 men with psycho-organic syndrome occupationally exposed to organic solvents for 7-38 years and in CSF from 8 neurologically healthy male volunteers. The concentration of VIP in the exposed group, 28 +/- 15 (SD) pmol/l, did not significantly differ from that of controls, 38 +/- 14 pmol/l. Thus, determination of VIP in CSF appears to be of little value for detecting effects of long-term solvent exposure. PMID- 6507042 TI - Onset symptoms as predictors of mortality and disability in multiple sclerosis. AB - 941 cases of definite/probable multiple sclerosis living in Los Angeles County, California and King and Pierce Counties, Washington in 1970 who had onset between 1960 and 1969 were followed for mortality and disability through 1980. Early age of onset and residence in Washington State were predictors of less rapid and severe subsequent course. Coordination symptoms at onset were prognostic of rapid progression to disability and/or early death, whereas early motor weakness was significantly predictive only for disability. The presence of sensory symptoms in addition to motor and/or coordination symptoms at onset, however, indicated a better prognosis than coordination and/or motor symptoms alone. This observation and the results of regression analyses indicated that specific groupings of symptoms at onset were more important for predicting course than the number of symptoms present at onset. PMID- 6507043 TI - CT-detected hemorrhagic infarction; relation with the size of the infarct, and the presence of midline shift. AB - The incidence of mass effect indicated by midline shift, and the incidence of hemorrhagic infarction were studied in 952 consecutive CT scans with supratentorial infarcts. Hemorrhagic infarction was found in 5.1% indicating that the incidence of hemorrhagic infarction during life is far less than was suggested from pathological studies. Midline shift was found in 3.6% and, accordingly, the chance of finding a hemorrhagic infarct with mass effect indicated by a shift of the midline would be 0.2% if these 2 phenomena were not related. However, this incidence appeared to be 12 times higher, indicating they are closely related. In addition, the incidence of hemorrhagic infarcts and midline shift were both related to large infarcts with bad outcome. Cardiac emboli were not more prevalent in patients with hemorrhagic infarcts than in a control series, indicating that cardiac emboli do not produce hemorrhagic infarction more often than other causes of cerebral infarction, and that cardiac embolic cause cannot be inferred from hemorrhagic infarction on CT. This probably also applies to carotid emboli. When anticoagulation is considered in patients with cerebral infarction, CT-confirmed hemorrhagic infarction and shift of midline structures as well as decreased consciousness are contraindications to such treatment. In their absence, and in the absence of general contraindications, anticoagulant treatment can safely be started. PMID- 6507044 TI - Demential syndromes and the lipid metabolism. AB - The present communication surveys the present knowledge about the extent to which formation of free radicals in the central nervous system may give rise to cross linking reactions finally ending in the deposition of lipofuscin pigments. Free radicals may be formed by autoperoxidation of polyunsaturated fatty acids. These fatty acids, e.g., C22:6 omega 3, are enriched in rods and cones of the eye and in phosphatidyl ethanolamine of synaptosomes. By peroxidation, malondialdehyde is formed. This aldehyde may cross-link through amino groups of proteins and certain phospholipids. Hereby, lipofuscin is deposited. The peroxidation process is counteracted by certain enzymic systems and by antioxidants. Thus, glutathionperoxidase (GSH-Px), catalase and superoxid dismutase may eliminate peroxides. GSH-Px is a selenium-containing enzyme. Peroxides are also formed by metabolic transformation of dopamine. 3 demential syndromes, i.e. Alzheimer's, Parkinson's and Batten's diseases, are discussed with regard to whether the "free radical theory" may explain the pathogenesis. Finally, it is discussed whether an antioxidative treatment including vitamins E and C as well as a supplement of selenium, e.g. sodiumselenite, may be a therapeutic alternative to other types of treatment of demential syndromes or a direct supplement to the L-DOPA treatment of Parkinson's disease. PMID- 6507045 TI - Influence of blood pressure on blood-brain barrier function in brain ischemia. AB - The influence of systemic blood pressure on blood-brain barrier leakage and hemorrhage in brain ischemia was evaluated in Sprague-Dawley rats with blood pressures at the lower and upper limit normally found in these animals when anesthetized on 70% N2O:30% O2. 24 h after unilateral cerebral microembolization when significant increases in water content and barrier permeability and decrease in blood flow is present - the extravasation of Evans Blue-albumin and inulin as well as hemorrhage in the infarcted brain area was considerably more prominent in animals with the higher blood pressure. The findings imply that attempts to elevate pressure, as well as subacute surgical circulatory reconstruction to increase perfusion of an ischemic area, may be potentially harmful. PMID- 6507046 TI - Friedreich's ataxia: clinical involvement and evoked potentials. AB - In 15 patients definitely affected by Friedreich's ataxia, precocious SEP abnormalities were constantly recorded independent of the duration of symptoms and the severity of clinical involvement; VEPs were frequently involved, but neither VEP abnormalities, nor visual impairment could be correlated with the severity or duration of Friedreich's ataxia clinical involvement; BAEPs were, to different extents, abnormal. These were completely dissociated from hearing disorders and significantly correlated (P less than 0.001) with Friedreich's ataxia clinical disability. Our observation of increased latency of the VEP P100 component and the early disappearance of BAEP Wave V with persistence of Wave I is in contrast with the hypothesis that changes are related to primary axonal degeneration. For practical purposes SEPs could help in the early diagnosis of Friedreich's ataxia, and BAEPs could be used for the electrophysiological monitoring of its clinical progression. PMID- 6507047 TI - Thiethylperazine and tardive dyskinesia. AB - Over a 14-month period in the outpatient department of a geriatric hospital, 7 female patients over 75 years of age were identified with tardive dyskinesia associated with the use of thiethylperazine. The indication for thiethylperazine treatment had been vertigo or dizziness. 3 of the patients also had symptoms related to cerebral arteriosclerosis and 2 had mild Parkinson's disease without levodopa therapy. None of them were markedly demented nor had chronic psychosis. Tardive dyskinesia appeared after a treatment period of 3 weeks to 6 years. These findings suggest that association of tardive dyskinesia with the use of thiethylperazine is not uncommon in geriatric outpatients. PMID- 6507048 TI - The density and distribution of ischemic brain injury in the rat following 2-10 min of forebrain ischemia. AB - The density and distribution of brain damage after 2-10 min of cerebral ischemia was studied in the rat. Ischemia was produced by a combination of carotid clamping and hypotension, followed by 1 week recovery. The brains were perfusion fixed with formaldehyde, embedded in paraffin, subserially sectioned, and stained with acid fuchsin/cresyl violet. The number of necrotic neurons in the cerebral cortex, hippocampus, and caudate nucleus was assessed by direct visual counting. Somewhat unexpectedly, mild brain damage was observed in some animals already after 2 min, and more consistently after 4 min of ischemia. This damage affected CA4 and CA1 pyramids in the hippocampus, and neurons in the subiculum. Necrosis of neocortical cells began to appear after 4 min and CA3 hippocampal damage after 6 min of ischemia, while neurons in the caudoputamen were affected first after 8 10 min. Selective neuronal necrosis of the cerebral cortex worsened into infarction after higher doses of insult. Damage was worst over the superolateral convexity of the hemisphere, in the middle laminae of the cerebral cortex. The caudate nucleus showed geographically demarcated zones of selective neuronal necrosis, damage to neurons in the dorsolateral portion showing an all-or-none pattern. Other structures involved included the amygdaloid, the thalamic reticular nucleus, the septal nuclei, the pars reticularis of the substantia nigra, and the cerebellar vermis. PMID- 6507049 TI - Complications and short-term consequences of tubal sterilization. A personal three- and twelve-month follow-up investigation. AB - The aim of the present study was to investigate the short-term complications and consequences of 216 consecutive female sterilizations. Information was obtained from 211 women (98%) within the first postoperative year. There was one failure (Pomeroy), three skin burns, a vesical lesion and problems with the induction of anesthesia in 2 cases. Thirty-nine women were bothered by minor complaints for 3 months or more, in most cases by discomfort of the laparotomy scar. The impact on postoperative marital life was mainly positive. Twenty-three women expressed doubts whether the sterilization had been sensible, 10 expressed real regret at at least one interview. At one year, 4 stated serious regret. One year after surgery, 68% had told friends about the sterilization; these women were younger than the remainder. Forty-six percent said they would have preferred an earlier operation. PMID- 6507050 TI - The social and gynecological long-term consequences of tubal sterilization. A personal six-year follow-up investigation. AB - The long-term consequences and complications of tubal sterilization were studied. Six years after surgery, information was obtained from 208 of 216 women. Five had been pregnant. Eight had been bothered by their scars for 2 years or more. The majority reported improved conjugal relations and a positive impact on marriage. Eighty-five percent had told others about the sterilization; the frankness was more common in the younger age groups. Although most women were satisfied, 6% would have preferred the sterilization undone. In 10% of the couples, at least one of the partners held that view. The most common cause for regret was the desire for more children, in most cases with a new spouse. Regret was not correlated to the woman's age, parity or social group. Regret was recorded with significant predominance when the sterilization had been suggested by a doctor at abortion application. In a controlled comparison between Pomeroy laparotomy and laparoscopic electrocoagulation, no differences in postoperative bleeding patterns were found. The present study indicates that tubal sterilization is not a major cause of subsequent menstrual irregularities. PMID- 6507052 TI - Estradiol and progesterone receptors in gynecologic sarcomas. AB - We report the concentrations of estradiol and progesterone receptors found in the tumor tissue of 5 patients with leiomyosarcoma, 4 of uterine and one of ventricular origin, and of 5 patients with uterine or ovarian carcinosarcoma. Steroid receptor positive and negative tumors were present in both groups of sarcoma. One uterine leiomyosarcoma had a high concentration of estradiol and progesterone receptors, 37 fmoles/mg protein and 156 fmoles/mg protein, respectively. We suggest that steroid receptors should be analysed in all gynecologic sarcomas. PMID- 6507051 TI - Estradiol and progesterone receptors in normal ovary and ovarian tumors. AB - Specific estradiol (ER) and progesterone receptors (PR) in the tumor cytosol of 54 patients with primary ovarian cancer were examined. Also 30 benign ovarian neoplasms and 19 normal ovaries were analysed. Of the malignant tumors, 46% contained ER and 41% PR. The ER content of most malignant tumors was 3-30 fmoles/mg protein; three tumors revealed an ER content over 30 fmoles/mg protein. The PR content of most malignant tumors was 8-80 fmoles/mg protein. Three endometrioid adenocarcinomas and three serous cystadenocarcinomas had a PR level over 100 fmoles/mg protein. ER and PR were simultaneously detected in 26% of the malignancies, whereas 39% of them were receptor negative. No significant differences were found between premenopausal and postmenopausal women, as regards the presence of steroid receptors. Carcinomas were significantly more often ER positive than were benign tumors. The ER content of both the benign neoplasms and the normal ovary was low, less than or equal to 15 fmoles/mg protein, whereas higher PR levels were found in these two groups. The presence of steroid receptors in malignant ovarian tumors can possibly be used as an indicator of hormone dependency of these malignancies. PMID- 6507053 TI - Computer-tomographic evaluation of gynecologic tumors. AB - The accuracy of contrast-enhanced computer tomography (CT) of the pelvis in the detection, characterization and staging of known or suspected pelvic tumors was compared with clinical and operative findings in a prospective study of 79 patients (25 cervical carcinomas, 27 endometrial carcinomas, 10 ovarian carcinomas, 4 vulval or vaginal carcinomas and 13 benign ovarian or uterine tumors). In cervical carcinoma, there was a tendency towards lower staging of the tumor, especially in stage IIa, which is not easily detected in CT. Even small tumors of the cervix and endometrium can be visualized by contrast enhancement, which clearly delineates heavily vascularized myometrium and less enhancing tumor tissue. The accuracy of CT in tumor detection, characterization and evaluation of spread was best in ovarian neoplasms, weakest in cervical carcinomas. The importance of proper CT technique is stressed. PMID- 6507054 TI - Ectopic pregnancies following female sterilization. A matched case-control analysis. AB - The present study compared 15 ectopic pregnancies occurring after female sterilization (EPs) with 30 non-pregnant control patients who had also undergone female sterilization (NPCs) for a history of induced abortion, any pelvic surgery, abdominal surgery, or pelvic infection. EP cases and controls were individually matched for clinic, surgeon, surgical approach, tubal occlusion technique, and date of operation, as well as patients age and parity. The only significant difference was the greater proportion of EP patients, reporting a history of induced abortion (matched triplet odds ratio = 9.0, 95% confidence limits = 1.39, 58.26). Women with EPs were further compared with 78 women with post-sterilization intra-uterine pregnancies (unmatched). Results again show a significantly greater risk of conceiving an EP following previous induced abortion (odds ratio 5.8, 95% confidence limits = 1.78, 18.60). Women with previous abdominal surgery also ran a significantly higher risk of post sterilization EP (odds ratio 10.0 95% confidence limits = 2.45, 40.83). Limitations of the data and clinical implications of the results are discussed. PMID- 6507055 TI - Circadian rhythm of fetal movements. AB - Intra-uterine fetal movements indicate the wellbeing of the fetus and can be used in the detection of chronic fetal asphyxia. The daily variations in fetal activity follow an irregular pattern, though showing a peak of activity in the evening. The pattern of nocturnal activity is not known. In this study, fetal movements were monitored by maternal subjective recordings in 116 women with a normal pregnancy. In gestational weeks 31-40, fetal movements were recorded intermittently for at least 3 hours, both in the daytime and at night. In the daytime, fetal activity was moderate. A maximum occurred in the evening between 9 and 10 p.m. At night there was a period of minimum activity between 1 and 5 a.m. A minor peak in fetal activity was seen between 7 and 8 a.m. The frequency of fetal movements followed a pattern of a circadian rhythm, which was influenced by exogenous factors. PMID- 6507056 TI - Boys born by forceps and vacuum extraction examined at 18 years of age. AB - An 18-year follow-up study was made of 62 males delivered by forceps and 38 by vacuum extraction in 1962-63. The obstetrical data are compared with the medical and psychological military draft board examinations. The mortality and morbidity rates were not significantly different from those of the total cohort of Norwegian conscripts, either in the forceps or in the vacuum group. Rotation of the fetal head with Kielland's forceps in midcavity extractions did not adversely affect the late results. A significantly elevated mean intelligence score was found in the forceps group, while the vacuum group did not differ from the national average. PMID- 6507057 TI - Estriol: absorption after long-term vaginal treatment and gastrointestinal absorption as influenced by a meal. AB - This study was designed to evaluate the vaginal absorption of estriol when given as a 21-day treatment. Vaginal absorption was compared with the oral absorption of a known estriol preparation (TriovexR, Leo AB, Sweden). One mg of estriol was administered intravaginally once a day for 21 days to 6 menopausal women. Plasma concentrations of unconjugated estriol were measured by a specific RIA-method at frequent intervals during 24 hours on the first and 21st day of treatment. One month later, 10 mg of estriol was given once orally and plasma estriol concentrations were measured in the same way. At vaginal administration, the absorption of estriol was very effective. When measured on the 21st day, the absorption had declined significantly but was still nearly in the same range as after oral administration of 10 mg of estriol. At oral administration, there was an initial plasma estriol elevation for 3 hours only followed by a second one immediately postprandially. It is concluded that estriol is readily absorbed from the vagina, but the absorption does decline significantly during prolonged treatment. A large single oral dose of estriol provides initially a high plasma estriol concentration but also a second one induced by eating a meal, possibly indicating an enterohepatic recirculation of estriol. PMID- 6507058 TI - Removal of IUDs in early pregnancy. PMID- 6507059 TI - Some factors affecting the intraocular pressure reduction after argon laser trabeculoplasty in open-angle glaucoma. AB - One hundred and thirty-five eyes in 120 patients with open-angle glaucoma were treated with argon laser trabeculoplasty and followed up for 6 months. The mean reduction in intraocular pressure in the whole material was 10.9 mmHg. 13.1 in eyes with capsular glaucoma and 7.2 in eyes with simple glaucoma. The possible influence of the degree of trabecular pigmentation, the pre-treatment intraocular pressure level and the presence of exfoliative material on the amount of pressure reduction was analysed. The presence of some trabecular pigmentation was a prerequisite for the effect of ALT, but the degree of pigmentation did not influence the pressure-reducing capacity of argon laser trabeculoplasty. The pressure reduction was found to be correlated to the pre-treatment intraocular pressure level without influence of the presence of exfoliative material. Eyes with capsular glaucoma had higher pre-treatment intraocular pressures and seldom had non-pigmented trabecular meshwork, which may explain the greater pressure reduction in this group. PMID- 6507060 TI - The short-term effect of laser trabeculoplasty on the glaucomatous visual field. A prospective study using computerized perimetry. AB - Several earlier studies have shown improvement of glaucomatous visual fields after pressure reduction achieved by acetazolamide or filtering surgery, while other studies have given conflicting results. In the present study laser trabeculoplasty was used to reduce the IOP in 42 eyes with glaucomatous visual field defects. Although good pressure reduction was achieved, no general regression of field defects was observed. The changes of the visual field were not correlated to the degree of pressure reduction. The results do not support the hypothesis that glaucomatous field defects are reversible when the IOP is reduced. PMID- 6507061 TI - Survival of elderly ophthalmic out-patients. AB - Elderly ophthalmic out-patients that had visited an eye-clinic were searched in a population register 7 years later. Observed numbers of survivors were compared with those expected according to appropriate life tables. Most observed numbers of survivors came close to the expected ones. Patients, aged more than 80 years when visiting the eye-clinic, had, however, a consistently increased survival rate. Glaucoma patients, less than 80 years old, had a slightly (not significantly) lower survival rate than expected. PMID- 6507062 TI - The pneumatonograph and Perkins' tonometer. A clinical study of the reproducibility in glaucomatous eyes. AB - Reproducibility by means of replicated single pressure readings of 82 eyes of 46 glaucoma patients in the supine position were compared. The standard deviation was 7% for the pneumatonograph compared to 13% for the Perkins hand held applanation tonometer. The difference of the reproducibility is highly significant. PMID- 6507063 TI - Ocular distribution of topically applied adrenaline in albino and pigmented rabbits. AB - Systemic absorption, ocular distribution and ocular metabolism in albino and pigmented rabbit of topically applied 1% [3H]l-adrenaline eye drops was studied by liquid scintillation counting and thin layer chromatography. The effect of adrenaline on the pupillary diameter was also registered. The peak plasma level of adrenaline was reached at 150 min. The corneal adrenaline metabolism was substantial, but did not vary with the rabbit strain. At 30 min after instillation, the total adrenaline concentration of pigmented iris and ciliary body exceeded that of corresponding albino tissues. At 180 min the drug concentration of the iris and ciliary body did not differ between the rabbit strains. The time course of adrenaline induced mydriasis was equal in both rabbit strains. Since neither total adrenaline concentration at 180 min nor the time course of adrenaline induced mydriasis differed between the rabbit strains, the higher initial adrenaline uptake by pigmented tissues is not explained by pigment binding. It is proposed that the increased initial binding of adrenaline by pigmented tissues is caused by a difference between pigmented and albino tissues in the number of adrenergic neurones; this is also supported by the literature. PMID- 6507064 TI - Choline transport through the blood-retinal and the blood-brain barrier in vivo. AB - The uptake index method was used to study retinal and cerebral uptake of [14H]labelled choline in rats. In both tissues a saturable uptake was observed. This uptake was significantly inhibited by 10-20 mM unlabelled choline chloride as well as by 10 mM hemicholinium-3. It is concluded that choline passes the blood-retinal barrier by a carrier-mediated transport system similar to that in the blood-brain barrier. PMID- 6507065 TI - Central retinal vein occlusions in young adults. AB - This study was a long term follow-up of 11 young adults aged 15-45 with central retinal vein occlusion (CRVO). Seven patients classified as the ischemic type of CRVO showed a poor visual acuity at the first examination and did not improve throughout the study. In addition, systemic diseases were found in all these patients. Four patients classified as venous stasis retinopathy type of CRVO, had, in contrast, fairly good visual acuity at the first examination and showed additional improvement during the follow-up period. No systemic diseases were detected. Physical examinations are recommended periodically for young adults with ischemic type of central retinal vein occlusion. PMID- 6507066 TI - Initial healing of the posterior corneal surface following perforating trauma in guinea pig: a scanning electron microscope study. AB - Using a scanning electron microscope, we have studied the healing of the posterior corneal surface after a small perforating trauma. Both corneas of adult guinea pigs were perforated with a needle and studied at various time intervals during recovery. Thirty minutes after the perforation the wound was sealed with a fibrous plug. Leukocytes adhered to the wounded area from the first day of healing on, but usually most of them disappeared after the third day. Fibroblast like cells were present during the entire healing process from the first day on. Endothelial cells at the margin of the wound lost their hexagonal shape and began to slide over the plug. In 7 days the wound was completely covered by irregularly arranged endothelium. The endothelial cells did not reach their regular arrangement during the 14-day follow-up period. PMID- 6507067 TI - The healing of rabbit corneal endothelium. AB - A circular 4 mm endothelial defect was induced by transcorneal freezing. The experimental damage and the healing took place in the living rabbit in 15 eyes, and in the isolated cornea in organ culture in further 20 eyes. The reparative process was studied by SEM, and proved to be the same in vivo and in vitro. The defect was covered with endothelial cells after 3 days. The normal hexagonal pattern was regained after 3 weeks. Both cell migration and cell division were involved in the reparative process. Only cells recruited from a zone close to the defect were active; the cells situated more than a few cell diameters from the original edge maintained their form and size unchanged. The first phase of cell division was the formation of a spherical cell with numerous blebs on its surface. PMID- 6507068 TI - The influence of age on the fragility of the cornea. AB - Corneal fragility was measured with the Cochet-Bonnet aesthesiometer on 171 eyes of various ages. It was found to remain the same until about age 40. It increased significantly and progressively afterwards. It was compared to corneal sensitivity which diminishes significantly after about the same age. PMID- 6507069 TI - Surgical removal of bone and muscle metastases of renal cancer. AB - Fifteen men and six women with renal cancer underwent surgical removal of metastatic lesions in bone (19 patients) or muscle (two patients). The operation was carried out 2 years before nephrectomy/renal resection in two patients, on the same occasion in four, and 1-196 months after in 15. Surgical interventions of various kinds were undertaken, resulting in the loss of a lower limb in seven patients and an upper limb in one. The observed 5-year survival was 4 out of 10. Six patients were alive at follow-up, five of them without evidence of disease. Eight of the remaining 15 patients died of an unrelated disease (five without evidence of tumor); the other seven patients died of metastatic tumor disease. Local recurrence was diagnosed, and removed, in two patients. The results compare favourably with reports on surgically removed pulmonary metastases of renal cancer and seem to justify an aggressive attitude towards solitary bone and muscle metastases of renal cancer. PMID- 6507070 TI - Planning an intertrochanteric femoral osteotomy. AB - A simple formula for calculating the displacement necessary to keep the hip-knee ankle axis normal after intertrochanteric osteotomy is presented. PMID- 6507071 TI - Instability of total hip prostheses at rotational stress. A roentgen stereophotogrammetric study. AB - Roentgen stereophotogrammetric analysis (RSA) has been carried out on 24 total hip prostheses (24 patients), which were all painful at weightbearing. The examinations were made with the hip at distraction, compression, external and internal rotation. One acetabular component showed instability only at distraction-compression and one showed instability only at rotation. Four femoral components showed instability at distraction-compression and at rotation, six only at rotation, but none showed instability only at distraction-compression. Thus rotational provocation demonstrated instability in all unstable femoral components; rotational stress must be of importance in mechanical loosening of the femoral component. PMID- 6507072 TI - Instability of trochanteric hip fractures following internal fixation. A radiographic comparison of the Richards sliding screw-plate and the McLaughlin nail-plate. AB - A comparison was made of the McLaughlin nail plate and the Richards sliding screw plate techniques for fixation of trochanteric hip fractures. The series included 96 patients in each group. The fractures were followed radiographically for 3 months. Technical failures were encountered in 31 per cent of the McLaughlin fractures and in 8 per cent of the Richards fractures; reoperation was performed in 9 per cent in McLaughlin vs none in the Richards fractures. The main failure was varus displacement in both groups, always combined with lateral cutting of the screw in the Richards fractures, and often combined with failure of the nail plate junction in McLaughlin fractures. Our study has shown that the sliding screw-plate is superior to the nail plate in both stable and unstable fractures. PMID- 6507073 TI - Two-year follow-up of femoral neck fractures. Comparison of osteosynthesis methods. AB - For 14 consecutive months, all 152 femoral neck fracture patients greater than or equal to 50 years of age admitted to the Lund University Hospital were operated on with two hook-pins if born on an uneven date and a four-flanged nail if born on an even date. A clinical 2-year follow-up revealed a 35 per cent mortality. Among survivors, radiographic healing complications were seen in undisplaced fractures in 1/13 pinned and 5/14 nailed (p greater than 0.05) and in displaced fractures in 12/36 pinned and 23/32 nailed (p less than 0.01). This outcome correlated well with the early postoperative scintimetry. Reoperation within 2 years had been performed for seven pinned and 19 nailed fractures. In hook pinning, thus, less than one patient out of 12 needed a reoperation with THR within 2 years. This figure is interpreted as strongly favouring hook-pinning before arthroplasty as the primary procedure in femoral neck fracture. PMID- 6507074 TI - Effects of vascular occlusion on the femoral head in growing rabbits. AB - Temporary vascular occlusion of the femoral head in 6-week-old rabbits was produced by a closed means in a hip spica; the hips were maintained for 24 h in the position of flexion, abduction and internal rotation. All animals developed necrosis of the capital femoral epiphysis, best seen histologically at 2 weeks, and this subsequently recovered. Despite marked histological changes only one hip developed radiographic changes. PMID- 6507075 TI - Treatment of failed open reduction for congenital dislocation of the hip. A 10 year follow-up of 14 patients. AB - Fourteen patients with 15 congenital dislocated hips with unsuccessful open reduction were referred for a secondary open reduction. All primary open reductions were incomplete due to an inadequate exposure and insufficient release of muscles and ligaments. The secondary open reduction was technically difficult. The patients were followed for 6-17 years. Six patients had no functional symptoms. Only three hips showed no radiographic deformity. In ten hips, femoral head necrosis was noted and two patients were left with shortening of 4 and 7 cm. PMID- 6507076 TI - Strength of polymethylmethacrylate increased by vacuum mixing. AB - The mechanical strength of high and low viscosity gentamicin-containing cement was analysed using three different mixing procedures: hand, vibration, and vacuum stirring. Vacuum mixing improved the flexural and compression strength and the modulus of elasticity by 15-30 per cent, especially for high viscosity cement. PMID- 6507077 TI - Knodt rod fusion of the lumbar spine. AB - Thirty-six patients were examined at least 2 years after they underwent Knodt rod distraction fusion of the lumbar spine. Thirty-two patients had a satisfactory clinical result and 23 patients had a solid bone fusion. Six patients had significant complications. It is concluded that Knodt rod distraction fusion is a useful salvage procedure after failed anterior spinal fusion and as a primary procedure in spondylolisthesis. PMID- 6507079 TI - Closed treatment of Achilles tendon rupture. AB - In order to minimize rerupture after closed treatment of Achilles tendon rupture, the period of immobilization was prolonged from 8 to 12 weeks and an above-knee plaster cast was used the first 3 weeks. In 37 consecutive patients, followed for an average of 3 years, rerupture had occurred in two patients. It is concluded that modified closed treatment is a good alternative to surgical treatment. PMID- 6507078 TI - Primary repair in posterior cruciate ligament injuries. AB - A retrospective study of 32 consecutive patients with acute injury of the posterior cruciate ligament (PCL) treated by primary repair is presented. Only six patients had isolated injuries of the PCL, five of these as avulsion of a bone fragment from the tibia. The remaining 26 patients sustained combined ligament injuries, including 18 total ACL tears. All ruptured ligaments were repaired. At follow-up after 4 (1-7) years, function in 26 patients was excellent good and in six fair-poor. Moderate or severe posterior instability was found in seven patients by clinical examination but their function was as good as in those with stable knees. Inferior functional results, however, were more often related to rotatory instability. Primary repair of PCL-injuries, including all associated ligament injuries, is recommended. PMID- 6507080 TI - Taping the ankle for chronic instability. AB - Twenty patients with chronic ankle instability were examined radiographically for anterior talar displacement and talar tilting. The examinations were carried out with the ankles untaped and taped, and the taped ankles were examined again after 20 min running. The measurable instability was significantly improved after taping, but after exercise this was seen only for talar tilting. Generally, the best stabilizing effect of taping was obtained in the ankles with the greatest degree of instability. After exercise, all but one of the adhesive taping bandages were loose and were mostly acting as canvas boots, affording the ankle only limited protection. PMID- 6507082 TI - Fracture of the head of the radius treated by elbow cast. AB - The management of fractures of the radial head is still a controversial subject. Fifty cases of radial head fractures have been treated by conservative means. These cases were immobilized in a plaster Paris cylinder cast for 3 weeks to restrict the movement of flexion and extension at the elbow, while encouraging supination and pronation movements from the very beginning. The cases have been evaluated and 43/50 have shown excellent results. PMID- 6507081 TI - Shoulder arthroscopy. AB - Arthroscopy of the shoulder joint has been carried out in 81 patients with different shoulder disorders. Thirty-two patients had rupture of the rotator cuff. Through cadaver studies and practice, a functional routine for examination has been established. Arthroscopy provides detailed and exact information of intraarticular conditions, and is valuable in planning for surgery and approach. PMID- 6507083 TI - Evaluation of instruments for measuring grip strength. AB - Three instruments for measuring grip strength: the steel spring dynamometer, the Martin Vigorimeter and the My-Gripper, were tested in a universal testing machine to evaluate the linearity of the readings. Furthermore, a clinical study including 100 normal probands evaluated the applicability of these instruments. It was concluded that the steel spring dynamometer was not suitable for clinical use, due to its lack of precision. The Martin Vigorimeter and the My-Gripper were both very precise instruments. The My-Gripper seems to be preferable for clinical use because it is cheap and easy to handle. Also, the instrument can accumulate the results of several trials, facilitating the calculation of average grip strength. A nomogram showing the relationship between the dominant and the non dominant hand is given. PMID- 6507084 TI - Decreased radial bone mass in Colles' fracture. AB - Computed tomography measurements on the radii of 18 women with Colles' fracture of the radius have shown that compared to normal women of the same age they tended to have a smaller bone cross-sectional area in the radius midshaft, a small deficit of cortical bone, and a substantial deficit of trabecular bone in the distal radius. PMID- 6507085 TI - Trochanteric fractures. PMID- 6507086 TI - Electron microscopic localization of acridine orange binding to DNA within various human brain tumor cells. AB - The ultracytochemical acridine orange (AO) method has been employed to demonstrate DNA template activity within untreated human brain tumors. A total of 16 biopsies from brain tumors removed for frozen section examination were investigated. Ultrastructural examination revealed that AO binds to DNA exclusively within the extended euchromatin portion of the cell nucleus of brain tumors. The percentage of AO positive cells varied from 6.0 to 48.6% in various types of brain tumors. A few AO reaction products were visible in the nuclei of the endothelial cells and in the pericytes of the capillaries within neoplastic tissue. The present results suggested that untreated human brain tumors exhibit de-repression of DNA template normally repressed in the adult state. This altered DNA templates may be related to abnormal cell proliferation and differentiation diverted from the normal state. PMID- 6507087 TI - Electron microscopic localization of acridine orange binding to DNA within rat astrocytoma C6 cells. AB - Combination of autoradiography and ultracytochemical acridine orange method in rat astrocytoma C6 cells is described. Electron microscopic examination revealed that AO binds to DNA exclusively within the euchromatin portion of the cell nucleus. X-ray microanalysis showed that AO reaction products contain lead, uranium, and osmium. These heavy metals seem to contribute to electron density of the AO reaction products. The percentage of AO positive cells was 51.8 +/- 1.9%, whereas average labeling index of C6 cells incubated with 3H-thymidine for 30 minutes was 25.6 +/- 1.7%. About 82% of 3H-thymidine-labeled cell nuclei were AO positive and the remaining 18% were free of AO reaction products. On the other hand, about 27% of AO positive cells were not labeled with 3H-thymidine. However, most of C6 cell nuclei with active 3H-uridine incorporation showed AO chromatin reaction products. The results suggest that visualization of AO chromatin reaction products might be related to RNA synthesis rather than DNA synthesis in the cell nuclei. PMID- 6507088 TI - High incidence of peliosis hepatis in autopsy cases of aplastic anemia with special reference to anabolic steroid therapy. AB - The livers were collected from 47 autopsy cases of aplastic anemia aiming to study the correlation between the use of androgenic anabolic steroid and the formation of peliosis hepatis. Association of peliosis hepatis was found in 7 cases out of 19 cases with anabolic steroid therapy, while peliotic cavities were found only in one case out of the remaining 28 cases without anabolic steroid therapy. Out of 7 cases specified above, peliotic cavities in 5 cases were phlebectatic; phlebectatic and parenchymal types of peliotic cavities coexisted in one case, and one case was parenchymatous. Besides these cavity formations, remarkable dilatation of sinusoids often distinct at the periphery of the hepatic lobule was found in the 7 cases. PMID- 6507089 TI - The distribution of concanavalin A- and cationized ferritin-binding sites on plasma membrane of human platelet and the changes of these sites in cells responding to adenosine diphosphate. AB - Investigations were carried out to study the distribution of the concanavalin A- and cationized ferritin-binding sites on the plasma membrane of human platelets and to ascertain the changes of these sites in cells stimulated with adenosine diphosphate (ADP) with time as well. The concanavalin A-binding sites of the unwashed fixed platelets were sparsely distributed on the plasma membrane at a distance of up to 80 nm from the outer leaflet of the plasma membrane. The washed unfixed platelets, however, showed a dense distribution within a range of 70 nm from the outer leaflet of the plasma membrane. Changes in the distribution of concanavalin A-binding sites on the plasma membrane of platelets stimulated with ADP were characterized by a marked increase in the number of binding sites and by protrusion up to a distance of 150 nm from the outer leaflet of the plasma membrane 1 minute after the reaction had occurred. The concanavalin-A binding sites may be semicryptic in view of the fact that they were exposed by washing or protruded as a result of the stimulation with ADP. The cationized ferritin binding sites were uniformly distributed with high density on the plasma membrane of the unwashed fixed platelets. In washed unfixed platelets, however, they were sparsely distributed with cluster formation. It is suggested that the glutaraldehyde fixation itself has an effect on the binding of the cationized ferritin particles on the plasma membrane of platelets. The various changes in the concanavalin A-binding sites appearing 1 minute after the reaction with ADP may represent morphological evidence indicating that the platelets have acquired adhesiveness. PMID- 6507090 TI - Relapsing polychondritis. Pathological and immunological findings in an autopsy case. AB - Relapsing polychondritis (RP) is a disorder of unknown etiology characterized by the destruction of cartilage. A case of RP in a 59-year-old male was autopsied, and systemic inflammation of various cartilages was confirmed. We demonstrated the circulating antibodies to Type II (cartilage) collagen. No antibodies to other collagen types were demonstrated. The presence of granular deposits of immunoglobulins, fibrinogen, and the C3 component of complement at the chondrofibrous junction was also demonstrated. From these findings, this case suggested that the pathogenesis of RP is related to an immune mechanism. PMID- 6507091 TI - Plasmacytoma of lymph node. Recurrent lymphadenopathy terminating in plasma cell dyscrasia with polyneuropathy and endocrine disturbances. AB - A case with lymphadenopathy of the left side of the neck in a 38-year-old male is described. He had a history of several relapses of about 10 years duration. Swollen lymph nodes were histologically similar to those of the hyaline-vascular type of Castleman's disease, but contained clear-cut lymph sinus and a sheet-like proliferation of plasma cells. Lymph follicles showed proliferation and atrophic germinal centers, in which cellular hypertrophy in the wall of ramifying small blood vessels, called angiosclerosis, was frequently encountered. During its progress, the patient developed plasmacytoma of the lymph nodes with varied clinical manifestations such as polyneuropathy, disturbance of gait, unusual perspiration, hirsutism, gynecomastia, bilateral papilledema, and albumino cytologic dissociation in cerebrospinal fluid. PMID- 6507092 TI - Atheromatous embolization. Report of two cases with unusual complications. AB - Two cases of spontaneous atheromatous embolization associated with unusual complications are presented. One is an 85-year-old man who developed an acute abdomen and underwent a surgical resection of totally infarcted left-sided colon. Histologically, multiple acute atheromatous emboli were found occluding the serosal and pericolic mesenteric arteries causing transmural necrosis of the involved portion of bowel. The other is an 80-year-old woman who had had a coronary heart disease, hypertension, and renal insufficiency, and terminally developed a rapid deterioration of renal function and melena. Postmortem examination showed a severely, ulcerated, aortic atherosclerosis and widespread, recurrent, atheromatous emboli in many abdominal organs with the resultant severe nephrosclerosis, gastrointestinal mucosal hemorrhagic necrosis, and multiple infarcts in the pancreas and spleen. In addition, there was focal cortical necrosis of the kidneys accompanied with glomerular capillary fibrin thrombi indicating disseminated intravascular coagulation (DIC). These findings seen in the present two cases were briefly discussed in light of the previous pertinent literature. PMID- 6507093 TI - Myocardial sarcoidosis with a tumor-like left atrial thrombus. AB - We report here an elderly woman who started vague complaints around the age of 50, was proved to be a sarcoidosis by negative skin reaction with purified protein derivative, bilateral hilar lymphadenopathy, and sarcoid lesions in biopsied liver and lymph nodes, and died of cardiac insufficiency after 15 years of the illness. Necropsy revealed a huge tumor-like left atrial thrombus with nonspecific fibrous lesions throughout the myocardium, a pulmonary hamartoma, pneumonia, liver cell necrosis, and cholecystopathy. To our knowledge, this may be the first case of myocardial sarcoidosis associated with this kind of atrial thrombus, although the sarcoidosis and thrombus may have occurred independently. PMID- 6507094 TI - Influence of dietary fats on ultrastructure and fatty acid. Composition of swine arterial tissue. AB - The effects of trans-fatty acid-rich and saturated acid-rich diets on the fatty acid composition and morphology of swine arterial tissues were studied. Three groups of two-month-old swine were fed either a basal diet or a basal diet containing 8.3% margarine or butter for 4 months. The most significant change observed in the fatty acid pattern was the accumulation of 18 : 2 omega 6 and the suppression of both 20 : 4 omega 6 and 22 : 4 omega 6 acids in the aortic tissues of swine fed either butter or margarine as compared to swine fed the basal diet. Also, omega 6 metabolites were significantly decreased in swine fed diets containing butter or margarine, as compared to those fed a basal diet. The group of swine which were fed either butter or margarine containing diets suffered a significant increase in intimal thickening of the coronary artery compared to those fed the basal diet. These thickened intima were characterized by the presence of modified smooth muscle cells, lipid containing cells, and degenerated cells without stainable lipids. However, there was no significant difference in the incidence and extent of intimal thickening of the coronary arteries between swine fed either of the two fat containing diets. PMID- 6507095 TI - Three-dimensional observations by scanning electron microscopy on the blood supply and organization of vasculature during hepatocarcinogenesis in rats. AB - Three-dimensional vascular changes in rats during hepatocarcinogenesis were studied by stereoscopic and scanning electron microscopic observation of vascular casts of sinusoids by injecting resin from hepatic artery (red color) and portal vein (blue color). Neoplastic lesions were synchronously induced by injection of diethylnitrosamine (DENA) followed by feeding of 2-acetylaminofluorene (2-AAF) plus partial hepatectomy, then periodically killed for examination. At 6 weeks after DENA injection sinusoids of hyperplastic foci (HF) were filled with blue resin similar to surrounding tissue, then at 8 weeks some HF and hyperplastic nodules (HN) took up red resin leaving surrounding sinusoids blue. At 12 to 18 weeks, red HN became more discrete with obvious compression of surroundings but decreased their number whereas blue HN were not. Red HN had incomplete anastomosing sinusoids giving a coral-like appearance. Spongy or cystic areas contained little or no resin, suggesting ischemic condition. Hepatocellular carcinomas (HCC) at 40 weeks took exclusively arterial red resin forming irregularly shaped anastomosing sinusoids. These findings indicate that acquisition of arterial blood supply by HF may relate to their further development to persistent HN and HCC. PMID- 6507096 TI - Early gastric cancer. Clinico-pathological analysis of 125 cases of early gastric cancer (EGC). AB - The frequency and the pathological findings of 125 early gastric cancers (ECGs), and particularly of small and minute lesions, were evaluated in a retrospective study of 839 surgical specimens of gastric carcinoma. Sixty two ECGs were believed to have risen from gastric epithelium, 27 from areas of intestinal metaplasia, and 3 from cardio-pyloric mucosa. The remaining lesions showed mixed histological patterns. The most frequent macroscopic type was IIc (24.8%) followed by IIb (16.8%), I (16.8%), and III (14.4%). In 63 cases (50.4%) the cancer was limited to the mucosa. In all specimens, and particularly in small and minute lesions, the surrounding mucosa was accurately analyzed to detect any lesions, from which the cancer could have developed. Intestinal ECGs, especially if protruded, seem to arise from areas of intestinal metaplasia or of chronic atrophic gastritis. Rarely ECGs seem to stem from polypoid lesions both hyperplastic and adenomatous. On the contrary, most important seems to be the role of ulcerative lesions, since in 14 cases of our series, carcinomatous foci were observed within the regenerative epithelium covering the crater. No correlation was found between histologic type, size, staging, and frequency of node metastasis; this suggests the existence of ECGs with different biologic behaviour. PMID- 6507097 TI - Dupuytren type fibromatoses. A clinicopathologic study of 62 cases. AB - This clinicopathologic study concerns 62 patients with one of the Dupuytren type fibromatoses. Of the 62 patients, 42 had the lesion in the palm (palmar fibromatosis), 12 in the sole (plantar fibromatosis), 2 in the penis (penile fibromatosis), and 6 in the ectopic locations, the dorsal aspect of the hand in 3 patients, the dorsum of the fingers in 2, and the forearm in 1. The clinically palpable nodules were histologically classified into those of the following three phases, according to LUCK'S classification: proliferative phase (27), involutional phase (23), and residual phase (12). In addition to fibroblastic proliferation, the lesion of the proliferative phase exhibited vascular features consisting of one or more layers of cells with oval nuclei around the vessels within the nodule. In the lesions of the late proliferative and involutional phase, the intracytoplasmic fine filaments were visible in cells compatible with myofibroblasts by Masson's trichrome stain. The nuclei of the elemental fibroblasts in the same phases were often crossed transversely by one or more fine basophilic lines. PMID- 6507098 TI - Cytofluorometric quantitation of acridine orange uptake by cultured cells. AB - The vacuolar accumulation of the lysosomotropic weak base acridine orange (AO) within living cells in culture was studied by cytofluorometry. Mouse peritoneal macrophages, malignant human glioma cells, and normal human glial cells were utilized. Exposure to AO resulted in granular bright red fluorescence, as well as a diffuse weak green background fluorescence. To obtain reproducible "staining" conditions, the red granular fluorescence was measured as a function of dye concentration and staining time. Exposure to high concentrations of AO (greater than 10 micrograms/ml) was found to cause cell damage in combination with markedly changed fluorescence distribution for the cell population with reduced mean fluorescence and increased variability. Granular uptake of AO was pH dependent and almost zero at pH 5.5. AO fluorescence, as measured by cytofluorometry, was found to be roughly linear to the amount of AO present in the cells, as measured by spectrofluorometry after cell solubilization, indicating negligible fluorescence quenching. AO labelling of living cells might serve as a useful indicator of the condition of the cellular vacuolar (lysosomal) apparatus. PMID- 6507099 TI - Correlation of estrogen and progesterone receptors and histological grade in human primary breast cancer. AB - The relationships between the presence of female sex steroid receptors and their concentrations, and the histological grade were investigated in primary breast carcinoma specimens from 151 patients. The concentrations of estrogen receptor were significantly lower in grade III tumours than in the more differentiated ones from pre- and post-menopausal patients, whereas the same was observed for progesterone receptor concentrations only between grades III and I in post menopausal patients. Generally estrogen and progesterone receptor-positive, estrogen receptor rich tumours frequently belonged to well-differentiated tumour categories. Whereas most of the tumours belonging to grade III group were receptor-negative, approximately three fourths of receptor-negative tumours belonged to grade I and II categories. It is therefore suggested that estrogen receptor-negativity or low receptor concentrations and grade III histological appearance of breast carcinoma are independent risk indicators, and their concomitant use is recommended in designing treatment strategies for individual patients. PMID- 6507100 TI - Intestinal lymphangiectasia in the Lundehund. Scanning electron microscopy of intestinal mucosa. AB - Intestinal lymphangiectasia of obscure etiology is frequent among Norwegian Lundehunds ("puffin-dog"). A study of three Lundehunds with typical symptoms, including wasting, diarrhea and ascites, revealed segmental distention of lymphatics resembling primary lymphangiectasia in man. Atrophy, fusion and balloon-like swelling of villi with occasional rupture of lacteals were seen. Subepithelial fluid accumulation caused bulging of the epithelium. Microvilli showed partial or complete atrophy. The protein loss in the Lundehund enteropathy may be due to rupture of lacteals, increased paracellular permeability, caused by enhanced hydrostatic tissue pressure, and decreased absorption through a malformed brush border. PMID- 6507101 TI - Epidemiology of soft-tissue sarcoma in the locomotor system. A retrospective population-based study of the inter-relationships between clinical and morphologic variables. AB - From all soft-tissue malignancies reported to the Swedish National Cancer Registry in Southern Sweden (1.3 mill. inhabitants) from 1964 through 1978, 278 cases were accepted as sarcomas after histologic re-examination. All these were malignancy-graded on a four-grade scale, without knowledge of the clinical course. A number of clinical and morphological variables were recorded and subjected to uni-, bi- and multi-variate analysis. Follow-up was available in all patients. The annual incidence rate over all ages was 1.4/100,000. The mean age was 58 years and males dominated (1.3/1). Malignant fibrous histiocytoma, liposarcoma and leiomyosarcoma were the most common histologic groups. Three fourths of the tumors were high-grade malignant (Grade III-IV). Sixty per cent were deep-seated, having a median size of 8 cm compared to 4 cm for the superficial tumors. One third of all tumors were located in the thigh. The histologic groups were characterized by age, tumor depth and size, the occurrence of pain, malignancy grade and five-year survival; it was seen that each group, with respect to at least one of the variables, differed significantly from all the other groups. Thus histologic classification seems to identify different tumor entities. Out of several pair-wise associations the strongest were as follows: histologic groups versus depth, size, malignancy grade and age; depth versus size; and size versus malignancy grade (Grade IV tumors being larger). The proportion of superficial and small tumors in this series is high, compared to several reported series, probably owing to "referral selection" in the previous studies. The inter-relationships found between several variables and conclusions based on selected series may explain, in part, the differing opinions which can be found in the literature regarding prognostic variables in soft-tissue sarcoma. PMID- 6507102 TI - Prognosis for soft-tissue sarcoma in the locomotor system. A retrospective population-based follow-up study of 237 patients. AB - To identify variables of prognostic importance for soft-tissue sarcoma in the locomotor system, we performed a retrospective follow-up study on a consecutive, unselected, population-based series of 237 patients mainly treated by surgery, 1964-1978. Patients with metastasis at the time of diagnosis were not included. All histologic material was re-evaluated and histologic malignancy-grading (four grade scale) performed without knowledge of the clinical course. The surgical procedures were classified as marginal and broad excisions. Patient follow-up ranged between 3- and 18 years. Multivariate analysis of the data by Coxs proportional hazard regression techniques disclosed seven negative prognostic variables of primary significance; high malignancy-grade (IV and III), pain at rest, male sex, increasing age and tumor size, a marginal excision and an extracompartmental tumor site, in order of decreasing relative risk (5.9-1.9) as regards survival. A secondary variable, that of local recurrence, was then included in the model and was found to have a stronger influence on survival than any of the other variables. Patients with local recurrence had a mortality risk which was 8.3 times that of patients without local recurrence. A risk curve based on the prognostic variables having primary significance was constructed. By this risk curve, patients with very good or very bad prognosis could be identified. The results are important when evaluating the efficiency of different therapies in non-randomized trials. In such studies the prognostic variables could be used to identify patients having comparable prognoses. In addition, patients found to have a good prognosis could be excluded from trials with adjuvant therapy. PMID- 6507103 TI - Flow cytometric studies on phagocyte function in bacterial infections. AB - Polymorphonuclear neutrophilic leukocyte (PMNL) phagocytosis of fluorescein isothiocyanate labelled Staphylococcus aureus was studied by flow cytometry (FCM) in 41 patients with bacterial infections. Practically all phagocytic cells (granulocytes and monocytes) showed active uptake of fluorescent bacteria. However, the mean fluorescence of the phagocytes was about 15% lower than that of cells from healthy volunteers. This reduction was only seen in the male patients, not in the females. The fluorescence reduction was related neither to the type of infectious agent (Gram-positive versus Gram-negative) nor to the white blood cell count or percentage of immature leukocytes. Five patients with cured infections had phagocyte fluorescence similar to that of the controls. In two patients, phagocyte fluorescence was very low, indicating reduced phagocytosis. Phagocyte fluorescence was not related to patient survival. PMID- 6507104 TI - Activation of human monocytes by free muramyl dipeptide (MDP). AB - Activation of human monocytes with MDP (N-acetylmuramyl-L-alanyl-D-isoglutamine) 1-100 micrograms per ml for 48 h in vitro enhanced the cytostatic activity against the target cell line K-562, while cytolysis remained unchanged. Catalase, 600 SU per ml, had no inhibitory effect on the cytostasis mediated by MDP activated monocytes. The optimal MDP concentration for activation was in the range 3-10 micrograms per ml. Supernatants from monocytes activated with MDP 1-30 micrograms per ml for 48 h exerted no cytostatic activity. MDP 1-100 micrograms per ml had no direct cytostatic or cytolytic effect on the target cells in a 24 h assay. When added to monocytes cultured in vitro for four days immediately prior to the chemiluminescence (CL)-assay, MDP 10-100 micrograms per ml enhanced both the zymosan and phorbol myristate acetate-triggered lucigenin-dependent CL. Monocytes pre-activated with MDP for 48 h did not demonstrate any enhanced CL response. MDP-activation 30 micrograms per ml for 48 h increased the zymosan triggered generation of H2O2 moderately. The enhanced cytostatic activity induced by MDP-activation is probably not mediated by hydrogen peroxidase or production of cytostatic factors. PMID- 6507105 TI - Active and passive immunization against Rift Valley fever virus infection in Syrian hamsters. AB - The protection by active and passive immunization of Golden Syrian hamsters challenged with Rift Valley Fever (RVF) virus intraperitoneally was studied. Six groups of 10 hamsters were inoculated with different amounts of immune serum while five groups were actively immunized with different doses of a formalin inactivated RVF vaccine. One day after passive and three weeks after active immunization all hamsters were challenged with 5000 plaque-forming units of RVF virus. Plaque reduction neutralization tests (PRNT) were performed with serum samples collected immediately before challenge. A PRNT titer of 10-20 or more was required for full protection against the RVF challenge in both actively and passively immunized hamsters. Actively immunized hamsters and control animals that succumbed to the infection died within the first 4 days after virus challenge, whereas some passively immunized hamsters died as late as 11 days post virus challenge. Animals that died early had developed massive liver necrosis, whereas late death was caused by encephalitis. PMID- 6507106 TI - IgA subclass distribution in paraproteinemias: suggestion of an IgG-IgA subclass switch pattern. AB - IgA subclass distribution in the serum of 40 patients with IgA multiple myeloma and 10 patients with benign monoclonal gammopathy of the IgA class was determined. All were found to be of the IgA 1 subclass. A review of the literature shows a marked predominance (93%) of IgA 1 paraproteins, suggesting an under-representation of IgA2 myelomas. The subclass pattern in 11 double paraproteinemias studied and those previously reported in the literature suggest a pattern of IgG1 - IgA1, IgA1 - IgG4 and possibly also IgG2 - IgA2 switches in malignant cells. PMID- 6507107 TI - Azathioprine as single drug in the treatment of rheumatoid arthritis induces complete suppression of natural killer cell activity. AB - Natural killer (NK) activity against K 562 target cells was studied in 60 patients with definite or classic rheumatoid arthritis (RA), grouped by medication into 1) Controls not in remission-inducing therapy, 2) Patients treated with penicillamine, and 3) Patients treated with azathioprine. NK activity was found to be completely suppressed in the azathioprine group as compared with the controls (3.2 +/- 4.2% versus 35.9 +/- 14.8% specific lysis; p less than 0.01) except for one patient who received incomplete azathioprine treatment. The NK activity was not suppressed in the penicillamine group. PMID- 6507108 TI - Back-crossing F1 (BN X PVG) rats with the PVG strain gives hybrids with high natural killer (NK) cell activity. AB - The genetic regulation of rat natural killer (NK) cell activity against the lymphoma YAC-1 in two rat strains, BN and PVG, with low and intermediate NK activity respectively, was studied. The F1 (BN X PVG) and the BN X F1 (BN X PVG) hybrids were both found to have NK activity intermediate between the BN and PVG parental strains, whereas approximately half of the PVG X F1 (BN X PVG) had high NK activity. No correlation to AgB types was found. Apparently at least two genes regulate NK activity in the rat, neither of which appears to be linked to the major histocompatibility complex. PMID- 6507109 TI - Failure of amantadine and bromocriptine to counteract alcoholic inebriation in man. AB - Oral amantadine 100 mg and bromocriptine 2.5 + 2.5 mg, alone and in combination with ethanol (1 g/kg), were investigated in two placebo-controlled, double-blind and cross-over trials. In the first trial the psychomotor effects of amantadine and bromocriptine were compared to those of placebo, and in the second trial ethanol was added to the treatment. Bromocriptine lowered serum prolactin levels, thus confirming its absorption. Amantadine and bromocriptine alone had no psychomotor effects but unpleasant sensations, nausea and dizziness were reported after bromocriptine. Ethanol impaired performance in terms of impaired coordinative and reactive skills, lowered tapping speed, prolonged critical flicker interval and reduced gaze nystagmus angle (P less than 0.05 to 0.001; two way ANOVA). Subjectively, ethanol induced mental slowness, clumsiness and impairment of performance (P less than 0.05 to 0.001). Amantadine and bromocriptine failed to counteract any of these ethanol-induced changes. It is concluded that in man, an acute dopaminergic activation by amantadine or bromocriptine does not significantly modify the psychomotor effects of ethanol. PMID- 6507110 TI - Sudden death related to advanced coronary atherosclerosis in mini-pigs: influence of some drugs. AB - Advanced coronary atherosclerosis was produced in 30 mini-pigs by a combination of a hypercholesterolaemic diet and X-irradiation to the precordial region. Within 11-25 weeks after the irradiation, 13 of the 30 animals died a sudden death probably caused by coronary atherosclerosis. The contents of free and ester bound cholesterol in the right coronary artery were significantly higher in the animals which died spontaneously than in surviving animals. In an untreated group of 12 animals 7 died whereas in a group treated with beta-pyridylcarbinol only 1 out of 5 died. In the coronary arteries, the contents of both free and ester bound cholesterol were significantly lower in the beta-pyridylcarbinol-treated animals. In a sulfinpyrazone-treated group 3 out of 8, and in a metoprolol treated group 2 out of 5 animals died. None of these drugs reduced the accumulation of cholesterol in the coronary arteries. The rate of sudden death was 26 +/- 6% (P less than 0.05) lower in the combined group of treated animals than in the untreated ones. By regular ECG recordings, signs which could predict the fatal outcome of the experiment were looked for. Although depressed ST segments were present before death in a few animals, this was not a regular phenomenon. It is concluded that advanced coronary atherosclerosis in mini-pigs often leads to sudden death and that this animal model seems suitable for testing the potential therapeutic effects of drugs. PMID- 6507111 TI - Antidotal treatment of the acute cardiovascular toxicity of verapamil. AB - Rats anaesthetized with pentobarbital and ventilated artificially were infused with 0.15 mg/kg/min. verapamil; without antidotal treatment, they died after 51.1+/-7.1 min. The survival time more than trebled upon an additional infusion with calcium chloride, epinephrine, isoprenaline, orciprenaline or prenalterol and nearly doubled upon administration of a plasma expander. It was not increased, however, by treatment with angiotensin or atropine. The infusion of verapamil declined the arterial blood pressure by 75%, and heart rate, cardiac output and peripheral resistance by about 50%; in the ECG, sinus bradycardia followed by AV-dissociation with nodal rhythm occurred. All antidotes that raised the lethal dose of verapamil increased the cardiac output. Calcium and the sympathomimetics with alpha-adrenergic activity also counteracted the verapamil induced hypotension. Calcium did not influence the ECG alterations produced by verapamil, while the sympathomimetics restored the sinus rhythm or accelerated the nodal pacemaker. Calcium, epinephrine and isoprenaline also antagonized the strong decrease of left-ventricular dp/dt max. induced by verapamil. In conclusion, calcium as well as sympathomimetic amines are potent antidotes against the cardiovascular toxicity of verapamil, the latter being superior to calcium in their ability to improve pacemaker activity and AV-conduction. PMID- 6507112 TI - Effect of cadmium and colcemide on the mitoses of a human epithelial cell line with high content of cytoplasmic metallothionein. AB - Cultures of cell strains with and without metallothionein were exposed to CdCl2 in doses ranging from 10 mu mol/l to 200 mu mol/l . Cell growth parameters were monitored by flow cytometric DNA-measurements, cell counts and counting of mitoses during the first two days after exposure. CdCl2 inhibited cell growth in a dose dependent way. The cadmium resistant cells were inhibited with concentrations above 100 mu mol/l, the concentration which the metallothionein containing cells had previously been adjusted to. Microscopy of the cell cultures showed a dose dependent accumulation of cells in the mitotic prophase, whereas the other phases of the cell cycle were unaffected as measured by flow cytometry. When exposed to colcemide, however, the two cell strains showed identical responsiveness. PMID- 6507113 TI - Solubility of copper and zinc containing proteins before and after 2 mercaptoethanol treatment of liver samples from normal and from chronically copper poisoned sheep. AB - The distribution between cytosol and pellet of Cu- and Zn-containing proteins was studied in livers from normal sheep and sheep with chronic copper poisoning (CCP). It was found that the relative amount of soluble Cu- and Zn-containing proteins was lower in liver homogenates from CCP sheep than in homogenates from normal sheep. Treatment of homogenate from the livers of 2-mercaptoethanol (ME) increased the solubility of Cu- and Zn-containing proteins, especially in CCP sheep. Oxidation of the liver homogenates from normal sheep with air oxygen gave a decrease in the relative amount of soluble CU-containing proteins and an increase in Zn-containing proteins present in the cytosol. It is proposed that oxidation in vivo of Cu and/or the metal-binding protein causes the observed decrease in soluble CU- and Zn-containing proteins seen in CCP sheep. PMID- 6507114 TI - Effects of nucleosides and nucleotides on tracheal tone. PMID- 6507115 TI - The hypertensive response to soman and its relation to brain acetylcholinesterase inhibition. AB - Intravenous injection of soman in the rat produced a rapid and dose related increase in blood pressure. The dose response curve was very steep, threshold responses occurring after intravenous injection of 10 micrograms/kg, and maximum increases of about 50 mmHg occurring after 40 micrograms/kg. Heart rate also generally increased. An increase in blood pressure also followed injection of soman subcutaneously, intramuscularly, intraperitoneally and into the cerebral ventricles, although the onset was slower and higher doses were required. The magnitude of the pressor response was correlated with the degree of AChE activity in the cortex, hypothalamus and brain stem, but not in the striatum. The pressor response was aborted or prevented by atropine, but not by methylatropine. It also was prevented by phenoxybenzamine. Atropine increased survival following an LD50 dose of soman; phenoxybenzamine prevented the pressor response but did not alter the survival rate. PMID- 6507116 TI - Biochemical effects and decreased body burden of cyclopentanone by extended vapour inhalation. AB - Male Wistar rats exposed intermittently to cyclopentanone vapour at 50, 100 or 300 p.p.m. 6 hrs daily 5 days a week for 1 to 15 weeks showed brain and perirenal fat solvent concentrations which correlated to the exposure although they decreased at the later stages of the experiment. Cyclopentanone caused almost no effects on liver drug metabolizing enzymes or aldehyde dehydrogenase activities while an early increase in the kidney 7-ethoxycoumarin O-deethylase was found after 1 week without a concomitant increase in the cytochrome P-450 content. This effect was abolished later so that an enhancement was found only at the highest exposure level after 15 weeks. Postmitochondrial fractions isolated from liver of exposed animals metabolized cyclopentanone more actively than controls after 15 weeks. PMID- 6507117 TI - Comparison of electrophysiological and mechanical effects of droxicainide and lidocaine on heart muscle isolated from rats. AB - A new antiarrhythmic drug, droxicainide, was compared with lidocaine in order to evaluate droxicainide's effect on heart muscle. Dose-response curves for electrophysiological and mechanical effects of the two drugs on spontaneously beating atria, electrically stimulated atria and papillary muscles isolated from rats were obtained. After increasing doses of both droxicainide and lidocaine sinus node automaticity decreased, atrial and ventricular excitability and contractile force decreased and refractoriness increased. The effects of the two drugs on atrial and ventricular muscle were qualitatively and quantitatively the same, but droxicainide was less potent. The results fit well with the concept that droxicainide is a class 1 anti-arrhythmic drug. PMID- 6507118 TI - Kinetics of white spirit in human fat and blood during short-term experimental exposure. AB - Seven volunteers were exposed to 100 p.p.m. white spirit (99% paraffins C8-C12) 6 hrs daily in 5 days. The mean concentration of white spirit after 5 days of exposure was 41.1 mg/kg fat (Friday afternoon). On the following Monday morning, the concentration was 31.7 mg/kg, i.e. only 23% had been eliminated during the exposure-free weekend. The estimated mean and median half-life was 7 and 8 days, respectively, elimination rate constant 0.0039 and 0.0036 hrs-1, time to reach steady state 5 to 8 weeks, maximal and minimal steady state concentration 85 and 66 mg/kg and 66 and 52 mg/kg, respectively. The concentration of white spirit in fat found each afternoon correlated significantly with the total dose. The concentration of white spirit/kg fat correlated positively with serum triglyceride and inversely with the percentage body fat (not significantly). The concentration of white spirit in the brain at steady state was estimated to maximum 11 mg/kg, while the half-life in the brain was estimated to maximum 18-19 hours. Minor differences occurred in the spectrometrical pattern produced by the in vivo biopsy evaporate as compared to in vitro specimens and white spirit vapours per se, thus indicating that the white spirit was slightly biotransformed or that the approximately 200 constituents of white spirit were absorbed differently. Thus, during exposure at the threshold limit value level, white spirit is accumulated in depot fat over weekends and in brain over working days. However, white spirit is almost eliminated from the brain during weekends. PMID- 6507119 TI - Age- and pressure-dependent changes of systemic resistance vessels concerning the relationships between geometric design, wall distensibility, vascular reactivity and smooth muscle sensitivity. AB - The resistance vascular function in normotension, and its alterations in primary hypertension and ordinary aging, was analysed concerning the interactions between geometric vascular design, wall distensibility, transmural pressure and smooth muscle activity. Paired hindquarter perfusions were used, comparing hemodynamic resistance characteristics in young, adult and old normotensive (WKY) and spontaneously hypertensive rats (SHR). From the experimental data pressure resistance diagrams were constructed, which quantitatively interrelate the four factors in all SHR-WKY groups. The diagrams show, over a wide pressure range, how altered smooth muscle activity as well as structural adaptation affect resistance vessel distensibility; likewise how distensibility considerably interferes with "active" resistance adjustments. They also show how markedly the range of active resistance responses during ordinary constant-pressure perfusion is affected whenever pressure is reset to new levels. Finally, the diagrams illustrate the fundamental hemodynamic difference between hypertensive and normotensive resistance vessels, mainly because of factors 1 and 2, which render the hypertensive vessels stronger, stiffer and hyperreactive. Thereby they are capable of a widened response range despite the higher pressure level, which is further accentuated on acute pressure normalization. In contrast, ordinary aging alters resistance vascular behaviour only little, smooth muscle contractility and sensitivity remaining almost unchanged. However, vascular reactivity is moderately enhanced at lower pressures, presumably a geometric consequence of age dependent, intimal-interstitial endowment. PMID- 6507120 TI - The effect of 2 hours of complete unilateral ureteral obstruction on tubuloglomerular feedback control. AB - The mechanisms affecting renal blood flow and filtration during and after unilateral ureteral obstruction (UUO) are incompletely understood. Since ureteral obstruction leads to changes in interstitial pressure and volume, and since we have previously shown that interstitial pressure conditions can modulate the sensitivity of the tubuloglomerular feedback (TGF) control system, we sought in the present study to define the contribution of the TGF system to changes in GFR during and after UUO, and to observe associated changes in pressures in vessels, tubules and the interstitial space. Interstitial pressures and glomerular filtration rate (GFR) were measured in one group of Sprague Dawley rats. Interstitial hydraulic pressure was determined with a thin catheter placed in the subcapsular space. Interstitial oncotic pressure was estimated from the protein concentration in collected hilar lymph. In a second group of rats proximal tubule pressure (PT) and stop-flow pressure (PSF) were measured during the first three hours of UUO and after 24 h UUO. In a third group of rats PSF was measured while the loop of Henle was perfused at different rates. The sensitivity of the TGF system was determined from the maximal drop in stop-flow pressure (delta PSF) and the turning point (TP)--the tubule perfusion rate at which 50% of this maximal stop-flow pressure response was obtained. In a fourth group of rats proximal tubule flow-rate was measured after release of 2 hrs UUO. The results show that PT and PSF are both increased during the first three hours of obstruction and that they return to normal or sub-normal levels after 24 h of UUO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507121 TI - Breathing pattern and occlusion pressure during moderate and heavy exercise. AB - We studied changes in breathing pattern and mouth occlusion pressure (P0.1) in 11 healthy subjects performing graded steady-state exercise on a cycle ergometer up to the maximal load sustainable for 4 min. With increasing work intensity both the tidal volume (VT) and end-inspiratory volume relations to inspiratory (TI) and expiratory (TE) durations were linear in the moderate work load range; in the high load range VT and end-inspiratory volume tended to plateau with further decreases in TI and TE. The ratio of TI to total breath duration (TI/Ttot) increased with work intensity. Intraindividual coefficients of variation for VT, breathing frequency (f), mean inspiratory flow (VT/TI), and other respiratory variables decreased with increasing work intensity, indicating that breath-to breath variations in breathing pattern became smaller as the level of ventilation increased. P0.1 rose with VT/TI as a power function with an exponent averaging 1.5 (range 1.3-1.9), indicating that the ratio P0.1/(VT/TI), an index of respiratory system impedance, increased with VT/TI and work intensity. We conclude that in moderate and heavy exercise the work of inspiration at a given ventilation is reduced because of the increase in TI/Ttot, the impedance of the respiratory system increases with work intensity because of both an increase in f and a flow-dependent rise in airway resistance, and the neuromuscular inspiratory activity is reflexly augmented because of internal flow-resistive loading. PMID- 6507122 TI - Higher albumin clearance in rat hindquarters perfused with pure albumin solution than with serum as perfusate. PMID- 6507123 TI - [Integrated lists of taxonomic evaluation criteria: LICET-S and LICET-D]. AB - LICET-S and LICET-D are diagnostic instruments containing all diagnostic criteria for two major groups of disorders. LICET-S assembles the criteria proposed for non-affective psychoses in 9 different systems. LICET-D integrates the criteria defining the depressive categories listed in 7 different systems. Initially constructed to elaborate empirical criteria for specific categories pertaining to traditional French nosology, the two lists also permit to formulate diagnostic decisions according to 9 respectively 7 classification systems, on the basis of the algorithms defining each of the systems under discussion. The authors present the rationale that led to the construction of the LICET-system. They describe the composition of the two lists and the guidelines for use of the system. They finally illustrate the utility of the instruments on the basis of results obtained in recent investigations. PMID- 6507124 TI - Mental impairment in Parkinson's disease. The role of anticholinergic drugs. AB - The trial has been carried out on 33 treated Parkinsonian patients and 14 healthy controls. A series of psychometric tests were employed in order to show a possible intellectual deterioration in Parkinsonian patients. Bender's test showed greater motor-perceptive deterioration in Parkinsonian patients respect to control, the Wechsler-Bellevue Intelligence Scale evidenced in patients significant deterioration of mnesic and psychomotor capacity. When considering drug treatments patients undergoing combined treatment or anti-cholinergics alone obtained worse results in all tests made whilst patients on L-Dopa alone obtained the best results. PMID- 6507125 TI - [Acute porphyria and psychiatry. Updating our knowledge]. AB - On the occasion of a clinical case of acute porphyria, the authors review the present knowledge on the biochemistry, pathophysiology, clinical picture, diagnosis and therapy of this group of disorders. They stress their importance in psychiatry and present two lists of authorized vs contra-indicated drugs in these disorders. PMID- 6507127 TI - Induced strategy shifts in spatial reasoning. PMID- 6507126 TI - [Cerebral atrophy diagnosed by computer tomography compared with the "memory output profile" (MOP) in a psychiatric population]. AB - The scope of the present study was a comparison between the profile of Andre Rey's mnesic rates and the results of CAT-scans for which were selected two groups of 20 patients, one of the groups suffering from brain atrophy and one presenting normal scans. The essential data derived from the present study is the practically complete lack of differences between both groups. Still, for the group suffering from brain atrophy slight variations appear in some sub-testing experiments in which memory only is not concerned but also the shape of simplified schemes to be reconstrued. It may thus be concluded that the notion of brain atrophy differs from the clinical concept of mnesic deterioration. PMID- 6507128 TI - Immediate and remote time estimation--a comparison. PMID- 6507129 TI - Maxillo-nasal dysplasia (Binder syndrome) and associated malformations of the cervical spine. AB - Forty-three patients with maxillo-nasal dysplasia have been subjected to a radiographic examination of the cervical spine. In 44.2 per cent malformations of the cervical vertebrae of a minor or major type were revealed. Dysplasia of the vertebral bodies related to persistence of the chorda dorsalis, a very rare malformation, was found in six cases. No correlation between the incidence or severity of the malformations and the degree of malocclusion of the jaws and facial deformity, characteristic of Binder syndrome, were noted. The maxillo nasal dysplasia and the spinal malformations probably have a common cause during the embryologic stage. PMID- 6507130 TI - Sialography and CT-sialography in the diagnosis of parotid masses. AB - Parotid masses were evaluated by sialography and CT-sialography in 22 patients. Nineteen were benign tumors and one a metastasis. All were identified by CT. Two patients with sialoadenitis were misinterpreted at CT. All benign tumors appeared as lobulated, sharply marginated masses, embedded in displaced glandular parenchyma. The metastasis was lobulated, irregular and located within the gland. With sialography, 17 tumors were identified and 3 small superficial tumors overlooked. Both patients with sialoadenitis were diagnosed by sialography. CT sialography is recommended in patients with suggested parotid masses, and sialography in suggested inflammatory disease. PMID- 6507131 TI - Lumbar myelography with iohexol and metrizamide. A double-blind clinical trial. AB - Two non-ionic contrast media, iohexol and metrizamide, were compared in a double blind clinical trial which included 50 patients who underwent lumbar myelography for disc herniation or spinal stenosis. The frequency of adverse reactions was lower for iohexol which is recommended for extended trials and for examination of other compartments of the subarachnoid space. PMID- 6507132 TI - Psychic changes following myelography with metrizamide and iohexol. A comparative investigation with psychologic tests. AB - Based upon the results of repeated psychologic tests, psychic impairment following myelography has been studied in 60 patients. Thirty of these had lumbar myelography with metrizamide and 30 with iohexol. Psychic impairment was noted in both groups, although with a higher frequency and much more marked in the group which had metrizamide myelography. For this type of examination iohexol is thus to be recommended. PMID- 6507133 TI - Transcatheter embolization of splanchnic arterial aneurysms. Report of two cases. AB - Two patients with large splanchnic arterial aneurysms (celiac and renal) were successfully treated by transcatheter aneurysmectomy using steel coils. The authors point out the advantage of this method over surgical intervention. PMID- 6507134 TI - Effect of ioxaglate on the liver and pancreas following selective visceral angiography in man. AB - Selective visceral angiography was performed with the ionic, monoacidic, dimeric contrast medium ioxaglate (280 and 320 mg I/ml). Twenty patients with and without disease of the liver and/or pancreas were prospectively and consecutively studied. Changes in the serum activities of ALAT, ASAT, GT, AP, and pancreatic isoamylase and changes in the level of serum bilirubin, prothrombin index and haematocrit were evaluated sequentially before and after angiography. The total volume of contrast medium ranged from 100 to 340 ml per patient and the median dosage was 3.5 ml per kg body weight. There was no statistically significant elevation within the entire group of patients in the measured parameters after angiography when compared with pre-angiographic values. No clinically important toxic effect on the liver or pancreas induced by the contrast medium was found. PMID- 6507135 TI - Effect of prostaglandin inhibition on the renal vascular response to ionic and non-ionic contrast media in the dog. AB - In an attempt to study the role of prostaglandins in the renal vascular response to contrast media in mongrel dogs, renal arterial injections of 6 ml of either the non-ionic contrast medium Iopamidol or the ionic medium diatrizoate meglumine/Na+ were performed, before and after intravenous injection of a buffered solution of acetylsalicylic acid (10 mg/kg) (ASA). Renal blood flow was recorded using non-occluding electromagnetic flow probes. The resting renal blood flow was significantly reduced after ASA. The usual biphasic response to contrast injection was observed both before and after ASA, and using either contrast medium. Analysis of the results failed to show any difference in degree of vasodilation or vasoconstriction after ASA. We conclude that prostaglandins may affect the resting level of renal blood flow but are not mediators of the instantaneous changes in response to contrast injection. PMID- 6507136 TI - Computed tomography in advanced carcinoma of the uterine cervix. AB - Computed tomography (CT) and clinical examination including complete evaluation of the true pelvis were performed in 32 patients of whom 2 had possible advanced primary and 30 possible recurrent carcinoma of the uterine cervix. Confirmation of the staging by surgery or autopsy was obtained in 22 patients and by repeat clinical examinations and CT in 10 patients. The CT diagnosis was correct in 29 and the clinical pelvic examination in 25 patients. The results confirm previous reports that CT is a complementary method to pelvic examination in advanced cervical carcinoma. PMID- 6507138 TI - Visual detection and physical characteristics of roentgenographic systems. Investigations on chest imaging chains. AB - The relationship between physical characteristics (physical resolution, large object contrast and radiographic mottle) and visual detection parameters was evaluated in a water phantom. To measure visual observer performance a minified Snellen E-plate made of gold (three contrast zones) and a high contrast lead bar test pattern were investigated. A trial to test four types of equipment chains for chest radiography was further done with the E-plate technique by simulating a clinical radiography with an Alderson thorax phantom. The observer performance of the high contrast lead bar test pattern showed a good linear correlation to the physical parameters. However, none of the physical system-related parameters fully predicted the visual detectability when the equipment chains were investigated with the E-plate technique. In Alderson phantom studies the rare earth screens and the air gap technique considerably reduced the radiation dose compared with that of the ordinary grid technique chest radiography, without impairing visual detectability significantly. The RP- and spotfilm techniques showed relatively poor properties of visual detectability. PMID- 6507137 TI - Prognostic radiographic aspects of spondylolisthesis. AB - A series of 202 patients (133 men, 69 women) with lumbar spondylolysis were examined radiographically on two occasions, first at the time of diagnosis and later at a follow-up, after an observation period of 20 years or more. The films from patients in groups without and with moderate and severe olisthesis were evaluated with respect to variables describing lumbosacral lordosis, wedging of the spondylolytic vertebra, lengths of the transverse processes and iliolumbar ligaments, disk height, progression of slipping, and influence on measured olisthesis of lumbar spine flexion and extension at the radiographic examination. The evaluation was made with special attention to possible signs which could be predictive for the prognosis of vertebral slipping. Progression of slipping did not differ between patients diagnosed as adults or adolescents. Reduction of disk height was correlated to the degree of slipping present at the initial examination and to the progression of olisthesis. Flexion and extension of the lumbar spine did not modify the degree of olisthesis. Data concerning the lengths of the transverse processes and the iliolumbar ligaments, and lumbar lordosis, cannot be used for prognostic purposes. The lumbar index reflecting the degree of wedge deformity of the spondylolytic vertebra was shown to be the only variable of prognostic value for the development of vertebral slipping. PMID- 6507140 TI - Anatomic characteristics of the grivet monkey insula. PMID- 6507139 TI - [Results of cytogenetic analysis of amniotic fluid cells]. PMID- 6507141 TI - Serum lipids and glucose in obese persons. PMID- 6507142 TI - Microscopic changes of endothelial cells in blood vessels of people died in shock. PMID- 6507143 TI - The borderline syndrome in adolescents. AB - The borderline adolescent is discussed in terms of diagnostic perspectives, characteristic features based on disturbed object relations, and treatment. The disorder is not fully manifest in adolescence but gradually emerges into a definable personality type, the various features of which express the unsatisfactory outcome of a complex psychodynamic struggle related to developmental arrests in psychic structure. Based on clinical observations, the diagnosis of borderline personality, like the schizoid personality, is considered to be compatible with a past, present or future schizophrenic disorder. Finally, therapeutic approaches in a day-treatment program, and individual therapy is considered from a developmental object relations viewpoint. PMID- 6507144 TI - The Wall Gang: a study of interpersonal process and deviance among twenty-three middle-class youths. AB - This paper reports the findings of a nonparticipant observational study of a "gang" of late-adolescent, middle-class youths in a Southern California beach community over an 11-year period. The significance of family background, interpersonal relationships in the home, and socialization processes were explored in relation to such factors as the use of drugs, sexual experiences, and other "deviant" behavior. The author also interviewed and interacted with other youths in the community of the same age range and similar socioeconomic background who were not members of the "gang." Case narration is supplemented by demographic data. The "gang" approximated Lewis Yablonsky's description of a "near-group." The youths were from above-average economic background, but 21 of the 23 "members" were from broken homes, frequently with multiple divorces and remarriages. The youths expressed attitudes of disgust with adult society and doubted the concern of their parents, particularly fathers and stepfathers, for their well-being. The youths sought out both "mother-figures" on whom they could be dependent for financial support as well as "father-figures" who would teach them to become independent. These "gang members" had erratic school and employment patterns. The types of drugs used by "nongang" youths, who had more stable family backgrounds, did not differ appreciably from those used by the "gang." The former group was distinguished in their use of drugs and alcohol by lower frequency and less tendency to use drugs in order to reduce anxiety or to facilitate their relations with the opposite sex. PMID- 6507145 TI - Adolescence, sexual conflict, and anorexia nervosa. AB - Anorexia nervosa is a life-threatening mental disorder. As many as one out of every 250 girls between the ages of 12 and 18 may develop anorexia nervosa. The high incidence of the disorder among adolescent girls suggests that developmental sexual pressure inherent in adolescence may be associated with the onset of the disease. The symptoms of anorexia nervosa appear with the onset of puberty and the development of the secondary sex characteristics. Symptom formation is related to the following developmental issues: physiological changes (menstruation and breast development) and psychological changes (body image and sexual identity). PMID- 6507147 TI - Measurement of social-evaluative anxiety in junior high school students. AB - This paper provides some initial normative and validity data on the Social Avoidance and Distress (SAD) and the Fear of Negative Evaluation (FNE) scales for junior high school students. Findings indicated: the level of social-evaluative anxiety does not significantly vary during the junior high school years or between sexes, junior high school students report similar levels of FNE to college students but less SAD, a significant positive correlation between treatment subjects' SAD scores and peer sociometric ratings of social-evaluative anxiety, and subjects treated for social anxiety reported significantly less SAD and FNE at follow-up assessment. Recommendations for future research and clinical use of the SAD and FNE are offered. PMID- 6507148 TI - The effect of a twelve-week dropout intervention program. AB - The problem of the high school dropout has been of serious concern to educators, service agencies, and society for many years. The problem has reached epidemic proportions in large urban communities with high concentrations of minority youngsters from low-income families. Given the magnitude of this problem from both the economic and humanistic perspective, the purpose of the study was to determine the effect of a twelve-week intervention program on potential dropouts. It was initiated in the Spring of the 1981-82 school year with a follow-up on the retention and absence rates in the fall of the same year. The results of the intervention revealed that the experimental intervention did impact significantly upon both variables of primary concern in the study, the retention and absence rates; the four affective measures of student attitude were not significantly affected by the program. These results pose serious questions concerning the generalizations of the self-concept to academic achievement. PMID- 6507146 TI - Sexual development and behavior in black preadolescents. AB - As part of a longitudinal study of the sociosexual development of black preadolescents, sexual maturation and sociosexual behaviors were assessed and the relationships between these variables determined in a sample of 101 nine- to eleven-year-old middle- and low-income boys and girls. Sexual maturation was measured by Tanner's staging criteria of specific secondary sex characteristics. Involvement in heterosexual behaviors was elicited via self reports and was classified on a five-point heterosexual physical activity scale (HPA). The data corroborate other studies in demonstrating that girls were more advanced than boys in the process of sexual maturation. Considerable variation in stages of maturation for chronological age existed in both boys and girls, but was more pronounced for girls. In girls, there was no significant association between HPA and degree of biologic maturation. However, genital development in boys was significantly related to their sexual behavior. Income level was not significantly associated with the HPA score. A baseline from which to chart the progress of sociosexual behaviors in these developing preadolescents was established. PMID- 6507149 TI - Short-term effects of teenage parenting programs on knowledge and attitudes. AB - The short-term effects of teenage parenting programs upon the knowledge and attitudes of pregnant teenagers were assessed. The programs studied produced a significant change in the teenagers' knowledge of sexuality and child development while having no apparent effect on the teenagers' parenting attitudes. The implications of producing changes in knowledge without accompanying changes in attitudes are discussed. PMID- 6507150 TI - Adolescent prostitution. AB - Although juvenile prostitution has been documented since antiquity, its rise since 1970 has been overwhelming. Newsweek (1978) reported an alarming increase in arrests of prostitutes under the age of 25 in New York from 24% to 74% in the previous 10 years. In Boston the average age of prostitutes is 20 years old; in Miami it is 18. The purpose of this paper is to explore the conditions which lead to teenagers' becoming prostitutes, and how our institutions and legal system deal with them. PMID- 6507151 TI - Personality tests as a predictor of success in a residential treatment center. AB - This study compares the profiles of two groups of emotionally disturbed female adolescents as measured by two objective personality tests, the HSPQ and the Jesness Inventory. The hypothesis tested was that the unsuccessful girls would score significantly differently on various dimensions of the two tests than the successful girls. Unsuccessful girls were those who did not complete the treatment program; successful girls were those who completed the program. A comparison of the mean scores of the various personality factors on each test showed significant differences upon admission. PMID- 6507152 TI - Similarities in becoming: transsexuals and adolescents. AB - The Gender Identity Service (located in Boston, Massachusetts) is an evaluative and counseling unit designed to provide full services including sexual reassignment to transsexuals. In that capacity, since the spring of 1972, we have seen over 120 transsexuals. During this time we have been impressed with behavioral similarities between our population of transsexuals and adolescents. This emerging observation provided impetus for the present paper. After carefully reviewing our caseload material it is our contention that indeed psychological, biological and sociological similarities do exist. Through a comparison of these, we hope not only to make transsexual behaviors more comprehensible but also to underscore the importance of the adolescent years for the development of adult gender identity. Using primarily an ego psychoanalytic approach, the paper attempts to demystify the diagnosis of transsexual by pointing to its dynamic similarities with adolescence. PMID- 6507153 TI - The assessment of renal calcium reabsorption. PMID- 6507155 TI - Effects of pH and sodium on phosphate transport across brush border membrane vesicles of small intestine. PMID- 6507154 TI - Verapamil improves defective intestinal calcium absorption in uremia. PMID- 6507156 TI - Intracellular processes that affect renal phosphate transport. PMID- 6507157 TI - Effect of calcium-sodium exchange and calcium channel inhibition on calcium release from bone in an in-vitro bone perfusion system. PMID- 6507158 TI - Phosphate-restricted diets versus calcitonin in the prevention of osteodystrophy in experimental renal disease. PMID- 6507160 TI - Influence of temperature on phosphate uptake by renal brush border membrane vesicles. PMID- 6507159 TI - Changes following parathyroidectomy in hemodialyzed patients. PMID- 6507161 TI - Parathormone and blood pressure in the spontaneously hypertensive rat. PMID- 6507162 TI - Trifluoperazine attenuation of PTH-induced vasodilation in the spontaneously hypertensive rat. PMID- 6507163 TI - Evidence of bPTH-(1-34) sensitive adenylate cyclase in isolated rabbit renal cortex arterioles. PMID- 6507164 TI - The myopathy of experimental magnesium deficiency. PMID- 6507165 TI - The myopathy of phosphate depletion. PMID- 6507166 TI - Myopathy of uremia. PMID- 6507167 TI - Calcium and phosphate metabolism in sarcoidosis. PMID- 6507168 TI - Biochemical studies of the control of renal tubular phosphate reabsorption. PMID- 6507169 TI - Hyperlipoproteinemia in phosphate depletion. PMID- 6507170 TI - Stimulation of cardiac contractility by catecholamines is diminished in experimental uremia. PMID- 6507171 TI - Changes in tissue calcium content during gentamicin acute renal failure. PMID- 6507172 TI - Phosphorus metabolites by NMR. PMID- 6507173 TI - Applications of nuclear magnetic resonance (NMR) in nephrology. AB - The 31P NMR techniques can be applied in different areas of nephrology. Particularly advantageous is the ability to detect metabolic events occurring in vivo by safe and noninvasive techniques. It will be interesting to see how clinically relevant these new applications will be. PMID- 6507176 TI - The usefulness of isolated renal cortical cells to study phosphate transport. PMID- 6507174 TI - Gluconeogenesis, cytosolic redox potential, and phosphate and fluid transport in the isolated rabbit proximal tubule. PMID- 6507175 TI - Comparison of the effect of nucleotides on phosphate transport in renal brush border membrane vesicles and intact proximal tubules. PMID- 6507177 TI - Calcium (Ca) mediated phosphate (PO4) transport in the proximal convoluted tubule (PCT) of the rabbit. PMID- 6507178 TI - Glucocorticoid-induced inhibition of the reabsorption of inorganic phosphate in the proximal tubule in the absence of parathyroid hormone. PMID- 6507179 TI - New approaches to the developmental dyslexias. AB - Although Hinshelwood (10-15), at the turn of the century, was interested in both analysis of individual cases and comparisons between acquired and developmental dyslexia, the most widespread approach to the developmental dyslexias has been the investigation of large groups of dyslexics in comparison to normal readers on a variety of tests. These studies ignore the heterogeneity of the disorder. In contrast, progress has been made in the investigation of acquired disorders of reading by conducting individual psycholinguistic analyses of reading difficulties and utilizing input from cognitive psychology to construct explanatory models and theories. Two of the disorders described and elucidated by this approach are acquired surface dyslexia, in which there is an impairment in whole word recognition and overreliance on sounding out words to obtain their pronunciation and meaning, and acquired phonological dyslexia, in which whole word recognition is good but sounding out of words and nonwords is poor. This approach has recently been used with cases of developmental dyslexia. This chapter compares and contrasts the pattern of performance of different dyslexic children when investigated in this way. Two of the children described are developmental phonological dyslexics; one is a developmental surface dyslexic. The developmental phonological dyslexics are poorer at reading words than non words; the developmental surface dyslexic performs equally well on both. The developmental surface dyslexic is significantly influenced by spelling-to-sound regularity; the developmental phonological dyslexics are unaffected by this linguistic dimension. The developmental surface dyslexic makes more neologistic responses than the developmental phonological dyslexics, and also makes more valid errors. The developmental phonological dyslexics make derivational, pseudoderivational, and visuosemantic errors. Both groups make visual errors. The developmental phonological dyslexics are significantly impaired when stimuli are presented in a way that prohibits global analysis; the developmental surface dyslexic is unaffected by this manipulation. The developmental surface dyslexic makes homophone confusions, but these are not made by the developmental phonological dyslexics. (ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6507181 TI - A psychomotor approach to improving speech by modulating suprasegmental control in motor dysphasia and articulatory apraxia. PMID- 6507180 TI - A physiologic theory of visual dyslexia. PMID- 6507182 TI - Dual addiction. Pharmacological issues in the treatment of concomitant alcoholism and drug abuse. PMID- 6507183 TI - Alcoholism and polydrug use: the need for the "basics". PMID- 6507184 TI - Selective attenuation of ethanol-induced performance impairment by naloxone in humans. AB - Healthy human subjects performed a vigilance task involving decision making and motor responses under four drug conditions involving random assignment and double blind procedures. Naloxone (0.4 mg) or saline was injected intravenously before subjects consumed a drink of alcohol (0.56 gm ethanol per kg body weight) or a simulated alcoholic drink. Blood alcohol concentrations averaged 60 mg/dl. The impaired performance of the task by this blood alcohol concentration was ameliorated by prior administration of naloxone at one testing point in the study sequence (40 minutes after ingesting the alcohol). The effect was associated with a history of light drinking (mean intake 0.93 gm/kg of body weight/month). Further studies to characterize this phenomenon more fully are proposed. PMID- 6507185 TI - Subjective responses to the sweat-patch test for alcohol consumption. AB - The sweat-patch test is a new diagnostic test to measure the amount of alcohol a person is drinking. This study monitored the subjective responses of 41 volunteers before undergoing the test, and at the conclusion of the test one week later. There were no significant differences between the pre-test responses of returnees and drop-outs. The post-test rating of the comfort of the test showed a significant increase (p less than 0.05) over the pre-test rating; no significant changes occurred in the other ratings. The subjects generally rated the test highly for its potential benefits, and liking the test even though they knew it would objectively reveal their drinking habits. There was a tendency to believe that the test might induce them to drink less alcohol than usual. Subjects were generally neutral about their desire for other people to see the sweat-collecting patches, and learn that they were taking the test. PMID- 6507186 TI - Clinical issues concerning alcoholic youthful narcotic abusers. AB - The combined addictive diseases of alcoholism and narcotics addiction are as common in the adolescent as in the adult population and have profound effects on health and outcome. Therefore proper clinical management of these patients requires the best available treatment of both the narcotic addiction and the best available treatment of the alcohol abuse problem. Alcoholism per se does not have negative effect on MMTP retention. Although methadone maintenance has been shown to be effective in the treatment of narcotics addiction in adolescents as well as in adults, methods and resources for the management of alcohol abuse within the modality are meager, parochial, and poorly defined. Future efforts must be directed towards developing more effective models for the treatment of the combined addictions. PMID- 6507187 TI - The role of selenium in Keshan disease. PMID- 6507188 TI - [Electromyographical study on human eye movements. Report 1: Simultaneous EMG recordings from 4 recti muscles in normal and peripheral oculomotor disturbances]. PMID- 6507189 TI - [Studies of the kinetic vitreous fluorophotometry. (2) Adult-onset diabetes mellitus]. PMID- 6507190 TI - [Fluorescein ERG and vitreous fluorophotometry]. PMID- 6507191 TI - [A clinicopathologic study on orbital and ocular adnexal lymphoid neoplasms]. PMID- 6507192 TI - [Long-term prognosis after cataract surgery. 3. Binocular function]. PMID- 6507193 TI - [Biosynthesis of glycosaminoglycans by chick retinal pigment epithelium in vitro. III. Difference between apical and basal side]. PMID- 6507194 TI - [Familial exudative vitreoretinopathy, rhegmatogenous retinal detachment and postoperative uveitis with massive subretinal exudation]. PMID- 6507195 TI - [Histochemical study on acid phosphatase activity in the normal corneal endothelium and after polystyrene latex particles injection into the anterior chamber in the rabbit]. PMID- 6507196 TI - Cerebral infantile hypotonia. A developmental study. PMID- 6507197 TI - Porphyrins and porphyrinogens--clinical importance and polarographic behaviour. PMID- 6507198 TI - A survey of cretinism in Bohemia and Moravia. I. A study of questionnaire survey. PMID- 6507199 TI - Sensory evoked potentials of the radial and sural nerves in healthy adult subjects: age- and sex-dependent normal values. PMID- 6507200 TI - Angiography in chest diseases. I. Method of angiographic studies. PMID- 6507201 TI - Angiography in chest diseases. II. Lung tumours. PMID- 6507202 TI - Angiography in chest diseases. III. Chronic bronchial diseases, inflammatory, granulomatous, and fibrosing lung diseases. PMID- 6507203 TI - Angiography in chest diseases. IV. Congenital and acquired diseases of pulmonary vessels, lung cysts, aspergilloma, and haemoptysis. PMID- 6507204 TI - [Architectural ultrastructure of the human urinary transitional epithelium]. AB - Human urinary bladder mucosa, confirmed to be normal by cystoscopic, histologic and bacteriologic examination, were obtained from four patients at prostatectomy and from two patients at an anti-VUR procedure. The luminal surface and the three dimensional architecture of the bladder mucosa were observed by scanning electron microscopy (SEM) after cryofracture of specimen and by transmission electron microscopy (TEM). The epithelium consists of superficial, intermediate and basal cells, and SEM and TEM showed that it was stratified. Intermediate cells reached the basal lamina by slender cytoplasmic processes but superficial cells were not directly in contact with the basal lamina. No pleomorphic or long microvilli were observed but short microvilli or granular protrusions were sparsely seen on the luminal surface of superficial cells. SEM of cryofractured surfaces revealed that cells from each cell layer were in contact with cellular junctions such as ridges, plicated projections and septum-like walls. Their junctions were more complicated with increasing depth of the cell layer. No pleomorphic or long microvilli were observed on any cell surface of the intermediate or basal cell layer. Under TEM, however, these junctional structures of ridges, plicated projections and septal walls appeared to be microvilli under TEM. Microvilli-like structures on TEM, therefore, have to be carefully distinguished from real microvilli. Careful observation is required when the presence of cells covered with microvilli is described as a sign of malignancy. PMID- 6507205 TI - [Serum tissue polypeptide antigen (TPA) in patients with urogenital cancer]. AB - We measured the serum TPA level in 260 patients with benign urogenital diseases, 189 patients with urogenital cancer and 72 healthy blood donors by using a radio immunoassay kit in order to evaluate its usefulness as an indicator for the presence of cancer. TPA value (mean +/- 2SD) in healthy blood donors was in the range of 36.8-110.8 units per liter, so that values higher than 110 U/L were considered to be abnormal. Significantly higher serum TPA levels were observed in patients with non-treated cancers, compared to healthy blood donors. But elevated serum TPA levels were also observed in the patients with benign diseases, especially in cases of benign prostatic hyperplasia with urinary tract infection. Consequently, it is considered that the serum TPA test is very useful for detecting urogenital diseases, but not for screening urogenital cancer. In cases of urogenital cancer, serum TPA levels elevated significantly by recurrence or recrudescence of the disease. Therefore, a good correlation was established between serum TPA and the efficiency of a given therapy in patients with prostatic cancer and bladder cancer. PMID- 6507206 TI - [Experience using the laser rod in urological surgery]. AB - The clinical use of a new surgical tool the "Laser Rod" is presented. This rod is made of ceramics and utilizes a neodymium-doped yttrium aluminum garnet (Nd-YAG) laser. With the Laser Rod, the surgeon can cut tissue by mechanical contact and still feel the resistance from the target tissue. In this study, this device has been used in various urological surgical procedures, such as nephrolithotomy, retropubic prostatectomy, ileocecal conduit diversion, urethroplasty and circumcision of the penis. Our results showed that laser surgery using this device, enables bloodless incision with minimal damage to adjacent tissue. In conclusion, the Laser Rod will probably be very useful in urological surgery, and its indications should be expanded through further study. PMID- 6507207 TI - [Pelvic recurrence of bladder carcinoma following total cystectomy]. AB - The patients who undergo total cystectomy for high stage bladder carcinoma have poor prognosis because of local extension or distant metastases. In the case of recurrent lesions after total cystectomy, radiotherapy and chemotherapy are generally selected. In some cases of recurrent tumors localized within the pelvic cavity and with no distant metastases, however, surgical resection of the tumor is effective in local disease control combined with radio- and chemotherapy. Surgical treatment is not only effective in reducing the cell number in a bulky tumor, but also improves clinical symptoms and conditions such as pain, bleeding, rectal irritability, intestinal obstruction and so on. We present here three patients who underwent extensive operation for pelvic recurrence of bladder carcinoma following total cystectomy. Two of these cases died of progressive disease, nine months and five months after the extensive operations. The third patient died of acute pericarditis thirteen months after the second operation. Autopsy revealed that the surgical treatment was effective in controlling the local recurrence in the third case. Furthermore, some problems regarding pelvic recurrence and surgical treatment are discussed. PMID- 6507209 TI - [Hemangiopericytoma of the prostate: a case report]. AB - A case of hemangiopericytoma arising in the prostate is presented. The patient, a 67-year-old male, was admitted to the hospital for difficulty in urination and underwent transurethral resection of the prostate. The pathological diagnosis was "well-differentiated adenocarcinoma and focal hemangiopericytoma". To the best of our knowledge, the only four cases of hemangiopericytoma of the prostate have been reported in the English literature so far and none in the Japanese literature. PMID- 6507208 TI - [A case of myocardial infarction related to total cystectomy and ileal conduit diversion under general anaesthesia]. AB - Prognosis is extremely poor when an aged patient is attacked by myocardial infarction during or after a major operation. This paper reports that a 63-year old male patient who had not been specifically diagnosed to have any coronary artery disease before operation recovered from a myocardial infarction which occurred during total cystectomy and ileal conduit diversion under general anesthesia. The continuous electrocardiogram monitoring carried out during general anesthesia enabled us to discover and treat the disease early and save the patient's life. References to the myocardial infarction and the general anesthesia are also discussed. PMID- 6507210 TI - [Perineal testis: report of two cases]. AB - Perineal testis is a very rare congenital anomaly. Since the first case of the disease reported by John Hunter in 1786, more than 113 cases have been reported in the English literature, and 13 cases have been reported in the Japanese literature. The 14th and 15th cases are presented herein. Case 1 was a 38-year old man who came to our clinic with the chief complaint of discomfort of the perineum. Physical examination revealed emptiness of the left scrotal contents and there was a small hen's-egg growth mass corresponding to the normal testis at the left side of the perineum. Excretory urogram showed no abnormality. Orchiopexy to the left scrotum was performed. On surgical exploration the gubernaculum testis was found obviously fixed to the perineum. Histologic examination of the biopsied ectopic testis revealed mild hypospermatogenesis. Case 2 was a 2-year-old boy who was referred to our clinic with the chief complaint of emptiness of the right scrotal contents. Physical examination revealed a bean-sized mass corresponding to the normal testis at the right side of the perineum. Orchiopexy to the right scrotum was performed. On surgical exploration the gubernaculum testis was found to be fixed to the perineum. PMID- 6507211 TI - [A case of bilateral testicular infarction without spermatic torsion]. AB - A case of bilateral testicular infarction without spermatic torsion in a 39-year old man is presented. Eighty cases of testicular infarct or necrosis, including this case, have been reviewed in the Japanese literature and the pathogenesis, clinical features, diagnosis and treatment of this disease are discussed. PMID- 6507212 TI - [Antibiotic concentration in kidney cell fractions]. AB - A two-compartment model of kidney cells is designed. The first compartment is the cytoplasm, the other is a large organelle fraction consisting of lysosomes and mitochondria. Drugs easily accumulated in the second compartment are considered to be harmful to the kidney. Although small molecular antibiotics move across membranes, they reach a certain equilibrium within 30 minutes. Therefore reproducible values of antibiotic concentrations in both fractions can be obtained. The two-compartment model provides a new approach to pharmacokinetic study at a subcellular level. PMID- 6507213 TI - [Primary hyperparathyroidism: clinical diagnosis]. AB - During the period from June, 1959 to September 1983, 177 patients with primary hyperparathyroidism (PHPT) were treated in our Department. On the basis of this experience, a retrospective study has been made on the clinical diagnosis of PHPT. Repeated measurement of serum calcium, serum ionized calcium, serum phosphorus and %TRP was most useful for detecting patients with PHPT, in addition to careful observation of the many symptoms and disorders caused by PHPT. On the contrary, it is also stressed that PHPT can not be excluded even when a single measurement of any of the above stated items reveals a normal value. PMID- 6507214 TI - [An operative technique for parathyroid surgery]. AB - A technique of parathyroidectomy based on our experience of fifteen cases with primary hyperparathyroidism was described. The success of the surgery would require an ability of the surgeon to be delicate in technic, but recently this operation itself has become less invasive and complicated. It is emphasized that the urologists should chose parathyroidectomy with priority because treatment of primary hyperparathyroidism is quite important for some patients with urinary calculous diseases. PMID- 6507215 TI - [Primary hyperparathyroidism in cases of urinary stone]. AB - During the 5-year period from October, 1978 to September, 1983, primary hyperparathyroidism has been found at our clinic in 16 out of 395 cases of urinary stones (4.1%) and in 12.6% of the recurrent or multiple stone-forming patients. Plasma-ionized calcium level and rapid rapid calcium load test were most valuable in the diagnosis of primary hyperparathyroidism. It has been proved that neck surgery for primary hyperparathyroidism prevents recurrence of urinary tract stones. PMID- 6507216 TI - [Total parathyroidectomy with autotransplantation in secondary hyperparathyroidism]. AB - Five patients with chronic renal failure were undergone total parathyroidectomy and immediate autotransplantation into the muscle of the forearm. All patients had relief of symptoms and restoration of PTH levels to normal. This technique of parathyroid transplantation offers the surgeon versatility in managing patients with hyperparathyroidism. PMID- 6507217 TI - Epidemiological investigations of trichostrongylid infections in young cattle in different parts of Norway. PMID- 6507219 TI - Quantitation of serum phospholipase A2 by enzyme-diffusion in lecithin agar gels. A comparative study in man and animals. PMID- 6507218 TI - Calcium effects on renal conservation of magnesium in cows. PMID- 6507220 TI - Prevalence of enterotoxigenic staphylococci in nose, throat and skin lesions in meat-workers. PMID- 6507221 TI - Clinical and endocrinological studies in primiparous post partum sows. Effects of lactation length and litter size. PMID- 6507222 TI - Levels of complement factors and immunoglobulins in asthmatic children undergoing hyposensitization. AB - We have studied the levels of IgG, IgE, IgM, IgA, total complementary activity, C3, Factor B, C4 components and rheumatoid factor in healthy and asthmatic children before, during and after seven months of hyposensitization treatment to house dust. The IgE, IgM, IgG, C3, Bf and C4 were found to be increased in the asthmatic group before the treatment, with regard to the healthy children. The results obtained from the asthmatic children before treatment and the same subjects after seven months of hyposensitization, suggest that immunotherapy produces a significant increase of IgA, total complementary activity, and also a significant reduction of IgM, IgG and C4. No positive rheumatoid factor was found in the serum of patients undergoing hyposensitization. PMID- 6507223 TI - [Role of prostaglandins in the pathogenesis of bronchial asthma in children and possibilities in therapeutic treatment]. AB - During the past few years, in relation to study of prostaglandins, biochemical active lipids recently identified, a large quantity of physiological and pathological processes involving these compounds have been described. Convincing data confirm the regulation of the tone of smooth trachea and bronchial muscles by these substances. In this sense and within the pathological states of the respiratory system, bronchial asthma is of special interest. Recently, a detailed description of the pathogenesis of bronchial asthma, and particularly of this atypical form, has been investigated. Classic mediators of anaphylaxis, such as histamin, SRS-A, serotonin, acetylcholin, etc., have important roles in the pathogeny. Fewer works, however, have been dedicated to the study of prostaglandins and the results obtained are often contradictory. In this study, the importance of prostaglandins E, F-2 alpha, A and B are investigated in 84 patients with a diagnosis of bronchial asthma. Their ages varies between 2 and 11 years. 51 suffered from the atypical form, 11 from infectious form and 22 the mixed form. To diagnose each case, detailed anamnesis and clinical tests were carried out as well as cutaneous tests with non bacterial and fungous allergens. The RAST technique and total levels of IgE were also used. The control group of 45 children were studied in the same way. With regard to the results obtained, during the intercrisis period a rise in PGF2-alpha and a decrease in PGE could be observed. During the crisis period, an even greater rise in the concentration of PGF2-alpha and a lesser of increase of PGE were observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507224 TI - Oral specific hyposensitization in the management of patients allergic to food. AB - Results are presented of a protocol of hyposensitizing treatment per os in 19 cases of food allergy (allergy to milk in 8, to egg in 8, to fish in 2, and to orange in one). Treatment, performed in the out-patients service, was successful in 14 out of the 15 patients who followed it correctly (i.e. 93.3% of cases). Treatment lasted between 3 and 12 months. PMID- 6507225 TI - [Value of eosinophilia in blood and nasal exudate in the diagnosis of different types of rhinitis]. AB - 162 patients with different patterns of rhinitis were studied. In 94 a diagnosis of allergic rhinitis was made. The remaining 68 were considered as nonallergic rhinitis. In the allergic group, 64 had seasonal allergic rhinitis. 24 of them were studied during the hay fever season and 40 out of the hay fever season. Positive nasal smear eosinophilia (up to 10%) was found in 56 of 96 patients from the allergic group (59.5%), 21 of them had perenneal allergic rhinitis and 35 had seasonal allergic, of those 20 were studied during the hay fever season. In the non allergic group, 35 were diagnosed as intrinsic rhinitis and 33 as cholinergic rhinitis. Positive nasal smear eosinophilia could be demonstrated in 15 out of 35 cases of intrinsic rhinitis (42.8%), but could not be shown in patients suffering from cholinergic rhinitis. Peripheral blood eosinophilic cells were found in normal values in all patients in spite of the character of the rhinitis. These results suggest that nasal smear eosinophilic cells count is a useful orientative datum in the diagnosis of allergic and intrinsic rhinitis (59.5% and 42.8% respectively in our cases) but is not useful in the diagnosis of cholinergic rhinitis (not one out of 33 cases). Blood eosinophil cells count had no value in nasal allergy diagnosis. PMID- 6507226 TI - [Allergic contact dermatitis caused by plants]. AB - The proliferation of house and garden plants, some of them highly sensitizing, produced by the general improvement of the standard of living, is causing an increase in the number of cases of contact dermatitis from plants with both irritative and allergic mechanisms. During the past 12 years, we have studied 43 cases of allergic eczema caused by plant contact as primary sensitization which supposes 2.4% of the patients with allergic contact dermatitis attended in our Services. The majority of patients were women (65%) as opposed to 35% men while the ages varied from 12 to 70 years with an average of 44.5. Below the age of 25 there were only 3 cases (6.9%) 12, 18 and 20 years respectively. In the clinical study, as well as the profession, secondary activities and hobbies were also evaluated. Through localization of lesions, an attempt was made to determine how the patient came in to contact with the different plants. The diagnosis was confirmed by the use of epicutaneous tests, as recommended by the ICDRG (3). Some plants in a natural state were used but etheral extracts were preferred. In cases of photo-dermatitis, photo-patch-tests were carried out using standard photo sensitizers and suspected plants. The plants found to be responsible were: Allium (garlic) in 11 cases, Frullania in 8, Primula (primrose) in 8. Compositae (composites) in 6, Pinus (pine) in 3, Umbelliferae (umbellifers) in 3, Philodendron (philodendron) in 1, Pelagonium (pelargonium) in 1, Citrus (citrus) in 1 and Chlorophora (iroko) in 1. The frequency of reactions to garlic and primrose is particularly interesting and their characteristics will be the object of a later study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507227 TI - Ebstein-Barr virus infection--an evolving disease. PMID- 6507228 TI - Smoking cessation--the physician's role. Behavioral aspects. PMID- 6507229 TI - Stone man: fibrodysplasia ossificans progressiva. PMID- 6507230 TI - Frostbite. AB - Frostbite can cause loss of life and limbs. Proper treatment and follow-up care are essential in reducing morbidity and mortality. Management of the frostbite patient consists of three stages. Initial care includes protection of the extremity from trauma or partial thawing. The second stage consists of rapid rewarming in a whirlpool bath containing hot water, with continued protection of the tissues. The third stage is long-term care of the affected body parts. PMID- 6507231 TI - Ruptured chordae tendineae. PMID- 6507233 TI - Mood disorders. PMID- 6507232 TI - Neonatal craniotabes. AB - Craniotabes is a frequent, benign physical finding in newborn infants. Resolution occurs spontaneously by two to three months of age. If the history and physical examination are otherwise normal, no further investigation is necessary or desirable. Craniotabes may be related to pressure due to early engagement of the fetal head or to subtle abnormalities of maternal calcium and vitamin D metabolism. PMID- 6507234 TI - The occurrence of angiographically detected intracoronary thrombus in patients with unstable angina pectoris. AB - To examine the role of intracoronary thrombus (ICT) in unstable angina, we reviewed the coronary arteriograms of 83 patients with unstable angina (group I) and 37 patients with stable angina (group II) for angiographic evidence of ICT. Group I and group II patients were similar with respect to mean age, presence of single and multiple vessel disease, and past history of myocardial infarction. Group I patients had no ECG or creatine kinase enzyme evidence of acute myocardial infarction. The angiographic criteria for ICT included an intracoronary filling defect, intraluminal staining, and total coronary artery occlusion with convex dye outline. ICT was found in 10 of 83 patients in group I (12.0%) vs 0 of 37 patients in group II (p less than 0.05). These findings suggest that in some patients coronary artery thrombosis plays an important role in the pathogenesis of unstable angina. PMID- 6507235 TI - High mortality early reinfarction with first nontransmural myocardial infarction. AB - Thirty-eight patients with first nontransmural myocardial infarction were studied to determine prognosis and clinical markers of a high-risk subgroup. We found a high incidence of reinfarction (18%) at a median time of 16 days post nontransmural infarction (seven patients). Reinfarction was uniformly associated with death within 24 hours. A total of 14 patients (37%) either died (eight patients) or required urgent revascularization (six patients). Predominant ST segment depression with presenting nontransmural infarction and a history of prior angina were associated with increased mortality (p less than 0.05 and p = 0.05, respectively). We conclude that patients with nontransmural infarction are at high risk for early recurrent infarction. Patients with history of prior angina and predominant ST segment depression may be at particularly high risk. Reinfarction in these patients is frequently extensive. We recommend that these patients be considered for early coronary angiography. PMID- 6507236 TI - Evaluation of biventricular involvement in hypotensive patients with transmural inferior infarction by two-dimensional echocardiography. AB - Hypotension in inferior myocardial infarction (IMI) may be due to extensive involvement of the right ventricle (RV), left ventricle (LV), or both. We verified this hypothesis in 24 patients with IMI and hypotension (systolic blood pressure less than 100 mm Hg), within 48 hours of admission, by means of two dimensional echocardiography (2DE). We measured the extent of regional RV and LV asynergy (akinesis and/or dyskinesis) in parasternal short-axis sections at mitral, chordal, midpapillary muscle, and low papillary muscle levels. Initial right heart catheterization revealed predominant RV dysfunction in 16 patients (group 1) and predominant LV dysfunction in eight patients (group 2). For all patients, the initial 2DE revealed: (1) biventricular asynergy involving the posterior RV, posterior LV, and posterior interventricular septum; (2) a wide range of values for the extent of asynergy (RV 21% to 90%; LV 19% to 48%); and (3) a direct correlation between peak creatine kinase levels and percentage of LV asynergy (r = 0.80, p less than 0.001) or percentage of RV plus LV asynergy (r = 0.72, p less than 0.001). Although the extent of LV asynergy was similar in the two groups (34% vs 34%, NS), the extent of RV asynergy was greater in group 1 than in group 2 (57% vs 30%, p less than 0.001). More important, the ratio of RV/LV asynergy was greater for group 1 than group 2 (1.75 vs 0.89, p less than 0.001), and this difference in ratios between the two groups was also found in 2DE studies at 10 days and 6 months. A RV/LV asynergy ratio value of 1.1 provided clear separation between the groups. Thus, the RV/LV asynergy ratio on an initial 2DE can clarify the clinical syndrome of hypotension in patients with IMI. An increased asynergy ratio might identify those patients with predominant RV involvement. PMID- 6507237 TI - Comparison of a QRS scoring system for estimating acute infarct size with radionuclide left ventriculography. AB - A QRS scoring system was compared with left ventricular ejection fraction (LVEF) in 40 patients enrolled in the Multicenter Post Infarction Program. A poor correlation was found between these two parameters. Possible reasons for these findings include the fact that the radionuclide studies were performed at several institutions or that there was a mean interval of 6 days between the time of the ECG and the radionuclide studies. It was determined that the ECGs could be scored by inexperienced scorers. The utility and limitation of the QRS scoring system for prediction of LVEF need further evaluation, particularly if it is to be applied to a multicenter study. PMID- 6507238 TI - Usefulness of the chest x-ray for predicting abnormal left ventricular function after acute myocardial infarction. AB - We evaluated 229 patients discharged after a definite acute myocardial infarction. Pulmonary venous congestion determined from chest x-ray films during the hospitalization and at discharge and the cardiothoracic ratio at discharge were compared to the left ventricular ejection fraction measured at discharge by a gated radionuclide technique. During hospitalization, pulmonary venous congestion was found on at least one x-ray frame in 94 patients (41%). At discharge 134 patients (59%) had abnormal ejection fraction (less than 0.51) and 35 had pulmonary venous congestion (15%). The sensitivity of the x-ray for detecting an abnormal ejection fraction was 20% when pulmonary venous congestion was observed on the discharge x-ray film (specificity 92% and predictive value 77%), 52% if pulmonary venous congestion was present on any x-ray film during the hospitalization (specificity 74% and predictive value 73%), and 47% if the cardiothoracic ratio was abnormal (greater than or equal to 0.50) on the discharge x-ray film (specificity and predictive value 66%). We conclude that an abnormal x-ray film at discharge or during the hospitalization will identify approximately one-half of the abnormal ejection fractions at the time of hospital discharge. Therefore, to reliably assess left ventricular function, either for prognostic or therapeutic purposes in the individual patient, a more direct measure of left ventricular function such as radionuclide angiography must be obtained. PMID- 6507239 TI - Intravenous quinidine by intermittent bolus for electrophysiologic studies in patients with ventricular tachycardia. AB - The safety and efficacy of intravenous quinidine gluconate, using intermittent boluses of 80 mg/cc every 5 minutes to a total dose of 800 mg, was evaluated in 61 patients referred for electrophysiologic studies (EPS). Patients were referred because of out-of-hospital cardiac arrest (12), symptomatic ventricular tachycardia (VT) (24), asymptomatic VT (18), syncope of unknown origin (6), and supraventricular arrhythmias (1). Clinical heart failure was present in 74% of patients, with a mean ejection fraction of 45 +/- 3 for all patients. Quinidine prevented VT induction in 78% of patients at a mean dose of 9.6 mg/kg and facilitated VT induction in 7% of patients. Quinidine failed to decrease mean arterial pressure in 14 patients, and in the remaining 47 patients arterial pressure decreased by 16%. Six patients had hemodynamically significant hypotension. Two patients had hypotension severe enough to require saline administration, while four had hypotension not needing fluid replacement. Sixteen percent of patients experienced other side effects. Quinidine can be administered safely by intermittent infusion and is effective in preventing programmed stimulation induction of VT. Carefully monitored, intravenous intermittent bolus administration of quinidine should be utilized more frequently in EPS, since significant adverse side effects are infrequent. PMID- 6507240 TI - Hyponatremia in patients treated with lorcainide, a new antiarrhythmic drug. AB - The effects of lorcainide, a new antiarrhythmic drug, on serum electrolytes and osmolality are described in a series of 33 patients with organic heart disease and complex ventricular arrhythmias treated with lorcainide. In eight patients, a mean decrease in serum Na+ of 8.25 +/- 3.2 mEq/L was observed after a single 200 mg intravenous dose of lorcainide. Sixteen of 33 patients developed significant hyponatremia and hypoosmolality during oral treatment with lorcainide. In all except two patients, serum Na+ returned to normal values within 3 to 12 months of continued lorcainide therapy. Low serum Na+ and hypoosmolality in the absence of volume depletion, clinically manifest edema, and unaltered renal, adrenal, cardiac, or thyroid function suggest that this antiarrhythmic drug produced the syndrome of inappropriate antidiuretic hormone secretion (SIADH). SIADH appeared to be transient and asymptomatic in our patients. One patient developed severe hyponatremia with serum Na+ of 108 mEq/L when hydrochlorothiazide was given to control hypertension. It is concluded that SIADH is an important side effect of lorcainide therapy. We recommend that serum Na+ be carefully monitored in patients started on lorcainide therapy, and extreme caution should be exercised in prescribing diuretics to patients with persistent hyponatremia. PMID- 6507241 TI - Predicting oxygen uptake from treadmill testing in normal subjects and coronary artery disease patients. AB - In order to evaluate the clinical practice of estimating oxygen uptake from treadmill time, patients with coronary heart disease and normal subjects had their oxygen uptake measured during treadmill testing. Continuous expired gas analysis was performed in order to see if the gas exchange anaerobic threshold could explain the difference between measured and estimated oxygen uptake. Below the gas exchange anaerobic threshold, normal subjects and patients had similar oxygen uptakes for a given workload. However, at workloads above this threshold, patients had approximately 1 MET lower oxygen uptake than normal subjects. Regression equations relating treadmill time to oxygen uptake are specific to groups of patients or individuals due to differences in anaerobic threshold. In addition, the use of standard workloads to predict aerobic capacity depends on the rate at which oxygen uptake obtains a steady state value. These findings must be considered in clinical practice when attempting to estimate aerobic capacity from treadmill testing. PMID- 6507242 TI - Nifedipine in congestive heart failure: effects on resting and exercise hemodynamics and regional blood flow. AB - Ten patients with moderate to severe congestive heart failure (CHF) underwent central and regional hemodynamic measurements at rest and central hemodynamic measurements during exercise before and after the oral administration of nifedipine (0.2 mg/kg). Nifedipine significantly decreased systemic blood pressure, systemic vascular resistance, pulmonary artery pressure, pulmonary vascular resistance, and pulmonary capillary wedge pressure. Stroke volume and cardiac output increased after nifedipine. The measured parameters of left ventricular inotropy did not change significantly for this calcium channel blocker. While blood flow to renal, hepatic, and limb vascular beds increased (p less than 0.05 for renal and limb) after nifedipine, only limb blood flow increased in proportion to the increase in cardiac output, suggesting preferential dilatation of limb vasculature. Although initial-dose nifedipine did not increase exercise duration, it elicited an improvement in exercise hemodynamics by reducing systemic vascular resistance and pulmonary capillary wedge pressure and increasing stroke volume and cardiac output. The calcium channel blocker, nifedipine, can be administered safely in the setting of ventricular failure and appears to favorably alter resting and exercise hemodynamics. A select number of patients with CHF may benefit from its long-term administration. PMID- 6507243 TI - Left ventricular function at rest and during Raynaud's phenomenon in patients with scleroderma. AB - We evaluated left ventricular function in 10 scleroderma patients with signs and symptoms suggestive of congestive heart failure. M-mode and two-dimensional echocardiography demonstrated normal to increased systolic function in all patients. The presence of pulmonary venous congestion on the chest radiograph was not useful in assessing left ventricular systolic function. Five of nine patients with normal to increased left ventricular ejection fraction (LVEF) had increased cardiothoracic ratios and increased pulmonary vascular markings. Left ventricular hypertrophy was associated with a worse New York Heart Association functional class, more pulmonary vascular congestion, and greater left atrial size. In the presence of normal systolic function and ventricular hypertrophy, diminished left ventricular diastolic compliance may account for the cardiac dysfunction in these patients. Cold pressor testing induced peripheral Raynaud's phenomenon in nine of nine patients; however, no ST segment changes or chest pain was provoked. In seven of nine patients there was no abnormal fall in LVEF. The mechanism for the fall in ejection fraction seen in two patients may be related to an increase in afterload or myocardial ischemia secondary to coronary atherosclerosis. We found little to suggest that a myocardial Raynaud's phenomenon affects left ventricular perfusion or systolic function. Clinical signs and symptoms of congestive failure as well as chest radiographs are poor indicators of impaired systolic function in scleroderma patients. Based on these findings, it appears that evaluation of left ventricular systolic function should include echocardiographic or angiographic study before such patients are treated for heart failure with inotropic agents. PMID- 6507244 TI - Differential diagnosis of various causes of systolic-diastolic murmurs using pulsed Doppler echocardiography. PMID- 6507245 TI - Imaging of acute myocardial infarction in man with contrast-enhanced computed transmission tomography. PMID- 6507246 TI - Myocardial bridge associated with pacing-induced coronary spasm. PMID- 6507247 TI - Heparin-related thrombosis after myocardial infarction. PMID- 6507248 TI - Tricuspid valve obstruction due to intravenous leiomyomatosis. PMID- 6507249 TI - Two-dimensional echocardiography for detection of primary right atrial thrombus in pulmonary embolism. PMID- 6507250 TI - Echocardiographic diagnosis of mobile right atrial thrombus: early recognition and treatment. PMID- 6507251 TI - Left ventricular dyskinesia following closed mitral commissurotomy. PMID- 6507252 TI - Two-dimensional echocardiographic demonstration of flail pulmonic valve due to infective endocarditis. PMID- 6507253 TI - Two-dimensional echocardiographic documentation of accessory chordae tendineae accompanying isolated anterior mitral cleft. PMID- 6507254 TI - Myocarditis presenting with "silent" atrium and left atrial thrombus. PMID- 6507255 TI - Unroofed coronary sinus demonstrated by two-dimensional echocardiography. PMID- 6507256 TI - Ventricular fibrillation during ambulatory electrocardiography. PMID- 6507257 TI - Systemic pulmonary arterial fistula diagnosed with aid of radionuclide angiography. PMID- 6507258 TI - Abnormal systolic sound associated with mobile prosthetic mitral valve vegetation. PMID- 6507259 TI - Pulmonary and subclavian steal phenomenon following modified Blalock-Taussig shunt. PMID- 6507260 TI - Nifedipine-induced alterations in serum quinidine concentrations. PMID- 6507261 TI - Echocardiographic findings in prosthetic mitral valve dysfunction. PMID- 6507262 TI - Subcostal echocardiography in ventricular tachycardia. PMID- 6507263 TI - Thrombectomy for obstructed Bjork-Shiley mitral valve prosthesis. PMID- 6507264 TI - Progression of coronary artery disease. PMID- 6507265 TI - Electrophysiologic effects of propafenone. PMID- 6507266 TI - Marked increase of plasma 3,4-dihydroxyphenylacetic acid in congestive heart failure. PMID- 6507267 TI - Ten-year survival after subacute heart rupture post AMI. PMID- 6507268 TI - Mechanism of cardiokymography. PMID- 6507269 TI - The diagonal rule: a useful mnemonic in ECG interpretation. PMID- 6507270 TI - Arrhythmogenesis during sleep-induced apnea. PMID- 6507271 TI - Rebound recovery of myocardial creatine phosphate with reperfusion after ischemia. PMID- 6507272 TI - Fighting colds & coughs 1984. PMID- 6507274 TI - Nonprescription analgesics. PMID- 6507273 TI - Competition: hallmark of health care in the decades ahead. PMID- 6507275 TI - "Megatrends" and the occupational safety & health professional. PMID- 6507276 TI - Effects of electrostatic charge on aerosol collection with polystyrene filter cassettes. AB - Electrostatic fields are present on polystyrene cassette filter holders commonly used to measure the concentration of particles in air. Beryllium concentrations were determined at a beryllium refinery using neutral, and positively and negatively charged cassettes. In laboratory experiments, tobacco smoke, magnetite and polyvinyltoluene latex spheres were collected by both charged and neutral cassettes. No differences in concentration measurements were observed in the experiments at the refinery. In the laboratory experiments, the concentration of a charged negative aerosol collected by a highly charged negative cassette was reduced. Thus, when collecting charged aerosols, the polystyrene cassettes should be charge neutralized. PMID- 6507277 TI - Solvent vapor exposures in booth spray painting and spray glueing, and associated operations. AB - Time-weighted average exposures for all solvents present at detectable levels were obtained for eighty-nine solvent-using workers and thirty-six control-group (unexposed) workers in seven plants of three companies applying paints and glues, primarily by spraying. Over twenty solvents were quantified if detected. Concentrations of specific solvents and cumulative fractions of TLVs were measured for various job types. All spray painting and most spray glueing was conducted in operating spray booths. Only low to moderate exposures were observed, with one TWA exceeding the cumulative TLV and three additional TWAs exceeding 50 percent of the cumulative TLV. It may be concluded that solvent TWA exposures in spraying of paints and glues are often well-controlled by common spray booths, and further, that other solvent-use operations including light-duty solvent wiping and manual paint mixing do not frequently produce high exposures (relative to TLV levels) in the presence of ordinary general room ventilation. PMID- 6507279 TI - Psychological stress--the unrecognized health hazard. PMID- 6507278 TI - Application of industrial hygiene air sampling data to the evaluation of controls for air contaminants. AB - Air contaminant concentration measurements are an important part of the evaluation of a local exhaust system's effectiveness. Comparisons of concentration measurements have been used to assess the importance of work practices and emission sources in relation to the worker's exposure. These comparisons can be stated as a null hypothesis. Statistical tests can be used to evaluate the validity of the null hypothesis. Applicable tests include student t test, analysis of variance and Duncan's Multiple Range Test. PMID- 6507280 TI - 1984 Cummings memorial lecture. Recognition, evaluation and control: the acceleration of the process. PMID- 6507281 TI - Comparisons between the median hearing threshold levels for an unscreened black nonindustrial noise exposed population (NINEP) and four presbycusis data bases. AB - The median hearing threshold level (HTL) data representing an unscreened black nonindustrial noise exposed population (NINEP) are compared to the median HTL data of three previously established presbycusis data bases by Hinchcliffe, Corso, and Rosen, and the data base developed by Robinson and Sutton. The data bases are all normalized relative to age 18. Comparisons are made between the black NINEP and the presbycusis data base HTLs for different sex and age groupings. The unscreened black NINEP exhibits median HTLs similar to those of the presbycusis data bases for ages less than approximately 35-45 years. However, for age groupings greater than 35-45 years, the median HTLs of the black NINEP are generally lower (better hearing) than those of the referenced presbycusis data bases even though this data base exhibited significant nonindustrial noise exposures, and medical and pathological problems which were not screened out of the population. PMID- 6507282 TI - The use of GC/MS analysis and fungal culturing in a pulp mill industrial hygiene program. AB - This paper describes the use of unconventional IH monitoring and analytical techniques to understand better an occupational environment with respect to suspected contaminants. The environment described is an underground wood chip conveying tunnel of a pulp mill, where employees would experience occasional dermatitis and/or respiratory distress symptoms. GC/MS and fungal culturing methods were used to identify contaminants. Appropriate control methods were implemented to eliminate the contaminant believed to cause the illness: fungi spores. PMID- 6507284 TI - Effects of exercise using industrial respirators. AB - Respirators (respiratory personal protective devices), used for protection against occupational toxic exposures, may impose flow resistance and dead space respiratory loading. Effects of exercise level, a 300 mL deadspace and single respirator cartridge inspiratory load were determined in ten healthy volunteers. Subjects tended to limit peak work rate (pressure generated and pressure X flow) and to prolong the inspiratory portion of the respiratory cycle due to respirator use. O2 consumption and heart rate were not significantly affected. The qualitative response was not affected by exercise level. During submaximal exercise, normal subjects did not reach their compensation limits for the variables studied. PMID- 6507283 TI - Size classification of fibers and isometric particles keeping each fraction airborne. AB - The hazardous properties of airborne fibers are generally thought to be related to size. The purpose of this study was to develop a technique for physically classifying airborne fibers on the basis of diameter, keeping the separated fractions in the suspended state. This would permit either fraction to be further classified, monitored by real-time instrumentation and/or used in size-related inhalation studies. Other fiber classification methods have involved deposition of fibers onto a substrate, which precludes these advantages. Diameter classification was achieved by the use of an opposing-jet aerosol classifier. With isometric aerosols, sharp diameter classification was achieved: D50/D16 = 1.1 for liquid particles, and D50/D16 = 1.3 for solid particles. Diameter classification of fibers was also achieved, but the sharpness of cut was much less; D50/D16 greater than 3. The decreased sharpness of cut for fibers is attributed to the more or less random bounce of fibers from the edge of the separation plate to either outlet flow of the classifier. The sharpness of cut is expected to be better in a classifier in which the thickness of the separation plate is smaller relative to the flow dimensions. PMID- 6507285 TI - Permeation of chlorinated aromatic compounds through Viton and nitrile glove materials. AB - The ASTM cell was utilized to study permeation of chloro-, o-dichloro-, and m dichloro-benzenes and o- and p-chlorotoluenes through Viton (unsupported) and nitrile (supported and unsupported) glove materials using isopropanol as collecting solvent, and FID/gas chromatography for quantitation. Adequate mixing in the collection chamber was accomplished by externally agitating the ASTM cell at the required speed in a moving-tray water bath at 25 degrees C. The Viton glove did not show permeation even after 4 hours. The nitrile gloves showed breakthrough times of less than 1 hour. The steady state molar flux rates for unsupported or supported nitrile gloves, or for the different challenge solvents were not statistically different. Thus, breakthrough times were better indicators of permeation than steady state molar flux rates. A "mixed" permeation mechanism was proposed, depending on swelling of the glove material. PMID- 6507286 TI - Variant angina: comparison of patients with and without fixed severe coronary artery disease. AB - To determine if the clinical features of variant angina are predictive of the severity of underlying coronary artery disease, 43 patients with variant angina who had less than 50% fixed coronary luminal diameter narrowing (group 1) were compared with 65 patients with variant angina who had 70% or greater diameter narrowing (group 2). Statistically significant differences were found in 3 clinical features between group 1 and group 2: (1) a more than 3-month history of angina at rest before diagnosis (80% vs 23%, p less than 0.001); (2) an abnormal electrocardiogram at rest (19 vs 48%, p less than 0.01); and (3) an abnormal stress test (26% [8 of 30] vs 84% [15 of 18], p less than 0.01). However, these features were not clinically reliable in separating patients with variant angina with and without fixed severe obstructions because of overlap between the 2 groups. No difference was found between the 2 groups in age, sex, predominant symptom at the time of catheterization, history of exertional angina, syncope with angina, prolonged angina, previous myocardial infarction or risk factors for coronary artery disease. There was also no difference in the location of ST elevation or occurrence of major arrhythmias during angina. Thus, among patients with Prinzmetal's variant angina, those with normal or mildly abnormal coronary arteriograms cannot be differentiated reliably by clinical features from those with fixed severe coronary obstructions. Coronary arteriography should be performed to define the underlying coronary anatomy and to determine optimal therapy in patients with variant angina. PMID- 6507287 TI - Clinical and angiographic predictors of new total coronary occlusion in coronary artery disease: analysis of 313 nonoperated patients. AB - A new coronary artery occlusion was found in 98 of 313 consecutive patients (31%) with coronary artery disease treated medically who underwent catheterization twice, 39 +/- 25 months apart. Multivariate logistic regression displayed 8 independent predictors of new occlusion. Four were available at the time of the second angiogram: the interval between the 2 studies (p = 0.005), a decrease in ejection fraction (p less than 0.01), the appearance of bundle branch block (p less than 0.01), and an interim myocardial infarction (p less than 0.05). Four other predictors were found at the time of the first angiogram: 2 angiographic characteristics, 1 related to the severity (presence of an 80% or greater luminal diameter narrowing of an artery supplying a non-akinetic left ventricular segment [p less than 0.005]) and 1 to the extent (count of the lesions narrowed 75% or less in luminal diameter in a 15-segment coding system [p less than 0.05]) of coronary artery disease, and 2 risk factors: smoking status (p less than 0.05) and male sex (p less than 0.05). The 140 male smokers with at least 80% diameter stenosis or at least 4 segments with moderate (75% or less) stenosis were at a higher risk of occlusion than the 173 other patients after intervals of less than 2 years (13 of 53 vs 7 of 74, p less than 0.01), 2 to 4 years (23 of 40 vs 10 of 47, p less than 0.005) and more than 4 years (27 of 47 vs 18 of 54, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507288 TI - Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease: a coronary artery surgery study project. AB - This retrospective study examines the prognostic significance of exercise-induced ventricular arrhythmia in patients with stable coronary artery disease (CAD) who were included in the multicenter patient registry of the Coronary Artery Surgery Study. The population is composed of 1,486 patients selected from 1975 to 1979 and followed an average of 4.3 years. All underwent a standard Bruce exercise test and had CAD by cardiac catheterization at entry. Patients were classified into group I or II depending on whether they had minimal or significant CAD. (Significant CAD was defined as 70% or greater diameter reduction in any major coronary artery or 50% or greater narrowing in the left main artery.) They were further subclassified into groups A or B depending on whether or not they had exercise-induced ventricular arrhythmia. Groups IA (16 patients) and IB (229 patients) had similar clinical and angiographic characteristics except for the average ejection fraction (EF), which was 50% for group IA and 64% for group IB (p less than 0.05). Group IIA (130 patients) had a higher prevalence of previous myocardial infarction, a lower mean EF and a higher proportion of patients with at least 2 coronary arteries significantly narrowed than group IIB (1,111 patients). The 5-year event-free survival was not influenced by the presence of exercise-induced ventricular arrhythmia; it was 76 and 88% in groups IA and IB, respectively (difference not significant), and 71 and 76% in groups IIA and IIB, respectively (difference not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507289 TI - Effects of nicardipine and nisoldipine on myocardial metabolism, coronary blood flow and oxygen supply in angina pectoris. AB - The effects of the calcium antagonists nicardipine and nisoldipine on left ventricular (LV) metabolism were analyzed in 32 patients with angina pectoris. Measurements were made at a fixed heart rate under the basal state and during a cold pressor test (CPT). After administration of the drugs, coronary blood flow increased significantly and the mean aortic pressure decreased by 10% (p less than 0.01) in the basal state and by 11% (p less than 0.01) during CPT. Despite the reduction in pressure-rate product, myocardial oxygen consumption was unchanged in the basal state (18 +/- 4 vs 19 +/- 4 ml/min, difference not significant) and during CPT (21 +/- 5 vs 21 +/- 5 ml/min, difference not significant); this discrepancy between a reduced pressure-rate product and an unchanged oxygen consumption was also noted when nicardipine was given after propranolol (0.1 mg/kg; 12 patients). Both agents also increased LV lactate uptake, particularly during CPT (+13 mumol/min, p less than 0.05 vs control CPT) and reduced LV glutamine production. In 10 patients in whom 14C-lactate was infused, the chemical LV lactate extraction ratio increased more than the 14C lactate extraction ratio after administration of the drugs, indicating a reduction in LV lactate production. The data are consistent with the hypothesis that nicardipine and nisoldipine improve perfusion and aerobic metabolism in chronically ischemic areas, resulting in an augmented oxygen consumption and in a reduced lactate production. PMID- 6507290 TI - Ventricular septal rupture complicating acute myocardial infarction: identification of simple and complex types in 53 autopsied hearts. AB - Fifty-three hearts with rupture of the ventricular septum complicating acute myocardial infarction (AMI) were studied. Thirty-three of the hearts were from men (average age 76 years) and 20 were from women (average age 73 years). The study showed 2 types of rupture of the ventricular septum: simple (28 patients) and complex (25 patients). Simple ruptures were direct through-and-through defects. Complex ruptures were associated with serpiginous dissection tracts remote from the primary site of tear of the ventricular septum. Specimens were classified as to the location of the underlying AMI and the level of the septum (apex to base) at which the rupture occurred. Twenty-nine hearts had an inferior AMI and 24 an anterior AMI. Complex ruptures occurred in 20 of the inferior AMIs (69%) and in 5 of the anterior AMIs (21%) (p less than 0.001). Ruptures that involved the inferobasal portion of the septum were much more likely to be complex (94%) than ruptures in all other locations (27%, p less than 0.001). Significant 3-vessel obstructive coronary arterial atherosclerosis was present in 48 hearts. Rupture of a second structure in addition to the ventricular septum was observed in 11 hearts (left ventricular free wall in 9 cases and papillary muscle in 2). The interval from the onset of the AMI to rupture of the septum could be estimated in 22 patients and averaged 4 days (median 2.5 days). Complete heart block reportedly occurred in 6 patients during hospitalization. PMID- 6507291 TI - Sudden coronary death: comparison of patients with to those without coronary thrombus at necropsy. AB - Among 70 victims of sudden coronary death (SCD), certain clinical and morphologic findings in the 13 with a coronary thrombus are compared with the findings in 57 victims without a coronary thrombus. The 13 with a thrombus were younger than those without (mean age 43 vs 51 years, p less than 0.02); had a lower mean percent of cross-sectional area (XSA) narrowing by plaque at the site of maximal coronary stenosis (89% vs 95%, p less than 0.01); and had a higher mean percent of 5-mm segments of the 4 major epicardial coronary arteries minimally narrowed (0 to 25% in XSA) by plaque (27% vs 19%, p less than 0.001). No differences occurred in the 2 groups with regard to sex, previous angina pectoris or clinical acute myocardial infarction, healed myocardial infarction at necropsy, mean heart weight, number of major coronary arteries narrowed 76 to 100% in XSA by atherosclerotic plaque, or the mean percent of 5-mm segments of the 4 major epicardial coronary arteries narrowed 76 to 100% in XSA by atherosclerotic plaque. Thus, coronary thrombi are infrequent in victims of SCD, and when observed, their significance is uncertain because victims of SCD without coronary thrombi have similar amounts of severe coronary narrowing. PMID- 6507292 TI - Predictive value of changes in R-wave amplitude after exercise in coronary heart disease. AB - To assess the predictive value of coronary events reflected by changes in R-wave amplitude after exercise, 146 patients with angiographically documented coronary heart disease were studied. All patients were followed up for 6 years, during which time myocardial infarction and death of cardiovascular origin were considered endpoints. The incidence of events in patients in whom R-wave amplitude decreased (normal response) and in those in whom R-wave amplitude did not change or increase (abnormal response) were compared. The incidence of coronary events in patients with a normal response was 23% and in those with an abnormal response, 45.8% (p less than 0.01). Correlating the results with several noninvasive and angiographic variables, an abnormal R-wave response showed a significantly higher rate of events in the subsets of patients with prior myocardial infarction, absence of cardiomegaly, maximal functional capacity lower than 4 METs, maximal heart rate higher than 140 beats/min and abnormal left ventricular function. Thus, the changes in R-wave amplitude after exercise is a variable that should be taken into account when assessing the risk of future events in patients with coronary heart disease. PMID- 6507293 TI - Inferoseptal myocardial infarction: another cause of precordial ST-segment depression in transmural inferior wall myocardial infarction? AB - Electrocardiographic ST-segment depression in the anterior precordial leads is a frequent observation during the initial hospital phase of acute transmural inferior myocardial infarction (MI), but is of uncertain significance. No available clinical studies have examined the prevalence of inferoseptal necrosis complicating inferior MI. Therefore, the clinical course, electrocardiographic features, radionuclide angiograms and cardiac enzyme changes in 57 patients with transmural inferior MI who did not have prior anterior or concomitant "true posterior" MI, associated anterior or posterolateral asynergy by radionuclide ventriculography, or left or right bundle branch block were reviewed retrospectively. Patients were categorized according to the presence (group A) or absence (group B) of precordial ST-segment depression and according to the presence (group I) or absence (group II) of radionuclide septal wall motion abnormalities. There were no significant differences in global left ventricular ejection fraction (group A, 49 +/- 8, group B, 52 +/- 41; group I, 51 +/- 7, group II, 51 +/- 6), right ventricular ejection fraction (group A, 45 +/- 9, group B, 42 +/- 7; group I, 43 +/- 8, group II, 41 +/- 8), or clinical outcome in the hospital. However, chi-square analysis revealed a significant (p less than 0.05) association between the presence or absence of septal asynergy and the presence or absence of precordial ST depression. In addition, average peak creatine kinase elevation (group I, 761 +/- 164 IU; group II, 698 +/- 178 IU) attained marginal significance by paired t test (p = 0.06). Precordial ST-segment depression during transmural inferior MI is frequently associated with septal asynergy by gated radionuclide angiography (15 of 26 patients, 58%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507294 TI - Assessment of potentially salvageable myocardium during acute myocardial infarction: use of postextrasystolic potentiation. AB - Twenty-three patients with evolving acute myocardial infarction (AMI) undergoing catheterization for thrombolytic therapy had interventional contrast ventriculography using programmed atrial stimulation. Postextrasystolic (PES) potentiation was present in 67% of infarct-related segments up to 9 hours after the onset of AMI. The presence of segmental potentiation was not related to time from onset of pain to ventriculography, initial ejection fraction, presence of collaterals, left ventricular end-diastolic pressure or the PES delay. In 18 patients reperfusion was successful using intracoronary streptokinase an average of 6.2 hours after the onset of AMI; in these patients repeat contrast ventriculography was performed an average of 11 days after AMI. Improved chronic segmental ventricular function was predicted by the presence of collaterals to the infarct-related artery at the time of acute catheterization (p = 0.02), but was best predicted by analysis of acute PES potentiation (p less than 0.0001). The predictive value of PES analysis was highest in segments without collaterals. Thus, atrial stimulation is safe during AMI and analysis of segmental ventricular function shows potentially viable myocardium up to 9 hours after the onset of AMI. In addition, analysis of PES segmental function can predict chronic function if reperfusion is successful, especially in segments without collaterals. PES ventriculographic analysis may allow prospective determination of which patients during AMI are most likely to benefit from acute thrombolytic therapy. PMID- 6507295 TI - Usefulness of intravenous diltiazem in predicting subsequent electrophysiologic and clinical responses to oral diltiazem. AB - Diltiazem, 0.25 mg/kg, was given intravenously during induced tachycardias in 6 patients with atrioventricular (AV) nodal reentrant tachycardia (group I) and in 24 patients with AV reentrant tachycardia incorporating a retrogradely conducting accessory pathway (group II). In all 6 group I and in 15 of 24 group II patients, tachycardias terminated within 1 minute after diltiazem administration, with a weak link in the anterograde direction. In 3 other patients in group II, tachycardias were terminated by a premature ventricular complex within 1 minute. In the remaining 6 patients in group II, in whom tachycardias failed to terminate, rates of tachycardias decreased as a result of suppression of anterograde AV nodal conduction by diltiazem. Electrophysiologic studies were performed subsequently 2 hours after the third dose of 90 mg of diltiazem, which was given orally at 8-hour intervals. In 18 responders to intravenous diltiazem who were subjected to oral diltiazem testing, sustained supraventricular tachycardia (SVT) could be induced in only 2. Of the 6 nonresponders, sustained tachycardias could not be induced in 3. Twelve patients, including 11 responders and 1 nonresponder to intravenous diltiazem who responded to oral diltiazem testing, were discharged with oral diltiazem therapy, 90 mg every 8 hours, with follow-up periods of 2 to 13 months (mean 7 +/- 4 [+/- standard deviation]). The frequency of recurrent SVT decreased significantly; 8 patients were free of tachycardias and 4 had occasional recurrences of SVT that required no hospital visit. In conclusion, intravenous diltiazem is effective in terminating SVT. Termination of SVT by intravenous diltiazem predicts subsequent electrophysiologic and clinical responses to oral diltiazem. PMID- 6507296 TI - Effect of amiodarone on ventricular function as measured by gated radionuclide angiography. AB - Myocardial size and contractility were measured by gated radionuclide ventriculography in 70 patients before and a mean of 66 days after beginning amiodarone therapy. The mean dose of amiodarone at the time of the second study was 481 mg. The mean left ventricular (LV) ejection fraction (EF) increased slightly, from 40% to 43% (p = 0.001). The mean right ventricular EF remained unchanged (38% to 39%, difference not significant [NS]). The LV end-diastolic volume (count-based method) increased by 9% (p = 0.01), but no change could be demonstrated for end-systolic volume (4%, NS). The LV stroke volume increased 19% (p = 0.001), but cardiac output remained unchanged (5%, NS) because the heart rate decreased by 9 beats/min (p = 0.001). The right ventricular end-diastolic volume increased by 12% (p = 0.01) and end-systolic volume increased by 11% (p = 0.03). Stroke volume increased by 18% (p = 0.005). There was no significant correlation between the change in LVEF and the pre-amiodarone LVEF, the time interval between studies, or with indexes of amiodarone effect (change in heart rate, QRS, QTc, TSH, amiodarone dosage). In 5 patients (7%), LVEF decreased significantly, requiring discontinuation of amiodarone therapy in 1 patient. At the time of the second study congestive heart failure was manifest in 19%, and there was a trend suggesting that congestive heart failure was more likely if the initial LVEF was less than or equal to 35% (p = 0.10). Thus, amiodarone may rarely adversely affect contractility, although myocardial contractility is typically unchanged. There is an associated small increase in the size of both ventricles. PMID- 6507297 TI - Prevalence of aortic valve prolapse with bicuspid aortic valve and its relation to aortic regurgitation: a cross-sectional echocardiographic study. AB - Although aortic valve prolapse (AVP) has been suggested as a cause of aortic regurgitation (AR) in patients with bicuspid aortic valves, neither the frequency of AVP nor its relation to AR in this setting has been defined. To assess these relations, 64 patients with bicuspid aortic valves diagnosed by 2-dimensional echocardiography and 20 normal subjects, similarly distributed according to age and sex, were studied. The presence and degree of AVP were defined using 3 quantitative terms: aortic valve prolapse distance (AVPD), area (AVPA) and volume (AVPV). Each was corrected (c) for patient size with reference to the diameter of the aorta at the level of insertion of the valve cusps. In normal subjects, the AVPDc averaged 0.09 +/- 0.06 (range 0 to 0.16) and the AVPAc averaged 0.08 +/- 0.06 cm (range 0 to 0.15). In patients with bicuspid aortic valves, the AVPDc averaged 0.26 +/- 0.10 (range 0.11 to 0.59, p = 0.00005 vs normal subjects), whereas the AVPAc averaged 0.35 +/- 0.17 cm (range 0.05 to 0.90, p = 0.00005 vs normal subjects). When the AVPDc criteria were used, 81% of the bicuspid valves were abnormal; when the AVPAc criteria were used, 87% were abnormal. The degree of prolapse defined by the AVPVc, which considers both cusp area and degree of apical displacement, was significantly greater for patients with bicuspid aortic valve with clinical AR than for those without (p = 0.008). However, because of the overlap between groups, there was no point at which this measure uniquely separated patients with and without AR.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507298 TI - Identification of the increased frequency of cardiovascular abnormalities associated with mitral valve prolapse by two-dimensional echocardiography. AB - Two-dimensional echocardiography (2-D echo) was performed in 86 consecutive patients with mitral valve prolapse (MVP) and in 25 normal subjects. In normal subjects, mitral leaflet thickness was 3.5 +/- 0.8 mm (mean +/- standard deviation) and the mitral leaflet thickness to aortic wall thickness ratio was 1.0 +/- 0.2. Patients with MVP were separated into 2 groups: those with normal mitral thickness (less than or equal to mean + 2 SD observed in normal subjects, i.e., less than or equal to 5.1 mm) and normal mitral thickness to aortic wall thickness ratio (less than or equal to mean + 2 SD observed in normal subjects, i.e., less than or equal to 1.4) (group I) and others in whom these values were increased (group II). In group I, mitral thickness was 3.6 +/- 0.6 mm and mitral thickness to aortic wall thickness ratio was 1.1 +/- 0.1, and in group II, mitral thickness was 8.8 +/- 1.2 mm and mitral thickness to aortic wall thickness ratio was 2.2 +/- 0.5. The only significant cardiovascular abnormalities in group I were mitral regurgitation in 2 patients and tricuspid valve prolapse in 1 patient. In group II, 7 patients had clinically significant mitral regurgitation, 8 had aortic root abnormalities, 4 had tricuspid valve prolapse and 6 had Marfan's syndrome. Cardiovascular abnormalities were present in 60% (18 of 30) of patients in group II and in 6% (3 of 56) of patients in group I (p less than 0.001). Two-dimensional echo enabled the identification of a subset of patients with MVP who had thickened mitral leaflets. These patients had an increased incidence of cardiovascular abnormalities. PMID- 6507299 TI - Clinical characteristics of patients younger than 60 years with mitral anular calcium: comparison with age- and sex-matched control subjects. AB - The clinical characteristics of 107 patients younger than 60 years with mitral anular calcium (MAC) were compared with those of 107 age- and sex-matched control subjects. The patients with MAC included 55 men and 52 women, mean age 51 years. The control group included 55 men and 52 women, mean age 51 years. Patients with MAC had a higher prevalence of cardiomegaly on chest x-ray (p less than 0.0001), left atrial and left ventricular enlargement by echocardiography (p less than 0.0001), precordial murmurs (p less than 0.0001), diabetes mellitus (p less than 0.0001), systemic hypertension (p less than 0.025) and total conduction defects on surface electrocardiograms (p less than 0.0001) compared with the age- and sex matched control subjects. The mean serum phosphorus and product of serum calcium and phosphorus were higher in patients with MAC (p less than 0.0025) than in the control subjects. The prevalence of coronary heart disease, aortic stenosis and hypertrophic cardiomyopathy and the mean serum cholesterol, triglyceride, total protein, albumin, creatinine, alkaline phosphatase and calcium levels were not significantly different between patients with MAC and the control subjects. PMID- 6507300 TI - Long-term prognosis after repair of double-chamber right ventricle with ventricular septal defect. AB - To determine long-term postoperative results in patients with double-chamber right ventricle and ventricular septal defect, 20 patients who had survived complete repair between 1959 and 1966 were recalled and studied. An interview, physical examination, electrocardiogram and chest x-ray were performed in all 20 patients, a treadmill exercise test in 16, 24-hour Holter monitor recording in 7 and postoperative cardiac catheterization in 8. Mean age at repair was 14 years and at follow-up evaluation 33 years. There were no late deaths. At a mean follow up of 19 years, 17 patients were in New York Heart Association functional class I, 1 patient was in class II and 2 patients were in class III. Reoperation was performed in 2 patients (10%), and at present only 1 patient (5%) is considered to have hemodynamically significant cardiac compromise. Aortic regurgitation, not present in any patient preoperatively, developed in 5 patients (25%). Mild residual right ventricular outflow obstruction was present in 2 (10%) and the murmur of a hemodynamically insignificant residual ventricular septal defect or tricuspid regurgitation was present in 5 patients (25%). One patient (5%) had cardiomegaly (cardiothoracic ratio greater than 0.55). The frequency of infective endocarditis in the postoperative follow-up period was 1 per 388 patient-years. Thus, 20 years after repair of double-chamber right ventricle, mild residua and sequelae are common, but serious cardiac compromise is infrequent. PMID- 6507301 TI - Modified Blalock-Taussig shunt operation without cardiac catheterization: two dimensional echocardiographic preoperative assessment in cyanotic infants. AB - Between May 1981 and December 1983, 25 infants with cyanotic congenital heart defects underwent 26 Blalock-Taussig shunt operations without cardiac catheterization and angiocardiography. In these infants, the diagnosis was established by 2-dimensional echocardiography (2-D echo) supplemented with clinical findings, chest x-ray and electrocardiography. The right and left pulmonary artery measurements, a prerequisite for a shunt operation, determined by 2-D echo were compared with those at surgery and had an excellent correlation (r = 0.94). No infant died as a consequence of an early shunt failure, and only 1 died of postoperative pyothorax. In conclusion, 2-D echo may eliminate the need for invasive investigation in selected patients undergoing the Blalock-Taussig anastomosis. PMID- 6507302 TI - Combined noninvasive assessment of the patent ductus arteriosus in the preterm infant before and after indomethacin treatment. AB - Fifteen preterm infants who weighed 0.7 to 2.0 kg and had clinical evidence of a patent ductus arteriosus (PDA) were studied by combined 2-dimensional and Doppler echocardiography before and after the administration of indomethacin. In 10 patients the PDA was widely patent at the time of the study and in 5 the lumen was narrow. In this latter group, the PDA was narrow at the pulmonary artery end in 2 patients, in the middle in 2 patients and at the aortic end and the middle in 1 patient. After the administration of intravenous indomethacin, the PDA closed completely in 12 patients and constricted in 3. The patterns of closure could be documented in those in whom serial studies were performed. In 3 patients, closure occurred after a single dose of indomethacin, in 3 after 2 doses and in the rest after a full course of 3 doses. Doppler interrogation at the aortic and pulmonary artery end of the PDA demonstrated the shunting patterns and provided a reliable assessment of patency after the ductal lumen was outside the range of lateral resolution following constriction. In no case did the PDA reopen after the course of indomethacin. This combined approach is a reliable method of assessing a PDA before and after a course of indomethacin. It should provide the means to answer many of the questions regarding the effect of various manipulations on the PDA in the preterm infant. PMID- 6507303 TI - Use of the rebreathing method in the differential diagnosis of congenital heart disease and persistent fetal circulation. AB - The differential diagnosis of congenital heart disease from persistent fetal circulation is clinically difficult and cardiac catheterization is often needed. The development of a safe, new technique for use of the rebreathing method has allowed the determination of effective pulmonary blood flow, lung tissue volume, lung diffusion capacity and functional residual capacity in 7 critically ill, ventilator-dependent infants at the bedside. Analysis of the data revealed highly significant differences for lung tissue volume and diffusion capacity, a minimally significant difference for effective pulmonary blood flow and no difference for functional residual capacity between the groups. Use of this method allows not only attainment of clinically useful information but also permits better insight into the pathophysiology of the disease state. PMID- 6507304 TI - Ambulatory electrocardiographic study of the frequency and cause of ventricular arrhythmia after correction of tetralogy of Fallot. AB - Ambulatory 24-hour electrocardiographic monitoring with a Holter recording system was performed in 100 patients after repair of tetralogy of Fallot. The incidence and severity of ventricular arrhythmia (VA) were studied relative to operative age, follow-up period after corrective surgery, hemodynamic data, ventricular function and operative method. Significant VA (Lown grade 2 to 4) was detected in 41 patients. Patients with significant VA (group I) were older (11.7 +/- 10.0 years old) at operation than those without VA (group II) (5.5 +/- 5.8 years, p less than 0.001). The follow-up period after operation in group I (9.5 +/- 4.8 years) was significantly (p less than 0.001) longer than that in group II (5.5 +/ 4.3 years). The incidence of elevated right ventricular (RV) systolic pressure was significantly (p less than 0.005) higher in group I (43%) than in group II (7%). RV ejection fraction in group I (48 +/- 6%) was significantly (p less than 0.001) lower than that in group II (56 +/- 5%). The new operative method for tetralogy of Fallot without or with minimal right ventriculotomy was more frequently performed in group II (49%) than in group I (15%, p less than 0.005). Pulmonary regurgitation, RV and left ventricular size, and left ventricular ejection fraction were not related to severity of VA. Thus, serious VA was related to higher age at operation, longer interval after surgery, elevated RV systolic pressure, depressed RV ejection fraction and RV scar. PMID- 6507306 TI - Analysis of ST-segment changes in normal subjects: implications for ambulatory monitoring in angina pectoris. AB - Continuous monitoring of the electrocardiogram in patients with angina pectoris and coronary artery disease (CAD) has shown episodes of asymptomatic ST-segment depression, suggesting frequent silent myocardial ischemia during normal daily life. Interpretation of this new finding depends on whether similar changes occur in normal subjects. Frequency-modulated ambulatory electrocardiographic recordings were performed in 80 asymptomatic normal volunteers (20 from each decade between 20 and 50 years and, 20 more than 50 years old) and in 20 patients with noncardiac pain, negative exercise and provocative tests and angiographically normal coronary arteries. Treadmill exercise testing was performed in all subjects more than 40 years old. Episodes of T-wave change were identified in 53 subjects. Five subjects younger than 40 years had episodes of ST elevation that were prolonged; they usually occurred at night. In 3 patients they could be reproduced by postural change. Only 2 subjects, both older than 40 years had planar ST depression during tachycardia; one of these subjects had a positive exercise test response. No patient with normal coronary arteries had significant ST depression. Tachycardia was frequently associated with upsloping ST depression (36%), which was more common in younger subjects: Five subjects also showed isolated single complexes with ST depression during baseline instability. With use of frequency-modulated recordings, transient ST depression of 0.1 mV or greater that lasted 80 ms or longer and more than 30 seconds in duration, was rare in a normal population. This finding supports the use of this signal to follow the activity of CAD out of the hospital, specifically in patients with typical angina and proved CAD. PMID- 6507305 TI - Pulmonary vascular disease in children with truncus arteriosus. AB - Pulmonary vascular structure was analyzed using quantitative morphometric techniques in lung biopsy (n = 17) and/or postmortem specimens (n = 18) from 23 patients aged 18 days to 13 years, with truncus arteriosus (TA) type I or II. All 14 patients younger than age 1 year, showed abnormal extension of muscle and an increase in pulmonary arterial medial thickness (p less than 0.01 in 18 of 24 biopsy and autopsy specimens), whereas 6 showed intimal proliferation. Structural abnormalities were usually potentially reversible, even in 5 infants with a pulmonary arteriolar resistance of greater than or equal to 8 units X m2. Abnormalities were more severe in 9 patients aged 3.5 to 13 years, 6 with medial atrophy and 4 with pulmonary arteriolar resistance of greater than 8 units X m2 that also showed intimal fibrosis, with or without plexiform lesions or hyalinized arteries. Findings indicate that biopsy specimens are helpful in assessing the severity of pulmonary vascular disease, and are representative of the entire pulmonary vascular bed (avoiding the lingula); however, interpretation can be difficult if a biopsy specimen is taken of only the peripheral intraacinar arteries, distal to the most damaged vessels. An intracardiac repair is recommended by 6 months, at which time severe pulmonary arterial medial hypertrophy and intimal proliferation can be expected to prejudice the repair. PMID- 6507307 TI - Cardiovascular sensitivity to epinephrine in the trained and untrained states. AB - Heart rate (HR), blood pressure (BP) and inotropic responses to acute exercise are partially mediated by sympathetic stimulation. Physical conditioning reduces exercise HR and improves maximal stroke volume and cardiac output. Uncertainty exists regarding the role of altered catecholamine sensitivity in producing these changes in man. In 6 highly trained men, noninvasive methods were used to serially assess the effect of cessation of training on the resting HR, BP and left ventricular contractile function in response to constant epinephrine infusion. Plasma epinephrine concentration during infusion did not vary with inactivity and was similar to that attained with strenuous exercise. Two subjects showed an increase in chronotropic sensitivity to epinephrine and 4 showed no consistent change. Despite a significant decline in exercise capacity and no apparent change in cardiac loading conditions, there was no persistent effect of inactivity on BP or left ventricular function as assessed by echocardiography and systolic time intervals. Therefore, an alteration in sensitivity to epinephrine is unlikely to account for the hemodynamic adaptations to endurance exercise training in healthy men. PMID- 6507309 TI - Effect of beta blockade and intrinsic sympathomimetic activity on exercise performance. AB - Beta-adrenergic receptor blocking drugs with intrinsic sympathomimetic activity may have the advantage of not depressing myocardial function and pulse rate at rest. Little is known about their effects during exercise. Thus, the effects of small and large doses of pindolol, a nonselective beta-adrenergic blocking drug with intrinsic sympathomimetic activity, were compared with the effects of small and large doses of propranolol in 13 normal men during treadmill exercise. Compared with placebo, all drug regimens decreased exercise duration (p less than 0.001). There were no significant differences in duration between pindolol and propranolol, or between the small and large dose of each drug. Maximal oxygen consumption tended to be lower with all preparations compared with placebo (p less than 0.10). With smaller doses, decrements of maximal heart rate (HR) and HR blood pressure (BP) product were equivalent for pindolol and propranolol (decreases of 46 vs 43 beats/min, and 13,000 vs 12,000 units). The HR-BP product decreased more with high-dose propranolol than high-dose pindolol (decrease of 18,000 vs 14,800 units) due to a greater decrement in HR with propranolol (decrease of 65 +/- 3 vs 53 +/- 3 beats/min). At both submaximal levels, for both low- and high-dose preparations, HR, BP and HR-BP product were lower for propranolol than for pindolol. Thus, in healthy subjects, pindolol and propranolol at doses that produced equivalent reductions in maximal oxygen consumption, exercise duration and, for the smaller dose, HR, had different effects on submaximal HR-BP product, an index of myocardial oxygen consumption, as a result of a higher HR and BP with pindolol. PMID- 6507308 TI - Assessment of the inotropic and vasodilator effects of amrinone versus isoproterenol. AB - The hemodynamic effects of graded-dose infusions of amrinone (maximal dose 30 micrograms/kg/min) (10 patients) and isoproterenol (maximum dose 4 micrograms/min) (11 patients) were assessed in patients with a range of left ventricular (LV) function. LV ejection fraction ranged from 0.13 to 0.77 (mean +/ standard deviation 0.47 +/- 0.23) among the patients who received amrinone and from 0.24 to 0.77 (mean 0.52 +/- 0.18) among those who received isoproterenol. Peak-dose amrinone produced a reduction in LV filling pressure (from 15 +/- 10 to 10 +/- 7 mm Hg, p less than 0.001), but no significant change in heart rate, cardiac output, mean aortic pressure, total systemic vascular resistance (TSVR) or LV dP/dt max. In contrast, peak-dose isoproterenol produced a similar reduction in LV filling pressure (from 17 +/- 12 to 13 +/- 13 mm Hg, p less than 0.05), but also caused increases in heart rate, cardiac output and LV dP/dt max and decreases in mean aortic pressure and TSVR (p less than 0.001). The absolute change in cardiac output and stroke volume correlated closely with the change in TSVR in response to amrinone (r = -0.90, p less than 0.001 and r = -0.84, p = 0.002, respectively), but not in response to isoproterenol. Although isoproterenol produced a marked increase in cardiac output and LV dP/dt max (not explained by heart rate changes alone) in all patients, amrinone produced an increase in cardiac output only in those with markedly elevated LV filling pressures (who had a reduction in TSVR), and an increase in LV dP/dt in a minority. PMID- 6507310 TI - Classification of ventricular arrhythmias based on parallel hierarchies of frequency and form. PMID- 6507311 TI - Time for a new approach to management of patients with both symptomatic and asymptomatic episodes of myocardial ischemia. PMID- 6507312 TI - Formation of new coronary arteries within a previously obstructed epicardial coronary artery (intraarterial arteries): a mechanism for occurrence of angiographically normal coronary arteries after healing of acute myocardial infarction. PMID- 6507313 TI - Functional "type I-like" distal atrioventricular block induced by atrial pacing. PMID- 6507315 TI - Catheter ablation of a concealed accessory pathway. PMID- 6507314 TI - Sudden death after left stellectomy in the long QT syndrome. PMID- 6507316 TI - Unusual features of ventricular tachycardia during respiration and exercise in arrhythmogenic right ventricular dysplasia. PMID- 6507317 TI - Failure of the postventricular premature beat DVI mode in preventing pacemaker circus movement tachycardia. PMID- 6507318 TI - Retrograde catheterization of left ventricle through tilting disc valves using a modified catheter system. PMID- 6507319 TI - Paradoxical embolism secondary to tricuspid valve endocarditis. PMID- 6507320 TI - Anomalous origin of the left anterior descending coronary artery from the pulmonary trunk with origin of the right and left circumflex coronary arteries from the aorta. PMID- 6507321 TI - Asymptomatic sinus of Valsalva aneurysm causing right ventricular outflow obstruction before and after rupture. PMID- 6507322 TI - Failure of St. Jude Medical mitral prosthesis diagnosed by two-dimensional echocardiography. PMID- 6507323 TI - Double-outlet left ventricle with atrioventricular discordance. PMID- 6507325 TI - Calcification of the ascending aorta and aortic and mitral valves in Gaucher's disease. PMID- 6507324 TI - Subdiaphragmatic fluid mimicking loculated pericardial effusion on echocardiography. PMID- 6507326 TI - Watching television and pulmonary embolism. PMID- 6507328 TI - Effects of intracoronary urokinase during acute myocardial infarction. PMID- 6507327 TI - Coronary arterial embolus from left atrial myxoma. PMID- 6507329 TI - Hypnotic control of upper gastrointestinal hemorrhage: a case report. PMID- 6507330 TI - It takes two to tango: some thoughts on the neglected importance of the hypnotist in an interactive hypnotherapeutic relationship. PMID- 6507331 TI - Hypnosis and biofeedback as adjunctive therapy in blepharospasm: a case report. PMID- 6507332 TI - Hypnotherapy and family therapy for the cancer patient: a case study. PMID- 6507333 TI - The use of hypnosis with defendants. PMID- 6507334 TI - Forensic hypnosis: to hypnotize, or not to hypnotize, that is the question! PMID- 6507335 TI - Improving competitive performance with hypnotic suggestions and modified autogenic training: case reports. PMID- 6507336 TI - Studies of the effects of hypnoanesthesia on regional blood flow by transcutaneous oxygen monitoring. PMID- 6507337 TI - A new approach for the estimation of body composition: infrared interactance. AB - A new method for the estimation of body composition in humans, called infrared interactance, is discussed. Infrared interactance is based on the principles of light absorption, reflection, and near-infrared spectroscopy. Body composition (percentage fat) was estimated in 53 adults (23 to 65 yr of age) by infrared interactance and compared to results from deuterium oxide dilution (r = 0.94), skinfold (r = 0.90), and ultrasound (r = 0.89) measurements. The method is safe, noninvasive, rapid, easy to use, and may prove useful to predict percentage body fat, especially in the obese. PMID- 6507338 TI - Decreased hepatic vitamin A after drug administration in men and in rats. AB - Eleven patients with moderate drug-induced liver changes were found to have extremely low hepatic vitamin A levels (less than 10% of normal). Their serum vitamin A, retinol-binding protein, and transthyretin were only slightly affected. In rats, two representative drugs (phenobarbital and methylcholanthrene) produced a significant depression of hepatic vitamin A, whereas plasma vitamin A levels remained normal. The livers of drug-treated animals showed no abnormalities except for the expected proliferation of the smooth endoplasmic reticulum and induction of microsomal enzymes and cytochrome P 450 (phenobarbital) and P-448 (methylcholanthrene). These findings suggest that the decrease in hepatic vitamin A may be secondary, at least in part, to enhanced microsomal metabolism. PMID- 6507339 TI - Body composition changes during recovery from anorexia nervosa: comparison of two dietary regimes. AB - Twelve patients with anorexia nervosa were studied on the Clinical Research Center for periods of 15 to 58 days. Five patients were fed a diet providing 20% of energy from protein and seven patients were fed a diet with only 10% of energy from protein. These patients had a reduced lean body mass in addition to a loss of body fat, and during recovery about two-thirds of the weight gain was lean tissue. The average energy cost of the weight gain was 5.3 kcal/g. There was no significant difference between the two diets for elemental metabolic balance, changes in anthropometric measures, in weight gain, or in potassium-40 counts; nor was there any difference in the energy cost of weight gain, in the rise in basal metabolic rate, or the change in hematocrit, serum albumin, or cholesterol. However, blood urea nitrogen was higher in those patients who received the high protein diet. Satisfactory nutritional rehabilitation of patients with anorexia nervosa does not require a high protein diet. PMID- 6507340 TI - The relationship between glycemic response, digestibility, and factors influencing the dietary habits of diabetics. AB - A significant relationship was found between the rate of release of the sugars; glucose, maltose, and maltotriose from amylitic digestion of 10 foods tested in vitro (expressed as the digestibility index) and the blood glucose response to 50 g carbohydrate portions of the same foods eaten by diabetics (expressed as the glycemic index), (r = 0.815, n = 10, p greater than 0.01). The glycemic index related to both the palatability of the foods (r = 0.731, p less than 0.05) and their frequency of use (r = 0.698, p less than 0.05). However, in this group of motivated diabetics food use was not related directly to palatability, but rather to health belief (r = 0.689, p less than 0.05). The results suggest that carbohydrate foods of potential use to the diabetic may be identified by their in vitro digestion characteristics but to a large extent their acceptance will depend on health belief and possibly ease of preparation. PMID- 6507341 TI - Studies of marginal zinc deprivation in rhesus monkeys. IV. Growth of infants in the first year. AB - Growth was evaluated in rhesus monkey infants that were the offspring of females given a marginally zinc-deficient diet (4 micrograms/g zinc) from the beginning of pregnancy and through 12 months of postnatal life. These zinc-deficient (ZD) infants were compared to controls whose mothers were fed a complete diet, either ad libitum or pair-fed to zinc-deficient dams, throughout gestation and lactation. Male ZD infants had evidence of growth retardation at birth. In contrast, growth retardation in female ZD infants was not observed until 1 month of age. From 3 to 9 months of age (late lactation and subsequent to weaning) ZD infants attained weights similar to those of the control group. However, analysis of crown-rump and femur length indicated that ZD infants' growth was less than optimal throughout the entire 1st yr of observation. In addition, skinfold thickness was markedly higher in ZD than in control infants in the postweaning period. In the juvenile period (9-12 months of age) both male and female ZD animals fell behind controls in body weight. ZD juveniles were also hypogeusic, as determined by a quinine acceptance test. Low weight ZD infants had reduced somatic growth as reflected in sitting height, long bone growth, head circumference, and limb circumference. Regression analysis indicated that impaired growth rates from 9 to 12 months were associated with both lower food intake and reduced food use efficiency. Plasma zinc concentration was, in general, inversely related to weight gain in both groups during the 1st yr. PMID- 6507342 TI - Studies of marginal zinc deprivation in rhesus monkeys. V. Fetal and infant skeletal effects. AB - Skeletal maturation was evaluated in newborn and infant rhesus monkeys that had been subjected to a marginally zinc-deficient diet (4 ppm zinc) from conception through 12 months of postnatal life. Serial radiographic assessment of skeletal development was performed and compared to both ad libitum and pair-fed controls. Radiographs were obtained at birth and at 1, 3, 9, and 12 months of age. In each age group a maturation indicator was selected to identify individuals with abnormal skeletal maturation defined on the basis of presence of epiphyseal ossification centers. Animals were compared only within a given sex group. Additionally, to evaluate endochondral bone mineralization, the appearance of the zone of provisional calcification on the metaphyseal side of the growth plate and the width of the growth plate were assessed. A marginal level of zinc deprivation during gestation and during the 1st yr of life was found to be associated with significantly delayed skeletal maturation and defective mineralization. This abnormality of bone mineralization has many features similar to human rachitic syndromes and suggests that zinc plays an important role in endochondral bone formation. PMID- 6507343 TI - Effect of calcium and phosphorus on zinc metabolism in man. AB - Calcium and phosphorus have been shown to inhibit the availability of zinc for absorption in animal studies, but limited information is available on this subject in man. In the present study, the effect of both calcium and phosphorus on zinc metabolism was investigated in adult men by determining metabolic balances of zinc during three intake levels of calcium of 200, 800, and 2000 mg/day, and during two intake levels of phosphorus of 800 and 2000 mg/day. The analyzed dietary zinc intake was normal and was kept constant throughout all study phases. Increasing the calcium intake from 200 mg to two higher intake levels up to 2000 mg/day did not significantly change the urinary or fecal zinc excretions or the zinc balance. Also, increasing the phosphorus intake from 800 to a high intake of 2000 mg/day did not have any effect. The simultaneous use of the high calcium and high phosphorus intake also had no effect on zinc excretions and on the zinc balance. PMID- 6507344 TI - The adaptation of the small intestine after resection in response to free fatty acids. AB - The effects of long-chain triglycerides and a mixture of free fatty acid on the adaptive response to small bowel resection were examined. Rats with a 50% small bowel resection were divided into four groups. Two received 10% of their calories intragastrically either as corn oil or as free fatty acid and the remaining calories intravenously while the two control groups were given all their calories either intravenously or orally. The results of DNA and protein determination show that free fatty acids were more effective than long-chain triglyceride in promoting adaptation (p less than 0.01) in both small intestine and in the colon. Furthermore the intragastric infusion of free fatty acids was as effective as the orally fed group. Of the plasma hormones measured (gastrin, gastric inhibitory polypeptide, enteroglucagon, and insulin) gastric inhibitory polypeptide was significantly higher (p less than 0.05) in the orally fed group and insulin levels in the free fatty acid group (p less than 0.05) than in other groups. There was no significant difference obtained in enteroglucagon and gastrin levels for the four groups. This study shows that a small amount of free fatty acids (10% of the total calories) given by continuous gastric infusion is effective in promoting intestinal adaptation after resection. PMID- 6507345 TI - Intestinal maturation: effect of growth retardation on L-valine absorption. AB - The absorption of L-valine was studied in segments of the jejunum and ileum using a one pass in situ perfusion technique in 1-, 2-, 3-, and 4-wk-old healthy control and in growth-retarded rats (suckled with mothers fed a protein-deficient diet and fed the same diet after weaning). In the jejunum of control rats, rate of absorption of L-valine declined from about 270 to 80 mumol/h per g mucosal weight, between 2 and 4 wk of life. At each age period, in both segments, rates of absorption of L-valine based on weight of the segments were significantly greater in the growth-retarded than in the control rats. However, based on length of the intestinal segments rates of absorption were similar in corresponding segments of the control and growth-retarded rats. These findings indicated that although the intestine in the growth-retarded rats was atrophic compared to that in control rats, the capability to absorb L-valine had been preserved, by increasing the rate of absorption per unit weight of intestine. PMID- 6507346 TI - The effects of the WIC program on the growth of infants. AB - The Special Supplemental Food Program for Women, Infants and Children (WIC) provides food supplements and nutrition counseling to pregnant and lactating women and children up to age 5 who are at nutritional risk. The purpose of this study was to determine the effects of the program on the growth of infants. Retrospective longitudinal anthropometric data were obtained on 906 WIC and 1001 non-WIC infants from birth to 18 months of age. A new methodology was developed that addressed two factors in longitudinal studies frequently confounded with program impact: 1) regression to the mean and 2) expected growth. Regression analyses indicated that children who were on WIC between 6 and 18 months of age were growing at greater than expected rates. The most persistent program effect was at 6 months of age, after the children had been on the program for an average of 4 months. The study indicated that data routinely collected by the program can be used for evaluation purposes. PMID- 6507347 TI - Estimation of energy expenditure and maintenance energy requirements of college age men and women. AB - Data from two nationwide dietary surveys have led to the suggestion that human energy requirements have been overestimated. A 5-wk energy balance study was conducted to estimate the energy expenditure and maintenance energy requirements of 12 college-age men and women, 20 to 29 yr of age, by the factorial method and by measurement of energy intake and changes in body energy content (intake/balance technique). Mean daily energy expenditure estimated by the intake/balance technique and the factorial method, respectively, was 3081 and 3040 kcal (r = 0.90) for the male subjects and 2183 and 2283 kcal (r = 0.53) for the female subjects. Although differences between the intake/balance and factorial estimations of energy expenditure tended to be greater for individuals than groups and for females than males, the factorial method as performed in this study provided accurate estimations of energy expenditure. In addition, the estimated energy requirements of the college-age subjects in this study provide evidence to support the Recommended Dietary Allowances for energy for this age group. PMID- 6507348 TI - Assessment of marginal vitamin A deficiency in Brazilian children using the relative dose response procedure. AB - Vitamin A status was determined using fasting plasma levels and the relative dose response (RDR) procedure before and 30, 120, and 180 days after administration of an oral massive (200,000 IU) dose of vitamin A. The study was carried out in Recife, Brazil among 93 children of 7 yr or less from low income families who attended two day-care programs. The RDR procedure is conducted by obtaining a fasting blood (A0), feeding 450 retinol equivalents and obtaining a second blood specimen after 5 h (A5). The RDR-(A5-A0)/A5 X 100. A single massive oral dose of vitamin A was given after conducting the base-line RDR test. The RDR procedure was repeated at 30, 120, and 180 days. Weight and height measurements were obtained at each observation and the bloods were analyzed for Hb, total protein, and serum iron, as well as vitamin A. Serum albumin was determined in 120- and 180-day bloods. Serum iron levels were improved 30 days after supplementation with the massive dose of vitamin A. The RDR procedure was found practical to apply in mildly undernourished children under nonclinical condition. In this group of low income children presumed to be habitually ingesting minimally adequate diets, a serum vitamin A level of 20 micrograms/dl or less invariably was associated with an elevated RDR test. Blood levels between 20 to 40 micrograms/dl were not consistently predictive of the RDR response. All elevated RDR tests reverted to normal after supplementation with vitamin A, presumably indirectly indicating a presupplementation inadequate vitamin A status. Hence, the RDR was a more sensitive indicator of inadequate vitamin A status than was only a serum level of vitamin A when blood levels were above 20 micrograms/dl.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507349 TI - Plasma zinc concentration of formula-fed infants. PMID- 6507350 TI - Cardiac dysfunction in obese dieters. PMID- 6507351 TI - Beltsville one-year dietary intake study. Beltsville Human Nutrition Research Center, US Department of Agriculture, Agricultural Research Center, Beltsville, MD. PMID- 6507352 TI - Rationale and design of the Beltsville one-year dietary intake study. PMID- 6507354 TI - Effect of making duplicate food collections on nutrient intakes calculated from diet records. AB - In a 1-yr study in which food intakes were recorded daily, subjects were asked to make duplicate food collections for 1 wk during each of the four seasons. Mean calculated energy intake of the 29 subjects was 12.9% less during the food collection periods than the mean for the entire year (which included collection periods). There were also significant reductions in the reported intake of all nutrients during the collection periods. Protein, vitamin A, saturated fat, and cholesterol intakes were decreased to the greatest extent. The actual decrease in energy intake was greater for the males than for the females, but the percentage was the same (12.9%). The younger group of subjects (less than or equal to 35) decreased energy intake 16.8% and the older group (greater than 35) 8.8%. Comparison of intakes during collection periods with intakes the week before and the week after showed that 28 of the 29 subjects decreased their energy intake from 1.1 to 32.3%. These data suggest that intakes of subjects during food collection periods do not represent their habitual levels of intake reported throughout the year. PMID- 6507353 TI - Evaluation of long-term dietary intakes of adults consuming self-selected diets. AB - Mean daily intakes of calories and 19 nutrients were calculated for 13 males and 16 females, ages 20 to 53 yr, who kept daily diet records for 1 yr. Mean daily caloric and 19 selected nutrient intakes of the subjects met or exceeded the 1980 recommended dietary allowances except for iron and calcium for females. Males had higher intakes than females for all nutrients studied except crude fiber, vitamin A, and vitamin C. However, nutrient density values were comparable for both sexes, except that the females had higher nutrient density values for vitamin A than did the males. The younger subjects had higher intakes of calories and saturated fat than the older ones. The younger males had higher intakes of total fat, saturated fat, and oleic acid than the older males. The consistency of reporting food intakes examined by applying a systematic sampling method designed for this study did not vary considerably when diet records kept over a long period of time were evaluated by four methods. PMID- 6507355 TI - Relationships among dietary constituents and specific serum clinical components of subjects eating self-selected diets. AB - Sex- and age-related differences in dietary and blood chemistry factors were investigated in subjects adhering to their usual lifestyles. Diet records were examined daily and blood chemistry profiles were monitored five times during the 1-yr study. As expected, high-density lipoprotein cholesterol was significantly higher in women than in men. Values of creatine phosphokinase, aspartic aminotransferase, alanine aminotransferase, glucose, triglycerides, urea nitrogen, uric acid, and total bilirubin were higher in men than in women. Glucose was lower while high-density lipoprotein cholesterol, albumin, and total protein were higher in the younger women than in older women. Alcohol consumption by men correlated positively with aspartic aminotransferase and alanine aminotransferase but not with high-density lipoprotein cholesterol. Alcohol consumption by women did correlate positively with high-density lipoprotein cholesterol but not with the aminotransferase enzymes. Correlations between serum high-density lipoprotein cholesterol and vitamin C intake were positive and significant in women. In men, high levels of high-density lipoprotein cholesterol seems to be associated with very high vitamin C intakes, but no associations were apparent at normal levels of these parameters. Serum cholesterol did not correlate significantly with dietary cholesterol, saturated fat, linoleic acid, or P/S in men or women. PMID- 6507356 TI - Variations in plasma fatty acid concentrations during a one-year self-selected dietary intake study. AB - A group of healthy volunteers, maintaining their usual lifestyle, was monitored as to their nutrient intake for a period of 1 yr. Diet records were kept daily and blood samples were collected at even intervals five times during the year. Plasma fatty acid levels were analyzed to determine any sex, age, or seasonal variations or if the plasma fatty acid levels could be correlated to dietary fat intake. In the population studied, there was a significant (p less than 0.0001) sex by age interaction, but no seasonal effect was observed. No major differences in plasma fatty acids related to diet were found. However, the younger men had the highest linoleic acid intake and the lowest plasma linoleic acid. Plasma linoleic acid levels for males older than 35 yr of age (87.0 +/- 3.1 mg/dl) were significantly greater than for males younger than 36 yr of age (67.9 +/- 1.8 mg/dl). The plasma linoleic acid levels of all the women were intermediate in value to the men but not different from each other (73.8 +/- 1.7 mg/dl for the younger women and 78.7 +/- 1.9 mg/dl for the older women). There was a significant (p less than 0.01) sex effect in the relative percentage of plasma linoleic acid (34.4 +/- 0.4% for the women and 32.4 +/- 0.6% for the men), but no age or seasonal effect was observed. PMID- 6507357 TI - Calorie and protein intake and balance of men and women consuming self-selected diets. AB - The calorie and protein intakes of 16 women and 13 men consuming self-selected diets over a 1-yr period were determined. During four 7-day balance periods, corresponding to the four seasons of the year, duplicates of diets consumed and urine and feces excreted were collected for analysis and calculations of available energy and nitrogen balance. During the four balance periods, the food intakes and thus the calorie and protein intake of the subjects decreased as documented by 7-day food records immediately before and after the balance periods. This unexpected decrease in food consumption made the nitrogen (N) balance results difficult to interpret. The energy digestibility of these diets ranged from 87 to 98% (mean +/- SD, 93.7 +/- 2.3). The nitrogen digestibility of the diets ranged from 80 to 96% (mean +/- SD, 88.6 +/- 3.4). The analyzed calorie values (heats of combustion) of the diet composites were approximately the same as calorie values of these diets calculated from diet records using food tables. This is surprising since calorie values in food tables are available energies which have been corrected by a coefficient of availability. PMID- 6507358 TI - Calcium and phosphorus intakes, balances, and blood levels of adults consuming self-selected diets. AB - Metabolic calcium and phosphorus balances, blood calcium and phosphorus levels, and alkaline phosphatase activity of 34 men and women, 20 to 53 yr of age, were determined each season during 1 yr while consuming customary diets. Dietary records were maintained 365 days. Analysis of variance indicated that serum Ca, P, and alkaline phosphatase levels were affected by season (p less than 0.0001), whereas calcium or phosphorus intakes were not. Calcium and phosphorus intakes of the men (1075 and 1533 mg, respectively) were higher (p less than 0.01) than of the women (695 and 1095 mg, respectively), but balances were not statistically different between them. Daily calcium balances for the men and women for the year were -81 and -85 mg, respectively; daily phosphorus balances were -239 and -130 mg, respectively. Stepwise regression analysis indicated that dietary calcium and protein were significantly associated with calcium and phosphorus balances, but in opposite directions, and only in women over 35 yr of age. PMID- 6507359 TI - Magnesium intakes, balances, and blood levels of adults consuming self-selected diets. AB - Magnesium balances and plasma and blood cell concentrations were determined in 34 men and women, 20 to 53 yr of age, during each season for 1 yr while they were consuming their customary diets. Dietary records were maintained 365 days. Analysis of variance indicated no seasonal variation in intake or balance. Blood cell magnesium correlated with magnesium intake (r2 = 0.203; p less than 0.04). Daily magnesium intakes of the men (323 mg) were significantly higher (p less than 0.01) than of the women (234 mg), and reflected greater calorie consumption for their greater body weights. Daily magnesium balances for the men and women were -32 and -25 mg, respectively. Multiple regression analysis showed that magnesium balance was associated not only with magnesium intake but also with the intake of other nutrients such as fiber, protein, calcium, and phosphorus. Moreover, the effect of these nutrients on magnesium balance varied with age and sex. PMID- 6507360 TI - Correlations of changes in dietary potassium and sodium with blood pressure during a one-year study. AB - Twenty eight adults, 12 men and 16 women, participated in a 1-yr study designed to assess accurately daily nutrient intake. All subjects lived at home, consumed self-chosen diets, and maintained a detailed daily dietary record throughout the year. Four times during the year blood pressure was measured. Mean daily sodium and potassium intake was calculated for each subject for the 7-day period before blood pressure measurements. Dietary intakes averaged 3.9 and 2.6 g/day of sodium and 3.3 and 2.2 g/day of potassium for men and women, respectively. Mean blood pressures for the four measurements were 120 mm Hg (systolic) and 77 mm Hg (diastolic) for men and 110 mm Hg (systolic) and 70 mm Hg (diastolic) for women. There were no significant correlations between absolute sodium or potassium intake and blood pressure. However, an individual's variability about his own mean potassium intake was significantly negatively correlated to the variability about his own mean systolic pressure in the male subjects (r = -0.43, p less than 0.002). There was no similar correlation in the female subjects. Changes in sodium intake were not associated with changes in blood pressure in either the men or women. PMID- 6507361 TI - Iron intake and status of men and women consuming self-selected diets. AB - Iron intakes and iron status (serum ferritin and iron balance) were determined in 16 women and 13 men consuming self-selected diets over a 1-yr period. Iron balance was determined during four 7-day balance periods corresponding to the four seasons of the year. The seasonal variation in iron intake and serum ferritin and the correlation among iron intake, iron balance, and serum ferritin was examined. No seasonal variation was found in iron intake or serum ferritin. No direct correlation could be found between iron status (ferritin levels and iron balance) and iron intake. However, the men who met or exceeded their recommended dietary allowance for iron intake had ferritin levels in a range indicative of adequate iron status. None of the women met their recommended dietary allowance and their ferritin levels indicated marginal iron stores. PMID- 6507363 TI - Breast cancer in young women treated definitively with radiotherapy. An early report. AB - Between 1977 and 1982, 34 breast cancers in 33 women aged less than or equal to 35 years were treated with primary radiotherapy following excisional biopsy and axillary lymph node dissection. The records of these cases were reviewed and compared to 156 women greater than age 35 with 157 breast cancers treated similarly during the same time period. Analysis of these cases was limited to patients with invasive cancers who were AJC Stages I or II. In the women less than or equal to age 35, there were only six failures (two with locoregional failure only and four with distant metastases). The treated breast was preserved in all of the younger women except for the two patients with locoregional failure only who were treated for salvage with a mastectomy. The actuarial freedom from breast relapse alone at 3 years was 96% in women less than or equal to 35 years vs. 97% in women greater than 35 years. Freedom from locoregional relapse only was 88% vs. 95% at 3 years in the above groups, and the actuarial disease-free survival at 3 years was 76% vs. 87%, respectively. None of the above comparisons between younger and older women are statistically different. We conclude that definitive radiation therapy for Stages I and II carcinoma of the breast in women less than or equal to age 35 yields similar results to those for women greater than 35. Such treatment achieves excellent preservation of the breast and should continue to be considered as an alternative to mastectomy. PMID- 6507362 TI - Zinc, copper, and manganese intake and balance for adults consuming self-selected diets. AB - Twenty-eight adult men and women participated in a year-long study designed to determine accurately the nutrient intake of adults who lived at home and consumed self-selected diets. During four metabolic balance periods, 7 days each, corresponding to the seasons (spring, summer, fall, winter), duplicates of the diet, and all urine and feces were collected. Daily mean intakes for zinc and copper were 9.9 and 1.2 mg, respectively. These levels were less than the recommended daily intakes of 15 mg for zinc and 2 to 3 mg for copper. In contrast, the mean dietary intake of manganese was 3.0 mg/day which is within the suggested safe and adequate range of 2.5 to 5.0 mg. Metabolic balances were negative for all three elements possibly due to a reduction in food intake during the collection periods compared to the noncollection intervals. The collection of the duplicate diets apparently influenced the food intake during the collection weeks. PMID- 6507364 TI - Breast carcinoma: pattern of recurrence and metastasis after mastectomy. AB - This is a retrospective review of 556 patients who had carcinoma of the breast (1971-1980). Among the 476 patients who had mastectomy, 38% have died and the median follow-up time of those who were alive was 53 months. When the axillary nodes were free of metastasis initially, 18% of the patients had relapse. Among the patients who had axillary nodal metastasis, 24% of those with 1-3 positive nodes, and 69% of those with greater than or equal to 4 positive nodes relapsed. Regarding specific type of first recurrence, about 10-30% had loco-regional relapse, 60-70% had distant metastasis and 10-30% had both (patients with greater than or equal to 4 lymph nodes involved are less likely to have only loco regional relapse). Postoperative radiotherapy decreased the frequency of isolated loco-regional relapse, but did not decrease the overall failure rate nor influence the chance of dissemination. Among patients who had one or more positive axillary nodes, adjuvant chemotherapy (melphalan or CMF) did not significantly decrease relapse rates nor change types of relapse. Thus, distant dissemination is the major problem for those who developed recurrence after mastectomy. The relative distribution of the initial spread is similar to that seen among the 80 patients who had Stage IV disease at diagnosis. The most common five sites are bone (which accounted for 40-60% of the distant metastasis), lung (15-22%), pleura (10-14%), soft tissue (7-15%), and liver (5-15%). PMID- 6507365 TI - Phase II study of VM 26 in extensively pretreated breast cancer. AB - A significant activity of VM 26 in solid tumors has been established in brain tumors, bladder cancer, and neuroblastoma. Preliminary favorable results in breast cancer stimulated a phase II study at our institution to define the activity of VM 26 in patients with advanced, homogeneously pretreated breast cancer. PMID- 6507366 TI - Combination chemotherapy for mycosis fungoides with cyclophosphamide, vincristine, methotrexate, and prednisone. AB - Seven patients with stage IV mycosis fungoides [TNM classification] have been treated with combination chemotherapy consisting of cyclophosphamide, vincristine, methotrexate, and prednisone [COMP]. A complete response rate of 57% was produced with an overall response of 100% in patients having limited prior steroid and/or chemotherapy. Complete responses range from 4+ to 20 months [median, 11 months]. Overall survival ranges from 2 to 40+ months [median, 12+ months]. The protocol was well tolerated except for one treatment-related death. Combination chemotherapy can produce effective remissions in patients with advanced mycosis fungoides. TNM classification should be considered in staging patients with mycosis fungoides for comparison of different treatment regimens. PMID- 6507367 TI - Prognostic impact of ploidy level in carcinoma of the cervix. AB - The single cell DNA content was analyzed by use of flow cytometry in cervical carcinoma. The study included 171 patients, Stages Ib-III. The ploidy level was calculated as a DNA index by comparison with diploid lymphocytes. Accordingly, the tumors were divided into two groups with DNA index below and above 1.5. This division proved to be important to the recurrence frequency. In all stages investigated, a statistically significant higher recurrence frequency was found in the group with DNA index above 1.5. The same relation applied concerning the survival. It is concluded that the DNA distribution is an important prognostic factor in cervical carcinoma. PMID- 6507368 TI - Levels of urinary cathepsin B-like substance in patients with gynecologic malignancy. AB - Because certain proteolytic enzymes are thought to be released by malignant cells, we have measured the activity of cathepsin B in the urine samples of 57 patients with gynecologic malignancies and 60 disease-free controls. A unit (U) of enzyme activity is the release of one n-mol of 7-amino-4-fluoromethylcoumarin (AFC) from BZ-val-lys-lys-arg-MNA min-1 ml-1. Units of activity in the malignant group (10.6 +/- 9.8) differed significantly (p less than 0.0001) from controls (2.8 +/- 3.3). Although enzyme activity in both groups correlated with increasing age, the difference between those subjects with malignancies and those with none remained significant (p = 0.049) by analysis of covariance after adjusting for age. There was no correlation between titers and the race or weight of the subjects in either group. Enzyme activity of subjects with malignant disease correlated (p = 0.003) with the clinical stage of disease. Optimum sensitivity and specificity as determined by Receiver Operator Characteristic Analysis with an upper normal level of 5 U were 84.2% and 86.7%, respectively. Our findings suggest that measurement of urinary cathepsin B might be useful in detecting and managing patients with gynecologic tumors. PMID- 6507369 TI - Survival of cultured human cells exposed to californium 252Cf radiation at low dose rates. AB - Human T-1 cells were used to determine the rbe of low dose rate 252Cf (n + gamma) radiation, compared to low dose rate gamma radiation. The T-1 cells were irradiated hypoxically at room temperature, and the dose rates were as follows: a) 252Cf (n + gamma), 0.045, 0.090, and 0.270 Gy/hour; and b) 137Cs gamma radiation, 0.117, 0.246, and 0.765 Gy/hour. The RBE was obtained as the ratio of the initial slope of the 137Cs survival curves (approximately the same for all three dose rates), and the initial slope of the 252Cf survival curves (same for all three dose rates). The RBE was 5.0 +/- 1.0 for all components of the 252Cf radiation and 7.1 +/- 1.7 for the neutron components. As the dose increased, an inverse dose rate effect (more sensitive at lower dose rates) for the 137Cs survival curves was observed. PMID- 6507370 TI - Mitoxantrone in epithelial carcinoma of the ovary. A Southwest Oncology Group study. AB - Thirty-nine patients with advanced heavily pretreated epithelial carcinoma of the ovary were treated with mitoxantrone (dihydroxyanthracenedione hydrochloride). Twenty-five patients were started at a dose of 12 mg/m2 q 21d and 13 patients, with compromised bone marrow, at a dose of 10 mg/m2 q 21d. Two stable responses (6%) occurred in 31 fully evaluable patients. The median duration of survival was 17 weeks. The principal toxicity, hematopoietic (primarily leukopenia), was mild and well tolerated. We conclude that mitoxantrone is a relatively inactive drug in the treatment of epithelial ovarian carcinoma. PMID- 6507371 TI - Phase II trial of 1,2-diaminocyclohexane-(4-carboxyphthalato) platinum(II) (DACCP) in colorectal carcinoma. AB - In an effort to investigate the antitumor activity of new cisplatin analogues, 1,2-diaminocyclohexane-(4-carboxyphthalato) platinum (II) (DACCP) was administered in a phase II disease-oriented trial to patients with advanced colorectal carcinoma. Six patients had not received prior chemotherapy, while four had received one drug, and two had received more than one drug. Primary sites of disease were in the liver only (8 patients), liver and lung (2 patients), and intra-abdominal (2 patients). Liver radionuclide scans and CT scans were the main parameter for evaluation. The drug was administered intravenously every 4 weeks at a dose of 640 mg/m2. There were no responses in 12 adequately treated patients. One patient had stable disease for 5 months. Nausea and vomiting was milder than that seen with cisplatin. A peripheral neuropathy was seen in four patients. Fever occurred in two patients and urticaria in one patient. No patient had significant drug-induced anemia, and renal dysfunction was not observed. DACCP at this dose and schedule demonstrated no efficacy as a single agent in the treatment of colorectal carcinoma. PMID- 6507372 TI - Phase II studies of mitoxantrone (dihydroxyanthracenedione) in the treatment of advanced colorectal carcinoma. AB - One hundred four patients with advanced colon carcinoma were treated with mitoxantrone 5 mg/m2 I.V. weekly. The patients were stratified into two groups: prior chemotherapy and no prior chemotherapy. Only one partial response was noted in the prior treatment category. PMID- 6507373 TI - A phase II study of the combination, 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and N-(phosphonacetyl)-L-aspartate (PALA), in patients with advanced large bowel cancer. AB - A phase II study of BCNU and PALA was undertaken in advanced large bowel carcinoma. Thirty patients with advanced metastatic colorectal carcinoma were treated with the combination BCNU (200 mg/m2) every 6 weeks, and PALA (5.0 g/m2) every 3 weeks. Fifteen patients had received no prior chemotherapy and 15 had been previously treated with one or more cytotoxic agents. Only one patient met the criteria for a partial response, and this response was of only 3 months' duration. It would seem unlikely that the combination of BCNU and PALA holds the potential of response greater than BCNU alone and that further trials of this treatment regimen for this tumor type seem unwarranted. PMID- 6507374 TI - Aclacinomycin. Phase II evaluation in advanced squamous carcinoma of the head and neck. AB - Aclacinomycin-A was evaluated in a phase II trial for advanced head and neck cancer. A weekly infusion of 65 mg/m2 was used. Eighteen patients were entered. Fifteen patients were evaluable for response and toxicity. One was evaluable for toxicity only and two died before completion of a full course of therapy. One patient without previous chemotherapy achieved a PR in a neck node for a short time. Six patients had stable disease with a median to progression of 6 weeks. Major toxicity encountered was bone marrow suppression. Aclacinomycin-A appears to have no activity in squamous cancer of the head and neck. PMID- 6507375 TI - Phase II evaluation of L-alanosine (NSC-153353) for patients with disseminated malignant melanoma. AB - The authors conducted a phase II study of L-alanosine in 39 patients (19 without prior chemotherapy) in advanced malignant melanoma. The intravenous dose was 250 mg/m2/days 1-3 repeated at 3-week intervals. There were two objective regressions (5%) in conjunction with generally transient and tolerable hematologic and gastrointestinal toxicity. L-alanosine as used in our study has limited activity against malignant melanoma. PMID- 6507376 TI - Survival after malignant melanoma in a black child. A case report and review of the literature. AB - A malignant melanoma of clinical and pathologic State I but deep microstage that occurred on the lower extremity of a prepubertal black male child, who is free of recurrence 3 years following surgical excision, regional node dissection, and BCG adjuvant immunotherapy, is reported. Previously described cases of malignant melanoma in black children indicate that it is a rare and virulent lesion, since all patients expired due to their tumors within 6 months. The judicious use of principles derived from management of adults with such lesions may prolong survival and disease-free interval in this patient population. PMID- 6507377 TI - Protracted vinblastine infusion. Phase I-II study in malignant melanoma and other tumors. AB - Twenty-six patients received vinblastine by ambulatory pump infusion via the subclavian vein for a median duration of 30 days of continuous therapy at an average dose rate of 0.5 mg/m2/day. Drug toxicity was minimal compared to the standard bolus schedule but bone marrow suppression was dose-limiting. There was no gastrointestinal or neurologic toxicity. The maximum duration of continuous therapy was 89 days (at 0.5 mg/m2/day) with the duration of therapy specifically related to the daily dose rate. Nondrug-related toxicity included subclavian vein thrombosis in two patients. Two of 11 patients with malignant melanoma had transient objective responses and 1/3 patients with soft tissue sarcoma had a partial response. Expanded phase II studies are ongoing at the dose of 0.5 mg/m2/day for a minimum duration of 30 days. PMID- 6507378 TI - A phase II study of dibromodulcitol (DBD) in stage IV melanoma. AB - Twenty-four patients were evaluated in a non-randomized study to assess the effectiveness of dibromodulcitol (DBD) in Stage IV melanoma. Patients received 100 mg/m2 of DBD orally for 35 days. The dose was escalated to 130 mg/m2 and then to 160 mg/m2 if no significant hematologic toxicity occurred. There were no objective responses, including six patients who had had no prior chemotherapy. Five patients (21%) remained stable. Median survival was 151 days. Survival favored females, nonvisceral involvement pretherapy, and patients with a disease free interval (DFI) of greater than 1 year. None of these advantages was statistically significant. Toxicity was predominantly hematologic, but nausea, vomiting, shortness of breath, and diarrhea were also seen. Oral DBD, using this dose and schedule, does not appear efficacious in advanced disseminated melanoma. PMID- 6507379 TI - Monitoring clinical research. A report from the Childrens Cancer Study Group. AB - This report describes an evaluative approach in assessing study quality in clinical trials. The size of the data set required is defined using decision analysis methods. Assuming entry of eligible patients, the minimum data set required in determining study quality includes: the treatment agent, the protocol stipulated treatment time, and the actual time of administration. While toxicity, complication and response data are primary for the resolution of the scientific issues, they are secondary for study performance questions. Separation of study performance and scientific questions simplifies the design and execution of complex, multimodal, multidisciplinary clinical trials. Application of separate criteria for study performance and scientific questions enhances understanding of protocol requirements by data managers, physicians, and nurses. Once study performance issues are resolved, the scientific issues addressed by the protocol can be considered in detail. The usual practice of focusing on science and study performance simultaneously precludes efficient consideration of either data set. The distinction between analyses of study performance and of scientific questions is illustrated using data from Childrens Cancer Study Group protocol CCG-551. This study is a controlled trial of therapies for non-Hodgkin's lymphoma. The protocol provides an example of modern diagnostic and therapeutic management complexities. PMID- 6507380 TI - Phase I study of mitoxantrone on a daily X 5 schedule. AB - Mitoxantrone (NSC-301739) is a synthetic amino anthraquinone DNA intercalater active in several experimental tumor systems. Thirty-three patients with advanced cancer received the drug on a daily X 5 schedule. Myelosuppression, especially leukopenia, was the dose-limiting toxicity and was reversible. Nausea and vomiting occurred sporadically. No definite hepatic, renal, or cardiac toxicities were noted. The recommended dose for phase II evaluation in solid tumor patients with little or no prior therapy is 4.2 mg/m2/day X 5. Patients with prior myelosuppressive therapy but adequate bone marrow reserve may be started at 2.6 mg/m2/day X 5. PMID- 6507381 TI - Quality of life in cancer patients. Who measures what? PMID- 6507382 TI - Vapor pressure and freezing point osmolality measurements applied to a volatile screen. AB - This is a report of a rapid and precise screening procedure, developed for the determination of ethanol in serum using osmolality measurements. The osmolality of the patient is determined by freezing point method (freezing point osmometry) and dew point (water vapor pressure osmometry) method. The difference between freezing point osmolality and vapor pressure osmolality (delta osm) is due to the presence of volatiles in the serum, because the volatiles are not measured by vapor pressure osmometry. The amount of ethanol (mg/dL) in serum is estimated by multiplying delta osm by a factor of 4.2. As a comparison method, ethanol also is measured by a spectrophotometric alcohol dehydrogenase method. In addition, a significant difference between an osmometric alcohol assayed value and enzymatic spectrophotometric measurement indicates the presence of volatiles, other than ethanol. In addition to ethanol there is a linear relationship between osmolality and isopropanol or methanol when added in vitro to serum. PMID- 6507383 TI - The frequency of perineurial ductules in vasitis nodosa. AB - In a retrospective histologic study, 154 vasovasostomy specimens (77 patients) yielded 50 examples of vasitis nodosa. These cases were examined for nerve invasion by proliferating ductules; benign neural invasion was present in four instances, and four additional cases were found on step sectioning the vasovasostomy specimens, totaling eight cases (16%) of the 50 studied. Usually only one or two nerves were invaded. The number of glands within individual nerves varied from one to eight. The findings are discussed in the context of benign glandular invasion of nerves in other locations. PMID- 6507384 TI - A solid phase antibody screen. AB - An automated solid phase antibody screen (SPAS) in microplates has been developed. Red blood cell (RBC) adherence was used as the end point instead of agglutination. Consequently, positive and negative reactions were readily distinguished by a microplate spectrophotometer. The SPAS performed as well as conventional antiglobulin methods for detecting IgG antibodies in donor sera and had increased sensitivity as determined by serial dilutions of antibodies. PMID- 6507386 TI - Clinical responsiveness to laboratory results. AB - Digoxin prescriptions written by physicians after obtaining digoxin assay results were reviewed for 100 patients in order to study aspects of experts' interpretation of test results; also 77 pathologists' interpretations of serum digoxin assay results and glucose tolerance curves were studied. There was agreement on the interpretation of only some extreme test result values. Borderline values evoked a mixture of opinions. Responsiveness to result values was measured in terms of the extent of agreement among interpreters and was found to depend on the amount of deviation of the result value from referent values. This is consistent with the idea that the attention given to tests varies with the result value according to its perceived contribution toward reducing clinical error rates. Thus, there is no requirement for unusual analytic precision near referent values, as clinicians respond to results with more skill than anticipated. PMID- 6507385 TI - Parentage testing using the serum protein plasminogen (PLG). AB - Isoelectric focusing of plasminogen (PLG) was tested on a Minnesota population of 2,187 white individuals and 451 paternity cases. A total of six different PLG allotypes were observed PLG*1, PLG*2, PLG*3, PLG*B, PLG*D and PLG*M. Observed gene frequencies predicted a probability P = 0.2 of excluding men who were falsely determined to be parents. The observed frequency of PLG exclusions among all exclusions detected in the study using a test battery of 14-16 genetic markers was similar to the expected value. PLG phenotyping proved to be a very useful genetic marker system in routine parentage testing. PMID- 6507387 TI - Lymph node finding in drug abusers. PMID- 6507388 TI - A case of large multilobated cell lymphoma. PMID- 6507389 TI - Acquired toxoplasmic lymphadenitis with demonstration of the cyst in imprints. PMID- 6507390 TI - The effectiveness of pediatric cardiopulmonary resuscitation. PMID- 6507391 TI - Cardiorespiratory arrest and resuscitation of children. AB - Ninety-one patients had cardiorespiratory arrest in a children's hospital emergency department over six years. Only five children survived, three with severe neurologic sequelae. The records of 40 other children in the same community resuscitated by paramedics, but taken to other hospitals, were reviewed and there were three survivors. The causes and outcomes of resuscitation of children are clearly different from those of adults. Cardiac disease and ventricular arrhythmias are uncommon. Neurologically intact survival was seen only in those children who received immediate resuscitation and responded promptly. Research in cerebral resuscitation at the cellular level is promising for the future. Prevention of some cardiorespiratory arrests through accident prevention and earlier recognition of serious infections is possible now. PMID- 6507392 TI - CSF shunt infections in pediatrics. A seven-year experience. AB - The medical records of children who had had CSF shunt procedures were reviewed for the seven-year period from 1975 through 1981. There were 516 procedures performed in 297 patients. Only three were ventriculoatrial shunts; the remainder were ventriculoperitoneal shunts. Fifty-nine infectious episodes (11%) occurred in 50 patients (17%); there were three relapses and six reinfections. The infecting pathogen was staphylococci in 75% of the infections and gram-negative bacilli in 19%, and there were two or more pathogens in 15% of the infections. The onset of the infection was within 15 days of surgery in 53% of the cases. The main symptoms were fever, irritability, and shunt malfunction. Gram's stain of the CSF was positive in 46% of the episodes and blood cultures were positive in 29%. Nineteen percent of patients had wound infection and 7% had peritonitis; in most of these cases there were no neurologic signs or symptoms. Thirteen episodes were managed with antibiotic therapy alone; among these, there were three relapses and two reinfections. Thirty-seven episodes were treated with antibiotics and immediate removal of the shunt; there were no relapses and three reinfections. Nine episodes were managed with antibiotics and delayed removal of the shunt; there was one reinfection. The median duration of antibiotic treatment was 15 days, and the time to defervescence was 24 hours in those with immediate removal of the shunt and six days in those in whom the shunt was not removed. PMID- 6507393 TI - The role of host factors in an outbreak of necrotizing enterocolitis. AB - During an outbreak investigation of necrotizing enterocolitis (NEC) in a neonatal intensive care unit, we identified nine definite and six suspected cases of NEC on the basis of histopathologic, clinical, and roentgenographic findings. Neonates of low birth weight (less than 1,250 g) had the highest incidence of NEC, supporting a role for prematurity in this disease. Patients with definite NEC and those with severe clinical features had significantly lower birth weights and postconception ages (gestational age at birth plus postnatal age at onset of NEC) than the patients with suspected NEC. In a case-control study using birth weight-matched control subjects, maternal toxemia was identified as a possible protective factor for NEC. To our knowledge, this is the first report of the relationship between NEC disease severity and postconception age. These findings also suggest that toxemia may be an important protective factor in NEC and should be examined in subsequent studies. PMID- 6507394 TI - Prolonged elevation of transaminase concentration in children with unsuspected myopathy. AB - Prolonged elevation of the serum transaminase concentration in an asymptomatic child is usually thought to be secondary to liver disease. Four children with unexplained persistent elevation of serum transaminase concentration were referred to a pediatric gastroenterologist for studies of liver disease. Subsequent evaluation disclosed abnormal muscle biopsy findings in all four patients. This experience suggests that an appropriate workup for occult myopathy is indicated in such patients before invasive diagnostic procedures for evaluation of liver disease are undertaken. PMID- 6507395 TI - Motor disorders of voice and speech in Reye's syndrome survivors. AB - Disorders of voice and speech were studied in 43 survivors of Reye's syndrome (RS). During hospital convalescence 26 (60%) of 43 were aphonic, hoarse, or had other alterations of speech production. These disorders occurred in those patients with the worst severity of RS. Four patients (9% of survivors) had a persistent motor voice or speech disorder at follow-up examination 1 1/2 to five years after recovery. All of the patients have breathy, low-intensity voice quality, whereas three of the four exhibit rapid and slurred speech. These four children have no difficulty with the symbolic aspects of language and their motor voice and speech impairment cannot be ascribed to global intellectual deficit. Although other neurologic deficits are present in three of these four children, the disorders of voice and speech are the major permanent disabling handicap in our RS survivors. PMID- 6507396 TI - Treatments for Centruroides exilicauda envenomation. AB - We treated two cases of severe envenomation by the scorpion Centruroides exilicauda. The first infant was treated with a species-specific scorpion antivenom, which produced a delayed but dramatic return of all vital signs to normal. A second infant was treated with two doses of intravenous propranolol hydrochloride and had a rapid, dramatic decrease in heart rate but only gradual resolution of neurologic symptoms. These cases demonstrate the severe symptoms of envenomation by this scorpion in the infant and show two possible treatments. PMID- 6507397 TI - Superficial cervical lymphadenopathy after insertion of earrings. PMID- 6507398 TI - Slipped capital femoral epiphysis in hypothyroidism. PMID- 6507399 TI - Type 2 corticosterone methyloxidase defect in a 2-year-old Iranian Jewish child. PMID- 6507400 TI - Fetal hydantoin syndrome characteristics. PMID- 6507401 TI - Mortality and airway obstruction. PMID- 6507402 TI - Adolescent substance abuse problems. PMID- 6507404 TI - Primary tuberculosis of the esophagus: pseudotumoral presentation. AB - A patient with primary esophageal tuberculosis is described. The clinical presentation and barium swallow study was also suggestive of carcinoma of the esophagus. This was excluded on biopsy obtained at endoscopy. The patient had a good response to antituberculous therapy with complete resolution of the esophageal lesion without any residual complication. A brief review of primary tuberculosis of the esophagus, a rare condition, is outlined. PMID- 6507403 TI - Crohn's disease of the esophagus: case report and review of the literature. AB - Crohn's disease of the esophagus is a rare entity, especially when the esophageal manifestations are the first symptoms. We describe a 28-year-old man who presented with dysphagia, fevers, and weight loss and was eventually found to have Crohn's disease of the terminal ileum, cecum, and esophagus. A review of the English language literature reveals approximately 30 reported cases of Crohn's disease of the esophagus, with or without other gastrointestinal involvement. PMID- 6507405 TI - Primary tuberculosis of the esophagus. AB - A case of primary tuberculosis of the esophagus is presented in an Asian patient. This is a rare site for tuberculosis and mimicked the appearance of a carcinoma. PMID- 6507406 TI - Verrucous carcinoma of the esophagus. PMID- 6507408 TI - The use of colonoscopy in the treatment of colonic volvulus: three cases and review of the literature. AB - Four to 10% of cases of large bowel obstruction are caused by volvulus. Nonoperative therapy is the preferred initial treatment of patients with colonic volvulus who do not have signs of bowel strangulation because of the high mortality associated with emergency surgery. We report our experience with three cases and review the literature on the use of the colonoscope to treat colonic volvulus. PMID- 6507407 TI - Late effects of gastric bypass for obesity. AB - We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat. PMID- 6507410 TI - Noninvasive investigation of the gastrointestinal tract in collagen-vascular disease. AB - We have investigated the use of 111Indium granulocyte scanning, which would be expected to identify areas of perivascular or generalized neutrophil infiltration, in patients with collagen-vascular diseases suffering from either gastrointestinal symptoms (diarrhea or abdominal pain in 15 patients) or otherwise unexplained fever (six patients). Among patients with gastrointestinal symptoms, seven of 15 had positive scans suggesting large or small bowel involvement--three of three patients with Behcet's syndrome, four of five with vasculitis, no patient in six with systemic lupus erythematosus, and no patient with Churg-Strauss syndrome. Among patients without gastrointestinal symptoms, only one patient with polyarteritis nodosa had a positive scan, showing both large and small intestinal involvement. White cell scanning offers a noninvasive, readily tolerated technique for identifying inflammatory involvement of the intestine in patients with collagen-vascular disorders. Gastrointestinal involvement is rare in the absence of symptoms; and among symptomatic patients, inflammatory involvement of the gut is more likely to be found in patients with vasculitis or Behcet's. PMID- 6507409 TI - Acute appendicitis and pernicious anemia as complications of gastrointestinal sarcoidosis. PMID- 6507411 TI - Spontaneous disappearance of limy bile: report of a case with review of the literature. AB - Spontaneous disappearance of limy bile is extremely rare, and only four cases have so far been reported. This is the account of the fifth case, a 42-year-old woman, who spontaneously lost a stone incarcerated in the neck of the gallbladder and all of the limy bile, after symptoms suggestive of a transient obstructive jaundice. Various investigations including ultrasound, computed tomography, and percutaneous transhepatic cholangiography suggested spontaneous passage of the stone through the cystic duct and the papilla of Vater, followed by limy bile. Apparently the patient's gallbladder had a contracting capacity. The literature on this subject is briefly reviewed. PMID- 6507412 TI - Primary sclerosing cholangitis occurring in a patient with systemic lupus erythematosus and diabetes mellitus. AB - A 42-year-old woman with a longstanding history of systemic lupus erythematosus and insulin-dependent diabetes mellitus was admitted to the hospital because of icterus, anorexia, pruritus, and weight loss of 3 months duration. During her evaluation the diagnosis of primary sclerosing cholangitis was established. The following case documents the unusual association of systemic lupus erythematosus and insulin-dependent mellitus with primary sclerosing cholangitis. PMID- 6507413 TI - Gastric emphysema. AB - Gastric emphysema is a rare condition in which gas from a nonbacterial source accumulates within the wall of the stomach. Gastric distension and vomiting frequently precede the formation of the intramural air. Pulmonary disease, instrumentation of the stomach, and obstructing lesions of the antrum and pylorus are also common contributing factors. A case report and an extensive review of the literature are presented. PMID- 6507414 TI - Gastroenterology and the law. PMID- 6507415 TI - The case for surgical training in gastrointestinal endoscopy. PMID- 6507416 TI - Placebo-controlled clinical trials in gastroenterology. A position paper of the American College of Gastroenterology. AB - Treatment programs for digestive diseases should be evaluated by randomized clinical trials. Under most circumstances, the best design for such trials requires placebo controls. For example, clinical trials should include groups of placebo-treated patients when there is no commonly accepted standard patients when there is no commonly accepted standard therapy for the disease under study, when standard therapy is of doubtful efficacy, or when standard therapy is unacceptably toxic. Moreover, illnesses--including peptic ulcer and IBD--may have sufficiently high response rates to placebo therapy as to favor placebo controlled study designs. Placebo treatment is also free of substantial risk, at least compared to active drug treatment, when the disease process is very mild or when the study period is very short. Acceptable alternatives to placebo control include direct comparisons of new agents to standard therapy and addition of either new agents or placebo to a continuing baseline of standard therapy. Similarly, both placebo and active-treatment groups can sometimes be permitted access to standard therapy on a p.r.n. basis, with utilization thereof serving as one of the criteria of therapeutic response. Placebo-controlled trials are therefore generally feasible and desirable methods for testing the safety and efficacy of various proposed treatments for gastrointestinal diseases. High ethical standards in clinical medicine depend on high scientific standards in clinical research. PMID- 6507417 TI - The esophagogastric polyp-fold complex. AB - A polyp-fold complex at the gastroesophageal junction is a rare finding. We made this diagnosis in a 51-year-old man who presented with abdominal discomfort after an episode of protracted vomiting. The esophagogastric polyp-fold complex is not always associated with reflux esophagitis, as was originally proposed. PMID- 6507418 TI - Long-term results of surgical treatment for alkaline reflux gastritis in gastrectomized patients. AB - Sixteen gastrectomized patients underwent surgical treatment for alkaline reflux gastritis by means of a Roux-en-Y loop duodenal diversion. Long-term evaluation of results was performed 5-9 years later. Ten patients (62.5%) showed good results, with absence of digestive symptoms and with an increase in body weight. Two patients (12.5%) had moderate results, with presence of sporadic and mild epigastric pain. Four patients (25%) had unsatisfactory results, with persistence of epigastric pain and absence of body weight increase. No patient had recurrent biliary vomiting or endoscopic evidence of endogastric biliary reflux. Among the six patients with moderate and unsatisfactory results, two had a significant alcoholic intake, two showed a high degree of anxiety on psychological assessment, and two had both factors. Alcoholism and psychological disturbances should be considered exclusion criteria when evaluating a gastrectomized patient for surgical cure of alkaline reflux gastritis. PMID- 6507419 TI - Duodenal schistosomiasis diagnosed by endoscopic biopsy of an isolated polyp. PMID- 6507420 TI - Delayed perforation of the cecum after diagnostic biopsy. AB - Colonoscopy is an important diagnostic study in monitoring patients with chronic ulcerative colitis for carcinoma and dysplasia (precancer). A 76-year-old woman with chronic ulcerative colitis of 13 years' duration underwent colonoscopy. Biopsies were obtained at 10-cm intervals throughout the entire colon. A delayed perforation of the cecum was diagnosed 48 h after the diagnostic study. This necessitated a subtotal colectomy. It is suggested that in such patients cecal biopsies should be obtained with extreme caution because of the relative increase in intraluminal pressures and the relative thinness of the cecal wall. PMID- 6507421 TI - Mechanism for the abnormal liver scan in acute alcoholic liver injury. AB - The mechanism of liver scan abnormality was investigated in patients with acute alcoholic liver injury evaluated shortly after admission (18 patients) with repeat examination 1 month later (14 patients). Indocyanine green (ICG) and Tc99 sulfur colloid extraction ratios (ERICG and ERSC), elimination rate constants (KICG and KSC), total body clearance (TBCICG and TBCSC), and hepatic clearance of sulfur colloid (HCSC) were determined from sequential blood samples obtained at the time of hepatic vein catheterization after the intravenous injection of ICG and Tc99 sulfur colloid. Liver size and sulfur colloid redistribution expressed as a scan score (SS) and redistribution ratio (RR) were assessed from an external scan immediately after the procedure. Improvement in hepatic tests and function was noted between the first and second study. At both the first and second study, the SS (or RR) correlated with the hepatic removal of sulfur colloid (ERSC; r = 0.59; p less than 0.001; HCSC: r = -0.56; p = 0.003) and ICG (ERICG: r = -0.85; p less than 0.001; KICG: r = -0.83; p less than 0.001). ERSC correlated with ERICG (r = 0.76; p less than 0.007) and both correlated with SS and RR consistent with intrahepatic shunting as the mechanism of decreased hepatic clearance and of sulfur colloid redistribution. However, the systemic clearance of sulfur colloid (KSC) did not correlate with redistribution (SS: r = -0.25; NS) at either study period or to ICG clearance (r = 0.23; p = NS) in the first period. The KSC/KICG ratio in both study periods correlated with serum bilirubin (r = 0.83; p less than 0.001 and r = 0.73; p less than 0.001), but was significantly higher in the first period (3.37 +/- 2.37 versus 2.00 +/- 0.75; p less than 0.01). This lack of correlation between intrahepatic shunting and systemic clearance of sulfur colloid is consistent with an increase in the nonhepatic clearance of sulfur colloid in patients with alcoholic liver injury and deep jaundice. A decrease in liver size between the first and second study correlated inversely with change in portal pressure (r = -0.67; p = 0.004) and SS (r = -0.49; p = 0.038) and directly with change in KICG (r = 0.48; p = 0.04). By virtue of these relationships, redistribution of Tc99 sulfur colloid by liver scan may have prognostic significance in patients with alcoholic liver disease. PMID- 6507422 TI - Gastric lipomas--an update of clinical presentation, diagnosis, and treatment. AB - Although gastric lipomas, an extremely rare tumor, were once found mostly during autopsy studies and laparotomy for upper intestinal hemorrhages and obstruction, we are now able to diagnose these masses with CT scanners and gastrointestinal endoscopy. Surgery is now necessary only under certain circumstances. We present two cases of gastric lipomas with different clinical presentations, both diagnosed preoperatively. PMID- 6507423 TI - Esophageal chest pain. PMID- 6507424 TI - Gastroenterology and the law. PMID- 6507425 TI - Seven-day activity and self-report compared to a direct measure of physical activity. AB - To determine how well a seven-day interview-administered activity recall used in a large epidemiologic study at Stanford University reflected seven days of self reported activity and directly measured physical activity, 30 white males, mean age 52 years, recorded daily physical activity for a week, and half of these wore an ambulatory solid-state minicomputer (Vitalog) which measures continuous heart rate and motion. Total hours of moderate, hard, and hard plus very hard activity were not significantly different for weekdays and weekends for self-report and recall and were significantly correlated. Total energy expenditure for subjects wearing the Vitalog averaged 38.5 +/- 6.7 kcal/kg/day compared to an average of 37.7 +/- 4.5 kcal/kg/day for recall or 39.6 +/- 7.2 kcal/kg/day for self-report. Conditioning activities are best remembered followed by home or leisure and job activities. Mean hours of sleep per week night were significantly greater reported by self-report than reported by recall, but the two were significantly correlated. It is concluded that a seven-day activity recall accurately reflects mean kcal/day expenditure, with conditioning activities being the best recalled. A self-report log used in conjunction with an interview-based seven-day recall might maximize accuracy of recall. PMID- 6507426 TI - Sex difference in the effects of sociocultural status on diabetes and cardiovascular risk factors in Mexican Americans. The San Antonio Heart Study. AB - The authors postulated that as Mexican Americans became more affluent and/or acculturated to "mainstream" United States life-style they would progressively lose their "obesity-related" pattern of cardiovascular risk factors which were defined as: obesity, diabetes, hypertriglyceridemia and low levels of high density lipoprotein cholesterol. This hypothesis was tested in 1979-1982 in the San Antonio Heart Study, a population-based study on 1,288 Mexican Americans and 929 Anglos living in three San Antonio neighborhoods: a low-income barrio, a middle-income transitional neighborhood, and a high-income suburb. The study population comprised 25-65-year-old men and nonpregnant women. In Mexican American women, all of the "obesity-related" risk factors fell sharply with rising socioeconomic status. In Mexican American men, by contrast, diabetes was the only "obesity-related" risk factor which fell with rising socioeconomic status. Moreover, it fell less steeply, there being an approximately twofold difference in diabetes prevalence between the barrio and the suburbs in men compared to a fourfold difference in women. Also, total and low density lipoprotein cholesterol rose with rising socioeconomic status in Mexican American men, but not in Mexican American women. "Obesity-related" risk factors were generally higher in Mexican Americans of both sexes than in their Anglo neighbors who were of similar socioeconomic status. These results suggest that cultural factors exert a stronger influence on diabetes and cardiovascular risk factors in Mexican Americans than do purely socioeconomic factors. PMID- 6507427 TI - Case-control study of risk factors associated with isolation of Salmonella saintpaul in hospitalized horses. AB - In an investigation of a 1981-1982 outbreak of nosocomial Salmonella saintpaul infection in hospitalized horses at the University of California Veterinary Medical Teaching Hospital in Davis, California, a case-control study was performed using data gathered from the records of 33 cases and 132 controls. Multiple logistic regression risk analysis was used to identify factors associated with isolation of the organism, controlling for the effects of other, possibly confounding variables. Horses receiving parenteral antibiotics were at 10.9 times greater risk of having S. saintpaul isolated than were horses not receiving parenteral antibiotics. Horses intubated with nasogastric tubes were 3.9 times more likely to have had the organism isolated from fecal specimens than horses not intubated, and horses with a presenting complaint of colic were at 2.2 times greater risk of isolation than horses with other presenting complaints. PMID- 6507428 TI - Retrospective assessment of dietary intake. AB - In studying the role of diet in chronic disease etiology, measurement of past intake may be of more relevance than measurement of that existing either at the time of or just preceding the clinical onset of disease. In 1983, in metropolitan Adelaide, South Australia, estimates of current and previous dietary intake were obtained, by use of a semiquantitative food frequency questionnaire, from 70 individuals (37 male, 33 female), from each of whom an estimate of intake, using the same questionnaire, had been obtained three years earlier. Over this three year period, median nutrient and energy intake had declined. In relative, if not absolute terms, individuals were able to make satisfactory retrospective estimates of original nutrient and energy intake; however, their retrospective estimates appeared to have been influenced by their current intakes. Nevertheless, the strong correlations observed between retrospective and original estimates of intake suggest that the semiquantitative food frequency method of retrospective dietary assessment allows a reliable relative ranking of individuals by nutrient intake within a population. PMID- 6507429 TI - Dietary measures of physical activity. AB - The relationships between cardiovascular fitness, body fatness, and the number of calories required to maintain stable body weight over a baseline period of three weeks were studied in 21 healthy obese males aged 20-44 years who participated in a controlled feeding experiment at the Division of Epidemiology (formerly the Laboratory of Physiological Hygiene) of the School of Public Health, University of Minnesota, in August 1980-June 1981. statistically significant relationships were found between the number of calories actually consumed per kg of body weight (kcal/kg) and body fatness (r = -0.79, p = 0.001), and number of calories consumer per kg of body weight and physical work capacity (VO2 max) (r = 0.76, p = 0.001). Using body fatness quartiles, the caloric intake per kg of body weight and VO2 max decreased progressively as body fatness increased through its four quartiles. These relationships were also seen when reported caloric intake from a three-day food record was used; however, the magnitude was attenuated. On the other hand, caloric intake unadjusted for body weight, whether actual or reported, was unrelated to both body fatness and VO2 max. To determine whether these relationships hold true for less obese subjects, the authors have also analyzed and compared their results with the data from previously reported feeding experiments done at the University of Minnesota. Correlations between body fat indices and actual caloric intake were similar for both studies. Therefore, the authors conclude that in these relatively young, healthy, and sedentary males with a wide range of body fatness and body weight, the observed relationships between caloric intake adjusted for body weight, body fatness and VO2 max reflect habitual physical activity. These data confirm epidemiologic observations of an inverse relationship between caloric intake per kg of body weight and body fatness, and provide a rationale for using caloric intake adjusted for body weight as a measure of long-term habitual physical activity. Thus, these data bolster the interpretation that an inverse relationship between caloric intake per kg of body weight and mortality reflects a positive health effect of long-term physical activity. This index may be particularly useful in large population studies. PMID- 6507430 TI - Use of the mental function index in older adults. Reliability, validity, and measurement of change over time. AB - The Mental Function Index is a weighted combination of scores on three brief tests. The Index was developed to aid in the discrimination of elderly persons with early cases of senile dementia from nondemented elderly individuals. In a previous report (Am J Epidemiol 1981;114:515-27), the authors described preliminary results with the Index in 195 elderly persons in a southern California retirement community. The present study seeks to assess whether similar results can be achieved in samples other than that from which the discriminant function defining the Index was derived. Seven separate studies were done on a total of 210 persons, comprising subjects recruited from a teaching hospital which serves a predominantly lower to lower-middle class population, referrals from the same physicians as in the earlier study, and (for the reliability sample) persons from the upper-middle class community which was the major referral source. It was found that scores on the brief measures correlate 0.86 with those on the three Halstead-Reitan subtests most sensitive to brain damage and to aging. The Index provides a graded measure of disease severity comparable to global neurologic assessment (r = -0.84) and level of social function (r = 0.76). Entry Index is a crude predictor of cognitive status in older adults after several years. Changes in the Index over time parallel those in independent measures of change. The results suggest that the Index will be useful for assessment of disease severity and of longitudinal change, as well as for diagnostic screening, in population studies of senile dementia. PMID- 6507431 TI - Epidemiologic modeling using a microcomputer spreadsheet package. AB - Epidemiologic modeling has provided both researchers and students with a means of studying complex disease processes as well as making intervention recommendations to decision makers. To develop more than the most elementary model, however, it has become necessary to be well versed in a computer programming language. While this has deterred many modelers in the past, with microcomputers it is now possible to develop even complex models without significant investment of time spent in learning a computer language. In addition to being affordable, many microcomputers offer "canned" spreadsheet packages which are readily adapted for epidemiologic modeling. To demonstrate this, two models were developed and run using a microcomputer spreadsheet package: 1) the classic Reed-Frost model, and 2) a modified Reed-Frost model with two intermixing subpopulations. PMID- 6507433 TI - Incidence estimates of retinopathy in Nauruan diabetics. PMID- 6507432 TI - Woodstoves, formaldehyde, and respiratory disease. AB - Telephone interviews were completed in Western Massachusetts in April 1983 for 399 households (91.5 per cent) in a random sample of households with elementary school children. Woodstoves were used in 64.7 per cent of the homes, but such use was not associated with acute respiratory illness. However, formaldehyde exposure was significantly related, with a risk ratio of 2.4 (95 per cent confidence interval 1.7-3.4). New construction/remodeling and new upholstered furniture had additive effects. Neither woodstove use nor formaldehyde exposure were significantly associated with asthma, chronic bronchitis, or allergies. PMID- 6507435 TI - Diffusion of innovation: computer technology in hospital pharmacy. AB - The diffusion of computer technology in hospital pharmacy departments was studied by surveying pharmacy directors in a randomly selected sample of 501 hospitals in the United States with at least 100 beds. Pharmacy directors were asked to indicate for which of 17 tasks a computer or memory typewriter was used in the pharmacy department. The time of first adopting computers in the department was compared with the predicted S adoption curve; adoption time was also correlated with characteristics of the hospital, pharmacy, and pharmacy director. Of the 417 respondents, 308 reported use of a memory typewriter or computer in the pharmacy. Fifty-one directors reported only memory-typewriter use, and 94 reported both computer and memory-typewriter use. Maintenance of patient census lists and patient billing were the most frequent uses of computers. The primary uses of memory typewriters were preparation of letters and labels. There was no significant difference in the actual and predicted S curves for time of adoption of computers. The number of months since first adopting computers was positively correlated with hospital bed size and the pharmacy director's number of years as a pharmacist, years in current position and with current employer, and number of subordinates; it was also positively correlated with number of pharmaceutical services and number of computer uses in the department. Computer technology is becoming more universally accepted in hospital pharmacy, and research on the diffusion of innovations suggests that acceptance will continue to increase. PMID- 6507434 TI - Comprehensive pharmaceutical services in a medical intensive-care unit. AB - The clinical and distributive services that have been provided by clinical pharmacists for the past 14 years in the medical intensive care unit (MICU) of a 1600-bed urban teaching hospital are described. The MICU pharmacy staff consists of 4.3 full-time equivalent pharmacists who provide daily 24-hour services. The pharmacists are actively involved in all pharmacological decisions with hands-on control of drug distribution from preparation through delivery and administration. They maintain up-to-date patient medication records and monitoring flow sheets for each patients. The pharmacists identify adverse reactions, formulate contingency plans, and promptly intervene to prevent crises. They provide comprehensive pharmacokinetic services, select drug administration times and routes, and prepare and deliver all medications. All i.v. medications are custom-made to meet the patients' fluid, sodium, or potassium restrictions. The pharmacists set up infusion pumps and select the proper infusion rates for i.v. and intra-arterial drugs. They also recommend and monitor the patients' nutritional support therapy. The program has been well accepted by nurses and physicians; however, only 20% of the inpatient clinical pharmacists desire to work in the MICU. The skills and educational requirements for managing patients in an MICU are discussed. Pharmacists have become an integral part of this MICU by optimal drug therapy, increasing productivity and efficiency, providing prompt and accurate services, and participating in research. PMID- 6507437 TI - Cephalosporin-use restrictions in teaching hospitals. AB - A survey of pharmacy directors in teaching hospitals was conducted in March 1983 to ascertain policies for management of cephalosporin use. Surveys were sent to 298 institutions in each of the United States except Alaska. Respondents were asked various questions regarding hospital policies on cephalosporin use. Responses were received from 179 hospitals that had formularies; 99 of these had formal restriction policies, more frequently for second- and third-generation agents than for first-generation agents, and 13 planned to institute restriction policies. In 68% of hospitals with restriction policies, restricted drugs were released only after consultation with the infectious disease service. Chart review was the most frequently reported method of monitoring use of restricted cephalosporins. Approximately 40% of respondents had therapeutic equivalence policies, and more than 40% had recently deleted one or more cephalosporins from the formulary. The percentage of hospitals with formal restriction policies (55%) was greater than in a 1979 survey (32%). Many teaching hospitals have initiated policies to curb rising drug costs associated with the use of cephalosporin antibiotics. PMID- 6507436 TI - Cost analysis of an aminoglycoside pharmacokinetic dosing program. AB - A two-year retrospective study was conducted on the effects on hospital costs and charges of a pharmacy-based pharmacokinetic consultation service for aminoglycosides. In a 185-bed, acute-care hospital, the pharmacy department provided a pharmacokinetic consultation service for all patients for whom serum aminoglycoside assays were ordered by the physician. Patient charges and hospital costs were determined for the 98 patients for whom, over a two-year period, pharmacokinetic consultations were performed. The effects of service were measured in terms of changes in costs and charges for drug products and supplies, changes in personnel costs based on altered dosing intervals, and laboratory costs and charges. Because many of the patients in the study were elderly, the kinetics service was able to increase the dosing interval for 45 patients. This produced reduced patient charges for drug products of $6284.55 for the 98 patients. Drug-assay charges were $9734.20 for these patients, but much of this cost would have been incurred without the kinetic service. Overall, the kinetic service reduced the hospital costs $563.28. Drug-charge savings to the patient and hospital costs were reduced by this pharmacy-based pharmacokinetic consultation service. PMID- 6507438 TI - Administrative reports for monitoring pharmacy purchasing. AB - The use of administrative reports in a hospital pharmacy department to monitor communication regarding drug supply problems and to assist pharmacy administration in assessing the performance of its purchasing area is described. The weekly drug supply problems report was developed as a method to communicate problems in the storeroom to other pharmacy areas. The weekly borrow and loan report, which accounts for all borrow and loan transactions, helps determine the proper reorder quantities of drug products borrowed frequently and monitors repayment for loaned items. The inventory assessment report is prepared annually; in this report, drug expenditures for a "market-basket" list of drug products are compared for the current and previous years. To assess the use of nonformulary drugs, a quarterly report of expenditures for nonformulary drugs is compiled. The purchasing pharmacist, who is responsible for inventory control, prepares these reports. When considered in relation to the budget and workload statistics, the reports can be used to assess the performance of the purchasing area. Increased accountability and more orderly operation of the purchasing area has accompanied the use of these reports. PMID- 6507439 TI - Behaviorally anchored ranking scale versus letters of recommendation for evaluating residency candidates. AB - A behavioral scale and traditional letters of recommendation were compared as tools for evaluating applicants for a hospital pharmacy residency program. In designing the behaviorally anchored ranking scale (BARS), a list of desirable characteristics of hospital pharmacy residents was compiled and descriptions were written of effective, average, and ineffective performance for these characteristics. Twelve characteristics in three categories (professionalism, special skills, and character attributes) were used. Each person who had written a letter of recommendation for the 1983-84 hospital pharmacy residency program at the University of Texas Medical Branch in Galveston was also asked to complete a BARS form. Pharmacy administrators involved in the resident-selection process used the BARS criteria to evaluate all letters of recommendation; responses on the BARS forms were then analyzed. For 18 applicants, 46 letters of recommendation and 39 BARS forms were completed. Many of the BARS characteristics were not addressed in letters of recommendation. None of the letters commented on leadership quality. Ability to work with others was the BARS characteristic most often mentioned in the letters (58.7%). Of characteristics that were mentioned in both the letters and the BARS, 82.4% were ranked equally in both. Of all the letters and scales, 59% were not in agreement with each other. The BARS provided a clearer picture of the characteristics and qualities of a hospital pharmacy residency candidate than did the letters of recommendation. PMID- 6507440 TI - Performance-based pharmacy internship program. AB - A structured training program based on behavioral objectives was developed for interns in a hospital pharmacy department. In an 831-bed hospital that employs eight pharmacy interns, each for an average of less than or equal to 20 hours per week, a program was developed to ensure (1) that interns have experience working in all service areas and (2) that staff pharmacists are consistent in the tasks they assign to interns. Interns worked with area supervisors and the internship coordinator to develop 23 learning objectives that covered 10 pharmaceutical service areas. A manual listing the objectives is used by interns to document their progress and by pharmacists to ensure uniform experience for all interns. All staff pharmacists work with interns and participate in their evaluations. This program using behavioral objectives provides interns with basic experience in all areas of hospital pharmacy operations. PMID- 6507441 TI - Quantitative measurements of inventory control. AB - The use of quantitative measurements for improving inventory management efficiency in hospital pharmacy is reviewed. Proper management of the pharmacy inventory affects the financial operation of the entire hospital. Problems associated with maintaining inadequate or excessive inventory investment are discussed, and the use of inventory valuation and turnover rate for assessing inventory control efficiency is described. Frequency of order placement has an important effect on inventory turnover, carrying costs, and ordering costs. Use of the ABC system of inventory classification for identifying products constituting the majority of inventory dollar investment is outlined, and the economic order value concept is explained. With increasing regulations aimed at controlling hospital costs, pharmacy managers must seek every possible means to improve efficiency. Reducing the amount of money obligated to inventory can substantially improve the financial position of the hospital without requiring a reduction in personnel or quality of service. PMID- 6507442 TI - The pharmacy computer system at The Ohio State University hospitals. AB - The pharmacy computer system designed, developed, and implemented at The Ohio State University Hospitals is described. The computer system was developed to make more efficient use of hospital facilities and professional staff time. The pharmacy system operates on the mainframe hospital system using computer terminals with light-pen and keyboard access. Current online applications include order entry, patient profiles, pharmacokinetic calculations, and preparation of unit dose cart fill lists. Batch processing functions include drug-use review, drug-drug interactions, and financial management reports. Approximately 95% of unit dose orders and 20% of i.v. orders are conditionally entered by pharmacy technicians for subsequent verification by pharmacists. The system saves considerable staff time in the i.v. admixture and billing areas and has relieved pharmacists from performing many clerical and repetitive tasks. Disadvantages of the system include (1) its dependence on another department for patient admission, transfer, and discharge information and (2) delays in obtaining approval for program modifications and new applications. The advantages of the pharmacy computer system lie in its ability to access information from other computerized databases in the hospital. Future modifications and enhancements to the system are discussed. PMID- 6507444 TI - Literature filing system for hospital pharmacy practice. PMID- 6507443 TI - Pharmacist financial compensation from 1979 to 1982. PMID- 6507445 TI - Effectiveness of a computer-supported refill reminder system. PMID- 6507446 TI - Effect of infusion pump fill-stroke flow interruptions on simulated serum concentrations of short half-life drugs. PMID- 6507447 TI - Antineoplastic drug information and handling guidelines for office-based physicians. PMID- 6507448 TI - Knowledge of nurses and respiratory therapists about using canister nebulizers. PMID- 6507450 TI - Pharmacist in paradise. PMID- 6507449 TI - Stability of citrated caffeine solutions for injectable and enteral use. PMID- 6507451 TI - Management of the ulcer patient. Therapeutic advances. PMID- 6507452 TI - Approaches to the long-term treatment of duodenal ulcer disease. AB - Determining a course of long-term management for the patient with peptic ulcer disease requires an assessment of the severity of the disease, prior ulcer history (including complications, therapeutic intervention, and response to treatment), the predictors of the disease course, the degree of disability, and the available therapy (pharmacologic or surgical). A consideration of the predictors of the disease course that have been previously identified as useful in ulcer clinical trials (sex, age, acid secretory response, serum pepsinogen concentration, cigarette usage) and of ulcer-related disability (nutritional, emotional, job status) provides objective criteria to be entered into the long term management decision. PMID- 6507453 TI - Drug interactions: theory versus practice. AB - Cimetidine inhibition of P-450 oxidative metabolism results in interactions with many drugs, leading to clinically significant drug toxicity. A one-year survey of inpatient prescribing practices revealed a 32.6 percent incidence of concomitant cimetidine and interacting drug use. Retrospective chart review showed statistically significant increased toxic drug plasma levels in patients receiving theophylline and cimetidine, and a strong trend to increased rates of drug toxicity in phenytoin-cimetidine treated patients. Ranitidine appears to be a superior choice in patients receiving drugs metabolized by P-450 oxidation. When cimetidine and known interacting drugs are prescribed together, more frequent assessment of blood levels of the affected drug will be required, increasing substantially the cost to patients. Drug interactions of clinical significance occurring due to altered absorption because of effects of H2 receptor antagonists on gastric secretion are reviewed. PMID- 6507454 TI - Research ethics at Tuskegee and Willowbrook. PMID- 6507455 TI - Reversible alteration of the visual evoked potential in hypothyroidism. AB - The pattern-shift evoked potential was measured in 19 hypothyroid patients before treatment, and after short- (one week) and long-term (12 to 24 weeks) thyroid hormone replacement therapy. Before treatment, nine patients had an abnormally prolonged visual evoked potential latency, more than 115 msec. After one week of therapy with 50 micrograms per day of L-triiodothyronine, the mean visual evoked potential latency for the entire group was unchanged, 114 +/- 8 to 114 +/- 7 msec. However, long-term therapy with 100 to 200 micrograms per day of L thyroxine significantly shortened the visual evoked potential latency to 105 +/- 1 msec (p less than 0.001). In eight of the nine patients with initially abnormal results, the visual evoked potential latency was completely restored to normal. The visual evoked potential amplitude was also significantly changed by long-term L-thyroxine, 4.8 +/- 0.7 to 9.0 +/- 1.0 microV (p less than 0.01). It is concluded that the visual evoked potential is reversibly altered in hypothyroidism. This neurophysiologic parameter permits quantitation of the effects of hypothyroidism on the central nervous system and the extent and rate of response to thyroid hormone replacement therapy. PMID- 6507456 TI - Carbon monoxide diffusing capacity as predictor of outcome in systemic sclerosis. AB - In order to determine the predictive value of lung function studies for subsequent prognosis in systemic sclerosis, 71 patients with systemic sclerosis were followed up for a mean of five years after pulmonary function testing. A carbon monoxide diffusing capacity less than or equal to 40 percent of the predicted reference value was associated with only a 9 percent five-year cumulative survival rate compared with a 75 percent cumulative five-year survival in patients with a carbon monoxide diffusing capacity greater than 40 percent of predicted. An obstructive ventilatory defect was also associated with increased mortality, and all six patients with obstruction and a diffusing capacity less than 70 percent of the predicted died during the study period. Male gender, independent of abnormalities of pulmonary function, was also associated with a poor prognosis. Although it is not clear whether a severely impaired diffusing capacity is indicative of interstitial pulmonary fibrosis or pulmonary vasculopathy or is a marker of generalized vascular disease, a severely depressed carbon monoxide diffusing capacity is an important predictor of mortality in patients with systemic sclerosis. PMID- 6507457 TI - Long-term antiarrhythmic therapy. Problem of low drug levels and patient noncompliance. AB - Maintenance of adequate serum blood levels is crucial to successful antiarrhythmic therapy. Serum levels of four antiarrhythmic agents (long-acting procainamide, quinidine sulfate, quinidine gluconate, and disopyramide) were determined in 98 consecutive ambulatory patients receiving long-term oral therapy. Medication dosages, dosing intervals, and time elapsed from last dosage until blood sampling were determined. Seventy-five patients (76.5 percent) had subtherapeutic blood levels (with mean levels less than 50 percent of the suggested minimum), and only 22 patients (22.5 percent) had therapeutic levels. Even among the 61 patients who claimed to have taken their medications within the six hours prior to blood sampling, 43 (70 percent) had subtherapeutic levels. These ratios held among all subgroups studied. Physicians should be aware of the high proportion of patients receiving long-term oral antiarrhythmic therapy with inadequate serum blood levels when planning therapeutic regimens. PMID- 6507458 TI - Phosphorus trichloride toxicity. Preliminary report. AB - A railroad accident in Somerville, Massachusetts, led to spillage of phosphorus trichloride liquid. Attempted clean-up with water led to the liberation of phosphorus trichloride, phosphoric acid, hydrochloric acid, and phosphorus oxides. Seventeen people exposed to this mixture were studied. Patients experienced eye irritation, lacrimination, nausea, vomiting, and dyspnea. Six patients had transient elevation of lactic dehydrogenase. Although all patients had normal chest roentgenographic findings, pulmonary function tests showed statistically significant decreases in vital capacity (p = 0.02), maximal breathing capacity (p = 0.02), forced expiratory volume in one second (p = 0.02), and maximal expiratory flow rate at 25 percent of vital capacity (p = 0.05) in those closest to the accident site. Further, patients exposed for less than one and a half hours had significantly greater maximal expiratory flow rates at 25 percent of vital capacity when compared with patients who had been exposed longer (p = 0.02). In seven patients, repeated pulmonary function tests one month later showed improvement, suggesting strongly that the acute effects may have been due to phosphorus trichloride toxicity. PMID- 6507459 TI - Serologic analysis of first-episode nonprimary genital herpes simplex virus infection. Presence of type 2 antibody in acute serum samples. AB - Acute serum samples from patients with nonprimary first-episode genital herpes were evaluated for the presence of type-specific antibody to herpes simplex virus type 1 and type 2. A standard microneutralization assay and western blot analysis, which identified the response to individual polypeptides of type 1 and type 2 herpes, were performed in both unadsorbed serum samples and serum samples adsorbed with either type 1 or type 2 antigens to remove cross-reacting antibodies. Of 24 serum samples examined, seven were found to contain only type 1 antibodies, 11 had type 2 antibodies alone, and six serum samples had both type 1 and type 2 antibodies. It is believed that a majority of the 17 patients whose acute serum samples already contained type 2 antibody were experiencing their first clinically apparent recurrence of a previous asymptomatic type 2 infection. Physicians should, therefore, acknowledge that patients with first-episode nonprimary herpes 2 infection may not have had a recent sexual contact with a herpes simplex virus-infected partner. PMID- 6507460 TI - Pneumococcal bacteremia at a medical/surgical hospital for adults between 1975 and 1980. AB - All 72 episodes of pneumococcal bacteremia from 1975 through 1980 at Montefiore Hospital, Pittsburgh, a medical/surgical hospital for adults, were reviewed. There were 10 to 14 episodes per year, accounting for 4 to 5 percent of all bacteremias; it was estimated that one episode occurred for every thousand patients discharged. Patients' ages ranged from 16 to 94 years (mean 61 years); 65 percent were male. There was an underlying disease in 87 percent of all patients, and 78 percent of the infections were community-acquired. Treatment with antimicrobial drugs was given to all but six patients. Overall mortality was 43 percent, but it was higher for asplenic patients (five of six died). In 44 percent of patients, one to four complications occurred. Outcome correlated with presence of coexisting disease (p less than 0.03), development of one or more complications (p less than 0.04), presence of asplenia (p = 0.04), and the type of antimicrobial treatment used (p less than 0.001; patients treated with penicillin alone fared better). Typing of isolates in the last two study years revealed that 67 percent of isolates were pneumococcal types present in 14-valent pneumococcal vaccine available at the time of the study. It is concluded that pneumococcal bacteremia occurs primarily in patients with underlying disease, and that pneumococcal vaccine should be offered to such patients. PMID- 6507461 TI - Ocular and pericardial involvement in Legionnaires' disease. AB - Legionnaires' disease can exhibit protean extrapulmonary manifestations. Pericardial involvement is rare and has been described in three case reports. A patient is described with Legionnaires' disease and pericardial and ocular involvement, an entity that has not been reported previously. This patient was successfully treated with intravenous erythromycin with resolution of his pericardial effusion and ophthalmologic findings. PMID- 6507462 TI - Cushing's disease associated with ovarian dysgenesis. AB - In a 29-year-old woman with ovarian dysgenesis and a Turner mosaic karyotype (45X0/47XXX), florid Cushing's disease developed and was cured by trans sphenoidal hypophysectomy. Reviewing the literature on pituitary involvement in Turner's syndrome reveals that this association may not have previously been reported. PMID- 6507463 TI - Successful thrombolytic therapy in two patients with renal vein thrombosis. AB - Thrombolytic therapy was administered to two patients with angiographically documented renal vein thrombosis. One patient with bilateral thrombotic disease complicating membranous glomerulonephritis was treated with systemic streptokinase; the second patient had unilateral renal vein thrombosis associated with chronic pyelonephritis and was treated with streptokinase and urokinase administered directly into the involved vessel. Lysis of all thrombus material was demonstrated by follow-up renal venography and was associated with a gratifying improvement of clinical well-being and laboratory function. These cases demonstrate the feasibility of dissolving renal vein thrombi of presumed recent onset and suggest that rapid lysis of the thrombus accelerates functional and clinical recovery. PMID- 6507464 TI - Cimetidine-methylprednisolone-theophylline metabolic interaction. AB - The pharmacokinetics of theophylline and methylprednisolone were examined before and during cimetidine treatment in an asthmatic woman who required long-term administration of these drugs. Cimetidine reduced theophylline plasma clearance by 30 percent, and measurement of urinary metabolites showed that 3 methylxanthine formation was inhibited more strongly than that of the methylated uric acid metabolites. Assessment of methylprednisolone disposition following oral and intravenous doses revealed no effect of cimetidine on the bioavailability (74 to 81 percent absorption) or plasma clearance (22 to 24 liters per hour) of the steroid. Thus, cimetidine exhibits variable and selective effects on the biotransformation pathways of drugs important in asthma therapy. PMID- 6507465 TI - Femoral osteonecrosis following soft tissue corticosteroid infiltration. AB - A case of osteonecrosis of the hip following an 18-year course of repeated soft tissue corticosteroid infiltration in a man with ill-defined musculoskeletal complaints is described. PMID- 6507466 TI - Intra-abdominal actinomycosis presenting with sulfur granules in the urine. AB - Intra-abdominal actinomycosis is rarely suspected and is difficult to diagnose. A 46-year-old woman with intra-abdominal actinomycosis is described in whom the condition was first suspected when sulfur granules were found in her urine. The infection had involved her bladder but not her kidneys. PMID- 6507467 TI - In quest of certainty. PMID- 6507468 TI - Modern correlates of Freudian psychology. Infant sexuality and the unconscious. PMID- 6507469 TI - Primary (AL) amyloidosis as a cause of breast masses. AB - Amyloidosis is rarely considered in the differential diagnosis of breast masses. During the past six years, 27 women with primary (24) and multiple myeloma associated (three) amyloidosis (AL amyloid) were evaluated at our center. In five of these patients, amyloid was demonstrated on microscopic examination of breast tissue. The clinical presentations were similar to fibrocystic breast disease in two cases and malignancy in two others. Amyloidosis of the breast may be more common than previously recognized, especially considering the predilection of amyloid for depositing around fat cells. Therefore, pathologic examination of nonmalignant breast tissue should include Congo red staining and viewing under polarized light. PMID- 6507470 TI - Effect of low calorie intake on abnormal pulmonary physiology in patients with chronic hypercapneic respiratory failure. AB - To explore the effects of low calorie, low carbohydrate intake on abnormal pulmonary physiology in chronic hypercapneic respiratory failure, spirometric, arterial blood gas tension, oximetric, and electrocardiographic studies were carried out before and after weight reduction in eight patients. During a single night of monitoring, the mean basal oxygen saturation was 68.4 +/- 20.7 percent with 38 hypoxemic "dips" (a fall in oxygen saturation of more than 10 percent for one minute or longer); six patients had resting tachycardia, four had a prolonged QTc interval, three showed multiple episodes of ST-T depression, and six patients had multiple atrial and ventricular premature contractions. After a low calorie (600 kcal per day) intake for 4.4 +/- 2.3 weeks, there was a mean weight loss of 8.5 +/- 3.6 kg, the mean arterial oxygen tension increased significantly (p less than 0.005) from 55.6 +/- 9.2 to 69.1 +/- 7.9 torr, the mean arterial carbon dioxide tension fell from 59.9 +/- 9.6 to 52.4 +/- 5.4 torr (p less than 0.01), the mean oxygen saturation increased significantly (p less than 0.05) to 85.0 +/- 9.0 percent with only two hypoxemic "dips," the resting heart rate decreased from a mean of 100 +/- 19 to 90 +/- 18 beats/per minute (p less than 0.05), there was a marked reduction in ectopic activity, the ST-T depression disappeared, and the QTc interval fell in two subjects. Follow-up data in four patients suggest that the improvements achieved in arterial blood gas values can be maintained with a low calorie intake. These studies show that a low calorie, low carbohydrate intake improves all the unfavorable physiologic abnormalities in chronic hypercapneic respiratory failure. PMID- 6507471 TI - Growth retardation, alopecia, pseudo-anodontia, and optic atrophy--the GAPO syndrome: report of a patient and review of the literature. AB - The GAPO syndrome is a rare but distinct autosomal-recessive disorder. The term GAPO is an acronym for the manifestations of Growth retardation. Alopecia, Pseudo anodontia (failure of tooth eruption), and progressive Optic atrophy. We are aware of five other published patients. All have a strikingly similar appearance. This, along with other distinct manifestations, should allow clear differentiation from other causes of growth retardation. The hypothesis of autosomal-recessive inheritance is based on parental consanguinity and affected sibs in several cases. PMID- 6507472 TI - GAPO syndrome: report of three affected brothers. AB - We present a sibship of three brothers affected with the GAPO syndrome. This is a rare and very characteristic autosomal-recessive trait whose main manifestations are growth retardation, alopecia, pseudo anodontia, and optic atrophy. So far nine affected individuals are known (4 males and 5 females). Two of them, the patient of Andersen and Pindborg cited in Tipton and Gorlin [1983] and one of the cases of Wajntal et al [1982], died at 39 and 37 years respectively. PMID- 6507473 TI - Macrocephaly with hamartomas: Bannayan-Zonana syndrome. AB - Familial macrocephaly with mesodermal hamartomas is described as a distinct syndrome in nine individuals from four families. Constant manifestations include symmetrical macrocephaly without ventricular enlargement, mild neurological dysfunction, and postnatal growth deceleration. Speech and motor delays observed in all the children were usually well compensated by adulthood. Two children had mild mental retardation and seizures which may have been related to intracerebral hemorrhage in one. Mesodermal hamartomas were present in affected persons from all four families, with 60% of individuals manifesting only discrete lipomas and hemangiomas. More serious tumors, including intracerebral hemangiomas, hemangiomatous involvement of the bone, and aggressive lipomas occurred in 40%. Other findings that make it possible to delineate a recognizable syndrome include down-slanting palpebral fissures (66%), a high palate (67%), joint hyperextensibility (55%), pectus excavatum (22%), strabismus or amblyopia (33%), and prolonged drooling (44%). The Bannayan-Zonana syndrome is an autosomal dominant trait with male predominance of affected individuals. PMID- 6507474 TI - Pseudoxanthoma elasticum: high calcium intake in early life correlates with severity. AB - The characteristic histopathologic lesion of pseudoxanthoma elasticum (PXE) is calcification of the central core of elastic fibers in affected organs; it is correlated with clinical severity. One hypothesis holds that lowering dietary calcium might reduce or prevent tissue injury and minimize clinical effects. This hypothesis would be supported by demonstrating that clinical expression is positively associated with previous calcium intake. We studied 32 unrelated PXE patients (20 men and 12 women, mean age 43 years, SE = 14.2, range = 13-71) by grading their clinical severity and their presumed calcium intake during childhood, adolescence, and adulthood. Overall severity in the study group varied greatly and correlated positively with age (P less than 0.001). Overall severity correlated positively with calcium ingestion as an adolescent (P less than 0.001, with the other predictor variables held constant). Overall cardiovascular and eye severity were a function of age (P less than 0.000001 for both), whereas skin severity was not. These results confirm that PXE is a highly variable condition that generally worsens with age and support the rationale for a clinical trial to determine the effects of different levels of dietary calcium ingestion in young PXE patients on their subsequent clinical course. PMID- 6507475 TI - Achondroplasia: unexpected familial recurrence. AB - We review six families in which recurrence of achondroplasia, inexplicable through autosomal dominant inheritance, has occurred. The clinical and radiographic characteristics of affected individuals in these families are identical to those usually seen in achondroplasia. Family histories and parental characteristics likewise seemed not to set this group apart from others with achondroplasia. While various mechanisms for these occurrences of achondroplasia in family members related through unaffected relatives can be postulated, the hypothesis that these recurrences were simply the result of two independent chance events cannot, at least for the moment, be excluded. PMID- 6507476 TI - "Unstable premutation" in achondroplasia: penetrance vs phenotrance. PMID- 6507477 TI - A "new" lethal multiple congenital anomaly syndrome: joint contractures, cerebellar hypoplasia, renal hypoplasia, urogenital anomalies, tongue cysts, shortness of limbs, eye abnormalities, defects of the heart, gallbladder agenesis, and ear malformations. AB - Three cases of a lethal malformation syndrome with severe visceral anomalies were seen in two families and include one pair of sibs. The predominating external manifestations are mesomelic dwarfism, micrognathia, V-shaped upper lip, microglossia, thick alveolar ridges, ambiguous genitalia, webbed neck, highly arched palate, clubfeet, fused fontanelles, inclusion cysts of the tongue, four finger creases, digital anomalies, apparently low-set ears, widely spaced nipples, and dislocated thighs and forearms. The internal findings include oligopapillary renal hypoplasia, severe congenital heart defect, cerebellar hypoplasia, pulmonary hypoplasia, hypoplastic larynx, and hypoplastic gallbladder. Other findings from the two autopsies and one clinical investigation not documented in all three patients include unilobar lungs, hydrocephalus, cataracts, microphthalmia, polydactyly, islet cell hyperplasia, suprapubic skin crease, urethral anomalies, and a decreased number of turns of the cochlea. The hypoplasia seen in the several affected organs is similar to the disordered development seen in experimental models of branching epithelial morphogenesis in which mesenchymal-epithelial interaction has been disrupted. PMID- 6507478 TI - Fibrochondrogenesis: lethal, autosomal recessive chondrodysplasia with distinctive cartilage histopathology. AB - Fibrochondrogenesis is a rare, neonatally lethal rhizomelic chondrodysplasia distinguished from other forms of lethal dwarfism by broad long-bone metaphyses, pear-shaped vertebral bodies, and by microscopic changes of cartilage with unique interwoven fibrous septa and fibroblastic dysplasia of chondrocytes. We report the second and third well-documented cases of this apparently autosomal recessive disorder and discuss the differential diagnosis. PMID- 6507479 TI - Fibrochondrogenesis: radiologic and histologic studies. AB - Fibrochondrogenesis is a distinct, neonatally lethal, short-limb skeletal dysplasia which was first described in a single patient in 1978. We report the radiographic and morphologic studies of 2 additional unrelated stillborn infants with fibrochondrogenesis. This syndrome has distinct radiographic and chondro osseous morphologic defects different from those seen in the other known skeletal dysplasias. The long bones are short and dumbbell-shaped with metaphyseal flare. The spine is platyspondylic with superior-inferior clefting defects, and the ribs are short and distally cupped. The growth-plate cartilage is grossly disorganized and has a densely fibrous collagenous matrix when examined by light and electron microscopy. Light, transmission, and scanning electron microscopy shows diaphyseal and metaphyseal trabecular bone to be normal. PMID- 6507480 TI - Effects of selection for serum cholesterol concentrations on serum lipid concentrations and body weight in baboons. AB - We examined the results of one generation of selection for serum cholesterol (SC) concentration on low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglyceride concentrations and weight in baboons (Papio cynocephalus). Parents of two lines (high SC response and low SC response) were chosen based on their SC response to a 4-month challenge with a cholesterol and saturated fat enriched diet. Parents of the control line were chosen without regard for SC levels. Expression of SC, LDL-C, and HDL-C concentrations was moderately influenced by additive genetic effects as evidenced by the direct and correlated responses of the serum lipoprotein concentrations of the juvenile offspring of the three lines. Realized heritability of SC and genetic correlations of SC with LDL-C and HDL-C were moderate to high. Sex and age were important factors influencing expression of SC, LDL-C, HDL-C, triglycerides, and weight in both adult baboons and their offspring. PMID- 6507482 TI - Prenatal diagnosis and fetal pathology of aspartylglucosaminuria. AB - The prenatal diagnosis of aspartylglucosaminuria (AGU), a lysosomal storage disorder of glycoprotein degradation, was made by demonstrating the deficiency of N-aspartylglucosaminidase on cultured cells from a midterm amniotic fluid sample. Four other amniotic fluid studies from at-risk pregnancies gave a normal or a heterozygote level of enzyme activity. These pregnancies have gone to term and the delivery of healthy babies. The pregnancy with the affected fetus was terminated and the prenatal diagnosis was verified by enzyme assays on cord blood lymphocytes, cultured cells from skin biopsy, and from placental villi. Electron microscopic evidence of lysosomal storage was seen in several organs of the fetus with the notable exception of the central nervous system. The undifferentiated mesenchymal fibroblasts particularly were heavily loaded with cytoplasmic inclusions in skin, liver, kidney, and placenta. PMID- 6507481 TI - A high frequency of structural chromosome abnormalities in a south central texas cytogenetics laboratory. AB - Abnormalities of chromosome number, such as the autosomal trisomies and sex chromosome aneuploidies, are considered to be sporadic events with low and constant recurrence risk across populations. On the other hand, abnormalities of chromosome structure can be generated by environmental agents and also transmitted in families and therefore may accumulate in certain populations. Evidence from several geographically diverse newborn infant screening studies and from clinical cytogenetics laboratories (including our own) supports the hypothesis that the frequency of structural abnormalities varies among populations, whereas the frequency of numerical abnormalities remains relatively constant among populations. The data from our laboratory, based on 1,201 patients over a 6-year period, suggest a two- to nearly fourfold higher frequency of structural defects over that of other populations (8.8% vs 4.2% and 2.5% of samples tested). Some of the problems associated with making comparisons among the published data sets are discussed, along with alternative explanations for the variability in the frequency of structural defects reported in different populations. PMID- 6507483 TI - Diagnostic definition of the FG syndrome. PMID- 6507484 TI - FG syndrome in a premature male. AB - A 30-week premature male infant is presented with dolichocephaly, frontal bossing, down-slanting palpebral fissures, hypertelorism, long philtrum, micrognathia, cleft palate, and imperforate anus. He is the fifth patient to be presented with FG syndrome and sensorineural deafness. The patient's syndromic manifestations became more obvious during an inpatient observation period of 3 months. PMID- 6507485 TI - Peculiar facial appearance, hydrocephalus, double-outlet right ventricle, genital anomalies and dense bones with lethal outcome. PMID- 6507486 TI - Homologous Robertsonian translocation. PMID- 6507487 TI - Additional case report of the DOOR syndrome. PMID- 6507488 TI - The relationship between uracil incorporation into DNA and the expression of fragile sites in human. PMID- 6507489 TI - Teratogenicity of anticonvulsant drugs. II: A prospective study. AB - To 468 women with epilepsy enrolled in the study, 171 children were born and evaluated prospectively. The mothers in this group were characterized by low socioeconomic status, high frequency of tonic-clonic generalized seizures, and use of combinations of anticonvulsants. Approximately 30% of infants exposed to diphenylhydantoin in utero had minor craniofacial and digital changes. The infants did not show an increased rate of growth retardation, mental retardation, or major malformations. It is suggested that the nature of the association of birth defects and maternal epilepsy is complex and that the teratogenicity of anticonvulsant drugs plays only a minor role in this association. The sample size necessary to demonstrate a two- to threefold increase in malformations is beyond the capability of a single center. PMID- 6507490 TI - Teratogenicity of anticonvulsant drugs. III: Radiographic hand analysis of children exposed in utero to diphenylhydantoin. AB - As part of a prospective study of the teratogenicity of anticonvulsant drugs, hand radiographs were obtained on 51 children born to epileptic mothers. The phalanges and metacarpals were measured and a diagnosis of distal digital hypoplasia (DDH) was made if the distal phalangeal to other digital bone ratio was more than 2 SD below the mean for age in at least two of the digits. By these criteria, roughly 30% of infants exposed to diphenylhydantoin in utero demonstrate DDH; this was in close agreement with the clinical diagnosis of DDH. The data suggest that there is no familial tendency to the expression of this teratogenicity, there is no sex influence, there is no difference between exposure to diphenylhydantoin alone and diphenylhydantoin in combination with other anticonvulsants, and that the digital changes occur most often in the absence of other sequelae of in utero exposure to diphenylhydantoin. PMID- 6507491 TI - Teratogenicity of anticonvulsant drugs. IV: The association of clefting and epilepsy. AB - Cleft lip with or without cleft palate (CL/P) is the most common congenital malformation reported among infants of epileptic mothers. This study sought to examine the relative roles of anticonvulsant teratogenicity and other factors responsible for this association. Among 175 families with a proband with isolated CL/P, there were 13 parents with epilepsy and a high frequency of other family members with CL/P and epilepsy. Evaluation of the 13 cases suggested that teratogenicity of anticonvulsant drugs was not the primary factor responsible for the observed association of maternal epilepsy and clefting. Among 140 families with a proband with clefting other than CL/P, there were no instances of parental epilepsy observed. PMID- 6507492 TI - Genetic background: the elusive component in the fetal hydantoin syndrome. PMID- 6507493 TI - Variable patterns of malformation in the mouse fetal hydantoin syndrome. AB - Controversy over the existence of a fetal hydantoin syndrome continues in medical literature despite numerous recent clinical studies describing additional patients with a characteristic pattern of abnormalities. Resistance to its acceptance as a clinical entity seems to stem from the variability of the component malformations seen in this syndrome. To examine this variability in a controlled experimental situation, we utilized data obtained in previously reported studies of a mouse model of the fetal hydantoin syndrome. In the mouse, prenatally exposed fetuses had congenital anomalies similar to those observed in the human syndrome. In terms of overall frequency of malformation there were no differences among three inbred mouse strains. However, when considering the individual rates of the 11 most common malformations, considerable differences were noted among the strains. These strain differences in the pattern of malformations appear to be related to genotypic differences in susceptibility to specific malformations. These results provide one possible explanation for the variability observed in the human fetal hydantoin syndrome. PMID- 6507495 TI - Geleophysic dysplasia. AB - On the basis of three affected sibs and one isolated case from the literature geleophysic dysplasia is defined as an acrofacial dysplasia with a peculiar, good natured facial appearance, short hands and feet due to short, plump tubular bones, small stature, and progressive valvular cardiac disease. It seems to be a hereditary disorder of glycoprotein metabolism with autosomal recessive transmission. PMID- 6507494 TI - Familial recurrence of geleophysic dysplasia. AB - We describe a girl with the manifestations of geleophysic dwarfism: small stature, a peculiar but pleasant and good-natured facial appearance, a dysostosis multiplex-like bone dysplasia affecting predominantly hands and feet, hepatomegaly and stenosis, and insufficiency of the aortic valve. The proposita's sister died of heart failure at 3 years and was reported by the mother to have been a tiny child with small hands. PMID- 6507497 TI - Direct intrachromosomal duplication of 16q and heritable fragile site fra (10) (q25) in the same patient. AB - We describe a woman with profound mental retardation and a direct duplication of 16q and fragile site fra(10)(q25). The identification and possible origin of the duplicated 16q is discussed along with the clinical manifestations. To our knowledge this is the first direct duplication of 16q to be reported. The karyotype is shown to be 46,XX, dir dup (16) (q11.2----q13). PMID- 6507496 TI - Acrofacial dysplasia resembling geleophysic dysplasia. AB - We report on a 12-year-old girl with acrofacial dysplasia, growth retardation, joint contractures, mitral valve incompetence and focal hepatic storage of material reacting histochemically as glycoprotein. The patient's phenotype resembles that of patients with geleophysic dysplasia but differs with respect to facial appearance, milder changes of hand bones and normal capital femoral epiphyses. It is undecided if her disorder is part of a wider phenotypic spectrum of geleophysic dysplasia or a different entity. PMID- 6507498 TI - Impact of PKU on the reproductive patterns in collaborative study families. AB - Factors that relate to reproductive patterns in 129 families after the birth of a child with phenylketonuria (PKU) include birth order of the index child, age of the parents at the birth of the index child, and expressed intentions of the parents whether or not to have additional children. Factors that do not correlate with reproductive histories include knowledge of the genetic and metabolic nature of PKU, the relationship of PKU to mental retardation and special diet, parental upset about the diagnosis, sex of the affected child, parental IQ, religion, education, and social class. Correlations found related to the question, "Is PKU the reason you don't want more children?" include stress factors in family functioning, mother's upset with the diagnosis, father's concerns about being a carrier, sex of the child with PKU, and degree of knowledge about PKU. Many of the Collaborative Study clinics tend to be more concerned about the consequences of PKU on the family than on society, and feel that families should receive genetic counseling to determine their reproductive risks and future plans. Upon self-report, many clinics declare their counseling to be either "completely nondirective" or making a "conscious effort to be nondirective." PMID- 6507499 TI - Linkage relationships between a major gene for catechol-o-methyltransferase activity and 25 polymorphic marker systems. AB - Segregation analysis has provided evidence suggesting the existence of a major gene for catechol-o-methyltransferase (COMT) activity in man. Five large families (4 Caucasian, 1 black), with a total of 1,189 individuals, were ascertained as part of a genetic study of blood pressure. Erythrocyte COMT activity and status at 25 polymorphic genetic marker loci were determined on more than 518 individuals in these pedigrees. Genetic linkage analysis of COMT with each of the 25 marker loci was performed in two ways: 1) using parameter estimates from segregation analysis of untransformed COMT activity, and 2) using parameter estimates from segregation analysis of the power transformation of the COMT activity that maximized the likelihood of the genetic hypothesis in each family. Tight and close linkage were excluded at 21 and 15 loci, respectively. A lod score of 1.27 at theta = 0.1 was found between the loci for COMT activity and phosphogluconate dehydrogenase (PGD). Transformation of the data had little effect on the outcome of the linkage analysis. PMID- 6507500 TI - Genetic causes of chronic musculoskeletal disease in childhood are common. AB - We surveyed admissions to a pediatric orthopedics hospital for calender years 1957 (polio era) and 1982 (post-polio era). The relative importance of genetic causes of musculoskeletal disease increased after poliomyelitis immunization became universal. Admissions for musculoskeletal disease with a genetic cause (chromosomal, Mendelian, multifactorial, and familial) accounted for 45% of the total in 1957 and 57% in 1982 (p less than 0.02); non-genetic causes were 44% in 1957 and 28% in 1982 (p less than 0.001). The high probability of recurrent disease in the families of these patients implies that genetics has an important place in the provision of services and in the education of staff in pediatric orthopedic hospitals. PMID- 6507501 TI - The split-hand and split-foot anomaly in a central African Negro population. AB - The split-hand and split-foot anomaly (ectrodactyly) was identified in five individuals of three generations of a kindred from a remote African Village; seven more were known to be affected in a further two generations. The malformations were confined to the hands and feet and inherited as an autosomal dominant trait with variable expression. Bilateral triphalangeal thumbs were present in three of the affected individuals. PMID- 6507502 TI - Clinical and biochemical characteristics of prolidase deficiency in siblings. AB - Two brothers with recurrent skin ulcers of the lower limbs, subnormal intelligence, developmental abnormalities, and poliosis were found to excrete large quantities of several imidodipeptides in their urine. Glycylproline was the most prominent imidodipeptide excreted and was also detected in their blood. Prolidase activity was markedly deficient in red blood cells from both patients (4.1% and 3.7% of control mean) and skin fibroblasts from the one brother so examined (3.7% of control mean). A total of 20 patients with prolidase deficiency, including the two in this report, have been described in the literature. Their manifestations and various attempts at treatment are reviewed. PMID- 6507503 TI - Genetic linkage analysis of epidermolysis bullosa simplex, Kobner type. AB - Genetic linkage relationships between a range of marker loci and the locus for epidermolysis bullosa simplex (EBS), Kobner type, were examined in a single kindred. A positive lod score of 1.2 at theta = 0.2 was found for Fy. To test the clinical observation that Kobner and Weber-Cockayne types may be the same disease determined by different alleles, published lod scores from definite Weber Cockayne families were added to those from this study. A lod score of 1.8 was found at theta = 0.2. This value falls to 1.5 at theta = 0.2 when all families other than Ogna type are included. The Kobner variant studied is not closely linked to GPT and is therefore distinct from EBS1 (Ogna type). Linkage analysis is consistent with an hypothesis that Kobner and Weber-Cockayne types are determined by a single locus; however, further evidence is needed before this locus can be designated EBS2 and assigned to chromosome 1. PMID- 6507504 TI - An autosomal recessive disorder with glomerular basement membrane abnormalities similar to those seen in the nail patella syndrome: report of a kindred. AB - We present a 9-year-old boy, the product of a consanguineous marriage, with proteinuria, edema, and microscopic hematuria with mild renal impairment since age 2 yr. Renal biopsy showed the histopathologic electron microscopic changes seen in hereditary osteo-onchyodysplasia (HOOD) [Hoyer et al, 1972; Bennet et al, 1973; DelPozo and Lapp 1970; Vernier et al, 1974; Morita et al, 1973] or "nail patella syndrome." Neither the patient nor his relatives had bone or nail abnormalities; however, 2 other sibs had died of complications of end-stage renal disease at age 6 and 9, leading us to suspect autosomal recessive inheritance of a severe nephropathy or glomerulodysplasia. PMID- 6507505 TI - Prune belly sequence associated with trisomy 13. PMID- 6507506 TI - Ehlers-Danlos syndrome IV due to a novel defect in type III procollagen. AB - Ehlers-Danlos syndrome type IV (EDS IV) is characterized by variable changes in the skin, arterial fragility, bowel perforation, minimal joint involvement, and either autosomal recessive or autosomal dominant inheritance. The unifying biochemical abnormality is a deficiency of type III collagen; all patients studied thus far have shown a defect in either synthesis or in secretion of type III procollagen. We report on an adolescent boy who inherited EDS IV from his father and who developed a spontaneous subclavian artery aneurysm. In vitro studies of collagen production in dermal fibroblasts showed normal amounts of pro alpha 1 (III) messenger RNA and synthesis and secretion of nearly equal amounts of normal and of structurally abnormal pro alpha 1 (III) monomers. This patient is biochemically distinct from previous cases of EDS IV and is likely heterozygous for a mutation that results in an aberrant type III procollagen that is particularly susceptible to protease degradation. PMID- 6507507 TI - Self-monitoring of blood glucose by diabetic women during the third trimester of pregnancy. AB - The clinical value of self-monitoring blood glucose in diabetic pregnancy at home was compared with hospital care in the thirty-second to thirty-sixth week of pregnancy in a prospective randomized study including 100 pregnancies in 97 patients (White's class B, 38; C, 25; D, 28; and F, 9) of which 54 were in the home group and 46 in the hospital group. The duration of pregnancy was not significantly different in two treatment groups, with a median duration of 266.0 days in the home group and 266.5 days in the hospital group. The mean blood glucose values during the study period were 5.9 mmol/L in the home group and 6.0 mmol/L in the hospital group, thus there were no significant group differences. There were no significant group differences in pregnancy complications; however, 10 of 54 (19%) had to interrupt home-monitoring because of pregnancy complications. The perinatal morbidity was not significantly different in the two treatment groups, with the following percentages of complications in the combined series: 4% idiopathic respiratory distress syndrome, 7% transient tachypnea, 2% symptomatic hypoglycemia, 16% hyperbilirubinemia, 22% feeding problems, and 10% erythrocytosis. PMID- 6507509 TI - Effects of diuretics on plasma volume in pregnancies with long-term hypertension. AB - The purpose of this randomized, prospective study was to investigate the effects of diuretics on plasma volume findings and perinatal outcome in pregnancies complicated by mild long-term hypertension. Twenty patients were in their first trimester and were receiving diuretics at time of entry to the study: Ten patients were allowed to continue their diuretic medication throughout pregnancy (diuretic group), whereas for the other 10 patients, diuretics were discontinued immediately. Plasma volume was serially measured throughout pregnancy with the use of the Evans blue dye-dilution technique. Initial plasma volume was similar in the two groups. However, in the diuretic group, subsequent plasma volume findings at various stages of gestation were markedly reduced when compared to respective plasma volume findings in the other group. In addition, plasma volume expansion was minimal in the diuretic group (mean increase of 18%), whereas it was normal in the other group (mean increase of 52%). Two patients in the diuretic group and one patient in the other group required other antihypertensive medication. There was no difference in perinatal outcome between the two groups. These results suggest that in hypertensive pregnancies, diuretics prevent normal plasma volume expansion without influencing perinatal outcome. PMID- 6507508 TI - Perinatal and maternal mortality in a religious group avoiding obstetric care. AB - We investigated perinatal and maternal deaths occurring among women who were members of a religious group in Indiana; these women received no prenatal care and gave birth at home without trained attendants. Members of the religious group had a perinatal mortality rate three times higher and a maternal mortality rate about 100 times higher than the statewide rates. These findings suggest that, even in the United States, women who avoid obstetric care have a greatly increased risk of perinatal and maternal death. PMID- 6507510 TI - Regional distribution of cerebral blood flow in experimental intrauterine growth retardation. AB - The regional distribution of cerebral blood flow was assessed in eight control and eight morphometrically growth-retarded fetal lambs to determine whether perfusion patterns within the cerebral circulation are altered in this model of intrauterine growth retardation. Growth retardation was induced by repetitive embolization of the uterine circulation, and flow distribution was assessed by use of microspheres. Distribution to 22 separate areas, expressed as a flow/weight ratio, was virtually identical in the two groups. Cortical gray matter received 56% of total cerebral flow, and cortical white matter received 7%. However, flow X gm-1 in cortical white matter was 85% of that in cortical gray matter. We conclude that perfusion patterns within the cerebral circulation are not altered in this model of intrauterine growth retardation and that, compared to gray matter, cortical white matter has a high flow X gm-1 in fetal life. PMID- 6507511 TI - Use of indigo carmine for twin amniocentesis and its effect on bilirubin analysis. AB - Indigo carmine is used commonly to mark the first-entered amniotic sac in twin amniocenteses. The presence of this dye significantly affects amniotic fluid bilirubin analysis. A method of chloroform extraction is recommended for determination of bilirubin in amniotic fluid previously contaminated by indigo carmine. PMID- 6507512 TI - Cervical cancer occurrence in Memphis and Shelby County, Tennessee, during 25 years of its cervical cytology screening program. AB - This review of the cytologic history of 430 women with histologically proved invasive cancer of the uterine cervix indicates that several significant subgroups can be defined. One major subgroup consists of 142 patients or 33% of the total group in whom invasive cancer developed within 1 to 5 years, with an average of 2.6 years, after one or more negative cytologic findings. This appears to be a significant proportion of the occurrence of invasive cervical cancer and warrants consideration in the recommendation of screening intervals. The second major subgroup, consisting of 88 patients (20.5%), had a delay in diagnosis averaging 9.9 years after the first abnormal cytologic finding. In some of these patients either the cytologic examination results reverted to negative for a period or the biopsy material did not confirm the cytologic abnormalities. The disease progressed to invasion. These findings appear to bear out the importance of close follow-up of patients with any abnormal cytologic finding in the intraepithelial neoplasia category even though intermittent cytologic studies may appear negative. PMID- 6507513 TI - Cryosurgical treatment of cervical intraepithelial neoplasia: four-year experience. AB - Cryosurgical therapy was used to treat 393 patients with cervical intraepithelial neoplasia. Therapeutic success was evaluated in relation to lesion size, grade, and endocervical extension. The overall cure rate with cryosurgical therapy was 84%. Size alone was found to be the major determinant of cryosurgical success. For one-quadrant lesions, there was a 99% cure rate. For two-quadrant lesions, the cure rate was 93%. For three- or four-quadrant lesions, the success rate was only 61%. Lesion size was found to be positively correlated with grade of dysplasia. As the grade of cervical intraepithelial neoplasia progressed, lesion size tended to increase. When this association was controlled for, grade of dysplasia was not a significant determinant of success rate. When endocervical extension occurred, although the upper limits of the lesion were seen, there was a significantly reduced success rate of 64%. Patients with large lesions or endocervical extension are at a much higher risk for failure with cryosurgical treatment. If cryotherapy is chosen for these patients, careful, long-term follow up is essential to ensure adequate treatment of disease. PMID- 6507514 TI - Human uterine fluid, examined in undiluted samples for osmolarity and the concentrations of inorganic ions, albumin, glucose, and urea. AB - Human uterine fluid and serum, when analyzed, had the same osmolarity. Both the total cation concentration and that of albumin were lower in uterine fluid than in serum. Decreased cation concentration is probably a regulatory mechanism maintaining electroneutrality in uterine fluid when the protein concentration is decreased, since protein molecules have multiple negative charges. Compared with their serum values, concentrations of potassium were high, and those of sodium and calcium were low. Concentrations of potassium and calcium in uterine fluid were found to vary cyclically, both having lower values at midcycle than in the proliferative and luteal phases. The concentrations of chloride, urea, glucose, and fructose in uterine fluid did not differ significantly from those in serum. A possible influence of the ionic composition of uterine fluid on sperm migration at midcycle and on the implantation process in the luteal phase was also considered. PMID- 6507515 TI - Pharmacokinetic study of moxalactam in patients undergoing gynecologic operations. AB - Moxalactam was administered prior to operation to patients undergoing operation for a known or suspected gynecologic malignancy. Subsequent plasma and tissue levels demonstrated a prolonged duration of action and rapid concentration in pelvic organs after infusion. PMID- 6507516 TI - Severe erythroblastosis fetalis secondary to anti-Kpb sensitization. PMID- 6507517 TI - Cervical scleroderma: a case of soft tissue dystocia. PMID- 6507518 TI - Prenatal diagnosis and treatment of fetal thyrotoxicosis. PMID- 6507519 TI - Fetal resuscitation with terbutaline during eclampsia-induced uterine hypertonus. PMID- 6507520 TI - Clarification of institutional position on the generation of pelvic inflammatory disease. PMID- 6507521 TI - Neonatal mortality bias and antenatal transfers. PMID- 6507522 TI - Adjunctive technique for amniocentesis in the presence of oligohydramnios. PMID- 6507523 TI - Co-existing hydatidiform mole with a live fetus. PMID- 6507524 TI - Naproxen sodium for pain relief in first-trimester abortion. PMID- 6507525 TI - Placenta percreta associated with a second-trimester pregnancy termination. PMID- 6507526 TI - Investigation of obstructive jaundice by an ultra-thin-caliber endoscope: a new technique for potential use in pregnancy. PMID- 6507527 TI - Exstrophy of cloaca with omphalocele: two cases. PMID- 6507528 TI - Postconceptional induction of menses with double prostaglandin F2 alpha impact. PMID- 6507529 TI - Analysis of electronically pulsed versus quasi-continuous wave carbon dioxide lasers in an animal model. AB - In this study we sought to compare laser tissue interaction in both the quasi continuous waveform and electronically pulsed waveform of the carbon dioxide laser. An intramode analysis of the electronically pulsed form (at 350 and 650 pulses per second) was also undertaken. Intraperitoneal laser incisions were made on New Zealand white female virginal rabbits and tested at days 0, 5, 15, and 20. Testing involved proximal and midsection analysis of the laser sites to evaluate total area of vaporization, total area of tissue thermal damage, maximum diameter of injury at epithelial surface, maximum depth of laser penetration, angle of vaporization crater edges, and angle of tissue thermal injury of the three modes. Analysis of proximal versus midsection preparation revealed different zones of vaporization and injury within the same laser site. The zone of injury with respect to time was nonuniform, suggesting that the laser output in the electronically pulsed mode was not constant. An in vivo tissue lens phenomenon was also detected, resulting in a compound thermal vaporization and injury pattern. PMID- 6507530 TI - Long-term effects of labor and delivery on offspring: a matched-pair analysis. AB - An investigation was undertaken in an effort to learn whether the type of delivery or the pattern of labor progression has any lasting effect on the infant. Paired-data design was chosen to ensure that the comparisons between homogeneous groups would be valid. Our objective was to reduce potential bias based on unequal distribution of patient characteristics that might be more or less commonly associated with abnormal labors or with difficult deliveries. Seven year intelligence quotient data for matched pairs of cases showed significant long-range adverse impact from midforceps operations but not from low-forceps procedures. Comparable paired-data analysis for the effect of labor disorder on the infant verified a similar deleterious influence from both arrest and protraction patterns. PMID- 6507531 TI - Inadequate treatment of syphilis in pregnancy. AB - Pregnant women with untreated syphilis have high rates of adverse pregnancy outcome. Early syphilis in pregnancy, if not treated, results in 40% loss either by spontaneous abortions, stillbirth, or perinatal death. Another 40% of such pregnancies result in an infant born with congenital syphilis. Only 20% of such pregnancies result in a normal infant. Currently recommended treatment of early syphilis in pregnant women uses a dosage of 2.4 million U of benzathine penicillin G. Because of the potentially disastrous effect syphilis has on pregnancy outcome, the occurrence of any treatment failure must be considered seriously. In this brief report we present clinical summaries of four pregnant women treated for syphilis who represent probable treatment failures. PMID- 6507532 TI - Management of spontaneous rupture of the membranes in the absence of labor in primigravid women at term. AB - One hundred and thirty-five healthy primigravid women at or near term with spontaneous rupture of the membranes without uterine contractions were submitted to a prospective trial of management. Rupture of the membranes was diagnosed by speculum examination. If labor did not commence, induction was performed by oxytocin infusion starting at 9 AM following admission. One hundred and five women went into labor spontaneously before induction became necessary. Sixty three of these women required augmentation with oxytocin. Twenty-seven percent of the induced group required cesarean section delivery compared to 10% of those in spontaneous labor augmented by oxytocin and to none of those who did not require oxytocin (p less than 0.01). Ninety-four percent of those in spontaneous labor were delivered vaginally compared to 73% of the induced group (p less than 0.01). Forty-one percent of the augmented group were delivered by forceps. Awaiting the spontaneous onset of labor for 24 hours or less did not result in clinical maternal or neonatal infection. We would therefore advocate awaiting the spontaneous onset of labor after spontaneous rupture of membranes without contractions at or near term in healthy primigravid women for up to 24 hours because it seems to confer significant advantages without producing any additional hazard. PMID- 6507533 TI - Specific 5 alpha-dihydrotestosterone receptor and 5 alpha-reductase activity in human amniotic fluid cells. AB - A macromolecular component which specifically binds tritium-labeled dihydrotestosterone is present in cultured amniotic fluid cells. The androgen binding complex is characterized by a 3.6S sedimentation coefficient, an apparent dissociation constant of 1 nmol/L, a mean binding capacity of 243 +/- 140 fmol/mg of DNA, and a specificity for testosterone and dihydrotestosterone. Similar properties have been reported for the androgen receptor of the fetal genital skin fibroblast, which suggests that the tritium-labeled-dihydrotestosterone-binding component in amniotic fluid cells is the androgen receptor. Amniotic fluid cell monolayers incubated with serum-free medium containing testosterone are able to transform testosterone into dihydrotestosterone. The 5 alpha-reduced product has been characterized by thin-layer chromatography and capillary column gas-liquid chromatography. Androgen receptors and 5 alpha-reductase activity are expressed in amniotic fluid cells. The prenatal diagnosis of 5 alpha-reductase deficiency or complete androgen insensitivity syndrome (testicular feminization) is thus theoretically possible and obviously prenatal testing would be indicated in the family at high risk. PMID- 6507534 TI - Partial hydatidiform mole with diploid karyotype: report of three cases. AB - Recent studies suggest that a partial mole with a triploid karyotype has little tendency to invade and metastasize and usually requires no therapy other than evacuation. This report describes three patients with a mole of normal diploid karyotype coexisting with a living fetus. Each patient had persistent elevation of human chorionic gonadotropin. Two patients required chemotherapy; one of these had invasive mole. The partial mole with normal diploid karyotype is a distinct clinical entity with the potential for malignant sequelae. The possibility of twin gestation cannot be excluded. PMID- 6507535 TI - Management of preterm prematurely ruptured membranes: a retrospective comparison of observation versus use of steroids and timed delivery. AB - A retrospective study of 38 women with preterm prematurely ruptured membranes was performed. Twenty were treated with intravenous hydrocortisone followed by timed delivery between 48 and 72 hours after initiation of steroid therapy. Eighteen were managed expectantly, with observation for labor and infection. There were no significant differences between steroid-treated patients and observed patients in the incidence of neonatal respiratory distress syndrome, perinatal mortality, or maternal or neonatal infections. PMID- 6507536 TI - Fetal echocardiography. IV. M-mode assessment of ventricular size and contractility during the second and third trimesters of pregnancy in the normal fetus. AB - M-mode echocardiographic examination of the right and left ventricles was performed on 82 normal fetuses between 18 and 41 weeks of gestation. The diameter of the right and left ventricles correlated with the biparietal diameter. The right/left ratio of the ventricular diameters remained constant (1:1) throughout gestation. Fractional shortening and mean circumferential shortening of both ventricles were independent of gestational age. The data presented in this paper will allow the clinician to evaluate abnormal fetal conditions that might affect cardiovascular structure and/or function. PMID- 6507537 TI - Midtrimester amniocentesis: obstetric outcome and neonatal neurobehavioral status. AB - The possible effects of midtrimester genetic amniocentesis on neurobehavioral status were studied in newborn infants of women who had had the procedure (N = 100) and in newborn infants of women who had declined the test (N = 56). Brazelton's Neonatal Behavioral Assessment Scale was administered to newborn infants born at term and did not reveal consequences of amniocentesis on neonatal orientation, range of state, motor ability, autonomic regulation, regulation of state, response decrement, or reflexes. Information on obstetric complications also was obtained. The findings raised questions regarding the temporal relationship between amniocentesis and fetal loss and focused attention on preterm birth as a potential risk that warrants further investigation. This study provides the foundation for our prospective longitudinal follow-up in which the cohort will be reassessed later in infancy and in childhood. PMID- 6507538 TI - Clinically silent polymicrobial amnionitis and intrauterine fetal death associated with a Cu-7 intrauterine contraceptive device. PMID- 6507539 TI - The importance of fluid absorption, traction, intraocular currents, and chorioretinal scars in the therapy of rhegmatogenous retinal detachments. XLI Edward Jackson memorial lecture. AB - The combination of traction on the retina and of intraocular currents in the presence of a retinal hole is the cause of rhegmatogenous retinal detachment. The strong suction forces of the pigment epithelium and choroid counteract such a development. Chorioretinal scars serve as a seal against currents. Eliminating the effects of traction and of intraocular currents and making use of the absorption forces of the pigment epithelium and choroid are the primary aims in successfully treating rhegmatogenous retinal detachment. Direct closure of the retinal hole is not always necessary. PMID- 6507540 TI - Surgical treatment of retinal detachments complicated by proliferative vitreoretinopathy. AB - During the last four years we treated 82 consecutive patients (83 eyes) with retinal detachments complicated by proliferative vitreoretinopathy. We used pars plana vitrectomy combined with a broad scleral buckle, cryotherapy to the retinal breaks, and a temporary intraocular gas bubble. The retina was successfully reattached in 55 eyes (66%). Our success rate improved from five of 12 eyes (42%) in 1980 to 25 of 31 eyes (81%) in 1983. We believe that a better understanding of the disease process and the use of a combination of surgical techniques were the main factors accounting for our improved results during the last years of this series. PMID- 6507542 TI - Acute sectorial choroidal ischemia. AB - Four eyes (of three patients) with sectorial choroidal ischemia by temporal arteritis or carotid obstruction underwent fluorescein angiography during and after the acute phase. In all cases hypoperfusion affected the whole temporal choroid; however, disturbance of retinal pigment epithelium was much less extensive. In two cases the retinal pigment epithelium became necrotic and scarred within a limited area that was typically triangular in shape; in the third case scarring was limited to some pigmented streaks, and in the fourth case, retinal pigment epithelium remained normal. The triangular scar that appeared after episodes of choroidal hypoperfusion did not seem to be a true reflection of the extent of the choroidal artery obstruction in the acute phase. Our observations suggest that the deficient choroidal perfusion involved more than the choroidal artery supplying the triangular area of pigment epithelium disturbance. Several mechanisms (for example, retrograde venous filling, restoration of perfusion) reduce the deleterious effects of ischemia. Thus the necrosis of the retinal pigment epithelium would appear in only those sectors where ischemia was particularly severe or prolonged. PMID- 6507541 TI - Retinal pigment epithelial rip during krypton red laser photocoagulation. AB - In three patients (two women, 73 and 74 years old, and one man, 74 years old), a pigment epithelial rip occurred near the edge of a hypopigmented, partly organized choroidal neovascular membrane at the time of its treatment with krypton red photocoagulation. In all three cases, final visual acuity was 20/200. PMID- 6507543 TI - Senile reticular pigmentary degeneration. AB - Of 104 consecutive patients with senile reticular pigmentary degeneration (207 eyes), 85 patients (82%) were more than 60 years old (mean age, 69.2 +/- 8.54 years). Forty-nine (47%) were men and 55 (53%) were women. Peripheral visual fields were not characteristically constricted. Although most eyes tested had visual acuities of 20/50 or better, 69 eyes (33%) had visual acuities of 20/100 or worse. A total of 136 eyes (66%) had senile macular degeneration at the time senile reticular pigmentary degeneration was first diagnosed, whereas only 43 control eyes (21%) from the same referral population also had senile macular degeneration (P less than .001). Macular degeneration was the primary cause for reduced vision when it was noted. In no instance could reduced visual acuity or constricted visual fields be attributed to the senile reticular pigmentary degeneration alone. Senile reticular pigmentary degeneration on routine ophthalmoscopy should alert the clinician to the possibility of co-existing macular degenerative disease. PMID- 6507544 TI - Avulsed retinal veins without retinal breaks. AB - A localized segment of a retinal vein can be avulsed or torn from the retina by vitreous traction without a concurrent retinal break or tear. Eight eyes in eight patients (five women and three men, 20 to 69 years old) with avulsed retinal veins without retinal breaks showed a wide range of underlying retinal abnormalities, including background diabetic retinopathy, pars planitis, and involutional proliferative retinopathies. Such avulsed retinal veins often cause recurrent vitreous hemorrhage. Despite vitreous hemorrhages in six of the eight eyes, the visual prognoses were excellent in all eyes. An avulsed retinal vein must be considered in the differential diagnosis of those patients with proliferative retinopathies who have vitreous hemorrhage. PMID- 6507545 TI - Graphics composition of fundus data. AB - I developed a simple, inexpensive method of combining and recording clinical fundus data from a variety of sources in an instant color print or color transparency format. The system is useful for sequential observation, for planning laser treatment, for reference during photocoagulation, and for follow up in many diseases including macular degeneration. PMID- 6507546 TI - Wegener's granulomatosis with destructive ocular manifestations. AB - A 27-year-old man developed bilateral destructive ocular manifestations of generalized Wegener's granulomatosis. Before the appearance of necrotic granuloma, which replaced almost all the original ocular components, the patient had suffered from severe headache and restricted ocular motility for five years. A general remission was achieved with azathioprine and prednisolone treatment although the patient is blind because of destruction of the globes. PMID- 6507547 TI - Pseudotumor cerebri. AB - Two young women with idiopathic pseudotumor cerebri were treated successfully with lumboperitoneal shunts. Their shunts were removed electively several years later, following which there was rapid increase of cerebrospinal fluid pressure. In one patient, rapid increase of intracranial pressure resulted in bilateral visual loss. These cases provide further evidence that idiopathic pseudotumor cerebri may not be a self-limited condition. PMID- 6507548 TI - Lagophthalmos in acquired oculomotor synkinesis. AB - Two consecutive patients who exhibited classic signs of unilateral acquired oculomotor synkinesis demonstrated an inability to appose eyelid margins on the affected side, when attempting gentle closure of the eyes. In one patient, this occurred in conjunction with a unilateral upper eyelid crease on the affected side, and in the other patient it was associated with accentuation of the crease in comparison with that of the opposite side. Bilateral eyelid closure normally induces a contraction of the superior recti muscles. The lagophthalmos and accentuated upper eyelid crease observed in our patients when they attempted gentle eyelid closure presumably resulted from inappropriate coactivation of the levator palpebrae superioris muscle by impulses destined for the superior rectus muscle. PMID- 6507549 TI - Computed tomographic evaluation of the optic canal in sudden traumatic blindness. AB - Using computed tomographic scans and reformatted images of the optic canal region, we were able to define osseous abnormalities in nine patients with sudden traumatic blindness resulting from indirect trauma to the optic nerve. Six patients had optic canal fractures, two had fractures of adjacent structures, and one patient did not have a fracture. Patients received corticosteroid therapy, surgical decompression of the optic canal, both types of treatment, or no specific treatment for the nerve injury. Although there was no correlation between the abnormality identified by computed tomography and treatment results, our findings provided further evidence that a canal fracture is not necessary for injury of the optic nerve to occur. We recommend that patients with sudden visual loss after blunt head trauma undergo a computed tomographic scan of the optic canal region. PMID- 6507550 TI - Prolonged complementary chromatopsia in users of video display terminals. AB - Induced prolonged complementary chromatopsia in four subjects (two men, 26 and 34 years old, and two women, 34 and 45 years old) was documented by abnormal responses to pseudoisochromatic color plates 30 minutes after cessation of monochrome video display terminal use. This phenomenon was unrelated to preexisting color vision anomalies, known ocular disease, or drug use, and defines a specific phenomenon probably related to afterimages. All four patients missed AOH-R-R plate 3 after using the video display terminal. One patient also had a delayed response to plate 6. One patient patched one eye before using the video display terminal and noted that the complementary chromatopsia occurred only in the unpatched eye. PMID- 6507551 TI - The effect of sodium hyaluronate on endothelial cell damage during extracapsular cataract extraction and posterior chamber lens implantation. AB - We conducted a prospective, randomized clinical trial of the use of 1% sodium hyaluronate (Healon) in the anterior chamber during anterior capsulotomy and nuclear expression in extracapsular cataract extraction with posterior chamber lens implantation. Two months postoperatively, the mean (+/- standard deviation) central endothelial cell loss was 6.1% +/- 11.4% in 92 eyes in which sodium hyaluronate was used for the capsulotomy and nuclear expression and 7.6% +/- 14.7% in 89 eyes in which it was not used (P greater than .6). Sodium hyaluronate was also used later in the procedure in all eyes to expand the capsular bag to facilitate lens implantation. No significant difference was noted between the two groups in the increase in intraocular pressure on the first postoperative day (mean increase, 4 mm Hg in each group) or in the corneal thicknesses preoperatively and two months postoperatively (no significant change in either group). Sodium hyaluronate was useful in maintaining the anterior chamber during difficult surgical cases. PMID- 6507552 TI - Effect of inverted body position on intraocular pressure. AB - We evaluated changes in intraocular pressure in eyes with primary open-angle glaucoma after inversion into a totally dependent position with the head down and compared them with the changes intraocular pressure in healthy nonglaucomatous eyes. Five minutes after inversion, intraocular pressure increased from 16.8 mm Hg +/- 2.8 (sitting) to 32.9 mm Hg +/- 7.9 in normal eyes and from 21.3 mm Hg +/- 2.3 (sitting) to 37.6 mm Hg +/- 5.0 in glaucomatous eyes. Although visual fields were unchanged after inversion, glaucomatous eyes may be particularly susceptible to such changes and unable to withstand the transient but significant increase in intraocular pressure that occurs after assuming an inverted position. We recommend that patients with ocular hypertension or glaucoma refrain from this activity. PMID- 6507553 TI - Therapeutic options in uveal melanoma. PMID- 6507554 TI - Pseudomonas aeruginosa ophthalmia neonatorum. PMID- 6507555 TI - A fiberoptic diathermy tissue manipulator for use in vitreous surgery. PMID- 6507556 TI - Improved visualization of the retina during endophotocoagulation. PMID- 6507557 TI - Biconcave contact lens for examination and laser treatment of the fundus in normal and gas-filled phakic eyes. PMID- 6507558 TI - Treatment of acquired epithelial inclusion cyst of the conjunctiva using the YAG laser. PMID- 6507559 TI - The cocaine test in normal patients. PMID- 6507560 TI - Treatment of macular hole retinal detachments with intravitreal gas. PMID- 6507561 TI - Polaroid for fluorescein angiography. PMID- 6507562 TI - Natural killer cell activity in patients with Behcet's disease. PMID- 6507563 TI - A 19-9 monoclonal antibody study of adenocarcinoma metastatic to the choroid. PMID- 6507564 TI - Postoperative positioning with a circular electric bed for a giant retinal tear in a retarded patient. PMID- 6507566 TI - Hydrocephalus and transient cortical blindness. PMID- 6507565 TI - The oculocardiac reflex with an orbital tumor. PMID- 6507567 TI - Piperacillin levels in human tears and aqueous humor. PMID- 6507568 TI - A randomized comparison of surgical procedures for infantile esotropia. PMID- 6507569 TI - Comparison of visual field defects in the low-tension glaucomas with those in the high-tension glaucomas. PMID- 6507570 TI - The cultural aspects of home care delivery. AB - The home care therapist must create an occupational therapy program that stimulates the participation of the patient and the caretakers. This case study demonstrates the pervasive influence of culture on the patient's volitional, habituation, and performance subsystems. Careful analysis of human and nonhuman cues guide the therapist's goal and treatment decisions. As a participant observer, the therapist has the opportunity to enter the patient's world, adapt treatment to suit the patient's needs, and make occupational therapy a vital part of the recovery process. PMID- 6507571 TI - Technology and occupational therapy in the rehabilitation of the bedridden quadriplegic. AB - In recent years, home health care services have been expanded considerably. These services, combined with current technological advances, allow severely disabled, even bedbound, people to remain at home. This report demonstrates how one individual, although bedridden and quadriplegic, has successfully adapted his home environment. His functional independence has been markedly improved through computers, environmental control units, innovative carpentry, and adaptations by the occupational therapist. His need for attendant care has been reduced and his quality of life significantly enhanced through increased control of his surroundings. This paper suggests innovative and technological solutions to environmental problems at home. These ideas may aid the home health care occupational therapist in treating individuals who are bedbound. PMID- 6507572 TI - Continuing education requirements. PMID- 6507573 TI - Attendance requirement for continuing fellowship in the Academy. PMID- 6507575 TI - The role of regional meetings. PMID- 6507574 TI - Competency requirements and a two-tiered membership. PMID- 6507576 TI - Clinical trial with commercial aspheric aphakic lenses. AB - A clinical trial with 11 subjects was conducted to compare the Armorlite Multiple Drop, the Signet Hyperaspheric, the Sola Hi-Drop, and the American Optical Fulvue types of aspheric aphakic lenses. Reasonable off-axis visual acuities were obtained with the Signet, Sola, and Fulvue types, but poor visual acuities were found with the Armorlite type. Similar visual field limits were found with the armorlite, Signet, and Sola types. Considerably larger limits were found with the Fulvue type than with the other types. However, subjects failed to appreciate these larger limits; this was attributed to the extremely poor image quality near the edge of the visual field with this lens type. Some subjects disliked the poor off-axis image quality with the Armorlite lens type, and it had poor acceptance relative to the other types. Concerning subjective perception of weight, cosmetic appearance, and visual field size, and subjective evaluation of performance of everyday activities, there were no significant differences between lens types. It was concluded that reducing lens off-axis power errors, corresponding to the rotating eye, should remain the most important principle of aphakic spectacle lens design. PMID- 6507577 TI - Visual electrophysiology and psychophysics in chronic alcoholics and in patients on tuberculostatic chemotherapy. AB - Twenty-one chronic alcoholics and 15 patients on tuberculostatic therapy were examined on repeated occasions using flash electroretinography (ERG), flash and pattern visual evoked responses (VER), visual fields, and flicker fusion thresholds. For both groups of visually symptomless patients, there is evidence of retinal abnormalities although more abnormal results are seen for the VER's. The results indicate that the mode of action of alcohol and tobacco differs from that of the tuberculostatic drugs. For ethambutol and possibly isoniazid therapy, the larger changes which are seen in the flash VER's than in the pattern VER's, suggest that these drugs have a generalized effect upon the visual system. On the other hand, the results for the alcoholics indicate that the effect of alcohol and tobacco is more specific for the macular region as the macular thresholds and VER's to the small check and field size are most affected. PMID- 6507578 TI - Peripheral refraction in aphakic eyes. AB - Peripheral refraction was measured in aphakic eyes and control eyes of approximately the same age, using a Topcon refractometer. In addition, two aphakic eyes in young patients were also measured and compared with data obtained on young patients by Millodot using the same technique. It was found that aphakic eyes have much less oblique astigmatism than phakic eyes of the same age, suggesting a large contribution to the crystalline lens. The total oblique astigmatism of the eyes increases with age but that of the cornea remains approximately the same, thus implying that this increase with age is also accounted for by the lens. Moreover, the total oblique astigmatism of old eyes is nearly the same as the theoretical value, suggesting that with age the lens becomes more spherical. PMID- 6507579 TI - Effect of a concurrent counting task on dynamic visual accommodation. AB - The visual accommodation of four male subjects was selectively recorded over a 3 day period using an objective, continuously recording, infrared optometer to determine the effects of a concurrent counting task on their ability to accommodate to a sinusoidally changing focus stimulus ranging from 0.0 to 3.0 D. There was an increase in their steady-state errors in the direction of negative accommodation of from 0.25 to 0.50 D, but the magnitude of the steady-state error induced by the concurrent task did not change over the three sine wave frequencies used (0.1, 0.2 and 0.4 Hz). The results are discussed in terms of an accommodative "lag" model of sympathetic-parasympathetic arousal induced by superimposing an extraneous mental task. PMID- 6507580 TI - Visual acuity and chart luminance. AB - It is desirable to standardize the conditions under which visual acuity is measured because of its importance in determining whether subjects meet occupational vision standards and as an indicator of the extent or stability of pathological conditions. The chart luminance is one parameter which needs to be standardized, and the effect of the luminance level upon acuity measurement is a critical factor in this determination. These data are measured for a subject population using Landolt rings and British letters. Over a "normal" photopic range of 40 to 600 cd/m2 the relation between the logarithm of the minimum angle of resolution (log MAR)) and log L (luminance) can be approximated by a straight line. A doubling of the luminance level within this range improves the acuity measurement by approximately one letter on a five-letter row. Landolt ring acuities are less affected by luminance than letter acuities. The application of these results to establishing a standardized luminance level and tolerance range is discussed. PMID- 6507581 TI - Equivalent oxygen percentage (EOP) technique: a standard calibration curve. AB - Between different oxygen concentrations (mixed with nitrogen) ranging from 0 to 21% were passed over the corneas of six subjects for 5 min. The resulting corneal oxygen responses were measured by polarography. The averages of these responses were used to calculate a "relative oxygen uptake response" (ROUR) value for each oxygen percentage. Analysis of these ordered pairs revealed a curvilinear relation which was best described by a third order equation; marked linearity was demonstrated in the middle of the oxygen range. The use of this third order equation as a "standard" or "average" equivalent oxygen percentage (EOP) calibration equation is suggested. PMID- 6507583 TI - Chinese standard acuity chart. PMID- 6507582 TI - Calcium deposits on glyceryl methyl methacrylate and hydroxyethyl methacrylate contact lenses. AB - Five patients wore a hydroxyethyl methacrylate (HEMA) lens on one eye and a glyceryl methyl methylcrylate (GMA) lens on the other eye. The eye with the GMA lens remained comfortable longer than the other eye. The GMA lens is less likely to acquire calcium deposits and continues to be wearable longer than the HEMA lens. PMID- 6507584 TI - Combination of a side shield with an ocular moisture chamber. AB - A low vision patient suffering from dry eye symptoms was helped by use of a side shield modified so as to create a moisture chamber. PMID- 6507585 TI - Mechanisms of cytoskeletal regulation. Modulation of aortic endothelial cell spectrin by the extracellular matrix. AB - Endothelial cells have a complex cytoskeleton that is responsive to a variety of stimuli such as shear and desquamative injury. The extracellular matrix is known to influence several aspects of cellular behavior, including attachment, spreading, and migration and may, in part, initiate and control vascular responses in growth, differentiation, wound repair, and neoplasia. It is likely that linkage between surface receptors responsible for sensing the matrix and the cytoskeleton may be relevant to understanding the mechanisms of these responses. Spectrin is a high-molecular-weight heterodimer recently identified in many cells that appears to link surface receptors to cortical actin filaments. We have confirmed the existence of spectrin in cultured aortic endothelial cells by metabolic labeling and immunoprecipitation and demonstrated that its organization and intracellular distribution is sensitive to the extracellular matrix. When bovine calf aortic endothelial cells (BAEC) are cultured to confluency on a fibronectin (Fn) substrate, they assume a flattened, spread morphology and exhibit a punctate spectrin distribution with no discernible peripheral localization. In contrast, BAECs cultured on a Type I/III collagen (I/III) substrate exhibit a fibrillar spectrin pattern with significant peripheral localization. When migrating cells were examined, the distribution of spectrin was strikingly different. The cells on the Fn substrate showed no changes in spectrin localization, whereas the cells on I/III exhibited a significant rearrangement, with spectrin being in a coarse fibrillar form, with the fibrils aligned parallel to the direction of migration. The differences in arrangement of this cytoskeletal component on the two substrata reflect the ability of the substrate to perturb the cytoskeletal organization and modulate some aspects of cell behavior such as spreading, proliferation, and migration. These data are consistent with the concept that the nonerythroid spectrins may function as transducers of information from membrane receptors to the cytoskeleton. PMID- 6507586 TI - Senile systemic amyloidosis. AB - The senile amyloidoses comprise a heterogeneous group of disorders with deposition of amyloid in a variety of tissues. Most of these amyloidoses are localized to one tissue. It has been shown previously that the amyloid fibrils in one form of senile amyloidosis affecting the heart contains a prealbumin-related protein, ASc1. It is shown in this paper by immunohistochemical study using a specific anti-protein ASc1 antiserum that this type of amyloidosis, previously called senile cardiac amyloidosis, is a systemic disease with amyloid deposits in many organs. The designation senile systemic amyloidosis is proposed for this disease, which differs from other systemic amyloidoses in distribution of amyloid deposits. PMID- 6507587 TI - Spontaneous nephrotic syndrome in a genetic rat model. AB - Advances in our understanding of the mechanisms of proteinuria in humans have depended on a variety of animal models. Most of these have been partially satisfactory because they require pretreatment of the animal with chemicals or toxins or they depend on an aging-related glomerular protein leakiness. The strain in this study was obtained by Koletsky after selective inbreeding of the offspring from a hypertensive Kyoto-Wistar and a normotensive Sprague-Dawley rat. The affected animals appear in 25% of the litters, indicating an autosomal recessive gene, and present with a spontaneous and progressive nephrotic syndrome detected as early as 3-5 weeks and associated with obesity, hypertension, hypoalbuminemia, hypercholesterolemia, and hyperlipidemia. Preliminary morphologic and immunofluorescence studies of their kidneys show progressive glomerular segmental sclerotic lesions and prominent mesangial deposition of IgM, a picture which resembles a steroid-resistant form of idiopathic nephrotic syndrome in humans, namely, focal glomerular sclerosis. PMID- 6507590 TI - Calcified microbial plaque. Dental calculus of dogs. PMID- 6507591 TI - Preparation for nuclear war: the final madness. PMID- 6507588 TI - Fibrin-mediated vascular injury. Identification of fibrin peptides that mediate endothelial cell retraction. AB - The deposition of fibrin, a ubiquitous component of acute and chronic inflammatory reactions, has been implicated by a number of recent studies as playing an active role in inflammation. In particular, fibrin deposition has been implicated in the development of tissue edema. As the "gateway" through which intravascular-to-extravascular movement of fluid, nutrients, and cells must pass, the vascular endothelial cells play a crucial regulatory role in this process. In support of this concept, recent studies in this laboratory have demonstrated that endothelial cells retract not only in the presence of fibrin but also in the presence of low molecular weight cleavage products of fibrinogen. It was further shown that this reaction was 1) specific for both vascular and corneal endothelial cells, 2) nontoxic, and 3) completely reversible. The present work examined the physiochemical nature of these endothelial-cell reactive factors. It was demonstrated by the use of enzymatically derived and synthetic fibrinogen peptides, that the active soluble fibrinogen-derived factor was associated with the amino-terminal end of the B chain of fibrinogen. The active factor has been tentatively identified as the B beta peptides, which is a primary plasmin cleavage product of fibrinogen and contains the thrombin-generated fibrinopeptide B. It is thus suggested that soluble, endothelial-cell-reactive peptides are released during both fibrinogenesis and fibrinolysis and, as such, modulate endothelial cell functions in vivo. PMID- 6507592 TI - Child maltreatment as a social problem: the neglect of neglect. AB - Child maltreatment is analyzed utilizing a "social problem" framework. Although data reveal that child neglect is more prevalent and its consequences as serious as child abuse, it has received far less attention than has abuse. Historical factors and the relationship between child neglect and poverty are viewed as the major reasons for the deemphasis of neglect relative to abuse. PMID- 6507589 TI - Monoclonal antibody localization of A and B isoantigens in normal and malignant fixed human tissues. AB - The expression of human blood group A and B isoantigens in normal and malignant tissues from stomach, colon, and pancreas was analyzed in an immunoperoxidase assay using monoclonal antibodies specific for these isoantigens. Appropriate isoantigen expression was demonstrated in the normal epithelium from the stomach, pancreas, and proximal but not distal colon of blood group A, AB, or B patients. Half of all gastric carcinomas and of proximal colon carcinomas showed complete loss of isoantigen, whereas the adjacent mucosa in these cases continued to express appropriate isoantigen. Isoantigen expression was completely lost in only 13% of pancreatic carcinomas tested. Neither A nor B isoantigen was detected in normal epithelium from the distal colon. By contrast, 85% of carcinomas derived from this site showed reexpression of isoantigen. Inappropriate expression of A isoantigen was detected in pancreatic carcinomas (2/5) but not in gastric or colon carcinomas (0/21). Inappropriate expression of B substance was not detected in any tissue (0/38). Interestingly, differential binding of antibodies to Type 1 versus Type 2 and/or difucosyl versus monofucosyl blood group B substances was manifested by differences in intensity of staining for endothelium and red blood cells. PMID- 6507593 TI - Family systems approaches to wife battering: a feminist critique. AB - It is suggested that, in theory and practice, family systems approaches to wife battering contain biases against women. Following a selective review of family systems literature on wife battering, systemic formulations of husband-to-wife violence are critically examined. Possible contraindications of conjoint therapy with battered women and abusive men are discussed. PMID- 6507594 TI - Deviations on exploration, attachment, and fear of strangers in high-risk and control infants at one year of age. AB - Exploratory behavior and deviations on three dimensions--fear of strangers, attachment to mother, and exploration--were studied in 46 infants of mothers with a history of psychosis and 80 control infants. While high-risk infants did not differ from controls on exploration alone, they showed multiple deviations on the three dimensions more frequently than did controls, especially in the case of offspring of schizophrenic mothers. PMID- 6507595 TI - Behavioral and emotional functioning in children of adolescent mothers. AB - This study compared children of mothers in three age groups--15-17, 18-19, and 20 24 years--at the birth of their first child. Outcome measures were ratings of psychological functioning obtained at three time periods from multiple sources. Results, controlling for family structure and maternal education, indicate that children of adolescent mothers were generally not different from children of mothers in their early twenties with respect to behavioral and emotional functioning. Maternal education had a far greater effect on the outcome measures than did maternal age. PMID- 6507596 TI - Subgrouping conduct disordered adolescents by early risk factors. AB - An analysis aiming to functionally subgroup seriously conduct disordered adolescents identified grade of onset of persistent classroom misconduct as the single most useful and discriminating variable for this purpose. Students whose misconduct began in the early elementary school were characterized by a prominent degree of developmental-educational limitations, whereas those with a later onset were--like the control group--remarkably free of early risk factors. PMID- 6507597 TI - School-based developmental facilitation groups for children of divorce: a preventive intervention. AB - A model of time-limited, school-based groups for children of divorce is presented. Common themes that emerged in groups conducted in three schools suggest that youngsters continue to wrestle with divorce-related conflicts years after the marital disruption. Developmental tasks created by specific post divorce stresses are described, and multiple brief interventions tied to nodal points in child development are proposed. PMID- 6507598 TI - Therapeutic space design: planning an inpatient children's unit. AB - The physical space of a treatment facility is conceptualized as therapeutic, in that it can facilitate and support clinical goals. A method for translating clinical concepts into architectural and interior design plans is described, and the environmental planning of a 12-bed psychiatric unit for latency-age children is set forth in detail. PMID- 6507599 TI - Discharge planning for the high-risk neonate: a consultation-liaison role for the infant mental health specialist. AB - Frequent difficulties in discharge planning for the high-risk neonate are discussed, and case material is used to illustrate brief, focused psychiatric consultation-liaison intervention on behalf of an infant and its parents at high medical and psychosocial risk, respectively. Familial and hospital team dynamics, particularly issues of affective bonding, are examined, and the role of the infant mental health specialist is delineated. Principals of consultation in the neonatal services unit are outlined. PMID- 6507600 TI - Ten ways for a self-help group to fail. AB - The importance of self-help groups as a competence-enhancing community resource is described--with the reservation that many developing groups are destined for failure due to their organizers' inexperience or lack of commitment. Ten effective techniques of group failure are presented to assist such groups in overcoming even the remote chance of success. PMID- 6507602 TI - Electromyographic patterns accompanying isokinetic exercise under varying speed and sequencing conditions. AB - The purposes of this study were: a) to investigate electromyographic patterns accompanying isokinetic exercise under varying speed and sequencing conditions, and b) to investigate the role of antagonist coactivation under these same conditions. Five adult males performed maximal knee extensions and flexions on a modified Orthotron isokinetic dynamometer. Tests were done at four speeds (100 400 degrees/sec) and under two counterbalanced conditions: extension followed by flexion (E/F) and flexion followed by extension (F/E). Simultaneous recordings of torque, knee joint position and agonist/antagonist EMG changes from the quadriceps and hamstring musculature were collected and analyzed. No consistent EMG patterns emerged that inferred intermittent surges of muscular activity as the primary mechanism yielding double peaked torques that characteristically occur in isokinetic exercise. Further analyses revealed relatively small co contractions of antagonists during the various phases of movement. The findings suggest that gravity and inertia of the limb/lever system were the major factors responsible for limb deceleration and substantive antagonist co-contraction was not required for braking. If isokinetic knee flexion and extension exercises are used for conditioning or developmental purposes of healthy subjects, any distraction of the co-contracting antagonist from the recorded force of the agonist appears to be small once the activity is learned. PMID- 6507601 TI - Reappraisal of the electroneurographic and electromyographic diagnosis of diabetic peripheral neuropathy. AB - Twenty, otherwise unselected, subjects with Type II diabetes mellitus were studied using electroneurographic and electromyographic techniques. Latencies, conduction velocities, amplitude and duration of evoked responses and change of amplitude and duration over distance, as well as H reflex and ulnar F wave were determined for motor nerves. Latency to onset and peak of negative deflection and amplitude of the evoked action potential were determined for sensory nerves. Eleven subjects had amplitude and/or latency abnormalities of the sural, superficial peroneal, and median sensory nerves. One additional subject had abnormality of both the sural and superficial peroneal nerves. Five subjects had mononeuropathies and 2 of these also had membrane instability of the abductor hallucis muscle. Ten subjects had clinical or electrophysiologic findings compatible with carpal tunnel syndrome either as an isolated lesion or superimposed on underlying peripheral neuropathy. It was concluded that all subjects with abnormality of 3 sensory nerves (median, sural and superficial peroneal) had findings compatible with diabetic peripheral neuropathy and that additional electrodiagnostic studies (unless otherwise indicated) did not identify additional abnormalities diagnostic of peripheral neuropathy in the remaining subjects. PMID- 6507603 TI - Bilateral wrist dislocation in an above knee amputee with advanced rheumatoid arthritis. Attempts at ambulation. AB - The ambulatory difficulties of a patient with long standing rheumatoid arthritis with an above knee amputation and bilateral wrist dislocations has not been previously reported. Although wrist fusion did in fact increase his hand strength, control and stability, he still lacked sufficient hand strength and grip to don and doff the prosthesis, nor could he use assistive devices in order to become an independent ambulator. The results of wrist fusion and attempts at ambulation are discussed. PMID- 6507604 TI - The collection of human skulls and postcranial skeletons at the department of human anatomy of the University of Torino (Italy). AB - The human osteological collection at the Department of Human Anatomy, University of Torino, Italy, has recently been rearranged and recatalogued, and is now available for study. It comprises 1,064 modern skulls of known sex (384 males and 680 females); the age is also recorded in 712 cases. Of these skulls, 162 are from persons aged less than or equal to 20 years of known sex. A few skulls also have the postcranial skeleton (35 males and 39 females). The collection includes microcephali and hydrocephali, and also some prehistoric, Etruscan, Phoenician, Egyptian, Greek, Roman, Ancient Jewish, and Lombard skulls. A brief catalogue is provided. PMID- 6507605 TI - Metamorphosis at the sternal rib end: a new method to estimate age at death in white males. AB - While the pubic symphysis and intracortical morphometry have provided successful results in estimating age at death, other methods and sites in the skeleton are needed to improve the accuracy of age estimation. This research is an attempt to develop a new age-determination technique by using the sternal extremity of the rib. The right fourth rib was collected at autopsy from 93 white males. The sternal extremity of each rib was analyzed in relation to the pit depth (component I), pit shape (component II), and rim and wall configurations (component III), each of which was divided into six stages. Results indicated that the age at death can be estimated from a rib within about 2 years in the second decade to about 7 years in the fifth and sixth decades of life. Pit shape and rim and wall configurations yielded better results than absolute pit depth alone. While this method has a potentially important contribution to skeletal anthropology, factors such as sex differences and biomechanical variation between individuals may affect the determination of age from the rib. PMID- 6507606 TI - Microevolution in prehistoric Andean populations: chronologic nonmetrical cranial variation in northern Chile. AB - Multivariate distance statistics were computed from 14 nonmetrical cranial variables among five prehistoric samples representing steps in the microevolutionary history of a coastal population in northern Chile. Roughly 70% of nonmetrical cranial variation was found to be explained by chronologic distance covering a period of 6,500 years. This estimate is similar to a previous one derived from craniometric data. Implications of these findings are briefly discussed. PMID- 6507607 TI - Age-specific variation in the secular trend for stature: a comparison of samples from industrialized and nonindustrialized regions. AB - Age-specific secular trend patterns for children in industrialized world regions have a regular pattern, beginning low at age 6 and increasing to a maximum at age 10 to 14, then declining. While magnitude differs, the patterns are ordinarily parallel, especially in the female samples. However, age-specific secular trend values for children from developing regions, or from areas of industrialized countries not benefitting substantially from development, are irregular in pattern and magnitude. Consequently, it is difficult to predict age at maximal secular change. We suggest that fluctuating environmental circumstances in these developing countries influence growth and, hence, the pattern of secular trend. As more stable environmental conditions relating to growth are present in the industrialized countries, this leads to more stable patterns of growth and age specific patterns of secular change. PMID- 6507608 TI - Primate cortical bone microstructure: relationship to locomotion. AB - Mechanical factors are implicated in the control of osteonal (Haversian) remodeling. Twenty primate species, representing a diverse range of locomotor behaviors, have been examined to determine whether the arrangement of secondary osteonal bone at femoral mid-diaphysis reflects behaviorally related biomechanical influences. The proportion of bone cortex occupied by secondary osteons (percent osteonal bone) is related to the biomechanical environment of these femora. Percent osteonal bone delineates groups which correspond to other skeletal and kinesiological categorizations of primate locomotion and distinguishes among arboreal quadrupedal, terrestrial quadrupedal, suspensory, and bipedal primates. PMID- 6507609 TI - Polymorphism of palmar C- and D-line terminations among the Sikligars of Chandigarh. AB - Modal types of palmar C- and D-line terminations of 60 couples of Sikligars from Chandigarh have been evaluated and compared with the populations from Northwestern India. The distribution of palmar C- and D-line terminations among the Sikligars resembles those of the Rajputs and Hindu Gujjars, suggesting a common population origin, an infrequent inflow of genes from the surrounding populations, and their biosocial isolation. Bilateral distribution asymmetry and sexual dimorphism were also observed. PMID- 6507610 TI - Kin groups and trait groups: population structure and epidemic disease selection. AB - A Monte Carlo simulation based on the population structure of a small-scale human population, the Semai Senoi of Malaysia, has been developed to study the combined effects of group, kin, and individual selection. The population structure resembles D.S. Wilson's structured deme model in that local breeding populations (Semai settlements) are subdivided into trait groups (hamlets) that may be kin structured and are not themselves demes. Additionally, settlement breeding populations are connected by two-dimensional stepping-stone migration approaching 30% per generation. Group and kin-structured group selection occur among hamlets the survivors of which then disperse to breed within the settlement population. Genetic drift is modeled by the process of hamlet formation; individual selection as a deterministic process, and stepping-stone migration as either random or kin structured migrant groups. The mechanism for group selection is epidemics of infectious disease that can wipe out small hamlets particularly if most adults become sick and social life collapses. Genetic resistance to a disease is an individual attribute; however, hamlet groups with several resistant adults are less likely to disintegrate and experience high social mortality. A specific human gene, hemoglobin E, which confers resistance to malaria, is studied as an example of the process. The results of the simulations show that high genetic variance among hamlet groups may be generated by moderate degrees of kin structuring. This strong microdifferentiation provides the potential for group selection. The effect of group selection in this case is rapid increase in gene frequencies among the total set of populations. In fact, group selection in concert with individual selection produced a faster rate of gene frequency increase among a set of 25 populations than the rate within a single unstructured population subject to deterministic individual selection. Such rapid evolution with plausible rates of extinction, individual selection, and migration and a population structure realistic in its general form, has implications for specific human polymorphisms such as hemoglobin variants and for the more general problem of the tempo of evolution as well. PMID- 6507611 TI - Dopamine may be a neurohormone in rat adrenal cortex. AB - In the periphery, dopamine (DA) is a precursor for norepinephrine (NE) and epinephrine (EPI) biosynthesis and is itself a neurotransmitter in sympathetic ganglia. In addition, DA may function as a neurohormone in providing maximum tonic inhibition of aldosterone secretion from the adrenal cortex. We have quantified the catecholamine content of the adrenal gland and have examined factors that regulate DA content of the adrenal cortex. Adult male Sprague-Dawley rats were assigned to one of four groups: adrenal demedullated (ADM); adrenal denervated via splanchnic nerve section (ADN); adrenal demedullated-denervated (DMN); and sham-operated controls (Sham). Ten days after surgery, rats were killed by decapitation, and the adrenals were removed and later assayed for catecholamine content. Compared with Sham, ADM and DMN decreased NE and EPI levels by 92-99% but DA levels by only 57-58%. ADN decreased levels of each catecholamine by 18-26%. These findings indicate that the adrenal cortex contains approximately 40% of the total gland content of DA and less than 8% of the total gland content of NE and EPI. Furthermore, DA in the adrenal cortex does not appear to require an intact splanchnic nerve supply to the adrenal. In a second experiment, we examined the effects of inhibition of catecholamine biosynthesis with alpha-methyl-p-tyrosine (alpha-MPT) on DA content in Sham and ADM rats. In Sham rats, alpha-MPT decreased adrenal DA by 44% and heart NE by 37%. In contrast, treatment of ADM rats with alpha-MPT increased adrenal DA by 49% but decreased heart NE by 36%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507612 TI - Hepatic and extrahepatic lactate metabolism in sheep: effects of lactate loading and pH. AB - Hepatic lactate metabolism was studied in five sheep receiving infusions of either lactic acid or sodium lactate using an arteriovenous difference technique. Hepatic uptake of lactate was a saturable process with second order (Michaelis Menten) kinetics. Although lactic acid infusion decreased blood pH, hepatic saturation of lactate uptake occurred before changes in pH could influence hepatic lactate metabolism. The Vmax for hepatic lactate metabolism is 5.72 mmol X kg-0.75 X h-1 and the Km 3.06 mmol/l. These findings have therapeutic relevance. In acidosis, the hepatic response to therapeutic administration of sodium lactate during fluid therapy will be variable. If plasma lactate is low, lactated fluids may increase hepatic uptake and produce an alkalizing effect. If plasma lactate is already high, hepatic lactate metabolism is nearly saturated, and additional lactate will not produce a hepatic alkalizing response. Extrahepatic tissues switch from lactate production to lactate utilization under conditions of lactate loading. They remove more lactate than liver at high plasma lactate concentrations. Muscle may be important in lactate removal in certain types of exercise. PMID- 6507613 TI - Brief decreases in dopamine result in surges of prolactin secretion in monkeys. AB - We have reported previously that the amount of dopamine in hypophysial stalk blood was sufficient to account for tonic hypothalamic inhibition of prolactin secretion in rhesus monkeys. In the present study we determined the effect on prolactin secretion of decreases in dopamine. When hypophysial stalk-transected, estrogen-treated monkeys were infused with dopamine at a rate (0.1 microgram X kg 1 X min-1) to achieve peripheral plasma concentrations similar to those previously measured in stalk blood, their elevated serum prolactin levels fell to base line (from 47.6 +/- 4.8 to 9.7 +/- 2.7 ng/ml, mean +/- SE, n = 4). Brief interruptions of the dopamine infusions lasting for 2.5, 5.0, or 7.5 min evoked rapid increases in serum prolactin concentrations (to 27.5 +/- 8.3, 52.9 +/- 3.6, and 58.9 +/- 8.1 ng/ml, respectively, at 10 min). Maximal prolactin levels were attained within 10 to 20 min after dopamine removal and serum prolactin remained elevated for an additional 35 to 150 min. Uninterrupted dopamine infusions of stalk-transected, estrogen-treated monkeys (n = 3) led to continuously suppressed prolactin values. These results demonstrate that brief decreases in dopamine lead to major increases in prolactin secretion. Thus, if a brief decrease in hypothalamic dopamine secretion occurs after a suckling stimulus in monkeys, as it does in rats, a decrease in dopamine secretion alone may account, in part, for suckling-induced prolactin secretion in monkeys. PMID- 6507614 TI - Protein turnover in heart and diaphragm of rat fetus. AB - Fractional rate constants for protein synthesis (KS) in fetal rat heart and diaphragm were determined by the constant infusion technique. Uniformly labeled [14C]tyrosine was infused at a constant rate into the maternal jugular vein of unanesthetized unrestrained pregnant rats for 6-10 h at days 19 and 21 of gestation and KS calculated from the protein-bound to tissue-free tyrosine specific radioactivity ratio and the rate constant for attainment of plateau tyrosine specific radioactivity in fetal plasma (lambda p). Rate constants for protein degradation (KD) were calculated by subtracting fractional growth rate (KG) from KS. In both tissues, protein accretion during the most rapid phase of growth (day 19) was accomplished by greater rates of synthesis and lower rates of degradation when compared with a time of lesser growth (day 21). PMID- 6507615 TI - Trophic response of hamster brown adipose tissue: roles of norepinephrine and pineal gland. AB - The objective was to find out whether the reduced amount of brown adipose tissue in myopathic hamsters [Am. J. Physiol. 239 (Cell Physiol. 8): C18-C22, 1980] was secondary to a refractoriness to the trophic influence of norepinephrine. However, no evidence for any trophic influence of norepinephrine on brown adipose tissue of either normal or myopathic hamsters could be detected under experimental conditions that have demonstrated such an influence in rats. A mediator other than norepinephrine, melatonin, secreted by the pineal gland, is known to mediate the control of brown adipose tissue growth induced in hamsters by short photoperiod. Further studies of intact or pinealectomized hamsters showed that the pineal gland was not required for either cold- or diet-induced growth of brown adipose tissue. It is concluded that the defect in control of brown adipose tissue size in the hamster with muscular dystrophy is not due either to abnormal control by norepinephrine or to the pineal gland since neither of these appears to participate in the normal regulation of brown adipose tissue size in relation to environmental temperature or to diet. PMID- 6507616 TI - Estimates for cytosolic concentration. PMID- 6507617 TI - Evidence for separate pathways of chylomicron and very low-density lipoprotein assembly and transport by rat small intestine. AB - Previously, we demonstrated that the hydrophobic surfactant Pluronic L-81 (L-81) inhibits the intestinal formation and transport of chylomicrons (CM) but not of very low-density lipoprotein-sized (VLDL) particles. The present study was undertaken to determine whether infusion of egg lecithin results mainly in secretion of VLDL by the small intestine and whether L-81 has any effect on their formation and secretion. Intestinal fistula rats were infused intraduodenally at a rate of 3 ml/h with a lipid emulsion containing 20 mM egg lecithin and 19 mM sodium taurocholate for 8 h. This was then followed by another 8 h of infusion of a similar lipid emulsion but with 0.5 mg/h of L-81 added. Lymphatic lipid output was measured, and lymph lipoproteins were sized by use of electron microscopy. Whether L-81 was present or not, no significant difference was detected in the lymphatic triglyceride, phospholipid, or cholesterol outputs. Based on agarose gel electrophoresis, sizing of intestinal lymph lipoproteins, and also the determination of lipid in the intestinal lymph CM and VLDL as separated by ultracentrifugation, VLDL were the major lipoproteins present in lymph during the infusion of egg lecithin. Thus, intraduodenal infusion of egg lecithin in the rat results mainly in the transport of VLDL and is not affected by the administration of L-81. The results suggest that CM and VLDL are assembled separately by the enterocytes and indicate the usefulness of L-81 in further investigating the pathways and regulation of intestinal lipoprotein synthesis, assembly, and secretion. PMID- 6507618 TI - Two distinct adaptive responses in the synthesis of exocrine pancreatic enzymes to inverse changes in protein and carbohydrate in the diet. AB - Rates of synthesis of 16 individual pancreatic exocrine proteins; tissue concentrations of amylase, trypsinogen, and chymotrypsinogen; and morphological assessment of pancreatic acinar cells were studied in the exocrine pancreas in response to inverse changes in protein and carbohydrate in the diet, administered for 12 days. Two distinct patterns of response were observed. During adaptation to diets containing normal protein (22%) or increased levels of protein (30, 45, 64, and 82% protein) and correspondingly decreased levels of carbohydrate, amylase and the majority of protease zymogens were synthesized in direct proportion to the nutritional substrates carbohydrate and protein, respectively, in the diet. With increases in dietary protein, anticoordinate patterns of response in the synthesis of exocrine isoenzymes were observed: 0.4- to 2.0-fold increases in trypsinogen forms 1 and 2, chymotrypsinogen forms 1 and 2, proelastase 1, and procarboxypeptidases A and B; 5- to 7-fold decreases in amylase forms 1 and 2; and insignificant changes in trypsinogen 3, proelastase 2, lipase, and ribonuclease. During adaptation to diets containing normal protein (22%) or decreased levels of protein (0 or 10% protein) and correspondingly increased levels of carbohydrate, amylase and the majority of protease zymogens were synthesized in inverse proportion to nutritional substrates in the diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507619 TI - Epithelial response to intestinal anaphylaxis in rats: goblet cell secretion and enterocyte damage. AB - The effects of immunoglobulin E (IgE)-mediated reactions on the intestinal epithelium were examined during intestinal anaphylaxis in the rat. Rats sensitized by intraperitoneal injection of egg albumin (EA) plus alum developed high serum titers of IgE anti-EA antibodies after 14 days; sham-treated littermate controls had no anti-EA antibodies. Two isolated loops of jejunum were prepared in vivo in anesthetized rats. The loops were injected with EA in saline or saline alone, and intraluminal contents of each loop were examined after 4 h. Mucosal histamine decreased in sensitized rat intestine exposed to EA. Luminal mucin, measured by radioimmunoassay, was not increased by antigen challenge. In contrast, DNA, protein, and sucrase activities were elevated in contents from the isolated segments exposed to EA in sensitized rats. Histology revealed that periodic acid-Schiff-stained material was contained in goblet cells in sections prepared from these segments after antigen exposure. Cellular debris was present over the tips of the villi. These findings suggest that IgE-mediated reactions in the intestine cause epithelial damage and loss of material from cells other than goblet cells. The results indicate that release of goblet cell mucus is not a feature of intestinal anaphylaxis. PMID- 6507620 TI - Maturational increases and decreases in acid secretion in the rat. AB - We compared basal acid output (BAO) and maximally stimulated acid output (MAO) in 15-, 30-, and 100-day-old anesthetized rats. At each age we measured BAO and MAO in response to six different stimuli, pentagastrin (120 micrograms X kg-1 X h-1), bethanechol (1 mg X kg-1 X h-1), histamine (8 mg X kg-1 X h-1), the H2-receptor agonist impromidine (0.9 mumol X kg-1 X h-1), hypothermia (30 +/- 2 degrees C core temperature), and pyloric ligation, and we determined H+ output by continuous perfusion of the gastric lumen of anesthetized rats. Both weight adjusted and absolute BAO were significantly greater in 30-day-old rats than in 15- or 100-day-old rats. Although 30-day-old rats had only one-fourth the fundic mass of 100-day-old rats, they could secrete two to three times more H+ per hour. These differences in MAO persisted even after subtracting BAO. Anatomic data indicate that these age-related changes do not correspond to changes in mucosal mass or parietal cell mass. PMID- 6507621 TI - Differential growth rate of rat gastric mucosal cells during postnatal ontogeny. AB - The growth rate of surface epithelial, chief, and parietal cells of the base and neck of oxyntic glands was studied in the albino rat by comparing morphometric measures at days 15, 21, 30, and 100 postnatally. All cells increased in size. The number of cells per micrometer squared increased rapidly for chief cells and base parietal cells, while neck parietal cells remained constant and surface epithelial cells decreased. There was a net increase in the volume density of parietal and chief cells and a slight net decrease in surface epithelial cells during postnatal development. In a second experiment, the effects of early weaning on these variables was studied. Early-weaned rats gained less body weight than normally weaned counterparts. The change in surface epithelial cell size was not affected by early weaning. However, parietal and chief cells grew more quickly, initially, in early-weaned rats than in normally weaned rats. Cell numbers were unaffected except for an initial decrease in relative number of neck parietal cells. One long-term effect of early weaning was noted. The size and volume density of neck parietal cells in early-weaned rats was smaller, in the adult animal, then in normally weaned rats. PMID- 6507622 TI - A map of membrane populations isolated from rat exorbital gland. AB - We combined separation procedures based on three independent physical properties, sedimentation coefficient, density, and partitioning in an aqueous polymer two phase system, to generate a three-dimensional subcellular fractionation of rat exorbital lacrimal gland. The distributions of protein and five enzymatic markers define a total of 13 physically and biochemically distinct membrane populations. These include epithelial cell apical membranes, purified 330-fold with respect to the initial homogenate; basal-lateral membranes, purified 80-fold; mitochondria, purified 19-fold; and a major endoplasmic reticulum population, purified 22-fold. Also apparent is a major Golgi population, which is extensively overlapped by other membrane populations; two populations that can be visualized as forming transitions between the endoplasmic reticulum and Golgi membranes; and several populations with unknown subcellular origins. Most of the markers have complex distributions among the isolated membrane populations; this complexity is consistent with current concepts of the synthesis and recycling of membrane constituents and the regulation of cytosolic electrolyte activities. PMID- 6507623 TI - Modulation of gallbladder motility by intrinsic cholinergic neurons. AB - The mechanical contraction and release of acetylcholine (ACh) were investigated by use of an isolated guinea pig gallbladder preparation subjected to transmural field stimulation. An increase in contraction amplitude was found to be related to the frequency (5-60 Hz) of applied stimulus. Treatment with tetrodotoxin and atropine prevented these electrically induced contractions. A simultaneous increase in the release of ACh was noted with electrical stimulation or depolarization by veratrine hydrochloride, and this increase was susceptible to blockade by tetrodotoxin. Neither contractions nor ACh release could be detected with stimulation at 0.1 Hz. When field stimulation was applied to contracted gallbladder induced by a supramaximal concentration of cholecystokinin octapeptide (CCK-8), a further increase in muscle tone was observed. The magnitude of this increase was frequency dependent. Although the onset of response to field transmural stimulation was relatively more rapid, the maximal response attained was only 70% of that elicited by CCK-8. When tissues were exposed to 2.2 X 10(-6) M CCK-8, the muscle contracted maximally but there was no increase in the efflux of [3H]ACh. These data provide a pharmacological characterization of the intrinsic gallbladder cholinergic neurons and demonstrate a possible role they may play in the control of gallbladder motility. PMID- 6507624 TI - Regulation of intestinal goblet cell secretion. IV. Electrical field stimulation in vitro. AB - To determine whether transmitters released from enteric neurons can elicit secretion from goblet cells, full-thickness sheets of adult rat distal ileum or descending colon were mounted in modified Ussing chambers, and mucus secretion was assessed morphologically after electrical field stimulation (EFS). Square wave pulses (56 V, 2 ms duration) were delivered at 10 Hz for 5 min. Goblet cells in colonic crypts, but not those on the mucosal surface, secreted mucus in response to EFS. This secretion was at least in part atropine insensitive, indicating a noncholinergic mechanism. In the ileum goblet cells located in the crypts, but not on villi, secreted mucus when tissue was mounted in the chamber, even in the absence of EFS. This "unelicited" secretion did not occur in unmounted control tissue in vitro, and it could be prevented by preincubating ileal tissue in 1 microM tetrodotoxin (TTX) or 10 microM atropine for 15 min before mounting. Furthermore, following preincubation with either TTX or atropine, EFS' failed to elicit secretion. Incubation of unmounted tissue with TTX, however, did not block the secretory response of crypt goblet cells to 20 microM carbachol. Thus, intrinsic cholinergic neurons may be stimulated during the mounting of the ileum in the chamber. Taken together, these data demonstrate that mucus secretion from crypt goblet cells may be regulated by cholinergic (in ileum and perhaps colon) and noncholinergic (in colon) elements of the enteric nervous system. PMID- 6507625 TI - Erythromycin mimics exogenous motilin in gastrointestinal contractile activity in the dog. AB - The gastrointestinal motor stimulating activity of erythromycin (EM) was studied in conscious dogs. It was found that a 20-min intravenous infusion of EM lactobionate at a dose of 50-100 micrograms (potency) X kg-1 X h-1 induced a group of strong contractions in the stomach and the duodenum, and the contractions migrated along the small intestine to the terminal ileum. The EM induced contractions were quite similar to the naturally occurring interdigestive migrating contractions (IMC) in the gastrointestinal tract in frequency, contractile force, and duration of the contractions, migrating velocity, and accompanying peaks of plasma motilin concentration. The EM-induced contractions in the stomach were inhibited by feeding and intravenous infusion of pentagastrin (1.5 micrograms X kg-1 X h-1) but were not affected by secretin; these findings are identical to those found with the naturally occurring and motilin-induced contractions. Like motilin, EM stimulated motor activity only during the interdigestive state. We conclude that EM induces IMC associated with the release of endogenous motilin in the dog. PMID- 6507626 TI - Influence of bile acid structure on bile flow and biliary lipid secretion in the hamster. AB - A comprehensive study of the influence of bile acid structure on bile flow and biliary lipid secretion was carried out by infusing pure bile acids at a physiological rate into the proximal small intestine of a bile fistula hamster. Twelve individual bile acids, cholate (C), ursocholate (UC), chenodeoxycholate (CDC), and ursodeoxycholate (UDC) as their glycine (G), taurine (T), or unconjugated form, were studied so that influence of the hydroxy substituents as well as side-chain structure could be defined. The pattern of bile acid output was dependent on bile acid structure and reflected the site and rate of intestinal absorption. Conjugated bile acid output was delayed because of late ileal absorption, and TUC was poorly absorbed. Unconjugated trihydroxy bile acids, C and UC, also exhibited a delay in absorption, while CDC and UDC were absorbed immediately and achieved the highest bile acid output. Unconjugated bile acids were conjugated initially mostly with taurine and then mostly with glycine. The effect of glycine conjugates of each bile acid on bile flow and biliary lipid secretion was similar to that of their corresponding taurine conjugates. All conjugated bile acids induced a similar rate of bile flow (9-15 microliter bile/mumol bile acid), but unconjugated bile acids other than C induced more flow (20-25 microliter bile/mumol bile acid) than their corresponding conjugates. Conjugates of the dihydroxy bile acids induced a greater secretion of phospholipid and cholesterol than cholyl conjugates, whereas conjugates of UC were unique in inducing extremely low phospholipid and cholesterol secretion. For an increase of 1 mumol X min-1 X kg-1 in bile acid output, the increase in phospholipid secretion was 0.072 mumol X min X kg for GCDC and TCDC; 0.051 mumol X min-1 X kg-1 for GUDC and TUDC; and 0.030 mumol X min-1 X kg-1 for GC and TC. Increase in cholesterol output per mumol X min-1 X kg-1 of bile acid output was 0.013 mumol X min-1 X kg-1 for GCDC and TCDC, 0.011 mumol X min-1 X kg-1 for GUDC and TUDC, and 0.005 mumol X min-1 X kg-1 for GC and TC. In general, unconjugated bile acids induced more phospholipid and cholesterol than their corresponding conjugates; however, the rank-order effect of the steroid nucleus substituents was similar to that observed for the respective conjugates. These results indicate that both nuclear and side-chain structure influence the enterohepatic circulation and biliary secretory properties of bile acids.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6507627 TI - Tubuloglomerular feedback-mediated decreases in glomerular pressure in Munich Wistar rats. AB - These experiments were performed to evaluate directly measured glomerular capillary pressure and single nephron glomerular filtration rate (SNGFR) tubuloglomerular feedback responses in Munich-Wistar rats during increased distal flow rate achieved by infusing an isotonic electrolyte solution into unblocked late proximal tubules. Arterial pressure averaged 114 +/- 2 mmHg and proximal tubule pressure was 14 +/- 1 mmHg. In eight tubules, control SNGFR based on distal tubular fluid collections averaged 22 +/- 3 nl/min, decreased to 15 +/- 2.3 nl/min when 10-12 nl/min of perfusate was infused into the late proximal tubule, and further decreased to 9 +/- 1.7 nl/min at an infusion of 20-24 nl/min. In 22 tubules, control glomerular capillary pressure was 55 +/- 1.6 mmHg, decreased to 43 +/- 2.5 mmHg with addition of perfusate into a late proximal tubule at a rate of 24 nl/min, and returned to 53 +/- 3.1 mmHg when perfusion was stopped. In eight nephrons, glomerular capillary pressure was shown to be responsive to smaller increments in the late proximal infusion rate and was reduced by 4 +/- 0.5 and 7 +/- 1.1 mmHg at the intermediate rates of 10 and 15 nl/min, respectively. These results demonstrate that glomerular pressure decreases during increased distal delivery even when the tubule is not blocked. They are consistent with the hypothesis that increases in afferent arteriolar resistance are primarily responsible for feedback-mediated reductions in glomerular filtration rate. PMID- 6507628 TI - Cl- transport via anion exchange in Necturus renal microvillus membranes. AB - We investigated the mechanism of Cl- transport in microvillus membrane vesicles isolated from Necturus kidneys. Cl- influx was insensitive to changes in membrane potential induced by K+ gradients and the K+ ionophore valinomycin, arguing against conductive Cl- transport. Inward gradients of Na+ or Na+ + K+ did not stimulate initial Cl- influx, arguing against direct Na+-Cl- or Na+-K+-Cl- cotransport. External Cl-, HCO3-, and NO3- each stimulated 36Cl efflux and inhibited 36Cl uptake, indicating anion exchange. Outward HCO3- gradients but not OH- gradients stimulated 36Cl influx, consistent with Cl- -HCO3- exchange. Cl- transport via anion exchange was inhibited by furosemide, bumetanide, and disulfonic stilbenes, but not by acetazolamide. External halides stimulated 36Cl efflux (Cl- = Br- greater than I- greater than F-) but the organic anions lactate, p-aminohippurate, and urate did not. Amiloride-sensitive Na+-H+ exchange was demonstrated. Finally, in the presence of a CO2/HCO3 buffer system, imposing an inward Na+ gradient caused a time-delayed stimulation of 36Cl uptake, consistent with indirect coupling of Na+-H+ and Cl- -HCO3- exchangers. We conclude that the parallel operation of Na+-H+ and Cl- -HCO3- exchangers rather than direct cotransport may account for the Na+-coupled uphill Cl- entry previously observed in the intact proximal tubular cell of Necturus. PMID- 6507629 TI - Response of renal NH3 production to chronic respiratory acidosis. AB - Although chronic metabolic acidosis results in an adaptive increase in the renal capacity to produce NH3, the response to a low pH produced by chronic respiratory acidosis is unknown. Rats were placed in a specially constructed chamber with an ambient CO2 of 10% for 3 days, which increased their PCO2 to 76 +/- 4 mmHg. NH3 production was determined in vitro using both isolated kidneys perfused with 0.5 mM glutamine and cortical tubules incubated with 1 mM glutamine. Conscious rats with chronic respiratory and chronic metabolic acidosis had similar arterial pHs (7.29 +/- 0.01 and 7.31 +/- 0.01), which were significantly lower than controls (7.41 +/- 0.04). NH3 production by kidneys from rats with chronic respiratory acidosis perfused at pH 7.4 did not differ significantly from normal controls (1.13 +/- 0.13 vs. 1.07 +/- 0.17 mumol X min-1 X g-1). By contrast, kidneys from rats with chronic metabolic acidosis produced significantly more NH3 than both these groups (2.73 +/- 0.29 mumol X min-1 X g-1). Cortical tubules from rats with chronic respiratory acidosis also showed no evidence of adaptation in both NH3 (8.8 +/- 0.8 vs. 11.6 +/- 0.8 mumol X min-1 X g-1) and glucose (1.38 +/- 0.08 vs. 1.41 +/- 0.13 mumol X min-1 X g-1) production in comparison with controls, whereas chronic metabolic acidosis stimulated both ammoniagenesis and gluconeogenesis twofold or more. Thus a low systemic pH does not account for the adaptation in the capacity of the kidney to produce either ammonia or glucose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507630 TI - Mutual dependence of sodium and chloride absorption by renal distal tubule. AB - Sodium transport and chloride transport by the renal distal tubule of rats were studied by in vivo continuous microperfusion to determine the effects of separately altering luminal sodium and chloride concentrations. Results showed that sodium absorption depends on luminal sodium concentration and chloride absorption depends on luminal chloride concentration; both relations are linear between approximately 10 and 100 mM and have slopes of approximately 2.5 pmol X min-1 X mM-1. Sodium absorption is also a saturable function of luminal chloride concentration, and chloride absorption is a saturable function of luminal sodium concentration; the half-maximal chloride and sodium concentrations are approximately 10 mM. Furosemide, 10(-4) M, when added to the fluid used to perfuse this segment inhibited sodium absorption and chloride absorption to a similar extent. Removal of chloride from luminal fluid (replaced with sulfate) and addition of furosemide to the perfusion fluid had little or no effect on the measured transepithelial voltage. The results are consistent with the presence of a mechanism in the luminal membrane of distal tubule cells that couples the absorptive transport of sodium and chloride. PMID- 6507631 TI - Feedback pressure-flow responses in normal and angiotensin-prostaglandin-blocked rats. AB - We have examined the response of directly and indirectly (stop-flow) measured glomerular capillary hydrostatic pressure (PGC) and single nephron glomerular filtration rate (SNGFR) to increases in late proximal tubular flow rate in hydropenic rats and rats in which angiotensin II (ANG II) and prostaglandin generation was reduced by 3- to 5-day pretreatment with converting enzyme inhibitor (MK-421) and meclofenamate. In control rats, PGC (48 +/- 2 mmHg) decreased 9 +/- 1 mmHg when 25 nl/min was added to late proximal flow in unobstructed tubules, and PGC decreased 9 +/- 1 mmHg when late proximal perfusion rate was increased from 0 to 40 nl/min, incrementally, in wax-blocked tubules. The turning point or half-maximal response for PGC was at perfusion rates of 23 +/- 2 nl/min. Stop-flow estimated PGC (47 +/- 1 mmHg = control) responses were nearly identical. SNGFR decreased from 30 +/- 1 to 21 +/- 1 nl/min with increased perfusion in control rats. In ANG II-prostaglandin-blocked rats, PGC and stop flow pressure responses were completely eliminated, yet SNGFR response persisted (36.2 to 28.0 nl/min) but to a somewhat lesser extent. Both direct and indirect PGC decrease with increases in late proximal flow rate in untreated rats. Studies in ANG II-prostaglandin-blocked rats suggest that tubuloglomerular feedback SNGFR responses can occur without changes in PGC, possibly via parallel changes in afferent and efferent arteriolar resistances. PMID- 6507632 TI - Cell and luminal pH in the proximal tubule of Necturus kidney. AB - Double-barreled, selective microelectrodes filled with liquid ion exchanger were used to determine proximal tubule cell pH (pHcell), luminal pH (pHlum), and peritubular capillary blood pH (pHbl.pt) in Necturus kidney in vivo. The average pHbl.pt of 16 animals was 7.64 +/- 0.3; pHcell was 7.36 +/- 0.02 (n = 50), and pHlum was 7.50 +/- 0.05 (n = 16). Because of the variability in pHbl.pt from one animal to another, we studied the blood/cell/lumen pH differences. We sequentially measured with a single microelectrode pHcell and pHlum, and then pHbl.pt in an adjacent peritubular capillary. In 25 such paired determinations, the average pHbl.pt - pHcell difference was 0.28 +/- 0.03, cell acid, and the pHbl.pt - pHlum difference was 0.14 +/- 0.02, lumen acid. The pHcell in this series was significantly more acid than the pHlum (by 0.14 +/- 0.02), but in a few instances the pH gradient across the apical cell membrane was inversed. All measurements were performed in the initial portion of the proximal tubule. We conclude that 1) proximal cell pH is acid with regard to peritubular blood pH, 2) the proximal tubule of Necturus kidney is capable of establishing a small transepithelial pH difference (lumen acid), and 3) pHcell is generally more acid then pHlum. PMID- 6507633 TI - Glomerular prostaglandin formation in two-kidney, one-clip hypertensive rats. AB - In vitro prostaglandin (PG) and thromboxane B2 (TXB2) formation by isolated glomeruli from normotensive (N) and two-kidney, one-clip hypertensive (2K,1C) rats was determined. When calculated on the basis of glomerular protein content, PGE2, 6-keto-PGF1 alpha and TXB2 production of glomeruli from clipped kidneys was significantly greater than PG and TXB2 formation of glomeruli from the untouched kidneys. When PG and TXB2 formation was calculated per amount of glomeruli, only PGE2 formation was found to be significantly greater in clipped kidneys. No severe damage of glomerular structure was found in the kidneys when studied by light microscopy. In additional in vivo studies, the effect of the cyclooxygenase inhibitor indomethacin on blood pressure and glomerular filtration rate (GFR) was evaluated. Following indomethacin GFR in 7 of 13 clipped kidneys of 2K,1C rats decreased from 363 +/- 77 to 188 +/- 51 microliter/100 g body wt, whereas six kidneys developed anuria. No effect of cyclooxygenase inhibition on GFR was found in N rats and in untouched kidneys of 2K,1C rats. Mean arterial blood pressure in 2K,1C hypertension fell significantly, from 158 +/- 10 to 135 +/- 7 mmHg, after cyclooxygenase inhibition. No effect was seen in N rats. The data suggest that increased glomerular PG formation in the clipped kidneys of 2K,1C rats is involved in the pathogenesis of hypertension in this animal model. PMID- 6507634 TI - Method for measurement of heart rate in awake, noninstrumented small mammals. AB - A method is described that enables the researcher to determine the heart rate in awake, noninstrumented small animals by recording the electrocardiogram (ECG) via the paws. Single animals are placed in a cage that has metal plates built into its floor. Through switches any two plates can be connected with an ECG recorder whenever contact with at least one front and one hind paw is made. The heart rate is then determined by measuring the number of R waves per unit of time. In rats of 140 and 300 g body wt mean resting heart rates of 384 +/- 10 and 320 +/- 4 beats/min, respectively, have been measured with this method. PMID- 6507635 TI - Repetitive ramped neck suction: a quantitative test of human baroreceptor function. AB - Bolus intravenous injection of an alpha-agonist is a widely accepted method used for studying baroreceptor function. However, the method is invasive, multiple baroreceptor regions are stimulated, and there are diverse direct effects of these pharmacologic agents, e.g., direct effects on the carotid sinus region. A recently described noninvasive neck suction technique may be highly specific for assessing the carotid sinus to sinoatrial node baroreflex. We compared neck suction-derived baroslopes with those obtained from the standard, invasive phenylephrine infusion method. These techniques were applied to 15 adult volunteers while awake and during 1.34 and 2% isoflurane anesthesia. The correlation coefficients between the two methods were 0.74 (P = 0.002) in awake subjects and 0.75 (P = 0.001) overall. The neck suction method of repetitive, ramped carotid stimuli yielded results that were qualitatively and quantitatively similar to those of the standard phenylephrine method. The neck suction method is simple, noninvasive, and can be repeated at frequent intervals. This method may be highly specific for determining carotid baroreceptor-cardiac reflex physiology in humans. PMID- 6507636 TI - A new method for preparation of isolated single adult myocytes. AB - A new technique for isolation of single cardiac cells from adult rat ventricles is described. The mechanical method is modified from the method of Jacobson (Cell Struct. Funct. 2: 1-9, 1977) by employing an enzyme-free dispersion medium containing Sr2+ or Ba2+ to replace Ca2+. This method produces a high yield of isolated rod-shaped adult mammalian cardiomyocytes that do not contract spontaneously, have a normal resting potential, and are Ca2+ tolerant. This method represents a promising technique for isolation of single, viable, intact, adult myocytes. PMID- 6507637 TI - Inhibition of myocardial rotenone-insensitive NADH cytochrome c reductase by amphiphilic compounds. AB - Because myocardial ischemia is correlated with both an elevation of intracellular levels of amphiphilic lipid metabolites and a decrease in the rotenone insensitive NADH cytochrome c reductase (RINCR), we investigated the effects in vitro of some amphiphilic lipid metabolites and synthetic detergents on the activity of RINCR-enriched subfractions of microsomes from isolated cardiac myocytes. RINCR activity was unaffected in vitro by the addition of lysophosphatidylethanolamine (up to 0.5 mM) but was inhibited (maximum 63%) by lysophosphatidylcholine (8 microM). Palmitoyl carnitine (up to 2 mM) was ineffective, but the coenzyme A thioesters of palmitate, stearate, oleate, and arachidonate were inhibitory at concentrations (less than 3 microM) below their critical micellar concentrations. Arachidonyl CoA was approximately one order of magnitude more inhibitory than the other long-chain acyl CoA thioesters. Kinetic analyses revealed the effect of arachidonyl CoA on RINCR activity to be exclusively an alteration of the Vmax with no change in the Km for cytochrome c. The inhibition of myocytic RINCR activity by long-chain acyl CoA may be unrelated to the bulk-phase detergency of this lipid amphiphile since the effects were observed at concentrations below the critical micellar concentration, and other lipid amphiphiles had no effect on RINCR activity. Inhibition of microsomal RINCR activity may result from localized disruption of the membrane microenvironment of the enzyme complex by penetration or dissolution of long-chain acyl CoA into the membrane. The pronounced sensitivity of myocytic RINCR activity to long-chain acyl CoA suggests a relationship between the decreased RINCR activity and the increased levels of this class of lipid metabolites observed in the ischemic myocardium. PMID- 6507638 TI - Na transport and blood pressure in the adrenalectomized rat. AB - The transmembrane distribution of Na, K, and water in freshly excised rat tail artery was measured 7 days after adrenalectomy, 3 days after withdrawal of support with 1% NaCl as drinking water. Cell Na decreased from 35.8 +/- 0.9 to 31.6 +/- 0.7 mmol/kg dry wt, tissue water increased from 2.93 +/- 0.03 to 3.08 +/ 0.04 l/kg dry wt, and tissue K remained unchanged. As concentration, [Na]i decreased from 22.5 +/- 0.9 to 18.3 +/- 1.0 mM in parallel with [Na]o which fell from 140.6 +/- 0.3 to 133.6 +/- 1.0. Conversely, while [K]i fell from 140 +/- 2 to 128 +/- 3, [K]o rose from 2.15 +/- 0.12 to 5.40 +/- 0.33 so that EK dropped from -109 to -83 mV. Aldosterone (120 micrograms X 100 g-1 X 24 h-1 sc; 3 X 10( 7) M if immediately distributed in the extracellular fluid) partially restored blood pressure, plasma [Na] and [K], and tissue water within 24-26 h but did not increase cell Na. Similar effects were produced with corticosterone at 400 microgram X 100 g-1 X 24 h-1 (3 X 10(-6) M if immediately distributed in the extracellular fluid). We conclude that the restoration of blood pressure in the adrenalectomized rat is independent of [Na]i or [Na]o/[Na]i but is associated with enhanced Na transport activity. PMID- 6507639 TI - Extracellular pH and tension during ischemia in the isolated rabbit ventricle. AB - To investigate the factors determining the rate of H+ accumulation during early ischemia, miniature intramyocardial pH electrodes (tip diam 0.2-0.5 mm) were used to record extracellular pH (pHo) in the isolated arterially perfused rabbit interventricular septum. Changes in pHo and the rate of fall of tension during global ischemia were compared under control conditions (37 degrees C, heart rate 75 beats/min) and after exposure to the following interventions: reduced heart rate (36 beats/min), hypothermia (27 degrees C), verapamil (0.5 microM), reduced extracellular Ca2+ concentration [( Ca2+]o 0.5 mM), norepinephrine (0.5 microM) in normal and catecholamine-depleted preparations, norepinephrine and reduced [Ca2+]o, and theophylline (4 mM). Under control conditions pHo declined by 0.61 0.73 pH units after 10 min of ischemia. The negative inotropic interventions and reduced temperature significantly decreased [H+]o accumulation during ischemia. Positive inotropic interventions did not affect the rate of [H+]o accumulation during ischemia except in reserpinized preparations. All of the interventions except for reduced temperature significantly altered the relationship between tension and pHo during ischemia. PMID- 6507640 TI - Cycle length-dependent action potential duration in canine cardiac Purkinje fibers. AB - We studied the effects of pharmacologic probes that affect predominantly the Na inward current [tetrodotoxin (TTX), lidocaine], the slow inward current [cobalt, isoproterenol, verapamil], and the potassium currents [tetraethylammonium chloride (TEA), SG-75] on the duration of the action potential (APD) of canine cardiac Purkinje fibers during steady state and restitution. A schema is proposed in which the APD during steady state or restitution is determined by three factors: maximum action potential duration (APDmax), kinetics of restitution, and "memory." The predicted APDmax was 469 +/- 34 (SE) ms (n = 27) in control. It was prolonged (P less than 0.05) by cobalt, verapamil, and TEA and shortened (P less than 0.05) by TTX, lidocaine, isoproterenol, and SG-75. In control, the kinetics of restitution were described by a sum of two exponentials with time constant T1 = 137 +/- 9 ms and T2 = 1,665 +/- 135 ms (n = 27), respectively. T1 was prolonged (P less than 0.05) by TTX, lidocaine, and verapamil but was not changed by other probes. None of the probes studied altered the T2 of restitution or the memory factor, computed at a cycle length of 500 ms from the predicted APDmax and the plateau of restitution. Low temperature (31 degrees C) prolonged APDmax and T1 and reduced the memory. We conclude that each of the proposed three factors is controlled by different mechanisms and that a TTX-sensitive current appears to contribute to the process of restitution of APD. PMID- 6507641 TI - Tetrodotoxin-resistant relaxation to transmural nerve stimulation in isolated saphenous vein. AB - The response to transmural nerve stimulation (TNS) was characterized in rings of canine saphenous veins following sympathetic (guanethidine 10(-4) mol/l; phenoxybenzamine 2 X 10(-5) mol/l; propranolol 2 X 10(-6) mol/l) and muscarinic blockade (atropine 5 X 10(-6) mol/l). In preparations which were contracted with prostaglandin F2 alpha, TNS was applied as intermittent trains of stimuli of 30 s duration at frequencies of 1-32 Hz. This stimulus elicited a frequency-dependent relaxation [maximum relaxation 3.4 +/- 0.21 (SE) g]. This relaxation was present in rings denuded of endothelium and was not altered significantly by cimetidine (10(-4) mol/l), indomethacin (10(-5) mol/l), aminophylline (10(-5) mol/l), or cyproheptadine (10(-6) mol/l). It was abolished by the Na+-K+-ATPase inhibitor ouabain (2 X 10(-4) mol/l) and in zero-K+ Krebs solution. When the experiment was repeated following storage of the isolated saphenous veins for 9 days at 4 degrees C TNS failed to induce any relaxation. However, the relaxation in fresh rings was not abolished by tetrodotoxin (10(-6) mol/l). The present study demonstrates a nonadrenergic noncholinergic relaxation to TNS in the saphenous vein which could be mediated by 1) a tetrodotoxin-resistant nerve or 2) a direct effect of TNS on the smooth muscle. PMID- 6507643 TI - Perinatal nutritional modification of weanling rat heart contractile protein. AB - The present study ascertained the influence of litter-size-induced perinatal nutritional modification on cardiac contractile protein enzymatic activity and isomyosin composition. Myofibrillar enzyme activities for Mg2+ -ATPase, Ca2+ ATPase, and creatine kinase (CK) in the weanling heart were unaltered by nutritional modification. However, these enzyme activities were all significantly augmented in the adult heart. Hill plot analyses of Mg2+ -ATPase activities indicated that myofibrillar calcium regulation was not influenced by either nutritional modification or the weanling-to-adult developmental progression. Isomyosin V1 composition (90 +/- 1%) correlated with plasma thyroid hormone level in normal-growth (8/litter) weanlings. Undernutrition retarded conversion of V3 isomyosin to the V1 species while overnutrition enhanced isomyosin conversion. Isomyosin composition in weanling rats subjected to perinatal nutritional modification was independent of thyroid status. In the adult rat, plasma thyroxine levels were increased, whereas V1 isomyosin remained unchanged (88 +/- 2%) compared with that of the weanling groups. Discrepancies in the relationship between contractile protein enzymatic activities, myosin composition, and heart function are apparent between both the litter-size-adjusted weanling rats and between weanling and adult animals. These discrepancies indicate the complex relationship between heart function and contractile protein properties. PMID- 6507642 TI - Renal effects of volume expansion in the renal-denervated nonhuman primate. AB - Experiments were performed to determine the role of renal nerves in mediating the renal excretory effects of volume expansion in the nonhuman primate. Male Macaca fascicularis monkeys underwent chronic bilateral renal denervation or sham surgery. After a 1- to 2-wk recovery period, each animal was anesthetized with pentobarbital sodium and volume expanded 20% of estimated blood volume. Two types of volume expansion were used, a hemodilutional expansion using 6% dextran in isotonic saline and an isohemic expansion using each monkey's own blood that had previously been withdrawn in exchange for dextran. Renal denervation did not attenuate the excretory responses to volume expansion in that similar increases in urine flow, sodium excretion, filtered load of sodium excreted, osmolar and free water clearances occurred in both the renal-denervated and sham-operated groups. The onset of the responses was not delayed by renal denervation. Furthermore, the results were the same with both volume expansions. These results suggest that, in the monkey, decreases in renal nerve activity that occur with volume expansion are not necessary for eliciting the excretory responses to this hypervolemic stimulus or that other factors compensate if the kidneys are chronically denervated. In addition, the failure of renal denervation to attenuate the excretory effects of a cell-free volume expansion is not related to any dilutional characteristics of the expansion. PMID- 6507644 TI - Differential effect of vasopressin on angiotensin and norepinephrine pressor action in rats. AB - The effect of vasopressin infusion on the pressor dose responses to angiotensin II and norepinephrine was studied in pentobarbital-anesthetized and unanesthetized nephrectomized rats. Pressor vasopressin (2-15 ng X kg-1 X min-1) given to anesthetized rats decreased sensitivity to angiotensin II in a dose dependent manner (r = 0.88), an effect completely reversible by dPMeTyrAVP, a vasopressin vascular antagonist. Subpressor vasopressin (0.5-1 ng X kg-1 X min-1) given to unanesthetized rats diminished sensitivity to angiotensin II in the presence or absence of pentolinium (10 mg/kg). Shifts in dose-response curves to angiotensin II were always parallel. In contrast, dose responses to norepinephrine were not modified by vasopressin in pentolinium-treated rats and showed a small nonparallel rightward shift in animals without pentolinium. In animals without pentolinium, the baroreflex-mediated reduction in heart rate elicited by angiotensin II was not altered by vasopressin infusion. Our data suggest that vasopressin reduces angiotensin II pressor action by diminishing pressor sensitivity to the peptide. They indicate that the effect may be specific, mediated through the vascular receptor for vasopressin and independent of actions of this hormone on the autonomic nervous system. PMID- 6507645 TI - Effects of arterial input impedance on mean ventricular pressure-flow relation. AB - The mean left ventricular pressure-flow relationship (Pv-Fv), determined under a constant preload and variable peripheral resistance, has been proposed as a quantitative representation of ventricular pump function (9). We determined the Pv-Fv relation in seven isolated cross-perfused canine hearts by varying resistance of a simulated arterial load in five steps from 6.0 to 0.375 mmHg X s X ml-1 while keeping end-diastolic volume, inotropic state, compliance, and characteristic impedance at various constant values. All of the 27 Pv-Fv relations thus determined were moderately nonlinear. Varying end-diastolic volume at three levels shifted the relation curve in an approximately parallel fashion (P less than 0.0001). At three levels of inotropic state (mean LVP of isovolumic contractions 34.3 +/- 8.2, 48.0 +/- 6.3, and 59.2 +/- 9.6 mmHg), the Pv-Fv relation shifted with predominantly a slope change (P less than 0.0001). Changing compliance at three levels (0.2, 0.4, and 0.8 ml/mmHg) caused a statistically significant but quantitatively small crossover of the Pv-Fv curves (P less than 0.0001). Changing characteristic impedance to 0.1, 0.2, and 0.4 mmHg X s X ml-1 caused a highly significant (P less than 0.0001) divergence of Pv-Fv relation over the high Fv range. We conclude that this sensitivity of the Pv-Fv relation to characteristic impedance limits its use as a contractility index. PMID- 6507646 TI - Coronary venous outflow persists after cessation of coronary arterial inflow. AB - During single long diastoles we simultaneously measured coronary arterial blood flow and coronary venous outflow. When vasomotor tone was intact, approximately 20% of the total volume of diastolic coronary venous outflow appeared after cessation of inflow. During maximal coronary dilation, approximately 40% of the total volume of diastolic coronary venous outflow appeared after cessation of inflow. Theoretically, coronary capacitance could enable persistence of diastolic coronary venous outflow during zero coronary artery inflow. Intramyocardial coronary capacitance calculated from these data was 0.10 ml X mmHg-1 X 100 g-1 with vasomotor tone intact and 0.21 during maximal coronary dilation. These results indicate that the diastolic coronary arterial stop-flow pressure cannot be equated with cessation of flow throughout the coronary vasculature due to the significant contribution of intramyocardial capacitance. We also found that the arterial pressure at which coronary outflow stopped (10-14 mmHg) was substantially less than that at which coronary artery inflow ceased (19-31 mmHg), yet slightly above right atrial pressure (5-9 mmHg). These studies indicate that coronary venous outflow stops at a lower pressure than arterial inflow. Furthermore, the cessation of venous blood flow in the coronary system during long diastoles occurs at pressures only a few mmHg above right atrial pressure. PMID- 6507647 TI - Hemodynamic and neural mechanisms of acute neurogenic hypertension in the rat. AB - Experiments were performed to test the hypothesis that acute hypertension caused by aortic baroreceptor deafferentation (ABD) is the result of sympathetic vasoconstriction. Cardiac output (CO), mean arterial pressure (MAP), and total peripheral resistance (TPR) were measured before and after ABD in anesthetized and conscious rats. The role of the sympathetic nervous system in acute ABD induced hypertension was evaluated by examining the ability of adrenalectomy, adrenal demedullation, guanethidine or combined adrenal demedullation, and guanethidine pretreatment to prevent, and total autonomic blockade to reverse, ABD-induced hypertension. CO did not change significantly after ABD at any time, whereas MAP and TPR increased significantly (P less than 0.05). Only combined adrenal demedullation and guanethidine pretreatment prevented ABD-induced hypertension, and autonomic blockade normalized MAP in ABD rats. Normalization of blood pressure was the result of a decreased TPR. It is concluded that acute ABD induced hypertension results from vasoconstriction caused by neurally released and/or circulating catecholamines. PMID- 6507648 TI - Amino acids induce renal vasodilatation in isolated perfused kidney: coupling to oxidative metabolism. AB - Renal vasodilatation regularly accompanies protein feeding and amino acid infusions, but the mechanism is unknown. The effects of several different amino acids on renal hemodynamics were studied in the isolated rat kidney, perfused with glucose as the only other substrate. Addition of amino acids produced a dose dependent, brisk, and sustained decrease in renal vascular resistance (by 5-35%) without change in glomerular filtration rate (GFR). The vasodilatation was associated with a parallel increase in O2 consumption (increases QO2). The effect was most marked with amino acids actively metabolized by the kidney, such as glutamine (at 2 mM), but was seen with most amino acids at 8 mM. The amino acid analogues alpha-aminobutyrate, taurine, and cycloleucine, cotransported with sodium but not metabolized, did not cause significant vasodilatation or increases QO2. Blocking active transport with ouabain blunted the amino acid-induced vasodilatation and increases QO2. Similar resistance to amino acids was produced by halting GFR with hyperoncotic medium. Restoration of GFR by increasing perfusion pressure in the presence of hyperoncotic medium reestablished amino acid-induced vasodilatation and increases QO2. Furosemide did not block the vasodilatory response. Inhibition of mitochondrial respiration by antimycin blocked both vasodilatation and increases QO2, but rotenone blockade could be bypassed by succinate or glutamine. Amino acids have a direct vasodilating action on isolated kidneys probably related to their role as metabolic substrates and linked to an increase in renal O2 consumption. PMID- 6507649 TI - Salt gland and kidney responses to intracerebral osmotic stimulation in salt- and water-loaded ducks. AB - Saltwater-adapted ducks with functioning supraorbital salt glands were chronically implanted with a device for perfusion of the third cerebral ventricle (icv perfusion) with artificial cerebrospinal fluid (CSF) of different tonicities. The osmoregulatory responses to icv stimulation were studied at conditions of salt and water loading in which only the salt glands, both salt glands and urinary fluid excretion, or only urinary fluid excretion were stimulated; in the latter experiments plasma antidiuretic hormone (ADH) was measured with a radioimmunoassay. Hypertonic icv stimulation enhanced salt gland secretion and caused antidiuresis, due to the increase of plasma ADH. Hypotonic icv stimulation inhibited salt gland activity and caused diuresis, due to the decrease of plasma ADH. Salt gland activity, urine formation, and plasma ADH reacted more sensitively to changes of icv tonicity in the hypertonic than in the hypotonic range. The effect of icv hypotonic stimulation could be obtained also with icv perfusion of isosmotic artificial CSF deficient in NaCl content. Perfusion with artificial CSF exceeding plasma tonicity by 50 mosmol X kg-1 or more caused inhibition of salt gland secretion associated with enhanced urinary output in several experiments. PMID- 6507650 TI - Diet-dependent hyperplastic growth of adipose tissue in hypothalamic obese rats. AB - Accelerated production of fat cells is often seen in dietary obesity in rats but not in obesity occurring in response to damage to the medial area of the hypothalamus (MH). The basis for this difference was examined. MH damage (MHD) was produced in rats by either electric current or small knife cuts. Rats were then fed either chow or a high-fat high-sugar diet (HFS) for up to 6 mo. Fat cell production did not accelerate during the 1st 16 wk after MHD in rats fed only chow, but acceleration clearly occurred in rats fed HFS during only 4 wk. At 18 wk after MHD rats fed only chow showed evidence of accelerated fat cell production. However, there was greater acceleration after MHD in HFS-fed rats held to the same weight gain as chow-fed rats. Rats allowed to freely eat HFS for 6 mo after MHD showed extremely large increases in body weight and fat cell number. The plateau in body weight often seen in rats fed only chow after MHD did not occur. Because HFS-feeding promoted unimpeded production of fat cells, accelerated weight gain induced by MHD could continue indefinitely. These findings suggest that enlargement of fat cells and components of the diet act synergistically in the promotion of adipocyte hyperplasia in adult rats and also suggest that accelerated weight gain after MHD is not due to elevation of a set point for body weight or body fat. PMID- 6507651 TI - Plasma melatonin concentrations in hibernating marmots: absence of a plasma melatonin rhythm. AB - Plasma melatonin concentrations were measured throughout bouts of hibernation in marmots maintained in a short photoperiod (light-dark 8:16) and ambient temperature of 5 or 15 degrees C. Melatonin concentration was also measured in two animals maintained in constant darkness. As an animal entered hibernation, plasma melatonin concentrations dropped to basal levels when body temperature reached 25 degrees C, and they remained low until arousal. During deep hibernation plasma melatonin values did not vary significantly (P greater than 0.05) with respect to time of day or different ambient temperatures. With nocturnal arousal plasma melatonin levels were similar to euthermic night values. Lack of a plasma melatonin rhythm during hibernation suggests that the pineal gland is not temperature compensated during hibernation, and due to the low tissue temperature of the pineal the circadian pacemaker driving melatonin secretion is incapable of stimulating a rhythm. PMID- 6507652 TI - Two kinds of timing in circadian incubation rhythm of ring doves. AB - Ring dove males share incubation with females by sitting on the nest for a block of time in the middle of the day. The timing of nest exchanges was studied by experimentally delaying the onset, in the morning, of the male's sitting bout. Such delays induced a concomitant but smaller delay in the offset of the male's sitting bout in the afternoon. The female, however, approached the nest to start her bout of sitting at the usual time in the afternoon even though her previous sitting bout had ended later than usual. These findings, together with data on interactions between the pair at the afternoon exchange, suggest that the behavior of the sitting male reflects an interval timing mechanism initiated with the onset of his sitting bout. In contrast the attempts to regain the nest by the nonsitting female probably reflect a circadian oscillation. PMID- 6507653 TI - Motor activity in decerebrate rats: spontaneous and nutrient-induced changes. AB - Bilateral decerebration was performed in adult Wistar rats of either sex under pentobarbital sodium anesthesia. Decerebrate rats were aphagic and adipsic and received 44 kcal/day subcutaneously by gastric intubation. Their motor activity was recorded in the morning after an 18-h fast, following various treatments: 10 ml mash (22 kcal) or 3.6 g glucose/kg; intragastric, intraperitoneal, or subcutaneous injection of glucose (3.6 g/kg) or glycerol (1.84 g/kg); or injection of epinephrine (25 micrograms/kg ip or im). These treatments were also applied to control rats previously maintained in the same conditions. Motor activity of both operated and control rats was generally reduced in a similar manner: intragastric mash greater than intraperitoneal glucose = intraperitoneal glycerol greater than or equal to intragastric glucose greater than intraperitoneal epinephrine. Subcutaneous glucose and glycerol and intramuscular epinephrine produced hyperactivity, at least for the first 30 min. Thus decerebrate rats respond like normal rats by reducing their general activity when subjected to the same satiating treatments given intragastrically or intraperitoneally. This suggests that the brain stem of rats can monitor peripheral information regarding caloric replenishment. PMID- 6507654 TI - Inhibition of plasma vasopressin after drinking in dehydrated humans. AB - To study the effects of nonosmotic and nonvolumetric factors that may influence secretion of vasopressin, serum Na+, K+, and osmolality (Osm), hemoglobin, hematocrit, plasma arginine vasopressin (AVP), aldosterone (PA), and renin activity (PRA) were measured in five men and three women (26-50 yr, 73 +/- 4 kg) before and after 24 h of mild dehydration (food but no fluid) and seven times during the 1st h after rehydration with 10 ml/kg of tap water (17.5 +/- 0.5 degrees C) consumed in 105 s (range 35-240 s). Dehydration increased mean serum Na+ 3.7 +/- 0.7 meq/l (P less than 0.05), osmolality 9.1 +/- 1.1 mosmol/kg (P less than 0.05), and AVP from a hydrated level of 1.7 +/- 0.2 to 3.3 +/- 0.5 pg/ml (delta = 1.6 pg/ml, P less than 0.05). After rehydration AVP fell to 2.4 +/ 0.3 pg/ml (P less than 0.05) within 3 min and reached the water-replete level of 1.8 +/- 0.3 pg/ml 9 min after drinking started. Serum Na+ and Osm did not change until 30-60 min after drinking. No significant changes occurred in PRA, hemogloblin, hematocrit, or calculated delta in plasma volume, but PA increased from 11.1 +/- 1.5 ng/dl after dehydration to 15.6 +/- 2.6 ng/dl (P less than 0.05) between 30 and 60 min after drinking. The rapid fall in plasma AVP after rehydration took place in the absence of the expected changes in the primary regulators of plasma AVP (i.e., osmolality and plasma volume), with no change in blood pressure. The results suggest that oropharyngeal factors, alone or combined with gastric stimuli, are implicated. PMID- 6507655 TI - Responses of primate T1-T5 spinothalamic neurons to gallbladder distension. AB - Extracellular unit recordings were obtained from 44 spinothalamic tract (STT) neurons in the T1-T5 segments of 15 alpha-chloralose anesthesized monkeys (Macaca fascicularis). Each cell had a somatic receptive field in the left chest region and was excited by electrical stimulation of cardiopulmonary sympathetic afferent fibers. Gallbladder distension to pressures between 20 and 100 mmHg increased activity in 16 of 44 neurons. Responses usually consisted of bursts of activity associated with increased gallbladder pressure (phasic responses) followed by maintained activity during the distension (tonic responses). Magnitude of phasic responses was linearly related to the distending pressure and was consistently greater than magnitude of tonic responses. The gallbladder-responsive and nonresponsive groups included similar proportions of wide dynamic range, high threshold, and high-threshold inhibitory cells. Nine of 10 gallbladder-responsive cells and 11 of 21 gallbladder-nonresponsive cells increased their discharge rate after injection of 2 micrograms/kg bradykinin into left atrium. Activity of cells with gallbladder input increased from 14 +/- 4 to 33 +/- 4 spikes/s. Cells without gallbladder input increased their discharge rate to a significantly less degree (10 +/- 3-23 +/- 4 spikes/s). These results indicate that upper thoracic STT neurons may increase their activity during gallbladder distension. Convergence of afferent information from the chest and gallbladder may explain chest pain occurring during gallbladder disease. Furthermore the tendency of gallbladder-responsive cells to respond to bradykinin injections with a high rate of discharge could explain how this chest pain of gallbladder origin may closely mimic pain of angina pectoris. PMID- 6507656 TI - Recovery of early memories associated with reported dream imagery. AB - In recent years dreaming has been characterized as an information-processing activity that functions adaptively to match new experience with representations of past events already stored in long-term memory. Nine patients who reported dreams in psychotherapy were asked expressly if the dream imagery recalled a specific event from early in their lives. Of 50 consecutively reported dreams, 46 were associated with early events whose imagery appeared in the dream. When questioning about the past was omitted in a later series of 34 dreams, the same patients spontaneously recalled early events represented in the dream imagery only 13 times. PMID- 6507657 TI - Abuses of the borderline diagnosis: a clinical problem with teaching opportunities. AB - The authors identify six ways in which the borderline diagnosis is commonly abused to express countertransference hate, mask imprecise thinking, excuse treatment failures, justify the therapist's acting out, defend against sexual clinical material, and avoid pharmacologic and medical treatment interventions. The paper focuses on diagnostic abuses that trainees present to clinical supervisors and educators. It attempts to show educators how to discern these abuses and turn them into teaching opportunities. These abuses are seen not only in trainees; they also occur in the professional community as a whole. Clinicians should expect the same diagnostic rigor of themselves that they expect of their students. PMID- 6507658 TI - The dexamethasone suppression test in normal control subjects: comparison of two assays and effect of age. AB - he authors used competitive protein binding assay and radioimmunoassay to measure cortisol levels in 38 normal control subjects three times before and three times after administration of 1 mg of dexamethasone. They found significant interassay differences at 11:00 p.m. before dexamethasone and at all three postdexamethasone times. Analysis of variance revealed significant overall positive relationships between age and cortisol levels measured by both techniques. Age correlated significantly with postdexamethasone cortisol levels measured by radioimmunoassay but not when measured by competitive protein binding assay. Clinicians should obtain data from their laboratories as to appropriate cutoffs for cortisol suppression on the specific assay used. PMID- 6507659 TI - Treatment for children of volatile psychotic adults in the adult psychiatric setting. AB - The authors describe a unique program for the treatment of troubled children of adult psychiatric patients at a Veterans Administration hospital. The location of this program within the adult setting greatly facilitated the successful treatment of these children. The program can also be a valuable addition to the treatment of adult patients, especially patients who are chronically ill and emotionally volatile and have been particularly difficult to treat. PMID- 6507660 TI - Impaired smooth pursuit eye movement: vulnerability marker for schizotypal personality disorder in a normal volunteer population. AB - Impaired smooth pursuit eye movement has been proposed as a possible biologic marker for schizophrenia. Preliminary studies have suggested that this impairment may be associated with social introversion and related psychopathology in a nonpsychiatric population. To evaluate the relationship between dysfunctional smooth pursuit eye movement and schizophrenia-related psychopathology, the authors screened a new, volunteer sample of 284 male college students for eye tracking accuracy. Volunteers identified as low-accuracy trackers were significantly more likely to be diagnosed (blindly) as having a schizotypal personality disorder by DSM-III criteria than those identified as high-accuracy trackers. The authors suggest that disordered smooth pursuit eye movement may reflect a vulnerability marker for schizotypal personality disorder. PMID- 6507662 TI - The contribution of epidemiology to clinical psychiatry. PMID- 6507661 TI - Earn-as-you-go pressures in academic psychiatry. AB - The future of academic psychiatry may be seriously jeopardized by recent funding cutbacks at federal and state levels. Hospitals and departments of psychiatry are having to function as businesses, and full-time faculty are increasingly concerned with profits, with less time for teaching. Shrinking departmental resources make it necessary for faculty to assume the new responsibility--in addition to their administrative, educational, and teaching roles--of generating large portions of their own salaries from private patient care revenues. Residents' opportunities to work with psychotherapy patients are being compromised by financial considerations. Other actual or potential consequences of the fiscal dilemma include decreased teaching of medical students and lessened scholarly productivity. PMID- 6507663 TI - A 4-6-year follow-up of 50 patients with primary dependence on sedative and hypnotic drugs. AB - The authors studied 50 of 55 patients originally hospitalized for primary sedative-hypnotic dependence 4-6 years after hospital discharge. Forty-two (84%) of the patients had resumed using sedative-hypnotics, 26 (52%) were abusing drugs at follow-up, and 21 (42%) had been readmitted for drug abuse. Three patients experienced delirious states and six experienced epileptic seizures associated with withdrawal. Physical signs of alcoholism had developed in 11 (22%); four (8%) had committed suicide. Social deterioration was noted in 24 patients. CAT scan results did not deviate from those found in a matched control sample. PMID- 6507664 TI - The theme of death in complex partial seizures. AB - The theme of death highlighted the depersonalization phenomena of four patients with complex partial seizures. These patients became preoccupied with death in association with psychomotor seizures, visual hallucinations, and altered perception of time and reality. The episodic sense of being dead or of having an appointment with death is a clue to the diagnosis of recurrent complex partial seizures even without overt motor stigmata of seizures. The syndrome differs from fear of death, steroid psychosis, the "near death syndrome," and Cotard's syndrome. Adjustment of antiseizure medication is an important therapeutic maneuver. PMID- 6507665 TI - Effects of methylphenidate on reading in children with attention deficit disorder. AB - Effects of methylphenidate on measures related to reading were studied in a group of nine boys who had attention deficit disorder with hyperactivity; a double blind crossover design using active drug and placebo was used. Administration of methylphenidate improved subjects' performance on language processing tests but not their performance on oral reading measures. The findings provide evidence in support of a two-factor theory of attention deficit disorder. PMID- 6507666 TI - Monosymptomatic hypochondriasis treated with tricyclic antidepressants. AB - The authors report on two patients with disabling monosymptomatic hypochondriasis who responded to tricyclic antidepressants. They include a brief review of the literature on this uncommon debilitating illness. PMID- 6507667 TI - Clonidine in the treatment of mania and mixed bipolar disorder. AB - The symptoms of three bipolar patients remitted after clonidine treatment. One patient presented with mixed bipolar disorder, two were manic, and all were psychotic. One patient's akathisia also appeared to respond to clonidine. Clonidine's thymoleptic effect paralleled resulting cardiovascular changes. PMID- 6507668 TI - Association between low plasma levels of dexamethasone and elevated levels of cortisol in psychiatric patients given dexamethasone. AB - In psychiatric inpatients, positive results on 40 dexamethasone suppression tests (elevated cortisol levels) were strongly associated with low plasma levels of dexamethasone. Bioavailability or pharmacokinetic factors may contribute importantly to the outcome of the dexamethasone suppression test. PMID- 6507670 TI - Article on alexithymia misleading? PMID- 6507669 TI - Increases in prolactin levels following bilateral and unilateral ECT. AB - Plasma prolactin levels were studied after bilateral and unilateral ECT in eight female melancholic patients. Although prolactin levels were higher after both treatments, patients who received bilateral ECT had significantly higher prolactin levels than did those who received unilateral ECT. PMID- 6507671 TI - Conscious and unconscious guilt in patients with traumatic neuroses. PMID- 6507672 TI - A role for psychiatrists in preventing nuclear war. PMID- 6507673 TI - Violence and temporal lobe epilepsy. PMID- 6507674 TI - Delirium and tricyclic antidepressants. PMID- 6507675 TI - ECT in pregnancy. PMID- 6507676 TI - Recent alcohol abstinence and the dexamethasone suppression test. PMID- 6507677 TI - Flaws found in Chowchilla study. PMID- 6507678 TI - Self-destructive behavior in a patient taking trazodone. PMID- 6507679 TI - Addison's disease initially diagnosed as bereavement and conversion disorder. PMID- 6507680 TI - Strategy and art in automated death searches. PMID- 6507681 TI - The 'trickle-down' theory--is that any way to make policy? PMID- 6507682 TI - Social policy implications of physician shortage areas in Missouri. AB - A model is used to identify counties in Missouri in which the supply of physician services is inadequate to serve the resident population. In the model, a formula is used to assess the gap between the physician services available in a county and the visits which would be required to serve the residents. Incorporated in the model are adjustments for the age and specialty of the physicians and the age and sex of the population. The model is applied to 1976 and 1981 data in order to analyze the changes which have occurred within the state during that time. The results show that in spite of a 34 per cent increase in the number of physicians practicing in Missouri between 1976 and 1981, 24 of the 115 counties in the state experienced a decrease in their ability to serve their resident populations adequately. Of these 24 counties, 23 had populations of less than 25,000 and 12 had populations of less than 10,000. A factor magnifying the underservice problem is the sharp increase in the proportion of older physicians located in small, rural counties. In 1981, 47 per cent of the primary care physicians located in counties with less than 10,000 people were aged 60 and over, compared to 34 per cent in 1976. This portends major problems in the future in obtaining replacements. PMID- 6507683 TI - The California Automated Mortality Linkage System (CAMLIS). AB - The California Automated Mortality Linkage System (CAMLIS), established in 1981 to facilitate the conduct of follow-up studies in the State of California, employs a combination of deterministic and probabilistic linkage decision criteria to perform the death clearance function. The system was evaluated against four traditional death clearance procedures and the performance of each procedure measured in terms of measures of sensitivity and specificity. Only one procedure was associated with a specificity lower than 0.99; for that one, the specificity was 0.93. There was much greater fluctuation in the observed sensitivity levels. In one of the procedures, CAMLIS demonstrated a sensitivity of 0.97 versus 0.79 for the Social Security Administration. A comparison against the National Death Index (NDI) produced sensitivities of 0.89 for CAMLIS and 0.94 for the NDI. An assessment of manual search procedures using a file of Japanese names produced a CAMLIS sensitivity measure of 0.92 compared with 0.93 for the manual search. Another manual search procedure using microfiche copies of the state death index produced a CAMLIS sensitivity of 0.97; in this evaluation, the sensitivity of the manual search was defined as 1.0. Another measure of performance of a death clearance procedure is its predictive value in identifying a person who has died; CAMLIS generated predictive values in these evaluations that ranged from 0.93 through 0.99, contrasted with the NDI value of 0.59. PMID- 6507684 TI - The national profile of access to medical care: where do we stand? AB - This paper presents analyses of recent national survey data on access to medical care. In particular, information on major access indicators and special problems associated with the economic and political climate of the 1980s collected in a 1982 national telephone survey of 6,610 United States adults and children, representing some 4,802 families, is compared with previous national surveys for key population subgroups--by age, place of residence, income, race, insurance coverage, and type of regular source of care. In general, the findings show that favorable progress has been made, but some inequities continue to persist. Some traditionally disadvantaged groups are more likely to have a regular family doctor, private insurance coverage, have been to a doctor, or had certain preventive tests and procedures than was true for them in the past. On the other hand, compared to the more economically and/or socially advantaged groups in 1982, they have still not "caught up" entirely. There also is evidence that they may be hardest hit by the exacerbation of the financial barriers to care that result from unemployment, inflation, and cutbacks in health program eligibility and benefits that have characterized the decade of the 1980s. PMID- 6507686 TI - Changes in the hours worked by physicians, 1970-80. AB - The hours worked by physicians are affected by changes in a number of factors, including attitudes towards labor-leisure tradeoffs, the characteristics of the physician workforce, and the level of demand for medical services. This paper analyzes changes in the hours worked per week by office-based physicians over the decade 1970-80. Overall, there has been a statistically significant decline in hours of approximately 3 per cent, or 1.5 hours per week. This decline was fairly uniform across most physician characteristics, although the decline was greater for those in primary care specialties. Female physicians increased their average hours worked, although this increase was not statistically significant. In terms of the delivery of skilled medical services, the decline in total hours was largely offset by an increase in the percentage of total hours devoted to patient care. The question of whether these trends will continue has important implications for the validity of projections of a physician surplus in the near future. PMID- 6507685 TI - The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System. AB - This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population. PMID- 6507687 TI - Current tuberculosis screening practices. AB - Health department officials in all 50 states and 14 major cities responded to a survey questionnaire designed to obtain information about current tuberculosis screening practices. Persons being screened fell into the groups designated as high risk by the American Thoracic Society (ATS) and the Centers for Disease Control (CDC). The methods used for screening were generally those advocated by ATS, CDC, and the Food and Drug Administration (FDA), although chest radiographs continue to be overused. Screening in about one-half of the groups is mandated by law or regulation. There appears to be some confusion about the circumstances in which "two-step" tuberculin testing should be used. Data on the productivity and costs of screening activities were very limited. We encourage those responsible for tuberculosis screening programs to evaluate them, discontinue those which are unproductive, and intensify those which are productive. PMID- 6507688 TI - Medical self-care education for elders: a controlled trial to evaluate impact. AB - We conducted a trial to evaluate the impact of medical self-care education on 330 elders whose average age was 71. The test group participated in a 13-session educational intervention with training in clinical medicine, life-style, and use of health services. The comparison group received a two-hour lecture demonstration. Both groups were assessed pre-intervention, post-intervention, and one year after entry. The results indicate medical self-care instruction: produces substantial improvements, that were sustained for one year, in health knowledge, skills performance, and skills confidence; stimulates many attempts to improve life-style; and generates improvements in life quality. The program had little influence on utilization of medical care or health status. PMID- 6507689 TI - Tubal sterilization in women 15-24 years of age: demographic trends in the United States, 1970-1980. AB - Between 1970-1980, approximately 942,000 women 15-24 years of age underwent tubal sterilization in the United States. These women represented about 17 per cent of all women ages 15-44 years who underwent tubal sterilization in the United States during this 11-year period. During 1970-1980, sterilization rates rose steadily from three per 1,000 to 11 per 1,000 for women in the 20- to 24-year age group, but remained stable at less than one per 1,000 for women in the 15- to 19-year age group. For each year, rates for Black women were greater than those for White women. Sterilization rates increased over the time period for both currently and previously married women, but remained low for never-married women. Most tubal sterilizations were performed after delivery of an infant. PMID- 6507691 TI - The effectiveness of automobile safety regulation: evidence from the FARS data. AB - In a paper published in the August 1981 issue of this Journal, Leon Robertson attempts to measure the effects of the vehicle safety and occupant protection standards implemented in the 1960s. Data from the Fatal Accident Reporting System are used. Additional statistical analysis with these data reveals a multicollinearity problem that makes the prediction of the effects of regulation uncertain. There is also bias in regression results due to the inappropriate inclusion of truck data in the regressions. Regressions on the car data reveal a lifesaving effect of regulation that, at best, is one-fourth the value reported by Robertson. PMID- 6507690 TI - Race and sex differences in hip fracture incidence. AB - Incidence rates for hip fracture in the United States were estimated using non federal hospital discharges from the National Hospital Discharge Survey for the years 1974-1979. Age-specific incidence curves for women and for men showed similar patterns of increase in risk with age, with risks approximately doubling every five years after age 50. Age-specific rates by five-year age groups were compared among the four race-sex groups. No significant differences were observed between Black females, Black males, and White males. In contrast, rates for White females were one and one-half to four times those for Black females after age 40 and were approximately double those for White males after age 50. Analysis based on an independent data source of non-federal hospital discharges in Washington, DC confirmed these relationships. In the Washington study, White women were at twice the risk for hip fracture (controlled for age) compared with Black women and at 2.7 times the risk for hip fracture (controlled for age) compared to White men. No significant differences were observed between Black women and Black men. PMID- 6507692 TI - Automobile safety regulation: rebuttal and new data. AB - A respecification of the regression model applied to additional data results in an estimate of about 45,000 lives preserved by regulations during 1975-78, similar to my previous estimates, and 105,000 lives during 1975-1982. The model allows for introduction of new regulations after 1968 and increased compliance. This result is similar to estimates obtained by several investigators using a variety of methods. PMID- 6507693 TI - Patients' therapeutic preferences in an ambulatory care setting. AB - One thousand two hundred-fifteen adult outpatients of an urban health maintenance organization completed questionnaires containing four hypothetical clinical situations. Of these patients, 72 per cent preferred a non-drug "home remedy" when given a choice among that and two different drug options. Risk aversion and willingness to accept current discomfort were stronger than demographic variables in predicting this preference. We conclude that patients informed about the risks and benefits of drug and non-drug therapies will prefer the latter if that option is offered. PMID- 6507694 TI - Absence of menopausal effect on hip fracture occurrence in white females. AB - The rate of hip fracture among White females rises sharply between ages 40 and 44 and then continues at a constant rate of acceleration doubling every five to six years throughout life with no deviation during, or in the years immediately following, menopause. We suggest that the important role of sex hormones and other factors in osteoporosis commences prior to menopause. A premenopause prevention strategy which postpones the onset of the osteoporotic process by five or six years would be expected to reduce the risk of hip fracture by 50 per cent throughout the remainder of a woman's life. PMID- 6507695 TI - Utilization of child health clinics following introduction of a copayment. AB - The effect of introduction of a copayment on utilization of well child services was investigated in St. Mary's County, Maryland between 1975 and 1979. Utilization declined between the pre-copayment and post-copayment periods for White and non-White infants under six months of age. The deterrent impact of the copayment suggested by the results may be related to crossover to private care but may also represent a drop in use of preventive services. PMID- 6507696 TI - Changes in perceived heart disease risk and health during a community-based heart disease prevention program: the North Karelia project. AB - To test whether the cardiovascular disease declines in North Karelia were accompanied by subjective improvements in health, we analyzed responses to two questions about perceived risk of heart disease and health status on independent random population samples surveyed 10 years apart. Age stratified perceived risk of heart disease declined significantly more (p less than .01) and age stratified perceived health status improved significantly more in North Karelia than in the reference area (p less than .005). PMID- 6507698 TI - Smoking habits of oil refinery employees. AB - Smoking habits of White male employees of a large oil company were analyzed. There were only slight differences in smoking habits between refinery and nonrefinery employees. Salaried employees, both at refineries and elsewhere, smoked much less than hourly employees. PMID- 6507697 TI - Patient attitudes toward physician consent in epidemiologic research. AB - Attitudes of patients toward the necessity of physician consent in epidemiologic studies were assessed. Questionnaires were mailed to women with breast, endometrial and ovarian cancers who had previously participated in a personal interview study (N = 692). Of respondents (N = 514), only 2 per cent would have preferred their physician to have withheld approval, and half considered physician permission necessary. Thirty-five per cent reported that their doctor talked to them about the study prior to the interview. Implications of including physician consent in study protocols are discussed. PMID- 6507699 TI - Fluoride analyses of patient water supplies requested by North Carolina health professionals. AB - The frequencies, patterns, and results of 1,900 patient drinking water assays for fluoride content requested in a six-month period by North Carolina health professionals were determined. Twelve per cent of the samples warranted adjustment from the full dosage fluoride supplement. Less than 3 per cent of physicians and 8 per cent of dentists submitted samples. Water supplies should be tested before a systemic fluoride supplement is prescribed. Either few dentists and physicians in North Carolina test water before prescribing supplements or few prescribe them at all. PMID- 6507700 TI - Making babies without sex: the law and the profits. PMID- 6507701 TI - On mental health services by HMOs. PMID- 6507702 TI - Maternal antipaternal immunity in couples predisposed to repeated pregnancy losses. AB - Maternal antipaternal immunity was compared between a group of 12 couples with normal reproductive histories and a group of 13 couples with obstetrical histories of more than one consecutive stillbirth or repeated pregnancy loss subsequent to having had successfully carried to term. Couples were studied for maternal-paternal HLA antigen sharing and for maternal antihusband immunity in tests detecting both complement dependent and independent antibodies as well as in an assay measuring direct cell-mediated cytotoxicity. There was no significant difference in the proportion of HLA antigen sharing between these two groups; however, the women in the pregnancy loss group demonstrated significantly more antipaternal immunity than their normal childbearing counterparts and more than previously described for aborting couples who share HLA antigens. Screening of the cytotoxic sera on a well characterized cell panel failed to reveal alloreactivity patterns consistent with paternal HLA antigen profiles. These data demonstrate that certain women who suffer recurrent pregnancy losses can mount vigorous immune responses to paternal lymphocyte antigens. We propose that the appearance of such lymphocytotoxins represents inappropriate maternal immune responses to fetal extraembryonic antigens that may subsequently result in fetal demise. PMID- 6507703 TI - Improvement of the rosette inhibition assay for the detection of early pregnancy factor in humans using the monoclonal antibody, anti-human-Lyt-3. AB - The detection of early pregnancy factor (EPF) is a controversial subject. The findings of independent groups attempting to confirm the phenomenon of EPF have been quite variable. The present article gives details of an improved rosette inhibition assay using a monoclonal antibody (anti-human-Lyt-3), instead of an anti-lymphocyte serum (ALS), in order to increase reproducibility. Results are calculated for the first time in terms of absolute monoclonal anti-Lyt-3 concentrations. It is suggested that results be expressed as the Rosette Inhibition Antibody Concentration (RIAC) or the more accurate extrapolated 25% Rosette Inhibition Antibody Concentration (25% RIAC), in place of the previously used Rosette Inhibition Titer (RIT), when monoclonal antibodies are used. Following a 1.5 h incubation period the mean 25% RIAC for pregnant serum was 15.9 +/- 4.0 ng/ml and for control serum 48.0 +/- 12.7 ng anti-Lyt-3/ml. The improved method described should enable different groups to establish the test and compare results. PMID- 6507704 TI - Monoclonal antibodies against human chorionic gonadotropin (hCG): II. Affinity and ability to neutralize the biological activity of hCG. AB - Monoclonal antibodies (MCA) against hCG have been characterized with regard to their affinity and their ability to neutralize the biological activity of hCG in vivo. The production and specificities of these reagents were described in the preceding paper of this series. Equilibrium association constants (Ka) of the MCA, determined by radioimmunological saturation assays, ranged from less than 1 X 10(8)M-1 up to 3.7 X 10(9)M-1 whereas values for conventional polyclonal antisera against hCG ranged from 8.9 X 10(9)M-1 to 1.8 X 10(10)M-1. The ability of MCA to neutralize the biological activity of hCG was tested in a rat bioassay in vivo; 9 of 13 different MCA preparations tested could neutralize hCG. Surprisingly, this property did not correlate with affinity or specificity, and was not restricted to those MCA recognizing the hormone specific beta-subunit. It could be demonstrated that determinants on each individual subunit as well as epitopes formed by both subunits are involved in the expression of the biological activity of hCG. PMID- 6507705 TI - Antibodies against the beta-subunit of ovine luteinizing hormone can decrease the clearance of human chorionic gonadotropin in rhesus monkeys. AB - Contraceptive vaccines based on active immunization against gonadotropic hormones are being investigated in humans and other primates. Immunization against the beta-subunit of ovine luteinizing hormone (oLH beta) reduces fertility in rhesus monkeys by inducing inadequate luteal phases and preventing corpus luteum rescue by rhesus chorionic gonadotropin (rhCG). These effects result from the cross reactions of the oLH beta-antibodies with rhCG and rhLH. We used human CG (hCG), which also cross-reacts strongly with anti-oLH beta to examine how the circulating oLH beta-antibodies affect the metabolic clearance rates (MCR) of hCG in rhesus monkeys. 125I-hCG was injected into four nonimmunized and seven immunized monkeys and blood was collected at frequent intervals over 7 days. Total and immunoprecipitable radioactivity did not differ significantly, suggesting that the radioactivity in the plasma consisted almost entirely of 125I hCG. This was confirmed by column chromatography. The MCR (mean +/- SE) was significantly lower (p less than 0.001) in six immunized monkeys (0.35 +/- 0.06 liters/day) as compared to controls (1.19 +/- 0.09 liters/day). The hCG disappearance curve in control monkeys was best described by a two-compartmental system (slow and fast) while an additional third (intermediate) compartment of distribution was typical for immunized animals. The half-lives of hCG for the two exponentials corresponding to the slow and fast components of distribution were not significantly different between the two groups. One immunized monkey had a MCR (1.44 liters/day) that was much greater than the MCR of the other six.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507706 TI - A simplified method using enzyme-linked immunosorbent assay for titration of antisperm antibodies. AB - We selected sera from 44 patients (36 males and 8 females) that were positive for antisperm antibodies using ELISA (titer ranged from 1:32 to 1:512) for the evaluation of a simplified method for determination of antisperm antibodies. This method uses a correlation between a single absorbant value and the endpoint titer of the same serum. This simplified procedure increases the number of the sera that can be tested on each plate, resulting in considerable saving of time, reagent costs, and materials. A standard curve allows the direct determination of endpoint titer using the absorbance value found at a single dilution. This modification improves the utility of the assay for the epidemiological screening of antisperm antibodies in patients who may have an immunological cause of infertility. PMID- 6507707 TI - Presidential address of the American Orthopaedic Society for Sports Medicine. PMID- 6507708 TI - Contractile properties of slow and fast muscle following tourniquet ischemia. AB - Tourniquet application is commonly used during surgery on an extremity to create a bloodless field. Investigations have focused on the ultrastructural, histochemical, and biochemical effects of tourniquet ischemia on muscle. Few studies, however, have examined the influence of tourniquet ischemia on the contractile properties of muscle. The purpose of this study was not only to examine this latter consideration, but also to determine whether slow and fast muscles exhibit a differential response. In adult male guinea pigs, the plantaris and soleus muscles of control (N = 5) and experimental legs (N = 5) were tested for time-peak-tension (TPT), one-half relaxation time (1/2RT), maximal twitch tension (Pt), and maximal tetanic tension (Po). The experimental leg was subjected to a 2 hour tourniquet which was placed around the thigh. Muscles of this leg were tested following a 2 hour recovery period. In three of the five animals, no response could be elicited from either the plantaris or soleus muscles of the experimental leg. In those instances where the experimental muscles were capable of generating force, the plantaris was clearly more effected. While tension production in the soleus was reduced by approximately 55%, the plantaris exhibited approximately a 90% decrease in tension output. Furthermore, both TPT and 1/2RT demonstrated consistent changes. These results indicate that the contractile properties of both the soleus and plantaris are dramatically effected by a 2 hour tourniquet. They further suggest that there may be a differential response based upon fiber type. PMID- 6507709 TI - Distal patellar pole fractures. A proposed common mechanism of injury. AB - A variety of names has been given to disorders of the inferior pole of the patella occurring in young athletic individuals and several different causes have been proposed for these disorders. Occasionally a direct blow will cause fracture of the inferior pole of the patella, but the only other mechanism which seems to be responsible is subluxation or dislocation. Ten cases of distal patellar pole fracture secondary to dislocation or subluxation of the patella are reported. From these cases and an extensive review of the literature it is concluded that patellar subluxation or dislocation is the usual common mechanism of distal patellar pole fractures in young, active individuals and that adequate treatment of this problem must address the patellar instability as well as the fracture. PMID- 6507710 TI - Dislocation of the tibialis posterior tendon in two athletes. AB - Dislocation of the tibialis posterior tendon occurred in an 18-year-old man and in a 36-year-old woman during running activities. Several years earlier both patients had suffered minor injuries to the affected ankle. The mechanism of the current injury was dorsal flexion and inversion of the foot. Suturing the flexor retinaculum to the posterior margin of the medial malleolus obtained good results in both cases. Dislocation of the tibialis posterior tendon is rare, but should be considered in athletes with even minor traumas to the foot accompanied by pain on the inside of the ankle. PMID- 6507711 TI - The effect of heel pads on the treatment of Achilles tendinitis: a double blind trial. AB - Thirty-three subjects entered a blind-observer, random, prospective study of three forms of conservative treatment of sports-induced Achilles tendinitis, results being assessed by clinical and biomechanical parameters. Two patient groups received heel pads, ultrasound, and exercises, while the third received only ultrasound and exercises. All three groups showed some improvement at both 10 day and 2 month assessment, but the claimed benefit of viscoelastic pads widely used by athletes was not substantiated. The more striking benefit from ultrasound and exercises alone occurred in patients with a shorter history; a comparison of duration of injury in all three groups suggested this was an important factor influencing outcome. The study has highlighted the need for biomechanical outcome measures as well as for more objective clinical outcome measures in the assessment of physical therapy. PMID- 6507713 TI - The effects of ankle guards and taping on joint motion before, during, and after a squash match. AB - The effects of ankle guards and taping on joint motion before, during, and after exercise were studied. Twelve league squash players played two matches, each lasting 1 hour. Two different ankle guards, and two types of tape applied by the same method, served as supports. A specially designed goniometer with electronic digital display (accuracy 1 degree) was used to determine joint range of motion: plantar-flexion and dorsiflexion, neutral inversion and eversion, plantar-flexed inversion and eversion. The results were statistically analyzed to determine the significance of the restriction provided by the supports. This revealed that the two ankle guards provided no significant support. The two tapes, however, provided significant support before exercise and after 10 minutes but not after 1 hour of exercise. Nonelastic (zinc oxide) tape proved to be the most restrictive at all times measured, especially prior to exercise, when the ankle's range of motion was decreased between 30% and 50%. However, once exercise commenced, the tape stretched, and restriction became less effective. PMID- 6507712 TI - Torque-velocity relationships of the knee extensor and flexor muscles in individuals sustaining injuries of the anterior cruciate ligament. AB - Muscle deficits in 58 patients with chronic anterior cruciate ligament (ACL) insufficiency were evaluated after completion of a 6 month rehabilitation program. Quadriceps and hamstring torques were measured on a modified Cybex II isokinetic dynamometer. Twenty-nine of our patients were tested just prior to undergoing ACL reconstruction, and patients who were continuing to tolerate their conditions served as controls. For the surgical group, significant quadriceps deficits (P less than 0.01) were found for all speeds and at both the 30 and 60 degrees positions. The nonsurgical group had significant deficits at the 30 degrees position at 180 degrees/sec, and at 60 degrees for the 0 degree/sec and 30 degrees/sec. However, in comparing the two groups no significant differences were noted. Regarding hamstring deficits in the surgical group, significant deficits were seen only at 30 degrees of flexion at 180 degrees/sec. The nonsurgical group had similar deficits. Of interest was the observation that the hamstring:quadriceps (H:Q) ratio was found to be both speed-position dependent. Overall, no correlation was found between the presence of strength deficits following a rehabilitation program and the need for surgery. PMID- 6507714 TI - Anomalous muscle in the leg: soleus accessorium. AB - In the last 4 years we have had the opportunity to investigate an anomalous muscle mass on the medial aspect of the distal leg of three young athletes. A review of the clinical literature has revealed only nine reported cases of a similar muscle mass in this area. Surgical exploration was carried out in each of our three cases with relief of symptoms in two of the cases following decompression of the overlying fascial sheath. We believe this muscle to represent the soleus accessorius and its presence, which may be rare. The presence of this muscle should be considered in the differential diagnosis of a symptomatic or asymptomatic mass of the posteromedial aspect of the distal leg. Surgical exploration and fascial release is recommended. PMID- 6507715 TI - Diagnosis of cruciate ligament injury using single contrast arthrography. AB - To evaluate the accuracy of arthrography for assessing the status of the anterior cruciate ligament (ACL), 212 arthrograms from 212 knees in 205 consecutive patients undergoing single contrast arthrography and subsequent arthroscopy or arthrotomy were reviewed. Criteria for evaluation of the ACL included the clarity of its radiographic appearance as well as the anterior laxity of the knee as seen on manual stress views. Of the 111 knees having intact ACLs at surgery, 98 (88%) were evaluated correctly by arthrography. Of the 101 knees having a damaged ACL, 85 were read as torn or attenuated on the arthrogram. When the torn and attenuated ligaments were considered separately, accuracy was decreased. Of the 87 ligaments actually torn, 68 (78%) were read as torn and 9 (10%) as attenuated. Of the 14 actually attenuated, 5 (36%) were read as attenuated and 3 (21%) as torn. Of 114 arthrograms read as intact, 98 (86%) were correct. Of 77 arthrograms read as torn, 68 (88%), were correct. Of 21 arthrograms read as attenuated, 5 (24%) were correct. Of 114 torn medial menisci, 112 (98%) were correctly diagnosed, as were 38 (69%) of 55 torn lateral menisci. Sixteen of the 17 missed lateral meniscus tears were in knees with torn medial menisci. Single contrast arthrography is, therefore, highly accurate in distinguishing intact from damaged ACLs. The distinction between torn and attenuated ligaments, however, is not valuable. PMID- 6507716 TI - Exercise performance of professional football players. AB - With the likely hypothesis that the degree to which a football player is physically suited to his position will determine his value as a player, we attempted to describe the characteristics of a given player and position and, from that, to determine the characteristics that make up a first class player in that position. Over a 4-year period 167 football players were examined at the National Athletic Health Institute, Inglewood, California, and grouped according to playing position and class. Position groups were: 1, linemen; 2, linebackers and tight ends; 3, running backs, quarterbacks and kickers; and 4, wide receivers and defensive backs. Classes were: I, rookies (nonstarters); II, veterans (nonstarters); and III, starters (veterans and an occasional rookie). Testing was in two phases, body characteristics and direct measurement of body function. All testing was done in connection with the preseason physical exam. Significant differences were found when data were analyzed by position. Position 1 players were taller, heavier, and had a higher percentage of body fat than players at other positions. These values decreased from Position 1 to Position 4. In terms of cardiovascular fitness the opposite trend was seen. Strength measures were also specific to given position groups. While few differences were seen when data were analyzed by class, one interesting finding was that Class III players (starters) were not only the oldest, but also had the highest level of cardiovascular fitness. Our conclusion is that while size, strength, and endurance are obvious advantages for the successful regular player, there is an unmeasurable quality reflected in the playing ability of the veteran player that is not easily identified in the beginning player. PMID- 6507717 TI - Osteochondral lesions of the talus in a sports medicine clinic. A new radiographic technique and surgical approach. AB - A retrospective review of 11 patients seen at the University of British Columbia Sports Medicine Clinic with osteochondral lesions of the talus was undertaken. From our data, a number of points became apparent. There was a predominance of posteromedial talar dome lesions. A flexion-inversion ankle injury could be documented in the majority of cases. There was frequently a long delay in diagnosing these ankle sprain mimics. Historical details which should raise one's index of suspicion include: (1) history of flexion-inversion injury; (2) exercise related ankle pain; (3) sensations of "clicking and catching"; and (4) persistent swelling. Surgery produced consistently good early results in these active patients without osteotomizing the medial malleolus. Experimental analysis and clinical experience suggest that the optimal radiographic technique for identifying the posteromedial osteochondral lesion consists of an anteroposterior view of the ankle in maximum plantar flexion with the kilovoltage set at 70. PMID- 6507719 TI - Muscle belly tear of the triceps. AB - Triceps injury at the tendo-osseous junction of the olecranon is not uncommon, but a muscle belly tear of the triceps is extremely rare. Two cases of muscle belly tears of triceps are reported. One case was treated surgically and the other conservatively. PMID- 6507718 TI - Compartment syndrome as a complication of arthroscopy. A case report and a study of interstitial pressures. PMID- 6507720 TI - Negative bone scans in impending tibial stress fractures. A report of three cases. AB - Three highly motivated military recruits who presented with tibial pain on exertion are reported. Their initial bone scan assessments to rule out stress fracture were normal, and the recruits were returned to demanding training. One month later, because of persistent and increasing tibial pain, they were rescanned and focal activity representative of tibial stress fractures was found in each case. Until now it has been assumed that a negative bone scan ruled out a stress fracture unequivocally. Our reported cases show that bone pain may in fact precede scintigraphic evidence of a stress fracture. Persistent and increasing bone pain during demanding physical activity, even in the presence of a prior normal bone scan, may represent stress fracture and repeat bone scan may be indicated. PMID- 6507721 TI - Primary gastrin cell hyperplasia. Report of five cases and a review of the literature. AB - Primary gastrin cell hyperfunction of the gastric antrum as a clinical syndrome consists of basal hypergastrinemia, an exaggerated gastrin response to feeding, the absence of any ectopic source of gastrin secretion, and peptic ulcer disease. The number of G-cells were quantitated in the gastric antrum of five patients with clinically diagnosed primary G-cell hyperfunction, and the results were compared to controls with a variety of gastric diseases. Patients with the clinical diagnosis of primary G-cell hyperfunction had a significantly increased number of antral G-cells (p less than 0.05). The clinical syndrome of primary G cell hyperplasia appears to be associated with hyperplasia of G-cells rather than with the hypersecretion of gastrin by a normal number of G-cells. PMID- 6507722 TI - Necrobiotic granulomas of the uterine cervix. A probable postoperative reaction. AB - Three cases of necrobiotic granulomas of the uterine cervix occurring in patients with a history of previous cervical surgery are described. This distinctive lesion histologically resembles a rheumatoid nodule but is not associated with infection or connective tissue disease. The clinicopathologic features of these cases are virtually identical to analogous postoperative lesions that have been described in the prostate. Such necrobiotic granulomas seem to be a result of prior surgery and should not be confused with other more portentous granulomatous diseases. PMID- 6507723 TI - Endobronchial polypoid adenocarcinoma of the lung. Histological and ultrastructural studies of five cases. AB - Five cases of adenocarcinomas of the lung with predominantly endobronchial polypoid growth in large bronchi were reported. The histology of these cases was well-differentiated papillary adenocarcinoma, the tumor cells of which were columnar (4/5) and cuboidal (1/5). More than 70% of the volume of each tumor grew in the bronchial lumen with neighboring intraepithelial growth. Ultrastructurally the tumor cells were characterized by numerous mitochondria (5/5), some basal bodies (5/5), poorly developed cilia (1/5), and many dilated smooth endoplasmic reticular near the cell surface (2/5); these are features characteristic of ciliated bronchial epithelial cells. There were some mucus-producing cells (3/5), which might be differentiating toward goblet cells. Membrane-bound secretory granules with an electron-dense core or fingerprint appearance were also found (2/5); these resembled Clara cell granules. The above findings suggested that polypoid adenocarcinoma in large bronchi had the ability to differentiate toward bronchial or bronchiolar surface epithelial cells with or without mucus production. PMID- 6507724 TI - Isospora belli enteritis in three homosexual men. AB - Isospora belli is an uncommon cause of diarrhea in man. Like the closely related Cryptosporidium, the organism causes disease that may be more severe and chronic in patients with underlying immune deficiency states. We describe three male homosexuals with Isospora enteritis. Each had several months of diarrhea. All three patients had lymphopenia and two had profound T cell helper-suppressor ratio reversal. In addition, two of the patients admitted to oral-anal contact, a practice associated with the acquisition of parasites and other enteric pathogens in the homosexual population. We suggest that Isospora belli may be a sexually transmitted pathogen which should be considered in the diagnosis of homosexual patients with diarrhea. PMID- 6507726 TI - The histology and ultrastructure of the Meyers-Kouwenaar body in ferrets infected with Brugia malayi. AB - A study was made of the Meyers-Kouwenaar (MK) body in the livers of experimentally infected ferrets. Meyers-Kouwenaar bodies, the carcasses of microfilariae (mff) covered by deposits of Splendore-Hoeppli (SH) material, were found in small abscesses of eosinophils and in granulomas. The SH deposits varied from an eosinophilic, hyaline fringe around intact mff to multilayered deposits surrounding an unrecognizable granular remnant. In abscesses, peroxidase activity was intense in SH deposits and the surrounding eosinophils. The presence and localization of IgG were variable in MK bodies, as detected by an enzyme-linked immunohistologic assay; and antigens of mff were not detected in the SH deposits. Electron microscopy of the MK body demonstrated a layered, radial deposition of amorphous and granular material on the mff and a structural heterogeneity which apparently included leukocyte granules and other cell organelles. Leukocytes surrounding MK bodies in abscesses were often degranulated and degenerate; incorporation of lysosomes of eosinophils and cellular debris into the SH deposits at the periphery of the MK bodies was indicated. PMID- 6507725 TI - Activity of immunoglobulin G-coated red cell ghosts containing pentamidine against macrophage-contained Leishmania in vitro. AB - Pentamidine is an antileishmanial agent that is often toxic at therapeutic dosages. The obligate intramacrophage localization of Leishmania indicates that encapsulation of pentamidine within a carrier phagocytized by macrophages (IgG coated sheep red cell ghosts) might improve activity. In in vitro experiments, treatment of infected mouse macrophages for 1 hour with a mean of 1.4 micrograms of encapsulated drug resulted in a calculated drug concentration of 180 micrograms/ml macrophage, and in 73% suppression of organism multiplication within the macrophages after 4-5 days of further cultivation. In comparison, 27 micrograms unencapsulated drug/ml was needed for similar suppression. Electron microscopic examination 5 hours after phagocytosis of IgG-ghosts revealed that 95% of organisms were adjacent to ghosts in phagolysosomes. Fusion of drug carrier with phagolysosome containing drug target is therefore an important step in carrier-mediated parasite suppression in this model. These results suggest that IgG-coated erythrocyte ghosts containing pentamidine have potential as an antileishmanial formation. PMID- 6507727 TI - Parasitologic survey of onchocerciasis (river blindness) in Babana District, Kwara State, Nigeria. AB - This study, made between November 1982 and January 1983 to ascertain the prevalence of onchocerciasis in the Babana District of Borgu Local Government Area, Kwara State, Nigeria, showed that 483 (48.6%) of the 993 subjects skin snipped in 12 communities were infected. The infection rate was significantly higher (P less than 0.001) for males (57.7%) than for females (37.0%), for subjects above 10 years of age (54.0%) than for those who were younger (10.7%), and for the Fulanis (63.8%) than for the Bokos (48.3%). Although various indications suggest that this district has a history of long-standing onchocerciasis, the knowledge of river blindness and its association with blackflies was poor throughout the district and, except for two teachers, no other subjects had ever received onchocercal chemotherapy. These factors, apparently, account for the frequent occurrence and severity of various clinical manifestations and complications of onchocerciasis identified in the district. PMID- 6507728 TI - A case of schistosomiasis japonica: resolution of CAT-scan detected cerebral abnormalities without specific therapy. AB - A 28-year-old Marine Corps officer developed Katayama fever with central nervous system (CNS) manifestations 6 weeks after swimming on Leyte Island in the Philippines. Symptoms consisted of fever, nausea and vomiting, focal visual field deficits and mild confusion. CAT-scan of the patient's head initially revealed multiple lucencies and severe edema in the left frontal, parietal and occipital lobes. No schistosome eggs were found in the patient's stool, and therefore he was treated with a 10-week course of dexamethasone with resolution of all symptoms over 3 months. Repeat CAT-scan after symptoms cleared showed complete resolution of the focal abnormalities seen earlier. The diagnosis was subsequently established by positive serology and by finding eggs in the patient's stool and in tissue obtained by liver biopsy. This is the first report of CAT-scan-detected focal CNS lesions in a patient with acute schistosomiasis japonica, and resolution of the CNS abnormalities, temporally related to non specific steroid treatment, is documented as well. PMID- 6507730 TI - Serologic survey of human hydatid disease in high risk populations from central Tunisia. Preliminary results. AB - The annual surgical incidence rate of hydatid disease in central Tunisia varies from 11.1 to 30.1 per 100,000 population depending on the district. In order to obtain more comprehensive data, we conducted a serologic survey in the district with the highest rate, using hemagglutination-inhibition to test 480 workers from a state farm and 190 inhabitants of villages in the neighborhood. The overall prevalence rate was 1.3% (9/670). Echotomography revealed liver cysts in all cases and the diagnosis was confirmed in the eight subjects who underwent surgery. If these preliminary results are confirmed by further surveys, mass screening might be considered in high risk districts. PMID- 6507729 TI - The effect of a single dose of metrifonate on Schistosoma haematobium infection in Egyptian school children. AB - Egyptian school children infected with Schistosoma haematobium and treated with a single dose of metrifonate, 10 mg/kg body weight, had a marked reduction in urine egg counts reaching 90% during a 30-week follow-up. While cure rate was higher among lightly infected persons, percentage reduction in egg counts was greater among the heavily infected. After a summer period of probable high risk exposure reinfection rate in those children who were treated and cured was 4.7% as compared to 6% in previously uninfected children. PMID- 6507731 TI - Typhoid fever in Santiago, Chile: a study of household contacts of pediatric patients. AB - We obtained clinical, epidemiological, and laboratory data (including three stool cultures) from 155 (96%) of 161 household contacts of 24 patients less than 16 years old with culture-confirmed typhoid fever; these 24 patients represented approximately 40% of such patients seen in three hospitals in Santiago during a 12-week period. A chronic typhoid carrier was identified in only one household, with concurrent or secondary cases seen in two other households. When index cases were matched with household members nearest in age, no specific risk factors for illness could be identified. There was evidence of generalized exposure to enteric pathogens within these households, with nine persons from seven different households culture-positive for non-typhoidal Salmonella, and nine, from eight different households, culture-positive for Shigella; transmission of these pathogens within households did not appear to be common since no household had more than one family member with the same serotype or species of either pathogen. PMID- 6507732 TI - California serogroup viruses in New York State: the role of subtypes in human infections. AB - The roles of various subtypes of the California serogroup viruses as infectious agents and as neuropathogens were evaluated by using the plaque reduction neutralization test. Sera from 394 patients with central nervous system (CNS) infections during 1971-1982 and from 501 persons without CNS manifestations were studied. Jamestown Canyon (JC) and La Crosse (LAC) viruses were found to have been common infectious agents in New York State for at least 16 years. JC virus was the prevalent indicated agent in patients with antibody to California serogroup viruses in screening tests (62 of 93 cases), followed by LAC virus (11 cases), snowshoe hare (2 cases), and trivittatus (1 case). In the remaining 17 patients the subtype was undetermined. LAC virus appears to be more pathogenic for children and to produce more serious illness, as judged by the frequent clinical diagnosis of encephalitis. JC virus affects mainly adults, and meningitis was the most common diagnosis. JC virus appears to cause a stronger neutralizing antibody response than does LAC virus, with a longer persistence of high levels of antibody. Some cases of JC virus infection may have been missed in the past due to the choice of a LAC-like isolate from New York State as the sole antigen in hemagglutination-inhibition (HI) screening tests. Comparison of the HI test and a single-dilution neutralization assay for screening for the two major subtypes, JC and LAC, indicated that the latter procedure is more broadly reactive and is less likely to miss cases if only one test antigen is used. PMID- 6507734 TI - Paradoxical effects of simulated larviciding on production of adult mosquitoes. AB - We determined whether simulated mortality of larval mosquitoes in food-deprived bodies of water increases emergence of adult females as well as their size by releasing the remaining larvae from competition for food. Removal of larval Aedes aegypti from rearing containers with suboptimal amounts of food increased the number of adults that emerged. Thus, larvicidal measures do not inevitably lead to reduced numbers of mosquito vectors of disease. In food-limiting breeding sites, partially effective anti-larvae measures can be counterproductive, perhaps increasing transmission of vector-borne disease. PMID- 6507733 TI - Clinical features of neurotoxic snake bite and response to antivenom in 47 children. AB - Among 47 children admitted to the Chulalongkorn Medical School Hospital for neurotoxic snake bite, the attackers were identified in 15; the cobra (Naja naja) was the snake involved in all cases. Clinical manifestations in all 47 children appeared to follow a similar pattern. Drowsiness heralded the systemic effects in most of the patients. The characteristic systemic signs were those resulting from the neuromuscular effects of the venom and included ptosis, frothy saliva, slurred speech, respiratory failure, and paralysis of the skeletal muscles. These episodes occurred within 8 hours in 94% of the cases, and at the latest 19 hours following the bite. In some cases unconsciousness accompanied respiratory failure. Necrosis in the region of the bite, the prominent local sign, developed in 40% of the cases at the end of the 1st week after the bite. Infusion of specific antivenom was an effective therapeutic measure for the neuromuscular changes. Respiratory assistance was mandatory in cases of respiratory failure. Edrophonium chloride demonstrated a supportive role as a countermeasure against the neuromuscular effects. PMID- 6507735 TI - Amyloidosis in experimental tegumentary leishmaniasis in mice. AB - Renal and hepatosplenic amyloidosis was found in chronic cutaneous leishmaniasis in mice infected with 10(6) purified amastigotes from lesions produced by the H21 strain of Leishmania mexicana amazonensis. After 1 year a progressive lesion leading to metastasis was observed in most animals. PMID- 6507736 TI - Ascaridoid larva (Nematoda) from the eye of a child in Uganda. AB - A nematode measuring approximately 1.25 mm by 42 micron, excised in a granuloma from the eye of a child in East Africa, was identified as a third-stage ascaridoid larva of a type having no ventriculus or cecum and bearing conspicuous lateral alae. PMID- 6507737 TI - The tail of the Mansonella streptocerca microfilaria. AB - Morphological studies of stained Mansonella streptocerca microfilariae from the skin of man and chimpanzees in West Africa revealed that the tail is bifid rather than blunt. This feature may be useful in characterization of related species. PMID- 6507739 TI - The significance of retinal hemorrhage in cerebral malaria. PMID- 6507738 TI - Occurrence of Rocky Mountain spotted fever in relation to climatic, geophysical, and ecologic variables. AB - To study the time of onset of cases of Rocky Mountain spotted fever (RMSF) in relation to mean winter temperature, average daily solar radiation, elevation, and potential climax vegetation, we analyzed cases of RMSF from a 19-state area in the southeastern United States during the years 1970-1980 according to the counties in which patients resided. A bimodal incidence of RMSF, with peak onset of cases in mid-May and in mid-July, was noted in the oak-hickory-pine, oak hickory, and Appalachian oak zones of potential climax vegetation during the years 1970-1974. In 1975-1980, however, coincident with an increase in incidence of RMSF, a single peak of illness in mid-June was observed in the oak-hickory pine zone, where the number of cases of RMSF was highest; bimodality persisted in the oak-hickory and in the Appalachian oak zones. Analysis of cases in the zones in which bimodality persisted indicated that the first peak of illness may predominate in northern, cooler areas, and the second peak, in southern, warmer areas. PMID- 6507740 TI - Presidential address. Systemic effects of smoking. AB - Millions of people continue to smoke. Recent studies confirm the pioneering epidemiologic data that indicated that, despite the well-established effects on the lung, most of the hundreds of thousands of premature deaths annually result from extrapulmonary toxicity, particularly accelerated cardiac and vascular disease. As with lung cancer, abstention significantly reduces the risk, even after myocardial infarction or surgery for complications of vascular disease. Erythrocytosis, thrombocytosis, and leukocytosis, by increasing blood viscosity, aggravate ischemia. The neutrophils of smokers release excessive amounts of oxidants which damage tissue and antiproteases. Increased alveolar permeability enhances allergy. Lymphocytic suppressor cells increase, which leads to immunocompetence, increased infection, and cancer. Smokers lose weight and die at an earlier age, even after cancer chemotherapy and peptic ulcer surgery. Smoking prevents inhibition of gastric night acid secretion by histamine-blocking agents. Menopause occurs earlier and children are damaged in utero and after birth by passive smoking. Recent evidence indicates that nicotine releases endorphins, which account for the addiction. Surgeons need to do more to combat this menace. Many victims need professional assistance to stop the habit. PMID- 6507741 TI - Edgar J. Poth Lecture. Critical decisions in the management of hepatic trauma. PMID- 6507742 TI - Follow-up of patients with colorectal cancer. AB - In our follow-up study of 65 patients after curative surgery for colorectal cancer, tests other than history and physical examination detected only two cases of potentially curable recurrent colorectal cancer. As a routine follow-up test, carcinoembryonic antigen determination is preferable to computerized tomographic scanning, since the sensitivity and specificity of carcinoembryonic antigen and computerized tomographic scanning were found to be equivalent and carcinoembryonic antigen is much less expensive. There was no benefit to the routine use of liver function tests or chest roentgenograms during follow-up. Since barium enema contributed little to what colonoscopy accomplished with greater comfort to the patient, barium enemas should be used only when colonoscopy is not totally successful in reaching the cecum. The most beneficial aspect of the follow-up of these patients is probably the elimination of future metachronous lesions by removal of small, benign polyps. PMID- 6507743 TI - Melanoma today does not require radical surgery. AB - From this study we conclude that melanoma has a more favorable outcome today than 20 years ago, 2 cm margins around the tumor achieve acceptable survival and local recurrence rates, primary closure is preferred when possible, elective regional node dissection is of questionable value, and further trials are warranted to determine optimal therapy for intermediate thickness melanoma. PMID- 6507744 TI - Acute diverticulitis. Comparison of treatment in immunocompromised and nonimmunocompromised patients. AB - The clinical course and required treatment of diverticulitis were reviewed in 76 nonimmunocompromised patients and 10 immunocompromised patients. The immunocompromised patients presented with either minimal or no symptoms and findings. Therefore, to make the diagnosis of acute diverticulitis in this group, a high index of suspicion must be maintained. The required treatment varied considerably between the two groups. In 45 nonimmunocompromised patients (76 percent), medical therapy was successful. Medical treatment failed in the other 14 patients (24 percent). However, the compromised group had no patients in whom medical therapy was successful (100 percent failure rate). Thirty-one of the nonimmunocompromised patients (41 percent) required an operation, whereas 100 percent of the immunocompromised patients with acute diverticulitis required an operation. By relating postoperative complications, we were unable to determine the initial operative procedure of choice in the nonimmunocompromised group; however, in the immunocompromised group, colostomy and resection had fewer surgical complications than colostomy and drainage. The immunocompromised patient with acute diverticulitis requires operation. We believe the operation of choice is colostomy and resection of the involved segment. PMID- 6507745 TI - Early surgery for biliary pancreatitis. AB - Herein, we documented our successful experience in performing definitive biliary tract surgery on patients with biliary pancreatitis as soon as the diagnosis was made and within 48 hours of admission. Early surgery reduced the length of hospital stay and did not result in associated morbidity, death, or complications of acute pancreatitis. The results of the study support the concept that removing obstruction of the pancreatic duct prevents progression of edematous pancreatitis to hemorrhagic pancreatitis. We conclude that patients with acute pancreatitis should be evaluated urgently for the presence of biliary tract stone disease and should be operated on as soon as the diagnosis of biliary pancreatitis is made, that early definitive surgery can be performed safely on patients with biliary pancreatitis, that cholecystectomy with intraoperative cholangiography and common duct exploration as necessary should be performed in all patients, and that length of stay for patients with biliary pancreatitis is reduced and morbidity and mortality possibly may be reduced by early surgery as compared with delayed surgery. PMID- 6507746 TI - Surgical treatment of chronic pancreatitis. AB - We studied the course of 100 consecutive patients who underwent surgery for pain or biliary obstruction from chronic pancreatitis or both between 1958 and 1982. Patients with pancreatic pseudocysts were excluded. Ten patients had pancreatic resection after previous pancreatic surgery had failed to control pain. Ten of 47 patients (21 percent) studied between 1972 and 1981 had bile duct entrapment from chronic pancreatitis and required biliary bypass operations. The results of longitudinal pancreaticojejunostomy were good in 67 percent of the patients, fair in 18 percent of the patients, and poor in 15 percent of the patients. The results of partial pancreatectomy were good in 60 percent of the patients (all with disease limited to the tail), fair in 20 percent of the patients, and poor in 20 percent of the patients. The results of subtotal pancreatectomy were good in 31 percent of the patients, fair in 37 percent of the patients, and poor in 32 percent of the patients. The results of pancreatic resection in patients with previous unsuccessful surgery for pain relief were good in only 10 percent of the patients. Biliary obstruction is present in many patients with chronic pancreatitis and must be treated surgically to prevent the development of biliary cirrhosis. Hemipancreatectomy is useful in patients with disease limited to the tail. The results of subtotal pancreatectomy are discouraging, especially in patients with a previous unsuccessful operation for pain. When the pancreatic duct is dilated, however, longitudinal pancreaticojejunostomy gives long-lasting relief of pain in most patients. PMID- 6507747 TI - Surgical management of the failed Nissen fundoplication. AB - A significant percentage of surgery performed for complications of gastroesophageal reflux at a major medical center has been performed for problems related to prior surgery. Our patients who required remedial surgery fell into three categories. Those with recurrent reflux generally fared well. Patients with dysphagia, gastric stasis, or both presented difficult problems. The key to success for these patients lies in choosing the operation best suited to the anatomic and physiologic situation as defined by preoperative contrast studies, pH monitoring, endoscopy, and selective gastric emptying studies. PMID- 6507749 TI - Diagnosing appendicitis during pregnancy. AB - In a 10 year period, 29 of 36 pregnant patients (81 percent) thought preoperatively to have appendicitis had the diagnosis confirmed at operation. Postoperative fetal complications included one intrauterine death and five premature births. There were no maternal deaths and morbidity was limited to atelectasis in five patients. Prompt surgical intervention in 90 percent of our patients did not prevent fetal complications. PMID- 6507748 TI - Emergency management of perforated peptic ulcers in the elderly patient. AB - The results of selective operative treatment for perforated peptic ulcers in 93 elderly patients 60 years of age or older have been found to be similar to those in a large group of patients of all ages with selective operative treatment for perforated peptic ulcers (1,127 patients). Elderly patients with previous symptoms of acid-peptic disease who do not have serious associated diseases that increase the risk of operation or generalized peritonitis or localized abscesses in the peritoneal cavity can undergo definitive ulcer procedures for perforated peptic ulcers with satisfactory morbidity and low mortality rates. Simple closure or omental patch closure is performed when such contraindications to a definitive operation are present and can be expected to have a greater mortality for this reason. Gastrectomy for a perforated gastric ulcer and truncal vagotomy and hemigastrectomy for a perforated duodenal ulcer offer the best long-term results for elderly patients who are fit to undergo definitive operation. PMID- 6507750 TI - Five hundred open taps or lavages in patients with abdominal stab wounds. AB - From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found to have several advantages, including earlier diagnosis of intraperitoneal visceral injuries in asymptomatic patients and a significant lowering of the incidence of unnecessary celiotomies in a busy county hospital. Also, it was extremely cost-effective. The major disadvantages were the number of false-positive results of taps and lavages based on red blood cell counts of more than 100,000/mm3, all of which resulted from bleeding from abdominal wall stab wound sites. An accuracy rate of approximately 91 percent was maintained throughout the period of the study, whereas there were only 1.8 false-negative results of lavage per year. Local wound exploration coupled with open peritoneal tap and diagnostic peritoneal lavage is recommended as a rapid, safe, and cost effective technique for the evaluation of large numbers of asymptomatic patients who present with anterior abdominal stab wounds. PMID- 6507751 TI - Bronchoscopic removal of aspirated foreign bodies in children. AB - Foreign body aspiration is the cause of death in over 500 children per year in the United States. Tracheobronchial inhalation of foreign bodies may result in acute respiratory distress, chronic pulmonary infections, atelectasis, or death. A review of 262 children ranging from 4 months to 13 years of age was undertaken to identify factors important in diagnosis to illustrate the effectiveness of newer endoscopic techniques and equipment, and to evaluate results and complications. Coughing, choking, and wheezing were the presenting symptoms seen in 91 percent of the patients. Inspiratory and expiratory chest radiographs were positive in 81 percent of the 224 children with foreign bodies removed. Fluoroscopy was positive in 41 patients, 88 percent of whom had foreign bodies removed. Bronchoscopy is required for treatment, and with experience, this procedure can be simple and safe. Ninety-nine percent of foreign bodies identified at bronchoscopy were removed successfully. Minor complications occurred in 8 percent of the patients, and there were no deaths. PMID- 6507752 TI - Reevaluation of early evacuation of clotted hemothorax. AB - During an 181/2 year period, we encountered 14,300 patients with blunt or penetrating thoracic or thoracicoabdominal trauma. In 155 patients, residual clotted hemothorax or empyema developed later. Thirty-nine patients underwent early evacuation of clotted hemothorax with no mortality and an average hospital stay of only 10 days. When progression to empyema occurred, the mortality rate increased to 9.4 percent and the average hospital stay to 37.9 days. The most common related event in the development of empyema was concurrent injury to intraabdominal organs and the inevitable bacterial contamination of the thorax. In a small number of patients, tube thoracostomy drainage is inadequate and results in residual clotted hemothorax. Despite recent pleas for conservative, expectant management, it is our experience that early evacuation of clotted hemothorax is not only cost-effective, it is also associated with lower morbidity, lower mortality, and reduces the chance of development of empyema. PMID- 6507753 TI - Civilian arterial trauma of the upper extremity. An 11 year experience in 267 patients. AB - Two hundred ninety-eight arterial injuries in 269 upper extremities were reviewed. Penetrating agents accounted for 250 injuries (93 percent) and blunt trauma for 19 (7 percent). Fifty-nine axillary, 126 brachial, 65 radial, and 48 ulnar arteries were damaged. Twenty-six extremities had more than one artery injured. The initial vascular examination revealed no abnormalities or was equivocal in 16 percent of all patients and in 32 percent of those with axillary artery injuries. Adjacent upper extremity structures were injured in 195 limbs (73 percent). Resection and primary anastomosis (54 percent) or vein interposition grafting (26 percent) were the most frequent methods of repair. Two deaths (0.7 percent) occurred and four amputations (1.5 percent) were required. Distal pulses were present at discharge in 93 percent of the evaluable extremities. Despite excellent success with arterial reconstruction, functional results were limited by associated nerve injuries. One hundred fifty patients (49 percent) had nerve deficits at discharge, and 71 (27 percent) had serious functional limitations. PMID- 6507754 TI - Risk of splenic salvage after trauma. Analysis of 200 adults. AB - This review was undertaken to analyze critically the complications resulting from operative splenic salvage. Over a 6 year period, 200 adults who sustained splenic trauma underwent laparotomy. The mechanism of injury was blunt in 138 patients (69 percent), a stab wound in 32 patients (16 percent), and a gunshot wound in 30 patients (15 percent). Splenorrhaphy was accomplished in 85 patients (42 percent). Methods of repair included cautery and hemostatic agents in 24 patients (28 percent), debridement and suturing in 42 patients (50 percent), and partial resection in 19 patients (22 percent). Six patients died, four from head trauma and two from multiple organ failure. Postoperative complications occurred in 14 patients. Four were intraabdominal. Three patients required reoperation for splenic hemorrhage; one (2 percent) after suture repair and two (11 percent) after partial resection. A left subphrenic abscess developed in another patient. Splenic reimplantation was performed in 43 patients (22 percent). Five deaths occurred. One was due to head trauma, three to multiple organ failure, and one to overwhelming pneumococcal infection. Eleven postoperative complications occurred, but none was related to splenic autotransplantation. Despite the enthusiasm for splenic salvage, the number of patients suitable for splenorrhaphy plateaued at 56 percent. Complications of splenorrhaphy are infrequent, and the risk increases with more complex salvage attempts. We believe that splenic reimplantation remains a safe procedure. PMID- 6507755 TI - Management of rectal trauma. AB - A 9 year review of rectal trauma was conducted. Forty-seven patients had major rectal trauma requiring diversion. Twenty-seven percent of patients presented in shock. Routine perioperative antibiotics were administered. Ninety-five percent of patients had positive findings on digital rectal examination or proctoscopy. There were 91 associated injuries. Rectal injuries were repaired in 19 patients. The absence of repair had no influence on postoperative morbidity or length of hospital stay. Ninety-five percent of patients had presacral drainage. One patient had distal rectal irrigation. Both loop and divided colostomies were utilized with no difference in morbidity or hospital stay. There were no deaths. Proctoscopy is essential in patients with wounds in proximity to the rectum. Diversion and presacral drainage for rectal injury is associated with a low mortality and acceptable morbidity. Rectal washout does not appear to be essential in civilian rectal injuries. PMID- 6507756 TI - Conservative approach to the elderly patient with burns. AB - A retrospective analysis of 55 elderly patients (more than 60 years of age) was undertaken to compare results of conservative management to standard operative treatment. Thirty-one percent of the patients died early from their injury. Twenty-three patients were treated without operation, with emphasis on careful outpatient wound care and physical therapy. The remaining 15 patients required excision and grafting of burn wounds or amputation. Conservatively managed patients had fewer complications, a shorter hospital stay, and functional results equal to the operative group. These results suggest that many elderly burn patients can be managed without operation with good outcome and lessened morbidity. PMID- 6507757 TI - Operative management of incidental cholelithiasis. AB - Incidental cholelithiasis was encountered at the time of celiotomy in 56 patients. Thirty-three of the patients underwent concomitant cholecystectomy. The overall morbidity and mortality were 27 and 3 percent, respectively, but only one complication (3 percent) was clearly related to the cholecystectomy. Cholecystectomy was not performed in 23 patients. Within 6 months of primary celiotomy, acute cholecystitis developed in 11 patients, 3 had attacks of biliary colic, and 2 became jaundiced. Fifteen patients (65 percent) underwent cholecystectomy and 6 of the 15 (40 percent) required common bile duct exploration. Concomitant cholecystectomy adds minimal morbidity to the operation and should be performed unless specific contraindications exist. Left untreated, cholelithiasis becomes symptomatic and leads to subsequent operation in most patients, which may require a more extensive procedure producing greater morbidity. PMID- 6507758 TI - Surgical implications of fibrinolytic therapy. AB - Intraarterial fibrinolytic therapy was used in 37 cases (34 patients) of severe peripheral ischemia. Nineteen patients (56 percent) required surgical intervention (5 amputations and 14 successful reconstructive procedures). Twenty four patients (71 percent) were significantly improved (average ankle-to-arm index 0.84), whereas only 5 patients (15 percent) lost their limbs. Five patients were angiographically unchanged with no or slight improvement in the ankle-to-arm index (0.22 to 0.32) and were discharged on anticoagulant therapy. One death and two cerebrovascular accidents occurred. The usefulness of intraarterial fibrinolytic therapy needs to be evaluated within the total realm of vascular surgery. It offers options for therapy where previously none existed. Some situations might be treated equally well with either intraarterial fibrinolytic therapy or surgery. Finally, surgery might be required to maintain initial successful results with intraarterial fibrinolytic therapy or to rescue intraarterial fibrinolytic therapy failures in striving to achieve superior results in limb salvage. PMID- 6507759 TI - Dilemmas in dealing with the blue toe syndrome: aortic versus peripheral source. AB - Six patients with unilateral blue toe syndrome presented a diagnostic dilemma with regard to the source of embolization: central aortic versus peripheral. Two patients had moderately severe aortoiliac atherosclerosis associated with focal stenoses in the superficial femoral arteries, and four patients had mild aortoiliac disease associated with localized plaques confined to either the superficial femoral or popliteal arteries. In all patients, it was elected to explore the peripheral lesions first. At operation, ulcerated plaques or focal stenoses were found, and all lesions had adherent white thrombi on their surfaces. All patients were treated either by localized thromboendarterectomy or short reversed saphenous vein grafting. There was no morbidity or mortality. Recurrent embolization did not occur during a follow-up of 8 to 24 months. Distal atherosclerotic lesions should be sought to explain distal embolization before more complex aortoiliac disease is incriminated. In the presence of concomitant aortoiliac disease, it is mandatory to directly explore the peripheral lesion, open the artery, and carefully examine the lesion in situ. Thrombus adherent to the surface of an ulcerated plaque is evidence of an embolizing source. This approach is associated with minimal morbidity and may be curative. If these findings are not present, it would be appropriate to proceed with staged correction of aortoiliac disease. PMID- 6507760 TI - Intraplaque hemorrhage: its significance in cerebrovascular disease. AB - Recently, carotid plaque factors, specifically intraplaque hemorrhage, have been studied with respect to the production of cerebrovascular symptoms. Ninety-five carotid endarterectomies were performed and the plaques that were removed were examined for intraplaque hemorrhage. Patients were separated into three groups: those with specific neurologic symptoms, those with nonlateralizing symptoms, and those who were asymptomatic. In the group of patients who presented with specific neurologic symptoms, correlation was made between the age of the intraplaque hemorrhage and the timing of symptoms. The vast majority of patients with specific neurologic symptoms exhibited carotid plaque hemorrhage, but patients with nonlateralizing symptoms and those who were asymptomatic also demonstrated an unexpectedly high percentage of intraplaque hemorrhage. Moreover, our results show a poor relationship between the timing of symptoms and the age of the intraplaque hemorrhage. These data do not refute the concept that intraplaque hemorrhage may play a role in the production of cerebrovascular symptoms, but they do refute the notion that the mere presence of hemorrhage causes specific neurologic symptoms and they also refute the previous report that demonstrates a good correlation between the timing of symptoms and the age of the intraplaque hemorrhage. PMID- 6507761 TI - Wound hematomas after carotid endarterectomy. AB - Fifteen of 596 (2.5 percent) carotid endarterectomies performed at Brooke Army Medical Center were complicated by significant wound hematomas requiring reoperation and hematoma evacuation. The wound hematomas resulted from capillary oozing in 80 percent of the cases and arteriotomy bleeders in 20 percent of the cases. Antiplatelet therapy and postoperative hypertension appear to be significant factors predisposing to the development of wound hematomas. In eight cases, local anesthesia was utilized for the hematoma evacuation, and there were no complications. When general anesthesia was utilized for hematoma evacuation, there was considerable difficulty with airway management in six of seven patients. Complications developed in four of these patients. One patient had respiratory insufficiency secondary to laryngeal edema. Two of the patients sustained myocardial infarctions, one of whom died, and a dense neurologic deficit developed in the fourth patient who died as a result of this complication. Meticulous surgical technique in obtaining hemostasis, control of postoperative hypertension, and wound drainage when indicated will help reduce the incidence of postoperative wound hematoma. When a significant postoperative wound hematoma does complicate carotid endarterectomy, the hematoma should be promptly evacuated utilizing local anesthesia. PMID- 6507763 TI - The effects of doxorubicin on hemodynamic parameters in rabbits. PMID- 6507762 TI - Trends in reconstruction for atherosclerotic renal vascular disease. AB - Twenty-eight patients underwent renal vascular reconstruction for atherosclerotic renal vascular stenosis. Ten patients had therapeutic renal artery reconstruction for isolated renal artery stenosis causing severe hypertension, nine patients had therapeutic renal artery reconstruction for severe hypertension combined with simultaneous aortic reconstruction, and nine patients had prophylactic renal artery reconstruction for renal artery stenosis combined with simultaneous aortic reconstruction. Ninety percent of patients undergoing therapeutic renal revascularization procedures for hypertension were cured or improved. The 10 patients undergoing prophylactic renal artery reconstruction combined with aortic reconstruction had an average 72 percent reduction in the diameter of the vessel. Dacron side grafts sutured to the aortic graft were used for revascularization in each of the patients with prophylactic revascularization and was found to be an expedient means of reconstruction with good patency rates. No increased morbidity or mortality rate was noted in the prophylactic group. We believe that prophylactic revascularization should be carried out in patients with atherosclerotic high-grade stenosis of the renal arteries to prevent hypertension and preserve renal function. PMID- 6507764 TI - [Evaluation and possible role of acetylcholine in Schistosoma mansoni (apropos of a biological assay)]. PMID- 6507765 TI - Effects of fructose-1,6-diphosphate on the red cell deformability in diabetic patients. PMID- 6507767 TI - Standards for building a vertical forces platform for clinical stabilometry: an immediate need. Association francaise de posturologie. PMID- 6507766 TI - [Pleural unclotting with fibrinolytics in coagulated postoperative hemothorax]. PMID- 6507768 TI - The influence of thymosin on arterial blood pressure in cats. PMID- 6507769 TI - Fructose diphosphate and mean erythrocytic survival after extracorporeal circulation. PMID- 6507771 TI - Specifications for building a vertical forces platform designed for clinical stabilometry. PMID- 6507770 TI - [Bupivacaine-fentanyl combination in obstetric epidural anesthesia. Apropos of 203 cases]. PMID- 6507772 TI - A newly designed automatic phonometer. PMID- 6507773 TI - [Distribution of ampicillin, gentamicin and ceporin in fetal organs after intra amniotic and parenteral administration]. PMID- 6507774 TI - [Asymptomatic bacteriuria and the course of the postoperative period]. PMID- 6507775 TI - [Preclinical diagnosis and prevention of suppurative-inflammatory diseases of the mother and newborn infant]. PMID- 6507777 TI - [Informative value of the NBT test in the early diagnosis of infectious inflammatory complications of cesarean section]. PMID- 6507776 TI - [Prognostic significance of protein metabolism indices in pregnant women at high risk for the development of puerperal infectious complications]. PMID- 6507778 TI - [Enzymatic status of leukocytes in the normal puerperal period and puerperal periods complicated by infection]. PMID- 6507779 TI - [Principles of antibiotic therapy of postpartum infectious diseases]. PMID- 6507780 TI - [Obstetric tactics in acute infectious viral diseases]. PMID- 6507781 TI - [Identification of factors predisposing to the development of acute puerperal mastitis]. PMID- 6507782 TI - [Use of bromocriptine in pathologic lactation and mastitis]. PMID- 6507783 TI - [Qualitative composition of milk in lactation mastitis]. PMID- 6507784 TI - [Various problems in the clinical picture and diagnosis of acute inflammatory diseases of the internal genitalia of women]. PMID- 6507785 TI - [Current possibilities for reconstructive therapy for patients with suppurative inflammatory conformations of the uterine adnexae in their reproductive years]. PMID- 6507786 TI - [Adaptive reactions in patients with chronic nonspecific inflammatory diseases of the uterine adnexae]. PMID- 6507787 TI - [Clinico-immunologic parallels after surgery for chronic inflammatory diseases of uterine adnexae]. PMID- 6507788 TI - [Features of the clinical course of tuberculosis of the female genitalia in postmenopausal patients]. PMID- 6507789 TI - [Ceruloplasmin and the histaminopexic index in the diagnosis of female genital tuberculosis]. PMID- 6507790 TI - [Detection of immune complexes circulating in the blood in chronic recurrent salpingo-oophoritis]. PMID- 6507791 TI - [Rational nutrition in inflammatory diseases of the internal genitalia of women]. PMID- 6507792 TI - [Vibratory massage in the treatment of inflammation of the uterine adnexae]. PMID- 6507793 TI - Moonshine consumption in West Alabama. PMID- 6507794 TI - The relationship of cementum to enamel at the cementoenamel junction. PMID- 6507795 TI - Hypothermia. PMID- 6507796 TI - Nutritional aspects of growing old. PMID- 6507797 TI - Nutrition and cancer. Prevention and treatment. PMID- 6507798 TI - Human protein requirements. Problems of maintaining nitrogen balance on a low income. PMID- 6507799 TI - Recommended Dietary Allowances (RDA) for folacin. An example of interpretive nutrition. PMID- 6507800 TI - Recent developments in obesity research. Electromagnetic tools for measuring total body fat. PMID- 6507801 TI - Medical pathology conference. Headache, fever, abnormal behavior, and dysphasia in an elderly man. PMID- 6507803 TI - The role of salt in hypertension. PMID- 6507802 TI - Vascularized bone grafts for reconstruction after tumor surgery. PMID- 6507804 TI - First trimester prenatal diagnosis of genetic disorders. Will chorionic villi sampling make it a reality? PMID- 6507806 TI - Update on a new home hazard--the disc battery. PMID- 6507805 TI - Hydralazine-induced lupus syndrome. PMID- 6507807 TI - On establishing an employee assistance program. PMID- 6507808 TI - The doctor-patient relationship through the ages. PMID- 6507809 TI - More about spongiosis. PMID- 6507810 TI - Shop talk. PMID- 6507811 TI - Spiral-shaped and spherical bodies within blood vessels in dermatosis eosinophilica. PMID- 6507812 TI - Unique aspects of a lesion of erythema elevatum diutinum. AB - A 70-year-old man with erythema elevatum diutinum developed new lesions on his right hand 4 years after initiation of treatment with dapsone. An unusual protruberant appearance of these lesions grossly and a peculiar fibrosing quality histopathologically of one lesion are features that, to our knowledge, have not been reported previously. PMID- 6507814 TI - Osteomyelitis secondary to cutaneous mucormycosis. Report of a case and a review of the literature. AB - An unusual case of osteomyelitis secondary to cutaneous mucormycosis developed in a diabetic with chronic renal insufficiency. Recovery followed curettage of the osseous lesion and "suboptimal" treatment with amphotericin B. A review of the literature on mucormycosis of bone and skin follows the report of the case. PMID- 6507813 TI - Hemorrhagic panniculitis caused by atheromatous embolization. A case report and brief review. AB - This brief review of the phenomenon of atheromatous emboli to the skin was prompted by the observation of a specimen in which a sizable mass of hemorrhagic panniculitis clinically simulated a "cyst" or "tumor" in a woman aged 90 years. While atheromatous embolization in other organs is well known and has been described in detail, the phenomenon in the skin has infrequently been reported, and therefore the attention of dermatopathologists is once more drawn to this occurrence. PMID- 6507816 TI - If you're all right, Jack, turn the page. A call for a Federal ban on cigarette advertising. PMID- 6507815 TI - Pathogenesis of ulcerations in deficiency of prolidase. The role of angiopathy and of deposits of amyloid. AB - The structure of the skin and the pattern of alteration in chronic ulcerations associated with deficiency of prolidase have been studied superficially in the past. We examined histologically several biopsies taken from apparently normal skin and from ulcerations afflicting a young woman with such a syndrome. Deposits of amyloid were found within the walls of medium-sized vessels and occasionally occluding their lumens. Impaired cutaneous microcirculation resulting from statis, moderate vasculitis, and abnormal structure of the dermis may be responsible for the regional preponderance of deposits of amyloid and ulcerations in the legs. PMID- 6507817 TI - Activities, accomplishments, and aspirations of the International Society of Dermatopathology. PMID- 6507818 TI - Continuing dermatologic education. Andragogy or pedagogy? PMID- 6507819 TI - New wrinkles in fingerprint identification. PMID- 6507820 TI - Biopsy of annular erythemas. PMID- 6507821 TI - [Clinical value of immunoglobulin E]. PMID- 6507822 TI - [Cross reactivity with gramineous plants (specially grasses)]. PMID- 6507823 TI - Drugs before anaesthesia. PMID- 6507824 TI - Choice of calcium salt. A comparison of the effects of calcium chloride and gluconate on plasma ionized calcium. AB - Equimolar quantities of calcium chloride and calcium gluconate produced similar changes in plasma ionised calcium concentration when injected intravenously into anaesthetised ferrets or when added to human blood in vitro. In vivo changes were followed with a calcium electrode positioned in the animal's aorta, and this showed that the ionisation of calcium gluconate on its first pass through the circulation is as great as that of calcium chloride. This does not support the common suggestion that calcium chloride is preferable to calcium gluconate because of its greater ionisation. PMID- 6507825 TI - Prevention of neostigmine-induced colonic activity. A comparison of atropine and glycopyrronium. AB - Colonic intraluminal pressure was recorded in eight patients receiving either atropine 1.2 mg (n = 4) or glycopyrronium 0.6 mg (n = 4) intravenously in a randomised, double-blind fashion and followed after 5 minutes by neostigmine 2.5 mg. Estimations of total colonic activity were made from the area under the recording of intraluminal pressure. There were no significant differences in mean intraluminal pressures or total colonic activity between the two groups. It is concluded that glycopyrronium offers no advantage over atropine with respect to protection of the bowel against the effects of neostigmine. PMID- 6507826 TI - Genesis of the 'true' negative pressure in the lumbar epidural space. A new hypothesis. AB - A hypothesis is suggested that the initial or 'true' negative pressure encountered when a needle first enters the epidural space is due to initial bulging of the ligamentum flavum in front of the advancing needle followed by its rapid return to the resting position once the needle has perforated the ligament. The bulging has been confirmed to occur in fresh cadavers, and pressure studies carried out during performance of epidural blocks in patients lend weight to this hypothesis. PMID- 6507827 TI - Difficult tracheal intubation in obstetrics. AB - Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will not meet the problem in their first few years and may thus be unprepared for it in obstetrics. However the problem can be simulated in routine anaesthesia, so that a drill for managing it can be practised. Laryngoscopy is carried out as usual, then the blade is lowered so that the epiglottis descends and hides the cords. Intubation has to be done blind, using the Macintosh method. This can be helpful as part of the training before starting in the maternity department, supplementing the Aberdeen drill. PMID- 6507828 TI - Postoperative myxoedema. A report of coma and upper airway obstruction. AB - The problems encountered in the immediate postoperative period in an undiagnosed myxoedematous patient are reported, the specific management of these problems discussed and the treatment of myxoedema coma outlined. The use of dopamine for cardiovascular support in this situation is commented upon. PMID- 6507829 TI - Cervical surgical emphysema following extradural analgesia. AB - Three patients requesting extradural analgesia for labour developed cervical emphysema. The extradural space was located by loss of resistance to injection of air. This complication has been reported before and means of prevention are considered. PMID- 6507830 TI - Training for day-case dental anaesthesia. Oxygen saturation during general anaesthesia administered by dental undergraduates. AB - Sixty-seven patients undergoing general anaesthesia for exodontia as outpatients were studied in order to measure the levels of oxygen saturation. Both the anaesthesia and extractions were performed by fourth year dental undergraduates working under direct supervision. Falls in oxygen saturation in excess of 5% were found in three groups of patients receiving 20%, 25%, and 30% oxygen in the inspired mixture. PMID- 6507832 TI - Postoperative analgesia: a technique using continuous intravenous infusion of buprenorphine. PMID- 6507831 TI - Entonox for casualties at 1000 m: use of nitrous oxide analgesia in Nigeria at moderate altitude. AB - Analgesia with nitrous oxide and oxygen (Entonox) has been found to give adequate pain relief for 90 minor casualty procedures in over 90% of cases at moderate altitude. It was self administered except in six patients. Children between 6 and 10 years of age comprised 14% of patients, and the majority of the remainder were young adults. Additional analgesia was required in 11 patients, with no increase in complications. Complications were few; drowsiness occurred in 9%, dizziness was troublesome in one patient, but there was no nausea or vomiting and no one became unconscious. In situations where trained personnel are scarce, and where supervision can only be given at the time of the procedure and even at moderate altitudes Entonox is a clinically effective safe analgesic. PMID- 6507833 TI - A brief technique of hypnoanaesthesia for children in a casualty ward. AB - Hypnoanaesthesia has been used in the past for the treatment of minor trauma in both adults and children. It is of particular value in the latter. However, the time required limits its application in the Accident and Emergency Department. A brief technique for hypnoanaesthesia particularly for children is described, offering a practical solution. A case is reported to illustrate its usefulness. PMID- 6507834 TI - Diabetic gastroparesis. PMID- 6507835 TI - Anaesthesia and scleroderma. PMID- 6507836 TI - Laser surgery in the airway. PMID- 6507837 TI - Angioneurotic oedema (Quincke's disease) and severe bronchospasm after chlormethiazole infusion. PMID- 6507838 TI - Monoplatythela and paravertebral block. PMID- 6507839 TI - Rotating catheter mount. PMID- 6507840 TI - Venous pressures in simulated Bier's block. PMID- 6507841 TI - Intracranial pressure after phenoperidine. PMID- 6507843 TI - Premedication in children. PMID- 6507842 TI - Gastric distension following ketamine. PMID- 6507844 TI - [Intraoperative mechanical autotransfusion: studies on preserved blood for retransfusion]. AB - The blood loss by 10 patients who underwent major thoracic or abdominal vascular surgery was saved with the Bentley Autotransfusion System ATS 2000. The blood was examined for several parameters. Disadvantages of the saved blood were: low haematocrit, high levels of free plasma haemoglobin, the size of fat particles, a shift to the left of the oxyhaemoglobin saturation curve and severe alteration of coagulation parameters. The results indicate, that autotransfusion should be used with caution. PMID- 6507845 TI - [Thoracic internal bleeding following subclavian puncture in a child]. AB - We report the case of a four year old female patient who underwent an unsuccessful puncture of the subclavian vein in another department with an adult subclavian catheter. Unilateral haematothorax with massive bleeding from the right Art. thoracica interna occurred as a sequel of this attempt and was successfully treated in our department. PMID- 6507846 TI - [Two new oncometers--results of a comparative study]. AB - In the course of a series of measurements of colloid oncotic pressure two newly introduced instruments were compared with an approved standard COD-measuring device as to accuracy and operational comfort. While the comparative tests produced practically identical results one instrument (number 2; Osmomat 050) did stand out for high precision but concerning speed of adjustment and simplicity in handling it was somewhat inferior to number 1 (BMT 921). The importance of repeated (or quasi on line) clinical control of colloid osmotic pressure by the aid of newly developed instruments now rather easy to operate is briefly outlined. PMID- 6507847 TI - [Remarks on the work of F. Hartmann-Andersen and B. Juhl. Is the circulatory stimulating effect of dopamine independent of metabolic acidosis?]. PMID- 6507848 TI - [A report on experiences of 1100 anesthesias with tramadol]. PMID- 6507849 TI - [Remarks on the work of G. H. Meuret et al. Does calcium have a place in resuscitation]. PMID- 6507850 TI - Two-dimensional separations: concept and promise. PMID- 6507851 TI - Analyzing chemical data with computers: errors & pitfalls. PMID- 6507852 TI - Determination of inorganic tellurium species in natural waters. PMID- 6507854 TI - Deuterium nuclear magnetic resonance relaxation study of mobile phase-stationary phase interactions in reversed-phase high-performance liquid chromatography. PMID- 6507853 TI - Liquid chromatography with electrochemical and/or spectrophotometric detection for automated determination of lead, cadmium, mercury, cobalt, nickel, and copper. PMID- 6507856 TI - Chromatographic band broadening theory using a random walk with a step-length distribution. PMID- 6507855 TI - End effects in field-flow fractionation channels: theory and means for reducing incremental zone broadening. PMID- 6507857 TI - Determination of acrolein in air as an oxazolidine derivative by gas chromatography. PMID- 6507858 TI - Development and validation of an air monitoring methods for 1,3-dichloropropene, trans-1,2,3-trichloropropene, cis-1,2,3-trichloropropene, 1, 1,2,3 tetrachloropropene, 2,3,3-trichloro-2-propen-1-01, and 1,1,2,2,3 pentachloropropane. PMID- 6507859 TI - Analysis of impregnated charcoals by desorption ionization mass spectrometry. PMID- 6507860 TI - Analysis of chronocoulometric data and determination of surface concentrations. PMID- 6507861 TI - Experimental observations of transient light scattering complexes formed during immunoprecipitin reactions. PMID- 6507862 TI - Theory of light scattering measurements as applied to immunoprecipitin reactions. PMID- 6507863 TI - Micelle-enhanced chemiluminescence and application to the determination of biological reductants using lucigenin. PMID- 6507864 TI - Optimization of experimental variables for the chemiluminescent determination of glucose in microporous membrane flow cells. PMID- 6507865 TI - Efficient packing of small particle microbore columns. PMID- 6507866 TI - Liquid chromatographic determination of nitrosamines in malt and beer with a photoconductivity detector. PMID- 6507868 TI - Spectrophotometric determination of nitrite in waters with 5,7-dihydroxy-4-imino 2-oxochroman. PMID- 6507867 TI - Comparison of mass spectrometric methods for trace level screening of hexachlorobenzene and trichlorophenol in human blood serum and urine. PMID- 6507869 TI - Matrix isolation mechanism for solid surface room-temperature phosphorescence induction. PMID- 6507870 TI - Fiber optic based sensor for bioanalytical absorbance measurements. PMID- 6507871 TI - Reverse-phase polystyrene column for purification and analysis of DNA oligomers. PMID- 6507872 TI - A new selective technique for characterization of polycyclic aromatic hydrocarbons in complex samples: UV resonance Raman spectrometry of coal liquids. PMID- 6507873 TI - Liquid chromatography with detection by alpha-alumina modified glassy carbon electrodes. PMID- 6507874 TI - Spectrophotometric method for the determination of uranium in urine. PMID- 6507875 TI - Screening procedure for total organic halogen. PMID- 6507877 TI - Determination of cobalt in feedingstuffs by solvent extraction and graphite furnace atomic-absorption spectrophotometry. PMID- 6507876 TI - Spectrophotometric determination of ozone in air with indigo disulphonate. PMID- 6507878 TI - Glucose oxidase membrane systems based on poly(vinyl chloride) matrices for glucose determination with an iodide ion-selective electrode. PMID- 6507879 TI - High-performance liquid chromatographic assay of temocillin and epimerisation of its diastereoisomers. PMID- 6507880 TI - Development and evaluation of a radioimmunoassay for the analysis of body fluids to determine the presence of tricyclic antidepressant drugs. PMID- 6507881 TI - Nerve fiber caliber analysis in the mouse facial trunk distal to the stylomastoid foramen with the electron microscope. AB - Nerve fiber counts and caliber analysis were performed with the electron microscope on 5 facial trunks distal to the stylomastoid foramen from 3 mice. On an average, about 89% of the total nerve fibers (3,205) were myelinated and about 11% unmyelinated. Majority (80.5%) of the myelin sheaths of the myelinated fibers in the nerves were 2.0-4.5 microns and majority (86.4%) of their axons were 1.0 3.0 micron in minor diameter. Their frequency distributions were similar in pattern to that of the large fiber zone of the motor root of the mouse facial nerve. Majority (86%) of the unmyelinated fibers in the facial trunk distal to the stylomastoid foramen were 0.1-0.5 micron in minor diameter. Its frequency distribution showed that the unmyelinated fibers of the facial trunk tend to be rather smaller than that of the other nerves examined in the previous studies. Ratios of the circumferential length of the myelinated fibers to that of the circles with the same areas ranged from 1.00 to 1.98, with 1.02-1.10 being most frequent (72%). Ratios of the axons of the myelinated fibers ranged from 1.00 to 2.54, with 1.04-1.14 being most frequent (51.8%). Ratios of the unmyelinated fibers ranged from 1.00-1.18 (84%), and those which over 1.20 were rare. PMID- 6507882 TI - [Relations between the accessory nerve and the distal ganglion of the vagus nerve in sheep during the prenatal period]. AB - This contribution presents the results of morphological studies regarding the nervus accessorius and the ganglion distale nervi vagi of the sheep during the prenatal period. Special attention was paid to the roots of the brain and spinal medulla, which are implicated in the formation of the nervus accessorius, and the region of the spinal medulla in embryos at different stages of development. We investigated the relationship between the above nerve and the ganglion distale nervi vagi. The morphology of this ganglion was also investigated, and its external structure is described. PMID- 6507883 TI - [Phylogenetic aspects of the Jacobson's organ and nasopalatine duct topography in insectivores, primates, Tupaia and Didelphis]. AB - A comparative study was made of the anatomy of the skeletal structures of Jacobson's organs and the nasopalatine ducts in insectivores, primates, Tupaia and Didelphis. The adult animals investigated can be devided in 2 groups according to the topography of this region. Each group has its characteristic structures. Tupaia, although a member of the eutherian mammals, shows striking similarities to the marsupial Didelphis. The structure of the nasal region of both points towards an ancestral origin. The organ of Jacobson of those primates and insectivores which were studied, are quite different with respect to the anatomy of these skeletal structures. Closest similarities within these both orders are found in Erinaceus and primates. The other insectivores studied, Talpa and the shrews, differ from them in so far as their cartilages of the corresponding region are for the most part ossificated. It seems that this nasal part is of value in revealing early phylogenetic relations. PMID- 6507884 TI - Histological and ultrastructural observations of the attachment between the oral cavity of the fetus and the nipple of the mother in opossum (Didelphis azarae). AB - The mechanism of fixation of the fetus to the maternal nipple of opossum (Didelphis azarae) was studied in fetus of different ages through histological sections of the oral cavity keeping the nipple inside it. No organic connection was found between the maternal nipple and the tissues of the fetus. The increase of the nipple volume inside the oral cavity of the fetus and the imbrication between the corneous extracts of the nipple, palate and tongue epitheliums increase the fixation strength and contribute to the act of suckling. PMID- 6507885 TI - Study on the jaw-closing muscle, Adductor mandibulae, of the salmon, Oncorhynchus masou. 1. Fiber types. AB - A histochemical study has been made on the jaw-closing muscle, Adductor mandibulae, of the Japanese salmon, Oncorhynchus masou. 3 main types of fibers can be distinguished on the basis of differences in SDH activity: 1. fibers with very high SDH activity; 2. fibers with intermediate SDH activity, and 3. fibers with low SDH activity, containing only a few formazan particles. And, fibers with large ranges in diameter were clearly observed in each of the three fiber types classified on the basis of SDH activity. Fibers with the highest SDH activity were recognized in the most medial part of the deep portion, whereas fibers with intermediate activity were mainly distributed in the lateral side of the deep portion. But, there was no discrete zone in the distribution of these fiber types, differing from the locomotor myotomes in the fish. These facts suggest that the A. mandibulae muscle is composed of, at least, more than 3 types of fibers and the function of this muscle is also complex in the fish as it is in the mammalian. PMID- 6507886 TI - [Application possibilities of an automatic image analyzer ("Quantimet 720") in bone histomorphometry]. AB - By the way of proofing of the preventive estrogen effect on the ovariectomy osteoporosis in rats the authors collected experiences in measuring of two histomorphometric parameters "trabecular bone volume" and "trabecular bone surface" with the automatic image analyser Quantimet 720. This method demands thin bone polishes or cuts, a very rich in contrast and selective colouring. The measurement with this device spares time and gives reliable results for "trabecular bone volume", but less reliable values for "trabecular bone surface". PMID- 6507888 TI - [Optical and histochemical polarization studies of the composition of the sialomucin coat at the trophoblast surface of the rabbit placenta depending on the stage of pregnancy]. AB - Polarization microscopical and histochemical investigations were performed in 43 placentas of rabbits from the 10th to the 35th d of pregnancy at the maternal surface of the metabolic barrier of the placenta. The carboxyl groups of sialic acid and of proteins, sulphur containing amino acids of proteins and neutral carbohydrates were detected quantitatively and qualitatively by polarization optical and histochemical investigations. It is possible, that the increase of proteins in case of placenta insufficiency has diagnostic importancy. PMID- 6507887 TI - Diameter of axons and thickness of myelin sheaths of the pyramidal tract fibres in the adult human medullary pyramid. AB - After perfusion fixation with a mixture of paraformaldehyde, glutaraldehyde, and potassium-chromate 4 adult human medullary pyramids were examined with the electron microscope. The myelin sheaths showed only mild signs of post mortal destructions. The periodicity of the lamellae is preserved and varies about 17 nm. For quantitative purposes specimens were taken at random from regions with an extend of half a mm2 on the cross section of the pyramid. On the average 62 lamellae (s = 5, n = 200) built up 1 micron myelin sheath in the 4 brains. The myelin sheath thickness and the inner circumference of the myelin sheath are measured. The axon diameter is calculated from the inner circumference. We obtained an average number of 66,000 fibres, s = 11,000 per mm2. Fibres with a total diameter below 4 microns amount to 87.9%, fibres from 4 to 10 microns to 10.77%, and larger than 10 microns to 1.4%. An axon diameter of about 0.5 micron combined with a thickness of the myelin sheath of 0.3 micron was most often found in all 4 cases. The fibres showed a broad variation of myelin thickness. In a given group of the small axons the thickest myelin sheath exceeded 3 to 4 times the value of the thinnest one. The coefficient of correlation between axon diameter and myelin sheath thickness was calculated as r2 = 0.56. No correspondence exists between frequency maxima and the ratio g, axon diameter to total diameter. Below a total fibre diameter of 5 microns the ratio g scatters broadly about 0.6, fibres larger than 5 microns exceed the value of 0.6. From the morphological data only large sized fibres can evoke a strong effect on compound action potentials if the method of reconstruction of the action potential from fibre size frequency distribution is employed. PMID- 6507889 TI - Mesangio-capillary processes and their reactivo-mobile potentials in extreme exertion on the kidney. AB - 3 types of mesangiocyte processes have been distinguished in the mesangium of a rat kidney by means of electron-microscopic investigation. Processes of type I contact with proliferations of glomerular capillary endothelium, those of type II begin prolabbing to the capillary, and processes of type III penetrate its lumen. In extreme conditions (simulating in rats of acute ischemia of the kidney with recirculation, compensatory hypertrophy of the remaining kidney) increase of the number and hypertrophy of mesangiocapillary processes of type is observed. Cases of complete displacement of a whole mesangial cell into the capillary have been described. The problem of functional significance of mesangio-capillary processes is being discussed. PMID- 6507890 TI - Variability in relationships of arteries and nerves in the human orbit. AB - Orbits of humans were examined by dissection to study anatomic relationships of selected arteries and nerves. The usual paths of the ophthalmic artery and nasociliary nerve were superior to the optic nerve, but the ophthalmic artery crossed inferior to the optic nerve in 28% of the cases, a higher incidence than generally reported. The anterior ethmoidal artery and nerve almost invariably passed between the superior oblique and medial rectus muscles. When present, the posterior ethmoidal artery and nerve generally coursed above the superior oblique muscle. PMID- 6507891 TI - Retinal fine structure in the european eel Anguilla anguilla. II. Photoreceptors of the glass eel stage. AB - The eye of the European eel (Anguilla anguilla) undergoes marked morphological changes during its long and complex life cycle. This report describes the fine structure of the photoreceptors of the glass eel stage and forms part of a comparative study of the retina of the eel during the major stages of its life cycle. The photoreceptors of the glass eels are readily divisible into rods and cones based on morphological criteria. Rods are more numerous and much longer than cone cells, reaching to the pigment epithelial layer. In rods the inner and outer segments are of the same diameter whereas in cones, inner segments are much wider than the outer segments which taper distally. While the nuclei of rods are located at all levels within the outer nuclear layer, in the light-adapted condition at least, cone nuclei are predominantly located scleral to the external limiting membrane. The synaptic terminal of rods displays 2-3 invaginated (ribbon) synaptic sites while cones have 8-10 such sites. Both rods and cones also possess superficial synaptic sites. Apparent cellular degeneration is quite widespread amongst rods and is also occasionally noted for cone photoreceptors. PMID- 6507892 TI - Eruption age of teeth in Nigeria. AB - Present study was carried out on 1,022 boys and 646 girls of various age groups. In this study, an attempt has been made to estimate the eruption age of teeth in various age groups, ranging from 6 to 23 years in Northern Nigerian population. From the data collected a mean have been provided for the eruption age of each tooth. The differences noticed in the eruption ages between boys and girls are not very marked. However, a few points of interest may be mentioned. The lateral incisor, first premolar and Canine erupt earlier amongst girls. The first molar and the central incisor seem to erupt earlier among boys than girls. The teeth of the lower jaw erupt before those of the upper jaw. The Nigerian's wisdom teeth erupt with some constancy between 14-21st years. The third molar tooth fails to erupt in 5% individuals. The second premolar was absent in 0.5% populations. PMID- 6507893 TI - Blood supply and drainage of the outer medulla of the rat kidney: scanning electron microscopy of microvascular casts. AB - Blood supply and drainage of the outer medulla of the rat kidney were studied by scanning electron microscopy of vascular casts, using both arterial (n = 10) and venous (n = 10) injections of resin. Both outer and inner stripes of the outer medulla were supplied through different arterial capillary networks arising from efferent arterioles and arterial (descending) vasa recta. In contrast to previous studies using silicone rubber and light microscopy, a rich arterial capillary network supplying the outer stripe was demonstrated. Capillaries in the outer stripe and outer part of the inner stripe drained into venous vasa recta between vascular bundles, while capillaries in the inner part of the inner stripe drained into venous vasa recta within the bundles. The results indicate that each zone in the outer medulla is supplied through separate capillary networks. The demonstration of a rich capillary network in the outer stripe of the outer medulla suggests that the predilection of this zone for tubular necrosis with ischemic or toxic injury is not related to a sparse capillary blood supply. PMID- 6507895 TI - The neonatal porcine lung: ultrastructural morphology and postnatal development of the terminal airways and alveolar region. AB - Morphology and postnatal development of the porcine lung are described in animals ranging in age from newborn through 60 days. Standardized fixation was accomplished by intratracheal instillation of glutaraldehyde under constant pressure. Light microscopic, scanning, and transmission electron microscopic investigations revealed that the porcine lung follows the common architecture of mammalian lungs, but has certain peculiarities as well: intravascular macrophages, ultrastructurally similar to Kupffer cells, are attached to endothelial cells in pulmonary capillaries and are involved in erythrophagocytosis during the first postnatal weeks. Type II pneumocytes of newborn pigs exhibit signs of cell activation, mainly complex nuclear bodies in the cell nuclei. At the same time high levels of 17-hydroxycorticosteroids are observed in the newborn blood plasma. Terminal airways of the porcine lung are nonalveolarized and are, therefore, of purely conductive function. At birth the porcine lung exhibits a high degree of maturity, and thick-walled primary saccules, as described in newborn rodents, are not seen. Septa appear straight and smooth, owing to rare ramification. Septal buds are discernible, and two capillary networks visible on both sides of septal cross sections are seen. Further subdivision of the airspaces occurs in the first two postnatal weeks. Precociousness and fast postnatal growth of the porcine species are assumed to be the reason of this advanced degree of lung maturity at birth and the following rapid pulmonary development. PMID- 6507894 TI - Carbohydrate cytochemistry of rhesus monkey tracheal epithelium. AB - Three types of nonciliated secretory epithelial cells contribute material to the mucous lining of pulmonary airways: mucous cells, serous cells, and Clara cells. Extensive interspecies variation exists, especially between humans and laboratory mammals, with regard to occurrence, distribution, and granule content of these secretory cells. This study was designed to characterize one aspect of these differences in one species of nonhuman primate, the rhesus monkey. The complex carbohydrates of secretory granules present in the tracheal epithelium were characterized cytochemically. The tracheas of seven monkeys were fixed by airway infusion, processed, and embedded for both light and transmission electron microscopy. Histochemical stains including Alcian blue-periodic acid Schiff, dialyzed iron, and high iron diamine-Alcian blue were applied to serial methacrylate sections. The mucous cells were the predominant secretory cell type of the trachea and contained periodate-reactive sulfated glycoconjugates. The mucous secretory granules, as resolved with the electron microscope, consisted of a mesh or matrix surrounding a biphasic core. The matrix was stained by all cytochemical reactions used, which included periodic acid-thiocarbohydrazide silver proteinate, dialyzed iron, low iron diamine, and high iron diamine. The biphasic core also reacted with the four stains, but most intensely with high iron diamine. We conclude from this study that 1) the mucous secretory granule contains carbohydrate throughout all phases of the granule, 2) the mucous granule contains periodate-reactive sulfated glycoconjugates, with sulfate esters concentrated in the core of the granule, and 3) the mucous granules of rhesus trachea morphologically and cytochemically resemble those described in human airways. PMID- 6507896 TI - Development of morphologic heterogeneity of hepatocyte mitochondria in the mouse. AB - The ultrastructure of mitochondria in periportal and perihepatic hepatocytes from newborn, 5-, 10-, and 20-day-old, and adult male ddY mice was analyzed by quantitative electron microscopy. In newborn and 5- and 10-day-old animals, the axial ratio (length per diameter), surface to volume ratio (area of the outer membrane per unit mitochondrial volume), and volume density were not significantly different between periportal and perihepatic cells. In 20-day-old and adult animals, the surface to volume ratio was greater in perihepatic cells than periportal cells, and the volume density was greater in periportal cells than perihepatic cells. The axial ratio became greater in perihepatic cells than periportal cells in adult animals. However, there were no differences in the surface density of the outer membrane, and of the inner membrane and cristae between the cells of both zones in all age groups examined. When the data were expressed as volume and area per cell, the patterns of subacinar distribution and age-related changes differed from the patterns seen in the volume and surface density data mainly in adult animals. This difference was generally caused by the marked increase in hepatocyte volume between 20 days of age and adulthood, especially in perihepatic cells. The results show that differences between mitochondria in periportal cells and those in perihepatic cells in the shape (the axial and surface to volume ratios), volume density, and area of the outer membrane per cell, evident in adult animals, are not present in newborn animals but arise during postnatal development. PMID- 6507897 TI - The effects of simulated increases in body weight for 30 and 60 days on bone robusticity of limb bones in rats. AB - The purpose of this study was to subject groups of weanling male rats each to a specific 10% simulated increase in body weight, ranging from 1.1G-2.0G, using constant centrifugation. (In this paper, "G" is the acceleration due to gravity.) After 30 and 60 days, rats were killed and perfused with 10% buffered neutral formalin (B.N.F.). The humerus, radius, ulna, femur, and tibia were removed, cleared of all soft tissues, weighed, and the total length measured. Bone robusticity was calculated using the ponderal index: bone length/3 square root bone weight. Tukey's Multiple Range Test was used. The data suggest that the specific limb bone, G, and duration of centrifugation are each factors in the response of limb bones to simulated increases in body weight. PMID- 6507898 TI - The effects of simulated increases in body weight for 60 days on robusticity and mineral content of limb bones of hypophysectomized rats. AB - The purpose of this investigation was to subject separate male and female groups of weanling hypophysectomized rats each to a specific 10% simulated increase in body weight using constant centrifugation, ranging from 1.1G to 2.0G, to study changes in bone robusticity and bone mineral content. (In this paper, "G" is the acceleration due to gravity.) After 60 days of centrifugation at 24 rpm, the rats were killed and the humerus, radius, ulna, femur, and tibia were removed, cleared of soft tissues, weighed, measured, decalcified with EDTA, and reweighed. Bone robusticity was determined using the ponderal index: P.I. = bone length divided by 3 square root bone weight; and bone mineral content (BMC) was determined using the formula: BMC = [(Wu - Wd) divided by Wu] X 100. Tukey's Studentized Multiple Range T Test was used. The data suggest that, for both male and female hypophysectomized rats, bone robusticity is decreased with simulated increases in body weight; also, for males, a bimodal curve describing the relationship between BMC and simulated increases in body weight is suggested. PMID- 6507899 TI - The effects of simulated increases in body weight from birth on bone robusticity of limb bones of rats. AB - Groups of newborn rats were each subjected to a specific 10% simulated increase in body weight, ranging from 1.1G to 2.0G, to study changes in bone robusticity. (In this paper, "G" is the acceleration due to gravity.) Constant centrifugation was used. At 90 days of age, the rats were killed and the humerus, radius, ulna, femur, and tibia were removed, weighed, and measured. Bone robusticity was calculated using the ponderal index: bone length/3 square root bone weight. Tukey's Multiple Range Test was used. The data suggest that, for both males and females, bone robusticity is increased with simulated increases in body weight. PMID- 6507900 TI - Structural development of the feline mental nerve. AB - The qualitative and quantitative structural development of the feline mental nerve (MN), a branch of the inferior alveolar nerve (IAN), was studied by electron microscopy from 40 days postconception (dpc) (about 2 weeks before birth) to 11 years after birth. Myelination was initiated at 40-45 dpc. At 2 months after birth de novo myelination was completed, and the larger myelinated axons had achieved a fully differentiated nodal-paranodal morphology. Size growth of myelinated axons continued until 6 months, when a bimodal size distribution between 1 and 12 months was established. When compared to the IAN, the MN contained a higher proportion of unmyelinated axons. Age-related signs of axon degeneration, which previously were recorded in the IAN, were lacking in the MN. This suggests that senescent IAN axon degeneration is related to dental rather than to cutaneous MN branches. PMID- 6507901 TI - Diameter and length changes in cerebral collaterals after middle cerebral artery occlusion in the young rat. AB - Rapid occlusion of the middle cerebral artery (MCA) in the 36-day-old normal Wistar rat results in change of the dorsal collaterals joining branches of the anterior and middle cerebral arteries. As compared to similarly positioned vessels on the opposite hemisphere and arterioles in unoperated rats of 56 days of age, there were significantly (P less than 0.001) more large (60-120 microM) diameter collaterals on the occluded side 20 days after MCA occlusion. There were fewer small (0-59 microm) diameter collaterals on the occluded side as compared to unoperated rats. The data suggest small diameter arterioles existing at occlusion became large diameter collaterals. The mean number of collaterals per hemisphere was not significantly different (P greater than 0.05) between occluded and unoperated rats. There was no evidence that new vessels were added during the 20-day ligation period. The mean collateral tortuosity value was significantly (P less than 0.01) greater for large diameter vessels on the right occluded side as compared to vessels on the left hemisphere or vessels in unoperated age-matched control rats. The greater tortuosity values of vessels on the occluded side were evidence that collateral vessel length was increased by 24-29% after MCA occlusion. Speculation was made about possible mechanisms responsible for these vascular changes. PMID- 6507902 TI - Ganglionic character of mesencephalic trigeminal neurons in the turtle Mauremys caspica. AB - A study of the morphology of the mesencephalic trigeminal neurons and their arrangement in the optic tectum has been made in the turtle Mauremys caspica employing the Cajal reduced silver method. The ganglionic features of its neurons suggest that the mesencephalic trigeminal nucleus (MTN) is a diffuse sensory ganglion located in the central nervous system. The different distribution of two cell populations, probably as a result of a distinct embryonic origin of their elements, and the atypical pattern of the ependyma lying underneath the MTN are discussed. PMID- 6507903 TI - The glial cells in the nerve fiber layer of the rat olfactory bulb. AB - In mammals the olfactory receptor neurons are the only ones that are known to undergo continuous cell renewal in the adult animal. This means that the axon of each newly formed neuron must grow into the olfactory bulb to find its appropriate target cell. It is presumed that astrocytes ensheath the olfactory axons as they course through the nerve fiber layer of the bulb even though the cells in question differ ultrastructurally from typical astrocytes. The purpose of the present study was to examine the glial cells in the nerve fiber layer of the rat olfactory bulb in an effort to resolve this apparent discrepancy. Two morphologically distinct types of glial cell were found in the nerve fiber layer. One type, which resembled the typical astrocytes that are present in other areas of the central nervous system, contained bundles of filaments in an electron lucent cytoplasm. These cells also formed endfeet on blood vessels and formed part of the external glial limiting membrane. They did not, however, ensheath the olfactory axons. The cytoplasm of the other type of glial cell was denser than that of typical astrocytes and contained fewer filaments, which were seldom grouped into bundles. These cells also formed part of the glial limiting membrane at the surface of the bulb and were the only ones that ensheathed the olfactory axons. It is concluded that the cell ensheathing the olfactory axons in the nerve fiber layer of the rat olfactory bulb is a morphological variant of the typical astrocyte.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507904 TI - The radioscapholunate ligament: a gross and histologic description. AB - The anatomic relationships of the carpal radioscapholunate ligament to its contiguous structures were analyzed by studying 1) 12 grossly dissected fresh adult wrists, and 2) multiple histologic sections from six adult wrists. Observations indicate that the radioscapholunate ligament originates from the prominence between the scaphoid and lunate articular facets on the distal articular surface of the radius, and from the palmar margin of the distal radius, deep and medial to the origin of the radiotriquetral and radiocapitate ligaments. The primary insertion of the radioscapholunate ligament is the medial margin of the proximal pole of the scaphoid. The ligament secondarily inserts into the lateral margin of the lunate and significantly contributes to the proximal portion of the scapholunate interosseous ligament. The radioscapholunate ligament is distinguished morphologically from the other palmar radiocarpal ligaments by its loosely organized collagen fibers and relatively high degree of vascularity. The radiotriquetral and radiocapitate ligaments are composed of densely fasciculated collagen fibers surrounded by perpendicularly oriented perifascicular and epiligamentous fibers. A fibrous capsular layer covers the most superficial aspect of each carpal ligament. On the deep surfaces of these ligaments, a condensation of epiligamentous fibers forms a synovial capsular layer. The palmar radiocarpal ligaments are truly intracapsular structures, as they are interposed between the fibrous and synovial capsular layers. No histologic evidence of elastin is present within the substance of these ligaments. PMID- 6507905 TI - Effects of intravenous bupivacaine on cardiovascular function and plasma catecholamine levels in humans. AB - The effects of the intravenous infusion of bupivacaine (2 mg/min for 3 hr) on cardiovascular function and various endocrine metabolic parameters were studied in a randomized single-blind crossover study in eight normal subjects. Bupivacaine infusion resulted in plasma concentrations about 1-2 micrograms/ml. Heart rate increased significantly from approximately 60 to 70 beats/min. Mean arterial blood pressure increased from 87 to about 100 mm Hg, and cardiac output decreased about 20%, both of these statistically significant. Oxygen consumption did not change significantly. Plasma epinephrine concentrations increased significantly from 0.03 to 0.08 ng/ml, but plasma norepinephrine levels did not change significantly, nor did blood concentrations of glucose, lactate and plasma cortisol, and free fatty acids. These results demonstrate that systematically administered bupivacaine results in plasma concentrations of bupivacaine comparable to those that may be observed during regional anesthesia, including a positive chronotropic and an arterial vasoconstrictive effect. These effects are probably caused mainly by a direct effect of bupivacaine on the cardiovascular system, because only quantitatively minor changes in plasma catecholamines and other endocrine metabolic parameters were observed. PMID- 6507906 TI - Evidence that halothane inhibits norepinephrine release from sympathetic nerve endings in dog saphenous vein by stimulation of presynaptic inhibitory muscarinic receptors. AB - Studies were done to determine the mechanism whereby halothane inhibits the release of norepinephrine from postganglionic sympathetic nerve endings. Helical strips of dog saphenous vein were mounted for superfusion and measurement of isometric contractile tension in the presence or absence of halothane (1.2 or 2.5%). Endogenous norepinephrine overflowing in response to electrical stimulation (10 V, 2 Hz for 15 min), and the content of norepinephrine remaining in the veins after stimulation, were measured by liquid chromatography with electrochemical detection. The data indicate that halothane decreased the stimulation-evoked release of norepinephrine by stimulation of prejunctional inhibitory muscarinic receptors. Evidence was also obtained that halothane may impair clearance of norepinephrine from the synaptic cleft. PMID- 6507907 TI - Nitrous oxide, too, is hepatotoxic in rats. AB - Anesthetic hepatotoxicity was tested under various conditions of hypoxia in rats pretreated with phenobarbital. Administration of 0.3 MAC halothane or fentanyl in 9% oxygen (fractional concentration of inspired oxygen = 0.09) for 46 min produced centrilobular hepatic injury in all rats (P less than 0.001 vs all other groups). Isoflurane, nitrous oxide, and thiopental at 0.3 MAC did not produce hepatic injury greater than that produced in control rats given 9% oxygen, nor was significant injury produced in control phenobarbital-pretreated rats who breathed 6 or 7.5% oxygen for 46 min. With an inspired oxygen concentration of 7.5%, hepatic injury occurred after exposure to 92.5% nitrous oxide (P less than 0.05), but not after enflurane, isoflurane, or thiopental. When hypoxia associated with 9% oxygen was extended to 2 hr, 91% nitrous oxide produced significant injury (P less than 0.001 compared with the controls), while enflurane, isoflurane, and thiopental did not. These and previous results suggest that all anesthetics can produce liver injury in the hypoxic rat model and that the ranking of hepatotoxicity (most to least) may be halothane, fentanyl, nitrous oxide, enflurane = isoflurane = thiopental. PMID- 6507908 TI - Differences in threshold for protamine toxicity in isolated atrial and ventricular tissue. AB - The inotropic and chronotropic effects of protamine sulfate on rabbit myocardium were studied using isolated preparations of atrial and ventricular tissue. Each tissue differed markedly in its susceptibility to depression of peak isometric developed tension. The threshold concentration for depression of tension was 0.022% for left atrium, 0.055% for right atrium, and 0.3% for right ventricular papillary muscle. Tension in the left atrial preparation increased 20% over control at a protamine concentration of 0.02%, but decreased to less than 30% of control at a concentration of 0.022%. Right atrial tissue tension decreased to 48% of control at a protamine concentration of 0.055% and then to 17% of control at a concentration of 0.6%. In papillary muscle, tension decreased to 64% of control at a concentration of 0.3% and then to 9% of control at a concentration of 0.35%. Thus a very steep dose-response curve was observed for each tissue. In the right atrium-sinoatrial node preparation, administration of protamine at concentrations of 0.05-0.06% produced intermittent atrial extrasystoles, but no significant change in overall rate of discharge. The narrow margin of safety of the protamine dose-response curve may provide a partial explanation for the precipitous nature of hypotensive episodes during clinical administration. PMID- 6507909 TI - Clinical comparison of midazolam hydrochloride and midazolam maleate for anesthesia induction. AB - The current study was undertaken to determine whether the same doses (mg/kg) of 5 mg/ml of midazolam hydrochloride and 2.5 mg/ml of midazolam maleate are required for the induction of anesthesia. Midazolam hydrochloride and midazolam maleate were compared in a prospective double-blind fashion, in which both cardiopulmonary and sedative effects were measured in 12 patients who required repeated anesthesia for serial gynecologic radium insertions. The results showed no significant differences in clinical activity between midazolam maleate and the newer preparation, midazolam hydrochloride. Time of onset, recovery time, lack of venous irritation, and stability of cardiopulmonary variables when using the hydrochloride were essentially the same with the maleate. PMID- 6507910 TI - Finding cerebrospinal fluid during epidural blood patch: how to proceed. PMID- 6507911 TI - Effect of thiopental and succinylcholine on serum potassium concentrations in children. PMID- 6507912 TI - Adductor pollicis monitor. PMID- 6507913 TI - Cardiovascular effects of electroconvulsive therapy in patients taking tricyclic antidepressants. PMID- 6507914 TI - Spinal anesthesia in children. PMID- 6507915 TI - Rectal burn after the use of an anal stainless steel electrode/transducer system for monitoring myoneural junction. PMID- 6507916 TI - Alopecia areata after epidural morphine. PMID- 6507917 TI - The incidence of aspiration in patients with tracheotomies. PMID- 6507919 TI - Improved technique for placement of Sorenson CVP catheters. PMID- 6507918 TI - Coagulability after hip surgery. PMID- 6507920 TI - Stress free: to be or not to be? PMID- 6507921 TI - Are volatile anesthetics really calcium entry blockers? PMID- 6507922 TI - Antifibrillatory effects of volatile anesthetics in acute occlusion/reperfusion arrhythmias. AB - Halothane, enflurane, and isoflurane were evaluated for antifibrillatory efficacy and compared with lidocaine, propranolol, procainamide, and verapamil in a canine acute left anterior descending (LAD) coronary artery occlusion/reperfusion model with basal pentobarbital anesthesia. Of the antiarrhythmic drugs, only verapamil prevented ventricular fibrillation during occlusion and reperfusion. Halothane 1% inspired after 15 min showed similar protection. Enflurane 2.5% inspired after 15 min resulted in significant protection but caused hypotension after occlusion in 4 of 17 dogs. Isoflurane 1.7% inspired after 15 min showed intermediate results. At inspired concentrations of 0.5% and 1.25%, respectively, halothane and enflurane protected against ventricular fibrillation without hypotension. It is concluded that the volatile anesthetics have antifibrillatory effects in this canine model but differ in their ability to cause hypotension in the presence of proximal LAD coronary artery occlusion. PMID- 6507923 TI - The effect of lidocaine infusion on the ventilatory response to hypoxia. AB - The authors studied the effect of lidocaine infusion on the ventilatory response to isocapnic hypoxia in nine healthy male subjects. Lidocaine infusion (serum concentration 3.6 +/- 0.1 micrograms/ml) was associated with a decrease in the shape factor, "A," of the hypoxic ventilatory response in eight of our nine subjects (P less than 0.02). Overall, "A" decreased from 419 +/- 102 1 . min-1 . mmHg before lidocaine to 335 +/- 77 1 . min-1 . mmHg during lidocaine infusion (mean +/- SEM, N = 9). The authors conclude that despite significant intersubject variability, clinically useful serum lidocaine concentrations depress hypoxic ventilatory drive. Patients with carbon dioxide retention, whose resting ventilation depends on hypoxic drive, may be at risk of ventilatory failure when lidocaine is administered for arrhythmia control or regional anesthesia. PMID- 6507924 TI - The pharmacokinetics of thiopental in pediatric surgical patients. AB - Thiopental pharmacokinetics and protein binding were determined in 24 pediatric surgical patients with normal hepatic and renal function, ranging in age from 5 months to 13 yr. These pharmacokinetic data were compared with those from 11 adult patients previously studied at our institution. All pediatric patients received a single intravenous bolus of thiopental, 4.0 +/- 0.08 mg . kg-1 (mean +/- SD), while the adult patients received 6.0 +/- 0.74 mg . kg-1. Distribution phase kinetics and volume of distribution at steady state (Vdss) did not differ statistically between the two groups. The degree of serum protein binding of thiopental also was similar in pediatric and adult patients with free fractions of 13.2% +/- 1.5% and 13.6% +/- 1.3%, respectively. The two patient groups showed a marked difference in elimination half-time and clearance of thiopental. Total drug clearance was 6.6 +/- 2.2 ml . kg-1 . min-1 for pediatric patients and 3.1 +/- 0.5 ml . kg-1 . min-1 for adults (P less than 0.001). The elimination half time of 6.1 +/- 3.3 hours found in pediatric patients was significantly shorter (P less than 0.005) than that for adults, 12 +/- 6 hours. Linear regression of the pediatric data failed to achieve significance (P = 0.06) for elimination half time to increase with age, while clearance decreased (P less than 0.001) with increasing age. The shorter elimination half-time seen in infants and children was due solely to greater hepatic clearance. Thus, recovery time after large or repeated doses may be more rapid for infants and children than for adults because of the higher clearance. PMID- 6507925 TI - Halothane antagonizes effect of morphine on the motor reaction threshold in rats. AB - The ability of halothane (used in "sub-MAC" concentrations) to modify the effect of morphine on motor response threshold to pressure was studied and compared with pentobarbital in 241 rat experiments. It was found that halothane (0.5-0.7%, insp.) decreased the reaction threshold to pressure, as did pentobarbital. Halothane (0.5%) increased morphine ED50 for the reaction threshold to pressure from 0.21 mg . kg-1 (95% fiducial limits: 0.13-0.29 mg . kg-1) to 0.52 mg . kg-1 (0.28-0.73 mg . kg-1, P less than 0.0001). Pentobarbital in a dose of 3 mg . kg-1 demonstrated a similar antanalgesic effect. Neither halothane nor pentobarbital antagonized the effect of morphine with motor response to the tail clamp. On the contrary, both agents strengthened this effect. It has been suggested that the effect of morphine on the motor response threshold to pressure results primarily from activation of inhibitory control mechanisms concerned with this response; halothane in a subanesthetic concentration depresses the inhibitory control mechanisms and, therefore, weakens the effect of morphine. PMID- 6507926 TI - Effect of halothane on cardiac acceleration response to somatic nerve stimulation in dogs. AB - In six dogs, the authors investigated the effect of halothane on cardiac acceleration response to the electrical stimulation of a cutaneous nerve. It was found that increasing the concentration of halothane was associated with a proportional depression of the cardiac acceleration response to somatic nerve stimulation (y--99.8 - 44.3x; y--delta HR, x--halothane end-tidal concentration). Relationship of the response to end-tidal anesthetic concentration was characterized by a strong correlation (r= -0.93, P less than 0.0001). Complete abolition of the increase in heart rate in response to somatic nerve stimulation was observed at a halothane end-tidal concentration of 2.2 vol% (extrapolation). It is suggested that suppression of heart rate increase to noxious stimulation may be used as a graded index of the depth of anesthesia for halothane. PMID- 6507927 TI - Liver circulation and function during isoflurane and halothane anesthesia. AB - Hepatic arterial blood flow (HABF) and portal blood flow (PBF) were measured in 18 dogs while awake and during isoflurane and halothane anesthesia. Surgical preparation 1 week before the measurements consisted of a left thoracotomy, placement of a left atrial catheter, and insertion of another catheter into the distal aorta via the left femoral artery. Cardiac output and liver blood flow were determined using microspheres at three stages: stage 1-awake state; stage 2 after 45 min of 1 MAC of isoflurane (eight dogs) or halothane (10 dogs) anesthesia; and stage 3-after 45 min of 2 MAC of inhalation anesthesia. Half-life and fractional clearance for indocyanine green (ICG) were determined 1 day before the experiment (awake state), and at the end of stages 2 and 3. Mean arterial pressure (MAP) and cardiac index (CI), as well as PBF, decreased during isoflurane and halothane anesthesia. HABF increased significantly during isoflurane anesthesia, remained unchanged during 1 MAC of halothane anesthesia, and significantly decreased during 2 MAC of halothane anesthesia. Apparently, hepatic oxygen supply was maintained much better during isoflurane than during halothane anesthesia. PBF correlated with CI during halothane (r = 0.97) and, to a certain extent, with MAP during isoflurane (r = 0.66). HABF correlated with CI and MAP during halothane (r = 0.74 and 0.71, respectively) but did not correlate with systemic hemodynamic variables during isoflurane. ICG half-life significantly increased during 1 and 2 MAC of halothane anesthesia. The degree of increase did not correlate with the level of anesthesia or the decrease in total hepatic blood flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507928 TI - Postpartum perioperative risk of aspiration pneumonia. PMID- 6507929 TI - Bronchospasm following interscalene brachial plexus block. PMID- 6507930 TI - Migrating disc complicating spinal decompression in an achondroplastic dwarf: intraoperative demonstration of spinal cord compression by somatosensory evoked potentials. PMID- 6507931 TI - Sensitivity to pain predicts CNS sensitivity to lidocaine. PMID- 6507933 TI - The topical use of sodium nitroprusside for relief of intraoperative arterial spasm. PMID- 6507932 TI - Masseter spasm with anesthesia: incidence and implications. PMID- 6507935 TI - Bupivacaine toxicity and Bier block: the drug, the technique, or the anesthetist. PMID- 6507934 TI - A complication of lightwand-guided nasotracheal intubation. PMID- 6507936 TI - Concerning the site of action of verapamil on skeletal muscle. PMID- 6507937 TI - Iatrogenic airway foreign body. PMID- 6507938 TI - The jury is still out in the case of isoflurane versus halothane in neurosurgical patients. PMID- 6507939 TI - Brain stem anesthesia following retrobulbar block. PMID- 6507940 TI - Safety of the sitting position. PMID- 6507941 TI - Did anesthetic mismanagement contribute to intraoperative death? PMID- 6507942 TI - Prevalence of angiographically recognizable atherosclerosis in non-dominant right coronary arteries. AB - Among 1,000 consecutive patients referred for coronary arteriography because of chest pain, 89 patients were found to have a non-dominant right coronary artery (NDRCA). These patients were compared to 89 consecutive patients with dominant right coronary artery (DRCA) matched for age, sex, smoking and serum cholesterol. There was a lower incidence of obstructive disease in NDRCA (23 of 89 patients, 26%) than in DRCA (55 of 89 patients, 62%), X2 = 23.368, p less than 0.001. The incidence of coronary disease was also lower in the NDRCA group, 50 of 89 patients (56%), than in the DRCA group, 68 of 89 patients (76%), X2 = 8.146, p less than 0.01. When only patients with coronary artery disease (CAD) were included in the analysis: 23 of 50 (46%) patients with CAD and NDRCA had obstructive disease in the right coronary artery (RCA) while 55 of 68 (80%) patients with DRCA and CAD had obstructive disease in the RCA, X2 = 15.646, p less than 0.001. The lower incidence of disease in NDRCA persisted even when only the proximal one-third of the DRCA was considered: 41 of 89 (46%) patients with DRCA had proximal lesions compared to the total length of NDRCA, 23 of 89 patients (26%), X2 = 7.940, p less than 0.01.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507943 TI - Treatment of hypertension in mild asthmatic patients with atenolol. AB - Fourteen patients with uncomplicated essential hypertension and mild asthma were treated with Atenolol 50-125 mg/day for up to 8 months. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), rate pressure index (RPI), stress testing time (STT) and peak expiratory flow rate (PEFR) were measured before, during and after stress testing (ST) before and during treatment. Atenolol significantly lowered HR, SBP, DBP and RPI. It prolonged STT and had no effect on PEFR. Furthermore, Atenolol did not worsen the patient's asthma except for one patient. The drug did not interfere with the bronchodilatation effect of salbutamol. Atenolol can be used cautiously to treat hypertension in asthmatic patients under certain conditions. PMID- 6507944 TI - Aortic valvular malformation associated with coincident cardiovascular anomalies: morphologic considerations. AB - The association of a bicuspid aortic valve with other congenital cardiac malformations, prominently coarctation of the aorta, is widely accepted with estimates of frequency reported to be 20% overall and ranging between 25-50% to as high as 85% when there is coarctation. The anatomic configuration of the valve has received little comment and, excepting those individuals requiring aortic valve surgery coincident with repair of other malformations, has been limited to postmortem examination. Recently, however, an angiographic technique for accurately evaluating the morphology of the aortic valve has been utilized allowing for the determination of aortic valvular appearance at routine evaluation by cardiac catheterization. We have currently examined 17 individuals with various forms of congenital cardiac malformations in whom an aortic valvular abnormality was suspected as a coexistent abnormality employing the technique of orifice-view aortography. The present report concentrates on the aortic valvular anatomy of these patients. PMID- 6507945 TI - Value of radionuclide angiogram for the diagnosis of Ebstein's anomaly. AB - A radionuclide angiogram in a patient with Ebstein's anomaly showed a very dilated right atrium with a minimally enlarged right ventricle and a normal sized left ventricle. This study led to the establishment of a definitive diagnosis by means of an echocardiogram. Late close of the tricuspid valve was demonstrated. In addition prolapse of the tricuspid and mitral valves was documented. A tricuspid valve prolapse has never been reported in this condition. PMID- 6507946 TI - Fibromuscular hyperplasia of the brachial artery--failure of calcium antagonist therapy. AB - Fibromuscular dysplasia (FMD) of the arteries of the extremities has been reported few times in the literature. The clinical significance of FMD relates to the consequences of interruption of arterial blood to the tissues. We report here the second case of FMD of the brachial artery and discuss the failure of the calcium channel blocker, nifedipine, in the therapy of this disorder. A review of the pertinent literature is included. PMID- 6507947 TI - Angiographic and pathologic evidence of hemorrhage into the myocardium after coronary reperfusion. AB - Severe myocardial hemorrhage can occur as a potential adverse effect of reperfusion therapy in evolving myocardial infarction. This report describes a 83 year-old man, who showed angiographic evidence of extravasation of contrast medium from the reperfused right coronary artery into the inferoposterior left ventricular wall. At autopsy, severe hemorrhage was transmurally observed in the inferoposterior wall of the left ventricle. The finding of extravasation is a useful angiographic sign of the production of hemorrhage during coronary reperfusion therapy, and great attention should be focused to the existence of this sign to prevent further hemorrhage. PMID- 6507948 TI - Acute anterior wall myocardial infarction secondary to blunt chest trauma. AB - We report here a young patient who developed an acute transmural anterior wall myocardial infarction secondary to blunt chest trauma in an automobile accident. At angiography we demonstrated that this patient had sustained a left anterior descending branch intimal tear (Figure 1). Closed chest wall injury with myocardial contusion is a common occurrence in automobile accidents. However, the occlusion of the coronary artery from blunt chest trauma is rare in itself. PMID- 6507949 TI - A complicated case of penicillin allergy. PMID- 6507950 TI - Nifedipine does not alter methacholine-induced bronchial reactivity. AB - Calcium ions have been shown to be involved in smooth muscle contraction and various secretory processes. Nifedipine, a calcium channel blocking drug, does not have any intrinsic bronchodilatory effect, but it has been suggested to possibly inhibit bronchial reactivity. Eight patients, with normal baseline pulmonary function studies and methacholine-induced bronchial reactivity, had a repeat metacholine challenge after nifedipine. Spirometry was obtained at baseline and three minutes after successive inhalations of normal saline and five, 15, 30, 50, 100 and 200 inhalation units of 0.5% methacholine. Plethysmographic lung volumes and airways resistance were measured at the start of the test and after the last inhalation of methacholine. The FEV1, FVC, MMEF and PEFR were reduced by an average of 35.6%, 20.6%, 54.4% and 30.6%, respectively, on the initial study, and by 35.4%, 20.5%, 54.8% and 34.5% after nifedipine. Airways resistance was increased by 249.3% in the initial study and by 265.7% after nifedipine. There was no statistical difference in baseline spirometry, spirometry obtained at any level of methacholine inhalation, or in airways resistance between the two studies. Despite comparable decreases in lung function, all patients were less symptomatic after receiving nifedipine. Nifedipine does not alter methacholine-induced bronchial reactivity. Until the role of nifedipine in asthma is better defined, caution should be used in prescribing nifedipine to asthmatic patients with heart disease, because their perception of airways resistance may be altered. PMID- 6507951 TI - The effect of high dose glucocorticoid therapy on immunoglobulin E in asthma. AB - Serum IgE levels were measured before and after high dose intravenous methylprednisolone therapy in 14 patients with severe asthma. Eight patients received methylprednisolone 125 mg every 6 hours, four received methylprednisolone 60 mg every 6 hours, and two patients received hydrocortisone 100 mg every 6 hours. In patients receiving the higher dose, in extrinsic asthma, and in those not recently receiving corticosteroids, total serum IgE levels tended to decrease within a short interval after corticosteroid therapy. PMID- 6507952 TI - A volumetric-aerobiologic study of seasonal fungus prevalence inside and outside dwellings of asthmatic patients living in northeast Netherlands. AB - Air sampling with an Andersen sampler was carried out over a period of 21 mo, in 28 houses of asthmatic patients with an allergy for moulds. Inside, the livingroom, bedroom, and kitchen were studied, and an additional outside sample was always taken. Indoors, Penicillium showed the highest concentration, especially in the autumn and winter months, while Aspergillus and yeasts were also found frequently. The outside air was dominated by Cladosporium and Alternaria during summer months and Botrytis, Aspergillus, Mycelia sterilia and Basidiomycetes all year round. The patients showed high sensitisation towards Aspergillus, irrespective of the concentrations of the airborne fungi. PMID- 6507953 TI - Modifying delivery technique of Fenoterol from a metered dose inhaler. PMID- 6507954 TI - Food allergies and intolerances. September 7-9, 1983, Lausanne, Switzerland. PMID- 6507955 TI - Diagnosis of intolerance to food additives. PMID- 6507956 TI - Diagnosis of food allergies and intolerances in the study of prophylaxis and control groups in infants. AB - There is no definitive way to distinguish a true atopic IgE-mediated sign or symptom due to food from an intolerance reaction due to irritation, enzyme deficiency or other idiosyncratic cause. The presence of IgE-specific antibody against a food as demonstrated by an immediate wheal and flare skin test reaction or a positive RAST is presumptive evidence of a cause and effect relationship. The younger the patient, the more likely a positive RAST or skin test is to be significantly causally related to the illness. Nevertheless, in almost 100 infants at 4 months of age, five were observed to have both a positive skin test and a positive RAST to a food, with only two having any detectable allergic illness. This observation in a prospective study of the value of a prophylaxis regimen in the prevention or amelioration of atopic allergic disease in infancy, underlines the problem of the ascertainment of allergy. The problem is even greater when the suspected allergen is a food, for a positive laboratory test does not rule it in nor a negative test rule it out. Thus, the diagnosis of food allergy is dependent on a careful history, physical examination, elimination diets, food challenges and the cautious interpretation of skin tests and laboratory tests including a total serum IgE level and RAST. Under ordinary circumstances an individual with complaints, signs and symptoms of allergic disease consults the physician to help find the cause of the illness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507957 TI - [Assay of plasma xanthine and hypoxanthine by coupled gas chromatography-mass spectrometry and sampling problems]. AB - The differential assay of xanthine and hypoxanthine in plasma, serum and erythrocytes was performed using a combination of GC and MS with chemical ionisation. The influence of sampling conditions was studied, in particular the latency period between the collection of the blood and the separation of the plasma and the cells, the nature of the anticoagulant used and the method of storage of the samples. Firstly, this study confirms that EDTA is the most appropriate anticoagulant. It also showed that an immediate deproteinisation is necessary after separation of the plasma and the cells, in order to prevent any "in vitro" modification of the oxypurines, in particular erythrocyte hypoxanthine. PMID- 6507958 TI - [Microassay of epsilon-aminocaproic acid by liquid chromatography]. AB - A method for the analysis of epsilon aminocaproic acid in plasma or serum has been developed. This report describes a simple and rapid assay with a small sample (20 microliter) by reverse phase high performance liquid chromatography. The supernatant is derivatized with fluorescamine after acetonitrile deproteinisation. Linearity, sensibility and accuracy are good. Save time extraction allows quick determination of many samples. PMID- 6507959 TI - [Assay of circulating anti-insulin antibodies by radioimmunoprecipitation]. AB - We report a radio-immunoprecipitation method for the measurement of circulating insulin antibodies using porcine, bovine or human radiolabeled insulin and precipitation of the bound fraction by a combined polyethylene glycol--second antibody method. The coefficient of variation for intra- and inter-assay is below 8,5 p. cent and 17 p. cent respectively. 100 insulin treated patients sera were tested in the three systems: the results showed a great scattering; for the same serum, the values obtained with porcine and human insulins are below that with bovine insulin. The data correlated statistically significantly with those found with a commercial kit (r = 0,97, n = 170, t = -4,91, p greater than 0,001). PMID- 6507961 TI - A new test circulatory system for research in cardiovascular engineering. AB - A new test circulatory system (TCS) has been developed for the in vitro testing of artificial hearts (AH) and for research in cardiovascular engineering, when connected to an AH that mimics the natural heart. The TCS is controlled by five variables whereby the slopes of the systemic and pulmonary venous return curves and the mean circulatory pressure can be fixed. It allows us to observe the mutual influence between TCS and AH characteristics and particularly the blood volume distribution, the pressure distribution, and the flowrates in steady-state conditions and (in the near future) also in dynamic conditions. A steady-state mathematical analysis describing the TCS is reported. Numerical results for the human circulatory system at different levels of activity and in physiologic conditions are shown. A first prototype of the TCS has been working for more than one year. The experimental results are in agreement with the mathematical analysis. PMID- 6507960 TI - Dual energy CT scanning for analysis of brain damage due to X-irradiation. AB - Therapeutic irradiation is commonly used in the treatment of malignant brain tumors and has the potential to cause severe injury to normal tissues adjacent to a lesion. Computed tomography (CT) can be used not only to visualize tissue damage but to monitor the development of a lesion using advanced quantitative CT techniques. We have used a postprocessing dual energy CT method to quantify changes in tissue composition following large single doses of X-rays to the normal canine brain. The results suggest that these techniques will provide more information about the character of a lesion than is obtainable from conventional imaging procedures. PMID- 6507962 TI - Impedance plethysmography in the diagnosis of arterial and venous disease. AB - The objective of this paper is to review the theoretical basis and clinical application of electrical impedance plethysmography in the noninvasive evaluation of peripheral arterial and venous disease. Theoretical, experimental and clinical studies have now demonstrated a direct relationship between electrical impedance changes and limb volume changes. Potential sources of error have also been identified. This has led to the development of clinical tests based on impedance plethysmography for the detection of peripheral arterial disease, venous insufficiency and venous outflow obstruction. Impedance plethysmography, using the method of venous occlusion, is presently the most commonly employed noninvasive method for the detection of deep venous thrombosis. PMID- 6507964 TI - Interaction of heart and arterial system. AB - We have studied the interrelation of left ventricle and arterial system in the anesthetized open-thorax cat. The ventricle was characterized by its pump function graph, relating mean ventricular pressure (Plv) and mean aortic flow (F). The pump function graph was determined by means of an artificial periphery and on a beat-to-beat basis. The periphery was characterized by relating mean aortic pressure (Pao) and mean flow. Mean aortic and mean left ventricular pressure could be related over a wide range of values by a proportionality factor Pao = a . Plv. In a series of five separate experiments a value of a = 1.72 +/- 0.14 (mean +/- SD) was found. This simplified relation allows direct comparison of apparent source resistance (i.e., slope of pump function graph), (Rs), and peripheral resistance (Rp). It was also found experimentally that total external power (w) could be calculated from mean aortic pressure and mean flow as well as from mean left ventricular pressure and mean flow (thus from the pump function graph) by w = c . Pao . F = c . a . Plv . F. The value of c = 1.16 +/- 0.12 (mean +/- SD, n = 4). Maximum external power was predicted for Rp/Rs = Pao/Plv = a. In six different cats Rp/Rs ratio in the working point (i.e., mean left ventricular pressure and mean flow when the normal periphery loaded the heart) was found to be Rp/Rs = 2.63 +/- 0.92. This value could not be shown to differ from that in the point where maximal external power was found, i.e., Rp/Rs = 1.81 +/- 0.08 (n = 6). PMID- 6507963 TI - Effect of nitroprusside on wave reflections in patients with heart failure. AB - The relationship between wave reflections and ventricular-vascular coupling has been the subject of considerable speculation. Since we have previously shown that low-dose nitroprusside infusion improved ventricular-vascular coupling (as evidenced by increases in cardiac output and in aortic and pulmonary arterial total external power) in patients with severe left ventricular failure and secondary pulmonary hypertension, we chose to examine the changes in their aortic and pulmonary arterial wave reflections in this study. Wave reflection indexes examined included calculated backward and forward pressure waves and the ratio of their magnitudes (reflection factor), the reflection coefficient spectrum obtained by taking the ratios of the corresponding Fourier harmonics of the backward and forward waves, two terminal reflection coefficients calculated as gamma t = (R - Zc)/(R + Zc), where Z is characteristic impedance and R is either total resistance or vascular resistance, and the difference between the maximum and minimum impedance moduli for frequencies of 4 to 15 Hz. In the systemic vasculature, nitroprusside produced large reductions in the elevated vascular resistances and decreased aortic reflections as indexed by the reflection factor and by both terminal reflection coefficients. In contrast, however, no significant changes were found in the pulmonary artery wave reflection indexes despite large reductions in the pulmonary resistances. PMID- 6507965 TI - Ventricular interaction with the loading system. AB - The purpose of this investigation was to develop a theoretical framework to predict stroke volume (and therefore cardiac output) when the ventricle is coupled with the arterial impedance. The ultimate objective is to arrive at an analytical description of cardiac output in the closed hydraulic loop of the entire circulatory system on the basis of the properties of the major system components. We developed the framework of analysis of ventriculo-arterial coupling by characterizing both the ventricle and arterial system in terms of the end-systolic pressure vs. stroke volume (Pes-SV) relationships. This approach, motivated by the load-insensitivity of ventricular end-systolic pressure-volume relationship (ESPVR), yielded stroke volume as the intersection between the ventricular Pes-SV relationship and arterial Pes-SV relationship. The theoretical outcome was validated by comparing the stroke volume predicted as a result of interaction between a given ventricular ESPVR and a set of arterial impedances against those SVs actually measured by imposing the same arterial impedance on the isolated canine ventricles. Furthermore, because of the mathematical simplicity of this approach, it enabled us to describe cardiac output in the closed circulatory loop with a small set of analytical equations. We conclude that the proposed framework is useful in analyzing the ventriculo-arterial coupling and various mechanisms which affect cardiac output in the closed circulatory loop. PMID- 6507966 TI - Impedance matching between ventricle and load. AB - Impedance matching in the cardiovascular system is discussed in light of two models of ventricle and load: a Thevenin equivalent consisting of a hydromotive pressure source and an internal, source resistance and compliance in parallel; and a time-varying compliance filled from a constant pressure source and ejecting into a load of three components, a central resistor, a compliance, and a peripheral resistance. According to the Thevenin analog, the energy source and the load are matched when the load resistance is T/t times the internal source resistance (T is total cycle length, t is systolic time interval). Both from this model and from the variable compliance model it appears that optimum matching between source and load depends on the compliance of the Windkessel, as low compliance shifts the matching load resistance to a low value. Animal experiments (isolated cat hearts) indicated that both left and right ventricles at normal loads work close to their maxima of output hydraulic power, and, according to experiments in the right ventricle, maximum power output is related to load resistance and compliance as predicted by the above models. From an experimentally determined relationship among instantaneous ventricular pressure and volume (right ventricle of isolated cat hearts), an optimum load impedance was calculated on the basis of the assumption that the ratio between stroke work and static, potential energy developed in the ventricular cavity is maximum. The optimum load impedance found by this procedure closely resembles the normal input impedance of the cat lung vessel bed. PMID- 6507967 TI - Informational analysis of left-ventricle/systemic-arterial interaction. AB - Studies of left ventricle (LV) and systemic arterial (SA) interaction can be grouped into four categories: 1) prediction of pressure and flow waveforms, 2) changes in LV/SA function with changes in SA properties, 3) identification of criteria that reveal matching between LV and SA properties, 4) definition of LV afterload. Whereas results from studies in categories 1, 2, and 3 reveal the consequences of interaction, results from studies in category 4 come closest to revealing the true character of LV/SA interaction. A useful description arising from category 4 is that of a circular feedback path connecting LV outflow, SA input-impedance, LV pressure, and LV pump properties. The identification of a node in this scheme results in the separation of LV functions into active functions and loading functions and the separation of LV/SA load into LV load and SA loading elements. The time-varying LV elastance participates in both LV active functions and LV loading functions, with the former dominating the latter. Total peripheral resistance dominates all other LV and SA loading elements in its loading effects. Although an elastance-resistance LV model coupled with a simple second-order SA load model accounts for many reported observations on LV/SA interaction, data from sudden aortic occlusion studies indicate a need to consider yet another interaction action. Evidence is presented to suggest the existence of an LV pump element that couples ejection events with relaxation and filling events. PMID- 6507968 TI - Intralingual naloxone reversal of morphine-induced respiratory depression in dogs. AB - A descriptive study was done to determine whether naloxone is efficacious in reversing morphine-induced respiratory depression in dogs when administered intralingually into the ventral lateral surface of the tongue. Mean minute ventilation was depressed to half of resting baseline levels using fixed intravenous doses of morphine sulfate. Intralingually administered naloxone reversed this respiratory depression rapidly within one minute, and resulted in a greater than fourfold increase in mean minute ventilation above established baseline levels. PMID- 6507969 TI - Effect of circumferential pneumatic compression devices on digital flow. AB - We reviewed the effects of circumferential pneumatic compression suits (CPCS) when applied to normal and ischemic limbs without prior application of prehospital orthopedic traction devices beneath the garment. The digital arterial toe pressures of 11 normal and six claudicating limbs were measured with the trouser applied and the limbs pressurized to 40, 60, 80, and 100 mm Hg. In addition, normal limbs had the Hare traction device and the Sager splint applied prior to application of the trouser and retesting of the digital arterial flow. We conclude that CPCS prevents flow into the limbs, and this may potentiate the development of compartment syndromes in the previously traumatized or ischemic limbs. Normal limbs with traction devices already applied may be at a higher risk for compartment syndromes, and we suggest that patients with fractured limbs who are in need of CPCS not have the traction device applied. PMID- 6507970 TI - Limitation on effectiveness of rapid defibrillation by emergency medical technicians in a rural setting. AB - First-responding emergency medical technicians (EMTs) trained to defibrillate have been shown to increase survival from prehospital ventricular fibrillation (VF) almost fourfold in Washington's King County. Using Nebraska ambulance rescue run data from 1982 and published information relating ambulance response time to the likelihood that a patient would be in VF, we constructed a model to analyze the difference in expected results for EMT defibrillation among communities of varying population. The model predicts that EMTs in urban Nebraska (mean population 242,000) will use the defibrillator once every six weeks. EMTs in intermediate cities (mean population 22,300) will defibrillate once a year. In rural Nebraska (mean population 1,500), the defibrillator will be used once every 5.6 years. Despite these figures, the model predicts relatively low cost per life saved (ranging from $566 in urban areas to $4,785 in rural Nebraska). The major problem with EMT defibrillation in rural areas is maintenance of skills and continuing education. PMID- 6507971 TI - Pediatric code drugs: a table for simplifying calculations. PMID- 6507972 TI - Wound ballistics: theory and practice. AB - Ballistics is the study of the natural laws governing projectile missiles and their predictable performances, and wound ballistics is the study of a missile's effect on living tissue. A knowledge of these topics is essential to determine the extent and type of injury from a missile. The type of missile can often be determined by radiography. The caliber can be measured directly if the bullet is close to the x-ray plate and the x-ray tube is at least six feet from the film. Changing these distances can result in a maximum magnification of the bullet image of 20%, and the exact amount can be calculated using a formula provided. Definitions of ballistic and wound ballistic terms are provided, as are examples of wound ballistics in application. PMID- 6507973 TI - Rocky Mountain spotted fever. PMID- 6507974 TI - Renal infarction associated with intravenous cocaine use. AB - The use of illicit cocaine continues to grow. This report is a documented case of renal infarction from intravenous cocaine use. The authors postulate that increased adrenergic stimulation from the intravenous cocaine, in association with an existing arterial thrombus, led to end organ infarction. This resulted in transient hypertension, but no long-term morbidity. The implications of this report extend to all patients with underlying arterial disease who use cocaine illicitly. Physicians and health professionals should be aware of this danger from intravenous cocaine usage. PMID- 6507975 TI - Lower extremity ischemia associated with use of military antishock trousers. AB - A 58-year-old man was admitted to a community hospital following an overdose of nifedipine. Military antishock trousers (MAST) were applied to combat severe hypotension. Blood pressure was restored to 110/50 mm Hg three hours after admission, but the patient remained comatose. Subsequent to MAST garment removal, ischemia of both legs and scrotum was observed; at surgery, both iliofemoral systems were occluded from the aortic bifurcation to the feet. The patient never regained consciousness and died from recurrent ventricular tachycardia. The possible contributing role of the MAST garment in producing lower extremity ischemia is discussed. PMID- 6507976 TI - Hernia en masse. AB - Described is the case of a patient who developed symptoms compatible with small bowel obstruction approximately 16 hours after a difficult self-performed left inguinal hernia reduction. Exploratory laparotomy was performed, and release of an incarcerated loop of ileum was performed. A large inguinal hernia defect also was found, and this was repaired with a Cooper's ligament repair. The patient recovered uneventfully. PMID- 6507977 TI - Entrepreneurism and benchmarks of emergency medical practice. PMID- 6507978 TI - Guidelines for emergency department physician staffing. PMID- 6507979 TI - Diltiazem for myocardial protection in CPR. PMID- 6507980 TI - Airway management in potential cervical spine injury. PMID- 6507981 TI - Legislative reform needed to strengthen obligations of driving. PMID- 6507982 TI - Amniotic fluid embolism and emergency cardiac care. PMID- 6507983 TI - Health status and the use of outpatient mental health services. PMID- 6507984 TI - Three Mile Island. Psychology and environmental policy at a crossroads. PMID- 6507985 TI - Evolutionary biology and personality psychology. Toward a conception of human nature and individual differences. PMID- 6507986 TI - Battered women, psychology, and public policy. PMID- 6507987 TI - Clinical treatment of the nondisclosing black client. A therapeutic paradox. PMID- 6507988 TI - AIDS. PMID- 6507989 TI - AIDS: a public health and psychological emergency. PMID- 6507990 TI - My personal experience with AIDS. PMID- 6507991 TI - The psychological impact of AIDS on gay men. PMID- 6507992 TI - AIDS in one city. An interview with Mervyn Silverman, Director of Health, San Francisco. Interview by Stephen F. Morin. PMID- 6507993 TI - Coping with the threat of AIDS. An approach to psychosocial assessment. PMID- 6507994 TI - Behavioral and psychosocial factors in AIDS. Methodological and substantive issues. PMID- 6507995 TI - Psychosocial research is essential to understanding and treating AIDS. PMID- 6507996 TI - The effect of inhaled verapamil on resting bronchial tone and airway contractions induced by histamine and acetylcholine in normal and asthmatic subjects. AB - In man, the influence of calcium entry blockers (CEB) on nonspecific bronchial sensitivity and resting bronchial tone is controversial. In 10 asthmatic and 8 normal subjects we recorded specific airway conductance (Gaw/VL) and flow volume loops before, 30, 60, and 90 min after the inhalation of saline, 10 (V10) and 20 mg (V20) of verapamil. The dose of inhaled histamine and acetylcholine producing Gaw/VL of -40% (PD40H and PD40ACH, respectively) with and without pretreatment with saline, V10, and, in 15 subjects, V20 was also determined. We measured plasma verapamil concentrations immediately after the end of nebulization of V10 and V20, and 30 and 60 min later. In normal subjects, V10 and V20 produced a maximal % delta Gaw/VL of 22.30 (+/- 19.50) and 33.00 (+/- 15.82), respectively (p less than 0.05). In asthmatics, V10 and V20 produced comparable % delta Gaw/VL of 22.00 (+/- 22.50) and 38.60 (+/- 38.60), respectively. This bronchodilating effect involved predominantly the large airways, persisted for 60 to 90 min, was reproducible, affected only some subjects (11 of 18), and was independent of the resting Gaw/VL, degree of bronchial sensitivity to H and ACH, and the time course of plasma verapamil concentration. The latter reached a maximum of 24.3 +/- 7.1 ng/ml after V20. In both normal and asthmatic subjects, saline or V10 did not significantly alter PD40H and PD40ACH. In normal subjects, pretreatment with V20 increased PD40H 5.3 times and PD40ACH 3.22 times (p less than 0.05). Except in 2 asthmatics, in whom V20 decreased PD40 and PD40ACH, it increased significantly PD40ACH (dose ratio: 3.15, p less than 0.05) but not PD40H.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6507998 TI - The protective effect of methylprednisolone on carbachol-induced bronchospasm. AB - We studied the effect of acute treatment with methylprednisolone in 12 asthmatics not dependent on steroids. Carbachol challenge was performed according to a standardized method. Baseline measurements of forced expiratory volume in one second (FEV1), specific airway conductance (SGaw), the provocative dose of carbachol for a 20% decrease in FEV1 (PD20), and that for a 35% decrease in SGaw (PD35) were established. Thereafter, patients returned for retesting at 2, 4, and 6 wk. Prior to each visit, the patients received 1 of 3 treatments: placebo, low dose (32 mg) methylprednisolone, or high-dose (128 mg) methylprednisolone given orally and distributed in a randomized double-blind fashion. Blood levels confirmed compliance in all subjects. All subjects remained stable throughout the study, with intrasubject FEV1 values agreeing within 5% at the start of each session. The pairwise differences for low-dose methylprednisolone versus placebo were significantly different for both PD20 (p = 0.0004) and PD35 (p = 0.0068). The pairwise differences for high-dose methylprednisolone versus placebo were also significantly different for PD20 (p = 0.04) and PD35 (p = 0.0034). Blocked comparisons of the 2 different methylprednisolone doses were not significantly different. We conclude that methylprednisolone has a protective effect on carbachol-induced bronchospasm, and that this effect is not dose-related at the two doses studied. PMID- 6507997 TI - Effect of an intranasally administered corticosteroid (budesonide) on nasal obstruction, mouth breathing, and asthma. AB - The effect of intranasally administered corticosteroid (budesonide) on nasal symptoms, mode of respiration (nasal versus mouth breathing), and asthma was investigated in 37 asthmatic children who were mouth breathers because of chronic nasal obstruction. After a 2-wk run-in period, the children were allocated randomly to 4 wk of intranasal therapy with either budesonide (400 micrograms/day) or placebo spray. A double-blind, parallel design was used. Diaries for peak expiratory flow, asthma, and rhinitis symptom scores and degree of mouth breathing were recorded at home. Nasal eosinophilia, nasal airway resistance at a flow of 0.2 L/s (NAR0.2), and lung function at rest and after exercise challenge were assessed at the clinic immediately before and at end of the 4-wk treatment. Budesonide, when compared with placebo, significantly decreased nasal obstruction (p less than 0.05), secretion (p less than 0.01), and eosinophilia (p less than 0.02), as well as NAR0.2 (p less than 0.05) and mouth breathing (p less than 0.01). The improvement in nasal obstruction correlated closely to the changes in mouth breathing (r = 0.80, n = 17, p less than 0.001). Furthermore, intranasally administered budesonide resulted in less exercise induced asthma (EIA) (p less than 0.02) and decreased cough and asthma severity significantly. Pulmonary mechanics were only marginally improved. The present study showed that intranasally administered budesonide is effective in the treatment of perennial allergic rhinitis. An attenuation of EIA and a tendency to less asthma after budesonide therapy suggest a decrease in bronchial reactivity, but the results gave no clear evidence of an association between nasal airway function and asthma. PMID- 6507999 TI - The relationship of inhaled sulfur dioxide reactivity to ingested metabisulfite sensitivity in patients with asthma. AB - When ingested in acid solution, the preservative sodium metabisulfite (MB) provokes asthma within minutes of ingestion in a proportion of asthmatic subjects. Freshly prepared acid solutions of MB liberate significant quantities of gaseous SO2. In order to test the hypothesis that asthma provoked by ingestion of acidified solutions of MB was due to supersensitivity to SO2 inhaled during swallowing, 3 groups of 10 subjects were studied. Groups 1 and 2 were asthmatics. Group 1 subjects were reactors and Group 2 were nonreactors to ingested MB. Group 3 subjects were nonasthmatic control subjects. Subjects were challenged, on separate days, with 50 mg of MB in citric acid and SO2 gas, via a steady-state system, at increasing concentrations (0.5, 1.5, 3, 5 ppm). The mean percent fall in peak expiratory flow rates after ingestion of MB for Group 1 was 35 +/- 14, Group 2 was 6 +/- 6, and Group 3 was 5 +/- 3. The mean SO2 provocation concentration (Pc20.SO2) for Group 1 was 1.19 +/- 0.78 ppm, for Group 2 it was 2.25 +/- 1.42 ppm, and for Group 3 it was greater than 5 ppm. The means for Pc20.SO2 of Groups 1 and 2 were not statistically different (p = 0.075), although the possibility of a Type 2 error is recognized. Five MB-sensitive subjects were subsequently challenged with the MB solution by mouthwash and nasogastric tube. Asthma was provoked in all 5 subjects by mouthwash but not by gastric challenge.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508000 TI - Interaction of peroxyacetyl nitrate and ozone on pulmonary functions. AB - The metabolic and pulmonary function effects were investigated in 10 nonsmoking, young adult men who were exposed for 2 h (20 degrees C (wet-bulb globe temperature) (WBGT] to 4 conditions: (1) filtered air (FA), (2) 0.30 ppm peroxyacetyl nitrate (PAN), (3) 0.45 ppm ozone (O3), and (4) 0.45 ppm O3 + 0.30 ppm PAN (PAN/O3). The subjects alternated 15-min periods of rest and 20-min periods of bicycle ergometer exercise at a work load predetermined to elicit a ventilatory minute volume (VE) of 27 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and postexposure. Forced vital capacity (FVC) was determined before and after exposure, and 5 min after each exercise period. Heart rate was monitored throughout the exposure, and (VE), oxygen uptake (VO2), respiratory rate (fR), and tidal volume (VT) were measured during the last 2 min of each exercise period. There were no changes in any variable consequent to FA or PAN exposure. The only metabolic changes to occur because of O3 and PAN/O3 exposure were a decrease in VT, a concomitant increase in fR, and consequently no change in VE. Both O3 and PAN/O3 induced significant (p less than 0.05) decrements in FVC, FEV1.0, FEV2.0, FEV3.0, FEF25-75%, IC, ERV, and TLC. The decrements after PAN/O3 exposure averaged 10% greater than the decrements after O3 exposure. The results suggest an interactive effect between PAN and O3, possibly explained by total oxidant load. PMID- 6508001 TI - Symptoms, pulmonary function, and bronchial hyperreactivity in western red cedar workers compared with those in office workers. AB - An epidemiologic health study was carried out on 652 cedar mill workers and a control group of 440 male office workers not exposed to air contaminants. Participants completed a medical-occupational questionnaire with trained interviewers, had allergy skin tests, performed spirometry, and had bronchial reactivity assessed by methacholine inhalation testing. After adjusting for differences in age, race, and smoking, cedar workers were found to have significantly higher prevalences of cough, phlegm, and dyspnea than did office workers. Symptoms of asthma and work-related asthma, but not persistent wheeze or doctor-diagnosed asthma, were reported in a significantly higher proportion of cedar workers than of office workers. Cedar workers also had significantly lower lung function test results than did office workers after controlling for height, age, race, and smoking. Bronchial hyperreactivity, defined by a methacholine PC20 less than 8 mg/ml, was more prevalent among cedar workers than among office workers, with the increase being limited to the nonatopic subgroup of workers. The prevalence of bronchial hyperreactivity increased with duration of employment among cedar workers but not among office workers. We conclude that exposure to western red cedar dust is harmful to the respiratory health of the workers, causing asthma and other respiratory symptoms, bronchial hyperreactivity, and lower levels of lung function. PMID- 6508002 TI - Abnormal bronchoalveolar lavage in asymptomatic dairy farmers. Study of lymphocytes. AB - Bronchoalveolar lavage (BAL) was performed on 24 asymptomatic dairy farmers. Thirteen had serum precipitins to Micropolyspora faeni (MF) antigens (Group 1), and 11 were seronegative control subjects (Group 2). All were nonsmokers and had no history of previous lung disease. Thirteen of 24 subjects (9 in Group 1 and 4 in Group 2) had a high percentage of lymphocytes (greater than or equal to 20%) in their BAL. The T-lymphocyte subpopulations as estimated by OKT3, OKT4, and OKT8 monoclonal antibody reactivity were measured in peripheral blood lymphocytes; OKT3 = 58.5 +/- 15.6% for Group 1, and 58.5 +/- 8.7% for Group 2; OKT4 = 40.6 +/- 10.7% and 39.9 +/- 10.0%; OKT8 = 21.5 +/- 10.6% and 22.4 +/- 8.0%, respectively (p = NS). These lymphocyte characteristics were also similar when subjects with a high percentage of lymphocytes in BAL were compared to those with a normal percentage. Specific (MF-coated) chicken erythrocyte lymphocytotoxicity (Group 1, 45.2 +/- 29.5%, Group 2, 49.2 +/- 23.4%), and nonspecific lymphocytotoxicity (Group 1, 43.9 +/- 28.6%, Group 2, 37.9 +/- 18.0%) were also similar. We conclude that a large number of asymptomatic dairy farmers have an increased percentage of lymphocytes in their BAL ("alveolitis") and that peripheral blood lymphocytes in these subjects have normal subpopulations, as assessed by monoclonal antibodies, and normal lymphocytotoxicity. PMID- 6508003 TI - Blood and lung mononuclear cell inhibition of fibroblast growth in sarcoidosis. AB - A defect in mononuclear cell inhibition of fibroblast growth may be important in the pathogenesis of tissue fibrosis in sarcoidosis. To test this hypothesis, supernatants were prepared from unstimulated and phytohemagglutinin (PHA) stimulated peripheral blood and nonadherent lung mononuclear cells of patients with sarcoidosis. The effect of these supernatants on human lung fibroblast log phase growth was compared with the effect of similar supernatants from normal persons and patients with other lung diseases. Supernatants from normal persons and the majority of patients with sarcoidosis had similar effects on fibroblast growth. Unstimulated blood and nonadherent lung mononuclear cells had no consistent effect on fibroblast growth, whereas PHA stimulated cells inhibited fibroblast growth in a dose-dependent fashion. However, unlike that in normal persons, the blood and/or lung mononuclear cells from approximately one third of the patients with sarcoidosis appeared to be activated in vivo because supernatants from these cells inhibited fibroblast growth without in vitro mitogen stimulation. Spontaneous inhibition of fibroblast growth was not seen in supernatants from blood or nonadherent lung mononuclear cells from patients with other lung diseases. Age, sex, lavage cell yield and differential, peripheral lymphocyte count, and percentage of activated T-lymphocytes did not differentiate patients whose mononuclear cells spontaneously inhibited fibroblast growth from those patients whose cells did not. However, patients whose lung mononuclear cells spontaneously inhibited fibroblast growth had fewer pulmonary function abnormalities than did patients whose cells did not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508004 TI - Complement activation in patients at risk of developing the adult respiratory distress syndrome. AB - In this prospective study of 50 patients, 36 of whom developed the adult respiratory distress syndrome (ARDS), early and intense complement activation was demonstrated. These patients were at risk of the ARDS because of multiple injuries, major abdominal surgery, acute pancreatitis, severe burns, or disseminated intravascular coagulation. Abnormal C3 consumption (as measured by the C3d/C3 ratio) and elevated plasma C5a-like activity (as measured by a leukocyte aggregation assay) were associated with, respectively, 84 and 86% of cases of ARDS. Both tests were more sensitive indicators of complement consumption than were assays of total hemolytic complement activity (CH50) or total C3. The C3d/C3 ratio showed a close, inverse correlation with CH50 in 47 healthy subjects, and was increased in 12 control patients after minor surgery. The C5a-like activity was found only in patients at risk of ARDS; it was highly associated with clinical conditions that predispose to the ARDS, but it cannot be considered as a real predictor of ARDS occurrence in these patients. Sequential samples from both sides of the pulmonary circulation showed initial pulmonary clearance followed by the release of C5a-like activity. No simultaneous changes in C3 levels were found, suggesting the possible presence of modulating factors. These observations suggest that other factors (e.g., hypoxia and metabolic cascades) may influence the development of ARDS. PMID- 6508005 TI - Charcot-Leyden crystal protein and eosinophil granule major basic protein in sputum of patients with respiratory diseases. AB - Sputum eosinophilia is characteristic of bronchial asthma, and sputum specimens from patients with asthma contain eosinophil-derived substances including Charcot Leyden crystals (CLC) and the eosinophil granule major basic protein (MBP). Prior observations have indicated that an elevated sputum level of MBP is associated with asthma. To determine whether CLC protein was also elevated in asthma, we measured by specific radioimmunoassays the quantities of MBP and CLC protein in sputum specimens from 106 consecutive patients with various respiratory diseases and in sputum specimens from 10 patients hospitalized for asthma. The CLC protein was detected in all sputum samples, and the levels in the 116 samples averaged 3.5 micrograms/ml (range, 0.01 to 25 micrograms/ml). The CLC protein was significantly elevated in sputum specimens from patients with acute asthma and from patients with certain other respiratory diseases when associated with bronchopulmonary infection. In contrast, MBP levels in the 116 samples averaged 0.32 micrograms/ml (range, 0.01 to 8.8 micrograms/ml) and were significantly elevated only in patients with asymptomatic or acute asthma. Sputum MBP was not elevated in patients with bronchopulmonary infections unless acute asthma was also present. Thus, an elevated sputum MBP level was specifically associated with asthma, whereas an elevated CLC protein level was associated with both asthma and with bronchopulmonary infection in certain patient groups. PMID- 6508006 TI - Supervised six-months treatment of newly diagnosed pulmonary tuberculosis using isoniazid, rifampin, and pyrazinamide with and without streptomycin. AB - In a previous study, we have shown that a 6-month regimen consisting of 2 months of isoniazid, rifampin, pyrazinamide, and streptomycin administered daily (2IRSZ) followed by 4 months of isoniazid and rifampin administered twice weekly (4I2R2) yielded no relapses after 30 months of follow-up. In order to assess the contribution of streptomycin to this treatment regimen, 213 patients with newly detected smear-positive pulmonary tuberculosis were randomly assigned to the following two 6-month treatment regimens: 2IRZ/4I2R2 and 2IRSZ/4I2R2. One hundred seventy-two of the 213 patients (81%) completed therapy, i.e., 116 of 135 patients (86%) treated with 2IRZ/4I2R2 and 56 of 78 patients (72%) treated with 2IRSZ/4I2R2. Adverse reactions requiring withdrawal of drugs for 7 days or longer were observed in 4.2% of patients (3.7% receiving the 2IRZ/4I2R2 regimen and 5.1% receiving the 2IRSZ/4I2R2 regimen). At the end of treatment, all patients in the 2IRZ/I2R2 series had negative smears and cultures. Two of the 116 patients (1.7%) in the 2IRZ/I2R2 series developed isoniazid resistance in the fourth month of treatment and remained sputum positive at the end of treatment. In the follow-up period, 4 patients (3.4%) treated with 2IRZ/4I2R2 relapsed and 1 (1.8%) treated with 2IRSZ/4I2R2 relapsed. The only significant difference between the 2 regimens was the higher dropout rate among those assigned to the 2IRSZ/4I2R2 regimen. PMID- 6508007 TI - A longitudinal study of spirometry in young black and young white children. AB - Spirometry was performed longitudinally over a period of 8 yr on 72 children (29 black females, 26 black males, 9 white females, and 8 white males) starting as early as 3 yr of age. Weighted straight-line regressions of 6 maximal expiratory flow-volume parameters--forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow during the middle half of the FVC (FEF25-75), and maximal expiratory flows after 50 and 75% of the FVC had been exhaled (Vmax50 and Vmax75, respectively) - on height were computed and were found to describe adequately the data over a height range of 100 to 150 cm. Statistical comparisons of regression lines revealed significant differences for FVC and FEV1 when white females were compared with white males, white females with black females, and white males with black males, but not for black females with black males. Regressions of FEF25-75 and Vmax50 for black females were significantly lower than for white females, and those for white males were lower than those for white females, but no differences were detected when black females and white males were compared with black males. Only white females compared with black females revealed significant differences for Vmax75. There were no significant differences for any of the comparisons for PEF. The data presented expand the age range for evaluating lung function in children, indicate the feasibility of testing pre-school-age subjects, and provide new approaches to analysis of longitudinally collected information. PMID- 6508008 TI - Lung mechanics in rachitic rats. AB - Lung mechanics was studied at 50 days of age in 7 rachitic rats born from mothers deprived of vitamin D. They were compared with 7 control rats raised in the same conditions but fed a diet supplemented with vitamin D. The animals were anesthetized, tracheotomized, and paralyzed. Quasi-static pressure-volume curves of the respiratory system and of the lungs were obtained. Body weight of the rachitic rats was within the range of the control rats, but dry lung weight (LW) was significantly lower (p less than 0.01). Lung volumes in absolute terms and when normalized for LW were significantly lower than in the control rats. Chest wall compliance (Ccw) of the rachitic rats was within the range of values of the control rats, except for 2 animals with an infinite Ccw. Analysis of the pressure volume curves of the lungs of the rachitic rats compared with those in the control animals showed a significant decrease in lung compliance (CL) and in CL/LW (p less than 0.01), indicating a decrease in lung distensibility. The more severe the rickets (according to microradiographic criteria of the tibia), the lower the CL/LW. It is speculated that decrease in lung distensibility may be related to abnormal lung growth caused by disturbed alveolar formation and lung connective tissue development. These abnormalities could be due to vitamin D deficiency acting on the growing lung, as on the growing bones, by a mechanism involving proteoglycans. PMID- 6508009 TI - Pulmonary function tests in the detection of small airway obstruction in a canine model of bronchiolitis obliterans. AB - We compared parameters of maximal expiratory flow with other tests used in the detection of small airways obstruction (SAD) in a canine model of bronchiolitis obliterans. Bronchiolitis was produced by instilling a 1% solution of nitric acid into the airways of 8 dogs (Group N). In 5 control dogs, a normal saline solution was instilled (Group C). Plethysmographic lung volumes, oscillatory airway resistance (RL), and tests for SAD were examined after bronchiolitis was produced. To evaluate peripheral airway function, the single-breath nitrogen washout curve was used to obtain the slope of phase III and to estimate the lung volume at which a terminal increase in N2 concentration was observed (closing capacity). Maximal expiratory flow-volume curves while the dogs breathed air and 80:20 helium:oxygen (HeO2) were performed to obtain the air flow rate at 50% vital capacity (V50), the corresponding HeO2 flow rate (delta Vmax), and the lung volume at which air and HeO2 flow rates were equal (Viso). After injury, the histologic aspects of the lung in Group N showed acute and chronic inflammation of the small airways. The RL did not change in Group N, despite a relative increase in peripheral airway resistance, which when measured increased about 4 times. Compared with Group C, significant increases in closing capacity and Viso and significant decreases in V50 were observed in Group N. Although predicted to decrease in SAD, delta Vmax did not change. We conclude that delta Vmax is relatively insensitive to SAD. Possible mechanisms resulting in reduced V50 but maintained delta Vmax in this model were further examined in terms of the concepts outlined by the wave-speed theory of flow limitation. PMID- 6508010 TI - Temporal changes after death in primate diaphragm muscle oxidative enzyme activity. AB - We have previously reported that muscle fibers in fresh samples of the diaphragm muscle of prenatal baboons have moderate to high oxidative capacity and are resistant to fatigue in vitro. These conclusions are in conflict with those of others on diaphragmatic muscle fibers studied in autopsy specimens from human infants. Reasons for these divergent interpretations could include species difference and the use of autopsy specimens rather than fresh tissue samples. We have, therefore, tested whether characteristics of human infant diaphragm muscle fibers differ from those of premature baboons, and whether the use of autopsy specimens alters interpretations of histochemical results. Samples obtained from premature, newborn, or adult baboons were quick-frozen immediately after death or after storage for as long as 24 h. Samples were obtained at autopsy from human infants at 4 to 24 h after death. Histochemical assay for NADH-TR activity was performed on cross sections. Samples from baboons at any age showed deterioration with storage, but the muscles from premature and newborn animals were considerably more susceptible to damage than those of adults. Fibers in human infant diaphragm obtained within 10 h of death looked remarkably similar to those of the infant baboons. However, samples obtained at later times after death showed deterioration and loss of oxidative enzyme activity. We conclude that diaphragmatic muscle fibers of humans and nonhuman primates are similar in enzymatic profile, but that elapsed time after death can reduce the intensity of mitochondrial enzyme assays. The decrement in tissue preservation with elapsed time after death is less pronounced in more mature muscles. PMID- 6508012 TI - Streptococcus pneumoniae infections and bacteremia in patients with acquired immune deficiency syndrome, with report of a pneumococcal vaccine failure. AB - Five patients had Streptococcus pneumoniae infections among the 35 hospitalized with acquired immune deficiency syndrome (AIDS) at the New York Veterans Administration Medical Center between January 1, 1982, and June 30, 1983. Three of these patients had pneumococcal bacteremia and 2 had pneumonia without bacteremia. Twenty-seven bacteremic S. pneumoniae infections occurred among 5,143 patients without AIDS admitted to the Medical Service of this hospital during the same period. Thus, pneumococcal bacteremia was more likely to occur in patients with AIDS than in the general hospitalized population (x2 = 26, p = less than 0.001). Two of the bacteremic infections were caused by S. pneumoniae type 4. One of these occurred in a patient who had been inoculated with the 14 valent pneumococcal vaccine 5 months earlier. There were no significant differences in concentrations of radioimmunoassay antibody to type 4 pneumococcal polysaccharide in sequential serum samples collected from this patient, and opsonic titers to this organism were not detected. It is concluded that pneumococcal infections are very common among patients with AIDS, and may not be prevented by active immunoprophylaxis. PMID- 6508011 TI - Zomepirac sodium (Zomax) hypersensitivity in aspirin-sensitive asthmatics. AB - Three asthmatic patients with a history of bronchoconstriction after aspirin ingestion were challenged with a new analgesic, zomepirac sodium (Zomax), for determination of sensitivity to this drug. Each patient had previously demonstrated sensitivity to aspirin during oral provocative challenges. In all 3 patients, zomepirac produced the typical asthmatic and nasal response, indicating hypersensitivity. These findings indicate that zomepirac sodium is not tolerated in aspirin-sensitive asthmatics and should not be prescribed to such patients. PMID- 6508013 TI - Pulmonary leukostasis in fatal human pneumococcal bacteremia without pneumonia. AB - An asplenic man developed fulminant pneumococcal bacteremia without pneumonia. He died of irreversible shock within 24 h. Autopsy revealed extensive pulmonary vascular leukostasis. This condition has been described in laboratory animals after intravascular challenge with endotoxin, gram-negative bacilli, and gram positive organisms including pneumococci. This case illustrates that death in pneumococcal disease can occur in the absence of pneumonia and may be attributable to cardiovascular collapse. We present a proposed mechanism based on activation of complement and release of vasoactive mediators. PMID- 6508014 TI - Is pulmonary artery catheterization necessary for the diagnosis of pulmonary edema? PMID- 6508015 TI - Diffuse endobronchial polyposis following a titanium tetrachloride inhalation injury. PMID- 6508016 TI - The effects of oxygen in patients with sleep apnea. AB - The effects of 6 h of continuous low flow, nasally administered oxygen were compared with the effects of breathing air in 10 men and 2 women with obstructive sleep apnea and daytime hypersomnolence. The overall quality of sleep, sleep fragmentation, the pattern of breathing, nocturnal oxygenation, and the clinical effects on daytime hypersomnolence determined by multiple sleep latency testing were evaluated. We found that in non-REM sleep, breathing 3 L/min of oxygen increased baseline percent arterial oxyhemoglobin saturation and decreased both the rate of sleep-disordered breathing from 69 +/- 36 to 56 +/- 39 (mean +/- SD) (p less than 0.02) episodes per hour and the peak fall in arterial oxyhemoglobin saturation from 11.5 +/- 5.6% to 6.5 +/- 4.0% (p less than 0.001). In addition, oxygen significantly reduced the percentage of central and mixed sleep-disordered breathing events, thus increasing the percentage of obstructive sleep-disordered breathing events. In contrast, during REM sleep, neither the baseline nor the peak fall in oxyhemoglobin saturation during disordered breathing improved; however, there was a significant reduction in hourly sleep-disordered breeathing rate from 70 +/- 17 to 56 +/- 23 (p less than 0.02) episodes. These improvements in oxygenation and pattern of breathing were associated with improved sleep architecture characterized by a decrease in the number of awakenings from sleep and an increased total sleep time from 335 +/- 72 to 369 +/- 68 min (p less than 0.05). Although 7 of 12 patients felt more alert after oxygen therapy, there was no overall improvement in multiple sleep latency test results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508017 TI - Frequency and significance of swallowing during prolonged apnea in infants. AB - To better document and describe the phenomenon of swallowing during apneic spells, we compared the frequency of swallowing during epidsodes of prolonged apnea with nonapnea control periods in 9 preterm and 1 term infant. Infants with a history of idiopathic prolonged apnea were studied for 2 to 3 h by monitoring, electrocardiogram, nasal air flow, oral CO2, abdominal respiratory movements, chin electromyogram, pharyngeal pressure, and pH. In 7 of the infants, additional observations were performed without the intrapharyngeal recording devices. One or more swallows occurred during 75% of the 100 spells observed. Swallows were far more common during apneic spells than during nonapnea control periods, and were more frequent during mixed and obstructive apnea than during central apnea (p less than .01). Asphyxia, regurgitation, and the intrapharyngeal recording devices did not appear to cause the increased frequency of swallows during apneic spells. Swallowing was temporally related to spontaneous recovery from apnea, with a swallow usually preceding recovery by 5 to 6 s. During apneic spells, we observed that swallows were often associated with a brief obstructed inspiratory effort ("swallow-breath"), a normal component of nonfeeding swallows in infants. These swallow-breaths were interspersed with higher amplitude "ordinary" obstructed breaths during apneic episodes. Thus, 2 distinctly different types of obstructed inspiratory efforts were identified during mixed and obstructive apnea episodes in infants. The sequence of events during apneic spells in the term and preterm infants was similar. PMID- 6508018 TI - Mechanics and gas distribution in normal and obstructed lungs during tidal breathing. AB - Quantitative characteristics of the dynamic mechanical and gas distribution behavior in 6 normal subjects and 5 subjects with COPD were compared during tidal breathing. Transpulmonary pressure, total lung volume, flow, and N2 fraction at the mouth were measured while N2 was washed out from the lung. The washouts were performed at several frequencies and lung volumes. As an index of nonuniform mechanical behavior, we calculated the frequency variation in dynamic pulmonary compliance (CLdyn). Based on a moment analysis of the multibreath N2 washout, we calculated a mean dilution number (MDN) as an index of the inhomogeneity of alveolar gas distribution and mixing. At FRC or above FRC the CLdyn decreased much more with frequency for the COPD subjects than for the normal subjects. The MDN was also much greater in the presence of COPD. However, the frequency dependence of the MDN was small for both the normal and COPD subjects and uncorrelated with the frequency dependence of CLdyn. Because the multibreath N2 washout and the frequency dependence of CLdyn reflect different aspects of ventilation inhomogeneity, these two responses are unique. PMID- 6508019 TI - Hypoxia-altitude simulation test. Evaluation of patients with chronic airway obstruction. AB - Increasing hypoxia with altitude ascent is a potentially serious problem for patients with hypoxemic chronic airway obstruction (CAO) at sea level. We developed a hypoxia-altitude simulation test (HAST) to assess acute cardiopulmonary responses to the inhalation of hypoxic gas mixtures (equivalent to the inspired oxygen tension (PO2) present at 5,000, 8,000, and 10,000 feet above sea level) alone and in combination with supplemental oxygen (O2). Twenty two subjects with stable normocapnic CAO were studied at sea level with a computer-based system that measured on-line, breath-by-breath resting ventilatory and gas exchange variables. Subjects breathed 20.9% (baseline), 17.1, 15.1, 13.9, and 20.9% (recovery) O2, and measurements were obtained once a "steady state" was reached at each level. Steady-state arterial PO2 (PaO2) and O2 saturation, alveolar PO2, and alveolar-to-arterial PO2 gradient decreased markedly during successive hypoxic levels, whereas arterial carbon dioxide tensions decreased only modestly. Minute ventilation and heart rate during 13.9% O2 increased only 12 and 10% above baseline. Ten subjects had asymptomatic cardiac arrhythmias during the HAST. Supplemental O2 significantly improved nearly all physiologic indexes. Sea level PaO2 best predicted acute, resting altitude PaO2. Sea level PaO2 values of 68 and 72 mmHg successfully classified more than 90% of the subjects with a PaO2 greater than 55 mmHg at 5,000 feet and a PaO2 greater than 55 mmHg at 8,000 feet, respectively. A regression equation and nomogram were derived to estimate PaO2 at altitudes between 5,000 to 10,000 feet in patients with normocapnic CAO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508020 TI - Nocturnal cough in patients with chronic bronchitis and emphysema. AB - Patients with respiratory disease commonly report that their sleep is disrupted by nocturnal cough. We have recorded cough during the night in 10 patients with severe chronic bronchitis and emphysema (forced expiratory volume in one second, 1.0 +/- SEM 0.1/L) who complained of nocturnal cough and correlated cough with electroencephalographic sleep stage and arterial oxygenation. Cough was recorded using a directional microphone and an auto-editing tape recorder system. Each cough was subsequently verified by a listener. There was a mean of 14.6 +/- 4.5 bouts of coughing per patient per night, each bout lasting on average 3.9 +/- 0.2 s. Eighty-five percent of coughing bouts occurred during electroencephalographically confirmed wakefulness (p less than 0.02 versus sleep), and coughs during true sleep were rare, with only 1 patient coughing during rapid eye movement sleep and none during Stages 3 and 4 sleep. Cough was only once followed by arousal. There was no correlation between cough and either apneas or hypoxemia during sleep. We conclude that spontaneous cough is suppressed during sleep and only rarely awakens patients. PMID- 6508021 TI - Splenectomy versus splenic salvage for spleens ruptured by blunt trauma. AB - Of 339 patients treated in three Charlotte hospitals from January 1960 through March 1983 for splenic rupture caused by blunt trauma, 317 (93.5%) underwent splenectomy, and 22 (6.5%) underwent splenic salvage operations. Perioperative mortality for splenectomized patients was 7.9 per cent, and that for those who received splenic salvage operations was 22.7 per cent. Perioperative sepsis occurred in 4.4 per cent of the splenectomized patients and in 9 per cent of those whose spleens were salvaged. Perioperative deaths and sepsis in both groups were related to associated injuries, not to splenic injuries. Follow-ups from 5 months to 22.4 years (mean, 9.5 years) of the 292 splenectomized patients who survived their injuries show that 252 (86.3%) are living, 22 (7.5%) have died of causes unrelated to splenic injuries, 18 (6.1%) could not be found, and none of the patients traced has died of sepsis. One patient (0.34%) experienced an episode of sepsis i.e., a nonfatal septicemia 7 years postsplenectomy, that may be related to splenectomy. These data suggest that the importance of splenic salvage for prevention of postsplenectomy sepsis has been overemphasized and that expeditious splenectomy remains the procedure of choice for patients with ruptured spleens, especially for those with hypovolemic hypotension, anemia from hemorrhage, or multiple injuries. Data to substantiate these views will be presented. PMID- 6508022 TI - Microwave ovens. A safe new method of warming crystalloids. AB - The multiple trauma patient often presents hypothermic. The infusion of warmed parenteral fluids is one of the least invasive methods of core rewarming the hypothermic patient. This study discusses and describes a safe, efficient method of warming normal saline and lactated Ringer's solution by microwave radiation. A 650-watt microwave oven was used to warm single liters of nondextrose containing crystalloid from room temperature (70 F) to 101 F. Total heating time required was 120 seconds. The technique involved midcycle (60 seconds) interruption with agitation and end-cycle agitation. Intra- and extrabag temperatures were confirmed with three separate thermometers. It was concluded that by following the recommended protocol, hospital personnel could be taught this safe method of rapidly warming nondextrose containing crystalloid. PMID- 6508023 TI - The effect of age on severity of murine burns. AB - There is a higher mortality in elderly subjects with burns. Whether the same amount of heat will cause a greater degree of thermal injury in elderly subjects and thus account, in part at least, for this increased mortality has not been determined and was, therefore, the purpose of this study. Swiss white mice, 1 year-old (elderly) and 3-months-old (young) were anesthetized with pentobarbital sodium and burned uniformly on a depilated area of the back with a steel disc at 100 F for 10 seconds (10% body burn). Burn severity was evaluated in a blinded manner by gross and microscopic criteria at 1, 2, and 4 days postburn. The mean burn severity 1 day postburn was significantly less in the elderly mice compared with the young mice (1.72 versus 3.22, (P less than 0.001). On the 2nd and 4th days postburn, no differences were noted in the degree of burn severity between the two groups. The early apparent diminished burn severity in the elderly mice was unexpected. Possible mechanisms to account for this difference in the old animals may relate to decreased cutaneous microcirculation, alteration in chemical composition of the skin, and the effects of thromboxane A2 and prostaglandin I2. The clinical relevance of these findings concerns the need for more careful clinical management with intentional overassessment of the initial degree of the thermal damage. PMID- 6508024 TI - Insertion of Hickman catheters. A comparison of cutdown and percutaneous techniques. AB - The insertion of Hickman catheters is useful in providing long-term vascular access in patients with a variety of conditions. Recently, enthusiasm has developed for the percutaneous insertion of the catheter because of the speed and ease of insertion. The insertion of 82 Hickman catheters in adults was reviewed. Thirty (94%) of 32 patients had a catheter placed successfully using a cutdown technique with success in 75 per cent of patients with the initial cutdown. Catheter placement was successful in 48 (96%) of the 50 patients with the percutaneous technique. The average operating time was 77 min for the cutdown technique compared with 33 min with percutaneous insertion. The overall complication rate was 18 per cent using the cutdown technique and 16 per cent for the percutaneous technique. The percutaneous technique for inserting Hickman catheters results in a much shorter operating time with minimal morbidity. As with any subclavian puncture, however, there is the risk of significant complications. The cutdown technique should be considered in patients with coagulopathy and when difficulty performing a percutaneous insertion is anticipated. PMID- 6508025 TI - Plasmid-mediated antibiotic resistance and colicinogeny among Salmonellae in Rio de Janeiro, Brazil. AB - A set of 25 multiple drug-resistant strains selected from Salmonellae isolated from sewage in Rio de Janeiro contained S. typhimurium (60%) and S. agona (20%) as the most frequent serotypes. There was resistance to ampicillin (Ap), 92%; chloramphenicol (Cm), 76%; gentamicin (Gm), 84%; kanamycin (Km), 84%; streptomycin (Sm), 96%; tetracycline (Tc), 76%; trimethoprim-sulfamethoxazole (SuTp), 84% and nalidixic acid (Na), 52%. The most frequent resistance patterns observed were Ap Cm Gm Km Sm Tc SuTp Na and Ap Cm Gm Km Sm Tc SuTp. Two strains, bearing the streptomycin, tetracycline double-resistance pattern were colicinogenic, producing type Ib colicin. The col+ character was cotransferable with the double-resistance; all these markers were associated with the presence of a single 60 Mdal plasmid. PMID- 6508026 TI - Chemical and physicochemical characterization of CB-1a, an allergenic fraction isolated from castor bean (Ricinus communis L.). AB - CB-1A chemical characterization comprised the determination of nitrogen (Kjeldhal: 15.5%: amino acid composition: 17.5%), total (6.8%) and reducing (1.6%) carbohydrates, amino acid composition (Lys4, His1, Arg11, Asp3, Thr1, Ser7, Glu16, Pro2, Gly5, Ala3, Cys6, Val3, Met1, Ile3, Leu4, Tyr1, Phe1; 82 residues). Its behaviour under several TCA concentrations, ultraviolet absorption of native and oxidized CB-1A under several solvents as well as its enzymatic susceptibility were explored. Physicochemical parameters such as MW (protein moiety - composition: 9.642 Da, column: 9.431 Da: glycoprotein-10.345) Da; E1%1cm,220mm = 49.7 E1%1cm,595mm = 29.7: partial specific volume (anhydrous: 0.703 cm3/g; hydrated; 0.924 cm3/g); Stokes radius (15.1 A); hydration water (22%) and frictional ratio (1:10) were determined. Calculated limit molecular dimensions (semi-axis of revolution: 11.4 to 19.8 A) and equatorial radius (13.2 to 17.5 A suggest dendency to sphericity. CB-1A showed allergenicity by PCA. Fourteen components were detected by IEF. PMID- 6508027 TI - [EEG with sleep deprivation in epileptic children]. AB - The role of sleep and sleep deprivation as inducer of paroxysmal abnormalities in EEG was studies in 104 infants and children under 14 years of age. These children suffered from various types of seizures and of normal standard EEG. These children who suffered from seizures of epileptic origin, after sleep deprivation had an EEG that showed a paroxysmal activity of 70.91% of the cases (p less than 0.001). The forced lack of sleep and the sleep that follows were found to be equally important as activators of paroxysmal abnormalities. The method of activation was found to be efficient in both partial an generalized seizures. The paroxysmal abnormalities were noted as being greater in phase II sleep. The EEG in sleep deprivation can show paroxysmal abnormalities, in children with epileptic seizures, that were hidden from standard EEG. PMID- 6508028 TI - [Lipid profile in low birth weight neonates, small for gestational age]. AB - Serum triglycerides, cholesterol, lipoproteins and fatty acids has been determined in 11 normal infants (RN) and 20 small for date newborn infants (SFD) at birth, before feeding, and at one week of life. All infants were bed with a milk formula (Maseda adaptado ) according with ESPGAN recommendations. Serum triglycerides are significantly increased in SFD after one week of feeding (p less than 0.01). Serum cholesterol in SFD show no differences in relation to normal infants. VLDL are significantly increased in SFD ab birth (p less than 0.01) reaching normal values after one week of feeding. After delivery SFD infants show a low serum level of linoleate (C18:2 omega 6) (p less than 0.05), linolenate (C18:3 omega 3) (p less than 0.02) and eicosadienoate (C20:2 omega 6) (p less than 0.02). No differences are observed in arachidonate (C20:4 omega 6). At one week after feeding no differences are observed in serum fatty acids between SFD and normal infants. PMID- 6508029 TI - [Bacterial meningitis in children. Analysis of 181 cases]. AB - Clinical records of 181 children, aged between one month and seven years, admitted in a four year period, from 1978 through 1982, with the diagnosis of bacterial meningitis are revised. Peak incidence occurred in the age group between six months and three years, and during the months of January to May. N. meningitidis (35%), pneumococcus (4.9%) and H. influenzae (2.7%) were the most frequently isolated bacteria. CSF culture was negative in 56% of the children. All of them had previously taken antibiotics. Complications were present in 6.4%, with highest incidence in the known-agent group, on the following order: septic shock, 11%, seizures, 6.6%, and subdural effusion, 2.2%. Permanent sequelae were present in 3.8%, being deafness predominant. Twelve (6.3%) out of the 181 died, and death was result of fulminant meningococcal sepsis with endotoxic shock in ten of these patients. Clinical and psychological followed-up of twenty-nine children with isolated causal agent, were compared with a control group, finding no statistically-significant difference. PMID- 6508030 TI - [Iliac horn syndrome. Apropos of a case and review of the literature]. AB - A case of "iliac horns" syndrome appears in a there month old baby girl, with alterations in the nails of the thumb and index fingers, which gave reason to suspect the existence of an associated osseous dysplasia. Diagnosis is confirmed with radiology, showing pathognomonic iliac horn of the syndrome. An extensive review is made of literature on this affection, extremely infrequent in infancy, establishing that this is the case involving the youngest age described to date. Interest in radiological study of minimal alterations in phenotype of the pediatric patient is emphasized. PMID- 6508031 TI - [McCune-Albright syndrome]. PMID- 6508032 TI - [Advances in cardiologic diagnosis. Echocardiography]. PMID- 6508033 TI - Evaluation of prognostic characteristics of stage I cutaneous malignant melanoma. AB - The prognostic characteristics of stage I cutaneous malignant melanoma were evaluated. For this purpose, all patients with malignant melanomas diagnosed between January 1, 1967, and December 31, 1982, at the Department of Pathological Anatomy of the S.S.D.Z. were examined. Of the 187 total cases of malignant melanoma, 169 patients had stage I disease. Of these, 101 were not included in the investigation for the following reasons: carcinoma in situ (2), previous radiation treatment (1), localization in mucous membrane (2), microscopic sections unsuitable for morphometry and measurement of tumor thickness (11), follow-up period shorter than 60 months (61), lost for follow-up (12) and cause of death unrelated to melanoma (12). Of the remaining 68 patients, 46 had been alive without metastases for at least 60 months ("survivors") and 22 had died from metastases within 60 months ("nonsurvivors"). The following parameters were investigated: age, sex, localization, histologic type, level of invasion according to Clark and Breslow, ulceration, mitotic activity index, morphometric parameters (relating to nuclear shape and size) and number, size and localization of nucleoli. Wilcoxon's test and the chi-square test showed significant differences between survivors and nonsurvivors with regard to ulceration (P = 0.005), mitotic activity index (P = 0.006), histologic type (P = 0.03), level of invasion according to Clark (P = 0.004), Breslow tumor thickness (P = 0.003), standard deviation of nuclear contour index (P = 0.04) and nuclear correlation coefficient (P = 0.008). The results showed that tumor thickness of cutaneous malignant melanoma is the most significant prognostic parameter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508034 TI - A quantitative analysis of the human bone marrow granulocytic cell lineage using the SAMBA 200 cell image processor. I. The normal maturation sequence. AB - A quantitative image analysis of the human normal bone marrow granulocytic line was performed using the SAMBA 200 image analyzer. The steps of image acquisition, preprocessing, segmentation and parametrization are described. Forty-one parameters were computed on 941 cell images belonging to the various maturation stages. The automated classification of these cells based upon a stepwise linear discriminant analysis resulted in 77% correctly classified cells; the five most discriminating parameters were the nuclear area, the nuclear convexity degree, the average cytoplasmic hue, the regularity of the nuclear boundary and the average cytoplasmic luminance. The evolution of the parameters correlates well with the cytologic evolution and the biochemical and functional events during the maturation process. It can be inferred from our results that the maturation sequence can be subdivided into two phases according to the evolution of the cell profiles. The first phase, from myeloblast to myelocyte, is discontinuous and appears as the critical point with regard to the expression of genes. The second phase, from myelocyte to polymorphonuclear cell, is a continuous sequence of transformations leading to the functional granulocyte. PMID- 6508035 TI - Rapid diagnostic DNA cytometry with an automatic microscope and a TV image analysis system. AB - A TV-based image-analysis system (Leitz TAS plus) combined with a Leitz automatic microscope was used for rapid DNA cytometry for diagnostic purposes. Malignant or suspicious cells found by the cytopathologists in conventionally stained smears were automatically relocated and measured. A program for automatic detection and measurement of nuclear DNA content was developed. DNA data are processed by an algorithm for the diagnosis and grading of malignancy. This diagnostic procedure is performed in real time and yields highly reproducible results. With this equipment, diagnostic DNA cytometry may be introduced in the routine cytology laboratory. Our mode of application does not replace the cytopathologist, but assists him or her in cases of doubtful diagnosis and in the grading of malignant tumors. PMID- 6508036 TI - Cytomorphometric differences among individual "moderate dysplasia" cells derived from cervical intraepithelial neoplasia. AB - Individual abnormal cervical epithelial cells can be categorized either by the lesion from which they are derived or by their unique cytologic characteristics. In building a data base for image analysis of cervical epithelial cells, categories of cells were defined according to distinct cytomorphologic characteristics, without knowledge of the lesion of origin. The three individual scorers, two cytopathologists and one senior cytotechnologist, most frequently agreed upon the cells classified as "moderate dysplasia." The measurements of digitized cells in this category had the smallest confidence intervals of any of the abnormal cell categories. For these two reasons, as well as the ubiquitous nature of "moderate dysplasia" cells in smears obtained from all patients with cervical epithelial neoplasia, cells in this category were studied in greater detail. Significant differences were noted in cell measurements among cells in this class when the cells came from patients with different grades of cervical neoplasia. The findings indicate that visually similar "moderate dysplasia" cells can be separated by digitized measurements into clusters dependent upon the parent lesion. The biologic implications are not yet clear, but such findings suggest that each disease is perhaps a committed lesion from inception. Therefore, predictability of ultimate outcome could be based on image analysis of cells derived from early cervical lesions, which would allow therapy to be performed on a more logical basis. PMID- 6508037 TI - Cytomorphologic and cytochemical analysis in the differential diagnosis of cervical epithelial lesions. AB - There is an increasing tendency to eradicate all cytologically diagnosed cervical epithelial lesions. A considerable number of the milder atypias are, however, known to originate from benign reactive cell populations. In nine women with initial mild or moderate dysplasia who had been followed by cytologic controls for 5 to 15 years, DNA analysis was retrospectively performed in characteristic smears from the follow-up. Progression to carcinoma in situ in six patients was invariably accompanied by a sequence of increasing DNA pattern deviations. In three patients with cervicitis as the final diagnosis, DNA patterns were constantly within normal limits. Although DNA analysis cannot conclusively determine whether a cell population is truly neoplastic, the method can establish the DNA pattern in a cell population as within normal limits or as clearly deviating from normal. A combination of cytomorphologic and cytophotometric diagnostic methods is suggested as a means to improve the differential diagnosis in cervical lesions between cell populations representing true dysplasias, i.e., premalignant lesions, and those resulting from reactive lesions and thus to avoid unnecessary overtreatment of nonneoplastic cervical abnormalities. PMID- 6508038 TI - [Surveillance of patients operated for cancer of the colorectum]. PMID- 6508039 TI - [Pancreatico-jejunal anastomosis in the treatment of chronic pancreatitis and calculosis of the Wirsung's duct]. PMID- 6508040 TI - [Current role of sympathetic nerve surgery in most peripheral chronic obliterative arteriopathies of the lower limbs]. PMID- 6508041 TI - [Current trends in the diagnosis and therapy of gastric leiomyoma]. PMID- 6508042 TI - [A case of breast tuberculosis]. PMID- 6508043 TI - [Therapy of arteriovenous fistulas: indications and limitations of embolization]. PMID- 6508044 TI - [Perianal fistula: problems of surgical therapy]. PMID- 6508045 TI - [C-peptide]. PMID- 6508046 TI - [Lymphocytic interstitial pneumonia in Gougerot-Sjogren syndrome with scleroderma]. AB - The authors report the case of a 70 year old woman with a 15 year history of the Gougerot-Sjogren syndrome, Raynaud's phenomenon and sclerodactyly. Progressive respiratory symptoms in this case were not due to pulmonary fibrosis secondary to scleroderma but to diffuse interstitial lymphocytic pneumonia (ILP) secondary to the Gougerot-Sjogren syndrome. The authors emphasize the diagnostic value of the significant, permanent lymphocytosis in the aspirate after broncho-alveolar lavage. The differential diagnosis is difficult because the radiological and clinical signs of pulmonary complications of the Gougerot-Sjogren syndrome and of scleroderma are very similar. Reports of the triple association of ILP-Gougerot Sjogren syndrome-scleroderma are uncommon in the medical literature. However, prospective studies suggest that paraclinical stigmata of the Sjogren syndrome are relatively common in patients with scleroderma. These observations suggest that some patients with clinical "pulmonary fibrosis" may in fact have ILP secondary to slowly progressive Sjogren's syndrome. PMID- 6508047 TI - [Scleroderma and pregnancy. New case and review of the literature]. AB - A new case of the rare association of scleroderma and pregnancy is reported. The pregnancy was complicated by renal failure in the last month of gestation which was initially well controlled by anti-hypertensive therapy but then suddenly progressed to pre eclampsia with signs of foetal distress necessitating emergency caesarian section. A moderately hypotrophic child was delivered. The mother progressively recovered; diuresis and blood pressure returned to normal and the proteinuria disappeared. In the light of previously reported cases and of recent advances in our knowledge of scleroderma, especially scleroderma renal disease, the authors discuss their attitude to the management of women with scleroderma wishing to become pregnant. They review the role and place of renal biopsy in the detection of subclinical renal lesions due to the scleroderma, the presence of which would be a decisive factor in assessing the risks of pregnancy. Scleroderma renal disease is, in fact, a major contraindication to pregnancy because of the very poor foetal prognosis and the risk of maternal death due to a lethal progression of renal failure. PMID- 6508048 TI - [Yellow-nail syndrome. Review of the literature apropos of 2 cases associated with cancer]. AB - Two cases of "yellow-nail syndrome" are reported: in the first, nail changes began eight months after the diagnosis of a breast cancer; in the second, yellow dystrophic nails were associated with hypertrophic osteoarthropathy due to pleuro pulmonary metastatic lesions. Clinical features are described: characteristic nail changes, lymphoedema, pleural effusions, and, often bronchopulmonary infections and sinusitis. Various combinations are seen, and the time between the development of the different manifestations may vary from several months to many years. Among associated diseases, immunological changes and malignancy are emphasized. The pathogenesis remains obscure. Accurate part taken by lymphoedema, immunological changes, is unknown, and the relationships between "yellow-nail syndrome" and malignancy are still uncertain. PMID- 6508049 TI - [Therapeutic leukapheresis in tricholeukocytic leukemia]. AB - Therapeutic leukapheresis was performed in a patient with hairy cell leukaemia (100,000 WBC/mm3; 98 p. 100 hairy cells) without signs of hypersplenism. Twenty five sessions were carried out in 12 weeks. A rapid and significant improvement was observed with the WBC falling to 25,000 WBC/mm3 with 70 p. 100 of hairy cells and the normalisation of the bone marrow biopsy. When these sessions were finished, splenectomy was performed in optimal conditions. This treatment would seem to be valuable in hairy cell leukaemia without severe hypersplenism. Long term improvement may be hoped because hairy cells have a very short turnover rate. PMID- 6508050 TI - [Traumatic left ventricular aneurysm disclosed by systemic emboli. Value of platelet labelling with indium]. AB - The authors report a case of traumatic left ventricular aneurysm, presenting with recurrent cerebral embolism, 36 years after a thoraco-brachial bullet wound. The 58 year old man had no symptoms of angina or particular cardiovascular risk factors. The ECG showed changes of chronic anterior wall infarction, observed 10 years previously on a routine preoperative recording. There was a calcified circular para-apical shadow on chest X-Ray. The antero-apical region showed hypofixation on myocardial scintigraphy, and hypokinesia on isotopic angiography. The coronary arteries were normal. Indium III platelet marking revealed a focus of hyperfixation within the left ventricle. At surgery, a true calcific para apical left ventricular aneurysm was discovered, containing a fresh thrombus. This lesion was resected. Peroperative Indium III platelet test confirmed that the thrombus was the site of high uptake. The surgical result was good at 6 months follow-up. This case illustrates: the value of the Indium test which would appear to be a very specific and sensitive method of detecting intraventricular thrombi. This test, which appreciates the thrombotic activity of intracardiac masses is a useful complement to other non-invasive methods such as 2D echocardiography; the special characteristics of post-trauma left ventricular aneurysms which are rare, often diagnosed late, at the time of complications such as systemic embolism, commonly pose medico-legal problems, and for which surgical treatment seems to be indicated in symptomatic patients. PMID- 6508051 TI - [Acute interstitial nephritis and Meckel's diverticulum]. AB - A case of acute haematogenous interstitial nephritis secondary to bacterial infection of a Meckel's diverticulum is reported. The incidence of acute infectious interstitial nephritis with a gastro-intestinal portal of entry is discussed. PMID- 6508052 TI - 1st International Meeting on Hemapheresis. Dijon, France, 14-17 November 1984. Abstracts. PMID- 6508053 TI - [The D.S.M. III in French]. PMID- 6508054 TI - [Permanence and relativity of mental disorders in the face of the environment]. PMID- 6508055 TI - [The psychiatric unit as a foreign body in the general hospital]. PMID- 6508056 TI - [Problems posed to general practitioners by the diagnosis and treatment of depression]. PMID- 6508057 TI - [Relations between general practitioners and public psychiatrists in a rural department]. PMID- 6508058 TI - [Depression and the environment]. PMID- 6508059 TI - [Psychopathologic problems posed by migrant populations in an urban center]. PMID- 6508060 TI - [Mental health and large buildings in western Europe]. PMID- 6508061 TI - [Hoboism of young people in an urban environment]. PMID- 6508062 TI - [Violent criminality]. PMID- 6508063 TI - [Epilepsy and violence. Myth or reality?]. PMID- 6508064 TI - [Psychological analysis of violent acts]. PMID- 6508065 TI - [Violence in psychopathics and perverts]. PMID- 6508066 TI - [Violence, society and institutions]. PMID- 6508067 TI - [Choice of symptoms in neuroses. Psychosomatic syndromes]. AB - We think that we have collected a certain amount of arguments in support of the following hypothesis: Without assuming if it is in itself the cause of neuroses, the way of being and of thinking in this world, characteristic of our times' positivistic technico-industrial culture seems to promote a more or less artificial and unconscious anti-anxiety behaviour leading to the psychosomatic syndromes. This way of being in the world and of thinking it is symptomatic of a discrepancy between the exogen (primacy of assimilation) and the endogen (primacy of accommodation) assimilation/accommodation balance. The non-decoupling of the exogen and endogen accommodation leads to a rigid content of concepts and limits the mind process to consider only the materially possible, leading to a regressive causality. Its' ultimate term is the object in which the essence includes the existence, the "causa sui" that is none other than the patient's body. Inability to take into account what is structurally possible makes it difficult to approach the notions of chance and of great numbers, proceeding on to apprehend the time in a way akin to Aristoteles', where the future is reduced to chance. This type of thinking limits the world's understanding to what is materially possible. Outside this, just everything is possible, including the possible the occult sciences account for. PMID- 6508068 TI - [Anxiolytics and mnemonic ability of the aged subject. Apropos of a double-blind study between tiapride and lorazepam]. AB - Starting from a study of memory performances while prescription in double blind of lorazepam (2 mg/day) versus tiapride (100 mg/day), during ten days, to patients over sixty years of age, the authors try to analyse the links between anxiety, anxiolysis and attention and memory capacities. Results seem to indicate that beyond anxiolysis, these products could have an independent action over memory performances. Statistical trial of results show significantly that performances decrease under lorazepam and increase under tiapride. PMID- 6508069 TI - [Focus on stereotypies in psychiatry]. PMID- 6508070 TI - [Description of the type strain of Bacillus badius]. AB - The type strain of Bacillus badius (ATCC 14574) was studied in detail. Out of a total of 201 sources of carbon and energy tested, only 19 were used. These included mainly organic and amino acids. No carbohydrates were used. The G+C content of its DNA was 47.5 mol %. The species B. badius therefore deserves to be included in approved lists of bacterial names. PMID- 6508071 TI - [Supplement No. XXVII (1983) to the Kauffmann-White scheme]. AB - In this supplement are given the characters of 52 new Salmonella serovars recognized in 1983 by the WHO collaborating Centre for Reference and Research on Salmonella. With regard to new taxonomic knowledge, the traditional classification of 4 Salmonella subgenera was replaced by the concept of 5 subspecies, designated I, II, IIa (monophasic Arizona), IIIb (diphasic Arizona), IV and V. Furthermore, names of serovars belonging to subspecies I are no longer printed in italics, indicating their infrasubspecific rank. Twenty serovars belong to subspecies I, 26 to II, 1 to subspecies IIIa, 3 to subspecies IIIb, 1 to subspecies IV and 1 to subspecies V. PMID- 6508072 TI - Identification and evolution of the cellulolytic microflora present during composting of cattle manure: on the role of Actinomycetes sp. AB - Population changes in cellulolytic microflora were studied during composting of cattle manure. Six bacterial and nine actinomycetes species were isolated. Among the isolates, two actinomycetes, Micromonospora chalcae and Pseudonocardia thermophila, were cellulolytic strains which were numerically dominant and might therefore play a notable role in the degradation of cellulose in cattle manure. Fungi were practically absent during the process, but two cellulose-degrading bacterial species, Sporocytophaga myxococcoides and Cytophaga hutchinsonii, appeared to coexist in equilibrium with actinomycetes during the maturation phase. PMID- 6508073 TI - Influence of carbon and nitrogen sources on arginine biosynthesis in Mycobacterium smegmatis ATCC 14468. AB - Arginine biosynthesis and its regulation by the presence of different carbon and nitrogen sources in the growth medium of Mycobacterium smegmatis was studied. Replacement of glycerol by glucose and fructose increased the activities of acetylglutamate kinase, acetylornithinase and ornithine transcarbamylase and the enzyme activities of the arginine biosynthetic pathway. The presence of succinate, fumarate, pyruvate or acetate in the growth medium (replacement for citrate) also increased these enzyme activities. However, when glutamate or glutamine was used as nitrogen source in place of asparagine, the enzyme activities decreased. The presence of ornithine or arginine in the growth medium repressed these enzyme activities, though the degree of repression was slight. The phenomenon of repression by arginine and ornithine was confirmed by dialysis experiments. Arginine inhibited the ornithine transcarbamylase activity from cells grown with asparagine as nitrogen source, but activated it when the cells were grown with arginine. Thus, in addition to the weak transcriptional control of arginine biosynthetic enzymes, feedback regulation of ornithine transcarbamylase by arginine also regulated arginine biosynthesis in M. smegmatis grown with asparagine as nitrogen source. PMID- 6508074 TI - Turnover of phospholipids and glycerides of spheroplasts of Mycobacterium smegmatis ATCC 14468. AB - The breakdown and renewal of phospholipids and glycerides from spheroplasts of Mycobacterium smegmatis ATCC 14468 were studied by means of pulse labelling techniques using 1-14C-palmitate. Most of the radioactivity incorporated into total lipids was recovered from phospholipids. Among the phospholipids studied, cardiolipin had the highest radioactivity and specific activity, suggesting its higher pool size as compared to other fractions. The appreciable loss of radioactivity for cardiolipin in pulse chase experiments within growing cells suggests its metabolically active and dynamic nature. Glycerides exhibited no appreciable turnover rates. PMID- 6508075 TI - Trimethoprim resistance plasmids. AB - Of 320 patients surveyed in a general hospital's medical wards during a 6-month period in 1981, 18 (5.6%) harboured enterobacteria which contained resistance plasmids conferring resistance to trimethoprim (Tp). At the beginning of the study period, Tp-containing therapy was not the first choice for treatment of infections caused by these bacteria and the incidence of plasmid-determined resistance was 10%. When Tp alone was used as the first choice of treatment of urinary tract infections and the use of this antimicrobial was correspondingly increased, the proportion of strains that contained Tp resistance plasmids (R plasmids) decreased to 4%. Relatively more patients with Tp-resistant strains in the bowel had significant bacteriuria compared with those without Tp-resistant organisms. The continuing occurrence of Tp-R-plasmid containing strains in the gut was associated with continuing antimicrobial therapy; the strains generally disappeared after antimicrobial therapy was stopped. PMID- 6508076 TI - Isolation and characterization of a new thermophilic Methanosarcina strain (strain MP). AB - A thermophilic Methanosarcina strain was isolated from a digester fed with water hyacinths and inoculated with ground termites from the Congo. Optimal growth temperature was 55 degrees C. Methane production was at its optimum between pH 6.5 and 7.0. The bacterium grew on acetate, methanol and methylamines in the absence of growth factors, but could not use H2-CO2 or formate. H2-CO2 inhibited acetate utilisation. Yeast extract and vitamins stimulated growth. PMID- 6508077 TI - [Morphology and cytology of Bacillus benzoevorans, a new filamentous, sheathed mesophilic species, degrading various aromatic acids and phenols]. AB - When cultivated on solid medium or in stationary liquid medium, most of the 11 studied strains of Bacillus benzoevorans grew as unbranched, flexible, immotile filaments (or trichomes) of undefined length and 1.8 micrometer diameter. They were enclosed in a sheath giving an overall diameter of 3.6 micrometer. When cultivated in vigorously shaken liquid medium, several strains grew as separate rods (1.8 X 2.2 micrometer), did not deform the filament and contained dipicolinic acid. The cytoplasm had a granular aspect due to the presence of poly beta-hydroxybutyric acid. The Gram reaction was variable but the Gram type was positive. Isolated and purified sheath contained 73% proteins, 12.9% reducing sugars and 8% lipids. In stationary liquid medium, the culture had a mycelial aspect and a thick pellicle formed at the surface. Colonies were circular, flat, opaque, whitish, mat and compact; they had irregular edges, spread out on the surface and did not adhere to the agar. PMID- 6508078 TI - [Biochemical characterization of Bacillus benzoevorans sp. nov., a new filamentous, sheathed mesophilic species, degrading various aromatic acids and phenols]. AB - The eleven strains studied were prototrophic and did not grow in media containing only 1% Bacto-peptone or Bacto-tryptone; they grew rapidly in media containing 0.4% yeast extract and 0.2% sodium acetate or benzoate. The maximal growth temperature ranged from 39 to 45 degrees C. Six aliphatic acids, four aromatic acids and five phenols were used as sole carbon and energy sources by the 11 strains. Carbohydrates and amino acids (except for glycine) were not used as carbon and energy sources. Nitrate (but not nitrite) was used anaerobically as a respiratory electron acceptor. Nitrous oxide was used and reduced to N2 by only 3 strains. The mean guanine-plus-cytosine content of the DNA was 41.3 +/- 1.1 mol %. Morphologically and nutritionally, the bacteria described are clearly different from the 5 known species of the first morphological group whose cells have a diameter greater than 1 micrometer: Bacillus megaterium, B. cereus, B. cereus var. mycoides, B. macroides, B. badius, and B. fastidiosus. Strain B1 (=CCM 3364) is the holotype of Bacillus benzoevorans sp. nov. PMID- 6508079 TI - [Biosynthesis of toluene in Clostridium aerofoetidum strain WS]. AB - Formation of toluene in growing cultures of Clostridium aerofoetidum strain WS was enhanced when the medium was supplemented with phenylacetic acid or with L phenylalanine and L-methionine together. Evidence for the role of L-phenylalanine was shown by the detection of [2H2]-methyl[2,3,4,5,6-2H5]benzene ("heptadeuterotoluene") in growing cultures with L-[2',3',4',5',6'-2H5]phenyl[2,3 2H3]alanine and L-methionine. PMID- 6508080 TI - Occupational cancer: problems in interpreting human evidence. PMID- 6508081 TI - Solubility of rockwool fibres in vivo and the formation of pseudo-asbestos bodies. PMID- 6508082 TI - Vegetable dust pollution in the textile industry. Comparison between various sampling methods. PMID- 6508084 TI - Non-pupillary block angle-closure glaucomas and their treatment by laser. Part II: Laser gonioplasty technique. PMID- 6508083 TI - A comparison of exposure to airborne dust in cotton processing plants estimated from personal and workzone samples. PMID- 6508085 TI - Computerized perimeters. PMID- 6508086 TI - Marginal melting of cornea in rheumatoid arthritis. AB - There was marginal melting of the cornea in a patient with inactive rheumatoid arthritis. Conjunctival biopsy revealed vasculitis which disappeared after treatment with topical steroids and systemic steroids and azathioprine. Conjunctival biopsy can serve as a diagnostic tool and for evaluation of treatment in marginal ulceration of cornea associated with rheumatoid disease. PMID- 6508087 TI - Relationship of senile ptosis to age. AB - A total of 1,073 patients were examined at random to determine the relationship between age and amount of senile ptosis. It was found that there is a progressive increase in the amount of ptosis as age increases for both men and women beginning in childhood. It is concluded from these findings that senile ptosis is not a disorder limited only to older age groups but is instead a cumulative process occurring throughout life and only becoming obvious in later years. PMID- 6508088 TI - Radial keratotomy for astigmatism. AB - Most ophthalmologists view radial keratotomy as a new and somewhat controversial method to decrease myopia by flattening the corneal curvature. Although the ophthalmologist does not initially perceive radial keratotomy as a means for correcting astigmatism, it follows that if he or she selectively flattens the cornea more in some meridians, the ophthalmologist is effectively correcting astigmatism. Although the predictability is slightly less in correcting astigmatism than that for correction of myopia, it is still rather good as the data herein presented will show. this communication will present the author's techniques as applied over the past three and one-half years in more than 2,500 radial keratotomy eyes, although only 186 patients are reported here so as to have a followup of at least two years on all patients. PMID- 6508089 TI - Intrastromal iris hemorrhage in a patient with hemoglobin C trait. AB - A 67-year-old man had a spontaneous intrastromal iris hemorrhage which resolved without complications. A thorough evaluation revealed no underlying abnormality except for the presence of hemoglobin C trait. PMID- 6508090 TI - Cupping of the optic disc with compressive lesions of the anterior visual pathway. AB - Cupping of the optic nerve, classically a sign of glaucoma, was demonstrated in 16 patients with lesions compressing the anterior visual pathway. Color contrast determinations of the cup/disc ratio demonstrated a ratio greater than 0.49 in 31 eyes. Further evaluation by stereobiomicroscopy showed cavernous degeneration by contour changes in 25 of the optic nerves. None of the patients had intraocular pressures greater than 22, and seven had normal tonography. Visual fields demonstrated bitemporal field defects in most patients and none were typical of glaucoma. Snellen acuity loss, out of proportion to the extent of optic disc cupping was found in 12 patients. This study indicates that diseases other than glaucoma can cause significant cupping of the optic nerves. Detailed evaluation of the disc changes and the visual fields will prevent confusion between compressive lesions of the optic nerves or chiasm and glaucoma. PMID- 6508091 TI - Clinical retrospective study comparing planned extracapsular cataract extraction and phakoemulsification with and without lens implantation. AB - We conducted a clinical retrospective study in which the records of 350 consecutive extracapsular cataract operations were reviewed in order to compare two cataract extraction techniques: planned extracapsular cataract extraction (PECCE) and phakoemulsification (PKE) with and without intraocular lens implantation. The patients in the PKE group experienced significantly better vision overall. However, when an adjustment was made for the difference in age between patient populations there was no significant difference in the percentage of patients achieving good vision between the two groups. Similarly, there was no statistically significant difference in the total number of operative or postoperative complications. The patients in the PKE group required less time for refraction to stabilize and averaged less postoperative astigmatism. Both of these differences were statistically significant even after an adjustment was made for the difference in age between populations. The presence or absence of an intraocular lens had no effect on the findings. PMID- 6508092 TI - Glare measurement as a predictor of outdoor vision among cataract patients. AB - Eighty-four cataractous eyes of 52 consecutive patients and 81 normal eyes of 48 subjects were evaluated with a commercially availability glare tester. Tests results were compared to visual acuity determinations in the refracting lane for ability to predict vision outdoors under daylight conditions. Among cataract patients, predictability of the two methods of measurement was not significantly different when subjects faced away from the sun. Glare scores were significantly better predictors (nearly twice as predictive) of outdoor visual acuity among cataract subjects facing the sun. These results demonstrate that measurement of sensitivity to glare is an important clinical procedure for evaluating functional visual disability in cataract patients under glare-producing conditions. PMID- 6508093 TI - Hypertension screening in the eye clinic. AB - We studied the suitability of the eye clinic as a site for hypertension detection with attention to the ophthalmologist's role in the broad context of hypertension control. Sixty of 300 consecutive eye clinic patients were referred to their primary care physician for re-evaluation of an elevated blood pressure recording. Only seven of these were started on therapy or had a change made in their existing regimen by the primary physician. When the benefit to this small percentage is weighed against the potential effects of such a high "false positive" referral rate we cannot support the proposal that the ophthalmologist does more good than harm by measuring the blood pressure of every patient. PMID- 6508095 TI - Oculo-visual symptoms in glaucoma patients. PMID- 6508094 TI - Bilateral optic nerve aplasia associated with hydranencephaly. AB - A case of bilateral optic nerve aplasia (ONA) associated with hydranencephaly and other multiple congenital anomalies in an infant is reported. Its occurrence in an offspring of a consanguineous union may implicate an autosomal recessive transmission. A brief review of ocular embryology is presented in relation to the possible pathogenesis of bilateral ONA. Bilateral ONA is most likely to be due to failure of the retinal ganglion cells to develop, consequently, the optic disc and nerve, and the retinal blood vessels are absent. Bilateral ONA is rare, and is associated with major CNS anomalies, and with other multiple, often severe congenital malformations. Bilateral ONA appears to be a distinct entity, independent from its unilateral counterpart and can be adequately diagnosed on clinical grounds. PMID- 6508096 TI - Induced corneal absorbance of ultraviolet light. PMID- 6508097 TI - The use of topical Healon tears in the management of refractory dry-eye syndrome. AB - We evaluated 28 patients with dry-eye syndrome in the setting of either primary or secondary Sjogren's syndrome, with topical Healon tears. In 26 of the 28 patients, we noted both subjective and objective improvement characterized by decreased itching, burning and foreign body sensation, decreased mucus stranding and Rose-Bengal staining of the cornea and conjunctiva, and increased corneal luster and tear break-up time. PMID- 6508098 TI - Central retinal vein occlusion in a case of arteriovenous communication of the retina. AB - A case of isolated arteriovenous communication of the retina (AVCR) decompensated to central retinal vein occlusion and visual loss resulted. This decompensation is not rare. Therefore, photocoagulation of the shunting vessels has to be the preferred treatment. PMID- 6508099 TI - Retinal telangiectasia, retinoschisis and retinal detachment. AB - A 32-year-old woman had progressive bilateral peripheral and central retinal telangiectasis with secondary exudative, nonrhegmatogenous, retinal detachment, and secondary retinoschisis. This is unique constellation of clinical findings, retinal telangiectasis itself being an uncommon disease, and usually occurring in young males, unilaterally. Theories for the etiology of this disease process are presented. The disease was successfully treated bilaterally with retinal cryopexy extensively applied to the retinal telangiectasis, both peripheral and paracentral, with both scleral buckling and drainage of copious amounts of thick subretinal exudation. PMID- 6508100 TI - Tetracaine toxicity. AB - Severe ocular complications developed in a patient after use of a topical anesthetic (tetracaine 0.5% ophthalmic ointment) over a period of two months. PMID- 6508101 TI - Surgical treatment of the upshoot and downshoot in Duanes retraction syndrome. AB - The upshoot and downshoot that occurs when the eye is rotated into the adducted position in Duanes retraction syndrome is believed to be related to a taut or leash effect from the lateral rectus muscle. When the eye is adducted, the lateral rectus muscle is believed to "slip" over the globe producing this abnormal movement. Five patients with Duanes retraction syndrome demonstrated this finding and underwent a splitting of the lateral rectus into a Y configuration. All five patients demonstrated a marked improvement in their up or downshoot after surgery. PMID- 6508102 TI - Pigmentary dispersion glaucoma secondary to posterior chamber intra-ocular lenses. AB - Thirteen cases of pigmentary dispersion glaucoma are presented. These had in common heavy pigment granule deposition in the trabecular meshwork in the operated eye alone, a history of posterior chamber intra-ocular lens implantation, and mild to marked iris pigment atrophy in areas contingent with or adjacent to the lens. High intra-ocular pressures were usually transient and easily controlled. One, however, eventually required trabeculoplasty. PMID- 6508103 TI - Hyperplastic primary vitreous with microphthalmos and ocular communicating orbital cyst. AB - A 4-month old child with findings of persistent hyperplastic primary vitreous was also noted to have an ocular communicating orbital cyst in the same eye. The ocular component of the cyst was observed to move. PMID- 6508104 TI - Noncycloplegic vs cycloplegic retinoscopy in pre-school children. AB - Refractive errors in 311 children between the ages of 18 and 48 months were assessed utilizing standard cycloplegic retinoscopy and a noncycloplegic near retinoscopy technique as promulgated by Mohindra. Results from this study indicate little agreement between the two objective refraction methods. PMID- 6508105 TI - Treatment of retinal pigment epithelial detachments. AB - Photocoagulation of retinal pigment epithelial detachments has been advocated in the past. Thirteen patients were treated with argon laser photocoagulation. Twenty-four percent improved and seventy-six percent lost vision. The study concludes that scatter laser photocoagulation is not an effective way to treat these lesions. PMID- 6508106 TI - Treatment of pseudophakic cystoid macular edema by elevation of intraocular pressure. AB - We have utilized topical steroid therapy (dexamethasone 0.1%, one drop four times a day) in the treatment of seventeen pseudophakic patients with postoperative cystoid macular edema. Our patients underwent either extracapsular cataract extraction and implantation of a posterior chamber lens or intracapsular cataract extraction and anterior chamber lens placement. All of our patients achieved 20/40 vision after one to three months of therapy. Forty percent attained final visual acuity of 20/20. We attribute resolution of cystoid macular edema to elevation of intraocular pressure induced by topical steroids. PMID- 6508107 TI - [Undifferentiated carcinoma and lymphoma of the thyroid gland. Apropos of a series of 38 cases]. AB - Twenty-seven patients with undifferentiated carcinoma and eleven with lymphoma of the thyroid are reviewed. Histologic sections of all tumors were re-examined critically. Most tumors were extensive forms spreading beyond the thyroid. Complete macroscopic excision was performed in 18 cases, incomplete excision in 12 patients. Surgery was not carried out in 8 patients, while radiotherapy was given to 27 cases. Local changes decide the prognosis whatever the findings on histology. Undifferentiated carcinomas have a poor local prognosis even after apparently satisfactory macroscopic excision. Effective local control was obtained in all cases of lymphoma treated by surgery and radiotherapy combined. PMID- 6508108 TI - [Initial chemotherapy of extensive cancers of the upper respiratory and digestive tracts]. PMID- 6508109 TI - [Clinical, audiological and radiological correlations in internal ear abnormalities]. AB - Based on findings in 20 children, with deafness associated with radiologically visible internal ear malformations, possible correlations between audiometric and clinical findings were studied which could suggest the presence of this type of malformation, leading to tomographic examinations to confirm the diagnosis. PMID- 6508110 TI - [Value of immediate prosthetic technics in hemiresections of the face]. AB - A brief historical survey is completed by the presentation of a technique for immediate prosthetic rehabilitation during facial hemiresections for malignant tumors. The method presents multiple advantages when compared to typical drainage procedures from the physiological, mechanical and psychological points of view. A detailed description of the introduction of this prosthesis is followed by a brief summary of postoperative sequelae and the advantages the method supplies due to its extreme simplicity in application. PMID- 6508111 TI - [Our experience in reconstruction after transmandibular buccopharyngectomy. Comparative study of various flaps. Apropos of 74 cases]. AB - A total of 74 cases of transmandibular buccopharyngectomy with reconstruction by local or regional flaps were analyzed to compare results of the use of temporofrontal and pectoralis major musculo-cutaneous flaps. Findings in this series suggested superiority for the use of the latter type. PMID- 6508112 TI - [Pectoralis major musculocutaneous flap after oncologic excision of the buccal cavity and oropharynx]. AB - A musculocutaneous flap from pectoralis major was used for reconstruction after widespread excision for cancer of the oral cavity and oropharynx in 54 cases, the method of choice being transposition as islets. Necrosis in 6 cases (11%), was partial in 5 patients and was limited to the skin layer only. The advantages of the musculocutaneous flap from pectoralis major when compared with other reconstructive procedures, particularly deltopectoral and temporofrontal flaps, are discussed. PMID- 6508113 TI - [Pectoralis major myocutaneous flap in cervicofacial oncology. Apropos of 61 cases]. AB - Personal experience with the use of musculocutaneous flaps from pectoralis major confirmed classical documented data. These flaps are reliable in use, they allow wide tumoral excision to be performed, and are therefore perfectly adapted for cervicofacial cancer surgery; however, carcinologic results have to be weighed against the operative procedures necessary. PMID- 6508114 TI - [Isolated fractures of the branches of the stapes. Apropos of 2 cases]. AB - Isolated fractures of the limbs of the stapes are relatively rare when compared with other traumatic lesions of the ossicula. Diagnosis, as in two recent cases, is suggested by the history of injury and the persistence of a recordable stapes reflex. Surgical re-establishment of transmission is simple but results are not always as spectacular as might be expected. PMID- 6508115 TI - [Treatment of peripheral facial paralysis with ultrasound]. AB - In a survey on the onset of peripheral facial paralysis, the roll of hypertension in the stylomastoid canal compressing the facial nerve is underlined. Intracanalicular hypertension is due to edema resulting from capillary vasodilatation, secondary to anoxia due to a regional vasospasm. When return channels of local circulation are blocked, the edema is further stabilized. Consequent nervous blockage however, very often does not go beyond the functional level; prompt recovery in the majority of cases after hypertension is averted, confirms this assertion. Nevertheless, current treatments seem to have little effect on Bell's palsy. In the present experiment, daily ultrasound irradiations of the mastoid process were tried on 30 cases of peripheral facial paralysis. Results give evidence that this therapy has particular efficiency when applied early in the course of the paralysis, before the onset of Wallerian degeneration. Integral cure or nearly complete recovery was attained before the 20 th sitting in 14 cases out of 15 patients where treatment was begun before the 8 th day of paralysis. The efficiency of ultrasound therapy proved to be less marked when applied with delay or applied on subjects with unhealthy systemic condition. Improvement in some of these cases was evident though and dependent on the presence and quantity of nervous fibres having escaped Wallerian degeneration. PMID- 6508116 TI - [Use of fiber optics in difficult intubations in young children]. AB - Difficulties in performing laryngotracheal intubation may arise in patients with cervicofacial anomalies, particularly when young children are involved. Technical artifices usually employed in adults, mainly intubation under fibroscopic guidance, cannot be used in these cases. Intubation was performed in three children aged between 3 to 4 years by means of a guide-catheter previously introduced into the trachea by using the fibroscope working canal, a method that is particularly recommended, even in younger children. The type of anesthesia used must be adapted to these circumstances. PMID- 6508117 TI - [The jugular foramen, the inferior bulb of the jugular vein and their surgical approach]. AB - Anatomical features of the sigmoid sinus and internal jugular vein and their connections are described. The jugular foramen is really only the opening of a bony canal between occipital and temporal bones, and is equivalent to a connective opening between the occipital vertebra and petrosal bone. The junction between the sigmoid sinus and internal jugular vein has the form and probably also the function of a siphon, but one in which the two arms are at right-angles. The jugular vein sinus has numerous vessels emptying into it, including some; condylar veins and inferior petrosal sinus, that are of high importance: valves are present at their orifices and the jugular sinus contains cords as in the cardiac cavities. The jugular vein sinus certainly plays a physiologic role in venous flow: a rigid-wall canal, the sigmoid sinus is followed by one with flexible, easily collapsible walls: the jugular vein. The latter is submitted to very high negative pressures that have to be compensated for by the sigmoido jugular siphon in order to maintain cerebral vascular filling. Surgical approach to the jugular vein sinus is complicated by two factors: the facial nerve and hemorrhage. The facial nerve in its bony canal is situated immediately adjacent to the jugular sinus and must be displaced to reach the vein. The sinus is almost always approached for jugular glomus tumors, which are very hemorrhagic lesions. To prevent blood loss, the sigmoid sinus and then the external carotid are linked to the jugular vein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508118 TI - [X-ray computed tomography: examination of choice in cervicofacial pathology? Radio-anatomical correlation. Imagery of the chosen cases]. AB - The authors present their experience of tomodensitometry in cervico-facial pathology. Their work approaches the subject successively from three angles, first comparing 51 cases of tomodensitometric exploration to the classic techniques used in cervico-facial pathology. Next, a correlation is established between the tomodensitometric images and surgical biopsies from 28 pharyngolaryngeal cancers. From the third angle, some selected cases are used to illustrate the contribution by tomodensitometry to the radiology of cervico facial pathology. From this study, tomodensitometry would appear to be a radiological investigation of choice in cervico-facial oncology for estimating the extent and depth of the tumour, while equalling if not being superior to the traditional radiological techniques for assessing the lesions in this region, whether they be benign or malignant. PMID- 6508119 TI - [Fibro-adhesive otitis: nosology and treatment]. AB - The term fibro-adhesive otitis is considered to correspond to filling of the middle ear with fibro-inflammatory tissue with an intact drum. When the fibrous tissue is very thin, that is to say when the mucosa is replaced by malpighian epithelium, the term epidermization or retraction pocket is preferred, this corresponding to different surgical problems, even though the roles of tubal insufficiency and seromucous otitis are probably the same in the etiology of fibro-adhesive otitis and epidermizations of the middle ear. Fibro-adhesive otitis presents as two different stages: a fibro-inflammatory phase in which the middle ear is filled with fibrous tissue and contains cystic spaces full of mucus; a fibro-adhesive phase when the whole middle ear is full of fibrous tissue and contains cholesterol granulomata but no cystic spaces. A study was conducted on 37 ears (8 at the fibro-inflammatory and 29 at the confirmed fibro-adhesive stage). Small cholesteatomas were associated in 15 ears and a posterior retraction pocket in 4. Results were frankly very poor for one-stage operations (exploration of the tympanic cavity with silastic and mastoidectomy (3 cases), tympanoplasty using a closed technique (1 case), and tympanoplasty using an open technique with obliteration (4 cases). Best results were obtained by a two-stage operation with prolonged inclusion of silastic between the two stages.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508120 TI - [Incus ossiculoplasty. 5 years' results]. AB - A 5-year follow up study of functional results of transposition of the anvil was conducted in 114 patients. Audiometric gains obtained could be rated as satisfactory since closure of more than half of the Rinne was obtained in 70% of cases and the gain was maintained over long periods. PMID- 6508121 TI - [Reconstruction surgery and repair using a musculocutaneous flap. Apropos of 124 cases]. AB - Between 1981 and 1983, 116 patients (109 men and 7 women) underwent reconstructive surgery with musculocutaneous flaps following major surgical excision of a cervicofacial tumor recurring after curative radiotherapy. Mean age of patients was 54 years. The most frequently used flap (110/124) was from the pectoralis major. Advantages of the use of a musculocutaneous flap for repair appear to be: first intention healing in most cases; notable reduction in hospital stay; possibility of wider tumoral excision and also of combining lymph node excision, and improved functional results. Follow-up surveillance has been for a mean of only one year, too short a period for assessing carcinologic results. PMID- 6508122 TI - [Conduction deafness and collapse of the auditory meatus. Value and limitations of the stapedial reflex in conduction deafness]. AB - Collapse of the auditory meatus constitutes an audiometric trap provoking a false transmission deafness. It can also permanently affect audition, whether it be primary in origin or post-mastoidectomy. The association of conservation of the stapedial reflex and transmission deafness is noticed immediately, but this is in fact compatible with an interruption in the chain by incus luxation. These notions must be known in order to avoid operation in false transmission deafness, and inversely to decide when to explore the cavity in certain post-mastoidectomy sequelae with meatal collapse. PMID- 6508123 TI - [Recent data on malignant melanoma of the upper respiratory and digestive tract mucosa. Apropos of a case]. AB - The choice of a therapeutic strategy for the treatment of mucosal malignant melanomas from upper digestive and respiratory tracts remains difficult. This is due to the very low frequency of such malignancies and to the subsequent scarcity of data on parameters of diagnosis and prognosis. Such informations have been available on cutaneous malignant melanoma as they have been known for a longtime and occur with much higher frequency. Parameters of diagnosis and prognosis have been determined from randomised clinical traits. Based on such parameters a more efficient therapeutic strategy can be applied to the various clinical cases. In this paper we review these parameters and in particular those which seem to apply to the mucosal malignant melanomas from upper digestive and respiratory tracts. Finally we report on currently used therapeutic protocols and we present recent data from the literature on adoptive immunotherapy of malignant melanomas in mice. PMID- 6508124 TI - Endolymphatic fistulization. AB - Three previous papers have detailed my experience with various methods of surgical treatment of Meniere's disease: 1) surgery for all patients; 2) surgery for only those patients who demonstrated patency of the vestibular aqueduct as seen on tomographic examination; and 3) prognostic tests to determine which patients were most suitable for endolymphatic sac surgery. This paper details the results of endolymphatic shunt surgery performed on 43 patients over a 3-year period, restudying my prior conclusions. All patients were operated using a new method of capillary endolymph dispersement regardless of tomographic findings. The results are compared to the results of the prior studies to determine whether the findings of tomography are correlated with success or failure of shunt operations, a conclusion that others have questioned. This study clearly shows that the present technique affords better results than prior methods regardless of the x-ray findings. In addition, the tomographic findings correlate closely to the clinical pattern of the disease and to the success or failure of the operation. PMID- 6508125 TI - Endolymphatic duct and sac in patients with Meniere's disease. A temporal bone histopathological study. AB - The endolymphatic ducts and sacs of 25 temporal bones with idiopathic endolymphatic hydrops from individuals with Meniere's disease were studied and compared with the same number of control bones without endolymphatic hydrops from individuals with no premortem history of otologic disease. The control bones were selected so that the sizes of their vestibular aqueducts matched those temporal bones from individuals with Meniere's disease. The endolymphatic ducts and sacs of all bones were studied by the medial view graphic reconstruction method and/or histological observation under a light microscope. In the endolymphatic duct and sac of many of the temporal bones from patients with Meniere's disease were noted a diminution of the width of the endolymphatic duct in its isthmus portion, an increase in the area of the collapsed lumen of the endolymphatic sac, fibrotic changes in the perisaccular loose connective tissue, and an increase in the quantity of intraluminal eosinophilic material. The frequencies with which these pathological findings were noted in bones from individuals with Meniere's disease and in control bones were statistically significantly different. No significant differences were observed under light microscopic study between these two groups with regard to the condition of the epithelial cells, the degree of rugosity of the endolymphatic sac, or the appearance of melanin-like pigmentation of hyalinization in the perisaccular connective tissue. PMID- 6508126 TI - Effects of influenza infection, aspirin, and an arginine-deficient diet on the inner ear in Reye's syndrome. AB - The individual effects of an influenza B viral infection, aspirin, and an arginine-deficient diet on the inner ear were assessed in the ferret model for Reye's syndrome using both functional and morphological parameters. Auditory brainstem evoked responses recorded from inoculated ferrets revealed threshold elevations and increased latencies during the first 72 hours, but approximated those of control animals by 96 hours. Although there was a mild distention of Reissner's membrane, no pronounced structural alterations in sensory or supporting cells were observed in cochleas from inoculated ferrets. The administration of aspirin appeared to alter neither the functional nor the structural integrity of the cochlea. The presentation of an arginine-deficient diet, creating a hyperammonemic condition, led to both altered auditory evoked responses and vacuolization of cochlear tissues after treated animals had undergone seizures and coma. These data demonstrated that both influenza B and the arginine-deficient diet individually affected the hearing of treated animals. The individual agents did not alter the cochlea as severely as when they were presented in combination. These results suggest that hearing impairment in patients with Reye's syndrome may be a result of potentiation of certain metabolic-altering agents. PMID- 6508127 TI - Neurotrophic interactions during in vitro development of the inner ear. AB - The objective of this study was to explore the hypothesis that developing labyrinthine sensory receptors attract ingrowing neurites by chemotaxis. Cocultured otic explants which shared a single statoacoustic nerve (VIIIn) ganglion were explanted from 11-, 12.5-, and 14-day-old mouse embryos. Heterotypic ganglion explants consisted of 12-day-old otic explants which had their VIIIn replaced by a 10.5-day-old trigeminal nerve (Vn) ganglion. All cultures were grown to the equivalent of 20 days of gestation. Neurites of the (+) VIIIn explants grew into the sensory areas of both the (+) and (-) VIIIn cocultured explants. Neurites of the 14-day-old cocultured otic explants were only found in association with sensory areas within the (+) VIIIn explant. Neurites of nerve V of the heterotypic ganglion explants were found in association with the sensory areas of these otic explants. These results support the hypothesis that a limited period of chemotaxis (nonspecific in nature) is a possible mechanism for the establishment of the pattern of neurite ingrowth to the areas of the inner ear sensory receptors. PMID- 6508128 TI - Cordless telephones: a threat to hearing. AB - Several patients with documented permanent sensorineural hearing losses secondary to the use of cordless telephones have been evaluated. In the interests of saving space and weight, these units have the ear receiver double as the ringing or bell device. The output of the bell on all of the units we have tested to date has been in the 140-dB range on the A scale. In each instance, the patient held the telephone against the ear when ringing occurred, and in three instances a loud extraneous crack was transmitted. Unlike regular cord-type telephones, these devices have no automatic gain control in the receiver circuit. PMID- 6508129 TI - Recent advances in hearing aid selection and adjustment. AB - Recent research has shown that speech is most intelligible for hearing-impaired individuals when it is amplified to a comfortable level in specific frequency regions between 250 and 6,000 Hz, and is limited below the discomfort level. If commercial hearing aids and earmold coupling are adjusted appropriately, they will provide amplified sound within these parameters for most hearing-impaired individuals. A clinical procedure is described 1) to preselect an aid and earmold with the approximate electroacoustic characteristics that are needed, 2) to determine the gain actually provided by this hearing aid/earmold combination, and 3) to adjust the hearing aid and/or earmold if the gain and maximum output do not meet the prescribed criteria, or if the wearer finds the sound quality unacceptable. PMID- 6508130 TI - High frequency audiometry. AB - After a brief discussion of the past use of and clinical need for high frequency hearing tests, a new technique is described that uses a special electric transduction mode: a 60-kHz carrier frequency is modulated by the desired audiofrequency. The combined signal is applied to the skin over the mastoids by Mylar-covered electrodes. On perception, the audiofrequency part of the input shows all the properties of a bone-conduction signal. The carrier frequency is dispersed in the tissues. Production and calibration of electrical high frequency signals, up to 20 kHz, is straightforward and easier than that of conventional air-conduction and (vibromechanical) bone-conduction signals. The efficacy of the method is illustrated by means of preliminary hearing tests conducted on several subjects. PMID- 6508131 TI - Aural rehabilitation in a teaching hospital: evaluation and results. AB - More than 1,000 hearing-impaired adults who underwent hearing aid evaluations in a teaching hospital were followed for a minimum of 1 year. Questionnaires, which included over 300 clinical items, were developed for computer entry by audiological staff. This data was analyzed to obtain demographic information about the population and the effectiveness of the intervention. The program was evaluated in terms of criteria ranging from simple compliance with the recommendation to purchase an aid, attendance at scheduled follow-up appointments, adequacy of the amplification system, patient competence in handling the aid, frequency and duration of aid use, and benefit in specific listening situations. It can be concluded that simple compliance figures overestimate program success. Even 1 year after purchase many patients still had practical difficulties with the aid, and use and benefit patterns were still developing. Directions for program change have been determined as measurement of success has been more critically defined and goals for rehabilitation have broadened. PMID- 6508132 TI - Postural disturbance in patients with benign paroxysmal positional nystagmus. AB - Abnormal vestibular function disrupts postural and ocular muscle control system references to gravity (earth) vertical. Vestibular disorders also prevent satisfactory resolution of normally redundant, but often conflicting, visual and somatosensory spatial references required for normal postural control during active and passive body motion. Using a moving platform and visual surrounds posturography technique to systematically interact visual, somatosensory, and vestibular inputs, it was clearly demonstrated that patients with the benign paroxysmal positional nystagmus type of distorted vestibular function employ an unstable, visually dependent postural sway distinct from the postural instability associated with unilateral or bilateral vestibular functional deficits. These findings have important clinical implications for diagnosis and management of patients with vestibular disorders. PMID- 6508133 TI - Development of the place principle. AB - Two experiments using embryonic and hatchling chickens examined how the representation of frequency along the basilar membrane changed during hearing development. In experiment 1, chicks were exposed to high intensity pure tones (500, 1,500, or 3,000 Hz) at one of three different ages. Analysis of hair cell degeneration indicated a discrete region of damage which systematically changed as a function of exposure frequency and age. With maturation, each frequency produced damage at progressively more apical locations. In experiment 2, the representation of frequency in the brain stem auditory nuclei was compared in embryonic, hatchling, and adult chickens. Microelectrode recordings indicated a systematic shift in the frequency representation. Neurons, which are activated by high frequencies in the adult, initially respond to only low frequencies. These experiments indicate how the mature pattern of frequency representation along the basilar membrane gradually emerges during the stages of hearing development. PMID- 6508135 TI - Fibrous dysplasia of the temporal bone. Update with case reports. AB - Fibrous dysplasia is a fairly common, well demarcated, misdifferentiation of the bone-forming mesenchyme affecting a single, several, or many bones, in which skeletal changes are the salient feature, but in which certain endocrinopathies, abnormal pigmentation of skin and mucous membranes, and occasionally other abnormalities form part of the entire disease process. The clinical and pathological aspects of the disease and its involvement with the temporal bone have been previously discussed. Two recent case histories are added here. PMID- 6508134 TI - Sensorineural hearing loss in otitis media. AB - Additional evidence is presented to support the hypothesis that both acute purulent otitis media (POM) and chronic suppurative otitis media (COM) can cause high frequency sensorineural hearing loss. In selected patients and in animals (chinchillas) in a pilot study using electrophysiological methods, both temporary threshold shifts and permanent threshold shifts of basal cochlear turn involvement were demonstrated in POM. Data of cochlear involvement in 475 ears with bilateral COM, 607 ears with unilateral COM, and 607 ears serving as controls were obtained from six centers in five countries. In group 1 (15 dB or greater), 43% of ears with unilateral COM and 42% of ears with bilateral COM showed losses, for a combined odds ratio eight times that in controls. In group 2 (30 dB or greater), 16% of ears with unilateral COM and 17% of ears with bilateral COM demonstrated, respectively, seven and ten times that in controls. These statistically significant findings influence clinical considerations. PMID- 6508136 TI - Stapes surgery in patients with osteogenesis imperfecta. AB - Osteogenesis imperfecta is not in itself a contraindication to stapedectomy. Thirty stapedectomies were performed on 24 patients with osteogenesis imperfecta. Thin ossicles, crural fractures, and thick, mushy, granular footplates predominate in this condition. Deficient, short crura that did not contact the footplate were noted in three patients; this is possibly a new clinical observation. Three times in this small series the endosteum was so thick that it was possible to fenestrate the soft, granular, mush-like footplate without invading the vestibule. Extreme caution in handling the incus is necessary. Conductive hearing loss can be relieved through stapedectomy in patients with osteogenesis imperfecta with about the same level of predictability as in those with otosclerosis. PMID- 6508137 TI - Congenital cholesteatoma of the ear. AB - Congenital cholesteatoma of the ear is a capricious and challenging problem for the otologist. We present 21 cases managed at the Mayo Clinic from 1961 to 1983. In all but one unusual case, the cholesteatoma developed behind an intact tympanic membrane and there was no history of aural infections. Preoperative symptoms and signs were predominantly conductive deafness with either a normal tympanic membrane or an opaque, whitish appearance to the drum. Disease was located in the middle ear or in the middle ear and mastoid, except in one patient who had cholesteatoma extending into the petrous apex. Surgical management depended on the extent of the lesion, and recurrences were unusual, suggesting that congenital cholesteatoma may not be as aggressive as acquired cholesteatoma. PMID- 6508138 TI - Surgical obliteration of the tympanomastoid compartment and external auditory canal. AB - The ideal patient for a radical mastoidectomy with total tympanomastoid cavity obliteration is one with chronic granulomatous otomastoiditis without cholesteatoma, profound sensorineural hearing loss, and a normal ear on the opposite side. A meticulous and thorough classical radical mastoidectomy is required. The resultant cavity is eliminated by filling it with pedicled flaps and/or adipose tissue taken from the abdominal wall. Suturing the skin of the anterior and posterior membranous canal walls completes the procedure. Healing is rapid and requires minimal postoperative care. The absence of a cavity eliminates the necessity of additional otologic care. Swimming, diving, and free participation in all other aquatic sports are important additional benefits. This procedure has been performed in 44 patients, 24 by author HFS and 20 by author JRC. PMID- 6508139 TI - Invasion of the microcirculation in head and neck cancer. AB - Microvascular invasion by carcinoma cells is one of the first steps for the potential development of metastases. Because of an extensive and destructive triage of the cells, the histologic finding of such invasion is not pathognomonic for the establishment of metastases. From a practical standpoint, microvascular invasion correlates with an increased incidence of lymph node metastases, but not with distant spread. PMID- 6508140 TI - Ecology of leishmaniasis in the south of France. 19. Determination of the hosts of Phlebotomus ariasi Tonnoir, 1921 in the Cevennes by bloodmeal analyses. AB - Engorged sandflies were collected using 58 CDC light traps set up nightly for 5 weeks at 12 stations in the commune of Roquedur, Gard, France, in the Cevennes focus of leishmaniasis. Of 782 engorged females, 593 were Phlebotomus ariasi, 3 were P. mascittii and 186 were not identified. Using the precipitin ring test and counter-current immuno-electrophoresis, the bloodmeals were tested with antisera to man, leporids, rodents, canids, mustelids, equids, suids, bovids, birds, lizards and amphibia. Of 530 identified bloodmeals, 2 were avian blood, 26 were mixed meals of mammalian blood and 25 were meals taken from unidentified mammals. Of the 477 other sandflies, 211 (44.2%) had fed on canids, 107 (22.4%) on man, 70 (14.7%) on bovids (presumed to be cattle at one station and goats elsewhere), 33 (6.9%) on leporids (probably mostly domesticated rabbits), 26 (5.5%) on mustelids (probably badgers), 17 (3.6%) on horses and 13 (2.7%) on rodents (probably brown rat). The proportions of feeds on different mammals varied according to their availability at each station. When both man and dog were equally available, the dog was preferred. The finding that, away from human habitation, P. ariasi commonly feeds on mustelids suggests the need for a reappraisal of animals of this family as possible reservoirs of leishmaniasis in the Cevennes. PMID- 6508142 TI - [In vitro development of hemolymph granulocytes of Biomphalaria glabrata (Gastropoda, Planorbidae). Study by scanning electron microscopy]. AB - The morphological evolution in vitro of Biomphalaria glabrata granulocytes on a cover-glass is described by scanning electron microscopy. 4 stages have been characterized: stage 1: globular cells showing low adhesion to cover-glass; stage 2: flattened cells in contact with substrate over a large surface, which present two well differentiated cytoplasmic zones: an endoplasm in which the nucleus is embedded and an ectoplasm which extends into very thin filopodia with a spherical terminal bulb; stage 3: cells which are very flattened and which adhere to each other; stage 4: cells which are completely spread on the cover-glass, in which the ectoplasm includes the filopodia. These 4 stages probably represent the granulocyte ontogenetic stages in their role in cellular defense against foreign substances. PMID- 6508141 TI - [Development of the sporocysts of Schistosoma bovis after microsurgical transplantation in Bulinus truncatus]. AB - Microsurgical transplantations of Schistosoma bovis daughter sporocysts to uninfected Bulinus truncatus leads to a dedifferenciation of transplanted sporocysts producing an additional generation of daughter sporocysts. These ones settle into the whole digestive gland and produce infective cercariae. For all the parasitosis, a part of the daughter sporocysts born from the transplanted ones, remains in the head-foot region and are in their turn responsible for an active sporocystogeny. Data demonstrate that the cercarial production dynamics is at least in part in relation with the intramollusc dynamics of sporocyst populations. Success of microsurgical transplantation of S. bovis sporocysts permits cloning perspective of this species. PMID- 6508143 TI - First record of Aspiculuris tetraptera (Nitzsch, 1821) (Nematoda : Oxyuroidea) and Dollfusentis chandleri (Golvan, 1969) (Acanthocephala : Illiosentidae) in Haemulon sciurus (Shaw 1803) (Pisces : Pomadasyidae). AB - Forty specimens of Haemulon sciurus were examined for endoparasites and this paper refers to the recovered Nematodes and Acanthocephalans. Aspiculuris tetraptera is for the first time referred in fish and Dollfusentis chandleri is recorded in Brazil and in a new host. PMID- 6508144 TI - The genus Mansonella (syn. Tetrapetalonema): a new classification. AB - Mansonella has been established as a valid genus, and Tetrapetalonema synonymized with it. Comparative morphological studies have resulted in the restructuring of the Mansonella group. The genus is characterized by the following features: cuticular pre-esophageal ring absent; esophagus slender, poorly differentiated; female tail with four terminal papillae; caudal papillae in male typically clustered around cloaca; and, microfilariae without sheath. Twenty-four species are assigned to the genus Mansonella. Five subgenera are proposed to accommodate these species. The subgeneric groups are distinguished principally on morphological criteria, although host range and geographical distribution are considered. The following systematic classification is proposed: Mansonella (Mansonella) subgen. n., to accommodate those species which have the following morphological features: cephalic extremity with dorsoventral orientation; male tail with tip flattened dorsoventrally; vulva in midesophageal region; and microfilariae without nuclei extending to tip of tail. Type species is M. (M.) ozzardi. Mansonella (Tupainema) subgen. n., to accommodate the single species M. dunni with the following characters: cephalic extremity with lateral orientation and body constricted to form cephalic extremity in shape of hemisphere narrower than body behind it; tip of male tail not flattened dorsoventrally; vulva at or posterior to base of esophagus; and, microfilariae without nuclei to tip of tail. Mansonella (Esslingeria) comb. n., to accommodate those species with the following characters: cephalic extremity with lateral orientation; male tail flattened dorsoventrally at tip or not; vulva in midesophageal region; and, microfilariae with nuclei to tip of tail. Type species is M. (E.) perstans. Mansonella (Tetrapetalonema) comb. n., to accommodate those species with the following characters: cephalic extremity with dorsoventral orientation or with body constricted to form cephalic extremity in shape of hemisphere narrower than body behind it; male tail not flattened at tip; vulva in midesophageal region; and, microfilariae with nuclei to tip of tail. Type species is M. (T.) marmosetae. Mansonella (Sandnema) comb. n., to accommodate those species with the following characters: cephalic extremity rounded, not oriented along lateral or median axis; tip of male tail not flattened; caudal papillae on male tail not clustered around cloaca; vulva near base of esophagus; and, microfilariae with nuclei to tip of tail. Type species is M. (S.) digitata. PMID- 6508146 TI - [Phlebotomus of Portugal. I--Natural infestation of Phlebotomus ariasi Tonnoir, 1921 and Phlebotomus perniciosus Newstead, 1911, by Leishmania in the zoonotic focus of Arrabida (Portugal)]. AB - The author presents the results of a sandfly survey carried out in the zoonotic focus of Arrabida for search of kala-azar vectors. The total of 195 dissected females belonged to the species Sergentomyia (S.) minuta. Phlebotomus (L.) ariasi and Phlebotomus (L.) perniciosus. Only the last two species were found parasitized by Leishmania promastigotes: 2 females of P. ariasi (4.88%) and 3 females of P. perniciosus (2.01%). This is the first finding of natural infection of P. ariasi in Portugal. PMID- 6508145 TI - Mansonella (E.) rotundicapita sp.n. and Mansonella (E.) longicapita sp.n. (Filarioidea : Onchocercidae) from Venezuelan capybaras, Hydrochoerus hydrochaeris. AB - Mansonella (E.) longicapita sp. n. and Mansonella (E.) rotundicapita sp. n., two filarial nematodes from the dermis of Venezuelan capybaras, are described. The two species can be distinguished on the size of the spicules (M. longicapita 327 and 139 micron, ratio of 2.3 : 1 ; M. rotundicapita 405 and 120 micron, ratio of 3.4 : 1), the degree of lateral elongation of the cephalic shield and in the size and configuration of the microfilaria. The microfilaria of M. rotundicapita is large (280 micron long), and in specimens fixed in 2% formalin, the posterior end of the body is bent in a shepherd's crook, while the microfilaria of M. longicapita is short (195 micron long) and when similarly fixed, assumes a gently curved attitude. Within the subgenus M. (Esslingeria), the species M. longicapita and M. rotundicapita are intermediate in size. Morphologically they resemble M. streptocerca and M. rodhaini most closely, but can be distinguished on size, spicule morphology, and microfilarial morphology. PMID- 6508147 TI - [Terminal spine schistosomes of Senegal]. PMID- 6508148 TI - [Influence of infestation by Protostrongyloidea on the geotaxic activity of terrestrial mollusks]. PMID- 6508149 TI - [Use of glycerol in continuous ambulatory peritoneal dialysis solutions. Metabolic value]. PMID- 6508150 TI - [Comparison of the effects of cocaine and dexamphetamine on pancreatic secretion in the conscious rat]. PMID- 6508151 TI - [Synthesis and pharmacologic study of saturated amino ethers]. PMID- 6508152 TI - [Comparative study of organotypic cultures of glomeruli isolated from the renal cortex of the rat by 2 different technics]. PMID- 6508153 TI - [High performance liquid chromatographic assay of drugs containing caffeine]. PMID- 6508154 TI - [Synthesis of new 4-dialkylamino-1-(2,3-dialkoxyphenyl)- and -3-(3,4 dialkoxyphenyl)butan-2-ones]. PMID- 6508155 TI - [Phenoxy- and phenylthiochalcones. Effect of substitution on the antifungal and antiprotozoal activity]. PMID- 6508156 TI - Replacement of the pharynx after pharyngolaryngectomy. AB - Twenty-two patients undergoing pharyngolaryngectomy and pharyngeal reconstruction are presented. Four patients died before leaving hospital swallowing. Fistulae and stricture formation were fairly common in patients who had been previously irradiated. The 2-year survival was 37%. PMID- 6508157 TI - Pretibial myxoedema. AB - This paper reviews the clinical, endocrine and lymphatic status of 6 patients with pretibial myxoedema. The lymphatics were studied to determine whether they were involved in the pathogenesis of the disease. The main lymph trunks were normal although there was occasionally some collateral flow and some of the lymph nodes had small irregular filling defects. These changes suggest compression of the lymphatics by the myxomatous material and the deposition of mucinous material in the lymph nodes. There was no evidence of a primary lymphatic abnormality. PMID- 6508158 TI - A new tumour marker tested in 98 patients with bladder carcinoma. AB - A new, indirect marker of human tumour has been tested in 98 patients with urothelial bladder carcinoma. The marker is detected by B5, a monoclonal antibody which agglutinates erythrocytes from tumour-bearing patients. Patients admitted for cystoscopy for diagnosis of bladder tumour, or for follow-up of known disease, were chosen to enable comparison between (a) B5 results and (b) visual assessment of tumour growth. Ninety per cent of those with new tumour (20) and, overall, 80% of patients with tumour (74), were B5 positive. These results were independent of tumour size and include very small recurrences, implying that B5 is a sensitive marker of tumour presence. The background incidence of B5 positive individuals is 18% in controls; a similar incidence occurs in patients who have been tumour-free for 9 months or more. Patients who had no visible tumour in this study, but who had tumour within 9 months, were often B5 positive (6/11). This may be due to the lifespan of erythrocytes causing a delay in change from B5 positive to B5 negative in those patients who will remain disease-free. PMID- 6508159 TI - Diagnostic laparotomy in suspected malignant lymphoma. AB - The place of laparotomy in the initial diagnosis of malignant lymphoma is investigated by reviewing a group of 25 patients with suspected lymphoma referred for diagnostic laparotomy. Intra-abdominal malignancy was found in 11 patients, although only 7 of these had a malignant lymphoma. A positive alternative diagnosis was made in a further 8 of the remaining 14 patients, but 6 patients remained undiagnosed following laparotomy. A scheme for the investigation of patients with suspected malignant lymphoma is therefore proposed. Patients with an abdominal mass other than a palpable liver or spleen should undergo early laparotomy, while those with no abdominal mass should undergo an extensive screening programme, appropriate to the mode of presentation and similar to that used in the investigation of a pyrexia of unknown origin, in which diagnostic laparotomy is used only as the final step. PMID- 6508160 TI - The place of fine needle aspiration cytology for the intraoperative diagnosis of pancreatic malignancy. AB - We report a 91% accuracy with fine needle aspiration cytology in 46 patients found to have a mass in the pancreas at laparotomy. Results were compared with conventional biopsy at operation which was accurate in only 56% of an earlier group of 48 patients with a localised mass compared with 97% in 33 patients with disseminated malignancy. Although we strongly advise a through attempt to establish a histological or cytological diagnosis before operation, there are many occasions when a surgeon is faced with an undiagnosed mass in the pancreas at laparotomy. Under these circumstances fine needle aspiration cytology of the pancreas should be advised in units with an experienced cytology service. PMID- 6508161 TI - The use of varicography to identify the sources of incompetence in recurrent varicose veins. AB - We have studied patients with recurrent varicose veins which were incompletely controlled by a thigh tourniquet. We used varicography, (a phlebogram via the varices), to detect sites of incompetence. Thirty patients (mean age 46 years) were investigated, 38 limbs being subjected to varicography and surgery. A primary operation had been performed between 3 months and 30 years earlier. A non thrombogenic contrast medium, sodium meglumine ioxaglate 320 (Hexabix 320) was used. Metal markers were placed alongside the limb to identify the site of perforating veins on the phlebograms. The principal value of the technique was in the identification of mid-thigh perforator incompetence (MTPI) as we cannot diagnose this accurately by clinical or Doppler-ultrasound examination. Varicography demonstrated MTPI in 15/38 limbs (39%) and in only one thigh was this not confirmed at exploration. Varicography can demonstrate short saphenous incompetence and this was mainly of value in 3 patients who had previously undergone attempted short saphenous ligation; in all 3 the short saphenous vein was present and had not been ligated. The technique was less useful in demonstrating recurrence in the groin. Overall varicography influenced the operation performed in 17/38 limbs (45%), its main value being in the diagnosis of MTPI. PMID- 6508162 TI - Experimental deep venous thrombogenesis by a non-invasive method. AB - Experimental deep venous thrombi were produced in the untraumatised leg veins of anaesthetised dogs. In place of trauma, the endothelium lining the valve pockets in femoral veins was damaged by hypoxaemia, and the pockets were then intermittently re-perfused with oxygenated blood. Histologically, the experimental thrombi resembled human valve pocket thrombi found at postmortem. PMID- 6508163 TI - The Biethium bridge--an advance in stoma care. AB - The majority of currently available colostomy bridges lie on the skin surface. Until their removal around the seventh postoperative day, they frequently prevent the formation of a complete seal between the appliance and the skin, resulting in faecal leakage. This is distressing to the new stoma patient. In contrast, the Biethium bridge is inserted subcutaneously producing a small, flush stoma to which the colostomy bag can easily be applied and therefore faecal leakage is no longer a problem. Our experience with 35 patients is described. PMID- 6508164 TI - Ketamine: effect of literacy on emergence phenomena. AB - A prospective study of the relationship between literacy rate and emergence phenomena with ketamine anaesthesia was carried out among Pathans on Pakistan's Afghan frontier. Findings support both a strong link between the literacy of the patient and the occurrence of emergence phenomena, and the acceptability and value of ketamine in this type of population. PMID- 6508165 TI - Safe lateral wall cuff pressure to prevent aspiration. AB - Although the incidence of cuff induced tracheal damage has been considerably reduced by judicious use of tracheal tubes with large-volume, low-pressure cuffs, aspiration continues to be a major problem. A study was conducted to determine the maximum hydrostatic pressure that can be produced by a column of liquid above the tracheal cuff. The vertical and horizontal distance between the upper central incisor teeth and suprasternal notch was measured in 200 supine adult subjects. The maximum vertical and horizontal distance between the upper central incisor teeth and suprasternal notch was 9 cm and 21 cm respectively. The implication of these findings are discussed and it is suggested that a fixed intracuff pressure in the range of 2.5 to 3kPa should be used to obtain an optimal tracheal seal. PMID- 6508166 TI - Orthopaedic audit: one year's experience in a district general hospital. AB - In 1982 a prospective Audit of complications and mortality and a quarterly retrospective analysis of work done were undertaken on the orthopaedic unit of Southmead Hospital, Bristol. Since no account has been presented of Orthopaedic Audit it was felt that a discussion of the method, results and whether the aims had been achieved and at what cost would be of interest to other surgeons, and to orthopaedic surgeons in particular. Two orthopaedic surgeons treated 1811 inpatients during the year; 73.7% of the patients undergoing surgery at Southmead Hospital were emergencies. Mortality, excluding fractures of the neck of femur, was 0.22% and total mortality 1.8%; 16.7% of patients had a recorded complication of which the largest group was technical failure (2.7%) followed by wound infection (2.4%). PMID- 6508167 TI - Delayed recognition of an intersphincteric abscess as the underlying cause of Fournier's scrotal gangrene. AB - It has recently become increasingly clear that Fournier's gangrene, far from being 'idiopathic' as initially thought, often originates from preexisting perianal or periurethral sepsis. The aetiology is discussed and an example quoted where the associated intersphincteric abscess was not recognised until some 3 months after the initial presentation. It is recommended that all patients presenting with Fournier's gangrene be examined by an experienced rectal surgeon early in the course of their illness. PMID- 6508168 TI - The effect of written advice on preoperative cigarette consumption. AB - Two groups, each of 100 smokers, were compared in terms of reduction in cigarette consumption in the 5 days prior to elective surgery. One group was admitted to hospital in the routine way and information on preoperative cigarette consumption obtained by questioning each patient after recovery from anaesthesia. In the second group, a letter strongly advising the patient to stop smoking for 5 days preoperatively was enclosed with the admission letter. A proforma to record the daily cigarette consumption was also enclosed. By the day before surgery the mean cigarette consumption had fallen to 52% in Group I and 16% in Group II and 14 and 46 patients respectively had then stopped smoking completely. The differences were highly significant (P less than 0.001). PMID- 6508169 TI - The provision of junior anaesthetic staff for the intensive care unit of a district general hospital: a workable solution? AB - The problems of staffing an ICU in a District General Hospital at junior level are discussed. The needs of the Unit, the junior staff and the Anaesthetic Department and possible ways of reconciling these are outlined. A system of providing cover using pairs of junior anaesthetists is described in detail. This has been successfully in operation for 18 months and its merits are discussed. PMID- 6508170 TI - The MCQ in the primary FRCS(Eng). AB - Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all examinations is emphasised. PMID- 6508171 TI - The results of Ramstedt's operation: room for complacency? PMID- 6508172 TI - Surgical emergencies and manpower. PMID- 6508173 TI - [Carcinoma of the nasopharynx in Algeria. Apropos of a series of 213 cases]. PMID- 6508174 TI - [X-ray computed tomography in pharyngolaryngeal tumors. Role in pretherapeutic evaluation and monitoring after treatment]. PMID- 6508175 TI - [Round table on the surgery of apparently primary bronchiectasis in children and adults]. PMID- 6508176 TI - [Surgical revascularization of myocardial infarction in the first 6 hours. Review of the recent literature]. PMID- 6508177 TI - [Postinfarction rupture of left ventricular aneurysm. 6 cases]. PMID- 6508179 TI - [Bioprosthesis in children and adolescents]. PMID- 6508178 TI - [Surgical repair of ruptures of the left ventricular free wall at the acute stage of myocardial infarction. Apropos of 2 cases]. PMID- 6508180 TI - [Fissural aortopulmonary shunt. A new technic of systemic-pulmonary anastomosis]. PMID- 6508181 TI - [Retrograde cardioplegia: experimental and clinical study]. PMID- 6508182 TI - [Traumatic interventricular communication and tricuspid insufficiency. Surgical repair. Apropos of a case. Review of the literature]. PMID- 6508184 TI - [Chylothorax associated with a posttraumatic interventricular communication. Apropos of a case. Review of the literature]. PMID- 6508183 TI - [Surgical treatment and prognosis of acute suppurative mediastinitis in cardiac surgery]. PMID- 6508186 TI - [Hematemesis caused by esophageal fissuring of an aneurysm of the arteria lusoria]. PMID- 6508185 TI - [Treatment of vascular or prosthetic infections after arterial revascularization of the lower limbs]. PMID- 6508187 TI - [Thoracic surgery in the aged]. PMID- 6508188 TI - [Pulmonary inflammatory plasma cell tumors]. PMID- 6508189 TI - [Mediastinal teratoma responsible for neonatal respiratory distress]. PMID- 6508190 TI - [Hydatid cysts of the liver open into the bronchi and pleura. Apropos of 18 cases]. PMID- 6508191 TI - [Pleuromediastinal complications of cervical phlegmon caused by anaerobic germs of dental or ORL origin]. PMID- 6508192 TI - [Is circulatory assistance necessary in the surgical treatment of acute massive pulmonary embolism?]. PMID- 6508193 TI - [Uni- and bidimensional echocardiography in the etiologic diagnosis of precordial pain]. AB - The distinction between precordial pain of cardiac origin and pain of extra cardiac origin is a daily problem. We wanted to study the value of echocardiography in this difficult diagnostic problem. In a series of 148 patients admitted to the unit in 1982 for chest pain. 104 were investigated by echocardiography and coronary angiography. In 36 per cent of patients, the echocardiogram was normal and was unable to predict the presence or absence of coronary artery disease. Further investigations seem to be justified in these cases. In 57 per cent of cases, the echocardiogram was abnormal, suggestive of a cardiac cause for the pain. The demonstration of a disorder of segmental kinetics in the left ventricle is suggestive of coronary artery disease, which is detected 82 per cent of cases and is a good indication for coronary angiography. The other abnormalities detected, mitral valve prolapse, hypertrophic cardiomyopathy and dilated cardiomyopathy are rarely associated with coronary artery disease, which was found in 0, 13 and 14 per cent of cases, respectively. Initially, these abnormalities may be sufficient to explain the symptomatology. Pericardial detachments are associated with coronary artery lesions in 50 per cent of cases and should be very carefully monitored. PMID- 6508194 TI - [Long-term fate of 103 patients with auricular fibrillation lasting for over 15 days treated with cardioversion and preventive therapy]. AB - 103 patients with atrial fibrillation lasting more than 15 days were treated by cardioversion, with a return to normal sinus rhythm in 92 per cent of cases. If the atrial fibrillation recurred during the first six months, a further electric shock was given and the treated was changed or better adapted to the patient. The sinus rhythm was maintained in 85.7 per cent of patients at one year, 84.4 per cent at 2 years, 80.1 per cent at 3 years and 76.1 per cent at 4 years. The factors which predict a good result are: sex, the presence of mitral valve disease, especially when it has been operated, good tolerance of the arrhythmia and good haemodynamic status prior to the shock. The treatment used were quinidine arabogalactane sulfate (QAGS) and amiodarone. QAGS was better tolerated, while amiodarone proved to be more effective. PMID- 6508195 TI - [Right intraventricular tumors. Apropos of a case]. AB - The authors report a case of right ventricular tumour in a 16 year old girl who presented with dyspnoea on effort, chest pain on exertion and loss of consciousness. The diagnosis was made on the basis of abnormal right intraventricular echoes on two dimensional echocardiography and was confirmed by angiography. The patient was operated with success. Histology revealed a mesenchymoma, a benign tumour, but whose infiltrating nature calls for a reserved prognosis. The echocardiogram can be used for regular post-operative surveillance. The young patient is well after 18 months' follow-up. PMID- 6508196 TI - [2 new cases of myocardial infarction after injection of vincristine]. AB - The authors report two cases of myocardial infarction following the injection of vincristine. The vincristine is held responsible for several reasons: absence of past history or risk factors of coronary artery disease, no past history of mediastinal radiotherapy, the development of coronary manifestations several hours after the injection of vincristine. Both cases followed a fatal course. The pathophysiology of this iatrogenic complications is unclear. Any patient receiving such treatment should be carefully monitored clinically and electrocardiographically. PMID- 6508197 TI - [Septicemia on endocavitary sounds for cardiac stimulation]. AB - Two cases of septicaemia on endocavitary cardiac pacemaker probes lead the authors to discuss the aetiological and therapeutic aspects of this type of infection. In both cases, the pacemaker had been in situ for a long time and had been replaced on several occasions, there was infection in the site of implantation and an attempt at removal of all of the pacemaker material failed, leaving a probe incarcerated in the right ventricle by one of its extremities with the other extremity floating free. The endocarditis associated with this septicaemia can, theoretically, be due to two mechanisms: metastatic implantation of infection form a distant site which must be detected or infection developing in contact with the pacemaker and propagated along the probe. The treatment of this type of septicaemia consists of appropriate antibiotics, which are only rarely sufficient to sterilize the infection. In most cases, all of the pacemaker material must be removed, which is easily achieved in the majority of cases. After cleansing of the site, the pacemaker has been successfully replaced. Sometimes, the probe is buried in the myocardium: surgical removal by cardiotomy, with or without extracorporeal circulation, seems to be preferable to the techniques of continuous traction which carry certain risks (tricuspid and myocardial lesions). Persistent floating probes must be removed surgically. PMID- 6508198 TI - [Hemodynamic effects of ARL 115 in left ventricular insufficiency]. AB - ARL 115 has vasodilator and positive inotropic properties which justify its use in heart failure. The effects of this drug were studied in 8 patients with advanced myocardial failure (7 cases of primary cardiomyopathy and 1 case of ischaemic cardiomyopathy) undergoing diagnostic cardiac catheterization, 15 minutes after angiocardiography. The cardiac output pressures were measured and the M mode electrocardiogram was recorded under basal conditions and following an infusion of 1 mg/kg of ARL 115 over 10 minutes. An improvement was observed in 7 cases, with an increase in the cardiac output and a decrease in the left ventricular diastolic pressure (p less than 0.05). There was no significant modification in the heart rate and there were no side effects. In one case, an abrupt fall in the diastolic pressure led to a decrease in the cardiac output. The arterial and venous vasodilator properties were demonstrated in every case, but a positive inotropic action (increase in the dp/dtmax and modification of the end-diastolic pressure: dimension ratio) was demonstrated in only two cases. The absence of positive inotropic action in the 6 other cases could be due to the advanced myocardial deterioration in these patients or to a delay in the positive inotropic effect in relation to the vasodilator effect. PMID- 6508199 TI - [Evaluation of the treatment of the aged hypertensive patient. Audit in medical practice]. PMID- 6508200 TI - Retrograde cardioplegia. New approach in cardiac surgery. PMID- 6508201 TI - Adriamycin instillations as recurrence prophylaxis in superficial urinary bladder cancer. AB - Fourteen patients suffering from recurring superficial urinary bladder carcinoma were studied. 50 mg of adriamycin was instilled intravesically approximately once monthly over a period of more than 17 months. Recurrence index (RI) with adriamycin prophylaxis was statistically monthly significantly lower and per cystoscopy highly significantly lower than without prophylaxis. The recurrence rate (RR), as well as the mean annual recurrence rate (MARR) were similarly significantly lower with prophylaxis than without. The total response, an expression used earlier, was 86% following prophylactic instillation. 57% of the patients (8/14) suffered from bladder irritation and urinary tract infections occurred in three of them. PMID- 6508202 TI - Manometry with needle cholangiography. A new technique. AB - A new method of cholangiomanometry developed on the basis of operative needle cholangiography is described. The pressure of the common bile duct is recorded during continuous infusion using two different speeds. The procedure is complemented by pressure controlled injections of a contrast medium and by fentanyl test to study the function of the sphincter of Oddi. PMID- 6508204 TI - Combined vaginal-abdominal delivery of twins. AB - During the five-year period 1977-1981, 120 twins were delivered at the University Hospital, Uppsala, Sweden. 6 or 5%, were delivered by the combined vaginal abdominal route. There was no case of foetal death among the second twins. Only one second twin had an Apgar score of less than eight at five minutes. Four mothers received blood transfusion because of blood loss related to the operation and two mothers developed fever during the puerperium. It is concluded that caesarean section may well be performed for rapid delivery of the compromised second twin, although the maternal morbidity is substantial. PMID- 6508205 TI - Recurrence prophylaxis of bladder cancer. PMID- 6508203 TI - Fistula-in-ano in a defined population. Incidence and epidemiological aspects. AB - The incidence and epidemiology of anal fistula were studied among the inhabitants of the City of Helsinki (population 510,000) during a 10-year period, 1969 to 1978. The mean incidence per 100,000 population was 8.6 for nonspecific and fistula, 12.3 for males and 5.6 for females. Of a total of 458 anal fistulae diagnosed during the period under study, the nonspecific fistulae accounted for 90.4%, the tuberculous fistulae for 0.2%, the postoperative and traumatic fistulae for 3.3% and fistulae originating in anal fissure for 3.3%. Anal fistulae associated with ulcerative colitis comprised 1.5% of the total series and fistulae associated with Crohn's disease 1.3%. At the time of diagnosis of the nonspecific anal fistulae, the mean age of the patients was 38.3 years; the male-female ratio was 1.8: 1. All the patients younger than 15 years of age were male. 35% of anorectal abscesses of nonspecific anal origin developed into a fistula. Sedentary occupations did not show any significance in anal fistula formation. PMID- 6508206 TI - A critical assessment of plasma alkaline ribonuclease as an indicator of protein nutritional status in infancy. AB - Plasma alkaline ribonuclease (RNase) was measured at birth and during infancy to assess its usefulness as an indicator of protein nutritional status. Cord blood enzyme activity did not indicate intra-uterine protein malnutrition in the less well-grown babies. Differences in enzyme activity were found which related to the quality of the dietary protein fed to both preterm and term light for gestational age babies. Higher activity on day 7 in those infants fed a predominantly curd protein formula suggested that this was less well utilised than a curd and whey protein formula. Serial enzyme measurements in four infants with metabolic disease showed how the enzyme activity altered in response to changes in the quantity of dietary protein. These results are critically discussed. PMID- 6508207 TI - Effects of storage and repeated freezing and thawing on plasma cholinesterase activity. AB - Plasma cholinesterase activity, determined using either benzoyl choline or butyrylthiocholine as substrate, is stable for prolonged periods (greater than 12 months) when stored at -20 degrees C. Likewise, repeated freezing and thawing of plasma did not markedly affect cholinesterase activity. PMID- 6508208 TI - Effect of heparin on determination of plasma albumin by Beckman Astra 8 (BCG) and Du Pont ACA II (BCP) autoanalysers. PMID- 6508209 TI - A single-step immunoradiometric assay for the measurement of serum ferritin. AB - An immunoradiometric assay (IRMA) which can be carried out in a single working day is described here. The assay is comparable to the conventional IRMA with respect to both sensitivity and reproducibility and is less labour intensive. PMID- 6508210 TI - Antigen binding in the two-site immunoradiometric assay for serum ferritin: the nature of the hook effect. AB - The two stages of a two-site immunoradiometric assay were investigated separately. In the first stage, the amount of ferritin bound to coated tubes initially showed a rapid increase with increasing concentration of added ferritin. This was followed by a plateau and then a further increase which appeared to be largely due to non-specific binding. During the second stage, a significant proportion of the bound ferritin dissociated from the solid phase and sequestered some of the labelled antibody in solution. Thus less antibody was available to bind to ferritin attached to the tube, causing a decrease in count rate at high ferritin concentrations. The use of a monoclonal antibody for coating the tubes did not eliminate this hook effect. PMID- 6508211 TI - Problems associated with the measurement of uric acid using two enzyme-mediated reaction systems. AB - We describe the problems encountered with the adaptation of two enzymatic assays for uric acid to a centrifugal analyser. A method employing the uricase/catalase/aldehyde dehydrogenase enzyme system sometimes suffered from interference due to light-scattering species in samples and reagents. The second method employing the uricase/peroxidase system gave results that were lower than the comparison method. PMID- 6508212 TI - Performance of three enzymic methods for filter paper glucose determination. AB - Collection of blood spots on filter paper offers a practical alternative for home monitoring of diabetic patients. We have compared the merits of three protein precipitants, trichloracetic acid (TCA), perchloric acid (PCA) and sulphosalicylic acid (SSA) for the elution of glucose from the filter paper, and their subsequent effects on three enzymic methods, glucose dehydrogenase (GDH), hexokinase (HK), and glucose oxidase (GOD) for the determination of glucose using a microcentrifugal analyser. The combination of TCA elutant with the GDH method was superior with respect to time course of reaction and elution time from the filter paper, and was chosen for routine use. Within- and between-batch precision for this method was 2.7% and 3.2% respectively at normal glucose concentrations. Recovery of glucose added to whole blood was 110 +/- 5%. Comparison with an automated glucose oxidase method for plasma glucose gave a slope of 1.1, intercept of -0.7 and a correlation coefficient of 0.9 (n = 64). We conclude that the combination of TCA and glucose dehydrogenase provides a robust, precise and accurate method for the quantitation of glucose in filter-paper blood spots. The procedure offers increased sensitivity and better precision than GOD methods. The use of TCA as elutant gives a faster elution time and has the least effect on any of the enzymic methods. PMID- 6508213 TI - A rapid assay for 17 alpha OH-progesterone in plasma, saliva and amniotic fluid using a magnetisable solid-phase antiserum. AB - A radioimmunoassay suitable for measurement of 17 alpha OH-progesterone concentrations in small aliquots of plasma (20 microL), amniotic fluid (20 microL) and saliva (200 microL) is described. The assay features an antiserum raised against a 17 alpha OH-progesterone-3-(O-carboxymethyl)oxime/BSA conjugate coupled to a magnetisable, solid-phase support; the homologous radioligand is a 125I-iodohistamine conjugate. This combination of a gamma-emitting ligand and a magnetic-separation procedure has the advantage of reducing assay time and cost; it also allows processing of plasma and saliva samples in the same assay batch. The method has satisfactory sensitivity, precision and accuracy. Data derived from clinical studies of patients with congenital adrenal hyperplasia indicate the usefulness of this assay in routine practice. PMID- 6508214 TI - A simple paired-ion liquid chromatography assay for serotonin in cerebrospinal fluid, platelet-rich plasma, serum and urine. AB - Anderson and co-workers recently described a simple high-performance liquid chromatographic/fluorimetric assay for serotonin and tryptophan, in which deproteinised samples were directly injected. Using this method routinely, we frequently observed interference which could not sufficiently be resolved from serotonin to allow accurate quantitation. However, when the amine was isolated by ion-exchange chromatography prior to HPLC separation as advocated by Koch and Kissinger, chromatograms were obtained with practically no extraneous peaks. In this paper the application of this method for the determination of serotonin in CSF, plasma, serum and urine is described. PMID- 6508215 TI - Determination of HDL-cholesterol using 2,4,6-tribromo-3-hydroxybenzoic acid with a commercial CHOD-PAP reagent. AB - The Boehringer one-component high-performance cholesterol oxidase reagent has been modified by the inclusion of 2,4,6-tribromo-3-hydroxybenzoic acid (TBHBA) to give a fourfold increase in sensitivity to a molar absorbance of approximately equal to 29,000 with respect to cholesterol. The resulting reagent system is particularly suitable for the determination of plasma HDL-cholesterol for which a reagent of high sensitivity is required. A simple method of bromination avoiding the use of elemental bromine is used to prepare TBHBA. The modified reagent system has been found to have good within- and between-batch precision and has shown itself to be reliable and trouble-free. PMID- 6508216 TI - The preparation and characterization of alkaline phosphatase-thyroxine conjugates and their use in the enzyme immunoassay of thyroxine. AB - Alkaline phosphatase from calf intestine was conjugated to thyroxine using cyanuric chloride, glutaraldehyde and 1-cyclohexyl-3(-2 morphoinoethyl) carbodiimide as coupling reagents. The conjugates produced were studied for incorporation of thyroxine, retention of enzyme activity and immunoreactivity in a thyroxine radioimmunoassay system against a range of thyroxine antisera. The use of these conjugates in thyroxine enzyme immunoassay was studied using second antibody separation. Comparison of the results with radioimmunoassay data was satisfactory and indicates the potential of these conjugates for thyroxine immunoassay. The use of cyanuric chloride as a coupling reagent was unsatisfactory, but good results were obtained with glutaraldehyde. Although satisfactory immunoreactivity of carbodiimide conjugates was observed in a radioimmunoassay system, these results were not reflected in the enzyme immunoassay systems studied. PMID- 6508217 TI - An improved method for separation of bound and free fractions in a free-T4 kit. PMID- 6508218 TI - Interference by Sotalol with the Pisano method for urinary metanephrines. PMID- 6508219 TI - Susceptibility to chronic gastritis in first degree relatives of gastric carcinoma patients. Effect of histological type of carcinoma and location of tumour. AB - To elucidate the behaviour of gastritis on a family level 301 first degree relatives of 73 patients with different types of gastric carcinoma have been subjected to a closer analysis. A stochastic mathematical approach was employed in calculating mean score values for each family. In addition, the location of the tumours was taken into account. The findings are compared with those in a series of 358 first-degree relatives (the "controls") of 73 control probands, computer-matched by age and sex to the carcinoma probands. The mean progression of gastritis in the body in the carcinoma families was significantly more rapid than in the controls. In the relatives of probands with diffuse carcinoma the progression of gastritis was significantly more rapid than in the controls in both body and antrum; no such difference was seen in the families of intestinal carcinoma probands. On the other hand, a significant positive correlation was established between the location of all carcinomas and the progression of both antral and body gastritis. Furthermore, intestinal carcinoma of antral location was associated with progression of antral gastritis significantly faster than expected. On the whole, in contrast to the control families, the mean gastritis scores of all carcinoma families were above zero. It is concluded that our earlier finding of a relationship between gastritis and gastric carcinoma at an individual level is also found at a family level. PMID- 6508220 TI - Systolic time intervals and the QT-QS2 interval in young female diabetics. AB - To detect subclinical cardiomyopathy in diabetic patients without evidence of coronary artery disease, systolic time intervals were measured in 51 insulin treated young female diabetics (mean age 27 years and mean duration of diabetes 12 years) and in 15 healthy women of the same age. The ratio of the pre-ejection period to the left ventricular ejection time (PEP/LVET) was used as an index of left ventricular performance. The PEP/LVET ratio was normal in all diabetics and did not differ statistically from that in the control group. The electrical (QT) and electromechanical (QS2) systole were measured from the same high velocity recordings. The QT-QS2 interval (mean +/- SD) was shorter in the diabetic group ( 16 +/- 22 ms vs. -33 +/- 9 ms, p less than 0.01). Ten diabetics but none of the healthy women, had the QT interval longer than the QS2. This was a result of both shortening of the QS2 and prolongation of the QT. In conclusion, our results suggest normal myocardial contractility in these young female diabetics. The significance and mechanism of the shortened QT-QS2 interval in the diabetics need further investigation. PMID- 6508221 TI - Upper abdominal complaints and gastritis. AB - To evaluate the significance of gastritis as a cause of upper abdominal complaints consecutive cases with upper abdominal complaints have been subjected to gastroscopy with biopsies of the antral and body mucosa. The results were compared with those obtained from two representative population samples: one Finnish and one Estonian. The progression of gastritis on an individual level was expressed as an age-adjusted score. It appeared that the progression of gastritis in the series did not significantly differ from the controls, confirming our earlier experience that gastritis as such can hardly be used for the explanation of upper abdominal complaints. PMID- 6508222 TI - The function and morphology of the liver in porphyria cutanea tarda. AB - The aminopyrine breath test, postprandial serum bile acids, and routine liver tests were assessed as indicators of liver dysfunction in 38 patients with porphyria cutanea tarda. In 17 patients needle biopsy specimens of the liver were obtained. Bile acids were increased in almost all the patients studied (97%) but impairment of aminopyrine demethylation was found in only 45%. More than 50% of cases had elevated activities of serum alanine aminopeptidase, leucine aminopeptidase, gammaglutamyl transpeptidase (GGTP), and alanine aminotransferase (ALAT). All liver biopsy specimens showed fluorescence characteristic of porphyrins. Histologic examination of biopsy material revealed cellular lesions in all cases, the most common pathological findings being fatty degeneration of varying degree and iron accumulation. The most frequent electronmicroscopic changes in the liver were fat droplets, granules containing bile material, and siderosomes in the cytoplasm of hepatocytes. However, there was no evident relationship between morphological and functional liver changes. PMID- 6508223 TI - Fatal Candida meningitis in a previously healthy adult. AB - A rare case of fatal Candida albicans meningitis in a healthy middle-aged woman is reported. The organism did not grow in four of the six cerebrospinal fluid cultures despite clinical meningo-encephalitic symptoms and clear cell reaction in cerebrospinal fluid. Death was unexpected with a generalised tonic-clonic seizure and cardiac arrest. A possible relationship between the coexistent long standing intra-uterine contraceptive device and Candida meningitis is discussed. PMID- 6508224 TI - Effect of anaesthesia on fentanyl-induced changes in human intracholedochal pressure. AB - Intracholedochal passage pressures (ICPP) were measured during halothane, enflurane and isoflurane anaesthesia as well as during anaesthesia without any volatile agent and in patients with a postoperative T-tube. There were no statistically significant differences in the mean ICPP between the study groups (altogether 49 patients). After i.v. fentanyl 0.1 mg a similar pressure increase (mean 0.5 kPa) was recorded in all anaesthetized groups as compared to a threefold increase (mean 1.6 kPa) in the postoperative group (p less than 0.001) with maximum at about 7 min in all groups. Intraoperative fentanyl did not cause surgically adverse effects i.e. false obstruction due to spasm in the operative cholangiography. It is concluded that all inhalation anaesthetics attenuate the ICPP response to fentanyl. PMID- 6508225 TI - HLA antigens in nickel allergy. AB - HLA-A, B and C antigens were determined in 38 and HLA-DR and MT antigens in 30 patients with nickel allergy. The prevalence of B12 was increased (p less than 0.007) and that of DR1 decreased (p less than 0.02). Although these deviations are statistically significant, it is more likely that they are only coincidental and not an evidence of a real association between HLA and nickel allergy. This data, as in earlier reports does not indicate significant associations between HLA antigens and nickel allergy. PMID- 6508226 TI - The effect of BCG-vaccine upon experimental visceral leishmaniasis in hamsters. AB - Stimulation with Bacillus Calmette-Guerin (BCG) vaccine has been reported to enhance resistance of mice against Leishmania donovani infection. Such infection is usually lethal in hamsters, thus providing a more stringent animal model to assess the effect of BCG upon visceral leishmaniasis. Animals receive two IP injections (2-8 X 10(7) BCG) pre or post IC challenge with 4 X 10(6) amastigotes. Controls received BCG alone (with no infection) or were untreated (NT). Pretreated animals exhibited significantly fewer (P less than 0.05) hepatic or splenic amastigotes than NT animals at days 7, 14, and 28 post challenge, but most BCG treated hamsters died earlier than NT. Post treated hamsters showed no significant reduction in parasite burdens, or in median time to death as compared to NT group. Hamsters which received BCG but were not infected appeared healthy during the study. The reason for increased susceptibility of BCG-treated hamsters to disease is not clear, but observed pathologic complications of L. donovani infected hamsters appear to be exacerbated by BCG stimulation. PMID- 6508227 TI - Heparin monitoring during cardiopulmonary bypass. AB - Three procedures have been compared for monitoring heparin in patients undergoing cardiopulmonary bypass: (1) activated clotting time (ACT) (2) protamine titration, and (3) fluorometric substrate assay. The ACT monitors the degree of anticoagulation. It is easy to perform and is relatively inexpensive, however, it does not correlate well with heparin levels and may not accurately predict the protamine dose for neutralization of heparin at the completion of bypass. A protamine titration assay or an assay using a thrombin-sensitive fluorometric substrate measures the heparin level and calculates the protamine requirement at the completion of surgery; however, these assays do not indicate the degree of anticoagulation. The fluorometric assay is the less expensive of the two assay measuring heparin, but it requires an experienced technologist to perform the test. PMID- 6508228 TI - Arteriohepatic dysplasia (Alagille's syndrome): a common cause of conjugated hyperbilirubinemia. AB - Syndromatic paucity of interlobular bile ducts is a common cause of conjugated hyperbilirubinemia in children. The clinical presentation is not always obvious. Therefore, the liver biopsy may be a useful diagnostic tool in the definition of this entity. The hepatic and biliary morphology of five children with arteriohepatic dysplasia (Allagille' syndrome) is described. Prior to diagnosis, four underwent Kasai procedures after intraoperative cholangiograms failed to demonstrate patency of the extrahepatic bile ducts. In three patients, a focal proximal hypoplasia of the common hepatic duct was demonstrated. Hypoplasia of the gallbladder occurred in two patients. Hepatic features of sequential liver biopsies obtained on the five patients, were divided into early and late changes. From birth to four months of age, the pathology consistent of cholestasis, paucity of interlobular bile ducts and portal fibrosis. The etiology of arteriohepatic dysplasia is unclear. The main pathogenic mechanisms are discussed. It is felt that the syndromatic duct paucity represents an acquired primary ductal defect resulting from a genetically determined immune response to as yet undefined agent or agents. PMID- 6508230 TI - [14th meeting of the Society of Experimental Neuroendocrinology. Abstracts of presentations and reports. Besancon, 27-28 September 1984]. PMID- 6508229 TI - Vitamin B complex in treatment of cadmium intoxication. AB - The effect of vitamin B-complex on cadmium nephrotoxicity and hepatotoxicity was investigated in rats. The administration of Cd (3 mg per kg, s.c., three days) increased the urinary excretions of lactic dehydrogenase (LDH), glutamic oxalacetic transaminase (GOT), and total proteins, decreased renal activities LDH and GOT and increased concentration in kidney tissue of Cd, Cu, and Zn, Cadmium also increased serum BOT and glutamic pyruvic transaminase (GPT), decreased hepatic activities of GOT and GPT, and increased hepatic levels of Cd and Zn. The supplementation of vitamin B-complex (10 mg per kg, orally) simultaneously with Cd caused less marked biological alterations. Cadmium concentration in renal tissue was significantly less on the eighth day whereas the hepatic level of Cd was unaffected by vitamin supplementation. The protective effect of vitamin B complex in Cd toxicity may be attributed to the interference by the constituents of vitamin B-complex in body absorption of Cd, possibly through forming readily excretable complexes. The results suggest that Cd toxicity can be reduced by vitamin B-complex supplementation. PMID- 6508231 TI - [The blood-testis barrier]. AB - The blood-testis barrier in man is mainly due to the tight junctions of Sertoli cells. It creates favorable conditions for the spermatogenesis and sperm survival in the testicular fluid. It prevents the occurrence of autoimmunity after puberty. The alteration of the blood-testis barrier allows the production of antisperm antibodies and may lead to infertility. PMID- 6508232 TI - [Seasonal variation in the nyctohemeral rhythm of prolactin in cows]. AB - Seasonal variation of prolactin nyctohemeral rhythm has been studied by radioimmunoassay on female cattle of the white blue belgian breed. Animals are divided into three groups as age is concerned : 6 calves, 6 heifers and 5 lactating cows. In december all groups of animals show a significant increase of plasma prolactin concentration between 5 a.m. and 7 a.m. Calves and heifers have a second secretion period either at the end of the afternoon between 17 and 19 p.m. or during the evening between 20 and 23 p.m. The circadian rhythm observed in may with heifers is similar to that in december with two waves whose relative importance is different at the two seasons considered. Nyctohemeral rhythm of prolactin in cattle is age and season dependent. PMID- 6508233 TI - Correlative changes in the Leydig's cells and male secondary sexual characters (SSC) in a freshwater fish Mystus (M) vittatus. AB - The study of testicular steroidogenic tissue in the freshwater fish Mystus (M) vittatus has been made by employing histochemical techniques to localize lipids. The Leydig's cells are steroidogenic. Their functional significance has been correlated with secondary sexual characters (SSC). The SSC have been found to follow a clear cut testicular cycle. The development of SSC is reflected by the abundance, numerical variations, size difference, hypertrophy and hyperplasia of the interstitial Leydig's cells. Functional identity of Sertoli cells in the development of SSC seems doubtful. PMID- 6508234 TI - Changes in gonadotrophin, lipid and cholesterol levels during annual reproductive cycle in the freshwater teleost, Cirrhinus mrigala (Ham.). AB - Pituitary gonadotrophin started increasing with gonadosomatic index from preparatory phase but increase in serum gonadotrophin became evident from prespawning phase. However, their peaks were noticed in spawning phase. During other phases of reproductive cycle their values were low except for female pituitary gonadotrophin potency which remained comparatively high during postspawning phase. An increase in ovarian and decrease in testicular lipid started from preparatory phase which continued till spawning phase. Liver lipid in either sex decreased during prespawning and spawning phases. Lipid level was low in ovary but was high in testis and liver during the remaining period of the year. Liver cholesterol was low during spawning and high in prespawning phase whereas serum cholesterol was low during prespawning and spawning phases and remained high during other and peak was recorded during spawning phase. Testicular cholesterol was low during preparatory and postspawning phases and high during the rest of the period of reproductive cycle. PMID- 6508235 TI - Diurnal variations in prolactin secretion and serum Na+ and K+ concentrations in the freshwater catfish. Clarias batrachus. AB - Variations in the pituitary gland and blood serum prolactin levels along with Na+ and K+ ions concentrations during 24 hr period were studied in Clarias batrachus. Prolactin secretion exhibited clear diurnal rhythm. Peaks in the prolactin content of pituitary and serum were recorded at early photophase 06.00 and 09.00 hr respectively. Troughs in the both pituitary and serum were noticed during mid darkphase at zero hour (24.00 hr). The concentration of serum Na+ and K+ ions also demonstrated marked diurnal changes but unlike prolactin levels, the highest cation concentrations were encountered during mid darkphase and the lowest at the middle of photophase. Apparently, there was no relationship between changes in prolactin secretion and Na+ and K+ ions concentrations. PMID- 6508236 TI - [Glutathione and tissue uptake of triiodothyronine]. AB - The effect of glutathione (GSH) on the 125I-Triiodothyronine uptake was studied in renal cortex slices. Addition of Diamide (30 mM), oxidizing reagent for GSH, to the incubation buffer decreases the hormonal uptake (-28%) while GSH (20mM) can reverse the effect of diamide. So the modification of T3 distribution previously shown in vitamin A-deficient rats can be attributed to the GSH deficiency already observed in these animals. PMID- 6508237 TI - Nuclear magnetic resonance imaging in evaluation of clinical stroke syndromes. AB - Proton nuclear magnetic resonance (NMR) imaging was performed on normal volunteers and patients with various types of clinical strokes. True three dimensional volumetric data were obtained for subsequent reconstruction of images at various orientations, including transverse, coronal, and sagittal, and for specific matching to x-ray computed tomographic planes. A variety of radiofrequency pulse sequences was used to generate images weighted by the NMR parameters spin density (p) and spin-lattice (T1) and spin-spin (T2) relaxation times. Quantitative T1 data and qualitative T2 information were obtained from appropriate sequences. Proton NMR images embodying T1 information provided adequate delineation of normal intracranial anatomical structure and a high level of gray matter-white matter contrast; high lesion detection sensitivity in various clinical forms of stroke was seen in images providing both T1 and T2 information. T1 and T2 relaxation times were prolonged in embolic, thrombotic, and watershed infarctions as well as in lacunae; shortening of T1 and T2 was found in hematomas. Serpiginous vessels in an arteriovenous malformation were seen that had particular pulse sequences. PMID- 6508238 TI - The risk of intracerebral hemorrhage during oral anticoagulant treatment: a population study. AB - In a retrospective study of 166 patients, all admitted to the University Hospital, Leiden, The Netherlands, between January 1, 1970 and December 31, 1979, we estimated the relative risk of intracerebral hemorrhage from oral anticoagulant therapy. The risk was more than ten times higher for patients over 50 years of age than for similarly aged untreated individuals in the general population. Within this age group the risk was influenced by neither age nor sex. Hypertension, present in 80% of the patients, was the most important predisposing condition; the risk of bleeding rose with increasing intensity of anticoagulation. There was no substantial difference in clinical condition at onset, rate of progression, mortality, or degree of recovery between patients with anticoagulant-associated hemorrhage and those with spontaneous intracranial hemorrhage. PMID- 6508239 TI - Perinatal cerebral infarction. AB - The diagnosis of perinatal cerebral infarction, although frequently suggested clinically, has been made most commonly at postmortem examination; few infants surviving stroke are reported in the literature. We evaluated 18 infants with perinatal cerebral infarction in a recent twelve-month interval. Seven were preterm neonates, 6 of whom had experienced neonatal intraventricular hemorrhage. Three full-term infants were thought to have experienced cerebral infarction in utero and had evidence of well-defined strokes on computed tomographic scans performed shortly after birth. Eight infants developed stroke at term. The most common cause of cerebral infarction in our series was perinatal asphyxia. Fourteen of the infants were seen with neonatal seizures. Fourteen of the 18 have died or are faring poorly at 4 to 12 months of age (corrected). PMID- 6508240 TI - Unique aspects of human newborn cerebral metabolism evaluated with phosphorus nuclear magnetic resonance spectroscopy. AB - In vivo phosphorus nuclear magnetic resonance spectroscopy (31P NMR) was used to evaluate the pattern of phosphate compounds in seven newborn babies (mean gestational age, 32 weeks; birth weight, 1,430 gm; age, 37 days) with a history of perinatal asphyxia. Spectra were collected in a 1.9 Tesla superconductive magnet with surface coil techniques. The spectra had characteristic peaks for phosphorylated monoesters (PME), inorganic phosphate (Pi), phosphodiesters (PD), phosphocreatine (PCr), and ATP. In contrast to cortical spectra from mature animals, these newborn infant 31P NMR spectra were dominated by a large PME peak and had small PCr, Pi, and PD peaks. Intracellular pH, as measured from the chemical shift of the Pi peak relative to the PCr peak, was 7.1 +/- 0.1 (SD). We studied one infant postmortem, and a large PME peak was present in his spectrum. The presence of PME 3 hours after death strongly suggests that it is not a sugar phosphate. In NMR spectroscopy, compounds are identified by their chemical shift relative to a known standard (PCr); the chemical shift of the PME peak was 6.5 ppm, suggesting that it is a mixture of phosphoryl ethanolamine and phosphoryl choline. The PCr/Pi ratio (1.3 +/- 0.7) and the PCr/ATP ratio (0.7 +/- 0.4) were lower in these babies than in mature animals (greater than 2 and greater than 1.4, respectively); the PME/PD ratio (1.2 +/- 0.6), however, was much greater in the infants (mature animals, less than 0.2). These findings suggest that there are unique aspects of human newborn cerebral metabolites and bioenergetic reserve. PMID- 6508241 TI - Fine structure of cortical tubers in tuberous sclerosis: a Golgi study. AB - The fine structure of cerebral cortex, including cortical tubers, was studied in 3 patients with tuberous sclerosis. Tubers were found to consist of two predominant cell populations, astroglia and small multipolar (stellate) neurons. Both cell types tended to form aggregates within tubers, with glia more prominent in the subpial region. The stellate neurons of tubers had beaded or varicose dendrites with few dendritic spines. The findings suggest that neurons within tubers are an aberrant primitive cell type that fails to express the pyramidal cell shape and dendritic morphology that is characteristic of normal human neocortex. Cortex intervening between tubers had basically normal dendritic morphology. However, quantitative study showed a decrease in the length of dendritic branches of pyramidal neurons, as also observed in several other conditions manifested by mental retardation. PMID- 6508243 TI - Successful treatment of two cases of intention tremor with clonazepam. PMID- 6508242 TI - Quality-specific taste changes in multiple sclerosis. AB - Taste sensitivity in 79 patients with multiple sclerosis (MS) and 65 age- and sex matched control subjects was measured with a sip-and-spit, suprathreshold scaling, magnitude estimation procedure using six concentrations each of sodium chloride, sucrose, citric acid, and quinine hydrochloride. Results were analyzed with a taste scoring system and by plotting psychophysical functions (log concentration versus log magnitude estimate) normalized to 1.0 M sucrose. Gender did not affect taste scores, but age was inversely related, so the results were analyzed by an analysis of covariance with age as the covariant. There was a significant alteration in taste sensitivity in the subjects with MS for sodium chloride and quinine hydrochloride stimuli but not for sucrose and citric acid; these results were confirmed by a separate analysis of the psychophysical functions. Some of the MS taste scores correlated with MS functional and physical disability scores. Taste sensitivity was not correlated with clinical history or presence of facial symptoms. PMID- 6508244 TI - Amantadine in essential tremor. PMID- 6508245 TI - Outcome in neonates with apneic seizures. PMID- 6508246 TI - Spontaneous resolution of epidural hematomas detected after the first day. PMID- 6508247 TI - Basic mechanisms of the epilepsies. Proceedings of a workshop at the Kroc Foundation Headquarters, Santa Ynez, California, December 7-9, 1982. PMID- 6508248 TI - Brain methylation and epileptogenesis: the case of methionine sulfoximine. AB - A brief review of the neurochemical effects of the convulsant agent L-methionine dl-sulfoximine (MSO) on cerebral methylation reactions is presented. Our findings point to the involvement of a number of endogenous methyl acceptor molecules, including histamine, membrane phospholipids, and membrane proteins, in the mediation of the convulsant effect. Our findings also associate the inhibition of methylations by high levels of S-adenosyl-L-homocysteine in brain with protection against MSO-induced seizures. We propose that MSO acts by eliciting the acceleration of a regulatory methylation-demethylation sequence at key molecular sites, including the benzodiazepine receptor complex, which creates an imbalance in this sequence's normal mediation of convulsant-anticonvulsant mechanisms. PMID- 6508249 TI - [Optical properties of DNA complexes with antitumor compounds of bivalent platinum]. AB - The optical properties of the DNA complexes with the compounds of bivalent platinum were studied. The compounds differed by the nature of the anionic and neutral ligands and their spatial arrangement about the platinum atom. It was shown that the same as cis-[Pt (NH3)2Cl2] the platinum compounds with the biological activity, i.e. [Pt (en) Cl2], cis-[PtNH3 (Bz) Cl2] and cis-[Pt (NH3)2NO2Cl] induced at low values of r (a ratio of the number of the platinum moles added to the number of the DNA nucleotide moles in the solution) an increase in the amplitude of the positive band in the spectrum of the circular dichroism (CD) of the linear DNA and a marked decrease in the amplitude of the negative band in the spectrum of the CD of the liquid crystalline microphase of DNA formed in the presence of polyethyleneglycol. By the character of the action on the CD spectrum of the linear and condensed DNA [Pt (tetrameen)Cl2] which had no selective antimitotic effect might be referred to the above platinum compounds. Trans-[Pt (NH3)2NO2Cl], [PtNH3PyCl2], cis-[Pt (NH3)2(NO2)2] and [Pt (NH3)3Cl]Cl having no biological activity either induced only a decrease in the amplitude of the positive band in the CD spectrum of the linear DNA or had no effect on the CD spectrum. The effect of these compounds on the CD spectrum of the liquid crystalline microphase of DNA was slightly pronounced or not observed. PMID- 6508250 TI - [Effect of levorin on the intracellular pool of free amino acids in Ehrlich ascites carcinoma cells]. AB - Levorene, a polyenic antibiotic, lowered the concentration of amino acids in the cells of Ehrlich carcinoma. The decrease in the intracellular level of the amino acids was due not only to inhibition of their entrance to the cells but also to their increased leaching from the cells. The effect of levorene on the intracellular level of the neutral amino acids was higher than that on the main amino acids which was associated with different sensitivity of the amino acid transport systems to the antibiotic. PMID- 6508251 TI - [A method of diffusion in agar for determining streptococcal sensitivity to antibiotics]. AB - An agar diffusion method for determination of antibiotic sensitivity to streptococci of different serological groups with semiquantitative estimation of the results was developed with the use of the dry nutrient medium of the I. I. Mechnikov Central Research Institute of Vaccines and Sera for isolation of hemocultures and cultivation of streptococci. The addition of blood or serum to this medium is not required. The standard inoculum (2 milliard microbial bodies) is added into the depth of the nutrient agar thus providing the optimal conditions for the growth of the facultative anaerobes. The MICs of the antibiotics and the diameters of the growth inhibition zones of 150 streptococcal strains were compared and an estimation table for interpretation of the data of the agar diffusion test was presented. This simple method provides a sufficient accuracy and satisfactory reproducibility in the clinical tests. PMID- 6508252 TI - [Variability of Vibrio cholerae as affected by subbacteriostatic concentrations of antibiotics]. AB - The effect of subbacteriostatic concentrations of some antibiotics on variation of the features characterizing the serovar and biovar of the cholera germ was studied on 10 strains of V. cholerae E1 Tor of the Inaba serovar having the typical properties. It was shown that even a single exposure to the subbacteriostatic concentrations of some antibiotics resulted in formations of clones differing from the parental strains by a number of significant features, such as the antigenic structure, phage lysability and enterotoxicity. The new features were inherited in a number of generations on multiplication in culture media and in sensitive animal hosts. PMID- 6508253 TI - [Lysozyme in the feeding of premature infants with mixed pathology]. AB - Lysozyme is an important component of the breast milk. In the gastrointestinal tract of infants it performs the function of a local protective factor. The efficacy of the use of milk enriched with lysozyme was studied in feeding of 64 premature infants suffering from concomitant diseases. This clinical and laboratory study was performed as a part of the combined treatment and prophylactic measures. Lysozyme was added to the donor breast milk or to the dry adapted acidophilic mixture "Malyutka" in an amount of 50 mg per 1 liter of the final product. 29 infants were feeded with such milk products for 14-21 days of the observation period. The control group included 12 infants with artificial feeding and 23 infants feeded with the above milk products without addition of lysozyme. In spite of the significant differences in the initial state of the infants, a favourable effect of the feeding with addition of lysozyme was shown. It was comparable to the feeding with the breast milk. Improvement of the general state of the infants and the pathological processes in them, an increase in the body weight, more rapid sanation of the infectious inflammatory foci, normalization of the stool, stabilization of the lysozyme levels in the coprofiltrates and a tendency to normalization of the increased levels of lysozyme in the blood serum were observed. Satisfactory tolerance of the lysozyme enriched milk products was shown. PMID- 6508254 TI - [Experimental study of lincomycin ointment and gel]. AB - The pharmacokinetics and safety of the lincomycin ointment and gel were studied. It was shown that diffusion of lincomycin through the skin was satisfactory. Investigation of their general toxicity and organotropic properties revealed neither irritating effect nor changes in the internal organs associated with the toxic effect of the drugs. On the basis of the data on the stability of the lincomycin ointment and gel obtained on their storage the lincomycin ointment was recommended for industrial production. PMID- 6508255 TI - [Shifts in tissue respiration of the lung and liver in rabbits administered penicillin and streptomycin]. AB - The experiments were performed on intact rabbits weighing 2.5-3 kg. The animals were treated with penicillin or streptomycin injected intramuscularly in doses of 20 000 units or 17 000 micrograms a day per kg bw for 12 days. The concentrations of lactic and pyruvic acids, cytochrome c, activity of cytochrome c oxidase and thiol spectrum were investigated in the lungs and liver immediately after the antibiotic use in 10 rabbits of every experimental series. To follow the period of persisting of the antibiotic-induced changes the other 10 rabbits were killed 29 days after the last injection of the drugs. It was shown that penicillin induced significant changes in the concentrations of lactic and pyruvic acids in the lung tissue, activated cytochrome c oxidase and decreased the concentrations of free SH and S-S groups immediately after its administration. 29 days after discontinuation of penicillin the activity of cytochrome c oxidase returned to normal, while the other biochemical indices remained changed. Penicillin induced changes in the concentrations of lactic and pyruvic acids and the activity of cytochrome c oxidase in the liver. The concentrations of free masked SH and S-S groups also changed. 29 days after discontinuation of penicillin the enzymatic system of cytochrome c-cytochrome c oxidase alone returned to normal. Like penicillin, streptomycin induced changes in the tissue respiration of the lungs and liver. The character of the streptomycin-induced changes was more pronounced both immediately and 29 days after discontinuation of the drug use. PMID- 6508256 TI - [Pathomorphological picture of the testes of mice administered antitumor antibiotics and their comparative evaluation]. AB - A single administration of the LD50 of bruneomycin, carminomycin, rubomycin or olivomycin and the use of the antibiotics for 10 days in a dose 2 times higher than the therapeutic one and amounting to 10 per cent of the LD50 induced dystrophic and destructive changes in the sexual glands of mice. The changes in the testis were more pronounced after the single use of the antibiotics. Recovery processes were observed in the testis beginning from the middle of the third week after the use of carminomycin and rubomycin and from the end of the second week after the use of olivomycin. Bruneomycin was an exception: the pronounced destructive changes in the sexual glands after its single or repeated use persisted within the observation period. PMID- 6508257 TI - [Isoniazid concentrations in the blood, resected lung tissue and the gallbladder bed in relation to the method of administration to pulmonary tuberculosis patients with stomach and liver diseases]. AB - The advisability of isoniazid administration in the form of ultrasonic aerosols in the treatment of patients with pulmonary tuberculosis and diseases of the gastrointestinal tract is shown. PMID- 6508258 TI - [Comparative effectiveness of immunomodulators in the therapy of bronchopulmonary diseases]. AB - One hundred and fifty-one patients with bronchopulmonary diseases were examined and it was shown that they had secondary immune deficiency mainly in the T-cells which could not be recovered with the routine therapeutic agents. The use of hemodez, levamisole or sodium nucleinate in the combined therapy promoted correction of the immune deficiency and increased the treatment efficacy. Sodium nucleinate proved to be the most efficient. PMID- 6508259 TI - Azlocillin and cefonicid penetration into bone enhanced by probenecid. AB - Azlocillin (AZL) and cefonicid (CFD) penetration into rabbit humerus and scapula was evaluated with and without concomitantly administered probenecid. Groups of animals received either 70 mg of AZL intravenously or 20 mg of CFD intramuscularly per kg of body weight; other groups were pretreated with 40 mg of probenecid per kg before the administration of antibiotics. Peak levels of AZL in the sera of animals not receiving probenecid were 76.0 micrograms/ml at 30 min and declined to 7.7 micrograms/ml by 2.0 h. Maximum concentrations in bone were 2.7 micrograms/g in the humerus and 7.1 micrograms/g in the scapula at 1 h. Pretreatment with probenecid significantly elevated levels of AZL in both serum and bone while increasing the half-life in serum from 0.44 to 0.65 h. Maximum drug concentrations in bones of probenecid-pretreated animals were 3.9 and 11.7 micrograms/g in the humerus and scapula, respectively, with detectable levels persisting in bone for up to 4 h. The peak level of CFD alone in serum was 36.7 micrograms/ml at 30 min and declined to 0.86 micrograms/ml at 8 h. Maximum concentrations in bone were 0.66 micrograms/g in the humerus at 1 h and 1.8 micrograms/g in the scapula at 2 h. Pretreatment with probenecid significantly elevated levels of CFD in both serum and bone while increasing the half-life in serum from 1.4 to 2.94 h. Pretreatment with probenecid achieved maximum concentrations of 1.7 and 2.8 micrograms/g in the humerus and scapula, respectively. Detectable levels of CFD persisted in the humerus for up to 4 h and in the scapula for 8 h. PMID- 6508260 TI - Piperacillin plus vancomycin in the therapy of febrile episodes in cancer patients. AB - Piperacillin and vancomycin were used as initial empirical therapy for 211 febrile episodes in cancer patients. The response rate in 95 episodes of documented infection was 72%. The response of bacteremias, soft tissue infections, and pneumonias was 78, 71, and 38%, respectively. The response in infections caused by gram-negative organisms was 73%. Only 6 of 10 Pseudomonas aeruginosa infections responded to therapy, although the organisms were sensitive in vitro to piperacillin. Of 14 infections caused by gram-positive organisms, 12 responded to this combination. No major side effects were observed with this regimen. Although the overall response rate with this antibiotic combination was comparable with other regimens used for neutropenic patients, superior results might be obtained by combining piperacillin with an extended-spectrum cephalosporin or an aminoglycoside. PMID- 6508261 TI - Improved procedure for determination of flucytosine in human blood plasma by high pressure liquid chromatography. AB - Several high-pressure liquid chromatography procedures for the determination of flucytosine in serum or plasma have appeared. Some of these suffer from significant disadvantages, and none was applicable in our routine clinical therapeutic-drug-monitoring laboratory. A new high-pressure liquid chromatography assay for flucytosine was therefore developed. A 100-microliter sample of plasma was treated with an aqueous 5-iodocytosine internal-standard solution, and the mixture was deproteinized with trichloroacetic acid. A portion of the protein free supernatant was diluted with 0.1 M ammonium phosphate, and an aliquot of the resulting solution was injected into the high-pressure liquid chromatography system. Chromatography was performed on a strong-cation-exchange column with a mobile phase containing aqueous ammonium phosphate, phosphoric acid, methanol, and acetonitrile. Detection was at 254 nm. The assay was shown to be linear in the 10 to 200-micrograms/ml drug-concentration range. Forty other drugs were tested for potential interference with the assay, and none was found. For routine use, a single-point working standard containing 75 micrograms of flucytosine per ml was used, giving intraassay coefficients of variation at 50 and 150 micrograms/ml of 1.8 and 2.3% respectively, whereas the day-to-day coefficient of variation at 50 micrograms/ml was 10.0%. Advantages of the procedure include the small sample size, the use of a convenient and reliable internal standard, speed, and simplicity. The assay is highly suitable for routine clinical drug-analysis laboratories. PMID- 6508262 TI - Use of lipids to potentiate the antibacterial activity of aminoglycosides. AB - Linolenyl alcohol has been shown to inhibit the in vitro growth of several species of gram-positive bacteria. Since the double bonds in linolenyl alcohol could undergo autooxidation, the antimicrobial activities of saturated primary alcohols of similar molecular sizes against Streptococcus mutans BHT were evaluated. Tridecan-1-ol was identified as the most active compound, eliciting a bacteriostatic effect at concentrations at which growth occurred in the presence of other saturated alcohols or linolenyl alcohol. Evidence is also presented that the combined use of tridecan-1-ol and gentamicin sulfate produces a synergistic effect that is bactericidal to S. mutans BHT. A similar bactericidal response was observed when tridecan-1-ol was combined with other aminoglycosides or tested alone against other strains of S. mutans. PMID- 6508264 TI - Alterations in human fecal flora, including ingrowth of Clostridium difficile, related to cefoxitin therapy. AB - To evaluate the effects of parenteral cefoxitin therapy on human fecal flora, we cultured fecal specimens obtained from six patients before, during, and after therapy and used standard methods to identify and quantify all microorganisms. The major changes (observed in at least three patients) included the acquisition or proliferation of group D Streptococcus species, coagulase-negative Staphylococcus species, cefoxitin-resistant members of the family Enterobacteriaceae, Pseudomonas species, and various species of the Bacteroides fragilis group. The most striking finding was ingrowth of Clostridium difficile, noted in five of the six patients. There was concomitant eradication or decrease of cefoxitin-susceptible Enterobacteriaceae family members, Bacteroides species other than the B. fragilis group, Clostridium species other than C. difficile, and Lactobacillus species. These marked alterations of fecal flora may have important clinical consequences. PMID- 6508263 TI - Timentin versus piperacillin or moxalactam in the therapy of acute bacterial infections. AB - In a randomized comparative study, 116 patients with acute bacterial infections were treated with timentin (ticarcillin plus clavulanic acid) or a comparative agent (piperacillin for respiratory or urinary tract infections, and moxalactam for soft tissue infections). There were 91 clinically evaluated infections (timentin, 46; piperacillin, 29; moxalactam, 16). Twelve patients were bacteremic. A satisfactory clinical response occurred in all 46 patients treated with timentin and in 42 of the 45 treated with a comparative agent. Two clinical failures were due to superinfection (a Staphylococcus aureus pneumonia in the piperacillin group and an enterococcal skin infection in the moxalactam group), and one clinical failure was due to a primary S. aureus skin infection (moxalactam group). One wound isolate of Pseudomonas aeruginosa developed resistance to timentin during therapy (despite clinical improvement). Adverse reactions were uncommon but did include one patient treated with timentin who developed unexplained hallucinations. PMID- 6508265 TI - Comparison of antimicrobial susceptibility patterns of Campylobacter jejuni and Campylobacter coli. AB - To determine whether employing antibiograms is useful to separate Campylobacter jejuni and Campylobacter coli, we determined the MICs of 12 antibiotics for 104 human clinical strains and 74 swine strains. Of 74 swine strains, 5 (7%) were hippurate positive, as were 93 (89%) of 104 human strains. The 12 antimicrobial agents tested were ampicillin, amoxicillin, clindamycin, chloramphenicol, erythromycin, furazolidone, norfloxacin, nalidixic acid, rosoxacin, rosaramicin, tetracycline, and Sch 32063. Isolates from humans were significantly (P less than 0.001) more susceptible than swine strains to clindamycin, erythromycin, rosaramicin, and Sch 32063. Of 11 human hippurate-negative strains, 3 (27%) were resistant to clindamycin, erythromycin, rosaramicin, and Sch 32063, compared with 1 of 93 (1%) hippurate-positive strains. Nearly all human and swine strains were susceptible to furazolidone and nalidixic acid. Campylobacter isolates from humans and swine have different antibiograms, and the susceptibility to certain antibiotics, such as clindamycin, may be helpful for differentiation of C. jejuni from C. coli. PMID- 6508266 TI - Early synergistic interactions between amikacin and six beta-lactam antibiotics against multiply resistant members of the family Enterobacteriaceae. AB - An in vitro comparison of the early synergistic interaction between amikacin and each of six beta-lactam antibiotics was made by using time-kill curves against 48 multiply resistant members of the family Enterobacteriaceae. Overall, these six combinations demonstrated early synergism (greater than or equal to 2 logs of increased kill after 7 h of incubation) against the 48 strains on 74% (range, 67 to 85%) of occasions; cefotaxime-amikacin and piperacillin-amikacin were the most efficacious combinations. Antagonism was not observed with any of the combinations against any of the 48 Enterobacteriaceae strains tested. PMID- 6508267 TI - Evaluation of Sch 29482 in experimental syphilis and comparison with penicillin G benzathine in disseminated disease and localized infection. AB - The present study was designed to assess the in vivo activity of Sch 29482, a new penem antibiotic, against disseminated and localized Treponema pallidum infections in rabbits. Animals were inoculated either intravenously or intradermally. Randomized groups then received 25 or 50 mg of Sch 29482 per kilogram of body weight twice a day for 7 days, two weekly injections of 200,000 U of penicillin G benzathine for comparative purposes, or no antibiotic therapy. In both infection models, striking differences were noted between the untreated control rabbits and rabbits receiving penicillin G benzathine or high-dose Sch 29482. Intravenously infected rabbits did not develop disseminated lesions or orchitis, and chancres produced by intradermal infection regressed and healed rapidly after both treatment regimens. Infectivity studies also suggested that high-dose Sch 29482 and penicillin G benzathine were effective since the testes and lymph nodes of treated animals were free of infectious organisms. Treatment of animals with the lower dose of Sch 29482 represented borderline or suboptimal therapy, with a failure rate of one in four for each infection model. PMID- 6508268 TI - Wide-spectrum antibiotic activity of bovine granulocyte polypeptides. AB - The antibiotic activity of a polypeptide fraction purified from bovine granulocyte granules was tested against Escherichia coli, Pseudomonas aeruginosa, Salmonella typhimurium, Bacillus subtilis, Bacillus stearothermophilus, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis, Streptococcus pyogenes, and clinical isolates of Staphylococcus and Enterobacter spp. All of these bacterial species were susceptible to the antibiotic polypeptide(s), with MICs ranging from 3 to 100 micrograms of protein per ml. The antimicrobial activity was resistant to boiling and abolished by proteinase treatment. Saccharomyces cerevisiae and human fibroblasts grew normally in the presence of 100 and 50 micrograms of antibiotic polypeptide(s) per ml, respectively. [3H]thymidine incorporation into bacterial, but not fibroblast, DNA was efficiently and promptly inhibited by the antimicrobial polypeptide preparation. This suggests that its main target is a component of the system, which catalyzes and regulates the biosynthesis of bacterial DNA. PMID- 6508269 TI - Protection by D-amino acids against growth inhibition and lysis caused by beta lactam antibiotics. AB - D-Isomers of several amino acids completely protected growing cultures of Escherichia coli against all antibacterial effects of beta-lactam antibiotics up to approximately two to three times the MICs of the antibiotics. L-Isomers of amino acids were ineffective. Protection depended on the concentration and time of addition of the D-amino acids. This appears to be the first demonstration of natural products capable of reversing the antibacterial effects of beta-lactam antibiotics. PMID- 6508270 TI - Susceptibilities of 45 clinical isolates of Proteus penneri. AB - Patterns of susceptibility of 45 Proteus penneri clinical isolates to 14 antimicrobial agents were evaluated by a macrobroth dilution method. All strains were highly susceptible to ceftizoxime, ceftazidime, moxalactam, cefoxitin, gentamicin, tobramycin, netilmicin, and, with few exceptions, to amikacin, piperacillin, and cefoperazone. Most strains were susceptible to cefotaxime and ceftriaxone. All strains were resistant to cefazolin and cefsulodin. PMID- 6508271 TI - In vitro activity of WIN 49375 compared with those of other antibiotics in isolates from cancer patients. AB - The activity of WIN 49375 [6-fluoro-1, 4-dihydro-1-(methylamino)-7-(4-methyl-1 piperazinyl)-4-oxo-3- quinolinecarboxylic acid], a new synthetic quinolone, was tested in vitro against 587 clinical isolates. The MICs for 90% of isolates of Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae were 0.20, 1.56, and 0.39 microgram/ml, respectively. The MICs for 90% of isolates of Pseudomonas aeruginosa and Serratia marcescens were both 3.12 micrograms/ml. WIN 49375 was minimally active against gram-positive cocci. Its in vitro activity suggests that it may be useful for the treatment of gram-negative bacillary infections. PMID- 6508272 TI - Antimicrobial susceptibility of Branhamella catarrhalis isolates from bronchopulmonary infections. AB - Fifty-four clinical isolates of Branhamella catarrhalis from patients with bronchopulmonary infections were studied. The MICs for 50 and 90% of the isolates and the geometric mean MICs were determined for 11 antimicrobial agents. All the strains were resistant to trimethoprim but were susceptible to clavulanate potentiated amoxicillin (Augmentin; Beecham Research Laboratories, London), chloramphenicol, co-trimoxazole, erythromycin, cefotaxime, and cefuroxime. Beta lactamase-negative strains were uniformly susceptible to penicillin and ampicillin. PMID- 6508273 TI - Treatment of typhoid fever with cefamandole. AB - Cefamandole therapy was evaluated in nine patients with typhoid fever. Six patients, including all five who received the antibiotic by continuous intravenous drip (8.0 g daily), were cured. Dosage schedules resulting in maintenance of antibiotic concentrations in serum high above the MIC seemed to correlate well with treatment success. PMID- 6508274 TI - Biliary elimination of apalcillin in humans. AB - Apalcillin was administered intravenously as a single 1-g dose on day 8 after surgery to 10 cholecystectomized patients with T-tube drainage. A peak of 2,093 +/- standard error of the mean 859 micrograms/ml of bile was attained at 3 h after dosage. Biliary recovery over a 12-h period amounted to 12.2% of the dose. In 20 patients undergoing biliary surgery, apalcillin concentrations 1 h after a 1-g dose were 65.5 +/- 5.0, 3,680 +/- 551, and 2,552 +/- 627 micrograms/ml in serum, choledochal bile, and gallbladder bile, respectively. PMID- 6508275 TI - Conference on lignocellulose biodegradation. Sept. 15-16, 1983, Littlehampton, West Sussex, UK. Abstracts. PMID- 6508276 TI - Proceedings of the colloquium on the use of embryonic cell transplantation for correction of CNS disorders. Chestnut Hill, Mass., June 27-29, 1983. PMID- 6508277 TI - Embryonic brain grafts in an animal model of Parkinson's disease. Criteria for human application. PMID- 6508278 TI - Use of embryonic cell transplantation for correction of CNS disorders. PMID- 6508279 TI - Treatment of severe Parkinson's disease by intraventricular injection of dopamine. PMID- 6508280 TI - Moral perspectives in the use of embryonic cell transplantation for correction of nervous system disorders. PMID- 6508281 TI - Legal implications of the use of embryonic cells for transplants. PMID- 6508282 TI - Brain tissue transplantation research. PMID- 6508283 TI - Mechanism of neuroadenolysis of the pituitary for cancer pain control. AB - Several theories have been advanced to explain how neuroadenolysis of the pituitary (NALP) relieves cancer pain. Interference with hormonal regulation, interruption of pain pathways and a compensatory overproduction of brain endorphins have been proposed. The purpose of the present experimental study is to determine whether neuronal activity of the pituitary gland, as related to the primary somatosensory cortex (PSC), may be involved in the pain perception pathway influenced by NALP, using EEG and tooth pulp evoked potentials (TPEPs). Pituitary activity showed a high voltage slow activity which slowed after alcohol injection into the sella turcica. When naloxone was injected after NALP, a rhythmic high voltage activity appeared in the pituitary gland. After NALP, the TPEP recorded from the PSC disappeared, while NALP induced an increase in the amplitude of the TPEP in the pituitary gland. An injection of naloxone severely decreased this response in the pituitary gland, in contrast to changes in the PSC where the original response reappeared after an injection of naloxone. Our hypothesis is that an increase of TPEPs (hyperactivity) in the pituitary gland is produced after alcohol wounding (wounding effect), leading to a decrease of pain response in the sensory cortex (decrease of TPEPs). This wound effect may be influenced by endorphins, because naloxone, a specific antagonist of opiate receptors, reversed the changes in TPEPs in both places. PMID- 6508284 TI - Comparison of methods of enumerating coliforms after UV disinfection. AB - In view of the differences that have been found between the most-probable-number and membrane filtration methods for the recovery of coliforms from chlorinated samples, the survival of total and fecal coliforms in UV-irradiated effluent samples, as tested by the most-probable-number and standard single-step membrane filtration methods, was compared. There were no significant differences in the survival of total and fecal coliforms, as tested by the two methods. In a separate set of experiments comparing total and fecal coliform survival, as tested by the most-probable-number method, only a very small but statistically significant difference of 0.1 log survival units was found. For UV-disinfected wastewater effluents, standard one-step membrane filtration procedures are comparable to standard most-probable-number procedures. PMID- 6508285 TI - Bacterial dry matter content and biomass estimations. AB - Approximately 20% dry-matter content appears to be an accepted standard value for bacterial cells. We have found that the dry-matter content of bacteria may be more than twice as high as generally assumed. The main reason for the low estimates seems to be that proper corrections for intercellular water have not been made when estimating the wet weight of the cells. Using three different bacterial strains, we determined a dry-matter content of cells ranging from 31 to 57%, suggesting not only that the accepted standard value is much too low but also that it is far from standard. To convert bacterial biovolume into biomass (carbon content), we suggest that 0.22 g of C cm-3 should be used as a conversion factor. PMID- 6508286 TI - Production and characterization of antibody against diacetoxyscirpenol. AB - Antibodies against diacetoxyscirpenol (DAS) were obtained from rabbits after immunizing them with hemisuccinate or hemiglutarate derivatives of DAS conjugated to bovine serum albumin (BSA). DAS-hemiglutarate-BSA was found to be a much better immunogen than DAS-hemisuccinate-BSA. Competitive radioimmunoassay revealed that the antisera obtained from rabbits after immunization with DAS hemiglutarate-BSA showed high specificity toward DAS. The concentrations causing 50% displacement of radioactive DAS by unlabeled DAS, 4-monoacetoxyscirpenol (MAS), and 15-MAS were found to be 1.5, 130, and 300 ng per assay, respectively. Thus, the cross-reactivities for 4-MAS and 15-MAS are ca. 87 and 300 times weaker than that of DAS. Practically no cross-reaction (less than 5% displacement) was observed when deoxynivalenol, T-2 toxin, deoxyverrucarol, and scirpentriol were tested at a concentration of 2,000 ng/ml. PMID- 6508287 TI - Production and characterization of antibody against deoxyverrucarol. AB - Immunization of rabbits with deoxyverrucarol (DOVE) conjugated to bovine serum albumin resulted in antibodies bound with either tritiated DOVE or diacetoxyscirpenol (DAS), but not with T-2 toxin. The affinity of antibodies with DOVE was found to be much higher than with DAS. When [3H] DOVE was used as a marking ligand in the competitive radioimmunoassay, the concentrations causing 50% inhibition of binding radioactivities by unlabeled DOVE, verrucarol, verrucarin A, and 4-monoacetoxyscirpenol were found to be 0.32, 1,070, 9,500, and 10,000 ng per assay, respectively. T-2 toxin, 15-monoacetoxyscirpenol, and deoxynivalenol gave less than 20% inhibition at 10 micrograms per assay. However, when [3H] DAS was used as the marking ligand, the concentrations causing 50% inhibition by DOVE, DAS, and verrucarol were found to be in the 50 to 60 ng per assay range. The antibodies are thus highly specific to DOVE rather than a common trichothecene backbone. The possible use of this antiserum for assay of macrocyclic trichothecenes is discussed. PMID- 6508288 TI - Use of a computer to group actinomycetes for studies on the ecology of soil microorganisms. AB - A computer program has been prepared for grouping soil actinomycetes into cluster groups based on the presence or absence of aerial mycelium, the color of soluble pigment, and the shade of color of surface and reverse mycelium. The program automatically condenses cultures with wide ranges of characteristics into a limited number of groups and provides a permanent record so that comparisons can be made among experiments performed over a span of time. The program permits the grouping of large numbers of cultures with minimal laboratory effort and has proven useful in defining some of the ecological factors that lead to changed actinomycete populations in soils. PMID- 6508289 TI - Morphological and genetic effects of benomyl on polyploid brewing yeasts: isolation of auxotrophic mutants. AB - An enrichment procedure after ethyl methanesulfonate mutagenesis and exposure to the fungicide benomyl yielded mutants auxotrophic for several amino acids from two polyploid Saccharomyces spp. Benomyl treatment was found to have a marked morphological effect on polyploid Saccharomyces cerevisiae, causing cells to adopt a characteristic doublet cell morphology in which buds are nearly as large as the parent cells. Experiments in which nuclear division was monitored in benomyl-induced doublet cells by Giemsa nuclear staining demonstrated an unusual sequence of cytological events which culminated in the formation of binucleate parental and mononucleate bud components. The frequency of formation of doublet and binucleate parent cells was found to depend on the strain employed and the benomyl concentration administered. PMID- 6508290 TI - Reovirus removal and inactivation by slow-rate sand filtration. AB - Laboratory column studies were conducted at the Utah Water Research Laboratory, Logan, Utah, to evaluate reovirus removal from drinking water supplies by slow rate sand filtration (SSF). Columns, constructed to simulate a full-scale SSF field operation, were inoculated with reovirus at ca. 1,000-times-greater concentrations than those typically found in domestic sewage. Reovirus removal and inactivation were investigated as functions of filter maturity and other filter sand characteristics. Reovirus removal studies demonstrated that the SSF process is capable of reducing reovirus in influent water by a minimum of 4 log concentration units under certain conditions of water quality, flow rate, and sand bed construction. Infectious reovirus was not detected in effluent samples from any of the sand beds studied, after inoculation of the SSF columns; therefore, removal efficiencies were not affected significantly by characteristics, including age, of the two filter sands evaluated. Studies conducted with radioactively labeled reovirus demonstrated that reovirus removed from influent water was distributed throughout the entire length of the filter beds. Concentrations of reovirus in the filter sands decreased with increasing bed depth. The greatest removal occurred in the top few centimeters of all sand beds. No infectious reovirus could be detected in clean or mature sand bed media, indicating that reoviruses were inactivated in the filter. PMID- 6508291 TI - Extracellular metabolism of sucrose in a submerged culture of Claviceps purpurea: formation of monosaccharides and clavine alkaloids. AB - Transformation of extracellular sucrose during cultivation of Claviceps purpurea led to the formation of mono- and oligosaccharides. Maltose was a suitable substrate for submerged fermentation of alkaloids. Fermentation in a medium with maltose was characterized by an insignificant formation of glucans, intensive sporulation, suspension growth of mycelium, and a higher formation of elymoclavine. Glucose alone yielded low levels of total alkaloids and high glucan formation; on the other hand, glucose promoted the formation of elymoclavine. PMID- 6508292 TI - Isolation of Legionella species from drinking water. AB - Three different species of Legionella were recovered from samples of water taken from chlorinated public water supplies where no coliform bacteria were simultaneously detected. Five of 856 samples yielded Legionella isolates. Three isolates were identified as Legionella pneumophila serogroup 1, the fourth was identified as Legionella dumoffii, and the fifth was identified as Legionella jordanis. Studies to determine the survival of L. pneumophila Flint 1 serogroup 1 in tap water at various temperatures and in tap water with added sodium hypochlorite were done. These organisms were found to survive for 299 days in tap water at 24 and 5 degrees C but not at 35 degrees C. A concentration of at least 0.2 mg of residual chlorine per ml was required to eliminate at least 90% of L. pneumophila and Escherichia coli inocula in 2 h. PMID- 6508294 TI - Viability of pathogenic and nonpathogenic free-living amoebae in long-term storage at a range of temperatures. AB - The long-term storage of pathogenic and nonpathogenic strains of both Naegleria and Acanthamoeba spp. were tested on Page amoeba saline agar slopes for 24 months at room temperature and for 8 months at -10, 4, 10, and 15 degrees C. Acanthamoeba strains showed better survival potential than Naegleria strains, particularly when they were stored at temperatures equal to or lower than room temperature. PMID- 6508293 TI - Specificity of marine microbial surface interactions. AB - The macromolecular surface components involved in intraspecific cell surface interactions of the green microalga Chlorella vulgaris and closely associated bacteria were investigated. The specific surface attachment between this alga and its associated bacteria is mediated by lectin-like macromolecules associated with the surfaces of these cells. The binding activity of these surface polymers was inhibited by specific simple sugars; this suggests the involvement of specific receptor-ligand binding sites on the interactive surfaces. Epifluorescent microscopic evaluation of bacteria-alga interactions in the presence and absence of the macromolecules that mediate these interactions showed that the glycoproteins active in these processes were specific to the microbial sources from which they were obtained. The demonstration and definition of the specificity of these interactions in mixed microbial populations may play an important role in our understanding of the dynamics of marine microbial populations in the sea. PMID- 6508295 TI - Isolation of enterotoxigenic, hemolytic, and antibiotic-resistant Aeromonas hydrophila strains from infected fish in Bangladesh. AB - Strains of Aeromonas hydrophila isolated from skin infections of common freshwater fish in Bangladesh were tested for enterotoxin production, hemolysin production, and any correlation between these two activities. We also tested the resistance patterns of A. hydrophila to different drugs, especially in relation to ampicillin. The A. hydrophila strains produced an enterotoxin that was related to their beta-hemolytic activities. Production of beta-hemolysin may thus be an indicator of enterotoxicity. As 50% of the strains of A. hydrophila were found to be susceptible to 12.5 micrograms of ampicillin per ml, media containing this antibiotic may not be suitable for their isolation. PMID- 6508296 TI - Plasmid coding for transferable drug resistance in bacteria isolated from cultured rainbow trout. AB - The occurrence of drug resistance and plasmid-mediated transferability was investigated in 170 strains belonging to eight bacterial groups isolated from cultured rainbow trout. It was found that 87.6% of the strains were resistant to at least one drug, with the highest percentages of resistance being detected for ampicillin (54.7%), sulfadiazine (46.5%), nitrofurantoin (38.2%), and chloramphenicol (37.0%). Six enterobacteria, two Vibrio, and one Aeromonas isolate transferred resistance factors to Escherichia coli K-12. The most common transmissible R factor determined resistance to chloramphenicol and sulfadiazine, demonstrating an association between a specific plasmid and the resistance pattern transferred. The presence of chloramphenicol in fish food was detected by bioassay. In general, transfer frequencies were similar in primary and secondary matings, which indicate the potential water-borne dissemination of these R plasmids. PMID- 6508297 TI - Detection of aflatoxin D1 in ammoniated corn by mass spectrometry-mass spectrometry. AB - Corn cultured with Aspergillus flavus to produce a high level of aflatoxin was ammoniated at 37 degrees C for 21 days. An extract of the ammoniated corn was separated by thin-layer chromatography, followed by reversed-phase high-pressure liquid chromatography. Examination of the fractions by tandem mass spectrometry led to detection of aflatoxin D1 as a product of the corn ammoniation process. PMID- 6508298 TI - Intracellular glycosidases of human colon Bacteroides ovatus B4-11. AB - Activity of various glycosidases in the intracellular enzyme fraction of Bacteroides ovatus B4-11 was investigated. During 120 h of incubation at 37 degrees C, ca. 30% of the crude hemicellulose was hydrolyzed by an intracellular enzyme fraction of strain B4-11. Xylose was the major sugar released from crude hemicellulose. Glycosidases (alpha-1,6-glucosidase, alpha-1,4-glucosidase, beta 1,4-glucosidase, and beta-1,4-xylosidase) were induced in B. ovatus B4-11 by crude hemicellulose and heteroxylan. When B. ovatus B4-11 was grown on either crude hemicellulose or heteroxylan, the predominant enzyme in the intracellular enzyme fraction was beta-1,4-xylosidase. PMID- 6508299 TI - Potential mutagenic activity of some vitamin preparations in the human gut. AB - Rutin is a nonmutagenic flavonol glycoside, whereas its aglycone quercetin is mutagenic. Cell-free preparations from fecal cultures (fecal preparations) contain a beta-glucosidase that, when incubated with rutin, hydrolyzes it to quercetin. This activity can be further induced when rutin is added to the fecal culture from which the cell-free preparation is made. When vitamin pills that contain rutin are added to the cultures, this induction is equally effective. The vitamin extracts by themselves, like rutin, were nonmutagenic; however, when the vitamin extracts were incubated with fecal preparations containing induced beta glucosidase, a great increase in mutagenicity was observed. PMID- 6508301 TI - Inhibition of growth and patulin synthesis in Penicillium expansum by potassium sorbate and sodium propionate in culture. AB - Potassium sorbate and sodium propionate brought about a marked inhibition in the growth of Penicillium expansum and a proportionally greater inhibition in the synthesis of patulin by the mold. At inhibitor concentrations used commercially in bakery products, propionate inhibited growth less efficiently than sorbate did but was a more effective inhibitor of patulin synthesis. PMID- 6508300 TI - Inhibitory effect of sterigmatocystin and 5,6-dimethoxysterigmatocystin on ATP synthesis in mitochondria. AB - The inhibitory effects of sterigmatocystin, O-methylsterigmatocystin, and 5,6 dimethoxysterigmatocystin on the ATP synthesis system in mitochondria were compared with that of aflatoxin B1, which disturbs the respiratory chain in mitochondria. Sterigmatocystin and 5,6-dimethoxysterigmatocystin were found to uncouple the oxidative phosphorylation process without causing depression of state 3 respiration. O-Methylsterigmatocystin did not exhibit uncoupling activity at the limited concentrations tested (due to its low solubility in an aqueous system). These compounds, as well as aflatoxin B1, elicited neither pseudo energized nor energized swelling of mitochondria and did not inhibit Ca2+-induced swelling of mitochondria. PMID- 6508302 TI - Microbial removal of wastewater organic compounds as a function of input concentration in soil columns. AB - The fate of six organic compounds during rapid infiltration of primary wastewater through soil columns was studied. Feed solutions were prepared which contained all six compounds in individual concentrations ranging from 1 to 1,000 micrograms/liter and were applied to separate soil columns on a flooding-drying schedule. Feed solutions and column effluents were analyzed for the compounds by XAD resin (Rohm and Haas Co.) extraction and gas chromatography-mass spectrometry during each of three successive inundation cycles. Breakthrough profiles of o phenylphenol were relatively consistent during the test, with fractional breakthrough (mass output/mass input) being independent of input concentration. Consistent profiles were also observed for 2-(methylthio)benzothiazole, although fractional breakthroughs were higher at lower input concentrations, indicating that removal processes were operating less efficiently at these levels. The behavior of p-dichlorobenzene was similar to that of 2-(methylthio)benzothiazole after the first inundation cycle, with the exception that increased fractional breakthroughs were observed at the highest input concentration as well. Microbial adaptation was evident for benzophenone, 2-methylnaphthalene, and p-(1,1,3,3 tetramethylbutyl)phenol, as indicated by increased removal efficiencies during successive inundation cycles, especially at the higher input concentrations. Column effluent concentrations of the latter two compounds were independent of input concentrations during the final stage of the test. Microbial activity and adaptation were confirmed for several of the compounds by using isotopes and measuring the extent of mineralization in batch tests with soil from one of the columns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508303 TI - Anaerobic inhibition of trace organic compound removal during rapid infiltration of wastewater. AB - When soil columns were operated aerobically on a flooding-drying schedule in a previous study, good removals were observed for several organic compounds at concentrations ranging from 1 to 1,000 micrograms per liter in primary wastewater. In this study, fractional breakthroughs of most compounds increased substantially once operating parameters were modified and the soil became anaerobic. These results imply that microbial removal of trace organic compounds can be inhibited if anaerobic conditions develop during rapid infiltration of wastewater. PMID- 6508304 TI - Simple method for isolation of 4-deoxynivalenol from rice inoculated with Fusarium graminearum. AB - A new method for preparative isolation of 4-deoxynivalenol (DON) is presented. This method avoids the loss of material during purification on silica gel by column chromatography. DON and 3-acetyldeoxynivalenol in crude extracts of rice inoculated with Fusarium graminearum were converted to triacetyldeoxynivalenol; the acetylated product was easier to purify by silica gel chromatography than DON is. After hydrolysis and further purification on a charcoal-alumina column, the 71% pure DON was recovered in yields as high as 450 mg of DON per kg of rice. Subsequent separation on a Sephadex LH20 column yielded DON that was greater than 90% pure. PMID- 6508305 TI - Recreational water quality analyses of the Colorado River corridor in Grand Canyon. AB - We intensively examined the recreational water quality of the Colorado River and 26 tributaries in Grand Canyon National Park over four consecutive summers. Highly ephemeral precipitation cycles and arid watershed hydrologies were the principal factors influencing water quality. Fecal coliforms (FC) in the river and in most tributaries were less than or equal to 10 FC 100 ml-1 and less than or equal to 20 FC 100 ml-1, respectively, during drought cycles. During rainfall cycles, FC densities were highly variable and often exceeded recreational contact standards. FC were not found to vary significantly in response to diurnal fluctuations in river stage height which resulted from hydroelectric stream flow regulation. River and tributary bottom sediments harbored FC in densities averaging 10 to 100 times those in the overlying waters. Sediment FC densities were not found to be reliable indicators of overlying water quality when storm flow and nonstorm flow periods were compared. PMID- 6508306 TI - Disinfection of bacteria attached to granular activated carbon. AB - Heterotrophic plate count bacteria, coliform organisms, and pathogenic microorganisms attached to granular activated carbon particles were examined for their susceptibility to chlorine disinfection. When these bacteria were grown on carbon particles and then disinfected with 2.0 mg of chlorine per liter (1.4 to 1.6 mg of free chlorine residual per liter after 1 h) for 1 h, no significant decrease in viable counts was observed. Washed cells attached to the surface of granular activated carbon particles showed similar resistance to chlorine, but a progressive increase in sublethal injury was found. Observations made by scanning electron microscope indicated that granular activated carbon was colonized by bacteria which grow in cracks and crevices and are coated by an extracellular slime layer. These data suggest a possible mechanism by which treatment and disinfection barriers can be penetrated and pathogenic bacteria may enter drinking water supplies. PMID- 6508307 TI - Effects of antimetabolites on the adhesion of an estuarine Vibrio sp. to polystyrene. AB - The effect of various metabolic inhibitors and antibiotics on the adhesion of an estuarine bacterium, Vibrio proteolytica, to polystyrene was investigated. Cells were either exposed to the substratum and the antimetabolite simultaneously or grown in the presence of a 25% MIC and presented the substratum in the absence of the antimetabolite. Based on the response elicited, these inhibitors could be divided into three classes: (i) those that had little or no effect on adhesion (fluorodeoxyuridine and nalidixic acid); (ii) those that only inhibited adhesion after growth at the 25% MIC (ampicillin, oxacillin, and streptomycin); and (iii) those that inhibited attachment when administered simultaneously with the substratum (azide, dinitrophenol, chloramphenicol, puromycin, azauridine, rifampin, p-chloromercuribenzoate, and cephalothin). Cells killed by heating, Formalin, or mercuric chloride treatment were also less adhesive than viable cells. Collectively, these results indicate that (i) physiologically active cells are more adhesive than dead or physiologically impaired cells, (ii) impairment of cell wall synthesis by beta-lactam antibiotics renders cells less adhesive, and (iii) energy production and protein synthesis (including transcription) are both involved in some aspect of the adhesion process, whereas DNA synthesis is not. PMID- 6508308 TI - Isolation and characterization of a new Cytophaga species implicated in a work related lung disease. AB - A yellow-pigmented, gram-negative, gliding bacterium isolated from an industrial water spray air humidification system was implicated as a causative agent in several occurrences of lung disease with hypersensitivity pneumonitis-like symptoms. The bacterium, designated WF-164, lacked microcysts or fruiting bodies and had a DNA base composition of 34.8 mol% of guanine plus cytosine. Gliding, flexing, nonflagellated cells measuring 0.3 by 3.5 to 8.9 micron were observed by using light and electron microscopy. Tests to determine utilization of selected carbohydrates revealed an amylolitic, chitinoclastic, noncellulytic bacterium. A number of additional biochemical and physiological tests were performed. DNA homology studies detected a 77.8% similarity to Cytophaga aquatilis (ATCC 29551). Comparisons of cellular fatty acid and carbohydrate contents of isolate WF-164 with a Flexibacter sp., several Cytophaga spp., and Flavobacterium reference strains revealed similar patterns to that of C. aquatilis. On the basis of these characteristics, isolate WF-164 was identified as a new Cytophaga sp. PMID- 6508309 TI - Acute toxicity of aminoglycoside antibiotics as an aid in detecting botulism. AB - Gentamicin sulfate or neomycin sulfate injected intraperitoneally into 24- to 27 g mice at a dose of 6.2 mg per mouse elicited botulism-like responses in less than 30 min, but a dose of 3.1 mg per mouse had no observable effect. The normally nontoxic 3.1-mg aminoglycoside dose aggravated the illness induced by an earlier injection of Clostridium botulinum type A or B toxin; it was usually lethal in 2 to 20 min if the preexisting illness was moderate to severe and worsened the condition of mice for about 30 min if the preexisting botulism was mild. The aminoglycoside had no effect when given shortly after the botulinum toxin was injected intraperitoneally; the sensitized state followed a latent period. It rapidly produced botulism-like effects when given to mice which had responded to a mixture of botulinum toxin and another mouse toxic agent with an illness that did not include signs of botulism. An unexpected illness devoid of botulism-like effects was encountered during intestinal colonization of mice by C. botulinum. The appearance of botulism-like signs soon after 3.1 mg of gentamicin sulfate was injected supported other suggestions that this illness included botulism that was masked by the effects of a second cause. PMID- 6508310 TI - Characterization of predominant bacteria from the colons of normal and dysenteric pigs. AB - Bacterial populations adherent to the mucosa of the proximal colons of weaned, healthy pigs were compared with populations from pigs with dysentery induced by inoculation with a culture of Treponema hyodysenteriae. Isolates (136) representative of the predominant flora adherent to colonic epithelia of normal pigs and isolates (162) from pigs with dysentery were cultured anaerobically on a rumen fluid-based medium and characterized. Most (71%) of the isolates from colonic epithelia of normal pigs were gram positive, whereas 88% of the epithelia associated isolates from pigs with dysentery were gram negative. The geometric mean of colony counts was 5.7 X 10(7)/cm2 of colonic tissue from three normal pigs and 7.7 X 10(8)/cm2 from four pigs with dysentery. A number of isolates obtained from contents of the lumens of normal pigs with dysentery were also characterized. Comparison of isolates from epithelial tissue and from contents of the lumens of the same pig indicated that these populations were different. Our results indicate that physiological changes that occur in the colons of pigs with dysentery are accompanied by marked changes in the microbial populations in the colons. The factors which regulate the population changes are not yet understood. PMID- 6508311 TI - Sensitivity of Legionella pneumophila to sunlight in fresh and marine waters. AB - Studies were carried out to assess the sunlight sensitivity of Legionella pneumophila suspended in fresh and marine waters. Comparison studies on sunlight sensitivity of lake water bacteria, Pseudomonas aeruginosa, Escherichia coli and Streptococcus faecalis, were also undertaken. The effects of full sunlight and polyacrylic-screened sunlight were monitored in the study. Results indicate that L. pneumophila cells are slightly more sensitive to sunlight in seawater than in fresh water. Enumeration of sunlight-stressed bacteria in fresh water was found to be dependent on the medium used, and the following order of sensitivity to sunlight, from least to most sensitive, was noted: natural lake water bacteria, L. pneumophila, P. aeruginosa, E. coli, and S. faecalis. PMID- 6508312 TI - Measurement of the surface free energy of bacterial cell surfaces and its relevance for adhesion. AB - An experimental technique is described to determine contact angles on bacterial layers deposited on cellulose triacetate filters. Measurements with water, water n-propanol mixtures, and alpha-bromonaphthalene were employed to calculate surface free energies of various oral bacteria. Differences of 30 to 40 erg cm-2 were obtained for four different bacterial species isolated from the human oral cavity, if the concept of dispersion and polar surface free energies is applied. The free energies obtained were used to calculate interfacial free energies of adhesion of these bacteria from saliva onto tooth surfaces. Bacterial adhesion is energetically unfavorable, if the enamel surface free energy is less than 50 erg cm-2. PMID- 6508313 TI - Role of stagnation and obstruction of water flow in isolation of Legionella pneumophila from hospital plumbing. AB - The stagnation of water in two of four hospital hot-water storage tanks found to contain Legionella pneumophila was reduced by keeping the two tanks continually on-line for 1 year. L. pneumophila colony counts in these two tanks fell quickly to low levels, whereas the organisms persisted in the two tanks that were not in use. L. pneumophila continued to be isolated from 50 to 100% of the hospital showerheads which were sampled during this period. We also examined aerators and other hospital faucet fixtures which obstruct water flow. L. pneumophila was isolated from 22 of 30 faucet aerators and 2 of 16 vacuum breakers but not from 26 nonobstructed faucets or 6 backflow preventers. Over a 7-month period, after nine faucet aerators were sterilized, 10 of 60 surveillance cultures revealed L. pneumophila, despite the inability to isolate the organism from the potable-water tanks in use. These data suggest that prevention of stagnation in hot-water tanks may be effective in reducing L. pneumophila concentrations in potable-water systems serving high-risk populations. We have also shown that faucet aerators, by providing a surface for L. pneumophila to colonize, can become secondary reservoirs for the organism in hospital plumbing. PMID- 6508314 TI - Numerical taxonomy of phenanthrene-degrading bacteria isolated from the Chesapeake Bay. AB - Phenanthrene-degrading bacteria were isolated from Chesapeake Bay samples by the use of a solid medium which had been overlaid with an ethanol solution of phenanthrene before inoculation. Eighteen representative strains of phenanthrene degrading bacteria with 21 type and reference bacteria were examined for 123 characteristics representing physiological, biochemical, and nutritional properties. Relationships between strains were computed with several similarity coefficients. The phenogram constructed by unweighted-pair-group arithmetic average linkage and use of the simple Jaccard (SJ) coefficient was used to identify seven phena. Phenanthrene-degrading bacteria were identified as Vibrio parahaemolyticus and Vibrio fluvialis by their clustering with type and reference strains. Several phenanthrene-degrading bacteria resembled Enterobacteriaceae family members, although some Vibrio-like phenanthrene degraders could not be identified. PMID- 6508315 TI - [Phase II study of KW 2083 [7-N-(p-hydroxyphenyl)-mitomycin C] in patients with various cancers]. AB - A phase II study of KW 2083 [7-N-(p-Hydroxyphenyl)-Mitomycin C] was carried out in 14 cases of stomach cancer, 5 of lung cancer, 5 of colon cancer and 5 other types of cancer. KW 2083 was intravenously injected at a dose of 40 mg/body weekly in 26 cases. Among 23 evaluable cases, partial response was obtained in 6 cases (26%). The PR cases were 4 of stomach cancer and 2 of lung cancer, the former being all undifferentiated adenocarcinoma. Regarding hematologic toxicities, thrombocytopenia was the most principal toxicity and an important weak point of KW 2083. Thrombocytopenia (less than 75,000/mm3) was observed in 13 cases (50%). Recovery took about 4 weeks, but by that time 3 cases had still not recovered to 75,000/mm3. leukocytopenia (less than 3,000/mm3) was observed in 17 cases (65%). Concerning gastrointestinal symptoms, anorexia occurred in 11 cases (42%), nausea and vomiting in 11 cases (42%), diarrhea in 1 case and stomatitis in 1 case. T1/2 (beta-phase) of KW 2083 was half that of Mitomycin C. PMID- 6508316 TI - [Tumor-regressive potency of soluble factors released from tumor-immune cells]. AB - Liposome-encapsulated soluble factors, which were prepared from activated peritoneal exudate cells or spleen cells by stimulation with tumor-associated antigens and Con A, successfully regressed line 10 tumors transplanted into strain 2 guinea pigs. By intralesional administration of these soluble factors, a tumor-regressive potency of 40-50% was attained. No direct cytotoxic activity of these factors was indicated against line 10 tumor cells in vitro. It is therefore postulated that liposome-encapsulated soluble factors activate immune cells which have accumulated around tumor cells which eventually leads to regression tumor. PMID- 6508317 TI - [Aggregation of monoclonal antibody A2B5 on fibrosarcoma in mice]. PMID- 6508318 TI - [Discovery and development of unknown potentialities of microorganisms with special reference to saframycin group antitumor antibiotics]. AB - After a long and energetic world-wide search for antibiotics from actinomycetes, the chances of finding new classes of biologically active compounds from these organisms seem to have drastically diminished. In this paper, sophisticated procedures for finding new potentialities of antibiotic-producing actinomycetes and isolating a novel class of antitumor antibiotics, the saframycins, are described. These antibiotics are satellite antibiotics which are co-produced in minute quantities with streptothricin by a strain of Streptomyces lavendulae. Saframycins, cyano-containing saframycin A in particular, are promising antitumor antibiotics because of their low toxicity to immunologically competent cells and organs, especially the bone marrow. Significant amplification of the yield of saframycin A was attained by the quite unexpected observation that the addition of cyanide to the culture broth significantly increased its production. Subsequent isolation of the saframycin A precursor, decyanosaframycin A or saframycin S, enabled us to prepare two kinds of labeled saframycin A which were critical for the elucidation of the unique molecular action mechanism of the antibiotic. On the basis of studies on saframycin biosynthesis, a method of preparing new saframycin derivatives using resting cells of the producing strain has been developed, and new saframycins with amino functional groups on their N pyruvoyl side chain were obtained. Their HCl salts are readily soluble in water and are expected to exhibit pharmacodynamic properties different from those of other saframycins. PMID- 6508319 TI - [Studies on antitumor activity of valinomicin]. AB - Streptomyces sp. No. 22 strain, which was freshly isolated from a soil sample froms Nossap Cape and considered to be closely related to Streptomyces alboviridis showed strong antitumor activity against L1210 culture established cells when incubated in glucose-starch bouillon under the usual conditions. An anti-L1210 substance was found at an early stage of mycelium development and in the filtrate. When extracted with organic solvents from the whole broth and purified with silica gel column chromatography, the substance was obtained as crystallized colorless platelets and chemically identified as the antifungal agent Valinomycin. The antitumor activity of Valinomycin was reported by A. J. Repta in 1981 as a result of the NCI screening test and was found to be effective against P-388 tumor. In an antitumor activity test carried out in our laboratory in vitro or/and in vivo, No. 22 substance was also revealed to be effective against P-388 tumor in host mice, KB cells, and so on. PMID- 6508320 TI - [Spergualin a novel antitumor antibiotic produced by Bacillus laterosporus]. AB - Spergualin, named after the spermidine and guanidine moieties in its structure, was isolated from culture broth Bacillus laterosporus of based on its greater growth-inhibitory activity against chick embryo fibroblasts (CEF) transformed by Rous sarcoma virus compared with that against normal CEF. The structure of spergualin was determined as (-)-(15S)-1-amino-19-guanidino-11, 15-dihydroxy-4, 9, 12-triazanonadecane-10, 13-dione. Spergualin is water-soluble, basic and a white powder. It shows cytotoxicity in vitro against mouse leukemias L1210 and L5178Y. It significantly prolongs the life span of mice transplanted with either of the above leukemic cells. It induces a strong and specific immunological effect on L1210 which has been maintained in our laboratory; L1210-transplanted CDF1 mice, once cured by spergualin, reject a second challenge of the leukemic cells. Spergualin hibits in growth in vitro of both Gram (+) and (-) bacteria at concentrations ranging from 6.25 to 100 micrograms/ml. PMID- 6508321 TI - [Induction of LAK cells in peritoneal cavity of mice after ip injection of OK-432 and antitumor effect of these LAK cells]. AB - More than 50% of BALB/c mice bearing BAMC-1 ascites tumor were completely cured after five consecutive (once every two days) ip injections of a 0.1 mg dose of OK 432, starting on day 2 of tumor implant. The antitumor effect of OK-432 was not abolished by prior anti-asialo GM1 serum treatment, which apparently caused the disappearance of NK cells. However in athymic nude mice or in antithymocyte globulin treated euthymic BALB/c mice, the same treatment increased the mice's length of survival, but they didn't recover from the tumor-death. Peritoneal exudate cells (PEC) obtained on day 12 from OK-432 treated BAMC-1 bearing mice were tested for cytotoxicity in vitro against fresh BAMC-1 tumor cells, NK resistant allogeneic tumor cells (EL4, P815 and B16) and NK-sensitive allogenic YAC-1 cells. These PEC were found to be capable of lysing syngeneic BAMC-1 tumor cells together with the other tumor cells, and the effect was abolished when PEC received anti-Thy 1 treatment. These results indicate that T-cells play a determinative role in the immunotherapeutic effect of OK-432. The cells responsible for killing BAMC-1 and other tumor cells appeared between day 8-12 in the peritoneal exudate and were characterized as a kind of lymphokine activated killer (LAK) cell. PMID- 6508322 TI - [Antitumor activity of bacterial fractions and related synthetic compounds]. AB - We have purified the cell-wall skeletons (CWS) of Mycobacterium bovis BCG, Nocardia rubra, Propionibacterium acnes and Listeria monocytogenes as the adjuvant-active principles of these bacterial cells. These cell-wall skeleton preparations were shown to have antitumor activities in experimental tumor systems. Especially BCG-CWS and N. rubra-CWS were applied for the treatment of human cancer. The synthetic immunoadjuvants such as cord factor, mycoloyl and quinonyl derivatives of N-acetylmuramyldipeptides were prepared and their immunological properties were investigated. The effectiveness of synthetic adjuvants on the stimulation of nonspecific host resistance against bacterial and viral infections was also discussed. PMID- 6508323 TI - [Low molecular weight immunomodulators produced by microorganisms]. AB - Immunomodulatory and antitumor activities of the low molecular weight, microbially-derived immunomodulators, bestatin and forphenicinol are reviewed. In addition, the inhibitory effects of the antitumor antibiotics, aclacinomycin and oxanosine, on the generation of suppressor cells are also represented. It is suggested that these substances will be useful for cancer treatment by chemotherapy and/or immunotherapy. PMID- 6508324 TI - [Immunotherapy with bestatin for acute non-lymphocytic leukemia (ANLL) in adults]. AB - A cooperative randomized controlled study of immunotherapy with bestatin for ANLL in adults was conducted at 16 institutions. After complete remissions were induced and consolidated with combination chemotherapy, patients were randomly allocated into two groups, one with maintenance chemotherapy alone (C) and the other with the same maintenance chemotherapy plus bestatin (B). Out of 115 patients entered in this study, 101 (B): 48, C: 53) were eligible. The 50% remission duration was 20.4 months for B compared with 11.1 months for C, and comparable 50% survivals were 33.3 and 18.9 months respectively. B had significantly longer remission duration and survival time than C. Remission duration and survival time in patients under 49 years of age were not significantly different in both groups. But in patients over 50 years of age B had significantly longer remission duration and survival time than C. Side effects of bestatin were mild and transitional. These data suggest the usefulness of bestatin for the treatment of adult acute non-lymphocytic leukemia. PMID- 6508325 TI - [Intra-arterial infusion of adriamycin in the treatment of locally advanced breast cancer]. AB - Intra-arterial infusion chemotherapy was performed in 27 patients with locally advanced breast cancer. Through two catheters placed in the subclavian artery and the internal mammary artery, 30-50 mg of ADM was injected intermittently with/without continuous infusion of 5-FU. Higher response rate was noted in cases treated with ADM alone (80.0%, 16/20) in comparison with ADM-5-FU (57.1%, 4/7). Overall response rate was 74.1% (20/27). The correlation between the total dose of ADM infused and the rate of tumor regression was observed. Out of 18 cases who received 120 mg or more of ADM, 16 cases (88.9%) showed tumor regression greater than 50%, in contrast to 4 of 9 (44.4%) cases who received less than 120 mg of ADM. A significantly higher concentration of ADM was detected in tumor tissues obtained one hour after intra-arterial injection of ADM, compared with patients who received intravenous injection of ADM. The side effects due to this course of treatment were considered to be tolerated. Prognostically, although no definite correlation was observed between clinical or pathological effects and survival rate, a more favorable prognosis seems to be expected with this treatment compared with other forms of therapy. PMID- 6508326 TI - Delayed hypersensitivity in drug-induced toxic epidermal necrolysis (TEN) PMID- 6508328 TI - Hyperbaric oxygen techniques. PMID- 6508327 TI - Methotrexate and etretinate in the treatment of psoriasis. PMID- 6508329 TI - Vitamin E and dapsone-induced hemolysis. AB - Sixteen patients, each receiving 100 mg of dapsone per day, were studied for evidence of hemolysis. Vitamin E (dl-alpha tocopherol acetate), 800 mg/day, was then administered for up to three months, and dapsone therapy was continued at the same dose. Hemolysis factors were reexamined immediately prior to cessation of vitamin E therapy. No substantial change was demonstrable for levels of hemoglobin, reticulocyte count, and haptoglobin at the end of vitamin E therapy, despite a significant rise in serum vitamin E levels. Erythrocyte survival measured in four patients before and at the end of vitamin E therapy also showed no substantial change. Erythrocyte Heinz body count, however, fell in nine of 15 patients studied, and none showed an increase in this measurement while receiving vitamin E. We conclude that in patients receiving dapsone at 100 mg/day, vitamin E therapy at 800 mg/day does not substantially ameliorate the hemolytic effect of this drug. PMID- 6508330 TI - Response of mycosis fungoides to topical chemotherapy with mechlorethamine. AB - Seventy-six patients with mycosis fungoides (MF) were given topical mechlorethamine hydrochloride therapy. Allergic contact hypersensitivity reactions to the drug developed in 51 patients (67.1%). Sixty-four patients of the original 76 continued therapy, with 43 (67.2%) achieving a complete remission and 12 (18.8%) achieving a partial remission. Stage I disease responded significantly better than did subsequent, more severe disease stages. The median times to complete remission were 5.6 months, 32.3 months, and 22.3 months for stage I, II, and III disease, respectively. The conditions of patients with contact sensitivity did not respond better than those of patients without contact sensitivity. Patients with substage A disease did not respond better patients with substage B disease. These findings are encouraging and indicate that the use of topically applied mechlorethamine for early-stage MF should be continued, despite the development of contact dermatitis to the drug. PMID- 6508331 TI - Amiodarone photosensitivity. AB - Amiodarone hydrochloride is currently being investigated in the United States as a cardiac antiarrhythmic agent. Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. In addition, corneal microdeposits of yellow-brown granules may occur. We report observations on a case of amiodarone photosensitivity and corneal deposits developing in a patient shortly after amiodarone therapy was begun. Symptoms included burning and stinging of the skin, with redness and swelling that developed immediately after sun exposure. Phototesting showed that the photoactivating wavelengths were primarily in the long-wave UV-A spectrum between 350 and 380 nm. Prior application of a 10% dioxybenzone sunscreen greatly reduced the phototest reaction. Four weeks after the patient stopped taking amiodarone, the UV-A sensitivity was still present but diminished, and by ten weeks it had disappeared. During this time, the corneal deposits were reduced in number. All ten patients we have treated so far with amiodarone for cardiac arrhythmias have shown a similar photosensitivity, indicating that this is probably a phototoxic reaction. PMID- 6508332 TI - Cryotherapy improves prurigo nodularis. AB - A 55-year-old black woman with an eight-year history of prurigo nodularis was treated successfully with blistering cryotherapy. Cryotherapy resulted in smooth macule formation and afforded extended relief of pruritus. Several standard modalities of treatment had been used previously and had resulted in only partial relief of symptoms and minimal reduction of nodule size. This case demonstrates that cryotherapy can be a useful therapeutic alternative for prurigo nodularis. PMID- 6508334 TI - Pathology quiz case 1: cutaneous leiomyoma (familial). PMID- 6508333 TI - Metastatic prostate carcinoma manifesting as penile nodules. AB - In three patients with prostate carcinoma, metastasis was manifested as nodular lesions about the corona and glans penis. One patient had priapism in addition. The patients had no other cutaneous metastatic lesions. Two of the patients died within two years of the appearance of the penile nodules, but the lesions in the third patient, followed up for one year to date, responded to intravenously administered mitomycin. PMID- 6508335 TI - Pathology quiz case 2: disseminated candidiasis. PMID- 6508336 TI - Perinatal transmission of hepatitis B. PMID- 6508337 TI - Malignant hyperpyrexia. PMID- 6508338 TI - Mycoplasma pneumoniae: acute illness, antibiotics, and subsequent pulmonary function. AB - One hundred and eight children presenting with Mycoplasma pneumoniae infection were assessed during the acute illness and followed for three years. The incidence of wheezing with the acute infection (40%) was greater than expected in a normal childhood population. The initial illness precipitated wheezing for the first time in some subjects but others wheezed only with the acute illness. In non-asthmatic subjects significant bronchodilator responsiveness was present one month after infection. Children given erythromycin during the first seven days of their illness had a significantly shorter fever duration compared with those treated inappropriately. No significant effects of treatment were noted on pulmonary function three years later but non-asthmatic children had abnormal mean forced expiratory volume in one second and forced expiratory flow after 50% of the expired vital capacity compared with 64 healthy controls. These findings indicate impaired function three years after initial infection. PMID- 6508339 TI - Pulmonary interstitial emphysema. AB - Forty one of 210 preterm infants ventilated for respiratory distress syndrome in a three year period had radiological evidence of pulmonary interstitial emphysema. The development of this condition was significantly associated with malpositioning of the endotracheal tube in a main bronchus and the use of high peak pressure ventilation. Pulmonary interstitial emphysema was associated with a significant increase in the number of pneumothoraces, intraventricular haemorrhages, and the need for prolonged respiratory support, but did not increase mortality. Although in 12 infants in whom fast rate ventilation was used there was a significant reduction in the number of pneumothoraces, outcome was not altered in any other way. Fast rate ventilation may be of greater benefit if initiated before the development of pulmonary interstitial emphysema. PMID- 6508340 TI - Costs and outcomes in a regional neonatal intensive care unit. AB - At the Birmingham Maternity Hospital the mean cost of caring for surviving infants who require neonatal intensive care ranges from approximately pounds 2500 (for infants above 1500 g birthweight), to pounds 5500 (for infants 1000 to 1499 g birthweight), to pounds 10 000 (for infants less than 1000 g birthweight). The mean cost of caring for non-survivors is pounds 1000 or less, with little difference between the birthweight groups. These figures are based on the lengths of stay in three treatment regimens-intensive care, high dependency care, and special care-the average daily costs of which are estimated to be pounds 235, pounds 122, and pounds 43 respectively. The survival of very low birthweight infants (less than 1500 g) at this hospital has improved from 42% to 73% since the introduction of regional funding for neonatal intensive care. This increase in survival has been brought about without undue disability in the survivors. PMID- 6508341 TI - Evaluation of a home based health record booklet. AB - Despite the widespread use of home based child health records of varying complexity in England, there is a notable absence of their evaluation. Such a record booklet developed in the West Lambeth Health Authority has been used by parents, doctors, and community nurses to build up an independent chronological record of a child's birth statistics, health, growth, immunisation, development checks, and contacts with health services. A randomised controlled evaluation of the record, analyses of entries in it, and a survey of the views of mothers and health professionals using the record have been carried out. The need for such a record was confirmed by those questioned and analyses of entries in the booklet helped to modify and improve it. The evaluation was unable to show, however, any effect of the record on immunisation and developmental assessment service uptake. Its value in improving communication between the numerous health and other care agencies was dependent on its proper use. PMID- 6508342 TI - Sudden unexpected infant death in a French county. AB - We report a study of sudden unexpected infant death (SUID) in a French county (Seine-Maritime) between 1978 and 1981 (rate of 2.71 per 1000 live births). The results agree with those of previous studies concerning sex ratio, seasonal variation, and peak age of death. No relation between gestational age and age of death was found. A comparison with matched living control infants was performed for 136 of the 207 total deaths for whom computerised medical data were available. Significant differences were found between these two groups in gestational age, birthweight, admission to a paediatric ward at birth, and proportion of single mothers. In analysing birthweight and gestational age separately, the birthweights of SUID cases were significantly lower than those of controls, whatever the gestational age. The converse was not true, however: in classifying infants by birthweight, a significant difference between the gestation period of SUID victims and controls was found only for low birthweight infants (less than 2500 g). It is considered that it may be possible to identify infants at particular risk of SUID within the group of babies admitted to hospital at birth for major problems, and a study is currently underway among infants born in Seine-Maritime in 1982. PMID- 6508343 TI - Coagulation defect of congenital tyrosinaemia. AB - Three infants with hereditary tyrosinaemia had a severe coagulation defect due to a combination of deficient hepatic synthesis of clotting factors and a consumption coagulopathy. In all three plasma failed to clot normally with the venom of Bothrops atrox (Reptilase) and we attribute this to a defect of fibrinogen (dysfibrinogenaemia). Treatment was unsuccessful, and all died. PMID- 6508345 TI - Paediatric referral to a child psychiatrist. PMID- 6508344 TI - Postnatal breast development of preterm infants. An index of gonadal function. AB - Development of breast nodules after birth was examined in 17 preterm infants; nodules developed regularly in girls but not boys. It is concluded that the pituitary-gonadal axis of preterm infants is active in the months after birth and that in preterm infants there is a definite phase of breast growth in early postnatal life. PMID- 6508346 TI - Hyponatraemia in preterm infants--arginine vasopressin secretion. PMID- 6508347 TI - Urinary albumin excretion in school children. PMID- 6508348 TI - Congenital diaphragmatic hernia: association between pulmonary vascular resistance and plasma thromboxane concentrations. PMID- 6508349 TI - Medical contribution to the management of dyslexia. PMID- 6508350 TI - Inquiries into perinatal and early childhood deaths in a health care district. PMID- 6508351 TI - Clinical features and prognosis of Reye's syndrome. PMID- 6508352 TI - Respiratory health at a pulpmill in British Columbia. AB - The respiratory parameters of 392 white male pulpmill workers were measured by standardized procedures and compared with those of 310 white male rail yard workers. The pulpmill workers complained more frequently of wheezing and chest tightness and missed work more commonly because of chest illness as compared with the rail yard workers. Significant airflow obstruction was noted in nonsmokers who worked in the bleach plant, and it was most striking in the younger members of this group. The principal environmental contaminant in this area was chlorine at levels generally below current permissible concentrations. Members of the maintenance group--especially older members--demonstrated significantly lower forced vital capacity compared to the rail yard workers. PMID- 6508353 TI - Effects of smoking on pulmonary function and symptomatology in occupationally exposed groups. AB - Records of 3006 employees of nine companies in southeast Texas screened by a local lung association during the years 1974-1975 were examined to assess the effect of smoking, age, and occupational and residential ambient air pollution exposure. The effects of smoking and occupational exposure were strong when tested against a respiratory morbidity response questionnaire considered to be diagnostic for early-stage bronchitis. Occupational exposure lost statistical significance after place of residence was controlled in the analysis. Smoking and age variables exhibited significant effects when the response variable was pulmonary function test results. The differences between questionnaire and pulmonary function test results may indicate early-stage vs. later-stage respiratory morbidity ascertainment. Agreement in classifying "abnormal" subjects with these two methods decreased with increasing levels of smoking. PMID- 6508354 TI - Combined effect of sulfur dioxide and cold in exercising asthmatics. AB - Twenty-four asthmatic volunteers were exposed to 0, 0.3, and 0.6 ppm sulfur dioxide (SO2) in purified background air at each of three temperatures--21 degrees, 7 degrees, and -6 degrees C--in a controlled-environment chamber. Relative humidity was approximately 80%. Exposures consisted of 5 min heavy exercise periods plus brief warmup and cooldown periods. Airway resistance, thoracic gas volume, and symptoms were measured immediately before and after exposure. For the group, increasing SO2 concentration and decreasing temperature were associated with statistically significant unfavorable effects on airway resistance and respiratory symptoms, as expected from previous findings. Effects of SO2 and cold usually appeared to combine in an additive or less-than-additive fashion; there was little evidence of synergism. Individuals' response patterns were variable: a few suggested synergism, but others suggested a mitigating effect of cold on the bronchoconstrictive response to SO2. PMID- 6508355 TI - A re-evaluation of radiological evidence from a study of U.S. strip coal miners. AB - In 1972, the U.S. Public Health Service examined 1438 workers employed at seven bituminous and one anthracite U.S. strip coal mines. One conclusion from the study was that workers without previous dust exposures were not at risk of category 2 or higher pneumoconiosis from their strip coal mining environment. Because of recent concerns for silicosis among strip coal miners, the radiographs were reinterpreted and the data re-evaluated. In addition, data from respirable coal mine dust samples collected from 1972 to 1979 in all surface coal mines were analyzed. The results showed that category 2 or higher pneumoconiosis was prevalent among strip coal miners with experience in an underground coal mine. Among those without underground coal mine experience, category 2 or higher was prevalent among anthracite strip miners, but not among bituminous strip miners. Average respirable coal mine dust exposures in the anthracite mine were less than 1 mg/m3 prior to 1975 and, coupled with the radiographic findings, suggest further study of the efficacy of the 2 mg/m3 U.S. Federal surface coal mine dust standard in anthracite coal mines. PMID- 6508356 TI - A report of occupational deaths attributed to fluorocarbon-113. AB - This study reports two occupational deaths resulting from exposure to fluorocarbon-113 (1,1,2-trichloro-1,2,2-trifluoroethane; FC-113) in enclosed and confined spaces. One incident involved a worker who was exposed to FC-113 after entering a small degreasing tank to clean it. The second case involved a significant spill of FC-113 onboard a marine vessel. The incidents are compared to other fatal exposures. PMID- 6508357 TI - Altitude and mortality from chronic obstructive lung disease in New Mexico. AB - This study tested the hypothesis that altitude increases mortality from chronic obstructive lung disease (COLD) in New Mexico. A death was attributed to COLD if it resulted from chronic bronchitis, emphysema, or chronic obstructive lung disease, according to the Eighth Revision International Classification of Diseases, Adapted for Use in the United States. New Mexico's average annual ethnic and sex-specific mortality rates from COLD were calculated using death certificate data for the period 1969 to 1977. Deaths were assigned to altitude groups according to the county of residence at the time of death. Mortality rates for whites exceeded nationwide rates at all altitudes. However, mortality rates showed no increase with altitude. In fact, mortality from COLD decreased significantly with altitude for non-Hispanic white (Anglo) males (P less than .02). Immigration of Anglos to the lower altitudes of New Mexico probably explains these results. PMID- 6508358 TI - Tobacco smoke inhalation studies: a dosimetric comparison of different cigarette types. AB - As part of a long-term inhalation bioassay study of cigarette smoke in rats, a detailed dosimetric comparison of three groups of rats exposed to smoke from different cigarette types was performed. Groups of 20 female F-344 rats were exposed, in Maddox-ORNL smoking machines, to 14C-dotriacontane-labeled smoke from three types of research cigarettes: high tar-low nicotine, low tar-high nicotine, and high tar-high nicotine. Analyses of lung tissues revealed similar deposition amounts and patterns of particulate matter for all three cigarette types even though the chamber smoke concentrations varied substantially. These results suggested that for rats exposed to different types of cigarette smoke, the amount of particulate material deposited may not be a function of concentration only. The authors conclude that when comparing cigarette smoke inhalation studies of different cigarette types, exposure parameters and smoke composition may both influence the amount of smoke inhaled and deposited in the lung and other organs. PMID- 6508359 TI - A simple method for measuring the respiratory uptake of carbon monoxide in unanesthetized rats: an application to rats acutely exposed to ozone. AB - A simple method for measuring the respiratory uptake of carbon monoxide in unanesthetized rats is described. This method is easy to operate, inexpensive, and is a sensitive means for detecting effects of short-term exposure to low concentrations of ozone. In this study, the exposure of 6- to 7-wk-old rats to 2 ppm ozone for 3 hr and 1 ppm ozone for 3-6 hr resulted in an apparent decrease in carbon monoxide uptake without significant change in the lung weight. PMID- 6508360 TI - Estrone sulfatase activity in normal and abnormal endometrium. AB - We investigated the activity of estrone sulfatase in normal and pathological endometrium. In normal endometrium, the estrone sulfatase activity [pmol E1 X min 1 X (mg prot)-1] was 23.13 +/- 8.44 (mean +/- SD). An increase (p less than 0.01) of estrone sulfatase activity (62.81 +/- 21.97) was noted in mild endometrial hyperplasia. In focal hyperplasia (when the measurements were performed in the normal endometrial biopsies) such an increase was not noted (19.10 +/- 5.33). Estrone sulfatase activities of moderate hyperplasia (25.30 +/- 11.40) and endometrial neoplasia (30.30 +/- 9.57) were in the same range as in normal endometrium. Treatment with progestagen simultaneously reduced hyperplasia and estrone sulfatase activity. But when morphologically abnormal endometrium persisted after treatment, estrone sulfatase activity remained increased. The increase of estrone sulfatase activity appeared to be specific to mild endometrial hyperplasia. The role of estrone sulfatase in the pathogenesis of endometrial hyperplasia is discussed. PMID- 6508361 TI - Serum levels of placenta-specific tissue protein 12 (PP12) in pregnancies complicated by pre-eclampsia, diabetes or twins. AB - PP12 is one of the recently discovered soluble tissue antigens of the placenta. During normal pregnancy maternal serum PP12 levels rise during the first 18 weeks reaching a mean peak value of 139.9 +/- 40.26 micrograms/l; after that there is a fall to a mean value of 111.9 +/- 42.39 micrograms/l between 28 and 40 weeks. Significantly higher mean serum PP12 levels were found in the third trimester in two high risk pregnancy groups (281.09 +/- 117.08 micrograms/l in pre-eclamptic toxaemia and 203.71 +/- 73.77 micrograms/l in diabetes) while serum PP12 levels remained normal (114.94 +/- 58.06 micrograms/l) in twin pregnancy. The increase of serum PP12 concentration in toxaemia and in diabetes may be of considerable diagnostic significance. PMID- 6508362 TI - Squamous cell carcinoma in a cystic teratoma of the ovary. PMID- 6508363 TI - [Alternative models of quantal response in the joint action of toxins]. PMID- 6508365 TI - [Pharmacokinetic study of a toxic dose of methaqualone administered intravenously to rabbits]. PMID- 6508364 TI - A study of the effects of cobalt administered orally to rats. PMID- 6508366 TI - [Changes caused by tricyclic antidepressants on the contraction of the isolated rat ileum by potassium (110 mM)]. PMID- 6508367 TI - [Passive cutaneous anaphylaxis in Sprague-Dawley rats]. PMID- 6508368 TI - ["In vivo" immunologic and compound 48-80 degranulation of cutaneous rat mast cells]. PMID- 6508369 TI - Updated review of oral anticoagulants resistance. A case report. PMID- 6508370 TI - [The action of GABA in arrhythmias induced by CaCl2 in the anesthetized rat]. PMID- 6508371 TI - [Methods of anatomoclinical study. Requirements of the technic]. PMID- 6508372 TI - [Anatomopathological aspects of fibromatosis]. PMID- 6508373 TI - [Electron microscopy in the diagnosis of fibroblastic tumors]. PMID- 6508374 TI - [Liposarcoma of the limbs]. PMID- 6508375 TI - [Sarcomas originating in the muscles of the limbs]. PMID- 6508376 TI - [Diagnosis and prognosis of breast lesions. Value of 3 immunological markers: fibronectin, carcinoembryonic antigen and bovine lactalbumin. Study of 40 cases]. PMID- 6508377 TI - [Histopathological aspects of lymph nodes in the prodromal phase of the acquired immunodeficiency syndrome and related conditions]. PMID- 6508378 TI - [Postembolic pulmonary artery hypertension. Necropsy study of 41 cases]. PMID- 6508379 TI - [Comparative morphogenesis of chorioangioma in singleton and twin pregnancies]. PMID- 6508380 TI - [Structure and histophysiology of the sinusoidal wall]. PMID- 6508381 TI - [Mesenchymatous hepatitis. Primary or secondary nontumoral lesions of the hepatic mesenchyma]. PMID- 6508382 TI - [Granulomatous hepatitis]. PMID- 6508383 TI - [Perisinusoidal fibrosis]. PMID- 6508384 TI - [Peliosis hepatis and sinusoidal dilatation]. PMID- 6508385 TI - [The hepatic sinusoid in hematologic pathology]. PMID- 6508386 TI - [Perisinusoidal hepatic deposits. Symptomatology and identification]. PMID- 6508387 TI - [Microfilaria in cervicovaginal smears in Gabon]. PMID- 6508388 TI - [Simple technologies for the water supply in developing countries]. PMID- 6508389 TI - [Intestinal schistosomiasis in the Ruzizi Valley (Burundi): preliminary studies]. PMID- 6508390 TI - [Recent findings on the transmission of onchocerciasis in Kinsuka, Kinshasa, Zaire]. PMID- 6508391 TI - [Clinical evaluation of antipneumococcal vaccination in children wtih homozygous sickle cell disease]. PMID- 6508392 TI - Late reversal reaction after combined treatment of a patient with multibacillary leprosy. PMID- 6508393 TI - Serodiagnosis of trypanosomiasis in dromedary camels using a card agglutination test set (Testryp CATT). PMID- 6508394 TI - Prevalence of trichinosis in pigs in Oyo State of Nigeria. PMID- 6508395 TI - Failure patterns following curative resection of colonic carcinoma. AB - To identify patterns of failure following curative resection of colonic (nonrectal) carcinoma, the medical records of 533 patients undergoing resection with curative intent were reviewed. The overall local failure rate was 19% (102/533 patients) with 32 patients having local failure alone and 70 patients having concurrent local failure and distant metastases. The incidence of local failure rose with advancing stage of disease. Tumors staged B3, C2, and C3 had local failure rates in excess of 30%. Local failures occurred predominantly in tumor bed and adjoining structures (82%) and not by regional nodal failure (18%). One hundred thirty-one patients (25%) developed distant metastases. One hundred ten patients (84%) failed in the abdomen-liver, peritoneal seeding, para-aortic, or portahepatic lymph nodes. Patients with Stage B3, C2, and C3 tumors were found to have abdominal failure rates (excluding local failure) of greater than 20%. The highest failure rates in the liver were in Stage C2 and C3 patients in which the subsequent development of liver metastases was 29% and 31%, respectively. In Stage C3, peritoneal seeding and abdominal lymph node failure occurred in 18% and 14% of the patients, respectively. PMID- 6508396 TI - Plasma cholecystokinin response to a liquid fat meal in vagotomized patients. AB - Since previous studies have suggested that in patients with truncal vagotomy (TV) the plasma cholecystokinin (CCK) secretion in response to nutrients is impaired, we have measured the plasma CCK response to a liquid fat meal (250 ml 20% Intralipid) in six patients with TV and pyloroplasty. We have compared the results with those obtained in eight normal subjects, six patients with duodenal ulcer, and eight patients with highly selective vagotomy (HSV). Plasma CCK concentrations were measured by a sensitive and specific radioimmunoassay employing antibody T204 directed against the sulphated tyrosine region of CCK. Basal plasma CCK concentrations were not significantly different among the four groups studied (2.1 +/- 0.4 pmol/l in normal subjects, 2.8 +/- 0.5 pmol/l in duodenal ulcer patients, 3.1 +/- 0.5 pmol/l in patients with TV, and 2.7 +/- 0.5 pmol/l in patients with HSV). The increments in plasma CCK after ingestion of the fat meal in patients with TV (15.7 +/- 3.1 pmol/l) and HSV (14.9 +/- 1.6 pmol/l) were significantly higher (p less than 0.01) than those in normal subjects (4.8 +/- 0.9 pmol/l) and in patients with duodenal ulcer (5.5 +/- 0.6 pmol/l). Similarly, the integrated plasma CCK secretions in patients with TV (554 +/- 139 pmol/l, 120 min) and in patients with HSV (876 +/- 132 pmol/l, 120 min) were significantly increased (p less than 0.05) compared to those in normal subjects (187 +/- 29 pmol/l, 120 min) and in patients with duodenal ulcer (264 +/- 35 pmol/l, 120 min). It is concluded that patients with TV and HSV show an increased plasma CCK secretion in response to a liquid test meal. PMID- 6508398 TI - Management of injury to the spleen in adults. Results of early operation and observation. AB - Seventy-seven adults with splenic trauma were treated at a Level I Trauma Center during a 4-year period. Sixty-seven patients had early operation (55 splenectomy, nine splenorrhaphy, three partial splenectomy). Ten adults with stable vital signs were initially managed by observation without operation. Patients who had other intra-abdominal injuries were more likely to have an early operation and splenectomy. Patients who had a lesser transfusion requirement were more likely to have initial nonoperative management. Only three of the 10 patients who were managed initially by observation avoided eventual operation. Six of the seven patients who failed observation management required splenectomy. Patients with isolated splenic injuries had a significantly shorter hospital stay after an early operation than after observation without operation (p less than 0.05). We recommend early operation for the management of splenic injury in adults. Observation of isolated splenic injuries frequently is unsuccessful in adults and unnecessarily prolongs hospital stay. PMID- 6508397 TI - Cystoduodenostomy. New perspectives. AB - Cystoduodenostomy for internal drainage of pancreatic pseudocysts has been both condemned and condoned. The current study reports the largest personal experience with a single method of cystoduodenostomy. Transduodenal cystoduodenostomy was performed in 14 cases followed an average of 39 months without mortality, fistula formation, abscess, or hemorrhage. Recurrent pseudocysts developed in two patients, neither in the pancreatic head. In a 15-year combined review of surgical procedures for pancreatic pseudocyst, transduodenal cystoduodenostomy evidenced mortality rates similar to other forms of internal drainage. In direct contrast, laterolateral cystoduodenostomy by suture anastomosis resulted in a 70% mortality rate and should rarely, if ever, be performed. PMID- 6508399 TI - Predictability and maintenance of portal flow patterns after small-diameter portacaval H-grafts in man. AB - Patients undergoing small-diameter (8, 10, 12, and 14 mm) portacaval H-grafts were followed up to 3.5 years. Eight- and 10-mm grafts maintained prograde portal perfusion in 50% of the patients. Follow-up studies performed from 6 to 36 months after surgery show late shunt patency to be 97%. Recurrent variceal hemorrhage has not occurred in any patients. Direction of portal flow after a shunt was related to the size of the portal vein and the size of the shunt. If the shunt diameter was less than 50% that of the portal vein measured on the preoperative angiogram, portal flow was prograde. Encephalopathy rates remained significantly lower in patients with prograde flow after small diameter (8 and 10 mm) portacaval H-graft (p = .0.1). If thrombosis and encephalopathy rates remain low, the small-diameter, polytetrafluoroethylene portacaval H-graft is an attractive alternative to standard portacaval and mesocaval shunts. PMID- 6508400 TI - Exclusion of nonisolated splenic vein in distal splenorenal shunt for prevention of portal malcirculation. AB - In an attempt to prevent portoprival malcirculation after distal splenorenal shunt (DSRS), a splenic hilar renal shunt (HRS) with proximal flush ligation of splenic vein was designed. To accomplish this procedure, two methods were compared: HRS alone (Group A) and HRS plus proximal flush ligation of the splenic vein (Group B). In Group A, which included 20 cirrhotic patients with esophageal varices, angiographic as well as pulsed Doppler flowmetric follow-up study revealed a portal thrombosis in two patients and severe narrowing of a portal vein in another two. Considerable stealing flow was observed in these four patients. In the Group B series, which included 33 cirrhotic patients, there were no gross changes in the portal hemodynamics. Normal prograde portal flow was confirmed by Doppler flowmeter in this series including 14 patients of more than 8 months after surgery. When the amount of nonisolated splenic vein embedded in the pancreas is minimized, portal malcirculation after distal splenorenal shunt can, to a great extent, be prevented. PMID- 6508401 TI - Successful treatment of Caroli's disease by hepatic resection. Report of six patients. AB - Caroli's disease is a congenital disease of cystic or saccular dilatation of the intrahepatic bile ducts. There are two disease entities: a simple type and a periportal fibrosis type. Frequent complications with the simple type are recurrent cholangitis, liver abscess, intraductal lithiasis, abdominal pain, and fever that often lead to fatal sepsis. Development of portal hypertension and esophageal varices is usually a final feature of the periportal fibrosis type. Malignancies are also possible complications with Caroli's disease. During the recent 13 years, the author had experiences with eight patients with Caroli's disease of the simple type; six of these eight underwent hepatic resection: right lobectomy in two, left lobectomy in three, and left lateral segmentectomy in one. Other two patients died of sepsis and cholangiocellular carcinoma, respectively. All six patients with hepatic resections were relieved from the disabling symptoms after surgery and have had no recurrent hepatobiliary problems for 3 months to 13 years. Hepatic resection may be indicated for more patients than previously assumed in the treatment of Caroli's disease of the simple type. PMID- 6508402 TI - Computerized 24-hour ambulatory esophageal pH monitoring and esophagogastroduodenoscopy in the reflux patient. A comparative study. AB - Ambulatory 24-hour esophageal pH monitoring and esophagogastroduodenoscopy were performed in 72 patients with symptoms suggestive of gastroesophageal reflux. Additionally, 22 asymptomatic healthy volunteers underwent pH monitoring. In patients with classic reflux symptoms and endoscopic esophagitis, a mean of 5.41 minutes/hour of reflux below pH 4 was found compared to 0.70 minutes/hour in controls (p less than 0.0001). The mean number and duration of reflux events in this group were 1.51 events/hour and 4.0 minutes/event, compared with 0.31 events/hour and 2.26 minutes/event in volunteers (p less than 0.001, p less than 0.01). A new system for ambulatory esophageal pH monitoring is presented using a pH-sensitive radiotelemetry pill or a pH probe and computerized methods for ambulatory data collection, analysis, and storage. An overall sensitivity of 76% was obtained with a 91% selectivity for detection of acid reflux in 51 patients having classic symptoms of gastroesophageal reflux. Ambulatory pH monitoring was positive for acid reflux in seven of 11 patients with normal endoscopic findings. Conversely, eight of 12 patients with normal pH monitoring had endoscopic esophagitis. In 19 patients presenting with atypical symptoms or previous gastric surgery, endoscopic findings were normal in 15. Nine of these 15 were identified as acid refluxers by pH monitoring. A combined approach using both pH monitoring and endoscopy is warranted for maximal detection and quantification of disease. A clear clinical role for pH monitoring is seen in the early diagnosis of acid reflux, particularly in patients having normal endoscopic findings with nonspecific gastrointestinal complaints or previous gastric operations. PMID- 6508403 TI - Survival after high or low ligation of the inferior mesenteric artery during curative surgery for rectal cancer. AB - In an attempt to determine whether "high ligation" of the inferior mesenteric artery during surgery for cancer of the rectum and rectosigmoid confers any significant 5-year survival advantage over "low ligation," the outcome of 1370 patients was reviewed. There were 784 patients in whom the inferior mesenteric artery was ligated below the origin of the left colic artery (low ligation) and 586 in whom it was ligated above this level (high ligation). The distribution of histologic grades of the tumors and incidence of venous invasion were similar in both groups. Five-year follow-up was complete in 98.5%. No difference in the crude or age-corrected 5-year survival was found for patients with Dukes A, B, C overall, or C1 tumors, whether having had a low or high ligation. In hopes of identifying a population that benefited from high ligation, C1 patients were further subgrouped according to tumor location and number of involved lymph nodes. However, in no such subgroup was any significant high ligation advantage seen. In conclusion, high ligation of the inferior mesenteric artery has not been found to improve 5-year survival in patients with cancer of the rectum or rectosigmoid. PMID- 6508404 TI - Anatomic and physiologic characteristics of transplanted fetal rat intestine. AB - Avascular segments of fetal rat intestine transplanted to the subcutaneous tissues of host syngeneic rats will become vascularized and grow. This study more fully characterizes this tissue, which we call "neogut," and compares it to normal rat small intestine. Anatomy was studied with light microscopy and scanning and transmission electron microscopy; transport and electrophysiologic parameters were measured in full-thickness pieces of tissue mounted in Ussing chambers; motility patterns, including slow wave and spike activity, were recorded. Subtle anatomic differences (shortened villi and microvilli) were noted in neogut compared to normal small bowel. Both neogut and normal rat ileum demonstrated net mucosal to serosal transport of d-glucose; the magnitudes of the electrophysiologic parameters (PD, Isc, and G) were less in neogut than in ileum. Slow-wave frequency of neogut was slightly less than native small bowel while spike activity was increased. These data show that neogut has structural and physiologic characteristics similar to normal rat small bowel and offers hope that this tissue may provide a nutritionally useful accessory gut for the patient with critical short-gut syndrome. PMID- 6508405 TI - Regulation of neutrophil migratory function in burn injury by complement activation products. AB - Polymorphonuclear neutrophils were isolated from patients with burn injury and random mobility, chemotaxis in response to C5adesArg (as agarose-activated control serum) and to N-formyl-methionyl-leucyl-phenylalanine (F-Met-Leu-Phe) were assessed. For a group of eight patients identified as not experiencing systemic infection, all three neutrophil migratory functions were observed to fall below control levels, beginning 4 to 6 days following burn injury, and to return to control levels after 21 to 30 days of hospitalization. Over this time the chemotactic differential (distance chemotactic migration-distance random migration) for F-Met-Leu-Phe remained positive, while the chemotactic differential for activated serum became nil after postburn day 4. This temporal, specific loss of a chemotactic response to activated serum was associated with rises in immunoreactive plasma C3a and C5a. This pattern of loss of chemotactic function was associated with a selective loss of C5a but not F-Met-Leu-Phe binding activity. These results demonstrate that burn injury can alter neutrophil migratory functions generally, and specifically depress chemotactic responsiveness to activated serum. The mechanism of the latter phenomenon appears to be related to desensitization of circulating neutrophils to C5a due to complement activation. PMID- 6508406 TI - The frequency of local recurrence and microsatellites as a guide to reexcision margins for cutaneous malignant melanoma. AB - A retrospective study was undertaken of local, regional, and distant recurrences in 346 patients with primary melanomas of tumor thickness less than 1.0 mm that were excised with margins of normal skin varying between 0.1 cm and 5.0 cm or more. Prospective histopathologic examination of 284 melanomas for the presence of microsatellites was also performed and their effect upon the frequency of local recurrence was studied. Margins of excision did not influence the frequency of local, regional, or distant metastases. Four recurrences of in situ superficial spreading melanoma occurred, however, when very narrow margins of excision (0.5 cm or less) were employed. Microsatellites were uncommon with tumors less than 3.0 mm in thickness (2.8% of all tumors of less than 3.0 mm in thickness, taken together), but relatively frequent in association with thicker tumors (37%). Melanomas with microsatellites were associated with a greater frequency of local clinical metastasis than those without (14% vs. 3%). Removal of more than 1.0 cm of normal skin around a melanoma of less than 1.0 mm in thickness does not further reduce rates of recurrence of any type. The use of margins of 0.5 cm or less for melanomas with a radial growth phase does appear to result in an increased frequency of local recurrence of the primary melanoma with an epidermal in situ component. These recurrences can be prevented by the removal of 1.0 cm of normal skin around such a melanoma. Microsatellites constitute a risk factor for local recurrence, but are a relatively uncommon phenomenon at tumor thickness less than 3.0 mm. PMID- 6508407 TI - A prospective randomized study of regional extremity perfusion in patients with malignant melanoma. AB - One hundred seven patients presenting with malignant melanoma of the extremities were included in a prospective randomized study, which was conducted to evaluate the effectiveness of adjuvant hyperthermic regional cytostatic perfusion. In a control group (A, N = 54) the tumors were excised widely and the regional lymph nodes were dissected. The patients in the second group (B, N = 53) received additional hyperthermic (42 C) perfusion with melphalan. The mean follow-up observation period was 554 days. We chose the disease-free survival time as the criterion for success. The study could be discontinued prematurely, since the intermediate evaluation revealed a highly significant difference between the groups (p = 0.0001). We observed 21 local recurrences in the control group and four recurrences in the perfusion group. The retrospective breakdown by clinical stages also showed significant differences. The recurrence rate in the control group was 27.8% in Stage I, 31.6% in Stage II, and 58.8% in Stage III. In the perfusion group we observed recurrences equaling 5.6% in Stage I, 5.5% in Stage II, and 12.5% in Stage III. The differences between the groups based on the target-criterion of disease-free survival represent significance levels of p = 0.09 in Stage I, p = 0.03 in Stage II, and p = 0.003 in Stage III. We feel that on the evidence provided by our study, shown in the above results, the adjuvant application of regional hyperthermic cytostatic perfusion has proven itself to be superior to conventional procedures alone. PMID- 6508408 TI - Head and neck melanoma in 534 clinical Stage I patients. A prognostic factors analysis and results of surgical treatment. AB - Single and multifactorial analyses were used to evaluate prognosis and results of surgical treatment in 534 clinical Stage I patients with head and neck cutaneous melanoma treated at the University of Alabama in Birmingham (U.S.A.) and the University of Sydney (Australia). This computerized data base was prospectively accumulated in over 90% of cases. Melanomas were about equally distributed between men and women. They were located on the skin of the face in 47%, neck in 27%, scalp in 13%, and the ear in 13% of patients. Both the results of the prognostic factors analyses and the surgical treatment demonstrated that lentigo maligna melanoma (LMM) was distinct from the other two growth patterns, superficial spreading melanoma and nodular melanoma (SSM and NM). In a multifactorial analysis of the 453 patients with SSM and NM, the dominant prognostic variables were tumor thickness (p less than 0.00001), anatomic subsite (p = 0.0213), and ulceration (p = 0.0289). Patients with melanomas on the scalp or neck subsites fared worse than those with tumors located on the face or ear. The results differed for LMM, where thickness was not a significant predictor of survival, and the most dominant prognostic variable was ulceration (p = 0.0042). Local recurrence rates were low, being 2.4% for tumors less than 2.5 mm in thickness, but were 12.3% for tumors greater than or equal to 4.0 mm in thickness. Patients with SSM and NM lesions located on the head and neck had a lower survival rate than those with extremity melanomas in every tumor thickness category, although only those in the 0.76 to 1.49 mm thickness subgroup were significantly different (p = 0.0007). After 5 years of follow-up, patients who underwent an elective lymph node dissection for SSM and NM with a thickness range of 1.5 to 3.99 mm had a better survival (72%) than patients with melanomas of equivalent thickness whose initial treatment was wide excision alone (45%). LMM had a less aggressive biologic behavior compared to SSM or NM and was treated more conservatively. Thus, LMM lesions had an 85% 10-year survival rate with wide excision only, and there was no significant improvement in survival with ELND. Growth patterns, tumor thickness, ulceration, and anatomic subsites should be considered when evaluating risk factors and when making treatment decisions in head and neck melanoma patients. PMID- 6508409 TI - Surgical strategy in hyperparathyroidism due to solitary adenoma. AB - Based on the postulate that parathyroid adenoma is practically always a solitary lesion, unilateral parathyroidectomy including the homolateral normal parathyroid was applied as a principle in the treatment of this form of primary hyperparathyroidism. The exploration was confined to the adenoma side if this was the first to be explored. Intraoperative oil-red-O staining of frozen sections was used to exclude the possibility of a multiglandular involvement. This principle was applied in a consecutive series of 102 patients operated for hyperparathyroidism from 1977 to 1981 and diagnosed as parathyroid adenoma. In 43 patients where the abnormal gland was found on the side explored first, unilateral parathyroidectomy was performed on that side, avoiding exploration of the contralateral side. In 45 patients where normal glands were found on the side first explored, unilateral parathyroidectomy was performed on the contralateral side. In 14 patients other types of operations were performed as the above mentioned principle could not be achieved. At follow-up 1 to 5 years after surgery, no cases of hypocalcemia were recorded. The results of the different operations were compared as to early and late hypocalcemia. Early hypercalcemia was more pronounced after a bilateral exploration. Two of the patients who had an atypical operation had a permanent need for vitamin D in order to maintain an adequate serum calcium level. Surgical principles for various possible exploratory findings are outlined. These are based upon the idea of performing a unilateral parathyroidectomy whenever intraoperative oil-red-O staining excludes multiglandular involvement as a cause for the hyperparathyroidism. PMID- 6508411 TI - Pacemakers and the public image. PMID- 6508412 TI - Isolated mitral valve replacement with the Hancock bioprosthesis: a 13-year appraisal. AB - Four hundred seventy-six patients underwent isolated mitral valve replacement (MVR) with the glutaraldehyde-preserved porcine Hancock bioprosthesis from March, 1970, through December, 1981. There were 312 female and 164 male patients ranging in age at operation from 9 to 68 years (average, 53 years). Associated surgical procedures were performed in 35 patients. Hospital mortality was 13%, the main cause of death being low-output syndrome. The survivors were followed from 1.6 to 13.2 years (mean, 5.2 years). Cumulative duration of follow-up is 2,180 patient years and is 97% complete. Overall late mortality is 3.1 +/- 0.3% per patient year, and actuarial survival is 73.8 +/- 3.4% at 13 years. Embolic accidents occurred in 45 patients and were fatal in 13; the linearized incidence of postoperative systemic thromboemboli is 2.1 +/- 0.3% per patient-year. Reoperation was necessary in 49 patients: in 4 because of valve endocarditis, with 3 deaths; in 6 because of perivalvular leak, with no deaths; in 2 because of left atrial thrombosis; and in 37 because of valve dysfunction due to primary tissue failure, caused mainly by calcific degeneration of the tissue, with 5 operative deaths. Actuarial freedom from primary tissue failure is 58 +/- 6.6% at 13 years. Extended follow-up after MVR with the Hancock bioprosthesis confirms the satisfactory performance and low thrombogenicity of this device up to 13 years after operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508410 TI - Successful long-term limb salvage using cephalic vein bypass grafts. AB - Successful long-term limb salvage using cephalic vein bypass grafts was attained in 70 limbs of 67 patients over the past 11 years. The saphenous vein was absent in 76% and inadequate in 24% of the cases. Revascularization for limb salvage was carried out in 83%. Ninety per cent of the grafts were extended to the infrageniculate level while 56% were to a tibial vessel. Patency rates at 1, 3, and 5 years were 85%, 72%, and 68%, respectively. Limb salvage rate was 85% at 5 years and thereafter. There were no operative deaths or upper extremity morbidity. The 5-year survival rate was 50%. The results obtained with cephalic vein were comparable to those reported using saphenous vein but superior to those reported for nonautogenous bypass grafts. PMID- 6508413 TI - Late outcome of patients with Braunwald-Cutter mitral valve replacement. AB - Eighty patients who underwent mitral valve replacement (MVR) with Braunwald Cutter prostheses (54, single valve replacement; 26, multiple valve replacement) between December, 1972, and September, 1975, are discussed. The period of follow up ranged from 72 to 120 months with a mean of 84.6 months. For the hospital survivors, actuarial survival at ten years was 73 +/- 6.7% for patients with MVR alone and 30 +/- 17.5% for those with multiple valve replacement. The linearized rate of embolic complications in patients with MVR was 3.2% per year and in patients with multiple valve replacement, 1.5% per year. These low rates of embolism allow a favorable comparison of the Braunwald-Cutter valve with other mechanical prostheses. There was no evidence of serious poppet wear or poppet escape after ten years of the valve in the mitral and tricuspid positions. Thus, elective replacement of the Braunwald-Cutter valve from the atrioventricular position because of this potential problem is not considered necessary. In the aortic position, escape of the poppet from the valve has occurred as late as 101 months. The overall morbidity for the group was high. Only 34% of the patients having MVR and 12% of those with multiple valve replacement are expected to be alive and to remain free from any major complication ten years after operation. PMID- 6508415 TI - An alternative method for repair of partial anomalous pulmonary venous connection to the superior vena cava. AB - The surgical management of 15 patients with partial anomalous pulmonary venous connection (PAPVC) to the high superior vena cava (SVC) is described. This new technique redirects the anomalous pulmonary venous flow into the left atrium through the cardiac end of the SVC, transected and oversewn above the anomalous pulmonary vein or veins, by coaptation of the atrial septal defect (or of the surgically created septal defect in patients with an intact atrial septum) to the intracardiac orifice of the SVC. Normal SVC-right atrial flow is reconstituted by atriocavoplasty to the cephalad portion of the transected SVC. A 31-year-old woman with severe pulmonary hypertension died early in the series; this was the only death. Surviving patients enjoy full activity. Except for one symptomatic SVC obstruction due to technical error (since relieved), this technique has achieved total correction of these congenital defects with marked reduction in the undesirable postoperative sequelae often associated with other methods of repair. PMID- 6508414 TI - Use of the BioMedicus centrifugal pump in traumatic tears of the thoracic aorta. AB - Traumatic blunt thoracic aortic injury is a clinical entity of increasing incidence. After the diagnosis of traumatic tear of the aorta is made, there is some controversy over whether the aorta should be repaired using cardiopulmonary bypass, a heparinized shunt, or cross-clamping and graft interposition without a shunt or bypass. At Allegheny General Hospital, 19 patients were treated for traumatic tears of the thoracic aorta between July 1, 1977, and June 30, 1983. They can be divided into two groups: Group 1 (July 1, 1977, through October 31, 1981), in which no shunt or bypass or only a heparinized shunt was used, and Group 2 (November 1, 1981, through June 30, 1983), in which left atrium-femoral artery bypass was performed using a BioMedicus heparinless pump and tubing. Among the 10 patients in Group 1, 4 died and 2 had paraplegia postoperatively. Among the 9 patients in Group 2, 1 died and none experienced paraplegia following operation. We believe that the BioMedicus centrifugal pump is a simple, safe means of perfusing the lower body, kidneys, and spinal column without necessitating heparinization in a patient with multiple injuries or the placement of a cumbersome heparinized shunt. Because of the simplicity and the reliability demonstrated, this pump should be considered for use in all patients with traumatic tears of the thoracic aorta. PMID- 6508416 TI - Surgical treatment of congenital esophageal atresia. AB - Severe gastroesophageal reflux was found in 9 out of 18 infants with congenital esophageal atresia studied radiographically shortly after primary reconstruction. Pulmonary complications were recorded in 18 out of 32 similar patients in long term follow-up. Strictures at the level of the anastomosis were detectable in 18 out of 32 patients; eleven strictures were severe enough to require dilation or surgical revision. These findings suggest that early evaluation for gastroesophageal reflux may be useful in management of infants with esophageal atresia. The precautions taken preoperatively to prevent complications of gastroesophageal reflux should be continued in the postoperative interval unless a competent lower esophageal sphincter is demonstrated. PMID- 6508417 TI - A family of epidermoid lung cancer models. AB - A method of sustained release implantation has been developed whereby Silastic cylinders, impregnated with benzo[alpha]pyrene (BP) or methylcholanthrene (MCA) each at 2% (low dose) and 10% (high dose) concentrations, were inserted into the bronchus intermedius of hamsters. High-dose BP and MCA, and low-dose MCA had first-order exponential release rates: the half-time of release was 40 days for high-dose BP, 30 days for high-dose MCA, and 165 days for low-dose MCA. Release rate of low-dose BP was a second-order function: half-time of release was 40 days. Atypical squamous metaplasia was noted by 4 weeks in more than 65% of hamsters after insertion of each high-dose carcinogen but in less than 30% with the low-dose carcinogens. Carcinoma in situ was noted approximately 8 weeks after high-dose BP and 19 weeks after low-dose BP. At about 15 to 17 weeks after a high dose carcinogen, 64% of animals had invasive epidermoid cancer, whereas after a low-dose carcinogen, only 21% did. After 25 weeks of exposure to a high-dose carcinogen, more than 85% of hamsters had invasive epidermoid cancer; up to 52 weeks were required for invasive epidermoid cancer to develop in 30% after a low dose carcinogen. Measured by image analysis, nuclear deoxyribonucleic acid content of cells with severe atypical squamous metaplasia was greater than tetraploid (mean +/- standard deviation [SD], 3.77 +/- 1.4), whereas cells with invasive epidermoid cancer were suprahexaploid (mean +/- SD, 6.48 +/- 3.6). These differences are significant (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508418 TI - Hospital mortality and long-term survival in relation to preoperative function in elderly patients with bronchogenic carcinoma. AB - During an eight-year period, 82 patients 70 years of age or older were operated on for bronchogenic carcinoma. Hospital mortality was 15.9%, and five-year survival was 32%. Results of preoperative dynamic spirometry and bicycle ergometry were predictive for post-operative six-week mortality but not for long term survival. PMID- 6508419 TI - Thrombolytic therapy for superior vena caval thrombosis following superior vena cava-pulmonary artery anastomosis. AB - Immediate postoperative thrombosis of left superior vena cava-left pulmonary artery anastomosis in a modified Fontan procedure for single ventricle and pulmonary artery stenosis is described. Before thrombolytic therapy with streptokinase is initiated, confirmation of thrombosis by venography is mandatory to lessen the risk of cardiac tamponade or hemothorax. By this technique major surgical intervention is avoided, but close attention to the dose of streptokinase and the coagulation profile is essential. Measures to be taken if bleeding occurs with streptokinase therapy are described. PMID- 6508421 TI - A safe approach to left ventriculotomy. AB - Left ventriculotomy through an anatomically normal left ventricle is an increasingly frequent clinical necessity. In this regard, it is important to envision the epicardial projection of the papillary muscle in order to avoid injuring it. One should open the ventricle from the base (parallel to the left anterior descending or posterior descending coronary artery) and extend the incision apically while continuously palpating the papillary muscle. PMID- 6508420 TI - A new method of closing the ventricular septal defect in corrected transposition of the great arteries. AB - A new method of closing a perimembranous malalignment ventricular septal defect (VSD) in corrected transposition of the great arteries (TGA) of the [S,L,L] type is presented. The method consists of combined approaches to the VSD through both a right atriotomy and an aortotomy without a ventriculotomy. The VSD is patched obliquely from the morphological right ventricular side of the septum, cranially through the aortic valve to the left ventricular side of the septum, caudally through the mitral valve. Although this method has been successfully applied in only one adult patient, some advantages may be expected: (1) prevention of trauma to the His bundle, which runs along the anterosuperior rim of the VSD on the left ventricular side; and (2) prevention of trauma to the tricuspid, mitral, and aortic valves without having to open the ventricles. We believe that this new method warrants a further trial as possibly better for closure of the VSD in corrected TGA of the [S,L,L] type. PMID- 6508423 TI - Brachial plexus injury after open-heart surgery. PMID- 6508422 TI - Use of a sagittal oscillating saw for repeat sternotomy: a safer and simpler technique. AB - A method of repeat sternotomy using a microsagittal oscillating saw is described. We have found this method to be safer and simpler than previously described techniques. We have used this technique in more than 50 repeat sternotomies without a single complication related to the mediastinal reentry procedure. PMID- 6508425 TI - IVF/Andrology International Symposium. September 13-16, 1984. Kiawah, South Carolina, USA. Abstracts. PMID- 6508424 TI - Aortic growth after aortoplasty. PMID- 6508426 TI - Quantitative evaluation of the human spermatozoal motility and acrosome reaction in infertile oligozoospermic and fertile euspermic men. AB - Idiopathic oligozoospermia is one of the most important problems in Andrology, but up to now it is poorly understood because the often routine conventional semen parameters, unquestionably are not directly related to the evaluation of the morphological and functional integrity that determines the spermatozoan fertilizing capacity. A non complex strategy was designed to determine the presence of alterations in the functional integrity of the spermatozoa from infertile men with idiopathic oligozoospermia and from euspermic fertile men, by the quantitative analysis of the spermatozoan motility and the acrosome reaction. There was a lower percentage of acrosome reacted spermatozoa within the semen of the infertile men, accompanied with a significant decrease in the motility percentage, sperm velocity and motility index in comparison with semen from fertile men. These data strongly support a possible detrimental structural and functional integrity of the spermatozoa from the oligozoospermic men. PMID- 6508427 TI - Nonspermatozoal cells in human sperm: a study of 1243 subfertile and 253 fertile men. AB - The presence of nonspermatozoal cells (NSC) and, more particularly, of immature seminal line elements (ISLE) in the semen of subfertile men seems to result from a dysfunction of spermatogenesis. A positive correlation was found between the number of NSC and the degree of teratozoospermia, as well as between the number of NSC and the percentage of ISLE. The degree of teratozoospermia and the percentage of ISLE were also correlated. There was no correlation between the number of NSC or the percentage of ISLE and the length of sexual abstinence. The number of NSC and the initial sperm motility were negatively correlated, but this correlating seems to be directly related to teratozoospermia. In the control population a negative correlation was found between the percentage of normal spermatozoa and that of ISLE. The question is raised whether findings such as normozoospermia associated with a high percentage of ISLE should not lead to further examination of the results. PMID- 6508428 TI - Glycosamineglycan sulfate as acrosomal reaction-inducing factor of follicular fluid. AB - Follicular fluid from different mammalian species possesses two factors responsible for the induction of capacitation: a sperm-stimulating factor and an acrosomal reaction-inducing factor. The glycosamineglycan-sulfate (GAGs) extracted from pig follicular fluid induce acrosome reaction in pig spermatozoa which exhibit no morphological difference between the GAGs-induced reaction and the natural one. Acrosomal reaction commenced 30 min after the addition of GAGs and depended on GAGs concentration reaching 80% of acrosomal reacted spermatozoa after 6 hr of incubation with 7 mg of GAGs/ml. Chemical composition differs with the chemical data that characterize them as proteoglycans since those we obtained were practically protein free (2%). Another difference resides in the uronic acid content, which is almost twofold higher (59%). Electron microscope observations of the acrosomal reacted spermatozoa revealed that the addition of 10 mg/ml of trypsin soybean inhibitor did not interfere with any of the acrosomal reaction steps. The active capacitating factors may also originate from the follicular fluid released into the genital tract during ovulation. PMID- 6508429 TI - Heparin-induced release of DNA template restrictions in human sperm zinc-depleted nuclei. AB - The addition of heparin to human sperm zinc-depleted nuclei releases DNA template restrictions. Spermatozoa depleted of zinc were assayed for (3H-methyl), thymidine incorporation was observed (27,500 +/- 1,248 dpm of 3H methyl thymidine). Sperm cells incubated in the presence of 10 mg/ml of soybean trypsin inhibitor shows no effect in sperm nuclear swelling or in the release of DNA template restrictions. This process runs in a parallel fashion to the nuclear swelling induced by heparin, suggesting that swollen nuclei might be the source of DNA template. This was confirmed by autoradiographic studies, since all the sperm cells whose nuclei were judged swollen by morphological criteria also appeared labeled. The fact that there was no need for ATP generating system or of exogenous DNA polymerase emphasized the control role that zinc plays in the physiology of the human spermatozoa. PMID- 6508430 TI - Soluble Mn2+-dependent adenylate cyclase activity in the testis of the blue fox (Alopex lagopus). AB - Soluble Mn2+-dependent adenylate cyclase (MnAC) activity was found in testicular cytosol from blue foxes castrated during the breeding season. The rate of MnAC activity was approximately constant for 30 min at 35 degrees C and for 2 hr after storage at 25 degrees C. Activity was directly proportional to cytosol protein concentration and was optimal in the physiological pH range. Enzyme activity declined in the presence of an alkylating agent (N-ethyl maleimide, NEM) and was eliminated at a concentration of 1 mM NEM. Low concentrations (0.1-10 mM) of a reducing agent (beta-mercapto ethanol, beta ME) did not increase MnAC activity, whereas a high concentration (100 mM) led to a significant reduction (p less than 0.01) in activity. Substitution of Mn2+ in the assay medium with Mg2+ led to a total loss of enzyme activity, which could not be regained by adding hormones or by preincubation of cytosol for 60 min. The Km for Mn2+ was estimated to be 3.5 mM. The affinity of the enzyme for Mn2+ was not altered by varying the concentration of ATP. In contrast, increasing concentrations of Mn2+ appeared to increase the affinity of the enzyme for MnATP2-. The Km for MnATP2- thus varied from 6 to 18 mM. PMID- 6508431 TI - Radioimmunoassay of diethylstilbestrol in plasma of patients with prostatic carcinoma. AB - A method for the radioimmunoassay of diethylstilbestrol (DES) was established and it was used to measure the plasma concentration of DES in patients with prostatic carcinoma receiving intravenous drip infusion of 500 mg of diethylstilbestrol diphosphate (DES-DP). The sensitivity of this assay system was 40 pg per tube, with a recovery of 98%. The cross reactivity of the anti-DES antibody with estradiol, testosterone, and ethynylestradiol was less than 0.01% of DES, and that with DES-DP was 0.7%. In patients with prostatic carcinoma, plasma DES concentration at 6 and 24 hr after was declined to 10.2% and 4.4% of the level at the termination of intravenous administration of DES-DP, respectively; however, the concentration in patients with renal dysfunction was higher than that in ones with normal renal function. PMID- 6508432 TI - Chronic anethole trithione treatment enhances the salivary secretion and increases the muscarinic acetylcholine receptors in the rat submaxillary gland. AB - Chronic treatment with trithio-p-methoxyphenylpropene (anethole trithione; ANTT) increased the salivary secretion from the rat submaxillary gland induced by electrical stimulation of the parasympathetic nerve and by injection of pilocarpine. In parallel with the enhancement of the salivary secretion, the number of the muscarinic acetylcholine receptors was significantly increased. The increased number of receptors may be involved in the enhancement of the salivary secretion by ANTT treatment. PMID- 6508433 TI - Dopaminergic activity of a nonhydroxylated aminotetralin derivative (TL-68) on cat hearts. AB - An aminotetralin derivative, N,N-dipropyl-2-amino-1,2,3,4 tetrahydronaphtelene (TL-68) produced dose- and concentration-dependent inhibition of heart rate increases induced by stimulation of the cardioaccelerator nerves of anesthetized cats and by transmural stimulation of isolated cat right atria. These inhibitions were reversed by the dopaminergic antagonist haloperidol and not by the alpha2 adrenergic antagonist yohimbine. Results suggest that TL-68-induced inhibition of heart rate responses to stimulation of postganglionic sympathetic nerve endings is by stimulation of presynaptic inhibitory dopaminergic receptors in cat hearts. Since the compound is active in both in vivo and in vitro experiments, TL-68 apparently does not require metabolic activation before interaction with dopaminergic receptors. PMID- 6508434 TI - Development of tolerance to guanethidine in three hypertensive rat models. AB - The development of tolerance to the antihypertensive effects of guanethidine was determined in one-kidney one clip and two-kidney one clip renovascular hypertensive rats and spontaneously hypertensive rats (SHR). The effect of gender on the tolerance development was also studied in SHR. Although initial guanethidine administration acutely reduced arterial pressure in all hypertensive models, initial dose responsiveness to the blood pressure lowering effects of guanethidine (50 mg/kg, i.p.) was greatest in male SHR. After two weeks of daily guanethidine dosing (50 mg/kg/day, i.p.) only female SHR demonstrated an acute depressor response to the day 14 guanethidine dose. During the two week dosing interval tolerance development began after day 3 in all models, and systolic pressure (SP) was not significantly different from preguanethidine values in tolerant animals by day 7. In both renovascular hypertensive models a subpopulation of guanethidine responders was identified which maintained a lowered SP (p less than 0.05) after day 3. SHR demonstrated a high degree of tolerance after day 7 regardless of gender. Tolerance did not develop to the guanethidine-induced bradycardia in any model. These data suggest that both renovascular models and SHR are suitable models for studying the mechanism(s) of tolerance development to guanethidine and possibly other sympatholytic drugs. PMID- 6508435 TI - Selectivity of histamine for the proximal muscle loop of the cat pylorus. AB - Most drugs stimulate tonic and phasic muscular activity of the gastroduodenal junction to similar degrees except for histamine which enhances purely phasic contractions. The present study examined whether this selective histamine effect is due to a preferential action of histamine on the proximal muscle loop of the pylorus (PPL) which, unlike the distal loop (DPL), generates mostly phasic contractions. Strips were cut so as to represent the mechanical activity of muscle from the antrum, the PPL and the DPL of the cat stomach. All strips responded to acetylcholine with a combination of tonic and phasic activity. Histamine increased the frequency and the amplitude of phasic contractions in most strips from the antrum and the PPL; it increased the tonic contraction of a few DPL strips. In all types of strips, maximal histamine effects were only a fraction of the effects occurring with acetylcholine. Exposure to histamine produced no mechanical response in one fifth of the antral strips and in more than one third of the strips from both the PPL and the DPL. Histamine tachyphylaxis was marked, and sometimes irreversible. Histamine also led to phasic interruptions of flow across the isolated gastroduodenal junction without altering baseline flow. The present study demonstrates that histamine acts preferentially on those parts of the gastroduodenal junction that generate phasic rather than tonic muscular activity. PMID- 6508436 TI - The effect of urethane on spontaneous and stimulated contractions of isolated rabbit urinary bladder. AB - The effects of urethane on the spontaneous and stimulated contractility of isolated strips from rabbit urinary bladder has been investigated to assess if, and at which concentrations, this anaesthetic interferes with the contractility of the bladder smooth muscle. Urethane produces a generalized depression of both spontaneous and stimulated bladder muscle contractility but is expected that, in concentrations similar to those found in plasma during anaesthesia, its effect does not exceed the 10-20% inhibition. Urethane depression of bladder muscle contractility appears attributable, at least in part, to an inhibition of calcium ions mobilization from an intracellular store. PMID- 6508437 TI - Progressive foot swelling in BUF rats. A new animal model for screening of anti inflammatory and anti-rheumatic drugs. AB - Buffalo rats of a low adjuvant-arthritis responder strain demonstrate a continually increasing swelling in the hind foot inoculated with mycobacterial adjuvant, characterized by extensive panostitis, new bone formation and long delayed bony calcification. A rapid regression of foot swelling was produced by a three-day course of therapy with indomethacin (1 mg/kg) or with dexamethasone (0.1 mg/kg), but a definite rebound was followed soon after termination of the therapy. This recurrent episode occurred repeatedly in the second and third therapeutic trials with the anti-inflammatory drugs in the same animals. The 5 days treatment with either levamisole (5 mg/kg) or cyclophosphamide (5 mg/kg) prevented further increase in the swelling for a long time period after withdrawal of the drug, and enhanced bone mineralization. PMID- 6508438 TI - Effect of gangliosides on nerve regeneration in rats. AB - The objective of the study was to investigate the effects of gangliosides on the regeneration of the sciatic nerve after a crush injury in the rat. After a temporary complete interruption of axonal conduction, nerve conduction velocity was again measurable on the 13th day. On that day and at all subsequent measuring times, the conduction velocity of the damaged nerves was greater in the ganglioside-treated rats than in the control animals which were treated only with the solvent and reached significant values on day 15 and 18. PMID- 6508439 TI - Association between arrhythmias and mitral valve prolapse. PMID- 6508440 TI - Nifedipine in the treatment of systemic hypertension. PMID- 6508441 TI - Magnetic resonance imaging. Ready yet for widespread clinical use? PMID- 6508442 TI - Galactorrhea and thyrotoxicosis. AB - Galactorrhea has been reported to occur with a variety of conditions. Because several women with thyrotoxicosis in an endocrine clinic were also noted to have "idiopathic" galactorrhea, a retrospective analysis using two control populations was conducted to study the association of thyrotoxicosis and galactorrhea; comparison showed that the association was significant. This analysis suggests that thyrotoxicosis should be considered in the differential diagnosis of the cause of galactorrhea. PMID- 6508443 TI - The widened renal fossa sign on liver-spleen scintigraphy and adrenal disease. AB - A widened renal fossa on the posterior view during liver-spleen scintigraphy using technetium Tc 99m sulfur colloid raises the possibility of renal or extrarenal disease. We encountered four patients with prominent renal fossae on liver-spleen scans. They were subsequently found to have lesions involving the right adrenal gland. Potential adrenal disease should be considered in patients whose liver-spleen scans show widened renal fossae. PMID- 6508444 TI - Chewing nifedipine to rapidly treat hypertension. AB - Nifedipine, a calcium channel-blocking agent, was administered buccally to 63 patients who had a diastolic BP of 120 mm Hg or higher (51 patients) or a systolic BP of 200 mm Hg or higher (46 patients). Forty-two patients responded to one dose of 10 mg of nifedipine with a drop in BP from 205.5 +/- 24.4/127.7 +/- 11.7 (mean systolic BP +/- SD/mean diastolic BP +/- SD) to 158.6 +/- 24.7/88.8 +/ 10 mm Hg in 39.9 +/- 13.0 minutes (mean +/- SD). Nineteen patients responded to two doses of 10 mg of nifedipine with a drop in BP from 212.1 +/- 27.1/128.2 +/- 17.3 to 165.4 +/- 24.5/93.8 +/- 10.7 mm Hg after 66.0 +/- 17.8 minutes. There were no side effects and no hypotension even among the 38 patients who had recently received other medications. Chewing perforated nifedipine capsules is a safe and effective method to lower BP promptly without parenteral medications. PMID- 6508445 TI - Estrogen receptors and the pattern of relapse in breast cancer. AB - To determine if the pattern of relapse in patients with breast cancer was influenced by the presence or absence of hormonal receptors, we examined 300 patients with breast cancer who had estrogen receptor (ER) assays performed on their primary tumors. A multivariate discriminant analysis of the initial site of recurrence was performed, and we included in the analysis such factors as ER status, menopausal status, axillary lymph node involvement, and the interaction between menopausal status and ER status. Estrogen receptor status was found to be the single most important independent variable associated with the pattern of recurrence. There was significantly higher likelihood of visceral metastasis with ER-negative tumors, 52.1% as opposed to 5.38% for ER-positive tumors. Conversely, there was a high frequency of osseous relapse with ER-positive tumors, 60.4%, as opposed to 13.4% for ER-negative tumors. We also found that postmenopausal women tended to be ER positive more often than premenopausal women, and progesterone receptor status appears to be a good indicator for five-year disease-free survival in patients without axillary node involvement. With the progression of disease, there was a loss of receptors, even without therapeutic intervention. PMID- 6508446 TI - Physician attitudes and practices at the time of patient death. PMID- 6508447 TI - Steroid-dependent nephrotic syndrome in lupus nephritis. Response to chlorambucil. AB - Nephrotic syndrome associated with mesangial lupus nephritis developed in a young woman. The heavy proteinuria exhibited a striking steroid-dependent course during a three-year period of time, with ten relapses occurring whenever attempts were made to withdraw prednisone therapy. A prolonged remission was induced by the administration of chlorambucil. PMID- 6508448 TI - Warfarin interaction with erythromycin. AB - The drug interaction between warfarin and erythromycin is not well known. We report a case in which erythromycin was observed to markedly potentiate warfarin anticoagulation, resulting in hemorrhage in a patient treated for Legionella pneumonia. The morbidity of this drug interaction is enhanced in elderly patients who have infection accompanied by anorexia and/or fever and who are receiving intravenous erythromycin. The well-documented, temporal relationship established erythromycin as the interacting drug. PMID- 6508449 TI - Severe hyperkalemia during piroxicam therapy. AB - Severe hyperkalemia developed in an 85-year-old man after he had been receiving piroxicam treatment for several months. At admission his serum potassium level was 9.3 mEq/L; total CO2 level, 11 mmole/L; chloride level, 122 mEq/L; serum urea nitrogen level, 54 mg/dL; and creatinine level, 2.5 mg/dL. Hyperkalemia resolved after withdrawal of the drug and polystyrene sodium sulfonate therapy and the nonanion gap acidosis subsided concomitantly. His serum urea nitrogen and creatinine levels remained unchanged. He had abnormally low plasma renin activity, which gradually returned to normal, and aldosterone concentration, which remained low. The nonsteroidal drug may have impaired renin secretion, adrenal responsiveness to angiotensin, or the action of aldosterone on the renal tubule. PMID- 6508450 TI - Adult onset idiopathic familial brain calcifications. AB - We treated a family with idiopathic calcifications of symmetric areas of the brain, including the basal ganglia, dentate, and cerebral white matter. Dementia, progressive dysarthria, incontinence, propulsive-ataxic gait, fixed facies, and cogwheel rigidity without dysmorphic features develop in affected persons. Calcium, phosphorus, and parathyroid hormone levels were normal in the two siblings tested. The literature is reviewed and five other families with a similar syndrome are identified. These six families seem to be clinically distinct from the larger group of idiopathic cerebral calcifications usually referred to as Fahr's disease. PMID- 6508451 TI - Diagnosing atrial infarction. PMID- 6508452 TI - High-dose furosemide in cardiac failure. PMID- 6508453 TI - Amiodarone therapy and hyperthyroidism in Europe. PMID- 6508455 TI - Outpatient care of diabetic patients. PMID- 6508454 TI - Documented sudden cardiac death in prolonged QT syndrome. PMID- 6508456 TI - Health care personnel and AIDS. PMID- 6508457 TI - Need for medical supervision with very-low-calorie diets. PMID- 6508458 TI - Lorazepam for chemotherapy-induced emesis. PMID- 6508459 TI - Amiodarone-induced relative pituitary insensitivity. PMID- 6508460 TI - Investigation of the CET levels in the serum during and after cardiopulmonary bypass. PMID- 6508461 TI - Effect of vitamin E as an immunopotentiation agent and its influence on tumor growth in mice. PMID- 6508462 TI - Experimental studies of anti-tumor effect induced by microwave tumor coagulation. PMID- 6508463 TI - Development of signs and symptoms of congenital choledochal dilatation: its relation to pregnancy with special reference to experimental study in guinea pigs. PMID- 6508464 TI - [Experimental studies on the effects of recirculation on focal cerebral ischemia, following occlusion of the middle cerebral artery: with special reference to regional cerebral blood flow and brain energy metabolism]. PMID- 6508465 TI - [Difference in colony growth and drug sensitivity between human gastric and colorectal cancers in clonogenic assay]. PMID- 6508466 TI - Risks in transthoracic esophageal transection--score for predicting operative mortality. PMID- 6508467 TI - [Clinical evaluation of serum tissue polypeptide antigen (TPA) in patients with colo-rectal cancer]. PMID- 6508468 TI - [Pilonidal disease in Japan; report of 4 cases and a review of the literature]. PMID- 6508471 TI - [Experimental studies on pathophysiology of acute pancreatitis, with special reference to pancreatic phospholipase A2 and the effect of CDP-choline]. PMID- 6508470 TI - Hepatectomy and arterial blood ketone-body ratio. I. Changes in arterial blood ketone-body ratio following massive hepatectomy in relation to blood concentration of energy fuels. PMID- 6508469 TI - Intracerebral hemorrhage with moyamoya disease: source of hemorrhage in three patients. PMID- 6508472 TI - Left atrial myxoma with embolic episodes--a case report. PMID- 6508473 TI - [Gliomatosis cerebri followed-up with sequential CT scans. Report of a case and a brief review]. PMID- 6508474 TI - [Unexpected effect of a shot from a 7,65 Browning cartridge: double death]. PMID- 6508475 TI - [Determination of time of death by rectal temperature. Mathematical analysis of empirical material versus thermodynamic modeling. A critical case presentation]. PMID- 6508476 TI - [Cyst of the septum pellucidum]. PMID- 6508477 TI - [Intracranial epidermoids. Cooperative study]. PMID- 6508478 TI - [Use of bromocriptine in Parkinson diseases in low doses at a slow rate. 40 patients]. PMID- 6508480 TI - [Intestinal absorption of minerals in newborn and premature infants]. PMID- 6508479 TI - [Presence of neurons and synapses in the inferior collicular synapse in the rabbit]. PMID- 6508481 TI - [Paroxysmal vagal hypertonia in infants. Apropos of 14 cases]. AB - Fourteen infants presenting with unexplained episodes of weakness or fainting were investigated by repeated Holter monitor recordings and oculocardiac reflexes (OCR). The recordings were then compared with those of 10 normal children in order to try to establish the criteria of vagal hyperreflexia. Results of OCR were collated with those of Holter: there was a good correlation between the length of the cardiac arrest on the OCR and the minimal instantaneous frequency and the maximal change of instantaneous frequency recorded on the Holter. The diagnostic difficulties of these vaso-vagal episodes in infants are emphasized. The potential gravity of these episodes and the possible relation with the sudden infant death syndrome are then discussed in the light of these cases. PMID- 6508482 TI - [Longterm pH measurement in the diagnosis of gastroesophageal reflux in children. Apropos of 20 cases]. AB - Long duration continuous recording of esophageal pH was performed in 20 children suspected of having gastroesophageal reflux. Six pH monitoring parameters were analysed and their values compared with normal standards found in the literature. The results of pH monitoring were compared with those of upper gastrointestinal series and with oesophagoscopy, performed in all patients but one. The diagnostic utility of long duration pH monitoring is discussed, according to data in the literature. PMID- 6508483 TI - [Chondrodysplasia punctata and maternal alcohol intoxication. Apropos of 7 cases]. AB - The authors report 7 cases of chondrodysplasia punctata in whom maternal alcohol intoxication was found. Most often, it consisted of chronic and confirmed alcoholism, except for the last case, in which an acute intoxication had occurred at about the 4th or 5th week of pregnancy. Clinically, the appearance of the children was evocative of fetal alcohol syndrome, except in the last case when, in contrast, the facial dysmorphy was very typical of chondrodysplasia punctata. The skeletal anomalies preferentially involve the lower limbs, sometimes the sacrum, and in one single case, the dorsal spine. Upper limbs are always spared. The maternal hepatic lesions may be responsible for the skeletal impairment, due to their repercussion on the metabolism of vitamin K. This skeletal impairment would then be close to that induced by treatments with warfarin during pregnancy. Whatever, it is absolutely necessary to X-ray the lower limbs in cases with fetal alcohol syndrome, in order to not overlook associated bone lesions. PMID- 6508484 TI - [Hypercalcemia associated with tumors in children. 20 cases]. AB - Thirty episodes of hypercalcemia were observed in 20 children with solid tumors: principally 9 cases of non Hodgkin's lymphomas, 4 cases of rhabdomyosarcomas and 4 cases of Wilms' tumors. The 2 children with neurological manifestations and hypertension had the most severe symptoms secondary to the high calcium levels. However, hypercalcemia was asymptomatic in 8 of the 20 children. Focal seizures and metastatic calcifications subsequently occurred in 6 children. Emergency treatment of hypercalcemia often had partial or transient efficiency. In contrast, high calcium levels always returned to normal after anti-tumoral treatment. PMID- 6508485 TI - [Hypophosphatemic rickets in premature infants independent of vitamin D]. AB - The etiology and prevention of rickets in prematures infants are still controversial: insufficient storage or intake in minerals and/or vitamin D, immature vitamin D metabolism, necessitating early vitamin supplementation, for some associated with calcium and phosphate supplementation. The authors report a case of rickets which could be related to an immaturity of the tubular mechanisms of phosphate reabsorption, with a favourable outcome following an increase in calcium and phosphate intake. PMID- 6508487 TI - [Radiological case of the month. Cervical pulmonary hernia]. PMID- 6508486 TI - [Shwachman's syndrome with neonatal thoracic manifestations]. AB - The authors report a case of Shwachman's syndrome in whom neonatal respiratory distress was the initial manifestation. Metaphyseal dysplasia, which was severe at birth, progressively disappeared. By the age of 10 years, radiologic anomalies persist only in the pelvis. PMID- 6508488 TI - [Costs of the initial care of children with birth weight less than or equal to 1500 g in 1981]. AB - In 1981, 151 neonates with birth weight (B.W.) less than or equal to 1500 g were admitted to the Port-Royal Intensive Care Unit (ICU) (31% of admissions), 81% being born outside. Total mortality was 26% (53% less than or equal to 1000 g). For children who died, the median hospital stay was 9 days; in survivors, it was 69d (109d for BW less than or equal to 1000 g 71d for BW 1001-1250 g, 61d for BW 1251-1500 g), similar in hypotrophic and eutrophic infants. Average weight at direct discharge from Port-Royal ICU was 2627 +/- 565 g. The smaller the infants were at birth, the later they were discharged after assumed term. Complications (more frequent in smaller infants) played a major part in discharge delay. The cost of initial care included every step from birth to final discharge, all hospital charges and transports. Average cost per survivor was 200,356 F, but it reached 336,545 F, in patients with bronchopulmonary dysplasia and 354,605 F in those with necrotizing enterocolitis. Although the mostly good quality of survival justifies these expenses, the authors advocate increased prevention of very early prematurity and severe intra-uterine growth retardation, and development of maternal transport, as well as of prenatal call for a neonatal team in cases of unexpected birth out a of a perinatal center. PMID- 6508489 TI - [Correction of the incorrect position of a Hickman catheter by the endovascular approach]. PMID- 6508490 TI - [Prevention of febrile convulsions and kinetics of diazepam per os]. PMID- 6508491 TI - [Sudden death caused by obstructive apnea in children]. PMID- 6508492 TI - [Fibroscopy and gastroesophageal reflux]. PMID- 6508493 TI - [Direct assay of free thyroxine in children. Application to the monitoring of the treatment of hypothyroidism]. AB - A direct measurement of free thyroxine (FT4) by a radio-immunologic method using an analogue of thyroxine as tracer allowed to establish the normal values in 341 children from birth to puberty. These values were used as reference for the determination of free T4 in the diagnosis and management of treatment for congenital hypothyroidism. In 44 treated hypothyroid children, there was a positive correlation between the serum concentration of free T4 and the amount of levothyroxine given daily (r = 0.46, p less than 0.01). There was also a negative correlation between free T4 and serum TSH (r = 0.59, p less than 0.001). Thus, the measurement of free thyroxine seems to be a more reliable, more accurate and more sensitive parameter than that of total thyroxine or TSH for controlling the treatment of congenital hypothyroidism. PMID- 6508494 TI - [Diffuse pulmonary lymphangiectasia of late disclosure associated with cardiopathy]. AB - Congenital pulmonary lymphangiectasia is a rare abnormality with dilatation of pulmonary lymphatics and the radiological pattern of a pulmonary interstitial syndrome. It is usually symptomatic at birth and is almost always lethal. The authors report the case of an infant with congenital pulmonary lymphangiectasis and congenital heart disease who is still alive. This case report is interesting from the pathogenic, nosologic and prognostic point of view. PMID- 6508495 TI - [Iron deficiency in infants. Study of risk factors]. AB - A study of iron deficiency was carried out in two districts in Paris among 207 children aged 10 months recruited from two well-baby out-patient clinics. The main results are as follows: 12% of children were anemic, ferritin was low in 21% and 40% had a borderline deficiency, as shown by a decrease in siderophilin saturation. The average daily milk intake was greater among the immigrants, but this group, being mainly fed whole cow milk with no iron supplementation, had a lower iron intake overall. A positive correlation was found between the percentage of ingested iron-supplemented formulas and the mean corpuscular volume or serum iron levels. Iron deficiency was more frequent in children born to multiparous mothers and in the absence of any iron supplement during pregnancy. Weight gain was inversely correlated to ferritin levels, suggesting a major role of fast growth on iron metabolism. PMID- 6508496 TI - [Accidental epileptic seizures in children]. AB - The authors report a series of 71 children admitted to a general pediatric hospital for a first non febrile, non symptomatic seizure and observed for an average of 6 years and 5 months. Among these patients, 19 cases corresponded to an isolated unexplained seizure without paroxysmal E.E.G. abnormalities, which did not reappear without treatment in a mean follow-up period fo 5 years and 3 months. The typical features of these "accidental seizures" are compared with other types of epilepsy. Finally, these "accidental seizures" can be classified into 2 groups: atonic seizures in the young child (1-4 years) and partial seizures in older children. A statistical analysis was undertaken to define the risk factors for recurrence after the first epileptic attack. A low recurrence risk is expected for children between 1 to 4 years with atonic type of seizures without paroxysmal E.E.G. abnormalities while there is a high recurrence risk for children under 1 year with generalized seizures and paroxysmal E.E.G. intercritical abnormalities. PMID- 6508497 TI - [Mental confusion in childhood migraine]. AB - From 3 cases reports, the authors emphasize the importance of acute confusional migraine in childhood. It is more frequent than in adulthood and it is often the presenting problem making the diagnosis more difficult. PMID- 6508498 TI - [Palatal myoclonus syndrome with spontaneous recovery in a child]. AB - In a 71/2 year-old boy clinically isolated palatal myoclonus was observed. It was continuous even during sleep. It disappeared spontaneously after 3 years of evolution. The authors distinguish this syndrome from the one observed in adults, which never regresses. PMID- 6508499 TI - [Iconographic rubric. Fahr's disease]. PMID- 6508500 TI - [New drive for perinatal prevention in agricultural social mutual insurance]. PMID- 6508501 TI - [Unusual cause of post-transfusional hemolysis in a newborn infant]. PMID- 6508502 TI - [Dietetic treatment of acute childhood diarrhea]. PMID- 6508503 TI - Major depression in patients with agoraphobia and panic disorder. AB - A review of the life-time occurrence of major depression, the temporal relationship of major depression to episodes of panic and agoraphobic disorders, and the severity of anxiety and depressive symptoms were determined in 60 patients with agoraphobia or panic disorder. Forty-one (68%) of the patients had a past or current episode of major depression, and 35 (85%) of these patients had endogenous-type major depression. Twenty patients (33%) had an episode of primary major depression, and an average of three years separated the end of primary major depression and the first panic attack. Secondary major depression occurred in 28 patients. Patients with a history of major depression had a more severe anxiety disorder. These data support the view that in a subgroup of patients, episodes of depression and panic anxiety disorder may be manifestations of a common underlying pathogenic process. PMID- 6508504 TI - Onset of major depression in early adulthood. Increased familial loading and specificity. AB - In a family study of 133 probands with major depression and 82 normal control subjects, and 1,518 of their first-degree relatives, we found a substantial inverse relationship between the age of onset of major depression in the probands and the risk of major depression in their relatives. The relatives of probands whose onset of major depression occurred when they were younger than 20 years of age had the highest risk of major depression, compared with the relatives of probands who had later ages of onset or with the relatives of normal subjects. Probands with an age of onset of 40 years or more had familial loading that was only slightly higher than the families of normal control subjects. Our statistical methods enabled us to examine the relationship of the ages of onset in the probands and their relatives while accounting for possible confounding factors. More studies will be needed to sort out secular changes in the rates of the occurrence of major depression among young persons (cohort effect) from the high familial loading of major depression that has its onset in childhood and adolescence, and to determine whether the specificity of transmission of early onset depression is the result of a single homogeneous disorder. PMID- 6508506 TI - Choosing a Global Assessment Scale to describe the functioning of children. PMID- 6508505 TI - 1983 World Health Organization symposium on psychovirology. PMID- 6508507 TI - [Antidiabetic agents. 2. 2-(4-Toluidino)pyrimidine]. PMID- 6508508 TI - [Synthesis and trichomonacidal activity of di(isopropylamino)-1,3,5-triazines]. PMID- 6508509 TI - [Cis-dichloro(bis(oligopeptide ester))platinum (II) complexes: studies on the demonstration of their antitumor action with a bacteriological test system]. PMID- 6508511 TI - [The anticoagulant arylalkyl- arylalkyidene-cyclopent-4-ene-1,3-diones]. PMID- 6508510 TI - [Antiviral agents. 24. 4(-2-Adamantyl)thiosemicarbazone]. PMID- 6508512 TI - Subcapital fractures of the fifth metacarpal bone. AB - The incidence of upper extremity fractures was 8.8 per 1,000 inhabitants per year. Five per cent of these fractures occurred in the subcapital region of the fifth metacarpal bone. In a patient series the volar angulation after subcapital fracture of the fifth metacarpal bone was determined with a novel technique and related to functional and cosmetic outcome. In spite of volar angulation, the patients' discomfort was minor. An absolute volar angulation exceeding 30 degrees requires reduction, however. PMID- 6508513 TI - Subtrochanteric fractures. Classification and results of Ender nailing. AB - With use of a simple classification based on anatomical criteria and anatomical function, 27 subtrochanteric fractures of the femur were studied. The series was derived from 156 elderly patients with extracapsular hip fractures, all of whom were operated on by the Ender method. There were no infections. Regarding intra- and postoperative bleeding, early mobilization, length of hospital stay, and final clinical outcome, the results were superior to those obtained with other methods so far presented. Three patients died within 3 months postoperatively. Technical failure occurred at an early stage in 4% and at a later stage in 12.5%. Short oblique fractures did not require any supplementary fixation. Neither comminution nor obliquity prevented early mobilization with full weight-bearing. Tibial traction for a short period in one patient did not prevent expected mechanical failure. The mean time in hospital was 19 days. The functional result was excellent or good in 79% of the patients. PMID- 6508514 TI - Clinical observations on Blauth's total endoprosthesis of the knee joint. AB - This article reports on 207 implantations of the Blauth hinged endoprosthesis of the knee joint. Follow-up was possible in 188 (91%) of the implanted cases. The results could be clearly evaluated with a comparison between the time before and after operation, by means of a four-point system. They were very good in 85% and good in 11% of the cases, with an average follow-up period of 33 months, maximum longer than 8 years. The rheumatoid patients showed somewhat better results than those with osteoarthrosis. One of the main features of the success of the implanation in our follow-up patients was the relief from pain. To date, neither aseptic loosening nor fracture of prosthesis has been observed. The follow-up results, based on clinical aspects and constructional characteristics of the model during an observation period as long as 8 years, were encouraging. There was convincing evidence that because of the efficiency and predominance of the Blauth endoprosthesis no modification of the model was needed for further implantations. Technical complications could be prevented by careful manipulation. However, infection was still the most serious complication, affecting predominantly rheumatoid arthritis patients [6]. It always caused troublesome problems in management and jeopardized the success of the arthroplasty. The patella syndrome was another postoperative problem, though it was less serious than infection. PMID- 6508515 TI - Shaving of the lumbar disk space--a new technique in lumbar nucleotomy. AB - A complete curettage of the intervertebral space using the common surgical instruments (forceps, sharp spoons) is not possible during nucleotomy because of the anatomic site and the shape of the instruments. An alternative technique- called "shaving"--is described, which enables a faster, more effective, and less traumatizing removal of free-floating, pulpy residue in the intervertebral space. PMID- 6508516 TI - Self-concept among persons with long-term spinal cord injury. AB - Seventy-one persons with spinal cord injury who had been injured at least four years before, completed the Tennessee Self-Concept Scale and a questionnaire examining demographic factors and activity levels. Compared to scale norms, respondents had significantly higher Personal Self, Moral-Ethical Self, and Social Self scores and significantly lower Physical Self scores. Perceived independence, provision of one's own transportation, assistance needed, and living arrangements were significantly related to self-concept. Findings were discussed in relationship to past and future research and practice in rehabilitation of individuals with spinal cord injury. PMID- 6508517 TI - Isokinetic torque levels in hemophiliac knee musculature. AB - The purposes of this study were to 1) measure peak torques generated by knee extensors and flexors in hemophilia patients; 2) describe flexor to extensor; 3) record the point in the arc of motion where peak torque was achieved; 4) correlate results with age, degree of hemophilic arthropathy, and presence of flexion contracture; and 5) compare results with reports on healthy subjects. Forty-seven patients (94 knees) with severe hemophilia were tested with a Cybex II isokinetic dynamometer at a speed of 30 degrees per second. Height, weight, thigh girths, and passive knee range of motion were recorded. Standing roentgenograms of the knee were evaluated to assess degree of arthropathy. Subjects were divided into groups by age and degree of arthropathy. Descriptive statistics were generated for all groups. Average peak extensor and flexor torque was similar for adolescents and adults. Increasing degree of arthropathy was associated with significant decreases in both extensor and flexor torque, an increase in flexor to extensor ratios and increasing knee flexion contractures. Across all groups, flexor to extensor ratios were abnormally high, particularly in patients with type IV arthropathy. The point in arc of motion where peak torques occurred did not differ significantly across groups and compared favorably with measures reported in the literature. For all ages, mean peak extensor and flexor torques were less than values reported in the literature for healthy subjects. Results of this study demonstrate the profound decrease in torque produced by knee musculature in hemophilia patients, particularly those with more severe arthropathy and knee flexion deformity. PMID- 6508518 TI - Prosthetic use: correlation of clinic team and ergonomic laboratory in predicting its success. AB - A group of 92 patients with lower limb amputations were evaluated in an effort to determine whether an appropriate clinical decision to prescribe a prosthesis could be made without using elaborate evaluation testing. The assessments were made independently by a clinic team and by an ergonomic laboratory, each applying its own criteria for predicting successful prosthetic use. The high correlation between the two areas indicated that the ergonomic laboratory made no additional contribution toward the decision to supply a patient who had no complicating features with a prosthesis. Nineteen patients had significant ST depressions during exercise testing and of these, nine died within one year. Two patients with no ST segment depressions died within one year. PMID- 6508519 TI - Paraplegic energy expenditure during negotiation of architectural barriers. AB - Long-leg braces are often used by persons with paraplegia to negotiate architectural barriers, and thereby increase their wheelchair mobility. Such barriers include ramps, stairways, and narrow corridors requiring multiple turns. This study was designed to measure the energy expenditure during such activities for two long-leg orthoses: standard braces without a dorsiflexion stop and Scott Craig braces. Energy expenditure was measured in eight subjects by indirect spirometry using Douglas bag collection and Haldane analysis. Data obtained were used to calculate oxygen consumption per minute, volume of oxygen per turn, step, or meter, and calories per minute during each activity. Using Scott-Craig braces on one day and standard braces on another day, each subject negotiated five 90 degrees turns and two 180 degree turns, ten 15.24 cm steps, both up and down, and an 11.9 m ramp inclined 12 degrees, both up and down. Milliliters of oxygen consumed per kilogram of body weight per turn, step, or meter were recorded for Scott-Craig braces, standard braces, and normal walking. All of these activities required a high expenditure of energy. No significant difference was apparent between the standard and the Scott-Craig braces for any activity. PMID- 6508520 TI - Spastic hemiplegia in a quadriplegic patient: treatment with phenol nerve block. AB - A quadriplegic patient with a C6 lesion had a stroke with aphasia and right hemiplegia 20 years after his cervical cord injury. The combination of hemiplegia and quadriplegia created unusual rehabilitation problems, the most disabling of which was a painful flexion contracture of the right elbow that prevented any useful right arm function. A sequence of phenol nerve blocks produced almost complete resolution of this contracture and was a key factor in his successful return to independent living. Although phenol block is much less commonly performed in the upper than lower extremities, its judicious use in carefully selected cases may be beneficial to the patient's functional outcome. PMID- 6508521 TI - Median nerve determinations. PMID- 6508522 TI - A proposed classification of intra-abdominal infections. Stratification of etiology and risk for future therapeutic trials. AB - Serious studies of ultra-abdominal infections have yielded a mortality that ranges from 3.5% (a composite of antibiotic studies evaluating 1,275 patients) to more than 60% in studies of multiple-organ failure. In reviewing these studies, it is apparent that under the umbrella of "serious intra-abdominal infection," different diseases, processes, and patients are being studied. We define a binomial classification incorporating both an anatomic and a functional approach to intra-abdominal infection. There are ten etiologic classifications of intra abdominal infections combined with an acute physiologic score (APS), measuring severity of illness, in three gradations. In the patient with undifferentiated intra-abdominal sepsis, the patient will be in class I, II, III, or IV, with a score, A, B, or C, added. Each of the groups V-X, defining a specific infectious category, can also use the APS, which has been verified in patients in intensive care and in those with intra-abdominal infection. It is anticipated that using this approach will provide a technique to evaluate patient groups uniformly in which drug or technical approaches to the management of intra-abdominal infections are being studied. The patients being studied will be more clearly defined, and studies will be comparable from one center to another. PMID- 6508523 TI - Late ovarian metastases in carcinoma of the colon and rectum. AB - We reviewed 63 patients with metachronous ovarian metastases from colorectal carcinoma to determine the natural history of this problem, and whether aggressive surgical treatment is beneficial. Ovarian metastases usually occurred in younger patients (mean age, 51 years) and in 55.5% of the patients, the metastases were part of diffuse intra-abdominal disease. The mean survival rate for all patients following surgery was 16.6 months. The survival rate did not correlate with menstrual status, interval to recurrence, or Dukes' stage of the original cancer. Ability to remove all gross disease at the time of oophorectomy was the major determinant of survival. Surviving patients who were rendered disease free surgically (n = 15) lived a mean of 48 months compared with 9.6 months for patients with localized, but unresectable disease (n = 9), and eight months for patients with diffuse disease (n = 35). Surgical attempts to remove all gross disease seem to result in significantly improved survival rates even though a cure is rare. Bilateral oophorectomy is warranted as part of the palliative treatment of women who are seen with stage D cancers to prevent the development of large symptomatic metastases that require further therapy. PMID- 6508524 TI - Acute cholecystitis as a complication in surgical patients. AB - Acute cholecystitis after operation or trauma is associated with reported mortalities of 10% to 50%. During a 16-year period at the Mayo Clinic, Rochester, Minn, 75 such patients were examined, eight of whom had traumatic injuries. The incidence of this complication was approximately one for every 10,000 surgical procedures. In contrast with acute cholecystitis that occurs de novo, elderly men who had other antecedent complications seemed to be at an increased risk. Also, acalculous cholecystitis with associated gangrene and perforation of the gallbladder was more commonly encountered. The diagnosis is difficult to establish in patients who have had recent abdominal operations and is based on physical signs and symptoms, although cholescintigraphy will be of value in future cases. The most common treatment is cholecystectomy. Clinicians must maintain a high index of suspicion and carefully examine any surgical patient in whom abdominal pain or unexplained fever develops. Once the diagnosis is confirmed, early operative intervention is indicated. PMID- 6508526 TI - Carotid artery surgery in diabetic patients. AB - We present a retrospective study of 191 carotid artery operations in which a large population of diabetic patients is compared with a smaller nondiabetic group of patients. Of the patients who were studied, 62.3% were diabetic and 37.6% were nondiabetic. The patients with a juvenile-onset diabetes fared poorly, with few of them living long enough to develop carotid artery disease. The patients with adult-onset diabetes differed from the nondiabetic patients only in the increased incidence of associated peripheral vascular disease. The incidence of symptomatic heart disease preoperatively, and the perioperative morbidity from heart disease was the same for both groups. The perioperative stroke rate was 2.6% and 0%, respectively, for asymptomatic patients. Long-term follow-up demonstrated the effectiveness of the procedure, with only two of the patients with transient ischemic attacks developing strokes later. There was, however, a highly significant increased death rate from myocardial infarction among the diabetic patients (55%), compared with the nondiabetic patients (25%). PMID- 6508525 TI - Renal and splanchnic circulation during infrarenal aortic cross-clamping. AB - The effect of infrarenal cross-clamping of the aorta on regional splanchnic and renal circulations was studied in seven dogs. Regional blood flow was determined with differentially labeled microspheres (9 and 15 micron in diameter) that were injected simultaneously into the left atrium. Blood flow was measured 30 minutes after surgical preparation was completed (stage I), 20 minutes after infrarenal aortic cross-clamping (stage II), and 20 minutes after supplemented sodium nitroprusside infusion (stage III). Infrarenal aortic cross-clamping was accompanied by a slight increase in the cardiac output (CO) without significant changes in mean arterial pressure (MAP). Blood flow through the gut, hepatic artery, and cortical layer of the kidneys, as determined with 15-micron spheres, was not changed. Nonentrapment of 9-micron spheres in the gut and renal cortex was increased substantially. Blood flow through the juxtamedullary layer of the kidneys was increased. Sodium nitroprusside supplementation decreased MAP by 30%; CO values returned to baseline level. Hepatic artery blood flow, compared with both baseline values and values during aortic cross-clamping, increased significantly. Blood flow, determined with 15-micron spheres, through the gut and renal cortex did not change, and nonentrapment of 9-micron spheres decreased to baseline values. The data suggest a certain shift of blood flow to the juxtamedullary layer of the kidneys during aortic cross-clamping and normalization of intrarenal blood flow distribution during supplemented sodium nitroprusside infusion. Controlled vasoplegia with sodium nitroprusside may help modify peripheral circulatory disturbances in the kidneys and splanchnic system during infrarenal aortic cross-clamping. PMID- 6508528 TI - Air gun injuries of the abdomen in children. AB - From July 18, 1978 to Sept 15, 1982, four boys were treated for air gun injuries of the abdomen at the North Carolina Baptist Hospital, Winston-Salem. Three patients had wounds of one or more of the hollow viscera, and one patient had an injury only of the liver. There was no morbidity or mortality following repair. Some present-day air (pneumatic) weapons have muzzle velocities that equal or exceed those of common civilian handguns, and they are frequently used by unsupervised children. These weapons are not restricted and regulated as are other firearms, and are believed to be incapable of serious injury other than to the eye. These cases and others in the literature dispute that belief. PMID- 6508527 TI - Simplification of cryoprecipitate coagulum choledocholithotomy by deletion of thrombin. Prevention of retained biliary duct stones. AB - Conventional removal of stones from the biliary ducts can be difficult and may result in retained stones. We developed a modified tenacious coagulum that entraps biliary duct stones, resulting in a more complete extraction. Coagulum choledocholithotomy was simplified by mixing 20 parts of cryoprecipitate with one part of 10% calcium chloride solution without thrombin. Tenacious coagula were generated that had a tensile strength of 106 to 140 g/sq cm within three to six minutes and were 106% to 300% stronger than coagula with thrombin. This technique was performed on six patients. In each case, an intact coagulum that entrapped more calculi than were seen on the cholangiogram was extracted. This modified technique is simple, safe, nontraumatic, and achieves a more complete extraction of stones. PMID- 6508531 TI - [The 34th general meeting of the Japanese Society of Allergology, 27-29 October, 1984, Kyoto, Japan. Abstracts]. PMID- 6508529 TI - Isolation of Eyach virus (Reoviridae, Colorado tick fever group) from Ixodes ricinus and I. ventalloi ticks in France. AB - During the spring of 1981, two strains of an identical virus were isolated in Mayenne, France, from Ixodes ricinus L. and Ixodes ventalloi Gil Collado, parasiting a wild rabbit (Oryctolagus cuniculus L.). Virological and serological results indicated that these strains belong to the Colorado tick fever serogroup and are indistinguishable from Eyach virus, a tick-borne virus previously described from West Germany. Study of dsRNA PAGE profiles confirmed these conclusions. The morphology and morphogenesis of French isolates were studied in infected suckling mouse brains showing some peculiar features previously described for Colorado tick fever virus. The importance of the isolation of Eyach virus in France is discussed. PMID- 6508530 TI - Changes in the morphology of influenza particles induced at low pH. AB - At low pH influenza virus causes membrane fusion. This phenomenon is thought to reflect a part of the infection mechanism of the virus. To obtain more information on the effect of low pH on the virus, the change in morphology of influenza virus particles was studied by electron microscopy. Further, the degradation of haemagglutinin (HA) after trypsin digestion as a function of pH was studied by gel electrophoresis. The results showed that a threshold value existed below which both a change in morphology and an increase in trypsin sensitivity were observed. This threshold pH was found to be strain specific. A number of strains showed a heterogeneity in the particle population with respect to the threshold pH. The various subpopulations appeared to differ genetically. Virus particles with uncleaved precursor HA, HAo, were not effected by the low pH treatment. PMID- 6508532 TI - Immunological aspects of autoimmune diseases. PMID- 6508533 TI - Hydroxycotinine metabolism in rabbit liver, lung and kidney tissue homogenates. PMID- 6508534 TI - [The effect of blood pH on the stability of fluoroapatite]. PMID- 6508535 TI - [Polyneuropathy caused by ethylene dioxide]. PMID- 6508536 TI - [Selection of spirometric tests in the evaluation of ventilatory function of the lungs]. PMID- 6508537 TI - [Importance of determining lung volume and airflow in evaluating the ventilatory function of the lungs]. PMID- 6508538 TI - [Why biological "monitoring"?]. PMID- 6508539 TI - [Effect of hypodynamia on the hemomicrocirculatory bed of the triceps muscle and brachial fascia in the rat]. AB - By means of amputation of the forearm (the place of the brachial musculus attachment is kept intact) in 30 male rats certain conditions are produced for decreasing force activity in the m. triceps brachii. Anatomical changes in structure and in distribution of links of the hemomicrocirculatory bed (HMCB) are followed in the medial head of the muscle and in the fascia covering it. Time of observations - 1-60 days. The sections of the muscles and some parts of the fascia are impregnated with silver nitrate solution. The greatest changes are observed to occur in the capillary-venular links of the HMCB during the interval of 1.14-4.5 days and are manifested as initial congestion of venous blood in these links. Later (4.5-15.3 and further 60 days) together with stable dilatation of all venous components of the blood bed certain qualitative changes take place in the arteriolar links of the HMCB. PMID- 6508540 TI - [Structure of the wall of the renal artery during limitation of motor activity]. AB - The structure of the renal artery wall has been studied in histological preparations at various time of a restricted motor activity using some morphometric methods. The revealed morphological changes of wave-like character present a respond of certain compensatory processes in the vascular wall to changes of the blood stream in the kidney which is connected with the change of the organ's function. PMID- 6508541 TI - [Morphologic features of the structure of the hand bones of young volley ball players]. AB - By means of roentgenography method with subsequent roentgenogramometry and roentgenodensitometry, morphological peculiarities of structure and mineralization of the hand bones in sportsmen-volley-ball players and in schoolchildren who do not go in for sports, at the age of 14-19 years have been studied. Systematic training in volley-ball produces certain increase in dimentions of the hand bones, prolongation of their synostosis time, intensification in development of the sesamoid bones and increasing amount of mineral salts in their bones. PMID- 6508542 TI - [Changes in the size of the long tubular bones and body weight of rats exercised at different times of the day]. AB - The observations were performed in autumn in 100 rats at the age of 1 month. The animals were trained in a horizontal treadmill with the speed 40 m/min, beginning with 3 min/day and gradually increasing the time up to 30 min. The control animals were not trained, the test animals were trained either once a day (at 7 a. m., 3 p. m., 11 p. m.), or three times a day and the total loading was equal to a single loading. The animals were weighed daily. Elongation of the bones, increase in their mass and in the body mass were different at training during different time of the day and the effect was not similar in different bones. Certain sexual differences of the training effect were revealed. PMID- 6508543 TI - [Features of the structure of the metacarpal bones of athletes in different specialties]. AB - Metacarpal bones have been examined in hand X-ray photos of 125 sportsmen at the age of 17-18 years who go in for swimming (dynamic loading on the hand) and competitive gymnastics (static loading on the hand). Under the effect of systematic trainings, which are connected with an increased loading on the hand, a number of morphological changes take place in the metacarpal bones. A prolonged loading of the dynamic character delays the synostosis process in the distal parts of the forearm bones and contributes to lengthening the I, III and IV and to widening the I-V metacarpal bones. As demonstrate decreasing indices of compactness in the swimmers, the widening diaphisis of the metacarpal bones occurs at the expense of dilatation of the medullary cavity. The static loadings result in a greater delay of the synostosis processes in the upper extremity parts mentioned, in a greater width of the I-III, V metacarpal bones in boy gymnasts. The increased index of compactness demonstrates that the widening diaphysis of the metacarpal bones takes place at the expense of thickening of the compact substance and narrowing of the medullary cavity. PMID- 6508544 TI - [Status of the circulatory bed of the vascular membrane of the eyeball and retrobulbar structures during experimental venous stasis]. AB - In 43 test animals the state of the blood bed in the retrobulbar formations and the eyeball vasular tunic has been studied under venous congestion produced by ligation of the anterior vena cava (in dogs) and both external jugular veins (in rabbits). A complex of histological, histotopographic, morphometric and variation statistical techniques has been used. The results obtained demonstrate that disturbances in the venous outflow in the anterior vena cava system produce certain responses in all parts of the retrotubular adipose tissue, of the eyeball muscles, of the optic nerve tunics, of the vascular tunic. Certain stageness is noted in the course of venous congestion. Places of the greatest morphological changes in the eyeball vascular tunic are determined. They are zones of vorticose veins formation and the area corresponding to the posterior pole of the eyeball. The analysis of the specific areas of the intermuscular arteries and veins cross sections demonstrates that in the reaction of these vessels to the different venous outflow in the anterior vena cava system these is certain unevenness in different ofthalmic muscles. PMID- 6508545 TI - [Various results and prospects for the study of the vascular system during restricted motor activity]. PMID- 6508546 TI - [Features of the contour of the inner surface of the cardiac ventricles and Thebesius-Vieussens vessels]. AB - Using certain morphological methods, relief peculiarities of the cardiac ventricle chambers, form and extent of the intertrabecular spaces, connections with the myocardial blood bed have been studied in 92 human hearts. Foramina, fissurae and excavations on the internal surface of the ventricles are the beginnings of the intertrabecular spaces, in their deep parts elements of the microcirculatory blood bed of the myocardium have openings. As demonstrate serial sections, there are not any immediate anastomoses between the myocardial arteries, veins and the intertrabecular spaces. This fact does not confirm the existing opinion that the smallest cardiac veins (Viessen-Thebesian vessels) belong to the arterio-venous anastomoses. A propose is made to use the term "the smallest cardiac veins" only to the veins that directly open into the auricular chambers. PMID- 6508547 TI - [Mechanism of the development of functional hyperemia in the palatal salivary glands of the rat]. AB - At various regimens of the secretory activity in the palatile salivary glands, changes occurring in the transversal profiles of the postcapillary venules, but not of the blood capillaries, are most noticeable. Under food stimulation of secretion, the former dilate essentially, that can demonstrate certain functional hyperemia developing in the palatine salivary glands. Some previous experiments concerning interpretation of principles on the microcirculatory bed spatial organization give a good reason to suggest that dilatation of the postcapillary venules is connected with an increased blood perfusion in the canals of the preferrable blood stream. The postcapillary dilatation is possible because blood from the precapillaries gets into the capacitance blood microvessels and its volume at that moment is greater than the capacity of the venous microvessels. A suggestion is made that filtrative function of the palatile salivary glands depends on development of the functional hyperemia. It is possible, that this mechanism is universal, since owing to it, reflectory reactions of the salivary glands directed to the immediate secure of the oral cavity with a necessary amount of liquor become possible. PMID- 6508548 TI - [Morphofunctional characteristics of the intrinsic arterial vessels of the kidney in healthy subjects and in various cardiovascular diseases]. AB - The investigation has been performed in 132 kidneys of corpses of persons at various ages, 96 of them died from some cardiovascular diseases and 36--from mechanical asphyxia. Injection, macro-microscopical, histological, biometrical and variational-statistic methods have been used. The total section areas of the arterial vessels is determined, it characterizes the vascular bed capacity of the renal cortical and medullary parts. At atherosclerosis, hypertension and cardiac ischemia an essential decrease in the vascular bed capacity in the cortical part and its increase in the medullary part of the kidney is observed. An increasing diameter of the juxtamedullary glomeruli is supposed to intensify the juxtamedullary blood stream. The greatest changes in architectonics and capacity of the renal arterial bed is observed at hypertension combined with atherosclerosis, and the least--at a chronic cardiac ischemia. PMID- 6508549 TI - [Development of the hemomicrocirculatory bed of the human gonads during the prenatal period of ontogeny]. AB - The formation of the organospecific hemomicrocirculatory bed of the ovaries and testes has been studied by a complex of light, transmissive and scanning electron microscopy in 3--9-month-old human fetuses. The change of the diffusive protocapillary bed is secured by: 1) reduction of some protocapillaries; 2) appearance of secondary capillaries from the growth buds of the preceeding microvessels; 3) formation of arteriolar and venular links of the hemomicrocirculatory bed from the protocapillaries at the expense of differentiation of the developing paravasal connective tissue into cellular elements of the muscular and adventitial tunics. The secondary blood capillaries of the human gonads are predominantly formed intraendothelially. During the prenatal ontogenesis presence of the secondary blood capillaries of somatic uninterrupted type is specific for the human gonads. PMID- 6508550 TI - [Morphologic and hormonal correlates of true hermaphroditism in the rabbit]. AB - A macro-microscopical and histological investigation of the urogenital system organs of a rabbit-hermophrodite has been performed with an aim to compare the content of sex steroids in the peripheral and in the gonadal blood estimated by means of radioimmunological methods. Certain anomalies have been found out in the development of external and internal sex organs, kidneys and urinary bladder. Testosterone and estradiol concentration in blood flowing from the ovotestis is decreased, as it is in the periphral blood. The rabbit urogenital system organs have been studied from the 12th day of the intrauterine development up to the 10th day of the postnatal life. The results of the investigation performed make it possible to consider that the developmental anomalies in the rabbit hermophrodite have, evidently, appeared between the 20th--25th days of its intrauterine development as a result of certain disbalance of sex steroids. PMID- 6508551 TI - [Importance of ultrasonic echolocation for human anatomy]. PMID- 6508552 TI - [Experience in training scientific-pedagogic morphology personnel]. PMID- 6508553 TI - [Initial neurons of the associative and callosal pathways of the lateral suprasylvian area of the cat brain]. AB - By means of the retrograde axonal transport method of the luminescent dye (primulin), it has been stated that associative afferent connections of the medial part in the lateral suprasylvian (LS) area of the cat cerebral cortex take their origin, mainly, from the neurons of the III layer in the optic portion of the cerebral cortex (the 17th, 18th, 19th and the anterior ectosylvian fields). The cortex in the lateral part of the LS area has projections from the acoustic (AI, AII and Ep) and associative fields of the optic system. The associative fields of the optic and acoustic systems (the 20th, 21st, 19th, Ep), as well as the "classic" associative field 5 are connected with posterior portions of the area studied. Middle-sized pyramidal cells of the III layer and small polymorphous neurons of the V--VI layers are the initial neurons of the afferent associative pathways in the lateral and posterior fields. The fields studied, having bilateral connections predominantly with the associative cortical parts, give origin only to homotopical callosal connections. Comparison of the data obtained with the results of some physiological investigations demonstrates a fine correlation of the functions and the structure in the interneuronal connections. PMID- 6508554 TI - [Composition and synaptic organization of the internal plexiform layer of the sensory membrane of the eye in turtles]. AB - Synaptic organization of the internal plexiform layer (IPL) of the retina has been studied electron microscopically in two aquatic and two land Chelonia species. Certain signs in common of the IPL structure have been revealed, they are similar with those in other Vertebrata, as well as common peculiarities inherent in Chelonia of all the four species studied. Any species-specific differences are not detected. In the land Chelonia, unlike the aquatic Chelonia, a relative content of the amacrinal cell synapses is higher in serial combinations. The ratio of the amacrinal cell synapses to all bipolar neurocyte synapses is within the limits 3.1-4.1. PMID- 6508555 TI - [Innervation of the blood vessels of the human lower extremities in occlusive arterial lesions]. AB - In 63 patients suffering from an obliterating thromboangiitis and atherosclerosis the state of the efferent innervation of the shin and foot vessels has been studied. The material has been obtained during reconstructive surgical operations from various segments of the extremities and in the patients suffering from regional ischemic disorders of various degree. Moreover, adrenergic structures of the lumbar sympathetic ganglia have been investigated after sympathectomy performed. In the patients suffering from thromboangiitis, in the adventitial arterial tunic some foci are revealed containing single adrenergic neural fibers. Topography concerning localization of these foci is extremely asystematic. At atherosclerosis the innervational structures have character of a chronic exhaustion. In the sympathetic ganglia neurons, catecholamine-containing structures are revealed; they are seen as accumulations of norepinephrine granules. As demonstrates the comparison of the clinical and neurohistochemical data, in development of the obliterating thromboangiitis a sharp catecholamine deficiency and a pervent effect of the disturbed innervational connections on the vascular tunics play an essential role. At atherosclerosis the mechanism of the chronic exhaustion of the neuromediators belongs evidently, to the phenomenon of the "postmediatory stage" of the neural elements ontogenesis. PMID- 6508556 TI - [Topography of the contours of the inner surface of the wall of the left ventricle of the heart in systole]. AB - Chosen at random 38 diastolic preparations of human hearts from persons having not any cardiac pathology, as demonstrate the postmortem examination, have been investigated. The left ventricle casts have been made during the first 24 hours after death according to a strictly fixed technique by means of filling the cardiac chambers with polymere mass--protacryl--under a physiological pressure of the diastolic filling. The trabecules are arranged as a spiral from the apex of the ventricle up to the atrioventricular fibrous ring, with approaching the apex the spiral step increases and the trabecules straighten. The left ventricle cast is devided into some planes, the envelopes and the trabecularity lines are measured. Average values of the shift in the trabecularity lines I, II, III and in the cross sections B, C, D, E are defined in relation to the plane A and in every case in relation to the previous plane Cn-1. The data obtained are presented in tables and diagrams. The greatest shift demonstrate the trabecularity lines I running predominantly along the posterior wall of the left ventricle in the planes B and which are situated nearer to the atrioventricular ring projection. Owing to the presence of the spiral-shaped course of the trabecules, it is possible to suppose that it influences the blood stream twisting clockwise in the left ventricle during the diastole phase. This indicates the necessity to work out some new constructions of artificial cardiac valves, securing the twisted blood stream. The condition mentioned should be taken into consideration while making prostheses of the cardiac valves. PMID- 6508557 TI - [Changes the structural elements of the organs of bats during periods of activity and hibernation]. AB - In hibernated animals (Myotis myotis) morphological changes are characterized by certain peculiarities in structure of the mitochondrial apparatus and some other cellular organells. In the animals, which are in the state of hibernation, the main plan of cardiomyocytes structure in the pulmonary vein wall, as well as in the myocardium itself does not change, as compared to those in the animals which are in the active state. The ultrastructure of the skeletal muscle fibers also does not undergo any essential alterations. A definitely seen narrowing of the capillary bed in the pulmonary alveoli is revealed. In the nuclei of their granular cells chromatin is substituted for lamellar myelin-like corpuscles; in cytoplasm there are inclusions that contain electron-opaque material of lamellar structure. In the active animals the inclusions contain electron-transparent material and are surrounded with a wide osmiophilic rim. In the liver of the hibernating animals hepatocytes loose their glycogen, but the number of lipid vacuoles and electron-opaque multivesicular corpuscles increase. PMID- 6508558 TI - [Intrinsic glands of the human esophagus]. AB - The esophagial glands obtained from 156 corpses of mature persons have been investigated by means of histological and histochemical methods. The glands studied are situated in the tela submucosa of the organ and, according to a number of structiral peculiarities and histological properties, they differ essentially from the salivary glands of the oral cavity. The glands are presented as large packets and have mucous, serous and mixed (seromucous and mucoserous) terminal parts. Their secret contains neutral glycoproteins, sialo- and sulfoglycoproteins and gets into the intercalary and further into the striated ducts which fuse and form a long common excretory duct; it opens at an acute angle into the esophageal cavity. There are single cells in the glands which possess secretory properties not connected with the excretory ducts of the gland. Their role in the organ is not yet clear. PMID- 6508559 TI - [Effect of vagotomy on the structure of the gastric mucosa in experimental ulcers]. AB - Development of experimental gastric ulcers has been investigated in rats from the 2d up to the 120th day using light, electron transmissive, scanning microscopy and radioautography. In 30-60 days after the ulcer induction, there is a clearly seen transmission of the ulcer into a chronic form. In the main and parietal cells at the edge of the ulcer cytoplasm undergoes vacuolization. The edges of the ulcer are formed with glands of the pyloric type. The truncal vagotomy, performed 30 days after the ulcer induction, contributes to epithelization of the ulcer defect. The latter is covered with cells resembling those of the pyloric gland; they are spreading from the edge of the ulcer. The enhanced epithelization of the ulcer after vagotomy is connected with a manifested increase of proliferative activity of the epitheliocytes in the edge of the ulcer. Vagotomy in animals without ulcer also produces an increasing proliferative activity of the cervical cells in corresponding parts of the gastric tunica mucosa. PMID- 6508560 TI - [Secretory immunoglobulins (IgA) in the development of the immunologic reaction to horseradish peroxidase]. AB - The aim of the investigation was to visualize transport of antibodies produced in the small intestine of the preliminarily sensibilized rats. Horseradish peroxidase (HP) was used as an antigen. Visualization of antibodies was performed by means of determining HP activity (R.S. Graham and M.G. Karnovsky method, 1966). In the lamina propria of the tunica mucosa of the sensibilized rat small intestine, plasmocytes synthesizing antibodies appeared on the 4th day after a challenge dose of the antigen had been injected. The synthesized immunoglobulins were transported in two directions: via epithelium in the intestinal lumen and into the vessels of the lamina propria of the small intestine tunica mucosa. These both processes occur by means of micropinocytosis. Out of the intestinal vessels the antibodies get into the system of the hepatic portal vein and are detected in the sinusoid capillaries and further they get into the perisinusoid space (Disse). Besides, the reaction product is revealed in micropinocytic vesicles situating in cytoplasm of hepatocytes and in bile capillaries. Thus, antibodies synthesized in the lamina propria of the small intestine tunica mucosa get into the intestinal lumen not only through epithelium, but also through biliary system of the liver. PMID- 6508561 TI - [Anatomy of the lacrimal point and the vertical portion of the lacrimal canaliculus]. AB - In order to define more accurately normal dimensions and form of the lacrimal point as well as peculiarities in the structure of the vertical part of the lacrimal canaliculus, 315 practically healthy persons (630 eyes) at the age of 18 60 years have been examined. The procedure has been performed by means of the slit lamp (shchl-1) . The lacrimal point has been found to have a round (36.1%) and an oval (63.9%) form. Transition of the lacrimal point into the vertical part of the lacrimal canaliculus in 83.5% of the observations is "fannel"-shaped with a maximal narrowing at the depth of 0.4-0.5 mm, and in 16.5%-- well"-shaped (without any narrowing). The normal diameter of the lacrimal point is 0.2-0.6 mm (the arithmetic mean-- 0.35 mm). When the diameter of the lacrimal point is less than 0.2 mm (at least in one of its sections), the lacrimation function correspondingly deteriorates, indices of the coloured nasolacrimal test become decreased or negative. PMID- 6508562 TI - [Characteristics of the human masseter muscle during hypokinesia]. AB - Bioptates of the m. masseter from 20 male persons at the age of 21-30 years have been studied 3, 6, 12 and 24 days after immobilization of the mandible in connection with its fracture. Succinate dehydrogenase (SDG) activity and cross section area of muscle fibers have been determined. Relative volume (Vv) of submicroscopic structures of myons have been found stereologically. In the muscle tissue reactive-destructive changes are revealed; they depend on hypokinesia duration: decreasing SDG activity, cross section area of the fibers and contents of pinocytic vesicles in the endothelial cells of the capillaries. Vv of mitochondria and tubular formations in the sarcoplasmic reticulum change. Certain stageness of structural rearrangements in the muscles are noted, they are considered as a result of the influence of the restricted function and some disturbances occurring between the blood vessels and the muscle fibers. PMID- 6508564 TI - [Photon absorbtiometry--a precise method of determining living bone minerals]. PMID- 6508563 TI - [Method of quantitatively describing the distribution of windows on cryofractograms of blood capillary endotheliocytes]. PMID- 6508565 TI - [Medical aspects of teaching histology]. PMID- 6508566 TI - Hansen's disease in Arizona. PMID- 6508567 TI - Tay-Sachs disease: Part 2. Model of a fatal, preventable, metabolic, genetic disorder. PMID- 6508568 TI - Case of the month No. 74.Adenoidal/nasopharyngeal [A/N] ratio. PMID- 6508569 TI - [Deleterious action of adrenaline on the endothelial lining of the vessels]. AB - Perfusion of the aorta of anesthesized rabbits with medium 199 containing adrenaline at a concentration of 10(-6)-10(-4) M results in multiple morphological damages of the endothelial lining: contraction of endotheliocytes with the dilation of intercellular borders, appearance of areas of swelling (from a diffuse edema of single cells up to massive swelling of several hundred cells). The surface of the deendothelized aorta was greater at the highest dose of adrenaline. Inclusion into the perfusate of adrenaline blockers, such as phentolamine and propranolol at a concentration of 10(-5) M prevented endothelial constriction and edema. Similar focal swelling in the intima of aorta and coronary arteries was found in children dying from grave stress (trauma, asphyxia). The data obtained indicate that adrenaline after its therapeutic intravenous or local use may exert a direct damaging effect on the vascular endothelium. PMID- 6508570 TI - [Cloning of bone marrow stromal fibroblasts from a focus of aseptic femur head necrosis]. AB - The number of bone marrow stromal precursors was studied by means of cloning in a patient with aseptic necrosis of the caput femoris. The precursors of stromal fibroblasts were detected in the spongious bone of aseptic necrosis, their number depended upon the patient age, stage and duration of the disease and its etiological factor. PMID- 6508571 TI - [Rhabdomyosarcoma of the kidney in children]. AB - Two cases of renal rhabdomyoid sarcoma with alveolar structures are described. Both children were under one year of age. In one of them the tumour was found at the age of two weeks and was combined with congenital anomaly of the calyx-pelvis system. The tumors were detected incidentally in both children who entered the hospital with the diagnosis of Wilms' tumour. Excretory urography revealed in one case the picture which somewhat differed from that typical for nephroblastoma. The histological and electron-microscopic examinations were performed in both cases. Differential diagnosis from rhabdomyosarcoma is discussed. PMID- 6508572 TI - [Metastasis of clear-cell cancer of the kidney to the tongue]. PMID- 6508573 TI - [Histopathology of the subacute stage of Vilyui encephalomyelitis]. AB - CNS histopathology of 2 cases of Vilyui encephalomyelitis (with neurological symptomatology of 7-month and 3-year duration) is presented. The picture demonstrates severe focal degenerative changes of neurons combined with nonpurulent inflammatory reaction in the pia mater and around the blood vessels of the cerebral and spinal cord white and gray matter. Characteristic features of the disease include swelling of the neurons and their processes, asymmetric thickening of the nuclear membrane, ectopy of the nucleoli and their exit from the nucleus and from the cell, karyocytolysis; formation of spongious foci and fine gliofibrous scars; considerable atrophic, edematous, and dystrophic changes in conduction tracts of the hemispheres, brain stem and spinal cord. An important pathohistologic feature of the disease is an extremely weak reaction of oligodendroglia which belongs to constitutional features of the CNS organization in patients with Vilyui encephalomyelitis and with which the progressive course of this severe disease is, probably, connected. PMID- 6508574 TI - [Healing patterns of wounds inflicted by a carbon dioxide laser]. AB - The problems concerning the wound healing by first intention and by second intention are discussed, on the instance of the wounds caused by a carbon dioxide laser. The authors claim that the cell system responsible for the resorption of necrotic tissues in the absence of purulent processes, i.e. absence of polynuclear leukocytes, is the system of mono- and multinuclear macrophages. The phase of leukocytic lysis of the necrotic tissues may be lacking during healing. PMID- 6508575 TI - [Morphology of the suppurative wound in treatment with a carbon dioxide laser]. AB - The morphological study was performed of biopsies from purulent wounds of 405 patients after an operative removal of the necrotic tissue or necrectomy with a beam of carbon dioxide laser and subsequent application of the primary suture, washing, drainage and active aspiration. The healing of the purulent wound coursed similarly to that of the pure surgical wound, due to aseptic productive inflammation not involving leukocytic infiltration of the granulation tissue. The presence of mononuclear cells and lymphoid cell infiltration in the granulation tissue is indicative of the immune processes enhancement in the host. The results obtained show that the use of a carbon dioxide laser for the treatment of purulent wounds favours their purification, stimulates the regeneratory processes and makes the period of the patient treatment 1.5-2 times shorter. PMID- 6508576 TI - [Endocrine structures of the kidney in hypertension]. AB - Comparative morphometric study of the juxtaglomerular complex and interstitial cells of the corticomedullary zone of the kidney was performed on the autopsy material in benign (26 cases) and malignant hypertension; for control, 15 cases were examined. The state of intrarenal arteries, arterioles and the degree of medulla interstitium sclerosis were taken into consideration. No activation of the renin-producing system was observed morphometrically in "benign" hypertension while it was pronounced in malignant hypertension. The hypothesis is put forward on the reserve renin secretion by mesangial cells in malignant hypertension. It is assumed that the prostaglandine-synthesizing function of the interstitial cells is not damaged in benign hypertension, but it is significantly lower in malignant course of the disease. Relationship is shown between the alterations of intrarenal arteries and arterioles and the degree of the medulla sclerosis in malignant hypertension. PMID- 6508577 TI - [Krabbe's globoid-cell leukodystrophy in a 3 1/2-month-old infant]. AB - Morphology of the brain and its meninges, and internal organs in a girl of 3.5 months is described. The variety of size and shape of the so-called globoid cells in the brain and its meninges is shown. The peculiarity of the observation consists in combination of the underlying disease with disseminated intravascular thrombosis with renal cortex necrosis and uremia. PMID- 6508578 TI - [Krabbe's globoid-cell leukodystrophy]. AB - Krabbe's globoid leukodystrophy was observed in a girl of 6 months. The pathological diagnosis of the disease is based on the oligodendroglia cell damage, nerve fibre demyelinization and presence of giant multi-nuclear globoid cells. PMID- 6508579 TI - [Gigantomastia in pregnancy developing in a case of status thymicolymphaticus]. AB - An 18-year-old female patient is described, suffering from the syndrome of the immunoendocrine insufficiency, status thymicolymphaticus with hyperplasia of the reticulo-epithelial cells and Hassall's corpuscles of the thymus, generalized hyperplasia of the lymphoid tissue and adrenal hypoplasia. When pregnant, she developed a giantism of the mammary glands with a high blood prolactin level. Death occurred several hours after surgery for artificial abortion from acute adrenal insufficiency resulting from adrenal hypoplasia possibly aggravated by the use of parlodel. Eosinophilic (prolactin-somatotrophic) adenohypophyseal hyperplasia which was much higher than that expected in pregnancy evidenced the role of both prolactin and somatotrophic hormone in the pathogenesis of the mamma giantism. The morphological manifestations of the latter were proliferation of the intralobular connective tissue and end ducts and marked interstitial edema of the mammary glands. PMID- 6508580 TI - [Two-dimensional echocardiography in severely ill neonates and infants]. PMID- 6508581 TI - [Valvular infection in patients without evidence of previous valvulopathy]. PMID- 6508583 TI - [Central venous catheter. Anomalous positioning and complications]. PMID- 6508582 TI - [The electrocardiogram in progressive muscular dystrophy and myotonic diseases. A study of 77 patients]. PMID- 6508584 TI - [Myocardial revascularization in syphilitic stenosis of the left coronary artery. A case report]. PMID- 6508585 TI - [Torsade de pointes induced by anti-arrhythmia agents. Report of 2 cases]. PMID- 6508586 TI - [Heart diseases in children: comparative study of 1257 cases attended in outpatient clinics and hospital wards]. PMID- 6508587 TI - [Influence of the anatomical pattern of the coronary arteries on myocardial infarction]. PMID- 6508588 TI - [Right internal mammary artery in retroaortic position for direct myocardial revascularization]. PMID- 6508589 TI - [Acute effect of digoxin on circulation and motility of the ischemic myocardium]. PMID- 6508590 TI - [Factors interfering with the survival of patients with permanent artificial pacemakers]. PMID- 6508591 TI - [Action of magnesium on ventricular fibrillation]. PMID- 6508592 TI - [Bradycardia-tachycardia syndrome in chronic Chagas' cardiopathy]. PMID- 6508593 TI - [Surgical angioplasty of the ostium of the left coronary artery. A case report]. PMID- 6508594 TI - Care of infants having cardiac surgery. PMID- 6508595 TI - [Immediate antihypertensive effect of nifedipine]. PMID- 6508596 TI - Hemodynamic changes during acetate and bicarbonate hemodialysis. AB - In a crossover, double-blind comparison, circulatory changes induced by hemodialysis with bicarbonate versus acetate dialysate were evaluated at the first exposure as well as after 2 weeks of acclimatization to each dialysate. Hemodialysis with bicarbonate dialysate resulted in only minor changes in blood pressure and left ventricular (LV) function as assessed by M-mode echocardiography. In contrast, the first exposure to acetate resulted in significant decreases in systolic (30 mm Hg) and diastolic (17 mm Hg) blood pressure as well as in LV end-diastolic and end-systolic dimensions (5-6 mm) and a rise in ejection fraction. After acclimatization, tolerance developed for the arterial vasodilatory effects of acetate, but not for the venous vasodilatory effect (persistent decrease in LV end-diastolic dimension). These results indicate that some of the circulatory changes induced by hemodialysis may be related more to the acetate infused than to fluid losses or relative autonomic insufficiency. PMID- 6508597 TI - Sodium modeling during hemodialysis: a new approach. AB - Sodium volume modeling during hemodialysis encounters several difficulties. First, the actual sodium distribution volume is the extracellular water, whereas the ultrafiltration flow reflects the variation of total body water. Thus, a two pool model must be considered. This will complicate the model by increasing the number of parameters and boundary conditions. An alternative is to consider the total body water as the apparent distribution volume of loaded or removed sodium, which leads to a single-pool model. Second, convective sodium transfer induced by ultrafiltration is not negligible compared with diffusive sodium transfer. Therefore, sodium transfer modeling must simultaneously take into account the diffusive and the convective part, with the coupling part related to both processes. Third, the Donnan effect due to nondiffusible anionic plasma proteins modifies the sodium transfer through the membrane. Adequate sodium volume modeling should be a compromise between oversimplification, resulting in discrepancies between calculated values and experimental data, and overcomplexity, involving a great number of parameters and boundary conditions, which leads to a model unsuitable for clinical application. A single-pool model is proposed with only one parameter that is estimated during the first period of the hemodialysis session. PMID- 6508598 TI - Migration of acetylated hemicellulose from capillary hemodialyzer to blood, causing scleritis and/or iritis. AB - From November 1981 to early March 1982, an outbreak of scleritis and/or iritis occurred among patients treated with a Nipro brand NAC series cellulose acetate capillary dialyzer. The rate of incidence with dialyzers produced in 1982 was significantly higher than that with dialyzers produced in 1981. An extract obtained from the dialyzers caused iritis in rabbits after its infusion into an auricula vein. Glycerol, acetylated carbohydrate (AC) derivatives, urethane derivatives, and polypropyleneglycol were found in the extract. AC derivatives caused iritis in rabbits, whereas they caused hyperemia of the bulbar conjunctiva in dogs. The AC derivatives contained xylose and glucose units in a ratio of 1.6 2.3:1. The amounts of AC derivatives were significantly larger in the extracts from 1982 than from 1981 devices. Moreover, another brand, but the same type, of dialyzer, the Cordis Dow 4000, contained a slight amount of them. These facts show that AC derivatives derived from hemicellulose played a primary role in the outbreak. PMID- 6508599 TI - Human thoracic anatomy based on computed tomography for development of a totally implantable left ventricular assist system. AB - Human thoracic anatomy was studied using computed tomography (CT) for the development of a totally implantable electrohydraulic left ventricular system [Nimbus, Inc., and The Cleveland Clinic Foundation (CCF)]. To obtain statistical dimensional information for the chest wall, apex of the heart, and aorta, routine calibrated CT scans of 18 men and 17 women were analyzed. A special radiopaque vest was worn by the patient just prior to the scanning and X-ray procedures, so that each transverse scan could be assigned to a specific chest level after combination with a standard vertical referencing system set on the patient's radiogram. A polar coordinate system and direct measurement of transverse distances from the vertical column to points on the chest wall were employed to define collectively the shape and size of the intrathoracic surface of the chest wall. Locations of the aorta and apex were described by measuring their normalized distances from the midline and vertical column to the intrathoracic surface of the lateral and anterior chest wall. The radius of curvature of the intrathoracic wall lateral to the left ventricle was determined to be approximately 10.4 cm for the average adult male chest. The present CCF intrathoracic pump with this curvature fits fairly well in both the average and individual thoraxes of these adult males. The location of the aorta, particularly of the descending aorta, was used to determine the optimal outlet design. The most critical anatomical area was the apex location. For adult males, an average distance of 2.8 cm from the apex to the internal chest wall was found. Because of this small dimension, careful design of the inflow port is being performed to avoid anatomical mismatch. PMID- 6508600 TI - Prolonged left ventricular dysfunction induced by sequential multifocal ischemic infarcts in dogs. AB - A method of creating multifocal ischemia in animals leading to left ventricular (LV) functional impairment is described. In a series of 10 mongrel dogs, electrodes were implanted in multiple branches of the coronary arteries. Subsequently, in seven animals, an 800-microA anodal current was applied for 3 h repeatedly over a span of 4-9 weeks. After current application, serum creatine kinase cardiac isoenzyme increased by 12.2 +/- 4.6 U/L (p less than 0.01) and ischemic electrocardiographic changes were consistently present. After an average of 10.7 current applications, all animals were tachypneic on mild exertion. Repeated measurement of LV function demonstrated a substantial reduction in cardiac reserve. No significant changes in three control animals were observed. The animals were sacrificed 80 days (range 49-108 days) after the initial current application. Presacrifice cineangiography and postmortem examination disclosed coronary artery occlusions, stenoses, recanalizations, and collateralization in the distributions expected on the basis of the time elapsed since electrode activation. In all cases, the myocardium exhibited diffuse fibrosis. This method reliably brings about multifocal myocardial ischemic changes in dogs and may provide a chronic LV failure model particularly suitable for the evaluation of LV assist systems. PMID- 6508601 TI - Quantitative approach to determine the application time of the left ventricular assist device. AB - This study was designed to establish a method for determining the optimal time of the application of the left ventricular assist device from the viewpoint of the metabolism of the vital organs. Quantitative systemic low flow states were made utilizing goats with total artificial hearts. During these experiments, arterial lactate and pyruvate values were sequentially measured. The behavior of anaerobic metabolism during low cardiac output states and in the recovery process following normalization of the cardiac output was quantitatively described and evaluated. The experimental results are summarized as follows: If a time when the decay of arterial lactate ceases at a level above the normal level by greater than 30 mg/dl is observed despite the use of intraaortic balloon pumping, that time is the exact optimal time for application of the left ventricular assist device. There is a great possibility that circulatory failure will be irreversible if left ventricular assist pumping is not initiated before the arterial lactate value increases to greater than or equal to 140 mg/dl. The method of evaluating the alteration of anaerobic metabolism described in this study is useful for determining the application time of the left ventricular assist device. PMID- 6508602 TI - New sequential external counterpulsation for the treatment of acute myocardial infarction. AB - Over a period of 6 years, 52 patients with acute myocardial infarction (AMI) were treated with sequenced external counterpulsation (SECP). Of the 23 patients who experienced severe chest pain, 22 had complete relief within 30 min of SECP, and 31 of the 52 patients showed remarkable improvement in their electrocardiogram after the first hour of treatment. Fifteen patients were studied using the 35 lead ST segment elevation-mapping method. sigma ST and NST, indicators of infarct size, showed decreasing trends in seven patients treated with SECP for a period of 6 days, whereas sigma ST and NST of the control group of eight patients increased during the same period. Our hemodynamic data indicate that in four of five patients with AMI and left heart failure, the central venous pressure and cardiac output increased after SECP, whereas the pulmonary wedge pressure decreased. Measurements of the P-wave terminal force of lead V1 also demonstrated that the application of SECP can improve left ventricular function in a majority of patients with AMI. PMID- 6508603 TI - Analytical comparison of single-pass and dead-end operation in cascade filtration plasmapheresis. AB - Derived mathematical models are employed to compare cascade filtration plasmapheresis in the dead-end and single-pass formats. The high filtration fraction and low sieving coefficients associated with single-pass cascade filtration are shown to require treatment of the retentate concentration profile in an integrated rather than a length-averaged fashion. The models are best applied to specific simulations, but in general predict that (a) for a given membrane, the dead-end format will yield a higher albumin recovery but a lower macroglobulin rejection than single pass; (b) the single-pass format is more suited to loose membranes and the dead-end to tight membranes; and (c) in the single-pass but not the dead-end format, solute recovery is conveniently independent of the quantity filtered. Agreement between predicted and measured performance is good, although a larger data base would be required for complete validation of the models. PMID- 6508604 TI - Differences in the effect of hemodialysis on the residual clearance of inulin, endogenous creatinine, and urea. AB - In a group of 20 patients on regular hemodialysis treatment (HD), the residual glomerular filtration rate was examined before and 12 h after the end of HD. Inulin clearance decreased significantly after HD (p less than 0.001), whereas endogenous creatinine and urea clearance did not change. The results suggest that HD influences the function of residual nephrons. PMID- 6508605 TI - A new hollow-fiber oxygenator for clinical cardiopulmonary bypass. AB - A new hollow-fiber oxygenator has become available for clinical cardiopulmonary bypass. It is available in three sizes for adult use, ranging from 3.3 to 5.4 m2. The surface area is dependent on the number of fibers, with blood and oxygen effecting very efficient gas transfer throughout the length of each of the fibers. The clinical experience now covers 100 patients, using the 3.3-m2 device in 16 patients, the 4.3-m2 device in 12 patients, and the 5.4-m2 device in 72 patients. In all cases, the oxygenator has proven highly efficient in gas transfer. The addition of an oxygen-blending unit was found to be necessary to prevent overoxygenation. It is a safe and effective device to use in routine clinical practice. PMID- 6508606 TI - Acquired cystic disease in kidneys of patients with chronic renal failure. PMID- 6508607 TI - Massive mediastinal hematoma caused by a double-lumen subclavian catheter. PMID- 6508608 TI - Mucous membrane grafting for severe palpebral vernal conjunctivitis. PMID- 6508609 TI - Retinopathy and systemic lupus erythematosus. PMID- 6508610 TI - Fenestrated sheen macular dystrophy. PMID- 6508611 TI - Orbital involvement in mycosis fungoides. PMID- 6508612 TI - Parenterally administered acyclovir for viral retinitis associated with AIDS. PMID- 6508613 TI - Intraocular surgery and choroidal hemorrhage. PMID- 6508614 TI - Epidemiology of presumed ocular histoplasmosis. PMID- 6508615 TI - Delayed nonexpulsive suprachoroidal hemorrhage. AB - Eight cases of delayed nonexpulsive suprachoroidal hemorrhage occurred after filtering operations in aphakic eyes. Sustained hypotonia resulting in serous choroidal detachments, scleral infolding, or both was observed prior to the hemorrhage in seven of the eight eyes. The prognosis was related to the extent of the hemorrhage and possibly to whether or not surgical drainage was performed. Only one of the five patients with massive hemorrhages recovered visual acuity better than hand motions; that patient had undergone prompt surgical drainage of the suprachoroidal blood. PMID- 6508616 TI - Limited choroidal hemorrhage associated with intracapsular cataract extraction. AB - In a prospective study, limited choroidal hemorrhage (LCH) was found in 16 of 521 eyes (3.07%) subjected to cataract extraction. It developed in ten of 69 highly myopic eyes (14.49%), three of 64 moderately myopic eyes (4.49%), and three of 388 eyes without clinically significant myopia (0.77%). A positive correlation was found between LCH and vitreous loss in myopic eyes. A cause and effect relationship was not established. Of systemic factors investigated, an association was found between LCH and cardiovascular disease (14 of 16 cases). The ophthalmoscopic appearance and clinical findings support the hypothesis that LCH and expulsive choroidal hemorrhage are manifestations of the same disease processes and share common pathophysiologic mechanisms. The cause in any one case is probably multifactorial. PMID- 6508617 TI - Evaluation of nerve fiber layer assessment. AB - More than 1,400 eyes with either ocular hypertension glaucomatous visual field loss, or normal pressures and fields (controls) were studied prospectively in standardized, masked fashion. The appearance of the nerve fiber layer was evaluated independently from red-free photographs with the discs blocked-out by two observers. The vast majority of photographs could be evaluated, the proportion varying with the observer and with the age and clinical status of the subject. Sensitivity (proportion of glaucomatous eyes with nerve fiber defects) and specificity (proportion of normal control eyes without defects) averaged 80% to 94%, varying with the observer and with the age, race, and severity of field loss. In two thirds of presumed false-positive eyes, but only 5% of true-positive eyes, the abnormalities were limited to focal slitlike defects. The prevalence of nerve fiber defects in eyes with elevated pressure and normal visual fields was similar to that in control eyes, approximately 10%. However, the proportion of eyes in which these defects included diffuse loss was considerably higher among the hypertensive eyes. PMID- 6508618 TI - Color appearance of the papilla in normal and glaucomatous eyes. A photopapillometric study. AB - The brightness of the papilla in three groups of subjects (young normal subjects, elderly normal subjects, and patients with glaucoma) was measured with a photopapillometer. By employing a sensor 1.0 mm in diameter with a fundus magnification of X2.5, it was possible to study specific sites on the rim of the papilla. Comparison of the values obtained indicated relatively little difference in the brightness of the two sites measured in the left eyes and an obvious difference in those measured in the right eyes, the temporal side being markedly brighter. This pattern persisted throughout all groups, including that of the patients with glaucoma. There was an interesting correlation between the brightness differences observed in the papilla of the subjects and the relative symmetry of the distribution of their retinal vessels. PMID- 6508619 TI - Multifocal choroiditis and panuveitis. A syndrome that mimics ocular histoplasmosis. AB - A review of 28 cases of multifocal choroiditis with vitreous inflammatory cells demonstrates that these patients have chorioretinal scars similar to those in the presumed ocular histoplasmosis syndrome (POHS), but they have a low incidence of positive histoplasmin skin test reactions and calcified granulomata on chest x ray films. Anterior chamber inflammation is a frequent finding. The epidemiologic background of these patients is different from those with POHS. The subjects in this study were also different from patients with birdshot or vitiliginous choroiditis and acute posterior multifocal placoid pigment epitheliopathy. However, unilateral cases are difficult to distinguish from cases of diffuse unilateral subacute neuroretinitis. While it is possible that a subretinal nematode may have caused some of the unilateral cases in this review, multiple causative agents are likely, including an unidentified agent that causes cross reactions to histoplasmin skin tests. PMID- 6508620 TI - Pathophysiology of the blood-retinal barrier in experimental diabetes. Vitreous fluorophotometry using carboxyfluorescein and fluorescein. AB - Carboxyfluorescein resembles fluorescein in size and spectral characteristics but is much less lipid soluble. Both dyes were used to differentiate between two groups of factors that influence penetration across the blood-retinal barrier: (1) factors that depend on lipid solubility, such as the area of the barrier, and (2) factors independent of lipid solubility, such as opened intercellular junctions or necrotic cells. Vitreous fluorophotometry was performed on normal and diabetic rats after injection of either dye. After the results were adjusted for sources of error, midvitreous-plasma dye ratios for carboxyfluorescein and fluorescein were of the same order of magnitude in normal rats. Ratios for both dyes increased in diabetic rats, and the increases were similar in magnitude. Our results suggest that lipid solubility contributes little to inward transport of these dyes in both the normal and diabetic states. PMID- 6508623 TI - Serum contains chemoattractants for human retinal pigment epithelial cells. AB - Blood or serum in the vitreous cavity is associated with cellular membrane formation in proliferative vitreoretinopathy and following severe trauma. Retinal pigment epithelial cells (RPE) are important components of these membranes. For RPE cells to effectively spread throughout the vitreous cavity and form contractile membranes, cell migration must occur. We found that fetal bovine serum and human serum increase human RPE cell migration in a dose-dependent manner; fibronectin (FN) caused a dose-dependent increase in RPE cell migration of similar magnitude. This effect was independent of any effect on cell attachment. The RPE cell migration occurred along a gradient from low to high concentrations of FN and thus represents chemotaxis. Serum depleted of FN lost much of its ability to stimulate RPE cell migration. These results demonstrate that serum contains chemoattractants for human RPE cells and that FN accounts for much of this activity. PMID- 6508621 TI - Comparative anesthetic effects on aqueous humor dynamics in the cynomolgus monkey. AB - Cynomolgus monkeys were anesthetized with either intravenous (IV) ketamine hydrochloride, IV ketamine and intramuscular (IM) diazepam, IM methohexital sodium and IM pentobarbital sodium, or endotracheal halothane. Intraocular pressure, aqueous humor flow rate (F), anterior chamber volume, corneal endothelial transfer coefficient (Ka), and anterior chamber elimination coefficient (Ke) were determined noninvasively, using applanation tonometry, keratometry, pachymetry, and fluorophotometry. Arterial blood gases (ABG), acid base balance, and mean arterial pressure (MAP) were monitored. The IOP was highest with ketamine and lowest with pentobarbital. The F and Ke were about 30% lower with halothane than with the other regimens, while Ka was highest with ketamine. The ABG and MAP were within normal physiologic limits with the three noninhalation regimens; pH was within normal limits with all four regimens. The MAP was lowest and PO2 highest with halothane, while pH was highest with pentobarbital. PMID- 6508622 TI - A fresh look at iontophoresis. AB - The rate of penetration of fluorescein and gentamicin ions into the anterior chamber of the rabbit was increased more than 100-fold by the passage of 1 mamp; the amount of drug that penetrates is better controlled by iontophoresis than by instillation. The potential value, the safety and the limitations of this procedure are discussed, and a theoretical basis for the increase is provided. Practical methods of using iontophoresis in the clinic are described. A 30-s application should result in a therapeutic level of the antibiotic in the anterior segment over a 12-hour period in eyes with an intact epithelium. PMID- 6508624 TI - Experimental YAG laser sclerostomy. AB - A Q-switched neodymium-YAG laser was used to produce a corneoscleral perforation in human cadaver eyes. A through-and-through incision could be created solely with the YAG-laser at peak pulse energies of 16 millijoules (mJ). The minimal total energy required for perforation was 3,312 mJ. However, "optimal" perforation, producing splitting along natural scleral cleavage planes, required 26,676 mJ. Scanning electron microscopy showed the perforations to be clean holes with little debris. PMID- 6508626 TI - Middle fossa vestibular neurectomy. Long-term results. AB - Middle fossa vestibular neurectomy is especially useful for treatment of Meniere's disease. We treated 59 cases of Meniere's disease with this technique and followed them up for at least ten years. Middle fossa vestibular neurectomy was effective against vertigo in Meniere's disease in 100% of the cases with unilateral involvement. Hearing, as well as tinnitus and hyperacusis, showed a clearly favorable evolution after vestibular neurectomy. The excellent long-term effects of this procedure on vertigo and low incidence of complications make middle fossa vestibular neurectomy one of the most effective surgical treatments for Meniere's disease. PMID- 6508625 TI - Hydrophobic lining of the eustachian tube imparted by surfactant. AB - The eustachian tubes were excised from nine rabbits and one pig, and the hydrophobic nature of each luminal surface was determined by placing upon it a drop of saline. Each surface resisted wetting, with the droplet "beading up" to give a mean contact angle between the tissue-fluid and fluid-air interfaces of 50.1 degrees for the rabbits and 49 degrees for the pig. Each measurement was determined by a goniometer. The hydrophobicity was eliminated by lipid solvents and largely by aspirin, which desorb surface-active phospholipids. These results are consistent with the hypothesis that surfactants identified in the eustachian tubes are absorbed to the luminal surfaces as adhesives to oppose the strongly adhesive nature of the proteins and thus maintain patency and ventilation of the middle ear. This concept implies that an inadequate layer of adsorbed phospholipid could lead to serous otitis. PMID- 6508627 TI - Endochondral pseudocyst of the auricle in Chinese. AB - Thirty-one patients with endochondral pseudocysts of the auricle were seen over a four-year period in the Department of Surgery at the University of Hong Kong. The lesions chiefly affected Chinese males (90.3%); 80.6% involved the scaphoid fossa on the anterior surface of the pinna. They were usually asymptomatic and static in size. Excision of the anterior wall, followed by contour pressure dressing, gave cosmetically satisfactory results in 90% of the patients, and there were no recurrences. Pathologic studies revealed the absence of an epithelial lining as well as multiple cystic spaces that contained abundant glycosaminoglycans (acid mucopolysaccharides). We postulate that the overproduction of glycosaminoglycans engendered by repeated minor trauma to the cartilage was the primary cause of the pseudocysts. PMID- 6508628 TI - Open v closed reduction of the fractured nose. AB - A stepwise study of nasal fractures includes an initial investigation that was carried out to discover why so many patients were awaiting rhinoplasty, which led us to find a 30% to 40% failure rate in nasal manipulation operations. We then studied the mechanics of nasal fracture by striking fresh cadaver noses. We found that if the nasal bones were deviated by more than half the bridge width, there was a concomitant C-shape fracture of the bony and cartilaginous septum. Two trials were performed, and patients with nasal deviation after trauma were allocated to either manipulation or manipulation plus excision of septal cartilage (closed or open reduction). Both trials were statistically significant, indicating that open reduction is the preferred treatment for patients with a deviation of more than half the bridge width of the nose. PMID- 6508629 TI - Inverted papilloma in a 10-year-old boy. AB - Inverted nasal papillomas are rare tumors in children. Four large series include only a single patient (of a total of 269) younger than 20 years. We report the occurrence of an inverted nasal papilloma in a 10-year-old boy; this tumor exhibited clinical and histopathologic features identical to those of similar neoplasms in adults. Inverted papillomas in children should be treated by wide local excision, usually using a lateral rhinotomy approach. The rationale for such aggressive surgery is based on the high rate of recurrence (25% to 75%) and a propensity for the development of carcinomas (5% to 15%) as associated lesions. PMID- 6508630 TI - Optic neuritis secondary to sinus disease. AB - Sinus disease is an infrequent, but treatable, cause of optic neuritis. We treated three patients in whom optic neuritis was caused by sinus disease. Treatment of the underlying sinus condition resulted in the improvement of vision. PMID- 6508631 TI - Pleomorphic lipoma. PMID- 6508632 TI - Extramedullary plasmacytoma. PMID- 6508633 TI - Identifying and excising tumor. PMID- 6508634 TI - Atherosclerosis and myocardial ischemic lesions in alloxan-diabetic rabbits fed a low cholesterol diet. AB - To reinvestigate the relationship between diabetes and atherosclerosis in rabbits, we fed alloxan-diabetic, alloxan-nondiabetic, and control rabbits a low cholesterol atherogenic diet for up to 40 weeks. Concentrations of plasma total cholesterol, phospholipids, and triglycerides were higher, the percentage of very low density lipoproteins was higher, and the percentage of high density lipoproteins was lower in diabetic than in nondiabetic rabbits. Smooth muscle cell proliferation was prominent, atherosclerosis was more extensive, and a high incidence (29%) of large, sharply demarcated, ischemic myocardial lesions occurred in the diabetic rabbits. These results are in contrast to those of earlier studies where the diabetic state resulted in a partial protection against atherogenesis in alloxan-diabetic rabbits fed larger amounts of cholesterol. PMID- 6508635 TI - Double pre-beta lipoprotein. Isolation and characterization of the two population of very low density lipoproteins by zonal ultracentrifugation. AB - Two electrophoretic populations of very low density lipoprotein are frequently observed in both normal and hyperlipidemic human sera. This gives the appearance of two pre-beta bands, called the "double pre-beta lipoprotein phenomenon." The slow and fast bands forming the double pre-beta lipoprotein were isolated by ultracentrifugation in the zonal rotor under rate flotation conditions. On the basis of the effluent position, the slow band showed a lower flotation coefficient than the fast one. The lipid and apoprotein composition of the two very low density lipoprotein populations isolated by zonal ultracentrifugation was in close agreement with those obtained by preparative agarose gel electrophoresis. The slow and fast pre-beta fractions had the same triglyceride fatty acid composition. Both fractions contained only higher molecular weight apo B-100, while the slow fraction was relatively enriched in apo E and apo C-III. Since the slow pre-beta fraction showed the typical properties of the remnant particle, studying this fraction could clarify the possible relationship between remnant lipoproteins and atherogenesis. Zonal rotor ultracentrifugation may be useful to characterize remnant particles in normal and hyperlipidemic subjects. PMID- 6508636 TI - Low density lipoprotein metabolism in familial combined hyperlipidemia. Mechanism of the multiple lipoprotein phenotypic expression. AB - Plasma low density lipoprotein (LDL) kinetics and their relation to plasma very low density lipoprotein (VLDL) and LDL composition were determined in patients with familial combined hyperlipidemia (FCHL) of varying lipoprotein phenotypes. In both Type II and IV subjects, LDL apolipoprotein B (apo B) synthesis was greater than normal. In Type IV, the VLDL triglyceride/apo B ratio was normal and almost all of the LDL apo B was derived from VLDL. LDL cholesterol/apo B ratio was diminished and LDL apo B fractional catabolic rate (FCR) was sufficiently increased to prevent a rise in plasma LDL concentration. In Type II, VLDL triglyceride/apo B was reduced and 14% to 50% of the LDL was formed by direct synthesis. LDL cholesterol/apo B was normal and LDL apo B FCR was lower than in Type IV subjects. In four patients whose plasma lipid levels became normal with carbohydrate restriction and intake of a fibric acid derivative, plasma VLDL and LDL composition and LDL kinetic measurements remained unchanged. By contrast, VLDL triglyceride-apo B decreased and direct LDL synthesis increased in four patients whose phenotype changed to Type IIa. LDL cholesterol/apo B also increased and LDL FCR declined. Among patients with FCHL, significant correlations between VLDL triglyceride/apo B, LDL apo B derived by direct synthesis, LDL cholesterol/apo B, and LDL apo B FCR were found. Thus, increased apo B synthesis is a characteristic feature of FCHL. The phenotypic expression is determined by the availability of triglyceride for hepatic coupling to apo B which could influence the source, composition, and removal rate of circulating LDL. Despite normalization of their plasma lipid levels, some patients continued to show the compositional and kinetic features of FCHL. PMID- 6508637 TI - Mobilization of stored triglycerides from macrophages as free fatty acids. AB - Because many or most lipid-laden foam cells in atheromas and in xanthomas derive from macrophages, it is important to understand how they accumulate lipids and how they can divest themselves of lipids. The mobilization of stored triglycerides from macrophages was studied in cell cultures. Mouse resident peritoneal macrophages and J774 macrophages increased their triglyceride content six- to tenfold during a 24-hour incubation with free fatty acids complexed to albumin. Subsequent incubation in fresh medium containing free fatty acid-poor albumin was accompanied by a fall in cell triglyceride content (50% in 20 hours) and a corresponding increase in medium-free fatty acid. Release of free fatty acid was linear as a function of time, provided fresh medium was added hourly. When medium was not changed, release rates fell off rapidly, probably due to re uptake of released free fatty acid. Chloroquine did not affect the rate of free fatty acid release. The results suggest that macrophages-foam cells can reduce their triglyceride stores via the action of a nonlysosomal (presumably cytoplasmic) neutral triglyceride lipase. PMID- 6508638 TI - Atherogenic diet-induced modification of the subfraction distribution of high density lipoproteins in monkeys. AB - High density lipoproteins (HDL) were isolated from the plasma of adult male African green monkeys fed control or atherogenic diets and were then subfractionated in a density gradient by centrifugation at 50,000 rpm, 20 degrees C for 18 hours in the Beckman VTi50 vertical rotor. Material from the gradient was pooled into six subfractions for further analysis. With increasing density across the gradient, the subfractions had progressively decreasing flotation rates, molecular weights, apo A-I/apo A-II mass ratios, lipid percentages of mass, and average sizes. Apoprotein content per particle was reasonably constant compared to lipid content. The physical and chemical properties of the HDL subfractions suggested that the gradient separated three subclasses of HDL equivalent to HDL 2b, HDL 2a, and HDL3 of human beings. When values among animals were compared, the atherogenic diet shifted the relationship between total plasma cholesterol concentration and total HDL concentration from a positive to a negative correlation. The subfractions most affected were those of d less than 1.10 g/ml (HDL2b), while the 1.10 less than d less than 1.13 g/ml (HDL2a) subfractions were affected to a lesser degree; the more responsive the animal to dietary cholesterol, the lower was the mass concentrations of these subfractions. This pattern suggested that diet-induced changes in HDL2 subfraction particle concentrations may be related to the development of atherosclerosis in African green monkeys; parallel changes in particle composition were not identified. PMID- 6508639 TI - Diving bradycardia. PMID- 6508640 TI - It's time to disabuse our patients. PMID- 6508641 TI - Acute scrotal pain in childhood and adolescence. Solving the dilemma. PMID- 6508642 TI - Circumcision. A review of the literature and survey of current practice. AB - Evidence suggests neonatal circumcision continues to be a common practice and that outmoded techniques are being used. Controversy and ignorance about normal care of the uncircumcised infant is widespread. More definitive teaching at undergraduate and postgraduate levels is required. PMID- 6508643 TI - Vasectomy. AB - Vasectomy has become a popular method of family planning in recent years in Australia. The relatively simple procedure is effective, has few complications and usually does not require hospitalisation. PMID- 6508644 TI - Evaluation of automated health testing at the Shepherd Foundation. Lifestyle changes three months and two years after testing. AB - Healthy changes in lifestyle are reported in this follow up of patients at three months and two years after automated health testing at the Shepherd Foundation. The study indicates that early changes are sustained. PMID- 6508645 TI - Catheterisation of the male. AB - Insertion of a catheter into the male urethra is not an insignificant procedure: inappropriate catheterisation or incorrect technique could have dire consequences for the patient. A plea is made for gentleness in technique and an operator's willingness to admit lack of experience. PMID- 6508647 TI - Pancoast's tumour (superior pulmonary sulcus tumour). PMID- 6508646 TI - Developing a hypothesis. A question about herpes zoster. PMID- 6508648 TI - Lame duck survival. PMID- 6508649 TI - Female urinary problems. A gynaecological view. AB - Urinary incontinence in women is common and it is surprising how many endure it in the erroneous belief that little can be done. Their life is made miserable by a problem which often can be cured or at least significantly alleviated by the judicious use of drugs or surgery. PMID- 6508650 TI - Clinical trials. Controlled or double blind? PMID- 6508651 TI - Occupational repetitive strain injuries. AB - The incidence of repetitive strain injuries is rising; they are the most common cause of loss of time from work for women and third most common for men. A detailed history and careful examination are required to determine specifically the muscles and tendons affected by overuse; treatment is directed primarily at avoiding stress to these areas. PMID- 6508653 TI - Using a computer medical record summary. PMID- 6508652 TI - Oral contraceptives. PMID- 6508654 TI - Sick leave certification in general practice. AB - Details were recorded of all sick leave certificates issued for six months in a family practice of 1750 patients in an immigrant Yemenite working class town. Certificates were issued most on Sundays and in the autumn festive season. The common diagnoses were inflammation of the upper respiratory or gastrointestinal tracts, locomotor disorders in men and gynaecological disorders in women. PMID- 6508655 TI - Isolation of choriomammotropin from the ovine placentome. AB - Placentomes, taken from ewes at 101-141 days gestation, were homogenized and subjected to differential and density gradient centrifugation. In the presence or absence of protease inhibitors, choriomammotropin (ovine chorionic somatomammotropin, oCS) was detected by radio-immunoassay, and banded at two positions in 30-60% w/v sucrose gradients. The first band (soluble form) eluted in the sample zone of the gradient and contained 33 +/- 6.1% (mean +/- s.e.m., n = 10) of the total oCS present in the gradient. The remainder (48 +/- 7.6%) of the oCS (particulate form) sedimented to 37.5-43% w/v sucrose. Both these bands became sharper with decreasing protein loaded onto the gradients. 125I-oCS, pre equilibrated with a placentome preparation, eluted in the same position as the first band of endogenous oCS. When loaded onto a second gradient the second band eluted at 38-41% w/v sucrose, but after being subjected to ultrasonic disruption or treatment with Triton X-100 this oCS eluted in the sample zone. There was no correlation between gestational age of the ewe and the percentage oCS in either the soluble or particulate form, the concentration of oCS, or enrichment by protein. We have shown that following homogenization, differential and density gradient centrifugation, oCS exists in two forms. We suggest that the particulate form of the hormone is contained within the electron-dense granules of placentome cells. The soluble form may represent oCS in the process of secretion and hormone which has leached out of the granules during homogenization and centrifugation of the placentomes. PMID- 6508656 TI - Single parent families. PMID- 6508657 TI - Child abuse and non-organic failure to thrive: similarities and differences in the parents. AB - A group of 39 mothers who had a physically abused child at an average of 6 years previously and a group of 14 mothers who had a child with non-organic failure to thrive (NOFTT) 13 years ago were reviewed. Each child was compared with a child matched for age and sex and for ethnic group, residential area and social class of the parents. The mothers from the NOFTT group knew less than their comparison mothers about their child's education and on a personality test were less able at intellectual and abstract concepts. The abuse group mothers were more mobile and more isolated than their comparison group. They were less likely to have been brought up by their own parents and had more negative feelings towards their fathers. They had lower self-esteem and higher expectations for their children than the comparison mothers. On a personality assessment they were more assertive, demanding and suspicious than the comparison mothers. Although child abuse and non-organic failure to thrive have been described as part of the same spectrum, the characteristics of the parents on follow-up are different. As some of the adverse characteristics of the parents persist long after the presenting incident, the need for a long term treatment programme aimed at supporting children who remain in these families is recommended. PMID- 6508658 TI - Temperament in Australian infants. AB - A convenience sample of 240 infants aged 4-8 months was studied to evaluate the suitability of a revised version of Carey's Infant Temperament Questionnaire (ITQ) for an Australian population. Data analyses indicated all item/dimension correlations significant at P less than 0.01 or better, satisfactory internal consistency of the instrument as measured by alpha coefficients, and test retest reliability of 0.79. Infants rated as having a 'difficult' temperament were significantly more likely to be reported as having problem behaviours. Significant differences were found between Australian and American infants on three of the nine temperament dimensions - rhythmicity, activity and intensity. The results of this study indicate that this revised ITQ is suitable for use with Australian infants. PMID- 6508659 TI - Reliability of mothers' reports of birth data. AB - To determine the reliability of recall of birth and early childhood events, a group of 47 mothers was asked details of their child's birth and about any child rearing problems at an average of 5-6 years after the birth. Thirty-four of these mothers were asked similar questions 3 years later. The information given by the mothers was compared with the information documented in the hospital records when the children were born. The mothers overestimated the length of pregnancy and overestimated the number of neonatal problems. Only half could recall the birth weight accurately. When asked the same questions 3 years later there was a tendency for memory to have mellowed with fewer pregnancy complications and child rearing difficulties being recalled than on the previous interview. Information given by mothers about such objective data as length of gestation, birth weight and obstetric complications is not necessarily accurate. Less objective data may be recalled even less accurately. PMID- 6508660 TI - Health care needs of the children of single mothers in a Perth suburb. AB - This paper reports a prevalence study of illness in children in a lower socioeconomic suburb of Perth. The study shows that single mothers reported higher rates of both emotional and physical disorder in their children compared with mothers from nuclear families. The children from single families were also reported as having a poorer immunization status. It is argued that children from single families constitute a vulnerable group and deserve special attention from those in the health system who care for children. PMID- 6508661 TI - Transcutaneous oxygen monitoring in acute asthma. AB - Arterial blood oxygen tensions (Pao2) were compared with simultaneously obtained transcutaneous oxygen measurements (TcO2) in 15 children during an acute asthma attack and in 18 children with an illness other than asthma. A close correlation between TcO2 and PaO2 was obtained in the non-asthmatic group but not in the asthmatics. It is suggested that impaired cutaneous blood flow may explain this poor correlation. PMID- 6508662 TI - Accuracy of radiological diagnosis in the Casualty Department of a children's hospital. AB - The radiographs of 1363 patients referred from a hospital Casualty Department were reviewed in order to study possible discrepancies between the interpretations of the films by the casualty medical staff and the radiologist. Interpretations by casualty staff were substantially correct in 96.3% of patients. Discrepancies were noted in 41 patients (3.0%)--pneumonia was overlooked on chest films in 7 cases, while 19 fractures were not noted by Casualty staff. These were almost all minor, with no problems resulting from delay in treatment. This study has implications for the training of Casualty medical staff, the cross-checking of their reports, and the possible need for Casualty department staffing by radiologists. PMID- 6508663 TI - Salmonella meningitis in infancy. AB - Despite adequate treatment, mortality and morbidity were high among the 13 cases of Salmonella meningitis in this series. Chloramphenicol, being a bacteriostatic agent against Salmonella species, is not a suitable antibiotic for the treatment of Salmonella meningitis. Treatment for 4-6 weeks is recommended with use of an antibiotic capable of achieving an adequate bactericidal concentration in the cerebrospinal fluid such as moxalactam. Intraventricular antibiotic treatment should be considered if there is a delay in the eradication of the Salmonella organisms from the cerebrospinal fluid after starting treatment. PMID- 6508664 TI - A case of agammaglobulinaemia complicated by meningoencephalitis due to Echo virus 27. AB - A boy with agammaglobulinaemia diagnosed and treated from the age of 3 years 2 months developed encephalitis at 4 years 3 months. The illness showed a remitting but deteriorating course until death aged 6 years 5 months. Echo virus type 27 was isolated from the cerebrospinal fluid during the terminal illness. The virus was not isolated from five earlier cerebrospinal fluid samples nor was virus detected in a temporal lobe biopsy. PMID- 6508665 TI - Giardiasis in Tasmania. PMID- 6508666 TI - Toxic adenoma in childhood. PMID- 6508667 TI - Anthelmintic resistance and sheep management practices in south western Victoria. AB - Twenty-eight farms in 7 shires in south western Victoria were selected and tested for presence of benzimidazole-resistant nematodes between November 1979 and June 1981. Mean faecal egg counts of sheep were less than 100 strongyloid eggs/g on 11 farms. Faecal egg count reduction tests were conducted on the remaining 17 farms and thiabendazole was less than 90% efficient in reducing egg counts in sheep from 5 (29%) of these farms. Thiabendazole-resistant Teladorsagia circumcincta were identified at necropsy of experimentally infected treated sheep. In further studies a survey of 104 farms was conducted in the Mount Rouse and Dundas shires of western Victoria in 1981 and 1982 respectively to determine the prevalence of anthelmintic resistance in these shires. Mean faecal egg counts among weaner sheep in the winter-spring of both years were less than 100 eggs/g which indicated low levels of parasitic nematode populations. A faecal egg count reduction test was conducted on 10 farms and thiabendazole was less than 90% efficient on 3; levamisole was greater than 90% efficient in all 10 tests. Most of the surveyed farms carried Merino or Merino crossbred sheep at 10 to 15 dry sheep equivalents per ha and weaners were treated with anthelmintics 3 to 6 times per year. Management procedures based mainly on anthelmintic therapy were effective in controlling nematode populations in weaner sheep, although many producers alternated between different groups of anthelmintics within the same year contrary to current recommendations for long-term preservation of anthelmintic efficacy. It was concluded that anthelmintic resistance was not of practical importance to the majority of sheep producers in the region. PMID- 6508668 TI - Illness in horses following spraying with amitraz. AB - Sickness occurred in 3 of 4 horses within 24 h of being sprayed with an 0.025% w/v aqueous suspension of amitraz. The latter consisted of a portion of an amitraz aqueous suspension made up some 3 weeks previously, to which some freshly prepared spray fluid had been added. It seemed likely that the amitraz in the older solution had broken down to the highly toxic N-3, 5- dimethylphenyl N methyl formamadine derivative and that this was in fact the main cause of the untoward effects observed. The horses displayed typical clinical signs of tranquillisation, depression, ataxia, muscular incoordination and impaction colic lasting up to 6 days. Subcutaneous oedema of the face occurred in one horse. The syndrome was accompanied by mild dehydration and acidosis. All horses survived after persistent symptomatic treatment including the giving of intravenous fluids, enemas, analgesics every 3 h, multiple doses of paraffin oil per os and dexamethasone intravenously. Following the eventual relief of constipation the horses scoured profusely for 24 h before their condition returned to normal. PMID- 6508670 TI - Recurrent and persistent infections in related Weimaraner dogs. PMID- 6508669 TI - Toxicity in utility pigeons caused by the coccidiostat dinitolmide. AB - Utility pigeons on 3 farms were affected by a severe neurological disturbance manifested by fine tremors, rolling gait and incoordination. Affected birds had necrosis of the Purkinje cells of the cerebellar cortex. The birds from the 3 farms had been fed a pelleted diet obtained from a single mix of feed prepared by a stockfeed manufacturer. When feed obtained from the farms was given to utility pigeons under controlled conditions at the laboratory, they suffered the same clinical signs and lesions as seen in birds from the farms. Cross-bred cockerels were not affected when given this feed from day-old to 6 weeks of age. Samples of the feed contained 185 to 226 ppm of the coccidiostat dinitolmide. Utility pigeons given a prepared diet containing a similar level (234 ppm) of dinitolmide developed an identical condition after 3 to 4 weeks feeding. Laying hens were not affected by this feed. Dimetridazole, which was also present in some of the original feed samples, did not exacerbate the condition when included in the diet at a rate of 233 ppm. Production of squabs from the affected farms was dramatically reduced, and many of the breeder had to be culled because of the long-standing neurological disease. PMID- 6508672 TI - Development of a model of caval syndrome in dogs infected with Dirofilaria immitis. PMID- 6508671 TI - Observations of the effects of Rapistrum rugosum on thyroid function. PMID- 6508673 TI - Inherited enchondrodystrophic dwarfism in English pointers. PMID- 6508674 TI - Pneumonia associated with Haemophilus somnus in a calf. PMID- 6508675 TI - The accuracy of clinical diagnoses by fine-needle aspiration cytology. PMID- 6508676 TI - Ruminal motility in sheep intoxicated with 2,3-dihydroxypyridine. PMID- 6508678 TI - Muscle fiber type composition and G-tolerance. AB - The relationship between sustained G-tolerance and muscle fiber type composition was studied in 28 fighter pilots and 10 nonpilots. The G-tolerance, as assessed by the aerial combat maneuver (ACM) acceleration profile and modifications of it, was measured in a human centrifuge. Percutaneous muscle biopsies were obtained from m. vastus lateralis at rest. Histochemical analyses were carried out to identify and calculate the percentage of fast twitch (FT) and slow twitch (ST) fiber types. Additional analyses were performed for determination of muscle fiber size and capillary density. Mean (+/- S.D.) muscle fiber type composition in pilots and nonpilots, respectively, were 60 +/- 5 and 52 +/- 10% FT. There was no correlation of fiber type composition, fiber size, or capillary supply with G tolerance. It is concluded that muscle fiber type composition and associated metabolic characteristics do not modify sustained G-tolerance to any significant extent. PMID- 6508677 TI - Liver biopsy and black disease in a sheep. PMID- 6508679 TI - The unresponsiveness of the immune system of the rat to hypergravity. AB - The immune response in rats exposed to simulated hypergravity (2.1 G and 3.1 G) by chronic centrifugation was assessed. Rats were immunized with sheep red blood cells (SRBC), either on the day of initial exposure to hypergravity (hyper-G), or after being centrifuged for 28 d and remaining on the centrifuge thereafter. Pair fed and ad libitum fed noncentrifuged controls were used. Although there were some alterations in leukocyte counts, hyper-G did not systematically affect the primary or secondary anti-SRBC response, hematocrits, or the sizes of the liver, spleen, kidneys, thymus, or adrenal glands. The immune system is thus remarkably homeostatic under hypergravity conditions which do affect other physiologic parameters. PMID- 6508680 TI - The effect of altitude on normal pulmonary function tests: a comparison between the Dead Sea area and Amman. AB - The Dead Sea area, which is 350 m below sea level, is by far the lowest region in the world inhabited by permanent population. To assess the effect of that low altitude on pulmonary function, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and forced mid expiratory flow rate between 25% and 75% of FVC (FMF 25-75%) were determined for 195 boys and 149 girls living in the Dead Sea region. These were compared with the same function values of 204 boys and 224 girls living in Amman Area (774 meters above sea level). The data were statistically analysed, considering a probability of error level of 1% as significant. When the data for boys were considered, the arithmetic mean test showed significant difference for FVC only while the variance test showed significance in the FVC, FEV1, and FMF (25-75%), the values of the Dead Sea area subjects being lower. On the other hand when the data for girls were analysed there were no statistically significant differences between the two groups, although there was a slight apparent difference in all values, with the Dead Sea area girls having higher figures. These data suggest that, although altitude may play a role in modifying ventilatory function, other factors should be considered. In particular the inhabitants and their children of the Dead Sea area are very actively involved in agriculture while the children of Amman have few exercise facilities available. PMID- 6508681 TI - Application of the compartmentalization/airlock concept to aircraft and tolerance of lung to rapid decompression. AB - The incidence of pulmonary hemorrhage of different laboratory animals undergoing rapid decompression was found to be markedly decreased by applying the compartmentalization/airlock concept to simulated pressurized aircraft. It was observed that, in protected rabbit, mouse, and rat lungs, 6 of 24 (25%), 7 of 24 (29%), and 6 of 24 (25%), respectively, exhibited a few petechial hemorrhages following rapid decompression. In unprotected animals, however, all 72 lungs showed slight-to-very-severe degrees of decompression-induced hemorrhages. The percent of mortality of the unprotected animals undergoing rapid decompression was 47%, while there were no deaths in protected animals. The incidence of such pulmonary hemorrhages and the mortality of experimental animals indicate that compartmentalization, combined with an adequate airlock, would be of great value in protection against accidental decompression of pressurized aircraft. PMID- 6508682 TI - Visual slant misperception and the 'black-hole' landing situation. AB - A theory is presented which explains the often quoted tendency for dangerously low approaches during night-landing situations. The two-dimensional information at the pilot's eye contains sufficient information for the visual system to estimate correctly the angle of slant of the runway relative to the approach path. An algorithm is developed which can perform this angle estimation. It is dependent upon perspective information being available a certain lateral distance out from the aimpoint, to either side of the runway edgelights. However, under 'black-hole' landing conditions this information is not available, and it is proposed that the visual system uses instead the only available information- namely the perspective gradient of the runway edgelights. An equation is developed which predicts what the perceived approach angle will be when this incorrect perspective is used. The predictions are in close agreement with existing experimental data. PMID- 6508683 TI - Sleep of shiftworkers within the arctic circle. AB - The sleep of shiftworkers in the Arctic has been investigated using electroencephalography. The subjects were studied four times a year over a 2-year period. There was a trend toward less restful sleep during the autumn and winter months, but otherwise sleep at various times of the day was similar to that of individuals elsewhere. This would suggest that sleep disturbance in polar shiftworkers can be managed in a similar way to that of shiftworkers in temperate regions. PMID- 6508684 TI - The effect of sleep loss on high intensity exercise and recovery. AB - The cardiovascular and metabolic responses of five male subjects during submaximal exercise (80% Vo2 max) were examined after 24 h of wakefulness. The protocol consisted of two sets of two trials separated by 7-10 days: first, a 20 min exercise bout, then a normal night's sleep, followed by another 20 minutes of exercise; second, a 20-min exercise bout, 24 h of wakefulness, then another 20 min exercise trial. Exercise ventilation, heart rate, and oxygen uptake were not affected by sleep loss. However, sleep loss caused the recovery ventilation and oxygen uptake to remain higher than normal during the slow phase of recovery. Blood glucose levels were found to be greater during the sleep deprived trials compared to controls, but were similar to controls 15 min after exercise. Blood lactates were lower at the end of exercise after sleep deprivation and remained lower during the recovery period. Changes in plasma volume were not affected by sleep loss. These results suggest that although sleep loss may not overtly affect acute submaximal exercise performance, it attenuates the recovery process. PMID- 6508685 TI - Increased susceptibility to radiofrequency radiation due to pharmacological agents. AB - The effects of chlorpromazine, methysergide, and propranolol on thermal responses to 2.8 GHz radiofrequency radiation were examined in anesthetized rats. During intermittent exposure at an average power density of 60 mW X cm-2 (specific absorption rate, 14 W X kg-1), when colonic temperature was not allowed to rise above 39.5 degrees C, none of the pharmacological agents had any significant effects on thermal responses. When exposure was continued until lethal temperatures resulted, animals which were administered chlorpromazine, methysergide, or propranolol exhibited significantly shorter survival times than saline-treated animals. Propranolol administration caused the greatest decrease in survival time and resulted in a significantly lower lethal temperature than that which occurred in saline-treated animals. PMID- 6508686 TI - Canine postradiation histamine levels and subsequent response to Compound 48/80. AB - Radiation-induced hypotension in the beagle is accompanied by increased intestinal blood flow (IBF) and hematocrit (HCT). This study was performed to correlate these radiation-induced changes with plasma histamine (PH) levels following radiation. The histamine (H) levels were monitored in the systemic arterial circulation (SA) and the hepatic portal vein (HPV) before and after radiation. To examine the effect of radiation on the mobilization of total body H stores, Compound 48/80 was given I.V., and H responses were monitored in both control and radiated animals. Data obtained indicated that 100 Gy, whole-body, gamma-radiation produced a decrease in systemic mean blood pressure (BP), an increase in IBF and an increase in HCT. Concurrently, the mean PH/SA values increased and the PH/HPV levels decreased. Compound 48/80 produced a marked increase in PH levels in both control and radiated animals; however, the levels found in the radiated animals were consistently lower than those in the controls, although not statistically different. This implies that H may mediate these observed intestinal responses and that the mobility of histamine is decreased in radiated animals. PMID- 6508687 TI - Transdermal therapeutic system scopolamine (TTSS), dimenhydrinate, and placebo--a comparative study at sea. AB - The efficacy of transdermally administered scopolamine was compared with the efficacy of oral dimenhydrinate and placebo therapy in the prevention of motion sickness at sea. Medication was administered on a controlled double blind basis to 140 subjects. A placebo effect reduced the motion sickness incidence (MSI) from 57.69% in the control group to 43.47%. Administration of dimenhydrinate reduced the MSI to 22.22% and the use of Transdermal Therapeutic System Scopolamine (TTSS) further reduced the MSI to 16.66%. TTSS afforded 61.67% protection against motion sickness at sea, compared to 48.88% protection with dimenhydrinate. PMID- 6508688 TI - Physical training and +Gz tolerance. PMID- 6508689 TI - Pentoxifylline reverses age-related deficits in spatial memory. AB - Pentoxifylline, a phosphodiesterase inhibitor, produces a marked reversal of an age-dependent spatial memory deficit in Fischer 344 strain male rats. Performance of 26-month-old animals treated chronically with pentoxifylline approached that of 3-month-old controls. The effect was not dependent upon concurrent administration of the acetylcholine precursor choline chloride. It is concluded that the pentoxifylline-induced reversal of the age-dependent memory decline is not dependent on any presumed facilitation of acetylation and utilization of exogenously supplied transmitter substrate. PMID- 6508690 TI - Stimulus selection in passive avoidance learning and retention: weanling, periadolescent, and young adult rats. AB - Periadolescent rats exhibit a number of behavioral differences in comparison with younger or older animals. For instance, periadolescents tend to show enhanced acquisition of simple active avoidance tasks, but impaired acquisition of more complex appetitive and aversive discriminations. In this experiment, rats were trained on a simple passive avoidance task at one of three ages, as weanlings (25 days), periadolescents (35 days), or young adults (45 days). Training occurred in the presence of both a redundant discriminative stimulus and a specified, redundant contextual stimulus. The periadolescents did not differ from either younger or older rats in rate of learning the passive avoidance task. The retention performance of these animals was then tested following a change in either, neither, or both of the redundant cues. When a measure of performance that controls for baseline activity was used, it was observed that periadolescents were not disrupted by a change in the redundant discriminative stimulus, a cue change that clearly disrupted performance in 25- and 45-day-old animals, and tended to be more disrupted by the contextual change than younger or older rats. It is hypothesized that the alterations in performance exhibited by periadolescents may be related to an ontogenetic alteration in stimulus selection modulated by the catecholaminergic systems. PMID- 6508691 TI - The DBA/1Bg and DBA/2Bg Y chromosomes compared for their effects on male sexual behavior. AB - Mount, intromission, and ejaculation number and latency were measured in male mice of the DBA/1Bg, DBA/2Bg, and DBA/2.DBA/1-YBg congenic strains. The DBA/2 and DBA/2.DBA/1-Y congenic strains differ in the source of their Y chromosome. Fifty percent of the DBA/2 and 13 percent of the DBA/2.DBA/1-Y males mounted at least once in the test of male copulatory behavior. There were no other significant differences between these two congenic strains. This finding suggests that the Y chromosome has an effect on the proportion of mice that mount in this test. PMID- 6508692 TI - A study of the contribution of hippocampal-accumbens-subpallidal projections to locomotor activity. AB - Locomotor activity recorded in an automated open-field apparatus was increased substantially by unilateral injections of carbachol, a cholinergic agonist, into the dentate gyrus of the hippocampus. Hyperactivity elicited in this way was reduced significantly when glutamate antagonists were injected into the ipsilateral nucleus accumbens. Injecting gamma-aminobutyric acid into the ipsilateral subpallidal region also reduced the hyperactivity from injections of carbachol into the dentate gyrus. When these compounds were injected into the contralateral accumbens and subpallidal region, respectively, there was little or no reduction in the carbachol-elicited locomotor activity. These observations suggest that neural pathways fom hippocampus to accumbens to subpallidal region may contribute to locomotor activity. PMID- 6508693 TI - Neuropharmacological evidence to suggest that the nucleus accumbens and subpallidal region contribute to exploratory locomotion. AB - Rats showed a substantial increase in locomotor activity when novel objects were introduced into an open-field apparatus. This exploratory locomotion was reduced significantly when glutamic acid diethyl ester HCl, a glutamate antagonist, was injected bilaterally into the nucleus accumbens or when gamma-aminobutyric acid was injected bilaterally into the subpallidal region. These observations provide preliminary support for a contribution of the nucleus accumbens and subpallidal region to exploratory locomotion. PMID- 6508694 TI - Age differences in within-session habituation of exploratory behavior: effects of stimulus complexity. AB - The effects of age on the habituation of exploratory behavior of 8-month- and 28 month-old male C57BL/NNia mice were examined under three different stimulus complexity conditions. Increases in the degree of stimulus complexity resulted in an attenuation of between-session habituation and an initial disruption of within session habituation by 8-month-old mice. Although increases in stimulus complexity also resulted in an increase in the overall level of exploration by aged mice, stimulus complexity was not found to have a systematic effect on between- or within-session habituation by aged mice. No between-session habituation was observed in aged mice under any of the stimulus complexity conditions. Further, aged mice exhibited significant within-session increases, rather than decreases, in exploration under each stimulus complexity condition. This disruption of within-session habituation in aged mice was found to persist over four daily test sessions. In view of the specific patterns of exploration by aged mice, the disruption of within-session habituation was attributed to age related differences in reactivity to the arousal-inducing properties of novel stimuli. PMID- 6508695 TI - Increased novelty-induced grooming in aged rats: a preliminary observation. AB - Age-related changes in grooming activity in female Fischer-344 rats were observed in a home cage and in a novel testing chamber for 50 min. Compared to the home cage condition with brief handling treatment, excessive grooming was found in the novel situation. The amount of novelty-induced grooming of aged rats (26-28 months) was about two times that of young animals (6-8 months). This increase in novelty-induced grooming of aged animals was attributable to an increase in the number of grooming bouts, prolongation of each grooming bout, and a slight increase in the duration of licking elements. However, there were no age differences in the percentage of face washing and the duration of face-washing elements. These results are discussed in terms of behavioral aging and age related changes in peptidergic pathways in the brain. PMID- 6508696 TI - Post-trial injection of atropine into the caudate nucleus interferes with long term but not with short-term retention of passive avoidance. AB - One-trial passive avoidance training was given to Wistar rats and retention of the task was measured 30 min and 24 h later. Atropine (60 micrograms) was injected into the anterior caudate nucleus 2 min after training. Excellent retention was evident 30 min after training, whereas a significant deficit in memory was found when retention was tested 24 h after training. These results suggest that blockade of cholinergic activity of the caudate nucleus induced shortly after training interferes with the consolidation of long-term memory but not with short-term memory processes. PMID- 6508697 TI - Passive-avoidance behavior of spontaneously hypertensive rats. AB - Spontaneously hypertensive rate (SHR) generally exhibit higher performance in avoidance tasks than Wistar-Kyoto control rats (WKY) do. The SHR are more active than the WKY after transfer to a novel environment and after electric footshocks. The present study examined the performance, behavior, and plasma corticosterone of young male SHR and WKY in a passive-avoidance task in which high levels of locomotor activity do not facilitate performance. The effects of three levels of discriminability of the safe area were studied. Passive-avoidance performance was statistically significantly lower in the SHR, but the difference was small. There was no difference between the SHR and the WKY in post-test plasma-corticosterone levels, and there was no relationship between ambulation and plasma corticosterone levels. The behavioral differences between the SHR and the WKY varied as a function of the discriminability of the safe area. Specifically, in the low-discriminability condition, ambulation, but not rearings, was equally suppressed in the SHR as in the WKY and there was no difference in immobility. In the high-discriminability condition the SHR exhibited more ambulation, more rearing, and less immobility than the WKY. These data confirm that the SHR exhibit an increased tendency for facilitation of locomotor activity during activation compared to the WKY. Because the passive-avoidance performance of the SHR was lower than that of the WKY, these data suggest that previous reports of superior avoidance learning in the SHR reflect their elevated level of locomotor activity rather than an improved ability to acquire conditioned responses. Ability to discriminate stimuli seems to be normal in the SHR since ambulation was modified according to stimulus parameters. PMID- 6508698 TI - Anxiety, pain and type of dental procedure. PMID- 6508699 TI - Effects of cold and mental stress on finger temperature in vasospastics and normal Ss. PMID- 6508700 TI - Self-efficacy, nicotine-fading/self-monitoring and cigarette-smoking behaviour. PMID- 6508701 TI - Cognitive dysfunction in compulsive checkers: further explorations. PMID- 6508702 TI - Generalization of treatment effects in training public speakers. PMID- 6508703 TI - Effects of repeated exposure to sexually violent or nonviolent stimuli on sexual arousal to rape and nonrape depictions. PMID- 6508704 TI - Abnormal and normal obsessions--a replication. PMID- 6508705 TI - Dental pessimism: negative cognitions in fearful dental patients. PMID- 6508706 TI - Spouse involvement and a possible long-term follow-up trap in weight loss. PMID- 6508707 TI - The psycho-social stressors associated with survival by dialysis. PMID- 6508708 TI - Generalization and maintenance of the reduction of self-injurious behavior maintained by two types of reinforcement. PMID- 6508709 TI - Physiological and psychological effects of acute intentional hyperventilation. PMID- 6508710 TI - Estimates of free-radical production in rat and swine hearts: method and application of measuring malondialdehyde levels in fresh and frozen myocardium. AB - Toxic peroxides result when oxygen radicals react with various peroxidic precursors in tissue or blood. A colorimetric method based on reactions of malondialdehyde (MDA), a key intermediate in the formation of peroxides, has been described in fresh tissues. The present report adapts this assay to measure MDA levels in frozen heart muscle from rats and swine. Mean tissue values of MDA ranged from 154-353 nmol/g (n = 13) in fresh rat hearts perfused by the Langendorff technique. Values in frozen samples were 228 +/- 14 nmol MDA/g (n = 22). When mechanical function was increased in isolated working rat hearts, tissue MDA levels decreased by -25 delta % (P less than 0.025). In working swine hearts, increasing perfusate levels of unsaturated fatty acids caused a 42% increase in tissue MDA levels, P less than 0.001. Suppressing fatty acid oxidation with either oxfenicine or low flow ischemia caused no significant shifts in peroxide contents. Thus, the thiobarbituric acid method for MDA measurements is well adapted to analyzing frozen myocardium, and MDA levels appear sensitive to alterations in mechanical function and the presence of excess fatty acids. PMID- 6508711 TI - Cardiac tamponade in dogs with normal coronary arteries. I. Effect of changing intravascular volume on hemodynamics and myocardial blood flow. AB - Intravascular volume expansion has been shown to improve cardiac output in experimental cardiac tamponade. To determine the limitations of intravascular volume manipulation, acute tamponade was created in 20 anesthetized, spontaneously breathing dogs. The intrapericardial volume causing tamponade was determined for each animal, and kept constant. Hemodynamics were recorded with and without tamponade at multiple levels of intravascular volume. During cardiac tamponade, intravascular volume expansion increased cardiac output only in animals which were initially volume-depleted. Volume expansion of normovolemic or hypervolemic animals caused minimal changes in cardiac output, but increased atrial and aortic pressures. Intravascular volume depletion of the normovolemic animal caused a significant decline in cardiac output, in contrast to the trend towards an increased output following phlebotomy of the volume-expanded animals. In general, the benefit of intravascular volume expansion during cardiac tamponade could only be demonstrated when atrial pressures were below 12 mm Hg. PMID- 6508712 TI - Cardiac tamponade in dogs with normal coronary arteries. II. Myocardial flow and metabolism with moderate and severe hemodynamic impairment. AB - To determine the effects of cardiac tamponade on myocardial blood flow and its distribution, dogs were prepared with indwelling pericardial catheters. Hemodynamic, myocardial blood flow, and myocardial metabolic data were collected in 5 closed-chest, spontaneously breathing animals with normal blood volumes and hemoglobin concentrations and 6 with acute anemia. Instillation of an average of 89.0 +/- 14.9 ml of modified Normosol into the pericardial space in dogs with normal hemoglobin levels produced mild tamponade with a modest decline in aortic pressure (119.5 +/- 14.3 to 96.8 +/- 12.1 mm Hg) and significant rises in left and right atrial and pericardial pressures to 7-8 mm Hg. Increasing the pericardial volume to 124.0 +/- 13.6 ml produced hypotension (mean aortic pressure 86.2 +/- 10.5 mm Hg) and rises in the left and right ventricular filling pressures and pericardial pressure to 10-11 mm Hg. Total myocardial blood flow fell from 1.19 +/- 0.18 to 0.73 +/- 0.17 ml/min/g (p less than 0.02) during mild tamponade, and fell further to 0.56 +/- 0.17 ml/min/g (p less than 0.05) with more severe tamponade. Despite these declines, the left ventricular wall inner/outer flow ratio and left ventricular flow as a proportion of total cardiac output were unchanged. In dogs with anemia more severe tamponade was created, with consequently more marked hemodynamic abnormalities. However, the relative changes in myocardial blood flow and inner/outer flow ratio were similar. Myocardial metabolic parameters could be evaluated only in the dogs with less severe tamponade.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508713 TI - Metabolic and physiological differences between zero-flow and low-flow myocardial ischemia: effects of L-acetylcarnitine. AB - The metabolic and physiologic differences between low-flow and zero-flow ischemia of varying duration were compared in the isolated perfused rat heart. Hearts subjected to 60 and 90 minutes of zero-flow ischemia recovered less cardiac work than hearts subjected to low-flow ischemia. Low-flow ischemia caused a build-up of both myocardial long-chain acyl coenzyme A and acyl carnitine esters, while zero-flow ischemia produced no change in long-chain acyl carnitine and only a transient increase in long-chain acyl coenzyme A. High energy phosphate depletion was greater in zero-flow ischemia. Perfusion with excess free fatty acids decreased the recovery of cardiac work after low-flow ischemia but had no effect after repeated episodes of zero-flow ischemia. L-Acetylcarnitine improved the recovery of cardiac work after low-flow ischemia in hearts perfused with 0.4 and 1.2 mM palmitate. With zero-flow ischemia, L-acetylcarnitine had no effect on the recovery of cardiac work in hearts perfused with 0.4 mM palmitate and a slight but statistically significant effect with 1.2 mM palmitate. Possible protective mechanisms of L-acetylcarnitine against ischemic damage are discussed. PMID- 6508715 TI - Volume control during periodic changes of blood volume in the alert rat. AB - Blood (3.4-13.5% of blood volume) was pumped in and out of the circulation of rats at different rates and period lengths during continuous measurements of blood conductivity (reciprocally related to hematocrit) and arterial pressure. Hct followed the same zig-zag course as the induced changes of blood volume in every case, indicating that fluid shifts (delta v) between interstitium and intravascular space closely follow blood volume changes. As the hct increase during reinfusion was not as great as the preceding decrease, hct dropped continuously during the 20-90 minutes of experimentation, so that a final volume increase (delta v) by about 4% was calculated, which was confirmed by a corresponding decrease of plasma protein concentration. Both final delta v and delta v during periodic volume change (delta % B.V.) were greater when arterial pressure dropped. delta v was directly related to delta % B.V. but not to its rate of change. Heart rate dropped slightly at the end of the reinfusion periods, whereas it rose to control at the end of the withdrawal periods. The results were regarded as evidence of blood volume regulation proportional to the absolute volume of blood lost in non-hypotensive hemorrhage. PMID- 6508714 TI - Tissue osmolality, metabolic response, and reperfusion in myocardial ischemia. AB - We studied the effect of tonicity of the perfusate during reperfusion after global ischemia, in both the rat and the porcine heart. After 50 min, tissue osmolality increased by about 40 mOsm/kg. Normotonic as well as hypertonic reperfusion resulted in limited areas of "no-reflow". Metabolic restoration after reperfusion was not dependent on the tonicity of the perfusate, nor was recovery of contractility. Hypertonic reperfusion induced a higher coronary flow rate. In porcine hearts, scatter of metabolic data indicated inhomogeneity of reperfused tissue. The results differ substantially from data obtained after reperfusion of regionally ischemic hearts. Reasons for these differences are discussed. PMID- 6508716 TI - Evaluation of the Penaz servo-plethysmo-manometer for the continuous, non invasive measurement of finger blood pressure. AB - Blood pressure in the finger was measured by a servo-plethysmomanometer constructed after the design of Penaz, which uses the principle of the unloaded arterial wall. The device contains a photoelectric plethysmograph mounted in an inflatable cuff and an electro-pneumatic transducer to control air pressure in the cuff via a servosystem. Comparison of simultaneous measurements of intra arterial pressure in the brachial artery was performed on 33 patients suspected of having hypertension. In 12 patients evaluation of the technique could not be carried out due to technical failures or distorted blood pressure wave forms. Results of the remaining 21 patients show a mean underestimation of intra arterial blood pressure by finger cuff blood pressure of 0.8 kPa (6 mm Hg), both for systolic and diastolic levels. The scatter range of the difference is from 1.9 to -3.5 kPa for systolic and 0.1 to -2.5 kPa for diastolic values. It appears that, although not all technical problems are solved, the Penaz servo-plethysmo manometer is potentially an elegant method by which to arrive at the fully calibrated wave form of blood pressure in a finger in a non-invasive and continuous fashion. PMID- 6508717 TI - An empirical definition of elementary school adjustment. Selection of target behaviors for a comprehensive treatment program. PMID- 6508718 TI - The "safe at home" game. Training comprehensive prevention skills in latchkey children. PMID- 6508719 TI - Sequencing of parent training procedures. Effects on child noncompliance and treatment acceptability. PMID- 6508720 TI - Treatment of severe hemifacial spasm with biofeedback. A case study. PMID- 6508721 TI - Reactions to assertive versus nonassertive behavior. Females in commendatory and refusal situations. PMID- 6508722 TI - [Individualized treatment of osteosynthesis in childhood]. PMID- 6508724 TI - [Indication and value of corrective osteotomy of the distal radius]. PMID- 6508723 TI - [The joint-bridging external fixation system in the treatment of open fractures]. PMID- 6508725 TI - [Efficiency and limits of the dynamic cruciate ligament replacement operation using Lindemann's method in chronic ligament instability]. PMID- 6508726 TI - [Surgical treatment of limited bending capacity of the knee joint following femoral fractures]. PMID- 6508727 TI - [Subcapital humerus rotation osteotomy using Weber's method and screwing of the limbus using Muller's method--2 methods for the treatment of recurrent shoulder dislocation]. PMID- 6508728 TI - Feed additives to chick starter mixtures under tropical conditions. AB - In two short-term experiments (28 and 31 days, respectively), the ergotropic effect was tested of the growth promoters nitrovin (25 mg/kg mixture, and a chinoxalin-1,4-N-dioxide derivate (25 and 50 mg/kg mixture). The experiments were carried out on a total of 1,952 unsorted one-day-old White Leghorn chicks under tropical conditions in Eastern Ethiopia (College of Agriculture at Alemaya). On addition of 50 mg chinoxalin-1,4-N-dioxide, the final weight of the chicks was 105.6 and 104.6%, respectively, in the first and second experiments as compared with the unsupplemented groups. The amount of feed required for each weight gain was reduced to 94.0 and 91.4%, respectively. Nitrovin and smaller amounts of chinoxalin-1,4-N-dioxide increased the body weight to 104.2 and 104.0%, respectively, as compared with the control. The feed requirement (94.6 and 99.9%, respectively) was not reduced significantly (alpha greater than 0.05). Further experiments will be necessary, using other feed additives, more chicks, and longer experimental periods. PMID- 6508729 TI - A five-year analysis of diseases of dogs and cats in the Veterinary Clinic of Freetown, Sierra Leone. AB - A survey is presented of the diagnoses found in 2938 dogs and 32 cats, treated between January 1976 and January 1980 at the Veterinary Clinic of Freetown. More than one third of the dogs (1175) and 13 cats were infected by Ancylostoma spp., whereas Toxocara canis and Toxascaris leonina were encountered in 236 and 232 dogs, respectively. Noteworthy is also the relatively high figure of 12 dogs affected by Negri bodies (rabies). It is pointed out that dogs and cats move about fairly freely in the city, which constitutes a considerable source of infection for humans. PMID- 6508730 TI - Cell-free lutropin-dependent desensitization of the lutropin-sensitive adenylate cyclase of pig ovarian follicles is dependent on ATP. AB - Experiments were conducted to clarify the nucleotide requirements for lutropin (LH)-dependent adenylate cyclase desensitization in a cell-free membrane preparation derived from a thecal-cell-enriched component of preovulatory pig ovarian follicles. The follicular membranes were extensively washed in 2M-urea to remove endogenously bound GTP, and ATP devoid of GTP was utilized. Results conducted in the presence of 60 microM-GTP and various concentrations of ATP confirm the dependence of LH-stimulated adenylate cyclase activation and desensitization on millimolar concentrations of ATP. In experiments in which adenylate cyclase activation was supported by Mg2+, LH and adenosine 5'-[beta, gamma-imido]triphosphate, GTP did not support the desensitization response. Moreover, although GTP increased both basal and LH-stimulable adenylate cyclase activities in a concentration-dependent manner, the percentage desensitization was not significantly modified by the presence of 10nM-10mM-GTP. These results demonstrate that, even in the presence of exogenous GTP and Mg2+, activation of adenylate cyclase by saturating concentrations of LH in the presence of adenosine 5'-[beta, gamma-imido]triphosphate is not sufficient to initiate desensitization; millimolar concentrations of ATP are also required for the adenylate cyclase desensitization response. PMID- 6508731 TI - 54Mn2+ as a tracer of the polymerization of actin. Intermediate oligomers condense to give F-actin. AB - Mg2+, at submicromolar concentrations, is needed for the nucleation of actin [Maruyama (1981) J. Biol. Chem. 256, 1060-1062]. I show here that Mn2+ fulfils the same function. It binds to oligomers present in the ATP-G-actin solutions with a ratio of 2-3 Mn2+ ions per 100 actin monomers and with an association constant of 0.66 X 10(10) M-1 at pH 8.2 at 25 degrees C. The time course of the binding of Mn2+ to polymerizing actin is not affected by the initial concentration of the protein. Analysis of the distribution of the binding shows that, both in the large oligomeric species and in the polymers, 1 Mn2+ ion is bound for every 14-25 actin monomers, whereas in the smaller oligomeric species 1 Mn2+ ion is bound for every 4 actin monomers. The proposal is made that Mn2+ stabilizes actin nuclei and decreases the concentration of the monomers at the steady state. It is also proposed that, at least in some experimental conditions, the direct condensation of oligomers of intermediate length is an effective mechanism of F-actin formation. PMID- 6508732 TI - Binding of trichloromethyl radicals to lipids of the hepatic endoplasmic reticulum during tetrachloromethane metabolism. AB - Metabolism of tetrachloromethane (carbon tetrachloride) by liver microsomal fraction under anaerobic conditions and in vivo leads to covalent binding of trichloromethyl radicals to lipids. The resulting covalently modified lipids contain two different types of fatty acids: a group of monomeric trichloromethyl fatty acid residues, usually with one double bond less than the precursor fatty acids, and a group of fatty acids that are not sufficiently volatile for gas chromatography. The liquid-chromatographic properties of the latter indicate high molecular mass, presumably due to cross-linking. The chemical structures of the monomeric fatty acids were elucidated, and these support the view that the most significant reactive metabolite of tetrachloromethane is the trichloromethyl radical. The isomer patterns of the monomeric trichloromethyl fatty acids in vitro and in vivo are almost identical, which shows that anaerobic incubation of tetrachloromethane with microsomal fraction very well reflects the processes involved in hepatotoxicity of tetrachloromethane in vivo. PMID- 6508733 TI - Studies in vitro on the uptake and degradation of sodium hyaluronate in rat liver endothelial cells. AB - Rat liver endothelial cells in primary cultures at 7 degrees C bind radioactively labelled sodium hyaluronate (HA; Mr 400 000) specifically and with high affinity (Kd = 6 X 10(-11) M). Maximal binding capacity is approx. 10(4) molecules per cell. Inhibition experiments with unlabelled HA and oligosaccharides from HA indicate that each molecule is bound by several receptors acting co-operatively and that the single receptor recognizes a tetra- or hexa-saccharide sequence of the polysaccharide. At 37 degrees C the liver endothelial cells endocytose the HA. The process combines the features of a receptor-mediated and a fluid-phase endocytosis. The rate of internalization does not show any saturation with increasing HA concentration, but is approximately proportional to the polysaccharide concentration at and above the physiological concentration. At 50 micrograms of free HA/l each liver endothelial cell accumulates 0.1 fg of the polysaccharide/min. Fluorescent HA accumulates in perinuclear granules, presumably lysosomes. Degradation products from HA appear in the medium about 30 min after addition of the polysaccharide to the cultures. The radioactivity from HA containing N-[3H]acetyl groups or 14C in the sugar rings is recovered mainly as [3H]acetate and [14C]acetate respectively. Estimations of the capacity of liver endothelial cells to internalize and degrade HA in vitro indicate that these cells may be primarily responsible for the clearance of HA from human blood in vivo. PMID- 6508734 TI - The discovery of a rapidly metabolized polymeric tetraphosphate derivative of adenosine in perfused rat heart. AB - The predicted presence in perfused rat hearts of a rapidly metabolized but hitherto unrecognized form of adenosine phosphate has been confirmed by specific radioactive labelling. The properties of the purified compound suggest that it is a heteropolymer of a small organic acid, phosphate and purine nucleoside in the proportions 1:4:1. PMID- 6508735 TI - Kinetic analysis of chemical reactions coupled to an enzymic step. Application to acid phosphatase assay with Fast Red. AB - Acid phosphatase assay with alpha-naphthyl phosphate as substrate and the use of diazonium salt (Fast Red TR) for chromophore formation was kinetically analysed as a system of two chemical reactions coupled to an enzymic reaction. This system follows a mechanism defined as enzymic-chemical-chemical (EzCC). The accumulation of chromophore with reaction time presented a marked lag period, which was only dependent on the rate constants of the chemical reactions and was independent of the enzymic step. The specific rate constants of each chemical step were determined in 3.8-5.0 pH and 10-35 degrees C temperature ranges. Thermodynamic parameters of the chemical steps were also obtained. Measurement of acid phosphatase activity can be carried out in the pH range 3.8-5.0 (4.8 was optimal pH) without the need to eliminate the lag period. PMID- 6508736 TI - The concentration of the mitochondrial pyruvate carrier in rat liver and heart mitochondria determined with alpha-cyano-beta-(1-phenylindol-3-yl)acrylate. AB - alpha-Cyano-beta-(1-phenylindol-3-yl)acrylate inhibited pyruvate transport into both liver and heart mitochondria approximately linearly with respect to its concentration until 65% inhibition was achieved. The extent of inhibition was dependent on the mitochondrial protein concentration. By extrapolation of plots of inhibition versus inhibitor concentration to total inhibition, or by mathematical analysis of the plots, the concentration of pyruvate transporter molecules per mg of protein was calculated to be approximately 100 pmol/mg for both heart and liver mitochondria, and the Ki about 7 nM. The data also suggest that pyruvate transport is rate-limiting for pyruvate oxidation by heart mitochondria in State 3, but not by liver mitochondria. PMID- 6508737 TI - Purification and properties of a beta-1,6-glucanase from Penicillium brefeldianum. AB - An inducible endo-beta-1,6-glucanase was purified from Penicillium brefeldianum by DEAE-cellulose, Bio-Gel P-150 and high-pressure liquid chromatography. The final preparation was essentially free from beta-1,3-glucanase and beta glucosidase activities. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis revealed one protein band with an Mr of 44000. The Vmax. and Km values were calculated to be 624 units (mumol/min)/mg and 2.78 mg/ml respectively. The glucanase had lytic activity against mycelial cells of the yeast Candida albicans. The yield of purified beta-1,6-glucanase from 100 mg dry weight of freeze-dried culture filtrate varied from 60 to 180 units. PMID- 6508738 TI - Altered protein kinetics in vivo after single-limb burn injury. AB - Recovery from burn injury is associated with stimulated whole-body protein turnover. Since skeletal muscle and liver are the tissues most likely to influence whole-body measurements, we studied protein kinetics in soleus and plantaris muscles as well as liver 3 days after a 3 s burn on one hindlimb of the rat. Muscles from both the burned and unburned limbs of burned rats were compared with those of uninjured controls to distinguish between local and systemic factors involved. The following measurements were performed: (1) fractional growth rate of the tissue protein pool, determined from tissue protein content on days 2, 3 and 4; (2) fractional protein-synthetic rate, measured by [14C]tyrosine constant infusion on day 3; (3) fractional protein-degradation rate, calculated from the difference between the rates of protein synthesis and growth. Protein growth by soleus and plantaris muscles of control rats and unburned limb of burned rats was not paralleled by those in the burned limb, which showed progressive atrophy between 2 and 4 days post-burn (P less than 0.005). Protein synthesis by soleus but not plantaris muscle in the unburned limb of burned rats was enhanced by 62% (P less than 0.04) above control. Protein synthesis by burned limb soleus and plantaris muscles was elevated by 114% (P less than 0.001) and 67% (P less than 0.02) respectively above control. Protein degradation by both soleus and plantaris muscles in the unburned limb of burned rats did not differ from control. In contrast, that of soleus and plantaris muscles in the burned limb was stimulated by 230% (P less than 0.001) and 164% (P less than 0.001) respectively compared with controls. Protein turnover of soleus muscles in both control and burned rats was more rapid than in corresponding plantaris muscles. Liver protein mass exhibited steady growth in control rats, but remained unchanged in burned animals between 2 and 4 days post-burn. Liver protein synthesis in burned rats was elevated by 56% (P less than 0.01) and protein breakdown was stimulated by 61% (P less than 0.002) above those of controls. The data indicate that both local and systemic factors influence tissue protein turnover in animals recovering from a single-hindlimb scald. PMID- 6508740 TI - Endogenous ligands of rat lung beta-galactoside-binding protein (galaptin) isolated by affinity chromatography on carboxyamidomethylated-galaptin-Sepharose. AB - Rat lung beta-galactoside-binding protein (galaptin) is developmentally regulated during postnatal lung development. In common with other vertebrate galaptins, it is very labile when purified and dependent on the presence of exogenous thiol reagents. Reaction of rat lung galaptin with iodoacetamide resulted in a stable active carboxyamidomethylated galaptin that could be coupled to Sepharose. The resultant affinity matrix bound asialoglycoproteins, and these could be quantitatively eluted with disaccharide haptens. The carboxyamidomethylated galaptin-Sepharose affinity matrix was used to search for endogenous ligands in 13-day-rat lung. Cytosolic fractions of developing rat lung contained no moieties that could be specifically eluted with disaccharide hapten. Only when membranous fractions were extracted with 1% Triton were glycoproteins solubilized that bound to the affinity matrix and could be specifically eluted with disaccharide hapten. The eluted glycoproteins were potent inhibitors of galaptin binding to asialo orosomucoid. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis identified these glycoproteins as being of high Mr, with three components of Mr 160000-200000 and a smaller component of Mr 75000. This is the first evidence for specific membrane-associated glycoproteins being the ligands of rat lung galaptin. PMID- 6508739 TI - Evaluation of alpha-tocopherol antioxidant activity in microsomal lipid peroxidation as detected by low-level chemiluminescence. AB - The significance of microsomal vitamin E in protecting against the free-radical process of lipid peroxidation was evaluated with the low-level-chemiluminescence technique in microsomal fractions from vitamin E-deficient and control rats. The induction period that normally precedes the ascorbate/ADP/Fe3+-induced lipid peroxidation was taken as reflecting the microsomal vitamin E content and was found to be 5-6-fold decreased in microsomal fractions from vitamin E-deficient rats. Supplementation of microsomal fractions from vitamin E-deficient rats with exogenous vitamin E partially restores the induction period observed in that from control rats. The decrease in chemiluminescence intensity and the increase in the induction period both correlate linearly with the amount of vitamin E added. However, the efficiency of exogenous vitamin E is about 50-fold lower than that exerted by the naturally occurring vitamin E in microsomal membranes. These observations are discussed in terms of the process of re-incorporation of vitamin E into membranes, the experimental model for lipid peroxidation selected, and the method to evaluate lipid peroxidation, namely low-level chemiluminescence. PMID- 6508741 TI - Effect of arginine modification on kidney brush-border-membrane transport activity. AB - The effect of phenylglyoxylation on brush-border-membrane functions was studied with membrane vesicles from rat kidney cortex. Na+-gradient-dependent uptake of phosphate, glucose and alanine was inhibited by 65, 88 and 70% by pre-incubation of vesicles with 50 mM-phenylglyoxal for 2 min. The inhibition showed a dependency for alkaline pH. Borate co-operativity in butanedione inactivation was used to prove that inhibition was caused by arginine modification. Intravesicular volumes, alkaline phosphatase, aminopeptidase M and Na+-H+ exchange were not affected by phenylglyoxal treatment. Inhibition of phosphate uptake was studied in more detail and showed that the chemical modification introduced by phenylglyoxal inhibited the overshoot of phosphate uptake caused by the Na+ gradient, and decreased the apparent maximal velocity of the phosphate-transport system in its interaction with Na+. Phosphate uptake measured in the absence of Na+ was not affected by phenylglyoxal. Shunting of the transmembrane electrical potential with K+ and valinomycin had no effect on phenylglyoxal inhibition, proving that the alteration of transmembrane electrical potential could not be responsible for this effect. Phenylglyoxal had no ionophoric effect on the Na+ gradients studied (1-100 mM). Na+ efflux was also unaffected by phenylglyoxal treatment. Na+, harmaline and amiloride were ineffective in protecting against phenylglyoxal inhibition, suggesting that the site modified was not an Na+ binding site. These results indicate the involvement of highly reactive arginine residues in phosphate, glucose and alanine uptake. PMID- 6508742 TI - Renal transport of monocarboxylic acids. Heterogeneity of lactate-transport systems along the proximal tubule. AB - The characteristics of D- and L-lactate transport in luminal-membrane vesicles derived from whole cortex, from the pars convoluta and from the pars recta of rabbit kidney proximal tubule were studied. It was found that uptake of both isomers in vesicles from whole cortex occurred by means of dual electrogenic transport systems, namely a low-affinity system and a high-affinity system. Uptake of both isomers in vesicles from the pars recta was strictly Na+-dependent and is mediated via a single high-affinity common transport system. Vesicles from the pars convoluta contained a cation-dependent but Na+-unspecific low-affinity common transport system for these compounds. The physiological importance of this system is briefly discussed. PMID- 6508743 TI - Effect of starvation and exercise on actual and total activity of the branched chain 2-oxo acid dehydrogenase complex in rat tissues. AB - Starvation does not change the actual activity per g of tissue of the branched chain 2-oxo acid dehydrogenase in skeletal muscles, but affects the total activity to a different extent, depending on the muscle type. The activity state (proportion of the enzyme present in the active state) does not change in diaphragm and decreases in quadriceps muscle. Liver and kidney show an increase of both activities, without a change of the activity state. In heart and brain no changes were observed. Related to organ wet weights, the actual activity present in the whole-body muscle mass decreases on starvation, whereas the activities present in liver and kidney do not change, or increase slightly. Exercise (treadmill-running) of untrained rats for 15 and 60 min causes a small increase of the actual activity and the activity state of the branched-chain 2-oxo acid dehydrogenase complex in heart and skeletal muscle. Exercise for 1 h, furthermore, increased the actual and the total activity in liver and kidney, without a change of the activity state. In brain no changes were observed. The actual activity per g of tissue in skeletal muscle was less than 2% of that in liver and kidney, both before and after exercise and starvation. Our data indicate that the degradation of branched-chain 2-oxo acids predominantly occurs in liver and to a smaller extent in kidney and skeletal muscle in fed, starved and exercised rats. PMID- 6508744 TI - Reversible inhibition of bacterial growth after specific inhibition of spermidine synthase by dicyclohexylamine. AB - The effect of dicyclohexylamine on seven freshly isolated bacterial strains of mastitis pathogens was studied. Streptococcus uberis was the most sensitive strain investigated, since 5 mM-dicyclohexylamine totally arrested its growth and 1.25 mM of the drug caused 60% growth inhibition. The Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa strains were also sensitive to the drug, but less so than Strep. uberis, since 5 mM drug caused only partial inhibition of growth. Micrococcus sp. and Klebsiella sp. grew in the presence of 10.0 mM-dicyclohexylamine, and, finally the growth of Streptococcus agalactiae was not at all affected by dicyclohexylamine. These different sensitivities towards dicyclohexylamine in vivo were paralleled by different sensitivities of the bacteria's spermidine synthase to the drug in vitro, and also by the ability of the drug to lower spermidine concentration in bacterial cells. Spermidine synthase from sensitive bacteria was inhibited by more than 90% by 50 microM dicyclohexylamine in vitro, and the concentration of spermidine was decreased in E. coli and Ps. aeruginosa by 70% and in Strep. uberis by 95%, whereas in Strep. agalactiae 5 mM-dicyclohexylamine did not affect the concentration of spermidine at all. Dicyclohexylamine treatment led to the accumulation of putrescine in Strep. uberis. Spermidine synthesis catalysed by the extracts of Micrococcus sp. required 500 microM-dicyclohexylamine for 90% inhibition, and Strep. agalactiae contained a spermidine synthase that was still active at 1000 microM dicyclohexylamine, The observed inhibition of growth was totally reversed by adding 50 microM-spermidine (final concentration) to the medium. Putrescine reversed the inhibition only when bacteria had a spermidine synthase activity insensitive to dicyclohexylamine. Spermine did not overcome the inhibition of growth caused by dicyclohexylamine, probably because it was not taken up by the bacterial cells used in this study. The inhibition of the growth by dicyclohexylamine (even in the case of Strep. uberis) was reversible in the sense that addition of 50 microM-spermidine 18 h after dicyclohexylamine still restored the growth rate of untreated controls. PMID- 6508745 TI - Branched-chain amino acid metabolism and alanine formation in rat diaphragm muscle in vitro. Effects of dichloroacetate. AB - Dichloroacetate (which activates pyruvate dehydrogenase) decreases the release of alanine, pyruvate and lactate in hemidiaphragm incubations with valine. Dichloroacetate interferes with alanine formation by diverting pyruvate into oxidative pathways, which not only limits pyruvate availability for direct transamination to form alanine but also indirectly affects branched-chain amino acid transamination by limiting 2-oxoglutarate regeneration from glutamate. PMID- 6508746 TI - Changes in oxygen consumption induced by t-butyl hydroperoxide in perfused rat liver. Effect of free-radical scavengers. AB - The addition of t-butyl hydroperoxide to perfused rat liver elicited a biphasic effect on hepatic respiration. A rapid fall in liver oxygen consumption was initially observed, followed by a recovery phase leading to respiratory rates higher than the initial steady-state values of oxygen uptake. This overshoot in hepatic oxygen uptake was abolished by free-radical scavengers such as (+) cyanidanol-3 or butylated hydroxyanisole at concentrations that did not alter mitochondrial respiration. (+)-Cyanidanol-3 was also able to facilitate the recovery of respiration, the diminution in the calculated rate of hydroperoxide utilization and the decrease in liver GSH content produced by two consecutive pulses of t-butyl hydroperoxide. It is suggested that the t-butyl hydroperoxide induced overshoot in liver respiration is related to increased utilization of oxygen for lipid peroxidation as a consequence of free radicals produced in the scission of the hydroperoxide by cellular haemoproteins. PMID- 6508747 TI - Hepatic antioxidant-sensitive respiration. Effect of ethanol, iron and mitochondrial uncoupling. AB - The addition of the antioxidants (+)-cyanidanol-3, butylated hydroxyanisole and ascorbate to the perfused rat liver resulted in a decrease in the rate of oxygen consumption. This basal antioxidant-sensitive respiration of 110-130nmol X min-1 X (g of liver)-1 represents 5-7% of total respiration. Increased antioxidant sensitive respiratory rates are found after the infusion of increasing concentrations of ethanol (1.8-72.2mM) or iron (35.5-248.5 microM). This respiratory component exhibits a dependence on ethanol or iron concentration, with maximal rates of 200-255 and 330nmol X min-1 X (g of liver)-1 respectively. After the addition of 100 microM-2,4-dinitriphenol, an antioxidant-sensitive respiratory component of 230nmol X min-1 X (g of liver)-1 is found, which is not observed at lower concentrations of the uncoupler (5-50 microM). The lack of effect of the antioxidants used on mitochondrial respiration [the preceding paper, Videla, Villena, Donoso, Giulivi & Boveris (1984) Biochem. J. 223, 879 883] and on the glycolytic rate of the perfused liver suggests that the basal and chemically induced antioxidant-sensitive respiration observed are related to oxygen required for one-electron transfer reactions associated with the generation of active species of oxygen and lipid peroxidation in the liver cell. PMID- 6508748 TI - Effect of inositol and tri-iodothyronine on the hormonal responsiveness of hepatocytes obtained from partially hepatectomized rats. AB - Hepatocytes obtained from animals partially hepatectomized (72 h before the experiment) have a diminished responsiveness to alpha 1-adrenergic amines, vasopressin, angiotensin and glucagon and an increased responsiveness to beta adrenergic amines. Administration of inositol or tri-iodothyronine to the hepatectomized animals induced a recovery in the hepatocyte responsiveness to the Ca2+-dependent hormones and abolished that to beta-adrenergic amines; the response to glucagon was not improved. PMID- 6508749 TI - Isolation of rat mammary epithelial cells for polyamine analysis. AB - Mammary epithelial cells were isolated from either abdominal-inguinal glands or mammary tumours of rats, after enzymic digestion of the tissues, and were analysed for polyamine content. Optimum conditions were developed for the isolation of cells in sufficient yield for the analysis of polyamines from 1 g of mammary gland or 0.5 g of tumour tissue. Complete recoveries of the polyamines in the tissues were achieved in the isolated epithelial cells. PMID- 6508750 TI - Effect of ligands on chemical modification of proteins. PMID- 6508751 TI - Studies of rat adipose-tissue microsomal glycerol phosphate acyltransferase. AB - Incubation of rat adipose-tissue microsomal fractions with iodoacetate caused an inactivation of glycerol phosphate acyltransferase that could be prevented by the presence of palmitoyl-CoA. A microsomal protein of subunit Mr 54 000 was found to react with radioactively labelled iodoacetate in the absence, but not in the presence, of palmitoyl-CoA. It is suggested that this protein is a component of glycerol phosphate acyltransferase. Incubation of rat adipose-tissue microsomal fractions with the catalytic subunit of cyclic AMP-dependent protein kinase, ATP and Mg2+ caused an inactivation of glycerol phosphate acyltransferase whose magnitude depended on the conditions used for assay of the acyltransferase. Rat adipose tissue microsomal proteins were phosphorylated by using protein kinase and [gamma-32P]ATP. One of the phosphorylated proteins was very similar, but not identical, in mobility to the Mr-54 000 protein labelled by iodoacetate. In contrast with a previous report [Sooranna & Saggerson (1976) FEBS Lett. 64, 36 39], no changes could be detected in the activity of glycerol phosphate acyltransferase in adipocytes treated with adrenaline. Adipocytes were labelled with [32P]Pi and treated with adrenaline, but no 32P was incorporated into the Mr 54000 protein labelled by iodoacetate. The results suggest that the activity of adipose-tissue microsomal glycerol phosphate acyltransferase is not directly controlled by phosphorylation. PMID- 6508753 TI - Native and modified low-density-lipoprotein interaction with human platelets in normal and homozygous familial-hypercholesterolaemic subjects. AB - The binding of low-density lipoproteins (LDL) as well as LDL modified by cyclohexanedione (CHD-LDL) to gel-filtered platelets (GFP) and its effect on platelet function were studied in normal and in homozygous familial hypercholesterolaemic (HFH) subjects. Only normal-derived LDL could significantly compete with normal 125I-labelled LDL for binding to normal platelets. When GFP from normal subjects were incubated with normal LDL at concentrations of 25-200 micrograms of protein/ml, platelet aggregation in the presence of thrombin (0.5 i.u./ml) was increased by 65-186%. CHD-LDL, at similar concentrations, caused the opposite effect and decreased platelet aggregation by 26-47%. Both LDL and CHD LDL (100 micrograms/ml) from HFH patients, when incubated with normal GFP, caused a significant reduction in platelet aggregation (33 and 50% respectively). When HFH-derived platelets were used, both patient LDL and CHD-LDL (but not the normal lipoprotein) could markedly compete with the patient 125I-labelled LDL for binding to the platelets. LDL and CHD-LDL (100 micrograms/ml) from normal subjects decreased aggregation of HFH-platelets by 52 and 85% respectively, while corresponding concentrations of LDL derived from HFH subjects (HFH-LDL) and CHD LDL derived from HFH subjects (CHD-HFH-LDL) increased platelet aggregation by 165 and 65% respectively. The present results support the following conclusions: platelet activation by LDL in normal subjects is through the arginine-rich apoprotein-binding site; more than one binding site for LDL exists on platelets; under certain circumstances, LDL binding can cause a reduction in platelet activity; specificity for LDL binding to the platelets resides in different regions of the lipoprotein in HFH and in normal subjects. We have thus suggested a model for LDL-platelet interaction in normal and in HFH subjects. PMID- 6508752 TI - Metabolism of valine and 3-methyl-2-oxobutanoate by the isolated perfused rat kidney. AB - Metabolism of branched-chain amino and 2-oxo acids was studied in the isolated perfused kidney. Significant amounts of 2-oxo acids were released by perfused kidney with all concentrations of amino acids tested (0.1-1.0 mM each), despite the high activity of branched-chain 2-oxo acid dehydrogenase in kidney. As perfusate valine concentration was increased from 0.2 to 1.0 mM, [1-14C]valine transamination (2-oxo acid oxidized + released) increased roughly linearly; [1 14C]valine oxidation, however, increased exponentially. Increasing perfusate concentration of 3-methyl-2-oxo[1-14C]butanoate from 0 to 1.0 mM resulted in a linear increase in the rate of its oxidation and a rise in perfusate valine concentration; at the same time significant decreases occurred in perfusate isoleucine and leucine concentrations, with corresponding increases in rates of release of their respective 2-oxo acids. Comparison of rates of oxidation of [1 14C]valine and 3-methyl-2-oxo[1-14C]butanoate suggests that 2-oxo acid arising from [1-14C]valine transamination has freer access to the 2-oxo acid dehydrogenase than has the 2-oxo acid from the perfusate. The observations indicate that, when branched-chain amino and 2-oxo acids are present in perfusate at near-physiological concentrations, rates of transamination of the amino and 2 oxo acids by isolated perfused kidney are greater than rates of oxidation. PMID- 6508754 TI - Catabolism and lability of S-adenosyl-L-methionine in rat liver extracts. AB - The fate of S-adenosyl-L-methionine was studied in rat liver extracts by analysing the distribution of radioactivity from labelled adenosylmethionine in decomposition products, which were separated from each other by chromatographic and electrophoretic means. Marked non-enzymic degradation to adenine, pentosylmethionine, methylthioadenosine and homoserine was evident at pH 6.9-7.8. Enzymic cleavage to methylthioadenosine was stoichiometric with the accumulation of spermidine and could be totally prevented by inhibiting S-adenosyl-L methionine decarboxylase. The results rule out the existence of adenosylmethionine cyclotransferase in rat liver and indicate that only two quantitatively significant enzymic processes are involved in hepatic adenosylmethionine degradation. Excluding nonenzymic decomposition, more than 99% of adenosylmethionine is demethylated and exclusively catabolized further by S adenosyl-L-homocysteine hydrolase. Less than 1% of adenosylmethionine is decarboxylated and immediately utilized totally for polyamine biosynthesis. PMID- 6508755 TI - Partial purification and properties of the external NADH dehydrogenase from cuckoo-pint (Arum maculatum) mitochondria. AB - The external NADH dehydrogenase has been purified from Arum maculatum (cuckoo pint) mitochondria by phosphate washing, extraction with deoxycholate, ion exchange and gel-filtration chromatography. Sodium dodecyl sulphate/polyacrylamide-gel electrophoresis shows, when the gel is silver stained, that the purified enzyme contains two major bands of Mr 78 000 and 65 000 and a minor one of Mr about 76 000. It is not possible at present to determine which of these, or which combination, constitutes the dehydrogenase. The enzyme contains non-covalently bound FAD and a small amount of FMN. Since the conditions of purification lead to considerable loss of flavin and possibly iron sulphur centres, it is not possible to decide with certainty whether the enzyme is a flavo- or ferroflavo-protein. The enzyme has been distinguished from the other NADH dehydrogenases on the basis of its substrate specificity, its capability of reducing electron acceptors such as ubiquinone-1 and 2,6 dichlorophenol-indophenol and its sensitivity towards Ca2+, EGTA and dicoumarol. PMID- 6508756 TI - Cycloheximide blocks changes in rat liver carnitine palmitoyltransferase 1 activity in starvation. AB - Starvation (24h) increased the maximum activity of carnitine palmitoyltransferase 1 in rat liver and increased the concentration of malonyl-CoA required to cause 50% inhibition of the enzyme (I50). Re-feeding (24h) with a standard cube diet or a high-carbohydrate diet reversed both of these changes, whereas re-feeding with a high-fat diet did not. Administration of cycloheximide (200 micrograms/100 g body wt.) blocked the increases in carnitine palmitoyltransferase 1 activity and I50 on starvation. It is suggested that increase in carnitine palmitoyltransferase 1 activity in starvation may involve synthesis of new enzyme. PMID- 6508757 TI - The regulation of phosphate-activated glutaminase activity and glutamine metabolism in the streptozotocin-diabetic rat. AB - The activity of phosphate-activated glutaminase was increased in the kidney, liver and small intestine of rats made diabetic for 6 days with injection of streptozotocin (75 mg/kg body wt.). Insulin prevented this increase in all three tissues. Treatment with NaHCO3, to correct the acidosis that accompanies diabetes, prevented the increase in renal glutaminase activity, but not that in liver or small intestine. Chemically induced acidosis (NH4Cl solution as drinking water) or alkalosis (NaHCO3 solution as drinking water) increased and decreased, respectively, glutaminase activity in the kidney, but were without significant effect on the activity in liver and small intestine. The increase in glutaminase activity in the small intestine during diabetes was due to an overall increase in the size of this organ, and was only detectable when activity was expressed in terms of whole organ, not mucosal scrapings or isolated enterocytes. Prolonged diabetes (40 days) resulted in an even greater increase in the size and glutaminase activity of the small intestine. Despite this marked increase in capacity for glutamine catabolism, arteriovenous-difference measurements showed a complete suppression of plasma glutamine utilization by the small intestine during diabetes, confirming the report by Brosnan, Man, Hall, Colbourne & Brosnan [(1983) Am. J. Physiol. 235, E261-E265]. PMID- 6508758 TI - Quantitative role of parenchymal and non-parenchymal liver cells in the uptake of [14C]sucrose-labelled low-density lipoprotein in vivo. AB - In order to assess the relative importance of the receptor for low-density lipoprotein (LDL) (apo-B,E receptor) in the various liver cell types for the catabolism of lipoproteins in vivo, human LDL was labelled with [14C]sucrose. Up to 4.5h after intravenous injection, [14C]sucrose becomes associated with liver almost linearly with time. During this time the liver is responsible for 70-80% of the removal of LDL from blood. A comparison of the uptake of [14C]sucrose labelled LDL and reductive-methylated [14C]sucrose-labelled LDL ([14C]sucrose labelled Me-LDL) by the liver shows that methylation leads to a 65% decrease of the LDL uptake. This indicated that 65% of the LDL uptake by liver is mediated by a specific apo-B,E receptor. Parenchymal and non-parenchymal liver cells were isolated at various times after intravenous injection of [14C]sucrose-labelled LDL and [14C]sucrose-labelled Me-LDL. Non-parenchymal liver cells accumulate at least 60 times as much [14C]sucrose-labelled LDL than do parenchymal cells accumulate at least 60 times as much [14C]sucrose-labelled LDL than do parenchymal cells when expressed per mg of cell protein. This factor is independent of the time after injection of LDL. Taking into account the relative protein contribution of the various liver cell types to the total liver, it can be calculated that non-parenchymal cells are responsible for 71% of the total liver uptake of [14C]sucrose-labelled LDL. A comparison of the cellular uptake of [14C]sucrose-labelled LDL and [14C]sucrose-labelled Me-LDL after 4.5h circulation indicates that 79% of the uptake of LDL by non-parenchymal cells is receptor dependent. With parenchymal cells no significant difference in uptake between [14C]sucrose-labelled LDL and [14C]sucrose-labelled Me-LDL was found. A further separation of the nonparenchymal cells into Kupffer and endothelial cells by centrifugal elutriation shows that within the non-parenchymal-cell preparation solely the Kupffer cells are responsible for the receptor-dependent uptake of LDL. It is concluded that in rats the Kupffer cell is the main cell type responsible for the receptor-dependent catabolism of lipoproteins containing only apolipoprotein B. PMID- 6508759 TI - Myofibrillar-protein isoforms and sarcoplasmic-reticulum Ca2+-transport activity of single human muscle fibres. AB - In this study the polymorphism of myofibrillar proteins and the Ca2+-uptake activity of sarcoplasmic reticulum were analysed in single fibres from human skeletal muscles. Two populations of histochemically identified type-I fibres were found differing in the number of light-chain isoforms of the constituent myosin, whereas the pattern of light chains of fast myosin of type-IIA and type IIB fibres was indistinguishable. Regulatory proteins, troponin and tropomyosin, and other myofibrillar proteins, such as M- and C-proteins, showed specific isoforms in type-I and type-II fibres. Furthermore, tropomyosin presented different stoichiometries of the alpha- and beta-subunits between the two types of fibres. Sarcoplasmic-reticulum volume, as indicated by the maximum capacity for calcium oxalate accumulation, was almost identical in type-I and type-II fibres, whereas the rate of Ca2+ transport was twice as high in type-II as compared with type-I fibres. It is concluded that, in normal human muscle fibres, there is a tight segregation of fast and slow isoforms of myofibrillar proteins that is very well co-ordinated with the relaxing activity of the sarcoplasmic reticulum. These findings may thus represent a molecular correlation with the differences of the twitch-contraction time between fast and slow human motor units. This tight segregation is partially lost in the muscle fibres of elderly individuals. PMID- 6508760 TI - A modified perifused incubation system for isolated fat-cells. Investigation of intermediary metabolism by perifusion. AB - Perifused fat-cells showed similar values for acylglycerol glycerol synthesis from glucose with insulin and for the effects of added palmitate to those in normal incubations and those reported in the literature. Fatty acid synthesis was lower in perifused cells compared with normal incubations, and there was a net release of fatty acids only with the perifused fat-cells. Hence fluxes of metabolites were different in the two incubation systems, and the perifusion system enables the investigation of the flux of metabolites under conditions which may more closely resemble those in vivo. PMID- 6508761 TI - Formation of n.m.r.-invisible ADP during renal ischaemia in rats. AB - Measurement of the adenine nucleotide and inorganic phosphate content of normoxic and ischaemic kidney in vivo has been made, comparing enzymic assay (after freeze clamping and acid extraction) with quantification by 31P-n.m.r. Both methods give similar results for ATP, and n.m.r. quantification of Pi gives a value 25-50% of that obtained by enzymic assay. ADP, which is largely invisible to n.m.r. in the normoxic kidney, remains invisible during ischaemia despite a 2-3 fold rise in enzymically assayed ADP. N.m.r. and enzymic assay of the acid extracts give similar values for all metabolites measured. The question of ADP binding in the kidney is discussed, as are the implications for the metabolic regulation of ADP dependent reactions. PMID- 6508762 TI - Potentiation by ammonia of the metabolic effects of pent-4-enoate in isolated rat hepatocytes. AB - The metabolic effects of pent-4-enoate were studied in isolated rat hepatocytes; 1 mM-pent-4-enoate did not significantly inhibit gluconeogenesis from lactate, alanine and glycerol, but significantly decreased glucose synthesis from pyruvate. The addition of 1 mM-NH4Cl led to a drastic inhibition of glucose synthesis from all these substrates. In hepatocytes incubated with 10 mM-alanine and 1 mM-oleate, pent-4-enoate at 0.05-1 mM slightly inhibited glucose synthesis and ketogenesis. The addition of ammonia resulted in a dramatic potentiation of the metabolic effects of pent-4-enoate. Half-maximum effect of ammonia was observed at 0.2 mM concentration. Concomitant cellular concentrations of ATP and acetyl-CoA were also decreased by the addition of ammonia, as were lactate/pyruvate ratio and beta-hydroxybutyrate/acetoacetate ratio. These data suggest that ammonia seriously interferes with the cellular metabolism of pent-4 enoate and leads to a dramatic potentiation of its effects. PMID- 6508763 TI - The binding of Ca2+ to actin monomer is monitored by the fluorescence of actin bound auramine O. AB - The fluorescence of the cation auramine O was substantially enhanced by the presence of actin monomer. Titrations of this fluorescence enhancement indicated that actin monomer had two auramine O binding sites, each with a dissociation constant of approx. 20 microM. Calcium ions had no effect on the number of actin monomer-bound auramine O molecules or on the dissociation constant for that interaction. However, calcium ions increased the maximum change of fluorescence that occurs when actin monomer was fully saturated with auramine O. This effect of calcium was saturable and yielded a Ca2+ dissociation constant of 1.6 mM. It was concluded that auramine O bound to sites on actin monomer and independently monitored the binding of Ca2+ ion(s) to other site(s) on actin monomer. Further, the magnitude of the Ca2+ dissociation constant suggested that this Ca2+-binding site may be representative of the multiple bivalent cation-binding sites on actin monomer which are thought to be directly involved in actin polymerization. However, the exact relationship between these sites remains unclear. PMID- 6508764 TI - Intralumenal pool and transport of CMP-N-acetylneuraminic acid, GDP-fucose and UDP-galactose. Study with plasma-membrane-permeabilized mouse thymocytes. AB - Treatment with NH4Cl of mouse thymocytes renders their plasma membrane permeable to sugar nucleotides both inwards and outwards. Using this model, we studied the entry and utilization of CMP-NeuAc, GDP-Fuc and UDP-Gal into intracellular vesicles in situ. It is shown that CMP-NeuAc and GDP-Fuc enter the vesicles in a manner indicating a carrier-mediated transport (substrate saturation curve, inhibition by substrate analogues, temperature dependence) and are entrapped in their uncleaved form. This leads to the formation of an intralumenal pool of these precursors which can be further utilized by the sialyltransferases and fucosyltransferases. The occurrence of an endogenous pool of CMP-NeuAc and GDP Fuc is demonstrated by the fact that, when the vesicles are disrupted by detergent, the release of the endogenous sugar nucleotides causes an isotopic dilution of the labelled precursors added to measure the glycosyltransferase activities. In contrast, no accumulation of UDP-Gal has been detected, suggesting that transport and transfer reaction are simultaneous events. However, experiments with UDP 2',3'-dialdehyde indicate that UDP-Gal is not transported through the membrane by galactosyltransferase action but by a distinct carrier molecule. PMID- 6508765 TI - Lipid organization in erythrocyte membrane microvesicles. AB - The aminophospholipids of microvesicles released from human erythrocytes on storage or prepared from erythrocyte ghosts by shearing under pressure are susceptible to the action of 2,4,6-trinitrobenzenesulphonic acid. The aminophospholipids of the former vesicles are also susceptible to attack by phospholipase A2. Under the same conditions, the aminophospholipids of erythrocytes undergo little reaction. This suggests that the phospholipids in microvesicle membranes are more randomly distributed than those in erythrocyte membranes. Measurements have also been made of the ability of filipin to react with the cholesterol of sealed and unsealed erythrocyte ghosts and of microvesicles prepared from them. From the initial rates of reaction, it was concluded that there is no preferential transfer of cholesterol molecules from one side of the bilayer to the other during the formation of the microvesicles. PMID- 6508766 TI - Evidence that cycloleucine affects the high-affinity systems of amino acid uptake in cultured human fibroblasts. AB - The influence of cycloleucine on kinetic parameters of uptake of L-alanine, L proline and L-leucine into cultured human fibroblasts was examined under initial rate conditions with substrate concentrations of 0.05-10 mM and 5 mM cycloleucine. Kinetic data obtained by computer analysis showed that, in the absence of cycloleucine, cell uptake was heterogeneous for each amino acid. L Alanine and L-leucine entered by two transport systems with different affinities; L-proline was taken up by one saturable transport system plus a diffusion-like process. This heterogeneity disappeared in the presence of cycloleucine, since the high-affinity systems were no longer detectable. The remaining process had the same kinetic constants as the low-affinity system for alanine and leucine and a KD similar to the diffusion constant for proline. The influence of cycloleucine on the amino acid uptake was not specific either to the amino acid concerned or to a particular transport system, since the three neutral amino acid-transport systems, A, ASC and L, were involved in these experiments. This influence was shown to be unaffected by the absence of Na+ (for leucine uptake). ATP content of the cells was identical in the presence or in the absence of cycloleucine. PMID- 6508768 TI - Domain structure of cartilage proteoglycans revealed by rotary shadowing of intact and fragmented molecules. AB - The rotary-shadowing technique for molecular electron microscopy was used to study cartilage proteoglycan structure. The high resolution of the method allowed demonstration of two distinct globular domains as well as a more strand-like portion in the core protein of large aggregating proteoglycans. Studies of proteoglycan aggregates and fragments showed that the globular domains represent the part of the proteoglycans that binds to the hyaluronic acid, i.e. the hyaluronic acid-binding region juxtapositioned to the keratan sulphate-attachment region. The strand-like portion represents the chondroitin sulphate-attachment region. Low-Mr proteoglycans from cartilage could be seen as a globule connected to one or two side-chain filaments of chondroitin sulphate. PMID- 6508767 TI - Design and synthesis of a consensus signal sequence that inhibits protein translocation into rough microsomal vesicles. AB - Most signal sequences are found to vary considerably in length and primary sequence, but possess some common structural features. Analysis of known signal sequences has led to the design of a 19-residue sequence that, although not a naturally occurring signal, possesses the structural features that commonly occur in pre-proteins. This peptide has been synthesized by solid-phase methods, and has been shown to inhibit, in a concentration-dependent manner, the processing in vitro of nascent pre-prolactin, pre-forms of pancreatic digestive enzymes, and pre-placental lactogen. The peptide acts at the cytoplasmic surface of microsomal vesicles added to the protein translation system, preventing translocation of the nascent chains to the lumenal space of vesicles where signal peptidase normally cleaves to remove the signal from nascent pre-proteins. PMID- 6508769 TI - Extraction and purification of proteoglycans from mature bovine bone. AB - Proteoglycans were extracted in good yields from the mineralized matrix of ground bovine bone, by using a two-step extraction procedure. Proteoglycans (8% of total), not associated with the bone mineral, were extracted at - 20 degrees C with 4M-guanidinium chloride containing proteinase inhibitors. Proteoglycans associated with the mineral, which accounted for 60% of the total, were then solubilized when EDTA was added to the extraction solvent. They were fractionated and purified in the presence of 4M-guanidinium chloride by CsCl-density-gradient centrifugations followed by chromatography on Sepharose CL-4B. Further purification was obtained by chromatography on DEAE-cellulose and hydroxyapatite in the presence of 7 M-urea. Three populations of proteoglycans and additional glycosaminoglycan peptides were obtained. The molecular dimensions of both intact molecules and of their side chains as well as their amino acid composition were different, indicating that they represent separate molecular entities. The main proteoglycan self-aggregated in the absence of 4M-guanidinium chloride or 7 M urea, a property that was abolished when the proteoglycan core protein was fragmented. PMID- 6508770 TI - Nicotine-stimulated proteins in mouse cells are distinct from heat-shock proteins. AB - Treatment of mouse tissue-culture cells with nicotine concentrations of 1 mM or less had no significant effects on cell viability, morphology or protein synthesis, but higher concentrations resulted in both altered cell morphology (rounding and vacuolization) and alterations in [3H]leucine-labelled protein profiles on sodium dodecyl sulphate/polyacrylamide gels. The synthesis of a Mr-70 000 protein was increased more than 2-fold relative to that of other major cellular proteins in 3T3 and L929 cells treated with 5 mM-nicotine and in B16 cells treated with 10 mM-nicotine, and this protein appeared to be a soluble cytoplasmic polypeptide. The radiolabelling of several additional polypeptides (Mr 62 000 in 3T3 cells, and Mr 45 000 and 38 000 in B16 cells) was also stimulated by nicotine. The nicotine-enhanced Mr-70 000 protein was distinct, however, from a major cell stress/heat-shock protein whose synthesis was stimulated after incubation of cells at 43.5 degrees C for 20 min. PMID- 6508771 TI - Proline in the cerebrospinal fluid of normal subjects and Alzheimer's-disease patients, as determined with a new double-labeling assay technique. AB - Past studies have implicated proline involvement in the function of memory and learning. A new micromethod has been developed that is suitable for measuring proline accurately in as little as 0.1 ml of CSF. In normal human CSF, the average proline level was found to be consistently about 1.3 microM. In the CSF of patients with Alzheimer's disease and mixed dementias, the levels of proline showed no statistically significant difference from proline levels in the CSF of normal controls. Furthermore, the proline levels in the CSF of the Alzheimer's disease patients did not reflect, consistently, the cognitive deficits or the symptomatic severity of the disease. Proline levels in CSF showed no statistically significant change with the age of individuals tested. PMID- 6508772 TI - Urinary excretion of dimethylarginines in premature infants. AB - Urinary excretion of NG,N'G-dimethylarginine (NG,N'G-Me2Arg) and NG,NG dimethylarginine (NG,NG-Me2Arg) was measured in premature infants. The NG,N'G Me2Arg/NG,NG-Me2Arg ratio was much higher in newborn infants than in older children or adults. Linear regression analysis showed a significant negative correlation between the degree of maturity and the excretion of NG,N'G-Me2Arg. A significant direct linear relationship also was found between the excretion of NG,N'G-Me2Arg and the rate of whole body nitrogen flux and of protein synthesis and catabolism. No correlation was found between the excretion of the dimethylarginines and 3-methylhistidine, but the dimethylarginine/3 methylhistidine ratio declined with advancing conceptual age. A direct linear relationship was found between excretion of NG,N'G-Me2Arg and NG,NG-Me2Arg and whole body nonskeletal muscle protein breakdown. No correlation was found between nonskeletal muscle protein catabolism and 3-methylhistidine excretion. We estimate that approximately 0.34 mumole of dimethylarginine are excreted per gram of nonskeletal muscle protein catabolized. Dietary intake did not affect the excretion of either NG,N'G-Me2Arg or NG,NG-Me2Arg. The data suggest that measurement of urinary dimethylarginines might be useful in the nutritional assessment of premature infants. PMID- 6508773 TI - Partial purification from rat and pig liver of cytosolic stimulators of hormone sensitive adenylate cyclase: quantitation and resolution of two components. AB - Procedures were carried out to isolate from liver cytosol the protein activators of hormone-sensitive adenylate cyclase. A method for quantifying amounts of activator protein was used to monitor recovery after each isolation step. The activator proteins were precipitable by ammonium sulfate (30-60% saturation) and partially recoverable from the precipitate. On gel filtration of cytosol, stimulatory activity for glucagon-sensitive adenylate cyclase was recovered in two peaks representing proteins with molecular weights of 49,000 and 25,500. Exposure to GTP-Sepharose reduced liver cytosol's content of stimulatory factors for glucagon-sensitive adenylate cyclase by up to 70%. However, soluble protein adenylate cyclase activators distinct from GTP could not be subsequently eluted from the affinity matrix. Purification efforts were thwarted by factor instability and large losses during simple and conventional steps despite the use of a variety of protein stabilizers and protease inhibitors. If the problem of stimulator instability can be overcome, large-scale purification should be possible using pig liver as a starting material. PMID- 6508775 TI - Influence of neonatal age on changes in fatty acid composition of microsomal lipids induced by long-term and short-term cholesterol feeding. AB - Changes observed as a function of chick age in fatty acid composition of lipids from liver microsomes were considerably small, while the unsaturation index increased throughout postnatal development. Supplementation of the diet with 2% cholesterol from hatching produced a significant decrease in the levels of palmitic acid and a clear increase in those of polyunsaturated fatty acids. Maximum effects were attained on day 19 of treatment. Alterations in the fatty acid composition were more pronounced after short-term (48 h) cholesterol feeding. Administration for 48 h of a standard diet to chicks fed a cholesterol diet for 10 days from hatching restored the levels of fatty acids to those of the controls. However, when cholesterol feeding was prolonged for 24 days from hatching, no effect was found after the same treatment. Suppression of the cholesterol diet for 48 h in animals cholesterol fed for 48 h had no effect in 12 day-old chicks while the change to a standard diet produced a reversion of the effect of cholesterol feeding in 26-day-old animals. PMID- 6508774 TI - Toward a chronophysiology of circulating aldosterone. AB - The physiology of aldosterone secretion has been prominently investigated by homeostatic studies on the levels of the steroid in plasma and/or urine. Aldosterone secretion is, however, arranged in a rhythmic fashion along the 24-hr cycle. The dynamics of aldosterone should thus be reanalyzed chronobiologically in order to gain further insight into the physiology of the hormone. Such a revisitation has been performed in the present study on four groups of clinically healthy volunteers categorized according to sex and age. Aldosterone has been assayed in the plasma of systemic venous blood six times a day (0600, 0800, 1200, 1800, 2000, 0000) in different conditions of physical activity and sodium intake. Time-qualified data have been analyzed by the single-cosinor method and then summarized by the population-mean cosinor procedure to quantify the circadian rhythms in their properties (mesor, amplitude, acrophase). Differences in rhythmometric parameters have been tested by a multivariate analysis for vectorial units. (Hotelling's T2 test). Cosinor analysis indicates that the dynamics of circulating aldosterone substantially changes in relation to posture. The habit of having a routine of diurnal activity leads the circadian rhythm of aldosterone to delay its acrophase from morning to afternoon. The postural shift of acrophase is essentially accompanied by an elevation in the 24-hr mean level. The restriction of salt intake is associated with an increase in mesor; the temporal localization of the circadian crest shows, however, a very high stability. Sex is not characterized by significant differences in the 24-hr patterns of aldosterone in the sense that young males and females show substantially identical time-qualified curves and circadian parameters. Increasing age until the seventh decade in life is responsible for changes mainly in 24-hr mean levels with a slight modification in amplitude. Such a chronophysiology for circulating aldosterone related to the motor-rest schedule, sodium intake, sex, and age, is of interest not only to heuristic but also to practical approaches in clinical medicine. PMID- 6508777 TI - A new purification procedure for Clostridium difficile enterotoxin. AB - Clostridium difficile produces two toxins, an enterotoxin and a cytotoxin. The enterotoxin was purified using fast methods (tangential flow filtration, fast protein liquid chromatography). The purified enterotoxin is composed of two subunits (A1 = 41,500, A2 = 16,000) and its pI is 3.5. PMID- 6508776 TI - Stimulation of tyrosine phosphorylation in lectin treated human lymphocytes. AB - Large increases in tyrosine phosphorylation have been detected in subcellular matrixes isolated from lectin treated human lymphocytes. In lectin stimulated cells proteins of molecular weight 105, 75, 58 and 35 kDa contained phosphotyrosine (P-tyr) whereas non-stimulated cells had no 105 and low levels of P-tyr in proteins of 75, 58 and 35 kDa. In stimulated cells increased tyrosine kinase activity was also shown using gastrin as substrate. In both stimulated and non-stimulated cells the 58 kDa phosphoprotein was the most heavily labelled, after partial proteolysis of the 58 kDa different phosphopeptides were generated. A peptide with a sequence analogous to the autophosphorylated tyrosine site of pp60src inhibited tyrosine phosphorylation in stimulated cells. The lymphocyte system provides a useful tool to study normal tyrosine protein kinases and their role in cellular proliferation. PMID- 6508778 TI - ATP produced by myocardial sarcolemmal-bound creatine kinase is not preferentially used by the Na+ pump. AB - It has been proposed (Grosse et al. (1980) Biochim. Biophys. Acta 603, 142-156) that membrane-bound creatine kinase and the ATP-dependent Na+ pump form a functional complex in cardiac sarcolemmal vesicles. In this model ADP produced at Na+ pump sites would be rephosphorylated by the creatine kinase for preferential delivery back to the Na+ pump. We have reexamined this hypothesis and find that under some conditions active Na+ transport can be stimulated by ATP produced by sarcolemmal creatine kinase. However, the characteristics of this stimulation are no different than stimulation produced by an added soluble ATP-regenerating system (phosphoenolpyruvate/pyruvate kinase). Thus, we are unable to detect coupling between the Na+ pump and sarcolemmal creatine kinase. PMID- 6508779 TI - Atriopeptin release from the isolated perfused rabbit heart. AB - Mammalian atrial extracts have been shown to contain bioactive peptides which exert natruiretic, diuretic, and smooth muscle relaxant effects. These extracts include several low molecular weight (less than 5,000 Mr) atrial peptides (atriopeptins) which exhibit identical sequences over a central core region which are derived from the high molecular weight peptide (atriopeptigen) precursor which has been purified and sequenced. In the current study we found that extracts of rabbit atria possess both high and low molecular weight bioactive atrial peptides, however, the coronary venous effluent obtained from the isolated perfused rabbit heart only contained the low molecular weight peptide. This trypsin labile activity causes a dose-dependent relaxation of rabbit aorta and chicken rectum assay strips. Separation of the bioactivity with gel filtration chromatography and reversed phase HPLC indicates the heart releases a single substance similar to atriopeptin III. There was no evidence that atriopeptigen was released from the isolated perfused rabbit heart. We suggest that atriopeptigen is proteolytically processed in the atria to an atriopeptin which is subsequently the released form of the atrial peptide. PMID- 6508780 TI - Reduction by N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7), a calmodulin antagonist, in the number of phorbol ester receptors in mouse skin. AB - A calmodulin antagonist, N-(6-aminohexyl)-5-chloro-1-naphthalene-sulfonamide (W 7), reduced the number of phorbol ester receptors in mouse skin in a dose- and time-dependent manner. The reduction occurred immediately after topical application of 30 mumoles of W-7, reaching a maximum of 86% after 5 min. Reduction in specific binding of 12-O-tetra-decanoylphorbol-13-acetate can explain the antitumor promoting activity of W-7 in mouse skin. PMID- 6508781 TI - Sequential assignment of the 1H and 31P resonances of the double stranded deoxynucleotide d (ATGCAT)2 by 2D-NMR correlation spectroscopy. AB - 31p-1H and 1H-1H chemical shift correlation spectroscopy are jointly used for providing a complete assignment of sugar proton (except H5' and H5") and phosphorus resonances in the double stranded oligonucleotide d (ATGCAT)2. In contrast to previous methods the specific assignment of overcrowded H5' H5" proton resonances is not required. Using the H3'-P coupling and also the long range H4'-P coupling, this quite general method can be easily implemented on intermediate field spectrometer. The present results pave the way to the 1H and 31P resonance assignment of longer double-stranded oligonucleotides. PMID- 6508782 TI - Extracellular matrix proteins involved in bone induction are vitamin D dependent. AB - Subcutaneous implantation of demineralized diaphyseal bone matrix into allogeneic rats results in local formation of cartilage and bone. However, implantation of demineralized bone matrix obtained from rachitic rats did not induce bone. Rachitic bone matrix was therefore dissociatively extracted with 4 M guanidine HCl and then reconstituted with an inactive collagenous residue of control as carrier. Such reconstituted materials also lacked bone inductive potential. On the other hand, reconstitution of guanidine HCl extracts of control bone matrix with inactive vitamin D deficient matrix did result in bone induction. Partial purification (fractions containing proteins (less than 50,000 daltons) of the guanidine HCl extract from rachitic rats on Sepharose CL-6B followed by reconstitution with inactive collagenous residues resulted in a weak (25% of control) inductive response. These observations imply that bone inductive proteins are vitamin D dependent and are reduced in matrix obtained from rachitic rats. PMID- 6508783 TI - Mechanism of action of S-100 protein(s) on brain microtubule protein assembly. AB - The inhibitory effect of S-100 on microtubule protein assembly is inversely related to the microtubule protein concentration and/or the temperature of assembly. Moreover, the S-100-induced decrease in the rate and extent of assembly is positively correlated with the length of the lag of assembly. When microtubule fragments are added to the microtubule protein solution, the S-100 effect is reduced but not abolished. These data suggest that S-100 interferes with both the nucleation and the elongation of microtubules. Since S-100 also inhibits the assembly of purified tubulin, S-100 is suggested to affect the microtubule assembly by interacting with and sequestering tubulin. PMID- 6508785 TI - Colcemid treatment of myeloma prior to cell fusion increases the yield of hybridomas between myeloma and splenocyte. AB - Effect of Colcemid treatment of myeloma (X63-Ag8-6.5.3.) prior to fusion with mouse spleen cell was studied in terms of hybridoma formation. Spleen cells from BALB/c mice immunized with various soluble antigens were fused with the myeloma cells by using polyethylene glycol solution. Colcemid treatment of myeloma cells prior to fusion increased the average number of hybridoma colonies per well by 26 570%. The yield of hybridomas producing antigen-specific antibodies was also higher with the Colcemid treatment. The results suggest that most of the proliferative hybridomas are formed by fusion of cells in the M-phase of the cell cycle. PMID- 6508784 TI - Preparation and characterization of Ca2+-Zn2+-derivatives of lentil and pea lectins and comparison with the native forms. AB - Ca2+-Zn2+-derivatives of lentil and pea lectins were prepared for the first time by a unique method involving dialysis of the native Ca2+-Mn2+-lectins against large excesses of metal ions in pH 4.0 buffer. Each derivative contained about 1.5 g atoms of Ca2+ and about 1 g atom of Zn2+ per monomer. The derivatives were found to be identical to their respective native forms, both in molecular weight and carbohydrate binding activities. Solvent proton relaxation dispersion measurements were used to characterize both the Ca2+-Zn2+- and Ca2+-Mn2+ complexes of the lentil lectin. PMID- 6508786 TI - Cell fusion responsible for horizontal oncogenesis by human tumors in nude mice. AB - Human tumor xenotransplants derived from 4 different carcinomas were established in athymic mice and maintained by serial passage. In vivo human/mouse cell fusion and induction of neoplastic growth of adjacent mouse tissue was investigated in serial passages by isoenzyme analysis, by chromosome analysis and by cloning of induced tumorigenic mouse cells. In 2 xenotransplants human/murine hybrid isoenzyme complexes of pyruvate-glutamate transaminase, glucosephosphate isomerase and mitochondrial malate dehydrogenase were detected. Metaphases containing human and murine chromosomes were found in the first in vitro passage of excised xenotransplants. Cloning of induced mouse tumor cells yielded tumor cell lines tumorigenic in athymic as well as in immunocompetent mice. PMID- 6508787 TI - Cyclic tetrameric clusters of chemotactic peptides as superactive activators of lysozyme release from human neutrophils. AB - The preparation of cyclic tetramers of formyl-methionyl-leucylphenylalanine (FMLP) amides from tetraazacycloalkanes incorporating different spacers is described. The corresponding monomeric analogs are also reported. The ability of these FMLP analogs to release lysozyme from human neutrophils was evaluated. The cyclic clusters proved to be superactive and in a manner suggestive of a cooperative response of the membrane receptors. The spasmogenicity of two prototype compounds on the guinea-pig ileum was also measured and the results briefly discussed. PMID- 6508788 TI - Synaptosomal phospholipase D: potential role in providing choline for acetylcholine synthesis. AB - The synaptic membrane (SM) prepared from rat brain synaptosomes displayed the highest activity of phospholipase D of mammalian tissue thus far observed. In common with the previously described latency of the microsomal enzyme, the SM phospholipase D (PLD) activity is barely detectable in the absence of 4 mM sodium oleate. Incubation of synaptosomes in the presence of choline labelled lecithin, sodium oleate and acetyl CoA resulted in the formation of a product co chromatographing with acetylcholine. The potential role of SM PLD liberating choline from lecithin into the synaptic cleft is discussed in relationship to acetylcholine formation. PMID- 6508789 TI - Differences in physical and biological properties of 50S ribosomes and 23S RNAs derived from tight and loose couple 70S ribosomes. AB - Tight couple (TC) 50S ribosomes on treatment with kethoxal lose their capacity to associate with 30S ribosomes whereas loose couple (LC) 50S ribosomes on such treatment fully retain their association capacity. The same is true for 23S RNAs isolated from treated 50S ribosomes or isolated 23S RNAs directly treated with kethoxal, so far as their capacity to associate with 16S RNA is concerned. At certain Mg++ concentrations TC 23S RNA is highly susceptible to the nucleolytic action of single-strand specific enzyme RNase I; LC 23S RNA is quite resistant. The Mg++-dependencies of the two species of 23S RNAs for association with 16S RNA are also quite different. The fluorescence enhancement of ethidium bromide due to binding to TC 23S RNA is slightly less than LC 23S RNA. The hyperchromicity of LC 23S RNA due to thermal denaturation is somewhat more than TC 23S RNA. LC 23S RNA has slightly more elliptic CD spectrum than TC 23S RNA. These results clearly show that 23S RNAs present in TC and LC 50S ribosomes are distinct from each other. It has been recently demonstrated in this laboratory that they can be interconverted by the agents involved in translocation and thus appear to be conformomers. PMID- 6508790 TI - TTX displacement of [H3]-nitrendipine binding in developing spinal cord neurons. AB - [3H] Nitrendipine binding was partially blocked by the presence of tetrodotoxin in developing spinal cord neurons. In young cultures, 1 micron tetrodotoxin displaced 29% and 26% of [3H] nitrendipine binding from the high and low affinity binding sites, respectively. In one month old cultures, tetrodotoxin had no effect on [3H] nitrendipine binding. The interaction between tetrodotoxin and nitrendipine in young cultures suggests ligand binding site similarities during development. PMID- 6508791 TI - Participation of peroxisomal beta-oxidation system in the chain-shortening of a xenobiotic acyl compound. AB - A drug, (E)-3-[4-(1-imidazolylmethyl)phenyl]-2-propenoic acid, was metabolized to 4-(1-imidazolylmethyl)benzoic acid in isolated hepatocytes of rats, which was enhanced markedly by the pretreatment of rats with clofibrate. With liver homogenates, the formation of the CoA-ester of this drug and its subsequent chain shortening were demonstrated. In the series of these reactions, acyl-CoA synthetase, CoA, ATP and NAD were required, whereas cyanide did not inhibit the reaction. These results indicate that peroxisomes are capable of shortening the acyl side-chains of drugs by the beta-oxidation, giving an additional suggestion on the functions of peroxisomes. PMID- 6508793 TI - Ganglioside composition of substrate-adhesion sites of normal and virally transformed Balb/c 3T3 cells. AB - The ganglioside composition of the so-called substrate-attached material (SAM), which remains tightly bound to the tissue culture dish after cells are detached by chelating agents, was compared with the ganglioside composition of released cell bodies in the cultures of normal and various virally-transformed Balb/c 3T3 cells. Regardless of whether the cells were untransformed or transformed, the SAM of their cultures shows a ganglioside structure characterized by a prevalence of the higher homologs, mainly GD1a, over the simpler gangliosides, even when the level of higher homologs was reduced in the cell bodies of transformed cells. This result cannot be ascribed to the presence of plasmamembranes in the SAM as shown by ganglioside analysis of the plasmamembranes of some of the cells under study. Only in a highly metastatic transformed cell line did the SAM contain the same low GD1a level as found in the cell bodies. PMID- 6508792 TI - Relationship between the rate of erythrocyte hexose monophosphate pathway and the glucose 6-phosphate concentration. AB - Erythrocytes of individuals with increased (+ 50%) or reduced (-35%) hexokinase activity contain respectively 70 and 17 nmole/ml RBC of glucose-6-phosphate (normal concentration 30 +/- 5nmole/ml RBC) and show comparable rates of the HMP (60 +/- 5nmole/hr/ml RBC). Similarly, in RBC of different ages, obtained by density gradient ultracentrifugation, the glucose-6-phosphate concentration range from 57 (young cells) to 18 (old cells) nmole/ml RBC but the rate at which glucose is utilized in the HMP is unchanged. These data exclude a regulatory role of glucose 6-phosphate in the HMP even if its concentration is under that required for maximal G6PD activity. PMID- 6508794 TI - Creatine kinase-BB isoenzyme in rat plasma after chronic lead intoxication. AB - Creatine kinase (CK) activity in plasma obtained non-invasively from adult healthy, Sprague-Dawley, male rats was found to be 528 +/- 270 U/L (N = 17), a value which was 7 times that obtained in human specimens. Agarose gel electrophoresis revealed that the only detectable CK isoenzyme present was CK-BB, in contrast to the human serum isoenzyme which was CK-MM. Furthermore, it was found that the rat CK-BB could be detected using an RIA technique designed to quantitate human CK-BB occasionally present in blood after brain injury (rat CK BB = 84.5 +/- 55.2 micrograms/L, N = 17, human CK-BB: Not detectable). It was thus possible to calculate the CK-BB specific activity (SA) in rat plasma using total CK assay and RIA (rat CK-BB SA = 6.25 +/- 3.87 U/micrograms, N = 17). When six rats (156 +/- 23 g) were treated with lead acetate in the drinking water (26 mM) for 3 weeks, the CK-BB SA rose to 18 +/- 5.8 U/micrograms (P less than .02). At this point the electrophoresis pattern of the CK-BB showed a transient change from a single band to a doublet. The dose was then increased to 52 mM for 6 weeks, during which time the CK-BB SA declined steadily to 1.6 +/- 0.6, a level significantly less than that of the untreated animals (p less than .02). The results suggest that chronic lead treatment evokes a biphasic response in CK-BB SA with the initial release of enzyme of high SA from tissues. Further treatment apparently results in an inactivation of the enzyme within lead sensitive tissues. PMID- 6508795 TI - Salmon calcitonin inhibits human sperm motility in vitro. AB - We have evaluated by a stroboscopic technique the in vitro effect of salmon calcitonin and human calcitonin on the motility of human migrated spermatozoa. We report here that human calcitonin is uneffective while salmon calcitonin is a potent inhibitor of the sperm motility. This salmon calcitonin action is abolished by the preincubation of the peptide with an anti-salmon calcitonin antiserum, demonstrating the specificity of the effect. In addition, we provide evidence that the release of intracellular calcium represents a necessary step for the action of the peptide. In fact, the salmon calcitonin effect is prevented in a dose-dependent way by dantrolene sodium which inhibits the release of calcium from intracellular stores while the calcium channel blocker verapamil is unefficacious. These results suggest a potential role for calcitonin in regulating human sperm motility. PMID- 6508796 TI - Identification of glycosphingolipid-glycoprotein hybrids in gastric epithelium. AB - A glycolipid fraction, obtained from dog gastric epithelium by detergent solubilization, was found to contain the glycoconjugates with features common to both glycosphingolipids and glycoproteins. Three such compounds have been purified to homogeneity and their composition and structural characteristics determined. The purified glycosphingolipid-glycoprotein hybrids had a molecular weight in the range of 14,000 and contained 88.2 - 91.1% carbohydrate, 3.1 - 4.5% protein, 2.0 - 2.4% sphingosine, and 1.1 - 1.9% fatty acids. The oxidation of the olefinic bond of sphingosine followed by beta-elimination reaction led to the release from each compound of glucose and mannose containing oligosaccharides. Deglycosylation with trifluoromethanesulfonic acid exposed the core regions of the hybrid molecules which were found to consist of sphingosine, glucose, N acetylglucosamine and amino acids. The data suggest that glycosphingolipid glycoprotein hybrid molecules are held together by amide linkages between the sphingosine and aspartic or glutamic acid. PMID- 6508797 TI - Preparation of an immunotoxin for Acanthamoeba castellanii. AB - Acanthamoeba castellanii (Neff) is a small free-living amoeba which is closely related to pathogenic organisms that produce almost invariably fatal human infections (1). The f(ab)' fragment of a monoclonal antibody (designated A9) specifically reactive to the A. castellanii cell surface, was covalently linked to the A chain of diphtheria toxin. This immunotoxin inhibited cell division completely, whereas nonspecific mouse IgG or nonspecific f(ab)' derivatized with diphtheria toxin A chain (DTA), A chain alone, or unlinked A chain and A9-f(ab)' in combination, had no effect on cell division. PMID- 6508798 TI - Characterization of a protein kinase-substrate complex precipitable with Ca2+ from the cytosol fraction of AH-66 hepatoma cells. AB - A protein kinase-substrate complex was precipitated by adding Ca2+ to the cytosol fraction of AH-66 ascites hepatoma cells. The amount of the precipitated complex was increased with increasing concentrations of Ca2+ and reached a plateau at about 5 mM Ca2+. In the presence of [gamma-32P]ATP, extensive uptake of radioactive phosphate into this complex occurred. The phosphorylation reaction was little affected by addition of cyclic nucleotides, Ca2+-phospholipid, Ca2+ calmodulin. When the complex after phosphorylation was analyzed by SDS-PAGE, a protein with molecular weight of 33,000 was most heavily phosphorylated. These phenomena were also observed for mouse myeloid leukemia cells (M1 cells). By contrast, the addition of Ca2+ to the cytosol fractions of regenerating rat liver, normal rat liver or brain caused little precipitation of the complex. PMID- 6508799 TI - Pulmonary macrophage: a major source of lipoprotein lipase in the lung. AB - The lipase released by heparin infusion into perfused rat lungs is shown to be identical with lipoprotein lipase on the basis of the following characteristics: 1) it required plasma for full activity; 2) it was largely inhibited by 1 M NaCl; and 3) it bound to a heparin-Sepharose gel and eluted with buffer containing 1.5 M NaCl. Macrophages prepared from rat lungs released a considerable amount of lipoprotein lipase, with characteristics similar to those of the lipoprotein lipase released from heparin-perfused rat lungs. Pulmonary surfactant-producing type II pneumocytes did not cause a significant release of lipoprotein lipase. No apparent lipoprotein lipase activities were detected in the conditioned medium of other lung cells from which macrophages had been selectively removed. PMID- 6508800 TI - A large-molecular-weight regulating factor for chromatin-dependent RNA polymerase II reactions in rat liver cytoplasm. AB - The author found a sugar-containing 70 KDa factor in rat liver nuclei as described in the previous report (1), which repressed RNA chain initiation by all classes of rat liver RNA polymerases and specifically stimulated chromatin dependent RNA chain elongation catalyzed by RNA polymerase II. In this communication, the localization of this factor in rat hepatic cells was studied. In the cytoplasmic fraction, a large-molecular-weight regulating activity for chromatin-dependent RNA polymerase II reactions was observed and it was characterized to be a 250 KDa glycoprotein. This factor showed the same biological activity for chromatin-dependent RNA polymerase II reactions as that of the factor reported previously (1). Furthermore, this factor was converted to the 70 KDa factor by the action of exogenous or unknown endogenous protease(s). These results suggest that a conversion mechanism from cytoplasmic factor to nuclear factor for RNA polymerase II-dependent transcription exists. PMID- 6508801 TI - Enhancement of the in vitro antibody response by thyrotropin. AB - The pituitary hormone thyrotropin (TSH) has been shown to enhance in a dose dependent manner the in vitro antibody response. Highly purified preparations of bovine and human TSH enhanced up to 375% the number of cells producing antibody to sheep erythrocytes. TSH had to be present prior to 24-48h of the initiation of culture for enhancement of the antibody response. An analogy is discussed between TSH and B lymphocyte growth and differentiation factors. PMID- 6508802 TI - Use of fast protein liquid chromatography in the purification of inhibin from bovine follicular fluid. AB - Inhibin from bovine follicular fluid was partly purified using affinity chromatography on immobilized Procion Red 3B, gel filtration on Sephadex G-25 and ion-exchange chromatography on the fast protein liquid chromatography system. Inhibin was subsequently characterized using preparative sodium dodecyl sulfate polyacrylamide gel electrophoresis and electroelution. Biological activity was associated with a protein with an apparent molecular weight of approximately 65 kD. PMID- 6508803 TI - Cis isomer of centchroman--a selective ligand for the microsomal antiestrogen binding site. AB - Several compounds structurally related to the triarylethylene antiestrogens, but possessing weak estrogen receptor affinities, were assessed for their ability to interact with the microsomal antiestrogen binding site. While all the compounds tested did interact with this site their relative affinities were somewhat lower than that of tamoxifen. One of these, viz., the cis isomer of centchroman, has however emerged as a selective ligand for the antiestrogen binding site since its estrogen receptor affinity is nearly 50,000 times lower on a relative scale. PMID- 6508804 TI - Characterization of a common genetic defect of cytochrome P-450 function (debrisoquine-sparteine type polymorphism)--increased Michaelis is Constant (Km) and loss of stereoselectivity of bufuralol 1'-hydroxylation in poor metabolizers. AB - In order to define the mechanism of the debrisoquine-sparteine type genetic polymorphism of drug oxidation we studied the kinetics of bufuralol 1' hydroxylation in liver microsomes from extensive and poor metabolizers and in a purified reconstituted human cytochrome P-450 isozyme with high activity for bufuralol 1'-hydroxylation, P-450[buf]. In extensive metabolizer microsomes the enzymatic reaction displayed apparent Michaelis-Menten kinetics and the (+) isomer was preferentially metabolized. By contrast, the enzymatic reaction in poor metabolizer microsomes was characterized by a 4- to 5-fold increase in Km and by a loss of stereoselectivity. In a non-membraneous reconstituted system containing NADPH cytochrome P-450 reductase, a NADPH regenerating system and phospholipids, P-450[buf] exhibited an almost complete substrate stereoselectivity for (+)-isomer 1'-hydroxylation. It is concluded that the purified cytochrome P-450[buf] is the target of the debrisoquine-sparteine type oxidation polymorphism and that poor metabolizers have a quantitative or qualitative deficiency of this isozyme. PMID- 6508805 TI - Membrane insertion of prothrombin. AB - The nature of the interaction of prothrombin with liposomes was examined by labelling with the apolar reagent 5-[125I] iodonaphthyl-1-azide (INA). When liposomes containing phosphatidylcholine were incubated with prothrombin and INA, the amount of incorporated label was greater in the absence of added calcium. Increasing the phosphatidylserine content of the liposomes, irrespective of CA++ resulted in a significant increase in the labelling of prothrombin by INA. Since INA is confined to the lipid core of the bilayer, these results strongly suggest that prothrombin binds to liposomes, and penetrates into the lipid bilayer. PMID- 6508807 TI - Distribution of protein-bound zinc in serum of analbuminemic rat. AB - The distribution of protein-bound zinc in serum of rat with analbuminemia was analyzed with gel filtration and affinity chromatography. From the profiles of chromatography, the zinc present in analbuminemic rat serum is composed of two principal species in similar to that of Sprague-Dawley rat: one fraction is firmly bound to alpha 2-macroglobulin, and a second fraction is more loosely bound to various proteins. PMID- 6508806 TI - Different susceptibility of alkylacyl--versus diacyl--and alkenylacyl- phosphatidylcholine subclasses to stimulation of biosynthesis by phospholipase C. AB - Krebs II ascites cells were incubated with [3H] or [14C] choline in the presence or in the absence of Clostridium welchii phospholipase C (PLC). At enzyme concentrations where cell lysis remained limited, PLC specifically enhanced phosphatidylcholine (PC) biosynthesis, as shown by comparison with [14C] ethanolamine. Further analysis revealed that the stimulating effect of PLC remained limited to 1,2-diacyl-sn-glycero-3-phosphocholine (diacyl-GPC) and 1 alkenyl-2-acyl-GPC, whereas the biosynthesis of 1-alkyl-2-acyl-GPC, the putative precursor of platelet activating factor (PAF-acether) remained unchanged. These differences reflect different localizations of the three PC subclasses in the plasma membrane and are discussed in relation to the regulation mechanism of PC biosynthesis. PMID- 6508808 TI - Inhibition of carrageenan edema formation by organotin compounds. AB - The effects of a single p.o. dose of 0.3-10 mg/kg of organotin compounds such as dibutyltin dichloride (Bu2SnCl2) and triphenyltin chloride (Ph3SnCl) on the development of edema after subplantar injection of 0.5 mg of carrageenan in 0.05 ml of pyrogen-free saline were examined as compared with those of hydrocortisone. Bu2SnCl2, Ph3SnCl and hydrocortisone did not significantly inhibit the development of the first phase of edema at any dose level, but produced more than 90, 70 and 90% inhibition of the second phase, respectively, at a dose of 10 mg/kg 1 hr before the irritant. Moreover, these inhibitions of the second phase were dose-dependent. PMID- 6508809 TI - Rapid reduction by IAA of malondialdehyde levels in avena coleoptiles, a possible effect on lipid peroxidation. AB - Treatment of Avena coleoptile sections with IAA results in a rapid decrease in the level of lipid peroxidation (LP), as measured by the thiobarbituric acid reaction for malondialdehyde (MDA). The response is specific for active auxins, is nearly saturated by 10(-6) M IAA and occurs even when turgor is reduced by 0.1 M mannitol. About half the reduction in MDA occurs within 1 min after addition of IAA to intact tissues; addition of IAA directly to homogenates, however, has no effect. Homogenates prepared from auxin-pretreated tissues, but not control tissues, continue to produce MDA over at least a six-hour period. This effect of auxin on LP is one of the most rapid biochemical responses to auxin known, and suggests that LP might alter the properties of membranes and thus influence cell enlargement. PMID- 6508810 TI - Thermodynamics of reverse electron transfer across site 1: ATP/2e- is greater than one. AB - ATP-driven, rotenone-sensitive, reverse electron transfer from succinate to acetoacetate was measured in rat liver mitochondria in the presence of cyanide. In the approach to equilibrium, the absolute ratio of the free energy change of electron transfer to that of ATP hydrolysis exceeded 1, tending towards about 1 1/4. The data support an H+/2e- stoichiometry of 5 for Site 1 as predicted by a thirteen-proton model of chemiosmotic coupling. PMID- 6508811 TI - Human leukemia K562 cells: relationship between hemin-mediated erythroid induction, cell proliferation and expression of c-abl and c-myc oncogenes. AB - We have studied the expression of the c-myc and c-abl oncogenes in two human leukemic K562 cell lines which do express hemoglobin genes retaining a differential rate of cell proliferation. Our data indicate that in hemin-induced K562(S) cells the expression of c-abl oncogene decreases and appears to be related to a decrease in the proliferation capacity rather than to the activation of differentiated functions. The K562(hC) cell line, which produces large amounts of Hb Gower 1 retaining an efficient rate of cell proliferation, expresses indeed the c-abl oncogene at high level. PMID- 6508812 TI - Purification of S-2-hydroxyacylglutathione hydrolase (Glyoxalase II) from calf brain. AB - S-2-Hydroxyacylglutathione hydrolase (Glyoxalase II) from calf brain has been purified 8333-times compared to 65,000 g supernatant of brain homogenate. The purification procedure employs Affi-Gel blue and preparative isoelectric focussing and offers a suitable method for the preparation of highly purified enzyme. Calf brain Glyoxalase II is a basic protein with a pl of 7.63 determined by isoelectric focusing. An evaluation of the relative molecular mass by gel filtration gave a value of about 23,000. During the purification procedure a constant Km value of about 0.325 mM was observed. A turnover number of 16,100 min 1 was calculated for the purified enzyme. PMID- 6508813 TI - Methionine-enkephalin precursor in neuroblastoma x glioma hybrid cells: in vivo and in vitro evidence. AB - The peptides obtained by proteolysis of both extracted proteins and in vitro translation products from Neuroblastoma x Glioma hybrids were purified by means of HPLC and then submitted to radioimmunoassay. Met-Enkephalin and Met-Enkephalin sulphoxide immunoreactivity was found. PMID- 6508814 TI - Phosphorylation of membrane proteins in monensin-resistant mutant of Chinese hamster ovary cell with altered insulin-receptor activity. AB - A Chinese hamster ovary (CHO) cell mutant resistant to the Na+/K+ ionophoric antibiotic, monensin, is partly defective in insulin-receptor activity. Growth of the monensin-resistant mutant required higher dose of insulin in defined medium than the parental CHO cell. Membrane proteins of CHO and a monensin-resistant clone, MonR-31, were compared for their capacity to be phosphorylated by endogenous phosphorylation enzyme in vitro in the absence or presence of insulin. Several membrane proteins of CHO were more highly phosphorylated as compared with MonR-31 in either the absence or presence of insulin. PMID- 6508815 TI - Role of metal ions in goat carboxypeptidase A-catalysed hydrolysis of acyl peptides. AB - The carboxypeptidase A purified from goat pancreas has been found to have a molecular weight of 34,600 +/- 300. The enzyme is a zinc-protein and the molar ratio of zinc to enzyme protein is 1:1. Removal of zinc yields an inactive apocarboxypeptidase A. The loss of activity of the native enzyme and restoration of the activity of the apoenzyme run parallel with the zinc content of the protein, thus showing the essentiality of zinc for the enzymatic activity. The exact role of zinc in the enzyme catalysed hydrolysis of the acylpeptides has been investigated after preparing metallo proteins by substituting the zinc of carboxypeptidase A with Co2+, Mn2+, Ni2+, Fe2+, Cd2+, Hg2+, and Cu2+ and determining the kinetic parameters of such metalloproteins. These studies indicate that the metal ion is involved in both binding the substrate and polarising the peptide bond. PMID- 6508816 TI - Alterations in rat lactate dehydrogenase: age-related comparison of M- and H-LDH. AB - Lactate dehydrogenase (LDH: EC 1.1.1.27) of skeletal muscle and heart was purified from young and old female albino rats. Properties of both types, muscle (M-LDH) and heart (H-LDH), were compared by using enzymes purified from skeletal muscle and hearts of young (22-weeks) and old (116-weeks) rats. M-LDH showed differences with respect to properties such as thermal stability and effects of pH, urea, and sodium sulfite. However, H-LDH did not show any significant alterations in enzyme properties. PMID- 6508817 TI - Correlations between phospholipid methylation and neuronal catecholamine transport. AB - A change in the fluidity of biological membranes can be produced by methylation reactions which sequentially transfer methyl groups from phosphatidylethanolamine to phosphatidylcholine. Since the physical properties of membranes may affect the function of membrane-localized transport proteins, the accumulation of norepinephrine (NE) by rat cortical synaptosomes was examined in the presence of S-adenosylhomocysteine (AdoHcy) which inhibits the methylation of phospholipids. A concentration-related decrease in the uptake of [3H]NE was produced by AdoHcy with coincident decreases in the S-adenosylmethionine (AdoMet)-dependent transmethylation of phospholipids in neuronal membranes. A kinetic analysis for the effects of AdoHcy on the neuronal uptake of NE revealed a significant decrease in both the apparent Km and Vmax. Treatment of synaptosomes with adenosine, L-homocysteine thiolactone (HTL), and erythro-9(2-hydroxy-3 nonyl)adenine (EHNA) which leads to the synthesis of intracellular AdoHcy resulted in a decrease in the Vmax with no significant change in the Km. Adenosine or EHNA alone had no effect on NE uptake, but HTL alone significantly inhibited NE uptake. The data suggest that the processes of enzymatic methylation of membrane phospholipids and the transport of norepinephrine may be associated within neuronal membranes. Inhibiting phospholipid methylation reactions can reduce the efficiency of neurotransmitter removal and perhaps indirectly alter synaptic function. PMID- 6508819 TI - Aging and reactivatability of plaice cholinesterase inhibited by soman and its stereoisomers. AB - A simple and rapid method to study aging of soman-inhibited cholinesterases was developed. The method was applied to study the aging characteristics of soman inhibited cholinesterase from the muscles of the plaice (Pleuronectes platessa). The orientation of the soman molecule in the active site is decisive both for the rate of aging and the degree of reactivation of unaged enzyme, a conclusion reached by using soman stereoisomers. Fluoride ions were found to affect reactivatability as well as aging rate. PMID- 6508818 TI - Effects of calcium channel blocking agents on membrane microviscosity and calcium in the liver of the carbon tetrachloride treated rat. AB - Membrane microviscosity was determined from the polarized fluorescence of diphenylhexatriene in plasma membranes and microsomes prepared from the liver of carbon tetrachloride treated rats. It was greatly depressed between 12 and 24 hr after the administration of the carbon tetrachloride. Depression of microviscosity was also seen in the liposomes which were prepared from these membranes. There were decreases in phospholipid content and phospholipid methyltransferase activity, but these changes did not appear to explain the decreased microviscosity. A large accumulation of calcium occurred in the liver cells between 12 and 24 hr after the administration of carbon tetrachloride. Chlorpromazine, verapamil and nifedipine, when administered prior to the carbon tetrachloride, partially reduced the later accumulation of calcium and reduced the degree of histological damage observed. When these agents were administered 12 hr after the administration of carbon tetrachloride, they did not reduce the subsequent accumulation of calcium. When administered prior to and 7 hr after carbon tetrachloride, they had a small but potentially significant effect on the microviscosity change. It is suggested that at low levels of microviscosity a critical threshold may exist below which entry of calcium into the cell is poorly controlled and that calcium channel blocking agents may be ineffective if administered at a time when membrane microviscosity is very low. Tissue calcium accumulation was associated with visible cell damage. PMID- 6508820 TI - Characterization of the benzene monooxygenase system in rabbit bone marrow. AB - The microsomal fraction of bone marrow contains cytochrome P-450 (39 +/- 11 pmoles/mg microsomal protein) and monooxygenase activity could be demonstrated by the O-dealkylation of 7-ethoxycoumarin (114 +/- 65 pmoles/(min X mg microsomal protein] and the hydroxylation of benzene to phenol (51 +/- 8.6 pmol/45 min X mg microsomal protein). This monooxygenase system differs from that in liver in various aspects. The conversion of benzene to phenol calculated as molecular activity was about 4 times higher than in liver and no induction by phenobarbital could be observed. Aroclor 1254 induced the cytochrome P-450 content about twofold but lowered the O-dealkylation activity of 7-ethoxycoumarin in contrast to liver. Pretreatment with benzene did not change the O-dealkylation in bone marrow, but had a stimulating effect on benzene monooxygenation and covalent binding of 14C-benzene metabolites. From these results we conclude that the bone marrow monooxygenase system develops its own pattern of cytochrome P-450 isoenzymes. Especially after chronic exposure to benzene this system can convert this chemical to phenol and secondary metabolites. The similar behaviour of phenol formation and covalent binding strengthens the hypothesis of a common pathway for metabolism and toxicity but the active intermediate still remains unknown. PMID- 6508821 TI - Binding of radiolabeled N-(phosphonacetyl)-L-aspartate to aspartate transcarbamylase from Ehrlich ascites tumor cells. AB - Binding of N-(phosphonacetyl)-[3H]L-aspartate (PALA) to aspartate transcarbamylase (ATCase, EC 2.1.3.1) in crude extracts from Ehrlich ascites tumor cells was examined. At pH 7.4, the dissociation constant was 1.39 +/- 0.22 nM; the maximal binding capacity indicated an average intracellular ATCase concentration of 0.13 microM. The presence of phosphate, MgCl2, or CaCl2 increased the apparent dissociation constant for [3H]PALA without altering the maximal binding capacity. Phosphate, a product of the ATCase reaction, probably acts as a competitor for the PALA binding site; Mg2+ and Ca2+ may inhibit [3H]PALA binding by forming a chelate which reduces the effective concentration of the free [3H]PALA. Carbamyl phosphate was a relatively weak inhibitor of [3H]PALA binding in N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES) buffer alone. Addition of NaF, an inhibitor of nonspecific phosphatases, decreased the carbamyl phosphate "Ki" as an inhibitor of [3H]PALA binding to 7 microM, a value close to the Km. NaF appears to act as an inhibitor of carbamyl phosphatase activity present in the cell extract. A first-order dissociation rate constant of 0.050 +/- 0.004 min-1 (T1/2 = 14 min) was determined by following displacement of [3H]PALA with excess unlabeled PALA. The dissociation rate was strongly temperature dependent. A second-order rate constant of 3.6 X 10(7) liters mol-1 min-1 was calculated from this rate constant and the dissociation constant. Using these kinetic constants, a simple computer model predicted that PALA binding to ATCase is 95% complete within 14 min under the conditions of the assay; at intracellular ATCase concentrations, binding is slightly faster. These results are discussed in the context of both the kinetics of inhibition and the reversal of inhibition of pyrimidine synthesis within the intact cell. PMID- 6508823 TI - Effect of surface curvature on the interaction of single lamellar phospholipid vesicles with aromatic and nonaromatic heptaene antibiotics (vacidin A and amphotericin B). AB - The interactions of unilamellar lipid vesicles with vacidin A, an aromatic heptaene antibiotic, and with amphotericin B, a nonaromatic heptaene antibiotic were compared. Uptake of both antibiotics, monitored by circular dichroism, was found to be faster with small vesicles than with large ones. By combining permeability measurements (Gary-Bobo and Cybulska, J. Antibiotics 35, 1068 (1982)) and circular dichroism spectra, we found that for vacidin A, the same permeability inducing species is formed regardless of vesicles size. However, at a given concentration of antibiotic, less of the permeability inducing species is formed in the presence of small vesicles than in the presence of large vesicles. This may account for the differences between small and large vesicles in antibiotics-induced permeability. For amphotericin B, the permeability inducing species formed in the presence of small vesicles differs from that formed in the presence of large vesicles. PMID- 6508822 TI - Effect of fenofibrate and LF 2151 on hepatic peroxisomes in hamsters. AB - Hamsters were given a diet containing fenofibrate (0.5% or 0.05%) or its metabolite, LF 2151 (0.15% or 0.015%) or a standard diet for a 3-week period. At the end of this period, the analysis of plasma lipids showed that the mean plasma triglyceride concentrations were not significantly different in the five groups of animals. The mean plasma cholesterol concentrations were significantly reduced in animals treated with both drugs but only when given at the high dosage. No consistent changes were noted in the liver weight/body weight ratio and the DNA content of the liver; the number of peroxisomes was increased in the hepatocytes of animals given fenofibrate at the high dosage. Liver homogenates were fractionated and the fractions rich in peroxisomes were used for assays of several enzymes involved in lipid metabolism. Compared with the control animals, activity of cyanide-insensitive fatty acyl-CoA (FA-CoA) oxidizing system was significantly increased by fenofibrate at the high dosage, carnitine acetyltransferase activity was markedly increased by both drugs at the high dosage and catalase activity remained unmodified. As there was a significant inverse correlation between the peroxisomal activity of FA-CoA oxidizing system and the plasma cholesterol concentrations, it is suggested that the increase of peroxisomal beta-oxidation activity can be involved in the hypocholesterolemic action of fenofibrate and LF 2151. This is further substantiated by the finding that fenofibrate and LF 2151 were present in the peroxisomal fraction only in hamsters displaying hypocholesterolemia and high activity of FA-CoA oxidizing system. The presence of fenofibric acid in the plasma of hamsters given LF 2151 suggested that hepatocytes are able to generate the parent drug from this metabolite, underlining that the pharmacokinetics of fenofibrate are rather complex in hamsters. PMID- 6508824 TI - Effects of 7H-pyridocarbazole mono and bifunctional DNA-intercalators on Chinese hamster lung cells in vitro. AB - The effects of two 7H-pyridocarbazole dimers, PyDi1 and PyDi2, on Chinese hamster lung cells in culture in vitro, were compared to those of the corresponding monomers, PyMo1 and PyMo2, by measuring the rates of macromolecule syntheses, the growth kinetics of the drug-treated cells, and the cell cycle progression. The dimers, which are endowed with a very high DNA affinity, were about 10- and 40 fold more cytotoxic than the monomers from which they markedly differ in the following ways: in contrast to monomers, the dimers do not provoke the arrest of cell cycle progression in the G2 + M phase; after a transitory exposure to either one of the dimers, the cell growth arrest was delayed for 6-8 generations. Therefore, the 7H-pyridocarbazole dimers express their cytotoxicity through a mechanism of action different from that of their mono-intercalating counterparts. They might then constitute a new series of antitumour drugs. PMID- 6508825 TI - Stimulation by doxorubicin of adrenochrome formation by bovine heart sarcolemma. PMID- 6508826 TI - A decrease in the capacity of hepatocytes isolated from aged male BN/BiRij rats to metabolize digitoxin. PMID- 6508827 TI - The effect of soman poisoning on phosphorylating capability and adenylate cyclase activity of isolated synaptosomal membranes. PMID- 6508828 TI - Gamma-allenyl GABA, a new inhibitor of 4-amino butyrate amino transferase. Comparison with other inhibitors of this enzyme. PMID- 6508829 TI - Variability in nifedipine pharmacokinetics and dynamics: a new oxidation polymorphism in man. PMID- 6508830 TI - Irreversible binding of etoposide (VP-16-213) to deoxyribonucleic acid and proteins. PMID- 6508831 TI - Renal processing of glutathione conjugates. Role in nephrotoxicity. PMID- 6508832 TI - A kinetic model for the action of the enzyme activated irreversible inhibitor 4 amino-5-hexynoic acid in vivo. AB - The extent of inactivation of three aminotransferases by the enzyme activated inhibitor 4-amino-hex-5-ynoate (acetylenic-GABA) increased with increasing dose in an exponential fashion. Theoretical treatment of the data allowed an estimate of the effective concentration of the drug at its site of action to be made and it was apparent that any rises in substrate concentration produced by the inactivation did not protect the enzyme significantly. Altered diet produced distinct changes in the extent of inactivation of aspartate aminotransferase, but not with ornithine aminotransferase. Cysteine sulphinate, a substrate only of aspartate aminotransferase, also affected the inactivation of ornithine aminotransferase, suggesting that secondary metabolic effects were responsible. PMID- 6508833 TI - A redox cycling mechanism of action for 2,3-dichloro-1,4-naphthoquinone with mitochondrial membranes and the role of sulfhydryl groups. AB - The addition of 2,3-dichloro-1,4-naphthoquinone (CNQ) to substrate-depleted, GSH supplemented rat liver mitochondria resulted in a dose-dependent depletion of reactable suflhydryl groups and a concomitant increase in mitochondrial disulfide content at a ratio of 2 thiols depleted/disulfide generated. The molar ratio of thiol depleted/CNQ added approached 20 at low CNQ concentrations and was unity at higher doses. The addition of CNQ to substrate-depleted mitochondrial suspensions resulted in O2 consumption which increased with increasing concentrations of mitochondria and was sensitive to N-ethylmaleimide (NEM) which establishes the ability of CNQ to interact with mitochondrial thiol redox centers. The CNQ mediated large amplitude swelling of rat liver mitochondria was exacerbated by thiol oxidizing agents and depressed by disulfide reducing agents. A redox cycling mechanism between mitochondrial thiol groups, CNQ and oxygen was proposed to lower the matrix glutathione pool and make the mitochondria more susceptable to toxic oxygen radicals which induce swelling in isolated mitochondrial suspensions. In support of this mechanism, alpha-tocopherol was shown to prevent the CNQ-mediated swelling process. Beef heart mitochondrial NADH was oxidized by CNQ in a 1/1 molar ratio anaerobically and in a 3/1 molar ratio under aerobic conditions, whereas the fully reduced quinone, CNQH2, oxidized NADH aerobically but not anaerobically. Thus, CNQ is capable of interacting with NADH of the mitochondrial electron transport chain in a redox cycling fashion. PMID- 6508834 TI - Interaction of calcium and neomycin with anionic phospholipid-lecithin liposomes. A differential scanning calorimetry study. AB - The interactions of calcium and neomycin with liposomes of various anionic phospholipids plus lecithin were studied by differential scanning calorimetry. Phosphatidylinositol bisphosphate differed from other acidic phospholipids in its interactions with both calcium and neomycin. Calcium, at concentrations as low as 1 mM, induced the appearance of a second transition peak in phosphatidylinositol bisphosphate-enriched liposomes only. Neomycin acted antagonistically and precluded this phase separation. In addition, neomycin lowered the phase transition temperature of phosphatidylinositol bisphosphate-lecithin liposomes while it raised the transition temperature of all other anionic phospholipid lecithin liposomes tested. This fluidizing effect of neomycin and the antagonism to calcium may induce critical alterations of properties of biological membranes. The study supports and extends our previous findings and conclusions that phosphatidylinositol bisphosphate may play a crucial role in the expression of aminoglycoside toxicity. PMID- 6508835 TI - Importance of aliesterase as a detoxification mechanism for soman (Pinacolyl methylphosphonofluoridate) in mice. AB - CBDP (2-/O-cresyl/4H:1:2-benzodioxaphosphorin-2-oxide) pretreatment produced a dramatic increase in the toxicity of soman in mice following the subcutaneous (s.c.) or intraperitoneal (i.p.) route of administration. This increase in soman toxicity was very highly correlated with inhibition of plasma aliesterase activity. Other enzymes (e.g. liver aliesterase and plasma cholinesterase) were inhibited by CBDP pretreatment; however, they did not appear to play a significant role in the potentiation of soman toxicity by CBDP. Liver aliesterase was not inhibited by doses of CBDP which produced significant increases in soman toxicity. Similarly, doses of Iso-OMPA, a selective inhibitor of pseudocholinesterase, which completely inhibited plasma cholinesterase, had no effect on soman toxicity. Pyridostigmine pretreatment which inhibited brain, diaphragm and plasma acetylcholinesterase 27, 57 and 60%, respectively, while not inhibiting plasma aliesterase, did not affect soman toxicity. The results of this study demonstrate that, in mice, plasma aliesterase is an extremely important detoxification route for soman. PMID- 6508836 TI - Inhibition by flavonoids of RNA synthesis in permeable WI-38 cells and of transcription by RNA polymerase II. AB - The effects of various flayonoids on RNA synthesis in permeable human fibroblasts or on transcription with mouse RNA polymerase II were studied. Quercetin or kaempferol inhibited transcription in permeable cells but flavone did so only slightly. In the transcription of naked DNA with purified RNA polymerase II, mutagenic quercetin, kaempferol or fisetin strongly inhibited the reaction but non-mutagenic or weakly mutagenic flavone and chrysin inhibited it only weakly. Quercetin seems to inhibit the transcription by interaction with the enzyme. PMID- 6508837 TI - Estrogen metabolism in rat liver microsomal and isolated hepatocyte preparations- I. Metabolite formation and irreversible binding to cellular macromolecules. AB - The metabolism of endogenous estrogens, estradiol and estrone, and the irreversible binding of estrogens to cellular macromolecules have been examined and compared in subcellular microsomal and in intact hepatocyte preparations. In studies with rat liver microsomal preparations containing estradiol, an NADPH generating system, and denatured DNA, the irreversible binding of radiolabeled steroid metabolite(s) to the microsomal proteins was 3.26 nmoles/mg protein in 1 hr (S.D. 0.39; 7.9% of total steroid) while binding to DNA was found to be 0.288 nmole/mg DNA/mg protein (S.D. 0.025; 0.39% of total steroid). No significant difference was observed between microsomal preparations from untreated, phenobarbital-treated or 3-methylcholanthrene-treated rats. Irreversible binding to proteins was also demonstrated in the intact hepatocyte cell incubations. After 2-hr incubations of estradiol with hepatocytes, 5.9% (S.D. 1.4%) of the steroid(s) was irreversibly associated with cellular proteins (approximately 1.43 pmoles/mg/min). Analysis of the organic-soluble metabolites demonstrated the presence of the catechol estrogens and their metabolites, 2-hydroxyestradiol, 2 hydroxyestrone, 2-methoxyestradiol, and 2-methoxyestrone. Estrone and estriol were also identified. The aqueous-soluble materials isolated from hepatocyte incubations contained glucuronide, sulfate, and apparent thioether conjugates, as determined by liberation from estrogen metabolites by treatment with beta glucuronidase, sulfatase, and Raney nickel. Thus, extensive primary and secondary metabolism of estrogens occurs in intact hepatocyte incubations. Furthermore, irreversible binding of estrogens to cellular proteins occurs in these intact cells having demonstrated conjugative pathways of metabolism. PMID- 6508838 TI - Effects of etomidate on steroid biosynthesis in subcellular fractions of bovine adrenals. AB - The imidazole derivative, etomidate, inhibits the 11 beta-hydroxylase in cell free systems and mitochondria isolated from bovine adrenal cortex. Fifty per cent inhibition is achieved at 3.10(-7) M. The less active hypnotic L-enantiomer is also a less potent inhibitor of the 11-hydroxylation. At a 2 times higher concentration, etomidate affects the cholesterol side chain cleavage. The inhibition of both steroidogenic enzyme systems may be due to binding of the unhindered nitrogen of the imidazole ring of etomidate to the heme iron atom of the adrenal cortex mitochondrial cytochrome P-450 species. PMID- 6508839 TI - Histamine uptake in pig platelets and isolated dense granules. AB - Histamine, a major constituent of the amine-storage organelles in pig platelets, is taken up by intact platelets in only trace amounts under conditions where 70% of 14C-serotonin is accumulated. Thrombin caused the release of 70-90% of endogenous histamine but only 5-10% of the newly absorbed 3H-amine; however, after 18 hr 30% of the 3H-amine could be specifically released by thrombin. Isolated storage organelles accumulated histamine in a reserpine-sensitive, ATP dependent manner but at a rate 80-100-fold less than serotonin uptake. Incubation of intact platelets with 1 mM serotonin until amine uptake was saturated caused no changes in platelet histamine content. Similarly, loading of isolated storage organelles with 1 mM histamine or 1 mM serotonin did not affect the levels of the other amine. These results suggested that the storage of each amine is independent of the other. Histidine decarboxylase was not detected in platelet lysates. Since platelets have a short half-life (1-2 weeks) and pig plasma levels of histamine are higher than in other animals, it is concluded that most of the histamine in the storage organelles is probably accumulated in the platelet precursor, the megakaryocyte, either by slow uptake or by synthesis. PMID- 6508840 TI - Effects of ticlopidine, a new platelet antiaggregating agent, and its analogues on mitochondrial metabolism. Oxidative phosphorylation, protein synthesis and DNA polymerase activity. AB - The effects of ticlopidine and six of its analogues on mitochondrial functions were studied in isolated rat liver mitochondria. The influence of ticlopidine and each of the following analogues: PCR 5325, PCR 4099, PCR 3787, PCR 2362, PCR 4499 and PCR 0665 was evaluated by determining their interaction with three major mitochondrial activities. (A) Oxidative phosphorylation, measured by oxypolarography, was assayed in the presence of glutamate or succinate as source of energy, and both State 4 and State 3 were recorded. Ticlopidine, at 20 micrograms/ml, slightly increased glutamate State 4, whereas it was without effect on that of succinate. At higher concentration (40 micrograms/ml), ticlopidine caused 40-45% inhibition of State 4 with both substrates. All the other analogues tested at either 20 or 40 micrograms/ml were virtually without effect on the respiration. However, at 20 micrograms/ml, ticlopidine and some of its analogues inhibited mitochondrial State 3, while under similar conditions other analogues had little or no effect on this state. (B) Mitochondrial protein synthesis, measured by [14C]-L-leucine incorporation, was not affected significantly by any of these drugs. Whereas chloramphenicol at 10 micrograms/ml caused 80% inhibition, ticlopidine and its analogues in concentrations inhibitory to State 3 did not inhibit mitochondrial protein synthesis. (C) Mitochondrial DNA polymerase activity, determined by [3H] thymidine 5'-triphosphate incorporation, was not inhibited by these drugs. We conclude that, while ticlopidine and analogues have little or no effect on either mitochondrial protein synthesis or mitochondrial DNA polymerase activity, ticlopidine and some of its analogues are inhibitory of the energy conserving mechanism in mitochondria. PMID- 6508841 TI - Relationship between the antiviral effects of interferons and their abilities to depress cytochrome P-450. AB - Several hybrid human interferons have now been constructed by recombinant DNA techniques. Two of these hybrid interferons, IFN-alpha AD(Bgl) and IFN-alpha AD(Pvu) differ by only three amino acids, but IFN-alpha AD(Bgl) was fifteen times more potent than IFN-alpha AD(Pvu) in antiviral activity towards infection of mouse L-929 cells by vesicular stomatitis virus. Only the hybrid with the greater antiviral activity in the mouse depressed cytochrome P-450, aminopyrine N demethylase and benzo[a]pyrene hydroxylase in the liver. These experiments demonstrate that minor changes in amino acid structure not only have a major effect on the antiviral properties of interferon but also influence the ability of interferon to depress cytochrome P-450 in the liver. PMID- 6508842 TI - Altered in vitro uptake of norepinephrine by cardiovascular tissues of young spontaneously hypertensive rats. PMID- 6508843 TI - Binding of phospholipase A2 to isolated heart muscle. PMID- 6508845 TI - Purification of endogenous modulators of monoamine oxidase from plasma. AB - A partial purification of endogenous modulators of monoamine oxidase-A (MAO-A) and MAO-B from human plasma has been achieved through Sephadex, ion-exchange and affinity chromatography. The MAO-A modulator had a molecular weight of about 4,000, was acidic or neutral, and did not contain the carbohydrate moiety mannose. It was thermostable but sensitive to trypsin treatment. It inhibited MAO A activity in a sonically disrupted mitochondrial preparation prepared from bovine striatum in a dose-dependent manner and altered the kinetic parameters of MAO-A by increasing the Km and decreasing the Vmax. The concentration of the MAO A modulator was higher than that of the MAO-B modulators, which had molecular weights of about 7,000, 14,000 and greater than 30,000 respectively. The MAO-B modulators increased the Km for tryptamine without changing the Vmax. These data indicate that human plasma contains peptides that may function as endogenous regulations of platelet MAO. The significance of this finding in relation to psychiatric disorders is discussed. PMID- 6508844 TI - The effect of cicletanide, a diuretic, on the platelet vessel wall interaction; its involvement in the arachidonic acid cascade. PMID- 6508846 TI - Ascorbic acid and alcohol oxidation. AB - Methanol and ethanol were rapidly metabolized to formaldehyde and acetaldehyde in the presence of ascorbate, 1,10-phenanthroline and either guinea pig hepatic 100,000 g supernatant or 12,000 g pellet fractions. The specific activity of methanol oxidation was 1720 nmoles formaldehyde formed/min/mg protein in the 100,000 g fraction and 790 in the 12,000 g pellet fraction. The specific activity of ethanol oxidation was 1590 nmoles acetaldehyde formed/min/mg protein in the 100,000 g fraction and 820 in the 12,000 g pellet fraction. The activity was enzymatic in that it was linear with time, proportional to protein concentration, and sensitive to temperature. Catalase appeared to be the enzymatic component responsible for the oxidation. In this ascorbate-dependent alcohol oxidation system, oxygen was consumed and H2O2 was formed. When purified catalase and ascorbate were used, complex I was detected and methanol was oxidized. PMID- 6508847 TI - Hepatic uptake and biliary excretion of organic cations--I. Characterization of three new model compounds. AB - Three quaternary ammonium compounds (QACs) with different lipophilicity, triethylmethyl ammonium iodide (TEMA), tripropylmethyl ammonium iodide (TPMA) and tri-n-butylmethyl ammonium iodide (TBuMA) were given as a bolus injection of 10 mumole and 1 mumole in an isolated perfused liver. TPMA and TBuMA exhibited saturation kinetics at a dose of 10 mumole, but not when 1 mumole of the agents was given. Biliary clearance of TEMA was equal to the bile flow (0.010 ml/min), whereas for TPMA and TBuMA much higher values of 0.8 ml/min and 2.2 ml/min were found respectively. Partition coefficients of TEMA, TPMA and TBuMA between n octanol and Krebsbicarbonate solution were 0.0013, 0.013 and 0.14 respectively. Liver-to-plasma concentration ratios were 4, 16 and 30 in the post-distribution phase, whereas bile-to-liver ratios were calculated to be 0.1, 1.3 and 14 respectively. The latter parameter varied roughly proportionally to the lipophilicity of the compounds. The liver/plasma concentration ratios corrected for intracellular binding exceeded a value of 12 indicating that accumulation in the liver of these agents cannot soley be explained by passive equilibration according to the membrane potential. Transport from liver into the bile of TPMA and TBuMA presumably also occurred against an electrochemical gradient. It was inferred that the small molecular weight compounds such as TEMA, can be transported from plasma into bile paracellularly by a passive process. Rapid uptake into the liver of such compounds may not lead to an appreciable biliary output and can even reduce the rate of biliary excretion. QACs with intermediate or high lipophilicity are transported by carrier mediated processes both at the level of hepatocyte uptake and bile canalicular transport. The influence of choleresis on hepato-biliary transport of the three QACs was investigated by giving sodium taurocholate (Tc) by constant infusion of 60 mumole/hr, increasing bile flow from 9 to 16 microliter/min. The biliary output of TEMA appeared to be basically unaffected, whereas the biliary excretion of TPMA and TBuMA was clearly elevated when the bile flow was increased. The stimulatory influence of taurocholate on the biliary output of the latter organic cations is explained by an increased net uptake of these agents into the liver and an increased net canalicular transport. This effect is proposed to be due to a reduced reabsorption from the biliary tree as a consequence of the higher bile flow and/or biliary micelle binding. Taurocholate increased liver-to-plasma ratios.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6508848 TI - Hepatic uptake and biliary excretion of organic cations--II. The influence of ion pair formation. AB - The influence of an anorganic anion iodide (I-) and an organic anion tetraphenylborate (TPB-) on the hepatic uptake and biliary excretion of three organic cations, triethylmethyl ammonium (TEMA), tripropylmethyl ammonium (TPMA) and tri-n-butylmethyl ammonium (TBuMA) was studied. The compounds were injected as a bolus (D = 1 mumole) and studied in isolated perfused livers. In the perfusion medium 25% of the amount of NaCl (3 mmole) was replaced by NaI, whereas in two other experiments TPB- was added to the medium in two concentrations (2 microM and 200 microM). NaI did not affect the biliary output of the three quaternary ammonium compounds (QACs) although an increased net rate of hepatic uptake was found for all compounds, most likely due to a decreased liver to plasma transport. Liver to plasma concentration ratios were increased, while the ratios between bile to liver and bile to plasma were not affected. TPB- in catalytic amounts added to the medium (2 microM) decreased the biliary output of TEMA and TBuMA, whereas the kinetic profile of TPMA was unchanged. The decreased biliary excretion rate of TEMA was explained by a decreased plasma level (due to the increased liver uptake) assuming that the small molecular weight compounds can enter the bile directly from plasma via the junctional complexes between the cells. The bile to plasma (B/P) ratio was not affected. In contrast, the bile to plasma (B/P) ratio and the bile to liver (B/L) ratio of TBuMA were decreased, compared with the control, probably due to an increased reabsorption from the bile, whereas the back transport from the liver into the plasma was also decreased. A large amount of TPB- (200 microM), added to the perfusion medium, dramatically changed the kinetic profile of the three QACs. Ion pair formation between the QACs and TPB- was supposed to be responsible for this effect. Plasma levels dropped more rapidly as a result of an increased rate of liver uptake. The biliary excretion of all compounds was greatly reduced (the excretion rates were 0.022, 0.19 and 0.18 nmole/min, compared with 0.047, 0.71 and 7.5 nmole/min for the controls). It is concluded that ion pair formation may play a role in the hepatobiliary transport. The rate of liver uptake of the QACs is enhanced in the presence of an anion, which is due to an increase in plasma to liver transport (k12) and a reduced liver to plasma transport (k21).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6508850 TI - Characterization of cholate-solubilized dopamine receptors from human, dog and rat brain. AB - [3H]Spiperone binding sites were solubilized in high yield from human, dog and rat brain with a mixture of sodium cholate (0.3% w/v) and sodium chloride (1.4 M). The binding sites were not sedimented after one hour at 100,000 g, they passed freely through 0.20 micron filters, migrated as a single peak in gradient sedimentation and were retarded upon gel filtration, proving that they were truly solubilized. The solubilized binding sites were definitely of dopaminergic nature. They showed saturable, reversible, high affinity binding of [3H]spiperone; displacement of [3H]spiperone binding by nanomolar concentrations of dopamine antagonists and micromolar concentrations of serotonin antagonists; stereo-specificity and a good correlation with drug affinities for membrane preparations. The non-displaceable, non-specific [3H]spiperone binding was very low. Gradient sedimentation analysis revealed a sedimentation coefficient of 12 S for dog solubilized preparations, 9 S for rat solubilized preparations and only 2.5 S for human solubilized preparations (values, uncorrected for detergent binding). Gel filtration experiments seem to confirm these molecular characteristics. Therefore the present results show that the dopamine receptor reveals the same pharmacological properties when solubilized with cholate-salt from rat, dog or human brain, while physico-chemical properties seem to indicate some differences. PMID- 6508849 TI - Metabolism in vitro of tris(2,3-dibromopropyl)-phosphate: oxidative debromination and bis(2,3-dibromopropyl)phosphate formation as correlates of mutagenicity and covalent protein binding. AB - Tris(2,3-dibromopropyl)phosphate (Tris-BP) was found to be metabolized by liver microsomes obtained from untreated and phenobarbital-pretreated rats. Metabolites of Tris-BP, whose formation was dependent on NADPH and oxygen, included bromide ion and bis(2,3-dibromopropyl)phosphate (Bis-BP). The rates of formation of these metabolites were markedly increased in liver microsomes isolated from phenobarbital-pretreated rats compared to microsomes from untreated rats. In the presence of either SKF 525-A or metyrapone, the formation rates of bromide ion and Bis-BP were decreased, whereas alpha-naphthoflavone had no effect. The effects of the various treatments on bromide release and Bis-BP formation paralleled those that have been previously observed with respect to the activation of Tris-BP to mutagenic and covalently protein bound metabolites. Furthermore, rates of oxidative debromination of several Tris-BP analogs directly correlated with their respective mutagenicities. Addition of glutathione (GSH) to microsomal incubations of Tris-BP increased bromide release substantially over control, values but had no effect on Bis-BP formation. On the other hand, the addition of GSH to microsomes decreased covalent binding and mutagenicity of Tris BP with increased formation of water soluble metabolites. GC/MS analysis of ethyl acetate extracts from incubations of rat liver microsomes with Tris-BP identified 2-bromoacrolein (2-BA) as a metabolite. Introducing deuterium at the carbon atom number 1 of the propyl moiety of Tris-BP had no effect on either bromide release or mutagenicity, whereas the analog labelled at carbon atom 3 showed significant isotope effects on both activities. In contrast, deuterium substitution at carbon atom 2 gave a significant isotope effect on bromide release, but not on mutagenicity. The data indicate that Tris-BP can be metabolized by rat liver microsomes to Bis-BP and 2-bromoacrolein catalyzed by cytochrome P-450 in a process liberating bromide ions. Further, the results are consistent with oxidation at the terminal carbon atom of Tris-BP thereby forming 2-bromoacrolein, which is postulated to be the metabolite mainly responsible for Tris-BP mutagenicity. PMID- 6508851 TI - Regiospecific and diastereoselective inactivation of mutagenic 9,10 dihydrobenzo[a]-pyrene 7,8-oxide by hepatic cytosolic glutathione S-transferase. AB - Racemic, (7R,8S)-(+)-, and (7S,8R)-(-)-9,10-dihydrobenzo[a]pyrene 7,8-oxides (DBPOs) showed markedly different mutagenicity towards Salmonella typhimurium TA 98 in the order of (7R,8S)-(+)- greater than racemic greater than (7S,8R)-(-) DBPOs. The enantiomeric epoxides were inactivated at significantly different rates by preincubating with rat liver cytosol fortified with glutathione (GSH) in the order of (7S,8R)-(-)- greater than racemic greater than (7R,8S)-(+)-DBPOs. Two non-mutagenic water-soluble metabolites were isolated from the preincubation mixture containing racemic DBPO as a substrate, separated by hplc, and identified by 13C nmr and uv absorption spectroscopy as diastereoisomers of S-(8-hydroxy 7,8,9,10-tetrahydrobenzo[a]pyren-7-yl)glutathione (conjugates I and II). Conjugates I and II were specifically yielded from (7R,8S)-(+)- and (7S,8R)-(-) DBPOs, respectively, at different rates by rat liver cytosol; apparent values of Km were 20.1 and 15.6 microM and of Vmax 17.2 and 26.7 nmole/mg protein/min for (7R,8S)-(+)- and (7S,8R)-(-)-DBPOs, respectively. Conjugates I and II, therefore, were reasonably assigned to have (7S,8S)- and (7R,8R)-configurations, respectively. Conjugate II was yielded preferentially to conjugate I from racemic DBPO at an early stage of the enzyme reaction. PMID- 6508852 TI - Inactivation of [125I]-angiotensin II binding sites in rat renal cortex epithelial membranes by dithiothreitol. AB - Preincubation of renal epithelial membranes with DTT produced a dose-dependent inhibition of specific [125I]-angiotensin binding, with an IC50 of 1 mM and total loss of binding at 5-10 mM DTT. Inactivation of specific [125I]-angiotensin II binding by DTT was temperature sensitive; the t1/2 at 22 degrees was 6 min compared with 30 min at 4 degrees. A rapid inactivation rate was dependent on the presence of NaCl. In the presence of 120 mM NaCl the t1/2 for inactivation by DTT was 6 min and 33 min in the absence of NaCl. Protection against DTT inactivation was obtained by preincubating membranes with unlabelled angiotensin II greater than angiotensin I greater than renin substrate while the dipeptide, Ileu-His was only effective in protecting the binding site at high concentrations (10 mM). Preincubations with DTT (1 mM) caused a 43% decrease in Bmax from 217.0 +/- 39.5 to 123.7 +/- 30.9 fmol bound/mg protein while the KD was not significantly affected. PMID- 6508853 TI - Inhibition of calcium uptake and catecholamine release by 8-(N,N-diethylamino) octyl-3,4,5-trimethoxybenzoate hydrochloride (TMB-8) in cultured bovine adrenal chromaffin cells. AB - Effects of intracellular calcium antagonists, 8-(N,N-diethylamino)-octyl-3,4,5 trimethoxybenzoate hydrochloride (TMB-8) and 1-(5-(p-nitrophenyl)-furfurylidene amino) hydantoin sodium hydrate (dantrolene sodium), on catecholamine release and 45Ca2+ uptake were studied using cultured bovine adrenal chromaffin cells. TMB-8 inhibited carbamylcholine-evoked catecholamine release and 45Ca2+ uptake in a concentration-dependent manner with a similar potency. On the contrary, dantrolene sodium did not show obvious inhibitory effects of catecholamine release and 45Ca2+ uptake. Although TMB-8 inhibited the high K+-evoked catecholamine release and 45Ca2+ uptake, the potency of the drug was approximately 100-fold less than when used to inhibit the carbamylcholine-evoked catecholamine release and 45Ca2+ uptake. The inhibitory effect of TMB-8 on the carbamylcholine-evoked catecholamine release was not overcome by an increase in an extracellular calcium concentration, and was not due to competitive antagonism at the nicotinic receptor site. Moreover, TMB-8 inhibited the carbamylcholine stimulated 45Ca2+ efflux, but dantrolene sodium failed to affect it. These results suggest that TMB-8, a well-known intracellular calcium antagonist, prevents the cellular calcium uptake in cultured adrenal chromaffin cells, and thus prevents catecholamine release. PMID- 6508854 TI - Displacement of [3H]phencyclidine binding to Torpedo electric organ membrane by calcium channel antagonists. PMID- 6508855 TI - Effects of erythromycin derivatives on cultured rat hepatocytes. PMID- 6508856 TI - [Toxic components of the venom of the Central Asian scorpion, Orthochirus scrobiculosus]. AB - Four polypeptide neurotoxins, possessing paralytic activity for mice, were isolated from the venom of the Central Asian black scorpion Orthochirus scrobiculosus. All these toxins, Os-1 - Os-4, were shown to be homogeneous by disc-electrophoresis and N-terminal group analyses. The amino acid composition of the toxins was determined, methionine residues being found in toxin Os-1. The neurotoxin Os-3 was subjected to tryptic and chymotryptic hydrolyses and its total amino acid sequence was established. It was shown that neurotoxin Os-3 consists of 67 amino acid residues with four intramolecular disulfide bonds. PMID- 6508857 TI - [Chromatographic-mass spectrometric analysis of sialic acids of disialosyllactosylceramides from the calf thymus]. AB - Gas-liquid chromatography/mass spectrometry of the compounds obtained on methanolysis and deuterioacetylation of the permethylated gangliosides has demonstrated that disialosyllactosyl ceramides of calf thymus contain three components - NeuAc alpha 2----8NeuAc alpha 2----LacCer, NeuAc alpha 2----8NeuGc alpha 2----LacCer and NeuGc alpha 2----8NeuGc alpha 2----LacCer. PMID- 6508858 TI - [Localization of tetranitromethane-modified tyrosine residues in domains of cholesterol-hydroxylating cytochrome P-450]. AB - As a continuation of earlier structure-function studies on cholesterol hydroxylating cytochrome P-450 from the adrenal cortex mitochondria, the present study is concerned with the distribution of tetranitromethane-modified tyrosine residues in the hemo-protein domains. With the aid of thiol-disulfide exchange chromatography and SDS polyacrylamide gel electrophoresis the F1 and F2 fragments of the modified cytochrome P-450 were isolated. Nitrated tyrosine residues were found in the F1 fragment, a heme-containing catalytic domain of the molecule. PMID- 6508859 TI - [Identification of a glutamate dehydrogenase amino acid residue modified by 2,2,6,6-tetramethyl-4-oxopiperidine-1-oxyl. Study of the type of inactivation of a catalytically active enzyme oligomer in modification]. AB - It has been shown that 2,2,6,6-tetramethyl-4-oxo-piperidine-1-oxyl selectively blocks epsilon-amino group of Lys126 residue in bovine liver glutamate dehydrogenase (L-glutamate NAD(P) oxydoreductase, EC 1.4.1.3). Modification of this residue in one of the six promoters of catalytically active hexamer is accompanied by the loss of about half of the enzymatic activity. The enzyme inactivation caused by modification has a cooperative character. PMID- 6508860 TI - Fractures after rheumatoid arthritis. A population-based study. AB - In a population-based study, the incidence of osteoporotic fractures in patients who have been diagnosed as having rheumatoid arthritis was investigated. This incidence was found to be increased, though not dramatically so: the relative risk for hip fracture, for example, was 1.5. Univariate analyses generally indicated increased risk associated with increasing age, earlier age at diagnosis of rheumatoid arthritis, disability, impaired ambulation, steroid use, and thinness, and decreased risk associated with obesity and estrogen use. In multivariate analyses, only aging, impaired ambulation, and thinness were identified as independent risk factors. PMID- 6508861 TI - D-penicillamine in patients with rheumatoid arthritis. Serum levels, pharmacokinetic aspects, and correlation with clinical course and side effects. AB - After administration of D-penicillamine to patients with rheumatoid arthritis, measurements of serum level and urinary excretion showed half-life times of 1.6 hours in the rapid phase and 4-6 days in the slow phase. The latter evidence suggests that tissue pooling occurs. With a dosage of 750 mg/day, basic serum levels of 100 microM are gradually reached. Serum D-penicillamine levels were shown to be the same for patients who responded well to treatment, those who did not respond, and for patients who had adverse side effects as well as those who had none. Intestinal resorption decreased when D-penicillamine was taken close to meals and was greatly reduced by iron preparations. PMID- 6508862 TI - Increased von Willebrand factor antigen in the plasma of patients with vasculitis. AB - The plasma concentrations of von Willebrand factor antigen (vWF:Ag) were determined in 101 patients who had the following diagnoses: vasculitis 8 patients, systemic lupus erythematosus (SLE) 51, rheumatoid arthritis (RA) 28, asthma 7, hereditary angioedema 7. The greatest mean concentration of vWF:Ag, 469% (normal 100% +/- 50), was observed in patients with vasculitis, often without elevation of the erythrocyte sedimentation rate. The mean concentration of vWF:Ag was also increased in both SLE (277%) and RA (194%). Twenty-four patients (15 with SLE, 6 with vasculitis, 3 with RA) had vWF:Ag concentrations greater than 300%. Four of these patients died within 1 year of the date of the study. Of the 15 SLE patients, 9 had vasculitis and 2 had active glomerulonephritis. The 3 RA patients had severe disease associated with extraarticular manifestations. Elevated vWF:Ag may reflect vascular damage, while markedly elevated levels of vWF:Ag appear to indicate a poor prognosis. PMID- 6508863 TI - Time course of response to nonsteroidal antiinflammatory drugs in juvenile rheumatoid arthritis. PMID- 6508864 TI - Polymyalgia rheumatica and rheumatoid arthritis: similarity of HLA antigen frequencies. PMID- 6508865 TI - Comment on Braunstein article. Computed tomography and conventional radiographs. PMID- 6508867 TI - Compliance with ASHA-PSB audiometer electroacoustic calibration standards. PMID- 6508866 TI - Connective tissue disease after augmentation mammoplasty. PMID- 6508868 TI - The SESL model. PMID- 6508869 TI - Pulmonary calcification in long-term hemodialysis: a mimic of pulmonary thromboembolism. AB - Metastatic pulmonary calcification is a frequent complication of chronic renal failure, especially in patients undergoing maintenance hemodialysis. We report a patient with chronic renal failure, who developed chest pain and hypoxia suggestive of pulmonary thromboembolism (PTE) and subsequently died. The ventilation/perfusion (V/Q) scan was also interpreted as consistent with PTE. At autopsy the areas of reduced perfusion on the scan corresponded to the areas of pulmonary calcification with no evidence of PTE. Physicians should be aware that this condition may mimic PTE, and that pulmonary angiography may be necessary to confirm the diagnosis prior to the initiation of anticoagulation. PMID- 6508870 TI - Metabolic acidosis in a young woman. PMID- 6508871 TI - Hemoglobin Hamadan or alpha 2 beta 256(D7)Gly----Arg in a Turkish family. PMID- 6508872 TI - [Capacity of hematopoietic colony-forming cells to maintain their own population in the late periods after prolonged radiation exposure]. AB - The content of multipotent CFUs in bone marrow and their self-maintenance capacity were studied for 15 months following protracted external radiation of CBA mice at the total dose 10 Gy (0.5 Gy per day). The mean life shortening was 16% in the irradiated mice. The proliferating, maturating and functional pools returned to normal within 1-3 months after exposure. The stem cell pool did not return to the values seen in the same age controls till the end of the life of experimental animals and averaged 55% of normal. The self-maintenance capacity of bone marrow CFUs was 2.5-4.5-fold as decreased in the irradiated mice. The failure of this unique property of multipotent CFUs was principally due to the foregoing increase in their proliferative activity. PMID- 6508873 TI - Alcohol and essential hypertension. PMID- 6508874 TI - Disunity amongst the few. PMID- 6508875 TI - Reduced Fc-receptor function in human monocytes exposed to ethanol in vitro. AB - Mononuclear phagocytes from healthy human donors were incubated with or without ethanol (12-55 mM, initial concentration) in non-sealed wells in an atmosphere of 5% CO2 in air for 6 or 24 hr on day 1 or day 7 in culture. The actual ethanol concentration was assayed in the media at the beginning and at the end of each incubation period. The ethanol content was reduced to about 70% of the initial concentration after 6 hr incubation, and to below 20% after 24 hr incubation. Binding properties of the Fc-receptors, and their associated phagocytic activity, were tested after ethanol exposure of the cells. An initial concentration of 12 or 22 mM ethanol caused no differences from controls at any time in culture. Mononuclear phagocytes assayed on day 1 (= monocytes) showed reduced binding (60% of control) as well as internationalization (70% of control) of particles via the Fc-receptors after addition of 55 mM ethanol and incubation for 6 or 24 hr. Incubation in corresponding ethanol concentration for 6 hr had no effect on cells cultured for 7 days (= macrophages), whereas 24 hr incubation depressed the Fc receptor function in these cells also. There were no changes in viability, morphology or spreading ability after ethanol treatment. PMID- 6508876 TI - Is there a genetic component to the pathogenesis of the Wernicke-Korsakoff syndrome? PMID- 6508877 TI - Assessment of cognitive function in alcoholics by computer: a control study. AB - Results are presented of the performance by 103 alcoholics and 90 controls on six computer-administered tests of cognitive function. The main analysis compared performance of the two groups when pre-existing differences in intellectual capacity, as estimated by NART, were accounted for statistically. The performance of the alcoholics was worse, at a statistically significant level, on 18 of 23 measures. Procedurally, the tests were found to offer practical advantages over conventional procedures. PMID- 6508879 TI - A study of alcoholism treatment units--I. Treatment activities and the institutional response. AB - Alcoholism treatment units (ATUs) appear as the major institutional treatment system for alcoholics within the National Health Service. This paper is the first of a series of papers to report the results of a national survey on ATUs. It examines the varied treatment activities which are carried out in the institutional setting. Although the policies of many ATUs are based on a combination of group theory and eclecticism, there is a diversity of proceedings and treatment objectives. Future treatment provisions and their evaluation should consider the full range of influences that derive from patient characteristics and from institutional settings. PMID- 6508878 TI - Hormonal changes in noncirrhotic male alcoholics during ethanol withdrawal. AB - Serum concentrations of iodothyronines, cortisol, prolactin, testosterone and the respective tropic hormones were measured in 32 noncirrhotic male alcoholics, aged 28-51 years, at the end of a long drinking period and subsequently during ethanol withdrawal over 1-2 weeks. Seven men had testicular atrophy. On admission one patient had high values for serum thyroxine (T4) and free thyroxine index (FT4I). A blunted response of serum thyrotropin (TSH) to thyrotropin-releasing hormone (TRH) was found in 9 men. Apart from a blunted TSH-response in one man the abnormalities disappeared during the first week of alcohol abstinence. Simultaneously the mean levels of serum T4, FT4I, triiodothyronine, free triiodothyronine index and reverse triiodothyronine were reduced by 12, 14, 5, 8 and 21%, respectively, and the mean of the maximum TSH-response to TRH was increased by 55%. At the time of stopping drinking two men had high morning values and six an abnormal diurnal rhythm of serum cortisol. High serum ACTH levels associated with normal serum cortisol concentrations were found in 12 men. During the first week of alcohol abstinence the mean morning values for serum cortisol and ACTH were reduced by 18 and 42%, respectively. The serum ACTH-levels remained high in 6 men but the abnormalities in cortisol secretion disappeared. On admission four men had low serum concentrations of testosterone which were normalized during ethanol withdrawal over one week. At the same time the mean level of serum testosterone was increased by 19%. Mild hyperprolactinaemia found in 7 patients on admission disappeared in 4 men during the first week of ethanol withdrawal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508880 TI - Alcoholic doctors. AB - Doctors are more vulnerable than the average citizen to alcohol dependence. Causal factors may include social conditioning, the patterns of drinking in medical schools and in early professional life, the responsible nature of the work and the associated emotional control. Statutory controls are an unfortunate necessity but informal schemes to provide help may have a valuable therapeutic and preventive function. For the future the hope may lie in promoting more intensive education concerning alcohol issues at all stages of medical education. The Medical Council on Alcoholism has an important part to play in this connection. PMID- 6508881 TI - The perivascular spaces of the central nervous system. Histophysiological data. PMID- 6508882 TI - [Pathology of perivascular spaces in the central nervous system]. AB - The perivascular spaces of the central nervous system are involved in various pathological situations. The aim of this paper is to focus on the histopathological lesions of the perivascular spaces which commonly occur in the infectious (bacterial, viral, parasitic), tumoral (carcinoma, lymphoma, leukemia), demyelinating (multiple sclerosis, allergic encephalomyelitis) and vascular diseases of the brain. According to their apparent function in each of these situations an attempt was made to classify the main physiopathological processes involving the perivascular spaces into 3 distinct groups. The perivascular spaces may be considered as follows: (1) double way route between the parenchyma and the leptomeningeal space (extension to the brain of a meningeal pathological process, drainage of parenchymal wastes); (2) elective location of the inflammatory reaction partly as a result of the presence of connective tissue; (3) site of particular lesions such as dilatation, the pathogenesis of which remains unclear. PMID- 6508883 TI - [Evaluation of the differences of opinion in the histopathologic diagnosis of soft tissue tumors]. AB - Evaluation of observers variation in the histopathologic diagnosis of soft tissue tumors. 260 cases of soft tissue tumors referred to the CTRC (Canadian Tumour Reference Center) for diagnostic opinion were reviewed. These tumors were collected from 98 different hospitals within the 10 canadian provinces and had been submitted to a specialized panel of pathologists having a particular interest in this field. 22 tumors of nonmesenchymal origin have been discarded. The main problem posed by the contributors related to the histologic typing of overtly malignant and sarcomatous tumors (122/238). Comparing the diagnoses proposed by contributors and the panel, a consensus in term of benign and malignant tumor was reached in 89% of the cases. Within this panel, there was consensus in 84% of the cases. However, regarding the histologic typing, a consensus was reached between contributors and the panel in only 65% of the studied cases. Within the panel, there was a majority diagnosis in merely 62% of them. A mean of three different diagnoses were proposed for each case. A review of the literature shows that histologic typing of soft tissue tumors is of only limited prognostic significance. On the other hand, the clinical staging comprising histologic grade, size, depth, local growth and metastases is essential to establish prognosis and treatment. However, since certain tumors respond differently to treatment, a precise histopathologic diagnosis using immunohistochemistry and electron microscopy is mandatory. PMID- 6508884 TI - [Primary malignant cutaneous lymphomas excluding mycosis fungoides. Anatomoclinical study of 16 cases]. AB - Cutaneous primary lymphomas excluding mycosis fungoides and Sezary Syndrome represent a rare condition. Few papers are published on the subject. The authors report a retrospective study of 16 cases concerning only these primary lymphomas. It comprises 10 adults and 6 children. In 13 cases the cutaneous tumor was solitary without extra-cutaneous lesion, in 3 cases there was a satellite simultaneous lymph node. The most frequent location was head and neck region (7 cases with 4 cases from children); limbs were concerned too (5 cases/16); more rarely trunk. Our cases were classified with reference to lennert's classification. We found that large cells lymphomas were predominant: centroblastic (4 cases), lymphoblastic (4 cases), immunoblastic lymphomas (6 cases). The clinical course was unfavourable in 50% of our cases in less than 3 years: 6 lethal cases, and 2 metastatic disseminations. These 8 cases belonged to the pejorative group of lymphomas (large cells type). The 2 cases with small cells population (centrocyto-centroblastic and lymphoplasmocytoid type) were free of disease for 5 and 2 years after diagnosis. Thus, our experience suggests that there is a relations hip between the histologic type of cutaneous lymphoma and the course of the disease. In disseminated cases, the extra-cutaneous extension was located in lymph nodes, bone marrow, as it was mentioned in literature. PMID- 6508885 TI - [Frontiers of the histopathologic diagnosis of pigmentary nevus/malignant melanoma in children. Apropos of 5 cases]. AB - The authors report 5 observations of melanocytic nevus (MN) in children, representing a stereotyped "entity" both clinically and histologically. They are characterized by their dark colour and their rapid extension, resembling a beginning malignant melanoma "in situ" Histologically, these MN present a particular "aggressiveness" for the whole epidermis, with large nests of fusiform, regular and pigmented cells. These observations are discussed in regard to the juvenile malignant melanoma, the dysplastic nevus syndrome, the pigmented spindle-cell nevus, the Spitz nevus and overall the "solitary active junctional nevus" of the child. PMID- 6508886 TI - [Ultrastructural aspects of a cutaneous biopsy in acquired immune deficiency syndrome (AIDS)]. AB - Herpes zoster blister was biopsied in an homosexual man presenting and AIDS. Ultrastructural findings were as follows: typical herpes virus particles, tubuloreticular inclusions (TRI), helical polyribosomes. The association of these three findings suggests that TRI may represent rather a particular way of cellular reaction than an etiologic ultrastructural marker in AIDS. PMID- 6508887 TI - [Presence of filamentary secretory granules in the mucous cells of human bronchial glands]. AB - Secretory granules containing 6-8 nm fine filaments are described in mucous cells of human bronchial glands. In contrast with the strongly marked classical mucous granules, filamentary granules exhibit weak positivity with Thiery's method providing an easy characterization. Exocytosis in glandular lumen are often observed. These undescribed filaments may probably represent an usual component of fibrillar matrix in bronchial mucus. PMID- 6508888 TI - [A new case of Urbach-Wiethe disease. Electron-microscopy study]. AB - A new case of Urbach Wiethe disease is reported. The diagnosis of this disorder, despite the existence of typical histological connective tissue deposits, was recognized late. The authors review the morphological characteristics of the disease, emphasizing that atypical clinical presentations may occur which underline the importance of the histological examination. PMID- 6508889 TI - [Congenital hypothyroidism. A problem of opportune diagnosis]. PMID- 6508890 TI - [Serum thyroxine and thyrotropin in the healthy newborn infant]. PMID- 6508891 TI - [Hemolysis in children with heart valve prostheses]. PMID- 6508892 TI - [Effect of nutritional education on food consumption in a group of children with insulin-dependent diabetes mellitus]. PMID- 6508893 TI - [The problem of causality in the analysis of perinatal mortality]. PMID- 6508894 TI - [Preliminary study in Mexico on the use of the transcutaneous bilirubinometer]. PMID- 6508895 TI - [Albendazole in the treatment of simultaneous infection by Trichuris trichiura and other intestinal helminths in children]. PMID- 6508896 TI - [Peritoneal dialysis using the Tenckhoff catheter. An adequate therapeutic alternative]. PMID- 6508897 TI - [Scleroderma in childhood]. PMID- 6508899 TI - Neurotoxic effects of acrylamide on rat retinogeniculate fibres. AB - The common laboratory chemical, acrylamide, causes various clinical effects including dysfunction of the visual system. Previous electrophysiological recordings from the rat lateral geniculate nucleus (LGN) following exposure to acrylamide suggested that X-like cells were selectively disrupted by the neurotoxin. This study examines the possibility that the diameter of the optic tract fibres may underlie their differential susceptibility, but shows that fibres of all sizes are affected by acrylamide intoxication and the results suggest that the selective effect of acrylamide is not due simply to disruption of optic tract fibres. PMID- 6508898 TI - [Prolonged gastroenteritis in children]. PMID- 6508900 TI - Orientational asymmetries in small-field optokinetic nystagmus in human infants. AB - Optokinetic nystagmus (OKN) is a pattern of reflexive eye movements which occurs when portions of the visual field are in continuous motion. Gratings moving at 7 deg/s either horizontally (left or right) or vertically (up or down) were presented on a viewing screen subtending 30 degrees by 22 degrees. Horizontal (HOKN) and vertical (VOKN) OKN were recorded under binocular viewing conditions from infants and adults. Eye movements were recorded by means of an infrared corneal reflection eye movement recorder. OKN to horizontal and vertical stimuli was different in pattern for infants. Infants' HOKN was of significantly higher frequency and lower amplitude than their VOKN. Infants below 4 months of age also showed an asymmetry within VOKN between upward and downward stimulus motion, with markedly lower gains and more variable slow phase following movements for downward moving stimuli. No differences were found in HOKN to the right and left. There was also no evidence of a build-up of slow phase velocity over time. Infants' fast phases showed peak velocity/amplitude relationships like those of adults, and like those of infant saccades recorded in a previous study of infants' fast eye movements. Across all directions of stimulus movement, infants had lower slow phase gains and OKN frequencies, and larger slow phase amplitudes than adults. The characteristics of infants' OKN are discussed in relation to those observed in other species and in adult clinical patients with eye movement disorders. PMID- 6508901 TI - Hippocampal electrical activity and behavior in the presence of novel environmental stimuli in rabbits. AB - Male rabbits have been used in a simultaneous study of their behavioral and neural activity in different experimental situations related to attention and emotionality. The electrical activity of the dorsal hippocampus and frontal cortex was recorded in the following experimental situations: Neutral Environment (response to a novel environment); Object (response to a novel stimulus); Stuffed sparrow hawk; and live cat. Results show that behavioral and electrical responses depend upon: (a) the nature of the stimulus; and (b) whether or not the stimulus is moving. As for the immobile stimuli, the stuffed animal presentation significantly reduced both behavioral activity and percentage and frequency of rhythmic slow activity (RSA); prolonged periods of ECoG synchronization were also recorded. The introduction of the live cat greatly increased the percentage and frequency of RSA, especially when the cat was looking at the rabbit. The experimental situations caused differences in the distribution of RSA frequencies as well. The percentage of high RSA frequencies (greater than 6.5 Hz during immobility; greater than 7.2 Hz during movement) recorded in response to the immobile stimuli was negatively correlated to the amount of RSA. Results are discussed in the light of attentional and emotional theories. PMID- 6508902 TI - Spontaneous and delayed spatial alternation following damage to specific neuronal elements within the nucleus medianus raphe. AB - Previous studies have shown that rats with electrolytic lesions of the nucleus medianus raphe (MR) show alterations in spontaneous alternation and in the acquisition of a delayed spatial alternation task. The current study was designed to investigate whether these changes are secondary to forebrain serotonin depletion or if they are due to the destruction of MR cells or fibers of passage within the region of the MR. To this end, rats were prepared with either an electrolytic lesion of the nucleus, or were given an intra-MR injection of either the serotonin neurotoxin 5,7-dihydroxytryptamine (5,7-DHT) or the excitotoxin ibotenate. Rats were then tested for the presence of spontaneous alternation in a T-maze, and were subsequently also trained on a contingently-reinforced delayed alternation task. Only the group with electrolytic lesions showed significant response perseveration in the spontaneous alternation task, although both the electrolytic and ibotenate groups were impaired in acquiring the delayed alternation task. Rats with 5,7-DHT injections performed comparable to controls in both tasks despite the fact that forebrain serotonin levels in this group were reduced at least as much as in the other two lesioned groups. These results suggest that these behavioral effects of MR lesions are due to the destruction of non-serotonergic fibers and/or cells within the region of the nucleus. PMID- 6508903 TI - Sensitization to the effects of repeated amphetamine administration on intracranial self-stimulation: evidence for changes in reward processes. AB - The effects of daily administration of 1.0 mg/kg of D-amphetamine for 20 consecutive days on self-stimulation responding from the substantia nigra, and nucleus accumbens were evaluated at several current intensities. Raising current intensity increased rates of responding when electrodes were situated in these areas, and amphetamine significantly enhanced rates of responding from both brain regions. Moreover, the drug-induced response enhancements were facilitated further after repeated drug/test pairings. Although response sensitization was observed at several current intensities, it developed sooner at the lower current levels indicating that the sensitizing effect of repeated drug administration on self stimulation responding was not due to variations in locomotor activity or arousal levels induced by amphetamine treatment. Furthermore, sensitization was observed at current levels that engendered both high and low levels of responding, suggesting that the sensitization was unrelated to the rate dependent effects of the drug. Rather, it was argued that repeated amphetamine treatment sensitized animals to the rewarding properties of electrical brain stimulation. Possible neurochemical and behavioral mechanisms that may be involved in the development of reverse tolerance after repeated amphetamine treatment were discussed. PMID- 6508904 TI - Discrete lesions of the cerebellar cortex abolish the classically conditioned nictitating membrane response of the rabbit. AB - The classically conditioned nictitating membrane response (NMR) of the rabbit is useful for analyses of brain structures and pathways involved in mammalian associative learning. Lesions of the entire cerebellum, its nuclei or its efferent pathway abolish conditioned NMR learning and prevent its reacquisition. Until now it has not been clear whether the cerebellar cortex is an essential part of the circuitry for NMR conditioning. Here we report that small lesions of the cerebellar cortex in the hemispheral portion of lobule VI, with sparing of the underlying nuclei, abolish the ipsilateral conditioned NMR and prevent it from being reacquired. PMID- 6508905 TI - Effects of externally imposed elastic loads on the ability to estimate position and force. AB - Normal adult subjects attempted, with vision excluded, to match the position of the left index finger by pointing to it with the right one, using only flexion extension movements at the right elbow. An elastic load applied at the right wrist was altered from trial to trial. When instructed to align the fingers, subjects were found to select the position of the right forearm by taking into account both a position signal and some measure of the force exerted by the elbow flexors. When instructed to match a target force, instead of position, the subjects were able to give greater weighting to signals of force than in the position matching task. PMID- 6508906 TI - Reduced locomotor activity as an acute effect of damage to superior colliculus in rats. AB - Rats with either electrolytic or radiofrequency lesions of the superior colliculus were tested in an open-field within 24 h of operation. They crossed significantly fewer squares and spent more time motionless then control animals, an effect that disappeared upon retesting 13 days later. Previously reported locomotor hyperactivity thus appears to be a chronic but not an acute effect of collicular damage in rats. PMID- 6508907 TI - Visual recovery in goldfish following unilateral optic tectum ablation: evidence of competition between optic axons for tectal targets. AB - Anatomical studies suggest that regenerating optic axons which invade the ipsilateral lobe of the optic tectum following ablation of the contralateral lobe compete with resident optic axons for synaptic sites on tectal neurons. Invader optic axons are initially uniformly distributed over the entire tectal lobe. With time, the invader and resident optic axons progressively segregate so that the invaders are localized in bands or islands separated by areas that are innervated mainly by the residents. When the resident optic axons are destroyed by ablating the eye opposite to the experimental eye, the invader axons remain continuously distributed and the segregation process apparently does not occur. We investigated the relationship between the segregation process and the recovery of visual function by the invader axons. Visual recovery was measured with a behavioral method in which the index of vision was the occurrence of a branchial suppression response to a moving spot of red light that was classically conditioned to an electric shock stimulus. The minimum time to reappearance of vision following ablation of the contralateral lobe of the tectum in two-eye fish was similar to the reported time of onset of the segregation process. Visual recovery occurred sooner when the opposite eye was removed. The restored vision in both groups disappeared following subsequent ablation of the remaining lobe of the tectum. These results suggest that the goldfish optic tectum normally contains no free synaptic sites for anomalous optic afferents and that the invader axons must compete for targets with the resident optic afferents. The invader axons can apparently remain unconnected or non-functional for several weeks following their arrival in the ipsilateral tectal lobe. PMID- 6508908 TI - Trigeminal denervation and operant behavior in the rat. AB - Selective section of trigeminal sensory and motor nerves was carried out in two experiments designed to examine the contribution of this sensorimotor system to the control of instrumental responses reinforced with food or water. Unilateral section of either V sensory or V motor nerves had no significant effect on lever pressing. Bilateral section significantly reduced lever pressing, and the deficit was greatest in subjects with trigeminal motor nerve section. Thus trigeminal orosensory or oromotor denervation disrupts performance on a food- or water reinforced task whose execution does not require a trigeminally mediated response. The results are discussed in terms of motivational and reinforcement accounts of instrumental learning. PMID- 6508909 TI - Trigeminal reflexes and ingestive behavior in the rat. AB - Photographic, electrophysiological, and neurobehavioral analyses were used to examine the contribution of trigeminally mediated jaw-opening reflexes to the control of ingestive behavior in the rat. During eating and drinking, jaw opening was always preceded by a period of perioral contact with the food or water source. Stimulation (electrical, mechanical) of perioral areas in anesthetized animals elicited jaw-opening reflexes (recorded from the mylohyoid nerve trunk) at short latencies and low stimulus intensities. Trigeminal orosensory deafferentation (sparing jaw muscle afferents and efferents, taste, vision, and olfaction) abolished or significantly reduced mouth opening during eating or drinking. It is concluded that motivational processes operate through trigeminal reflexes to generate eating in the rat. PMID- 6508910 TI - Effects of 4-hydroxyamphetamine on in vivo brown adipose tissue thermogenesis and feeding behavior in the rat. AB - The influence of 4-hydroxyamphetamine (4-OHAM) on food and water intake and in vivo brown adipose thermogenesis was examined in two experiments. In Experiment 1, female rats were treated with 0.00, 0.25, 0.50, 1.00, or 2.00 mg/kg 4-OHAM (ip) prior to assessment of interscapular brown adipose tissue (IBAT) thermogenesis. The 4-OHAM treatment induced dose-dependent activation of IBAT thermogenesis consistent with the enhanced serum levels of norepinephrine and epinephrine observed in 4-OHAM-treated rats immediately after temperature measurement. In Experiment 2, the influence of 4-OHAM on food and water intake was assessed during 120-min test intervals in female rats fed food and water ad lib. Although there was a trend for 4-OHAM to increase water intake, there was no significant effect of 4-OHAM (0.40, 0.80, 1.00, 2.00, and 4.00 mg/kg) on either food or water intake. These data suggest that brown adipose thermogenesis does not play a role in the anorexia induced by amphetamine or in the regulation of feeding. PMID- 6508911 TI - Learned aversions to proteins in rats on a dietary self-selection regimen. AB - Rats were allowed continuous access to protein and carbohydrate macronutrient sources during a sequence of cyclophosphamide (Cytoxan) injections. Significant aversions developed to the protein but not the carbohydrate source in three studies in which the composition of both protein and carbohydrate diets was varied. These results suggest that animals on a dietary self-selection regimen are more likely to develop conditioned aversions to the protein source than the carbohydrate source. In a final study, the generality of these findings was examined by determining whether aversions would selectively arise to protein but not carbohydrate when these nutrients were conditioned in a single trial, with a meal-feeding paradigm. Proteins again proved more salient targets for aversions than carbohydrates. These findings suggest that the tendency to associate proteins with drug-induced illness more readily than carbohydrates is not limited to a self-selection regimen. The possible role of taste factors and/or postingestive effects as the basis of the differential conditioning of proteins and carbohydrates is discussed. PMID- 6508912 TI - Noise and the young mouse: genotype modifies the sensitive period for effects on cochlear physiology and audiogenic seizures. AB - A sharply defined "critical period" has been described for the young C57BL/6 mouse, during which acoustic trauma will profoundly alter subsequent auditory behavior (audiogenic seizures, acoustic startle reflex). In several genotypes and species, a broader "sensitive period" exists, during which acoustic trauma is most damaging to cochlear functions in the young ear. In order to examine the correspondence of these two events, C57BL/6 and CBA inbred mice, at eight ages ranging from 12 to 54 days, were exposed to 2 min of a 124-dB (SPL) octave band noise (8-16 kHz). A noninvasive electrocochleographic technique was used to assess cochlear microphonic (CM) and action potential (AP) thresholds in exposed mice and their nonexposed littermate controls. This allowed cochlear functional measures and behavioral tests (susceptibility to audiogenic seizures) to be made in the same animals. Noise has no observable effect on the 12-day-old CBA mouse, produced a maximal threshold elevation (47 dB for AP, 28 dB for CM) at 30-36 days, with the effect declining to nearly half of this value in 54-day-old subjects. Susceptibility to audiogenic seizures in the exposed CBA mice was greatest at the peak of this sensitive period for cochlear damage (r = .95). C57BL/6 mice also appeared unaffected when noise exposure occurred at 12 days of age; they had maximal AP (23 dB) and CM (17 dB) threshold elevations at 36 days, and 54-day-old mice had an 18-dB elevation of the AP and their CM was no longer affected. Susceptibility to audiogenic seizures was greatest in C57BL/6 mice exposed to noise at 18 days, and it did not correspond with the sensitive period for cochlear damage (r = .21). Therefore, both genotypes have a sensitive period for the effects of noise trauma on the CM and AP, the CBA has a sensitive period for acoustic priming for audiogenic seizures, and the C57BL/6 has a critical period for acoustic priming. Genetic differences in age-related losses of central nervous system auditory functions are postulated as being responsible for these behavioral differences. These data are compared with known auditory functions of the SJL and BALB/c mouse strains in order to explain genetically determined differences of the sensitive (or critical) period of acoustic priming, and for the length of time the mice subsequently remain susceptible to audiogenic seizures. PMID- 6508913 TI - Effects of volatile and nonvolatile chemical signals on male sex behaviors mediated by the main and accessory olfactory systems. AB - Estrous hamster vaginal discharge (HVD) contains both volatile and nonvolatile chemical signals which collectively elicit both male attraction to females and male mating behavior. These two aspects of normal sexual behavior are differentially affected by lesions involving afferents of the main and the accessory olfactory systems. The results of lesions that involve the main olfactory system suggest that it provides information primarily concerning those volatile components of HVD that normally signal the presence of a female. Lesions restricted to the accessory olfactory system do not impair a male's interest in or relative preference for HVD but do significantly interfere with subsequent stages of sexual behavior by reducing the amount of mating obtained upon exposure to HVD. Stimulation of the accessory olfactory system by nonvolatile components of HVD has thus been implicated in the production of mating behavior. In these experiments, male hamsters were attracted to female odor and engaged in significant amounts of mating behavior with surrogate females when only the volatile components of HVD were available to them. These behaviors were further enhanced when both volatile and nonvolatile components of HVD were provided. Lesion studies of the afferents involved reinforce the hypothesis that the main olfactory system is preferentially involved with processing those volatile chemical signals in HVD that denote female attractiveness whereas the accessory olfactory system is preferentially involved with processing those chemical signals, both volatile and nonvolatile, that evoke subsequent steps in male sexual behavior. PMID- 6508914 TI - Electrophysiological and ultrasonic correlates of reproductive behavior in the male rat. AB - The purpose of the present study was to examine the electrophysiological correlates of copulatory behavior in the rat and correlate brain electroencephalographic (EEG) activity with the ultrasonic vocalizations that have been shown to play a major role in the integration of mating behavior. Ultrasonic vocalizations of male rats with chronically implanted hippocampal and cortical electrodes were monitored during mating with a female rat. Hippocampal theta rhythms were significantly correlated with high activity, mounting, intromissions, and preejaculatory excitatory behavior and were also significantly associated with 50-kHz short ultrasonic vocalizations. Postmount or postintromission behaviors (grooming, exploration) were closely correlated with an absence of ultrasonic vocalizations and the onset of irregular low-amplitude hippocampal EEG recordings. Long 22-kHz vocalizations occurred in all tests during the postejaculatory refractory period. Shorter 22-kHz vocalizations occurred during mating and were associated with unsuccessful intromissions or mounting attempts. Postejaculatory long 22-kHz vocalizations were significantly associated with irregular high-amplitude hippocampal EEG tracings, and preejaculatory short 22-kHz vocalizations were also accompanied by sleep-like irregular high-amplitude hippocampal EEG tracings with cortical spindling. The correlation of ultrasonic vocalizations with electroencephalographic and behavioral manifestations of central arousal and inhibitory processes suggests that these vocalizations are indicators of the sexual arousal of the mating pair. PMID- 6508915 TI - Effects of inferior temporal lesions on visual discrimination performance in monkeys with complete and incomplete striate cortex ablations. AB - In order to determine whether inferior temporal cortex participates in the relearning of visual discriminations following striatectomy, monkeys were retrained to perform two preoperatively acquired discriminations (brightness-flux and brightness-area) after receiving bilateral striate cortex lesions and then retested in the same tasks after bilateral inferior temporal surgery. After inferior temporal surgery, the monkeys with histologically verified total ablation of striate cortex showed little or no impairment in relearning the discriminations, whereas the monkeys with remnants of intact striate cortex were severely impaired. These findings suggest that inferior temporal cortex is, at most, of minor importance in relearning brightness-flux and brightness-area discriminations in the absence of striate cortex. This interpretation is consistent with the view that the contribution of inferior temporal cortex to visual discrimination performance depends on input from striate cortex. PMID- 6508916 TI - Visual experience, unilateral cortical lesions, and lateralization of function in rats. AB - The effects of early visual experience and later unilateral neocortical lesions on the behavior of male hooded rats were measured on an open-field, 17-arm spatial maze, and a visual field or perimetry test. The comparison of behavior observed in the open field revealed that light-reared (LR) rats that suffered a right hemispheric lesion were more active and reared more than any of their dark reared (DR) counterparts as well as LR animals that had left hemispheric or sham operations. On the radial maze task in which 8 of 17 arms were baited, the rats with unilateral lesions performed less effectively than did the sham-operated animals. The effect of the lesions was significantly greater for LR rats than their DR counterparts. The perimetry testing revealed that although the operated animals did react to stimuli throughout their visual field, some contralateral neglect was evident in the case of both LR and DR rats. The lesions did have a much greater impact on orientational behavior of operated LR rats. However, as was the case with respect to performance on the radial maze, no evidence emerged of any functional asymmetry following the unilateral cortical lesions. The results are discussed in terms of Denenberg's (1981) hypothesis about cerebral and functional asymmetry in the rat. PMID- 6508917 TI - Extinction-induced spatial dispersion in the radial arm maze: arrest by ethanol. AB - Adaptive changes in response to extinction can be observed if provisions are made that permit behavior to shift away from trained routine. In the present case, the baiting of four arms in the eight-arm radial maze increasingly restricted subject movements to those arms. The unbaited arms afforded a new direction for behavior to take during extinction. Withdrawal of reward was followed by an immediate and active expansion of sites visited. The previously unrewarded arms were now regularly sampled. This was one consequence of extinction. The other was the well known decline in overall rate of arm entry, whether arms were previously baited or not. Ethanol, at doses of 1.5 or 2.0 g/kg, eliminated the spatial dispersion attendant upon nonreward. It did not affect the decline in overall responsiveness. Ethanol's deletion of extinction-induced spatial variability may account for its impairment on reversal and other kinds of tasks that require a shift away from old patterns of behavior. PMID- 6508918 TI - [Results of 2 years of primary and secondary prevention of arterial hypertension in women in an organized population]. PMID- 6508919 TI - [Sodium and calcium metabolism in isolated cardiomyocytes]. PMID- 6508920 TI - [Results of basic research of the Research Institute of Preventive Cardiology of the All-Union Cardiology Science Center of the Academy of Medical Sciences of the USSR for 1983]. PMID- 6508921 TI - [Comparative evaluation of the importance of transesophageal electrical stimulation of the left atrium and bicycle ergometry in diagnosing ischemic heart disease]. AB - Comparisons were made between the clinical picture, results of bicycle ergometry and selective coronaroangiography, and the data of transesophageal electrical stimulation of the left atrium in 52 patients, including 31 with stenosing coronary atherosclerosis. The feasibility of applying the transesophageal stimulation for the diagnosis of coronary heart disease is shown. The sensitivity of transesophageal electrical stimulation of the left atrium in detecting stenosing coronary atherosclerosis was 81%, its specificity being 79%. PMID- 6508922 TI - [The dipyridamole test in the diagnosis of ischemic heart disease in women]. AB - Bicycle ergometry and the dipyridamol test were performed in 25 females with coronary artery stenosis and 42 with unchanged coronary arteries (according to the coronarography data). The sensitivity of the dipyridamol test was 80% at its specificity was 78% according to the electrocardiographic data that correlated well with those of bicycle ergometry. The dipyridamol test can be used for examining females with suspected coronary heart disease. PMID- 6508923 TI - [Left ventricular function in patients who have had a myocardial infarct, based on echocardiographic study data]. AB - The significance of a combined echocardiographic study of patients who survived myocardial infarction for evaluation of ventricular hemodynamic disturbances was shown. According to the ultrasonic B-scanning data the left ventricular end diastolic and endsystolic volumes in such patients were increased, and ejection fraction values, delta S and VCF were markedly decreased. The most pronounced left ventricular pump and contractility dysfunctions occurred in transmural and anterior myocardial infarctions. During M-mode echocardiography in patients with posterior wall hypokinesia, the prolongation of isovolumic relaxation and contraction followed by the shortening of rapid filling was observed. A significance correlation between the prolongation of isovolumic relaxation and polygraphic T interval was found. The thinning of the left ventricular hypokinetic posterior wall was observed during the ejection period, and that of hypokinetic ventricular septum was seen within the cardiac cycle. The signs of more marked left ventricular dilatation with its decreased contractility were found in patients with systolic murmur recorded soon after myocardial infarction development. Such a murmur phonocardiographically recorded was a sign of mitral valve insufficiency. PMID- 6508924 TI - [Modern diagnostic apparatus for noninvasive diagnosis in cardiology]. PMID- 6508925 TI - [Right heart function based on 2-dimensional echocardiographic data in heart failure patients]. AB - The right atrium and right ventricle were examined by contrast echocardiography. The function of the right chambers was evaluated by determining the changes in the heart cavity section areas while using echocardiography during different phases of the cardiac cycle. The patients with primary pulmonary hypertension and mitral valve disease and healthy subjects were examined. It was typical of the patients with mitral valve disease to have a marked decrease in the functional parameters of the right atrial fibrillation and diminished right ventricular function indices. The indices of the functional state of the right ventricle in the patients with primary pulmonary hypertension changed to a less extent despite the fact that they had a more pronounced dilatation of the right ventricle than those with mitral valve disease. PMID- 6508926 TI - [Method for the automated mapping of 35 ECG leads]. AB - The method of recording the ECGs, inputting them into a computer and automatic analysis of 35 ECG leads is described. The proposed method largely diminishes the time expenditure and difficulties in obtaining and analysing 35 ECG lead mapping grams, as the computer makes all measurements and calculations and produces a final document. PMID- 6508927 TI - [Potentials for long-term ECG recording using the Soviet-made band MT equipment unit]. AB - "Band-MT" (Lenta-MT) is a new Soviet apparatus for outpatient ECG monitoring. The main indications for the patient examination were listed. The problem of the occurrence of artefacts during the outpatient monitoring was discussed. PMID- 6508928 TI - [NMR tomographic method of studying central nervous system function in arterial hypertension patients]. AB - Nuclear magnetic resonance (NMR) tomography of the brain was performed in 41 patients (17 males and 24 females) and 15 normal persons. Imaging of the brain structure, skeleton, soft tissues of the skull in various projections is possible on the brain tomograms. In all cases the method made it possible to distinguish the gray and white matter of the brain, to exclude the presence of voluminous formations and when the sequelae of cerebrovascular disturbances and cysts of 0.5 -1.5 cm were present it allowed one to determine the location and character of a pathological process. The method provided additional information on the central nervous system state in the patients and on its genesis promoting further choice of tactics and methods of treatment. High resolution capacity, imaging precision, safety for patients, comparability of the results of NMR with the data of x-ray computerized tomography and other investigation methods suggest wide prospects for NMR tomography. PMID- 6508929 TI - [Multifactorial rating scale of psychosocial changes in patients with a history of myocardial infarct]. AB - The developed multifactorial assessment schedule is sufficiently valid and can be successfully applied to dynamic studying the psychosocial factors, which are connected with the rehabilitation of the patients who have survived myocardial infarction. Owing to its simplicity and universality the schedule can be easily introduced into health care practice and applied according to the study tasks. PMID- 6508930 TI - [Psychodiagnostic examination of patients with the initial stages of arterial hypertension at a district polyclinic]. AB - In a district polyclinic, psychodiagnostic study of subjects with borderline blood pressure (140/90--159/94 mm Hg) and patients with essential hypertension of the first stage was performed followed by psychotherapy of this group. Psychometric procedures: multisided personality study procedure (modified and restandardized variant of MMPI test and Cattell's 16-factorial personality test) were employed together with clinical examination. Various psychopathological manifestations were observed in 48.1% of the patients examined, which was reflected in the increase in the profile of multisided personality study procedure (MPSP) up to 70. Diastolic blood pressure in these persons rose as MPSP profile increased, and there was no enhancement in systolic blood pressure at that time. Psychotropic drug treatment in combination with psychotherapy of psychopathological symptoms and arterial hypertension proved efficient. PMID- 6508931 TI - [Antianginal and hemodynamic effect of propranolol and atenolol in patients with exertion angina]. AB - In patients with angina of effort, the changes of the central hemodynamic indices were estimated after oral administration of effective antianginal doses of propranolol and the cardioselective beta-blocker atenolol, which had been individually selected. Atenolol maximum effects on the hemodynamics were somewhat superior to those of propranolol. At the same time, the degree of hemodynamic changes did not correlate with their antianginal action. The effect of atenolol on the total peripheral vascular resistance was not higher as compared to that of propranolol. PMID- 6508933 TI - [Algorithm for calculating socioeconomic loss in relation to premature mortality]. AB - Methods for assessing the social and economic losses due to premature death are considered. The calculation algorithm of such an assessment including economic and demographic aspects has been devised. The calculation methods are illustrated by the results of carrying out the arterial hypertension preventive programs at one of the Moscow large enterprises. Unaccounted discount coefficient and survival expectancy rates are shown to contribute to the increase in the amount of economic losses due to premature death by 30-50%. It is also shown that measures promoting decrease in death rates caused by myocardial infarction and stroke, due to the prevention of arterial hypertension in the organized population groups within 4 years is followed by decrease in labour losses and by increase in economic effect by more that 160 thousand roubles (at the rate per 100 patients with arterial hypertension). PMID- 6508932 TI - [Possibility of developing tolerance to the antianginal effect of verapamil]. AB - Ten patients with ischemic heart disease and stable angina of effort have been examined for the possibility of tolerance development to verapamil antianginal effect, which was assessed using bicycle ergometry. Antianginal effect after the course of treatment with 80 mg of verapamil 3-4 times per day, and 120 mg of verapamil 3-4 times per day, was significantly more pronounced than after single administration of 80 and 120 mg of the drug. Thus, no tolerance to verapamil antianginal effect was observed during the course of treatment with verapamil, moreover the effect was enhanced. PMID- 6508934 TI - [Malondialdehyde content of plasma lipoproteins and thrombocytes in patients with ischemic heart disease]. AB - Malonic dialdehyde (MDA) content was studied in 23 patients with CHD due to coronary atherosclerosis, and in 6 with neurocirculatory dystonia without clinical and angiographic signs of CHD. MDA content as an indirect equivalent of cyclic endoperoxides was higher in the platelets, LDL and VLDL in patients with CHD. It may be a cause of TxA2 and PGI2 unbalance in the blood circulation and leads to the activation of thrombus formation, the decrease in the synthesis of "antiatherogenic" biologically active substances, in particular PGI2, thus promoting the development of CHD due to coronary atherosclerosis. PMID- 6508935 TI - [Diffusion capacity of the myocardial capillary bed in graded decrease in the coronary blood flow]. AB - In closed chest dogs with controlled perfusion of the left coronary artery coronary blood flow was reduced by 10, 20, 30, 40, 50 and 70%. Diffusion capacity of myocardial capillary bed (permeability surface area product) decreased in all but the first (10%) series of experiments. 23-64% fall of the product occurred irrespective of coronary vessel reserve state but with respect to the degree of blood flow reduction. The amount of coronary influx possibly determined the number of perfused capillaries in the heart. Thus, 20% and more reduction of coronary blood flow cannot be compensated at the level of myocardial capillary bed. PMID- 6508936 TI - [Diagnostic significance of psychoemotional loading tests in patients with ischemic heart disease]. PMID- 6508937 TI - [Diagnosis of dilated cardiomyopathy based on data from x-ray studies and 201T1 scintigraphy of the myocardium]. PMID- 6508938 TI - [Disorders of the heart rhythm in dilated cardiomyopathy]. PMID- 6508939 TI - [Effectiveness and mechanism of the anti-arrhythmic action of ritmilen in patients with paroxysms of atrioventricular node reciprocal tachycardia]. PMID- 6508940 TI - Measurement of immunoreactive gastrin in tissue. AB - A method for measurement of gastrin in human antral mucosa or in extragastric tissue has been developed and validated. Tissue gastrin was extracted by boiling followed by homogenization at neutral pH. Extractable gastrin immunoreactivity was measured by radioimmunoassay using an antiserum with equal affinity towards G 17 I, G-17 II, G-34 I and G-34 II molecular forms. Almost all extractable gastrin immunoreactivity was recovered after a single extraction and no significant interference by other peptides and/or substances present in tissue was found. The mean gastrin concentration in antral mucosa of healthy subjects was similar to that observed in duodenal ulcer patients, while patients with type A chronic atrophic gastritis or with antral gastrin cell hyperplasia had mean values significantly higher. Gastrin concentration in all specimens from gastrinoma or its metastases was above the upper limit of the range of control tissue. Measurement of tissue gastrin seems to be a valuable tool in the diagnosis of antral gastrin cell hyperplasia and Zollinger-Ellison syndrome. PMID- 6508942 TI - Toxoplasma meningoencephalitis in a young girl. PMID- 6508941 TI - [Autoantibodies and respiratory allergy: immunologic case study]. AB - Sera obtained from 212 patients with rhinopathy and/or asthma of allergic origin (pollens and/or mites) and from 87 apparently healthy controls were studied for the presence of organ and non organ specific autoantibodies. These were determined by indirect immunofluorescence techniques (5) using test tissue from monkeys (thyroid) and rats (stomach, liver and kidney). Two groups were matched for age and sex and the tests were performed using the double-blind method. The incidence observed was not dissimilar to that detected in healthy subjects, with the exclusion of smooth-muscle antibodies. These were present to a lesser extent in patients with respiratory allergies (0.94%) in contrast with the incidence of 5.73% in normal subjects (P less than 0.01). On the basis of our findings, it seems possible to hypothesize that allergic patients have a lesser tendency to autoimmune diseases because the immune system is committed to the IgE-mediated immunoreactions. In conclusion, autoantibodies do not seem to play a role in the pathogenesis of respiratory allergies to inhaled allergens. PMID- 6508943 TI - The relationship between sensitization with squaric acid diethylester and IgE mediated allergy. PMID- 6508944 TI - [Introduction to the Round Table on Leptospirosis]. AB - The renewed interest in leptospirosis derives from the expansion of this infection which, broken out from its historical strictly professional role, now interests wider categories of the population, represented by frequenters of zones with water or swamp for sport or week-ends. A greater knowledge therefore is needed on the diffusion of leptospirosis and its epidemiology which is notoriously non-homogeneous and variable. The necessity for the meeting arose from this new reality, not sufficiently known, of this infection, and from the necessity to cover the national territory with reference centres coordinated by the Istituto Superiore di Sanita and in the more general epidemiological picture promoted by the WHO. PMID- 6508945 TI - [Biological diagnosis of the leptospiroses: technics and interpretations]. AB - According to the chronological data of Physio-Pathology of leptospiroses, diagnosis is: Direct: isolation of the germ in the beginning of the acute phase of the disease: blood culture, culture of cerebrospinal fluid, animal inoculation. Identification is the work of a specialized laboratory. Indirect: demonstration of antibodies. Immunological tests are divided into two groups: Screening tests, available for all laboratories: they give an indication of Leptospirosis. They are carried out during the acute phase: slide macroscopic agglutination test, hemagglutination test, complement fixation test. Confirmatory tests, performed only by specialized laboratories. Interpretation is dependent on the case history of the patient. PMID- 6508946 TI - [The diagnosis of leptospirosis in the hospital microbiology laboratory]. AB - Confirmatory diagnosis of clinical leptospirosis may be achieved by each hospital laboratory performing all-purpose bacteriological methods. Direct microscopic examination of blood may frequently demonstrate circulating leptospiras in the first few days of pyrexia. Leptospiras may be tentatively cultured from blood in the same initial period of illness, in fluid semisynthetic commercial media according to the original Ellinghausen medium. Sero-conversion for leptospira antibodies is constantly observed on two serum samples taken in the first few days of illness and ten days thereafter respectively, in each case of current leptospirosis. PMID- 6508947 TI - [Identification of proposed laboratories for leptospirosis surveillance at the regional and multiregional levels]. AB - A geographic emplacement of reference Centres for the epidemiological control is proposed here according to recommendation by the Istituto Superiore di Sanita and the instructions of the WHO. While the ordinary laboratories make serodiagnosis for clinical use only, the reference Centres must carry out the epidemiological control by typing of leptospires strains in order to establish the prevalence of the serotypes in the different territories. For these more complex epidemiological techniques, closer relations between the Centres and the Istituto Superiore di Sanita are necessary. The national map proposed, object of discussion at the meeting, refers to reference Centres (location and person) that have made themselves available for this duty. PMID- 6508948 TI - [Diagnosis and surveillance of leptospirosis in the Venetia Region]. AB - The Microbiological Laboratory of Verona Hospital is the leptospirosis reference Centre since 1980. It uses routinely the lysis/agglutination test with leptospires strains in order to confirm the clinical diagnosis and to define the typing of strains. Although this Centre is not yet officially recognized, it is in fact, at the service of the Veneto region and greater part of the Trentino Alto Adige. It examines 600 samples a year (about 3000 determinations) from these two regions, therefore it can construct a biregional epidemiology although the data is neither referred to superior Committees nor, perhaps, utilized in the requesting territory. The aspects of this service to be improved are the incompleteness of data with samples and their not perfect condition on arrival for testing. The most interesting point is that the epidemiology in the Veneto region has not changed since 1980: the prevailing leptospira is the icterohaemorrhagiae and then the canicola and pomona. PMID- 6508950 TI - [The Pavia Center for the study and diagnosis of leptospirosis]. AB - According to his deep experience in this field, the Author greatly appreciates the program agreed during this congress. He thinks that Leptospirosis is a still widely diffused zoonosis, for which accurate diagnostic work-up is requested, coupled to an adequate epidemiologic study. Among his own contributions to this argument, the A. remarks the studies on the experimental infection of the guineapig with L. icterohaemorrhagiae, providing evidence that jaundice and lethal course of the illness are due to the Leptospira and not, as it was currently supposed, to an overcoming Staphylococcal septicemia. Furthermore the A. observed a striking epidemic by L. pomona affecting 90 out of 120 rice-workers in the neighbourhood of Pavia. This Leptospira, previously unreported in Europe, was found to be carried by Norvegian rats captured in that country. These data were in contrast with the more frequent incidence, in this work environment, of L. bataviae, carried by Micromis minutus sorcinus. Following the amount of observations and researches in this field "Center for study and diagnosis of Leptospirosis" was founded in 1954, and is still working in Pavia. The necessity of isolation of the infective agent, in addition to the simple serologic study, was claimed by the observation of five cases of meningitis in young pigherds, in which L. canicola (instead of the more common L. pomona) was demonstrated and ielded from the CSF of a patient. In the field of veterinary medicine, the A. demonstrated the L. australis A as responsible of some cases of miscarriages in openair breeded cattle. In those cases the hedgehog (Erinaceus europeus) was the natural carrier.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508949 TI - [Diagnostic research on leptospirosis in the Milanese territory]. AB - 168 serum specimens have been tested for Leptospirosis in the years from 1980 to 1983. The identification procedure was a macroscopic plate agglutination screening test with formalin fied antigens and a confirmatory microscopic agglutination-lysis test of live antigens of actively growing cultures of different pathogenic serotypes propagated in a fluid medium. 34 serum specimens (23.8%) relevant to 18 cases were positive. L. icterohaemorrhagiae was positive in 12 cases (63.1%), L. pomona in 2 cases (10.5%), L. canicola in 1 case (5.3%), 1 case was positive for both L. grippotyphosa and L. bataviae and 1 case was positive for L. poi and L. sejroe. During the summer-fall of 1981 40 specimens of surface water from 4 pre-alpin lakes of the Provincia of Como were tested for Leptospiras with the cultural and biological examinations, following the detection of several leptospirosis cases on the relevant area. All water specimens gave negative results. PMID- 6508951 TI - [Activity in the field of leptospirosis at the University of Trieste]. AB - The activity of Leptospira Laboratory in our Institute is briefly explained. The laboratory acts as International Reference for Leptospira typing, for microbiological diagnosis of leptospirosis and for basic research on pathogenesis and new trends in the serodiagnosis. PMID- 6508952 TI - [Intracerebral hemorrhage--special reference to the cerebrovascular lesion of hypertensive intracerebral hemorrhage, hemorrhagic cerebral infarction, cerebral aneurysm and cerebral arterial malformation]. PMID- 6508953 TI - [Surgical treatment and results of surgery for hypertensive intracerebral hemorrhage]. PMID- 6508955 TI - [Pituitary oncocytoma]. AB - Since the first reports of pituitary oncocytoma by Kovacs and Horvath, and Landolt and Oswald increasing numbers of cases have been reported with the advent of electron microscopy. It has been posturated that more cases were not precisely diagnosed because of lack of electron microscopic study. We reported two cases of pituitary oncocytoma and discussed clinicopathological aspects. Case 1 A 66-year old woman had a 6 year history of visual impairment. Neurological examination revealed loss of vision on the left and decreased visual acuity (0.3) with temporal hemianopsia on the right. The endocrinological study revealed moderate panhypopituitarism. Plain skull X-ray, computed tomography and cerebral angiography showed the findings of a pituitary tumor with suprasellar extension. Subfrontal removal of the tumor followed by irradiation was performed. Case 2 A 50-year-old man was well until 8 years previously, when he experienced loss of libido. Three years before entry, the left sided exophthalmos and ptosis were noted. Neurological examination showed a severe visual impairment with a bitemporal field defect, bilateral optic atrophy and disturbance of eye movements on the left. Endocrinological study revealed panhypopituitarism. Radiological studies showed a pituitary tumor with a suprasellar extension and an invasion into the left orbital cavity. Transcranial and then transsphenoidal partial removal of the tumor were done followed by irradiation. Histological examination of the tumors revealed a poorly granurated adenoma with very weak affinity to acid dyes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508954 TI - [Spontaneous intracerebral hematoma and cryptic angioma]. PMID- 6508956 TI - [A comparative study of free amino acid levels in serum and cerebral cortex in uremic rat]. AB - The etiology of uremic encephalopathy remains largely unknown. In order to elucidate the role of amino acid changes in uremic encephalopathy, the free amino acids in serum and cerebral cortex were measured in the experimental uremic models. The rats weighing 200 g underwent bilateral ureteral ligation for 48 hours (acute uremia), while the other animals were kept for 4 months after unilateral nephrectomy followed by partial 2/3 nephrectomy of the remaining kidney (chronic uremia). They were confirmed to develop chemical changes compatible with uremia showing markedly elevated serum levels of BUN, creatinine and K+, and were compared with the sham-operated controls. The amino acid patterns, obtained from serum and cerebral cortex, were essentially identical in both acute and chronic uremia. In serum, aspartic acid, glycine and 3 methylhistidine were significantly elevated, and in addition citrulline, alpha aminoadipic acid, cystine and gamma-aminobutyric acid specifically appeared in uremia. On the contrary, glutamic acid, leucine, lysine, tryptophan, tyrosine and valine were significantly reduced. Tyrosine/phenylalanine ratio, valine/glycine ratio, essential amino acids/non essential amino acids ratio were also apparently reduced in uremia. In cerebral cortex, aspartic acid, glutamine, glycine, histidine, ornithine, phenylalanine, phosphoethanolamine and taurine were significantly elevated, whereas 1-methylhistidine and 3-methylhistidine were specifically detected. Carnocine, glutamic acid and ornithine disclosed a significant reduction in uremia. The above complicated changes in cerebral cortex could not be explained simply by the enhanced permeability of the blood-brain barrier, or by the accelerated ammonia fixation. Therefore, it was suggested that the amino acid levels in cerebral cortex vary under the control of the sophisticated mechanism. PMID- 6508957 TI - [Spontaneous speech disturbances in so called transcortical motor aphasia- comparison of 3 cases with the different lesion sites]. AB - So called transcortical motor aphasia (TCMA) is frequently subdivided, because the clinical features and the localization of the lesions are variable. The authors have been attempting to classify TCMA into three types according to the distribution of the lesions, such as Type F 1, Type F 2 and Type F 3. Case 1 N.S. belongs to Type F 1 showing the clinical features of TCMA with bleeding in the territory of the left anterior cerebral artery. Case 2 M.E. belongs to Type F 2 (published case). This case is similar to Luria's dynamic aphasia in its clinical features and results from the lesions including the posterior parts of left middle frontal gyrus. Case 3 N.T. belongs to Type F 3 who recovered from typical Broca aphasia after language training for four years. The case is similar to Goldstein's Type 1 of TCMA in its clinical features. These three cases are compared with regard to the fundamental bases of spontaneous speech disturbance. The items of comparison are as follows; the volume of speech production and the the time taken to start speech, word fluency test, cue effects necessary for the success of sentence constructions grammatical ability. The results are summerized in Table 2. Type F1 shows the most conspicuous defect of spontaneous speech, but no disturbance in grammatical ability. And when the top word of a sentence (a subject word) is given by the examiner, the patient can construct a structurally correct sentence. These findings imply that the spontaneous speech disturbance of Type F 1 is due to a defect of the starting mechanism of speech.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508958 TI - [Spongiform encephalopathy in mice inoculated with scrapie material of sheep origin]. AB - The authors report spongy degeneration in experimental scrapie (second passage) in mice. The scrapie agent was originally isolated from Suffolk sheep imported from Canada and diagnosed histopathologically to be infected with scrapie by intracerebral inoculation into JCL/ICR mice. Ten female SIc/ICR mice, 4 weeks of age, were injected intracerebrally in the right frontal lobus with 20 microliter of 10(-1) or 10(-4) dilution of JCR/ICR mice brain homogenate involving scrapie agent. All animals showed signs of the advanced stages of the disease, clinically manifested by lassitude, arched backs, lethargy and paresis of hind quarters. They were sacrificed five to six months post inoculation, and sections of the brain and spinal cord were examined by light and electron microscopy. Focal symmetrical spongiform lesions were seen light microscopically in the cerebral mantle, thalamus, hypothalamus, midbrain, medulla oblongata, cerebellum and cervical mark. There was evidence that these lesions tended to be more intense in the mice inoculated a higher concentration of scrapie agent. Astrocytic proliferation was present in the deep layer of cerebral gray matter, white matter, corpus callosum, dorsal part of hippocampus and thalamus. No leukocytic infiltration was observed. Electron microscopically, the spongiform lesions were shown to be caused by vacuolation or swelling within the neuropil, and vacuolation and focal swelling in the neuronal perikaryon. The changes in the neuronal perikaryon were caused by enlargement of endoplasmic reticulum and cisterns of the Golgi apparatus, accompanied by spherical swelling of a part of the cytoplasm. The vacuolation near or within the neuron produced deformation of the cell contours and displacement of the nucleus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508959 TI - [A biological rhythm in a patient with normal pressure hydrocephalus--comparative studies in pre- and postoperative patients by a polygraphy]. AB - The authors had studies the correlation between the appearance of the pressure waves and the level of the sleep in pre- and postoperative patients with normal pressure hydrocephalus (NPH). The changes from preoperative findings to postoperative ones were discussed in detail with the relation of the pathophysiological state in these patients. Seventeen patients were evaluated for the suspected diagnosis of the disease of NPH. Thirteen patients of them were treated with ventriculo-peritoneal shunts. Four representative cases among them were evaluated by pre- and postoperative polygraphic studies. A polygraphic overnight study includes a monitoring of an intracranial pressure (ICP), electroencephalography (EEG), electrooculography (EOG), respiratory movement and electromyography (EMG). Each data was recorded for the analysis on data recorder using a computer system. A pressure waves (largely B type) appeared accompanied with an apnea at a resting state (so-called sleep) of each patients. An arousal response in EEG was also observed in the raising period of the pressure waves. At the peak respiration was resumed with transient activities in EMG and continued to the disappearance of the pressure wave. Pressure waves were observed frequently and continually in hours in the resting state of these patients. As a result the level of sleep alternated frequently between an awake stage and a stage 1, including extremely rare appearance of stage 2. In short, the level of sleep was frequently interrupted by the appearance of the pressure waves and apneas. Such pathological states of patient's sleep were involved in the entity of the sleep apnea syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508960 TI - [Auditory evoked brain-stem responses (ABRs) in brain dead status]. AB - Auditory evoked brain-stem responses (ABRs) were recorded in 19 out of 52 brain dead cases in Department of Emergency Medicine, University of Tokyo Hospital from May, 1981 to January, 1984. The causes of brain death were severe head injury (9 cases), cerebro-vascular disease (7 cases), anoxia (2 cases), hydrocephalus (1 case). Eleven cases of them fulfilled the clinical criteria which included absence of cortical and brain-stem functions excluding severe hypothermia and depressant drug intoxication. The remainders who were subjected to barbiturate therapy were diagnosed as brain death for non-filling phenomenon in cerebral angiography. Results were as follows; Fourteen cases (74%) had no identifiable ABR waves. One case (5%) had only 1st wave. Three cases (16%) had 1st and 2nd waves. One case (5%) had 1st, 2nd, and 3rd waves. In spite of definition of clinical brain death, 5 cases had at least 1st wave, and therefore these datum suggested that ABR might have less clinical utility in diagnosis of brain death. Each case did not necessarily demonstrate the total extinction of ABRs, as was shown in (2) to (4) mentioned above. The clinical status which met the criteria of brain death might therefore possibly imply any conditions in which brain death was impending gradually to result in the total brain death of cerebrum through medulla oblongata. Under these circumstances, how barbiturate might produce ABRs abnormality remained unsolved, though it has been said not to produce ABRs abnormality. Among 8 cases under barbiturate therapy, there were 5 cases with no identifiable waves and 3 cases with 1st and 2 nd waves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508961 TI - [Absence of anal reflex in patients with central nervous system diseases]. AB - The anal reflex was examined electromyographically in 336 patients with central nervous system disease. The absence of anal reflex was found in a total of 78 patients. The incidence of the absence of anal reflex was 31 over 132 (23.7%) in the patients with pyramidal signs in lower extremities, 7 over 41 (17.0%) in patients with extrapyramidal signs in lower extremities, 12 over 50 (24.0%) in patients with both signs and 28 over 113 (24.8%) in patients without both signs. Further incidence of the absence of anal reflex was 6 over 26 (23.1%) in patients with unilateral pyramidal signs, 24 over 106 (22.6%) in patients with bilateral pyramidal signs, 3 over 13 (23.1%) in patients with unilateral extrapyramidal signs and 4 over 28 (14.3%) in patients with bilateral extrapyramidal signs. There was no statistical difference among the above groups, therefore the absence of anal reflex appeared to have no specific relationship to pyramidal or extrapyramidal signs. On the other hand, the incidence of the absence of anal reflex was 33 over 81 (40.7%) in patients with and 45 over 255 (17.6%) in patients without disturbance of light touch and/or pinprick in sacral area. The incidence of the former is statistically higher than that of the latter. Therefore we may conclude that the central afferent arch of the anal reflex has a strong relationship to superficial sensory tract, but the central efferent arch has almost no connection with pyramidal or extrapyramidal tracts. PMID- 6508962 TI - Coronary artery disease in Asians in Birmingham. AB - The severity and pattern of coronary artery disease in patients referred for investigation of the disease was compared between Asian and white patients living in Birmingham, matched for age, sex, blood pressure, and duration of symptoms, to investigate the clinical impression that Asians have worse, in particular worse distal, coronary artery disease than whites. Risk factors and outcome were also examined. The coronary angiograms of 34 Asians were compared blindly and repeatedly with those of 68 whites by two independent observers. Coronary artery disease was found to be quantitatively more severe in Asians, but the distribution of the disease was the same. Some risk factors were significantly different: fewer Asians were smokers; fasting cholesterol concentrations were higher in whites; and whites were heavier, with a larger body surface area. Follow up data showed that more Asians were refused coronary artery bypass surgery because of the severity of their disease. PMID- 6508963 TI - Effect of timolol maleate on pacing induced myocardial ischaemia. AB - The effects of timolol maleate administered intravenously on coronary and systemic haemodynamics, myocardial metabolism, and plasma catecholamine concentrations were assessed in 10 patients with confirmed coronary artery disease. Rapid atrial pacing to the onset of angina was performed in all patients. Timolol reduced cardiac output at rest and during pacing and reduced resting heart rate but did not affect arterial blood pressure. Left ventricular stroke work index fell during pacing. Coronary sinus blood flow was unchanged, but pulmonary artery diastolic pressure rose after timolol. The drug produced clinical improvement in nine of the 10 patients with prolongation of the mean pacing time to angina. There was evidence of improved myocardial metabolism with a change from production to extraction of lactate: Arterial noradrenaline concentrations at rest rose after timolol. In these patients with coronary artery disease timolol produced an increased tolerance to atrial pacing stress, which appears to be due to a combination of effects including reduced myocardial contractility and decreased lipolysis. PMID- 6508964 TI - Left ventricular bands. A normal anatomical feature. AB - Discrete delicate fibromuscular structures crossing the cavity of the left ventricle were identified on morphological examination in 329 (48%) of 686 hearts from patients of all ages with congenital heart disease, acquired heart disease, or normal hearts. These structures were also present in 151 (95%) of 159 hearts from animals of six species. Cross sectional echocardiographic findings compatible with these structures were obtained in 39 (21.7%) of 179 children reviewed retrospectively and in three of 800 (0.4%) adults studied prospectively. These structures appear to be a normal anatomical finding. PMID- 6508965 TI - Coronary sinus orifice atresia and persistent left superior vena cava. A report of two cases, one associated with atypical coronary artery thrombosis. AB - Fourteen previously reported cases of atresia of the coronary sinus ostium, in which the coronary venous flow entered the right atrium by a persistent left superior vena cava, the innominate vein, and the right superior vena cava, are reviewed and two new cases reported. The first new case was in a 43 year old woman with atypical chest pains in whom investigations for suspected ischaemic heart disease, including coronary arteriography, yielded normal results. She died suddenly from massive myocardial infarction due to extensive old thrombotic occlusion of a major coronary artery without any appreciable underlying disease of the vessel wall. Exercise testing is considered to be advisable in symptomatic patients with normal coronary angiograms and attention to the venous phase might be informative. The second new case occurred in a child with an atrial septal defect and complete transposition of the great arteries, who died aged 1 month. PMID- 6508966 TI - Athlete's bradycardia as an embolising disorder? Symptomatic arrhythmias in patients aged less than 50 years. AB - One hundred and sixty consecutive patients less than 50 years of age (mean 38 years) referred for long term electrocardiographic recording were evaluated retrospectively. Significant cardiac arrhythmias were detected in 51 of 107 (48%) patients examined because of syncope or dizzy spells or both. Of 39 patients examined for cardiac complaints or presumed complex arrhythmias, 15 (38%) had significant arrhythmias. Of 14 patients examined because of otherwise unexplained strokes, nine had slow sinus rates. Of these, one patient had recently undertaken moderately intensive athletic activity and four had been undertaking vigorous athletic activities for several years. All of the 12 active athletes who were followed up on account of syncope or dizzy spells were free of symptoms after reducing their athletic activities. The cardiac rhythm returned to normal in four out of five who underwent repeat long term electrocardiographic recording. It is suggested that vigorous athletic activity in subjects of 30-50 years of age may transform the adaptative bradycardia of the athlete into a condition similar to the embolising sick sinus syndrome. PMID- 6508968 TI - Pathology of the heart and the cardiac conduction system in Wegener's granulomatosis. AB - Two cases of Wegener's granulomatosis occurred in two women aged 53 and 67 years. The clinical course in both was of rapid deterioration resulting from renal failure and leading to death. At necropsy both cases showed severe and disseminated necrotising granulomatosis in the lungs, kidneys, and spleen but with variable degrees of cardiac and systemic vasculitis. One patient, with appreciable cardiac damage, developed a P wave abnormality due to atrial disease. In patients with Wegener's granulomatosis damage to the heart should be suspected and signs of conduction system abnormalities looked for on the electrocardiogram. PMID- 6508967 TI - Cardiac performance in various stages of renal failure. AB - Cardiac catheterisation was performed to evaluate cardiac function in 12 patients with various stages of renal failure. All patients were studied at rest and during supine exercise to subjective exhaustion. Eight patients had a normal arteriovenous oxygen difference at rest and during exercise whereas three had a low arteriovenous oxygen difference and one a high arteriovenous oxygen difference. Left ventricular stroke work did not increase normally at transition from rest to exercise in most patients with serum creatinine concentrations greater than 500 mumol/l. The left ventricular end diastolic pressure was abnormally raised during exercise in all patients (range 20-42 mm Hg) and also at rest in most of them (range 8-36 mm Hg), indicating myocardial dysfunction. These observations suggest that patients have abnormal cardiac performance at a relatively early stage of renal failure. PMID- 6508969 TI - Behcet's syndrome presenting as myocardial infarction with impaired blood fibrinolysis. AB - A 34 year old man with no known coronary risk factors presented with acute myocardial infarction. Shortly after admission, and over the next eight years, he had recurring clinical features consistent with a diagnosis of Behcet's syndrome. Coronary angiograms recorded six months after infarction were normal. Although he was well with maintenance steroid treatment, blood fibrinolysis was impaired. Myocardial infarction has not previously been reported as a presenting feature of the syndrome. PMID- 6508970 TI - Shoshin beriberi: a rare diagnostic problem. PMID- 6508971 TI - Prevalence of coronary artery disease in patients with isolated aortic valve stenosis. PMID- 6508972 TI - Clinical anaesthesia with isoflurane. A review of the multicentre study. AB - Following its approval for use in man, an unblinded, unrandomized epidemiological study of isoflurane anaesthesia was undertaken in the United States and Canada. The haemodynamic and reflex behaviour of 6798 patients were compared with their demographic characteristics and the anaesthetic drugs used. The decrease in arterial pressure and the increase in heart rate during isoflurane anaesthesia were confirmed. Intraoperative arrhythmias were most often associated with a history of similar arrhythmia before operation, as well as the occurrence of intraoperative hypertension. Airway reflexes were the predominant form of reflex activity identified, with coughing being the most frequently observed reflex. Serious complications were infrequent, and were unrelated to the use of isoflurane as the anaesthetic agent. The safety and efficacy of isoflurane anaesthesia in man was confirmed. PMID- 6508973 TI - Physical and chemical properties of anaesthetic agents (with an appendix on the manufacture of isoflurane). AB - The physical and chemical requirements of today's modern inhalation anaesthetic agents have resulted in the production of compounds that closely approach those of the ideal agent. As medical science develops and defines the need for better drug characteristics, the complexity of the research problems for the organic chemist is intensified. Many of the inhalation anaesthetic agents in use 30 yr ago would not pass a clinical investigator screen today, and would be rejected as inhalation anaesthetic agents. An outline of the manufacture of isoflurane is given as an Appendix to this paper. PMID- 6508974 TI - Plasma disposition of vitamin K1 in relation to anticoagulant poisoning. AB - The disposition of vitamin K1, after intravenous (10 mg) and oral doses (10 mg and 50 mg) was studied in six healthy male subjects. After intravenous administration, the plasma concentration-time profile was adequately fitted with an average terminal half-life of 1.7 h. After oral administration (10 mg and 50 mg) the availability of vitamin K showed marked inter-individual variation (10 63%). With the higher dose intra-individual variation was also observed. Experiments in brodifacoum-anticoagulated rabbits demonstrate that the duration of action of a pharmacological dose (10 mg/kg) is short (9 h) and that high plasma concentrations (ca 1 microgram/ml) of the vitamin are required to drive clotting factor synthesis during maximum coumarin anticoagulation. Taken collectively, these data indicate that the short duration of action of vitamin K, frequently observed in cases of coumarin poisoning, is a consequence of requirements for high vitamin K concentrations and rapid clearance of the vitamin. PMID- 6508975 TI - Do gastric contents modify antidotal efficacy of oral activated charcoal? AB - The effect of food on the antidotal efficacy of activated charcoal was studied in six healthy volunteers, who ingested aspirin 1000 mg, mexiletine 200 mg and tolfenamic acid 400 mg in a randomized cross-over study. Activated charcoal 25 g, suspended in water, was administered 5 min or 60 min after the drugs were taken on an empty stomach or after a standard meal. The serum concentrations and the cumulative excretion into urine of the drugs were followed for 48 h. When the drugs were taken on an empty stomach, activated charcoal given 5 min or 60 min afterwards reduced the bioavailability of the drugs by 75-98% or 10-60%, respectively. Food moderately weakened the effect of activated charcoal administered 5 min after the drugs, but when the charcoal was given 1 h later the effect was still practically the same, the reduction of absorption varying in both cases in the range of 45-85%. Thus the efficacy of charcoal given 60 min after the drugs was better after a standard meal than on an empty stomach. Presence of food in the stomach of patients with drug overdosage modifies the efficacy of activated charcoal and gives it more time to adsorb drugs in the gastrointestinal canal, possibly by slowing gastric emptying rate. PMID- 6508976 TI - Ethosuximide in epileptic women during pregnancy and lactation period. Placental transfer, serum concentrations in nursed infants and clinical status. AB - A total of 10 epileptic mothers treated with ethosuximide (ES) as well as their 13 newborns were included in this study. At birth foetal/maternal serum concentration ratios were 0.97 +/- 0.02 (n = 7) and ES half-lives in three neonates were 32, 37 and 38 h. The breast milk concentrations of ES were similar to those in maternal serum (milk/serum: 0.86 +/- 0.08, n = 12) and the nursed infants maintained serum levels between 15 and 40 micrograms/ml. Two major malformations (bilateral clefting, hare-lip) were observed in two neonates whose mothers received either ES/PB or ES/PMD comedication. The number of minor anomalies was higher in the ES group (6.2, n = 12) than in the pair-matched control group of infants born to non-epileptic mothers (2.1, n = 10). Neonatal behaviour complications occurred in seven infants, two of them were severely affected. PMID- 6508977 TI - Pharmacokinetics and efficacy of high-dose metoclopramide given by continuous infusion for the control of cytotoxic drug-induced vomiting. AB - To avoid the accumulation of metoclopramide that occurs with repeated i.v. bolus doses, a new regimen for the administration of high-dose metoclopramide consisting of a loading dose followed by a continuous infusion was investigated to determine the pharmacokinetics and antiemetic efficacy of the drug when given in this manner. Nine patients with non-Hodgkin's lymphoma entered the study, of whom six completed the study, receiving each of three dosage schedules of metoclopramide during three consecutive courses of chemotherapy. In these six patients plasma metoclopramide half-life was 5.9 +/- 0.4 h (mean +/- s.e. mean) and plasma clearance was 25.4 +/- 4.8 l/h (mean +/- s.e. mean). Neither half-life nor clearance were dose-related. Steady-state was achieved during 9/18 infusions. Nausea and vomiting were completely controlled in 13/24 treatment courses (57%) and adverse effects were minimal. We conclude that steady-state plasma concentrations of metoclopramide can be achieved using a weight-related infusion regimen, though the optimum plasma concentration remains to be determined. PMID- 6508978 TI - Estimation of gentamicin clearance and volume of distribution in neonates and young children. AB - Gentamicin therapy should be guided by serum level monitoring in all age groups, dosage adjustments depending on age related changes in pharmacokinetics. Population data analysed from two centres (43 infants from Glasgow and 100 infants and children from Manchester) by the computer program NONMEM showed that volume of distribution was related to body weight by a proportionality factor that decreased from the region of 0.41-0.46 l/kg in children less than 3 months to 0.25-0.32 l/kg in older children, a value which merges with that accepted for adults (0.25 l/kg). In both young and older children, clearance was also found to be dependent on body weight. Renal function (creatinine concentrations) provided no further explanatory power. When these results were used prospectively to forecast gentamicin concentrations with a Bayesian kinetic parameter estimation program, trough concentrations were more precisely predicted than peaks when a single concentration measurement was used. In clinical practice, however, two concentration measurements are usually routinely available and these should lead to greater precision of both peak and trough predictions. These results have been incorporated into a simple nomogram which can be used to determine a dose of gentamicin which will achieve target peak concentrations in infants, assuming that troughs should not exceed 2 micrograms/ml. PMID- 6508979 TI - Influence of rifampicin treatment on antipyrine clearance and metabolite formation in patients with tuberculosis. AB - The influence of an 8-day therapy with rifampicin (600 mg daily) was studied on antipyrine plasma clearance and metabolite formation in seven patients with tuberculosis (age 18-79 years), who were also treated with isoniazid and pyrazinamide. After rifampicin treatment the elimination half-life of antipyrine had decreased in all patients from 12.9 +/- 5.0 to 8.8 +/- 2.0 h (P less than 0.05). Antipyrine clearance had increased from 2.2 +/- 0.9 to 2.9 +/- 0.7 l/h (P less than 0.05), while no change in apparent volume of distribution was observed. The increase in antipyrine clearance was primarily due to a selective increase in the rate of formation of norantipyrine by 80% from 6.9 +/- 3.4 to 12.4 +/- 3.4 ml/min. Rifampicin seems to induce preferentially the cytochrome P-450 (iso-) enzyme(s) involved in the demethylation of antipyrine to norantipyrine. Other pathways of antipyrine metabolism were hardly affected. This provides further evidence for the involvement of different iso-enzymes of the cytochrome P-450 system in antipyrine metabolism in man. PMID- 6508980 TI - Antipyrine clearance and metabolite formation in patients with alcoholic cirrhosis. AB - The effect of liver cirrhosis on plasma clearance and metabolite profile of i.v. administered antipyrine was studied in 23 patients with alcoholic liver cirrhosis (age 37-70 years) and 17 healthy subjects (age 28-55 years). Liver volume was also measured and was found to be larger in patients than in controls, mean values being 1.86 and 1.36 l respectively. The elimination half-life of antipyrine in patients with alcoholic liver cirrhosis was significantly longer than in the healthy subjects (P less than 0.001). Mean values were 39.9 and 10.1 h respectively. Alcoholic liver cirrhosis had no effect on the apparent volume of distribution of antipyrine, but antipyrine plasma clearance was substantially reduced in the patients. Mean clearance values (ranges) were 13.5 (9.3-22.8) ml/min in the patients and 49.3 (31.1-103) ml/min in healthy subjects. Normalization of antipyrine plasma clearance for liver volume resulted in an only slightly increased distinction between patients and healthy subjects, mean values (ranges) being 7.8 (3.3-13.0) ml min(-1) 1(-1) and 36.1 (21.9-35.9) ml min(-1) 1( 1) respectively. The cumulative renal excretion of 4-hydroxyantipyrine (OHA) and norantipyrine (NORA) was significantly lower in patients with alcoholic liver cirrhosis than in healthy subjects, as was the total recovery of antipyrine and major metabolites from urine. Mean values were 15.0, 8.4 and 41.2% of dose in the patients respectively and 24.3, 25.8 and 68.9% of dose in the control subjects. Excreted amounts of total and unconjugated 3-hydroxymethylantipyrine (HMA) and of unchanged antipyrine were the same in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508981 TI - Haemodynamic dose-response effects of i.v. nicardipine in coronary artery disease. AB - The haemodynamic dose-response effects of the slow channel blocking agent nicardipine were evaluated in 10 male patients with angiographically confirmed coronary artery disease. At rest, following a similar control saline period, four doses of the drug (log cumulative dosage: 1.25, 2.5, 5.0 and 10.0 mg) were administered by i.v. infusion over a total duration of 40 min; haemodynamic variables were recorded in the 3-5 min following each 5 min infusion. During steady-state exercise the haemodynamic effects of the drug were evaluated by comparison of a control exercise period with observations made at the same workload (200-500 kpm) following the maximum cumulative dose (10 mg). Following the four i.v. infusions, the plasma nicardipine level increased log-linearly with the infused dose (r = 0.68). Compared with control measurements at rest after saline, these plasma concentrations (35 +/- 8 to 141 +/- 24 micrograms/l) resulted in a linear decrease in systemic blood pressure and vascular resistance with significant increase in cardiac index (maximum delta CI + 1.6 l min(-1) m( 2); P less than 0.01), stroke index (maximum delta SI + 11 ml/m2; P less than 0.01) and in pulmonary artery occluded pressure (maximum delta PAOP + 2 mm Hg; P less than 0.01). There was a significant increase in heart rate; the stroke work index was unchanged. During upright bicycle exercise the reduction in systemic blood pressure was accompanied by an increased exercise cardiac output without change in stroke index. The exercise pulmonary artery occluded pressure was unchanged compared with control observations, the stroke work index fell significantly (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6508982 TI - Stereoselective first-pass metabolism of highly cleared drugs: studies of the bioavailability of L- and D-verapamil examined with a stable isotope technique. AB - The pharmacokinetics of dextro(+)- and levo(-)-verapamil were studied in five healthy volunteers following oral administration of pseudoracemic verapamil containing equal amounts of unlabelled (-)- and dideuterated (+)-isomer. (+) verapamil exhibited approximately five times greater Cmax (+): 240 +/- 81.1 ng/ml, (-): 46.1 +/- 15.7 ng/ml, P less than 0.0001) and AUC than (-)-verapamil. The apparent oral clearance (CLo) for (+)-verapamil was significantly smaller than that for (-)-verapamil (+): 1.72 +/- 0.57 l/min, (-): 7.46 +/- 2.16 l/min, P less than 0.001). The bioavailability of (+)-verapamil (50%) was 2.5 times greater than that of (-)-verapamil (20%), P less than 0.005). Thus following oral administration verapamil exhibited a stereoselective first-pass metabolism. Neither tmax nor the elimination t1/2,z were different between the isomers. The elimination of t1/2,z for each verapamil isomer obtained following oral administration (+): 4.03 h, (-): 5.38 h) were similar to those previously obtained following intravenous administration (+): 4.15 h, (-): 5.38 h, respectively. Whereas the (+)- to (-)-verapamil plasma concentration ratio following oral administration was 4.92 +/- 0.48, the ratio following i.v. administration was approximately 2. (-)-verapamil has been demonstrated to possess 8 to 10 times more potent negative dromotropic effect on AV conduction than (+)-verapamil. Therefore, following oral administration the same concentration of plasma verapamil consisting of a two to three times smaller proportion of the more potent (-)-isomer appeared to be less potent than that following i.v. administration with regard to the negative dromotropic effects on the AV conduction. PMID- 6508983 TI - Stereoselective ring oxidation of propranolol in man. AB - The objective of this study was to elucidate stereoselective mechanisms of propranolol metabolism in man. Five normal subjects were given single 80 mg oral doses of deuterium-labeled pseudoracemates of propranolol, and the stereochemical composition of propranolol and its major metabolites in urine was determined by GC/MS. The (-)/(+)-enantiomer ratios for unchanged propranolol, 1.50 +/- 0.10 (mean +/- s.e. mean), and propranolol glucuronide, 1.76 +/- 0.10, were similar to previous findings in plasma. All products of side-chain oxidation also consisted mainly of the (-)-enantiomer, with an overall (-)/(+) ratio of 1.61 +/- 0.11. A ( )/(+) ratio of 1.04 +/- 0.17 for 4-hydroxypropranolol did not indicate stereoselectivity in ring oxidation. However, the ratio for its glucuronic acid conjugate of 1.78 +/- 0.19 and for its sulphate conjugate of 0.27 +/- 0.03 suggested stereoselectivity in either the glucuronidation or sulphation of 4 hydroxypropranolol, or both. When the stereoselectivity in these secondary pathways was taken into consideration, the overall ring oxidation strongly favoured (+)-propranolol with a (-)/(+)-enantiomer ratio of 0.59 +/- 0.09. The composite observations of the stereochemistry of propranolol metabolism in man are consistent with stereoselective ring oxidation of (+)-propranolol, leading to a greater bioavailability of the pharmacologically more active (-)-propranolol and subsequent preferential side-chain oxidation and glucuronidation of this enantiomer. PMID- 6508984 TI - Tissue extraction of amiodarone and N-desethylamiodarone in man after a single oral dose. AB - The hepatic extraction of amiodarone and N-desethylamiodarone has been investigated in seven patients following catheterization of the portal and hepatic veins under general anaesthesia. Amiodarone (600 mg) was administered orally 4 h before regional blood sampling. Concentrations of amiodarone and N desethylamiodarone, determined by h.p.l.c., were about twice as high in the portal vein compared with those in the hepatic vein, the calculated hepatic extraction ratios of both compounds being 0.39 +/- 0.07 and 0.34 +/- 0.03, respectively. The presence of N-desethylamiodarone in the portal vein in higher concentrations than in the hepatic vein strongly suggests that N-dealkylation of amiodarone occurs in the gut wall or lumen, a finding which might account for the low and highly variable intersubject amiodarone bioavailability. PMID- 6508985 TI - Indobufen interacts with the sulphonylurea, glipizide, but not with the beta adrenergic receptor antagonists, propranolol and atenolol. AB - This study assessed the possible interactions of the cyclooxygenase inhibitor indobufen with one sulphonylurea, glipizide, and with two beta-adrenoceptor antagonists, one of which is extensively metabolised already in the first passage through the liver (propranolol) while the other essentially escapes biotransformation (atenolol). Indobufen was first given as a single 200 mg dose and then for a 5 day period in a dosage of 200 mg twice daily, to six healthy volunteers. Glipizide (5 mg), propranolol (80 mg) and atenolol (100 mg) were given as single doses before and during indobufen medication. The drug concentrations were measured by selective and sensitive h.p.l.c. methods. The findings suggest that the lipophilic acid indobufen can inhibit the metabolic inactivation of another lipophilic acid, glipizide, but does not interfere with the disposal of the two basic drugs, propranolol and atenolol. The increased glipizide concentrations following indobufen were associated with an enhanced blood glucose reduction. Hence, this interaction may be clinically relevant. PMID- 6508986 TI - Relationship between alpha 1-acid glycoprotein and plasma binding of disopyramide and mono-N-dealkyldisopyramide. AB - Highly purified serum albumin did not bind either disopyramide (DP) or mono-N dealkyldisopyramide (MND). The unbound fraction of DP and MND in highly purified serum alpha 1-acid glycoprotein (AAG) at 0.5 g/l was 57 and 62 and at 2.0 g/l 19 and 30% respectively. Unbound DP and MND were measured in spiked plasma (10 mumol/l of DP or MND), from 60 patients, having AAG concentrations varying from 0.4 to 3.0 g/l. Unbound drug varied from 13 to 58 and from 24 to 62% for DP and MND, respectively, and was inversely related to the plasma concentration of AAG (r = -0.9016, r = -0.9157). A linear relationship was found between the binding ratio (moles bound divided by moles unbound) and the plasma concentration of AAG for both DP (r = 0.9199) and MND (r = 0.9270), whereas no relationship was found between the binding ratios of DP or MND and the plasma concentrations of total protein, albumin, haptoglobin, alpha 1-antitrypsin or the immunoglobulins IgG, IgA or IgM. In patients on DP maintenance therapy, a linear relationship was found between percent unbound DP and the plasma concentration of DP in samples with similar AAG concentrations. Furthermore, a linear relationship was found between the binding ratio of DP and the plasma concentration of AAG in samples with similar DP concentrations. The present findings support the concept that AAG is the major serum protein responsible for the binding of DP and MND. PMID- 6508987 TI - The protein binding of timegadine determined by equilibrium dialysis. AB - The protein binding of timegadine to albumin, serum, plasma and plasma enriched with the acute phase reactants alpha 1-acid glycoprotein, alpha 1-anti-trypsin and C-reactive protein was determined by equilibrium dialysis. The effects of other analgesic and anti-inflammatories (indomethacin, ketoprofen, paracetamol and sodium salicylate) and other basic drugs (disopyramide, lignocaine, propranolol and quinidine) on the binding of timegadine were also determined. Timegadine binding was concentration-dependent up to 0.5 micrograms/ml, but independent above this level up to 10.0 micrograms/ml, the mean and standard error being 93.8 +/- 0.5%. Albumin accounted for only 32.4% of timegadine bound to plasma. Plasma enrichment with the acute phase reactants led to significant increases in timegadine binding. Simultaneous dialysis with other drugs caused significant decreases in timegadine binding. PMID- 6508988 TI - The effect of omeprazole on gastric emptying in patients with duodenal ulcer disease. AB - The effect of a single oral dose of omeprazole (90 mg) on gastric emptying was assessed with a dual isotope scintigraphic technique in eight patients with a history of duodenal ulcer disease. Omeprazole had no significant effect on solid or liquid gastric emptying. The bioavailability (AUC0-2 h) of omeprazole in all patients was greater than that required for total suppression of acid secretion. No adverse clinical or laboratory effects were observed. PMID- 6508989 TI - Nicotine from cigarette smoking enhances clonidine-induced increase of serum growth hormone concentrations in men. AB - In order to determine whether nicotine exerts its stimulant effect on serum concentrations of growth hormone (GH) by interacting with an adrenergic pathway, we evaluated the effect of cigarette smoking on the response of GH to the administration of clonidine, a specific alpha-adrenoceptor agonist. In six normal volunteers, clonidine significantly increased serum levels of GH. When subjects smoked two non-filter cigarettes, GH response to the alpha-adrenoceptor agonist was greatly enhanced. These findings suggest that in man nicotinic cholinergic and adrenergic mechanisms might interact in the stimulation of GH secretion. PMID- 6508990 TI - Alpha 1-acid glycoprotein concentrations and propranolol binding in elderly patients with acute illness. AB - Alpha 1-acid glycoprotein (AAG) concentrations and propranolol binding were investigated in the serum of elderly hospitalized patients with acute illness, and healthy elderly and young subjects. Significantly greater AAG concentrations and reduced unbound propranolol fraction were observed in the elderly with acute disease compared to the elderly controls. The greatest changes (up to five-fold) occurred with cancer, with lesser changes associated with myocardial infarction and ischaemic heart disease, acute infection, heart failure, chronic obstructive respiratory disease, and cerebrovascular accident. Various miscellaneous conditions were also associated with high AAG concentrations and enhanced propranolol binding. The healthy elderly had higher AAG concentrations and lower unbound propranolol fractions than the healthy young group. Overall there was a highly significant correlation between the propranolol binding ratio (bound/free) and the serum AAG concentration. These results suggest that the elderly population may be particularly susceptible to changes in AAG concentrations, and that during acute illness interpretation of serum concentrations of drugs which bind mainly to AAG, may require knowledge of their free fractions. PMID- 6508991 TI - The costs of using trained and supervised volunteers as part of a speech therapy service for dysphasic patients. PMID- 6508992 TI - Speech therapy in Parkinson's disease: a study of the efficacy ad long term effects of intensive treatment. PMID- 6508993 TI - The teaching of tones to children with profound hearing impairment. PMID- 6508994 TI - Detecting abnormal auditory behaviours in infancy: the relationship between such behaviours and linguistic development. PMID- 6508995 TI - Acoustic measurement of voice quality in dysphonia after severe closed head trauma: a follow-up study. PMID- 6508996 TI - The mathematical achievements of deaf children from different educational environments. PMID- 6508997 TI - The effect of pictures on the acquisition of a small vocabulary of similar sight words. PMID- 6508998 TI - The transferability of two pictorial scientific tasks between different spatial dimensions. PMID- 6508999 TI - A portable instrument for quantifying erythema induced by ultraviolet radiation. AB - The design and performance of an instrument for quantifying ultraviolet-induced cutaneous erythema are discussed. If the instrument is used to record an 'erythema index' at a site on the skin before and after irradiation, the difference between those two readings is essentially related to an increase in vasodilation and is largely independent of the melanin content of the epidermis. PMID- 6509000 TI - Quantitative studies on cutaneous erythema induced by ultraviolet radiation. AB - A reflectance instrument was used to measure the variation in UVR-induced erythema at different positions on the back. The pre-irradiation erythema index decreased from top to bottom of the back but the increase in index remained constant for a fixed exposure dose. In contrast, the minimal erythema dose was higher at lower sites on the back. The measured erythemal response increased linearly with the logarithm of the radiation dose from approximately the minimal erythema dose up to at least fifteen times this value. PMID- 6509001 TI - Migration and mitosis in the epidermis. PMID- 6509002 TI - British Society for Investigative Dermatology annual meeting. University of Keele, September 1984. Abstracts. PMID- 6509003 TI - Migration and mitosis in the epidermis. PMID- 6509005 TI - Some algebraic properties of the Reticular Action Model for moment structures. PMID- 6509004 TI - The prevalence of water-induced itching. PMID- 6509006 TI - A low cholesterol Christmas. PMID- 6509007 TI - Ocular changes in patients undergoing long-term desferrioxamine treatment. AB - In a group of young patients with thalassaemia and iron overload treated by subcutaneous infusions of desferrioxamine we have found a number of minor alterations in retinal function. The incidence of such changes is not related to drug dosage or to ferritin level but to abnormality of the extended glucose tolerance test. PMID- 6509008 TI - Pattern and Ganzfeld electroretinograms in macular disease. AB - The pattern electroretinogram has been found to be abnormal in all except three cases of maculopathy. This is in contrast to other electrophysiological tests, which are frequently unaffected. The degree of reduction is related to the loss of visual acuity. The response to focal flashes is less affected than the response to pattern. PMID- 6509009 TI - Low-contrast letter charts in early diabetic retinopathy, ocular hypertension, glaucoma, and Parkinson's disease. AB - Diabetes can cause visual loss that is not detected by standard reading tests such as the Snellen test but can be detected by low-contrast letter charts. This visual loss is quite different from loss caused by refractive error. These low contrast charts are diagnostically at least as sensitive as the sinewave grating contrast sensitivity test. They are inexpensive, and the test is brief and simple. Preliminary evidence is that patients with diabetes who have abnormal low contrast chart results give abnormal intravenous fluorescein (IVF) test results, even though visual acuity is normal. Low-contrast charts also detect visual loss in patients with ocular hypertension, glaucoma, and Parkinson's disease, including patients with normal visual acuity. PMID- 6509010 TI - Ocular side effects of disopyramide. AB - A patient who suffered from severe decrease of accommodation and pupillary dilatation following the systemic use of disopyramide is described. The ocular side effects when this drug is used in large doses result from its anticholinergic action. PMID- 6509011 TI - Granulomatous conjunctivitis in a patient with Crohn's disease. AB - A 13-year-old boy with severe, active granulomatous ileocolitis presented with bilateral conjunctival nodules and infiltrates, iritis, and uniocular corneal infiltrates. Gastrointestinal biopsy revealed deep focal ulcers of the bowel wall with adjacent granulomas. Conjunctival biopsy disclosed non-caseating granulomatous inflammation. PMID- 6509012 TI - Purification and sequence of a presynaptic peptide toxin from Conus geographus venom. AB - A novel toxin, omega-conotoxin (omega-CgTX), from the venom of the fish-eating marine mollusc Conus geographus has been purified and biochemically characterized. Recently, this omega-conotoxin has been shown to inhibit the voltage-activated entry of Ca2+, thus providing a potentially powerful probe for exploring the vertebrate presynaptic terminal [Kerr, L. M., & Yoshikami, D. (1984) Nature (London) 308, 282-284]. The toxin is a basic 27 amino acid peptide amide with three disulfide bridges. An unusual feature is a remarkable preponderance of hydroxylated amino acids. The sequence of omega-CgTx GVIA is Cys Lys-Ser- Hyp-Gly5-Ser-Ser-Cys-Ser-Hyp10-Thr-Ser-Tyr-Asn-Cys15-C ys-Arg-Ser- Cys Asn20-Hyp-Tyr-Thr-Lys-Arg25-Cys-Tyr-NH2. PMID- 6509013 TI - Amino-terminal arm of the lambda repressor: a 1H NMR study. AB - The N-terminal arm of the lambda repressor is shown to be flexible in solution by one- and two-dimensional 1H NMR methods. In particular, the relaxation of Thr-2 is largely independent of macromolecular tumbling. The conformation of the operator-binding domain is not affected by the removal of the first three residues nor by a point mutation, Lys-4----Gln. These results support a proposed model of the lambda repressor-operator complex in which the N-terminal arm of the repressor is assumed to be flexible and to wrap around the operator double helix. PMID- 6509014 TI - Reconstitution of nativelike nuclear acceptor sites of the avian oviduct progesterone receptor: evidence for involvement of specific chromatin proteins and specific DNA sequences. AB - A specific fraction of avian oviduct chromosomal proteins can be reannealed to pure avian DNA to reconstitute nativelike specific nuclear binding sites (acceptor sites) for the oviduct progesterone receptor (PR). These specific nuclear binding sites represent the difference between the binding to the reconstituted NAP and that to pure DNA. The specific fraction of chromatin protein which contains the acceptor activity, fraction CP-3, is very tightly bound to hen DNA in a complex termed nucleoacidic protein (NAP). Removal of the CP-3 fraction from NAP results in a loss of specific PR binding sites. Resins containing chromatin adsorbed to hydroxylapatite are used as a rapid method to isolate the CP-3 fraction. Reconstitution of the CP-3 fraction to DNA by the described method involving a regressing gradient of 6-0 M guanidine hydrochloride (Gdn-HCl) results in a reconstituted NAP which displays specific PR binding sites identical with those in native (undissociated) NAP and whole chromatin. Optimal conditions and potential problems for reconstituting these nucleoproteins are described. Only partially purified receptor preparations were used in these cell free binding analyses since they have been shown to bind with similar properties and patterns as the nuclear binding in vivo. Therefore, the binding of PR to the reconstituted NAPs was demonstrated to be receptor dependent, saturable, and of high affinity. Further, the pattern of binding to the reconstituted sites mimics those which are observed in vivo. Thus, nonfunctional receptors that cannot translocate and bind to the nuclear acceptor sites in vivo also failed to bind to the acceptor sites on the reconstituted NAPs generated by the acceptor proteins. In contrast, the binding to pure DNA does not reflect these receptor differences in receptor bindings. Specific binding of PR to reconstituted NAP can be reversed by again removing the protein fraction. Moreover, the specific binding can be destroyed by proteases and protected by protease inhibitors, indicating that acceptor activity is proteinaceous in nature. The reconstitution of the activity is both a concentration-dependent and time-dependent process. During the reconstitution, acceptor activity appears to reconstitute on the DNA when the Gdn HCl concentration reaches 2.0 M. By use of the reconstitution method as an assay for acceptor activity, the activity in the CP-3 fraction was shown by molecular sieve chromatography to elute in a relatively broad molecular weight range between 13 000 and 25 000. The activity also focuses in isoelectric focusing resins with apparent pI's of 5.2 and 6.4.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 6509015 TI - Substrate specificities and structure-activity relationships for acylation of antibiotics catalyzed by kanamycin acetyltransferase. AB - Antibiotic resistance caused by the presence of the plasmid pMH67 is mediated by the aminoglycoside acetyltransferase AAC(6')-4, also known as kanamycin acetyltransferase. Bacteria harboring the plasmid are resistant to the kanomycins plus a broad range of other deoxystreptamine-containing aminoglycosides but not to the gentamicins XK62-2 and C1 which are substituted at the 6'-position. Substrate specificity studies on the purified enzyme, however, now show that the enzyme acetylates an even broader range of aminoglycosides, including the gentamicins XK62-2 and C1. The enzyme also accepts several acyl-CoA esters, which differ in nucleotide as well as in acyl chain length. Application of the method of analysis of structure-activity data developed earlier for gentamicin acetyltransferase [Williams, J. W., & Northrop, D. B. (1978) J. Biol. Chem. 253, 5908-5914] to the kinetic data obtained for AAC(6')-4 shows that the turnover of the acylation reaction is limited by catalysis and not by the rate of release of either the acetylated antibiotic or CoA. Most structural changes in aminoglycosides cause changes in rates of release, and only drastic changes, near the 6'-amino group, affect catalysis. The structural requirements on aminoglycosides for enzymatic activity run parallel to the structural requirements for antibacterial activity. PMID- 6509016 TI - Reversible self-association of a human myeloma protein. Thermodynamics and relevance to viscosity effects and solubility. AB - Monoclonal IgG paraproteins associated with multiple myeloma, Felty's syndrome, and idiopathic cryoglobulinemia frequently produce disease due to a tendency to self-associate in vivo. The insolubility and viscosity effects of these proteins are of specific interest as molecular disease mechanisms. In sedimentation equilibrium studies at 21 degrees C an IgG1-lambda myeloma protein (IgG-MIT) associated with the hyperviscosity syndrome is shown to undergo a reversible polymerization reaction. On the basis of the theory and data-fitting methods of Adams and co-workers [Tang, L. H., Powell, D. R., Escott, B. M., & Adams, E. T., Jr. (1977) Biophys. Chem. 7, 121-139], the data are consistent with a nonideal cooperative indefinite (SEK type III) model self-association in which one equilibrium constant (K12 = 6.3 X 10(3) L/m) governs dimerization while another (K = 1.7 X 10(4) L/m) governs all subsequent additions of monomer to the polymer. Temperature effects on K12 and K between 11 and 30 degrees C suggest negative van't Hoff enthalpies for all association steps and a positive entropy change [delta S degree = 2.5 cal/(mol-deg)] for steps beyond the dimer. An increase in ionic strength from I = 0.03 to I = 0.18 promotes the polymerization of IgG-MIT through a marked increase in K while paradoxically enhancing bulk solubility. These results suggest that this self-association proceeds through a combination of weak nonionic and hydrophobic interactions. The enhancement of both polymerization and solubility by increased ionic strength suggests that the hyperviscosity induced by IgG-MIT results from its ability to form large, highly soluble polymers in serum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509018 TI - Reversible modification of D-beta-hydroxybutyrate dehydrogenase by diamide. AB - D-beta-Hydroxybutyrate dehydrogenase is a lipid-requiring enzyme with a specific requirement of lecithin for function. The purified enzyme devoid of lipid (apodehydrogenase) is inactive but can be reactivated by forming a complex with phospholipid containing lecithin. We find that, of the six half cysteines present in D-beta-hydroxybutyrate dehydrogenase, only two are in the reduced form and available for modification with N-ethylmaleimide, even after denaturation in sodium dodecyl sulfate. Diamide treatment of either the inactive apodehydrogenase or the active enzyme-phospholipid complex resulted in complete loss of enzymic activity, the apodehydrogenase being assayed after addition of phospholipid. The inactivation by diamide can be reversed by the addition of dithiothreitol with full recovery of activity. Derivatization using N-[14C]ethylmaleimide showed that diamide modified only one sulfhydryl per enzyme monomer. The other sulfhydryl appears not to be essential for function since full activity can be restored after this sulfhydryl had been covalently derivatized with N-ethylmaleimide. Protein cross-linking was not observed after diamide modification of D-beta hydroxybutyrate dehydrogenase, indicating that a disulfide bridge was not formed between enzyme subunits. The diamide-modified enzyme retains the ability to bind coenzyme, NAD(H), as detected by quenching of the intrinsic fluorescence of the protein. However, resonance energy transfer from protein to bound NADH and enhancement of NADH fluorescence were not observed, indicating that diamide modification of the protein alters the nucleotide binding site.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509017 TI - Half-site reactivity of an essential thiol group of D-beta-hydroxybutyrate dehydrogenase. AB - D-beta-Hydroxybutyrate dehydrogenase is a lipid-requiring enzyme, which is a tetramer both in the mitochondrial inner membrane and as the purified enzyme reconstituted with phospholipid. For the active enzyme-phospholipid complex in the absence of ligands, we previously found that reaction with N-ethylmaleimide (at 5 mol/mol of enzyme subunit) resulted in progressive loss of enzymic activity with an inactivation stoichiometry of 1 equiv of sulfhydryl derivatized per mole of enzyme and a maximum derivatization of 2 equiv [Latruffe, N., Brenner, S. C., & Fleischer, S. (1980) Biochemistry 19, 5285-5290]. We now find, in the presence of nucleotide or substrate, that the rate of inactivation is significantly reduced, which indicates that these ligands afford protection of the essential sulfhydryl. Further, in the presence of ligands, the inactivation stoichiometry is 0.5, consistent with half-of-the-site reactivity of the essential sulfhydryl. Thus, at a low ratio of N-ethylmaleimide to enzyme, nucleotide or substrate affords essentially complete protection of the nonessential sulfhydryl from derivatization. The binding characteristics of NADH to both the native and N ethylmaleimide-derivatized enzyme have been compared by fluorescence spectroscopy. Quenching of intrinsic tryptophan fluorescence of the protein shows that the enzyme, derivatized with N-ethylmaleimide either in the absence or in the presence of NAD+, binds NADH but with a reduced Kd (approximately 50 microM as compared with approximately 20 microM for native enzyme). However, a critical change has occurred in that resonance energy transfer from protein to bound NADH, observed in the native enzyme, is abolished in the N-ethylmaleimide-derivatized enzyme.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509020 TI - Effect of alpha-methylation on inactivation of monoamine oxidase by N cyclopropylbenzylamine. AB - Monoamine oxidase (MAO) was shown previously [Silverman, R. B., & Hoffman, S. J. (1980) J. Am. Chem. Soc. 102, 7126-7128] to catalyze the oxidation of N cyclopropylbenzylamine (N-CBA) at two sites on the molecule. Oxidation at the benzyl methylene gave benzaldehyde and cyclopropylamine; oxidation of the cyclopropyl group, which involved cyclopropyl ring cleavage, led to inactivation of the enzyme. In this paper it is shown that methylation of the benzyl methylene dramatically alters this partition ratio in favor of enzyme inactivation. Contrary to a previous report [Alles, G., & Heegaard, E. V. (1943) J. Biol. Chem. 147, 487-503], it is shown here that alpha-methylbenzylamine is a substrate for MAO; consequently, N-cyclopropyl-alpha-methylbenzylamine (N-C alpha MBA) is a good candidate for mechanism-based inactivation. N-Cyclopropyl[7-14C]benzylamine, N-cyclopropyl-alpha-methyl[phenyl-14C]benzylamine, N-[1-3H] cyclopropylbenzylamine, and N-[1-3H]cyclopropyl-alpha-methylbenzylamine are synthesized, and product formation following MAO inactivation is quantified. The results obtained with these compounds indicate that with N-C alpha MBA, alpha methylbenzyl oxidation (which produces acetophenone and cyclopropylamine) is only 1% that of cyclopropyl oxidation (which gives enzyme inactivation), whereas with N-CBA the amount of oxidation at the corresponding sites is equal. It also is shown that the Ki values for (R)-(+)- and (S)-(-)-alpha-methylbenzylamine are similar, suggesting that dimethylation of N-CBA should not interfere with binding to MAO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509019 TI - Kinetic mechanism and location of rate-determining steps for aspartase from Hafnia alvei. AB - Coupled spectrophotometric assays that monitor the formation of fumarate and ammonia in the direction of aspartate deamination and aspartate in the direction of fumarate amination were used to collect initial velocity data for the aspartase reaction. Data are consistent with rapid equilibrium ordered addition of Mg2+ prior to aspartate but completely random release of Mg2+, NH4+, or fumarate. In addition to Mg2+, Mn2+ can also be used as a divalent metal with Vmax 80% and a Kaspartate 3.5-fold lower than when Mg2+ is used. Monovalent cations such as Li+, K+, Cs+, and Rb+ are competitive vs. either aspartate or NH4+ but noncompetitive vs. fumarate. A primary deuterium isotope effect of about 1 on both V and V/Kaspartate is obtained with (3R)-L-aspartate-3-d, while a primary 15N isotope effect on V/Kaspartate of 1.0239 +/- 0.0014 is obtained in the direction of aspartate deamination. A secondary isotope effect on V of 1.13 +/- 0.04 is obtained with L-aspartate-2-d. In addition, a secondary isotope effect of 0.81 +/- 0.05 on V is obtained with fumarate-d2, while a value of 1.18 +/- 0.05 on V is obtained by using (2S,3S)-L-aspartate-2,3-d2. These data are interpreted in terms of a two-step mechanism with an intermediate carbanion in which C-N bond cleavage limits the overall rate and the rate-limiting transition state is intermediate between the carbanion and fumarate. PMID- 6509021 TI - Stability of quaternary structure and mode of dissociation of fructosediphosphate aldolase isoenzymes. AB - Using a highly sensitive "subunit exchange" assay, we have studied the relative strengths of interactions between different subunit types (A and C) of fructosediphosphate aldolase and have determined the mode of dissociation of aldolase tetramers in vitro. Interactions between C subunits within C4 tetramers were found to be considerably more resistant to disruption than were interactions between A subunits in A4 tetramers with regard to increasing concentrations of H+, OH-, or urea. Slight dissociation of A4 was also observed in 1.2 M magnesium chloride. These observations suggest that the quaternary structure of aldolase C4 is inherently more stable than that of aldolase A4. Also, the symmetrical heterotetramer A2C2 was found to be more resistant to urea-mediated dissociation than was the aldolase A4 homotetramer; this observation suggests that, even when in heteromeric combination, C subunits have a stabilizing influence on the quaternary structure of aldolase tetramers. In no case did we find evidence for a stable dimeric intermediate in the dissociation of aldolase tetramers to monomers. These observations are considered in terms of the tetrahedral arrangement of subunits in the aldolase tetramer. The general applicability of the subunit exchange assay described here for studying the subunit structure and mode of dissociation of oligomeric enzymes is discussed. PMID- 6509022 TI - Cofilin, a protein in porcine brain that binds to actin filaments and inhibits their interactions with myosin and tropomyosin. AB - Cofilin, a 21 000 molecular weight protein of porcine brain, reacts stoichiometrically with actin in a 1:1 molar ratio. Upon binding of cofilin, the fluorescence of pyrene-labeled actin under polymerizing conditions is changed into the monomer form, irrespective of whether cofilin is added to actin before or after polymerization. Cofilin decreases the viscosity of actin filaments but increases the light-scattering intensity of the filaments. The centrifugation assay and the DNase I inhibition assay demonstrate that cofilin binds to actin filaments in a 1:1 molar ratio of cofilin to actin monomer in the filament and that cofilin increases the monomeric actin to a limited extent (up to 1.1-1.5 microM monomer) in the presence of physiological concentrations of Mg2+ and KCl. Cofilin is also able to bind to monomeric actin, as demonstrated by gel filtration. Electron microscopy showed that actin filaments are shortened and slightly thickened in the presence of cofilin. No bundle formation was observed in the presence of various concentrations of cofilin. The gel point assay using an actin cross-linking protein and the nucleation assay also suggested that cofilin shortens the actin filaments and hence increases the filament number. Cofilin blocks the binding of tropomyosin to actin filaments. Tropomyosin is dissociated from actin filaments by the binding of cofilin to actin filaments. Cofilin was found to inhibit the superprecipitation of actin-myosin mixtures as well as the actin-activated myosin ATPase. All these results suggest that cofilin is a new type of actin-associated protein. PMID- 6509023 TI - Deoxyguanosine nucleotide analogues: potent stimulators of microtubule nucleation with reduced affinity for the exchangeable nucleotide site of tubulin. AB - Four analogues of guanosine 5'-triphosphate (GTP) (dGTP, 3'-deoxy-GTP, arabinosyl GTP, and 2',3'-dideoxy-GTP), which support more rapid and extensive microtubule assembly than GTP, were hydrolyzed more rapidly than GTP in reaction mixtures containing tubulin plus microtubule-associated proteins (MAPs). As with GTP, hydrolysis of the four analogues was initially closely coupled to the onset of polymerization and continued at a slower rate at the turbidity plateau. Relative to GTP, however, these analogues (and the cognate GDP analogues), particularly 3' deoxy-GTP and 2',3'-dideoxy-GTP, bound poorly to tubulin and had a reduced ability to displace bound radiolabeled GDP under nonpolymerizing reaction conditions. Despite their reduced binding to the tubulin dimer, if polymerization occurred, all four analogues were incorporated into microtubules (as the diphosphates) in stoichiometric amounts comparable to the incorporation of GTP (in the form of GDP) with displacement of the GDP initially present in the exchangeable site. Microtubule nucleation was specifically enhanced in the presence of the analogues. With MAPs the analogues initiated microtubule assembly at temperatures 10-15 degrees C below that required by the GTP-supported reaction, and the average microtubule length was significantly reduced. In addition, MAP-independent polymerization occurred only with 2',3'-dideoxy-GTP with tubulin at 1.0 mg/mL, with the other three analogues at 2.0 mg/mL, and with GTP at 5.0 mg/mL. GTP inhibited analogue-supported polymerization at 20 degrees C with MAPs and at 37 degrees C without MAPs (tubulin, 3.5 mg/mL). Both 3'-deoxy GTP and 2',3'-dideoxy-GTP were poor inhibitors of GTP binding and hydrolysis, but GTP potently inhibited the more vigorous hydrolysis of these analogues. We conclude that alteration of the ribose moiety reduces the affinity of a guanine nucleotide for the exchangeable site of tubulin but that a nucleotide's affinity for this site is not the major factor in its ability to support the nucleation of tubulin polymerization. PMID- 6509024 TI - Effect of surface composition on triolein hydrolysis in phospholipid vesicles and microemulsions by a purified acid lipase. AB - Sonicated dispersions of egg yolk phosphatidylcholine and triolein as vesicles and microemulsions have been used as substrates for the assay of a purified acid lipase. Previous studies have also shown that triolein localized in the surface phase of emulsions is the preferred substrate. In this study, we examined enzyme activity following several surface modifications using both vesicles and microemulsions. When the acidic phospholipids phosphatidylserine and phosphatidic acid were incorporated into both vesicles and microemulsions at up to 10 mol % of the total phospholipid, a dose-dependent reduction in the apparent Km was observed. Using the vesicles as substrate, a dose-dependent decrease in Vmax was also observed. Agarose gel electrophoresis was used to verify suspected changes in net particle charge. Analogous inclusion of phosphatidylethanolamine, sphingomyelin, or cholesterol did not affect kinetic parameters. Addition of oleic acid to sonication mixtures produced vesicles with a decreased apparent Km and Vmax, but triolein hydrolysis in microemulsions was not significantly altered. Triolein-containing vesicles prepared by using dimyristoyl- or dipalmitoylphosphatidylcholine were hydrolyzed maximally at the gel liquid crystalline transition temperatures of the appropriate phospholipid. Differential scanning calorimetry was used to verify the temperatures of transition in these vesicles. The results indicate that acid lipase activity is influenced by the charge or physical state of the surface phase of model substrates and suggest that degradation of core components of naturally occurring substrates such as lipoprotein may be influenced by chemical changes on the surface of these particles. PMID- 6509025 TI - Distances of tyrosine residues from a spin-label hapten in the combining site of a specific monoclonal antibody. AB - The nuclear magnetic resonance spectra of an Fab fragment of a monoclonal antibody specifically directed against a nitroxide spin-label hapten have been recorded at different concentrations of the hapten. The hybridoma producing this antibody was grown on deuterated phenylalanine, tryptophan, and 3,5 dideuteriotyrosine or 2,6-dideuteriotyrosine. Difference spectra--without hapten minus with hapten--were calculated for each concentration of hapten. The difference spectra reveal five well-resolved singlet proton resonance signals from tyrosine deuterated in the 3,5-positions (H 2,6 Tyr) and nine from tyrosine deuterated in the 2,6-positions (H 3,5 Tyr). The measured intensities of these signals as a function of combining site occupation have been interpreted in terms of a theory involving intrinsic line widths (T2), the hapten off-rate (k), and distances to the paramagnetic center. Good agreement with theory is found for all of the isolated proton signals. The best estimate of k is 350 s-1; distances in the range 13 to less than 9 A are calculated. Extension of this analysis to other amino acids is discussed. PMID- 6509026 TI - Interaction of rat liver glucocorticoid receptor with heparin. AB - When rat liver cytosol containing [3H]dexamethasone-glucocorticoid receptor complex is exposed to immobilized heparin (Sepharose-heparin; Seph-hep) the steroid receptor complex binds to the substituted Sepharose avidly [Kd = 3.5 (+/- 1.7) X 10(-10) M], and 80-90% of the receptor present is adsorbed to the solid phase after 40 min at 0 degree C. The binding is enhanced by Mn2+ (10 mM) and Mg2+, whereas Ca2+ and Sr2+ are ineffective. Sodium molybdate (10 mM) does not influence the reaction but enhances receptor stability. Moreover, binding of the receptor to Seph-hep is dependent on the ionic strength of the medium, because binding is totally reversed by 300 mM KCl. The bound [3H]dexamethasone-receptor complex can be recovered from Seph-hep with solutions (4 mg/mL) of heparin (95% release), dextran sulfate (88%), and chondroitin sulfate (63%); total calf liver RNA is less effective (9%), whereas dextran, D-glucosamine, N-acetyl-D glucosamine, D-glucuronic acid, and sheared calf thymus DNA are totally ineffective (less than 3%). Both "native" and temperature "transformed" forms of the glucocorticoid receptor interact with immobilized heparin. These results strongly suggest that the receptor site that binds heparin is distinct from that binding DNA. An immediate application of this newly found ability of the glucocorticoid receptor to interact with heparin is the use of Seph-hep for affinity chromatography purification of the glucocorticoid receptor. A purification of 10-fold, with a recovery of 55-65%, can be achieved by using either 4 mg/mL heparin or 300 mM KCl to elute [3H]dexamethasone-receptor bound to the resin. PMID- 6509027 TI - Hydroperoxides as inactivators of aromatase: 10 beta-hydroperoxy-4-estrene-3,17 dione, crystal structure and inactivation characteristics. AB - The crystal structure of 10 beta-hydroperoxy-4-estrene-3,17-dione (10 beta-OOH) was determined, and its inhibition of human placental aromatase was investigated. In the absence of added NADPH, 10 beta-OOH caused a time-dependent loss of aromatase activity (e.g., 50% loss after 90 s with 2.16 microM 10 beta-OOH). Protection against this loss of activity was provided when a substrate, androstenedione, was included in the incubation. Centrifugation and resuspension of the 10 beta-OOH-treated microsomes in fresh buffer failed to restore the activity, but partial recovery could be effected by dithiothreitol. Experiments to detect destruction of aromatase protoheme were done but were inconclusive. In the presence of NADPH, 10 beta-OOH did not cause a time-dependent loss of activity but was instead a competitive inhibitor (Ki = 330 nM) of androstenedione (Km = 21 nM) aromatization. The added NADPH was not utilized for the aromatization of 10 beta-OOH to estrogens, and enhanced reduction of 10 beta-OOH to 10 beta-hydroxy-4-estrene-3,17-dione could not be detected. In addition, microsomes alone were incapable of using 10 beta-OOH to support the aromatization of androstenedione. Cumene hydroperoxide and H2O2 were also investigated as inactivators of aromatase. Losses of activity comparable to those found for 10 beta-OOH could only be observed at 500-1000-fold higher concentrations of these agents, and no protection was provided by either androstenedione or NADPH. Extensive destruction of microsomal protoheme was found with these nonsteroidal agents. PMID- 6509028 TI - Kinetic mechanism in the direction of oxidative decarboxylation for NAD-malic enzyme from Ascaris suum. AB - Measurement of the initial rate of the malic enzyme reaction varying the concentration of NAD at several different fixed levels of Mg2+ (0.25-1.0 mM) and a single malate concentration gave a pattern which intersects to the left of the ordinate. Repetition of this initial velocity pattern at several additional malate concentrations and treatment in terms of a terreactant mechanism suggests an ordered mechanism in which NAD adds prior to Mg2+ which must add prior to malate. On the other hand, when a broader concentration range of Mg2+ (0.25-50 mM) is used, data are consistent with a random mechanism in which Mg2+ must add prior to malate. By use of product inhibition studies, pyruvate is competitive vs. malate and noncompetitive vs. NAD, while NADH is competitive vs. NAD and noncompetitive vs. malate. These results are consistent with the random addition of substrates and further suggest rapid equilibrium random release of products. Tartronate, a dead-end analogue of malate, is competitive vs. malate and noncompetitive vs. NAD. Thio-NAD is a slow substrate which is used at 2.4% the maximum rate of NAD. When used as a dead-end analogue of NAD, thio-NAD is competitive vs. NAD and gives a complex inhibition pattern vs. malate in which competitive inhibition is apparent at low concentrations of malate (less than 12.5 mM), and this changes to uncompetitive inhibition at high concentrations of malate (greater than 12.5 mM). These data are consistent with a steady-state random mechanism in the direction of oxidative decarboxylation in which Mg2+ adds in rapid equilibrium prior to malate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509029 TI - Determination of dissociation constants for enzyme-reactant complexes for NAD malic enzyme by modulation of the thiol inactivation rate. AB - Incubation of NAD-malic enzyme from Ascaris suum with the sulfhydryl reagents N ethylmaleimide (NEM), 5,5'-dithiobis(2-nitrobenzoic acid) (DTNB), or 4,4' dithiodipyridine (4-PDS) results in rapid and complete loss of malate oxidative decarboxylase and pyruvate reductive carboxylase activities. With DTNB, this loss of activity occurs concomitantly with the modification of about 1 thiol group per subunit. The majority of the activity is lost when 0.5 thiol per subunit is modified, indicative of possible half-site reactivity with DTNB. Complete restoration of activity follows addition of dithiothreitol to enzyme inactivated by DTNB and 4-PDS but not with NEM. With the DTNB-inactivated enzyme, replacement of the thionitrobenzoate moiety with cyanide restores activity. The presence of a divalent metal ion (Mg2+ or Mn2+) results in enhancement of the inactivation rate with all sulfhydryl reagents. However, malate alone or competitors of malate provide protection which is more effective in the presence of Mg2+, while NAD provides only about 25% protection. Thus, the Ascaris suum NAD-malic enzyme has a thiol group probably located in or near the malate binding site, which is not essential for enzyme activity. The changes in the rate of inactivation in the presence of reactants were used to determine the dissociation constants for enzyme-reactant complexes. These data suggest that all three possible binary and all three possible ternary complexes form. The binding of malate to free enzyme exhibits negative cooperativity, which is eliminated by the presence of either NAD or Mg2+.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509030 TI - Purification and characterization of a Ca2+/calmodulin-dependent protein kinase from rat brain. AB - A soluble Ca2+/calmodulin-dependent protein kinase has been purified from rat brain to near homogeneity by using casein as substrate. The enzyme was purified by using hydroxylapatite adsorption chromatography, phosphocellulose ion-exchange chromatography, Sepharose 6B gel filtration, affinity chromatography using calmodulin-Sepharose 4B, and ammonium sulfate precipitation. On sodium dodecyl sulfate (NaDodSO4)-polyacrylamide gels, the purified enzyme consists of three protein bands: a single polypeptide of 51 000 daltons and a doublet of 60 000 daltons. Measurements of the Stokes radius by gel filtration (81.3 +/- 3.7 A) and the sedimentation coefficient by sucrose density sedimentation (13.7 +/- 0.7 S) were used to calculate a native molecular mass of 460 000 +/- 29 000 daltons. The kinase autophosphorylated both the 51 000-dalton polypeptide and the 60 000 dalton doublet, resulting in a decreased mobility in NaDodSO4 gels. Comparison of the phosphopeptides produced by partial proteolysis of autophosphorylated enzyme reveals substantial similarities between subunits. These patterns, however, suggest that the 51 000-dalton subunit is not a proteolytic fragment of the 60 000-dalton doublet. Purified Ca2+/calmodulin-dependent casein kinase activity was dependent upon Ca2+, calmodulin, and ATP X Mg2+ or ATP X Mn2+ when measured under saturating casein concentrations. Co2+, Mn2+, and La3+ could substitute for Ca2+ in the presence of Mg2+ and saturating calmodulin concentrations. In addition to casein, the purified enzyme displayed a broad substrate specificity which suggests that it may be a "general" protein kinase with the potential for mediating numerous processes in brain and possibly other tissues. PMID- 6509031 TI - CO bond angle changes in photolysis of carboxymyoglobin. AB - Previous studies [Chance, B., Fischetti, B., & Powers, L. (1983) Biochemistry 22, 3820-3829] of the local structure changes around the iron in carboxymyoglobin on photolysis at 4 K revealed that the iron-carbon distance increased approximately 0.05 A but was accompanied by a lengthening of the iron-pyrrole nitrogen bonds of the heme (approximately 0.03 A) that was not as large as that found in the deoxy form. Further analysis of these data together with comparison to model compounds indicates that the Fe-C-O bond angle in carboxymyoglobin is bent (127 +/- 4 degrees), having a structure identical, within the error, with the "pocket" porphyrin model compound FePocPiv(1-MeIm)(CO) [Collman, J. P., Brauman, J. I., Collins, T. J., Iverson, B. L., Lang, G., Pettman, R., Sessler, J. L., & Walters, M. A. (1983) J. Am. Chem Soc. 105, 3038-3052]. On photolysis, this angle decreases by 5-10 degrees. In addition, correlation is observed between the increase in the length of the Fe-C bond and the decrease of the Fe-C-O angle. These results suggest that the rate-limiting step in recombination is the thermal motion of CO in the pocket to achieve an appropriate bonding angle with respect to the iron. These changes constitute the first molecular picture of the photolysis process, as well as the structure of the geminate state, and are important in clarifying nuclear tunneling parameters. PMID- 6509032 TI - Assignment of resonances in the 31P NMR spectrum of d(GGAATTCC) by regiospecific labeling with oxygen-17. AB - The chemical synthesis of the octanucleotide d(GGAATTCC) in which each of the phosphate groups is sequentially replaced by an 17O-containing phosphate group using a polymer-supported phosphoramidite method is described. All seven phosphorus resonances in the 31P spectrum of d(GGAATTCC) can be resolved. Assignment of these resonances to a particular phosphate group in the chain is possible because labeling of a phosphate with 17O causes its particular signal to disappear from the spectrum. Phosphate residues toward the middle of the octamer have 31P NMR shifts similar to those found in polydeoxynucleotides, whereas those toward the ends resemble those of dinucleoside phosphates. These data are interpreted in terms of less flexibility of the phosphate groups in the center of the molecule as compared to those at the ends. PMID- 6509033 TI - Measurement of intracellular pH and deoxyhemoglobin concentration in deoxygenated erythrocytes by phosphorus-31 nuclear magnetic resonance. AB - Deoxygenation of erythrocytes produced marked changes in their 31P nuclear magnetic resonance spectra in the superconducting spectrometer. Most significantly, all intracellular and extracellular phosphates underwent downfield shifts. In fully deoxygenated blood the extracellular phosphates showed downfield shifts that were dependent upon packed cell volume, when added pyrophosphate was used as a measure of extracellular chemical shift behavior. This effect on extracellular signals was attributed to the paramagnetic contribution of deoxyhemoglobin to the "bulk" magnetic susceptibility of the red cell suspension. Line broadening was observed in deoxygenated whole cell systems but not in hemolysates, as a result of paramagnetic susceptibility gradients across the cell membrane. The degree of downfield shift upon deoxygenation was of different magnitude for each intracellular phosphate [2-P of 2,3-diphosphoglycerate (2,3 DPG) greater than 3-P of 2,3-DPG greater than inorganic phosphate greater than ATP phosphates], independent of packed cell volume but dependent on the degree of deoxygenation of hemoglobin. When deoxygenation shift effects in adult cells were compared to those of cord blood cells containing 70% fetal hemoglobin, it was found that 45% of the 2,3-DPG shift effects were attributable to binding of that compound to hemoglobin. By use of a nonphysiologic phosphate analogue, methylphosphonate, as an internal reference, it was found that an increase in pH of deoxy cells contributed to the downfield shift of inorganic phosphate. In hemolysates, the methylphosphonate - inorganic phosphate chemical shift difference was found to be pH dependent, with a sensitivity of (-) 0.39 pH unit/ppm, independent of the hemoglobin oxygenation state. PMID- 6509034 TI - Pressure effects on the photocycle of purple membrane. AB - We studied the effects of hydrostatic pressure on the kinetics of the photocycle of purple membrane from Halobacterium halobium. The data were interpreted in terms of a unidirectional and unbranched model. We found that all of the distinct processes of the photocycle are retarded by pressure, with the earlier, fast processes showing less sensitivity to pressure than the later, slow processes. The qualitative similarity of these results with the effects of solvent viscosity on the photocycle kinetics suggests that the primary effects of pressure on the kinetics are via the intrinsic viscosity of the membrane and not via activation volumes. There is a strong quantitative correlation between the pressure effects and the solvent viscosity effects, further supporting this interpretation. We observed a monotonic decrease in the positive absorbance change signal at 640 nm near the end of the photocycle as the pressure is increased. This signal is usually ascribed to the O intermediate, and we interpreted our finding, along with evidence from other experiments, to mean that an ionizable group or groups, such as carboxylic acids, are undissociated and uncharged in O. PMID- 6509035 TI - Acyl chain interdigitation in saturated mixed-chain phosphatidylcholine bilayer dispersions. AB - The molecular packing of various fully hydrated mixed-chain phosphatidylcholines was studied by X-ray diffraction and electron microscopy. All of the mixed-chain phosphatidylcholines under study were shown to adopt a lamellar or bilayer form in aqueous media. The bilayer thickness of these mixed-chain phosphatidylcholines was determined from the lamellar repeat distance in the small-angle X-ray diffraction region by controlled swelling experiments. At T greater than Tm, the bilayer thickness of C(18):C(12)PC and C(18):C-(10)PC is found to be comparable to that of C(14):C(14)PC. In contrast, the bilayer thickness of these highly asymmetric phosphatidylcholines is considerably less than that of the symmetric C(14):C(14)PC at temperatures below Tm. Moreover, the wide-angle X-ray diffraction patterns taken at T less than Tm consist of at least two sharp reflections at 4.2 and 4.6 A. These X-ray diffraction data suggest that these highly asymmetric mixed-chain phospholipids, in excess water, form mixed interdigitated bilayers in the gel state and that the acyl chain packing in the gel-state bilayer is not hexagonal. The freeze-fracture planes of these mixed chain phosphatidylcholines are discontinuous at T less than Tm, supporting the conclusion drawn from X-ray diffraction data that these highly asymmetric phosphatidylcholines form interdigitated bilayers at temperatures below Tm. The molecular packing of fully hydrated C(18):C(14)PCs in bilayers is distinctively different from that of C(18):C(10)PCs or C(18):C(10)PCs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509036 TI - A possible role of cholesterol in membrane adhesion. AB - Calcium phosphate induced membrane aggregation was studied for erythrocyte vesicles and lipid membrane vesicles. The later lipid membrane components were similar in composition to those of erythrocyte membranes. The presence of an appropriate amount of cholesterol is an important factor in the production of the calcium phosphate dependent membrane aggregation. PMID- 6509037 TI - Occurrence of novel antigenic phosphoinositol-containing sphingolipids in the pathogenic yeast Histoplasma capsulatum. AB - Five alkali-stable lipids from the yeast phase of Histoplasma capsulatum have been purified and analyzed. Each compound has equimolar amounts of hydroxysphinganine (phytosphingosine) and a hydroxy or nonhydroxy 24:0 fatty acid. All yield inositol phosphate after acid hydrolysis, and several are novel in that they also yield dimannosylinositol (compound V) and isomeric galactosyldimannosylinositols (compounds VI and VIII) after strong ammonolysis. The foregoing as well as other data suggest that compound V is a dimannosylinositolphosphoceramide and compounds VI and VIII are galactosyldimannosylinositolphosphoceramides with isomeric head groups. The chromatographic behavior of compounds II and III indicates that they are similar to the inositolphosphoceramides previously observed in Saccharomyces cerevisiae. Compounds V and VI are virtually absent from the mycelial phase of H. capsulatum. Antibodies that react with compounds V, VI, and VIII have been detected in sera from patients with histoplasmosis. PMID- 6509038 TI - Carbohydrate structures of three novel phosphoinositol-containing sphingolipids from the yeast Histoplasma capsulatum. AB - From the yeast phase of the human pathogen Histoplasma capsulatum, three novel glycolipids were isolated, shown to react with sera from histoplasmosis patients, and partially characterized: compound V, ceramide-P-inositol-[mannose2]; compound VI, ceramide-P-inositol-[mannose2, galactose]; compound VIII, an isomer of compound VI [Barr, K., & Lester, R.L. (1984) Biochemistry (preceding paper in this issue)]. Ammonolysis of these lipids has yielded all the carbohydrate (oligosaccharides V, VI, and VIII) as novel, intact oligosaccharides suitable for characterization. Anomeric configurations were determined by specific glycosidase digestion and by the stability of peracetylated saccharides to CrO3 oxidation. Linkages were established by methylation analysis. These experiments yielded the following structural assignments: (formula; see text) The occurrence of galactofuranose is novel for glycosphingolipids, and it is noteworthy that compound VI is immunoreactive. PMID- 6509039 TI - Localization of the hemagglutinating activity of platelet thrombospondin to a 140 000-dalton thermolytic fragment. AB - The platelet protein thrombospondin (TSP) which is secreted from alpha-granules upon platelet activation agglutinates trypsinized, glutaraldehyde-fixed human erythrocytes. Optimal conditions for the hemagglutinating activity require that both Ca2+ and Mg2+ be present in final concentrations of 2 mM. In the presence of dithiothreitol (i.e., reduction of disulfide bonds), the lectin-like activity decreases in a manner proportional to the extent of reduction of the molecule from its native trimeric configuration into its Mr 180 000 subunits. Proteolysis of purified TSP with thermolysin, which produces discrete domains with the capacity to bind fibrinogen and heparin, also diminishes, but does not abolish, the hemagglutinating activity. Fibrinogen was without effect on hemagglutinating activity while heparin was found to be a potent inhibitor. Other proteoglycans such as hyaluronic acid, chondroitin sulfate, keratan sulfate, dermatan sulfate, and heparan sulfate had no effect. That portion of the TSP molecule apparently responsible for the hemagglutinating activity was identified by incubating a thermolytic digest of TSP with red blood cells and then determining which fragment was bound to the cell surface. The binding site resides within a peptide fragment of 140 000 daltons but is absent from an Mr 120 000 fragment derived from the Mr 140 000 fragment. Under the conditions for optimal expression of hemagglutinating activity (i.e., 2 mM MgCl2 and 2 mM CaCl2), this Mr 140 000 fragment was also shown to have heparin binding activity. PMID- 6509040 TI - Differential dissociation of histone tails from core chromatin. AB - The dissociation of the trypsin-sensitive basic tails of the core histones in core chromatin has been followed as a function of [NaCl] using proton NMR spectroscopy. The tails dissociate in a highly cooperative all or none manner over the salt concentration range 0.2-0.6 M, that is, below the salt concentration required to dissociate the complete molecule. Assuming that each basic tail dissociates independently, the total number of salt linkages involved in binding the tails to DNA is 103. This equals the number of basic side chains in the tails of an octamer. The standard free energy of dissociation, delta G degree, in 1 M NaCl at 297 K is 3.6 kcal/mol. Temperature had no effect on the extent of dissociation up to 45 degrees C. However, between 45 and 65 degrees C, where the premelting transition in the core chromatin occurs, the tails dissociated completely. Dissociation of the tails was associated with a conformational transition in the DNA consistent with loss of supercoiling. From this, and the results of a previous study, it can be shown that the structured, trypsin-resistant domain of each core histone octamer makes 100 salt linkages to DNA. Thus, in 10 mM salt, each core octamer makes a total of 203 salt linkages to DNA. PMID- 6509041 TI - Carbon-13 nuclear magnetic resonance studies of cobalamins. AB - The carbon-13 nuclear magnetic resonance spectra of aquocobalamin, adenosylcobalamin, methylcobalamin, and (carboxymethyl)cobalamin have been interpreted. The assignments were made by a comparison of the spectra with that of cyanocobalamin, by a study of the pH dependence of the chemical shifts, by an analysis of the effect of the axial ligands on the carbon atoms of the corrin ring, and by a study of the specific line broadening effect of the paramagnetic ions Mn2+ and Gd3+. The chemical shift changes that accompany the "base-on"--- "base-off" conversion of the organocobalamins demonstrate that the conformation of the "western" half of the corrin ring and the conformations of the a, b, c, d, f, and g side chains are relatively constant. In contrast, the conformations of the "eastern" half of the corrin ring and the e propionamide side chain are highly variable. PMID- 6509042 TI - On the localization of ubiquinone in phosphatidylcholine bilayers. AB - The location of ubiquinone-10 in phospholipid bilayers was analyzed using a variety of physical techniques. Specifically, we examined the hypothesis that ubiquinone localizes at the geometric center of phospholipid bilayers. Light microscopy of dipalmitoylphosphatidylcholine at room temperature in the presence of 0.05-0.5 mol fraction ubiquinone showed two separate phases, one birefringent lamellar phase and one phase that consisted of isotropic liquid droplets. The isotropic phase had a distinct yellow color, characteristic of melted ubiquinone. [13C]NMR spectroscopy of phosphatidylcholine liposomes containing added ubiquinone indicated a marked effect on the 13C-spin lattice relaxation times of the lipid hydrocarbon chain atoms near the polar head region of the bilayer, but almost no effect on those atoms nearest the center of the bilayer. X-ray diffraction experiments showed that for phosphatidylcholine bilayers, both in the gel and liquid-crystal-line phases, the presence of ubiquinone did not change either the lamellar repeat period or the wide-angle reflections from the lipid hydrocarbon chains. In electron micrographs, the hydrophobic freeze-fracture surfaces of bilayers in the rippled (P beta') phase were also unmodified by the presence of ubiquinone. These results indicate that the ubiquinone which does partition into the bilayer is not localized preferentially between the monolayers, and that an appreciable fraction of the ubiquinone forms a separate phase located outside the lipid bilayer. PMID- 6509043 TI - Inhibition of erythrocyte plasma membrane NADH dehydrogenase by nucleotides and uncouplers. AB - Erythrocyte ghost NADH dehydrogenase is inhibited in a competitive fashion by ATP and ADP whereas other nucleoside di- and triphosphates, cyclic nucleosides, as well as non-phosphorylating ATP analogs are relatively ineffective. In addition, this enzyme, measured with ferricyanide as electron acceptor, is inhibited by uncouplers of oxidative phosphorylation (proton-conducting reagents), the inhibition being competitive in character (i.e., the uncouplers were without influence upon maximum velocity). The effectiveness of the uncouplers was in the order of their hydrophobic character with the presence of the alkyl side chain rendering nonyl-dinitrophenol much more active than 2,6-dinitrophenol itself. Hydrophobic compounds that are not protonophores (e.g., eosin, proflavin or valinomycin) were not inhibitory. Whereas adenine nucleotides probably inhibit NADH oxidation competitively through structural similarity with the substrate, it appears unlikely that uncouplers compete at the NADH site directly. Rather, the apparently-competitive inhibition in the latter case may reflect competition for proton transfer to an acceptor residing in a hydrophobic region of the enzyme complex. PMID- 6509044 TI - Modification of the erythrocyte membrane by a non-specific lipid transfer protein. AB - The non-specific phospholipid transfer protein purified from bovine liver has been used to modify the phospholipid content and phospholipid composition of the membrane of intact human erythrocytes. Apart from an exchange of phosphatidylcholine between the red cell and PC-containing vesicles, the protein appeared to facilitate net transfer of phosphatidylcholine from the donor vesicles to the erythrocyte and sphingomyelin transfer in the opposite direction. Phosphatidylcholine transfer was accompanied by an equivalent transfer (on a molar basis) of cholesterol. An increase in phosphatidylcholine content in the erythrocyte membrane from 90 to 282 nmol per 100 microliters packed cells was observed. Phospholipase C treatment of modified cells showed that all of the phosphatidylcholine which was transferred to the erythrocyte was incorporated in the lipid bilayer. The nonspecific lipid transfer protein used here appeared to be a suitable tool to modify lipid content and composition of the erythrocyte membrane, and possible applications of this approach are discussed. PMID- 6509045 TI - Acylglucosylceramide causes flattening and stacking of liposomes. An analogy for assembly of the epidermal permeability barrier. AB - When 5% of 1-(3'-O-acyl)-beta-D-glucosyl-N-(omega-hydroxyacyl)sphingosine, isolated from pig epidermis, was added to distearoylphosphatidylcholine and cholesterol (10:1), the lipid mixture formed liposomes in phosphate buffer which were flattened and aggregated like stacks of coins. Other glycolipids from pig epidermis did not cause this phenomenon. This supports the hypothesis that the acylglucosylceramide is responsible for assembly of the lamellar granules found in epidermal cells. PMID- 6509046 TI - Interaction of amphotericin B with membrane lipids as viewed by 2H-NMR. AB - The effects of amphotericin B upon the organization and dynamics of multibilayer membranes of dimyristoylphosphatidylcholine (DMPC) were investigated by means of 2H-NMR. At high amphotericin B concentrations (30 mol% with respect to the lipid) and at temperatures above 25 degrees C, DMPC experiences two different environments which are in slow exchange on the 2H-NMR time scale. In one of these, the lipid is immobilized by the antibiotic, in a molar ratio of approximately 1:1, whereas the lipid unsequestered by amphotericin B is more ordered than in its pure state. This ordering effect is perceived at relatively low antibiotic doses (4%). The local lipid order, and the relative percentage, of sequestered DMPC, are temperature-independent (up to 65 degrees C), whereas the ordering of the unsequestered lipid domain is not. The perturbation induced by amphotericin B is manifest similarly at the edges as well as in the center of the bilayer. Antibiotic addition leads to large decreases in the transverse relaxation time, T2, of the labelled lipid, but not in the spin-lattice relaxation time, T1. This indicates an increased density of slow motional modes and little change in rapid motions. PMID- 6509047 TI - Evidence for a highly asymmetric arrangement of ether- and diacyl-phospholipid subclasses in the plasma membrane of Krebs II ascites cells. AB - (1) Krebs II ascites cells were taken as a model of the neoplastic cells to investigate the transverse distribution of phospholipids in the plasma membrane. The experimental procedure was based on non-lytic degradation of phospholipids in the intact cell by Naja naja phospholipase A2 and Staphylococcus aureus sphingomyelinase C and on phospholipid analysis of purified plasma membranes. It was shown that the three major phospholipids, i.e., phosphatidylcholine, phosphatidylethanolamine and sphingomyelin, are randomly distributed between the two halves of the membranes, whereas phosphatidylserine remains located in the inner leaflet. (2) The membrane localization of phosphatidylcholine and phosphatidylethanolamine subclasses (diacyl, alkylacyl and alkenylacyl) was also examined, using a new procedure of ether-phospholipid determination. The method involves a selective removal of diacyl species by guinea pig pancreas phospholipase A1 and of alkenylacyl species by acidolysis. This analysis revealed a 50% increase of ether phospholipids in the plasma membrane as compared to the whole cell (36.5 and 23.1% of total phospholipid, respectively). Furthermore, a strong membrane asymmetry was demonstrated for the three phosphatidylcholine subclasses, since 1-alkyl-2-acyl-sn-glycerol-3-phosphocholine (alkylacyl-GPC) was entirely found in the inner leaflet, whereas both diacyl- and alkenylacyl-GPC displayed an external localization. The same pattern was observed for phosphatidylethanolamine subclasses, except for 1-alkenyl-2-acyl-sn-glycero-3 phosphoethanolamine, which was found randomly distributed. These results are discussed in relation to the process of cell malignant transformation and to the biosynthesis of platelet-activating factor (PAF-acether or 1-alkyl-2-acetyl-GPC). PMID- 6509048 TI - Distribution of platelet glycoproteins and phosphoproteins in hydrophobic and hydrophilic phases in Triton X-114 phase partition. AB - Platelets, either unlabelled, surface-labelled by the periodate NaB3H4 method or metabolically labelled with 32P were solubilized in Triton X-114 and partitioned into aqueous and detergent phases. The phases were analysed by two-dimensional polyacrylamide gel electrophoresis followed by silver-staining, fluorography or indirect autoradiography. Each of the phases contains a distinct set of proteins. The surface-labelled glycoproteins partition into the hydrophobic phase with the notable exceptions of glycoproteins Ib and GP17(5.8-6.5) and minor amounts of a few others. The phosphoproteins which undergo increased phosphorylation on platelet activation in general separate in the hydrophobic phase, while higher molecular weight phosphoproteins were principally in the hydrophilic phase. This method might be used as a first step in purifying many platelet components. PMID- 6509049 TI - Evidence for a water-soluble intermediate in exchange of cholesterol between membranes. AB - The mechanism of inter-membrane cholesterol exchange has been a matter of some debate. Evidence from kinetic studies indicates that cholesterol must transfer to and from membranes in a water-soluble form. In this study attempts have been made to demonstrate that this occurs using either dialysis membranes or a barrierless multiphase polymer system to physically separate the membranes. In both systems small amounts of cholesterol were seen to transfer from one membrane pool to another using both liposomes and erythrocyte membranes as donors or acceptors. The cholesterol transfer was shown to be independent of the movement of other membrane components. The amount of transfer observed was limited by the physical properties of the systems employed. The barrier to cholesterol transfer in the dialysis membrane system is primarily the pore size of the membrane, while in the multiphase polymer system the transfer was limited by the viscosity of the medium and the distance between the lower and upper phases containing the membranes. Nevertheless, the results provide evidence that cholesterol transfer is by a dissociation of molecules from membranes into the aqueous medium and does not require the formation of a collision complex between the membranes. PMID- 6509050 TI - Differences in membrane lipid composition and fluidity of transplanted GRSL lymphoma cells, depending on their site of growth in the mouse. AB - GRSL lymphoma cells were isolated from various growth sites in the host. The relative membrane lipid fluidities of these cells and of normal lymphoid cells were estimated by fluorescence polarization, using the probe diphenylhexatriene and by measuring the (free) cholesterol/phospholipid molar ratio in whole cells. The results indicate that the membrane fluidity (reciprocal of the lipid structural order) of the lymphoma cells increases in the order of their location: peripheral blood less than spleen less than mesenterial lymph node less than ascites fluid. The membrane fluidities of normal lymphocytes from thymus, mesenterial lymph node and spleen were about the same, but higher than of peripheral blood lymphocytes, and between those of the lymphoma cells from lymph node and spleen. These results are confirmed by more extensive analysis on purified plasma membranes from the splenic and ascitic GRSL lymphoma cells and from normal splenocytes and thymocytes. The significantly higher lipid order parameter found in the GRSL plasma membrane isolated from the spleen as compared to those from the ascites cells could be fully explained by the differences measured in the major chemical determinants of the fluidity, i.e., the cholesterol/phospholipid ratio, the sphingomyelin content and the degree of saturation of the fatty acyl groups of the phospholipids. It was also found that the cholesterol/phospholipid ratio in erythrocyte membranes isolated from the peripheral blood of the tumor bearers was higher than in those from normal control mice. The observed differences in membrane fluidity between distinct subsets of tumor cells may be relevant to the sensitivity of these cells to immune attack or to drugs. PMID- 6509051 TI - Uptake of uric acid, xanthine and hypoxanthine by brush-border membrane vesicles from mouse small intestine. AB - Using mouse small intestine brush-border membrane vesicles virtually free of xanthine oxidase (EC 1.2.3.2) and free of uricase (EC 1.7.3.3) the uptake of the purines uric acid, xanthine and hypoxanthine have been studied. The sodium dependent overshoot phenomenon shown to exist for the uptake into the vesicles for D-glucose and L-phenylalanine was not observed with the purines. However, the uptake of the three purines in the presence of NaCl or KCl was greater than the uptake in the presence of either NaSCN or mannitol. Although 12.9% of the xanthine uptake and 17.6% of the hypoxanthine uptake was attributed to binding to the membranes, almost all the uric acid uptake was due to transport into an osmotically active space. The apparent intravesicular volume, calculated after 60 min incubation, for the three purines was consistently greater than the values obtained with D-glucose, L-glucose and L-phenylalanine equilibration, suggesting slow continuing penetration of purines associated with swelling or an apparent accumulation of purines within the vesicles associated with normal vesicle volume. PMID- 6509052 TI - Dielectric analysis of mitochondria isolated from rat liver. I. Swollen mitoplasts as simulated by a single-shell model. AB - A re-evaluation of the dielectric studies on isolated mitochondria (Pauly, H., Packer, L. and Schwan, H.P. (1960) J. Biophys. Biochem. Cytol. 7, 589-601, and ibid. 7, 603-612) is presented. The suspensions of 'mitoplasts' prepared from rat liver mitochondria by a hyposmotic (10 mM KCl) treatment showed a dielectric dispersion with its characteristic frequency lying in the 1-100 MHz range. In the analysis of data special emphasis was put on the choice of the theoretical models to employ after scrutiny of their applicability to the suspensions tested. As such we adopted the theory of Hanai et al. (Hanai, T., Asami, K., and Koizumi, N. (1979) Bull. Inst. Chem. Res., Kyoto Univ. 57, 297-305) that was advanced to include concentrated suspensions of shelled spheres. Curve fittings based on that theory resulted in a better agreement with experiment than the fittings based on a conventional theory for dilute suspensions. Major findings from our analyses on the swollen mitoplasts are that: (i) the limiting membrane of the mitoplasts has a specific electrical capacity of 1 microF/cm2, (ii) the ratio of permittivity (or dielectric constant) for the mitoplast interior and permittivity for the external medium is 0.6-0.7, and (iii) the conductivity ratio between the interior phase and the medium is approx. 0.6. Reasons for discrepancy between the results of Pauly et al. and ours are discussed. PMID- 6509053 TI - Dielectric analysis of mitochondria isolated from rat liver. II. Intact mitochondria as simulated by a double-shell model. AB - The dielectric dispersion of isolated intact mitochondria in suspension has been measured between 10 kHz and 500 MHz. In isotonic KCl media at 4 degrees C, the mitochondria maintained their characteristic 'double membrane' structure as examined by electron microscopy, and the observed dispersion curves were successfully simulated in terms of a superposition of two sub-dispersions having different characteristic frequencies and different permittivity magnitudes. Taking these observations into account we analyzed the dispersion data on the basis of a 'double-shell' model in which two concentric shells are meant to represent the mitochondrial outer and inner membranes. The analyses by a computerized curve-fitting method revealed that: (i) electric capacities for the outer and the inner membrane are 1.7 and 0.5 microF/cm2, respectively, (ii) relative permittivity for the inner compartment (or the equivalent homogeneous matrical space) = 50-60, (iii) outer compartment-to-external conductivity ratio = 0.4-0.6, and (iv) inner compartment-to-external conductivity ratio = 0.14. The implications of these parameter values are discussed with due attention paid to the limitations inherent in our 'double-shell' model approach. PMID- 6509054 TI - Studies on the mechanism of cholesterol uptake and on the effects of bile salts on this uptake by brush-border membranes isolated from rabbit small intestine. AB - The effect of bile salts and other surfactants on the rate of incorporation of cholesterol into isolated brush-border membranes was tested. At constant cholesterol concentration, a stimulatory effect of taurocholate was noticed which increased as the bile salt concentration was raised to 20 mM. Taurodeoxycholate was as effective as taurocholate at concentrations of up to 5 mM and inhibited at higher concentrations. Glycocholate was only moderately stimulatory whereas cholate was nearly as effective as taurocholate at concentrations above 5 mM. Other surfactants such as sodium lauryl sulfate and Triton X-100 were very inhibitory at all concentrations tried whereas cetyltrimethyl ammonium chloride was stimulatory only at a very low range of concentrations. These micellizing agents all caused some disruption of the membranes and the greater effectiveness of taurocholate in stimulating sterol uptake was partly relatable to the weaker membrane solubilizing action of this bile salt. Preincubation of membranes with 20 mM taurocholate followed by washing and exposure to cholesterol-containing lipid suspensions lacking bile salt, did not enhance the incorporation of the sterol. In the absence of bile salt the incorporation of cholesterol was unaffected by stirring of the incubation mixtures. Increasing the cholesterol concentration in the mixed micelle while keeping the concentration of bile salt constant caused an increase in rate of sterol incorporation. This increased rate was seen whether the cholesterol suspension was turbid, i.e., contained non micellized cholesterol, or whether it was optically-clear and contained only monomers and micelles. When the concentration of taurocholate and cholesterol were increased simultaneously such that the concentration ratio of these two components was kept constant, there resulted a corresponding increase in rate of cholesterol uptake. The initial rates of cholesterol incorporation from suspensions containing micellar and monomer forms of cholesterol were much larger than from solutions containing only monomers of the same concentration. The rates of incorporation of cholesterol and phosphatidylethanolamine from mixed micelles containing these lipids in equimolar concentrations were very different. The results as a whole suggest at least for those experimental conditions specified in this study, that uptake of cholesterol by isolated brush-border membranes involves both the monomer and micellar phases of the bulk lipid and that the interaction of the micelles with membrane does not likely involve a fusion process. PMID- 6509056 TI - 2',3'-Dideoxy-3'-aminonucleoside 5'-triphosphates inhibit the repair of DNA in rat liver chromatin. AB - 2',3'-Dideoxy-3'-aminonucleoside 5'-triphosphates are shown to be strong inhibitors of repair DNA synthesis in gamma-irradiated rat liver chromatin. The activity of these compounds is comparable with that of the most effective inhibitor of the DNA polymerase beta-catalyzed repair DNA synthesis. PMID- 6509055 TI - Selective solubilization by melittin of glycophorin A and acetylcholinesterase from human erythrocyte ghosts. AB - Melittin, the main basic and hydrophobic peptide of bee venom, has been used for solubilizing membrane components of the human erythrocyte ghost. Up to 1.0 mM, it does not extract any phospholipid. Between 0.1 and 1.0 mM, it solubilizes partially glycophorin A and acetylcholinesterase. When the membrane is first degraded by phospholipase A2, the solubilization of both proteins by melittin is total, and 48% of the phospholipids are removed, mainly as lysoproducts, whereas phospholipase A2, by itself, has no solubilizing properties. In its melittin solubilized state, acetylcholinesterase is in a dimeric form and displays a slow time-dependent irreversible inactivation. Triton X-100 at 1.0% (v/v) interrupts the inactivation. We suggest that melittin binds to the hydrophobic site of acetylcholinesterase which anchors it in the lipid bilayer. PMID- 6509057 TI - Inhibition of replicative DNA synthesis in nuclei of Strongylocentrotus intermedium urchin embryo by 2',3'-dideoxy-3'-aminonucleoside 5'-triphosphates. AB - 2',3'-Dideoxy-3'-aminonucleoside 5'-triphosphates have been shown to be inhibitors of replicative DNA synthesis in isolated nuclei of sea urchin embryo. These compounds inhibit the Okazaki fragment synthesis. The effect of 2',3' dideoxy-3'-aminothymidine 5'-triphosphate and arabinothymidine 5'-triphosphate is reversible when adding the corresponding substrate for DNA synthesis, 2' deoxythymidine 5'-triphosphate. PMID- 6509058 TI - Sequence specificity of cytosine methylation in the DNA of the Chinese hamster ovary (CHO-K1) cell line. AB - We have determined the DNA renaturation kinetics for those DNA sequences of the Chinese hamster ovary (CHO-K1) cells in which enzymatic cytosine methylation occurred immediately after strand synthesis and for those in which methylation was delayed after strand synthesis. DNA sequences showing immediate or delayed methylation were found to be distributed throughout all repetition classes of the DNA of these cells, with a slight concentration of immediate methylation in moderately repetitive sequences and with delayed methylation being slightly over represented in the highly repetitive fraction. However, DNA sequences showing both classes of methylation were represented equally in unique DNA sequences. We interpret these data to mean that the methylase acting near the replication forks (the 'immediate' methylase) is a relatively inefficient enzyme, missing some 20% of hemimethylated sites produced by DNA replication in these cells. We suggest that the methylase performing maintenance methylation at sites remote from the replication forks (the 'delayed' methylase) is simply a back-up enzyme for the first and that it has no true sequence specificity. The implications of this for the function(s) of DNA methylation in mammalian cells are discussed. PMID- 6509059 TI - The role of multiply phosphorylated S6 in ribosome degradation. AB - Rat liver ribosomes, prepared 1-24 h after intraperitoneal cortisol injection, contain multiple phosphorylated S6 consisting of four distinct derivatives in addition to the original non-phosphorylated S6. 25 h following the hormone injection the extent of S6 phosphorylation, as judged by its electrophoretic pattern in two-dimensional gels, resembles that of untreated rats. Ribosomal subunits with gradually increased degree of S6 phosphorylation, isolated at different time intervals after cortisol injection, exhibit polyphenylalanine polymerization levels inversely proportional to the extent of S6 phosphorylation. In addition, they show an elevated misincorporation of leucine in a poly(U) programmed in vitro system. The lower amount of polyphenylalanine synthesized by multiple phosphorylated ribosomes in vitro is likely due to an enhanced susceptibility of nascent polypeptide chains synthesized in the in vitro system to proteinases present in the pH 5 and S-100 fractions. Liver polysomes derived from cortisol-treated animals lose their highly phosphorylated derivatives when exposed to S-100 enzymes. The loss can be prevented by concomitant action of proteinase and RNAase inhibitors (phenylmethylsulfonyl fluoride and heparin) but not by an inhibitor of phosphatase (sodium fluoride). In the absence of RNAase and proteinase inhibitors only degradation of old 40 S subunits can be demonstrated. 25 h after the cortisol treatment degradation of liver ribosomes occurs simultaneously with S6 dephosphorylation and is preceded by polysomal breakdown. PMID- 6509060 TI - The binding of actinomycin D and Adriamycin to supercoiled DNA, single-stranded DNA and polynucleotides. AB - The effect of actinomycin D and adriamycin on synthetic polynucleotides, single stranded viral DNA and supercoiled DNA has been studied employing the fluorescent probe, terbium. Marked displacement of the probe was observed when any deoxyribose-containing polynucleotide was pretreated with either drug. With supercoiled DNA, an unwinding of the supercoil was observed at very low drug concentrations (at approx. 1:500 molar ratio of drug:DNA) prior to the displacement of the terbium. This unwinding was visualized by agarose gel electrophoresis at molar ratios of approx. 1:200. The effect was more apparent and occurred at lower drug: DNA ratios with actinomycin D than with adriamycin. Unlike cis-dichlorodiammine platinum(II), actinomycin D did not protect pBR322 DNA from cleavage at its BamHI site. The hydrolysis of phi chi 174 DNA by a series of G-C-specific restriction nucleases (including HhaI, HpaII and HaeIII) was also not affected by prior treatment of the DNA with actinomycin D. PMID- 6509061 TI - Raman spectroscopy and deuterium exchange of the filamentous phage fd. AB - The filamentous phage fd has been investigated using the techniques of Raman spectroscopy and deuterium exchange. Despite the rather uniform secondary structure of the fd phage coat protein, which is predominantly alpha-helix, the deuterium exchange is complex. A substantial fraction of the helical peptides exchange deuterium by 8 h at room temperature, yet another substantial fraction does not exchange following an additional 5 months at 4 degrees C. Heating the phage to 70 degrees C for several hours leads to additional deuterium exchange compared to samples soaked for 5 months in heavy water. We suggest that the wide variation in peptide exchange rates may be related to the phage protein quaternary structure, which has been shown to be a double layer of tightly packed helices. The accomplishment of enhanced exchange by reaction at high temperature combined with digital difference spectroscopic methods has enabled us to define the structure of the amide III and III' bands. The complexity of these bands is unexpected for a simple helical protein, but we suggest that the complexity arises at least in part from end-effects that become important in short alpha helices. PMID- 6509062 TI - The nature of the trifluoperazine binding sites on calmodulin and troponin-C. AB - We have employed 1H-nuclear magnetic resonance spectroscopy to study the interaction of the drug trifluoperazine with calmodulin and troponin-C. Distinct trifluoperazine-binding sites exist in the N- and C-terminal halves of both proteins. Each site consists of a group of hydrophobic side-chains brought into proximity by the Ca2+-dependent juxtaposition of two alpha-helical segments of the protein, each, in turn, belonging to a different Ca2+-binding site in the protein half. The trifluoperazine-induced inhibition of the biological activating ability of calmodulin appears to result from conformational restrictions conferred upon the protein by the bound drug. PMID- 6509063 TI - A differential scanning calorimetry analysis of the age-related changes in the thermal stability of rat skin collagen. AB - Differential scanning calorimetry (DSC) has been applied to the study of connective tissue to evaluate the denaturation process of collagen. We have applied this technique to the study of the ageing of rat skin. We have tried to correlate the variations of the parameters measured by DSC and the modifications of collagen crosslinks with ageing. The thermograms obtained are composed of one main peak located between two shoulders. The relative size of each peak varies with time: the first peak diminishes regularly from 2 to 20 months whilst, at the same time, the third peak increases; the recovery temperature increases with age (+ 16 degrees C between 2 and 20 months); the total denaturation enthalpy does not vary: the main value obtained is 5.9 X 10(-2) J/mg collagen. On the other hand, the assay of reducible collagen crosslinks in rat skin, over the same age range, shows a decrease of heat-labile aldimine crosslink (essentially hydroxylysinonorleucine). These results and the study of thermograms obtained with altered rat skin (animals treated with beta-aminopropionitrile or skin reduced with NaBH4) allow us to conclude that heat-labile and heat-stable crosslinks account for a collagen thermal stabilization which can explain the delay of denaturation characterized by the third peak of DSC thermograms. PMID- 6509064 TI - The repair of oxidized amino acids by antioxidants. AB - Natural and synthetic antioxidants have been shown to repair tryptophan radicals produced from the one-electron oxidation of the free tryptophan amino acid. It has also been observed that both tryptophan and tyrosine radicals in lysozyme can be repaired by these antioxidants to varying degrees of efficiency. Although SDS solubilized alpha-tocopherol efficiently repairs free tryptophan radicals, it is very inefficient in repairing the amino acids in lysozyme. The rigidity and immobility of solubilized alpha-tocopherol can explain this lack of efficiency. PMID- 6509065 TI - Acylation of human hemoglobin with polyoxyethylene derivatives. AB - Monomethoxypolyoxyethylene (Mw = 5000) was covalently linked to human hemoglobin via an amide bond formed between amino groups of the protein and a carboxylic group introduced onto the polymer. The conjugates thus obtained have a molecular size corresponding to that of a globular protein with a molecular weight of about 190 000. Their oxygen-binding properties depend upon the initial conformation of the hemoglobin and reaction pH: hemoglobin modified in the deoxy state exhibited a lower oxygen affinity than that modified in the oxy state, and the lower the reaction pH, the lower the oxygen affinity of polymer-linked hemoglobin. However, the affinity of modified hemoglobin is always higher than that of native hemoglobin. On the other hand, when deoxyHb was complexed with organic phosphates during the condensation reaction, the resulting conjugates exhibited oxygen binding characteristics quite similar to those of native hemoglobin, i.e., the same oxygen affinity, modified cooperativity and the same alkaline Bohr effect. Finally, in order to decrease the oxygen affinity of hemoglobin conjugates, the polymer was coupled to deoxy hemoglobin previously covalently modified with pyridoxal phosphate. The oxygen affinity of such conjugates was in fact as low as that of the initial pyridoxylated hemoglobin. PMID- 6509066 TI - Stabilization of ornithine decarboxylase and N1-spermidine acetyltransferase in rat liver by methylglyoxal bis(guanylhydrazone). AB - The activities of ornithine decarboxylase and spermidine N1-acetyltransferase started to rise in normal rat liver 4 h after the intraperitoneal injection of methylglyoxal bis(guanylhydrazone) (MGBG; 80 mg/kg). Ornithine decarboxylase had its greatest activity 24 h after a single injection of MGBG and the acetyltransferase peaked 8 h after the injection. Measurement of the apparent half-life of ornithine decarboxylase after MGBG treatment revealed a clear decrease in the decay rate of the enzyme in both normal and regenerating rat liver. MGBG slowed the decay of the transferase also in normal rat liver, as well as inhibiting its activity in vitro. The stabilization by MGBG of these two short lived proteins involved in metabolism of polyamines should lead to their accumulation in liver, thus explaining their increased activities. In the case of ornithine decarboxylase, studies with a specific antibody against mouse kidney ornithine decarboxylase showed that the rise in ornithine decarboxylase activity after MGBG application was not due to the appearance of an immunologically different isozyme. PMID- 6509067 TI - High-field, variable-temperature Mossbauer effect measurements on oxyhemeproteins. AB - We measured Mossbauer spectra of human oxyhemoglobin, its isolated beta chains, and of oxymyoglobin from horse and sperm whale in fields of 4 or 6 T between 4.2 and 200 K in order to characterize the electronic state of the oxyheme complex. Diamagnetic sodium nitroprusside measured under the same conditions served as a control. The spectra of all compounds are reproduced adequately by a model that assumes a diagmagnetic iron and treats the quadrupole splitting, the asymmetry parameter and the Mossbauer linewidth as adjustable parameters. The results provide no indication in the oxyhemeproteins of the excited triplet state that was postulated by Cerdonio and co-workers (Cerdonio, M., Congiu-Castellano, A., Mogno, F., Pispisa, B., Romani, G.L. and Vitale, S. (1977) Proc. Natl. Acad. Sci. USA 74, 398-400) on the basis of susceptibility measurements on oxyhemoglobin. PMID- 6509068 TI - Purification and crystallization of bovine liver phosphorylase. AB - We have purified and crystallized bovine liver phosphorylase a. Starting from 2.5 kg of liver, we obtain 250 mg of phosphorylase a, with a specific activity of 90 units/mg, representing 15% recovery. SDS polyacrylamide gels show three bands, a 95 kDa band with the same mobility as muscle phosphorylase, and two smaller bands of 55 kDa and 40 kDa, which are probably proteolytic fragments. These fragments remain associated and have native conformation and catalytic activity. Crystals which diffract to 2.8 A resolution, were prepared by the hanging drop method using polyethylene glycol PEG 4000 as precipitant. The crystals were prepared in the presence of activators maltotriose and phosphite and crack when placed in solutions containing the inhibitors glucose and caffeine. This suggests phosphorylase is present in an active conformation. PMID- 6509069 TI - Mechanism of inhibition of sickling by dimethyl adipimidate. Effects of intertetramer cross-linking. AB - Dimethyl adipimidate (DMA), an effective antisickling agent in vitro, reacts with free amino groups producing chemically modified and cross-linked molecules. In this report, we have investigated the effect of cross-linked hemoglobin tetramers on sickle hemoglobin polymerization. Since the extent of cross-linking is pH dependent, we first compared the solubilities of deoxygenated hemolysates prepared from sickle cells previously treated with dimethyl adipimidate at either pH 7.4 or 8.4. The solubility of the hemolysate increased from 18.6 +/- 0.8 g/dl in the untreated sample to 20.9 +/- 1.5 g/dl (pH 7.4) and to 25.4 +/- 3.0 g/dl (pH 8.4) after dimethyl adipimidate treatment. Removal of cross-linked hemoglobin tetramers from hemolysate obtained from dimethyl adipimidate-treated cells abolished part of this effect; at pH 7.4, the solubility decreased from 20.9 +/- 1.5 to 19.4 +/- 0.2 and at pH 8.4 from 25.4 +/- 3.0 to 21.0 +/- 1.5. However, the ratio of [14C]DMA-labelled hemoglobin in the sol phase to that in the gel phase in the unfractionated hemolysate was 1.17 at pH 7.4 and 1.25 at pH 8.4, suggesting that part of the cross-linked hemoglobin tetramers was incorporated into the gel. In order to further investigate the effect of cross-linked hemoglobin tetramers on sickle hemoglobin polymerization, we separated cross linked hemoglobin tetramers on a gel-filtration column, prepared mixtures of untreated sickle hemoglobin and cross-linked hemoglobin tetramers and studied the polymerization of these mixtures. The Csat of the untreated hemolysate increased progressively from 18.6 +/- 0.8 to 22.5 +/- 0.8 g/dl with 33% cross-linked hemoglobin tetramers. The hemoglobin concentration in the gel decreased from 43 +/- 1.0 to 33.8 +/- 1.0 g/dl with 33% cross-linked hemoglobin tetramers, while the pellet volume fraction, phi p, increased with and almost approached 1 at 50% cross-linked hemoglobin tetramers. In addition, the sol phase contained a higher molecular weight distribution of cross-linked hemoglobin tetramers than the gel phase. These observations suggest that a loose polymer was formed in the gel phase with a hemoglobin concentration much lower than that of the control. Thus, polymerization of sickle hemoglobin is inhibited by: (1) exclusion of higher molecular weight cross-linked hemoglobin tetramers from the gel, and (2) loose incorporation of cross-linked hemoglobin tetramers into the gel, perhaps preventing lateral packing and formation of tightly ordered fibers. PMID- 6509070 TI - Thermodynamic features of bile salt-human serum albumin interaction. AB - Interaction with human serum albumin is responsible for important aspects of the physiological behaviour of bile salts, although this factor has not been adequately examined. The nature of the binding is investigated here by means of thermodynamic parameters determined by equilibrium dialysis and microcalorimetric measurements. The positive enthalpy and entropy values obtained indicate the presence of a poorly specific hydrophobic bonding. PMID- 6509071 TI - Silicon compounds as substrates and inhibitors of acetylcholinesterase. AB - Several trimethylsilyl derivatives were found to be ligands of acetylcholinesterase (acetylcholine acetylhydrolase, EC 3.1.1.7): trimethylsilylethyl acetate (III) and trimethylsilylmethyl acetate (V) are substrates of the enzyme, whereas trimethylsilylethanol (VIII) is a competitive inhibitor. The silicon compounds have kinetic parameters similar to those of their carbon analogues, except for trimethylsilylmethyl acetate, which is a substrate of acetylcholinesterase, whereas its carbon analogue is not susceptible to enzymic hydrolysis. PMID- 6509072 TI - Alterations of cell membrane composition during prolonged fasting in lizards. AB - Male lizards fasted for 35 days showed significant alterations in the lipid composition of membranes isolated from a variety of organs and tissues. Unesterified cholesterol was significantly increased in membranes from kidney, skeletal muscle, small intestine, testis and heart but not in those from lung, brain and liver; cholesterol/phospholipid molar ratio was also significantly increased in membranes from all organs except brain and liver. Membrane total phospholipids were reduced for all tissues except brain and liver, whilst significant reductions in the molar ratio of membrane phosphatidylcholine to sphingomyelin occurred in kidney, muscle, testis, intestine and liver. Similar alterations in lipid composition were found in plasma and significant correlations between plasma and membrane cholesterol/phospholipid and phosphatidylcholine/sphingomyelin molar ratios were found for those organs in which significant lipid changes occurred during fasting. Lizards fasted for 35 days and then refed a natural diet, such that they started to regain weight, had normal membrane lipid compositions. These observations suggest that during prolonged fasting certain tissues of the lizard are unable to maintain a normal membrane lipid composition and that abnormal plasma lipoproteins may be involved in this process. PMID- 6509073 TI - Selective promotion of ferrous ion-dependent lipid peroxidation in Ehrlich ascites tumor cells by histidine as compared with other amino acids. AB - Among tumors in general, Ehrlich ascites tumor cells are particularly resistant to lipid peroxidation. In this study lipid peroxidation was measured in terms of the formation of malondialdehyde-equivalent material in Ehrlich tumor cells during incubation in vitro. It was shown that the high antioxidant potential of these cells could be overcome by a strong radical-promoting agent like ferrous ion. Various amino acids were tested for their capability to augment the effect of Fe(II). Histidine and its 3-methyl-derivative turned out to be the most effective pro-oxidants, whose action could be ascribed to the presence of the imidazole group. From studies with homogenized and denatured cells it was concluded that lipid peroxidation stimulated by Fe(II)-histidinate is an autoxidation process and that no carrier effect of iron by histidine is predominating. The stimulatory action of Fe(II)-histidinate could be completely suppressed by vitamin C, which was shown to be a potent anti-oxidant under the conditions used. The combined application of Fe(II)-histidinate and vitamin C may offer a means to study lipid peroxidation of Ehrlich tumor cells in a controlled manner. PMID- 6509074 TI - Specific stimulation of phospholipase activities with phosphatidylethanolamine in transformed cells. AB - Phospholipase A1, A2 and C activities with phosphatidylethanolamine were enhanced in C6 cells relative to primary astrocytic cultures. Enhancement was a function of cell density. Phospholipase activities with phosphatidylcholine were unchanged as a function of cell density, while phospholipase C activity with phosphatidylinositol was reduced. All acid phospholipase activities measured were low or essentially absent in the three transformed cell lines examined. These results suggest that arachidonate release upon confluency is mainly from phosphatidylethanolamine. PMID- 6509075 TI - Inhibition of microsomal lipid peroxidation by cytosolic protein in presence of ADP and high concentration of Fe2+. AB - Microsomal lipid peroxidation induced by NADPH, but not by ascorbate, was found to be inhibited by liver cytosol. This inhibition was not dependent on glutathione and was enhanced by ADP in presence of Fe2+ at a concentration of 50 microM or higher. ATP was also effective, but not AMP or cyclic AMP. The cytosolic factor appeared to be a protein as it was heat-labile (greater than 70 degrees C), was non-dialyzable and was precipitated by ammonium sulfate and acetone. It was stable for several months in frozen state and also when heated at 50 degrees C for 10 min. The inhibition by the cytosolic protein was obtained by producing a lag in the activity of lipid peroxidation and was reversed by ceruloplasmin but not by catalase, cytochrome c, hemoglobin or superoxide dismutase. This inhibitory effect by cytosol was limited to formation of lipid peroxides whereas oxygen uptake and NADPH oxidation remained unaffected. Regulation of lipid peroxidation by nucleotide-Fe complexes and cytosolic proteins is indicated by these studies. PMID- 6509076 TI - Characterization and metabolic fate of two very-low-density lipoprotein subfractions separated by heparin-sepharose chromatography. AB - Human very-low-density lipoproteins (VLDL) have been separated into two discrete subfractions by heparin-Sepharose chromatography. The retained fraction relative to the unretained fraction is characterized by an increased cholesterol ester/triacylglycerol ratio and an increased ratio of apolipoprotein E relative to apolipoprotein C. We have subfractionated VLDL from type IV hyperlipoproteinemic subjects and characterized these subfractions with respect to (i) composition and (ii) the metabolic fate of apolipoprotein B of each subfraction. The unretained fraction accounted for an average of 42% of total VLDL in type IV subjects. A similar distribution was obtained with VLDL from Type III subjects; however, only 25% of normal VLDL is in the unretained fraction. The apolipoprotein E/apolipoprotein C ratio was 2-8-fold higher in the retained fraction. The distribution of apolipoprotein E isomorphs and the individual C apolipoproteins were similar in each fraction. Retained and unretained fractions were labelled with 125I and/or 131I and injected simultaneously into miniature pigs. Apolipoprotein B of retained fractions was catabolized at a greater rate (fractional catabolic rate = 0.98 h-1 vs. 0.54 h-1, n = 7, P less than 0.05) compared to unretained fractions. These results are consistent with the concept that reduced content of C apolipoproteins in VLDL is correlated with enhanced uptake by perfused rat livers. Apolipoprotein B from retained fractions was converted to intermediate-density lipoproteins (IDL) at a greater rate, and apolipoprotein B from both fractions were converted to low-density lipoproteins (LDL). Although the unretained fraction may be the precursor of the retained fraction, the possibility exists that each fraction is largely synthesized and catabolized independently. PMID- 6509077 TI - Developmental changes in molecular species of phosphatidic acid in rat lung and liver during the perinatal stage. AB - A new and sensitive method for the determination of the molecular species of phosphatidic acid was developed. The developmental profiles of the structural heterogeneity of phosphatidic acid in rat lung and liver are presented. The individual molecular species of phosphatidic acid at different stages of development were analyzed as [14C]dimethylphosphatidates. The content of phosphatidic acid gradually increased from 20 to 40 nmol/g wet tissue during development of both lung and liver. The relative distribution of the disaturated species of lung phosphatidic acid accounted for 10.1 +/- 2.4% at -2 days of gestation and slightly decreased at -1 day and 1 day after birth (8.4 +/- 1.1%), then increased significantly to the adult level of 14.6 +/- 3.2%. The developmental pattern of the disaturated species of phosphatidic acid was not similar to that of diacylglycerol or phosphatidylcholine. On the other hand, the relative distribution of the disaturated species of liver phosphatidic acid did not change (4.1-6.0%) during development. The level of the disaturated species of phosphatidic acid was significantly higher in lung than in liver at any stage of development. The overall results strongly suggest that disaturated phosphatidic acid could be effectively formed via the de novo pathway in fetal as well as in adult lung. PMID- 6509078 TI - Molecular species of monoglycosylceramides in embryonic and adult Japanese quail intestine. AB - Molecular species of monoglycosylceramides from embryonic and adult Japanese quail intestine were separated without derivatization by high performance liquid chromatography and analyzed by fast atom bombardment-mass spectrometry. The reversed-phase chromatography on an octadecyl silica beads column separated the lipids by the difference in their ceramide moieties which contain considerable amounts of hydroxy fatty acids and 4D-hydroxysphinganine (phytosphingosine). The phytosphingosine and sphingosine in the ceramide moieties of the isolated monoglycosylceramide fraction gave characteristic fragment ions of (M - 162)H+ for the phytosphingosine, and (M - 18)H+ for the sphingosine components. The presence of phytosphingosine and hydroxy fatty acids in the ceramide moieties of the monoglycosylceramide early in the embryonic stage necessarily excludes the possibility of their exogenous origin such as bacterial flora and nutrients. PMID- 6509079 TI - Comparison of very-low-density lipoproteins isolated from rat liver perfusate, rat serum and human plasma as acceptors for cholesteryl ester transfer. AB - Using two methods, we have compared the ability of three types of very-low density lipoprotein (VLDL), namely, rat hepatic perfusate VLDL, rat serum VLDL and human plasma VLDL, to accept cholesteryl esters from human plasma high density lipoprotein (HDL). Both net mass and isotopic transfers of cholesteryl ester were evaluated. The VLDL concentration in the incubation media was adjusted on the basis of equivalent amounts of either cholesteryl ester, apolipoprotein B or triacylglycerol. In each case, the net mass transfer of cholesteryl ester was found to be greatest to rat hepatic VLDL, lower to rat serum VLDL and lowest to human plasma VLDL. Similar results were obtained with the isotopic transfer method when the VLDL concentration was adjusted on the basis of cholesteryl ester or apolipoprotein B. However, when VLDL were matched on the basis of triacylglycerol concentration, the isotopic transfer rate into human plasma VLDL was twice as high as into rat hepatic VLDL which presumably reflects the decreased number of hepatic VLDL particles by this criterion. In conclusion under fasted conditions (chylomicron excluded), nascent VLDL have been shown to be the best cholesteryl ester acceptor compared to their plasma counterpart. PMID- 6509080 TI - Effect of lithocholic acid on cholesterol synthesis and transport in the rat liver. AB - The cellular origin of cholesterol which accumulates in liver cell plasma membrane fractions enriched in bile canalicular structures after lithocholic acid treatment was determined in vivo. Rats were given [3H]cholesterol followed 16 h later by [2-14C]mevalonic acid, [2-14C]acetic acid or lithocholic acid. Lithocholic acid injection enhanced the de novo synthesis of cholesterol in the microsomes and both compounds were transported to the bile canalicular membranes. However, in vitro studies demonstrated that lithocholic acid is capable of stripping cholesterol from microsomal membranes even in the absence of increased de novo synthesis. This suggests that transfer of cholesterol from subcellular organelles (microsomes) to bile canalicular membranes may be the initial step in the development of lithocholic acid-induced cholestasis. PMID- 6509081 TI - Lithocholic acid-cholesterol interactions in rat liver plasma membrane fractions. AB - This study was designed to elucidate the steps involved in the incorporation of lithocholic acid and the increase in cholesterol in liver plasma membranes after lithocholic acid injection. In vitro, cholesterol incorporation or binding to liver plasma membrane fractions enriched in bile canalicular structures occurred only when cholesterol was added simultaneously with lithocholic acid. The addition of cholic acid did not prevent the incorporation or binding of lithocholic acid and of cholesterol. However, when cholic acid was incubated with membranes already containing lithocholic acid and cholesterol, the ratio of cholesterol to lithocholic acid increased from 2 to more than 3 via a reduction of lithocholic acid. The binding of lithocholic acid and cholesterol to membranes rose 5-fold in the presence of cytosolic proteins. By electron microscopy the canalicular membrane structures with a high cholesterol content exhibited few microvilli, and their lumen appeared to have collapsed. These data suggest that simultaneous interaction of lithocholic acid and cholesterol, and not prior incorporation or binding of lithocholic acid to the membrane, may be a prerequisite to cholesterol accumulation in the membrane. PMID- 6509082 TI - Appearance of serum amyloid protein in high-density lipoproteins of rabbits subjected to relatively mild stimuli. AB - Relatively mild stimuli have been found to induce an appearance of the serum amyloid protein in the high-density lipoproteins (HDL) of rabbits. Large amounts of serum amyloid protein appeared in the HDL of rabbits, following intravenous infusions of the artificial triacylglycerol emulsion, Intralipid. Lesser, but still significant amounts of serum amyloid protein also appeared in rabbit HDL after intravenous infusions of sterile saline and even in non-infused rabbits that had been subjected to no more than serial blood sampling. Given that these latter procedures are necessary components of many metabolic experiments performed in vivo, the observation that they induce an appearance of serum amyloid protein in HDL has potentially major implications in terms of the interpretation of in vivo studies of HDL metabolism. PMID- 6509083 TI - The availability of endogenous and exogenous disaturated diacylglycerol for the diacylglycerol-consuming reactions in lung microsomes. AB - Lung tissue is characterized by its high level of dipalmitoylphosphatidylcholine, which can be synthesized by lung microsomes with endogenous and exogenous 1,2 dipalmitoylglycerol as the substrate. This endogenous substrate species was also available for the triacylglycerol synthesis but not for the de novo synthesis of phosphatidylethanolamine. From exogenous disaturated diacylglycerol the corresponding species of phosphatidylcholine, triacylglycerol and also phosphatidylethanolamine were formed. These results support the thesis that endogenous disaturated diacylglycerol is not available for all diacylglycerol consuming reactions. PMID- 6509084 TI - Inflammation-induced increases in dolichol synthesis and hydroxymethylglutaryl coenzyme A reductase activity in mouse liver are prevented by a high-cholesterol diet but not by fasting. AB - The inflammatory response in mammals is characterized by the synthesis in the liver of several N-linked serum glycoproteins called acute-phase reactants. In C57BL/6J mice, turpentine-induced inflammation was accompanied by increases in 3 hydroxy-3-methylglutaryl-coenzyme A reductase activity, dolichol synthesis, and dolichyl phosphoryl mannose synthesis. Cholesterol feeding, but not fasting, prevented these inflammation-induced increases in reductase activity and dolichol synthesis. However, the rate of incorporation of [3H]mannose into total serum glycoproteins was not affected by the high-cholesterol diet, and this rate increased during acute inflammation in control and cholesterol-fed mice. PMID- 6509085 TI - Monoclonal antibody to rat uterine peroxidase and its use in identification of the peroxidase as being of eosinophil origin. AB - Peroxidase was purified from uteri of estrogen-treated rats by calcium chloride extraction, affinity chromatography on concanavalin A-Sepharose and hydrophobic interaction chromatography on phenyl-Sepharose. An overall purification of greater than 1700-fold was achieved with a final recovery of 27%. Monoclonal antibodies to peroxidase were subsequently prepared by immunization of male C57BL/10J mice with the highly purified peroxidase from rat uterus. Spleen and lymph node cells from the mice were fused with Sp2/0-Ag 14 mouse myeloma cells. The resultant hybrid cells were screened for production of antibody using a solid phase, double antibody radioimmunoassay. The mature rat spleen, shown previously to be abundant in eosinophils, contains high peroxidase activity. Spleen peroxidase purified by the same procedure as the uterine enzyme cross-reacted with a monoclonal antibody, designated IgG-107B, used in all subsequent studies. Peroxidase extracted from isolated rat eosinophils also cross-reacted with the antibody and yielded identical titers as the spleen and uterine peroxidases. Spleen, uterine and horse eosinophil peroxidase had the same apparent molecular weight, 57000, as determined by sodium dodecyl sulfate-urea polyacrylamide gel electrophoresis. Following electrophoretic transfer to nitrocellulose, spleen, uterine and eosinophil peroxidase reacted with monoclonal antibody, using an immunoblotting technique. These results provide biochemical and immunological evidence that the majority of the calcium chloride-extractable peroxidase activity from the uteri of estrogen-treated rats is derived from infiltrating eosinophils. PMID- 6509086 TI - The inactivation of acetylcholinesterase by alpha-terthienyl and ultraviolet light. Studies in vitro and in larvae of the mosquito Aedes aegypti. AB - Acetylcholinesterase (EC 3.1.1.7) was inactivated photochemically in solution, in the presence of dissolved terthiophene sensitizers. Alpha-terthienyl (2,2':5,2" terthiophene) and its isomers 3,2':5',2"- and 3,2':5',3"-terthiophenes showed very similar sensitizing properties. With all three terthiophenes, the photosensitization was completely suppressed under anaerobic conditions, and therefore the inactivation process required the presence of oxygen. The enzyme was inactivated in vivo when fourth instar larvae of the mosquito Aedes aegypti were treated with alpha-terthienyl in the presence of long-wavelength ultraviolet light. No inactivation was observed when the organisms were treated with the ultraviolet light alone, with the chemical alone, or with a previously irradiated sample of the chemical. This paper represents the first example of acetylcholinesterase inactivation in vivo by a photoactive insecticide. PMID- 6509087 TI - Mouse 3T3 cell filtrability correlating with concanavalin A agglutinability. AB - In a previous study of the dextran gel sphere model system, a possible correlation between cell deformability and agglutinability by concanavalin A was indicated. Cell deformability was evaluated as filtrability, using polycarbonate membrane filtration. With 25-mm diameter filters and 5-ml cell suspensions at (0.8-16) X 10(5) cells/ml, the filtrability at a given filter pore size was highly reproducible and was not affected by variations in cell population, viability, washings of cells retained on filter, or temperature. The filtrability of EDTA-dissociated 3T3 cells through 12-micron pore size filter was 8%, and a suspension of 10(6) cells/ml was not agglutinated by 600 micrograms concanavalin A. The filtrability of trypsin-dissociated 3T3 cells was 95%, and these cells were agglutinated by 200 micrograms of the lectin. EDTA-dissociated SV-3T3 cells had a filtrability of 73% and were also highly agglutinable. Formalin fixation reduced the high filtrability to 6%, and also abolished the agglutinability. As a further test of the correlation, trypsin-dissociated 3T3 cells were admixed with the fixed cells. The agglutinability varied with the proportions of the two cell components, and the admixtures could be separated according to filtrability into the original components with distinctly different agglutinability. Furthermore, 25% of a random population of EDTA-dissociated SV-3T3 cells retained by the filter were found to be non-agglutinable. The separated SV-3T3 cell fractions could also form admixtures of different agglutinability. It is concluded that the agglutinability of mouse 3T3 and SV-3T3 cells by concanavalin A can be correlated with and predicted by cell filtrability. PMID- 6509089 TI - Regulation of energy flux through the creatine kinase reaction in vitro and in perfused rat heart. 31P-NMR studies. AB - Fluxes catalyzed by soluble creatine kinase (MM) in equilibrium in vitro and by the creatine kinase system in perfused rat hearts were studied by 31P-NMR saturation transfer method. It was found that in vitro both forward and reverse fluxes through creatine kinase at equilibrium were almost equal and very stable to changes in phosphocreatine/creatine ratio (from 0.2 to 3.0) as well as to changes in pH (from 7.4 to 6.5 or 8.1), free Mg2+ concentration and 2-fold decrease of total adenine nucleotides and creatine pools (from 8.0 to 4.0 mM and from 30 to 14 mM, respectively). In the rat hearts perfused by the Langendorff method the creatine kinase-catalyzed flux from phosphocreatine to ATP was increased by 50% when oxygen consumption grew from 8 to 55 mumol/min per g of dry wt. due to transition from rest to high workload. These changes could not be exclusively explained on the basis of the equilibrium model by activation of heart creatine kinase due to some decrease in [phosphocreatine]/[creatine] ratio (from 1.8 to 0.8) observed during transition from rest to high workload. Analysis of our data showed that an increase in the flux via creatine kinase is correlated with an increase in the rate of ATP synthesis with a linearity coefficient higher than 1.0. These data are more consistent with the concept of energy channeling by phosphocreatine shuttle than with that of the creatine kinase equilibrium in the heart. PMID- 6509088 TI - The effect of various chelating agents on the mobilization of iron from reticulocytes in the presence and absence of pyridoxal isonicotinoyl hydrazone. AB - The chelating agent pyridoxal isonicotinoyl hydrazone (PIH) has recently been shown to mobilize 59Fe from reticulocytes loaded with non-heme 59Fe. In this study, various chelating agents were tested for their ability to effect the mobilization of iron from reticulocytes by PIH. They fall into several groups. The largest group includes chelators such as citrate, ethylenediaminetetracetic acid and desferrioxamine, which fail to affect PIH-induced iron mobilization and do not mobilize iron per se. Either these chelators do not enter reticulocytes or they do not take up iron from PIH-Fe complexes. The second group includes chelators such as 2,2'-bipyridine, 1,10-phenanthroline, bathophenanthroline sulfonate and N,N'-ethylenebis(o-hydroxyphenylglycine) which inhibit PIH-induced iron mobilization from reticulocytes and, when added together with PIH, induce radioiron accumulation in an alcohol-soluble fraction of reticulocytes. It appears that these chelators enter the cell and compete with PIH for 59Fe(II), but having bound iron are unable to cross the cell membrane. Spectral analysis suggests that Fe(II) chelators such as 2,2'-bipyridine and 1,10-phenanthroline remove iron from Fe(II)PIH but are not able to do so from Fe(III)PIH. Then there are compounds such as 2,3-dihydroxybenzoic acid and catechol which potentiate PIH induced iron mobilization although they are unable to mobilize iron from reticulocytes by themselves. Lastly, there is a group of miscellaneous compounds which include chelators that either potentiate the iron-mobilizing effect of PIH as well as mobilizing iron from reticulocytes by themselves (tropolone), or that reduce PIH-induced iron mobilization while themselves having an iron-mobilizing effect (N,N'-bis(2,3-dihydroxybenzoyl)-1,6-diaminohexane). In further experiments, heme was found to stimulate globin synthesis in reticulocytes, the heme synthesis of which was inhibited by PIH, suggesting that PIH is probably not toxic to the cells. PMID- 6509090 TI - Microspectrofluorometry of fluorescent photoproducts in photosensitized cells. Relationship to cellular quiescence and senescence in culture. AB - Microspectrofluorometry of L and WI-38 cells reveals chemical/structural changes due to quiescence or senescence, i.e., lipid peroxidation, spontaneous or photosensitized by hematoporphyrin. Cells treated with hematoporphyrin and a lysosomal umbelliferone probe show a fast-rising umbelliferone emission, plus a fluorescent photoproduct. Studies in rapidly growing versus quiescent L, early passage/late passage WI-38 cells, suggest accumulation of fluorescence Schiff bases (i.e., their association with granular regions of cells in stationary phase, spectral properties, fast increase in photosensitized cells) and a possible lysosomal membrane permeabilization in quiescent or senescent cells. PMID- 6509091 TI - Flow cytofluorometric investigation of the uptake by hepatocytes and spleen cells of targeted and untargeted liposomes injected intravenously into mice. AB - Untargeted liposomes (composition: PC-PS-cholesterol) and targeted liposomes (composition: PC-PS-cholesterol-lactosylceramide) having encapsulated concentration-quenched carboxyfluorescein were injected intravenously into mice. 1 h after injection, the mice livers were perfused, excised and the hepatocytes were separated from nonparenchymal cells and analysed in a fluorescence-activated cell sorter analyzer. The result was that hepatocytes took up significantly more liposomes when lactosylceramide was inserted in the liposome bilayers, which was in good agreement with observations made on the in vivo uptake of liposome encapsulated insulin gene (Soriano, P. et al. (1983) Proc. Natl. Acad. Sci. USA, 80, 7128-7133). Cytofluorimetric analysis of the spleen cells showed that approx. 10% of the splenic lymphocytes take up high amounts of lactosylceramide liposomes, whereas most of the phospholipid liposomes are taken up by the phagocytic cells. The flow cytofluorimetric analysis shows, moreover, the internalization of the liposomes by the target cells and allows a quantitation of this uptake. Thus, in vivo targeting of the liposomes to specific liver and splenic cells, by means of glycolipid insertion in the liposome bilayer, is shown to take place with delivery of the liposomal aqueous space marker to these cells. PMID- 6509092 TI - The fluorinated anesthetic halothane as a potential NMR biologic probe. AB - Fluorinated anesthetics such as halothane preferentially partition into hydrophobic environments such as cell membranes. The 19F-NMR spectrum of halothane in a rat adenocarcinoma (with known altered lipid metabolism and membrane composition) shows an altered chemical shift pattern compared to the anesthetic in normal tissue. In eight tumor samples examined, the 19F-NMR spectra exhibit two distinct resonances, compared to a single resonance observed in normal tissues. This is explained by an enhanced or altered hydrophobic component in the tumor tissue giving rise to two discrete halothane environments. Another fluorinated anesthetic, isoflurane, shows similar behavior in distinguishing normal from diseased tissue. Given the large chemical shift range of fluorine and the inherent sensitivity of this nucleus, 19F-NMR spectra of fluorinated anesthetics can also be used to follow anesthetic degradation by the liver. The ability of fluorinated anesthetics to discriminate tissues and to monitor metabolic processes is potentially useful for in vivo 19F-NMR surface coil and imaging studies. PMID- 6509093 TI - A comparison of measurements of intracellular Ca by Ca electrode and optical indicators. AB - Squid giant axons were injected with aequorin or arsenazo III and impaled with a Ca-sensing electrode. The light output of aequorin or the spectrophotometer output when measuring arsenazo was compared with the voltage output of the electrode when the squid axon was depolarized with high-K solutions, when the seawater was made Na-free, or when the axon was tetanized for several minutes. The results from these treatments were that the optical response rose (as much as 50-fold) with all treatments known to increase Ca entry, while the electrode remained unaffected by these treatments. If axons previously subjected to Ca load are treated with electron-transport poisons such as CN, it is known that [Ca]i rises after a time necessary to deplete ATP stores. In such axons one expects a rise of [Ca]i in axoplasm which does not necessarily have to be uniform although the source of such Ca is the mitochondria and these are uniformly distributed in axoplasm. Under conditions of CN application, the optical signals from aequorin or arsenazo and Ca electrode output do rise together when [Ca]i is high, but there is a region of [Ca]i concentration where aequorin light output or arsenazo absorbance rises while electrode output does not. Axons not loaded with Ca but injected with apyrase and vanadate have mitochondria that still retain some Ca and this can be released by CN in a truly uniform manner. The results show that such a release (which is small) can be readily measured with aequorin, but again the Ca electrode is insensitive to such [Ca]i change. PMID- 6509094 TI - [Activation energy of enzymatic hydrolysis of different substrates of alpha chymotrypsin]. AB - Analysis of the experimental data for the series of alpha-chymotrypsin-catalyzed reactions of ester hydrolysis was carried out on the basis of modern elementary act theory of chemical processes. It was concluded that activation energy of considered reactions is attributed by repulsion potential for nucleophilic particle and carbonyl centre. It was supposed that the reason for abrupt changes of activation energy accompanying small enzyme-substrate complex structure shifts lies in the corresponding changes of carbonyl centre polarizability governed by its electrophilic environment. PMID- 6509095 TI - [Effect of the size of the ligand molecule on the stability of the DNA double helix]. AB - The influence of ligand length on helix-coil transition parameters in the presence of different ligand concentrations has been considered theoretically. A decrease of this influence with an increase of ligand length when the binding constant has a constant value was shown. When binding free energy is proportional to the ligand length, i. e. when K = K0m (K-binding constant, m-ligand length) the length effect is unambigous. In the presence of low-ligand concentration the stability of DNA double helix increases with their length, whereas in the presence of high concentrations it decreases. PMID- 6509096 TI - [A model of lipid and cholesterol interactions in hydrated phases: formation of linear cholesterol multimers]. AB - On the ground of Martin and Yeagle's model based on the possibility of formation of cholesterol dimers in the course of its interaction with lipids, the scheme of lipid cholesterol interaction is presented. Its essence is connected with possible formation of linear cholesterol multimers circled by unshared aliphatic chains. PMID- 6509097 TI - [Specific electric resistance of a narrow gap between two lipid bilayer membranes]. AB - The study deals with measurements of specific electric resistance of a narrow gap between two bilayer lipid membranes (BLM). The technique is based upon the influence of the outer electric field on the distance between two BLM which has been revealed earlier. The curve of specific resistance/solution ionic strength obtained suggests that surface conductivity is significant in similar systems. In gaps narrower than 40 nm possible increase of water viscosity must be also taken into consideration. A hypothetic mechanism of electric connection between cells is proposed. PMID- 6509098 TI - [Iodine-containing hormones--dipole modifiers of phospholipid membranes]. AB - The hormones of thyroid gland thyroxine and triiodothyronine were shown to increase the permeability of bilayer lipid membrane (BLM) and inner mitochondrial membrane for hydrophobic positively charged complex K+-nonactine and to decrease the permeability of these membranes for hydrophobic anion FCCP-. These facts imply that the thyroid hormones affect the phospholipid membranes like the dipole modifyers decreasing the positive potential of hydrophobic region of the membranes in respect to the water phase. PMID- 6509099 TI - [The use of the annihilated delayed fluorescence phenomenon in the study of the structural organization of the sarcoplasmic reticulum]. AB - Self-interaction of triplet-excited probes and interaction between the triplet excited probes and a quencher (ferrocene) at 30 degrees C have been studied in Sarcoplasmic reticulum membranes (SR) and in dimiristoyl phosphatidylcholine liposomes by means of annihilated delayed fluorescence (ADF) registration. Perylene, 7,12-dimethyl benzanthracene and 4-(2-anthryl) butanoic acid have been used as triplet probes. An average time decay ADF of perylene and 4-(2-anthryl) butanoic acid in SR is equal to 4,2: 10(-5) s and 2,3 X 10(-5) s, respectively. Triplet states constant quenching of perylene by ferrocene is equal to 2,1 X 10(7) (mM/g of lipids)-1 X s-1 in SR and 4,5 X 10(7) (mM/g of lipids)-1 X s-1 in liposomes. This means that lipids in a liquid crystalline phase form continuous extended regions containing more than 7 X 10(3) lipid molecules and free of significant hindrances in probes diffusion. PMID- 6509100 TI - [Magnetic susceptibility and magnetic capture of cells]. AB - A phenomenon of magnetic capture of human erythrocytes and lymphocytes in paramagnetic and diamagnetic modes of motion near a transversely magnetized wire has been investigated. The values of magnetic susceptibility of numerous individual erythrocytes containing hemoglobin in various forms and lymphocytes were determined using a trajectory analysis. The distribution histograms of erythrocytes in various states and lymphocytes of magnetic susceptibility have been constructed. This histogram for lymphocytes cannot exclude magnetic identification of these cells. The method of determination of physiological concentration of methemoglobin in erythrocytes based on the distribution histogram has been suggested. PMID- 6509101 TI - [A mechanism of changes in the electrophoretic motility of erythrocytes after UHF irradiation]. AB - A decrease of electrophoretic mobility is revealed in white rat erythrocytes under the effect of microwave radiation. This decrease depends on duration of irradiation. The mechanism of the influence of microwave radiation on the erythrocytes is suggested. PMID- 6509102 TI - [A model of regional deposition of aerions in the human lungs]. AB - The numerical solution of the equation of airions mass transfer in the human lung is obtained considering diffusional deposition. More than 90% of airions inhaled during breathing are deposited. The deposition occurs in the first 10-12 generations of the lung tree, and therefore the airions do not reach the alveolar region. PMID- 6509103 TI - [Study of electro-mechanical coupling in heart fibers by an optical method]. AB - It has been shown on frog auricle fibres that optical recording of contraction related to the action potential or ionic currents allows to distinguish between phasic (concerned with calcium current coming into the cell) and tonic (concerned with Ca++ input through Na/Ca metabolic diffusion) contraction components and to investigate the regulation of these components by compounds. PMID- 6509104 TI - [Muscle as a system with parametric excitation]. AB - A mechanical model for oculorotatory muscle consisting of a neurally controlled Voigt element in parallel with a mass and in series with a passive elastic element, is proposed. The magnitude of each element without the mass and the series elasticity is shown as a function of length and the viscosity as a function of velocity. The non-linear Voigt element is shown as a time-varying element to describe the activation of muscle. The characteristics resulting from the mathematical development agree well with the experimental data published for the operating range. PMID- 6509105 TI - [Configuration generators of neuronal rhythm]. AB - Neural nets that exhibit oscillations with a period n, so that n greater than N (N--number of neurons) are analysed. It is shown that the nets capable of learning can be taught to be patterned oscillators. These modes of activity may be considered as a generalization of selfwaves in topologically simple excitable tissues on more complex structures. PMID- 6509106 TI - [Does a limit of the life span really exist?]. AB - Mathematical models of aging are in conflict with real data on centenarian's survival, when these models are based on the concept of maximal life span potential. It seems that there is no absolute superior limit for the duration of life. PMID- 6509108 TI - In vivo EMG biofeedback in violin and viola pedagogy. AB - In vivo EMG biofeedback was found to be an effective pedagogical tool for removing unwanted left-hand tension in nine violin and viola players. Improvement occurred rapidly and persisted throughout a 5-month follow-up period. Further studies will be necessary to assess the effect of biofeedback independent of placebo effects. The brevity of the method and the magnitude of improvement warrant further investigation. PMID- 6509107 TI - Operant control of EEG and event-related and slow brain potentials. AB - Research on operant control of brain potentials is reviewed. From single-unit firing and spontaneous EEG activity to event-related potentials such as sensory and pain evoked potentials, and slow potential shifts, most of the aspects of electrical brain activity have been investigated. Results produced by conditioning of spontaneous EEG oscillations (alpha and theta) dampened the early enthusiasm: e.g., no increase above baseline levels could be achieved and no reliable behavioral effects became manifest. Evidence accumulates, however, that operant conditioning of the sensorimotor rhythm (12-15 Hz) may lead to successful self-regulation and that epileptic patients may profit from the training. First steps in the conditioning of brainstem, as well as pain evoked potentials suggest that self-regulation of EPs can be achieved by adequate biofeedback procedures. If some of the observed behavioral effects prove to be stable, the therapeutic usefulness seems to be within reach. A comparable progress has been achieved for the operant control of slow potentials (DC-shifts across seconds). Biofeedback procedures have been used successfully as a scientific tool to achieve systematic variations on a psychological level and to record psychological covariations. This method may provide insights into the behavioral meaning of electrical brain activity. PMID- 6509109 TI - Biofeedback, relaxation training, and music: homeostasis for coping with stress. AB - This study compared the efficacy of five relaxation training procedures, four of which employed EMG auditory feedback: biofeedback only (BF), autogenic training phrases (ATP), music (MU), autogenic training phrases and music (ATP & MU), and a control group, in developing self-regulation of a "cultivated low arousal state" as a countermeasure to tensed muscular reaction to stressful imagery. Twenty subjects established a pre- and posttraining frontalis region EMG biofeedback baseline measurement. Sixteen subjects were assigned at random to the 25-minute taped relaxation training procedure. After eight training sessions (4 weeks), MU and ATP & MU groups achieved highly significant differences when compared with the control group. The ATP & MU group attained the lowest postbaseline arousal level measured by the EMG. EMG as a physiological measure for transfer of training functioned well in detecting the psychophysiological affect of stressful imagery. PMID- 6509110 TI - Behavioral treatment of chronic cluster headache in a geriatric patient. AB - While nonpharmacological treatment of migraine and tension headache has increasingly been demonstrated to be efficacious, relatively little attention has been focused upon treatment of the more severe cluster headache. This has particularly been the case for the type of cluster headache known as chronic cluster. The present case study focused upon the treatment of a 69-year-old male with a 37-year history of headache activity. The description of headache matched those criteria currently considered to be indicative of chronic cluster headache. Following 6 weeks of baseline, during which daily ratings of head pain and daily ingestion of "as needed" (PRN) pain medication were collected, a 7-week treatment phase was implemented. Treatment consisted of thermal biofeedback coupled with a spouse contingency program (i.e., directing the spouse to avoid consequating subject reports of head pain). During the treatment phase, a near-100% reduction in amount of weekly PRN pain medication ingested was noted, along with a decrease in self-reports of head pain. Both of these decreases were maintained at 1-month, 4-month, and 15-month follow-ups. Implications for treatment of chronic cluster headache were discussed. PMID- 6509111 TI - Self-reported physical stress reactions: first- and second-order factors. AB - Stress Inventory-6, a 72-item self-report questionnaire designed to tap 18 factors of physical stress reactions, was subjected to factor analysis. The instrument was given to 474 students (254 females, 206 males, and 14 who failed to indicate their gender). The final factor solution identified 16 first-order and 4 second-order factors. The first-order solution replicated most of the factors identified in a previous study and defined factors in terms of organ system, muscle group, and simple content. In the second-order solution, Factors I, III, and IV include symptoms that are immediate and direct, appear to be related to arousal of the somatic and sympathetic nervous system, and are marked prominently by cardiorespiratory activity. In contrast, Factor II includes symptoms that are indirect and often delayed consequences of sustained arousal (Fatigue and Lack of Energy, Headaches, Backaches, etc.). A major distinction can be made between stress arousal Factors I and III. Factor III appears to be a simple "fight or flight" arousal pattern characterized by fairly direct manifestations of striated muscle tension as well as cardiorespiratory activity. In contrast, Factor I is a complex arousal pattern characterized by diffuse autonomic arousal, self-directed attention, and possibly low self-esteem. The results of this study draw into question the extent to which popular stress inventories tap a representative sample of stress symptoms. Clinical implications are discussed. PMID- 6509112 TI - Comparative accuracy of two new electronic devices for the noninvasive determination of blood pressure. AB - Recent developments in behavioral approaches to cardiovascular disease have called for physiological monitoring devices that reduce experimenter bias, are easy to operate, can be used ambulatorily, and/or provide ongoing, automated monitoring of pertinent cardiovascular functions--i.e., blood pressure and heart rate. Neither the invasive monitoring (via catheterization) nor the standard auscultatory method of blood pressure determination, however, has these characteristics. In the present study, two new methods/devices--(1) a low-weight, low-cost, battery-operated sphygmomanometer (SM), and (2) a more expensive automated electronic SM with electrical pump-are compared with each other and with the more common auscultatory method and a standard mercury SM. Both new devices were also compared with a standard pulse count. Data were derived from 10 readings of 10 healthy subjects each across the three possible comparisons, thus totaling N = 30. Correlation coefficients and average differences were computed and indicated high intercorrelations (between r = .89 and r = .99) between each pairing of the new electronic devices and the mercury SM. Intercorrelations of blood pressure determination with the two new electronic devices, however, were only moderate. Potential reasons for the variability are discussed, and guidelines for the optimal use of the new, easy-to-operate electronic devices are presented. PMID- 6509113 TI - Individual differences in motor skills ability affect the self-regulation of heart rate. AB - Twenty males who scored relatively high on the rotor-pursuit motor skills task (High performance group) were given seven 2-minute trials to increase heart rate and seven 2-minute trials to decrease heart rate, as were 20 males who scored relatively low on the rotor-pursuit task (Low performance group). Visual analogue feedback was not provided during the first and last acceleration and deceleration trials but was presented during all other trials. Both groups of subjects were able to decrease heart rate significantly with and without feedback. Subjects in the High performance group were able to increase heart rate significantly with feedback and could generalize this increase to a no-feedback trial following feedback trials. Subjects in the Low performance group could not increase heart rate with or without feedback. Changes in respiration rate paralleled those noted for heart rate, but changes in chin electromyographic activity generally did not parallel the heart rate results. The heart rate data are discussed in terms of motor skills theories of self-regulation of heart rate. PMID- 6509115 TI - The effect of activation versus inhibition of feedback on perceived control of EEG activity. AB - This study explores a model in which perceived control is affected by multiple sources of feedback at three different stages of the control sequence--person, response, and outcome. Behavior that enhances feedback is termed activation, while behavior that diminishes feedback is termed inhibition. The study tests the hypothesis that activation at any stage of the sequence leads to greater perceived control than inhibition. Eighty subjects increased or decreased their brain-wave activity (EEG) by making a tone go either on or off, using either an active or a passive strategy. Following 10 60-second trials, subjects rated their perception of control over their EEG activity. The hypothesis that making a tone go on (activation of the outcome) leads to a greater perception of control than making the tone go off (inhibition of the outcome) was confirmed only when subjects decreased their EEG activity. Perceived control was not significantly correlated with actual control, supporting the expectation that they are separately mediated. The results did not support the hypothesis that increasing EEG activity or using an activity strategy would lead to a greater perception of control than decreasing EEG or using a passive strategy. These findings are interpreted as evidence that attention to feedback may be necessary for the predicted bias in perceived control to occur, and that activation and inhibition should be operationalized as the absolute presence versus absence of feedback in testing the hypothesis for the first two stages of control. PMID- 6509114 TI - Predictors of success in the EMG biofeedback training of hyperactive male children. AB - EMG biofeedback training is continuing to evolve as a promising treatment of hyperactivity. But while research on its application suggests that this technique induces significantly lower EMG levels in experimental samples as a whole, it also discloses that some children evidence but limited reductions. Most likely, this variability is introduced by differences in subject attributes. This study assessed that prospect by examining whether four common subject characteristics correlated with the extent of decrease in EMG level achieved by 59 hyperactive school-aged boys. Those variables were pretreatment EMG level, age degree of hyperactivity, and locus of control. Number of applications or training sessions was included as the fifth predictor. A multiple regression analysis determined that only locus of control was predictive of success in EMG training; however, it accounted for 72% of the variance. Implications of these findings are discussed. PMID- 6509116 TI - Latency of visually evoked saccadic eye movements. I. Saccadic latency and the facilitation model. AB - The paper deals with the initiation of visually guided saccades, in order to break down the saccadic reaction time into functionally different periods of time. It takes into account that spatial processing of information is so basic that modelling of saccadic control properties should include spatio-temporal arrangements. The output signal of the saccadic system was measured in response to visual stimuli in which the time between the appearance of a visual stimulus in the peripheral field and the disappearance of the central fixation point was varied. The variation of the mean saccadic latency time, measured with respect to the onset of the peripheral stimulus, as a function of stimulus asynchrony was highly significant. This variation may be represented by a so-called gap-overlap curve, which is characterized here by means of five parameters. A facilitation model is introduced to fit the results of the gap-overlap experiments. The facilitation model for the initiation of visually evoked saccades incorporates a mechanism which governs the efficiency of processing of signals that arise from a stimulus presented at a particular position in space. It explains how visual information may be affected by other sensory information before it is used to command further saccades. It allows determination of saccadic system parameters, such as the peripheral and the foveal afferent processing time, the central processing time for a saccade and the degree of facilitation. These quantities were found to be characteristic for the given test subjects, and where these data could be compared with neurophysiological data, the agreement was within the experimental error. PMID- 6509117 TI - Latency of visually evoked saccadic eye movements. II. Temporal properties of the facilitation mechanism. AB - The validness of a model describing the relation between mean saccadic latency and stimulus asynchrony based on facilitation instead of suppression was tested experimentally. As a result, suppression of signals generated by the onset of a peripheral stimulus due to fixation of another target, giving rise to an increase of mean saccadic latency, does not seem very likely. The influence of the intensity of the fixation target on the latency of visually evoked saccades was studied. According to the facilitation model, the offset of the fixation target induces after an afferent delay, a transition of the state of the facilitation mechanism from the unfacilitated condition into a mode of maximal facilitation. The time-period during which this change is accomplished is called Facilitation Rise-Time (FRT). An interpretation within the context of the facilitation model of gap-overlap latency data for different values of the intensity of the fixation stimulus suggests, in combination with computer-computations of the model, that lowering of this intensity causes an increase in FRT. The results in normal subjects of step stimulus experiments with a dim fixation point substantiate the hypothesis of a facilitation mechanism, which is triggerable not only by an external signal such as the offset of the fixation point, but also by some internal stimulus independent signal. Moreover, data for tracking by an amblyopic eye seem to support this conclusion. The findings of increased saccadic latencies in amblyopic and Optic Neuritis (ON) eyes suggest a slowing of processing of visual information in the sensory pathways from the central retina, subsequently utilized by the oculomotor system in the generation of saccades.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509118 TI - Growth with regulation in fluctuating environments. II. Intrinsic lower bounds to population size. AB - Population growth is modelled by means of diffusion processes originating from fluctuation equations of a new type. These equations are obtained in the customary way by inserting random fluctuations into first order non linear differential equations. However, differently from the cases so far considered in the literature, equations possessing two non trivial fixed points are taken into account. The underlying deterministic models depict the regulated growth of a population whose size cannot decrease below some preassigned lower threshold naturally acting as an absorbing boundary. A fairly comprehensive mathematical description of these models is provided. PMID- 6509119 TI - Stabilization of Hebbian neural nets by inhibitory learning. AB - In Hebbian neural models synaptic reinforcement occurs when the pre- and post synaptic neurons are simultaneously active. This causes an instability toward unlimited growth of excitatory synapses. The system can be stabilized by recurrent inhibition via modifiable inhibitory synapses. When this process is included, it is possible to dispense with the non-linear normalization or cut-off conditions which were necessary for stability in previous models. The present formulation is response-linear if synaptic changes are slow. It is self consistent because the stabilizing effects will tend to keep most neural activity in the middle range, where neural response is approximately linear. The linearized equations are tensor invariant under a class of rotations of the state space. Using this, the response to stimulation may be derived as a set of independent modes of activity distributed over the net, which may be identified with cell assemblies. A continuously infinite set of equivalent solutions exists. PMID- 6509120 TI - Invariants in loaded goal directed movements. AB - Goal directed movements, executed by means of a manipulator with various dynamics, were investigated in order to establish to what extent the loading affects the executed movement. The desired movement concept, together with a describing function model for goal directed movements, was applied to parameterize the movements. Analysis of the results showed that the position trajectories, when scaled by means of a fundamental scale property, with respect to the maximum velocity of the desired movements, were invariant under variation of the manipulator dynamics. From this invariance in the phasing of the movements, it was concluded that the subjects fully adapted to the applied loads. PMID- 6509122 TI - A multi-stage model for border contrast. AB - A multi-stage model has been constructed. In this model, the first level is expressed by a convolution of the physical luminance function with a line spread function whose parameters depend on luminance. The second level extracts the gradient of the response that is processed at the first level. The third level detects, as edges, the inflection points of the response that is processed at the first level. The fourth level averages the response gradients over each interval between the edges, while keeping the total magnitude of the final response within the interval the same as those of the initial response at the first level. The model was applied to border contrast phenomena as described by Bergstrom (1966). PMID- 6509121 TI - Limit cycle oscillations of the human eye. AB - The altered feedback technique is very suited to display nonlinearities of the human smooth pursuit system. In fact, when the gain of the retinal feedback path is raised, for the horizontal channel, above its normal unitary negative value, a threshold is met beyond which sustained horizontal self-excited smooth oscillations of the eye can be observed, which point out the existence of a stable limit cycle. Furthermore, the characterizing features of both the transient and steady state show a well defined dependence on the total feedback factor K. In particular, the analytical dependence on K of the amplitude and frequency of limit cycle oscillations can be derived. Implications of the experiment with respect to the mathematical modelling of the system are discussed. PMID- 6509123 TI - A model for size- and rotation-invariant pattern processing in the visual system. AB - The mapping of retinal space onto the striate cortex of some mammals can be approximated by a log-polar function. It has been proposed that this mapping is of functional importance for scale- and rotation-invariant pattern recognition in the visual system. An exact log-polar transform converts centered scaling and rotation into translations. A subsequent translation-invariant transform, such as the absolute value of the Fourier transform, thus generates overall size- and rotation-invariance. In our model, the translation-invariance is realized via the R-transform. This transform can be executed by simple neural networks, and it does not require the complex computations of the Fourier transform, used in Mellin-transform size-invariance models. The logarithmic space distortion and differentiation in the first processing stage of the model is realized via "Mexican hat" filters whose diameter increases linearly with eccentricity, similar to the characteristics of the receptive fields of retinal ganglion cells. Except for some special cases, the model can explain object recognition independent of size, orientation and position. Some general problems of Mellin type size-invariance models-that also apply to our model-are discussed. PMID- 6509124 TI - Effect of doublet impulse sequences on the transient and steady responses in the computer-simulated nerve cell. AB - The effects of doublet impulse sequences of the excitatory axon on the output response as firing probability (pr.) in the computer-simulated nerve cell were examined. A simple model was formulated to simulate the nerve cell, including the property that the resetting potential is influenced by the final membrane potential in the previous stage before firing. The relationship between input sequences with alternating long and short interval at the same mean rate and the transient and steady responses of the nerve cell was investigated. In this simulation, three summarized results were obtained: i) The responses were very sensitive to changing small size of excitatory post-synaptic potential (EPSP), especially in the firing stage of the transient state. ii) In the transient state, the size of characteristic area of responses was depending upon the size of absolute refractory period (ARP). The rise for shorter intervals was faster than that for longer intervals, agreeing well with part of the experimental results from the crayfish claw opener muscles. The transient responses were almost finished before the fifth firing. iii) In the steady state, the doublet impulse sequences usually produced the minimum response or valley-like response at which the doublet interval Td was 20 and/or 25 ms. These effects related to the characteristic areas in the transient responses. PMID- 6509125 TI - The effects of motor unit synchronization on the power spectrum of the electromyogram. AB - A realistic model for two synchronized motor unit action potential trains (MUAPT) is presented in which the variability of the time difference between corresponding action potentials (hereafter denoted by delay) is taken into account. Specifically, this delay is modeled as a continuous random variable that may assume both positive and negative values. Expressions are derived for the auto- and cross-power spectra of two such trains using their relations with the auto- and cross-correlation functions, respectively, with which they form Fourier transform pairs. The results show that the auto- and the cross-power spectra of two such synchronized MUAPTs differ from the auto- and the cross-spectra of two independent MUAPTs. The contribution of the statistics of the interpulse intervals to one of the auto-power spectra is smaller and the cross-power spectra no longer reduce to a Dirac sigma-function at the origin but are now determined by the other auto-power spectrum and by the Fourier transform of the density function associated with the time difference between corresponding action potentials. As a consequence of this change in the cross-power spectra synchronization leads to an absolute increase of power at low frequencies and to a relative decrease of power at high frequencies. The results are then generalized to electromyograms (EMG) composed of more than just two MUAPTs and illustrated with simulated power spectra with which the theory shows excellent agreement. PMID- 6509126 TI - Autoregressive time series analysis via representatives. AB - In any realization of an autoregressive time series there exist a few observations having a noticeable feature: they express the useful properties of the time series and, therefore, they represent the entire process. Such representative observations (or, simply, representatives) can be determined by an optimization procedure, provided that the absolute value criterion is used instead of the customary least squares. To achieve this, a special kind of optimization operator (optimator) which generate the parameters of the time series is considered. The concepts of strong and weak similarity of the time series are defined in terms of the representatives and sufficient conditions for both strong and weak similarity are derived. It is shown that there exists a subclass of strongly similar processes, say X such that ordinary addition is a binary operation in X. An analogous result is shown to hold for weakly similar autoregressive processes. Some examples illustrating these results are given. PMID- 6509127 TI - Self-organizing mechanism for the formation of ordered neural mappings. AB - A model for the formation of ordered neural mappings in general, and of retinotectal connections, in particular is given. The main point came from the theory of "noise induced transitions", i.e. order may be the result of the interplay between deterministic and random interactions. An activity-dependent self-organizing mechanism is presented in terms of modifiable synapses. Simulation experiments were done not only for the normal ontogenetic development but also for the plastic behaviour of the retinotopic connections. PMID- 6509128 TI - [Measurement of the optical parameters of animal and human tissues in exposure to lasers]. AB - A new method for calculation of low laser-energy exposure in biological tissues has been worked out. This method allows to determine the exposition of laser treatment in each laser exposure more exactly. PMID- 6509129 TI - [Effect of adrenaline on nucleotide composition and the degree of DNA methylation in the canine myocardium]. AB - Nucleotide composition and changes of 5-methylcytosine content (m5C) in DNA isolated from male-dogs' cardiac muscle (stomach) under the influence of adrenalin have been studied. After slow intravenous injection of adrenalin in extremal doses (7 mg during 5 days) quantity of m5C in DNA decreases in 1,2 times in comparison with the control. Is has been suggested that the decrease of DNA methylation by cytosine is possible as a result of increase of enzyme activity demethylizing DNA by cytosine and (or) inactivation of methilase specifically methylizing DNA by cytosine. PMID- 6509130 TI - [Participation of the kidneys in the reaction of the anticoagulation system to thrombin administered into the blood stream]. AB - Thrombin injection into white rats jugular vein in dose 20 units on 200 g of body mass results in more considerable release of plasminogen activator in blood of renal vein as compared with blood of cava inferior and jugular veins. In this case the fibrinolytic activity of kidney cortical part decreases, but in medullar part it does not alter. The decrease of antiplasmin content in blood of renal vein is due to alpha 2-macroglobulins, in blood of jugular and cava inferior veins--to alpha 1-antithrypsin. PMID- 6509131 TI - [Reactivity of the sleeping human brain: motor and electro-encephalographic correlates of evoked reactions]. AB - Human brain reactivity during sleep has been studied. Complex stimuli: auditory stimulus 1 s--interstimulus interval 4 s--verbal instruction to clench one's fist were presented to human subjects at equal 30-second intervals throughout all night's sleep. Conditioned motor and EEG responses were elicited during the second and the third experimental nights by repeating only auditory stimuli at 30 or 15-second intervals respectively. It has been suggested that a short-term memory store functions during sleep for at least 30 s after presenting stimuli. PMID- 6509132 TI - Effect of dopamine infusion on pulmonary gas exchange in lambs. AB - We studied the effects of dopamine HCl, a potent vasoactive catecholamine, on ventilation-perfusion matching and pulmonary hemodynamics in infant lambs breathing room air and a hypoxic gas mixture. Neither alveolar hypoxia alone, nor dopamine infusion alone during room air breathing, significantly altered the ventilation-perfusion (VA/Q) distribution or intrapulmonary shunt size. Dopamine infusion during room air breathing did increase pulmonary blood flow (PBF; p less than 0.05). Dopamine infusion plus alveolar hypoxia was associated with a significant increase in minute ventilation, PBF, and pulmonary arterial pressure (Ppa), a doubling (p less than 0.01) of the fraction of PBF to low VA/Q lung regions, and a significant increase (p less than 0.05) in intrapulmonary shunt when compared to results obtained during hypoxic gas breathing without dopamine infusion. We conclude the dopamine infusion increased PBF during room air breathing, and perturbed ventilation-perfusion matching and increased Ppa and minute ventilation with no net change in arterial pO2 during the breathing of a hypoxic gas mixture. PMID- 6509133 TI - Changes in cysteine dioxygenase and cysteinesulfinate decarboxylase activities and taurine levels in tissues of pregnant or lactating rat dams and their fetuses or pups. AB - The level of taurine and the activities of the two enzymes involved in its synthesis, cysteine dioxygenase and cysteinesulfinate decarboxylase, were measured in tissues of rat dams during pregnancy and lactation and in their fetuses or pups. The most marked changes observed in the dams included an increased hepatic taurine concentration in late pregnancy (20 days), a decreased plasma taurine concentration during late pregnancy and throughout lactation, and a decrease in tissue cysteine dioxygenase activity in late lactation (20 days). These observations suggest that the dam's taurine pools may be an important source of taurine for secretion in the milk and that pregnant dams may prepare for the onset of lactation by accumulating additional taurine in the liver. There was little if any correlation between the activities of either of these key enzymes in taurine synthesis and tissue taurine levels. The taurine concentrations in liver, brain, heart and plasma of the young decreased between 1 day before birth and 20 days of age. Cysteine dioxygenase and cysteinesulfinate decarboxylase specific activities increased in the brains of pups between birth and 20 days of age, and cysteinesulfinate decarboxylase activity increased in the livers of pups between birth and 20 days of age. Cysteinesulfinate decarboxylase activity in 80-day-old male rats was more than six times that in female littermates, but no effects of sex on cysteine dioxygenase activity or tissue taurine concentrations were observed. PMID- 6509134 TI - Effect of cortisone on intestinal uptake of lead in the suckling rat. AB - A previous study showed that there is extensive uptake of lead by the duodenum and the ileum of the suckling rat. At both sites, uptake declines with advancing age. This paper reports the effects of administration of cortisone acetate on in vivo lead uptake in 14- to 15-day-old rats. The results indicate that the duodenal uptake component is unaffected by hormone treatment whereas the ileal uptake component is markedly suppressed. There was no significant difference in blood lead concentrations in cortisone-treated pups as compared with vehicle treated controls. We conclude that lead absorption in the suckling rat occurs primarily in duodenum and is not under glucocorticoid control. The ileal uptake of lead probably represents intestinal retention rather than absorption: its responsiveness to cortisone would be consistent with uptake via pinocytosis. PMID- 6509135 TI - Environmental and endogenous control of reproductive function in the Great Basin pocket mouse Perognathus parvus. AB - Pocket mice captured in the field at various times of year were introduced into laboratory experiments to examine the short-term sensitivity of reproductive function to environmental factors, principally day length, and the tendency of the reproductive system to become active spontaneously over longer durations. Spontaneous enlargement and partial activation of the gonads occurred over the course of 4-5 mo in continuous darkness during the hibernation season. Males held for 13 mo in 12L:12D showed patterns of testicular enlargement, but with only partial regression; the degree of endogeneity in the reproductive control system of P. parvus is therefore considerably below that of the pronounced and persistent "endogenous circannual rhythms" shown by certain rodents of the squirrel family. Responses to day length varied seasonally. The partially activated reproductive system of mice that emerged from hibernation in spring was further stimulated by long days (16L:8D); in summer gonadal growth was insensitive to differences in day length, and in autumn the gonads remained undeveloped in short days (8L:16D) but were sensitive to stimulation by long days. This "photoperiodic" response of P. parvus is based on an endogenous circadian rhythm of photosensitivity as proposed by Bunning (1936). We also found that reproductive function of P. parvus is somewhat retarded by low temperature and reduced availability of water. We discuss the general nature of environmental sensitivity of reproductive function and the ways in which the photoperiodic response and spontaneous pattern of winter gonadal development in P. parvus are likely to interact with environmental factors that lead to fine-tuning the final reproductive response. PMID- 6509136 TI - Granulosa cell steroidogenesis before in vitro fertilization. AB - Endocrine and gametogenic functions of the ovulatory follicle may be linked. To verify this, we studied granulosa cell steroidogenesis in relation to oocyte fertilization and preimplantation embryo development in vitro. Multiple follicles were stimulated in in vitro fertilization patients with clomiphene citrate and ovulation was induced with human chorionic gonadotropin (hCG). Oocytes were fertilized with husband's sperm and normal embryos were replaced 48 h later. Granulosa cells were separated from follicular fluid from 64 follicles and incubated for 3 h with and without aromatase substrate (1 microM testosterone). Progesterone and estradiol levels were measured in follicular fluid and incubation medium. Follicular fluid steroid levels and granulosa cell steroidogenesis showed no significant differences for oocytes which cleaved normally and those which did not. Granulosa cell aromatase activity was high in all follicles, suggesting that the low periovulatory follicular fluid estradiol level is not explained by a fall in granulosa cell aromatase after hCG. High granulosa cell progesterone production and follicular fluid progesterone were consistent with advanced granulosa cell luteinization. Oocytes undergoing polyspermic activation were from larger follicles with elevated follicular fluid progesterone levels, suggesting that follicular size and follicular fluid progesterone are correlated with "over-ripeness" and polyspermy. No simple relationship exists between oocyte function and the present indices of granulosa cell steroid metabolism. PMID- 6509137 TI - Some properties of acid and alkaline phosphates from boar sperm plasma membranes. AB - Boar sperm plasma membranes were purified by differential and sucrose density equilibrium centrifugation and were found to yield a single band at a density of 1.14 g/cm3. Both alkaline and acid phosphatase activities were enriched in this fraction. The alkaline phosphatase activity was optimal in 100 mM tris (hydroxymethyl) methylamine (Tris)-NaHCO3 at pH 9.9 with 0.05% Triton X-100 and 1 mM MgCl2. This activity was inhibited by ethylenediaminetetraacetic acid (EDTA), cadmium, zinc or heating at 60 degrees C for 30 min. Also, L-homoarginine caused approximately 70% inhibition and L-phenylalanine or L-leucine caused about 10 to 20% inhibition. Acid phosphatase activity was optimal in 100 mM sodium acetate at pH 5.1 with 0.05% Triton. Sodium dodecyl sulfate, potassium fluoride (KF) or sulfhydryl reagents inhibited the activity, while EDTA or heating at 60 degrees C had no effect. These data for enzymes from boar sperm plasma membranes can be used for future work on the quantitation of the enzymes, distinguishing these two phosphatases from other phosphohydrolases, purification of the enzymes and for comparison to phosphatases in other tissues. PMID- 6509139 TI - Changing frequency of pulsatile luteinizing hormone and progesterone secretion during the luteal phase of the menstrual cycle of rhesus monkeys. AB - Experiments were conducted to examine the pulsatile nature of biologically active luteinizing hormone (LH) and progesterone secretion during the luteal phase of the menstrual cycle in rhesus monkeys. As the luteal phase progressed, the pulse frequency of LH release decreased dramatically from a high of one pulse every 90 min during the early luteal phase to a low of one pulse every 7-8 h during the late luteal phase. As the pulse frequency decreased, there was a corresponding increase in pulse amplitude. During the early luteal phase, progesterone secretion was not episodic and there were increments in LH that were not associated with elevations in progesterone. However, during the mid-late luteal phase, progesterone was secreted in a pulsatile fashion. During the midluteal phase (Days 6-7 post-LH surge), 67% of the LH pulses were associated with progesterone pulses, and by the late luteal phase (Days 10-11 post-LH surge), every LH pulse was accompanied by a dramatic and sustained release of progesterone. During the late luteal phase, when the LH profile was characterized by low-frequency, high-amplitude pulses, progesterone levels often rose from less than 1 ng/ml to greater than 9 ng/ml and returned to baseline within a 3-h period. Thus, a single daily progesterone determination is unlikely to be an accurate indicator of luteal function. These results suggest that the changing pattern of mean LH concentrations during the luteal phase occurs as a result of changes in frequency and amplitude of LH release. These changes in the pulsatile pattern of LH secretion appear to have profound effects on secretion of progesterone by the corpus luteum, especially during the mid-late luteal phase when the patterns of LH concentrations are correlated with those of progesterone. PMID- 6509138 TI - Characterization of the estrogenic properties of a nonsteroidal estrogen, equol, extracted from urine of pregnant macaques. AB - Recent reports of substantial urinary levels of equol in pregnant macaques and humans pose a concern, because equol poisoning in the ovine is characterized by an often permanent failure of reproductive processes. Equol (Fig. 1), a metabolite of phytoestrogens, is thought to act through estrogen receptors. The present study made a direct comparison of the estrogenic activity of equol from macaque urine, (+/-) equol and 17 beta-estradiol (E2) in vitro and in vivo. Relative binding affinity of equol for rat uterine receptor was 1% that of E2, and the dissociation rate of equol from the receptor was very high. Consistent with equol's binding properties in vitro, it was ineffective in stimulating rat uterine weight gain and possessed limited ability to increase progesterone receptor. Uterine nuclear receptors after doses of equol sufficient to produce depletion and replenishment of cytosol estrogen receptor were not measurable by exchange assay. No antiestrogenic activity of equol could be demonstrated. Equol's weak potency and lack of antiestrogenic activity are difficult to reconcile with its ability to induce ovine infertility. We conclude species differences at some level other than classical estrogen receptor as defined in the rat model are responsible for variability in equol's impact. PMID- 6509140 TI - Role of ovarian steroid hormones in the regulation of adenylate cyclase during early progestation. AB - The hormonal regulation of uterine adenylate cyclase (AC) was measured in the rat by radiochemical analysis. Animals made pseudopregnant by cervical stimulation were ovariectomized on Day 1 (the first appearance of leukocytes in the vaginal smear) and injected for 6 days with sesame oil, 0.1-10.0 micrograms estrone, 2.0 mg progesterone, or 1.0 microgram estrone + 2.0 mg progesterone. AC activity in ovariectomized controls remained at basal levels (2.8-3.3 pmol cAMP formed/min X mg protein). The injection of progesterone did not alter AC activity significantly, but estrone increased AC activity during Days 3-5, and the response (5-17 pmol) was dose dependent. The action of estrone was not inhibited by progesterone. The present experiments revealed: a) AC from estrone-treated rats was activated 2- to 4-fold by 10 mM NaF; b) following treatment with estrone + progesterone, AC was activated 2- to 3-fold by a trauma to the uterus; c) unlike the response to fluoride, the effect of trauma was temporally limited to Day 4; and d) when AC was activated by trauma, no further increase was elicited by NaF. The data indicated that the transient sensitivity of AC to activation by trauma on Day 4 in E+P-treated rats was identical to that in intact rats and paralleled the normal timing of uterine sensitivity to decidual induction. PMID- 6509141 TI - Effect of suckling and ovariectomy on the control of luteinizing hormone secretion during the postpartum period in beef cows. AB - Twenty-two mature pluriparous beef cows were randomly assigned to one of six treatments in a 2 X 3 factorial experiment in order to study the role of suckling and ovarian factors on control of the tonic and episodic release of luteinizing hormone (LH). Twelve cows remained intact (INT) and 10 were ovariectomized (OVX) within 4 days following the day of parturition (Day 0). The suckling intensities were nonsuckled (0), suckled once daily for 30 min (1) and suckled ad libitum by two calves (2). Blood samples were collected at 15-min intervals for 6 h weekly, from Days 6 to 76 postpartum. The postpartum intervals to initiation of ovarian luteal function were 31 +/- 3, 41 +/- 4 and 67 +/- 1 days (means +/- SEM) for INT cows with 0, 1 and 2 suckling intensities, respectively. Mean LH concentrations and frequency of LH pulses increased as time of ovulation approached in INT cows. In OVX animals, both mean LH concentrations and frequency of LH pulses increased as time postovariectomy progressed. No differences were detected in mean LH concentrations or frequency of LH pulses between the two suckled OVX groups. Mean LH in the OVX-0 cows was greater on Days 13, 20 and 27 postpartum when compared to the respective days in suckled OVX cows. Frequency of LH pulses tended to be lower (P less than 0.10) in both suckled OVX groups when compared with OVX-0 cows from Day 6 to Day 55 postpartum. It is postulated that suckling and ovarian factors act together during the postpartum period to suppress LH levels and frequency of LH pulses in beef cows. PMID- 6509142 TI - Quantification of the human Sertoli cell population: its distribution, relation to germ cell numbers, and age-related decline. AB - The human Sertoli cell population was characterized in 14 men by histometric analysis and by direct counts of nuclei in testicular homogenates. Testes obtained at autopsy were perfused with glutaraldehyde and embedded in Epon. Nucleolar and nuclear volumes were determined by the formula of a sphere given the diameter of the nucleoli or average diameter of nuclei measured at the height and width. Nuclear volume was also estimated by adding volumes of nuclear profiles in 0.5-micron serial sections. Sertoli cell number/g was calculated by the product of the percentage nucleoli or nuclei in the parenchyma, parenchymal volume, and histologic correction factor divided by the volume of a single nucleolus or nucleus. Also, Sertoli cell nuclei were counted directly in homogenates of fixed parenchyma. Number of Sertoli cells/g was similar (P greater than 0.05) whether determined by serial sections or in homogenates, but the estimate based on the nucleolar method was higher (P less than 0.01) and the nuclear measurement method was lower (P less than 0.01) than that for serial sections. A group of 37 men aged 20 to 48 yr had significantly (P less than 0.01) more Sertoli cells than did 34 men aged 50 to 85 yr. It is concluded that: 1) the homogenate method is valid for quantification of the Sertoli cell population, 2) Sertoli cells are evenly distributed in different regions of the testis, 3) the average human Sertoli cell supports relatively few germ cells, 4) the human Sertoli cell population declines with age, and 5) there is a significant relationship between sperm production rates and number of Sertoli cells. PMID- 6509143 TI - Localization of thiol and disulfide groups in guinea pig spermatozoa during maturation and capacitation using bimane fluorescent labels. AB - The distribution of thiols and disulfides in the guinea pig spermatozoon during maturation and capacitation was studied using both membrane-permeable (mBBr) and impermeable (qBBr) forms of bromobimane, a specific fluorescent probe for thiol groups. In conjunction with the disulfide (SS)-reducing agent dithiothreitol (DTT) and the thiol-alkylating agent N-ethylmaleimide (NEM), quantitative spectrofluorometric measurements of the relative amounts of total thiol (SH) versus SS were performed on cauda epididymal spermatozoa. Under conditions labeling 70% of the reactive thiols, the ratio total SS/SH was 2.4/1.0. Contamination by other cell types prevented similar measurements on spermatozoa at earlier stages of epididymal maturation; thus, the qualitative localization of SH and SS groups in these and in capacitated spermatozoa was visualized using fluorescence microscopy. As spermatozoa moved from the testis to the caput epididymidis, there was a slight apparent increase in staining both on the surface and internally in all regions. Thereafter, surface and internal staining decreased by the time spermatozoa reached the cauda epididymidis. Fluorescence patterns were unaltered under short-term (1 h) capacitation conditions in calcium free modified Tyrode's medium containing lysophosphatidyl choline and after induction of the acrosome reaction with 2 mM calcium. However, long-term capacitation (16-18 h) in calcium-free modified Tyrode's medium resulted in a loss of detectable SH in the head and acrosome. Regardless of the stage examined, sperm tails contained the greatest relative amount of SH, followed by the head and the acrosome. In addition, there was always more SH detectable internally than on the surface. DTT pretreatment caused a dramatic increase in staining in all regions, both surface and internal, consistent with the quantitative estimates of the SS/SH ratio. PMID- 6509144 TI - Evidence for a proteinase inhibitor binding component associated with murine spermatozoa. AB - The supernatants of frozen-thawed murine epididymal sperm suspensions contain a heat-labile component capable of binding a low molecular weight, acid-stable proteinase inhibitor of seminal vesicle origin. The substance has a molecular weight of approximately 15,000 and can be isolated by affinity chromatography using the inhibitor as the ligand. Although the substance has no inherent enzymatic properties, it will decrease the activity of the seminal inhibitor in the standard N-benzoyl-DL-arginine-p-nitroanilide (BAPNA) assay. Enzyme-linked immunosorbent assays (ELISA) indicate that the substance, when bound to microtiter plates, is capable of binding the seminal vesicle inhibitor. Turkey egg white trypsin inhibitor will decrease the amount of the seminal inhibitor that will bind to the substance, while noninhibitor proteins, e.g., bovine serum albumin or insulin, have no effect. Turkey egg white and lima bean trypsin inhibitor will also decrease the amount of seminal vesicle inhibitor capable of binding to washed sperm. These data indicate the presence of an inhibitor acceptor site associated with murine epididymal spermatozoa. PMID- 6509145 TI - Comparison of chromosomal abnormalities in hamster egg and human sperm pronuclei. AB - One thousand human sperm and hamster egg haploid karyotypes were analyzed at the pronuclear stage after in vitro penetration. The frequency of abnormalities in human sperm was 8.5%, with 5.2% aneuploidy and 3.3% structural abnormalities. The hamster egg complements had an abnormality rate of 3.8%, with 3.3% aneuploidy and 0.5% structural abnormalities. In both human and hamster complements, chromosome abnormalities were observed in all chromosome groups, demonstrating that all chromosomes are susceptible to nondisjunction, not just acrocentric or small chromosomes. There is an intriguing difference between the frequency of hyperhaploid and hypohaploid complements in human sperm and hamster eggs. In the human complements, 2.4% were hyperhaploid and 2.7% hypohaploid. This is very close to the theoretical 1 to 1 ratio expected from nondisjunction. The hamster egg complements had more hypohaploid (2.2%) than hyperhaploid (0.9%) complements, despite identical treatment. Higher rates of hypohaploidy are generally ascribed to artificial loss of chromosomes, but may in fact reflect a predisposition of oocytes to anaphase lag during meiosis. The frequency of abnormalities (both numerical and structural) is higher in human complements than in hamster. This may reflect an innate propensity for meiotic chromosome abnormalities in humans or may result from greater exposure of humans to mutagenic agents. PMID- 6509146 TI - Growth characteristics of human first trimester decidual cells cultured in serum free medium: production of prolactin, prostaglandins and fibronectin. AB - A procedure for the establishment of pure human first trimester decidual cells in primary cultures has been developed. The high rate of success in obtaining such cultures resulted from the elimination of fibroblasts by appropriate enzyme dissociation and filtration of the initial tissue sample, and subsequent maintenance of the cells in a serum-free medium supplemented with insulin, fibroblast growth factor (FGF), estradiol, progesterone, hydrocortisone, transferrin and sodium selenite. Under these culture conditions, we obtained pure and actively dividing decidual cells forming tightly packed and nonoverlapping epithelioid cell monolayers covering more than 75% of the culture area. The cultured decidual cells retained their in vivo capacity to produce prolactin and various prostaglandins (PGs), primarily PGE2. There was a marked reduction in hormone production after 20 days in culture. A massive network of fibrillar surface fibronectin was detected by indirect immunofluorescence staining of the cultured cells. The production of prolactin and PGs together with the secretion of fibronectin may play a role in the implantation and subsequent growth of the embryo. The described procedure of obtaining fibroblast-free decidual cell monolayers will promote studies on the hormonal regulation of this tissue at the time of early intrauterine life. PMID- 6509147 TI - Sperm concentration and the fertilization of human eggs in vitro. AB - The effect of sperm concentration on the fertilization of preovulatory and immature human eggs was studied in the context of an ongoing in vitro fertilization-embryo transfer (IVF-ET) program. Fertilization success was independent of the follicular recruitment protocol used, and with preovulatory eggs, was inversely related to sperm concentration over the range of 2.5 - 50 X 10(4) motile sperm/ml. Maximum fertilization (80.8%) occurred at a concentration of 2.5 X 10(4) motile sperm/ml. The incidence of polyspermic fertilization was directly related to the sperm concentration, decreasing from 5.5% at 10 X 10(4) to 0% at 1-2.5 X 10(4) motile sperm/ml. Immature eggs cultured in vitro, then inseminated, also demonstrated an inverse relationship between fertilization and sperm concentration with a maximum fertilization rate of 66.6% at 5 X 10(4) motile sperm/ml. The percentage of motile sperm in the inseminating population had no influence on fertilization rates unless the value dropped below 40%. Fertilization success using sperm from oligospermic and polyzoospermic males was also examined. In contrast to males with normal semen parameters, oligospermic males demonstrated highest fertilization success at 50 X 10(4) motile sperm/ml. The IVF of preovulatory eggs using sperm from polyzoospermic males was comparable to that for males with normal semen parameters at equivalent sperm concentrations. The implications of these findings to the application of IVF-ET technology to the infertile couple is discussed. PMID- 6509148 TI - Coordination of sucking, swallowing and respiration in infants with sleep apnea syndrome. PMID- 6509149 TI - [On the problem of repeated sterilization of polyethylene implants--a literature search]. PMID- 6509150 TI - NMR relaxation studies of intracellular Na+ in red blood cells. AB - The state of intracellular Na+ in human and dog erythrocytes was characterized by 23Na-NMR using dysprosium complexes as shift reagents. Intracellular Na+ concentrations were determined using integration of the inner Na+ NMR signals and measurements of the intracellular volume using 59Co-NMR of extracellular Co(CN)3 6. T2 was found to be significantly shorter than T1, indicating some binding to macromolecules. While the longitudinal magnetization decay follows a single exponential, the transverse magnetization could be fitted with a double exponential function. It was shown that neither the binding to the inner side of the membrane nor binding to hemoglobin contributes to the relaxation enhancement. PMID- 6509151 TI - Linear free energy relationship for osmotic water flow through a membrane. AB - A linear free-energy relationship has been found for the osmotic water flux through membranes in a broad variety of systems including electrolytes, organic compounds, intact biological cells and industrial scale filtration. In all cases, broad concentration ranges were found in which the equation 1n v = alpha 1n m + beta (v, flux (in kg cm-2 min-1; m, molarity] was valid. The parameters alpha and beta were interpreted in terms of molecular weight, mean ionic radius, enthalpy of solvation, electronic structure and H-bonding propensity. The equation is independent of the membrane material and of the presence of other solutes and precipitates, as long as the latter are incompressible. Its parameters are only slightly dependent upon the temperature. The contributions from different solutes to the osmotic flux are at appreciable concentrations even additive. The relationship permits the prediction of the osmotic water flux and of the rate of filtration of systems of known composition. For simple systems it permits determination of the molecular weight, mean ionic radius, degree of hydration and enthalpy of solvation. It is suggested that osmosis is primarily due to the shift of hydration equilibria and that guanidine hydrochloride, in a realistic concentration range, forms practically infinite clathrates with water. The properties of the urea and Gdn X HCl systems indicate that these solutes either reversibly change the membrane structure and/or display intrinsic hysteresis. PMID- 6509152 TI - Polydispersity effects on head-to-tail polymerization of F-actin. A theoretical treatment. AB - A theoretical description of the release of labeled subunits of F-actin that undergoes head-to-tail polymerization utilizing random-walk theory is extended to the case of a finite-length polymer. An exact expression is given for the number of released subunits in a suitable form for numerical calculation. By comparing the results for a finite-length polymer with that for an infinite-length case, the limitation of the infinite-length approximation is readily known. The results for finite-length polymers are applied to systems with polydispersity. It is shown that the number of labeled subunits released from F-actin depends strongly on the distribution functions of the polymer lengths and the values of the transition probabilities of the random walkers. PMID- 6509153 TI - Mass spectral identification of benzothiazole derivatives leached into injections by disposable syringes. AB - Five benzothiazole derivatives leached into injections by the rubber plunger seals of disposable syringes were identified by electron impact (EI) and chemical ionization (CI) mass spectrometry. These are 2-hydroxybenzothiazole, 2 mercaptobenzothiazole, 2-(methylmercapto)benzothiazole, 2-(2 hydroxyethoxy)benzothiazole and 2-(2-hydroxyethylmercapto)benzothiazole. 2 Mercaptobenzothiazole is used as a vulcanization accelerator. The other four compounds are formed from the zinc derivative of 2-mercaptobenzothiazole during sterilization with ethylene oxide. Toxicological, technological and legal consequences of the leaching are discussed briefly. PMID- 6509155 TI - Determination of phenobarbital, p-hydroxyphenobarbital and phenobarbital-N glucoside in urine by gas chromatography chemical ionization mass spectrometry. AB - A sensitive and efficient analytical procedure was developed to determine phenobarbital-N-glucoside, phenobarbital and p-hydroxyphenobarbital in urine. The stable-isotope labeled internal standards used in this assay were obtained in urine from a subject who ingested 15N-labeled phenobarbital. PMID- 6509154 TI - Positive and electron capture negative ion methane chemical ionization mass spectrometry of pyrrolizidine alkaloids. AB - Pulsed positive and negative ion methane chemical ionization mass spectrometry of pyrrolizidine alkaloids is reported. Positive ion spectra are characterized by a high relative abundance of [MH]+ ions while the negative ion spectra exhibit ion peaks due to dissociative electron capture. Fragmentation in both positive and negative ion spectra primarily occurs at the ester groups with the positive charge residing with the pyrrolizidine ring system while the negative charge in contrast tends to reside with the necic acid moiety. Esterification at C-9 v. C-7 can be distinguished for non-cyclic esters of retronecine in the positive ion spectra. PMID- 6509157 TI - Desorption ionization mass spectrometry of synthetic porphyrins. AB - The desorption ionization mass spectra are reported for two classes of synthetic porphyrins--'tailed' derivatives of deuteroporphyrin IX and meso-substituted derivatized tetraphenylporphines. The mass spectra were obtained by three desorption ionization techniques--fast atom bombardment (FAB), desorption chemical ionization (DCI) and 'in-beam' or desorption electron ionization (DEI). The emphasis of this study is to determine the usefulness of the three desorption ionization methods for the molecular weight and side-chain structure determinations of synthetic porphyrins. The molecular parent ions and the major fragmentation pathways are discussed in detail. The DEI method yielded the fewest mass spectra showing molecular parent ions from the compounds studied, whereas FAB gave the most. The major fragmentation pathways were compound dependent and similar for all three ionization methods; generally, those cleavages alpha and beta to carbonyl groups predominated. The FAB spectra showed strong molecular adduct ions in several spectra that could be attributed to an in situ coordination of iron-containing porphyrins with the thio-containing liquid matrix molecules. PMID- 6509156 TI - High-performance liquid chromatographic isolation and fast atom bombardment mass spectrometric identification of Di-N-desethylamiodarone, a new metabolite of amiodarone in the dog. AB - Amiodarone is an antiarrhythmic drug which has received considerable attention in recent years. It has been suggested that the unusual pharmacodynamic characteristics of this drug may be due in part to the influence of active metabolites. Using fast atom bombardment (FAB) mass spectrometry we have identified a new metabolite of amiodarone, the di-N-desethyl analog (DDEA). This metabolite was present in the blood of dogs treated with the parent drug, and showed a greater affinity for myocardium than did the parent drug. The unique features of FAB mass spectrometry over electron impact mass spectrometry was an essential element in facilitating the identification of this new metabolite. Whether or not this metabolite has pharmacologic activity or is responsible for some of the side effects occurring during amiodarone administration is not known. PMID- 6509158 TI - Effect of alkylation with N-methyl-N-nitrosourea and N-ethyl-N-nitrosourea on the secondary structure of DNA. AB - We have earlier reported that alkylation of DNA by the chemical carcinogen dimethyl sulphate, which mainly alkylates N-7 of guanine and N-3 of adenine, causes the formation of partially denatured regions in double-stranded DNA (Rizvi RY, Alvi NK & Hadi SM, Biosci. Rep. 2, 315-322, 1982). It is known that the major site of alkylation in DNA by N-ethyl-N-nitrosourea (EtNu) are the phosphate groups. N-methyl-N-nitrosourea (MeNu), on the other hand, causes the alkylation of mainly guanine residues. We have therefore studied the effect of these two alkylating carcinogens on the secondary structure of DNA. DNA alkylated with increasing concentrations of EtNu and MeNu was subjected to alkaline and S1 nuclease hydrolysis. Thermal melting profiles of alkylated DNA were also determined using S1 nuclease. The results indicated that alkylation by the two alkylating agents had a differential effect on the secondary structure of DNA. EtNu-alkylated DNA was found to be more thermostable than native DNA at neutral pH. It was however more alkali-labile than MeNu-alkylated DNA. The greater stability of EtNu-alkylated DNA was considered to be due to abolition of negative charges on phosphate alkylation. PMID- 6509159 TI - Increased glycolysis in ageing cultured human diploid fibroblasts. AB - With increasing population doubling in vitro, human diploid fibroblasts exhibited a highly significant increase in glucose uptake from the growth medium and a corresponding increase in lactate production. The switch to glycolysis occurred prior to the onset of changes in intracellular glucose and lactate concentrations or in the specific activity of the glycolytic regulatory enzyme, pyruvate kinase. It also preceded the morphological alterations held to be characteristic of cellular senescence. PMID- 6509160 TI - Quantitation of excretion of dolichol and dolichyl phosphate from the rat. AB - In order to gain information on the metabolism of dolichol, the rates of excretion of dolichol and dolichyl phosphate were determined in rats maintained on a dolichol-free diet for 10 days. Analysis of fecal samples collected every 48 h yielded mean output values of 9.0 +/- 1.4 and 20.7 +/- 3.0 micrograms/rat/day of dolichol and dolichyl phosphate, respectively. Urinary output rates were 0.56 +/- 0.12 and 0.50 +/- 0.28 microgram/rat/day of dolichol and dolichyl phosphate, respectively. Thus, excretion is one fate of endogenously synthesized dolichol compounds in the rat. PMID- 6509161 TI - Methylglyoxal inhibits the translation of natural and chemically decapped mRNAs. AB - Methylglyoxal was a weak inhibitor of translation in the reticulocyte-lysate cell free system and it did not display cap-dependent inhibition. A similar inhibition was obtained in a wheat-germ cell-free system that displayed extensive cap dependent inhibition with the cap analogue 7-methylguanosine phosphate. These results show that the chemical reaction of methylglyoxal with 7-methylguanosine is not the mechanism for the inhibition of protein synthesis by methylglyoxal and that methylglyoxal is a weak general inhibitor of translation. PMID- 6509162 TI - Craniofacial mesenchyme in morphogenesis and malformation. Symposium, Seattle, Washington, June 19, 1983. PMID- 6509163 TI - Craniofacial development in arthrogryposis (congenital contractures). PMID- 6509164 TI - [Changes in the carotid artery tonus of cats in response to changes in the blood flow rate]. AB - It was shown in acute experiments on cats that the carotid artery is sensitive to the rate of blood flow. The increased blood flow with the unchanged perfusion pressure causes carotid artery enlargement which is maintained throughout the entire period till the arterial blood flow remains increased. The reduction of blood flow to the initial level is accompanied by the diameter returning to the initial value. The latent period of the dilatatory response of the carotid artery to the increased blood flow does not exceed 25 s, the maximal magnitude of the response averages 25 +/- 6%. In the physiological blood flow range (from 10 to 50 ml/min) the response is linearly dependent on the degree of the blood flow increase. PMID- 6509165 TI - [Phospholipid and malondialdehyde content in the cerebral cortex of rats with incomplete ischemia and in the postischemic period]. AB - During severe incomplete brain ischemia caused by combined bilateral ligation of the general carotid arteries and blood pressure reduction to 50 Hg by blood withdrawal from the femoral artery, the cortex of cerebral hemispheres demonstrates, by the 60th minute of ischemia, a 15.4%-lowering of the content of total phospholipids (PL) and a 33.3%-increase in the content of malonyl dialdehyde (MDA). By the 30th minute of the postischemic period the content of total PL remains decreased, the content of monophosphoinositides (MPI) rises by 110.2%, whereas the content of MDA remains high. By the 60th minute of postischemia the content of total PL and MDA returns to the initial levels. However the content of MDA remains high as before. PMID- 6509166 TI - [Early manifestations of the effect of Salmonella endotoxin on the antioxidizing enzyme systems of the liver and intestines in the rat]. AB - A study was made of the effect of salmonellosis endotoxin (SE) on the activity of glutathione transferase (GT), glutathione peroxidase (GP-GTB and GP-H2O2), glutathione reductase (GR) and superoxide dismutase (SOD) in cytosols of the rat jejunal mucosa and liver. The activity of all the test enzymes of both the small intestine and liver was marked by drastic changes at the early stages of SE action. Thus, the activity of SOD and GP-H2O2 in the liver decreased after 30 min or 1 h of endotoxin action, respectively. In the jejunal mucosa, the activity of GP-H2O2 and SOD dropped after 4 h of SE action. GT in the jejunum remained unchanged, whereas in the liver, it was activated. The activity of GR and GP-GTB in the liver and jejunum was dissimilar. The causes and consequences of the abnormalities of the antioxidant enzymatic system and the role they play in the pathogenesis of salmonellosis intoxication are discussed. PMID- 6509167 TI - [Protective action of antioxidant preparations on the development of experimental allergic encephalomyelitis in guinea pigs]. AB - The authors studied the action of combined tocopherol, lithium hydroxybutyrate and pyridoxal phosphate on the development of experimental allergic encephalomyelitis (EAE) in guinea-pigs. The use of the combined drug from the first days of immunization with encephalitis-inducing material prevented the development of EAE, activation of lipid peroxidation (LPO), and the appearance of the blood serum neurotropic activity. Administration of the combined drug starting from the 7th day after immunization appeared ineffective as was the administration of each drug alone, starting from the first days of immunization. The data obtained support an important role of LPO activation for the pathogenesis of the neuroallergic process. PMID- 6509168 TI - [Quantitative histoenzymological characteristics of changes in the red and white fibers of skeletal muscle tissue of the extremities in temporary ischemia and postischemic recirculation]. AB - Histoenzymological study of red and white fibers of limb skeletal muscles was performed in dogs with experimental acute occlusion of aorta trifurcation during ischemic and postischemic periods. A dramatic fall in the activity of aerobic enzymes was recorded in all observation periods (3, 6, 9 and 12 h). LDH activity rose considerably during short-term and descended slowly in prolonged ischemia. Red muscle fibers showed more substantial disorders in metabolism than white fibers. Recirculation after 6, 9 and 12 h of ischemia led to an appreciable decrease in the metabolic rate in muscle tissue. Irreversibility of metabolic alterations in acute ischemia lasting over 6 h may attest to the failure of the compensatory-adaptive mechanisms. PMID- 6509169 TI - [Mesenteric microvessel reactivity in rats in mesenteric shock]. AB - Reactivity of rat mesenterial microvessels was studied during mesenterial shock. The development of the shock was discovered to involve two phases in the changes of microvascular reactivity. The sensitivity of microvessels to adrenaline was increased at the beginning of the shock whereupon it started descending. This phenomenon evidences that vasodilatation occurring at the late stages of the shock development is determined not only by a reduction in the concentration of endogenous adrenaline and noradrenaline but also by a decrease in the sensitivity of microvessels to these agents. The data obtained make it possible to explain the mechanism of steady vasodilatation in response to injection of exogenous adrenaline and noradrenaline, which is seen at the late stages of mesenterial shock. PMID- 6509170 TI - [Changes in the indices of lipid peroxidation in liver mitochondria of white rats during simulation of in vitro anoxic damage]. AB - Lipid peroxidation was studied in the course of the development of anoxic injury to the mitochondria in vitro. Hydrolysis of mitochondial phospholipids was accompanied by an increase in antioxidant activity (AOA) of the organelles. At the same time the ability to transoxidation in liposomes formed from lipids extracted from the injured mitochondria was discovered to be increased. It is assumed that AOA of the mitochondria rises at the expense of antioxidants not extractable with a mixture of chloroform and methanol. PMID- 6509171 TI - [Changes in the activity of antioxidizing enzymes during spermatogenesis]. AB - A study was made of variation in the activity of the antioxidant defense system enzymes superoxide dismitase (SOD), glutathione peroxidase, (GP) and glutathione S-transferase (GT) in the cells of mouse spermatogenic epithelium. The cells were fractionated in the gradient of human serum albumin using the STAPUT system. SOD activity was comparable to that in liver cells, that of GP was one order to magnitude lower, and that of GT one order of magnitude higher than in the liver. Differentiation of spermatogenic cells demonstrated phase variations in the activity of these enzymes, with a maximum seen at the stage of late pachytene spermatocytes. SOD, GP and GT activities were discovered to be reduced in postmeiotic cells (early spermatid fractions) by 2.8-3.5; 1.9-2.3 and 4.2-5.6 times, respectively. That reduction was followed by activation of the enzymes at the late stages of spermiogenesis. PMID- 6509172 TI - [Biochemical criteria of 5-fluorouracil sensitivity and resistance of stomach tumors]. AB - It has been shown that based on the intensity of labeled 5-fluorouracil incorporation in RNA and activity of uridinekinase and thymidinekinase or alkaline phosphatase activity in tumorous tissue of the stomach one can form the judgement about the sensitivity of gastric carcinomas to chemotherapy with 5 fluorouracil. PMID- 6509173 TI - [Antithrombin III activity in long-developing hypercoagulation in animals]. AB - Old rats aged 12-18 months and rats kept on an atherogenic diet for 3.5 months demonstrate high blood antithrombin III content at the initial period of the development of anticoagulation function suppression and of hypercoagulation. During long-developing hypercoagulation, the high content of antithrombin III might be regarded as compensatory reaction interfering with formation in the blood of thrombin microamounts. With hypercoagulation becoming more pronounced and with a further increase of blood thrombin concentration the content of antithrombin III progressively descends, which is accompanied by steady development of anticoagulation function suppression. PMID- 6509174 TI - [Comparative study of several preparations in different models of cerebral hypoxia]. AB - The antihypoxic effects of gutimine, piracetam, sodium hydroxybutyrate and lithium hydroxybityrate were studied on different models of brain hypoxia. All the drugs under study produced a remarkable antihypoxic effect in experimental asphyxic hypoxia, increasing brain resistance to oxygen deficiency and rapidly restituting brain function. Drug pretreatment of the animals with carotid artery occlusion raised the number of animals which survived 24 h after the operation. GABA salts appeared the most effective. Sodium hydroxybutyrate increased the lifespan of rats under histotoxic hypoxia. PMID- 6509175 TI - [Comparative characteristics of the discriminative and analgesic effects of morphine]. AB - Experiments on mice were made to study and compare the discriminative and analgesic effects of morphine. The time-course of tolerance to the drug effects was found to be different. The Schild method permitted one to determine significantly different characteristics of naloxone antagonism (pA2) as regards the analgesic and discriminative effects of morphine. The data obtained attest to the different mechanisms of the analgesic and discriminative effects of morphine. PMID- 6509176 TI - [Interrelation between the analgesic and ulcerogenic action of cysteamine]. AB - Interrelationship was studied between the influence of cysteamine on pain threshold and ulcerogenic effect on the duodenum. Cysteamine (350 mg/kg) induced analgesia in mice which was prevented by naloxone (1.5 mg/kg). In rats, cysteamine produced duodenal ulcers with concomitant analgesia. The intensity of ulceration was higher in animals with lower basal pain threshold. The correlation between central and peripheral effects of endogenous opioids in the development of experimental duodenal ulcers is discussed. PMID- 6509177 TI - [Effect of low temperature on lipid peroxidation in the lungs and on pulmonary macrophage activity in rats]. AB - The pulmonary tissue of rats exposed to prolonged (8 days) intensive (-7 degrees C) cold was examined for the intensity of lipid peroxidation and activity of pulmonary macrophages. The data obtained during cold exposure attest to activation of the pulmonary compartment of the system of mononuclear phagocytes. Activation of lipid peroxidation in the lungs (days 1-8) associated with inhibition of the antioxidant systems (tocopherol, glutathione) is regarded as a possible mechanism of pulmonary tissue injuring by cold which stimulates the macrophagal response. A possible role of the activated forms of oxygen produced by macrophages during lipid peroxidation stimulation is discussed. PMID- 6509179 TI - [Ambiguous action of splenocytes from tumor-bearing mice on the formation of metastases in the lungs of mice in an adaptive transfer system]. AB - The growth of the syngeneic tumor MMT1 in C3H of mice was accompanied by significant changes in the spleen weight and in the number of nucleated cells in the spleen. Tumor excision led to the reduction of these indicators to the initial level. Adoptive transfer of splenocytes from tumor-bearing to intact mice exerted an inhibitory (on days 5, 14) or stimulatory (on day 25) action on the development of experimental metastases in intact animals depending on the tumor growth time. The result of splenocyte transfer from the operated on mice depended on the presence or absence in donors of tumor growth relapses (the development of lung metastases was inhibited only by splenocytes from donors with tumor relapses). Splenocyte transfer from mutant nude mice, both tumor-bearing and intact, produced an equipotent inhibitory effect. It is suggested that different mechanisms may be responsible for the development of metastasis inhibition in normal tumor-bearing mice and in tumor-bearers with T-cell system immunity deficiency. PMID- 6509178 TI - [Erythrocyte membranes during malignant growth]. AB - Suspensions of red cells from normal subjects and cancer patients were incubated in the presence of hydrogen peroxide. The incubation gave rise to a flash of chemiluminescence including rapid and slow components. The concentration dependencies of chemiluminescence were plotted as was the dependence of chemiluminescence on the temperature of the suspension under test. The differences were found between chemiluminescence of donors' red cells and that of patients'. It is inferred that red cell membranes of cancer patients show both the decreased membrane resistance to the damage-inducing action of hydrogen peroxide and elevation of antioxidant activity. PMID- 6509180 TI - [Influence of carnosine on the immunosuppressive effect of histamine]. AB - It has been demonstrated in experiments that histamine is capable of suppressing the antigen-induced proliferation of mouse spleen cells. This histamine effect was suppressed by its H-2 antagonist metiamide but not H-1 antagonist mepiramine. Carnosine exerted an action similar to metiamide, also inhibiting the histamine caused suppression of murine lymphocyte proliferation. This makes it possible to classify it with the group of H-2-histamine blockers. The H-2-antihistamine properties exhibited by carnosine necessitate its further study as a new antiallergic drug. PMID- 6509181 TI - [A count of osteogenic precursor cells in the bone marrow and their multiplication in cultures]. AB - The progeny of clonogenic stromal medullary fibroblasts from rabbits was cultivated by repeated passage. As a result of several passages the number of cells under consideration could be raised hundreds of thousand times as compared with the initial cell quantity. The strains of stromal medullary fibroblasts were found to have osteogenic properties; during reverse transplantation to the body they formed osseous tissue, creating the medullary organs. It was shown that during cultivation, the amount of osteogenic units in a cell culture dramatically rose, i. e. the osteogenic precursor cells multiplied and were self-maintained. According to all these signs the clonogenic stromal cells of the bone marrow can be regarded as stem osteogenic cells. PMID- 6509182 TI - [Early changes in the permeability of cellular and lysosomal membrane in rat testes after local heating of the scrotum]. AB - Immersion of rat scrotum into water (41 degrees C) for 30 min leads to gross impairment of spermatogenesis. During incubation in Ringer-Krebs solution at 33 degrees C for 1h, fragments of the decapsulated testes taken from the heated rats secrete to the medium a high amount of substances that increase the optical density of the incubation liquid at 270 nm. This phenomenon can be recorded shortly after scrotum heating is completed. The optical density increases further 12 and 24 h after heating. During incubation, fragments of the testes heated in vivo also secrete a high amount of the lysosomal enzymes, acid phosphatase and cathepsin D. It is assumed that post-thermal degeneration of the spermatogenic epithelium may be determined by a change in the permeability of cellular and lysosomal membranes. PMID- 6509184 TI - [Proliferation of precursor cells of the hemopoietic microenvironment in long term mouse bone marrow cultures]. AB - Active proliferation of stromal precursors was observed in long-term bone marrow cultures 2-11 days after seeding as measured by the hydroxyurea suicide method. In two-four-week-old cultures, the stromal precursors were mitotically dormant. PMID- 6509183 TI - [Early postradiation recovery of precursor cells of the hemopoietic stroma]. AB - The author studied the ability of stromal precursor cells of mouse bone marrow to intracellular repair of radiation-induced injuries. It was shown that the slow restorable, highly radioresistant population of stromal precursor cells is capable of early post-radiation recovery. PMID- 6509185 TI - [Electron microscopic and cytointerferometric study of the cortical neurons from the 2d-generation progeny of preneurosensitized female rats]. AB - A study was made of the sensorimotor cortex of the brain of the second generation offspring of preneurosensitized female rats. Vacuolization of the neurocyte nuclei, elevated lability of nuclear membranes, appearance of numerous dark neurons were discovered at all times of postnatal ontogenesis (from 2 to 90 days). At the same time ultrastructure of a considerable number of neurons was unchanged. The tendency toward normalization of cellular structures was noted by the 3d month. The one-month-old rats demonstrated a decrease in the content of protein substances in the nucleus and cytoplasm of the neurons as compared to normal. By the 3d month this indicator rose but did not reach the control level. It is concluded that neurosensitization of females before pregnancy affects the morphofunctional state of the neurons of the cerebral cortex in both first and second generation offspring, although the changes seen in the latter offspring are less marked, being compensated for with time. PMID- 6509186 TI - [Morphometric and dispersion analysis of the components of the lung acinus during total cooling]. AB - Lung acinus components of 60 rats were studied by morphometry on the 2d, 4th and 6th week of stepped general cold exposure in a climatic chamber at a temperature of 5 degrees C to 20 degrees C. Stepped adaptation reorganization of the acinus of experimental rats was revealed, with this reorganization being in the form of an increase in the volume of the dead respiratory space, in the total alveolar surface, and hypervolemia of the capillary and arterial bed of the lungs. Dispersion analysis confirmed the agreement between the changes in the acinus and stages of cold exposure. PMID- 6509188 TI - [Ultrastructurometric study of the reaction of the enterocyte microvilli in the rat small intestine in natural feeding]. AB - A study was made of the time-course of changes in the length of the microvilli at three main sites of the rat small intestine after natural feeding with a mixture of milk, bread and sunflower seeds. The length of the microvilli during fasting was shown to be maximal in the upper third of the villi and minimal in the apical pole of the villi. After feeding the microvilli experienced shortening which was least marked in the ileum. The morphometric parameters of the microvilli response in enterocytes of the intestinal parts under test are provided depending on their location on the villi. Actomyosin complex of the microvilli was found to take an active part in absorption. The findings confirm the hypothesis of the pinocytic mechanism by which the nutrients are absorbed. PMID- 6509187 TI - [Ultrastructural changes in the neurons of the sensorimotor cortex in rats under prolonged hypokinesia]. AB - The authors studied the neuronal ultrastructure of the sensorimotor cortex of rats exposed to 90 days of hypokinesia and at different times after its withdrawal. During prolonged restriction of motor activity, dystrophic changes seen in the cortical neurons were most demonstrable. During the first week of the posthypokinetic period, the degree of dystrophic lesions was reduced and the signs of intracellular regeneration were fairly conspicuous. Three weeks after hypokinesia withdrawal the ultrastructure of most neurons returned to normal, with the structure abnormalities being still observed in individual cells. PMID- 6509189 TI - [Quantitative local x-ray spectral microanalysis of single erythrocytes]. AB - Quantitative x-ray microanalysis was used to study the content of sodium, potassium, phosphorus and chlorine in single peripheral red blood cells of man. The method for sample preparation described permits its successful use under clinical and field conditions. PMID- 6509190 TI - [Relative volume of open capillaries in the skeletal muscles of rats with chronic local arterial hypotension]. AB - A modification of Pickworth's method for detection of open capillaries was used. The modification is based on freezing an organ in situ with liquid propane, cooled with liquid nitrogen, followed by lyophilization of the preparation and its fixation in gaseous formaldehyde. It was shown in rat experiments that the number of functioning capillaries in m. gastrocnemius and m. soleus 14 and 90-12 days after reduction of pressure in the hindquarter of the body with the narrowing of the abdominal aorta lumen was practically the same as that in the control animals. The data support the view that reduction of the hydraulic resistance in the area of regional hypotension does not correlate with increase in the number of parallel-functioning vessels. PMID- 6509191 TI - [Method of dissecting peripheral nerve sheaths with an ultrasonic microscalpel that does not disturb neural conduction]. AB - A new method for dissection of the nerve sheaths by an ultrasonic microscalpel was tested in in-vivo experiments with the cat saphenus nerve. The compound nerve action potential consisting of A beta, A delta and C waves did not change after successive one-cm long dissections of the major nerve sheaths, epineurium and perineurium, demonstrating innocuous character of the method. Not deep plunging of the ultrasonic scalpel into the nerve, hemocoagulation when dissecting as well as drastically reduced mechanical efforts are the principal advantages of new method. PMID- 6509192 TI - [Impulse activity of the nodose ganglion neurons in myocardial ischemia]. AB - Standard microelectrode techniques were used to study the impulse activity of different types of nodosal ganglion neurons in the course of the development of myocardial ischemia. The cardiopulmonary late inspiratory and inspiratory expiratory neuronal responses were estimated upon ligation of the coronary artery during the first respiratory cycle after blood flow stoppage. Spontaneous activity of cardiopulmonary neurons was not dependent on coronary circulation disturbances at the moment of coronary artery ligation. Later on, however, during the development of myocardial ischemia, there occurred substantial changes in all the types of nodosal ganglion neuronal activity, excluding real inspiratory neurons. PMID- 6509193 TI - [Hemodynamic and motility disorders of the gastrointestinal tract in intramural ischemia]. AB - Angiotensometry and pulsomotorography were used to study ischemia in the hollow organs in dog experiments. Specific and nonspecific disturbances, criteria of compensation and decompensation were determined. Using different methods of stimulation, stable microhemodynamic signs of ischemia--lowered pulse and motor oscillations, intramural blood pressure elevations and transformation of impulse blood flow into continuous one--were found. PMID- 6509194 TI - [Effect of an alternating magnetic field on the development of spontaneous hypertension in rats]. AB - The effect of varying magnetic field on the development of spontaneous hypertension was studied in experiments on Okamoto rats. The influence of magnetic field during antenatal development caused persistent changes in lymphocyte and organ metabolism and accelerated the appearance of spontaneous hypertension in rats. Based on enzymatic activity of lymphocytes it is possible to predict the development of spontaneous arterial hypertension. PMID- 6509196 TI - [Disorders of the deamination of nitrogenous compounds in the heart muscle in experimental atherosclerosis]. AB - The development of alimentary hypercholesterolemia in rabbits (confirmed by morphometric, electrophysiological and biochemical data) was accompanied by a decrease of the serotonin, benzylamine and tyramine deamination rates in heart muscle mitochondria. At the same time a qualitatively new reaction of cadaverine deamination could be seen in the mitochondria. The data obtained suggest that impairment of deamination of the nitrogenous compounds in atherosclerosis may be due to reversible qualitative modification (transformation) of mitochondrial monoamine oxidase activity. Some of the drugs which decrease the level of lipids in blood serum of hypercholesterolemic rabbits abolished and prevented the impairment of deamination of nitrogenous compounds. PMID- 6509195 TI - [Mechanism of the clinical effects of UV-irradiated blood: the stimulation of DNA synthetic activity of human cells in culture]. AB - Supernatants of UV-irradiated specimens of donor whole blood, leukocyte-platelet or red cell suspensions added to human embryonic cells in vitro produce a 1.4-1.6 fold increase in 3H-thymidine incorporation into human embryonic cells. Irradiation of blood plasma without the cells by the same doses as therapeutic ones is not followed by the effect indicated. Therefore the stimulation of the growth capacity of the blood after irradiation is connected with its cells. It is suggested that the effect under discussion is derived from the release of some active components from the blood cell surface (outer perimembranous layer) because of its photochemical destruction during UV-irradiation. PMID- 6509197 TI - [Mechanism of the decrease in intracranial pressure as affected by furosemide]. AB - The correlation was established between the increase in diuresis and natriuresis and fall of CSF pressure after intravenous injection of 10 mg/kg furosemide into dogs. Osmolarity and ion concentration in the serum and CSF did not change in these experiments. In nephrectomized dogs, furosemide did not changes CSF pressure. Furosemide dehydrated brain with traumatic edema, reduced brain Fe content probably due to diminishing brain blood content. The mechanism of intracranial pressure fall after furosemide injection can be explained by acute excretion of a large volume of fluid by the kidneys, leading to a decrease in the blood content of the skull cavity. PMID- 6509198 TI - [Effect of bone marrow mediator myelopeptides on the summation-threshold index and behavioral reactions of rats]. AB - Transmitter peptides having immunostimulant and endorphine-like properties were isolated from supernatant of medullary cell culture. Bioregulatory peptides were called myelopeptides. Myelopeptides provoked changes of the summation-threshold index in rats, which augmented in time. These changes pointed to the realization of the analgetic effect of myelopeptides via the spinal-stem structures of the central nervous system. Having a remarkable analgesic effect myelopeptides administered in the doses tested did not produce any action on the behavioral responses. The latter circumstance makes them differ from narcotic analgesics and known endorphines. PMID- 6509199 TI - [Glucocorticoid hormones and the immune response of CBA and C57BL strains of mice of different ages]. AB - Experiments on CBA and C57BL mice were made to study the relationship between the function of the hypothalamus-pituitary-adrenocortical system (HPACS) and the intensity of immune response to sheep red blood cells. The immune response evaluated from the number of rosette-forming cells appeared to be lowered in low respondent C57BL mice, depending on the age, whereas in CBA mice, the lowering of the immune response was not age-dependent. The intensity of the HPACS response measured according to the level of 11-OHCS two hours after immunization was not found to be dependent on the genetic differences. However, the level of 11-OHCS significantly dropped with age only in C57BL mice with a low response to sheep red blood cells. Thus, a correlation was discovered between the intensity of immune response to T-dependent antigen and the function of the HPACS, which was particularly noticeable during aging of mice belonging to a definite genotype. PMID- 6509200 TI - [Antibody-dependent cell cytotoxicity and the effect of interferon on K-cell functional activity in vitro in chronic viral hepatitis B in children]. AB - Antibody-dependent cell-mediated cytotoxicity (ADCC) and in-vitro effect of interferon (IF) on the K cell activity was investigated in children with chronic hepatitis B (CHB) and normal donors. The ADCC in CHB was significantly decreased under normal values. The low K cell activity in CHB might determine inadequate elimination of infected liver cells and continuation of hepatitis B virus replication. IF in vitro significantly stimulated the ADCC of normal blood donors but was unable to significantly increase the ADCC of CHB patients. The in-vitro stimulation of the ADCC of normal donors by IF might be a phenomenon due to an increase of the adult K cell cytotoxic potential and/or activation of pre-K cell maturation. The lack of in-vitro augmentation of the ADCC of CHB patients by IF might result from the decreased quantity of K cells of pre-K cells in the peripheral blood and/or their low susceptibility to the stimulating effect of IF. PMID- 6509201 TI - [Mechanisms of the activating effect of a closed chest injury on the immune response]. AB - Experiments on male Wistar rats weighing 180-240 g have demonstrated a stimulatory effect of closed chest trauma (CCT) on immune response to T-dependent antigen. The enhancement of immune response correlated with the growing of T but not B cell number in the spleen. Thymectomy completely abolished the posttraumatic activation of antibody production. The enhancement of immune response was also noted after thoracotomy. The combination of thoracotomy with thymus trauma did not give, however, such an effect. The immunomodulatory effect of the CCT is concluded to be non-specific, which is mediated by the T cell system. PMID- 6509202 TI - [Variability of alkaline phosphatase activity in diploid human cells in vitro]. AB - Experiments were made with 19 strains obtained from different tissues (skin, lungs, muscles) of 8-10-week-old medical abortions and skin biopsies of healthy donors to study the manifestations of alkaline phosphatase (AP) activity in human diploid cells in vitro. Based on the data obtained it is concluded that AP activity is marked by demonstrable intra- and interstrain variability. The spectrum of "AP activity" trait variability is broader for transformed cells than for human diploid cells. PMID- 6509203 TI - [Effect of hydrocortisone on the liver cytochrome P-450 system and the intensity of food anaphylaxis in guinea pigs]. AB - Intraperitoneal injection of hydrocortisone in single daily doses from 0.1 to 25.0 mg/kg, for 3 days was followed by reduced activity of liver microsomal monooxygenases and decreased content of cytochrome P-450 and b5. Hydrocortisone diminished the activity of the liver cytochrome P-450 system in vivo that significantly potentiated hexenal sleep. The hydrocortisone-inhibited activity of the liver chromosome P-450 system was followed by intensified food anaphylaxis in guinea-pigs. PMID- 6509204 TI - [Chronobiological patterns of the action of thyroxine on cell reproduction in Ehrlich ascites tumor]. AB - Experiments on white random-bred male mice were made to study the effect of L thyroxine on cell proliferation of the hyperdiploid strain of Ehrlich's ascites carcinoma. It was shown that upon prolonged thyroxine administration (during 6 days of carcinoma growth) the action of the latter appeared dose-dependent. The doses used were 1, 10, 30, 60, 100 micrograms/100 g bw. Circadian rhythms were noted in the sensitivity of the dividing cells to the hormone applied in a dose of 10 micrograms/100 g bw as was a certain decrease in the total level of the mitotic activity. At the same time thyroxine did not exert any noticeable effect on the average daily magnitudes of the number of DNA-synthesizing cells and did not change the pattern of modulations in the radioactive index. The changes in the mitotic index and radioactive index were asynchronous in control and experimental animals. PMID- 6509205 TI - [Induction of sensitivity of a fibroblast culture to hypophyseal somatotropin by a thermostable blood serum factor]. AB - A study was made of the effects of highly purified preparations of human and bovine pituitary somatotropin on DNA biosynthesis in fibroblast cultures from adults' skin. The intensity of DNA biosynthesis was evaluated from 3H-thymidine incorporation into the cells. It was established that both somatotropin preparations are capable of stimulating DNA synthesis by fibroblasts. However, simultaneous presence in the medium of the thermo- and acid-resistant fractions of rat blood serum is required for the stimulating effect of the hormone to manifest. It was found that the activity of blood serum factor inducing fibroblast sensitivity to somatotropin depends on the pituitary and rises after hypophysectomy. PMID- 6509207 TI - [Developmental patterns of dopaminergic neurons in dissociated cultures of the substantia nigra from mouse embryos]. AB - Dopaminergic neurons of Substantia nigra of 18-19-day-old mouse embryos were dissociated and cultured in Maximov's chambers for 2 weeks. The neurons showed an active synthesis of dopamine beginning from the first week of cultivation as demonstrated by the histofluorescent method. It is suggested that the process of differentiation of dopaminergic neurons is relatively independent of target cells and is genetically determined. Nonuniform distribution of dopaminergic neurons in aggregates suggests that these neurons are capable of selective adhesion. PMID- 6509206 TI - [Effect of cystamine on the morphology of gunshot wound healing (a light and electron microscopic study)]. AB - Electron microscopy and histochemical tests were used to study the effect of cystamine on gunshot wound healing in experiments on 24 rabbits. Cystamine was established to speed up maturation of the granulation tissue, epithelization of the wound surface and to make the period of gunshot wound healing 4-5 days shorter. PMID- 6509208 TI - [Quantitative evaluation of cell proliferation and death in the horn of Ammon and dentate gyrus of the developing hippocampus in the mouse]. AB - The mitotic and pyknotic indices were counted in the local germinative zones of Ammon's horn and dentate gyrus of normal mice from embryonic day 18 (ED 18) to postnatal day 60 (PD 60). The local germinative zone of Ammon's horn (the suprafimbrial zone) forms from ED 16 but the first pyknoses appear in it from ED 20. After a rapid increase of the mitotic and pyknotic indices with a maximum reached on PD 3 there is a sharp decrease of their values corresponding to the reduction of the suprafimbrial zone. The local germinative zone of the dentate gyrus is generated from ED 14, however pyknoses appear from PD 1. The greatest values of the mitotic and pyknotic indices fall within PD 3. Later on the values of both indices gradually decrease, however, they are sufficiently pronounced even on PD 60. It is suggested that the mitotic death by means of pyknotic degeneration is connected with elimination of the spontaneous mutations of glial precursors in the germinative zones of the brain. PMID- 6509209 TI - [Intracellular transformation of fatty acids into glycogen in alloxan diabetic rats, based on electron autoradiographic data]. AB - Alloxan diabetic rats were treated with intravenous injections of 3H-oleic or 3H arachidonic acids. Radioautographs were found in glycogen accumulations in hepatocytes and cardiomyocytes as well as in pure glycogen fractions. The conclusion was made about transformation of fatty acids to glycogen. PMID- 6509210 TI - [Morphological bases of myocardial revascularization by laser radiation]. AB - The mechanism of myocardial revascularization was studied in 30 dogs with the aid of impulse carbonic acid laser after ligation of the anterior descending branch of the left coronary artery. In the control group, 4 dogs died of myocardial infarction. In 26 animals laser canals were formed. The walls of the canals comprised cardiomyocytes with the manifestations of a coagulation thermal necrosis. Morphological studies disclosed the aseptic productive nature of the inflammatory reaction and the absence of marked leukocytic infiltration of the tissues adjacent to the area of necrosis. The laser canals were lined with endothelium by the 10th-14th day after operation, they were not obliterated or sclerosed. Morphological, laboratory, and radionuclide studies attest to adequate perfusion of the myocardium with the aid of the laser canals preventing the development of myocardial ischemia and infarction. PMID- 6509211 TI - [Ultrastructure of sensorimotor cortex neurons and interneuronal connections in the progeny of alcoholized rats]. AB - The sensorimotor cortex of the alcoholized rat progeny showed the signs of the delayed ultrastructural development of neurons and interneuronal connections and their dystrophic changes, particularly in 21-day-old experimental rats. Thirty day-old animals demonstrated pronounced reparative alterations. But in spite of this fact the ultrastructure of cortical neurons, particularly of dendrites was not completely restored. PMID- 6509212 TI - [Lysosome participation in collagen resorption by hepatocytes during regression of liver cirrhosis]. AB - Electron microscopy and electron histochemistry employed in experiments on mice with liver cirrhosis regression have demonstrated the presence of vacuoles with collagen in the cytoplasm of hepatocytes as well as the presence in these vacuoles of a reaction product to acid phosphatase. Based on the data obtained it is concluded that during liver cirrhosis regression, there takes place an intracellular resorption of collagen by hepatocytes via phagocytosis with an active involvement in this process of lysosomal enzymes. PMID- 6509213 TI - [Effect of lysosomal enzymes on myocardial electrical and contractile activity in burn shock]. AB - Marked depression of the amplitude of isometric contractions of myocardial preparations, which was induced by lysosomal enzymes from the liver of control animals, was demonstrated in isolated rabbit papillary muscles. The decrease of contractility was not accompanied by remarkable changes in the amplitude or in the duration of intracellular action potentials. The negative inotropic action of lysosomal enzymes was similar to that of blood plasma of the burnt animals. Based on the appearance and subsequent activation of lysosomal enzymes in blood of the animals by the 20th to 60th min after thermal injury it is suggested that lysosomal enzymes might be one of factors that depress myocardial contractility in burn shock. PMID- 6509214 TI - [Effect of long-term arterial hypotension on the relative volume of functioning capillaries in working skeletal muscles]. AB - In control rats, the relative red cell volume, mirroring the number of the functioning capillaries, was substantially greater in the soleus than in the gastrocnemius muscle, while the rise of this parameter seen during contraction of both the muscles, provoked by stimulation of the sciatic nerve, amounted to 37 and 54%, respectively. Fourteen days and 3-4 months after abdominal aorta constriction by a metal spiral, that produced a 30-50% lowering of the blood pressure in the vessels of the animal's body posterior, contractions of the gastrocnemius muscle did not provoke any increase in the relative red cell volume, whereas contractions of the soleus muscle were accompanied by a marked elevation of the relative red cell volume. It is assumed that the mechanisms underlying the working hyperemia of the gastrocnemius and soleus muscles are different. PMID- 6509216 TI - High-dose intravenous IgG in pregnant women with autoimmune thrombocytopenia: a cautionary note. PMID- 6509215 TI - The kinetics of hematopoietic stem cells during and after hypoxia. A model analysis. AB - A previously described mathematical model of the hematopoietic stem cell system has been extended to permit a detailed understanding of the data during and after hypoxia. The model includes stem cells, erythroid and granuloid progenitors and precursors. Concerning the intramedullary feedback mechanisms two basic assumptions are made: 1) The fraction "a" of CFU-S in active cell cycle is regulated. Reduced cell densities of CFU-S, progenitors or precursors lead to an accelerated stem cell cycling. Enlarged cell densities suppress cycling. 2) The self renewal probability "p" of CFU-S is also regulated. The normal steady state is described by p = 0.5, indicating that on statistical average each dividing mother stem cell is replaced by one daughter stem cell, while the second differentiates. Diminished cell densities of CFU-S or enlarged densities of progenitors and precursors induce a more intensive self renewal (p greater than 0.5), such that the stem cell number increases. The self renewal probability declines (p less than 0.5) if too many CFU-S or too few progenitors and precursors are present. The model reproduces bone marrow data for CFU-S, BFU-E, CFU-C, CFU-E, 59 Fe-uptake and nucleated cells in hypoxia and posthypoxia. Although the ratio of differentiation into the erythroid and granuloid cell lines is kept constant in the model, a changing ratio of CFU-E and CFU-C results. The model suggests that stem cells and progenitor cells are regulated by a regulatory interference of erythropoiesis and granulopoiesis. PMID- 6509217 TI - Factors affecting the distribution of transpulmonary pressure in animals and in man. PMID- 6509218 TI - Interactions between chest wall, respiratory muscles and lung function in disease. PMID- 6509219 TI - Loaded breathing. PMID- 6509221 TI - Ventilatory muscle fatigue governs breathing frequency. AB - When the ventilatory muscles are unable to develop the required force as it occurs during fatigue, hypercapnic respiratory failure ensues. We present evidence that when the respiratory muscles work in a fatiguing load domain the central controllers respond at an early stage with tachypnea, while when the muscles fail bradypnea ensues which is followed by apnea. Although bradypnea and apnea in addition to muscle inability to develop force may reduce alveolar ventilation by virtue of reducing the total minute ventilation, tachypnea may also be followed by hypercapnia at constant total minute ventilation by virtue of a reduction in tidal volume (VT). Such a strategy will increase the ratio of dead space (VD) to tidal volume (VD/VT) and PCO2 will rise. It is argued that this mechanism could satisfactorily explain the high levels of CO2 in patients with chronic obstructive lung disease, as well as the CO2 retention at an early stage in acute cases of fatigue during, for example, the weaning period of a patient from the respirator. Bradypnea and apnea contribute to CO2 retention at a later stage, when the muscles are exhausted and total ventilation decreases. This sequence in frequency of breathing is explained as an advantageous strategy adopted for the respiratory muscles, because it allows the muscles to operate at an optimal length. It is also hypothesized that muscle afferents, probably via the small fibers III and IV and/or Golgi and tendon organs, are responsible for this interaction of CNS and respiratory muscles. PMID- 6509220 TI - Respiratory muscle testing. PMID- 6509222 TI - Respiratory disease prevention and control. Report of a joint WHO/IUAT meeting held in Paris, 28-31 March 1983. PMID- 6509223 TI - Proceedings of the XXVth world conference of the IUAT (International Union Against Tuberculosis). Buenos Aires, 15-18 December 1982. PMID- 6509224 TI - The structure of the IUAT, its budget and its scientific committees. PMID- 6509225 TI - An outlook on tuberculosis control and new technologies in primary health care of developing countries. PMID- 6509226 TI - Non-tuberculous respiratory disease. PMID- 6509227 TI - Developments in the national tuberculosis control programme in Tanzania. PMID- 6509228 TI - Some of the main unsolved problems in tuberculosis control in developing countries. PMID- 6509229 TI - Pattern recognition in several sequences: consensus and alignment. PMID- 6509230 TI - Distinguished words in data sequences: analysis and applications to neural coding and other fields. PMID- 6509232 TI - The uniqueness of protein sequences. Uniqueness diagrams for the Dayhoff file- 1984. PMID- 6509231 TI - Searching the protein sequence database. PMID- 6509233 TI - Weight loss maintenance as an aspect of family emotion and process. AB - The Expressed Emotion Index (EE) has been used with a high degree of success in predicting relapse of psychiatric patients in Great Britain. The present study examined the usefulness of EE as a predictor of weight loss maintenance in women in the United States. In a sample of 28, with a relapse rate of 50 per cent, EE correctly predicted maintenance for 78.5 per cent of the cases. A more economical, paper-and-pencil test of marital relationship (Relationship Style Inventory) correlated significantly with EE (r = 0.64) but did not successfully predict weight maintenance (r = 0.29). PMID- 6509234 TI - Assessment of a behavioural programme to treat incontinent patients in psychogeriatric wards. AB - Three female psychogeriatric wards were selected for the study of behavioural programmes for the incontinent. Ward A underwent the full package of environmental changes and toilet training at the patients' peak evacuation times. Ward B combined five weeks of two-hourly toileting with the environmental changes, whereas Ward C had only the environmental changes. The results showed that there was a small decrease in incontinence only when the full programme was implemented. The other two wards showed such a large deterioration of continence that the results on Ward A became significant in comparison with them. Variables such as age, cognitive state and length of stay had no effect upon the continence level at the end of the programme, whereas there was a clear association between the initial level of incontinence and the end results. The relevance of early treatment is discussed. PMID- 6509235 TI - Dual perspectives: clients' and therapists' perceptions of therapist responses. AB - This study compares clients' and therapists' perceptions of individual therapist responses. Three segments of four responses each were sampled from early, middle, and late in actual therapy sessions with 16 client-therapist pairs. Using interpersonal process recall, both therapists and clients independently described their perceptions of the therapist's response intentions in their own session. They also rated the impact of therapist responses according to four variables, including response helpfulness and therapist empathy. Client-therapist agreements on intentions and impacts were computed using indices of both covariation and mean difference. Clients' and therapists' response-by-response reports of therapist intention were positively associated, but their average ratings for the session were not. On the other hand, their response-by-response ratings of impact were not associated, but their average ratings of helpfulness and affective impact were. Correlates of agreement were also studied. Contrary to expectations, length of therapeutic relationship was not correlated with client-therapist agreement: in fact, there was a trend toward lower agreement for client-therapist pairs of longer duration. Therapist experience also did not predict client therapist agreement. PMID- 6509236 TI - Client disclosure and psychotherapy session evaluations. AB - Clients' percentage of disclosure (first person, subjective utterances) was compared with evaluative session ratings by clients, therapists, and an external rater across 43 psychotherapy sessions. In contrast to observers' perceptions, participants' perceptions of session depth and value were not correlated with client disclosure. Sessions high in disclosure (relative to the client's usual level) were rated from all three perspectives as relatively rough, unpleasant, difficult, and dangerous. PMID- 6509237 TI - Improving the social validity and implementation of behaviour therapy training for psychiatric nurses using a patient-centred learning format. AB - Low levels of behavioural care plan implementation and criticisms of the format of an earlier 'classroom' course led to a patient-centred approach to training psychiatric nurses. The critical change involved a series of practical learning tasks with patients on the ward, leading to a single-subject care plan. The 24 psychiatric nurses attending the new course achieved superior results on two of the skill measures by post-testing. They also conducted more care plans and credited the course with more social validity than their predecessors (n = 41). These findings are important in showing how training formats can overcome institutional constraints on service innovation. PMID- 6509238 TI - [Role of hypothalamo-hypophyseal control in the adjustment of thyroid function to iodine deficiency]. PMID- 6509240 TI - Unraveling the symbiotic bond. Psychotherapeutic change in a schizophrenic patient. PMID- 6509239 TI - L-carnitine and ammonia toxicity. PMID- 6509241 TI - Narcissistic disorders in children. A developmental approach to diagnosis. PMID- 6509242 TI - Moral issues and mental illness. PMID- 6509243 TI - Borderline personality: DSM-III versus a previous usage. PMID- 6509244 TI - A study of fatal hemorrhagic dengue cases in Cuba, 1981. PMID- 6509245 TI - Establishment of a colony of nonhuman primates (Aotus lemurinus griseimembra) in Colombia. PMID- 6509246 TI - Health effects in residents of regions with high background radiation. PMID- 6509247 TI - Control of drugs in a university hospital surgical ward. PMID- 6509249 TI - Pan-Caribbean disaster preparedness and prevention. PMID- 6509248 TI - A retrospective study of the PAHO fellowships program in the Caribbean, 1970 1979. PMID- 6509250 TI - Ciguatera poisoning in Canada. PMID- 6509252 TI - The worldwide incidence of low birth-weight: an update. PMID- 6509251 TI - Immunization against leprosy: progress and prospects. PMID- 6509253 TI - Cardiovascular diseases. PMID- 6509254 TI - Paget's disease of bone (osteitis deformans). PMID- 6509255 TI - Chronic perineal pain. AB - The "ideal case" for doctors dealing with acute medical or surgical patients has a clearly defined disease that is amenable to treatment. A successful outcome should make both doctor and patient happy. The truly depressing patient has no recognizable disease and little prospect of treatment. Such is frequently the case with men complaining of chronic perineal pain. PMID- 6509256 TI - Too many fits. AB - Continuing seizures for the chronic patient with epilepsy require careful assessment. In practice, attention to unsatisfactory drug therapy compounded by poor compliance is most rewarding. Reappraisal of the psychological aspects in the widest sense can be revealing and new diagnostic and therapeutic possibilities can be uncovered. PMID- 6509257 TI - Malaise and fatigue. AB - Patients used to complain of not being "in the pink". Nowadays they are "bushed", "beat", or "washed out". They used to expect a simple diagnosis and treatment; now both are much more complex. PMID- 6509258 TI - "A bit dizzy". AB - Dizziness is greeted by most doctors with a degree of despair and is often dismissed as a trivial complaint, despite the many causative pathologies. For the patient, it is disabling, disorientating, and, in unresolved cases, may lead to chronic invalidism. A simple approach to the problem is given. PMID- 6509259 TI - Private practice--4. PMID- 6509260 TI - Solubilization of dopamine-D2 receptors from synaptosomal membranes of the bovine caudate nucleus. AB - Dopamine D2-receptors were solubilized from synaptosomal membranes of the bovine caudate nucleus using different detergents. They were labelled with [3H] spiperone and assayed by polyethylene glycol precipitation. CHAPS was found to be the best solubilizing agent among all detergents used. Optimal conditions for solubilization were: 0.25% CHAPS, 3.5 mg ml-1 protein, 25 min, 4 degrees C and the yield of D2-receptors was 18.6%. Addition of some sulphobetain detergents increased the extent of solubilization, 125 mM NaCl and 0.25 M sucrose decreased it, while SH-group protecting agents (2 mM dithiothreitol and 6 mM beta mercaptoethanol), as well as MEGA-9 and MEGA-12 were almost ineffective. -log IC50 values for solubilized dopamine D2-receptors are in linear correlation with the corresponding values for membrane-bound receptors (r = 0.962, slope factor 0.96) and Kd value of solubilized receptors was 3.61 +/- 0.94 nM, while that of membrane-bound receptors was 1.25 +/- 0.10 nM. Specific binding of [3H]-spiperone to the solubilized receptors resolved by linear sucrose density gradient centrifugation shows two maxima, one in the first several fractions from the bottom and the other with an apparent S value of 7.3. PMID- 6509261 TI - Comparison of the biphasic excitatory junction potential with membrane responses to adenosine triphosphate and noradrenaline in the rat anococcygeus muscle. AB - The effects of field stimulation and ionophoretic application of adenosine triphosphate (ATP) and noradrenaline were studied in the rat anococcygeus by means of an intracellular microelectrode. Field stimulation at room temperature produced three types of electrical membrane response: (a) a 'fast' excitatory junction potential (e.j.p.) which had a latency of less than 100 ms and a time to peak of 300 ms; (b) a 'slow' e.j.p. which had a latency of several hundred ms and a time to peak of 1-2 s, and (c) an inhibitory junction potential (i.j.p.) which had a time to peak of about 1.5 s. All three responses were blocked by tetrodotoxin. The ionophoretic application of ATP produced both monophasic and biphasic depolarizations; these responses had a latency of less than 30 ms and a time to peak of 150-300 ms. In contrast, ionophoretically-applied noradrenaline produced a depolarization which had a mean latency of 471 ms and a time to peak of 861 ms. The 'slow' e.j.p. and the noradrenaline-induced depolarization were blocked by prazosin whereas the 'fast' e.j.p. and the ATP responses were resistant to this antagonist and also to atropine. These results are further evidence that the 'fast' e.j.p. in some smooth muscle tissues is mediated by ATP. PMID- 6509262 TI - Pharmacokinetics and biliary excretion of bromosulphophthalein, [3H]-ouabain and [3H]-taurocholic acid in rats with glycerol-induced acute renal failure. AB - The pharmacokinetics and biliary excretion of bromosulphophthalein (BSP), ouabain and taurocholic acid (TChA) have been studied in rats with glycerol-induced acute renal failure (ARF). In rats with ARF, the hepatic uptake and initial biliary excretion of BSP were decreased. In addition, the rate of BSP conjugation with glutathione by rat liver homogenates was also decreased. This latter change may contribute to the initial decrease in the biliary excretion of BSP. No change was found in the hepatic uptake and biliary excretion of ouabain, but the area under the concentration-time curve was increased and the plasma clearance (Clp) decreased in rats with ARF. This decrease in Clp was not due to reduced renal excretion. The decreased Clp of ouabain in rats with ARF may come from reduced tissue binding and a concomitant decrease in its volume of distribution (Vd). The hepatic handling of TChA appeared unaltered in ARF, but the rate constant for the terminal part of the concentration-time curve (beta) was decreased. This change probably resulted from a large increase in Vd in rats with ARF. It is concluded that the decreased uptake of BSP was not due to a non-specific disturbance of hepatocyte function in ARF because the hepatic handling of ouabain and TChA were unaltered. PMID- 6509263 TI - Reduction by phentolamine of the hypotensive effect of methionine enkephalin in anaesthetized rabbits. AB - In intact rabbits anaesthetized with pentobarbitone, methionine enkephalin (Met enkephalin, 1-1,000 micrograms kg-1 i.v.) produced a dose-dependent bradycardia and hypotension. The bradycardia and hypotension were antagonized by naloxone hydrochloride (1 mg kg-1), but not by naloxone methobromide (1.3 mg kg-1). Phentolamine (1 and 4 mg kg-1 i.v.) blocked both the hypotension and bradycardia produced by Met enkephalin. The inhibitory effect of phentolamine was not due to a simple hypotensive action of this drug per se because a similar degree of hypotension induced by nitroprusside (15 micrograms kg-1, i.v.) caused a further reduction of pressure when Met enkephalin was added. Atropine (2 mg kg-1) reduced the bradycardia but not the hypotensive response to Met enkephalin. Met enkephalin did not antagonize the vasopressor effect of exogenous noradrenaline (2-8 micrograms kg-1, i.v.). Met enkephalin had no significant effects in superfused thoracic aortic strips and in isolated perfused hearts of rabbits. It is concluded that the cardiovascular effects of Met enkephalin are more probably due to an action on the central nervous system, although a peripheral site of action cannot be completely excluded. PMID- 6509264 TI - The molal volumes of atropine and hyoscine in relation to their respective potencies. AB - The partial molal volumes, V2, at infinite dilution of atropine and hyoscine were determined in each of eight different solvents having cohesive energy densities in the range 64 to 144 cal cm-3. V2 for hyoscine in a given solvent was invariably and significantly smaller than that of atropine in the same solvent. The difference being 1.58 cm3 mol-1 in the least polar solvent (n-propylbenzene) and 4.29 cm3 mol-1 in the most polar one (acetonitrile) in the series studied. It is proposed that the lower affinity of atropine relative to that of hyoscine for the muscarinic cholinoceptor could be accounted for by the relative increase in enthalpy in the adsorption of atropine to the receptor with respect to the same process with hyoscine. PMID- 6509266 TI - Psychiatry in jeopardy. PMID- 6509267 TI - Schizophrenic patients discharged from hospital--a follow-up study. AB - A cohort of 120 patients, comprising all those who met the St Louis criteria for a diagnosis of schizophrenia, discharged from a mental hospital over a five-year period, were followed-up in the community after an interval of five to nine years; 105 were traced and 94 were alive. Of those, 66 were living in UK, out of hospital, and willing to be seen. Their mental states, and social functioning and circumstances were assessed by interview with the patients and those with whom they lived; 18% had recovered to the extent that they had no significant symptoms and appeared to function satisfactorily. More than 50% had definite psychotic features. No patients and few relatives sought a return to hospital care, but severe emotional, social, and financial difficulties were commonplace; 27% of the sample had no contact with medical or social services, a further 14% saw only community nurses, and 24% only their general practitioners. The findings emphasise the limitations of community services in dealing with the chronicity and severity of the impairments resulting from schizophrenic illness. PMID- 6509268 TI - The DST and its relationship to psychiatric diagnosis, symptoms and treatment outcome. AB - The dexamethasone suppression test (DST) was administered shortly after admission to 102 consecutive in-patients with a Hamilton depression score greater than or equal to 16. Post-dexamethasone cortisol exceeded 6 micrograms/dl in 16 cases, and levels correlated significantly with Hamilton scores; with the AMP syndromes 'hypochondria', 'apathy' and 'catatonia'; and with the IMPS 'retarded depressive' syndrome. The criterion of suppression/non-suppression did not distinguish significantly between diagnostic categories (RDC or ICD), nor between endogenous and neurotic depression. (Newcastle scale). Both base-line and post-dexamethasone cortisol levels were reduced by prior treatment with minor tranquillisers, but not by major tranquillisers or antidepressants. DST results cannot be used as straightforward indicators of prognosis. PMID- 6509265 TI - Proceedings of the British Pharmacological Society. University of Dundee, 11th 14th September, 1984. Abstracts. PMID- 6509269 TI - Psychiatric hospital admissions in Bristol. I. Geographical and ethnic factors. AB - The distribution of in-patient psychiatric admissions throughout the city of Bristol during the period 1978-1981 is described. High rates were found from the central urban areas of low social class and with a high concentration of immigrants. The findings suggest that immigrant groups (mainly of West Indian origin) are no more likely than others living in the city centre to become psychiatric hospital in-patients, but when they do so, they are more likely to require compulsory admission. PMID- 6509270 TI - Psychiatric hospital admissions in Bristol. II. Social and clinical aspects of compulsory admission. AB - Three groups of patients admitted compulsorily from populations with markedly different rates of compulsory psychiatric admissions were compared on a range of social and clinical data. Whilst West Indian and white patients from inner city areas differed in many respects, they were both more likely than other patients to be referred to the psychiatric services through police agencies, with little GP involvement and were often admitted from public places following disturbed behaviour. However, levels of violence and threatening behaviour were no higher among inner city patients, black or white, and once admitted, these groups showed similar treatment compliance to white patients who had been admitted compulsorily from suburban areas. Implications for primary care and delivery of psychiatric services are discussed. PMID- 6509271 TI - Day-to-day mood changes after childbirth: further data. AB - The depression and lability of mood which have been previously reported on the fifth day after childbirth are largely restricted to women with high neuroticism scores. The pattern of day-to-day mood changes is the same after Caesarian section as after vaginal delivery, but there is no 'day five' phenomenon after hysterectomy. Post-partum mood disturbance is less prominent in women who return home 48 hours after delivery. PMID- 6509272 TI - The Scottish survey of chronic day-patients. AB - All chronic day-patients (n = 422), defined as patients aged 18-64 years attending a day facility of a psychiatric hospital or general hospital psychiatric unit continuously for more than a year, were identified in hospitals and units serving 56% of the Scottish population. The number of day patients was 14.8 per 100,000 of the general population, but the range between hospitals was very great--0 to 37.7 per 100,000--indicating the patchy development of such care. A typical day patient was a rather chronic middle-aged male schizophrenic, who lived on his own or with ageing parents. Most patients' accommodation was satisfactory, but the occupational activity of more than a third was inappropriate; 18% could have attended a local authority sheltered workshop if one had been available. PMID- 6509274 TI - Marital intimacy and depression. AB - Recent research has suggested that the absence of an intimate, confiding relationship may be a vulnerability factor in the development of depression in women living under adverse circumstances. This study demonstrates a significant association between severity of depression and deficiencies of marital intimacy; depressed patients with the lowest levels of marital intimacy failed to improve at one month follow-up, while 36% of the spouses of the depressed patients had symptoms of non-psychotic emotional illness. The depressed patients and their spouses' perception of their marital intimacy differ, but these differences appear not to be solely related to the spouse's depression. PMID- 6509273 TI - The impact of political violence on mild psychiatric morbidity in northern Ireland. AB - Evidence concerning the impact of the violence in Northern Ireland on psychiatric morbidity is limited to studies examining admission rates and psychotropic drug prescribing rates; their results varied from suggesting no effect to indicating that greater levels of violence are actually equated with higher levels of mental health. The present study is the first to use a community sample, in which respondents (797) from two towns, which have experienced contrasting levels of violence over the last ten years, completed the 30-item version of the General Health Questionnaire (GHQ), and also indicated their perception of the level of violence in their area and how safe they felt this was to live in. Those who lived in the more violent town scored higher on the GHQ, as did women compared to men and those who perceived that their area had experienced more violence. There was also a two-way interaction, such that the small number of people, who perceived much violence in their area and who also lived in the more violent town, scored more highly on the GHQ. It is possible that the majority of people in Northern Ireland deal effectively with stress generated by the political violence, but do so by denying the existence of this violence around them. PMID- 6509275 TI - Changes occurring in appetite and weight during short-term antidepressant treatment. AB - Changes in appetite and weight were recorded in mild to moderately depressed out patients during the course of clinical trials of various antidepressant drugs. After six weeks, differences due to treatment regimes were minimal. Patients who on becoming depressed experienced severe changes in appetite and weight in either direction, tended to return to normal. The significant associations of appetite and weight change during treatment were with weight, appetite, and carbohydrate preference at presentation, and also with the 'appetite history' and 'weight history'. The associations with the degree of depression were relatively minor. PMID- 6509276 TI - On the value of P300 event-related potentials in the differential diagnosis of dementia. AB - The possible value of event-related potentials (ERPs) in the differential diagnosis of dementia was investigated in a group of 42 demented elderly patients, 29 non-demented elderly patients, and 10 healthy young controls. The auditory evoked potentials were elicited by using target and non-target auditory stimuli. There was no significant difference in N100 and P200 latency between these groups. Our results indicate an age-related increase of P300 latency of 0.3 msec/year in the non-demented subjects. There was no significant difference in P300 latency between demented and non-demented patients, and the latencies vary widely within the groups of elderly patients. PMID- 6509277 TI - Serum immunoglobulin concentrations in patients admitted to an acute psychiatric in-patient service. AB - Serum immunoglobulins were quantified in 85 consecutively admitted patients from an acute-care psychiatric in-patient unit. The patients were diagnosed as: major depressive disorder, 53; chronic schizophrenia, 12; schizophreniform psychosis, 4; substance abuse disorder, 12; and miscellaneous other diagnoses, 4. A small sub-group of these patients, which included six with major depression, one with chronic schizophrenia, and one with a personality disorder, were found to have low IgM concentrations. Immunoglobulin levels were not associated with use of medication or length of illness prior to this hospital admission. This study provides further evidence for suppression of humoral immunity in some psychiatric patients (approximately 10%). PMID- 6509278 TI - An investigation of the aetiology of chronic headache. The role of headache models. AB - Headache sufferers (n = 30) reported significantly more immediate family members with headache, compared to controls (n = 22). Sensitivity, specificity, and efficiency analyses revealed that knowledge of family headache history has predictive value. The results are consistent with findings with other pain disorders. PMID- 6509279 TI - Jumping from a great height. PMID- 6509280 TI - Dietary vitamin B12 deficiency. PMID- 6509281 TI - Rock and roll delusions. PMID- 6509282 TI - Sleep and memory. AB - The possible effects that sleep may have on long-term memory are first considered using the restorative hypothesis of sleep. This hypothesis proposes that protein synthesis is facilitated by sleep. The confounding role of circadian rhythms in previous sleep and memory experiments is also considered. Two experiments are reported. The first experiment investigated the effect of sleep on memory, in part using a sleep-deprivation technique. The second experiment controlled both for the interference effects and for possible non-specific effects of sleep deprivation. Results supported the restorative hypothesis and suggested that sleep was affecting memory by modulating trace consolidation. PMID- 6509283 TI - Phenobarbitone and the relationship between extraversion and reinforcement in verbal operant conditioning. AB - The present investigation was designed to study the relationship between phenobarbitone, extraversion and modes of reinforcement in verbal operant conditioning. A factorial design involving three treatments (placebo and two doses, 30 and 100 mg, of phenobarbitone), two levels of extraversion (extraverts and introverts) and two reinforcement conditions ('good' and 'electric shock') with repeated measures on the first factor, was used. Sixty postgraduate female students were individually subjected to Taffel's verbal conditioning procedure. The results support the following conclusions: (1) under the placebo condition, the extraverted subjects condition better with the rewarding reinforcer ('good') while the introverted subjects condition better with the punishing reinforcer ('electric shock'); (2) under the influence of the smaller dose of the drug, as compared with the placebo, the conditioning scores of extraverted subjects increase with the punishing reinforcer but decrease with the rewarding reinforcer, while the conditioning scores of the introverted subjects decrease with the punishing reinforcer, under the influence of the larger dose of the drug, but remain uninfluenced with the rewarding reinforcer. PMID- 6509284 TI - The radiological features of "solid" aneurysmal bone cysts. AB - The radiological features of nine solid aneurysmal bone cysts (ABC) have been reviewed. The appearances form a spectrum ranging from lesions indistinguishable from the classical ABC, to an osteolytic lesion with a wide zone of transition, cortical destruction and soft tissue extension. Over half the lesions reviewed fell into the latter category and all were situated in the axial skeleton. Discrimination between the more aggressive solid ABC, giant cell tumour and malignancy may be difficult. Demonstration of an expanded partial cortical rim by either conventional or computerised tomography suggests the diagnosis of solid aneurysmal bone cyst. PMID- 6509285 TI - Myelography in severe lumbosacral spondylolisthesis. AB - The radiological and myelographic appearances of 14 patients with severe lumbosacral spondylolisthesis have been reviewed in relation to compression of the cauda equina and their clinical symptomatology. Patients could be separated into two groups as defined by the position of the L5 neural canal. In Group 1, the arch was displaced downwards and the cauda equina compression was due to pressure from the L5/S1 disc and was related to the degree of listhesis. L5 root sheath abnormalities predominated in this group. In Group 2 the neural arch maintained a more normal position and the compression, which was unrelated to the degree of slip, occurred between the arch and the posterior aspect of the sacrum. S1 root lesions occurred in these patients due to pressure from the arch. Clinical symptoms and signs were also more prominent in this group. PMID- 6509286 TI - Thickening of the posterior wall of the bronchus intermedius in right lung pneumonia. AB - A recent paper in the literature described thickening of the posterior wall of the bronchus intermedius (PWBI) in patients with congestive heart failure, and/or enlarged lymph nodes and neoplastic infiltrations. At this institution we have seen two recent cases of right upper lobe viral pneumonia demonstrating abnormal thickening of the posterior wall of the bronchus intermedius on lateral chest radiographs. A retrospective survey of our museum cases supported the hypothesis that pneumonia of the right lung, involving the right upper, middle, lower or any combination of these lobes may show thickening of the posterior wall of the bronchus intermedius. PMID- 6509287 TI - Computed tomography and sialography of chronic pyogenic parotitis. AB - We performed Computed Tomography (CT) immediately following, or simultaneous with, conventional sialography on a group of 45 patients with parotid gland swellings over a two-year period. Tumours occurred in eight, sarcoidosis in 22, actinomycosis in two and chronic pyogenic parotitis in 13 patients. In the latter group, there were two cases of bilateral disease, for a total of 15 glands. The sialographic and the combined CT-sialographic features were retrospectively analysed. In all cases, ductal pathology was more severe in the main and proximal branches, was better demonstrated on conventional sialography and was diagnostic in 10/14 glands (71%). CT-sialography was the superior modality in the evaluation of the gland parenchyma and the adjacent structures, demonstrating diagnostic features of infection in 8/14 glands (57%). However, a combination of both modalities presented a consistent pattern of infection in all cases, distinctive from tumours and sarcoidosis. CT-directed aspiration was performed on the four glands which were equivocal on conventional sialography, and two of these underwent a simultaneous aspiration-irrigation with antibiotics. Although this report is based on a limited experience, CT-sialography with aspiration appears to be an interventional radiological alternative to the traditional diagnostic superficial parotidectomy. Ultrasonography (two cases) and nuclear scintigraphy (one case) added little useful information in chronic pyogenic parotitis. PMID- 6509288 TI - Adverse reactions to radiopharmaceuticals. United Kingdom 1977-1983. AB - Details of reports to the UK Adverse Reaction Reporting Scheme for the years 1977 1983 are given. These show a changing pattern since earlier reports, in part due to the discontinuance of older radiopharmaceuticals and changes in quality control measures, but also to the introduction of methylene diphosphonate for bone imaging which has accounted for nearly half of our more recent reports. Colloids for reticulo-endothelial (liver) scans account for about one third of this series. The great majority of reactions are of an idiosyncratic hypersensitive nature and none due to sterility problems or pyrogens. Accurate incidence figures are difficult to obtain but including even the trivial forms of reaction, we estimate a reaction rate of between 1:1000 and 1:10,000 in vivo nuclear medicine procedures, a figure considerably higher than most previous surveys have suggested. PMID- 6509289 TI - Use of a microcomputer to store information on radiology cases. AB - A microcomputer program for storage of qualitative patient data has been applied to CT and special procedures case data. Different vocabularies have been established and utilised for these two case categories. Experience over two years involving more than 10,000 cases is discussed. Utility for statistical, research, and patient care purposes is demonstrated. PMID- 6509290 TI - Intracavitary dosimetry of a high-activity remote loading device with oscillating source. AB - Dosimetric experiments have been carried out in order to obtain the dose distribution in water around a Fletcher applicator loaded by a Buchler system containing two 137Cs 148 GBq (4 Ci) sources and one 192Ir 740 GBq (20 Ci) source. The mechanical system which controls the movement of the 192Ir source and the resulting motion of the source are described. The dose distribution around the sources was measured photographically and by a PWT Normal 0.22 cm3 ionisation chamber. The absolute dose rate was measured along the lateral axes of the sources. The measurements of exposure in water near the sources were corrected for the effect due to the finite volume of the chamber. The "quantisation method" described by Cassell (1983) was utilised to calculate the variation of the dose rate along the lateral axes of the sources. The dose distribution around both 192Ir and 137Cs sources was found to be spherical for angles greater than 40 degrees from the longitudinal axes of the sources. A simple algorithm fitting the data for the moving 192Ir source is proposed. A program written in FORTRAN IV and run on a Univac 1100/80 computer has been used to plot dose distributions on anatomical data obtained from CT images. The uncertainties of the measurements and calculations have been examined and the greatest error has been found to be 5.5%. The clinical significance of the treatment method is discussed. PMID- 6509291 TI - The mechanism of diarrhoea resulting from pelvic and abdominal radiotherapy; a prospective study using selenium-75 labelled conjugated bile acid and cobalt-58 labelled cyanocobalamin. AB - An attempt was made to elucidate the mechanism of diarrhoea resulting from pelvic and abdominal radiotherapy in a prospective study of 10 patients undergoing treatment for curable pelvic malignant tumours using the synthetic trihydroxy 75Se-labelled conjugated bile acid, SeHcat and 58Co-labelled cyanocobalamin (58Co Vit B12). Evidence of malabsorption of vitamin B12 measured as a significant fall in whole body percentage retention of 58Co Vit B12 from baseline levels was found in all nine patients who developed diarrhoea during radiotherapy. Only four out of these nine patients also had malabsorption of the trihydroxy conjugated bile acid, cholic acid, measured as a significant fall in SeHcat whole body percentage retention and these patients had the most severe diarrhoea. The findings are discussed in the light of what is known about the pathophysiology of diarrhoea during pelvic and abdominal radiotherapy and lend support to previous work which implicated increased bowel motility in the pathogenesis of radiation-induced diarrhoea. The hypothesis that local neuroendocrine mechanisms in the gut may be involved is put forward, with possible implications for treatment. PMID- 6509292 TI - Cell-cycle distributions and radiation responses of Chinese hamster cells cultured continuously under hypoxic conditions. AB - Cell-cycle distributions were measured by flow cytometry for Chinese hamster (CHO) cells cultured continuously under hypoxic conditions. DNA histograms showed an accumulation of cells in the early S phase followed by a traverse delay through the S phase, and a G2 block. During hypoxic culturing, cell viability decreased rapidly to less than 0.1% at 120 h. Radiation responses for cells cultured under these conditions showed an extreme radioresistance at 72 h. Results suggest that hypoxia induces a condition similar to cell synchrony which itself changes the radioresistance of hypoxic cells. PMID- 6509293 TI - The installation of a commercial resistive NMR imager. AB - It has been demonstrated that a relatively low-cost resistive NMR imager can be installed in a normal hospital environment without many major or expensive modifications. The magnet can be adjusted to give adequate uniformity and there is sufficient RF shielding to give good quality clinical images (Fig. 3). The fringe field of the magnet of this system, which operates at the lowest field strength of any commercial NMR imager, does not present a problem to imaging unit staff (NRPB, 1984). The long term reliability and detailed specifications with regard to image quality have yet to be determined. These will be determined whilst the imager is being used for clinical studies as part of the national clinical evaluation of NMR imaging supported by the Medical Research Council. PMID- 6509294 TI - Therapeutic ureteric embolisation. PMID- 6509295 TI - Oesophageal tuberculosis: an unusual cause of dysphagia. PMID- 6509296 TI - Production and processing of digital ionographic X-ray images. PMID- 6509297 TI - Radiopharmaceuticals: reporting of defective products and abnormal in vivo distributions. PMID- 6509298 TI - Exporting and importing pigs: the problems and risks. PMID- 6509299 TI - The use of milk progesterone profiles for assessing the response to cloprostenol treatment of non-detected oestrus in dairy cattle. PMID- 6509301 TI - An investigation of the causes and of the financial loss of rejection of pig carcasses and viscera unfit for human consumption. II. Studies at seven abattoirs. PMID- 6509300 TI - Week-to-week variation in blood composition of dairy cows and its effect on interpretations of metabolic profile tests. PMID- 6509302 TI - Sheep slaughtering procedures. III. Head-to-back electrical stunning. PMID- 6509303 TI - A survey of drug resistance in salmonellae isolated from animals in England and Wales from 1979 to 1981. PMID- 6509304 TI - Trenbolone levels in tissues of trenbolone acetate-implanted steers: radioimmunoassay determination using different antisera. PMID- 6509305 TI - A comparative study of metabolic profiles obtained in dairy herds in Romania. PMID- 6509307 TI - Impairments of visual object transforms in monkeys. AB - Monkeys were first trained on a series of standard, unchanging visual objects to obtain food reward. After reaching criterion on each subject, training with it continued but on 20 per cent of the trials the object was transformed in (1) size, (2) orientation, or in (3) its shadow configuration. Monkeys with lesions either of the inferotemporal cortex or the foveal prestriate region were impaired in identifying all three types of transforms as the rewarded object. They were also slightly impaired in continuing postcriterion high levels of performance on the nontransformed objects, but it was shown that the transform deficit was still present when this factor was partialled out. The groups with transform deficits were also impaired initially in their discrimination between solid cones of varying apical angle, although their final performance approached that of controls. The inferotemporal group, especially with the lesion placed anteriorly, had a deficit in their initial learning of the untransformed objects as well as in the retention of a preoperatively learned pattern discrimination; they were also deficient in selecting food objects from among an array of nonfood objects. No deficits were seen in animals with lesions of the parietal lobe or the fundus of the superior temporal sulcus in any task. The results and other relevant animal evidence are interpreted in terms of the view that the anterior temporal lobe is concerned with the storage of an object-centred prototype, necessary in turn for the attachment of positive or negative meaning, and the more posterior inferotemporal lesions with the addressing of view-centred visual information en route to the anterior regions. They are also consistent with the findings on the recognition of 'unusual views' made by Warrington and coworkers in patients with posterior lesions. PMID- 6509306 TI - A bioassay technique for prostaglandin-like activity in equine inflammatory exudate. PMID- 6509308 TI - Congenital trigeminal anaesthesia. A review and classification. AB - Forty-three patients with the syndrome of congenital trigeminal anaesthesia (CTA) have been reported to date. The cases have been divided into three groups based on the presence and nature of any associated clinical problems. Three additional cases are presented as characteristic of each of the groups. A different aetiology is proposed for each group. Group I consists of patients with CTA as an isolated finding. It is almost always bilateral, and typically involves the distribution of only the first division of the fifth nerve. There is no evidence of other neurological abnormalities or associated mesoectodermal congenital anomalies. The aetiology is suspected to be a primary neural hypoplasia. Patients with associated congenital mesenchymal anomalies were placed in the second group. CTA was often a minor part of another well defined, more extensive clinical syndrome, such as Mobius or oculoauriculovertebral dysplasia (OAVD). The sensory abnormality was either unilateral or bilateral. The skin of the face was almost always involved, as well as the cornea and conjunctiva. This may be a heterogenous group with multiple aetiologies having in common an injury early in embryogenesis. The third group is defined as patients with CTA without evidence of mesenchymal dysplasia. These cases differ from the first group primarily because of the presence of associated focal brainstem signs. The aetiology is thought to be due to focal neural dysgenesis secondary to a prenatal injury, possibly vascular in nature. PMID- 6509309 TI - Cognition and the basal ganglia. Separating mental and motor components of performance in Parkinson's disease. AB - Central to the concept of subcortical dementia is the implication that the increased response latencies, which distinguish the syndrome, are due to a slowing of thought processes. The term 'bradyphrenia' has been applied to this presumed slowing of thought in Parkinson's disease and implies (1) that increased response latencies are not strictly motoric but are due to slowed information processing, and (2) that the mental slowing is analogous to the bradykinesia observed in the motor domain and, hence, attributable to dysfunction of dopaminergic basal ganglia mechanisms. The current study attempts to validate this definition of bradyphrenia by seeking a slowing of thought in Parkinson's disease which can be linked directly to bradykinesia. Six parkinsonian patients with end-of-dose akinesia were studied in three experiments which allowed separation of the speed of specific cognitive operations from the speed of motor responses. Serving as their own controls, they were tested both during the parkinsonian 'off' state, and when bradykinesia was alleviated by drug therapy. Four additional patients with newly diagnosed Parkinson's disease were studied before and following successful treatment with L-DOPA/carbidopa. The first experiment measured the rate of memory scanning, the second examined orientating of attention in the visual fields, and the third measured the time required to prepare a manual movement. The results show that overall reaction time increased when patients were in the untreated state, but without a concomitant slowing of purely cognitive components. The slowing of thought often reported in Parkinson's disease does not necessarily accompany bradykinesia and thus may not be related to dopaminergic dysfunction. These findings emphasize the need for caution in inferring a slowing of thought from increased response latencies in subcortical disorders. PMID- 6509310 TI - Psychophysical and electrophysiological approaches to the pain-relieving effects of heterotopic nociceptive stimuli. AB - The nociceptive flexion reflex (RIII reflex) and the concurrent subjective pain score elicited by right sural nerve stimulation at random intensities were studied in 10 healthy volunteers. A close relationship was found between the recruitment curves of the reflex and the pain score as a function of stimulus intensity. As a consequence, the threshold of the RIII reflex (Tr) and of pain sensation (Tp) were found to be almost identical (mean: 9.8 and 11.3 mA, respectively). Similarly, the threshold for obtaining a maximal reflex response (Tmr) was found to be very close to that for intolerable pain (Tip): 33.5 and 35.1 mA, respectively. These four parameters were studied before and during the immersion of the left hand into a heated thermoregulated waterbath at various temperatures (from 40 to 47.5 degrees C). While nonnociceptive temperatures (40 to 44 degrees C) were without effect, higher conditioning temperatures induced an increase in the four thresholds. In addition, a highly significant linear relationship was observed between the increase in these thresholds and the intensity of the conditioning stimulus in the 44 to 47.5 degrees C range. These four parameters were also studied before and during three other nociceptive conditioning stimuli: immersion of the left hand into a 6 degrees C waterbath, 10 watts muscular exercise of the left hand performed under ischaemia and a painful (5.5 kg/cm2) pinch applied on the nasal septum. These three conditioning situations induced a very significant increase of the four thresholds considered in this study with the greatest being observed during nociceptive cold applied to the left hand. During all the conditioning situations, variations in Tr and Tp as well as in Tmr and Tip were found to be linearly related. This indicates a close relationship between the effects of the conditioning nociceptive stimuli on the reflex and the related pain sensation. These results suggest that the modulation of pain by heterotopic nociceptive stimuli can be explained at least in part by a depression in the transmission of nociceptive messages at the spinal level. They are discussed with reference to the counterirritation phenomena and common features with 'diffuse noxious inhibitory controls' (DNIC) are underlined. PMID- 6509311 TI - Degraded discrimination between speech-like sounds by patients with multiple sclerosis and Friedreich's ataxia. AB - We previously found that some patients with multiple sclerosis are selectively 'deaf' to changes in the pitch of a tone, even when audiometric sensitivity to pure tones is unimpaired. This subtle form of deafness is not experienced by patients with noise-induced hearing loss of exclusively peripheral origin. It was suggested that this auditory defect may be one possible cause for difficulties in discriminating speech, on the grounds that frequency changes in the speech waveform are known to be important for intelligibility. This implication is not self-evident; our earlier studies tested hearing with a single pure tone that was either frequency-modulated or amplitude-modulated, while even a simple approximation to speech sounds involves not one, but three narrow bands of noise (formants) whose frequencies and intensities change from instant to instant. The present study has investigated the ability of subjects to discriminate between speech-like sounds. These consisted of three formant frequencies generated by computer. The only difference between the sounds was that the lowest-frequency formant rose or fell in pitch by different amounts. In order to ensure that subjects used frequency (pitch) cues rather than any associated loudness cues were mixed different loudness shifts with the frequency shifts. Nineteen control subjects, 25 patients with multiple sclerosis (MS) and 4 patients with Friedreich's ataxia (FA) were tested. Nine of the patients with MS and all 4 patients with FA gave results that fell outside the range of the control subjects. A possible pathophysiological basis for this observation is the finding that some neurons in the auditory pathway of animals respond preferentially to changes in tone frequency: homologues of these neurons might be functionally impaired in some patients with MS and FA. PMID- 6509312 TI - Visual stabilization of posture. Physiological stimulus characteristics and clinical aspects. AB - Visual stabilization of posture is critically dependent on stimulus characteristics as well as on the performance of the visual system. The purpose of the present investigation was to obtain quantitative data in man by means of posturography of fore-aft and lateral body sway in relation to different visual stimulus characteristics. Visual acuity, when decreased logarithmically, causes a linearly increasing postural instability, twice as prominent for fore-aft than for lateral sway. Any measurable visual contribution for fore-aft sway ceases with an acuity lower than 0.03 and for lateral sway with an acuity lower than 0.01. The central area of the visual field as compared with the peripheral retina dominates postural control. The foveal region exhibits a powerful contribution, in particular for lateral sway. A partial but significant visual stabilization is preserved with a visual input rate between 1 to 4 Hz flicker frequency. As soon as continuous motion perception becomes involved with frequencies higher than 4 Hz, visual stabilization gradually improves with a saturation at frequencies higher than 16 Hz. Lateral body sway activity and eye-object distance are linearly related: body sway decreases with increasing distance corresponding to the linear decrease of net retinal displacement with increasing eye-object distance. Aspects of 'afferent' and 'efferent' visual motion perception, which involve fore-aft and lateral body sway differently, are evaluated. The clinical relevance is demonstrated in patients with oculomotor disturbances. The results are discussed with respect to the variety of related clinical disorders, which involve reduction in visual acuity, field defects, accommodation disturbances and ocular oscillations. PMID- 6509313 TI - Evidence for different mechanisms of primary and secondary hyperalgesia following heat injury to the glabrous skin. AB - Characteristics of primary (within the area of injury) and secondary (outside the area of injury) hyperalgesia were determined after a heat injury applied to the glabrous skin of the hand in 8 human volunteers. The heat injury consisted of two burns (53 degrees C, 30 s) applied over an area 7.5 mm in diameter separated (centre to centre) by a 2 cm interval. Following the injury, a zone of hyperalgesia to mechanical stimuli measuring 20.1 +/- 3.6 cm2 (mean +/- SEM) developed in an area surrounding and including the burns. Within this zone, the pain threshold for mechanical stimuli decreased significantly by a similar amount for all areas tested (12.0 +/- 1.1 bars to 5.2 +/- 0.5 bars). Hyperalgesia to heat occurred only within the area of the burns. The heat pain threshold decreased and total ratings of heat pain increased significantly. In contrast, there was decreased pain to heat stimuli between the two burn sites, and no change in painfulness of the heat stimuli at other areas within the zone of hyperalgesia to mechanical stimuli. Particularly notable was the coexistence of hypalgesia to heat stimuli and hyperalgesia to mechanical stimuli in the uninjured region between the two burn sites. These results indicate that the characteristics of primary and secondary hyperalgesia differ and also suggest that the mechanism for hyperalgesia to mechanical and thermal stimuli differ. PMID- 6509314 TI - A neurological basis for visual discomfort. AB - Certain patterns of stripes are judged to be unpleasant to look at. They induce illusions of colour, shape and motion that are sometimes perceived predominantly to one side of fixation. People who suffer frequent headaches tend to report more illusions, and if the pain consistently occurs on the same side of the head the illusions tend to be lateralized. The parameters of the patterns that induce illusions (including their shape, spatial frequency, duty cycle, contrast and cortical representation) closely resemble those that elicit epileptiform electroencephalographic abnormalities in patients with photosensitive epilepsy. The viewing conditions under which such abnormalities are likely to appear are also those under which more illusions are seen. PMID- 6509315 TI - Cholinergic activation of the electrocorticogram: role of the substantia innominata and effects of atropine and quinuclidinyl benzilate. AB - Systemic injection of quinuclidinyl benzilate partially abolished low voltage fast activity (LVFA) in the neocortex of waking rats, resulting in the appearance of large irregular slow waves during Type 2 behaviors (e.g. immobility, sniffing without head movement, face washing). These slow waves did not occur during Type 1 behavior (e.g. walking, head movement). Atropine sulfate produced a similar effect but it was less potent by a factor of about 12. Injection of kainic acid into the substantia innominata: (a) destroyed local cells which contain acetylcholinesterase (AChE) and reduced AChE staining in the ipsilateral neocortex; and (b) produced large slow waves in the ipsilateral neocortex during Type 2 behavior but not during Type 1 behavior. These slow waves were abolished by systemic injection of pilocarpine. Kainic acid injection into the thalamus produced extensive local cell loss but failed to produce slow waves in the neocortex. The data suggest that the LVFA which is normally present in the neocortex during waking Type 2 behavior is dependent on a cholinergic input to the neocortex from the substantia innominata. The relevance of these findings to Alzheimer's disease is discussed. PMID- 6509316 TI - Effect of neonatal treatment with capsaicin on the numbers and properties of cutaneous afferent units from the hairy skin of the rat. AB - Neonatal treatment with capsaicin caused a 40% reduction in the number of C fibres in the rat saphenous nerve. Within the reduced total the proportion of nociceptive C fibres was similar in both capsaicin-treated and untreated rats. No change was found in the conduction velocities or firing thresholds (to pressure and to heat) in A-fibre and C-fibre nociceptors. The perimeters of axons were also unchanged by capsaicin. From a comparison of the morphometric and conduction velocity (v) data it is suggested that in the rat saphenous nerve v (m/s) = 1.9 X axon perimeter (micron) for A fibres and v = 0.44 X square root of the axon perimeter for C fibres. PMID- 6509317 TI - GABAergic agents in the medial septal nucleus affect hippocampal theta rhythm and acetylcholine utilization. AB - Neurons of the medial septal nucleus are important in regulating the physiological activity of the hippocampus. If intraseptal injection of putative neurotransmitter substances affects the turnover rate of hippocampal acetylcholine, then concomitant changes would be expected in the electrophysiologic activity of the hippocampus. A GABA agonist, muscimol, was injected into the medial septum of rats and the effects on hippocampal electrical activity and acetylcholine utilization were studied. The intraseptally injected muscimol (100 ng) resulted in hippocampal electrographic records containing low amplitude asynchronous waves and significantly less rhythmic slow activity (RSA, 6-9 Hz), compared to control injections of saline. This effect was antagonized by prior intraseptal injection of bicuculline (3 micrograms). The hippocampal electrical activity returned to normal within 100 min. The utilization of acetylcholine was significantly reduced by intraseptal muscimol at times after administration when electrographic activity was also altered, and spontaneous behavioral movement was increased. These results suggest a physiological connection between hippocampal RSA generation and GABAergic mechanisms in the septum. PMID- 6509318 TI - Inhibitory modulation of cat somatosensory cortex: a pharmacological study. AB - In anesthetized preparations, GABA and taurine produced rapid, reversible inhibition of the negative component (N20) of the primary somatosensory evoked potential (SEP) without effect on the earlier positivity (P11). This effect was also produced by low doses of 4-aminopyridine. Neither bicuculline or picrotoxin antagonized these drug effects. A predominance of type B GABA receptors in the superficial layers of the somatosensory cortex is proposed. PMID- 6509319 TI - Bilateral midbrain transections block the behavioral effects of cholecystokinin on feeding and exploration in rats. AB - The mechanism by which peripherally administered cholecystokinin (CCK) reduces feeding and exploration involves a sensory feedback pathway from the gastrointestinal regions, via the vagus nerve through the nucleus tractus solitarius (NTS). Bilateral dorsal midbrain transections rostral to the NTS abolish the ability of CCK to reduce food consumption, decrease exploratory approaches, and increase pauses of behavioral inactivity, as compared to these actions of CCK in normal and sham-lesioned control rats, suggesting that ascending NTS fibers are a necessary component in this feedback system. PMID- 6509320 TI - Sleep-awake responses elicited from medial preoptic area on application of norepinephrine and phenoxybenzamine in free moving rats. AB - The study makes an attempt to find out the action of norepinephrine (NE) and phenoxybenzamine (PB), applied at medial preoptic area (mPOA), in altering the sleep-awake responses, in free moving rats, which has not yet been reported. Effects of application of NE during day and PB during night, at mPOA, on sleep awake responses, were compared with application of saline during identical periods. Application of NE produced arousal, whereas, PB produced the opposite effect. The findings are suggestive of the involvement of NE terminals at mPOA in normal arousal. PMID- 6509321 TI - The colchicine experimental epileptic focus: an intracellular study. AB - A new experimental epileptic focus is described in which colchicine is topically applied to neocortex. Stable epileptiform discharges developed, with bursts of action potentials, coincident with the surface epileptiform events. There were depolarizing and hyperpolarizing neuronal potentials and glial depolarizations concomitantly with the surface epileptic spikes. PMID- 6509322 TI - Hyperpolarizing action of baclofen on neurons in the rat substantia nigra slice. AB - GABA, muscimol and L-baclofen inhibited zona compacta neurons in the rat substantia nigra slice, D-baclofen was inactive, L-baclofen produced a potent hyperpolarization of the membrane potential. The actions of muscimol but not GABA and L-baclofen were reversed by bicuculline. The actions of muscimol and baclofen are likely to be mediated by interactions with two different receptors. PMID- 6509323 TI - Quantitative determination of angiotensin II binding sites in rat brain and pituitary gland by autoradiography. AB - Rat brain and pituitary angiotensin II (AII) binding sites were quantitated by incubation of tissue sections with 125I-[Sar1] AII, Ultrofilm radioautography, computerized densitometry, and comparison with 125I-standards at appropriate film exposure times. The highest number of AII binding sites was found in anterior pituitary and the circumventricular organs, organon subfornicalis and organon vasculosum laminae terminalis. PMID- 6509324 TI - A suspected infrared-recipient nucleus in the brainstem of the vampire bat, Desmodus rotundus. AB - We discovered in the brainstem of infrared-sensitive vampire bats, Desmodus rotundus, a specific nucleus not known in other species of bats. Because it corresponded in location and histological features to the infrared nucleus of infrared-sensitive snakes, we suggest the probability of its being part of the infrared processing system of vampire bats. PMID- 6509326 TI - Vasopressin release to central and peripheral angiotensin II in rats with lesions of the subfornical organ. AB - Angiotensin II (Ang II), peripherally or centrally administered, increases plasma vasopressin concentrations in the rat. Peripherally injected Ang II was unable to effect the release of vasopressin in rats with subfornical organ (SFO) lesions. In contrast, a normal increase of plasma vasopressin levels was induced by centrally injected Ang II. These results suggest that peripherally administered Ang II elicits antidiuretic hormone (ADH) release by stimulating receptors in the SFO, whereas centrally administered Ang II acts at receptors outside the SFO. PMID- 6509325 TI - Regional heterogeneity of choline acetyltransferase activity in primate neocortex. AB - Choline acetyltransferase activity in precentral and temporal regions of primate neocortex is 2.5-fold higher than in occipital cortex. These results suggest large differences in the density of innervation in different regions of primate neocortex by the nucleus basalis of Meynert. PMID- 6509327 TI - A quantitative electron microscopic analysis of the infraorbital nerve in the newborn rat. AB - The infraorbital nerve (n = 3) was examined in newborn rats using electron microscopic techniques. Counts of the entire nerve revealed an average of 42,051 (S.D. = 2083) unmyelinated and 168 (S.D. = 47) myelinated fibers. The unmyelinated axons averaged 0.46 micron (S.D. = 0.16) in diameter while the myelinated fibers averaged 1.71 micron (S.D. = 0.17). PMID- 6509328 TI - Rhythmic discharge of mitral cells in the carp olfactory bulb. AB - We examined conditions in which rhythmic discharges of the mitral cell are obtained in the carp olfactory bulb. When the mean firing rates of the responses to various concentrations of NaCl solutions were high (more than 5 Hz), rhythmic discharges appeared. Results provide experimental support for the rhythm generation hypothesis on the dendrodendritic synapse in the vertebrate olfactory bulb. PMID- 6509330 TI - Neonatal facial nerve extirpations fail to produce alterations in the barrel field in the primary somatosensory cortex of mice. AB - Branches of the facial nerve were transected in newborn mice, resulting in paralysis of whisking of the mystacial vibrissae. After maturation, the brains were examined in Nissl preparations for alterations in the barrel field of the primary somatosensory cortex. There were no evident changes as a result of this intervention. PMID- 6509329 TI - Electrophysiological identification of neurons in the parabrachial nucleus projecting directly to the hypothalamus in the rat. AB - Experiments were done in urethane anesthetized rats to identify single units in the region of the parabrachial nucleus (PBN) projecting directly to 'cardiovascular' responsive sites in either the paraventricular nucleus of the hypothalamus (PVH) or the supraoptic commissure and nucleus (SOC-SON) region. Fifty-five single units were antidromically activated in the ipsilateral PBN by electrical stimulation of either the PVH (n = 27) or SOC-SON region (n = 28) with latencies corresponding to conduction velocities of 0.3-5.1 m/s. The axons of PBN units projecting to the PVH conducted at significantly slower velocities (0.5 +/- 0.04 m/s) than those projecting to the SOC-SON region (1.6 +/- 0.25 m/s). These data suggest that ascending fibers from the PBN to the PVH are unmyelinated, whereas those to the SOC-SON region are primarily a little myelinated. In addition, since the PBN is known to receive cardiovascular and visceral afferent inputs, it is suggested that these neurons likely function in relaying this afferent information to hypothalamic areas involved in autonomic regulation. PMID- 6509331 TI - [10 years' experience with Soviet compression-distraction systems]. PMID- 6509332 TI - [Care of children with scoliosis at the Orthopedic Clinic in Bratislava]. PMID- 6509333 TI - [Empirical genetic risk for siblings of probands with pes equinovarus]. PMID- 6509334 TI - [Results of the treatment of bilateral coxarthrosis using Poldi's total endoprosthesis]. PMID- 6509335 TI - [Corrosion of metal implants--causes of unsuccessful surgical treatment of injuries of the osteoarticular system]. PMID- 6509336 TI - [Alloplasty of the knee joint in progressive polyarthritis and osteoarthritis]. PMID- 6509337 TI - [Occurrence of dactylitis tuberculosa in adults]. PMID- 6509338 TI - [Personal experience with the treatment of traumatic luxations of the acromioclavicular joint]. PMID- 6509339 TI - [The significance of varicose veins in the pathogenesis of hydrops of the knee]. PMID- 6509340 TI - [Aggregatability of blood platelets and changes in plasma coagulation factors in patients with chronic liver diseases]. PMID- 6509341 TI - [Congenital hemolytic anemias due to defects in glycolysis and the hexose monophosphate shunt and their incidence in Slovakia]. PMID- 6509342 TI - [The significance of hemostasis determination in clinical practice]. PMID- 6509343 TI - [Anemia in chronic diseases. Brief review]. PMID- 6509344 TI - Undergraduate general practice teaching in the University of Bristol. PMID- 6509345 TI - Splenic cyst: the case against splenectomy. PMID- 6509346 TI - The radiology of tumours of the pelvis. PMID- 6509347 TI - Bristol medical care. PMID- 6509348 TI - Vitamin E improves cell-mediated immunity in the burned mouse: a preliminary study. AB - Profound immunosuppression occurs after major burn injuries. The ability of vitamin E to prevent post-burn immunosuppression was tested in mice using ear swelling in response to a challenge with 2,4-dinitrofluorobenzene (DNFB) as an in vivo measure of cell-mediated immunity (CMI). Vitamin E was administered to burned mice every other day for 14 days by either the topical or intraperitoneal route. Dimethyl sulphoxide (DMSO) was compared to white petroleum jelly (VAS) as a vehicle for topically administered vitamin E. Mean CMI +/- the standard error of the mean (SEM) was depressed to 55 +/- 4 per cent of normal control in untreated burned mice. Treatment with either parenteral vitamin E in corn oil or topical vitamin E in DMSO improved CMI dramatically compared to burned controls (P less than 0.005) while vitamin E in VAS had a less beneficial effect on CMI (P less than 0.05). We conclude that vitamin E is an effective immunomodulator in burned mice. PMID- 6509349 TI - Tulle-gras dressings. AB - Tulle-gras backed with a soluble polyvinyl alcohol film has been compared with standard tulle-gras to treat patients with minor burns. The new material although less comformable to body contours offered the advantages of decreased dressing time and improved patient comfort. No adverse effects were observed on wound flora or healing rate. PMID- 6509350 TI - The tangential excision of extensive or deep burns. AB - This report contains our experience gained over 13 years of the tangential excision of burned tissue in 627 patients. We have discussed the indications for and timing of tangential excision, methods of determining the margin between viable and non-viable tissue using histological studies in some patients and the problem of wound coverage after tangential excision. PMID- 6509351 TI - WHO and the global problem of nosocomial infections. PMID- 6509352 TI - Trends in anti-infective treatment of burn patients: a 3-year retrospective review. PMID- 6509353 TI - Topical treatment of serious infections with special reference to the use of a mixture of silver sulphadiazine and cerium nitrate: two clinical studies. AB - Much progress has been made in recent years in the field of topical burn therapy. Preparations are now available which meet most of the requirements for ideal topical agents and further improvements have been demonstrated. However, much work has to be done to find even better products, in particular agents that are sufficiently inexpensive, so that they could well be used in countries with limited resources for medical care. PMID- 6509354 TI - Management of serious infections of burns of the upper extremities. PMID- 6509355 TI - Multistage risk models and the age pattern in familial polyposis coli. AB - Multistage risk models provide a close fit to most age patterns of adult-onset cancers. Such models posit that a number of events must occur before some cell in a tissue is transformed from normal to neoplastic. When an approximate version of the models has been fitted to data, this number has been estimated to be about 4 6. In fitting the same approximate model to the age pattern of onset of colon cancer in bearers of the Familial Polyposis coli (FPC) gene, several authors have found that the number of stages estimated was about two to three fewer than those for colon cancer in the general population. However, when an exact multistage model is used rather than an approximation to it, this is no longer the case: the number of stages estimated from the general population becomes too large to be compatible with what is known about carcinogenesis from laboratory experiments, and the number estimated from FPC victims is larger than that for the general population. "Inherited-hit" models of the nature of the FPC gene may be correct at the cellular level, but multistage models as commonly formulated cannot be used on data on the age-onset patterns in populations of individuals to infer such mechanisms or estimate their parameters. PMID- 6509357 TI - Effects of chemotherapeutic agents on the immune response. I. PMID- 6509356 TI - Stability of doxorubicin in relation to chemosensitivity determinations: loss of lethality and retention of antiproliferative activity. AB - The chemical stability of doxorubicin in a variety of tissue culture media has been studied by thin layer chromatography (TLC). In all the media examined, authentic doxorubicin was converted to a chemically distinct form as evidenced by the failure of this form to migrate on TLC plates. The rates of conversion were rapid enough (t 1/2 approximately equal to 3 hr) to be of consequence in chemosensitivity determinations, especially if working solutions of doxorubicin were to be routinely made and stored in tissue culture media. The addition of certain antioxidants to media did not prevent the conversion of authentic doxorubicin. However, doxorubicin was quite stable in distilled water. No single component of media was found to be responsible for the conversion of authentic doxorubicin, although arginine, histidine, tyrosine, NaHCO3, and Fe(NO3)3 could each generate a form of doxorubicin which did not migrate in TLC analysis. Purification of the nonmigrating form of doxorubicin demonstrated that in vitro conversion resulted in considerable loss of lethality while antiproliferative activity was retained. These observations provide possible explanations for the variability in chemosensitivity determinations and may explain some of the failures to predict clinical responsiveness. PMID- 6509358 TI - Animal rights movement: a threat to biomedical research? PMID- 6509359 TI - Design of phase I and II clinical trials in cancer: a statistician's view. PMID- 6509360 TI - Animal rights, academic freedom, and progress in biomedical research. PMID- 6509361 TI - Effect of cholesterol upon the conformation of band 3 and its transmembrane fragment. AB - Vesicles enriched in the anion transport protein band 3 and its transmembrane domain were prepared, and the cysteine residues were labelled with an extrinsic fluorescent probe, monobromobimane. Fluorescence energy transfer was demonstrated between intrinsic tryptophans and monobromobimane, and an average interchromophoric distance, Rav, was defined. Rav values and fluorescence emission wavelengths were used to monitor the conformation of band 3 and its transmembrane domain as a function of cholesterol content. The vesicles were treated with ovolecithin liposomes to reduce the cholesterol concentration, and there was an increase in Rav from 17.25 to 20.70 A (1 A = 0.1 nm) in intact band 3. A somewhat smaller increase in Rav for the transmembrane domain was observed (18.03-19.04). The tryptophan fluorescence emission wavelength was also blue shifted in the cholesterol-depleted preparations relative to the untreated samples. Combining the effects of cholesterol depletion upon Rav and the fluorescence emission maxima, it is suggested that the conformation of band 3 is influenced by the level of cholesterol in the bilayer. PMID- 6509362 TI - Photoactivated linkage of catechol O-methyltransferase and S-adenosyl-L methionine. AB - The formation of a stably linked complex of tritiated S-adenosyl-L-methionine (AdoMet) and catechol O-methyltransferase (COMT) has been achieved by irradiating the enzyme and ligand in Tris-HCl buffer (pH 7.5) with ultraviolet light at 254 nm. The reaction is specific as shown by a number of criteria. COMT inhibitors such as S-adenosylhomocysteine can block this photoactivated linkage. The [3H]AdoMet-COMT adduct has been shown to be a homogeneous protein by Sephadex gel filtration, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and isoelectric focussing. After extensive proteolysis of the [3H]AdoMet-COMT adduct with pronase P, one major labelled product was released. This fragment could be separated by paper chromatography and was shown to be chromatographically identical to that released from the [3H]AdoMet-phenylethanolamine N methyltransferase adduct. PMID- 6509363 TI - Effects of heparin fractions of different affinities to antithrombin III and thrombin on the inactivation of thrombin and factor Xa by antithrombin III. AB - To investigate the relative contribution of heparin-binding thrombin and antithrombin III to the enhancement of the rate of inactivation of thrombin by antithrombin III, standard heparin was fractionated on matrix-linked thrombin and (or) antithrombin III. There was a good correlation between heparin affinity for antithrombin III and its ability to enhance the inactivation of thrombin and factor Xa. In addition, there was a good correlation between affinity of heparin for thrombin and its catalytic activity on the inactivation of thrombin by antithrombin III. Thus fractions with high affinity to thrombin had similar rate enhancing activity for thrombin inactivation to that of fractions with high affinity to antithrombin III. Fractions with high affinity to both proteins were more potent than fractions with high affinity to either protein alone. No significant differences in mean molecular weight were observed among the various heparin fractions. A heparin fraction with very low affinity to thrombin and high affinity to antithrombin III was prepared by repeated fractionation of a low molecular weight heparin on the two affinity columns. This fraction had very weak rate-enhancing activity for the inactivation of thrombin by antithrombin III, but retained substantial activity for the inactivation of factor Xa. The results of these studies support the concept that, for both standard and low molecular weight heparin, the enhancement of the inactivation of thrombin by antithrombin III requires the interaction of the heparin with both thrombin and antithrombin III. PMID- 6509364 TI - Interaction of high and low density lipoproteins on glycosaminoglycan secretion by human vascular smooth muscle cells and fibroblasts. AB - Low density lipoprotein (LDL) increased secretion of glycosaminoglycans (GAG) and the cell cholesterol content of proliferating fibroblasts and smooth muscle cells in culture; with increasing cell density the GAG effect decreased, but the cholesterol effect did not. High density lipoprotein (HDL, d greater than 1.063) decreased GAG secretion by slowly proliferating cells; when cells were actively proliferating, HDL alone did not affect GAG secretion, but it inhibited the increase caused by LDL. Thus HDL appeared to influence GAG secretion by two separate mechanisms, an inhibition which was overcome by rapid proliferation and an anti-LDL effect. HDL2 (d = 1.063-1.100) partially reproduced the latter effect. In addition, HDL, HDL2, and HDL3 increased cell cholesterol; the ability of LDL to increase cholesterol was correspondingly reduced in the presence of HDL and its subfractions, suggesting that they act by common mechanisms. PMID- 6509365 TI - The effect of racetrack design on gait symmetry of the pacer. AB - A survey of a western Canadian racetrack determined the superelevation and transition curves to be less than the cited design standards. High-speed cinematography was used to film seven Standardbred pacers as they proceeded around one curve of the track at racing speed and for each horse 19 temporal stride parameters were obtained from these films using a film analyzer system. Average velocities were calculated and the mean stride length was found to vary from 5.08 m to 5.77 m. In all frames analyzed the hind foot was observed to contact the track surface prior to the ipsilateral forefoot and all horses displayed significant (p less than 0.05) contralateral asymmetry of some temporal stride parameters. Fifteen temporal stride parameters were significantly different (p less than 0.05) when compared between horses but only three temporal stride parameters were significantly different (p less than 0.05) when their values were compared between segments of the curved portions of the track. It is suggested that temporal gait asymmetry should not be used to judge the standards of racetrack design. PMID- 6509366 TI - Hematology and biochemistry reference values for Ontario swine. AB - The purpose of this study was to establish blood reference values for Ontario swine from various age groups. Weanling pigs, feeder pigs, gilts and sows on 11 randomly selected swine farms were sampled using the orbital sinus bleeding technique. Routine hematological and biochemical determinations were performed using whole blood and serum. For the variables examined in each age group the means, the standard deviations and the 95% upper and lower limits were calculated. PMID- 6509367 TI - Patterns of preweaning diarrhea in piglets on a central California ranch. AB - To determine risk factors for development of diarrhea in litters of preweaned piglets, data were analyzed from records of 4,397 litters of swine farrowed on a central California ranch 1978-1982. Sixty-four percent of litters were treated for diarrhea. Statistical analysis by multiple logistic regression showed that litters born to young sows (parity less than or equal to 2) were 1.7 times more likely to develop diarrhea before weaning than were litters born to older sows (parity greater than or equal to 3) and that litters born on one end of farrowing barns were 1.3 times more likely to develop diarrhea than were litters born in the other end. The association of diarrhea with other variables--dam breed, sire, gestation group, gestation length, size of litter, number of mummies, runts or stillbirths per litter, farrowing barn of birth or day of the week farrowed--was weak or nonexistent (P greater than 0.01). PMID- 6509368 TI - Morphological and hormonal features of an ovine and a caprine intersex. AB - A caprine and an ovine intersex were examined to compare their morphological and hormonal features in light of their cytogenetic make-up. Both animals, registered as females at birth, developed male-like appearance and behaviour as they approached the age of sexual maturity. Plasma testosterone concentrations in the intersexes were similar to those in adult males of the respective species. Cytogenetic analyses showed male and female cells in the blood while cultures of solid tissue contained only female cells suggesting that both were blood chimeras similar to the bovine freemartins. PMID- 6509369 TI - Congenital hyperostosis in piglets: a consequence of a disorganization of the perichondrial ossification groove of Ranvier. AB - The combination of histopathological and microradiographic examination and fluorescence microscopy was used to study the pathophysiology of the thick leg syndrome of the piglet. The genesis and evolution of the lesions in radioulnar hyperostosis may be the result of an initial lesion situated at the anchorage site of the periosteum to the epiphysis at the level of the perichondrial ossification groove of Ranvier. In this way, a true separation appears, which in turn could be the cause of the fine supernumerary trabeculae of woven bone. The sequence of appearance of the lesions is discussed. PMID- 6509370 TI - Intrathoracic pressure measurement in cattle: standardized procedure. AB - A procedure to standardize the position of an esophageal catheter (eso-cat) tip, used to measure intrathoracic pressure, was tested in ten healthy Dutch Friesians. The cattle were in normal condition with body weights (BW) between 52 and 670 kg and thoracic perimeters (TP) between 80 and 210 cm. The position of the neck and head was standardized. The eso-cat was introduced via the nose into the thoracic portion of the esophagus. The distance between the nares and the eso cat tip (Lcat), which was positioned between the crossing point with the aorta and the caudal mediastinal lymph nodes, was measured for each animal. The regression equation, calculated between the Lcat and the BW and TP was, respectively: Lcat (cm) = 65 + 0.115 x BW (kg) (r2 = 0.99) and Lcat (cm) = 22 + 0.535 x TP (cm) (r2 = 0.97). The corresponding residual standard deviations were respectively 2.52 and 4.37 cm. The multiple and curvi-linear regression equation did not give a significantly better fit of the data. PMID- 6509371 TI - Accuracy of thermodilution measurement of cardiac output in low flows applicable to feline and small canine patients. AB - A model system of feline or small canine cardiac output was used to produce known liquid flow rates in the range of 100 to 750 mL/min for comparison against a thermodilution technique of flow measurement. Thermal indicator size was decided by the thermal time concentration curve detected by the Edwards 9520A cardiac output computer. Ten consecutive readings for each flow were made. Regression analysis and Student's t-test were used to evaluate the results. The computer was found to give good correlation with the accurate flow measured by a graduated cylinder over a period of time (r = 0.99). An error of less than 7% overestimation of flow by thermodilution was found with flows greater than 200 mL/min (p less than 0.05). A significant error of more than 20% overestimation of the actual flow occurred with flows less than 200 mL/min (p less than 0.05). The Edwards 9520A computer was compared to the older Edwards 9510A model by averaged triplicate measurements at six different cardiac outputs in an anesthetized cat. The measurements were not significantly different (p less than 0.01). Thermodilution using an Edwards computer proves to be a promising tool in the measurement of low flows applicable to feline and small canine cardiac outputs. PMID- 6509372 TI - Serotypes and antibiotic sensitivity of Moraxella bovis isolated from an outbreak of infectious bovine keratoconjunctivitis. AB - Samples of conjunctival fluid of four calves, from a herd with infectious bovine keratoconjunctivitis, were collected five times at monthly intervals and from another 16 calves in the initial stages of the disease, were collected only once. Moraxella bovis was recovered from 82.3% of the samples. Twenty-six isolates were typed with polyvalent sera and 25 with monovalent sera. The antibiotic sensitivity of 13 isolates was also studied. Twenty of the 26 isolates reacted with polyvalent sera and 16 of 25 tested isolates, reacted with monovalent sera. The isolates recovered from the same animal in a different collection or from a different animal in the same collection did not always belong to the same serogroup. Different serotypes were prevalent in each collection. Differences in the antibiotic sensitivity of the isolates were also detected. PMID- 6509373 TI - Comparison of selenium levels and glutathione peroxidase activity in bovine whole blood. AB - Blood glutathione peroxidase activity and selenium levels were found to correlate well, indicating that glutathione peroxidase activity can be used to assess blood selenium levels in beef cattle. The glutathione peroxidase activity of blood is less stable than is the selenium concentration but when blood was stored at 4 degrees C, the glutathione peroxidase activity remained constant for seven days. PMID- 6509374 TI - The function of motor nerves innervating slow tonic skeletal muscle in hens with delayed neuropathy induced by tri-o-tolyl phosphate. AB - The reduction of neurogenic posttetanic potentiation in the slow twitch, soleus muscle is an index of impaired motor nerve function in cats with organophosphate induced neuropathy. We have applied the measurement of posttetanic potentiation to study the functional state of the slow, tonic, plantaris muscle and its motor innervation in adult White Leghorn hens with tri-o-tolyl phosphate (TOTP)-induced neuropathy. At suitable intervals following single oral doses of vehicle or TOTP (500 mg/kg), nerve conduction velocity and posttetanic potentiation were measured in anesthetized hens. Conduction in the sciatic nerve was not altered by TOTP. The plantaris muscle of birds treated with vehicle (peanut oil) either failed to contract or responded to nerve stimulation at 0.4 Hz with very small twitches. Following nerve stimulation at frequencies inducing tetanus (50-140 Hz), the muscles responded with large, slow twitches that gradually decayed in amplitude. The area under the curve formed by the amplitude of these twitches over time (posttetanic potentiation) was directly proportional to the frequency and duration of nerve stimulation. In hens at 1,2, and 4 weeks following treatment with TOTP, the average amount of posttetanic potentiation was reduced concomitantly with the development of ataxia, paralysis, and pathological changes in the peripheral nerves. This difference between vehicle- and TOTP-treated hens was not significant, owing to large interbird variations. Since TOTP-treated hens showed greater disturbances in gait following moderate exercise, the fatigue of posttetanic potentiation with periodic neuronal stimulation was measured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509375 TI - The lipid content of the diabetic kidney of the rat. AB - Rats were made diabetic by intravenous administration of streptozotocin, 100 mg/kg. Six groups of animals were studied: normal; animals given a supplement of 100% corn oil margarine; insulin-treated normoglycemic diabetic; hyperglycemic nonacidotic diabetic; ketoacidotic diabetic; and NH4Cl acidotic. The kidneys were removed from anesthetized animals. The renal cortex was separated from the medulla, freeze-clamped, and homogenized. Total lipids were extracted and measured gravimetrically. Lipid fractions were determined by thin-layer chromatography. Fatty acids of triacylglycerols and of phospholipids were analyzed by gas chromatography. Plasma triacylglycerols were elevated in hyperglycemic nonacidotic rats and more so in ketoacidotic animals. Total kidney lipids were 18% higher in nonacidotic hyperglycemic rats and 56% higher in ketoacidotic diabetic rats. This was due to accumulation of triacylglycerols while the phospholipid and cholesterol fractions did not change. Examination of long-chain fatty acids of kidney cortex triacylglycerols revealed that palmitate rose in a significant fashion while linoleate fell. This pattern was similar in all three groups of diabetic animals. The present data characterize the lipid content of the experimental rat diabetic kidney. They establish that the accumulation of lipids in the renal cortex during diabetes is related to triacyclgycerols and their palmitate content. Our study also provides a clear profile of plasma triacylglycerols during diabetes mellitus in the rat. PMID- 6509376 TI - Thyroid hormones modulate ornithine decarboxylase in the immature rat cerebellum. AB - In this study, we measured ornithine decarboxylase (ODC) activity as a potential parameter to evaluate the response of the developing rat brain to thyroid hormones. In cerebellum, neonatal hyperthyroidism (40 micrograms thyroxine/100 g body weight daily from birth) increased ODC activity at 2 and 5 days of age and then accelerated its developmental decline. Conversely, ODC activity was decreased in 2- and 5-day-old hypothyroid rats (propylthiouracil to the mother), but it was not significantly different from normal thereafter. No significant differences were observed in the forebrain following either treatment. In hypothyroid rat cerebellum, a single injection of triiodothyronine (T3, 100 micrograms/100 g 18 h before sacrifice) increased significantly ODC activity at all ages. A dose-response study showed that 0.5 micrograms T3/100 g is sufficient to obtain maximal stimulation. Finally, administration of antiserum against rat growth hormone had no significant effect on ODC response to T3. These results show that ODC is a useful marker of thyroid state and tissue response in the neonatal rat cerebellum. PMID- 6509377 TI - Effects of intraventricular injections of gamma-aminobutyric acid and related substances on feeding behavior in satiated sheep. AB - Feed intake was measured following injections of gamma-aminobutyric acid (GABA), muscimol (a GABA agonist), and picrotoxin (a GABA antagonist) into the lateral ventricles of satiated sheep. Doses ranging from 0.20 to 3200 nmol of GABA did not affect feeding behavior at 15, 30, 60, and 120 min postinjection. A dose of 160 nmol of muscimol induced a marked increase in feeding, comparable to that provoked by an injection of 78 mumol of pentobarbital. Muscimol-induced feeding was blocked effectively by a preinjection of picrotoxin. These observations implicate that neurons sensitive to gamma-aminobutyric acid may be involved in the control of feeding behavior in ruminants. PMID- 6509378 TI - Structural basis for function of circular muscle of canine corpus. AB - The structural relationship of nerve, muscle, and interstitial cells of Cajal in circular muscle of the lesser curvature of the dog stomach (corpus) has been studied. This muscle has also been characterized functionally. Muscle cells are arranged in bundles and are interconnected by numerous gap junctions averaging 30 per 100 cross-sectioned muscle cells, and leading to an estimate that each cell has about 200 gap junctions. No other smooth muscle studied to date has such a high density of gap junctions. Nerve varicosities, mostly containing a predominance of small agranular vesicles with some containing a predominance of large granular vesicles, are located outside muscle bundles, usually in small- to medium-sized bundles. Very few nerves containing small granular vesicles, presumably adrenergic, were found in agreement with functional studies. A substantial number of damaged nerve profiles was also found, perhaps contributing to the loss of nerve-dependent responses present in vivo, but absent in vitro. Interstitial cells of Cajal were rare in this tissue, about 1 per 1000 cross sectioned muscle cells. When present, they often made gap junction contact with smooth muscle and were closely innervated. The findings of a structural basis for very tight coupling between cells, the absence of a structural basis for direct neural control over motor function, and other findings have implications for the control of contractions in this muscle. PMID- 6509379 TI - Relationship of electrical slow wave and spike bursts in the dog jejunum in vivo. AB - The temporal relationship between the slow wave and the spike bursts was studied in the fasted and the fed states in conscious dogs implanted with serosal electrodes on the jejunum. A fully automatic computerized method processed more than 225 h of recording. For each slow wave cycle that contained a spike burst, the program computed the cycle duration and the times elapsed from the beginning of the cycle to the onset and to the end of the burst. In the fasted state as well as after feeding, the spike bursts began and ended at any time within the segment of the slow wave cycle on which spike activity occurred. These results indicate that in vivo in the dog jejunum, the temporal relationship of the slow wave and spike bursts is not fixed. They suggest that the slow wave allows the spikes to occur during limited time intervals, but does not determine their precise location and duration within these intervals. Furthermore, differences existed in the patterns of the slow wave and in its relationship with spike activity (period, location, and duration of the segment on which the spike bursts occurred) between the various phases of the migrating myoelectric complex in the fasted state and the fed state. PMID- 6509380 TI - Biointeraction of dietary T-2 toxin and zinc in mice. AB - The effect of varying dietary levels of zinc was evaluated in mice fed T-2 toxin. A semipurified diet was used to produce a low zinc (less than 2 parts per million (ppm], a zinc replete (100 ppm), and a high zinc (2500 ppm) diet. T-2 toxin was added to the three zinc diets at a concentration of 10 ppm. The mice were fed one of the six diets ad libitum for up to 28 days. Mice from each diet were submitted for necropsy after 14 and 28 days and after 14 days zinc absorption and retention was measured in mice from each of the low and replete zinc diets, with and without T-2 toxin. Animals receiving a low zinc diet with T-2 toxin had reduced weight gains. The high zinc diet did not depress growth and did not influence T-2 depression of growth. The diets produced significant hematological changes without evidence of a T-2 toxin - zinc interaction. While zinc absorption was greater in mice fed the low zinc diet than those fed the replete zinc diet, T-2 toxin decreased absorption of zinc in the low zinc group and increased absorption in the replete zinc group. T-2 toxin did not influence the biological half-life of retained zinc in either the low or replete zinc groups. The biological half life of zinc was significantly increased in the mice fed the low zinc diet relative to the replete zinc diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509381 TI - The effect of propranolol on blood viscosity changes induced by experimental coronary occlusion. AB - The effect of propranolol treatment was investigated in the myocardial ischemia induced hyperviscosity state in anesthetized dogs. In untreated control dogs, low shear blood viscosity rose progressively, following an acute occlusion of the left anterior descending coronary artery; this effect was partially but significantly reduced by intravenously administered propranolol (0.2 mg/kg). The effect of the in vitro addition of propranolol was also determined upon viscosity of blood samples obtained at hourly intervals from dogs subjected to similar coronary ligation. The in vitro addition of propranolol did not produce a similar reversal of the hyperviscosity state observed in the blood obtained from dogs after coronary ligation. PMID- 6509382 TI - Relation between fetal arterial PO2 and oxytocin-induced uterine contractions in pregnant sheep. AB - The relation between oxytocin-induced type A uterine contractions and fetal arterial PO2, measured continuously with an intravascular oxygen electrode, was studied in nine chronically catheterized sheep during late pregnancy. Oxytocin provoked dose-related increases in intrauterine pressure (IUP) and decreases in fetal PaO2. There was a significant positive relationship between changes in IUP and the maximum decrease in fetal PaO2 (average r = 0.696, df = 92; P less than 0.001). We conclude that changes in uterine activity contribute to transient fetal hypoxemia, and that administration of exogenous oxytocin provides an experimental paradigm to examine the consequences of this relationship. PMID- 6509383 TI - A comparison of the effects of cationic, anionic, and neutral amphipathic agents on the contractile behaviour of frog skeletal muscle. II. Amplitude of depolarization and repolarization-induced contractures. AB - Sufficiently high concentrations of cationic (n-alkyl trimethylammonium) or neutral (n-alkanols) amphipathic agents reduced the amplitude of maximum K contractures of frog toe muscles, an effect which was antagonized by reduced temperature, by the presence of perchlorate anions, or (to a lesser extent) by an increased concentration of divalent cations. Enhancement of the similar effect of tetracaine was prominent only with alkyl trimethylammonium compounds. Enhancement of the depressant effect of acidity (pH 5.0) was observed with octyl trimethylammonium and octanol but not with octanesulfonate or butanol. Partial restoration of potassium contractures in media lacking divalent cations was produced by octane- or nonane-sulfonate and by propanol but not by octyl trimethylammonium or octanol. The alkyl sulfonates differed from the other agents studied in producing tonic contractures at concentration which did not reduce maximum K-contracture tension. The alkyl sulfonates also differed from other amphipaths of similar size in their ability to elicit small repolarization induced contractures in the absence of perchlorate, although this property also was shared by small alkanols. Sufficient concentrations of all amphipaths reduced the amplitude of repolarization-induced contractures in the presence of perchlorate. The intensity of the effects of these agents on contractile function usually was proportional to the size of their apolar group, and with ionic apmphipaths such effects were apparent only with compounds having hydrocarbon chains containing eight or more carbon atoms. These experiments indicate that hydrophobic interactions in the external lamina of the sarcolemma can influence the potential-dependent control of contractile function in skeletal muscle, presumably by effects on the conformational transitions of integral membrane proteins.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509384 TI - Chronotropic, inotropic, and coronary artery blood flow responses to stimulation of specific canine sympathetic nerves and ganglia. AB - Electrical stimulation of the major sympathetic cardiac nerves and ganglia in chloralose-anesthetized, open-chest dogs elicited specific changes in heart rate, coronary blood flow, regional intramyocardial pressure, or intraventricular pressure. The effects produced by stimulation of a cardiac nerve were similar to, but never greater than those produced by stimulation of the ipsilateral stellate ganglion. Coronary blood flow was increased when neural stimulation increased intramyocardial pressure. In contrast, coronary blood flow was not altered significantly when neural stimulation induced tachycardia without increasing intramyocardial pressure. It is concluded that in the intact heart, electrical stimulation of the sympathetic cardiac nerves or ganglia increases coronary blood flow by augmenting intramyocardial pressure, not chronotropism. PMID- 6509385 TI - Inotropic effect of amrinone in rabbit papillary muscle: reversal of the myocardial depressant effect of halothane. AB - In rabbit papillary muscles, the pronounced inotropic effect of amrinone (0.4-0.8 mg/mL) observed at low stimulation frequencies (0.1-0.5 Hz) diminished as the frequency was increased to 1.0-2.0 Hz. Reversal of the negative inotropic effect of halothane (1%) by amrinone (0.8 mg/mL) was similarly dependent on stimulation frequency. The contractile response to paired-pulse stimulation in the presence of amrinone (0.8 mg/mL) was summation rather than postextrasystolic potentiation. Amrinone (0.8 mg/mL) was not effective in reversing the negative inotropic effect of halothane (1%) on potentiated state contraction generated by paired-pulse stimulation. These results suggest that amrinone increases the influx of extracellular Ca2+ across the sarcolemma but not the availability of cellular Ca2+ which accumulates, most likely in sarcoplasmic reticulum, under the condition of potentiation. PMID- 6509386 TI - Effects of digoxin on the chronotropic responses to repetitive vagal stimulus bursts in the dog. AB - We studied the effects of digoxin on the chronotropic responses of the heart to repetitive bursts of vagal stimulation in chloralose-anesthetized dogs. The frequency of the stimulus bursts was increased linearly with time. Over a certain range of frequencies, the cardiac pacemaker became synchronized with the vagal stimulation in a 1:1 ratio of heart beats to stimulus bursts. Digoxin increased the range of cardiac cycle lengths over which 1:1 synchronization occurred during repetitive vagal stimulation. This increment in the range of synchronization varied directly with the dose of digoxin. Before digoxin was given, the range of cardiac cycle lengths over which synchronization occurred when the vagus nerve was stimulated with 10 pulses per burst was 272 +/- 50 (mean +/- SE) ms. However, after a cumulative dose of 120 micrograms/kg-1 digoxin had been given, the range of 1:1 synchronization increased to 396 +/- 32 ms. Digoxin did not appear to have a proportionately greater effect on those processes that take place in the phase of the cardiac cycle during which the pacemaker cells are maximally responsive than on those processes that occur in the phase of the cycle during which the pacemaker cells are minimally responsive. Therefore, we conclude that the augmented entrainment induced by digoxin is ascribable to its tendency to enhance the chronotropic response to vagal stimulation. PMID- 6509387 TI - Cardiomyopathic hamsters, CHF 146 and CHF 147: a preliminary study. AB - The time course and characteristics of lesion development in both cardiac and skeletal muscle from two strains of cardiomyopathic hamsters (CHF 146 and CHF 147) were studied by histological methods. The chronology of lesion development and the histological characteristics of the lesions were similar in both strains. However, increased calcification of cardiac lesions was present in the hearts of CHF 147 animals. This may account for the difference in lifespan between the CHF 147 (350 days) and the CHF 146 (440 days). PMID- 6509388 TI - Mycoflora of the human dermal surfaces. AB - The mycotic flora of the scalp and interdigital areas of the hand and foot of 1296 apparently healthy human inhabitants of three Amazonian communities were surveyed by means of microscopic examination of epidermal scrapings and cultural isolation on Mycosel agar. No macroscopic or microscopic evidence of fungal infection was detected in any of our study subjects. From 133 (10%) individuals, 143 fungi representing 13 genera and 39 species were recovered. Yeasts constituted 85% of the fungi. Seventy-five percent of the isolates were fungi with pathogenic potential: Aureobasidium pullulans, Candida albicans, Candida guilliermondii, Candida parapsilosis, Candida stellatoidea, Candida tropicalis, Exophiala werneckii, Geotrichum candidum, Rhodotorula rubra, Torulopsis glabrata, Trichophyton tonsurans, Trichosporon cutaneum, and Wangiella dermatitidis. The low frequency with which each species was represented resulted in a mosaic distribution of the fungi with respect to human anatomical sites and study areas. The lack of similarity in species composition between the human dermal mycoflora and soil mycoflora in the same study areas supports the conclusion that distinct yeast species occupy different environmental niches. PMID- 6509389 TI - Differential mechanisms for liposome uptake by vegetative and aggregation competent cells of Dictyostelium discoideum. AB - Liposomes labelled with 125I-labelled albumin were used as carriers for the introduction of albumin into vegetative and aggregation competent cells of Dictyostelium discoideum. The subcellular distribution of albumin and its degradation products was followed. The results show that 44 and 67% of the radioactivity incorporated by vegetative and aggregation competent cells, respectively, was found in soluble form in the cell. These figures fall to 26 and 34% in the presence of metabolic inhibitors with a concomitant increase of membrane-bound radioactivity. Differences in the mode of liposome--cell interaction in the two stages of development of the organism and the possibility that metabolic inhibitors may operate at the site of the vacuole--liposome fusion step are discussed. PMID- 6509390 TI - Porcine haemophili and actinobacilli: characterization by means of API test strips and possible taxonomic implications. AB - Thirty Haemophilus strains and six Actinobacillus strains, all of porcine origin, were examined for their biochemical reactivity on API 20E and API ZYM test strips using dense cell suspensions (supplemented with NAD as appropriate) as strip inocula. When combined with a test for V-factor dependency, the use of both strips allowed adequate differentiation of closely related organisms. Numerical taxonomic analysis of the data demonstrated that the majority of the haemophili and actinobacilli studied could be placed in one of four major clusters; these clusters contained, respectively, the H. pleuropneumoniae--A. pleuropneumoniae strains, the H. parasuis strains, strains belonging to Haemophilus taxon "minor group," and strains belonging to an unusual group of mannitol-positive, urease negative haemophili. A representative of Haemophilus species taxon C and an unusual Actinobacillus isolate appeared to be comparatively unrelated to organisms in the four major clusters. Although it may, on occasion, be difficult to place an unusual isolate in any one particular group, owing to the uncertain taxonomy of some of these organisms, it is concluded that API test strips can serve as useful tools for the characterization and differentiation of porcine haemophili and actinobacilli. PMID- 6509391 TI - Lectin grouping of Bacillus thuringiensis serovars. AB - Twelve lectins, 11 of plant and 1 of animal origin, were tested against the 28 serovars of Bacillus thuringiensis to study their agglutinating specificities. Except for the sialic specific lectin from Limulus polyphemus, tube agglutination assays were performed using lectin concentrations of 10, 50, and 100 micrograms against 0.2 mL of 10(9) cells/mL in a final volume of 1.0 mL. The agglutination studies with the Limulus lectin were performed using 10 and 50 micrograms of lectin. Tubes were incubated overnight at room temperature (25 degrees C) and observed for agglutination patterns. Ten of the 28 serovars were individualized according to their ability to bind with various lectins. The study shows that the various serovars have different carbohydrate residues which indicates that the O somatic antigens differ. PMID- 6509392 TI - Recovery and survival of nontuberculous mycobacteria under various growth and decontamination conditions. AB - The survival of microorganisms of the Mycobacterium avium, M. intracellulare, and M. scrofulaceum (MAIS) complex was evaluated after various soil and water decontamination regimens. Survival was reduced by growing cells in natural waters compared with laboratory media and by inclusion of malachite green in media as an antifungal agent. Decontamination with benzalkonium chloride, while reducing survival significantly less than 1% NaOH, failed to eliminate many fungi. Recovery from soil was further reduced by transfer losses and by irreversible cell adsorption onto particulates. PMID- 6509393 TI - Properties of oral asaccharolytic black-pigmented Bacteroides. AB - Bacteroides endodontalis, a newly described asaccharolytic black-pigmented Bacteroides, along with the other two recognized species of this group (B. gingivalis and B. asaccharolyticus) were studied for their susceptibility to various dyes and inhibitory agents and for some of their enzymatic activities to facilitate differentiating between them. Bacteroides endodontalis resembles B. asaccharolyticus physiologically except for the fact that the former cannot grow on media containing methylene blue, neutral red, or 3% sodium chloride, whereas B. asaccharolyticus can. On the other hand, B. endodontalis and B. gingivalis can grow on a medium containing Congo red while B. asaccharolyticus cannot. PMID- 6509394 TI - Morphology of Pasteurella multocida bacteriophages. AB - Twenty-one tailed phages with icosahedral heads belong to the Myoviridae, Siphoviridae, and Podoviridae families and to four morphological types. Type AU, with 10 phages, has a contractile tail and is morphologically identical with coliphage P2. Lysates contain contracted tail sheaths assembled end-to-end and abnormal structures with long tails and multiple tail sheaths. Types C-2 and 32, with one and three phages, respectively, have long, noncontractile tails. Type 22 includes seven phages, has a short tail, and resembles coliphage T7. Our results agree with previous biological data and suggest that types AU, C-2, 32, and 22 correspond to four different phage species. PMID- 6509395 TI - Purification and characterization of an exoglucanase from Streptomyces flavogriseus. AB - Streptomyces flavogriseus, a mesophilic actinomycete, produces high levels of extracellular enzymes capable of hydrolyzing cellulose and xylan. One such enzyme, an exoglucanase, has been purified to molecular homogeneity by a sequence involving DEAE Bio-Gel A chromatography, gel permeation chromatography on Bio-Gel P-60, preparative isoelectric focusing, and concanavalin A affinity chromatography. This purification sequence disclosed the presence of several distinct endoglucanase and xylanase fractions. Homogeneity of the purified enzyme was demonstrated by analytical isoelectric focusing and sodium dodecyl sulphate- polyacrylamide gel electrophoresis. The purified enzyme had a molecular weight of approximately 45 000 and an isoelectric point of 4.15. The enzyme demonstrated negligible activity with carboxymethylcellulose as the substrate. It was able to extensively hydrolyse acid-swollen cellulose; the main product of enzyme action was cellobiose. PMID- 6509396 TI - A clinical classification of hereditary ataxias. AB - We present a working and flexible classification of inherited ataxic syndromes based on the use of simple tools available to every clinician: a good history (particularly pinpointing the age of onset, the rate of progression and the mode of inheritance) and a neurological examination (identifying the presence of ataxia, deep tendon reflexes in the knee, optic nerve, retinal and/or 8th nerve signs). This classification is easily coded for computer translation on any personal computer. The place occupied by a given disorder may, by contiguity, give a clue to its pathophysiology. PMID- 6509397 TI - Quebec Cooperative Study on Friedreich's Ataxia. PMID- 6509398 TI - The natural history of Machado-Joseph disease. An analysis of 138 personally examined cases. AB - We have examined 138 cases of a disorder previously described in people of Portuguese origin and which has received many names. By computer analysis of 46 different items of a standardized neurological examination carried out in each patient, we have been able to delineate the main components of the clinical presentation, to conclude that the marked variability in clinical expressions does not negate the homogeneity of the disorder, and to describe the natural history of this entity which should be called, for historical reasons, "Machado Joseph Disease". This hereditary disease has an autosomal dominant pattern of inheritance, presenting as a progressive ataxia with external ophthalmoplegia, and should be classified within the group of "Ataxic multisystem degenerations". When the disease starts before the age of 20, it may present with marked spasticity, of a non progressive nature but often so severe that it can be accompanied by "Gegenhalten" countermovements and dystonic postures but little frank dystonia. There are few true extrapyramidal symptoms except akinesia. When the disease starts after the age of 50, the clinical spectrum is mostly that of an amyotrophic polyneuropathy with fasciculations accompanying the ataxia. For all the other cases the clinical picture is a continuum between these two extremes, the main determinant of the clinical phenotype being the age of onset and a secondary factor, the place of origin of the given kindred. The ataxic and amyotrophic components are clearly progressive with time in contrast to the spasticity component. Although the majority of known cases are of Portuguese origin, this is not obligatory. The next research endeavour should be a search for the chromosomal site of the gene, using molecular biology technology such as those for recombinant DNA. PMID- 6509399 TI - Evidence that Charcot-Marie-tooth disease with tremor coincides with the Roussy Levy syndrome. AB - We report data on 3 members of a family affected by a dominantly inherited disorder closely resembling Roussy-Levy syndrome (RLS). Electrophysiological findings showed a marked decrease of motor and sensory conduction velocities and EMG signs of mild neurogenic damage. Light and electron microscopy of sural nerve biopsy showed a hypertrophic neuropathy with diffuse onion-bulb formations and marked decrease of large size fibers. Teased fiber preparations evidenced reduced internodal lengths and segmental demyelination. Other data from the literature on RLS are reviewed and discussed. The hypothesis that RLS is not a disease entity but a hypertrophic-type of Charcot-Marie-Tooth disease with essential tremor (HMSN type 1) is strongly supported. PMID- 6509400 TI - Familial spastic ataxia associated with Ehlers-Danlos syndrome with platelet dysfunction. AB - Four members of a family with consanguineous relationships, the proband and his three children (2 sons and 1 daughter) are affected with Familial Spastic Ataxia and with Ehlers-Danlos' Syndrome with platelet aggregation dysfunction. In the four cases, this exceptional association appears remarkably homogeneous both in clinical and laboratory studies. The two syndromes are of dominant-autosomic transmission and probably originated in a new mutation which presumably maintained a genetic linkage. Spastic ataxia is characterized by a precocious onset and a slow evolution. The first-born son shows a dominant pyramidal syndrome with mild ataxia suggesting that it is a transitional form of familial spastic paraplegia. The Ehlers-Danlos syndrome pertains to form II or "mitis" with moderate skin hyperelasticity and joint hypermobility. The abnormal platelet aggregation curves have the same profile in all the patients. The first-born son also presents a mitral valve prolapsus as we may find either in Ehlers-Danlos syndrome or in spastic ataxia. The neurophysiological, tomographical, histological, ultrastructural and biochemical studies attempt to accomplish a better definition of these associated nosological entities. PMID- 6509401 TI - Quantitative evaluation of the effects of acetazolamide in Friedreich's ataxia: a pilot study. AB - We evaluated the effects of acetazolamide in 4 young patients with Friedreich's ataxia by clinical and quantitative laboratory methods. Dynamic muscle function of the lower extremity was measured during isokinetic knee movements and gait. The acetazolamide trial was terminated at 7 to 11 weeks because of reported side effects or increased ataxia in 3 of the patients. The quantitative evaluations revealed lower dynamic strength values and alterations in the gait movement pattern in all patients. These changes, which were interpreted as deterioration, were partially reversible with cessation of acetazolamide. The advantages of such quantitative evaluations of dynamic muscle function in the evaluation of therapy in Friedreich's ataxia are discussed. PMID- 6509402 TI - A progressive neurological syndrome associated with an isolated vitamin E deficiency. AB - Several authors have recently reported a neurological disorder associated with chronic vitamin E deficiency in man. Except in one patient, this deficiency has always been secondary to an underlying disease resulting in lipid malabsorption. We report a second case of such a neurological syndrome in a patient in whom vitamin E deficiency was an isolated finding. The clinical picture in our patient was characterized by a diffuse muscle weakness most prominent distally and in the lower limbs, generalized areflexia, a decrease in proprioception and vibration sense and slight limb and gait ataxia. His condition improved on alpha tocopherol therapy so that it is very likely that vitamin E deficiency is responsible for his neurological deficit. Since in our patient as well as in several other reported cases this condition has been treatable, it is important that this syndrome be recognized in children presenting a suggestive clinical picture even if they do not have lipid malabsorption. PMID- 6509403 TI - Visual evoked potentials and brain stem auditory potentials in Friedreich's ataxia--a longitudinal study. AB - Six patients with Friedreich's ataxia, 4 males and 2 females, their ages ranging from 13 to 33 years, were studied. The early manifestations started between age 7 and 13 with an evolution time between 6 and 20 years. Serial visual and brain stem auditory evoked potential recordings were made. A progressive increase in latency, reduction in amplitude and in latency inter-ocular difference of P100 were observed. The pattern of the reversal checker-board visual evoked potential was preserved. A disorganized BAEP pattern, a well defined potential I, a very small potential V and a delay in the interpeak latency were constant findings. The assumption is made of a progressive involvement of both visual and central auditory pathways. Pathophysiological mechanisms are discussed. PMID- 6509404 TI - Follow-up study of electronystagmographic findings in Friedreich's ataxia patients and evaluation of their relatives. AB - Fourteen Friedreich patients (F group) who had undergone a first electronystagmogram (E.N.G.) reported in 1978, had the same test 12 to 24 months after the first one. In the second study, there are more patients with bilateral hypoactive caloric nystagmus failure of fixation suppression, ocular dysmetria, irregular pendulum tracking and ocular flutter. These signs are probably most representative of the progression of the disease. Nineteen unaffected relatives of these patients (H group) also had an electronystagmogram but no special "familial" electronystagmographic pattern could be identified. Irregular ocular poursuit, nearly invariable in the F group but absent in the H group, was one of the most important differences between patients and their relatives. PMID- 6509405 TI - A simple device to obtain reliable foot radiographs of ambulatory and non ambulatory Friedreich's ataxia patients. AB - A simple radiographic apparatus standardizing foot position and simulating weight bearing effects in the feet is described in this paper. It provides an effective means of obtaining reliable radiographic data for both ambulatory and non ambulatory patients. This device is presently used in an on-going study on pes cavus in Friedreich's ataxia. PMID- 6509406 TI - Evaluation of foot deformity using a three-dimensional geometric model. AB - A three-dimensional geometric model of the foot's bony structure based on the use of a stereoradiographic technique is presented. To illustrate the potential of such a model it has been applied here to the study of cavus foot in a patient having Friedreich's ataxia. This model permits an accurate evaluation of this complex spatial foot deformity. PMID- 6509407 TI - Scoliosis assessment in Friedreich's ataxia by means of intrinsic parameters. AB - Spinal deformities have been evaluated in a five year retrospective study where 28 boys and 25 girls all having Friedreich's ataxia were on the average assessed once a year in a multidisciplinary clinic. Scoliosis seems somewhat more progressive in girls than in boys and more severe in non-ambulatory than ambulatory patients. Some of those scolioses are very progressive reaching 60 degrees to 100 degrees Cobb angle values requiring spinal surgery while other progress less rapidly and do well on their own. In addition it was shown that the intrinsic geometric spine curve parameters namely that of curvature and torsion are a powerful diagnostic tool in the assessment of evolutive scoliosis. PMID- 6509408 TI - The cardiomyopathy in Friedreich's ataxia: isotopic ventriculography and myocardial imaging with thallium-201. AB - Myocardial scanning after the intravenous administration of Thallium 201 was used to evaluate regional myocardial perfusion in 14 patients with Friedreich's ataxia. Isotopic ventriculography was also used to assess left ventricular contractility. Myocardial images in patients with Friedreich's ataxia were found to be precociously abnormal irrespective of the degree of neurological impairment or of the severity of myocardial hypertrophy. PMID- 6509409 TI - The neuropathology of "typical" Friedreich's ataxia in Quebec. AB - We present the pathological data from the autopsies performed on 6 Friedreich's disease patients since the start of the Quebec Cooperative Study. All patients met the strict diagnostic criteria of the QCSFA. The anatomical lesions found in the peripheral and central nervous system were similar in all 6 cases and do not differ from those described in the literature. The clinical findings correlate closely with the histological lesions found in the peripheral nervous system and spinal cord. The evidence of segmental demyelination and remyelination in the spinal ganglia and posterior roots further supports the dying-back axonopathy hypothesis. PMID- 6509410 TI - Platelet taurine content in Friedreich's disease. AB - We have studied the concentrations of taurine and of 6 other amino acids in platelets from 12 patients with Friedreich's disease and 12 age sex-matched normal control subjects. No significant differences could be demonstrated between the two groups. The glycine/serine ratio was lower in all the patients but this change did not reach statistical significance. From these and other data, we conclude that the taurine retention deficit observed previously in Friedreich's disease cannot be the primary causal defect. PMID- 6509411 TI - Studies on the role of taurine in Friedreich's ataxia. AB - New studies were undertaken to verify the previous findings of increased urinary excretion of taurine, in the basal state and after challenge with a taurine load, in Friedreich's disease. Particular attention was paid to possible causes of error such as weight, muscle mass, creatine and creatinine excretion, variability with time and appropriate control groups. Although the overall findings were confirmed, their interpretation is open to question because of all these factors of error. Many possibilities must still be further explored to account for the apparent taurine retention defect observed in many cases of Friedreich's disease. PMID- 6509412 TI - Free amino acids and calcium, magnesium and zinc levels in Friedreich's ataxia. AB - Free amino acid levels and zinc, magnesium and calcium content have been determined in autopsy samples of 9 areas of the brain, two skeletal muscles, and the right ventricle, left ventricle and septum of the heart of a Friedreich's ataxia subject. PMID- 6509413 TI - Hair trace elements in Friedreich's disease. AB - Concentrations of zinc, copper, manganese, chromium, cobalt and selenium were measured in the hair obtained from subjects with Friedreich's disease, other inherited ataxias and neurological control patients. Although zinc and copper concentrations were significantly higher in Friedreich than in the two control groups, the mean values for all groups were well within the normal range. No major deficiency in zinc or selenium was demonstrated in Friedreich's disease using the approach. This does not, however, indicate that there is no defect in zinc and selenium metabolism, availability or transport in this disorder. PMID- 6509414 TI - Zinc and taurine in Friedreich's ataxia. AB - Zinc and taurine were measured in urine in the fasting state and following a 4mg/kg load of taurine in subjects with Friedreich's Ataxia (FA), and healthy controls (C), and subjects with Duchenne type muscular dystrophy (MD). Of the FA, 25% had increased fasting excretion of zinc, and 50% had increased excretion of zinc following the taurine load. The MD subjects all had increased zinc excretion at all times. The increased zinc excretion did not correlate with increased excretion of taurine. As an index of zinc deficiency, uptake of zinc by erythrocytes was measured in all subjects and in heterozygotes for FA. The pattern of uptake was abnormal for FA and heterozygotes. Hair analysis for zinc showed that 10 of the 12 FA subjects had low values. We conclude that significant abnormalities in zinc metabolism exist in some, but not all cases of FA. The evidence available does not permit definition of the cause of these abnormalities, whether zinc deficiency or abnormal zinc transport is the primary factor. PMID- 6509415 TI - Distribution of apolipoprotein E phenotypes in Friedreich's ataxia. AB - Allelic polymorphism at the apolipoprotein E (apo E) gene locus (alleles epsilon 2, epsilon 3, and epsilon 4) is responsible for the existence of 6 discrete electrophoretic phenotypes of plasma apo E. Since the presence of the epsilon 2 allele in the genotype tends to be associated with higher triglyceride levels, a study was undertaken to determine if a higher frequency of this allele could account for the presence of higher plasma triglycerides in subsets of patients with Friedreich's Ataxia. The frequency of the apo E phenotypes was determined in 37 subjects with Friedreich's Ataxia and compared with that of 102 normolipidemic and 102 hyperlipidemic individuals. There was no increased prevalence of the E3/2 phenotype and the epsilon 2 allele in the Friedreich's sample as is found in a hyperlipidemic sample. Furthermore, the epsilon 2 subset did not have significantly higher plasma triglycerides than the non-epsilon 2 subset and the hypothesis was rejected. On the other hand, there was a trend for a decreased frequency of the E4/3 phenotype in the Friedreich's sample relative to the hyperlipidemic group but the difference did not reach statistical significance. The apo E phenotype distribution was also measured in a smaller sample of Charlevoix-Saguenay disease; this led to the discovery of two siblings with the relatively rare E2/2 phenotype and unexpectedly low levels of plasma lipid and lipoprotein concentrations. Plasma apolipoprotein E concentrations in both diseases were within the normal range except for subjects bearing the E2/2 phenotype. PMID- 6509416 TI - Plasma cholesteryl sulfate in Friedreich's ataxia. AB - Alteration of membrane fluidity and anomalies of membrane structural proteins have been suspected in Friedreich's ataxia. Plasma lecithin:cholesterol acyltransferase (LCAT) activity is also lowered in this disease, presumably because of a substrate effect. The membrane-stabilizing effect of cholesteryl sulfate (CS) and its inhibitory effect on LCAT activity prompted us to measure this substance in the plasma of Friedreich's ataxia patients as well as in normal subjects and in patients with Charlevoix-Saguenay disease. Plasma cholesteryl sulfate concentrations were significantly higher in Friedreich's ataxia, with levels above the upper limit of normal in nearly half of the cases. This increase was unrelated to age, sex or plasma cholesterol levels, but closely associated with the severity of the disease and thus considered to be secondary. A similar phenomenon (except the association with severity) was observed in Charlevoix Saguenay ataxia. Levels also tended to be higher in first-degree relatives of Friedreich cases. The significance of these findings is discussed in the light of recent knowledge and experimental data obtained in this laboratory on rats made deficient in essential fatty acids. The highest concentrations of CS observed in Friedreich's ataxia (1097 micrograms/dL, 6 times the normal mean) was only 25% as high as the concentrations reported to inhibit LCAT activity. PMID- 6509417 TI - Friedreich's ataxia: malic enzyme activity in cellular fractions of cultured skin fibroblasts. AB - We have measured the activity of malic enzyme NADP+ dependent in the nuclear, mitochondrial, lysosomal and cytosolic fractions of cultured skin fibroblasts from twelve patients with Friedreich's ataxia and nine control subjects. Hexosaminidase, cytochrome-C-oxidase, lactate dehydrogenase and malic enzyme NAD+ dependent were used as marker enzymes. The activity of malic enzyme NADP+ dependent was not significantly reduced in the mitochondrial fraction of patients with Friedreich's ataxia as compared with controls. When corrected for possible contamination between mitochondrial and cytosolic fractions, malic enzyme NADP+ dependent activity was still not significantly reduced in patients with Friedreich's ataxia. Unless critical methodological differences were overlooked in this or previously published studies, we conclude that mitochondrial malic enzyme deficiency is not the primary genetic defect underlying Friedreich's ataxia. PMID- 6509418 TI - Cardiac malic enzyme in Friedreich's disease. AB - We measured the activity of cytosolic and of mitochondrial malic enzyme in the hearts from 4 patients with Friedreich's disease and from two non-ataxic control subjects. There was a wide variability in the results and the slight overall decreases in both enzyme activities were not considered to be statistically significant. From these and other results, we conclude that deficient mitochondrial malic enzyme activity is not a constant or primary feature of Friedreich's disease. PMID- 6509419 TI - The Quebec Cooperative Study of Friedreich's Ataxia: 1974-1984--10 years of research. AB - In this paper the author reviews the progress accomplished in the understanding of Friedreich's disease since the start of the "Quebec Cooperative Study of Friedreich's Ataxia" in 1974. The last ten years have indeed seen important strides taken in the definition and nosography of the hereditary ataxias and the characterization of a number of new entities. Biochemically, the principal leads uncovered during the initial prospective survey, have been pursued to great detail. Unfortunately no clear-cut constant and severe enzyme block in the principal metabolic pathways has yet been identified, despite intensive studies. It is postulated that the defect may instead be a regulatory one and involve a decreased availability or utilization of one of the vitamin cofactors that are known experimentally, or clinically, to produce central nervous system damage with ataxia: Vitamin E, Biotin or Pantothenic Acid. Studies in that direction and in molecular genetics to localize the Friedreich's disease gene are being undertaken for the next phase of the Cooperative Study. PMID- 6509420 TI - Ethics in behaviour therapy: historical aspects and current status. AB - Ethical problems in clinical practice arise when clinicians confront competing value systems. Historically, behaviour therapy has been criticized because of alleged special ethical, moral and legal problems. These problems are no greater or smaller than in other forms of psychotherapeutic practice. But they can differ in emphasis. This article describes partial responses to selected ethical dilemmas facing general psychotherapy, and outlines relatively novel issues raised by certain features of behavior therapy practice. PMID- 6509421 TI - Body image perception and preference in anorexia nervosa. AB - Nineteen female anorexics (10 restrictors and 9 with episodes of bulimia) and 19 matched normal weight females participated in a study of dimensions of body image perception and preference. Nineteen silhouettes which varied systematically in size of breasts, abdomen, buttocks, and legs were sorted according to perceived similarity and ordered according to preference by the subjects. Subjects also selected the silhouette which resembled themselves most. Multidimensional scaling analyses were performed. Five dimensions of perception were interpreted: four dealt with size of buttocks and abdomen and one with breast size. The perceptual dimensions were similar for both groups. No group differences were found regarding body image preference. Preference ratings of own body silhouette were lower for anorexic restrictors than for bulimic anorexics and normals. Thus, a distorted body image and a thin body ideal may not be as critical to anorexia nervosa as has been assumed. PMID- 6509422 TI - [Rape by 2 assaillants and gang rape in Montreal]. AB - A survey was conducted in 230 cases of rape and rape attempts heard in the Judicial District of Montreal between January 1975 and May 1978. Data were compiled from the 30 assaults including two or more assaillants. Results show that in cases of rape committed by two men the aggressors are older than gang rapists, meet the victim mainly in her flat or in a bar, and rape her in her own home, in a car or a hotel. In these cases, voyeurism seems to be an important factor since, most of the time, rape is committed by only one of the two aggressors. On the other hand, gang rapists are younger, meet the victim in public places, on the street or when she is hitch-hiking and attack her in one of the aggressors' house, in public places or on the street. Exhibitionism seems more present in this group of rapists. For both groups the victims are mainly single, younger than the aggressors and have diverse occupations. Finally, regarding the legal outcome half of the subjects were liberated or acquitted in both groups. Rape committed by two men had never been studied or compared with gang rape up until now. Results of this survey show dynamic and demographic differences between these two groups of sexual delinquents. PMID- 6509423 TI - The effects of timolol maleate on subjective and physiological components of air travel phobia. AB - Twenty-one monophobic patients with moderately severe fear of flying were exposed to two 40 minute challenge flights after taking either Timolol 20 mg/day or placebo. Heart rate, blood pressure, subjective ratings of anxiety, fear and palpitation and Hamilton Anxiety Scale ratings were made at the predetermined assessment intervals. Post-treatment global ratings of improvement were provided by patients and the attending psychiatrist. Results showed that heart rate significantly increased from baseline with placebo while Timolol successfully inhibited tachycardia during the challenge flights. Subjective ratings of anxiety, fear and palpitations did not show any drug group differences. These variables, however, showed a non-significant decrease from outgoing to return flight assessments after an initial significant increase from baseline scores. Hamilton Anxiety Scale ratings showed a significant decrease from baseline to post-treatment assessments, irrespective of drug group. Global improvement ratings revealed no significant differences between drug groups. Overall ratings by the psychiatrist were generally more positive than patients' ratings, with the difference between the two sources of assessment reaching significance only in the placebo group. Disregarding group membership, heart rate was positively and significantly correlated with subjective ratings of fear, but not with palpitations or ratings of overall anxiety. PMID- 6509424 TI - Methodological guidelines for reading drug-evaluation research. AB - The present paper discusses methodological issues in psychopharmacological research. The intention is to provide readers of drug-evaluation research with a set of basic guidelines that will assist them to critically evaluate the investigations they encounter in the psychiatric literature. This paper describes the underlying rationale and basic principles associated with applying statistical analyses to drug-evaluation research data, and also addresses 11 additional methodological issues: specification of the research sample with respect to descriptive variables, diagnostic criteria, reliability of the diagnosis, the control group, random assignment of subjects to treatment conditions, blindness, subject attrition, treatment complications and side effects, the power of statistical tests, multivariate statistical analysis, and the reliability of the dependent variable. Evidence is presented to support the premise that there is a need to read drug-evaluation research critically. PMID- 6509425 TI - Psychiatric assessment of competency to care for a new-born. AB - General hospital consultation psychiatrists are sometimes asked to assess the ability of a recently delivered mother to safely care for her new-born at home. There are surprisingly few papers in the literature that deal with this problem. The authors review their experience with 56 women referred by a maternity unit over a 10 year period and discuss the demographic characteristics, diagnosis, management, and outcome of their intervention. They discuss how such an assessment should be carried out and review the literature. Some conclusions are drawn about high risk factors, and the need for early identification of these mother-infant pairs as part of primary prevention. They point out the need to take decisive action when the infant's safety appears to be seriously at risk and note that the mothers and infants in their group have done fairly well during the follow-up period with appropriate treatment, teaching and supervision. PMID- 6509426 TI - Patients' attitudes at the time of their commitment. AB - The discussion concerning who should be committed and by whom, has dominated the psychiatric literature for many years (1). More recently, the issue of whether committal allows merely for incarceration in the least restrictive alternative or whether it also entitles patients to be treated against their will, if necessary, has also received attention (2-5). As yet, few studies have attempted to define the characteristics of the committed population (6-11). Even fewer studies have attempted to define what patients themselves thought of their committal to hospital (12-15) and for the most part, have not obtained their opinions regarding the broader issues of committal that are being debated in the professional literature. This study seeks to elicit the opinions of patients in these matters. PMID- 6509428 TI - Medication mini-doses in some aged patients. PMID- 6509427 TI - A comparative study of filicidal and abusive mothers. AB - It is generally believed that some abusive parents if untreated eventually kill their children and "the murder of a child is the final chapter in his history of maltreatment." Yet only few authors have investigated the homicide of abused children. In this paper the authors report on a study of 8 filicidal and 52 abusive mothers referred to them by courts for pre-trial psychiatric evaluation. They found that there were significant differences between the two groups in that all (100%) of the filicidal women suffered from a major psychiatric illness before and at the time of committing the murder of their child while only 4 (7.7%) abusive mothers had a major psychiatric illness (x2 = 24.41, df = 1, p less than .001). They conclude from this study that the filicidal mothers are different from abusive mothers and that the risk of fatality as a complication of child abuse increases significantly when the mental illness is present in the mother. They point to the implications of their findings for child protection and intervention procedures and suggest that one should act very vigorously and take the child into protective custody when the mother is found to have a major psychiatric illness. PMID- 6509429 TI - ECT as a form of restraint. PMID- 6509430 TI - Residents training in the mental status examination. PMID- 6509431 TI - Biclonal trisomy 3 in a case of epithelioid cellular lymphogranulomatosis (Lennert's lymphoma). AB - Biclonal trisomy 3 in a case of epithelioid cellular lymphogranulomatosis (Lennert's lymphoma) was demonstrated by Q-banding polymorphisms of chromosome #3. Seventeen of 19 mitoses with trisomy 3 showed duplication of 1 of the homologous chromosomes and the remaining 2 showed duplication of the other chromosome. It is assumed that both chromosomes #3 independently underwent nondisjunction and that this led to the development of the two abnormal clones. Moreover, there appeared to be a qualitative difference between the two clones, because one of them made up a major proportion and the other a minor proportion of the cells in both of the two samples studied at different times. PMID- 6509432 TI - Effect of piroxicam on primary intestinal tumors induced in rats by N methylnitrosourea. AB - Piroxicam, a non-steroidal anti-inflammatory agent, was administered in the feed to rats which had been inoculated intra-rectally with N-methylnitrosourea (MNU). When examined 5 months later, the piroxicam-treated rats had a significant reduction of intestinal tumors compared to tumor incidences and tumor numbers in rats which were fed drug-free diet. There was no evidence of toxicity associated with the consumption of piroxicam. PMID- 6509433 TI - Effects of agents known to antagonize the enhancement of in vitro transformation by 12-tetradecanoyl-phorbol-13-acetate (TPA) on the TPA suppression of metabolic cooperation. AB - Utilizing the phenomenon of metabolic cooperation in Chinese hamster V79 cells, we have studied the effects of agents which suppress the 12-tetradecanoyl-phorbol 13-acetate (TPA) enhancement of transformation in vitro, on the TPA suppression of cell-cell communication. None of the agents tested, namely all-trans-retinoic acid, the trimethyl methoxyphenyl analogue of N-ethyl-retinamide, soybean trypsin inhibitor, antipain nor superoxide dismutase, decreased the enhanced recovery effect of TPA on metabolic cooperation. One of the compounds, retinoic acid, significantly increased the % recovery above that observed for TPA alone. PMID- 6509434 TI - Inhibition of growth and metastases in mice by immunization with cholesterol hemisuccinate-enriched tumor cells. AB - Incorporation of cholesterol hemisuccinate (CHS) into the membrane of tumor cell rigidifies the lipid layer, exposes cryptic antigens, and enhances immunogenicity. The local growth and metastatic spread of the 3LL Lewis lung carcinoma were studied in conjunction with immunizations by CHS-enriched 3LL cells. C57BL/6J mice received 2 consecutive immunizations with 10(7) CHS-treated, irradiated (10,000 rad) 3LL cells. Two control groups were immunized with MCA-102 sarcoma cells or CHS-enriched syngeneic spleen cells. All groups were challenged with viable 3LL cells after immunizations. Mice pre-immunized with CHS-enriched 3LL cells showed a delayed tumor growth after subsequent challenge with 3LL. Effect of immunization on the growth of established tumors was examined in 3LL bearing mice which were treated with 10(7) CHS-enriched tumor cells on days 1-12 after initial tumor implantation. A second identical immunotherapy was given 6 days after the first immunization. Tumor growth was significantly inhibited in mice which received the first immunization 1 day after tumor implantation, while immunization on day 3 or after inhibited the growth rate to a lesser extent. Suppression of pulmonary metastases was assessed after excision of a primary 3LL tumor growing in the foot pad which had reached 8 mm in diameter. Immunization consisted of intraperitoneal injection of 10(7) irradiated CHS-enriched tumor cells following excision and repeated after 6 days. This immunization resulted in a significant decrease in pulmonary metastasis as scored by direct counts of metastatic nodules, by [125I]iododeoxyuridine (125IUdR) incorporation, and by lung weight. Metastatic 3LL cells from nodules which survived immune elimination were isolated and implanted into mice which were pre-immunized with primary 3LL cells enriched with CHS. For comparison, a group of mice was immunized and challenged with primary 3LL cells. Inhibition of tumor growth and pulmonary metastasis formation was observed only in the mice which were challenged with the primary tumor. PMID- 6509435 TI - Effects of vitamin E on liver DNA. AB - Vitamin E, both in the form of dl-alpha-tocopherol and dl-alpha-tocopheryl acetate, was capable of inducing an increased alkaline elution rate of liver DNA from rats treated i.p. with the vitamin. This activity was clearly both dose- and time-dependent. A statistically significant effect was observed at dosages (1.25 5.00 mg/kg) that are in the range of biological activity of the vitamin in the rat (reabsorption-gestation bioassay). Moreover, the effect was observed at dosages that are clearly not toxic. An increased alkaline elution rate of DNA is usually interpreted as suggestive of DNA damage, however recent observations seem to indicate that functional modifications of chromatin packaging can also affect the elution rate of DNA. PMID- 6509436 TI - Glucose consumption, newborn weight and nitrosomethylurea transplacental carcinogenesis in rats. AB - This study used rats bred at the Petrov Research Institute of Oncology. On the 21st day of pregnancy N-nitrosomethylurea (NMU) (20 mg/kg) was administered to the animals intraperitoneally. From the 7th day of pregnancy experimental rats were treated with 10% glucose solution instead of drinking water, and during 1.5 months after delivery the rats of this group and their progeny received 5% glucose solution. The present work has revealed an increase of fetal weight in pregnant rats treated with glucose. A significant increase of tumor frequency was detected in the progeny of these rats. In the male progeny, tumors of the nervous system and kidneys, typical for NMU, predominated and in females, tumors of other organs and tissues, particularly the mammary gland, pituitary body and hemopoietic system, predominated. This paper discusses a possible mechanism of the modifying effect of glucose on transplacental carcinogenic action of NMU. PMID- 6509437 TI - The mouse ear edema: a quantitatively evaluable assay for tumor promoting compounds and for inhibitors of tumor promotion. AB - The induction of edema in the mouse ear has been established as a reliable in vivo assay for tumor promoting compounds and for inhibitors of tumor promotion. Apparently all skin tumor promoting compounds induce an edema, and all inhibitors of a tumor promoter-induced edema are most likely inhibitors of skin tumor promotion. No exception to this rule has been found as yet. Besides the application of this assay in the screening of compounds, the assay allows comparison of various compounds (e.g. complete and incomplete tumor promoters) with respect to their kinetics and dosage response in the induction of edema. PMID- 6509438 TI - Urinary excretion of 3-hydroxy-benzo[a]pyrene after percutaneous penetration and oral absorption of benzo[a]pyrene in rats. AB - A method for the monitoring of exposure to benzo[a]pyrene was applied to rat urine samples. Benzo[a]pyrene was administered percutaneously and orally with repeated doses of 10, 20 and 50 mumol/kg body wt. At low dose levels, the urinary excretion of 3-OH-benzo[a]pyrene was higher after percutaneous treatment than after oral administration. The excretion of 4 benzo[a]pyrene metabolites, including 3-OH-benzo[a]pyrene, is faster after oral administration. The percutaneous absorption of small doses of benzo[a]pyrene appears to be greater than the oral absorption. PMID- 6509439 TI - Mutagenic activity in the stomach and small intestine of rats after oral administration of nitrosated beef extract. AB - The products formed by the reaction of beef extract with nitrite were assayed in the Salmonella/microsome mutagenicity test. In strain TA1538, TA98 and TA100 a direct-acting mutagenic response was observed. The presence of liver-microsome preparation resulted in decreased mutagenicity. To study the absorption, distribution and excretion of mutagenic substances in nitrosated beef extract, the test material was given perorally to rats. Investigations of the stomach, bile fluid, urine, small intestine and blood samples were carried out, and mutagenicity was found in the contents of stomach and small intestine. It is supposed that unlike beef extract itself, its nitroso product is not excreted in the bile but passes directly from the stomach and small intestine. PMID- 6509440 TI - Nitrosoproline formation in control and antibiotic-treated rats given nitrate and proline. AB - The role of the gastrointestinal microflora in the nitrate-dependent formation of nitrosoproline was assessed in control and antibiotic-treated rats. Urinary nitrosoproline excretion as an index of in vivo nitrosamine formation was shown to be unaffected by bacterial decontamination of the alimentary tract, and proceeded in the absence of detectable nitrate reductase activity in the intestinal contents. These observations suggest that the gut microflora are not required for the formation of nitrosamino acid from nitrate and proline. PMID- 6509441 TI - Binding of hormonal steroids to isolated oligodendroglia and astroglia grown in vitro on a naturally produced extracellular matrix. AB - The ability of glial cells, grown on extracellular matrix (ECM), to bind corticosterone (CS), dexamethasone (Dex), and testosterone (T) was investigated. Isolated oligodendrocytes were able to specifically bind CS as well as T. Bound [3H]CS was partially displaced by excess T, whereas no displacement of [3H]T was observed with excess CS. Oligodendrocytes were not able to bind [3H]Dex. Astrocytes derived from hippocampal or hypothalamic slices showed no binding of either [3H]CS or [3H]Dex. The results demonstrate that ECM-grown oligodendrocytes possess receptors for CS and T but not for Dex. Furthermore, the binding sites for CS were less specific than the comparable sites for T. These results substantiate the notion that oligodendrocytes are involved in the action of steroid hormones within the brain. PMID- 6509442 TI - The incidence of brain tumors: a retrospective study. PMID- 6509443 TI - Estrogen and progesterone receptors in intracranial tumors. AB - Cytoplasmic estrogen receptor (ER) and progesterone receptor (PR) proteins were measured by a dextran-coated charcoal absorption technique in 19 intracranial tumors (10 meningiomas, two acoustic neurinomas, two glioblastomas, one primary tumor of neuroectodermal origin, one hemangioblastoma, one metastasis of carcinoma, one chordoma, and one pituitary adenoma). Positive PR values (greater than or equal to 10 fmol/mg of protein) were found in nine meningiomas (90% of these tumors), in the chordoma, in one glioblastoma, and in the hemangioblastoma, whereas positive ER values were recorded only in the pituitary adenoma and in one glioblastoma. Evidence of PR in meningiomas might explain their predominance in women. A possible pharmacological therapy, based on these findings, is discussed. PMID- 6509444 TI - Steroid receptors in the pathogenesis of chronic subdural hematoma. AB - Chronic subdural hematoma (CSDH), located between the dura mater and the arachnoid and usually characterized by a well-vascularized external capsule (HEM), has a higher incidence in male patients with elevated urinary estrogens than in female patients. In an attempt to increase our understanding of the physiopathogenesis of CSDH, total estrogen receptor (ER) was measured in HEM specimens from four male patients by a sodium thiocyanate exchange assay and cytosol progesterone receptor (PRc) in three specimens by a dextran-coated charcoal adsorption assay. Although no nuclear ER could be detected, ERc and PRc were found in all three specimens examined. The presence of ER in a mesenchymal tissue like HEM could suggest that, in addition to inducing vascular changes, estrogens might act directly on HEM through a receptor-mediated mechanism more pronounced in men than in women, whose vascular network is adapted to high estrogen values. PMID- 6509445 TI - Steroid receptors in intracranial tumors. AB - Cytosolic estrogen (ER), progesterone (PR), androgen (AR), and glucocorticoid (GR) receptors were evaluated in 6 meningiomas and 12 gliomas (6 astrocytomas and 6 glioblastomas) using a dextran-coated charcoal method. Thirty-three percent (two) of the meningiomas and 17% (two) of the gliomas contained positive (greater than or equal to 10 fmol/mg protein) but low ER levels. On the other hand, positive PR, GR, and AR levels were detectable in 100% (six) of the meningiomas. PR was present in 50% (six), AR in 42% (five), and GR in 58% (seven) of the gliomas. PR, GR, and AR values were statistically higher in meningiomas than in neuroepithelial tumors. PMID- 6509446 TI - Steroid receptors in human meningioma. AB - It is well recognised that there is an increased frequency of meningioma in women compared with men and that rapid progression of the disease may occur during pregnancy. Recent studies have demonstrated steroid receptors in human meningioma. In this study we have looked for the presence of nuclear and cytoplasmic estrogen receptor (ER) and cytoplasmic progesterone receptor (PR) in 22 cases of meningioma. Radioreceptor assays using a six-point dextran-coated charcoal procedure failed to demonstrate specific ER, but 17 of 22 meningiomas did have specific PR (range 11-314 fmol/mg cytosol protein). Flat-bed isoelectric focusing in agarose gel was used to confirm the results in a few of these cases. We were not able to correlate the presence of receptor with age or sex of patient, or the site of tumour with receptor content. Of the five PR-negative tumors, one was a poor specimen when the histology was examined and two belonged to the angioblastic group (haemangiopericytic variety), a particularly aggressive tumour with a tendency to be more necrotic. The presence of PR in many of these tumours suggests a possible role for hormone therapy where total resection is not possible. PMID- 6509447 TI - Estrogen receptors in brain tumors. AB - We examined the cytosolic estrogen receptor (ER) level in tumor tissue from 77 patients: 36 meningiomas, 20 gliomas (12 glioblastomas, 2 cerebellar astrocytomas, 2 ependymomas, and 4 medulloblastomas), 8 neurinomas, 7 pituitary adenomas (2 prolactin-producing adenomas, 1 growth hormone-producing adenoma, and 4 nonfunctioning adenomas), and 6 metastatic brain tumors (1 from breast cancer, 4 from lung cancers, and 1 from colon cancer). Nuclear ER levels were assayed in 11 meningiomas and 2 glioblastomas. ER was determined by the dextran-coated charcoal method and calculated by Scatchard analysis. Cytosolic ER was detected in 100% of the pituitary adenomas, 50% of the meningiomas, 50% of the metastatic brain tumors, 25% of the neurinomas, and 15% of the gliomas. In gliomas, only medulloblastomas had ER activity. Nuclear ER was found in three premenopausal women with meningioma. The dissociation constant of the ER complex was, in each case, less than 10(-9) M. These observations suggest that some brain tumors may be responsive to estrogen via the cellular ER. PMID- 6509448 TI - Progestin and estrogen receptors in human meningioma. AB - Progestin receptors (PR) were detected with a dextran-coated charcoal assay and Scatchard plot analysis in 40 of 45 cytosols from human meningioma. The mean PR level in samples from female patients (297 +/- 104 fmol/mg protein; mean +/- SEM; n = 28) was not different from that in samples from male patients (190 +/- 76; n = 12). No differences were observed in the PR content of meningiomas resected from different locations. In the three cases studied, nuclear progestin binding was also detected. An estrogen-binding component was detected in the cytosol of 7 of 44 samples, but the binding capacity was relatively low (13 +/- 13 fmol/mg protein; mean +/- SD). During isoelectric focusing only part of this binding component behaved as might be expected from a true estrogen receptor. Nuclear estrogen binding was not observed in two samples with detectable cytoplasmic estrogen binding. The presence of both cytoplasmic and nuclear PR suggests that in meningioma a functionally active progestin-receptor system comparable with that in other progestin target tissues is operating. In contrast to these other tissues, however, the synthesis of PR in meningioma may not be influenced by estrogens. Further research should focus on evaluating whether the growth rate of meningiomas can be modulated by antiprogestins. PMID- 6509449 TI - Estrogen and progestin receptors in meningiomas: clinicopathological correlations. AB - Estradiol and progesterone receptors were studied in 44 patients with meningiomas and correlated to the clinicopathological features and amount of preoperative corticosteroid therapy. Thirty-four (77%) of the meningiomas contained high titers of specific high-affinity cytosol [3H]promegestone (R 5020) binding sites (mean 2,902 fmol/g tumor; range 0-9,598 fmol/g tumor) whereas only miniscule amounts of a nonspecific cytoplasmic [3H]estradiol binding component (mean 48 fmol/g tumor; range 0-201 fmol/g tumor) were detectable. No nuclear binding activity for [3H]estradiol was demonstrable. There was no convincing correlation between high PR activity and the age, sex, or menopausal status of the patients. The correlation study between the amount of preoperative corticosteroid therapy with the amount of [3H]promegestone binding revealed no dose relationship. Correlating [3H]promegestone content with the histologic type, we found 96% of meningothelial, 71% of transitional, and 40% of fibroplastic meningiomas to contain progesterone receptors. The necessity of in vitro studies is stressed to assess the biosynthesis and biological activity of the progesterone receptor in meningiomas, which is apparently not estrogen regulated, as is the case in other estrogen target tissues. PMID- 6509450 TI - Cytosolic and nuclear sex steroid receptors in meningioma. AB - To determine the nature of the hormone dependency of meningioma, particularly whether progestin receptor (PR) and tumor growth are estrogen-dependent, we measured the cytosol estrogen receptor (ER) and PR separately by an exchange assay with [3H]R 2858 (for ER) and [3H]RU 27987 (for PR) in 21 meningiomas. We correlated these receptors with age, plasma estradiol and progesterone concentrations, histological subtypes, clinical data such as uterine fibromas, and finally preoperative glucocorticoid therapy. ER was detected at low levels in the cytosol and in the nucleus of a few tumors whereas PR was found in 20 of 21 cases at moderate to high levels, usually with higher concentrations in the cytosol than in the nucleus. No clear relation could be drawn between either cytosol or nuclear ER and PR levels and estradiol and progesterone plasma concentrations, or with the other parameters. On the contrary, a clear correlation could be drawn between cytosolic PR and androgen receptor (AR) concentrations (measured with [3H]R 1881 in the presence of triamcinolone acetonide), leading to several hypotheses of hormonal regulation in meningioma. PMID- 6509451 TI - Biological expression of steroid hormone receptors in primary meningioma cells in monolayer culture. AB - Primary meningiomas have been grown in monolayer culture and tested for the presence of steroid hormone receptors and sensitivity to various steroids and steroid antagonists. None of the 10 solid tumors or the primary cultures derived from them contained estrogen receptors, either in the cytoplasm or in the nucleus. Progesterone receptors were present in 50-70% of the solid tumors and some of the primary cultures. Four of four and five of five primary cultures contained, respectively, androgen and glucocorticoid receptors. When one of the primary cultures was tested for growth sensitivity to estrogen, tamoxifen, progesterone, hydrocortisone, and dihydrotestosterone, the last two had noticeable stimulatory effects on growth by day 5. Interestingly, only androgen and glucocorticoid receptors were present in the primary tumor cells in culture, suggesting that these receptors mediated the effects of their respective hormones on growth. PMID- 6509452 TI - Study of erythrocyte mean corpuscular volume during cytotoxic therapy as a predictive parameter of the risk of secondary leukemia in Hodgkin's disease. AB - Erythrocyte mean corpuscular volume (MCV) evolution was studied during cytotoxic therapy in 12 patients with Hodgkin's disease who developed secondary acute leukemia and in 83 patients with Hodgkin's disease without secondary leukemia as control group. Significant differences were observed in the maximum MCV and in the MCV maximum increase during therapy between the two groups of patients. These differences remained significant between the patients treated with chemotherapy alone and those treated with chemotherapy and radiotherapy. MCV maximum increase greater than 23.9 fl was observed in all patients with secondary leukemia and in only 20% of those without secondary leukemia; it was reached 46.3 months before the first sign of preleukemia. Its value in predicting the leukemic risk in Hodgkin's disease is discussed. PMID- 6509453 TI - High-dose etoposide for refractory malignancies: a phase I study. AB - Etoposide is active against a number of solid tumors when used in a standard dose. The toxicity at a standard dose level is mild myelosuppression without extramedullary toxicity. Recent studies in man support the dose-response relationship of etoposide. In a group of 22 patients with progressive disseminated malignancies, the dose of etoposide was escalated to define dose limiting extramedullary toxicity, which was oropharyngeal mucositis at a dose level of 3.5 g/m2. Bone marrow toxicity was completely reversible. No cumulative toxicity was seen. Partial responses were seen in nine patients. In two of three patients with CNS metastases, improvement was seen. Etoposide is a suitable drug for high-dose chemotherapy. PMID- 6509454 TI - Use of decline in D-xylose absorption to predict infection following intensive chemotherapy. AB - Oral D-xylose absorption and urinary excretion were measured before and after 32 courses of intensive chemotherapy in 14 patients with acute leukemia in complete remission. The incidence of severe and life-threatening infectious complications was greatest in those patients in whom the absorption and excretion of D-xylose fell below normal immediately following 4-7 days of chemotherapy. Gram-negative bacilli and staphylococci were the most common organisms to cause bacteremia in these patients. PMID- 6509455 TI - Phase II study of mitoxantrone in advanced breast cancer: an Eastern Cooperative Oncology Group pilot study. PMID- 6509457 TI - Phase II study of spirogermanium in advanced breast cancer. PMID- 6509456 TI - Phase II trial of etoposide in the management of advanced or recurrent non squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. PMID- 6509458 TI - Nutrition and aging: an overview. PMID- 6509459 TI - The use of cardiac pacemakers. PMID- 6509460 TI - Long-term oral antiarrhythmic therapy with aprindine: effects on cardiac function and adverse effects. AB - The effects of long-term aprindine administration on cardiac function were clinically investigated in seven patients with supraventricular or ventricular arrhythmias associated with organic heart disease. Three patients had normal cardiac function and four had various degrees of cardiac dysfunction before treatment with aprindine. The drug was administered orally in doses of 25 to 75 mg daily (mean +/- SD, 54 +/- 14 mg/day). The duration of follow-up ranged from six to 23 months (mean +/- SD, 14 +/- 6 months). An antiarrhythmic effect was achieved in five cases. No worsening or newly acquired symptoms or signs of cardiac dysfunction were recognized. No significant changes in end-diastolic dimension or ejection fraction were observed echocardiographically. Results of this study suggest that aprindine, which has been reported to have a negative inotropic action, does not cause significant deterioration of cardiac function even when given as long-term antiarrhythmic therapy to patients with cardiac dysfunction. PMID- 6509462 TI - Hydrochlorothiazide plus methyldopa in the treatment of isolated systolic hypertension in the elderly. AB - An open-label clinical trail comparing the effectiveness of the combination of methyldopa with hydrochlorothiazide in low doses with that of hydrochlorothiazide therapy alone was conducted in 21 elderly patients with isolated systolic hypertension. The combination therapy reduced the systolic blood pressure to levels markedly lower than those measured at baseline and after two weeks of hydrochlorothiazide therapy. Standing blood pressure fell from a mean of 166/90 mmHg at baseline to a mean of 164/88 mmHg after two weeks of hydrochlorothiazide treatment and to a mean of 132/80 mmHg after 16 weeks of treatment with hydrochlorothiazide and methyldopa. Side effects were mild, and there were no significant changes in laboratory findings. PMID- 6509461 TI - Indapamide, a new antihypertensive/diuretic agent, in the treatment of patients with edema. AB - A multicenter, double-blind, parallel-group study of 219 patients with pitting edema of various causes was undertaken to determine the efficacy and safety of indapamide, administered orally (PO) in a 2.5-, 5-, or 10-mg once-daily dose, as compared with hydrochlorothiazide, administered PO in a 100-mg once-daily dose. Efficacy was evaluated by determining each patient's weight and degree of pitting edema periodically during 12 weeks of active treatment. Lessening of edema was measured by changes in the depth of pitting in the pretibial area, ten to 14 inches below the patella. The depth of pitting was assigned an arbitrary number between 0 and 4, with 0 equivalent to no edema and 4 equivalent to more than 6 mm of pitting edema. After one week of treatment, the mean reduction of pitting edema from baseline, using the 0 to 4 scale, was 1.6 (30%) in both the indapamide (mean of the three groups) and hydrochlorothiazide groups. There were no significant differences among the three dosage levels of indapamide. After 12 weeks of treatment the mean decrease from baseline was 1.8 (34%), indicating a stable reduction of edema. The mean weight loss at one week was 2.5 kg for the three indapamide groups and 2.6 kg for the hydrochlorothiazide group; this loss was maintained for the 12 weeks of the study. The mean decreases in weight and pitting edema were clinically and statistically significant (P less than 0.05) for both medications. PMID- 6509463 TI - Cefoperazone in the treatment of postsurgical wound infection, sepsis, and abscess of the spinal cord and brain. AB - Cefoperazone was used in the treatment of 23 cases of serious bacterial infection in 20 patients. Ten postoperative scalp wound infections, five infections at the site of tracheostomy, four cases of extradural spinal cord abscess, three cases of sepsis, and one abscess of the cerebellopontine angle were treated with cefoperazone (1 to 2 gm BID, usually for seven to 27 days). There were excellent or good clinical responses in 87% (20/23) of the cases (14 of the 15 postsurgical wound infections, three of the four cases of spinal cord abscess, and all three cases of sepsis). Most of the organisms isolated from the patients' cultures were sensitive to cefoperazone. Excellent or good responses occurred in ten of the 12 infections due to Staphylococcus aureus, in all three infections due to Pseudomonas sp, all three due to Citrobacter freundii, the two due to Serratia marcescens, one of the two due to Klebsiella sp, and the one due to Escherichia coli. Two patients with ventriculitis were clinically improved by three 1-gm infusions, via a shunt, of cefoperazone. No adverse effects of the antibiotic therapy were reported. PMID- 6509464 TI - [Thank God, is it only tuberculosis?]. PMID- 6509465 TI - [Prevention of tuberculosis in Czechoslovakia and its importance]. PMID- 6509466 TI - [Current possibilities of the clinical diagnosis of extrapulmonary tuberculosis]. PMID- 6509467 TI - [New aspects of tuberculosis control]. PMID- 6509468 TI - [Pulmonary function in patients with nonspecific intestinal inflammations]. PMID- 6509469 TI - [Chemical carcinogenesis and cytogenetic screening]. PMID- 6509470 TI - [Does the biological availability of acetylcholine assure intellectual functioning? Risks of anticholinergics]. PMID- 6509472 TI - [Problems in internal medicine in Algeria]. PMID- 6509471 TI - [The Latin teacher as a medical historian]. PMID- 6509473 TI - [Notes on a trip to China]. PMID- 6509474 TI - [Long-term treatment of hirsutism with spirolactone]. PMID- 6509476 TI - [Abnormal secretion of thyrotropic hormone and prolactin in acute intermittent porphyria]. PMID- 6509475 TI - [The effect of intraperitoneal administration of Traumacel P on hemocoagulation tests in rats and rabbits]. PMID- 6509477 TI - [Radioimmunologic determination of triiodothyronine in blood using the 2-phase aqueous system]. PMID- 6509478 TI - [The educational system at the University of Manchester Medical School in Great Britain]. PMID- 6509479 TI - [Viscosity of the blood in hypertension and ischemic heart disease]. PMID- 6509480 TI - [Thromboangiitis and atherosclerosis obliterans: differences in location and smoking habits]. PMID- 6509481 TI - [The echocardiographic picture in sarcoidosis]. PMID- 6509482 TI - [The effect of hemodialysis on the function of residual nephrons]. PMID- 6509483 TI - [Comparison of the permeation properties of experimental hemodialysis membranes made of cellulose acetate and the permeation properties of cellulose membranes]. PMID- 6509484 TI - [The effect of hemodialysis on pulmonary volumes. Ventilatory changes during recession of congestion in the lesser circulation]. PMID- 6509485 TI - [Present and prospective tasks in epidemiology]. PMID- 6509486 TI - [Psychological care of patients in surgery departments]. PMID- 6509487 TI - [Initial experience with the functional treatment of fractures]. PMID- 6509488 TI - [Surgical treatment of chronic stenosis of the internal carotid]. PMID- 6509489 TI - [The importance of monitoring carcinoembryonic antigen levels in carcinomas of the large intestine and rectum]. PMID- 6509490 TI - [Phalloplethysmographic reactions in perpetrators of sexual offenses against adult women]. PMID- 6509491 TI - [The gene concept and its gradual recognition]. PMID- 6509493 TI - [Biochemical and genetic aspects of hereditary connective tissue disorders]. PMID- 6509492 TI - [Are we capable of preventing congenital defects?]. PMID- 6509494 TI - [The significance of genetic examination in the families of children with congenital cataracts]. PMID- 6509496 TI - [Initial experience with calculation of the surface area of the stenosed mitral opening according to a formula not dependent on diastolic pressure gradients]. PMID- 6509495 TI - [Initial experience with the use of chorionic biopsy in prenatal diagnosis during the 1st trimester of pregnancy]. PMID- 6509497 TI - [The hyperventilation test for provoking spasm in coronary arteries]. PMID- 6509498 TI - [Mesothelioma of the pericardium diagnosed by echocardiography]. PMID- 6509499 TI - [Care of the aged population in Denmark]. PMID- 6509500 TI - [Late results of nuclear and chemical weapons in man]. PMID- 6509501 TI - [What do we need to know in neuroendocrinology?]. PMID- 6509502 TI - [Therapeutic use of prostaglandins]. PMID- 6509503 TI - [Free urinary cortisol in the diagnosis of Cushing's syndrome]. PMID- 6509504 TI - [Endocrine orbital diseases in hypothyroidism]. PMID- 6509505 TI - [A simplified method of determining total 17-oxosteroids (without hydrolysis) and 17-OH-corticosteroids in urine]. PMID- 6509506 TI - Restoration of fast muscle characteristics following cessation of chronic stimulation. The ultrastructure of slow-to-fast transformation. AB - When fast-twitch skeletal muscles of the adult rabbit are subjected to continuous low-frequency activity by electrical stimulation of the corresponding motor nerves, the fibers undergo an ultrastructural transformation, so that after 6 weeks they have acquired an appearance typical of slow-twitch fibers. In the present study, stimulation was discontinued at this stage in order to follow the reverse transformation, in which the fibers recovered their original morphological characteristics under conditions of normal endogenous activity. Stereological techniques were used to assess the time course of this process over a period of 20 weeks in terms of fiber cross-sectional area, extent of T-system, thickness of the Z-band, and volume fraction of mitochondria in the fiber core. Fibers of transformed muscles were smaller than those of control muscles, but the differences were no longer evident after 9 weeks of recovery. After 2 weeks the T system was still of limited extent, as is characteristic of slow-twitch fibers; it increased toward the amount typical of fast-twitch fibers between 2 and 4 weeks, and had reached its full extent by 12 weeks. The wide Z-bands characteristic of slow-twitch fibers were retained for 4 weeks, but the thickness had begun to decrease by 8 weeks and recovery was complete by 12 weeks. The mitochondrial volume did not increase during recovery, in contrast to the large increases which had been observed to take place between 2 and 6 weeks during the fast-to-slow transformation. Overall, the recovery of fast-twitch ultrastructural characteristics was complete, but followed a more extended time course, and involved less myofibrillar disruption at an intermediate stage, than the original fast-to-slow transformation. PMID- 6509507 TI - Intraovarian adrenergic nerves in the guinea-pig: development from fetal life to sexual maturity. AB - The development of the intraovarian adrenergic nervous system was investigated in the guinea-pig by use of chemical determination of catecholamines with high performance liquid chromatography (HPLC) and with the formaldehyde-induced fluorescence method for visualization of adrenergic nerves (Falck-Hillarp technique). Ovaries from fetuses (39-40, 45-50, 55-57, 60-63 days of gestation) and young animals (1, 2, 3, 7, 14, 30, 40-45 days of age) were included in the study. The noradrenaline concentration was low in the ovaries from the youngest fetuses but increased with age, reaching a maximum level at 2 days post partum. A marked decrease in noradrenaline concentration from the second to the third day of life was found as a consequence of the rapid increase in the ovarian weight during this time. A similar decrease in ovarian noradrenaline concentration after a period of rapid ovarian growth was noted at 30 days of age. Measurable amounts of adrenaline were found in the ovary only in the fetal stages; the highest concentration (0.73 microgram) was detected at 55-57 days of gestation. PMID- 6509508 TI - Fine structure of the small, granule-containing cells in the superior cervical ganglia of hydrocortisone-treated early postnatal and adult rats. AB - Hydrocortisone injections into rats on postnatal days 3-9 caused an increase in the number of small granule-containing cells in the superior cervical ganglia. These cells, corresponding to the small, intensely fluorescent cells, showed an extensive rough endoplasmic reticulum, a large Golgi apparatus and a very large number of granular vesicles. In addition to the granular vesicles, 70-160 nm in diameter, in which the dense core filled most of the vesicle, most cells of the hydrocortisone-injected rats contained also larger granular vesicles, up to 350 nm in diameter, in which the dense core was eccentrically located. A minority of the cells contained only granular vesicles 70-100 nm in diameter, which was the only type seen in the saline-treated control rats. Thirty days after discontinuation of the hydrocortisone treatment, most of the cells with large granular vesicles had disappeared, and only two profiles of such cells were seen on day 40. The other small cells contained only granular vesicles 70-160 nm in diameter, and these cells could not be distinguished from the small granule containing cells of 40-day-old control rats treated early postnatally with saline. Hydrocortisone treatment, first on days 3-9 and subsequently on days 40 46, caused reappearance of the small granule-containing cells with large granular vesicles up to 350 nm in diameter, the dense core of which was eccentrically located. Hydrocortisone treatment on days 40-46 only was not followed by appearance of such cells in rats treated with saline on days 3-9. PMID- 6509509 TI - Electron-microscopic study of innervation of smooth muscle cells surrounding collecting tubules of the fish kidney. AB - The fine structure of the collecting tubules of the trout and killifish kidney was studied. These tubules are surrounded by layers of smooth muscle cells which are commonly innervated. The nerve terminals contain synaptic vesicles and, occasionally, a few dense-cored granules as well. Capillaries occur in the connective tissue space between these smooth muscle cells and the collecting tubule. Epithelial cells of the collecting tubules contain abundant mitochondria and a well developed membrane system displaying parallel arrays, and were considered to be actively involved in the transport of materials. In the trout, the collecting tubules contain peculiar cells in addition to regular tubule cells. The fine structure of these peculiar cells is highly reminiscent of that of gill chloride cells. The significance of these findings may be summarized as follows: If the smooth muscles around the collecting tubule contract under neural influence, intratubular pressure may be increased and, thus affect glomerular filtration rate. The contraction of these muscles may also cause the collapse of peritubular capillaries, affecting the transport activity of tubule cells. PMID- 6509510 TI - Three-dimensional organization of fibroblasts and collagen fibrils in rat tail tendon. AB - The orderly arrangement of fibroblasts and collagen in tendons and ligaments suggests that these cells may have precise relationships with one another and with the collagen fibrils. The spatial organization of rat tail tendon was therefore examined using scanning and transmission electron microscopy and by reconstructing a 35-microns long segment of tendon from serial transmission electron micrographs. Fibroblasts were regularly arranged in columns and showed more intimate association in the longitudinal than in the transverse plane. Thin cytoplasmic sheets extended up to 3 microns transversely, frequently forming junctional attachments with similar processes from adjacent cells or from the same cell. Longitudinal processes were longer, often extending for more than 20 microns and forming junctional attachments with other cells in the same column. Such processes often exhibited invaginations in which there were single fibrils or small groups of fibrils; this arrangement may be indicative of fibril elongation or may serve to transmit tension between the fibroblast and the collagen fibrils. This organization has interesting implications for the growth and function of other fibrous connective tissue, such as the periodontal ligament. PMID- 6509511 TI - On the nature of the opaque and translucent enamel regions of some macropodinae (Macropus giganteus, Wallabia bicolor and Peradorcas concinna). AB - Teeth of three macropod species, M. giganteus, W. bicolor and P. concinna, have been studied using the techniques of light microscopy, scanning- and transmission electron microscopy and hardness measurement. Light microscope observations showed that the teeth of these species had a translucent enamel region close to the dentine and an outer opaque enamel region at the tooth's surface. These regions were not related to the presence or absence of tubules which are a characteristic feature of marsupial enamel. Hardness tests showed that the opaque enamel was softer than the translucent enamel. Scanning electron microscope observations revealed that there was no correlation between any particular prism packing or orientation and the opaque and translucent enamel regions. Transmission electron microscope observations showed that the translucent enamel region consisted of well defined prisms and well packed, lath-like crystals, whereas the opaque enamel was disrupted by voids (which ranged in size from enlarged micropores to about 2 microns in diameter in extreme cases) between crystals and some randomly oriented, loosely packed crystals. This disruption within the opaque enamel region was more common at prism boundaries but pockets of disrupted enamel were also found within prisms and interprismatic regions. The opacity of the enamel was caused by scattering of light from the voids. The ultrastructure of the opaque enamel region indicated that this region was hypomineralized; hardness tests and polarized light microscope observations were consistent with these results. PMID- 6509512 TI - An ultrastructural study of relationships between the ovarian haemal system, follicle cells, and primary oocytes in the sea star, Asterias rubens. Implications for oocyte nutrition. AB - The genital haemal sinus, present throughout the gonad wall of sea stars, is supposed to be the site of ultimate accumulation of nutrients for the germinal epithelium. Early vitellogenic pear-shaped oocytes are attached to this sinus by stalk-like processes. The ultrastructure of this association and of the oocyte follicle cell complex is described with emphasis on mechanisms involved in oocyte nutrition. The genital haemal sinus, and sometimes portions of the surrounding genital coelomic sinus, contain a fine granular ground substance and amoeboid cells. Material similar to the haemal ground substance also fills vacuities in the inner basal laminae of the haemal sinus and intervenes between this layer and adjacent germinal and follicle cells in the ovarian lumen. Vitellogenesis is first detectable as numerous vacuoles accumulate within the oocyte-stalk near the haemal sinus; they contain flocculent material and often fuse with adjacent lysosome-like vacuoles. As vitellogenesis proceeds, oocytes develop complex and tenuous connections with the haemal sinus. These consist of a network of pseudopodia that interdigitate with thin sheet-like extensions of follicle cells. These cells are attached to the oolemma by microfilamentous processes and contain regularly arranged concentrations of glycogen granules and well developed rough endoplasmic reticulum. It is concluded, that follicle cells provide each oocyte with a compartmentalized microenvironment within the ovarian lumen, that such compartments are intimately associated with the nutrient laden haemal sinus, and that nutritive and vitellogenic substances, derived extragonadally and stored temporarily in the ovarian wall, can pass through the oocyte-stalk. PMID- 6509513 TI - Interdigitating cells in the thymus of the turtle Mauremys caspica. Possible relationships to macrophages. AB - Interdigitating cells are non-lymphoid elements in the thymus and peripheral, secondary lymphoid organs of higher vertebrates. Their origin and functional significance are a matter of controversy. In the present investigation we analyze, for the first time, the nature of presumptive interdigitating cells of the thymus of an ectothermic vertebrate, the turtle Mauremys caspica. This model is specially useful because of the seasonal variations that affect the reptilian lymphoid organs. Immature pro-interdigitating cells and phagocytosing mature interdigitating cells are described with special emphasis on their ultrastructural characteristics and possible relationships with monocytes and macrophages. PMID- 6509514 TI - The effect of long-term denervation on the ultrastructure of Pacinian corpuscles in the cat. AB - The ultrastructure of Pacinian corpuscles of the cat located in the crural region and innervated by the interosseous nerve was studied 1 to 14 months after denervation. Both the Pacinian inner core and capsule remained well preserved one month after denervation. However, the denervated inner cores underwent progressive atrophy and wasting, which resulted in a gradual reduction of the amount of inner-core cells and lamellae, widening of interlamellar clefts, formation of empty spaces in the axial region and a considerable increase in the number of collagen fibrils. In spite of the wasting, the inner core still survived 14 months after denervation, but at least half of its volume became occupied by collagen fibrils which surrounded the remaining inner-core cells and lamellae. Collagen fibrils assembled in the denervated core were markedly thinner than those found in the capsule, as is also the case in normal Pacinian corpuscles. In the capsule, discrete focal degeneration, occasional pyknosis of the innermost capsular cells and macrophage infiltration were observed from the first month after nerve section onward, but the number of capsular layers remained within the normal range (30-40) up to 14 months after denervation. PMID- 6509515 TI - Morphological evidence for the presence of two cell types in the ependyma of the subcommissural organ of the snake, Natrix maura. AB - Two different types of ependymal cells were found in the subcommissural organ (SCO) of Natrix maura. Most secretory cells showed morphological features resembling the general structure and ultrastructure of cells in the SCO of other vertebrates. This report describes a second population of cells lining a portion of the dorsal groove of the SCO. These cells were not selectively stained by chromalum-hematoxylin and, under the electron microscope, they were characterized by scarce surface differentiations, sparse apical cytoplasm and short basal processes. Flat, parallel cisternae of the rough endoplasmic reticulum produced vesicles that appeared to be transported to the well-developed Golgi apparatus. Dense secretory granules about 200 nm in diameter were found in the Golgi region. Similar granules were seen in the vicinity of the apical plasma membrane; some of them opened toward the ventricle. All these characteristics clearly differentiate this cell group from the other secretory cells lining the SCO laterally and ventrally. PMID- 6509516 TI - Co-existence of immunoreactivity to anti-dopamine, anti-serotonin and anti vasotocin in the cerebral giant neuron of the pond snail Lymnaea stagnalis. AB - Consecutive sections of certain neurons in the central ganglia of the pond snail Lymnaea stagnalis appear to be immunoreactive to anti-dopamine and anti serotonin. The Cerebral Giant Neurons stain in addition with anti-vasotocin. The observations indicate the presence of two biogenic amines within the same neuron and in addition their co-existence with a biologically active peptide. PMID- 6509517 TI - Marginal plates in hepatic peroxisomes of Ichthyophis glutinosus (Amphibia: Gymnophiona). A cytochemical study. AB - The ultrastructure of hepatic peroxisomes was investigated in Ichthyophis glutinosus (Amphibia: Gymnophiona), employing perfusion fixation and the diaminobenzidine (DAB) technique for the visualization of catalase. The majority of peroxisomes is circular or rod-shaped, although elongated particles occasionally occur. They contain a finely granular matrix, lightly stained after the DAB procedure. Their mean diameter is approximately 0.25 micron. Serial sections reveal that the circular and rod-shaped peroxisomal profiles are cross and oblique sections of highly tortuous, tubular organelles exceeding 2 micron in length. In addition to tubular profiles, elongated, rectangular particles, as well as straight dumbbell-shaped organelles with distinct marginal plates are observed. They range from 900 to 1650 nm in length (mean = 1200 nm). In the flattened, thin central portion of the dumbbell-shaped particle, the peroxisomal membranes form a cisterna enclosing one or two uniformly thick marginal plates, which display a definite substructure with a periodicity of 10 nm. These findings indicate that peroxisomes in the liver of Ichthyophis exhibit a complex organization. It is suggested that the organelles undergo a specific differentiation process, morphologically characterized by the formation of enlarged segments of unusual shape. PMID- 6509518 TI - Intermitochondrial junctions in the extraocular muscle of the rat. AB - Intermitochondrial junctions with a spacing of 17-21 nm were observed in the superior rectus muscle of a rat. Periodic rounded densities are aligned midway between the apposed outer mitochondrial membranes at some of these junctions. Such densities have a diameter of about 8-10 nm and a center-to-center spacing of about 26-30 nm. These junctions occur in cases where one mitochondrial profile is enclosed within another or where two profiles are interlocked so that their combined overall form has a smoothly contoured profile. Intermitochondrial junctions seem not to have been previously described in muscle, but have been reported in other kinds of tissues. In agreement with those previous reports, the presently observed intermitochondrial junctions usually involve mitochondria that display atypical features indicative of tissue abnormality or stress. Such junctions were never observed in normal extraocular muscle. PMID- 6509519 TI - Ontogeny of endocrine cells in the gut of the insect Periplaneta americana. AB - The ontogeny of the endocrine cells of the gut of the cockroach Periplaneta americana was studied by immunohistochemistry. During embryogenesis, the midgut begins to be formed as an outgrowth of the foregut and hindgut invaginations. Gut endocrine cells with pancreatic polypeptide (PP)-like immunoreactivity begin to appear at the anterior and posterior ends of the forming midgut. These cells are restricted to the midgut epithelium, and no mitotic cells with PP-like immunoreactivity are observed. These results strongly suggest that the gut endocrine cells, at least those with PP-like immunoreactivity, are derived from precursor cells they have in common with other epithelial cells of the midgut. PMID- 6509520 TI - Evidence against surf-riding as a general mechanism for surface motility. AB - The mechanism responsible for the energy-dependent movement of membrane components (ie, surface motility) is unknown. Recently a potentially unifying model, termed "surf-riding" [Hewitt, 1979] or "surf-boarding" [Berlin and Oliver, 1982], has been proposed to explain surface motility. Using phase-contrast light microscopy and membrane surface markers (polystyrene microspheres), we have tested the surf-riding/surf-boarding hypothesis on two protozoan systems: the axopodia of the heliozoan Echinosphaerium nucleofilum and the reticulopodial networks of the allogromiid foraminiferans Allogromia laticollaris and Allogromia sp, strain NF. Our evidence indicates that surface motility, as displayed by these organisms, does not occur by a surf-riding/surf-boarding mechanism. Previous observations on surface motility associated with the Chlamydomonas flagellum indicate that this system is also incompatible with the surf boarding/surf-riding hypothesis. PMID- 6509521 TI - Cytoplasmic tubulin from the unfertilized sea urchin egg: II. Variation of the intrinsic calcium sensitivity of Strongylocentrotus purpuratus egg tubulin as a function of temperature and brain microtubule-associated proteins. AB - Cytoplasmic tubulin purified from unfertilized sea urchin eggs self-assembles in the absence of microtubule-associated proteins (MAPs) [Suprenant and Rebhun, 1983; Detrich and Wilson, 1983] with a critical concentration for polymerization of 0.8 mg/ml at 15-18 degrees C, a value well below the 3 mg/ml tubulin present in these eggs [Pfeffer et al, 1976]. Studies of the calcium sensitivity of unfertilized S. purpuratus (sea urchin) egg tubulin were initiated to help understand how this tubulin is maintained unassembled in the unfertilized egg. Egg microtubules, assembled at physiological temperatures (15-18 degrees C) were depolymerized by a 100-fold lower free calcium concentration than egg microtubules assembled at the higher temperatures (25-37 degrees C) generally used to assemble mammalian brain microtubules. The initial rate of egg microtubule assembly was much more sensitive to calcium than was microtubule depolymerization at steady state at 37 degrees C. However, both processes were sensitive to near physiological free calcium concentrations at 18 degrees C. The co-assembly of bovine brain MAPs and sea urchin egg tubulin produced microtubules that required a 1,000-fold higher concentration of free calcium for depolymerization than microtubules assembled at 18 degrees C from egg tubulin alone. While calcium regulatory MAPs have not yet been found in sea urchin eggs, the fact that brain MAPs interact with egg tubulin and regulate both its critical concentration for polymerization [Suprenant and Rebhun, 1983] and its calcium sensitivity, suggests that such regulatory molecules exist. These results suggest that sea urchin egg tubulin assembly in vivo could be controlled by variations in intracellular calcium levels acting in concert with urchin egg proteins similar in function to brain MAPs. PMID- 6509522 TI - Axonal elongation as a stochastic walk. AB - A new formula calculates rates of directed axonal growth (elongation or retraction) using measurements of growth cone movements. By explicitly separating changes in axonal length from other nonelongational growth cone movements, the calculated rates reflect the detailed cellular growth mechanisms more directly than previous growth measures. In addition, the formula produces three distinct parameters of axonal elongation: n, a growth step rate; s, a growth step size; and P, a probability that a growth step leads to axonal elongation. For normal and regenerating individual chick and frog axons in culture, the formula has quantitated the following differences: the axon itself can elongate more rapidly in the chick, and the axon elongates in smaller steps in the chick. The underlying dynamics of growth of regenerating axons are quite similar to normal axons, but, in the short term, regenerating axons elongate in larger steps and at a slower rate. The distribution of these new rate measurements suggests that the elongation of axons can be usefully modelled as a one-dimensional stochastic walk. PMID- 6509523 TI - Time course of the motion of bull sperm flagella. AB - Detailed measurements were made of the time course of the motion of bull spermatozoa. Fourier analysis of the data showed the time course to be basically sinusoidal within 2% to 3%. An asymmetry in the motion was present, resulting in a second harmonic component in the Fourier spectra of normal sperm of approximately 11% of the main component. When the energy metabolism of the sperm was inhibited or when the external viscosity of the medium was raised, the asymmetry was reduced. When the internal Mg2+ content of the sperm was lowered, the asymmetry was increased. The asymmetries and the corresponding second harmonic components in the Fourier spectra were correlated with the overall bend shape of the sperm and with the curvature of the path in which the sperm were swimming. Model calculations showed that the asymmetry could reside in either the internal active moments in the sperms or in the stiffness of the sperm flagella. PMID- 6509524 TI - Energy requirements for pigment aggregation in fundulus melanophores. AB - Teleost chromatophores are filled with individual pigment granules that rapidly aggregate to the cell center or become dispersed throughout the cytoplasm in response to environmental stimuli. Microtubules appear to be required for pigment aggregation (movement toward the cell center), and recent findings have suggested that a dynein-like ATPase may participate in force production. Based on previous studies, however, it has been argued that pigment aggregation does not require energy directly, a view that supports the involvement of an elastic component in granule movement. To examine this point further, we have reinvestigated the energy requirements for pigment aggregation using both intact cells and detergent permeabilized cell models of Fundulus melanophores. Poisons of oxidative phosphorylation, namely, 2,4 dinitrophenol and NaCN, reversibly inhibit melanosome aggregation in response to adrenaline. Inhibition of movement results directly from depletion of intracellular ATP, since pigment translocation can be reactivated in permeabilized cells by the addition of exogenous ATP to the lysis buffer. Non-hydrolyzable analogues, including beta, gamma-imidoadenosine-5' triphosphate (AMPPNP), beta, gamma-methylene adenosine-5'-triphosphate (AMPPCP), and ATP gamma S, will not substitute for ATP in reactivation of movement. Similarly, other nucleotides such as ADP, AMP, GTP, CTP, and ITP, have limited ability to support melanosome aggregation in metabolically poisoned cells subjected to detergent lysis. ATP itself has no effect on intact cells. These results indicate that melanosome aggregation is ATP-dependent and energy-driven, and are consistent with a role for a force-transducing ATPase in particle movement. PMID- 6509525 TI - [A survey on the antibody level against Legionella pneumophila among adults in the Nanjing area]. PMID- 6509526 TI - [Relationship between rubella-infected pregnancies and the occurrence of congenital physical defects in newborn infants]. PMID- 6509527 TI - [A water-borne outbreak of diarrhea]. PMID- 6509528 TI - [The effect of leptospiral outer envelope vaccine. IV. A study among a small population]. PMID- 6509529 TI - [A serological study on primary hamster kidney cell cultured rabies vaccine]. PMID- 6509530 TI - [Distribution of local Oncomelania snail infestation without aboriginal human schistosomiasis]. PMID- 6509531 TI - [An epidemiological survey of kala-azar after its eradication in Henan Province]. PMID- 6509532 TI - [Epidemiological survey of scabies in Jingman County, Hubei Province]. PMID- 6509533 TI - [The Brucella-killing activity of Co60-gamma-ray in wool]. PMID- 6509534 TI - [The disinfective activity of microwaves on cafeteria meal coupons ]. PMID- 6509535 TI - [A survey of the sources of contamination of Chinese paper money and the disinfective activity of microwaves]. PMID- 6509536 TI - [A prepared microencapsulated insecticide mixture and its lethal effects on cockroaches]. PMID- 6509537 TI - [The infection of Angiostrongylus cantonensis in definitive and intermediate hosts in Guangzhou 1979-1982]. PMID- 6509538 TI - [The natural life cycle and seasonal dynamics of Aedes albopictus in Boai County, Henan Province]. PMID- 6509539 TI - [Surveillance of birth defects]. PMID- 6509540 TI - A decade or more of cranial and caudal angled projections in coronary arteriography--another look. PMID- 6509541 TI - Significance of elevated MB creatine kinase in patients after cardiac catheterization. AB - To clarify the etiology of elevations in plasma MB creatine kinase (CK) in patients after cardiac catheterization, we studied 32 consecutive patients undergoing cardiac catheterization and coronary arteriography. Total CK and MB CK were within the normal range in all patients prior to catheterization. Total CK activity rose from a mean of 61.46 +/- 33.8 IU/1 (SD) to 141 +/- 105 in the first sample after catheterization (p less than .005) and 121.6 +/- 92.4 in the second catheterization sample (p less than .0005). The MB CK activity also rose from a mean of 3.2 +/- 1.6 IU/1 prior to catheterization to a maximum value of 5.0 +/- 2.9. The mean increase in MB CK, though statistically significant (p less than .005), was only 1.8 IU/1. Only one patient's value for MB CK rose to outside of the normal range (greater than 12) likely due to cardiac injury. Thus, our data document that marked elevations in MB CK after cardiac catheterization are unusual. They likely represent cardiac muscle injury rather than MB CK released due to skeletal muscle injury induced by the catheterization itself. PMID- 6509542 TI - Reproducibility of ventricular function measurements by contrast angiography. AB - Interobserver reproducibility of single plane contrast angiographic measurements of end-diastolic volume (EDV/m2), end-systolic volume (ESV/m2), stroke volume (SV/m2), and ejection fraction (EF) was studied in two groups of patients. The first group (n = 42) was an unselected, consecutive series of patients in which the calculations of volume were performed manually, representing day-to-day results from a clinical quantitative angiographic laboratory. The second group (n = 31) was selected on the basis of optimal filming technique and volume calculations were performed digitally with the aid of a computer. This group characterizes the reproducibility that could be attained for investigational purposes. In the selected group, interobserver reproducibility of four regional ejection fractions was determined. The correlation coefficient (r), standard error of the estimate (Sy.x), average difference, and 95% confidence limits are given. Measurement variation accounted for 9-15% of the variance in this study for EDV/m2 (consecutive series), indicating that caution is needed when relating contrast angiographic measurements to other (e.g., noninvasive) measures of volume by simple linear regression. PMID- 6509543 TI - Subclavian artery to internal jugular vein fistula following percutaneous internal jugular vein catheterization. AB - The percutaneous internal jugular vein approach is now a commonly performed procedure for central venous catheterization. Iatrogenic arteriovenous fistulae are a very infrequent complication. We report an asymptomatic subclavian artery to internal jugular vein fistula following two percutaneous internal jugular vein catheterization attempts. PMID- 6509544 TI - Complete heart block during cardiac catheterization in a normal individual. AB - A 44-year-old white male who developed third-degree heart block during cardiac catheterization is presented. Right heart catheterization precipitated bifascicular block, right bundle branch block with left posterior hemiblock, and resulted in third-degree heart block during the left heart procedure. It is recommended that multiple electrocardiographic lead monitoring be considered during cardiac catheterization in order to recognize more easily high-risk conduction disturbances, ie a bifascicular block pattern with frontal plane axis shifts. PMID- 6509545 TI - Modification of cradle angiographic tables to more easily obtain axial coronary views. AB - With greater utilization of angled coronary views for better elucidation of coronary anatomy, many laboratories are still limited by the rotating cradle systems which make angulation for these views somewhat difficult. The following report describes a simple, inexpensive way to modify existing cradle structures to accommodate easy cranial angulation. PMID- 6509546 TI - Nomogram for calculation of stenotic cardiac valve areas from cardiac output and mean transvalvular gradient. AB - In 15 patients (group 1) with isolated mitral stenosis and in 14 patients (group 2) with isolated aortic stenosis the stenotic valve areas were calculated according to: A) Gorlin's formula; B) Hakki's simplified formula, using mean mitral gradient by planimetry or peak-to-peak aortic gradient; C) the three-point simplified formula, using mean gradient calculated by the three-point method for both mitral and aortic valve. The three-point method is definitely easier to use than planimetry. The values (mean +/- SD) of mitral valve areas in group 1 patients were, respectively: 1.56 +/- 0.63 cm2; 1.56 +/- 0.55; 1.51 +/- 0.53. The values of aortic valve areas in group 2 patients were: 0.91 +/- 0.63; 0.77 +/- 0.41; 0.88 +/- 0.52. An excellent correlation was shown between the valve area calculated by Gorlin's formula and both Hakki's simplified formula and the three point simplified formula. For aortic valve area the correlation is even better if the mean gradient by the three-point method is used instead of the peak-to-peak gradient. On the basis of the simplified formula, a nomogram was constructed which allows an immediate calculation of valve areas from cardiac output and transvalvular gradient. PMID- 6509547 TI - Combined fluid-filled and micromanometer-tip catheter system for high-fidelity pressure recordings in infants. AB - Investigation of pressure-derived indices of systolic and diastolic function in infants and young children has been limited, in part due to difficulty in obtaining high-fidelity pressure recordings. Standard fluid-filled catheter manometer systems have a frequency response which is inadequate for this purpose, whereas high-frequency response micromanometer-tip catheters systems are difficult to use in this age group. Therefore, a system was investigated whereby a micromanometer-tip catheter (Millar) was connected directly to a standard pigtail catheter. The frequency response of this combined system was defined using 3.2 Fr pigtails of 40, 50, and 65 cm, 4.0 Fr pigtails of 50, 65, and 80 cm, and 5.0 Fr pigtails of 80 and 100 cm. In three different catheters of each diameter and length, minimal variation in response was seen. The 3.2 Fr-40-cm system demonstrated a flat line (100%) response to 90 Hz with a resonant frequency of 130 Hz. This is certainly adequate for determination of pressure derivatives for heart rates up to 120 beats per minute. The longer 3.2 Fr catheters demonstrated a poorer frequency response. The 4.0-Fr-50-cm system was flat line to 60 Hz, rising to 175% response at the resonant frequency of 85 Hz. This is adequate for determination of pressure derivatives at heart rates up to 120 beats per minute. Increasing the diameter or length of the pigtail catheter resulted in further deterioration of the frequency response. Thus, this system provides high-fidelity tracings suitable for assessment of pressure-derived indices of systolic and diastolic function in infants and young children. PMID- 6509548 TI - Percutaneous brachial catheterization using a modified sheath and new catheter system. AB - An alternative method for left heart catheterization via the brachial artery, without cutdown, is described. Percutaneous brachial catheterization was done with a modified 7F side-arm sheath with check valve. A modified 7F high flow catheter was developed employing characteristics of both multipurpose and Sones catheters. The technique was used in 100 patients for left heart catheterization, in patients with and without aortic valve disease, for left ventricular angiography and selective coronary angiography. There were no failures or serious complications. All puncture sites were managed with 15-20 minutes of compression using only a blood pressure cuff or finger pressure. Bleeding was controlled with restoration of the radial pulse in all but one patient, who had severe peripheral brachial atherosclerosis. Cutdown and thrombectomy performed before he left the laboratory using standard catheterization techniques promptly restored blood flow. It is our impression that this technique facilitated outpatient catheterizations, repeat catheterizations at sites of previous cutdowns, and reduced patient discomfort. PMID- 6509549 TI - Anaphylactoid reaction to contrast agents. PMID- 6509550 TI - DNAase I encapsulated in liposomes can induce neoplastic transformation of Syrian hamster embryo cells in culture. AB - We have used liposomes to deliver DNAase I inside normal Syrian hamster embryo (SHE) cells. We showed the entrance of DNAase I inside the cell by dose-dependent cytotoxicity; and the entrance of DNAase I into the nucleus by the induction of chromosomal aberrations and somatic mutation at the HPRT locus (but not at the Na+/K+ ATPase locus). The induction of neoplastic transformation in cultures treated by DNAase I-in-liposomes was manifested by increased saturation density, colony formation at low seeding density, colony formation in 1% serum and 0.3% agar, and tumorigenicity in 100% of injected animals. The acquisition of anchorage-independent growth became apparent only after 39-57 posttreatment population doublings. Thus damage to DNA alone can initiate the neoplastic transformation process; but for full expression of the neoplastic phenotypes, a long progression time is required for the acquisition of anchorage-independent growth and tumorigenicity. PMID- 6509551 TI - Biogenesis of epithelial cell polarity: intracellular sorting and vectorial exocytosis of an apical plasma membrane glycoprotein. AB - To study the biogenetic pathway of influenza hemagglutinin (HA), a model apical glycoprotein, in polarized epithelial MDCK cells, anti-HA antibodies were added to the basolateral surface during influenza infection. In monolayers grown on collagen gels influenza and VSV plaque development was blocked only when the antibodies were added to the respective budding surface. Addition of anti-HA antibodies to the basal medium of monolayers grown on nitrocellulose filter chambers neither resulted in HA-coupled transport of antibody nor inhibited HA migration to the apical surface. These results indicate that the bulk of HA is vectorially inserted into the apical surface of MDCK cells by polarized exocytosis. Other apical proteins in epithelia may use a similar mechanism during biogenesis. PMID- 6509552 TI - Discoidin I is implicated in cell-substratum attachment and ordered cell migration of Dictyostelium discoideum and resembles fibronectin. AB - All three forms of discoidin I, an endogenous N-acetylgalactosamine-binding lectin from D. discoideum, contain the amino acid sequence gly-arg-gly-asp also found in fibronectin and implicated in its attachment to cells. Synthetic peptides containing these and adjacent amino acids of discoidin I block organized streaming during aggregation of D. discoideum and, at higher concentrations, block cell attachment and spreading on a plastic surface and formation of fruiting bodies. Pure discoidin I (with or without N-acetylgalactosamine) and univalent anti-discoidin I also block formation of streams during aggregation. Two mutants of D. discoideum with low levels of discoidin I apparently reflect the deficiency of this endogenous lectin by failing to form streams or to spread on plastic and by a partial failure to enter aggregates. Together, the results indicate that discoidin I functions like fibronectin to promote cell attachment and spreading as well as ordered cellular migration during morphogenesis. PMID- 6509553 TI - Gene mapping within the T/t complex of the mouse. III: t-Lethal genes are arranged in three clusters on chromosome 17. AB - Lethal t mutations belonging to seven different complementation groups have been mapped. The overall picture emerges as three clusters of t-lethal genes: one near the proximally located tail interaction factor (tT) containing tw73; one numerous cluster associated with the MHC and including tw32, t12, tw5, tw18, and tLub-1; and one distal cluster close to the locus of tf encompassing, t0, t6, and tw12. In the two cases examined, members of the same complementation group map to the same location. Evidence is presented that more than one mutant site may be necessary for the lethality of some lethal t "mutations," and that the expression of a specific lethal phenotype may depend on cis-interactions between multiple mutations. PMID- 6509554 TI - Megakaryocytopoiesis in bone marrow-derived stromal-hemopoietic cells co cultures: action of Tamm-Horsfall glycoprotein. AB - Murine bone marrow cells are cultured in agar in the presence of marrow-derived fibroblasts and pokeweed-stimulated spleen conditioned medium. Granulo-monocytic colonies and a few megakaryocytic and mixed colonies are induced. The addition of Tamm-Horsfall glycoprotein - a human glycoprotein produced in the kidneys - increases the number of colonies and stimulates megakaryocytopoiesis. The glycoprotein does not have colony-stimulating activity nor does it induce megakaryocytopoiesis in monolayer cultures. Its major glycopeptide retains the ability to increase the number of colonies, but not to induce megakaryocytopoiesis. Cell-cell interactions occurring in the hemopoietic microenvironment and the effect of glucides are discussed. PMID- 6509555 TI - The cholinergic system of the primitive streak chick embryo. AB - The presence of neurotransmitters at stages of embryonic development prior to neurulation has been demonstrated in several systems. Although the functions of these molecules at early stages of embryogenesis have not been ascertained, it is possible that they are involved in aspects of cell migration, regulation of the synthesis of macromolecules, intercellular communication, and in the transmission of positional information during gastrulation. As an initial approach to the resolution of questions concerning the function of transmitters during early development, we have begun a study of the cholinergic system in the primitive streak chick embryo (Hamburger-Hamilton stages 3 + to 5). We have found that the chick embryo: (1) can use exogenously applied choline for the synthesis of acetylcholine; (2) possesses a true acetylcholinesterase, which is predominantly in the form of the 4-6s monomer; and (3) can take up exogenous choline through a sodium-dependent, high-affinity choline transport system. To date we do not have any evidence for the presence of nicotinic or muscarinic receptors at the primitive streak stage. PMID- 6509556 TI - Interaction between rat brain microtubule associated proteins (MAPs) and free ribosomes from Xenopus oocyte: a possible mechanism for the in ovo distribution of MAPs. AB - The binding of microtubule associated proteins (MAPs) to free 80 S ribosomes isolated from Xenopus laevis oocytes inhibits in vitro tubulin assembly (Jessus et al., 1984). The inhibition of tubulin polymerisation was shown to be dependent upon GTP. The dose of GTP needed to induce 50% of the maximal effect was 0.5 mM. Furthermore, the inhibition is enhanced by pretreatment of the ribosomes with ATP gamma-S, and partially abolished after phosphatase treatment, which strongly suggests that protein phosphorylation regulated the inhibitory effect. When fluorescent purified MAPs are microinjected into Xenopus laevis oocyte, they cap 1 h later the basal nuclear envelope; in contrast, when the fluorescent MAPs ribosome complex is injected, the fluorescent MAPs remain in the cytoplasm and never reach the region underlying the nuclear envelope. PMID- 6509557 TI - Complement activation by cell-associated immune complexes in contact sensitivity. AB - Lymph node cells collected 4 days after painting the skin with picryl chloride activate the first components of the classical pathway of complement cascade, as shown by consumption of C4 of rabbit complement with total sparing of C5 and factor B activity. In contrast, lymph node cells collected 1 or 6 days after sensitization fail to do so. The ability of "4-day" cells to activate complement is inhibited by treating the cells with specific low-molecular-weight hapten, which is known to dissociate the immune complex present on the cell surface. When mouse serum was used as source of complement, a different behavior in complement activation between CBA/J and B10.D2-New/SnJ serum was observed: "4-day" cells failed to consume CBA/J serum whereas a normal complement activation was detected when B10.D2-New/SnJ serum was used. Using these two sera which differ in the level of C4, an inverse relationship between the ability of "4-day" cells to activate complement and their capacity to induce contact sensitivity when injected into the footpad of normal recipients was reported. Experiments performed using sera from C5 genetically deficient mice demonstrate that only the early complement components are involved, suggesting that membrane immune complexes are solubilized as a result of complement activation; on the other hand, membrane bound activated complement components could alter the immunizing potential of "4-day" cells. PMID- 6509558 TI - Solubilization of a human lymphocyte factor for autorosette. AB - With incubation at 45 degrees C, human peripheral blood lymphocytes (PBL) loose 80% of their capacity to form 1-hr autorosettes (AR). However, the addition of supernatant from heated lymphocytes (SHL) restores 93% of their rosette-forming capacity, while producing an inhibitory effect on nonincubated lymphocytes. A soluble factor present in SHL is active to a 1/5000 dilution; is absorbable on autologous red blood cells but not on sheep red blood cells; is RNase and DNase resistant and sensitive to trypsin and pronase; and acts variably on allogenic cells. PMID- 6509559 TI - The influence of dissection and of the contact with glass on the contractile activity of plasmodial strands. AB - The non-invasive photometric techniques recording the contraction-relaxation cycles demonstrate the absence of any lag period in pulsation of isolated veins in situ. Contractions are temporarily inhibited at the site of contact of the vein surface with a glass rod. This indicates that the results obtained with the techniques, in which glass sensors were used to detect the contractile activity, are not conclusive and provide no reliable data about the motive force generation site in plasmodium. PMID- 6509560 TI - Heterogeneous participation of the hepatocyte population in amyloid protein AA synthesis. AB - Amyloid protein AA is believed to be synthesized in the liver in a form of its precursor, the acute phase reactant, SAA. To identify precisely the cell involved in SAA biosynthesis, immunohistochemical reaction to anti-mouse AA was analysed on the liver sections from CBA/J mice which had received a single casein injection and were sacrificed at predetermined times up to 48 hours. Two different primary localizations of the reaction were revealed. One was in the cytoplasm of certain hepatocytes. This reaction peaked at 6-8 hours after the casein injection in the intensity of the reaction and in the number of the cells involved. The hepatocytes with positive cytoplasmic reaction were scattered over the lobule and even at the peak did not exceed 20% of the total hepatocyte population. The other localization of the reaction covered linearly the surface of the hepatocyte cords, and peaked at 12-16 hours after the casein injection. PMID- 6509561 TI - Lymphocyte lactate dehydrogenase isoenzymes in association with depressed mitogen responsiveness. AB - Purified lymphocyte preparations from cancer patients were less responsive to the mitogen phytohaemagglutinin (PHA) than were lymphocytes from healthy donors as measured by [3H]-thymidine uptake over periods in culture up to 96 hours. The uptake of radiolabel was paralleled by total cellular lactate production. The isoenzymic composition of lactate dehydrogenase (LD) in lymphocytes from healthy individuals was altered following PHA stimulation with increasing proportions of LD-1 and LD-2 throughout the culture period. This phenomenon was markedly reduced in lymphocytes from cancer patients. This defect in lymphocytes from cancer patients is thought to reflect an impaired capacity to accomplish an early mitogen-induced enhancement of glucose metabolism, which is a prerequisite for lymphocyte proliferation. PMID- 6509562 TI - Absorption of experimentally administered materials by the hepatopancreas cells of the crayfish, Procambarus clarki. AB - After long term starvation, the crayfish, Procambarus clarki was administered protein silver, iron lactate and olive oil, and its hepatopancreas was subsequently examined by electron microscopy. The reserve cells showed changes suggesting the absorption of these materials from the acinar lumen had taken place. In contrast, the hindgut of crayfish seemed to have no absorptive ability. In crustaceans the hepatopancreas is the largest gland in the body. The chief functions of this gland are the secretion of digestive juice into the stomach and absorption of digested food. It is also where materials which are necessary for hardening of animals that have undergone ecdysis are stored. Although these roles are commonly accepted, the absorptive ability of the gland has been rarely studied. Yonge (1924) and van Weel (1955) attempted to obtain evidence for the absorptive function of hepatopancreas cells of Nephrops norvegicus and Atya spinides using iron lactate and iron saccharate, and obtained some positive results. They used the histochemical Prussian blue test to demonstrate absorbed iron. Vonk (1960) referred to the results of a few authors who had tried to show fat deposits in reserve cells of the hepatopancreas after the administration of olive oil to the animals. But because starvation did not affect the quantity of stored fat in the hepatopancreas cells, the attempt failed to reveal the absorption of fat by the hepatopancreas. In the present paper, the authors describe the results of studies on the absorption of experimentally administered materials by hepatopancreas cells of the crayfish, Procambarus clarki, using electron microscopy. PMID- 6509563 TI - LR white resin and improved on-grid immunogold detection of vicilin, a pea seed storage protein. AB - LR White resin combined with post-embedding immunogold labelling was used to localize the storage protein vicilin within developing pea seed cotyledons by electron microscopy. Fine structural preservation is comparable to that obtained with Spurr's resin, and antibody labelling is improved. More gold binds to protein bodies, to rough endoplasmic reticulum and to Golgi vesicles, and in addition, vicilin was detected within Golgi cisternae, a site not previously observed. PMID- 6509564 TI - Development of transformed characteristics by sheep thyroid cells irradiated as differentiated primary cultures. AB - A method has been developed which allows four stages of transformation to be detected in subcultured populations of sheep thyroid cells exposed to gamma irradiation as differentiated primary cultures. The cell populations initially irradiated and the subcultures deriving from these retain a number of differentiated properties of thyroid cells, including iodine uptake, follicle formation and T4 production. The stages of transformation which develop in the subcultures are nonsenescence, focus development on a confluent monolayer, i.e. loss of contact inhibition, colony formation in soft agar, i.e. anchorage independence, and reduced serum dependence. The technique offers a method for detecting the development of transformation in primary differentiated epithelial cultures. PMID- 6509565 TI - Ageing of the collagenous layer in Bruch's membrane of the teleost Poecilia reticulata. PMID- 6509566 TI - Molecular phenotyping of non-transformed and chemically transformed C3H10T1/2 mouse fibroblasts. AB - A systematic molecular phenotyping approach based on two-dimensional gel electrophoresis is being applied in an attempt to identify protein changes associated with malignant transformation. Using the C3H10T1/2 mouse cell line, two-dimensional polypeptide maps of the non-transformed cell line, several chemically transformed lines and a tumour cell line were compared. Although there is a large degree of similarity between the protein profiles of all cell lines, clear differences are evident. Initial results are consistent with the view that many of the protein changes are incidental to malignant transformation. Changes induced by 3-methylcholanthrene are retained after transplantation of the cells into nude mice. PMID- 6509567 TI - Absence of gap junctional complexes in two established renal epithelial cell lines (LLC-PK1 and MDCK). AB - The type of junctions present in the membranes of the two renal epithelial cell lines, LLC-PK1 and MDCK, and of subcultured porcine aortic endothelial (PAE) cells have been studied by freeze-fracture. No gap junctions were observed in the two renal cell lines, while they were numerous in the endothelial cells. Tight junctions were abundant in LLC-PK1 and MDCK cells and varied in numbers of ridges from one to ten. ONly a few simple tight junctions unconnected with gap junctions were observed in PAE cells. The occurrence of gap junctions in these cells correlates with their ability to form intercellular communicating channels. PMID- 6509568 TI - Aster formation in vitro is nucleated by granules isolated from the mitotic apparatus. AB - Mitotic apparatuses (MAs) isolated from sea urchin eggs contained clusters of granular material in their centrospheres. After cold treatment and mild agitation, the MA fraction formed asters when combined with tubulin. Many microtubules grew from isolated centrospheres most of which were covered with astral residues. Homogenization of the isolated MA fraction dispersed the centrospheres which broke into fragments or into aggregates of small granules that formed small asters when tubulin was added. Electron microscopy showed that more than ten microtubules were nucleated from a granular aggregate composed of several approximately 90-nm granules. The aster-forming activity was lost with time when the MAs were kept at 0 degree C. Only glycerol stabilized this activity. The aster-forming activity also was heat labile and trypsin sensitive, but it was resistant to RNase treatment. When the dispersed MAs were extracted with a buffer solution of high ionic strength, aster-forming activity was recovered only in the extract; that is, when the extract had been dialyzed against a solution of low ionic strength, the fine granules self assembled and retained their aster-forming ability. PMID- 6509569 TI - Further characterization of the effects of alpha-1-acid glycoprotein on the passage of human erythrocytes through micropores. AB - Effects of human alpha-1-acid glycoprotein (AG) on the passage of human red blood cell(s) (RBC) through membrane filters with micropores were examined in vitro. RBCs, with a mean major diameter of 7.2 micron, that had been suspended at 1% in physiological phosphate-buffered saline (PBS), were filtered through membrane filters of various pore diameters under positive pressure. The percentages of cells that passed through the micropores and of cells hemolyzed during filtration were determined. RBCs suspended in PBS did not pass through micropores that had an average pore diameter of 3 micron; instead hemolysis took place. Neither temperature nor applied pressure affected cell passage; but when AG at 0.1 mg/ml or above was added to an RBC-suspension, it promoted cell passage through the 3 micron micropores and reduced the degree of hemolysis. The effects of AG were dose dependent up to a concentration of 0.5 mg/ml. The addition of AG to an RBC suspension that contained 90% human serum had the same additive effects. Washing AG-treated RBCs with normal saline produced a marked decrease in cell passage through the 3 micron pores. Fluorescence antibody staining revealed that the exogenous AG was localized on the membrane surface of the RBCs. Our results suggest that the AG bound to the surface of the RBCs acts as a lubricant between the RBCs and the wall of the micropore; this would facilitate RBC-passage through the micropores. PMID- 6509571 TI - [Determination of reference values for beagles]. PMID- 6509570 TI - [Potentiation of the response of arterial strips to the exogenous administration of noradrenaline and transmural stimulation by vasopressin]. PMID- 6509572 TI - [Study of the readability and level of intelligibility of work published in professional pharmaceutical journals]. PMID- 6509573 TI - [Professional management in pharmacies]. PMID- 6509574 TI - [Levels of prolactin and growth hormone after administration enkephalin analogs in rats]. PMID- 6509575 TI - [Binding of 3-chloro-4-[3H]-benzyloxyphenylacetic acid ([3H] benzofenac) to plasma proteins]. PMID- 6509576 TI - [Inhibition of liver aminotransferase with potential cytostatics]. PMID- 6509577 TI - [Successful cooperation by gynecologists and sexologists in Slovakia]. PMID- 6509578 TI - [Mortality in malignant tumors of the female genitalia in Czechoslovakia. I. Bohemia]. PMID- 6509579 TI - [Mortality in malignant tumors of the female genitalia in Czechoslovakia II. Slovakia]. PMID- 6509580 TI - [Mortality in malignant tumors of female genitalia in Czechoslovakia. III. Czechoslovakia]. PMID- 6509581 TI - [The present state of obstetrical psychoprophylaxis in practice. II. The effects of preparation]. PMID- 6509582 TI - [Psychosomatic complications of contraception]. PMID- 6509583 TI - [Tubal pregnancy after fertilization in vitro and transfer of the embryo into the uterus]. PMID- 6509584 TI - [Problems of treatment and outpatient care of women in the postreproductive years]. PMID- 6509585 TI - [Experience in our prenatal counseling service with congenital fetal arrhythmias]. PMID- 6509586 TI - [Symphisitis abscendens metastatica as an uncommon complication in the puerperium]. PMID- 6509587 TI - [The immune system and cell proliferation, fetal tolerance and tumor growth. II]. PMID- 6509588 TI - [Activating mechanisms of immunologic tolerance]. PMID- 6509589 TI - [Electronic device for the automatic zero-reading of (short-circuit) potentials in large-surface nonexcitable biological membranes]. PMID- 6509590 TI - [Etiology of maxillary sinusitis]. PMID- 6509591 TI - [Personal experience with medial maxillectomy by Session's technic]. PMID- 6509593 TI - [Use of transtympanic tubes in the treatment of conduction deafness in children]. PMID- 6509592 TI - [Late development of osteoplastic flaps in operations on the frontal sinuses]. PMID- 6509594 TI - [Controlled transoral intubation]. PMID- 6509595 TI - [Mycoses of the paranasal sinuses]. PMID- 6509596 TI - [Manifestations of malignant melanoma in the ORL area]. PMID- 6509597 TI - [Dynamics of auditory changes after acoustic trauma in patients treated at the Otorhinolaryngology Department of the Military Hospital in Brno from 1973 to 1982]. PMID- 6509598 TI - [Stuttering and cluttering from the aspect of biochemical indicators]. PMID- 6509599 TI - [Cellular (neuronal) mechanisms from the aspect of their relation to the regulation of motor activity. Prognostic study]. PMID- 6509600 TI - [Computer analysis of the EEG. Normal electroencephalogram]. PMID- 6509601 TI - [Quantification of daytime somnolence in patients with narcolepsy and hypersomnia]. PMID- 6509602 TI - [Visual evoked potentials. I. Normal distribution of the frequency and variability of data in microcomputer-assisted analysis]. PMID- 6509603 TI - [Separation of proteins in non-concentrated cerebrospinal fluid using polyacrylamide gel electrophoresis]. PMID- 6509604 TI - [Spastic or spastic-tonic opisthotonus in severe disorders of the central nervous system in early childhood]. PMID- 6509605 TI - [Clinical value of neurologic methods used in the detection of mild motor deficits]. PMID- 6509606 TI - [Brain tumor in stenosis of the carotid artery]. PMID- 6509607 TI - [Aspects of morphological manifestations of the plasticity of the peripheral nervous system. I. Plasticity of the neuromuscular system]. PMID- 6509609 TI - [Microsurgical reconstruction of the facial nerve]. PMID- 6509608 TI - [Treatment of facial hemispasm by microvascular decompression of nerve VII]. PMID- 6509610 TI - [EEG examination in traumatic apallic syndrome]. PMID- 6509611 TI - [Post-traumatic hemorrhage and infarcts of the basal ganglia in children]. PMID- 6509612 TI - [Resection of the thrombosed internal carotid]. PMID- 6509613 TI - [Visual evoked potentials. II. Changes during focal cerebral ischemia in relation to the location of the lesion]. PMID- 6509615 TI - [Improvement of the sexual parternership of exhibitionists]. PMID- 6509614 TI - [Psychopathological findings in sexual aggressors]. PMID- 6509616 TI - [Possibilities of objective characterization of the clinical picture and therapeutic effects in neuroses using the iontophoretic autonomic test with adrenaline and dionine]. PMID- 6509617 TI - [Mental anorexia and sexuality in women]. PMID- 6509618 TI - [Amential delirium syndrome as a complication of cardiosurgical procedures]. PMID- 6509619 TI - [Problems in intubation and tracheotomy in children]. PMID- 6509620 TI - [The value of examining the lungs in the lateral decubital position in the radiologic diagnosis of unknown foreign body aspiration in children]. PMID- 6509621 TI - [Problems in the differential diagnosis of Ebstein's anomaly]. PMID- 6509622 TI - [Foreign bodies in the gastrointestinal tract in children]. PMID- 6509623 TI - [The knowledge of parents and children about diabetes mellitus and the compensation status in the disease]. PMID- 6509624 TI - [Organophosphate insecticides as a cause of poisoning in children]. PMID- 6509625 TI - [Diagnostic significance of orosomucoid in bacterial infections in children]. PMID- 6509626 TI - [Etiologic heterogeneity of cleft defects of the oral cavity]. PMID- 6509627 TI - [Indications for surgery of thyroid diseases in children and adolescents]. PMID- 6509628 TI - [Congenital liver fibrosis associated with tubulointerstitial nephropathy resembling nephronophthisis in an 8-year-old boy]. PMID- 6509630 TI - [Changes in the regulations regarding the length of the isolation period of patients with chickenpox]. PMID- 6509629 TI - [Indications and the standard procedure for excretory urography and micturition cystourethrography in children]. PMID- 6509631 TI - [Therapy of hypertensive crises in infants]. PMID- 6509632 TI - [Methods of echocardiographic examination in children]. PMID- 6509633 TI - [Obstructive changes in the respiratory tract in children, adolescents and young adults with bronchial asthma and clinical signs of the disease]. PMID- 6509634 TI - [Neonatal cholestasis in non-conjugated and conjugated hyperbilirubinemia]. PMID- 6509635 TI - [The ultrastructure of the epithelium of large bronchi in children with bronchial asthma]. PMID- 6509637 TI - [Incontinentia pigmenti--the Bloch-Sulzberger syndrome]. PMID- 6509636 TI - [Levels of serum lipids and blood pressure in children of families with a history of cardiovascular disease. I. Reference values]. PMID- 6509638 TI - [Shock]. PMID- 6509639 TI - [Indications for esophagogastroduodenoscopy in children and adolescents]. PMID- 6509640 TI - [Levels of IgE in the blood of healthy and allergic children]. PMID- 6509641 TI - [Crying vital capacity in children in the 1st year of life]. PMID- 6509642 TI - [Monitoring the lipoprotein spectrum in so-called high risk children]. PMID- 6509643 TI - [Undesirable phenomena in the nutrition of Czechoslovak children in early childhood]. PMID- 6509644 TI - [Primary lymphoma of the skin in a 10-year-old child with dermatomyositis]. PMID- 6509645 TI - [Bronchial adenoma as a cause of bronchiectasis]. PMID- 6509646 TI - [Results of vaccination with Czechoslovakian vaccine against parotitis]. PMID- 6509647 TI - [Early detection of scoliosis by examinations at schools]. PMID- 6509648 TI - [Prevention and treatment of Hymenoptera stings]. PMID- 6509649 TI - [ECG in neonatal hypocalcemia]. PMID- 6509650 TI - [Hygienic and epidemiologic protection in the operation of large hospitals]. PMID- 6509651 TI - [Health education in the therapeutic-preventive care of children]. PMID- 6509652 TI - [Methods of training general physicians for field service in East Germany, Hungary and Czechoslovakia]. PMID- 6509653 TI - [Basic problems in determining the need for physicians and allied health personnel]. PMID- 6509654 TI - [The rise in the number of allied health personnel during the past 10 years in Czechoslovakia]. PMID- 6509655 TI - [Analysis of drug prescription order forms using a computer]. PMID- 6509656 TI - [Analysis of the expenditures in maintaining the Institutes of National Health in the East Bohemian Region]. PMID- 6509657 TI - [Use of the output of automated information systems by management personnel of maintenance-technical services]. PMID- 6509658 TI - [Analysis of expenditures in a hospital with a polyclinic in the East Bohemian Region]. PMID- 6509659 TI - [Requirements of a modern hospital for economic and technical operations]. PMID- 6509660 TI - [Prognosis of future trends in infant mortality]. PMID- 6509661 TI - [Evaluation of analgesics--an inquiry of physicians]. PMID- 6509662 TI - [Conceptual questions in the health service information system]. PMID- 6509663 TI - [Questions of integration and specialization in the socialist system of health protection]. PMID- 6509665 TI - [Indicators for evaluating the activity of inpatient hospital departments]. PMID- 6509664 TI - [Possible uses of microprocessors in the health services]. PMID- 6509666 TI - [Trends in the mortality of cerebrovascular diseases in Czechoslovakia from 1961 to 1981]. PMID- 6509667 TI - [The purpose of information systems in health care]. PMID- 6509668 TI - [Aspects of the role, concepts and development of general medicine]. PMID- 6509669 TI - [Approaches to the implementation of the principles of NOT--the scientific organization of work in health institutions]. PMID- 6509670 TI - [Preventive care in general practice and its documentation]. PMID- 6509672 TI - [Tasks of the division for counseling within the framework of the medical field of work capacity evaluation]. PMID- 6509671 TI - [Relation of COHb to physical fitness and lipid metabolism parameters in recruits]. PMID- 6509674 TI - [Problems of expenditure norms]. PMID- 6509673 TI - [Methods of evaluating drug therapy, particularly in cardiovascular diseases]. PMID- 6509675 TI - [Verifying new economic mechanisms in Bulgaria]. PMID- 6509676 TI - [Regulation of wages in health care]. PMID- 6509677 TI - [Differences in the structure of expenditures of selected hospital departments]. PMID- 6509678 TI - [Radiographic examination of the stomach in routine practice]. PMID- 6509679 TI - [Chronic foreign body in the esophagus of a 13-month-old child]. PMID- 6509680 TI - [Primary sclerosing cholangitis]. PMID- 6509681 TI - [Pulmonary changes in leukemia and their complications]. PMID- 6509682 TI - [Multiple echinococcal pulmonary cysts. Case report]. PMID- 6509683 TI - [Equipment and procedures for the control of detection parameters of scintillation cameras]. PMID- 6509684 TI - Drug interactions in biotransformation of 1-phthalidyl 5-fluorouracil to 5 fluorouracil in rat liver. AB - Two rat liver hydrolases were found to be involved in the metabolism of 1 phthalidyl 5-fluorouracil (PH-FU) to 5-fluorouracil (5-FU), one of which was induced by phenobarbital (PB) treatment of rats. Both inducible and constitutive enzyme were soluble and showed different characteristics in gel filtration and response to inhibitors. Further study showed that the blood level of PH-FU could be modulated by PB-pretreatment or coadministration of enzyme inhibitors to rats. PMID- 6509685 TI - Inhibition of polymorphonuclear leukocyte functions by fluorinated nitrobenzenes. AB - The bifunctional fluorinated nitrobenzenes, 1,5-difluoro-2,4-dinitrobenzene (DFDNB) and 4,4'-difluoro-3,3'-dinitrodiphenyl sulfone (DFDNDPS), and the monofunctional 1-fluoro-2,4-dinitrobenzene (FDNB) inhibit chemotaxis, phagocytosis, exocytosis and the respiratory burst of rabbit polymorphonuclear leukocytes. Inhibition occurs in the micromolar concentration range; the bifunctional compounds are stronger inhibitory than the monofunctional one. The inhibitory effect can be counteracted by sulfhydryl compounds and not with amino group containing compounds. The results suggest that an interaction with vulnerable sulfhydryl groups, located in a hydrophobic surrounding, is the basis of the inhibitory effect of the fluorinated nitrobenzenes. PMID- 6509686 TI - Interaction of sea cucumber saponins with multilamellar liposomes. AB - The effect of three sea cucumber saponins, echinoside A, bivittoside D and holothurin A, on multilamellar liposomes was investigated. An ideal osmotic behavior of liposomes was described as a linear relationship between the reciprocal 3/2 s power of absorbance at 450 nm and the osmotic gradient across the membrane. Sea cucumber saponins at concentrations below critical micelle concentration (CMC) disturbed this linear relationship in liposomes composed of egg phosphatidylcholine, phosphatidic acid and cholesterol. Cholesterol-free liposomes were not susceptible to these saponins. Results of optical measurements were consistent with those of transmission electron microscopy, which showed saponin-induced changes in liposomal structure. The lytic activity of sea cucumber saponins on liposomes depended on their chemical structure. These results suggest that sea cucumber saponins as monomers can interact with liposomes and that cholesterol serve as a principal binding site for the sea cucumber saponins. PMID- 6509687 TI - Repair and replication of DNA in rat and mouse tissues in relation to cancer induction by N-nitroso-N-alkyl-ureas. AB - The high susceptibility of certain organs, for example rat brain, to induction of cancer by N-nitroso-N-alkyl-ureas, has been related to a low ability to remove O6 alkylguanine (O6AG) from DNA. It is therefore reasonable to ask why mouse brain, in which there is also a slow disappearance of O6AG from DNA after treatment with nitroso-alkyl-ureas, is not susceptible and why, in mice, thymus and lung are the main target organs. The explanation of the species difference could lie in the fact that replication of alkylated DNA is an essential event in initiation. If nitroso-alkyl-ureas had a greater inhibitory effect in some organs than in others, replication might be inhibited until after the O6AG had been removed, so preventing replication of DNA while still alkylated. This concept was tested by comparing the effect of N-nitroso-N-methyl-urea (NMU) on incorporation of [3H]TdR into DNA of relevant organs in Wistar rats and C57BL mice, and by determining ability to remove O6AG from DNA by measuring the alkyl acceptor protein (AAP) concentrations in these organs. No evidence was obtained that the AAP content was lower or inhibition of replication was less extensive in the organ of the species more susceptible to carcinogenesis than in the same organ of the less susceptible species. PMID- 6509688 TI - [Review of the organogenesis of the respiratory system (excluding the pulmonary parenchyma)]. AB - A simplified panorama of the different formation phases of the upper respiratory system (larynx, trachea, main bronchi) is presented. Chronologic evolution of organogenesis in embryologic phase and fetal phase is emphasized. Post-natal growing is also described. A classification of malformations of the upper respiratory system is done, based on topographic data. The mechanism of genesis of the malformations remains of hypothetical value. PMID- 6509689 TI - [Diagnostic endoscopy in congenital tracheobronchial abnormalities]. AB - High quality of anesthesia and efficiency of light sources and optical systems now allow safe examination of upper respiratory tract and ability to give very precise informations in neonates and infants. Endoscopy now is then an essential procedure for diagnostic of congenital anomalies of respiratory tract. The necessary conditions for a safe examination and the necessity of complete exploration (Polyendoscopy) are exposed as well as endoscopic aspects of various congenital anomalies. PMID- 6509691 TI - [Congenital tracheoesophageal fistulas in children]. AB - Among 107 cases of congenital H-Type tracheoesophageal fistula without esophageal atresia collected, since 1955 to 1983 about 69 have been reported. The clinical aspect is significative when the digestive and respiratory symptoms are associated and very doubtful when only one is recovered. Often, the tape recording confirms the diagnosis, sometimes repeated examinations are necessary. The tracheoscopy with a rigid tube is probably more than the fibroscopy. The surgical correction is easy and induce the cure. PMID- 6509690 TI - [Diastema or laryngeal or posterior laryngotracheal cleft. Analysis of 16 cases]. AB - Laryngeal diastema or laryngeal or posterior laryngotracheal cleft is a rare congenital malformation producing an aerodigestive communication of abnormal location which leads to severe or even fatal respiratory and infective complications. Findings in 16 cases are presented and the characteristics and particular problems of treatment of this malformation discussed. Diagnosis is presently based on results of microlaryngoscopic examination. Details are given of therapy of the commonest forms of the affection (cricoidal and upper cricotracheal), operations being performed in 9 such cases, and the place and course of forms limited to the interarytenoidal space discussed. Frequency and effect on prognosis of associated malformation are outlined. Considerable improvement has been obtained in the postoperative prognosis of cricoidal (I) and upper cricotracheal (II) forms during the last few years, and these forms must now be considered as curable. PMID- 6509692 TI - [Rare congenital aerodigestive fistulae]. AB - Within the 1984 Symposium of the French Society of Pediatric Surgery, concerning tracheal and main bronchi malformations surgery, a synthesis is done from the observations of rare aerodigestive fistulae (esophageal atresia, H type tracheoesophageal fistula, esolaryngotracheal clefts excluded). The two types of aerodigestive fistulae reported in the literature are the communications with the esophagus and the biliary tract. 1) In the group of communications with the esophagus, the study concerned: fistulae associated with tracheal agenesia, with bad prognosis; fistulae associated with bronchopulmonary agenesia, with possible esophageal atresia; fistulae associated with bronchopulmonary foregut malformations. 2) The quite tracheobiliary fistulae, setting up the second group of aerodigestive fistulae, are reviewed. This report analyse the etiologic, anatomic, clinic and therapeutic data of every one malformations. PMID- 6509693 TI - [Congenital laryngeal stenosis]. AB - This presentation is a retrospective study on 79 infants and children with congenital laryngeal stenosis, among which there were 18 webs, 15 glotto subglottic stenosis, 43 sub-glottic stenosis and 3 atresias. For each one of these anomalies, clinical features, radiologic evaluation, endoscopic findings and treatment are reviewed. PMID- 6509694 TI - [Obstruction due to congenital tracheal and bronchial stenosis]. AB - Report of seven cases of congenital tracheal and bronchial stenosis in infants, successfully treated by endo-resection (2 cases), tracheoplasty (1 case) and resection with anastomosis (4 cases). The review of several cases of literature let to emphasize some points: the frequency of severe manifestations since neonatal period and during the first months leading to repeated hospitalisations with the treatening of broncho-pulmonar infections; the necessity of early diagnosis and complete anatomic evaluation of stenosis, which sometimes requires to be promptly treated in front of a sudden recurrence of respiratory distress; at last, improvements of reconstructive surgical technique, tracheoplasty for diffuse stenosis, endo-resection or resection with anastomosis for segmental lesions, which the results point out the possibilities and indications of that surgery in the infants. PMID- 6509695 TI - [Tracheomalacia in esophageal atresia]. AB - On the basis of a series comprising 154 cases of Type III oesophageal atresia and 19 cases of Type I oesophageal atresia the authors have tried to define the place of tracheomalacia in association with oesophageal atresia. We have studied a certain number of technical and anatomical factors as well as the relation of tracheomalacia to the other complications, in order to class more precisely the therapeutic solutions available. PMID- 6509696 TI - [Bronchogenic cysts compressing the trachea and main bronchus]. AB - 21 cases of bronchogenic cysts and 8 cases of oesophageal duplications obstructing trachea and main bronchus are described. These mediastinal obstructing cysts should be recognized very early to avoid complications: respiratory distress and destroyed lung particularly. Surgery is not difficult and the results are good. 28 children are alive with no symptom and one death only occurred. PMID- 6509697 TI - [Digestive duplications compressing the trachea and main bronchi]. AB - Digestive duplication affecting the oesophagus is rare, and forms causing compression of the airways are even more so. We prefer to distinguish these lesions from bronchogenic cysts and have collected 8 cases: 6 of Jaubert at Beaujon and 2 personal. The group includes 6 boys and 2 girls. PMID- 6509698 TI - [Tracheobronchial compression by congenital tumors]. AB - The writer reports on 21 observations of congenital cervicomediastinal tumors with respiratory distress by tracheo-bronchic compression (7 cystic hygromas, 4 hemangiomas, 8 teratomas, 2 thymic cysts), and review the literature about: frequence of respiratory troubles caused by these tumors (44% among benign mediastinal tumors, younger than 2 years child); and their etiopathology: tracheal compression by tumor (cystic hygroma, teratoma), tracheal invasion (hemangioma), post surgical tracheomalacia, nervous lesions; diagnostic (Xray, TDM, endoscopy) and therapeutic (intubation, tracheostomy) accessments in pre and postoperative periods. PMID- 6509699 TI - [Abnormal aortic arch in children and infants. Experience in 322 cases]. AB - The authors report on their experience in 322 cases of aortic arch anomalies surgically treated in infants and children. The progress recently achieved through improved diagnosis and resuscitation care have made possible to obtain good results in the great majority of cases. PMID- 6509700 TI - Is Planorbarius metidjensis compatible with Schistosoma haematobium and S. bovis? AB - On the basis of laboratory snail infection experiments it is concluded that Planorbarius metidjensis is unimportant in the epidemiology of Schistosoma haematobium in North West Africa. 410 P. metidjensis Spain were exposed to 8 isolates of S. haematobium from Ghana, Kenya, Madagascar, Mauritius, Morocco, Tanzania, South Africa and Sudan. 50 P. metidjensis Morocco and 50 P. metidjensis Algarve were exposed to S. haematobium Morocco. All infections failed to develop to maturity. Serial sections of P. metidjensis Morocco infected with S. haematobium Morocco at 24 h, 48 h and 72 h post infection showed that 34% of the miracidia penetrated the snail epithelium, but young sporocysts were encapsulated and killed by an ameobocytic host response. Two hypotheses are postulated to explain the reports in the literature that P. metidjensis transmits S. haematobium. The dual infectivity of B. truncatus and B. africanus by S. haematobium from Guinea Bissau suggests that this isolate is probably an infraspecific hybrid with enhanced intermediate host infectivity. By analogy with work on Biomphalaria glabrata and S. mansoni, field observations of P. metidjensis transmitting S. haematobium could be explained if the snail had been previously infected with a compatible digenean, thus rendering a refractory snail into a susceptible snail. S. bovis Spain is compatible with P. metidjensis Morocco, Portugal and Spain with 14.3%, 29.2% and 73.3% of the snails respectively surviving the prepatent period becoming infected. P. metidjensis Spain is refractory to S. bovis Iran and Sudan. Thus, P. metidjensis may be important in the epidemiology of S. bovis in the Iberian Peninsula and North West Africa. PMID- 6509701 TI - [7th epidemic of cholera in Maghreb. Epidemiologic data compared]. AB - Epidemiological characteristics are very similar into the concerned countries. From official data of Algeria and Tunisia, authors described the main variables: distribution in age, seasonal variations and secular trends. Case fatality rate is similar in the two countries (between 5 and 8%). PMID- 6509702 TI - [Infection by hepatitis B virus among expatriates]. AB - Anti-Hbs antibodies have been sought in 545 expatriates having a total sojourn in endemic areas of 3,340 years. The results permit evaluating the frequency of contaminations in endemic areas at 1 for 175 year-expatriates, while it is 1 for 700 year-subjects in the not-expatriate group. This risk seems to justify vaccination against hepatitis B of persons who are to be assigned for long periods in endemic areas. PMID- 6509703 TI - [Human cryptosporidiosis: a propos of 4 cases]. AB - Cryptosporidiae are ubiquitous protozoan belonging to the coccidiae family which parasite many wild and domestic animals bowels. Man gets infested by ingestion oocysts. The parasite complete cycle takes place on the surface of intestinal epithelial cells microvillosities. Human cases that we described occurred among patients presenting (or not) with acquired or congenital immunity depression. Diarrhea is the main symptom. Diagnosis is based on parasitological stool examination and pathological study of intestinal biopsies. At the present time no specific treatment is known and only the immunity deficit correction can possibly cure cryptosporidiosis. PMID- 6509704 TI - [Cryptosporidiosis: apropos of 11 cases]. AB - Fecal samples of 61 patients were investigated for Cryptosporidium: it was identified in four cases of acquired immunodeficiency syndrome, five cases of lymphadenopathic syndrome, one case of immunosuppressive therapy. One person was immunocompetent but in close contact with one of the patient. The authors report clinical and epidemiological characteristics of the 11 patients. PMID- 6509705 TI - [Heterohemagglutinins in human malaria: immunopathologic implications]. AB - The prevalence of heterohemagglutinins was investigated both in sera of Africans from a malaria endemic area of Upper Volta and in sera of individuals with acute malaria from a parisian hospital. Hemagglutinins against horse, sheep, goat, chicken, pigeon and duck red blood cells were tested. The results showing an increased frequency of high titres of these hemagglutinins are discussed in terms of the mechanisms leading to autoantibody hyperproduction in malaria. PMID- 6509706 TI - [Clinical aspects of Kaposi's disease]. AB - Three forms of Kaposi's sarcoma are now described: European and Mediterranean forms; they have been described first, are more frequent in old people, and characterised by angiomatous plaques and nodules; the evolution is slow with relapses and remissions. African forms. They are more frequent in young people; clinical features are different with verrucous and tumoral aspects; the evolution is the same with relapses and remissions. In Eastern Africa forms involvement of the lymph nodes are seen; the evolution is rapid above all for children beneath 10. American forms. They appeared recently, in 1981. They are seen in young homosexuals, middle aged about 32, and related to A.I.D.S.; the evolution is severe without remissions and with visceral involvement. If you compare those 3 different forms, you can see that only when associated with A.I.D.S. Kaposi's sarcoma present a complete and permanent immunodeficiency. PMID- 6509707 TI - [Histopathology of Kaposi's sarcoma]. AB - After reviewing the histo-pathological characteristics of Kaposi's sarcoma, the authors show particular patterns of this disease in equatorial Africa (especially Cameroon). They note 3 associations with lymphomas, with special emphasis on 13 new observations of general lymph node enlargement in children. For 2 of these cases, remissions were observed. Finally, they stress the lack of information on the histogenesis with the mysterious links between lymphocytes and Kaposi's sarcoma. PMID- 6509708 TI - [Epidemiology of Kaposi's sarcoma in Africa]. AB - The epidemiology of Kaposi's sarcoma in Africa south of the Sahara is reviewed. The disease is characterized by its high incidence in natives only and by the presence of the lymphadenopathic form of children with fast evolution, but is otherwise not very different from the classical form. Incidence increases with age. The mean younger age of patients is a consequence of the demographic structure. The disease prevails always in males even, though to a lesser extent, in children. Maximal incidence is observed in the center of the continent and decreases at distance from the equator. No defined risk factor has been identified, geographical, tribal or socio-economical. Associations to other malignancies, especially lymphomas, appear uncommon in Africa, but might be underestimated. The three main clinical forms of the disease are probably epidemiologically different and the infantile form could be related to some unidentified immunosuppressive factor. The disease appears ancient in Africa and not directly related to the present A.I.D.S. epidemic, though a recent increase in aggressive Kaposi's sarcoma cases may be associated with it. PMID- 6509709 TI - [Kaposi's sarcoma overseas (according to the Overseas Pasteur Institutes]. PMID- 6509710 TI - [Kaposi's sarcoma in Madagascar. 1954-1982]. PMID- 6509711 TI - Mediterranean Kaposi's sarcoma: preliminary communication about 131 cases. PMID- 6509712 TI - [Kaposi's sarcoma in Israel: epidemiologic data, 1960-1980]. PMID- 6509713 TI - [Kaposi's angiosarcomatosis in the indigenous population of Algeria]. PMID- 6509714 TI - [A proposal for an epidemiologic indicator. Apropos of 118 cases of Kaposi's disease]. AB - On the basis of 118 cases of Kaposi's sarcoma observed in different African countries, the authors study the distribution of this disease according to age and sex. They suggest a test to compare various populations independently of their behaviour versus medical structures. The test is based on a simultaneous study of Kaposi's sarcoma and malignant melanoma. It includes the calculation of a sex- standardised ratio. PMID- 6509715 TI - [Kaposi's sarcoma and AIDS]. PMID- 6509716 TI - [Treatment of Kaposi's sarcoma]. AB - To conclude, no completely satisfactory form of therapy is available at the moment. Combinations are always desirable: either radiotherapy and chemotherapy or interferon and monochemotherapy. However, the choice of therapeutic schedules depends both on the availability of the drugs which is obviously quite different in developing countries including Central Africa, and on the extent of Kaposi's Sarcoma. It is therefore always advisable to carry out a pre-therapeutic examination to assess the extent of the Kaposian lesions. This requires endoscopic, digestive and bronchial examinations and also histological biopsies. The examination should also include a search for the many opportunistic infections which could be associated. PMID- 6509718 TI - [Malaria in 1984: an alarming reality]. PMID- 6509717 TI - [Echocardiography in the diagnosis of coronary heart disease]. PMID- 6509719 TI - [Malaria--how to protect the traveler in 1984]. PMID- 6509720 TI - [Acquired immunodeficiency syndrome--AIDS]. PMID- 6509721 TI - [AIDS and blood products]. PMID- 6509722 TI - Identification of constraints acting on motor development in young visually disabled children and principles of remediation. AB - Babies and preschool children with severe visual disabilities have been studied in a developmentally orientated clinical research setting. Severe congenital visual disability delays and alters development in all areas; the impact on motor development is complex with much secondary to delays in other areas. The constraints on motor development are identified and discussed together with ideas for remediation and developmental prevention. PMID- 6509723 TI - Cerebral high energy phosphates after hypoxic-hypotension: effect of verapamil and nifedipine. AB - Rats were subjected to 30 minutes of hypoxic-hypotension and then allocated to one of four treatment groups. Group I was resuscitated by restoration of FIO2 = 30% and reinfusion of shed blood plus an equal volume of additional saline. Group II received in addition nifedipine, 10 micrograms/kg, and groups III and IV received in addition either verapamil, 0.2 mg/kg or 1 mg/kg, respectively. Significantly (P less than 0.01) higher concentrations of creatine phosphate and ATP were present in the brain after nifedipine and after 1 mg/kg verapamil treatment. PMID- 6509724 TI - Organ blood flow and the cause of death following massive hemorrhage. AB - We tested the hypothesis that death occurring shortly after massive hemorrhage can be attributed to the development of positive feedback loops arising from deficient blood flow to one or more vital organs such as the heart, brain, and respiratory muscles. The radiomicrosphere technique was used to measure organ blood flow in unmedicated, chronically instrumented swine subjected to removal of 41 ml/kg of blood in 15 min. Ten swine survived the experiments and five died, all within 2 hr after completion of hemorrhage. Cardiac output but not blood pressure was lower in nonsurvivors (mean +/- 1 SD). No difference was found in regard to blood flows to the heart, brain, and diaphragm (flow in ml/gm/min) between survivors and nonsurvivors. Although blood flow posthemorrhage to kidney, organs of the splanchnic bed, and the carcass tended to be greater in survivors compared to nonsurvivors, the difference reached statistical significance only in the small intestine. We conclude that in this model there is no evidence that death following massive hemorrhage results from positive feedback loops arising from deficient perfusion of the coronary or cerebral circulation. It is more likely that death results from abnormalities arising in the carcass and/or splanchnic bed. PMID- 6509725 TI - Increased survival of endotoxin-injected dogs treated with methylprednisolone, naloxone, and ibuprofen. AB - The effects of methylprednisolone, naloxone, and ibuprofen--alone and in various combinations--on survival, blood pressure, hematocrit, and peripheral platelet and white blood cell counts were studied in a canine Escherichia coli endotoxin LD100 shock model. Treatment was started 10 minutes after shock induction. The dogs were kept on a respirator and given intravenous fluids for 4 hours, then disconnected from the respirator and allowed to recover. Dogs surviving 7 days were considered permanent survivors. All control animals died within 36 hours. Five of nine dogs receiving a combined treatment of methylprednisolone, naloxone, and ibuprofen were permanent survivors and showed no macroscopic abnormalities when autopsied. The combined treatment with methylprednisolone and ibuprofen also increased survival. Mortality was delayed in animals treated with methylprednisolone and naloxone. Dogs receiving ibuprofen, a cyclooxygenase inhibitor, had a rapid reversal of hypotension. Hematocrit and platelet counts were similar in all groups. The combined treatment caused an increase in the recovery rate of white blood cells. PMID- 6509726 TI - Effect of burn shock on myocardial function in guinea pigs. AB - The effect of burn shock on myocardial function was studied using an isolated working heart preparation. Guinea pig hearts were studied 2-, 4-, and 8-hr following burn injury as well as in time-matched controls. The hearts were excised from both burned (35% body surface area) and unburned unresuscitated animals, and ventricular function curves were generated on each heart. The 4- and 8-hr postburn hearts, particularly the 4-hr group, exhibited depression in cardiac output, stroke volume, coronary flow, peak systolic pressure, mean aortic pressure, estimated myocardial work, stroke work, and oxygen consumption when compared to controls. The ventricular function curve for the 4-hr postburn hearts was shifted to the right indicating a decrease in contractility, which complements a decrease seen in compliance. These pronounced changes seen in the 4 hr postburn hearts were not observed 2 hr after burn injury. The data suggest that intrinsic myocardial function following burn injury is depressed and the degree of dysfunction is influenced by the time from thermal injury. PMID- 6509727 TI - Depression of left ventricular performance during canine splanchnic artery occlusion shock. AB - We studied canine left ventricular contractile performance following splanchnic artery occlusion (SAO) shock. We evaluated contractile performance by analyzing the left ventricular end systolic pressure-diameter relationship (sigma ES) because we have previously shown that sigma ES is independent of large changes in preload, afterload, and heart rate but sensitive to changes in ventricular contractility. Following release from 2 hours of SAO, seven dogs survived, five expired immediately, and ten expired between 0.5 and 3.5 hours (termed nonsurvivors, [NS]). The NS dogs exhibited slight tachycardia, slight increase in total peripheral resistance, marked decreases in +dP/dt, cardiac output, arterial blood pressure, stroke volume, and stroke work. Ventricular performance (sigma ES) declined with time following SAO release in the nonsurviving dogs; in contrast, surviving animals exhibited an augmentation of sigma ES during SAO and following SAO release. Sham dogs exhibited no time-dependent changes in sigma ES. The dogs that expired immediately following SAO release exhibited a precipitous decline in sigma ES from 43.0 +/- 9.0 to 23.0 +/- 4.8 mm Hg/mm within minutes of SAO release. We analyzed these data by Cox multiple regression analysis to determine the major covariates of survivability. The analysis revealed that sigma ES at the midpoint in time between SAO release and death was best correlated with the survival function. These results suggest that cardiovascular collapse of SAO shock is associated with an early and sustained loss of ventricular contractility. PMID- 6509728 TI - Local blood flow changes in the renal cortex during tourniquet and burn shock in rats. AB - Intermittent patchy ischemia in the renal cortex has been observed in dogs during traumatic shock. In search of a model for further studies of this phenomenon in anesthetized rats, we induced tourniquet shock by bilateral hindlimb occlusion for 3 1/2 h, and burn shock by scalding the hind 50% of body surface for 30 sec in 90 degrees C water. Local cortical blood flow (RCF) was repeatedly measured by the H2-washout technique. After releasing the tourniquets, mean arterial pressure (AP) and RCF decreased by 44 and 68% whereas hematocrit (Hct) rose to 66 vol%. Only two episodes of local ischemia were observed. After scalding, Hct first fell to 49 vol%, probably due to hemolysis, but rose toward 54 vol% in the next 2 h. Following an initial drop to 99 mmHg, AP was relatively well maintained throughout the experiment. The RCF fell to 53% of control within 15 min with a further decrease to 40% during the next 2 h. The cortical vascular resistance was increased by 89%. Increased local flow heterogeneity and episodes of patchy intermittent ischemia were observed in six out of eight rats. During the second hour postburn, 21% of the washout curves showed abrupt shifts of washout rates, indicating local cortical ischemia. The burn shock model seems well suited for studies of the mechanisms causing intermittent local ischemia. PMID- 6509729 TI - Methylprednisolone plus ibuprofen increases mortality in septic rats. AB - Steroids and cyclooxygenase inhibitors have been advocated as adjunctive treatment for sepsis. We studied the influences of these treatments on the survival of 98 male Sprague-Dawley rats in which sepsis was induced by cecal ligation and puncture. Rats received one of four treatments: sodium chloride (NaCl); methylprednisolone, 30 mg/kg (MP); ibuprofen, 12.5 mg/kg (I); methylprednisolone, 30 mg/kg, plus ibuprofen, 12.5 mg/kg (MP + I). Cumulative survival statistics were determined daily for 14 days thereafter. Survival was not altered by either MP or I when compared to animals receiving NaCl only. However, the combination of MP + I increased mortality from day 2 through day 14. The authors conclude that (1) MP administration alone does not increase mortality in septic rats; therefore, the results do not support the contention that steroid treatment in the absence of antibiotic therapy may be detrimental; (2) the cyclooxygenase inhibitor I does not improve survival in septic rats; and (3) the combined administration of MP and I increases mortality in septic rats and the possibility that this combination might be harmful in septic patients should be considered also. PMID- 6509730 TI - Bradycardia during severe but reversible hypovolemic shock in man. AB - Severe bleeding and hypovolemic shock causing hypotension are most often associated with tachycardia. In response to passive head-up tilt, five healthy men exhibited an increase in heart rate (HR) from 62 to 79 beats X min-1 and a gradual increase in the plasma concentration of aldosterone and protein. The increase in HR was followed by a decrease of 29 beats X min-1 (range 11-46) at the time when blood pressure decreased 38 mmHg (6-73). When tilted back to 0 degree, blood pressure immediately reversed while HR remained unchanged. Hypotension was associated with large but variable increases in plasma vasopressin (86 +/- 28 pg X ml-1) accompanied by peripheral vasoconstriction. In two cases where patients with internal bleeding presented with a moderate HR of 96 beats X min-1, the ensuing fall in blood pressure was associated with a decrease in HR to 68 and 76 beats X min-1, respectively. Administration of albumin solution and blood normalized cardiovascular function. Two other patients showing initial HR of 130 and 100 beats X min-1, respectively, also developed relative bradycardia in conjunction with a decrease in blood pressure. Administration of ephedrine and atropine increased HR temporarily from 56 to 90 and from 36 to 110 beats X min-1, respectively. The latter two patients died in extreme bradycardia and autopsies revealed severe internal bleeding. It is concluded that although hypovolemic shock is most often associated with an increase in HR, the increase is modest and a paradoxical bradycardia develops in severe but potentially reversible hypotensive hypovolemic shock. PMID- 6509731 TI - [Ectopic localization of adult Schistosoma japonicum in the kidney]. PMID- 6509732 TI - [Effect of control measures in schistosomiasis observed by the annual incidence in a risk population in the Philippines]. PMID- 6509733 TI - [Effect of albendazole in the treatment of 269 cases of intestinal nematode infection]. PMID- 6509734 TI - [Preliminary observation on praziquantel in the treatment of paragonimiasis sichuanensis]. PMID- 6509735 TI - [Severe side effects of pyquiton in the treatment of 9 cases of schistosomiasis]. PMID- 6509736 TI - [Detection of Schistosoma japonicum antigens and antibodies by K-ELISA]. PMID- 6509737 TI - [Studies on the microsomal antigens of Schistosoma japonicum. II. Extraction, fractionation and chemical and immunological properties of microsomal antigens of adult worms]. PMID- 6509738 TI - [Scanning electron microscopy of Fasciolopsis buski expelled from patients treated with pyquiton]. PMID- 6509739 TI - [The spreading of Oncomelania snails due to shrimp-catching during the ebb-tide of lakewater in Yueyang City]. PMID- 6509740 TI - [Female genital schistosomiasis and tubal pregnancy]. PMID- 6509741 TI - [Experimental therapy of hepatic fibrosis in schistosomiasis japonica. II. Effect of colchicine on hepatic fibrosis]. PMID- 6509743 TI - [Changes in the reedland and snail distribution in Jiayu County]. PMID- 6509742 TI - [Effect of artemether on the tegumental surface antigen of Schistosoma japonicum]. PMID- 6509744 TI - [Cultivation of Giardia lamblia and observation on its binary fission process]. PMID- 6509745 TI - [Clinical observation on 121 cases of acute schistosomiasis treated with pyquiton]. PMID- 6509746 TI - [Immunogenicity of secretion materials of the acetabular glands of Schistosoma mansoni cercariae]. PMID- 6509747 TI - [Continuous cultivation of erythrocytic Plasmodium cynomolgi in vitro]. PMID- 6509748 TI - [Follow-up of 23 cases of paragonimiasis treated with bithionol]. PMID- 6509749 TI - [Assay of superoxide dismutase activity in the peripheral blood cells of patients with schistosomiasis]. PMID- 6509750 TI - [Analysis of recurrent snail spots in Suzhou Prefecture in 1982]. PMID- 6509751 TI - [Observation on the fecal egg count in 10 cases of schistosomiasis over a 16 month period]. PMID- 6509752 TI - [Pathological changes and clinical types in advanced schistosomiasis]. PMID- 6509753 TI - [Allergic manifestation after pyquiton treatment of schistosomiasis]. PMID- 6509754 TI - [New developments in the clinical study of praziquantel]. PMID- 6509756 TI - [Observation on the radula of Oncomelania from four counties in Guangxi]. PMID- 6509755 TI - [Studies on the mechanism of the antischistosomal action of praziquantel]. PMID- 6509757 TI - [Measures and effects of schistosomiasis control in Liuhe Commune, Sanshui County]. PMID- 6509758 TI - [Control measures of schistosomiasis in the hilly and mountain regions of Pingguo County]. PMID- 6509759 TI - [A case of acute schistosomiasis complicated with spinal cord disorders]. PMID- 6509760 TI - [A case of mammary schistosomiasis complicated with breast cancer]. PMID- 6509761 TI - Hyaluronic acid. PMID- 6509762 TI - Syneresis: a forgotten culprit. PMID- 6509763 TI - Aspheric silicone lenses for keratoconus. PMID- 6509764 TI - Refining toric soft contact lens prescriptions. PMID- 6509765 TI - A new bandage lens for treatment of corneal disease: Softcon XT. PMID- 6509766 TI - The spectrum of bronchial asthma in Kuwait. AB - Kuwait, situated in the north-west corner of the Arabian Gulf, has an arid climate with very hot dry summers and mild winters. Sandstorms are a regular climatic feature, occurring most frequently in summer. Before the mid-1950s allergy was not considered to be a problem. Since then it has become a major cause of morbidity; 18% of the population are reported to suffer from its manifestations. Over the past 3 years 1000 asthmatic patients attending a central clinic have been carefully studied. The present paper analyses various aspects of the asthmatic condition in this desert country. PMID- 6509767 TI - Relationship of diet in the development of atopy in infancy. AB - We examined the relationship of diet to the development of atopic manifestations in a group of infants with an immediate family history of atopy, followed prospectively from birth for up to 20 months of age. There was no relationship between the development of atopic dermatitis, rhinitis and wheeze and either 2 or 4 months exclusive breast feeding, or the introduction of cow's milk or solids in the first 4 months of life. In addition there was no relationship between the introduction of milk, egg or wheat into the diet and the development of skin-test positivity to these foods. In fact, five infants developed positive skin tests to the food prior to its introduction into the diet, suggesting exposure via maternal breast milk. Thus we have been unable to show a protective effect of either breast feeding or cow's milk or solid avoidance on the development of atopic disease in infancy. PMID- 6509768 TI - Passage of cows' milk protein in breast milk. AB - An enzyme-linked immunosorbent assay has been used to search for lactoglobulin and bovine casein in breast milk. Initial results suggest this may be a simple and useful method for such studies. Detection and prevention of antigen passage could influence the prevalence of atopic disease. PMID- 6509769 TI - Reproducibility of skin tests. A comparative study of the Pepys prick test and the Morrow-Brown needle and their correlation with the serum IgE level. AB - Fifty patients allergic to mite were tested for D. pteronyssinus using two prick test techniques; the classical method by Pepys and the Morrow-Brown needle. Each patient received six tests with each method on the two forearms. The evaluation of the weal areas was conducted in two ways: by weighing the shapes of the tests transferred on to paper, and by measuring the two greatest diameter lengths. No significant difference was observed between the two methods. No significant difference was observed between the measurements of the same tests carried out at 2-monthly intervals by the same examiner. With the Pepys method the weal area sizes are significantly larger than with the Morrow-Brown needle, and the variance is much greater with the Pepys technique. However, the coefficients of variation are similar and in both cases the techniques are equally reproducible. No significant difference was found in the weal sizes with regard to the injection sites on the forearm with either of the two methods. The correlation between the weal area sizes and the log of the IgE levels is closer with the Morrow-Brown needle. PMID- 6509770 TI - Allergic urticaria and hereditary angioedema. Independent association in the same patient. AB - A patient presented with both allergic urticaria and hereditary angioedema. The two conditions occurred independently, the urticaria being associated with allergy to food (which could be managed by control of the diet), whereas the angioedema was associated with C1 esterase inhibitor deficiency. PMID- 6509771 TI - Lipase assay in duodenal juice using a conductimetric method. AB - Lipase activity in duodenal juice is known to undergo important variations in pathologic states, especially in cases of chronic pancreatitis. Almost all of the current assay methods are based on the measurement of hydrolysis of olive oil or triolein, mainly by potentiometry. As we have developed a conductimetric method for enzyme activity measurements, we have applied it to lipase assay. A higher experimental conductimetric sensitivity is obtained when liberated acids have a short chain (higher limiting equivalent conductivity). We have therefore used triacetin as a substrate and compared out method with potentiometry (pH-stat) and spectrophotometry. The correlation coefficients of both methods with conductimetry were 0.94 and 0.97, respectively, indicating that the conductimetric method may be used for lipase assay in duodenal juice, using triacetin as a substrate. PMID- 6509772 TI - Studies of phenylalanine hydroxylase activity in patients with chronic renal failure: the effect of haemodialysis. AB - The effect of serum from patients with renal failure on phenylalanine hydroxylase activity has been measured in normal individuals, patients with steady-state chronic renal failure and patients undergoing haemodialysis. Significant inhibition of enzyme activity was induced by serum from patients with steady state chronic renal failure but not from patients undergoing haemodialysis. Inhibitor(s) was readily diffusible in vitro and appeared to have an approximate molecular mass of 800. The results suggest that the low-plasma tyrosine levels observed in patients with chronic renal failure are due, at least in part, to the inhibition of phenylalanine hydroxylase. PMID- 6509773 TI - A new enzymatic serum creatinine measurement based on an endogenous creatine eliminating system. AB - We describe a new colorimetric determination of serum creatinine which does not require a blank to correct for endogenous creatine. In the first reaction, creatinase (creatinase amidinohydrolase EC 3.5.3.3) and sarcosine oxidase (sarcosine: oxygen oxidoreductase (demethylating) EC 1.5.3.1) were used in the enzymatic hydrolysis of endogenous creatine to produce hydrogen peroxide. In the presence of horseradish peroxidase, 2,4-dichlorophenolsulfonate (2,4-DCPS) was converted to a colorless polymer by hydrogen peroxide. In the second reaction, creatininase (creatinine amidohydrolase EC 3.5.2.10) and 4-aminoantipyrine (4-AA) were added, and only the creatine generated from creatinine by creatininase was hydrolyzed sequentially by creatinase and sarcosine oxidase to produce hydrogen peroxide. This newly-formed hydrogen peroxide was measured at 510 nm in a coupled reaction catalyzed by peroxidase, with 2,4-DCPS/4-AA as a chromogen. The standard curve was linear up to 20 mg/dl; 40 microliter of serum and 20 min were required for determination. Analytical recovery of creatinine added to either normal or abnormal sera averaged 98.5%. Within-day and day-to-day studies gave CV values of less than or equal to 2.9% and less than or equal to 4.8%, respectively. No significant interferences were observed with the proposed method. The results obtained by the present method correlated well with those obtained by the Jaffe procedure. PMID- 6509774 TI - Amniotic fluid alkaline ribonuclease activity: an indicator of foetal growth retardation and anencephaly. AB - Amniotic fluid alkaline ribonuclease (RNase) activity was measured in 55 normal and 29 neural tube defect pregnancies. The pregnancies which resulted in neural tube defects gave a mean value of 2,500 U/l with a SD of 600 compared with a mean activity of 1,600 U/l (SD 350) from the control normal pregnancies. The mean amniotic fluid RNase activity of 15 anencephalic pregnancies was 2,600 U/l (SD 600), compared with 1,600 U/l (SD 350), for 28 gestational age-matched controls. Highest RNase activities appear to be related to anencephaly. PMID- 6509775 TI - Improved electrophoretic resolution of bone and liver alkaline phosphatases resulting from partial digestion with neuraminidase. PMID- 6509776 TI - Increased leukocyte aggregation in patients with hypercholesterolaemia. AB - Leukocyte aggregation induced by N-formylmethionyl-leucyl-phenylalanine (FMLP) has been measured in a group of patients with hypercholesterolaemia (n = 22) and in a group of control subjects (n = 26), age- and sex-matched. When hypercholesterolaemic patients were divided into two groups, with a discriminatory level of 7.7 mmol/l of plasma cholesterol, FMLP-induced leukocyte aggregation of patients with greater than 7.7 mmol/l of plasma cholesterol was significantly higher compared both with control subjects and patients with plasma cholesterol levels less than 7.7 mmol/l. A positive significant correlation was found between leukocyte aggregation and plasma cholesterol, whereas no correlation was observed between leukocyte aggregation and plasma triglycerides or APO-B levels. These findings provide further support for the hypothesis that elevated plasma cholesterol levels may induce a cellular membrane abnormality responsible for the increased leukocyte aggregation and, subsequently, endothelial damage. PMID- 6509777 TI - Chromatographic behavior of immunoglobulin-bound creatine kinase on DEAE-Sephadex A-50. AB - We investigated the chromatographic behavior of CK isoenzymes and immunoglobulin bound macro-CK by discontinuous gradient elution from DEAE-Sephadex A-50 at pH 7 and 8. In four of five patients with macro-CK, the macro-CK was eluted with the MB buffer at pH 8, but a significant portion of the complex was eluted with the MM buffer at pH 7, in a region between CK-MM and CK-MB. In the fifth patient, the macro-CK was eluted with the MB buffer at both pH values. The immunoglobulin patterns of all five patients and of normal serum showed that IgG and IgM are eluted mainly with the MM and MB buffers, respectively, at both pH values, whereas IgA is eluted mainly with the MB buffer at pH 8, but at pH 7, shows a significant shift similar to that of macro-CK. These characteristic patterns allowed the identification of the immunoglobulin in macro-CK as IgA in the first four patients, and as IgM in the fifth patient. PMID- 6509778 TI - Fractionation of cystine aminopeptidases ('oxytocinase') from term human placenta and maternal serum. AB - Cystine aminopeptidase (EC 3.4.11.3) enzymes, present in term human placenta and maternal serum, were compared with respect to their behaviour on ion-exchange columns, Km and pH optima, chelator, metal ion and L-methionine effects, Sepharose 6B elution profiles and molecular weights. From placental extracts two activity peaks (CAS I and II) hydrolysing S-benzyl L-cysteine paranitroanilide were separated on DEAE Sephacel. Differences in properties between the two forms were evident. Maternal serum enzyme eluted from the DEAE Sephacel column in a position similar to that of placental CAS I. In addition, the maternal serum enzyme was similar in properties to placental CAS I. It is possible that of all the different cystyl aminopeptidase enzyme systems present in placental tissue, only one appears in maternal blood. PMID- 6509779 TI - Effect of storage on the precipitation procedure for the measurement of HDL subclasses in serum. PMID- 6509780 TI - A rapid method for erythrocyte membrane phospholipid determination. PMID- 6509781 TI - Effect of 'physiological' doses of triiodothyronine replacement on the hormonal and metabolic adaptation to short-term semistarvation and to low-calorie diet in obese patients. AB - In four groups of obese patients matched for Body Mass Index (BMI), we studied the effects of different 3-week semi-starvation treatments followed by an 8-week hypocaloric (1008 kcal, protein 20%, carbohydrate 40%) diet with or without low doses of T3 therapy. Dietary intake (formula diet) in the semi-starvation period was 480 kcal, with 66 g protein (P) and 51 g carbohydrate (CHO) in groups I and III and with 33 g P and 84 g CHO in groups II and IV. Moreover, groups III and IV were given low doses (20 micrograms twice a day) of T3 while groups I and II received a placebo. During semi-starvation periods, a similar fall in BMI values was found in all groups, while during the low-calorie diet, T3-treated patients showed the greater BMI reduction. During semi-starvation, nitrogen balance was significantly more negative in low-protein than in high-protein-treated groups; differences between T3-treated (III and IV) and control (I and II) groups were not significant over this relatively short treatment period. No differences in 24 h urinary 3-methylhistidine or alanine excretion were evident between the four groups. During the entire period of study, daily urine creatinine excretion did not change in any group. In conclusion, in our study low-dose T3 therapy was seen to favour weight loss during low-calorie diet although negative effects on protein metabolism were not excluded, particularly when relatively small amounts of protein were administered. PMID- 6509782 TI - Differential TSH and PRL responses to dopamine receptor blockade in acromegaly. AB - The serum TSH and prolactin responses to dopamine receptor blockade (domperidone 10 mg i.v.) were measured in eight acromegalic subjects and seven normal controls. The serum TSH response was exaggerated in acromegalics when compared to controls (sum of the increments 12.2 +/- 2.8 mU/l and 4.0 +/- 1.2 mU/l respectively P less than 0.05), whereas the serum prolactin response was blunted (sum of the increments 5029 +/- 1377 mU/l and 14 673 +/- 2889 mU/l respectively P less than 0.01). Dopamine receptor blockade did not significantly alter basal growth hormone levels in either group. To ascertain whether this response was merely a reflection of high circulating growth hormone levels six normal controls were pretreated for 24 h with either intramuscular growth hormone (three injections of 4 IU) or an equivalent volume of saline before the administration of domperidone (10 mg i.v.). The serum TSH and prolactin responses were not affected by prior growth hormone treatment. The opposite TSH and prolactin responses to dopamine blockade do not allow any firm conclusions to be made about the level of hypothalamic dopamine activity in acromegaly. PMID- 6509783 TI - Twenty-four hour variations of thyroid hormones and thyrotrophin concentrations in hypothyroid infants treated with L-thyroxine. AB - The 24 hour plasma profile of T4, FT4, T3 and TSH was measured in a group of infants treated for congenital hypothyroidism with an oral aqueous preparation of L-T4 (5-7.5 micrograms/kg) given as a single dose at 0800 h. Mean basal plasma T4 was 8.4 +/- 2.0 micrograms/dl (mean +/- SD) and remained constant during the study while mean serum FT4 increased significantly from 1.64 +/- 0.50 ng/dl to a maximum of 2.08 +/- 0.63 ng/dl 4 h after medication. Plasma T3 decreased significantly from 241 +/- 48 ng/dl to 202 +/- 36 ng/dl 6 h after drug administration. Finally, plasma TSH decreased significantly from a mean of 24.2 +/- 18.8 microU/ml to 14.8 +/- 10.5 microU/ml 6 h later. Therefore during treatment of congenital hypothyroidism with L-T4 no specific schedule for T4 sampling is required. However, TSH determination 4 to 8 h after medication could slightly underestimate mean levels. In addition, any attempt to monitor treatment by FT4 determination should take into consideration variations of plasma values in the hours following L-T4 absorption. PMID- 6509784 TI - Transsphenoidal microsurgery for Cushing's disease. AB - Nineteen patients thought to have Cushing's disease were treated by transsphenoidal microsurgery; the type of operation performed depended upon the findings in the individual patient. Seventeen patients remitted. Failures occurred in a patient with an invasive macroadenoma and in a patient who was subsequently found to have a thymic carcinoid tumour secreting ACTH. One patient who remitted suffered a recurrence during pregnancy, 30 months after operation. The ten patients (Group I) who had a selective removal of a microadenoma or a limited resection of the gland were often GH deficient, but seven regained cortisol reserve and all ten regained normal pituitary-thyroid and pituitary gonadal responses. By contrast abnormalities of pituitary function were common in nine patients who had a radical or total hypophysectomy. We conclude that transsphenoidal microsurgery is the best treatment for Cushing's disease and that, when feasible, a selective microadenomectomy is the most appropriate operation. PMID- 6509785 TI - Low sodium diet augments plasma and tissue catecholamine levels in pithed rats. AB - Plasma and tissue (cardiac, vascular, renal, and adrenal) catecholamine concentrations were measured in pithed male Wistar rats maintained on low (10 mEq/kg diet), basal (115 mEq/kg diet), or high (1200 mEq/kg diet) sodium test diets for five weeks. Significant differences in catecholamine disposition were observed only in response to sodium restriction; responses to basal and high sodium intakes were consistently similar. Baseline plasma catecholamine levels (p less than 0.01) as well as those in response to stimulation of the entire sympathetic outflow at 4 Hz were markedly enhanced in low sodium rats (p less than 0.001). The facilitation of stimulation-induced increments in plasma norepinephrine levels in low sodium rats may be related to the finding that norepinephrine content was also elevated in noradrenergically innervated tissues (atria, ventricles, mesenteric artery, and kidneys) (p less than 0.01). Adrenal catecholamine levels, however, were not affected by dietary sodium restriction. Despite the peripheral catecholamine changes associated with a low sodium intake, pressor and tachycardic responses to sympathetic nerve stimulation were similar across dietary sodium groups. The results indicate that a low sodium intake enhances plasma and tissue catecholamine levels, adaptations that may be important in the maintenance of sympathetic responsiveness. PMID- 6509786 TI - Cardiovascular and sympathetic effects of leukotriene D4 in renovascular and spontaneously hypertensive rats. AB - Leukotriene D4 (LTD4), a constituent of slow-reacting substance of anaphylaxis (SRS-A), elicits a pressor response followed by prolonged hypotension in spontaneously hypertensive (SHR) but not in Wistar-Kyoto (WKY) rats. In order to investigate whether the depressor response to LTD4 in SHR rats is related to hypertension itself, we have studied the cardiovascular and sympathetic effects of LTD4 in 1-kidney, 1-clip hypertensive rats and 1-kidney, normotensive rats. In all groups of conscious rats, intra-arterial administration of LTD4 (0.2-20 micrograms/kg) caused dose-dependent pressor responses of similar degree except in WKY rats, which responded less. Only SHR rats developed a significant and progressive hypotension (-58 +/- 5 mm Hg) following pressor phase. In all but WKY rats, the response phase was attended by an increase in plasma levels of norepinephrine and epinephrine. Only SHR rats showed marked and persistent hemoconcentration following pressor effect. Thus, depressor response of SHR rats to systemic administration of LTD4 does not appear to be merely due to the magnitude of blood pressure elevation and may in part result from microcirculatory changes not present in other hypertensive rats. PMID- 6509787 TI - The blood pressure and metabolic effects of 19-nor-deoxycorticosterone and 19-nor progesterone in sheep. AB - The present study examines the blood pressure and metabolic effects of 5 day infusions of 19-nor-deoxycorticosterone (19-nor-DOC) and 19- nor-progesterone (19 nor-PROG) in the intact conscious sheep. Both these steroids raise blood pressure in the rat. 19-nor-DOC (5 mg/d) produced a significant increase in mean arterial pressure (MAP) of 17 mmHg on day 5 (p less than 0.001), associated with 'mineralocorticoid' effects hypokalaemia, hypernatraemia and an initial urinary sodium retention. In contrast 19-nor-PROG (5 mg/d and 50 mg/d) had no effect on MAP and displayed no 'mineralocorticoid' activity. PMID- 6509788 TI - The influence of potassium loading on the pressor and metabolic effects of 9 alpha-fluoro-cortisol in sheep. AB - 9 alpha-Fluorocortisol (9 alpha FF) is an analogue of cortisol with 'mineralocorticoid', 'glucocorticoid' and 'hypertensinogenic' activity. 9 alpha FF was infused at 2 mg/day for 5 days to sheep receiving a normal Na intake (100 mmol/d) and a high K intake (congruent to 800 mmol/d). K loading modified the Na retaining effects of 9 alpha FF but had no effect on the development of the hypertension. These experiments suggest that the effects of K loading on the development of 9 alpha-FF hypertension are not related simply to the effects that K has on modifying the Na retaining effects of the steroid. PMID- 6509789 TI - Effect of angiotensin II on vasopressin in plasma and platelets in SH and WKY rats. AB - A study was carried out of the effects of iv angiotensin II on vasopressin release and the distribution of vasopressin between platelets and plasma in 12 week old conscious unrestrained SH and WKY rats. Angiotensin II was infused at rates of 31.25 to 500 ng/kg X min for 20 min. There was an enhanced pressor responsiveness to angiotensin II in the SH rats. Angiotensin II caused a moderate increase in plasma vasopressin concentrations, but only at doses which produced maximal pressor responses (250 to 500 ng/kg X min). There were no significant differences in vasopressin responses to angiotensin II in SH compared to WKY rats. Approximately 30% of circulating immunoreactive vasopressin was found in platelets in both SH and WKY rats, and this distribution was not greatly affected by the iv infusion of angiotensin II. PMID- 6509790 TI - Cardiopulmonary hemodynamics in perinephritic hypertensive dogs: effect of intravenous volume load. AB - To investigate the role of decreased venous distensibility in the regulation of cardiac output, cardiopulmonary hemodynamic measurements were performed at rest and after a volume load (6% dextran in saline, 12 ml/kg iv) in 18 awake dogs with chronic one-kidney, one-wrapped hypertension and 9 normotensive control dogs. The distribution of blood volume between the peripheral and cardiopulmonary vascular beds and the increase in cardiac output after volume load in the two groups of dogs were the same. There was no echocardiographic evidence of left ventricular dysfunction (shortening fraction) in hypertensive dogs. The rise of heart rate after volume load in hypertensive dogs, 17 +/- 3 beats/min (mean +/- SE), was attenuated compared to that of control dogs, 38 +/- 4 (p less than 0.001). Compared to values in normotensive dogs, the in vitro left atrial pressure-volume curves of hypertensive dogs were shifted in the direction of the pressure axis (p less than 0.02). The findings do not provide a role for decreased venous distensibility in the regulation of cardiac output in chronic renal hypertension. Decreased distensibility of the left atrium may play a role in the pathogenesis of the attenuated Bainbridge effect in hypertensive dogs. PMID- 6509791 TI - Audiological investigation of chronic alcoholics. AB - Pure tone audiometry performed on 67 alcoholics showed a sensorineural hearing loss in 70% of the ears examined. The prevalence of the hearing loss was related to the duration of heavy drinking. Twenty-two subjects with hearing loss were evaluated using impedance audiometry, SISI test, tone decay test and fixed frequency Bekesy recording. The results of these tests are suggestive of a retrocochlear lesion in chronic alcoholics. PMID- 6509792 TI - The gastro-oral pathway of intestinal bacteria after head and neck cancer surgery. AB - Intestinal aerobic Gram negative bacilli (IAGB) are frequently associated with wound infection after head and neck surgery. The origin of these organisms has not been previously identified. The stomach was investigated as a potential endogenous source. Saliva was examined in 15 patients 24 h before surgery. Following surgery, saliva and gastric aspirates were cultured daily for 10 days. All feeds were sterile. Though IAGB were never isolated pre-operatively, 29 species were detected in both the mouth and stomach of 14 patients post operatively. Biochemically identical strains, initially present in the stomach, were detected 1-4 days later in the mouth in 8 patients. Three patients developed fistulae associated with IAGB but frank wound infection did not occur. Evidence demonstrating the gastric origin of faecal micro-organisms in the operative field and upper aerodigestive tract is presented and discussed. PMID- 6509794 TI - Obesity. PMID- 6509793 TI - The anatomy of the lymph nodes of the parotid gland. AB - A series of 17 parotid glands were obtained by radical parotidectomy. Between 1 and 11 lymph nodes were found in them. Superficial parotidectomy only leaves an average of 1 node in the deep parotid. There is a 1 in 4 chance of there being no nodes left. There were no nodes easily accessible immediately under the deep part of the parotid gland. There seems to be a discrepancy between the number of nodes found in a radical surgical specimen and serial sections of the area. This suggests a significant number may be left in the skin flap. The place of excision of this skin is discussed. PMID- 6509795 TI - Modulation of macrophage suppressive activity and prostaglandin release by lymphokines and interferon: comparison of alveolar, pleural and peritoneal macrophages. AB - In order to better characterize the mechanisms which regulate the immune response at the pulmonary level, the effects of beta-interferon (IFN-beta) and lymphokines (LK) on prostaglandin E (PGE) release and the suppressive capacity of mouse resident alveolar (AM phi) and pleural macrophages (PlM phi) were investigated in comparison with peritoneal macrophages (PM phi). After in vitro exposure to IFN beta, PlM phi and PM phi showed a significant decrease of suppressive capacity and PGE release, whereas LK treatment did not affect such activities. In contrast, pre-treatment of AM phi with LK caused a strong impairment of their suppressive capacity. This effect was optimal after an incubation time of 20 h, was evident also at very low doses of LK and was not paralleled by any change of PGE release. Again in contrast with PlM phi and PM phi, suppressive capacity of AM phi was decreased only by very high doses of IFN-beta, whereas lower doses caused either an increase or no change of this activity. Furthermore, PGE release by AM phi was markedly increased after treatment with IFN-beta. Thus, suppressive capacity of AM phi appears to be controlled by different mechanisms from those of PlM phi and PM phi. In addition, a dissociation is evident between suppressive capacity and PGE release by AM phi. PMID- 6509796 TI - Studies on the enhancement of human eosinophil function by mononuclear cell products in vitro. AB - Previous studies have shown that human mononuclear cells produce during culture an activity that enhances the functional properties of mature eosinophils, including their helminthotoxic potential (Veith & Butterworth, 1983). We have now found that the enhancing activity in mononuclear cell culture supernatants (MCS) is stable to dialysis for 24 h at pH 2 and sensitive to trypsin (0.1 mg/ml). It has a principal pI of 4.4 and possible secondary peaks with pI values of 5.0 and 5.7. The effect of MCS on eosinophils appears to be a general early stimulation of several functions. In comparison with eosinophils incubated in medium only, the proportion of eosinophils with Fc receptors is increased after incubation with MCS for 3.5 h (39 +/- 11% vs 16 +/- 3%) and 7 h (28 +/- 4% vs 17 +/- 3%). The temperature-dependent phase of eosinophil adherence to antibody coated schistosomula is enhanced after 3-4 h. The uptake of deoxyglucose is enhanced after a 1 h pre-incubation with MCS (24 +/- 1 X 10(3) d/min), compared with that of controls (15 +/- 2 X 10(3) d/min). Whether these effects are due to one mediator in MCS awaits further investigation. PMID- 6509797 TI - Polymorphonuclear leucocyte locomotion and aggregation in patients with alcoholic liver disease. AB - Defects in stimulated movement of polymorphonuclear (PMN) leucocytes was detected in 57% of patients with alcoholic liver disease. Serum from patients with the cellular defect had no effect on the function of normal PMN leucocytes. Aggregation responses of patients' PMN leucocytes suggest that the cellular defect may be related to specific abnormalities in the response to the C5a chemotactic factor. Defective serum attractant activity was found in 65% of the patients tested and the presence in the patients serum of humoral directed antagonists appeared to be responsible for the defect in majority of cases. Further analysis pointed to the presence of at least two distinct antagonists and the possible involvement of proteases in this serum abnormality. The activity of the serum antagonists or the severity of the cellular defect were unrelated to the presence of bacterial infection or elevations in serum IgA or IgG. The high frequency of cellular defects, possibly as a result of in vivo activation, in conjunction with serum abnormalities could account for the increased susceptibility of patients with alcoholic liver disease to bacterial infection. PMID- 6509798 TI - Circulating immune complexes and platelet IgG in various diseases. AB - Correlation between platelet associated IgG (PAIgG), platelet count, and plasma polyethylene glycol (PEG) precipitable IgG immune complex (IC) like material was tested in normal subjects and patients with immune thrombocytopenia (ITP), systemic lupus erythematosus (SLE) and various types of liver disease. Elevated IC were observed in 27% and 22% of ITP and recovered ITP, respectively. A significant inverse correlation between platelet count and PAIgG was demonstrable in the ITP group. A significant direct correlation between platelet count and IC was found only in SLE patients. Impaired reticuloendothelial cell (RE) Fc receptor function in SLE patients is suggested as a possible explanation for the data. If receptor function was normal in SLE patients, lower IC levels and lower platelet counts would have been expected. PMID- 6509799 TI - Circulating immune complexes (CIC), carcinoembryonic antigen (CEA) and CIC containing CEA as markers for colorectal cancer. AB - It has been suggested that circulating immune complexes (CIC) would provide a useful tumour marker system and that carcinoembryonic antigen (CEA) may form an antigen component of CIC found in patients with colorectal cancer. In this study the clinical usefulness of CIC and CIC containing CEA (CEA-IC) was investigated. Concentrations of CIC were measured in 30 patients with colorectal cancer. Fourteen patients were studied sequentially at approximately 1 month intervals after apparent curative resection of the primary tumour. Results were correlated with those obtained from serum CEA and compared to clinical status. CEA-IC were measured using a novel assay and compared with CIC and CEA values in 29 patients. CIC concentrations were elevated in patients with known disease and predicted clinical relapse in four of 14 patients. In two patients CIC remained elevated despite sustained remission. CEA-IC were not detectable in any of the patients studied. CIC estimations may augment CEA measurements as indicators of disease recurrence but lack of specificity makes them of little practical value as tumour markers in colorectal cancer. No evidence was found to support previous reports that CEA was an antigen component of CIC in this disease. PMID- 6509800 TI - Serum IgG subclasses in chronic and recurrent respiratory infections. AB - Serum IgG subclasses and IgG, IgA and IgM were measured in 47 patients with chronic respiratory tract infection, 53 patients with recurrent acute respiratory infections and 66 healthy normal adults. Compared to the healthy control group, mean serum IgG2 was significantly lower in patients with chronic infection (P less than 0.01) and in those with recurrent infection (P less than 0.001), whereas mean serum IgG3 was significantly higher (P less than 0.001 for those with chronic and P less than 0.05 for those with recurrent infection). Five patients with recurrent infection and two with chronic infection had serum IgG2 concentrations greater than 3 s.d. below the geometric mean of the control group, and three of these had concomitant IgA deficiency (less than 0.01 g/l). IgG4 was undetectable in five patients with recurrent and four with chronic infection, two of these also had IgG2 deficiency. In 13 of the 14 patients with IgG subclass deficiencies, total IgG was within the normal range. Selective IgA deficiency with normal IgG subclasses was found in five patients. Twenty-seven patients had raised levels of one or more Ig classes or subclasses. We feel that it is important to screen patients with chronic or recurrent respiratory infection for IgG subclass deficiencies in view of the reported beneficial response to gamma globulin therapy. PMID- 6509801 TI - Monoclonal rheumatoid factors from B6-lpr/lpr mice. AB - Monoclonal rheumatoid factors (MoRF) were prepared from autoimmune B6-lpr/lpr mice to investigate the influence of strain background on the specificity of these autoantibodies. Using screening assays for binding to heterologous rabbit IgG, four IgM MoRF were obtained. Three of these antibodies showed a broad pattern of reactivity with IgG antigen, binding BALB/c myeloma IgG1, IgG2a and IgG3 as well as heterologous IgG. One of the antibodies, however, had a distinct form of IgG interaction and was without reactivity with any of the BALB/c myelomas tested. None of the antibodies had significant reactivity with IgG2b. These results suggest common features of B6-lpr/lpr rheumatoid factor (RF) specificities, some of which may be shared by comparable products derived from MRL-lpr/lpr mice. Comparison of these antibodies with those in other reported series suggests that the background genome as well as the nature of the inducing mechanisms may affect the specificity of RF as well as their pathogenetic role. PMID- 6509802 TI - A functional comparison of IIIindium-labelled elicited peripheral blood neutrophils and peritoneal neutrophils in the rat. AB - A functional comparison between elicited peripheral blood neutrophils has been made in vivo and in vitro. Preliminary experiments showed that separation of peripheral blood cells on a metrizamide gradient yielded too few neutrophils for efficient radiolabelling with indium (In): hence a mixed cell preparation comprising 80% neutrophils was elicited in the peripheral blood of adult male rats by the administration of endotoxin (0.25 mg i.a.) and cobra venom factor (200 microliter i.p.) 20 h before. Peritoneal neutrophils were collected 4 h after the i.p. injection of 6 ml thioglycollate. Both populations differed markedly from normal peripheral neutrophils on the in vitro testing of random locomotion, chemotaxis and phagocytosis of Candida. After labelling with IIIIn tropolonate, a greater proportion (mean = 8%) of peripheral blood cells localized to an E. coli/Freund's complete adjuvant-induced abscess compared with peritoneal neutrophils (mean = 3%). The abscess could be visualized externally by scanning with both cell preparations, but the distribution of activity differed markedly. The greater hepatic sequestration of peritoneal neutrophils suggested cell damage or activation. To overcome the difficulty of harvesting normal peripheral blood neutrophils in the rat, either of these populations can be used to follow the kinetics of inflammation. However, elicited peripheral blood cells yield a higher proportion of responding cells. PMID- 6509803 TI - Renal biopsy in the elderly: clinicopathological correlations in 143 patients. AB - The clinical presentation and spectrum of renal histopathology is described in 143 patients aged 60 years or more, with renal disease. In 82 patients renal biopsy revealed primary renal disease. In the remainder, changes associated with systemic conditions were found. These included amyloidosis, polyarteritis nodosa and hypertension. Fifty patients present with the nephrotic syndrome, one third of whom had a membranous glomerulonephritis on the renal biopsy. Three patients had a carcinoma associated with this renal histology. Two patients had a minimal change lesion and their nephrotic syndrome responded to corticosteroids. Renal biopsies from the 45 patients present with renal failure revealed a variety of histopathology which included idiopathic crescentic nephritis and antiglomerular basement membrane disease. Percutaneous renal biopsy is a valuable diagnostic aid in elderly patients with renal disease. PMID- 6509805 TI - Subentities within adult primary IgA-nephropathy. AB - Since its definition is purely descriptive, IgA-nephropathy (IGAN) may comprise more disease entities which share the (epi)phenomenon of mesangial IgA depositions. IGAN patients with macroscopical hematuria (macro-H) differ from the other IGAN patients in 9 aspects: history, HLA-DR, Gm-allotypes, actuarial kidney survival, initial creatinine clearance, initial proteinuria, initial microhematuria, age at presentation and light microscopy of the renal biopsy. The difference in the last five parameters may either be explained by the existence of subentities or by earlier detection of patients with macro-H. The dissimilarity in the first four parameters can only be due to the former theory. Therefore, we conclude that IGAN probably comprises at least two disease entities. PMID- 6509804 TI - Renal involvement patterns of amyloid nephropathy: a comparison with diabetic nephropathy. AB - Thirty kidney specimens obtained from 26 patients with intrarenal amyloid deposition were evaluated. The deposited amyloid belonged to AL protein in 15 cases and AA protein in 11. The intrarenal distribution was examined. Intraglomerular nodular pattern showed a wider extraglomerular distribution of amyloid with a florid accumulation along the vasa recta in the outer medulla, whereas intraglomerular diffuse pattern had amyloid deposition confined mainly to a narrow range surrounding the glomeruli. However, no essential difference was appreciated between AL and AA proteins in the intrarenal distribution, although the former more often disclosed the diffuse pattern. There were many morphological expressions resembling diabetic nephropathy; in addition to the diffuse and nodular pictures, capsular drop-like deposits along Bowman's capsule, simultaneous deposition in the afferent and efferent arterioles, glomerular microaneurysm of early stage, and accumulation along the tubular basement membrane were observed in amyloid nephropathy. Thus, the spicule formation in renal amyloidosis and the diffuse thickening of glomerular and tubular basement membranes in the diabetic emerged as the respective specific lesion. The implicated pathogenesis of diabetic nephropathy was also discussed. PMID- 6509807 TI - Partial recovery of renal function in an oligoanuric patient affected with Goodpasture's syndrome after treatment with steroids, immunosuppressives and plasmapheresis. PMID- 6509806 TI - Diphtheroid peritonitis associated with continuous ambulatory peritoneal dialysis. AB - Five patients on continuous ambulatory peritoneal dialysis (CAPD) developed peritonitis caused by diphtheroid bacteria. Peritoneal catheter exit site inflammation and/or discharge preceded all cases and relapses were common. Antimicrobial therapy alone failed to eradicate the bacteria and peritoneal catheter removal was required before peritonitis resolved. Laboratory culture of the diphtheroid bacteria was difficult and prolonged incubation was often necessary. Diphtheroid bacteria are important opportunistic pathogens in immunocompromised patients and should be carefully sought for in all cases of culture-negative CAPD-associated peritonitis. PMID- 6509808 TI - Understanding focal glomerular sclerosis. PMID- 6509809 TI - Abnormal left ventricular filling in patients with sustained myocardial relaxation: assessment of diastolic parameters using radionuclide angiography and echocardiography. AB - Parameters of left ventricular filling obtained from time-activity curves of radionuclide angiograms were compared with parameters of myocardial relaxation from digitized M-mode curves of the free wall endocardium in 25 consecutive patients. Eight patients had normal left ventricular systolic and diastolic function. Five patients with low ejection fraction (EF less than 50%) also had abnormal values of peak filling rate (PFR), time to peak filling rate (Tr), and/or time constant of endocardial retraction (Te). Twelve patients with normal EF had three (40%), two (40%), or one (20%) of the diastolic parameters within the pathological range. Tr correlated significantly with Te (r = 0.88, p less than 0.001), and patients with Te prolongation always had high values of Tr. One of the diastolic parameters (PFR) correlated significantly with EF (r = 0.60, p less than 0.01). Parameters of left ventricular filling and myocardial relaxation are thus abnormal in many patients with normal systolic function, indicating that diastolic parameters may be more sensitive to myocardial deterioration. PMID- 6509810 TI - Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain. AB - The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery disease present in percentages and to assess the need for coronary angiography on a five-point scale (1 = definitely not indicated, 5 = definitely indicated). After obtaining the results of thallium-201 imaging following dipyridamole (0.50 mg/kg intravenously) administration, the physicians were again requested to estimate probability and need for angiography. In the 43 patients with coronary artery disease the judgment of probability was increased significantly after 201Tl from 75.6 +/- 20.2% to 82.9 +/- 23.2% (p less than 0.001) and the need for angiography from 4.3 +/- 0.9% to 4.5 +/- 0.9% (p less than 0.001). In the subgroup of patients with atypical angina the relative change in probability was higher than in other subgroups of patients with coronary artery disease. In the 17 patients with normal coronary arteries the probability estimation fell after 201Tl from 36.7 +/- 22.0% to 24.8 +/- 21.0% (p less than 0.001), the need for angiography was decreased from 2.7 +/- 1.1% to 2.2 +/- 1.2% (p less than 0.001). With the 201Tl information, cardiologists performed a better diagnostic differentiation of patients with and without coronary artery disease than noncardiologists. The study demonstrates the improvement of clinical diagnosis in patients with chest pain by thallium-201 imaging and confirms the favorable influence of the method on the management of the patients in terms of indications for coronary angiography. PMID- 6509812 TI - Spontaneous retroperitoneal bleeding associated with raised right ventricular pressure and dilatation of the inferior vena cava. PMID- 6509811 TI - Tuberculous pericarditis in Transkei. PMID- 6509813 TI - Hemoptysis following Mustard repair: a late complication. AB - Hemoptysis was the presenting symptom in a 4-year, 11-month-old male who had had a Mustard operation for hemodynamic correction of transposition of the great vessels at the age of five months. Chest roentgenography demonstrated hyperlucency of the left lung and tomography showed compression and narrowing of left main stem bronchus. Angiography documented the absence of antegrade flow in the left pulmonary artery and no pulmonary venous drainage on the left. The left lung was supplied by bronchial collateral arteries which drained by retrograde filling of the left pulmonary artery. It is surmised that pulmonary venous drainage on the left was compromised at surgery and that the dilated main pulmonary artery compressed the left main stem bronchus. This combination promoted bronchial collateral ingrowth. Hemoptysis is a complication of enlargement of bronchial collateral vessels. PMID- 6509814 TI - Elevated gastric juice enzymes--a marker for increased gastric cancer risk? AB - Measurement of beta-glucuronidase and lactic dehydrogenase in the fasting gastric juice of dyspeptic patients is a useful test for gastric cancer, but about 10% of patients tested have positive results without a demonstrable carcinoma. We have compared the histological features of multiple endoscopic gastric biopsies from 17 such patients with apparently false positive enzyme tests with gastric biopsies from 17 age and sex matched patients with negative enzyme tests. Epithelial dysplasia, a precancerous lesion, was found in 3 patients with positive enzyme tests but was not found in those with negative enzyme tests. Sulphomucin-containing intestinal metaplasia, another lesion which is associated with carcinoma of the stomach, was found in 8 patients with a positive enzyme test (including all 3 with dysplasia) but in only one patient with a negative enzyme test. These findings suggest that patients with positive gastric juice enzyme tests who do not have an established carcinoma form a group who are at increased risk of developing gastric cancer in the future and who may be worthy of long-term follow-up. PMID- 6509815 TI - Gastric remnant recurrence--detection and implications for the management of gastric cancer. AB - The ability of endoscopy to detect remnant recurrence of gastric cancer has been evaluated in patients, either as a follow-up procedure (17 patients) or after symptomatic referral (7 patients). Overall 15 out of 24 (62.5%) patients developed some form of recurrence. Fourteen out of 15 (94%) had local disease either alone or in combination with distant metastases. Remnant recurrence was observed in 11 of these and after excluding those referred with symptoms, the true incidence of remnant recurrence was 41.2%. Patients in the follow-up group had 'early' remnant lesions which were diagnosed sooner after surgery than in the symptomatic group who had 'advanced' remnant recurrences. The detection of premalignant histology occurred earlier in those who developed remnant recurrence and this short time interval could be used to predict recurrence. Despite the early diagnosis of remnant recurrence, resection of the remnant at second laparotomy was only possible in one patient as the majority had other sites of extensive recurrence. The implications for the management of 'early' and 'advanced' gastric cancer are discussed. PMID- 6509816 TI - Oral urea in the treatment of colo-rectal liver metastases. AB - A consecutive series of 10 patients with hepatic metastases from colo-rectal carcinoma have been treated with oral urea. This substance has been reported to produce regression of hepatic secondaries from a variety of primary sources including colon. Although well tolerated, and leading to subjective improvement in some patients, no objective benefit has been confirmed from the treatment in this study. PMID- 6509817 TI - Nasopharyngeal carcinoma in Malaysians under the age of 20 years. AB - A total of 52 cases of NPC were found in a five-year survey from 1978 to 1982 in Malaysia. The annual rate of occurrence was 3.4, 3.0, 2.4 and 1.8 for Chinese, Malays, Kadazans and Sarawakians, respectively. The age-specific incidence rates per 100 000 were highest for Kadazans (2.34 to 7.59) in comparison to the other races (0.11 to 1.24). The proportion of NPC in young Malaysians formed 1.2% in Chinese, 7.2% in Malays and 6.9% for others. A sexual bias was present in Chinese (male:female = 2.2) and Sarawakians (1.7) but not in Kadazans and Malays (0.9). In most Chinese, the primary tumour histologically is of the poorly differentiated characteristic and this type is the predominant tumour in the country. The Kadazans presented with well differentiated primary tumour and the Malays with all three histological types i.e. well-, poorly- and undifferentiated. At first examination enlarged lymph nodes were found in 95.7% of the patients and 65.2% had epistaxis and growth in the postnasal space. Antibodies to IgA anti-VCA were present in half of the 6 patients serologically studied. PMID- 6509818 TI - A clinical assessment of loading dose tamoxifen for advanced breast carcinoma. AB - Seventy patients with advanced breast carcinoma were treated with a loading dose regimen of 160 mg Tamoxifen on day 1 followed by a maintenance dose of 20 mg daily from day 2 onwards. Compliance was 100% and only 3 patients developed mild side effects. In 27% regression of disease was observed within 1 month and in 57% within 2 months. This regimen is recommended for routine clinical use. PMID- 6509819 TI - Fine needle aspiration breast cytology in district general hospital practice. PMID- 6509820 TI - Teaching ward nurses to monitor cancer patients. AB - Eight ward nurses were trained to assess psychological and physical adjustment following mastectomy. Training included provision of a standard assessment form, practice interviews and audiotape feedback of performance. All nurses improved in their ability to cover salient areas, the use of relevant interviewing techniques and identification of problems. They also reported greater job satisfaction and had used their new skills with other patients. These findings, albeit with a small sample, suggest that other general nurses could, with similar training, play an important part in the early recognition of the psychological problems which can develop in cancer patients. PMID- 6509821 TI - [A case of primary aberrant oculomotor regeneration due to intracavernous aneurysm]. PMID- 6509822 TI - [Treatment of dystonia with high-dosage trihexyphenidyl]. PMID- 6509823 TI - [A sporadic case of startle disease]. PMID- 6509825 TI - [A case of progressive supranuclear palsy with fibrillary gliosis of the mid brain and pontine reticular formation]. PMID- 6509824 TI - [CT scanning of the brain and lumber CSF monoamine metabolites in spinocerebellar degenerative disorders]. PMID- 6509827 TI - [Electrophysiological aspects of 639 symptomatic extremities with carpal tunnel syndrome]. PMID- 6509826 TI - [A case of hydrocephalus due to cysticercosis cerebri]. PMID- 6509828 TI - [Intermittent spinal claudication due to vertebral hemangioma--a case report]. PMID- 6509829 TI - [Peripheral nerve involvement in spino-cerebellar degenerations. 2. Histopathological characteristics]. PMID- 6509830 TI - [Homolateral imitative synkinesia--symptomatological study. Part 1: Homolateral imitative movement in normal children]. PMID- 6509831 TI - [Homolateral imitative synkinesia--symptomatological study. Part 2: Homolateral imitative synkinesia in adult patients]. PMID- 6509832 TI - [An autopsy case with unusual muscle rigidity resembling the stiff-man syndrome]. PMID- 6509833 TI - [Metrizamide CT myelography of Hirayama's disease with localized atrophy of the lower cervical spinal cord]. PMID- 6509834 TI - Myocardial uptake of a bone tracer associated with hypercalcemia. AB - A patient with end-stage renal disease and hypercalcemia was referred for a radionuclide bone imaging study. Deposition of Tc-99m hydroxymethylenediphosphonate was apparent in the lungs and myocardium as well as in the skeleton. Renal uptake was also noted, despite anuria. Computed tomography demonstrated nephrocalcinosis but no myocardial calcification. The cause of myocardial uptake of tracer is unknown. Amyloidosis is suggested as a possibility but is not validated in this case. PMID- 6509835 TI - Pseudoaneurysm of the left ventricle. Diagnosis by first pass scintigraphy. AB - False aneurysm of the left ventricle is a rare complication of myocardial infarction with a high propensity for late rupture. Timely diagnosis is important and surgical repair is curative in a high percentage of patients. A case in which a false left ventricular aneurysm was recognized by first pass radionuclide angiography and confirmed by contrast ventriculography is reported. Surgery was then performed successfully. The diagnosis of false left ventricular aneurysm using radionuclide angiography, as well as other diagnostic imaging modalities, is discussed. PMID- 6509836 TI - Cystic hypernephroma mimicking an hepatic mass. AB - A renal mass was correctly identified with Tc-99m sulfur colloid liver-spleen scan and Tc-99m glucoheptonate scintigraphy while CT scan was misinterpreted as showing a hepatic lesion. PMID- 6509837 TI - Multiple imaging techniques. CSF shunted Arnold Chiari malformation with false negative brain death radionuclide angiograms. PMID- 6509838 TI - Discordant gallium-67 and indium-111 leukocyte images in a suspected pelvic abscess. AB - An Indium-111 labeled white blood cell scan suggested the presence of a pelvic abscess in a woman at four weeks postpartum. This was not identified on a subsequent gallium scan. This discrepancy can be attributed to the normal accumulation of white blood cells within the uterus at one month postpartum. PMID- 6509839 TI - Acro-osteolysis in a patient with Hajdu-Cheney syndrome demonstrated by bone scintigraphy. PMID- 6509840 TI - Identification of intrathoracic hemorrhage with Tc-99m sulfur colloid. AB - Tc-99m sulfur colloid has been shown to be accurate in the detection of intrapulmonary bleeding (1,2). The present example demonstrates the usefulness of Tc-99m sulfur colloid in identifying an unusual manifestation of intrathoracic hemorrhage. PMID- 6509841 TI - Esophageal radionuclide transit tests. Potential false-positive results. AB - Esophageal radionuclide transit testing is a sensitive technique for assessing esophageal clearance. Experience with the technique in 150 patients has led to an awareness of several pitfalls which might lead to false-positive results. Potential problems may be grouped into technical factors, clinical aspects, and misinterpretations. Examples of these are presented and techniques to minimize such problems are discussed. PMID- 6509842 TI - Abdominal and pelvic imaging as part of liver-spleen scintigraphy for the detection of mesenteric bleeding in trauma. A case report. AB - Liver--spleen scintigraphy in patients who have incurred blunt abdominal trauma is accepted as a useful diagnostic tool. Abdominal and pelvic imaging to detect extrahepatic or extrasplenic sites of hemorrhage should be a routine part of liver--spleen imaging in the evaluation of blunt abdominal injury. A patient with mesenteric bleeding and a normal liver and spleen detected by liver--spleen scintigraphy is reported. PMID- 6509843 TI - Diagnostic imaging in mediastinal thyroid tumor. AB - Various diagnostic imagings in nine patients with mediastinal goiters were presented. The clinical manifestations of these patients were various, from totally asymptomatic to severe dyspnea. Six of the nine patients underwent surgical intervention, three were follicular adenomas and three were nodular goiters. A chest radiograph (positive in seven out of nine patients) provided the most valuable initial localization of a goiter mass to the anterior, middle, or posterior compartment. Esophagograms (performed in four patients) showed compression of esophagus by the mediastinal mass. I-131 scintigraphy (performed in seven patients) was capable of detection of functional (in three patients) vs nonfunctional status of thyroid status (in four patients). Angiography (performed in five patients), characterized by anatomic continuity with cervical thyroid gland, calcifications, well-defined border of masses and/or contrast enhancement, offered important roles to direct a diagnosis of intrathoracic goiter. The computed tomography becomes increasingly important because all mediastinal goiters are not radioiodine avid. PMID- 6509844 TI - Bone scan in the hand-foot syndrome. AB - The Hand-Foot Syndrome is a form of sickle cell disease that occurs in infancy. A bone scan performed on such a patient showed evidence of infarction in the hand. This was useful in the management of the patient. PMID- 6509845 TI - Lymphoscintigraphy. Pulmonary lymphangiectasia. AB - A case of Noonan's syndrome with pulmonary lymphangiectasia detected with lymphoscintigraphy is reported. PMID- 6509846 TI - Scintigraphic demonstration of coexisting adenoma and metastasis of the adrenal gland in a patient with bronchogenic carcinoma. PMID- 6509847 TI - Apparent filling defects of the liver. PMID- 6509848 TI - Radionuclide demonstration of improvement of spatial distribution of pulmonary function after removal of bullous lesion. PMID- 6509849 TI - Displacement of right lobe of the liver caused by retrohepatic herniation of the large bowel. PMID- 6509850 TI - Diaphragmatic herniation of the liver in a newborn demonstrated by liver scan. PMID- 6509851 TI - Axillary-femoral shunt visualization. A serendipitous finding during abdominal radionuclide angiograms. PMID- 6509852 TI - Uptake of indium-111-labeled leukocytes in a cutaneo-cecal-vaginal fistula. Case report. PMID- 6509853 TI - Candida albicans infected aortic graft detected by indium-111 oxine labeled white blood cells. PMID- 6509854 TI - Contraception update. PMID- 6509855 TI - Natural methods of family planning. AB - Reliable indicators to detect the fertile and infertile phases in the menstrual cycle are now available, largely due to the intensive scientific research into fertility over the past decade. This means that couples who follow the rules of the different NFP methodologies have a highly effective means of birth control, without the introduction of hormones, chemicals or devices into the body. New scientific techniques can be expected within the next couple of years which will simplify the detection of the fertile phase and hopefully help to elucidate the grey area of the early fertile days, where most of the unplanned pregnancies occur. Fertility awareness by both partners is an important positive contribution to the whole sexual relationship and emphasizes that NFP is an educational delivery system rather than a technological one. The modification of sexual behaviour and the motivation of both partners for the successful use of NFP may initially present a problem to some couples. On the other hand, many partners find the discipline enhances their sexual relationship and dialogue. Whatever the motivation, today more and more couples are happier to be in autonomous control of their bodies and their fertility. PMID- 6509856 TI - Intrauterine devices. PMID- 6509857 TI - The Oxford-Family Planning Association contraceptive study. AB - The Oxford-Family Planning Association contraceptive study involves over 17 000 women who were recruited at 17 clinics in England and Scotland during the interval 1968-74 and have been followed up ever since. This paper describes the survey methods, the characteristics of the participants, the progress of the study, the main results and publications to date, and the proposals for future work. Although the study was originally mainly concerned with the benefits and risks of oral contraceptives it has, in fact, contributed to knowledge about a wide variety of birth control methods. The data on efficacy are of special value in that they cover all methods of contraception in common use and have been derived from a homogeneous and closely observed population. The mortality figures, while limited in extent, have supplemented the findings in the Royal College of General Practitioners study. Reports on morbidity from many different diseases have been published; these have documented both beneficial and harmful effects of various contraceptive methods. The study data on return of fertility after discontinuation of contraception are unique, while contributions have also been made to knowledge about outcome of pregnancy in those stopping contraception to have a planned baby or becoming accidentally pregnant while using a birth control method. The study, which is supported by the Medical Research Council, is currently funded until mid-1989. PMID- 6509858 TI - The Royal College of General Practitioners' Oral Contraception Study: some recent observations. AB - The Royal College of General Practitioners' Oral Contraception Study is a continuing cohort survey of the effects of oral contraceptives on the health of users. Neurotic depression is associated with the oestrogen content of combined oral contraceptives, but the risk is small in general, and there is no excess risk associated with oestrogen doses of 35 micrograms or less. It now appears likely that, in the long-term, oral contraceptives are not associated with any increased risk of gallbladder disease, although there is an acceleration of the disease in those women susceptible to it. The progestogen activity of combined oral contraceptives is associated with an increased risk of hypertension and arterial disease. Duration of use no longer seems to influence the occurrence of the latter. Cigarette smoking by oral contraceptive users is the predominant associated risk factor for the occurrence of arterial diseases. Non-smokers using low-progestogen-dose brands may safely use oral contraceptives, probably up to the age of 45 years. In the author's opinion, there is no convincing evidence that oral contraceptive use increases the risk of breast cancer. The evidence for an association with cervical cancer is firmer, but, if confirmed, is unlikely to affect more than one in 3000 users a year. Increased safety in the use of oral contraceptives in future is likely to be achieved through the use of tests which will allow the adjustment of dose to be made to each patient's particular requirements. PMID- 6509860 TI - Cabbages and condoms: packaging and channels of distribution. AB - Contraception is only rarely a therapy for disease. Usually, contraceptives help adults implement informed choices. Therefore, wider channels of distribution and promotion are possible and necessary than in the case of curative therapies. The more channels of distribution that are available for the same method of contraception, the higher the prevalence of use. Establishing new channels of distribution can be as important as developing new methods of contraception. Family planning is an important element in public health, and active promotion enhances the health of individuals and physicians. Other health professionals need to understand the role of non-medical skills and channels of contraceptive distribution. PMID- 6509859 TI - Postcoital contraception. AB - Changes in sexual mores have led to the need for an effective emergency postcoital contraceptive agent. To meet this need various individual steroids, either alone or in combination, have been evaluated and shown to be effective in preventing pregnancy as a result of a single, unprotected coital act. No drug has received specific marketing approval in North America for this purpose. However, in western Europe, the combination of ethinyloestradiol and levonorgestrel is marketed specifically for use as a postcoital contraceptive agent. Intrauterine copper contraceptive devices have also been shown to be effective postcoital contraceptive agents, but their applicability is confined to a specific segment of the population. Other agents are also being investigated for their postcoital contraceptive effectiveness, including prostaglandins, anti-progestins, GnRH agonists, super agonists and antagonists, and HCG antagonists. Sufficient interest exists in postcoital contraception that the World Health Organization has undertaken, through their task force dealing with postcoital, once-a-month and menses-inducing agents, to develop other postcoital drugs. PMID- 6509861 TI - Population pharmacokinetics of procainamide from routine clinical data. AB - Routine clinical pharmacokinetic data collected from patients receiving procainamide were analysed to estimate population pharmacokinetic parameters. 116 plasma concentration determinations for procainamide and 14 timed urine collections for the drug and its major metabolite N-acetylprocainamide (NAPA) were obtained from 39 patients, mostly males. The data were analysed using NONMEM, a computer program designed for population pharmacokinetic analysis that allows pooling of data from many individuals. Estimates of the influence of weight, height, renal function, and the presence of congestive heart failure (CHF) on the renal clearance (CLR), acetylation clearance (CLA), miscellaneous metabolic clearance (CLO), and volume of distribution (Vd) of procainamide were obtained. The mean (SE) CLR, CLA, CLO and Vd for procainamide in a 70kg patient with normal renal function were estimated to be 14.4 (2.3) L/h, 10.1 (1.7) L/h, 1.2 (1.3) L/h, and 136.0 (20.0) L, respectively. These pharmacokinetic parameters vary linearly with bodyweight; height adds no information if weight is known. The presence of CHF has no significant effect on either CLO or Vd, but reduces CLA and CLR by 11% (p less than 0.01). Even after adjustments for CHF, renal function and weight, the total clearance and Vd of procainamide vary unpredictably among individuals, with a coefficient of variation between 30 and 40%, and less than 50%, respectively. PMID- 6509862 TI - Two prospective dosing methods for nortriptyline. AB - This study compared two prospective pharmacokinetic dosing methods to predict steady-state concentrations of nortriptyline. One method required multiple determinations of the nortriptyline plasma concentration to estimate the drug's steady-state concentration. The second method required a single nortriptyline concentration drawn at a fixed time, preferably 36 hours, following a nortriptyline test dose. The 36-hour nortriptyline plasma concentrations (NTP 36h) were substituted into the straight-line equation of Cssav = 17.2 + 3.74 (NTP 36h), where Cssav is the average steady-state concentration for a 100 mg/day dose of nortriptyline. No differences were noted between the observed steady-state nortriptyline concentration of 121 +/- 19 ng/ml, the 36-hour single-point prediction mean concentration of 121 +/- 21 ng/ml, or the multiple-point prediction mean concentration of 122 +/- 19 ng/ml. Because of the similar findings between the two methods, the clinical advantages and disadvantages of each kinetic approach are discussed to put these prospective dosing protocols into their proper perspective. PMID- 6509863 TI - Further studies on human plasma aldosterone-binding globulins: isolation, purification, and evidence for heterogeneity. AB - The present study further characterizes the aldosterone-binding globulin (ABG) in human plasma. Isolations were performed by ultrafiltration, Blue Sepharose CL-6B, or ion-exchange chromatography and gel filtration. New ABG species were identified: interconvertible with ABG in plasma is a thermolabile (MW less than 70,000) and a thermostable ABG macromolecule (MW 27,500). All forms were extensively purified to electrophoretic homogeneity (SDS-PAGE) showing microheterogeneity in isoelectric focusing (pI 4.76 and 4.8) and reversible high affinity binding for aldosterone. Chromatography of lipoprotein-free plasma in DEAE-Sephadex A-50 gel (ionic gradient) revealed the presence of a dimer of ABG (MW 55,000) which was found to be interconvertible with ABG and was the main carrier of aldosterone in normal fresh plasma. Selective adsorption of albumin from lipoprotein-free plasma on Blue Sepharose CL-6B permitted in a single novel step the complete resolution of bound aldosterone (binding ABG) and bound cortisol (binding corticosteroid-binding globulin). Both ABG and the dimer can be separated from corticosteroid-binding globulin by Blue Sepharose chromatography. A new homeostatic mechanism in which ABG participates in blood pressure regulation by interacting with aldosterone is postulated. PMID- 6509864 TI - Calculated distribution of various inorganic phosphate constituents in body fluids, based on the principles of complex equilibria. AB - The distribution of inorganic phosphate ions in body fluids is calculated by equilibrium studies. Equations of partial mol fractions of each complex species are calculated with known stability constants, measured pH and electrolyte concentrations. We present these results in serum and urine in health, and in some diseases, with characteristic pH values and electrolyte concentrations. Distribution of various inorganic phosphate complexes, similar to total and ionized calcium, may be of practical importance. PMID- 6509865 TI - Can patients be asked to pay for experimental treatment? PMID- 6509866 TI - Researchers' access to patient records: an analysis of the ethical problems. PMID- 6509867 TI - Informed consent for research publication of patient-related data. PMID- 6509868 TI - A proposal to ban cigarette advertising. PMID- 6509869 TI - Effect of exchange-reduction transfusion on carbamazepine. PMID- 6509870 TI - Sublingual morphine sulfate in chronic pain management. PMID- 6509872 TI - Antihypertensive agents and hyperlipidemia. PMID- 6509871 TI - Anaphylactoid reaction to acetylcysteine. PMID- 6509873 TI - Data in case reports questioned. PMID- 6509874 TI - Effect of hemodialysis on serum glucose concentrations. PMID- 6509875 TI - Efficacy of 0.9% sodium chloride injection with and without heparin for maintaining indwelling intermittent injection sites. AB - The efficacy of 0.9% sodium chloride injection with and without heparin in maintaining indwelling intermittent ("heparin lock") injection sites was studied. All patients in whom heparin locks were placed after admission to the medical and surgical units of a 128-bed acute-care hospital during a six-month period were included in the study. Three different solutions were used to flush heparin locks: 0.9% sodium chloride injection alone, heparin 10 units/ml in 0.9% sodium chloride injection, and heparin 100 units/ml in 0.9% sodium chloride injection. Solutions were randomly assigned to all patients on a given nursing unit for a two-month period; flush solutions were switched every two months until each of the three solutions had been used on both the medical and surgical units. Heparin locks were flushed after each medication administration and every eight hours when medications were not being given. Using a standardized evaluation form, one of five i.v. therapists evaluated each site daily for the presence of phlebitis and loss of patency. Length of catheter placement and the percentage of patient days during which patients received cephalosporin and penicillin antibiotics were examined for each group. Rates of site loss caused by phlebitis or loss of patency were compared in each group. A total of 412 patients representing 1448 patient days of heparin-lock therapy was evaluated. No significant differences were found among the three groups in the mean duration of heparin-lock placement, the percentage of patient days during which antibiotics were prescribed, or the rate of site loss caused by phlebitis or loss of patency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509876 TI - Absorption characteristics of three phenytoin sodium products after administration of oral loading doses. AB - The absorption characteristics of three phenytoin sodium products given orally as loading doses in five healthy men were studied. Extended phenytoin sodium capsules, prompt phenytoin sodium capsules, and phenytoin sodium injection were administered in a randomized, crossover trial as single 18-mg/kg doses and as divided doses of 6 mg/kg every three hours for three doses. Each dose was given with 200 ml of water, and a two-week washout period followed each treatment. The maximum plasma concentration (Cmax), time to reach maximum plasma concentration, time to reach the lower end (10 mg/liter) of the therapeutic range, time to reach a plasma concentration greater than 15 mg/liter, and time within the therapeutic range were determined for each loading-dose regimen. Prompt phenytoin sodium capsules (prompt PHT) given in divided doses produced a mean Cmax of 22.0 mg/liter, which was significantly higher than that observed with any of the other loading-dose regimens. In addition, all subjects receiving prompt PHT in divided doses had plasma phenytoin concentrations of 10 mg/liter within six hours; only this treatment produced plasma concentrations greater than 15 mg/liter at nine hours in all subjects. Plasma concentrations remained within the therapeutic range (10-20 mg/liter) for 81 and 78% of the first 24-hour period for prompt PHT in divided and single doses, respectively. Adverse effects were minimal in all regimens. The prompt-release phenytoin sodium capsules used in this study may provide an alternative means for rapidly achieving therapeutic phenytoin concentrations in situations where i.v. administration is not indicated or practical.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509877 TI - Bioavailability of pseudoephedrine and triprolidine from combination and single ingredient products. AB - The bioavailability of pseudoephedrine and triprolidine from combination and single-ingredient products was evaluated in a randomized, four-way crossover study. Healthy men volunteers received single doses of a tablet containing triprolidine hydrochloride and pseudoephedrine hydrochloride, a syrup containing the same two drugs, and single-ingredient tablets of each drug. Blood samples were collected before each dose and at 13 sampling times over 24 hours for determination of drug concentrations by radioimmunoassay. Observed peak concentration (Cmax), corresponding observed peak time (tmax), area under the plasma drug concentration-time curve from dosing to time infinity (AUC), and the ratio between plasma clearance and extent of bioavailability (CL/F) were determined. Nonlinear regression analysis was used to obtain estimates of lag time for absorption, first-order rate constant for absorption, first-order rate constant for elimination, and ratio between volume of distribution and extent of bioavailability. Data were analyzed for 19 of 20 men entering the study; data were complete for 16 of these. Pseudoephedrine concentrations were significantly different for the combination tablet and the syrup at four sampling times; no significant differences were found between pseudoephedrine concentrations for the combination tablet and single-ingredient tablet. Cmax, tmax, AUC, and CL/F for pseudoephedrine were not significantly different for the three formulations. Triprolidine concentrations at 8 hours were significantly higher for the combination tablet than for the single-ingredient tablet, and tmax for triprolidine was significantly higher for the combination tablet than for the syrup. For both pseudoephedrine and triprolidine, the combination tablet was bioequivalent to the syrup and to the single-drug tablets. PMID- 6509878 TI - Lack of cross-allergenicity between mezlocillin and other semisynthetic penicillins. PMID- 6509879 TI - Neonatal seizure recurrence following discontinuation of phenobarbital. AB - The recurrence of seizures in neonates following discontinuation of phenobarbital was studied. All neonates treated for seizures in the intensive care nursery over a period of four years were followed for seizure recurrence after discharge from the hospital. Of 64 neonates treated for seizures, 50 were followed until they were at least 12 months of age. Their charts were reviewed for birth date, birth weight, gestational age, Apgar scores, age at seizure onset, seizure type, seizure etiology, duration of anticonvulsant therapy, and any neurologic deficits. Information on seizure activity and neurologic and developmental status was obtained through clinic observation or telephone interviews with parents and pediatricians. Anticonvulsant therapy was continued for 4 to 97 days; however, 85% of patients were treated less than three weeks. Those treated longer than three weeks either could not be withdrawn from anticonvulsants or were premature infants who had prolonged, severe illness. The length of follow-up ranged from 12 to 47 months, the average follow-up age being 24 months. Six patients were found to require long-term anticonvulsants because of persistent or recurring seizures. The severity of neurologic damage was a good predictor of seizure recurrence. The duration of anticonvulsant therapy in neonates should be limited to the period when the neonate is acutely ill. PMID- 6509880 TI - Amoxicillin-potassium clavulanate: rational pharmacology meets clinical infectious disease. PMID- 6509881 TI - Intraspinal hematoma as a complication of anticoagulant therapy. AB - Two patients who developed intraspinal hematomas associated with anticoagulation therapy are described, and the pathology, clinical presentation, risks, evaluation and management of this rare hemorrhagic consequence, which results in spinal cord injury (SCI), are discussed. A 49-year-old man was taking warfarin sodium 7.5 mg orally every day for two weeks for thrombophlebitis. Prothrombin time (PT) was 24 sec (control = 17 sec). Two days after a dosage reduction for a PT of 36.5 sec (control = 11 sec), he developed severe neck pain, numbness and weakness of the legs, and then quadriplegia. Warfarin therapy was discontinued, and 25 mg of phytonadione was administered intravenously. An epidural hematoma was removed via a C3-C6 laminectomy, and the patient remains a C3 complete quadriplegic. The second patient was a 64-year-old man who was taking warfarin sodium 5 mg and 7.5 mg orally on alternate days following an aortic-valve replacement. PT was maintained at 1.5 times the control value. Four years later, he fell and sustained flexion distraction and compression injuries of the spine at the L1-L2 level. He complained of severe neck pain and headache. Warfarin therapy was stopped, and 10 mg of phytonadione was administered i.v. During a hospital transfer he developed complete paraplegia. PT was 12.4 sec (control = 10.8 sec). Twelve days later, a laminectomy was performed to remove the T6-L1 subdural hematoma revealed by computed tomography (CT). The patient remains a T5 complete paraplegic. Unlike intracranial hemorrhage, intraspinal hemorrhage usually occurs in the epidural space, most often in the dorsal thoracic spine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 6509883 TI - How to choose a non-steroidal anti-inflammatory drug. PMID- 6509882 TI - Quinidine-induced digoxin toxicity after discontinuing digoxin in a patient with renal failure. PMID- 6509884 TI - Azathioprine. PMID- 6509885 TI - Common problems in pediatric gynecology. PMID- 6509886 TI - Childhood depression. PMID- 6509887 TI - Tuberous sclerosis in children: diagnosis and course. PMID- 6509888 TI - An approach to chronic abdominal pain in adolescents. PMID- 6509890 TI - Some properties of the reactive hydroxylysyl residues in collagen: their possible role in nucleation during fibril formation. AB - Native or heat-denatured collagens were incubated under controlled conditions of temperature and pH with variable molar ratios of KCNO or 2,4,6-trinitrobenzene sulphonic acid. The results obtained suggest that a small number of free amino groups are available for reaction on the native protein, while all the free amino groups react on the denatured protein. The highly reactive free amino groups in the native protein are hydroxylysine residues and have an abnormally low pK of 8.5 which is conformation dependent; this pK becomes normalized upon denaturation of the protein. The reactive hydroxylysines appear to be located in basic regions that could be the nucleation sites needed for fiber formation in the heat gelation assay; the modified protein does not form stable fibrils upon heating at 37 degrees C and the few fibers formed are not stabilized after reduction with NaBH4. Our results also suggest that the triple helix in collagen is heterogeneous with respect to the reactivity of free amino groups and that several discrete transition temperatures are observed with two main breaks at 30 degrees C and at 37 degrees C, respectively. PMID- 6509889 TI - Regulation of type I collagen fibril assembly by link protein and proteoglycans. AB - Link protein, a glycoprotein, that is present both in cartilaginous and non cartilaginous tissues, has previously been shown to bind to collagen and to proteoglycan. Here, we have examined the effects of link protein and proteoglycans, both alone and in combination, on the assembly of type I collagen fibrils in vitro. Link protein alone had no effect on the kinetics of fibril formation or on the size of the fibrils. Link protein, however, modulated the effects of various proteoglycans including those from bone, cartilage, cornea and sclera. Link protein had the most significant effect on fibril assembly in the presence of the low molecular weight bone proteoglycan. Although the bone proteoglycan alone had no effect on fibril formation, the fibrils were wider in the presence of link protein and proteoglycan. Cartilage proteoglycan alone increased the extent of fibril formation and the resultant fibrils were wider in diameter with a complement of incompletely assembled fibrils. In the presence of both link protein and cartilage proteoglycan, the fibrils were fully formed with the characteristic banding pattern. Further, corneal and scleral proteoglycans alone decreased the extent of fibril formation and the width of the fibrils was either unaltered or slightly decreased in the presence of the link protein. Our results indicate that both link protein and tissue-specific proteoglycans may regulate the organization of collagen fibrils in tissues. PMID- 6509891 TI - Collagen biosynthesis by cells in a tissue equivalent matrix in vitro. AB - Collagen biosynthesis by fibroblasts and subsequent processing and polymerization have been studied in conventional monolayer cultures and in a new model system in vitro in which cells organize into a tissue like structure. While the bulk of the newly made collagen becomes tightly and selectively bound to the matrix of the tissue equivalent model, in monolayer cultures most of the collagen passes into the culture medium. Collagen biosynthesis appears to be regulated differently in cells of the tissue equivalent model as compared with monolayered cells. In the former there is a 6- to 8-fold decrease in collagen output even though overall protein synthesis per unit of DNA is twice as great as in monolayered cells. Cells grown in tissue lattices exhibit much higher collagenolytic activity than cells in monolayer suggesting the model may also be of special use for studying collagen turnover and matrix remodeling. PMID- 6509892 TI - The influence of cell culture variables on human collagenase inhibitor expression. AB - This study investigated the modulation of human collagenase inhibitor expression by a variety of cell culture variables. Inhibitor production was found to be largely invariant with respect to the concentration of serum incorporated into culture medium. Similarly, environmental pH failed to affect inhibitor expression over the pH range of 6.8-8.2. When inhibitor production was examined as a function of cell culture density, synthesis of this protein per cell was greatest during logarithmic growth and early confluence, but even in late post-confluent cultures levels approaching 50% of maximal were routinely observed. When basal levels of collagenase and inhibitor were compared in 8 different normal human skin fibroblast cell lines, inhibitor production varied by only 2-fold, whereas collagenase levels displayed a range exceeding 20-fold. Thus, despite manipulations in the presence or absence of serum and even across different cell lines, inhibitor production seemed to be marked most conspicuously by its constancy. The kinetics of inhibitor secretion into culture medium were also examined. Whether cultured in the presence or absence of serum, inhibitor levels reached maximal values in the medium after 24-48 hours of incubation and remained constant thereafter. Interestingly, assessment of intracellular versus extracellular quantities of inhibitor demonstrated that there was no significant intracellular storage of this protein. Thus, the data suggest that human collagenase inhibitor is a secretory protein which is rapidly exported into the extracellular space without significant accumulation intracellularly. PMID- 6509893 TI - Age variation in histidinoalanine cross-links in proteoglycan subunits from human articular cartilage. AB - The proteoglycan subunits isolated from human articular cartilage of various ages (ranging from the newborn to the mature adult) were analyzed for their content of histidinoalanine. It was noted that while the young juveniles and adolescents contained about 1 nmole of histidinoalanine per mg protein, the skeletally mature adults contained about twice this amount. Unlike many age-related changes in proteoglycan structure that occur prior to the end of growth, this variation would appear to be more related to maturation of the adult. PMID- 6509894 TI - Intracellular degradation of newly synthesized collagen. AB - This assay reviews current work on intracellular degradation of newly synthesized collagen in cell culture systems. Various methodological and conceptual problems are discussed and areas of disagreement are highlighted, and a model that accounts for much of the experimental data is proposed. All degradation studies are based on the premise that free hydroxyproline is a marker for collagen breakdown. A recent hypothesis that some hydroxyproline might be produced independently of collagen synthesis has been subjected to various tests, and the evidence strongly suggests that the hypothesized mechanism is not operative in cell culture systems. Approximately 15% of the collagen synthesized by human fibroblasts maintained under normal culture conditions is broken down rapidly. This process, termed basal degradation, functions continuously and independently of collagen synthesis; it is posttranslational rather than cotranslational; and it is not inhibited by lysosomotropic agents or colchicine. Degradation is enhanced when culture conditions are manipulated so that structurally abnormal collagen is synthesized; the increase above the basal level can be suppressed by lysosomotropic agents and colchicine. Degradation is also enhanced when cells are exposed to agents that elevate the intracellular level of cAMP. The major feature of the proposed model is that there are two distinct pathways for degradation. Basal degradation is viewed as a stochastic, or random, process. Collagen molecules that enter this pathway are not distinguishable from molecules that escape breakdown, and the probability of being degraded is ca. 1/6. The model predicts that the basal degradation mechanism is located in the distal region of the endoplasmic reticulum (smooth ER) or the cis-region of the Golgi complex, and that enzymes capable of attacking collagen or collagenous peptides are located in one of these organelles. Enhanced degradation is depicted as a deterministic process that results from the interaction between newly synthesized collagen molecules and an apparatus that recognizes abnormal structures, responds to external signals, and directs molecules either toward sites for packaging into secretory vesicles or toward the site of degradation. This apparatus is probably located in the Golgi complex, but the actual breakdown of the molecules occurs in lysosomes. Transport from the recognition and sorting mechanism to the site of degradation can be blocked by colchicine. A specific prediction of the model is that all enhanced degradation is mediated by lysosomal proteases and occurs in lysosomes. PMID- 6509895 TI - Central capacity limits in consistent mapping, visual search tasks: four channels or more? PMID- 6509897 TI - Inequalities in health--directions for research. PMID- 6509896 TI - Reference and comprehension: a topic-comment analysis of sentence-picture verification. PMID- 6509898 TI - Teachers' smoking habits. PMID- 6509900 TI - Cervical screening: letting the patient know. PMID- 6509899 TI - Social class, sexual habits and cancer of the cervix. PMID- 6509901 TI - Management information in the National Health Service: the use of the child health computer system. PMID- 6509902 TI - Outcome measures for district and regional health care planners. PMID- 6509903 TI - Individual variations in color vision among squirrel monkeys (Saimiri sciureus) of different geographical origins. AB - A forced-choice discrimination procedure was used to test color vision and visual sensitivity in 10 squirrel monkeys (Saimiri sciureus) originating from three geographical locations (Bolivia, Colombia, Guyana). In agreement with results from an earlier study of vision in squirrel monkeys of Peruvian origin, striking individual variations in color vision were found among these squirrel monkeys. Some of these animals had trichromatic color vision, while others were dichromats. Within these two categories, a total of five color vision phenotypes could be discerned. Most of these types are qualitatively similar to common forms of human color-defective vision. PMID- 6509904 TI - A vocabulary test for chimpanzees (Pan troglodytes). AB - Chimpanzees can communicate in American Sign Language (ASL) to independent human observers whose only source of information is the ASL signs of the chimpanzees. A vocabulary test was presented to 4 cross-fostered chimpanzees (4-6 years old). Thirty-five-millimeter color slides were projected on a screen that could be seen by the chimpanzee subject but not by the human observers. There were two observers: O1 was the questioner in the testing room with the subject; O2 was in a different room. Neither observer could see the other, or the responses of the other observer. O1 and O2 agreed in their readings of both correct and incorrect signs, and most of the signs were the correct ASL names of the slides. In order to show that the chimpanzees were naming natural language categories--that the sign DOG could refer to any dog, FLOWER to any flower, SHOE to any shoe--each test trial was a first trial in that test slides were presented only once. Analysis of errors showed that two aspects of the signs, gestural form and conceptual category, governed the distribution of errors. PMID- 6509905 TI - Urinary chemosignals from mice (Mus musculus): acceleration and delay of puberty in related and unrelated young females. AB - A series of five experiments was carried out to determine the possible differential effects that urinary chemosignals from genetically related and unrelated donors have on puberty onset in female mice. The first four experiments, with a laboratory mouse strain, demonstrated no differential acceleration or delay of sexual maturation, with respect to a close genetic relation between donors and recipients, due to the chemosignals from estrous, diestrous, pregnant, or lactating females or grouped females. In the last experiment, wild stock Mus were used; all of the results were comparable to those found in laboratory stocks. There were no instances of differential acceleration or delay based on close genetic relatedness of donors and recipients. The results conform with a general hypothesis that the urinary chemosignals in mice communicate information about the adequacy of reproductive conditions to conspecifics. PMID- 6509906 TI - Carnitine ester hydrolysis in arteries from normal and cholesterol-fed rabbits and the effects of carnitine esters on arterial microsomal ACAT. AB - Carnitine ester hydrolysis was observed in homogenates of normal rabbit (Oryctolagus cuniculus) aortas and in intact aortas from normal and cholesterol fed rabbits using [14C]palmitoylcarnitine as a substrate. Hydrolytic activity was decreased approximately 50% in arterial tissue from cholesterol-fed rabbits and may account for the observation that carnitine esters accumulate in arteries of animals fed atherogenic diets. Long-chain acylcarnitines (C14-C18) were found to be moderate inhibitors of microsomal acylCoA:cholesterol acyltransferase (ACAT, EC 2.3.1.26); short-chain acylcarnitine (C2-C10) and carnitine itself were not inhibitors. The data suggest that the increase in activity of arterial ACAT that characteristically parallels the development of atherosclerosis does not occur as a result of carnitine ester accumulation. PMID- 6509907 TI - Modification of glyceraldehyde-3-phosphate dehydrogenase, EC 1.2.1.12, isolated from rainbow trout during acclimation at 5 or 15 degrees C--I. Changes in the activity of individual muscle isolates as evidence for variable adaptive responses. AB - The mean Km and Vmax values for G3PDH isolated from the lateral muscle of cold adapted (5 degrees C) rainbow trout, Salmo gairdneri, were twice those of enzyme from warm-adapted (15 degrees C) trout when assayed at 7 degrees C but not at any other temperature. The entropy of activation of warm enzyme was about 3 times that of cold enzyme. However, enthalpy or free energy of activation among acclimation groups differed less or not at all. Individual G3PDH isolates within either adaptation group differed in kinetic characteristics. PMID- 6509908 TI - Modification of glyceraldehyde-3-phosphate dehydrogenase, EC 1.2.1.12, isolated from rainbow trout during acclimation at 5 or 15 degrees C--II. Biochemical characterization of G3PDH muscle isolates. AB - G3PDH was isolated from the lateral muscle of rainbow trout (Salmo gairdneri) acclimated at 5 degrees C (cold) and 15 degrees C (warm). No differences were found in muscle concentration, molecular weights, isoelectric focusing patterns, amino acid compositions or peptide maps between cold and warm isolates. Cold and warm G3PDH contained mannose in variable concentration but no other prosthetic groups. PMID- 6509909 TI - Comparative studies on the leucine aminopeptidase activity of different types of leukocytes. AB - The distribution of the leucine aminopeptidase activity among different types of leukocytes in a few animals was examined. In guinea-pig, the enzyme activity was detected in all cell types examined but its activity per cell was diverse among leukocytes, i.e. neutrophils and monocyte-macrophage cell lines, so-called "professional" phagocytes, showed higher enzyme activity than other types of leukocytes, lymphocytes and eosinophils. The same distribution pattern of leucine aminopeptidase activity as that in guinea-pig was also observed among leukocytes in human, rat and mouse. When leukocytes were modified with a poorly permeant reagent, diazotized sulfanilic acid to examine the subcellular localization of leucine aminopeptidase in leukocytes, the leucine aminopeptidase activity of the cells was inhibited by 50% without the inhibition of lactate dehydrogenase, a soluble cytoplasmic enzyme, in various types of leukocytes from all animals used here. The possibility was suggested from these observations that higher leucine aminopeptidase activity is distributed on the cell surface of "professional" phagocytes. PMID- 6509910 TI - Seasonal, genetic and age variation in non-esterified fatty acid concentrations in the ewe. AB - Plasma samples were collected at intervals of about 2 weeks from about ten 2 1/2 year old, or older, and five 1 1/2 year old ewes of each of the Scottish Blackface, Finnish Landrace and Tasmanian Merino ewes and were assayed for their non-esterified fatty acid (NEFA) concentrations. The NEFA concentrations showed an increase with time for every animal. The NEFA concentrations and their linear increase was least in the Finnish Landrace animals. The increase with time was greatest in the Merinos. There was no difference between the age groups. There was no evidence of any annual, cyclical trend. PMID- 6509911 TI - Effect of hibernation on liver and kidney metabolism in 13-lined ground squirrels. AB - Metabolic rates and adenine nucleotide content of liver and kidney from hibernating ground squirrels were measured and compared to rats to study the biochemical adaptation to hibernation. High rates of renal and hepatic gluconeogenesis were observed in squirrels, particularly from propionate and glycerol compared to rat. During hibernation and starvation soluble phosphoenolpyruvate carboxykinase activity was increased in both liver and kidney. Although metabolic rates are decreased during hibernation the results suggest that the enzymic complement is maintained at high activity even during torpor. PMID- 6509913 TI - Ribosomal RNA structure in the diploid and phylogenetically polyploid amphibian species Hyla and Odontophrynus. AB - Ribosomal RNA of the diploid amphibian species Hyla chrysoscelis and Odontophrynus americanus is structurally modified by hidden breaks. Phylogenetically polyploid related species like the tetraploid Hyla versicolor, the tetraploid Odontophrynus americanus and the octoploid Ceratophrys ornata do not show hidden breaks in ribosomal RNA. Structural modifications of rRNA molecules in diploid amphibians has no detectable effect on the ribosomal activity in vitro. PMID- 6509912 TI - Gonadotrophin induced development of the "special zone" in the adrenal cortex of immature female possums (Trichosurus vulpecula) with concomitant activation of steroid reductases. AB - The effect of gonadotrophin and oestradiol administration on adrenocortical special zone (S.Z.) development and steroidogenesis was studied in immature female possums. Adrenals were examined histologically to determine S.Z. formation, and cell-free homogenates were incubated with 3H progesterone in the presence of an NADPH-generating system. Treatment with PMS + hCG, resulted in the development of S.Z.s. varying in volume from 10 to 60% of the total adrenal gland. This response was independent of ovarian status (i.e. immature or multifollicular). Treatment with porcine FSH (NIH-FSH-P2) also induced development of a S.Z. Oestradiol treatment was ineffective. The appearance of the S.Z. was associated with a change in steroidogenesis. The adrenals of controls produced cortisol and corticosterone in yields of approx. 70%, while these products were less than 22% in the animals with S.Z.s. The major conversion products in the treated animals were 5 beta-reduced pregnane derivatives, in yields ranging from 67 to 93%. The yields of products from the oestradiol treated animals closely resembled those of the controls. It was concluded that FSH is capable of inducing the development of an adrenocortical S.Z. in immature female possums and consequently stimulating adrenal steroid reduction. It appeared that oestradiol was not involved in this process. PMID- 6509914 TI - Thermostability characteristics of glucosephosphate and triosephosphate isomerase in erythrocytes from several species. AB - Significant differences in the thermostability of both glucosephosphate and triosephosphate isomerase were noted among a series of six primate and five nonprimate species. The enzyme structural differences among species, as assessed by thermostability profiling, was greater than expected from electrophoretic mobility patterns. Microheterogeneity of GPI, i.e. differences in thermostability within a species that are not detectable by electrophoresis, was detected in two primate species. Major differences in the levels of erythrocyte enzyme activity were observed with human and cow differing by 18-fold for TPI and baboon and cow differing by seven-fold in GPI activity. PMID- 6509915 TI - Interrenal function during amphibian metamorphosis: in vitro biosynthesis of radioactive corticosteroids from (4(14)C)-progesterone by interrenal in Xenopus laevis tadpoles. AB - Whole kidneys of Xenopus laevis tadpoles (containing interrenal cells) or the outer postero-dorsal part of adult kidney (containing a few or no interrenal cells) were incubated with (4(14)C)-progesterone. Methylene chloride extractable radioactivity of tissue homogenates in their incubation medium were purified by sequential paper chromatography and identification of some isolated fractions was attempted. A significant conversion of progesterone was only observed when interrenals were present in incubation; however, possible steroidogenic activity of the other tissue types present in the kidney cannot be ignored. At all the developmental stages of tadpoles (from stage 45 to stage 66) and in juveniles, the same steroids were isolated. Hence the metabolic pathways for corticosteroidogenesis in Xenopus laevis remained unchanged during metamorphosis and several weeks after the end of this process. Aldosterone was identified. Corticosterone and 11-dehydrocorticosterone were also synthesized but not completely purified. Their yields were always larger than those of aldosterone. Cortisol was never detected. PMID- 6509916 TI - Purification, catalytic and regulatory properties of Rana ridibunda erythrocyte pyruvate kinase. AB - Pyruvate kinase of Rana ridibunda erythrocytes is one of the regulatory enzymes of glycolysis. PK was purified about 7800-fold. The purified enzyme showed on SDS electrophoresis three protein bands with an apparent molecular weight of between 60 and 65 kD. The enzyme is subject to activation by FDP and to inhibition by ATP. It showed Km values for PEP and ADP of 0.095 and 0.98 mM respectively. It was activated by K+, Mg2+ and Ca2+ ions whereas it was inhibited by Na+ ions. The role of PK of Rana ridibunda erythrocytes, as a key and rate controlling enzyme of the glycolytic flux is discussed. PMID- 6509917 TI - Analysis and lipoprotein lipase activation capacity of plasma lipoproteins isolated from atherosclerosis-susceptible White Carneau pigeon and atherosclerosis-resistant Show Racer pigeon. AB - The lipoprotein composition and apoprotein composition of the major lipoprotein fraction (high density lipoprotein) were compared in White Carneau and Show Racer plasma. The capacity of the plasma and lipoproteins to activate the triacylglycerol hydrolyzing activity of lipoprotein lipase in vitro was compared in the two strains of birds and found to be identical in each case. It appears unlikely that differences in lipoprotein composition or tissue lipoprotein lipase activity will be reflected in the flux rates of lipoproteins in the two strains which have different susceptibilities to atherosclerosis. PMID- 6509918 TI - Protochordate immunity--II. Diverse hemolymph lectins in the solitary tunicate Styela clava. AB - Hemolymph lectins (agglutinins) of the tunicate Styela clava were analyzed by agglutination, cross-absorption and carbohydrate-hemagglutination inhibition using several vertebrate erythrocytes. Lectin activity was heat labile, dependent on divalent cations and refractory to neuraminidase-treated erythrocytes. Four lectins with different carbohydrate specificities were found. Carbohydrate specificities included L-rhamnose, D-glucuronolactone, maltose, D-galactosamine, D-mannosamine, D-galactose, hyaluronic acid and bacterial lipopolysaccharide. Since S. clava lectins can be inhibited by carbohydrates found in the extracellular capsule or cell wall of most bacteria, we propose that the lectins may be part of the tunicate immuno-defense system. PMID- 6509920 TI - The lipid composition of ovine placental tissue homogenate and its subcellular fractions. AB - Homogenates of the placental tissue of near term sheep were separated by differential centrifugation into mitochondrial, microsomal and cytosolic fractions. The relative proportions of the major neutral lipids and phospholipids, together with their fatty acid compositions, were determined in the homogenates and in each subcellular fraction. The cytosolic fraction contained the highest proportion of cholesteryl esters (CEs) and these possessed a fatty acid composition markedly different from the total CEs extracted from the homogenate. Both the mitochondrial and microsomal fractions contained significant proportions of solvent front phospholipid (SFP) and whereas the mitochondrial SFP displayed the relatively unsaturated fatty acid composition characteristic of diphosphatidylglycerol (cardiolipin), the fatty acids of the microsomal SFP were distinctly more saturated. These results are compared with those obtained from other mammalian tissues, both ruminant and non-ruminant, and discussed in terms of the function of the components of the subcellular fractions. PMID- 6509919 TI - The origin of plasma alkaline phosphatase activity in mice and rats. AB - Swiss albino mice displayed the highest activity of alkaline phosphatase at 4-6 weeks with a precipitous decline by 18 weeks of age to a value seen in the mature animal. Circulating activity of alkaline phosphatase was significantly higher in the rat than the mouse in the fed state. With fasting, enzyme activity declined in the rat yet increased in the mouse. The net result was significantly higher plasma alkaline phosphatase activity in the mouse than the rat after the 48 hr fast. L-Phenylalanine inhibition of plasma alkaline phosphatase was greater in plasma from the rat than the mouse in the fed state. Yet in the fed condition, L homoarginine and L-p-bromotetramisole inhibited alkaline phosphatase activity in plasma from mice to a greater extent than in rats. Heat inactivation as well as urea denaturation of alkaline phosphatase was significantly faster with plasma of the mouse than the rat in the fed state. Thus, it appears that the alkaline phosphatase isoenzyme of skeletal origin contributes a greater proportion of the circulating activity in the fed Swiss albino mouse than occurs in the Sprague Dawley rat in which the intestinal isoenzyme plays a greater role in the fed condition. PMID- 6509921 TI - Comparative study of avian ovalbumins by means of glycosidase treatment and following HPLC analysis of their dansyl glycopeptides. AB - Dansylated glycopeptides (DNS-GP) derived from ovalbumins (chicken, quail, goose and turkey) were treated with commercial endo-beta-N-acetyl-glucosaminidases (Endo-D and Endo-H). Susceptibility of DNS-GP components against those enzymes was examined by analysing the reaction product by HPLC. As reported previously (H. Iwase, Y. Kato and K. Hotta, 1984, Comp. Biochem. Physiol., 77B, 743-747), DNS-GP from chicken ovalbumin was separated into 13 peaks (C1-13) on HPLC. Beta galactosidase treatment of the DNS-GP resulted in the disappearance of three peaks and the increase of their neighboring peaks. The results indicated that among 13 DNS-GP components from chicken ovalbumin, three (C6,8,11) were bearing galactose residue at the nonreducing terminal and another three (C7,9,12) would be bearing a galacto- sugar chain from each corresponded component. PMID- 6509922 TI - Fatty acids in the roe lipids of common food fishes. AB - The roe lipid fatty acids of Baltic herring, roach, perch, burbot and rainbow trout were quantitatively studied by capillary-GLC. The composition of roe fatty acids remain fairly stable during the fish maturation. The fatty acid profiles are very similar in various fish roes though differences exist in the relative amounts of individual components. On average perch and burbot have longer chain lengths and higher unsaturation degrees in their roe fatty acids compared to the other species. Variations in the fatty acids can be related to the roe lipid compositions and apparently also to the diet of the parent fish. PMID- 6509923 TI - Blue-green color and composition of Stejneger's beaked whale (Mesoplodon stejnegeri) milk. AB - Two hundred ml of milk were obtained from a lactating Stejneger's beaked whale stranded at Ninilchik, Alaska on 21 Oct, 1980. Total solids (41%) were similar to values reported for sperm and belukha whales, while fat (17%) was half as great and crude protein (17%) was 2-4 times greater than in milk of these species. Lactose was not detected. Calcium (0.22%) was greater than reported for pigmy sperm whales but less than for blue whales. Phosphorus (0.07%) was less than for any of the above species. Sodium and potassium concentrations were 0.13% and 0.11%, respectively. Values (microgram/g) for other elements analyzed (magnesium, 42; iron, 35; copper, 2.6; zinc, 1.5; manganese, 0.3; selenium, 0.36) have not been reported for whale milk. Based on SDS-gel electropherograms, this whale milk did not contain a whey protein corresponding to cattle milk alpha-lactalbumin. A blue-green pigment in the milk was identified as biliverdin. PMID- 6509925 TI - A comparative study of the size-heterogeneous high mannose oligosaccharides of some insect vitellins. AB - Comparative studies of the carbohydrate component from vitellins of the cockroaches Blattella germanica, Blaberus discoidalis, Periplaneta americana and Simploce capitata and the locust Locusta migratoria have been conducted. Chemical, enzymatic and chromatographic analyses show that each vitellin contains variably processed high mannose type oligosaccharides. While all have a common size range they occur as two distinct classes based on the proportion of individual saccharides present. Oligosaccharide size distribution is not a characteristic of an individual animal but of the species. Because oligosaccharide heterogeneity also occurs in B. germanica vitellogenin (the hemolymph precursor of vitellin), it does not result from structural changes during or after its uptake by the egg. PMID- 6509924 TI - Postmortem metabolism of short-finned squid muscle (Illex illecebrosus). AB - Postmortem biochemical changes were examined in the mantle muscle of the short finned squid (Illex illecebrosus) in relation to the physical events associated with rigor. Unlike mammalian muscle, the major muscle phosphagen is arginine phosphate rather than creatine phosphate. Arginine phosphate levels did not change dramatically during the progress of rigor development. ATP depletion was found to be closely related to glycogen depletion as is often observed in mammalian muscle. The postmortem accumulation of octopine was related to the initial muscle glycogen content at death but a significant lag in its production was observed. The postmortem conversion of glucose to glucose-6-phosphate appeared to be the rate-limiting step in the overall conversion of glycogen to octopine. The intermediates found in the postmortem catabolism of squid muscle ATP were ADP, AMP, IMP Ino and Hx. Unlike most vertebrate fishes, AMP was found to accumulate in squid before conversion to IMP whereas accumulations of IMP and Ino were less than those normally found in vertebrate muscle. PMID- 6509927 TI - Plasma lipoprotein profiles and arylesterase activities in two inbred strains of rabbits with high or low response of plasma cholesterol to dietary cholesterol. AB - Cholesterol feeding for 4 weeks of female and male rabbits of two inbred strains increased plasma cholesterol concentrations by about 11 and 48 mmole/1 in the hypo- and hyperresponsive strain, respectively. On the low-cholesterol pre experimental diet, the hyporesponsive animals had significantly higher plasma HDL (high density protein) cholesterol levels than hyperresponders. In both strains, cholesterol feeding caused elevations of cholesterol in all lipoprotein classes, the difference between the hypo- and hyperresponsive strains in essence only being observed in the VLDL (very low density lipoprotein) fraction. Basal plasma total arylesterase activity was significantly higher in the hypo- than in the hyperresponsive rabbits. Dietary cholesterol caused an increase in plasma esterase activity in both We suggest that in rabbits a low plasma arylesterase activity and a low concentration of HDL cholesterol are associated with an increased sensitivity to dietary cholesterol. PMID- 6509926 TI - High performance liquid chromatographic profiles of nucleosides, bases and tryptophan in the plasma of the Tasmanian devil and four other marsupial species. AB - Plasma profiles of nucleosides, bases and trytophan of five marsupial species were established using the reversed-phase mode of high performance liquid chromatography (RHPLC). Within each species, the profiles were highly reproducible and between species there were distinct differences. In the Tasmanian devil, the circulating levels of constituents examined with one exception, were generally lower than in the other marsupials. The exception was a constituent present in large amounts and having the characteristics of a purine nucleoside derivative which was found only in the plasma of the devil. PMID- 6509928 TI - Catabolism of avian and mammalian haptoglobins and their complexes with haemoglobin in chicken. AB - The following 125I-labelled preparations of human and chicken haptoglobins (Hph, Hpc) and their complexes with human and chicken haemoglobins (Hph-Hbh, Hpc-Hbc, Hph-Hbc) were injected intravenously to chickens. Hpc exhibited long half-life time (t1/2 = 12.9 hr), whereas the homologous Hpc-Hbc complex disappeared from circulation faster (t1/2 = 3.1 hr). This suggested that the Hpc-Hbc complex was internalized by the receptor-mediated process in the avian liver. Mammalian Hph Hbh complex was eliminated from chicken circulation rather fast (t1/2 = 0.5 hr) in contrast to "mixed" Hph-Hbc complex which was characterized by the relatively long half-life time (t1/2 = 4.4 hr). Hph-Hbc complex displayed 1-2 sites for binding an anti-Hph antibody i.e. less than Hph-Hbh or Hph-Hbc complexes. The Hph binding with Hbc seems to be weaker than with mammalian haemoglobins. PMID- 6509929 TI - Characterization and function of isolated hemoglobins from the marine teleost Girella tricuspidata. AB - Five isohemoglobins were characterized from the marine teleost fish, Girella tricuspidata, using polyacrylamide gel electrophoresis and isoelectric focusing. O2-equilibrium (OEC) studies of the five components separated by column chromatography showed functional heterogeneity with respect to Hill's coefficient n, the O2 affinity, P50, and the Bohr coefficient phi, = delta logp50/delta pH. Recombination and examination of the isolates gave an OEC similar to that of "stripped" hemolysate and similar to a curve synthesized from a model incorporating the OEC parameters of the isoHbs. PMID- 6509930 TI - Muscle D-glyceraldehyde-3-phosphate dehydrogenase from Caiman sp. II New data for enzyme characterization. AB - Muscle GPDH from Caiman sp. was activated by dithioerythritol and 2 mercaptoethanol. Maximal activation was obtained with the reducing agent at 10mM final concentration. The binding of NAD to the apoenzyme occurs at four sites per tetramer, but ligand affinity seems to be heterogeneous. Incubation of the holo or the apoenzyme with NADH at 37 degrees C caused inactivation of the enzyme, with partial loss of SH-titrable groups. Incubation of the holo or the apoenzyme with G3P at 37 degrees C caused partial inactivation of the enzyme. The apoenzyme was demonstrated to be more stable than the respective holoenzyme, in the assay conditions used. PMID- 6509932 TI - TMAO-ase activity in tissues of fish species from the Northeast Atlantic. AB - The influence of various parameters (evacuation; pH value; addition of Fe2+, cysteine, ascorbic acid and methylene blue) on the activity of the trimethylamine oxide demethylase (TMAO-ase) in extracts from the kidney of saithe (Pollachius virens L.) is described. Assay conditions resulting in maximum formaldehyde (FA) production were used to measure the TMAO-ase activity in kidney, spleen, liver, pyloric caeca, blood and muscle from Northern Atlantic fish species. Only in organs from fishes of the order Gadiformes could TMAO-ase activity be detected. The TMAO-ase was most active in kidney and spleen whereas in muscle the enzyme activity could be barely detected. PMID- 6509931 TI - Use of bovine parathyroid hormone, labelled specifically in the N-terminal region by [3H]methyl exchange, to compare hepatic and renal metabolism of this hormone in the rat. AB - [3H]bPTH, prepared by [3H]methyl exchange, was administered intravenously to rats. Analysis of kidney and liver extracts on Sephadex G-50 showed some low mol.wt (peak IV) and some bound (peak Ia) material. A peak of intermediate mol.wt (peak II) was present in kidney but absent from liver. Kidneys that had been perfused with [3H]bPTH contained similar metabolites to those described, indicating that they are generated de novo. Analysis of peak II by reverse-phase h.p.l.c. showed a number of metabolites. The significance of these findings is discussed. This study demonstrates the value of [3H]methyl exchange labelling in investigating peptide metabolism. PMID- 6509933 TI - Glycolytic enzymes of fowl and turkey spermatozoa. AB - It was confirmed that, under anaerobic conditions, fowl spermatozoa formed lactate from glucose thirteen times faster than turkey spermatozoa. The profiles of glycolytic enzyme activities were similar for spermatozoa from both species; however fowl spermatozoal activities were generally 2- to 4-fold higher. Exceptions were glycerophosphate mutase and lactate dehydrogenase activities which were respectively 9.5 and 41 times greater in fowl spermatozoa. In both species, spermatozoal glyceraldehyde-3-phosphate dehydrogenase had the lowest activity of the glycolytic enzymes. PMID- 6509934 TI - Mosquito protein microassay. I. Protein determinations from small portions of single-mosquito homogenates. AB - A microassay is described for determining protein levels in individual mosquitoes. This method requires only a small portion of a homogenate of a single mosquito. Protein levels in Anopheles albimanus are positively correlated with body weight. Protein levels for different geographic strains of Anopheles albimanus and different generations of laboratory rearings are compared. PMID- 6509935 TI - Mosquito protein microassay. II. Modification for potential field use. AB - A simple microassay is described for determining protein levels in individual mosquitoes; this method should be useful on a routine basis in the field. This method requires only a small portion of a homogenate of a single mosquito. Sugar fed adult female Anopheles albimanus showed a slow decline in protein level for 14 days post-emergence. Blood volumes and blood-meal protein levels were microassayed, and changes in protein level were monitored throughout the reproductive cycle. Blood-fed Anopheles albimanus protein levels return only slowly to pre-feeding levels following egg deposition. PMID- 6509936 TI - Purification and properties of pyruvate kinase from liver of the flounder (Platichthys flesus L.). AB - Two forms of pyruvate kinase, PK I and PK II, have been demonstrated in flounder liver. PK I, purified 991-fold to a specific activity of 105 units per mg of protein, has an unusually high molecular weight of about 2 X 10(6). PK II, purified 172-fold to a specific activity of 16.5 units per mg of protein, has a molecular weight of 210,000 when determined on a sucrose gradient but of 300,000 when derived from gel chromatography. PK I and PK II differ in sensitivity to the inhibitor L-phenylalanine, a fact which is used to evaluate the amount of each of them in a mixture. pH optimum for both forms is 6-6.6. PK I and PK II behave different in an Arrhenius plot--PK II showing a transition at 21 degrees C. PMID- 6509937 TI - External incubation alters the composition of squamate eggshells. AB - Eggshells of the skink, Eumeces fasciatus, and of the rough green snake, Opheodrys vernalis, contain 28-40% of total shell mass as calcium at oviposition. After incubation, both calcium concentration and content were reduced 17-41%. Protein accounted for 33-65% of shell mass in Eumeces and Opheodrys eggshells at oviposition. Reductions in protein concentration and content from 22-86% following incubation were observed. Comparing amino acid compositions of eggshells collected following oviposition with those collected from the same clutch after hatching reveals similarities among all eggshells except those of Eumeces from Michigan which lack desmosine and isodesmosine. Concentrations of desmosines in eggshells from Missouri and Michigan Eumeces appeared to decrease following incubation by 49.7% and 12.2%, respectively. Although neither the mechanisms involved in apparent losses of calcium and protein, nor the fate of the mobilized materials are known, possible pathways for mobilization of eggshell constituents are outlined and their pertinence to the physiology of squamate eggs and the evolution of viviparity in reptiles is suggested. PMID- 6509938 TI - Branched chain alpha-keto acid dehydrogenase in tissues from rainbow trout (Salmo gairdnerii). AB - Mitochondria isolated from skeletal red muscle of rainbow trout (Salmo gairdnerii) have remarkably high activity of branched chain alpha-keto acid dehydrogenase as measured with alpha-keto isocaproic acid as substrate. The activity of the dehydrogenase increases several-fold after preincubation of the mitochondria with an uncouple and oligomycin. The accumulation of the first product, isovaleryl-CoA is strongly stimulated by high concentrations of CoASH. In the crude mitochondrial lysates we have used, an unknown compound accumulates with time, during incubation with alpha-keto isocaproic acid, CoASH and NAD. The compound, probably a CoA derivative, is more hydrophobic than isovaleryl-CoA. PMID- 6509939 TI - AMP deaminase from the gill of Salmo gairdnerii Richardson: effects of anions, cations and buffers. AB - The AMP deaminase isoenzymes from trout gill were activated by sodium and potassium, sodium being the most efficient. The optimal concentration for activation was 30-50 mM. The enzyme was sensitive to ionic strength, and imidazole was an inhibitor at concentrations higher than 25 mM. A possible regulation of gill AMP deaminase by intracellular imidazole buffers is discussed. AMP deaminase activity was tested in the presence of physiological concentrations of sodium and potassium. When the concentration of one of these cations was varied around its physiological concentration, the enzyme activity was relatively stable, indicating that the intracellular AMP deaminase activity would be insensitive to changes in the concentrations of monovalent cations. The effects of the sodium salts of different inorganic and organic anions were tested. Except chloride and gluconate, all were inhibitors of gill AMP deaminase. PMID- 6509940 TI - Computer modeling of the recombination reaction of rhodopsin. AB - Various mechanistic schemes for the recombination reaction of rhodopsin were designed and tested using computer modeling and simulation with data from kinetics experiments. The reaction schemes were mathematically modeled by systems of nonlinear first-order ordinary differential equations (ODEs) with unknown rate constants. Each model was fitted to the experimental data by using a modified simplex algorithm for parameter (rate constant) estimation and Gear's method for solving stiff systems of ODEs. The recombination reaction of rhodopsin was best modeled by branched, multistep reaction schemes which included formation of noncovalent complexes, acid-base equilibria, and acid and base-catalyzed dehydration of a Schiff base intermediate. The biochemical bases for these models are discussed. PMID- 6509941 TI - Mathematical modelling of the growth processes in the developing chick wing bud. AB - This paper illustrates how a simple geometric model resembling the shape of the chick wing bud at an early growth stage can be mathematically expanded to simulate subsequent growth characteristics of the developing bud. The model was tested against several sets of experimental data and gave an acceptable representation of growth over the range considered. Representing growth patterns in this form enables the determination of differential growth characteristics in different parts of the bud and provides boundary constraints which will play an important part in the eventual evaluation of internal growth mechanisms. PMID- 6509942 TI - An interactive microcomputer-based graphics system for analysis of cardiodynamic function. AB - An on-line interactive, modular, menu-driven microcomputer-based data acquisition and analysis system was designed and implemented. This system includes a low-cost commercial desk-top graphics computer with a modular construction. All these operations are performed using extended BASIC "CALL" statements. The system is designed to be used in a cardiovascular research and laboratory environment where the assessment of hemodynamic and cardiodynamic function includes routine measurements of pressure and flow. In addition, the measurement of regional and global left ventricular chamber dimensions have been implemented. The modular design of the software system is "human-engineered" to enable a simple, cost effective computer system to perform physiological measurement and control. Extended BASIC language instructions provide the casual computer user with a simple yet effective means of implementing on-line data acquisition, analysis and graphic production and display. PMID- 6509944 TI - A computer-aided method to evaluate the function of implanted Bjork-Shiley prosthetic heart valves. AB - Evaluation of the function of implanted prosthetic valves is important in early diagnosis of valve dysfunction. Bjork-Shiley valves contain two radiopaque rings, which are projected as ellipses in cineradiography. From these ellipses the actual valve opening angle can be calculated. A computer-aided method was developed that enables measurement of ellipse characteristics reliably, independent of projection angle and valve opening. It is demonstrated that calculated and real opening angles differ less than 2 degrees with this method. Using the same technique the tilting angle of the valve ring during the cardiac cycle is computed for evaluation of progression of valve dehiscense in case of a paravalvular leak. Application of the method to patient data is illustrated by three cases. The method is suitable for use by technicians. It can be implemented on a small microprocessor system. The method proved to be a powerful tool in the evaluation of patients with implanted Bjork-Shiley valves. PMID- 6509943 TI - Use of a programmable calculator for rapid, low-cost processing of echocardiographic records. AB - A comparative study was performed to determine the accuracy of a programmable calculator with supplemental digitizer in echocardiographic analysis. Twenty separate measurements were collected per heart beat from five different dogs, taking five heart beats from each dog. The measurements were made by an echocardiographic technician (ET), echocomputer (EC), and by a programmable calculator (HP). In a triple comparison (ET-HP, ET-EC, HP-EC) there were no significant differences in the values obtained, suggesting that the programmable calculator can provide a highly accurate and rapid means of processing echocardiographic measurements, thereby providing the advantages of the echocomputer without the cost of such a device. PMID- 6509945 TI - Clinical classification of regional cerebral blood flow (RCBF) by partitioning. AB - An algorithm is proposed to classify the regional cerebral blood flow (RCBF) of two groups of subjects. A 32-tuple training vector is defined corresponding to 32 detectors used to measure 133Xe washout following inhalation. For any index of 133Xe washout, each detector is associated with two cumulative distributions (cds) each corresponding to a population. The 32 index values at which the differences between cds are maximum are defined as partition values. All index values are then compared to their partitions and are designated binary values of 1 or 0 for being above or below the partitions. A representative sum of the binary numbers (0 to 16) indicates the number of detectors in each hemisphere which exceed their respective threshold. In the example, a normal group of subjects (n = 40) is compared to an abnormal group (n = 82). The abnormal group was identified independently of RCBF by clinical testing as having Alzheimer's disease, a subcategory of dementing diseases. The classification algorithm defined a training vector to which the two populations were compared. The normal subjects had higher representative scores than the abnormals with a tight clustering of these scores. Although some abnormals scored well, the great majority had representative scores well below 12 for each cerebral hemisphere. The training vector can be used to classify new studies or can be updated by new studies until no significant changes result. At this point, the new tracing vector is used as a reference set of partition values. PMID- 6509946 TI - Three-dimensional vector graphics: a method for displaying results in a drug trial. AB - Three-dimensional computer graphics are used to depict multidimensional outcome measures in a clinical drug trial. This graphics approach was used in a study of 116 patients with active rheumatoid arthritis, in a randomized, double-blind 21 week comparison of placebo, oral gold, and injectable gold. Three health status components, physical disability, psychological status, and pain, were generated using the Arthritis Impact Measurement Scales (AIMS). Results were presented in a three-axis perspective, one axis for each component, plotting individual patient vectors for magnitude and direction on a 10 X 10 X 10 coordinate matrix. Vectors for each patient are plotted from time 1 (start) to time 2 (finish) over the 21 week trial period. Vector symbols were added for clarity and subgroup delineation. Vector displays show trends in treatment response that clarify and strongly reinforce the statistical results. It is concluded that three dimensional vector graphics are a useful adjunct to the statistical analysis of clinical trial results. The graphics facilitate the visual interpretation of a complex data set, and clarify the analysis of the results for both the clinician and researcher. PMID- 6509947 TI - Multicompartment model of lung dynamics. AB - A mathematical model was developed to simulate the function of the lungs. The lungs are represented by 24 compartments each corresponding to a generation of the Weibel model A. In the model it is assumed that gases are transported in the lungs by convection and diffusion from one compartment to the other. Furthermore, the clearance of gases from the lungs by the blood perfusion is taken into account. The driving force of the inhalation and exhalation processes is the filling and emptying of the alveolar volume which follows a sinusoidal pattern. Mathematically the model is represented by two sets (one for inhalation, the other for exhalation) of 24 first-order coupled ordinary differential equations which were numerically integrated by means of a computer. The model predicts quite well the buildup of gases in the lungs and the washout of gases from the lungs. PMID- 6509948 TI - Is progression of coronary artery disease occurring at bouts or as a continuous process? Serial cineangiographic studies in 44 patients. AB - In order to assess if coronary artery disease progression occurs as a slow, continuous process or at bouts, the coronary angiograms of 44 patients catheterized three times were reviewed. A previously developed logistic model, taking into account time interval between the angiograms, age, occurrence of unstable angina, and extent score of coronary artery disease, was used to compute a probability of progression from the second to the third angiogram. Two groups of patients were considered: those with (n = 15) and those without (n = 29) progression from the first to the second angiogram (PROGRESSION 1-2). A simulation provided in each group the distribution of the expected number of patients with progression from the second to the third catheterization. In the group without PROGRESSION 1-2, the observed number of progressions from the second to the third angiogram was in agreement with the expected one. However, in the group with PROGRESSION 1-2, the progression from the second to the third angiogram was more frequent than expected (p = 0.068). These results suggest that, in many patients, coronary artery disease progression is continuous over several years. PMID- 6509949 TI - Orientation of MR images. PMID- 6509950 TI - Magnet systems used in medical NMR. AB - The object of this paper is to inform prospective users of clinical NMR equipment about the various magnets which may form the heart of the system. The peripheral magnetic field of the magnet must be considered when the site is planned and prepared. Some of the planning criteria are discussed with respect to the magnet, and its ancillary equipment and services. PMID- 6509951 TI - Sequential computed tomography in tuberculous meningitis in infants and children. AB - Clinical and serial CT findings in 9 children, mainly infants with advanced tuberculous meningitis are presented. Hydrocephalus, tuberculomas and brain infarction were common findings in the acute stage of the disease. CT scan, allowing the detection and follow-up of cerebral manifestations of tuberculosis, proved to be an accurate and effective diagnostic method, which should be used in all cases of tuberculous meningitis. PMID- 6509952 TI - Tuberous sclerosis with increasing calcification in the brain during a 15-month period: a case report. AB - We report here a patient with tuberous sclerosis who, over a 15-month period, had markedly increasing brain calcification on CT (computed tomography). When first seen, the 2-month-old boy had a white spot on the right thigh. His mother, maternal uncles, grandfather and great-grandfather had not only white spot but also sebaceous adenoma. Infantile spasms were noted 2 days after birth. His first brain CT at 3 months of age showed a slightly higher than normal density area in the right occipital lobe. Subsequent CT scans at 6 and 18 months of age revealed progressively increasing density in this area (CT number above 60). PMID- 6509953 TI - Clinical and computed tomographic correlations of pineal neoplasms. AB - Ten patients with pineal neoplasms were evaluated by CT. Germinomas appear as hyperdense lesions in the posterior third ventricular region on plain scan and show homogeneous enhancement which sometimes extends to the anterior third and lateral periventricular region. The pineal gland usually appears normal. Tumors originating from pineal cell cause abnormal pineal calcification and appear as iso or hypodense masses with heterogeneous calcification on plain scan. They usually show heterogeneous enhancement. Based upon CT findings differentiation of the varied types tumors of pineal region or differentiation from astrocytomas is not usually possible. PMID- 6509954 TI - CT diagnosis of left atrial thrombus undiagnosed by echocardiography. AB - Although effectiveness of CT scan in the diagnosis of intracardiac masses is considered limited by heart pulsations, it may be effective in diagnosis of lesions not detected by echocardiography. This report presents a case where a large left atrial thrombus which was undiagnosed by 2D echocardiogram was diagnosed by CT scan. PMID- 6509955 TI - Factors related to low contrast resolution in CT scanners. AB - The concept of "low contrast resolution" in CT scanners is examined. Several questions are raised, not only about limitations to interpretation of figures of merit of low contrast resolution, such as contrast-detail diagrams; but also, interpretation of related CT physical performance parameters, such as: noise, dose, spatial resolution and slice width (or sensitivity profile). Caveats are raised concerning interpretation of contrast-detail studies and the degree to which first-order observer studies are reflective of the actual clinical situation. Particular care is suggested in interpretating contrast-detail diagrams in which sensitivity, specificity and the number of target signals may be varying. PMID- 6509956 TI - Granulomatous diseases of the CNS as demonstrated by computerized tomography. AB - The CT findings in 32 patients with pathological conditions characterized by granulomatous disorders are reviewed. The characteristic CT finding in caseating granuloma due to tuberculous disease is a nodular enhancing lesion with a central hypodense region. The granulomas representing sarcoidosis show homogeneous enhancing nodular lesions. The granulomas due to cryptococcal fungal disease showed ring pattern with large central hypodense region which represented cyst formation. In certain vasculitides which affected the CNS and had pathological evidence of granuloma formation, CT showed nodular enhancing lesions. Based upon the CT findings, it was not possible to differentiate these nodular enhancing lesions which represented granulomatous disease from other intracranial diseases, i.e. abscesses, neoplasms, multiple sclerosis, gliosis. PMID- 6509957 TI - CT diagnosis of fracture of the coracoid process of the scapula. AB - A case of fracture of the coracoid process of the scapula is presented in which the findings were not apparent on plain films. CT demonstrated the fracture, and the absence of soft tissue mass suggested a remote traumatic etiology rather than metastatic disease. The findings were confirmed surgically and pathologically. PMID- 6509958 TI - Relationships of mood and interpersonal perceptions. PMID- 6509959 TI - Psychiatric symptoms in medical students. PMID- 6509960 TI - Polypharmacy in psychiatric practice. PMID- 6509961 TI - An evolutionary perspective on psychiatry. PMID- 6509962 TI - Proposed criteria for the diagnosis of alcohol abuse in adolescents. PMID- 6509963 TI - Physical illness and psychiatric disorders. PMID- 6509964 TI - Depression viewed as a state of disturbed psychic contact. PMID- 6509965 TI - Breast cancer: are preoperative bone scans necessary? PMID- 6509966 TI - Intravenous biopsy of a tumor thrombus filling the inferior vena cava. PMID- 6509968 TI - The legal status of the medical staff. PMID- 6509967 TI - Removal of life support systems. Kenneth Foody, et al. vs. Manchester Memorial Hospital, et al. PMID- 6509969 TI - The legal status of the medical staff. PMID- 6509970 TI - Needed: a new way to train doctors (2). PMID- 6509971 TI - Deciding for the incompetent patient: a reasonable role for the law. PMID- 6509973 TI - Vision training and learning disorders. PMID- 6509972 TI - Failure to diagnose secondary syphilis. Two case reports. PMID- 6509974 TI - Organ transplantation, medical technology assessment and resource allocation. PMID- 6509975 TI - Rabies prevention--United States, 1984. Centers for Disease Control, Atlanta. PMID- 6509976 TI - Oral contraceptive use: prospective follow-up of women with suspected glucose intolerance. AB - 593 women from a cohort of 8,652 healthy women failed a 1-hr glucose screening test. These 593 women with suspected glucose intolerance were classified as normal or as having impaired glucose tolerance (IGT) or diabetes mellitus (DM) after an oral standard glucose tolerance test (SGTT) and were followed over a mean 8.55 years. No permanent change in glucose status as a result of oral contraceptive use was found in an analysis for impaired glucose tolerance, diabetes mellitus, diabetic symptoms, or use of oral agents and/or insulin. Increased glucose intolerance was observed for women who were older, had a positive family history of diabetes, or were of greater relative weight. Diabetic symptoms correlated most closely with the onset of persistent fasting hyperglycemia. PMID- 6509977 TI - Interval insertion of intrauterine device in women with previous cesarean section. AB - The cesarean delivery rate is increasing worldwide. The effect of previous cesarean section on the performance of IUDs is considered in a group of 318 women with 1+ cesarean deliveries who were matched by center, device type, age and parity with 617 women with no history of cesarean section. All insertions were performed at least six weeks after termination of the woman's last pregnancy. No statistically significant differences in expulsion rates or other pertinent event rates were detected. Two delayed uterine perforations, one in each group, were identified. The findings are, in general, reassuring for the efficacy and safety of interval insertion of IUDs in women with previous cesarean section. PMID- 6509979 TI - Multicenter clinical trial of implanted norethindrone pellets for long-acting contraception in women. Program for Applied Research on Fertility Regulation. AB - Long-acting, biodegradable, subcutaneous implants of fused pellets composed of norethindrone (NET) and pure cholestrol were evaluated in 50 healthy, normally menstruating volunteers from five clinics. Evaluation of serum NET levels indicated a steady release rate over the 6-cycle follow-up period. There were no serious local reactions to the pellets. Menstrual cycle length remained unchanged, but the incidence of intermenstrual bleeding and/or spotting was higher during the initial 2-3 months of pellet use. Following pellet removal menstrual cycle parameters returned to their pre-pellet implantation values. Serum gonadotropin assays indicated the incidence of ovulatory cycles increased over the follow-up period. No significant changes in serum lipoproteins, SMAC-12 or enzyme profiles were observed. Although women were advised to use additional methods of contraception, three became pregnant while using the implants. Fibrous tissue was noted to form around the pellets, thus limiting the release of NET. Additional trials of higher NET doses are being evaluated. PMID- 6509978 TI - Pharmacokinetics, pharmacodynamic and endometrial effects of a single dose of 200 mg norethisterone enanthate. AB - Ovulation was confirmed by daily analyses of the peripheral plasma levels of estradiol (E2)4) and progesterone (P) in a pre-treatment cycle of 14 subjects. An endometrial biopsy was taken either in the proliferative or in the secretory phase of the cycle. On the 5th day of a subsequent cycle 200 mg norethisterone enanthate (NET-EN) was administered intramuscularly. The levels of E2, P and those of NET were analyzed during the next 19 days and again during 44-60 days following the injection. The endometrial biopsy was repeated on the 23rd and 59th day of the treated cycle. The levels of NET reached a peak of 34.3 nmol/1 on the sixth post-injection day and decreased to below detectable limits in 3 of 12 subjects by the end of the observation. Ovarian activity was completely suppressed in all women during the first period, but returned to different levels in 11 subjects during the second. Four of them exhibited ovulatory steroid pattern. The morphologic changes of the endometrium reflected the progestogen effect in the first post-injection period but were characteristic of the ovarian reaction in the second. PMID- 6509980 TI - Comparative in vitro spermicidal effects of (+/-)-gossypol, (+)-gossypol, (-) gossypol and gossypolone. AB - The comparative in vitro spermicidal effects of (+)-gossypol, (-)-gossypol and (+/-)-gossypol were evaluated on the spermatozoa of human, monkey, rabbit, mouse, rat and hamster. The spermicidal effects of gossypol isomers were also compared with those of gossypolone, which is a proposed major metabolite of gossypol. Gossypol isomers and gossypolone were all spermicidal. (+)- and (-)-Gossypol demonstrated spermicidal activities at the same concentration at which (+/-) gossypol shows spermicidal effects on the spermatozoa of all species tested. However, gossypolone was less potent than the gossypol isomers. The spermicidal action of gossypol may be a nonspecific effect unrelated to the antifertility mechanism of orally administered gossypol, since (+)-gossypol which is not an effective male antifertility agent also showed the equivalent spermicidal effect to that of (+/-)-gossypol. PMID- 6509981 TI - The action of (S)-alpha-chlorohydrin and 6-chloro-6-deoxyglucose on the metabolism of guinea pig spermatozoa. AB - (S)-alpha-Chlorohydrin inhibits the conversion of fructose to lactate by mature guinea pig spermatozoa in vitro. At a concentration of 2mM, there is a specific inhibition of glyceraldehyde-phosphate dehydrogenase resulting in the accumulation of fructose-1,6-bisphosphate, dihydroxyacetone phosphate and glyceraldehyde-3-phosphate and a concomitant decrease in the concentration of endogenous lactate. (R,S)-[3-36Cl]-alpha-Chlorohydrin is metabolised by the spermatozoa to 3-chlorolactaldehyde of unknown configuration. Exogenous (R,S)-3 chlorolactaldehyde (2mM) is an inhibitor of glyceraldehyde-phosphate dehydrogenase in guinea pig spermatozoa, whereas (R)-alpha-chlorohydrin (10mM) has no significant effect on the metabolism of fructose. 6-Chloro-6-deoxyglucose (10mM) inhibits glyceraldehyde-phosphate dehydrogenase in guinea pig spermatozoa in vitro and is metabolised to 3-chlorolactaldehyde which is presumably the (S) isomer. The anti-glycolytic actions of (S)-alpha-chlorohydrin and 6-chloro-6 deoxyglucose in guinea pig spermatozoa are suggested to be due to the action of a common metabolite, (S)-3-chlorolactaldehyde. PMID- 6509982 TI - Vitamin E prevents the platelet abnormalities induced by estrogen in rat. AB - Platelet lipid biosynthesis in relation to aggregation has been studied in female rats treated with ethynylestradiol and fed laboratory chow or a vitamin E deficient diet. In both normal and vitamin E-deficient rats, administration of ethynylestradiol highly significantly (p less than .001) increased the biosynthesis of total lipids but mostly of lanosterol (+ dihydrolanosterol) by thirteen-fold in normal rats and by nine-fold in vitamin E-deficient rats. The increased lipid synthesis was associated with a higher response of platelets to thrombin-induced aggregation. Concomitant administration of alpha-tocopherol acetate in both normal and vitamin E-deficient rats depressed markedly the enhanced lipid synthesis and aggregation induced by estrogen. Administration of ethynylestradiol lowered considerably the level of vitamin E in plasma but not in platelets. Treatment by tocopherol partly corrected the low plasma level of vitamin E resulting from estrogen administration. In vitro addition of lanosterol to platelets highly significantly increased the response of platelets to thrombin and ADP-induced aggregation. This hyperaggregability was almost entirely inhibited by preincubation of platelets with tocopherol acetate. In the present in vivo and in vitro studies, alpha-tocopherol was able to neutralize most of the adverse effects of estrogen on blood platelets. PMID- 6509983 TI - Aged gametes, adverse pregnancy outcomes and natural family planning. An epidemiologic review. AB - Unconfirmed epidemiologic studies suggest a possible increased risk of birth defects associated with Natural Family Planning (NFP) use, and an increased incidence of spontaneous abortion or frequency of chromosomal abnormalities in abortuses associated with conceptions outside the most "fertile period". The risk is approximately two- to four-fold, but the evidence is by no means conclusive. The implication for NFP depends on the frequency of method failures in user populations, but is not likely to constitute a major hazard. Further research could utilize a data bank of NFP charts. PMID- 6509984 TI - Fertility regulation in nursing women. VI. Contraceptive effectiveness of a subdermal progesterone implant. AB - Six progesterone pellets implanted subdermally were tested as contraceptive method for lactating women. One pregnancy was diagnosed in 1614 woman-months of observation, a failure rate which was similar to that observed in a contemporary group of Copper T users. Nineteen pregnancies were diagnosed in the 677 woman months observed in untreated lactating women. The progesterone implants were effective when administered either at 30, 60 or 240 days after delivery. The duration of the effective life was 5 months and fertility was quickly restored afterwards. There were no deleterious effects upon maternal or infant health or upon lactation and the rate of child growth. The main problem encountered was the occurrence of pellet expulsion at a variable rate which appeared related to the manufacturing procedure. PMID- 6509985 TI - Insertion technique, not design, affects expulsion rates of postpartum intrauterine device. AB - A Lippes type intrauterine device (IUD) was modified to be used for immediate postpartum insertion. In 114 patients in whom the modified IUD was inserted immediately after delivery, expulsion rates at six months averaged approximately 30%. Expulsion rates were significantly different, at p less than 0.05, for women in whom the IUD was inserted digitally (19.5 +/- 5.6% at 6 months) compared to those in whom it was inserted using surgical forceps (39.6 +/- 7.1%). Furthermore, expulsion rates were higher for inexperienced inserters (p less than 0.01). We conclude that: 1) this modification of an otherwise standard IUD has a continued high expulsion rate, and 2) the technique of insertion has significant impact upon the likelihood of expulsion. PMID- 6509987 TI - Tubal sterilization with Filshie Clip. A multicentre study of the ICMR task force on female sterilization. AB - Female sterilization by the application of Filshe Clip Mark IV has been studied, on a prospective multicentric basis in 869 women for a period of two years. Sixty involuntary pregnancy following ligation were reported giving a failure rate of 8.6 per 100 women at the end of 24 months. Method failures were observed to be evenly distributed throughout the period of observation except in puerperal ligation in whom majority of the pregnancies occurred after six months following ligation. Failure rate was significantly higher in post-abortal ligations as compared to interval ligations. Due to unexpectedly higher failures rate further recruitment of study subjects was discontinued. Information on the status of the clip was available in only 30 of the sixty failures and the clips were in situ in only 4 cases, indicating improper application of clips. In view of high failure rates attributable to improper clip application, the method does not appear to be suitable for programmatic conditions in our country. PMID- 6509986 TI - Use effectiveness of the Prentif cervical cap in private practice: a prospective study. AB - Of two-hundred-sixty women seeking cervical cap contraception, exactly half subsequently used the Prentif cavity rim cap as their sole method of contraception. The one year continuation rate for these exclusive cap users was 56.7 per hundred. No major side effects related to the use of the Prentif cap were observed in the course of this study, involving 918 women-months in year 1. Pregnancy and dislodgement of the cap during use were the principal reasons for discontinuation of exclusive use, with gross rates of 19.1 and 12.9 per 100 at one year, respectively. PMID- 6509988 TI - Development of a low-dose monthly injectable contraceptive system: I. Choice of compounds, dose and administration route. AB - A low-dose combined estrogen-progestogen sustained release system has been developed. The control of crystal size of the steroids produced sustained dissolution in vitro and in vivo. A dose-response experiment carried out in healthy women indicated that 10 mg of norethisterone (NET) with 1 mg of ethinylestradiol (EE2) when given by intramuscular injection maintained NET serum levels above 1 ng/ml for at least 25 days. The system is considered suitable for one month contraceptive protection. PMID- 6509989 TI - Pharmacokinetic observations on ST-1435 administered subcutaneously and intravaginally. AB - Plasma levels of ST-1435 were determined by radioimmunoassay in 36 women and three men during treatment with subdermal capsules releasing ST-1435. The total lengths of the capsules used were 180 mm, 90 mm, 30 mm, 15 mm and 7.5 mm. A linear correlation between the mean plasma concentrations of ST-1435 and capsule length was found during the treatment period studied. However, great interindividual variation in plasma levels of ST-1435 between study subjects having similar capsules was observed. In comparison with the mean plasma concentrations in the initial months, only less than half of these plasma concentrations of ST-1435 were measured after six months of treatment, which indicates a short lifetime for this contraceptive system. In two women the disappearance of ST-1435 from the circulation was studied by measuring ST-1435 concentrations in the plasma after removal of a contraceptive vaginal ring (CVR) releasing ST-1435. Triphasic disappearance curves of ST-1435 were found, with half-lives 0.7-1.0 h, 3.1-4.0 h, and 10.7.3-11.8 h. PMID- 6509990 TI - Clinical and experimental study of cold cardioplegic myocardial protection. AB - The authors used a multi-dimensional approach to the study of the effects of intra-operative myocardial protection; the results of three series of investigations are reported. First, conditions underlying the effectiveness of the authors' modified cardioplegic solution were studied by laboratory and histological methods in ex vivo guinea pig hearts. Evidence is presented for the detrimental effects of catecholamines and the beneficial action of inosine. The second part of the report deals with problems of effective myocardial cooling in partially ischaemic canine hearts, investigated by infrared thermographic examinations of temporal and spatial thermal distribution over the entire visible cardiac surface. At last the authors present the result of their complex intra- and postoperative enzyme analysis combined with mathematical evaluation (cluster analysis in a group of patients suffering from ischaemic heart disease). PMID- 6509991 TI - Determinants of the left ventricular function in patients with coronary heart disease: a multivariate approach. AB - 251 patients with coronary heart disease (CHD) and a control group of 32 normal persons were examined with the purpose of establishing the determinants of the left ventricular function and comparing these determinants with the functional significance of coronary stenosis. The subjects were divided into four groups: I- controls; II--patients with normal left ventricular function (EF more than 60%); III--patients with impaired LV function (EF less than 60%) and Group IV--patients with left ventricular aneurysm. Nine parameters were obtained by multivariate discriminant analysis, which characterize and classify the left ventricular function: the ejection fraction (EF), angina pectoris, exercise ECG, left ventricular end-diastolic pressure, mean velocity of circumferential fibre shortening, left ventricular functional index, longitudinal shortening, LV systolic pressure/systolic volume ratio, and coronary index. On the basis of these parameters, all the normal persons, 88% of Group II, 92% of Group III and 72% of Group IV were classified correctly. The study proves that there is a good correlation between the EF and the haemodynamic and angiocardiographic parameters. The complex left ventricular function index facilitates the prognosis of surgical results. Abnormalities in left ventricular function cannot be reliably assessed by the coronary index values alone. PMID- 6509992 TI - Surgical treatment of post infarction left ventricular aneurysms. AB - The results of surgical treatment of post-infarction left ventricular aneurysms (PILVA) in 121 patients are analyzed. 64 patients underwent resection of the aneurysm, in 57 the resection was combined with aortocoronary shunt. Hospital mortality amounted to 11.6%. Analysis of mortality in relation to the initial values of the clinical, haemodynamic and contractility indicators has shown that the results of surgical treatment depend on the contractile function of the viable part of the left ventricle, on the blood flow in the left ventricular lateral wall and on the cardiac output. After surgery, signs of heart failure diminished or disappeared in 81% of the patients. The postoperative clinical course depended on the preoperative value of the ejection fraction of the contracting part of the left ventricle. Stenocardial pain disappeared or its frequency decreased in 91% of the patients. The patients' survival rate in the five-year postoperative period was 68%. The main factors of long-term prognosis were the degree of the coronary affection and the contraction capacity of the viable myocardium. PMID- 6509993 TI - Treatment of ischaemic heart disease complications. AB - After myocardial infarction, 20% of all patients suffer from left heart aneurysm, the papillary muscle rupture and ischaemic septal perforation. Symptoms, diagnostic methods and surgical treatment are described. Special attention is paid to aneurysm of the posterior wall which, though relatively rare, presents special therapeutic problems. PMID- 6509994 TI - Long-term results of coronary surgery. AB - Coronary angiography was performed in a total of 3,696 patients at the Institute for Clinical and Experimental Medicine from 1971 to 1980. From this number 720 were in the subsequent period treated surgically for ischaemic heart disease (IHD). In the majority of them myocardial revascularization was performed using saphenous vein aortocoronary bypass graft and in 7% resection of left ventricular aneurysm was carried out, either separately or together with the aortocoronary bypass. The remaining patients with IHD were treated medically. All patients were followed up for a period ranging from 1 to 10 years (mean 50 months). In most of the patients there was symptomatic improvement and increased tolerance of physical exercise. Among patients with double- and triple-vessel disease there was higher survival in those treated surgically. There was no difference in survival between surgically and medically treated patients with single-vessel disease and patients after aneurysmectomy. Neither was there a marked difference in survival symptoms, exercise tolerance and the occurrence of postoperative myocardial infarction between patients with preoperative MI and those without it. No influence was found of surgical treatment of IHD on the occurrence of sudden death. PMID- 6509995 TI - Topical problems in rehabilitation following valve replacement. AB - The paper deals with fundamental aspects and phases of rehabilitation in patients who underwent cardiac surgery, and with problems of methodology of bicycle ergometric testing. The efficacy of rehabilitation programme is evaluated according to the results of comparison of a control group of patients without rehabilitation, and rehabilitated patients after mitral or aortic valve operation. As criteria there served the changes in the distribution of patients to functional classes, changes of physical working capacity and rate of return to work. PMID- 6509996 TI - Complications of vascular catheterization in critically ill children. AB - Invasive hemodynamic monitoring is widely used in the care of critically ill children. In a prospective study, a total of 330 arterial catheters, 397 central venous catheters, and 47 pulmonary artery catheters were placed in 467 children, between February 1981 and September 1982. Complications observed included: bleeding in seven of 774 vascular catheterizations, arterial obstruction in three of 377 arterial catheterizations, and sepsis in 11 of 774 vascular catheterizations. Of the 21 complications noted, 71% occurred in children less than 5 yr of age. A total of 19 (4.1%) children suffered complications of bleeding, arterial obstruction, and/or sepsis. In contrast, the overall mortality in this group of patients was 16%. The risk of morbidity from vascular catheterization appeared justified in this group of critically ill children. PMID- 6509997 TI - Coma scale for use in brain-injured children. AB - The association between admission coma score and eventual outcome was assessed using a coma scale developed for children with a variety of central nervous system injuries. As opposed to the Glasgow coma scale, this scale does not demand assessment of verbalization, and thus can be applied to the preverbal or previously intubated child. Cortical function is graded from 6 (purposeful, spontaneous movements) to 0 (flaccid), and brainstem function is graded from 3 (intact) to 0 (absent and apneic). Maximum total score is 9. In 91 children treated for intracranial hypertension, the association was moderately good. The scale was better in predicting the outcome of patients with hypoxic encephalopathy and head trauma than that of patients with Reye's syndrome, meningitis, or encephalitis. No child with a score of less than 3 survived in spite of intensive therapy. Most of these children were flaccid with depressed or absent brainstem reflexes. No child with flaccidity on admission survived.